PMID- 2694033 TI - Does weight change in young adulthood influence long-term mortality? PMID- 2694034 TI - Regulation of growth hormone gene expression by retinoic acid. PMID- 2694035 TI - Myocardial infarction imaging. PMID- 2694036 TI - The renal background in the determination of renal clearance by means of the gamma camera and the 99Tcm-DTPA complex. PMID- 2694037 TI - [Transgenic mammals in the biology of development]. AB - Cells and chromosomes of the embryo can be labeled by integrating foreign DNA into its genome. Genes coding for some cytotoxic products can selectively destroy embryonic rudiments in which these genes are expressed. Insertional mutations arise in transgenic animals and this facilitates identification and cloning of the genes that affect the development. Embryos carrying mutations in certain genes were produced using transformed stem cells. Some kinds of mutations can be corrected by introducing the cloned genes into mutant oocytes. Use of transgenic animals substantially increases the properties of methods employed in developmental genetics and experimental embryology of mammals. PMID- 2694038 TI - [Genetic regulation of the processes of neurogenesis]. AB - Neurons proved to be a convenient experimental model for studies of regulatory properties of the genetic apparatus during development. Formation of neuronal ensembles is controlled by multiple modifier-genes at different levels. The following gene groups can be distinguished: 1) Genes that function in differentiating neurons; 2) Genes that function in other neurons; 3) Genes that function in glial cells; 4) Genes that function in surrounding tissues; 5) Genes that function at the organism level. PMID- 2694039 TI - [Morphogenetic reactions of cells and the reprogramming of their syntheses]. AB - Several groups of experimental findings concerning the influence of alteration of cell shape on cell proliferation and differentiation are reviewed. Analysis of the data suggests that interactions between cells and extracellular matrix may control the programming of intracellular synthesis. The pathways of this control remain obscure. It is stressed that this control mechanism plays essential role in development. PMID- 2694040 TI - [Mechanical stresses as factors in the autoregulation of morphogenesis]. AB - Since morphogenetic processes are nonlinear, feedback must be essential for their regulation. Two concepts of feedback in morphogenesis are developed: 1) inhibition by diffusing morphogenetic substances and 2) action of mechanical strain resulting from morphogenetic movements. The data on the role of mechanical strain in formation of integral structure of embryonic tissues, primary demarcation of embryonic epithelia and mesenchymal rudiments and bending of epithelial layers are presented. Evolutionary aspects of morphogenetic role of mechanical strain and its possible use in applied biotechnology are discussed. PMID- 2694041 TI - [Temporal patterns of animal development]. AB - A summary of studies on temporal characteristics of animal development performed during last 30 years using dimensionless unit as a parameter of development duration is presented. This approach allowed to introduce time as a parameter in comparative embryological studies. Thus the time of development became a subject of the embryological studies. Perspectives for the future work are defined. PMID- 2694042 TI - [The nature of the dependence of the rate of development on temperature determines the greatest efficiency of metabolism at optimal temperatures]. AB - Metabolism intensity and development rate have different pattern of dependence on temperature. Oxygen intake and several other metabolic processes bear an exponential relationship to temperature. The pattern of this relationship is similar in different poikilothermal species. On the contrary, the relationship between the rate of development and temperature is species-specific and more complex. Hence, the curves obtained by plotting oxygen intake per developmental stage against temperature resemble parabola and the minimum values of oxygen intake correspond to optimal temperatures. Such a correspondence is almost solely determined by parameters of the relationship between the rate of development and temperature. Therefore, the efficiency of metabolism does not determine the range of optimal temperatures. It is suggested that adaptive alterations of this range during evolution proceed via changes of the parameters of relationship between the rate of development and temperature dependence. Relatively small number of mutations is required to produce such changes. PMID- 2694043 TI - [Vladimir Pavlovich Efroimson (21 November 1908-21 July 1989)]. PMID- 2694044 TI - "Outlier" intraocular pressure readings: valid or invalid for statistical analysis? AB - Wide variations in the response to intraocular (IOP)-lowering medications may be due to the normal response of the subjects or to variables unrelated to the effect of medication, eg, noncompliance or recording errors. We used data from a previous study of medications designed to lower IOP to investigate the influence of readings showing an unusually large increase in IOP from baseline on the statistical analysis and conclusions. These readings, which could have been due to variables unrelated to the effect of medication, were defined as "outliers" by a statistical method. A statistically insignificant difference between two IOP lowering medications became significant on excluding two subjects with outlier IOP readings. We explain how reporting results obtained with and without including outliers in the analysis may provide clinicians with more complete information. PMID- 2694045 TI - Transscleral fixation of posterior chamber intraocular lenses in the absence of capsular support. AB - We present results obtained by transscleral ciliary sulcus fixation of posterior chamber intraocular lenses in secondary implantation, lens exchange, and in primary implantation of transsclerally fixated lenses during complicated cataract extraction. Follow-up data on 38 patients, 17 of whom have been followed for more than 12 months, are included. We conclude that the procedure is safe, effective, and predictable. PMID- 2694046 TI - Role of prism relocation in improving visual performance of patients with macular dysfunction. AB - Patients with macular dysfunction were given spectacle lenses with prism and a control group of similar patients were assessed without prism. About 60% of those without prisms learned to improve acuity by eccentric viewing. Over 90% of those fitted with prisms showed an improvement in acuity and performed better on locomotion tests. PMID- 2694047 TI - Hydrogen peroxide in anterior segment physiology: a literature review. AB - The role of hydrogen peroxide when it is physiologically produced or when it is applied externally to the eye is examined in this review. Three enzymes deal with the endogenously produced H2O2. They are catalase, superoxide dismutase, and glutathione peroxidase. These enzymes are present at different concentrations in ocular tissues and function most efficiently at different concentrations of H2O2. For H2O2 which contacts the external surface of the eye, the same enzymes also seem to act to metabolize the H2O2. In general the eye is more sensitive to changes in pH than to low concentrations of topically applied H2O2 at concentrations less than about 400 ppm. So, the small amounts of residual H2O2 which remain on contact lenses after disinfection in H2O2 solutions do not pose a great risk to the eyes. PMID- 2694048 TI - The changing management and improved prognosis for corneal grafting in herpes simplex keratitis. AB - Graft survival in a previously reported cohort of patients recruited between 1967 and 1978 (10.6 years' mean follow-up) was reviewed and compared with that for a cohort recruited between 1979 and 1987 (3.8 years' mean follow-up). This allowed analysis of improved graft survival due to changes in management, introduced after critical review of the first group in 1978. The salient changes included transition from intracapsular to extracapsular cataract surgery (P = 0.001) and treatment of rejection episodes with antiviral prophylaxis. Extracapsular cataract surgery improved graft survival (P = 0.07) benefiting inflamed eyes which more frequently required concomitant surgery (P = 0.005). Survival of rejection episodes was improved by antiviral prophylaxis (P = 0.02), and the incidence of recurrent keratitis was reduced (P = 0.0005). The complete and prompt removal of loose sutures improved graft survival (P = 0.025). Long-term survival of first grafts was 70%, and management changes improved overall survival (P = 0.036) despite an increased number of eyes (P = 0.05) grafted when inflamed. PMID- 2694049 TI - A randomized trial of conjunctival autografting for pterygium in the tropics. AB - This is the first report of a randomized trial of the conjunctival autografting technique for pterygium removal. This trial was conducted in the Caribbean where risk of pterygium recurrence is considered to be high. Although not statistically significant, there was a lower recurrence rate in grafted cases (21% of 19 cases) than in controls done by the bare sclera technique (37% of 16 cases). The author found that age of the patient was strongly associated with recurrence regardless of which procedure was used. Findings of this study emphasize the importance of randomized controlled trials in assessing the efficacy of specific procedures for pterygium removal. PMID- 2694050 TI - Malignant rhabdoid tumor of the orbit. AB - Malignant rhabdoid tumor (MRT), originally described as a sarcomatous variant of Wilms' tumor, is now recognized as a distinct, highly malignant entity. The authors describe, for the first time, a primary tumor of the orbit with histologic, immunohistochemical, and ultrastructural features of MRT. Their findings suggest both epithelial and mesenchymal differentiation of this unique tumor. PMID- 2694051 TI - A two-layer closure of sino-orbital fistula. AB - A two-layer closure of sino-orbital fistulae using tension-free local flaps is described. For small fistulae, the opening is first closed with a mucosal turnover flap; this is combined on the orbital surface with a local rotational advancement flap of the orbital skin. For larger fistulae where a mucosal turnover flap cannot be fashioned, a two-stage, delayed, composite mucocutaneous rotational flap is used. The advantages of these techniques are: (1) a mucous membrane to provide nasal or sinus lining, insulating the raw ventral surface of the skin flap; (2) each flap has an independent blood supply; (3) local flaps are used, avoiding the use of a pedicle flap from forehead; (4) excellent cosmesis since tissues outside the orbital rim are not disturbed; and (5) does not require refitting of exenteration prosthesis since the integrity of the orbital rim is maintained. The authors have used these techniques in six patients with chronic sino-orbital fistulae of the exenterated socket. In one patient, a wound dehiscence occurred and a small fistula measuring 3 to 4 mm in diameter persisted. The fistulae of the remaining five patients were successfully closed. PMID- 2694052 TI - Overview and historical perspective of oral reconstructive surgery. AB - Pioneers in the field of dental reconstruction had little to offer their edentulous patients other than prostheses that were generally fitted without preparation or augmentation of the alveolar ridge. By the mid-1940s, the development of surgical procedures and the introduction of new materials offered significant advances. Increased denture retention was achieved by some implant methods and through use of the mandibular staple bone plate. Improvements in hydroxylapatite provided a material that could be used for alveolar ridge augmentation. It proved effective in limiting resorption and increasing attachment to soft and hard tissue. The recent development of purified fibrillar collagen in combination with hydroxylapatite enhances our ability to provide effective, long-lasting dental prostheses. PMID- 2694053 TI - Functional mandibular reconstruction of patients with oral cancer. AB - For the patient with oral cancer who has undergone quadrant resection, mandibular reconstruction provides normalization of the lower facial contour, regained architectural support, and reestablishment of occlusal relationships. Reconstruction with vascularized bone offers the most rapid rehabilitation. Replacement of dentition provides improved deglutition, mastication, and speech. In eligible patients the use of osteointegrated implants can provide rigid stabilization for dental prostheses. In previous studies these implants were placed in a secondary procedure. In the present study microvascular mandibular reconstruction was combined with primary placement of osteointegrated implants in the treatment of seven patients. Preliminary results indicate that the combination of procedures can provide more rapid and effective rehabilitation for the patient with cancer. Issues for further study are also identified. PMID- 2694054 TI - Osteoinduction: a report on the discovery and research of unique protein growth factors mediating bone development. AB - Osteoinductive factor, a unique glycoprotein, is the latest growth factor to be discovered. When combined with transforming growth factor-beta 1 or transforming growth factor-beta 2, osteoinductive factor can stimulate the formation of endochondral bone in a collagen-ceramic composite. Preliminary laboratory studies indicate a wide potential for the use of osteoinductive products in orthopedics, oral reconstruction, and periodontal procedures. PMID- 2694055 TI - [Necrobiosis lipoidica without diabetes mellitus (diagnostic and therapeutic possibilities)]. AB - The goal of the present study was to follow the clinical behaviour of 6 non diabetic patients (5 females and 1 male, aged 23-68) suffering from necrobiosis lipoidica. Thickening of the basalmembrane of capillaries could be confirmed by electron microscopy, although the histological structure of skin alterations are not different from those observed in diabetes mellitus. Three patients (2 females and one male) showed impaired glucose tolerance, 2 other patients had increased levels of total cholesterol, whereas one patient suffered from both metabolic disturbances. After treatment with ASA (acetylsalicylic acid, 1.0 g/day) and dipyridamole (200 mg/day) for six weeks, the decrease of platelet in vitro aggregation in platelet rich plasma could be observed by stimulation with arachidonic acid, epinephrine, ADP and collagen, respectively. Healing of the exulceration of skin lesion could be detected by the use of the combined treatment of ASA and dipyridamole in 4 cases. PMID- 2694056 TI - [Serum fructosamine studies in pediatric diabetology]. AB - To determine the metabolic conditions of insulin dependent patients the authors have been applying since 1986 a control based on blood sugar profile and serum fructose-amine test taken simultaneously in certain sections of the day. Studying the results of 178 blood sugar profiles and fructose-amine examinations of 43 diabetic patients correlation was sought for between certain parameters calculated from the profile and the fructose-amine level. Significant correlation was found between every parameter studied (mean value of blood sugar concentration/day, standard deviation, amplitude, pathological amplitude) and the identical serum fructose-amine concentration. Analysing the data of the patients their carbohydrate metabolic conditions were found to improve significantly following the introduction of the fructose-amine examination. On the basis of their results the authors consider the determination of fructose-amine level in addition to the profile-control informative and well applicable in the diabetological care. PMID- 2694057 TI - [40 years of thoracic surgery at Debrecen]. PMID- 2694058 TI - [Thyroid function in severe non-thyroidal diseases]. AB - The aim of the present study was to find out whether a change in the function of the pituitary-thyroid axis can be revealed in a relatively homogenous group of hematological patients. To clarify this problem serum levels of total-thyroxine and triidothyronine, free-thyroxine and free-triiodothyronine, reverse triidothyronine and thyrotropin were detected in these patients. The majority of subjects with chronic myelogenous leukemia (in the remission phase) have normal pituitary-thyroid function, however a change in the peripheral metabolism of thyroxine can be revealed. Longitudinal studies in patients with acute myelogenous leukemia indicate that in some cases with the progression of the disease serum TSH and thyroid hormone levels decrease referring to secondary hypothyroidism and in these cases the measurement of serum free-thyroxine content by an analogue tracer method is not recommended. On the basis of the investigational results it is stated that in hematological patients the pituitary thyroid function is influenced by the phase of illness and by the results of the given treatment. PMID- 2694059 TI - [Experience with Cefobid in severe infections complicating immunodeficiency diseases]. AB - As a 3rd generation cephalosporin Cefobid monotherapy was applied during 1985 1986 with 16 hematological patients in immunodeficient, immunosuppressive states where the available aimed and combined antibiotic therapy failed to be effective for the treatment of bacterial infections of grave course and septic character. 4 g/day was the average I.V. dose of Cefobid, higher doses were applied only in especially grave septic states. The hematological patients tolerated well the Cefobid in monotherapy. Recovery form the septic state and excellent clinical effect was found with 9 patients, good effect with 4 and satisfactory effect with 1 patient. In 1 case the therapy had to be stopped owing to drug hypersensitivity. Cefobid is regarded as an antibiotic drug that is effective if used in monotherapy for treating grave, septic infections of hematological patients in immunodeficient--immunosuppressive--myelodepressive states having received earlier antineoplasmic polychemotherapy. PMID- 2694060 TI - [The nomenclature of the Medical Society]. PMID- 2694061 TI - [70 years nursing school Innsbruck]. PMID- 2694062 TI - Surgical approaches to cholesteatoma. AB - A number of surgical approaches have been advocated for the removal of cholesteatoma. Specific indications for particular surgical approaches are given. The author describes his technique in detail. Suggestions for altering the basic techniques to fit individual patients' needs are also given. PMID- 2694063 TI - Surgical techniques and recidivism in cholesteatoma. AB - Cholesteatoma is a difficult disease to treat as demonstrated by the relatively high recidivism rate attained by the best of surgeons. The concept of recidivism encompasses all reoccurrence of the disease, regardless of the theorized origins. This is a term that should be accepted so that some uniformity may be introduced into the evaluation of this disease. A standard reporting format that includes the extent of the disease, the eustachian tube function, the integrity of the ossicles, and a uniform description of the surgical procedure would enhance future evaluations of this disease. The future of otology still lies in finding new ways to eradicate this disease and to avoid recidivism. PMID- 2694064 TI - Cholesteatoma: what is it, how did it get there, and how do we get rid of it? AB - Cholesteatoma has been recognized as a clinical entity for over 150 years. Our understanding of its pathogenesis and treatment has evolved over this time. This article traces our changing concepts of treatment from life-saving radical procedures to more purposeful and limited techniques. PMID- 2694065 TI - Pathogenesis of cholesteatoma. AB - Aural cholesteatomas consist of accumulations of desquamating keratinized epithelium within the middle ear or other pneumatized portion of the temporal bone. Cholesteatomas may be classified according to presumed etiology as congenital or acquired. The theoretical mechanisms of the pathogenesis of the two types are discussed. PMID- 2694066 TI - Biology of cholesteatoma. AB - Acquired cholesteatoma is a disease of the posterior superior part of the middle ear cleft that may arise from the external epithelium of the tympanic membrane. Three distinct epithelial zones of differing thicknesses characterize the development of this latter epithelium, and the thickness differences and their distribution in the eardrum and deep external canal, which delineate the zones, are found at all stages of life, including the mature ear. It is postulated that epithelial migratory activity follows the pathways of early development, the flow occurring through the three zones. The detailed validity of this model was confirmed by otoscopic photography of dye movements on the tympanic membrane. Cholesteatoma may develop from the earliest and most active of these zones situated on the pars flaccida. The pathologic anatomy of cholesteatoma suggests vigorous growth. Retraction pockets provide a source for bands of squamous epithelium growing into the middle ear. Cholesteatoma and tympanic membrane epithelium move en masse in tissue culture, a property not shown by any other stratified squamous epithelium. PMID- 2694067 TI - The surgical anatomy of cholesteatoma. AB - The majority of cholesteatomas assume typical growth patterns that are dictated by their site of origin and related anatomic structures. These routes of penetration tend to develop along vestigial planes that were created during the embryogenesis of the middle ear and mastoid. Knowledge of the relevant surgical anatomy allows the surgeon to recognize and remedy pathologic changes and avoid complications. PMID- 2694068 TI - Contemporary radiologic imaging in the evaluation of middle ear-attic-antral complex cholesteatomas. AB - High-resolution computerized tomography with its ability to produce excellent contrast and exquisite anatomic detail remains the primary modality in the preoperative evaluation of middle ear cholesteatomas. The radiographic findings not only support the clinical diagnosis but also determine the surgical approach. The presence of disease in areas that are difficult to evaluate, such as the sinus tympani and the anterior portion of the facial canal, can now be documented. The major contribution of MRI appears to be in defining the relationship of middle ear disease with intracranial pathology. The role of MRI in assessing focal middle ear disease awaits improved spatial resolution. PMID- 2694069 TI - Selection of cases and classification of tympanoplasty. AB - Meticulous mastoid surgery does not always result in a dry, stable ear. Eustachian tube malfunction has been accepted as an important factor in chronic and recurrent middle ear infection. There are many parameters of eustachian tube malfunction, which form a complicated problem for investigation and analysis. Of most importance appears to be varying degrees of malformation of the nasopharynx and palate. A gradient from mild to overt deformity appears to be related to the degree of eustachian tube function. Other factors, such as nasal infection and allergy, nasopharyngeal scar tissue and tumors, and general resistance to infection, are of less importance but must be considered in the etiology of chronic ear disease. Tympanoplasty is relatively unsuccessful in a chronic discharging ear, as the infection ultimately destroys a surgical repair. Persistent otorrhea can be caused by either eustachian tube malfunction or a reservoir of chronic infection in the mastoid cavity. A mastoidectomy often controls the infection in the mastoid cells and a tympanoplasty may be done as a secondary procedure when the cavity is stable. A careful preoperative evaluation should be made in every case to determine the responsible factors for persistent ear infection. If possible, attempts should be made to eliminate the causative factors prior to the tympanoplasty. Classification of cases into four groups helps to separate those cases with a good prognosis from those that will continue to suppurate and will have a poor functional result. A dual classification of tympanoplasty has been established in which the type of reconstruction is documented and the stability of the ear against infection is estimated. Classified clinical material forms the basis for a clearer representation of the cases under investigation and the results of tympanoplastic surgery become statistically comparable. Classification of cases also aids in the selection of cases for surgery by identifying preoperatively those cases that will be successful from those that may not have a good result. With this information at hand it is possible to more accurately inform the patient preoperatively regarding hearing improvement and control of infection following a tympanoplasty. PMID- 2694070 TI - Congenital cholesteatomas of the middle ear in children: origin and management. AB - Cholesteatomas (epidermoids) of the middle ear appearing medial to a normal tympanic membrane are identified in increasing numbers of young children. The evidence that these lesions are congenital in origin includes the young mean age of presentation, the normal appearance of the middle ear mucosa in almost all cases of small lesions, normal mastoid pneumatization documented by computerized tomography, the relatively large number of children with associated minor or major congenital malformations, and the consistent 3:1 ratio of males to females with the disorder in all of the large series reviewed. A direct relationship between congenital cholesteatomas (epidermoids) of the middle ear and the epidermoid formation is supported by the position of the epidermoid formation at a histologic transition zone in the anterior superior lateral quadrant of the tympanic cavity, which is also the site of greatest occurrence of congenital cholesteatomas. The epidermoid formation may not always involute and as it expands it would be expected to become visible medial to the tympanic membrane in the anterior superior quadrant. It seems evident that as the congenital cholesteatoma expands it can block the eustachian tube; during a bout of otitis media the tympanic membrane could perforate and the cholesteatoma could become secondarily infected. The congenital cholesteatoma in this situation would be difficult or impossible to distinguish from the more common acquired type. PMID- 2694071 TI - Acquired cholesteatoma in adults. AB - The objectives of cholesteatoma surgery are to obtain a safe, dry, hearing ear. Controversies in regard to accomplishing these objectives center on indications for staging the operation and management of the mastoid using either a canal-wall up or canal-wall-down procedure. The author discusses in detail the indications for each procedure. PMID- 2694072 TI - Petrous apex cholesteatoma. AB - In this chapter we have reviewed the etiology, diagnosis, and surgical treatment of petrous apex cholesteatoma. The etiology is usually congenital for those tumors arising within the apex, but acquired for lesions secondarily invading the apex. Diagnosis is primarily radiographic. CT remains an excellent modality for determining the extent of disease, whereas recent advances with MRI help in differential diagnosis. In our experience the middle fossa approach and the translabyrinthine-transcochlear approach allow the surgeon the best opportunity to effectively treat this rare and challenging tumor. PMID- 2694073 TI - [The biology of the 3d month and its importance for infant care]. PMID- 2694074 TI - Genetic causes of hearing loss in children. AB - Hearing loss affects various related aspects of a childs overall development. It is the cause of impaired development of speech and language, as well as poor performance in school and loss of cognitive potential. Hearing loss may also hinder and impair the childs social and emotional relationships. Genetic causes of congenital deafness in children are rare, nevertheless they are important, since early detection and effective treatment of hearing loss is one of the most urgent duties of any physician who cares for small children. Diagnosis is equally important as well, in terms of genetic counseling. PMID- 2694075 TI - The role of CCK caerulein, and CCK antagonists in nociception. AB - The octapeptide form of CCK predominates in the central nervous system (CNS) of mammalian species, including man. Many of the physiological roles of CCK in the CNS are unknown, but it is believed to be involved in nociception. CCK is distributed throughout cortical grey matter, periaqueductal grey matter, ventromedial thalamus and spinal dorsal horn, all of which are areas known to be associated with pain modulation. CCK receptor subtypes have been identified and may be classified according to their affinity for the sulphated and desulphated forms of CCK-8 and the recently described selective antagonist. MK-329. CCK-A receptors have high affinity for sulphated CCK-8 and for MK-329 but low affinity for desulphated CCK-8 and CCK-4 whilst CCK-B sites bind MK-329 with low affinity and discriminate poorly between sulphated and desulphated CCK-8. CCK-A receptors are found predominantly in peripheral tissues but they also exist in discrete regions of the primate CNS, including the spinal cord. CCK-B receptors are found ubiquitously throughout other regions of the neuraxis. The results of studies on the effects of CCK-8 and the decapeptide analogue caerulein on pain thresholds are conflicting. Some workers suggest that large doses of CCK-8 and caerulein induce naloxone-reversible analgesia in certain pain models. However, it appears likely that analgesia induced by large doses of CCK and caerulein in animals may be a pharmacological rather than a physiological phenomenon. Accordingly, others have found that small (and most probably, physiological) doses of CCK-8 attenuate the analgesic effects of morphine, and of endogenous opioids. Thus, it has been proposed that CCK may act as an endogenous opiate antagonist. Studies in rats with the selective CCK antagonist MK-329 have helped clarify the interaction between CCK and morphine-induced analgesia. Treatment with MK-329 enhances morphine analgesia and chronic treatment with MK-329 prevents the development of tolerance to morphine analgesia. However, the antagonist does not prevent naloxone-precipitated withdrawal symptoms in morphine-dependent rats. In man, caerulein prevents pain associated with gall-bladder contraction, probably by relaxation of the sphincter of Oddi. Caerulein has also been shown to reduce renal colic and the pain of intermittent claudication. Preliminary clinical studies with the weak, non-selective, CCK antagonist proglumide, indicate an enhancement of morphine analgesia. As yet, no studies have demonstrated analgesic effects of CCK antagonists in man when administered alone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2694076 TI - Production and characterization of human monoclonal antibodies against Schistosoma mansoni. AB - We have produced a panel of human monoclonal antibodies (MoAb) from patients infected with Schistosoma mansoni in order to analyse more carefully the human immune response to this helminth infection. This study describes the production, characterization and analysis of these MoAbs. Briefly, peripheral blood mononuclear cells from chronically infected patients were (1) isolated and stimulated with parasite antigens in vitro, (2) positively selected for B-cells on anti-Ig columns, and (3) then transformed with Epstein-Barr virus (EBV). Once EBV cell lines were established, they were selected for anti-S. mansoni antibodies using an ELISA, cloned, retested and then fused with the mouse-human heteromyeloma SHM-D33. In this study, we describe five MoAbs which have different antigenic specificities for life-cycle stages based on ELISA to soluble crude antigen preparations, membrane immunofluorescence on whole intact organisms, and immunofluorescent staining of cryostat frozen sections. The importance of these reagents with regard to the human immune response to S. mansoni is currently being evaluated. PMID- 2694077 TI - [The coevolution of ixodid ticks and terrestrial vertebrates]. AB - Paleontologic and zoogeographic data speak in favour of Mesozoic origin of ixodid ticks. The absence of strict restrictions for the feeding on unusual species of hosts has caused the domination of polyphagy and oligophagy over monophagy among ixodid ticks. The same peculiarities of ixodid ecology are responsible for a restricted part or absence of phylogenetic parallelism with hosts in their evolution. Primary food relations with reptiles are, apparently, preserved only in the genus Aponomma and in many species of Amblyomma while hosts for most species of other genera are mammals and, to a lesser extent, birds. The number of potential hosts in these species can be much greater than that of real ones. Restrictions in the distribution of some species are connected rather with direct effect of unfavourable environmental factors on their nonparasitic stages of the life cycle than with the absence of suitable hosts. During the evolution of natural landscapes and at a shorter stages under the influence of successions or anthropogenic factors ixodids easily adapt themselves to feeding on new species of hosts. So the differentiation of primary and secondary hosts of these parasites is rather difficult. PMID- 2694078 TI - [Retinoic acid: its properties]. PMID- 2694079 TI - Serum lipids and lipoproteins during malaria infection. AB - Total serum cholesterol and lipoproteins levels were determined in a selected group of healthy and Plasmodium falciparum infected Cameroonians. There was a significant difference (P less than 0.05) in the level of the cholesterol between normal individuals (1.61 +/- 0.60 g1-1) and patients (1.23 +/- 0.37 g1-1). The mean values +/- SD of HDL cholesterol were (0.62 +/- 0.25 g1-1) and (0.46 +/- 0.36 g1-1) for controls and malaria infected subjects respectively. The LDL cholesterol concentration was (0.77 +/- 0.85 g1-1) in patients compared to (0.99 +/- 0.33 g1-1) for controls. There was a significant difference between the apolipoprotein B concentration in the sera of non infected (1.03 +/- 0.50 g1-1) and infected subjects (1.64 +/- 0.50 g1-1) (P less than 0.05). A decrease of apolipoprotein A was observed in the sera of patients (1.36 +/- 0.60 g1-1) compared to controls (1.70 +/- 0.34 g1-1). These results suggest a possible atherogenic risk during persistent malaria infection. PMID- 2694080 TI - [New paraclinical approaches for the diagnosis of autoimmune bullous diseases]. AB - In this paper, four new techniques for the fine diagnosis of autoimmune blistering diseases have been reviewed: immunoelectron microscopy, immunoblotting, immunofluorescence on salt-split-skin substrate and immunoprecipitation. They have allowed a better understanding of the pathogenesis of various diseases such as bullous pemphigoid and epidermolysis bulosa acquisita. Indeed the antigens have been precisely localized at the ultrastructural level and their biochemical nature determined; moreover their synthesis has been studied using cell cultures. The next step will use the molecular biology in order to ultimately define and understand these diseases. PMID- 2694081 TI - [Endocrine consequences of infection by human immunodeficiency virus (HIV)]. AB - The acquired immunodeficiency syndrome (SIDA) is a severe multivisceral affection that is sometimes composed of a clinical expression compatible with an endocrine insufficiency. The post-mortem verifications confirmed the high frequency of the suprarenal, pituitary and testicular lesions. The hormonal functional exploration confirmed the possibility of a decrease in the cortical suprarenal function that contrasts with a moderate hypercortisolemia and an hypogonadism without elevation of the gonadotrophins. The clinical expression of the deficits is unusual. Nevertheless a few cases of obvious suprarenal or antepituitary insufficiency bond to a secondary inflammatory necrosis, an infection by CMV, or a toxoplasmosis have been reported. More often, these hormonal alterations are moderate. There mechanisms are still imprecise. The non-specific response to the stress led by the disease doesn't give an explanation to the observed abnormalities. The described existence of antihormone antibodies in AIDS or the secretory potentialities of the activated lymphocytes might contribute to the physiopathology of the endocrine modifications outside of any infections or endocrine metastatical localisation. PMID- 2694082 TI - [Malpighian epithelia infected by DNA viruses and Langerhans cells]. AB - Malpighian epithelia exhibit an immune surveillance through Langerhans cells (LC) against the DNA viruses, which induce various epithelial lesions, mainly on the skin, conjunctiva, mouth, uterine cervix. These viral infections are usual during childhood. The most common DNA viruses are: adenoviruses (more than 40 types), human papillomaviruses (HPV, more than 50 types) and Herpes viruses (herpes simplex type 1 and 2, varicella and Zooster, Epstein-Barr virus). Different clinical aspects are observed (exanthema, erythema, eruption, papillomas, vesicle, bullous) are well as histological signs. All of these viruses are replicating in the nuclei of epithelial cells which show eosinophilic inclusions and finally cell degeneresence with a typical aspect for each virus such as koilocyte for HPV infection. These lesions are commonly infiltrated with T lymphocytes; the intensity of the local cellular immune response varies with the lesion. LC are reduced in infected epithelia; they are sometimes found in conjunctive tissues and their morphology can be altered; their role in antigen presentation to T lymphocytes has only been demonstrated in herpes simplex virus infections. Profound modifications of membrane antigens of epithelial cells (loss of HLA class 1 antigen) might contribute to the disappearance of LC or to their functional inability. Most of the DNA virus infections are inapparent, benign and transient. However some lesions can evolve towards malignancy; this progression depends on the oncogenic potential of the viruses (such as HPV types 16 and 18 or herpes simplex virus type 2) associated to a local or a general immune deficiency of the patient as well as to other exogenous factors (UV for example). PMID- 2694083 TI - [Pathophysiologic aspects of the action of hyperbaric oxygenation on the body]. PMID- 2694084 TI - [Free-radical oxidation in the pathogenesis of the diseases associated with aging]. PMID- 2694085 TI - Orbeli's experimental work on color discrimination in dogs. AB - In the 1900's, L.A. Orbeli, on I.P. Pavlov's request, attempted to establish color discrimination in dogs. Previous experiments used the motor discrimination method and gave inconsistent results. In contrast, Orbeli used the salivary conditional reflex method, which he considered to be more precise than the method that relied on erratic movements of a dog. After experimentation that lasted about one and a half years, Orbeli failed to establish color discrimination. When subsequent experiments by Russians and Germans yielded positive results with the motor discrimination method, Orbeli switched to this method and also obtained positive results. These findings were confirmed by most subsequent experiments on color discrimination in dogs. The utility of Pavlovian conditioning in sensory experimentation was not universally justified and its importance was greater in the study of learning. PMID- 2694086 TI - High-frequency jet ventilation for severe respiratory failure. AB - High-frequency jet ventilation (HFJV) is a newer form of mechanical ventilatory support that has shown promise in the treatment of severe neonatal respiratory distress syndrome. It is now also being studied as a possible treatment for adult respiratory distress syndrome in older children. PMID- 2694087 TI - Measurement of ventilatory mechanical impedance in infants using a head pressure generator. AB - Two methods of measuring ventilatory mechanical impedance (Z) by forced oscillations between 6 and 20 Hz were compared in 24 infants aged 2 to 49 months: 1) the application of pressure oscillations at the airway opening (Z1); and 2) the application of pressure oscillations around the head (Z2). The latter has been recently proposed to minimize the influence of compliant upper airway walls (Peslin et al., J Appl Physiol. 1985, 59:1790-1795). Ventilatory resistance and compliance (Rsb, Csb) were also obtained with the single breath method. The real part of Z1 (R1) was markedly lower than that of the corresponding Z2 (R2), at any frequency. R1 exhibited a systematic negative frequency dependence, in contrast with R2. At any frequency, the slope of the regression equation on Rsb was closer to unity for R2 than for R1. The imaginary part of Z1 (X1) was negative over the whole frequency interval, and negative values of inertance were derived from X1. X2 was negative at low and positive at high frequencies. Resonant frequency (mean +/- SD = 10.5 +/- 3.5 Hz) was always reached with Z2 and correlated negatively with body weight (r = -0.61). Inertance estimated from X2 was positive and correlated negatively with body height (r = -0.66). The compliance derived from Z1 (C1 = 3.35 +/- 2.32 10(-3) L.cm H2O-1) was not significantly different from that derived from Z2 (C2 = 2.99 +/- 2.02 10(-3) L.cm H2O-1). The marked difference observed between Z1 and Z2 is related to the importance of the upper airway shunt and may be explained by inaccuracies of both methods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694088 TI - Determining optimum inspiratory time during intermittent positive pressure ventilation in surfactant-depleted cats. AB - This study compares two methods of selecting inspiratory time (Ti) during mechanical ventilation. One selects a standard Ti producing a brief inspiratory pressure plateau (P). The other uses simultaneous pressure, flow and tidal volume (VT) waveforms, generated by a computer-assisted lung mechanics analyzer, to reduce Ti to the point where Vt ceases to accumulate and flow returns to zero. This method does not produce a pressure plateau (NP). Following saline lung washout, ten intubated, paralyzed surfactant-depleted cats were ventilated with pressure-preset infant ventilators at constant measured VT and rates. Five animals were initially ventilated with P (Ti = 0.98 +/- 0.02 s) and five with NP (Ti = 0.77 +/- 0.10 s). Ti was then varied to produce P or NP by using a four period crossover design. All other ventilator variables remained constant. Intravascular pressures, thermodilution cardiac outputs, arterial and mixed venous blood gases and oxygen saturations, airway pressures, Ti, VT, and gas flows were measured; respiratory system mechanics, alveolar-arterial oxygen gradients, and intrapulmonary shunts were determined for each study period. When P and NP states were compared, only mean airway pressures differed (10.1 vs. 8.9 cmH2O; P less than 0.001). Blood gas values, intravascular pressures, cardiac output, and respiratory system mechanics were all similar. Under the conditions of this study, there was no advantage to prolonging Ti beyond the point where VT ceased to accumulate. PMID- 2694089 TI - The barrier function of the skin in relation to percutaneous absorption of drugs. AB - There is currently a high level of interest in using the skin as a route for delivering drugs. The skin, however, provides an efficient barrier against percutaneous absorption of drugs. This barrier function can be ascribed to the macroscopical structure of the stratum corneum, which consists of alternating lipoidal and hydrophylic regions. For this reason, physico-chemical characteristics of the drug, such as partition coefficient and molecular weight, play an important role in determining the facility of percutaneous absorption. Another factor to consider in transdermal drug delivery, is the vehicle in which the drug is formulated as it acts on the release of drug from the formulation. Moreover, vehicles may also interact with human stratum corneum, thereby affecting its barrier function. Surfactants and penetration enhancers are well known examples of the latter. Subsequently, dosing conditions, such as humidity, temperature and occlusion, also have their impact on the actual input (rate) of drug through human skin. Finally, all bits of information are combined to form a reasonably faithful picture of percutaneous absorption. PMID- 2694090 TI - Oxidative stress. Biochemistry and human disease. AB - The early involvement of free radicals in the evolution of life may explain their ubiquitous presence and vital physiological role. Imbalance between protection against free radicals and their generation, explains the likely association of various diseases with toxic oxygen species. An elaborate defence system against oxygen-free radicals exists. The effects of oxidative stress are manifold. Direct demonstration of oxygen radicals in intact biological systems is difficult. Frequently, effect-related measurements are used in this respect. The clinical conditions adult respiratory distress syndrome and multiple organ failure, reflex sympathetic dystrophy and sugar cataract are discussed and the role of oxygen radicals in the aetiology of these diseases are described. PMID- 2694091 TI - [Diagnostic imaging for breast cancer]. AB - With the westernization of the Japanese diet and way of life, the mortality due to breast cancer continues gradually to increase. This disease, however, is a type of cancer that can be well controlled by primary preventive measures and early detection. Numerous techniques of diagnostic imaging for breast cancer have been established, but the most common are mammography and ultrasonography. For X ray mammography, a low tube voltage is necessary so that small differences in X ray absorption by the various tissues within the breast may be detected, but when the surface dose is increased, it is a source of anxiety because of the possible development of secondary carcinoma. Ultrasonography of the breast, however, is free from the dangers of radiation exposure, and may be conducted in conjunction with palpation, thus representing a highly reliable approach. The diagnostic reliability of mammography and ultrasonography was investigated in 251 cases in which breast cancer was confirmed by these methods in a total of 752 outpatients who visited the Department of Breast Surgery of the Aichi Cancer Center Hospital in Nagoya, Japan. As a diagnostic procedure for breast cancer, mammography was shown to have a sensitivity of 89.2%, a specificity of 92.6%, and an accuracy rate of 91.5%, the respective values for the ultrasound technique being 84.9%, 88.9%, and 87.5%. These results are superior even to those of surgeons with 30 years of experience specializing in the breast (86.9%, 85.3%, and 85.8%), especially when tumors cannot be palpated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694092 TI - Granulocyte-associated immunoglobulins in asymptomatic HIV-infected subjects. AB - The purpose of this study was to determine the prevalence of granulocyte associated immunoglobulins (GA-IgG) during the follow-up of asymptomatic human immunodeficiency virus (HIV)-infected subjects. An increase in GA-IgG was detected in 32 asymptomatic HIV seropositive subjects by a granulocyte immunofluorescence test (GIFT). At study onset, 7 (21.8%) had a positive GIFT. The prevalence of positive GIFT increased with time in the study subjects. No neutropenia was found. No significant difference was observed in subjects with positive or negative GIFT with respect to mean CD4 lymphocyte count and mean neutrophil count. The presence of GA-IgG was not associated to a positive direct antiglobulin test or of elevated platelet associated IgG. PMID- 2694093 TI - Class II alloantigen expression on leukemic cells. AB - Class II antigen expression on leukemic cells has been mainly studied using monoclonal antibodies (Mabs). On the other hand, class II polymorphism has been mainly studied using alloantisera. The present study shows that the reactivity of leukemic cells from different lineages with class II Mabs was not always the same as that obtained with alloantisera and that the reactivity varied depending on the leukemic cell-type studied. PMID- 2694094 TI - ets-1 and ets-2 proto-oncogene expression in human leukemia cells and cell lines. AB - c-ets-1 and c-ets-2 are 2 proto-oncogenes known to be possibly involved in some human myelomonocytic leukemias. However, very few studies concern c-ets-1 and c ets-2 RNA expression in human hematologic malignancies. We have studied 18 leukemic patients, and 10 cell lines for their ets RNA contents. c-ets-1 was strongly expressed in 5 and c-ets-2 in 8 of the 18 patients. All the cell lines expressed both c-ets-1 and c-ets-2 RNAs. This expression was highly variable from one patient to another, and from one cell line to another, regardless of the cellular leukemia subtype. The variability of this expression in patients may reflect differences in the proliferative potential of leukemic cells. PMID- 2694095 TI - Eleven cases of neoplastic microangiopathy. AB - Between 1981 and 1988, we recorded 11 patients presenting a neoplastic microangiopathy. All patients suffered from adenocarcinoma, except one with an undifferentiated lung carcinoma; the origin of the tumor was mammary in 5 cases and gastric in 3. In our study, microangiopathy was the first manifestation of the neoplastic disease on 3 occasions; on 7 occasions it was a complication of an advanced stage of a known oncological disease; and on 1 occasion it occurred during a course of intra-arterial chemotherapy. Regenerative anemia (mean 9.5 g/dl hemoglobin), thrombocytopenia (mean 42,000 platelets/mm3), and an elevated LDH value (mean 1,268 U/l) characterized these patients. Disseminated intravascular coagulopathy (DIC) was found in half the cases in which it was sought. In spite of aggressive antitumoral treatment, the course was disastrous with an average survival of 13.6 days. The most frequent causes of death were renal insufficiency or hemorrhagic diathesis. These data corroborate those cited in the literature since 1979, and are consistent with those reported by Antman during the period 1962-1979. PMID- 2694096 TI - About Gaucher disease. PMID- 2694098 TI - 'Bart's for nurses'. PMID- 2694097 TI - Pentoxifylline (Trental) has no significant effect on laboratory parameters in sickle cell disease. AB - The possible effect of pentoxifylline (Trental) in sickle celle disease was tested in 2 clinical trials: a controlled double-blinded intravenous study involving patients hospitalized with painful crises and an ublinded 5-month oral study in steady state patients. In the intravenous trial 29 painful episodes were treated in 16 patients. Complete blood counts, serum chemistries, red cell density gradients, intracellular pH, p50, whole blood viscosity, plasma viscosity and red cell distribution widths were monitored daily during the hospital admission. We confirmed the decrease of dense red cells during crisis and found, in addition, the related significant decrease in whole blood p50. There were no major differences in any of these parameters when pentoxifylline was compared to placebo for each individual day. When the data was examined over time, minor differences emerged. The red cell distribution width, the number of cells in density fraction SS2 (discocytes) and the plasma viscosity were all slightly higher over time in the pentoxifylline group than in the control group. In the oral group 23 patients were monitored for the same parameters on seven visits during a five month period. Administration of oral pentoxifylline produced no changes from baseline for all parameters examined except for a statistically significant, but minor, increase in plasma viscosity demonstrable for these patients during one visit only. We conclude that pentoxifylline has little effect on laboratory parameters in sickle cell disease. PMID- 2694099 TI - Curriculum tales. PMID- 2694100 TI - Renaissance nurse. Interview by Laurence Dopson. PMID- 2694101 TI - The nursing pin: symbol of 1,000 years of service. AB - The nursing pin is a 1,000-year old symbol of service to others. The earliest ancestor of the pin dates back to the Maltese Cross, adopted by crusaders and worn on their habits as a symbol of service to Christianity. Over the centuries, variations of the crusader's symbol were gradually modified and became family coats of arms, often symbolizing service to a ruler. By the Renaissance, guilds had adopted coats of arms symbolizing masterful service to the community. The most recent ancestor of the pin is the hospital badge of 100 years ago. It was given by the hospital school of nursing to the students to identify them as nurses who were educated to serve the health needs of society. This symbol of service involves many professional rights and responsibilities. PMID- 2694102 TI - [Physiopathology of the exocrine pancreas in children]. AB - The mechanism leading to exocrine pancreatic disease in children differs from those encountered in adult patients: I. In acute pancreatitis autodigestion of the gland by proteolytic enzymes may occur and two mechanisms may play a role. 1. Reflux of biliary secretions (e.g. in malformations of the duct system) facilitates activation of trypsinogen by enteropeptidase and leads to the presence of active proteolytic enzymes in the gland (exogenous activation). 2. Lysosomal enzymes may play a role in the intracellular activation of zymogens if inflammation leads to a fusion of lysosomes with zymogen granules (endogenous activation). II. In chronic relapsing and hereditary pancreatitis malformations of the pancreatico-biliary duct system must be sought because surgery may be indicated (common channel syndrome and choledochal cysts). III. Among the hereditary diseases leading to pancreatic insufficiency cystic fibrosis (CF) plays the main role. Haplotype analysis has shown that two genetically different types of CF exists (PS and PI). The pancreas shows manifest insufficiency only in the PI-types which occur in more than 70% of cases but the distribution of haplotypes is different in different ethnic groups. In spite of the recent discovery of the cystic fibrosis gene the exact mechanism leading to exocrine pancreatic dysfunction in CF is not clear, but diminished chloride and bicarbonate secretion, may be the result of a disturbance in the regulation of chloride channels, on acinar or ductular level. In the Shwachman-Diamond syndrome a very severe type of exocrine insufficiency with unknown etiology is encountered at birth. PMID- 2694103 TI - [Liver transplant in children. I]. AB - Hepatic transplantation is the only therapeutic choice for end-stage pediatric liver diseases. The survival improvement, registered in the last few years is mainly due to the employment of cyclosporine in therapy, but also to new and sophisticated surgical techniques and immunosuppressive drugs. The indications in children are: biliary atresia after unsuccessful Kasai procedure, paucity of intrahepatic bile ducts (of syndromic and not syndromic type), some metabolic diseases (alfa1 antitrypsine deficiency, hereditary tyrosinemia), post infective cirrhosis, acute fulminant hepatic failure, hepatic malignancies. Absolute contraindications include severe systemic illness, severe cardiac or kidney failure, thrombosis or abnormalities of caval and portal veins, systemic sepsis, HIV infection. Other drawbacks are mental deficiency and the inability of family to care for the child and follow therapy after discharge. Relative contraindications are: HBsAg positivity, HIV positivity without infection, malnutrition. Finally the scarcity of donors of liver of adequate size is an important limitation for transplant especially in childhood. PMID- 2694104 TI - [Azlocillin in the treatment of pulmonary infections in patients with cystic fibrosis: plasma concentrations and therapeutic indications]. AB - Azlocillin plasma concentrations have been studied in 10 cystic fibrosis patients suffering from chronic pulmonary infections with Pseudomonas aeruginosa. Patients were given single i.v. doses of 100 e 200 mg/kg body weight as intravenous infusion over 30 minutes. Azlocillin plasma levels have been assayed by a rapid, sensitive and precise high performance liquid chromatographic method. After the dose of 100 mg/kg body weight concentrations of azlocillin decreased below the therapeutic concentrations after three hours; dose of 200 mg/kg was followed by plasma concentrations in the therapeutically desirable range during the 6-8 hours study period. The pharmacokinetic analysis offers further evidence of the dose dependent nature of azlocillin elimination. Higher dosage of 200 mg/kg body weight and monitoring of plasma drug levels are recommended in the therapy of patients with cystic fibrosis. PMID- 2694105 TI - [Evaluation of atopy risk factors during the first year of life. Multicentric study]. AB - The AA studied 406 newborn babies during the 1st year of life in order to verify the correlation between atopy risk factors and the appearance of early symptoms, particularly gastroenteric (GE). The results obtained did not demonstrate a significant difference concerning the blood cord IgE level and subsequent appearance of food allergy symptoms, whereas positive familiarity showed a better correlation. No significant difference was observed between breast--or formula- fed infants, or between those weaned before or after the 5th month of life. The comparison of dietary regimen adopted during the 1st quarter in the asymptomatic and atopic children respectively, demonstrated that the presence of predisposing factors influences the appearance of GE symptoms much more than the diet in itself. An allergologic study, randomly performed by Prick-test in 156 cases and by RAST in 200 cases, showed a prevalent, positive response with RAST technique in symptomatic children. PMID- 2694106 TI - [Treatment of somatotropic deficiency with biosynthetic growth hormone]. AB - A total of 21 patients with somatotropic deficiency have been enrolled in a clinical trial of biosynthetic growth hormone (bio-GH) and pituitary growth hormone (pit-GH). Five of them not previously treated (naive) and 7 previously treated with pit-GH, received bio-GH; 9 received only pit-GH. Biosynthetic-GH was given 12 UI/m2/week. Height velocities during treatment rose, for naive patients, from 3.6 +/- 0.3 cm/year (before treatment) to 8.7 +/- 1.3 cm/year (after 12 months treatment). For previously treated patients, after a period at least 6 months without any GH therapy, the increase in height was from 2.5 +/- 0.9 cm/year to 6.8 cm/year; and for the patients who received only pit-GH was from 3.4 +/- 1.2 cm/year to 8.0 +/- 1.1 cm/year. No significant difference was observed between the growth velocities obtained with the two preparations. No specific side-effects were noted. PMID- 2694107 TI - [Conjunctivitis of bacterial origin in children. Local antibiotic treatment with tobramycin collyrium]. AB - A total of 122 children, from one to twelve years old, with suspected bacterial conjunctivitis, were treated with Tobramycin 0.3% eye drops. The follow up control was at the 3d (+2), the 7th (+2) day and a third control was performed around the 15th day, in case of a longer therapy. All patients showed a significant remission of the sign and symptoms already at the first control. No local or systemic side effect was noticed. Locally the product was well tolerated. PMID- 2694108 TI - [Biliary lithiasis in thalassemia major]. AB - The presence of cholelithiasis was diagnosed by ultrasonography in 10 patients with thalassemia major aged 16 to 33 years. Other 10 patients aged 7 to 19 years showed acalculous cholecystopathy. Serum liver enzymes and ferritin levels, as well as splenectomy do not influence significantly the production of gallstones. Significant differences were observed in the age of patients with gallstones when compared to subjects without gallstones or with acalculous cholecystopathy. Although, in the last years, the high transfusional regimen has decreased the incidence of cholelithiasis, the frequent liver disease could be a cause of acalculous cholecystopathy in younger thalassemic patients. PMID- 2694109 TI - [Hematoma of the adrenal gland]. AB - Two neonates, with a palpable mass in the loin, turned out to have adrenal haemorrhage. One of them had also hypertension and a poorly functioning kidney on the same side. None of them needed surgery. PMID- 2694110 TI - [Hypohidrotic ectodermal dysplasia syndrome. Description of a clinical case]. AB - A case of Hypohidrotic Ectodermal Dysplasia is reported. Inability of sweating is associated with characteristic craniofacial anomalies, oligo-anodontia and rare, thin hair. X-linked and autosomal inheritance are both supposed. PMID- 2694111 TI - [Simple testicular cysts in children. Presentation of a case]. AB - A case of simple intraparenchymal testicular cyst in a two and half months old child is reported. Dysplastic cysts of the testicle are exceedingly rare, in children only eight such cases have been described in the Literature, all, except one, treated by orchiectomy. In the herein reported case a conservative approach with cyst enucleation and sparing of the residual testicular parenchyma has been satisfactorily employed. PMID- 2694112 TI - Clinical features and treatment of Lyme disease. AB - Lyme disease is caused by the spirochete Borrelia burgdorferi, which is carried by infected ticks. This disorder has a variable clinical course with multisystem manifestations, including dermatologic, neurologic, cardiac, and rheumatologic abnormalities. Although Lyme disease has been commonly associated with stages, the utility of staging may be limited due to the inconsistency of clinical manifestations among patients. Furthermore, stages may overlap as a result of the acute and chronic phases of the disease. The laboratory characteristics of Lyme disease are highly variable. The use of microbiologic cultures in establishing the diagnosis requires several weeks and has a low yield of positivity. Serologic assays using indirect immunofluorescence and enzyme-linked immunosorbence are preferred. Because of the highly variable features of Lyme disease, clinical and laboratory features must be correlated and interpreted in the context of the disease. Treatment should be initiated as early as possible after the onset of illness. Prompt therapeutic intervention may result in early resolution of the dermatologic hallmark, erythema chronicum migrans, as well as prevention and attenuation of subsequent complications. PMID- 2694113 TI - Pharmacokinetics of felbamate, a novel antiepileptic drug: application of mixed effect modeling to clinical trials. AB - Felbamate is a novel antiepileptic drug currently undergoing clinical trials in the United States. Serum felbamate concentration data from a phase II safety and efficacy trial were analyzed using NONMEM. A one-compartment, open model with first-order absorption and elimination was used. Body weight, sex, concurrent folic acid therapy, and phenytoin dose and dose:concentration ratio did not affect the estimates for felbamate clearance (Cl). Carbamazepine dose and dose:concentration ratio (CDCR) led to significant improvements in the objective function. The final models for felbamate clearance and volume of distribution (Vd) were as follows: Cl(L/hr) = 2.43 + 0.429*CDCR/240, Vd (L) = 51. The coefficient of variation of clearance was only about 12%, which may be indicative of the highly selective patient population. The clearance estimates are similar to those obtained in healthy volunteers and in patients receiving lower dosages of felbamate. The volume of distribution estimate, however, is slightly smaller than that reported previously. Valuable pharmacokinetic information can be obtained from the routine monitoring of serum concentrations during safety and efficacy trials. PMID- 2694114 TI - Use of a trypsin, Peru balsam, and castor oil spray on the oral mucosa: case report and review of the literature. AB - Granulex is an aerosolized spray (Dow B. Hickman Pharmaceuticals, Sugar Land, TX 77487) that contains trypsin, Peru balsam, and castor oil. It has been available for many years as a topical spray for the treatment of decubitus ulcers. We used Granulex to promote tissue healing of a necrotic ulcer of the oral mucosa in a patient with advanced oropharyngeal squamous cell carcinoma. PMID- 2694115 TI - [Effect of propranolol therapy on the secretion of insulin, glucagon, gastrin and pancreatic polypeptide in patients with essential hypertension]. AB - A group of 20 patients with primary hypertension (NT) were studied for the influence of six-week propranolol therapy on the secretion of immunoreactive insulin (IR-I), gastrin glucagon (IR-G) and pancreatic polypeptide (IR-PP) induced by a high-fat test meal. The results of the examination before the therapy were compared with examination of 10 healthy persons. Before the therapy, the patients with NT revealed a decreased reactivity of IR-PP to the food stimulus. After propranolol therapy, the authors found a significant change of glucagonemia profile and pancreatic polypeptide concentration induced by a test meal. The results of the examinations made suggest a direct or indirect participation of beta-adrenergic endings in the regulation of glucagon and pancreatic polypeptide secretion in patients with primary hypertension. PMID- 2694116 TI - [Plasmapheresis and plasma exchange in the treatment of internal diseases]. PMID- 2694117 TI - [Nephrotoxicity of aminoglycosides]. PMID- 2694118 TI - [Sudden death in attacks of dyspnea in patients with bronchial asthma]. PMID- 2694119 TI - [Effect of calcitonin on gallbladder volume between food intake and on its emptying after meals in humans]. AB - The effect of increasing i.v. doses of synthetic salmon calcitonin: 0.0044, 0.0088, 0.0175, and 0.0350 i.u..kg-1 min-1 versus placebo on the fasted gallbladder volume was assessed in 7 normal subjects according to a double-blind study protocol. In addition the action of calcitonin on meal-induced gallbladder emptying was examined. Gallbladder volumes were measured by means of real-time ultrasonography. An excellent day-to-day reproducibility of the fasted gallbladder volume was reflected by a coefficient of variation amounting to 12.2%, whereas the correlation coefficient between the fasted gallbladder volumes on day 1 and 2 amounted to r = 0.98, p less than 0.001. Calcitonin evoked a dose dependent relaxation of the fasted gallbladder. A statistically significant increase of the fasted gallbladder volume was observed with 0.0175 (23.4 +/- 5.50 cm3 placebo vs 33.9 +/- 7.74 cm3 calcitonin, p less than 0.001) and 0.0350 (21.4 +/- 4.62 cm3 placebo vs 36.1 +/- 8.42 cm3 calcitonin, p less than 0.01) i.u..kg-1 min-1 calcitonin, where as mean increase of the gallbladder volume amounted to 32.1 and 46.5%, respectively. A significant delay of the gallbladder emptying after calcitonin was reflected by a decrease of the ejection fraction: 23.2 +/- 8.33% calcitonin vs 57.8 +/- 6.94% placebo (p less than 0.02) at 20 min, and 40.5 +/- 8.76% calcitonin vs 67.2 +/- 3.75% placebo (p less than 0.02) at 30 min after the test meal. Calcitonin is concluded to increase significantly the interdigestive gallbladder volume and to delay the meal-induced gallbladder emptying in humans. PMID- 2694120 TI - [Beta 2 microglobulin in the blood pf patients with chronic renal failure treated by hemodialysis and kidney transplantation]. AB - Beta 2-microglobulin serum concentration was measured in 25 patients on chronic haemodialysis with end stage renal failure, in 52 patients with renal transplant and in 26 healthy control subjects. In hemodialysed patients with end stage renal failure the concentration of beta 2-microglobulin was 15-20 times, and in patients with renal transplant 3-4 times that of healthy controls. Elevated serum beta 2-microglobulin concentration in patients with renal transplant seems to depend not only on the kind of immunosuppression applied but also on other factors, such as, for instance, the functional efficiency of the transplanted kidney. PMID- 2694121 TI - [Hypersensitivity to aspirin and other non-steroidal anti- inflammatory agents- the methods of detecting the hypersensitivity and the development of the state of tolerance]. PMID- 2694122 TI - The use of lectins in histopathology. AB - Lectins are proteins and glycoproteins extracted predominantly from plants which have the capacity to bind sugars specifically. This property makes them of interest for histopathology since they will bind to saccharides forming parts of glycoproteins and glycolipids of tissue constituents. Lectins have and can be used as reagents for mucin histochemistry, to identify specific cells, in the recognition of glycoprotein alterations in disease states, in studies of infectious diseases, and in the assessment of glycoconjugate alterations occurring with malignancy. They can be used for both light microscopic and ultrastructural localisation and various methods are available. It is important though, to consider the nature of the glycoconjugates under study and select lectins appropriately because of their varying specificities and binding characteristics. A panel of lectins should be used to study a particular configuration. Care should be taken with tissue fixation and processing. It must be remembered that an open and critical mind should be kept concerning interpretation of results. At the present time lectins have a limited value diagnostically, but the binding of Ulex europeus agglutinin to endothelium is certainly of value. PMID- 2694123 TI - What's new in malignant tumors in acquired immunodeficiency disorders? AB - An increased incidence of malignant tumors has long been recognized in patients with primary immune defects such as the X-linked lympho-proliferative syndrome or the Wiskott Aldrich syndrome and has recently become a major concern also in cases with acquired immunodeficiency. The latter may be induced by cytostatic therapy for cancer, extended immunosuppression following organ transplantation or HIV infection. The spectrum of secondary cancers is, however, different within these three groups of secondary immune defects with acute myeloid leukemia being the most common malignant disease after cytostatic therapy, with skin or lip cancer followed by non-Hodgkin's lymphoma as the prevalent malignancies after organ transplantations and Kaposi sarcoma and non-Hodgkin's lymphoma as the predominant cancers associated with HIV infection. The pathogenesis of Kaposi sarcoma and non-Hodgkin's lymphoma is possibly related to viral infections by cytomegalovirus and Epstein-Barr virus inducing an increased proliferation and possibly the coactivation of transforming genes of oncogenic potential. In AIDS patients Kaposi sarcoma is diagnosed in up to 40% of homosexual men while the other risk groups are less frequently involved. 4-10% of HIV infected patients experience non Hodgkin's lymphoma predominantly of B-cell type and intermediate or high grade malignancy with frequent extranodal manifestations. Other types of tumors occur at a substantially lower frequency and are not clearly related to the HIV infection. The overall survival of patients suffering from malignant tumors in the state of immunodeficiency is poor and the possibilities for therapeutic intervention are limited by the risk of accelerating the pre-existing suppression of defense mechanisms. PMID- 2694124 TI - What's new in steroid receptor immunocytochemistry in clinical oncology? AB - In this review we outline the many practical advantages of immunocytochemistry for estrogen receptors (ER) and the staining intensity index for its interpretation. We discuss the heterogenous distribution of ER in malignant and non-malignant breast tissue and the correlation of ER staining with pathologic features. In predicting the response of breast cancer to endocrine therapy, we conclude that both fine needle aspirates and tissue sections are adequate for the assessment of ER. PMID- 2694125 TI - What's new in the localization of sex steroids in the human ovary and its tumors? AB - It is important to understand the distribution of steroidogenesis in steroid producing tissues in order to obtain a better understanding of steroid metabolism. Recent advances in purification and subsequent generation of antibodies against cytochromes P-450 specific for steroid hormone biosynthesis have made it possible to localize the sites of steroidogenesis immunohistochemically. This review provides the localization of sex-steroid hormone biosynthesis in normal and pathological human ovaries including sex-cord stromal tumors, hyperthecosis and Brenner tumor, as determined by the tissue distribution of immunoreactivity of individual enzymes specific for different stages of the biosynthetic process. PMID- 2694126 TI - Pemphigoid in children. AB - Pemphigoid is an autoimmune blistering disease that is rare in childhood. A review of the English, German, and French literature published prior to 1989 revealed 31 cases of juvenile bullous pemphigoid and 12 of other forms (10 cases of juvenile cicatricial and 2 of juvenile localized bullous pemphigoid). Childhood pemphigoid, although less frequent, seems no different than its adult counterpart. While oral lesions are more common in the juvenile bullous form, there is no association with malignancy, which is a controversial and presumably incorrectly assumed association in the adult disease. The prognosis for children is good in most cases, and the disease is self-limiting. The mainstay of therapy has been oral corticosteroids, but dapsone also often produces a good response. A relatively new approach is to give a combination of erythromycin and niacinamide with dapsone for a steroid-sparing effect. In some patients the response to erythromycin plus niacinamide alone has been satisfactory; however, controlled therapeutic trials are lacking. It has been stated that high doses of steroids and immunosuppressive drugs are indicated for the cicatricial, as opposed to juvenile, bullous pemphigoid. From this review of the few cases of childhood cicatricial disease, it seems that the therapeutic approach might be the same for both forms. PMID- 2694127 TI - Comparative histopathology of porcine and human cutaneous melanoma. AB - Pigmented tumors resembling cutaneous melanoma were first reported in Sinclair miniature swine in 1967. Since that time, carefully planned breeding has established that this is an inherited malignancy the natural history of which mimics human cutaneous melanoma in a number of ways. Because of these characteristics, miniature swine melanoma appears to be an effective model with which to investigate the mechanisms influencing initiation, growth, and progression of human melanoma. This investigation characterized histologically the cutaneous melanoma in miniature swine and compared the findings with human neoplasm. Primary cutaneous melanoma in swine has been reclassified and standardized according to the classifications currently in vogue in human melanoma. Our results suggest that the condition in miniature swine is histologically similar to that in humans. These observations will provide a basis for interpretation of the results derived in the biologic studies performed in this model. PMID- 2694128 TI - Blistering dactylitis caused by group B streptococci. AB - A 6-month-old girl had blisters on her volar index finger and palm. Bacterial culture grew group B streptococci. Group B streptococci (in addition to group A streptococci) can be a cause of blistering dactylitis. PMID- 2694129 TI - Congenital monocytic leukemia: report of a case with cutaneous involvement, and review of the literature. AB - Congenital leukemia is a rare disease that can become manifest soon after birth. Cutaneous involvement consists of red, brown, or purple papules and nodules, and confluent areas of purpura. The diagnosis is established by the presence of leukemic cells in biopsy specimens of bone marrow and involved skin, and by immunocytochemical characterization of these cells. We report a case of congenital monocytic leukemia with a normal karyotype, whose disease underwent temporary spontaneous regression. PMID- 2694130 TI - Epidermal nevus syndrome: case report and review of clinical manifestations. AB - The epidermal nevus syndrome is a disorder characterized by epidermal nevi and associated neurologic, skeletal, and other abnormalities. We cared for a 3-month old male with multiple epidermal nevi and severe central nervous system involvement. PMID- 2694131 TI - Michelin-tire baby syndrome resulting from diffuse smooth muscle hamartoma. AB - We cared for an infant who was born with the Michelin-tire baby syndrome characterized by dermatomegaly and hypertrichosis. Histology revealed a diffuse smooth muscle hamartoma. PMID- 2694132 TI - Breast-feeding. AB - The pediatrician plays a crucial role in the success of breast-feeding by providing well-researched, practical advice and support to the lactating woman, beginning in the prenatal period and continuing until total weaning. The pediatrician can provide much needed support and affirmation when the mother is sabotaged by well-meaning friends and relatives who are misinformed about the value or techniques of breast-feeding. Mothers state that their pediatrician is the most important member of the support team but also the one most apt to obstruct success with inappropriate advice. An understanding of lactation as a physiologic process will provide a sound basis for anticipatory guidance. PMID- 2694133 TI - Abdominal masses in the newborn. PMID- 2694134 TI - Recurrent infections. PMID- 2694135 TI - Thyroiditis in children. PMID- 2694136 TI - Aetiology and pathogenesis of ulcerative colitis and Crohn's disease. PMID- 2694137 TI - Giant cell arteritis: difficult decisions in diagnosis, investigation and treatment. PMID- 2694138 TI - Colchicine cardiotoxicity following ingestion of Gloriosa superba tubers. AB - The clinical features of colchicine toxicity in a patient following ingestion of Gloriosa superba tubers are described. Gastroenteritis, acute renal failure, cardiotoxicity and haematological abnormalities were the main toxic manifestations. There was no hypotension and no neurological manifestations. Electrocardiographic changes were noteworthy and have not been reported previously. PMID- 2694139 TI - Sarcoidosis presenting with an acute Guillain-Barre syndrome. AB - A 28 year old Caucasian male presented with an acute Guillain-Barre syndrome and bilateral facial weakness. He had an abnormal chest radiograph. Lumbar puncture revealed acellular fluid with a raised protein count and lung function tests showed a restrictive ventilatory defect. The patient deteriorated and required mechanical ventilation for 14 days. Steroids and plasmapheresis were not used and the patient spontaneously recovered. Two months after presentation limb power was almost normal but there was residual partial bilateral facial weakness. The chest radiograph remained abnormal and repeat lung function tests showed a persistent restrictive ventilatory defect and a reduced gas transfer coefficient. A transbronchial biopsy revealed non-caseating granulomata. The association between neurosarcoidosis and Guillain-Barre polyneuropathy is discussed and the literature reviewed. PMID- 2694140 TI - Retroperitoneal lymphadenopathy in familial Mediterranean fever. AB - Peripheral lymphadenopathy is rarely observed, whereas mesenteric lymphadenopathy is found occasionally on laparotomies in patients with familial Mediterranean fever (FMF). Retroperitoneal lymphadenopathy was reported only once in an autopsy of a patient with FMF. Our case is the second one, and the first one to be diagnosed during life, by means of abdominal ultrasonography and computerized tomography. In patients with FMF, where lymph node biopsy was done, the pathological finding was non-specific lymphoid hyperplasia. PMID- 2694141 TI - Conversation piece--the pharmaceutical medicine doctor. Interview by P. D. Welsby. PMID- 2694142 TI - Comparison of chlortenoxicam and indomethacin on frusemide-induced diuresis. AB - A single oral dose of chlortenoxicam 4 mg, a new non-steroidal anti-inflammatory drug, significantly antagonized the diuretic and natriuretic actions of frusemide when compared with placebo in normal human volunteers. Indomethacin 50 mg significantly reduced the natriuretic, but not diuretic action of frusemide. PMID- 2694143 TI - Early stage Hodgkin's disease in adults: which is the correct treatment? PMID- 2694144 TI - Intensive care medicine--a review. PMID- 2694145 TI - Is intravenous cholangiography an alternative to the routine per-operative cholangiogram? AB - Ultrasonography, although an accurate method of detecting stones within the gall bladder, is unreliable for the detection of bile duct stones for which per operative cholangiography remains the standard investigation. Fifty seven patients undergoing elective cholecystectomy had both a pre-operative intravenous cholangiogram and per-operative cholangiography. The pre-operative investigation is shown to be at least as effective in the detection of common bile duct stones and only missed a duct stone in one patient. The substitution of pre-operative intravenous cholangiography for routine per-operative cholangiography would result in a significant reduction in operating time, may provide advance knowledge on the biliary anatomy and would allow advance planning of the likely procedure. It is suggested that pre-operative intravenous cholangiography, carried out on the day of admission, should be considered as a preferred alternative investigation to per-operative cholangiography. PMID- 2694146 TI - The use of disease modifying antirheumatic drugs in the management of rheumatoid arthritis. PMID- 2694147 TI - Bilateral adrenal phaeochromocytomas associated with unilateral renal artery stenosis. AB - A 21 year old male was discovered to be severely hypertensive. He was found to have bilateral adrenal phaeochromocytomas and a single renal artery stenosis. More than 40 cases of coexisting renal artery stenosis and phaeochromocytomas have been reported. The aetiology of renal artery stenosis in association with phaeochromocytoma maybe multifactorial and the radiographic appearances are not always clear-cut. Renin levels in this patient were elevated prior to the removal of the phaeochromocytomas but the renal vein renin ratio did not suggest that the renal artery stenosis contributed significantly to his hypertension. The patient's hypertension resolved following successful removal of the phaeochromocytomas despite persistence of the renal artery stenosis. Thus, though renin levels may be misleading in these cases, renal vein renin ratios may still be helpful in deciding on patient management. PMID- 2694148 TI - Carcinoma of the gall bladder--can we do anything? PMID- 2694149 TI - Public health nursing and The Future of Public Health. AB - The recent Institute of Medicine report, The Future of Public Health, reviews the history, current status, and potential of the public health system in the United States, and makes detailed recommendations for its revitalization. Although public reports such as this risk speedy obscurity, many are used by planners and legislators and a few exert significant influence. Public health nursing is inadequately represented in this potentially influential document, and this has unfortunate implications for public health nursing. PMID- 2694150 TI - Advances in the treatment of sciatica. PMID- 2694151 TI - [The superego or conscience. On the difference between the 2 concepts and its significance for psychotherapy of children and adolescents]. AB - Proceeding from the matter-of-fact equation of conscience to superego in recent psychoanalytical papers the author first describes the phenomenon of conscience which is subdivided in manifestations attributed to the good and the bad conscience. By means of the Freudian conception developing from egoideal via idealego to superego Freud's reception of conscience is examined. In this connection the author demonstrates an obvious onesidedness in Freud's use of the term of conscience which leans towards the accusing, punishing, bad conscience. Among Freud's successors, on the part of the psychology of the proprium, heed is paid to those aspects of conscience neglected by Freud, the implicit total aspect of the phenomenon of conscience, however, was lost. Finally the author discusses the double aspect of conscience, the good and the bad conscience, with respect to its impact on the psychotherapy of children and adolescents. PMID- 2694152 TI - In utero ultrasonographic features of campomelic dysplasia. AB - A prenatal diagnosis of campomelic dysplasia in a primigravida is described. First level fetal ultrasonography demonstrated bowing and shortening of lower limbs. Second level examination allowed the correct diagnosis by demonstrating several skeletal anomalies pathognomonic of campomelic dysplasia. PMID- 2694153 TI - Prenatal diagnosis of Opitz (BBB) syndrome in the second trimester by ultrasound detection of hypospadias and hypertelorism. AB - Prenatal diagnosis in a kindred with the Opitz (BBB) syndrome is presented. The inheritance is consistent with either autosomal dominant inheritance with sex limited expression or X-linked inheritance. The abnormalities in the kindred consist of hypertelorism, hypospadias, ambiguous genitalia, urocolic fistula, imperforate anus, mental retardation, diaphragmatic hernia, and malrotation with volvulus. A male fetus at 19 weeks was found by ultrasound to have hypertelorism and hypospadias with a small phallus consistent with the syndrome. The diagnosis was confirmed by pathologic examination after pregnancy termination. This is the first report of prenatal diagnosis of Opitz syndrome by ultrasonographic demonstration of hypertelorism and hypospadias in the second trimester. PMID- 2694154 TI - Exophthalmus--prenatal ultrasonic features for diagnosis of Crouzon syndrome. AB - Prenatal real-time ultrasonographic diagnosis of exophthalmus is presented. Diagnosis was made at the 35th week of gestation in a fetus of a patient affected with Crouzon syndrome (craniofacial dysotosis). Recognition of exophthalmus as a part of Crouzon syndrome and the easy visualization of the eye balls and palpebrae in the third trimester made the diagnosis possible. PMID- 2694155 TI - Chemoprevention and modern cancer prevention. AB - Chemoprevention is a new area of research emphasis in cancer control. The rationale is based on the accumulation of laboratory and epidemiological data indicating that various agents may halt or reverse cancer progression in animals and may reduce risks in humans. For planning purposes, research leads are submitted to a strategic system of staging with defined criteria and decision points. A research lead that enters an intervention stage must evolve through a series of phases of testing and evaluation. Human intervention clinical trials have begun to test the hypothesis that certain agents can lower cancer incidence. PMID- 2694156 TI - Chemoprevention of experimental carcinogenesis in animals. AB - Retinoids are well-established chemopreventive agents for experimental carcinogenesis of many target organs including mammary glands, urinary bladder, lung, skin, liver, pancreas, colon, and esophagus. Modification of the basic retinoid structure has produced analogs with enhanced target organ specificity, increased inhibitory activity, and reduced toxicity. N-(4 hydroxyphenyl)retinamide (4-HPR) currently appears to be the most efficacious retinoid against carcinogen-induced breast, urinary bladder, and lung cancer in rodents. Retinoids are most effective when administered shortly after the carcinogen treatment; however, the treatment can be delayed significantly while maintaining its chemopreventive effect. Under various experimental conditions combining retinoid treatment with other modifiers of growth enhances its chemopreventive activity; for example retinoid plus hormonal modulation can provide better protection against mammary cancer than either treatment alone. More recently chemopreventive activity of various other classes of agents, such as thiols, phenols, antioxidants, inhibitors of prostaglandin synthesis, etc., have been investigated in experimental mammary, urinary bladder, and lung cancer models. PMID- 2694157 TI - Carotenoids as chemopreventive agents. AB - Carotenoid pigments have been suggested as chemopreventive agents for reducing cancer risk in humans. In this article, the functions of carotenoids are reviewed, and the experimental evidence for carotenoid inhibition of mutagenicity, malignant transformation, and tumor formation is reviewed. It is suggested that the antioxidant function of carotenoids may explain their divergent effects as chemopreventive agents. PMID- 2694158 TI - Cancer chemoprevention by supplemental carotenoids in animals and humans. AB - Experiments were carried out in mice demonstrating that dietary carotenoids (beta carotene or canthaxanthin), starting before cancer initiation and continuing throughout the experiment, have a protective effect against indirect skin carcinogenesis induced by benzo[a]pyrene +/- UVA and breast cancer induced by 8 methoxypsoralen + UVA. Experiments in rats demonstrated that carotenoids also prevent the direct gastric carcinogenesis induced by N-methyl-N'-nitro-nitroso guanidine. Recently, prevention by beta-carotene against colon cancer induced in mice by dimethylhydrazine, another indirect carcinogen, was confirmed by others. The prospects for carotenoid intervention with humans were based on their antitumorigenic effect, which is quite independent of pro-vitamin A activity, their lack of toxicity even after prolonged administration, and their immunostimulating activity. These facts helped to build up a rationale predicting that any epithelial cancer, after radical surgery, can be chemoprevented with supplemental carotenoids. Thus, it is expected that the remaining initiated epithelial tissue will be protected by quenching oxygen radical formation, against the onset of a second primary malignancy. This type of prevention can be envisaged in organs like the lung, urinary bladder, breast, stomach, and colon rectum. At present, human intervention protocols with a randomized drug/placebo method are underway under the supervision of the Centro Tumori of Pavia to chemoprevent with beta-carotene second primary lung or bladder cancer after radical surgery. Preliminary observations regarding findings in humans without randomization (1980-1988) in Pavia are also reported here. This consisted of chemoprevention with beta-carotene plus canthaxanthin against recurrence of different epithelial malignancies after radical treatment (surgery +/- chemoradiotherapy). None of the 11 cases recruited, on the basis of radical nature of treatment and patient adherence, have shown any recurrence beyond their expected disease-free intervals. PMID- 2694159 TI - Synthesis and evaluation of some new retinoids for cancer chemoprevention. AB - Many derivatives and analogs of the natural vitamin A compounds have been synthesized, and some of these retinoids are very active in various bioassays that may be predictive for cancer chemopreventive activity. Analogs have been synthesized in which parts of one, or more, of the three traditional subdivisions of the retinoid structure--the terminal polar group, the conjugated side chain, and the cyclohexenyl region--have been altered or replaced. In addition, structural alterations have produced compounds (arotinoids) in which two, or more, aromatic rings replace much of the classical retinoid structure. Further structural modifications that effected replacement of the entire retinoid structure by aromatic groups and certain linking groups have been made. Some of the arotinoids and further structural variants, which appear superficially to represent immense alteration of the classical retinoid structure, have potent activity in various retinoid bioassays. Four types of new classical retinoids (retinoylamino acids, bifunctional analogs, retinyl ethers, and 4-oxoretinoid derivatives) have been synthesized and evaluated in our laboratories. All-trans- and 13-cis-retinoyl alpha-amino acids are active in a hamster trachea organ culture assay and show much promise in potentiating immune responses. Retinoic acid analogs that have a bifunctional terminus bind to CRABP even though they have a bulky alpha-substituent, induce differentiation of F9 embryonal carcinoma cells, and have good activity in an immune-potentiation assay. A new retinyl either, retinyl propynyl ether, has chemopreventive activity against mammary carcinogenesis in vivo. Oral administration of this retinoid produces high and sustained concentrations in the rat mammary gland. New congeners of 4-oxoretinoic acid demonstrate high activity in a spectrum of bioassays. PMID- 2694160 TI - Antiestrogens as chemopreventive agents in breast cancer: promise and issues in evaluation. AB - Tamoxifen citrate, the most extensively evaluated antiestrogen, acts primarily as a cytostatic agent by binding to the estrogen receptor. In rodent mammary model systems, when tamoxifen is given continuously after exposure to a carcinogen, the majority of expected tumors do not develop. In humans, adjuvant tamoxifen therapy, particularly when given for several years, is associated with significant improvement in relapse-free, and, in some studies, absolute survival. These benefits are achieved without major clinical toxicity and have led to suggestions that the use of tamoxifen as a chemopreventive agent in breast cancer be evaluated. In considering timing, optimal study population, study design, and methods for a chemoprevention trial using tamoxifen, the need for further data on the pharmacologic, biologic, and symptomatic effects of this agent becomes clear. Studies addressing this need are in progress and combined with ancillary data developed from ongoing adjuvant studies, should provide the critical information within the next few years. PMID- 2694161 TI - Basic and clinical investigations of dietary calcium in the prevention of colorectal cancer. AB - Long-standing investigations into the role of diet in colon cancer have generally supported the notion that some aspect of dietary fats acts to promote cancer at this site. Understanding of the chemical behavior of lipids in the colon led to a hypothesis suggesting that depletion of calcium could partly explain the tumor promoting effects of dietary fat. Calcium levels may control critical intracellular events in the course of proliferation. Lack of availability or loss of calcium may result in abnormalities in the regulation of colonic proliferation. Basic and clinical studies suggest that calcium supplementation reduces colonic proliferation implying a potential reduction in cancer risk. The current evidence supporting calcium as a cancer chemoprevention agent is reviewed. PMID- 2694162 TI - The role of serum and tissue pharmacology studies in the design and interpretation of chemoprevention trials. AB - The design and interpretation of chemoprevention trials are challenging tasks. Innovative methodological approaches to these investigations are in initial stages of development. Important pharmacologic issues should be addressed as early as possible in these trials to facilitate the optimal design of large, Phase III, randomized trials. These include determining the optimal dose of the compound and the toxicity profile. Other key areas involve the use of serum concentrations to monitor subject compliance, the evaluation of concentration of the chemopreventive agent in the target tissue, adequate assessment of the drug delivery systems, and the evaluation of the relationship between the dose administered and the serum or tissue concentrations achieved. Whenever possible the investigation of the relationship between serum or tissue concentrations of a chemopreventive agent vs its biologic activity should be determined. Specific examples involving the retinoids and carotenoids are presented. PMID- 2694163 TI - Some statistical considerations for design of cancer prevention trials. AB - Carcinogenesis is believed to occur in at least two stages, initiation and promotion, followed by a preneoplastic lesion which develops into cancer. Cancer prevention trials can be classified as primary if the intervention precedes initiation, secondary if it occurs during promotion, and tertiary if it is applied to a preneoplastic lesion. Tertiary prevention trials resemble treatment trials, but primary and secondary prevention trials may be very different in size, duration, and cost. After reviewing some basic questions which must be addressed in designing any cancer prevention trial, some special design considerations appropriate for primary and secondary prevention trials are discussed. These include the use of factorial designs, group or cluster randomization, special sample size calculations needed for large-scale trials of long duration with cancer incidence as the endpoint, and the idea of the case cohort approach for monitoring and for subsequent exploratory analysis of trial data. PMID- 2694164 TI - Recruitment for an efficacy study in chemoprevention--the Concerned Smoker Study. AB - Efficacy studies are important for the development of long-term cancer prevention strategies. Recruitment aims for a highly motivated group of participants. The Concerned Smoker Study is aimed at smokers with at least a 15 pack-year history and bronchial atypia on sputum sampling Recruitment has been primarily through use of the media. During the first year of randomization 905 potential participants expressed interest. Of these, 80 were eventually randomized. With over 60 participants having completed the study only one has defaulted and compliance with the study protocol has been high. Participants became aware of the study through the following sources: daily newspaper 36.6%, weekly newspaper 16.2%, television 14.9%, radio 13.8%, community television 1.3%, other sources 13.3%. Over 90% of potential participants who initially express interest in such a chemoprevention project may not ultimately be suitable. The population chosen for such studies may not be very representative of the more general population; however, a high degree of compliance can be obtained which will provide valuable information on treatment efficacy. PMID- 2694165 TI - Methodological issues in adherence to cancer control regimens. AB - A six-factor model provides a heuristic framework for understanding adherence behavior: (1) effective provider communication; (2) rapport with provider; (3) client's beliefs and attitudes; (4) client's social climate and norms; (5) behavioral intentions; and (6) supports for and barriers to adherence. Four classes of methodological issues are discussed. Recruitment may be affected by the sociodemographics of the target population, biomedical variables, population size and location, and patient sources utilized. Interventions can be structured to maximize enrollment, participation and long-term retention, and adherence to the regimen promoted with behavioral methodology. Measurement of adherence optimally includes multiple measures at multiple time points, a well-defined focus and unit of adherence, well-constructed response options, and multiple sources of information. Sample size calculations and interpretation of clinical trial results are affected by adherence rates. Multivariate analytic techniques, such as structural equation modeling, make it possible to specify models depicting hypothesized structural relationships between different theoretical constructs and to evaluate the plausibility of these models. PMID- 2694166 TI - Interpretation of cancer prevention trials. AB - Principles and methods to guide interpretation require a different emphasis for cancer trials. Assumptions used to design a trial must be validated and modified during the trial to avoid limitations. To maximize information from such trials, recruitment strategies for commonly free-living subjects, measurements of safety and compliance, and ascertainment with pathologic review of endpoints must be obtained. Consideration of multiple endpoints may provide a better interpretation of cancer prevention for skin, colon, and transient occurrences illustrated by cervical dysplasia or biochemical precursors. A careful definition of the limitations of preventive trials is required. These include the actual size of the intervention groups, completeness and duration of follow-up, and comparison between trial participants and a defined source population. To obtain a valid interpretation with adequate precision of intervention effectiveness, time to endpoints should be evaluated using statistical multivariate methods such as Cox proportional hazard or relative risk models. These permit adjustment for important confounding and risk modifiers such as compliance, dietary intake, and drift in control group. The magnitude of the intervention efficacy and the generalizability of results of the trial will be negatively impacted if the intervention has a delayed (latent) effect. Such delay in intervention effect requires added considerations with possible extension of trial duration. Use of confidence limits for intervention effectiveness provides added insight and improved interpretation of prevention trials. The final component of a cancer prevention trial, as with any study, is to interpret and report its results. Providing a valid interpretation with adequate precision to hypotheses of a cancer prevention trial requires added emphasis on the accuracy of the assumptions made to design the trial and the duration of the trial. Design assumptions regarding compliance to the prescribed interventions, time until the experimental intervention achieves full effect, and the frequency of endpoints directly impact on the number of endpoints observed. Terminating a cancer prevention trial before adequate information is obtained, thus severely flawing its interpretation, requires ongoing awareness. Interpretation of a cancer prevention trial should include several added steps: first, investigators to critically review the actual manner in which the trial was conducted; second, carry out an appropriate analysis of the data; and third, review the results and note exceptions or limitations in the data. The results of the trial should be contrasted with previous studies. Implications of the results to future trials should be considered. Finally, these interpretations should be documented in a written report and made available to the scientific community. PMID- 2694167 TI - Retinoids as potential chemopreventive agents in squamous cell carcinoma of the head and neck. AB - Although newer combined modality approaches, including neoadjuvant cytotoxic chemotherapy, for patients with squamous cell carcinoma (SCCA) of the head and neck have produced high initial complete response rates, they have not improved overall survival for patients with advanced disease. Vitamin A plays an essential role in the normal differentiation of epithelial tissues. Retinoids, analogs of vitamin A, are active in certain premalignant and malignant disorders including SCCA. Six studies, including one recently reported placebo-controlled randomized trial, have demonstrated the efficacy of retinoids in oral leukoplakia. Two studies (totalling 48 patients) have shown significant retinoid activity (67% overall complete response rate) in patients with aggressive, recurrent laryngeal papillomatosis. Two trials (including a randomized phase II trial) of isotretinoin in advanced, refractory SCCA of the head and neck have produced an objective response rate of 16%, which is comparable to that reported in single agent studies with cytotoxic drugs. There is a need for further study of retinoids in head and neck cancer. The high initial response rates with current therapy and the high subsequent risks of local recurrence and of developing second primary tumors in head and neck cancer patients offer an excellent opportunity to investigate the use of retinoids as adjuvant therapy for this malignancy. PMID- 2694168 TI - Significance of blood urea nitrogen as an index of renal function in mice infected with Plasmodium berghei. AB - Parameters of renal function were evaluated in severe malarial infection, using mice infected with Plasmodium berghei. When 7-week-old male BALB/c mice were inoculated with 1 x 10(7) P. berghei NK65-infected red blood cells, the rodents died an average of 7.4 days after inoculation. Anemia developed on day 5 after inoculation and progressed markedly on days 6 and 7. Plasma urea nitrogen increased rapidly on day 6 or 7, after which death occurred within 24 h. In contrast, urinary urea nitrogen excretion decreased on the same day. Urinary beta N-acetyl-D-glucosaminidase (NAG) activity increased from day 3 to day 5, then decreased to normal levels on day 7. Renal ATP concentration and energy charge decreased markedly on day 7. These data indicate that the blood oxygen supply to the tissues began to decrease on day 6 and that renal insufficiency developed in the terminal stage of infection. We concluded that even a moderate increase in the level of plasma urea nitrogen could be a useful index of renal insufficiency in this infection system. PMID- 2694169 TI - Larvae of Taenia crassiceps (Cestoda): host specificity and localisation. PMID- 2694170 TI - The effect of tunicamycin and monensin on the association of Trypanosoma cruzi with resident macrophages. AB - The effect of incubation of parasites (epimastigote and trypomastigote forms of Trypanosoma cruzi) or macrophages in the presence of tunicamycin (TM) or monensin (M) on the parasite-macrophage association was analysed. Treatment of the parasites with TM, a drug which interferes with the process of N-glycosylation of proteins, increased by about 70% and decreased by about 27% the infection of epimastigote and trypomastigote forms, respectively. Treatment of the macrophages with TM increased by about 65% and reduced by about 45% the ingestion of epimastigote and trypomastigote forms, respectively. Treatment of the parasites or the macrophages with monensin, a drug which interferes with the sorting of membrane proteins, significantly reduced the ingestion of epimastigote and trypomastigote forms by the macrophages. The effects of both drugs were reversible. Treatment of the macrophages with trypsin followed by their incubation in fresh medium containing tunicamycin or monensin was used to analyse further the effects of these two drugs on the macrophages. The effects of the drugs on macrophages and parasites were controlled by electron microscopy. The results obtained suggest that the N-glycosylated proteins exposed on the surface of both cells are involved in the process of parasite-macrophage interaction and that interference in the process of sorting of membrane components alters the interaction. PMID- 2694171 TI - Body temperature changes during inflammation: their mediation and nutritional significance. PMID- 2694172 TI - Modification of rheumatic symptoms by diet and drugs. PMID- 2694173 TI - Complete nucleotide sequence of the rabbit beta-like globin gene cluster: insights into evolution and regulation. AB - The general pattern of sequence matches between the beta-like globin gene clusters of rabbits and humans are summarized in Fig. 7. The regions of matching sequences are shaded, and it can be seen that the matches extend from one end of the gene cluster to the other. This provides very strong evidence that the ancestral species had a gene cluster containing the parents to all the contemporary beta-like globin genes in the same arrangement that we observe today. Much of the intergenic DNA has been diverging at a rate consistent with neutral drift, but smaller regions can be detected that are diverging more slowly and which are good candidates for functional sequences. The comparisons between this same gene cluster in mouse and humans show many fewer matches in the intergenic regions (Shehee et al., 1989), indicating either an earlier split between rodents and primates or a faster rate of divergence in rodents. However, this more divergent sequence may prove particularly valuable in a search for functional sequences, especially in a three-way alignment between the sequenced gene clusters. Every repetitive element in homologous segments of the rabbit and human beta-like globin gene clusters interrupts the homology; no repeat is in the same position in both species. Hence all the repeats have been inserted into the gene clusters after the divergence between lagomorphs and primates. This is true even for the L1 repeats, which are very similar between species in their ORF regions. This pattern of interspersion of repeats in long orthologous regions shows that many members of the LINE and SINE families are recent additions to the genome, and that these repeats are in fact transposable elements. It is easy to imagine negative and neutral effects of the expansion and transpositions of these repeat families, but some positive effect has not been ruled out. One of the intriguing inferences from the observations about repeats is that the ancestral gene cluster may not have contained repetitive elements. If it did, then those repeats have been completely replaced by different repeats independently in lagomorphs and primates. PMID- 2694174 TI - Expression of human beta globin genes introduced into primitive murine hematopoietic progenitor cells by retrovirus mediated gene transfer. PMID- 2694175 TI - Very-long-chain fatty acids from the animal and plant kingdoms. PMID- 2694176 TI - Intestinal absorption and metabolism of hydrocarbons. PMID- 2694177 TI - The metabolism of glycerophospholipid and its regulation in monocytes and macrophages. PMID- 2694178 TI - [The transnasal route of drug administration. Aspects of nasal anatomy and physiology]. AB - The use of transnasal administration of drugs has gained interest with the synthesis of new polypeptidic biologically active substances. Since few years an increasing number of therapeutical hormones delivered through the nose are now available to treat disorders that only used to require parenteral injections to be effective. In its first part the present review describes the anatomy and physiology of the nose in order to gain insight in this site of delivery. The second part deals more specifically with models used to study transnasal absorption and describes parameters that modify drug absorption in relation with the model chosen. PMID- 2694179 TI - Enhanced prostaglandin production in the ischemic-reperfused myocardium by captopril linked with its free radical scavenging action. AB - Captopril, an angiotensin converting enzyme inhibitor, has been shown to increase prostaglandin production by an as yet unknown mechanism, which this study was designed to explore. Isolated rat heart was perfused by the Langendorff technique for 15 minutes in the presence or absence of captopril. Ischemia was then induced for 60 minutes by terminating the coronary flow, followed by 60 minutes of reperfusion. Our results indicate that captopril stimulated prostaglandin and thromboxane production, but it inhibited malonaldehyde formation. Coronary flow and high energy phosphate compounds were increased, but lactate dehydrogenase and creatine kinase release decreased, demonstrating cardioprotective effects. Captopril also inhibited the production of hydroxyl radical in the heart during reperfusion, suggesting that stimulated prostaglandin production may be linked with the generation of free radicals via the eicosanoid system. PMID- 2694180 TI - Arbaprostil's [15(R)-15-methyl PGE2] effects on intrauterine pressure in the nonpregnant and pregnant human female--a report of four clinical trials. AB - Four clinical trials evaluating arbaprostil's effects on the human uterus are reported. The initial two trials measured intrauterine pressures in nonpregnant and pregnant human females following arbaprostil doses of 10, 25, and/or 50 mcg. No statistical differences were found at any dosage level in either study for average uterine resting pressures, average peak pressures, the number of contractions or Montevideo units. Subsequently, two trials determined the abortifacient potential of arbaprostil in pregnant women during the first trimester. The first utilized total daily doses of 400 and 800 mcgs. while the second used total daily doses of 1200 and 1600 mcgs. Vaginal spotting was noted in one woman receiving 400 mcgs, three receiving 1200 mcgs. and in two receiving 1600 mcgs. One episode of moderate bleeding was seen in the latter study. Based on these studies, arbaprostil exhibits little potential for inducing abortifacient activity at these dosages in these patient populations. PMID- 2694181 TI - [Mental patients as psychic talents. Common neurochemical characteristics]. PMID- 2694182 TI - [Development of pharmaceutical science at universities of the GDR between 1949 and 1989]. PMID- 2694183 TI - [40 years of regulation and control by the drug service in the German Democratic Republic]. PMID- 2694184 TI - [A central institute for pharmaceutical services and medical technics-retrospect, profile, perspective]. PMID- 2694185 TI - [Development of the Pharmaceutical Society of the GDR]. PMID- 2694186 TI - [Stability and stabilization of enzymes]. PMID- 2694187 TI - [Application of ion exchangers for the preparation of biological probes in drug control]. PMID- 2694188 TI - [The contribution of German professors to pharmaceutical chemistry and phytochemistry in the 19th and 20th centuries. 40. The history of pharmaceutical science]. AB - The aim of this article is to trace some features of the historical development of phytochemistry. In the period from 1870 to 1920 pharmacy at universities attempted a new phase, the emancipation as an independent science. The article analyses the contributions to phytochemistry by the professors E. Schmidt (1845 1921), H. Thomas (1859-1931), H. Beckurts (1855-1929) and their research schools as well as those of K. Polstorff (1846-1911) and m. Scholtz (1861-1919). PMID- 2694189 TI - [Enzyme immunoassay--principles and use]. PMID- 2694190 TI - [The state of and perspectives on liposome research]. AB - Liposomes have been used for about 20 years in different fields of biological, medical and biophysical research, especially extensive for the encapsulation of pharmacologically active substances. In comparison with other drug carriers liposomes have some advantages, like variable productibility, biological degradability and relative toxicological and immunological safety. Despite these obvious advantages liposomes are not established pharmaceutical formulations, clinical trials are in the very beginning. In the submitted paper the up-to-date knowledge of liposome research with special emphasis of oncology is examined and future trends are derived. PMID- 2694191 TI - [Carl Wunibalt Otto--communist, pharmacist and chemist]. AB - Along with the cigarette factory worker P. Roser, the tailors P. J. Nothjung und F. Lessner, the editor H. Burgers, the publisher H. Becker, the clerk J. Ehrhardt and the doctors R. Daniels, J. Klein, A. Jacobi and W. Reiff, the 1852 Cologne communist trial also tried the pharmacist and chemist C. W. Otto. His life and his work for the German revolutionary worker's movement in the ninetieth century, up till now hardy mentioned, is discussed with the aid of archive sources. PMID- 2694192 TI - Imbalance of neuronal excitability as a cause of psychic disorder. AB - Electrical activity of neurons is characterized by an equilibrium between excitation and inhibition, maintained by negative feedback mechanisms at the cellular, synaptic and neurohumoral level. A central mechanism is the interaction between excitatory calcium currents and inhibitory potassium currents, linked by intracellular calcium concentration. These conductances are located in the somato dendritic part of the neuron and fundamentally influence spontaneous activity and the processing of synaptic input. The electrical equilibrium is altered by different neuromodulators, such as biogenic amines, peptides, and steroids and by several drugs. Neuromodulatory desequilibration towards increased excitability may occur task-related in a transient way or in a cascade of desequilibrating and partially compensating mechanisms, producing distinct grades of functional impairment. Pharmacotherapeutic principles interfere with this process. It is postulated, that the imbalance between excitation and inhibition is a central factor in the origin of psychic disorder. PMID- 2694193 TI - The Erlangen micro-lightguide spectrophotometer EMPHO I. AB - The Erlangen micro-lightguide spectrophotometer EMPHO 1 was designed for fast diffuse reflection (remission) spectrophotometry in small tissue volumes. The aim was to construct a compact, modular instrument with a high repetition rate which can be adapted to moving organs, e.g. the beating heart in situ, by the use of highly flexible micro-lightguides. Focusing problems, which cannot be solved when conventional optical devices such as microscopes are used in moving tissues, become negligible. A bandpass interference filter disk, which is rotated by a motor serves as a monochromating unit. One diffuse reflection spectrum in a selected wavelength domain is recorded during each revolution of the motor. Special filter disks, with spectral ranges of 400-520, 500-630, 600-1200 nm can be used for different tasks. The monochromated light is transmitted by means of a flexible fluid-lightguide to a photomultiplier tube. The electrical signal, which is proportional to the light intensity is recorded by an IBM-compatible AT. An analogue to digital converter has been developed for the AD conversion. Sampling of the spectra occurs in steps of 2 nm triggered by a decoding unit, containing an EPROM where the function between the wavelength-angular position characteristic of the filter disk is stored. A decoder wheel mounted on the same axle as the driving motor is used to program the decoder unit and to recall the wavelength position function. The decoding procedure enables a high wavelength reproducibility to be attained. The monochromating device allows a sampling velocity of 100 spectra per second. The EMPHO I has been successfully applied to experiments in the beating heart, the brain, the eye, the liver, the small intestine and the skeletal muscle of mammals. First investigations have also been performed in the heart during open heart surgery and in human skin. The apparatus has a high sampling rate and the small catchment volume allows measurements of remission spectra in tissue volumes supplied by only a few capillaries. The absolute oxygenation and the relative haemoglobin concentration can be determined by on-line computer evaluation of the recorded spectra and displayed on a screen. PMID- 2694194 TI - Residual DNA-bound proteins are a source of in vitro transcription inhibitor peptides. AB - Enzymatic breakdown of residual proteins occurs at mild alkaline pH (pH optimum 8.5) as monitored by using radioiodinated, purified genomic DNA from calf thymus. These DNA fibers also possess a differential ability to hydrolyze added exogenous small and linker histones. The results described argue strongly that a putative protease activity, co-purified with DNA, is the source of short chain peptides which inhibit transcription in vitro3. Therefore, we propose that RNA repressor peptides must be of higher molecular weight than previously reported. PMID- 2694195 TI - Effects of field orientation during 700-MHz radiofrequency irradiation of rats. AB - Ketamine-anesthetized Sprague-Dawley rats were exposed to far-field 700-MHz continuous-wave radiofrequency radiation (RFR) in both E and H orientations. Irradiation was conducted at whole-body average specific absorption rates (SARs) of 9.2 and 13.0 W/kg (E and H, respectively) that resulted in approximately equivalent colonic specific heating rates (SHRs). Exposures were performed to repeatedly increase colonic temperature by 1 degree C (38.5 to 39.5 degrees C). Tympanic, tail, left and right subcutaneous (toward and away from RFR source), and colonic temperatures, arterial blood pressure, and respiratory rate were continuously recorded. In spite of equivalent colonic SHRs and the reduced E orientation average SAR, the right subcutaneous, tympanic, and tail SARs, SHRs and absolute temperature increases were significantly greater in E than in H orientation. The cooling rate at all monitoring sites was also significantly greater in E than in H orientation. Heart rate and mean arterial blood pressure significantly increased during irradiation; however, changes between orientations were not different. Respiratory rate significantly increased during irradiation in H, but not in E orientation. These results indicate that during resonant frequency irradiation, differences occur in the pattern of heat deposition between E- and H-orientation exposure. When compared with previous investigations performed at supraresonant frequencies, the lower level of cardiovascular change in this study was probably related to the lower periphery-to-core thermal gradient. PMID- 2694196 TI - [The ethical views of Antoni Kepinski]. PMID- 2694197 TI - [Nursing is my life (Maria-Irena Nieliwodzka)]. PMID- 2694198 TI - Polysaccharides in pharmacy: current applications and future concepts. AB - Polysaccharides constitute a structurally diverse class of biological macromolecules with a wide range of physicochemical properties, which are the basis for the different applications in the broad field of pharmacy and medicine. Besides the classical applications of these biopolymers in industry and pharmaceutical practice, the relatively new field of the physiologically active polymers will be discussed. Some examples will be given for the so-called immune modulating antitumor polysaccharides which have been shown to be prominent candidates for an adjuvant tumor therapy. PMID- 2694199 TI - [Self evaluation questionnaires for clinical psychodiagnosis in school-age children]. AB - A survey of the literature is given on methodological problems associated with, and results of, the clinical diagnosis of personality in school age with questionnaires for self-evaluation. Further is given an outline of a number of major personality inventories used in (german) practice. Finally are presented the results of validation and standardisation gained with two children's inventories (PF/SF) for the multidimensional registration of psychic and social features of behaviorally disturbed children. PMID- 2694200 TI - [Georg Ilberg (1862-1942). His life and medical-humanistic legacy]. AB - Georg Ilberg, who is almost forgotten nowadays, was a scholar of Kraepelin and Ganser. From 1910 to 1928 he was director of the Landes-Heil- und Pflegeanstalt (country mental hospital) for mental patients Sonnenstein at Pirna. He was active in the scientific-literary field to a great age and worked as editor of the Allgemeine Zeitschrift fur Psychiatrie from 1924 to 1934. Although he principally advocated the exclusion of certain mental patients from reproduction at the beginning of the 1930s, in a review in 1942, his integer humanist basic position and his pronounced social feeling made him to protest in public against the putting to death of mental in-patients. PMID- 2694201 TI - Clomipramine and EEG sleep in depression. AB - Recent studies with clomipramine (CMI) have demonstrated that a pulse-loading approach is associated with a rapid improvement in symptomatology in the absence of continuous treatment. In the present study, sleep changes were evaluated to ascertain the rapidity of clomipramine's effect on electroencephalographic sleep, especially rapid eye movement (REM) and delta wave sleep measures. Clomipramine produced rapid changes in sleep with reduced sleep continuity and almost complete suppression of REM sleep as well as a redistribution of slow wave sleep. Delta waves during sleep were also found to be shifted to the earlier part of the night and increased in intensity. Spectral analysis revealed an increase in power in the delta frequency range that was correlated with clinical responsiveness. These studies point toward a role for clomipramine in the rapid treatment of depression and confirm that sleep physiology may be a good predictor of antidepressant action. PMID- 2694202 TI - The introductory placebo washout: a retrospective evaluation. AB - We examined the effects of the "introductory placebo washout" technique by reanalyzing the results of a recent trial of an experimental antidepressant. At the beginning, all patients were placed on placebo in a single-blind design. Patients who were rated as placebo responders with the physician-administered Hamilton Rating Scale for Depression (HRSD) were excluded from the trial. In spite of this technique, an alternative measure of depression indicated that many patients with a positive response to placebo had been entered in the trial. In the reanalysis, elimination of these "hidden placebo responders" did not lower the final placebo response rate and actually diminished the differences observed at the end of the study between the active treatment and placebo groups. These data suggest that the introductory placebo washout may have unpredictable, possibly confounding effects on patient samples in trials of antidepressant agents. PMID- 2694203 TI - HPA axis disturbance in obsessive-compulsive disorder. AB - Twenty nondepressed outpatients with DSM-III obsessive-compulsive disorder entered a 10-week placebo-controlled study of clomipramine and underwent a 1-mg dexamethasone suppression test (DST) at baseline; 11 had a repeat DST at the end of treatment: Nonsuppression was rare. When compared to 82 previously described outpatients with panic disorder studied in a similar fashion, OCD patients had postdexamethasone cortisol values that were substantially lower and more stable over time. Results within the OCD group closely resembled those from a group of never-ill controls. PMID- 2694204 TI - Memory for action events: a new field of research. PMID- 2694205 TI - Anorexia nervosa, Felix Deutsch, and the associative anamnesis: a psychosomatic kaleidoscope. AB - An abiding mystery of the mind-body connection is that it should seem mysterious at all--an indication, perhaps, of how deeply conditioned we have been by "dualism." That doctrine, laid down more than three centuries ago by French philosopher Rene Descartes, sees mind and body as distinct entities, to be treated separately. It became the paradigm for medicine, and still dominates medical thinking. PMID- 2694206 TI - [What protects health? On the research status and importance of personal resources in managing daily stresses and life change events]. AB - In recent developmental and psychosomatic studies the focus shifts from pathogenic to health protective factors. Literature on coping with daily stresses, life events and biographic determinants is reviewed. Despite conceptual (negative health definitions, divergent theoretical backgrounds and values) and methodological problems (reliance on self-report and trait measurement) moderate, however consistent health protective affects of personal resources are shown. These are mainly generalized attitudes of persons toward self and their environment (e.g. optimism, internal locus of control, self-efficacy, commitment). Contrasting influential concepts (sense of coherence, hardiness) the bias toward self-reliant, internal control as health protective resource is criticized and a plea is made for conjoint consideration of health-protective influences of social relationships. PMID- 2694207 TI - A "class A" institution: the struggle for the University of Puerto Rico School of Medicine. AB - Although the possibility of developing a medical school in Puerto Rico surfaced periodically between 1900 and 1940, it was not until World War II, when the military draft uncovered the poor conditions of the Puerto Rican population and deprived the island of many physicians, that a doctor shortage was discovered and pressures for the creation of a medical school mounted. University authorities and the A.M.A. conducted separate studies to determine the viability of such a school; both concluded that Puerto Rico could support a medical college, but endorsed only a "Class A" school. There was less of a consensus concerning the benefits and objectives of the school, its location, and the relationship between the proposed institution and the existing School of Tropical Medicine. These issues embroiled a number of academic and political parties in a struggle which lasted five years. PMID- 2694208 TI - Antiphospholipid antibodies and disease. PMID- 2694209 TI - The clinical and renal biopsy predictors of long-term outcome in lupus nephritis: a study of 87 patients and review of the literature. AB - The prognostic markers in 87 consecutive patients with lupus nephritis who underwent renal biopsy are reported for five clinically relevant long-term outcomes--renal insufficiency, renal failure, death due to renal systemic lupus erythematosus, death due to non-renal SLE and death due to SLE, both renal and non-renal. We have demonstrated that a number of previously neglected or rarely studied predictors were important prognostic markers. These included the duration of renal disease before biopsy, overall severity of SLE, as well as the presence of vasculitis, hypertension or a comorbid ailment. Furthermore, the study confirms the predictive importance of serum creatinine, 24-h urinary excretion of protein, C3, and of the activity and chronicity indices on biopsy. However, overall a simple measure of tubulointerstitial disease was the best predictor obtained from biopsy. Prognostic models based on clinical data alone were developed for each of the five outcomes. The models amplify our clinical understanding of lupus nephritis. Markers of renal severity were most important in predicting renal outcomes such as renal insufficiency and renal failure. Prognostic factors less directly related to renal disease (comorbidity and vasculitis) were important predictors of fatality. A marker of immunologic disease activity (C3) was a valuable predictor for many of the outcomes. Thus markers of disease severity reflecting organ damage due to SLE and other comorbid conditions could be combined with markers of immunologic activity to predict a variety of outcomes of relevance to a clinician. When biopsy data obtained by light or electron microscopy were evaluated for their ability to add new predictive information to the clinical models, only a limited value for biopsy was noted. It is likely that this reflected the close correlational relationships between clinical and biopsy variables, the strong clinical models generated, and the inclusion in the clinical models of the previously neglected clinical variables, duration of renal disease before biopsy and the presence of vasculitis or comorbid disease. PMID- 2694210 TI - Management of the anaemia of chronic renal failure with recombinant erythropoietin. PMID- 2694211 TI - Outcome of end-stage renal disease in patients with rare causes of renal failure. II. Renal or systemic neoplasms. AB - We describe a large experience with patients with end-stage renal disease (ESRD) whose primary cause was considered multiple myeloma, renal cell carcinoma and amyloidosis. Data were obtained by a collaboration of the majority of the ESRD Networks of the United States. The data presented reflect recent practice in the United States. Even though it is likely that some selection bias plays an important role, the demographic characteristics, choice of early treatment and overall survival data provide some assistance to physicians when advising their patients with these rare conditions. More detailed analyses are needed to assess the outcome by choice of treatment as well as the age- and treatment-adjusted survival for these diagnoses. PMID- 2694212 TI - Failla memorial lecture. The search for critical cellular targets damaged by heat. PMID- 2694213 TI - Changes of lipofuscin-like pigments in erythrocytes and spleen after whole-body gamma irradiation of rats. AB - Whole-body gamma irradiation of rats induced the formation of lipofuscin-like pigments in erythrocytes. Erythrocytes that were damaged by oxidation were scavenged in the spleen, and lipofuscin-like pigments were transferred from erythrocytes to the spleen during this process. The time course of lipofuscin like pigments in erythrocytes and spleen indicates that the pigments were not induced by the action of free radicals produced by ionizing radiation but rather were a sequela of postirradiation metabolic changes. PMID- 2694214 TI - Radioresistance induced by oncogenic transformation. AB - Rat embryo cells at various stages of oncogenic transformation are obtained by a combination of X irradiation and transfection with the ras and the myc oncogenes. Transfection with either the ras or the myc oncogenes can lead to increased radioresistance, relative to the parental cells. X-ray-transformed clones of the transfected cells do not show additional alteration in radioresponse. Incorporation of the two oncogenes appears to lead to a higher degree of radioresistance. PMID- 2694215 TI - Accelerated heavy ions and the lens. IV. Biomicroscopic and cytopathological analyses of the lenses of mice irradiated with 600 MeV/amu 56Fe ions. AB - The lenses of mice exposed to 600 MeV/amu iron ions were evaluated by slit-lamp biomicroscopy and cytopathological analyses. The doses ranged from 0.05 to 1.6 Gy, and the lenses were assessed at several intervals postirradiation. Cataract, the development of which is dependent on both time and dose, is significantly more advanced in all of the exposed mice when compared to the unirradiated controls. The great difference between the severity of the cataracts caused by 0.05 Gy (the lowest dose used) and those that developed spontaneously in the control animals is an indication that 0.05 Gy may far exceed the threshold dose for the production of cataracts by accelerated iron ions. Cytopathologically, a similar dose dependence was observed for a number of end points including micronucleation, interphase death, and meridional row disorganization. In addition the exposure to the 56Fe ions produced a long-term effect on the mitotic population and a pronounced "focal" loss of epithelial cytoarchitecture. The microscopic changes support the view that the mechanism of heavy-ion-induced cataractogenesis is the same as that for cataracts caused by low-LET radiation. PMID- 2694216 TI - Additivity in the sensitizing effects of nitrous oxide and oxygen. AB - In earlier work, we proposed that nitrous oxide (N2O) and low concentrations of oxygen (10(-6) less than [O2] less than 10(-4) mol dm-3) share a common sensitizing mechanism. We also proposed that the basis for sensitization by N2O is different from that by high concentrations of oxygen ([O2] greater than 10(-4) mol dm-3). We have now tested these proposals with several Escherichia coli strains using mixtures of O2 and N2O. In the strains that are sensitized by N2O, we found that damage from low concentrations of O2 does not add to that from N2O. In contrast, we did find additivity in the sensitizing effects of N2O and high concentrations of O2. In those E. coli strains that are not sensitized by N2O, the effects of any concentration of O2 are the same in either N2 or N2O. These results are qualitatively the same as those from our previous study with E. coli B/r, and they support our proposals concerning similarities and differences in sensitizing mechanisms of N2O and O2. PMID- 2694217 TI - [Role of the genotype in the mutagenic action of radiation with different LET on cells of Escherichia coli]. PMID- 2694218 TI - [Type D and A Clostridium botulinum in necropsy samples from bovines with "mal de Aguapey"]. AB - Bacteriological studies were carried out on several necropsy samples from five animals whose deaths had been attributed to bovine botulism. This disease, regionally called Mal de Aguapey, enzootically affects animals from a wide area of the north-east of Argentina (Province of Corrientes) with a bovine population estimated at near to 2,500,000. Either C. botulinum type D, its toxin or both were identified in all animal samples, alternatively in contents of rumen, jejunum, ileum, caecum and in samples of spleen, liver and kidney (Table 1). C. botulinum type A was isolated respectively from the liver and the kidney of two animals. Cultures of 100 soil samples taken in the enzootic area were positive only for C. botulinum type A (3%). These results enlarge and confirm previous findings and lend support to the botulinic etiology of the Mal de Aguapey. PMID- 2694219 TI - [Use of formalinized epimastigotes for the detection of anti-Trypanosoma cruzi antibodies using immunoenzyme technics]. AB - Formalin-fixed epimastigotes of T. cruzi were employed to develop an ELISA and a Dot-immunobinding assay (Dot-IA). The results were compared with those obtained by the indirect fluorescent antibody test (IFA). Fifty positive and twenty negative sera for Chagas disease, supplied by the reference center (Institute Mario Fatala Chaben, Buenos Aires, Argentina), were analyzed. When the quantitative indirect ELISA was performed, no overlapping between positive and negative sera was observed and the correlation with IFA was 100%. The sensibility of Dot-IA was greater than that of IFA with 2.5% of false positives. Dot-IA performed with epimastigotes is a simple and qualitative test which could be applied for screening of blood donors. On the other hand, the ELISA presented here is an objective test which does not require specialized equipment and could replace with advantage the IFA test for the serodiagnosis of Chagas' disease. PMID- 2694220 TI - Integrated function of neurones in the rostral ventrolateral medulla. PMID- 2694221 TI - The selectivity of descending vasomotor control by subretrofacial neurons. PMID- 2694222 TI - Adrenergic neurons in the rostral ventrolateral medulla: ultrastructure and synaptic relations with other transmitter-identified neurons. AB - The first part of this chapter demonstrates that the C1 adrenergic neurons have high mitochondrial content and a close proximity to capillaries and glia suggestive of a high metabolic activity and a possible chemosensory function. Adrenergic terminals arising primarily from these neurons (1) can influence sympathetic nerve discharge through direct contacts on sympathetic preganglionic neurons in the IML of the spinal cord; and (2) are one of the more prevalent synaptic inputs to the principally noradrenergic neurons in the locus coeruleus. In both the IML and locus coeruleus, adrenergic terminals may be either excitatory (asymmetric synapses) or inhibitory (symmetric synapses) depending on their distribution on the post-synaptic target. The second part of this chapter shows that C1 adrenergic neurons in the RVL are modulated by synaptic associations with a variety of transmitter systems (see schematic Fig. 8). Specifically, C1 adrenergic neurons receive (1) major inhibitory input (symmetric synapses) from GABA-ergic and opioid terminals as well as from unidentified (unlabelled) transmitter-containing terminals; (2) major excitatory input (asymmetric synapses) from terminals containing substance P as well as other unidentified terminals and (3) minor inputs from cholinergic, adrenergic and noradrenergic pathways. Moreover, cholinergic terminals in the RVL form symmetric synapses mainly on unidentified transmitter-containing neurons rather than the C1 neurons suggesting that the reported cardiovascular effects of cholinergic agents in the RVL are most likely mediated via inhibitory interneurons. Within the RVL, adrenergic and noradrenergic terminals innervate cholinergic and opioid neurons. Thus, these results not only provide direct evidence that a number of transmitters modulate the activity of C1 adrenergic neurons, but also suggest new directions for studies of functional interactions involving catecholaminergic regulation of other transmitter-containing neurons within the RVL. PMID- 2694223 TI - Control of neurosecretory vasopressin cells by noradrenergic projections of the caudal ventrolateral medulla. AB - Activation of noradrenergic afferents arising from the A1 cell group of the caudal VLM excites neurosecretory AVP cells of both the supraoptic and paraventricular nuclei, thus stimulating the release of this potent vasoconstrictor into the circulation. Although this effect is mimicked by application of alpha 1-adrenoreceptor agonists to AVP cells, the excitatory effects of A1 afferents may not be mediated by activation of post-synaptic alpha 1-receptors. Evidence has also been obtained that the actions of A1 afferents are not dependent upon the release of excitatory amino acids or NPY, although the latter is co-stored with NA in A1 cells and potentiates the actions of low concentrations of NA on AVP cells. Although a projection to AVP and OXY neurosecretory cells from the A2 NA cell group of the NTS has been established, this projection does not appear to contribute directly to the control of SON AVP cell activity. Rather, NTS stimulation excites SON AVP cells via a relay projection through the A1 cell group. This pathway is likely to correspond to that involved in the stimulatory effects of haemorrhage and caval constriction on AVP secretion, although it is uncertain whether the effects of these particular stimuli are contingent upon unloading of arterial baroreceptors and atrial stretch receptors, as commonly presumed, or upon the activation of other receptors such as ventricular mechanoreceptors or chemoreceptors. On balance, current evidence suggests that the A1 projection is unlikely to be critically involved in mediating the effects of arterial baroreceptor, arterial chemoreceptor, or atrial stretch receptor activation on AVP cells. PMID- 2694224 TI - Central control of the circulation by the rostral ventrolateral reticular nucleus: anatomical substrates. PMID- 2694225 TI - Inhibitory vasomotor neurons in the caudal ventrolateral region of the medulla oblongata. PMID- 2694226 TI - Cognitive enhancers: potential strategies and experimental results. AB - 1. Cognitive impairments follow natural processes such as aging, diseases, exposure to neurotoxins, and traumatic injury. In all of these instances, the brain possesses some capability for recovery. 2. A cognitive enhancer is any compound that will help this recovery occur more rapidly, or increase the final level of performance. 3. This chapter describes the types of strategies that can be used to develop a cognitive enhancer with emphasis on studies of the cholinergic system. PMID- 2694227 TI - Human neuroethology of emotion. AB - 1. Based on ethological theory, the question of what is the difference between human and nonhuman primate emotionality is investigated. 2. The anatomical basis for this difference is the greater number of neurons in the anterior thalamic nuclei in humans than in monkeys and apes. This may represent an increased differentiation of the limbic message being sent to the cortex. 3. Only humans can report about experiences and subjective feelings in certain motivational states. The two most general states are wakefulness and sleep. The subjective aspect of (desynchronized) sleep is dreaming. The causal relationship between dreaming and certain lower brain stem mechanisms is analysed. 4. Whereas the motor system is usually blocked during desynchronized sleep, there are individuals who voice their emotions and speak while sleeping. As there are essential differences in the substrates for the voluntary control of the voice in the human and nonhuman primates there are essential differences in the voluntary control of emotions. 5. Similar to the motor matching theory of speech perception a motor matching process of affect perception is suggested. 6. The evolutionary change in the human motivational system is thought to be one of several prerequisites for the evolution of language. PMID- 2694228 TI - Attack and defense in rodents as ethoexperimental models for the study of emotion. AB - 1. In wild and laboratory rats, offense and defense constitute nonoverlapping behavior patterns seen in response to resource or dominance challenge, or, to predatory, conspecific or environmental threat, respectively. 2. Defensive behaviors are determined by both the threat stimulus and the situation. Defense patterns to discrete, approaching, predators or conspecifics and to nondiscrete, potential, threat have several behaviors in common. However, the latter also includes an important risk assessment complex not seen to discrete, present, threat. Behaviorally and functionally, risk assessment shows considerable similarity to the apprehensive expectation and vigilance and scanning components of generalized anxiety reactions. 3. There are parallels between lower mammal offense and human angry aggression in terms of eliciting stimuli, and a variety of experiential factors including inhibition by fear/pain, and reinforcement effects. 4. A variety of neuroanatomical or pharmacological manipulations have different, often opposite, effects on offense and defense. Differentiation of the two and attention to the specific behaviors involved provide a more precise basis for the use of these patterns as animal models of emotion states. PMID- 2694229 TI - Can the pattern of neuropsychological improvement obtained with cholinergic drugs be used to infer a cholinergic mechanism in other nootropic drugs? AB - 1. Enhancement of episodic memory and reduction of intrusion errors are considered as the most characteristic outcome of cholinergic drugs administration in AD patients. 2. Since the nootropic drugs Piracetam and Oxiracetam are deemed to act through a cholinergic mechanism, we checked whether AD patients treated with these drugs would show the same pattern of neuropsychological improvement. 3. Results were negative, since (a) episodic memory showed a similar degree of improvement both in patients treated with these drugs and in patients treated with placebo; (b) the number of intrusions tended to increase, rather than to decrease, after the treatment period. PMID- 2694230 TI - Trends in searching for new cognition enhancing drugs. AB - 1. The great interest for new drugs having cognition enhancing properties is highlighted, particularly for the treatment of dementia of Alzheimer type. 2. A short survey is given of the pharmacological models currently used to mimic cognitive impairment. 3. A systematic survey is given of the major cognition enhancing drugs and of the new compounds showing activity. PMID- 2694231 TI - Nootropic drugs and brain cholinergic mechanisms. AB - 1. This review has two aims: first, to marshal and discuss evidences demonstrating an interaction between nootropic drugs and brain cholinergic mechanisms; second, to define the relationship between the effects on cholinergic mechanisms and the cognitive process. 2. Direct or indirect evidences indicating an activation of cholinergic mechanisms exist for pyrrolidinone derivatives including piracetam, oxiracetam, aniracetam, pyroglutamic acid, tenilsetam and pramiracetam and for miscellaneous chemical structures such as vinpocetine, naloxone, ebiratide and phosphatidylserine. All these drugs prevent or revert scopolamine-induced disruption of several learning and memory paradigms in animal and man. 3. Some of the pyrrolidinone derivatives also prevent amnesia associated with inhibition of acetylcholine synthesis brought about by hemicholinium. Oxiracetam prevents the decrease in brain acetylcholine and amnesia caused by electroconvulsive shock. Oxiracetam, aniracetam and pyroglutamic acid prevent brain acetylcholine decrease and amnesia induced by scopolamine. Comparable bell shaped dose-effect relationships result for both actions. Phosphatidylserine restores acetylcholine synthesis and conditioned responses in aging rats. 4. The mechanisms through which the action on cholinergic systems might take place, including stimulation of the high affinity choline uptake, are discussed. The information available are not yet sufficient to define at which steps of the cognitive process the action on cholinergic system plays a role and which are the influences of the changes in cholinergic function on other neurochemical mechanisms of learning and memory. PMID- 2694232 TI - Pre-clinical evaluation of cognition enhancing drugs. AB - 1. The need of the treatment of cognitive impairment due to aging or dementia has led to the search for potential cognition enhancing drugs. The various compounds presently under development represent an alternative to the cholinomimetic therapy and include new chemical entities as well as piracetam and its newer analogs. 2. Recent results from pre-clinical evaluation of the effects on learning on memory are summarized. Emphasis is put on learning and memory experiments under normal and pathological conditions. Most of the nootropics attenuate experimental amnesias induced by scopolamine, cycloheximide, ECS, hemicholinium-3 or forebrain ischemia. These findings suggest that the nootropics may be influencing a common mechanism underlying the amnesias. 3. Biochemical data suggest a potential cholinergic neuronal activity of some of the piracetam analogs. They increase high-affinity choline uptake, and antagonize scopolamine- and ECS-induced decreases in acetylcholine concentrations in the hippocampus. The mode of action of these and all other nootropic compounds, however, is still not known. 4. Despite the interesting results from learning and memory studies and from biochemical investigations, the clinical relevance of these results for amelioration of the cognitive impairment in humans remains to be proven for most of the compounds. PMID- 2694233 TI - Fractionated total body irradiation and allogeneic bone marrow transplantation for standard risk leukemia. AB - From March 1982 to December 1986, 32 patients with standard risk leukaemia were conditioned for allogeneic bone marrow transplantation (BMT) with low dose fractionated total body irradiation (TBI) after infusion of alkylating agents. This series includes six children and 26 adults. Minimal follow-up was 24 months. The total dose of 11 Gy, given in 5 daily fractions of 2.20 Gy, was given in the lateral position, following chemotherapy with either melphalan or cyclophosphamide. Lungs were shielded for 2 out of the 5 fractions. All patients had in vivo dosimetry. The death rate is 25% without relapse or rejection. Disease-free survival is 73% at 5 years. Toxic deaths are detailed: 2 from sepsis and veino-occlusive disease of the liver, 3 from severe graft versus host disease (GVHD), 2 from GVHD associated with virus pneumonitis and one from HIV infection. Fractionated low dose rate TBI is discussed regarding its decreased toxicity and its efficiency for disease control. PMID- 2694234 TI - Simple exercise testing. PMID- 2694235 TI - The place of lung 99mTc DTPA aerosol transfer in the investigation of lung infections in HIV positive patients. AB - Pneumocystis carinii pneumonia (PCP) is the most common cause of pneumonia in HIV antibody positive patients, but other pneumonias remain important, i.e. streptococcal and mycobacterial infections. A definitive diagnosis relies on obtaining samples from the lung either noninvasively (induced sputum), or invasively (bronchoalveolar lavage, transbronchial or open lung biopsy). We have used the noninvasive technique of nebulized 99mTc DTPA transfer, to assess patients with PCP (n = 30) and other lung infections (n = 20) to see whether this test will distinguish between the various infections. The presence of a biphasic, rapid transfer curve indicates severe extensive alveolar damage and is seen in PCP or legionella pneumonia. The mean transfer time (T50 +/- SEM) for patients with PCP (whether smokers or nonsmokers) was 2.1 +/- 0.2 min, and for two of the patients with legionella 3.2 min. In PCP effective treatment causes the transfer to slow (mean T50 22.7 +/- 3.3 min, n = 24) and become monoexponential. Other causes of these changes in transfer are discussed. The other pneumonias (streptococcal, mycobacterial, and staphylococcal) did not result in biphasic curves or very rapid times, their T50 values are indistinguishable from cigarette smokers. In this patient group the DTPA transfer is a useful noninvasive investigation with a very rapid, biphasic curve indicating a high probability of PCP. PMID- 2694236 TI - Pulmonary involvement in systemic sclerosis: the detection of early changes by thin section CT scan, bronchoalveolar lavage and 99mTc-DTPA clearance. AB - Systemic sclerosis is frequently complicated by fibrosing alveolitis although clinical and radiological abnormalities are not usually apparent until the lung disease is well established. The aim of this study was to investigate pulmonary involvement in systemic sclerosis by thin section CT scan, bronchoalveolar lavage (BAL) and 99mTc-DTPA clearance studies, and assess the value of these tests in defining pulmonary abnormalities in patients with a normal chest radiograph. Patients were divided into those with an abnormal chest radiograph (Group I, n = 14) and those with a normal chest radiograph (Group II, n = 16). CT scans were abnormal in all patients in Group I and 7 of 16 (44%) in Group II. BAL inflammatory cell counts were raised in all 12 (100%) patients studied in Group I and 11 of 15 (73%) in Group II. There was no difference in the type of inflammatory cells observed between the two groups. 99mTc-DTPA clearance was faster than normal controls in ten of 14 patients (71%) in Group I and seven of 15 (47%) in Group II and correlated with carbon monoxide transfer factor (P less than 0.05). Lung biopsies were performed on nine patients in Group I and three in Group II all of whom had abnormal CT scans. Fibrosing alveolitis was confirmed in every case. Group II biopsies could not be distinguished from Group I biopsies; both showed fibrosis as well as inflammation suggesting that pulmonary fibrosis is an early abnormality in systemic sclerosis. Our results indicate that CT scans, BAL and 99mTc-DTPA are frequently abnormal in asymptomatic patients with systemic sclerosis who have normal chest radiographs. When the CT scan is normal abnormalities of BAL and/or 99mTc-DTPA (99mTechnetium diethylenetriamine pentacetate) clearance may indicate lung disease at a still earlier stage. This observation requires further investigation. PMID- 2694237 TI - [Traumatic lesions of the radial nerve of the arm]. AB - The authors analyse their experience with 63 lesions of the radial nerve in the upper arm. 39 cases were associated with fractures of the humeral shaft, 20 cases with open wounds or nerve contusions, and 4 cases with grade 3 complicated humeral fractures with neurovascular lesions. In contusions and open wounds the indication for nerve reconstruction is obvious and results are good or very good after graft-reconstruction or suture. In closed humeral fractures, the results of nerve reconstructions and the improvement of microsurgical techniques, together with precise indications are in favor of treatment of radial nerve lesions by suture or graft-reconstruction. Muscular transfers are only secondary procedures to the nerve reconstruction itself. The indications for treatment in emergency of fractures of the humeral shaft associated with radial nerve palsy, depend on the type of fracture, the associated lesions and the cutaneous status. An osteosynthesis is desirable in specific situations, like in poly-traumatised patients or multiple-level fractures of the upper limb, and an exploration of the radial nerve will be done during exposure. We believe also that an osteosynthesis with exploration of the radial nerve is indicated in severely displaced fractures, in particular in oblique or spiral midshaft fractures, and in fractures of the distal third of the humerus, because in this type of fracture a majority of radial nerve lesions, accessible to direct suture are found. In all the other cases, conservative treatment remains indicated with clinical and electromyographical follow-up and exploration two months after fracture union, in the rare cases of absence of recovery. PMID- 2694238 TI - [Valve diseases (II). Physiopathology of pressure and volume overloads in the left ventricle secondary to valve disease]. PMID- 2694239 TI - [Barrett esophagus: epidemiologic data and risk of becoming malignant]. AB - A series is presented of 152 patients diagnosed over a 9-year period by endoscopy and biopsy as Barrett's esophagus. We analyzed epidemiological data and the risk of malignancy, and calculated the prevalence and incidence in our series. PMID- 2694241 TI - [Vagotomy of oxyntic cells as treatment of gastric ulcer]. PMID- 2694240 TI - [Pyogenic hepatic abscesses: role of ultrasonography in their diagnosis and treatment]. AB - We present 26 cases of pyogenic hepatic abscess diagnosed by echography, 14 of which were treated by percutaneous drainage guided by ultrasound. An analysis is made of the clinical and radiological findings, as well as the differential diagnosis of focal hepatic lesions. Due to the lack of clinical specificity in many patients, we recommend fine needle biopsy directed by ultrasound to confirm the suspicion of pyogenic hepatic abscess and isolation of noncausative microorganisms. We think that the treatment of choice in these patients is percutaneous drainage guided by echography. PMID- 2694242 TI - [Lipoma of the stomach. Presentation of a case and a review of cases reported in Spain]. AB - Gastric lipoma is an infrequent benign submucosal tumor that is usually asymptomatic. In view of the few reports of this pathology in the Spanish and international bibliography, a new case that debuted as massive upper gastrointestinal hemorrhage is communicated. We reviewed the cases published in Spain to date, emphasizing the methodology of preoperative diagnosis, with special attention to the endoscopic signs characterizing gastric lipoma and computerized axial tomography, which is now viewed as the technique of choice. Therapeutic options are discussed. PMID- 2694243 TI - [Current radiologic diagnosis of retained surgical gauze]. AB - Four cases are presented of surgical compresses retained in the abdominal cavity that were studied by simple radiology, gastrointestinal transit, echography and/or computerized tomography. Depending on their location, they appeared as heterogeneous intra- or extraluminal masses, often containing air or calcifications. The radiological findings, as well as the existence of surgical antecedents, allowed the preoperative diagnosis of the lesion in all the cases. PMID- 2694244 TI - Renal uptake and degradation of trapped-label insulin. AB - In order to study the kinetics of insulin degradation in the kidneys and liver, insulin was labelled by a trapped-label procedure and injected into rats. In contrast to conventional 125I-insulin, the trapped-label preparation allows quantitative measurements of the extent of degradation in vivo because the final degradation products do not leave the cells. One hour after injection, the amount of radioactivity in the kidneys from a trace dose of trapped-label insulin was 10 times higher that from conventionally labelled insulin; over 80% of the increase was due to low molecular weight degradation products which were retained in the kidneys. The amount of acid-precipitable radioactivity in the blood was the same for both labelled preparations, indicating that their rates of clearance were similar. In the kidney, we detected no degradation products of molecular weight intermediate between intact insulin and the end products of proteolysis. After 2 h, 33% of the injected dose remained in the kidneys and only 13% in the liver. Over 80% of the renal radioactivity was sedimentable in an isotonic density gradient, indicating that intact insulin, as well as degradation products in the cells, were enclosed within membrane-bound vesicles. PMID- 2694245 TI - Mollicutes DNA polymerases: characterization of a single enzyme from Mycoplasma mycoides and Ureaplasma urealyticum and of three enzymes from Acholeplasma laidlawii. AB - The DNA polymerase activity of different members of Mollicutes was studied. A single DNA polymerase was found in Mycoplasma mycoides and Ureaplasma urealyticum, type species of the genera Mycoplasma and Ureaplasma, and was compared with the previously described Mycoplasma orale enzyme. Most of their properties were comparable; an immunological relationship was demonstrated between M. orale and M. mycoides enzymes by immunoblotting. In contrast to these results, three different DNA polymerases were purified in Acholeplasma laidlawii, type species of the genus Acholeplasma which, in this aspect, resembles the genus Spiroplasma. A 3'-5' exonuclease activity was found in the different purified preparations. In M. mycoides, M. orale and one of the three A. laidlawii preparations, the 3'-5' exonuclease could be separated from the DNA polymerase by non-denaturing PAGE. The presence of a single DNA polymerase seems to be a typical feature of the Mycoplasmataceae, which include the genera Mycoplasma and Ureaplasma, in contrast to the occurrence of three enzymes within the Acholeplasmataceae and Spiroplasmataceae. These results are in agreement with the phylogenetic tree of Mollicutes proposed from their 5 S and 16 S rRNA sequence comparisons, in which the evolution of Acholeplasma and Spiroplasma branches led, by genome reductions, to Mycoplasma and Ureaplasma species. PMID- 2694246 TI - Evidence for broken minocycline by NMR and HPLC techniques: a new additional resistance mechanism mediated by tetB determinant. AB - As demonstrated by microbiological assays, a decrease in the active minocycline level occurs in spent media from each Escherichia coli K12 recipient containing one of 10 different plasmids bearing tetB determinants. No such decrease was detected when tetA, C, D or E determinants were tested under the same conditions. Likewise, no decrease in tetracycline or doxycycline levels was detected when 20 plasmids bearing tetA to E determinants were tested. Studies carried out by nuclear magnetic resonance and high pressure liquid chromatography proved that minocycline is broken by a mechanism mediated by the tetB determinant. This new mechanism can be considered as additional to the active efflux of minocycline. PMID- 2694247 TI - Isolation and properties of carboxylesterase P4 from Yersinia pseudotuberculosis. AB - The carboxylesterase P4 produced by Yersinia pseudotuberculosis was purified 330 fold by gel permeation and DEAE-trisacryl chromatography with a final yield of 21%. The apparent molecular weight, as determined by fast-protein liquid chromatography, was 45 kDa. The hydrolytic activity of esterase P4 was higher with the 1-naphthyl esters than with the 2-naphthyl esters of acetic, propionic and butyric acids. The apparent Km values were identical for 1-naphthyl acetate and 1-naphthyl propionate (0.15 mM). The enzyme was unstable at pH values below 5, but retained 80% of its initial activity after 30 min at 65 degrees C. It was unaffected by EDTA, eserine, tosyl-L-lysine chloromethylketone, iodoacetamide or 4-hydroxymercuribenzoate, but was strongly inhibited by low concentrations of diisopropyl fluorophosphate, suggesting the presence of serine in its active site. The purified enzyme gave a single precipitin line on Ouchterlony double immunodiffusion with homologous antiserum. This antiserum cross-reacted with the esterase bands E3 and E5 of Y. enterocolitica biotype 1, whereas there was no cross-reaction with the esterase bands produced by Y. enterocolitica biotypes 2 to 5, Y. intermedia, Y. frederiksenii, Y. kristensenii or Y. aldovae. The carboxylesterase P4 produced by Y. pestis was physicochemically, biochemically and immunologically indistinguishable from Y. pseudotuberculosis carboxylesterase P4. The latter enzyme and carboxylesterase B of Escherichia coli showed some biochemical similarities, but were antigenically unrelated. Our data confirm the relevance of esterases to phylogenetic and taxonomic studies of Enterobacteria. PMID- 2694248 TI - Mathematical modelling of growth of Escherichia coli at subinhibitory levels of chloramphenicol or tetracyclines. AB - A mathematical model is suggested to describe the subinhibitory effects of chloramphenicol upon growth of Escherichia coli. It represents a generalization of Monod's equation. Our model was constructed entirely on the basis of biochemical factors, such as the reversibility of the interaction between the drug and its ribosomal target or intracellular uptake. The subinhibitory effects of chloramphenicol were satisfactorily described by this law within the range of 0.4-2.4 micrograms/ml. After simplifying the equation, this model was extrapolated to provide an accurate description of the mode of action of other bacteriostatic antibiotics which also inhibit the 50-S ribosomal subunit (tetracycline and doxycycline). The expanded model seems to accurately typify the effect of these antibiotics, whereas bactericidal aminoglycosides follow a completely different growth law. PMID- 2694249 TI - Comparison of culture methods for enumeration of microaerophilic bacteria in marine sediments. AB - Agar-mixed cultures in semi-solid media provide a range of oxygen concentrations which fulfill microaerophilic bacterial requirements. Such conditions are more suitable than those provided by liquid media since, in broth cultures, the oxygen concentration must be determined at a level which might later show a lack of or excess of sensitivity to microaerophilic bacteria, thereby giving an erroneous count. A high content of organic substrates appears to be disadvantageous. It can prevent enumeration of microaerophilic growing rings or even induce false results. Minielectrodes permit the control of the oxygen concentration in each growing ring so as to confirm the efficiency of the culture method used for a selective count of microaerophilic bacteria. Semi-solid seawater culture medium supplemented with calcium succinate at 0.5 gram per litre appears to be an adequate culture medium for counting microaerophilic bacteria in marine sediments. PMID- 2694250 TI - Biology and pathogenicity of treponemes. PMID- 2694251 TI - Replication of the bovine immunodeficiency-like virus in diploid and aneuploid cells: permanent, latent and virus-productive infections in vitro. AB - Bovine immunodeficiency-like virus (BIV) is an infectious and leukotropic retrovirus, the sole lentivirus candidate which has been isolated from cattle. Although BIV has recently been shown to be related to the human immunodeficiency virus, there is very limited information on the replication and the pathogenesis of BIV. It is reported here that BIV can permanently infect diploid and aneuploid cells from four different species: bovine, canine, ferret and ovine. With the exceptions of a bovine diploid and a canine aneuploid cell line, all lines were virus non-productive. However, BIV was rescued by co-cultivation of virus non productive cells with homologous BIV-free or canine cells (Cf2Th). A permanent and BIV-productive infection was established for 90-serial subcultures in a canine cell line. A BIV titre of 1 x 10(6)/0.1 ml was observed in stationary culture and 1 x 10(10)/0.1 ml in suspension culture. The canine cell line above was used for production of BIV antigens, whereas BIV-free canine cells were routinely used to isolate BIV from BIV non-productive cells infected in vitro and from blood from experimentally BIV-infected cattle. The different steps of virus maturation were similar by electron microscopy to those of lentiviruses. BIV results are compared to those of lentiviruses. PMID- 2694252 TI - A paradigm for oncogene complementation in human breast cancer. AB - Multiple cellular oncogenes are amplified in malignant tumours, and it is possible to invoke gene dosage as a possible base for product activity. In vitro data have shown that two different oncogenes can cooperate in converting a normal cell into one that is tumorigenic. This suggested that multiple cooperative alterations might be involved in cancer progression. Breast cancers have a broad spectrum of clinical behaviours ranging from highly aggressive neoplasms to almost chronic diseases. Fifty months of clinical follow-up were studied in 143 patients with primary breast cancers. Uni- and multivariate analyses were performed in order to determine any synergistic effect of amplified c-myc, erbB-2 and int-2 genes on the disease-free state and overall survival. We showed that c myc amplification was associated with early recurrence and shorter survival; in contrast, erbB-2 and int-2 extra copies resulted in later relapse events, especially in patients whose tumours showed a normal copy number of c-myc genes. This pointed out sequential activation of complex regulatory cascades within the cell. Such particular behaviour enabled us to categorize erbB-2 and int-2 oncogenes into a group showing delayed action, in contrast to c-myc involvement in rapid spread of the tumour. As expected, co-amplified c-myc and erbB-2 genes showed positive cooperation with respect to recurrence and shortening of overall survival. Finally, the harmful effects of amplified c-myc and erbB-2 oncogenes were dramatically increased in patient subgroups showing a normal copy number of the int-2 gene. Multivariate analysis was used to evaluate disease-free survival and to test for potential interactions of oncogene covariates. It pointed out multiple independent combinations which enabled us to define complementation groups with respect to clinical patient behaviour. PMID- 2694253 TI - [Neutrophil elastase and the lung, with special reference to the pathogenesis of ARDS]. PMID- 2694254 TI - [Mechanisms and clinical profile of inotropic action of medicines for heart failure]. PMID- 2694255 TI - [Complications and practical problems in the measurements with the use of Swan Ganz catheter]. PMID- 2694256 TI - [Primary spontaneous coronary artery dissection]. PMID- 2694257 TI - Chemotherapy of renal cell carcinoma: 1983-1989. PMID- 2694258 TI - Immunotherapy of renal cell carcinoma. AB - Metastatic renal cell carcinoma remains a frustrating disease to treat. Although there is significant evidence that this tumor is responsive to alterations in the immune system, a complete understanding of the antitumor immune response is still elusive. The early trials have been aimed primarily at nonspecific methods for stimulation of the immune system, with the equal possibility that aside from stimulation of the effector cells responsible for tumor containment, there may be stimulation of other mechanisms that will inhibit this response. The better responses in some cases appear to be in the treatments that produce the most toxicities, though even these treatments only have a 20% to 30% response in most trials. Although the prior trials of immunotherapy have yielded modest results, they have provided a better understanding of the immune system in the oncologic setting. Newer trials are now being directed at combinations of lymphokines, which is the beginning of the application of basic science in the clinical setting. With a better appreciation of the basic science behind the immune response, the current factors available will be put into better therapeutic perspective, and newer factors, including various growth factors, may play an important role in future therapy. Also, the addition of antisuppressor regimens to stimulation trials is a sign of recognition of the complexity of the immune response. Aside from suppressor cells, investigators are beginning to realize that there are circulating proteins probably generated either by the tumor or in response to the tumor that are immunosuppressive (eg, circulating IL-2 receptors). Inhibition of these proteins by pheresis or other methods may provide increased immunoreactivity to the tumors, as has already been shown in a small series. Monoclonal antibodies offer the promise of the most specificity; however, the technology is still far from making this therapy imminently available. Only through additional laboratory and clinical investigation, will significant advances be made. PMID- 2694259 TI - Renal cancer associated with acquired cystic disease of the kidney and chronic renal failure. PMID- 2694260 TI - Animal models of renal cell carcinoma. AB - Animal models are extremely valuable in studying disease processes and evaluating new therapeutic modalities. RCC in men is resistant to any type of chemo- or hormonal therapeutic regimens. Developing appropriate models is therefore important to test new therapeutic modalities or to understand basic mechanisms of this malignancy. From our review renal cell tumors appear spontaneously with a certain frequency in humans, rats, mice, and hamsters, but are extremely rare in rabbits and have not been described in guinea pigs. Some tumors have been used as renal carcinoma models, such as the VX-2 in the rabbit or a mouse tumor described by Myers, which on further evaluation do not represent true RCC. The tumors described here are either chemically induced or spontaneous tumors in a variety of species and will serve investigators as a valuable resource regarding the origin and the biologic characteristics to be applied to specific experiments. PMID- 2694261 TI - Kidney-derived cell lines. PMID- 2694262 TI - Monoclonal antibodies to renal cancer antigens. PMID- 2694263 TI - [Determination of the blood flow in the common carotid arteries by Echo-Doppler ultrasonography in healthy subjects]. PMID- 2694264 TI - The science of biological specimen preparation for microscopy and microanalysis 1988. Proceedings of the 7th Pfefferkorn Conference. Sept. 11-16, 1988, Surrey, U.K. PMID- 2694265 TI - The evolution of correlative techniques for electron microscopy--an overview. AB - The papers presented at this Pfefferkorn Conference demonstrate the dramatic recent progress in the science of biological specimen preparation for electron microscopy. This progress results largely from increased use of more diverse, critical, correlative scientific methods. This paper outlines several strategies that tend to promote this type of scientific approach, and that have proven generally useful in biological research. The strategy most commonly chosen to augment both the empirical and the cross-disciplinary components of structural studies is the correlative use of diverse experimental techniques on samples which are parallel to those prepared for microscopy. This type of approach tends to advance our understanding of biological structure and function and also of the scientific methodology. Such approaches redirect attention to the biological problem under study and tend to open new areas of investigation. A second strategy which promotes more rigorous scientific approaches is the application of correlative techniques to identical structures. In contrast with parallel studies, data from identical structures document directly the coincidence of different features within each individual structure, and these data establish the distributions of these features in the study population based on relatively few observations. A third strategy to promote more critical science is to utilize the effects of the specimen preparation as experimental parameters by varying the preparative methods with appropriate controls. This approach is especially valuable in studies of biological specimen preparation, where the potential impact of systematic errors warrants especially rigorous scientific practice. PMID- 2694266 TI - Problems associated with the preparation of whole mounts of cytoskeletons for high resolution electron microscopy. AB - The resolution currently available in both transmission and scanning electron microscopes is theoretically adequate to visualize the organization of the cytoskeleton at the supramolecular and macromolecular levels. However, achieving this resolution in practice requires that the methods used to prepare the specimens both preserve the structures of interest and render them visible for observation in the microscope without obscuring or altering them. In this paper we discuss our own and others efforts to develop methods to overcome several problems associated with preparing whole mounts of cytoskeletons for observation by electron microscopy. These problems include: controlling the degree to which cellular components are extracted; the effects of osmium tetroxide on the cytoskeleton; controlling and recognizing shrinkage and drying artifacts; the choice of a method of visualization; deposition of grain-free ultrathin films of metal; and interpreting the results. The standard procedure which we currently use consists of the following steps: growing cells on carbon-stabilized Formvar coated gold electron microscope grids; extracting in 0.5% Triton X-100 detergent in a microtubule stabilizing buffer; postfixing in 2.5% glutaraldehyde in stabilizing buffer; freeze-drying; magnetron sputter-coating with 1.5 nm of tungsten; and observation by TEM, SEM, or STEM. Cytoskeletons prepared in this manner contain over 100 polypeptides and are composed of a complex three dimensional meshwork of clean, uniform filaments, the smallest of which are 7 nm in diameter. A structure resembling the microtrabecular lattice is present only if the cells are prefixed with a relatively long bifunctional protein crosslinking reagent prior to extraction with detergent. PMID- 2694267 TI - The case for low voltage high resolution scanning electron microscopy of biological samples. AB - Dried biological samples are low in scattering power, non-conducting and sensitive to radiation damage. These facts complicate the choice of the optimum beam voltage Vo at which they should be observed in the scanning electron microscope (SEM) because they add as variables the type and thickness of the coating material and degradation/contamination of the specimen by the beam. Heretofore, high resolution SEM could only be carried out at relatively high Vo (20-30kV) because available equipment could not produce small beam diameters at low Vo. Modern instruments can produce beam diameters of about 3nm at 1.5kV. As normal preparative procedures (fixation, critical point drying, coating) are unlikely to preserve reliable structure below this level, it is now possible to investigate the possible advantages associated with low Vo operation such as a reduction in charging and radiation damage and improved topographic contrast. The conclusion recommended by this paper is that the term resolution needs careful definition. The size of the smallest features visible in a micrograph is a function of many variables. Although probably the most important is specimen preparation, a number of others (probe size, beam penetration range, contamination, coating thickness needed to provide contrast and avoid charging etc) are functions of Vo. Of these variables at least probe size and possibly contamination become more favorable at higher Vo while the remainder favor low Vo. As a result the optimum will occur at a Vo where the best balance of these factors occurs for a particular sample. When using the Hitachi S-900, we have found that the optimum seems to be at 1.5-2.5kV for topologically diverse samples, but may extend to 5kV on samples on which very small structural details have been preserved and which are relatively stable to radiation damage. PMID- 2694268 TI - Preparation of thin, fine-grained, tantalum metal replicas for freeze-fracture electron microscopy. AB - Two critical factors in the preparation of metal films on biological specimens are the type of metal used and the potentially damaging effects of radiant energy from the hot metal source. The excessive heating of surfaces is a major limitation to the replication of heat-sensitive aqueous specimens with refractory metals such as tungsten and tantalum, although these metals are known to form smaller grains and thinner films than the more commonly used platinum/carbon deposited under similar conditions. We describe here an electron gun designed for the evaporation of pure tantalum; surface heating is reduced through intermittent deposition controlled by varying the open/closed intervals of a fast shutter that operates in ultra-high vacuum. The effectiveness of the shutter was evaluated with a thin thermocouple in place of the specimen. The composition of the replicas was determined by x-ray microanalysis and by direct observation of the initial melting and subsequent evaporation of the tantalum bead supported on a tungsten rod that remained unchanged during the evaporation. The quality of the tantalum replicas was demonstrated with freeze-fracture replicas of reconstituted proteoliposomes and native membrane vesicles. With shutter intervals of 0.5 sec open and 1.0 sec closed, the surface heating was reduced enough to prevent unintentional etching and to preserve small pits complementary to protein particles in hydrophobic membrane surfaces and in ice. PMID- 2694269 TI - Improved representation of cell surface structures by freeze substitution and backscattered electron imaging. AB - A surface preparation method for the SEM based on cryofixation is presented suitable for the demonstration of membrane particles on whole cells. LLC-PK1 cells (a renal epithelial cell line in culture) were fast frozen, freeze substituted, critical point dried, shadowed with 2 nm of platinum carbon and stabilized with a carbon backing layer. Membrane bound particles are visualized by the material dependent backscattered electron image mainly originating from the platinum shadow. The surface of the LLC-PK1 cells is almost free of precipitated material indicating that the culture medium is removed during freeze substitution or critical point drying. The apical plasma membrane with microvilli and ciliae is well preserved and differences in particle density can be detected. The feasibility of the coating technique for backscattered electron imaging was tested on the well known hexagonally arranged intramembranous particles of fractured and partially freeze dried yeast. This 16.5 nm periodic structure is clearly demonstrable on the bulk SEM-specimen stablized with the carbon backing layer. Without a carbon layer severe shrinking artifacts occurred. PMID- 2694270 TI - Cryotechniques in macromolecular research (a comparative study). AB - There is no single method which would provide an unambiguous image of all types of biological macromolecules. The choice of method depends largely on the size and properties of the macromolecule. Obviously small molecules are best visualized by negative staining, the problems appear with negative staining of larger structures. Here, the uncertainty about which part of the complex is actually stained (top or bottom) makes correct interpretation difficult. Shadowing techniques have the advantage of both visualizing the surface and also delineating the whole macromolecule, but suffer from lower resolution due to the graininess of the metal. However, they are superior to negative staining for the visualization of thin linear macromolecules. The next series of problems includes the interaction of macromolecules with supporting films, glass coverslips or mica, which can be hydrophobic, hydrophilic or charged and these properties can influence the orientation of the molecules. Surface tension forces during air drying must also be considered. We have used a variety of preparative techniques in our studies of biological macromolecules: (a) negative staining; (b) air drying from ethanol; (c) glycerol-spraying; (d) adsorption freeze-drying; (e) monolayer freeze-etching. These methods have been tested on small viruses, water soluble proteins (ribosomes, F-actin, microtubules) and transmembrane proteins requiring the presence of detergents (sarcoplasmic reticulum ATPase, fibronectin receptor). We find that freeze-drying is the most reliable and easy method for molecules that withstand distilled water; freeze-etching can be successfully applied to transmembrane proteins (even in the presence of detergents or salt); the glycerol-spray technique provides an excellent alternative to the cryotechniques in particular for studies of single linear molecules. PMID- 2694271 TI - High pressure freezing comes of age. AB - High pressure freezing permits the successful cryoimmobilization of thick biological specimens (up to approx. 500 microns). A very high yield of adequately frozen specimens, in which no segregation patterns due to ice crystal formation is apparent after freeze-substitution or freeze-fracturing, is obtained with suspensions of microorganisms as well as plant and animal tissue. This very high yield is attributed to an optimized transfer of pressure and cold to the biological specimen. This is achieved by replacement of extraspecimen water or buffer by 1-hexadecene, a chemically inert, hydrophobic paraffin oil of low viscosity and low surface tension. PMID- 2694272 TI - Labeling properties of sucrose-infiltrated cryosections. AB - Plastic transverse sections of labeled semithick and ultrathin cryosections prepared by the Tokuyasu procedure demonstrate that section surfaces can be smooth or rough, sometimes showing fracture-like structures. These surface irregularities can arise from specimen properties, sectioning/fracturing and compression during sectioning, loss of cytoplasmic material during labeling, and from the final drying step. Nevertheless, small and sensitive marker molecules like 4 nm gold-protein A, ferritin-IgG and 1 nm gold-IgG bind predominantly to the cryosection surface of even mildly fixed specimens as long as the section is well preserved. In our experiments, marker penetration is enhanced by section damage. Marker incubation of ultrathin cryosections obtained by cryo transverse sectioning of IgG-labeled semithick cryosections shows also that penetration of uncoupled antibodies into cytoplasm and nuclei of chicken erythrocytes is limited. PMID- 2694273 TI - The application of cryo-ultramicrotomy and freeze-substitution in immuno-gold labelling of hybrid proteins in Escherichia coli. A comparison. AB - To study the possible effects of chemical fixation upon antigenicity and structural preservation, the subcellular localization of LamB-LacZ hybrid proteins in Escherichia coli K-12 strains pop3234 and pop3299 was investigated both by cryo-ultramicrotomy and freeze-substitution. Immuno-gold labelling of sections of freeze-substituted bacteria showed the same localization of the hybrid protein as found after cryo-ultramicrotomy. The efficiency of labelling of the accumulated form of the hybrid protein was lower after freeze-substitution whereas the efficiency of labelling of the membrane-bound form showed no difference. Different fixatives and Lowicryl resins had no clear effect on the label-efficiency but the complex substitution medium, containing osmium tetroxide, uranyl acetate and glutaraldehyde, in combination with the apolar Lowicryl HM20 gave the best sectioning properties and membrane contrast. For this specific problem, although the somewhat better preservation after freeze substitution, cryo-ultramicrotomy is to be favored since it is much less time consuming, there are no freezing problems, ultrastructural preservation is sufficient and the theoretical benefits of freeze-substitution are not expressed. PMID- 2694274 TI - Influence of fixatives and embedding media on immunolabelling of freeze substituted cells. AB - Fixatives and embedding media are known to alter antigen epitopes and reduce antibody recognition unpredictably. Every antigen-antibody interaction may be influenced differently. In this study we concentrate on the influence of fixatives, commonly used in immuno-electron microscopy, the dehydration process, and the embedding media Lowicryl HM20 and K4M. The results obtained with our model system show that: the lesser chemical fixation, the more intense the labelling, and that dehydration by freeze-substitution preserves the antigenicity better than dehydration by progressive lowering of temperature, PLT, and finally that there is no obvious difference in labelling between the apolar Lowicryl HM20 and the polar Lowicryl K4M. PMID- 2694275 TI - Brief review on progresses in enzyme-gold cytochemistry. AB - Initially developed for the in situ localization of nucleic acids, the enzyme gold approach has been extended to the detection of a large variety of biological molecules. The enzyme-gold approach, based on the highly specific interaction existing between an enzyme and its substrate, can be used both in pre-embedding and post-embedding labeling procedures. Fixation and embedding conditions for the best preservation of each particular substrate under study have to be defined. On the other hand, conditions required to adsorb purified enzymes on colloidal gold particles should be determined according to the biochemical properties of each protein. Labeling protocols must be performed taking into consideration the optimal conditions for the enzymatic activity. The enzyme-gold complexes have been shown to retain their biochemical properties and the specificity of each labeling obtained has been assessed through various control experiments. Initially applied for the demonstration of nucleic acids, the approach has been extended to the ultrastructural localization of various substrates, and in particular, more recently, glycoconjugates and phospholipids. Indeed, various glycosidase-gold complexes and a phospholipase-gold complex, applied in pre- and post-embedding labeling protocols, did specifically label plasma membranes as well as various defined subcellular compartments. In addition, the morphometrical evaluation of labeling intensities revealed differences in amounts of binding sites between compartments. Considering its versatility, simplicity and efficiency, the enzyme-gold technique provides an alternative, very valuable cytochemical tool for the localization of a variety of biological molecules at the cellular and subcellular level. PMID- 2694276 TI - [Hypertension and atherosclerosis]. PMID- 2694277 TI - [Why and how can non-pharmacological treatment of arterial hypertension be accomplished?]. PMID- 2694278 TI - [The contribution of ambulatory arterial pressure measurement in the management of hypertensive patients]. PMID- 2694279 TI - [Pulmonary embolism]. PMID- 2694280 TI - Effect of carbohydrate ingestion on exercise of varying intensity and duration. Practical implications. PMID- 2694281 TI - The physiological effects of aerobic dance. A review. AB - Aerobic dance exercise is currently one of the most commonly practised adult fitness activities. The majority of the research pertaining to this form of exercise supports its application as a valid cardiovascular training alternative, especially for adult females if performed according to the American College of Sports Medicine (ACSM) guidelines. If, however, the participant is interested in modifying body composition, training frequency, duration, or efforts toward caloric restriction may need to be increased or altered beyond those employed in the aerobic dance training investigations. The amount of energy expended during a bout of aerobic dance can vary dramatically according to the intensity of the exercise. 'Low intensity' dance exercise is usually characterised by less large muscle activity and/or less lower extremity impact, and music of slower tempo. Dance exercise representative of this variety requires a cost of approximately 4 to 5 kcal/minute. Several trials, however, have shown that vigorous 'high intensity' aerobic dance which entails using the large muscle groups can require 10 to 11 kcal/minute. The associated training outcomes could be affected by such differences in dance exercise intensity and style. PMID- 2694282 TI - Cross-country skiing injuries and biomechanics. AB - Cross-country skiing exercises most of the joints, muscles and tendons in the body giving the skier an all around workout. This, in combination with a low incidence of injury, makes cross-country skiing an ideal recreational and competitive sport. The new skating techniques developed during the last decade have resulted in greater velocity. The maximum speed during the diagonal stride technique is 6 m/sec compared to 8 to 9 m/sec when skating and double poling. Top level skiers today use strong and ultra light skis of fiberglass and graphite. The ski weight is less than 500g. Today's skating technique does not require any waxing and only the cambered portion of the ski is waxed when performing the diagonal stride. The preparation of the ski course has improved with the development of special track machines. This allows top-level skiers to reach 60 to 80 km/h on downhill slopes, which has resulted in an increased risk of injury. Because cross-country skiing takes place wherever snow is available, it is difficult to establish accurate injury rates in comparison to alpine skiing which is performed on very specialised terrain at ski areas. Studies estimate the cross country ski injury rate in Sweden to be around 0.2 to 0.5 per thousand skier days. A prospective study of cross-country ski injuries conducted in Vermont revealed an injury rate of 0.72 per thousand skier days. 75% of the injuries sustained by members of the Swedish national cross-country ski team during 1983 and 1984 were overuse injuries while 25% resulted from trauma. The most common overuse injuries included medial-tibial stress syndrome, Achilles tendon problems and lower back pain. Most common among traumatic injuries were ankle ligament sprains and fractures, muscle ruptures, and knee ligament sprains. Shoulder dislocation, acromioclavicular separation and rotator cuff tears are not infrequent in cross-country skiing. Injuries to the ulnar collateral ligament of the metacarpal phalangeal joint of the thumb (Stener's lesion) is the most common ski injury involving the upper extremity. Cross-country skiers 16 to 21 years of age complained more frequently of mild lower back pain than similarly aged non skiers. This may result from repetitive hyperextension motions during the kick phase and the recurring spinal flexion and extension during the double poling phase. Repeated slipping on hard and icy tracks infrequently produce partial tears or microtrauma in the muscle tendinous units of the groin.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2694283 TI - Prevention and treatment of overuse tendon injuries. AB - Overuse injuries are common in recreational and competitive sports as well as in day-to-day activities. The musculotendinous unit comprises the tissue most frequently involved: structural damage to the tendon occurs from repetitive strain and loading, from either endurance or skill activities that require technique and power. The potential for injury is enhanced by a great variety of predisposing intrinsic or extrinsic factors. Tendinous tissue will become fatigued as its basal reparative ability is overwhelmed by repetitive dysfunctional and microtraumatic processes. Tendinitis is the earliest recognisable manifestation of overuse injury: as damage progresses, partial tears and complete ruptures may ensue. The diagnosis of overuse injury rests with identification not only of the affected tendinous unit, but also of the underlying predisposing condition or conditions. Treatment can then proceed with elimination or correction, if possible, of these conditions, together with control of inflammation and programmes of modalities designed to restore the structural and functional integrity of the tendon. Knowledge of overuse problems has grown exponentially in the past 3 decades, as evidenced by the outpouring of scientific and medical literature. Sophisticated analytical techniques, supplementing a sound history and physical examination, have greatly facilitated the diagnosis of overuse problems and allowed the application of scientific therapeutic principles. As the number of participants in recreational activities continues to grow, the application of these techniques in ever more innovative ways holds the greatest promise for the prevention of overuse tendon injuries. PMID- 2694284 TI - [Pathologic study of the eye and central nervous system in 25 cases of AIDS]. AB - We have reviewed the clinical and pathologic findings of 25 patients with the acquired immunodeficiency syndrome (AIDS) who had a complete post-mortem examination including a study of the nervous system and of one or both eyes. Cytomegalovirus (CMV) retinitis was the most frequent type of ocular infection observed fundoscopically (9 of 18 cases examined clinically). There were only 3 cases of CMV encephalitis amongst the 8 cases of CMV retinitis documented pathologically. Cerebral toxoplasmosis was found in 12 of the 25 cases and in only one of these could Toxoplasma gondii cysts be demonstrated in the optic nerve. Cotton wool spots were the most frequent lesion observed fundoscopically (10 of 18 cases examined clinically). In the 3 cases where they were observed microscopically they corresponded to cytoid bodies which represented axonal swellings within the nerve fiber layer. The pathogenesis of this lesion in patients with AIDS is not understood. Intraocular lymphoma was present in only one case. PMID- 2694285 TI - [Myelopathy, polymyositis and systemic manifestations associated with the HTLV-I virus]. AB - A case of HTLV-I associated myelopathy in a 51 year-old Haitian woman is reported. MRI showed high signals in the cerebral white matter on T2-weighted images. There also was clinical and electrophysiological evidence of myositis, and a biopsy of the quadriceps muscle showed dense inflammatory infiltrates surrounding several small perimysial blood vessels. The virus was not demonstrated in the muscle. The presence of several systemic abnormalities (polyclonal gammapathy, circulating immune complexes, Sjogren's syndrome) and the vasculitis suggest an immunopathological mechanism for this HTLV-I associated myositis. PMID- 2694286 TI - [Abnormal postural movements: transient ischemic episodes of the carotid?]. AB - Following post-operative occlusion of the right internal carotid artery, a 65 year old man developed abnormal left involuntary movements which appeared in upright position or at exercise and disappeared in sitting or supine positions. The clinical and electroencephalographic features of these movements could have been epileptic. However, this case together with data from the literature suggest that transient ischemic episodes in the carotid territory may be expressed as involuntary movements occurring in certain positions, betraying a severe and abrupt fall in cerebral blood flow. PMID- 2694287 TI - [Recurrent meningitis, hydrocephalus and tegmen tympani dehiscence]. AB - Cerebrospinal fluid (CSF) otorrhea is the usual presenting symptom of spontaneous tegmen tympani defects. A case associated with recurrent meningitis and CSF rhinorrhea without otorrhea is described. The coexistence of an hydrocephalus had led initially to ventriculoperitoneal shunting, which did not prevent meningitis recurrence. Previously reported in cases of anterior fossa and sella defects, an aqueduct stenosis was here associated with the tegmen tympani defect. PMID- 2694288 TI - [Acute spinal amyotrophy in toxoplasmosis]. AB - A 19 year-old man developed an acute syndrome of the anterior horn of cervical spinal cord during a primo-infection with toxoplasma. The neurological syndrome was completely regressive after treatment with 1 600 mg/day of trimethoprim sulfamethoxazole for three months. PMID- 2694289 TI - [Carbamazepine-sensitive neuromyotonia and Charcot-Marie-Tooth disease of the neuronal type]. AB - Following an anti-smallpox vaccination a 17 year-old boy developed spontaneous muscular activity with cramps and fasciculations in the lower limbs. There was distal amyotrophy of the lower limbs and pes cavus. Clinical signs suggested a cholinergic hyperfunction. EMG showed a significant spontaneous activity and was neurogenic in the lower limbs. Nerve conduction velocities were consistent with axonal damage. Muscular biopsy showed aspects of chronic denervation. Neuromyotonia disappeared with carbamazepine treatment. This case can be added to the reported associations of neuromyotonia and Charcot-Marie-Tooth disease. Such cases are an additional argument for the axonal origin of neuromyotonia. PMID- 2694290 TI - [Surgical treatment of acute pancreatitis: experience at a general hospital]. AB - The authors present a study of 15 cases of necrotizing acute pancreatitis treated surgically at the Surgery Department of the University Hospital of the University of Sao Paulo. All patients in the series were submitted to exploratory laparotomy with sequestrectomy and drainage. Etiology, sex, age, complications, and Ranson prognostic criteria were compared to mortality. Overall mortality was 33%. PMID- 2694291 TI - [Thalidomide: an eclectic medication in dermatology]. AB - The authors review the indications for the use of thalidomide in dermatological conditions. They consider leprotic reaction, prurigo nodularis of Hyde, actinic prurigo, discoid lupus erythematosus, Weber-Christian panniculitis, recurrent mouth aphtosis, Behcet's syndrome, and pyoderma gangrenosum. The dramatic situation created by the use of thalidomide in the sixties not-withstanding, interest in its use is warranted within certain limits due to its wide therapeutic action. PMID- 2694292 TI - [Meta-analysis: a new option in clinical research. Basic principles and a clinical example]. AB - The authors present some basic concepts of meta-analysis, a process to evaluate and combine the results of conflicting studies. Authors illustrate the process by presenting a practical example in rheumatology. PMID- 2694293 TI - [Morbidity and mortality in patients presenting with acute abdominal pain]. AB - We reviewed the files of all patients who entered the hospital because of acute abdominal pain within a period of one year in order to study the frequency of this symptom and its lethal effects. The total cases found (562) were divided into two groups: patients under 50 years of age (279) and patients older than that age (283). The most frequent causes in the first group were reno-urethral lithiasis, acute appendicitis and acute pancreatitis. While in the second group were abdominal wall hernias, peptic acid disease and mesenteric thrombosis. No differences where found between the sexes of patients. Hospital mortality was 13.9% and that related to surgery 20.9%. The most frequent cause of death among patients under 50 years of age was acute pancreatitis and in those older than 50 years of age it was peptic acid disease. PMID- 2694294 TI - [Granulomatous hepatitis secondary to ingestion of carbamazepine. Report of a case]. AB - A 51-year-old man with epilepsy received carbamazepine during three weeks. He developed fever, jaundice, dark urine and pale stools. Laboratory data showed hepatocellular injury and cholestasis; six weeks after withdrawal of the drug these abnormalities returned to normal limits. The liver biopsy showed acute cholangitis, bile duct injury, granulomas and eosinophils in the portal areas. PMID- 2694295 TI - [Clinical importance of Campylobacter pylori. Second part]. PMID- 2694296 TI - [Pathogenesis of AIDS: possible role of co-factors in HIV reactivation]. AB - One of the most intriguing aspects concerning the pathogenesis of AIDS is the long period of latency of the HIV in human cells, not causing any cytopatic effect in some and, on the other hand, causing cell destruction, at short periods, in others. The various agents and the mechanisms they adopt to reactivate the latente HIV, were described. Also the frequent epidemiological observation on the presence of both such agents and the HIV in AIDS patients allowed the authors to speculate on the probable important role of a cohort of co factors which determine the destiny of such individuals. Special considerations were made in respect to the hepatitis B virus, cytomegalovirus, herpesviruses (HHV-1, e and 6), EB virus, HTLV-1 and 2 retroviruses, group B arbovirus Maguary, malaria and other endemic infectious diseases which victimize millions of Brazilians. Accepting the importance of such co-factors acting on the viral gens that regulate the HIV expression in the host cell, it was speculated on the possible role of vaccines, such as the hepatitis B vaccine, and some antiviral drugs which could be useful in the indirect prevention of AIDS-disease in both HIV-carriers and those practising AIDS-high-risk-activities. PMID- 2694297 TI - [Pyogenic sacroiliitis in a patient with HLA B27]. AB - The authors report on a patient with bilateral sacroillitis and positive HLA B27 who developed a pyoarthritis in one of the sacro-iliac joints. They comment the diagnostics difficulties in this type of septic arthritis and the association of the histocompatibility antigen B27 with pyogenic sacroiliitis. PMID- 2694298 TI - [Deviations in the immune response. I. Immunologic tolerance]. PMID- 2694299 TI - [The carcinoembryonic antigen (CEA)--its biology and implications in pathology]. PMID- 2694300 TI - [Microbiological and physicochemical indicators of viral contamination of the drinking water]. AB - The paper reviews the connection between the human viruses and some common sanitary indicators of drinking water contamination. An analysis is made of: physico-chemical indicators (water turbidity, residual chlorine, some products of the bacterial metabolism in the intestine), bacterial indicators (total and faecal coliforms, Escherichia coli, faecal streptococci, clostridia and other intestinal anaerobic bacteria, saprophytic mycobacteria, Pseudomonas aeruginosa) and some bacteriophages. The conclusion is drawn that if such indirect indicators of water faecal pollution are generally useful in sanitary-microbiological assessment of drinking water, for finding its viral pollution, in certain epidemiological and hygiene-sanitary situations the virologic examination of the drinking water is quite compulsory. PMID- 2694301 TI - [Reagin allergies]. PMID- 2694302 TI - [The heterogeneity of mast cells and basophils]. PMID- 2694303 TI - [The use of bacterial preparations in the treatment of asthma in children]. PMID- 2694304 TI - Labeling of Salmonella typhimurium with iodine-131 to study phagocytic function in rats. AB - The present study describes a method for labeling Salmonella typhymurium with iodine-131 to evaluate both the morphological and the functional characteristics of the reticulo-endothelial system. A suspension containing 2 x 10(9) bacteria per ml was labeled with carrier-free Na131I without reductor, with a labeling yield of 46.5 +/- 3% and 3.5 +/- 1.3% of free Iodine-131. The biodistribution of the labeled bacteria in rats was studied with a large-field-of-view scintillation camera equiped with a pinhole collimator. Whole body images were obtained 15 and 30 minutes after intravenous injection of the labeled microorganisms. Images showed accumulation of bacteria in the liver and both normal and transplanted spleens of the animals. Autoradiographs of liver and spleen demonstrated labeled bacteria within the cells of the reticulo-endothelial system. The method described is easy to perform, has a good labeling yield and allows the functional evaluation of the reticulo-monophagocytic system, including transplanted spleens. PMID- 2694305 TI - Differences in the antigenic profile of bloodstream and cell culture derived trypomastigotes of Trypanosoma cruzi. AB - A comparative study of the antigenic profile of bloodstream and cell culture derived trypomastigotes showed many differences in their components. Using mouse anti-T. cruzi antibodies the differences were located mostly in the 120 kDa band, whereas using chagasic patient sera the differences were located in the 85 and 52 kDa bands. These findings might explain known physiological differences between trypomastigotes obtained from cell culture and from infected blood. A brief report of this work has already been published. PMID- 2694306 TI - [A fatal case of human pulmonary adiaspiromycosis]. AB - A fatal case of human pulmonary adiaspiromycosis is reported. The patient, a male farm laborer from Pernambuco, in the Northeastern part of Brazil, had moved to Planaltina, DF., one year prior the onset of his illness. The main clinical manifestations consisted in fever, myalgia, cough and dyspnea. After being sick for five weeks, the patient developed severe respiratory failure and died. Grossly, disseminated nodular lesions, a few millimeters in diameter, were observed throughout the lobes of both lungs. Microscopically, round structures, up to 600 microns in diameter, with a thick membrane, identified as adiaconidia of Chrysosporium parvum var. crescens, were seen in the center of the nodular lesions. These adiaconidia appeared predominantly inside microabscesses or necrotic areas, both surrounded by a granulomatous reaction. The pulmonary alveoli not affected by the nodular lesions contained an inflammatory exudate composed of macrophages and neutrophils. The finding of several non-fatal cases of the disease in the area of the Federal District suggests that adiaspiromycosis is endemic in the Central Brazilian Plateau region, where the dry, warm and windy climate, particularly from August to October, may provide the appropriate environmental conditions for the dissemination of C. parvum conidia. PMID- 2694307 TI - Effect of antimalarial drugs and of clindamycin on erythrocyte metabolism. A review. PMID- 2694308 TI - [Immunoreactive methods and their importance for the diagnosis of clinical forms of toxoplasmosis]. PMID- 2694309 TI - [Anti-idiotypic antibodies in therapy: current status and prospects]. PMID- 2694310 TI - [Management of asthmatic children by the non-specialized physician. Mario Salazar Mallen Lecture]. PMID- 2694311 TI - [Current concepts on the physiopathology of allergic rhinitis]. PMID- 2694312 TI - [Recent findings on generators of evoked potentials]. AB - In the study of potential generators the dipole localization method is often used. The "equivalent dipole" represents the resultant of all the neurobiological processes (excitatory and inhibitory post-synaptic potentials, action potentials) that concur to generate the evoked potentials. According to the dipole's distance from the active electrode, "near-field" and "far-field" potentials will be recorded, with differences in the spatiotemporal distribution to the skin. The main hypotheses about the generators of standard components of somatosensory evoked potentials (SEP) from median and posterior tibial nerve, visual evoked potentials (VEP), auditory brainstem evoked potentials (BAEP) and P300, are analyzed. PMID- 2694313 TI - Detection of circulating trypanosomal antigens in Trypanosoma evansi-infected animals using a T. brucei group-specific monoclonal antibody. AB - An antigen-detection enzyme immunoassay based on a T. brucei group-specific monoclonal antibody was used for the detection of circulating antigens in several animal species experimentally infected with T. evansi stocks from Sudan, Indonesia, Thailand and South America. Circulating antigens were detected as early as 6 days after infection, and they persisted throughout the observation period of up to 60 days postinfection. In an analysis of sera from naturally infected water buffaloes from Thailand, the test identified all the animals with positive parasitological findings, and 3 additional cases that had not been diagnosed by parasitological techniques. In an analysis of sera from pigs on a farm in Thailand suspected of a T. evansi outbreak, the assay detected "antigenaemia" in 66.7% of the animals, with antigen titres ranging from 1:2 to 1.512. PMID- 2694314 TI - Ophthalmological results from a placebo controlled comparative 3-dose ivermectin study in the treatment of onchocerciasis. AB - One hundred and ninety eight patients with moderate to heavy infection with Onchocerca volvulus and with eye involvement in most, were allocated randomly to treatment with 100, 150 or 200 mcg/kg body weight of ivermectin or placebo given as a single oral dose in a double-blind dose finding study. The patients were drawn from an area under over ten years of vector control in Northern Ghana by the Onchocerciasis Control Programme, OCP. They underwent detailed clinical, laboratory and ophthalmological examination before treatment and in the review period of one year in hospital. Ivermectin given in a dose of 100, 150 or 200 mcg/kg eliminated microfilariae similarly slowly over 3-6 months and was associated with inflammatory reaction in the anterior segment which resolved without treatment. No changes in the fundus of the eye was detected by fluorescein angiography and no no-table other adverse eye reaction was observed. The ceiling of therapeutic activity of ivermectin in the eye is therefore put at 100 mcg/kg which is lower than the level fo 150 mcg/kg found in the skin. The apparent discrepancy may be due to different dose requirements on account of different mechanisms of action of ivermectin at the two sites. In the skin there is active killing while in the eye it is presumed there is a passive elimination of microfilariae. PMID- 2694315 TI - The chemotherapy of onchocerciasis. XIII. Studies with ivermectin in onchocerciasis patients in northern Ghana, a region with long lasting vector control. AB - One hundred and ninety eight patients with moderate to heavy infections with Onchocerca volvulus were randomly assigned to receive single doses of 100, 150 or 200 mcg/kg of ivermectin or matching placebo capsules. Detailed systemic, ocular and parasitological examinations were carried out at intervals over a period of one year. Nodules were excised twelve months after treatment to evaluate the effect of the treatment with ivermectin in adult O. volvulus. The three ivermectin-treated groups produced massive reductions in skin microfilariae (over 97%) with low levels being maintained over one year. The 150 and 200 mcg/kg doses were however superior to the 100 mcg/kg dose in achieving a greater reduction in skin microfilarial counts initially and in maintaining significant lower levels throughout the period of observation. There was no difference between the 150 and 200 mcg/kg doses at anytime. The three ivermectin doses were equally effective in the clearance of ocular microfilariae. The proportion of dead adult worms was very high in all treatment groups, which is effected by the successful ten years lasting vector control in northern Ghana. In spite of this superannuation of the worm population, an impact of the treatment with ivermectin on the reproductivity of the parasite could be shown. Systemic total clinical reaction was mild and was similar in the ivermectin treated groups. However, severe symptomatic postural hypotension (SSPH) was limited to patients treated with 150 or 200 mcg/kg of ivermectin. Ocular reactions were mild in all patients and no ocular deficiency occurred.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694316 TI - The systemic vasculitides. AB - The systemic vasculitides include a heterogenous group of diseases, characterized by inflammatory and necrotic lesions of the vessel walls, with subsequent ischemic changes in different organs. Various factors are incriminated in the vasculitides etiology, despite the fact that, in most of the cases, the etiologic agents are unknown. The pathogenic mechanisms are generally mediated through circulant immune complexes, which induce the inflammatory reaction at the vessel wall site, accompanied by complex immune reactions. A classification of vasculitides should take into account the type of the injured vessel, the elements of the inflammatory infiltrate and the triggering pathogenic mechanisms. The definition and monitoring of the therapeutic regimen are difficult but, generally, the main elements of medication are represented by corticosteroid and cytotoxic drugs. PMID- 2694317 TI - Silent myocardial ischemia. II. Pathophysiology, relation to risk factors, treatment. AB - The second part of this selective review on silent myocardial ischemia summarizes major hypotheses, viewpoints, findings and conclusions concerning: (a) the pathophysiology of silent myocardial ischemia; (b) the influence exerted by some risk factors for coronary heart disease in the precipitation of silent myocardial ischemia, particularly smoking and psychosocial stresses; (c) the medical treatment of silent myocardial ischemia, which, in a monitored environment, can produce definite improvements in laboratory tests, evolution of coronary heart disease and survival rates. PMID- 2694318 TI - Endoscopic hemostasis. AB - The paper is a survey of the methods of perendoscopic hemostasis used in the treatment of bleeding esophageal varices and ulcers. The various procedures used are enumerated and their technical indication, risks, limitations and complications are described. The advantage of the new methods as compared with the classical treatments (conservative or surgical) are pointed out. PMID- 2694319 TI - Early influence of ultrasonographic examination of the abdominal cavity on the concentration of the lipid system parameters in blood serum of healthy people. AB - Ultrasound waves play an important part in contemporary diagnosis and medical therapy. The effect of the ultrasounds used in medicine, on the course of the metabolic processes of the human organism exposed to the activity of ultrasounds is not known. An experiment was carried out to detect the early influence of ultrasonographic (USG) examination of the abdominal cavity on the concentration of the lipid system parameters in the blood serum of healthy subjects. A statistically significant decrease in the concentration of triglycerides and free fatty acids was noted 2 hours after USG examination. No change of concentration of total cholesterol and beta-lipoproteins was observed. The mechanisms of the interaction between ultrasounds and living matter are discussed. PMID- 2694320 TI - Clinical application of D-penicillamine in ankylosing spondylitis: a 9-month study. AB - The lack of effective therapy of ankylosing spondylitis is a reason to search a better kind of treatment. Trials to use D-penicillamine are scarce and usually limited to a short time of observation. We studied 49 patients with ankylosing spondylitis non-responding to classical therapy. Before and during treatment periodically complex clinical and laboratory tests were performed. During 9 months of therapy a significant decrease of score and involvement of vertebral column movement measured by several tests were observed. No side effects of treatment were found during this period. It is probably partly connected with the dosage of D-penicillamine which was used. It should be underlined that during 9 months of therapy, no relapse was observed in any case. The efficacy of D penicillamine therapy was found not only in the peripheral form of ankylosing spondylitis but also in central one. However, the therapy was more effective in the former. It seems that D-penicillamine may be an effective and safe drug in the therapy of ankylosing spondylitis. PMID- 2694321 TI - Comparative study of insulin antibodies in diabetic patients with primary insulin dependence (type I) and secondary insulin-dependence (type II). AB - Insulin antibodies (% binding) were determined by RIA method in 404 insulin treated diabetic patients divided into two groups: (A) primary insulin-dependent patients (Type I diabetes): 300 cases, 170 M, 130 F, mean age +/- SD 29.2 +/- 7.5 yrs, disease and insulin treatment duration 7.7 +/- 6 yrs: (B) Type II diabetic patients needing insulin (secondary insulin-dependence): 104 cases, 47 M, 57 F, aged 53.4 +/- 9.2 yrs, duration of diabetes 13.1 +/- 8.3 yrs, and of insulin treatment 3.1 +/- 2.1 yrs. Both groups of patients were with the same types of insulin preparations. In 297 cases, all belonging to group (A), fasting C-peptide was also determined. The titre of insulin antibodies was significantly (p less than 0.001) higher in patients with secondary insulin dependence than in those with primary insulin dependence (22.96 +/- 15.1% vs 10.25 +/- 9.89) in spite of the longer duration of insulin treatment in the later group; the mean C-peptide value found in 58 Type I diabetic patients with a binding capacity less than 10% was significantly lower (p less than 0.001) than that found in 11 Type I diabetic cases with a binding capacity greater than 20% (0.091 +/- 0.57 vs 0.273 +/- 0.37 pmol/ml); no correlation was found between insulin antibodies and metabolic control, insulin requirements or chronic complications. PMID- 2694322 TI - [Echography in simple shoulder pain]. PMID- 2694323 TI - [Outcome of rupture and complete perforation of the unoperated rotator cuff of the shoulder]. PMID- 2694324 TI - [Criteria for activity of rheumatoid polyarthritis]. PMID- 2694325 TI - Fasting for 72 h decreases the responses of counterregulatory hormones to insulin induced hypoglycaemia in normal man. AB - We have evaluated the influence of fasting on the response of counterregulatory hormones to insulin-induced hypoglycaemia. Eight healthy, non-obese volunteers were studied after an overnight fast and again after a 72-h fast period. Levels of blood glucose were higher after overnight fasting (4.59 +/- 0.10 mmol/l) than after 72 h of fasting (3.38 +/- 0.12 mmol/l). Hypoglycaemia was induced by a constant insulin infusion (2.4 mU/kg/min) and clamped between 2.1 and 2.3 mmol/l of glucose by a variable glucose infusion. Hypoglycaemia evoked stimulation of glucagon release after the overnight fast but did not alter release after 72 h of fasting. The response of other counterregulatory hormones were also influenced by the longer fasting period: the normal rise in adrenaline levels during hypoglycaemia was delayed and attenuated and the normal rise in cortisol levels was absent; paradoxically, cortisol levels decreased during hypoglycaemia. Seventy-two hours of fasting, therefore, profoundly alters hormonal responses to hypoglycaemia. PMID- 2694326 TI - Effect of a slow release transcutaneous scopolamine application on salivary flow, pH, buffering action, and salivary levels of Streptococcus mutans and lactobacilli. AB - A motion sickness plaster releasing a powerful antisialogogic agent, scopolamine, was tested in a double blind clinical trial for its effect on salivary parameters in 14 healthy young men. The agent caused a decline in salivary flow rates, which was most pronounced during unstimulated conditions. Salivary pH and buffer capacity were also reduced. Salivary levels of Streptococcus mutans and lactobacilli showed a tendency to increase during 2 days on the antisialogogic agent, but the effect on S. mutans levels was not statistically significant. PMID- 2694327 TI - Gingival crevicular fluid fibronectin degradation in periodontal health and disease. AB - The molecular forms of fibronectin (FN) in gingival crevicular fluid of five subjects with at least two sites exhibiting clinical signs of inflammation and pockets of at least 4 mm (test group) and five subjects with clinically healthy periodontium (control group) were investigated. Samples were collected with standard filter paper strips. In the test group samples from both diseased and healthy sites were collected. After collection the test group received one episode of periodontal treatment (scaling and root planning). The sampling and clinical recording were repeated for the diseased sites after about 2 wk. The crevicular fluid FN was analyzed using sodium dodecyl sulphate gel electrophoresis followed by western blotting with polyclonal antibodies against FN. Both intact FN and FN fragments were found in all samples. A larger proportion of FN was in degraded form in the diseased sites than in the healthy or the treated sites. FN was also degraded into smaller peptide fragments in the diseased than in the treated sites. These results suggest that crevicular fluid FN is partially degraded both in periodontal health and disease and that the degree of degradation of FN increases with periodontal inflammation and decreases with periodontal treatment. PMID- 2694328 TI - Gingival fluid, beta 2-microglobulin and protein levels as indicators of periodontal disease. AB - beta 2-microglobulin (beta 2-m), lysozyme and protein concentrations in gingival fluid were analyzed in 19 patients with severe periodontitis and in 19 controls devoid of any clinical signs of inflammation. A significant increase of the total protein and beta 2-m levels was found in periodontal subjects. In contrast, lysozyme concentration did not reflect the inflammatory status of the periodontium. Statistical analyses showed significant correlations between beta 2 m and protein concentrations in both groups. Furthermore, the values obtained by Periotron 600 closely correlated with the protein and beta 2-m contents, indicating that this method is a reliable aid in assessment of the quantity and quality of crevicular exudate and thus the severity of periodontal disease. PMID- 2694329 TI - Radiographic control of fixture-abutment connection in Branemark implant technique. AB - In the treatment with osseointegrated implants ad modum Branemark a radiographic control of the fixture-abutment connection is recommended. The purpose of the present study was to analyze the possibilities of detecting incomplete connection by radiography using the recommended technique. In an experimental model the influence of film density, orientation of the fixture hexagon, angulation between film plane and fixture axis, leakage width, and partial connection were analyzed. Slits of 0.05 mm were detectable under optimum projection conditions. On the other hand, slits of 0.1 mm were obscured even at deviations of 5 degrees. A number of factors, e.g. low density level and "unfavorable" orientation of the hexagon in relation to the X-ray beam, reduce the possibilities of detecting slits. It is concluded that in clinical cases a demonstration of incomplete fixture-abutment connection by the use of the recommended radiographic technique radiography to some extent is fortuitous, and that radiographic control has certain limitations. PMID- 2694330 TI - Campylobacter pylori and non-ulcer dyspepsia. 1. The final results of a double blind multicentre trial for treatment with pirenzepine in Italy. AB - In a double-blind multicentre trial to study the effect of pirenzepine in the treatment of non-ulcer dyspepsia, 104 of 128 patients, 52 in each of the study and control groups, completed the 4 weeks of the investigation. There was improvement of the endoscopic and clinical findings but no change of the degree of the mucosal inflammation or the extent of colonisation by campylobacter pylori. The mode of action of pirenzepine in patients with non-ulcer dyspepsia associated with campylobacter related gastroduodenitis remains obscure. Further studies are needed to investigate the possibility of a causal relationship between mucosal colonisation with campylobacter pylori and gastroduodenitis specially in cases of non-ulcer dyspepsia. PMID- 2694331 TI - Octatropine-methyl-bromide and sulglycotide salt in the short-term treatment of active duodenal ulcer. A double blind endoscopic study of 40 outpatients. AB - Forty outpatients with endoscopically confirmed duodenal ulcers were entered in a double blind trial. They were randomly allocated to octatropine-methyl-bromide and sulglycotide salt (GVP) or placebo. The results show that the combination of the two drugs is less efficacious than the two constituent substances taken separately, is not more efficacious than placebo in ulcer healing, and is ineffective with regard to ulcer pain. PMID- 2694332 TI - Healing rate of duodenal ulcer with hyper-aggressive peptic activity under H2 receptor antagonists. AB - In 60 cases of hyper-aggressive duodenal ulcer an endoscopic examination was made, at short intervals (4,7,11,13,21,28 days) after the treatment with H2 receptor antagonists. The open trial was based on random cases under ranitidine 150 mg b.i.d. (31 cases) or cimetidine 400 mg b.i.d. (29 cases). The healing rate has been calculated from the regression slope of the ulcerative area in mm2. Regression does not have a linear slope; it is slow in the first week, increases in the second week, in which it reaches the maximum value, and then decreases gradually in the following weeks. H2-receptor antagonists have no doubt an accelerating effect on healing; cimetidine, in comparison with ranitidine, has a faster and more evident action in the first week. But then, it reduces its action more rapidly in the following weeks so that, on the whole, it turns out to be slightly less valuable. These results can be practically useful for the treatment of hyper-aggressive D.U. as far as early risks are concerned. PMID- 2694333 TI - Aortoduodenal fistula revisited. AB - Two new cases of primary aortoduodenal fistula (ADF), one associated with an arteriosclerotic aneurysm and the other without, are presented and 4 cases of primary ADF without aneurysm published between 1972 and 1985 are reviewed. The anatomic relationship of the distal part of the duodenum to the infrarenal segment of the aorta, arteriosclerosis, mechanical trauma, infection and sepsis are prominent factors in the pathogenesis of ADF irrespective of its type. Intermittent haematemesis and/or melaena are the main presenting symptoms in all variants of ADF and awareness of the existence of this condition is essential for its early detection. Upper gastrointestinal endoscopy including examination of the distal part of the duodenum and explorative laparotomy are important tools in the preoperative diagnostic workup specially in primary ADF without previous knowledge of the presence of an aneurysm. PMID- 2694334 TI - Surgical considerations for antireflux therapy. AB - Surgery has a major role to play in the treatment of reflux disease. Several factors should be considered prior to utilising the surgical approach. Severity of the reflux disease and response to conservative treatment are generally acceptable criteria for deciding whether a patient should undergo a surgical procedure. Once the decision is made to utilise a surgical approach, a specialised centre with an abundance of experienced, skilled surgeons and a specialised diagnostic laboratory should be selected. It is the responsibility of the referring physician and surgeon to diagnose accurately the presence of reflux disease. Endoscopy, pH-metry, and manometry are useful in precisely diagnosing the presence of reflux disease. Fundoplication is the favoured surgical procedure. The most common complications associated with this procedure are gas bloat and hypercontinence, which are acceptable tradeoffs for reflux disease. The patient must be educated about the surgical procedure and its consequences prior to the operation and informed of the alternatives. Accurate diagnosis, coupled with selection of an experienced surgeon and patient education can have a dramatic impact on reflux disease in the individual patient. PMID- 2694335 TI - Approaches to oesophageal columnar metaplasia (Barrett's oesophagus). AB - The oesophageal squamous mucosal ulceration caused by peptic oesophagitis is followed by healing, with metaplastic columnar mucosa in around 12% of patients. The major significance of this condition, oesophageal columnar metaplasia (OCM), is the relatively high risk that it has for development of oesophageal adenocarcinoma. Fibreoptic endoscopy with multiple mucosal biopsies is the only effective method for detection and evaluation of OCM. Peptic oesophagitis merits treatment in its own right in patients with OCM. There are, however, no clear indications that once OCM has developed, successful healing of oesophagitis by medical or surgical therapies has any impact on the risk of malignancy. Management, therefore, hinges on effective treatment of severe oesophagitis before OCM develops, and surveillance for adenocarcinoma in OCM patients in whom oesophagectomy is considered a therapeutic option. Currently, the most effective screening method is to examine for dysplasia multiple closely spaced biopsy specimens from the columnar lined segment. Mild to moderate dysplasia probably warrants yearly endoscopy and multiple specimens. Severe dysplasia indicates a very high risk for invasive adenocarcinoma. In such patients, oesophagectomy should be seriously considered. Currently, there is a lively interest in research into more sensitive and cost-effective methods for screening for adenocarcinoma. PMID- 2694336 TI - Respiratory complications of gastro-oesophageal reflux. AB - The association between pulmonary symptoms and gastro-oesophageal reflux has been well documented. However, it is still unclear whether abnormal pulmonary function causes increased reflux or reflux causes pulmonary symptoms. Available data suggest that both theories may be accurate. Clinical features of patients with reflux-induced pulmonary complications have been identified, although there are no specific methods for confirming this diagnosis. An algorithm that defines a series of diagnostic tests is presented. From the results of the small number of published clinical trials, it appears that antireflux surgery is the most effective and longest-lasting treatment for the correction of pulmonary symptoms. PMID- 2694337 TI - Gastro-oesophageal reflux disease, an important cause of angina-like chest pain. AB - Angina-like chest pain in patients with coronary arteriography raises difficult diagnostic problems. The pain may be due to microvascular angina (or syndrome X). It is postulated that during the typical angina of these patients, the ST segment shifts on exercise electrocardiogram and the abnormal electrophysiologic tests on cardiac catheterisation are due to a decreased coronary flow reserve related to microvascular abnormalities. Angina-like chest pain may also be of oesophageal origin. Gastro-oesophageal reflux and oesophageal motility disorders are the two commonest oesophageal abnormalities held responsible for the pain. Recent observations suggest that sensitivity of the oesophagus to several stimuli may be another important cause of chest pain of oesophageal origin. This condition is called irritable oesophagus. Twenty-four hour pH- and pressure-recording is at present the best way to reach a specific diagnosis about the nature of the oesophageal abnormality. PMID- 2694338 TI - General considerations in the management of typhoid fever and dysentery. AB - Typhoid fever is diagnosed on the basis of isolation of Salmonella typhi from blood, bone marrow, or bile. S. typhi found in stool or urine may reflect chronic asymptomatic carriage. Although antimicrobial therapy may not eliminate carriage, it is effective for the treatment of clinically evident acute disease. Among the drugs currently available, chloramphenicol is the most widely used. Chloramphenicol is effective and inexpensive, but it is associated with a 3% rate of chronic carriage, a high relapse rate, and, in rare cases, aplastic anemia. For these reasons, and because of the emergence of chloramphenicol-resistant strains of S. typhi, alternative drugs need to be considered. Dysentery is characterized by the passage of unformed stools that commonly contain blood and mucus and in which large numbers of leukocytes can be detected on microscopic examination. Invasion of the intestinal epithelium is the distinguishing characteristic, and Shigella sp are the most frequent cause. Although oral rehydration is useful in dehydrated patients, dehydration is not a common problem in acute dysentery, and antimicrobial treatment is indicated for this disease. An antimicrobial agent should be selected on the basis of knowledge of the susceptibility patterns of locally isolated Shigella strains. PMID- 2694339 TI - Furazolidone and chloramphenicol for treatment of typhoid fever. AB - Seventy-one adults who were hospitalized between March 1985 and March 1987 were entered into a randomized, double-blind study to compare the efficacy and safety of furazolidone and chloramphenicol in therapy for typhoid fever. Patients received chloramphenicol capsules (total daily dosage, 2 g) plus placebo tablets for furazolidone tablets (total daily dosage, 800 mg) plus placebo capsules for 14 days. Seven patients were excluded from the analysis of efficacy because blood, bile, or bone marrow cultures at admission failed to demonstrate the presence of Salmonella typhi. Four additional patients were excluded because of intercurrent illness or failure to return for follow-up visits. Cure was achieved in 31 (97%) of 32 chloramphenicol recipients and 24 (86%) of 28 furazolidone recipients. In the chloramphenicol group, one patient experienced moderate sideroblastic anemia, and another experienced moderate neutropenia. Both adverse reactions resolved spontaneously within 7 days. Mild gastritis was reported by two patients who received furazolidone and one who received chloramphenicol. This study has demonstrated that furazolidone is an effective and safe alternative to chloramphenicol for the treatment of typhoid fever in adults. PMID- 2694340 TI - Acute invasive diarrhea in the pediatric patient. AB - In acute invasive diarrhea, the pathogen penetrates the epithelial cells of the intestinal mucosa. Symptoms are produced by one or more of the following mechanisms: production of enterotoxins, increased synthesis of prostaglandins, and impaired reabsorption of fluids and electrolytes. The invasive process often results in dysentery, which is characterized by watery stools containing blood and mucus, accompanied by cramps, rectal burning, fever, and, sometimes, toxicity. Among the complications are bacteremia and toxic megacolon. Diagnosis is based on the patient's clinical condition and examination of stools. Microscopic examination of stools can rule out parasites and detect leukocytes, particularly polymorphonuclear leukocytes, a finding that suggests a bacterial origin for the disease. Because most patients are not severely dehydrated, rehydration is not the mainstay of treatment; in most cases, fluids can be replaced orally. Absorbents are ineffective, and antiperistaltic drugs should not be used routinely in children. Although often unnecessary in simple cases of invasive diarrhea, antimicrobials are useful when risk factors related to age, clinical condition, malnourishment, dehydration, or underlying disease are present. In such cases, antimicrobial therapy should begin when the clinical diagnosis has been made, to ensure the best clinical response. PMID- 2694341 TI - A comparative study of furazolidone and placebo in addition to oral rehydration in the treatment of acute infantile diarrhea. AB - Between July and October 1987 an outpatient study of 191 children with acute diarrhea was undertaken in two rural communities in Mexico. Through a double blind randomization we compared the efficacy of a combination therapy of furazolidone, 7.5 mg/kg/day, plus standard oral rehydration therapy (ORT) (96 patients) versus a placebo plus ORT (95 patients), each given for 5 days. Diarrheal stool samples were collected from all patients before therapy. By means of a two-vial transport media system the samples were sent to a university laboratory and examined for viral, bacterial, and parasitic organisms. The most commonly isolated organisms were enterotoxigenic Escherichia coli (13%) and Giardia lamblia (13%). Patients who received furazolidone plus ORT showed a greater reduction in duration of diarrhea when compared with those receiving placebo plus ORT (63.4 h versus 71.44 h). There was also a trend toward shorter duration of diarrhea in patients with Giardia who were treated with furazolidone/ORT compared with Giardia patients in the placebo/ORT group. When fecal leukocytes were present in the stool, the furazolidone/ORT-treated patients had a significantly higher percentage of clinical cures (79% versus 54%, p = 0.03) and an overall shorter duration of diarrhea (62.0 h versus 80.6 h, p = 0.055) at the end of 5 days of therapy than did the placebo/ORT-treated group. PMID- 2694342 TI - Absorption, distribution, metabolism, and excretion of furazolidone. A review of the literature. AB - Systematic determination of profiles of absorption, distribution, metabolism, and excretion of drugs is standard in the pharmaceutical industry today, and powerful, precise, and specific analytical methods are available to carry out such studies. In the case of furazolidone, developed in the late 1940s, the data were obtained with less precise analytical procedures. This gave rise to the misconception that furazolidone is poorly absorbed and inactivated in the intestine. Newer techniques, such as chromatography and 14C studies, have helped to establish that the drug is indeed well absorbed. Levels of radiolabeled analyte measured in urine indicate that more than 65% of an oral dose is recovered in each animal species tested. Chromatographic methods indicate that little or no intact drug is recovered. PMID- 2694343 TI - A randomized, controlled, single-blind study comparing furazolidone with trimethoprim-sulfamethoxazole in the empirical treatment of acute invasive diarrhea. AB - An outpatient study of 125 children with acute invasive diarrhea was conducted at the Hospital Infantil de Mexico Federico Gomez. Through a single-blind randomization, we compared the efficacy of furazolidone, 7.5 mg/kg/day (49 patients), with trimethoprim-sulfamethoxazole (TMP-SMX), 8 mg/40 mg/kg/day (52 patients), each given for 5 days. A control group of 24 patients received no antimicrobials. Stool samples were collected from all patients at the time of admission, and active drugs were administered before the stool culture results were available. At baseline, 48 of 125 patients (38.5%) had negative stool cultures. In the other patients, the most frequently isolated pathogens were Shigella sp and enteropathogenic Escherichia coli. Of the total population who completed the study 43 of 49 (87.8%) of the patients in the furazolidone group and 43 of 52 (82.7%) of the patients in the TMP-SMX group achieved clinical cure by day 3, compared with 10 of 22 (45.5%) of the patients in the control group. Day 3 cure rates were similar between groups, independent of baseline stool culture results. Of those patients who had positive stool cultures on day 1, 20 of 34 (58.8%) in the furazolidone group and 19 of 29 (65.5%) in the TMP-SMX group had negative culture results on day 6, compared with 4 of 12 (33.3%) in the control group. Overall, clinical and bacteriologic success was achieved in 31 of 49 (63%) patients treated with furazolidone and in 36 of 52 (69%) patients treated with TMP-SMX, compared with 5 of 22 (23%) patients in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694344 TI - A comparison of furazolidone and ampicillin in the treatment of invasive diarrhea. AB - A single-blind, parallel, randomized study comparing the efficacy of furazolidone and ampicillin in the treatment of children with acute invasive diarrhea was conducted among outpatients at the Hospital General de Ciudad Nezahualcoyotl in Mexico between August 1986 and October 1987. Seventy-eight patients were admitted to the study; 39 were randomized to receive furazolidone (5 mg/kg/day for 5 days), and 39 were randomized to receive ampicillin (100 mg/kg/day for 5 days). The enteropathogens Shigella sp, Salmonella sp, and Escherichia coli were isolated in 87.2% of the initial stool cultures. A preliminary assessment of the patients' clinical status was made on day 3. At that time 97.4% of furazolidone patients had improved, compared with 65.7% of patients in the ampicillin group (p = 0.002). At the end of the treatment period (day 6), 100% of evaluable patients treated with furazolidone had a negative stool culture, compared with 71% of evaluable patients treated with ampicillin (p = 0.002). Both absence of watery stools by day 5 and a negative day 6 stool culture determined treatment success. Overall, there was a greater percentage of treatment successes in the furazolidone group than in the ampicillin group (92.3% versus 51.3%, p = 0.001). Tolerance to both drugs was very good. One patient treated with ampicillin developed urticaria, which required discontinuation of treatment; the reaction resolved spontaneously after treatment discontinuation. No adverse reactions were reported in the furazolidone group. The results of this study showed that furazolidone was more effective than ampicillin in the treatment of acute invasive diarrhea. It is suggested that furazolidone should be the treatment of choice for this disease. PMID- 2694345 TI - Recent advances in the diagnosis and management of giardiasis. AB - Management of patients with giardiasis is often difficult because of problems related to diagnosis, lack of knowledge about pathophysiology, and a less than satisfactory chemotherapeutic armamentarium. Treatment, particularly in children, presents several problems: What drug should be used, and at what dosage? Should the patient's contacts be treated? How does one cope with treatment failures? An overview of data available in the literature is presented, and studies on the susceptibility and resistance of Giardia isolates to different drugs in in vitro and in vivo models are discussed. In such models, tinidazole, metronidazole, and furazolidone were most active in terms of susceptibility; quinacrine was least active. However, Giardia strains resistant to all four drugs were isolated. Nitroimidazoles were associated with poor compliance in children, whereas furazolidone was well tolerated. It is concluded that management of symptomatic giardiasis is complicated by a range of factors, including drug resistance, patient compliance, and the lack of an accurate, sensitive, and noninvasive diagnostic test. PMID- 2694346 TI - Furazolidone and metronidazole for treatment of giardiasis in children. AB - One hundred children were entered into a randomized study to compare the efficacy and safety of furazolidone and metronidazole when given in liquid suspension for treatment of giardiasis. The study was conducted between May 1985 and February 1986. Dosages were calculated on the basis of body weight, and treatment lasted 10 days. Clinical diagnosis of giardiasis was confirmed by the presence of Giardia cysts in stools. Children were excluded from the study if stool culture was positive for pathogenic bacteria. Eighteen of the 100 children were withdrawn from the study because of noncompliance with the protocol. Of the 82 remaining patients, 37 received furazolidone and 45 metronidazole. No statistically significant differences in efficacy between treatments were found. With the exception of one case of urticaria, which occurred in a patient who received metronidazole, both drugs were well tolerated. In this study, furazolidone and metronidazole were equally safe and effective in treating children with giardiasis. PMID- 2694347 TI - Adverse reactions to furazolidone and other drugs. A comparative review. AB - Furazolidone is a synthetic nitrofuran with a broad spectrum of antimicrobial action and has been widely used in the treatment of gastrointestinal infections. This article reviews the adverse reactions to furazolidone reported in the world literature. Of 10,443 adults and children who were treated with the drug, approximately 8.3% (864) experienced such reactions. Because some of these patients had more than 1 adverse reaction, 1178 reactions were reported in these studies. Nausea with vomiting, the commonest adverse reaction, was reported by 51% of the 864 patients who experienced adverse reactions. The authors compare the adverse reactions to furazolidone with those reported for other antimicrobial and antiprotozoal drugs that are frequently used to treat gastrointestinal infections. PMID- 2694348 TI - Risk of cancer in inflammatory bowel disease: why are the results in the reviewed literature so varied? AB - It is important to know the risk of cancer in inflammatory bowel disease and to know the magnitude of the problem. It then becomes possible to answer some questions on the management of patients. It is useful to have a surveillance procedure and follow all patients considered at risk of developing cancer? Should prophylactic surgery be recommended for all patients with long-standing extensive disease, and what will be its impact on the quality of life? There is a wide range of reported incidence of colorectal cancer in inflammatory bowel disease. This is likely to be due to selection bias and problems with generalization and validity of the results rather than any real differences in the underlying cancer incidence. Rigorous methodologic standards must be used to measure the risk of cancer in inflammatory bowel disease. PMID- 2694349 TI - Diagnosis of infection caused by Chlamydia pneumoniae (strain TWAR) in patients with "ornithosis" in southern Sweden 1981-1987. AB - Serological distinction between ornithosis and infection by Chlamydia pneumoniae (strain TWAR) was attempted by microimmunofluorescence (MIF) of 156 cases previously considered as ornithosis on the ground of a positive complement fixation test with a chlamydia group antigen. At least 23% of these cases were TWAR infections according to the results at retesting by MIF. The highest frequency of TWAR infections was demonstrated during 1981 with a decreasing number and proportion thereafter. We contend that the sudden increase in the reported number of ornithosis cases in 1981 may have been caused by TWAR infections which seem to vary in incidence over time. Family clusters of respiratory infections were much more common with TWAR infections than with ornithosis. PMID- 2694350 TI - Erythema nodosum--a manifestation of Chlamydia pneumoniae (strain TWAR) infection. AB - We describe 2 cases of erythema nodosum (EN) secondary to an infection with the TWAR strain of chlamydia, recently designated Chlamydia pneumoniae. Two young patients, 17 and 11 years old, were admitted with EN and no physical signs of pneumonia. One patient had a non-productive cough and fever. The other patient only ran a high fever. Chest radiography revealed bronchopneumonias. Infection with the C. pneumoniae species was proven by serologic testing using microimmunofluorescence technique. Serology and cultures for other bacteria known to induce EN were negative. Thus, C. pneumoniae (strain TWAR) can elicit EN. PMID- 2694351 TI - Early fall of circulating iron and rapid rise of lactoferrin in septicemia and endotoxemia: an early defence mechanism. AB - Total serum iron, plasma lactoferrin and circulating leukocytes were measured in piglets during the early phase of severe gram-negative septicemia and endotoxemia in 3 experimental settings: intravenous (i.v.) infusion of lipopolysaccharide (LPS) (n = 8), i.v. infusion of live Escherichia coli (n = 7) and intraperitoneal (i.p.) infusion of E. coli (n = 6). Iron dropped significantly during the first 30 min of LPS infusion from a median of 32 microM to 13.4 microM. A similar decrease in serum iron was demonstrated in the 2 other groups with minimum values at 120 min after the start of E. coli infusion. Plasma levels of lactoferrin increased significantly 120 min after the start of LPS infusion (median 6 mg/l) when compared to preinfusion values (0.25 mg/l). After i.v. infusion of E. coli a significant rise of plasma lactoferrin was demonstrated already 30 min after bacterial infusion (to 2.1 mg/l) compared to preseptic values (0.8 mg/l). This increase was accompanied with a significant drop of circulating leukocytes (to 7.3 x 10(9)/l) compared to before the infusion (17 x 10(9)/l) in the pigs given E. coli i.v. After i.p. E. coli infusion no significant change of plasma lactoferrin was observed. The rapid fall of total serum iron seen during endotoxemia and E. coli septicemia may in part be explained by the release of lactoferrin from granulocytes and the clearance of iron-bound lactoferrin in the blood or peritoneal cavity. PMID- 2694352 TI - Vibrio vulnificus infection. AB - We report 3 cases of Vibrio vulnificus infections from Taiwan. Patient 1, who manifested symptoms of primary septicemia, died after 2 days. Patient 2, who had a wound infection and signs and symptoms of sepsis but negative blood cultures, responded to tobramycin and chloramphenicol plus surgical debridement, and recovered after 26 days of hospitalization. Patient 3 had secondary septicemia originating from a wound inflicted by a shrimp. Originally, the patient seemed to respond to ceftazidime and amikacin treatment along with surgical debridement, but subsequently died from adult respiratory distress syndrome (ARDS) induced by several episodes of aspiration which occurred after initial clinical improvements. We conclude that, for patients with severe wounds and evidence of V. vulnificus infection, an appropriate, powerful antibiotic, such as one of the third generation cephalosporins should be used as initial therapy unless the nature of the infection indicates other treatment. PMID- 2694353 TI - Vibrio vulnificus septicaemia presenting as spontaneous necrotising cellulitis in a woman with hepatic cirrhosis. AB - Vibrio vulnificus is a virulent marine organism commonly found in Hong Kong coastal waters which contaminates local sea-food. It may produce a primary septicaemia, often associated with secondary skin lesions, following ingestion of raw shell fish. We report a rapidly fatal case of primary V. vulnificus septicaemia in a 50-year-old housewife with post-hepatitic cirrhosis presenting as spontaneous necrotising cellulitis of the legs. V. vulnificus infection should be considered in patients with a history of liver disease with acute septicaemia and characteristic skin lesions. PMID- 2694354 TI - Schistosomiasis. Immunological, serological and clinical aspects. PMID- 2694355 TI - Interactions between oxygen free radicals and proteins. Implications for rheumatoid arthritis. An overview. PMID- 2694356 TI - Low power laser therapy of shoulder tendonitis. AB - 30 patients with supraspinatus or bicipital tendonitis were randomly allocated to active infrared laser therapy at 904 nm three times weekly for 2 weeks, dummy laser or drug treatment for 2 weeks. Objectively maximum active extension, flexion and abduction of the shoulder, and subjectively pain stiffness movement and function were measured at 0 and 2 weeks. Significant improvement of active over dummy laser was noted for all seven assessments. Active laser therapy produced significant improvement over drug therapy for all three objective measures and pain. Naproxen sodium significantly improved only movement and function compared to dummy laser. These results demonstrate the effectiveness of laser therapy in tendonitis of the shoulder. PMID- 2694357 TI - The physical state of potassium in the human lymphocyte: a review. AB - Studies of the effects of chemical potential, temperature, and metabolic perturbation on static ion contents, kinetics of the approach to equilibrium, and kinetics of ionic self-exchange in human lymphocytes are reviewed. The results contradict the classical concept of cell ion and water physiology, the membrane osmotic, pump-leak theory, and are re-interpreted by an adsorption model of the cell. In this model, most of cell water exists in a physical state sufficiently ordered to reduce the partition function of dissolved ions, and most of cell potassium is associated with fixed charges on macromolecules. Competing adsorption of potassium and sodium is cooperative and has a critical temperature dependence. The kinetics of the approach to equilibrium are described by a time dependent Ising model. High rates of isotopic self-exchanges of potassium and sodium near the transition point are postulated to result from an increased rate of fluctuations within the ensemble of ion-adsorbing proteins. PMID- 2694358 TI - Surface heterogeneity of tumor cells and changes upon ionizing radiation. AB - Heterogeneous distribution of surface domains is a characteristic feature of the tumor cell surface and the distribution differs from that of normal cells. During the malignant transformation the heterogeneity may change or disappear. Cell lines with various metastasizing capacities show different distributions of membrane domains or other differences in membrane or surface organization. We have demonstrated that the amount and distribution of negatively charged sites of B 16 melanoma membranes changed upon ionizing radiation (X-ray, 60Co-gamma). In the case of the P 388 lymphoma, however, only the amount of negatively charged sites change after irradiation, the distribution remains unaltered. Both features proved to be radioresistant in human lymphoid leukemic cells. PMID- 2694359 TI - Gastrointestinal surface changes: interpretation problems and indexing possibilities (a review). AB - The purpose of this review on state-of-the-art and new perspectives on the use of scanning electron microscopy (SEM) in gastrointestinal pathology is to discuss the possibility of developing an index for quantitatively grading mucosal epithelial injury. This topic is reviewed within the framework of ulcer indices previously developed for gross lesions, where analogous problems exist, and in relation to the transmission electron microscope staging of epithelial cell pathology. If such an index could be developed it would increase objectivity and standardization of data analysis from laboratory to laboratory, and would allow for quantitative and statistical analysis of morphometric data. It is concluded that an index is possible based upon fields of injured cells rather than upon the grading of individual cell injury progression. An example of a useful SEM lesion index is presented. There are definite limitations to development of such an index, and guidelines are provided to help minimize some of the numerous complicating factors. These guidelines include comments on magnification, tissue contour, cell versus tissue analysis, morphometric considerations, sources of error, and other factors. PMID- 2694360 TI - Quantitative measurement from vascular casts. AB - A review of quantitative measurements show casting materials shrink from 0.2 - 20% and have viscosities ranging from 1.4 - 100,000 centipoise. Blood vessels have highly variable mechanical properties. Some microvessels are very stiff having little change in dimensions with pressure. Larger vessels generally change diameter significantly but show highly variable changes in length with pressure. Perfusion fixation does not fix the dimensions of blood vessels. Dog carotid arteries well fixed with glutaraldehyde at physiologic dimensions retain approximately 20% of their elastic recoil circumferentially and approximately 30% longitudinally. We recommend vascular casting as a method of accurately measuring the vasculature if care is taken to use low shrinkage casting resins and maintain physiologic transmural pressures for the duration of any casting procedure, even if prefixation is used. We measured a approximately 10% error in our method of measuring both the size and location of periorificial atherosclerotic lesions from aortic casts. Little is known about how vascular smooth muscle tone changes during casting. PMID- 2694361 TI - Bone lining cells: structure and function. AB - Bone lining cells (BLC's) cover inactive (nonremodeling) bone surfaces, particularly evident in the adult skeleton. BLC's are thinly extended over bone surfaces, have flat or slightly ovoid nuclei, connect to other BLC's via gap junctions, and send cell processes into surface canaliculi. BLC's can be induced to proliferate and differentiate into osteogenic cells and may represent a source of "determined" osteogenic precursors. BLC's and other cells of the endosteal tissues may be an integral part of the marrow stromal system and have important functions in hematopoiesis, perhaps by controlling the inductive microenvironment. Because activation of bone remodeling occurs on inactive bone surfaces, BLC's may be involved in the propagation of the activation signal that initiates bone resorption and bone remodeling. Evidence also suggests that BLC's are important in the maintenance of the bone fluids and the fluxes of ions between the bone fluid and interstitial fluid compartments for mineral homeostasis. PMID- 2694362 TI - [Methods for determining antinuclear antibodies and their clinical significance]. AB - Antinuclear antibodies are directed against different nuclear antigens such as deoxyribonucleic acid, ribonucleic acid, nucleoproteins, histones and non histones-antigens. The importance of ANAs in the characterization of different systemic rheumatic diseases, e.g. autoimmune diseases, has been recognized. The most commonly used assay for ANAs is indirect immunofluorescence. Several methods, such as radioimmunoassays, double immunodiffusion in agarose gel, counterimmunoelectrophoresis or immunoblotting, have been developed and serve to identify antibodies of different specificities. This overview describes the clinical importance of ANAs with reference to the methods of detection. The immunologic diagnosis aspect of different autoimmune and collagen diseases is presented. PMID- 2694363 TI - [Swiss simvastatin multicenter study: 1. Efficacy of 10 mg simvastatin daily in patients with primary hypercholesterolemia]. AB - In a Swiss multicenter study with determination of lipid and lipoprotein parameters in a central laboratory, the efficacy of simvastatin, MSD, was evaluated in patients with primary hypercholesterolemia. Lipid and lipoprotein values were determined in 109 patients before and after 6 weeks' therapy with 10 mg simvastatin per day. A significant decrease in total cholesterol, LDL cholesterol and apo B, of 21.1, 25.8 and 24.1% respectively, was observed. No influence of simvastatin on apo A-II was found, but HDL-cholesterol and apo A-I were slightly increased (+6.1 and 4.4% respectively). The data show that HMG-CoA reductase inhibitors constitute a new class of effective drugs for the treatment of hypercholesterolemia. PMID- 2694364 TI - [Current concepts in the regulation of the immunologic response]. AB - Regulation of the immunological response occurs at several levels which reflect the increasing complexity of our defense systems and of the immune apparatus. These regulation levels could be compared to the various floors of a building which are first explored and analyzed individually. They are (a) the development and differentiation of the immune system; (b) antigen presentation and genetic predispositions for a specific immune response; (c) idiotypic regulation of the immune response; (d) isotypic regulation and genetic control of the classes of antibodies produced, in particular IgE; (e) immunological regulation through various lymphocyte subpopulations; (f) regulation of the reactivity of inflammatory cells and (g) neuroendocrine regulation of the immune system. Any one of these chapters or levels may be presented and discussed as such, and are at the present time relatively well understood. It is more difficult, however, to evaluate the vertical communications between the various levels of regulation and the relative importance of the individual regulating systems in the development of a global immune response by the organism. PMID- 2694365 TI - [Morphology of the immune response]. AB - This review attempts to summarize current knowledge of the cellular reactions observed during immune responses. A short presentation of organs and cells of the immune system is followed by a summary of the ontogeny of T and B cells and particularly of antigen receptors. Some examples of practical applications are quoted. PMID- 2694366 TI - [Clinical aspects, diagnosis and therapy of insect bite allergy]. AB - Systemic allergic reactions following insect stings, most often by hymenoptera (honey bee, wasp), are usually of the immediate type and thus mediated by venom specific IgE-antibodies. The most frequent clinical symptoms are urticaria, angioedema, asthma and anaphylactic shock. While in epidemiological surveys up to 4% of individuals report a history of systemic allergic reactions following hymenoptera stings, fatal cases are extremely rare. Diagnosis is based on history, skin tests and estimation of venom specific serum IgE-antibodies (RAST). For treatment of mild systemic reactions antihistamines are often sufficient. In all cases with respiratory and/or cardiovascular symptoms, adrenalin must be given either by inhalation or by injection. All patients with a history of systemic reactions to hymenoptera stings must be instructed in prophylactic measures and receive emergency medication including adrenalin. The efficacy of venom immunotherapy is well documented but this treatment is expensive. It is therefore mainly indicated in patients with a history of sever systemic reactions and a high degree of exposure. PMID- 2694367 TI - [Combined GM-CSF and erythropoietin therapy in myelodysplastic syndrome]. AB - A 60-year-old patient with a myelodysplastic syndrome (MDS) corresponding to refractory anemia with an increase in blast cells (RAEB) was treated with granulocyte-macrophage colony stimulating factor (GM-CSF) and erythropoietin (EPO) for severe symptomatic pancytopenia. During the GM-CSF treatment a distinct increase in granulocytes was observed, but the reticulocytes and thrombocytes decreased to the point where treatment had to be discontinued after eight days. After subsequent treatment with EPO the reticulocyte count rose from 0% to 2%. However, this rise alone was insufficient to decrease the number of blood transfusions required. The thrombocyte count rose to the original values after the cessation of GM-CSF therapy while continuing treatment with EPO. Bone marrow investigations were performed before and after GM-CSF treatment and indicated a distinct increase in the myeloid precursor cells after therapy, without an increase in blasts. On the other hand, an obvious decrease in erythro- and megakaryopoiesis was observed. PMID- 2694368 TI - [Does post-puncture syndrome following lumbar puncture depend on needle diameter?]. AB - The impact of needle size on the frequency of post-lumbar puncture syndrome (PPS) was investigated in 77 patients undergoing diagnostic lumbar puncture. 22-gauge needles were used in 44 patients (group A) and 19-gauge needles in 33 (group B). Because of severe postdural headache, an epidural blood patch was applied in 6 patients and resulted in immediate relief of symptoms. In the remaining 71 patients, PPS occurred in 57% of group A and in 48% of group B. A statistically significant relationship could not be found between needle size and duration of PPS (p = 0.2), but an inverse ratio was found between age and duration of post lumbar puncture headache (p = 0.006). A review of previous studies in this field shows that needles with a diameter smaller than 24 gauge reduce the incidence of PPS. However, technical skill is also of prime importance in lowering the frequency of postdural headache. PMID- 2694369 TI - [Evaluation of a new ambulatory blood pressure measuring device, the Sandoz Pressure System]. AB - The accuracy of "Sandoz Pressure System", in comparison with the mercury sphygmomanometer, was studied in 171 patients in 2 centers. The correlation, as estimated for 657 pairs of measurements, was excellent: systolic and diastolic coefficients were r = 0.986 and r = 0.940 respectively. The individual difference is less than or equal to 5 mm Hg for 90% of the systolic values and 82% of the diastolic values. The ambulatory reliability is demonstrated for 300 profiles, of which 279 (93%) are complete. Of 7902 determinations, 59 (0.75%) were deleted because considered to be incorrect. PMID- 2694370 TI - [The risk of sudden death in sports practice--can it be diagnosed and reduced?]. AB - The sudden death of a sportsman in full action is fortunately rather uncommon. Nevertheless, it is all the more frightening, as it befalls unexpectedly someone who is seemingly in full health. Moreover, this type of accident, essentially a cardiac event, strikes more often competitive athletes than leisure sportsmen, who are submitting themselves to more moderate exertions. The mechanism leading to death is in most cases a heart rhythm problem ending in ventricular fibrillation. Its origins are generally a cardiomyopathy or an inborn structural anomaly of the heart in young subjects. In men over 30 years of age, most deaths can be explained by degenerative coronary disorders. It is important to note that 93% of sudden death victims related to exertion in sports are men, even if women form 45% of practising sports people. A large part of the decreased had already a functional disorder, often angina, before the tragic event took place. 38% of this group even took medical advice from a cardiologist. We may thus consider that a fraction of these deaths could be prevented through diagnosis and subsequent treatment. Therefore, sports people should be better informed on the risks they incur in not taking care of themselves. This information has to be distributed on a large scale. With regard to the other cases, we should examine which detection tests are to be discussed and used. They may involve a financial problem, but should nevertheless be considered carefully. PMID- 2694371 TI - Eikenella corrodens: an unusual cause of endocarditis in a patient with silent mitral valve prolapse. AB - A 69-year old man with clinically silent mitral valve prolapse developed infective endocarditis secondary to Eikenella corrodens after dental work. The patient required surgical removal of abscessed teeth and long-term antibiotic therapy. E. corrodens is a gram-negative coccobacillus which normally inhabits the oropharynx, gastrointestinal tract, and upper respiratory tract. The organism can cause cutaneous and abdominal abscesses, meningitis, osteomyelitis, and endocarditis. Patients with mitral valve prolapse and a pre-existent systolic murmur or Doppler echocardiographic evidence of mitral regurgitation should receive prophylactic antibiotics for any procedure associated with a bacteremia. An infection caused by E. corrodens should be considered in patients with fever after dental manipulation or in patients with "culture-negative" endocarditis. PMID- 2694372 TI - Determination of lead in blood by graphite furnace atomic absorption spectrometry -a critique. AB - Graphite furnace atomic absorption spectrometry (GFAAS) is increasingly becoming the method of choice for the determination of Pb in blood. The major GFAAS methods that have been published to date include: (i) direct introduction of the sample into the furnace; (ii) dilution with water, Triton X-100 or acid; (iii) deproteinization with nitric acid; (iv) matrix modification; and (v) solvent extraction. This review focuses on the difficulties associated with each of these methods, and highlights recent attempts to overcome matrix interferences and improve the accuracy and precision of Pb determination in blood using modern furnace technology, especially the stabilized temperature platform furnace. PMID- 2694373 TI - Enzyme immunoassay (Chlamydiazyme) for the detection of chlamydial antigen in endocervical specimens. AB - Endocervical swabs taken from 86 women were tested by the Chlamydiazyme enzyme immunoassay test to detect chlamydial antigens. Compared to cell culture, Chlamydiazyme was 100% sensitive and 90% specific. This test is suitable as alternative diagnostic method to cell culture and has the potential for automation. PMID- 2694374 TI - The neurology of AIDS. PMID- 2694375 TI - Update on molar pregnancy and choriocarcinoma. AB - The term gestational trophoblastic disease encompasses a wide spectrum of disorders ranging from the benign hydatidiform mole to the malignant choriocarcinoma and placental site trophoblastic tumor. Recent advances in cytogenetics and pathological criteria have brought to light the occurrence of the partial mole, which is probably more common than the complete mole. The World Health Organisation has proposed a classification to rectify the current confusion that exists with clinical and pathological terms. Evacuation of the uterus followed by meticulous followup with sensitive beta subunit Human Chorionic Gonadotropin assay remain the cornerstone of management of molar pregnancy. Prompt chemotherapy is the most important aspect in managing malignant sequelae. Newer chemotherapy regimes have helped to salvage failures from the usual drugs. Judicial use of surgery in metastatic trophoblastic disease can reduce the duration and toxicity of chemotherapy. All patients with gestational trophoblastic disease should be managed in a tertiary care centre with the expertise and facilities easily available to manage these cases. PMID- 2694376 TI - Management of thyroid disease in pregnancy. AB - Thyroid disease occurs in pregnant at the rate of 0.2-0.6%. Graves' disease is the most common thyroid disorder in our pregnant patients. Thyroid disease is suspected if a significant goitre is detected during pregnancy. Confirmation by thyroid function tests is necessary but their interpretation requires an understanding of changes in the maternal thyroid physiology. Pharmacotherapy with the thionamides is the treatment of choice. Changes in dosage are influenced by the effect of pregnancy on the disease and the optimal level of control for the mother and the foetus. The dose is best titrated against the free thyroxine index or free thyroxine level. The outcome of pregnancy depends on early diagnosis and skillful manipulation of antithyroid drugs. PMID- 2694377 TI - A review of the prevalence and causes of myopia. AB - In this study, we reviewed the prevalence of myopia by country. Different types of myopia are elaborated and the causes of myopia are presented. It appears that the origin of myopia is due to both environmental and genetic factors. PMID- 2694378 TI - [Psychotherapies inspired by analysis. Methods and indications]. PMID- 2694379 TI - [Freud and psychoanalysis in the history of psychiatry]. PMID- 2694380 TI - [Echosonography and retrograde cholangiopancreatography in selecting surgical tactics in mechanical jaundice]. AB - The results of the diagnosis and treatment of 134 patients with obstructive jaundice are analyzed. The diagnostic potentialities of the ultrasonic method and endoscopic retrograde cholangiopancreatography (ERCPG) are compared. ERCPG has been found more effective for the diagnosis of the causes, localization, and severity of the bile duct obstruction in patients with mechanical jaundice. Endoscopic papillosphincterotomy is an effective treatment modality that helps eliminate or reduce the jaundice, remove the concrements from the duct, and reduce the scope of abdominal cavity surgery in cholelithiasis. PMID- 2694381 TI - [Use of cytostatics deposited in cellulose acetate microspheres in the treatment of ovarian cancer]. PMID- 2694382 TI - [Neuroendocrine disorders in epilepsy and their hormonal correction]. PMID- 2694383 TI - [Palpitin in disorders of cardiac rhythm]. PMID- 2694384 TI - [Hypotensive effect of tobanum in hypertension]. PMID- 2694385 TI - [Comparative effectiveness of decaris and saparal in recurrent peptic ulcer]. PMID- 2694386 TI - [Surgical tactics in acute colonic diverticulitis]. PMID- 2694387 TI - The idiopathic double thoracic curve pattern. Its recognition and surgical management. AB - Recognition of the idiopathic double primary thoracic curve pattern has become increasingly important as more effective methods of internal correction of curves have been developed. Overcorrection of the lower thoracic curve beyond the spontaneous correctability of the upper thoracic curve may lead to an undesirable asymmetric neck and shoulder contour. PMID- 2694388 TI - The neuroradiographic diagnosis of lumbar herniated nucleus pulposus: I. A comparison of computed tomography (CT), myelography, CT-myelography, discography, and CT-discography. AB - The accuracy of five imaging modalities for the diagnosis of lumbar herniated nucleus pulposus (HNP) is compared prospectively in 124 patients, all of whom underwent surgical exploration. All tests were read independently of each other and the level of confidence in each diagnosis was recorded. The results are based on negative (106) as well as positive (125) findings at the 231 disc sites (level and side) explored. Computed tomography-discography (disco-CT) was the most accurate test (87%) compared to 77% for CT-myelography (myelo-CT), 74% for CT, 70% for myelography, 64% for disc injection pain, and 58% for discography. The false positive rate was lower for disco-CT (19%) than for myelo-CT (24%), CT (24%), and myelography (30%). The false negative rate was also lower for disco-CT (8%) than for myelo-CT (22%), CT (29%), and myelography (30%). Disco-CT was the most accurate test (94%) in patients who had prior disc surgery compared with 81% for myelo-CT, 80% for CT, and 74% for myelography. Disco-CT was also the most accurate test for patients with foraminal HNP (91% compared with 71% for CT, 65% for myelo-CT, and 58% for myelography). Disc injection reproduced the patient's clinical pain pattern in only 36% of herniated discs. This test has high specificity (89%), but low sensitivity (43%). The risks from myelography followed by discography within a 72-hour period are similar to those reported for myelography alone. Disco-CT is the most accurate of these tests (P less than 0.05) for the diagnosis of lumbar HNP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694389 TI - The neuroradiographic diagnosis of lumbar herniated nucleus pulposus: II. A comparison of computed tomography (CT), myelography, CT-myelography, and magnetic resonance imaging. AB - The accuracy of computed tomography (CT), myelography, CT-myelography (myelo-CT) and magnetic resonance imaging (MRI) for the diagnosis of lumbar herniated nucleus pulposus (HNP) is compared prospectively in 59 patients, all of whom underwent surgical exploration. All tests were read independently of each other and the level of confidence in each diagnosis was recorded. The results are based on the negative (61) as well as positive (59) findings at the 120 disc sites (level and side) explored. Magnetic resonance imaging was the most accurate test (76.5%) compared with myelo-CT (76.0%), CT (73.6%), and myelography (71.4%). The false positive rate was lowest for MRI (13.5%) followed by myelography (13.7%), CT (13.8%), and myelo-CT (21.1%). The false negative rate was lowest for myelo-CT (27.2%) followed by MRI (35.7%), CT (40.2%), and myelography (44.1%). In that subset of 19 patients who had prior surgery, myelography was the most accurate means of diagnosing lumbar HNP (88.8%), followed by MRI (83.3%), myelo-CT (78.4%), and CT (72.6%). The false positive rates in these patients were 11.6% for myelography, 13.2% for MRI, 14.5% for CT, and 16.4% for myelo-CT; the false negative rates were 22.7% for MRI, 24.4% for myelography, 29.5% for myelo-CT, and 47.7% for CT. Magnetic resonance imaging compares very favorably with other currently available imaging modalities for diagnosing lumbar HNP. Magnetic resonance imaging is painless, has no known side effects or morbidity, no radiation exposure, and is noninvasive. The authors recommend it as the procedure of choice for the diagnosis of most lumbar disc herniations. PMID- 2694390 TI - Discography and magnetic resonance imaging in the diagnosis of lumbar disc disruption. AB - Four cases of patients with normal magnetic resonance (MR) studies of the lumbar spine and abnormal discography are presented to illustrate that normal lumbar disc signal intensity does not necessarily rule out disc degeneration. PMID- 2694391 TI - Congenital spine deformity: "What's the latest and what's the best"? PMID- 2694392 TI - Intrasacral meningocele. Case report and review of the literature. AB - We have presented a case of a 28-year-old woman with an intrasacral meningocele. Diagnosis of this case was aided by the use of MRI. The literature regarding this problem has been reviewed. PMID- 2694393 TI - Cervical pneumomyelogram secondary to a closed fracture-dislocation of the thoracic spine. A case report. PMID- 2694394 TI - [Pathological changes in cartilage of the knees in rabbits immunized with Escherichia coli 0:14]. AB - Pathological changes in the articular cartilage were found in the knees of rabbits immunized with heat-killed Escherichia coli for 8-10 months at significantly higher rate (33.3%, 12 of 36 knees, p less than 0.05) than in those immunized for 1-4 months (17.6%, 6 of 34). Cartilage degeneration showed two types which were pannus invasion at the cartilage-synovial junction, and degeneration at superficial layer of the articular cartilage as seen in rheumatoid arthritis of human. Depositions of immunoglobulin were found in 10 out of 16 knees (62.5%) with the pannus invaded lesion and 5 out of 8 knees (75%) with the degenerated superficial layer of articular cartilage. PMID- 2694395 TI - [Cytokines and rheumatoid arthritis]. PMID- 2694396 TI - [Assessment of efficacy of RPY-001 in rheumatoid arthritis]. PMID- 2694397 TI - [Ciprofloxacin in urinary infections: analysis of the Italian data pool]. AB - Efficacy and safety of oral ciprofloxacin (500-1000 mg/die) were evaluated in 231 patients with bacteriologically documented infections of the urinary tract. The clinical resolution rate was 89.6% with eradication of the aetiological organism in 90.1% of cases. Superinfection, both bacterial or fungal, as well as side effects were minimal. It is concluded that ciprofloxacin represents an effective and safe therapy in urinary tract infections. PMID- 2694398 TI - [Megakaryoblastic leukemias]. PMID- 2694399 TI - [Red cells and the immune system]. PMID- 2694400 TI - Potential mechanisms for coordinate gene activation in the rheumatoid synoviocyte: implications and hypotheses. AB - Evidence is reviewed to support the concept that synovial cells in rheumatoid arthritis have undergone distinctive alterations at the cellular and subcellular level that result in their taking on some of the characteristics that are also manifest by transformed cells. These phenotypic modulations could be indirectly driven by cytokines in a paracrine or autocrine fashion. Specific regional patterns of cell phenotype modulation were used to argue against a simple widely diffusing direct inductive effect to cytokines and in favor of microenvironmental determinants. It is hypothesized that these extracellular factors induce novel activation in a coordinate manner by acting through master regulatory genes operating in cells with specific microenvironmental interactions. Two of these regulatory genes, fos and jun, are discussed in detail because of their induction by growth factors and their central role in the transactivation of genes which have been implicated in rheumatoid synovitis. A model for gene activation in the rheumatoid synovium is proposed based on the premise that fos and jun are an important link in the intracellular transduction pathways used by cytokines to induce cellular phenotypic changes. PMID- 2694402 TI - T cell regulation and T cell clones in relation to synovial inflammation. PMID- 2694401 TI - The role of neutrophils in vascular injury: a summary of signal transduction mechanisms in cell/cell interactions. PMID- 2694403 TI - The B cell system in the rheumatoid inflammation. New insights into the pathogenesis of rheumatoid arthritis using synovial B cell hybridoma clones. PMID- 2694404 TI - What can we learn about rheumatoid arthritis from animal models? PMID- 2694405 TI - B and T cell antigen receptor repertoires in lupus/arthritis murine models. PMID- 2694406 TI - Autoreactivity to the cardiac myocyte, connective tissue and the extracellular matrix in heart disease and postcardiac injury. PMID- 2694407 TI - Congenital AV-block: role of anti-Ro and anti-La antibodies. PMID- 2694408 TI - Humoral immune response to cardiac conducting tissue. PMID- 2694409 TI - Heart transplantation: cellular and humoral immunity. PMID- 2694410 TI - Autoreactive mechanisms in infective endocarditis. AB - Infective endocarditis is not a simple interaction between a microbial agent and a cardiac valve. For the infection of a non-bacterial thrombotic vegetation, predisposition is required which is at least partially operative by a decreased suppressor T cell activity. During infection, peripheral blood natural killer cell activity is decreased, but normalizes under anti-microbial therapy. Non major histocompatibility complex-restricted lymphocytotoxicity to isolated heart cells can be present in one third of patients. Circulating immune complexes normalize during therapy. They may be the cause of many clinical symptoms of infective endocarditis. Anti-bacterial and also anti-sarcolemmal antibodies which are cross-reactive to the bacterium are secreted in a polyclonal immune response. Anti-sarcolemmal antibodies which are cytolytic in vitro in the presence of complement may partly explain the myocardial factor of heart failure in patients with only marginal valve incompetence due to the endocarditic vegetation. PMID- 2694411 TI - Immune complexes in infective endocarditis. PMID- 2694412 TI - The pathogenesis of endomyocardial fibrosis: the role of the eosinophil. PMID- 2694413 TI - Retrospective and perspectives in the immunology of cardiac diseases. PMID- 2694414 TI - Brown's syndrome. AB - Brown's syndrome is a well-recognized clinical disorder of ocular motility manifesting most notably a restriction of active and passive elevation in adduction. The original name, "superior oblique tendon sheath syndrome," is no longer appropriate, since it has been shown that the tissue surrounding the anterior superior oblique tendon is blameless as a restrictive force. "True" and "simulated" as descriptive modifiers should also be discarded, as they relate to the disproven sheath concept. Brown's syndrome occurs as a congenital or acquired, constant or intermittent condition; the common link is restriction of free movement through the trochlea pulley mechanism. The various etiologic theories are reviewed and the spectrum of medical and surgical treatments are described and evaluated. Evidence suggests that subtypes of Brown's syndrome lie on a single continuum and that spontaneous resolution occurs in each group, probably more often than previously recognized. A simplified classification scheme is encouraged and possible future directions in Brown's syndrome research are introduced. PMID- 2694415 TI - The infant with nystagmus, normal appearing fundi, but an abnormal ERG. AB - Many retinal disorders present during infancy with nystagmus, decreased vision, and normal-appearing fundi, but an abnormal ERG. The most common of these disorders are Leber's congenital amaurosis, achromatopsia, and congenital stationary night-blindness. Other disorders with similar ocular manifestations may be associated with a variety of life-threatening systemic abnormalities. This review describes the clinical, electrophysiological, and laboratory findings that can be used to distinguish among these conditions. PMID- 2694416 TI - Ocular complications of systemic cancer chemotherapy. AB - Cancer chemotherapy has changed rapidly in recent years. New agents are constantly being developed. Established agents are being used with increased frequency, in new combinations, at higher dosages, and via new routes of administration. Enhanced survival, as well as increased drug toxicity, has resulted. Ocular toxicity is not uncommon and can greatly impact on quality of life. Practitioners in all fields are increasingly caring for patients who are receiving cancer chemotherapy. The recognition of eye disease resulting from chemotherapy is essential to appropriate patient management. We provide a review of the rapidly growing body of literature on the ocular toxicity of systemic cancer chemotherapy with particular attention to context, clinical course, mechanism, prevention and treatment. PMID- 2694417 TI - Trends and current status in childhood mortality. United States, 1900-85. AB - Mortality statistics for children 1-19 years of age by race, sex, and cause of death are analyzed focusing on differences in external and natural causes. General trends from 1900-68 as well as trends in leading causes of death for 1968 85 are examined. Geographic variation by cause of death and cross-national comparisons are also presented. PMID- 2694418 TI - Effect of theophylline and enprofylline on bronchial hyperresponsiveness. AB - The effect of increasing intravenous doses of theophylline and enprofylline, a new xanthine derivative, on bronchial responsiveness to methacholine was studied in eight asthmatic patients. Methacholine provocations were carried out on three days before and after increasing doses of theophylline, enprofylline, and placebo, a double blind study design being used. Methacholine responsiveness was determined as the provocative concentration of methacholine causing a fall of 20% in FEV1 (PC20). The patients were characterised pharmacokinetically before the main study to provide an individual dosage scheme for each patient that would provide rapid steady state plasma concentration plateaus of 5, 10, and 15 mg/l for theophylline and 1.25, 2.5, and 3.75 mg/l for enprofylline. Dose increments in the main study were given at 90 minute intervals. FEV1 showed a small progressive decrease after placebo; it remained high in relation to placebo after both drugs and this effect was dose related. Methacholine PC20 values decreased after placebo; mean values were higher after theophylline and enprofylline than after placebo (maximum difference 2.0 and 1.7 doubling doses of methacholine); the effect of both drugs were dose related. Thus enprofylline and theophylline when given intravenously cause a small dose related increase in FEV1 and methacholine PC20 when compared with placebo. PMID- 2694419 TI - Heterotopic brain tissue in the lung causing acute respiratory distress in an infant. AB - A three month male infant with a 24 hour history of cyanotic attacks was found to have heterotopic brain tissue at thoracotomy. He has remained well over 20 years of follow up. The pathogenesis of the condition is discussed. PMID- 2694420 TI - Sleep apnoea and systemic hypertension. PMID- 2694421 TI - Is quantitative determination of fibrin(ogen) degradation products and thrombin antithrombin III complexes useful to diagnose deep venous thrombosis in outpatients? AB - We studied the diagnostic value of recently introduced ELISA's for the determination of thrombin-antithrombin III (TAT) complexes, fibrin degradation products (FbDP), fibrinogen degradation products (FgDP) and total degradation products (TDP) for deep venous thrombosis (DVT) in plasma of 239 consecutive outpatients, suspected for DVT by their family doctor. DVT was confirmed by impedance plethysmography in 60 patients. Using the 95th percentile range of 42 healthy volunteers the sensitivity for the detection of DVT was: 37% for TAT, 95% for TDP, 92% for FbDP and 90% for FgDP. Specificity was: 88% for TAT, 16% for TDP, 20% for FbDP and 25% for FgDP. We conclude that these assays are of little value in the diagnosis of DVT in outpatients. PMID- 2694422 TI - Indirect activation of blood coagulation in colon cancer. AB - Systemic activation of the coagulation mechanism is known to exist in patients with colon cancer. The mechanism of such activation was investigated using immunohistochemical techniques applied to fresh frozen sections of resected primary colon cancer specimens. Tumor cells stained for tissue factor, factor V, and urokinase-type plasminogen activator. Perivascular and intercellular areas stained for fibrinogen and the "a" subunit of factor XIII. Staining was minimal or absent for protein C, protein S, plasminogen activator inhibitors 1-3, factor VII, factor X, and fibrin (the antigenic site on the amino-terminal portion of B beta chain that is exposed following thrombin cleavage of fibrinopeptide B was not detected). The lack of an intact thrombin-generating pathway in situ associated with viable colon cancer cells is consistent with the findings of others that coagulation activation in colon cancer may be triggered by a soluble tumor product that exerts its effect at sites distant from the tumor. These results may explain the absence of clinical responsiveness of colon cancer to antithrombotic drug therapy and may clarify therapeutic strategies for this common tumor. PMID- 2694423 TI - Gold-labeled bovine fibrinogen for study of human platelets. AB - Fibrinogen coupled to colloidal gold has proven to be a useful agent for probing the glycoprotein IIb-IIIa receptor on human and bovine platelets at the ultrastructural level. The reagent has helped to demonstrate fundamental differences in the reorganization of the fibrinogen receptors on human and cattle platelets following surface activation. However, commercial preparations of human fibrinogen have not yielded a stable reagent in our hands when coupled to colloidal gold. The present study has substituted bovine for human fibrinogen. Bovine fibrinogen gold proved to be a more stable reagent and could be substituted for human fibrinogen gold in all experiments on human and bovine platelets. PMID- 2694424 TI - Plasma von Willebrand factor proteolysis in patients with chronic myeloproliferative disorders: no possibility of ex vivo degradation by calcium dependent proteases. AB - Patients with chronic myeloproliferative disorders (CMPD) frequently have abnormalities of plasma von Willebrand factor (vWf) multimers. The pathogenesis of this phenomenon is still unknown. In order to evaluate the possibility of ex vivo degradation of vWf during blood processing, we compared vWf antigen, ristocetin cofactor and the multimeric composition of vWf in plasmas obtained in the presence of trisodium citrate with or without calcium-dependent protease inhibitors (leupeptin, N-ethylmaleimide and Na2EDTA). The subjects included 20 patients with CMPD, 11 with other diseases and 8 normal subjects. In patients with CMPD and normal subjects, the values of vWf antigen, ristocetin cofactor, ristocetin cofactor/vWf antigen ratio and the relative amount of large multimers of vWf did not significantly differ from each other in plasma samples with and without protease inhibitors. In other diseases, especially in a patient with disseminated intravascular coagulation, a somewhat higher amount of large multimers were found in plasma with protease inhibitors than without inhibitors. These findings indicate that the ex vivo proteolysis during blood processing is negligible in patients with CMPD, and that the observed abnormalities in vWf is an in vivo phenomenon. PMID- 2694425 TI - [The 1989 Nobel Prize in physiology and medicine]. PMID- 2694426 TI - [A health cure for the body and soul?]. PMID- 2694427 TI - [The disease and death of Olaf Bull. Thoughts about alcohol, disease and creativity]. PMID- 2694428 TI - [Vilhelm Magnus. A pioneer of experimental medicine and neurosurgery]. PMID- 2694429 TI - [Morten Parelius. A polyhistorian and an occasional poet, but above all a physician]. AB - Parelius worked as local medical officer in the western parts of Norway. He wrote poems and medical articles, most of which were published in journals. This article is a biography. PMID- 2694430 TI - [Plague epidemics in Bergen and population crises]. AB - Ten epidemics of plague are known to have occurred in Bergen, Norway, from the Black Death in 1349 to the last epidemic in 1637. Seven of them took place after 1530, and the primary sources of only three are known from the first 180 years of the plague period. Therefore, additional epidemics have probably occurred of which we have no knowledge. After the Black Death, bubonic plague probably hit Bergen, and the infection seems to have always been imported by ships, especially ships from Baltic cities. During the last five epidemics in Bergen 12,900-14,500 people died on plague in the course of 70 years, i.e. twice the population of the city. Extended immigration following each epidemic kept the size of the population up to 6,000-7,000. The death rate was clearly lower among the Germans at the Hanseatic Office than in the Norwegian city population. This was probably because an increasing percentage of Germans had become immune to plague after each epidemic, since the losses at the Office were not compensated for by immigration. It is concluded that the plague epidemics are the main reason for the population crises in Bergen in this period. PMID- 2694431 TI - [Absalon Pedersson's report on the plague in Bergen during 1565-1567]. AB - The plague in Bergen 1565-67 was reported by Absalon Pedersson, a citizen of Bergen, in his diary. The diary describes the onset of the epidemic and reports the deaths from day to day. The plague was brought to Bergen on about 10th August 1565 by a ship from Danzig. Altogether 1,500 people died of bubonic plague in Bergen, i.e. 21-25% of its population. The peaks of the epidemic occurred during the autumn months of 1565 and 1566. In both years the city was almost free from plague from February to July. During the first phase the infection must have been transmitted by rat fleas, but human fleas were the carrier during the cold autumn months. The recurrence in August 1566 and 1567 must have been due to the establishment of a plague reservoir among the rats in the grain stores. PMID- 2694432 TI - [The medical situation in Bergen during the late medieval period described in the diary of Absalon Pedersson in 1552-1572]. AB - First-hand information on Norwegian medical matters in the late Middle Ages is very scarce. Occasional brief information of medical interest may be found in private letters and in more systematic general records. However, a unique and particularly interesting document from this period is Master Absalon Pedersson's diary. The diary covers a twenty-year period of the history of Bergen from the middle of the 16th century, and is characterized by its detailed information, also on matters of medical interest. Absalon was a well-educated man who without doubt had considerable medical insight. The events he describes have been personally experienced and analysed. He has seen the sick and describes the symptoms, and today, the information he provides allows us to draw conclusions about the nature of the diseases. Absalon's diary therefore provides interesting insight into medical matters in Bergen at that time and knowledge on diseases and what was known about them, causes of death, barber surgeons and hospitals. PMID- 2694433 TI - [The history of dental amalgam]. AB - This article reviews the history of dental amalgam. There are indications that dental amalgam was used in the first part of the T'ang Dynasty in China (618-907 A.D.), and in Germany by Dr. Strockerus in about 1528. Ever since its introduction in the Western World in the 1830s, amalgam has been the subject of recurrent controversies because of its mercury content. Early amalgam was made by mixing mercury with the filings of silver coins. PMID- 2694434 TI - [Hip luxation, joint manipulators and district practitioners. A 100-year history]. PMID- 2694435 TI - [Is medicine without a history?]. PMID- 2694436 TI - [Mammography screening after the consensus conference--will Norway be left behind again?]. PMID- 2694437 TI - [Kaare Nygaard--surgeon and sculptor]. PMID- 2694438 TI - [Veterinary care and concerns and intensive animal husbandry]. AB - Developments in intensive animal husbandry as well as the reactions called forth by this new form of livestock husbandry in various groups of society and in research workers are reviewed in the introductory part; it was only during the past few years that veterinary medicine in the Netherlands began to concern itself with the negative effects of intensive animal husbandry on animal health and welfare. The practical situation in poultry and pig husbandry is then subjected to a critical analysis. It is concluded from a number of objective observations such as the use of pharmaceutical agents and vaccines and the appearance of particular pathological changes that limits should be imposed on growth. Reflection in veterinary medicine, resulting in the acceptance of health and welfare in animals and man, environment and economic values as equivalent factors, is advocated. PMID- 2694439 TI - [Insulin: U40 and U100]. PMID- 2694440 TI - From a synthetic, microporous, compliant, biodegradable small-caliber vascular graft to a new artery. AB - Microporous, compliant, biodegradable vascular grafts prepared from physical mixtures of polyurethane and poly(L)lactide acid can function as temporary scaffolds for the regeneration of a new arterial wall. In this overview article, the basic ideas behind the properties and construction of these grafts, the basic mechanisms of regeneration, and the scope, limitations, and further prospectives of the use of these biodegradable grafts are reviewed and discussed among literature. PMID- 2694441 TI - Intracardiac rhabdomyoma--report of a patient and review of literature. AB - This report describes a rare case of intracardiac rhabdomyoma in an infant, review of the literature, and its management. PMID- 2694442 TI - Lipomas of the peripheral lung--a case report and review of the literature. AB - Bronchial lipomas are uncommon benign neoplasms of the lung and the number of these tumours is only 109 cases in the international literature (108 cases reported in English and one in German) up to date. Moreover, most of the tumours occur in the proximal portions of lobar or segmental bronchi: the references in the literature to peripheral lipoma of the lung make up only 6 cases. Peripheral lipomas of the lung are thought to originate from fatty tissue in the wall of peripheral bronchi. We present a further case of peripheral lipoma and analyze the reported 7 cases. PMID- 2694443 TI - Intrabronchial neurilemmoma--review of cases in Japan. AB - We recently encountered a case of intrabronchial neurilemmoma. The patient was a 15-year-old boy who had a wheeze. After observation with a bronchofiberscope, a wedge resection of the left main bronchus was performed. No postoperative complications nor recurrence was seen. To date, five cases of intrabronchial neurilemmoma have been reported in the Japanese Journals. Surgical removal was performed in 4 of 5 and bronchofiberscopic excision in 1. This paper summarizes the clinical features of these cases as well as our own case. PMID- 2694444 TI - Fibronectin network recovery in confluent PtK2 cells after acrylamide treatment. AB - Confluent PtK2 cells 4 hr treated with 5 mM acrylamide were FN-detected by indirect immunofluorescence. The initial fibrillar-FN network was replaced by an alveolar-type network located at the cell-cell contacts areas in the form of a thick frame with a lace-like appearance. Afterwards, acrylamide removal was obtained by several washes with fresh FCS-free culture medium. Then, PtK2 cells were returned to the incubator for 20 hr. Cell recovery was indicated by reversion of the initial fibrillar-FN network. These data show that FN reversion was possible without any changes in shape and cytoplasmic organization of non motile growing cells. PMID- 2694445 TI - Culture media conditioned by wounded cells modify the fibronectin localization pattern of unwounded confluent PtK2 cells. AB - A confluent PtK2 cell sheet was incised in a serum-free culture medium, at 15 min, 2 hr and 24 hr after wounding. The culture media were collected in the same way and used as conditioned media. Unwounded confluent cells were cultured in the conditioned medium for 24 hr. They showed a modification of fibronectin localization similar to that which we had previously observed in wounded confluent PtK2 cells: cells lost their normal fibronectin fibrils and were surrounded by fibronectin lace. This finding suggested that during wound healing, the cells released soluble chemical factors which could modify the fibronectin localization pattern of unwounded confluent cells. Subconfluent cells did not respond to conditioned media, showing that confluent cells and subconfluent cells had different susceptibilities. PMID- 2694446 TI - [Several surgical operations in animal husbandry for healthy birds required or implemented by animal welfare regulations]. AB - Trimming of the comb, devocalisation, trimming of claws, pinioning and caponisation of birds are procedures, which are often requested or carried out by keepers of animals. Surgery of this kind, however, has far-reaching consequences for the affected animal. A well considered range of indications is a basic requirement for the performing of the mentioned surgical procedures by a veterinarian. PMID- 2694447 TI - [Sonography in pleural effusion of horses]. AB - Pleural effusion in the horse can be caused by diseases such as pneumonia, trauma, pulmonary abscesses and thoracic neoplasms. Besides clinical (auscultation, percussion) and radiographic diagnostic procedures, the ultrasonic examination represents a method that supplies detailed information on quantity and location of fluid in the pleural space. By means of ultrasonic examination the most favourable position for a thoracentesis can be determined. Control of thoracentesis' efficiency as well as exact supervision of the disease's course are made feasible by repeated sonographic examinations. PMID- 2694448 TI - Identifying incentive targets. PMID- 2694449 TI - Determining the appropriate type of plan. PMID- 2694450 TI - Administrative and control procedures. PMID- 2694451 TI - Funding and award formulas. PMID- 2694452 TI - Proceedings of the LeMaire Symposium, Part I. Miami, Florida, December 1-2, 1988. Held in honor of William J. LeMaire. PMID- 2694453 TI - [Genomic "dactyloscopy" with the use of bacteriophage M13 as a DNA probe (the expertise of material evidence and personal identification)]. AB - In this article the authors give a scientific evaluation of genetic dactyloscopy method in which the sites of human chromosomal DNA, possessing structural polymorphism, act as genetic markers. Technology of genome "dactyloscopy" including both the series of standard conventional methods and new methods is presented. The method is highly sensitive and requires small amounts of material for investigation. A practical case is described when genome "dactyloscopy" gave positive results which led to a conclusion on suspect's involvement in the crime. PMID- 2694454 TI - What is the function of peripheral lymphocytes migrating to the thymus and of B lymphocytes proliferating in the thymus? AB - In studies on the role of other lymphoid organs in lymphocyte production and lymphocyte migration in young pigs and lambs, lymphocytes from these tissues were always found in the thymus. There were no major differences in the entry of labelled cells when the spleen, lymph nodes, bone marrow or Peyer's patches were selectively labelled. The immigrants were both mature small lymphocytes and lymphocytes just produced in the peripheral lymphoid organs. They enter via specialized venules at the outer part of the thymic medulla and do not migrate into the cortex. The lymphocyte homing is markedly reduced by prior incubation with trypsin. The relative numbers of immigrants within the thymus were small but, due to the huge cellular content of the thymus, the absolute number entering per day totalled several million from each peripheral organ. Another unexpected finding was the high mitotic rate in the medulla of the thymus. Moreover, in the adult rat thymus although there were only 0.14% B cells, these proliferated at a higher rate than in peripheral organs. The functional meaning of these data is obscure so far and the studies should stimulate further work on these topics of lymphocyte entry and B lymphocyte production in the thymus. PMID- 2694455 TI - The morphology of perivascular spaces in the thymus. AB - The perivascular spaces (PVS) are a functional component of the thymus gland that allows cells or possibly soluble products to reach or leave the medulla without the necessity of passing through the cortex. They are connective tissue compartments, continuous with the tissue around the gland, that extend to the cortico-medullary junction where they become merged with the medulla. Around the gland and in their course to the cortico-medullary junction they are delimited by a continuous layer of type-1 epithelial cells (subcapsular/perivascular cells) that rest on a basal lamina. They contain the major blood vessels to and from the medulla, and capillary loops that enter the cortex from the medulla are also ensheathed by the type-1 cells. Capillary loops in the medulla may not be ensheathed. Nerves run in the tunica adventitia of the blood vessels and may also be found separate from the vessels as small unmyelinated fibres that enter the cortex. Lymphatic vessels are formed either in the medulla or at the cortico medullary junction and leave the gland along the main PVS between thymic lobes. PVS frequently contain lymphocytes, plasma cells and myeloid cells. Lymphocytes free in the connective tissue are commonest at the cortico-medullary junction: macrophages, plasma cells, eosinophils are frequent in the connective tissue of all PVS, and mast cells are closely associated with the veins of PVS and the capsule around the lobes. Some possible functional correlates of this morphological arrangement are discussed. PMID- 2694456 TI - Binding of cortical thymocytes to a medullary epithelial cell line: a brief review. AB - In this review, we bring together data regarding complexes formed between thymocytes and a line of thymic epithelial cells, E-5. We show that E-5 has all the markers which identify it as of epithelial and medullary origin. We show that thymocytes which form complexes with it belong to the double positive, CD4 + CD8 + population, and that the receptor responsible for binding to epithelial cells is likely to be an as yet unidentified glycoprotein. The ligand on E-5 cells is also a glycosylated protein. Adhering thymocytes are in a state of mitotic activity, and their incubation with E-5 cells does not induce increased responsiveness to polyclonal mitogens. Non-adhered thymocytes, on the other hand coincubated With E-5 cells increase their responsiveness to ConA and initiate responsiveness to PHA. Differentiation of adhering thymocytes is evidenced by their acquisition of refractoriness to a secondary adherence, and by the modification of their surface phenotype. PMID- 2694457 TI - Can malaria-associated polyclonal B-lymphocyte activation interfere with the development of anti-sporozoite specific immunity? AB - To study the relevance of polyclonal B cell activation (PBA) associated with malaria in the development of specific anti-sporozoite immunity, we used a reverse haemolytic plaque assay and an immunoradiometric assay employing the synthetic peptide (NANP)3, the main epitope of the circumsporozoite (CS) protein of Plasmodium falciparum, to assess respectively the degree of activation of IgG and IgM secreting cells and the level of anti-sporozoite antibodies in 95 subjects with malaria and 21 non-infected individuals. A positive correlation was observed between the anti-(NANP)3 antibody levels and the number of past attacks of malaria but not between the former and the age of individuals or the number of months of residence in the endemic region. Individuals with high numbers of IgG or IgM secreting cells (SC) had lower levels of anti-(NANP)3 antibodies; those with levels of antibodies above the mean for malaria-infected individuals had lower numbers of IgGSC and higher haematocrit and haemoglobin values. These data show the existence of a negative relationship between malaria-induced PBA and anti-sporozoite immunity, and it is suggested that either PBA blocks the development of anti-sporozoite immunity or, alternatively, the latter protects individuals against malaria and malaria-associated PBA. PMID- 2694458 TI - Antibodies to blood stage antigens of Plasmodium falciparum in rural Gambians and their relation to protection against infection. AB - Cross-sectional and longitudinal studies were performed in a rural population living in The Gambia to examine the relationship between several in vitro assays of the host immune response to asexual stages of Plasmodium falciparum and protection from malaria in vivo. Assays included an enzyme-linked immunosorbent assay for antibodies to schizont antigens; an indirect immunofluorescence assay for total antiblood-stage antibodies; an immunofluorescence assay on glutaraldehyde-fixed parasites to detect antibodies to antigen Pf 155; an assay for serum inhibition of red blood cell invasion; a micro-agglutination assay to detect antibodies to neo-antigens on the surface of infected red blood cells; and an assay using polymorphonuclear leucocytes to detect antibodies capable of opsonizing schizont infected red blood cells. There were marked differences in the age-related pattern of response for different assays performed on sera obtained at a cross-sectional survey of 280 individuals. Examination of the correlation between the various immune responses and malariometric indices at the population level and at the individual level provided no evidence that any of the in vitro assays were related to protective immunity. The relationship between in vitro measurements of the anti-malarial immune response and protection from clinical episodes of malaria was examined in a group of 134 children aged 11 years and under who were monitored weekly throughout an entire malaria transmission season. The only immune factor to show a consistent protective effect against clinical malaria was the titre of antibodies to neo-antigens on the infected erythrocyte surface (P = 0.01). The same longitudinal techniques were used to examine the effect of two non-immunological factors, sickle cell trait and mosquito net usage, both of which showed significant protection against clinical episodes and malaria. PMID- 2694459 TI - A new method of plasma collection suitable for large scale seroepidemiological surveys of malaria in the tropics. PMID- 2694460 TI - Plasmodium falciparum: administration of anti-sporozoite antibodies during sporogony results in production of sporozoites which are not neutralized by human anti-circumsporozoite protein vaccine sera. AB - Five days after receiving a Plasmodium falciparum NF54 infectious blood meal, Anopheles stephensi mosquitoes were fed rat anti-P, falciparum sporozoite or rabbit anti-R32tet32 antibodies. Sporozoites isolated from salivary glands were tested by the inhibition of sporozoite invasion (ISI) assay using monoclonal antibody (Mab) 2A10 to P. falciparum circumsporozoite protein or sera from human volunteers immunized with P. falciparum R32tet32 or (NANP)3-TT vaccines. Whereas sporozoites from control mosquitoes were neutralized by Mab 2A10 and vaccine sera, only the Mab and not the vaccine sera neutralized sporozoites from immune fed mosquitoes. The implications of these results in vaccine design and the impact on transmission are discussed. PMID- 2694461 TI - Chloroquine resistant Plasmodium falciparum in indigenous residents of Cameroon. AB - Thirty-nine percent (36 of 92) of children in Limbe, Cameroon, treated with chloroquine (10 mg/kg body weight on days 1 and 2, and 5 mg/kg on day 3) for falciparum malaria failed to respond within 7 d of treatment. Twenty-two of these children with chloroquine-resistant malaria were successfully treated with Fansidar [one-half tablet (250 mg sulfadoxine and 25 mg pyrimethamine) per 10 kg body weight], while the other 14 children were cured with mefloquine (25 mg/kg body weight). In vitro, a combination of verapamil at 1.0 x 10(-6) M with chloroquine or desethylchloroquine reversed resistance to the antimalarial drug and its primary metabolite in each of the 2 isolates successfully adapted and maintained in continuous culture. Similar combinations had no effect on susceptibilities of a sensitive reference clone, D6, used as control. Both chloroquine-resistant isolates from Cameroon were significantly more susceptible to mefloquine and halofantrine in vitro than the chloroquine-sensitive reference clone. Clinical observation, and in vitro confirmation, of chloroquine-resistant falciparum malaria in these indigenous children from Cameroon, and the current socio-economic condition in West Africa, underscore the need for pragmatic health management policies for efficient use of alternative antimalarial drugs in controlling drug resistant Plasmodium falciparum in the region. This observation of reversal of chloroquine resistance in isolates of P. falciparum obtained from West Africa, and a previous report on clones obtained from south-east Asia and South America, suggest that the mechanism(s) of resistance to chloroquine may be identical in resistant parasites from the 3 continents. PMID- 2694462 TI - Multiple drug resistance of Plasmodium falciparum in Liberia. PMID- 2694463 TI - The effectiveness of chemoprophylaxis against malaria for non-immune migrant workers in eastern Thailand. AB - A randomized, double-blind field trial was carried out to compare the effectiveness of mefloquine plus sulfadoxine-pyrimethamine (MSP) with that of sulfadoxine-pyrimethamine (SP) in chemoprophylaxis against malaria. The study was conducted in 193 migrant workers in the eastern rural areas of Thailand which are known to be highly endemic for multidrug-resistant Plasmodium falciparum infection. MSP was found to be more effective than SP in the suppression of both P. falciparum and P. vivax parasitaemias, when administered weekly for 12 weeks (P = 0.0014). Complete suppression of P. falciparum was achieved by MSP while 8 subjects receiving SP developed parasitaemia. One subject in the MSP group developed P. vivax parasitaemia, compared with 4 in the SP group. However, in view of the reported complications associated with the use of long-acting sulphonamides, some of which can be life threatening, prophylactic regimens containing sulfadoxine, though proved efficacious, must be used with extreme caution. PMID- 2694464 TI - The first case of Plasmodium falciparum resistant to chloroquine treatment discovered in the Republic of Afghanistan. PMID- 2694465 TI - Recombinant polypeptides for serology of malaria. AB - We have evaluated 3 molecularly defined polypeptides encoded by encloned Plasmodium falciparum genes for their ability to serve as antigens for detecting antimalaria antibodies. The recombinant proteins correspond to (i) a conserved part of 190-200 kDa schizont merozoite surface component, (ii) the carboxy terminal part of the P. falciparum aldolase, and (iii) the 5.1 antigen. Antibodies were detected using enzyme-linked immunosorbent assays (ELISA) in a high percentage of sera from individuals from a malaria endemic area in The Gambia (up to 99% for some adult groups). These results were further improved, especially for detection of antimalaria antibodies in children, when a pool of all 3 polypeptides (ELISA MIXT) was used as antigen. This ELISA MIXT improves presently available assays for the detection of antimalaria antibodies directed against asexual blood stages in respect of standardization, sensitivity and specificity. PMID- 2694466 TI - Age-dependent occurrence of protective anti-Plasmodium falciparum sporozoite antibodies in a holoendemic area of Liberia. AB - Antibodies to Plasmodium falciparum sporozoites were detected in children aged 6 months to 9 years, and in adults, in a holendemic village near Yekepa, Liberia, by enzyme linked immunosorbent assay (ELISA) using the recombinant circumsporozoite protein R32tet32 or by inhibition of sporozoite invasion (ISI) of hepatoma cells. Both assays were significantly correlated with each other and showed that anti-sporozoite antibodies increase with age. ISI was more sensitive than ELISA and demonstrated significantly increased anti-sporozoite antibodies at age 5-6 years, when young children show partial clinical resistance to malaria. These results suggest that anti-sporozoite antibodies, as measured by ISI, may contribute to protection against malaria. PMID- 2694467 TI - Evaluation of malaria clinics in Maesot, Thailand: use of serology to assess coverage. AB - The clinics of the anti-malaria programme in Thailand serve an increasingly important role in the strategy for control of malaria within a context of multi drug resistant falciparum malaria. Figures from clinics in Maesot District show a predominance of young males among positive cases treated (56% of all cases). In contrast, sero-epidemiological findings from a random sample of over 500 villagers in the area show similar exposure rates among males and females of equal age. There were no statistically significant differences between males and females 0-15 and 16-30 years old in percentages positive by indirect fluorescent antibody tests or enzyme-linked immunosorbent assays (ELISA), mean level of ELISA positivity, or rate of sero-conversion. Differences in level of positivity did occur between males and females over 30. An index constructed from the serological findings indicated under-representation of children and women of all ages in clinics but suggested that coverage of children could be improved by the provision of a community-based, fixed-schedule mobile clinic. PMID- 2694468 TI - Falciparum malaria with bone marrow abnormalities resembling malignant histiocytosis. PMID- 2694469 TI - Clindamycin is effective against Plasmodium falciparum but not against P. vivax in mixed infections. PMID- 2694470 TI - Microfilaraemia, serum antibody and development of clinical disease in microfilaraemic subjects infected with Wuchereria bancrofti and treated with diethylcarbamazine citrate. AB - A seroepidemiological survey of bancroftian filariasis was carried out in 2 townships in Sri Lanka with the objectives of determining the microfilaraemia rates, dependence on age and sex, susceptibility to re-infection, effect of diethylcarbamazine therapy on serum antibodies to microfilarial surface antigens, and the predictive value of the indirect fluorescent antibody test. The mean microfilaraemia rate was 5.4%. Microfilaraemia was not sex-dependent but a marginally elevated incidence was seen in the 6-35 year age groups. In up to 58% of the microfilaraemic patients who had been treated for microfilaraemia previously, a second phase of microfilaraemia was seen 2-7 years after treatment. This was unlikely to have been due to incomplete parasite elimination. Antibodies to microfilarial surface were found in 24-35% of microfilaraemic patients and in 14-63% of amicrofilaraemic symptomatic subjects. Serum anti-microfilarial surface antibody levels did not alter with chemotherapy with diethylcarbamazine citrate. The findings of follow-up investigations of microfilaraemic subjects were compatible with the notion that microfilaraemia does not necessarily lead to clinical disease. PMID- 2694471 TI - Finger-prick blood collection and computer-assisted enzyme-linked immunosorbent assay for large-scale serological studies on leprosy. AB - An immunoglobulin M anti-phenolic glycolipid 1 assay was standardized and optimized using specimens of dried blood collected on commercial precut filter paper discs, followed by a computer-assisted enzyme-linked immunosorbent assay (ELISA). The correlation between venepuncture and finger-prick methods, the calibration of the quantity of absorbed blood, and the reproducibility of the ELISA test were excellent. A slight decline of activity was observed when the samples were stored for 3 months at +4 degrees C. Skimmed milk can be used as diluent instead of bovine serum albumin, contributing to lessening the cost of the test. Using the method described, as many as 300 samples can be collected in the field and 480 ELISAs per day can be run in the central laboratory by one trained person. PMID- 2694472 TI - Changing pattern of primary glomerulonephritis in a south Indian hospital. AB - Data were reviewed on 2805 patients with primary glomerulonephritis admitted to a south Indian hospital in 1972-1987. A decrease in the proportion of endocapillary proliferative, crescentic and mesangial proliferative types was noted. There was also a decrease in group A beta-haemolytic streptococcal isolates among the 24,657 throat swab cultures made during the same period. This suggests a decreasing prevalence of nephritogenic streptococcal infections in this tropical region. PMID- 2694473 TI - Antiplasmodial activity of an aqueous infusion prepared from Brucea javanica fruits against Plasmodium falciparum and P. berghei. Laboratory meeting, London School of Hygiene and Tropical Medicine. 17 November 1988. Abstracts. PMID- 2694474 TI - New techniques in antivenom production and active immunization against snake venoms. PMID- 2694475 TI - Roles of tumour necrosis factor in the illness and pathology of malaria. AB - Evidence is accumulating that the illness and pathology observed in malaria are not caused directly by parasite products, but by normal components of the immune response, mainly monokines such as tumor necrosis factor (TNF), produced in excess. These mediators are released from the host's monocytes and macrophages, apparently in response to stimulation by parasite products. Recombinant TNF, if injected into a range of animal species or into tumour patients, is demonstrably toxic, giving rise to changes typical of acute malaria, and several groups have detected circulating TNF in serum from patients acutely ill with malaria. The short serum clearance time of TNF and TNF tolerance have to be considered when interpreting such data. Current studies indicate that some malarial antigens, in the absence of lipopolysaccharide, can trigger release of TNF. This and other monokines could contribute to cerebral malaria in at least 2 ways: by increasing thrombospondin secretion, and hence favouring local sequestration of knob-bearing parasitized red cells, and, as has been demonstrated in clinical trials in tumour patients, by causing neurological symptoms directly. In addition, it seems that TNF does not act alone, but as part of an interdependent synergizing network of polypeptide mediators. These evidently act together to induce secretion of other cell products, such as platelet-activating factor, prostaglandins, reactive oxygen species and procoagulant activity, that actually cause illness, biochemical change and tissue damage. Understanding these processes should lead to a range of new therapeutic interventions. PMID- 2694476 TI - Tropical obstetrics and gynaecology. 1. Anaemia in pregnancy in tropical Africa. AB - Major causes of anaemia in pregnancy in tropical Africa are malaria, iron deficiency, folate deficiency and haemoglobinopathies: now there is added also the acquired immune deficiency syndrome (AIDS). Anaemia is often multifactorial, with the different causes interacting in a vicious cycle of depressed immunity, infection and malnutrition. Anaemia progresses through 3 stages: compensation, with breathlessness on exertion only; decompensation, with breathlessness at rest and haemoglobin (Hb) below about 70 g/litre; cardiac failure, with Hb below about 40 g/litre. Without treatment, over half of the women with haematocrit less than 0.13 and heart failure die. Maternal anaemia, malaria and deficiencies of iron and folate cause intrauterine growth retardation, premature delivery and, when severe, perinatal mortality. Surviving infants have low birthweights, immune deficiency and poor reserves of iron and folate. They have entered already the vicious cycle of infection, malnutrition and impaired immunity. Treatment with blood transfusions is even more hazardous since the advent of AIDS, and should be limited to saving the life of the mother. Treatment of malaria is complex as chloroquine-resistant strains are now common. Prevention remains relatively easy with proguanil and supplements of iron and folic acid and is highly cost effective in the improvement of maternal and infant health; it is more important than ever as it avoids the unnecessary exposure of women and infants to HIV transmitted through blood transfusion. PMID- 2694477 TI - Tropical obstetrics and gynaecology. 3. Vesico-vaginal fistula--a tropical disease. AB - The predominantly obstetric origin of vesico-vaginal fistulae in the tropics is contrasted with the mainly surgical aetiology of those in Europe by analysis of 543 cases treated in Nigeria and in the United Kingdom. Reasons are given for the high incidence in tropical countries of obstructed labour and hence of vesico vaginal fistulae. The general management of patients with obstetric fistulae is described, followed by the principles of their surgical treatment and postoperative nursing care. The importance of success at the first attempt at repair is stressed, and the small place for managing failures by urinary diversion is mentioned. It is concluded that obstetric fistulae should be preventable in the tropics, having now been effectively eliminated from industrialized countries. PMID- 2694478 TI - The black death past and present. 2. Some historical problems. AB - This paper looks, from a historian's point of view, at the black death and the epidemics of plague which succeeded it in Europe from the fourteenth to the seventeenth centuries. It identifies the controversial questions, of medical as well as historical interest, which have been raised by recent work. These include the origins of plague epidemics, the role of rodents and insect vectors in them, and the reasons for their disappearance from western Europe. PMID- 2694479 TI - Field applications of agglutination and cytoadherence assays with Plasmodium falciparum from Papua New Guinea. AB - Plasmodium falciparum isolates obtained directly from patients in Papua New Guinea were tested in their first cycle of growth in vitro for adherence to melanoma cells and for susceptibility to agglutination by immune serum. Binding varied among isolates and, in many cases, increased with further rounds of replication under optimal culture conditions. Binding inhibition assays and agglutination assays demonstrated extreme heterogeneity of surface antigens; apparently none of the sera from adult patients recognized all of the variants presented. PMID- 2694480 TI - A comparative study of two methods for the cryopreservation of Plasmodium falciparum. PMID- 2694481 TI - The interrelationship of Plasmodium falciparum and P. vivax in the Punjab. AB - Analysis of data obtained from Giemsa-stained blood films from patients with mixed Plasmodium vivax and P. falciparum parasitaemias seen in outpatient clinics held over 20 consecutive months in 4 villages in the Pakistani Punjab suggest that infections with P. falciparum and P. vivax were independent of each other. There was no evidence to support the hypothesis that P. falciparum suppressed P. vivax. A likely explanation for the seasonal variation in species parasitaemia rates in the Punjab is that P. vivax was predominant early in the transmission season due to late relapses, while P. falciparum was predominant later in the transmission season because of community-wide development of immunity to P. vivax. PMID- 2694483 TI - Plasmodium-specific immunoglobulin E in sera from an area of holoendemic malaria. AB - Serum samples obtained from adults living in an area of holoendemic malaria in Papua New Guinea and from control residents of Hawaii were tested for Plasmodium specific immunoglobulin (Ig) E antibody by the enzyme-linked immunosorbent assay. Fifteen (33.3%) of the New Guinea sera had absorbance values indicative of seropositivity. Only half of the IgE-positive sera were concomitantly positive for antimalarial IgG antibody. All of the control sera were negative for antibody of both immunoglobulin classes. PMID- 2694482 TI - Tolerance of mefloquine alone and in combination with sulfadoxine-pyrimethamine in the prophylaxis of malaria. AB - A randomized double blind study was performed to evaluate the tolerance and the acceptance of mefloquine alone (Lariam) compared to a combined drug regimen consisting of mefloquine, sulfadoxine and pyrimethamine (MSP; Fansimef) in the prophylaxis of malaria. 175 Europeans travelling to different malaria endemic areas received either mefloquine alone (250 mg/week) or its combination with sulfadoxine (500 mg/week) plus pyrimethamine (25 mg/week). One person taking mefloquine and two taking MSP discontinued the drug intake because of moderate clinical side effects. Mild and moderate adverse clinical reactions predominantly concerning the gastro-intestinal tract and the autonomous nervous system were reported with a significantly higher occurrence in the MSP group. With both prophylactic regimens, reversibly elevated liver enzyme activities (glutamate oxalate transaminase and glutamate pyruvate transaminase [GPT]) were observed after prophylaxis. The increase of GPT serum activity correlated significantly with relatively high GPT levels before prophylaxis in both groups. This finding suggests a limited use of both regimens in cases of liver dysfunction. One case of mefloquine-resistant Plasmodium falciparum malaria was observed from West Africa; this patient was cured by a standard regimen of chloroquine. PMID- 2694484 TI - The role of some risk factors of exposure to malaria in determining the outcome of the immunofluorescent antibody test in an urban population. AB - Data obtained previously were analysed to assess the relative importance of variables which relate to the risk of exposure to malaria in explaining the level of indirect fluorescent antibody (IFAT) reactions observed among the urban study population. In the analysis specific activities, notably travelling out of the main towns, season when out of the main towns, length of period since having been out of the main towns, and history of having had malaria in the last year, were of help in predicting the level of IFAT reaction. Sensitivity and specificity values of history of malaria, history of having been out of the main towns, and serological results were higher in older people in both periods and were highest in the March-April 1985 survey period. PMID- 2694485 TI - Falciparum malaria resistant to chloroquine, quinine and Fansidar in a non-immune patient infected in Ghana. PMID- 2694486 TI - Does chloroquine resistance occur in refugee camps in eastern Sudan? PMID- 2694487 TI - In vitro activity of proguanil, chlorproguanil and their main metabolites against Plasmodium falciparum. PMID- 2694488 TI - Clinical studies on treatment of cerebral malaria with artemether and mefloquine. PMID- 2694489 TI - Evolution of resistance of Plasmodium falciparum to antimalarial drugs in Rwanda, 1985-1987. PMID- 2694490 TI - Sudden increase in number of isolates of Plasmodium falciparum resistant to chloroquine in Madagascar. PMID- 2694491 TI - An open clinical trial of nifurtimox for arseno-resistant Trypanosoma brucei gambiense sleeping sickness in central Zaire. AB - Twenty-five patients with arseno-resistant Trypanosoma brucei gambiense sleeping sickness were treated with oral nifurtimox, 12-17 mg/kg/d for 60 d. During treatment, trypanosomes disappeared from the cerebrospinal fluid (CSF) of 7/7 patients; the CSF infections; leucocyte was significantly lower at the end of treatment than before it was begun (pre-nifurtimox: 124.2 (+/- 149.3) per microliter; post-nifurtimox: 11.9 (+/- 12.1) per microliter; P less than 0.001). Nifurtimox was well tolerated, with gastro-intestinal disturbances in 6 patients and a reversible cerebellar syndrome in 2 patients. Among the 19 patients seen at least once at follow-up, 12 (63%) relapsed. The other 7 patients have been followed for 3-18 months, and the CSF remained completely normal in 4 of them. This study confirms that nifurtimox has some activity against T.b. gambiense, but a daily dosage higher than 15 mg/kg/d will be necessary to achieve cure of most patients. PMID- 2694492 TI - Comparison of Tensilon and antivenom for the treatment of cobra-bite paralysis. AB - We prospectively compared the ability of anti-venom and edrophonium (Tensilon) to improve paralytic symptoms in 8 patients envenomed by the Philippine cobra (Naja naja philippinensis). Twenty, 50 or 100 ml of Philippine cobra antivenom were administered in a double-blind fashion by constant intravenous infusion over 30 min. Even the largest dose of antivenom failed to produce marked improvement within 2 h, though enzyme-linked immunosorbent assays and neutralization tests demonstrated that it possessed high titres of anti-neurotoxin antibodies. Tensilon given at 2 h was significantly more effective than antivenom at increasing the duration of upward gaze (78 +/- 28 vs 43 +/- 26 sec, P less than 0.001), and either completely reversed or markedly decreased paralysis in every patient. The Tensilon test should be given to all patients with paralytic envenoming by cobras, and anticholinesterases administered to those with a positive response. PMID- 2694493 TI - Mappa Mundi and tropical medicine. PMID- 2694494 TI - Two populations of women with high and low spleen rates living in the same area of Madang, Papua New Guinea, demonstrate different immune responses to malaria. AB - Specific malaria and total IgM antibody responses were measured in 2 linguistically distinct coastal Papua New Guinean populations living in the same endemic malarious area, but exhibiting different adult female spleen rates (51% and 30%), in order to establish whether the higher spleen rates in the former group were due to hyper-reactive malarious splenomegaly (HMS). Malaria parasite rates were comparable, and geometric mean titres of IgG malaria antibody were the same, in both groups, indicating comparable exposure to malaria. A higher mean total IgM was observed in the high spleen (HS) rate group (6.07 g/litre, compared with 4.62 g/litre), a higher proportion was seropositive for IgM antibody to Plasmodium falciparum (63% compared with 54%), and HMS was found rather more frequently (4.7% compared with 2.6%). In both groups total IgM concentrations increased significantly with rising parity, and the mean level of 5.27 g/litre in young nulliparous women from the HS group suggested that IgM levels in this group at least were elevated from childhood. In both groups a rise in total IgM was associated with higher P. falciparum IgM geometric mean titres of antibody activity, a fall in parasite rates (HS group: 30% to 15%, P = 0.02; LS group: 24% to 0%, P = 0.034), and higher spleen rates (HS group: 38% to 65%, P = 0.001; LS group: 20% to 67%, P = 0.00012). It is concluded that the difference in spleen rates between the 2 groups was the result of differing degrees of acquired immunity to malaria, probably due to genetic differences in immune responses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694495 TI - Sensitivity in vitro of Plasmodium falciparum to chloroquine and mefloquine in two regions of Benin. PMID- 2694496 TI - Susceptibility of Plasmodium falciparum strains to chloroquine and mefloquine in the Amazonas Federal Territory of Venezuela. AB - The susceptibilities of 27 Plasmodium falciparum strains to chloroquine and mefloquine were studied in the area of Puerto Ayacucho, Amazonas Federal Territory of Venezuela, to determine their levels of resistance in vivo and in vitro. 50% of these strains showed chloroquine resistance in vivo. No grade III chloroquine resistance was found. 25% of the strains were resistant to chloroquine in vitro and 9% were resistant to mefloquine in vitro. Preliminary results suggest that strains resistant to Fansidar may also be found. PMID- 2694497 TI - Chloroquine resistance of Plasmodium falciparum in semi-immune children in Zaria, northern Nigeria. AB - Fifty-nine children with Plasmodium falciparum malaria were subjected to the World Health Organization (WHO) extended field test to assess the in vivo sensitivity of the parasite to chloroquine in Zaria urban area, Nigeria. The parasites in 53 children (90%) were positive but those in 6 (10%) were resistant at the RI-RII level. 36 isolates from the patients were successfully cultured in vitro for the WHO standard microtest. 13 (37%) of the isolates underwent schizogony at chloroquine concentrations of 1.6 microM/litre and above. Probit analysis showed that the chloroquine concentrations producing 50% (EC50), 90% (EC90) and 99% (EC99) schizont inhibition were 0.4, 1.6 and 4.9 microM/litre, respectively. The results indicate a rapid decline in the sensitivity of P. falciparum to chloroquine in the study area during the past 3 years. PMID- 2694498 TI - Electrophoretic variants of enzymes in isolates of Plasmodium falciparum, P. malariae and P. vivax from Thailand. AB - A new electrophoretic variant of glucose phosphate isomerase (GPI), which we now denote GPI-3, has been found in isolates of Plasmodium falciparum from 6 patients, all of whom acquired the infection in the same region (in or near Prachinburi province) of Thailand. In other regions, from which 453 isolates have been tested, only GPI-1 and/or GPI-2 have been found. Two isolates of P. malariae from patients at Kanchanaburi showed a band of GPI activity on cellulose acetate gels at a cathodal position quite distinct from that of any previously known GPI variants in other human malaria parasites. Thirty-nine isolates of P. vivax from 3 regions of Thailand have been examined for variants of GPI and lactate dehydrogenase (LDH). Three forms of GPI were found, corresponding approximately in band positions to GPI-1, 2 and 3 of P. falciparum. The position of the band of LDH activity in P. vivax was the same in all the isolates examined, and different from that of LDH-1 in P. falciparum. PMID- 2694499 TI - Malaria relapses and chloroquine resistance at the BHEL industrial complex, Hardwar, India. PMID- 2694500 TI - A mixed infection of vivax and falciparum malaria apparently resistant to 4 aminoquinoline: a case report. PMID- 2694501 TI - Anopheles neivai: a vector of malaria in the Pacific lowlands of Colombia. PMID- 2694502 TI - Failure of mebendazole treatment in Giardia lamblia infection. PMID- 2694503 TI - Vector competency of Culex quinquefasciatus (Haitian strain) following infection with Wuchereria bancrofti. PMID- 2694504 TI - Estimation of age-specific rates of acquisition and loss of Wuchereria bancrofti infection. AB - This study uses a reversible catalytic model to estimate the age-specific rates of gain and loss of Wuchereria bancrofti infection from data collected during a control programme in Pondicherry, South India. The data describe the infection status in 1981 and 1986 of two cohorts of individuals, one living in an area where vector reduction had been achieved, and the other in a comparable endemic area. The rate of loss of infection in the absence of reinfection is estimated for the cohort in the control area, and the rate of gain of infection by the cohort in the endemic area estimated by substitution in the model. The mean expected life span of patent infection is estimated to be 5.4 years. The instantaneous rate of loss of infection is independent of age, while the rate of gain of infection exhibits a convex age-profile, peaking in the 16-20 year age class. The reduced rate of gain in adults is largely attributable to the increasing proportion of potentially resistant individuals with clinical disease. The results suggest that the age-distribution of bancroftian filariasis is primarily determined by age-dependency in the rate of acquisition of infection. PMID- 2694505 TI - Coconut milk and the cultivation of Plasmodium in vitro. PMID- 2694506 TI - Estimate of anti-Plasmodium falciparum sporozoite activity in humans vaccinated with synthetic circumsporozoite protein (NANP)3. AB - A mathematical model was defined to estimate the degree of in vivo activity against Plasmodium falciparum sporozoites expressed by volunteers vaccinated with a synthetic peptide comprising the immunodominant epitope of the circumsporozoite protein. Relative to the course of infection in non-immunized controls, infections in vaccinated volunteers corresponded to the neutralization or delay of development of greater than 99% of challenge sporozoites. PMID- 2694507 TI - Use of lyophilized antigen prepared from continuous cultures of Plasmodium falciparum for serological diagnosis by the indirect fluorescent antibody test. PMID- 2694508 TI - Efficacy of a 3-day oral regimen of a quinine-quinidine-cinchonine association (Quinimax) for treatment of falciparum malaria in Madagascar. AB - In the search for an effective, safe and field-adapted alternative to chloroquine for therapy of chloroquine-resistant Plasmodium falciparum infections in Africa, a 3-d oral regimen of Quinimax (an association of quinine, quinidine and cinchonine) was evaluated in 35 individuals with P. falciparum in Madagascar, an area with chloroquine resistance. 63% of the parasite strains isolated were resistant in vitro to chloroquine, and 59% of the infections were present despite previous chloroquine intake. Three daily oral doses of 10 mg/kg Quinimax for 3 d cleared parasitaemia and improved clinical status in all subjects. Mean parasite and fever clearance times were 51.7 and 37.4 h, respectively. All patients were aparasitaemic at the end of the 7-d follow-up. When formulating therapy guidelines, the 3-d Quinimax regimen should be considered as a valuable alternative to chloroquine for treating falciparum malaria in African areas with clinical resistance to chloroquine. PMID- 2694509 TI - Chemosuppression of malaria by the triple combination mefloquine/sulfadoxine/pyrimethamine: a field trial in an endemic area in Malaysia. AB - Malaria, particularly that due to chloroquine-resistant Plasmodium falciparum, which requires management with antimalarial drugs capable of protecting against multiresistant strains, has emerged in Malaysia. A study was carried out to assess the efficacy and tolerability of 2 dosages of mefloquine/sulfadoxine/pyrimethamine (MSP; RO 13-5112) compared to Fansidar in a malaria endemic area. 914 subjects in 3 random groups were studied. Occurrence of malaria was assessed both clinically as well as by blood films. Plasma drug levels were also measured. The results showed that the low dose of MSP was completely effective in suppressing parasitaemia. 2.7% of the study population reported adverse drug reactions, the lowest incidence being in subjects on the low dose; their blood chemical profiles were also the least affected. The plasma levels of pyrimethamine and sulfadoxine achieved in the low dose group were slightly higher than expected, but there was no significant difference in bioavailability. The study showed that, for chemoprophylaxis, a low dose of MSP provided effective protection with minimal side effects. PMID- 2694510 TI - Sensitivity to mefloquine in vitro of chloroquine-resistant Plasmodium falciparum from Vanuatu. PMID- 2694511 TI - Chloroquine-resistant Plasmodium falciparum malaria in Senegal. PMID- 2694512 TI - Treatment of malaria: some considerations and limitations of the current methods of assessment. AB - The currently used methods for assessing the therapeutic response to antimalarial drugs are relatively imprecise and insensitive. These methods are inadequate in severe malaria when the objectives of treatment are to save life and prevent complications. Very large studies are needed to demonstrate significant differences in mortality, but measurement of the rates of clinical, biochemical, and parasitological response may provide useful comparative information. Definitions, assessment criteria, procedures, and data collection forms should be standardized and evaluated prospectively. Antimalarial drug treatment in different clinical situations should be assessed in terms of the balance between the risks of drug toxicity and the benefits of the antimalarial drug action. This balance is considerably different in severe falciparum malaria compared with uncomplicated malaria infections. PMID- 2694513 TI - Human neurocysticercosis: comparison of enzyme immunoassay capture techniques based on monoclonal and polyclonal antibodies for the detection of parasite products in cerebrospinal fluid. AB - Current diagnosis of neurocysticercosis relies mostly on computerized tomography and nuclear magnetic resonance, with detection of antibodies being confirmatory rather than decisive. An assay which detects parasite products in cerebrospinal fluid would conclusively demonstrate a current infection and could be important when decisions regarding treatment must be made. Cerebrospinal fluid from patients with neurocysticercosis was used in 4 enzyme immunoassay capture tests designed to detect parasite products. Of the systems tested, one, based on the use of a monoclonal antibody reactive with a surface and secretion component of the metacestode, was particularly promising, giving a sensitivity of 72%. The assay has the double advantage of a very low background and a proved specificity for the products of living cysticerci. The other 3 systems (monoclonal anti vesicular fluid antibody, polyclonal antibody against a saline extract and polyclonal anti-antigen B antibody) were less sensitive. Results with the anti antigen B system support the proposal that products of low immunogenicity are the most appropriate targets for the serological detection of the parasite. PMID- 2694514 TI - Laboratory diagnosis of boutonneuse fever by enzyme-linked immunosorbent assay. AB - Little is known about the use of the enzyme-linked immunosorbent assay (ELISA) in the diagnosis of boutonneuse fever, and the reports which do exist have concerned the use of a strain of African origin and a peroxidase-labelled conjugate. We have used, as antigen, a Sicilian strain of Rickettsia conorii recently isolated from a patient with boutonneuse fever and anti-human immunoglobulins G and M labelled with alkaline phosphatase as conjugate. 432 (84.6%) of 500 sera from patients with boutonneuse fever, 4.4% of 384 sera from patients with various other pathologies, and 2.9% of 204 sera from blood donors gave positive reactions. The ELISA was highly sensitive and specific in the diagnosis of boutonneuse fever, and seems to be the test of choice for sero-epidemiological investigations, and when a large number of specimens must be examined. The test is more sensitive than the indirect immunofluorescence test, at least in the early stage of the disease (44.9% vs 21.3% positive respectively), and a long time after an acute attack. PMID- 2694515 TI - Some considerations of receptor specificity. AB - Since the amino acid sequences for several muscarinic and adrenergic receptors are known, an attempt was made to correlate side chain hydrophobicity surrounding the aspartate anionic groups with binding structure-activity relationships. No positive correlation was found, suggesting that secondary binding effects of head group substituents are non-local. Displacement of aspartate ionization is unlikely to be due to such neighbour effects. PMID- 2694516 TI - New subtypes of muscarinic acetylcholine receptors. AB - Human and rat genes and/or cDNAs for five different mAChRs have been cloned. The m1, m2 and m3 receptors correspond most closely to the pharmacologically defined M1, M2 and M3 receptors and are expressed in both brain and peripheral tissues. The m4 and m5 receptors are previously unrecognized pharmacological subtypes whose mRNAs are found predominantly in brain. Other less related but uncharacterized genes could represent additional subtypes. The properties of the five receptors and their genes are reviewed and their implications for future research are discussed. PMID- 2694517 TI - Functional diversity of muscarinic receptor subtypes in cellular signal transduction and growth. AB - The regulation of cellular signal transduction and growth by four human muscarinic acetylcholine receptor (mAChR) subtypes has been studied comparatively. The four mAChRs fall into two functional sub-groups, based on their primary effects on second messenger formation; two of the receptors strongly inhibit adenylyl cyclase activity, whereas the other two strongly stimulate PI hydrolysis. Studies on mAChR regulation of two cellular events involved in cellular growth regulation, the transcription of proto-oncogene c-fos and DNA synthesis, indicate that these events are efficiently activated by those mAChRs which couple primarily to phospholipase C. PMID- 2694518 TI - Localization and structure of the muscarinic receptor ligand binding site. AB - A conserved aspartic acid residue in transmembrane helix 3 of the muscarinic acetylcholine receptors is important in binding the headgroup of muscarinic ligands. This acidic amino acid probably points into a relatively hydrophilic cavity whose walls are formed by the amphipathic transmembrane helices of the receptor. Amino acid side chains within this cavity contribute to ligand binding. PMID- 2694519 TI - The modes of binding of ligands to cardiac muscarinic receptors. AB - Ionizable groups on the cardiac M2 muscarinic receptor which regulate the binding of ligands have been examined by studying the pH dependence of the ligand affinity constants. The presence of three titratable residues (approximate pK values, 5.4, 6.8 and 7.5) whose protonation modulates antagonist binding has been demonstrated. Cardioselective antagonists are selectively affected by the protonation state of the pK 6.8 residue, whereas the binding of antagonists having differing selectivities is more strongly affected by protonation of the pK 5.4 residue on cardiac receptors. Methoctramine is capable of binding to both the pK 5.4 and 6.8 residues simultaneously. Protonation of the residue of highest pK produces a conformational change at the receptor which can affect both agonist and antagonist binding. It is now possible to demonstrate differences both in the way ligands bind to a given receptor subtype and in the way a given ligand binds to different subtypes. PMID- 2694520 TI - Diverse functions of muscarinic acetylcholine receptor subtypes. AB - Muscarinic acetylcholine receptor subtypes m1, m3 and m5 couple strongly to phosphatidylinositol turnover and hence to intracellular Ca2+ concentration via pertussis toxin (PTX) sensitive and insensitive G proteins. The m2 and m4 muscarinic receptor subtypes strongly inhibit adenylyl cyclase production via PTX sensitive G proteins. Additionally, the cardiac M2 receptor is closely coupled to a K+ current (IK.ACh). To characterize this functional diversity more completely, we measured the ACh-induced Ca2+ responses of cells transfected with the muscarinic receptor subtypes m1, m2, m3 and m4. As expected, cells transfected with m1 or m3 receptors exhibited large dose-dependent increases in Ca2+ in response to ACh application. Unexpectedly, cells transfected with m2 or m4 receptors also exhibited increases in Ca2+ in response to agonist application. The m2- or m4-coupled responses were smaller in amplitude, required higher concentrations of agonist and were much more sensitive to PTX treatment when compared to m1- or m3-coupled responses. We discuss this remarkable diversity of function in terms of the receptor subtype's coupling to G proteins. PMID- 2694521 TI - Selective effector coupling of muscarinic acetylcholine receptor subtypes. AB - Attempts have been made by means of recombinant DNA technology to understand the molecular basis of the functional heterogeneity of the muscarinic acetylcholine receptor (mAChR). Molecularly defined mAChR subtypes have been produced from the cloned DNAs in Xenopus oocytes and NG108-15 neuroblastoma-glioma hybrid cells as transient and stable expression systems, respectively, and agonist-induced cellular responses have been examined. The results obtained provide evidence that mAChR subtypes are selectively coupled with different effector systems, albeit not exclusively. PMID- 2694522 TI - Regulation of muscarinic acetylcholine receptor function in cardiac cells and in cells expressing cloned receptor genes. AB - The regulation of the number and function of the muscarinic receptors has been investigated in cultured chick cardiac cells and in cells expressing cloned genes encoding mammalian, Drosophila, and chick muscarinic receptors. A serum-free defined medium for the culture of chick embryonic heart cells has been used to study the regulation of mAChR number and function by serum lipoproteins. Addition of rooster high density lipoprotein to the culture medium results in an attenuation of muscarinic receptor-mediated inhibition of cAMP accumulation without a change in the number of receptors or inhibitory G proteins. Clones encoding the mouse m1 receptor and a homologous receptor from Drosophila have been isolated. When expressed in Y1 adrenal cells, both receptors stimulate phosphoinositide hydrolysis but do not inhibit cAMP accumulation. Deletion of 123 out of the 156 amino acids in the third cytoplasmic loop of the mouse m1 receptor does not impair its ability to stimulate phosphoinositide hydrolysis. A genomic clone encoding a muscarinic receptor expressed in chick heart has been isolated. When expressed in Y1 cells, it causes inhibition of cAMP accumulation but does not stimulate phosphoinositide hydrolysis. PMID- 2694523 TI - Structure-activity relationships and pharmacological profile of selective tricyclic antimuscarinics. AB - The discovery of the M1-selective receptor antagonist pirenzepine was the impetus for a research project directed towards the development of selective muscarinic antagonists. In the pursuit of this objective, compounds with different selectivity profiles have been found. AF-DX 116 was the first cardioselective antagonist synthesized. Subsequently novel M2 receptor antagonists have been discovered with higher potency and selectivity. Moreover, a pirenzepine-type compound UH-AH 37 has been identified that, in contrast to pirenzepine, shows a higher affinity for ileal than for atrial muscarinic receptors. Among tricyclic muscarinic receptor antagonists three different selectivity profiles have been identified, namely: M1 greater than M3 greater than M2, Msm for pirenzepine; M2 greater than M1 greater than M3, Msm for AF-DX 116, AF-DX 384, AQ-RA 741; and Msm congruent to M1 greater than M2, M3 for UH-AH 37 and its (+) enantiomer. PMID- 2694524 TI - Polymethylene tetraamines as muscarinic receptor probes. AB - The possibility that polymethylene tetraamines act as divalent ligands has been explored. Structure-activity relationship studies among polymethylene tetraamines have shown that four nitrogens are necessary for high affinity binding to M2 receptors while being less important for M3 muscarinic receptors. Replacement of one terminal methoxybenzyl group of the potent and selective muscarinic antagonist methoctramine by different moieties led to weaker antagonists suggesting that the two terminal nitrogens of methoctramine interact with two similar receptor sites. Data are presented which suggest that methoctramine might interact with four acidic residues of the receptor: two residues are buried in the third transmembrane segment whereas the others are located extracellularly on the loop 4-5 which may represent the allosteric site where several antagonists such as gallamine bind. An hypothetical model describing the interaction of methoctramine with the M2 receptor is proposed. It may provide a useful working hypothesis for the design of new selective muscarinic ligands. PMID- 2694525 TI - Pharmacology of hexahydro-difenidol, hexahydro-sila-difenidol and related selective muscarinic antagonists. AB - A series of hexahydro-difenidol (HHD) and hexahydro-sila-difenidol (HHSiD) analogues modified in the amino group, the phenyl ring and in the alkylene chain were investigated for their binding and functional properties at muscarinic M1, M2 and M3 receptors. Novel muscarinic receptor antagonists were obtained which exhibited different receptor selectivity profiles from the parent compounds HHD and HHSiD (M1 congruent to M3 greater than M2), e.g. HHD and HHSiD methiodides, M1 greater than M2 congruent to M3; p-fluoro-HHSiD, M3 greater than M1 greater than M2; trans-hexbutenol, M1 greater than M3 greater than M2; and (s)-p-fluoro hexbutinol, M3 greater than M2 congruent to M1. Stereoselectivity ratios [(R)/(S)] for the enantiomers of HHD, hexbutinol and p-fluoro-hexbutinol were highest at M1, intermediate at M3 and lowest at M2 receptors. PMID- 2694526 TI - Stereoselectivity of the interaction of muscarinic antagonists with their receptors. AB - The stereoselectivity of the interaction with muscarinic receptors of enantiomers of a series of chiral antagonists is receptor subtype dependent. There is no overall relationship between stereoselectivity and receptor affinity. Depending on the antagonist studied, receptor stereoselectivity may indeed reflect: (1) the weakening or loss of a single interaction involving one of the four groups bound to the asymmetric carbon; (2) steric hindrance preventing optimum interaction of the low affinity steroisomer with the receptor; and/or (3) the inversion of the relative positions of two moieties of the ligand with similar structural and electronic properties i.e. comparable affinities for the two corresponding subsites in the receptor. PMID- 2694527 TI - The design of full agonists for the cortical muscarinic receptor. AB - In the present study we describe a novel series of oxadiazole based tertiary amines which include the most efficacious and potent muscarinic ligands known. These compounds possess physicochemical characteristics which enable rapid equilibration into the CNS and are able to fully activate cortical muscarinic receptors. Data obtained from this series have allowed us to propose a pharmacophoric model which distinguishes high and low affinity state binding. This in turn has led us to suggest that agonists and antagonists may bind at two independent sites on the receptor protein and to speculate on the steps putatively involved in agonist-induced receptor activation. PMID- 2694528 TI - Cholinergic mechanisms in pain and analgesia. AB - There is now substantial evidence that acetylcholinesterase inhibitors and muscarinic receptor agonists increase the pain threshold after both systemic and spinal administration. In rats, physostigmine gave a significant dose-dependent increase in latency times in the tail immersion test following intrathecal administration. The effect was antagonized with atropine. Neostigmine gave more prolonged latencies as did the muscarinic receptor agonist carbachol. Spinal cholinergic pathways for antinociception interacted with the spinal opioid and adrenergic nerve tracts. No cross-tolerance to the selective alpha 2 adrenoreceptor agonist guanfacine or to morphine was seen in rats tolerant of spinal carbachol antinociception. The mechanism of spinal cholinergic antinociception is not known but a muscarinic interneuron may explain the interactions with other neurotransmitters. Clinically, the centrally active cholinesterase inhibitor physostigmine has been shown to give postoperative pain relief although of short duration. Severe neurogenic pain has been successfully treated with physostigmine or distigmine. PMID- 2694529 TI - Muscarinic receptor subtypes in human neurodegenerative disorders: focus on Alzheimer's disease. AB - Much evidence has clearly revealed the existence of marked cholinergic deficits in cortical and hippocampal areas in Alzheimer's disease. Although not necessarily of etiological origin, these deficits have been associated with learning and memory disabilities observed in this neurogenerative disorder. We report here that in addition to deficits in choline acetyltransferase (ChAT) activity, the maximal densities of high affinity [3H]acetylcholine and [3H]AF-DX 116 (possibly M2), but not M1 muscarinic receptor binding sites are decreased in cortex and hippocampus in Alzheimer's disease. Similar findings are also observed in Parkinson's disease with Alzheimer's type dementia. Additionally, animal studies suggest that a population of M2 receptors is presynaptically located on cholinergic nerve terminals where they can act as negative autoreceptors to decrease acetylcholine release. Interestingly, blockade of these sites facilitates acetylcholine release and learning in rats. This may be relevant for the design of more appropriate therapeutic approaches toward the treatment of certain symptoms of Alzheimer's disease. PMID- 2694530 TI - Muscarinic agonists for senile dementia: past experience and future trends. AB - Clinical experience with muscarinic agonists in the symptomatic treatment of Alzheimer's disease includes studies of the effects of pilocarpine, arecoline, bethanechol, oxotremorine and RS 86. Although the results are somewhat conflicting, there is evidence that a subgroup of patients may respond with an improvement of cognitive and/or behavioural function. The existing agents tend to induce adverse effects due to the stimulation of peripheral muscarinic receptors. Furthermore they reduce (at least in vitro) acetylcholine release by an action on presynaptic receptors. Strategies to overcome these problems include the development of potent agonists with high blood-brain barrier penetration, the search for agents selective for muscarinic receptor subtypes (using cloned receptors as tools) and the identification of agents acting as presynaptic receptor antagonists, to increase acetylcholine release. PMID- 2694531 TI - Muscarinic pharmacology of the airways. AB - Muscarinic receptors have been identified in the airways in several species, including humans, located on airway smooth muscle, secreting cells and on the nerves. M1 receptors are found in sympathetic ganglia in the guinea-pig and in parasympathetic ganglia in humans. M2 receptors (inhibitory autoreceptors) are found in cholinergic parasympathetic nerve terminals in many species, including humans, whereas the muscarinic receptors found on airway smooth muscle and mucus glands belong to the M3 subtype. It is possible that a defect in neuronal M2 receptor function may explain beta-blocker-induced asthma. M2 antagonists such as methoctramine are promising tools for elucidating the role of muscarinic receptor subtypes in the lung. However, they can potentially increase acetylcholine release. This property is not shown by drugs with a higher selectivity for M1 and M3 receptors which are likely to be useful clinically in the treatment of airway disease. PMID- 2694532 TI - Selective antagonists reveal different functions of M cholinoceptor subtypes in humans. AB - Effects of atropine and of the subtype selective mAChR antagonists pirenzepine (PZ) and AF-DX 116 were studied in humans. Dose- or time-response curves were established for heart rate and salivary flow. Plasma samples were drawn in parallel with the effect measurements and analysed for drug concentrations. Subtype-selective radioreceptor assays of the samples served to estimate the respective receptor occupancy in vivo. It is shown that low doses of PZ (M1 selective blockade) cause cholinomimetic effects indicated by bradycardia and increase in salivary flow. After high doses of PZ or atropine, tachycardia and inhibition of salivary flow are observed in parallel with occupancy of both the M2 and M3 subtypes. AF-DX 116 induces a tachycardia together with an increased salivary flow in agreement with its selectivity profile (M2 greater than M1 greater than M3). The diagnostic and therapeutic applications of M1- or M2 selective blockade by low dose PZ or AF-DX 116 respectively are discussed. PMID- 2694533 TI - Disease states can modify both receptor number and signal transduction pathways. PMID- 2694534 TI - The 5-HT4 receptor: naughty, but nice. PMID- 2694535 TI - Receptors and the common cold. PMID- 2694536 TI - New anti-ischaemic drugs: cytoprotective action with no primary haemodynamic effects. AB - Currently therapy for ischaemic heart disease is based on drugs such as beta adrenoceptor antagonists, Ca2+ antagonists and nitrates, which have pronounced haemodynamic effects. However, these drugs can have adverse reactions including systemic haemodynamic effects, leading to low blood pressure and peripheral oedema in some patients. Recent observations that certain types of Ca2+ antagonist prevent the Ca2+ overload that occurs after ischaemia have led to the design of new anti-ischaemic drugs that are cytoprotective, but have no (or few) haemodynamic effects. In this article, Pieter van Zwieten and colleagues assess the therapeutic potential of these drugs. PMID- 2694537 TI - Transmembrane signalling at the epidermal growth factor receptor. AB - The EGF receptor, which is homologous to the v-erb-B oncogene product, has intrinsic tyrosine kinase activity, and mediates an increase in polyphosphoinositide turnover and [Ca2+]i. Recently, great progress has been made in understanding the mechanism of signal transduction at this receptor. Jacopo Meldolesi and colleagues discuss how this knowledge may lead to a better understanding of the control of cell proliferation. PMID- 2694538 TI - Interaction of CCK with pancreatic acinar cells. AB - Recent studies demonstrate that cholecystokinin-like peptides are widely distributed in the CNS as well as in the peripheral nervous system and gastrointestinal tract. Studies with agonists have demonstrated multiple classes of receptors and recently potent receptor antagonists have been described which will distinguish these classes and should allow a better understanding of the role of CCK in various physiological processes. One of the known peripheral physiological functions of CCK is the stimulation of digestive enzymes from pancreatic acinar cells. In recent years the interaction of CCK with pancreatic acinar cells has been extensively studied and significant advances have been made in understanding its cellular basis of action. Robert Jensen and colleagues report on each of these areas. PMID- 2694539 TI - Neurotrophic, neurotoxic and mitogenic activities of 'amyloid' proteins. PMID- 2694540 TI - This and that: the war on drugs and the evolution of sulfur. PMID- 2694541 TI - The relevance of pharmacological dose--response curves to airway narrowing. AB - A defect in the smooth muscle of airways has been discarded as a possible cause of asthma in recent years because of the lack of correlation between airflow obstruction in patients and the contractile responsiveness of the isolated airway smooth muscle. Howard Mitchell and Malcolm Sparrow question the relevance of comparing parameters obtained from pharmacological dose-response curves (e.g. EC50) of strips of airways in vitro with those describing airways narrowing in vivo (e.g. resistance). They point out that in small airways the upper half of the dose-response curves seen in strips of airway wall is not represented in perfused tubular airway segments because they are fully constricted at or near the EC50 of the strip. PMID- 2694542 TI - Substituted 2-oxiranecarboxylic acids: a new group of candidate hypoglycaemic drugs. AB - Drugs to treat diabetes that can be taken orally have long been sought, although the successful management of insulin-dependent diabetes mellitus by simple chemotherapy may be an unachievable goal. The only drugs currently used for the treatment of non-insulin-dependent diabetes have limited effectiveness. In this article Peter Selby and Stanley Sherratt describe the development of a new group of candidate hypoglycaemic drugs, esters of substituted 2-oxiranecarboxylic acids, which merit full clinical evaluation. These drugs are hydrolysed to the free acids which are then converted to their coenzyme A esters in cells. The CoA esters inactivate carnitine palmitoyltransferase I in the outer mitochondrial membrane, thus preventing the excessive oxidation of long-chain fatty acids that occurs in diabetes. This causes a secondary decrease in hepatic gluconeogenesis and an increase in peripheral glucose utilization leading to improved glucose tolerance. PMID- 2694543 TI - Dextromethorphan and neuromodulation: old drug coughs up new activities. AB - Dextromethorphan is one of the most widely used non-opioid cough suppressants, representing the active ingredient in several over-the-counter antitussive formulations. It does not possess the CNS pharmacology of other opiates in humans (i.e. analgesia, respiratory depression, abuse liability or psychotomimetic properties), but since the discovery in 1981 of high affinity recognition sites in brain for dextromethorphan a unique neuropharmacological profile has emerged for this relatively innocuous drug. Anticonvulsant and neuroprotective properties have been demonstrated, and treatment with dextromethorphan has been shown to improve the cerebrovascular and functional consequences of global cerebral ischemia. Frank Tortella and colleagues review the CNS pharmacology of dextromethorphan, its possible involvement with NMDA or sigma-receptors, and the potential clinical importance of this old 'new' drug. PMID- 2694544 TI - 1,4-Dihydropyridine activators and antagonists: structural and functional distinctions. AB - The dihydropyridine series of drugs contains both potent antagonists and potent activators of Ca2+ channels. The structural differences between antagonists and activators are small and, indeed, activators can behave as antagonists at high levels of membrane depolarization. Here, David Triggle and David Rampe describe recent insights into the factors--including structure of the drug and activation state of the channel--that influence the behavior of these drugs, and discuss models that have been proposed to describe their mechanism of action. PMID- 2694545 TI - [Growth factors--the new regulators of reproduction]. AB - Experimental data on the role of growth factors in the processes of oocyte maturation and of proliferation and differentiation in the mammalian ovaries are reviewed. Evidence is provided that theca and granulosa cells can synthesize epidermal, fibroblast, insulin-like and transforming growth factors and have receptors to all of them. The regulation of oocyte maturation induction by the growth factors is analysed. A possible physiological influence of growth factors and inhibin on regulation of folliculogenesis and gametogenesis and also on selection of the dominant follicle in the mammalian ovaries is discussed. PMID- 2694546 TI - [Fibroblast spreading in the presence of cytochalasin D: immunoelectron microscopy of the cytoskeleton]. AB - Spreading of mouse embryo fibroblasts in the presence of cytochalasin D (1 microgram/ml) was studied using scanning electron microscopy, immunofluorescence, and electron microscopy of platinum replicas. Whereas circular lamellae were formed around the cell body during normal spreading, separate processes appeared at the cell periphery during spreading in cytochalasin-containing medium. The processes gradually elongated and branched. Cytoskeletons of fibroblasts spreading in the cytochalasin-containing medium were obtained by Triton X-100 extraction. They contained microtubules, intermediate filaments, actin "paracrystals" looking like short microfilament bundles, and patches of a meshwork-granular material. Immunogold coating of the cytoskeletons with anti actin antibody showed that some meshwork-granular patches were decorated with gold particles, whereas the others were not. Non-actin patches were usually located on the distal ends of the processes, thus leaving behind the actin cytoskeletal components during the process growth. Another characteristic feature of this unidentified material is its usual association with the substratum and microtubules. These results suggest that the process protrusion during cell spreading in cytochalasin-containing medium may occur not due to actin polymerization as in the control cells, but due to involvement of some other non actin cytoskeletal components. These components seem to be able to move along microtubules and to bind to the substratum. PMID- 2694547 TI - [Monoclonal antibodies to the muscle isoform of alpha-actinin--a marker for the study of the differentiation of skeletal and cardiac muscles]. AB - A battery of monoclonals to the rabbit skeletal muscle alpha-actinin has been produced. The majority of monoclonals proved to be species-specific by indirect immunofluorescence on the isolated rabbit skeletal myofibrils and on the differentiating cultures of chicken and rat skeletal muscles. One monoclonal, EA 53, reacts with the skeletal muscle alpha-actinin of various species (rat, rabbit, chicken) in immunofluorescence and immunoblotting. The monoclonal EA-53 recognizes also heart muscle alpha-actinin in cultured cardiomyocytes of human, rat and mouse origin. EA-53 does not stain alpha-actinin in myoblasts, fibroblasts, and endothelial cells. The monoclonal antibody EA-53 discriminating muscle and nonmuscle alpha-actinin isoforms could be used as a tool to study the mechanisms of skeletal and cardiac myogenesis. PMID- 2694548 TI - [The cryopreservation of isolated liver cells]. AB - Recent literature data on cryopreservation of isolated hepatocytes are summarized. The hepatocytes are considered to constitute a promising system for investigation of liver metabolic peculiarities as well as for elucidating mechanisms of low temperature effects on biological systems. PMID- 2694549 TI - Bovine Babesia bigemina seroreactors in Jamaica. PMID- 2694550 TI - Photosensitisation: a note of caution in the use of Brachiaria pastures--a review. PMID- 2694551 TI - Local anti-P32 humoral response in tuberculous meningitis. AB - We report five cases of severe pulmonary tuberculosis admitted to hospital with a suspicion of meningeal involvement. The diagnosis of tuberculous meningitis was confirmed by standard bacteriological techniques in two of the five patients. Specific IgG class antibodies directed against the recently purified BCG antigen P32 were detected by a dot immunoblotting technique in the serum and in the cerebrospinal fluid of each patient; however, a higher anti-P32 immunoglobulins/total immunoglobulins ratio was observed in the cerebrospinal fluid of patients with tuberculous meningitis than in their serum while the reverse situation was observed in the other patients. PMID- 2694552 TI - Genetic transformation of BCG. AB - Two substrains of BCG, the Pasteur and Japanese, were successfully transformed with E. coli-mycobacteria shuttle plasmids, constructed from the E. coli plasmid, pIJ666 and the M. fortuitum plasmid, pAL5000. Individual plasmids (pYUB13, pYUB14) were obtained that contain selectable antibiotic resistance markers for kanamycin and chloramphenicol resistance that can replicate in both E. coli and BCG. Transformation of two substrains of BCG was successfully accomplished in 8/14 experiments by means of electroporation, and assessed by the growth of kanamycin-resistant colonies. The E. coli plasmid pIJ666 alone was unable to effect transformation. The results suggest that the M. fortuitum sequences required for transformation function as an origin of replication in BCG. The introduction, persistence and the identity of the plasmids were monitored by re isolation from consecutive subcultures and restriction analysis. The variables associated with transformation, including the age, viability, and glycine pretreatment of BCG cultures, as well as the electroporation parameters on transformation frequencies are analysed. Consecutive transformations of BCG with plasmid DNA isolated from a BCG transformant increased the efficiency from the level of 10(1)-10(2) obtained with the initial library to 10(3)-10(4) colonies/micrograms DNA with functional pYUB plasmids. The hybrid plasmids were genetically stable and maintained expression of kanamycin resistance in continuous subcultures containing kanamycin for 250 generations. The introduction and stable expression of foreign DNA in BCG on a plasmid vector establishes a basis for the construction of polyvalent recombinant BCG vaccine vehicles expressing not only putative protective mycobacterial antigens, but also antigens for other infectious and malignant diseases. PMID- 2694553 TI - Results of blood cultures for detection of mycobacteria in AIDS patients. AB - Since the advent of the acquired immunodeficiency syndrome (AIDS) numerous M. avium intracellulare disseminated infections have been recognised. Blood culture is a convenient method for diagnosing these infections. At Pitie-Salpetriere hospital AIDS patients with persistent unexplained fever each had three blood cultures. The blood samples, taken on 3 consecutive days without taking in account fever peaks, were collected in the Isolator-10 lysis-centrifugation system and inoculated onto Lowenstein-Jensen medium with and without 0.25% sodium pyruvate. From February 1986-September 1987, 564 samples taken from 165 patients were cultivated for the detection of mycobacteria. Sixty one (10.8%) taken from 19 patients (11.5%) were positive. M. avium intracellulare was the most frequently isolated mycobacterial species. In 10 patients, the positive blood culture was the only or the first positive culture for mycobacteria. PMID- 2694554 TI - Ki-67 labeling index in breast cancer. AB - Measurements of cell cycle kinetics have been found to correlate with the clinical course of patients with breast cancer. However, the thymidine labeling index and more rapid methods like flow cytometry remain complicated and costly. We assessed cell proliferation of 67 breast carcinomas by an immunoperoxidase procedure using a monoclonal antibody, Ki-67, which reacts with a nuclear antigen in proliferating cells. The percentage of Ki-67 positive cells ranged from 2% to 70%. Tumors with high mitotic rate, high nuclear grade, high histologic grade, and negative estrogen receptors had statistically higher Ki-67 labeling rates. We found no significant differences between the Ki-67 labeling rate and other clinical (age at diagnosis, menopausal status) or pathologic (necrosis, fibrosis, vascular invasion, lymphatic invasion, cellular reaction, tumor size, lymph node metastases) features assessed. These results parallel previously reported data, and confirm that this immunohistochemical staining of breast carcinoma by Ki-67 monoclonal antibody can be considered a rapid and convenient method for assessing cell cycle kinetics. However, further studies, evaluating the correlation between Ki-67 labeling rate and prognosis are needed to better define the real usefulness of this analysis in clinical practice. PMID- 2694555 TI - Clear cell carcinoma of the larynx: immunocytochemical study. AB - A case of clear cell carcinoma of the larynx with multiple metastases is reported. The histological and immunohistochemical characteristics of this tumor are discussed as well as the main differential diagnoses. An origin from sero mucous glands of the larynx is proposed. A literature review showed that clear cell carcinoma of the larynx is rare and is characterized by extremely high aggressiveness. PMID- 2694556 TI - A case of parathyroid adenoma with brown tumors diagnosed by 201thallium 99mtechnetium subtraction scintigraphy. AB - A case of parathyroid adenoma detected by 201thallium-99mtechnetium subtraction scintigraphy is presented. Focal areas of thallium uptake were observed in the bone. Bone biopsy findings revealed Brown tumors associated with hyperparathyroidism. PMID- 2694557 TI - Biological consequences of hyperthermia. AB - Because of the potential for certain modalities of clinical ultrasound to cause tissue heating, it was deemed important to survey the literature for reports on temperatures and hyperthermia exposure durations at which biological effects occur in a wide spectrum of organisms. In general the higher the temperature or the longer the hyperthermia exposure, the greater the chance for observing a perturbation to the biological system. Special attention was given to ascertaining temperature exposure conditions below which no biological effects have been reported. The physical mechanism(s) by which heat produces biological effects is(are) not known but substantial quantities of empirically derived data have allowed for the calculation of exposure temperature-duration equivalences. It appears reasonably well established that short exposures to sharply-elevated temperatures result in a protective effect against further thermal insult; the generation of heat shock proteins by cells coincides with the onset of such "thermal protection." The information contained in this review indicates an absence of reported effects in animals below 39 degrees C. PMID- 2694558 TI - An ultrasonic measurement of superficial femoral artery wall thickness. AB - An ultrasonic measurement of the superficial femoral artery wall thickness was performed on 16 volunteers. The measurement included all echogenic tissue between the lumen of the superficial femoral artery and the lumen of the superficial femoral vein. The average arterial wall plus vein wall thickness in volunteers with peripheral arterial disease was 2.13 +/- 0.87 mm, significantly greater than the 1.27 +/- 0.50 mm found in those without detectable peripheral arterial disease. PMID- 2694559 TI - Spatial resolution of transcranial pulsed Doppler technique in vitro evaluation of the sensitivity distribution of the sample volume. AB - The spatial resolution of pulsed Doppler sonography is determined by the size of the sample volume. It is known that the axial length is dependent upon the duration of the range gate interval and the lateral extension upon the beam width. In addition, the working size is also a function of the sensitivity distribution within the sample volume. All of these parameters determine the working size of the sample volume. Especially for the transcranial Doppler evaluation of the basal cerebral arteries, the site and the working size of the sample volume are essential diagnostic criteria. To measure the working size of the sample volume a flow rig with a thin tube target has been developed and used. The highest sensitivity (100% level) was registered only in a relatively small area and only if the center of the sample volume hit the target. At the 10% level the size of the sample volume increased 5 to 10 times in the lateral and axial dimension in comparison with the 90% level. Therefore, the Doppler signal from a strong reflector distant from the center of the sample volume may mask the signal of a weak reflector located within the center. This lack of spatial resolution due to sensitivity effects may result in clinical misinterpretation. The manufacturers should be urged to supply more precise information relative to the sample volume size. PMID- 2694560 TI - Doppler spectral waveform generation in vitro: an aid to diagnosis of vascular disease. AB - This paper describes a microcomputer controlled pump which generates pulsatile flows similar to those found in the human peripheral circulation. Continuous wave Doppler ultrasound was used to investigate the flows generated by the pump and the behaviour of diagnostic indices derived from the spectra was examined. Sonograms were recorded from elastic and rigid tubes with various degrees of axisymmetric constriction. Heart rate, stroke volume, severity of vessel constriction, vessel wall elasticity, distal resistance, and systemic peripheral impedance were varied in turn and the resulting Doppler spectra compared. Indices considered were the pulsatility index, spectral broadening index and peck Doppler frequency. In general, the indices lacked the sensitivity to detect low to moderate levels of disease. PMID- 2694561 TI - Clinical evaluation of a new anti-aliasing technique for ultrasound pulsed Doppler analysis. AB - Clinical evaluation of a new method of Doppler spectral analysis is discussed in this paper. According to this method, which basically involves a proper reformatting of the data provided by a conventional spectrum analyser, the frequency range usually considered in pulsed systems is considerably extended. This has been demonstrated even in extreme clinical conditions, corresponding to tight stenosis in major arteries. Details of materials and methods employed in this evaluation are included. Examples of experimental results are reported, along with a discussion about some possible applications of the new technique. PMID- 2694562 TI - Parameter estimation for nonlinear frequency dependent attenuation in soft tissue. AB - Most current attenuation estimation methods are based on an assumption that tissue attenuation is linearly frequency dependent. For tissues exhibiting nonlinear attenuation, such methods could produce biased results. This paper describes a new time-domain, amplitude method for estimating two parameters, beta and n, in nonlinear attenuation. In this method, echo signal of each A-line is first filtered in parallel by a bank of narrow-bandpass filters. Attenuation values at filter center frequencies can be calculated from the envelope peaks of each filtered narrowband signal, and beta and n are then estimated from these attenuation values. A quantitative study of the estimation uncertainty indicates that there is a significant increase in the variance of beta estimate when the attenuation model is changed from linear to nonlinear. The analysis yields insights into the tradeoff between estimation accuracy and estimation precision when tissue attenuation is only slightly deviated from linearity. PMID- 2694563 TI - [Initial results of the biocompatibility, cytotoxicity and genotoxicity of Aramid]. AB - Tissue biocompatibility of aramid fibres was tested over up to 16 weeks after subcutaneous (A = nine) and intraarticular (B = twelve animals) implantation in the rabbit. Histologically all specimens showed connective tissue ingrowth with interspersed mesenchymal cells. Foreign body giant cells were numerous and demonstrated intracellular dye or aramid particles. Following implantation into the knee joint the aramid ligament was invaded by longitudinally arranged, stress oriented collagen fibres as soon as four weeks postoperatively. In spite of reactive new bone formation a functional bony anchorage in the bore holes did not take place during the 16 week period. Additional investigations in bacteria (particularly the Salmonella-microsome Assay according to Ames) and mammalian cell cultures showed no evidence for any cyto- or genotoxic effects of aramid fibres. PMID- 2694564 TI - [Proteinuria and beta 2-microglobulinuria in patients with tumors of the renal pelvis and ureter and in healthy persons from areas of endemic nephropathy]. AB - Total proteinuria (SSA test) and beta-2-microglobulinuria (radial immunodiffusion and radioimmunoassay tests) were measured in 60 rural patients with histologically proven tumors of the renal pelvis and ureters and as many individually matched controls. The controls were the first neighbours of the same sex, age (+/- 2 yrs), profession and migratory history. Urinalysis was performed twice with an interval of nine years (in 1973/4 and 1982/3). As expected, both proteinuria and beta-2-microglobulinuria were more frequently elevated among the patients. However, these tests were very often positive among the controls as well. Thus, the prevalence rate of hyper-beta-2-microglobulinuria, as measured by the RIA method in 1982/3, was 26.3% in the control group. A high frequency of the tubular damage, as revealed by this test, among presumably healthy persons has been attributed to the fact that most upper urothelial tumor cases come from the Balkan endemic nephropathy foci where a significant proportion of inhabitants show signs of kidney affection. PMID- 2694565 TI - [The diagnosis and treatment of cystic diseases of the kidneys by using transcutaneous puncture methods under ultrasonic monitoring]. AB - Presented in the paper are the methods of ultrasonic diagnosis and percutaneous paracentetic treatment of cystic kidneys under ultrasonic monitoring. Paracenteses were performed in 172 patients: 59 with polycystic and 113 with cystic kidneys. If the cysts located in the middle or lower segments of posterior, lateral or inferior drainage that was pushed through the guide into the cyst lumen. A thin-needle aspiration was used and the drainage avoided if the cyst located in the anterior part of middle or upper renal segments. Cystography and cystomanometry associated with the determination of the cyst tension index followed elimination of the aspirates for cyto- and bacteriological investigations. Paracentesis was accomplished under the ultrasonic monitoring of the position of a needle tip. The cavity of the cyst was sclerosed with 96% spirit in 84 patients; strong radiopaque agents were used in 8 and medicinal cyanacrylate glue in 13 patients. The drainage of the cysts with a long-term exposure to sclerosing agents (from 2 to 24 hrs) was employed in 32 patients. Postaspiration relapses were documented in all the patients with intrasinus cysts and cysts, whose major portion was surrounded by parenchyma. In the patients with other patterns of cyst location, the postaspiration relapses were noted in 94.4 per cent. A four-year follow-up of 13 patients who sustained the glue application registered 2 relapses which were successfully cured by a repeat application of the glue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694566 TI - [The proteolysis-ion theory of the pathogenesis of nephrolithiasis]. AB - A study was made of urinary proteolysis. This parameter turned to be decreased in patients with nephrolithiasis versus normal subjects. The authors developed an original proteoclastic-ion theory of nephrolithiasis pathogenesis, based on the two main risk factors triggering the disease: low levels of urinary proteolysis leading to the formation of a calculous matrix; the urine pH values optimal for the sedimentation of lithiasic salts. The combination of both risk factors was responsible for the development of calculous crisis and the formation of microlith. The decreased index of urinary proteolysis calculated with the formula offered could be regarded as a risk indication to the microlith formation. A possible elimination of the both risk factors was demonstrated. The technique of microlithiasis metaphylaxis was developed with regard to the major and minor risk factors and the possibility of their elimination. The values of urinary proteolysis were the criteria for a successful therapeutic response. With regard to the number of risk factors the risk of primary nephrolithiasis or lithiasis relapses could be predicted. PMID- 2694567 TI - [Microsurgery of the appendix testis (experimental research)]. AB - Based on their own experience with 83 reconstructive microsurgeries performed for epididymis obstruction the authors concluded that a simple incorporation of microsurgical techniques into the surgery of excretory infertility failed to substantially improve the results of the treatment. Supposing a well-managed clinical study to be the main tool to provide better results and the data of animal studies to be inapplicable for the diseases of the human reproductive system, the authors suggested that the aforementioned study in the clinical settings should conform to the two major requirements: an uniform pattern of the techniques employed and an exacting control over anastomosis application. As a method of choice, end-to-side vasoepididymostomy was offered. A training model for gaining the mastery of epididymis microsurgery techniques was developed as well. The reliability of the method was proved by experiments on 20 rabbits. 17 animals gave offsprings. The system of epididymal ducts studied in health opened the possibility of a well-founded division of epididymis into zones of surgical importance. PMID- 2694568 TI - [The history of the development of ureteral catheterization]. PMID- 2694569 TI - [Our experience with reducing incisions after keratoplasty]. AB - A good anatomical result (clean graft) after keratoplasty with transparent taking in of the transplant is not always associated with a good functional result, i.e. with a sufficiently high vision acuity; this is due to high postoperative astigmatism. A surgical intervention is suggested to solve this problem; this operation may be performed on an outpatient basis. The results are reported. PMID- 2694570 TI - [Hemophthalmos and posterior detachment of the vitreous body (an ultrasonic study)]. AB - A total of 133 patients with hemophthalmos and its aftereffects have been examined with the use of a digital processing gray scale ultrasonic B-scanner. Posterior detachments of the vitreous body (PDVB) have been revealed in 45 (33.8%) patients. In half of these patients the hyaloid membrane has been found bound to the optic disk or to the retina; this bond indicates the site of the hemorrhage from the injured vessel. V-shaped PDVB, connected with the optic disk, may be difficult to differentiate from a detachment of the retina. Three major factors should be borne in mind in such a differential diagnosis: the amplitude of the echo signal, the detachment topography and mobility. In 5 patients PDVB were combined with detachments of the retina. In 9 case PDVB have been a consequence of a retrovitreal hemophthalmos. PMID- 2694571 TI - [Scheimpflug photography of the crystalline lens]. PMID- 2694573 TI - [Treatment of patients with acute intestinal obstruction in diabetes mellitus]. PMID- 2694572 TI - [Pathogenetic mechanisms of optic nerve lesions in acute vascular optic neuropathies]. AB - The authors analyze the findings of histomorphologic and immunomorphologic studies of 20 cadaver optic nerves from subjects with a history of acute vascular optic neuropathies due to atherosclerosis, eventuating in optic nerve atrophy: 13 atrophic optic nerves and 7 pair nerves from clinically normal eyes of the same patients were examined. The blood sera of 30 patients suffering from acute vascular optic neuropathies were tested. Noteworthy that vascular optic neuropathy associated with atherosclerosis is a bilateral process. Vascular insufficiency due to sclerotic changes in vessels of various diameters undoubtedly contributes to the pathogenesis of the optic nerve impairments in the involved and clinically healthy eyes. The developing immune status disorders and autoimmune processes also contribute to the genesis of sclerotic shifts in the vessels and optic nerve atrophy in both eyes. PMID- 2694574 TI - [The reticuloendothelial system if the liver in patients with peritonitis]. PMID- 2694575 TI - [Surgical treatment of complicated gastroduodenal ulcers]. AB - Results of surgical treatment of complicated forms of gastroduodenal ulcers in 225 patients were summed up. The patients were operated upon using different variants of gastric resection. Results of the surgical treatment were followed-up during the period from 2-3 months up to 3-5 years. Promising results of the operative treatment of patients with complicated forms of gastroduodenal ulcers using tubular resections of the stomach allow to widely recommend them for surgical practice. PMID- 2694576 TI - [A method of suturing of dilated cardial veins in patients with portal hypertension]. AB - Ultrasonic fluorometry used in 22 patients with portal hypertension facilitates the detection, marking the venous trunks of the cardia with inflammatory alterations of the mucosa. Intraoperative control of surgical treatment with the help of ultrasonic fluorometry allows operations to be performed more radically and to considerably reduce the intraoperative blood loss. PMID- 2694577 TI - [Intestinal decompression in the treatment of gunshot abdominal wounds]. PMID- 2694578 TI - [Neck trauma with injury of the trachea]. PMID- 2694579 TI - [Penetrating rupture of the myocardium in closed trauma]. PMID- 2694580 TI - [Treatment of injuries of the extension system of the fingers]. PMID- 2694581 TI - Turkey problems herald Christmas. PMID- 2694582 TI - A comparison of two oral rehydration solutions in experimental models of dehydration and diarrhoea in calves. AB - Two oral rehydration solutions (ORS 1 and ORS 2) were evaluated in isolated intestinal loops of anaesthetised calves, in an experimental model of dehydration in the calf, in calves with experimentally induced diarrhoea and in 164 calves with clinical diarrhoea. The studies in isolated intestinal loops indicated that water absorption was significantly greater from ORS 2 than from ORS 1. After the intraperitoneal administration of hypertonic mannitol combined with intravenous diuretics, the plasma volume of calves was reduced by about 30 per cent, and was more rapidly expanded after treatment with ORS 2 than ORS 1. The plasma volume remained significantly reduced (P less than 0.01) three hours after dosing with ORS 1 whereas after treatment with ORS 2 it was not significantly different from the initial value. Acidosis was corrected to a significantly (P less than 0.01) greater extent after treatment with ORS 2, and peripheral perfusion also returned to normal more rapidly in calves given ORS 2. In newly purchased calves in which diarrhoea was induced experimentally with an E coli challenge, base deficit and diarrhoea were corrected more rapidly in the calves receiving ORS 2. When the solutions were tested in the treatment of 164 clinical cases of diarrhoea and dehydration there was no statistically significant difference in mortality between the formulations, although the overall mortality was 4.8 per cent in the calves treated with ORS 2, compared with 8.6 per cent in the calves treated with ORS 1. It was concluded that ORS 2 performed better than ORS 1 especially in the expansion of plasma volume and the correction of acidosis. PMID- 2694583 TI - Restraint and anaesthesia of primates. AB - The methods available for the restraint and anaesthesia of captive primates are discussed, emphasising the differences between the techniques for primates and those for other mammals; the importance of humane methods of physical restraint is emphasised. The agents available for chemical restraint and surgical anaesthesia are considered in terms of their ease of administration, the dose rate required, speed of induction and recovery, analgesic properties, muscle relaxation and side effects. New agents are available which are potentially useful in primates. PMID- 2694584 TI - Different morbilliviruses in European and Siberian seals. PMID- 2694585 TI - Chemical risk assessment: a review. AB - People are exposed to a staggering assortment of chemicals and foreign substances. Potential health risks accompany these exposures. Intelligent, informed decisions are needed on which risks can and should be reduced, eliminated, or simply ignored. Therefore, a method of determining the attendant human health risks involved in chemical exposure is necessary. This need has resulted in the evolution of the risk assessment process which was developed to aid in identifying, characterizing and quantifying risks. Risk assessment today is an essential component of regulatory decision-making. In the context of chemical exposure, risk assessment is an evaluation of the risk in human exposure to chemicals in the environment. Quantitative risk assessment (QRA) is the use of experimental laboratory data and/or human epidemiological data in a process to derive a quantitative value for the estimate of the probability of harm occurring to exposed human populations. It is a sophisticated process involving an array of techniques that can be used to identify potential risks to human health. There are 4 components involved in the formalized risk assessment process--hazard identification, toxicity assessment, exposure assessment and risk characterization. These 4 steps collectively address each of 6 key areas identified as essential in characterizing a risk situation involving a chemical exposure. The process of risk estimation involves uncertainties because there are always gaps in knowledge or a lack in understanding mechanisms. These crucial gaps in knowledge are filled when extrapolations, models or assumptions are used. The uncertainties inherent in the risk assessment process are the basis of arguments against the use of the process. Many of these sources of uncertainty inherent in the risk assessment process are examined herein. These include, but are not limited to, modeling methods, understanding mechanisms and pharmacodynamics, exposure data, assumptions and extrapolations. Some new techniques and approaches being applied to the risk assessment process are examined. These include improved models for extrapolating data and quantifying risks, improved laboratory techniques for investigating pharmacodynamic and mechanistic pathways and advancements in quality and application of epidemiological data. The actual concept of uncertainty is being examined and attempts are being made to directly address, quantify and manage uncertainty. PMID- 2694586 TI - Aluminum toxicity in mammals: a minireview. AB - The element aluminum is ubiquitous in nature. Although its role in the metabolism of living systems remains to be elucidated, under certain circumstances aluminum is known to be toxic. The following topics concerning the toxicologic aspects of aluminum in mammals are covered in this brief review: major sources of the metal in humans, clinical toxicology, and experimental toxicology. Diagnosis, prevention and treatment of aluminum overload are also discussed in the clinical toxicology section. Moreover, acute and chronic toxicity studies, behavioral and neurofibrillary changes, mutagenicity, carcinogenicity, and reproductive and developmental effects of the metal are reviewed in the experimental toxicology section. Aluminum, under ordinary circumstances, can accumulate in patients receiving long-term hemodialysis, which has been associated with various severe disorders. PMID- 2694587 TI - The production and application of non-rodent monoclonal antibodies in veterinary science. AB - The requirement for monoclonal antibodies derived from species other than rats and mice is becoming increasingly realised in veterinary, as well as human, medicine. This paper reviews current knowledge of the production of inter-species hybridomas (heterohybridomas) by the fusion of rodent myeloma cell lines with lymphocytes from species of veterinary importance. To date a number of monoclonal immunoglobulins derived from sheep, cattle, pig, rabbit, mink and primate species have been produced to a variety of different bacterial, viral and nematode pathogens as well as to blood group and MHC determinants and to hormones. The technique opens up a number of possibilities for the future; some of these applications are discussed in relation to the antibodies produced thus far. PMID- 2694588 TI - Expression of post-transcriptional regulatory gene of HTLV-I, rex, in Escherichia coli. AB - Human T-cell leukemia virus type-I (HTLV-I) has a post-transcriptional regulatory gene termed rex. We have designed the rex gene to express in E. coli. Synthesis of rex protein, p27rex, was examined by immunoblot analysis using anti-p27rex antibody. No difference in electrophoretic mobility in NaDadSO4-PAGE was observed between p27rex expressed in E. coli and in an HTLV-I-infected cell line, MT-2. Slower migration of p27rex, corresponding to a 27-kD protein, in NaDodSO4-PAGE when compared with the calculated molecular weight from the amino acid sequence (Mr = 20,367) is suggested to be caused not by post-translational modification, but by the intrinsic nature of the protein, which is rich in proline and arginine. PMID- 2694589 TI - Neuropeptide Y-like immunoreactivity in neurons of the human retina. AB - The distribution of neuropeptide Y-like immunoreactivity (NPY-LI) was investigated in wholemounts and in transverse sections of the human retina. NPY LI was localized to the soma and axonal processes of large ganglion cells (GCs) and to the soma and dendritic arborization of amacrine cells (ACs). NPY-LI GCs were unevenly distributed across the retina, the highest density of 875 cells/mm2 was found in the fovea centralis and the lowest density of 15 cells/mm2 in the peripheral retina. The total number of NPY-LI GCs in the retina was estimated to be about 85,000. The soma sizes of NPY-LI GCs increased from 116 microns 2 +/- 23 (s.d.) in the retinal centre to 251 microns 2 +/- 57 in the retinal periphery. The soma size of NPY-LI ACs was in the range of 40 and 50 microns 2. In transverse sections NPY-LI was seen to be localized to the optic fibre layer, to the somata of GCs, to the scleral sublamina of the inner plexiform layer (AC dendrites) and to the innermost part of the inner nuclear layer (somata of ACs). The gradients of soma sizes and retinal distribution of NPY-LI GCs were taken as an indication that they correspond to the class of large to very large GCs, previously identified in the human retina by Golgi impregnation. PMID- 2694590 TI - [Sensitivity and specificity of programmed stimulation of the cardiac ventricles]. AB - The authors used programmed pacing of the ventricles in a total of 55 subjects (41 men and 14 women). In a group of 36 patients with chronic relapsing ventricular tachycardias they assessed the sensitivity of this method as 83.3%. In 19 subjects without serious organic heart disease and without clinically confirmed tachyarrhythmias programmed pacing of the ventricles did not reveal diagnostic ventricular tachycardias. The specificity of the method was 100%. The highest detection rate of diagnostic ventricular tachycardias was obtained when four extrastimuli were applied during the sinus rhythm and 2-4 extrastimuli, using the basic stimulation rate of 100/min. PMID- 2694591 TI - [The use of vagotomy in treating complicated pyloroduodenal ulcer]. PMID- 2694592 TI - [Organization of the admission of the wounded and sick to therapeutic installations of local evacuation centers during World War II]. PMID- 2694594 TI - [The history of military medical expertise in the Navy in the Soviet period]. PMID- 2694593 TI - [Medical evacuation support for the troops of the 61st Army in the Riga Operation (the reminiscences of a participant)]. PMID- 2694595 TI - [An automated hospital system for collecting and processing of medical information]. PMID- 2694596 TI - [The 70th anniversary of the Military Publishing House]. PMID- 2694597 TI - [One of the first Soviet textbooks on the organization and tactics of medical service]. PMID- 2694598 TI - [Military medicine during the great French Revolution (on the 200th anniversary of the Revolution)]. PMID- 2694599 TI - [Basic trends in the development of military psychiatry in foreign armies]. PMID- 2694600 TI - [Immunoenzyme method of determination of antithrombin III]. AB - Immunoenzymatic assay is developed for estimation of antithrombin III (AT-III). Sensitivity of the assay was 7.8 ng of AT-III per 1 ml. The test system developed corresponded to the requirements for serological assays. Estimation of AT-III in blood plasma of healthy persons and in patients with various diseases showed that the assay may be recommended for clinical practice. PMID- 2694601 TI - [A method of redoxometry in clinical studies]. AB - Direct estimation of redox-potential in human skin and muscles using platinum electrodes enables to carry out dynamic evaluations of redox-state in these tissues. A similar technique might be used for potentiometric measurement of the rate of local tissue circulation using hydrogen clearance. Increase in the electrodes sensitivity, required for studies of circulation severe impairments, was possible by means of additional platinum overlaying. Examination of patients with obliterating atherosclerosis showed a considerable decrease of redox potential in ischemic zone; this impairment was partially reduced after surgical operation. The validity of alterations in electrode potential was supported by means of oxygenometry, blood pH-metry and rates of tissue circulation measurements. Interpretation of the data obtained is limited due to requirements of obligatory functional loading and theoretical considerations. However, the procedure of electrode potential registration allowed to obtain an information essential for choice of suitable treatment course. PMID- 2694602 TI - [Immunoaffinity purification of alpha 1-protease inhibitor from human plasma]. AB - A single-step procedure is described for isolation of alpha 1-inhibitor of proteases (alpha 1-IP) from human blood plasma using affinity chromatography on immunosorbent containing monoclonal antibodies against alpha 1-IP. Activity of the alpha 1-IP preparation, estimated by means of specific trypsin inhibition, was increased 61.1-fold after the chromatography, with a yield of the end product 20%. The preparation of alpha 1-IP obtained exhibited electrophoretic and immunochemical homogeneity. PMID- 2694603 TI - Autoimmune thrombocytopenia in three patients treated with captopril. PMID- 2694605 TI - Guidelines for autologous blood transfusion. A consensus opinion of the Committee of Experts on Blood Transfusion and Immunohematology. PMID- 2694604 TI - Pharmacokinetics of intravenous immunoglobulin in neonates. AB - Intravenous immunoglobulin (IVIG) may be a therapeutic adjunct to antibiotic treatment of neonatal infections. We examined the pharmacokinetics and safety of IVIG in human neonates. Thirty neonates with suspected sepsis were randomly assigned either to a treatment (receiving either 250, 500, or 1,000 mg/kg of IVIG plus antibiotics) or control (antibiotics alone) group. The 500 mg/kg dose produced a rise in total IgG for greater than 8 and in group B streptococcus (GBS) type-specific IgG for greater than 4-14 days. The type-specific antibody elevation varied with the amount of pathogen-specific antibody and dose of IVIG. Pharmacokinetic analysis suggests a Vdss of 42 ml/kg, Cl of 3.0 ml/kg/day, a biphasic elimination curve, and a terminal elimination half-life of 24.2 days. No toxicity was observed. These data may be valuable in determining optimal dosing schedules for IVIG in treating or preventing neonatal infections. PMID- 2694606 TI - [AIDS and malignant neoplasms]. AB - Literary data are used to describe the types of immunodeficiency, association of malignant tumours with immunodeficiency including acquired (AIDS). The author reports the incidence of AIDS among the population of Europe and the prognosis to 1990, describes the main typical clinical symptoms of AIDS and the tactics of the medical personnel in conditions of admission of patients suspicious of AIDS. PMID- 2694607 TI - [Hypophosphatemia (a review of the literature)]. PMID- 2694608 TI - [The digestive processes of the stomach and small intestine in complicated peptic ulcer]. AB - Investigation of the state of intraventricular proteolysis and membraneous digestion in the small intestine in 148 patients revealed that ulcer disease is accompanied by potentiation of the digestive processes in the stomach and their reduction in the small intestine. With appearance of complications of ulcer disease, the disorders of digestion deteriorated. This resulted in different manifestations of the enteral syndrome. It is concluded that examination of the intraventricular proteolysis and membraneous digestion may be used for objective evaluation of the activity and grade of severity of the ulcer process as well as for functional evaluation of treatment results. PMID- 2694609 TI - [Disorder in the ratio of cortisol and insulin secretion in peptic ulcer and following vagotomy]. AB - It was established that non-operated patients with duodenal ulcer and patients after organ-saving operations associated with vagotomy show an essential increase of insulin and cortisol secretion and reveal a strict dependence of hormonal secretion on the severity of the pathological process and time after operation. The increased cortisol/insulin ratio correlated with a reduction of the body mass of patients. PMID- 2694610 TI - [The treatment of recurrent duodenal ulcers after vagotomy]. AB - The authors report data on reoperation of 36 patients of ulcer disease of the duodenum with a history of surgical intervention using vagotomy. Reoperation was performed for recurrence. The method of duodenal stump suturing and complex prophylaxis of inconsistency of the duodenal stump sutures during the operation and in the postoperative period is described. PMID- 2694611 TI - [The use of lasers in medicine (a review of the literature)]. PMID- 2694612 TI - [The use of mildronat with stenocardia patients]. AB - Against placebo background 50 patients with effort stenocardia received mildronate, a new native cardioactive drug and its effects on the clinical course in conditions of spirometric bicycle ergometry were studied. It was found that monotherapy with mildronate is accompanied by an antianginal effect and an increase of the physical working capacity of patients. PMID- 2694613 TI - [The pathomorphologic characteristics of the arrhythmogenic heart]. AB - A complex pathomorphological study was carried out of 80 hearts from patients who died of cardiosclerosis with marked heart rhythm disorders and 20 control cases with the purpose of assessment of the criteria of diagnosis of the arrhythmogenic heart. METHODS USED: postmortal coronarography and cardioventriculography, microdissection, WHO standard anatomical method, morphometric histological, histochemical and histotopographic methods. The author established pathomorphological criteria of diagnosis of the arrhythmogenic heart including a separate construction with prevailing changes of the right ventricle, fibro- and lipomatosis of the myocardium, extensive coronary obstruction forming ischemia foci in the conduction system zones which are the site of formation of arrhythmogenic substances. PMID- 2694614 TI - [The effect of therapeutic physical factors on the mechanisms of the generation of a cure]. AB - Literary data and own clinical observations as well as experimental investigations on large laboratory animals indicate an essential effect of the energy of different physical factors on the main systems of body defense, substantiate the possibilities of stimulation of the processes of sanogenesis. The authors emphasize the importance of the problem of differentiation of the effect of physical factors on such sanogenetic mechanisms as restitution, regeneration, immunity. The proposed approach of the authors to the employment of physical factors widens the possibilities and perspective of their practical use, favours development of new methods of treatment, increases the efficacy of treatment. PMID- 2694615 TI - [Current aspects of renal amyloidosis]. PMID- 2694616 TI - [Clinico-echographic parallels in patients with pyelonephritis and exacerbated chronic kidney failure]. AB - 24 patients with chronic renal failure due to chronic pyelonephritis were studied prospectively. In 18 of them (51%) the deterioration of the renal function was caused by obstruction, urinary infection, dehydration, etc. In 13 patients with chronic renal failure in exacerbation there were clinical data for activation of the pyelonephritis which was followed up dynamically. The ultrasound examination revealed enlarged kidneys with unclearly outlined renal structures. The changes were reversible and the pattern resembled that of acute renal failure. With the disappearance of the echographic data for interstitial renal edema an improvement of the renal function was established. The serum creatinine fell from 697.4 to 347.6 mumol/l (p less than 0.025) and plasma osmolality tell from 327.8 to 287 mOsm/l. No such changes were found in other II patients with chronic pyelonephritis and chronic renal failure without exacerbation. PMID- 2694617 TI - Exploring health policy as a concept. PMID- 2694618 TI - Bacterial vaginosis. AB - Bacterial vaginosis is a common, non-inflammatory infection of the vagina. It is characterised by the presence of a thin, homogenous, greyish-white discharge. The differential diagnosis includes infection with Trichomonas vaginalis and Candida albicans. A diagnosis of bacterial vaginosis may be made by the detection of three of the following: characteristic discharge, pH of 5 or greater, clue cells and a positive KOH amine test. Culture of vaginal discharge is not necessary to effect a diagnosis. Bacterial vaginosis responds readily to treatment with metronidazole at a dosage of 400 mg twice daily for seven days, although a proportion of patients suffer a recurrence of symptoms. Treatment of sexual partners may be necessary in such cases. Bacterial vaginosis results from the synergistic interaction of Gardnerella vaginalis and obligate anaerobes, including Bacteroides and Mobiluncus species. The pathogenesis, laboratory diagnosis, treatment, and the mechanisms by which these organisms produce the symptoms of bacterial vaginosis are discussed. PMID- 2694619 TI - The Mauriac syndrome. AB - An insulin-dependent diabetic was diagnosed at the age of 7 years. After two years of satisfactory control she began to have several bouts of hospitalization with hyperglycaemic ketoacidosis, and developed tender hepatomegaly, which persisted to age 11 years. With restabilisation of her diabetes, the liver regressed and she continued to maintain good health for another 1 1/2 years when she died suddenly while asleep. Post-mortem examination by the coroner revealed ascites in the abdomen, hepatomegaly and fatty metamorphosis of the liver. Her diabetes control required up to 2.3 i.u. insulin per kg body weight per day plus a 1,900 calorie diet. Her growth was well below the tenth percentile, weight for height (Harvard charts). This clinical picture of high insulin dosage, hepatomegaly, unstable diabetes and growth failure approximates to the Mauriac syndrome. PMID- 2694620 TI - Infection with the human T-lymphotropic virus type I. A review for clinicians. AB - The human T-cell lymphotropic virus type I (HTLV-I) is the first retrovirus identified in humans. It has been responsible for a number of clinical syndromes, most notably adult T-cell leukemia or lymphoma and tropical spastic paraparesis. In the United States, infection with this virus is most frequently found in specific subsets of our population, particularly in those who live in the southeastern states, have southern Japanese ancestry, or share intravenous drug paraphernalia. Understanding the epidemiology and clinical manifestations of this virus is necessary to properly diagnose and care for patients with HTLV-I infection. PMID- 2694621 TI - Bone marrow transplantation. Part I--Allogeneic. AB - Major progress in experimental and clinical research has made allogeneic bone marrow transplantation a highly effective therapy for a variety of malignant and nonmalignant diseases. Allogeneic bone marrow transplantation from histocompatible donors is now the therapy of choice for some of these disorders. We review in part I the history, technical approach, complications, and the results achievable with this therapeutic approach. Further experimentation and future goals are also discussed. PMID- 2694622 TI - Update on pseudomembranous colitis. AB - These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Homer A. Boushey, MD, Professor of Medicine, under the direction of Lloyd H. Smith, Jr, MD, Professor of Medicine and Associate Dean in the School of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143. PMID- 2694623 TI - Warfarin and stroke. PMID- 2694624 TI - [Systemic side effects in immunotherapy of allergic diseases--a comparative study]. AB - Data on systemic side effects (SSE) of specific immunotherapy of allergic diseases recorded in 99 publications over the past 10 years were evaluated and compared with the figure of 0.4% SSE, according to number of injections, published in 1987 by the authors of the present study. The latter figure ranks among the lowest of comparable publications and under present conditions represents the standard. Reasons for the small number of side effects may be found in persistent use of antihistamine premedication before each injection and reduction of vaccination dosage to 50,000 SQ units maximally. Chemically modified allergens are by no means less liable to produce side effects than other allergens. The comparison was undertaken with respect to the following preparations: Alavac P, Allergovit, Allpyral, Alutard, Aquagen (ALK aqueous), Conjuvac, Diephuis, Migen, Novo Helisen, Pangramin Depot, Pharmalgen, Pollinex, Reless, Spectralgen, Stallergenes Depot, and some vaccines, prepared by the authors themselves. PMID- 2694625 TI - [Psychological problems and management of cancer patients from the viewpoint of the clinical psychologist]. AB - Since beginning of his illness the patient suffering from cancer no longer feels like active participant, but passive onlooker towards social life. He has to fight against intensive feelings of loss (e.g. loss of health, of organs, of abilities...); cancer always means leave-taking, grief and bereavement. Patients in hospitals have to suffer mainly from: decline of activities, decrease of subjectively perceived physical status, labile selfesteem, depression and exhaustion. It is pointed out that knowledge of one's self means an inalterable assumption for every person working with cancer patients. PMID- 2694626 TI - Parallels between neurasthenia and premenstrual syndrome. AB - Neurasthenia and premenstrual syndrome became medical diseases because of the historical recognition of menstruation as a medical disease. Both the nineteenth and twentieth century cultural views of women were important in the establishment of menstruation, neurasthenia and premenstrual syndrome as medical conditions. Uncertainty of diagnosis with ever expanding diagnostic criteria, therapy undertaken without an adequate physiological basis, and often adverse effects from therapy, were characteristic of the medicalization of neurasthenia and premenstrual syndrome. A recognition of the cultural basis of these conditions is essential to a better understanding of women as human beings. PMID- 2694627 TI - [Treatment of hyperlipidemia with HMG-CoA reductase inhibitors]. AB - HMG-CoA-reductase inhibitors represent an interesting new class of cholesterol lowering substances. At the moment there is only one of these substances, lovastatin (Mevacor), registered in Austria. HMG-CoA-reductase inhibitors act primarily through an increase of the expression of the LDL-receptors presumably in the liver. By this mechanism they cause a marked reduction of LDL-cholesterol levels and thus should markedly reduce the risk of coronary heart disease. The once daily dosage of these drugs, their effectiveness in low doses and the low incidence of side effects facilitate the patient's compliance. With the exception of rhabdomyolysis which occurs very rarely when avoiding a combination therapy with fibrate-analoges or cyclosporin, this kind of treatment is relatively free of serious side effects. Results from long-term studies indicate that the hypocholesterolemic effect of these drugs is maintained during prolonged therapy; possible drug-related side effects did not differ from those reported in short term studies. PMID- 2694628 TI - [Drug treatment of hyperlipidemia]. AB - In the therapy of hyperlipemia nicotinic acid derivates, cholestyramine, fibrate derivates and HMG-CoA-reductase inhibitors are drugs of choice. The most important drugs of each group, the mode of action and the side effects are presented. In the therapy of hypercholesterolemia HMG-CoA-reductase inhibitors alone or in special cases in combination with low dose of cholestyramine are best qualified. For the treatment of hypercholesterolemia and hypercholesterolemia fibrate derivates are recommended. PMID- 2694629 TI - [Pathophysiology of lipid transport in plasma]. AB - Atherosclerosis of coronary and peripheral arteries is a major cause of death and disability in civilizations outside the third world. Disturbances of the lipid transport in plasma are a major cause for atherogenesis. The transport of exogenous and endogenous lipids in plasma is facilitated by lipoproteins. The concentration of the various lipoprotein families is subject to complex regulation such as secretion by intestine and liver, intravascular metabolism and clearance by hepatic and extrahepatic receptors of high and low affinity. To understand the pathophysiology of lipid transport and the role of certain lipoproteins as risk factors for atherosclerosis it is important to understand the regulatory mechanisms governing lipoprotein concentrations. Elevated concentrations of certain lipoproteins such as low-density-lipoproteins (LDL) constitute an increased risk for atherosclerosis. This elevation of LDL in plasma can be caused by increased production and/or reduced catabolism. With a better understanding of the pathophysiology of the lipid transport system more rational and precise modalities of both treatment and prevention of atherosclerosis can be expected. PMID- 2694630 TI - [Hyperlipidemia and coronary heart disease]. AB - The relationships between total serum cholesterol levels greater than 200 mg/dl or LDL-cholesterol levels greater than 155 mg/dl (135 mg/dl) and the incidence of coronary heart disease is well established. In contrast an inverse relationship could be shown between HDL-cholesterol levels and the frequency of cardiac death and non fatal myocardial infarction. It also seems to be possible that elevated triglyceride levels (greater than 200 mg) may represent an additional risk factor. Subsequent studies with a large number of patients and longterm observation proved, that fat-modified diets or drug treatment of hyperlipidemia results in a reduction of morbidity and mortality due to coronary heart disease, whereby the reduction of coronary events correlates directly to the degree of reduction of total cholesterol or LDL-cholesterol, respectively. This knowledge allows the clinician to identify persons at high risk for coronary heart disease and to start effective individual therapy in accordance with the recommendations of the European Atherosclerosis Society. PMID- 2694631 TI - [Disorders of lipid metabolism in diabetes mellitus]. AB - Diabetes mellitus is the most frequent endogenous cause of fat metabolism disorder. In diabetics the risk for arteriosclerosis is significantly higher and the clinical significance of hyperlipidemia should be estimated more serious as in non-diabetics. The predominant abnormality of fat metabolism in diabetes is hypertriglyceridemia due to an increase of triglyceride-carrying lipoproteins, the chylomicrons and the very-low-density lipoproteins. In type I-diabetics the decisive pathogenetic factor for hypertriglyceridemia is the impaired degradation of VLDL and the reduced chylomicron-clearance, caused by decreased activity of the lipoproteinlipase. In ketoacidosis there is an additional increase in hepatic VLDL-triglyceride-production due to increased lipolysis with elevated free-fatty acid flux. Total cholesterol in type I-diabetics is only significantly elevated when metabolic control is poor, low-density lipoprotein (LDL-)-cholesterol-levels can be increased and high-density lipoprotein (HDL-)cholesterol decreased in dependence on the metabolic control. In type II-diabetics the decisive pathogenetic factor for hypertriglyceridemia is increased VLDL-triglyceride synthesis in the liver especially due to augmented free-fatty-acid flux. Additionally the activity of the lipoproteinlipase can be reduced. Usually in non insulin-dependent diabetics LDL-cholesterol-levels can be seen elevated and HDL cholesterol-concentration decreased in correlation with the metabolic control. Primary hyperlipoproteinemia appears frequently in diabetics, but this can be explained by the association with obesity in type II-diabetics. PMID- 2694632 TI - The enigma of the stigma of ECT: 50 years of myth and misrepresentation. PMID- 2694633 TI - Nutritive value of cereal products with emphasis on the effect of milling. PMID- 2694634 TI - Composition and nutritive value of beans (Phaseolus vulgaris L.). PMID- 2694635 TI - Starch in human nutrition. PMID- 2694636 TI - Chemical composition and the nutritive value of wheat bran. PMID- 2694637 TI - [The significance of thrombolytic therapy in acute myocardial infarct in advanced age]. AB - The thromboticgenesis and the close time dependence of the development of the acute myocardial infarction (AMI) are decisive findings of the dynamic development in the past ten years. Therapy started in time including the elimination of the thrombotic coronary occlusion as soon as possible leads to the reperfusion of the vessel affected by the infarction and thus to the limitation of the size of the myocardial infarction. Because of the temporally limited tolerance of ischaemia of the myocardium, an efficient thrombolytic therapy (TT) with an objectifiable improvement of the left-ventricular function (ejection fraction global-EFg) is possible up to the 4th ApS hour. The median value of the maximum creatine kinase activity (CKmax) time was 11.8 h with effective TT; with ineffective TT 21.5 h (p less than 0.001). There is no significant difference of the CKmax-t between the age groups (less than 60 and greater than 60 years). CKmax significantly differentiates between the deceased and ineffective/effective TT (p less than 0.001). Monitoring the EFg shows significant differences in the deceased (16.3), ineffective TT (34.0), and effective TT (42.5%) both in the acute phase and in the first weeks after AMI by the dynamism of the EFg. So, - EFg was verified to be 6% with effective TT to - EFg to be 1.6% (absolute) with ineffective TT. The percentage of cases of death was restricted also for patients greater than 60 years. After effective TT less patients are found in the high and medium risk group after AMI. 70% of the patients had an effective TT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694638 TI - [Changes in dendrites in disease and aging]. AB - Just like in other organs, e.g. in the skin or in the supporting tissue, in the CNS too the reactions to diverse noxae or causes are always stereotyped. The mental or motor retardations are distinguished by a deterioration of the neuropils, especially by the recession of the dentritic branching and their spinae. Also during physiological aging the dendritic apparatus decreases. The neuropilic differences during physiological and pathological aging, however, are rather quantitative than qualitative ones. Dendritic proliferation as a compensation mechanism for neuron recession in old age is of particular importance. PMID- 2694639 TI - Biologically active peptides in milk proteins. AB - Bioactive peptides have been identified as digestion products of several food proteins. All the bioactive sequences are hidden in an inactive state inside the polypeptide chain of the larger protein. Milk proteins are a rich source of biologically active peptides such as exorphins (casomorphins), phosphopeptides and immunopeptides. Such peptides are released during intestinal digestion of caseins and whey proteins. They may be involved in regulation of nutrient entry and influence the postprandial metabolism via stimulation of the secretion of hormones. Furthermore, they may exert a stimulating effect on the immune system. These findings offer new aspects for evaluating the nutritive value of food proteins. Moreover, bioactive peptides have already found interesting applications as dietary supplements and as pharmaceutical preparations. PMID- 2694640 TI - [The role of iron as a deficient element]. AB - Iron is an essential trace element. In its heme-form as well as in its non heme form it is a part of enzymes and hemoproteins. For a safe and adequate dietary intake 10-18 mg of iron are recommended daily. Frequently, this quantity is not available: approximately 20% of the world population is iron-deficient. In this state the enteral transfer capacity for toxic metals, e.g., Cd and Pb, is increased and the adaptation to physical strain as well as the immunological responses are depressed. Alterations of body iron-stores are almost exclusively balanced by adequate adaptation of the enteral iron-transfer capacity. The mechanism of this adaptation process can neither be satisfactorily explained by the "mucosal block hypothesis", nor by the "mucosal transferrin hypothesis". When the time-course of iron storage and its relation to intestinal iron transfer was investigated after i.v. iron administration to iron-deficient rats, the results indicated that the process of adaptation is located in the intestinal mucosa. Intestinal iron loading is decreased in iron deficiency, whereas the iron transfer into the organism is increased. Further investigation is necessary to find out by which mechanism the iron manages to bypass existing mucosal storage capacity in this situation. The geographical distribution of iron deficiency is influenced by a variety of local factors. Still, the paramount causes of iron deficiency are unbalanced iron losses and the lack of bioavailable iron in the diet. The bioavailability of non heme iron is influenced by the composition of the diet. The effect of promotors of iron absorption, such as meat, amino acids, polycarbonic acids and ascorbate is opposed by the influence of inhibitors, such as bran, soya products, vegetables and egg-dishes. Iron losses are mainly due to blood losses. Thus, the wide distribution of hookworm diseases in tropical areas contributes significantly to the endemic iron-deficiency in these regions. A more physiological loss of iron is caused by menstruation and pregnancy. In small infants the iron-demand of the organism is increased by rapid growth, which in turn increases the intestinal iron transfer. An increased iron-demand can be balanced by an iron-supplemented diet or by pharmaceutical iron compounds. Acute intoxications can be caused by an overdose of such preparations. The pathophysiology and symptoms of acute iron intoxication are summarized. Their frequency has markedly decreased since "childproof" packaging has been introduced for iron-preparations. To meet the increased iron demand of young children, commercial infant formulas are frequently fortified with iron, preferentially with heme-iron.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2694641 TI - [Excretion of antibody-coated bacteria in chronic pyelonephritis]. AB - Of 168 urine sediments, which were obtained from 55 patients with chronic pyelonephritis in the course of 3 years when a significant bacteriuria with E. coli was present, we demonstrated antibody-coated bacteria in 81 cases (48.21%). In the active stage of the disease with 54.10% were found significantly more than in the inactive with 32.61%. In obstructive chronic pyelonephritis the positive rate was 54.79% in contrast to 43.16% in non-obstructive chronic pyelonephritis. While in the active stage of the obstructive chronic pyelonephritis with 57.41% more antibody-coated bacteria were excreted only ACB+-, 34.29% only ACB-- and 40% ACB+- and ACB--germs in the course of the disease. The ACB-positive quote was in rough forms with 62.50% statistically significantly increased in contrast to 45.54% in O-typable and 42.86% in non-O-typable strains. In the ACB+-group the immunofluorescence titres to the homologous strain and the C3-activator in the serum as well as the urine lysozyme were significantly higher than in the ACB- group. PMID- 2694642 TI - [Rapid typing of Escherichia coli K antigens using bacteriophages]. AB - E. coli capsular (K) antigens are important virulence factors contributing to the development of urinary tract infections (UTI). Serotyping of these antigens is laborious and depends on the availability of respective antisera which are difficult to prepare because of the low immunogenicity of these polysaccharide antigens. The application of specific K phages are a big advantage. Two collections of E. coli strains (500 from Rostock, 214 from Erfurt) isolated from patients with UTI have been investigated with a set of ten K specific bacteriophages including phi 1, phi 2, phi 5, phi 7, phi 9, phi 12, phi 13, phi 20, phi 30 and phi 36. The K1 antigen has been found to be the most frequent capsular antigen (16.4% in Rostock; 12.2% in Erfurt) followed by K13/K20 in Erfurt (8.9%) and K5 in Rostock (8%) and Erfurt (7.5%). The collection of phages proved to be suitable for the detection of UTI associated K antigens covering the most common O serogroups found in UTI. The method appears to be simple, non laborious and applicable for routine use. PMID- 2694643 TI - [Differentiation of coagulase negative staphylococci from significant bacteriuria]. AB - According to our experience in identifying coagulase negative staphylococci (CNS) a modified Kloos-Schleifer-scheme proved useful in species identification. Of 595 urine isolates from cases with significant bacteriuria tested 89.5% could be identified. For routine identification on the one hand the Kloos-Schleifer-scheme is only practical by using commercial identification systems, on the other hand applying an abbreviated scheme species identification is unsatisfactory. As an alternative for identification of CNS in clinical microbiology the Phosphatase Novobiocin-Mannose-Inhibition-Test (PNMI-Test) is presented. This test in combination with a coagulase test proved suitable to identify the three most important staphylococcal species S. aureus, S epidermidis, and S. saprophyticus and seems to be an acceptable compromise in the bacteriological routine laboratory. For extended species identification of CNS the Kloos-Schleifer-scheme should not be reduced but this identification should be reserved to special laboratories. PMID- 2694644 TI - [Status and developmental trends in the use of fluorescence microscopy studies in microbiology]. AB - There are many applications for fluorescence microscopy in the field of microbiology for diagnostic and scientific purposes. Autofluorescence as well as secondary fluorescence induced by staining of specimen with fluorochromes or with fluorochrome labeled antibodies are used for detection and differentiation of microorganisms. Small demands for object preparation and short test times are advantages for screening tests. During the last time considerable progresses in methods and technical equipments are noticeable and offer numerous new applications for fluorescence microscopy. New microscopes show clearly increased intensity of excitation. This requires a selection of object slides and cover glasses with lowest autofluorescence, blocking of fading by addition of PPD to embedding medium and a better adaptation of filters for excitation and fluorescence to the characteristics of fluorochromes. Multiple fluorochroming and combined application of fluorescence and alternative contrast techniques such as phase contrast are of rising importance in practice. PMID- 2694645 TI - [New developments in bedside diagnosis]. AB - The time required to isolate microorganisms, identify them, interpret results, and provide guidance for therapy is inordinate for urgent decisions in primary care. The emphasis for a more rapid diagnosis bedside or in the office, respectively, is caused apart from medical reasons by economic restrictions necessitating earlier diagnosis, more immediate and appropriate treatment, shorter patient hospital stays, and allowing the patient to resume normal productivity earlier. After describing some general criteria with regard to the design of tests for bed-side diagnosis we discuss well known and novel procedures: microscopy of clinical specimens, microbial antigen detection, and nucleic acid hybridization. In concluding remarks we underline the necessity of careful clinical studies concerning sensitivity, specificity, and reliability as well as quality control measures for every novel assay before and during introduction in clinical and office practice. PMID- 2694646 TI - [Direct gas chromatography analysis of volatile fatty acids and lactic acids in microbiological diagnosis]. AB - The gas chromatographic analysis of short-chain fatty acids is of great significance in the rapid diagnosis of anaerobic infections and bacterial meningitis. A new analytical method is presented detecting lactic acid without prior derivatisation in addition to volatile fatty acids in the aqueous phase directly. Lactic acid levels greater than 30 mg/dl are measured in cerebrospinal fluids of patients with acute bacterial meningitis. The sole detection of acetic acid in concentrations higher than 20 mg/dl indicates aerobes in clinical materials. A high correlation exists between the determination of n-butyric acid as well as iso-valeric acid and the occurrence of anaerobic bacteria. PMID- 2694647 TI - [Determination of Candida albicans mannan antigen in serum]. AB - An enzyme-linked immunosorbent assay (ELISA) for detection of Candida albicans mannan antigen in sera pretreated with pronase was used for investigation of antigenemia in 3 groups of patients: Group A: No antigen was detected in patients (n = 270), which were under control by a mycological surveillance programme. They were clinically not suspicious of candidosis and had no remarkable mycological findings. Group B: Candida antigen was detected in 13 cases of 158 patients (= 8.2%), which suffered from unclear clinical symptoms. Therefore a mycological laboratory diagnosis was performed yielding no remarkable findings neglecting the positive antigen detection. Group C: Candida antigen was also detected in 9 cases of 64 patients (= 14.0%), which were suspicious of candidosis and/or had remarkable mycological laboratory findings. The difference between the frequency of antigenemia in group B and C was not significant. According to our preliminary experiences the detection of Candida mannan antigen may support the early diagnosis of invasive candidosis. Yet antigen findings should not be separately interpreted but included in all available clinical and mycological results. PMID- 2694648 TI - [Detection of legionellas in clinical samples using FITC-marked antibodies]. AB - Using serogroup/species specific FITC-conjugates against Legionella (L.) pneumophila serogroups (SG) 1 to 6, L. micdadei, L. bozemanii and L. jordanis 186 sputum samples, 43 pleural fluids and bronchial washings and 39 lung tissue samples from 251 pneumonia patients were checked for Legionellae with the direct fluorescent antibody technique (DFAT). In samples from 201 patients which were negative if tested for antibodies and for urinary antigen and/or using culture methods, the DFAT was negative, too. One Pseudomonas strain isolated from a bronchial washing showed crossreactions. In 19 out of 49 patients with legionellosis L. pneumophila SG 1 (3x), SG 2 (1x), SG 3 (4x), SG 4 (1x), SG 5 (5x), L. micdadei (3x) and L. bozemanii (2x) were found. Positivity of the DFAT was significant higher in specimens, taken in early stages of illness (p less than 0.01). DFAT can be used for specific detection of Legionellae in clinical specimens, but the relative low sensitivity (39%) does not allow to exclude legionellosis. Further diagnostic tests like detection of antibodies and urinary antigen and culture are necessary to diagnose legionellosis. PMID- 2694649 TI - [Microscopy procedures for direct pathogen detection in Lyme borreliosis]. AB - Dark-field microscopy, fuchsin stain and Fontana silver stain were used for a rapid detection of spirochaetes in fresh materials from patients with Lyme borreliosis. The spirochaetes were shown to be present in 2 cerebrospinal fluids, 2 synovial fluids and in one brain cyst fluid. It is pointed out that these techniques require further improvement and optimization. PMID- 2694650 TI - [Axial filament antigen enzyme immunoassay (AF-ELISA) in syphilis serology]. AB - 179 sera from patients with various stages of syphilis were investigated in the axial filament enzyme linked immunosorbent assay (AF-ELISA), the Treponema pallidum haemagglutination assay (TPHA), the fluorescence treponemal antibody absorption (FTA-ABS) test and the cardiolipin micro precipitation test (CMT). For the control of specificity 30 problem sera from non Treponema pallidum infected patients with a high quantity of Treponema genus specific antibodies and 40 sera from people without syphilis were also investigated. The sensitivity of the AF ELISA (98.3%) was comparable with the TPHA (99.4%) and the FTA-ABS-test (98.9%). It was a high unspecificity in the group of problem sera. PMID- 2694651 TI - [Characterization of treponemal axial filament antigens using the Western blot]. AB - Analysis by SDS-PAGE of axial filaments of cultivable treponemes showed 3 major bands: a 33/34 kD doublet and a 37 kD polypeptide. In sera from patients with various stages of syphilis, from biological false positive reactors, and from negative controls the most consistent reaction was detected against the doublet, but only sera from patients with primary or secondary syphilis reacted with the 37 kD axial filament polypeptides. About 6 weeks after antibiotic treatment sera had lost their reactivity with 37 kD antigens in agreement with decreasing antibodies in VDRL-test. Because of their recognition early in infection 37 kD proteins are postulated to use in serodiagnostic assays, but our data emphasize also the need for use further antigens in tests for diagnosis in later stages of syphilis. PMID- 2694652 TI - [Characterization of monoclonal antibodies to Toxoplasma gondii]. AB - Proteins of Toxoplasma lysate were separated by SDS-polyacrylamide gel electrophoresis with subsequent transfer to a nitrocellulose sheet by electrophoretic blotting. The range of protein bands was 6-100 kD. Monoclonal antibodies 1B2, 5B10, 4F6 reacted with antigens of 21 kD, 35 kD and 66 kD. Monoclonal antibodies reacted with major antigens of the RH-tachyzoiten surface and HanR-cysts. PMID- 2694653 TI - [Rapid diagnosis of Bacteroides using immunofluorescence]. AB - Intestinal Bacteroides species belong to the most common causative agents of human anaerobic infections. Because their cultural diagnosis is complicated by the presence of a so-called "empty interval of diagnosis" lasting for several days, rapid diagnostic methods are of great significance. Due to the possibility of specific antigen detection the fluorescence antibody technique (FAT) is especially qualified for this purpose. The presented investigations demonstrate that the direct FAT should be preferred to the indirect method in the diagnosis of infections caused by intestinal Bacteroides species. PMID- 2694654 TI - [Prevalence of cholelithiasis. Results of an epidemiologic study using sonography in East Germany]. AB - In two middle-sized towns in the northern part of the German Democratic Republic, a random sample of the population and unselected subjects, respectively, were examined for gallbladder stones (GS) by ultrasound. The prevalence of cholelithiasis (sum of GS detected by ultrasound and history of cholecystectomy for GS) ist higher than in other European populations screened by similar methods. It is suggested that dietary habits are responsible for this finding. About one third of subjects with GS had complications of GS and about one third gave a history of cholecystectomy for GS. The frequency of nonspecific dyspeptic complaints was the same in persons with GS as in persons without GS. PMID- 2694655 TI - [Percutaneous drainage of recurrent peripancreatic fluid collections in acute pancreatitis. A case report]. AB - The case of a 36 year old patient with acute pancreatitis is presented whose clinical course was dominated by extensive peripancreatic fluid exsudation and formation of cysts. Risky surgery in the acute phase of the disease could be avoided by ultrasonic guided percutaneous punction and placing of several, partly transhepatic, catheters. The fluid collections could be drained completely and showed no recurrence. PMID- 2694656 TI - [Principles of epithelial transport mechanisms: importance for pathophysiologic understanding, differential diagnosis and treatment of diarrheal diseases]. AB - First, general principles of epithelial transport and the epithelial barrier function are described. The cellular mechanisms of Na-glucose cotransport, electrogenic Cl-secretion, and electrogenic Na-absorption are presented. Second, the pathophysiology of epithelial transport systems and their regulation is given as far as relevant for the onset of diarrhea. This includes congenital deficiency of transport proteins and mucosal transformation as e.g. during celiac disease, tropical sprue, and the blind loop syndrome. Finally, regulation of epithelial transport by the enteric nervous system, GI-peptides, hormones, and the intestinal immune system is discussed in respect to disturbances of this regulation as for example seen in the presence of bacterial enterotoxins. PMID- 2694657 TI - [Functional upper abdominal pain in Campylobacter-associated gastritis: does the patient profit from bismuth therapy?]. PMID- 2694658 TI - [Pattern of the coronary endothelium in the human]. AB - The ultrastructural morphology of the endothelium of the normal human coronary arteries is equal to the endothelial cells of other locations in the macrovascular system. However, the patterns of the endothelial nuclei and the endothelial cell shape are consistent with unidirectional laminar blood flow conditions lacking secondary flow phenomena in this particular part of the arterial tree. On the other hand secondary flow probably occurs in areas of sclerotic plaques and a "cobblestone" pattern of the endothelial layer is often found at such places. In addition, multinuclear giant cells which might be of a heterogeneous origin, as well as other non-endothelial cells are a regular constituent of the endothelial layer of sclerotic lesions in the human coronary arteries. PMID- 2694659 TI - [The endothelium and arteriosclerosis]. AB - The endothelium is of great importance in the development of early atherosclerotic lesions, as suggested from animal experiments. Denudation of the endothelium may stimulate the proliferation of smooth muscle cells which are a major constituent of sclerotic plaques. Furthermore, injury of the endothelium causing no morphologic alterations may be enough to induce secretion of endothelial-derived growth factors or attachment of monocytes/macrophages at the endothelial surface. Recent immunohistochemical studies indicate that monocyte derived cells can be included in the endothelial layer, but the function of such non-endothelial cells is not yet known. Endothelial cells at the surface of advanced sclerotic lesions are often structurally abnormal. The endothelial patterns at the shoulders of stenotic lesions indicate blood flow irregularities, but on the other hand, the endothelium of the stenotic channel is suggestive of an unidirectional laminar flow. Atherosclerosis in humans is the touchstone of experimental atherosclerosis. PMID- 2694660 TI - Endothelium-dependent vascular responses: effect of hypertension and cyclosporin A. AB - Through the release of endothelium-derived relaxing and contracting factors, the endothelium can profoundly affect local vascular tone. In hypertension and during chronic cyclosporin A therapy, morphological changes of the endothelium develop. Recent studies in isolated arteries have demonstrated that endothelium-dependent relaxations induced by a variety of substances are decreased in acute and chronic hypertension and during cyclosporin A therapy. A reduced vascular smooth muscle responsiveness to endothelium-derived relaxing factor, the release of a cyclooxygenase-dependent endothelium-derived contracting factor in some animal models of hypertension, and possibly a decreased release of EDRF under some conditions may contribute to these functional alterations. In hypertension and during cyclosporin. A therapy, functional changes of the endothelium may contribute to increased peripheral vascular resistance and to vascular damage occurring under these conditions. PMID- 2694661 TI - [Reactions of the endothelium in endotoxic shock]. AB - The endothelium should be regarded as a cellular system that plays an important part in maintaining the hemostatic balance of the organism. Depending on the vascular region a number of different types of non-endothelial cell are present in the normal intimal layer, but macrophages and lymphoid cells are always found. In some vessels other kinds of cells have also been described: the fat-storing cells in the hepatic sinusoids, for instance. Macrophages and lymphoid cells in the liver sinusoids were proved to originate from the bone-marrow in both physiological and pathological circumstances. Animal experiments were undertaken to assess the effects of administering shock-inducing doses of endotoxin. The damage incurred by the endothelium varied considerably both from place to place and in degree. Repair of the damage was characterized by an interaction between endothelial and non-endothelial cells, as well as by a great increase in the proliferation of both kinds of cell. The changes which follow endotoxin-induced shock can therefore be described as a generalized inflammation of the intima. PMID- 2694662 TI - Assessment of the vasomotility of epicardial coronary arteries with quantitative coronary angiography. AB - Quantitative in vivo analysis of the vasomotility of epicardial coronary arteries is based on the measurement of changes of the vessel diameters. Vessel contours can be determined with the help of a precision caliper by the investigator or with computer-assisted geometrical analysis systems applying a contour detection algorithm; the variability of the results from repeated coronary diameter measurements in the identical film frame is comparably low with all systems (less than or equal to 0.12 mm standard deviation). When investigating the influence of an intervention on coronary vasomotility the variability of the measurements can only be kept low by careful standardization of the entire method. Repeated coronary angiograms are performed in identical angiographic projections (mono- or biplane) with standardization of the inspiratory status of the patient and of the rate of contrast material injection (automatic injection pump). For quantitative analysis all coronary segments with a diameter greater than 1 mm which are clearly outlined, free from overlaps, and mainly run parallel to the image plane, are selected by the investigator in preferably end-diastolic cineframes. Whereas with a caliper and with most of the semi-automatic edge detection systems the segment diameter can only be measured at particular sites defined by the investigator, few systems are able to analyze and average the diameter over the entire segment length. The variability of measurements of the minimal diameters of coronary stenoses in different cine frames is particularly high; therefore, only distinct changes of this parameter (e.g. with the CAAS-system greater than 0.24 mm) may be considered significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694663 TI - [The endothelium as the central control site of the coagulation cascade]. AB - Regulation of coagulation by endothelial cells has been the focus of intense studies during recent years. The importance of cellular receptors for coagulation factors leads to a model of the prethrombotic state and perhaps to the possibility of receptor blockade as an anticoagulant therapy. The prethrombotic state is initiated by stimuli such as interleukin 1, Tumor Necrosis Factor, endotoxin, or norepinephrine. These agents shift the steady state of coagulant reactions on the surface of normal anticoagulant active endothelial cells to a prethrombotic surface, capable of initiating coagulation and promoting clot formation. These stimulated endothelial cells have an increased expression of procoagulant and a decreased expression of anticoagulant binding sites for clotting factors. PMID- 2694664 TI - The role of vascular endothelial cells in the regulation of fibrinolysis. AB - Vascular endothelial cells play an important role in the regulation of fibrinolysis. They synthesize and secrete tissue-type plasminogen activators (t PA), urinary-type plasminogen activators (u-PA), as well as plasminogen activator inhibitor type 1 (PAI-1). Synthesis of t-PA, u-PA, and PAI-1 are regulated by a variety of external agonists. The fibrinolytic capacity of endothelial cells derived from macrovascular and microvascular origin is regulated differently. Furthermore, endothelial cells bind plasminogen, plasminogen activators and plasminogen activator inhibitors. Depending on their state of activation endothelial cells may promote or inhibit fibrinolysis. PMID- 2694665 TI - The adenosine hypothesis of metabolic regulation of coronary flow in the light of newly recognized properties of the coronary endothelium. AB - With the aid of specially developed methods it has become possible to differentiate the purine metabolism of the heart at the level of the different myocardial tissues. This permits an evaluation of the biochemical mechanisms postulated by the adenosine hypothesis of the metabolic regulation of coronary blood flow. It is now clear that the coronary endothelium determines the metabolism of purines in both the interstitial and intravascular spaces of the myocardium on the basis of its great biochemical potency. Coronary flow increases evoked by adenosine and adenine nucleotides are mediated by the endothelium, which is apparently closely coupled to the vascular smooth muscle. These observations can still be reconciled with the adenosine hypothesis, albeit with considerable modification and extension. The results of our studies on purine metabolism in highly purified cardiomyocyte preparations from guinea-pig hearts, however, are completely at odds with the hypothesis. The intact cardiomyocyte is obviously unable to release adenosine, and is almost incapable of resynthesizing lost purine bodies. The impression is gained that the large amounts of adenosine and its degradatives detected, e.g., in the effluent of isolated hearts, are more likely to indicate myocardial damage than the production of a physiological mediator of coronary flow regulation. Presumably many experimental and clinical studies will need to be re-evaluated in the light of these interesting new aspects. PMID- 2694666 TI - Endothelium-derived relaxing factor in human coronary artery. AB - Over the last few years it has become apparent that endothelial cells release many vasoactive substances, including prostacyclin, endothelium-derived relaxing factor (EDRF), endothelium-derived contracting factor(s), and endothelium-derived hyperpolarizing factor. The picture that is rapidly emerging from research in this field is that abnormalities in the production and release of these substances may occur and contribute to many pathophysiologic states. For example, an impaired release of EDRF, the endogenous prototype of the nitrovasodilator drugs and a powerful vasodilator, appears to be involved in abnormal vasomotor function in diseases, such as atherosclerosis and hypertension. This view is supported by recent pharmacological experiments with isolated human coronary arteries freshly obtained from patients at heart transplantation, and clinical studies using quantitative coronary angiography. However, even in atherosclerotic arteries, EDRF-mediated vasodilation may contribute considerably to the actual vascular tone, since the release of EDRF upon appropriate stimulation in patients with moderate coronary artery disease appears to result in a vasodilation which is similar to that induced by an intracoronary infusion of nitroglycerin. PMID- 2694667 TI - The vascular endothelium as target of humoral auto-reactivity in myocarditis and rejection. AB - The vascular endothelium plays a key role in immunologic reactions that also involve the heart: Increased expression of class 1 and 2 antigens of the major histocompatibility complex a common finding in acute rejection after heart transplantation whereas in myocarditis this finding is less pronounced. Another form of involvement of the endothelial cells in the secondary immune response has been reported only infrequently; anti-endothelial antibodies, which may be cytolytic to living cultured human endothelial cells, were demonstrated to be bound to the endomyocardial biopsies of patients with different forms of rejection and with biopsy proven myocarditis and circulating in the peripheral blood of the patients as cytolytic autoantibodies. PMID- 2694668 TI - Cell analysis in clinical chemistry. AB - The present state and the future of clinical chemistry are considered. Attention is called to the diagnostic value of chemical analysis on cellular level and the procedures designed for such examinations so far are described. The author's results obtained by fluorescence polarisation and bioluminescence are presented. Novel analytical trends, whose introduction into clinical chemistry may be expected greatly to promote diagnostics through our knowledge of intracellular events, are touched upon. PMID- 2694669 TI - [Help with decisions on the assessment of clinical chemistry results]. PMID- 2694670 TI - [So-called humero-scapular periarthropathy--classification and analysis based on 1,266 cases]. AB - 1266 cases of Periarthropathia humeroscapularis (PHS) were analyzed according to their clinical and sonographic findings. We found in 32.8% a PHS simplex (simple tendinitis), in 12.6% a PHS adhasiva (stiff and painful shoulder with intact cuff), in 17% a PHS calcarea (calcareous tendinitis) and in 33.3% a PHS destructiva (rotator cuff lesions). Isolated tendinitis of long head of biceps was rare (0.7%). Frozen shoulder (adhaesive capsulitis) was differentiated from PHS adhasiva and accounted of 1.9%. 33.3% of frozen shoulder patients suffered from type I Diabetes mellitus. Women were more affected by PHS calcarea and Frozen Shoulder. The average age of patients with PHS adhasiva and PHS destructiva was definitely higher than that of PHS simplex cases. PHS adhasiva and Frozen Shoulder had an even distribution of affected sides, whereas the right side was favoured from 1.7:1 (PHS calcarea and PHS destructiva) to 3.5:1 (isolated bicipital tendinitis). Cases of rotator cuff tears were stiff in 33.7%, and had active limited motion (pseudoparalysis) in 28.5%. PMID- 2694671 TI - [Historical aspects of pain relief during normal parturition]. AB - Traditional methods used for the relief of pain during normal delivery are few and the medical literature remained silent on this topic up to the middle of the 19th century. Indeed, the first effective method was etherization, and it was introduced by Simpson (Edinburgh) in 1847. Obstetric inhalation analgesia was followed by many other methods the development of which was based on new discoveries in chemistry, pharmacology, physiology, and psychosomatic medicine. This paper reviews the milestones in the historical development of obstetric analgesia. PMID- 2694672 TI - [Current treatment of viral warts]. PMID- 2694673 TI - [Erythema nodosum in patients with hypertrophy of the nasopharyngeal tonsil]. AB - The author analyzes the clinical observations of erythema nodosum in patients with hypertrophic nasopharyngeal tonsils. Basing on the literature data and her own observations, she suggests a relationship between adenoid growth and nodular eruption. PMID- 2694674 TI - [Phenotypic analysis of human T-cell lymphoma with reference to cell differentiation and morphological classification]. AB - The recognition of the dichotomy of the immune system was a first step in differentiating between a humoral and cellular immune response. This distinction was to be of fundamental importance in the subsequent demonstration of distinct compartments in the lymphatic cell system. Animal studies and investigations on humans with congenital immune defects soon made it possible to differentiate between functionally different cell compartments in lymphatic tissue even on morphological grounds. This formed the basis for the subdivision of lymphatic tissue into B- and T-cell areas. A multiplicity of morphologically highly varied lymphatic neoplasias confronted this clear division. In principle, there are two possible explanations for the morphological and immunological heterogeneity of neoplasias: 1. The variety of lymphatic neoplasias is an expression of a dedifferentiation of cells in which neither the morphological picture nor the immunological properties of the stem cells are expressed. 2. Lymphatic neoplasias represent stages of "arrested" differentiation in the normal cell development. The present study attempts to demonstrate the distribution and development of normal T lymphocytes by analysis of their morphology and antigen constellation. The knowledge thus gained should then make it possible to define the neoplasias of the T-cell system. Thirty-six monoclonal antibodies were employed in addition to standard enzyme-histochemical methods for demonstration of cell antigens; some of the monoclonal antibodies were developed especially for this purpose. The study included normal tissue and samples from 148 lymphomas and leukemias of the T-cell system. Subdivision of the various entities was based on morphology, which enabled us to make a direct distinction between the morphologically defined entity and its corresponding phenotype. These phenotypic analyses of malignant T cell lymphomas were conducted in pursuit of 3 basic goals: 1. To catch T-cell neoplasias in the full variety of their phenotypical spectrum by using assorted T cell properties. 2. To bring these varied entities into a sequence corresponding to normal cell differentiation by correlating the neoplasias to normal cell compartments. 3. To determine the extent to which neoplastic equivalents exist for normal T cells with varied phenotypes and/or functional properties. A clear morphological subdivision of the T-cell neoplasias is already possible: 1. lymphoblastic lymphomas and leukemias; 2. peripheral or mature cell T-cell lymphomas. The lymphoblastic lymphomas and leukemias have until now been characterized primarily according to their positivity for the enzyme TdT. The T lymphoblastic lymphomas and leukemias we analysed phenotypically shared the constant features of CD7 antigen expression, whereas other T-cell features showed a clear variability. PMID- 2694675 TI - [On the methodology of morphology and levels of morphologic analysis]. AB - Unjustified narrowing of the problems of morphology by merging the terms "morphology" and "anatomy" leads to stagnation in morphology. The merging of "classic" and "modern" biology will enrich both morphology and molecular biology and genetics. The latter will be able apply conceptual models of morphology to more primitive structural level of life. The possibility to apply V. A. Dogel' 's ideas on the role of oligomerization and polymerization in science to the analysis of molecular evolution has been demonstrated with the analysis of DNA content in the genomes of Chordata taken as an example. The data on DNA content do not allow both to consider lungfishes as ancestors of all Tetrapoda and develop monophyletic concept of Tetrapoda origin at the same time. The possibility of application of concepts of comparative morphology to analysis of molecular evolution has been considered. PMID- 2694676 TI - Split tRNA genes and their products: a paradigm for the study of cell function and evolution. PMID- 2694677 TI - Nuclear pre-mRNA splicing in yeast. PMID- 2694678 TI - High level of expression of a protective antigen of schistosomes in Saccharomyces cerevisiae. AB - Strains of Saccharomyces cerevisiae expressing P28-I, an antigen inducing protection against schistosomiasis, have been constructed. Transformants containing a very high copy number of a P28-I expression vector were selected by genetic complementation involving deficient LEU2 or URA3 alleles carried by plasmids. Using the ura3 fur1 auto-selection system, constitutive and stable expression of P28-I could be obtained in cultures grown in rich medium. The accumulation of the foreign protein exceeds 25% of total yeast proteins when estimated by Coomassie Brilliant Blue staining of SDS-PAGE. Moreover, P28-I which was located intracellularly was soluble and biologically active. PMID- 2694680 TI - [Determining the diagnosis--tumor of the kidney pelvis--using sonography]. AB - The advantages and deficiencies of diagnostic imaging procedures especially of ultrasonography in the diagnostics of solid masses in the renal collecting system are presented. The intravenous urography is important as basic examination, but ultrasonography is valuable for additional information especially in the non functioning kidney. A tumor could identified in the renal collecting system if its size is greater than 10 mm. PMID- 2694679 TI - Isolation, DNA sequence and regulation of a new cell division cycle gene from the yeast Saccharomyces cerevisiae. AB - A new complementation group of temperature-sensitive mutants of the yeast Saccharomyces cerevisiae (ts26-1 and ts26-2) has been isolated and characterized. This mutation maps at 40.7 cM from arg8 and 48.9 cM from arg1 on the left arm of chromosome XV of yeast, providing that it is a newly identified gene. The dumbbell-shape terminal morphology of the mutant cells at the restrictive temperatures is a characteristic of mutants defective in DNA replication. To study the defect of macromolecule synthesis in the mutant cells, DNA, RNA, and protein synthesis were measured at both permissive and restrictive temperatures. The data suggest that the primary defect of this mutation is at the initiation step of DNA synthesis. The gene has been cloned from an S. cerevisiae genomic library by rescue of the conditional lethality of the mutants. It is present as a single copy in the haploid genome. DNA-RNA hybridization of the gene has identified 1 kb RNA, which is under cell-division-cycle control. DNA sequence analysis of the gene has identified an open reading frame capable of encoding a protein of molecular weight 25,055 (214 amino acids). PMID- 2694681 TI - [Optimized follow-up after kidney pelvis-plasty using sonography and functional scintigraphy]. AB - The results of the operative treatment in 33 patients suffering from pelviureteral obstruction and of the follow-up control using ultrasonography and renography are presented. A reduced radiation exposure and diminished treatment costs are the results of this changed diagnostic and therapeutic strategy. PMID- 2694682 TI - [Percutaneous nephrostomy and temporary immunosuppression in treatment of idiopathic retroperitoneal fibrosis (Ormond disease)]. AB - Our experiences in the diagnostics, treatment and follow-up-course of 10 patients suffering from idiopathic retroperitoneal fibrosis are reported. The ureterolysis and temporary nephrostomy, initially as percutaneous nephrostomy, and a long-term immunosuppressive therapy is the treatment of choice. In the follow-up control ultrasonography and computerized tomography are valuable and the prognosis of the disease quoad functionem is good. PMID- 2694683 TI - [Leiomyoma of the urinary bladder]. AB - It is reported on a 42-year-old female patient suffering from a giant leiomyoma of the urinary bladder. After operative tumor excision the unilateral renal obstruction resolved. PMID- 2694684 TI - [Realization of an online connection of laboratory apparatus with personal computers]. AB - Online data transfer from laboratory equipment to personal computer is more and more accepted as standard for animal experiments. This paper deals with the connection of the laboratory devices to the computer by using the serial RS-232C interface. Both the simplex and the duplex mode of data transfer are described as well as a fundamental concept of data handling in BASIC. PMID- 2694685 TI - Histological classification of synovitis. AB - A simple system of synovitis classification is proposed based on histomorphological evaluation of 400 random specimens of synovial tissue. It discriminates between two types of diagnosis: 1) one with a high degree of information, being called C-synovitis (synovitis with a characteristic or diagnostic histomorphological pattern), where the clinical diagnosis can be predicted on the basis of the histomorphological pattern, 2) a second type of diagnosis with a lower degree of information, being called NC-synovitis (synovitis with non-characteristic or non-diagnostic morphological findings in the synovial membrane). We subdivided NC-synovitis into 4 subgroups and determined the RA-probability of each subgroup in order to permit clinical use of the proposed histomorphological classification. In addition, by using immunoperoxidase staining methods for immunoglobulins the subgroups were shown to have different quantities of extravasally deposited immunoglobulins in the synovial membrane. The subgroup with the highest RA-probability also turned out to have the highest amount of extravasally deposited immunoglobulins. PMID- 2694686 TI - Osteoclast-type giant cell tumor of the endometrium. An immunohistochemical study. AB - We present a rare case of a 55 year old female with an osteoclast-type giant cell tumor of the endometrium associated with leiomyoma and adenomyosis. Multinucleated giant cells and mononuclear stromal cells reacted with vimentin and alpha-1-antichymotrypsin (AACT) using the immunoperoxidase method. Epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), and keratin exhibited negative immunoreaction in these tumor cells. Our immunohistochemical results do not support the epithelial origin of an osteoclast-type giant cell tumor and mesenchymal derivation appeared more likely, suggesting histiocytic origin. PMID- 2694687 TI - [Anatomic preparations in the Petersburg "art chamber"]. AB - The first museums on history of nature were opened in early Enlightenment and had originated from baroque curio galleries at most of the European courts. Peter the Great, too, had his "Art Chamber" converted to a universal museum primarily designed to didactic purposes. Much of the space was devoted to anatomic and teratological exhibits. To complete these collections, Peter repeatedly ordered all malformations to be handed over ("Monster Decree"). When travelling abroad, he purchased anatomic, zoological, botanic, and mineralogical collections, such as the famous collection previously owned by Frederik Ruysch in Amsterdam, with injected anatomic specimens with period-style decorations. The Art Chamber collection was later on described by K. W. Burdach, anatomist, and K. E. v. Baer, anthropologist. Many of its exhibits are still at show. PMID- 2694688 TI - [Pregnancy-associated alpha2-glycoprotein (alpha2-PAG)--past, present and future]. AB - The pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG), first described 30 years ago, is a high-molecular neuramino-glycoprotein. Its serum concentration is normally low, but substantially increases during pregnancy and in some malignant tumour diseases. A review is given of occurrence and quantification of alpha 2 PAG under physiological and pathophysiological conditions, site of synthesis and localization, purification and physico-chemical properties, biological role and possible clinical use. PMID- 2694689 TI - [The role of the antilysozyme activity of Shigella flexneri as a factor controlling the degree of its resistance to the lytic action of bacteriophages]. AB - The level of the antilysozyme activity of S. flexneri in ensuring the high level of their phage resistance has been studied. The realization of the phage protective effect of antilysozyme activity has been noted to occur due to disturbances in the lysis of infected bacteria by phage-synthetized lysozyme-like enzyme. The direct relationship between the level of the lysozyme production of bacteriophages and their capacity for overcoming the antilysozyme protection of the host bacterium has been shown. PMID- 2694690 TI - [The characteristics of the chemical composition and biological activity of Proteus antigens isolated using hydroxylamine]. AB - The comparative study of the chemical composition and biological properties of antigens isolated from Proteus vulgaris with the use of hydroxylamine and by two classical methods (Boivin's and Westphal's methods) has been made. As shown in this study, the treatment of bacteria with hydroxylamine makes it possible to obtain antigenic complexes with lower toxicity. At the same time hydroxylamine produces no denaturing effect on lipopolysaccharides and protein fractions of bacterial cells. PMID- 2694691 TI - [The plasmid heterogeneity of Shigella sonnei phase-I and -II strains]. AB - The plasmid composition of S. sonnei standard strains has been studied by the method of electron microscopy of the preparations of plasmid DNA. In S. sonnei cells I-941-HP, phase I, plasmids of 2,500; 5,000; 5,600; 6,100 and 6,800 base pairs, as well as plasmids of 85,000-117,000 and 170,000-235,000 base pairs have been detected. In S. sonnei cells, phase II, plasmids of 2,500; 4,900 and 6,100 base pairs, as well as plasmids of 85,000-109,000 base pairs, have been found. Thus, virulent S. sonnei in phase I contain additional plasmids of 5,600; 6,800; 110,000-117,000 and 170,000-237,000 base pairs. The range of plasmid lengths between 85,000-117,000 and 170,000-237,000 base pairs exceeds the usual background of electron-microscopic studies, which makes it possible to come to the conclusion on the intrastrain heterogeneity of these classes of plasmids. The suggestion has been made that the transition of S. sonnei from phase I to phase II is linked with the loss of fragments of the genetic material, limited by inverted DNA repetitions. PMID- 2694692 TI - [The adhesive properties of a nonenteropathogenic strain of Escherichia coli in systems in vitro on isolated rat enterocytes and in vivo]. AB - The adhesive properties and colonizing capacity of E. coli strain O83, isolated from feces of healthy humans and marked according to its resistance to rifampicin and nalidixic acid, were studied. In vivo experiments on germ-free rats revealed that these bacteria were capable of colonizing intestinal mucosa; colonization increased from the small to large intestine and E. coli cells were mainly concentrated in the intestinal lumen and in mucin. In vitro studies showed that this nonenteropathogenic E. coli strain possessed pronounced adhesive properties with respect to the colonic cells of germ-free rats; these properties were considerably less pronounced with respect to the enteric cells of the small intestine. The electron microscopic study of E. coli cells revealed the presence of fimbriae and fibrillae on their surface. PMID- 2694693 TI - [Shigellosis in the USSR: the etiological role of Shigella dysenteriae]. AB - The etiological role of S. dysenteriae in Shigella infections at different territories of the USSR in 1983-1987 is analyzed. The study shows that S. dysenteriae pertain to territories with unfavorable water supply of the population. At some of these territories, in particular the Uzbek SSR, Grigor'ev Shiga dysentery seems to gain ground and the restoration of the area of its spread occurs. In recent years the penetration of Grigor'ev-Shiga dysentery from abroad became more frequent in the presence of the pandemic of this dysentery in the world, which caused the appearance of the disease in 17 out of 27 basic territories of the All-Union Center of Shigella Infections. The ways for increasing the control of this infection are outlined. PMID- 2694694 TI - [Cytogenetic control over the safety of merthiolate]. AB - The capacity of merthiolate (also known as thimerosal), a mercury organic compound used as preservative in vaccines, to induce chromosomal aberrations was studied in vivo in experiments on mice. The metaphasic method of the registration of anomalies was used. In a dose of 3.3 micrograms/kg body weight merthiolate did not produce a damaging effect on the chromosomes of marrow, spleen and embryonal liver cells. Cyclophosphamide (in a dose of 25-50 micrograms/kg) used as positive control induced a significant rise in the frequency of chromosomal transformations. PMID- 2694695 TI - [The use of an immunoenzyme method for the rapid diagnosis of legionellosis]. AB - An enzyme immunoassay (EIA) system for the detection of L. pneumophila antigen in clinical material (sputum, urine, bronchial washings) has been developed. The use of EIA permits the detection of L. pneumophila antigen in the urine of 75-80% of patients during the first week of the disease. The specificity and sensitivity of EIA makes it possible to recommend this method for the rapid diagnosis of L. pneumophila infection. PMID- 2694696 TI - [Interleukin-1-inducing activity of the polysaccharide-containing antigens of the cell wall in Yersinia pestis]. AB - The induction of the synthesis of interleukin-1 (IL-1) in human monocytes under the influence of the endotoxic preparations (LPS) and Y. pestis basis somatic antigen has been experimentally studied. The results obtained in this study make it possible to come to the conclusion that the capacity of the endotoxin of Y. pestis cell wall, consisting of LPS of type R, for inducing the synthesis of IL-1 in human monocytes is not different from the corresponding capacity of Salmonella and Shigella LPS, type S. Y. pestis O-specific polysaccharide in a discrete state has considerably greater IL-1-inducing activity in comparison with other preparations used in this experimental study. Such typical changes, characteristic of the initial stage of Y. pestis infection, as a sharp rise in temperature, transitory neutropenia, significant primary suppression of the oxygen-dependent metabolism of polymorphonuclear neutrophils are probably due to the induction of the synthesis of IL-1 by the polysaccharide-containing antigen of Y. pestis cell wall (LPS, basic somatic antigen) in cells of the mononuclear phagocytizing system. PMID- 2694697 TI - [The cold chain: its role and significance in fighting infections controllable by specific prophylactic agents]. PMID- 2694698 TI - [The radioactive iodination of protein compounds for radioimmunological analysis]. PMID- 2694699 TI - [Clinical and therapeutic evaluation of atypical antidepressants]. AB - A comparative clinical analysis was made of the therapeutic efficacy of 13 atypical antidepressants (of the second generation and novel ones) and 5 typical (tricyclic) antidepressants in 1107 patients with depressions of varying nosology, syndromal structure and gravity. The data on psychotropic activity of atypical antidepressants and preferable indications for their administration are provided. The correlations between thymoleptic, anxiolytic and activating influences seen in the spectrum of their psychotropic action are discussed. Recommendations are given for the treatment with these agents of relatively mild depressions of the neurotic and psychopathic types in slow-progressive and border line mental diseases. It is assumed that the second generation antidepressants occupy an intermediate position between antidepressants, tranquilizers and psychostimulants in the current systematics of psychotropic agents. PMID- 2694700 TI - [Autonomic-vascular paroxysms (attacks of panic). (Review of the literature)]. PMID- 2694701 TI - [Various psychiatric and psychological aspects of AIDS (review of the literature)]. PMID- 2694702 TI - [Clinical pharmacokinetics of carbamazepine (review of the literature)]. PMID- 2694703 TI - The response of the double strand-specific nuclease V1 to Y-base removal in yeast tRNA(Phe). AB - The patterns of limited hydrolysis of yeast tRNA(Phe) and tRNA(-YPhe) by double strand-specific ribonuclease V1 show some differences in cleavage of both the acceptor stem and the anticodon stem. These regions are considerably better substrates for RNase V1 in tRNA(-YPhe) than in tRNA(Phe). The results are interpreted in favour of conformational changes taking place in yeast tRNA(Phe) upon the Y-base1 removal. PMID- 2694704 TI - [Deep venous thrombosis--choice of treatment method]. PMID- 2694705 TI - [Noninvasive diagnosis of venous diseases]. PMID- 2694706 TI - [Diagnosis of venous diseases]. PMID- 2694707 TI - [Treatment of breast cancer--description of the surgical technics and instruments in the Instituzioni Chirurgiche di Lorenzo Heistero, Venice, 1752]. PMID- 2694708 TI - [External fixation: its beginnings and its future]. PMID- 2694709 TI - [Ultrasound, an important diagnostic method for the diagnosis of echinococcosis of the liver]. PMID- 2694710 TI - [Duplex ultrasonography in the diagnosis of compression of vascular structures at the level of the upper thoracic outlet]. AB - In order to determinate place of compression and degree of haemodynamic disturbance we examined 34 patient and 30 asymptomatic volunteers. By duplex scan we studied retroscalenal part of subclavian artery. Using real-time (B-mode) imaging we founded significant reduction of lumen diameter of subclavian artery during Adsons, manoeuvre in 51% of cases. We examined haemodynamic changes during Adsons, costoclavicular and hyper-abduction manoeuvre and found significant changes in linear blood velocity, reduction of blood flow and turbulence in 91% of cases. Adsons manoeuvre was positive in 52%, costoclavicular in 29% and hyper abduction (to 90 degrees) in 19% of cases. Place of compression we founded in 82% of cases by duplex ultrasonography prospectively, but using other methods respectively we located compression in 91% of cases. PMID- 2694711 TI - Renal glucose and lactate metabolism in endotoxin shock in dogs. AB - Renal metabolism of glucose and lactate was studied in ten adult beagle dogs during pentobarbital anesthesia. Six dogs were submitted to hypodynamic shock by means of an intravenous bolus injection of Escherichia coli endotoxin, 0.5 mg/kg over 15 min. Four dogs received only saline solution and served as controls. Sudden cardiac depression, hypotension and moderate renal hypoperfusion were observed in the endotoxin-injected animals. Acidosis and oliguria also occurred during the 5-hour study. Arterial and renal venous glucose concentration increased transiently during the early phase of endotoxin shock. In the control group glucose levels increased slightly by the end of the experiment. Despite marked hyperlactatemia in the endotoxin group, the arteriovenous lactate difference remained almost unchanged. Renal uptake of lactate and output of glucose were not influenced during the moderate renal hypoperfusion caused by endotoxin. PMID- 2694712 TI - Osteoporosis: a modern disease. PMID- 2694713 TI - Care of pressure sores: a controlled study of the use of a hydrocolloid dressing compared with wet saline gauze compresses. AB - An occlusive hydrocolloid dressing (Comfeel Ulcus) was compared with a conventional wet saline gauze dressing regarding the effect on ulcer cleansing and healing processes, experience of pain and the consumption of nursing time, in a controlled, randomized and partially single-blind study with parallel groups of long-stay patients with pressure sores. After a few weeks' treatment the relative decrease in ulcer areas with time was larger in the group treated with the hydrocolloid dressing. The difference was almost statistically significant at week 5 (p = 0.054) and definite at week 6 (p = 0.006). At week 6 the median remaining ulcer area in per cent of the initial area was 0% in the hydrocolloid dressing group and 31% in the group treated with saline gauze (p = 0.016). Analysis of the healing distribution function showed the hydrocolloid dressing to be more effective, although the overall difference was non-significant (p = 0.15). Care of the pressure sore took significantly less time with hydrocolloid dressings. PMID- 2694714 TI - Hormone-fuel metabolism during exercise of insulin-dependent diabetic patients treated with an artificial B-cell unit. AB - The effects of restoration of glucose homeostasis on hormone-fuel metabolism of diabetic individuals during exercise (40% maximal O2 consumption) were determined by monitoring fuel oxidation rates and levels of substrates and hormones in nine normal subjects and five insulin-dependent diabetic patients while on conventional insulin therapy and after 3 days on artificial B-cell directed glucose regulation. The non-protein respiratory quotient (npRQ) and carbohydrate oxidation rate of the conventionally-treated diabetic subjects (0.908 +/- 0.002 and 538 +/- 5 mg/m2.min) were lower and the lipid oxidation rate (101 +/- 2 mg/m2.min) was significantly higher than those of the normal group during the bicycle exercise (101 +/- 2 mg/m2.min) was significantly 70 +/- 4 mg/m2.min, respectively). After 3 days of artificial B-cell insulin therapy, the npRQ and carbohydrate oxidation rate of the exercising diabetics significantly increased to 0.965 +/- 0.004 and 693 +/- 13 mg/m2.min, while the lipid oxidation rate declined to 39 +/- 4 mg/m2.min (p less than 0.001). We conclude that artificial B cell directed insulin therapy increases carbohydrate oxidation and decreases lipid oxidation in exercising insulin-dependent diabetic subjects. However, if restoration of metabolic response identical to that of exercising normals is desired, the excess in carbohydrate oxidation coincident with elevated blood lactate and pyruvate levels suggest that the artificial B-cell therapy may not have been completely optimal, probably due to the hyperinsulinization of the diabetic patients. PMID- 2694715 TI - Effect of some novel synthetic analogues of CCK-4 on insulin and glucagon secretion. AB - The biologic activities of three synthetic analogues of CCK-4 (Trp-Met-Asp-Phe NH2) in which (i) the C-terminal residue Phe was N-methylated (peptide I); (ii) the C-terminal Phe residue was N-methylated and Ser is substituted for Met in position 2 (peptide II); (iii) Pro was substituted for Trp in position 1 and the C-terminal amino nitrogen was methylated (peptide III), have been described. Peptides I and II have been found to inhibit the release of both insulin and glucagon, while peptide III was found to be a potent releasing agent for insulin and an inhibitor for glucagon. PMID- 2694716 TI - Somatomedin-C (SM-C). Study in diabetic patients with and without retinopathy. AB - In the present study we evaluated somatomedin-C (Sm-C) plasma levels in diabetic patients, with and without retinopathy. One hundred and thirty four diabetic patients (65 type I and 69 type II) and 90 controls, strictly matched for age and sex, were enrolled in the study. Ophthalmoscopy and fluorescein angiography allowed to distinguish: 49 patients without retinopathy, 45 patients with background retinopathy, and 40 with proliferative retinopathy. Growth hormone (GH) and Sm-C plasma levels were measured using a pool of 20-24 blood samples over 24h. Sm-C levels in type I (0.62 +/- 0.11 U/ml) and type II (0.56 +/- 0.09 U/ml) patients were significantly decreased (p less than 0.01) when compared to controls (0.89 +/- 0.30 U/ml). The mean daily secretion of GH was significantly (p less than 0.01) greater in diabetic patients (7.8 +/- 2.6 ng/ml) than in controls (4.1 +/- 1.5 ng/ml), but no correlation was found between Sm-C and GH (r = 0.15; p = n.s.). Our findings did not show any correlation between Sm-C plasma levels and either the existence of retinopathy, regardless of the degree of microvascular damage, or duration of the disease, or degree of metabolic control, as evaluated by HbA1c. PMID- 2694718 TI - [Flow cytometric analysis of T lymphocyte subsets after human bone marrow transplantation using monoclonal antibodies and dual immunofluorescence]. AB - Using monoclonal antibodies and a dual immunofluorescence technique, we studied the abnormalities of T lymphocyte subsets after human marrow transplantation. T lymphocytes bearing HLA-DR antigen increased both in patients with acute and chronic graft-versus-host disease (GVHD). Parallel to a decrease in CD4+ cells, a CD4+ 2H4+ subset decreased and gradually recovered with time while the percentage of CD4+ 4B4+ cells increased. A significant increase of CD8+ cells observed after marrow transplant corresponded mainly to an increase in CD8+ CD11- cells. Patients with chronic GVHD tended to have a higher proportion of CD8+ CD11+ cells. These results indicate abnormalities of T cell subsets among both CD4+ and CD8+ cells after marrow grafting. PMID- 2694717 TI - Impairment of lymphocyte suppressive system in recent onset insulin-dependent diabetes mellitus. Correlation with blood glucose and serum insulin levels. AB - In a previous study, we observed an impairment of the theophylline-induced suppressive system in recent onset IDDM patients, and demonstrated also a correlation with metabolic derangement. The aim of this study was to better investigate the relationship between theophylline sensitivity (ThS) and blood glucose/plasma insulin levels in recent onset IDDM patients subjected to preprogrammed variations by an insulin/glucose clamp with artificial pancreas. Eight patients were studied within 8 weeks from the onset of IDDM. ThS was evaluated as the ability of theophylline to inhibit blastogenic response of peripheral blood lymphocytes (PBL) to Concanavalin A (ConA), after 120 min preincubation of the cells. All patients were connected to an artificial pancreas. Through i.v. continuous insulin infusion (0.02 U/kg/h) and/or i.v. continuous glucose and saline infusion, the following experimental conditions, lasting at least 1h, were obtained: T1: relative euglycemia and normal insulinemia; T2: relative euglycemia and hyperinsulinemia; T3: hyperglycemia and normal insulinemia; T4: hyperglycemia and hyperinsulinemia. ThS was maintained in 6/8 patients at T1 and in 8/8 patients at T4. ThS was lost in 4/8 patients at T2 and T3. These data suggest that the loss of ThS induced by hyperglycemia can be corrected by hyperinsulinemia, and that it is maintained when euglycemia is accompanied by hypoinsulinemia. It is lost when these two parameters lose their interrelationship. PMID- 2694719 TI - Morphological and immunocytochemical examinations on development of B-cells in human embryonic and fetal liver. AB - Morphological characteristics of B cell in human embryonic and fetal livers during the first trimester of gestation were examined. Light microscopically, CD9+, CD10+, CD19+, and CD20+ cells of B cell lineage became detectable as small lymphoid cells from 8 weeks gestation. Tdt+ cells first appeared also as small lymphoid cells on the 43th day of gestation. Ia+ or CD34+ cells in embryonic livers between the 33th and 43th day of gestation were large blastic cells resembling myeloblasts while some of Ia+ or CD34+ cells after the 43th day of gestation as well as Tdt+ cells were similar to lymphocytes. Electron microscopically, all Ia+, CD10+, and CD19+ cells existed solitarily in intercellular spaces of hepatocytes, but not in intravascular spaces. Ultrastructural aspects of these cells were distinguishable each other. These findings indicate that 1) B cells developed and differentiated in the fetal liver, but the fetal liver during the first trimester was not a lymphoid organ, 2) lymphohemopoietic progenitor cells were derived from Tdt+ cells in the livers between 43th and 56th day of gestation. Ia+ cells detected as a small lymphoid cell in the liver at the 50th day were considered to be progenitor cells of lymphocytic lineage. PMID- 2694720 TI - Multiple myeloma in husband and wife. AB - A married couple with multiple myeloma (MM) is reported. Although we could not find any definite pathogenetic factors of MM in the spouses examined, the salient features of the 10 couples with MM reviewed, including ours, were summarized to obtain a better understanding of the pathogenesis of MM. The appearance of MM in spouses suggests that environmental factors are involved in the pathogenesis of MM. PMID- 2694721 TI - Factor IX molecular defects in diagnosing hemophilia B: a review. AB - The past several years have seen an explosive growth in the application of recombinant DNA methods to study the molecular pathology of various inherited disorders. As a consequence, molecular defects responsible for the disease have been identified at the sequence level. In this review, I briefly describe the recent progress in the uses of factor IX gene probes in clinical diagnosis of hemophilia B (Christmas disease) carriers, as well as their use for analyzing the structural gene abnormalities that are responsible for the disease. PMID- 2694722 TI - [c-myc gene amplification and N-ras transforming gene in two cases of acute myelocytic leukemia with double minute chromosomes]. AB - We report two leukemia patients with double minutes (DMs) chromosomes. Both patients were diagnosed as having acute myelocytic leukemia (AML) FAB M2. Cytogenetic analysis showed normal chromosome karyotype with 1-53 DMs chromosomes in the first patient, and complex chromosome aberrations including deletion of chromosome 8 at 8q24 region and 1-84 DMs chromosomes in the second patient who had a history of extensive radiotherapy for laryngeal cancer 8 years prior to the development of leukemia. Analysis of DNA from the two patients revealed that oncogene of c-myc was amplified about 5 to 10 folds in the leukemic cells. The other fourteen oncogene of c-myc was c-myb, c-abl and N-myc, showed no increases of gene content. Furthermore, a transforming gene, N-ras was detected in the first patient by in vivo selection assay method. This is the second report on AML patients with c-myc gene amplification and DMs chromosomes. PMID- 2694723 TI - [Two-phenotype and two-clonal leukemia]. PMID- 2694724 TI - [In memory of Prof. Julian Aleksandrowicz]. PMID- 2694725 TI - [Effect of mercury on the hematopoietic system]. PMID- 2694726 TI - Cerebral blood flow and metabolism in sleep. AB - A review is presented of the electrical activity of the brain and its global and regional blood flow and metabolism in the different stages of sleep and in wakefulness in animals and humans. During slow-wave sleep (SWS), the blood flow and metabolism of the brain decrease slightly below the level of wakefulness. During rapid eye movement the activity of the brain increases above that of SWS and sometimes above that of wakefulness. Some studies suggest that both at sleep onset and at arousal the brain stem-cerebellar complex (BSC) may be activated before the cortex and the right hemisphere before the left. Variation of hemispheric dominance seems to be a phenomenon of both wakefulness and sleep. PMID- 2694727 TI - Evoked and psychogenic epileptic seizures. I. Precipitation. AB - The precipitation of seizures by external stimulation (evoked seizures) is well known. Less well known is the precipitation of seizures by a change in the patient's thinking or feelings. This artick uses Lockhart's monkey model of focal epilepsy to propose that there is a close relationship between seizures and ongoing brain activity. Thus, seizures precipitated by both voluntary and spontaneous changes in behaviour and thinking must commonly occur. Clinical examples of such seizure precipitation is described. PMID- 2694728 TI - Beta-2-microglobulin in the cerebrospinal fluid of patients with infections of the central nervous system. AB - Beta-2-microglobulin was determined in 147 patients admitted to hospital because of suspicion of CNS disease. Patients with meningism were chosen as control group. The concentration of beta-2-microglobulin in the spinal fluid of control patients was correlated with age. Reference values for 0-40 years were 0.34-1.58 mg/l. Above 40 years of age the values were 0.46-3.14 mg/l. CSF beta-2 microglobulin levels of patients with meningism, aseptic and bacterial meningitis overlap too much to be relevant in distinguishing between these entities. Five patients with herpes simplex encephalitis had markedly elevated levels ranging from 4.4 to 9.0 mg/l. Ten patients with herpes zoster-associated encephalitis had values from 1.1 to 6.1 mg/l. In the patient groups with CNS infections, the ratio of serum to spinal fluid beta-2-microglobulin was significantly more frequently less than 1 as compared with the meningism group, indicating intrathecal production of the protein. Further studies on the clinical relevance of CSF beta 2-microglobulin in the diagnosis of encephalitis seem warranted. PMID- 2694729 TI - A new measuring design for autonomic dysfunction of skin in neuropathies: hyperthermal laser-Doppler flowmetry. AB - Twenty patients suffering from diabetic neuropathy, 20 patients suffering from alcoholic neuropathy and 20 healthy volunteers within the same age range were studied for the stimulability of microcirculation with a new measuring design. A laser method (laser-Doppler flowmetry) was used to evaluate the increase of the microvascular blood flow of the skin during the hyperthermal phase. It evaluated the degree of increase of microcirculatory blood flow as well as the time from the beginning of hyperthermy to the onset of change in perfusion (the hyperthermal perfusion latency). This was significantly prolonged in both neuropathy groups; the increase of the microvascular blood flow in the diabetic neuropathies was significantly lower than found in alcoholic neuropathies and in healthy volunteers. PMID- 2694730 TI - Intrathecal synthesis of beta-2-microglobulin in multiple sclerosis and aseptic meningo-encephalitis. AB - Beta-2-microglobulin (beta 2m) levels were studied in the cerebrospinal fluid (CSF) and plasma of 52 patients with clinically definite multiple sclerosis (MS) and of 14 with aseptic meningo-encephalitis (AM). Reference values for beta 2m were defined in 72 subjects of different age groups with tension headache (TH). Plasma levels of beta 2m increased with age in TH controls, particularly in the older age group, while no significant age variation could be detected for CSF beta 2m. Increased levels of beta 2m were found in the CSF and plasma of AM patients and in the CSF in MS. Calculations of CSF/plasma beta 2m ratios showed higher values in AM, reflecting intrathecal beta 2m synthesis, while only borderline alterations were evident in MS. Demonstration of intrathecal production of beta 2m is an additional CSF finding that may be useful in evaluating, among others, inflammatory nervous system disorders, but it has limited importance in the study of MS patients. PMID- 2694731 TI - Epidemiological approaches to the etiology of Parkinson's disease. AB - In the search for the cause of Parkinson's disease epidemiology serves several purposes. Valuable clues to the etiology may be derived from the epidemiological features of the disease, and the subsequent search for risk factors in analytical studies can be narrowed correspondingly. On the other hand, knowledge of the epidemiology of Parkinson's disease is necessary in creating etiological hypotheses, since only hypotheses consistent with the epidemiological profile deserve careful testing. PMID- 2694732 TI - Transplantation strategies in the treatment of Parkinson's disease: experimental basis and clinical trials. AB - Neural grafting has over the last decade emerged as a possible tool for the substitution of damaged neurons in the central nervous system and for the promotion of symptomatic recovery after brain damage. Transplantation studies in the 6-hydroxydopamine lesion rat model of Parkinson's disease were initiated in the late seventies. The first studies were based on the neuronal replacement paradigm, using developing dopamine brain cells obtained from the substantia nigra region of embryonic cadavers. When implanted into the striatum such grafts were found to reinnervate part of the previously denervated striatum and restore dopamine turnover and release to near-normal levels. In both rats and monkeys the nigral grafts have been shown to normalize some, but not all, Parkinson-like symptoms in the dopamine deficient recipients. Grafting of adrenal medullary tissue was introduced in the early eighties as an alternative to the use of embryonic cadaver tissue. The adrenal medullary grafts have, however, so far shown poor long-term survival in both rats and monkeys, and consistent with this no sustained dopamine release have been observed in the brain of long-term grafted animals. Likewise, no long-lasting effects of adrenal medullary grafts on spontaneous motor or sensori-motor behavior have so far been documented in either the rat or the monkey model. The results so far reported from trials using adrenal medullary grafts in patients with Parkinson's disease appear to conform to the available animal experimental data at least in two important respects: significant long-term graft survival has not been possible to document, and any clear-cut functional effects consistent with sustained graft-induced dopamine release have not been demonstrated. Initial results from ongoing trials using grafts of fetal nigral tissue are presented and discussed. PMID- 2694733 TI - Oxidants and the central nervous system: some fundamental questions. Is oxidant damage relevant to Parkinson's disease, Alzheimer's disease, traumatic injury or stroke? AB - Radicals are species containing one or more unpaired electrons. The oxygen radical superoxide (O2-) and the non-radical oxidant hydrogen peroxide (H2O2) are produced during normal metabolism and perform several useful functions. Excessive production of O2- and H2O2 can result in tissue damage, which often involves generation of highly-reactive hydroxyl radical (.OH) and other oxidants in the presence of "catalytic" iron ions. A major form of antioxidant defence is the storage and transport of iron ions in forms that will not catalyze formation of reactive radicals. Tissue injury, eg. by ischaemia or trauma, can cause increased iron availability and accelerate free radical reactions. This may be especially important in the brain, since areas of this organ are rich in iron and cerebrospinal fluid cannot bind released iron ions. Oxidant stress upon nervous tissue can produce damage by several interacting mechanisms, including rises in intracellular free Ca2+ and, possibly, release of excitatory amino acids. Recent suggestions that iron-dependent free radical reactions are involved in the neurotoxicity of aluminium and in damage to the substantia nigra in Parkinson's disease are reviewed. Finally, the nature of antioxidants is discussed, it being suggested that antioxidant enzymes and chelators of iron ions may be more generally-useful protective agents than chain-breaking antioxidants. PMID- 2694734 TI - MPTP-induced parkinsonism as a model for Parkinson's disease. AB - It is now well recognized that 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) can induce a syndrome in human and non-human primates similar to Parkinson's disease. This highly selective neurotoxin, which affects specific catecholaminergic nuclei in the brainstem, has provided an important new tool for the study of Parkinson's disease. In this article we review several specific areas related to current research on MPTP, including the question of disease progression, issues regarding the validity of the animal model induced by MPTP, the role of aging in regard to its neurotoxicity and Parkinson's disease, and new therapeutic strategies that have evolved from basic research with the compound. We conclude that both clinical and basic research stemming from the discovery of MPTP have provided valuable insights regarding both the cause and treatment of Parkinson's disease. PMID- 2694735 TI - Strategy and tactic of modern Parkinson therapy. AB - The aim of modern Parkinson therapy is to overcome the dopamine deficit in the brain of parkinsonian patients which is the cause of their motor disability. This can be achieved in two ways: (a) substitution of the lacking dopamine by l-dopa, or (b) stimulation of the endogenous biosynthesis by activating the enzyme tyrosine hydroxylase. The latter approach is possible by the iron compound oxyferriscorbone or by the coenzyme nicotinamide adenine dinucleotide (NADH). In addition to these two major medications the essential therapeutic additives such as the decarboxylase inhibitor benserazide, the monoamineoxidase B inhibitor deprenyl and the dopamine receptor agonist lisuride should be used for the fine adjustment of the individual patient. PMID- 2694736 TI - Problems and unanswered questions concerning levodopa treatment in Parkinson's disease. AB - The main problems in long-term treatment of Parkinson's disease with levodopa are: 1. progressive decline in efficacy; 2. psychiatric complications; 3. the development of motor fluctuations. These are discussed, and important unanswered questions addressed, including when levodopa therapy should be started and at what dose; whether levodopa is in fact harmful in any way; what is the pharmacological role of O-methyl-dopa, present in such high concentrations; and the best management of motor fluctuations. PMID- 2694737 TI - RU 486 (mifepristone): clinical trials in China. AB - Four multicentre clinical trials on interruption of early pregnancy (less than or equal to 49 days of amenorrhea) using RU 486 have been conducted in China, including 2321 subjects. The data from trials 1, 2 and 4 are presented here. RU 486 (600 mg as a single dose) was given to 299 women. A further 422 women were given RU 486 (600 mg) plus a vaginal suppository containing the Chinese domestic prostaglandin PGO5 (1 mg) 36-60 hours later. Complete abortion was achieved in 63.5% of patients receiving RU 486 alone and in 94.1% of patients receiving RU 486 plus PG (p less than 0.001). RU 486 given alone showed decreasing efficacy as the duration of amenorrhea increased. However, RU 486 combined with PG was equally effective at all time points studied (less than or equal to 35 days of amenorrhea: 98.1%, 36-42 days: 92%, 42-49 days: 87.4%). When compared with RU 486 alone Ru 486 + PG also produced a shorter bleeding time and a lower volume of blood loss (n = 21, 52 ml vs n = 13, 117 ml). Two patients from the RU 486+PG group and 4 given RU 486 alone suffered heavy bleeding, necessitating emergency curettage. No transfusions were required. The time elapsed between RU 486 intake and expulsion of the conceptus was significantly shorter in the RU 486+PG group (n = 97, 31 days) than that in the RU 486 alone group (n = 95, 4.4 4.4 days). Main side effects, nausea/vomiting and headache/dizziness, were mainly due to RU 486. PG increased the incidence of diarrhea and uterine cramp.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694738 TI - Contragestion with RU 486: a new approach to postovulatory fertility control. AB - The steroidal derivative RU 486 (17 beta-hydroxy-11 beta-(4-dimethyl-aminophenyl) 17 alpha-(prop-1-ynyl) ester-4, 9-dien-3-one) is the first potent antiprogestin to be used clinically. RU 486 blocks the action of progesterone by a reversible inhibition of the action of progesterone on its own receptors. This reversibility allows endocrine functions to return quickly to normal after discontinuation of treatment. However, target cells which depend upon a continuity of progesterone action will be irreversibly disrupted by receptor blockade. In normal women, RU 486 acts during the luteal phase in the endometrium, provoking bleeding, and decreasing pituitary luteinizing hormone (LH) secretion and hence luteolysis. In pregnant women, it affects the decidua, increases myometrial contractility and ripening of the cervix and ultimately leads to termination of pregnancy. Detachment of the trophoblast leads to a further fall in gonadotropin production. Clinical studies indicate that RU 486 can be a very efficient agent for the termination of early pregnancy, and as a postcoital menstrual regulator. In about 20% of cases when RU 486 is given alone, termination of pregnancy fails. This can be overcome by taking in addition a small amount of prostaglandin. PMID- 2694739 TI - Clinical trials with RU 486 (mifepristone): an update. AB - This paper reviews much of the clinical data obtained with the antiprogestin RU 486 (mifepristone) in the fields of obstetrics and gynecology. To interrupt early pregnancy (less than 50 days of amenorrhea) RU 486 as a single dose of 600 mg followed 36-48 hours later by a prostaglandin derivative, constitutes an alternative to vacuum aspiration or dilatation and curettage (D and C). All three methods have comparable efficacy, provided that they are performed in centers with adequate medical facilities. RU 486 is the first antiprogestational steroid available for clinical purposes. Its pharmacological properties have been reviewed in detail elsewhere (1,2). The present paper reviews the main clinical data obtained during trials monitored by Roussel Uclaf. PMID- 2694740 TI - Gestrinone in the treatment of myomas. AB - In a study involving over 300 women, gestrinone has been found to induce regression of uterine myomas. Gestrinone was given in doses of 2.5-5 mg (orally or by vaginal pessary), two or three times weekly. The treatment regimen depended upon tumor size and tumor age. Patients with small tumors, i.e. uterine volumes of less than 200 cm3, were treated for 6 months, whereas those with uterine volumes of 200-300 cm3 were treated for 1 year. In severe cases where uterine volumes were greater than 400 cm3, the patients were treated for 2 years. Large myomas of 300 cm3 or more required higher doses of steroid. During the first 6 months of treatment there was a marked reduction in uterine volume, but subsequently the rate of tumor regression was slower. Following discontinuation of treatment, reactivation of tumor growth was slow in most patients. Gestrinone caused amenorrhea in all patients and in most women it lasted throughout therapy. The abdominal discomfort, dyspareunia and dysuria which resulted from the myoma were progressively alleviated during treatment. Most patients experienced at least some side-effects associated with the mild androgenicity of gestrinone. These included weight gain, seborrhea and acne (which developed in most patients). Hirsutism, hoarseness and increase in libido were less common, affecting 10-20% of patients, depending on the dose and duration of treatment. All side effects were reversible. PMID- 2694741 TI - Reduced rate of postoperative infections in emergency cesarean section after two doses of cefuroxim perioperatively. A placebo-controlled study. AB - The rate of postoperative infections after cesarean section was studied in a prospective double-blind randomized study to compare cefuroxim with a placebo. Intravenous bolus injections were given at the beginning of, and 12h after the operation. Eighty patients received cefuroxim and 80 received placebo. Endometritis or wound infection, or both, was diagnosed in 2/80 (2.5%) patients receiving cefuroxim and in 23/80 (29%) patients receiving placebo. No side effects were demonstrated or reported by the patients. Thus, two bolus injections of 1.5 g of cefuroxim given perioperatively significantly reduced postoperative infectious morbidity after emergency cesarean section. PMID- 2694742 TI - Preoperative clindamycin treatment and vaginal drainage in hysterectomy. AB - In a randomised study, comprising 166 patients, aged 25-75 years, the effect of a single preoperative dose of Clindamycin was compared with no antibiotic treatment at all in patients undergoing elective abdominal hysterectomy with drainage of the upper part of the vagina. Febrile Morbidity, frequency of postoperative infections, the amount of secretion and the number of hospital days were recorded. Preoperative administration of clindamycin resulted in a reduction (from 24% to 14%) in the febrile morbidity, and in the amount of secretion (from 24 to 12.5 ml) both of marginal statistical significance, whereas the reduction in the frequency of postoperative infections (from 19 to 10%) was without statistical significance. A statistically significant reduction in the hospitalisation period (from 8.4 to 7.9 days) was observed. The frequency of urinary tract infections was similar in the two groups. No adverse reactions occurred in connection with the clindamycin treatment. PMID- 2694743 TI - Gonadotropin--releasing hormone agonist as an adjunct in conservative surgery for uterine leiomyomas. AB - Preoperative treatment of a large uterine leiomyoma with a gonadotropin-releasing hormone agonist resulted in a volume reduction of 45%. PMID- 2694744 TI - Termination of early pregnancy with RU 486 (mifepristone) in combination with a prostaglandin analogue (sulprostone). AB - The antiprogestin RU 486 (mifepristone) has been shown to induce abortion when administered in early pregnancy, but the rate of incomplete abortion is high, around 40%. As blockage of the progesterone receptor increases the myometrial sensitivity to prostaglandins, a combination of RU 486 and a prostaglandin E2 analogue was tested for termination of pregnancy. One hundred and sixteen women, with a gestational length of less than 49 days from the first day of the last menstrual period, were treated with a daily dose of 50 or 100 mg RU 486 for 3 to 6 days, complemented with an intramuscular dose of 0.25 mg sulprostone (16 phenoxy-PGE2-sulfonylamide) on the last day of RU 486 treatment. The results confirmed that a reduction of treatment duration to 3 days is just as effective for inducing abortion (91% complete abortion) as a 4-6-day treatment regimen (95% complete abortion). Six patients had an incomplete abortion and in one the pregnancy continued unaffected. Side effects included intense uterine pain after the prostaglandin administration (16%), vomiting associated with the antiprogestin intake (9%) and after the prostaglandin administration (9%). One woman needed emergency curettage due to heavy bleeding. Six percent of the treated patients had a decrease in hemoglobin exceeding 20 g/l during the first week but no patient needed blood transfusion. No serious side effects were recorded. PMID- 2694746 TI - Granular corneal dystrophy Groenouw type I (GrI) and Reis-Bucklers' corneal dystrophy (R-B). One entity? AB - This paper maintains that Reis-Bucklers' corneal dystrophy and granular corneal dystrophy Groenouw type I are one and the same disease. Included are some of the technically best photographs of Reis-Bucklers' dystrophy found in the literature, and these are compared with photographs from patients with granular corneal dystrophy examined by the author. It is argued that most of the histological and ultrastructural findings on Reis Bucklers' dystrophy described in the literature are either congruent with what is found in granular corneal dystrophy or unspecific. PMID- 2694745 TI - Preoperative dilatation of the cervix at legal abortion with a synthetic, fast swelling hygroscopic tent. AB - Preoperative dilatation of the cervix at first trimester legal abortion has been shown to facilitate the vacuum aspiration procedure and to reduce per- and postoperative complications as well as late sequelae. The present study represents a clinical trial in which a new synthetic hygroscopic tent, Dilapan, has been evaluated. Dilapan tents of different diameters with different durations of cervical exposure were tested on a case material of 450 nulliparous women. It was found that treatment with 4 mm tents during 3-4 h or 3 mm tents during 16-20 h produced a cervical dilatation that allowed an easy evacuation of the uterus with a minimum of complications. The advantage of this particular tent is its property of rapid swelling. PMID- 2694747 TI - Central corneal thickness in full-term newborns. AB - The central corneal thickness (CCT) was measured in 30 full-term newborns in the first week post partum using ultrasonic pachometry. The mean CCT in the right eyes was 0.581 +/- 0.047 mm. In 19 babies the CCT was measured twice. The mean CCT in the second reading was 0.584 +/- 0.042 mm. This difference was not statistically significant. There was no correlation between gestational age, birth weight and length, and CCT. The small difference between girls and boys was not statistically significant. The values in the left eyes were similar to the data for the right eyes. These results confirm the results in the only previous study on CCT in newborns, that is, that CCT is significantly larger than the CCT in adults. PMID- 2694748 TI - [2-stage reconstruction of extensive subglottic tracheal stenosis]. AB - The authors describe an open technique, used over the past 25 years to reconstruct the subglottic region in two stages after extensive laryngo-tracheal stenosis. After submucosal resection of fibrous tissue and reconstruction of the subglottic-tracheal skeleton by means of two autologous osseous grafts, a large laryngo-tracheostomy is created during the initial stage. A few weeks later, in a second stage, the anterior wall is closed using two cervical hinge-door flaps. Ten patients underwent this procedure and have had a minimal follow-up of 3 years. All ten patients could be decannulated after completion of the treatment and no recurrence of a stenosis could be observed during the follow-up. PMID- 2694749 TI - Radiosensitizing with cis-platin in advanced head and neck cancer. Results and problems. AB - Treatment consisting of surgery and/or radiation therapy for patients with squamous cell carcinoma of the head and neck has frequently been successful in earlier stages of disease. Advanced and non-resectable tumor stages have a very poor cure rate. We initiated this trail to assess the role of the potentiation between cis-PDD and radiation previously reported in advanced head and neck tumors. Eighteen patients were investigated in this study. The treatment consisted of cis-PDD and hyperfractionated radiotherapy. Seventeen (94%) of the patients responded to the treatment regimen with either a complete regression (5/18 = 33%) or a partial regression (11/18 = 61%) of the tumor. Median survival was short and lasted 12+ months among complete responders and 8+ months among partial responders. However all patients did experience an increased and not tolerable incidence of delayed radiation toxicity such as mucositis combined with necrotic stomatitis. Both complications limited the compliance to the therapy. Because of these complications we had to stop the ongoing study. PMID- 2694750 TI - Some remarks on nasal polyposis. AB - After a short historical and literature review the authors present their definition of nasal polyposis. The importance of CT scanning is stressed and the results of a CT-scan study of 350 patients with nasal complaints is presented. The authors discuss the incidence of sinusitis, presence of polypi and nasal anomalies in this population. Furthermore 111 biopsies of nasal polypi were studied and the cellular content, the ducts, glands, veins, aspect of the basal membrane and epithelial layer were described. As an oral ASA provocation test can be hazardous, the authors tested a nasal provocation test with acetylsalicylic acid. Although the test showed some interesting results, the reproducibility was poor. Finally the authors conclude that endoscopy and CT-scanning enable the diagnosis of nasal polyposis in an early stage of the disease. PMID- 2694751 TI - [Echographic studies of the paranasal sinuses]. AB - On the basis of a literature review the author describes the use of the A-mode echography for examination of the paranasal sinuses. He concludes that echography is a useful additional investigation method for the evaluation of sinus pathology. PMID- 2694752 TI - [Nasal respiratory stenosis and maxillary hypoplasia. Changes after orthodontic treatment with rapid palatal expansion]. AB - The relationship between hypoplasia of the upper maxillary bone and nasal respiratory insufficiency in a group of twenty infants with malocclusion being treated by rapid maxillary expansion (RME) were studied. Prior to treatment all patients presented endognatia with discrepancies of from -4 to -7 mm in the transverse basal skeleton. These were often associated with adenoid hypertrophy (70% of the cases), increased total nasal resistance (70%), oral respiration (80%) and middle ear diseases (30%). RME led to resolution of occlusion alterations in all cases and often also brought about a regression in adenoid hypertrophy (57% of the cases), normalization of the total nasal resistance (70%) and respiration (80%). These effects were achieved alone without association with any other form of medical or surgical E.N.T. treatment. The functional results confirmed by the radiological and clinical findings indicate an increase in the diameters of the nasal fossa and in the distance between the canines, between premolars and between molars as well as reduction in adenoid vegetation and in the diffuse hypertrophic tissues lining the naso-pharyngeal space. Nonetheless, hypoplasia of the upper maxillary bone and nasal respiratory insufficiency remain strictly linked and are bound to a variable, and at times uncertain, cause-effect relationship. Is nasal stenosis the moving force of maxillary-mandibular dysmorphism and gnatological dysfunction or does it result from an overall genetic conditioning of facial skeleton development? During their vast experience in adenoid and metadenoid pathologies in infancy the authors have, at times, observed significant maxillo-facial dysmorphisms. They have likewise found that "facies adenoidea" were not always associated with hypertrophy of the pharyngeal tonsil.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694754 TI - Predictive and preventive pathology of cardiovascular diseases. AB - The development of genetic models for research on hypertension and stroke, spontaneously hypertensive rats (SHR) and stroke-prone SHR (SHRSP), have contributed not only to the elucidation of the pathogenesis of hypertension related cardiovascular diseases (CVD) but also to their prediction and prevention. Since both genetic and environmental factors are involved in the pathogenesis of hypertension and stroke in SHR and SHRSP, the detection of the genetic factors and the control of environmental factors have been proven to be useful as predictive and preventive measures against hypertension and related CVD. Early rise in blood pressure, sympathetic overresponsiveness, early development of cardiovascular hypertrophy, increased salt-sensitivity and membrane abnormalities detected in vascular smooth muscle cells (VSMC) from SHR and SHRSP, which are related to the pathogenesis of hypertension, have been examined for their applicability to the prediction of hypertension in man. Pathogenic mechanisms of stroke in SHRSP have been studied by electron microscopy, and VSMC degeneration and necrosis were noted to start at the outer media of intracerebral arteries which were exposed to local hypoxia and hyponutrition due to limited diffusion through the blood-brain barrier. Macrophages are involved in the process of arterionecrosis with fibrin deposition in SHRSP, and their involvement has also been proven immunohistochemically in human autopsy cases. Moreover, reduction of regional cerebral blood flow, hypoxic vulnerability of the brain detected by the NMR technique and additional cellular abnormalities such as membrane fragility and accelerated lipid incorporation may possibly be applied to the prediction of stroke and atherosclerotic diseases in man. On the other hand, experimental control of cellular, neural and vascular mechanisms of hypertension and stroke in these animal models have been proven to be effective for the prevention of CVD not only pharmacologically but also non pharmacologically by dietary sodium reduction, and increased intake of potassium, calcium, protein and dietary fiber. The applicability of dietary control of hypertension and stroke to humans has been supported by our epidemiological studies in Japan as well as by the WHO-coordinated international cooperative study on cardiovascular diseases and alimentary comparison (WHO CARDIAC study). These new experimental and epidemiological findings are extending new horizons in medicine, where the main medical activity should be focused on the prediction of diseases by detecting genetic disposition as well as on prevention by the control of environmental factors. PMID- 2694753 TI - [Intra-parotid lymph node metastasis of malignant skin neoplasms of the head]. AB - More than 75% of parotid metastases represent a secondary localization in the parotid region lymph nodes of malignancies arising from the skin of the head. Among 94 parotidectomies performed at the Otolaryngologic Clinic of the University of Brescia in the years 1980-1987, 21 were primary malignant growths and of these 5 (23.8%) proved to be intraparotid lymph node metastases of previously resected cutaneous tumors of the face (1 melanoma and 4 squamous cell carcinomas). Parotid metastases were treated by lateral (3 cases) or total parotidectomy (2 cases) with preservation of the facial nerve; in 4 cases a homolateral neck dissection of the functional type was performed in the same session (N+ in 1 case only). Three out of four patients with squamous cell carcinoma were subsequently submitted to Co60 radiation therapy. Four patients died 1 to 22 months after the treatment: in three, death was due to a local recurrence or a distant metastasis; in 1 case to osteoradionecrosis with no signs of relapse of the tumor. One patient only treated with total parotidectomy, functional neck dissection (N-) and postoperative radiation therapy is still alive and free of disease 18 months after surgery. PMID- 2694755 TI - An electron microscopic study of hepatic angiomyolipoma. AB - Three cases of hepatic angiomyolipoma, each composed of an intimate mixture of numerous abnormal blood vessels and various-sized fat, spindle and/or epithelioid cells, are presented along with the findings of an electron microscopic study. The spindle cells were confirmed to be smooth muscle by immunohistochemical staining for desmin and by their ultrastructural characteristics. The mature fat cells, smooth muscle cells, immature short spindle cells apparently intermediate or transitional between the former two cell types, and the epithelioid cells were observed adjacent to the endothelial cells. Ultrastructurally, the epithelioid cells were characterized by unusual cytoplasmic organelles such as myofilaments having focal densities and dense attachments, numerous large electron-dense bodies, and a large number of glycogen particles and lipid droplets. Therefore, it is considered that the immature short spindle and epithelioid cells in hepatic angiomyolipoma might be primitive mesenchymal cells having an ability to differentiate toward both smooth muscle and fat cells. PMID- 2694757 TI - [Pharmacodynamics of dihydroartemisinine against Plasmodium berghei in mice]. AB - Dihydroartemisinine (DHA) is a derivative of qinghaosu(artemisine), which is an antimalarial drug. DHA was given to mice inoculated with Plasmodium berhgei ANKA strain by intramuscular injection. Within proper dose range, the dose-effect and time-effect curves of DHA against the malaria can be described by y = 4.9960 + 2.9536 x and y = 7.2654 - 0.3414 t, respectively, where y is the estimated value of parasitemia suppressing rate in probit; x is log dose; t is the period since drug administration im. Accordingly, the ED50 = 1.00 +/- 0.13 mg/kg and the time of half-effect was 6.6 h, when the dose was 5.0 mg/kg im. The elimination rate constant of the effective dose in vivo was 0.2662h-1 with a half-life of 2.6 h. PMID- 2694756 TI - An unusual hormone pattern in a virilized woman affected by Sertoli-Leydig cell tumor. Report of a case. AB - A 24-year-old woman was admitted to hospital because of hirsutism, virilism and amenorrhea, which had appeared 6 months earlier. Endocrinological evaluation showed a slightly elevated serum level of testosterone (1.2 +/- 0.05 ng/ml), normal plasma levels of dehydroepiandrosteronesulfate (DHEA-S) (2,070 +/- 6 ng/ml), androstenedione (1.8 +/- 0.5 ng/ml) and sex hormone-binding globulin (SHBG)(42 +/- 3 nM/L); there was normal urinary 17-ketosteroid (17-KS) excretion (11.7 mg/24 h), low urinary estrogen (E) excretion (3 +/- 0.4 micrograms/24 h), suppressed basal gonadotropin concentrations (LH 0.9 microUI/ml; FSH 3.2 microUI/ml) and an exaggerated response to the LH-RH test. At laparotomy, a monolateral ovarian tumor was found, which was proved histologically to be a Sertoli-Leydig cell tumor. After tumor ablation, a regular menstrual cycle followed and progressive reduction of virilism was noted. This was followed within 4 months by complete normalization of LH, FSH, estrogen and progesterone serum levels. The responsiveness to LH-RH also became normalized. Two years after this operation, the patient had a normal pregnancy. This case of virilization in a woman affected by a benign Sertoli-Leydig cell tumor was primarily characterized by an unusual response of the hypothalamopituitary axis against an endocrinological background of notable alteration of the androgen/estrogen ratio, where the androgens were slightly increased and the estrogens greatly reduced. PMID- 2694758 TI - [Synthesis and antimalarial and antineoplastic activities of some derivatives of 2,4-diamino-5-methyl-6-substituted benzylaminoquinazolines]. AB - This paper reports the synthesis and the antimalarial and anticancer activities of some derivatives of 2,4-diamino-5-methyl-6-substituted benzylaminoquinazolines. These compounds were synthesized by condensation of 5 methyl-2,4,6-triaminoquinazoline with substituted benzyaldehyde to produce Schiff base, followed by reduction, formylation or nitrosation. The suppressive therapeutic effects against Plasmodium berghei in mice showed that the suppressive rate of three compounds (IV 2,5,6)was 100 per cent at the dosage 5 mg/kg. The anticancer activity in vitro showed that II7 and IV3 had the strongest inhibition and their IC50 against L1210 Leukemia cell were 3.910 X 10(-3) micrograms/ml and 6.172 X 10(-3) micrograms/ml. PMID- 2694759 TI - Effects of Tremella polysaccharides on immune function in mice. AB - It was found in vitro that Tremella polysaccharides (TP) (50, 100, 150 and 200 micrograms/ml) augmented lymphocyte proliferation induced by Con A and did not antagonize the suppressive effect of hydrocortisone on lymphocyte proliferation. In vivo TP promoted the plaque-forming cell (PFC) response to SRBC in mice. TP 50 and 100 mg/kg ip for 5 d produced 77.6% and 81.8% increases in PFC response respectively. At the doses of 150 and 200 micrograms/ml, TP decreased the interleukin 2 (IL-2) activities in the supernatant of culture media of mouse spleen cells. TP (50 micrograms/ml) enhanced the lymphocyte proliferation induced by Con A and increased the PFC response to SRBC by 47.1% in 14-month-old mice. PMID- 2694760 TI - [Influence of aminophylline on immune function of mice]. AB - The effects of aminophylline (Ami) on immune systems in normal NIH mice were studied. Ami ig 25, 50 and 100 mg/(kg.d) x 8-10 d increased hemolytic ability of plaque forming cells and antibody concentration while it decreased the delayed type hypersensitivity (DTH) reaction and peripheral white blood cells phagocytosing function. Ami 1, 5, 10 micrograms/ml also promoted lymphocyte transformation of [methyl-3H] TdR incorporation induced by PHA in vitro. PMID- 2694761 TI - Specificity of the cell-to-cell transmission of hormonal imprinting in cell cultures. AB - Chang liver cells and Chinese hamster ovary (CHO) cells were imprinted either with insulin or with thyrotropin (TSH). Chang liver cells responded to insulin but not to TSH. As an effect of imprinting evoked by insulin administration the binding of insulin administered for the second time was enhanced. In the mixed culture of imprinted and intact cells the extent of the binding was similar to that seen in the cultures of the cells having received imprintatory treatment alone. CHO cells also responded to TSH, imprinting developed and was transmitted to the cells which were not in interaction with the hormone (intact cells). In CHO cells also insulin gave rise to imprinting for insulin, whereas TSH gave rise to moderate binding imprinting for insulin. On the other hand, insulin imprinting did not enhance the binding of TSH. The obtained results indicate that both the imprinting itself and the specificity of the transmission of imprinting depend on the characteristics of the cell-type in question. The extent of the transmission, however, is always proportional to the extent of imprinting. PMID- 2694762 TI - Conditioned taste aversion elicited by intracerebral administration of drugs. AB - Conditioned taste aversion (CTA) is a vital adaptive reaction governed by highly reliable but poorly understood central mechanisms. In an attempt to elucidate the site of action of various CTA eliciting drugs, equipotent dosages were applied by the systemic (i.p.) and intracerebral (i.c.) route. Rats were offered water on days 1 and 2. On day 3 they received 0.1% sodium saccharin (CS) followed by pentobarbital anaesthesia and i.p. or i.c. injection of the drug (US). After water on day 4, the rats were allowed to choose between water and saccharin on day 5. The putative central action of amphetamine was not confirmed by this experimental arrangement, since CTA was evoked by only moderately (about 10 times) lower i.c. than i.p. dosages. Similar ratio of the i.c. to i.p. effective dosages was obtained with carbachol. On the other hand, CTA of clearly central origin was caused by harmaline and by other monoamine oxidase inhibitors, pargyline and clorgyline, which elicited comparable aversion using 500, 400 and 250 times lower i.c. than i.p. dosages, respectively. The intracerebral gradient of the effect pointed to the lower medulla (inferior olive, raphe nuclei) as the critical brain region and to serotonin as the transmitter participating in the aversive labeling of the gustatory stimulus. The CTA-forming mechanism can also be studied by analysing the action of drugs, e.g. convulsants, which do not produce CTA even when applied at highly toxic dosages (LD 50) eliciting long lasting convulsions (picrotoxin, 5 mg/kg; bicuculline, 5 mg/kg). It is concluded that comparison of brain events elicited by drugs which can or cannot serve as unconditioned stimuli in the CTA paradigm may substantially contribute to the exploration of the underlying neural mechanisms. PMID- 2694763 TI - Endocrinological aspects of potassium metabolism. AB - After reviewing the anatomy and physiology of potassium the endocrine regulation of the "external" and "internal" potassium balance is summarized. As the plasma potassium concentration has an extraordinary role in the maintenance of the activity of the living cell membrane, the review focuses on endocrine factors inducing hypokalaemia and hyperkalaemia. Modern research has revealed many renal and extrarenal influences and we have learned a lot concerning the development of plasma potassium changes. The renal and extrarenal mechanisms governing potassium homeostasis are regulated by precisely coordinated endocrine mediators. The most important hormones involved in the regulation of internal potassium balance are the catecholamines, insulin and aldosterone. Several drugs causing changes in the plasma potassium level exert their effect through the above mentioned hormones. PMID- 2694764 TI - Clinical evaluation of acetylsalicylic acid to improve glycemia in type II diabetic patients. AB - The glycoregulation of 17 type II diabetics was observed to improve by administering 1 g of acetylsalicylic acid three times per day, during a one-year study. The subjects did not lose weight during the experimental period, but the insulin daily requirement of 7 patients did decrease by 60%. PMID- 2694765 TI - Effects of continuous positive- and negative-pressure breathing on the pattern of breathing in man during exercise. AB - Breathing pattern and static lung volumes were studied in 10 subjects at rest and during incremental-load cycle ergometry under three different conditions, viz. with normal pressure in the airways (control) and during continuous positive- and negative-pressure breathing (CPPB, CNPB) of +15 and -15 cmH2O. End-expiratory, end-inspiratory and mid-expiratory volumes were increased by CPPB and decreased by CNPB; these effects were especially pronounced at rest and during mild exercise. Both at rest and during exercise mean inspiratory flow (VT/TI) was exaggerated by CPPB and attenuated by CNPB. At rest these changes were due mainly to concomitant changes in tidal volume (VT) which was increased by CPPB and decreased by CNPB, while inspiratory time duration (TI) was relatively unaffected by pressure breathing. The transition from rest to loadless pedalling induced an increase in VT but no change in TI in the control condition, whereas in the CPPB and CNPB conditions TI decreased and VT remained unaltered. This CPPB- and CNPB induced change in the volume-time threshold relationship at the onset of pedalling is attributed to increased stretch receptor activity in the extrathoracic portion of the trachea as a result of the increments in transmural pressure. During the course of exercise there was an inverse relationship between the slope of the VT-TI curve and the mid-expiratory volume in that the slope was greater in the control than in the CPPB condition and greatest during CNPB, suggesting that in exercise hyperpnoea the VT-TI relationship is also determined by pulmonary and/or thoracic wall stretch receptors capable of sensing the absolute lung volume. PMID- 2694766 TI - Increased plasma levels of endothelin-like immunoreactivity during endotoxin administration in the pig. PMID- 2694767 TI - The Scottish first episode schizophrenia study. VII. Two-year follow-up. Scottish Schizophrenia Research Group. AB - Of 49 schizophrenic patients followed up 2 years after their first admission to hospital, 37% were well, 47% had been readmitted to hospital at some time over the 2 years, and 38% showed schizophrenic symptoms at follow-up. A poor outcome at 2 years was associated with male sex, poor outcome after the first 5 weeks of the first admission, negative schizophrenic symptoms on first admission, and a diagnosis of definite or probable schizophrenia using the Feighner criteria. Only 23% were in employment. A small double-blind discontinuation study of maintenance antipsychotic medication during the second year found more relapses in those switched to placebo medication. Repeat psychometric assessment at 2 years confirmed modest improvements found at 12 months; that is, there was no evidence of intellectual decline. Relatives showed no more psychosocial distress than that found in a normal community sample; what distress there was correlated with patients' schizophrenic symptoms. PMID- 2694768 TI - [Epidemiology: concepts and diagnosis of diabetes mellitus]. AB - A review is presented of present concepts about diabetes mellitus and the several etiopathogenic mechanisms. Diagnostic criteria and classification are summarised. Some epidemiological data and their implications on prevention are reviewed. PMID- 2694769 TI - [Biguanides in the treatment of diabetes mellitus]. AB - Biguanides are useful drugs in diabetes but their indications are very precise. The danger of lactic acidosis can be avoided with the use of metformin, the less toxic of biguanides, and strict respect for contraindications. All biguanides have a similar action, through different pharmacokinetics, and besides their hypoglycemic effect, have a favourable action on blood lipids, which increases their usefulness. Haemorheological effects, recently studied in animal research, may open a new field in the employment of biguanides. PMID- 2694770 TI - [Insulinotherapy]. AB - Pharmacological aspects of presently used insulins are reviewed. A discussion of different forms of insulin therapy in insulin dependent and non insulin dependent diabetes mellitus is presented. PMID- 2694771 TI - [Hypoglycemia]. AB - With near optimal metabolic control, in diabetes mellitus, hypoglycaemia has become a very important problem. Its main causes are excessive insulin or sulfonylurea dosages, omission of meals, unprogrammed physical exercise or disturbances of the neurohormonal counterregulatory mechanisms. PMID- 2694772 TI - [Hypoglycemia: prevention and treatment]. AB - The main measure against hypoglycaemia in diabetes mellitus is prevention by educating patients, their relatives and close friends. Therapy of a hypoglycaemic reaction depends on its severity cause and type of diabetes. Administration of small molecule sugars (saccharose/glucose) is mandatory. Full recovery is usual depending on the rapidity of diagnosis and treatment. Therapeutic measures for diverse hypoglycaemic situations and some practical considerations in relation to prevention are discussed by the authors. PMID- 2694773 TI - [Diabetes mellitus and pregnancy]. AB - The author presents a review of the metabolic alterations occurring during pregnancy and of the maternal and fetal risks of diabetes pregnancy. The problems of diabetic patients who become pregnant are discussed as well as gestational diabetes and its diagnostic criteria. PMID- 2694774 TI - [Diabetes mellitus and pregnancy--treatment]. AB - Correct treatment of diabetes during pregnancy is of utmost importance, in the previously diabetic woman as well as in gestational diabetes. It is aimed at avoiding consequences of the metabolic disturbances on the mother and the fetus. Intensive insulin therapy and correct food intake are the cornerstones of treatment, euglycaemia without hypoglycaemic reactions or ketosis being their goal. PMID- 2694775 TI - [Long-term complications in diabetes mellitus]. AB - Diabetes mellitus is a chronic disease with early and late complications. In the clinical care provided to diabetics, prevention of late complications is as important as good metabolic control. To achieve these goals education of the diabetic subject is essential. Eye and nervous system complications are particularly highlighted. PMID- 2694776 TI - [The diabetic foot]. AB - A review of the physiopathology of foot problems in diabetics is presented and the need for all the members of the health care team to take part in educating the diabetic in appropriated foot care is stressed. A quick evaluation of three components (vascular, neuropathic and infectious) is essential. Primary and secondary prevention with proper evaluation of predisposing and precipitating factors are stressed as fundamental to reduce the number of amputations and improve quality of life. PMID- 2694777 TI - [Arterial hypertension in diabetes mellitus. Etiopathogenesis and treatment]. AB - The different aspects of the etiopathogenesis of arterial hypertension in diabetes mellitus are reviewed. Therapeutic approaches and the several phases of treatment are discussed, with particular emphasis on the most recent developments. PMID- 2694778 TI - [Cardiac complications of diabetes mellitus]. PMID- 2694779 TI - [Diabetes mellitus in the elderly]. AB - The authors discuss the pathogenesis of glucose intolerance occurring in advanced age and the importance of peripheral insulin resistance due to deficiency of post receptor mechanisms. Prevalence of diabetes increases with age and its diagnosis should not be overlooked as it can cause considerable morbidity and mortality in this age group. Acute and chronic complications are discussed as well as the aggravating influence of coexistent pathology and its medication, and of social, environmental and economic factors. Therapeutic measures and desirable therapeutic goals are considered for this specific age group, taking into account the need for an individualised treatment and the priority of well being and safety over too strict control. PMID- 2694780 TI - [Nutrition and physical exercise in diabetes mellitus]. AB - Correct food intake and physical exercise, together with insulin or oral antidiabetics constitute the basic triad of diabetes treatment. The authors discuss the general rules of dietetic measures in diabetes and review the importance of physical exercise, its indications and limitations in the metabolic control of the diabetic subject. PMID- 2694781 TI - Diabetes mellitus type I. The present and the future. AB - Insulin dependent diabetes is an organ specific immunologic disease caused by pancreatic B cell destruction, mediated by T lymphocytes Present knowledge about insulin dependent diabetes immunogenetics and their relationship with the HLA system is reviewed, highlighting the polymorphism of the D area of that system and its connectors with diabetes. Possible therapeutic interventions in the autoimmune destructive process are discussed. PMID- 2694782 TI - [Sulfonylureas]. AB - Oral antidiabetics are an important aspect of treatment in many diabetics and in the last few years with new developments in the knowledge of type II diabetes physiopathology, there has been a lot of interest in their actions mechanisms. Oral therapy is nevertheless a mere complement which needs to be fitted into a wider group of measures: diabetics have to receive education to become active participants striving for good control, through self-monitoring, regular physical exercise and adequate diet and general hygienic measures. PMID- 2694783 TI - [Kidney transplant: the current situation in Portugal, 1989]. AB - The modern treatment of renal failure has been one of the most exciting developments of modern medicine. Within this field the portuguese doctors had a performance that compares with the average developed countries. The number of patients that need haemodialysis and renal transplantation is still increasing. These treatments are very expensive. As the patients would die if not treated, this whole issue is a political concern and a public health problem. We give the demographic outline of this CRF patients group. Dialysis and transplantation should be in balance, with a particular stress on transplantation because it is much less expensive. Shortness of organ supply has been like elsewhere the most important limiting factor of renal transplantation. Some public controversy concerning brain death, permission, and commercial profit from organ donation, has been sometimes deleterious. We review the results of renal transplantation. In 1987 and 1988, 92% of transplanted kidneys had still function after one year. We conclude that our programs in Portugal can expand, on the condition that people keep their acceptance and give their support to transplanting teams. PMID- 2694784 TI - [Bone marrow transplant: current perspectives]. AB - Bone marrow transplantation was introduced over thirty years ago in the treatment of several immuno-hematological conditions. During the last decade, there has been a substantial increase in the number of transplanted patients. However, results over the last five years have not significantly improved. Clinical indication conditioning regimens and related complications are reviewed and new developments pointed out. PMID- 2694785 TI - [The state of the art in cardiology: realities and perspectives of ischemic cardiopathy for the 90's]. PMID- 2694786 TI - [Relation of basic sciences and medicine: institutional, professional and pedagogic implications]. PMID- 2694787 TI - [The state of the art in cardiothoracic surgery: development of thoracic surgery]. PMID- 2694788 TI - [The state of the art in immuno-allergology: histamine releasing factors (HRF)]. AB - The present concepts on histamine releasing factors are discussed, their cellular origins, their effect on the target cells and its importance in asthma immunopathology. Personal results on the production of HRF by alveolar macrophages stimulated by allergen and its action on non atopic basophils are presented. Alveolar macrophages from atopic asthmatics release HRF in presence of allergen. Macrophage from non atopic do not. HRF has been tested in a Human Basophil Degranulation Test (HBDT) preparation, a significant degranulation induced by HRF from atopic patient being only observed when atopic basophils are used in HBDT. These results confirm that allergen could induce HRF production from alveolar macrophages and that this HRF could degranulate basophils in atopic and induce mediators release. PMID- 2694789 TI - [The state of the art in plastic and reconstructive surgery: a growing art]. AB - On studying the state of the art in Plastic and Reconstructive Surgery there are two different aspects that have achieved very different levels of advance and progress: the organisation and establishment of this speciality, and scientific and technical progress. In an analysis of the former. The author outlines the principal problems facing Plastic Surgery in Portugal, the present shortcomings and the almost complete lack of coherent planning, and the prevailing rules for the training of new specialists. A study of the second aspect reveals manifest progress and innovation in many areas of this speciality. The Author describes in greater detail, controlled tissue growth, innovations with flaps, principally facial-cutaneous and inverted flow, advances in the remodelling of the face where there are many examples of implantation of material, modelling osteotomy and surgical interventions in the field of muscular dynamics, and lipo-aspiration which has extended horizons in both Plastic and Reconstructive Surgery. PMID- 2694790 TI - [The state of the art in rheumatology: several historic notes]. PMID- 2694791 TI - [Cardiac manifestations of connective tissue diseases]. AB - We have studied the cardiac manifestations of connective tissue diseases. In 213 files of patients with connective tissue disease of the Department of Medicina I, Hospital Santa Maria, during 21 years. Cardiac manifestations were observed in 63 (90%) SLE. Pericarditis was the most frequent manifestation and occurred in 33 patients (43%). The cardiac manifestations were observed in 40 (41%) RA. Pericarditis appeared in 11 patients, valvulopathy in 12 patients and coronaropathy in 11 patients. In 10 of PD diagnosed patients, ECG abnormalities were the only findings. Arrhythmias, conduction disturbances, cardiac failure and coronaropathy were the cardiac manifestations of PSS in 11 patients. Polyarteritis Nodosa patients had myocardial ischemia and another had a malignant hypertension diagnosis. We found pericardial effusion in one patient and angina in another one with MCTD diagnosis. We did'nt find any cardiac manifestation in AS. Cardiac manifestations are frequent in connective tissue diseases. The ECG, ECO and pathology show abnormal findings. Although there is not clinical cardiological expression of the disease we suggest the use of ECG. ECO Holter electrocardiography and isotopic myocardial perfusion scan technics in the clinical evaluation of such patients. PMID- 2694792 TI - [Functional disorders of Oddi's sphincter]. AB - The sphincter of Oddi (SO), located at a crucial anatomical site, continues to present diagnostic and therapeutic problems. A combination of the techniques of endoscopic retrograde cholangiopancreatography and manometry has permitted direct assessment of the SO function, and has opened up a new era in the study of this structure. PMID- 2694793 TI - [Oxygen free radicals]. PMID- 2694794 TI - [Congenital cardiopathy and cerebral abscess]. AB - During 1986 the authors came across two cases of brain abscess among children with congenital heart disease followed at the Pediatric Cardiology Service and decided to evaluate their global experience on the subject. In a retrospective study of 860 infants and children with cyanotic congenital heart disease and final diagnosis, there were four cases complicated with brain abscess. The following items were evaluated: prevalence of the complication, type of congenital heart disease, date and age at the diagnosis of brain abscess, diagnostic methods, neurosurgical treatment and results. The main findings were: all patients were above two years of age and had noncorrected cyanotic congenital heart disease belonging to the classic high risk group; the first two cases had been treated in other institutions and only scanty information was available; two recent cases had early diagnosis on CAT scan followed by neurosurgical treatment. All children survived. CONCLUSIONS: brain abscess is a rare but severe complication occurring in patients with noncorrected cyanotic congenital heart disease above two years of age; whenever prevention turns impossible, early diagnosis and treatment provide good short term and long term results. A multidisciplinar approach with full cooperation is advocated. PMID- 2694795 TI - [The extra-peritoneal approach in the surgical treatment of atherosclerosis in the aorto-iliac region]. AB - Based upon a series of 27 cases the results obtained with the extraperitoneal approach for the surgical management of atherosclerosis of the aorto-iliac segment, are presented and discussed. The patients, ranging in age from 55 to 87 years (mean 70.9 years) were considered as high risk patients because of associated respiratory, cardiac and renal diseases. The technique of extraperitoneal approach was applied in 8 cases (29.7%) of abdominal aortic aneurysms (AAA), and 19 cases (70.3%) of aorto-iliac occlusive disease (DOAI), with an operative mortality of 3.7%. It has been concluded that the extraperitoneal approach is an attractive alternative to the conventional transabdominal approach, particularly in those patients with significant risk factors, requiring aorto-iliac surgical reconstruction. PMID- 2694796 TI - [Neurovascular compression syndromes of the posterior fossa]. AB - The authors review the various syndromes of vascular compression of the cranial nerves in the Posterior Fossa and present a series of patients in whom a microvascular decompression was carried out. The indications for surgery, the technique and the results of this type of procedure are discussed. PMID- 2694797 TI - [Etiopathogenesis of auto-immune thyroiditis]. AB - The author reviews the etiopathogeny of autoimmune thyroiditis: sequestered antigen, clonal selection, acquired tolerance with low doses of antigen and disordered immunoregulation. The main thyroid autoantibodies, their characteristics and functions are described. The genetic susceptibility associated to HLA antigen as well as the importance of inappropriate expression in thyroid epithelium are also pointed out. The experimental autoimmune thyroiditis, induced or spontaneous is shown as a model to the study of human autoimmune thyroiditis. PMID- 2694798 TI - The development of neurosurgical techniques: the postoperative notes and sketches of Dr. Harvey Cushing. AB - In the early development of American neurosurgical techniques, Harvey Cushing is often considered the founding father. As an accomplished artist and prolific writer his original operative sketches and detailed notes at the Peter Bent Brigham Hospital (1912-1932) are now being explored as early documentation of this pioneering surgeon's development of a field. We present four brain tumor cases with his unpublished sketches and direct quotations to illustrate both the trials and tribulations of those times and Cushing's innate surgical genius. PMID- 2694799 TI - A double-blind, cross-over trial with madopar HBS in patients with Parkinson's disease. AB - Fourteen patients with Parkinson's disease and motor fluctuations were given 125 mg of Madopar HBS or placebo twice a day in addition to their optimal standard Madopar treatment in a double-blind, cross-over study. Clinical response was evaluated by the King's College Hospital Parkinson's Disease Rating Scale, the Mobility in Bed Scale and self-scoring diaries. A significant improvement with the drug was found according to the rating scales, whereas evaluation by self scoring diaries showed no significant changes. In three patients we observed worsening of abnormal involuntary movements. The present trial suggests that a low dose of Madopar HBS can be useful in addition to levodopa therapy in some patients on long-term treatment. PMID- 2694800 TI - [Surgical treatment with prosthesis implantation in 100 patients with erectile sexual dysfunction]. AB - We present our case study of 100 penile prostheses in patients suffering from erectile sexual dysfunction of different etiologies. We carry out a review of the different diagnostic stages and the different surgical approaches for prosthetic implant and their complications. PMID- 2694801 TI - [Echography and cytology versus cystoscopy in the follow-up of patients with superficial tumors of the bladder]. AB - We present a prospective study on 100 consecutive patients diagnosed with superficial vesical tumour who have had a transurethral resection done on them. For the detection of relapses we use the echography-cytology association and confirm the findings observed by performing a cystoscopy. In view of the high rate of concordancy obtained we conclude by backing this association as a possible alternative to be applied in the control of specific patients with superficial vesical tumours. PMID- 2694802 TI - [Sclerotherapy of hydroceles and spermatoceles with oxytetracyclines]. AB - We present a sclerosing treatment with oxytetracycline in 23 patients with hydrocele and 8 with spermatocele. We injected 250 mg of the drug in cases with less than 250 cc of liquid extracted and 500 mg in the others. The cure rate with the first injection reaches 69.5% and absolute failure 13.04%. Complications were 26.08%, consisting of a chemical febrile orchiepididymitis. It is a method for elderly and high-risk patients. It is economical, simple, repeatable and is carried out on an out-patient basis without any need for hospitalization. PMID- 2694803 TI - [Conservative treatment with transurethral resection of stage T2 cancer of the bladder: retrospective study]. AB - We carry out a review of all the primary bladder T2 tumours in the service in order to evaluate the possibilities of conservative treatment in this category of tumour. Despite being tumours that infiltrated the muscularis, there were all treated initially by transurethral resection. Minimum criteria for classification were the case history, urographies, bimanual touch under anaesthetic and transurethral resection of all tumoural formations, including the whole bladder wall and pericystium. It is a group of 73 patients, 66 males and 7 females, having an average age of 65.6 (range 51-58 years old), with primary transitional bladder tumour, who were followed up over a period ranging from 3 months to 10 years, three years on average. 55 (75.3%) are single tumours and 18 (24.6%) multiple tumours. The degree of anaplasia is G2 in 23 (31.5%) and G3 in 50 (68.5%). Of the 73 patients, 43 (58.9%) 43 (58.9%) are free of disease, 33 (45.2%) of them after a single transurethral resection and 10 who required various transurethral resections due to fresh occurrences of lesser degree and stage. The probability of survival of T2 tumours at 5 years is 72% with a margin of reliability of 11% (p less than 0.05). PMID- 2694804 TI - [Adenocarcinoma of the kidney in children]. AB - Renal adenocarcinoma in infancy is a rare tumour. The presence of a case in our service has encouraged us to submit it and to carry out a review of the literature available. PMID- 2694805 TI - [Syringocele of Cowper's gland]. AB - The dilatation of the duct of Cowper's gland is known as Cowper's Syringocele, a rarely occurring pathology, usually of a congenital origin. We offer two new cases corresponding to a perforated Syringocele and a non-perforated Syringocele. We analyse the clinical, radiological and therapeutic aspects of this entity. PMID- 2694806 TI - [Adenocarcinoma of the kidney pelvis]. AB - We present a case of primitive renal pelvis and calix adenocarcinoma. The clinical evaluation was carried out by means of UIV, echography and TC. Although the tumoral type diagnosis is histologic, the clinical manifestations of chronic renal infection-inflammation, whether associated with obstruction and/or lithiasis or not, are suggestive of this possibility. PMID- 2694807 TI - Molecular pharmacology of protein kinase C. PMID- 2694808 TI - Myosin and contractile activity in smooth muscle. PMID- 2694809 TI - Inositol phosphate metabolism and cellular signal transduction. PMID- 2694810 TI - Conditional-lethal mutant of calmodulin in yeast. PMID- 2694811 TI - Role of calcium released from the sarcoplasmic reticulum of smooth muscle cells as induced by inositol phosphatides. PMID- 2694812 TI - Recognition of influenza A virus by human cytotoxic T lymphocytes. PMID- 2694813 TI - Important diseases with a possible viral aetiology. PMID- 2694814 TI - The immunobiology of respiratory syncytial virus: prospects for a vaccine. PMID- 2694815 TI - Pathogenesis of dengue haemorrhagic fever: current perspectives. PMID- 2694816 TI - Nerves and neuropeptides in the regulation of mucosal immunity. PMID- 2694817 TI - Adenoviruses as vectors for the transfer of genetic information and for the construction of new type vaccines. AB - At present many types of corpuscular nondefective, conditional-defective and helper-dependent expressing adenoviral vectors are available which can be used in constructing gene-engineered live or inactivated viral vaccines. In particular, promising results have been obtained with live recombinant human adenoviruses expressing the S antigen of hepatitis B virus, capsid protein of rotaviruses and gB protein of herpes virus. These recombinants are proper candidates for testing as corresponding vaccine strains, a good alternative to well-known recombinant vaccine virus. PMID- 2694818 TI - Delta virus hepatitis. PMID- 2694820 TI - Characterization of anti liver kidney microsomal antibody associated with chronic HDV infection by immunoblotting. PMID- 2694819 TI - Different expression of HLA class I antigens in liver of children with chronic hepatitis B, evaluated by immunohistochemical method. AB - Studies on the quantitative expression of the Major Histocompatibility Complex (MCH) in hepatocytes chronically infected by Hepatitis B Virus (HBV) report that an increased expression of these antigens could be related to a good immunological response. In the present work we analyze the expression of the MCH antigens in cryostatic sections of liver biopsies taken from subjects (19 children) with various forms of HBsAg positive chronic hepatitis. A high expression of HLA class I antigens and a high degree of hepatocyte necrosis was evident in Chronic Active Hepatitis (CAH) and Chronic Lobular Hepatitis (CLH). On the contrary, subjects with histological diagnosis of Chronic Persistent Hepatitis (CPH) showed a low expression of such antigens. There was however, the difference that in subjects with high hepatic cytolysis and high expression of HLA class I antigens, serum HBV-DNA was clearly present in almost all the cases with CAH, but not detectable in all cases with CLH. The expression of HLA class II antigens and of Beta2 microglobulin was the same in all 19 cases. All cases with HBV-DNA positivity with high class I antigen expression had active hepatitis which seems to suggest that all attempts at viral clearance on the part of the immune system have been in vain. We hope our paper will be an additional parameter for evaluating the course of hepatitis during Interferon treatment. PMID- 2694821 TI - Multiple sclerosis and zoster encephalomyelitis: a probable common etiopathogenesis. PMID- 2694822 TI - The immune response of humans to live and inactivated influenza vaccines. PMID- 2694823 TI - Reappraisal of the risk/benefit of nitrofurantoin: review of toxicity and efficacy. PMID- 2694824 TI - Clinical aspects of carbon monoxide poisoning. PMID- 2694825 TI - [Clinical evaluation of micturitional dysfunction after the operation for rectal cancer and effects of mecobalamin on that dysfunction]. AB - Examination including residual urine measurement, cystometry and urethral pressure profile was performed before and 8 weeks, 3 months and 6 months after the operation in 17 patients with rectal cancer who were divided into mecobalamin administered group (8 patients) and non-administered group (9 patients) at random. Administration of mecobalamin (500 gamma i.m., 3 times a week for 4 weeks) was started within 3 weeks after the operation. In the 17 patients, the rate of patients with residual urine over 51 ml was 65% at 8 weeks, 24% at 3 months and 24% at 6 months. The mean value of bladder pressure at maximum capacity after the operation in the 17 patients showed a significant increase compared to that before the operation, while the mean value of maximum urethral pressure after the operation showed a significant decrease compared to that before the operation. The bladder pressure in patients with residual urine less than 50 ml was significantly lower than that in patients with residual urine over than 5 ml. The bladder pressure in patients with residual urine reduced to less than 50 ml at 3 months showed a tendency to decline. The rate of patients with residual urine of less than 50 ml at 8 weeks was 50% in the mecobalamin administered group and 22% in the non-administered group. There was no significant difference in bladder pressure between the two groups, or before and after the administration of mecobalamin. PMID- 2694826 TI - [Ganglioneuroma of the adrenal gland: report of a case]. AB - A 38-year-old man was referred to our clinic with the complaint of upper abdominal discomfort. Ultrasonography and computerized tomography showed a mass occupying the left retroperitoneal space. Endoclinological results were within the normal range except for 17-OHCS and 17-KS. Preoperative diagnosis was left non-functioning adrenal tumor. Exploration was done via transperitoneal approach. The specimen weighed 100 g and was 11 x 6 x 5 cm in size. Histopathological diagnosis was ganglioneuroma of the left adrenal gland. There have been 35 reported cases with ganglioneuroma of the adrenal gland including our case in the Japanese literature and we reviewed the pathogenesis and treatment of this rare disease. PMID- 2694827 TI - [A case of renal cell carcinoma in a horseshoe kidney: a case report]. AB - A case of renal call carcinoma associated with horseshoe kidney is reported. The patient was a 59-year-old woman complaining of right flank mass. Radiological examination showed right renal tumor and horseshoe kidney, and right nephrectomy was performed. Histological examination showed it to be clear cell type renal cell carcinoma. Only 17 cases of horseshoe kidney with renal cell carcinoma have been reported in Japan. We report the 18th case with a review of the literature. PMID- 2694828 TI - [A case of emphysematous pyelonephritis--review of 32 cases in Japanese literature]. AB - A case of emphysematous pyelonephritis is presented. A 66-year-old woman with diabetes mellitus was hospitalized for sudden pyrexia and left abdominal pain on January 13, 1987. She had shown preshock, pre-disseminated intravascular coagulation, hyperglycemia and renal dysfunction. Plain X-ray films of the abdomen and abdominal computer tomographic scanning showed a gas shadow in the left kidney. Retrograde pyelography demonstrated the left complete ureteral obstruction. A diagnosis was made of emphysematous pyelonephritis associated with diabetes mellitus and ureteral obstruction. Left nephrectomy was performed on January 17, 1987, and the pus obtained from the kidney yielded E. coli. After the operation, she has been doing well with diabetes mellitus under good control without insulin therapy. Thirty two cases of emphysematous pyelonephritis in the Japanese literature including our case are reviewed. PMID- 2694829 TI - [Infectious cysts of a mullerian duct: a case report]. AB - We report a case of infectious cysts of Mullerian duct. A 48-year-old male patient was referred to our department complaining of terminal miction pain on July 19, 1985. The excretory urogram showed right lateral displacement of bladder and pelvic CT-scan demonstrated a large mass containing multiple cysts. A total of 5 percutaneous punctures was performed, but without success. The cysts were removed completely on November 26, 1985. A large volume of pus subsequently yielded a pure culture of Serratia marcescens and multilobular cysts were observed in the incised tumor. Wound healing was delayed because of severe infection. We discussed the difficulty of the management for infectious cysts of the Mullerian duct. PMID- 2694830 TI - [Transurethral unroofing of the mullerian duct cyst: a case report]. AB - Management of Mullerian duct cyst depends on the size and symptomatology. Here we report a case of recurrent Mullerian duct cyst which was treated successfully by transurethral approach. A 57-year-old man was first admitted because of dysuria in 1981. Under the diagnosis of Mullerian duct cyst, he underwent resection of the cyst by suprapubic retrovesical approach that resulted in incomplete extirpation. In 1982, he was readmitted for recurrence of the cyst. Excision by transsacral approach was unsuccessful because of severe adhesion. He was followed by periodic puncture of the cyst and alcohol instillation. In 1988, he was hospitalized because of persistent urinary symptoms. Since open surgical procedure was thought to be difficult, it was replaced by transurethral management. A cyst bulging into the trigone was found with a cystoscope and the bladder wall over the cyst was resected transurethrally until the cyst was entered. A 2 cm opening between the bladder and the cyst was created with a resectoscope. Follow up CT scan two months later demonstrated sufficient communication between the bladder and the cyst. The patient voided well with no discomfort. We believe that transurethral unroofing of the cyst provides a safe treatment in selected cases. PMID- 2694831 TI - [A case of cavernous hemangioma of the testis]. AB - A 4-month-old boy was admitted with the chief complaint of painless mass in the right scrotum. A right testicular tumor complicated with hydrocele was diagnosed preoperatively by physical examination and ultrasonography. Right high orchiectomy was performed and the pathological diagnosis was cavernous hemangioma of the right testis. This disease is very rare, and our case is the 13th in the domestic and foreign literature. PMID- 2694832 TI - [Treatment of urinary tract infection with cefixime]. AB - Cefixime (CFIX) was administered orally in the treatment of 59 cases of urinary tract infection (UTI). According to the response criteria defined by the Japanese UTI committee, the rate of clinical efficacy for 26 cases of uncomplicated cystitis was 96.2%. The rate of clinical effectiveness of five patients with complicated UTI and five with uncomplicated pyelonephritis was 80.0%. In the other 23 cases which did not meet the response criteria, the efficacy rate was also high. The results indicated that CFIX was an effective drug for the treatment of UTI. PMID- 2694833 TI - [Changes in the management of urolithiasis: endourologic treatment of calculi in the upper urinary tract]. AB - Three hundred seventy cases with calculi in upper urinary tract were treated by endourology, 210 cases were subjects of percutaneous nephrolithotripsy (PNL) and 160 cases of transurethral ureterolithotripsy (TUL), in Nara Medical University Hospital and 13 affiliated hospitals. Of the PNL cases, PNL was completed in 184 cases (87.6%) and not completed in 16 cases (12.4%). 168 cases (80.0%) had successful results by PNL alone, stone-free or stone fragments less than 5 mm, in spite of the stone location and size. No serious adverse effect was experienced throughout the study. However, changes like a scar formation or fibrosis around the nephrostomy tract were revealed as a late complication by excretory urography, computed tomography and renal scanning. Of the 160 TUL cases, TUL was successful in 132 cases (82.5%) and unsuccessful in 28 cases (17.5%). The results of TUL for the calculi above the upper iliac cresta were not favorable, success rate for stone 6-10 mm in diameter was 70.3% and that for stones larger than 11 mm 37.5%. However, the results of TUL for the calculi below the upper ileac cresta were favorable, the success rate for the 6-10 mm calculi was 91.5% and for the calculi larger than 11 mm 88.4%. Of 28 TUL failures, 7 cases underwent PNL and 21 cases received open surgery. Throughout our endourologic treatments, the most problematic stone was calculi impact in the ureter. The indication of endourology for the calculi in upper urinary tract is discussed with consideration of ESWL which is becoming the main stream of stone treatment. PMID- 2694834 TI - [Renal cell carcinoma associated with tuberous sclerosis: a case report]. AB - Renal angiomyolipoma associated with tuberous sclerosis is well known. On the other hand, few cases of renal cell carcinoma in connection with tuberous sclerosis have been reported. We report a patient with tuberous sclerosis whose kidney was involved with renal cell carcinoma. A 18-year-old woman was first admitted in August 1987 for evaluation of left renal tumor. Diagnosis of tuberous sclerosis was made when she was 11 years old on the basis of mental retardation, papules on her face, seizures, white leaf-shaped macules and periventricular calcifications. Computerized tomographic scan demonstrated a large mass arising from the left kidney and small masses in the right kidney. Angiography confirmed bilateral hypervascular renal tumors. On these bases, a clinical diagnosis of bilateral renal angiomyolipomas was made and surgical treatment of the left kidney was recommended because of its large size. However, her parents did not permit treatment until March, 1988. Finally, left nephrectomy of 4,750 g was performed and histological examination revealed renal cell carcinoma with clusters of spindle cells. In the literature available to us, we found twelve reports of malignant renal tumors associated with tuberous sclerosis including five renal cell carcinomas in Japan. PMID- 2694835 TI - [Testicular leydig cell tumor in a child: a case report]. AB - A 7-year-old boy was admitted to the department of pediatrics in our hospital with the complaint of sexual precocity manifested by a growth spurt, penile enlargement and pubic hair development. He was referred to our department because of the enlarged left testis. The diagnosis of Leydig cell tumor of the left testis was suggested by hormonal laboratory data and testicular ultrasonographic investigation. Left orchiectomy was performed. The histological examination revealed the characteristics of Leydig cell tumor. Twenty-four cases of testicular Leydig cell tumor reported in the Japanese literature until 1988 are clinically analyzed. We discuss the usefulness of ultrasonography in detecting and localizing the tumor. PMID- 2694836 TI - [Clinical evaluation of aztreonam (AZT) in the treatment of complicated urinary tract infections]. AB - Aztreonam (AZT, Azactam) was given to 176 patients with complicated urinary tract infections (UTI), of whom 110 cases satisfied with the "Criteria of UTI Committee for the Evaluation of Drug Efficacy in the UTI (3rd Ed.)", which was modified by adopting the midstream urine data in cases of women. Aztreonam was administered by drip infusion at a daily dose of 1 to 4 grams (mostly 2 grams) for at least five days long. The overall clinical efficacy rate of AZT in the 110 cases with the complicated UTI was 64%, estimated by the criteria cited above. The efficacy rate according to the infection type groupings was 66% for the 38 patients in the 1st group, 33% for the 3 in the 2nd group, 79% for the 19 in the 3rd group, 85% for the 21 in the 4th, 47% for the 19 in the 5th and 42% for the 12 in the 6th group. The disappearance rate of Gram negative bacilli was 87.1%. Especially 15 strains of Pseudomonas aeruginosa were eliminated out of 25 (60%) after AZT administration. Forty-six strains appeared after AZT treatment, 36 (76%) of which were Gram positive cocci. Subjective side effects and abnormal laboratory findings in a total 176 cases were: diarrhea in one, upper abdominal discomfort in one, increases in glutamic pyruvic transaminase in 8, increases in glutamic oxaloacetic transaminase in 5 and eosinophilia in 1. All of these disappeared after termination of the drug. AZT might therefore be a useful and safe antibiotic for the first choice use against complicated UTI. PMID- 2694837 TI - [Treatment of female acute cystitis with a single dose of cefminox]. AB - Thirty six female patients with acute cystitis were treated with one shot intravenous injection of 1 g cefminox. Clinical efficacy was evaluated based on extent of subjective symptoms, pyuria and bacteriuria. Of 36 patients, an excellent efficacy was shown in 32 cases, moderate in 3 cases and poor in 1 case. This poor case was diagnosed as complicated urinary tract infection because of right vesicoureteral reflux. Therefore, the overall effectiveness rate of this treatment for acute uncomplicated cystitis in women was 100%. Single dose chemotherapy with an adequate antibiotic is considered a useful treatment for female acute cystitis. PMID- 2694838 TI - A review of the evidence for a learning-disabled, hearing-impaired sub-group. AB - Hearing-impaired students are known to encounter significant difficulty achieving appreciable levels of academic achievement. Recently, many professionals have advanced the concept that some hearing-impaired students' lag in achievement may owe to learning disabilities in addition to hearing impairment. Definitional differences, survey data and studies are discussed in an exploration of whether or not a discernible hearing-impaired-learning-disabled sub-group exists. PMID- 2694839 TI - The impact and experience of adventitious deafness. AB - Relatively little well controlled, empirical research has examined the problems, experiences, functional limitations and coping strategies of late-deafened individuals. The present paper summarizes, integrates and evaluates the literature on adventitious deafness. Several issues are explored in detail, including: a) a comparison of congenital and acquired deafness; b) a critical review of the literature investigating the psychiatric problems experienced by late-deafened individuals; c) an examination of the effects of acquired deafness on identity and personal control; and d) a consideration of adventitious deafness among the elderly. PMID- 2694840 TI - Morphology of pulmonary intravascular macrophages (PIMs) in ruminants: ultrastructural and cytochemical behavior of dense surface coat. AB - Recent studies have indicated that pulmonary intravascular macrophages (PIMs) are a resident cell population which in structure and function resemble mature macrophages of the mononuclear phagocyte system (MPS) in various domestic species, particularly the ruminants. The ultrastructural features of PIMs of the goat and calf lungs were studied by using vascular perfusion and direct airway instillation of fixatives. Staining with tannic acid as a component of paraformaldehyde-glutaraldehyde-based fixative revealed the presence of an electron-dense coat on the surface of the cell membrane of the PIMs. The surface coat disappeared after heparin infusion and after enzymatic digestion with lipolytic lipase, suggesting that the surface coat was predominantly lipoprotein in nature. The lipoprotein coat was organized in the form of a linear chain of spherical globules with a consistent periodicity created by the intervening translucent space between individual globules. The surface coat was separated from the outer-leaflet of the cell membrane by an empty space measuring 35-39 nm in width. PIMs possessed a significant number of coated pits and coated vesicles, the cell organelles of receptor-mediated endocytosis of lipoproteins. In concurrence with the coated pits and vesicles, microtubules, multivesicular bodies, and lipoprotein-positive vesicles were also observed. It is conceivable that PIMs are involved in lipid metabolism and are the major source of vasoactive substances, which significantly influence both the dynamics of pulmonary circulation and the surfactant turnover of the ruminant lung. PMID- 2694841 TI - A medical review approach to Medicare outpatient documentation. AB - Blue Cross of California has recognized the problem of reimbursement delays due to Medicare claims that have been returned or denied. The information in this article applies to the medical review process and suggests an interpretation of the new Medicare outpatient guidelines used by the Blue Cross of California Medicare reviewers. As a solution to the problem of delayed reimbursement, medical reviewers--who are also practicing occupational therapists--offer an explanation of the Medicare review process and suggestions for correcting technical billing errors. Methods for keeping complete and timely medical records are discussed, with the suggestion that clinicians follow these methods from the start of care. A process for documentation is presented that will clearly prove to the medical reviewer the need for the special skills of an occupational therapist. This article also proposes reasons for noncoverage because of insufficient medical necessity. It is important to note, however, that variance between fiscal intermediaries' interpretations and requirements exists nationwide. This article, therefore, represents only one fiscal intermediary's approach to reviewing claims and medical records. PMID- 2694842 TI - Listing of educational programs in occupational therapy. November 1989. PMID- 2694843 TI - Hypnosis and conversion disorders. AB - A review of the literature shows that presently held views on the relation between hypnosis and conversion disorders had their origin in the previous century. This also holds for therapeutic techniques as they are still applied today. A case report illustrates that successful symptom removal may be independent of the patient's hypnotizability and of the techniques used. PMID- 2694844 TI - [Laminaria in obstetrical and gynecological practice]. PMID- 2694845 TI - [The role of echography and hysteroscopy in detection of the causes of uterine hemorrhage in the postmenopausal period]. AB - Forty-six patients with bloody discharge in the postmenopausal period were examined by echography and hysteroscopy, and the data of these techniques were compared with the results of endometrial curettage. The results evidence that echography is a valuable diagnostic method that permits the detection of or ruling out the hyperplastic processes of the endometrium in the postmenopausal period. Diagnostic curettage of the uterine cavity, monitored by hysteroscopy, improves the accuracy of the diagnosis of causes of hemorrhages in the postmenopausal period, for it helps purposefully remove the involved sites of the endometrium. PMID- 2694846 TI - [Use of computers in the roentgenological diagnosis of gynecologic diseases]. AB - The authors analyze the use of computers in x-ray examinations of gynecologic patients. X-ray signs of infertility, endometritis, tuberculosis, myoma, malignant tumors, etc. were formalized. A total of 131 patients were examined and a council of physicians for these cases was computer-simulated. Variants of computer-processed x-ray diagnoses are presented, their informativeness indexes ranging from 0 to 100%. Programmed processing may be realized via SM-4, SM-1420, IZOT-1016C, Electronika 100-25 computers. The FORTRAN program language was employed to make up the programs. PMID- 2694847 TI - [Systemic approach to the diagnosis of combined benign hyperplastic uterine diseases in patients of reproductive age]. PMID- 2694848 TI - [Conservative myomectomy in the complex treatment of patients with uterine myoma]. PMID- 2694849 TI - [Chlamydia infection in obstetrics and gynecology]. PMID- 2694850 TI - Treatment of CNS neoplasms in childhood by the Pediatric Oncology Group. AB - The incidence of brain tumors in children under 15 years of age in the United States is 2.4/100,000. Based upon a US population of approximately 60 million black and white children, there are only 1,200-1,500 newly diagnosed causes of CNS neoplasia diagnosed in children each year in the US. These relatively small numbers, the large geographic dispersion, and the multitude of histologic types, make it unlikely that all but a few medical centers can develop a large experience with this diverse group of tumors. The Brain Tumor Committee (BTC) of the Pediatric Oncology Group was formed, in part, to address this problem. Each of the four goals of the BTC will be addressed separately. A justification for the rationale for each goal is given, following which there is a discussion of how each goal is being met. PMID- 2694851 TI - The changing panorama of infantile hydrocephalus and cerebral palsy over forty years--a Swedish survey. AB - The time trends and background of infantile hydrocephalus (IH) and cerebral palsy (CP) are surveyed. The changes in live birth prevalence, disability patterns, associated neuroimpairments and distribution of etiologies are analysed. Both the risk of IH and that of CP sharply increase with decreasing birth weight and gestational age. It is concluded that the remarkably enhanced survival of particularly very preterm infants, those at the highest risk of long-term morbidity, implies an increasing number of impaired children as long as the outcome of survivors is not drastically improved. The data presented are thought to be of relevance as to reconsideration of the effectiveness of perinatal care for preterm babies. PMID- 2694852 TI - Changing concepts of motor areas of the cerebral cortex. AB - Recent development of studies on cerebral cortex of primates provides evidence that there exist multiple motor representation areas in the frontal lobe. By analyzing the activity of single cells in association with performance of a variety of motor behavior, new concepts on the functional role of each area are developing. PMID- 2694853 TI - Remaining problems in the staging and treatment of childhood lymphoblastic leukemia. AB - During the past decade, advances in the treatment of childhood acute lymphoblastic leukemia (ALL) have continued. Progress is largely due to improved disease-free survival of poor-prognosis subgroups, improved sanctuary therapy, shortening of therapy duration, and salvage of relapsed patients by use of better chemotherapy regimens and bone marrow transplantation. Nonetheless, more children continue to die of ALL than of any other childhood cancer. This article reviews the progress and indicates remaining problems in the staging and treatment of ALL. Remaining problems include a lack of standardization between staging systems, variable application and interpretation of multivariate analysis, and occurrence of epiphenomenon. Also, to have statistical validity, clinical studies require numbers of patients larger than have been the case as results of treatment improve. Confusing also is the biological interface between ALL, non Hodgkin's lymphoma, and the myeloid leukemias; the lack of reliable in vitro tests of chemosensitivity and chemoresistance; and the inability to quantitate residual leukemia after remission induction or to detect drug-resistant clones of cells before they are clinically manifest. Delivery of optimum therapy and supportive care to all children with ALL remains an elusive goal. PMID- 2694854 TI - Diamond-blackfan anemia: etiology, pathophysiology, and treatment. AB - Diamond-Blackfan anemia (DBA) is manifested by a wide variety of clinical and in vitro abnormalities. Despite this biological diversity, the hematological phenotype is remarkably similar for all patients and consists of a normochromic macrocytic anemia in early childhood, reticulocytopenia, and a normocellular marrow with a selective deficiency of red cell precursors. Fetal hemoglobin is usually increased, distributed heterogeneously, has a fetal G gamma/A gamma pattern, and is associated with increased expression of red cell i antigen. Although most cases are sporadic, there are examples of autosomal recessive and autosomal dominant inheritance patterns. Approximately 70% of patients with DBA respond to prednisone, and many can be maintained on tapered doses. Those who are steroid-dependent at high dosage as well as those who do not respond are managed on a transfusion and iron chelation program. Claims of efficacy for other therapies, such as cyclosporine or high-dose intravenous methylprednisolone, require substantiation. Bone marrow transplantation has been successfully performed in patients who have tissue-matched donors, and the procedure cures the anemia. Recombinant growth factors may be a therapy of the future. Regarding pathophysiology, initial reports of humoral or cellular inhibitors of erythropoiesis were not confirmed in all laboratories. However, some patients have lymphocyte dysfunction with decreased T cells, decreased T4/T8 ratios, and defective lymphocyte-mediated suppression of lymphoproliferation. A large body of data indicates that the erythroid stem cells are intrinsically defective in DBA, and they are partly or completely refractory to erythropoietin. The role of elevated red cell adenosine deaminase activity in the pathogenesis of this abnormal erythropoiesis is not clear, but this finding is characteristic of the syndrome in most patients. Present studies using recombinant growth factors have demonstrated a diversity of defects in erythropoiesis in patients with DBA. Blocks in red cell production and red cell maturation were seen at various levels along the differentiation pathway. Of clinical interest, interleukin-3 has a corrective effect in vitro on the aberrant marrow erythropoiesis of steroid refractory patients, and, hence, it may have therapeutic application. PMID- 2694855 TI - Basic molecular biology for the pediatric hematologist/oncologist. AB - Recent advances in molecular biology have permitted a broader understanding of the pathogenesis of human cancer. Furthermore, the elucidation of pathogenetic mechanisms underlying the malignant transformation of normal cells has begun to suggest new approaches for the diagnosis, prognosis, and therapy of cancers. To familiarize the practicing hematologist/oncologist with the implications of current advances in the molecular biology of cancer, this article will review the basic concepts of molecular biology, and will summarize salient aspects of the most frequently used techniques. Also, several biologic principles which have lead to a further understanding of oncogenesis will be discussed in detail. PMID- 2694857 TI - [Midazolam for premedication of infants. A comparison of the effect between oral and rectal administration]. AB - Midazolam (M) has been successfully used in oral and rectal premedication of children of one to six years of age. The following study was designed to investigate the efficacy of both methods when used as premedication "on demand". 60 children (1-6 years) were randomly assigned to 0.3 mg/kg bw M orally and 0.5 mg/kg bw M rectally. Psychological, behavioural and physiological parameters were measured at special time intervals and special stressful events (separation from the mother or father, induction of anaesthesia). Rectally premedicated children were found to be better prepared concerning psychological and behavioural parameters. This can be due to the dosage as well as the faster absorption of M. In the postoperative period orally premedicated children experienced significantly more nausea and vomiting. This might be due to the preparation with saccharin, peppermint oil and ethanol. - In "premedication on demand" rectal Midazolam must be preferred to orally administered Midazolam in the preparation mentioned above. PMID- 2694856 TI - [Selective flora suppression for control of infection in surgical intensive care medicine]. AB - The question to be answered in this study was: Is prophylactic selective florasuppression advantageous compared to conventional antibiotic policy as far as microbial colonisation, infection, mortality and development of resistance are concerned? A prospective, consecutive, placebo-controlled study in two ICU's was carried out during four 6-months periods. 200 patients who were intubated for at least 3 days, required intensive care for a minimum of 5 days, and belonged to either class III or IV according to the "Therapeutic Intervention Scoring System" were included in the study. They received either placebo or the prophylaxis regimen described by Stoutenbeek et al., consisting of polymyxin E, tobramycin and amphotericin B. Oropharyngeal, tracheobronchial and rectal colonisation with aerobic gram-negative bacilli markedly decreased in the test groups. The rates of nosocomial bronchopulmonary infections (ICU I and II) and urinary tract infections (ICU II) were significantly reduced. There was no significant reduction in wound infection, septicaemia and mortality rates. No development of resistance and no increase of multi-resistant strains occurred. Selective florasuppression is effective in reducing infection rates in critically ill patients without development of resistant strains. PMID- 2694858 TI - [Alfentanil combination anesthesia in adeno-tonsillectomy in children--a comparison with ethrane inhalation anesthesia]. AB - In two groups, each comprising 25 children undergoing adenotonsillectomy, two different methods of anaesthesia were used. Group I received ethrane inhalations, group II an alfentanil combination anaesthesia. The objective was to find out, whether or not the two methods differed in respect of haemodynamics, side-effects and practicability. In the patients of group II more haemodynamic stability, less ethrane consumption and faster postanaesthetic recovery was observed. The incidence of vomiting was equally low in both groups. Other side-effects ascribable to alfentanil, such as respiratory depression, chest rigidity and bradycardia, had no clinical significance. One may conclude from the results, that on account of the advantages described an alfentanil combination anaesthesia represents a true alternative to the routinely used "pure" inhalation anaesthesia in children undergoing adenotonsillectomy. PMID- 2694859 TI - Professor Emeritus Sir Robert Reynolds Macintosh 17 October 1897-28 August 1989. PMID- 2694860 TI - Assessing the position of the tracheal tube. The reliability of different methods. AB - Various methods have been developed to confirm proper intubation of the trachea. This blind, randomised study evaluates some of these quantitatively and qualitatively. Forty patients had both their trachea and oesophagus intubated. A procedure that included auscultation of the upper abdomen and lungs was 100% reliable independent of which tube was ventilated. Auscultation of the lungs resulted in a wrong conclusion in 15% (6-30, 95% confidence limits) of the cases when the oesophagus was ventilated: the sounds were misinterpretated as normal breath sounds. Suction on the tubes with a 60-ml syringe was also a reliable test. Other methods assessed were observation for condensation of water vapor, and abnormal movements of the upper abdomen; these were unreliable. PMID- 2694861 TI - Alfentanil used to supplement propofol infusions for oesophagoscopy and bronchoscopy. AB - This randomised double-blinded study compared the cardiovascular stability and rate of recovery when propofol infusions with or without alfentanil were used to provide anaesthesia for rigid oesophagoscopy and (or) bronchoscopy. Forty-six patients were allocated randomly to receive either alfentanil 10 micrograms/kg or saline just before a rapid sequence induction with propofol. Suxamethonium 1 mg/kg was given and infusions of suxamethonium 10 mg/minute and propofol (10 mg/kg/hour for 10 minutes, 8 mg/kg/hour for 10 minutes and then 6 mg/kg/hour thereafter) were started. There were 23 patients in each group with no significant demographic differences between the groups. A significantly mean lower induction dose of propofol was needed in the alfentanil group (1.7 mg/kg compared to 2.2 mg/kg). Cardiovascular measurements were made on the ward pre operatively, just before induction, just after induction, just after intubation, and at 3-minute intervals thereafter. Arterial pressure was significantly lower during the procedure in the patients who received alfentanil and there was a significant incidence of hypotension. There was no significant difference between the groups in respect of heart rate, with a significant increase in both groups just after intubation compared to the baseline values. Recovery from anaesthesia was assessed using the critical flicker fusion threshold. No differences were found between the groups and patients in both groups had returned to baseline values by 60 minutes. No patient had any recall of intra-operative events, and there were no other adverse effects of any significance. PMID- 2694862 TI - [Spongia somnifera. Medieval milestones on the way to general and local anesthesia]. AB - Medieval medicine was highly innovative compared to ancient and early modern medicine. The achievements then did not merely comprise new models from the viewpoint of the history of science: development of the university, a well defined curricula and official degrees, obligatory fees and cost reducing measures. They also included therapeutic procedures like nerve suture, antisepsis, chemotherapy (colchicine), cardiac glycosides (scillaren, convallerin), the development of visual aids (binoculars, magnifying glass, microscope, presbyopic glasses) and further improvement of plastic surgery by the application of delayed grafts (lips/nose plastic). Modern medicine at first rejected and forgot these techniques, which were not rediscovered until the 19th and 20th century. This holds true for the extirpation of abdominal tumors as well as for the concept of therapeutic fever. It also pertains to anesthesia, which in the Middle Ages was developed from ancient methods of sedation. Medieval scholars perfected the method into achieving the first total anesthesia (resorption/inhalation anesthesia) and then local anesthesia (application of morphine at the cornea). PMID- 2694863 TI - [The functional principle, reliability and limitations of pulse oximetry]. AB - Pulse oximetry has found wide-spread application in recent years. It is simple, noninvasive and continuous method for measuring arterial oxygen saturation. This survey deals with the history of pulse oximetry, its technical foundations, the differential indications and contraindications, and its limitations and possibilities for error. A number of suggestions are made for improving the accuracy of measurement and the interpretation of values. These include improved calibration, including low saturation ranges (below 70%) and the development of pulse oximeters that measure with more than two wavelengths, which would eliminate measuring errors due, for example, to carboxyhemoglobin. PMID- 2694864 TI - Enhanced chemiluminescent enzyme immunoassay for cannabinoids in urine. AB - An enhanced chemiluminescent enzyme immunoassay was developed for the detection of cannabinoids in urine. It utilises an antiserum specific for tetrahydrocannabinol and its major metabolite, a donkey anti-sheep antiserum and a horseradish peroxidase labelled antigen conjugate. The bound enzyme is detected via its catalytic activity on the chemiluminescent luminol-H2O2 reaction in the presence of an enhancer. This immunoassay employs mild experimental conditions and is extremely sensitive (0.13 microgram l(-1), making it suitable for the detection of cannabinoids in samples obtained several days following drug use. None of several medicinal and other drugs of abuse tested interfered in the assay. Greater sensitivity and simplicity make it a feasible non-isotopic alternative to radioimmunoassay and it is amenable to automation and routine screening to large sample batches. PMID- 2694865 TI - The influence of cell-matrix interactions on the development of quail chorioallantoic vascular system. AB - The extracellular matrix-component fibronectin (FN) was detected in close localisation to the vascular system (VS) of the quail chorioallantoic membrane (CAM). We have examined the role of cell-fibronectin interactions within the developing CAM. In two series of experiments the CAM was directly exposed to (1) an antibody against the cell-binding fragment of FN, and to (2) RGD-containing synthetic peptides which are recognized by the FN receptor. For controls an antibody against tubulin and a SHLVE-pentapeptide that does not interfere with the FN-receptor were applied. In the presence of anti-FN antibodies and RGD sequences the CAM could not establish a normal vascular system. We observed hypo- and partially avascular regions; the resulting vascular pattern was atypically lacunar. None of the control substances affected the regular development of the chorioallantoic vascular system. These results demonstrate the essential role of FN in CAM angiogenesis. PMID- 2694866 TI - Axial interactions during neurogenesis in dysraphic mice. AB - The spatial relationships of midline axial structures were compared in normal and dysraphic embryos of the loop-tail (Lp) mutant mouse at 9 days of gestation, and the distribution of two glycoproteins, fibronectin and laminin, was determined in this region by means of immunofluorescence histochemistry. At various levels of the trunk in abnormal embryos, the notochord, ventral midline of the neural folds, dorsal aorta(e) and/or gut were variably separated from one another, in contrast to the closer contact that occurred among these midaxial structures at comparable trunk levels in normal embryos. Positive anti-fibronectin and anti laminin reactions were noted within areas of contact in the normal embryos and at the interfaces of tissue separation in the abnormal embryos. Although the intensity of the immunofluorescent reaction could not be assessed or compared quantitatively, the presence and distribution of fibronectin and laminin in the abnormal embryos suggest that these two glycoproteins may not be causally or fundamentally involved in producing the abnormal spatial relationships and separation of the midaxial structures. PMID- 2694867 TI - The CellSoft computerized semen analysis system. I. Consistency of measurements and stability of results in relation to sample size analyzed. AB - The CellSoft TM computer-assisted digital image analysis system was evaluated for reproducibility of measurements and for the sample size needed to obtain stable results for seven parameters characterizing human spermatozoa. The parameters were sperm density, velocity, linearity, percent motile cells, maximum and mean amplitude of sperm head's lateral displacement (ALH max and ALH mean) and beat cross frequency. Thirty men were assigned to three equally large groups according to sperm density, and the groups were studied separately. Consistency of measurements was highly acceptable for all parameters (coefficient of variation ranging from 0.9% to 3.7%). The average minimum number of sample size needed for stable results varied between the groups and within each group dependent upon the parameter studied. Velocity and linearity seemed to require the lowest average cell number, while percentage motile cells and ALH max needed the highest sample size. Our current recommendation of sample sizes is outlined in detail and limitations and future utility of CellSoft is discussed. PMID- 2694868 TI - Monthly prevalence (in 1986) of antibody titers against equine monocytic ehrlichiosis in apparently healthy horses in Illinois. AB - The seroprevalence and seasonal trend of antibody titers against equine monocytic ehrlichiosis (Potomac horse fever) were determined in apparently healthy horses in selected areas of Illinois in 1986. Sera from 1,367 horses (6 months to 29 years old) were evaluated for the presence of antibodies against Ehrlichia risticii with indirect immunofluorescence. The majority (88%) of the horses were Thoroughbred or Standardbred racehorses. The number of horses with antibodies against E risticii was 229/1,367 (16.75%). The titers in these horses ranged from 1:10 to 1:640. As the year progressed, the number of seropositive horses (titers greater than or equal to 1:10) and the magnitude of the titers increased significantly, both reaching a maximum in July and August, respectively (P less than 0.05). A relationship between seropositivity and gender was not detected. In the year prior to sampling, 56.8% of the seropositive horses had not been ill, whereas 0.8% had diarrhea, an episode of acute abdominal pain, or laminitis. It was concluded that a large number of horses in Illinois are exposed to E risticii, that maximal exposure occurs in July, and that the most common form of the disease in Illinois is not associated with clinical signs. PMID- 2694869 TI - Immunohistochemical diagnosis of Neospora caninum in tissue sections. AB - An avidin-biotin-peroxidase complex immunoperoxidase staining method was developed to detect Neospora caninum in formalin-fixed, paraffin-embedded tissue sections. Specific antiserum to N caninum was made in rabbits and used to probe tissues from dogs naturally and experimentally infected with N caninum. The test detected tachyzoites and bradyzoites of N caninum. A reaction was not observed to Toxoplasma gondii, Hammondia hammondi, Sarcocystis cruzi, S capricanis, S tenella, Besnoitia jellisoni, Caryospora bigenetica, Hepatazoon canis, Atoxoplasma sp, or the organism causing canine dermal coccidiosis. When antiserum made in rabbits to T gondii was used in the test, reaction to N caninum was not observed. PMID- 2694870 TI - Equine RAS proto-oncogene expression. PMID- 2694871 TI - [Treatment of status asthmaticus. Experience of intravenous beta-adrenergic bronchodilator therapy in 71 cases]. AB - A retrospective study of the patients admitted during the last 8 years with status asthmaticus is reported. We compare the requirement of mechanical ventilation with the beta-agonist therapy received and the type of asthma. About 71 patients admitted, 67% were IgE dependent asthmatic (EDA) children and 31% no IgE dependent asthmatic (nEDA) ones. They needed intermittent positive pressure ventilation (IPPV) in 20 instances; no difference was found between both types of asthma. We studied the ventilatory parameters used. The 33% of EDA children was treated using a continuous IV infusion of hexoprenalina, requiring IPPV in 5 (31%) of them. The rest received a continuous IV of isoproterenol, and only the 16% required IPPV. We found isoproterenol to be more effective than hexoprenalina in the treatment of status asthmaticus. Similar results were obtained with the nEDA group. The Downes score was showed to be a good predictor-index scoring system in many cases. PMID- 2694872 TI - [Giant fetal ovarian cyst. Diagnosis and treatment]. AB - A case of a prenatally diagnosed fetal ovarian cyst is presented. The pregnancy was uneventful and the girl delivered by cesarean because of the size of the cyst. The cyst was removed by laparotomy on the day of the delivery and luteum ovarian cyst was the histologic diagnosis. PMID- 2694873 TI - [Ring chromosome 17 and recurring pneumopathy]. PMID- 2694874 TI - [Definition and epidemiology of the post-cholecystectomy syndrome]. PMID- 2694875 TI - [Clinical and instrumental diagnosis of the postcholecystectomy syndrome]. PMID- 2694876 TI - [Postcholecystectomy syndrome and secondary bile duct calculi: therapy notes]. PMID- 2694877 TI - [Postcholecystectomy syndrome caused by inflammation of the terminal choledochus and papilla]. PMID- 2694878 TI - [The postcholecystectomy syndrome caused by biliary and pyloroduodenal dyskinesia]. PMID- 2694879 TI - [Post-cholecystectomy pseudo-syndromes]. PMID- 2694880 TI - [Optimal preparation of the colon for elective surgery. A personal proposal]. AB - Positive results of modern elective colon surgery are founded not only on a correct anatomo-surgical technique, but also on antibiotic prophylaxis and on the best possible "preparation" both mechanical and microbiological to surgery of colon. Also if in recent literature the opportunity of the last kind of preparation is controversial, here are considered principles and the various most modern related available methods. As regards the mechanical preparation, the most useful dietetic directives, a correct and safely employ of laxative, and also orthograde and retrograde use of physiologic and hyperosmotic solutions of bowel lavage are here considered. As regards the microbiological drainage of colon, criteria of choice between various available antibiotics and plans of their employ, mainly in a prophylactic use, are here recorded. At the end is offered the personal proposal of colon preparation, founded on a synthesis of preliminary mechanical endoscopic colon dressing with a preoperative microbiological drainage, following the most modern principles of antibiotic prophylaxis of colon surgery complications. PMID- 2694881 TI - [Risk factors and etiopathogenesis of cancer of the gallbladder]. AB - Primary cancer of the gallbladder is uncommon but not rare, being in Italy the fourth cause of death for gastrointestinal cancer in females over 65 years old. Two centuries after the first description, this tumor remains characterized by an unfavorable prognosis due to the silent progression of the clinical course and the frequent unresectability at the time of surgery. Early diagnosis, aggressive surgical approach and chemotherapy are the basis for longer post-operative survival rates; in fact, despite the advances in ultrasonography and computer assisted imaging devices, the prevention of gallbladder cancer remains a problem. In the statistical terms, the risks of an indiscriminate surgical prophylaxis would outweigh the advantages of cancer prevention; in this optic, a recognition of the patients "at major risk" appears to be essential. With this aim we have undertaken a review of current knowledge of the "risk factors" involved in the epidemiology and etiology of gallbladder cancer, deduced from Literature and our surgical experience. It is reasonable to assume that the etiology of this cancer is based on the correlationship between factors with a wide and different penetration in racial-ethnic areas: genetic, systemic and local risk-factors. A genetic influence can be highly suspected in the familiar cases, in the non carcinoma tumors and in the geographic predominance of the tumor. None of the systemic factors suggested as risk factors (age, sex, obesity, occupational and chemical carcinogens, drugs, etc.) appear to be directly involved; moreover, the main factors, such as female sex and age, are probably mediated through cholelithiasis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694882 TI - [Current problems in the surgical treatment of primary lymphoma of the stomach]. AB - The surgical treatment of the primary gastric lymphoma (P.G.L.) presents some controversial aspects still. The authors discuss the problem on the basis of the most recent data published in the literature and on their own experience concerning 14 cases of P.G.L. They confirm that surgery maintains an important role, at first, in the determination of the diagnosis exactly. The incidence of preoperative diagnosis of P.G.L. is unsatisfactory still, although increasing with the appropriate technique of endoscopic biopsies and modern immunohistochemical analysis. Moreover, the surgical approach is necessary for the definitive staging of the disease, which at the laparotomy, must be performed with these modalities: gastrectomy, regional and extra-regional lympho adenectomy, fine needle aspiration and surgical biopsy of the liver. The extension of the gastrectomy is based on the location of the tumor. In the P.G.L. localized in the middle and in the upper stomach a total gastrectomy must be performed; on the contrary in a neoplasm localized in the lower part, a subtotal gastrectomy could be considered as a curative treatment. Integrated with chemotherapy, surgery offers appreciable results in long term survival, much better than those obtained after surgical treatment of gastric cancer. PMID- 2694883 TI - [Short-term antibiotic prophylaxis with ceftriaxone in general surgery]. AB - The authors report their own experience on the efficacy of a short term antimicrobial prophylaxis involving a long-acting cephalosporin, ceftriaxone (Rocefin), in surgical patients. A study was carried out to evaluate the efficacy of a single dose of 1 or 2 g by i.v. administered 1 h. before elective surgery. 100 patients were admitted to study. Therapeutic success was achieved in 92 cases (92%). PMID- 2694884 TI - [Anhedonia in psychiatry: a review]. AB - Anhedonia, the loss of the capacity of feeling pleasure, was first introduced at the end of the last century by a French psychologist, Ribot, and has been the object of much research, essentially in English, for the last decades, in schizophrenia, in depression, in schizoid disorders. After considering the problems of quantitative evaluation, we review the literature and conclude that anhedonia appears to be a multi-morphological symptom and the are probably several types of anhedonia, which shows the necessity of developing more specific reliable evaluation instruments and of diversifying the approaches. We show the utility, in particular, of a psychophysiological approach using endogenous Evoked Potentials. Then several research directions in psychiatry are discussed: what place has anhedonia in the negative form of schizophrenia? Does anhedonia constitute a specific marker of certain endogenous depressions? Does it constitute a personality trait that predisposes to morbidity? PMID- 2694885 TI - [Marc, the king's doctor and forensic surgeon]. PMID- 2694886 TI - [LENTCA: nosographic evaluation software for alimentary disorders]. PMID- 2694887 TI - [New validation of the Montgomery and Asberg Depression Scale (MADRS) on a sample of 147 hospitalized depressed patients]. PMID- 2694888 TI - [Current status of obsessional compulsive disorders: theories, epidemiology and treatment]. PMID- 2694889 TI - [Minkowski's concept of lived time]. AB - After a statement of the works of P. Janet, in a precedent article, the authors study the lived time in Minkowski. They expose then the notions of syntony and schizoidy inherited by Minkowski from Bleuler and the diagnosis by penetration. The notion of lived time is at last studied in schizophrenia, then in mania where there is a subduction of lived time, it is the contrary in melancholia where the lived time is slower and some times stopped. PMID- 2694890 TI - [Nonverbal communications and psychotherapy]. AB - The authors review the research on non-verbal communications in therapy; they distinguish between psychoanalytic, psychiatric, phenomenological and ecosystemic approaches and compare their respective methodologies. They show that the structural approach is the most advanced as far as systematic description of non verbal behavior is concerned and therefore is presently the most promising for the inference of the therapeutic process. PMID- 2694891 TI - [Memory and depression]. PMID- 2694892 TI - [Endogenous depression and the Newcastle Index. I. Review of the literature]. PMID- 2694893 TI - [Documents from the history of psychiatry. Epidemic encephalitis in the Society of Clinical Psychiatry]. PMID- 2694894 TI - [Peroperative radiotherapy and cancer of the base of tongue. Technic, indications and preliminary results]. AB - This study involved 15 patients suffering from large volume squamous carcinomas of the base of the tongue, who were likely to benefit from curative therapy (tumours graded T3, T4, N0, N1, N2, TNM UICC 1987). In 13 patients, treatment included transmaxillary bucco-pharyngectomy (TMBP) carried out either as first intention (10 cases), or as a second stage procedure after radiotherapy (3 cases). 2 patients underwent total laryngectomy with secondary basi-glossectomy. Per-operative radiotherapy was performed on the basi-lingual resection site, delivering a boost of 15 to 20 Gy using adapted localisers. A pectoralis major musculo-cutaneous flap procedure was carried out for the TMBP. Post-operative external radiotherapy to the tumour zone for patients treated as first intention was limited to 50 Gy with a boost of 15 Gy to the cervical lymphatic clearance wound in the event of capsular rupture. The aim of this method was to deliver an elective basi-lingual boost allowing better loco-regional control, while reducing the complications of high dose external oro-pharyngeal irradiation. The technique (reliability-tolerance) and the preliminary results are presented. PMID- 2694895 TI - [Therapeutic results in a series of 73 cases of nasopharyngeal carcinoma]. AB - From 1975 to 1982, 73 cases of nasopharyngeal carcinoma were treated in Strasbourg (Centre Paul Strauss) and Metz (CHR Bon Secours). 34.1% of the patients were of maghrebine origin, the others were europeans. Two histological types were studied: undifferentiated carcinomas of UCNT type, spinocellulars carcinomas of CS type. 60.3% of the patients had T3 and T4 stages, and only 27.4% of the patients had no pathological nodal. As to treatment, radiotherapy is the best choice, because of the deep situation and the frequent involvement of nodals in the nasopharyngeal carcinoma. Taking into account the level of radiation doses, complications remain acceptable. The rate of overall failure is 51.3% at 3 years. The prognostic factors are essentially linked with sex, age, tumor site, site, histological type, T stage of UICC classification and TNM of the same classification, N stage of HO classification, and evaluation of treatment response realised at 4 months. The crude overall survival rate is 52% for patients of the serie. PMID- 2694896 TI - [Radiotherapy of cancer limited to the vocal cords]. AB - 197 patients, with an early glottic cancer, were heated with radiotherapy at the Institute Gustave Roussy, between 1970 and 1983. Radiation was delivered up to a dose of 65 Gy over 6 1/2 weeks on a small area centered on the glottic region. All patients had previously undergone direct laryngoscopy and showed T1 stage tumours (175 T1a and 22 T1b) although in 32 cases there was a suspicion of very limited involvement of the ventricle or sub-glottis. 5 year survival for the overall population was 77.5%. 38 local recurrences were observed, 1/4 of these occurring after 3 years. For the overall population, local control at 5 years was 85.7%. Suspicion of supra or sub-glottic involvement and the presence of impaired mobility of the larynx were shown to be important prognostic factors. Local control at 5 years was 90% for "true T1" cases. Few complications were observed and the functional results of irradiation were judged to be excellent. PMID- 2694897 TI - [Paraganglioma of the head and neck. Familial forms]. AB - The clinical, epidemiological and genetic aspects of familial paragangliomas of the head and neck are discussed in relation to 6 recent cases from two families which accounted for 2 and 4 patients respectively. Tumors of the carotid body are the most frequent. Bilaterality and association with other paragangliomas are suggestive of a hereditary disorder and should lead to investigation of the family. The establishment of a family tree will define those subjects at risk in whom systemic screening should be performed. The recent advances obtained using new imaging techniques in the diagnosis, evaluation of extension and treatment should enable treatment to be instituted at an earlier stage and thus reduce functional sequelae. PMID- 2694898 TI - [Midazolam in ORL endoscopy in adults]. AB - A prospective study was carried out in 20 selected subjects undergoing ENT endoscopy, with spontaneous ventilation of room air after premedication with midazolam IM 1.5 kg-10 [corrected] and then sedation with 0.07 mg.kg-1 IV and dextromoramide 0.03 mg.kg-1 IV and local anesthesia. The procedure was satisfactorily completed in the 20 cases; alertness was preserved in the 20 cases; total amnesia for the procedure was obtained in 19 cases. There were significant alterations in systolic blood pressure, heart rate and respiratory rate but these remained within strictly physiological limits. Blood gas results were similarly affected but at the limit of normal in 6 cases after 30 minutes of the procedure. Cardiovascular tolerance was excellent but close surveillance of the sedative effects on ventilation was required. Provided these conditions are respected, midazolam would appear to be of particular interest in ENT endoscopy. PMID- 2694899 TI - [Mucocutaneous hyalinosis: clinical polymorphism]. PMID- 2694900 TI - [Florid cutaneous sarcoidosis. Therapeutic difficulties]. PMID- 2694901 TI - [Porphyria cutanea tarda associated with pure cutaneous dermatomyositis]. PMID- 2694902 TI - [Streptococcal myonecrosis. Apropos of a case]. PMID- 2694903 TI - [Inflammatory tumor of the thigh after total hip prosthesis]. PMID- 2694904 TI - Relationship between Mycobacterium avium, M. paratuberculosis and mycobacteria associated with Crohn's disease. AB - Recently some mycobactin-dependent mycobacteria were isolated from patients with Crohn's disease. These mycobacteria should be very similar to M. paratuberculosis which is closely related to M. avium. The author has investigated the relationship between M. avium, M. paratuberculosis and the mycobacteria associated with Crohn's disease. PMID- 2694905 TI - [The value of tumor markers in digestive oncology]. AB - Over the last few years, many tumor markers have been proposed to clinicians but only a limited number of them meet the necessary criteria to be useful for either screening, diagnosis, prognosis or follow-up of gastrointestinal (GI) tumors. Both CEA and Ca 19-9 have proven to be clinically useful for the detection of recurrent tumors. AFP remains the most useful marker for the follow-up of hepatocellular carcinoma (HCC). Its interest for the early detection of primary tumor is debated. Recent data suggest that assays based on monoclonal antibodies to AFP could be used for detection HCC in high risk populations. Decarboxy prothrombin assay may be a complement to the AFP test in this localization. In addition to GI hormones, serotonin and urinary 5HIAA, Neuron Specific Enolase appears to be a valuable marker for the follow-up of neuroendocrine tumors of the GI tract. Only a few of the new tumor-associated antigens detected by monoclonal antibodies, appear to be promising clinical ly e.g. Ca50 TAG-72, PAO. Monoclonal antibodies to tumor-associated markers have also been used with other techniques: Immunohistochemistry: this technique is useful to the pathologist for the diagnosis of undifferentiated tumors by demonstrating the presence of specific antigens on tissue samples. Immunoscintigraphy: it can be useful for the detection of either metastases of recurrences of colorectal cancer by using anti ACE antibodies labeled with Iodine 131 iodine 123 or indium 111. However immunoscintigraphy is less sensitive than both ultrasonography and CT scan for localizing hepatic metastases. At the present time the best indication of this method remains the diagnosis of pelvic recurrences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2694906 TI - [Value of non-reperitonization for preventing lymphocele after extended lymphadeno-colpo-hysterectomy. Our experience in a comparative retrospective series of 124 cases]. AB - Pelvic lymphadenectomy for genital cancer can lead to numerous complications, particularly lymphoceles. Two types of drainage were compared in a series of 124 patients treated by extended lymphadeno-colpo-hysterectomy. In the first group (n = 83), hermetic peritonization with aspiration drainage was performed, and in the second group (n = 41), non-peritonization combined with omentoplasty was performed. Lymphoceles developed in 20% of patients in the first group (17 cases), requiring 7% of repeat operations (5 cases). Lymphoceles occurred in only one patient in the second group. The combined use of the reabsorption qualities of peritoneum and omentum avoids lymphoceles complications, particularly in patients previously treated by external radiotherapy. PMID- 2694907 TI - [Parathyroid cancer]. AB - The study of one case of parathyroid cancer and a literary review permitted to state the following characteristics: it is a rare but not exceptional tumor. The endocrine syndrome represented by a hypercalcemia is frequently severe present. The tumor syndrome is often associated with locoregional invasion or metastasis. Clinical signs of malignity are as important as the anatomopathologic data. The surgical treatment is essential after a mecal hypocalcemic preparation. Thus, the prognosis may be good if the carcinologic rules are respected. PMID- 2694908 TI - Role of the standard 'liver function tests' in current clinical practice. AB - A prerequisite of current therapy in liver disease is precise diagnosis. The rapid increase in the number of tests available--immunological, virological, histological and radiological--testifies to this, and reflects the inadequacy of the 'standard' liver function tests (LFTs). The LFTs are, however, in contrast to these more sophisticated tests, observer independent and despite their lack of specificity, several characteristic patterns of abnormality can be recognised which direct the physician to the most appropriate definitive investigation. The cheapness and non-invasive nature of the LFTs makes them particularly appropriate for monitoring the course of liver diseases once the diagnosis has been established and this, together with screening for hepatotoxicity of newly developed drugs, is now their main role. A second generation of liver function tests based on the capacity of the liver to eliminate various test compounds may come closer to offering a true estimate of liver function. More accurate methods of measuring the various bilirubin fractions, particularly bilirubin conjugates may also become available in the near future and provide more sensitive tests of liver dysfunction. PMID- 2694909 TI - Biochemical investigation of muscle disease. PMID- 2694910 TI - Management of the ageing dental patient. AB - Dental care of elderly persons is very similar to that of younger persons but is often modified by a variety of age related and age associated changes. Diseases and the medications taken to treat them often have a direct effect on oral health. Clinical decision-making for the dental care of older adults can be more complex. Dental disease patterns within the ageing population seem to be changing and seem to be expressed differently resulting in more modifying factors which will require actual diagnosis and complicate treatment planning. This paper presents some definitions of geriatric patients with specific applications to dentistry. Using the available data the characteristics and needs of these patients have been described with particular reference to decision-making. Selected management issues have been discussed with particular reference to stress, communication, prevention and premedication. Some concepts in restorative care especially related to root caries were discussed. In prosthodontics the problems related to treatment have been identified and the incremental treatment technique discussed. Issues in the care of older dental patients are not often related to technical problems but are issues related to what is considered appropriate care, necessary treatment, where it should be carried out and the sequence in which it should be completed. PMID- 2694911 TI - Arthroscopy of the temporomandibular joint-technique and indications. AB - Temporomandibular joint arthroscopy has gained wide interest in reviews of recent literature. With this technique a proper understanding of the anatomical landmarks is important to ensure success. The technique for anesthesia, puncture and the arthroscopic examination are fully described. An inferior lateral approach to the joint compartment is advocated. A description of the equipment used for this procedure together with the functional elements of the instruments are emphasised. Indications for diagnostic arthroscopy together with the possible postoperative complications are presented. PMID- 2694912 TI - Flange design in removable partial dentures. AB - Flange design is an important component in the success of removable partial dentures. There are a number of factors such as undercuts, state of residual ridge, aesthetics, etc. that would influence the design. All these factors are interrelated and must be considered together. Only then will the denture serve its function for aesthetics without compromising the health of the remaining supporting tissues. The importance of each factor and its relationship to others are discussed. PMID- 2694913 TI - Jaw relationships and complete dentures. AB - In order to ensure comfort and efficiency from a denture it is important to record correct intermaxillary relationship both vertically and horizontally. A variety of techniques have been developed to produce accurate records and it would appear that a functional technique is most appropriate. Of the methods available evidence suggests that function of swallowing may be particularly useful in this respect. PMID- 2694914 TI - The development of a composite restorative system. AB - Composite resin restorative materials have been used in dental practice for over 25 years. The original composite resins were subjected to discolouration and marginal breakdown. These problems have largely been overcome with the exception of marginal gaps at the dentine-restoration interface. The introduction of dentine adhesives has reduced but not eliminate this problem. This study shows how the marginal gaps at the dentine-restoration interface were significantly reduced firstly by the introduction of an intermediate resin and then further by using a dentine adhesive. PMID- 2694915 TI - Aesthetic anterior restorations for children and young adults. AB - Indications for aesthetic anterior restorations include caries, trauma, congenital enamel defects, unaesthetic contour and shape of teeth, tooth discolouration and minor tooth malalignment. Conventional Class III, IV or V cavities can be restored with third and fourth generation composite resins, while glass ionomer cement can be used to restore Class III or V cavities. Laboratory fabricated resin or porcelain veneers enable major shape or colour adjustments of the labial surfaces of anterior teeth. They may be used to treat unaesthetic defects on the tooth surface, moderate to severe tooth discolouration and minor tooth malalignments. The clinical techniques of these restorative treatment modalities have been presented. PMID- 2694916 TI - Management of tooth discolouration. AB - Discolouration of teeth is a commonly seen dental problem which may affect not only facial aesthetics but also patient's self-image and psychological profile. There is an increasing awareness of such discolouration which may be localised or generalised. Restoration and improvement of this clinical problem has also improved with newer clinical techniques and better dental materials. The aetiology of discolouration is considered first, as this forms the basis of treatment modality to be selected. Management principles should clearly be considered with emphasis on patient input and acceptance. This has been enhanced with computer-aided projection of treatment results. The range of treatment modalities has been widened so that each specific problem can be treated with a method which improves final prognosis. The treatment methods are outlined with clinical cases presented as examples. PMID- 2694917 TI - Oral submucous fibrosis: a review. AB - Oral Submucous Fibrosis (SF) which is a relatively unknown disease in the early 60s is now widely regarded as a precancerous condition. In this paper, the author who is associated with the conception of this disease in India would, in addition to sharing his cumulative experience on this subject, review all the literature published since 1967 on Oral Submucous Fibrosis. An attempt is also made to unify current thoughts on the epidemiology, aetiology and clinical significance of this disease. PMID- 2694918 TI - Human immunodeficiency virus (HIV) infection and AIDS: an update in relation to dentistry. AB - Infection with the human immunodeficiency virus (HIV), the aetiologic agent of AIDS has emerged as the medicine's modern scourge of mankind. Despite the millions of pounds and dollars spent on conquering the disease, it is spreading globally and millions are thought to be currently infected. There is, therefore, little doubt that a large number of dental practitioners have either knowingly or unknowingly treated HIV infected individuals and they will continue to do so in the future. Therefore, all dental personnel should be aware of the epidemiology and clinical manifestations of the disease and the implications for clinical dentistry. This update is an attempt to review the expanding body of data on HIV infection and AIDS, particularly in relation to dentistry. PMID- 2694919 TI - [Non-steroidal anti-inflammatory agents and digestive lesions]. PMID- 2694920 TI - [Isolated high digestive angiodysplasia, an anatomo-clinical entity]. PMID- 2694921 TI - Bromocriptine alters hormone rhythms and lipid metabolism in swine. AB - Hormones, metabolites and activities involved in lipid synthesis were assayed in pigs made leaner by bromocriptine treatment. Market size female swine were allowed free access to food under natural lighting conditions and implanted with bromocriptine pellets designed to release 10 mg/pig/day for 28 days in an effort to inhibit prolactin secretion. Between the 2nd and 3rd week of treatment, plasma samples were obtained from each group at 4-hour intervals throughout the day for assays of prolactin, cortisol, insulin, triglyceride, cholesterol and glucose concentrations. Twenty-eight or thirty days after the implantations, all animals were sacrificed for determinations of backfat thickness and insulin binding in the liver. At sacrifice, bromocriptine treatment reduced backfat thickness by 14% and insulin binding to partially purified hepatic membranes by 39% compared with control values. At 14 days following implantations, there were dramatic daily variations in plasma cortisol and prolactin levels in the control pigs and these rhythms were markedly altered in phase and amplitude in the bromocriptine-treated pigs. Bromocriptine reduced by 45, 20 and 13% the high levels of triglyceride, glucose, and cholesterol, respectively, that were found in control pigs near sunset. Plasma insulin concentrations did not vary during the day in control pigs and bromocriptine did not influence the insulin levels. The findings support important roles for a temporal synergism of cortisol and prolactin rhythms in maintaining hepatic lipogenic responsiveness to insulin. Bromocriptine treatment alters these hormonal relations and reduces lipid synthesis. PMID- 2694922 TI - Insulin extraction and glucose output by the perfused liver of starved rats. AB - Using the isolated and perfused liver of rats, we investigated the effect of starvation on hepatic glucose output and hepatic insulin extraction. The rats were starved for 72 h. The intestines of fed and starved rats were isolated and perfused, and portal venous effluent (PVE) was collected. The liver of fed and starved rats was perfused with synthetic medium or PVE containing 100 mg/dl glucose and 100 muU/ml insulin. Fractional uptake of insulin and reduction in glucose output by the perfused liver were almost the same in all groups. These results suggest that the removal and action of insulin in the liver were not altered by short-term starvation in rats. PMID- 2694923 TI - Effects of fish oil capsules in two dosages on blood pressure, platelet functions, haemorheological and clinical chemistry parameters in apparently healthy subjects. AB - The effects of a fish oil concentrate with an omega-3 fatty acid content of 42% was determined in two dosages in a double-blind, placebo-controlled study with a parallel group comparison over a period of 5 weeks with 30 healthy subjects. The daily intake chosen was four and eight capsules corresponding to 1.26 or 2.52 g omega-3 fatty acids. Plasma viscosity, erythrocyte rigidity and systolic blood pressure were significantly decreased (p less than 0.01) after a 5-week administration of 2.52 g omega-3 fatty acid daily. The reduction in vitamin E concentration was significant (p less than 0.01) only in the low-dose fish oil group. Lipids and lipoproteins remained unchanged throughout this experiment. PMID- 2694924 TI - [Significance of flow cytometry in the prognosis of tumors of the kidney in adults]. AB - The DNA index was measured by flow cytometry on paraffin-embedded tissue blocks, from a series of 50 renal tumours studied retrospectively. These tumours consisted of 48 renal cell carcinomas and 1 oncocytoma. The mean follow-up was 3 years. TNM classification and Syrjanen's combined histological grading were used. There was a significant correlation between ploidy and nuclear grading (P = 0.02); between ploidy and TNM classification (72% of diploid tumours were T1 and T2, M0, N0, P = 0.01); between ploidy and development of metastases during the follow-up (71% of aneuploid tumours developed metastases, P = 0.04). In contrast, ploidy was not related with tumour differentiation (P = 0.052), and did not influence the overall long-term survival (P = 0.2). The small number of patients studied did not allow a significant survival rate to be established for each stage according to ploidy. The measurement of the DNA index by flow cytometry is prognostically useful for renal tumours, but must be compared with other prognostic parameters. Its therapeutic value will only be able to be assessed in the future; especially in conservative surgery indications, possibly in the choice of complementary therapeutic associations and even in the approach to treatment of metastases. PMID- 2694925 TI - [Cystic prostatic utricle in adults. Apropos of 3 cases]. AB - Three cases of cystic prostatic utricle, without any other urogenital abnormality, have been observed in patients of about thirty years old. Two of them were revealed by urinary and ejaculatory obstructive symptoms. The third, discovered by chance, contained calculi. In the three cases, treatment consisted of transurethral endoscopic resection of the anterior lining of the cyst which permitted ample drainage and ensured lasting healing. PMID- 2694926 TI - [Clinical epidemiology using an electronic value-added tabulator. Application to cancer of the prostate in TNM classification and in calculating Kaplan-Meier curves]. AB - The authors have been using the WHO-TNM 1977 classified, modified in 1982, for prostatic cancer for more than ten years. This classification has been considered to be insufficient to allow precise choice of therapeutic determinants and to accurately evaluate the results of treatments. A new WHO TNM 88 classification has been recently published and has raised many controversies in the urological literature which complicates the development of this classification. The authors have developed a value added system of TNM scoring using the Excel programme on a personal computer, which tries to integrate the various classifications 78-82-88. Very precise rules must be determined for information collection, the most reproducible medical indicators must be selected and they must be made as objective and as pertinent as possible. The rules of the WHO classification must then be formalized and introduced into the expert system as rules of production. The system allows optimal transcription of the scores from one classification to another, depending on the political orientations of the necessity of translation. Lastly, the system calculates, in real time, the actuarial survival and/or Kaplan Meier curves for all of the events identified by an indicator for the patient files entered into the system. PMID- 2694927 TI - Sewall Wright's contributions to physiological genetics and to inbreeding theory and practice. PMID- 2694928 TI - The molecular genetics of self-incompatibility in Brassica. PMID- 2694929 TI - Genetics of proteolysis in Escherichia coli*. PMID- 2694930 TI - Genetics of alcoholism. PMID- 2694931 TI - Homologous recombination in mammalian cells. PMID- 2694932 TI - Multipartite genetic control elements: communication by DNA loop. PMID- 2694933 TI - Genetic analysis of protein stability and function. AB - There is tremendous variability in the importance of individual amino acids in protein sequences. On the one hand, nonconservative residue substitutions can be tolerated with no loss of activity at many residue positions, especially those exposed on the protein surface. On the other hand, destabilizing mutations can occur at a large number of different sites in a protein, and for many proteins such mutations account for more than half of the randomly isolated missense mutations that confer a defective phenotype. At sites that are key determinants of stability or activity, even residue substitutions that are generally considered to be conservative (e.g., Glu in equilibrium Asp, Asn in equilibrium Asp, Ile in equilibrium Leu, Lys in equilibrium Arg and Ala in equilibrium Gly) can have severe phenotypic effects. Unfortunately, this means that there is no simple way to infer the likely effect of an amino acid substitution on the basis of sequence information alone. A nonconservative Gly----Arg substitution could be phenotypically silent at one position while a conservative Asn----Asp change could lead to complete loss of activity at another position. For proteins whose structures are known, it is often possible to predict whether particular residue substitutions will be destabilizing, as long as detailed estimates of the destabilization energy are not required. Substitutions that introduce polar groups, large cavities, or overly large side chains into the hydrophobic core are potentially the most destabilizing. Substitutions that disrupt hydrogen bonding or electrostatic interactions can also have significant effects, although the destabilization caused by these substitutions is smaller than that caused by severe core mutations. Destabilizing substitutions that involve replacing glycines in turns, or introducing prolines into alpha-helices and other disallowed positions are also reasonably common. Finally, most solvent exposed residues can apparently be freely substituted without serious effects on protein stability. Although exceptions may occur, these generalizations serve to summarize a large body of information and can be rationalized in physical and chemical terms. It is an especially encouraging result that proteins appear to tolerate most substitutions, even those that are destabilizing, without significant changes in the native structure. For proteins whose structures are known, this means that it is reasonable to interpret mutant phenotypes in terms of the wild-type structure. For proteins whose structures are not known, it is reasonable to infer that mutations that reduce activity without affecting stability are directly involved in function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2694934 TI - Prokaryotic signal transduction mediated by sensor and regulator protein pairs. PMID- 2694935 TI - Evolutionary quantitative genetics: how little do we know? PMID- 2694936 TI - Mechanisms that contribute to the stable segregation of plasmids. PMID- 2694937 TI - The molecular genetics of 21-hydroxylase deficiency. PMID- 2694938 TI - Habituation: heritable variation in the requirement of cultured plant cells for hormones. PMID- 2694939 TI - Molecular structure of human chromosome 21. PMID- 2694940 TI - Genetic regulation of bacterial virulence. PMID- 2694941 TI - Rhizobium genetics. PMID- 2694942 TI - Molecular genetics of nematode muscle. PMID- 2694943 TI - Alternative splicing in the control of gene expression. PMID- 2694944 TI - Structure and function of telomeres. PMID- 2694945 TI - Mechanism and developmental program of immunoglobulin gene rearrangement in mammals. PMID- 2694946 TI - The isochore organization of the human genome. PMID- 2694947 TI - Recombinational controls of rDNA redundancy in Drosophila. PMID- 2694948 TI - Gene amplification contributes to sulfonamide resistance in Escherichia coli. AB - A sulfathiazole-resistant strain of Escherichia coli was isolated and shown to contain a fourfold tandemly amplified segment of DNA 18 kilobase pairs in length in addition to a mutationally altered dihydropteroate synthase, the target enzyme for sulfonamide inhibition. The amplified DNA contained a gene designated sur that contributed to sulfathiazole resistance when present in greater amounts than those in the wild type. Sulfathiazole resistance was markedly decreased upon loss of the amplified DNA after nonselective growth. Plasmids that contained sur also conferred only weak sulfathiazole resistance on wild-type strains. Comparison of the restriction maps of the amplified DNA, wild-type DNA, and sur-containing plasmids showed that a DNA rearrangement occurred before or concomitant with the DNA amplification event. The DNA rearrangement resulted from an IS5 insertion, which, in conjunction with an IS5 element residing near sur in the wild-type strain, resulted in an -IS5-sur-IS5- configuration. Homologous recombination could account for duplication and subsequent amplification of the sur region. High-copy-number plasmids containing the sur locus did not express a sulfathiazole-resistant dihydropteroate synthase, nor did they overexpress wild type dihydropteroate synthase. These data suggest that the high level of sulfathiazole resistance in this strain results from a synergistic effect of two different mutations. PMID- 2694949 TI - Binding and killing of bacteria by bismuth subsalicylate. AB - Bismuth subsalicylate (BSS) is a compound without significant aqueous solubility that is widely used for the treatment of gastrointestinal disorders. BSS was able to bind bacteria of diverse species, and these bound bacteria were subsequently killed. A 4-log10 reduction of viable bacteria occurred within 4 h after a 10 mM aqueous suspension of BSS was inoculated with 2 x 10(6) Escherichia coli cells per ml. Binding and killing were dependent on the levels of inoculated bacteria, and significant binding but little killing of the exposed bacteria occurred at an inoculum level of 2 x 10(9) E. coli per ml. Intracellular ATP decreased rapidly after exposure of E. coli to 10 mM BSS and, after 30 min, was only 1% of the original level. Extracellular ATP increased after exposure to BSS, but the accumulation of extracellular ATP was not sufficient to account for the loss of intracellular ATP. The killing of bacteria exposed to BSS may have been due to cessation of ATP synthesis or a loss of membrane integrity. Bactericidal activity of BSS was also investigated in a simulated gastric juice at pH 3. Killing of E. coli at this pH was much more rapid than at pH 7 and was apparently due to salicylate released by the conversion of BSS to bismuth oxychloride. It is proposed that the binding and killing observed for BSS contribute to the efficacy of this compound against gastrointestinal infections such as traveler's diarrhea. PMID- 2694950 TI - Antibodies to nystatin demonstrate polyene sterol specificity and allow immunolabeling of sterols in Saccharomyces cerevisiae. AB - Polyclonal antibodies elicited by injection into rabbits of a nystatin-bovine serum albumin conjugate were reactive with both nystatin and amphotericin B. Upon labeling of polyene-treated Saccharomyces cerevisiae sterol auxotrophs grown on various sterols, nystatin reacted specifically with ergosterol, while amphotericin B did not react preferentially with ergosterol, cholesterol, or cholestanol. Time course labeling experiments demonstrated the rate of ergosterol transport into cholesterol-grown cells. PMID- 2694951 TI - Molecular characterization of the gene encoding SHV-3 beta-lactamase responsible for transferable cefotaxime resistance in clinical isolates of Klebsiella pneumoniae. AB - In Klebsiella pneumoniae 86-4, cefotaxime resistance was due to a transferable broad-spectrum beta-lactamase, SHV-3. The plasmid-borne gene encoding SHV-3 has been cloned, and the primary structure of the enzyme was deduced from its nucleotide sequence. SHV-3 differs from SHV-1 in two positions. The extended substrate profile of SHV-3 probably results from the substitution of Ser-213 for Gly, as in SHV-2, whereas replacement of Arg-180 by Leu resulted in a decrease in the pI from 7.6 to 7.0. The blashv-3 gene is highly homologous (92% DNA sequence identity) with the chromosomal gene coding for LEN-1 beta-lactamase of K. pneumoniae, suggesting that the origin of the SHV-encoding genes now present on many plasmids may be chromosomal. PMID- 2694952 TI - Drug susceptibility testing of Mycobacterium leprae in the BACTEC 460 system. AB - The susceptibility of Mycobacterium leprae to clinical and experimental antileprosy agents was assessed in the BACTEC 460 system. Nude-mouse-derived M. leprae (10(7) cells), incubated in BACTEC 12B medium at 33 degrees C under reduced oxygen, maintained a fairly constant growth index (14CO2 evolution) for 2 to 3 weeks. At concentrations ranging from 0.031 to 2.0 micrograms/ml, dapsone, rifampin, clofazimine, ethionamide, ofloxacin, clarithromycin, and minocycline all effected reductions in the growth index within 1 to 2 weeks, the extent of inhibition increasing with the incubation time. An in vivo rifampin-resistant isolate displayed markedly reduced susceptibility to rifampin compared with an in vivo-susceptible strain. This system appears to be highly suitable for in vitro drug susceptibility testing of M. leprae. PMID- 2694953 TI - Comparison of electronic and viability counting methods for determination of postantibiotic effect of oxacillin on Staphylococcus aureus. AB - The postantibiotic effect of oxacillin on Staphylococcus aureus ATCC 6538P was determined under different test conditions by reference (viability counting) and semiautomated (electronic counting) methods. Differences in durations of the postantibiotic effect obtained with the two counting methods were not statistically significant. The semiautomated method provided a more rapid and convenient alternative to viability counting. PMID- 2694954 TI - Interaction of E1040 with cephalosporinase from Citrobacter freundii GN7391. AB - The interactions of E1040 with cephalosporinase from Citrobacter freundii, including affinity and hydrolysis, were studied in comparison with those of cefotaxime and ceftazidime. E1040 showed a higher stability at low drug concentrations and a much lower affinity for the enzyme than did cefotaxime or ceftazidime. These enzymological properties explain the high activity of E1040 against cephalosporinase-producing C. freundii. PMID- 2694955 TI - Structural features related to hydrolytic activity against ceftazidime of plasmid mediated SHV-type CAZ-5 beta-lactamase. AB - Tryptic peptides of the novel ceftazidimase CAZ-5 were sequenced by manual Edman degradation and aligned according to strong homology (more than 98%) with SHV-1 and SHV-2 beta-lactamase sequences. CAZ-5 differed from SHV-1 by five amino acid substitutions. Unusually high activity of CAZ-5 towards ceftazidime was imputed to substitution of a Lys for a Glu at position 214 of the mature protein. PMID- 2694956 TI - Animal models for antiviral chemotherapy. AB - Traditionally animal models have formed a vital part of the preclinical evaluation of new forms of antiviral therapy. A variety of models used in the past or potentially useful in the future are considered in this short review. Several valuable and complex questions concerning virus-drug interactions in vivo have been successfully addressed by means of animal models. Better understanding of drug modes of action and virus pathogenesis in the models enable even more accurate predictions to be made for the outcome of antiviral therapy in man. The complexity of virus infections in man is such that animals are likely to remain an important part in drug evaluation for many years. To this end, new developments such as improved techniques in the production of transgenic animals are opening up a variety of completely novel methods for studying inhibitors of a wider group of viruses in vivo including the human immunodeficiency virus. However, the correct interpretation of animal data requires the critical evaluation of animal models. This review will identify several important difficulties which confront those working on antiviral chemotherapy in animals and which must continue to be addressed if confidence in animal data is to be maintained. PMID- 2694957 TI - Coenzyme Q systems in ascomycetous black yeasts. AB - 72 Strains belonging to 44 species of ascomycetous black yeasts were analyzed for their coenzyme Q systems. Prevalent were Q-10 and dihydrogenated Q-10 systems. Members of the Dothidealean suborder Dothideineae have Q-10(H2), while those belonging to the suborder Pseudosphaeriineae mostly have Q-10. The anamorph genus Exophiala Carmichael and the teleomorph genus Capronia Sacc. seem to be heterogeneous. PMID- 2694958 TI - The neonate in surgery. Perioperative nursing care. PMID- 2694959 TI - Comparison of membrane filtration and Autoanalysis Colilert presence-absence techniques for analysis of total coliforms and Escherichia coli in drinking water samples. AB - Over a 4-month period, 950 samples of treated drinking water were analyzed for total coliforms (TC) and Escherichia coli by both membrane filtration (MF) and Autoanalysis Colilert presence-absence (AC) techniques. The two tests agreed 97% of the time on the basis of presumptive TC results and 98.5% of the time on the basis of verified TC results. Samples which produced disagreement between the two tests were most often TC positive by MF and TC negative by AC. E. coli was recovered four times: twice by MF only, and twice by AC only but without the diagnostic fluorescence reaction. In two samples, E. coli could not be isolated from fluorescence-positive AC tests. On the basis of these results, the AC test was implemented as the routine analytical procedure for TC but not for E. coli. PMID- 2694960 TI - Trichloroethylene degradation by Escherichia coli containing the cloned Pseudomonas putida F1 toluene dioxygenase genes. AB - Toluene dioxygenase from Pseudomonas putida F1 has been implicated as an enzyme capable of degrading trichloroethylene. This has now been confirmed with Escherichia coli JM109(pDTG601) that contains the structural genes (todC1C2BA) of toluene dioxygenase under the control of the tac promoter. The extent of trichloroethylene degradation by the recombinant organism depended on the cell concentration and the concentration of trichloroethylene. A linear rate of trichloroethylene degradation was observed with the E. coli recombinant strain. In contrast, P. putida F39/D, a mutant strain of P. putida F1 that does not contain cis-toluene dihydrodiol dehydrogenase, showed a much faster initial rate of trichloroethylene degradation which decreased over time. PMID- 2694961 TI - Two Bacillus beta-mannanases having different COOH termini are produced in Escherichia coli carrying pMAH5. AB - The nucleotide sequence was determined for the alkalophilic Bacillus sp. strain AM-001 beta-mannanase gene which produced two beta-mannanases (A and B) in Escherichia coli transformants. The putative beta-mannanase gene was 1,539 base pairs long and encoded a mature beta-mannanase protein of 487 amino acids and a signal peptide of 26 amino acids. The COOH-terminal amino acid of beta-mannanase A is an arginine residue located at amino acid 513 of the deduced amino acid sequence, and that of beta-mannanase B is a valine residue located at amino acid 365. Deletion derivatives having 1,098 base pairs from the ATG start codon maintained the beta-mannanase activity of the encoded polypeptide. However, clones harboring DNA fragments (1,051 base pairs) shorter than the gene which encoded beta-mannanase B (1,095 base pairs) did not exhibit the beta-mannanase activity. The simultaneous production of both beta-mannanases A and B in an E. coli transformant was demonstrated by the maxicell procedure. PMID- 2694962 TI - Evaluation of immunofluorescence techniques for detection of Cryptosporidium oocysts and Giardia cysts from environmental samples. AB - Cryptosporidium and Giardia species are enteric protozoa which cause waterborne disease. The detection of these organisms in water relies on the detection of the oocyst and cyst forms or stages. Monoclonal and polyclonal antibodies were compared for their abilities to react with Giardia cysts and Cryptosporidium oocysts after storage in water, 3.7% formaldehyde, and 2.5% potassium dichromate, upon exposure to bleach, and in environmental samples. Three monoclonal antibodies to Cryptosporidium parvum were evaluated. Each test resulted in an equivalent detection of the oocysts after storage, after exposure to bleach, and in environmental samples. Oocyst levels declined slightly after 20 to 22 weeks of storage in water, and oocyst fluorescence and morphology were dull and atypical. Oocyst counts decreased after exposure to 2,500 mg of sodium hypochlorite per liter, and fluorescence and phase-contrast counts were similar. Sediment due to algae and clays found in environmental samples interfered with the detection of oocysts on membrane filters. Two monoclonal antibodies and a polyclonal antibody directed against Giardia lamblia cysts were evaluated. From the same seeded preparations, significantly greater counts were obtained with the polyclonal antibody. Of the two monoclonal antibodies, one resulted in significantly lower cyst counts. In preliminary studies, the differences between antibodies were not apparent when used on the environmental wastewater samples. After 20 to 22 weeks in water, cyst levels declined significantly by 67%. Cysts were not detected with monoclonal antibodies after exposure to approximately 5,000 mg of sodium hypochlorite per liter. PMID- 2694964 TI - Disorders of gonadal development in humans. PMID- 2694963 TI - Competition for glucose between the yeasts Saccharomyces cerevisiae and Candida utilis. AB - The competition between the yeasts Saccharomyces cerevisiae CBS 8066 and Candida utilis CBS 621 for glucose was studied in sugar-limited chemostat cultures. Under aerobic conditions, C. utilis always successfully completed against S. cerevisiae. Only under anaerobic conditions did S. cerevisiae become the dominant species. The rationale behind these observations probably is that under aerobic glucose-limited conditions, high-affinity glucose/proton symporters are present in C. utilis, whereas in S. cerevisiae, glucose transport occurs via facilitated diffusion with low-affinity carriers. Our results explain the frequent occurrence of infections by Crabtree-negative yeasts during bakers' yeast production. PMID- 2694965 TI - [Acrosome reaction in mammalian spermatozoa. Biochemical aspects]. AB - Mammalian sperm capacitation and the acrosome reaction (AR) are essential prerequisites for fertilization. This report examines part of the molecular events developed during capacitation and the AR of mammalian spermatozoa; especially those events related to sperm head membrane bound enzymes and phospholipids. For this purpose, it has been analysed results obtained from an in vitro capacitation/acrosome reaction inducing system for golden hamster spermatozoa. First of all, the analysis is focused in the phospholipid transmethylation reactions possibly occurring at plasma membrane level during capacitation and the AR; it is suggested too, that this pathway could provide the substrate for a sperm head membrane bound phospholipase A2 which is able to produce a lysophospholipid (a fusogen) and fatty acids; both of them, very likely involved in the late steps of the AR. These assumptions are confirmed by experiments demonstrating that exogenous lysophospholipids and/or cis-unsaturated fatty acids are able to accelerate AR in previously capacitated spermatozoa. It is also suggested future research in this field, which could involve a sperm phospholipase C specific for phosphatydil-inositol, 4.5 bisphosphate; its products, Inositol trisphosphate and diacylglycerol could act as second messengers with a probable physiological function during capacitation. Finally, an integrative mechanism for the AR-involving phospholipid methylation, acrosin activation, phospholipase A2 activation and endogenous lysophospholipids and fatty acids production is proposed as a model for discussion. PMID- 2694966 TI - [Bioassay of gamete membrane fusion: the past, present and future]. AB - The gamete membrane fusion test, that uses zona-free hamster oocytes to evaluate the fertilizing ability of human spermatozoa, is being widely used in andrologic laboratories throughout the world. This test evaluates several steps of the reproductive process such as: a) sperm capacitation; b) acrosome reaction; c) gamete membrane fusion; d) sperm chromatin decondensation; e) chromosome condensation; f) egg activation as measured by the cortical granule breakdown and completion of meiosis. This test does not evaluates the sperm transit from the vagina to the site of fertilization nor the sperm passage through the human egg vestments. However, the sperm transit has been partly solved by the use of naturally occurring human cervical mucus to obtain seminal plasma free spermatozoa. This latter technique has greatly increased the diagnostic value of the gamete membrane fusion test. Notwithstanding, the results obtained with this test can vary considerably among the different laboratories, because of variations in the experimental design of the test. These differences can have an important effect upon the attitude the scientist and/or the physician might take in a given case of infertility. The parameters that vary most among the different laboratories are: a) obtention of seminal plasma-free spermatozoa; b) sperm concentrations; c) sperm preincubation time; d) type and concentration of serum albumin used. The original objective of this test was to evaluate the fertilizing ability of spermatozoa of men with problems of infertility. Nowadays is being also used for the assessment of male infertility agents and drugs that might affect the human reproductive function. The correlation found between the results of the gamete membrane fusion test with fertility has resulted in its use in testing the fertilizing ability of bovine and equine spermatozoa. PMID- 2694967 TI - [Cyto and genotoxic effect of some environmental contaminants on spermatogenesis]. PMID- 2694968 TI - Three-dimensional morphometry of mammalian cells. I. Diameters. AB - Three-dimensional measurements of eleven kinds of cells, obtained from serial sections of five different organs, excised from eleven adult mammals of different body sizes-from a 40 g mouse to a 450 kg cow-were made. In order to minimize technical errors all organs were submitted to standardized fixation and staining procedures. Twenty cell diameters (at the nuclear level) were measured in each of the 7 microns serial tissue section which were made in two planes, after a 90 degree rotation of the fixed and embedded organ specimens. The mean values of the cell diameter measurements were submitted to a cluster analysis by means of a computer program, to establish the cell type groups with similar morphometric characteristics. The dendrograms of the cell-type groupings were then compared with the results obtained by applying the traditional statistical analysis of the cell sizes (in micrometers) in the three dimensions of space, and also with the principal component analysis. With the three statistical methods we came to analogous conclusions. The empirical allometric exponents for the three cell diameters, when expressed independently as functions of body mass, are not significantly different from zero, and in consequence cell sizes are independent of body mass. The physiological meaning of the body-size-independence of the mean three cell diameters is discussed. PMID- 2694969 TI - Doppler blood flow velocity waveforms in the fetal renal artery. AB - In 19 out of 20 human fetuses we recorded blood velocity waveforms in the renal artery by means of a duplex Doppler sector scanner. One fetus was at 22 weeks gestation, 7 fetuses were between 32 and 35 weeks, and 12 fetuses between 36 and 40 weeks. There was no evidence of intrauterine growth retardation and there was a normal quantity of amniotic fluid in all pregnancies. We also recorded waveforms in the umbilical artery, the descending aorta, and the internal carotid artery. The RI in these vessels showed normal values in all cases. There was no end-diastolic flow in four of the seven fetuses studied at 32 to 35 weeks gestation. The mean RI of fetuses with end-diastolic flow was 0.86 (SD 0.03). The interpretations of these results, and ideas for future studies are discussed. PMID- 2694970 TI - Hemodynamic and hemorheological profiles in women with proteinuric hypertension of pregnancy and in pregnant controls. AB - We obtained blood samples from 52 patients with pre-eclampsia and from 40 pregnant controls for measurement of plasma urate levels, hematocrit, white cell count and various hemorheological parameters. We also used impedance cardiography to measure cardiac output in both groups and from the results derived values for total peripheral resistance and oxygen transport. Central venous pressure was measured with a superior vena cava catheter in patients with pre-eclampsia but not in controls. Women with pre-eclampsia had significantly lower cardiac output and central venous pressure when compared with a control group. A modest correlation was observed between central venous pressure and cardiac output. The majority of pre-eclamptic patients had significantly raised hematocrit, leucocyte count, uric acid and red cell aggregation. Red cell deformability was significantly decreased in patients with pre-eclampsia. Most patients with severe pre-eclampsia (BP diast. greater than 100 mmHg) had a low Antithrombin III and colloid osmotic pressure level. The leucocyte count was raised when compared with the women with moderate pre-eclampsia. Oxygen delivery was reduced in patients with pre-eclampsia because of impaired rheological properties of their blood. PMID- 2694971 TI - [Myelolipoma of the adrenal gland: a study of 2 cases using ultrasonography and computerized axial tomography]. AB - We report on two patients with myelolipoma of the adrenal gland submitted to assessment by ultrasound (US) and CT. No patient had clinical symptoms or signs; the tumor had been discovered incidentally. US and CT currently permit diagnosis of this tumor type because of its characteristic images. PMID- 2694972 TI - [Ureteral perfusion test in the urodynamic evaluation of the upper urinary tract: critical review and case study]. AB - The authors report on their clinical experience with the use of Whitaker test in 38 patients (27 men, 5 women; age 3 months-66 years). Clinical applications of ureteral pressure-flow test are extensively reviewed. A standardized method with simultaneous recording of bladder pressure and combined video-pressure-flow study are basic points to be considered in order to obtain more objective data. PMID- 2694973 TI - [Multicystic kidney: retroperitoneal mass frequently found in newborn infants]. AB - Ten cases of multicystic kidney in newborn infants are described herein. The diagnostic value of ultrasound during the prenatal period and postnatal follow-up is highlighted. The therapeutic approach in this condition is discussed. PMID- 2694974 TI - [Carvernosometry in impotence: method and standardization of normal values]. AB - Cavernosometry and cavernosography in conjunction with artificial erection have been included in the protocol for the evaluation of sexual dysfunction in the male. The device is comprised of a volumetric infusion pump with a digital flow indicator, and the technique employed is bilateral puncture of the corpora cavernosa. Pressures are recorded by one needle while saline and contrast medium are introduced through the other. Eight males with no organic disorder were assessed for erection flow (EF) and maintenance flow (MF) to determine the normal and pathologic values for this method of evaluation. These values have a normal distribution. Calculation using formulas with a 99% reliability gave the following as pathological values: EF greater than 181 ml/min. or MF greater than 99 ml/min. PMID- 2694975 TI - [Angiomyolipoma of the kidney. Presentation of a case]. AB - We report on a patient with renal angiomyolipoma, an uncommon disease entity. The results of the clinical workup and complementary evaluation methods are presented. The surgical technique is described and the result of the pathological examination of the surgical specimen is presented. The literature is reviewed and the most important aspects are discussed. PMID- 2694976 TI - [Eosinophilic polypoid cystitis with flat carcinoma in situ of the overlying epithelium]. AB - A case of eosinophilic polypoid cystitis with flat carcinoma in situ of the overlying epithelium is described. This is the first case with such an association encountered in our series comprised of 26 bladder surgical specimens and represents an incidence rate of 0.38%. The clinical case described herein is that of a 62-year-old male patient with a clinical picture of hematuria, frequency and urgency. Patient cystoscopic evaluation revealed a congestive and edematous mucosa at the level of the trigone and sessile polyps. Microscopic examination revealed flat urothelium with anisokaryosis, hyperchromatic nuclei, atypical mitosis, and loss of polarity; chorion with diffuse, dense inflammatory infiltrate comprised of eosinophils accounting for greater than 90% of the cell population, plasma cells, mastocytes, edema and vascular congestion. Epithelial erosion and capillary thrombosis were also observed. We discuss the etiology, clinical features and treatment reported elsewhere. PMID- 2694977 TI - The kidney in rheumatic diseases. PMID- 2694978 TI - Thiabendazole vs. albendazole in treatment of toxocariasis: a clinical trial. AB - Between 1986 and 1988, 34 patients (age range six to 83 years) with visceral or ocular larva migrans were randomly assigned to a five-day treatment with thiabendazole 2 x 25 mg kg-1 day-1 (15 patients) or albendazole 2 x 5 mg kg-1 day 1 (19 patients). On the fifth treatment day, six patients (40%) in the thiabendazole group and 11 patients (58%) in the albendazole group showed excellent or good drug tolerability. Efficacy of treatment was assessed after 30 weeks (range six to 56 weeks). In the thiabendazole group, median eosinophilia remained at 14% and four patients (27%) were clinically cured. In the albendazole group, the median eosinophilia decreased from 10 to 3.5% and six patients (32%) were clinically cured. We recommend albendazole for treatment of visceral and ocular larva migrans with a minimum dose of 10 mg kg-1 daily for five days. PMID- 2694979 TI - Echinococcus multilocularis: ultrastructural effect of in vivo albendazole and praziquantel therapy, singly and in combination. AB - Cotton rats with Echinococcus multilocularis infections of one month's standing were treated for six months with albendazole (50 mg kg-1 day-1), or praziquantel (500 mg kg-1 day-1), or both drugs simultaneously. The germinal layer of albendazole-treated cysts differed little from control tissue apart from marginal increase in cyton vesiculation and the presence of small lamellated residual bodies. Protoscolex tissue appeared unaffected. The germinal layer of praziquantel-treated cysts differed markedly from control tissue, with increased vesiculation and mitochondrial number in those with intact germinal layers, and disintegration and detachment of the layer in other cysts. Protoscoleces were necrotic. After combined therapy, the germinal layer was either intact but with increased vesiculation and residual bodies present, or was disintegrating and detaching from the laminated layer. PMID- 2694980 TI - Observations on human echinococcosis (hydatidosis) and evaluation of transmission factors in the Maasai of northern Tanzania. AB - An attempt was made to estimate the prevalence of hydatid disease amongst the Maasai people of northern Tanzania and to examine the factors which would contribute to the transmission of the disease in this region. Retrospective review of hospital records revealed an annual surgical rate of hydatid disease for 1977 through 1986 of 11 per 100,000 people. Ten (1%) of 959 people screened by ultrasound scanning had hydatid cyst-like echoes, giving a prevalence estimation of 1.4%. Thirty per cent of positive ultrasound cases were also positive in an ELISA antibody test. Three of four dogs necropsied and two of six dogs purged were found to harbour patent Echinococcus infections. Quantitative man:dog contact studies, examination of soil and water samples for Echinococcus eggs and comparison of the anti-Echinococcus antibody responders revealed that there are few marked differences in exposure to infection between the Maasai and the Turkana, who have a much higher prevalence of hydatidosis and perhaps the highest prevalence in the world. Hypotheses to explain the differences in the infection rate between these two groups of pastoralists who share a similar traditional lifestyle are presented. The Maasai, like the Turkana, had no knowledge of hydatid disease, and it is suggested that the best way to control the disease in Maasailand would be by proven dog control measures, supported by a suitable, more durable, educational programme. PMID- 2694981 TI - Changes in serum transferrin and iron concentrations in humans suffering from malaria with parasitaemia. AB - Sera from non-malarial (control) and Plasmodium falciparum-infected (malaria) subjects were assayed for transferrin and iron. The mean serum transferrin concentration in the malaria sera was found to be elevated by 44% above the control value. The mean serum iron was also raised in the malaria sera, but the increase (19%) was found to be well below that of transferrin. The mean saturation of serum transferrin with iron fell from 42 +/- 17% in the control group to 37 +/- 9% in the malaria group. It is suggested that the increase in transferrin concentration in the sera of malaria subjects probably resulted from an increase in the rate of transferrin synthesis, perhaps in response to the raised serum iron and/or the hypoxia which is known to be associated with malaria infection. PMID- 2694982 TI - Sporozoite antibodies and malaria in children in a rural area of The Gambia. AB - Sporozoite antibody levels were measured in a group of children aged one to nine years resident in a rural area of The Gambia, using an ELISA to the repeat peptide (NANP)40. The prevalence and titre of antibodies varied with age but not with sex or ethnic group. Significant variations in prevalence were recorded within a group of adjacent villages. Children who were seropositive at the beginning of the dry season had higher spleen and parasite rates both at this time and at the end of the subsequent rainy season than did seronegative children, suggesting that they were exposed more frequently to infection. However, seropositive children had fewer episodes of fever accompanied by high levels of parasitaemia than did seronegative children, suggesting that they had a greater degree of clinical immunity. No differences were found in seroprevalence rates or in mean antibody titres between children who slept under conventional or Permethrin treated bed nets and those who did not, even though bed nets significantly reduced the number of bites by vector mosquitoes. PMID- 2694983 TI - Ion exchange paper adsorption and thin-layer chromatography for detection of chloroquine in urine for the study of chemosensitivity of Plasmodium falciparum. AB - With a view to determining the chemosensitivity of Plasmodium falciparum to chloroquine, two qualitative tests for the detection of this antimalarial agent in urine were compared in Central African schoolchildren: the test of Dill and Glazko and a thin-layer chromatography technique involving ion exchange and extraction. Results obtained with 149 subjects showed the marked superiority in specificity and sensitivity of the chromatography test. This is of particular interest when selecting subjects before a therapeutic trial is undertaken. After administration of a single dose of chloroquine (10 mg kg-1) to 14 schoolchildren, both urinary detection tests gave positive results at 24 and 48 hours. However, on day 7 all results with the chromatography test were positive, while 57% of false negatives were recorded by the Dill and Glazko test. PMID- 2694984 TI - A history of sleeping sickness in Kenya. AB - Gambian sleeping sickness entered what is now Kenya from Uganda in about 1901 and quickly spread along the Kenyan shores and islands of Lake Victoria, reaching Tanzania in 1902. By 1910 the disease had spread 25 miles inland along the Kuja and Migori rivers and their tributaries. Sleeping sickness waxed and waned in these areas despite attempts to control tsetse fly populations by various methods. It was not until 1950, when the use of insecticides (DDT) applied by backpack sprayer proved successful against Glossina fuscipes at Kibigori, that eradication of G. fuscipes and Gambian sleeping sickness seemed possible. Subsequently the Kuja-Migori endemic area was cleared of flies and disease, as well as the South and Central Nyanza lake shores and islands. By 1965 Gambian sleeping sickness had virtually disappeared from Kenya. A more virulent form of the disease, Rhodesian sleeping sickness, may have also spread to Kenya from Uganda, although its appearance in diverse areas of the Gambian disease suggest that local ecological factors may have played a role in enhanced virulence of trypanosomes stocks. The Rhodesian form of sleeping sickness appeared in the Lambwe Valley, South Nyanza, in about 1959, and despite attempts to eradicate this disease it still persists as the only remaining endemic area in Kenya at this time. The usual transmission of Rhodesian sleeping sickness by G. pallidipes in Kenya was altered when an outbreak occurred at Alego, in Central Nyanza, in 1964. It was discovered that G. fuscipes was the vector and that domestic cattle were an important reservoir of infection. Glossina fuscipes was also the vector of Rhodesian sleeping sickness in an outbreak in Samia in 1976 and another along the lakeshore in South Nyanza in 1981. Sleeping sickness has been restricted primarily to the Western and Nyanza Provinces of Kenya (Fig. 1). PMID- 2694985 TI - Sleeping sickness in the Lambwe Valley in 1978. AB - Even though tsetse control measures were discontinued in the Lambwe Valley in 1974 the prevalence of Rhodesian sleeping sickness remained at low levels. A survey conducted in 1978 verified a low prevalence of disease (0.1%). Thirty-four per cent of the individuals tested were positive for malaria with the highest prevalence (44%) in children aged 0-9 years. Thirteen of 1340 individuals (0.97%) tested and found negative for sleeping sickness in 1978 developed the disease by 1985. Fourteen individuals with moderate titres (2+) in the IFAT but who showed no evidence of disease were traced and found to be alive and well seven years later. Three of these patients still had positive titres but the others had converted to negative. Sera from four patients infected and treated in 1978 were also positive, but only one of five patients treated in 1977 reacted in the test. The CFT as described did not appear useful as a diagnostic test. PMID- 2694986 TI - Diagnosis of Rhodesian sleeping sickness in the Lambwe Valley (1980-1984). AB - In primary Rhodesian sleeping sickness patients, parasitological diagnosis was best performed by rodent inoculation of blood (98.5%+) followed by Giemsa-stained thick blood smears (93.3%+). Parasitological diagnosis in relapse patients was sometimes impossible and clinical diagnosis based on CSF examination was necessary. Early during a disease outbreak in 1980, 89% of the infections were detected by mobile field teams, but once established in the endemic area a stationary diagnostic facility detected most of the cases. A total number of 23,751 examinations for Rhodesian sleeping sickness and malaria were made by mobile field teams during 1980-1984; 102 primary cases (0.43%) and 25 (0.10%) relapse cases were diagnosed. A total of 9339 individuals (39%) had patent malaria infections. The IFAT was positive in 89% of the primary sleeping sickness patients and 77% of the relapse patients. Seventy-nine per cent of the primary patients were positive in a CFT test, and 77% of the relapse patients were considered positive. PMID- 2694987 TI - Immunodiagnostic tests on cerebrospinal fluid in the diagnosis of meningoencephalitic Trypanosoma brucei rhodesiense infection. AB - Fourteen cerebrospinal fluid (CSF) samples obtained from Rhodesian sleeping sickness patients from the Lambwe Valley at relapse were positive for the presence of anti-trypanosomal antibody by both IFAT and ELISA. The mean optical density (o.d.) in the ELISA test was 0.804 +/- 0.362 and ranged from 0.258 to 1.363. CSF from five patients from the same area without evidence of meningoencephalitis were all negative by ELISA (mean o.d. 0.023 +/- 0.016, range 0.011-0.051). Control CSF samples from U.K. patients without Rhodesian sleeping sickness but with elevated levels of CSF total protein were also negative. Antibody detected by ELISA declined after Mel-B treatment of relapse and most samples had returned to negative within two years of treatment. We present evidence that serological evaluation of the CSF by ELISA and/or IFAT can provide supportive evidence of the trypanosomal origin of the infection. This is especially important at the time of relapse, when parasitological diagnosis may be impossible and records of treatment for the primary infection may not be available. PMID- 2694988 TI - [Study of the sensitivity of the L-forms of group A Streptococcus to antibiotics in artificial nutrient media and in human cell cultures]. AB - Sensitivity of L-forms of group A streptococci to 5 antibiotics such as erythromycin, lincomycin, tetracycline, gentamicin and chloramphenicol was studied in an artificial nutrient medium and cell cultures i.e. human fibroblast diploid cells and transplantable human heart cells (Girardi). In vitro investigation of the antibiotic effect on the streptococcal L-forms revealed their sensitivity to erythromycin (MIC, 0.4 micrograms/ml), lincomycin (MIC, 0.08 microgram/ml) and tetracycline (MIC, 2 micrograms/ml). The streptococcal L-forms were slightly sensitive to gentamicin (MIC, 6 micrograms/ml) and chloramphenicol (MIC, 30 micrograms/ml). Complete inhibition of the growth of the L-forms in the Girardi cells on the 1st day of the experiment after the antibiotics administration in single doses was induced by lincomycin, 5 micrograms/ml, erythromycin, 10 micrograms/ml, and tetracycline, 100 micrograms/ml. In the diploid cells, the respective figures were 50, 100 and 200 micrograms/ml. Chloramphenicol and gentamicin had an inhibitory effect on the growth of the L forms but produced no sanative effect. PMID- 2694990 TI - [Resistance of Shigella to antibiotics]. AB - Antibiotic sensitivity of 104 Shigella clinical strains and 104 Escherichia coli strains isolated from patients with acute dysentery not treated with antibiotics in 1986-1987 was studied. It was shown that 100 per cent of the dysentery pathogens and colon bacilli were antibiotic resistant. Strains resistant simultaneously to chloramphenicol, ampicillin, streptomycin, tetracycline, monomycin and kanamycin were the most frequent among the dysentery pathogens. Colon bacilli and dysentery pathogens isolated from the same patient had specific sets of antibiotic resistance markers. Pathogenetic therapy of dysentery and exclusion of antibiotic use for several years did not result in lower numbers of Shigella antibiotic resistant strains. PMID- 2694989 TI - [Drug resistance of the causative agent of Grigo'rev-Shiga dysentery (Shigella dysenteriae 1)isolated in the USSR]. AB - Forty strains of S. dysenteriae 1 isolated in the USSR within 1986-1988 were tested for their resistance to 11 antibacterial drugs. It was shown that 92.5 97.5 per cent of the isolates were resistant to chloramphenicol (Cm) and tetracycline (Tc), 22.5 per cent to streptomycin (Sm), 17.5 per cent to nalidixic acid (Nal) and 10 per cent to ampicillin (Ap) and polymyxin (Pm). Resistance to Cm Tc (51.4 per cent) and Cm Tc Nal (13.5 per cent) represented the predominating phenotype. 35 per cent of the strains carried conjugative R plasmids. In the majority of the cases, the determinants of resistance to Cm and Tc were transferred, which must define the high frequency of the strains resistant to Cm and Tc. All the tested strains were sensitive to gentamicin, neomycin, rifampicin, cefamezin and ciprofloxacin. Since the strains of S. dysenteriae 1 proved to be highly sensitive to the tested drugs it appeared possible to consider them as the drugs of choice in etiotropic therapy of patients with dysentery caused by the pathogens of the Grigoryev-Shiga group. PMID- 2694991 TI - [Current principles of antibiotic therapy of acute bacterial meningitis]. PMID- 2694992 TI - [Low-molecular weight immunomodulators of microbial origin]. PMID- 2694993 TI - Immunocytochemistry of male reproductive organs. AB - Immunological techniques have enabled us to see that mammalian sperm undergo complex surface changes during maturation in the male reproductive tract. Binding affinity and sperm surface binding domains have been demonstrated using immunocytochemical technique. Recent studies using monoclonal antibodies suggest that these highly specific probes are useful for detecting changes in the sperm surface during epididymal transit and in defining the role of these complex changes in sperm maturation and the process of fertilization. Studies involving immunological mapping of the sperm surface, in parallel with immunohistological and functional inhibition test, have provided important information concerning the role of individual sperm antigens in fertility. A better understanding of local antibody production and cell-mediated immune responses in the male reproductive tract has also led to the understanding of immunological infertility. Sperm membrane is comprised of multiple domains each of which is sharply demarcated, with a unique composition and physiological role. PMID- 2694994 TI - Interpretation and misinterpretation of semen parameters. AB - Semen analysis, which is traditionally used to evaluate male fertility, may be misleading if sample is lost or inadequately mixed. A short or excessive abstinence period may cause a low count or a high count with low motility. Damage from low temperature or delay in evaluation may decrease the reported motility. Computer-assisted semen analysis has eliminated some of the variability and has allowed the evaluation of other sperm motion variables such as sperm velocity, linearity, maximum and mean amplitude lateral head displacement, and beat-cross frequency. These measurements may also occasionally be misleading. Other tests may give a better indication of the function of sperm. The hamster egg penetration test has been used but is technically difficult, and perhaps that is why there is controversy as to the clinical value of the test in predicting subfertile sperm despite normal conventional semen analysis. Some recent data suggest that the hypo-osmotic swelling test, which determines the functional integrity of the sperm membrane, may be the appropriate prognosticator. There is a need for further studies to define the best method to determine whether a male factor is responsible for a couple's infertility. PMID- 2694995 TI - Laser radiation and motility patterns of human sperm. AB - Human sperm were exposed in vitro to laser radiation. An increase in progressive sperm motility was associated with a faster rate of sperm ATP consumption. Computer-assisted analysis of sperm motility confirmed the positive effect of laser irradiation on velocity and linearity of sperm. PMID- 2694996 TI - Chlamydial infection and male infertility: an epidemiological study. AB - Chlamydia-positive genitourinary infections are common causes of male and female infertility. Semen abnormalities are often associated with Chlamydia infections. A large population of male patients, admitted to our clinic for genitourinary infection, were examined for genitourinary pathogens, including Chlamydia, and for semen abnormalities. There were higher abnormalities semen in Chlamydia infected patients than either non-Chlamydia-infected or healthy controls. Chlamydia therapy by antimicrobial agents improved semen characteristics. Chlamydia infection contributes to seminal fluid abnormalities and probably to male infertility. A search for chlamydial infection is warranted whenever semen abnormalities are noted. An antimicrobial therapy improves semen quality when effective in eradicating Chlamydia. PMID- 2694997 TI - Semen characteristics and infertility in aging. AB - A study was initiated to compare the spermiograms according to age in 570 consecutive men with a history of infertility. The semen was evaluated by computer-assisted semen analysis (CSA) and by the hyposmotic swelling test (HOS). A statistical difference was seen between men over 50 years of age compared with younger men, but only for the HOS scores and velocity. No statistical differences were found on any of the other parameters. Since most semen parameters were similar even in the men over age 50, a definite decline in fertility potential with increasing age could not be determined by this study. PMID- 2694998 TI - [Mineralization and structure of enamel (a study using scanning electron microscopy and X-ray micro-analysis of the lower incisor of the albino rat)]. AB - In order to know the morphostructural changes that occurs in the enamel during the mineralization and to study the rod tridimensional orientation, the author has examined the literature concerning these subjects comparing it to the results of his researches realized by S.E.M. and Rx-microprobe-analysis. It has been demonstrated that three phases can be distinguished during the mineralization: "fibrillation phase", "rod density phase", "interrod density phase". The fibrillation phase begins in the middle of the ameloblastic secretion phase, ends 8 mm from the cervical ansa and is characterized by the unmasking of the matrix subunits and chemically by the disappearance of the sulphur. The rod density phase occurs in the area included between 8 and 14 mm from the cervical ansa, that is in the ameloblastic modulation phase, and is characterized by the aggregation of the intraprismatic subunits and by the calcium increase. The interrod density phase that occurs during the ameloblastic pigmentation phase, is characterized by the aggregation of the interprismatic subunits and by the presence of the iron in the most superficial enamel layers. The rod orientation in the space has been studied during the second phase of the mineralization suice the intraprismatic subunits join while the interprismatic ones remain in the fibrillation phase; besides the author has compared the results of these studies to the morphology of the external opening of the honeycomb pits. In such a way it has been demonstrated that the rod originates from the dentine-enamel junction forming a 60 degree angle that opens in the cuspidalmesial or cuspidal-lateral direction. In the outer enamel layer the rod loses its mesial or lateral inclination and bends further towards the cusp delimiting a 30 degree angle; finally it bends outward and as a sharpend that is ortogonal to the enamel external surface. It is eventually discussed how this model of rod reconstruction is fit to convert the tangential forces that develop during the mastication into compression forces. PMID- 2694999 TI - [Recent ultrasonographic advances in the early diagnosis of carotid stenosis]. AB - We review the present status of screening technology in the early diagnosis of carotid stenosis, underlining the advantages of TSA echo-Doppler screening and transcranial Doppler, versus invasive (arteriography) and non-invasive indirect methods. We describe the screening technique and classification criteria for carotid disease with this technique, providing several clinical cases emphasizing the need to adopt a risk strategy, which coordinates primary assistance with modern technology to approach asymptomatic patients and to reduce the cerebrovascular mortality rate. PMID- 2695000 TI - [The neurology of sleep]. PMID- 2695001 TI - Extrapolation of pharmacological and toxicological data based on metabolic weight. AB - Small animal species require higher doses of drugs and more frequent administrations than larger species. However, when drugs are metabolized to a toxic by-product, the contrary may be true. For many non-carcinogenic products a valid relationship has been found to exist between dose, plasma levels, body size, and response. Extrapolation of pharmacological and toxicological data based on metabolic weight (W body 0.756) seems to be safe within the groups of ruminants and monogastric herbivores as well as from one carnivorous species to another. If great variations are observed in response of some animal species, with no relationship to animal size, it will be unlikely that any prediction can be made for other animal species. If pharmacokinetic equivalence is critical, pharmacokinetic studies should be conducted to ensure that dosage regimens are equivalent in each species. The dosing guidelines suggested on the basis of metabolic weight apply to testing of drugs, consumer products, and environmental contaminants. The approaches suggested in the discussion for a solution to the problem may help expanding possibilities for extrapolation of pharmacological and toxicological data from laboratory animal to those relevant to man and other mammalian species. PMID- 2695002 TI - [40 years of the German Democratic Republic reflected in the "Archiv fur experimentelle Veterinarmedizin"]. PMID- 2695003 TI - [25 years of Mycoplasma research in the Institute for Bacterial Animal Epidemic Research in Jena]. AB - Twenty-five years of persistent research at the Jena Institute of Bacterial Animal Diseases have yielded substantive results of relevance to general knowledge and veterinary practice in the following fields: Mycoplasma species in farm animals-isolation, demands on culturing substrate, and differentiation; Virulence testing; Development, production, and application of diagnostic preparations; Development to full application maturity of diagnostic techniques and concepts for control of several mycoplasmal infections of relevance in terms of economy. The mycoplasma laboratory in Jena has become established as the reference centre for mycoplasma species in mammals for all CMEA member countries. PMID- 2695004 TI - [Escherichia coli enterotoxins--their significance for food hygiene and recent findings on the structure and mode of action (review)]. AB - Enterotoxin-forming Escherichia (E.) coli germs may be a cause of food poisoning. Any assessment of E. coli in various types of foodstuff together with an appraisal of its relevance to food hygiene will be of inadequate reliability unless virulence properties of germs are investigated, as well. No comprehensive evaluation can be made of quantitative occurrence of food poisoning caused by enterotoxigenic E. coli strains. Literature data are now being compiled on the occurrence of such strains in food items and on the incidence of intoxications. Reference is made in great detail to recent findings on structure and mode of action of heat-labile and heat-stable enterotoxins of E. coli. PMID- 2695005 TI - Genetic and molecular characterization of pR351 plasmid from enteropathogenic Escherichia coli strain. AB - A pR351 plasmid (Tc Ap Cb) conferring drug resistance of naturally occurring E. coli strain was examined. Conjugation and transduction experiments have indicated that this plasmid is R plasmid aggregate consisting of three independent plasmids: a) conjugative plasmid pR351 A (SuTc) fi- (F) belonging to incompatibility group L, b) conjugative plasmid pR351 B (SuApCb) fi- (F) belonging to incompatibility O, and c) non-conjugative plasmid pR351 C (ApCb). The existance of these plasmids in pR351 plasmid aggregate was confirmed by the agarose gel analysis of plasmid DNA isolated from the lysates of E. coli J53 transconjugants carrying pR351 A or pR351 B plasmids and from E. coli K12 C600 transductant carrying pR351 C plasmid. Molecular mass of these plasmids was found to be 55.60 and 3 Mdal respectively. The non-conjugative pR351 C plasmid could be mobilized by Col B and F factors. Our findings have indicated that two fi- (F) R plasmids can stably coexist in R plasmid aggregate. PMID- 2695006 TI - The T cell receptor in the mouse. AB - In the eighties the genes of the T lymphocyte antigen receptor (TcR) have been cloned. The search for the elusive and controversial TcR is over. It is clear that genes for TcR are distinct from those of Ig genes although these genes belong to the immunoglobulin supergene family. The aim of this article is to scan briefly a history of the searching for TcR, than to update our knowledge about TcR. With the search for TcR behind, a new set of question and goals lies ahead. How does TcR, which is similar to Ig, recognize foreign antigen in association with major histocompatibility complex (MHC) gene products? What is the relationship between TcR and Iat molecules, including misterious I-J product? PMID- 2695007 TI - Inhibitory effect of new pyrimidine bases on Trypanosoma cruzi. AB - Nine analogues of pyrimidine bases have been tested in vitro, using cultures of epimastigote forms of Trypanosoma cruzi: Three of them are inhibitors of the normal development of Trypanosoma cruzi. PMID- 2695008 TI - Investigations on the antiproliferative effects of amino acid antagonists targeting for aminoacyl-tRNA synthetases. Part I--The antibacterial effect. AB - Amino acid antagonists with proven or potentially inhibitory activities on aminoacyl-tRNA synthetases were tested for their antiproliferative effect against E. coli B. The compounds 4- and 6-fluoro-tryptophan, 5-methyltryptophan, selenocystine and beta-(2-thienyl)alanine gave strong growth inhibition in minimal medium, which disappeared after addition of structurally related natural amino acids or in an enriched broth. The inhibitory effect on amino-acyl-tRNA synthetases and the minimal inhibitory concentration for growth inhibition in minimal medium could not be correlated. PMID- 2695009 TI - Functional results following fractures of the proximal humerus. A controlled clinical study comparing two periods of immobilization. AB - In order to compare 1 and 3 weeks of immobilization following proximal humeral fractures a prospective controlled trial was performed in 85 patients. Clinical follow-up according to the Neer assessment system was done after 1, 3, 6, 12, and 24 months. One week of immobilization resulted in a better total score due to less pain during the first 3 months. After 6 months no difference in pain, function, or mobility was found and no further recovery of shoulder function was seen after 12 and 24 months. PMID- 2695010 TI - Incisional hernia through iliac crest defects. A report of three cases with a review of the literature. AB - Although the iliac crest is the most common site from which autogenous bone grafts are obtained, complications are surprisingly rare. One of these is incisional hernia through the resulting bony defect. Occasionally, the herniated contents may proceed to obstruction or strangulation and require emergency surgery. Elective repair of such hernias is advisable in order to avoid such complications. Attention to primary closure of bony iliac defects when complete is mandatory to prevent the occurrence of incisional hernia. PMID- 2695011 TI - Malignant schwannoma. A case report and review of the literature. AB - A rare case of a malignant schwannoma presenting as a central fracture dislocation of the acetabulum is reported. Histological examination showed a high grade sarcoma. A pleural metastasis was present. A local reconstructive procedure consisting of local tumor excision with an acetabular prosthetic replacement and adjunctive radiation therapy was elected for the patient, who had a short-term prognosis. PMID- 2695012 TI - Brachial plexus injury caused by electric current through the ulnar nerve. Case report and review of the literature. AB - A case of brachial plexus injury caused by electric current is reported. A 14 year-old boy touched a bare electric cord with his right fifth finger. The electric current ran from the finger through the extremity to the neck. Then it caused brachial plexus palsy gradually. The clinical course and the electrophysiological examination revealed that the affected nerve fibers were in a state of neurapraxia. PMID- 2695013 TI - [Reticulosarcoma: diagnostic problems]. AB - Diagnostic problems connected with reticulum cell sarcoma are analyzed. Clinical, radiological, biochemical and hematological investigations combined with an accurate pathologic study are essential in order to arrive at a precise diagnosis. Ewing's sarcoma and other osteolytic sarcomas are discussed in the differential diagnosis. PMID- 2695014 TI - [Two-dimensional echotomography in the prevention of congenital hip dysplasia]. AB - Examination of the infant hip with real time ultrasonography is spreading and affirming in these last years. It allows accurate and reliable investigation of the anatomic structures which are not visualized on a radiograph, so that it appears of great interest in the early screening of congenital dislocation of the hip (CDH). In this paper, the authors examine and discuss some particular features of the sonograms which are usually employed for the investigation of neonatal hips, attempting to dissolve some doubts and perplexities which commonly come out in the first approach to a new diagnostic image technique. The systematic examination of infant hips with real time ultrasonography promises a decisive improvement in the problem of the early diagnosis of CDH. PMID- 2695016 TI - Ames test and trenbolone. PMID- 2695015 TI - Development of an ELISA for detection of an organophosphorus compound using monoclonal antibodies. AB - This paper describes a specific and highly sensitive ELISA system using monoclonal antibodies in order to assay an organophosphorus compound. The soman derivative methyl phosphonic acid, p-aminophenyl 1,2,2,-trimethyl-propyl diester (MATP) served as model substance. In order to obtain antibody-producing hybridomas BALB/c mice were immunized with MATP linked onto human serum albumin (HSA). The spleen cells of immunized mice were fused with syngenic plasmacytomas of the non-producer-line X63Ag8.653 with the aid of polyethylene glycol. To eliminate undesirable cross-reaction, common screening procedures were modified by directly coating the ELISA plates with hapten. Five out of 15 positive cell lines were cloned by limiting dilution and further propagated. The respective immunoglobulin class and subclass of the obtained monoclonal antibodies was determined. Four of which were identified as IgG1, the other as IgG2a. After enrichment of antibodies in ascites and their isolation by protein A-sepharose, the affinity of various monoclonal antibodies was estimated in competitive inhibition enzyme immunoassay (CIEIA) by measuring the IC50 rates of free MATP. The rates were found to lie between 2.5 x 10(-6) mol/l and 4.3 x 10(-4) mol/l MATP. The IC10 rate for detectable MATP concentration was 5.4 x 10(-7) mol/l MATP. Test duration was 280 min. The reactivity of the monoclonal antibodies with structurally related substances was used to check their specificity. Cross reaction turned out to be negative. In order to develop a direct competitive ELISA, MATP was linked to horse radish peroxidase (HRPO) by adding a spacer. This helped to reduce total duration to 40 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695017 TI - [A new stage in the development of the membrane concept of the pathogenesis of primary hypertension: the role of cellular oncogenes in the genesis of membrane disorders]. AB - The membrane concept of the primary (essential) hypertension pathogenesis considers the start of the disease as being linked to the characteristic disturbances of the cation-transport function. The membrane alteration result in the increase of the free calcium ion concentration in the cell cytoplasm and are the cause of both the contractile properties alteration of the vascular smooth muscle cells and the alteration of the neuromediator release in the nerve endings. The further stage in the evolution of this concept was the observation of the pathogenetic ling between the membrane "defect" in the primary hypertension and the alteration of the cell oncogenes (proto-oncogenes) function. The presence of such a link may be confirmed by both the indirect proofs considered in the paper and the results of the DNA study in rats with a spontaneous hypertension by method of RFLP analysis. PMID- 2695018 TI - [The atherometric system]. AB - Atherometric system designed for the evaluation of the atherosclerotic changes in the individual arteries and alterations in the organs affected is described. The system includes two groups of functions--arterial and organ-dependent. Using these interrelated functions and biophysical and mathematical methods it becomes possible to estimate quantitatively pathomorphological and pathophysiological changes in the arteries and organs supplied by them. PMID- 2695019 TI - [Precancer and cancer of the lung]. AB - The problem of the patho- and morphogenesis of the lung cancer is discussed. Central and peripheral lung cancer differ from each other not only by their localization but by the etiology, pathogenesis, morphogenesis, histogenesis and precancer epithelial changes as well. The central cancer morphogenesis is connected with the precancer changes of the large bronchi epithelium resulting as a rule from the carcinogen inhalation. The morphogenesis of the peripheral cancer is less studied and belongs to the problem of the "carcinoma in the scar". Peripheral lung carcinoma is shown to develop in the pneumosclerotic foci after tuberculosis, pneumonia, lung infarct, around foreign bodies. The histogenesis of the lung cancer is connected with the pluripotential and unipotential cell precursors of the lung epithelia the variety of which is particularly pronounced at the lung periphery, this explaining the differences in the histological types of central and peripheral lung cancer and complexity of its morphological classification. PMID- 2695020 TI - [Pulmonary arteriovenous fistula. A case report and review of the literature]. AB - The aim of this paper is to review clinical and laboratory features of this unusual pathology and its complications, indicating transcatheter embolization as a first choice for its management. Our case report is of a seven year-old child, with complex pulmonary arteriovenous fistula of the anterior segment of right superior lobe, which was diagnosed mainly by cintilography and pulmonary angiogram. Clinically she had cyanosis, fatigue with exertion, clubbing of the fingers and polycythemia with low partial pressure of oxygen (PAO2: 68.1 mmHg; Sat O2: 92.4%; Hct: 47.5%; Hb: 16 gr%). She did not have Rendu-Osler-Weber disease. The anatomic structure and localization of the complex fistula was showed by cineangiographic study. We preferred to manage this fistula with transcatheter embolization with a 02 gauge stainless steel coil occluding device (Gianturco-Wallace), as it was single and the patient was too young for sustain surgical trauma and the outcome would be positively satisfactory. After the embolization cyanosis was relieved and we could see normal pulmonary circulation following the point of the pre-existing fistula. We concluded that a judicious assessment by cineangiography could help select the transcatheter embolization procedure as an attractive therapeutic approach instead of surgery. PMID- 2695021 TI - [Acute myocardial infarct of the right ventricle]. PMID- 2695022 TI - Corpus callosum stimulation and stereotactic callosotomy in the management of refractory generalized epilepsy. Preliminary communication. AB - Corpus callosum stimulation produced by chronically implanted electrodes, placed either by craniotomy or stereotactically, failed to control refractory generalized epilepsy in humans and also in experimentally produced penicillin epilepsy in cats. However, the patients that suffered craniotomy, frontal lobe retraction or pneumoencephalograms, without callosal section, showed remarkable improvement of their seizure condition due to these unspecific manipulation effects. Stereotactic anterior callosotomy emerged as a sequel of these functional neurosurgical findings, and as an alternative procedure to preclude undesirable neuropsychological and neurological side effects of split brain syndrome and of brain retraction, associated to conventional callosotomy. Ten patients with various disabling convulsive disorders have undergone this new operation, which showed to be less traumatic and better tolerated than open callosotomy. PMID- 2695023 TI - Penetrating injuries involving the anterior cranial fossa. AB - Penetrating injuries of the anterior cranial fossa may result in permanent neurologic changes or even death if injuries are unrecognized and remain untreated. The diverse etiologies of such injuries are reviewed, as well as their diagnosis, treatment and prognosis. PMID- 2695024 TI - Current concepts of periodontal maintenance. AB - Changing concepts and a more complete understanding of the aetiology of chronic marginal periodontitis allow a more rational approach to the treatment of patients with periodontal diseases. A sequence of treatment steps of increasing complexity is presented for the prevention of recurrence of chronic marginal periodontitis during the maintenance phase of treatment. PMID- 2695025 TI - Biological and clinical evaluation of the transmandibular implant. AB - The transmandibular implant has been shown to be a successful clinical solution to prosthetic rehabilitation of patients with gross mandibular atrophy. Aspects of the biocompatibility of the implant material including the component metals in the alloy have been tested in an animal model utilizing sheep. The initial Adelaide results in the clinical multicentre trial are presented. These were generally excellent and the reasons for the few failures are presented. PMID- 2695026 TI - Differential diagnosis of severe periodontal lesions. AB - In current clinical practice, a differential diagnosis of severe localized periodontal lesions is rarely made; such lesions are considered to be manifestations of periodontitis caused by specific microbes from the commensal oral flora. However, deep seated lesions of the periodontium which are in communication with the alveolar crest, are well documented periodontal consequences of pulpal pathoses and can mimic the signs and symptoms of 'periodontitis'. The very low incidence of tooth-threatening periodontal disease in ancient and modern man is revealed when differential diagnoses are used in the examination of alveolar defects in anthropological materials and when epidemiological studies use more appropriate indices. However, no periodontal index to date has incorporated a differential diagnosis between gingival and pulpal causes of alveolar bone loss. The gingival and periodontal signs of severe localized periodontal lesions are reviewed and the imprecise nature of current clinical diagnostic tests (radiography, 'pulp testing', darkfield microscopy, bleeding on probing, periodontal probing) is discussed. None of these tests is able to detect disease activity and cannot be used to predict future patterns of disease behaviour. However, the commonly held belief that the tests are accurate has resulted in most severe periodontal lesions being falsely labelled as periodontitis. Failure to carry out differential diagnosis of severe periodontal lesions has resulted in the instigation of periodontal therapy for many lesions of non-gingival origin. Whenever severe localized lesions of the periodontium are detected, the differential diagnosis between pulpal and periodontal origins should be made. The results of diagnostic tests in current use should be interpreted with extreme caution; clinicians are left to exercise their judgment based on consideration of all the available evidence. PMID- 2695027 TI - Dental alginates and quality control. PMID- 2695028 TI - Fetal echocardiography in the diagnosis of congenital heart disease. AB - Fetal echocardiography provides an opportunity to diagnose congenital heart disease as early as the midtrimester of pregnancy, allowing for proper planning of perinatal care and counselling of the parents. This paper reviews the accuracy and outcomes of fetal cardiac ultrasound studies at The Prince Charles Hospital over the past 4 years. A total of 43 fetuses, of gestational ages 16-39 weeks, were studied. The indications for these were: previous sibling with cardiac anomaly (16 cases); abnormal heart on obstetric ultrasound scan (USS) (13 cases); abnormalities found on obstetric USS with normal appearing heart (one case); fetal bradycardia (seven cases); fetal tachycardia (four cases); irregular fetal heart beat (two cases). At birth all fetuses assessed because of a previously affected sibling were normal. Of the 13 referred because of structural heart lesions suspected on obstetric USS, eight were abnormal, four were normal and one was terminated without autopsy. Important rhythm disturbances occurred in nine of the 11 referred because of abnormal heart rates. One false positive diagnosis of a possible coarctation was made, and in four cases an abnormality was noted on USS but the diagnosis was not completely correct. Nine of the 19 infants with abnormalities detected have died. Fetal echocardiography is an accurate and useful method of diagnosing congenital heart disease in utero. Although the mortality of affected fetuses is high, antenatal diagnosis allows planning of medical care and offers the greatest chance of a successful outcome. PMID- 2695029 TI - Urinary tract calculi in aboriginal children. AB - Forty-three Aboriginal children with urinary tract calculi are reviewed. There was a preponderance of male children and the majority presented early in life with urinary tract infection. Associated gastrointestinal and other problems were also common. The calculi caused considerable morbidity: 34 major surgical procedures were undertaken and three kidneys were lost. PMID- 2695030 TI - Systemic candidiasis with DIC and candida endophthalmitis in a postoperative neonate. AB - A full-term male neonate, weighing 2540 g at birth, was admitted to hospital on day 2 because of vomiting and severe dehydration. Duodeno-duodenostomy was performed on day 5 for congenital duodenal atresia. The child was well postoperatively until day 9, when he developed fever. Intermittent fever continued despite treatment with several antibiotics. He became seriously ill on day 15 and developed disseminated intravascular coagulation. Treatment with antifungal drugs (amphotericin B and 5-flucytosine) was effective for systemic candidiasis, but candida endophthalmitis developed. There was a persistent vitreous lesion in the left eye, which after cessation of therapy has been improving gradually. Systemic candidiasis and candida endophthalmitis should be considered in neonates who develop signs of sepsis postoperatively. PMID- 2695031 TI - Early history of the Veterinary Research Station, Glenfield. PMID- 2695032 TI - Clinical and pathological responses of water buffalo (Bubalus bubalis) to experimental infection with bovine ephemeral fever virus--Chinese strain. PMID- 2695033 TI - Introduced animals and exotic disease: assessing potential risk and appropriate response. PMID- 2695034 TI - A review of Australia's extensive grazing livestock industries: size, significance and disease status. PMID- 2695035 TI - An overview of arboviruses affecting domestic animals in Australia. PMID- 2695036 TI - Bovine ephemeral fever and rhabdoviruses endemic to Australia. PMID- 2695037 TI - Malignant catarrhal fever. PMID- 2695038 TI - Neonatal viral diarrhoeas. PMID- 2695039 TI - The fisheries industries. PMID- 2695040 TI - An overview of Australia's poultry industry in 1989. PMID- 2695041 TI - Poxviruses as vectors for veterinary vaccines. PMID- 2695042 TI - Newcastle disease. PMID- 2695044 TI - An overview of the pig industry. PMID- 2695043 TI - Avian influenza. PMID- 2695045 TI - The potential of the polymerase chain reaction in veterinary research and diagnosis. PMID- 2695046 TI - The role of the Australian Animal Health Laboratory. PMID- 2695047 TI - Hemagglutination, hydrophobicity, enterotoxigenicity, and drug-resistance characteristics of avian Escherichia coli. AB - A total of 35 Escherichia coli isolates obtained from necropsy materials of hens with septicemia in the Konya region of Turkey were examined for hemagglutination (HA), cell-surface hydrophobicity, enterotoxigenicity, and drug resistance. HA tests were performed on live cultures with human (group A), bovine, avian (chicken), and guinea pig erythrocytes with and without mannose. Nine HA patterns were observed. Of the 35 isolates, 62.8% exhibited mannose sensitive hemagglutination (MSHA), 8.6% exhibited mannose resistant hemagglutination (MRHA), and 28.6% did not hemagglutinate. Of the isolates, 85.7% were hydrophobic by a salt aggregation test (SAT). Only three isolates were enterotoxigenic by a suckling mouse assay. The majority of the isolates were resistant to chloramphenicol, tetracycline, streptomycin, ampicillin, erythromycin, and trimethoprim + sulfamethoxazole but were highly sensitive to gentamicin and nalidixic acid. PMID- 2695048 TI - Protection of chicks against Salmonella infection with a mixture of pure cultures of intestinal bacteria. AB - A mixture of 28 pure cultures was prepared from the organisms isolated from native gut microflora (fecal and cecal contents) of adult Salmonella-free birds. This mixture was orally administered to 1-day-old chicks and examined for its efficacy against challenge with 10(5) colony-forming units of nalidixic-acid resistant Salmonella typhimurium in six consecutive trials during a 20-month period. The efficacy of the mixture, which was prepared for each trial from stored isolates, progressively decreased, while that from stored fecal content remained unimpaired. Twenty-three cultures in the mixture were tentatively identified as belonging to seven different genera; the genus of the five other cultures remained unknown. PMID- 2695049 TI - Monitoring poultry farms for Salmonella by drag-swab sampling and antigen-capture immunoassay. AB - Drag-swab (DS) sampling, at the rate of four DS gauze pads per flock (house); modified culture procedures (novobiocin-supplemented plating media and delayed secondary selective enrichment); and Salmonella antigen-capture (SAC) technology were combined in screening one layer flock and 38 market-age broiler flocks. The results showed that low (negative) SAC sample-to-positive control (S/P) ratios were related to the negative culture recovery of Salmonella. Similarly, high (positive) S/P ratios were related to and indicative of positive culture recoveries. Extensive sampling and testing of 18 of the 39 flocks disclosed A) that five flocks with negative culture recoveries from feathers and freshly voided feces had essentially no positive DS-SAC values, and B) that 13 flocks with positive culture recoveries from feathers and/or fresh feces all had positive DS-SAC values. PMID- 2695050 TI - Effect of time and temperature on growth of Salmonella enteritidis in experimentally inoculated eggs. AB - Influence of time and temperature on Salmonella enteritidis multiplication in experimentally injected eggs was examined. There was an increase in the number of S. enteritidis with the increase in temperature of egg storage. There was less increase of S. enteritidis in eggs stored at 4 degrees C than in eggs held at temperatures higher than 4 degrees C (P less than 0.05). These results suggest a possible method for monitoring commercial eggs for the presence of S. enteritidis. It was concluded that the chances of recovery of S. enteritidis can be increased 10(6)-fold or more by holding the eggs at temperatures of 21 or 27 degrees C for more than 20 days and culturing their contents. PMID- 2695051 TI - Suppression of resistance to Salmonella typhimurium in young chickens inoculated with Corynebacterium parvum. AB - The effect of Corynebacterium parvum on resistance to Salmonella typhimurium infection was evaluated in young chickens. One-day-old chickens were inoculated subcutaneously (SC) or intraperitoneally (IP) with 1.4 mg killed C. parvum and challenged by IP injection with 5.0 X 10(7) S. typhimurium 4 days later. Spleen and bursa of Fabricius weights were not altered in the C. parvum-inoculated chickens. A transient increase in thymus weight occurred 3 days after inoculation with C. parvum. Phytohemagglutinin-elicited cutaneous hypersensitivity was significantly suppressed in the C. parvum-inoculated chickens. Morbidity due to Salmonella infection increased significantly from 15% and 21% in the control groups to 43% and 46% in the chickens inoculated IP or SC with C. parvum. The results indicated that inoculation of 1-day-old chickens with C. parvum suppressed cell-mediated immune responsiveness and decreased resistance to peritoneal infection with S. typhimurium. PMID- 2695052 TI - Campylobacter fetus subsp. jejuni in poultry reared under different management systems in Nigeria. AB - Cloacal swabs from 487 live birds in 36 flocks and 70 poultry carcasses were cultured for Campylobacter fetus subsp. jejuni. It was isolated from 12.3% of the birds in 19 flocks. Chickens, turkeys, and guinea fowl differed from one another in isolation rates of the organism. Management system affected its occurrence, and only 7.1% of eviscerated carcasses yielded it. It was concluded that bird species, management system, and immersing slaughtered poultry in boiling water before dressing affect recovery of C. fetus subsp. jejuni from live birds and carcasses. PMID- 2695053 TI - The consequences of intrauterine growth retardation: what do we know? AB - This paper restricts itself to a discussion of the development of term infants born small, and presumed to have suffered fetal malnutrition. They form a subgroup of low birth weight infants, and have been sparsely studied to date. Investigations have usually failed to differentiate between the kinds of fetal undergrowth exhibited at birth, and it is clear that further understanding of the processes and consequences of early behaviour based on clear categorization of the growth retardation is needed. This together with more systematic investigation of the characteristics of the families of these infants is required before effective efforts can be made to ameliorate the potential effects of fetal malnutrition. The evidence so far suggests that the development of small for gestational age infants is susceptible to environmental intervention despite its physical origins; however we are far from understanding the aetiology and the precise consequences of this complex phenomenon. PMID- 2695054 TI - Group B streptococcal colonization and preterm labour. AB - Recent publications have highlighted the controversy regarding the significance of Lancefield Group B Streptococcal (GBS) colonization in pregnancy and preterm delivery. In this prospective study vaginal swabs from 692 women at approximately 24 weeks' gestation were cultured for GBS. GBS was detected in 91 (13.2%) women. The rate of preterm labour (PTL) (less than 37 weeks) was significantly higher in GBS positive women than in GBS negative women (18.7% versus 5.5%; p less than 0.001). This association remained significant even when patients with other recognized factors predisposing to PTL were excluded (11.5% versus 3.9%; p less than 0.001). The rate of premature rupture of membranes (PROM) was also significantly higher in GBS positive women (9.9% versus 2.7%; p less than 0.005) and remained significantly higher when patients with other recognized risk factors were excluded (6.1% versus 1.8%; p less than 0.025). These results unequivocably show that pregnant women who are vaginal carriers of GBS have a significantly increased risk of PROM and PTL. PMID- 2695055 TI - Ureteric obstruction by the gravid uterus. AB - This paper reports the only 6 cases of ureteric obstruction apparently caused by the gravid uterus diagnosed at the Mercy Maternity Hospital in the past 17 years, during which time there were 82,836 confinements. In 3 of the 6 cases there was clear radiographic evidence that the level of obstruction was at the pelvic brim. The rapid resolution of the ureteric obstruction shortly after delivery strongly suggested that the gravid uterus was the cause of the obstruction. Cases 1-3 were the only patients of 793 with polyhydramnios who developed bilateral ureteric obstruction and acute renal failure. In Cases 4 and 5 there was unilateral ureteric obstruction and pyelonephritis; in Case 4 a ureteric catheter was inserted from below, and in Case 5 a ureteric stent was inserted via a nephrostomy tube. In Case 6 a percutaneous nephrostomy tube was inserted. PMID- 2695056 TI - The conservative management of a hydatidiform mole with coexistent living fetus. A case report. PMID- 2695057 TI - Cervical incompetence in a pregnancy following a cervical ectopic pregnancy. AB - A case of cervical incompetence is reported which occurred in a pregnancy which followed soon after treatment of a cervical ectopic pregnancy using a Foley catheter. Very few pregnancies following cervical pregnancy have been reported. Although this isolated case is clouded by other risk factors, cervical incompetence should be considered as a potential complication of such pregnancies. PMID- 2695058 TI - Two sequence-specific binding proteins from the promoter region of the c-Ha-ras-I oncogene. AB - The role of sequence-specific binding proteins in transcriptional control in higher eukaryotes is unclear. We have investigated the control region of the c-Ha ras-I protooncogene containing upstream sequences from the transcriptional initiation point. Two proteins, which bind these sequences, with molecular weights of 20 K and 43 K were found. The possible role in the process of transformation is discussed. PMID- 2695059 TI - Genetic studies on pancreatic proteinase in Japanese quail. AB - A genetic variation was found in pancreatic proteinase of Japanese quail. In eight bands of proteinase isozymes, the variation of band 5 (presence or absence) was detected among quails. Band 5 was identified as a chymotrypsin. The presence and absence of band 5 are controlled by a pair of allelic genes (Prt-5A and Prt 5a) on an autosomal locus, and gene Prt-5A, causing expression of band 5, is dominant to gene Prt-5a, a null allele for band 5. Zymograms of proteinases and their zymogens were also compared; no variation of chymotrypsinogen; corresponding to chymotrypsin Prt 5 were detected. It is suggested that the Prt-5 variant of chymotrypsin may be formed during activation of chymotrypsinogen. PMID- 2695060 TI - Variation in four acid hydrolase activities in filarial-susceptible and refractory genotypes of Aedes aegypti. PMID- 2695061 TI - Variation among lines selected for body size in the fractional rate of degradation of protein and acid protease activity in the muscle of quail (Coturnix coturnix japonica). AB - Fractional rates (%/day) of degradation of muscle protein were determined by measuring the output of NT-methylhistidine (NT-MH) in the excreta at 2 and 10 weeks of age in three lines of quail, a random-bred line and two lines selected for body size, one for increased and the other for decreased size. In all lines, fractional rates of degradation of muscle protein at 2 weeks of age were higher than those at 10 weeks of age. The fractional rate of degradation at 2 weeks of age was highest for the RR line, 9.1-9.2%/day. However, at 10 weeks of age, the rank order changed, and the RR line showed the lowest rate, 1.8-1.9%/day. The SS line (5.8-6.2%/day at 2 weeks and 5.8-5.9%/day at 10 weeks of age) was significantly higher than the LL line (4.1-4.2%/day at 2 weeks and 2.1-2.2%/day at 10 weeks of age). Acid protease activities in supernatants of homogenized muscle of the three lines of quail at 2 and 10 weeks of age were measured. In all lines, the acid protease activities in supernatant of homogenized muscle decreased from 2 to 10 weeks of age. At 2 weeks, the protease activity of the RR line was significantly higher than that of the LL and SS lines, which did not differ significantly. However, at 10 weeks of age, the SS line had higher activity in both sexes than the LL and RR lines. The results suggest that selection for body size brings about significant changes in both fractional degradation rate and acid protease activity in the muscle. PMID- 2695063 TI - A transient-kinetic study of the nitrogenase of Klebsiella pneumoniae by stopped flow calorimetry. Comparison with the myosin ATPase. AB - The pre-steady-state kinetics of MgATP hydrolysis by nitrogenase from Klebsiella pneumoniae were studied by stopped-flow calorimetry at 6 degrees C and at pH 7.0. An endothermic reaction (delta Hobs. = +36 kJ.mol of ATP-1; kobs. = 9.4 s-1) in which 0.5 proton.mol of ATP-1 was released, has been assigned to the on-enzyme cleavage of MgATP to yield bound MgADP + Pi. The assignment is based on the similarity of these parameters to those of the corresponding reaction that occurs with rabbit muscle myosin subfragment-1 (delta Hobs. = +32 kJ.mol of ATP-1; kobs. = 7.1 s-1; 0.2 proton released.mol of ATP-1) [Millar, Howarth & Gutfreund (1987) Biochem. J. 248, 683-690]. MgATP-dependent electron transfer from the nitrogenase Fe-protein to the MoFe-protein was monitored by stopped-flow spectrophotometry at 430 nm and occurred with kobs. value of 3.0 s-1 at 6 degrees C. Thus, under these conditions, hydrolysis of MgATP precedes electron transfer within the protein complex. Evidence is presented that suggests that MgATP cleavage and subsequent electron transfer are reversible at 6 degrees C with an overall equilibrium constant close to unity, but that, at 23 degrees C, the reactions are essentially irreversible, with an overall equilibrium constant greater than or equal to 10. PMID- 2695062 TI - Sulphane sulphur in biological systems: a possible regulatory role. PMID- 2695064 TI - 32P-labelling anomalies in human erythrocytes. Is there more than one pool of cellular Pi? AB - 1. Human erythrocytes were incubated in autologous plasma containing [32P]Pi, and sampled by a method which avoids washing the cells. 2. In experiments of up to 3 h duration, the specific radioactivity of cellular Pi stabilized at a value below that of extracellular Pi. This can be explained on the basis of a single cellular Pi pool exchanging with a large unlabelled pool of cellular organic phosphates. 3. However, a rapid initial phase of labelling, occurring within 30 s, was inconsistent with the situation described in point 2. A possible explanation is that about 1/4 of cellular Pi occurs in a separate, fast-labelling pool. 4. When the extracellular Pi concentration was doubled, most of the corresponding increase in the steady-state cellular Pi concentration was accounted for by the apparent fast-labelling Pi pool, which also doubled. 5. The observed initial rate of labelling of cellular organic phosphates [which probably occurs through the reaction catalysed by glyceraldehyde-3-phosphate dehydrogenase (E.C. 1.2.1.12)] was considerably lower than that predicted from the flux through the Embden Meyerhof pathway. This implies that the enzyme is exposed to Pi whose specific radioactivity is lower than the mean specific radioactivity of cellular Pi, and fails to support earlier suggestions that this enzyme uses extracellular Pi. 6. In 3 h incubations, the rate of organic phosphate labelling was roughly constant throughout, even though the specific radioactivity of cellular Pi had risen slowly to a plateau. Viewed in conjunction with point 5, this again suggests some inhomogeneity in cellular Pi. 7. Cellular Pi and extracellular Pi only reached isotopic steady state after 2 days. At this stage some organic phosphates were probably still incompletely labelled. 8. We conclude that, whatever their physical or technical reasons, such labelling inhomogeneities and slow attainment of isotopic steady state may cause serious misinterpretation of results if ignored during 32P-labelling of intact cells. PMID- 2695065 TI - The role of protein kinase C in cholinergic stimulation of insulin secretion from rat islets of Langerhans. AB - The role of the Ca2+/phospholipid-dependent protein kinase C (PKC) in cholinergic potentiation of insulin release was investigated by measuring islet PKC activity and insulin secretion in response to carbachol (CCh), a cholinergic agonist. CCh caused a dose-dependent increase in insulin secretion from cultured rat islets at stimulatory glucose concentrations (greater than or equal to 7 mM), with maximal effects observed at 100 microM. Short-term exposure (5 min) of islets to 500 microM-CCh at 2 mM- or 20 mM-glucose resulted in redistribution of islet PKC activity from a predominantly cytosolic location to a membrane-associated form. Prolonged exposure (greater than 20 h) of islets to 200 nM-phorbol myristate acetate caused a virtual depletion of PKC activity associated with the islet cytosolic fraction. Under these conditions of PKC down-regulation, the potentiation of glucose-stimulated insulin secretion by CCh (500 microM) was significantly decreased, but not abolished. CCh stimulated the hydrolysis of inositol phospholipids in both normal and PKC-depleted islets, as assessed by the generation of radiolabelled inositol phosphates. These results suggest that the potentiation of glucose-induced insulin secretion by cholinergic agonists is partly mediated by activation of PKC as a consequence of phospholipid hydrolysis. PMID- 2695066 TI - Types of oligosaccharide sulphation, depending on mucus glycoprotein source, corpus or antral, in rat stomach. AB - Radiolabelled mucus glycoprotein was obtained from tissue and a culture medium each of the corpus and antrum of rat stomach incubated with [35S]sulphate in vitro. Gel-filtration analysis of oligosaccharides liberated by alkaline borohydride treatment from glycoproteins indicated that 35S-labelled oligosaccharides from the corpus vary considerably with respect to chain length whereas those from antral mucus glycoprotein are composed of small oligosaccharides. Examination of the reduced radiolabelled products obtained by HNO2 cleavage of the hydrazine-treated oligosaccharides indicated sulphate esters of N-acetylglucosamine to be present at three locations on a carbohydrate unit: [35S]sulphated monosaccharide (2,5-anhydromannitol 6-sulphate), [35S]sulphated disaccharide [galactosyl(beta 1-4)-2,5-anhydromannitol 6-sulphate] and [35S]sulphated trisaccharide [fucosyl(alpha 1-2)-galactosyl(beta 1-4)-2,5 anhydromannitol 6-sulphate]. Sulphated disaccharide and trisaccharide, possibly originating from the N-acetyl-lactosamine and fucosyl-N-acetyl-lactosamine sequences respectively, were detected in the corpus, especially as large oligosaccharides, but were present in the antrum in only very small amounts. The sulphated monosaccharide, however, most probably originating from 6-sulphated N acetylglucosamine residues at non-reducing termini, was present in all oligosaccharide fractions in both the corpus and antrum. PMID- 2695067 TI - Inhibition of hyaluronan uptake in lymphatic tissue by chondroitin sulphate proteoglycan. AB - Afferent lymph vessels entering the popliteal lymph nodes of sheep were infused with [3H]acetyl-labelled hyaluronan [HA; Mr of (0.85-1.2) x 10(5)] for up to 4 h at a rate of 17.4-23.1 micrograms/h. As much as 22.8 micrograms (99%) of infused [3H]HA was taken up by the node per h and degraded. During this interval it was observed that infused HA polymers of higher Mr were absorbed by the node to a greater degree than those of lower Mr. When proteoglycan monomer (PG; Mr 5 x 10(5); 400 micrograms of hexuronic acid/h) was infused concurrently with [3H]HA, the absolute amount of radioactivity appearing in efferent lymph (i.e. labelled material not absorbed by the node) increased, whereas the amount of labelled metabolites of low Mr was reduced considerably. During this period the Mr distribution of labelled HA in efferent outflow reverted to that of the infused material within 30-60 min. Our findings suggest that PG subunits and their chondroitin sulphate chains compete with HA for uptake into the peripheral lymph node of sheep. This indicates that PG, chondroitin sulphate and HA share the same pathway of elimination in this tissue, and is consistent with the view that the lymph node is involved in the metabolic turnover of normal intracellular matrix. PMID- 2695068 TI - Heat-stable protein that stimulates acid alpha-glucosidase. AB - A hot-water extract of bovine spleen and guinea pig liver exhibited the ability to enhance acid alpha-glucosidase activity, with methylumbelliferyl alpha glucoside, glycogen or maltose as substrate. The level of activator required for maximal stabilization was similar for all three substrates, indicating direct action on the enzyme rather than on substrate. The stimulator was partially purified by chromatography with gel-permeation (apparent Mr 20,000-24,000), ion exchange and C4 reverse-phase columns. It was retained by a narrow-pore dialysis tubing and destroyed by treatment with Pronase, and is presumably a protein. The stimulating protein protected the enzyme against denaturation by heat or incubation with a buffer of high ionic strength in the absence of substrate. RNA inhibited the enzyme, and the activator protein was able to counteract the effect. Activating material was found in a variety of mouse and rat tissues, as well as human urine. PMID- 2695069 TI - Characterization of the hydroxyproline-rich protein core of an arabinogalactan protein secreted from suspension-cultured Lolium multiflorum (Italian ryegrass) endosperm cells. AB - An arabinogalactan-protein (AGP) purified from the filtrate of liquid-suspension cultured Italian-ryegrass (Lolium multiflorum) endosperm cells by affinity chromatography on myeloma protein J539-Sepharose was deglycosylated with trifluoromethanesulphonic acid to remove polysaccharide chains that are covalently associated with hydroxyproline residues in the peptide component of the proteoglycan. The protein core, which accounts for less than 10% (w/w) of the intact proteoglycan, was purified by h.p.l.c. It has an apparent Mr of 35,000, but reacts very poorly with both Coomassie Brilliant Blue R and silver stains. Amino-acid-sequence analysis of the N-terminus of the h.p.l.c.-purified protein core and of tryptic peptides generated from the unpurified protein reveals a high content of hydroxyproline and alanine. These are sometimes arranged in short (Ala Hyp) repeat sequences of up to six residues. Polyclonal antibodies raised against the protein core do not cross-react with native AGP, the synthetic peptide (Ala Hyp)4, poly-L-hydroxyproline or poly-L-proline. The results suggest that the polysaccharide chains in the native AGP render the protein core of the proteoglycan inaccessible to the antibodies and that the immunodominant epitopes include domains of the protein other than those rich in Ala-Hyp repeating units. PMID- 2695070 TI - Inhibition of the formation of the complement membrane-attack complex by a monoclonal antibody to the complement component C8 alpha subunit. AB - The effect of nine monoclonal antibodies to complement component C8 on the interaction of C9 with preformed cell-surface C5b-8 complexes and on the functional insertion of C8 into the membrane-attack complex (MAC) was investigated. None of the antibodies prevented C9 insertion into a preformed C5b 8 complex. One antibody (F1) directed to the C8 alpha subunit clearly inhibited formation of a functional MAC. It is proposed that this antibody prevents the C8 alpha subunit unfolding and distorting the bilayer to allow C9 insertion. PMID- 2695071 TI - [Identification and localization of exopeptidase activities bound to membranes of Acinetobacter calcoaceticus]. AB - After gel filtration the supernatant of Triton X-100 treated membrane sediments of Acinetobacter calcoaceticus shows activities for alanyl aminopeptidase, leucyl aminopeptidase, glutamyl aminopeptidase, prolyl aminopeptidase, aminopeptidase My, gamma-glutamyl arylamidase, dipeptidylpeptidase IV and prolyl carboxypeptidase. The intracellular localization of the enzymes was analyzed by sucrose density gradient centrifugation of the DNase/RNase pretreated membrane sediments. Most of the exopeptidases are located in the inner membrane fractions (band L). Only gamma-glutamyl arylamidase is located with its main activity in the cytoplasmic membrane (band M). Only small exopeptidase activities could be found in the outer membrane (band H). PMID- 2695072 TI - REP3-derived yeast shuttle vector. AB - A yeast-shuttle vector using a XbaI-PstI fragment of the 2 microns DNA 1293 bp in length has been constructed. This sequence spans the REP 3 locus and the origin of replication. Besides the 2 microns DNA derived sequences the resulting yeast shuttle vector contains the yeast LEU 2 gene and the Tet' gene of pBR 322. The results demonstrate that the XbaI-PstI fragment is sufficient for proper amplification and partitioning of 2 microns DNA derived yeast-shuttle vectors in yeast. The interruption of the FRT site in this type of vector seems to prevent any recombination between endogenous 2 microns DNA and hybrid plasmid molecules. Moreover, the disturbance of the FLP-system has no influence on the copy number of the plasmid stability. PMID- 2695073 TI - [Kinetic characteristics of methionine sulfoxide-thermitase]. AB - For methionine sulfoxide(226)-thermitase the kinetic parameters Km and kcat were determined with p-nitrophenyl acetate and Suc-dialanyl-phenylalanyl 4 nitroanilide as substrates. A drastic decrease in the catalytic rate but only small changes in the substrate affinity were observed in comparison to the native enzyme. Also with the high-molecular weight substrate casein the affinity remained unaffected whereas the catalytic rate was diminished to one-half only. The Ki for the reversible inhibitors phenylboronic acid and Z-dialanyl-phenyl alanine methyl ketone showed only small changes. PMID- 2695074 TI - Characterization of a periplasmic insulin-cleaving metalloproteinase from Acinetobacter calcoaceticus. AB - In Acinetobacter calcoaceticus, a Gram-negative bacterial species, a soluble insulin-degrading proteinase, located in the periplasm as well as in the cytosol, could be established. The periplasmic and cytosolic enzymes agree in their inhibition pattern, pH-optimum and molecular weight. The insulin-degrading enzyme of Acinetobacter calcoaceticus resembles the corresponding proteinases of Escherichia coli. It is a metalloproteinase with a pH-optimum in the neutral range and can be reactivated by divalent ions after EDTA-inhibition, but it is not entirely identical with any of the described proteinases of Escherichia coli in its inhibitory behaviour. PMID- 2695075 TI - RNA folding: pseudoknots, loops and bulges. AB - The three-dimensional structures adopted by RNA molecules are crucial to their biological functions. The nucleotides of an RNA molecule interact to form characteristic secondary-structure motifs. Tertiary interactions orient these secondary-structure elements with respect to each other to form the functional RNA. Here we describe the basic structural elements with special emphasis on a novel tertiary motif, the pseudoknot. PMID- 2695076 TI - Protein changes underlying long-term facilitation in Aplysia. PMID- 2695077 TI - New developments in the Ames assay: high-sensitivity detection of mutagenic arylamines. PMID- 2695078 TI - Generation of multiple N-CAM polypeptides from a single gene. AB - The neural cell adhesion molecule (N-CAM) is believed to be a key regulator of adhesive events in the nervous system and skeletal muscle. The recent isolation of N-CAM cDNAs from different tissues has identified a high degree of diversity in primary amino acid sequence between different isoforms. In this article, we review these recent studies and discuss methods for unravelling the functional consequences of the generation of multiple N-CAM polypeptides using gene transfection approaches. PMID- 2695079 TI - Uvomorulin-catenin complex: cytoplasmic anchorage of a Ca2+-dependent cell adhesion molecule. AB - The cytoplasmic domain of the cell adhesion molecule uvomorulin associates with three independent proteins, named catenins, which are structurally related in different cell types of various species. This complex formation connects uvomorulin and cytoskeletal structures and might, moreover, be involved in other adhesion-dependent mechanisms. PMID- 2695080 TI - Insect baculoviruses: powerful gene expression vectors. AB - Baculovirus vectors have proven useful in producing high levels of biologically active eukaryotic proteins and providing cellular fractions which are enriched in the protein of interest. Expression occurs in infected insect cells which also provide a suitable environment for post-translational modification and folding of the protein product. Stable baculovirus vectors can be constructed rapidly with a minimum of viral manipulation. PMID- 2695081 TI - Epithelial shape change in mouse embryonic submandibular gland: modulation by extracellular matrix components. AB - Early morphogenesis of mouse submandibular gland provides an excellent model for the formation of epithelial lobules as a consequence of epithelial-mesenchymal interactions. Both proteoglycans and a glycosaminoglycan, high molecular weight components which contain amino-sugars and hexuronic acids, seem to be important in maintaining the lobular structure through the formation of epithelial basal lamina. Collagen also appears to play a crucial role in this morphogenesis. By visualizing the distribution of collagen fibrils and by changing the concentration of collagen in the gland, we have developed a new hypothesis which emphasizes the mechanical role of mesenchyme in epithelial cleft formation. Precise mechanisms for the involvement of these molecules have not been elucidated, yet it is now clear that knowledge of the function of the extracellular matrix components is a prerequisite for understanding the epithelial-mesenchymal interactions. PMID- 2695082 TI - Trichothiodystrophy and the relationship between DNA repair and cancer. AB - The identification of cellular deficiencies in the ability to repair damage in DNA in individuals with several cancer-prone genetic disorders, has led to the idea that defective DNA repair results in cancer. In patients with trichothiodystrophy, however, a recently discovered defect in the repair of ultraviolet damage in DNA is not associated with cancer-proneness. Thus our previous ideas about the connections between DNA repair capacity and cancer susceptibility need to be reevaluated. PMID- 2695083 TI - What is the role of the cys-his motif in retroviral nucleocapsid (NC) proteins? AB - Retroviruses encode a small, basic nucleocapsid (NC) protein that is found complexed to genomic RNA within the viral particle. The NC protein appears to function not only in a histone-like manner in packaging the RNA into the particle but also in specifically selecting the viral genomic RNA for packaging. A cysteine-histidine (cys-his) region, usually composed of 14 amino acids and reminiscent of the 'zinc fingers' of transcription factors, is the only highly conserved sequence element among the retroviral NC proteins. This review discusses the biochemical properties of NC, and its possible role(s) in retroviral replication. We also speculate on how the biochemical properties may relate to its function in RNA recognition and packaging. PMID- 2695084 TI - A spontaneous sarcoma dependent on host tumor-specific immune lymphocytes. AB - The immune surveillance theory postulates that spontaneous tumors are normally rejected by the immune system and appear only when they override host-immune recognition and rejection mechanisms. The present mini-review describes a spontaneous tumor system, the reticulum cell sarcomas (RCS) in SJL/J mice, that is dependent on host tumor-specific immune lymphocytes for growth. This continuous tumor-specific response results in tumor progression and death of the host. This tumor system contradicts the basic concept of immune surveillance. We propose as an explanation that some highly antigenic tumors, like the RCS, may have evolved in a non-autonomous fashion but, nevertheless, have lost regulatory controls of cell proliferation. In the RCS system, the tumor expresses Class II MHC I-E like specificities that are not expressed on the host cells and which selectively stimulate a subpopulation of I-E specific T cells, the V beta 17 a+ clonotype, leading to their expansion and continuous nurturing of the tumor via secreted lymphokines. This neoantigenic stimulation bypasses the tumor regulatory response that might have resulted if the tumor had not expressed neoantigens. Furthermore, passive administration of anti-clonotypic antibody to tumor-bearing mice results in tumor regression and long-term survival through removal of the tumor reactive T cells. Thus, in this tumor system, immunosuppressive treatments are the prescription for tumor rejection. PMID- 2695085 TI - Sorting out the secretory pathway. PMID- 2695086 TI - Drosophila at Marseille: the 11th European Drosophila Research Conference. PMID- 2695087 TI - The mouse genome at Oxford: what can mouse gene mapping do for mammalian genetics? PMID- 2695088 TI - Modulation of A and B cell functions by tolbutamide and arginine in the pancreas of thiamine-deficient rats. AB - The effects of administration of glucose orally and tolbutamide or arginine intravenously on insulin and glucagon secretion and blood glucose level were studied in normal and thiamine-deficient rats. In thiamine deficiency, insulin secretion and glucose tolerance were impaired during glucose ingestion. Tolbutamide decreased the blood glucose level in both control and thiamine deficient rats but its stimulatory effect on insulin secretion was minimal in thiamine-deficient rats unlike the control animals. Arginine did not alter substantially the blood glucose or insulin in thiamine-deficient rats, whereas it increased the insulin level in control rats. The fasting plasma glucagon level was high in thiamine deficiency. Tolbutamide increased the plasma glucagon in control rats, but did so only marginally in thiamine-deficient rats. Arginine also increased the glucagon secretion throughout the period of study in control rats. In thiamine-deficient rats the glucagon secretion was pronounced only after 20 min of arginine administration. These results suggest that an unimpaired glucose metabolism is a prerequisite to induce proper insulin secretion. Only proper insulin secretion can check the glucagon secretion rather than the increased glucose level. Hypoglycemia can induce glucagon secretion independent of the insulin level. PMID- 2695089 TI - The molecular chaperone concept. AB - Molecular chaperones are a ubiquitous family of proteins whose proposed role is to mediate the folding and assembly of other proteins into oligomeric structures. The essential function of molecular chaperones is to prevent the formation of incorrect structures which may result from the transient exposure of charged or hydrophobic surfaces normally involved in interactions between or within polypeptide chains. Such transient exposure may occur during the synthesis of polypeptides, the unfolding and refolding that occurs during their transport across membranes, the association of polypeptides made in one subcellular compartment with those made in another, changes in protein-protein interactions during the normal functioning of a complex, and recovery from stresses such as heat shock. Three classes of molecular chaperone are discussed: the nucleoplasmins, the BiP group, and the chaperonins. PMID- 2695090 TI - Haemopoietic growth factor control of normal and neoplastic cellular proliferation. AB - Endotoxin induces the appearance of granulocyte colony stimulating factor (G-CSF) and macrophage (M)-CSF in the serum of mice. No GM-CSF was detectable in endotoxin serum. Phytohaemagglutinin stimulated human T-lymphocytes to secrete three major forms of GM-CSF. All of the haemopoietic growth factors (HGFs) are active in vivo, but the cellular responses are different for each HGF. Prolonged administration of G-CSF increases the number of circulating neutrophils and does not lead to adverse side-effects. Chronic exposure to GM-CSF induces an accumulation of activated macrophages which can cause considerable tissue destruction. Although the 'src-like' oncogenes induce HGF production by chicken myeloblasts, factor-dependent murine cells can be converted to a tumorigenic phenotype without autocrine growth factor production. PMID- 2695091 TI - Nuclear pre-mRNA splicing in Saccharomyces cerevisiae. AB - While there are some differences in the nuclear pre-mRNA splicing machineries of Saccharomyces cerevisiae and higher eukaryotic cells, it is apparent that the fundamental mechanism of this reaction is highly conserved. S. cerevisiae is, therefore, an attractive organism for the study of splicing, since it is amenable to classical and molecular genetics as well as traditional biochemical methods. Here we present an outline of some of the advances which have resulted from this powerful combination of approaches. PMID- 2695092 TI - [The enantioselectivity of drugs]. AB - The syntheses of racemic and enantiometric basically substituted barbiturates, pyrrolidinediones (succinimides) and piperidinediones (glutarimides) are reported. Their absolute configurations are determined. In animal experiments most of the enantiomers show differences in their efficiency. The enantiomers of the barbiturates 4b and 4h and of the pyrrolidinedione 23a possess qualitatively different effects: (S) (-) 4b and (R) (+) 4h are narcotics, (R) (+) 4b and (S) ( )4h are convulsives; (R) (+) 23a is active as an anticonvulsant, (S) (-) 23a is toxic in the doses used. PMID- 2695093 TI - Current developments in thrombolytic therapy using novel plasminogen activators. AB - As a result of intensive recent research, the molecular mechanisms governing the human fibrinolytic system could be elucidated. Clinical trials using streptokinase and urokinase demonstrated that therapeutic thrombolysis is a valuable regimen in the treatment of patients with thromboembolic diseases. After unsuccessful attempts to increase the clot specificity of these agents, efforts were increased towards developing fibrin-specific substances with high thrombolytic potency and negligible effects on systemic hemostasis. Tissue-type plasminogen activator manufactured by recombinant DNA technology (rt-PA) is currently the most comprehensively investigated fibrin-specific thrombolytic agent with the most clearly understood mechanism of action in vivo. Pro-urokinase has also become available through biotechnology. A large number of clinical trials studying thrombolytic therapy of myocardial infarction have proved that intravenous rt-PA posesses superior efficacy compared to conventional fibrinolytic agents. Comparatively few clinical studies have been performed using pro-urokinase. At therapeutic doses, the fibrin specificities of these agents differ. So far it has not been possible to correlate the incidence of bleeding complications during fibrinolytic therapy with alterations in hemostasis parameters. For routine laboratory monitoring of thrombolysis the determination of fibrinogen and thrombin clotting time can be recommended. New developments with potential for yielding the next generation of thrombolytic agents are mutants and chimeras of t-PA and pro-urokinase, and conjugates of these substances with fibrin specific antibodies. PMID- 2695094 TI - [In memoriam. Bernard Jaulmes. 10 July 1922 - 15 May 1989]. PMID- 2695095 TI - HIV blood test counseling. PMID- 2695096 TI - Error analysis and applications in transportation systems. AB - This paper presents an overview of the field of error analysis. Section 1 shows why discussions about human error are relevant for societal safety. With regard to safety research, it is important to predict abnormal events. At the machine side, reliability studies proved their value, but to predict failures in the human factor has been shown to be very difficult. Therefore, problems in how to define the notion of human error (Section 2) and how to classify different types of error (Section 3) are discussed. Some researchers started to use systematical classifications of human error types based on a recent, hierarchical model of human task performance. The outline of the model is presented. Examples of error analysis studies from the field of transportation research (Section 4) provide some basic suggestions on how to reduce error rates. Some conclusions on error control are given in Section 5. The responsibility of managers and system designers in this respect is strongly emphasized. PMID- 2695097 TI - A comparison of the psychosocial characteristics of alcoholics responsible for impaired and nonimpaired collisions. AB - In this study, the psychosocial characteristics of male alcoholics with different collision records were examined. Male hospitalized alcoholics were divided into three groups: (1) collision-free drivers, (2) those responsible for collision(s) in which they were impaired by alcohol, and (3) those responsible for collision(s) in which they were not impaired by alcohol. People in each of the three groups were compared. People responsible for impaired collisions were significantly lower in socioeconomic status, drove while impaired with more dangerous styles of driving, and had more disrespect for authorities than the noncollision group. By contrast, those responsible for nonimpaired collisions possessed a variety of personality characteristics that distinguished them from people with no collisons. Specifically, those with nonimpaired collisions were significantly less responsible, more impulsive, more depressed, more aggressive, and experienced more undesirable life events than people without collisions. The results are suggestive that male alcoholics with impaired collisions might have differences from those people with nonimpaired collisions that enhance their driving risk. PMID- 2695098 TI - On the site of interaction of some muscarinic agonists and competitive antagonists. AB - The stereochemistry of interaction of several 1,3-oxathiolane muscarinic ligands is considered and discussed. On the basis of the identical absolute configuration of the most affinitive enantiomers of agonists and antagonists it is suggested that the two kinds of ligands interact with an identical binding site, namely the recognition site of Acetylcholine. The hypothesis is extended to other muscarinic antagonists like the bulky esters of choline, 2,2-disubstituted-1,3-dioxolanes and Atropine-like compounds; a model for such an interaction is proposed. PMID- 2695099 TI - DNA-intercalating ligands as anti-cancer drugs: prospects for future design. AB - Interest in DNA-intercalating ligands as anti-cancer drugs has developed greatly since the clinical success of doxorubicin. However, despite a great deal of 'rational design' of synthetic DNA-intercalators, only a few such compounds have proved clinically useful. This review briefly surveys the history of DNA intercalators as clinically-used anti-cancer drugs, summarizes the known structure-experimental activity relationships and modes of action, and concludes that a factor in the slow progress is that much of the work on these compounds has been carried out by chemists, who were generally more interested in ligand/DNA interactions than drug development. Future development of the class rests on a careful consideration of the biochemical reasons behind the common limitations of the present drugs. The most important are: the inherent resistance of non-cycling cells, the rapid development (even by cycling cells) of resistance by the expression of both P-glycoprotein and altered topoisomerase II, limitations on drug distribution to and transport into tumours, low extravascular pH in tumours and the cardiotoxic side-effects of quinonoid chromophores. These considerations provide a set of constraints on physicochemical properties which must be considered in future design. However, within these constraints, there are useful future avenues for the development of DNA-intercalators as anti-cancer drugs. These include: (i) the production of improved topoisomerase inhibitors (by consideration of drug/protein as well as drug/DNA interactions); (ii) the development of reductively-activated chromophores as hypoxia-selective agents; and (iii) the use of DNA-intercalators of known DNA binding orientation as 'carriers' for the delivery of other reactive functionality specifically (sequence-, regio- and site-specifically) to DNA. PMID- 2695100 TI - 1,25 dihydroxyvitamin-D3 regulation of immunoglobulin production in peripheral blood mononuclear cells of patients with systemic lupus erythematosus. AB - Systemic Lupus Erythematosus (SLE) is a multisystem disease characterized by an increase in the secretion of autoantibodies. The mechanisms of autoantibody induced disease have not been clarified. 1,25-Dihydroxy-vitamin D3 (1,25-D3) is known to be important in the regulation of normal human lymphocyte functions. Among its regulatory functions is the ability to inhibit mitogen-stimulated production of immunoglobulin. The experiments reported here explored the regulation of IgG production by peripheral blood mononuclear cells (PBMCs) of patients with inactive and active SLE. 1,25-Dihydroxyvitamin D3 inhibited mitogen stimulated IgG production in cells from normal individuals and inactive SLE patients, but not spontaneous IgG production by PBMCs from active SLE patients. Addition of exogenous IL-2 (5-50 U/ml) to 1,25-D3-treated cells from all patient groups did not affect IgG production significantly under any conditions tested. The addition of IL-2 to PMBCs had no effect on IgG production in normal individuals or inactive SLE patients, but stimulated IgG production in PBMCs of active SLE patients. We conclude that the regulation of mitogen-stimulated IgG production in inactive SLE patients by 1,25-D3 and IL-2 is similar to normal individuals, but IgG production by active SLE PBMCs is unresponsive to 1,25-D3 regulation and is increased with the addition of IL-2. PMID- 2695101 TI - Detection of human autoantibody against intercalated cells of kidney-collecting tubule. AB - Serum from a 24-year-old woman with a history of habitual abortions was examined for autoantibodies by indirect immunofluorescence microscopy. Fluorochrome labelled antibodies to IgG revealed cytoplasmic staining of single cells in rat kidney collecting and connecting tubules. An identical staining pattern was reproducibly obtained in human and rabbit kidney, pointing to a cytoplasmic antigen concentrated in the apical pole of these cells. Lectin-binding histochemistry and immunohistochemical experiments using markers for different cell populations of the renal collecting tubule by double immunofluorescence technique, identified the cells recognized by the autoantibody as intercalated cells (ICC). Remarkably, this autoantibody reacted with a different antigen from those described to date in ICC, as evidenced by distribution and intracellular localization. The pattern of immunostaining suggests that all ICC are recognized in total rather than only one subpopulation. The connection between habitual abortions and this novel autoantibody are discussed. PMID- 2695103 TI - Chemical carcinogens and ras gene activation. PMID- 2695102 TI - CD44--a molecule involved in leukocyte adherence and T-cell activation. AB - The study of cell surface molecules that are involved in interactions between immune and non-hematopoietic cells in various microenvironments is currently an area of great interest. One molecule that appears to be involved in multiple steps of normal immune cell function is now called CD44 and has been known previously as Pgp-1, In(Lu)-related p80, Hermes, ECM-III and HUTCH-I. Within the past year, the co-identity of all of these independently discovered molecules has become apparent, and the role of the CD44 molecule in T-cell activation has been discovered. In this review, Barton Haynes and his colleagues bring together numerous divergent lines of investigation on the CD44 molecule, review the many functional roles attributed to it, and present a unifying view of how, with numerous ligands, it may participate in several areas of normal immune cell function. PMID- 2695104 TI - Insulin-induced phosphorylation of the beta-4 integrin subunit expressed on murine metastatic carcinoma cells. AB - A tumor surface protein (TSP-180) that is highly expressed on highly malignant metastatic cells has been identified on murine lung carcinomas. On SDS-PAGE under reducing conditions, TSP-180 shows a complex banding pattern corresponding to 204, 183, 150, 135, and 116 kDa. All bands of the TSP-180 complex are glycosylated and are labeled by lactoperoxidase-catalyzed radioiodination of viable cells. The mouse TSP-180 complex described here is homologous to the human integrin alpha 6 beta 4 complex, and in particular it has been demonstrated that protein corresponding to 204 kDa is homologous to the beta 4 subunit of the integrin complex. It has been shown recently that monoclonal antibody to TSP-180 (MoAb 135-13C) stimulates cell growth in vitro and induces phosphorylation of the 204-kDa protein. We now report that insulin increases the phosphorylation of the 204-kDa protein 30-fold in intact carcinoma cells and epidermal growth factor (EGF) causes a threefold increase. Insulin-like growth factor (IGF-I) and platelet-derived growth factor have no effect. The effect of insulin and of IGF-I on phosphorylation of their own receptors was studied using solubilized cell membranes. Insulin and IGF-I each induced a fivefold increase in the phosphorylation of their respective receptor beta subunits. In order to test if phosphorylation of the 204-kDa protein was induced by direct binding of growth factors to TSP-180 and to identify growth factor receptors on line 1 cells, affinity cross-linking studies were performed. Affinity labeling of receptors demonstrated that insulin and IGF-I both bind to a 135-kDa protein that corresponds to the insulin and IGF-I receptor alpha subunits. Affinity labeling of EGF receptors failed to demonstrate EGF receptor molecules (175-kDa protein) on line 1 cells. Further investigations by using a different approach confirmed the very low amount of EGF receptors on line 1 cells. Direct phosphoamino acid analysis of the 204-kDa protein purified from insulin-stimulated cells demonstrated that this beta 4 integrin subunit is phosphorylated on serine and tyrosine. We conclude that beta 4 integrin molecule is a target for phosphorylation through an indirect receptor-mediated mechanism. PMID- 2695105 TI - Materno-trophoblastic immunological balance. PMID- 2695106 TI - Enzyme-linked immunosorbent assay (ELISA) for detecting antisperm antibodies in mice with testicular autoimmunity. AB - We developed an ELISA for measuring antisperm antibodies in the mouse by using serum samples obtained from mice immunized with murine testicular antigens in complete Freund's adjuvant (CFA) as well as from mice rendered vasectomized. Sperm antigens used were syngeneic epididymal spermatozoa and two types of soluble, murine testicular antigens prepared in our laboratory. This study deals with a) the sequential changes of antisperm antibody levels following immunization; b) determination of immunoglobulin classes of these antibodies; c) a correlation between the absorbance values and the endpoint titers of antisperm antibodies; and d) comparison of endpoint titers of antisperm antibodies detected by ELISA with those by immunoperoxidase staining method in immune and nonimmune sera. It is suggested that serum dilution as high as 1/800 or more is required for detecting antibody titers of immune sera, because nonimmune mouse sera reveal a definite, although low, level of absorbance value at a serum dilution of 1/400 or less. PMID- 2695107 TI - [A comment on studies of Chinese herbal processing in 1988]. PMID- 2695108 TI - [A survey on the medicinal history of Pinellia ternata Breit]. AB - The work in this paper has a twofold aim: 1 Verifying the Chinese drug "Banxia" in medicinal books before 1900 as the tuber of Pinellia ternata (Araceae), While P.ternata in Qizhou (Licheng County, Shandong Province) had been mistaken for P.tripartita which only grow in Japan; 2 proving young tuber of P.pedatisecta to be "Youba" which was confused with "Banxia" in some ancient medicinal books, while "Youba" has been regarded as Arisaema regens so far. PMID- 2695109 TI - [Enhancing effect of danggui injection on immunologic function]. AB - Experiments have shown that Danggui injection enhances phagocytic function of macrophage in normal mice, and antagonizes the immunosuppressive activity of macrophage by cytoxan. The injection may increase the function of B cells and the activity of serum lysozyme, thus increasing the function of humoral immunity and nonspecific immunity. PMID- 2695110 TI - Skull radiography after recent trauma--a review. PMID- 2695111 TI - [Neonatal cholestasis]. PMID- 2695112 TI - [Generalized sclerosis (scleroderma) in children]. AB - Five patients with childhood scleroderma, were studied from a total group of 50 cases with the disease, 39 of them with diffuse systemic sclerosis and 11 with the CREST syndrome. The average age for these five patients when the disease onset was 13 (the age ranged from 5.5 to 16 years) with an average follow-up of 3.6 years (ranging from 1 to 6.5 years). Of the five, four girls were classified as having diffuse systemic sclerosis and the remaining boy, as suffering from the CREST syndrome. We found no family history or personal and occupational antecendents related with the appearance of the illness. Also excluded were conditions associated with changes similar to scleroderma as are seen in cases of diabetes mellitus, phenylketonuria, toxic oil syndrome, or graft-host rejection reactions. The clinical manifestations seen at the start of the disease included the Raynaud phenomenon, subcutaneous edema and muscular-skeletal abnormalities as arthralgia and myalgia with objective data of inflammatory myopathy. Proximal scleroderma was seen in all five patients; three of them, in addition, developed rapidly progressive cutaneous changes, causing the loss of elasticity and cutaneous hardening of the face during the first year of the disease. In all of the cases, the skin biopsy showed histopathological changes compatible with the diagnosis already given. The most important changes seen in the organs of these children were oesophageal dysfunction and fibrosis of the lung. The X-rays of three of the patients showed them to suffer from intestinal malfunction. We found no kidney, liver or nervous system disorders.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695113 TI - [Oral rehydration therapy in acute diarrheal syndrome. A critical analysis of various aspects]. AB - The use of the "universal" glucoelectrolytic solution proposed by the World Health Organization (WHO) for the treatment of the acute diarrheal syndrome, has now been recognized worldwide and successfully employed in the treatment of diarrhea and the maintenance of the normohydrated state once the patient has recuperated. All in all, it is necessary to comment and distinguish its beneficial aspects once placed into practice. This article primarily focuses on: 1. The recognition that local health indicators will determine importantly, the evaluation of the results obtained from the use of oral rehydration therapy; 2. The establishment of sound elements of judgement for the evaluation of the rehydrating solution from its composition to the volume employed; 3. Comment on the contraindications of oral rehydration therapy and describe the treatment plan suggested by the WHO; 4. Explain why in some parts of the world a sodium concentration of 60 is preferred over the 90 mmol/L found in the rehydrating solution; 5. Point out the risk of producing hypernatremia in patients rehydrated with the WHO solution and mechanisms which tend to reduce it; and finally, establish individualized management of water and electrolytic disturbances for certain regions of the world according to their health characteristics. Acute diarrhea; oral rehydration; critique. PMID- 2695114 TI - [Iron deficiency in children: clinical manifestations, therapy and prevention. II]. AB - A better understanding of the physiopathological and pathogenic characteristics underlying iron deficiency, has allowed for a more precise diagnosis and the opportune treatment of this disease. On the other hand, it has also permitted the designing of more efficient preventive programs. This study includes what is known to date and the applicable experiences when confronted with this problem in children. Iron deficiency; clinical manifestations; treatment; prevention. PMID- 2695115 TI - Cobalt probing of structural alternatives for insulin in solution. AB - Inorganic anions and phenolic compounds make the subunits of insulin hexamers undergo the T----R transition whereby the extended N-terminal B chain becomes helical and the octahedral metal coordination tetrahedral. The role of the metal ions is permissive. With cresol the transition is also undergone by metal-free hexamers. For coordinative reasons only zinc insulin can be transformed by moderate concentrations of inorganic anions. At higher concentrations and particularly with cresol transformation is also possible if Zn2+ is replaced by other metal ions. Owing to its d--d transitions in the visible cobalt lends itself as a spectroscopic probe for studying the interdependence of transformation and coordination. The transformation-related change in coordination is reflected in both the isotropic absorption and the CD spectrum. Cresol achieves T6----R6 transformation whereas that induced by SCN- ions is T6-- -T'3R3 with only the axial metal-binding site being realized in the R3 trimer. The spectral effects of the transformation of the two trimers are not additive; an extra contribution seems to be indicative of trimer/trimer interaction. Oxidation of 2 Co2+ insulin to a certain extent affects the structure of insulin; a characteristic positive band appears at 251 nm. Because of its extremely stable and exclusively octahedral complexes the Co3+ ion most strongly withstands transformation. The oxidation of tetrahedrally liganded Co2+ ions in R3 trimers proceeds with reduced velocity. Independent transformation of the Zn2+ trimers is possible in Zn2+/Co3+ metal hybrids of insulin. PMID- 2695116 TI - Secondary fungal metabolites and their biological activities, I. Isolation of antibiotic compounds from cultures of Heterobasidion annosum synthesized in the presence of antagonistic fungi or host plant cells. AB - Heterobasidion annosum (Syn. Fomes annosus), one of the most pathogenic basidiomycetes in conifer forests, produces a series of new metabolites specifically in the presence of antagonistic fungi or some plant cells. These "ecological metabolites" have been isolated and chemically characterized. The time course of production was measured with regard to their biosynthetic pathway. In bio-assays with other fungi, E. coli and cell cultures of Picea abies and Nicotiana tabacum, it could be shown that some of the compounds have antibiotic and growth-inhibiting properties. PMID- 2695117 TI - Tumorigenic sublethal whole-body X-irradiation of RFM mice enhances cell-mediated cytotoxicity while transiently depressing T- and B-lymphocytes. AB - The immunocyte composition of spleens and peritoneal exudates (PEC) from RFM mice was examined following tumorigenic doses of whole-body, sublethal X-irradiation. T-cells, B-cells and macrophages were quantitated using mAb and flow cytometry. The cell mediated cytotoxicity (CMC) potential of PEC following immunization with allogeneic tumor cells was also assayed. Although the percentages of T- and B cells were depressed in irradiated mice, the CMC activity of PEC from these same mice was increased. Thus irradiation resulted in an increased incidence of tumors coincident with an increased CMC potential against tumor targets. PMID- 2695118 TI - Antitumor effect of lactobacilli substances: "L. bulgaricus effect". AB - Scattered reports suggest a moderate effect, difficult to reproduce, of products from strains of specific lactobacilli (L. bulgaricus) used for yogurt on cancer and leukemia in mice. Skeptics have disregarded that even lyophilized preparations of demonstrated activity will lose effect when stored above -80 degrees C. This explains some inconsistencies of results and difficulties in repetition. Flow DNA fluorometry of ascitic fluid from leukemic mice has shown some accumulation of cells in the G2 + N phase after 8 hours, clearly different from the effect of 5-fluorouracil, although occasionally similar in strength. The effect depends on the strain of lactobacilli, and seems to deserve rational analysis by modern methods. PMID- 2695119 TI - Mental health of caregiving spouses: coping as mediator, moderator, or main effect? AB - Coping strategies used by 315 persons providing care to a spouse diagnosed with Alzheimer's disease were characterized as either emotion-focused (wishfulness, acceptance, intrapsychic) or problem-focused (instrumental). Models in which coping strategies were postulated as having mediator, moderator, and independent main effects were tested using multiple indexes of mental health. Wishfulness and intrapsychic strategies mediated the relationship between degree of stress and CES-D, Anxiety, and Depression. Wishfulness had a direct effect on Obsessive Compulsive, Somatization, and Interpersonal Sensitivity; intrapsychic strategies had a direct effect on Obsessive-Compulsive, Somatization, and Interpersonal Sensitivity; and instrumental strategies had a direct effect on Positive Affect. Hierarchical regression analyses indicated that stressors and coping strategies explained between 12% and 40% of the variance on mental health indexes. PMID- 2695120 TI - Cross-cultural studies of dementia: use of a Chinese version of the Blessed-Roth Information-Memory-Concentration test in a Shanghai dementia survey. AB - A culturally adapted Chinese version of the Blessed-Roth Information-Memory Concentration test (CIMC) was used in a dementia screening survey of a probability sample of 5,055 elderly Shanghai residents. The individual items on the CIMC that best predicted the overall score were similar to the best predictor of an American version of the IMC. Performance on the CIMC was markedly affected by the level of education or lack thereof. In a subsample for whom clinical diagnoses were obtained, it was possible to establish cutoff values on the CIMC by stratifying the sample according to education. PMID- 2695121 TI - Direct and indirect tests of memory for category exemplars in young and older adults. AB - Young and older adults were compared on direct (cued recall) and indirect (exemplar generation) tests of memory for category members. Because category names served as cues in both tasks, amount of retrieval support was constant across tasks. Although older adults produced fewer category members in cued recall, priming of category exemplars in the generation task did not vary with age. These results suggest that age constancy in priming tasks does not depend on physical similarity between study materials and retrieval cues provided at test and point to the importance of deliberate recollection as a factor in determining the extent of age differences in memory. PMID- 2695122 TI - Structure of insulin: results of joint neutron and X-ray refinement. AB - Neutron diffraction data for porcine 2Zn insulin were collected to 2.2 A resolution from a single crystal deuterated by slow exchange of mother liquor. A joint neutron/X-ray restrained-least-squares refinement was undertaken using the neutron data, as well as the 1.5 A resolution X-ray data collected previously. The final R factors were 0.182 for the X-ray data and 0.191 for the neutron data. Resulting atomic coordinates were compared with the initial X-ray model, showing a total r.m.s. shift of 0.36 A for the protein and 0.6 A for the solvent. Protonation of a number of individual amino acids was investigated by analysis of the neutron maps. No D atoms were found between the carboxylates of Glu B13 which make an intermolecular contact, suggesting nonbonded interaction rather than the predicted hydrogen bond. Amide hydrogen exchange was investigated in a refinement of their atomic occupancies. Regions of unexchanged amide groups were found in the center of the B helices. The results of this study emphasize the limited amount of information available in neutron diffraction studies of proteins at resolution lower than 2 A. PMID- 2695123 TI - The genetics of depression: current approaches. AB - It is widely accepted that depression shows a tendency to run in families. This is partly due to genetic influences--and the subject has been covered in recent reviews. This article, therefore, does not aim to recapitulate the genetic evidence but rather aims to elucidate the mode of transmission, to achieve an understanding of relevant gene-environment co-actions and interactions, and to describe attempts to identify and localise major genes. PMID- 2695124 TI - Suicide and antidepressant overdosage in general practice. AB - Depression is a very common condition, and most depressed patients in many countries are treated by their General Practitioners. It is a frequent cause of suicide - one of the major causes of death in young adults - and is the disorder most commonly associated with deliberate self-poisoning, a large percentage of suicides being due to poisoning with drugs that are only available on prescription. Self-poisoning with older tricyclic antidepressants (TCAs) poses major clinical management problems, since the majority of patients who overdose with these agents do not reach hospital alive. Though there is no convincing evidence that any one antidepressant is more effective than others or more rapid in onset of therapeutic action, antidepressants do differ substantially in their side-effect profiles and in their toxicity in overdosage, those introduced before 1970 being relatively more toxic. Since suicide rates have been reduced by limiting the availability of toxic substances such as barbiturates and harmful domestic gas, restricting the use of older antidepressant in favour of newer, safer compounds for depressed patients being treated in general practice would also seem to be advisable. PMID- 2695125 TI - Tyramine and new monoamine oxidase inhibitor drugs. AB - The hypertensive crisis induced by the ingestion of cheese in subjects undergoing treatment with monoamine oxidase inhibitors (MAOIs) led to their virtual disappearance in many parts of the world. Three strategies to try and diminish the risk of this reaction have been developed: the combination of current (irreversible and non-selective) MAOIs with tricyclic antidepressants, the use of new selective MAOIs, and the use of new reversible MAOIs. The relative effectiveness of these different approaches can be assessed by the tyramine pressor test. The introduction of reversible and selective monoamine oxidase-A (MAO-A) inhibitors looks especially promising clinically. PMID- 2695126 TI - Tyramine and irreversible monoamine oxidase inhibitors in clinical practice. AB - The cheese reaction following use of the irreversible monoamine oxidase inhibitors (MAOIs) began to be reported in the UK with increasing frequency from about 1961. By 1965, the underlying mechanism (tyramine-provoked hypertension) had been essentially elucidated. Thereafter, this potentially severe side-effect could have been largely avoided by the use of fairly simple dietary precautions. Unfortunately, suspicion and fear burgeoned, and both the seriousness and the frequency of risk were dramatically inflated. This was a major factor in the subsequent general disuse of the irreversible MAOIs. Second-generation MAOIs which are selective for monoamine oxidase-A and B are now being synthesised and may eliminate the eventuality of hypertension without special dietary precautions. PMID- 2695127 TI - Antidepressants in panic disorders. AB - The efficacy of antidepressants for panic disorders has had major effects on our understanding of the classification, pathophysiology, and treatment of anxiety disorders. Psychiatric practice has also been significantly affected, but important issues remain unresolved, such as the mechanisms of therapeutic effect, optimal duration of therapy to minimise relapse, and the interaction and sequencing of medication with cognitive behavioural treatments. PMID- 2695128 TI - The pharmacology of reversible monoamine oxidase inhibitors. AB - The older monoamine oxidase inhibitors (MAOIs) are mechanism-based, irreversible inhibitors of MAO; most inhibit both the A and B forms of MAO. Several of the drugs are hydrazine derivatives which have non-specific effects other than MAO inhibition. These properties convey disadvantages, which may be seen as serious, though infrequent, adverse events--the 'cheese effect', hepatotoxicity, amphetamine-like activity, orthostatic hypotension and anticholinergic effects. New, reversible MAOIs stem from a variety of chemical classes and are more specific in their effects, with relatively rapid onset of action, direct relationship between plasma concentration and pharmacological effect, and no prolonged carry-over phenomena. PMID- 2695129 TI - A double-blind comparative trial of moclobemide v. imipramine and placebo in major depressive episodes. AB - Patients (n = 490) suffering from a major depressive episode according to DSM-III criteria were randomly allocated to groups receiving either moclobemide, imipramine, or placebo treatment. Subjects were treated as out-patients for 6 weeks. On overall assessment of efficacy and on results of the Hamilton Rating Scale for Depression, both moclobemide and imipramine were superior to placebo, but the differences between moclobemide and imipramine were not significant. Premature termination due to insufficient efficacy was more frequent with placebo than with moclobemide or with imipramine, these differences being significant. The overall assessment of tolerance clearly favoured placebo and moclobemide over imipramine. This was also reflected in the frequency of premature terminations due to poor tolerance, as well as in the frequency of adverse events, which were highest in the imipramine group. The only cardiovascular finding was an increase of the mean heart rate with imipramine, maximum at the end of week 1, while placebo and moclobemide displayed no relevant changes. There were no other important drug-related changes. PMID- 2695130 TI - Efficacy and tolerability of moclobemide compared with imipramine in depressive disorder (DSM-III): an Austrian double-blind, multicentre study. AB - The antidepressant efficacy, tolerability, and safety of moclobemide, a reversible, monoamine oxidase-A inhibitor, were compared with those of imipramine in parallel groups of patients with a major depressive episode, in a 4-week, multicentre (17 centres), randomised study. A total of 381 patients were randomly allocated to either treatment; they were not required to avoid tyramine-rich foods. Drop-out rates were comparable in both groups at about 17%. Judged primarily on the HRSD, no significant differences in efficacy were observed between the groups, but the number of patients presenting with adverse events, as well as the total number of adverse events, was greater with imipramine. Cardiovascular tolerability was satisfactory and physical examination, body weight, and laboratory values were essentially unaffected in both groups. PMID- 2695131 TI - Pre-clinical pharmacology of moclobemide. A review of published studies. AB - The novel antidepressant, moclobemide, is a reversible inhibitor of monoamine oxidase (MAO) preferentially of monoamine oxidise-A (MAO-A); it emerged for study out of a series of lipid-lowering agents. In spite of its weak MAO-A inhibition in vitro, moclobemide is a potent inhibitor of MAO-A, in vivo; its in vivo activity is of short duration, in contrast to the extremely long-lasting inhibition, e.g. by tranylcypromine. Moclobemide only slightly potentiates the pressor effect of oral tyramine in freely moving rats, again in contrast to tranylcypromine; it is not anti-cholinergic and is free of hepatotoxicity. Published evidence on the preclinical pharmacology is reviewed. PMID- 2695132 TI - The concept of negative symptoms. PMID- 2695133 TI - Three syndromes in chronic schizophrenia. PMID- 2695134 TI - The prognostic significance of negative symptoms in schizophrenia. PMID- 2695135 TI - Psychological and social aspects of negative symptoms. PMID- 2695136 TI - Psychological treatments for negative symptoms. AB - Psychological training programmes for patients presenting with negative symptoms have developed from an environmentally based approach (the token economy) through interactive programmes (social and life skills training) to programmes which focus directly on facilitating and enhancing the cognitive skills of the individual patient (self-instructional training and problem-solving). It is clear that this sequence of research has generated a range of approaches which are probably undervalued in the management of patients suffering from negative symptoms. Problems remain with respect to the generalisation of some procedures but it seems likely that these problems may be overcome by tailoring treatments to the particular cognitive deficits of different groups of patients. This will obviously require a detailed analysis of the structure of negative symptoms and the deficits associated with them. The distinction between difficulties in initiating behavior and difficulties in organising behaviour may prove to be particularly important in this respect. PMID- 2695137 TI - A current view of the type II syndrome: age of onset, intellectual impairment, and the meaning of structural changes in the brain. PMID- 2695138 TI - The 'basic' symptoms of schizophrenia. PMID- 2695139 TI - The historical evolution of the concept of negative symptoms in schizophrenia. AB - Table IV schematically summarises the models of some important theoreticians in order to indicate the heterogeneity of the conceptual basis for the distinction between positive and negative forms of schizophrenia. Thus, in different terminologies, positive and negative symptoms by Reynolds and Jackson are related to different mental and somatic disturbances. Bleuler mainly judges associations and their possible alterations, particularly by affect. When Berze, through the insufficiency of mental activity, places a negative element into the centre of his schizophrenia theory, he is interested in the conscious mental acts and intentionality. Gruhle, on the other hand, considers the different activity of hyper- and hypo-phases and, as an additional dimension, the comprehensibility of motives. Janzarik, in his dynamistic conception, first of all analyses the positive and negative conditions from the viewpoint of energy and emotion. This simple review advises caution when composing historical positions to a unitarian concept of positive and negative psychoses. Considering the present discussion, however, we find a similar situation with quite different areas, which serve as support for the division into a positive and negative form of schizophrenia. The logic of these tendencies corresponds with the present trend to a multiaxial or multidimensional registration of clinical, psychopathological and biological data. However, the various levels of explanation have questionable relations to each other. According to the clinical model based on natural sciences, we expect an approach to valid entities by an optimisation of the defining criteria which are derived from psychological, somatological and clinical sources (Sass, 1987).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695140 TI - The assessment of negative and positive features in schizophrenia. PMID- 2695141 TI - The Scale for the Assessment of Negative Symptoms (SANS): conceptual and theoretical foundations. PMID- 2695142 TI - Neural mechanisms of negative symptoms. PMID- 2695143 TI - The 90,000 dalton heat shock protein, a lot of smoke but no function as yet. PMID- 2695144 TI - Tubulin synthesis, structure, and function: what are the relationships? AB - In most eukaryotes, families of tubulin genes give rise to multiple isoforms of tubulin, which may be modified post-translationally. The synthesis of isotubulins is spatially and temporally regulated, leading to the presence of different tubulins within an organism. The cellular localization of tubulin is also nonrandom with discrete isoforms residing in specific regions of some cells. Much work, dependent upon interrelated molecular and immunological technologies, has gone into determining why cells produce multiple isotubulins. One proposal would have us believe that isotubulins are functionally discrete and that the isotubulin composition of a microtubule determines its function. A second idea is that tubulin multigene families arose by gene duplication and subsequent genetic drift. The duplicated genes survive in modified form, as they provide the cell with the ability to effectively regulate tubulin synthesis at the transcriptional level while yielding multifunctional tubulins. Analysis of mutant tubulin genes is revealing functionally important regions of tubulin, prompting a return to the consideration of those properties of the molecule that are fundamental to microtubule formation rather than function per se. A model for autoregulation of tubulin synthesis has been developed, but little is yet known of other molecular signals or mechanisms involved in regulation of tubulin production. Further study of flagella formation promises to change this situation. Complementing the genetic studies is the examination of tubulin posttranslational modifications including detyrosination/tyrosination, acetylation/deacetylation, and phosphorylation. Enzymatic mechanisms mediating tubulin posttranslational changes are partially elucidated, as are the influences of the modifications on microtubule properties. Potential functions of the posttranslational changes are the modulation of microtubule-associated protein binding to microtubules, the provision of a mechanism to indicate microtubule age, or as mediators of cellular morphogenesis, a role which could be dependent upon the first two functions. Despite the progress that has been made, the physiological significance of having several isotubulins within a single cell and the molecular details of microtubule function remain obscure. PMID- 2695145 TI - Ribosomal protein S1 and initiation factor IF3 do not promote the ribosomal binding of approximately 19-nucleotide-long mDNA and mRNA models. AB - A number of model mDNAs and mRNAs, about 19 nucleotides in length, were obtained by automated synthesis and T7 RNA polymerase directed transcription from synthetic DNA templates, respectively. These mDNAs and mRNAs had Shine-Dalgarno sequences that were four to eight nucleotides long and their sequence was similar to the R17 coat protein initiation site. The effect of S1 or initiation factors (IFs) on the rate and extent of ribosomal binding of these mDNAs and mRNAs was investigated by nitrocellulose filtration. No effect was detected, suggesting that the main function of S1 or IFs included neither the direct recognition or binding of short messengers to the 30S subunits, nor their rejection as "false" for possessing the wrong sugars or an insufficient length. A pulse-chase experiment with one of the mRNAs also showed that S1 or IF3 did not influence the exchange rate of mRNA bound to the 30S subunit. PMID- 2695146 TI - The neural crest cell lineage problem: neuropoiesis? PMID- 2695148 TI - Mechanisms of airway goblet cell mucin release: studies with cultured tracheal surface epithelial cells. AB - Confluent hamster tracheal surface epithelial (HTSE) cells in primary culture are enriched with secretory cells that synthesize and release mucins. Using this cell culture system, we investigated possible mechanisms of goblet cell mucin release by altering the media bathing the apical surface of HTSE cells: medium hyperosmolarity decreased mucin release, whereas hypo-osmolarity increased release without causing a cytoplasmic leak due to plasma membrane damage. A Ca2+ ionophore, A23187, did not influence mucin release. Both acidic (pH less than 4) and basic (pH greater than 9) media caused significant increases in mucin release secondary to cell membrane damage. Physiologic concentrations of chemical mediators such as prostaglandins (PGE2 and PGF2 alpha) and leukotrienes (LTC4 and LTD4) did not influence mucin release. Both elastase and cathepsin G derived from human neutrophils caused marked increases in release, whereas trypsin from the porcine pancreas produced a small increase only at a high concentration. We conclude that mucin release by cultured airway goblet cells can be enhanced by: (1) irritant gases, (2) luminal fluid osmolarity, (3) pharmacologic concentrations of LTC4 and LTD4, and (4) cationic proteases, each presumably acting by different mechanisms. Each of these mechanisms may play a role in epithelial mucin secretion associated with airway inflammation. PMID- 2695147 TI - An antibody to the Drosophila period protein recognizes circadian pacemaker neurons in Aplysia and Bulla. AB - The molecular mechanisms of the pacemakers underlying circadian rhythms are not well understood. One molecule that presumably functions in the circadian clock of Drosophila is the product of the period (per) gene, which dramatically affects biological rhythms when mutated. An antibody specific for the per protein labels putative circadian pacemaker neurons and fibers in eyes of two marine gastropods, Aplysia and Bulla. As was found for the Drosophila per protein, there is a daily rhythm in the levels of the per-like antigen in Aplysia eyes. Thus, certain molecular features of the per protein, as well as aspects of the temporal regulation of its expression, may be conserved in circadian pacemakers of widely divergent species. PMID- 2695149 TI - Some bonding characteristics of a HEMA/maleic acid adhesion promoter. AB - A recently released dentine adhesion promoter, based on a HEMA/maleic acid primer, was found to bond exceptionally well to dentine (14.1 MPa) if the adhesion promoter layer was applied thickly enough. Air inhibition of the promoter layer during its initial cure was seen to reduce the bond strength by a half if the promoter layer was air-thinned prior to curing. The adhesion promoter was found to greatly enhance the bond strength of composite to glass ionomer, removing the necessity to acid etch the glass ionomer prior to applying the composite. The failure of the composite/glass ionomer bond was always within the glass-ionomer cement itself, with the higher bond strengths resulting in a greater incidence of oblique cracks at 45 degrees to the bond surface than had been previously observed. PMID- 2695150 TI - The strange tale of Martin van Butchell. AB - In the eighteenth century, a pedestrian strolling around Georgian London may have witnessed the bizarre sight of an ageing gentleman parading the streets on a painted horse and brandishing the jawbone of an ass. Not only was this man an eccentric, he was also a dentist. David Watkins here relates the remarkable story of Martin van Butchell, a dentist extraordinaire. PMID- 2695151 TI - Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia. AB - Fifty pre-menopausal women with severe and persistent cyclical mastalgia entered this randomised, double-blind, parallel group study comparing bromocriptine and placebo. Patients were treated for three months followed by a further three months on the same medication if treatment was satisfactory. Symptoms were assessed before treatment and after one, two and three months of treatment. For patients whose mastalgia was not controlled after three months, the treatment code was broken and either the dose of bromocriptine increased or the patient given active medication instead of placebo. Bromocriptine, compared with placebo, caused a significant (p less than 0.01) and sustained improvement in breast pain, tenderness and nodularity together with a reduction in serum prolactin levels (p less than 0.01). Adverse events were experienced by 9/23 (39 per cent) of patients taking bromocriptine and 2/22 (nine per cent) taking placebo. The majority of side effects reported were mild or moderate. This study shows that bromocriptine, at a dose of 5 mg/day for three months, effectively controls the symptoms of cyclical mastalgia with minimal side effects. PMID- 2695152 TI - A large multicentre, parallel group, double-blind study comparing tenoxicam and piroxicam in the treatment of osteoarthritis and rheumatoid arthritis. AB - A total of 1,328 patients with osteoarthritis or rheumatoid arthritis were entered into this double-blind, parallel group study of tenoxicam and piroxicam. The patient populations were well matched. An improvement was seen in pain on moving and at night in both groups and in both indications. Stiffness was also improved by both drugs, being most marked in the rheumatoid arthritis group. The primary efficacy variable was global assessment, and this showed tenoxicam to have slightly greater effect in osteoarthritis and the reverse in rheumatoid arthritis. There were no statistically significant differences in any of these findings. There were no significant differences in tolerance ratings, although the more serious gastrointestinal events occurred in the piroxicam group. PMID- 2695153 TI - Diagnosis of infantile hypertrophic pyloric stenosis by ultrasound. PMID- 2695154 TI - Characteristics of persistent ovarian masses in asymptomatic women. AB - Persistent ovarian masses have been found in a substantial proportion of 5479 self-selected asymptomatic women who were screened for early ovarian neoplasia. Each woman was scheduled to undergo three ultrasound screens (consisting of 1-12 scans) to detect regressing and non-regressing masses. A total of 14,594 screens (15,977 scans) was performed. The average interval between successive screens was 595 days (range 214-1134 days). Overall, 650 screens (4.4%; 10.1% of women) produced a positive result which became negative with successive scans (four times more frequently in pre- than naturally postmenopausal women), and 338 screens (2.3%; 5.9% of women) had a final positive result (at least one ovary that was grossly abnormal or contained a persistent mass). Biopsies were taken from 336 ovaries (89% of total, 271 women). Overall, 134 tumour-like conditions and 119 benign tumours were identified. The detection rate of tumour-like conditions was 1.5 times higher in premenopausal than naturally postmenopausal women, whereas the proportion of tumours to normal ovaries was similar in both groups. Overall, 51% of tumour-like conditions and 70% of all tumours were detected at screen 1. Four women had metastatic ovarian cancer (three at screen 1, one at screen 2; two were bilateral). Five women (0.1%) had a primary malignant tumour (two at screen 1, three at screen 2; four were stage 1a and one was stage 1b). All women are being monitored to obtain additional information about the significance of the findings. PMID- 2695156 TI - The efficacy of paracervical injections of lignocaine before laser ablation of the cervical transformation zone. A randomized placebo-controlled double-blind clinical trial. AB - In a prospective double-blind randomized placebo-controlled clinical trial the efficacy of paracervical lignocaine was compared with saline in reducing pain in 70 women undergoing laser ablation of the cervical transformation zone. Paracervical lignocaine had no significant measurable effect on reducing the pain experience during the laser procedure. The mean subjective visual linear analogue pain score in the lignocaine and saline groups was 27% (95% CI 17 to 38) and 30% (95% CI 24 to 41) respectively (t = 1.0; P = 0.35). The median (quartiles) objective pain scores for the same groups were 0 (0-2) and 0 (0-1) respectively (P = 0.58). PMID- 2695155 TI - Induction of labour after fetal death: a randomized controlled trial of two prostaglandin regimens. AB - A total of 85 women with antepartum fetal death between 14 and 42 weeks gestation was randomly assigned to one of two regimens of intravenous infusion of the prostaglandin analogue 16-phenoxy-17, 18, 19, 20-tetranor-PGE2-methylsulphonamide (sulprostone) for inducing labour. Women received either 1 microgram/min until delivery or the commonly recommended treatment of 1500 micrograms in 8 h followed by another, identical course of treatment if delivery did not occur within 24 h. The 1 microgram/min dose schedule used half the amount of prostaglandin and resulted in statistically significantly fewer gastrointestinal side-effects compared with the conventional treatment. All women were delivered vaginally and there were no differences in induction-to-delivery intervals between the two treatments. Sulprostone infused at a rate of 1 microgram/min resulted in a 50% chance of being delivered within 12 h and a 90% chance of being delivered within 24 h, with an overall frequency of side-effects of 20%. PMID- 2695157 TI - Monozygotic twin pregnancy: diagnostic and Doppler ultrasound studies. AB - Of 178 consecutive twin pregnancies, 63 were both monozygotic and also studied prenatally by real-time B-scan (and usually Doppler) ultrasound. The 48 pregnancies with monochorionic placentas (in which vascular anastomoses are almost universal) were compared with the 15 monozygotic pregnancies having dichorionic placentas. The type of placenta found at delivery was predicted with substantial accuracy by ultrasound examination in mid-pregnancy. We were unable to identify any inter-group difference in fetal growth rate, discordance of fetal growth between twins or pattern of umbilical artery flow velocity waveform. In the absence of the rare florid twin transfusion syndrome, the vascular anastomoses that have been shown to be common in monochorionic placentas do not exert a strong influence on fetal growth or fetoplacental blood flow. PMID- 2695158 TI - Progestogen-induced regression in low-grade endometrial stromal sarcoma. Case report and literature review. PMID- 2695159 TI - Pulmonary oedema and salbutamol in preterm labour. Case report and literature review. PMID- 2695160 TI - Discordant umbilical artery flow velocity waveforms and pregnancy outcome. PMID- 2695161 TI - p10 single-stranded nucleic acid binding protein from murine leukemia virus binds metal ions via the peptide sequence Cys26-X2-Cys29-X4-His34-X4-Cys39. AB - The RNA binding protein of 56 residues encoded by the extreme 3' region of the gag gene of Rauscher murine leukemia virus (MuLV) has been chemically synthesized by a solid-phase synthesis approach. Since the peptide contains a Cys26-X2-Cys29 X4-His34-X2-Cys39 sequence that is shared by all retroviral gag polyproteins which has been proposed to be a metal binding region, it was of considerable interest to examine the metal binding properties of the complete p10 protein. As postulated, p10 binds the metal ions Cd(II), Co(II), and Zn(II). The Co(II) protein shows a set of d-d absorption bands typical of a tetrahedral Co(II) complex at 695 (epsilon = 565 M-1 cm-1), 642 (epsilon = 655 M-1 cm-1), and 615 nm (epsilon = 510 M-1 cm-1) and two intense bands at 349 (epsilon = 2460 M-1 cm-1) and 314 nm (epsilon = 4240 M-1 cm-1) typical of Co(II)----(-)S- charge transfer. The ultraviolet absorption spectrum also indicates Cd(II) binding by the appearance of a Cd(II)----(-)S- charge-transfer band at 255 nm. The 113Cd NMR spectrum of 113Cd(II)-p10 reveals one signal at delta = 648 ppm. This chemical shift correlates well with that predicted for ligation of 113Cd(II) to three -S- from the three Cys residues of p10. The chemical shift of 113Cd(II)-p10 changes by only 4 ppm upon binding of d(pA)6, indicating that the chelate complex is little changed by oligonucleotide binding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695162 TI - Proteolytic processing of polyproteins in the replication of RNA viruses. PMID- 2695163 TI - Electrical potentials in trypsin isozymes. AB - Cow and rat trypsin differ in net charge by 12.5 units yet have the same enzymatic mechanism. The role of electrical potentials in the catalytic mechanism of these trypsin isozymes is investigated by using the finite difference Poisson Boltzmann method. The calculations reveal that the active sites are effectively shielded from surface charge, thus making it possible for the two enzymes to have essentially identical potentials in their catalytically important regions. The potentials in both active sites are dominated by local interactions arising both from partial charges and from the negative charge on Asp-102. The latter is found to stabilize the transition state by about 4 kcal/mol, a value that is consistent with the extent of reduced catalytic activity in the variant Asn-102 trypsin, in which the negative charge is absent. The calculations predict that Asp-102 is ionized and that His-57 is neutral in the resting state of the enzyme. In contrast to their negligible effect on catalytic activity, the cumulative effect of surface charges is found to raise the pK of the N-terminal alpha-amino group of Ile-16 in the rat enzyme by about 1.5 units relative to that of cow trypsin. This charged amino acid forms an ionic bond with Asp-194, which stabilizes the active conformation of the enzyme. An increase in pK of Ile-16 thus provides a possible explanation for the retention of activity of rat trypsin at high pH. The results of this study could not have been obtained from an electrostatic model based on Coulombic potentials. PMID- 2695164 TI - An amphitropic cAMP-binding protein in yeast mitochondria. 1. Synergistic control of the intramitochondrial location by calcium and phospholipid. AB - A cAMP-binding protein is found to be integrated into the inner mitochondrial membrane of the yeast Saccharomyces cerevisiae under normal conditions. It resists solubilization by high salt and chaotropic agents. The protein is, however, converted to a soluble form which then resides in the intermembrane space, when isolated mitochondria are incubated with low concentrations of calcium. Phospholipids or diacylglycerol (or analogues) dramatically increases the efficiency of receptor release from the inner membrane, whereas these compounds alone are ineffective. Also, cAMP does not effect or enhance liberation from the membrane of the cAMP-binding protein. Photoaffinity labeling with 8-N3 [32P]cAMP followed by mitochondrial subfractionation and sodium dodecyl sulfate polyacrylamide gel electrophoresis does not reveal differences in the apparent molecular weight between the membrane-bound and the soluble form of the cAMP receptor. The two forms differ, however, in their partitioning behavior in Triton X-114 as well as in their protease resistance, indicating that the release from the membrane is accompanied by a change in lipophilicity and conformation of the receptor protein. Evidence is presented that a change of the intramitochondrial location of the yeast cAMP-binding protein also occurs in vivo and leads to the activation of a mitochondrial cAMP-dependent protein kinase. The cAMP-binding protein is the first example of a mitochondrial protein with amphitropic character; i.e., it has the property to occur in two different locations, as a membrane-embedded and a soluble form. PMID- 2695165 TI - An amphitropic cAMP-binding protein in yeast mitochondria. 2. Phospholipid nature of the membrane anchor. AB - We describe the first example of a mitochondrial protein with a covalently attached phosphatidylinositol moiety acting as a membrane anchor. The protein can be metabolically labeled with both stearic acid and inositol. The stearic acid label is removed by phospholipase D whereupon the protein with the retained inositol label is released from the membrane. This protein is a cAMP receptor of the yeast Saccharomyces cerevisiae and tightly associated with the inner mitochondrial membrane. However, it is converted into a soluble form during incubation of isolated mitochondria with Ca2+ and phospholipid (or lipid derivatives). This transition requires the action of a proteinaceous, N ethylmaleimide-sensitive component of the intermembrane space and is accompanied by a decrease in the lipophilicity of the cAMP receptor. We propose that the component of the intermembrane space triggers the amphitropic behavior of the mitochondrial lipid-modified cAMP-binding protein through a phospholipase activity. PMID- 2695166 TI - An amphitropic cAMP-binding protein in yeast mitochondria. 3. Membrane release requires both Ca2(+)-dependent phosphorylation of the cAMP-binding protein and a phospholipid-activated mitochondrial phospholipase. AB - The amphitropic cAMP-binding protein in mitochondria of the yeast Saccharomyces cerevisiae is released from the inner membrane into the intermembrane space by the degradation of its lipid membrane anchor consisting of or containing phosphatidylinositol. The releasing reaction depends on the presence of an N ethylmaleimide-sensitive protein (releasing factor) in the intermembrane space and is controlled by Ca2+ and phospholipid (or lipid derivatives). Here we demonstrate that these two effector molecules act on different activation steps within a complex releasing pathway involving both the cAMP receptor and the releasing factor: Ca2(+)-dependent phosphorylation of the receptor protein seems to be prerequisite for its subsequent lipolytic liberation from the inner membrane. In the presence of phospholipid (or lipid derivatives) the previously soluble releasing factor, which may be identical with a soluble diacylglycerol binding protein in the mitochondrial intermembrane space, associates with the inner membrane. This change in the intramitochondrial location of the releasing factor, which thus exhibits amphitropic behavior itself, may be required for (direct or indirect) activation of the mitochondrial phospholipase which then releases the cAMP receptor from the inner membrane in a form liable to dissociation from the C subunit by cAMP. PMID- 2695167 TI - The HIV epidemic: medical and social challenges. AB - The sudden appearance, rapid spread, and devastating clinical impact of HIV infection in Africa, Europe and North America has created a medical problem unprecedented in the modern era. HIV is sexually transmitted, afflicts sexual and racial minorities in developed countries, and appears likely to be fatal and incurable in a majority of infected people. Its epidemiology (transmission and natural history) and clinical manifestations have been well described, but treatment of HIV remains minimally effective, creating only a short respite from progressive deterioration. In the absence of effective vaccination, HIV will continue to spread, abetted by a long period of asymptomatic carriage during which carriers are infectious. It has spread internationally to most undeveloped countries aided by fear and ignorance. The problem will resist simple technological solutions and adversely impact the lives of tens of millions of people in these areas over the next several decades. In developed countries HIV will strain medical resources and kill several million people before the end of the century. Despite the tremendous problems created by the AIDS epidemic, it has driven a remarkable expansion of virologic and immunologic understanding which promises to ultimately lead to control of not only AIDS, but a variety of other serious diseases. The following reviews of pivotal issues in AIDS research document this progress. PMID- 2695168 TI - Characteristics of HIV infection and pathogenesis. PMID- 2695169 TI - HIV infection and the immune system. PMID- 2695170 TI - The molecular biology of the human immunodeficiency virus. PMID- 2695171 TI - Strategies for developing vaccines against acquired immunodeficiency syndrome. AB - There exists an abundance of literature on the prospects for developing vaccines against the etiologic viral agent of acquired immunodeficiency syndrome (AIDS). Excellent reviews from a variety of investigators are available on this subject. It is our intention to review the literature relative to potential strategies for developing a successful AIDS vaccine and to impart some of our concerns on the different types of vaccine that are being tested. We have also focused on some vaccine strategies that have not received much attention in previous review articles. Finally, the role of animal models in assessing vaccine safety and efficacy against AIDS has been briefly described. PMID- 2695172 TI - Do testosterone and estradiol-17 beta enforce inhibition or stimulation of luteinizing hormone-releasing hormone secretion? AB - The effects of gonadectomy and gonadal steroid replacement on hypothalamic luteinizing hormone-releasing hormone (LHRH) secretion in vivo and in vitroi in the rat are reviewed. The evidence revealed that the part played by testosterone or estradiol-17 beta in regulation of LHRH signals to pituitary gonadotropes is more complex than that which has been surmised from measurements of steroidal effects on luteinizing hormone (LH) release. There is little evidence to date to corroborate the assumptions that the rate of hypothalamic LHRH drive is enhanced to sustain the post-gonadectomy LH response and that gonadal steroids inhibit LHRH secretion in gonadectomized rats. There is a dire need to develop newer techniques not only to characterize the LHRH pulsatility pattern reaching the pituitary gonadotropes on a moment-to-moment basis but also to fully explain the existing evidence that suggests a facilitatory influence of gonadal steroids and invokes participation of newer neural and steroidal and nonsteroidal gonadal factors in regulating the communication between LHRH secreting neurons and pituitary gonadotropes. Plainly, further studies will be necessary to provide a unified view on the exchange of information between the gonads and hypothalamus for control of reproduction. PMID- 2695173 TI - Sertoli cells in culture: views from the perspectives of an in vivoist and an in vitroist. AB - Culturing Sertoli cells has proven to be a valuable technique to study the responses of these cells under a variety of conditions. This minireview focuses on the culture system and how it has contributed to our knowledge of the capabilities of isolated Sertoli cells. In addition, it focuses on the limitations of the system and the gaps in our knowledge about Sertoli cells in culture and what the results of in vitro studies mean in the intact animal. Caution is urged in interpreting in vitro results to the intact animal without their validation in vivo. PMID- 2695174 TI - A comparison of the actions of stimulatory follicular fluid and gonadotropin releasing hormone analogs on progesterone secretion by porcine granulosa cells. AB - Granulosa cells from small and medium porcine follicles (1-5 mm) were incubated with charcoal-treated follicular fluid from large (6-10 mm) follicles or porcine serum in the presence and absence of gonadotropin-releasing hormone (GnRH) analog and luteinizing hormone (LH) or follicle-stimulating hormone (FSH). A GnRH agonist inhibited follicular fluid's enhancement of basal and LH-stimulated progesterone secretion but did not block follicular fluid's enhancement of FSH stimulated progesterone secretion. A GnRH antagonist mimicked follicular fluid's enhancement of basal and LH-stimulated progesterone secretion but did not mimic follicular fluid's action on FSH-stimulated progesterone secretion. When the GnRH antagonist and follicular fluid were added together, they acted synergistically in stimulating basal progesterone secretion, and were additive in enhancing LH stimulated progesterone secretion. These observations suggest that separate follicular fluid molecules are responsible for its influence on LH and FSH actions on granulosa cells and that a GnRH-antagonist-like molecule could be responsible for some of follicular fluid's "luteinization stimulatory" action. Alternatively, the stimulatory follicular fluid molecule may not resemble GnRH but may act via a mechanism that is opposed by GnRH. PMID- 2695175 TI - Effect of hyperprolactinemia on luteinizing hormone and prolactin secretion assessed using the reverse hemolytic plaque assay. AB - Hyperprolactinemia (hyperPRL) frequently suppresses luteinizing hormone (LH) and endogenous rat prolactin (rPRL) secretion under a variety of experimental circumstances. Several lines of evidence suggest that elevated prolactin (PRL) may act at the hypothalamic-pituitary axis to inhibit pituitary hormone secretion. The goal of this study was to determine whether hyperPRL, achieved by administration of ovine PRL (oPRL), influences LH and rPRL secretion as assessed by the reverse hemolytic plaque assay. Young Sprague-Dawley rats were ovariectomized on Day 0 and were treated with oPRL (4 mg/kg body weight, 3 times/day) beginning at 0900 h on Day 4. They were killed at 1000 h on Day 6, anterior pituitaries were collected, and cells were dispersed and prepared for the reverse hemolytic plaque assay. We analyzed mean plaque area by using a computerized image analysis system and determined the percentage of plaque forming cells by counting the number of plaques compared to the total number of cells. HyperPRL decreases the percentage of LH plaque-forming cells under basal conditions. Although the mean LH plaque area was the same in vehicle-treated and oPRL-treated rats under basal and gonadotropin-releasing hormone-stimulated conditions, hyperPRL altered the frequency distribution of different-sized plaques under basal conditions. It appears that hyperPRL shifts the distribution of different-sized plaques such that there are more small plaques and no plaques of the largest size classes. Basal and thyrotropin-releasing hormone-induced rPRL release from single lactotropes, as measured by mean plaque area and the percentage of plaque-forming cells, is lower in lactotropes from hyperPRL rats than in controls after 1 h, but not 2 h, of incubation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695176 TI - Methods for evaluating the acrosomal status of mammalian sperm. AB - A full understanding of the acrosome reaction is central to understanding sperm function. Acrosomal status can be determined on living, motile sperm in only a few mammalian species. For other species, many light microscopic methods have been developed, including colored stains for bright-field microscopy, and probes for fluorescence microscopy. We review the existing methods and the criteria that should be considered in the choice of an assay. PMID- 2695177 TI - The role of bronchoalveolar lavage in providing access to the evaluation of immune mechanisms taking place in lung cancer. AB - The introduction of bronchoalveolar lavage into clinical practice has greatly improved our knowledge of the pathogenesis of interstitial lung disorders. By recovering cells from the lower respiratory tract, bronchoalveolar lavage allows the study of the infiltration of immunoinflammatory and immunocompetent cells in the lung interstitium. Major new advances in biomedical medicine, especially in immunology and molecular biology, are gradually being applied to the evaluation of bronchoalveolar lavage, thus further extending the efficacy of this procedure. In the present study we have summarized major reasons giving a rationale for using this methodology in cancer patients, notably the possibility of generating new insights into the comprehension of immunological mechanisms taking place in lung cancer and the possibility to increase the diagnostic chances in different neoplastic conditions. PMID- 2695178 TI - Total body irradiation in bone marrow transplantation: fractionated vs single dose. Acute toxicity and preliminary results. AB - The usefulness of total body irradiation (TBI) plus chemotherapy as a preparative regimen prior to bone marrow transplantation has been widely documented. However, the procedure can be highly toxic. Fractionated and low dose rate TBI has been said to enhance therapeutic ratio by increasing normal tissue tolerance and increasing leukemic cell kill. We report here the acute toxic effects and preliminary results on 2 consecutively groups of patients, treated with bone marrow transplantation (BMT) for leukemia or multiple myeloma, and conditioned by 2 TBI regimens. Group A patients received 10 Gy-Co-60 single dose of TBI plus 120 mg/kg of cyclophosphamide over a period of 2 days (8 Gy lungs). Group B received 12 Gy Co-60 of TBI in 6 fractions (2/day), (8 Gy lungs) plus 120 mg/kg of cyclophosphamide over a period of 3 days. The acute toxic effects recorded were similar in both groups. Only a 40% vs 0% (P = 0.02) incidence of parotiditis in groups A and B favors fractionation. Other results obtained to date are as follows: an incidence of interstitial pneumonitis of 39% and 31% (ns); relapses of 10% and 20% (ns), and mortality of 55% and 60% for each group respectively. An interesting finding was that IP was associated with acute grade II-IV graft vs host disease in 87% and 100% of cases of group A and B, respectively. We conclude that fractionated TBI is at least as effective as single dose TBI as a conditioning regimen; however, only randomized trials would allow definitive conclusions. PMID- 2695179 TI - Antisense oligonucleotides as potential antiviral and anticancer agents. PMID- 2695180 TI - [Efficacy of chemotherapy and combined chemo-radiotherapy in gastric adenocarcinoma]. PMID- 2695181 TI - [Adjuvant chemotherapy of colorectal cancer: what can be learned from meta analysis?]. PMID- 2695182 TI - [Hepatic chemo-embolization]. PMID- 2695183 TI - [Diagnosis and treatment of unknown primary tumors]. AB - Cancers of unknown origin represent approximately 5% of all cancers and are therefore as frequent as some solid tumors such as gastric or pancreatic cancers. The diagnosis of cancer of unknown origin should be based on a detailed pathological examination including immunohistochemical techniques and electron microscopy; hormonal receptors should also be measured. Besides detailed medical history and physical examination, only a few additional tests should be carried out: routine chemistry including the assay of HCG, alphafoetoprotein and specific antigen of the prostate, chest X-ray, thyroid scan, mammography and abdominal CT scan. Other tests are generally not of sufficient specificity and sensitivity. Unknown primary tumors arising in the cervical area are frequently squamous cell carcinomas corresponding to occult primary tumors of the upper aerodigestive mucosae and are efficiently treated by cervicofacial radiotherapy or lymph node dissection. Women presenting with axillary lymph nodes with no obvious primary tumor should be treated according to the guidelines used for breast cancer. The patients with inguinal lymph nodes of unknown origin are usually treated with radiation therapy. The syndrome of germinal tumors of extragonadic origin corresponds to cases of undifferentiated or poorly differentiated carcinomas in patients under 50 years of age and with one of the following characteristics: involvement of the median organs, lung involvement, lymph node involvement or increase of alphafoetoprotein or HCG. The therapeutic approach recommended for these patients consists of the chemotherapeutic combination used for testicular cancer. For all other patients, the prognosis remains poor. Patients with local symptoms may be treated by radiation therapy; others may receive a combination of fluorouracil, doxorubicin and mitomycin. PMID- 2695184 TI - [Chemoresistance of tumors. Factors related to tumor kinetics and the occurrence of resistant cells]. PMID- 2695185 TI - [Multidrug resistant genes MDR1]. PMID- 2695186 TI - [Dose factors/time factors in chemotherapy]. PMID- 2695187 TI - [Chemotherapy of cancer of the esophagus]. PMID- 2695188 TI - A systemic approach to the oral problem of mandibular resorption. AB - It is argued that mandibular resorption can be considered as osteoporotic in nature. This calls for a systemic approach in its treatment. One aspect mostly neglected is the tendency of bone to bind calcium and phosphate ions. A direct measure for this tendency is the difference in pH between the bone extracellular fluid and blood plasma. This pH difference is directly reflected by the degree of saturation of blood plasma with octocalcium phosphate. Calculation of these degrees of saturation of about 2000 data of blood plasma compositions given in the literature indicates that calcitonin injection, estrogen replacement and magnesium supplementation increase the tendency of bone to bind calcium and phosphate ions and hence should be used in the therapy of mandibular resorption and of bone resorption in general. PMID- 2695189 TI - [The structure and ultrastructure of the pulp in Vipera aspis (Viperidae)]. AB - The present paper using classical and transmission electron microscopy brings the first data on the pulp of the fangs of Viperidae (poisonous serpents with terrestrial or semi-aquatic habits). The pulp of the fangs of Viperidae shows a poor collagen and fibroblast content and a high developed vascular system. The odontoblasts are polarized, with a high organelle content. The interconnections are constituted of lateral "gap junction" systems. At a late secretion stage, the odontoblastic processes show a poor cytoplasm, mainly constituted of microfilaments. PMID- 2695190 TI - Dystrophin under scrutiny. PMID- 2695191 TI - The role of endothelium in vascular reactivity. AB - 1. This review describes the role of vascular endothelium in the response induced by different vasoactive agents. 2. The interaction between endothelium, vascular smooth muscle and platelets is discussed. 3. The hormone control as well as physicochemical alterations that interfere with some endothelium-dependent vascular responses are described. PMID- 2695192 TI - Effect of tityustoxin and ouabain on protein phosphorylation in a crude synaptosome fraction. AB - 1. The effect of tityustoxin (TsTX) and ouabain on the incorporation of 32P into a protein of the same apparent molecular weight as synapsin I is described. 2. Tityustoxin-stimulated protein phosphorylation in a crude synaptosome fraction increased up to a concentration of 3.0 microM at an incubation time of 15 s. 3. Trifluoperazine (100 microM) inhibited, while trifluoperazine sulphoxide (100 microM) did not alter the effect on the protein phosphorylation induced by tityustoxin. 4. Unlike tityustoxin, ouabain (100 microM) had no effect on protein phosphorylation even after incubation up to 20 min. 5. Ouabain at 10 microM, a concentration having no effect on rates of respiration and ATP hydrolysis in brain cortical slices, also had no effect on protein phosphorylation. PMID- 2695193 TI - Rates of pyruvate utilization and lactate formation by lymphocytes from young and aged rats. AB - The rates of pyruvate utilization and lactate formation were measured in lymphocytes from young (newly weaned), adult (3-month old) and aged (15-month old) rats. Lymphocytes obtained from mesenteric lymph nodes were incubated at 37 degrees C for 1 h. The conversion of pyruvate to lactate accounted for 92.5% of the total pyruvate utilized by lymphocytes from young rats and was 34.2% and 44.5% for adult and aged rats, respectively. When lymphocytes were stimulated with concanavalin A there was an increase of 65.6% and 37.1% in the rates of pyruvate utilization by lymphocytes from young and adult rats, respectively. No changes in pyruvate utilization were observed in response to concanavalin A in lymphocytes from aged rats. PMID- 2695194 TI - Consonantal intraoral air pressure characteristics in Brazilian postoperative cleft palate speakers with velopharyngeal disorders. AB - 1. In the present study we measured intraoral air pressure (Po) during the production of the stop consonant /p/, in a syllabic contex, in normal and surgically repaired cleft palate subjects. Po was measured by placing a sensing catheter between the lips in the oral cavity. The catheter was connected to a pressure transducer and the output signals were amplified and transmitted to a recorder. 2. When compared to normal individuals, cleft palate patients with velopharyngeal insufficiency (VPI) and oral articulation for /p/ presented significantly lower Po levels (P less than 0.01) but pressure curves of normal shape. 3. In cleft palate patients with VPI and glottal coarticulation for /p/, Po was absent or markedly reduced; in the latter case, the Po curve was of a characteristically irregular shape. 4. These results suggest that measurement of Po during the production of a selected consonant appears to be a suitable instrumental method for identifying VPI and discriminating an oral stop from the compensatory glottal stop often observed in postoperative cleft palate speakers. PMID- 2695195 TI - Peripheral muscle glucose and potassium transport in a family with acanthosis nigricans and insulin resistance. AB - This study was designed to determine the forearm exchange of glucose and potassium in four members of a family exhibiting acanthosis nigricans and insulin resistance. Total areas under the curves for potassium release or uptake were within the normal range in all patients. Peripheral glucose uptake, however, was normal in 3 patients and lower in one patient. In the latter patient, the dissociation observed between glucose and potassium transport suggests several manners of differential impairment of insulin action and/or steps distal to the insulin receptor as being responsible for insulin resistance. PMID- 2695196 TI - [3H]-acetylcholine release from rat atria in chronic chagasic cardiopathy. AB - Isolated superfused rat atria release [3H]-acetylcholine when depolarized with 57 mM potassium. The depolarization-induced [3H]-acetylcholine overflow was significantly reduced in atria from chronically T. cruzi-infected rats with electrocardiographically characterized cardiopathy. This fact suggests the occurrence of functional alterations of cardiac parasympathetic control in these animals, probably related to cardiac ganglion cell destruction. PMID- 2695197 TI - Bradycardic responses to vagal stimulation and methacholine injection in sinoaortic denervated rats. AB - The bradycardia that occurs in response to vagal stimulation or to methacholine after 6 h of sinoaortic denervation (SAD) was studied in SAD rats before and after adrenergic blockade to determine whether the peripheral vagal action was impaired by sympathetic hyperactivity. A marked attenuation in the responses to methacholine and no difference in the responses to vagal stimulation were observed in SAD rats compared to sham-operated controls. The adrenergic blockade attenuated the responses to both vagal stimulation and methacholine in control rats but not in SAD rats. These findings revealed an impairment of peripheral vagal function after 6 h of SAD, probably due to a decreased sensitivity of the muscarinic receptors. PMID- 2695198 TI - [Academic elegy of Professor Franz Lavenne, titular member]. PMID- 2695199 TI - [Postmenopausal osteoporosis: its epidemiology, prevention and treatment]. AB - Postmenopausal osteoporosis is a burden both to the society and to its victims. Many factors concur to make this burden heavier. Yet the means of prophylaxis are available. Curative therapy, once the disease is established, is at hand, but much remains to be done in this area. PMID- 2695200 TI - Exposure to hepatitis B: review of current concepts. PMID- 2695201 TI - Creating a smoke-free environment in a medical center: an overview. AB - Beth Israel Medical Center committed itself to a smoke-free environment on May 7, 1987 after seven months of careful study by a policy determination committee and, thereafter, seven months of meticulous planning for its announcement and implementation. The policy rests on two premises: passive smoking is harmful to nonsmokers; a medical center "employer," above all others, has a special, impelling obligation to shield persons in its environs from such exposure. The impetus came from the medical staff. The policy acceptance and commitment had the combined approval of the medical staff, administration, and trustees. The ban applies to all who serve, are served in, or otherwise visit the Center. Care was taken to prepare all staff and patients for the stringent policy effective May 7, 1987. Its medical basis was made clear. Support was arranged for smokers who were interested. Response in the first year and a half has been increasing acceptance, which reflects careful preparation as well as in depth support from the medical staff. Problems are met with discussion and reasoning, not punitively. PMID- 2695203 TI - AIDS in New York City: the role of intravenous drug users. AB - The key to the future of the HIV epidemic is the intravenous drug user. In New York City the future has arrived--intravenous drug use is now the predominant risk factor among new cases of AIDS. Our limited knowledge of most facets of drug abuse prevention and treatment and the emotional polarity and politicalization of the issues surrounding AIDS have made control of its spread among intravenous drug users very difficult. Clearly new research efforts are needed better to decide how to reduce the further spread of HIV infection among this group. But efforts to stop the spread cannot await these results. Intense and immediate efforts should focus on five areas for potential control of the spread of HIV infection among drug users: education, treatment on demand, expanding support services, providing sterile equipment, and readjustment of some of society's moral judgments that currently block action. Let us hope that in 10 years we do not look back and realize that we did too little too late while it was still possible to make a difference. PMID- 2695202 TI - Menstrual function and its relationship to stress, exercise, and body weight. PMID- 2695204 TI - Martin Robison Delany (1812-1885): physician, black separatist, explorer, soldier. AB - Martin Robison Delany's great contribution to American life and black history stems from his defiant blackness. He was America's first "Black Nationalist" and the intense embodiment of black pride. Ever changing in his career, he always identified with the black experience and its place in history. In an active life he was doctor, dentist, orator, editor, publisher, Harvard medical student, explorer, dabbler in Central American politics, army officer, and Reconstruction office seeker. PMID- 2695205 TI - Deinstitutionalisation--from hospital closure to service development. AB - The necessary components of a comprehensive service of local non-institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co-ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages. PMID- 2695206 TI - Treatment of depression. The relevance of research for clinical practice. PMID- 2695207 TI - The history of general hospital psychiatry. AB - General hospital psychiatry in Britain began in 1728, and thereafter several new voluntary hospitals provided separate wards for lunatics, but none survived beyond the middle of the 19th century. Less severe nervous organic disorder has always been common in the general wards of voluntary hospitals, and was accepted as the responsibility of neurologists and other physicians; all forms of disorder were admitted to the infirmaries of workhouses. During the present century psychiatrists began to take an interest in non-certifiable mental illnesses and in working in general hospitals. Out-patient clinics became more common following the Mental Treatment Act 1930. The growth of general hospital psychiatric units in the last 30 years began amidst controversy, but has received little recent critical attention. PMID- 2695208 TI - Olfaction and psychiatry. AB - Recent clinical studies have identified significant olfactory deficits in several neuropsychiatric disorders, notably Alzheimer's disease and Parkinson's disease. These have correlated with neurochemical and neuropathological studies of the olfactory system. The presence of a specific sensory deficit may be related to the localisation of pathology within the brain. There is a need for incorporation of olfactory testing into routine clinical examination. PMID- 2695209 TI - Sports medicine in the Federal Republic of Germany. PMID- 2695210 TI - Echocardiography of valve disease. AB - Recent technical developments have led to the combined use of imaging and Doppler modalities in cardiac diagnosis to produce a reliable and non-invasive approach to the accurate assessment of cardiac valve disease. Anatomical detail is visible on two dimensional imaging, accurate measurement and timing can be derived from M mode studies and Doppler studies give detailed insight into cardiac valve haemodynamics. In the majority of patients valve gradients can be calculated using continuous wave Doppler techniques, while pulsed Doppler techniques (including colour flow mapping) can give accurate information about valve regurgitation. In many cases these techniques provide an adequate substitute for cardiac catheterisation and they can be repeated as often as necessary to monitor progress of disease and treatment. PMID- 2695211 TI - Cross-sectional echocardiography. AB - Cross-sectional echocardiography has become an essential part of the investigation of infants and children with heart disease. Frequently, it provides a precise diagnosis. In many instances, particularly in neonates and infants, surgery can be undertaken without the need to proceed to cardiac catheterisation. Although cross-sectional echocardiography provides little information about pulmonary or systemic vascular resistance and flow, considerable information about the latter can be established by Doppler. Echocardiography is essentially the representation of cardiac morphology in life. This technique can, therefore, readily be used in sequential segmental analysis of all patients. PMID- 2695212 TI - Assessment of left ventricular structure and function by cross sectional echocardiography. AB - Cross sectional echocardiography can be used to give semiquantitative estimates of ventricular volumes and ejection fraction which are very valuable in detecting the severe abnormalities seen clinically. The technique has also been widely used to study regional abnormalities of wall motion. However, with a frame rate of 30 s-1 and lateral resolution of 3-4 mm critical analysis of disturbances of timing is not possible, so the method should be used in conjunction with M-mode and Doppler techniques. In spite of physical limitations, based on the underlying mechanisms of image generation, its advantages of real time application and noninvasive nature, its ability to demonstrate myocardial thickness as well as echo intensity, and its relative cheapness have made cross sectional echocardiography a major tool in documenting abnormalities of left ventricular function occurring in disease. PMID- 2695213 TI - Colour flow mapping in cardiology: indications and limitations. AB - Colour flow mapping (CFM) produces a two-dimensional representation of blood flow within the heart and great vessels by analysing data acquired from multiple pulsed Doppler sample volumes, and displaying mean velocity and turbulence of flow at each site. Constraints imposed by the time required to process these data mean that CFM cannot be used for precise velocity measurements. Instead it depicts flow patterns in healthy and abnormal hearts and the precise location and direction of turbulent jets. CFM is an integral part of the standard echocardiographic examination; it is especially useful in neonates and children with congenital heart disease, and in adults for the semi-quantitative assessment of valve regurgitation, and the description of flow patterns in complex acquired disease. Transoesophageal echocardiography with CFM is invaluable for the diagnosis of mitral prosthetic valve dysfunction, aortic dissection, and complications of infective endocarditis. Intraoperative epicardial CFM provides the equivalent of intraoperative angiography. PMID- 2695214 TI - Technical introduction to echocardiography. AB - Pulse-echo ultrasound can be used to measure distance along a narrow beam with resolution limited by the wavelength and, ultimately, by attenuation. Time position (M-mode) recording can be used to study structure motion. Real-time two dimensional imaging can be achieved with mechanical scanning or electronically controlled phase array transducers, the frame rate being limited by the depth of penetration and the image line density. Blood flow can be detected by the Doppler effect. Continuous wave Doppler systems lack depth discrimination, but this can be provided by pulsed Doppler although range-velocity ambiguities may occur. Blood flow volume rate can be estimated from measurements of velocity and area; the simultaneous use of wide and narrow beams reduces the errors. Duplex scanning uses two-dimensional real-time imaging for Doppler sample volume localization. Two-dimensional colour-coded images of blood flow can be produced in real time. Endoscopic scanning avoids problems due to bone and gas. Contrast agents can be used to enhance the echogenicity of blood. PMID- 2695215 TI - Technical introduction to nuclear imaging. AB - It is very important to pay attention to technical detail when acquiring nuclear scans of the heart. It must be remembered that not only is the heart a three dimensional structure, which imposes its own limitations on the interpretation of information represented as two dimensional images, but the organ also moves which will in turn degrade static images. Dynamic studies of left ventricular function must be able to resolve the rapidly changing events of the cardiac cycle which makes specific technical demands upon the imaging equipment and computer system used. In spite of these potential drawbacks, both static and dynamic imaging of the heart using radiopharmaceuticals are widely used in a clinical and research environment. In this article some of the technical considerations will be covered as they apply to both the commonly used clinical applications of nuclear cardiology and some of the newer but potentially exciting techniques will also be covered briefly. PMID- 2695216 TI - The principles of magnetic resonance. AB - Magnetic Resonance (MR), which has no known biological hazard, is capable of producing high resolution thin tomographic images in any plane and blocks of 3 dimensional information. It can be used to study blood flow and to gain information about the composition of important materials seen and quantified on dimensionally accurate images. The MR image is a thin tomographic slice or a true three dimensional block of data which can be reconstructed in any desired way rather than a shadowgram of all the structures in the beam. It is the only imaging technique which can acquire data in a 3-dimensional format. CT images can be reconstructed to form a pseudo 3-D image or a hologram but the flexibility conferred by acquiring the data as a true 3-D block gives many advantages. The spatial resolution of MR images are theoretically those of low powered microscopy, the practical limits with the present generation of equipment are voxel sizes of one third by one third by two millimetres. The term Magnetic Resonance Imaging (MRI) is used commonly, particularly in the USA, avoiding association with the term, nuclear, and emphasizing the imaging potential of the technique. The terms Nuclear Magnetic Resonance (NMR) or Magnetic Resonance (MR) more correctly describe the most powerful diagnostic instrument yet devised. The simplified description of the phenomena involved in MR which follows is intended to be comprehensive and does not require foreknowledge of classical physics, quantum mechanics, fluency with mathematical formulae or an understanding of image reconstruction. There are many explanations of MR, some omitting the more difficult concepts. An accurate, comprehensive description is found on the textbook on MR by Gadian, Nuclear Magnetic Resonance and its Applications for Living Systems (Oxford University Press, 1982). PMID- 2695217 TI - Radionuclide assessment of ventricular function in patients with coronary artery disease: clinical perspective. AB - This paper describes how the clinical applications of radionuclide ventriculography have developed during the last decade. The role of resting radionuclide angiography in the assessment of myocardial infarctions, suspected left ventricular aneurysms, and the assessment of right ventricular function are discussed. Currently exercise radionuclide angiography probably represents the best way of assessing left ventricular function under stress. Extensive experience has been gained with this technique in a large number of centres worldwide. Initially the techniques were compared against coronary arteriography as the gold standard, figures for sensitivity, specificity and predictive value of the test in predicting stenosed coronary arteries were produced. This article points out that the exercise study demonstrates the physiological response of the left ventricle to exercise and not every patient with coronary artery disease can be expected to manifest abnormal physiology. Certain valuable prognostic information may be obtained from the results of the exercise radionuclide studies which may guide cardiologists as to which patients should be treated conservatively and which patients should undergo a prognostic intervention. The techniques are of major value in determining the results of both medical and interventional therapy. Abnormal ventricular function response to exercise is not specific for coronary artery disease however, and the relevance of the study must be analysed in relationship to the population under investigation. PMID- 2695218 TI - Perfusion imaging. AB - The term perfusion has varied connotations in different situations. The word perfusion comes from the Latin to pour or diffuse through or over. Myocardial perfusion depends on (a) coronary artery or vessel flow, and (b) myocardial or muscle flow. The factors which determine perfusion at rest and during stress in coronary vessels and within the myocardium are clearly related but not with a predictable linear relationship. In animals there is extensive literature concerning the regulation of coronary flow and perfusion obtained by many sophisticated methods. In contrast, the techniques that are applicable to humans are relatively crude. To date, the clinical data available suggests that the normal control of coronary flow in man and in dogs is fairly similar but that models of pathology in animals bear little relation to the compensatory changes found in the coronary circulation in man. Although the data available is limited and subject to many technical inaccuracies, this article is confined to the assessment of myocardial perfusion in clinical practice. PMID- 2695219 TI - Whole heart distribution of myocardial perfusion, metabolism and myocardial viability by positron emission tomography. AB - The three dimensional evaluation of regional myocardial perfusion and metabolism of the whole left ventricular wall is now possible using the new generation of Positron Emission Tomography scanners (PET). We have used whole heart PET to study the metabolic consequences of transient myocardial ischaemia distal to critical coronary obstructions and to assess the viability of non contractile myocardium. At present whole heart PET should be considered a sophisticated technique for clinical research but its remarkable potential and further possible technical advances suggest its diagnostic application could be considered in the future, if justified on a cost benefit basis. PMID- 2695220 TI - Cardiac magnetic resonance imaging. Anatomical display using spin echo images. AB - Magnetic resonance is a new method of imaging which is completely non-invasive and is being increasingly applied to the study of the heart. Spin echo images using cardiac gated acquisition have the advantage that moving blood has no signal giving excellent contrast compared to the surrounding soft tissues. Images can be acquired in orthogonal or oblique planes, and up to 16 can be produced within 3 to 4 minutes depending on heart rate. Useful information can be obtained in a variety of conditions including lesions of the myocardium, aorta and pericardium, the detection of tumours and thrombus and the complete display of anatomy in patients with congenital heart disease, both pre- and postoperatively. Although its place in the investigation of heart disease is still being established, already it can be regarded as an imaging technique complementary to echocardiography, which has partially replaced diagnostic invasive angiography and may eventually replace it completely. PMID- 2695221 TI - Cine magnetic resonance imaging and flow measurements in the cardiovascular system. PMID- 2695222 TI - MRI studies of atherosclerotic vascular disease: structural evaluation and physiological measurements. AB - The widespread prevalence of atherosclerotic vascular disease has given rise to the need for a noninvasive imaging examination. Magnetic resonance imaging has been shown to allow assessment of early arterial disease non-invasively and without the use of ionising radiation. Arterial compliance, pulse wave velocity, and the pattern of flow within the aorta may all be disturbed by disease and these parameters can be measured by magnetic resonance. In addition, atheroma can be imaged directly, its size measured, its shape described, its lipid content assessed, and its effects upon vascular haemodynamics studied. Magnetic resonance imaging is thus a potential tool not only for the detection of disease but also for studying its natural history and the effects of interventions, such as the control of risk factors and of lipid lowering agents. PMID- 2695223 TI - Value of ultrafast CT scanning in cardiology. AB - Computed tomography became available in 1973 and within a few years was accepted as a useful diagnostic technique in nearly every organ system. The heart, however, was the exception because long exposures (over 1 second) produced motion blurred images. Although ECG gating was possible it proved impractical. Conventional CT nevertheless has been undervalued by most radiologists and cardiologists who have little or no experience with cardiac CT. The recent development of Ultrafast CT should rapidly change this concept. PMID- 2695224 TI - [Eulogy of Jean Cheymol (1896-1988)]. PMID- 2695225 TI - [When was the Royal Academy of Surgery founded? What were its statutes?]. AB - The Royal Academy of Surgery was generally thought to have been created in 1731. In reality, it was a group called "the Academy Society of Surgery" which met at this time. The true date for the foundation of the Royal Academy of Surgery was in July 1748. PMID- 2695226 TI - [Passive smoking: from annoyance to disease, an unrecognized risk taken into account]. AB - The I.S. is an uncontestable health hazard. Carboxy-hemoglobin and cotinine are present in biologic fluids of the non smoking people exposed to I.S. The health hazard is important among young children. The excess of lung cancer mortality among non smokers exposed to I.S. is today well known. Legislation and regulation might be completed and applied in public places. Specific measures might be decided and applied in the workplaces. In the family, parents might be educated to take in account the risk of I.S. for their children. PMID- 2695227 TI - Characterization and tumorigenicity of a butyrate-adapted T24 bladder cancer cell line. AB - We have adapted T24P, a tumorigenic subline of the T24 human bladder cancer cell line, to grow in 5 mM butyrate. In the presence of butyrate, the adapted cells (T24P/B) grow more slowly than the unadapted cells (T24P/C), have a lower saturation density, increased serum requirement for growth, loss of ability to form colonies when plated at low cell density, and decreased ouabain sensitivity. Morphologically, T24P/B cells in butyrate are large and flattened with increased cytoplasm. When T24P/B cells are grown without butyrate, the morphological changes, growth rate, plating efficiency, and ouabain sensitivity return to those of T24P/C. While the saturation density increases, it does not return to levels of T24P/C, and the size of colonies never reaches that of the T24P/C colonies. Both T24P/C and T24P/B are tumorigenic in nude mice, however, the T24P/B tumors differ grossly and microscopically from those produced by T24P/C in that they contain large cystic structures filled with clear fluid and lined by transitional cell epithelium with flattened surface layers. Although the transformed phenotype and tumorigenicity of T24P are modified by adaptation to growth in butyrate, no significant changes in ras oncogene RNA or protein expression were identified. PMID- 2695228 TI - Prospects for clinical cancer treatment using interleukin-2. AB - Even if many of these immunologic approaches to anticancer therapy show the desired effect, with a greater percentage of patients having antitumor responses (hopefully without need for ICU level toxicity), it may be unrealistic to hope that these biological treatments will significantly prolong the survival of most patients with large progressively growing tumors. It is possible that the large, yet finite, number of cells with LAK activity that can be activated endogenously, or infused into a patient, may only be able to destroy a finite number of neoplastic cells. If so, the smaller the number of neoplastic cells at the time of in vivo LAK induction therapy, the more likely the chance for effective eradication of all tumor cells. Experimental animal studies support this postulate (46). Clinical regimens utilizing IL-2 therapy, alone or combined with other agents, with documented immunologic and antitumor activity, will need to be tested in a large number of patients in randomized adjuvant trials. This testing will probably require the involvement of large cooperative oncology trials groups, in order to determine the potential prolongation of survival by any adjuvant IL-2 approach. A vast number of regimens could presently be suggested for combining these separate approaches in groupwide trials (especially when issues of dose, route, and scheduling are considered). Trials in murine models must continue rapidly and be interpreted with caution in generating regimens to be tested clinically. Further treatment improvements, to be identified in Phase I and Phase II clinical trials, are still required to allow large groupwide randomized Phase III trials to test tolerable and effective IL-2-containing regimens likely to significantly prolong survival. PMID- 2695229 TI - Smoking: human and economic costs. PMID- 2695230 TI - Corticosteroids in cancer: neuropsychiatric complications. AB - The addition of corticosteroids in the early 1950s to the treatment armamentarium provided cure of some diseases and control of many. They have become an integral part of many cancer treatment regimens. Early reports of severe affective disorders appear less frequent today in patients receiving steroids, though controlled studies are rare. Minor mood changes are common, ranging from the euphoria of initial treatment to depressive symptoms on withdrawal. The most common severe disturbances seen clinically in cancer patients are the organic mood disorders and delirium. Studies are needed, especially in cancer, which control for prior psychiatric history, cancer site, cancer treatment, pain regimen, coexisting cancer complications, especially central nervous system complications, and physical performance status. DSM-III-R terminology must be used as the diagnostic classification for reliable investigation. A more careful clinical delineation of the mental changes with steroids is desirable not only for the clinical relevance, but for the potential understanding of the etiology of mood disorders and mental changes seen in delirium. PMID- 2695231 TI - Adjuvant external beam and intraoperative radiation therapy in rectal cancer. AB - The use of radical surgery has maximized local control, sphincter preservation, and overall survival in patients with rectal cancer. Despite the advances in surgical techniques, local recurrence still remains a problem. Following potentially curative surgery, the incidence of local recurrence in patients with stages B2, C disease varies from 15% to 65%. There are four major approaches in which radiation therapy (RT) has been used in the adjuvant treatment of rectal cancer. These include postoperative RT +/- chemotherapy, preoperative RT +/- chemotherapy, both pre- and postoperative RT (sandwich technique), and intraoperative RT in conjunction with preoperative external beam RT. In patients with resectable rectal cancer, adjuvant RT has been shown to decrease the incidence of local recurrence and, in some series, may influence survival rates. In patients with locally advanced, unresectable, or recurrent rectal cancer, the use of preoperative radiation therapy, attempted surgical resection, and intraoperative RT further enhances local control. PMID- 2695232 TI - Embryonic lens induction: more than meets the optic vesicle. AB - The classic model of lens induction stipulated that the optic vesicle is both a necessary and sufficient inductor of the lens in amphibian development. Although this view has subsequently been modified to encompass the contributions of earlier inductors, such as the involuting endo-mesoderm, it is still widely reported that the optic vesicle alone is able to elicit lens formation from ectoderm. Recent work, which has employed a host- and donor-marking scheme, has shown the optic vesicle to be a weak inductor of the lens, involved only in the final rather than the initial phases of determination. In addition, a review of the literature substantiates this conclusion since many of the transplantation experiments arguing for the sufficiency of the optic vesicle are characterized by the lack of adequate criteria for judging the authenticity of the resulting lens responses, particularly the absence of a host- and donor-marking strategy. This analysis of the literature, together with our own results, lead us to propose a new model of lens determination in which tissue interactions during gastrulation are required to confer a lens-forming bias upon a large area of head ectoderm allowing the optic vesicle to induce lens formation in a defined area of this primed ectoderm. Data from studies on mesoderm and neural induction are also beginning to suggest a multistep model involving the initial establishment of bias and subsequent interactions resulting in determination, and we propose that this framework will serve as a general paradigm for embryonic induction. PMID- 2695233 TI - [Value of anti-contamination specimen brush in the etiologic diagnosis of bacterial pulmonary infections]. AB - This paper reports the results of sampling the secretion of lower respiratory tract by protected specimen brush(PSB) via fiberoptic bronchoscope for the isolation of pathogenic organisms in laboratory and clinic. Studies in vitro showed that the technique of PSB is better than that of single shear catheter brush (SSC) or cytologic brush (CB) for anti-contamination. The specificity and sensitivity of sampling were 93% and 100% respectively. The application of PSB in the diagnosis of pneumonia in canine models revealed that both specificity and sensitivity were 100% Sampling in 18 cases of pulmonary bacterial infections and 17 cases of other pulmonary diffusing diseases indicated that the specificity and sensitivity were 86% and 94% respectively. The authors are of the opinion that PSB sampling technique has a better anti-contamination effect and can increase the isolation rate of pathogens. The PSB may be a satisfactory sampling tool in etiologic diagnosis of pulmonary infections. PMID- 2695234 TI - [Epidemiologic survey of severe heatstroke in 1988 in Nanjing]. PMID- 2695235 TI - [Relation of the adhesion of enteropathogenic Escherichia coli O127H6 and outer membrane protein and its related plasmids]. PMID- 2695236 TI - [Antibody-mediated graft rejection in kidney transplantation]. PMID- 2695237 TI - Generation of macrophage cell line from fresh bone marrow cells with a myc/raf recombinant retrovirus. AB - We have studied the effects of infection of fresh murine bone marrow (BM) cells by recombinant retroviruses carrying v-raf and v-myc oncogenes, either alone or in combination. Viruses containing v-raf or v-myc alone failed to induce BM proliferation in 24 out of 27 experiments performed so far, only the J2 virus containing both v-raf and v-myc oncogenes induced BM proliferation. Exogenous growth factors (GF) were not required to sustain the mitogenic effect of J2 virus. Infection with retroviruses carrying only v-raf or v-myc did not induce BM cell growth, indicating that co-expression of the two oncogenes was needed to provide the mitogenic signal(s) for BM proliferation. The kinetics of growth of the J2 virus-infected cells (J2 cells) were characteristically biphasic. The initial burst of proliferation was always followed by a quiescent phase culminating in cell death, which could not be reversed by addition of exogenous GF. In contrast, active proliferation of the quiescent monolayers could be restored by addition of dextran-based beads to the cultures, showing that the growth arrest of J2 cells was a reversible process. J2 cells actively growing in the presence of CT-beads could be expanded and cloned and subsequently grew continuously independent of the CT-beads. Eighteen clones obtained from different infections were all macrophages (M phi) by morphological criteria and all of them expressed the same membrane phenotype compatible with M phi, demonstrating that J2 virus infection leads to immortalization of the same BM-derived monocytic subpopulation. When injected in vivo, J2 cells produced histiocytic tumors in nude mice, but did not grow in immunocompetent syngeneic mice. The cells induced to proliferate in vitro in response to J2 virus infection appeared to be limited to the BM compartment, since spleen cells, thymocytes, peritoneal M phi and liver large granular lymphocytes did not grow in vitro in response to J2 virus. The immortalization of BM cells by J2 virus infection represents a novel reproducible experimental system to deliberately generate M phi lines, which proliferate in response to viral oncogenes and do not require exogenous GF to initiate or to sustain their continuous proliferation. PMID- 2695238 TI - Cell cycle phases of two human lung tumor cell lines derived from squamous cell carcinoma and pulmonary metastasis of a rhabdomyosarcoma (HS 24 and HS 57) and N acetylalanine aminopeptidase activity. AB - The cell cycle phase distribution of two human lung cancer cell lines (HS 24 and HS 57) grown both to half-confluency and confluency was determined. Both cell lines were then synchronized by applying a thymidine block forcing them to stay in the S-phase. After removal of the thymidine block, which allows the cells to go then through their cell cycle phases, N-acylamino acylpeptide hydrolase (EC 3.4.19.1) activity was measured using N-acetylalanine-p-nitroanilide as substrate (N-acetylalanine aminopeptidase). At the same times that the enzymatic activity was measured, the cell cycle phase distribution was analyzed, in order to determine the cell cycle phase of N-acetylalanine aminopeptidase synthesis. However, the cell cycle phase of N-acetylalanine aminopeptidase synthesis could not be determined. This result was caused by the fact that the cells remained synchronous only for a short period of time. PMID- 2695239 TI - The role of chemotherapy in the treatment of gliomas in adults. AB - Glioblastomas and previously irradiated recurrent gliomas remain incurable. Chemotherapy is able to palliate patients by shrinking tumors, thereby improving neurological status and quality of life. Chemotherapy may also be capable of prolonging survival in some instances. The effectiveness of chemotherapy against gliomas is comparable to the efficacy of chemotherapy against many other solid tumors. When given in an adjuvant setting along with radiation postoperatively, studies suggest that the nitrosoureas, dibromodulcitol, dianhydrogalactitol, procarbazine, teniposide, dacarbazine, and cisplatin may possibly be useful, although results for many of these drugs are inconclusive. Some chemotherapy combinations also appear to be useful in an adjuvant setting, particularly BCNU plus ifosfamide, BCNU plus cisplatin, CCNU plus dibromodulcitol, and CCNU plus lonidamine. However, there is not yet conclusive evidence that combination chemotherapy is superior to single agent adjuvant chemotherapy in the treatment of gliomas. While the use of chemotherapy prior to postoperative cranial radiation is worthy of further study, it has not to date proven to be more effective than chemotherapy combined with radiation. In patients whose tumors have recurred following radiation, palliation may be achieved with the nitrosoureas, procarbazine, teniposide, and diaziquone. Cisplatin, high dose methotrexate, the interferons, and a variety of other medications also may be of use. As in the case of adjuvant chemotherapy, chemotherapy combinations for recurrent tumor have not been conclusively demonstrated to be superior to single agent treatment, although some CCNU-based combinations are of interest. Many different chemotherapy drugs have been administered by intracarotid infusion. There is a moderately high risk of serious local retinal and neurological toxicity using this approach, and efficacy has not been proven to be improved by this approach. However, further studies of intraarterial administration of chemotherapy are warranted in light of theoretical considerations, pharmacological observations of enhanced local drug concentrations, and the observation that patients who have failed the same drugs intravenously may respond when lower doses of the drug are administered intraarterially. In addition, some patients have had tumor shrinkage in the area infused while tumor has grown in other areas. Thus, while intracarotid chemotherapy must be regarded as still investigational and potentially quite toxic, further studies are indicated. High dose chemotherapy has been administered in combination with autologous bone marrow rescue. High response rates and prolonged survival durations have been reported in some instances, justifying further study despite substantial toxicity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2695240 TI - LHRH analogues in the treatment of cancer. PMID- 2695241 TI - Breast conservation techniques for early breast cancer. PMID- 2695242 TI - Synthesis of "dihydroacarbose", an alpha-D-glucosidase inhibitor having a pseudo tetrasaccharide structure. AB - "Dihydroacarbose" (2), an alpha-D-glucosidase inhibitor having a pseudo tetrasaccharide structure, was synthesized by reductive coupling of 4(3)-amino 1(1),6(1)-anhydro-2(1),3(1),2(2),3(2),6(2),2(3),3(3)-hepta-O- benzyl-4(3),6(3) dideoxy-beta-maltotriose and 2D-(2,4/3,5)-2,3,4-tris(benzyloxy)-5 (trityloxymethyl)cyclohexa non e with sodium-cyanoborohydride. The former intermediate was prepared from a partially benzylated 1(1),6(1)-anhydro-beta maltotriose, and the latter was prepared from a chiral, penta-substituted cyclohexene derived from D-glucose. The synthetic 2 was found to be a strong, non competitive inhibitor (Ki = 1.13 x 10(-6) M) against small-intestinal sucrase of rat. PMID- 2695243 TI - Hepadnavirus-induced liver cancer in woodchucks. AB - Woodchuck hepatitis virus (WHV), a member of the Hepadnaviridae, is closely related to hepatitis B virus (HBV) in its virus structure, genetic organization, and mechanism of replication. As with HBV in man, persistent WHV infection is common in natural woodchuck populations and is associated with chronic hepatitis and hepatocellular carcinoma (HCC). In 1980, a program was initiated to develop the woodchuck as an experimental model of hepadnavirus infection and disease. The experimental studies have established that WHV causes HCC in woodchucks. Chronic WHV carriage as an outcome of experimental infection is a function of animal age at time of exposure, virus dose, and, possibly, virus strain. Almost all (97%) chronic carriers developed histologically confirmed HCC within 3 years; no HCC developed in uninfected animals held concurrently in the same laboratory setting. The model has application to studies of the underlying mechanisms of hepadnavirus induced hepatocarcinogenesis and to the development of prophylactic and therapeutic strategies of disease control. PMID- 2695244 TI - Synergistic interactions between chemical carcinogens, tumor promoters, and viruses and their relevance to human liver cancer. AB - This paper reviews evidence from experimental animal model systems and tissue culture systems in which viruses or virus-encoded genes interact synergistically with specific environmental chemicals to cause malignant cell transformations. These synergistic interactions include both DNA and RNA viruses and chemicals that have genotoxic (DNA-damaging) activity or are nongenotoxic tumor promoters. They also include both fibroblast and epithelial and both rodent and human cell systems. In many cases, the precise mechanisms are not known but examples are described in which specific virus-encoded genes interact with the products of cellular oncogenes, a tumor suppressor gene, or cellular signal transduction pathways. Recent evidence that DNA damage by chemical agents and irradiation can induce trans-acting factors that enhance viral DNA synthesis is also described. Finally, the relevance of these chemical-viral synergistic interactions to the causation of liver cancer and other forms of cancer in humans is discussed. Such synergistic interactions could be directly relevant to new strategies for cancer prevention. PMID- 2695245 TI - Genomic organization of the T cell receptor. AB - A majority of T cells recognize antigens by means of a T cell receptor (TcR) composed of either alpha-beta (alpha beta) or gamma-delta (gamma delta) chains. These TcR genes are members of the immunoglobulin gene superfamily. This family includes the major histocompatibility complex (MHC) genes, whose products are essential for recognitions of foreign antigens by the TcR. This phenomenon is known as MHC restriction. All the TcR chains have similar protein structures consisting of extracellular variable and constant domains, intracellular cytoplasmic tails, and a hydrophobic transmembrane region with several potential N-linked glycosylation sites. On the cell surface, the TcR heterodimers are found to be associated with the CD3 complex. This CD3 complex which is composed of at lease four chains (CD3 gamma, CD3 delta, CD3 epsilon, and CD3 zeta) is thought to be responsible for the transduction of antigen-binding signal through the cell membrane to facilitate the appropriate T cell function. The germline TcR genes are composed of noncontiguous variable (V), diversity (D), joining (J), and constant (C) gene segments. During T cell ontogeny, these VDJ or VJ gene segments rearrange to form a TcR gene encoding a unique variable domain, which is then joined to the C region sequences by RNA splicing following transcription. This process of rearrangement allows the generation of large numbers of new and unique TcR genomic structures, before a primary transcript can be made. In this review article, we summarize the recent findings on the genomic organization of these TcR genes in both the human and murine systems. PMID- 2695246 TI - Cytochrome P450IID phenotypes and human cancer risk. AB - This paper reviews the work carried out by the author and his colleagues which has sought to determine the relative risk of various cancers and related conditions in extensive (EM) and poor (PM) metabolizer phenotypes which arise from the P450IID-mediated 4-hydroxylation of debrisoquine. Sex, phenotype, and occupation all markedly influence the relative risk of lung tumors in smokers, the last two of which demonstrate a powerful interaction. Future studies will need to be large and to use molecular and/or immunocytochemical approaches. PMID- 2695247 TI - Mechanisms of action of oxidant carcinogens. AB - Oxidants can act at multiple stages of carcinogenesis. While they cause genetic damage and are cytotoxic, they also activate cellular pathways which alter gene expression, growth, and differentiation. Certain pathways used by polypeptide growth factors and hormones are also activated by oxidants. For example, oxidants stimulate the phosphorylation of the ribosomal subunit S6, the phosphotransferase activity of protein kinase C, and induce its translocation to the plasma membrane. On the genomic level, oxidants increase the transcription of the growth competence-related protooncogenes c-fos and c-myc. In addition to these growth factor-type reactions, oxidants induce pathways which are unique to them. Poly ADP-ribosylation of chromosomal proteins is of particular relevance to oxidant carcinogenesis. It represents an epigenetic consequence of DNA-breakage. Both histones and nonhistone proteins are poly ADP-ribosylated in response to oxidants. Among non-histones, ADPR-transferase, topoisomerase I, and the fos oncoprotein were identified as acceptors. Inhibition of poly ADP-ribosylation suppressed the oxidant-induced transcription of c-fos. Since fos oncoprotein serves as a transcriptional regulator, we speculate that its poly ADP ribosylation and that of other chromosomal proteins plays a role in the modulation of gene expression in response to oxidative stress. PMID- 2695248 TI - Antiretroviral chemotherapy against human immunodeficiency virus (hiv) infection: perspective for therapy of hepatitis B virus infection. AB - It has been shown that the replication of human immunodeficiency virus (HIV) can be suppressed in the clinical setting by drugs based on the selective in vitro antiretroviral activity. We now know that such antiretroviral chemotherapy can confer prolonged survival and improved quality of life in patients with advanced HIV infection. Hepatitis B virus (HBV) resembles retroviruses, including HIV, in several respects. In particular, both viruses contain reverse transcriptase and replicate through an RNA intermediate. Thus, emerging knowledge of the replicative cycle of HIV may provide a perspective for antiviral therapy of diseases caused by HBV. PMID- 2695249 TI - Prevention of primary liver cancer by immunization. AB - Primary liver cancer is one of the ten most common cancers of man and approximately 80% of cases are associated etiologically with infection with hepatitis B virus (HBV), often early in life. Infection with HBV is now preventable by active immunization, so that large-scale immunization programs will prevent the initial infection and the development of persistent infection and the carrier state, the most important risk factor in hepatocarcinogenesis. PMID- 2695250 TI - [Jan Evangelista Purkinje in the creative arts and the Purkinje medals of Milan Knobloch]. PMID- 2695251 TI - A calcium flux at the termination of replication triggers cell division in Escherichia coli. Hypothesis. AB - Cell division in Escherichia coli is coupled to chromosome replication. Even in the absence of known inducible division inhibitors, perturbations of chromosome replication affect cell division. Early studies suggested that a signal at the termination of replication might trigger subsequent division. Although later studies have suggested that fork encounter during termination is an active process involving specific termination sites and the tus protein, the coupling mechanism between termination and cell division remains to be elucidated. Recently it has been shown that the chromosome of a bacterium, Pseudomonas tabaci, contains a high proportion of calcium. E. coli maintains an intracellular concentration of free calcium identical to that of higher organisms and in dividing cells of E. coli a twenty-fold increase in the level of total calcium in the cytoplasm, a flux, occurs. In this article I propose that during the replication of the chromosome calcium entry balances calcium binding to DNA. At the termination of replication, there is a brief interval between the end of calcium binding to the chromosome and the end of calcium entry or release into the cytoplasm. During this interval the level of free calcium therefore rises. This rise may result in the observed flux by triggering the entry of calcium directly via voltage-gated calcium channels or indirectly via changes in phospholipid configurations. Mechanisms whereby these changes in calcium levels might be coupled to cell division and to a phospholipid control of the cell cycle are discussed. PMID- 2695252 TI - Somatic cell mutants of low density lipoprotein receptor. PMID- 2695253 TI - Transgenic mice as tools in the study of HBV-related liver diseases. PMID- 2695254 TI - Effect of colchicine on the intracellular transport of secretory proteins in rat liver parenchymal cells. Immunocytochemical observations. AB - We studied the effects of colchicine on the intracellular transport of secretory proteins in rat liver parenchymal cells using the direct immunoenzyme technique. Livers were perfusion-fixed 0.5, 1, and 2 h after injection of colchicine. Vibratome sections of the fixed liver were stained using peroxidase-conjugated Fab' of anti-albumin or anti-fibrinogen. By light microscopy, reaction deposits showing albumin and fibrinogen were observed in the cytoplasmic granules of hepatocytes. Such stained granules decreased 30 min after injection, but later increased gradually and crowded in the cytoplasm. The Golgi complex stained for the proteins decreased after 30 min but increased in the juxtanuclear region after 60 min. The analysis of serial sections showed that colchicine severely disturbed the spatial relationship between the Golgi apparatus and the bile canaliculus. We obtained similar results by electron microscopy; a positive reaction for albumin and fibrinogen was observed in a small number of the cytoplasmic granules after 30 min. After 1 h of treatment, most of the Golgi complexes were fragmented and lost their stacked cisternae. However, they reappeared accompanied with vacuolated cisternae and secretory granules, which were partially stained for albumin and fibrinogen. After 2 h, the secretory granules positive for both proteins accumulated further. Some of them lined a long the plasma membrane, and others made a cluster in the cytoplasm. The profiles showing exocytosis were very rarely seen. These results showed that in the first 30 min, colchicine primarily disturbs partially the Golgi assembly but does not affect the post Golgi secretory pathway much. Later, the drug affects both the post Golgi pathway and the Golgi assembly, and it causes a marked accumulation of secretory granules. PMID- 2695255 TI - Intracellular distribution of a 32-KDa calcium-dependent phospholipid-binding protein from human placenta. AB - A 32-KDa calcium dependent phospholipid-binding protein was purified to homogeneity from human placenta by affinity adsorption to polyacrylamide immobilized phosphatidylserine followed by elution with 5 mM EGTA and ion exchange chromatography. Immunochemical studies using the polyclonal antibody against the 32-KDa protein revealed that this protein was present around the nucleus in the cytoplasm but not clearly associated with cell organelles and cytoskeletons. In KB cells treated with insulin, 32-KDa protein was localized in the ruffling membranes in addition to the cytoplasm. Purified 32-KDa protein was shown to coprecipitate with skeletal muscle actin under polymerizing conditions. These findings suggest that the 32-KDa protein interacts with networks of actin filaments in cells. PMID- 2695256 TI - [The effect of heart surgery during extracorporeal circulation and deep hypothermia on glucose metabolism in infants and young children]. AB - Authors examined levels of glucose, insulin, and C-peptide in the plasma of 6 infants and small children with the isolated transposition of the great arteries (3 pts) and ventricular septal defect (3 pts) in the course of open-heart surgery in deep hypothermia. The mean age of the patients was 7.2 months (6 to 15) and weight 5.6 kg (5.2-7.5). Exogenous intake of glucose during the operation was excluded. Methods of anaesthesia, operation technique, and conduction of extracorporeal circulation (ECC) were constant in all patients. Fresh ACD blood diluted with Hartman solution approximately 1:1 was used for the prime of ECC circuit (content 800 ml) to get the hematocrit 0.27 +/- 0.2 after mixing the prime with the patient's blood volume. Glycemia was determined by Beckman ERA 2001 analyzor, and levels of insulin and C-peptide by radioimmunoassay kits MJ-96 (Poland) and Novo (Denmark). Significant hyperglycemia was found in all patients during the period of hypothermia, and was overlasting to the rewarming period until the end of the operation and 1 hour postoperatively. Then level of glycemia was decreasing to the normal values which were found in the last sample (17 hours post-op). The raise of glycemia was not a stimulus to the proportional increase of insulin and C-peptide levels in plasma. It proved transitional suppress of insulin secretion in the beta cells of the pancreas in the cooling period. Levels of insulin and C-peptide significantly and concordantly increased after 20 min. of rewarming (r = 0.83). However, hyperglycemia overlasted during the course of rewarming, too.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695257 TI - [Factors affecting mucociliary transport]. PMID- 2695258 TI - [Insulin levels in plasma during a 3-hour blood glucose profile in obese children monitored by the Biostator]. PMID- 2695259 TI - Therapeutic failure with chloroquine in Plasmodium falciparum infections; possibility of high grade resistance. AB - Three case reports of falciparum malaria not responding to standard chloroquine therapy and necessitating the use of alternative antimalarial drugs for clinical improvement, are documented. In vitro drug sensitivity tests and chloroquine assays were not carried out to conclusively exclude drug failure. However, the clinical course and the persistence of parasitaemia on thick blood film monitoring were suggestive of high grade chloroquine resistance. Such patients require clinical vigilance and the timely use of alternative antimalarials. When rapid clearance of parasitaemia is required quinine is the drug of choice. In malarial chemotherapy it is mandatory that strict therapeutic criteria be followed, to safeguard the efficacy of chloroquine as well as to prevent abuse of alternative drugs. In this context, the availability of thick blood films and in vitro drug sensitivity testing facilities in hospitals would be useful to clinicians. PMID- 2695260 TI - S. C. Paul oration--1988. Malaria--the scourge of Polonnaruwa. PMID- 2695261 TI - [Usefulness of long-term endoscopic follow-up of gastric ulcer. Study of related epithelial dysplasia]. AB - Over the period from January 1980 to March 1988 the frequency of dysplastic abnormalities associated wits 202 apparently benign gastric ulcers was determined and their course monitored. The relevant data were then evaluated separately for the various subgroups the ulcers were divided into on the basis of their natural history. No correlation was detected between natural history of gastric ulcer, dysplasia and onset of cancer. Though all dysplastic forms (mild, moderate and severe) may regress, all three showed a possibility of progression to EGC, obviously in increasing percentages: mild dysplasia: 2.53%; moderate dysplasia: 4.76%; severe dysplasia: 14.29%. The last of these three values appears to indicate a greater risk of cancer onset than in simple gastric ulcer and thus proves a useful marker for a more thorough monitoring of such patients. PMID- 2695262 TI - [Biomechanico-clinical interpretation of firearm wounds. General problems (III). A propedeutic ABC on terminal ballistics]. AB - The surgeon should have a comprehensive knowledge of firearms as thermochemico ballistic machines in order to come to grips in an adequate manner with the wounds they inflict on the human body. The traces left on the body to all intents and purposes embrace a cultural "cul de sac" which risks being defrauded of most of its content by a lack of those propedeutics elements which painstaking reflection is capable of affording us. Only the interpretation of each individual ballistic phase, both as a complete phenomenon in itself and as a component in a single articulated complex, can offer such elements: credit is due at least for a wholehearted commitment in this direction, while never losing sight at any time of the clinical perspective of such wounds. PMID- 2695263 TI - [Oncocytoma of the parotid gland (observations on a case)]. AB - The authors report on an isolated case of parotid gland oncocytoma observed in an elderly patient who developed an oxyphilic cell adenoma of the parotid gland. As this conditions is very rare, they describe the clinical features of the case and review the available literature on the disease. PMID- 2695264 TI - [Liposarcoma in children. Apropos of 3 cases and a review of the literature]. AB - Liposarcoma is an uncommon tumour in childhood. Three cases are reported. Two patients remain alive and well without local recurrence or metastasis following the initial treatment, however one patient died as a result of direct tumour extension despite chemotherapy. A review of the literature revealed the following features: the extremity are the most common location, the predominance of myxoid histology and its best prognosis. The treatment is the complete surgical excision, the efficiency of radiotherapy or chemotherapy has not been formally proved. PMID- 2695265 TI - [Antenatal diagnosis of lung malformations. Apropos of 9 case reports]. AB - The authors report 9 cases of prenatal diagnosis of lung malformations. The diagnoses was performed between 17 to 33 weeks amenorrhea (mean = 25.5 weeks). The clinical findings were: 7 cystic adenomatoid malformations of the lung, 1 intralobar sequestration and 1 bronchogenic cyst associated with extralobar sequestration and esophageal duplication. In two cases of cystic adenomatoid malformation of the lung with polyhydramnios and fetal hydrops death occurred at 27 and 32 weeks amenorrhea. In the seven other cases surgery was performed shortly after birth, before any serious complications occurred. No problems were encountered following the surgical intervention and the remaining lung inflated after a few days. All these children are currently alive and well, without pulmonary or thoracic disorder. The authors first explain the echographic findings in each malformation and later discuss the sonographic criteria of the diagnoses. The antenatal diagnosis permits early recognition and thus adequate management using a team of neonatologists, radiologists and pediatric surgeons. This type management involves: --normal vaginal delivery if there are no obstetrical problems; --if it is possible, artificial ventilation should be avoided as it may increase respiratory distress. If however, it is necessary, the healthy lung should be intubated; --the surgical procedure should be performed as soon as possible, before complications as respiratory distress or recurring pulmonary infections occur; --the major risk of this surgery is respiratory and heart failure when the child is placed in the operating position. A rapid thoracotomy permits the extraction of the compressed lung and the resuscitation of the patient. PMID- 2695266 TI - [Surgical treatment of a recent Monteggia's fracture in newborn infants. Apropos of a case]. AB - The authors report a case of a recent Monteggia's fracture, occurring to a one year-old child, which is a very unusual age (2 from 286 cases in literature). Orthopedic ulnar reduction failed and intramedullary pinning was required. According to this observation, the authors propose a therapeutic procedure of Monteggia's fracture in young children. PMID- 2695267 TI - [Van Gogh's xanthopsia]. AB - Critical study of two features of the painting of Van Gogh: the colored haloes, assignated to glaucoma; and the prevalence of yellow, assignated to xanthopsis induced by digitalis. PMID- 2695268 TI - [Goniotomy in congenital glaucoma: therapeutic results]. AB - Sixty-eight eyes presenting with congenital glaucoma and operated on by goniotomy, have been followed up for 1 to 10 years. Intra-ocular pressure was normalized in 91.18 p. cent of cases by one or more goniotomies with or without medical treatment. We have also analyzed the functional results of these operations. PMID- 2695269 TI - [Albert Bronner's predecessors: the Strasbourg Chair of Ophthalmology from 1919 to 1969]. PMID- 2695270 TI - [Symptomatic treatment of filamentary keratitis by reversible occlusion of the lacrimal meatus]. PMID- 2695271 TI - Guidelines (1988) for training in clinical laboratory management. International Federation of Clinical Chemistry (IFCC) Education Division and International Union of Pure and Applied Chemistry (IUPAC) Clinical Chemistry Division Commission on Teaching of Clinical Chemistry. AB - Trainees in laboratory medicine must develop skills in laboratory management. Guidelines are detailed for laboratory staff in training, directors responsible for staff development and professional bodies wishing to generate material appropriate to their needs. The syllabus delineates the knowledge base required and includes laboratory planning and organisation, control of operations, methodology and instrumentation, data management and statistics, financial management, clinical use of tests, communication, personnel management and training, and research and development. Methods for achievement of the skills required are suggested. A bibliography of IFCC publications and other material is provided to assist in training in laboratory management. PMID- 2695272 TI - Development and applications of ultrasensitive enzyme immunoassays for antigens and antibodies. AB - Some enzymes can be measured at lower molar concentrations than the radioisotopes used as labels in radioimmunoassay. Therefore, enzyme immunoassay should be capable of higher sensitivity than radioimmunoassay, if appropriate techniques are used for enzyme-labelling of antibodies and formulation of assay protocols. Techniques required for enzyme immunoassay with attomole sensitivity have been developed, and successfully applied to the measurement of clinically important ligands at levels below those possible using radioimmunoassay. In addition, a novel enzyme immunoassay technique (immune complex transfer enzyme immunoassay technique) is being developed to provide higher sensitivity. PMID- 2695273 TI - Microbial enzymes for creatinine assay: a review. AB - A novel metabolic pathway for the degradation of creatinine with N methylhydantoin, N-carbamoylsarcosine and sarcosine as successive intermediates was found to operate in Pseudomonas putida 77 and many other microorganisms. Enzymes involved in this pathway were purified from cells of P. putida 77 and characterized. The first step, deimination of creatinine, is catalyzed by cytosine deaminase/creatinine deiminase. The following two steps, ring-opening of N-methylhydantoin and decarbamoylation of N-carbamoylsarcosine, are catalyzed by new enzymes, N-methylhydantoin amidohydrolase and N-carbamoylsarcosine amidohydrolase, respectively. The former requires ATP, Mg2+, and K+ for the hydrolysis and the reaction proceeds as follows: N-methylhydantoin + ATP + 2 H2O- --N-carbamoylsarcosine + ADP + Pi. The latter catalyzes the following reaction; N carbamoylsarcosine + H2O----sarcosine + NH3 + CO2. Sarcosine dehydrogenase was found to be the responsible enzyme for the oxidation of sarcosine to glycine in P. putida 77, but sarcosine oxidase was also found to be involved in this oxidation in several microorganisms. These enzymes were found to be useful tools for determination of creatinine. PMID- 2695274 TI - Diagnostic application of mitochondrial enzymes and isoenzymes. AB - Evolutionary, topological and metabolic aspects of mitochondrial enzymes and isoenzymes are reviewed, and the structural and functional heterogeneity of mitochondria is demonstrated. Primary deficiencies of mitochondrial enzymes are described and the need for their proper recognition is illustrated. Species differences of secondary dysfunction of mitochondrial enzymes are shown. The release of mitochondrial enzymes is compared to that of cytosolic enzymes from liver and heart muscle cells and the diagnostic significance of assays of mitochondrial enzymes in serum is evidenced. Possible mechanisms of mitochondrial enzyme release from cells and unresolved questions pertaining to this process are discussed in light of potential diagnostic utility of mitochondrial enzymes in serum. PMID- 2695275 TI - Regulation of protein kinase C by sphingosine and lysosphingolipids. AB - Protein kinase C (PKC), a calcium and phospholipid dependent protein kinase C, has emerged as a key element in signal transduction and cell regulation. It is activated by sn-1,2-diacylglycerol (DAG) second messengers and it serves as the receptor for phorbol esters, potent tumor promoters. PKC is now known to occur as a family of isoenzymes sharing similar structural features that allow regulation of activity by calcium, phospholipid, and DAG. In vitro mechanisms of PKC regulation by phospholipid, DAG, and phorbol esters have been studied using mixed micelles of Triton X-100/lipids. PKC activation occurs at physiologic mole fractions of phospholipid and DAG, does not require a bilayer, and appears to occur by a two-step mechanism whereby PKC initially interacts with a phospholipid surface and is then activated by the addition of DAG. Similar methodology has been used to explore the inhibition of PKC by different inhibitors that interact with its regulatory domain. Sphingosine and lysosphingolipids are potent inhibitors of PKC that prevent its interaction with DAG/phorbol esters. These naturally occurring metabolites have been shown to affect PKC activity in different cell systems. Disturbances in sphingolipid metabolism may lead to accumulation of lysosphingolipids with consequent inhibition of PKC. Additionally, these naturally occurring metabolites may have physiologic functions in regulating PKC activity by counteracting the action of DAG. The mechanism of action of sphingosine/lysosphingolipids and their possible physiologic function will be discussed. PMID- 2695276 TI - Metabolic considerations in the treatment of the black hypertensive. AB - Hypertension and its cardiovascular consequences are both common and potentially devastating among black Americans. Recent evidence suggests that not all antihypertensive agents have similar efficacy in hypertensive patients, nor do all convey the same benefit in terms of reducing the risk of cardiovascular disease. This review considers the efficacy of various antihypertensive agents in blacks, with particular reference to the impact of these agents on cardiovascular disease risk factors and on associated diseases often encountered in black hypertensives. Emphasis is placed on the use of therapeutic approaches other than diuretics alone or in combination with other antihypertensive agents from the vantage point of efficacy and enhancement of cardiovascular and metabolic benefits. PMID- 2695277 TI - Lateral pontine and extrapontine myelinolysis associated with hypernatremia and hyperglycemia. AB - Efforts to understand and prevent pontine and extrapontine myelinolysis have focused on the correction of hyponatremia, but controversy persists. We report a woman who presented in hyperosmolar diabetic coma with hypernatremia (169 mEq/l) and hyperglycemia (954 mg/dl). Plasma sodium rapidly increased to 188 mEq/l before gradually returning to normal. She remained obtunded and died 21 days later. Autopsy showed widespread, symmetrical demyelination involving the subcortical white matter, corpus callosum, anterior commissure, extreme, external, and internal capsules, fornix, thalamus, cerebellum, and lateral pons. The central pons and lateral geniculate nuclei were uninvolved. This case illustrates that lateral pontine and extrapontine myelinolysis can be associated with hypernatremia and hyperosmolality. In both hypo- and hypernatremic states, the significant event may be an increase in serum sodium or serum osmolality of sufficient rapidity and magnitude. PMID- 2695279 TI - Measurement of Doppler velocity in diagnosis of peripheral vascular disease in diabetics with peripheral pulse deficit. AB - Forty-nine diabetics (aged 50-69 yr, with a pulse deficit in 54 legs) were examined for peripheral vascular disease (PVD). In relation to pulse deficits PVD was proved by oscillography in 24 (44%), by qualitative Doppler velocity measurements in 19 (51%) and by quantitative Doppler in 28 (35%) cases. The overall rate of the agreement in the diagnosis between the two Doppler techniques and oscillography was 76.8% and 73.5% respectively. The differences in the PVD frequency detected by Doppler sonography were not significant. However, a comparison of Doppler deficits and pulse deficits showed that PVD was more frequently found by the qualitative Doppler technique (76.0% vs 35.2%, p less than 0.0005). Also in 94.7% of all cases PVD could be detected by the qualitative examination of only one artery. The quantitative Doppler results were directly correlated to localized findings in the foot in PVD. Thus, it can be concluded that in comparison to oscillography the qualitative Doppler velocity measurements are simpler and more time-saving for a screening diagnosis of PVD, while the quantitative technique is useful for evaluating the severity of evident PVD. PMID- 2695278 TI - Carbohydrate, lipid and amino acid metabolism of insulin-dependent diabetic patients regulated by an artificial beta-cell unit. AB - To characterize the effects of artificial beta-cell directed insulin therapy on carbohydrate, lipid and amino acid metabolism, five insulin-dependent diabetic patients were challenged with a 100-g glucose meal while on conventional (single or split mixed insulin injections) therapy and again after 72 hr on an artificial beta-cell unit. It was verified that the high levels of blood glucose of the conventionally treated diabetics were marked reduced toward normal by the artificial beta-cell therapy, while the blood lactate and pyruvate concentrations increased significantly to levels higher than in normal controls. The elevated levels of FFA, glycerol, and ketones in the diabetics under conventional therapy were entirely normalized during the artificial beta-cell regulation. Furthermore, the artificial beta-cell insulin therapy showed capable to restore the abnormalities in the blood profiles of alanine, glutamine and branched-chain amino acids, exceeding in some points the normal response. It was also detected hyperinsulinemia in the diabetics treated with the artificial beta-cell unit and no change in the pancreatic beta-cell function during this period of regulation, evidenced by low and unchanged blood levels of C-peptide. Marked suppression of pancreatic alpha-cell secretion was detected by the significant decrease of the hyperglucagonemia in the conventionally treated diabetics by the artificial beta cell therapy. These studies reveal that the artificial beta-cell insulin therapy is capable of restoring to normal not only the abnormal glucose metabolism of conventionally treated diabetics, but also other substrate metabolism related to the lipid and protein homeostasis of the organism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695280 TI - Renal haemodynamics during short-term angiotensin converting enzyme inhibition in normotensive normoalbuminuric insulin dependent diabetics. AB - Effective renal plasma flow (RPF) and glomerular filtration rate (GFR) were assessed in early insulin dependent diabetics (duration of diabetes less than 10 yr) during short term administration of angiotensin converting enzyme inhibitor. In a double blind randomized study, RPF and GFR were measured in normotensive normoalbuminuric (albumin excretion rate less than 20 micrograms/min) male IDDs before and after two weeks of Captopril 25 mg bd (n = 6) or placebo (n = 6). RPF and GFR were measured by means of a primed constant infusion of 125I iodohippurate and 51CR EDTA, respectively and corrected for 1.73m2 surface area. Supine blood pressure was measured throughout the study period. Mean (+/- SE) systolic and diastolic blood pressures were unchanged in both groups of subjects, being 124 +/- 5 mmHg and 78 +/- 4 mmHg before and 126 +/- 5 mm and 81 +/- 4 mm during Captopril and 121 +/- 6 mm and 79 +/- 4 mm before and 120 +/- 5 mm and 80 +/- 3 mm during placebo administration. RPF and GFR remained unchanged during Captopril administration, from 719 +/- 28 ml/min and 148 +/- 6 ml/min prior to and 721 +/- 26 ml/min and 149 +/- 6 ml/min during therapy. Similarly RPF and GFR were unchanged in the placebo treated group at 634 +/- 24 ml/min and 143 +/- 5 ml/min before end 630 +/- 28 ml/min and 140 +/- 7 ml/min after two weeks. Glycaemic control was unchanged in either group during the study period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695281 TI - Tubular Na+ handling in type I insulin-dependent diabetics during saline and ketone body infusion. AB - It has been reported that patients with type I insulin dependent diabetes mellitus (IDDM) are characterized by reduced Na+ excretion during water immersion and saline infusion and abnormal glomerulo-tubular balance. Aims of the present study were therefore to investigate firstly the fractional tubular Na+ reabsorption during saline infusion to clarify the altered tubular site and secondly the glomerulo-tubular balance during acute increase of glomerular filtration rate induced by sodium acetoacetate infusion in IDDM. During saline and euglycaemic glucose clamp, after an overnight fast, glomerular filtration rate, renal plasma flow, filtration fraction and plasma sodium were 99 +/- 15 ml min-1 1.73 m-2, 452 +/- 109 ml min-1 1.73 m-2, 0.23 +/- 0.04 and 142 +/- 8 mmol l 1 (Mean +/- SD) in 10 type I insulin dependent diabetic patients and 96 +/- 18, 452 +/- 87, 0.21 +/- 0.02, 143 +/- 2 in five matched normal subjects, respectively. The lithium and sodium clearances were significantly lower in diabetic patients than in normal subjects (23 +/- 5 ml min-1 1.73 m-2 vs 28 +/- 6, p less than 0.05 and 1.1 +/- 0.4 vs 1.6 +/- 0.3, p less than 0.01 respectively). The fractional lithium reabsorption was greater (0.77 +/- 0.04 vs 0.72 +/- 0.03, p less than 0.05) and the distal fractional sodium reabsorption smaller (0.22 +/- 0.04 vs 0.27 +/- 0.03, p less than 0.01) in the diabetic patients compared to the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695282 TI - The influence of zinc supplementation on glucose homeostasis in NIDDM. AB - Decreased serum zinc levels and hyperzincuria occur in some non-insulin dependent diabetic subjects (NIDDM). Zinc deficiency was demonstrated in various tissues of animal models for NIDDM. Serum zinc and 24-hr urine zinc of subjects with NIDDM were compared with that of age- and sex-matched healthy volunteers. Zincuria was significantly increased in the diabetic group. Thirteen diabetic subjects with hyperzincuria and hypozincemia were supplemented with zinc sulfate 220 mg x 3/day for 7-8 weeks. At the end of the study, glucose disposal (evaluated by kg) decreased significantly from 0.562 +/- 0.03 to 0.414 +/- 0.05 (p less than 0.05) and fasting glucose and fructosamine were significantly increased from 177 +/- 10 mg/dl to 207 +/- 15 mg/dl (p less than 0.05) and from 2.7 +/- 0.2% to 3.2 +/- 0.28% (p less than 0.05), respectively. T-lymphocyte response to phytohemagglutinin was increased significantly. We conclude that zinc supplementation to NIDD patients with hypozincemia and hyperzincemia might aggravate their glucose intolerance. More accurate methods to assess zinc deficiency in NIDD patients is needed to justify the supplementation of zinc in these patients. PMID- 2695283 TI - The effect of islet-activating protein (IAP) of pertussis toxin on the spontaneous diabetic syndrome in the rat. AB - The administration of the Islet-Activating Protein (IAP) of pertussis toxin results in an increased insulin response to oral glucose in a dose- dependent manner. This response can be detected for up to 12 days after a single injection. In addition, IAP increases the number of peripheral blood leucocytes and lymphocytes. Inbred strains of rats differ in the magnitude of the leucocyte but not the insulin responses to IAP. Multiple injections of 1,000 ng of IAP to diabetes-prone BB rats at 50, 64 and 78 days of age caused an increased release in response to glucose challenge and a slight increase in peripheral blood leucocytes when compared to animals receiving saline injections. The prevalence of insulin-dependent diabetes in BB rats was increased in the IAP group as compared to controls. Histolgic examination of the pancreas at the time of detection of diabetes revealed a widespread intense insulitis. We speculate that the increased expression of disease observed in the BB rats receiving IAP may be secondary to the chronic increase in insulin release and/or to an effect on the cells of the immune system. PMID- 2695284 TI - Combined effects of fasting and vinblastine treatment on serum insulin level, the size of autophagic-lysosomal compartment, protein content and lysosomal enzyme activities of liver and exocrine pancreatic cells of the mouse. AB - 1. The volume fraction of autophagic vacuoles in liver parenchymal and exocrine pancreatic cells was smallest and the serum insulin level highest in the 24 hr prestarved mouse immediately after 3 hr feeding period. 2. The size of the autophagic vacuole and lysosome (dense body) compartments increased in both types of cells during 2-72 hr fasting parallel with decreasing serum insulin levels. 3. The protein content of the cells decreased and the DNA-based activity of acid phosphatase showed little change throughout fasting. The activity of cathepsin D increased during days 2 and 3 of food deprivation. 4. Vinblastine (50 mg/kg body wt) applied for the last 2 hr of different periods (2, 12, 24, 48 and 72 hr) of fasting decreased serum insulin level and increased the fractional cytoplasmic volume of autophagic vacuoles and dense bodies. This increase was smaller when the drug was applied shortly after feeding and much larger after prolonged fasting. The increase was more pronounced in the pancreatic than in the liver cells. 5. Our data show that the effect of vinblastine on the size of the autophagic-lysosomal compartment depends on the feeding status of the animals. PMID- 2695286 TI - 50 years ago. From the Journal of the Connecticut State Medical Society. November 1939: Modes of transmission in poliomyelitis. PMID- 2695285 TI - Immunization of sheep against modified peptides of gonadotropin releasing hormone conjugated to carriers. AB - The efficacy of antigens based on modified GnRH peptides in stimulating the production of antibodies against GnRH in sheep was tested. In the first study cysteine-containing GnRH peptides were conjugated to keyhold limpet haemocyanin (KLH) in 3 different orientations. The 3 conjugates were prepared in an emulsion of Freund's complete adjuvant (FCA) and were injected into 3 groups of 6 castrated male lambs. The 3 vaccines efficiently induced anti-GnRH titers in all the animals treated. The specificity of the GnRH antisera raised varied depending on the orientation of the GnRH molecule in the antigen and on the individual animal. In a second trial designed to evaluate carrier molecules, a cysteine containing GnRH peptide was conjugated to either KLH, equine serum albumin, ovalbumin or tetanus toxoid. The conjugates were prepared with FCA and injected into intact male lambs. All 4 vaccines stimulated the production of antibodies against GnRH in all the animals treated. The conjugates prepared with equine serum albumin or ovalbumin were the most effective in raising high anti-GnRH titers. In 18 of 20 lambs treated, anti-GnRH titers resulted in a marked atrophy of the testes. We conclude that: 1) the different epitopes of the GnRH molecule are equally immunogenic in sheep; 2) the GnRH antibody response is affected by the carrier used; and, 3) anti-GnRH vaccines based on cysteine-substituted GnRH analogues show potential for use in immunocastration of livestock. PMID- 2695287 TI - Oral contraceptives and lipids and lipoproteins: Part II--Relationship to plasma steroid levels and outlier status. AB - A randomized clinical trial of oral contraceptives evaluated 67 women on 50 ug ethinyl estradiol (EE) and 1.0 mg norethindrone (NE), 61 women on 35 ug EE and 1.0 mg NE, and 64 women on 35 ug EE and 0.5 mg NE. At baseline, three, six and nine months, lipids and lipoproteins were measured as well as selected plasma determinations of the contraceptive steroids. Data was related to change in outlier status for lipids/lipoproteins (less than 10th percentile for high density lipoprotein cholesterol and apolipoprotein A-1, greater than 90th percentile for all others). Women on the lowest dose preparation had the smallest trend towards outlier status for high-density lipoprotein cholesterol and apolipoprotein A-1. An increase over the time period of the study in the initial slope (one hour level minus zero hour level over time) of NE and a decrease in the initial slope of EE was associated with a shift to outlier status for low density lipoprotein cholesterol. A number of other relationships were also shown. Use of the techniques described might assist in identifying sub-groups of women at risk for adverse cardiovascular sequelae associated with oral contraceptive use. PMID- 2695288 TI - A study of the vaginal contraceptive sponge used with and without the fertility awareness method. AB - The actual effectiveness rates of natural and barrier methods of family planning are lower than the theoretical ones. If couples accurately defined the limits of the fertile phase and used barriers at that time, then actual effectiveness might increase. A randomized, controlled clinical trial was initiated to determine the effectiveness of the contraceptive sponge used only during the fertile time and to compare this with sponge use at every intercourse. Recruitment problems and discontinuation forced the early termination of this study, but qualitative information about compliance and acceptability was collected. Common sponge problems were reported as were misuses of the sponge, but problems and misuse were not related. Determination of the fertile phase was reportedly easy, but complaints of and discontinuation for inconvenience occurred. For unplanned pregnancies, contraceptive behaviors around the time of conception are presented. PMID- 2695289 TI - Eukaryotic DNA methylation and gene expression. PMID- 2695290 TI - Recognition of DNA by type II restriction enzymes. PMID- 2695291 TI - A new method for differentiating simple intra-abdominal from strangulated small intestinal obstruction. AB - We developed a model that aids in the differentiation of simple from strangulated intra-abdominal small-intestinal obstruction and reached an accuracy rate of 97 percent in predicting strangulated obstruction. Fifty-three criteria were analyzed from the records of 229 patients and by the Bayes statistical mode; five statistically significant criteria were identified. Using these, and another 16 criteria that indicated trends, we were able to predict strangulated obstruction with a 97 percent accuracy. Neither laboratory tests nor abdominal roentgenography aided in the diagnosis. PMID- 2695292 TI - Structures and activities of activated abl oncogenes. PMID- 2695293 TI - Eukaryotic RAS proteins and yeast proteins with which they interact. PMID- 2695294 TI - [Interventional radiology in bile duct diseases]. PMID- 2695295 TI - [New endosonographic examination technic for improving the assessment of small rectal tumors]. AB - Conventional endosonographic techniques of examination in early carcinoma and sessile rectal adenoma have shown unsatisfactory results. We therefore fill the rectal cavity directly with water. Using this technique the anatomy of the rectal polyp is preserved, and the separate layers are easier to differentiate, especially when the 10-MHz scanner is used. The clinical results in 56 patients show an improvement concerning the preoperative staging especially in those tumors which are not palpable. PMID- 2695296 TI - [Endosonography in preoperative assessment of rectal tumors]. AB - Together with digital examination and rectoscopy, the endorectal ultrasound is of great value in the preoperative diagnostics of rectal carcinoma. In 90% of these patients it is possible to determine the depth of infiltration preoperatively. At the same time assessment of lymph node involvement can be made with a sensitivity and specificity of 78%. Thus, endorectal ultrasound gives decisive criteria for the therapeutic plan. Furthermore, endorectal ultrasound represents a fitting instrument for the postoperative follow-up of patients with anterior resection of the rectum. Intramural as well as extrarectal sited recurrences of the tumor can be detected. Whether endosonography will have an influence on the prognosis of rectal carcinoma, remains to be seen. PMID- 2695297 TI - [Surgery of cryptoglandular anorectal fistula and abscess. With special reference to complicated infections]. AB - In an unselected personal consecutive series of anal fistulous abscesses (n = 253) 21 patients (8%) had a complex fistula, i.e. a translevatoric pelvirectal extension of an ischiorectal track (n = 7), a high intersphincteric fistulous abscess with an intramural or a pelvirectal extension (n = 7), a suprasphincteric fistula (n = 2), an intralevatoric fistulous abscess (n = 5). Treatment procedures were an ischiorectal laying open with translevatoric coring out, an intraluminal laying open into the lower rectum, and partial external sphincter division with seton drainage, respectively, as proposed in the literature. For the posterior levator space abscesses circular laying open into the anal canal lead to healing. In 2 patients with an anterior extension of an intralevatoric and with a suprasphincteric fistulous abscess, respectively, a posterior approach with a transsphincteric longitudinal excision of the diseased anosphincteric tissue was employed, with primary suture of the anorectum and of the sphincters, and with a covering colostomy. The procedure revealed to be useful with respect to exposure, fistula healing, and repair of previously transsected muscle. PMID- 2695298 TI - [Continuous 2-layer suture of the femoral hernia. Initial clinical results with 31 patients]. AB - In a retrospective study the two-lined continuous suture for the repair of femoral hernia was examined. From 1.12. 1985 till 31.5. 1988 the femoral defect was closed by a continuous two-lined suture 33 times in 31 patients. In almost 50% (16 cases) the hernia was incarcerated, in total 10 surgeons took part. Postoperatively occurred one wound infection and one serom. During a postoperative observation time of 1-28 months up to now no recurrence has been seen. Thus the two-lined continuous suture of femoral hernia seems to use a sure, simple and practical operation technique, that can be used very well in the every day-practice, also in case of incarcerated hernia. PMID- 2695299 TI - [Transanal endoscopic microsurgery in rectal cancer]. PMID- 2695300 TI - [Acute hemorrhage as a complication of pancreatic pseudocysts]. PMID- 2695301 TI - [Relation of placental prolactogen and E3 in the blood of pregnant women to placental grading by ultrasonography and its clinical significance]. AB - Serum HPL and E3 of normal pregnant women and some pathologic pregnancies were dynamically measured and the relationship between their levels and placental gradings were investigated. The peak values of HPL and E3 were found in 13.16 +/- 7.49 and 15.68 +/- 6.51 days before delivery. The serum concentrations of the two hormones in women with severe PIH syndrome, postdate pregnancy and intrauterine fetal growth retardation (IUGR) were lowered. E3 declined earlier than HPL Analysis of the HPL, E3 levels in comparison with placental grading showed that the decline of the two hormones was mainly found in patients with grade III placenta. PMID- 2695302 TI - [Factors influencing lactation and breast-feeding]. PMID- 2695303 TI - [Doppler flow velocity wave forms of the maternal uterine artery and fetal umbilical artery in normal pregnancy and pregnancy induced hypertension]. AB - A simple non-invasive continuous-wave Doppler ultrasound system was used to record the flow velocity wave forms of the maternal uterine artery and the fetal umbilical artery in 113 normal pregnancies and 39 cases of PIH or essential hypertension complicating pregnancy. The systolic/diastolic (S/D) ratio of flow velocities was measured as an index of peripheral resistance. In normal pregnancy the umbilical artery velocity wave S/D ratio declined from 3.9 to 2.1 during the 20th to 40th week while the uterine artery S/D ratio remained constant between 1.8 to 1.9. After the 30th week, either an umbilical artery S/D ratio greater than or equal to 3, or uterine artery S/D ratio greater than 2.6 was defined as abnormal. In 32 PIH cases there were 9 with abnormal umbilical artery S/D ratio and 4 with abnormal uterine artery S/D ratio and the umbilical arterial change seemed to precede the uterine arterial. The rate of abnormal velocity wave forms in PIH was significantly higher than that in normal pregnancy. If both uterine and umbilical artery wave forms were abnormal the fetal outcome was usually poor. The results showed that the method is good for predicting the fetal outcome and once again supported the hypothesis that spasm of arterioles and venules in the placenta leading to high peripheral resistance especially in the fetal side may play an important role in the pathogenesis of PIH. PMID- 2695304 TI - [Formation and prevention of postoperative abdominal adhesions in gynecology]. PMID- 2695305 TI - Calcium: an important second messenger in mast cells. AB - Recently there has been considerable controversy over the mechanism(s) by which intracellular Ca2+ is elevated when receptors for IgE on the surface of mast cells are aggregated by antigen. The central role played by calcium in the initiation of secretion from these cells has also been called into question. In a mast cell line which has been widely used to study stimulus-secretion coupling in non-excitable cells it is now clear that calcium is indeed important in the physiological response of the cells but that other intracellular messengers are also involved. In addition it has been shown that while the increase in intracellular Ca2+ probably originates from intracellular stores it can only be sustained by the influx of calcium across the plasma membrane. The nature of the Ca2+ permeability pathway has yet to be elucidated although a number of candidates for the calcium channel in mast cells have been proposed. Significant oscillations and spatial gradients of Ca2+ are often seen when the responses of individual antigen-stimulated cells are measured using digital imaging microscopy. The complexity of these responses highlights the importance of single cell measurements in elucidating the relationship between IgE receptor activation, Ca2+ movements and exocytosis. PMID- 2695306 TI - Molecular genetics of human immune responsiveness to allergens. AB - Specific immune responsiveness to certain highly purified allergens is significantly associated with particular HLA-D types. In one striking example, IgE and IgG responsiveness to the ragweed Amb V (Ra5) allergens is strongly associated with HLA-DR2/Dw2. We studied the HLA-D gene sequences of 67 Caucasoid subjects. All Dw2+ (Dw2 +/- in one case) high responders to Amb a V, before or after high-dose ragweed immunotherapy, possessed typical DRB1*2.2 and DRB3*2.2 (Dw2-associated DR beta) gene sequences. Their DQB1 genes all had typical Dw2 associated DQB1*1.2 sequences, with two exceptions (DQB1*1.21 and DQB1*1.18, that are usually associated with Dw21 and Dw18, respectively). The finding of these unusual sequence combinations in these Amb a V responders implicates a DR alpha beta I2.2 or a DR alpha beta III2.2 molecule as the major Amb a V Ir gene product. This conclusion is supported by our finding of one non-responder (after prolonged immunotherapy) who possessed the DQ1.2, but not the DR2.2, sequences. In ragweed-allergic subjects further data suggest that a DR2.2 molecule is generally a necessary and almost always a sufficient requirement for high Amb a V responsiveness. An Amb a V-specific T cell clone obtained from a Dw2+ subject was DR-restricted according to inhibition studies using anti-HLA-D monoclonal antibodies. Also, antigen-presenting cells that were DR2.2+ or DR2.12+, but not DR2.21+ or DR2.22+, were able to present antigen to the cloned T cells, implicating certain DR2 molecules as restriction elements. In similar studies using the rye grass allergen Lol p III we obtained preliminary data implicating the DR beta I sequence E9 YSTS13 (found in DR3, DR5 and DRw6 genotypes) in the recognition of a major Lol p III agretope. Since Lol p I and II are homologous to Lol p III in one region of their amino acid sequences the EYSTS sequence may also be involved in the recognition of similar agretopes of these molecules. These and other studies demonstrate the power of the allergy model for genetic and molecular studies of the human immune response. PMID- 2695307 TI - Epidemiology of the allergic response. AB - Asthma and related common allergic diseases are significant worldwide health problems which cause considerable morbidity and appreciable mortality and make severe demands on the time and costs of medical and hospital care. The more readily available epidemiological data relate to asthma, which has a wide prevalence, ranging from a general figure of 4-8% for developed countries to less than 1% in some European, African, Indian and Melanesian countries. Earlier reports that asthma is uncommon in the tropics, particularly in rural areas, appear from later studies to be an over-generalization; the highest prevalence of asthma in the world has been reported in the Western Caroline Islands, the Maldives and Tristan da Cunha. Atopic diseases are associated with excess IgE production, which is genetically controlled, and it is likely that additional genes control allergic shock organs. However, the development of allergic disease is balanced between genetic and environmental factors, principally exposure to aggressive allergens, which is particularly relevant during the first six months of life, amplified by maternal smoking both pre- and postnatally, and IgA deficiency in breast milk. Other factors such as viral infections and atmospheric pollution play important but lesser roles. A unique feature of asthma in village communities in developing countries, in contrast to developed, is that it is much less frequent in children than in adults. Although this may be relevant to understanding the regulation of allergic disease in general the mechanism(s) remain to be determined. PMID- 2695309 TI - Different mast cell mediators produced by different mast cell phenotypes. AB - The activation of mast cells results in the release of a large variety of inflammatory mediators, many of which are preformed and stored within the secretory granules. Exocytosis of the secretory granule contents releases a macromolecular complex composed of proteoglycan and the neutral proteases. The proteases include both endo- and exopeptidases, suggesting the possibility of a concerted action on unknown substrates. Different proteases are expressed by different mast cells originally defined by histochemical and ultrastructural criteria. From adoptive transfer experiments it appears that the mast cell phenotype is profoundly influenced by the microenvironment. Understanding the development and regulation of the mast cell phenotype is being approached by the development of: (1) An in vitro system of differentiation using in vitro differentiated mast cells which upon co-culture with fibroblasts demonstrate a phenotypic shift; (2) Kirsten virus-transformed mast cells exhibiting a spectrum of phenotypes. These reagents have allowed the isolation and characterization of the cDNAs of the various preformed protein mediators including the secretory granule proteoglycan peptide core, serine proteases and carboxypeptidase. These cDNAs have provided the first probes for the molecular characterization of the mast cell-associated proteoglycan peptide core, a carboxypeptidase A and a 28,000 Mr serine protease. PMID- 2695308 TI - Structure and function of Fc epsilon receptor II (Fc epsilon RII/CD23): a point of contact between the effector phase of allergy and B cell differentiation. AB - The Fc epsilon receptor II (Fc epsilon RII/CD23) has been proposed to have multiple functions as a membrane-bound or soluble molecule: a function in B cell growth and differentiation and a role in the effector phase of IgE-mediated immunity. We recently demonstrated the presence of two forms of Fc epsilon RII (Fc epsilon RIIa and Fc epsilon RIIb) whose structures differ only at their N terminal cytoplasmic regions. The regulatory mechanisms of their expression strongly suggest that Fc epsilon RIIa and Fc epsilon RIIb function in B cells and in the effector cells of IgE-mediated immunity, respectively. To elucidate the function of soluble Fc epsilon RII/CD23 (sFc epsilon RII) the recombinant soluble molecule was produced. This recombinant receptor could competitively block the IgE binding of eosinophils, monocytes and even basophils and could inhibit the IgE-mediated function of effector cells such as monocytes. These findings suggested that sFc epsilon RII could competitively regulate the function of effector cells in IgE-mediated immunity and that the recombinant sFc epsilon RII could be applied clinically for the control of allergic reactions. The expression of Fc epsilon RII on Fc epsilon RII-negative B and T cell lines by cDNA transfection resulted in homocytic aggregation. The function of Fc epsilon RII on B cells as an adhesion molecule was also demonstrated. PMID- 2695310 TI - [Meningioma of the fourth ventricle]. AB - Description of 2 rare cases of meningioma located in the 4th ventricle, of which only 21 other cases have been published, is followed by a review of the relevant literature. The authors point out that CT scan and selective vertebral angiography are the main laboratory investigation in making the diagnosis and total removal of the benign tumor can gain satisfactory result, although the tumor is difficult to be differentiated from ependymoma in naked eye. PMID- 2695311 TI - [The initial report of the surgical effect in chronic psychoses]. AB - The report of the surgical curative effect in 37 cases of chronic and aggressive behaviour psychoses. The cerebral amygdaloid nucleus and the cinguli bundle were damaged in the part by the cerebral stereotaxic operation. Through we have been evaluated strictly and follow-up survey for 2 years, that shown 67% in the effective rate, the behaviour and hallucination were recovered especially. Select the operative target and some medicine administration in the period of postoperation about improve the curative effect are significant especially also. PMID- 2695312 TI - [The history and current status of psychosomatic medicine]. PMID- 2695313 TI - [Hemangioblastoma of the central nervous system]. PMID- 2695314 TI - [Polypoid lesions of the gallbladder]. AB - 26 cases of polypoid lesions of the gallbladder are reported. 19 were benign lesions, among them, there were 12 (63%) cholesterol polyp, 4 adenoma, 1 inflammatory polyp, and 2 others. 95% of benign lesions were less than 1 cm in diameter, 63% of which were less than 0.5 cm in diameter, 15 cases were multiple lesions; all cases were not associated with gallstones. 7 cases were carcinoma of the gallbladder, of which, 5 were more than 1 cm in diameter, 2 were less than 1 cm which were carcinoma in situs; 3 were associated with gallstones. The accuracy of preoperative diagnosis of polypoid lesions of the gallbladder made by B-mode ultrasonography, cholecystography, CT, endoscopic ultrasonography were 84%, 53%, 80% and 75% respectively. It is concluded that preoperative diagnosis of polypoid lesions on the gallbladder mainly depends on the B-mode ultrasonography; the lesions less than 0.5 cm in diameter should not be treated by operation for the time being; the lesions between 0.5-1 cm should be followed up by B-mode ultrasonography; the operation may be considered if stones present; the lesions more than 1 cm should be resected since malignancy could not be excluded. PMID- 2695315 TI - [Aorto-anastomotic fistula following resection of carcinoma of the esophagus]. AB - This paper reports 5 cases of aorto-anastomotic fistula following resection of carcinoma of the esophagus with a review of literature. There were 4 males and 1 female. The tumors were located in the lower third of the esophagus in all cases. All patients had anastomosis under the aortic arch. The hemorrhage occurred postoperatively from 15 to 22 days. All patients died. The interval between hemorrhage and death varied from 1 to 7 days. Three of the 5 patients underwent autopsy. The clinical characters, diagnostic methods, surgical treatment and preventive measures are discussed. PMID- 2695316 TI - [Ultrasonically guided fine-needle biopsy of space-occupying lesions in liver]. AB - 105 patients with liver space-occupying lesions were biopsied with fine-needle guided by ultrasound. Smear cytologic examination was performed in all and histologic examination was done simultaneously in some. The diagnosis accuracy rate was 95.2%, sensitivity was 94.9%, specificity was 96.2% which were higher than those diagnosed by ultrasound only (accuracy rate 86.7%) and no complications occurred. The results of cytology, histology and both methods combined are analysed and compared. It shows that the combined examination may increase the diagnosis accuracy rate. PMID- 2695317 TI - The prevalence of dysequilibrium and related disorders in older persons. AB - Dysequilibrium disorders such as dizziness, balance and gait changes, and falls are among the most common yet poorly understood medical problems for older persons. A recent analysis of data about people aged 65 and older indicates that dysequilibrium is one of most common diagnoses in short-stay hospitalizations, and it accounts for an average of 4.3 days of medical care. Older people without overt disease of any type tend to perform more poorly on balance tests than do younger people. Gait deficits in many older people are associated with considerable functional impairments. Deficits in postural control are associated with an increased risk of falling. Geriatric dysequilibrium disorders can be caused by one or more factors--vestibular, vascular, visual, neuromuscular, pharmacologic--each of which must be considered to understand and appropriately treat the dysequilibrium. The accurate identification of the cause of dysequilibrium must involve the testing of multiple, interacting systems. The literature suggests that often no clear cause for an older person's dysequilibrium can be found, and indicates the possible existence of presently unappreciated etiologic factors. Progress in understanding these problems probably has been stymied by the fact that only a small, select subgroup of older patients is referred to specialists in otolaryngology. Quite probably, considerable progress on the understanding of the cause, diagnosis, and treatment of geriatric dysequilibria would result from more extensive research collaboration between otorhinolaryngologists, geriatricians, epidemiologists, and other specialists. PMID- 2695318 TI - Enzyme immunoassay for oxytocin. AB - A competitive, double antibody enzyme immunoassay for oxytocin in a heterologous system was developed. Horseradish peroxidase was conjugated with oxytocin using N succinimidyl 3-(2-pyridyldithio) propionate, and rabbit anti-oxytocin serum was produced by immunization of oxytocin-bovine serum albumin complex which was prepared by the carbodiimide method. The sensitivity of the assay was 4 microIU/tube, which corresponded to 10 microIU per ml using 400 microliters of the sample which was extracted from the same volume of plasma by means of SEP-PAK C18 cartridges. The coefficients of variation for different levels of oxytocin ranged from 6.8-15.9% and 8.5-16.7%, for intra- and inter-assay. Recovery of oxytocin added to plasma after extraction was 99-117%. No or little cross reaction with arginine- and lysine-vasopressin was found. Plasma oxytocin concentrations determined by the proposed enzyme immunoassay were well correlated with those determined by radioimmunoassay (r = 0.90). PMID- 2695319 TI - Effects of pancreastatin on insulin and pancreatic polypeptide secretion in the dog. AB - Porcine pancreastatin (1.19 nmol) was administered into the peripheral vein (i.v.) or the third cerebral ventricle (i.t.v.) of dogs and its effect on the secretion of insulin and pancreatic polypeptide (PP) studied. Neither means of administration had any effect on basal and glucose-induced insulin or PP secretion. However, i.v. pancreastatin did inhibit the i.v. CCK-8-induced insulin but not PP release. Pancreastatin may thus play a role in the regulation of insulin secretion in the canine pancreas. PMID- 2695320 TI - Albumin index in spot urine from outpatients with noninsulin-dependent diabetes mellitus. AB - The albumin index (mg/g . creatinine) was determined in untimed spot urine collected in the early morning from 92 randomly selected outpatients with noninsulin-dependent diabetes mellitus (NIDDM). The patients were divided into three groups: 49 patients with normo-albuminuria (albumin index less than 9.1), 24 with micro-albuminuria (albumin index between 9.1 and 100), and 19 with overt albuminuria (albumin index over than 100). With diabetic duration, the frequency of the patients with overt-albuminuria was increased, but that with normo albuminuria was decreased. The patients treated with only a diet almost showed normo-albuminuria. In contrast, micro-and overt-albuminuria were found more frequently in the patients treated with oral hypoglycemic agents or insulin. Micro- and overt-albuminuria were found more frequently in the patients with poor glycemic control than in those with good glycemic control. The urinary albumin index was significantly high in the micro-albuminuric patients with poor glycemic control. Similarly, micro- and overt-albuminuria were found more frequently in the patients associated with diabetic retinopathy or neuropathy than in those without diabetic complications. In addition, overt-albuminuria was found more frequently in the patients with hypertension. The urinary albumin index was significantly high in the overt-albuminuric patients with hypertension. In conclusion, the determination of the albumin index in spot urine may be outpatients with NIDDM. PMID- 2695321 TI - Plasma glucagon response to intravenous alanine in obese and non-obese subjects. AB - To investigate glucagon (IRG) and insulin (IRI) responses to alanine infusion in obesity and to assess the effect of body weight reduction with respect to hormonal balance, we compared six obese subjects with nine normal weight controls. None of the subjects were diabetic by OGTT criteria. Plasma IRI and IRG were measured following IV alanine at a rate of 0.1 g/kg over a period of 2 min. Our obese subjects had an increase in IRG response to alanine, which was due to decreased suppression of alpha-cell function due to insulin resistance. Weight reduction via calorie restriction reduced insulin demand, resulting in reduced plasma IRI by restoring beta-cell function, and the IRG response was paradoxically decreased as compared with that before weight loss. It is conceivable that improvements in insulin sensitivity after body weight reduction may re-establish the normalization of pancreatic beta-cell function and the insulin-induced inhibition of IRG secretion. Our obese subjects were characterized by decreased IRG secretion which was reflected in a change in body weight reduction. PMID- 2695322 TI - Modeling multiphase migration of organic chemicals in groundwater systems--a review and assessment. AB - Over the past two decades, a number of models have been developed to describe the multiphase migration of organic chemicals in the subsurface. This paper presents the state-of-the-art with regard to such modeling efforts. The mathematical foundations of these models are explored and individual models are presented and discussed. Models are divided into three groups: a) those that assume a sharp interface between the migrating fluids; b) those that incorporate capillarity; and c) those that consider interphase transport of mass. Strengths and weaknesses of each approach are considered along with supporting data for model validation. Future research directions are also highlighted. PMID- 2695323 TI - Adsorption of organic chemicals in soils. AB - This paper presents a review on adsorption of organic chemicals on soils sediments and their constituents. The first part of this review deals with adsorption from gas and liquid phases and gives a discussion on the physical meaning of the shape of adsorption isotherms. Results show that no general rules can be proposed to describe univocally the relation between the shape of isotherms and the nature of adsorbate-adsorbent system. Kinetics of adsorption is discussed through the description of various models. Theoretical developments exist both for the thermodynamics and the kinetics of adsorption, but there is a strong need for experimental results. Possible adsorption mechanisms are ion exchange, interaction with metallic cations, hydrogen bonds, charge transfers, and London-van der Waals dispersion forces/hydrophobic effect. However, direct proofs of a given mechanism are rare. Several factors influence adsorption behavior. Electronic structure of adsorbed molecules, properties of adsorbents, and characteristics of the liquid phase are discussed in relation to adsorption. Such properties as water solubility, organic carbon content of adsorbing materials, and the composition of the liquid phase are particularly important. Evaluation of adsorption can be obtained through either laboratory measurements or use of several correlations. Adsorption measurements must be interpreted, taking into account treatment of adsorbent materials, experimental conditions, and secondary phenomena such as degradations. Correlations between adsorption coefficients and water-octanol partition coefficient or water solubility are numerous. They may be useful tools for prediction purposes. Relations with transport, bioavailability, and degradation are described. PMID- 2695324 TI - Quantitative modeling of soil sorption for xenobiotic chemicals. AB - Experimentally determining soil sorption behavior of xenobiotic chemicals during the last 10 years has been costly, time-consuming, and very tedious. Since an estimated 100,000 chemicals are currently in common use and new chemicals are registered at a rate of 1000 per year, it is obvious that our human and material resources are insufficient to experimentally obtain their soil sorption data. Much work is being done to find alternative methods that will enable us to accurately and rapidly estimate the soil sorption coefficients of pesticides and other classes of organic pollutants. Empirical models, based on water solubility and n-octanol/water partition coefficients, have been proposed as alternative, accurate methods to estimate soil sorption coefficients. An analysis of the models has shown (a) low precision of water solubility and n-octanol/water partition data, (b) varieties of quantitative models describing the relationship between the soil sorption and above-mentioned properties, and (c) violations of some basic statistical laws when these quantitative models were developed. During the last 5 years considerable efforts were made to develop nonempirical models that are free of errors imminent to all models based on empirical variables. Thus far molecular topology has been shown to be the most successful structural property for describing and predicting soil sorption coefficients. The first order molecular connectivity index was demonstrated to correlate extremely well with the soil sorption coefficients of polycyclic aromatic hydrocarbons (PAHs), alkylbenzenes, chlorobenzenes, chlorinated alkanes and alkenes, heterocyclic and heterosubstituted PAHs, and halogenated phenols. The average difference between predicted and observed soil sorption coefficients is only 0.2 on the logarithmic scale (corresponding to a factor of 1.5). A comparison of the molecular connectivity model with the empirical models described earlier shows that the former is superior in accuracy, performance, and range of applicability. It is possible to extend this model, with the addition of a single, semiempirical variable, to take care of polar and ionic compounds and to accurately predict the soil sorption coefficients for almost 95% of all organic chemicals whose coefficients have been reported. No empirical or nonempirical models have ever predicted the soil sorption coefficients to such a high degree of accuracy on such a broad selection of structurally diverse compounds. An additional advantage of the molecular connectivity model is that it is sufficient to know the structural formulas to make predictions about soil sorption coefficients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2695325 TI - Principles and problems of environmental pollution of groundwater resources with case examples from developing countries. AB - The principles and problems of environmental pollution and contamination are outlined. Emphasis is given to case examples from developing countries of Africa, Asia, and Latin America with a comparative analysis to developed countries. The problems of pollution/contamination are widespread in developed countries but are gradually spreading from the urban to rural areas in the developing countries. Great efforts in research and control programs to check pollution-loading into the environment have been made in the industrialized countries, but only negligible actions have been taken in developing countries. Pollutants emanate from both point and distributed sources and have adversely affected both surface water and groundwaters. The influences of the geologic and hydrologic cycles that exacerbate the incidences of pollution/contamination have not been well understood by environmental planners and managers. Professionals in the different areas of pollution control projects, particularly in developing countries, lack the integrated multiobjective approaches and techniques in problem solving. Such countries as Nigeria, Kenya, Brazil, and India are now menaced by pollution hazards. Appropriate methods of control are hereby suggested. PMID- 2695326 TI - Prediction of contaminant retention and transport in soils using kinetic multireaction models. AB - Mathematical models that describe the retention reactions of contaminants in the soil system are presented. Single and multireaction-type models for simultaneous retention and transport in the soil profile are discussed. Single retention models are classified into two types: equilibrium and kinetic models. Emphasis is given to the nonlinearity and kinetic behavior of solute retention processes in soils. Two-site models that include the equilibrium-kinetic types as well as the fully kinetic type are also examined. A multireaction-type model is also presented, which includes reversible and irreversible retention processes of the equilibrium and kinetic types. Advantages of the multireaction approach over the single or two-site models are discussed. The predictive capability of the two site model and the multireaction model for their description of experimental results for phosphorus and two heavy metals (Cd and Cr) are examined. PMID- 2695327 TI - Applications of numerical methods to simulate the movement of contaminants in groundwater. AB - This paper reviews mathematical models and numerical methods that have been extensively used to simulate the movement of contaminants through the subsurface. The major emphasis is placed on the numerical methods of advection-dominated transport problems and inverse problems. Several mathematical models that are commonly used in field problems are listed. A variety of numerical solutions for three-dimensional models are introduced, including the multiple cell balance method that can be considered a variation of the finite element method. The multiple cell balance method is easy to understand and convenient for solving field problems. When the advection transport dominates the dispersion transport, two kinds of numerical difficulties, overshoot and numerical dispersion, are always involved in solving standard, finite difference methods and finite element methods. To overcome these numerical difficulties, various numerical techniques are developed, such as upstream weighting methods and moving point methods. A complete review of these methods is given and we also mention the problems of parameter identification, reliability analysis, and optimal-experiment design that are absolutely necessary for constructing a practical model. PMID- 2695328 TI - Comparative in vitro antibacterial activity of the new carbapenem meropenem (SM 7338). AB - The in vitro antimicrobial activity of the new carbapenem meropenem (SM-7338) was determined by an agar dilution method in comparison with imipenem, ticarcillin/calvulanic acid, ceftazidime and the fourth-generation cephalosporin cefepime (BMY 28142). Meropenem showed superior activity against Enterobacteriaceae (MIC90 less than or equal to 0.06 mg/l) and against non fermentative gram-negative rods, with the exception of Xanthomonas maltophilia. Meropenem had excellent activity against beta-lactamase-producing Haemophilus influenzae and Neisseria gonorrhoeae, and against the Bacteroides fragilis group. Imipenem was slightly more active then meropenem against gram-positive cocci especially Enterococcus faecalis. PMID- 2695329 TI - Effects of cilofungin (LY121019) on carbohydrate and sterol composition of Candida albicans. AB - Cilofungin (LY 121019) is a novel analogue of echinocandin B with potent activity against Candida albicans. The effects of cilofungin on the sterol and cell wall carbohydrate composition of Candida albicans were investigated. Exposure of Candida albicans to cilofungin resulted in a 55-60% decrease in ergosterol and a 4-13% decrease in lanosterol content relative to controls. Carbohydrate analysis revealed a 72-79% decrease in glucan content and no significant decrease in mannan or chitin content relative to controls. These studies suggest that cilofungin specifically inhibits glucan synthesis in Candida albicans and thus may be less toxic to mammalian cells. The effects of cilofungin on sterol composition may be non-specific and will require additional investigation. PMID- 2695330 TI - Quinolones and the gastrointestinal tract. AB - A number of studies have evaluated the efficacy of the new fluoroquinolones for therapy of bacterial enteric diseases and for prevention of gram-negative sepsis in granulocytopenic patients. The success of the quinolones in these settings is related to several special features of these agents, including their spectrum of activity and high fecal levels, which are in turn reflected in their effect on the gastrointestinal flora. Other factors that are important, particularly for invasive disease such as typhoid fever and shigellosis, include good intracellular and bowel wall penetration, and lymph node and systemic drug concentrations many times higher than the MICs of the causative organisms. This article reviews the factors that contribute to the changes in fecal flora, and the results of clinical studies in patients with diarrhea, granulocytopenic patients, and patients with selected other infections of, or related to, the gastrointestinal tract. PMID- 2695331 TI - Clinical utility of new quinolones in treatment of osteomyelitis and lower respiratory tract infections. AB - In the eight major clinical studies published on use of oral quinolones in therapy of contiguous osteomyelitis, clinical and microbiologic cure/improvement rates were 75% and 73%, respectively, when drug therapy was combined with appropriate surgical debridement. This included many cases of polymicrobial osteomyelitis, as well as infection caused by recalcitrant pathogens such as Pseudomonas aeruginosa. In contrast, the response of staphylococcal osteomyelitis to oral quinolones, especially in cases caused by methicillin-resistant strains, appeared suboptimal. Quinolones appear to have a limited role in the treatment of community-acquired pneumonia, since other established antibiotic regimens have been proven effective in such situations. Quinolones may play an important role in the treatment of nosocomially acquired aerobic gram-negative bacillary pneumonia, either as primary parenteral therapy or as transitional oral therapy when affected patients become outpatients. In cystic fibrosis-associated acute exacerbations of chronic pseudomonal pneumonitis, the outcome of oral ciprofloxacin therapy was very satisfactory in the six major studies reported (approximately 85% improvement rates). In three comparative studies oral quinolone treatment of such pulmonary exacerbations resulted in clinical response rates equivalent to those for aminoglycoside plus beta-lactam therapy given intravenously. Quinolone-resistant Pseudomonas aeruginosa strains were commonly isolated from sputum during treatment; however, such patients continued to respond clinically to quinolone treatment, and sputum became rapidly repopulated with quinolone-susceptible Pseudomonas aeruginosa strains after discontinuation of therapy. PMID- 2695333 TI - Vascular control by purines with emphasis on the coronary system. AB - There is growing evidence for several different roles for purines in the control of blood flow. (1) Adenosine 5'-triphosphate (ATP) acts as a cotransmitter with noradrenaline and neuropeptide Y released from sympathetic perivascular nerves. In most vessels it acts via P2x-purinoceptors to produce vasoconstriction synergistically with alpha-adrenoceptor activation, while in some coronary vessels it appears to act via P2Y-purinoceptors to produce vasodilatation in concert with beta-adrenoceptor activation. (2) Adenosine, via P1-purinoceptors, acts as a prejunctional modulator of transmitter release from perivascular nerves; it also acts directly on vascular smooth muscle to produce vasodilatation. (3) ATP is stored in and released from vascular endothelial cells (including those from the coronary bed) during changes in blood flow or during hypoxia, and acts via P2Y-purinoceptors on endothelial cells to release endothelium-derived relaxing factor, resulting in vasodilatation. (4) ATP may be released together with substance P and calcitonin gene-related peptide from some sensory nerves during 'axon-reflex' activity when antidromic impulses pass down collaterals supplying blood vessels. (5) Finally, there is evidence to suggest that ATP released from intrinsic (non-sympathetic) neurones in the airways and heart has potent actions on the resistance vessels. PMID- 2695332 TI - Quinolone antibacterial agents for the treatment of genitourinary tract infections. AB - The fluoroquinolones have expanded the therapeutic options available for the treatment of genitourinary tract infections. Their ease of oral administration, favourable pharmacokinetics, low incidence of adverse reactions, and broad spectrum of in vitro activity against aerobic and facultative organisms make them especially suitable for treating bacteriuria, particularly when pathogens are resistant to other available oral agents. Their efficacy has also been established in the treatment of prostatis, gonorrhea and chancroid. They have lower in vitro activity against chlamydia, ureaplasma and anaerobes, and their role in the treatment of non-gonococcal urethritis, vaginitis and acute pelvic inflammatory disease is less well established. PMID- 2695334 TI - Coronary vasomotor tone: a heterogeneous entity. AB - Changes in coronary vasomotor tone are undoubtedly involved in the pathogenesis of many ischaemic coronary syndromes. The term coronary artery 'spasm' should be limited to the situations characterized by focal coronary constriction sufficient to cause transient total or sub-total coronary occlusion. Mild coronary artery constriction is also observed in many other situations, without even causing coronary artery occlusion. We present suggestive evidence that the mechanisms underlying coronary artery 'spasm' and 'physiological' coronary artery constriction are different. PMID- 2695335 TI - Morphometric versus densitometric assessment of coronary vasomotor tone--an overview. AB - The main advantage of the morphometric approach is that the spatial orientation of the vessel with respect to the image intensifier is not very important. Its most severe limitations are that reasonable accuracy can only be obtained with circular lumina, and that accuracy decreases rapidly with the vessel diameter. The densitometric approach is much less dependent on the shape of the lumen and on the correct identification of the vessel wall in the image. A further essential advantage is that one measures directly the cross-sectional area of the vessel instead of a 'diameter' of low haemodynamic relevance. Severe requirements must however be met if the potential accuracy of densitometry is to be fully exploited. The morphometric approach seems thus preferable for absolute or relative diameter measurements on intact vessels, while densitometry is superior in case of irregular or small lumina. Morphometric calibration using the injection catheter can induce non-negligible errors in both approaches. Grid calibration is probably more accurate, but also more tedious. In the densitometric approach, '3D-calibration' by help of a cube of known size allows also determination of the spatial orientation of the vessel in space. This solution requires however biplane imaging. PMID- 2695336 TI - Neurogenic regulation of coronary vasomotor tone. AB - Controversies on acetylcholine-induced increases or decreases in coronary blood flow arise from obvious species differences, the role of endothelium in mediating vascular smooth muscle responses and the marked negative chronotropic and inotropic effects of acetylcholine. In man, there appears to be a predominant dilation of intact epicardial coronary arteries and a constriction of atherosclerotic segments. However, at present there is no evidence for a vagal initiation of myocardial ischaemia. Coronary vascular beta-receptors mediate dilation, but appear to be functionally insignificant during sympathetic activation. The beta-adrenergic mechanisms contributing to myocardial ischaemia are indirect, mediated by a tachycardia-related redistribution of blood flow away from the ischaemic myocardium. alpha-receptors mediating epicardial coronary artery constriction in experimental studies appear not to be responsible for the initiation of ischaemia in patients with angina at rest. However, alpha adrenergic constriction of coronary resistance vessels resulting in the precipitation of poststenotic myocardial ischaemia was demonstrated in experimental studies and recently confirmed in patients with effort angina. PMID- 2695337 TI - A new endothelium-dependent vasoconstricting factor (EDCF) in pig coronary artery. AB - In order to investigate the influence of the endothelium on hypoxia-induced vasospasms we examined vascular tone after reduction of the oxygen supply, dependent on endothelial function. Therefore, after ligation of all side branches, vessel segments of porcine or human right coronary arteries or of rabbit abdominal aorta, prepared either with or without endothelium, were cannulated, perfused with Tyrode's solution and arranged in a serial manner (system I: endothelium-denuded vessel followed by a normal segment; system II: normal vessel followed by an endothelium-denuded segment). The pressure gradient over each segment was continuously measured as a function of vessel radius. After 2 h equilibration the oxygen concentration in the perfusion and superfusion solutions was lowered (reduction from 'control' = 95% O2/5% CO2 to 'hypoxia' = 95% N2/5% CO2) leading to a marked long-lasting vasoconstriction in those endothelium-denuded vessel segments which were mounted distal to a normal vessel with an intact endothelium, whereas the other vessels did not change their tone. This hypoxic contraction could be inhibited by pretreatment with either 1 mumol l 1 dexamethasone or quinacrine or indomethacine. From these results it is concluded that endothelium releases a vasoconstricting factor (EDCF) under hypoxic conditions probably dependent on phospholipase A2 and cyclooxygenase. This EDCF may be of pathophysiological importance by inducing or aggravating hypoxic vasospasms. PMID- 2695338 TI - Effects of opioid drugs on capsaicin-sensitive neurones in guinea-pig atria. AB - Transmural nerve stimulation of isolated guinea-pig atria in the presence of atropine induced a biphasic positive inotropic effect but only a slow increase in contractility (NANC response) in atria obtained from 6-hydroxy-dopamine pretreated animals. The latter effect disappeared after exposure of the preparations to capsaicin. The effects of some opioid peptides were investigated on NANC responses. [D-Ala2,D-Leu5]enkephalin (DADLE) and [D-Ala2,N-Me-Phe4,Gly5 ol]enkephalin (DAGO, 0.1-10 microM) inhibited the cardiac response to transmural nerve stimulation in a dose-dependent and naloxone-sensitive manner. Dynorphin-(1 13) and morphine, at 10-fold higher concentrations (1-10 microM), reduced the response in a naloxone-sensitive manner. Naloxone alone however did not affect the response. Opioid peptides were not able to reduce the positive inotropic effect induced by calcitonin gene-related peptide (CGRP), or the increase in cardiac contractility produced by capsaicin. These results suggest that opioid receptors exert a modulatory role on peripheral terminals of capsaicin-sensitive sensory nerves. PMID- 2695339 TI - NG-monomethyl-L-arginine does not inhibit the hindquarters vasodilator action of endothelin-1 in conscious rats. AB - Regional haemodynamic responses to endothelin-1 were assessed in conscious, unrestrained Long Evans rats, chronically instrumented with pulsed Doppler flow probes. Bolus injection of endothelin-1 (0.04 nmol) caused an early transient hypotension and increase in hindquarters vascular conductance. In the presence of NG-monomethyl-L-arginine (L-NMMA), which inhibits endothelial cell nitric oxide production, the hindquarters vasodilator response to endothelin-1 was unchanged and similar to that seen in the presence of vasopressin when the latter was infused to simulate the pressor effects of L-NMMA. These results indicate that the hindquarters vasodilatation in response to endothelin-1 is not dependent upon release of nitric oxide from endothelial cells. PMID- 2695340 TI - Guinea-pig tracheal epithelium and endothelin. AB - Removal of the epithelium increased the responsiveness of isolated guinea-pig trachea to the contractile effects of endothelin. This phenomenon was observed in the presence of indomethacin (5 microM), captopril (10 microM), bacitracin (20 micrograms/ml) or leupeptin (50 microM), but was inhibited by phosphoramidon (10 microM). Bacitrain enhanced contraction produced by endothelin. The increased responsiveness of denuded guinea-pig trachea to endothelin may be due to removal of an epithelium-derived phosphoramidon-sensitive peptidase. PMID- 2695341 TI - Epithelial modulation of non-adrenergic, non-cholinergic and vasoactive intestinal peptide-induced responses: role of neutral endopeptidase. AB - Relaxation of guinea-pig trachea was induced by vasoactive intestinal peptide (VIP) or electrical field stimulation. Mechanical removal of airway epithelium potentiated responses to VIP and attenuated inhibitory non-adrenergic, non cholinergic (i-NANC) responses to low stimulation frequencies. Phosphoramidon potentiated responses to VIP in intact but not de-epithelialised preparations, and had no effect on i-NANC responses. These findings suggest that neutral endopeptidase localised to the epithelium may modulate relaxation of guinea-pig trachea induced by VIP but not i-NANC nerve-stimulation. PMID- 2695342 TI - [Natural science and medicine of the Renaissance]. PMID- 2695343 TI - The anatomy of the limbus. AB - The limbus forms the border between the transparent cornea and opaque sclera, contains the pathways of aqueous humour outflow, and is the site of surgical incisions for cataract and glaucoma. Externally the epithelial cell border between conjunctiva and cornea possesses multipotential cells important for differentiation of the respective cell types. By the same token, the internal limbal border zone between corneal endothelium and anterior trabeculum appears to contain specialised cells some of which are activated to migrate and repopulate the trabecular meshwork after trabecular injury. The oblique interface between corneal and scleral stroma determines the appearance of the surgical limbus whose landmarks vary around the circumference of the globe but predictably correlate with structures of the anterior chamber angle. The vasculature of the limbus derives in primates primarily from the anterior ciliary arteries. Their superficial branches form arcades to supply the limbal conjunctiva and peripheral cornea. Perforating branches contribute to the vascular supplies of the deep limbal structures and the anterior uvea. PMID- 2695344 TI - The multipotential cells of the limbus. AB - Ample evidence exists that there is a centripetal movement of cells from the periphery of the cornea toward the centre. While conjunctival cells have the capacity to transdifferentiate into corneal epithelial cells, the limbal region appears to act as a barrier between the conjunctival and corneal epithelia, even after large epithelial defects are created. The existence of limbal stem cells is suggested by the apparent role of the limbus in acting as a source of peripheral corneal cells. While specific staining of limbal cells has been reported in the rabbit, there is no positive identification of such stem cells in the human. However, in the human there is negative staining for both a keratin cytoskeleton antigen and a cell surface antigen in the limbal epithelial zone. Efforts positively to identify human limbal stem cells continue, as do efforts to culture and transplant such cells. PMID- 2695345 TI - The circulation of fluid at the limbus (flow and diffusion at the limbus). AB - Diffusion of molecules, e.g. ions, proteins, etc. and flow of water takes place across the physiological limbus. This 'structure' is estimated to be a zone approximately 1 mm in width and to bridge the anatomical limbus. The source of most molecules that diffuse into the corneal stroma across the limbus under normal circumstances is the perilimbal vascular system with its rich capillary bed. Small ions are lost within 2-3 mm of movement into the stroma, whereas larger molecules may diffuse to the centre of the cornea. Diffusion or flow may be bidirectional; however, it is anticipated that the majority of the flow, albeit small, is inward toward the cornea. The sclera, compared to the corneal stroma, has been found to be less resistant to fluid flow, but more resistant to diffusion of ions and larger molecules. Under normal circumstances, there have been few substances identified of importance that diffuse or flow across the limbus in either direction. There are a number of substances that traverse the limbus that are of importance in disease states, e.g. Wilson's disease, with the corneal Kaiser-Fleischer ring and angiogenic factors stimulating corneal neovascularisation. Under normal circumstances, the limbus would, therefore, seem to be more important as a zone that restricts flow and diffusion rather than an area of active molecular movement. PMID- 2695346 TI - The circulation of the human limbus. AB - The superficial circulations of the anterior segment of the human eye have been studied by the following techniques: photographic and video low-dose fluorescein angiography, video-microscopy using red-free light and stereoscopic colour photography. The results are combined to give a dynamic description of the limbal circulation, including its arterial supply and venous drainage. PMID- 2695347 TI - Concept and application of limbal stem cells. AB - Cumulative reported evidence indicates that some fraction of limbal basal epithelial cells are the stem cells for corneal epithelial cell proliferation and differentiation. Limbal epithelium is therefore crucial in maintaining the cell mass of corneal epithelium under normal conditions and plays an important role in corneal epithelial wound healing. Deficiency or absence of limbal stem cells explains well the pathogenesis of several ocular surface disorders characterised by defective conjunctival transdifferentiation or conjunctivalisation of cornea. This paper reviews and updates the basic concept of stem cells, the reported findings of limbal stem cells for corneal epithelium, and their therapeutic applications. Through this review, one hopes to gain a more complete understanding and increase proficiency in treating these diseases. PMID- 2695348 TI - The role of the limbus in corneal allograft rejection. AB - The state of the recipient peripheral cornea and limbus exerts a strong influence on subsequent corneal graft survival. In particular, graft outcome is influenced by the number of dendritic cells (Langerhans cells) that have infiltrated the graft bed from the limbus. The number of dendritic cells present in the donor button also affects subsequent graft survival. PMID- 2695349 TI - Cellular response to inflammation at the limbus. AB - The role in ocular (limbal) inflammation of the rich vascular and lymphatic supply is discussed in detail. The distribution of lymphocytes, mast cells, Langerhans cells, macrophages and other cellular elements are discussed as well as their individual and collective response to inflammation whether due to infectious or non-infectious disease states. Among the non-infectious causes of limbal cellular inflammation are the four types of hypersensitivity response. PMID- 2695350 TI - Limbal allergic granulomatosis. AB - Four limbal diseases characterised by granuloma formation as part of an allergic response are discussed. A series of histological specimens from patients with Wegener's granulomatosis were re-examined. Genuine granulomatous disease at the limbus is rare, only occurring in two patients, whilst secondary, more non specific limbal active chronic inflammation was more common. Comparisons between this disease, Churg Strauss allergic angiitis, some varieties of Mooren's ulcer and allergic granulomatous nodules were made. The role of the mast cell in promoting this eosinophilic leucocytic mediated group of disease is discussed briefly. PMID- 2695351 TI - Superior limbic keratoconjunctivitis (SLK). AB - Superior limbic keratoconjunctivitis (SLK) is a disease characterised by inflammation of the upper palpebral and superior bulbar conjunctiva, keratinisation of the superior limbus and corneal and conjunctival filaments. It may be associated with other diseases such as keratoconjunctivitis sicca, hyperthyroidism and hyperparathyroidism. Although its exact aetiology is unknown, a mechanical hypothesis seems most attractive. Treatment is aimed at altering the abnormal mechanical interaction of the upper lid and superior corneal limbus. PMID- 2695352 TI - The pathology of tumours at the limbus. AB - The histopathology of tumours originating at the corneoscleral limbus is reviewed with special reference to some 636 specimens examined over a 40 year period at the Institute of Ophthalmology, London. Over half the lesions involved melanocytes (351 cases) derived from the limbal conjunctiva and of these two thirds were benign naevi. Conversely, benign squamous cell tumours were rare, only five unequivocal papillomas having been seen compared with 137 premalignant lesions and 73 carcinomas. Solid dermoids accounted for approximately 10 per cent of all tumours involving the limbus. PMID- 2695353 TI - Pathogenesis of pterygium. AB - This paper reviews the histological and epidemiological characteristics of pterygium which suggest that chronic exposure to ultraviolet radiation plays an important role in the pathogenesis of this disorder. However, there is conflicting evidence indicating that chronic inflammation from other causes can induce the disease. The results of two epidemiological surveys undertaken in Southern Africa show that pterygium is not closely linked to other chronic actinic disorders such as pinguecula and climatic droplet keratopathy. Pterygia differ from these disorders by their vascularity which is probably induced by chronic inflammation. On histological examination, we found that excised pterygia contained a lymphocytic infiltration consisting predominantly of T cells. In the pathogenesis of pterygium we believe that chronic irritation (from whatever cause) produces a chronic inflammatory cell infiltration with resultant inflammatory oedema, attempt at repair and cell induced angiogenesis. These processes, together with actinic damage, are responsible for the fibrovascular reaction so characteristic of a growing pterygium. PMID- 2695354 TI - Lipid deposition at the limbus. AB - Lipid deposition at the limbus is a feature of familial and non-familial dyslipoproteinemias and can also occur without apparent accompanying systemic abnormality. Hyperlipoproteinemia, most notably type II hyperlipoproteinemia, is frequently associated with bilateral corneal arcus, with less common association in types III, IV and V. Diffuse bilateral opacification of the cornea with accentuation towards the limbus is a feature of HDL deficiency syndromes and LCAT deficiency. Whereas the lipid accumulation of hyperlipoproteinemia may be representative of excessive insudation of lipoprotein from plasma into the cornea that of hypolipoproteinemia is more likely to be a consequence of defective lipid clearance. The situation is yet further complicated by the modifying influences of secondary factors, both local and systemic. PMID- 2695355 TI - Direct mycological examination in dermatology: a comparison of different methods. AB - Direct examination for fungi in skin and nail scrapings can be done by light microscopy with or without staining, or by fluorescence microscopy using specific fluorochromes for the fungal cell wall constituents. The principal techniques described in the literature and two new methods (Congo red and Na2S-Blankophor P flussig) were compared for their efficiency and rapidity. PMID- 2695357 TI - Association of cutaneous T cell lymphoma and bullous pemphigoid. PMID- 2695356 TI - Interleukin 1 alpha and beta in psoriatic skin: enzymoimmunoassay, immunoblot studies and effect of systemic retinoids. AB - Interleukin 1 alpha (IL-1 alpha) and interleukin 1 beta (IL-1 beta) proteins were studied by enzymoimmunoassay (EIA) and Immunoblot analysis in the 10,000 g supernatant of normal and psoriatic (lesional and nonlesional) human skin specimens. By EIA IL-1 alpha was the principal form detected in all the specimens, which contrasts with the predominance of IL-1 beta in human blood monocytes. In psoriatic plaques relatively less IL-1 alpha and more IL-1 beta were detected. On Immunoblot analysis the mature form (17 kD) was not detected in normal skin, which showed only 52-kD immunoreactive forms. In contrast the 17-kD form was found in psoriatic skin. This indicates either a distinct processing of IL-1 molecules or a contribution of inflammatory cells infiltration to the IL-1 pool in psoriatic plaques. During systemic retinoids therapy the amount of both IL-1 species decreased in lesional and nonlesional psoriatic skin. PMID- 2695358 TI - Molecular biology of Na+/glucose cotransport. PMID- 2695359 TI - Mechanisms of protein import into the endoplasmic reticulum and protein export in Escherichia coli. PMID- 2695360 TI - Protein secretion in Escherichia coli with particular reference to haemolysin. PMID- 2695361 TI - Provision of biosciences information in the academic environment: experience of a large academic library in accessing bibliographic databases. PMID- 2695362 TI - Activation of cellular p21ras by myristoylation. AB - p21ras is palmitoylated on a cysteine residue near the C-terminus. Changing Cys 186 to Ser in oncogenic forms produces a non-palmitoylated protein that fails to associate with membranes and does not transform NIH 3T3 cells. To examine whether palmitate acts in a general way to increase ras protein hydrophobicity, or is involved in more specific interactions between p21ras and membranes, we constructed genes that encode non-palmitoylated ras proteins containing myristic acid at their N-termini. Myristoylated, activated ras, without palmitate (61Leu/186Ser) exhibited both efficient membrane association and full transforming activity. Unexpectedly, we found that myristoylated forms of normal cellular ras were also potently transforming. Myristoylated c-ras retained the high GTP binding and GTPase characteristic of the cellular protein and, moreover, bound predominantly GDP in vivo. This implied that it continued to interact with GAP (GTPase-activating protein). While the membrane binding induced by myristate permitted transformation, only palmitate produced a normal (non-transforming) association of ras with membranes and must therefore regulate ras function by some unique property that myristate does not mimic. Myristoylation thus represents a novel mechanism by which the ras proto-oncogene protein can become transforming. PMID- 2695363 TI - Acylation of HIV proteins. PMID- 2695364 TI - Post-translational processing of ras proteins. PMID- 2695365 TI - Transport of peptides across the gastrointestinal tract. PMID- 2695366 TI - Peptidase activities in absorptive mucosae. PMID- 2695367 TI - Transcytosis of drug carriers carrying peptides across epithelial barriers. PMID- 2695368 TI - Rectal route of administration for peptides. PMID- 2695369 TI - Hyperproinsulinemia and amyloid in NIDDM. Clues to etiology of islet beta-cell dysfunction? AB - Impaired islet function is a feature of non-insulin-dependent diabetes mellitus (NIDDM), which is manifested in part by disproportionate proinsulin release. A disproportionate increase in proinsulin also occurs in insulinomas, suggesting that enhanced proinsulin release results from an increase in synthesis and premature release of proinsulin-rich immature granules in both conditions. However, recent human and animal studies suggest that normal beta-cells respond to an increase in synthetic demand by enhancing their ability to process proinsulin. Thus, impaired processing of proinsulin is likely in NIDDM. A new point of similarity with insulinoma has been the demonstration of a novel pancreatic peptide isolated from insulinomas and the pancreas of patients with NIDDM. This peptide, named islet amyloid polypeptide or amylin, is also present in normal islets. Because of its association with two apparently dissimilar disease states, we propose a hypothesis that encompasses the observations related to proinsulin and islet amyloid polypeptide and suggest they are manifestations of the same abnormality. In this hypothesis, we suggest that this new pancreatic peptide is a normal participant in the process of proinsulin processing and storage. We also suggest that in the presence of defective proinsulin processing and insulin release, as occurs in NIDDM, hyperglycemia stimulates amylin biosynthesis so that this peptide is deposited in increased quantities in the islet as amyloid. This then further exacerbates the diabetic process, resulting in progressive hyperglycemia and deterioration in islet function. PMID- 2695370 TI - Age-dependent stimulation of neonatal insulin release and inositol phosphate accumulation by CCK-8 and carbachol. AB - Development of a robust insulin secretory response to glucose occurs during the early neonatal period. To determine if neuroendocrine agents play a role during this time, we studied the effects of selected peptides and neurotransmitters on insulin release and polyphosphoinositide metabolism in islets isolated from 1- and 3-day neonatal rats. Vasoactive intestinal peptide had no effect on glucose stimulated release in either islet population. In contrast, sulfated cholecystokinin octapeptide (CCK-8) significantly enhanced glucose-induced insulin release in both islet groups. One-day islets were stimulated only by a concentration of 300 nM, whereas 3-day islets were responsive at 3 nM. Similar to CCK-8, there were clear differences in responses to carbachol between 1- and 3 day islets. One-day islets required a concentration of 200 microM for insulin release to be significantly greater than with glucose alone; 3-day islet insulin release was significant at 2 microM carbachol. Both agonists stimulated inositol phosphate accumulation in 3-day islets, but only CCK-8 caused a significant increase over glucose-induced levels in 1-day islets. These results indicate that islet responsiveness to CCK-8 and carbachol develops in parallel during the early neonatal period. This development may be linked to the maturation of a critical step of stimulus-secretion coupling through which these agents act. PMID- 2695371 TI - Peripheral neuropathy in diabetic monkeys. AB - Peripheral neuropathy is a significant complication of human diabetes and a source of morbidity. Appropriate experimental models may aid in understanding its pathogenesis and in developing therapeutic strategies. We sought to determine whether spontaneously diabetic obese adult monkeys developed peripheral neuropathy and whether it occurred early or late in relation to the onset of hyperglycemia. We studied nerve conduction in both motor (peroneal, median, and ulnar) and sensory (median and ulnar) nerves in 13 adult male rhesus monkeys, 4 overtly diabetic and 9 nondiabetic (mean age 21 +/- 2 and 16 +/- 2 yr, respectively, NS; mean fasting plasma glucose 14.5 +/- 3.4 and 4.4 +/- 0.6 mM, P = .001). The diabetic animals had significantly reduced motor conduction velocities and prolonged F-wave latencies. Motor-evoked amplitudes did not differ. In the diabetic monkeys, nerve conduction times were increased in motor fibers, which could be identified as early as 2 yr after the onset of hyperglycemia. These abnormalities are similar to those seen in humans and suggest further study of these animals as a primate model of human diabetic neuropathy. PMID- 2695372 TI - Insulin release in RINm5F cells and glyceraldehyde activation of protein kinase C. AB - In the insulin-secreting, glucose-insensitive islet cell subclone RINm5F, the distribution of protein kinase C (PKC) activity in the cytosol and membrane fractions was determined, and the activation of the enzyme, as reflected in its translocation to the membrane fraction, was characterized in conjunction with insulin release. DL-Glyceraldehyde (15 mM) evoked a rapid redistribution of PKC from the cytosol to the membrane fraction; insulin release increased concomitantly. When monitored over 5 min with 15 mM glyceraldehyde, membrane stabilization of PKC reached a maximum at 30 s and decreased thereafter; insulin release occurred at a high rate for the first 15 s and diminished thereafter. With 2-20 mM glyceraldehyde, a dose-dependent increase in membrane stabilization of PKC occurred and was accompanied by a matching increase in insulin release. Exogenous 1,2-dioctanoyl-sn-glycerol (100 microM) induced a rapid membrane stabilization of PKC and concomitant stimulation of insulin release. Glucose (15 mM) failed to evoke any redistribution of PKC or release of insulin. Depletion of total PKC activity by 95% induced by 18-h incubations with 2 microM 12-O tetradecanoylphorbol-13-acetate resulted in a 67-91% reduction in glyceraldehyde induced insulin release. We conclude that in the RINm5F islet beta-cell subclone 1) the rapid activation of PKC, which occurs in response to the administration of glyceraldehyde, a nutrient secretagogue, plays an amplifying role in the initiation of stimulated insulin release; and 2) the failure of the activation of PKC may be responsible for the insensitivity to glucose. PMID- 2695373 TI - Long-term effects of vanadyl treatment on streptozocin-induced diabetes in rats. AB - The vanadate and vanadyl forms of vanadium have been shown by many investigators to have insulinlike effects on glucose metabolism. Many investigators have shown that vanadium, or its salts, counteracts the hyperglycemia associated with streptozocin-induced diabetes (STZ-D) in the rat, although insulin secretion remains depressed. Studies of the action of vanadate on insulin secretion and glucose metabolism have not addressed the question of possible long-term effects of this compound on glucose metabolism extending beyond the period of oral administration. This study was undertaken to assess the effects of treatment (3 wk) and withdrawal of vanadyl sulfate (13 wk) on glucose metabolism, insulin secretion, and islet insulin content of STZ-D rats. Our results indicate that STZ D rats that have had blood glucose levels normalized by 3 wk of vanadyl treatment remain normoglycemic after 13 wk of withdrawal from treatment. Normal glucose tolerance was observed in vanadyl-treated diabetic animals despite depressed fasting and glucose-stimulated plasma insulin levels. Insulin secretion from the isolated perfused pancreas was greater after vanadyl treatment than in untreated diabetic rats, although it was only 12% of values from controls. Three weeks of vanadyl treatment of STZ-D rats, followed by 13 wk of withdrawal, yielded islets close in size and insulin content of control islets, even though in vivo and in vitro insulin secretion was impaired. This study has shown that short-term vanadyl treatment of STZ-D rats yields normalization of glucose tolerance and protection of islets from destruction by STZ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695374 TI - Correlation between residual beta-cell function and islet cell antibodies in newly diagnosed type I diabetes. Follow-up study. AB - To establish whether there is a correlation between the autoimmune response to the islets and beta-cell function during the initial stages of type I (insulin dependent) diabetes, and islet cell antibody (ICA) titer and C-peptide levels (fasting and glucagon stimulated) were determined in 39 newly diagnosed patients at onset of diabetes and every 3-6 mo for 2 yr. ICAs were detected in 74% of the patients, and beta-cell function was detected in 84% of the patients at onset. The ICA+ and ICA- groups had similar C-peptide values at diagnosis and at 3 mo, but from 6 mo on, the ICA+ group consistently showed a tendency to lose C-peptide secretory capacity more quickly when assessed by fasting and glucagon-stimulated C-peptide levels (ICA+ vs. ICA- fasting C-peptide levels at 18 and 24 mo, P = .013 and .017, respectively; ICA+ vs. ICA- glucagon-stimulated C-peptide levels at 6, 18, and 24 mo, P = .023, .007, and .028, respectively). The initial ICA titer had the highest predictive value on the outcome of beta-cell function (P = .04), and patients with complement-fixing ICAs did not behave differently from the general ICA+ group. This correlation between beta-cell function and ICA titer supports the role of autoimmunity in the pathogenesis of type I diabetes and has important implications for the design of immunotherapy trials. PMID- 2695375 TI - Distribution of in vivo insulin action in Pima Indians as mixture of three normal distributions. AB - If a single gene produced insulin resistance, with environmental effects creating some additional variance, insulin action might be distributed as a mixture of two normal distributions if the gene is dominant or recessive or as a mixture of three normal distributions if the gene is codominant. To estimate maximal insulin stimulated glucose uptake rates (MaxMs), hyperinsulinemic-euglycemic clamps were performed on 245 nondiabetic Pima Indians (126 men, 119 women). Five models (for 1, 2, 3, 4, or 5 components each, normally distributed with a common variance) were fitted to the frequency distribution of MaxM by iterative maximum-likelihood estimation. The three-component model fit the data significantly better than a single normal distribution (chi 2 = 14.3 with 4 df P less than .01) or a mixture of two normal distributions (chi 2 = 9.9 with 2 df, P less than .01). Mixtures of four or five normal distributions did not fit the data significantly better than a mixture of three normal distributions. The first component of the distribution comprised 23%, the second 48%, and the third 29% of the total distribution. Similarly, the frequency distributions of fasting plasma insulin concentrations and a principal component score derived from MaxM and fasting insulin were best fitted by a mixture of three normal distributions. These results are consistent with the hypothesis that among Pimas, insulin resistance is determined by a single gene with a codominant mode of inheritance. Segregation analyses of studies performed in pedigrees are indicated to prove or disprove this genetic hypothesis. PMID- 2695376 TI - Ganglioside expression in human pancreatic islets. AB - Recent biochemical studies have shown that the cytoplasmic islet cell-antibody autoantigen has properties of a monosialoganglioside (GM). To characterize islet glycolipids and ascertain whether islets express unique gangliosides, we determined the pattern of ganglioside expression in whole human pancreas and isolated human islets using high-performance liquid chromatography (HPLC) and high-performance thin-layer chromatography (HPTLC). The major gangliosides detected in glycolipid extracts of whole human pancreas were GM3, GD3 (disialoganglioside), and in a lesser amount, a GD1a-comigrating ganglioside. In contrast to whole human pancreas, isolated human islets were found to predominantly express GM3, an acidic glycolipid comigrating with GM2, and a ganglioside with mobility between GM2 and GM1 by both HPLC and HPTLC. Quantitation of the major ganglioside UV peaks seen on HPLC gave the following results. In whole pancreas, GM3 represented 66.7% of total gangliosides detected; an asialoglycolipid comigrating with GM2, 2.0%; a ganglioside migrating between GM2 and GM1, 2.6%; GD3, 22.6%; and a GD1a-comigrating ganglioside, 6.1%. In isolated islets, these components were found at the following levels: GM3, 14.9%; GM2-comigrating glycolipid, 74.2%; a ganglioside migrating between GM2 and GM1, 9.8%; GD3, 1.1%; and the GD1a-comigrating ganglioside, not detectable. PMID- 2695377 TI - Prevention of cyclophosphamide-induced diabetes by anti-V beta 8 T-lymphocyte receptor monoclonal antibody therapy in NOD/Wehi mice. AB - Walter & Eliza Hall Institute nonobese diabetic (NOD/Wehi) mice exhibit a low incidence of spontaneous diabetes mellitus, but one large dose of cyclophosphamide (CY) can lead to a rapid progression to overt diabetes. Macrophages and Lyt-2+ and L3T4+ cells have been demonstrated to be involved in beta-cell destruction in this model. The role of a specific subset of T lymphocytes expressing a particular T-lymphocyte-receptor segment was examined in CY-induced diabetic NOD mice with a mouse anti-V beta 8 T-lymphocyte-receptor monoclonal antibody (F23.1). After administration of CY, only 4 of 51 treated mice became hyperglycemic compared to 23 of 47 untreated mice, 13 of 26 mice treated with an isotype-matched control ascites, and 4 of 6 mice given antibody negative ascites. Insulitis was significantly reduced in the F23.1-treated group, and immunocytochemistry revealed the absence of V beta 8 expression on cells in the lymphoid organs and insulitis of these mice. This investigation revealed that V beta 8+ cells were implicated in CY-induced diabetes in NOD/Wehi mice. PMID- 2695378 TI - Basement membrane heterogeneity and variation in corneal epithelial differentiation. AB - We have previously shown that the expression of a major 64-Kda keratin (K3) in corneal epithelium is site-related. It is found suprabasally in limbal epithelium, but uniformly (basal cells included) in central corneal epithelium. In the present study, we used a panel of antibodies against various components of corneal epithelial basement membrane to investigate a possible correlation between basement membrane heterogeneity and differential (basal vs. suprabasal) K3 keratin expression. One of these antibodies, AE27, stains human conjunctival basement membrane weakly, limbal basement membrane heterogeneously, and central corneal basement membrane strongly. Basal cells resting on basement membrane that stains strongly with AE27 tend to stain with monoclonal antibody AE5, which recognizes keratin K3. Basal cells on basement membrane staining weakly with AE27 tend not to stain with AE5. No such correlation exists between AE5 staining and type IV collagen, which is detectable immunohistochemically in conjunctival and limbal basement membrane, but not in corneal basement membrane overlying Bowman's layer. These results suggest that basement membrane of human corneal/conjunctival epithelium can be divided into at least three domains: the conjunctival basement membrane (type IV collagen-positive, AE27-weak), the limbal basement membrane (type IV collagen-positive, AE27-strong), and corneal basement membrane (type IV collagen-negative, AE27-strong). The results also raise the possibility that basement membrane heterogeneity may play a functional role in regulating keratin expression and other aspects of differentiation of corneal epithelium; more experiments are needed to test this hypothesis. PMID- 2695379 TI - Immunotoxicity of the semiconductor gallium arsenide in female B6C3F1 mice. AB - The effects of gallium arsenide (GaAs) exposure on immunocompetence of B6C3F1 female mice were investigated. GaAs was administered as a single intratracheal instillation at doses of 50, 100, and 200 mg/kg. Fourteen days after exposure, various cellular and humoral immune parameters were assessed. GaAs exposure increased spleen cellularity in a dose-dependent manner. However, the percentages of Thy 1.2 positive and Ig positive cells were decreased and that of F4/80 positive cells was increased dose dependently. The IgM and IgG antibody-forming cell response of the spleen to the T-dependent antigen sheep erythrocytes was reduced by 66 and 48%, respectively, at 200 mg/kg. Levels of the serum complement protein, C3, were increased by as much as 16% with no significant change in CH50 levels. The mitogenic response of splenic T cells to Con A and PHA was unaffected by GaAs, but that of B cells to LPS was increased by 52%. The delayed hypersensitivity response to keyhole limpet hemocyanin and mixed lymphocyte response were significantly reduced in a dose-dependent manner by GaAs exposure. Natural killer cell activity against the YAC-1 mouse lymphoma was enhanced in treated mice. Analysis of peritoneal exudate cells (PEC) revealed a dose dependent decrease in number and a shift in the composition of PECs. The percentage of PEC monocytes increased from 53% of the population to 81%, while the lymphocytes decreased from 46 to 20%. The adherent PEC population demonstrated decreased phagocytosis of covaspheres and increased phagocytosis of chicken erythrocytes (CRBC). GaAs exposure had no effect on host resistance to Plasmodium yoelii or Streptococcus pneumoniae, but dose dependently increased resistance of the mouse to Listeria monocytogenes. Treated mice demonstrated a significantly decreased resistance to the B16F10 melanoma with a sevenfold increase in tumor burden at 200 mg/kg. GaAs affects both humoral and cellular immune parameters in mice and impairs the ability of the immune system to protect against B16F10 tumor challenge. PMID- 2695380 TI - Immunohistochemical localization of acetaminophen-bound liver proteins. AB - A sensitive immunofluorescence assay was developed for localizing acetaminophen (APAP) protein adducts in liver sections from treated mice. Affinity-purified anti-APAP antibodies, when applied to liver sections from mice given 600 mg APAP/kg, po, were preferentially localized in cells of the centrilobular region. At 30 min after dosing, covalently bound APAP was detected only in those cells most proximal to the central vein. Thereafter, binding spread throughout the centrilobular zone. However, by 8 hr the overall intensity of staining decreased and binding appeared more diffuse. Western blot analysis of electrophoretically resolved proteins from similarly treated mice revealed a corresponding temporal arylation of cytosolic proteins by APAP and indicated that the fluorescence detected at 30 min was associated with arylation of protein(s) of 44 kDa. The findings demonstrate the sensitivity and utility of immunohistochemical techniques in the study of covalently bound toxicants and emphasizes the temporal link between selective protein arylation in individually targetted cells to the development of APAP hepatotoxicity. PMID- 2695381 TI - [Efficacy of diltiazem in elderly patients with stable effort angina]. AB - The antianginal effects of 360 mg/day of diltiazem were evaluated, using intrapatient comparisons, in a double/blind, randomized, placebo/controlled trial in 24 young patients (50 +/- 7 years) and in 16 elderly patients (67 +/- 3 years) with stable effort angina. All patients had angiographic documentation of significant coronary artery disease. An open-labelled, randomized, crossover design was employed. For 1 week prior to beginning the study, the patient was on no medication except sublingual nitrates. The study consisted of an initial 2 week single-blind placebo run-in period followed by a 4-week randomized double blind crossover between diltiazem, 120 mg t.i.d., and placebo. A diary of chest pain and nitroglycerin usage was kept during this period and run-in. Exercise tests were carried out during the run-in period (2 tests) and at the end of the 4 week treatment. After diltiazem 12 of the 24 young patients stopped the exercise test because of angina. A similar number (9/16) of elderly patients stopped the exercise test because of angina. During diltiazem treatment, weekly angina frequency was significantly reduced in the young patients (1.25 +/- 0.67 vs 3.87 +/- 1.19-run-in, 4.08 +/- 1.24-placebo; p less than 0.01) and in the elderly patients (0.87 +/- 0.71 vs 4.06 +/- 1.48-run-in, 4.12 +/- 1.5-placebo; p less than 0.01). Weekly TNT consumption significantly decreased in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695382 TI - [Cardiovascular applications of magnetic resonance imaging]. PMID- 2695383 TI - [Fatal hyperkinetic ventricular arrhythmia: diagnostic-prognostic evaluation]. PMID- 2695384 TI - Does post myocardial infarction rehabilitation prolong survival? A meta-analytic survey. AB - Cardiac rehabilitation undoubtedly helps post-myocardial infarction patients to feel better; however, it is under consideration whether or not it also prolongs their survival. Since 1972 several published studies have examined the role of physical rehabilitation in relation to patient survival after myocardial infarction. Eight randomized controlled trials were reviewed in order to compare the rate of events (total death, cardiac death, recurrence of non-fatal myocardial infarction) in the trained and untrained patient population. A tendency toward a positive training effect on survival was present in almost all trials; however, in only one study was the number of cardiac deaths shown to be significantly reduced in trained patients. The aim of this study was to use a quantitative analysis based on estimates of individual trials to evaluate the effect of post-myocardial infarction rehabilitation programs on survival. The analysis of pooled data revealed a significant decrease in total mortality (relative risk 0.68 with 95% confidence limits 0.53-0.86; p = 0.002), and cardiac mortality (relative risk 0.62 with 95% confidence limits 0.48-0.82; p less than 0.001). However, there was a non-significant increase in recurrences (relative risk 1.12 with 95% confidence limits 0.84-1.49; p = 0.45). These data are very similar to those found by another meta-analytic survey performed on a different set of published studies, i.e., odds risk for total death 0.76, for cardiac mortality 0.75 and for non-fatal myocardial infarction 1.15.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695385 TI - [Cardiomyopathy in Italy today: extent of the problem]. AB - Since the number of patients suffering from cardiomyopathy in Italy is unknown at present, a multicentre survey was carried out in 15 University and Hospital cardiological centres. Each centre was asked to report the number of cases of dilated, hypertrophic or restrictive cardiomyopathy observed between 1970 and 1987. Information was also sought regarding the residence of the patient at the time of diagnosis. Diagnostic criteria for each type of cardiomyopathy, based on those published in the current literature, were sent to the participating centres. For the entire period, a total of 2,229 patients with dilated, 913 with hypertrophic, and 64 with restrictive cardiomyopathy were reported. The number of cases observed between 1980-87 was about four times greater than that observed between 1970-79 for dilated cardiomyopathy and three times greater for hypertrophic cardiomyopathy. In the period 1970-79, a minimal annual incidence of dilated cardiomyopathies was calculated. In the centres this ranged from 0.005 to 1.8 per 100,000 inhabitants, although no systematic evaluation was made. On the contrary, minimal prevalence for hypertrophic cardiomyopathy ranged from 0.4 to 5.6 between 1970-79. These rates increased to 0.09-3.4 for dilated cardiomyopathy and to 1.0-23.0 for hypertrophic cardiomyopathy in the period 1980-87. On the basis of this survey the number of patients with a diagnosis of dilated and hypertrophic cardiomyopathy seems to be on the increase in our country. This increase may be due to the diagnostic facilities available, such as echocardiography, and possibly to a better knowledge and a greater interest in cardiomyopathies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695386 TI - [Acute and long-term effects of captopril in patients with left ventricular dysfunction and dilatation: evaluation of function and work capacity]. AB - To assess acute hemodynamic effects and exercise capacity of an intravenously administered single dose of captopril and to compare the acute response with chronic variation in hemodynamic and functional parameters after long-term oral administration, (in order to determine the profile of responders and non responders) we studied 12 patients with chronic congestive heart failure due to primary dilated cardiomyopathy (11 pts) and ischemic heart disease (1 pt). Hemodynamic response was assessed using transthoracic electric impedance with cardiac output measurement. The exercise capacity was determined using multistage bicycle ergometer symptoms limited stress test. The hemodynamic and functional evaluation--resting cardiac output, exercise capacity (Ex. Dur.) and cardiac output rise at maximum workload (% CO)--were investigated at first as a control; after i.v. captopril administered in 10 min (25 mg) (acute); after captopril per os (25-75 mg for 30 days) (chronic) and after 5 days of withdrawal (wash out). (Table: see text). Improvement of left ventricular performance mainly during exercise after acute and chronic administration of captopril occurred, as evidenced from cardiac output increase at maximum work load, and rise of exercise duration. Moreover, our data suggest that captopril may have a sustained beneficial effect, for a few days, even after drug withdrawal. Nevertheless, the lack of correlation in single cases between acute and chronic response, also indicates that captopril deserves further study to determine its role in acute and/or chronic management of congestive heart failure in order to choose the ideal strategy. PMID- 2695387 TI - [Genetic control of the number of copies of type K2 killer plasmids in Saccharomyces cerevisiae]. AB - 13 non-linked chromosomal mutations derepress the negative genetic control of copy number of K2 yeast killer plasmids and lead to 1.5-2-fold elevating of copy number of that type plasmids -L2A and M2 virus-like dsRNA. The content of both plasmids is increased 3-5-fold in cells with chromosomal ski5 mutation, as compared to the strains of wild type. Expression of ski5 allele is recessive. The dose effect of this allele is observed on haploid and diploid levels. Dominant ochre nonsense suppressors suppress the action of ski5 and the ski6 allele epistates that of ski5. PMID- 2695388 TI - [A comparative analysis of mutagenic and SOS-induced activity in three classes of chemical compounds]. AB - Mutagenic and SOS-inducing potential of 23 derivatives of fluorenone, phenanthrenequinone and biphenyl have been studied in tester strains of Salmonella typhimurium and in Escherichia coli strain PQ 37. 14 of these compounds revert the mutation hisD3052 (much less than -1 much greater than type), but none of them induce mutations in the strain TA 1535. Maximal mutagenic activity has been shown in strain TA 1538 for amide of 2,7-dinitrofluorenone-4 carbonic acid (580 revertants per nmol), 2,7-dinitrophenanthrenequinone (308 revertants per nmol), 2,4,7-trinitrophenanthrenequinone (306 revertants per nmol) and 2',4,4'-trinitrobiphenyl-2-carbonic acid (251 revertants per nmol). In plasmid-containing strain TA 98 the mutagenic potential of the compounds tested is lower than in the TA 1538 strain. It has been suggested that mutagenic activity of these compounds can be attributed to their acceptor properties, namely, the ability to form charge transfer complexes with DNA. SOS-inducing activity has been shown for 5 compounds, also positive in mutation induction. Mutagenic and SOS-inducing activities positively correlate in fluorenone derivatives. Among phenanthrenequinone derivatives, compounds with high mutagenic activity only can induce SOS response. None of the biphenyls tested induce SOS functions. The compounds giving the positive result in the SOS-chromotest have rigid co-planar structure. PMID- 2695389 TI - RelA mutation and pBR322 plasmid amplification in amino acid-starved cells of Escherichia coli. AB - Plasmid pBR322 is amplified following amino-acid limitation in Escherichia coli relA hosts. In relA+ hosts there was no significant amplification or a much smaller one. Plasmid amplification is due to the relA mutation; when the relA+ allele is transferred into the relA mutant CP79 this strain no longer amplifies plasmid DNA during amino acid starvation. It is concluded that ppGpp is a negative effector of plasmid replication. Amplification is temperature dependent, being maximal at 32 degrees C and negligible at 37 degrees C. PMID- 2695390 TI - Selection of the initiator tRNA by Escherichia coli initiation factors. AB - We have developed a new technique, called 'toeprinting,' which has allowed a study of the tRNA-binding properties of Escherichia coli translation initiation complexes. In response to natural mRNAs, the initiator tRNA and a variety of elongator tRNAs bind to the same tRNA-binding site on the 30S ribosomal subunit as long as a cognate codon is present near the Shine and Dalgarno sequence. The selection of the initiator tRNA in 30S initiation complexes is accomplished by initiation factors IF2 and IF3. 70S ribosomes accept both initiator tRNA and elongator tRNAs on natural mRNAs, much like 30S ribosomal subunits; IF3 and IF2 do not, however, select the initiator tRNA on 70S initiation complexes unless the initiation factor IF1 is present. PMID- 2695391 TI - The activity of sigma 32 is reduced under conditions of excess heat shock protein production in Escherichia coli. AB - The expression of heat shock genes in Escherichia coli is controlled by the action of an alternate sigma-factor of RNA polymerase, sigma 32, which directs core RNA polymerase to recognize the promoters for heat shock genes. After a shift from 30 degrees C to 42 degrees C, both the level of sigma 32 and transcription initiation at heat shock promoters transiently increase, indicating that heat shock gene expression is regulated by changes in the concentration of sigma 32. Here, we report that heat shock gene expression is regulated by changes in the activity of sigma 32 under some conditions. Our results show that the transient repression of heat shock protein synthesis, which follows a shift down from 42 degrees C to 30 degrees, occurs as a result of decreased transcription initiation at heat shock promoters, but this repression is accompanied by only a small decrease in the level of sigma 32. In addition, the induction of heat shock proteins following overproduction of sigma 32 from a multicopy plasmid is only transient, despite the fact that the level of sigma 32 remains elevated. Constitutive overproduction of sigma 32 also fails to cause a proportionate increase in heat shock gene transcription. These three examples suggest that the activity of sigma 32 is reduced under conditions of excess heat shock gene expression. PMID- 2695392 TI - Comparison of the nucleotide and amino acid sequences of the RsrI and EcoRI restriction endonucleases. AB - The RsrI endonuclease, a type-II restriction endonuclease (ENase) found in Rhodobacter sphaeroides, is an isoschizomer of the EcoRI ENase. A clone containing an 11-kb BamHI fragment was isolated from an R. sphaeroides genomic DNA library by hybridization with synthetic oligodeoxyribonucleotide probes based on the N-terminal amino acid (aa) sequence of RsrI. Extracts of E. coli containing a subclone of the 11-kb fragment display RsrI activity. Nucleotide sequence analysis reveals an 831-bp open reading frame encoding a polypeptide of 277 aa. A 50% identity exists within a 266-aa overlap between the deduced aa sequences of RsrI and EcoRI. Regions of 75-100% aa sequence identity correspond to key structural and functional regions of EcoRI. The type-II ENases have many common properties, and a common origin might have been expected. Nevertheless, this is the first demonstration of aa sequence similarity between ENases produced by different organisms. PMID- 2695393 TI - Nucleotide sequences of the Erwinia chrysanthemi ogl and pelE genes negatively regulated by the kdgR gene product. AB - The nucleotide sequences of the coding and regulatory regions of the genes encoding oligoglacturonate lyase (OGL) and pectate lyase e isoenzyme (PLe) from Erwinia chrysanthemi 3937 were determined. The ogl sequence contains an open reading frame (ORF) of 1164 bp coding for a 388-amino acid (aa) polypeptide with a predicted Mr of 44,124. A possible transcriptional start signal showing homology with the Escherichia coli promoter consensus sequence was detected. In addition, a sequence 3' to the coding region was found to be able to form a secondary structure which may function as an Rho-independent transcriptional termination signal. For the pelE sequence, a long ORF of 1212 bp coding for a 404 aa polypeptide was detected. PLe is secreted into the external medium by E. chrysanthemi, and a potential signal peptide sequence was identified in the pelE gene. In the 5' upstream pelE coding region, a putative promoter resembling E. coli promoter consensus sequences was detected. Furthermore, the region immediately 3' to the pelE translational stop codon may function as an Rho independent translational termination signal. In strain 3937, the synthesis of OGL and PLe, as well as the other enzymes involved in the pectin-degradative pathway (particularly the kdgT product), are known to be regulated by the KdgR repressor, which mediates galacturonate and polygalacturonate induction. Synthesis of these enzymes is also regulated by the CRP-cAMP complex which mediates catabolite repression. Analysis of the regulatory regions of ogl and pelE allowed us to identify possible CRP-binding sites for these two genes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695394 TI - Genetic analysis and regulation of the Rhizobium meliloti genes controlling C4 dicarboxylic acid transport. AB - The genes controlling the transport of C4-dicarboxylic acids from Rhizobium meliloti have been cloned and analysed. The nucleotide sequence of the control region of the structural dctA and the regulatory dctBD genes has been determined. Comparison with the Rhizobium leguminosarum dct genes revealed a high degree of homology. Gene fusions to the enteric lacZY reporter gene were constructed and the expression of the dctA and dctBD genes studied under various physiological conditions. In free-living cells, the regulatory dctBD genes are absolutely required for the expression of the dctA gene. In the root nodule environment, a dctA::lacZY gene fusion was found to be expressed in an R. meliloti strain mutated in both the dctB and dctD genes, but not in a strain mutated in the dctB gene alone. The presence of the conserved upstream NifA-binding sites on the dctA promoter sequence, coupled with the fact that the dctA::lacZY gene fusion is not expressed in root nodules formed by a nifA mutant strain of R. meliloti, supports the suggestion that NifA may be involved in the symbiotic expression of dctA in the absence of the regulatory dctBD genes. Under micro-aerobic conditions, however, NifA induction alone is not sufficient for expression of the dctA promoter, even though the NifA-dependent nifHDK promoter is highly expressed under these conditions. PMID- 2695395 TI - Cloning and sequence analysis of the ntrA (rpoN) gene of Pseudomonas putida. AB - The gene encoding a sigma factor NtrA (RpoN) was cloned from Pseudomonas putida by cross-hybridization with a probe containing a part of the corresponding Escherichia coli gene. The cloned gene complemented an ntrA mutation of E. coli in activation of xyl genes on the TOL plasmid. The predicted amino acid (aa) sequence of P. putida NtrA (497 aa; Mr 56,215) is highly homologous to NtrA proteins from Azotobacter vinelandii (81.7%), Klebsiella pneumoniae (52.6%), and Rhizobium meliloti (36.1%). There are two other open reading frames (ORF1, ORF3) upstream and downstream from the ntrA gene, respectively. These ntrA-flanking ORFs are also highly homologous to the corresponding ORFs of K. pneumoniae, A. vinelandii, and R. meliloti. PMID- 2695396 TI - Sequence and characteristics of the Bifidobacterium longum gene encoding L lactate dehydrogenase and the primary structure of the enzyme: a new feature of the allosteric site. AB - The gene ldh, encoding L-lactate dehydrogenase (LDH; EC 1.1.1.27) of Bifidobacterium longum aM101-2, was cloned in Escherichia coli using an oligodeoxyribonucleotide hybridization probe. The amino acid (aa) sequence, deduced from the sequence of the cloned DNA, was consistent with the results of protein chemical analysis of B. longum LDH. The transcription start points (tsp) in B. longum were identified by S1 nuclease mapping. A sequence, GTAGCAA-(14 bp) TTATAGA, which is located a few bp upstream from the tsp, was assigned as the promoter of this ldh gene. In the 3'-noncoding region, there were two structures that strongly resembled the Rho-independent transcriptional termination signal of E. coli. Therefore, the B. longum ldh gene might form a monocistronic unit. The deduced primary structure of B. longum LDH had 40% identity with LDHs from Thermus caldophilus, Bacillus stearothermophilus, Lactobacillus casei and dogfish muscle. Most bacterial LDHs are allosterically regulated by fructose 1,6 bisphosphate (FBP), while the vertebrate LDHs are not. The anion-binding site of vertebrate LDHs has been thought to correspond to the FBP-binding site of bacterial LDHs. Although the B. longum LDH was regulated by FBP, the charge properties of aa residues in the putative FBP-binding site of the LDH were closer to those of the vertebrate LDHs than to those of bacterial LDHs. PMID- 2695397 TI - Phage Trojan horses: a conditional expression system for lethal genes. AB - The EcoRI restriction enzyme (ENase) cleaves DNA molecules within the sequence GAATTC. Cells expressing this lethal activity normally make a second enzyme, the M.EcoRI methyltransferase (MTase), which protects their chromosomal DNA by modifying the EcoRI recognition sites. To isolate mutants of the EcoRI ENase, its gene was cloned into a filamentous phage vector (M13mp18) under control of the lac promoter. Normally, filamentous phages (M13, f1 and their derivatives) form turbid plaques by impairing the growth of their host cell without killing it. In contrast, phages expressing the EcoRI ENase kill the host cell, but survive long enough to produce plaques which are very clear. Expression of the M.EcoRI MTase rescues the host and restores turbid plaque formation. EcoRI ENase mutants were isolated by screening for mutants that make turbid, instead of clear, plaques on an M- host. This conditional expression system may be useful for cloning and mutating genes for other toxic proteins. PMID- 2695398 TI - Cloning and sequence analysis of the fermentative alcohol-dehydrogenase-encoding gene of Escherichia coli. AB - A 6-kb fragment of DNA, which complemented defects in the alcohol dehydrogenase (ADH)-encoding gene (adhE) of Escherichia coli, was cloned into a multicopy vector. Both ADH and coenzyme-A-linked acetaldehyde dehydrogenase (ACDH) activities were encoded by the plasmid, pHIL8. The adhE gene was identified as an open reading frame of 891 codons encoding an Mr 96,008 protein (minus the initiating methionine). Codon usage analysis indicates that adhE should be highly expressed. This gene shows no significant homology to any previously sequenced ADH-encoding gene. PMID- 2695399 TI - Sequence analysis of operator mutants of the phase-1 flagellin-encoding gene, fliC, in Salmonella typhimurium. AB - In phase-2 cells of diphasic Salmonella strains, expression of the phase-1 flagellin-encoding gene, fliC, is repressed by the repressor encoded by the fljA gene. Nine operator-constitutive (Oc) mutants of fliC were isolated from S. typhimurium by selecting those which could express fliC in the presence of the repressor. Among them, eight mutants could express fliC both in the presence and the absence of the repressor, whereas the ninth one could express only in the presence of the repressor. Nucleotide sequence analysis revealed that the Oc mutations of the former type were all located between bp 7 and 20 upstream from the coding region of fliC, which suggests that this region may correspond to the operator for fliC. The latter mutant was found to have a tandem duplication of 28 bp which contains a part of the operator sequence, and seems to require the repressor to activate fliC expression. PMID- 2695400 TI - The P2 phage old gene: sequence, transcription and translational control. AB - The old (overcoming lysogenization defect) gene product of bacteriophage P2 kills Escherichia coli recB and recC mutants and interferes with phage lambda growth [Sironi et al., Virology 46 (1971) 387-396; Lindahl et al., Proc. Natl. Acad. Sci. USA 66 (1970) 587-594]. Specialized transducing lambda phages, which lack the recombination region, can be selected by plating lambda stocks on E. coli that carry the old gene on a prophage or plasmid [Finkel et al., Gene 46 (1986) 65-69]. Deletion and sequence analyses indicate that the old-encoded protein has an Mr of 65,373 and that its transcription is leftward. Primer extension analyses locate the transcription start point near the right end of the virion DNA. A bacterial mutant, named pin3 and able to suppress the effects of the old gene, has been isolated [Ghisotti et al., J. Virol. 48 (1983) 616-626]. In a pin3 mutant strain, carrying the old gene on a prophage or plasmid, the amount of old transcript is greatly reduced. The effect of the pin3 mutation is abolished by the wild-type allele of argU, an arginine tRNA that reads the rare Arg codons AGA and AGG, which are used for eight of the 14 Arg codons in the old gene. Thus the pin3 allele probably stalls translation of the old mRNA, causing this mRNA to be degraded. Isoelectric focusing and electrophoretic analysis identify the old gene product as a basic protein of approx. 65 kDa. PMID- 2695401 TI - Characterization of a cryptic plasmid from Lactobacillus plantarum. AB - The complete nucleotide sequence of pLB4, a cryptic plasmid isolated from Lactobacillus plantarum NCDO1088 has been determined. Three open reading frames, which encode proteins of 42, 25 and 6 kDa, have been identified. In vitro transcription/translation of pLB4-derived DNA restriction fragments confirm the existence of all three polypeptides, which show homology to replication proteins and site-specific recombinases from other Gram+ plasmids. Three major regions of dyad symmetry with delta G of -28.8, -15.0 and -17.0 kcal were observed. One of these regions contains a sequence which shows perfect homology to the nick site of the Gram+ replicons, pE194, pLS1 and pADB201. In addition, a 21-bp sequence located upstream from the site-specific recombinase shows 80% homology to the recombination sites of pE194 and pT181. PMID- 2695402 TI - The molecular cloning, sequence and expression of the hdcB gene from Lactobacillus 30A. AB - We previously cloned the structural gene hdcA, which encodes the enzyme histidine decarboxylase (HDC; EC 4.1.1.22), from Lactobacillus 30a and found what appeared to be the start of a second gene 59 nucleotide (nt) downstream from the hdcA stop codon [Vanderslice et al., J. Biol. Chem. 32 (1986) 15186-15191]. Here we report the complete nt sequence of this second gene, which we have named hdcB, and show that it encodes a 20-kDa protein, HDCB, which was purified from Escherichia coli. The hdcA and hdcB genes together comprise an operon, the transcription from which is shown to be increased threefold by the presence of histidine in the growth medium. Western blots were used to quantitate the rise in concentrations of both gene products during histidine induction of the hdc operon. This increase was found to be proportional to the observed threefold increase in the concentration of the respective mRNAs. Transcription of the hdc operon in the mutant-3 strain of Lactobacillus 30a [Recsei and Snell, Biochemistry 12 (1973) 365-371] was shown to be constitutively 15-fold greater than in uninduced wild type cells and was unaffected by histidine. The transcription start point was defined as a guanine 73 nt 5' to the start codon of the hdcA gene. Of the transcripts initiated at this promoter, 15% include both hdcA and hdcB sequences, the remainder terminate in the intergenic region and thus encode only hdcA. PMID- 2695403 TI - Bacteriophage PRD1 terminal protein: expression of gene VIII in Escherichia coli and purification of the functional P8 product. AB - The gene VIII coding for the bacteriophage PRD1 terminal protein P8 has been cloned under the control of the lambda pL promoter. The recombinant plasmid thus obtained (pUSH20) was able to complement a mutation in the phage terminal-protein gene VIII. High expression of the cloned gene from this plasmid could be obtained by raising the growth temperature from 28 to 42 degrees C. This heat induction resulted in an increased synthesis of a protein of 30 kDa, the size expected for the P8 protein. When complemented with an extract of cells carrying the PRD1 DNA polymerase gene, the extract from the cells harboring the plasmid pUSH20 was able to form the P8-dGMP replication initiation complex. The PRD1 replication initiation reaction was optimized and used to detect the biological activity of the expressed terminal protein. Subsequently, P8 protein was purified to almost homogeneity and shown to be biologically functional after the various purification steps. PMID- 2695404 TI - The organization of the right-end early region of bacteriophage PRD1 genome. AB - Bacteriophage PRD1 is the only protein-primed DNA replication system known to operate in Escherichia coli. The left-genome end of PRD1 contains the early genes for the terminal protein and the DNA polymerase. These genes have been sequenced and the proteins have been produced separately. In this investigation we completed the analysis of the PRD1 early DNA regions by cloning and sequencing the right end genome containing early genes XII and XIX. We compared the structure of the right- and left-terminal regions. The genome organization of both ends was found to be rather uniform. The inverted terminal repeats, the first promoters and the first translation start codons are located almost exactly at the same distance from the genome ends. The PRD1 early gene products, P12 and P19, do not share similarities with proteins found in other protein-primed replication systems. PMID- 2695405 TI - Correlation between temperature-dependent cytoplasmic solubility and periplasmic export of a heterologous protein in Escherichia coli. AB - The coding sequence of mature human tumor necrosis factor (hTNF) was fused to the signal-encoding sequence of beta-lactamase (Bla). Mature hTNF was exported into the periplasm of Escherichia coli. A mutant hTNF [Van Ostade et al., FEBS Lett. 238 (1988) 347-352], which displays a temperature-dependent intracellular solubility, was fused to the same Bla signal-encoding sequence. We found that the export competence of the mutated hTNF was correlated with the intracellular solubility of this protein. We postulate that the secretion proficiency of eukaryotic proteins, when fused to a prokaryotic export signal, depends on the ability of the mature protein to readily fold into a soluble conformation. PMID- 2695406 TI - Antioxidant functions of carotenoids. AB - Carotenoid pigments, including hydrocarbons such as beta-carotene or xanthophylls such as lutein and zeaxanthin, are very widely distributed in nature, where they play an important role in protecting cells and organisms against the harmful effects of light, air, and sensitizer pigments. This process has been demonstrated in bacteria, algae, plants, animals, and even in humans in the light sensitive disease, erythropoietic protoporphyria. The primary mechanism of action of this phenomenon appears to be the ability of carotenoids to quench excited sensitizer molecules as well as quench 1O2. In addition to this protection, and potentially of even greater biological importance, is the fact that carotenoids can also serve as antioxidants under conditions other than photosensitization. This review presents the data available indicating the extent of this important function. Antioxidant action can be documented in both enzymic and nonenzymic systems, and has been reported in subcellular, cellular, and animal studies. In fact, the many reports indicating that carotenoids may possess some anticarcinogenic properties may well be related to their ability to interact with and quench various radical species that can be generated within cells. PMID- 2695407 TI - Carcinogenic nitrosamines: free radical aspects of their action. AB - NDMA and other nitrosamines may be activated into DNA binding intermediates by a cytochrome P450-dependent formation of alpha-nitrosamino radicals or photochemically. Within the catalytic site of cytochrome P450, these radical intermediates either combine with HO. to form alpha-hydroxynitrosamines or decompose into nitric oxide and N-methylformaldimine. In the presence of phosphate, nutagenic alpha-phosphonooxy derivatives are formed from radicals generated chemically/photochemically. Studies on lipid peroxidation, in vivo and in vitro, have further suggested that radicals are formed as intermediates from N nitrosodialkylamines. The level of nitrosamine-induced lipid peroxidation parallels hepatocarcinogenicity in rats. These data, although preliminary, provide further evidence that free radical damage and DNA alkylation are involved in carcinogenesis induced by nitrosamines. PMID- 2695408 TI - Protection against tissue damage in vivo by desferrioxamine: what is its mechanism of action? AB - Desferrioxamine (deferoxamine) is an inhibitor of iron-dependent free radical reactions that has been used to investigate the role of such reactions in several animal model systems for human disease. In vitro, desferrioxamine is not only an iron chelator but also binds other metal ions, reacts with superoxide and hydroxyl radicals, affects eicosanoid synthesis, can act as a substrate for peroxidases and can generate a reactive nitroxide radical. However, considerations of desferrioxamine concentration in vivo suggest that its ability to inhibit iron-dependent free radical reactions is the major factor that accounts for desferrioxamine's generally-protective action in animal models of human disease. PMID- 2695409 TI - Toxicity of thiols and disulphides: involvement of free-radical species. AB - Sulphur is essential to life, and thiols and disulphides play essential roles in cellular biochemistry. Such compounds are also widely distributed in the food of man and his domestic animals, and they are extensively used in industry. However, many thiols and disulphides have been shown to be toxic. Aliphatic, aromatic, and heterocyclic compounds of this type are haemolytic agents in animals while aminothiols have been shown to induce many cytotoxic effects in vitro and the epidithiodioxopiperazine mycotoxin, sporidesmin, is a potent hepatotoxic agent. Structure-activity relationships among these compounds and factors which modulate their harmful effects are consistent with a toxic mechanism involving redox cycling between the thiol and the corresponding disulphide. Thiyl radicals and "active oxygen" species are formed in this process, and it is suggested that these substances are responsible for initiating the tissue damage provoked by thiols and disulphides. PMID- 2695410 TI - Neuromagnetism: a new approach for localizing brain function. AB - The physical origins of neuromagnetic signals are described from which it is concluded that magnetoencephalography is potentially much more applicable than electroencephalography for localizing the sources of a variety of neural activities in the brain. The magnitudes of typical neuromagnetic signals are discussed. Selected examples of MEG studies are given. Recent experiments which appear to indicate directly the association of spreading cortical depression with migraine headache are briefly described. PMID- 2695411 TI - Antenatal measurement of scapula length using ultrasound. AB - In 76 fetuses from 14 weeks of gestation through to term, measurements of the scapula were made using ultrasound. Statistical analysis of the results revealed a highly significant correlation between scapula measurements and gestational age, biparietal diameter, fetal femur length and fetal abdominal circumference (r = 0.93, 0.91, 0.95, and 0.91, respectively). In particular, values related to length of the scapula were highly correlated with femur length. These findings show that this measurement is useful as an adjunct to assessing development as well as growth of the femur and dating parameters of the fetus in utero. PMID- 2695412 TI - Ultrasonic evaluation of liver development in the fetus in utero. AB - A total of 573 measurements of the human fetal liver size were made from 18 to 41 weeks gestation. The right hepatic lobe increased linearly throughout gestation, whereas the left lobe increased linearly until approximately 32 weeks gestation, after which a slight slowing was observed. There was a significant correlation between both hepatic lobe sizes and gestational age (r = 0.94, r = 0.88; p less than 0.01, p less than 0.001). PMID- 2695413 TI - Naproxen sodium in the treatment of premenstrual symptoms. A placebo-controlled study. AB - The prostaglandin system is thought to play a role in the etiology of the premenstrual syndrome. Many authors describe that prostaglandins are involved in both central and peripheral symptoms. To test this hypothesis, we studied the effects of naproxen sodium treatment (550 mg twice daily, from day -7, in relation to next menses, to the 4th day of the cycle) in 34 patients suffering from premenstrual syndrome. Six cases dropped out. Fourteen women were given placebo for the first three cycles of the trial, followed by active drug. The other 14 patients were given naproxen sodium, beginning from the first cycle. In order to evaluate premenstrual symptoms, the Moos menstrual distress questionnaire was prospectively applied during the 2-month run-in period and at the 3rd and 6th cycles of treatment. During our double-blind naproxen sodium study, both menstrual and premenstrual 'pain' decreased during active drug treatment, while placebo was ineffective. We also obtained a significant improvement of premenstrual 'behavioral changes' which is probably related to the relief of painful symptomatology. In conclusion, this study indicates that naproxen sodium is a useful and safe drug in the treatment of premenstrual and menstrual pain related symptoms. PMID- 2695414 TI - Ultrasound assessment of the bladder volume after anterior colporrhaphy. AB - In 40 gynecological patients 44 different determinations of the bladder volume were made using ultrasonic methods. The product of bladder depth, height, and width, as determined from transverse and sagittal scans, showed the best correlation with the bladder volume measured by urethral catheter (r = 0.981). For 73% of the measurements the error was under 20% when the true bladder volume was greater than 100 cm3. This method gives a reasonable assessment of the bladder residual volume. It is quick, safe, and repeatable and, therefore, useful in postoperative clinical practice. PMID- 2695415 TI - [Cefaclor and trimethoprim-sulfamethoxazole for recurrent otitis media]. AB - The efficacy of cefaclor and of trimethoprim-sulfamethoxazole (TMP-SMX) in the management of recurrent otitis media was evaluated in a randomized single-blind controlled trial. The median age of the patients was 12 months (range 5-37); there were 37 boys and 19 girls. All had received 1 or more courses of antibacterials for acute otitis media in the previous 2-3 weeks. 27 were treated with oral cefaclor suspension, 40 mg/kg/day in 3 divided doses, and 29 with 1 mg/kg/day of TMP-SMX (trimethoprim 8 mg, sulfamethoxazole 40 mg) in 2 divided doses, each group for 10 days. 70% of the cefaclor group and 90% of the TMP-SMX group were cured after the 10 days of therapy (0.1 greater than p greater than 0.05). Results were not better on the 21st day as compared with the 10th. Our data indicate a mild preference for TMP-SMX (although p was not less than 0.05), since it needs to be given only twice a day and costs less than cefaclor. PMID- 2695416 TI - [Genital herpes simplex virus infection in the pregnant woman and in the newborn infant]. PMID- 2695417 TI - [Current management of urolithiasis]. PMID- 2695418 TI - [Retinoids--at the beginning of the second decade]. PMID- 2695419 TI - [High-frequency oscillatory ventilation]. PMID- 2695420 TI - [Locked-in syndrome: some neurological and rehabilitational aspects]. PMID- 2695421 TI - [Differentiation and maturation processes of the hematopoietic system in bone marrow using flow cytometry]. PMID- 2695422 TI - [Diagnosis and treatment of streptococcal pharyngitis]. PMID- 2695423 TI - [Surfactant for the treatment of respiratory distress syndrome]. PMID- 2695424 TI - [Treatment of large cell lymphoma]. AB - During 1977-1985, 50 patients with Stages III and IV large cell lymphoma (diffuse histiocytic [DH] and diffuse mixed [DM] types, Rappaport classification) were treated with the CHOP regimen (cyclophosphamide, adriamycin, Oncovin and prednisone). The male:female ratio was 1:1, the mean age at treatment 57 years, and mean follow-up 37 months. 80% had the DH type and 20% the DM type. 46% were in Stage III and 54% in Stage IV. The average relative dose intensity of CHOP was 0.68, which was well tolerated. In 68% a complete response was achieved after a mean of 4 treatment cycles. The average number of cycles for all patients was 7.2. The 5-year survival for those in Stage III was 50% and in Stage IV, 34%. Females survived better than males (60% vs 23%, respectively; p less than 0.02). The 5-year survival of the complete responders was 60% and their relapse-free survival 44%. In our experience, CHOP is a useful combination in the treatment of DH and DM lymphoma; it has yet to be proved in a randomized fashion that the current third generation of combinations is superior to it. PMID- 2695425 TI - [Regional differences in fat metabolism--diabetogenic and atherogenic obesity]. PMID- 2695426 TI - [Breast cancer and pregnancy]. PMID- 2695427 TI - [Thermal sensation and pains]. PMID- 2695429 TI - [Anaphylactic reaction]. PMID- 2695428 TI - [Ketogenic diet--an update]. PMID- 2695430 TI - [Meniscal repair]. PMID- 2695431 TI - [Tarsal coalition]. PMID- 2695432 TI - [The Hospital of the Knights of St. John of Jerusalem and its later history]. PMID- 2695433 TI - [Dendritic cell involvement in the acquired immunodeficiency syndrome]. PMID- 2695434 TI - [Anxiety and its control]. AB - Anxiety has many faces--including suppressed anxiety and "non-anxiety". Our present age is increasingly being referred to as the "age of anxiety", our society as an "anxious society", probably because we constantly feel threatened not only by physical, but also by psycho-social anxiety. If we are unable actively to combat or escape from a threat, or to cope with emotional reactions and stress, insecurity, anxiety and fear result. If this becomes extremely pronounced and appears irrational to the person affected, the term phobia is employed to describe a specific fear (fear of bridges, crowds, confined spaces, etc.). The more susceptible the person, the smaller are his chances of compensating. The increase in anxiety disorders and psychosomatic disturbances seen today, are an indication that we must learn not merely to combat anxiety, but also to accept it. PMID- 2695435 TI - [Change in the diagnosis and therapy of anxiety disorders. 1: Phenomenology of anxiety and new approaches in the classification of anxiety disorders]. AB - The pathological states anxiety neurosis and phobias, diagnostically classified under the neuroses, are, influenced by a recent American diagnostic classification, now designated anxiety disorders in clinical psychiatry. With this approach, which is more phenomenological than etiological in orientation, new diagnostic possibilities--among other things--have arisen. In the first place, an accurate differentiation of periodic and chronic states of anxiety can be made, while the clinical phenomena can be considered from various aspects, in order to evaluate simultaneously 1. the current clinical manifestation, 2. the underlying personality traits, and 3. the physical disorders presenting. PMID- 2695436 TI - [Medical advice for golfers]. AB - Although golf is an ideal form of exercise for all age groups, complete mastery of the specific movements involved is a prerequisite. The typical golfing injuries and and pathological sequelae are usually the results of faulty driving and hitting techniques. Apart from golfer's shoulder and golfer's elbow, complaints affecting the lumber spine predominate. PMID- 2695438 TI - [Some aspects of GABAergic neurons in the central nervous system]. PMID- 2695437 TI - [Bencyclane in stage II arterial occlusive disease. Results of a controlled study]. AB - In a single-center, double-blind, randomized study, 19 patients with peripheral arterial occlusive disease stage II Fontaine were treated with bencyclan, and a further 19 patients with buflomedil for 10 weeks after a wash-out phase of 2 weeks. Both groups showed a significant increase in painfree and total walking distances. No significant difference was found between the two groups. PMID- 2695439 TI - [Importance and actual problems of antenatal diagnosis of fetal anomalies]. PMID- 2695440 TI - [Pathogenesis and laboratory diagnosis of venous thrombosis]. AB - Due to the increasing number of elderly as well as chronically-ill patients, venous thrombosis assumes an increasing role as a typical complication of many courses of disease. Postoperatively, in patients without anticoagulation, fibrinogen tests show venous thrombosis in the lower extremities in up to 50% but not all were clinically relevant. Prophylactic treatment has markedly lowered the manifestation of deep venous thrombosis. Nevertheless, in current epidemiologic studies, the prevalence of thrombotic disease is three-fold higher (1:7,500) than that of bleeding diseases (1:20,000). PATHOGENESIS: Congenital deficiency or congenital dysfunction of inhibitors of activated clotting factors have provided insight into the functional principles of limited proteolysis. Unequivocal causes of recurrent thrombosis are deficiency or dysfunction of AT III, protein C, protein S or plasminogen (Figure 1). Dysfibrinogenemia, in about 10% of the patients, leads to a tendency to thrombosis. Unclarified remains the relevance of lowered values for factor XII, heparin-cofactor II (HC II) and histidine-rich glycoprotein (HRG) (Table 1). Congenital disorders usually manifest themselves in the early adulthood. For the clinical manifestation of venous thrombosis, imbalance between pro-coagulatory and inhibitor factors are of importance, therefore the compensatory capabilities of other protease inhibitors, for example, alpha-2-macroglobulin should be taken into consideration. In acquired lowering of hemostasis factors, the balance in the plasma protein cascade should be assessed (Figure 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695441 TI - [Duplex sonography diagnosis of deep leg- and pelvic vein thromboses]. AB - The diagnosis of thrombosis of the deep leg veins or pelvic veins is usually established on the basis of technical procedures. Clinical signs such as swelling, erythema or warming are unreliable. Plethysmographic measures have a low specificity, nuclear medicine studies enable assessment, limited to the lower leg, only after 24 hours. Continuous-wave Doppler sonography, as is the case with plethysmography, does not allow differentiation between intra- or extravascular cause of the obstruction to flow; hemodynamically-unimportant, floating thrombi cannot be detected. Ascending phlebography is an invasive procedure exposing the patient to contrast medium with its possible allergic reactions, radiation and thrombosis or local inflammation. Duplex-sonography enables the combination of high-resolution ultrasonic B-imaging with a pulsed Doppler unit which provides a noninvasive means for direct visualization of the involved vessel. For the examination, preferably, linear scanners are employed with a frequency of at least 5 megahertz. With the patient in the supine position, first, the iliac vein, medial to the artery, is imaged, then the common femoral vein and the great saphenous vein (Figure 1). Then the patient is turned and the popliteal vein and, as far as possible, the veins of the lower leg are examined from the back. Direct proof of thrombosis is considered the documentation of intraluminal echo-intense structures (Figure 2) associated with absence of complete compressibility of the vascular lumen in cross-section with slight pressure of the transducer (Figures 3a and 3b).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695442 TI - Therapy of deep vein thrombosis. AB - Adequate anticoagulation treatment in patients with deep vein thrombosis reduces the risk of thrombus extension or embolization to less than 5%. Thrombolytic treatment may possibly prevent subsequent postthrombotic syndrome. Heparin is the initial treatment of choice for most patients with deep vein thrombosis. The dose is adjusted according to the results of tests such as the whole blood clotting time, thrombin clotting time, activated partial thromboplastin time or plasma heparin concentration. The most commonly used test is the activated partial thromboplastin time which should be maintained at 1 1/2 to two times the control level. Initially the test should be performed two to three times daily and when optimal adjustment has been established, clotting studies are required only at 24 hour intervals. In general, treatment with intravenous heparin should be continued for seven to ten days. Thereafter, for secondary prophylaxis, treatment with oral anticoagulants is carried out for six to eight weeks for symptomatic lower leg thrombosis, for twelve weeks in the case of proximal venous thrombosis and pulmonary embolism. Oral anticoagulant therapy with warfarin should be given overlapping the last few days of heparin with the dose adjusted to prolong the prothrombin time to 1.3 to 1.5 times control. Initially, the prothrombin time should be monitored weekly, thereafter at intervals of two to three weeks. If oral anticoagulant therapy is contraindicated, secondary prophylaxis with subcutaneous heparin given twice daily in doses sufficient to prolong the activated partial thromboplastin time to 1 1/2 times control is an effective and safe alternative. The major side effect of oral anticoagulant therapy, as well as that of heparin, is bleeding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695443 TI - Treatment of biliary stones using extracorporeal shock waves (ESWL). AB - The use of extracorporeal shock waves (ESWL) for the treatment of biliary stones was introduced into medicine in 1985. Since then several thousand patients had been treated throughout the world. Treatment is reasonably safe, and the best candidates are patients with solitary radiolucent stones in an opacifying gallbladder and those with bile duct stones primarily unamenable to endoscopic measures. PMID- 2695444 TI - Advantages of nonsurgical treatment of bile duct stones. AB - A variety of effective nonsurgical forms of treating bile duct stones have emerged to challenge the traditional role of surgery. Four distinct philosophies have evolved upon which to base treatment: the partisan, supermarket, combination, and deductive philosophies. Adopting the latter, it is argued that surgery remains the gold standard for the great majority of patients. Surgery should, however, give way to non-operative forms of treatment in those who are at high surgical risk because of concomitant medical problems, acute cholangitis and severe gallstone pancreatitis. These newer treatments should increase the proportion of symptomatic patients amenable to treatment. PMID- 2695445 TI - Advantages and disadvantages of the newer "interventional" procedures for the treatment of cholecystolithiasis. PMID- 2695446 TI - Pros and cons of the nonsurgical treatments for gallbladder stones. AB - Dissolution of gallbladder stones is usually possible if the cholesterol content of the stones is high. Oral treatment with chenodiol or ursodiol is least invasive, but also least effective and slow. methyl tert-butyl ether requires delivery by percutaneous transhepatic catheter, but is rapidly effective. Extracorporeal shock wave lithotripsy enhances dissolution by oral bile acids, but is highly effective only for solitary stones less than or equal to 20 mm in diameter. Percutaneous cholecystostomy is most invasive, but effective regardless of stone composition. Stones will probably recur in 50 percent of patients with a patent cystic duct and intact gallbladder. PMID- 2695447 TI - Advantages of elective surgical treatment of gallstones. AB - The author presents the mortality and morbidity of the surgical treatment of calculous disease of the biliary tract, especially cholecystectomy for chronic cholecystitis and cholelithiasis. Between 1932 and 1984, 10,749 patients underwent cholecystectomy, with an operative mortality of 0.4%. The most frequent cause of death in these patients was advanced age and cardiovascular diseases. Comparatively few patients with gallstones have been treated with bile acids alone or in combination with shock wave lithotripsy or by contact dissolution with MTBE. Although success with the non-operative techniques is improving, the high recurrence of biliary calculi imposes serious limitations on their effectiveness. PMID- 2695448 TI - A prospective randomized trial of schedules for sclerosing esophageal varices. 1 versus 2-week intervals. AB - A prospective randomized trial was performed to compare the efficacy and complications of 1-week (20 patients) and 2-week (20 patients) interval schedules of endoscopic injection sclerotherapy for patients with esophageal varices; 6 were acute, 3 were elective and 31 were prophylactic cases. There were no significant differences between the 1-week and 2-week interval groups with regard to total number of sclerotherapy sessions, total volume of the sclerosant used (5% ethanolamine oleate) or rate of complications such as pyrexia, stricture and pleural effusion. The incidence of ulcer and/or slough formation after EIS was the same in the two groups. Neither early nor recurrent bleeding occurred in any patient in the two groups. Eradication of varices in the 2-week interval group was achieved significantly earlier (p less than 0.05) than in the 1-week interval group. PMID- 2695449 TI - Peroperative ultrasonography in the diagnosis of splenic vein thrombosis. AB - A case of recurrent bleeding from gastric varices due to isolated splenic vein thrombosis is reported. There was no evidence of pancreatic, retroperitoneal or infectious disease. The final diagnosis was made by intraoperative ultrasonography during an emergency laparotomy for massive bleeding from a ruptured gastric vein. Splenectomy is the treatment of choice in this case. The patient was cured after splenectomy. PMID- 2695450 TI - The influence of cholecystectomy on the duodenogastric reflux of bile. AB - The effect of cholecystectomy on postprandial duodenogastric bile reflux was studied by biliary excretion scintigraphy in a group of 20 patients examined before and after gallbladder removal. Dyspeptic complaints were correlated with the presence of postprandial duodenogastric reflux in 37 patients admitted to the hospital for cholecystectomy. The removal of the gallbladder, whether functional or not, in patients presenting with gallstones, did not seem to influence the occurrence of postprandial duodenogastric bile reflux. Dyspeptic complaints were positively correlated with postprandial gastric reflux. This reflux was observed in 90% of dyspeptic patients, while only 7% of the patients without dyspepsia had reflux. The role of duodenogastric reflux in the production of dyspeptic complaints is open to discussion, but the removal of the gallbladder does not seem to interfere with the occurrence of bile reflux into the stomach after a milk meal. PMID- 2695451 TI - Gastric cancer: the pathologist's role. PMID- 2695452 TI - Imaging diagnosis of obstructive jaundice. AB - In the past, before the development of biochemical tests for serum enzymes, differentiation between obstructive (surgical) and parenchymal (medical) jaundice was difficult. It was based mainly on patient history, physical examination and the experience of the physician, and the definitive diagnosis depended on surgical exploration. Even with known serum aminotransferase and alkaline phosphatase levels, a distinction between the two types of jaundice was not always certain. Then came the era of new imaging techniques. With the development of direct cholangiography followed by x-ray CT and real-time ultrasonography (US), differential diagnosis of surgical and medical jaundice is no longer a problem. In the clinical setting, the current issue is how quickly and how less invasively the diagnosis could be made. In this chapter, current imaging diagnosis in patients with obstructive jaundice will be discussed, along with its differentiation from medical jaundice. PMID- 2695453 TI - [Optic, scanning and transmission electron microscopic observations of synthetic fibers implanted in rabbit skin]. AB - Artificial hair made of synthetic leacryl fibre was inserted into the skin of a rabbit in order to evaluate the biocompatibility of the insertion of heterologous material. On the 7th and 30th day following insertion, samples were taken from the areas involved and were observed by MO, TEM and SEM studies. Granuloma in both the early stage (7th day) and later at 30 days was evidenced and found to develop to cicatricial sclerosis. PMID- 2695454 TI - [Werner's syndrome and intracranial meningioma]. AB - A case of Werner's Syndrome in a 47-year-old man, with typical features of progeria associated with intracranial meningioma is described. A revision of the literature showed that meningioma is the most frequent benign neoplasm in Werner's Syndrome. Meningioma is a peculiar model of neoplasm, because of the frequency of cytogenetical aberrations concerning chromosome n. 22. Either chromosome n. 22 and other chromosomal alterations could be detected in peripheral blood lymphocytes of our patient. These findings suggest a correlation between chromosomal instability and the onset of neoplasms in Werner's Syndrome. Furthermore, the possibility of detecting chromosome n. 22 aberrations in peripheral blood lymphocytes of Werner's Syndrome patients could provide a clue to the presence of a meningioma at a preclinical stage. PMID- 2695455 TI - [Thymopentin in the treatment of cutaneous melanoma]. AB - Thirty-three patients were treated with thymopentin (synthetic thymic-hormone) after complete surgical removal of cutaneous malignant melanoma without clinical evidence of metastases and with evidence of immunocellular deficiency, with the aim of obtaining a normalization of the immunological parameters. The cell mediated immunity was evaluated by utilizing monoclonal antibodies CD3, CD4, CD8, CD21, NK and the Multitest C.M.I. (Institut Merieux-Lyon-France), before treatment and then every three months. A follow-up at 29 months showed an improvement of the immune parameters: respectively 58%, 67% and 42% of the patients undergoing therapy had an increase of 40% of the CD3, CD4 and NK lymphocytes. Seven patients, with pre-existing hypergy following tests of skin reactions, present a normalization of this parameter during the treatment. In the follow-up three patients had metastases. The results show the improvement of the considered immunological parameters and low percentage of relapses. It may be considered as a preventive measure for immunological control of relapses. PMID- 2695456 TI - Binding properties of diethylcarbamazine. AB - Diethylcarbamazine (DEC) reacted with liver cell plasma membrane of rodent hosts cotton rat, albino rat and Mastomys natalensis exhibiting the presence of both saturable and unsaturable components. The presence of lectins or sugar derivatives did not affect the binding significantly. The drug showed similar binding pattern with serum but the saturation was reached at a much lower concentration of the ligand. Data obtained with a variety of macromolecules, particularly with the homopolymers of amino acids indicate that DEC does not require any specific constituent of the membrane for binding. The nonspecific nature of DEC binding does not provide any convincing clue for the accumulation of microfilariae specifically in the liver following the drug treatment. PMID- 2695457 TI - Study of medical mycology in India--an overview. PMID- 2695458 TI - Incidence of klebocinogeny using two indicator systems. AB - The incidence of bacteriocinogeny among 117 clinical isolates of Klebsiella pneumoniae was examined using two systems of indicators-K. pneumoniae WC indicator and the Abbott-Shannon set of indicators. None of the isolate tested produced bacteriocin active on K. pneumoniae WC while 23 per cent positivity was observed with the Abbott-Shannon indicators. Most of the bacteriocin producers were urinary isolates (53.8%) followed by 15.3 and 30.7 per cent respectively of faecal and miscellaneous isolates. Our results indicate the advantages of using a set of indicators over a single indicator strain. PMID- 2695459 TI - Immunoprotection by beta-1,3 glucan antigen combination in Plasmodium berghei infection in mice. AB - In an attempt to protect mice against experimental infection with P. berghei, mice were immunized against soluble extract of P. berghei in combination with beta-1,3 glucan or FCA and also independently. Mice immunized against P. berghei antigen-glucan developed well defined cell mediated and humoral immune responses, while mice injected with antigen FCA or antigen alone developed only an antibody response. Antigen-glucan immunization afforded a high degree of immune protection to the host against the challenge with live parasites. PMID- 2695460 TI - A simple deterministic model for host-parasite relationship in Wuchereria bancrofti infection & its relevance to parasite regulation in human host. AB - A deterministic immigration-death model, which reflects the population dynamics of W. bancrofti in human host has been applied to study the relationship between vector and human infections. Application of the model showed that the rate of acquisition and loss of human infection were approximately equal (L = 0.130 and M = 0.129). The relationship of infective resting density (IRD) in vector population with maximum intensity (Imax) of infections and microfilaria prevalence (MFP) in human population were examined by using the least squares polynomial regressions. The fifth order polynomial regressions were found to be adequate to describe the observed pattern (Imax vs IRD: R2 = 0.8464, P = 0.0015; MFP vs IRD: R2 = 0.7246, P = 0.019). The observed relationships indicated that at an infective resting density of 0.26 per man hour or above, the density-dependent factors start regulating the human infections, which showed a declining trend, following this level. PMID- 2695461 TI - Biotypes of Gardnerella vaginalis isolated from non-specific vaginitis patients in Bombay. AB - The incidence and prevalent biotypes of G. vaginalis in patients with non specific vaginitis from Bombay, was studied. Of 300 patients screened, 105 were diagnosed to have nonspecific vaginitis (NSV). G. vaginalis was isolated from 71 per cent patients with NSV; 34.6 and 29.3 per cent G. vaginalis were belonging to biotypes 5 and 1 respectively. In 55 per cent patient, G. vaginalis was associated with anaerobes. None of the isolated strains of G. vaginalis was sensitive to 5 micrograms metronidazole disc whereas 93 per cent of the strains were sensitive to 50 micrograms metronidazole disc. PMID- 2695462 TI - Evaluation of the new rapid rabies immunodiagnosis technique. AB - The rapid rabies enzyme immuno-diagnosis (RREID) kit was evaluated for its sensitivity and specificity in comparison to fluorescent antibody technique (FAT) and biological test (BT) for the diagnosis of rabies. While 93 per cent correlation was observed in case of fresh brain samples, 71 per cent correlation was noted with glycerol preserved samples, where RREID was more sensitive than FAT. RREID test can be employed for rapid diagnosis of rabies, when facilities for FAT are not available. However, to test, at one time, small number of specimens, the RREID kit needs to be modified. PMID- 2695463 TI - Effects of central administration of insulin in normal and VMH (ventromedial hypothalamus) lesioned rats on food intake. AB - Central effects of insulin on 20 min. food intake were studied in rats. Insulin administration in the lateral ventricular cerebrospinal fluid (CSF) did not alter food intake in the intact or lesioned ventromedial hypothalamus (VMH) rats. Whereas, after insulin injection in VMH there was a decrease in food intake. In VMH lesioned rats, subcutaneous injection of insulin increased food intake. PMID- 2695464 TI - The pineal gland: its physiological and pharmacological role. AB - Our perception of pineal gland function has attained new dimensions during the last decade. The gland is active throughout the life of an individual and secretes melatonin, the major pineal hormone, and many indoles and polypeptides. The secretion of pineal gland is regulated not only by sympathetic nerve fibers but by other central pinealopetal projections also. Many neurotransmitter receptor sites have been identified recently in the pineal gland. The gland plays an established role in controlling reproduction and is involved in the control of sexual maturation. It has a major influence on the circadian organization of vertebrates including human beings. The hormone melatonin has a potential therapeutic valve in treating disorders that are associated with biological rhythm disturbances like sleep disorders, "jet lag" phenomena and affective disorders. The gland is actively involved in the mechanisms controlling sleep wakefulness cycle and human mood disorders. It actively participates in the neuroendocrine mechanism controlling stress and acts even as an oncostatic gland. The pineal gland may be considered an "equilibrating-tranquilizing gland" contributing to longevity. PMID- 2695465 TI - Effect of isoniazid on insulin induced hypoglycemia in rabbits. PMID- 2695466 TI - Propranolol. PMID- 2695467 TI - Exposure of peritoneal catheter of ventriculoperitoneal shunt following minor trauma. PMID- 2695468 TI - Pathogenetic mechanisms in essential hypertension. Analogies between a rat model and the human disease. AB - Essential hypertension is a genetic disease. Its phenotypic expression depends on the interaction between genetic and environmental factors. In prehypertensive rats of the Milan hypertensive strain (MHS) a genetically inherited increase of tubular reabsorption was found, which causes the increase of blood pressure. Studies of ion transport systems in these rats have shown that the Na-K cotransport activity is increased both in erythrocytes and in tubular cells of MHS rats compared with their normotensive controls (MNS) and that this alteration is genetically linked to the transmission of high blood pressure levels. Also, in young human normotensives prone to develop essential hypertension there is an abnormal pattern of renal function which could be in agreement with a primitive increase in tubular reabsorption. Studies of erythrocyte ion transport systems in these subjects suggest that at least in a subgroup of humans predisposed to develop essential hypertension a pathogenetic mechanism similar to the one proposed for the MHS rat can be at work. PMID- 2695469 TI - The Na-K-Cl cotransport in essential hypertension: cellular functions and genetic environment interactions. AB - The present paper examines factors involved in the expression of the Na-K-Cl cotransport system present in erythrocytes and in vascular cells. This transport system is modulated by vasoactive peptides such as atrial natriuretic factor and bradykinin in vascular smooth muscle and endothelial cells. The Vmax of the Na-K Cl in human red cells displays large interindividual differences which can be mainly accounted for by genetic factors. Elevation of the Km for Na of the outward Na cotransport is found in red cells of some Caucasian hypertensives and in Black normotensives born of hypertensive parents whose blood pressure increases with salt loading. Reduction of Na intake from 200 to 10 mEq/day does not influence the activity of the cotransport in normotensive individuals but decreases the Km for Na of hypertensive subjects to values similar to those of the normotensives. These findings indicate that the Na-K-Cl cotransport is an important probe of genetic and environmental factors in the hypertensive process. PMID- 2695470 TI - Arterial pressure and aging. AB - Systolic arterial pressure increases with aging. This increase encompasses both the clinically normal and hypertensive ranges of pressure and is due in part to arterial stiffening. To what extent it may be modulated by life style changes that accompany aging is unknown. The stiffer arterial tree transmits the pulse wave with a higher velocity such that reflected waves return to the aortic root during the ejection period. This causes the aortic impedance to increase at this time, leading to a late peak in systolic pressure. Cardiac adaptation to these vascular changes include left ventricular hypertrophy and prolonged Ca2+ activation of contractile proteins leading to prolonged contraction. The resultant delayed contractile relaxation, in part, leads to a slower velocity of early left ventricular filling; however, this is offset by an enhanced atrial contribution to filling. These myocardial adaptations with aging, which in animal models appear, in part at least, to be controlled from within the genome permit a relatively normal heart volume and ejection fraction in the presence of chronically elevated afterload. These changes that occur with aging in otherwise healthy individuals can occur at a younger age in clinical hypertensives and can be produced in young experimental animals by hypertension. Thus, aging has sometimes been referred to as blunted hypertension, or hypertension as accelerated aging. PMID- 2695471 TI - The MMPI profiles of narcotics addicts. I. A review of the literature. AB - This paper reviews three approaches to using the Minnesota Multiphasic Personality Inventory (MMPI) in the assessment of narcotics addicts' psychopathology. Two approaches examine the relationship of MMPI profiles to established sociodemographic or psychiatric typologies; the third pertains solely to MMPI-derived personality typologies. Findings from the research literature are presented and their implications for clinical assessment and treatment are discussed. PMID- 2695472 TI - On the course of epidemics of some infectious diseases. PMID- 2695473 TI - Population screening for cervical cancer in The Netherlands. A report by the Evaluation Committee. AB - A programme of population-based screening for cervical cancer in three adjacent regions in the Netherlands is described. The target female population aged 35-54 was 370,000. Screening was performed three times with intervals of three years during the period 1976-84. The total numbers of histologically proven abnormalities were 406, 1025 and 215 for severe dysplasia, carcinoma in situ and invasive carcinoma respectively. Detection rates were highest in the more urbanized regions and they fell from 3-5 per 1000 in the first to less than 2 per 1000 in the third screen. Specificity of screening was high enough to reach a predictive value of a positive test of 80% in the first screen and of 60-70% in the second and third screen. Population-based cervical cancer registries enabled the investigators to calculate the sensitivity of screening; if defined as the percentage of invasive cancers appearing within three years of cytological test result showing less than severe dysplasia, sensitivity was 60-70%. Further cytological follow-up of cytological smears with moderate dysplasia could be shown to increase sensitivity to about 80%. A case-control study showed that screening protects against a diagnosis of invasive cervical cancer (odds ratio 0.22 with 95% Cl 0.07-0.69) within the next five years. Prognosis of cervical cancer detected early is generally good. Survival statistics from the programme compare favourably with those from the 'normal care' system. Still, the stage distribution of the latter category has much improved over the last decades, probably due to introduction of the cervical spatula in general practice in 1975. Cost-effectiveness studies and future government health policy are discussed. PMID- 2695474 TI - Alcoholic beverage consumption and the risk of endometrial cancer. Cancer and Steroid Hormone Study Group. AB - Previous studies have suggested that alcoholic beverage consumption may lead to a decrease in a woman's oestrogen levels. It is possible that any such alcohol associated decrease could lead to a decrease in endometrial cancer risk. To study the association between alcohol consumption and endometrial cancer, we examined data from the Cancer and Steroid Hormone Study, a multi-centre, population based, case-control study. A total of 351 women with primary epithelial endometrial cancer and 2247 women selected from the same geographical areas as the cases were interviewed for the study. As part of the interview, the participants provided information regarding their alcohol consumption during the preceding five years. Analysis of these data revealed that women who were non-drinkers had a risk of endometrial cancer of 1.83 relative to the risk of women who had consumed an average of 150 grams or more of alcohol per week (95% Cl, 1.11, 3.01). Women who drank, but who consumed less than 150 grams of alcohol per week, were at an intermediate risk. The increased risk associated with abstinence from alcohol consumption was particularly great in overweight women and was virtually absent in lean women. These results argue that alcohol ingestion may reduce a woman's risk of endometrial cancer, particularly if she is overweight. PMID- 2695475 TI - A meta-analysis of acupuncture for chronic pain. AB - Results of 14 randomized controlled trials of acupuncture for chronic pain were pooled in a meta-analysis and analysed in three subgroups according to site of pain; and in two subgroups each according to type to trial, type of treatment, type of control, 'blindness' of participating agents, trial size, and type of journal in which results were published. While few individual trials had statistically significant results, pooled results of many subgroups attained statistical significance in favour of acupuncture. Various potential sources of bias, including problems with blindness, precluded a conclusive finding although most results apparently favoured acupuncture. PMID- 2695476 TI - Occupational cohort studies: the influence of design characteristics on the healthy worker effect. AB - A cross-sectional analysis of the relation between the estimated healthy worker effect (HWE), as measured by a total Standardized Mortality Ratio (SMR) less than 100, and relevant design characteristics in 270 published retrospective occupational cohort studies is presented. The majority of the reviewed studies showed a HWE, varying in SMR from 50 to 99 (mean: 84). The estimated HWE seemed to influence the final outcomes of the studies to a great extent. A tendency for a positive relation between the study size in terms of the number of exposed workers, total number of person-years of follow-up, and the HWE emerged. Studies with a comparatively short follow-up period had an increased chance of resulting in a HWE. Cross-sectional cohorts did not show a stronger HWE than open cohorts. Studies of chemical exposures revealed a fivefold excess of having a HWE compared with other studies. PMID- 2695477 TI - Development of rapid epidemiologic assessment methods to evaluate health status and delivery of health services. AB - This paper describes the evolution of the concept of rapid epidemiologic assessment (REA) from a series of ideas to a defined area of epidemiologic research. Five broad areas of research are defined: small area survey and sampling methods, surveillance methods, screening and individual risk assessment, community indicators of risk or health status, and case-control methods for evaluation. REA techniques can provide health information more rapidly, simply and at less cost than the standard data collection methods and yet still yield reliable results. The use of these methods is described with examples from both a research programme designed to stimulate the development of REA methods and from other studies in the literature. The further development of REA techniques can lead to better decisions regarding the delivery and allocation of health services in both developing and industrialized countries. PMID- 2695478 TI - Growth failure prediction in Chile. AB - The purpose of this investigation was to develop screening instruments for the prediction of infants' growth failure. Biological and social variables of subjects attending public clinics in Santiago, Chile, were prospectively collected and screened as possible risk factors of being underweight/age at the end of the first year of life using three methodologies. Methodologies used were: simple relative risk, logistic regression, and classification and regression trees. As judged by sensitivity and specificity properties, the screening instrument developed by the latter methodology is much better than the other two. PMID- 2695480 TI - Blood viscosity in human obesity: relation to glucose tolerance and insulin status. AB - Obesity is known to be associated with an elevated risk for cardiovascular disease. Rheological disturbances could be factors contributing to these vascular complications. Therefore we have evaluated blood viscosity parameters in 128 obese (BMI greater than 28 kg/m2) adults and in 90 non-obese healthy subjects. Whole blood, plasma and erythrocyte viscosity values were determined with a Contraves LS30 viscosimeter. Plasma and whole blood viscosity were significantly (all P less than 0.001) increased in the obese subjects. The increased low shear erythrocyte viscosity suggested a diminished erythrocyte deformability in obesity. The rheological abnormalities were present even in the absence of impaired glucose tolerance, diabetes, hypertension or hyperlipidaemia. In the obese group the rheological parameters showed significant correlations (at least P less than 0.05) with BMI, insulin or C-peptide area during an oral glucose tolerance test and plasma lipids. Our findings demonstrate that obesity per se may be associated with abnormal blood viscosity properties. PMID- 2695479 TI - Development and evaluation of a colour-coded scale for birthweight surveillance in rural Egypt. AB - Birthweight surveillance is an important epidemiologic tool, yet it is largely unattainable in locales where most births occur at home attended by traditional midwives. A tempered-steel hand-held scale developed by Program for Appropriate Technology in Health (PATH, Seattle, USA) was adapted for use by Egyptian traditional midwives; it identified newborns weighing less than 2.5 kg by a colour code (yellow versus blue). The scale and reporting system were field tested in a rural Egyptian village. Traditional midwives reported 98% of 299 livebirths attended and 85% were reweighed by Salter scale within 48 hours. Sensitivity of the scale was 100%, specificity 94%. Field conditions are specified for incorporating this method into a surveillance system. PMID- 2695481 TI - Effects of BRL 35135, a beta-adrenoceptor agonist with novel selectivity, on glucose tolerance and insulin sensitivity in obese subjects. AB - BRL 35135 is a novel oral agent which, when dosed chronically to obese rodents with abnormal glucose tolerance, improves both insulin sensitivity and glucose tolerance. To study its effect in man, 10 obese patients on a weight-maintaining diet received BRL 35135 2 mg four times per day for 5 days and then 6 mg four times per day for 5 days. Oral 100 g glucose tolerance tests were performed 1 day prior to and 12 h after the 10-day treatment with BRL 35135. Simultaneously, energy expenditure, glucose oxidation and glucose storage were measured by open circuit indirect calorimetry. No significant changes in body weight occurred during the 10-day treatment with BRL 35135. Areas under the curves for glucose and insulin were reduced following treatment with BRL 35135 (1518 +/- 152 to 1277 +/- 132 mmol/1/3 h, P less than 0.001 and 13.8 +/- 1.7 to 9.5 +/- 1.3 U/l/3 h, P less than 0.01) (mean +/- s.e.m.). In addition, plasma glucose concentrations, 2h post-oral glucose, were reduced significantly (8.7 +/- 1.0 mmol/l to 6.7 +/- 0.78, P less than 0.01). There was no effect of the treatment on glucose-induced thermogenesis and glucose oxidation did not change but glucose storage increased significantly. The results suggest that BRL 35135 improves glucose tolerance by an increase in insulin sensitivity that is independent of body weight. Glucose storage accounted for the increased glucose disposal. PMID- 2695482 TI - Distribution and function of organized concentrations of actin filaments in mammalian spermatogenic cells and Sertoli cells. AB - Actin filaments are concentrated in specific regions of spermatogenic cells and Sertoli cells. In spermatogenic cells they occur in intercellular bridges and in the subacrosomal space. In Sertoli cells they are abundant in ectoplasmic specializations and in regions adjacent to tubulobulbar processes of spermatogenic cells. At all of these sites, the filaments are morphologically related to the plasma membrane and+or intercellular membranes, and, as in many other cell types, are arranged in either bundles or networks. In at least two of the locations just indicated (ectoplasmic specializations and intercellular bridges), elements of the ER are closely related to the actin filaments. In tubulobulbar complexes, ER is present but is more distantly related to the filaments. Elements of the ER, when present, may serve a regulatory function. The filaments in ectoplasmic specializations and in regions adjacent to tubulobulbar processes of spermatogenic cells are suspected to be involved with the mechanism by which intercellular junctions are established, maintained, and degraded. In intercellular bridges, actin filaments may serve to reinforce and perhaps regulate the size of the cytoplasmic connections between differentiating germ cells. Filaments in the subacrosomal space may serve as a linking network between the acrosome and nucleus and may also be involved in the capping process. Because of the possibility that the actin filaments discussed before may be related to specific membrane domains involved with intercellular or interorganelle attachment, and that changes in these membrane domains are prerequisite to processes such as sperm release, turnover of the blood-testis barrier, formation of the acrosome, and coordination of spermatogenic cell differentiation, an understanding of exactly how these actin filaments are related to elements in the membrane and how this interaction is controlled is fundamental to our understanding, and perhaps our manipulating, of male fertility. I suspect that working out the molecular organization of these actin filament-containing sites and determining how their organization is controlled will be the major focus of research in this field over the next few years. PMID- 2695483 TI - Localized mRNA and the egg cytoskeleton. PMID- 2695484 TI - Regulation of membrane fusion during exocytosis. PMID- 2695485 TI - Studies on scaffold attachment sites and their relation to genome function. PMID- 2695486 TI - Biochemistry and cell biology of amphibian metamorphosis with a special emphasis on the mechanism of removal of larval organs. PMID- 2695487 TI - [What is assured in therapy with HMG-CoA reductase inhibitors (cholesterol synthesis inhibitors)?]. PMID- 2695488 TI - [What is assured in therapy with angiotensin converting enzyme (ACE) inhibitors?]. PMID- 2695489 TI - [What is assured in therapy of gastrointestinal diseases with drugs acting on motility?]. PMID- 2695490 TI - [What is assured in therapy with expectorants?]. PMID- 2695491 TI - [Determination of lymphocyte subpopulations in peripheral blood]. PMID- 2695492 TI - [Severe tumor lysis syndrome in acute lymphatic leukemia]. PMID- 2695493 TI - Antibody molecules: mediators of disease and diagnostic tools. PMID- 2695494 TI - Maximising safety when prescribing non-steroidal anti-inflammatory drugs. AB - Current knowledge on side-effects of non-steroidal anti-inflammatory drugs (NSAIDs) is reviewed. These occur most commonly in the gastro intestinal tract and include peptic ulceration and haemorrhage as well as effects on the small and large bowel. Renal effects with many manifestations are also increasingly described. Photosensitivity is the most common adverse dermatological effect. The role of various NSAIDs in causing asthma is now well recognised. Many less common side-effects occur, the most significant of which is marrow aplasia. Phenylbutazone and indomethacin are rarely but definitely associated with this, but other NSAIDs including ibuprofen are also suspected, but unproven, causes. A strategy for minimising side-effects is outlined. Where there is not a strong indication for use of an NSAID, local physical measures or a pure analgesic can be substituted. If an NSAID is really necessary, it is best to commence with a drug of lesser potency in the first instance, unless the patient is suffering from a severe inflammatory disorder. Indomethacin and piroxicam should be reserved for when other NSAIDs have not been effective. Patients who have a past or present history of peptic ulceration but still need to continue their NSAID therapy, should combine it with an anti-ulcer drug. In the case of younger patients a H2 receptor antagonist is the drug of first choice, whereas in the older patient a mucosal protective agent such as sucralfate is preferred. In the event of ulcer relapse, combination with a prostaglandin analogue is the next step. The growing awareness of side-effects with NSAIDs suggests that monitoring of patients commencing NSAIDs and on long-term treatment, should be increasingly practiced. PMID- 2695495 TI - Dying at the right time: a critical legal theory approach to timing-of-death issues. PMID- 2695496 TI - The infant with anencephaly: moral and legal dilemmas. PMID- 2695497 TI - [HIV in sperm]. AB - HIV in the semen is located in the mononuclear cell fraction, which contains CD4 lymphocytes and monocytes/macrophages, i.e. the classic HIV host cells. In addition, HIV is also present in cell-free seminal fluid. The results on HIV binding to spermatozoa are still controversial. Genital tract infections are a possible cofactor that might increase the risk of HIV transmission by way of the semen, because they lead to a marked increase in the number of potential HIV host cells in semen. PMID- 2695498 TI - [Serology of HIV infection]. AB - Serological testing aimed at the detection of antibodies against the human immunodeficiency virus (HIV) is now performed throughout the world to screen stored blood for transfusion, for the diagnosis of HIV infection and of AIDS, and to determine the prognosis of AIDS patients. The present report, based on 258,090 serum samples screened for HIV antibodies, gives an overview of the theoretical and practical aspects of both modern screening methods and confirmation tests for HIV1 and HIV2, the demonstration of serological antigen and IgM, and HIV serology of the cerebrospinal fluid. Knowledge of HIV serology appears to be important for any physician, and in particular for the dermatologist, since HIV infection (like syphilis) can cause a variety of dermatological manifestations mimicking other dermatoses. PMID- 2695499 TI - [Keratoacanthoma centrifugum marginatum]. AB - Keratoacanthoma centrifugum marginatum (KCM) is a rare distinct variant of keratoacanthoma. Based on three personal observations and a review of the literature, the authors describe the clinical and histological features of this neoplasm. Clinically KCM is characterized by the lack of a tendency for spontaneous remission and by continuous centrifugal spread. Histologically there is a subclinical, iceberg-like growth pattern. Like keratoacanthoma, KCM is a highly differentiated, biologically benign, non-metastasizing tumour. The treatment of choice is early excision of the tumour. PMID- 2695500 TI - [Use of the TDF factor in soft roentgen radiotherapy]. AB - In a prospective randomized study 164 patients with altogether 142 basal cell carcinomas and 24 squamous cell carcinomas were each irradiated with a single dose of 3 Gy daily on 20 consecutive days, giving a total dose of 60 Gy (TDF factor 123). In another group of 155 patients, with altogether 148 basal cell carcinomas and 20 squamous cell carcinomas, each patient received 4 Gy 3 times per week until 12 irradiations had been administered, giving a total dose of 48 Gy (TDF factor 103). The cure rates in patients with basal cell carcinomas did not differ between the two groups: 90% were cured by the higher total dose and 92%, by the lower dose. The high dose regimen brought about a cure in 96% of squamous cell carcinomas, in contrast to only 85% with the low dose regimen. Owing to the small number of patients the difference was not statistically significant. These data demonstrate that basal cell carcinomas can be controlled by low-dose irradiation regimens. Squamous cell carcinomas may have a lower radiosensitivity than basal cell carcinomas and may require higher doses. PMID- 2695501 TI - [Pancreatogenic panniculitis. 2 case reports with a literature review]. AB - We present 2 cases of subcutaneous fat necrosis associated with pancreatic disease. In 1 of these cases the correct diagnosis led to the detection of a clinically asymptomatic chronic pancreatitis. The pathogenesis of this disease, not yet fully explained, and the differential diagnosis of other forms of panniculitis are reviewed. PMID- 2695502 TI - [Chalazion or basalioma in an oil painting of the National Portraits Gallery in London]. AB - Using an oil painting by G.F. Watts displayed in the National Portrait Gallery of London, we made an attempt to diagnose the dermatological alterations recognizable. PMID- 2695503 TI - A health promotion program: Staying Healthy After Fifty. AB - In this article, a description of how a comprehensive health promotion program for older adults was developed, tested with a quasi-experimental study design, and then revised to become a nationwide AARP and Red Cross program is presented. Teaching and learning methods used in the course are described with supporting education and behavioral theory. The course content for instructors, facilitators, and course participants is outlined. The key elements in the preparation of instructors and facilitators are identified. Results of the implementation of the program are given. PMID- 2695504 TI - Cyclical changes in emotional information processing in sleep and dreams. AB - Our scientific tools have rapidly advanced in recent decades. Urine tests and hormone assays allow us to know exactly where a woman is in her menstrual cycle and to document precisely her hormonal rhythms. Sleep-laboratory techniques allow us to know exactly when someone is dreaming so that we can obtain that communication that Freud prized so highly. Furthermore, we now have quantifiable means to measure accessibility to nonverbal mental representations, which derive from important advances in theory and method in cognitive psychology in the last several decades. None of the studies we surveyed combined these tools. The sleep laboratory studies did not document menstrual-cycle phase with either temperature or hormone levels. Moreover, the relationship between their findings and daily functioning is still unclear. The psychoanalytic study by Benedek and Rubenstein carefully documented cycle phase, but statements about fantasy and conflict were large and sweeping and the focus was on drive-related rather than information processing effects. Careful work must be done by modern investigators before the field of medical psychoanalysis can address the basic questions of mind-body functioning that are at issue here. We have presented one approach to entering the communication network of mind-brain functioning, that is, the application of the dual-code model to dreams, in the context of the influence of hormones across the menstrual cycle. Although prior research has demonstrated cyclical fluctuations of psychodynamic themes in dream content (Baron, 1977; Benedek & Rubenstein, 1939a, b; Hertz & Jensen, 1975; Lewis & Burns, 1975; Swanson & Foulkes, 1968), the existence of a cyclical cognitive pattern as regulated by gonadal function has not previously been explored. While the findings are preliminary and limited, this is the first study to provide evidence that there are psycholinguistic styles characteristic of different phases in the menstrual cycle, and that this variation in verbal expression reflects a correspondence between hormone production and the ability to access and communicate nonverbal representations. Although the relationship between referential activity and phases of the menstrual cycle represents a statistical relationship and is hardly conclusive, the article does demonstrate how the dual-code model permits us to translate our psychoanalytic observations into operational terms. This provides one means of access to the network of communication between neuropeptides and mental representation, or in more general terms, between body and mind. PMID- 2695505 TI - Sigmund Freud and money. AB - I have tried to clarify Sigmund Freud's attitude toward money during the different time periods of his life. Most biographers have written that Freud was born into a poor family that later was elevated to the socioeconomic middle class in Vienna. This traditional viewpoint can be supported by various of Freud's letters and writings. A very different viewpoint has been proposed by the well known American economist, Peter Drucker. As has been noted, his parents knew the Freud family in Vienna where Drucker actually met Freud. Drucker contends that Freud unconsciously misrepresented his parents' financial situation by creating the myth that they lived in poverty. Furthermore, Freud also developed another myth that it was because of the strong anti-Semitism in Vienna that he was so delayed in being appointed a professor of psychiatry. Drucker points out that the majority of the Viennese physicians were Jewish and that Freud's becoming a professor did not entail a delay and was not affected by any anti-Semitism in Vienna. Another area of conflict between Freud and the other Viennese physicians was Freud's refusal to treat any of his psychoanalytic patients without a fee. Freud believed that treating a patient in analysis for free created a transference-countertransference problem that might doom the treatment to failure. Freud's transference explanation for not taking on charity patients did not satisfy many of his Viennese physician colleagues. They believed that Freud was given an opportunity to accept their traditional standards and turned it down. In their eyes, Freud rejected them, they did not reject him. The same reasoning applied to the Viennese physicians' request for some scientific proof of the efficacy of psychoanalysis. Freud could only provide them with anecdotal or testimonial evidence to support psychoanalytic treatment. This placed psychoanalysis in the category of a belief system and not a scientific treatment. Drucker explains Freud's "obsession" with having lived in poverty as a manifestation of his "poorhouse neurosis." According to Drucker this syndrome was frequently found among Viennese during the last quarter of the 19th century. It was an irrational and deep-seated fear that an individual and his family were on the verge of being placed in the poorhouse because they lacked any funds. Freud does not specifically mention his having this irrational fear or obsession, but he made several statements quoted here indicating such a dread. At a recent psychoanalytic meeting I asked Freud scholar John Gedo of Chicago if he thought Freud experienced a "poorhouse neurosis."(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2695506 TI - Mechanism of LHRH-stimulated steroidogenesis in rat Leydig cells: lipoxygenase products of arachidonic acid may not be involved. AB - Luteinizing hormone releasing hormone agonist, [(imBzl)-DHis6,Pro9,NEt]-LHRH (LHRH-A), caused a two to threefold increase in in vitro testosterone (T) secretion by rat Leydig cells. This LHRH-A-induced T secretion was completely blocked by quinacrine and chloroquine, inhibitors of phospholipase A2. Addition of phospholipase A2, however, was ineffective in stimulating basal or LHRH-A induced T secretion. Phospholipase C, on the other hand, significantly stimulated both basal and LHRH-A-induced T secretion. Exogenously added arachidonic acid stimulated basal T secretion in a dose dependent manner, the maximum increase being about 100% over basal at a dose of 100 microM. Higher doses of arachidonic acid had no stimulatory effect. In the presence of LHRH-A, the stimulatory effect of arachidonic acid was additive up to a concentration of 100 microM; but higher concentrations of arachidonic acid (200 microM) were inhibitory. LHRH-A-induced steroidogenesis was inhibited by 5, 8, 11, 14 Eicosatetraynoic acid (ETYA), an inhibitor of all the three known pathways of arachidonic acid metabolism, and by nordihydroguaiaretic acid, and inhibitory of the lipoxygenase pathway of arachidonic acid metabolism. LHRH-A-stimulated T secretion was not inhibited by indomethacin, an inhibitor of the cyclo-oxygenase pathway of arachidonic acid metabolism. ETYA inhibited arachidonic acid-induced T secretion. Nordihydroguaiaretic acid, on the other hand, augmented basal, arachidonic acid-, phospholipase C-, or phorbol 12, myristate 13 acetate-induced testosterone secretion. These results suggest that arachidonic acid, whose release is influenced by phospholipase C, is involved in LHRH-A-induced T secretion by rat Leydig cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695507 TI - Normal gonadal functions and fertility after 23 months of treatment of prepubertal male and female dogs with the GnRh agonist [D-Trp6, des-Gly NH2(10)]GnRH ethylamide. AB - The GnRH agonist [D-Trp6, des-Gly-NH2(10)]GnRH ethylamide was administered to prepubertal male and female dogs daily for 23 months by subcutaneous injection. During GnRH agonist treatment, plasma steroid levels, namely dehydroepiandrosterone, androst-5-ene-3 beta-17 beta-diol, androstenedione, testosterone, dihydrotestosterone, 5 alpha-androstane-3 alpha, 17 beta-diol, 5 alpha-androstane, 3 beta, 17 beta-diol were markedly inhibited in male animals, whereas in female animals, the plasma concentration of DHEA and delta 5-diol were decreased. Within 2 months following cessation of therapy, all steroids increased to normal adult levels. Morphological studies reveal that treatment of male animals with the GnRH agonist is accompanied by a small volume of seminiferous tubules, Leydig cells, and prostate gland, whereas in the ovaries of female animals, there is a large number of primordial follicles, a few primary follicles, but no secondary follicles. In the pituitary gland of animals of both sexes, LH-secreting cells have high levels of glycogen particles in their cytoplasm and tend to be either of normal appearance with dilated rough endoplasmic reticulum (RER) or strongly atrophied with a dark-stained cytoplasm, a contraction of RER, and a decrease in the number of secretory granules. Reticular cells of the connective tissue also show high levels of glycogen particles. After the 14 month recovery period, spermatogenesis has a normal adult appearance, the prostate gland shows a normal secretory epithelium, and secondary follicles are easily observed in the ovary. Gonadotrophs are free of glycogen accumulation, but reticular cells continue to show an accumulation of glycogen particles in their cytoplasm. Two male and two female animals were mated after the recovery period and produced normal offspring with normal fertility. The present results indicate that GnRH agonist treatment achieves a blockade of sexual maturation and that following cessation of treatment, normal pituitary gonadal functions resume, with apparently normal fertility and normal offspring. PMID- 2695508 TI - Excitement in the beta-lactamase arena. PMID- 2695509 TI - Treatment of anaerobic pulmonary infections. PMID- 2695510 TI - The effect of mutations in the SOS response on the kinetics of quinolone killing. AB - The SOS response is induced in Escherichia coli by agents that damage DNA, such as quinolone antibiotics. It has been proposed that induction of the SOS response by these agents may have a role in the mechanism of quinolone action. SOS mutants derived from Escherichia coli AB1157 were investigated by susceptibility testing and killing kinetic studies at various quinolone concentrations to determine whether SOS response induction was protective or damaging to quinolone-treated bacteria. Susceptibility testing showed some differences between the SOS mutants, but killing kinetic studies demonstrated further differences, some of which could be explained with respect to the SOS phenotype. The effect of ciprofloxacin and nalidixic acid on the mutants cannot be explained with respect to the SOS phenotype, although the presence of a defective SOS response makes the bacteria less sensitive to the action of these agents. Evidence is provided that the induction of the SOS response may be protective to fleroxacin and enoxacin treated bacteria. These results suggest that quinolones may not have a common mechanism of action, as was first thought. PMID- 2695511 TI - Reaction products of chloramphenicol acetyltransferases from enterobacteria and Haemophilus influenzae. AB - The reaction products of Types I, II and III chloramphenicol acetyltransferases (CATs) from reference strains of Escherichia coli and Type II CATs from clinical isolates of Haemophilus influenzae were examined by HPLC. Types I and III CATs produced 1, 3 diacetylchloramphenicol at pH 6.8 and 7.8 whereas Type II enzymes failed to produce this diester at either pH. All the CATs produced monoacetylchloramphenicol at both pH values. Neither mono- nor di acetylchloramphenicol was stable. Breakdown of enzymically-produced mono- and di esters proceeded more rapidly at pH 7.8 than at pH 6.8. Similar breakdown behaviour was observed with synthetically manufactured 1, 3 diacetylchloramphenicol. PMID- 2695512 TI - Intracellular activity of cefamandole and aztreonam against phagocytosed Escherichia coli and Staphylococcus aureus. AB - The intracellular activity of cefamandole and aztreonam against phagocytosed Escherichia coli and cefamandole against phagocytosed Staphylococcus aureus was studied using a sensitive and standardized method of murine peritoneal macrophages. Cefamandole and aztreonam exerted an intracellular antibacterial activity against E. coli which was greater than their extracellular one. With concentrations of both antibiotics up to 16 x MBC a dose-dependent decrease of the initial number of intracellular E. coli which ranged from 32% to 90% was observed. However, similar antibiotic concentrations above the MBC affected the viability of extracellular E. coli by only 20% to 30%. The intracellular antibacterial activity of both antibiotics against E. coli was further enhanced by immune serum. Cefamandole at 4 x the MBC did not affect the survival of intracellular S. aureus, but killed 41% of extracellular bacteria by 1 h and 99% after 3 h. The intracellular activity of both antibiotics against E. coli was also maintained in NaF-pulsed macrophages which have an impaired oxidative metabolism. The data suggest that both cefamandole and aztreonam possess an intracellular antibacterial activity against E. coli that seems at least in part due to a positive cooperation of antibiotics with the O2-independent microbicidal system of macrophages. PMID- 2695513 TI - Sucralfate in the short-term treatment of duodenal ulcer. A double-blind comparison with cimetidine and placebo. AB - A phase III randomised, double-blind, placebo controlled study was conducted to compare the efficacy and adverse effects of sucralfate and cimetidine in the short-term management of active duodenal ulcer. Standard therapeutic doses were used. Antacids were permitted on an ad lib basis. Eighty patients with endoscopically proven DU were treated for 4 weeks with sucralfate (SUC) (n = 40), cimetidine (CIM) (n = 20) and placebo (PLA) (n = 20), of whom 60 patients--SUC (32), CIM (14) and PLA (14) completed the trial. Baseline clinical and endoscopic data were comparable amongst the 3 groups. The patients were reexamined clinically at 1, 2 and 4 weeks and endoscopically at 2 and 4 weeks. The data comprising pain and non-pain symptom scores, and ulcer size before and after the trial were analysed using the Mann-Whitney test. There were no significant differences in the rate of ulcer healing between SUC and CIM at 4 weeks. 71.8% of the SUC group had complete healing, as compared with 71.4% in the CIM group and 35% in the PLA group. Both SUC and CIM were superior to PLA. (p less than .05) Non-pain symptom scores at the end of 1 week were significantly lower with CIM (p less than 0.001), but levelled at 4 weeks when compared with SUC. Both SUC and CIM were superior to placebo (p less than .001). Day-time pain relief was significantly better with both SUC and CIM as compared to placebo (p less than 0.1). There was no significant difference in night-pain relief between the 3 groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695514 TI - Tuberculosis in the Indian scene. From a clinician's angle. PMID- 2695515 TI - Autoantibodies in systemic lupus erythematosus. PMID- 2695516 TI - Ovarian granulocytic sarcoma in chronic granulocytic leukaemia with myeloblastic crisis. AB - Granulocytic sarcoma is an uncommon tumour composed of granulocytic precursor cells. A rare presentation of granulocytic sarcoma of the ovary occurring in a patient with chronic granulocytic leukaemia in blastic crisis is reported. PMID- 2695517 TI - Klebsiella pneumonia with lung abscess. PMID- 2695518 TI - Extra-intestinal manifestations of shigellosis. PMID- 2695519 TI - [Local tumefaction of the gallbladder wall due to pancreatic heterotopia]. AB - A 38-year-old woman was examined because of vague abdominal symptoms. Cholecystography and US studies demonstrated a lobulated tumor, 14 mm in length, with a homogeneous structure, sharp limits, adjacent to the posterior wall of the gallbladder and producing no acoustic shadow. Pathological examination demonstrated subserosal pancreatic heteropia. More than 22 different kinds of focal lesions affecting the gallbladder wall have been described. Unfortunately, no clinical or US criteria allow a definite diagnosis. Only the size makes a difference: more than 94% of the adenomas measuring less than 10 mm are benign whereas 88% of the malignant lesions are over 10 mm. Considering the absence of specific criteria, surgical removal is therefore indicated for lesions over 10 mm. PMID- 2695520 TI - Fibrous mesothelioma. Case report. AB - A case of fibrous mesothelioma is presented. Chest films suggested an elevation of the left diaphragm and a limited pleural effusion, which was confirmed on computed tomography. Percutaneous needle biopsy showed mesothelial cells. At thoracotomy the tumor was attached to the pleura of the mediastinum by a pedicle. Complete surgical resection was possible. Clinical, radiological and histological data in literature are summarized. The radiological features of the presented case correspond to those described in the literature. PMID- 2695521 TI - Spondylolysis of the axis. A case report and review of the literature. AB - Bilateral congenital defects in the pedicles of the second cervical vertebra were noted on conventional X-rays and tomography of a 42-year-old male. He had been assaulted after which he suffered upper neck and occipital pain. Subsequent CT scanning demonstrated the incomplete nature of the axis defects. This is felt to be important in prognosticating the likelihood of spondylolisthesis formation and counselling the patient with regard to acceptable future physical activity. The role of CT examination for this purpose has not been stressed before. The importance of differentiation from old trauma is emphasized. PMID- 2695522 TI - [Appendicitis: advantages of US and CT in aspecific clinical and radiological findings]. AB - We present the case of a 23-year-old woman with atypical clinical and radiological findings of subacute appendicitis. When abdominal plain film and contrast medium enema examination show atypical findings and ultrasound results are uncertain, CT should be considered. CT after peroral and intravenous contrast administration can confirm or exclude the diagnosis of suspected appendicitis showing the possible presence, location and degree of inflammation, phlegmon and abscess masses. PMID- 2695523 TI - Benign intramural leiomyoma of the uterus. PMID- 2695524 TI - Rupture of the external iliac artery after total hip replacement. PMID- 2695525 TI - Retroperitoneal textiloma. PMID- 2695526 TI - Polymalformation syndrome. PMID- 2695527 TI - Breast metastasis from lung carcinoma. PMID- 2695528 TI - Metastatic liver adenocarcinoma. PMID- 2695529 TI - Three-dimensional analysis of morphogenesis induced by mating pheromone alpha factor in Saccharomyces cerevisiae. AB - Ultrastructural analyses of cytoplasmic changes in Saccharomyces cerevisiae X2180 1A (MATa) that had been treated with alpha factor were performed by using the freeze-substitution fixation method. After alpha factor treatment, cells exhibited a pointed projection, which is a unique pattern of oriented cell surface growth. The relationship between projection formation and intracellular organelles was examined using serial thin sections and computer-aided three dimensional reconstructions. Using these analyses membrane vesicles and other organelles were detected, and studies on their dynamic structural reorganization became feasible. Production of membrane vesicles (average 65 nm in diameter) was induced upon exposure of the cells to alpha factor before projection emergence. The total number of membrane vesicles increased at the early stage and decreased at the late stage of projection formation. Three-dimensional analysis indicated that the vesicles were at first dispersed throughout the cell, then accumulated at the site where the projection formed. Morphological changes and multiplication of the Golgi body were seen during the process of projection formation. Other intracellular organelles (nucleus, vacuole, rough endoplasmic reticulum and mitochondria) were also rearranged, showing a polar organization of the cytoplasm during projection formation. PMID- 2695530 TI - The localization of the divergent beta 2-tubulin isotype in the microtubular arrays of Physarum polycephalum. AB - The beta 2-tubulin isotype of Physarum polycephalum is only 83% identical in amino acid sequence with the constitutively expressed beta 1B-tubulin and the myxamoeba-specific beta 1A-tubulin isotypes. A polyclonal antibody specific for beta 2-tubulin was used to monitor the subcellular distribution of the beta 2 tubulin antigen in the mitotic spindle of the mature plasmodium - the sole microtubular array in that stage of Physarum. By immunofluorescence, the beta 2 tubulin antigen was detected throughout this anastral mitotic spindle, at all stages of mitosis. Physarum myxamoebae contain astral mitotic spindles and cytoskeletal microtubules. No beta 2-tubulin antigen was detected in the myxamoebal stage. However, as cultures of myxamoebae developed into plasmodia, the beta 2-tubulin antigen was found in the astral mitotic spindles and cytoskeletons in developing cells. Thus, the presence of the plasmodial beta 2 tubulin isotype in a mitotic spindle does not determine a closed, anastral mitosis. PMID- 2695531 TI - [A new case of cystic lymphangioma of the pancreas]. AB - The authors describe a new case of cystic lymphangioma of the pancreas treated surgically by cephalic duodeno-pancreatectomy associated with right hemicolectomy. Following a review of the literature, they recall the anatomo pathological and clinical characteristics of vascular connective tissue tumors of the pancreas. From a therapeutic viewpoint, they conclude on the necessity for complete removal of these unusual tumors, either by tumor resection or by appropriate pancreatic resection, which are the only guarantees of a definitive curve. PMID- 2695532 TI - [Boerhaave's syndrome. Apropos of 2 cases diagnosed at a late stage and treated by a combined surgical and radiologic approach]. AB - Two cases of Boerhaave syndrome are presented which were diagnosed at a late stage. After failure of the primary suture of the perforation, the first case was treated by selective intubation of the oesophagus and percutaneous drainage of the abscess under radiological control. In the second case fistulization was produced first surgically, and secondly with drains of decreasing calibre being inserted percutaneously. The diagnosis of Boerhaave syndrome is often made at a late stage. In cases of important mediastinitis and after failure of primary suture, oesophageal exclusion and oesophagectomy are sometimes recommended. However, these procedures require repeated interventions with a significant morbidity. From this viewpoint a combination of controlled fistulization and percutaneous oesophageal intubation under radiological control is a valuable alternative. PMID- 2695533 TI - [Hepatic hydatid cyst with destruction of the biliary confluent. Apropos of 2 cases treated by direct reconstruction]. AB - The authors present two cases of hepatic echinococcus cyst with destruction of the biliary confluent. The severity of this exceptional lesion requires uncommon treatment. Experience with treatment of biliary fistulas when there is a residual cystic cavity, provides arguments for and against primary suture of these fistulas. In these cases, the required treatment consists in reconstruction of the hepatic biliary ducts destroyed (right, left and common) by using the pericystic envelope itself as a plastic neoformative element. The result has demonstrated its efficacy after many years of use, as we have indicated in this article. "Echinococcus granulosus" itself is only rarely a problem in the host, but a hepatic echinococcus cyst does not only pose a spatial problem, except insofar as it often involves the biliary tree. In the cases reported here, the hepatic echinococcus cyst causes biliary problems in over 60% of the cases (1). These biliary problems were as follows: Compression of the common bile duct by the cys; More often, compression of the intrahepatic bile ducts causes the cyst to open inside the biliary duct and to fissure, leading to a biliocystic fistula. PMID- 2695534 TI - [Immunotherapy and cancer: the role of monoclonal antibodies]. AB - Monoclonal antibodies, produced in vitro from hybridoma supernatants, may be administered to cancer patients either directly or after coupling to an anticancer agent (immunoconjugates). Monoclonal antibodies concentrate in tumor site, where they initiate an anti-tumor effect, either by activation of the patient's immune system or by the cytotoxic agent which is present at high concentration within the tumor, while systemic concentrations of this agent remain low. Monoclonal antibodies which are radiolabelled also allow the immunoscintigraphic study of the immunoconjugates' diffusion within the body. Given certain precautions of administration, the clinical and biological tolerance of this type of treatment is satisfactory, most of the side effects correspond to an allergic response to the murine antibodies used. Clinical studies performed in patients with leukemias have demonstrated a significant antitumor effect although this effect is transitory. Studies performed on small series of patients with solid tumors (gastrointestinal neoplasms, melanoma, leptomeningeal localizations, ovarian peritoneal carcinosis) have shown a few cases of major responses and/or complete remissions having lasted up to periods of many months. These studies as well as the perspectives for the development of this type of therapy are presented and discussed. PMID- 2695535 TI - [Pyocholecyst strangulated in a Spiegelan hernia]. PMID- 2695536 TI - [Appendiceal mucoceles. Apropos of 2 cases]. AB - Most often called muco-secreting tumors, the mucocele of the appendix are rare (0.2 to 0.3% of appendicectomies). The clinical signs are not specific; ultrasonography and scannography would contribute to diagnosis. The pathogenis is not known yet. The benign forms are cured by appendicectomy. The malignant forms still have a bad prognosis. PMID- 2695537 TI - [Conservative treatment of splenic lesions by splenorrhaphy and incomplete splenectomy in abdominal injuries]. AB - Fifteen cases of rupture of the spleen were reported, in which a conservative form of treatment was applied with success. These consisted of 4 splenorrhaphies and 11 partial splenectomies. Collagen (PANGEN) was used in 6 of the cases to buttress the suture. In view of the relatively low incidence of post of complications, the authors are of the opinion that the above described treatment be widely applied in cases of rupture of the spleen, especially in the child where the spleen still plays a vital role. PMID- 2695538 TI - Flow cytometric assays for monitoring production of recombinant HIV-1 gp160 in insect cells infected with a baculovirus expression vector. AB - A baculovirus expression system for the HIV-1 envelope glycoprotein gp160 has been used as a model for development of flow cytometric assays for monitoring production of cell-associated recombinant antigen. Using monoclonal antibodies to the transmembrane (gp41) or envelope (gp120) portion of gp160, gp120, but not gp41, could be reproducibly detected on the surface of insect cells 48 h after infection with the recombinant baculovirus. In contrast, fixation and permeabilization of infected cells prior to staining, to allow access of monoclonal reagents to the intracellular compartment, markedly improved the sensitivity of detection, with reactivity to both monoclonal antibodies observed at 24 h post-infection. Specificity of the intracellular immunofluorescence was verified by demonstrating that the appropriate native or recombinant HIV-1 protein blocked reactivity of monoclonal antibody with infected cells. In addition, it was observed that production of gp160 following baculovirus infection was associated with a marked increase in the 90 degrees light scatter of insect cells, as determined by flow cytometry, and that this correlated with the kinetics of cell-associated gp160 production as determined by immunofluorescence. These procedures should be of great utility for routine monitoring of recombinant proteins produced in insect cells in response to infection with recombinant baculovirus. PMID- 2695539 TI - HIV-1 antibody testing strategy: evaluation of ELISA screening and western blot profiles in a mixed low risk/high risk patient population. AB - The Westmead HIV-1 antibody testing strategy showed that, regardless of ELISA screening kit manufacturer, sera which were repeatedly positive by two ELISA screening assays (one indirect and the other competitive format) had a 97-98% chance of being confirmed positive by Western blot for HIV-1 antibody or a less than 3% chance of either being identified as a seroconverter (1%) or a late stage AIDS patient (1.2%). Sera which were discordant by two ELISA screening assays had a less than 4% chance of either being confirmed positive by Western blot (2.5%) or identified as a seroconverter (1.3%). The incidence of non-specific indeterminate Western blot profiles were shown to be inversely proportional to the specificity of the ELISA screening kits used. The use of a recombinant envelope ELISA was able to confirm the viral specificity of HIV-1 envelope bands (gp160, 120 or 41) on Western blot. Guidelines suggested by the Australian National HIV Reference Laboratory, Fairfield Hospital, Melbourne, which categorized indeterminate or typical Western blot profiles into four reaction groups were found to be useful for the interpretation of Western blot patterns. A Western blot profile which is reactive for HIV-1 viral glycoproteins (gp160, 120 and 41) alone or in combination with not more than two other viral proteins (Indeterminate Group 4) and which is confirmed viral envelope specific by a recombinant envelope ELISA can be used as a predictor of seroconversion. PMID- 2695541 TI - Historical precedent and the obligation to treat AIDS patients. PMID- 2695540 TI - Clinical and immunological studies in patients with an increased serum IgD level. AB - Increased levels of serum IgD can be found in single patients with a variety of clinical syndromes and in the disease entity designated hyper-IgD syndrome which is associated with periodic fever and lymphadenopathy. We investigated 17 patients, both children and adults, with high serum IgD levels ranging from 220 to 5300 IU/ml. Eight patients had periodic fever and lymphadenopathy, four showed a humoral immunodeficiency, and the remainder had a variety of clinical abnormalities. Serum IgA levels were consistently high in all patients except in those with an immunodeficiency. Serum IgD complexes were detectable in each serum, which indicates that the occurrence is not pathognomic for the syndrome of periodic fever. Antibody formation against the primary antigen Helix pomatia hemocyanine and the secondary antigen tetanus toxoid showed no abnormalities in the patients without an immunodeficiency. Bone marrow origin of serum IgD was strongly suggested by enumeration of IgD-containing plasma cells. We conclude that no apparent relationship exists between the several clinical syndromes and increased serum IgD. PMID- 2695542 TI - The status of identity: reflections on the need for intervention. AB - The primary purpose of this article is to examine the need for intervention in the context of the information we have gathered to date about identity formation. The research evidence indicates that the identity achievement status is associated with the greatest effectiveness in psychological functioning while the identity diffusion status is related to poorer functioning. The moratorium and foreclosure statuses generally occupy intermediate positions in this regard. The identity activity of adolescents and youth is also reviewed. The complexity of the identity construct is discussed as it relates to domains, developmental patterns, gender, historical and social contexts. The author uses the findings from a longitudinal study to illustrate the need for, and purposes of, intervention while respecting the richness of the identity construct of the individual. PMID- 2695543 TI - Identity status research: implications for career counseling. AB - The purpose of this paper is to describe an empirical approach to the study of adolescence and to apply research findings to vocational counseling. The study of identity status has enriched and supported Erikson's theory of psychosocial development. Case histories of hypothetical clients in the four identity statuses are presented and different approaches for counseling with such clients are suggested. PMID- 2695544 TI - Curricula interventions for identity change: substantive and ethical considerations. AB - The rationale for school-based curricula interventions to promote identity formation is based on the advantages of psychological functioning associated with use of the more sophisticated identity statuses and the opportunities available in school settings to create the conditions facilitating developmental movement in that direction. A variety of education strategies pertaining to identity development are described, along with their probable impacts upon various aspects of the processes involved in forming a sense of identity. Ethical considerations for both supporting and opposing identity-related interventions are presented. Suggestions are offered as to how best to proceed when implementing identity related education curricula. PMID- 2695545 TI - Clinical status of dentine bonding agents. AB - Dentine bonding agents are an important clinical contribution to modern composite technology. Important differences exist between the first- and second-generation materials which offer complementary advantages. The second-generation materials offer higher dentine bond strengths at the expense of greater chairside complexity. Indications for the use of both types of material are discussed. The role of smear layer and the primed layer is discussed and the connection is made between bond mechanism and clinical techniques. The clinical criteria, such as retention, microleakage and tooth strengthening, are related to the role of the hard tissue bond. PMID- 2695546 TI - [Nontraditional areas for the use of pharmacologic preparations based on research on the molecular mechanisms of their action]. AB - On the basis of analysis of a number of documents concerning the molecular mechanisms of actions of well-known drugs the first attempt has been made to subdivide their activities into traditional and nontraditional ones. The possibility of application of a number of well-known drugs to nontraditional fields of pharmacology has been demonstrated. PMID- 2695547 TI - [The effect of CuCl2 on the efflux of inorganic phosphate from Escherichia coli]. AB - The influence of CuCl2 on inorganic phosphate efflux from resting E. coli and those treated with glucose has been studied. Maintaining of high phosphate gradient on the membrane is possibly only in case of continuous supply of external metabolic energy. Treatment with CuCl2 does not lead to the increase in permeability of the resting cell membrane for phosphates, but it causes the efflux of phosphates in glucose-treated cells. The above data suggest that the efflux is determined by inhibition of energy influx into cell by CuCl2, not by damaging the cytoplasmic membrane. PMID- 2695548 TI - Sodium-sensitive essential hypertension: emerging insights into an old entity. AB - Essential hypertension has long been assumed to be a multifactorial disease. However, recent evidence suggests that it is a syndrome rather than a disease with a common symptom--an elevated blood pressure. One large segment of the hypertensive population--approximately 60%--has in common an increased blood pressure sensitivity to salt intake. Further analysis of this subgroup suggests that it is also heterogeneous, consisting of at least six major entities: renal parenchymal disease, bilateral renal artery stenosis, primary aldosteronism, acromegaly, low renin essential hypertension, and the most recently described entity--nonmodulating essential hypertension. This subset's name is derived from the fact that sodium intake does not modify (modulate) renovascular and adrenal responses to angiotensin II, as occurs in normotensives and modulating hypertensive patients. The following abnormalities have been reported in these patients: (1) a failure of renal blood flow to increase with salt loading; (2) a reduced ability to excrete a salt load; (3) reduced renin suppression both by salt and angiotensin II; and (4) a hypertensive response to salt load. These patients also have a strong family history for hypertension and an increase in erythrocyte sodium countertransport. With a better understanding of the mechanisms underlying the elevated blood pressure in a specific patient, a more rational approach to therapy is possible. For example, in the salt-sensitive hypertensive patient a diuretic would be the presumed treatment of choice. While this is correct for some salt-sensitive hypertensives, in nonmodulators diuretics may be relative ineffective while converting enzyme inhibitors may be more effective because they specifically correct the underlying pathophysiologic derangement. PMID- 2695549 TI - The effect of dietary interventions to reduce blood pressure in normal humans. AB - Changes in electrolyte intake have been advocated to lower the prevalence of hypertension in the normal population. To elucidate the potential impact of such strategies, we conducted a comprehensive analysis of data from three interventions, namely, salt (NaCl) restriction, calcium (Ca) supplementation, and potassium (K) supplementation in normal volunteers. Eighty-two adults lowered their Na intake from 157 +/- 6 S.E. to 68 +/- 3 mEq/day for 12 weeks. Population mean systolic and diastolic blood pressure decreased less than or equal to 2 mm Hg. Ca supplementation, 1.5 g daily for 12 weeks in 37 men, decreased blood pressure compared to 38 men receiving placebo. Ca supplementation, 1 g daily for 8 weeks in an older group of 44 normal subjects, decreased supine diastolic and standing systolic blood pressure. K supplementation with a nonchloride salt in 64 normal adults for 4 weeks had no effect on systolic or diastolic blood pressure even though urinary excretion was increased by 20 mmol/day. The responses to all interventions were Gaussian in distribution. A potentially adverse effect on blood pressure in some normal individuals cannot be excluded on the basis of the currently available data. Although all three interventions may benefit some hypertensive and some normal individuals, the data from these relatively short term cross-sectional studies are insufficient to warrant generalized dietary recommendations for the normal population. PMID- 2695550 TI - Upper body adiposity and the risk for atherosclerosis. AB - Since there is evidence that fat distribution is a better predictor of cardiovascular disease than the degree of obesity, some risk factors for atherosclerosis have been evaluated in middle age Type II male diabetics and in obese subjects with and without glucose intolerance. In non-insulin-dependent diabetics (NIDD), abdominal obesity reflected by the waist/hip-circumference ratio (WHR) is related to parameters of metabolic control, lipid parameters, insulin status and response, hypertension, and vascular complications. High WHR is associated with: (a) significantly (p less than 0.01) higher HbA1 values than in the group without abdominal fat distribution; (b) a highly significant (p less than 0.001) negative correlation with high-density-lipoprotein cholesterol (HDL C) and a positive correlation with the total/HDL-C ratio, which remains after correction for the body mass index; (c) higher apolipoprotein B concentrations; and (d) an elevated atherogenic index. Both fasting and postprandial insulin and C-peptide values may be a link between abdominal fat deposits and metabolic disturbances. Obese patients with upper body fat accumulation have significantly lower HDL-C levels, and a higher prevalence of glucose intolerance and diabetes than do patients with lower body fat obesity. Fasting glycemia, insulin, and the insulin area under the curve during an oral glucose load are significantly (p less than 0.005) increased in those with the greatest WHR, which is similar to that in NIDD and central obesity. An excess of abdominally located fat, even without manifest obesity, is associated with metabolic disturbances that indicate increased risk of atherogenesis and of higher morbidity and mortality, which may be due to characteristics of abdominally located adipocytes. PMID- 2695551 TI - Food variety is associated with less macrovascular disease in those with type II diabetes and their healthy controls. AB - In developed countries, the health outcome most under scrutiny with respect to food intake is macrovascular disease. Since food is so complex, global indices of food intake are required to assess the relation. In the present study, an index of food variety was examined for its ability to predict changes in the arterial wall. Arterial wall indices were measured noninvasively by Doppler ultrasound in patient with Type II diabetes and in matched apparently healthy subjects. Each subject kept a 7-day food record, which was cross-checked by a nutritionist so as to calculate an index of food variety. The arterial wall indices measured were compliance over the aorto-iliac segment and pulse wave damping at the common femoral and posterior tibial arteries. Significant correlations, both parametric and nonparametric, were found between total food variety, and plant food variety, and each arterial wall index when the diabetics and apparently healthy subjects were grouped together (p less than 0.01 in all cases for total variety and at least less than 0.05 for plant food variety). Between 13 and 19% of the variance in arterial wall indices was explained by food variety. PMID- 2695552 TI - Decreased diet-induced thermogenesis in gluteal-femoral obesity. AB - Resting metabolic rate (RMR) and diet-induced thermogenesis (DIT), induced by 100 g glucose given orally, were measured in two groups of obese women, characterized by the abdominal or gluteal-femoral type of obesity. No difference in RMR was found between the two groups. Obese women with an abdominal fat mass distribution have a higher and more prolonged DIT in comparison with gluteal-femoral obese women. This finding may help explain why women with upper body obesity are more able to lose weight than women with lower body obesity. PMID- 2695553 TI - A comparison of pregnancy outcome in overweight and normal weight women. AB - From a population of singleton pregnancies, 152 overweight women (greater than 110% of standard) were matched with normal weight women (95-110%) for age, height, parity, race, and smoking habits. Comparisons were made of initial weight (weight at the first prenatal visit) and gestational weight gain and pregnancy outcome. Mean birth weights and gestational ages of infants of normal and overweight women were not significantly different. For normal weight women birth weight increased significantly as height, initial weight, and body mas index increased (p less than 0.01), but no such relationship existed for overweight women. The lack of effect of initial weight on birth weight in overweight women is attributable, in part, to the significantly less gestational weight gains of these mothers (6.3 kg vs 8.2 kg). When normal and overweight gravida had gestational weight gains of less than 7 kg, offspring of overweight mothers were significantly heavier. Gestational weight gain was positively correlated with birth weight for both normal (p less than 0.0001) and overweight women (p less than 0.001). Within the overweight and normal weight groups, smokers had lower initial weights and gestational weight gains than nonsmokers. Offspring of normal weight smokers had a mean birth weight 232 g less than that of nonsmokers (p less than 0.01). The difference in birth weight between overweight smokers and nonsmokers (135 g) was not statistically significant. While there is substantial data to support a weight gain of 10-12 kg in normal weight gravida, it would appear that a gain of approximately 7 kg in overweight middle class women does not impair fetal growth as measured by birth weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695554 TI - The role of vitamin C in athletic performance. AB - There is widespread belief among athletes that special nutritional practices--in particular high-protein diets--will enhance their achievements in competition. Supplementation with vitamins, especially vitamin C, is equally popular. But because genetic predisposition, hard physical training and psychological factors play a most important role in determining performance, and because any potential difference in achievement will be small, it is almost impossible to obtain scientific evidence of a beneficial effect of a particular nutrient. There have been many investigations during the past four decades of the potential effect of high-dose vitamin C supplementation on physical performance. The variables used have included maximum oxygen uptake, blood lactic acid levels, and heart rate after exercise, and in some cases performance was assessed in competitive events. The results have been equivocal: Most studies could not demonstrate an effect. On the other hand, a suboptimal vitamin C status results in an impaired working capacity which can be normalized by restoring vitamin C body pools. Athletes, who follow irrational, unhealthy eating patterns often not including vitamin-C containing fruit and vegetables, are in need of nutrition education. PMID- 2695555 TI - The intestinal absorption of dietary folates in health and disease. AB - Dietary folates exist as pteroylpolyglutamates (PteGlun) that undergo hydrolysis to pteroylmonoglutamate (PteGlu) forms during the process of intestinal absorption. Using the technique of jejunal perfusion of separately labeled folates, our laboratory has demonstrated that hydrolysis of PteGlun occurs on the surface of the jejunum and is a prerequisite for folate absorption. An intestinal brush border pteroylpolyglutamate hydrolase (BB-PPH) has been identified in human and pig jejunum with characteristics that are distinct from those of an intracellular hydrolase (IC-PPH). Functional parallels of BB-PPH with in vivo hydrolysis of PteGlun in human and pig intestine and the clinical responsiveness of BB-PPH to different disease states indicate that this enzyme plays the major physiological role in folate absorption. Folate malabsorption is found in diseases which affect the jejunal mucosa and in response to various drugs. In most of these clinical conditions, folate malabsorption results from suppression of both of the processes of hydrolysis of PteGlun and jejunal uptake of PteGlu. Ongoing studies in miniature pigs are aimed at definition of the sequence of development of folate malabsorption in chronic alcoholism. PMID- 2695556 TI - [Presumed toxoplasmic chorioretinitis: comparative study of treatment with pyrimethamine and sulfadiazine or clindamycin]. AB - A prospective, randomized study was conducted in 29 patients with presumed toxoplasmic retinochoroiditis to compare the efficacy of oral pyrimethamine and sulfadiazine (P + S) with subconjunctival injections of clindamycin. There was no difference in the mean visual acuity in both groups after treatment; the mean healing time was similar in the two treatment groups, 1.80 months with clindamycin and 1.88 month with P + S. However subjective improvement was obtained earlier with clindamycin. After 14 months' follow up, recurrences of ocular toxoplasmosis developed in both groups, 21% with clindamycin and 36% with P + S, respectively (NS). Other than the discomfort due to topical treatment, clindamycin did not produce any side-effects, which did happened after oral P + S. Subconjunctival injections of clindamycin provide an interesting alternative in the choice of an antitoxoplasmic ocular therapy. PMID- 2695557 TI - [Parry-Romberg progressive facial hemiatrophy and localized scleroderma. Nosologic and pathogenic problems]. AB - A case of a 65-year-old caucasian woman with progressive hemifacial atrophy (Parry-Romberg syndrome) is reported. The atrophy had begun ten years before. At time of presentation, she was suffering from facial pain and diplopia. She presented with severe enophthalmos associated with eyelid atrophy, loss of cilia and mild blepharoptosis. There was a patch of alopecia and atropic areas of skin, recognised as scleroderma "en coup de sabre". Ophthalmic examination showed miosis. Horner's syndrome and ocular motility disturbance. Biomicroscopic examination of anterior and posterior segments was normal; there was no heterochromia and no disc atrophy. Aesthetic surgical treatment was proposed. The etiology of hemifacial atrophy remains controversial, and its relations with scleroderma and autonomic nervous system disorders are discussed. PMID- 2695558 TI - [Argon laser trabeculoretraction in chronic open-angle glaucoma with normal pressure. A prospective study on the tonometric and perimetric effect]. AB - A prospective randomised study was undertaken on sixty eyes, thirty five patients, (27 women, 8 men) followed in the Saint-Joseph hospital of Paris, with low tension glaucoma (LTG). The thirty five patients were selected at random and had either an argon laser trabeculoplasty (ALT) or received only vascular medications (medial). The first group (ALT) included 29 eyes. The second group (medical) included 31 eyes. The two groups were comparable: mean age, men/women distribution, mean intraocular pressure, mean C/D ratio, mean total visual capability (TVC) with the friedmann analyser. The mean follow up for the two groups was seven years. Nevertheless for the ALT group the mean follow up after ALT was four years. We compared for the two groups: --the aspect of the mean intraocular pressure (IOP) curve with time, --the evolution gradient of visual capabilities with time. For the ALT group we compared: --the mean IOP and 24 hours diurnal curves before and after laser treatment and the evolution gradient of visual capabilities before and after laser treatment. The introduction of ALT in the treatment of LTG had neither tonometric effect nor effect on the slope of visual field damage. We concluded that ALT is not recommended in LTG, but not that the IOP should not be reduced in this form of glaucoma. PMID- 2695559 TI - [Age-related macular degeneration and laser treatment]. PMID- 2695560 TI - [Prevention of retinal detachment]. PMID- 2695561 TI - [Pre-equatorial contusion syndrome. Analysis apropos of 59 cases]. AB - The term "pre-equatorial syndrome" covers post-traumatic involvement of the anterior segment and of the pre-equatorial retina, due to a frontal distension mechanism. In a retrospective study, we studied 582 cases of ocular contusions from 1973 to 1986 in patients who required a brief hospitalisation in our clinic because of the severity of the initial injury. The aim of the study was to assess the occurrence of this syndrome, its clinical features and evolution. 59 complete pre-equatorial syndromes were found in this sample (10.2% of all the ocular contusions). The follow up ranged from one to 168 months. Games and sports injuries in children and work injuries in young men were most commonly found causes (2/3 of the cases). Hyphema and angle recession were the most frequently observed lesions (69%). All hyphemas disappeared spontaneously without surgical drainage. Subluxation of the lens was present in 10.6% and late post traumatic cataract occurred in four cases; all eyes were operated on by intracapsular extraction, three of them in the first year following the traumatism and the last twelve years latter. Intraocular pressure was high in 15.3% (but was easily controlled) and was very low in 5.1%. Retinal edema and haemorrhages were the most common involvement of the peripheral retina. Retinal dialysis was noticed in 13.6% especially in the upper nasal area: buckling surgery was performed in these cases with good results. Anterior and peripheral retinal damages was situated on the same meridian in 80% of the cases, five eyes showed a 180 degrees opposite setting while there was no obvious alignment in 15 of the cases. This syndrome did not impair final visual function alone, whereas severe associated ocular contusions of the posterior pole gave a very low visual outcome in 16 cases. This retrospective review emphasizes the main characteristics of this syndrome. Accurate examination of the irido-corneal angle and peripheral retina is of paramount importance in every ocular contusion. PMID- 2695562 TI - [A case of exteriorized malignant ciliochoroidal melanoma in a negroid patient]. PMID- 2695563 TI - [Optics of self-portrait painting]. AB - This paper is a study of the relationships between optics, right or left handedness and self-portrait, according to the concepts elaborated by Arthur Linksz. Four topics are studied: 1) Image reversal in the looking-glass: making his self-portrait, the painter looks at an self-image in a mirror, and so is copying an image of himself where right and left are, so to speak, inverted; eyes, ears, clothes, and above all, hands: the real right hand is the left hand in the picture, and the real left hand is the right hand in the picture. 2) Due to this reversal, the painter has two possibilities: either he can accept this apparent reversal, and represent himself as left-handed (painting using his left hand); or he can refuse this apparent reversal, and correct the reflected image in the picture. Both these options have in fact been used by painters, depending on whether they painted before or after the birth of photography: before photography, painters, generally, refused to seem left-handed; so, they used many tricks to correct the reflected image: suppression of the two hands in the self portrait; suppression of the painted left hand (i.e. the real right hand); brushstroke in the painted right hand (i.e. the real left hand) and/or palette in the left painted hand (i.e.; the real right hand); only a few painters accepted to seem appearing left-handed in the self-portrait.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695564 TI - [Diffuse infiltrating retinoblastoma]. AB - We report 3 new cases of diffuse infiltrating retinoblastoma, and we review the 21 cases of the literature. Clinical features are typical but must not be confused with uveitis. The average age of onset is about 7 years, later than the usual retinoblastoma. Clinical features associate ocular redness, pseudo hypopion, iris nodules, clusters on the pupil and in the anterior chamber, opacities on the posterior face of the cornea. Hypertension appears resistant to medical treatment. The vitreous is hazy but the retina is still visible. The ophthalmoscopic examination reveals exudates covering the peripheric retina, and gray infiltrated retina. Usually there is no focal tumour mass, but totally diffuse tumoral infiltration. Echographic examination does not reveal calcification as in typical retinoblastoma. Neoplastic cells are demonstrated in anterior chamber paracentesis. Cytologic examination of aqueous humor aspirates may be misinterpreted and should be evaluated carefully. Because of tumor cells seeding, lactate dehydrogenase assay is of diagnostic value, prior to considering definitive therapy. None of the tumors were bilateral. The prognosis after enucleation appears good. PMID- 2695565 TI - [Problematic glaucoma]. PMID- 2695566 TI - Long-term immunoregulatory effects of therapy with corticosteroids and anti thymocyte globulin. AB - Corticosteroids and anti-thymocyte globulin (ATG) have been extensively used in the treatment of autoimmune diseases, aplastic anemia and organ graft rejection; nonetheless, the precise mechanisms of action of these agents are unknown. Studies of their long term immunoregulatory effects, particularly in humans, have been limited. We examined the long term effects of therapy with ATG given for 2-4 weeks and prednisone for 2 months in 4 patients with newly diagnosed insulin dependent diabetes (IDD). Three matched newly-diagnosed untreated IDD patients and 17 healthy volunteers served as controls. No differences in total lymphocyte count, percentage of B cells, percentage of total T cells (CD3), helper-inducer T cells (CD4) or cytotoxic-suppressor cells (CD8), lymphocyte blastogenesis assays, or pokeweed mitogen-induced IgG secretion in T & B cell co-cultures were detected before therapy. A transient lymphopenia following ATG administration was the only immunological defect found in the first month of therapy. At 2 months, however, patients treated with ATG and prednisone had diminished immunoregulatory T cell function demonstrated by production of only 28 +/- 3% IgG expected in T & B co culture, compared to 205 +/- 35% for untreated IDD patients and 107 +/- 13% for normals (p less than 0.01). This diminished IgG production resulted from excessive suppressor function, since co-cultures of T cells from treated patients with T and B cells from normal volunteers suppressed the latter's IgG production by 76 +/- 9%. This enhanced suppressor activity persisted for 3-6 months following therapy. Other immunological functions were not statistically different from those present at the inception of the study. Thus, treatment with corticosteroids and ATG produces long-term enhanced suppressor activity, a finding which suggests that treatment with combination ATG and Prednisone is a rational form of immunomodulation in conditions associated with decreased suppressor function. PMID- 2695567 TI - Interleukin-2 induced systemic toxicity: induction of mediators and immunopharmacologic intervention. AB - Interleukin-2 has been tested as an anti-cancer agent, either alone or in combination with immune cells, but severe dose limiting adverse toxic effects have been observed. Because the pathogenesis of the toxicity has remained uncharacterized, it has not been possible to determine whether the therapeutic and the toxic events could be separated. We have examined immunopharmacologic regulation of IL2 induced mediator induction and toxicity syndrome and have compared this data with our earlier information on IL2 enhancement of immune function in murine systems. The results of this study have shown that treatment with recombinant human interleukin-2 induced increased cellular TNF activity in lymphoid organs and this activity was abrogated by an anti-TNF antibody. Additionally, continuous daily treatment with interleukin-2 also induced increases in serum corticosterone but no detectable increases in serum IL1 or TNF. The increases in serum corticosterone occurred later in the treatment process and coincided with histopathologic changes in the adrenal glands and other tissues. Animals that died as a result of IL2 treatment had ascites and hydrothorax. Histopathologic changes were noted in the lungs, liver, adrenals, kidneys, gastrointestinal tract, heart and lymphoid organs. Cyclophosphamide, dexamethasone and anti-ASGM1 antibody were most effective in increasing survival and inhibiting immune enhancement but differentially effective in inhibiting TNF induction (or in certain cases gamma interferon induction), decreasing ascites or hydrothorax or affecting lymphoid proliferation in the lungs and spleen. Cyclosporin A and azathioprine were not as effective in enhancing survival and had differential effects on the other parameters. Possible mechanisms of both therapeutic and toxic events are discussed. PMID- 2695568 TI - [Fetal blood sampling for karyotype using echoguided puncture of the cord. Study of 103 pregnancies]. AB - Subcutaneous ultrasound guided puncture of the umbilical cord was carried out in order to obtain samples of blood in 103 fetuses. This was done to get the result of the karyotype quickly, i.e. in 72 hours. The indications were for diagnosis, particularly of malformations (63 cases) or intra-uterine growth retardation (24 cases). A small proportion of the indications were those for failures to carry out amniocentesis early or for checking on mosaics that were obtained after the culture of amniotic fluid cells. In 88% of the cases it was possible to obtain a karyotype and the results were checked with the sex of the fetus and the karyotype that had been obtained from amniocentesis. There were 11 abnormalities diagnosed. The chief indication of chromosome abnormality is fetal malformation. Because the result are obtained so quickly cordocentesis should replace late amniocentesis, at present when looking for fetal abnormalities. PMID- 2695569 TI - [Sarcoma of the uterus. A clinical study apropos of 50 surgically treated cases at the Gustave Roussy Institute. Review of the literature]. AB - From 1970 to 1987 fifty patients with uterine sarcoma who have been operated at the G. Roussy Institute (IGR) were studied. The histological material was reviewed according to the W.H.O. classification and the Hendrickson and Kempson's criteria. Staging was done on surgical and histological findings according to the pTNM classification of the UICC for endometrial carcinoma. There were 22 cases of heterologous malignant mixed mullerian tumor (MMT), 5 cases of homologous MMT, 20 cases of leiomyosarcoma (LS), 1 high grade stromal sarcoma, 1 low grade stromal sarcoma (stromal myosis (SM], 1 adenosarcoma. There were 22 cases of stage T1 T2, 23 cases of stage T3 T4 and 5 TX (first surgery outside IGR). Total hysterectomy with bilateral salpingo-oophorectomy was performed in 86% of the cases. Radiation therapy was performed in 26 cases mostly external pelvic irradiation associated with endobrachytherapy. "Cyvadic" combination chemotherapy was used in 16 cases associated with platinum in few cases. There were 2 postoperative deaths, 11 cases of progression and 37 cases of complete remission (CR). Of the 37 cases of CR, 10 patients are alive with NED 6 months to 10 years after diagnosis in 2 cases of MMT. 27 patients presented recurrence or metastasis. Of the 22 patients with pelvi-abdominal recurrence, 10 had debulking surgery (one total pelvic exenteration (PE), three posterior PE). Among them five are alive 14 to 78 months later (3 LS, 1 AS, 1 SM). Thirty percent of the patients developed lung metastasis. The overall five-year survival was 42 +/- 16% (28 patients) (Kaplan Meier's method), similar to literature data.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695570 TI - [Contribution of kidney echography to upper urinary tract infection in pregnancy]. AB - The authors carried out a prospective study and also looked at the literature in order to assess the contribution ultrasound makes in the diagnosis of the aetiology of upper urinary tract infections in pregnancy. They studied two matched series (patients and controls). They note that ultrasound is reliable in the aetiological diagnosis of upper urinary tract infections without complications and they discuss its place and the contribution it can make as compared with more invasive investigations of infections of the upper urinary tract in pregnancy (such as I.V.U. and C.T. scanning). PMID- 2695571 TI - Clinical behaviour of hydatidiform mole. AB - Forty-eight patients of hydatidiform mole are reviewed. Forty cases (83.3%) were between 20 and 30 years of age and 24 women (50%) were primigravidae. The most common presenting symptom was intermittent bleeding. Ultrasound which became available during the latter part of the study has helped in early and definitive diagnosis. Oxytocin drip followed by suction evacuation was the mainstay of treatment. Four of the women who were followed up had persistent high titre of HCG and were treated with cytotoxic drugs. A regular follow-up is mandatory for early diagnosis and treatment of persistent trophoblastic activity. PMID- 2695572 TI - Internal carotid artery thrombosis: a complication of closed craniocervical trauma. PMID- 2695573 TI - An elementary information processing component in the circuitry of the retina generating the on-responses. AB - A pattern of neural connections that is a compulsory feature of photoreceptor terminals and is referred to as the synaptic ribbon complex was analyzed, and by combination of the structural information and information gained by intracellular recordings from photoreceptors, horizontal cells, and bipolar cells, it is possible to explain how the hyperpolarizing effect of light stimulating the photoreceptors is changed to a depolarization of depolarizing bipolar cells. The sign reversal is accomplished by the hyperpolarizing action of the horizontal cells on the photoreceptors, which blocks the transmission between the photoreceptors and the bipolar cells. This blocking action is controlled by the photoreceptor and it functions like a gate that is opened only when the photoreceptor is stimulated by light. The synaptic ribbon complex offers an example of an elementary information processing component with three input channels to the bipolar cells with each channel contributing a different piece of information and with the processing occurring presynaptically. Additional processing of information occurs within the dendritic tree through interactions of the responses of the individual dendritic endings to different types of input. This interaction can involve partial blocking of the conduction within the dendritic tree, making the interaction considerably more complex than simple summation. The responses recorded intracellularly from neurons reveal only the end result of the processing of information at the level of that neuron. PMID- 2695574 TI - Effects of dietary composition on growth of M. leprae in mouse footpads. AB - The number of bacteria per mouse footpad were measured at intervals beginning with the third month in male, weanling BALB/c mice infected with M. leprae and fed for a period of 6 months to test the effects of diet on multiplication of bacteria. The mean bacteria count per footpad in mice remaining at 6 months in the two high fat diets was higher (p = 0.014) than the mean of the two low fat diets. Likewise, the pooled mean bacterial count of mice fed the two diets of animal origin had a tendency to a higher mean bacterial count compared to mice fed the two diets of plant origin. Low level of dietary protein in early life also seemed to predispose to M. leprae multiplication. Our data in mice suggest that the association of diet with human leprosy should be investigated. PMID- 2695575 TI - Primary dapsone resistance as assessed by uptake of labelled thymidine by the macrophage resident Mycobacterium leprae. AB - 12 untreated lepromatous leprosy patients were screened for primary dapsone resistance by the uptake of labelled thymidine by macrophage resident M. leprae. There were found to harbour primary dapsone resistant strains of M. leprae and another three partially resistant strains to the drug. This rapid, simple and reliable method should be used routinely to screen leprosy patients, for drug resistance. PMID- 2695576 TI - Bacillaemia and bone marrow involvement in leprosy. AB - Fifty patients (24 new and 26 receiving specific treatment) of leprosy were investigated to study the concentration and morphological index (MI) of the lepra bacilli in skin, peripheral blood and bone marrow. The organisms were detected in 28 cases on skin slit smear examination, in 38 cases on bone marrow examination and in 38 cases on examination of smears made from buffy coat of peripheral blood. Out of 22 cases negative for the bacilli on skin slit smears, 15 had the organisms either in buffy coat or bone marrow or both. Acid fast bacilli in peripheral blood and bone marrow with skin smear negativity were mainly observed in patients with paucibacillary type of the disease and in those who were receiving treatment. Examination of buffy coat and bone marrow for presence of lepra bacilli is suggested to establish the diagnosis in doubtful cases. PMID- 2695577 TI - Effect of temperature, cholesterol and nerve tissue on multiplication of armadillo M. leprae. AB - The effect of temperature, nerve tissue and certain constituents of the medium on multiplication of armadillo M. leprae was studied using Hanks BSS. An equal or better growth was seen at 30 degrees C and 10 degrees C compared to 37 degrees C. Multiplication was also seen at -20 degrees C. Adding cholesterol, foetal calf serum, cystine-HCl, sodium thioglycollate or nerve suspension and covering medium with liquid paraffin each showed beneficial effect. Hanks containing foetal calf serum, cholesterol with sodium thioglycollate or cystine-hydrochloride showed maximum multiplication. These combinations may be used for testing additional factors for further improvement of the medium. PMID- 2695578 TI - Growth of Mycobacterium leprae in a redox system: III. Evidence of growth at low temperature (psychrophilia) and, further refinement of growth medium. AB - Considerable growth enhancement, largely as non-acid fast, slender and long rods has been seen when incubated at 10 degrees C. Concentration of some of the media constituents have been reduced that has improved the quantum of growth. A remarkable proneness to physical disintegration of the grown bacilli has been seen and its significance discussed. Also, the possible immunogenic advantage of non-AF M. leprae has been discussed. The question of identification is still not solved, and work is in progress. PMID- 2695579 TI - Bacteriological study of urine samples from leprosy patients: a preliminary communication. AB - A.F.B. and biological structures related to its multiplication reported previously from skin and blood of patients were seen also in their urine. Implications of these findings in transmission and possible application in detecting sub-clinical infections should be studied. PMID- 2695580 TI - Process of disintegration and degradation of M. leprae: study of tissue imprints and tissues. AB - The existence, distribution and behaviour of degradation products of M. leprae in leprosy lesions were investigated in tissue specimens fixed in neutral formalin and embedded in paraffin. Cytopathologic findings using tissue imprints were unsatisfactory. Sections were stained with hematoxylin-eosin, acid-fast stains, silver methenamine and by an immunochemical (PAP) technique using serial paraffin sections. A comparison in respect of the distribution of the bacilli within the macrophages showed considerable differences between the superficial and deep granulomas. This corresponds roughly with the central, intermediary and peripheral locations. In a small granuloma seen in BL lesions, there were two zones: central and peripheral. In a large LL granuloma, three zones were seen, central, intermediary and peripheral zones. It is suggested that the degradation of disintegrated particles of bacilli might be due to the lysosymal activity of macrophages. The phagocytized bacilli are slowly degraded with long incubation periods, but the undigested debris remains inside the phagosomes. The chemical complexity of cytoplasm, cell wall and lipid fractions of M. leprae, and it is such that the lipid fractions of M. leprae mask some other antigenic components, which may be responsible for the cellular response and lysosymal production. According to our findings we believe that chemotherapy kills M. leprae but degraded products are not removed. These components are chemically complex and digested with difficulty. Lysosymal enzymes could be inhibited from productions by the bacterial debris or the lipid fractions could serve as a mask to delay lysosymal production in the cell. These aspects need further study. PMID- 2695581 TI - Detection of subclinical infection in leprosy: an 8 years follow-up study. AB - A follow-up study has been carried out using Fluorescent Leprosy Antibody Absorption (FLA-ABS) test in 1069 healthy contacts of multi and pauci-bacillary leprosy patients. Simultaneously lepromin testing with Dharmendra antigen has also been done to determine their delayed type hypersensitivity. In nearly 8 years of follow-up, 46 contacts have developed disease and of these 41 contacts were FLA-ABS positive and lepromin negative. It is inferred that test (along with lepromin) can be used to identify the contacts who are at higher risk of developing the disease. FLA-ABS test has also been found to be highly sensitive for detection of subclinical infection specially in younger age groups. This test could therefore serve as a very sensitive epidemiological tool for assessing the extent of disease in the community and for monitoring the transmission of disease especially after MDT and other intervention measures. PMID- 2695582 TI - [A case report of Campylobacter fetus subspecies fetus bacteremia]. AB - An unusual case of Campylobacter fetus subspecies fetus bacteremia was presented. A twenty four year old male was admitted to our hospital due to abdominal pain, general malaise, diarrhea, high fever, and hemoptysis. He was alcoholic and fond of eating raw liver. He had a history of partial gastrectomy and disturbance of pancreatic function. He showed pulmonary empyema, pleuritis, thrombophlebitis of lower legs, jaundice, hepatomegaly, diarrhea, pneumothorax, and low T3 low T4 syndrome. C. fetus subsp. fetus was detected from the venus blood and pleural effusion on admission. He was successfully treated by gentamicin, chloramphenicol, and minocycline. This is the fourth case of C. fetus subsp. fetus bacteremia in the Japanese literature. This microanerophilic gram negative curved bacillus has been increasingly associated with human disease and relapsing in nature, so protracted antimicrobial therapy was recommended. PMID- 2695584 TI - [Active site of acid proteases]. PMID- 2695583 TI - [New topics of Alzheimer's disease research]. PMID- 2695585 TI - [Developments in titanium and Ni-Ti alloys for dental uses]. PMID- 2695586 TI - Herpetic infections of the digits. PMID- 2695587 TI - Early mobilisation after flexor tendon repair. PMID- 2695588 TI - Flexor tendon surgery. Part 2: Free tendon grafts and tenolysis. AB - We have attempted to review the development and current status of flexor tendon surgery. The methods of acute flexor tendon repair, conventional free tendon grafting, staged flexor tendon reconstruction, tenolysis and pulley restoration have been discussed, with the published results included for each procedure. The role of rehabilitation has also been reviewed and the ongoing quest for an active flexor tendon prosthetic implant has been briefly mentioned. It may be seen that flexor tendon surgery is a complex and difficult art which requires a thorough appreciation of the normal flexor tendon system, the exact status of that system following injury and surgery and a strong understanding of the techniques which may be best utilised to restore tendon gliding and digital joint motion. The procedures described require both technical skill and experience and the post operative therapy programmes must be carefully chosen for each patient. With the important laboratory and clinical advancements occurring in many areas of flexor tendon surgery, it is realistic to believe that in the future the techniques described here will be substantially altered and modified and to hope that results will continue to improve until the patient and surgeon can expect to restore most digits to nearly full function after flexor tendon interruption. PMID- 2695589 TI - An evaluation of suture materials used in tendon surgery. AB - The following suture materials have been evaluated for their suitability for use in flexor tendon repairs: 4/0 gauge monofilament and multifilament stainless steel, mono-filament nylon, monofilament polypropylene, monofilament polybutestor, braided polyester, braided polyglycolic acid and a monofilament polyglyconate. These were investigated for their tensile strength (both knotted and unknotted), their extension to failure and knot-holding properties. Stainless steel and monofilament polyglyconate appeared to be the most suitable in that they had high tensile strengths, both knotted and unknotted, and had good knot holding security. The only disadvantages are that stainless steel is difficult to use and monofilament polyglyconate is absorbable. Polypropylene and braided polyester, although having lower tensile strengths, are reasonable alternatives. PMID- 2695590 TI - Isolated anterior interosseous nerve palsy following herpes zoster infection: a case report and review of the literature. AB - A 64-year-old lady noticed weakness of her thumb within two weeks of having developed "shingles" causing vesicular lesions on her arm and hand. Clinical and neurophysiological testing confirmed a lesion of the anterior interosseous nerve. Although motor involvement after herpes zoster infection is recognised, this usually has a myotomal distribution; isolated involvement of a branch of a peripheral motor nerve has not previously been described. PMID- 2695591 TI - Founders of hand surgery. Sir Harold Gillies: plastic surgeon extraordinary. PMID- 2695592 TI - Cachectin/tumor necrosis factor decreases human adipose tissue lipoprotein lipase mRNA levels, synthesis, and activity. AB - The effects of the cytokine cachectin/tumor necrosis factor (TNF) on human adipose tissue lipoprotein lipase (LPL) were studied. TNF is produced by activated macrophages and is thought to play a role in mediating hypertriglyceridemia and wasting of adipose tissue triglyceride stores (cachexia) that often accompany infection and malignancy. TNF effects were studied in human adipose tissue fragments maintained in organ culture in the presence of insulin and dexamethasone to induce high LPL activity. Addition of TNF to the culture medium for 20 h caused a dose-dependent inhibition of LPL activity to an average of 37% of controls at 50 U/ml TNF. This inhibition of LPL activity was explained by specific decreases in levels of LPL mRNA (to 40% of controls) and rates of LPL synthesis determined by biosynthetic labeling and immunoprecipitation (to 32% of controls). The decline in LPL synthesis was specific, as it occurred despite a small increase in overall protein synthesis in the presence of TNF. Comparable decreases in LPL activity were observed when TNF was added to adipose tissue cultured solely in the presence of insulin. Thus, similar to results in rodent models, TNF is a potent inhibitor of LPL gene expression in human adipose tissue. TNF may therefore play a role in the disorders of triglyceride catabolism and the pathogenesis of cachexia that occur with stimulation of the immune system in humans. PMID- 2695593 TI - Effects of high-fructose (90%) corn syrup on plasma glucose, insulin, and C peptide in non-insulin-dependent diabetes mellitus and normal subjects. AB - Interest in sweetening agents is encouraging manufacturers and researchers to find a safe substance to maintain the life quality of diabetics. The popularity of sweetened food items has increased recently in Taiwan. The glycemic index of fructose has been reported to be 20%, much lower than most carbohydrate foods. A high-fructose corn syrup (HFCS) has come onto the market of sweetening agents and has been proposed as a low-cost substitute for fructose in dietetic management of diabetes. The aim of this study was to compare the glycemic effects of HFCS and glucose to see if there is a place for high-fructose corn syrup in diabetic management. In 8 normal and 21 non-insulin dependent diabetes mellitus (NIDDM) subjects, we performed oral tolerance tests. After an overnight fast, the subjects were given either 75g of glucose or an equivalent amount of HFCS containing 75g of carbohydrate. Blood was sampled before and at 30, 60, 90, 120 and 180 minutes after the glucose load. Blood glucose was analyzed by the glucose oxidase method using YSI 23 A (Yellow-Springs Intrument). The insulin and C peptide were measured by RIA kits from Daiichi. The area under the curves (AUC) was calculated for plasma glucose, immunoreactive insulin (IRI) and immunoreactive C-peptide (IRCP). The results showed that the glycemic effect of HFCS was 73% of glucose. The AUC of IRI after HFCS was 56% of that of glucose. The AUC of IRCP after HFCS was 57% of that of glucose. The high glycemic index of HFCS in our study does not support the use of HFCS as a substitute for fructose. PMID- 2695594 TI - [Choledochal cyst: findings of intravenous radionuclide cholescintigraphy, sonography, and endoscopic retrograde cholangiography]. PMID- 2695595 TI - Relationship between the production of spirosomes and anaerobic glycolysis activity in Escherichia coli B. AB - The effects of culture conditions (aerobic or anaerobic) and glucose in the medium on the production of spirosomes in Escherichia coli B were studied by SDS PAGE and electron microscopy. The Mr of the spirosome of E. coli B was estimated to be 97,000. Electron microscopy revealed that the amount of spirosomes derived from anaerobic cultures was about eightfold larger than that from aerobic cultures. In SDS-PAGE, the bands of spirosome protein derived from anaerobic cultures were more intense than those derived from aerobic cultures, either in peptone water or in Davis-Mingioli's minimal medium. With increased glucose concentration under aerobic conditions, the intensity of the band of spirosome protein was similar to that observed under anaerobic conditions in basal media. These results suggest that spirosome production by E. coli B is related to its anaerobic glycolysis activity. PMID- 2695596 TI - Cloning and expression of an adhesin antigen of Streptococcus sanguis G9B in Escherichia coli. AB - A genomic library of Streptococcus sanguis, strain G9B, was constructed and expressed in Escherichia coli using a lambda gt11 expression vector. The amplified library was probed with polyclonal anti-G9B IgG and 13 antigen-positive clones were isolated. A lysate of one clone, designated PP39, absorbed the adhesion-inhibitory activity of anti-G9B IgG. This clone contained an insert of approximately 2000 bp and expressed unique 200 and 53 kDa proteins that reacted with monospecific anti-adhesin antibody. The 200 kDa protein also reacted with anti-beta-galactosidase IgG, indicating that it is a fusion protein of which 84 kDa represents the streptococcal adhesin. The 84 and 53 kDa proteins are similar in size to the major polypeptides in a streptococcal antigen complex which is associated with the adhesion of G9B to saliva-coated hydroxyapatite. The 53 kDa fragment may result from post-translational cleavage of the recombinant polypeptide. PMID- 2695597 TI - Identification of DNA regions homologous to nitrogen fixation genes nifE, nifUS and fixABC in Azospirillum brasilense Sp7. AB - A 30 kb DNA region from Azospirillum brasilense Sp7, containing the nitrogenase structural genes (nifHDK), has been cloned. The presence of nif genes, in the 20 kb located next to nifHDK, was explored by Tn5 mutagenesis after subcloning various restriction fragments in the broad-host-range suicide vehicle pSUP202. Over 25 mutations due to Tn5 random insertions were obtained in the 20 kb and each recombined into the genome of strain Sp7. Four new nif loci were identified, located at about 4, 9, 12 and 18 kb downstream from nifK respectively. Hybridization with heterologous nif probes from Klebsiella pneumoniae, Bradyrhizobium japonicum and Azorhizobium caulinodans was performed to characterize the new nif regions. The region proximal to nifK appears to contain nifE and the region distal to nifK contains genes homologous to nifUS and fixABC. nifgene(s) from the fourth locus were not identified. Mutants in this locus, which were devoid of nitrogenase activity when tested under nitrogen-free conditions, displayed a high nitrogenase activity when glutamate was added to the growth medium. This phenomenon was also observed with mutants of the fixABC homology region, but to a lesser extent. Homology between strain Sp7 total DNA and a nifB-containing probe from B. japonicum was detected, although the hybridizing region was not part of the nif cluster described above. PMID- 2695598 TI - Bidirectional stimulation of the white-opaque transition of Candida albicans by ultraviolet irradiation. AB - Most strains of Candida albicans are capable of switching spontaneously and at high frequency between a number of phenotypes distinguishable by colony morphology. The switching frequency of Candida albicans strain WO-1 between two predominant phenotypes, 'white' and 'opaque', and a minor phenotype, 'fuzzy', increased dramatically with low doses of ultraviolet irradiation that killed less than 20% of the population. The ultraviolet irradiation effect continued to be expressed over many generations as evidenced by stimulated sectoring. Ultraviolet irradiation stimulated switching in both the white-to-opaque and opaque-to-white direction, suggesting that a common mechanism functions in both directions. PMID- 2695599 TI - Parallel changes in catabolite repression of haem biosynthesis and cytochromes in repression-resistant mutants of Saccharomyces cerevisiae. AB - Effects of three mutant genes, CAT1-2d, cat2-1 and hex2-3, on catabolite repression of mitochondrial cytochromes and the first two enzymes of haem biosynthesis were compared. The CAT1-2d mutation gave no resistance to glucose, whereas cat2-1 endowed both cytochromes and 5-aminolaevulinate dehydratase with resistance, but did not alter the effect of glucose on 5-aminolaevulinate synthase. The hex2-3 mutation caused repression resistance of cytochromes and of the two haem biosynthetic enzymes. hex2-3 strains also accumulated intracellular 5-aminolaevulinate. Co-inheritance of the latter traits, sensitivity to maltose inhibition and ability to grow on raffinose in the presence of 2-deoxyglucose, demonstrated that the pleiotropic phenotype is a function of the single gene hex2 3. Revertants which grew on maltose regained sensitivity to deoxyglucose and exhibited normal sensitivity of cytochromes and haem biosynthesis enzymes to repression. Addition of the hex1-18 mutation, which renders cytochromes resistant to repression, to a cat2-1 strain did not produce the same effect on 5 aminolaevulinate synthase as hex2-3. It is concluded that repression patterns of haem and cytochrome biosynthesis are substantially affected by hex2-3 and cat2-1 but not by CAT1-2d. PMID- 2695600 TI - Overproduced beta-lactamase and the outer-membrane barrier as resistance factors in Serratia marcescens highly resistant to beta-lactamase-stable beta-lactam antibiotics. AB - In a clinical isolate of Serratia marcescens different states of low and high resistance to different beta-lactam antibiotics considered to be beta-lactamase stable, viz. cefotaxime, ceftizoxime, ceftazidime, aztreonam, cefoxitin and imipenem, were found to be connected with the presence of constitutively overproduced, chromosomally encoded beta-lactamase at concentrations in the bacterial periplasm of 0.4 and 0.9 mM, respectively. All the antibiotics were degraded by the beta-lactamase. However, kinetic constants varied widely: k(m) from 92 to 0.012 microM and k(cat) from 3.4 to 2x10(-4)s(-1). The relative contributions to resistance by the functioning of periplasmic beta-lactamase, resynthesis of this enzyme, and limitation of antibiotic penetration by the bacterial outer membrane were analysed by computer simulations according to steady-state and non-steady-state models of interactions in the periplasm. Results for cefotaxime, ceftizomime, ceftazidime, aztreonam and latamoxef revealed overproduced beta-lactamase as the sole cause of the state of low resistance while antibiotic permeability was the same as in non-resistant S. marcescens strains. In contrast, high resistance was due to beta-lactamase action and decreased permeability of antibiotics. For resistance to aztreonam, only, immobilization of the antibiotic as covalent acyl-enzyme by newly synthesized beta-lactamase was essential. For cefoxitin, ampicillin and imipenem the analyses indicated that additional resistance factors may play a role, e.g. induction of beta-lactamase. PMID- 2695601 TI - Natural infection of duck embryos with duck hepatitis B virus: time and tissue sequence of infection. AB - There have been no studies addressing the detailed sequence of embryonic infection with duck hepatitis B virus (DHBV). Therefore, duck embryos from flocks infected with DHBV were examined to study the sequence of infection by DHBV in various embryonic tissues. Embryos from flocks infected with DHBV were harvested in duplicates from 7 to 25 days of incubation. Whole embryos (to 12 days) or dissected embryonic tissues were fixed, paraffin embedded, and stained for DHBV surface antigen (DHBsAg) using a peroxidase-antiperoxidase technique. Isolated hepatic cells were infected in 7-day-old embryos, and these increased in number until 11 days, when most cells were positive for DHBsAg. Endocrine pancreatic cells were positive from day 10, but only an occasional exocrine pancreatic cell was infected after day 20. Renal tubule cells were positive for DHBV by day 11, increasing in number until about day 18, after which a decline in numbers of infected cells occurred. Renal glomeruli became positive for DHBsAg from day 24. When present in the developing embryo, thymus, bursa of Fabricius, spleen, bone marrow, lung, and duodenum remained negative for DHBsAg. It was concluded that the timing of infection of specific tissues was not necessarily related to cellular maturity but may reflect a need for specific metabolic functions that permit viral replication. PMID- 2695602 TI - Construction of a maxillary prosthesis with a hollow obturator by the balloon technique and a case report. AB - The authors devised a new method for making a maxillary prosthesis with a hollow obturator, which was named the Balloon Technique. This new technique has a number of advantages over the conventional method in that it not only facilitates the molding of a soft plastic hollow obturator in a single process, but also simplifies the trial fitting of the completed obturator. Furthermore, it makes possible firm adhesion of the hollow obturator and the denture base by the hot melt method while the denture base resin is cured. Finally, the completed maxillary prosthesis is extremely light. PMID- 2695603 TI - Lucille Shapson Hurley, 1922-1988. PMID- 2695604 TI - Maternal brown fat metabolism returns to control level by four weeks postweaning in rats. AB - We studied body composition, white and brown adipose tissue cellularity, lipoprotein lipase activity and metabolic enzyme activity in three groups of rats: nonpregnant controls, lactating dams and nonlactating dams (i.e., dams not permitted to suckle their young). Nine to 11 rats in each group were killed on d 12 postpartum (study d 34) and on d 40 postpartum (study d 62). During lactation, brown fat citrate synthase, beta-hydroxyacylCoA dehydrogenase (HOAD) and lipoprotein lipase activities were significantly lower in the lactating than in the nonlactating dams or virgin controls. Although the nonlactating dams had their pups removed within 24 h after delivery, by d 12 postpartum citrate synthase and HOAD activities were significantly lower than those of nonpregnant controls. By the end of the study there were no differences among the three groups except in the case of HOAD. HOAD activity in the lactation group was significantly lower than in the nonlactation group. White fat cell number in the parametrial depot was significantly increased in the nonlactation groups by d 12 postpartum. In the lactation group, increased white fat cell number in this depot was detectable at d 40 postpartum, when carcass fat stores and fat cells had been repleted. These results demonstrate that both lactating and nonlactating dams undergo cellular hyperplasia, at least in the parametrial depot. This may predispose them to obesity. Also, decreased brown fat metabolism in the nonlactating dams may be contributing to their significantly greater carcass fat content at d 12 postpartum. PMID- 2695605 TI - The effect of acarbose and miglitol (BAY-M-1099) on postprandial glucose levels following ingestion of various sources of starch by nondiabetic and streptozotocin-induced diabetic rats. AB - The effect of two alpha-glucosidase inhibitors, acarbose (BAY-G-5421) and miglitol (BAY-M-1099), on postprandial glucose levels following intubation of corn, rice, spaghetti and potato (0.5 g/100 g body wt) was evaluated in nondiabetic and diabetic rats. The peak plasma glucose level and total incremental glucose were significantly decreased following ingestion of each starch source when acarbose (8 mg/100 g body wt) or BAY-M-1099 (2 mg/100 g body wt) were simultaneously intubated. The effect of both inhibitors was more pronounced in diabetic rats than in nondiabetic rats, and their effect on digestion was in a substrate-specific manner. Potato starch digestion was inhibited 58 +/- 11% by BAY-M-1099, and by acarbose, 38 +/- 9%. Rice starch digestion was inhibited by 65 +/- 2% by acarbose, and by BAY-M-1099, only 30 +/- 9%. Both drugs had a similar inhibitory effect when corn or spaghetti was ingested. BAY-M-1099 appears to be more potent than acarbose on both a weight-per weight basis and on a molar basis. When corn or rice was used, only 2 mg of BAY-M 1099 was required to achieve a similar inhibitory effect to that of 8 mg of acarbose (9.7 X 10(-3) M) vs. 12.2 X 10(-3) M). Since both drugs blunted to varying degrees the rise in glucose level following starch ingestion, they may be a useful adjuvant in the treatment of diabetic subjects. Simultaneous use of both drugs in therapeutic treatment should be seriously considered. PMID- 2695606 TI - Interactions between vitamin A deficiency and Plasmodium berghei infection in the rat. AB - It has been claimed that vitamin A deficiency increases the severity of malarial infection in rats. We measured parasitemia, mortality, serum retinol, liver retinol, spleen weight, and degree of xerophthalmia in vitamin A-deficient rats (A-), pair-fed control rats (A+PF), and ad libitum-fed control rats (A+AL) infected with Plasmodium berghei, a rodent malarial parasite. In experiments 1 and 2 vitamin A deprivation began at weaning. Parasitemia and mortality among mildly deficient (expt. 1, mean serum retinol 19 micrograms/dl) or acutely deficient rats (expt. 2, mean serum retinol less than 5 micrograms/dl) infected with P. berghei were not significantly different from those of infected A+AL or A+PF rats. Furthermore, when the mildly deficient rats were given a second, larger dose of P. berghei, all demonstrated complete immunity to the parasite. However, when vitamin A was withdrawn midway through pregnancy (expt. 3), the A- rats experienced significantly higher parasitemia and mortality during infection with P. berghei. Malaria caused a significant decrease in the serum retinol but not liver retinol of the A+PF and A+AL rats. Among the acutely deficient rats, xerophthalmia was significantly more prevalent and more severe among those infected with malaria than among those not infected with malaria. Malaria and vitamin A deficiency acted synergistically to increase spleen weight, and this interaction was highly significant. In these experiments, vitamin A deficiency decreased the rats' ability to recover from malaria, but only when the deficiency began early in life, was very severe, and the rats were young when infected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695607 TI - Leaders in medicine. Leroy Goodman, MD. PMID- 2695608 TI - [Immunohistochemical study on the primary olfactory neuron of rat and suncus]. AB - Carnosine (beta-alanyl-L-histidine), a putative neurotransmitter, was identified immunohistochemically in the primary olfactory neuron, using newly developed anti carnosine antiserum. Similar results were obtained in the rat and suncus. Carnosine-like immunoreactivity was observed in the olfactory cells and its apical dendrites of the olfactory epithelium. The olfactory nerve and glomerular layer of the olfactory bulb showed positive reaction. At electron microscopic level, carnosine-immunoreactive end products widely spread out in the cytoplasm of olfactory nerve cells and also on microtubules of olfactory cilia. In the glomerular layer, reaction products were found diffusely in many axon terminals. These terminals had small spherical vesicles and often made asymmetric synaptic contacts to the second neuron. Unilateral closure of the olfactory naris resulted lower immunoreactivity of tyrosine hydroxylase in periglomerular cells, which are dopaminergic interneurons and are thought to regulate neurotransmission of olfactory input. In contrast no remarkable changes were seen on carnosine immunoreactivity in olfactory bulb. The present results suggest that carnosine may play some important roles in the olfactory mucosa. The functional role of carnosine remarks to be further examined. PMID- 2695609 TI - AIDS update: prevalence, prevention, and medical management. AB - This article summarizes the epidemiology of AIDS and human immunodeficiency virus (HIV) infection among intravenous drug abusers (IVDAs) in the United States and discusses the status of approaches to prevent HIV infection and to treat AIDS patients. Finally, the status of research of selected community-based prevention programs, such as needle-exchange programs and programs distributing bleach to IVDAs for needle and syringe cleaning, will be reviewed. PMID- 2695610 TI - Role of 99mTc-disofenin in duodenal and gastric aspirates in the evaluation of persistent neonatal cholestasis. AB - A prospective study was undertaken on 49 infants with prolonged neonatal cholestasis to determine whether the specificity, sensitivity, and accuracy of 99mTc-disofenin scintigraphy can be improved by performing simultaneous radioactivity measurements on duodenal and gastric aspirates along with routine imaging. Specificity of routine scintigraphy was improved by this modification from 45.7 to 76.4%. Accuracy of the test was also superior in improving from 55% with routine scintigraphy to 78.4% by counting additional radioactivity on both duodenal and gastric aspirates. We suggest that this modified technique be applied in the evaluation of infants with conjugated hyperbilirubinemia so that invasive procedures such as open liver biopsy and operative cholangiogram may be avoided. PMID- 2695611 TI - Ultrasonographic prediction of the presence and severity of esophageal varices in children. AB - Twenty-eight consecutive children with either chronic liver disease or portal vein obstruction were investigated to study the presence of gastroesophageal collaterals due to portal hypertension by ultrasound and endoscopy. Sonographic measurements of the ratio of the lesser omentum thickness to aortic diameter (LO/Ad) and of portal vein diameter to body surface (Pv/m2) were significantly higher in children with esophageal varices than in those without varices. With a lower limit for the LO/Ad ratio of 1.3, no false negatives and only three false positives (91% predictive value of esophageal varices) could be detected. The combination of LO/Ad and Pv/m2 would exclude the possibility of detecting esophageal varices if the LO/Ad ratio is less than 1.8 and the Pv/m2 is less than 12 mm. All children with an LO/Ad ratio greater than 1.9 had varices. Even in the presence of an overlap between children with small and large varices, it is possible to identify with high probability a child with large varices if the LO/Ad ratio is greater than 2.5. This study confirms the value of ultrasound in the diagnosis and management of children with portal hypertension and suggests an algorithm to screen children with small and large varices. PMID- 2695612 TI - Clinical and immunological heterogeneity of anti-liver-kidney microsome antibody positive autoimmune hepatitis in children. AB - A group of children with autoimmune hepatitis is characterized by the presence in their sera of anti-liver-kidney microsome antibody (LKMA) as defined by immunofluorescence. Immunoblot analysis of the sera of 21 such children using rat liver microsome total proteins as antigen allowed separation into three groups- group 1, whose sera recognized a 50 kDa protein; group 2, whose sera recognized a 66 kDa protein; and group 3, whose sera recognized both proteins. Patients with the anti-66-kDa reactivity more often displayed an acute onset of the disease, less signs of portal hypertension, better sensitivity to immunosuppressive therapy, and less tendency to relapse. They also displayed a lower titer of anti rat-liver microsome antibody in enzyme-linked immunosorbent assay (ELISA) and a serum reactivity with a rat-liver cytosolic protein. These results (a) indicate that the LKMA-positive autoimmune hepatitis of children is heterogeneous from both clinical and immunological view points, (b) suggest that children with anti 66-kDa reactivity could have a less severe disease than children with the 50-kDa reactivity, and (c) indicate that immunoblot analysis should be added to ELISA and immunofluorescence studies to achieve better characterization of these patients. PMID- 2695613 TI - Prediction of total daily fecal excretion during acute childhood diarrhea. AB - Clinical data from 133 male patients between 3 and 36 months of age were reviewed to identify factors that could predict high rates of fecal excretion during acute diarrhea. Diarrheal severity after hospitalization was measured by separate 4-h quantitative collections of feces during 6 days: the number of these 4-h collection periods with any stool output was used as an estimate of the number of bowel movements each day. The number of 4-h periods with any stool output was highly correlated with total fecal excretion expressed as grams per kilogram of body weight per day (p less than 0.001). The age of the patient, type of diarrhea, and type of diet had little effect on the relationship between stool "number" and amount. The number of bowel movements, as estimated during this study, was a highly sensitive (greater than 90%) and reasonably specific (greater than 70%) predictor of children at risk of high fecal excretion rates (greater than 50 g/kg/day or greater than 100 g/kg/day) during acute diarrhea. PMID- 2695614 TI - Intraocular histiocytic lymphoma: a pediatric case presentation. AB - An 11-year-old white female with a 5-month history of stage IV systemic histiocytic lymphoma presented in relapse with a red, painful left eye with a decrease in visual acuity. A diagnostic anterior chamber paracentesis was performed revealing cells consistent with the systemic diagnosis of histiocytic lymphoma. Also, at that time, central nervous system involvement was found. This is the youngest patient to our knowledge to have documented intraocular involvement from histiocytic lymphoma. She is also unusual in that the ocular involvement was predominantly localized to the anterior segment. PMID- 2695615 TI - [Antigen recognition and signal transduction in T lymphocytes]. AB - Stopped-flow fluorometry gave a unique opportunity to observe a direct cellular interaction between functionally different subsets of lymphocytes in vitro. By this method the molecular mechanism of receptor-mediated recognition and signaling in T lymphocytes (T cells) has been well analyzed. The method is further in progress to observe calcium signals in a single T lymphocyte by using a digital imaging fluorescence microscope. PMID- 2695616 TI - Unidirectional internuclear transfer of linked genes in heterokaryons of Candida albicans. AB - Nutritionally balanced heterokaryons of the naturally diploid, asexual yeast, Candida albicans are produced by fusing protoplasts of complementing auxotrophic strains. Spontaneous unidirectional internuclear transfers of an intact gene linkage group in established heterokaryons is demonstrated. Evidence is presented that a transfer event (i) typically involves a single chromosome which is added to the resident homologues of a recipient nucleus, (ii) can occur equally well in either direction between complementing nuclei and (iii) may encourage gene conversion at transferred loci in the recipient nucleus. The bearing of these findings on application of protoplast fusion to parasexual genetic analysis of C. albicans is discussed. PMID- 2695617 TI - The influence of the medical profession on dentistry in Philadelphia. PMID- 2695618 TI - Neuroendocrine responses to stimulation of the splanchnic nerves in bursts in conscious, adrenalectomized, weaned lambs. AB - 1. Effects of stimulation of the peripheral ends of the splanchnic nerves below behavioural threshold at either 4 or 7 Hz continuously for 10 min, or at 40 or 70 Hz for 1 s at 10 s intervals for 10 min. have been compared in conscious adrenalectomized lambs. 2. Both patterns of stimulation resulted in an abrupt rise in mean aortic blood pressure of closely similar extent which was associated with reflex bradycardia. 3. At the lower frequencies both patterns of stimulation elicited a closely similar rise in mean plasma glucose, glucagon and pancreatic polypeptide concentration, but the fall in mean plasma insulin concentration was significantly greater during continuous stimulation. 4. Unlike other species in which the release of NPY and bombesin-like immunoreactivity (BLI) is potentiated by intermittent high-frequency stimulation, no significant differences were produced by changing the pattern of stimulation. The release of BLI was found to be frequency related over the ranges tested (4-7 Hz continuously and 40-70 Hz in bursts) whereas the release of NPY was not. 5. Splanchnic nerve stimulation also produced detectable rises in the mean plasma concentrations of noradrenaline and adrenaline. The mean average concentration of noradrenaline during stimulation in bursts was significantly higher than that during continuous stimulation (P less than 0.02). There was also a steady rise in mean plasma 3,4-dihydroxyphenylacetic acid (DOPAC) during stimulation followed by a further rise to significantly higher values (P less than 0.02) following stimulation in bursts at 40 Hz. 6. It is concluded that the pattern of stimulation is a less important determinant of autonomic responses to splanchnic nerve stimulation in sheep than in certain other species. PMID- 2695619 TI - Vesiculobullous mucocutaneous disease: pemphigus vulgaris. AB - Pemphigus vulgaris is a potentially fatal autoimmune mucocutaneous disease in which oral lesions may be the initial and predominant manifestation. The disease is characterized by acantholysis in the immediately suprabasal layers of the stratified squamous epithelium, giving rise to blisters which readily rupture leaving erosions which show little tendency to heal. Immunogenetic studies indicate a marked genetic susceptibility to the disease, with the immune response associated HLA-DR4 and DRw6 alleles being especially important. The trigger for autoantibody formation is unknown. The antigen in pemphigus vulgaris is probably a 130-140 kD cell adhesion molecule located in the cell membrane of basal and immediately suprabasal keratinocytes. Antibody binding to this antigen is likely to interfere with normal intercellular adhesion, leading to desmosomal detachment. Propagation of acantholysis and cell damage are attributable to complement activation, with deposition of the membrane attack complex on the keratinocyte cell membrane, and proteolysis due to increased plasminogen activator production. Steroid therapy is the treatment of choice, but significant mortality is still associated with the disease. PMID- 2695620 TI - Oral candidiasis and human immunodeficiency virus infection. AB - The association of oral candidiasis with the human immunodeficiency virus (HIV) infection has been known since the advent of the acquired immunodeficiency syndrome (AIDS) pandemic. Oral candidiasis is one of the earliest premonitory signs of HIV infection and its diagnosis may have grave prognostic implications for the eventual development of full blown AIDS. There is now an expanding body of data on novel clinical variants of this 'old' disease, its epidemiology in HIV seropositive individuals and, advances in its management, particularly with respect to the recently introduced bis-triazole antifungals. Current concepts pertaining to the epidemiology, clinical features, pathogenesis, laboratory diagnosis and management of oral candidiasis in HIV infection are reviewed. PMID- 2695621 TI - Pheochromocytoma of the urinary bladder (report of 2 cases with review of literature). PMID- 2695622 TI - Profile of congenital cholesteatomas of the petrous apex. AB - Congenital cholesteatomas of the petrous apex are now frequently being approached by otologists. Involvement of the cerebello pontine angle by this lesion produces a myriad of signs and symptoms. Otological as well as neurosurgical literature is reviewed to achieve an overall understanding of the nature and behaviour of this uncommon but interesting lesion. PMID- 2695623 TI - Somatization: a psychiatrist's perspective. AB - Psychiatrists are referred only a small and unrepresentative proportion of patients who somatize. To a large extent this is due to the fact that patients consider themselves physically ill and regard psychiatric referral as inappropriate. Although somatization has several social advantages it obscures underlying psychopathology and leads to unnecessary physical investigations with a risk of iatrogenic disease. It is important to establish a psychiatric diagnosis as early as possible so that treatment can be started before a chronic pattern of illness behaviour is established. PMID- 2695624 TI - Noncompliance with iron chelation therapy in patients with beta thalassaemia. AB - Twenty-three percent of patients with beta thalassaemia were found noncompliant to iron chelation. Excluding separation anxiety disorder and primary functional enuresis, the frequency of psychiatric disorders in the noncompliant and the compliant patients was 68% and 10%, respectively. Oppositional disorder was the most frequent psychiatric disorder; it was also associated with the most profound deviation from compliance. Separation anxiety disorder and primary functional enuresis were not associated with noncompliance. In one-third of the noncompliant patients no psychiatric disorder was identified. School performance was poorer in the noncompliant patients. The presence of psychiatric disorders (mainly oppositional disorder), other than separation anxiety disorder and primary functional enuresis, in thalassaemic patients is a risk factor for noncompliance to treatment. Early identification of noncompliance and appropriate psychiatric intervention may help these patients to become compliant with medical treatment. PMID- 2695625 TI - Dysfunctional cognitions, attributional style, and depression in bulimia. AB - A group of 44 bulimic women (DSM-III) as well as 38 women with no indication of an eating disorder, comparable with respect to age, weight and height, were studied by means of the Beck Depression Inventory (BDI), the Dysfunctional Attitude Scale (DAS), the Attributional Style Questionnaire (ASQ), and an Eating Disorder Questionnaire (EDQ). Bulimics showed significantly higher BDI, DAS and ASQ (bad events) scores, respectively. In both groups BDI scores were significantly correlated with DAS and ASQ (bad events) results. BDI was highly predictive of severity of bulimia while no significant prediction was obtained from either DAS or ASQ (bad events) scores. The findings provide first evidence that dysfunctional attitudes and depressive attributional style are predominant in bulimic women but at the same time are not necessarily predictive of the severity of the disorder. PMID- 2695626 TI - [Current radiologic aspects of surgical technics for resection of cancer of the rectum]. AB - The aim of this work is to describe the current surgical rectum resection techniques for the treatment of cancer and the corresponding radiological images. The authors emphasize the mechanical, "trans-suture" anastomoses and on the colo anal anastomoses with colic container, which radiologists will have to follow up postoperatively. PMID- 2695627 TI - [Cervical ectopic thymus]. AB - Two cases of cervical aberrant thymus in infants are reported; it's important to identify such ectopia because thymic tissue involutes spontaneously later on; neither surgery nor other treatment is needed. Ultrasonography is a method of choice for tissue characterization of ectopic thymus and differential diagnosis with other cervical masses. PMID- 2695628 TI - Photoperiodic regulation of reproduction in the male silver fox (Vulpes vulpes). AB - Six silver fox males were exposed to short days (6L:18D) from February, when the testes were fully developed, until June 1986 (Group 6L). Eight males maintained in natural daylight served as controls (Group N). Histological sections from the testes of 2 males in Group 6L killed in June indicated full spermatogenic activity. Three blue fox vixens inseminated the following year with semen collected and frozen in June from 3 males in Group 6L failed to produce litters. One possible explanation for the reproductive failures could have been that the high environmental temperatures in June influenced semen quality. There was no significant difference (P greater than 0.05) in LH release in response to GnRH stimulation in June, but testosterone response to LH release was significantly higher (P less than 0.01) in animals subjected to a restricted photoperiod, demonstrating that testicular testosterone production was maintained longer than in control animals. Two males in Group 6L were retained in 6L:18D from June until December 1986 and then exposed to natural daylight until the end of the study in May 1987 (Group 6L:6L:N). These males started to shed their winter coat and showed clinical signs of testicular regression in December, i.e. after approximately 11 months exposure to 6L:18D. The 2 remaining males in Group 6L were moved to cages with natural daylight in June 1986, where they were kept until the end of the experiment (Group 6L: N:N). These males displayed testicular regression soon after the change in photoperiod but maintained their capacity for testicular redevelopment during the following breeding season.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695629 TI - Pregnancy, lactation and the oestrous cycle of the pouched mouse, Saccostomus campestris. AB - The anatomy and histology of pouched mouse ovaries were studied during the oestrous cycle, pregnancy and lactation along with the relationship between the ovarian structures and circulating concentrations of progesterone. The structure of the ovaries resembled that of most rodents. Follicular development indicated that ovulation takes place on the night between pro-oestrus and oestrus, i.e. at the time when mating normally occurs. Corpora lutea were accumulating in cyclic females, while successively disappearing during pregnancy, leaving only the set formed after conception. After parturition luteal regression was rapid. Theca interna, included in the corpora lutea, formed glandular stromal tissue after regression of the luteal tissue formed from granulosa cells. The progesterone profile of non-pregnant females indicated a short but functional luteal phase (peak at metoestrus) during the cycle. During pregnancy three peaks of progesterone stood out: (1) when implantation starts, (2) when older sets of corpora lutea showed rejuvenation and placental signs were found in the vaginal smears, and (3) 3 days before expected parturition when luteal development (as judged by histology) reached a peak. The placenta may participate in but not 'take over' the progesterone production during later stages of pregnancy. Very low concentrations of peripheral progesterone during lactation and a very low level of follicular development at that time support an earlier suggestion of a lactational anoestrus in pouched mice. PMID- 2695630 TI - Formation and function of GnRH-induced subnormal corpora lutea in cyclic ewes. AB - Of 19 dioestrous ewes given 50 micrograms GnRH on Day 10 of the oestrous cycle, 15 (79%) formed corpora haemorrhagica within 2 days after injection of GnRH. After excision of the Day 10 spontaneous CL, the GnRH-induced CL were short lived when compared to spontaneous CL in saline-treated ewes (3.1 +/- 0.4 vs 17.3 +/- 0.3 days, respectively). Hysterectomy of ewes bearing the GnRH-induced CL prevented regression of the short-lived CL, thus extending functional lifespan greater than or equal to 38 days. Serum concentrations of progesterone produced by the GnRH-induced CL in hysterectomized ewes were less than those observed during a comparable interval (Days 7-14) in saline-treated, non-hysterectomized ewes (2.24 +/- 0.1 vs 3.67 +/- 0.15 ng/ml, respectively; P less than or equal to 0.001). When GnRH was given before (5 h before) or during (5 h after) PGF-2 alpha induced regression of the Day 10 spontaneous CL, the GnRH-induced CL which formed were also short-lived. In contrast, when GnRH was given following (36 h after) PGF-2 alpha-induced regression of the Day 10 spontaneous CL, the CL which formed were not different in lifespan or production of progesterone from spontaneous CL. Efforts to enhance function of the GnRH-induced subnormal CL by treating ewes with the synthetic progestagen, norgestomet, to suppress follicular development after CL formation, were unsuccessful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695631 TI - Immunohistological localization of human pregnancy-associated endometrial alpha 2 globulin (alpha 2-PEG), a glycosylated beta-lactoglobulin homologue, in the decidua and placenta during pregnancy. AB - Monoclonal and polyclonal antibodies to pregnancy-associated endometrial alpha 2 globulin (alpha 2-PEG), a glycosylated human beta-lactoglobulin homologue, were used in an immunohistological technique to determine the cellular localization of this protein in the decidua and placental tissues during pregnancy. During the first trimester the protein was principally localized to the glandular epithelium of the decidua spongiosa region of the endometrium with only weak staining associated with glands of the decidualized decidua compacta region. No significant cellular staining was detected in the decidua capsularis. At term in the decidua of the amniochorion and the placental bed weak staining for alpha 2 PEG was only associated with the epithelium of attenuated glands. No significant staining was detected in the placenta during pregnancy. These results suggest that the epithelium of glands associated with non-decidualized stroma represents the primary source of alpha 2-PEG during the first trimester and that a function of the decidua spongiosa in early pregnancy may be related to production of alpha 2-PEG. The decline in production of alpha 2-PEG during pregnancy is suggested to result from involution of the decidua spongiosa and at term the attenuated glands of the decidua represents the source of alpha 2-PEG. PMID- 2695632 TI - Localization of androgen receptors in ram epididymal principal cells. AB - Androgen receptor was immunolocalized in the epididymal epithelium of rams and in isolated cells using an antibody against a synthetic polypeptide representing a portion of the androgen receptor. Immunostaining was predominant in the epithelium in tissue sections. Concentrations of androgen receptor were determined in cells from the central caput, distal caput, and central corpus epididymidis enzymically dissociated and elutriated to provide two fractions. On the average (n = 18), Fraction I contained 8% principal cells while Fraction II contained 71% principal cells; the stromal cells in each fraction were primarily smooth muscle and fibroblasts. For each sample, the number of DHT receptors (fmol) per 10(6) total cells was greater in Fraction II than in Fraction I. Few cells in Fraction I were immunostained for androgen receptor, whereas most cells in Fraction II were intensely stained. The numbers of DHT receptors per cell, or per principal cell, were similar for the central caput and distal caput, but lower in the central corpus epididymidis. The results support our hypothesis that most epididymal DHT receptors are localized in principal cells and confirm that the region between the central caput and proximal corpus of the ram epididymis is most dependent on androgen stimulation. PMID- 2695633 TI - Aromatase activity in fetal rat gonads. PMID- 2695634 TI - Induction of ovulation in bitches with pulsatile or continuous infusion of GnRH. PMID- 2695635 TI - Induction of fertile oestrus in anoestrous dogs by constant infusion of GnRH agonist. AB - The continuous, subcutaneous administration of the GnRH superagonist lutrelin for 14 days was evaluated as a means to induce oestrus in 24 anoestrous beagle bitches, beginning 90-146 days after the previous oestrus. The recent occurrence of pregnancy and lactation (N = 12) vs a non-pregnant cycle (N = 12) did not appear to affect the incidence of pro-oestrus (10/12 vs 11/12 bitches), or oestrus (8/12 vs 11/12 bitches), the timing of pro-oestrus (5 +/- 0.4 days) or oestrus (13 +/- 0.3 days) or the incidence of ovulation (8/12 vs 10/12 bitches), but did reduce the number of ovulating bitches that gave birth to litters after mating the induced oestrus (3/8 vs 6/10). The mean magnitude of the endogenous preovulatory or preovulatory-like LH surges at Day 8-15 varied (P less than 0.5) among the 9 bitches that became pregnant (4.7 +/- 0.9 ng/ml), the 9 bitches that ovulated but did not become pregnant (2.7 +/- 0.6 ng/ml), and the 6 bitches that failed to ovulate in response to treatment (1.9 +/- 0.3 ng/ml). Overall, mean LH surges (3.3 +/- 0.5 ng/ml) were lower than those in 12 contemporary spontaneous control cycles (16 +/- 3 ng/ml) and may have been compromised by pituitary down regulation caused by continued agonist administration. The latter was suggested in ovariectomized bitches treated similarly with agonist by the suppression, within 10 days of start of treatment, of LH from 35 +/- 6 to 3 +/- 0.5 ng/ml. The 50% success rate obtained in early anoestrous bitches after non-pregnant cycles suggests that constant infusion of GnRH agonist might be useful for the induction or synchronization of fertile oestrus in dogs, particularly if initiated later in anoestrus. PMID- 2695636 TI - The use of hormones, especially progestagens, to control oestrus in bitches. PMID- 2695637 TI - Immunological approaches to contraception in dogs. AB - The demand for safe, effective and cost-efficient means of pet population control has generated interest in the development of alternatives to surgical gonadectomy. The purpose of this review is to discuss the potential of immunological approaches to fertility control and to outline recent developments that may aid their design. Among the most promising candidates for immunoneutralization is gonadotrophin releasing hormone (GnRH). We have developed a reliable and reproducible GnRH-protein conjugate antigen and demonstrated that immunologically induced infertility is possible in dogs. PMID- 2695638 TI - Termination of pregnancy in bitches by administration of prostaglandin F-2 alpha. PMID- 2695639 TI - Endocrine regulation of the corpus luteum of the bitch as a potential target for altering fertility. PMID- 2695640 TI - Biology and endocrinology of ovulation, pregnancy and parturition in the dog. AB - There is considerable variation among bitches in commonly encountered intervals between cycles (5-12 months), durations of anoestrus (1-8 months), durations of follicular phase pro-oestrus (3-21 days) and periovulatory oestrous behavior (3 21 days), intervals from preovulatory LH surge to oestrus onset (-2 to 5 days), and intervals from fertile mating to parturition (57-68 days). The extent of variation within bitches ranges from slight to great. However, there appears to be very little variation in the intervals from LH surge to ovulation (2 days), to post-ovulatory oocyte maturation (approximately 4 days), to implantation (approximately 18 days), to selected developmental stages of pregnancy, or to parturition (64-66 days). There are no tests diagnostic of early pregnancy. The onset times of persistent pregnancy-specific changes have been estimated, including radio-opaque fetal details (Day 46), elevated blood prolactin values (Day 35), elevated blood relaxin values (Day 25), echogenic heart beats (Day 24) and embryonic vesicles (Day 19), and potentially palpable uterine enlargements (Day 21). As in humans, there is an anaemia of pregnancy involving a 30% reduction in haematocrit and an increased incidence of insulin resistance during the second half of gestation. Ovarian progesterone is required throughout pregnancy. LH and prolactin are luteotrophic in the pregnant bitch as well as during the 2-month luteal phase of the non-pregnant bitch. Parturition follows a luteolysis which occurs during an increase in prostaglandin F-2 alpha that begins 36 h pre partum. Factors regulating the duration of anoestrus are not known but termination of anoestrus is associated with increased pulsatile secretion of LH. PMID- 2695641 TI - Semen evaluation, cryopreservation and factors relevant to the use of frozen semen in dogs. PMID- 2695642 TI - Sexual differentiation and inherited disorders of sexual development in the dog. PMID- 2695643 TI - Premature gonadal failure in female dogs and cats. AB - Premature gonadal failure has been detected in phenotypically female dogs and cats with defective prenatal germ cell migration (ovarian aplasia), defective prenatal differentiation of the gonadal ridge into ovarian tissue (true hermaphroditism, male pseudohermaphroditism, ovarian dysgenesis in the presence of XO or XXX sex chromosome complements) or defective gamete maturation in the presence of primordial ovarian follicles (lymphocytic oophoritis, thyroid insufficiency). The most common of these is defective gonadal differentiation in animals with true hermaphroditism and failure of gamete maturation in thyroid insufficiency. A common clinical sign of premature gonadal failure in companion animals is failure to show a pubertal oestrus by 2 years of age. Diagnostic evaluation of such animals should include determination of the karyotype, plasma concentrations of LH and FSH and of thyroid hormones, gonadal histology, and gross evaluation of the Mullerian duct system at laparotomy. PMID- 2695644 TI - Reproductive biology of the domestic cat with special reference to endocrinology, sperm function and in-vitro fertilization. PMID- 2695645 TI - Real-time ultrasonic imaging of the ovary and uterus of the dog. AB - The reproductive tracts of 50 bitches were ultrasonically imaged to evaluate the appearance of the uterus and ovaries at different stages of the oestrous cycle. Ovarian follicular growth was observed throughout the oestrous period. Follicles increased in size slowly until 7 days after the onset of pro-oestrus. Thereafter there was a rapid increase in diameter, indicating impending ovulation. The maximum recorded follicular diameter was 13 mm. It was not possible to observe ovulation since in the bitch follicles do not collapse as rapidly as in other species. During the post-ovulatory period there was a gradual loss of follicle shape and an increase in wall thickness. It was not possible to image the uterus of prepubertal bitches or young nulliparous bitches in anoestrus. During pro oestrus and oestrus the uterus became increasingly hypoechoic with central regions of hyperechogenicity, which may represent uterine oedema. Uterine involution was observed in 5 bitches, and a rapid change in uterine diameter occurred over the first 3 days post partum. The ultrasonographic appearance was characteristic at this time. PMID- 2695646 TI - Efficacy of light support pantyhose. AB - The results of a multicenter, double-blind clinical trial indicate that the use of light support pantyhose significantly reduced the incidence of aches, swelling and fatigue in the lower legs of healthy women. A trend toward reduced foot and leg circumference was noted; however, it did not correlate significantly with subjective symptomatology. PMID- 2695647 TI - Comparison of the nipple stimulation and exogenous oxytocin contraction stress tests. A randomized, prospective study. AB - In a prospective, randomized trial, 103 women underwent a total of 203 antenatal stress tests. One hundred four nipple stimulation contraction stress tests (BSTs) and 99 oxytocin challenge tests (OCTs) were performed. The patient populations were similar for the two groups. Uterine hyperstimulation with abnormal fetal heart rate patterns occurred with 2.9% and 1% of the BSTs and OCTs, respectively. The failure rate for the BST group was 22%. Maternal age and weight, parity and gestational age were not associated with test failure. Only one patient failed more than one BST, but she did not fail every such test. When test time (time from initiation to completion of the test) was compared between the two groups, a significant difference was found when the BST was successful. However, when test time in the total BST group (successful and unsuccessful BSTs followed by an OCT was compared to that in the OCT group, no difference could be found. Though an OCT following an unsuccessful BST took longer to perform than did a primary OCT, the difference was not statistically significant. It appears that BST test failure may relate more to the technique of nipple stimulation used than to intrinsic patient factors. PMID- 2695648 TI - Bacterial infection and human fetal wastage. AB - Twenty-eight of 57 fetuses delivered after intrauterine death were found to have a variety of aerobic and facultative bacteria in the heart, anus, placenta, brain and cerebrospinal fluid. Subclinical maternal bacteremia, possibly originating in the urinary tract, appears to be a common cause of second- and third-trimester fetal demise. PMID- 2695649 TI - Antenatal diagnosis of epignathus with neonatal survival. A case report. AB - Antenatal diagnosis was made of bilobed epignathus arising from the fetal palate. The fetus survived. Antenatal recognition of this malformation allows adequate preparation of the neonatal and surgical teams to ensure optimal fetal survival. PMID- 2695651 TI - Changes in lipid metabolism, tissue cations, and water content after fluid percussion-induced traumatic brain injury in rats. PMID- 2695650 TI - Epithelial cell adhesion mechanisms. PMID- 2695652 TI - Traumatic brain injury: improving functional recovery. AB - Most physical injuries in this country are the result of motorized vehicle accidents. Head trauma accounts for one fourth of all trauma deaths, and the cost to treat patients with head trauma is $83 billion. The author discusses injury patterns, methods of resuscitating patients with head injuries, surgical management and monitoring, and the clinical course and prospects for rehabilitation. An interdisciplinary approach to the management of such patients is encouraged, and the medical and surgical interventions undertaken at one institution are reviewed. PMID- 2695653 TI - A critical care helicopter system in trauma. AB - Civilian helicopters and emergency medical services in the United States have been in existence for approximately 15 years. The rapid growth of this type of health care delivery coupled with an increasing number of accidents has prompted professional and lay scrutiny of these programs. Although they have a demonstrated history of benefit to patients, the type and severity of injuries to patients who are eligible for helicopter transportation need further definition. The composition of the medical crews and the benefits that particular crew members bring to the patients require ongoing evaluation. Significant questions regarding the number of pilots in a helicopter and in a program remain to be answered. This article reviews the role of emergency medical air transport services in providing care to trauma patients, staff training and evaluation, and safety criteria and offers recommendations to minimize risks to patients and crews. PMID- 2695654 TI - Breast cancer in the young. AB - Breast cancer in the young is rare. Some cases can be treated with modest surgical intervention and prognosis is good. We present a report of a 17-year-old black girl with adenocarcinoma of the breast. In our case, the disease pursued a devastatingly rapid course in spite of treatment and the patient died within 6 months of diagnosis. The literature relating to clinical experience with various types of breast carcinoma seen in pre- and postpubertal patients is also reviewed. We conclude that this case, and certain other cases cited, demonstrates the need for a high index of suspicion and earlier and more aggressive intervention in young patients with axillary breast masses. PMID- 2695655 TI - Psychiatric morbidity and health problems among black Americans: a national survey. AB - This study examined the relationship between symptoms of psychiatric morbidity and health problems among a nationally representative, cross-sectional sample of 2107 black adults from the National Survey of Black Americans. Subjects experiencing a high level of psychiatric symptomatology had a significantly higher number of health problems and reported a lower level of satisfaction with their overall health than blacks with low levels of psychiatric symptoms or those who never experienced emotional problems. Individuals with the highest level of psychiatric symptomatology were more likely to have been physician-diagnosed as having ulcers, hypertension, diabetes, kidney problems, nervous-emotional problems, and circulatory system difficulties. These relationships persisted after controlling for age, gender, socioeconomic factors, and traditional risk factors for health problems, such as smoking and alcohol use. Although generally consistent with previous research on predominantly white samples, these specific findings underscore the complexities involved in drawing inferences from associations between psychiatric symptomatology and health problems observed in cross-sectional surveys. Prospective psychiatric epidemiologic studies, utilizing better measures of psychological distress and objective health outcome measures, are needed to clarify the relationship between psychiatric difficulties and health problems among black Americans. PMID- 2695656 TI - Silent myocardial ischemia is not a benign sign. AB - 1. Objectively, provoked angina is different from non-provoked angina. a) During pacing stress testing, provoked angina showed lesser increase in coronary sinus blood flow. b) During Ergotamine testing, variant angina showed a more marked decrease in flow. c) The myocardial lactate extraction ratio was lower during the pacing induced angina. 2. During the asymptomatic period, the polyparametric changes which would become manifest appeared following differing intervals. The early recognition of the myocardial ischemia was achieved by detection of the abnormality of the regional cardiac wall motion using a newly developed device, the cardiomoveogram. 3. Therefore, we can at least conclude that silent myocardial ischemia is not a good prognostic sign. PMID- 2695657 TI - [Susceptibility of bacteria isolated from patients with lower respiratory tract infections to antibiotics (1986)]. AB - Enlisting the help of various research institutions across the nation, Ikemoto et al. have been pooling cultures of clinical isolates of respiratory tract infections and mapping out the correlations between patient backgrounds and the causative bacteria and the changes in the sensitivity spectra of the bacteria to various antibacterial and antibiotic agents annually since 1981. The following is a report of the 1986 findings. During the period from September, 1986 to March, 1987, 558 cases of respiratory infections were reported at 17 institutions across the nation and a total of 657 apparent causative strains were isolated from sputum samples. Of these strains, 75 strains of Staphylococcus aureus, 108 of Streptococcus pneumoniae, 150 of Haemophilus influenzae, 107 of Pseudomonas aeruiginosa (non-mucoid production type), 21 of P. aeruginosa (mucoid production type), 32 of Klebsiella pneumoniae, 8 of Escherichia coli, and 55 of Branhamella catarrhalis were subjected to MIC determination of various antibacterial and antibiotic agents to map drug sensitivities. In addition, diagnoses, age distributions by diagnoses, frequencies of infectious diseases, types of isolated bacteria, and usage statuses of the antibacterial and antibiotic agents the times of at isolation were also investigated. MIC determinations were carried out to investigate susceptibilities of causative organisms of respiratory tract infections to various antibacterial and antibiotic agents. From the 558 cases of respiratory tract infections, 657 strains were detected at concentrations not less than 10(4-6)/ml and identified to be the causative organisms. Of these strains, 603 could be used for MIC determination. An overwhelming majority of major causative bacteria, inclusive of H. influenzae and S. pneumoniae, showed sensitivity patterns similar to the sensitivity patterns found a year earlier, P. aeruginosa alone, however, showed some increase in its susceptibility to penicillin and cephem antibiotics. Regarding patient backgrounds, the age distribution was heavily biased towards the higher end of the scale, which patients with ages of 50 or higher accounting for 77.9%, compared to 73.5% in 1985. When the patients were classified by diagnoses, chronic bronchitis, bacterial pneumonia and bronchiectasis accounted for the majority of the infections: 28.7%, 23.3%, and 19.0%, respectively. The percentages of chronic bronchitis and bacterial pneumonia 28.7% and 23.3%, respectively, were somewhat higher in 1986 than in 1985. The disease which was comparatively frequent in all age groups was bronchiectasis, which accounted for 44.0% in patients with ages 29 years or lower, 18.4% in patients between 30 years and 69 years, and 16.7% in patients with ages 70 years or higher. The next most frequent infection was bacterial pneumonia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2695658 TI - [In vitro susceptibility of pathogenic Nocardia to beta-lactam antibiotics, especially imipenem, a carbapenem antibiotic]. AB - In vitro antibacterial activity of 30 beta-lactam antibiotics including 2 beta lactamase inhibitors (clavulanic acid and sulbactam) against 2 major pathogenic Nocardia, i.e. Nocardia asteroides group and Nocardia brasiliensis was studied. Among the antibiotics tested, a newly developed carbapenem antibiotic, imipenem (IPM), was found to be the most active, followed by oxacephem group antibiotic flomoxef (FMOX). IPM exhibited activity against only N. asteroides group (N. asteroides, Nocardia farcinica and Nocardia nova). On the other hand, FMOX showed activity against all pathogenic Nocardia tested. A 2- to 30-fold decreases in minimum inhibitory concentration (MIC) for N. asteroides, N. brasiliensis and N. farcinica was noted when antibiotics and beta-lactamase inhibitors were combined compared to antibiotics alone. Further combination and enzymatic studies indicated that all pathogenic Nocardia possess beta-lactamase except for a half of the strains of N. nova. These species' specific sensitivity patterns of pathogenic Nocardia are discussed in this paper with references to their taxonomic positions. PMID- 2695659 TI - [Molecular pathogenesis of bacillary dysentery caused by Shigella flexneri]. PMID- 2695660 TI - [Improvement of the membrane filter technique for enumeration of enterococci in water]. AB - The membrane filter technique with AC agar medium supplemented with 0.04% NaN3 and 0.00015% 2,3,5-triphenyltetrazolium chloride for enumeration of enterococci in water is described. An appropriate volume of a water sample was filtered through the membrane filter. The membrane filter was put on an AC agar plate (designated as the AC.MF technique), which was incubated at 37 C for 18 hr and further at 45 C for 24 hr. By this AC.MF technique, all the colonies grown on the membrane filters were identified as enterococci, and the count of enterococci obtained by the AC.MF technique was similar to that by the AC.MPN technique. The AC.MF technique may be useful for accurate and rapid enumeration of enterococci in water and serve as a simple method for determining the sanitary quality of water. PMID- 2695661 TI - [Follicular lymphoma in Japan: retrospective study on natural history and therapeutic results in 50 cases collected from 4 institutions]. AB - Clinical data of the 50 patients with nodal follicular lymphoma were collected from 4 institutions in Japan and were analysed retrospectively. A frequency of follicular lymphoma was 9.3% in the 364 patients with nodal lymphoma registered between 1981-1986. Twenty-one patients (42%) were classified as follicular medium sized cell type (F-medium; identical with follicular small cleaved cell type by Working Formulation criteria), 12 (24%) as follicular mixed (F-mixed), and 17 (34%) as follicular large (F-large). There were 31 (62%) patients with Stage III IV disease involving bone marrow in 6 patients, liver in 2, bone marrow and liver in 2, stomach in 1. Overall five- and ten-year survival rates were 65% and 32%, respectively, in the 49 patients whose median follow-up period was 3 years, ranging from 2 to 11 years. Adriamycin-based combination chemotherapy [ADM(+) therapy] produced 10 (100%) complete response (CR) of 10 patients with F-large lymphoma and 8 (80%) of them were free from relapse. But, in the patients with F medium lymphoma, ADM(+) therapy produced one (17%) CR of 6 patients and their survivals were not superior to those treated with ADM(-) therapy, single agents or radiotherapy alone. There was no difference in the natural history or therapeutic results between the patients in Japan and United States, although the frequency of follicular lymphoma was extremely lower in Japan. ADM(+) therapy can be accepted as the first-line chemotherapy for the patients with F-large lymphoma, but the best modality of treatment should be investigated for the patients with F-medium lymphoma. PMID- 2695662 TI - [Portal hypertension in chronic lymphocytic leukemia]. AB - Portal hypertension in chronic lymphocytic leukemia (CLL) is rare. A 64-year-old woman with CLL for 5 years and increasing hepatosplenomegaly developed portal hypertension and bleeding gastric varices. There was no portal vein thrombus by abdominal echography and angiography. Following splenectomy and devascularization of the fornix, the gastric varices disappeared. The liver biopsy showed dense leukemic cell infiltration in portal triads, but no fibrosis. The portal hypertension in this case may be mainly due to increased portal flow from the enlarged spleen and leukemic cell infiltration in the liver. Previously reported cases are summarized. PMID- 2695663 TI - [Peripheral T-cell lymphoma initially presenting as secondary myelofibrosis]. AB - A case of peripheral T-cell lymphoma presenting with secondary myelofibrosis and meningeal involvement is described. A 65-year-old female was admitted because of remarkable weight loss and pancytopenia. On admission, she was confused and showed tiny cervical lymph nodes but no hepatosplenomegaly. Bone marrow aspiration resulted in dry tap and its biopsy showed remarkable myelofibrosis with marked decrease of hematopoiesis and increase of lymphoid cells. Lymph node biopsy revealed diffuse medium sized cell lymphoma, which was diagnosed as CD3+4+8-peripheral T-cell lymphoma with immunohistochemistry (anti-HTLV-1 antibody negative). The lymphoid cells of bone marrow expressed the markers of T cell lineage (LCA+ UCHL1+ MT1+ L26- MB1-). The cerebrospinal fluid examination revealed many lymphoma cells. She was treated with CHOP regimen and intrathecal injection of MTX. After three months, bone marrow biopsy showed recovery of hematopoiesis and disappearance of lymphoma cells and reticulin fibers. Immunohistochemical analysis of bone marrow specimen was useful for the diagnosis of atypical myelofibrosis. PMID- 2695664 TI - [Late appearance of Philadelphia chromosome with bcr gene rearrangement in an acute myelocytic leukemia patient]. AB - A case of acute myelocytic leukemia (AML-M2) with a late appearance of Philadelphia chromosome (Ph1) is presented. Chromosome analysis revealed a normal karyotype at the time of diagnosis and for 23 months, when hematological relapse occurred, accompanied by abnormal clones, 46, XX, t(9;22) (q34;q11) (78%) and 45,XX, -16, t(9;22) (q34;q11), del (5) (q13q31) (22%). The patient died of GVHD after bone marrow transplantation. Molecular analysis confirmed bcr gene rearrangement in the cells with Ph1 chromosome. Acquisition of Ph1 chromosome during the course of hematological malignancies other than CML is extremely rare. This case is undoubtedly important for the understanding of leukemogenesis and the evolution of leukemia clones. The authors discussed possible mechanisms of Ph1 acquisition in the late stages of AML. PMID- 2695665 TI - [Clinical significance of growth hormone analysis in pituitary function tests]. PMID- 2695666 TI - [Clinical significance of serum thyroglobulin analysis in endocrine tests of the thyroid-parathyroid system]. PMID- 2695667 TI - [Clinical significance of human placental lactogen analysis in endocrine tests of the gonadal and placental system]. PMID- 2695669 TI - [Measurement and pathophysiology of Tamm-Horsfall glycoprotein (THP)]. PMID- 2695668 TI - [Clinical significance of plasma progesterone analysis in endocrine tests of the gonadal and placental system]. PMID- 2695670 TI - [Clinical significance of myoglobin analysis in biochemical laboratory tests]. PMID- 2695671 TI - [Clinical significance of beta 2-microglobulin analysis in biochemical laboratory tests]. PMID- 2695672 TI - [Clinical significance of human neutrophil elastase alpha 1-proteinase inhibitor complex]. PMID- 2695673 TI - [Significance of pancreatic lipase analysis in clinical tests]. PMID- 2695674 TI - [Significance of vitamin B12 analysis in clinical tests]. PMID- 2695675 TI - [Clinical significance of D Dimer analysis in blood coagulation and fibrinolysis tests]. PMID- 2695676 TI - [Clinical significance of arginase analysis in blood cell chemical tests]. PMID- 2695677 TI - [Clinical significance of granulocyte elastase analysis in blood cell chemical tests]. PMID- 2695678 TI - [A case of huge duodenal leiomyosarcoma]. AB - A case of duodenal leiomyosarcoma with large central necrosis was reported. Tumor was 15 X 10 X 10 cm in size. Ultrasonography showed a cystic tumor with thick wall in the right upper abdomen. CT scan revealed a gas formation in the central cystic cavity of the tumor. The gas formation was probably caused by bacterial infection. The diagnosis was confirmed histologically. PMID- 2695679 TI - [The roles of proteinase production and germ tube formation in the invasion of Candida albicans into newborn mouse skin]. AB - The pathogenic factors of Candida albicans involved in invasion of the skin were studied. Strains of C. albicans differing in their abilities to secrete proteinase in vitro and to produce germ tube were inoculated onto the skin surface of newborn mice, and the invasion of the yeast cells into the horny layer was examined by histological techniques. The strains capable of producing germ tubes could penetrate into the skin, but those incapable of germ tube formation could not. The penetration of the yeast cells into the skin was independent of the ability to secrete proteinase, but, once penetrated, Candida cells from the proteinase-producing strains proliferated more profusely than those of proteinase deficient ones. The results suggested that the invasion of C. albicans into the skin consisted of two processes; penetration and proliferation of the yeast cells in the tissue. The former might depend on the ability of germ tube formation and the latter on the secretion of proteinase. PMID- 2695680 TI - Expression of Forssman glycolipid and blood group-related antigens A, Le(x), and Le(y) in human gastric cancer and in fetal tissues. AB - The expression of Forssman glycolipid antigen in human gastric cancers was investigated by thin-layer chromatogram immunostaining of glycolipid fractions. Incompatible blood group A antigen, Le(x) and Le(y) antigen were also studied in comparison with Forssman antigen. Forssman glycolipid as the pentaglycosylceramide was demonstrated in nine out of 12 gastric cancers, and in three out of 10 adjacent uninvolved tissues. In most cases the content of Forssman glycolipid was increased in the cancers compared with that in the uninvolved counterparts. Forssman pentaglycosylceramide was also detected in some normal gastric mucosae (two out of four), and in a fetal gastrointestinal tract tissue. In immunohistochemical examination of gastric cancer tissues, sialidase treatment revealed a positive staining with anti-Forssman antibody. Some cancer tissues from patients with blood group O were found to contain blood group A active glycolipids, which could be distinguished from Forssman glycolipid by thin layer chromatogram immunostaining. The incidence of incompatible A-active glycolipids was two out of 10 cancers from patients with blood group O or B. Le(x)- and Le(y)-active glycolipids were detected in most of the preparations and were not accumulated consistently in the cancers. PMID- 2695681 TI - [Image diagnosis of renal disease]. PMID- 2695682 TI - [Effect of captopril on various components of the kinin system and plasma renin activity in patients with idiopathic arterial hypertension]. AB - Authors studied effect of captopril on serum kininogen and prekallikrein concentrations, as well as on plasma renin activity (PRA) in patients with primary hypertension. The control group consisted of 18 healthy persons, 5 patients were in I, 12 in II and 8 in III WHO class. Monotherapy with 150 mg per day of captopril had been performed for 3 weeks. Patients were 3 times examined: 1--before therapy, 2--after 24 hours of treatment, 3--after 3 weeks of captopril therapy. It was proved, that captopril lowers arterial pressure with coexisting PRA increase and induces changes in kinins system such as: decrease of kininogen+ concentration and increase of serum prekallikrein level in comparison with their pretreatment values. Maximum PRA increase and blood pressure decrease were observed after 24 hours of captopril administration, whereas changes in kinins system were taking place during the whole observation period. Presented studies indicate that antihypertensive action of captopril is related to Renin Angiotensin-Aldosterone System as well as to plasma kinins one. PMID- 2695683 TI - [Diagnostic value of the captopril test in patients with arterial hypertension]. AB - In 30 patients with renovascular hypertension, 50 with hypertension in a course of arteries, 71 hypertensive subjects with coexisting parenchymal nephropathy and in 63 with primary hypertension the captopril test was performed after 8 hours night rest and within high sodium diet. Positive test result was stated in 76.67% of patients with renovascular hypertension, in 70.59% of patients with arteritis, in 53.52% of patients with hypertension and coexisting parenchymal nephropathy and in 63.49% of patients with primary hypertension. Significant correlation between increase of plasma renin activity and blood pressure decrease after captopril administration was only stated in patients with renovascular hypertension and in those with arteritis. Results of performed studies impaired the captopril test value in diagnostics of renin-dependent hypertension. PMID- 2695684 TI - [Effect of captopril on superoxide dismutase (SOD-1) activity and malondialdehyde (MDA) level in blood platelets in patients with arterial hypertension]. AB - 18 patients aged 40-50 with diagnosed hypertension (II class by WHO) underwent the study. SOD-1 activity, platelets MDA concentration and degree of platelets aggregation were estimated before and after 1.5 and 24 hours of administration of 12.5 mg captopril single dose. Values of evaluated parameters significantly changed after 1.5 hours of captopril administration: SOD-1 activity increased whereas MDA concentration and platelets aggregation decreased; after 24 hours of drug administration values returned to initial ones. It suggests inhibitory effect of captopril on lipids peroxidation and platelets reactivity. PMID- 2695685 TI - [Effect of a single dose of captopril on left-ventricular function in patients with chronic congestive cardiomyopathy]. AB - In 15 patients with mild, chronic congestive heart failure the effect of a single dose of captopril (25 mg/m2 b.s.) on heart rate, systolic and diastolic blood pressure as well as on left ventricular function was studied at rest and after a submaximal physical effort. Preejection period (PEP), left ventricular ejection time (LVET) and the contractility index PEP/LVET were polycardiographically determined++. Left ventricular end diastolic volume (DVol), and systolic volume (SVol), ejection fraction (EF), stroke volume index (SVI) and cardiac index (CI) were estimated using two-dimensional echocardiography. Obtained data indicate, that in patients with chronic, congestive heart failure, a single dose of captopril lowers blood pressure at rest without significant changes of hemodynamic parameters, but improves left ventricular function during physical effort. PMID- 2695686 TI - [Captopril-induced attacks of bronchial asthma]. AB - There was presented the case of a bronchial asthma attack in 29 years old patient with congestive heart failure and a history of atopic bronchial asthma in 30th minute after 12.5 mg of captopril administration. PMID- 2695687 TI - [Neurohumoral compensatory mechanisms and their role in the pathophysiology of chronic congestive heart failure]. PMID- 2695688 TI - [Shibasaburo Kitasato and Sahachiro Hata]. PMID- 2695689 TI - [Flattening of the anterior chamber and myopic results in sulcus fixation of posterior chamber lenses]. AB - Ultrasonographic biometry was performed in 56 patients immediately after implantation of a posterior chamber intraocular lens to measure the position of the lens. A modified applanation method was used to avoid injury to the scleral suture. Ten months later, 44 of these patients were examined by the same method. The anterior chamber depth was found to have decreased from 4.26 mm (s = 0.39 mm) in the immediate postoperative period to 4.2 mm ten months later. However, axial length, at 23.28 mm postoperatively and 23.34 mm at follow-up, and mean corneal refraction (43.28 D and 43.34 D, respectively) were practically unchanged. There was a shift in the spheric equivalent of refraction from postoperative emmetropia (mean -0.07 D) to slight myopia (mean -0.76 D) at follow-up. This mean myopization of 0.69 D corresponded to the tendency toward a shallower anterior chamber. Shrinkage and fibrosis of the posterior capsule, reduced elasticity of the polypropylene loops, flattening of the cornea and axial changes are discussed as possible causes. The tendency toward myopization should be taken into account when calculating the power of sulcus-fixated posterior chamber lenses. PMID- 2695690 TI - [Final clarification of Goethe's findings in the examination of color blind patients]. AB - During his researches on colour-vision Goethe has examined two colour blind students. The reports and the colour tests made by Goethe himself are mostly preserved. Due to the colour confusions in the whole purple zone Goethe decided that the subjects were blue blind. During the 19th century-- however--the supposition arose that it must have been a red-green-blindness. It was Trendelenburg, who supposed a deuteranopia. On the other hand reconstructions of Goethe's examinations had the result that it was in all probability a protanopia. A final solution of this discussion is now possible after a great-grandson of Goethe's subject Gildemeister was found out and examined at Nagel's anomaloscope. He is a typical protanope. According to the pedigree demonstrating the typical x linked hereditary transmission, we can be sure that Goethe's subjects were protanopes. PMID- 2695691 TI - Febrile illness in an Afghani "freedom fighter". PMID- 2695692 TI - Asymmetry of Doppler spectrum in stenosis differentiation. AB - The asymmetry of the spectral distribution of ultrasonic Doppler flow velocity signals, assessed using the coefficient of skewness, is discussed as a criterion of stenosis differentiation. Its performance is compared with that of the index of turbulence intensity for both in vitro and in vivo flow Doppler signals, recorded distal to a stenosis. The power spectral distributions are computed using the direct Fourier transform and maximum likelihood method. The asymmetry of spectral distribution has proved to be a more efficient criterion than the turbulence intensity. The maximum likelihood method ensures better stenosis differentiation than the direct FFT method. PMID- 2695693 TI - Selection of a spectral analysis method for the assessment of velocity distribution based on the spectral distribution of ultrasonic Doppler signals. AB - The direct Fourier transform method, autoregressive modelling, the maximum likelihood method and the Wigner-Ville distribution were applied to the Doppler signal obtained from a fully insonated laminar model flow. The appreciation of the spectral method was based on the properties of the ratio variance/(fmean)2 (INT) of the spectrum. The basic criterion was the sensitivity of INT to the analysis parameters, especially the data window. The results of spectral analysis, as well as the properties of INT, were strongly affected by the method applied. The maximum likelihood method appeared best suited for the purpose of assessment of velocity distribution and is expected to give the best results in the case of in vivo blood flow. The performances of other discussed methods were inferior, due to their stronger incompatibility with the signal properties. PMID- 2695694 TI - Effect on EEG responses of removing ocular artefacts by proportional EOG subtraction. AB - Work undertaken to investigate the effect on EEG responses of ocular artefact removal by proportional electro-oculogram subtraction using the least-squares method is reported. The ocular artefact model and the least-squares approach to estimation of the model parameters and hence of the EEG waveform, including the response, are described. Results are presented to show that the response shapes become modified if ocular artefact removal is implemented recursively. This happens because the response is incorrectly treated as part of the random background EEG. The solution is to incorporate a model of the response within the ocular artefact removal algorithm. The results of tests on simulated data confirm these conclusions. The results of the incorporation of response models in removing ocular artefacts from CNV recordings are presented. Even with modelling recursive ocular artefact removal is found to modify the shape of the CNV, and so reliable results can only be obtained if the removal is implemented nonrecursively. Evidence is given that it is advisable to remove DC levels from the recorded data. PMID- 2695695 TI - [Probucol, HDL and inverse transport of cholesterol]. PMID- 2695696 TI - [Acute T-cell lymphoproliferative syndromes. A study of 29 cases]. AB - The clinical and hematological profile, the response to therapy and the clinical evolution of 29 patients with acute T lymphoproliferative syndromes (ATLS) diagnosed during the last 5 years were evaluated. Mean age was 22.6 (SD 9.5) years. 24 patients were males and 5 females. Lymphadenopathy was present in 25 patients, hepatomegaly in 16 and splenomegaly in 14. Seventeen patients had a mediastinal mass. Anemia was present in 41% of patients and thrombocytopenia in 50%. The mean leukocyte count was 71 x 10(9)/l (SD 93). Bone marrow infiltration was found in 25 patients. The acid phosphatase reaction was positive, centrosomal type, in all cases except two. The immunophenotypic study classified the ATLS patients in the subtypes pre-T (10 cases), cortical thymic (15 cases), and mature thymic (4 patients). The cases with pre-T phenotype had a greater degree of bone marrow infiltration and lower frequency of mediastinal mass than the rest of patients. The rate of complete remissions (CR) was 83%. At the time of closing the study 12 patients had relapsed, with a median time of CR of 9.4 months. In addition, 11 patients had died, with a median survival of the series of 19 months. The results of the present study indicate that, despite some heterogeneity, those cases of ATLS with a more immature immunological phenotype (pre-T) have clinical and biological features more akin to acute leukemia, unlike those with a thymic phenotype (cortical or mature), which would be closer to lymphoblastic lymphoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695697 TI - [Homosexuality and viral infection]. PMID- 2695698 TI - [Recent findings in pleural pathology]. PMID- 2695699 TI - [Evaluation of the treatment of Cushing's syndrome using ketoconazole]. AB - The effectiveness of ketoconazole for the therapy of Cushing's syndrome, both of adrenal and pituitary origin, was retrospectively evaluated. To this end, the clinical and hormonal results in 5 patients were assessed. There were 4 females and one male, with ages ranging between 17 and 64 years. Three of them, who had Cushing's disease, received sustained treatment with ketoconazole when other therapeutic measures had failed. The two remaining patients (one with Cushing's disease and the other with adrenal adenoma) were treated with this drug in the preoperative period to alleviate the deterioration in the clinical condition caused by hypercortisolism. The clinical evolution of the patients is described, as well as the plasma adrenocorticotropin (ACTH) and the free cortisol in 24 hour urine in the subsequent controls. In view of the study results, we feel that ketoconazole is an effective treatment for the long term control of Cushing's syndrome. In addition, it may be also useful as preoperative therapy in those patients severely deteriorated by the sustained hypercortisolism. PMID- 2695700 TI - [Legionellosis]. PMID- 2695701 TI - [Cocaine and pregnancy: effects on the pregnant woman, the fetus and the newborn infant]. PMID- 2695702 TI - [Diabetes mellitus, a pending subject for endocrinologists]. PMID- 2695703 TI - [Primary antiphospholipid syndrome]. PMID- 2695704 TI - [Verapamil: a 1st choice antihypertensive agent]. PMID- 2695705 TI - [Effectiveness of continuous positive airway pressure in the long-term treatment of the obstructive sleep apnea syndrome]. AB - Eight patients with obstructive sleep apnea syndrome were treated with continuous positive airways pressure by nasal route. The treatment was carried out in the hospital during the initial days. If the procedure was effective and the tolerance was good, the patients were discharged to continue with treatment at home. Polygraphic sleep recordings carried out 2-4 months after the beginning of therapy showed normalization of the structure and the phases of sleep, apnea and desaturation being virtually absent. After a mean follow up of 18 months the patients are asymptomatic. The treatment has been well tolerated and significant side effects have not developed. PMID- 2695706 TI - [Infective endocarditis caused by coagulase-negative staphylococci]. PMID- 2695707 TI - [Guidelines for the prevention of nosocomial pneumonia]. PMID- 2695708 TI - [Metabolism of lipoproteins in diabetes mellitus]. PMID- 2695709 TI - [The HLA system and predisposition to diseases]. PMID- 2695710 TI - [Agreement on the control of blood cholesterol in Spain]. PMID- 2695711 TI - [Comparison of the trends in mortality from ischemic heart disease and other cardiovascular diseases between Spain and other developed countries, 1970-1980]. PMID- 2695712 TI - [Primary hepatic lymphoma in acquired immunodeficiency syndrome]. PMID- 2695713 TI - The representation of uncertainty in medical expert systems. AB - The development of the rule-based expert system has provided important new techniques for the representation of knowledge. However, continued use of this representational scheme has highlighted some of its deficiencies. In particular, many within scientific and non-scientific fields attempting to use the rule-base design to describe natural phenomena often find it difficult to represent the complexities of the world as 'absolute' rules. For this reason, many investigators acknowledge the need to add an uncertainty mechanism to the rule base construct. Such a facility would allow the quantification of accuracy or strength of association within individual rules Although agreement exists on the need for an uncertainty representation facility, the debate concerning the most appropriate methodology is far from resolved. The purpose of this paper is to provide a review and commentary on the current state of debate over the five most popular candidate uncertainty models: symbolic representation, MYCIN certainty factors, Bayesian, Dempster-Shafer and fuzzy set logic. The advantages and disadvantages of each uncertainty calculi will be presented and assessed with respect to their applicability to the medical expert systems domain. PMID- 2695714 TI - [Woolly hair nevus associated with systemic epidermal nevus]. AB - A 22-year-old female with two woolly hair nevus of the scalp and a systematized epidermal nevus is reported. This association has been rarely described. Scanning electron microscopy of the woolly hair demonstrates oval and triangular hair shaft sections and longitudinal grooves. The structure of the cuticle was not disturbed. PMID- 2695715 TI - [Prospective study of pityriasis versicolor incidence in a population of the city of Santo Andre (state of Sao Paulo)]. AB - The authors studied prospectively the incidence of pityriasis versicolor (PV) in the population of Santo Andre, Sao Paulo State, Brazil, researching Malassezia furfur on the skin of suspected cases. They consider M. furfur as the only etiologic agent for PV diagnosed by the "cellophane tape" method (Porto, 1953). The work registered 132 positive cases (3.1%) in 4,267 examined people. The study revealed a bigger incidence in males (4.34%, among the negroes (4,475) and in the group between 10 and 15 (4,205). As M. furfur is an opportunistic agent, the authors emphasized that it is of great interest not only for cutaneous pathology, but also for the study of systemic infections, mainly in children with low immunity. PMID- 2695716 TI - [Spitz's nevus: clinicopathologic study of 25 cases]. AB - We reviewed the clinical and histopathologic findings in 25 Spitz's nevus who were evaluated at our institution from 1980-1988. 18 cases in patients aged 20 years or less and 7 cases in adults. 14 are female and 11 are male. Represent the 3.88% of melanocytic nevi etude in the same time. Eosinophilic globules were find in 64% of the cases. We include a pigmented spindle cell nevi (non-Spitz), we thinks is a variant of Spitz's nevus. PMID- 2695717 TI - [Purpura fulminans. Presentation of a clinical case]. AB - Purpura fulminans is a catastrophic febrile illness, characterized by confluent ecchymosis skin lesions, low blood pressure an disseminated intravascular coagulation. The case of 32 year old female ratify that it is not only a pediatric condition. We emphasize the importance of an early diagnosis and the adequacy of the treatment. The possible etiology is discussed. PMID- 2695718 TI - [Ulcerative plantar lichen. Is it an indicator of an autoimmune disease?]. AB - A 48 years old female has had erosive and ulcerative lichen planus with sores in both heals, onychodystrophy and typical lesions in oral mucous membranes. Laboratory examination revealed specific abnormalities indicative of autoimmune thyroiditis and primary biliary cirrhosis. This clinical variant of lichen planus was associated with immunological disturbances. Autoimmune diseases must be investigated in patients with erosive and ulcerative lichen planus. PMID- 2695719 TI - [Intravascular coagulation associated with aortic aneurysm]. AB - A consumption coagulopathy is presented, featuring a chronic and localized intravascular coagulation syndrome, with cutaneous manifestations exclusively, associated to an aortic aneurysm. The infrequency of this association is remarkable, being assumed as capital factors from the physiopathogenic side the parietal alteration and the blood stasis. They both determine the consumption of platelets adding further thromboplastic material that maintains the process. PMID- 2695720 TI - [Familial sarcoidosis]. PMID- 2695721 TI - [Hyperkeratosis lenticularis perstans (Flegel)]. AB - The case of a female patient, 67 years old, with hyperkeratotic papules in the lower extremities which are characteristic of hyperkeratosis lenticularis perstans is reported. The clinical, histological and ultrastructural findings are shown. We have recorded the absence of Odland bodies in the area of the lesion, the persistence of desmosomes in the stratum corneum and lymphocytes with cerebriform nuclei within the inflammatory cell infiltrate. She was satisfactorily treated with etretinate and topical 5-fluorouracil We have reviewed the existing literature on this subject. PMID- 2695722 TI - [Oral hairy leukoplakia. A study of 5 cases]. AB - Oral hairy leukoplakia (HL) is a newly described lesion (1984) in human immunodeficiency virus infected patients. Patients with HL show a high probability of developing an acquired immunodeficiency syndrome (AIDS). The results of histopathological, microbiological, immunological and ultrastructural studies in five patients with HL and AIDS are reported. The histopathological exam revealed in all cases acanthosis, parakeratosis, koilocytosis and keratin projections on the surface. Dermis was normal. Herpes type virus were seen in four cases and in one of them papilloma virus was also present in electron microscopic examination. There was immunocytochemical evidence of papilloma virus in one lesion. Candida albicans was found in 5 lesions by culture but only in two ones by periodic acid Schiff stain. Virus cultures for herpes virus were negative. Immunocytochemical search of Langerhans cells (S-100, HLA-DR, OKT4, OKT6) showed nearly absence of these cells in HL lesions. These results favour the viral etiology hypothesis of hairy leukoplakia. PMID- 2695723 TI - [Kinetics of eicosanoid formation in human epidermal cells in suspension]. AB - Increased levels of eicosanoids in lesions of psoriasis suggest activation of arachidonic acid metabolism in different cell types play a physiopathologic role. The contribution of each cell type present in psoriasis has been the subject of some controversy, which has led us to study the metabolism of arachidonic acid in human epidermal cells suspensions. 12-HETE was found to be the main product, followed by PGE2 and PGF2 alpha; no 5-lypoxygenase products were found. Thus epidermal cell contribution to LTB4 levels present in plaques of psoriasis appears to be irrelevant. Conversely, increased levels of 12-HETE probably do result from arachidonic acid metabolism by epidermal cells. PMID- 2695724 TI - Lack of cross-resistance between efrotomycin and antibacterial agents used in the therapy of human and animal infections. AB - Efrotomycin is an N-methylhydroxypyridone glycoside antibiotic with activity primarily against Gram-positive bacteria. It is intended for use as a feed additive for swine. Although efrotomycin is unrelated to any antibacterial drug used in human or veterinary medicine, the possibility of cross-resistance with other antibacterials is of concern. The minimum inhibitory concentrations (MICs) of efrotomycin were determined for a broad panel of bacterial isolates. In addition, the susceptibility of each isolate to 12-15 antibacterials was determined using a standardized disk susceptibility test. No evidence of cross resistance between efrotomycin and any of the 12-15 antibacterial compounds was observed. When the MIC of efrotomycin for nine selected isolates was increased from 16- to greater than 100-fold by serial passage in subinhibitory concentrations of efrotomycin, no increased resistance to the 15 antibacterials was noted. Subinhibitory concentrations of efrotomycin had no effect on the conjugative transfer of antibacterial-resistance plasmids between K-12 strains of Escherichia coli. The data from this study suggest that if resistance to efrotomycin should occur, it is unlikely to result in the appearance of multiply resistant bacterial populations. PMID- 2695725 TI - Changes in plasma active renin and prorenin after endoscopic retrograde pancreatography. AB - Plasma active renin, total renin (active renin plus prorenin) and immunoreactive trypsin were measured simultaneously before and after endoscopic retrograde pancreatography (ERP) in 9 subjects suspected of having pancreatic or biliary disease. After ERP, their plasma immunoreactive trypsin level increased significantly (p less than 0.02) from 12.4 +/- 1.5 to 163 +/- 57 ng/ml (means +/- SEM), while their plasma renin activity, total renin activity and ratio of active renin to total renin did not change. Individual values for the ratio of active renin to total renin correlated significantly (p less than 0.01) with those for immunoreactive trypsin in the basal condition (before ERP), but not after ERP. These results suggest that plasma trypsin is involved in activation of prorenin to active renin in the basal condition, and that ERP-induced increase in plasma trypsin has no effect on activation of prorenin. PMID- 2695726 TI - A comparative study of cefotaxime sodium versus a combination of cefapirin and gentamicin in the prophylactic treatment of patients undergoing cholecystectomy. AB - This was a randomized open evaluation of claforan vs. combination treatment of cefapirin + gentamicin. Patients taking part in the study were randomized in 3 parallel groups: 3 x 1 g claforan given during a period of 24 h (regimen I) was compared to 1 x 1 g claforan given at the time of incision (regimen II) and to a combination of cefapirin + gentamicin given in divided doses for 5 days (regimen III). Sixty-five patients (31 males and 34 females) aged between 23 and 76 years, who underwent cholecystectomy, were included in the study. There were no significant differences between the study groups in terms of sex, age, height, weight, diagnosis, aggravating factors and clinical condition of patients. Sixty of sixty-five patients noted "cholelithiasis" as diagnosis. The majority of patients documented an acute exacerbation of chronic condition. Twenty-three patients documented concomitant diseases/conditions or aggravating factors. The most frequent were: Diabetes mellitus, jaundice and clonorchiasis. During the study no additional administration of antibiotics or other concurrent treatment was recorded. Tolerance of the test substances was noted as "good" by 63 patients and satisfactory in 2 patients. In 3 patients (one patient in each treatment group) a postoperative wound infection was documented. One patient from regimen II with wound infection, therefore, received more than 1 g claforan. Postoperative hemoglobin decreased in all 3 groups (p less than 0.05). BUN decreased in the regimen group I (p less than 0.05) and increased together with creatinine in the group of regimen III (p less than 0.05). No side effects were documented in any treatment groups. The use of a single or three doses of claforan was more convenient and simple than the combination regimen. Less laboratory adverse effects (renal function) were also noted in claforan treated patients than the combination of cefapirin + gentamicin group. PMID- 2695727 TI - [Assessment of the degree of severity in acute pneumonia and diagnostic accuracy]. AB - Efficiency analysis of application of the machine independent programme for identification of critical degree of acute pneumonia on 41 patients is presented. The following benefits as perception visibility of the monitoring results, decrease of the "error omission", possibilities to prognosis the course of the disease were exposed. PMID- 2695728 TI - [Construction of left ventricle-aorta conduits (review of the literature)]. AB - The development prospectives of the design problem for extracardial conduits, which lies in creation of different sizes series of conduits design for left and right part of the heart relating to the age of the patient, type of obstruction lesion and anatomic peculiarities of its heart is discussed. PMID- 2695729 TI - [The catatonic dilemma]. AB - In discussing some clinical cases the paper suggests an interpretation of catatonic syndrome based on the original and main characteristics of this psychopathological condition. Kahlbaum described this disease underlining the "affective" symptoms, but since then, catatonia has been considered a schizophrenic syndrome. The paper proposes a definition of catatonia based on Kahlbaum's earlier view in which the complex of psychomotor disturbances can be seen as the expression of schizophrenia, bipolar psychoses or of a specific cyclic disease. PMID- 2695730 TI - [Evolution of man's concept of death over time. II]. AB - Durkheim's sociocultural theories about suicide form the basis for an analysis of current sociocultural conditions as possible causal elements for the alleged recent increase in adolescent suicides. PMID- 2695731 TI - [Social adaptation of patients with recurrent depressive episodes]. AB - A catamnestic study has been carried out in 45 patients with "major affective disturbance" precedents so as to ascertain the possible presence of a "residual syndrome" or a personality "at risk" for depressive disease emerging during so called interval periods. Special attention is paid to examination of social adaptation in these periods. The instruments employed for the investigation, apart from the clinical conversation and documentation relating to prior admissions were: APDI (record of personal data in the case of adults), the Hamilton Scale, the B.P.R.S. (Brief Psychiatric Rating Scale), the S.A.S. (Scale of Social Adaptation) and Rorschach's Psychodiagnosis. The results obtained evidence a series of more or less marked, but always present psychic disturbances characterising the interval period, with problems of adaptation both to working activity and to social relations, especially in the extra-familial environment. These disturbances are attributable in part to a personality at risk and in part to an authentic residual syndrome. PMID- 2695732 TI - [Socio-familial reinsertion of the mental patient. Psychological aspects of related difficulties]. AB - The problems of the reinsertion of the mentally sick into his family and into his social group are examined. As already seen in a previous paper on "involvement of the family in the rehabilitation of the mentally sick", the phenomenon of the "expressed emotion" is examined and the stereotype-like definition of the person who is "different" as a synonym of danger and risk analysed. In conclusion, it is pointed out that the fear of his dangerousness makes the procedure for rehabilitation the psychiatric patient in his social and family group a complex one. PMID- 2695733 TI - [Psychotherapy and public institutions. The first year's experience of the "three year training course in psychotherapy" of the Valenza Po National Health Unit]. AB - The article begins by examining the position of psychotherapy in Italy's current cultural climate. This is followed by a brief review of an experiment in the training of National Health Service psychiatrists at National Health Unit 71 in Valenza Po (Piedmont). The experiment was designed and conducted as the first year of a "3-year Course in Psychotherapy" intended to offer training in the practice of psychotherapy within the National Health Service. It was therefore necessary to teach the correct approach both to relations with the patient and to the complex network of relations arising in team work in such cases. PMID- 2695734 TI - [Dapsone inhibition of the bactericidal action of rifampicin on Mycobacterium leprae in mice]. AB - In the experimental infection of mice by Mycobacterium leprae, the bactericidal effect of 4 weekly doses of rifampicin (RMP) is completely suppressed if this administration is preceded by a daily treatment of dapsone (DDS) during one month then continued in conjunction with rifampicin. The application of this methodology: the delayed adding of rifampicin clearly shows the bacillary persistence induced by dapsone (DDS). The rifampicin appears to be less effective on Mycobacterium leprae when its metabolism is inhibited either by the action of a drug such as dapsone (DDS), or spontaneously. The highlighting of this late appearing antagonism between rifampicin and dapsone in mice, should not at present lead to the questioning of the therapeutic procedures recommended by the WHO, because of the limits of this experimental model, namely the small size of bacillary populations studied over relatively short periods of time. PMID- 2695735 TI - [History of human African trypanosomiasis in Moyen-Chari (Chad)]. AB - The authors give on historical record of the focus of the sleeping disease in Moyen-Chari (South of Chad) from 1914 to 1989. Over such a period, they describe the fighting means used to control this endemic disease. PMID- 2695736 TI - [Malaria morbidity in the urban environment. Study of 353 fever attacks]. AB - The authors make a study of malaria morbidity in Dakar during October and November 1988 in Dakar where malaria is endemic but with a pick in pathophoresis during the rainy season. Out of 353 surveyed cases of malaria, 110 were carriers of Plasmodium falciparum, i.e., 31%. Mean parasitic density was 7462 red cells/mm3 and more than an half of patients got an higher density. Parasitic density was higher in children (0-14 years old) than in adults, but with no significant indication. Malaria fever represents 20.4% of all types of fever observed and was the first cause to consult during the rainy season. Whatever threshold of parasitic density selected parasitologic criterion may be in order to identify a malaria fever, percentage of diagnosis misinterpretation linked up to clinical examination was always higher than 30%. PMID- 2695737 TI - [The value of malaria antibody level determination in non-immune subjects in a holoendemic area]. AB - The use of indirect immunofluorescence in non-immune people under heavy risk of chloroquine resistant Plasmodium falciparum malaria has a fair interest for diagnosis because of atypical clinic features and poor parasite density in thin smears. Indirect immunofluorescence has been used in Cotonou where chloroquine resistant strains of Plasmodium falciparum was described since 1986. This lead to detect numerous cases of malaria with negative thin smear. Under epidemiological considerations, non-autochthonous people's antibody acquiring curve related to residence time in endemic area is parallel to the autochthonous children's antibody acquiring curve. However, average of antibody titer is strongly lesser in non-autochthonous population even after living more than 12 years in holoendemic area. This can reveal a lesser capacity to acquire immunity in non autochthonous people due to a lesser exposure or to prophylaxis. This has to be pointed out when prophylactic strategies are proposed to those who live endemic areas. Authors propose to look back upon past obsolete prophylactic methods as repellents, insecticides, mosquito nets, air conditioned, etc. PMID- 2695738 TI - Recently described innate broad spectrum virus inhibitors. PMID- 2695739 TI - Virulence of Mycobacterium avium complex strains from acquired immune deficiency syndrome patients: relationship with characteristics of the parasite and host. AB - The virulence of 24 strains of Mycobacterium avium complex (MAC) isolated from patients with acquired immune deficiency syndrome (AIDS) was assessed using the beige mouse model. Most changes in colony forming unit (cfu) counts in spleen and lungs, and spleen weights occurred between days 1 and 14, with comparatively smaller changes 14-28 days postinfection. The virulence was assessed by a score formulated from the four most useful parameters: mortality, spleen cfu, lung cfu and spleen weights at 28 days. The scores of the 24 strains showed a normal distribution; four strains falling above one standard deviation from the mean were classified as high virulent, those four falling below one standard deviation as low virulent, and the remaining 16 as of intermediate virulence. Virulence was associated with the total number of plasmids and the occurrence of large plasmids (greater than 100 MDa) in the MAC strains. There was an inverse correlation between virulence and the organism's capacity to trigger the release of oxygen metabolites from peritoneal macrophages. Macrophages from mice infected with the MAC strains of different degrees of virulence released superoxide anion (O2-) with a peak at two weeks, the peak levels bearing an inverse correlation to virulence. No association was seen between virulence and source of specimens, biochemical characteristics, drug susceptibility, serotypes or phage types. PMID- 2695740 TI - Evidence for clathrin mobilization during directed phagocytosis of Shigella flexneri by HEp2 cells. AB - The enteroinvasive species Shigella flexneri expresses a plasmid-mediated capacity to penetrate epithelial cells by directed phagocytosis involving actin polymerization. In the present work, HEp2 cells were depleted of intracellular K+ in order to arrest receptor-mediated endocytosis and to evaluate the role of this endocytic pathway in the internalization of invasive microorganisms. Such a treatment, which efficiently inhibited diphtheria toxin endocytosis and dissociated clathrin coats of the cells, also totally prevented HEp2 cells internalizing Shigella. K2-depletion only weakly decreased actin polymerization induced by invasive Shigella, and rather increased the duration of this response. Double fluorescence staining of clathrin and filamentous actin in infected HEp2 cells showed accumulations of clathrin labelling underneath the region involved in actin polymerization. Such accumulations of clathrin-labelling could not be detected in K(+)-depleted cells. These results suggest a participation of clathrin in the internalization of S. flexneri into epithelial cells. PMID- 2695741 TI - Mechanism of chromosomal integration of microinjected DNA. AB - Most transgenic animals have been produced by directly injecting DNA into one of the embryo pronuclei in the period immediately following fertilization. Transgenic animals are produced when DNA becomes integrated into the chromosomes, in most cases the transgenic genotype is transmitted to progeny through the germ line. The characteristics of the foreign DNA include tandem arrangement of multiple copies of the input DNA, predominantly in direct rather than inverted orientation, and illegitimate recombination with the chromosome at the site of integration. Foreign DNA integrated into chromosomes of cultured cells has identical characteristics. We argue that these and other similarities between the integration of foreign DNA into the chromosomes of microinjected embryos on the one hand and on the other of transfected and microinjected cells, strongly suggest that the processes have the same basis. By considering mainly the literature relating to cell transfection and microinjection, we conclude that tandemly arranged concatemers of input foreign DNA are built up by a process of homologous but non-conservative recombination. End-joining and illegitimate recombination events characterize the integration of the concatemers into the chromosome, and also contribute to the formation of the concatemers. We also suggest that these superficially different processes are based on the same opportunistic repair-ligation mechanism; the frequencies of the different types of event reflect both the frequencies with which different sorts of association occur between DNA molecules and their relative stability. PMID- 2695742 TI - Transgenic approach for the study of pathogenesis induced by human viruses. AB - An understanding of the pathogenesis of human viral diseases has been hampered by the lack of suitable animal models. However, with the advent in the last decade of transgenic technology, it is now possible to introduce one or more viral genes into the germ-line of animals. Thus, transgenic technology allows for the study of viral gene expression and function in the context of the whole animal. The focus of this review is to define the advantages and disadvantages of the transgenic approach in studies of viral pathogenesis. Studies involving a human DNA tumor virus (JCV) and a human retrovirus (HIV) will be described to illustrate these points. PMID- 2695743 TI - Regulation of the RAD2 gene of Saccharomyces cerevisiae. AB - Regulation of the DNA damage-inducible RAD2 gene was investigated in yeast cells transformed with centromeric plasmids containing RAD2-lacZ fusion constructs. Deletion analysis defined several regions in the 350bp region upstream of the translational start codon which are required for induction of beta-galactosidase activity. No deletions resulted in constitutively enhanced expression. We therefore conclude that induction of RAD2 by DNA-damaging agents is positively regulated. Two domains required for induction have a similar sequence and are located approximately 70 and approximately 140bp upstream of the major transcriptional start site. Four other sequence domains required for induction contain uninterrupted poly(dA) poly(dT) stretches 9-13bp long. Deletion of some of these AT-rich domains also affects constitutive expression of RAD2. Expression of RAD2 is not cell-cycle-regulated in mitotic cells. However, meiosis is accompanied by increased steady-state levels of RAD2 mRNA in the absence of DNA damage. This enhanced transcription is not dependent on the presence of upstream sequences required for regulation of induction by DNA damage. Increased steady state levels of RAD2 mRNA are induced by cycloheximide in asynchronously dividing populations of cells, but not in non-replicating cells arrested in G1 phase of the cell cycle. Following exposure to u.v. irradiation induction is also dramatically reduced in non-replicating cells. PMID- 2695744 TI - Nickel deficiency gives rise to the defective hydrogenase phenotype of hydC and fnr mutants in Escherichia coli. AB - Hydrogenase activity and other hydrogenase-related functions can be restored to hydC mutants by the specific addition of nickel salts to the growth medium. These mutants are defective in all three hydrogenase isoenzymes and the restoration is dependent upon protein synthesis. The cellular nickel content of the mutant when grown in LB medium is less than 1% of that of the parental strain. Partial suppression of the hydrogenase phenotype of hydC mutants occurs when growth takes place in a different medium. This correlates with an increased cellular nickel content. The phenotype of the mutant is also fully suppressed by growth in media of very low magnesium content. Such media facilitate nickel uptake via the magnesium transport system, which leads to the acquisition of a normal cellular nickel content. Mutations in the fnr gene, which encodes a transcriptional regulator for several anaerobically expressed enzymes, abolishes hydC expression and gives rise to a defective hydrogenase phenotype. The hydrogenase phenotype of fnr is closely similar to that of hydC in all respects examined. The hydrogenase activity of fnr strains can be restored by the presence of a functional hydC gene on a multicopy plasmid. The hydrogenase phenotype of fnr strains therefore arises indirectly via suppression of hydC, which leads to a low cellular nickel content. Nickel has no influence on fumarate reductase or nitrate reductase activities in fnr strains. The hydrogen-metabolism phenotype of fnr strains is, therefore, dependent upon their ability to acquire nickel from growth media. It is likely that hydC encodes a specific transport system for nickel. PMID- 2695745 TI - Multi-gene amplification: simultaneous detection of three virulence genes in diarrhoeal stool. AB - Enterotoxigenic Escherichia coli (ETEC) and Shigella account for a substantial proportion of acute diarrhoeal illnesses among Third-World children. Rapid detection of these infectious agents in faeces followed by the prompt implementation of public health measures could help reduce their spread during the early phase of epidemics. Towards this end, three pairs of synthetic oligonucleotide primers were prepared and shown to hybridize specifically to the genes encoding the heat-stable (ST) and the heat-labile (LT) enterotoxins of ETEC and to invasion-associated loci (ial) of the large Shigella virulence plasmid. When the three primer pairs were used together in the polymerase chain reaction (PCR), the three corresponding genetic loci could be simultaneously amplified using DNA extracted directly from stool; the amplified products were readily detected by ST-, LT- and ial-specific, alkaline phosphatase-labelled oligonucleotide probes (AP probes). The performance of this system was evaluated in a Mayan community in southeastern Mexico, where diarrhoeal illnesses are a common cause of childhood morbidity and mortality. Using only simple and inexpensive laboratory equipment, multigene amplification with these primers and probes led to the identification of ETEC and/or Shigella in the stools of 20 out of 71 children with diarrhoea; the procedure could be completed in seven hours and was more sensitive than conventional diagnostic tests or DNA probes used without amplification. PMID- 2695746 TI - Stability of ColE1-like and pBR322-like plasmids in Escherichia coli. AB - The average copy number, the level of ampicillin resistance conferred by one plasmid, and the degree of plasmid multimerization were determined for several ColE1-like and pBR322-like plasmids. From the results obtained, the variance of the units of partition corresponding to each plasmid studied was calculated. Experimentally determined plasmid stability was compared with that calculated using the variance of the units of partition and the ratio between the generation times of plasmid-free and of plasmid-carrying cells, assuming that the units of partition are distributed randomly between daughter cells. Stability of the pBR322-like plasmids present mainly as monomers in the bacterial host was consistent with random partitioning, whereas pBR322-like plasmids, present mainly as dimers, and the ColE1-like plasmid showed greater stability than that predicted with random partitioning at cell division. PMID- 2695747 TI - Mutations in genes downstream of the rpoN gene (encoding sigma 54) of Klebsiella pneumoniae affect expression from sigma 54-dependent promoters. AB - Two open reading frames (ORFs), designated ORF95 and ORF162, downstream of the Klebsiella pneumoniae sigma 54 structural gene (rpoN) have been sequenced and shown to encode polypeptides of 12 kD and 16 kD, respectively. ORFs homologous to ORF95 are present downstream of four out of five rpoN genes sequenced to date from a range of Gram-negative bacteria, and ORF162 is also conserved, at least in Pseudomonas putida. Chromosomal mutations have been created in each gene using a kan cassette and both have the same phenotype, i.e. they cause an increase in the level of expression from sigma 54-dependent promoters. We propose that the products of both genes function to modulate the activity of E sigma 54, although a physiological role for these proteins has not yet been identified. PMID- 2695748 TI - Extracellular and periplasmic isoenzymes of pectate lyase from Erwinia carotovora subspecies carotovora belong to different gene families. AB - Pectate lyase (Pel) plays a crucial role in the maceration of vegetables by soft rot Erwinia spp. We have characterized the four Pel isoenzymes of Erwinia carotovora subspecies carotovora strain SCRI193. In this paper we concentrate on two isoenzymes which have different locations in SCRI193: PLb is periplasmic and PLc is extracellular. Comparison of the gene products and nucleotide sequences of pelB and pelC allowed us to assign them to different gene families. In addition, we have identified a number of conserved amino acid residues that are common to all extracellular Pel isoenzymes. PMID- 2695749 TI - A simple method for maximizing the yields of membrane and exported proteins expressed in Escherichia coli. AB - The feasibility of using a beta-lactamase fusion approach for maximizing the levels of periplasmic or membrane-bound proteins expressed in Escherichia coli was investigated. The coding region for mature TEM beta-lactamase was fused after the signal peptide and aminoterminal portion of the coding region of a weakly expressed periplasmic protein, PBP3*. The resultant plasmid was mutagenized and transformants expressing increased levels of ampicillin resistance were selected. The PBP3* gene of the unmutagenized beta-lactamase fusion plasmid, and of two mutant derivatives encoding increased ampicillin resistance, were then reassembled and the latter constructs were found to express increased levels of PBP3*. The applications of a beta-lactamase fusion approach in monitoring and optimizing levels of extracytoplasmic gene products expressed in E. coli are considered. PMID- 2695750 TI - Bacterial polysaccharide capsule synthesis, export and evolution of structural diversity. AB - Elaboration of a capsule composed of one of a range of acidic polysaccharides is a common feature of many bacteria, particularly those capable of causing serious infections in humans. Biochemical and genetical analyses of capsule biogenesis in Escherichia coli are beginning to reveal new aspects of polysaccharide biosynthesis. Genes have been identified which are thought to encode products responsible for the translocation of these high molecular-weight polysaccharides across the cytoplasmic and outer membranes, and the organization of exported polysaccharide into a capsule. Their further analysis should provide new insights into membrane biology, particularly since the genes in question are absent from the often used laboratory strains of E. coli. Genetic analysis of capsule diversity is beginning to suggest possible mechanisms for the generation of the structural diversity of polysaccharides. PMID- 2695751 TI - Secretion, processing and activation of bacterial extracellular proteases. AB - Many different bacteria secrete proteases into the culture medium. Extracellular proteases produced by Gram-positive bacteria are secreted by a signal-peptide dependent pathway and have a propeptide located between the signal peptide and the mature protein. Many extracellular proteases synthesized by Gram-negative bacteria are also produced as precursors with a signal peptide. However, at least two species of Gram-negative bacteria secrete one or more proteases via a novel signal-peptide-independent route. Most proteases secreted by Gram-negative bacteria also have a propeptide whose length and location vary according to the protease. Specific features of protease secretion pathways and the mechanisms of protease activation are discussed with particular reference to some of the best characterized extracellular proteases produced by Gram-positive and Gram-negative bacteria. PMID- 2695752 TI - Salmonella as an intracellular parasite. AB - Salmonella species are facultative intracellular parasites, capable of penetrating (invading), surviving, and often multiplying within diverse eukaryotic cell types, including epithelial and phagocytic cells. These processes are essential for virulence, and involve both bacterial and host cell products. The use of cultured eukaryotic cells and other model systems has facilitated the study of bacterial-host cell interactions, and has led to a better understanding of the genetic and molecular basis of Salmonella pathogenicity. PMID- 2695753 TI - Non-genotoxic carcinogenesis: implications for testing and extrapolation to man. AB - It is argued that non-genotoxic mechanisms may be more important than genotoxic mechanisms in the genesis of cancer and that the use of tests for genotoxicity to screen chemicals for carcinogenicity in the hope of being able to prevent human cancer is ill-based. The general applicability of the two-stage model for carcinogenesis is also questioned. It is argued that tumour promotion as a second step in a two-stage process is only one of many possible non-genotoxic mechanisms involved in carcinogenesis and not a very important one at that. Many cancers arise against a background of prolonged disturbance of hormonal status leading to hypertrophy and/or hyperplasia of the tissues in which cancers eventually arise. This sequence of events does not fit the two-stage paradigm according to which genetic-damage (initiation) is followed by the stimulation of cell proliferation (promotion). In hormonal carcinogenesis cellular proliferation precedes genetic damage. It is suggested that the genetic damage that occurs as a secondary event in hormonal carcinogenesis may be due, not to exposure to environmental (exogenous) mutagens, but to endogenous mutagens generated during normal metabolic processes in hyperplastic and hypermetabolic cells. Perhaps the rate of damage to DNA in such cells overwhelms the capacity for DNA repair. Cancer is an ageing-related disease. The incidence and severity of both non-neoplastic and neoplastic lesions are greatly enhanced by over-nutrition in laboratory rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695754 TI - Analysis of the National Toxicology Program data on in vitro genetic toxicity tests using multivariate statistical methods. AB - A series of multivariate statistical methods have been used to explore the results of a set of four in vitro short-term tests (STT) on 73 chemicals reported by the US National Toxicology Program (NTP). Cluster analysis showed that the mouse lymphoma mutation (MLY) and sister-chromatid exchange (SCE) were similar in performance, as were the Salmonella (STY) and chromosomal aberration test (CHA). The lack of association between tests using the same genetic end-point or at the same phylogenetic level found in previous analyses was confirmed in this study. Factor analysis was used to derive a scale of genetic damage. This measure was contrasted with rodent carcinogenicity; only a limited association was found (rank correlation coefficient, rs = 0.32). Linear discriminant analysis was used to study whether the STTs could be used to complement one another. The combination of STY with the other STTs did not improve significantly the prediction of rodent carcinogenicity of STY alone. In the entire set of chemicals, 33% were negative in STY and positive in at least two other STT, and 11% was negative in STY and positive in the three other tests. SCE and MLY were complementary to STY for identifying the most genotoxic chemicals, but CHA was not a useful complement. The presence of potential electrophilic sites in the chemicals was highly correlated with the STY results, but did not improve the ability of STY to identify genotoxic chemicals or predict rodent carcinogens. In conclusion, the other in vitro STTs did not complement STY for predicting carcinogenicity, but were an important complement for describing the potential genotoxicity of chemicals. PMID- 2695755 TI - Micronuclei, kinetochores and hypoploidy: tests with some agents. AB - Micronuclei were induced by treating mouse L-cells with diethylstilboestrol, colchicine and benomyl. These micronuclei were analysed for the presence of kinetochores by using antikinetochore antibody. The three chemicals induced micronuclei which differed with regards to their (i) relative distribution per cell, (ii) relative frequency for being kinetochore positive or being kinetochore negative and (iii) overall relationship between their induction and hypoploidy which in part may originate from laggards expressing as micronuclei. The data indicate that a study of micronuclei may help determine the differences between the actions of different chemicals on the genetic apparatus. PMID- 2695756 TI - A comparative study of the clastogenic activity of ethylating agents. AB - The comparative clastogenic effects of six ethylating agents, namely N-ethyl-N nitrosourea (ENU), N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG), diethyl sulphate (DES), ethyl methane sulphonate (EMS), epichlorohydrin (ECH) and ethylene dibromide (EDB) have been determined in cultured Chinese hamster ovary (CHO) cells. The relative order of potency of the six ethylating agents for the induction of chromosome aberrations related to exposure concentration was ENNG greater than ECH greater than ENU greater than EDB greater than DES greater than EMS with each agent inducing aberrations over a discrete concentration range. In the case of monofunctional agents, ENNG, ENU, DES and EMS there was a relationship between the induction of chromosome aberrations with the Swain-Scott S-value and O-alkylation with those agents with the lowest S-value and the highest proportion of O-alkylation producing chromosome aberrations at the lowest exposure concentrations. PMID- 2695757 TI - Mutagenic nitrenes/nitrenium ions from azido-imidazoarenes and their structure activity relationships. AB - New heterocyclic arylazides (azido-imidazoarenes) structurally related to the food mutagen/carcinogen 2-amino-3-methyl-imidazo[4,5-f]quinoline (IQ) have been prepared. Their photolysis yields nitrenes and/or nitrenium ions which induce mutations in Salmonella typhimurium. The relationships between the chemical structure and mutagenic activity of these species are the same as those found in our previous studies of the amino- and nitro-imidazoarenes. Therefore the efficiency of the reaction with DNA of the ultimate metabolite, the nitrene/nitrenium ion, is the critical step governing the mutagenic potency of the amino- and nitro-imidazoarenes. The efficiency of DNA-binding depends on the delocalization of the positive charge of the nitrenium ion or of the electron deficiency of the nitrene. It is typical of the N-1-substituted and N-3 substituted arenimidazolyl-nitrenium ions that they can form another nitrenium resonance structure very similar to the parent nitrenium ion structure. We suggest that this property of the nitrene/nitrenium ion, in combination with its aromatic structure facilitating carbonium ion resonance structures, is the basic reason for the extremely potent mutagenic activity of IQ and related food mutagens/carcinogens. PMID- 2695758 TI - Re-evaluation of the effect of ellagic acid on dimethylnitrosamine mutagenicity. AB - Dimethylnitrosamine (DMN) is activated to mutagenic species in the Ames test (Salmonella typhimurium strain TA100) by hamster hepatic S9 preparation. This S9 activity is induced by administration of ethanol to the animals. The organic solvents dimethylsulphoxide (DMSO) and N-methyl-2-pyrrolidinone (MP) inhibit this mutagenicity, apparently because they inhibit DMN demethylase activity (assayed as formaldehyde production). Ellagic acid, dissolved in DMSO or MP, had no inhibitory effect on DMN mutagenicity, beyond the effect of the solvent vehicle. PMID- 2695759 TI - DNA repair induction by UV irradiation and various mutagens requiring metabolic activation in rat hepatocytes maintained in culture for several days. AB - Freshly isolated rat hepatocytes cultivated in Williams Medium E (WME) quickly lose their cytochrome P-450-dependent metabolic activities. A significantly better maintenance of cytochrome P-450 was achieved by supplementing WME with hormones and nutrients and 2% DMSO and 10% fetal calf serum. After 72-h cultivation in this medium the cytochrome P-450 content was still 72% of the amount measured in freshly isolated cells. Over the same period of time the activity of 7-ethoxycoumarin-O-deethylase dropped to approximately 55% of its initial value. DNA repair induction by UV irradiation, hydrogen peroxide, benzo[a]pyrene and 2-acetylaminofluorene was measured. A clear dose-dependent increase of the incorporation of [3H]thymidine was found with all agents tested, regardless of whether the treatment of the hepatocytes began 4 or 52 h after cell isolation. In the case of UV light and hydrogen peroxide the maximum effects were slightly lower after prolonged cultivation, whereas little change or even a slight increase was found with benzo[a]pyrene and 2-acetylaminofluorene. These results indicated that cell cultivation led to a slight loss of DNA repair activity but did not, despite the loss of cytochrome P-450, cause a decrease in DNA-damaging intermediates produced from the two indirect mutagens. The absolute amounts of [3H]thymidine incorporated by the solvent control cells of the 52-h groups was consistently found to be twice the level measured in the corresponding 4-h control groups. The incorporation of deoxy[3H]cytidine was not changed when tested in parallel. The increase in [3H]thymidine incorporation can therefore be explained by the assumption of a diminution of the thymidine pool during cell cultivation. PMID- 2695760 TI - Clonally derived cell lines with altered DNA methylation as models for error correction and mutation in tumours. AB - We have investigated the relative importance of DNA methylation-directed repair of replication errors to the production of mutation/gene rearrangements in mammalian cells with hypomethylated genomes. Using a series of sibling (Chinese hamster derived) cell clones with stably altered DNA methylation levels, we found that genomic hypomethylation was frequently associated with an elevated spontaneous mutation rate in the hypoxanthine phosphoribosyl transferase (HPRT) gene and with increased sensitivity to 2-aminopurine, a known inducer of DNA base mismatches. However, while there are some alterations in sites of DNA methylation around the HPRT gene, there was no systematic direction of change to differentiate between cells with normal or with elevated mutation rates. Further, the nature of gene alterations giving rise to the HPRT mutations suggested that methylation-directed mismatch repair is of little if any significance in influencing error avoidance in mammalian cells with hypomethylated genomes and that increased mutation associated with DNA hypomethylation is more likely to be due to increased genomic instability through activation of such factors as transposable elements. PMID- 2695761 TI - The SCE-inducing potency of the furoquinoline alkaloid, gamma-fagarine, and a gamma-fagarine-containing tincture from Rutae Herba, in cultured human lymphocytes. AB - gamma-Fagarine, a furoquinoline alkaloid naturally occurring in Rutae Herba induces sister chromatid exchanges (SCEs) in human lymphocyte cultures in a dose dependent manner. The alkaloid is a direct-acting but weak SCE inducer. Similar direct but weak activity was detected in a sample of a commercial Rutae Tinctura which contained 68 micrograms/ml of gamma-fagarine. The strong toxicity of the tincture makes it difficult to test a broader concentration range. There is some evidence that the SCE-inducing activity of the tincture is mainly due to the presence of gamma-fagarine. PMID- 2695762 TI - Genotoxicity testing: phage T7 inactivation test of various furan and arenofuran derivatives. AB - The genotoxic activities of 28 furan and arenofuran derivatives were tested by the phage T7-inactivation test. The genotoxic activity of the compounds was characterized quantitatively. All the compounds studied have pronounced genotoxic activities in our system. Empirical rules relating structure to genotoxic activity were found. Data obtained with our system were compared with the results of other biological systems (Salmonella assay, SOS Chromotest, CHO/HGPRT, gene amplification) in the case of some compounds included as references. PMID- 2695763 TI - Comparison of acridine orange and Giemsa stains in several mouse bone marrow micronucleus assays--including a triple dose study. AB - Data from four mouse bone marrow micronucleus assays are presented in which sister slides were stained with Giemsa or Acridine Orange (AO). These data are used to support our decision to change from Giemsa stain to AO when conducting rodent bone marrow micronucleus assays. The AO method leads to definitive assessments of the incidence of micronucleated polychromatic erythrocytes on a slide, and in so doing, it saves reading time and increases confidence in data. Preliminary experiments with DMBA using the triple-dose/single sample protocol of MacGregor are also described, and it is concluded that this protocol shows great promise. PMID- 2695764 TI - Micronuclei: origins, applications and methodologies--a workshop sponsored by the Health and Safety Executive held in Manchester, May 23-25, 1988. PMID- 2695765 TI - Human cells with multiple monosomies. An overlooked resource for readily isolating cells with autosomal recessive mutations? PMID- 2695766 TI - Glycosphingolipids: structure, biological source, and properties. PMID- 2695767 TI - Mannose/N-acetylglucosamine-binding proteins from mammalian sera. PMID- 2695768 TI - Sialate 9-O-acetylesterase from rat liver. PMID- 2695769 TI - Glycoprotein sialate 7(9)-O-acetyltransferase from rat liver Golgi vesicles. PMID- 2695770 TI - Decreasing sulfation of proteoglycans produced by cultured cells. PMID- 2695772 TI - Ceramide glycanase from leech, Hirudo medicinalis, and earthworm, Lumbricus terrestris. PMID- 2695771 TI - Specific activity of radiolabeled hexosamines in metabolic labeling experiments. PMID- 2695773 TI - Glycolipid transfer protein from pig brain. PMID- 2695774 TI - Information systems to support medical practice and scientific discovery. AB - In many educational applications of the computer, systems are designed to contain information or knowledge that is to be conveyed to the student or user via an interactive learning scheme. In contrast, most NLM systems strive merely to increase the user's access to the broad range of published scientific literature, or to link the user to appropriate factual databases. Providing or enhancing access is, of course, made more difficult than in didactic systems because of the relatively large size of the files that make up the bibliographic and factual databases. For example, the MEDLARS files contain over 12 million records, made up of roughly thirty billion online characters. Users send electronic queries to these files on-line via commercial value-added networks (24 hrs/day, 365 days/year), in total about 4 million queries per year. Of the 4 million, approximately half of the queries were (in the opinion of the users polled) prompted by questions that arose in caring for a particular patient. The remaining 2 million queries concerned research, teaching, and public policy. PMID- 2695775 TI - Factors affecting computer-mediated instruction in medical education. AB - Although computer technology has progressed rapidly in the last decade, the use of computer mediated instruction as an adjunct to medical education has made only limited progress. This paper will attempt to analyze some of the major factors bearing on this limitation will review those areas where computer based instruction is potentially of greatest use, and will suggest means by which medical education can make greater use of the rapidly evolving information technologies. The Medical PLATO project at the University of Illinois will be used as an example to illustrate many of the points relating to the development of this field. PMID- 2695776 TI - Teaching medical informatics to medical students in the Federal Republic of Germany. AB - The medical curriculum in the Federal Republic of Germany (FRG) is regulated by federal legislation. Medical informatics is part of this curriculum and is therefore taught by all 27 medical faculties in the FRG, 24 of which have related departments. The teaching situation in general and the specific approach at the author's department are described. PMID- 2695777 TI - Description of a blockcourse in medical informatics. AB - This paper describes a blockcourse in medical informatics. The course is presented to fourth, fifth and sixth year medical students and lasts one week. During the course all aspects of medical informatics are considered. Programming, databases, information systems, signal analysis, pattern recognition, expert systems, etc. are explained. Lectures alternate with hands-on experience. The subjects discussed in the lectures are rehearsed during the practical sessions, so that gaps in the student's knowledge are immediately detected. The blockcourse has been positively rated by the students. PMID- 2695778 TI - Computer applications for staff development and patient education. AB - The changing and evolving profession of nursing necessitates extensive staff development activities on the part of nursing management. This ongoing responsibility is essential to maintaining the currency and competence of practicing nurses and facilitating their professional growth. Simultaneously there are economic constraints coinciding with increased consumer demands for patient education. The purpose of this paper is to explore an innovative teaching method, the use of instructional computing for staff development and patient education programs. The theoretical frameworks for this instructional modality are identified and general advantages and disadvantages of instructional computing applications are described. Specific examples of programs from the literature are briefly discussed. PMID- 2695779 TI - Teaching medical informatics: teaching on the seams of disciplines, cultures, traditions. AB - This paper reviews different concepts of medical informatics and identifies two families of approaches to education in it: a "specialist" approach, whereby medical informatics is taught as a specialization track for established disciplines like medicine, computer science, nursing, engineering, etc., and a "generalistic" approach, whereby it is taught as an integrated discipline incorporating essential traits of the aforementioned disciplines. The pros and cons of these approaches are outlined. The need to accommodate specific requirements of education is emphasized and these are identified, together with an outline of particular challenges that we are facing. PMID- 2695780 TI - Software engineering education in medical informatics. AB - Requirements and approaches of Software Engineering education in the field of Medical Informatics are described with respect to the impact of (1) experiences characterizing the "software misery", (2) status and tendencies in software methodology, and (3) educational status and needs in computer science education influenced by the controversy "theoretical versus practical education". Special attention is directed toward the growing importance of analysis, design methods, and techniques in the professional spectrum of Medical Informatics, the relevance of general principles of systems engineering in health care, the potential of non procedural programming paradigms, and the intersection of Artificial Intelligence and education. Realizations of and experiences with programs in the field of Software Engineering are reported with respect to special requirements in Medical Informatics. PMID- 2695781 TI - Computers in a human perspective: an alternative way of teaching informatics to health professionals. AB - An alternative way of teaching informatics, especially health informatics, to health professionals of different categories has been developed and practiced. The essentials of human competence and skill in handling and processing information are presented parallel with the essentials of computer-assisted methodologies and technologies of formal language-based informatics. Requirements on how eventually useful computer-based tools will have to be designed in order to be well adapted to genuine human skill and competence in handling tools in various work contexts are established. On the basis of such a balanced knowledge methods for work analysis are introduced. These include how the existing problems at a workplace can be identified and analyzed in relation to the goals to be achieved. Special emphasis is given to new ways of information analysis, i.e. methods which even allow the comprehension and documentation of those parts of the actually practiced 'human' information handling and processing which are normally overlooked, as e.g. non-verbal communication processes and so-called 'tacit knowledge' based information handling and processing activities. Different ways of problem solving are discussed involving in an integrated human perspective--alternative staffing, enhancement of the competence of the staff, optimal planning of premises as well as organizational and technical means. The main result of this alternative way of education has been a considerably improved user competence which in turn has led to very different designs of computer assistance and man-computer interfaces. It is the purpose of this paper to give a brief outline of the teaching material and a short presentation of the above mentioned results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2695782 TI - The implications of cognitive psychology for computer-assisted instruction. AB - An information processing model is used to describe the learning process. The implications of some of these cognitive concepts are examined in the context of computer-assisted instruction. PMID- 2695783 TI - Use of the Quick Medical Reference (QMR) program as a tool for medical education. AB - The original goal of the INTERNIST-1 project, as formulated in the early 1970s, was to develop an expert consultant program for diagnosis in general internal medicine. By the early 1980s, it was recognized that the most valuable product of the project was its medical knowledge base (KB). The INTERNIST-1/QMR KB comprehensively summarizes information contained in the medical literature regarding diagnosis of disorders seen in internal medicine. The QMR program was developed to enable its users to exploit the contents of the INTERNIST-1/QMR KB in educationally, clinically, and computationally useful ways. Utilizing commonly available microcomputers, the program operates at three levels--as an electronic textbook, as an intermediate level spreadsheet for the combination and exploration of simple diagnostic concepts, and as an expert consultant program. The electronic textbook contains an average of 85 findings and 8 associated disorders relevant to the diagnosis of approximately 600 disorders in internal medicine. Inverting the disease profiles creates extensive differential diagnosis lists for the over 4250 patient findings known to the system. Unlike a standard printed medical textbook, the QMR knowledge base can be manipulated "on the fly" to format displays that match the information needs of users. Preliminary use of the program for education of medical students and medical house officers at several sites has met with an enthusiastic response. PMID- 2695784 TI - Creation of realistic appearing simulated patient cases using the INTERNIST-1/QMR knowledge base and interrelationship properties of manifestations. AB - The Internist-1/Quick Medical Reference (QMR) knowledge base (KB) describes the clinical manifestations of some 600 diseases in the domain of internal medicine. This KB, while not representing deep causal modelling of disease processes, is nonetheless effective in providing medical diagnostic assistance through the QMR medical decision support system. One potential application of this extensive KB is the generation of simulated patient cases for use in educating health professionals. However, the "flat" KB is not adequate for this because the clinical manifestations used in the disease descriptions are not mutually independent. While it is theoretically possible to construct disease descriptions which embody pathophysiologic mechanisms of disease causality, it is not practical from the standpoint of resource utilization. Short of constructing a causal knowledge base, the authors herein describe the generation of realistic appearing simulated patient case data using existing information in the knowledge base. This existing information in the KB is in the form of properties which represent a shallow form of interrelationships of the manifestations. The authors conclude that this ability to generate simulated cases represents another view in which to look at an extensive knowledge base, as well as having application to constructing intelligent tutoring systems for health professionals in training. PMID- 2695785 TI - Effect of a computer-assisted general medicine diagnostic consultation service on housestaff diagnostic strategy. AB - Quick Medical Reference (QMR) is a microcomputer-based decision support system designed to provide diagnostic assistance in the field of internal medicine. In addition to providing plausible diagnostic hypotheses based upon patient specific findings, the program highlights history, physical and laboratory items which are potentially useful in discriminating among the diagnoses under consideration. We have evaluated the impact of a computer-assisted diagnostic consultation service on the diagnostic and management strategy of a housestaff in a university internal medicine training program. Differential diagnoses were obtained before and after the use of the program, and a questionnaire was used to assess the educational value of the service and the effect of the service on the diagnosis and planned management. Over an eight week period, 31 cases were identified which met inclusion criteria. The QMR consultation added a diagnosis to the original list in 14 out of 31 cases. The consultation reordered the diagnosis in an additional 7 cases, and in 8 cases a diagnosis was ruled out by the use of the program. After the use of the program the housestaff reported they would obtain an additional lab test in 10 cases, change the order of planned tests in two cases and eliminate a lab test in one case. The use of the program was rated as helpful educationally in 81% of the cases, and helpful with respect to management in also 81% of the cases. PMID- 2695786 TI - Interactive computer-video modules for health sciences education. AB - Advances in electronic image recording and computer technology have resulted in a remarkable increase in the power and flexibility of interactive computer-video teaching systems. The University of Washington Health Science Videodisc Development Group first demonstrated a laser videodisc controlled by a remote central computer in 1980. Even this rudimentary unit highlighted basic medical informatics principles including: rapid accessibility; a "generic" or multi purposed format; ease of computer control; and large collections of valid, rigorously reviewed images. Advances in medical informatics have led to the development of the following previously undescribed series of teaching units: 1. The hypertext programs Hypercard, Linkway, and Guide have been used with videodiscs to develop easy-to-use instructional and reference materials. These materials demonstrate the ease with which a computer-naive instructor may develop new programs and the advantages that the intuitive nature of these programs brings to student users. 2. Patient simulations using single and double screens plus pre-defined knowledge structures; 3. Interactive single topic tutorials using preset knowledge structures; 4. A key-word-based disc searching system; 5. Electronic video microscopy; 6. A series of programs developed independently by health science faculty who have purchased multi-purpose videodiscs that demonstrate the flexibility of the multi-purpose or "generic": collection concept. PMID- 2695787 TI - Computer-based exercises in anemia diagnosis (PlanAlyzer). AB - PlanAlyzer is a microcomputer-based, event-driven system for instructional research in medical education. Aimed at the second year medical student, PlanAlyzer elicits and critiques a student's approach to the diagnosis of a common medical disorder. In this paper we discuss the concept, development, implementation and formative evaluation of the PlanAlyzer system for the evaluation of anemia. PMID- 2695788 TI - Iliad: moving medical decision-making into new frontiers. AB - If the essence of clinical practice is a process of sequential problem-solving, whereby a physician works with a patient to formulate a series of decisions about diagnostic treatment, then it would naturally follow that the essence of medical education should evolve around the training of would-be clinicians in the difficult art of diagnostic decision-making. Yet this is not often the case. PMID- 2695789 TI - An application of monoclonal antibodies to identification of leptospires of serogroup icterohaemorrhagiae found in China. AB - For the purpose of improving the procedures of identification of leptospires, a set of 5 monoclonal antibodies with different serological reactivity against serovars of Leptospira interrogans Icterohaemorrhagiae serogroup isolated in China was developed. One hundred and eight strains isolated from epidemic fields in 5 provinces in southern China were distinctly identified into 4 serovars of Icterohaemorrhagiae serogroup by the monoclonal antibody procedure, i.e., 98 isolates were identified as serovar lai, 7 as icterohaemorrhagiae, 2 as copenhageni, and 1 as H2. Factor antiserum procedure was used at the same time as control for typing these strains and an identical result was obtained. PMID- 2695790 TI - Chemotaxonomic study of Vibrio cholerae bio-serogroup Hakata on the basis of the sugar composition of the polysaccharide portion of its lipopolysaccharides. AB - A chemotaxonomic study was carried out on 31 strains of non-O1 Vibrio cholerae bio-serogroup Hakata, isolated in Japan, which possesses the Inaba antigen C of O1 V. cholerae. On the basis of the compositional sugar pattern of the polysaccharide portion of their lipopolysaccharides, the 23 strains isolated from the environment were separated into two groups, one (20 strains) containing mannose, glucose, fructose, L-glycero-D-mannoheptose, glucosamine, perosamine, quinovosamine, and an unidentified amino sugar AS, and the other (3 strains) containing two additional sugars, galactose and a trace amount of galactosamine. All of the eight strains isolated from imported seafoods belonged to the former group. PMID- 2695791 TI - Morphological changes in Escherichia coli cells exposed to low or high concentrations of hydrogen peroxide. AB - Escherichia coli cells challenged with low or high concentrations of hydrogen peroxide are killed via two different mechanisms and respond with morphological changes which are also dependent on the extracellular concentration of the oxidant. Treatment with low concentrations (less than 2.5 mM) of H2O2 is followed by an extensive cell filamentation which is dependent on the level of H2O2 or the time of exposure. In particular, addition of 1.75 mM H2O2 results in a growth lag of approximately 90 min followed by partial increase in optical density, which was mainly due to the onset of the filamentous response. In fact, microscopic analysis of the samples obtained from cultures incubated with the oxidant for various time intervals has revealed that this change in morphology becomes apparent after 90 min of exposure to H2O2 and that the length of the filaments gradually increases following longer time intervals. Analysis of the ability of these cells to form colonies has indicated a loss in viability in the first 90 min of exposure followed by a gradual recovery in the number of cells capable of forming colonies. Measurement of lactate dehydrogenase in culture medium (as a marker for membrane damage) has revealed that a small amount of this enzyme was released from the cells at early times (less than 150 min) but not after longer incubation periods (300 min). Cells exposed to high concentrations of H2O2 (greater than 10 mM) do not filament and their loss of viability is associated with a marked reduction in cell volume. In fact, treatment with 17.5 mM H2O2 resulted in a time-dependent decrease of the optical density, clonogenicity, and cellular volume. In addition, these effects were paralleled by a significant release in the culture medium of lactate dehydrogenase thus suggesting that the reduced cell volume may be dependent on membrane damage followed by loss of intracellular material. This hypothesis is supported by preliminary results obtained in electron microscopy studies. In conclusion, this study further demonstrates that the response of E. coli to hydrogen peroxide is highly dependent on the concentration of H2O2 and further stresses the point that low or high concentrations of the oxidant result in the production of different species leading to cell death via two different mechanisms and/or capable of specifically affecting the cell shape. PMID- 2695792 TI - [The biological properties of Rickettsia burnetii isolated in the northwestern Ukrainian SSR]. AB - Biological properties of two strains of the Burnet rickettsia isolated in the natural foci of the Q fever in the northwest of the Ukrainian SSR are studied. Strain "Gishin" was characterized by high virulence for the laboratory animals and considerably exceeded the strain "Politsa" in the virulent properties. Antigen of phase I prepared from the strain "Politsa" was highly active in revealing the corresponding antibodies. The high-sensitive reaction of indirect immunofluorescence has shown the possibility to determine antibodies to phase I of the agent already from the 17th day after infection. Circulation of the Q fever agent with different virulent properties has indicated the necessity of purposeful diagnosis of this sickness both among the acute fever diseases and among flaccid course, subclinical and chronic ones not excluding the etiological role of the Burnet rickettsia. PMID- 2695793 TI - [An electron microscopic study of the structure of Erwinia carotovora 268 bacteria]. AB - The electron-microscopic studies have shown that the bacterium Erwinia carotovora 268 (a producer of L-asparaginase) does not differ essentially from other representatives of enterobacteria. When growing on the artificial nutrient medium M9, the division of bacteria is inhibited and the bacterial cell itself elongates. Certain functionally specified structural peculiarities such as the formation of the protein microcapsule, formation of cavities and compacted sites of the cytoplasm and mucus on the cell poles are typical of bacteria, that is associated with the synthesis of L-asparaginase and erwiniocinogeny. PMID- 2695794 TI - [The compositional characteristics of the cellular fatty acids in strains of Klebsiella pneumoniae serovar K 1]. AB - Klebsiella pneumoniae, serovar K1 strains, differ essentially in the composition of cellular fatty acids from serovar strains K 2, K 3, K 7-K 72, K 74-K 80 of this species and are analogous to K. rhinoscleromatis and K. ozaenae by the given trait. The differences concern the concentration of cyclopropane fatty acids and their biosynthetic precursors--monounsaturated fatty acids, that is typical of a number of other bacteria belonging to the related species and, evidently, may be a marker of phenetic differences at the level of related taxonomic groups. The data obtained evidence for taxonomic separation of K. pneumoniae serovar K1 strains from representatives of other serovars of the given species. PMID- 2695795 TI - [The effect of the method of inoculation on the growth and variability of Bacillus thuringiensis H14 266/2-1]. AB - The method of inoculation was studied for its effect on the growth and variability of Bacillus thuringiensis H14 266/2-1 when cultivating them in the liquid nutrient medium inoculate with inoculum prepared by different procedures. Optimal conditions of the inoculum preparation are determined. Productivity of the strain when inoculating the medium with the aerial-dry inoculum was studied as compared to the inoculation by the inoculum taken from the mown agar. It is established that selection of the virulent R-form from colonies should serve as a basis for the preparation of the stable morphologically uniform inoculum. The aerial-dried culture of bacilli is shown to be more effective since it is characterized by higher and stable indices of productivity and is more prepared to a long-duration storage than the inoculated agar media. A more rapid transition (by 2-4h) of the culture to the use of the carbon source is marked. The culture of bacilli is different in a higher developmental level: sporulation and crystallization initiate during the first hours of inoculation and by the 24th hour sporulation reaches 100% with the prevailing content of R-form. PMID- 2695796 TI - [The mitogenic activity of the glycopolymers from Clavibacter (Corynebacterium) michiganense and Pseudomonas solanacearum]. AB - A comparative study of the mitogenic activity of glycopolymers has shown that the activity of polysaccharides isolated from Clavibacter michiganense is higher than that of lipopolysaccharide of Escherichia coli, Pseudomonas solanacearum and mefenaminic acid (the synthetic mitogen). Lipid A and the core oligosaccharide fraction are established to be responsible for the mitogenic activity of the P. solanacearum lipopolysaccharide. O-specific chains and fractions of KDO phosphates do not manifest the mitogenic activity. PMID- 2695797 TI - [Exchange of polyamines between the cell and the environment as one of the factors determining the growth of cultures of Escherichia coli with additional feeding]. AB - Escherichia coli growth in a synthetic medium with glucose is accompanied by the interdependent change of putrescine content in the cell and its environment, which maintains a homeostatic equilibrium. The rate of putrescine efflux at the early stage of the culture growth is directly proportional to putrescine intracellular pool but the rate of putrescine uptake is inversely proportional to its value. The constitutive form of ornithine decarboxylase with the pH optimum 8.0 is responsible for putrescine synthesis. Glucose deficiency favours the utilisation of acidic glucose metabolites but the homeostatic system of putrescine makes its intracellular content remain at a high level, which stimulates constructive processes in the following growth. PMID- 2695798 TI - [Growth of a turbidostatic culture of yeast under conditions of thermal stress at various pH's of the media]. AB - A turbidostat Saccharomyces cerevisiae 14 culture was grown at pH 6.0 to 2.25 and subjected to a heat pulse (the optimal temperature of 30 degrees C was elevated to 37.5 degrees C) in order to study its response. The growth rate was determined in the first cell generation after the pulse. The culture grown at pH 6-4 was shown to be thermotolerant whereas the yeast was thermosensitive at pH 2.4-2.25. The cells became thermotolerant at 37.5 degrees C after the transitions: pH 2.25- --4 and pH 2.35----4. The yeast thermoresistance was shown to depend on H+ concentration. Apparently, the yeast thermotolerance was determined by the effective functioning of the chemo-osmotic system. PMID- 2695799 TI - [Existence of an additional structural component in the basal bodies of Escherichia coli and Vibrio alginolyticus flagellae]. AB - The structure of Escherichia coli and Vibrio alginolyticus flagella was studied using electron microscopy. An additional protein structure was shown to exist in the basal bodies of intact flagella in these organisms. It is possible that this structure involves three proteins important for the assembly of flagella, energy transduction, and a change-over in the direction of flagellar rotation. PMID- 2695800 TI - [Effect of dehydration of heat-induced restructuring of the cytoplasm membrane of yeast cells]. AB - The effect of dehydration on the cytoplasmic membrane of yeast cells was studied using the method of spin labels. In the course of dehydration, the thermoinduced transition of lipids from the solid to a liquid-crystalline state was found to occur at a higher temperature as compared with native membranes. PMID- 2695801 TI - [Prevention of occupational tumors: an update]. AB - A review is made of studies on occupational cancer conducted in different countries in order to compare estimates of the attributable risks (i.e., the proportion of cancers occurring in the general population due to occupational exposure), and to identify the sources of variation. Estimates vary according to several factors, including different study designs and chiefly, different proportions of exposed workers in the geographical areas that have been investigated. For lung cancer, estimates ranged between 1 and 35%, with values of 10-15% occurring frequently; for bladder cancer, the range was between 1 and 19%. The implications of this variability in prevention programmes are discussed and the problems encountered in the identification and compensation of occupational cancer are examined. PMID- 2695802 TI - [Pesticide immunotoxicity]. AB - Pesticides have been reported as altering immune functions in animals and man. The authors review published data from which it emerges that pesticide exposure is often associated with depressed humoral and cellular responses in mammals. The immunomodulating effects are affected by the route of administration and can also occur without general toxic effects, with a clear dose-effect correlation and for different dose levels. Immunotoxicity has also been investigated in workers occupationally exposed to pesticides: many kinds of effects are described, since many immunotoxicants have multiple effects on immune functions but the authors emphasize the importance of further studies carried out in workplace situations where exposure levels can be more accurately measured. PMID- 2695803 TI - Behaviour of urinary beryllium in general population and in subjects with low level occupational exposure. AB - Occupational exposure to beryllium (Be) is nowadays much lower than in the past. While the classic Be diseases, such as berylliosis, are clearly on the decline, attention is currently being focussed on the immunological and carcinogenic effects of Be, which suggest that subjects with low-level occupational exposure should also be accurately controlled. Urinary Be (BeU) values were determined in a sample of the general population and in a group of dental technicians exposed to environmental Be concentrations ranging from 0.04 to 1.7 micrograms/m3. The mean BeU values of these workers (0.34 micrograms/l) were higher than those of the general population (0.26 micrograms/l) and the subgroup of dental technicians exposed to higher Be air concentration showed higher BeU levels. Although at present the relationships between external and internal dose and between internal dose and early effects, are not known, we believe that biological monitoring supplies useful information on occupational Be exposure. PMID- 2695804 TI - [Elements of probability calculation. I]. AB - This is the first of a series of articles on probability calculation, consisting of a simple introduction to the definitions of probability. A brief historical background explains some of the reasons for the delay in the development of probability calculation and recalls the main problems that had to be faced, the solution of which marked the birth of the theory of probability. Classical, frequentist and subjective approaches are addressed and their relative merits and weaknesses are discussed. PMID- 2695805 TI - Thoughts after reading Robert Jay Lifton's 'The Nazi Doctors'. AB - Robert Jay Lifton's remarkable book The Nazi Doctors and its tragic subject matter provided an opportunity to try and place the complicity of doctors in such barbarity in historical perspective. Massive episodes of killing of human beings by other human beings have been an ongoing saga for centuries. Misguided belief and misguided science, and the abuse of constantly advancing technology in the name of one or other nation-state, have made possible the acceleration of megadeath. The Nazi concentration and death camps were a particularly vicious manifestation within the spectrum of killing. Modern weaponry makes omnicide quite feasible. Our urgent need is to learn the lesson and to cultivate and promote planetary patriotism as promptly as possible. Adherence to an international code of human ethics is a compelling requirement. The origin of the International Committee of the Red Cross in 1863 was an inspiring and promising beginning. The formulation of the Declaration of Geneva by the World Medical Association in 1947 profoundly enhanced the value of the Hippocratic Oath and provides a sound ethical basis for the national and international guidance of the medical profession today. The International Physicians for the Prevention of Nuclear War establishes another firm step in the right direction. PMID- 2695807 TI - [Update oncology '89. II]. PMID- 2695806 TI - [Dose finding study of telenzepine (1.5 vs. 3 vs 5 mg once daily) in acute treatment of duodenal ulcer. A double-blind, randomized, multicenter parallel group comparison]. AB - Three different doses of the M1-selective antimuscarinic compound telenzepine were investigated in the treatment of acute duodenal ulcer in a randomized, double-blind dose-range finding study. In four investigating centers, 120 patients with endoscopically proven, florid duodenal ulcer were treated with either 1.5 mg, 3 mg or 5 mg telenzepine once daily at bedtime (40 patients per dose group). After two weeks of treatment differences in the healing rates were statistically not significant. After four weeks the ulcers of 26 (65%) patients in the 1.5 mg group and 34 (85%) and 31 (78%) in the 3 mg and 5 mg groups, respectively, were completely healed. Only the difference in the healing rates between the 1.5 and 3 mg groups was significant at p less than 0.05. Mean reductions in ulcer area were 90% (1.5 mg), 97% (3 mg) and 93% (5 mg) after four weeks; 1.5 vs. 3 mg, p less than 0.025. These results show that telenzepine dose dependently accelerates ulcer healing and that maximal effect is obtained with the 3-mg dose. The ulcer symptoms were dose-dependently alleviated. Dry mouth of moderate or severe intensity was stated more frequently under 5 mg telenzepine (by 14% of patients) than under 1.5 and 3 mg (5% each). The antimuscarinic side effect "disturbed accommodation" was rarely found. It is concluded that once daily administration of 3 mg in the evening must be regarded as the optimal dosage regimen of telenzepine. PMID- 2695808 TI - [Marfan syndrome. Current knowledge of pathogenesis, etiology and therapeutic possibilities]. PMID- 2695809 TI - [Current status and future developments of percutaneous transluminal coronary angioplasty]. PMID- 2695810 TI - [Passive euthanasia in intensive care medicine?]. PMID- 2695811 TI - [Violence involving minors. Reflections on medical ethics]. AB - A case of violence involving a minor is analysed from the ethical point of view, pointing out that the so-called principles of biomedical ethics (autonomy, beneficence, justice) intersect and are sometimes in conflict one with the other. A series of conditions is proposed for tracing the authentic representative of the interests of pediatric patients, and the clinician's role in difficult cases, which should be that of a guardian and an adviser as well as a technician is underlined. PMID- 2695812 TI - [Metopic craniosynostosis. Surgical results in 35 surgically treated cases under 1 year of age]. AB - The clinical features, the diagnostic findings and the surgical results obtained on 35 children, under 1 year of age, operated on because of an early synostosis of the metopic suture are presented. In 79% of cases, the diagnosis was obvious at birth. A M/F ratio of 2.0 was observed in this series. Associated malformations were recorded in eleven patients (30.5%). The surgical procedure consisted of bilateral frontal craniectomy, opening of the roof of the orbit, advancement of the superior orbital margin, and repositioning of the frontal flaps after 180 degrees rotation. The cosmetical correction was satisfactory even in the immediate postoperative period. No mortality was recorded. The surgical correction was followed by a normal psychomotor development in 33 cases; delayed milestones were recorded in 2 children in whom the metopic synostosis was part of a complex malformative syndrome. On the grounds of our results, the young age of the patients at the operation should not be regarded as an obstacle to the immediate surgical correction; in our advice, the early correction results also in better functional and cosmetic long-term outcomes. PMID- 2695813 TI - [A critical review of the methods used in evaluating the antistreptolysin titre as a diagnostic index]. AB - Authors review the most common laboratory tests showing an immunologic response caused by group A beta-hemolytic streptococcus infections. After a preliminary evaluation on characteristics and peculiarities of different methods the results obtained are compared with the usually employed systems. The survey of most common analytical methods and personal experience lead to confirm and emphasize the laboratory results supporting and confirming, without substituting, the clinical data. PMID- 2695814 TI - Plasma cortisol concentration following breakfasts of different composition in healthy subjects. AB - We measured plasma cortisol concentrations following breakfasts of different fat:carbohydrate ratio in 23 healthy subjects. A meal-related peak of plasma cortisol concentration was not found, as well as any difference in plasma cortisol levels following the two meals. Since the two meals elicited plasma glucose and plasma insulin levels which were significantly different, it is suggested that plasma cortisol is not acutely affected by ambient glucose and insulin concentrations. The same results were found when the study group was subdivided in nonobese (n = 13) and obese (Body Mass Index greater than n = 10), thus confirming the previous statement in the presence of different body weights. PMID- 2695815 TI - [Clinical efficacy of treatment with salmon calcitonin, administered intranasally for 1 year, in stabilized postmenopausal osteoporosis]. AB - Several controlled clinical studies have confirmed the rationale of calcitonin therapy in postmenopausal osteoporosis. However, administration by injection and side-effects reduced patient compliance and flexibility of dosage. Recently, evidence has been given that an intranasal spray may provide an effective alternative administration route for calcitonin. Forty women with established postmenopausal osteoporosis (at least on vertebral crush fracture) divided into three groups, entered and completed a one-year controlled study on the effects of treatment with synthetic salmon calcitonin nasal spray on bone mass and mineral metabolism. The first group (n = 20) received a daily treatment with 100 I.U. of salmon calcitonin (sCT) nasal spray; the second group (n = 10) received 100 I.U. of sCT by subcutaneous injection every second day; the control group (n = 10) received an oral calcium supplement, 1 g per day. Bone mineral content (BMC), evaluated by dual photon absorptiometry, was measured at the distal radius before and after 6 and 12 months of treatment. Every three months, throughout the year, an evaluation of some parameters of bone remodeling was made. BMC increased (p less than 0.01) in the treatment groups, whereas at the end of treatment, a decrease (p less than 0.05) was observed in the control group. Biochemical estimates of bone resorption, such as urinary hydroxyproline excretion showed a significant decrease in the calcitonin groups. No changes in markers of bone formation, serum alkaline phosphatase and osteocalcin were observed in all patients. This study demonstrates that one-year treatment with sCT nasal spray is able to increase bone mass in osteoporotic patients without important local side effects. PMID- 2695816 TI - [Insulin secretion and hepatic extraction in juvenile non-insulin-dependent diabetes]. AB - Beta-cell secretion is still a point of controversy. As the liver is the major site of insulin metabolism, evaluation of hepatic insulin extraction is crucial for correct measurement of beta-cell secretion. Methods for calculating the secretion and hepatic extraction of insulin indirectly from peripheral C-peptide concentration have been proposed by some investigators. To characterize the low insulin response of a group of young non-insulin-dependent diabetics we evaluated secretion and hepatic insulin extraction during an oral glucose tolerance test by peripheral IRCP determination and IRCP/IRI molar ratio. Our data show that in this population of young non-insulin-dependent diabetics, the low peripheral insulin response to an oral glucose challenge is a possible consequence of diminished beta-cell secretion, as hepatic insulin extraction is at near normal value. PMID- 2695817 TI - [Osteocalcin and endocrine pathology]. AB - The field of metabolic bone diseases has recently received useful information from the examination of the role of new collagenous and non-collagenous bone proteins, such as osteocalcin (also called bone Gla-protein) and osteonectin. It appears that at present, serum osteocalcin is the one bone protein that has the most promise for assisting in the diagnosis and management of high turnover metabolic bone disease states. Since endocrine diseases are frequently associated with altered bone turnover due to a disequilibrium between formation and bone resorption, we examine the role of osteocalcin, a specific marker of osteoblastic activity, in these clinical conditions. PMID- 2695818 TI - [Phenotype study of varieties of carcinomas originating in the oro-pharyngo laryngeal mucosa. Anatomo-clinical considerations]. AB - An immunohistological analysis with a panel of monoclonal and polyclonal antibodies was performed in 20 cases of squamous cell carcinoma originating in the oral cavity, oropharynx and larynx. The epithelial antigens were detected in all cases with variable patterns of positivity: cytokeratins and epithelial membrane antigen were positive in a high number of neoplastic cells in the carcinomas with a high grade of differentiation, whereas a lesser number of positive cells was observed in the poorly differentiated carcinomas. On the contrary the tissue polypeptide antigen was detected in a considerable number of neoplastic cells in the poorly differentiated carcinomas as well as in the fields with basal and cylindric cells. Mesenchymal antigens were negative in all tumors, except one case with pseudosarcomatous patterns, which was vimentin-positive. The detection of an immunohistochemical spectrum of squamous cell carcinomas may give further information on the biological characteristics, and consent to identify subtypes with a different histogenesis. PMID- 2695819 TI - [Reliability of exfoliative cytology in neoplasms of the oral cavity]. AB - Exfoliative cytology is highly important in the early diagnosis of epidermoidal carcinomas of the oral cavity. The simplicity of the test and its nil invasivity make it particularly indicated in the screening of large samples of patients. A double blind study was carried out to evaluate the diagnostic reliability of this technique with regard to the traditional bioptic examination. The data collected are compared with those reported in the literature. PMID- 2695820 TI - [Evaluation of the therapeutic efficacy and tolerance of a new thiamine compound (benzoyloxymethylthiamine) in the treatment of postoperative pain symptomatology in odontostomatological surgery]. AB - The therapeutic effectiveness of benzoyloxymethyl-thiamin in controlling post operative pain in odontostomatological surgery has been examined. The double blind study used a placebo and concerned 100 patients subjected to avulsion of the third molar in dysodontiasis on an out-patient basis. The results point to the effectiveness of benzoyloxymethyl-thiamin in the symptomatic treatment of post-operative pain symptomatology both as regards its duration and intensity; the drug also proved to be very well tolerated and its administration was not accompanied by any unwanted side-effects. PMID- 2695821 TI - [Ultrastructural aspects of root planing: scanning electron microscopy (S.E.M.)]. AB - The basis of Periodontal treatment is represented by scaling and root planing. The aim of this study was to compare root morphology after the use of three currets: a new Hu Friedy Gracey 7/8, a semi-new Hu Friedy Gracey 7/8, a worn Hu Friedy Gracey 7/8. The research indicates that manual treatment with the new curette is effective in removing tartar but can cause excoriations on the enamel of the tooth. In contrast, the use of the semi-new curette is less damaging and obtains the same results removing tartar without injuring the enamel surface. PMID- 2695822 TI - Title XVIIII. PMID- 2695823 TI - Neurological application of botulinum toxin. AB - Botulinum toxin, a potent biological toxin with paralytic properties, has found use as a therapeutic agent in various diseases. The authors review the toxin's therapeutic value in three neurological diseases. PMID- 2695824 TI - Ultraviolet photoproducts at the ochre suppressor mutation site in the glnU gene of Escherichia coli: relevance to "mutation frequency decline". AB - Ochre suppressor mutations induced by UV in the Escherichia coli glnU tRNA gene are CG to TA transitions at the first letter of the anticodon-encoding triplet, CAA. Premutational UV photoproducts at this site have long been known to exhibit an excision repair anomaly ("mutation frequency decline" or MFD), whereby postirradiation inhibition of protein synthesis enhances their excision and reduces suppressor mutation yields ten-fold. We sought to clarify the basis of this unique repair response by determining the spectrum of UV photoproducts on both strands of a 36 bp region of glnU which includes the anticodon-encoding triplet. We found that four different photolesions are produced within the 3 bp sequence corresponding to the tRNA anticodon: (i) on the transcribed strand, TC (6-4) photoproducts and TC cyclobutane dimers are formed in equal numbers at the site of the C to T transition, indicating that this site is a hotspot for the usually less frequent (6-4) photoproduct; (ii) on the nontranscribed strand, TT dimers are found opposite the second and third letters of the anticodon-encoding triplet, adjacent to the mutation site; and (iii) on the nontranscribed strand, an alkali-sensitive lesion other than a (6-4) photoproduct is formed, apparently at the G in the mutation site. We suggest that mutation frequency decline may reflect excision repair activity at closely spaced UV lesions on opposite strands, resulting in double-strand breaks and the death of potential mutants. PMID- 2695825 TI - Isolation and characterization of Saccharomyces cerevisiae mutants supersensitive to G1 arrest by the mating hormone a-factor. AB - Nine independent mutants which are supersensitive (ssl-) to G1 arrest by the mating hormone a-factor were isolated by screening mutagenized Saccharomyces cerevisiae MAT alpha cells on solid medium for increased growth inhibition with a factor. These mutants carried lesions in two complementation groups, ssl1 and ssl2. Mutations at the ssl1 locus were mating type specific: MAT alpha ssl1- cells were supersensitive to a-factor but MATa ssl1- were not supersensitive to alpha-factor. In contrast, mutations at the ssl2 locus conferred supersensitivity to the mating hormone of the opposite mating type on both MAT alpha and MATa cells. The alpha-cell specific capacity to inactivate externally added a-factor was shown to be lacking in MAT alpha ssl1- mutants whereas MAT alpha ssl2- cells were able to inactivate a-factor. Complementation analysis showed that ssl2 and sst2, a mutation originally isolated as conferring supersensitivity to alpha factor to MATa cells, are lesions in the same gene. The ssl1 gene was mapped 30.5 centiMorgans distal to ilv5 on chromosome XII. PMID- 2695826 TI - Molecular cloning, overexpression and mapping of the slt gene encoding the soluble lytic transglycosylase of Escherichia coli. AB - The gene of the major autolysin of Escherichia coli, the soluble lytic transglycosylase (Slt), was isolated from an expression gene library. The cloned slt gene was used to determine its chromosomal map position adjacent to trp R at 99.7 min on the E. coli linkage map. PMID- 2695827 TI - Plasmid multimerization is dependent on RAD52 activity in Saccharomyces cerevisiae. AB - A mutant plasmid, pX, derived from the 1453 base pair small plasmid, YARp1 (or TRP1 RI circle), consists of 849 base pairs of DNA bearing the TRP1 gene and the ARS1 sequence of Saccharomyces cerevisiae and, unlike YARp1 and other commonly used yeast plasmids, highly multimerizes in a S. cerevisiae host. The multimerization of pX was dependent on RAD52, which is known to be necessary for homologous recombination in S. cerevisiae. Based upon this observation, a regulated system of multimerization of pX with GAL1 promoter-driven RAD52 has been developed. We conclude that the regulated multimerization of pX could provide a useful model system to study genetic recombination in the eukaryotic cell, in particular to investigate recombination intermediates and the effects of various trans-acting mutations on the multimerization and recombination of plasmids. PMID- 2695828 TI - Membrane alterations in health and disease with particular reference to immune function and cancer. AB - Ever since the early microscopists and experimental biologists distinguished the fundamental differences between the animal and plant cells, investigations on the structure and function of the cell membrane have become a fascinating field of biomedical research. The membranes of all types of cells provide the biological border, and maintain the integrity of the cell by protecting it from toxic insult rendered by chemicals, biochemicals, toxins etc. The toxic damage of the cell membrane results in an alteration of the transport mechanism or transmits a message for altered DNA, RNA and protein synthesis, vis-a-vis altered cell division which ultimately leads to death of the cell. In fact, the ligand receptor binding, with particular reference to toxicants of different kinds, may alter the normal physiological function of the cell. If the damaged cell is involved in immune function, the host becomes more susceptible to infection. Prolonged immunosuppression may predispose the host to develop cancer, although cancer cells themselves originate as a result of genetic damage caused by environmental toxicants, endocytosed after binding with membrane receptors, finally reaching the genomic material to cause carcinogenic alteration. The phenomena of membrane binding, transmission of message, processing of message and eventual alteration of biomolecular structure consequently resulting in a disorder or disease process are described in the present communication. PMID- 2695829 TI - Effects of membrane acting-drugs on plasmodium species and sickle cell erythrocytes. AB - The effects of several membrane-acting drugs on malaria and sickle cell anemia was studied. In the initial experiments, propranolol and W-7 were shown to increase red cell density. In vitro, these drugs inhibited the growth of P. falciparum. However, in vivo experiments using the murine malarial parasite, P. vinckei, demonstrated little, if any, anti-parasite activity with the doses of drugs employed. Subsequently, prostaglandin oligomeric derivatives were found to inhibit the growth of P. falciparum in vitro and P. vinckei in vivo. Since prostaglandin oligomers inhibited the formation of dense, dehydrated cells (irreversible sickle cells), they may also have therapeutic efficacy in sickle cell anemia. PMID- 2695830 TI - The nomenclature and conformational analysis of lipids and lipid analogues. AB - Lipids form an essential part of the biomembrane and it is of paramount importance to study their conformational aspects. It is found that the present methods of nomenclature for lipids are totally inadequate for describing these diverse amphipathic molecules. Further the existing methods are incompatible in terms of assignment of the absolute configuration. A systematic method for the naming of lipids which is rationally extendible to a wide class of amphipaths is described. The conformational features of the natural glycerolipids as well as a synthetic amphipath containing a glutamic acid moiety known to undergo interesting phase transitions, have been examined in detail using the framework of the current nomenclature system. The implications of the conformational flexibility of these molecules on assemblies of these systems is touched upon. PMID- 2695831 TI - Loss of membrane phospholipid asymmetry during activation of blood platelets and sickled red cells; mechanisms and physiological significance. AB - Membrane phospholipid asymmetry is considered to be a general property of biological membranes. Detailed information is presently available on the non random orientation of phospholipids in red cell- and platelet membranes. The outer leaflet of the lipid bilayer membrane is rich in choline-phospholipids, whereas amino-phospholipids are abundant in the inner leaflet. Studies with blood platelets have shown that these asymmetries are not maintained when the cells are activated in various ways. Undoing the normal asymmetry of membrane phospholipids in activated blood cells is presumably mediated by increased transbilayer movement of phospholipids. This process, which leads to increased exposure of negatively charged phosphatidylserine at the outer surface, plays an important physiological role in local blood clotting reactions. A similar phenomenon occurs in sickled red cells. Phospholipid vesicles breaking off from reversibly sickled cells contribute similarly to intravascular clotting in the crisis phase of sickle cell disease. The loss of membrane phospholipid asymmetry in activated platelets seem to be strictly correlated with degradation of cytoskeletal proteins by endogenous calpain. It is remarkable that membrane phospholipid asymmetry can be (partly) restored when activated platelets are treated with reducing agents. This leads to disappearance of phosphatidylserine from the outer leaflet where it was previously exposed during cell activation. These observations will be discussed in relation to two mechanisms which have been recognized to play a role in the regulation of membrane phospholipid asymmetry; i.e. the interaction of amino-phospholipids to cytoskeletal proteins, and the involvement of a phospholpid-translocase catalyzing outward-inward transbilayer movement of amino-phospholipids. PMID- 2695832 TI - Membrane effects of the polyene antibiotic amphotericin B and of some of its derivatives on lymphocytes. AB - Amphotericin B (AmB) exhibits immunomodulating properties in mice. In vitro studies on lymphocytes, in relation with these properties, are reported here with AmB and two of its derivatives: the N-Fructosyl (N-Fru AmB) and the N thiopropionyl (AmBSH) derivatives. Interactions of these molecules with thymocytes, a sensitive cell type, demonstrated that the extent of binding is not a toxicity parameter. In contrast, membrane fluidity changes have been observed and appeared to be related to toxicity. Experiments performed with normal B lymphocytes have shown that Amphotericin B derivatives were more potent polyclonal B cell activators than the parent compound. To go further in the understanding of these events, we have investigated in a B cell line WEHI 231, the changes in intracellular Ca2+ and membrane potential induced by AmB and AmBSH. The two polyenes were shown to induce membrane depolarization but no intracellular Ca2+ increase. PMID- 2695834 TI - Design of liposomes to improve delivery of amphotericin-B in the treatment of aspergillosis. AB - The efficacy and toxicity of free and liposome intercalated amphotericin-B (Amp B) in controlling Aspergillosis, caused by Aspergillus fumigatus in BALB/c mice were studied. Liposomal Amp-B had higher LD50 (8.1 mg/kg) as compared to that of the free drug (1.2 mg/kg). An improvement in the therapeutic index of the drug was observed with liposomal formulation of the drug. We also focussed on the effect of lipid composition and surface sugar in modulating the therapeutic potency of Amp-B. The most effective liposomal preparation was composed of egg phosphatidylcholine (EPC): L-alpha-phosphatidylethanolamine, dipalmitoyl (DPPE): cholesterol (Chol) in the molar ratio of 6:1:3. Amp-B intercalated into mannose grafted liposomes (LD50 = 9.3 mg/kg) was more effective as compared to the other formulation tested. PMID- 2695833 TI - Mechanisms of transmembrane signalling in human T cell activation. AB - Several monoclonal antibodies directed against a number of T cell surface molecules are used to elucidate the role of these molecules (cell surface molecules) in T cell activation. The activation of T cells via these molecules are both antigen-dependent (CD3/TcR complex) and antigen-independent. Irrespective of their antigen dependency, these monoclonal antibodies activate T cells by a classical signal transduction pathway, in which the binding of monoclonal antibodies to their cell surface receptors leads to activation of phospholipase C resulting in the depolarization of plasma membrane, hydrolysis of IP2 and IP3 and DAG, the 'second messengers'. IP3 leads to mobilization of intracellular calcium to contribute to an increase in [Ca++]i, whereas DAG causes activation and translocation of PKC and an increasing apparent affinity for Ca++. The role of IP4 in the mobilization of intracellular calcium is emerging. In addition, influx of extracellular calcium also contributes to increase in [Ca++]i. The increase in [Ca++]i following activation via some T cell surface antigen is predominantly due to intracellular mobilization of Ca++ (e.g. CD3/TcR complex), whereas activation via other T cell surface antigen, the increase in [Ca++]i is almost entirely due to an influx of extracellular calcium (e.g. CD5 antigen). All these molecules activate autocrine system of T cell growth, namely IL-2 production, IL-2 receptor expression and T cell proliferation. PMID- 2695835 TI - Effect of incorporation of drugs, vitamins and peptides on the structure and dynamics of lipid assemblies. AB - The characteristics of vesicles formed from Dipalmitoyl Phosphatidyl Choline (DPPC) are sensitive to the presence of perturbing molecules such as drugs, peptides, hormones and vitamins. We have used ESR spin labeling and NMR techniques for studying interaction of such molecules with lipid bilayers. ESR spin labeling has been used to monitor thermotropic behaviour of model membranes. Different NMR probes such as 1H, 31P, 13C have been used to gather information regarding the mode of interaction. It has been observed that the model membrane systems respond differently depending upon the localization of the perturbing molecules in the lipid bilayer. Small molecules such as neurotransmitters epinephrine and norepinephrine decrease gel to liquid crystalline phase transition temperature significantly even when present in small amounts. Vitamin E acetate having a hydrophobic hydrocarbon tail orients parallel to the lipid molecule and thereby exhibits dynamics similar to palmitate chain. When the acetate group is replaced by hydroxyl group (alpha-tocopherol), the phase transition becomes broad and the lipid molecules loose freedom of lateral diffusion. This can be attributed to formation of hydrogen bond between the hydroxyl group of alpha-tocopherol and phosphate moiety of lipid. The conformation of antidepressants nitroxazepine and imipramine is significantly altered when embedded in lipid bilayer. Anaesthetic etomidate not only modifies thermotropic characteristics but also induces polymorphism. The normal bilayer arrangement of lipids gets transformed into hexagonal packing. Amino acid tryptophan induces cubic phases in the normal bilayer arrangement of DPPC dispersions. Peptide gonadoliberin shows a reduced internal motion due to the lipid peptide interaction. The major consequences of binding of lipids with externally added molecules are changes in the fluidity and permeability properties of membranes. It has been shown that permeability is effected by the presence of molecules such as propranolol, alpha-tocopherol and its analogue, neurotransmitters, etc. The magnetic resonance methods have thus evolved as power techniques in the study of membrane structure and function. PMID- 2695836 TI - Neurobiology of reproduction in the female rat. A fifty-year perspective. AB - With respect to the ovarian status and the estrous cycle as expressed by the vaginal cytology, it was emphasized that there is only a rough correspondence between the vaginal stages and the days of the cycle. The 4-day cycle tends to be the most frequent, with the 5-day cycle a normal variant. Spontaneous persistent vaginal estrus (SPE), an acyclic state occurring in older adult rats, reflects the presence in the ovaries of large vesicular follicles failing to luteinize and, hence, the absence of corpora lutea once the condition becomes well established. Pseudocyclic fluctuations in the vaginal smear during SPE resemble those in ovariectomized rats treated chronically with estrogen. The age of onset of SPE varies among different rat strains, appearing as early as 5 or 6 months in the DA and CD strains, but rarely before 12 months in the O-M strain. O-M/DA hybrids were intermediate. In the DA strain there was also a marked influence of length of daily illumination on the occurrence of SPE: exposure to 10 hours or less of light per day restored cycling to rats that had already shown SPE while exposed to longer days. An hereditary influence of age was also apparent in the rapidity with which continuous illumination induced persistent estrus (LLPE). Young DA females rapidly entered LLPE within 10 days, while young O-M females remained cyclic for 5 weeks. Hybrids again were intermediate. At middle age. O-M rats became as responsive as young rats of the DA strain. Like SPE in DA rats. LLPE was reversible, for estrous cycles returned after daily exposure to light was reduced. The special sensitivity of DA rats to lighting may have been a trait acquired from outcrossing with wild gray rats in years past. Normal cycling could be restored in SPE rats by daily injection of progesterone at low dosage. The same effect followed isolated treatments with progesterone upon return of proestrus/estrus after interruption of SPE. This was the first demonstration of positive feed-back of progesterone, the first sign of its biphasic action, and an indication that progesterone facilitates the action of estrogen in promoting ovulation. When progesterone treatment was delayed after proestrus/estrus there was progressively lower effectiveness during the next 10 days. Indirect support of regular ovulatory cycles resulted from treating DA SPE rats with prolactin (PRL) daily at low doses, provided that an initial set of corpora lutea was first induced by other means.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2695837 TI - [Number and frequency of upper anterior artificial teeth]. AB - By this study, a survey has been made of the number and frequency (percentage) of the selections made by form of Trubyte Bioblend artificial teeth applied to 1,507 cases of removable denture fitted for 17 years from Number, 1971, to November, 1988, at Department of Prosthodontics, Dental hospital in Nihon Univ. School of Dentistry at Matsudo. As a result, significantly high selecting frequency was observed of all forms as: 2 forms of Square Tapering in 548 cases (36.4%) and Tapering Ovoid in 270 cases (17.9%); and by sex, single form of Square Tapering in 253 male cases (48.8%) and 2 forms of Square Tapering in 295 cases (29.9%) and Tapering Ovoid in 234 cases (23.7%). PMID- 2695838 TI - [Cross sectional study of removable partial denture design in general practitioners]. AB - Many reports have been made on statistical observation on prostheses, among which removable partial denture frequently becomes the subject of investigation from the two sides of cross- and longitudinal- sectional surveys, because its constituent factors are divergent. However, many of such reports used, as subject, the removable partial dentures fitted at clinical practices at the hospitals affiliated to dentistry universities (dentistry departments), and it is hard to say that these reports have grasped the actual circumstances in which removable partial denture is involved since each therapeutic principle as educational hospital constitutes its own specific environment, if the fact that difference occurs in the selecting criteria for each constituent factor according to the operators' designing conception and medical environment is taken into consideration. Then, we have made investigation of edentulous pattern and kinds of denture base material and retainers in 141 cases with removable partial denture fitted at general practitioners, and the following conclusions have been reached. 1. Among the direct retainers of free-end denture, those of clasp with distal rest (Aker's clasp) were the largest in number. 2. By base material, among the direct retainers of free-end denture, many of those of Bar type which has mesial rest (RPI clasp) were observed, in case of metal base, compared with resin base, but difference was observed in the frequency of use of the other retainers. 3. Free-end denture held a majority both in the upper and lower jaws. 4. As base material, resin base was overwhelmingly large in number, compared with metal base. PMID- 2695839 TI - Localization and characterization of dystrophin in muscle biopsy specimens from Duchenne muscular dystrophy and various neuromuscular disorders. AB - Dystrophin, surmised to be the causative protein of Duchenne muscular dystrophy (DMD), was studied for its intracellular localization and characterization by immunostaining and Western blotting using antidystrophin antibodies. In normal controls and in patients with various neuromuscular diseases other than DMD and Becker's muscular dystrophy (BMD), dystrophin was detected homogeneously on the entire surface membrane of the muscle fibers, whereas it was absent in DMD patients and partially observed in BMD cases. The density of dystrophin was low in BMD and female DMD patients. In mouse skeletal and cardiac muscles, too, dystrophin localized in the muscle surface membrane, and its presence in the brain was also suggested. However, dystrophin was not detected in mdx mice. These data suggest that myofiber necrosis in DMD patients and mdx mice is likely to be the result of plasma membrane instability. PMID- 2695840 TI - The positive inotropic effect of epinephrine on skeletal muscle: a brief review. AB - Chronic and acute administration of epinephrine or related sympathomimetic agents are typically prescribed for the treatment of clinical disorders such as hypotension, anaphylactic and allergic reactions, and bronchial asthma. In addition to its effects on these infirmaties and on carbohydrate metabolism, epinephrine also exerts a positive inotropic effect on fast-contracting skeletal muscle in a variety of animal species. At present, the precise mechanisms responsible for the inotropic effect are not known. This communication reviews the positive inotropic effects of epinephrine on fast-contracting skeletal muscle and discusses possible mechanisms which might mediate this phenomenon. Epinephrine potentiates muscle twitches via the second messenger, cAMP, secondary to hormone binding to membrane-bound beta-receptors. Cyclic AMP then acts to increase carbohydrate metabolism, alter sodium/potassium exchange, phosphorylate myosin isozymes, and/or alter intracellular calcium exchange. Based on theoretical grounds, the first three mechanisms can be excluded. Therefore, it is tentatively hypothesized that the effect is due to cAMP-enhanced calcium exchange within the muscle fiber and/or to increased influx of extracellular calcium. This notion is consistent with the mechanism of the positive inotropic effects of epinephrine on cardiac tissue. If this hypothesis is correct, it would also suggest a role, at least under some conditions, for extracellular calcium in the process of skeletal muscle excitation-contraction coupling. PMID- 2695841 TI - In vitro antifungal activity of saperconazole (R 66905) against Candida and Torulopsis. AB - The susceptibility of several strains of Candida and Torulopsis to saperconazole, a new triazole antifungal compound, was compared to that of ketoconazole. The MICs of the two antifungal agents were determined against 70 strains of Candida albicans, 10 strains of C. guilliermondii, 10 strains of C. krusei, 10 strains of C. parapsilosis, 10 strains of C. pseudotropicalis, 10 strains of C. tropicalis and 15 strains of Torulopsis glabrata. The fungistatic activity was evaluated by the agar dilution method using BHI and casitone media after incubation for 48 hours at 28-30 degrees C. The in vitro activity of saperconazole was similar to that of ketoconazole for most of the Candida spp. tested except for C. krusei in particular. An MIC of less than or equal to 3.12 micrograms/ml for saperconazole was found with 92% of the C. albicans strains tested. In contrast, T. glabrata was more susceptible to ketoconazole. PMID- 2695842 TI - Scanning electron microscopic pattern of recurrent vaginitis by Candida albicans in the mouse. AB - The scanning electron microscopic pattern of the development of yeasts of Candida albicans on the vaginal mucosa of mice in oestral phase, was studied in four consecutive infections performed at 30 d intervals. The findings were practically identical following the 1st and 2nd infections, evidencing a progressive mycelial development starting from 12 to 72 h after inoculation with C. albicans yeasts. In the 3rd and 4th infections the mycelial tufts appeared extremely reduced in number and size, although there was an acceleration in the early evolutive phases and the filamentation process had already started 6 h after infection. It can be concluded that, after successive infections with C. albicans, mouse vaginal mucous membrane develops a local state of resistance evidenced by the decrease in mycelial tufts. The possible causes of the early onset of the filamentation process are discussed. PMID- 2695843 TI - Candida albicans gastrointestinal colonization and invasion in the mouse: effect of antibacterial dosing, antifungal therapy and immunosuppression. AB - Infant mice infected with Candida albicans by the oral-intragastric route became colonized in the gut and were persistently colonized into adulthood. Faecal levels of Candida were correlated with total gastrointestinal Candida and provided a useful means of detecting yeast overgrowth or elimination. Antibacterial agents promoting Candida overgrowth when given by the oral or parenteral route included ceftriaxone, augmentin and cefoperazone. Ceftizoxime had less effect. Ceftazidime and latamoxef produced raised levels only by the oral route. Gentamicin, vancomycin and metronidazole did not affect the Candida levels. Dosing with some antibacterials promoted an increase in gastrointestinal Candida and invasion to a greater extent than immunosuppression. Antifungal therapy to reduce gastrointestinal colonization was investigated using amphotericin B, nystatin, ketoconazole, intraconazole and fluconazole. Fluconazole was most effective at reducing faecal Candida. PMID- 2695844 TI - Cryptococcus neoformans var. gattii Vanbreuseghem and Takashio, 1970. PMID- 2695846 TI - [Gene technology and biological safety]. AB - A "European Biosafety Workshop on the Uncontained Use of Modified Organisms in the Environment" was held in Berlin on 27-30 November 1988. The author's concluding remarks are given here in a free German translation. The article briefly summarizes the overall conditions for a general evaluation of potential benefits and risks that may be associated with the use of genetically modified organisms. PMID- 2695845 TI - [Regulation of liver functions by autonomic hepatic nerves]. AB - The liver is the glucose reservoir of the organism and moreover an important blood reservoir, which takes up or releases glucose and blood depending on demand. Activation of the sympathetic nerves increases glucose release, shifts lactate uptake to output and reduces a.o. oxygen uptake. Moreover, it elicits a reduction of blood flow, and, by closing of sinusoids, an intrahepatic redistribution as well as a mobilization of blood. Activation of parasympathetic nerves enhances glucose utilization and causes a re-opening of closed sinusoids. The actions of sympathetic nerves can be modulated by hormones. Extracellular calcium as well as the mediators noradrenaline and probably also prostaglandins are involved in the signal chain. Intracellularly the signal chain is propagated by an increase of cytosolic calcium. PMID- 2695847 TI - [Dowel and core systems for endodontically treated molars--in vitro loading]. AB - The restoration of broken down pulpless molar teeth generally implies the provision of a cast post and core with a crown. In this experiment the failure resistance of some restoration methods utilizing amalgam and composite resin was investigated under an oblique load. Significant differences could be detected between the cast dowel and core, the methods utilizing composite resin and the methods utilizing amalgam. All systems could resist forces of more than 1000 Newton. PMID- 2695848 TI - [Decision making analysis and the diagnosis of approximal caries]. AB - A decision tree approach to dental caries diagnosis has been described, using information obtained from the literature on caries prevalence and on the accuracy of dentists when using a mirror and probe or bitewing radiographs for diagnosing doubtful approximal carious lesions. In this example, three different diagnostic pathways are compared with the pathway 'no dental examination'. The expected value of clinical information was calculated for the three pathways as were the predictive values, positive and negative, for the various test combinations. In a sensitivity analysis the caries prevalence and diagnostic accuracy were varied for the above calculations within realistic levels. Extrapolations from the results indicated that the procedure 'probe and look' is counter productive at low caries prevalence, since, for all pathways, diagnosing 'sound' surfaces as having dentine caries becomes an increasing problem. This decision making approach highlights the fact that more information on the diagnostic process is needed before recommendations about changing diagnostic criteria, pathways or techniques are made. In particular the diagnostic accuracy of dentists using radiographs and especially the weighting they put on different diagnostic outcomes should be investigated. PMID- 2695849 TI - [Oral stereognosis test in patients with complete dentures]. AB - An oral stereognosis test was performed in patients with complete dentures. Two groups were selected: patients without complaints of their dentures of professionally assessed poor quality and patients with complaints of professionally assessed good dentures. There was no statistical significant correlation between the measure of scores of an oral stereognosis test and the presence of complaints related with the dentures. PMID- 2695850 TI - [The single, hollow titanium cylinder implant (I.T.I.)]. AB - In cases of extreme bone loss of the edentulous jaw, nowadays, implants are suitable to create retention and stabilisation for the dentures, next to the wellknown preprosthetic surgical techniques. It is also possible to use this implant as replacement of a single tooth or as abutment for a bridge. The single hollow titanium cylinder implant type F is described. Also the surgical technique for application of this implant is explained. In the period October 1983 till December 1987, 126 implants (39 patients) were placed; eight of them are removed (6%). PMID- 2695851 TI - [Maxillofacial prosthodontics. Its possibilities and limitations]. AB - The maxillofacial prosthodontist acts primarily as a member of the head and neck oncology team. Using special methods and techniques, and more or less specific materials, speech, chewing, swallowing and facial expression are to be regained as good as possible. Due to the complexity of several orofacial functions, surgical or prosthodontic rehabilitation cannot always be accomplished. PMID- 2695852 TI - [Materials for osteo-dural reconstruction in the cranium. An update]. AB - Materials available for repair of a bony or dural defect at the cranial level are reviewed with particular attention stressed on their qualities and drawbacks for neurosurgical purposes. These materials include autologous or heterologous bone graft and biologically stable or biodegradable implants. No material can demonstrate ideal qualities of biocompatibility and biofunctionality. It should be either perfectly stable biologically and inert or perfectly biodegradable allowing simultaneous new bone reconstruction; moreover, it should be sterilizable, disposable, easy to handle and of low cost. Autologous grafts (iliac bone, split bone flap, pericranium...) have the best features but irradiated heterologous bone can be used instead; the latter needs a particular organization (bone graft bank) to fill the strict conditions of safety, especially regarding the risks of virus transmission. Implants have more recently been developed (acrylic, coral, B.O.P., ceramic, collagen-vicryl...) and present some drawbacks: generally high cost and not well established or insufficient biological properties. The experience of French neurosurgeons is reported from a questionnaire (102 answers) on the most frequently used materials. Autologous bone grafts, and acrylic as bone substitutes and pericranium for dural repair are preferentially used. Some materials, including coral, B.O.P. and collagen-vicryl, have a decreasing utilisation because of poor results especially with regards to bone incorporation and water tightness. Particular techniques (acrylic + teflon, acrylic with pre-op external casting and even non-repair of bone defects) are proposed by some neurosurgeons. New materials still under experimentation are finally presented (lyophilized bovine pericardium, collagen IV, polylactic acid). PMID- 2695853 TI - [Stereotaxic technics with an open skull in the treatment of space-occupying brain lesions]. AB - When intra-cerebral space-occupying lesions are small or when they are deeply located in the brain parenchyma, it is sometimes difficult to localize them at surgery or to design the most direct and least hazardous surgical approach. Therefore we have developed a method which combines conventional neurosurgical techniques with craniotomy using stereotaxic guidance. We have used the Brown Roberts-Wells (B.R.W.) stereotaxic system which allows for CT scan or MRI guidance and does not interfere with the absolute sterility mandatory every time a flap is created. Eleven patients were operated on using this method. The deep tumors were approached through a linear incision of the cerebral cortex; then a needle fixed in the right position on the arc system of the B.R.W. was inserted toward the surface of the lesion; the exposure was finally widened by the inflation of a rubber balloon set on the stereotaxic needle. The post-operative course was very uncomplicated in all these patients. No permanent post-operative neurological worsening was observed, even after the removal of an intra-thalamic tumor. PMID- 2695854 TI - [Parasellar chondrosarcoma: report of a case operated on through a pteriono temporal approach and review of the literature]. AB - Cartilaginous tumours represent 0.16% of all intracranial tumours; among them 14% are chondrosarcomas (Ch-S). A majority (56%) arise from the skull base, especially from the spheno-occipital and spheno-temporal synchondroses. The others develop at the level of the dura mater convexity, falx and choroid plexuses, probably from ectopic cartilages or mesenchymatous cells with multiple potentialities. Parasellar Ch-S originate from the spheno-temporal synchondrosis and expand inside the cavernous region. With 21 published cases, they represent 51.2% of the 41 skull base Ch-S and 28.7% of the whole 73 intracranial primary Ch S. The authors report a recent case of such a parasellar Ch-S, revealed by a left progressive, and finally total, ophthalmoplegia. The responsible mass, which eroded the lateral part of the sella turcica, was shown partially calcified and not enhanced by contrast medium at CT-scan, and was avascular on angiogram. The tumour, which was identified as a low grade myxoid Ch-S, could be entirely removed through an intradural pteriono-temporal approach. After a two-year follow up, the clinical status was unchanged (total ophthalmoplegia) and the CT-scan did not show any sign of recurrence. The 21 cases of parasellar Ch-S published in the literature are reviewed. PMID- 2695855 TI - Hemodynamic effects of endothelin after systemic and central nervous system administration in the conscious rat. AB - The effects of endothelin-1 (ET-1) administered i.v. or intracerebroventricularly (i.c.v.) on arterial pressure (MAP), heart rate and cardiac output were studied in the conscious rat. Systemic injection of ET-1 (0.1 to 1 nmol/kg i.v.) increased dose-dependently MAP and decreased heart rate. The doses of 0.3 and 1 nmol/kg produced initially transient hypotension and tachycardia which were accompanied by a decrease in total peripheral resistance index (TPRI). Cardiac output was significantly reduced and TPRI increased during the pressor response to 0.3 and 1 nmol/kg ET-1. ET-1 i.c.v. (30 pmol/kg) produced a profound pressor and vasoconstrictor response which was followed by cardiovascular collapse and death within 20 min after i.c.v. injection. Low doses (1 to 10 pmol/kg) of ET-1 i.c.v. had no effect on the cardiovascular system. The present data are in accordance with the studies demonstrating biphasic blood pressure and heart rate responses to i.v. ET-1 in the rat. Profound cardiac depressor and peripheral vasoconstrictor responses were found to accompany the pressor phase. Our results also showed for the first time direct central pressor and vasoconstrictor effects of ET-1 insinuating that endothelin might be a neuropeptide participating in the central cardiovascular control. PMID- 2695856 TI - [Mitral valve insufficiency and Doppler technics. The limits in the quantitative definition of the severity of the regurgitation]. PMID- 2695857 TI - [Effects of simvastatin on plasma levels of lipids, lipoproteins and apolipoproteins in primary hypercholesterolemia]. AB - To evaluate the effectiveness, tolerance and safety of simvastatin (MK 733), a new HMG-CoA reductase inhibitor, a 28-week, single blind study with placebo was carried out on 10 patients suffering from primary hypercholesterolaemia. All patients followed the AHA Phase 1 or Phase 2 diet and underwent active treatment for 24 weeks with increasing doses of simvastatin from 10 to 40 mg in a single evening administration. A reduction in plasma levels of total cholesterol (-29%, p less than 0.001 and -41%, p less than 0.001), LDL cholesterol (-35%, p less than 0.001 and -49%, p less than 0.001), VLDL cholesterol (-9%, ns and -38%, ns), Apo-B (-27%, p less than 0.005 and -37%, p less than 0.001), Apo-A2 (-3%, ns and 3%, ns), and triglycerides (+2%, ns and -10%, ns), was obtained in the VIth and XXIVth week. There was also an increase in HDL cholesterol (+4%, ns and +17%, p less than 0.05), HDL2 subfractions (+9%, p less than 0.05 and +36%, p less than 0.05), HDL3 (+3%, ns and +11%, ns) and Apo-A1 (+7%, ns and +4%, ns). In all patients, simvastatin was generally tolerated and there were no clinical, laboratory or ophthalmological side-effects related to the drug. If long-term studies confirm its safety, simvastatin will offer excellent prospects for the prevention of ischaemic cardiopathy. PMID- 2695858 TI - [Pre-operative identification of patients at risk for septic complications after surgery for neoplasms of the digestive system. A multiphasic multicenter study]. AB - One hundred ninety-six patients undergoing surgical treatment for digestive tract cancer were recruited in a polycentric, multistep study to value significant differences of pre-operative nutritional and immunologic parameters between patients with or without post-operative infections. Such parameters might be useful for the identification of "septic risk" patients. Primarily, 63 patients were given a complete anthropometric evaluation, laboratory screening and immunologic assessment (surface marker analysis of peripheral blood mononuclear cells, polymorphonuclears in vitro chemotaxis and phagocytosis). Only a few serologic parameters were significantly reduced in patients with post-operative infections, namely: total serum proteins (p less than 0.02), albumin (p less than 0.02), beta-globulins (p less than 0.01), and C3c (p less than 0.05). These parameters were elaborated with Fisher's linear discriminant function to detect the optimal discriminant threshold able to identify "septic risk" patients. The predictivity of this discriminant function was validated in a second group of patients (n = 49) in which total serum protein with electrophoresis were pre operatively assayed as well as skin test reactivity to intradermal injection of recall antigens (Multitest skin-testing); discriminant sensitivity was 80%, the specificity 50%, and positive predictivity 62%. This low discriminant power of the equation based only on serum proteins assessment coupled with the significant negative relationship between skin testing and post-operative infections (male, p less than 0.005; female, less than 0.025) suggested a re-elaboration of the discriminant function, including the skin-testing score. The definite assessment of this new discriminant equation was evaluated in the third sample of patients (n = 84) which showed 67% sensitivity, 88% specificity, and 76% positive predictivity, thus suggesting the high reliability of this test for the pre operative selection of "septic risk" patients. PMID- 2695859 TI - [Use of elemental diet in intestinal lesions]. AB - The recognition of potentially noxious physiological substances in the intestinal milieu, prompted the use of an "elemental" semi-hydrolysed formula diet in the prophylaxis of experimental acute ischemic enteropathy. An elemental diet protects the intestinal mucosa of rodents from radiation injury and facilitates mucosal healing. Clinical trials have shown the benefits of this form of treatment in the prevention of acute radiation enteritis and therapy of delayed enteropathy and Crohn's disease. PMID- 2695860 TI - [Usefulness of supplemental treatment with glypressin during the eradication phase of esophageal varices using endoscopic sclerotherapy]. AB - The response of 20 patients with oesophageal varices randomly assigned to treatment by endoscopic sclerotherapy with or without adjuvant Glipressina was assessed on the basis of the following parameters: mean eradication time for oesophageal varices and frequency of bleeding during that period. The preliminary results suggest that the drug may have a favourable influence on both eradication time and bleeding in sclerotherapy. PMID- 2695861 TI - [Alizapride in upper digestive endoscopy. A double-blind study vs metoclopramide and placebo]. AB - In order to assess the antiemetic properties of alizapride in the specific context of premedication for endoscopy, a double blind test was conducted on 100 patients against both metoclopramide and a placebo. Efficacy was assessed on the basis of the following parameters: technical judgement of the endoscopist; assessment of evident signs of "discomfort" by an outside observer; comparative judgement (better, worse, same) of the patient's condition after the two endoscopies performed. In the case of the first two parameters, alizapride proved significantly more effective than the control substances. The patients themselves only expressed a significant preference for alizapride vis-a-vis the placebo. It is concluded that given its efficacy and the absence of side effects, alizapride is of value in premedication for endoscopy. PMID- 2695862 TI - [Preventive role of pirenzepine in gastric damage during cytostatic therapy. A controlled randomized double-blind study with placebo]. AB - Steroids and cytostatic drugs have an undoubtedly damaging action on the gastroduodenal mucosa. The action of pirenzepine was compared with that of the placebo in preventing the gastroduodenal lesions brought on by antiblastic therapy. Sixty patients were separated into two random group under double blind conditions and received 100 mg/die/os of pirenzepine or equivalent placebo for a continuous period of 12 weeks. Antiblastic drugs were administered at the same time. Final endoscopic control and symptomatological findings showed a statistically significant different in favour of the pirenzepine-treated group as early as the 6th week of treatment. No side-effects attributable to pirenzepine were reported. PMID- 2695863 TI - [The screening of thyroid tumefactions by real-time echography. Preliminary data]. AB - Recent experience in the ultrasound study of thyroid swellings is reported. The results are discussed and it is pointed out that for accurate differential diagnosis of the thyroid pathology examined ultrasound data must be backed up by scintigraphic studies of the gland and if necessary by needle biopsy. PMID- 2695864 TI - [The plague as a divine scourge. Plague infections in Monferrato and particularly the epidemic of 1522-1530 in Casale, the capital]. AB - Plaque mortality in the Monferrato area, especially in the first half of the 16th century, is discussed. The scourge struck a population that was prey to marauding soldiers from all the armies that looked at the Monferrato area as easy plunder. Promiscuity and the poor living conditions of the time did not permit effective defence against epidemic infections and the misery in which the population lived made contagion easy. One interesting element is the resort to fire to destroy everything infected or suspected to be so as the only possibility of defence as rules of hygiene were totally lacking. PMID- 2695865 TI - [Fibroleiomyoma in adolescents. Apropos of a case]. AB - A personal observation of an uterine myoma in teenagers led the Authors to evidence the exceptionality of this clinical case. With regard to therapy, myomectomy is the most effective treatment. PMID- 2695867 TI - [Hysterectomy in obstetrics. Analysis and comparison of a group of cases from the Italian and the international literature (536 cases)]. AB - The Authors made a comparison between the frequency of obstetric hysterectomies carried out at the "La Sapienza" University Obstetrics and Gynaecology Departments and of those reported in international publications regarding Great Britain, USA, Australia, Saudi Arabia and Libya. Data obtained covered the 462 hysterectomies effected out of the 442,174 births from 1972 to 1895. Results were compared as under: general frequency per number of births, reasons for surgery, type of operation carried out, age of the patient, gestation period, obstetrical history and complications. PMID- 2695866 TI - [Effects of low-dose oral contraceptives on sugar metabolism]. AB - The effects on carbohydrate metabolism by four low-dose oral contraceptives were evaluated in four low-dose oral contraceptives were evaluated-66 young women randomly divided in four groups. In the various preparations there were a different dosage of estrogen (ethinylestradiol) together different doses and types of progestogen (desogestrel, gestodene, cyproterone acetate). After six months of treatment, in all groups a slight increase of glycemic and insulinemic responses during OGTT was observed; the significance was achieved with the preparation containing cyproterone acetate alone. Glycated hemoglobin did not change. Our results suggest that these new low-dose oral contraceptives induced negligible metabolic side effects. PMID- 2695868 TI - [Surgical stress and anesthetic protection]. AB - Surgical pain triggers a series of neuro-endocrine change in the patient's organism both during the operation and at the post-operative stage, exposing the patient to a parapathological and quite afinalistic situation. It is the task of anaesthesia to prevent these adaptation reactions setting in or at least to attenuate them. Various anaesthesiological techniques are compared and results are examined with a view to establishing what technique is capable of procuring most anaesthesiological "protection". PMID- 2695869 TI - [Gynecologic and obstetric implications of female circumcision in Somalia]. AB - Some historical and cultural notes on the traditional practice of female circumcision are presented, the various forms and features of the population of Somaliland being described. The complications of circumcision are illustrated, particularly its most mutilating form (infibulation) which can present to the observation of the gynaecologist, together with a summary description of some clinical cases. Finally, mention is made of the current and future outlook for the spread of this traditional mutilating practice. PMID- 2695870 TI - Which therapy for Graves' hyperthyroidism in children? PMID- 2695871 TI - [Ways to increase the information value of ultrasonic studies in the diagnosis of intraocular tumors]. AB - The paper discusses possibilities to increase information value of ultrasound investigations in diagnostics of intraocular tumors by means of a developed informative system of acoustic diagnostics ISAD-2 on the basis of a microcomputer "Electronika-60" (OVK-2) and broad-band ultrasound piezo-transformer with a working frequency from 2 to 20 mHz. Examination of 50 patients (50 eyes) with suspected intraocular tumors resulted in enucleation of the eye ball in 45 patients (45 eyes). Comparison of ultrasound and histomorphologic investigations revealed a correlative connection between the structure of intraocular tumor and the texture of their radio-frequency echograms as well as with relative frequency dependence of ultrasound attenuation in it. The possibility of in vivo detection of the tumorous process influence on the eye ball sclera and extrabulbar invasion of the tumor is determined. Different data bases are created which consider questionnaire data of examined patients, ecologic situation, the factor of a genetic risk, results of ultrasound and histomorphologic investigations, etc. Amalgamation of data bases makes it possible to classify intraocular tumors by different informative signs and to identify them depending on their microstructure. PMID- 2695872 TI - [Differential diagnosis of neoplasms of the lacrimal gland using ultrasonic scanning]. AB - The paper describes results of ultrasound scanning in 32 patients with new formations in the lacrimal gland area, using a device "Ophthalmoocuscan, Model 200 A" (USA), with ultrasound fluctuation frequency--10 mHz, exposition time of probing impulse--0.2 microseconds. It was found that in case of lacrimal gland pathology the highest information value is received when the probe is placed at the superior external margin of the orbit and its scanning surface is directed on the site of the lacrimal gland projection. Characteristics of scanograms of different histologic types of new formations in the lacrimal gland area described: those of pleomorphic adenoma, adenocarcinoma, lymphoma, inflammatory pseudotumor, retention cysts. Typical scanograms were obtained in 78.1% of patients. The obtained characteristics of scanograms are recommended to be used in a complex with other methods for differential diagnostics of lacrimal gland new formations of different genesis. PMID- 2695873 TI - [Suture material in microsurgery of the anterior eye segment]. PMID- 2695874 TI - Hemostatic effects of air versus fluid in diabetic vitrectomy. AB - The potential hemostatic effect of an intravitreal air bubble after diabetic vitrectomy was studied in an animal model and in a randomized clinical trial. One day after vitrectomy with induced intraoperative hemorrhage, vitreous cavity hemorrhage was present in 60% of air-filled rabbit eyes compared with 27% of fluid-filled eyes. The prevalence and extent of hemorrhage was equal in the two groups on postoperative days 3 and 7. In a clinical trial of 51 eyes undergoing diabetic vitrectomy, 70% of eyes randomized to air-filled vitreous cavity after vitrectomy had vitreous cavity hemorrhage on postoperative day 1 compared with 50% of fluid-filled eyes. At 1 week, the incidence of hemorrhage was 78% for air and 61% for fluid. The 6-month visual and anatomic results were similar in both groups. These findings suggest that an intravitreal air bubble neither improves hemostasis nor reduces the visual outcome after diabetic vitrectomy. PMID- 2695875 TI - Uveal melanoma radiation. 125I brachytherapy versus helium ion irradiation. AB - The optimum radiation therapy for uveal melanoma is uncertain. Both helium ion irradiation and 125I brachytherapy have been used to treat this neoplasm. This investigation analyzed the control and complication rates of uveal melanomas treated with helium ions of 125I plaques. In both a retrospective and a prospective dynamically balanced study, the control rates appeared to be similar. There were more posterior segment complications after 125I plaques and more anterior segment complications, including neovascular glaucoma, after helium ion irradiation. The follow-up period is too short to draw definitive conclusions on the radiation complications. Overall, approximately 89% of eyes were retained and less than 4% of treated eyes were removed because of failure to control the tumor. PMID- 2695876 TI - Sorsby's fundus dystrophy. AB - Ever since Sorsby described his pseudoinflammatory dystrophy in five families, its characteristics have been unclear. The findings in ten affected members of a seven-generation pedigree are discussed and the literature is reviewed. Patients with this dominantly inherited fundus dystrophy lose central vision between the second and fourth decade of life. Three variations in the fundus appearances were distinguished: in the first and most common, white to yellow fundus spots (which are not drusen) accompany a disciform macular degeneration; in the second, the fundus spots are absent; in the third, the yellow deposits are associated with atrophic macular degeneration. Atrophy of the retina, pigment epithelium, and choroid then slowly progresses toward the periphery. Treatment does not halt the progress of the disease. Although variations in this dystrophy may be examples of genetic heterogeneity, Sorbsy's fundus dystrophy is a distinct clinical disorder. PMID- 2695877 TI - Pneumatic retinopexy, revisited. PMID- 2695878 TI - [Artificial synovial fluid for the joints]. AB - The author presents the results of his biomechanical, experimental and clinical studies to produce an artificial synovial fluid for therapeutic correction when administered intraarticularly in inflammatory and degenerative diseases, traumas and operations on the joints. According to the results of the rheologic investigations, the 15% aqueous solution of mean molecular polyvinylpyrrolidone (PVP) and its complex with a biopolymer (PVP-hyaluronate) turned out to be most similar to the natural synovial fluid of the joints. The experimental studies (201 rabbits) revealed a suppression of the inflammatory process in the joints and an antiadhesive action of the artificial synovia which improved the metabolism of the acetabular cartilage and the functions of the joints. In the clinical part of the study (514 patients) the preparations of the artificial synovial fluid and its complexes with other drugs were administered intraarticularly to the patients with rheumatoid arthritis and deforming osteoarthrosis. An improvement in many values of the function of the joints and of the laboratory and biochemical data has been revealed. There have been no side effects in the patients under study; an improvement in the working ability has been noted, including the evaluation of the long-term results (1 to 10 years). PMID- 2695879 TI - [The role of the Kiev Institute of Orthopedics in the founding of the traumatologic and orthopedic services]. PMID- 2695880 TI - A review of the clinical applications of the pattern electroretinogram. AB - The pattern electroretinogram (PERG) has recently been introduced as a clinical procedure. It has been thought by many to represent activity of the retinal ganglion cells, although this is still a matter of contention. The exciting prospect of a selective test of ganglion cell function led to the application of the PERG in a variety of ophthalmological conditions. In the course of these investigations the PERG was found to be diminished in cases of maculopathy, optic atrophy, optic neuritis, toxic optic neuropathy, neurotransmitter disorders, glaucoma and ocular hypertension and in retinal vascular disorders such as diabetes. It was also affected in some cases of amblyopia. This paper briefly describes the techniques used to record the PERG and reviews current literature pertaining to its clinical application. PMID- 2695881 TI - Alternatives to toric contact lens fitting--for regular and irregular astigmatism. AB - Although toric contact lenses have improved in design and development and their use is increasing, further consideration should be given to the alternative methods of astigmatism correction by contact lenses. Much can still be achieved by non-toric lens, both for a wide range of astigmatism and for ease of supply. A number of these alternatives are examined, their advantages and disadvantages reappraised, and the merits of lens correction compared with surgical methods considered. PMID- 2695882 TI - A brief review of magnetic fields from the human visual system. AB - Both the eye and brain generate magnetic fields when stimulated with a variety of visual cues. These magnetic fields can be measured with a magnetometer; a device which uses superconducting technology. The application of this technique to measuring the magnetooculogram, magnetoretinogram and visually evoked fields from the brain is described. So far the main use of this technique has been in pure research. Its potential for diagnosing ocular and neurological diseases is discussed. PMID- 2695883 TI - [Therapeutic value of flavonoids in Rhinovirus infections]. AB - The clinic evaluation of the canadian pharmacologic agent "propolis" verified its value known from the literature in common cold infections. 50 persons were treated in ENT Clinic of Marcinkowski's Medical Academy in Poznan during the 1987 year. The observed therapeutic effects were shortening of the disease duration. The regression of symptoms occurred in the first day of the therapy and the complete recovery followed in 1 day in 5 patients, in 2 day in 16, and in 3 day in 3. The placebo group has his full recovery in mean 4.80 days. In the therapeutic group the symptoms lasted 2.5 time shorter than in placebo one. PMID- 2695884 TI - [Treatment of sudden deafness of vascular etiology with venoruton]. AB - The sudden deafness of vascular origin was treated by Venoruton. 4 patients were observed with positive results as improvement of hearing acuity and disappearance of tinnitus. PMID- 2695885 TI - [Nosocomial infections caused by multi-resistant Serratia marcescens at a university clinic--clinical aspects and drug resistance]. AB - Serratia marcescens (S.m.) has become increasingly important as a nosocomial pathogen and displayed an increasing resistance to antimicrobial agents in the past decade. We recently studied in 1985 and 1986 an epidemic caused by multi resistant S.m. strains that involved 27 infants and 1 adult patient. 14 neonates (in most cases very low birth weight infants) in a neonatal intensive care unit developed a S.m.-septicemia and/or meningitis, 11 of them died. In a ward for young infants with congenital heart diseases 13 patients suffered a S.m. infection and one patient died in the adult intensive care unit in consequence of a S.m. septicemia. PMID- 2695886 TI - [Newborn infants of mothers with endocrinopathies]. AB - When pregnancy and endocrinological disease evolve together, the course of the endocrinological disease and/or the pregnancy and/or the development of the fetus can be altered. Pathophysiological interactions and their therapeutic consequences are reviewed regarding 21-hydroxylase deficiency congenital adrenal hyperplasia, ovary and adrenal virilizing tumours, Addison disease, primary hyperaldosteronism, pheochromocytoma, Graves' disease, Hashimoto thyroiditis, primary hypothyroidism, primary hypo- and hyperparathyroidism and bromocriptine treatment of hyperprolactinaemia. PMID- 2695887 TI - [Newborn infants of psychotic mothers]. AB - Pregnancy in women with psychotic disorders raises the problems of its advisability in such a psychiatric condition, of its fetal consequences, and of the child's future. The acceptance of pregnancy depends on the disease and the physician. Fetal consequences are mainly related to the use of psychotropic drugs because of their possible teratogenic effects, of neonatal intoxication and of postnatal withdrawal syndrome. The long-term outcome is conditioned by the quality of the mother-to-child relation, which needs frequent controls during the first years of life. PMID- 2695888 TI - [Children born to mothers with malignant disease]. AB - In contrast to widespread opinion, recent statistical data show that children born to mothers surviving from malignant diseases have a good outcome if radiotherapy has been avoided during pregnancy. Current chemotherapeutic agents are well tolerated by the developing fetus even in the first trimester of pregnancy. Offspring of patients treated for cancer in childhood bears no more risks of cancer than controls with the exception of the rare cases of hereditary predisposition to cancer. PMID- 2695889 TI - [Hemolytic uremic syndrome and febrile urinary Escherichia coli infection]. AB - The authors report on 2 cases of hemolytic uremic syndrome in 2 infants during a febrile Escherichia coli urinary tract infection. They discuss the role of urinary tract infection in the occurrence of hemolytic uremic syndrome and the possible role of specific Escherichia coli strains. PMID- 2695890 TI - [Which treatment for primary tuberculosis?]. AB - Primary tuberculosis should be treated in all cases. In adults, the total treatment course for pulmonary tuberculosis can be shortened to 6 months. If the disease is not symptomatic, the rifampicin-isoniazid combination (10 mg/kg/day each) appears to be preferable to single drug therapy. In patients with symptomatic disease, pyrazinamide (30 mg/kg/day) should be added during the first 6-8 weeks and in some cases, corticosteroid therapy is also required. The drugs are usually well tolerated, but hepatic function should be monitored. PMID- 2695891 TI - [Monitoring and treatment of toxoplasmosis in the pregnant woman, fetus and newborn]. AB - A protocol of monitoring and treatment in toxoplasmosis is suggested by the authors. During pregnancy, the administration of spiramycine at a 9 m UI daily dose remains the basic preventive treatment when a seroconversion occurs after a 4 week post-conception period. In the fetus, the antenatal diagnosis is made by ultrasound started on the 18th week after conception and repeated every 4 weeks, amniocentesis and eventually umbilical cord puncture associated with a pyrimethamine-sulfamide drug treatment in case of positive diagnosis. A therapeutic pregnancy termination is considered when lesions have been detected by ultrasound. In the newborn (neonatal or post-natal period), the diagnosis is made by transfontanel ultrasonography, ocular fundi and spinal fluid examination, detection of specific IgM antibodies in cord blood and the evolution and importance of serum antibodies response requiring a drug treatment during 15-18 months with spiramycine and pyrimethamine + sulfadoxine (Fansidar). PMID- 2695892 TI - Reading efficiency and the development of left-to-right writing by the ancient Greeks. AB - Ancient Greeks added vowels to a consonantal language and changed their horizontal writing direction from right-to-left to left-to-right. The idea that the dextral majority in ancient Greece developed left-to-right writing solely because writing efficiency was greater is questioned. Cerebral hemispheric functions that might be involved during fixation pauses in reading suggest that horizontal ancient Greek was read more efficiently from left to right than from right to left, the other direction in which it usually was written. The same considerations suggest that horizontal consonantal scripts are read more efficiently from right to left than from left to right. The importance of boustrophedon, a continuous writing style, in the development of left-to-right writing and aspects of the reciprocity between cerebral hemispheric functioning and writing direction of vocalic scripts are discussed. PMID- 2695893 TI - Bombesin-induced hypothermia in the insulin-treated rat: effect on tail-skin temperature. AB - Bombesin-like peptides are widely distributed in the mammalian central nervous system and appear to participate in the regulation of a variety of autonomic functions. Bombesin has been shown to alter feeding behavior, locomotor activity, and thermoregulation. Microinfusion of bombesin into the preoptic area of the hypothalamus produces a reduction in core body temperature, but only if the rat has been cold-exposed, food-deprived, or pretreated with insulin. The mechanism for bombesin-induced hypothermia under the latter two conditions is unknown. The present study evaluated the possible contribution of peripheral heat loss mechanisms in bombesin-induced hypothermia. Rats were administered insulin (10U/kg, Regular Iletin I i.m.) or saline followed by an intrahypothalamic injection of bombesin (.05 microgram/.25 microliter) or peptide vehicle. Rectal and tail-skin temperatures were measured continuously for 120 min. Changes in temperature were evaluated at 30, 60, 90, and 120 min., using analysis of variance. As previously demonstrated, bombesin produced hypothermia in rats pretreated with insulin. This reduction in core temperature was not associated with any significant alteration in tail-skin temperature. Results suggest that bombesin-induced hypothermia in rats pretreated with insulin may not be mediated by an increase in peripheral heat loss. PMID- 2695894 TI - [Ethics and medication]. PMID- 2695896 TI - [The need for periodontal therapy--an update]. PMID- 2695895 TI - [Periodontics in Norway--a short historical overview]. PMID- 2695897 TI - [Periodontal surgery. Is the need for periodontal surgical procedures indicated as the treatment of choice for the future?]. PMID- 2695898 TI - Dr. Mellor R. Holland: a perspective on achievement, influence, and dedication. PMID- 2695899 TI - Opossum insulin, glucagon and pancreatic polypeptide: amino acid sequences. AB - Pancreatic hormones have been purified from the opossum, a New World marsupial. Opossum insulin contains a Leu substitution at the N-terminus of the B-chain in place of the Phe that is generally present in mammalian insulins. In addition, there are two other amino acid substitutions in the opossum insulin A-chain (positions 8 and 18) compared to pig insulin. Opossum glucagon is identical to chicken glucagon with both differing from the usual mammalian glucagon by Ser in place of Asn at its penultimate C-terminal position. Opossum PP differs from the porcine peptide in only 3 sites (position 3, 19 and 30). PMID- 2695900 TI - Comparison of synenkephalin and methionine enkephalin immunocytochemistry in rat brain. AB - Immunocytochemistry using an antiserum to the C-terminal octapeptide of synenkephalin, proenkephalin(63-70), was performed throughout the rat brain and revealed numerous immunopositive fibers and some cell bodies. The morphology and distribution of synenkephalin immunoreactivity was extremely similar to that of a commercial methionine enkephalin (Met-ENK) antiserum. Colchicine pretreatment allowed the immunostaining of cell bodies not otherwise possible without pretreatment, but did not affect the distribution of immunoreactive fibers. Using 6 microns serial sections, we were able to colocalize synenkephalin and Met-ENK immunoreactivities in gigantocellular neurons of the medullary reticular formation. Preabsorption of the antiserum with [Tyr63]proenkephalin(63-70) octapeptide (YEESHLLA) completely eliminated immunoreactivity in the rat brain, while preabsorption with all other peptides used had no detectable effect. We conclude that our antiserum to synenkephalin is specific for enkephalinergic cell bodies, fibers and terminals. The synenkephalin antiserum used in these studies may have advantages over other antisera utilized for immunocytochemical detection of proenkephalin gene expression. PMID- 2695901 TI - Endogenous opiates: 1988. AB - This paper is the eleventh installment in our annual review of the research during the past year involving the endogenous opiate system. It is concerned with nonanalgesic and behavioral studies of the opiate peptides that were published during 1988. The specific topics this year include stress; tolerance and dependence; eating; drinking; gastrointestinal, renal, and hepatic functions; mental illness; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical activity; locomotor activity; sex, pregnancy, and development; immunology and cancer; and other behavior. PMID- 2695902 TI - Immunohistochemical localization of endothelin in human vascular endothelial cells. AB - The cellular localization of endothelin (ET), a novel vasoconstrictor peptide, was studied in human vascular tissues by immunohistochemistry. Distinct and diffuse staining for ET-like immunoreactivity was demonstrated in the cytoplasm of vascular endothelial cells, but not in smooth muscle cells or adventitial fibroblasts. The specificity was confirmed by the negative results following immunoabsorption. These findings suggest that human vascular endothelial cells function as an endocrine and/or paracrine cells for ET secretion. PMID- 2695903 TI - [Determining the degree of progression of Hodgkin's disease in children before starting combined therapy]. PMID- 2695904 TI - [Therapeutic use of superoxide dismutase as an anti-inflammatory agent]. PMID- 2695905 TI - Diet and coronary heart disease. PMID- 2695906 TI - Lipid-lowering therapy and its effect on atherosclerosis. PMID- 2695907 TI - Mechanisms of excess cardiovascular mortality in diabetes. PMID- 2695908 TI - Therapeutic aspects of hyperlipidaemia in diabetes. PMID- 2695909 TI - Treatment of hypertension in diabetic patients. AB - There is increasing evidence that a slight elevation of blood pressure values may have a deleterious effect on diabetic angiopathy. Hypertensive diabetic patients are prone to suffer clinical and/or biological side effects of antihypertensive agents. More recently calcium antagonists and angiotensin converting enzyme inhibitors have proved effective and better tolerated in hypertensive diabetic patients. New data from the literature and from our group are reviewed. In patients with incipient or clinical nephropathy, angiotensin converting enzyme inhibition reduces urinary albumin excretion and preserves glomerular filtration rate. The effects of treatment of hypertension on blood pressure control obtained in small groups of selected and motivated patients are at variance from those obtained in routine practice. Poor compliance is the major problem in hypertensive diabetic patients. The rationale exists to provide early aggressive antihypertensive treatment in this population but we must develop new drugs that are more effective and better tolerated. We have also to improve health care delivery, information and education for these patients. PMID- 2695910 TI - Prevention of cardiovascular morbidity and mortality in hypertension: benefits of blood pressure reduction and cholesterol lowering. PMID- 2695911 TI - ACE inhibitors and strategies for managing hypertension. AB - Angiotensin converting enzyme inhibitors are effective hypotensive agents, lowering blood pressure in patients with mild to moderate hypertension either alone or in combination with a low dose loop diuretic. They are generally well tolerated and score well in quality of life studies. However, in some patients they do cause cough, which may lead to their withdrawal, and their association with renal failure and death in elderly patients may reduce their usefulness in this age group. Nevertheless they have established a role as first line therapy in patients with asthma and diabetes. PMID- 2695912 TI - Apolipoproteins in lipid transport, an impressionist view. PMID- 2695913 TI - Response of White Leghorn chicks fed ascorbic acid and challenged with Escherichia coli or with corticosterone. AB - This study was undertaken to assess the effects of dietary ascorbic acid on the growth and immunoresponsiveness of chickens when subjected to particular types of stress. White Leghorn chicks were fed diets containing no supplemental ascorbic acid, and ascorbic-acid diet (330 ppm) for 2 days or for 19 days before challenge. Then, half of the females were inoculated with Escherichia coli; half of the males were challenged with dietary corticosterone (30 ppm) for 12 days; and the remaining chicks were maintained as controls. These chicks, reared under "good" husbandry procedures, did not realize advantages in growth or feed efficiency due to the short- or long-term consumption of diets containing ascorbic acid. Incubation with E. coli resulted in considerably higher heterophil to-lymphocyte ratios 24 h after inoculation, and E. coli-induced mortality was higher for pullets on short-term ascorbic acid than for those on long-term or no ascorbic acid. Dietary corticosterone caused differences in body weight and the relative weights of certain organs, regardless of dietary levels of ascorbic acid. The antibody response to red-blood-cell antigens from sheep was enhanced in unchallenged cockerels (no dietary corticosterone) fed ascorbic acid on a long term basis, but dietary corticosterone overshadowed the advantageous effects of dietary ascorbic acid. These data showed that the effects of supplemental ascorbic acid on growth and on immunoresponsiveness were related to the quality of the husbandry, length of supplemental feeding, age of the chicks, endogenous exogenous balance for ascorbic acid, and the relationship with corticosterone. PMID- 2695914 TI - The stereoselectivity of drug action. PMID- 2695915 TI - Guanfacine inhibits excitatory amino acid release from rat cerebral cortex through a non-adrenergic mechanism. AB - The effect of guanfacine on the release of excitatory amino acids from rat cerebral cortex slices was assessed after preloading the slices with 3H-D aspartate. It was found that guanfacine dose-dependently inhibited the veratridine stimulated release of the excitatory amino acid analogue; the ED50 of guanfacine being 6.4 +/- 2.3 microM (mean +/- S.E.M.) and the veratradine stimulated efflux being completely abolished at about 48 microM of guanfacine. Guanfacine also inhibited the veratridine stimulated release of endogenous aspartate and glutamate with similar potency to the inhibition of 3H-D-aspartate efflux. The inhibitory effect of guanfacine on the veratridine stimulated 3H-D aspartate efflux was neither affected by high concentrations of the alpha 2 adrenoceptor blocker idazoxan nor by high concentrations of the alpha 1 adrenoceptor blocker prazosin. It is concluded that guanfacine inhibits the neural excitatory amino acid release in the rat cortex by a novel non-alpha 2/alpha 1-adrenergic mechanism. PMID- 2695916 TI - High-performance liquid chromatography separation of nikkomycins X and Z. AB - A reversed-phase, C-18 HPLC method for separation, with baseline resolution, of the chitin synthase inhibitors nikkomycin X and Z is described. This permits, for the first time, satisfactory identification of nikkomycin X and Z contained in a mixture. The use of 30 mM ammonium formate (pH 4.7) containing the ion-pair agent heptanesulfonic acid (1 mM) was critical for the successful separation of these fungicides. PMID- 2695917 TI - [The relationship of disorders of glucose tolerance in patients with chronic hepatitis and liver cirrhosis to the severity of the pathological process]. AB - Altogether 155 patients with different clinical types of liver lesions were examined: 73 with chronic persistent hepatitis (CPH), 39 with chronic active hepatitis (CAH), and 43 with liver cirrhosis (LC). The patients with chronic liver diseases demonstrated hyperinsulinemia and a decrease in glucose tolerance, a frequency and degree of this decrease growing with the severity of a pathological process. It is postulated taking experiments with partial hepatectomy of rats by way of example that intolerance to glucose and hyperinsulinemia is caused by partial loss of glycogen synthetic function by the liver resulting from a decrease in the number of functionally active cell elements. Experience with 8 LC patients with secondary diabetes mellitus has shown that the addition of the latter is connected with the reduction of secretory capacity of pancreatic beta-cells and with the development of relative insulin insufficiency. PMID- 2695918 TI - [The experimental use of surfagon, a synthetic analog of luliberin, in follicular ovarian cysts]. AB - The use of a synthetic peptide analog of LH-RH agonist--[D-Ala6, des Gly10, Pro9] LH-RH ethylamide (surfagon) at microdoses and in short courses returned to normal the ovulatory cycle in the anovulatory condition in rats and caused luteinization of follicular cysts in rats and cows with further normalization of ovarian function. It is assumed that surfagon will be effective for the treatment of anovulatory condition and ovarian follicular cysts in women. PMID- 2695919 TI - [The efficacy of using thymalin in diabetes mellitus in children]. AB - A possibility of the use of thymalin was studied in children with diabetes mellitus using adequate immunohormonal investigations. Clinico-metabolic investigations proved the efficacy of the use of the new immunomodulator thymalin in multimodality therapy of diabetes mellitus in children. PMID- 2695920 TI - [Iodine, iodine-131 and the problems of thyroidology]. PMID- 2695921 TI - Plasmodium falciparum ookinetes migrate intercellularly through Anopheles stephensi midgut epithelium. AB - The migration of Plasmodium falciparum and P. berghei ookinetes through the midgut epithelium in Anopheles stephensi was studied by transmission electron microscopy. With ruthenium red (RR) staining, the results of previous studies were confirmed: P. falciparum ookinetes take an intercellular route through the midgut epithelium. In the same mosquito species, the rodent parasite P. berghei appeared to take an intracellular position, as previously suggested by other authors. The intra- or intercellular ookinete migration of P. berghei or P. falciparum, respectively, can perhaps be related to the higher mortality of P. berghei-infected mosquitoes within the first 2 days of infection. Evidence is presented that oocyst capsule formation begins as early as during the migration of the ookinete. After localization between the epithelial cells and the midgut basal lamina, the rapidly expanding oocyst stretches the overlying layer of the latter at the haemocoelic surface while a new basal lamina is generated between the oocyst and epithelial cell. PMID- 2695923 TI - Genetic linkage studies in bipolar disorder: a review. AB - For the past 20 years, researchers have been using genetic linkage studies as a tool to better understand the etiology of bipolar disorder. During this time, there have been reports of linkage between the symptom complex of bipolar disorder and 7 genetic markers located on 4 different chromosomal areas. All of these reports continue to be surrounded by controversy causing some observers to consider the field to be ambiguous and contradictory. This review provides some historical perspective on the controversies, while outlining the current status and future direction of the field. PMID- 2695922 TI - Left striato-pallidal hyperactivity in schizophrenia. Part II: Phenomenology and thought disorder. AB - Our previous paper summarized abundant evidence that schizophrenic patients show forms of sensory and motor hemineglect compatible with a left striato-pallidal hyperactivity model of schizophrenia. In this paper we discuss how the model may also account for some of the cognitive and phenomenological aspects of this disorder. Hemineglect can be associated with pallidal hyperactivity through its mediation of the anterior attention system of the frontal lobe. We postulate that this same attentional deficit can also affect higher functions such as the control of language and thought by internal motivations. Many symptoms of schizophrenia can be explained as a form of hemineglect of these higher functions. PMID- 2695924 TI - The concept of mental illness. AB - In recent years it has often been suggested that there is no such thing as mental illness. In naive Cartesianism this assertion starts out from the assumption that illness may develop solely from physical causes. Before clarifying what mental illness is, we should ask what is understood by the general notion of 'illness'. A constituent of the general disease concept is an unvoluntary and sufficiently serious disturbance of vital functions that needs to be defined in detail-and not just any region of disease causes or symptoms. The general disease concept can be defined in the context of everyday life and in the social and legal context and be filled with detailed normative and threshold values in the medical context. A society with a humanitarian orientation responds to the incapacity of its members owing to illness with attempts at institutionalization, which find their expression in norms, privileges and duties. Special disease concepts were developed for defining specific diseases and distinguishing them from others. Since solely the general disease concept, on which the distinction between illness and deviations from moral or legal norms is founded, is aetiologically neutral, it can be filled with any explanation model at the physical or at the mental level in the frame of specific disease concepts: e.g. with the one cause- one disease model, with multifactorial models or behavioural dysfunction models. PMID- 2695925 TI - Hyperactivity of the left striato-pallidal projection. Part I: Lower level theory. AB - We have observed increased relative blood flow to the left globus pallidus and evidence for subtle forms of right-sided hemineglect in neuroleptic-naive schizophrenic patients. These findings occur in animals following certain lesions such as unilateral destruction of midbrain dopaminergic neurons, and are presumed to be due to left striato-pallidal hyperactivity. A survey of the literature reveals many similarities between animals with unilateral dopaminergic denervation and schizophrenic patients. It has previously been suggested that available evidence does not preclude the possibility that schizophrenic patients have something like a dopaminergic deficiency. Other studies demonstrate that neuroleptics reverse asymmetries in indices of dopamine turnover. A model based upon dopaminergic hemideficiency is outlined, and can potentially explain other abnormalities in schizophrenic patients including eye movement abnormalities and the link between temporal lobe epilepsy and psychosis. A companion article describes how this model can account for some of the phenomenological symptoms of psychosis. PMID- 2695926 TI - Site-directed mutagenesis of the T4 endonuclease V gene: mutations which enhance enzyme specific activity at low salt concentrations. AB - Previous structure/function analyses of the DNA repair enzyme, T4 endonuclease V, have suggested that the extreme carboxyl portion of the enzyme is associated with pyrimidine dimer-specific binding (Recinos and Lloyd, and Stump and Lloyd, Biochemistry 27:1832-1838 and 1839-1843, 1988, respectively). Within the final 11 amino acids there are 5 aromatic, 2 basic, and no acidic residues and it has been proposed that these residues stack with and electrostatically interact with the kinked DNA at the site of a pyrimidine dimer. The role of the tyrosine residue at position 129 has been investigated by oligonucleotide site-directed mutagenesis in which the codon for Tyr-129 has been altered to reflect conservative changes of Trp and Phe and more dramatic changes of Ser, a stop codon, deletion of the codon or introduction of a frameshift. Both changes to the aromatic amino acids resulted in proteins which accumulated well in E. coli and not only significantly enhanced the UV survival of repair-deficient cells but also complemented a defective denV gene within UV-irradiated T4 phage. Partially purified preparations of the Tyr-129----Trp and Tyr-129----Phe mutants were assayed for their ability to processively incise UV-irradiated plasmid DNA (a nicking reaction carried out at low 25 mM salt concentrations). The mutant enzymes Tyr 129----Phe and Tyr-129----Trp displayed a 1000% and 500% enhanced specific nicking activity, respectively. These reactions were also shown to be completely processive. Assays performed at higher (100 mM) salt concentrations reduced the specific activities of the mutant enzymes approximately to that of wild type for the Tyr-129----Phe mutant and to 20% that of wild type for the Tyr-129----Trp mutant. PMID- 2695927 TI - Characterization and autoprocessing of precursor and mature forms of human immunodeficiency virus type 1 (HIV 1) protease purified from Escherichia coli. AB - A recombinant plasmid encompassing the human immunodeficiency virus type 1 (HIV 1) protease coding sequence and flanking regions (Ala-13 to Gly-185 of the pol open reading frame) has been expressed in two distinct strains of Escherichia coli, AR58 and AR68. In the first strain, AR58, the primary translation product, a 25 kilodalton (kDa) precursor protein, is short-lived and rapidly processes itself to the 11 kDa mature protease in vivo. In the second strain, AR68, the 25 kDa species is only partially processed, and it, a 13 kDa intermediate, and the mature 11 kDa enzyme accumulate at a ratio of 3:4.5:2.5, respectively. The 11 kDa mature protease from AR58 and the 25 kDa precursor from AR68 have been purified to homogeneity. The yield of 11 kDa enzyme from AR58 is approximately 0.02 mg/g wet weight of E. coli cell pellet. The protease has both the expected NH2- and COOH-terminal sequences. The yield of 25 kDa enzyme from AR68 is approximately 0.1 mg/g wet weight of E. coli cell pellet. In vitro, the 25 kDa precursor enzyme rapidly (t1/2 approximately equal to 9 min) processes itself into a species with a mass of approximately 13 kDa and a species with a mass of approximately 11 kDa. Both of these latter species can be separated by RP-HPLC, have the NH2-terminal sequence expected for the mature protease, and are active. The 11 kDa enzyme from AR58 comigrates with the 11 kDa enzyme from AR68 on RP-HPLC and SDS polyacrylamide gel electrophoresis. On extended incubation at 4 degrees C at either neutral or acidic pH all species of the protein exhibit further autodegradation at defined sequences. The availability of the mature, 11 kDa enzyme and the 25 kDa precursor will allow biochemical and physical studies on this critical viral enzyme. PMID- 2695928 TI - The molten globule state as a clue for understanding the folding and cooperativity of globular-protein structure. PMID- 2695929 TI - In memoriam: Irving S. Sigal 1953-1988. PMID- 2695930 TI - Chemical modification of the RTEM-1 thiol beta-lactamase by thiol-selective reagents: evidence for activation of the primary nucleophile of the beta lactamase active site by adjacent functional groups. AB - The RTEM-1 thiol beta-lactamase (Sigal, I.S., Harwood, B.G., Arentzen, R., Proc. Natl. Acad. Sci. U.S.A. 79:7157-7160, 1982) is inactivated by thiol-selective reagents such as iodoacetamide, methyl methanethiosulfonate, and 4,4' dipyridyldisulfide, which modify the active site thiol group. The pH-rate profiles of these inactivation reactions show that there are two nucleophilic forms of the enzyme, EH2 and EH, both of which, by analogy with the situation with cysteine proteinases, probably contain the active site nucleophile in the thiolate form. The pKa of the active site thiol is therefore shown by the data to be below 4.0. This low pKa is thought to reflect the presence of adjacent functionality which stabilizes the thiolate anion. The low nucleophilicity of the thiolate in both EH2 and EH, with respect to that of cysteine proteinases and model compounds, suggests that the thiolate of the thiol beta-lactamase is stabilized by two hydrogen-bond donors. One of these, of pKa greater than 9.0, is suggested to be the conserved and essential Lys-73 ammonium group, while the identity of the other group, of pKa around 6.7, is less clear, but may be the conserved Glu-166 carboxylic acid. beta-Lactamase activity is associated with the EH2 form, and thus the beta-lactamase active site is proposed to contain one basic or nucleophilic group (the thiolate in the thiol beta-lactamase) and two acidic (hydrogen-bond donor) groups (one of which is likely to be the above mentioned lysine ammonium group). PMID- 2695931 TI - Recombinant HIV1 protease secreted by Saccharomyces cerevisiae correctly processes myristylated gag polyprotein. AB - The protease of the human immunodeficiency virus type I (HIV1) was expressed both intracellularly and extracellularly in Saccharomyces cerevisiae. Intracellular expression of the protease was achieved by fusing a 179 amino acid precursor form of the protease to human superoxide dismutase (hSOD). Self-processing of the viral enzyme from the hybrid precursor was demonstrated to occur within the yeast host. Secretion of the protease was achieved by fusing the leader sequence of yeast alpha-factor to the precursor form of the protease or to the 99 amino acid mature form of the protease. Authentic and active forms of the retroviral enzyme were detected in yeast supernatants of cells expressing the precursor or the mature form of the protease. A D25E active site variant of the retroviral enzyme exhibited diminished autocatalytic activity when expressed intracellularly or secreted from yeast. The wild-type protease was active in an in vitro assay on the natural substrate, myristylated gag precursor, Pr53gag. Correct processing of Pr53gag at the Tyr 138-Pro 139 junction was confirmed by amino terminal sequence analysis of the resulting capsid protein (CA, p24). The secreted protease was purified to homogeneity from yeast media using preparative isoelectric focusing and reverse-phase HPLC. Amino terminal sequence analysis showed a sequence beginning at amino acid 1 of the mature enzyme (Pro) and another sequence beginning at amino acid 6 (Trp). This shorter sequence may represent a natural autolytic product of the protease. PMID- 2695932 TI - Alternate succession of steps can lead to the folding of a multidomain oligomeric protein. AB - The beta 2 subunit of Escherichia coli tryptophan synthase can be either unfolded in 6 M guanidine, or extensively denatured at acidic pH. These two denatured forms of beta 2 have different circular dichroism spectra and thus correspond to distinct physical states. Here we compare the folding pathways of these two different denatured forms of beta chains. We describe the kinetics of regain of a variety of physical, functional, and immunochemical signals characteristic of six successive steps previously identified on the folding pathway of guanidine unfolded beta 2. It is shown that whereas identical molecular events occur with the same kinetics, the two folding pathways are different, and involve different structural intermediates. PMID- 2695933 TI - Structural analysis of NADH-cytochrome b5 reductase in relation to hereditary methemoglobinemia. PMID- 2695934 TI - Computer model of human erythrocyte metabolism. PMID- 2695935 TI - The molecular basis of aging and sequestration of mammalian erythrocytes. PMID- 2695936 TI - Blood substitutes--minireview. PMID- 2695937 TI - Red cell membrane lipid dynamics. PMID- 2695938 TI - Effect of hemoglobin denaturation on membrane structure and IgG binding: role in red cell aging. PMID- 2695939 TI - Predictions and tests of a new integrated reticulocyte model: implications for dehydration of sickle cells. PMID- 2695940 TI - Immunological effects of zinc deficiency in sickle cell anemia (SCA). AB - Zinc deficiency occurs frequently in SCA subjects. Our studies have shown that several parameters of cellular immune functions may be altered in SCA subjects and related to a deficiency of zinc. These include anergy to certain common antigens, which was reversible following zinc supplementation, decreased activity of natural killer (NK) cells, decreased production of interleukin (IL-2), decreased T4/T8 ratio and serum thymulin. Inasmuch as we have observed similar immunological changes in human volunteers (non-SCA) in whom we restricted only zinc intake and produced a mild specific deficiency of zinc, we conclude that the above changes in SCA were due to zinc deficiency. Although it is well known that susceptibility to infections is a common problem in SCA subjects, the pattern of infections related to cell mediated immune dysfunction has not been well documented. Whether or not supplementation with zinc will alter the pattern of infection and decrease morbidity in SCA on a long-term basis remains to be determined. PMID- 2695941 TI - Cathepsin D in erythroid cells. AB - We have detected, solubilized, and purified to near-homogeneity a membrane-bound acid protease from rabbit reticulocytes. Chemical, physical, immunological, and catalytic characterization demonstrate that the enzyme is cathepsin D. With cytochrome b5 as substrate, the enzyme shows a surprisingly high pH optimum and is stimulated by ATP and DPG. Possible roles for the protease include protein processing of microsomal enzymes, degradation of subcellular organelles, and destruction of excess hemoglobin chains. The possible role of cathepsin D in protein processing of microsomal enzymes will be best assessed by the molecular biological approaches described in the following two presentations. PMID- 2695942 TI - Characterization of the spontaneous diabetes obesity syndrome in mature male CBA/Ca mice. AB - A spontaneous maturity onset diabetes obesity syndrome occurs in a small proportion (10-20%) of male CBA/Ca mice. Inbreeding can increase the incidence to 80%. It occurs at 12-16 weeks of age, and is characterized by hyperphagia, obesity, hyperglycaemia, hypertriglyceridaemia, hyperinsulinaemia, and an impaired glucose tolerance. The mice are also resistant to exogenous insulin. Female mice remain normal except for a slight increase in serum insulin. The male obese diabetic mice have a normal life expectancy. It is proposed that CBA/Ca mice can provide examples of a useful model for investigating the aetiology of type 2 diabetes and obesity, and the effectiveness of antidiabetic and antiobesity drugs. PMID- 2695943 TI - Failure of SCH 23390 to function as a discriminative stimulus in rats. AB - Four rats were studied in a two-lever, food-reinforced drug discrimination paradigm using the Dl dopamine antagonist SCH 23390 (0.03 mg/kg, IP, 30 minutes prior to the session) and saline as the training stimuli. After at least 100 training sessions there was no evidence of stimulus control over responding by SCH 23390 in 3 of the 4 rats, and only briefly in the fourth. On the other hand, food delivery exerted control over behavior indicating that SCH 23390 did not disrupt control of behavior by the reinforcing stimulus. An increase in training dose to 0.06 mg/kg for an additional 12 sessions did not improve discriminative accuracy although this dose reduced rate of responding to an extent that made further training using 0.06 mg/kg untenable. The results provide no evidence of stimulus control of behavior by SCH 23390 and suggest that SCH 23390 does not function as a discriminative stimulus in rats. PMID- 2695944 TI - Cardiovascular and respiratory effects of an opioid kappa agonist ethylketazocine and sigma agonist N-allylnormetazocine in acutely decerebrated dogs. AB - Effects of opioid kappa agonist ethylketazocine (EKC), sigma agonist (+-)-N allylnormetazocine (NANM), and naloxone alone and in combination on mean blood pressure (MBP), heart rate (HR), respiratory rate (RR) and minute volume (MV) were studied in acutely decerebrated dogs. EKC (0.5 mg/kg) decreased HR, MBP, RR and MV. Post-EKC NLX increased RR and MV and reversed the bradycardia and hypotension produced by EKC. NANM (1 mg/kg) produced respiratory depression and tachycardia without changing MBP. Post-NANM NLX antagonized tachycardia, increased MBP, however did not significantly change RR and MV. When decerebrate dogs were spinalized at the C-1 level, EKC decreased MBP and HR. These effects were antagonized by NLX. NANM did not change HR but raised MBP in spinalized decerebrate dogs. Since EKC- and NANM-induced cardiovascular and respiratory depression were not observed in conscious intact or chronic spinal dog, it is suggested that: 1) kappaergic system rostral to mesencephalon may play a role in counteracting these depressant effects of EKC; 2) sigma receptor-mediated tachypnea and tachycardia are dissociable; the tachypneic effect may be mediated through higher center while the medulla oblongata is involved in producing tachycardia. These results also suggest that (+-)-NANM probably has several mechanisms of action at several brain sites in producing its effects on respiration and cardiovascular function. PMID- 2695945 TI - Postlunch smoking for pleasure seeking or arousal maintenance? AB - Interactions between smoking and eating might be expected, since the craving to smoke increases after a meal, since smokers tend to have a lower body weight and since they have also been suggested to differ from nonsmokers with respect to metabolism. Further, both eating and smoking have been reported to affect mental performance. In the first experiment the influences of a heavy meal, a light meal and no meal on smoking behavior and subjective ratings were compared in 15 subjects. Whereas puffing behavior was not affected by the meal conditions, craving and smoking enjoyment increased after the meals. In the second experiment the effects of smoking on postlunch performance and concomitant central and peripheral physiology were investigated. Postlunch smoking (compared to postlunch no smoking) distinctly showed the usual increases in heart rate, peripheral vasoconstriction and electrocortical arousal, but it failed to affect rapid information processing performance and its concomitant event-related EEG potentials as well as several indices of metabolic activity. It appears, thus, that under the conditions of the present experiments, pleasure seeking may be a more important factor in postmeal smoking than the effects on performance, EEG or metabolism. PMID- 2695946 TI - Intravenous cocaine infusions in humans: dose responsivity and correlations of cardiovascular vs. subjective effects. AB - Eight experienced IV cocaine users were intravenously administered 0, 10, 20, and 40 mg of cocaine hydrochloride on separate days in a pseudo-randomized ascending dose series, such that the 20 mg dose always preceded the 40 mg dose. They were subsequently administered 0, 20, and 40 mg of cocaine in a fully randomized presentation order. Cardiovascular effects of cocaine were significantly different from placebo for the 20 mg, but not the 10 mg dose, in contrast to subjective responses which differed from placebo for the 10 mg dose. Cardiovascular and subjective effects of cocaine did not differ between the 20 and 40 mg dose conditions for the pseudo-randomized trials, but did differ in the fully randomized trials. This lack of difference in responsivity between the 20 and 40 mg dose in the earlier trials may possibly have been due to contrast effects. Cardiovascular responses were not consistently correlated with subjective responses, either within a cocaine dose condition or across doses. PMID- 2695947 TI - Use of charge coupled device camera for imaging of intracellular phthalocyanines. AB - A highly sensitive charge-coupled device (CCD) camera, linked to a computerized image processor, has been used to obtain fluorescence images of chloro-aluminum sulfonated phthalocyanine (ClAlSPc), and its mono- to tetra-sulfonated constituents, in cells recovered from the peritoneal cavity of dye-treated mice. Immunofluorescence and cytochemistry showed that cells which preferentially took up ClAlSPc and its sulfonated species were predominantly of the monocyte macrophage series. While this technique may be of use in determining the nature of those cells capable of taking up light sensitive dyes and, perhaps, the intracellular location of such agents, the possibility that photoinactivation by dye aggregation could reduce the sensitivity of this procedure is discussed. PMID- 2695948 TI - Singlet oxygen induced mutagenesis of benzo[a]pyrene derivatives. AB - Singlet oxygen activates the mutagenicity of several benzo[a]pyrene (BP) derivatives in the absence of mammalian metabolic action. This has been demonstrated using a separated-surface-sensitizer system for generating chemically pure singlet oxygen, eliminating most of the complications that arise with singlet oxygen generation by conventional photosensitization. Salmonella typhimurium bacteria were exposed to singlet oxygen in the presence of certain BP derivatives and the mutation frequency determined with an azaguanine forward mutation assay. The mutation frequency was increased by exposure to singlet oxygen compared to light-only controls for those BP derivatives that were saturated at either the 7,8 or 9,10 positions but not both. The increase in mutation frequency depends on both the concentration of BP derivative and on the dose of singlet oxygen. Mutation frequency was also significantly increased when bacteria were treated with a solution of trans-7,8-dihydrodiol-BP that had been separately exposed to singlet oxygen, unequivocally demonstrating that the mutagenicity is due to the formation of a product of BP derivative oxidation by singlet oxygen and that this product has a lifetime at least on the order of minutes in acetonitrile. The requirement for singlet oxygen rather than some other form of reactive oxygen was confirmed by determination of the gas phase lifetime of the intermediate responsible for activating mutagenicity. This was performed by measuring the dependence of the mutation frequency on the distance separating the sensitizer from the target. This gives a value of 88 +/- 35 ms, which is in excellent agreement with the mean value of 89 ms calculated from previous independent determinations of the gas phase lifetime of singlet oxygen reported in the literature. PMID- 2695949 TI - Neonatal treatment of male rats with a gonadotropin-releasing hormone antagonist impairs ejaculation and fertility. AB - Pituitary-gonadal suppression of neonatal male rats with a gonadotropin-releasing hormone antagonist N-Ac-D-Nal(2)1,D-p-Cl-Phe2,D-Trp3,D-hArg(Et2)6,D-Ala10 -GnRH (RS 68439; Syntex; 2 mg/kg/day) during days 1-10 of life resulted in infertility of adult animals, when studied at the age of 90, 115 and 150 days. Numbers of fertile animals per rats tested at these ages were 1/10, 2/14 and 4/14, respectively, in the antagonist treated animals (vs. 8/10, 9/13 and 9/13 in controls; p less than 0.01-0.05). The numbers of mounts and intromissions were unaffected by the antagonist treatment, but none of the treated animals (n = 10) ejaculated in four subsequent behavior tests. However, if the vaginal smears were checked in a group of rats after caging the males separately with a normal female for 8 days before the behavior tests, each male had ejaculated but the females were not fertilized. When the neonatally GnRH antagonist-treated rats were followed in the long-term, fertility slowly recovered, and at the age of 220 and 350 days, the number of successful pregnancies was similar to that of age-matched controls. It is concluded that short-term neonatal pituitary-gonadal suppression with GnRH antagonist results in impaired ejaculation and infertility of adult male rats, but fertility slowly recovers within a year. PMID- 2695950 TI - Verapamil and indomethacin attenuate endotoxin-induced anorexia. AB - To characterize the mechanism of the anorexia during infection, we investigated the effect of E. coli lipopolysaccharide (LPS) on feeding in rats under various conditions: LPS (125, 100, 75, and 50 micrograms/kg body weight = b. wt.) injected intraperitoneally (IP) reduced food intake by decreasing meal frequency without affecting meal size. The Ca++-channel blocker verapamil (5 mg/kg b. wt., IP) or the antipyretic and antiphlogistic drug indomethacin (2.5 mg/kg b. wt., IP), but not combined alpha- and beta-adrenergic receptor blockade by IP phentolamine plus propranolol (500 micrograms/kg b. wt., each) attenuated the anorectic effect of LPS (125 or 100 micrograms/kg b. wt.). The results suggest that a phospholipase A2-sensitive mechanism contributes to the anorexia during injection. PMID- 2695951 TI - Shuttle plasmids constructed by the transformation of an Escherichia coli cloning vector into two Deinococcus radiodurans plasmids. AB - An Escherichia coli plasmid that confers kanamycin resistance (Kmr) was inserted into the large Deinococcus radiodurans cryptic plasmids pUE10 and pUE11, yielding pS28 and pS19. The method of insertion involved both in vitro splicing and the natural transformation of D. radiodurans and yielded full-length clones in E. coli of pUE10 and pUE11. Both pS28 and pS19 replicated and expressed Kmr in E. coli and D. radiodurans. In both pS28 and pS19, D. radiodurans plasmid sequences were immediately upstream from the Kmr determinant. Transformation experiments suggested that Kmr expression in D. radiodurans was initiated in upstream D. radiodurans sequences. Restriction maps of pS28 and pS19 showed that each plasmid contained three MraI sites. Both pS28 and pS19 transformed the MraI-producing D. radiodurans strain R1 at low frequencies. D. radiodurans strain Sark, which naturally contains pUE10 and pUE11, was transformed by pS28 and pS19 at much higher frequencies. A Sark derivative that was cured for pUE10 was isolated by screening Sark/pS28 subisolates for loss of kanamycin resistance. PMID- 2695952 TI - Amplification of bacterial plasmids without blocking protein biosynthesis. AB - The effect of amino acids (presence or absence from the growth media) and metal ions on the replication of Escherichia coli plasmids in rel A+ strains was studied. It was found that: (i) The absence of one amino acid from the growth media had no effect on the plasmid copy number in prototrophic E. coli strains: (ii) The presence of only one amino acid in artificial media free of amino acids had a negligible effect on the plasmid copy number for the amino acids Ala, Arg, Glu, His, Leu, Phe, Thr, Trp, and Tyr: (iii) The combination of Met and Thr caused a rise in pBR322 plasmid copy number up to 90-100 plasmid copies per cell: (iv) The Fe3+ concentration had an amplification effect on E. coli plasmids. The pBR322 plasmid copy number for media free of amino acids and supplemented with 0.2-0.4 mM FeCl3 was 60-80 plasmid copies per cell: (v) The combination of Fe3+ with certain amino acids (Ala, Arg, Glu, Leu, Thr, and Trp) leads to a dramatic increase in the plasmid copy number reaching 180-270 plasmid copies per cell for the plasmid pBR322 and 20-24 for the plasmid pR100. PMID- 2695954 TI - Laughter: nature's epileptoid catharsis. AB - The ability to laugh, like other favored behavioral traits, may have evolved over many generations in response to environmental stresses favoring reproduction among successfully adapted people. This speculative overview depicts laughter as a symbolically-triggered release mechanism that unleashes instinctive drive energies associated with survival, in the process lowering anxiety. The use of humor to trigger the laugh reflex has become a cultural activity in which unacceptable impulses are expressed in an acceptable manner. As this occurs, there is an emancipatory release of repressed energies and assorted conflicts are "resolved". An attempt is made to examine the neurological events of laughter; here, there is a suspension of cortical-diencephalic inhibitory control, and tensions are discharged from lower centers, the presumed custodians for some of the encoded programs of instinct and emotion. PMID- 2695953 TI - Effect of induction of SOS response on expression of pBR322 genes and on plasmid copy number. AB - Several lines of evidence are presented that indicate that the level of tetracycline resistance of Esherichia coli strains harboring plasmid pBR322 varies according to whether the SOS system of the host bacteria has been induced. These include use of strains in which the SOS system is expressed constitutively (lexA def.), is thermoinducible (recA441) or noninducible (lexA ind-), or is highly repressed (multiple copies of lexA+). Similar induction was observed with the product of another plasmid gene, beta-lactamase. The amounts of extractable plasmid DNA were also increased by SOS induction, and we propose that the SOS induced increases in levels of tetracycline resistance and beta-lactamase activity are due to an increased plasmid copy number. PMID- 2695955 TI - The quality of life and suicide rates in American cities in 1930. PMID- 2695956 TI - Taste thresholds in man are differentially influenced by hydrocortisone and dexamethasone. AB - The present study focused on sensory processing (taste threshold) in healthy young men given different cortisol doses within the normal physiological range. It aimed to differentiate the effects of dexamethasone, a synthetic pure glucocorticoid, compared to hydrocortisone, which has both glucocorticoid and mineralocorticoid properties. In a double-blind, cross-over design, 18 male subjects participated in three sessions. Subjects were pretreated orally with hydrocortisone (50 mg), dexamethasone (2 mg) or placebo. Taste detection was tested by a forced-choice three stimulus drop technique to determine detection acuity and a signal detection procedure to determine the ability to detect differences in NaCl concentration. Cortisol concentrations were determined in blood and saliva. Hydrocortisone and dexamethasone had opposite effects on taste detection acuity. With the highest cortisol levels after intake of hydrocortisone, subjects made more errors in detection trials with respect to stimuli close to the absolute taste detection threshold than after intake of dexamethasone. Detection of differences was impaired by both glucocorticoids. This type of behavioral study in man may help clarify the roles of heterogeneous corticosteroid receptor systems within the human brain. PMID- 2695957 TI - Factors influencing the outcome of treatment of foot lesions in Nigerian patients with diabetes mellitus. AB - A prospective cross-sectional study of 84 foot lesions in 50 diabetic patients was done in a Nigerian teaching hospital over a three-year period (1982-1984) to assess factors that may influence the choice of treatment and treatment outcome. Age, gender, duration of diabetes, mode of treatment of diabetes and tobacco smoking did not influence whether or not a diabetic with a foot lesion will have major amputation, an unsatisfactory outcome of primary treatment, prolonged hospital stay or will die. Similarly, the presence of foot infections alone, microangiopathy (nephropathy, retinopathy), foot ischaemia alone or neuropathy alone had no relationship to poor prognostic indices. However, when these complications appeared in concert (neuropathy, ischaemia and infection) and when, at presentation, there was associated systemic disease (as shown by anaemia and leucocytosis), severe fasting hyperglycaemia, evident bone destruction and anaerobic superinfection, the outcome of treatment was adverse. In addition, hypertension and infection of the foot were related to need for major amputation. Poor long-term control did not influence prognosis adversely. We therefore suggest that the high morbidity seen with diabetic foot lesions could be reduced by optimizing glycaemic control, using combination antibiotic chemotherapy, vigorously correcting anaemia and encouraging early presentation of even mild lesions before underlying bone disease supervenes. PMID- 2695958 TI - Primary sepsis presenting as fulminant hepatic failure. AB - Four patients who were referred to the Liver Failure Unit with an initial diagnosis of fulminant hepatic failure were found to have severe bacterial infection from a primary septic focus as the cause of their illness. Clinical and biochemical characteristics were not helpful in differentiating these patients from those with hepatic failure from other causes, and only a high degree of suspicion will prevent delay in the diagnosis of underlying sepsis and initiation of appropriate treatment. The possible mechanisms responsible for this uncommon association are discussed. PMID- 2695959 TI - Sulphonylureas in the treatment of non-insulin-dependent diabetes. PMID- 2695960 TI - Hyperglycaemia and stroke. PMID- 2695961 TI - Applications of ultrafast laser spectroscopy for the study of biological systems. PMID- 2695962 TI - Oligonucleotide structure: a decade of results from single crystal X-ray diffraction studies. PMID- 2695963 TI - [Anesthesia progress in dental treatment (I)]. PMID- 2695964 TI - [Adhesive bond between elastomers and impression trays]. PMID- 2695965 TI - [Posterior tooth placement in connection line between canine points and Trigonium retromolare]. PMID- 2695966 TI - [Restorative correction of medial diastema using Helio-progress composite]. PMID- 2695967 TI - [Clinical advances and choice of impression material with telescopic and precision attachment prostheses]. PMID- 2695968 TI - [New method of treatment of periodontal furcation cases (II)]. PMID- 2695969 TI - [System for instrumental root planing]. PMID- 2695970 TI - [Dehiscence and fenestration in two early middle aged skeleton populations]. PMID- 2695971 TI - [Combination denture--compromise between form, color and function (II)]. PMID- 2695972 TI - The aging gastrointestinal tract: cell proliferation and nutritional adaptation. PMID- 2695973 TI - Assessment of trace element status in humans. AB - Trace elements occur in the body in very small or 'trace' amounts. Deficiencies of essential trace elements produce multiple and diverse clinical signs and symptoms. These may arise from inadequate dietary intake, decreased bioavailability, iatrogenic factors, certain disease states in which decreased absorption, excessive excretion and/or utilization occurs, and physiological states in which trace element requirements are increased and/or body stores are reduced. This review discusses both the static and functional laboratory tests used for the assessment of chromium, copper, selenium, and zinc status in humans, with emphasis on those tests suitable for community use. Static tests measure the total quantity of the trace elements in various accessible tissues and body fluids such as hair, nails, blood or some of its components, and urine; functional tests measure the activity of trace-element-dependent enzymes, or a physiological or behavioural function dependent on a specific trace element. The advantages and limitations of each test are discussed, together with the effects of non-nutritional factors that may confound the interpretation of the results. Interpretive criteria are also given, where possible. PMID- 2695974 TI - Calcitonin gene-related peptide in the nervous tissue. PMID- 2695975 TI - Human EEG and odor response. PMID- 2695976 TI - Neuroendocrine [corrected] regulation of prolactin release. PMID- 2695977 TI - [Laboratory and oligobiopsy studies of the liver in patients with psoriasis treated by the combination of Tigason-PUVA-cignoline (RePUVA+C)]. AB - In 10 patients with generalized psoriasis treated by this method biochemical and histological examinations of liver biopsy specimens were done before and after 60 days of the treatment. In some cases a transient rise of A1AT activity, raised activity of alkaline phosphatase and gamma-glutamyltranspeptidase were noted. Histological examinations demonstrated slight hepatocellular damage with microfocal necrosis, fatty infiltration of some cells and increase in the structural elements of cytoplasm. PMID- 2695978 TI - [Usefulness of photochemotherapy in allergic diseases of the skin]. AB - PUVA treatment was applied in 16 patients with chronic urticaria (7 with solar urticaria, 2 with cold urticaria and 7 with urticaria of unknown etiology), 26 with chronic disseminated eczema and 41 with atopic dermatitis. In all 9 patients with physical urticaria, a clear-cut improvement was observed. The results from the treatment of chronic urticaria of unknown etiology were considerably poorer (improvement in 2 out of 7 cases). In patients with chronic disseminated eczema, a full remission was present in 5 and considerable improvement in 20 cases. In group of 41 patients with atopic dermatitis, 52 cures were carried out; in 8 patients the cure was repeated 2-3 times at 1,0-0,5-year intervals. Complete recovery was achieved in 34 and significant improvement in 16 out of them. The results presented seem to indicate the effectiveness of PUVA treatment to some allergic skin diseases, the more so that the number of exposures required to obtain a considerable improvement, or even full remission, is comparatively low (3-21 occasions), which reduces the risk of complications. PMID- 2695979 TI - [Mechanisms of myocardial damage in the conditions of ischemia and reperfusion]. PMID- 2695980 TI - [Various theories on the pathogenesis of diarrhea and malabsorption syndromes in Giardia intestinalis infection]. PMID- 2695981 TI - Insulin hypoglycemia increases the levels of neuropeptide Y and calcitonin gene related peptide, but not of chromogranins A and B, in rat chromaffin granules. AB - The levels and subcellular distribution of chromogranin A and B, of calcitonin gene-related peptide (CGRP) and of neuropeptide Y (NPY) were investigated in rat adrenals before and after insulin treatment. Six days after insulin-induced hypoglycemia the levels of chromogranin A and B were similar to controls, however those of NPY and CGRP were increased by a factor of 2.5 and 35, respectively. This treatment also elevated mRNA levels of NPY and CGRP, establishing an increased biosynthesis of these two neuropeptides. As shown by subcellular fractionation, all peptides were present in chromaffin granules after insulin treatment. Furthermore, immunostaining at the ultrastructural level demonstrated the co-localization of chromogranin A, NPY and CGRP within the same chromaffin granules. These results establish that insulin-induced hypoglycemia changes the levels of the secretory peptides in chromaffin granules leading to an altered composition of the secretory cocktail. Apparently, the biosynthesis of the secretory peptides and their storage organelles can be regulated in distinct patterns. PMID- 2695983 TI - Suicide and ethnicity in the United States. Committee on Cultural Psychiatry. Group for the Advancement of Psychiatry. AB - In the preceding chapters we have reviewed the available data on suicide among four major ethnic groups in the United States. In this final chapter, we wish to draw together the thematic threads observed in several of the groups we have studied. We also wish to point out thematic differences in the suicide data among the four groups studied and the possible significance of these differences. The most striking common theme that emerges from the analysis of suicide data for the four ethnic groups is the finding that suicide occurs most frequently among youth and young adults, and predominantly among young men. This is the case for Blacks, Native Americans, Puerto Ricans, and Mexican-Americans. The data for Japanese Americans, showing a minor peak of suicide in young adulthood, allow some consideration of this general theme for this ethnic group as well. A notable exception is the Chinese-American group. A second major theme is the low rate of suicide among Black, Native American, Puerto Rican, and Mexican-American women, compared with males of this age group and compared with the majority population. Here, too, Chinese-American women are a dramatic exception, with peak suicide incidence occurring in older women. A third common theme is the comparatively low rate of suicide among older people in three of the four ethnic groups: Blacks, Native Americans, and Hispanics--both Puerto Ricans and Mexican-Americans. There are important differences in frequency of suicide between the majority population and the ethnic groups, but these differences are not consistent for the four ethnic groups studied. Most dramatic are the substantially higher aggregate rate of suicide among Native Americans than that which occurs among the majority population and the lower rates among Blacks, Puerto Ricans, and Mexican Americans. The rates for Chinese- and Japanese-Americans are lower than the national figures, but not strikingly dissimilar. It is important to highlight the notion that no explanatory theory by itself accounts in a consistent way for the differences in suicide rates between the majority, White US population and the four ethnic groups we have studied. PMID- 2695982 TI - GIP and insulin release in relation to gastric emptying of a mixed meal in man. AB - To clarify the role of GIP (gastric inhibitory polypeptide) as an incretin, we related temporally the gastric emptying of fat, protein and glucose to plasma levels of glucose, GIP and insulin in man. Five healthy volunteers with a multiple lumen duodenal tube ingested a mixed meal with phase-specific markers for the aqueous phase, liquid fat and the solid protein phase. Duodenal passage was determined by intraduodenal infusion of a second set of phase-specific non absorbable markers. Plasma insulin rose rapidly from a basal value of 59 pM to 300 pM at 60 min, and then declined to reach basal levels after 180 min. By contrast, plasma GIP rose more slowly than insulin, from a basal value of 9.4 pM, and remained elevated, in the range of 14-18 pM, throughout the 240 min observation period. The time course of plasma insulin concentration paralleled gastric emptying of the aqueous phase, containing most of the meal's glucose (r = 0.952, P less than 0.001). The time course of plasma GIP concentrations paralleled the gastric emptying of fat and protein (r = 0.763-0.834; P less than 0.01-0.05). Plasma insulin concentrations showed no correlation to the rate of emptying of fat and protein (r = 0.142-0.420; n.s.) and to plasma levels of GIP (r = 0.365; n.s.). The threshold for plasma glucose at which GIP would exert an incretin effect only reached at one time point, 30 min after ingestion of the meal. Our findings of simultaneously tracked gastric emptying of meal nutrients, hormone release and plasma glucose levels do not support an important physiological role for GIP as an insulinotropic hormone after ingestion of mixed meals in man. PMID- 2695984 TI - Contributions of nuclear magnetic resonance to study of acute renal failure. AB - Nuclear magnetic resonance (NMR) has contributed considerably to our understanding of experimental acute renal failure. Changes in energy metabolism which are caused by ischemia, urinary obstruction, and nephrotoxic drugs have been characterized with NMR spectroscopy. Data from our laboratory and others utilizing 31P NMR have demonstrated that levels of adenosine triphosphate fall rapidly with ischemia, and that the ability of the kidney to regenerate ATP correlates with ultimate functional recovery. Additionally, development of intracellular acidosis appears to occur early with ischemia and may, if severe enough, predict poor functional recovery. Urinary obstruction is associated with the rapid development of a large peak resonating in the phosphodiester region of the P-31 NMR kidney spectrum which is attributable to increases in urinary inorganic phosphate. Nephrotoxic acute renal failure with a variety of nephrotoxins is associated with little to no changes in high energy phosphates. Renal transplant allograft rejection is associated with energy metabolic changes similar to those seen with ischemia; however, the intracellular pH remains normal. These findings allow causes of experimental acute renal failure to be differentiated among each other in both native and transplanted kidneys. With recent advances in NMR software and hardware, the application of this methodology to human acute renal failure is now possible. PMID- 2695985 TI - [Relation of hepatitis B virus markers in the serum and hepatic tissue in chronic carriers of HBsAg]. AB - The authors studied 23 chronic carriers of HBsAg, to classify them in terms of serology, histopathologic findings and behaviour of markers HBsAg and HBcAg in hepatic tissue. Immunohistochemical techniques were used to establish possible relations between these parameters. Among patients with positive HBeAg found all exhibited HBcAg in hepatic tissue, but in 16 patients in which HBeAg was negative, liver HBcAg was positive in 3 cases (18.7%). No correlation was found between the HBeAg system/anti-HBe and histopathologic findings because chronic active hepatitis was observed in 6/8 anti-HBe positive patients (75%). These findings suggest that, the evaluation of chronic carriers of HBsAg, requires a histologic analysis of the liver, including a tissue research for the virus in addition to a complete serologic study of HBV. PMID- 2695986 TI - [Infection and immunity in sickle cell disease]. AB - There is a high incidence of bacterial infections in sickle cell disease, particularly in sickle cell anemia. Pneumonia, urinary tract infections, osteomyelitis, meningitis and pneumococcal septicemia occur mainly in younger patient. The pathological basis for this susceptibility to infections is complex. Defective splenic function is the most important factor. There are also abnormalities of opsonization, alternate complement pathway, antibody production, leucocyte function, and cell-mediated immunity. Pneumococcal immunization and prophylactic penicillin are indicated in the prevention of pneumococcal infections. PMID- 2695987 TI - Transplantation of the lungs. AB - Over the last eight years a completely new form of treatment has been introduced for end-stage pulmonary vascular disease and chronic lung disease, including cystic fibrosis. Lung transplantation and heart-lung transplantation have moved from an experimental and innovative stage to clinical treatments. The exclusion criteria for selecting potential recipients have become relaxed whilst preservation techniques have improved to allow ischaemic times of donor organs to be extended beyond 4 h. Monitoring of graft function with daily spirometry and use of transbronchial lung biopsy have enabled early diagnosis of lung rejection or infection and thus effective treatment. Lung transplantation and heart-lung transplantation, by their success, are providing new insight into lung disease and pulmonary physiology. PMID- 2695988 TI - [Cholestasis]. PMID- 2695989 TI - [Effect of muscle relaxation in hypertensive patients]. AB - The efficacy of muscle relaxation in the treatment of hypertension has been described by several authors. Our experience with this type of technique is analyzed in this report. The clinical histories of 38 individuals who have taken part in the relaxation program since the end of 1984 (relaxation group: RG) with at least 6 months of follow up, have been reviewed. For each RG patient, two sex, age, and initial diastolic blood pressure (DBP) matched controls were found, obtaining thus a control group (CG) consisting of 70 hypertensive patients who were not participating in any relaxation program. The final efficacy of the program was evaluated recording the systolic blood pressure (SBP), the DBP, and heart rate (HR) 6 and 12 months after the initiation of the program also considering the drop outs and the need of drugs (evaluated with a therapeutic index: TI). There were no differences in the initial parameters between the two groups except for the TI (uncontrollable variable) which was higher in the RG. The final values in the RG showed a slightly lower blood pressure (RG = 135.2/86.9 mm Hg; CG = 139.4/90.4 mm Hg, p = 0.082 for the DBP) as well as a lower number of drop outs (RG = 18.4%); CG = 32.9%, p less than 0.1). 10 patients in the RG while none in the CG were medically discharged. (p = 0.000). The only significant difference found was the increase in TI in the CG (p = 0.000), while the increase observed in the RG was not statistically significant. PMID- 2695990 TI - [Pancreas transplant]. AB - Pancreas transplantation offers the possibility of preventing the development and progression of diabetic lesions by adequate control of hydrocarbon metabolism. Moreover, the diabetic patient is freed from dietary and physical restrictions, as well as from insulin treatment. However, this is achieved at the expense of an immunosuppression not always free of risk. For this reason, up to now, the transplantation has been reserved to those patients at a risk higher than that of immunosuppression: uremic patients who also require a kidney transplantation, patients suffering of preproliferative retinopathy, and those patients with urine protein above 150 mg/24 hours but less than 3 g/24 hours. The introduction of cyclosporine has greatly improved the transplantation results, achieving a 53% actuarial survival of the graft per year. Out of the different technics used, the one that yields best results is the transplantation of the whole organ, deriving the exocrine secretion to the urinary bladder. This method also enables early diagnosis of graft rejection by monitoring urine amylase. PMID- 2695991 TI - [Treatment of chronic cholestasis]. PMID- 2695992 TI - [Non-pharmacologic treatment of hyperlipemia: diet and exercise]. PMID- 2695993 TI - [Antiphospholipid antibodies: which ones and when?]. PMID- 2695995 TI - [Hypomagnesemia and diabetes mellitus]. PMID- 2695994 TI - [Women and ischemic cardiopathy]. PMID- 2695996 TI - [A 67-year-old male patient diagnosed with low-grade lymphoma, readmitted because of sciatic syndrome]. PMID- 2695997 TI - [Edematous papule-type lesion as a skin manifestation of systemic cryptococcosis AIDS]. PMID- 2695998 TI - [Postinfection reactive arthritis caused by Salmonella enteritidis in a HLA B27 negative patient]. PMID- 2695999 TI - [Compliance of antibiotic treatment in primary health care. Value of the personalized prescription]. AB - A controlled clinical study was carried out in order to evaluate the efficacy of a personalized prescription as a measure to improve the fulfillment of a short course antibiotic treatment. 180 patients completed the study (96 in the active group and 88 in the control group) finding no differences in selected variables between the two groups. Evaluation of treatment fulfillment was performed with an interview and counting the pills, finding with this method that 57.94% of the patients fulfilled the treatment. Except for a higher incidence of adverse side effects in the control group (p less than 0.05) no other significant differences were found between the two groups. The interview showed a 37% sensibility and a 97% specificity, which was specially usefull in the detection of nonfulfillers. The correlation coefficient between both groups was 0.66 (p less than 0.001). Our results suggest that the personalized prescription does not improve the patient compliance achieved by a good verbal information in the short course antibiotic treatment. PMID- 2696000 TI - [Perspectives on early prevention of coronary heart disease, especially in reference to Spain. Fernandez-Cruz Lecture]. PMID- 2696001 TI - [Symptomatic dorsal arteriovenous malformation of the dura mater associated with lumbar lipoma and spina bifida in adults]. PMID- 2696002 TI - [Necrosis of the bone marrow and cancer]. AB - Bone marrow necrosis (BMN) is a rare complication and is characterized by the presence of an eosinophilic amorphous material in the bone marrow. The clinical, analytical and histological characteristics of 4 patients with BMN associated to a neoplastic process are described. One of them was a gastric cancer but the neoplastic origin could not de determined in the other three cases. Three patients presented bone pain, but in all four patients thrombopenia, anemia, leuko-erythroblastic reaction and elevated LDH was found. A literature review is carried out and the possible physiopathological mechanisms are discussed. PMID- 2696003 TI - [Cardiac metabolism and free radicals]. PMID- 2696004 TI - [Arterial hypertension in the elderly: a therapeutic problem]. PMID- 2696005 TI - [Polycystic ovary: old concepts, new perspectives]. PMID- 2696006 TI - [Anti-env and anti-gag antibodies in subjects infected with the human immunodeficiency virus]. AB - Antibodies to antigens codified by the env and gag genes of HIV were separately assayed for in the sera of 150 infected people. From a practical standpoint, enzyme immunoassay was a more convenient and reliable technique than Western blot. Anti-env was positive in 100% and anti-gag in 70% of the cases. A positive anti-env test was confirmatory of serological diagnosis, but lacked any prognostic value. A higher frequency of negative results for anti-gag antibody was significantly associated with the presence of more severe clinical manifestations, more profound impairment of lymphocyte subpopulations (especially CD4 cells), and the finding of HIV antigens in blood. The absence of anti-gag antibodies, which seem to behave as protective, is an unfavorable feature in the clinical and immunological evaluation of patients. PMID- 2696007 TI - [A cystic mass in the right iliac fossa]. PMID- 2696008 TI - [XXV anniversary of the Andalusia-Extremadura Association of Anesthesiology and Reanimation (1963-1988)]. PMID- 2696009 TI - [Postoperative analgesia and dexamethasone]. AB - A randomized, double-blind, prospective study was carried out in 100 patients who had undergone some type of surgical treatment in order to evaluate the degree of pain and relief of pain, the degree of achieved analgesia according to the opinion of the observer and consumption of analgesic agents. The evaluation was carried out on seven occasions during the first 12 hours of the postoperative period. Patients received dexamethasone (4 mg before or after the operation or 8 mg after the operation), 6-methylprednisolone (16 mg at the end of the operation) or nothing (control group). Regardless of type, dose or timing of administration of the drugs, all patients receiving corticosteroids presented less pain, more relief of pain (expressed by themselves or in opinion of the observer) and needed lower doses of analgesics during the studied time. PMID- 2696010 TI - [XXV anniversary of the Andalusa-Extremadura Association of Anesthesiology and Reanimation (1963-1988)]. PMID- 2696011 TI - [Spanish pioneers in the technics of laryngotracheal intubation]. AB - Tracheal intubation technique is the result of centuries of experiments, studies and clinical trials. Among the pleiad of physicians who definitely introduced tracheal intubation in clinical practice, several Spanish physicians especially contributed to its diffusion with their research work and discoveries and in some cases they were true pioneers in techniques considered as so advanced at the beginning of this century that it was thought they would never be systematically used in clinical practice. In the present work, we discuss the contributions of these Spanish pioneers to laryngotracheal intubation technique, a technique widely used in modern medicine. PMID- 2696012 TI - [Current and controversial aspects of cardiopulmonary resuscitation]. PMID- 2696013 TI - [On "The Medical Telegraph"]. PMID- 2696014 TI - [Valvulopathies (III). Analysis of the right ventricle function and its importance in heart valve disease]. PMID- 2696015 TI - [Isolated ventricular inversion associated with complete atrioventricular septal defect with total anomalous pulmonary venous drainage]. AB - Based upon the description of the clinico-pathological characteristic of a case with isolated ventricular inversion plus other cardiac malformations, the clinical, diagnostic and embryo-pathological implications of this entity are reviewed. PMID- 2696016 TI - [Perforated sigmoiditis. Experiences with 805 cases. A multicenter study]. AB - This was a multicenter study corresponding to 40 services. For each patient, a card containing 90 questions was filled out. At the same time we sent a personal survey card with 11 criteria questions. Our cases corresponded to 805 patients, 457 males and 348 females. The highest frequency was between 50-80 years. The therapeutic methods most often used were: drainage plus Hartmann, 37.1%; drainage plus colostomy, 24.9%; resection and anastomosis without colostomy, 12.45%, and with colostomy, 5.11%; drainage plus exteriorization, 5.98%, and conservative, 4.6%. We studied the morbimortality correlation according to different anatomoclinical groups and techniques used. The results were nonsignificant for mortality and statistically significant for evisceration, eventration, diffuse peritonitis, upper gastrointestinal bleeding, anastomotic dehiscence and type of anastomosis, manual or instrumental. PMID- 2696017 TI - [Benignancy of the Delorme operation in the treatment of rectal prolapse. Indications and results]. AB - In five patients, three male and two female (average age 74 years), with complete rectal prolapse, Delorme's operation was performed, realizing resection of the entire prolapsed rectal mucosa and the suturing the plicature of the rectal muscular layer, which permits its invagination into the muscular funnel formed by the outer sphincter. This technique, which also tenses the longitudinal muscle of the rectum that is lax in every total prolapse, partially remedies the dislocation of the hiatal ligament and improves the function of the elevator muscle, which is disordered in these patients. The five patients were followed-up for 3 to 36 months. There was no postoperative morbi-mortality in patients of advanced age or high risk had to be operated for rectal prolapse. PMID- 2696018 TI - [Physiopathologic concepts related to patients undergoing total gastrectomy]. AB - Total gastrectomy due, principally, to malignant diseases, has two aims: a) to carry out an adequate oncological operation, and b) to perform a simple reconstruction of the digestive tract which must avoid biliary esophageal reflux. All other functional disturbances may be controlled by adequate diet. Pseudogastric jejunal pouches are, at present, being abandoned. The reduced intestinal malabsorption--favored by the loss of the stomach and the bacterial proliferation--is kept under control, it seemed, by the function of the "ileal brake", which, when certain fat acids and other substances reach the ileum, produce hypomotility of the jejunum with slowing up of the intestinal flow. In such patients, an important catabolism prolongs for some weeks after the operation, and lose also weight due to poor appetite and not eating enough. In view of this, it is considered justified the application of an enterostomy tube during the operation, in order to provide a supplement of food by direct intestinal way, which should begin to be used only after the first postoperative days (five-six). PMID- 2696019 TI - Regulatory mechanisms of fibroblast activity. AB - Fibroblasts are mesenchymal cells present in most organs which play a crucial role in repair processes but are also involved in the development of fibrosis. Although fibroblasts have been grown in culture for many years, their multiple functions including migration, chemotaxis, protein synthesis and others have only recently been investigated in detail. These studies demonstrated that cellular responses of fibroblasts can be elicited by matrix-mediated signals as well as by cytokines released from inflammatory or other differentiated cells. The aim of the present paper is to review the influence of such signals and to discuss their role in disease processes, particularly in fibrosis, keloids or scleroderma. PMID- 2696020 TI - [Therapy and iron supplements with ferritin iron during pregnancy. Randomized prospective study of 458 cases]. AB - A randomized polycentric study was programmed to establish the effects of daily administration of ferritin iron from early pregnancy to puerperium. 254 women with normal iron balance at the beginning of their pregnancy were randomized receiving no supplements or 40 mg iron daily. At the end of pregnancy iron balance was still normal only in one third of the pregnant women of the first group versus two third of the second group. 204 women who were iron-deficient received daily 40 or 120 mg of iron; in this group anemia developed less frequently (13% versus 29%) and iron balance normalized in one subject on four; the great majority of these women remained iron-deficient. Unwanted effects of minimal or mild relevance, and almost always sporadic were observed in 6.5% of cases and with the reduction or withdraw of the treatment in only 1.4% of cases. These results showed that daily administration of ferritin iron during pregnancy is effective and well tolerated; furthermore they suggest that the treatment must be done with at least 60 mg daily in women with normal iron balance and protracted also after the puerperium in iron deficient subjects. PMID- 2696021 TI - [Erythema nodosum: epidemiology, etiology, pathogenesis, clinical picture and therapy]. AB - Erythema Nodosum (EN) is a painful nodular syndrome, most likely of immunologic origin, which involves dermis and subcutaneous tissue. Pathologic process is that of vasculitis of the small veins with inflammation of the septa of the fat lobules (septal panniculitis). It is generally agreed that EN represents a hypersensitive reaction to a variety of antigenic stimuli and thus may be observed in the course of several diseases (infections, immunopathies, malignancies) as well as during drug therapy (with halides, sulfonamides, oral contraceptives). In approximately 50 per cent of the cases an underlying etiology is not apparent (idiopathic form). The clinical picture is always that of a nonspecific systemic illness with low-grade fever (in 60%), malaise (in 67%), arthralgias (in 64%) and arthritis (in 31%), while when there is an associated illness, this may dominate the presentation. Laboratory tests show no specific abnormalities except for those related to an underlying disease. Treatment of idiopathic form includes nonsteroidal antiinflammatory agents which usually ease the discomfort. Steroids, although highly effective, are not recommended because of the benign nature of EN and the danger of disseminating an underlying disease. PMID- 2696022 TI - Patterns of treatment failure--implications for new treatment approaches. PMID- 2696023 TI - The Milan experience with adjuvant chemotherapy in premenopausal breast cancer. PMID- 2696024 TI - Adjuvant chemo- and endocrine therapy alone or in combination in premenopausal patients (GABG Trial 1). PMID- 2696025 TI - Scottish adjuvant breast cancer trials: results in pre-menopausal patients. PMID- 2696026 TI - The role of adjuvant endocrine therapy in primary breast cancer. PMID- 2696029 TI - Correlation of dose intensity and prognosis in adjuvant chemotherapy: an extended controversy. PMID- 2696028 TI - Chemo- or endocrine adjuvant therapy alone or combined in postmenopausal patients (GABG Trial 1). PMID- 2696030 TI - Prognosis in breast cancer. PMID- 2696027 TI - Adjuvant chemo-endocrine therapy or endocrine therapy alone for postmenopausal patients: Ludwig Studies III and IV. PMID- 2696031 TI - Significant survival benefit of node-negative breast cancer patients treated with adjuvant chemotherapy: seven-year results. PMID- 2696032 TI - Adjuvant immunotherapy in node-negative patients: results of a Scandinavian study. PMID- 2696033 TI - Breast-conserving surgery and the role of adjuvant radiotherapy: a review. PMID- 2696034 TI - Therapy of early breast cancer: preliminary results of the German Breast Cancer Study. AB - The German Breast Cancer Study Group has a large, homogeneous patient population with pT1 pN0 breast cancers who have undergone a detailed pathohistological work up and uniform treatment. Seventy institutions take part in this study, mostly community hospitals. All pathologic specimens are reviewed by the Pathology Reference Center. Moreover, in order to improve the quality of radiation therapy, all dosimetric data, radiation protocols, and localization, and verification films are reviewed by the Radiotherapeutic Study Centre. By January 31, 1988, 762 patients had been recruited. At the moment, after an admittedly short follow-up period for the majority of our patients, there is no evidence of differences between the two treatment arms concerning the incidence of local and distant recurrences, contralateral breast cancers, and other malignancies. However, the study demonstrates several unresolved problems, mainly the collection of follow up data which can arise when many institutions especially community hospitals and general practitioners, are involved in a prospective trial. PMID- 2696035 TI - Methods for assessing treatment efficacy in trials for adjuvant therapy for breast cancer. PMID- 2696036 TI - Overview of adjuvant radiotherapy for breast cancer. PMID- 2696037 TI - Randomized multicenter 2 x 2-factorial design study of chemo/endocrine therapy in operable, node-positive breast cancer (protocol 2). PMID- 2696038 TI - Dose response for adjuvant chemotherapy of breast cancer: experimental and clinical considerations. PMID- 2696039 TI - Adjuvant therapy of primary breast cancer. Closing summary and outlook. PMID- 2696040 TI - Randomized perioperative therapy in operable breast cancer: the Ludwig Trial V. PMID- 2696041 TI - Is there a role for perioperative adjuvant cytotoxic therapy in the treatment of early breast cancer? PMID- 2696042 TI - Radiation therapy in prevention and salvage of local relapse: its prognostic implication. PMID- 2696043 TI - Salvage treatments in relapsing resectable breast cancer. PMID- 2696044 TI - New information on drug resistance: implications for the adjuvant treatment of breast cancer. AB - We would suggest on the basis of our analysis that drug resistance still appears to represent a plausible explanation for drug treatment failure in adjuvant breast chemotherapy. It may not be the only factor, but, if present, clearly has to be circumvented if treatment results are to be improved. Since it seems most unlikely that a new wonder drug for breast cancer will emerge in the next few years, then it is to our existing armamentarium of antineoplastic agents that we will have to turn for improved therapeutic results. Fundamental questions will need to be asked about what indeed are the most appropriate agents to be used in combination chemotherapy protocols for this disease and what are the optimal dose ratios. Our own institutional experience in a number of areas has suggested that many chemotherapeutic protocols that are widely used represent significant underdosing and that achieving optimal results requires pushing therapeutic agents closer to the reasonable limits of tolerance. Enhanced techniques for patient support during programs of more intensive chemotherapy are now available, and it has also been our experience that patients tolerate briefer, intensive programs of chemotherapy better than they do protracted, less intensive protocols. The role of new drug combinations that incorporate synergistic or significant biochemical modulation effects (i.e., platinum-etoposide, 5 fluorouracil-leucovorin) need to be examined in the context of the management of breast cancer. We appear to have reached something of a plateau with existing protocols and approaches, and it is time to move ahead. PMID- 2696045 TI - Detection of recurrence: a critical assessment of existing methods and programs. PMID- 2696046 TI - 27th Forum in Immunology. The macrophage resistance gene Lsh/Ity/Bcg. PMID- 2696047 TI - The macrophage resistance gene Lsh/Ity/Bcg. PMID- 2696048 TI - A comparison of genetic linkage maps surrounding the Lsh/Ity/Bcg disease resistance locus. PMID- 2696049 TI - A reverse genetics approach to Bcg/Ity/Lsh gene cloning. PMID- 2696050 TI - The search for a human homologue of the mouse Bcg host resistance locus. PMID- 2696051 TI - Mycobacterium lepraemurium and the Ity/Lsh/Bcg mouse gene. PMID- 2696052 TI - Functional expression of the Bcg gene in macrophages. PMID- 2696053 TI - Role of Lsh in regulating macrophage priming/activation. PMID- 2696054 TI - Lsh, antigen presentation and the development of CMI. PMID- 2696055 TI - Ity and after. PMID- 2696056 TI - Acetylaminofluorene-labelled ribosomal RNA for use in molecular epidemiology and taxonomy. AB - The use of acetylaminofluorene-labelled 16 + 23S rRNA (from Escherichia coli) is described for determining rRNA-gene-restriction patterns. The labelled probe allowed molecular fingerprinting of bacteria belonging to diverse phylogenetic branches (Enterobacteriaceae, Haemophilus, Pseudomonas, Acinetobacter, Brucella, Leptospira, Cytophaga, Campylobacter, Methylophaga). The labelled probe can be stored frozen (-20 degrees C) for at least a year and can endure vacuum dessication, ethanol precipitation or lyophilization. PMID- 2696057 TI - Nucleotide sequence of the plasmid-borne virulence gene mkfB from Salmonella typhimurium. PMID- 2696058 TI - Linear chromosome of Borrelia burgdorferi. AB - The DNA organization of several European and American isolates of Borrelia burgdorferi, the aetiological agent of Lyme disease, was analysed in pulse-field agarose gel electrophoresis. The results of in situ cell lysis in agarose plugs demonstrated a unique arrangement for the DNA of this spirochete. The chromosome of Borrelia behaved as a eukaryotic linear chromosome with a size of around 1,000 kb. The genome also comprised several circular and linear plasmids which varied in size from 15 to 60 kb. PMID- 2696059 TI - Activation of amino acid transport during steady-state growth of Escherichia coli. AB - Accumulation of amino acids in exponentially increasing cultures of Escherichia coli was linear, supporting the interpretation that the biphasic response observed when cultures grew without these acids reflects a transient perturbation in accumulation. Rates of accumulation of glutamine, histidine and glycine were compared in steady-state and non-steady-state cultures. Their uptake rates were markedly enhanced in steady-state cultures at low exogenous concentrations, 10 microM or less. The results support the activation of amino acid transport systems by low concentrations of the particular amino acid present during growth. This activation was decreased when exogenous concentrations of the amino acid were markedly increased or when cells were washed free of the amino acid. Upon readdition of the amino acid after washing, recovery of enhanced transport required several generations, supporting a process of recovery other than enzymatic induction. The observation of amino acid enhancement of transport for eight other amino acids examined in steady-state culture suggests that this enhancement is a common process. PMID- 2696060 TI - Legionella gratiana sp. nov. isolated from French spa water. AB - During an epidemiologic survey, an unidentified strain of Legionella was isolated from water of a thermal spa in France. The strain (Lyon 8420412) had the cultural and biochemical characteristics typical of the genus Legionella. In direct immunofluorescence tests, the strain reacted weakly with fluorescein-conjugated antisera prepared against L. bozemanii serogroups 1 and 2, L. longbeachae serogroups 1 and 2 and L. anisa, and failed to react with sera prepared against 36 other species or serogroups. A fluorescein-conjugated antiserum prepared against strain Lyon 8420412 reacted strongly with the homologous strain and only weakly with the above-mentioned species. The cell-wall fatty acid profile, with a predominance of hexadecenoic (16:1) and hexadecanoic (16:0) acids, ubiquinone Q10 as the major quinone and a characteristic protein electrophoresis profile suggested that the isolate was different from other Legionella species. In DNA DNA hybridization experiments, the strain was distinct from all named Legionella species, and from all unnamed species currently under study at the Centers for Disease Control. The name Legionella gratiana is proposed for the new species (type strain Lyon 8420412; CDC 1242). A serologic survey of antibodies reacting against L. gratiana indicated that personnel or patients at the spa therapy centre where the organism was isolated had higher antibody titres than a control population. PMID- 2696061 TI - The sarcoidosis and granulomatous disorders in Portugal some considerations and historical remarks. PMID- 2696062 TI - [Role of the thyroid in first-trimester miscarriage]. AB - In case of maternal hypothyroidism, the number of miscarriages is higher and reaches 50% in this multicenter study. Several hypotheses are advocated in order to explain this frequent occurrence: the most remarkable is that as substitute treatment is very effective and decreases noticeably the risk of abortion. In case of maternal hypothyroidism, the frequency of abortions in this study reaches 35% before the disease is diagnosed and this figure is not modified (35%) after the diagnosis is made and the treatment initiated. Finally, in case of goiter or euthyroid nodules, there is also a relatively high number of spontaneous abortions. Therefore, there are still a number of unknown factors regarding the role of dysthyroidisms in spontaneous first-trimester abortions. PMID- 2696063 TI - [Hyperthyroidism and pregnancy. A retrospective multicenter study Nord-Picardie Champagne. Report of 48 cases]. AB - In 92,130 pregnancies followed between 1980 and 1987, 48 cases of hyperthyroidism were reported including 38 Grave's diseases, 5 toxic adenomas, 4 multinodules goiters. In comparing the results with those mentioned in the literature, a number of conclusions may be reached. In case of hyperthyroidism treated before the pregnancy or discovered at the beginning, there is, in every other case, an aggravation at the end of the first trimester, then a stabilization in the 2nd or 3rd trimester and finally an aggravation in the post-partum period. There is a high rate of abortions (35 p. cent), a delayed intra-uterine growth in half of the cases. The problem of the treatment is of paramount importance; there is no problem with Beta-blockers but the SAT are not without danger: risk of hypothyroidism and fetal goiter, but also risk of maternal hypothyroidism. From the 15th week, the doses should therefore be decreased, and sometimes the treatment discontinued and replaced with Beta-blockers. The best SAT drug during pregnancy is the propylthioracile which is the least likely to cross the fetal barrier. Surgery is only exceptionally indicated. In a woman who is cured from her Grave's disease, recurrences are always possible, and also fetal hyperthyroidism caused by crossing of thyreostimulins immunoglobins, even in case of maternal euthyroidism. PMID- 2696064 TI - [Thyroid cancer and pregnancy]. AB - Thyroid cancer is very rare during pregnancy, but a thyroid nodule is more likely to be cancerous if discovered during pregnancy (43 p. cent versus 15 p. cent). The diagnosis is more difficult. Tests using radioactive substances are contraindicated during pregnancy. Ultrasonography does not permit to specify the nature of the nodule and aspiration biopsy with cytological examination becomes the examination of choice. One should not hesitate to operate on these nodules, during pregnancy, if the diagnosis is made. It is difficult to assert that the prognosis is aggravated by pregnancy since there are so few cases, but several authors report a few cases with an abnormally fast progression during pregnancy. Forms which are properly treated and occurred before the age of 40, are not a contraindication to subsequent pregnancies, if they are not anaplastic or metastatic forms. However, a reasonable delay of the surgery is advised in order to stabilize the hormonal treatment and the calcium-phosphorus balance. PMID- 2696065 TI - [Children of hyper- and hypothyroid mothers]. AB - A multicenter study was able to utilize 120 medical files of children born from mothers who presented an abnormal thyroid function, 67 euthyroid goiters, 29 hyperthyroidisms, and 24 hypothyroidisms. In the first case, whether or not an inhibiting treatment was initiated, all children were perfectly normal. In case of maternal hyperthyroidism, the risk of malformations is not increased, deaths in utero and mostly in utero growth delays (1 case in 2) are more frequent. At birth, the child may present a hyperthyroidism due to the effect of SAT with elevated TSH and a goiter, sometimes compressing and impairing breathing, or also a hyperthyroidism due to transplacental crossing of stimulating immunoglobulins with possibility of thyreotoxic crises and heart failure. The diagnosis could be made in utero in the presence of tachycardia or with T4 and TSH assays in the cord. In case of maternal hypothyroidism, usually the children have no problems and the risk of neonatal hypothyroidism is mostly present in premature infants if the maternal balance is poor (2 in 24 cases in our series). Finally, in the reference population, the risk of neonatal hypothyroidism remains 1 in 3600 and justifies systematic screening on the 5th day of life. PMID- 2696066 TI - [Proposal for a new therapeutic strategy in high genital infections]. AB - 78 cases of acute salpingitis were treated with the association Oflocet-Augmentin in a multicenter study. An accurate clinical and bacteriological evaluation was carried out prior to the treatment and a control laparoscopy was performed in 31 cases. A Chlamydia infection was responsible in 56 p. cent of the cases; only one bacteria was identified in 56 cases and an association of two or three bacteria in 15 cases; in 7 cases, no bacteria was identified. The antibiotic association was effective in 96 p. cent of the cases, with a good clinical and biological tolerance. Three failure were reported: one in an infection secondary to a non identified bacteria, and two in Chlamydia infections where, despite the clinical cure, a positive culture persisted in the abdomen. The association Oflocet Augmentation is therefore recommended in the treatment of high genital infections. PMID- 2696067 TI - [Anatomo-surgical study of hemorrhagic risks in urethro-vesical Burch-type suspension]. AB - The authors studied the topographical anatomy of the areas involved in urethro vesical suspension, type Burch, in 25 female cadavers. They notice that, with the Burch procedure, the specific haemorrhagic risks are represented by lesions of the external iliac vein and sometimes lesions of the anastomosis between epigastric and obturator artery, which may be caused when the needle goes through the most lateral portion of Cooper's ligament, if this needle is directed upwards and outwards. PMID- 2696068 TI - [Transvesical cesarean section]. AB - On the basis of a clinical case the authors report the technique of laparotomic transvesical incision for cesarean section, which, nevertheless, has limited and special indications. PMID- 2696069 TI - [Etiopathogenesis of aplastic anemia and of the severe form treated with immunosuppression and bone marrow transplantation]. AB - Aplastic anemia is a condition characterized by bone marrow hipoplasia and pancytopenia. Various etiologic agents are related to the acquired form of this disease but in many cases the causative agents remain obscure. Severe aplastic anemia has been treated by immunosuppression and allogeneic marrow transplantation. PMID- 2696070 TI - The Rhode Island Medical Journal heritage. PMID- 2696071 TI - Treatment of granulomatous disorders of the nose and paranasal sinuses. AB - The granulomatous disorders discussed in this review are Wegener's granulomatosis (WG), lymphomatoid granulomatosis (polymorphic reticulosis) and "idiopathic midline granuloma". The treatment of choice of WG is combined therapy with corticosteroids and cyclophosphamide. Severely ill patients may be treated with intravenous bolus infusions of cyclophosphamide. Otherwise oral administration is used. Therapy must be adjusted according to leucocyte and thrombocyte counts. After clinical remission cyclophosphamide must be continued for at least a year under hydration sufficient to cause nycturia in order to protect the bladder mucosa. Corticosteroids can be withdrawn 9-10 months after clinical remission. Relapse of WG can be identified by clinical and laboratory (ESR, CRP, HB, urinary sediment) findings, including detection of anti-neutrophil cytoplasm antibodies (ANCA). Alternate treatment with azathioprine or trimethoprim/sulfamethoxazole may be used in patients with localized or smoldering disease. Furthermore trimethoprim/sulfamethoxazole may be used as adjunctive treatment. Lymphomatoid granulomatosis appears to be a T-cell lymphoma and should be treated aggressively with combination cytotoxic therapy and irradiation of localized manifestations. "Idiopathic midline granuloma" does not seem to exist but appears to be either WG or lymphomatoid granulomatosis when repeated biopsies are examined with monoclonal antibodies and/or serum examined for ANCA. PMID- 2696072 TI - A review of the role of radiology in non-healing granulomas of the nose and nasal sinuses. AB - This paper reviews the radiological features of 20 patients with Wegener's granulomatosis and seven cases of lethal midline granulomas. It compares the findings of plain sinus radiographs and tomography. There are no specific radiological features of either Wegener's granulomatosis or lethal midline granuloma. Plain sinus radiographs underestimate the extent of bony changes and the differences between Wegener's and lethal midline granulomas are one of degree. Computerised tomography will show the extent of the disease. The role of nuclear magnetic resonance is also discussed. Nuclear magnetic resonance does not show bone destruction but the T2 weighted response of the tissues helps to differentiate the condition from neoplasia. The literature is reviewed and compared with the study. PMID- 2696073 TI - Frequent irrigation in maxillary sinusitis therapy. AB - 190 cases of maxillary sinusitis with retention of secretions were treated by frequent irrigation through an irrigation tube inserted via inferior turbinate sinus. The technique of the tube insertion through a Lichtwitz needle is described. Repeated irrigations do not need any anaesthesia and are better approved by the patients than the usual puncture irrigation. The response seems to be at least equally good as has been observed in similar patient series by repeated puncture irrigations. The patients' requests of reinsertion of irrigation tube in cases of recurrencies gives addition support to the recommendation to accept such a therapy. PMID- 2696074 TI - The effect of physical work on the mucosal blood flow and gas exchange in the human maxillary sinus. AB - The paranasal sinuses are lined with respiratory mucosa of principally the same structure as in the nasal mucosa but somewhat thinner. This mucosa has a rich blood flow and advanced system of blood vessels regulated mostly by the autonomous nervous system but also by other factors as acid/base balance and endocrine activity. The thickness of the nasal mucosa regulates the nasal breathing resistance and varies with among other factors, body activity. In this investigation we have studied the effect of physical work on the human maxillary sinus mucosa. The investigation shows that, as in the nose, the blood flow and the pulse amplitude are considerably reduced during physical work, in situations of heavy work falling to about half of the normal level, and probably result in the redistribution of blood from the respiratory mucosa. The gas exchange in the paranasal sinus is reduced only to a small extent, the reduction being too small to change the antral gas composition towards pathological conditions. PMID- 2696075 TI - Nasal provocation with histamine: a comparison of the determination of the threshold of reactivity by three methods of rhinomanometry. AB - Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (P.A.R.). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from A.A.R. and P.A.R. (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For A.A.R. and A.P.R., histamine thresholds were assessed at five different pressure values as well as at five different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357). PMID- 2696076 TI - Critical review of Vidian neurectomy. AB - The author presents the critical review of Vidian neurectomy since 1961. Golding Wood (1961, 1962) recommended this type of operation in vasomotor rhinitis. Many authors modified this operation. The author concludes that Vidian neurectomy is indicated in the cases of vasomotor rhinitis with profuse secretion refractory to conservative treatment. PMID- 2696077 TI - A history of otorhinolaryngology in Japan and China. PMID- 2696078 TI - Classification, distribution and importance of arboviruses. AB - This essay reviews in concise form an extensive subject. Arborviruses belong to a number of different taxonomic groups, some of which include viruses not transmitted by arthropods. A state of the art definition of arboviruses is given which does recognise the importance of vertical transmission in arthropods to the basic maintenance of some arboviruses. Most of the arboviruses which affect humans are included in the families Togaviridae, Flaviviridae, Bunyaviridae, Reoviridae and Rhabdoviridae. Many arbovirus infections are symptomless. Clinical manifestations range from mild febrile illness, which may or may not be accompanied by skin rash and by arthralgia, to severe and often fatal encephalitis or haemorrhagic fever with shock. Three arboviral diseases considered at present as the most important ones are discussed in more detail: dengue and dengue haemorrhagic fever (DHF), yellow fever and Japanese encephalitis (JE). They have caused some of the most devastating epidemics in recent years. DHF has developed into a major paediatric problem in South East Asia and the Western Pacific with over 6,000,000 hospital admissions and 20,000 deaths in the two regions over the last 20 years. Spectacular outbreaks of yellow fever, such as the one in Ethiopia in 1960-1962 with 15,000-30,000 estimated deaths, still occur in Africa in areas contiguous to rain forest regions where jungle yellow fever is enzootic. JE is characterized by significant mortality in children and old people in many countries of Asia, where the epidemiological patterns and the distribution of the disease have changed in recent years. The complex interrelated factors which are involved in arbovirus ecology are illustrated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696079 TI - The seroreactivity against Pf155 (RESA) antigen in villagers from a mesoendemic area in Somalia. AB - Pf155 (RESA), a malaria antigen in the membrane of infected red cells, was recently identified as a possible future malaria vaccine candidate. In this study the seroreactivities against this antigen were compared with those against crude parasitic antigens in 195 subjects from a Somali village with mesoendemic malaria. The seroreactivities were determined with immunofluorescence. With age, there was an increased seroreactivity to both Pf155 and the crude parasitic antigens. However, the acquisition of seroreactivity was much slower against Pf155. Hence in the age group 15-24 years, only half of the subjects had detectable antibodies against Pf155. PMID- 2696080 TI - Detection of Wuchereria bancrofti antigen in serum and finger prick blood samples by enzyme immunoassay: field evaluation. AB - We have recently reported that a monoclonal antibody-based enzyme immunoassay for detection of filarial antigen in human serum is sensitive and specific for active infection with Wuchereria bancrofti. The present studies were undertaken to assess the feasibility of testing whole blood collected by finger prick in this assay. A preliminary study was performed to compare antigen test results obtained with whole blood, blood dried on filter paper, and serum. Results obtained with anticoagulated whole blood specimens agrees with serum results in 94 of 97 cases. All whole blood and serum specimens from 28 people with positive microfilaria smears were positive in the test. Filter paper blood specimens were less satisfactory because of decreased sensitivity and specificity. A population-based survey of 1009 persons was conducted in a village near Calicut, India, to evaluate the use of finger prick blood specimens for filarial antigen detection in field studies. Thirty-eight of 39 microfilaria carriers had positive antigen tests. In addition, 10.7% of amicrofilaremic endemic controls had positive tests. Additional studies are needed to test the hypothesis that filarial antigenemia in endemic controls indicates the presence of subclinical infection. PMID- 2696081 TI - Specific detection of human antibodies to Onchocerca volvulus. AB - Specific diagnosis of antibodies to Onchocerca was achieved through (1) the construction of direct and indirect ELISA systems, and (2) restricting ELISA assays to the IgG4 class. The direct ELISA was based on the isolation of a surface derived, low molecular weight surface antigen preparation containing two main antigens (M. wt. 16.2 and 12.8 kDA) as defined by Western blot analysis. The direct ELISA system detected antibodies in children of six years old, and may therefore be applicable to detecting reinvasion in OCP areas of Onchocerca volvulus control. The indirect ELISA system was a competitive binding ELISA-based assay using a monoclonal antibody recognising two Onchocerca components (M. wts. 15.6 and 25.9) on a Western blot. The direct and indirect ELISA systems were similarly specific and sensitive when evaluated in a preliminary survey. The direct ELISA system yielded a specificity and sensitivity of: 100% and 100% respectively, using Mexican endemic and Mexican intestinal nematode infection sera as positive and negative controls respectively: 91% and 96% respectively, using Venezuelan endemic and Venezuelan Mansonella ozzardi infection sera as positive and negative controls, respectively: 87% and 93% respectively, using African endemic and Papuan (New Guinea) Wuchereria bancrofti infection sera as positive and negative controls respectively: 93% and 93% respectively, using African endemic and Indian W. bancrofti infection sera as positive and negative controls respectively. Similar specificity and sensitivity levels were obtained when the same comparisons were made using the indirect (inhibition) ELISA assay. These values may be contrasted with the currently used PBS extract of O. volvulus which yielded specificities of less than 10% in all the above comparisons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696082 TI - Further evidence of a skewed distribution of microfilariae in capillary blood. AB - Reported are results for 23 Haitian patients with capillary Wuchereria bancrofti microfilaremias greater than 30 mf/20 cmm blood. In capillary blood, the number of microfilariae was 0.9 to 7.8 times greater than expected when compared with that in venous blood. When the values for venous blood and capillary blood from these high count patients were plotted, the simple linear regression y = a + bx (r2 = .36) and the exponential function y = aebx (r2 = .34) both represented the relationship. However, when values for high and low count patients were plotted, the power function y = axb (r2 = 0.82) best described the relationship between the number of microfilariae in venous and capillary blood. PMID- 2696083 TI - The American concept of schizophrenia. AB - The American concept of schizophrenia is built primarily upon concepts advanced by Kraepelin, Bleuler, and Schneider. Because of the influence of major research studies such as the International Pilot Study of Schizophrenia and the U.S./U.K. study, emphasis has been placed on developing reliable descriptions of symptoms and a precise definition of the disorder. This research also led to a recognition that the American concept of schizophrenia was relatively broad in comparison with that used in the rest of the world. This led to a critical reappraisal of American diagnostic practices during the 1970's, culminating in the narrower definition of schizophrenia in the third edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III). This definition requires the presence of psychotic features, established chronicity, evidence of deterioration, and the exclusion of affective and "organic" features. In comparison with this definition, the Soviet concept appears to be much broader and to include non-psychotic forms. Treatment implications of these differences are discussed. PMID- 2696084 TI - Sluggish schizophrenia in the modern classification of mental illness. AB - The concept of latent schizophrenia was developed by E. Bleuler (1911) and was further promoted in the studies of a number of research psychiatric schools of Europe, the United States, Japan, and other countries. In Soviet psychiatry, there is a long-established tradition of studying "soft" forms of schizophrenia (Kerbikov 1933; Rozenshtein 1933; Brukhanskii 1934). In the systematics of schizophrenia, developed by Snezhnevsky (1969) and his colleagues, sluggish schizophrenia is viewed not as an initial (prodromal) stage of schizophrenia, but rather an independent diagnostic category characterized by a slowly progressive course, subclinical manifestations in the latent period, overt psychopathological symptoms in the active period, and then by a gradual reduction of positive symptoms, with negative symptoms predominating the clinical picture during patient stabilization. Studies are reviewed examining the relationship of constitutional and genetic factors to the clinical manifestation of sluggish schizophrenia. Finally, the importance of methodological considerations and an examination of divergent factors in the U.S. and Soviet concepts of schizophrenia are presented. PMID- 2696085 TI - Dangerousness and commitment of the mentally disordered in the United States. AB - This article describes recent developments in mental health laws in the United States, especially as they relate to uses of the concept of "dangerousness" in the civil and criminal commitment of the mentally ill. In addition to providing a brief overview of the U.S. legal system and noting the importance of the Rule of Law, we review the historical development and current status of the relevant laws, provide some basic epidemiological statistics, and refer to some of the considerable body of extant empirical research in the field. PMID- 2696086 TI - Can schizophrenia be related to prenatal exposure to alcohol? Some speculations. AB - There is a growing body of evidence implicating prenatal insults in the etiology of schizophrenia, although the etiological process is unclear. In this article we propose that prenatal exposure to alcohol may relate to a small fraction of patients who later develop schizophrenia. PMID- 2696087 TI - [Organ manifestations of malignant lymphoma. Results of 10 years' sonographic follow-up of 550 patients]. AB - Over a period of 10 years and by performing slightly more than 5,000 examinations, the incidence rate of organ infiltrations in case of malignant lymphomas was determined in 550 patients. 316 of these patients had non-Hodgkin lymphomas of low malignancy (NHLL), 127 non-Hodgkin lymphomas of high malignancy (NHLH) and 107 patients had lymphogranulomatosis. Liver infiltrations were detected in 30.9% of the patients with LG, in 31.5% of the patients with NHLH and in 13% of the patients with NHLL. In respect of histology, sonography had a sensitivity of 89 and a specificity of 95%. 17.8% of the patients with LG, 8.7% of those with NHLH and 6% of those with NHL had a nodular spleen infiltration; only 2 out of 21 patients of whom comparative histology was available had been falsely assessed negatively. In 2.8% of the patients with LG, 13.4% of those with NHLH and 5% of those with NHLL an infiltration of the gastrointestinal tract was seen. Compared with histological findings, sonography had a sensitivity of 85.7% and a specificity of 93.2%. Infiltrations of the pleura were more frequent in patients with lymphogranulomatosis (13.1%) than in patients with NHLH (7.8%) or NHLL (3.8%). The same phenomenon was seen in infiltrations of the pericardium (LG 10.3%, NHLH 8.7%, NHLL 2.8%). Infiltrations of thyroid, kidneys and urinary bladder are less frequent; the assessed rate of incidence is at the most 2%. Sonography is the imaging method of choice in the diagnosis and follow-up control of organ infiltrations in malignant lymphomas. PMID- 2696088 TI - [Sonography in acute pancreatitis--diagnosis, assessment of etiology and evaluating prognosis]. AB - Fifty consecutive patients suffering from acute pancreatitis were studied prospectively with regard to the role of ultrasound (US) in diagnosis, in detection of a biliary origin, and in initial assessment of prognosis. In six patients the pancreas could not be visualised, whereas in 19 only partial examination was possible. In 34% no diagnostic abnormalities were found. US was superior to computed tomography (CT) in respect to the detection of small amounts of ascites, but less suitable than CT for the detection of necrosis. Compared to endoscopic retrograde cholangiography US was of little help in detecting bile duct stones. Neither a lethal outcome nor a severe course could be predicted with sufficient accuracy. The positive predictive value for the presence of necrosis was 33% and the negative predictive value 67%. The data demonstrate a limited role of US in diagnosis and staging in acute pancreatitis. PMID- 2696090 TI - [Duplex sonography in postoperative monitoring of pancreatic transplants--initial experiences]. AB - Duplex ultrasound has gained importance in postoperative monitoring of renal transplants; however, there is no published data on its value in pancreatic transplants. The present study reports on simultaneous pancreatic and renal transplantation of two patients submitted to Duplex scan and conventional ultrasound. During intervals without clinical evidence of complications continuous systolic/diastolic flow was observed. In one case of acute pancreatic rejection Duplex sonography delineated significant reduction of diastolic flow paralleling morphological changes in US. Therefore, relevance of clinical exploration and diagnostic US may be increased by supplementary use of duplex ultrasound. PMID- 2696089 TI - [Control of surgical portosystemic shunt in children using computerized duplex sonography]. AB - The major postoperative question is whether or not the shunt is patent. We demonstrate the possibilities of the postoperative controls of shunt patency with computer Duplex scan. Direct visualization of the shunt only is not a good parameter for shunt patency and function. An early postoperative control of shunt patency is possible by a Duplex sonographic investigation including flowmetry of the shunt, the portal vein, the hepatic artery and the hepatofugal collaterals. In this article we demonstrate the change of the portal system after a portosystemic shunt is made. If the shunt is patent, we found a decrease of the diameter, the time average velocity and the flow of the portal vein and the hepatofugal collaterals. These parameters can be used as indirect signs of patency. PMID- 2696091 TI - [Possibilities of 3-dimensional ultrasound imaging]. AB - This is a report on the clinical use of sonographic imaging. Experimental studies have shown that parallel sonographic sections are available only in vitro, which means no in-vivo three-dimensional reconstruction is possible as it is with magnetic resonance and computed tomography. The idea that a coordinated sequence of sections can be obtained by spatial rotation of the plane of sound so that the individual sections differ from one another by defined angular distances, enables three-dimensional reconstruction of sonographic in-vivo sections. A transducer was constructed that enables the production of sonographic sections rotating around a fixed center of rotation. Its clinical usefulness was tried and confirmed in the imaging of early pregnancies, benign and malignant carcinomas of the breast, and in imaging a gallbladder with a solitary gallstone. Three dimensional imaging can be achieved either as a ring-shaped structure or with a continuous surface. This points to the possibility of diagnosing malformations early in pregnancy if the number of sections is sufficiently high. In tumour imaging the malignant tumour seems to be clearly distinguishable from the benign one; three-dimensional diagnosis is likely to furnish important additional criteria in diagnosis. Further clinical studies will have to verify this. PMID- 2696092 TI - [I. S. Belostotskii--the first organizer of Soviet public health in the Central Ural]. PMID- 2696093 TI - [From the history of sanitary organization of Amur water basin]. PMID- 2696094 TI - Toxic epidermal necrolysis. AB - Toxic epidermal necrolysis is a potentially fatal dermatological disease. Large bullae covering extensive areas of the body cause continuous exfoliation of skin, which requires immediate medical attention. Intraoral manifestations may precede cutaneous lesions. Two cases with different treatment protocols are presented. PMID- 2696095 TI - [Functional control of vena cava filters using duplex sonography]. PMID- 2696096 TI - [Changes in the flow behavior of veins of the lower leg with the use of compression]. PMID- 2696097 TI - [Duplex sonography of primary varicose veins]. PMID- 2696098 TI - [Hemostaseologic changes as causes of venous thromboses]. PMID- 2696099 TI - [Anticoagulant treatment following deep venous thrombosis]. PMID- 2696100 TI - [Physical prevention of thrombosis]. PMID- 2696101 TI - Thrombolytic therapy in deep vein thrombosis. PMID- 2696102 TI - [Diagnosis of deep leg vein thrombosis with color-coded duplex ultrasound]. PMID- 2696103 TI - [Status of color-coded Doppler ultrasound in imaging of stenoses and occlusions of the femur and knee]. PMID- 2696104 TI - [Duplex ultrasound measurement of hemodynamic parameters at rest and following arterial stenosis: effect of intra-arterial infusion therapy with prostaglandin E1]. PMID- 2696105 TI - [Use of color-coded Duplex sonography for morphologic and hemodynamic assessment of postoperative aneurysms in bioprostheses]. PMID- 2696106 TI - [Color Doppler ultrasound of the carotid artery]. PMID- 2696107 TI - [Effect of muscle, fascia and fatty tissue on quantitative measurement with duplex and color Doppler ultrasound]. PMID- 2696108 TI - [Can echo-contrast enhancing substances improve imaging of the superficial femoral artery in the adductor canal using angiodynography?]. PMID- 2696109 TI - [Conventional and color-coded duplex sonography in a comparative study: quantitative flow measurements in a phantom in vitro]. PMID- 2696110 TI - [The effect of naftidrofuryl on macro- and microcirculation, tissue oxygen supply and blood rheology]. PMID- 2696111 TI - ["Doppler color" ultrasound: principles and results of examining peripheral vessels]. PMID- 2696112 TI - [Duplex ultrasound of the cerebrovascular area]. PMID- 2696113 TI - [Clinical use of duplex ultrasound in vascular disorders of the abdomen]. PMID- 2696114 TI - [Clinical use of duplex ultrasound in peripheral arterial occlusive disease]. PMID- 2696115 TI - [Exploration of peripheral veins using ultrasound technics (echography with Doppler)]. PMID- 2696116 TI - [Laser Doppler flux motion in peripheral arterial occlusive disease]. PMID- 2696117 TI - [A new triple probe for simultaneous measurement of transcutaneous oxygen partial pressure in combination with laser Doppler flowmetry and dynamic fluorescence videomicroscopy]. PMID- 2696118 TI - Peripheral necrosis of hind legs of rabbits immunized with elastin. PMID- 2696119 TI - Evaluation of endoscopic ultrasonography for gastric tumors and presentation of three-dimensional display of endoscopic ultrasonography. AB - We have studied the usefulness of endoscopic ultrasonography (EUS) for: (1) differentiation between extragastric mural compression (EGMC) and submucosal tumors (SMT); (2) qualitative assessment of these lesions; (3) diagnosis of serosal invasion by malignant gastric tumors; (4) presentation of three dimensional display of EUS findings. A total of 103 patients with submucosal lesions protruding into the gastric lumen on endoscopy were examined. Differentiation between EGMC and SMT could be made by EUS in all cases. Qualitative assessment of these lesions was made by observing their EUS findings, i.e. their internal and marginal echo pattern and their location in the gastric layers. The correct diagnosis was made in 88% (23/26) of EGMC. Of 50 patients with SMT, comprising myogenic tumor (32), aberrant pancreas (8), lipoma (3), gastric cyst (4) and malignant lymphoma (elevated type; 3), differentiation between malignant and benign myogenic tumors was impossible by EUS alone. In addition, 48 patients with advanced gastric cancer and malignant lymphoma were examined. Invasion to the serosal surface was diagnosed as interruption of the fifth layer of the gastric wall. Invasion to other organs was diagnosed by interruption and fusion of the fifth layer into the border of the adjacent structure. Serosal invasion was diagnosed accurately in 65% of 48 patients. Microscopic invasion was difficult to diagnose, and gastric stenosis by tumor was an obstacle to adequate scanning. EUS can be valuable in the differential diagnosis between EGMC and SMT and in the qualitative diagnosis of gastric lesions. It is also effective in detecting serosal invasion by gastric malignant tumors. Three-dimensional display of pathological lesions is new in EUS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696120 TI - Endoluminal sonography in follow-up of rectal carcinoma. AB - Fourteen patients who had undergone local excision, anterior resection or low anterior resection for rectal carcinoma were examined by endoscopic ultrasonography. In two of three cases of local recurrent carcinomas, endoscopic sonography was superior to computed tomography in determining the depth of tumor infiltration. There were difficulties in differentiating scar tissue from local tumor formation when the mucosa appeared normal upon endoscopic examination. Only repeated follow-up examinations starting in the postoperative period, will allow a differentiation between scar tissue and local tumor recurrence. PMID- 2696121 TI - [The fight about people's genes]. PMID- 2696122 TI - [The first issue of the Danish Dental Journal in 1889]. PMID- 2696123 TI - [Working conditions for Danish dentists 100 years ago]. PMID- 2696124 TI - [Gold foil]. PMID- 2696125 TI - [Glass ionomers--types and clinical application]. AB - With the formation of the glassionomers one wanted to combine the major qualities of the silicate cement, the composite resins and the polycarboxylate cement. The greatest advantages are bonding to tooth structure, the release of fluorides and thereby an inhibition of secondary caries, and a thermal coefficient similar to tooth structure. The glassionomers are more compatible to the pulp than the old silicates. The bonding to tooth structure is increased through pretreatment where polyacrylic acid is most recommendable. Today there are two major types of glassionomers: the water-based which contain freeze-dried acid in the glass powder, and the original, determined by the addition of an aqueous solution of polyacrylic acid to the glass powder. Certain types are delivered in premeasured capsules for mechanical blend, which decreases the sensitive handling of the material. The use of glassionomers serves a number of purposes and will properly be more widespread in the future, especially the concern of lining in combination with composite resins, the metal-reinforced to crown-buildup and the luting types, when the considerations about earlier hypersensitivity after luting of castings is clarified. The restorative types shows better promising results than composite resins in Class V restoration. PMID- 2696126 TI - [Retrograde root filling utilizing resin and a dentin bonding agent: indication and applications]. AB - With Gluma a methacrylate-based resin may be chemically bonded to dentin with considerable strength. Resin may therefore be used for retrograde root fillings. Whereas a retrograde amalgam filling demands a box-like preparation, retroplast (Gluma and resin) may be applied to a slightly concave root surface. It may therefore be employed in areas normally inaccessible with amalgam technique. Retroplast can thus be used on roots of all molars and to restore root perforations, root resorptions, cracks, grooves and defects of the root. In addition on lateral canals, on extremely thin roots and to cover perforating root canal posts, this technique can also be used. Dentin/root-cement transplantation may be performed for the purpose of reattachment. The article discusses the technique and its applications with examples showing that it may result in satisfactory healing. PMID- 2696127 TI - [Dentists and dental practice in Greenland prior to 1940]. PMID- 2696128 TI - [Retrograde root filling utilizing resin and a dentin bonding agent: frequency of healing when compared to retrograde amalgam]. AB - Gluma, an aqueous solution containing 5% glutaraldehyde and 35% HEMA, may bond resin chemically to dentin with considerable strength and without cracks. In retrograde root filling, Gluma and resin (retroplast), can adhere to a flat or slightly concave root surface, so that it may be employed to otherwise inaccessible roots. Gluma may cause toxic reactions, but properly used, it is tolerated well. Of 400 consecutive cases with retroplast, 388 were controlled (99 front teeth, 86 premolars and 203 molars) up to 1 year after operation. The healing after these was compared with a series of retrograde amalgams with the same number and distribution in the various tooth types 1 year postoperatively. The result after retroplast was 74% complete healing, 4% fibrous healing, 15% uncertain and 7% failures. After retrograde amalgam 59% complete healing, 3% fibrous healing, 30% uncertain and 8% failures. Complete healing occurred significantly more often after retroplast than after amalgam (P less than 0.00005). After retroplast significantly fewer cases with complete healing occurred in lower front teeth than in other tooth types. There were no significant differences in the occurrence of postoperative complications after retroplast and amalgam. There were two patients with serious osteitis after retroplast. PMID- 2696129 TI - [Resin bonded porcelain veneer facings]. PMID- 2696130 TI - [The dental clinic of the state hospital--pioneer in the field of AIDS]. PMID- 2696131 TI - [Angina bullosa haemorrhagica--case presentation and literature review]. PMID- 2696132 TI - [The last bleeder and the first dentists in Umea]. PMID- 2696133 TI - [Precancerous conditions and cancer of the endometrium]. AB - In recent years the incidence in endometrial cancer is rising. The relation of cervical to endometrial cancer has shifted to almost 1:1. The peak of age distribution is between 50 and 60 years of age. Accompanying diseases are obesity, diabetes and hypertension. The endometrial cancer has its precancerous stages. The pertinent estrogenic stimulus is probably significant for the development of precancerous lesions: adenomatous hyperplasia of the endometrium without atypias is known as an optional, that with atypia as an obligatory precancerous lesion. The range of morphologic variation extends from mature endometrial adenocarcinoma with favorable prognosis to immature neoplasias with unfavorable outcome. Besides various other parameters of neoplastic disease the depths of infiltration into the myometrium is known to be significant. The leading sign of endometrial cancer is uterine bleeding. The histological diagnosis is established by the examination of the tissue produced by curettage from the cervical canal and from the uterine cavity. A true early diagnosis--in comparison to the early detection of cervical cancer--does still not exist for endometrial cancer. Exfoliative cytology from the uterine cavity or ultrasonography does still not allow the final and definite diagnosis. Among the therapeutic alternatives abdominal hysterectomy in combination with bilateral adnexectomy plays the most important role. Depending from more specific morphologic criteria of a given case additional pelvic and paraaortic lymphnode dissection is advised. Surgical therapy in general accounts for a 10 to 20 percent better survival. In patients who cannot surgically be treated because of the local extension of the tumor or due to a general high risk situation the primary therapy is pelvic irradiation both by packing and percutaneously. Disseminated neoplasms, adenocarcinomas in particular, respond well to large dosages of progestins, whereas combinations of cytostatics have failed to show favorable results, perhaps with the exception of those containing adriamycin. All endometrial cancer patients need special posttreatment care, because early recurrences still have a certain chance of survival when recognized and appropriately treated. PMID- 2696134 TI - [Diagnosis and primary treatment of malignant epithelial ovarian tumor]. AB - The treatment of ovarian cancer is still a challenge to gynecological oncology. Due to the onset of the disease without significant signs or symptoms in more of 70% of the cases, most patients already show extended metastatic disease once the primary diagnosis has been established. Following the diagnosis--which is late in most of the cases--the initial surgical treatment will be difficult because of commonly vast and rapid intraabdominal tumor growth. Consequently--in many cases- vital residual tumor has to be left in place during surgery; therefore, optimal surgery requires skill, training in surgical oncology and personal experience concerning the spread of the given type of a tumor, all the more than primary surgery has to be placed right in the center of a comprehensive therapeutic concept. Except a few, all patients suffering from ovarian cancer will be in need for post-treatment care. In FIGO stage-III/IV cases the polychemotherapy with the inclusion of platinum-compounds is generally accepted to be the best choice. Sequential therapeutic regimen starting with surgery and followed by polychemotherapy results in remission rates of 70% and more. Specifically high rates of recurrences as well as the lack of convincingly effective treatment protocols--be it for the time after primary surgery or be it for secondary approaches in cases with evidence of recurrent disease--are factors believed to cause the final poor outcome in most of the cases. As there is a tendency to progression or to recurrence specifically in ovarian cancer, knowledge about all established variations of therapeutic alternatives is so far essentially required. Furthermore, the therapy should always follow the principle of 'nihil nocere', but--on the other hand--not withhold an effective palliative treatment to those who are in need for medical help. PMID- 2696135 TI - [Ablative versus conservative treatment of breast cancer]. AB - In the past 20 years, the opinion about the biology, the growth, the generalization and, therefore, the treatment of breast cancer has totally changed. Several big international multicenter and randomised therapy studies over many years have proved that breast conserving therapy, performed under certain conditions, has the same results in survival as an ablative therapy. Following these results, it is necessary to inform patients who fulfill the conditions about the possibility of a breast conserving therapy about the principles and rules of this kind of operative treatment. Therefore, strong efforts should be made in early detection of breast cancer. On the other hand, breast cancer is regarded as a general disease which should be treated also with general medication, in addition to local treatment and according to the tumor biology. PMID- 2696136 TI - [Zidovudine. The current status of its evaluation]. AB - 3'-azido-3'-deoxythymidine is a thymidine analogue with an in vitro as well as in vivo efficacy towards HIV-mediated infection. Zidovudine exerts its action, following an intracellular three-step phosphorylation, through viral reverse transcriptase inhibition. Its half-life is approximately one hour. Oral biodisponibility is 65%, and passage through blood-brain barrier results in therapeutic levels is CSF. Clinical evaluation has enabled demonstration of a beneficial effect on survival of stage IV AIDS patients, when treated after a PCP episode. In this setting, aggregate survival ratios reach 73% after one year of follow-up, and 41% after 2 years. In addition, zidovudine activity has been demonstrated in treatment of HIV-induced thrombopenias as well as HIV-related central nervous system disorders. Presently, zidovudine therapeutic evaluation proceeds through the following main axes: dosage tuning (either by lowering of standard dose, and/or dose interval modification); combination with other antiviral therapies; lastly, patient treatment et an early stage of disease. PMID- 2696137 TI - [Potassium channel activators: from pharmacology to therapeutics]. AB - Potassium channels activators (PCA) are drugs which open or prolong the open state duration of potassium channels. Hence they promote potassium efflux, hyperpolarize the cell membrane, thus preventing intracellular penetration of calcium through the voltage-dependent calcium channels. The resulting decrease in intracellular free calcium concentration induces relaxant effects in smooth muscle cells (vessels, bronchi, bladder, etc.) which are the rationale for the present and future therapeutic indications of PCA, namely hypertension, asthma, etc. In animals, PCA produce vasodilating, hypotensive and antihypertensive effects, accompanied by tachycardia and stimulation of the renin-angiotensin system. The regional vasodilator profile of PCA is heterogeneous and their hypotensive properties are antagonized only by glibenclamide, an antagonist of ATP-dependent potassium channels. In patients, only pinacidil, minoxidil and diazoxide are presently used as antihypertensive drugs. PMID- 2696138 TI - Comparison of the efficacy of endoscopic ultrasonography and submucosography in diagnosing the depth of gastric cancer invasion. AB - Diagnosis of the depth of the cancer invasion is necessary to select the indication of endoscopic treatment. We used endoscopic ultrasonography (EUS) and Submucosography (SMG) to diagnose the depth of cancer invasion and compared their efficacy against 63 lesions in 60 cases of gastric and esophageal cancers. SMG could diagnose the invasion correctly in 97% of m (mucosa) cancers, 88% of sm (submucosa) cancers and 100% of advanced cancers. On the other hand, linear-type EUS could diagnose the cancer invasion correctly in 60% of the m cancers, 83% of the sm cancers and 100% of advanced cancers. The results of the comparison of radial-type EUS and SMG showed similar results. Both EUS and SMG are appropriate for the judgement of endoscopic treatments. However, for the selection of the indication of endoscopic treatment which is applied to relatively small sized lesions in general, SMG appears to be superior to EUS in both resolution power and accuracy in shooting. PMID- 2696139 TI - The causation of oral precancer and cancer. AB - Most cases of oral cancer result from the action of exogenic carcinogenic agents, some of which act synergistically in producing their effects. The evidence implicating tobacco and alcohol abuse is overwhelming and cannot be refuted. Other clearly identifiable aetiological agents include betel nut chewing and excessive exposure to sunlight. While there is increasing evidence of a viral causation, this is not yet clearly established. Similarly, the role of Candida albicans remains uncertain. Lichen planus and discoid lupus erythematosus may constitute important predisposing conditions, but the documentation remains inadequate and inconclusive, as does that implicating electrogalvanism. Tertiary syphilis is no longer considered a significant factor in oral cancer. Sideropenic dysphagia and haemoglobin and serum iron deficiencies may be of importance in the development of oral carcinoma, particularly in elderly women with no history of tobacco and alcohol abuse. The roles of poor oral hygiene and sharp edges of teeth and dentures have probably been overemphasized in the past. PMID- 2696140 TI - The ultramicrotome superstage: a versatile aid for section manipulation. AB - The design and properties of a rigid, box-like device to be placed on the knife stage of a Porter-Blum MT-2 ultramicrotome are described. This "superstage" acts as a hand and tool rest, and a wind screen for the knife boat. The superstage easily permits tight rafts of ultrathin sections to be centrally located on grids. Additionally, it aids in placing 1 micron thick sections at the same relative location on glass slides to facilitate their examination in the light microscope. PMID- 2696141 TI - A new method for preparation of undecalcified bone sections. AB - A new method for preparation of sections of undecalcified bone is described. Samples of ovine bone were embedded in methylmethacrylate and thick-sectioned with a cutoff machine or commercial band saw. Composite slides were prepared by gluing white acrylic to glass using cyanoacrylate glue. Bone sections were glued to the composite slide and then surface polished by grinding or ultramilling. The polished surface of the section was then etched and stained. The techniques described in this paper reduce the time spent grinding or milling sections and improve resolution of surface-stained features of undecalcified bone sections. PMID- 2696142 TI - [A method for bone suture of the mandible]. AB - A technique of mandibular osteosynthesis with a bone suture is described, consisting in the formation of 2 pairs of through holes close to the fracture plane and fixation of fragments with a thread drawn alternately through the upper pair of holes and, after a preliminary crossing on the internal surface of the bone and overlapping the lower edge of the mandible, through the lower pair of holes. The horizontal portion of thread passing longitudinally between the upper holes is entrapped with one of the thread ends, then the thread is stretched tight and its ends are tied. A wire may be used as suture material. This technique was used in the treatment of 38 patients. PMID- 2696143 TI - [End-to-side type of plastic repair of the facial nerve branches]. AB - In 19 rabbits, lower branches of facial nerve were experimentally sectioned and sutured to its middle branches to form a 'side to end' pattern with 2 to 3 epineural sutures. Morphological investigation showed that regenerating axons of the middle branch penetrate into the sutured trunk and grow further. The technique was applied in 7 patients. Full functional recovery was evidenced in 4 of them. The technique is recommended for clinical routine. PMID- 2696144 TI - [The results of the use of porcelain crowns prepared on refractory models]. AB - The authors describe the technique for making porcelain crowns without platinum matrices. A two-year clinical follow-up of 170 crowns has shown that such crowns are in full accord with the esthetic, functional, and biological requirements of dental prosthetics. PMID- 2696145 TI - [Jan Evangelista von Purkinje and the representatives of Russian science and culture]. PMID- 2696146 TI - [Indications and contraindications for the orthodontic treatment of dental arch defects using implants (a review)]. PMID- 2696147 TI - [The video impression--a CAD procedure for manufacture of ceramic inlays]. AB - Study was provided, creating a CAD/CAM technique for automated producing of ceramic inlays based on a optical topographic scanning procedure. PMID- 2696148 TI - [Clinically controlled examination of the utilization of adhesive technology with bridgework prosthetics]. AB - The article reports on the re-examination results of bridges which were made on the Bezirkspoliklinik fur Stomatologie Schwerin since 1983. In two cross sectional examinations 1986 54 and 1987 90 adhesive bridges were controlled. The failure rate of the re-examined adhesive bridges in 1987 was 18.9%. PMID- 2696149 TI - [Application of mineral facets by optimization of the binding by silicoating and ceramic covering]. AB - The binding technology of the mineral facet with the metal frame had been optimized by experimental examinations of the strainability of phantom facet crowns, by analyses of the adherence and light-microscopical representation of various combinations of material. Facet crowns equipped with ceramic covers exhibited the best results. The technology of manufacture can be modified by a holder for the adhesive-opaker mixture. PMID- 2696150 TI - [Clinically controlled experiment on frequency of secondary caries in amalgam and mold fillings]. AB - The purpose of the present controlled clinical study was to assess and compare the secondary caries rate of amalgam fillings and castings, respectively. 154 pairs of fillings (class I and II) were included in the trial and the time of observation was two years. The fillings were made under equal clinical conditions particularly with regard of dentist's care. The secondary caries rate of the amalgam fillings was 20.1% and of the castings 18.2%, respectively. The difference was not significant (chi-square-test). The reason of that is probably the similar care of the manufacturing of fillings. Therefore the authors recommend amalgam fillings for the restoration of class I and II cavities. PMID- 2696151 TI - Influence of antibodies neutralizing cytokines on murine fetal thymic organ cultures. AB - The role of cytokines in early T cell development was evaluated in a thymic organ culture system. Fetal thymic lobes from 14 day old mouse embryo's were cultured in the presence of antibodies neutralizing either IL-4, IL6 or TNF. In addition antibodies neutralizing TNF were added to cultures supplemented with human recombinant IL-2. The influence of these different treatments were evaluated by analyzing the different subsets generated after 12 days of culture with a panel of monoclonal antibodies. The antibody treatment did not result in dramatic changes in the cell populations nor did the anti-TNF inhibit the significant changes that are induced by the IL-2 treatment. These results show that based on the cellularity and thymocyte subsets no influence can be shown by inhibiting these cytokines. Other criteria, e.g. repertoire specificity have to be evaluated to address the influence of these treatments on early T cell development. PMID- 2696152 TI - Proteosome-hydrophobic 'foot' malaria peptide vaccines for Plasmodium falciparum and P. vivax. AB - The immunogenicity of synthetic peptides representing the repeating portions of circumsporozoite proteins of Plasmodium sporozoites was greatly increased by complexing them to proteosomes via hydrophobic moieties added to their amino termini. Proteosomes have been used safely in people in the development of meningococcal vaccines and therefore proteosome-peptide vaccines are prime candidates for use against malaria. PMID- 2696153 TI - Cerebral lesions in mice infected with Plasmodium berghei are the result of an immunopathological reaction. AB - Cerebral lesions in mice with Plasmodium berghei infections can be prevented by timely treatment with immune serum, by splenectomy, and by administration of dexamethasone. T cell deficient mice do not develop cerebral lesions. The results of these studies are compatible with the hypothesis that a pathological reaction is responsible for development of cerebral lesions in mice infected with P. berghei. PMID- 2696154 TI - A seroepidemiological study to evaluate the role of passive maternal immunity to malaria in infants. AB - Parasitaemias and loss of natural antibody to Plasmodium falciparum were studied in 104 infants in a highly endemic area of Papua New Guinea. There were 4 cases of congenital infection. Most infants lost malaria-specific immunoglobulin G (IgG) between 4 and 7 months (median = 21 weeks). 73% of heavy infections developed in infants without detectable antimalarial IgG. Infections in the presence of antimalarial IgG were asymptomatic and had scanty parasitaemias. PMID- 2696155 TI - Immunopathophysiology of babesial infections. AB - Humans infected with Plasmodium falciparum and bovines infected with Babesia bovis display severe haemolysis, alterations in red cell deformability and rigidity, and endothelial cell damage leading to pulmonary oedema and cerebral dysfunction. Much of the pathology associated with these infections is not easily attributable to the relatively small numbers of parasites present. This paper considers the possible roles of soluble mediators released from macrophages, and chemical and physical changes in the infected red cell membrane, in the pathogenesis of babesial infections, and also discusses the effects of prior immunization with various immunogens. PMID- 2696156 TI - Recently developed methods for the detection of babesial infections. AB - During the acute phase of babesiosis the direct identification of the causative agent is possible by examination of stained blood smears. An improved identification procedure for the diagnosis of Babesia bovis using DNA hybridization has been reported recently. For the diagnosis of both acute and chronic babesiosis, various serodiagnostic techniques have been developed. Recent advances in serodiagnosis designed for the detection of anti-Babesia antibodies were partly achieved by improving and standardizing the indirect immunofluorescence and complement fixation tests. The use of soluble antigens derived from Babesia culture supernatants or enriched, purified merozoites in the micro-enzyme-linked immunosorbent assay, solid phase radioimmunoassay and latex agglutination test has provided increased sensitivity and specificity in detecting anti-Babesia antibodies. Immunoblots and monoclonal antibodies have been used for the characterization and identification of babesial antigens and antigenic determinants. The advantages and disadvantages as well as the area of application of the currently available test systems will be discussed. PMID- 2696157 TI - Recent advances in the parasitology of malaria. AB - This review represents a highly personal view of only some of the advances made on the biology of malaria in the period 1986-1987. Progress has stemmed largely from new or refined techniques applied to the logical demonstration of eukaryotic principles; and more rarely from either new conceptual advances, or the revelation of critical differences in the biology of Plasmodium from that of other eukaryotes. Significant steps have been made in the recognition of the complexity of interaction between the parasite and both its vertebrate and invertebrate hosts. It is this very complexity of interaction which warns against the presumption that the successful application of any single control strategy is imminent. PMID- 2696158 TI - The impact of cultural and environmental changes on the epidemiology and control of human babesiosis. AB - The infection of humans with Babesia spp. has provided a well studied example of how cultural and environmental factors have contributed to the spread of an infection. Individuals developing babesiosis have been those engaging in life styles which put them at risk of tick bites. Farmers, hunters and other outdoor types are most frequently infected. The forms of human babesiosis which occur in the north-eastern United States are directly related to the spread of deer and the deer tick, which is the vector of the Babesia responsible for human infection. The spread of deer in the region was a direct result of cultural changes resulting in altered human behaviour which permitted deer to exist close to human settlement areas. PMID- 2696159 TI - The current state of studies of malaria vectors and the antivectorial campaign in west Africa. AB - Most malaria transmission in West Africa is by Anopheles funestus and An. gambiae s.l. An. funestus is not very polymorphic and is generally susceptible to currently used insecticides. An. gambiae in contrast is very polymorphic. On the basis of chromosomal polymorphism An. gambiae can be divided into forest and savannah forms. The savannah forms in turn exist as several types, viz. Bissau, Mopti and Bamako. Insecticide susceptibility does not correlate with chromosomal type in most cases; nevertheless, correct identification of vectors is necessary if a successful antimalarial campaign is to be developed. It is particularly important to determine which of the mosquitoes in the region under study are the important vectors of malaria. In the light of the difficulties encountered in mass vector control programmes, individual control measures such as home spraying and use of impregnated bed nets and curtains may be considered for malaria control. PMID- 2696160 TI - A reappraisal of vector control strategies for babesiosis. AB - This review suggests that we are on the threshold of a new epoch in the control of ticks and the diseases transmitted by them. Ecological studies of parasitic and non-parasitic stages of the tick life cycle have shown how strategic dipping can lead to effective control of Boophilus ticks. However, this approach can lead to drastic reduction in tick populations which may favour the development of enzootic instability. On the other hand, mathematical models and field studies indicate that we can eradicate babesiosis without eradicating the tick vector. As no well-established vaccine exists for babesiosis or its vectors, it is important to anticipate the possible effects of low or fluctuating populations of ticks caused by strategic control programmes. Under these conditions, it is probable that babesiosis will disappear before the tick vector does. Prudent use of tick bionomic data from several centres of field research, as well as models to analyse these data, should accelerate the latter process. Epidemiological models should be included in the analysis of babesiosis in areas that run the risk of converting from stable zones to unstable zones due to strategic dipping. These observations and projections underscore the value of integration of traditional and modern techniques in the control of babesiosis and other vector-borne diseases. PMID- 2696161 TI - Asexual blood stage vaccines: from merozoites to peptides. AB - Asexual blood stage proliferation is responsible for the morbidity and mortality associated with malaria infection in man. These developmental stages are therefore obvious targets for the development of malaria vaccines. Several asexual blood stage components have been identified as potential candidates for the development of vaccines and some of them have been shown, following immunization, to induce at least partial protection in a variety of Plasmodium host combinations. Studies on defined parasite components and on synthetic peptides derived from them have revealed new insights at the molecular level into parasite mechanisms involved in propagation and survival in the infected host, and into the interaction between parasite components and the host immune system. Practical application of these findings is likely to provide the basis for the design of more appropriate antigens for the development of vaccines. PMID- 2696162 TI - Development of sporozoite vaccines for malaria. AB - Various candidate sporozoite vaccines have been produced and tested. These have been produced by genetic engineering techniques and by polypeptide synthesis. The immunity produced by these synthetic vaccines is mediated by antibody and weak. The antibody levels achieved in human volunteer tests were similar to those resulting form natural infection. Immunity resulting from immunization with irradiated sporozoites is multifactorial. It includes reaction to malaria antigens on infected hepatocytes and it has cell-mediated components; the synthetic vaccines do not induce such reactions. Genetic restriction of cell mediated immune responses may also limit the utility of synthetic vaccines. Development of an effective vaccine to prevent malaria will not be accomplished easily. PMID- 2696163 TI - Application of exoantigens of Babesia and Plasmodium in vaccine development. AB - The University of Illinois malaria vaccine programme uses culture-derived soluble exoantigens of Plasmodium falciparum and the squirrel monkey as an experimental model. Exoantigens are soluble polypeptides naturally released into the blood plasma of animals infected with Babesia or Plasmodium species, or into the supernatant medium of in vitro cultures of these organisms. Immunization with soluble B. bovis and B. bigemina exoantigens prepared from culture supernatant fluids protected cattle against homologous and heterologous challenge. Similarly, vaccination of squirrel monkeys with supernatant fluids from P. falciparum cultures containing exoantigen induced protective immunity against acute clinical malaria. Susceptible monkeys have been vaccinated with an aluminium hydroxide fortified antigenic fraction partially purified from supernatants of P. falciparum strains Indochina I and Geneve/SGE-1; this conferred significant clinical protection against needle challenge with the homologous Indochina I strain, and a moderate degree of immunity to the heterologous strain. Following sequential purification by high performance liquid chromatography, the N-terminal amino acid sequences of P. falciparum 100 kDa, 83 kDa and 70 kDa exoantigens were determined. A 29 amino acid peptide constructed from the N-terminal sequence of the P. falciparum (Geneve strain) 83 kDa exoantigen has been synthesized. When coupled to a carrier protein, the peptide was immunogenic in rabbits, mice and squirrel monkeys, inducing antibodies which were trophozoite-specific, reactive to native parasite proteins in a two-site enzyme immunoassay (EIA) and in Western blots, and which inhibited P. falciparum growth in vitro. Using this synthetic peptide, EIAs are being developed for the detection of antibodies to P. falciparum blood-phase parasites in individuals living in malaria-endemic areas of Africa, Asia and South America. PMID- 2696164 TI - Development of babesial vaccines. AB - The most widely used vaccine against cattle babesiosis was blood from a carrier animal. The development of a calf passage attenuated strain in Australia was a great improvement in vaccine safety and efficacy. The degree of immunity generated by this vaccine remains a standard against which to compare other vaccines. Vaccines derived from culture supernatants have also been developed. These have considerable value. To date no efficacious recombinant vaccine exists. A variety of antigens will probably be required in any synthetic vaccine. Study of clones derived from calf passage attenuated vaccines indicate that the vaccine contains a variety of parasites of differing virulence. The attenuation process enriches for the less virulent clones. The clones may also vary in their antigenic characteristics. To date no single clone gives immunity equal to the original uncloned preparation. An ideal vaccine should not be a living agent. It will probably contain a variety of antigens and may induce less strong immunity than the living vaccine but its greater safety, stability and ease of handling will more than compensate for this. PMID- 2696165 TI - Analysis of available measures for malaria control in Africa south of the Sahara. AB - Africa south of the Sahara is not homogeneous and presents several extreme conditions where malaria persistence is ensured by a complex and highly adaptable vector system. Plasmodium falciparum is the most widespread and life threatening of the malaria parasites of man, particularly for young children and pregnant women. Large-scale residual spraying was not totally effective and was very costly, and mass chemoprophylaxis was not feasible. The spread of chloroquine resistance added arguments against uncontrolled use of drugs. Chemoprophylaxis is now recommended only for pregnant women, especially in their first pregnancy, whilst chloroquine 25 mg base/kg over 3 days is recommended for curative treatment in villages. Second line treatment regimens should be available, together with the possibility of referring severe malaria cases quickly to appropriate clinical facilities. Other control measures include self-protection against mosquito bites by bednets (especially those impregnated with synthetic pyrethroids), mosquito coils, repellents, window and door screening; other measures to prevent man-mosquito contact, such as careful siting of settlements and zooprophylaxis; anti-larval measures, i.e. source reduction, protection of wells and water reservoirs, larviciding, introduction of larvivorous fish; and sprays against adult mosquitoes. The elaboration of strategies for control and their application requires a study of the existing situation. A core of specialists is required in each country, to help with decentralized planning and evaluation of malaria control and to ensure quality control of services, training and applied field research. Additional measures may become available in the future, especially anti-malaria vaccines, and countries should be ready to study their application. PMID- 2696166 TI - Immunoprophylactic control of bovine babesiosis: role of exoantigens of Babesia. AB - A major breakthrough in babesiosis vaccine research was achieved with the development of methods for continuous propagation in vitro of Babesia parasites. The development of a soluble, exoantigen-containing immunogen, free of erythrocytic antigens, has been proposed as a practical and realistic means of immunoprophylactic control of babesiosis. Such immunogens have been tested for immunogenicity of different strains, minimal protective dose, and protective efficacy of a combined B. bovis-B. bigemina immunogen. During the last 7 years, most of these aspects have been studied in a co-operative research programme between the University of Illinois and the Veterinary Research Institute of Venezuela. The Babesia exoantigen vaccine prevents clinical disease, is effective against different parasite strains, induces protective immunity for at least 13 months, does not immunize against host blood groups, is antigenically stable for at least 3 years at 4 degrees C, and is available in large quantities. Continued improvement of currently available culture-derived immunogens will best guarantee the successful production of food-producing animals in the tropics. Since July 1984, 16 field vaccination trials have been conducted in 7 states of Venezuela in areas where large-scale dairy and beef production is crucial for the livestock industry. These ranches encompassed a cattle production of 14,000, of which 3000 have been vaccinated with a combined B. bovis-B. bigemina immunogen in 2 subcutaneous inoculations with a 4-week interval. In the first 5 trials, a 1-year monitoring period following vaccination and natural tick exposure indicated that the culture-derived vaccine has effectively controlled the clinical manifestation of infection. Studies on antigen characterization are shifting the emphasis from crude antigenic preparations to purified polypeptides, isolated and identified using new biochemical techniques. Current research efforts are directed toward isolation of protective antigens and the production of synthetic vaccines. Until optimal molecular vaccines are developed, a polyvalent inactivated B. bovis-B. bigemina immunogen may offer the best combination of potency, efficacy and safety available for effective immunoprophylaxis against bovine babesiosis. PMID- 2696167 TI - Introduction to, and evaluation of, immunoassays in a malaria research institute in Tanzania. AB - Various immunoassays have been introduced into, and evaluated at, the Amani Medical Centre in north-east Tanzania. These include immunoblotting to identify mosquito bloodmeals, immunoradiometric and immunoenzymatic assays to assess the presence of circumsporozoite protein in mosquitoes, and enzyme-linked immunosorbent assays to measure antibodies to circumsporozoite antibody in people. The assays were shown to be reliable and practicable for use in the study of malaria epidemiology. PMID- 2696168 TI - The regulatory role of thioredoxin in chloroplasts. PMID- 2696169 TI - Confocal scanning microscopy: three-dimensional biological imaging. AB - Confocal scanning optical microscopy, arguably the most significant in biological light microscopy in this decade, enables one to obtain quantitative non-invasive optical sections through labelled biological specimens, virtually free from out of-focus blur. A set of these optical sections collected at a series of focal levels through an object constitutes a three-dimensional image which may then be processed digitally for display as a computer reconstruction, a stereo pair or an animation sequence. PMID- 2696170 TI - A pitfall in the computer-aided quantitation of autoradiograms. AB - Computer-aided quantitation of autoradiograms is now available as a result of recent developments in optical scanners and microcomputers. Data expressed as optical density values, however, are based on the unverified assumption that optical density and radioactivity density are linearly correlated. This article demonstrates the need to construct a calibration curve which should be used to calculate radioactivity density values more precisely. PMID- 2696171 TI - The repeat of the same. PMID- 2696172 TI - Self-cleavage of RNA in the replication of small pathogens of plants and animals. AB - The ability of certain small, circular, pathogenic RNAs of plants and animals to self-cleave at specific sites in vitro in the complete absence of protein most likely plays a central role in their replication in vivo by a rolling circle mechanism. The self-cleavage of an RNA transcript from a satellite DNA of the newt indicates that this reaction is not limited to pathogenic RNAs. Further, the site-specific self-cleavage in trans by two separate RNA molecules suggests that such reactions may be important in gene regulation in normal cells as well as in the genesis of symptom expression on infection by RNA pathogens. PMID- 2696173 TI - Barnase and barstar: two small proteins to fold and fit together. AB - Barnase and barstar are the extracellular ribonuclease and its intracellular inhibitor produced by Bacillus amyloliquefaciens. Both are small single-chain proteins and thus are suitable for application to the study of how a protein's sequence directs its fold. Barnase has neither disulfide bonds nor non-peptide components and unfolds reversibly in what closely approximates a two-state reaction. The genes for both these proteins have been cloned in E. coli. Expression of barstar is necessary to counter the lethal effect of expressed active barnase. Site-directed mutagenesis is being used to answer specific and general questions relating to protein folding and protein-protein interaction. PMID- 2696174 TI - Extracellular signals, transcriptional responses and cellular specificity. AB - The expression of a relatively small set of common primary response genes is frequently induced, in a variety of cellular responses, by growth factors, protein hormones and neurotransmitters. The characterization of these genes and their products may provide clues to the mechanisms by which ligand- and cell specific responses may be generated. PMID- 2696175 TI - Evolving to dissimilate hydrocarbons. PMID- 2696176 TI - The gluconeogenicity of fatty acids in mammals. AB - Although excess glucose can be readily converted to fatty acids in mammals, most textbooks state that glucose cannot be formed from fatty acids. Whilst this remains largely true, several pathways have now been discovered in mammals in which fatty acids are potentially gluconeogenic. PMID- 2696177 TI - Channeling of glycolytic intermediates by temporary, stationary bi-enzyme complexes is probable in vivo. PMID- 2696178 TI - How are substrates recognized by the ubiquitin-mediated proteolytic system? AB - A necessary step in the degradation of proteins by the ubiquitin system is recognition by the ubiquitin-protein ligases(s). Various structural features of the proteolytic substrate render it susceptible to conjugation with ubiquitin. The N-terminal residue plays a major role in this process, with distinct sites on the ligase(s) recognizing specific types of N-termini. Post-translational modification of some of these residues is required prior to their recognition. A free N terminus is not the only marker; proteins with either free or blocked N termini can be recognized via structural domains that are downstream and distinct from this residue. PMID- 2696179 TI - Nitric oxide: biosynthesis and biological significance. AB - The recent discovery that mammalian cells can synthesize nitric oxide coincided with the identification of this simple gas as a factor involved in cellular communication. Nitric oxide has now been shown to be derived from L-arginine in macrophages, endothelial cells and possibly other cell types. Its physiological role in macrophages may be as a cytotoxic agent. However, nitric oxide produced by endothelial cells is thought to trigger vascular smooth muscle relaxation through activation of the enzyme guanylate cyclase. PMID- 2696180 TI - Haem as a multifunctional regulator. AB - Haem has long been known as the prosthetic group of haemoproteins such as haemoglobin, catalase and the cytochromes. Its biosynthesis is regulated by feedback mechanisms that ensure its adequate production but prevent its overaccumulation, which is highly deleterious as diseases such as porphyrias attest. However, recent years have seen rapid strides in our understanding of how haem (or more accurately haemin, its oxidized form) itself acts as an intracellular regulator of a variety of other metabolic pathways for systems that utilize oxygen. PMID- 2696181 TI - Pseudogenes, chimaeric genes and the timing of antigen variation in African trypanosomes. PMID- 2696182 TI - Immunoglobulin gene transcription: molecular mechanisms. AB - Recently, many of the proteins involved in transcriptional regulation of immunoglobulin genes have been identified, purified and their cDNAs cloned. This detailed molecular information has revealed fascinating similarities among different classes of DNA-binding proteins and has dramatically expanded the number of potential mechanisms for achieving precise tissue- and developmental stage-specific immunoglobulin transcription. PMID- 2696183 TI - The egg came first, of course! Anterior-posterior pattern formation in Drosophila embryogenesis and oogenesis. AB - The anterior-posterior body pattern of the Drosophila embryo is initiated through the action of maternal gene products. In particular, three groups of maternally acting genes (the anterior, posterior and terminal groups) have been shown to direct the synthesis and spatial restriction of the three major organizing activities in the egg. The initial spatial localizations of the maternal organizing activities are established during oogenesis. After fertilization these activities regulate zygotic gene activity along the anterior-posterior axis of the egg. PMID- 2696184 TI - The mammalian pseudoautosomal region. AB - Despite being morphologically dissimilar, mammalian sex chromosomes pair in male meiosis. Molecular studies of the X and Y chromosomes in humans and mice have identified the pseudoautosomal region, a genetically unique region of shared, recombining sequences that fall within the meiotic pairing region. Complete meiotic and physical maps of the human pseudoautosomal region have been produced and the pseudoautosomal boundary has been cloned and sequenced. These studies have provided clues to mammalian sex chromosome function and evolution. PMID- 2696185 TI - The alpha 1-antitrypsin gene and its deficiency states. AB - alpha 1-antitrypsin, a 52 kDa antiprotease, provides the major defense to the lower respiratory tract against the ravages of neutrophil elastase, a powerful serine protease. A variety of mutations in the coding exons of the alpha 1 antitrypsin gene result in 'alpha 1-antitrypsin deficiency', leading to emphysema at an early age. A subset of mutations cause liver disease and a rare mutation is associated with a bleeding diathesis. Preventive treatment for the emphysema associated with alpha 1-antitrypsin deficiency is available in the form of intermittent infusions with alpha 1-antitrypsin, and strategies have been developed to reverse the deficiency state with gene therapy. PMID- 2696186 TI - [A new case of the "double hypophysis--multiple congenital developmental defects" complex]. AB - The results from clinical and genetic analysis of a case with "double hypophysis- multiple malformations" complex and data from literature are presented. The complex is supposed to be a consequence of "midline" field disturbance with multifactorial mode of inheritance. PMID- 2696187 TI - [Salmonella typhimurium strains used in the study of environmental mutagens]. PMID- 2696188 TI - [Geneticists--victims of repressions]. PMID- 2696189 TI - [Morphofunctional characteristics of the striated centrosome rootlets of cultured embryonic pig kidney cells]. AB - The analysis of the centrosome structure in PK-cells has shown that the striated rootlets occur in 25-30% of the cells. Most frequently, the centrosome contains 1 2 rootlets, oriented either to the active or to the nonactive centriole. Occasionally, they occur in both the centrioles simultaneously. The presence of striated rootlets does not correlate with the presence of a primary cilium in the centrosome: there occur centrosomes with the primary cilium but without striated rootlets, and conversely: with striated rootlets but without the primary cilium. PMID- 2696190 TI - [Amylosis: recent advances]. PMID- 2696191 TI - [Surgical treatment of malformation uropathies]. PMID- 2696192 TI - [A case of optic nerve tumor treated by radiotherapy]. PMID- 2696193 TI - Failure of cytotoxic chemotherapy, 1983-1988, and the emerging role of monoclonal antibodies for renal cancer. AB - A review of 36 cytotoxic agents used singly in over 1,900 patients with renal cancer between 1983 and 1988 finds marginal antitumor activity, less than 5-10%. The future role of monoclonal antibodies for therapy of this disease may offer some hope with the recent description of rather specific phenotypic expression, URO 10+/URO 8+, suggesting the cell origin of most renal tumors from the distal portion of the proximal tubule. PMID- 2696194 TI - Spontaneous peripelvic extravasation due to squamous cell carcinoma of the ureter. AB - A case of spontaneous urinary peripelvic extravasation secondary to an obstructing squamous cell carcinoma of the ureter is presented. A review of the literature reveals that peripelvic extravasation caused by tumor obstruction of the ureter is rare and most of its underlying lesions are metastatic retroperitoneal adenopathy. PMID- 2696195 TI - Intussusception ureterectomy. AB - A modification of intussusception ureterectomy is described. Dilatation of the ureter is unnecessary before the procedure and closure of the bladder wall defect is recommended to avoid urine extravasation. PMID- 2696196 TI - Prevention of erection after penile surgery. A double-blind trial of intracavernous noradrenaline versus placebo. AB - To prevent nocturnal erections after penile surgery a randomized, double blind trial of nocturnal intracavernous infusion of noradrenaline (10 micrograms per hour) versus placebo in 20 patients was carried out. During infusion the corpus cavernosum pressure was continuously registered. The patients made a record of nocturnal erections and associated pain. The pressure registration confirmed total absence of erections in the noradrenaline group. In the placebo group half of the patients were devoid of nocturnal erections. No signs of ischaemia was seen, but in four patients receiving noradrenaline infusion was stopped due to pain. This treatment seems effective in preventing nocturnal erections after penile surgery. PMID- 2696197 TI - Detection of Chlamydia psittaci in free-ranging koalas (Phascolarctos cinereus): DNA hybridization and immuno-slot blot analyses. AB - DNA-slot hybridization and immuno-slot blot analyses were compared for the detection of Chlamydia psittaci in crude swab material from free-ranging koalas. Immuno-slot blot analysis detected chlamydiae in 43 out of 68 koalas, with the sensitivity of the assay varying from 52 to 73% depending on the site of infection. Gene probe analysis was also used employing a genus-specific probe pCKO-10 isolated from a koala chlamydial gene library (ocular strain) and a plasmid probe pCKU cloned from a urogenital strain. The sensitivity of these two assays was comparable and they were considerably more efficient than the immuno slot blot method for the detection of chlamydiae. Comparison of these data with a cell-culture method of detection, previously used with the same samples, demonstrated that gene probe analysis detected more positives than observed with cell culture. However, this appears to reflect more on the condition of the swab material rather than the sensitivity of the method. PMID- 2696198 TI - Serotypes in Cowdria ruminantium and their relationship with Ehrlichia phagocytophila determined by immunofluorescence. AB - Two tick-borne rickettsial pathogens of ruminants, Cowdria ruminantium (causative agent of heartwater disease) and Ehrlichia phagocytophila (causative agent of tick-borne fever), were successfully cultivated in caprine or ovine neutrophilic granulocytes. Infected cultures were subsequently used as antigens in the indirect fluorescent antibody test. Low-level bilateral serological cross reactions could be detected between Cowdria and Ehrlichia. In addition, comparison of five Cowdria stocks using immunofluorescence demonstrated the existence of distinct serotypes within the genus of Cowdria. It is concluded that the occurrence of these serotypes will considerably complicate the current serodiagnosis of heartwater. PMID- 2696199 TI - The specificity of antibody response in experimental and natural bovine paratuberculosis studied by crossed immunoelectrophoresis with intermediate gel. AB - The sonicate antigen (MPS) of a local strain (IVRI) of Mycobacterium paratuberculosis and a commercial lysate of Strain 18 were analysed using hyperimmune rabbit and calf antisera to MPS in crossed immunoelectrophoresis with intermediate gel (CIE-ig) and sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). The rabbit antiserum was more potent than the calf antiserum and it precipitated 35 and 15 antigens, respectively, among MPS and lysate antigens. SDS-PAGE resolved 50 and 32 peptides among these antigens respectively, of which, 35 and 15 were precipitated by rabbit antiserum. A CIE-ig reference system, with 30 MPS antigens, was standardized and used to analyse antibody specificities among sera derived from animals experimentally and naturally infected with bovine paratuberculosis. Fourteen antigens of MPS were found to be reactive with these sera and among these, Antigens 2 and 5 were found to be serodominant; sonicate antigens of M. bovis BCG and M. avium did not contain these antigens. Both were high molecular weight (greater than 60 kDa) antigens which may be of serodiagnostic value. PMID- 2696200 TI - [Treatment of diabetic neuropathy]. AB - The author presents in his review information on contemporary possibilities in the treatment of diabetic neuropathy. This treatment is focused on strict compensation of diabetes, on support of the metabolism in the peripheral nerves and on symptomatic relief of the patient's complaints. Treatment of diabetic autonomic neuropathy which is so far only symptomatic, still remains a problem. PMID- 2696201 TI - [Medicine in the life and work of Zikmund Winter]. PMID- 2696202 TI - Pseudo-ectopic pregnancy: an ovarian cyst mimicking ectopic pregnancy. PMID- 2696203 TI - [Evaluation of the protective effects of nifedipine and verapamil in patients with bronchial hyperreactivity]. AB - The protective effect was studied of the drugs blocking the calcium channel on histamine-induced bronchospasm. In a group of 107 studied subjects with clinical suspicion of bronchial hyperreactivity in 37 cases hypersensitivity to histamine was diagnosed. The protective effect of one oral dose of nifedipine 20 mg and verapamil 1.6 mg administered by inhalation was assessed. A protective effect of nifedipine was observed in 61% and that of verapamil in 37% of cases. These drugs may be used in the prophylaxis and treatment of bronchospastic conditions. PMID- 2696204 TI - [Therapeutic management of esophageal burns]. AB - Poisonings and burns of the oesophagus are frequent diseases, particularly in children. The manifestations of oesophageal burns, successive phases of oesophageal wall damage and damage to the lower parts of the digestive tract are discussed. On the basis of own experiences and a review of the pertinent literature a method of therapeutic management including surgery is outlined. PMID- 2696205 TI - [Health conditions in Polish villages in the second half of the 19th century (exemplified by the conditions in Radzymin county)]. PMID- 2696206 TI - [Preliminary evaluation of erythrapheresis in the treatment of chronic cor pulmonale]. AB - Reduction of polyglobulia is one of the principal rules in therapeutic management of decompensated cor pulmonale syndrome. In the Department of Internal Diseases, Medical Academy in Cracow since over two years erythrocytapheresis was used in 27 cases as an adjunct therapy with oxygen and pharmacological treatment. The criteria qualifying for this procedure were: haematocrit over 60%, hemoglobin over 160 g/l, erythrocytosis over 5.0 x 10(9)/l. The procedure was carried out as follows: from a peripheral vein about 450 ml of whole blood was taken each time into a special container made by Fenwal (USA) containing CPD solution, and was centrifuged for 20 minutes at 1500 r.p.m. After centrifugation plasma was reinfused. Erythrocytapheresis was done at intervals of 2-3 days, and its number was determined by the degree of polyglobulia. In patients with very high values of haematocrit, haemoglobin and erythrocyte count the procedure was done using a Progress BT 790 A separator. The separator made possible an earlier normalization of these parameters, since several separations could be done on one day. The treatment was followed by earlier improvement of wellbeing, longer duration of normal values of blood cells, considerable improvement of gasometric indices, regression of or reduction of central cyanosis, earlier regression of peripheral oedema disappearance of coexistent left-ventricular failure, increased effort tolerance, regression of features of right-ventricular strain. In the light of observations collected as yet it may be concluded that combination of treatment with erythrocytopheresis and typical pharmacotherapy should be the basic method of treatment in chronic advanced cor pulmonale syndrome. PMID- 2696207 TI - [Effectiveness of infiltration anesthesia of postoperative abdominal wound using bupivacaine solution for alleviation of postoperative pain]. AB - In a group of 40 patients after abdominal operations a high effectiveness was noted of infiltrations anaesthesia of the postoperative wound with 0.5% bupivacaine solution for alleviation of pain and reduction of requirements for narcotics in early postoperative period (randomized study). PMID- 2696208 TI - [Hormonal inhalation preparations in the treatment of bronchial asthma in children]. AB - Hormonal inhalation preparations (Becotide, Beclomet) were given to 59 children aged 3 to 18 years with severe and long-standing asthma. In most cases (70% a striking improvement of the general condition was achieved with complete regression or alleviation of dyspnoeic attacks. In 15 out of 17 children prednisone could have been withdrawn. No side effects were noted. In 4 children administration of Becotide or Beclomet was not possible. PMID- 2696209 TI - [Results of using Dorsiflex in various neurologic diseases in children]. AB - Therapeutic results are described obtained with the preparation Dorsiflex produced by the Yugoslav institution Lek Ljubliana. The drug was given to 40 children aged 8 to 14 years with various neurological diseases with muscle hypertonus as the prevailing sign. The preparation was found to exert a good myorelaxant effect, facilitating comprehensive rehabilitation in cases in infantile cerebral palsy, after craniocerebral injuries, encephalomeningitis, degenerative diseases and other conditions. The drug was well tolerated. PMID- 2696210 TI - [Obstetrics in Graz. A comparison 1887-1987]. AB - We compared obstetric data from the archives in Graz for 1887 with those of 1987. In 1887, 85% of all deliveries took place in the home or with a midwife--compared with only 0.46% in 1987. Maternal mortality in 1887 was 0.75%; two-thirds of the deaths occurred in the puerperium. Perinatal mortality was 11.0% in 1887 and 1.03% in 1987. The intrauterine fetal death rate, including deaths during delivery, was 6.7% and 0.35%, respectively; 2.7% versus 0.26% were macerated. The percentage of stillbirths among unwed mothers is higher today than in 1887. Perinatal mortality in 1887 was frequently associated with prematurity, abnormal presentations, and operative vaginal deliveries. 14.4% of the children of multiple pregnancies died in utero or during delivery. In 1987, 83% of mothers were bearing their first or second child, as compared with 50% in 1887. Grand multiparae were much more common in 1887. The percentage of mothers under 20 years old is twice as high today as 100 years ago. PMID- 2696211 TI - [In memory of J. F. F. Theodor Langhans (1839-1915)]. AB - On occasion of the sesquicentennial of the birth of J.F.F. Theodor Langhans, a tribute is made to his life and work. PMID- 2696212 TI - [Risk factors for venous thromboembolism]. AB - In addition to the well known general risk factors for thromboembolic events certain alterations of the clotting system are of considerable importance and are, therefore, described in detail. Such preexisting alterations should be suspected when spontaneous thrombosis is found in patients under 40 years of age and when there is also a history of thrombosis in the patient's family. PMID- 2696213 TI - [Instrumental and phlebography diagnosis of deep venous leg and pelvic vein thrombosis]. AB - Since plethysmography was introduced as the earliest screening method of peripheral veins there was a constant improvement of apparatus and methods. Presently the color-coded Duplex sonography gives results more detailed than any other screening test and is comparable with the accuracy of phlebography. Nevertheless, since the introduction by Mahler of the "climbing pulse rate" as the best known clinical sign of thrombosis a fundamental problem still waits for the solution: diagnosis of the very beginning of thrombosis. Only when the initial symptoms of the disease are correctly interpreted the best suitable diagnostic methods can be carried out stepwise. A wrong interpretation of the patient's complaints still causes serious retardations of the induction of an adequate therapy. PMID- 2696214 TI - [Isotope studies in the diagnosis of venous thromboses and lung embolism]. AB - Early diagnosis of deep venous thrombosis and pulmonary thromboembolism is still a clinical problem and led to the development of non invasive diagnostic methods using radioactive tracers. There are 2 principles of procedures. One is diagnosing deep venous thrombosis with the 125 (131) iodine-fibrinogen uptake test. The use of 125 (131) J fibrinogen, its advantages and disadvantages are described. Others are imaging techniques developed as an alternative to ascending contrast venography still considered as the "golden standard", using 99m Tc labelled microspheres of human serum-albumin or Tc 99m labelled red blood cells (blood pool imaging). In spite of certain discrepancies a good correlation of 90% exists, between the imaging methods mentioned. Several authors reported a sensitivity of 87% and a specificity of 85% as compared with Doppler-ultrasound Investigations of lower extremities. A great advantage of radionuclidvenography is the possible combination with lung-perfusion scanning for the diagnosis of pulmonary embolism. Lung-perfusion- and ventilation-studies are still the only non invasive method to diagnose pulmonary embolism. Sensitivity of this method is very high, specificity improves with taking in account predisposing factors of developed deep vein thrombosis. Indium 111 or 99m Tc labelled monoclonal antifibrinantibodies are developed recently: an imaging agent suitable for evaluation of both pelvic and lower extremity vein thrombosis. First promising results were published last year and it seems, that this reliable imaging agent for clots and thrombo-embolic diseases will fill this diagnostic need in the future. PMID- 2696216 TI - [Clinical aspects and treatment of post-thrombotic syndrome]. AB - The treatment of the postthrombotic syndrome is determined by the individual clinical symptoms and signs. As long as there is no alteration of the skin nor edema or varicosis but only uncomplicated lesions in the deep veins basic therapy is sufficient. In this case the physiological venous reactions should be supported by the avoidance of standing or sitting for long times and of high environmental temperatures. Local cooling and other measures as defined by Robert May are advisable. In the case of symptoms compression therapy is necessary which in most cases will be lifelong. PMID- 2696215 TI - [Prevention of venous thromboses with oral anticoagulants]. AB - Oral anticoagulants are effective for prophylaxis of venous thromboembolism. The therapy is usually monitored by the one-stage prothrombin time (Quicktest). The aim of anticoagulant therapy is to reduce the coagulability of blood into a so called therapeutic range within which the patient is protected against thrombosis while being exposed to a minimal risk of bleeding. The standardization of methods for the prothrombin time assay by the International Normalized Ratio is of further benefit for monitoring the therapy in the individual patient. PMID- 2696217 TI - [Therapeutic consequences of hemorheologic research]. AB - One of the possibilities to ameliorate blood perfusion is the modification of the rheological properties of blood. Hemodilution, enzymatic defibrinogenation and oral drugs are available at present to achieve this aim. Hemodilution is clinically successful with certain indications. The efficacy of enzymatic defibrinogenation cannot be judged finally. Within the group of rheologically active drugs a variety of substances are of proven effectiveness. Yet it is open whether this is brought about exclusively by hemorheological mechanisms. PMID- 2696219 TI - Nonendocrine theories of the etiology of benign breast disease. AB - This article summarizes 15 years of clinical and laboratory studies that have continued the search for a biochemical basis for the development and resolution of symptomatic benign fibrocystic disease. The clinical response to diet modifications is presented along with simultaneous laboratory tissue and serum studies. An ongoing study of the clinical response to complete and total methylxanthine abstention, especially caffeine, is presented in the initial part of the article. Following the clinical observations, is a series of laboratory studies, some of which actually preceded the clinical investigation and, in fact, pointed out that a beneficial clinical response might occur in some women following complete abstention. In the last paragraph, we present current information that may identify which women are susceptible to fibrocystic breast disease development. PMID- 2696218 TI - The endocrine basis of benign breast disorders. AB - There is sound clinical evidence that many benign breast conditions, especially pain, nodularity, and cysts, are likely to have their pathogenesis in hormonal events during reproductive life. Yet the classical theories of persisting hyperestrogenism and luteal progestogen deficiency have not stood up to detailed investigation. Recent work has demonstrated the importance of dynamic hormonal changes and of chronobiological rhythms--daily, menstrual, and seasonal. Recent developments and findings are reviewed to point to the directions in which the basic etiology of these conditions is likely to be discovered. PMID- 2696220 TI - Radiological evaluation of benign breast disorders. AB - The radiological features of common benign conditions of the breast and the radiological procedures used in the investigation of benign breast disorders are presented. PMID- 2696221 TI - The use of ultrasound in benign breast disorders. AB - The role of ultrasonography in the diagnosis of benign conditions of the breast is presented. The images seen with common benign conditions are illustrated and diagnostic problems are discussed. PMID- 2696222 TI - Management of breast pain and nodularity. AB - The management of mastalgia consists of classification into its various patterns: reassurance, drug therapy for severe cases, and, rarely, surgery. Differentiation into cyclical and noncyclical patterns on a simple pain chart is useful for objective assessment of pain severity and for selection of appropriate drug therapy and subsequent monitoring of response. About 85% of new patients will be satisfied with adequate reassurance, but some 15% will have persistent pain and warrant medical treatment. Only a small number of drugs have been adequately tested in controlled trails and have been demonstrated to be more effective than placebo; these are bromocriptine, danazol, evening primrose oil, and tamoxifen. No ideal agent exists and the choice of drug will depend on efficacy, side effects, and cost. Noncyclical pain has a lower response rate compared to cyclical mastalgia, but differentiation of a subgroup with chest wall pain leads to an overall 90% response to treatment by local infiltration with steroid and lignocaine. Newer agents such as LHRH agonists are currently undergoing evaluation in double-blind controlled trials against placebo. The management of nodularity is based on the clinical differentiation of the normal spectrum of physiological change within the breast (ANDI), requiring simple reassurance, from a true dominant breast nodule that will require excision biopsy to exclude malignancy. When pain and lumpiness coexist, some reduction in overall nodularity (with the use of agents given for mastalgia) may occur. PMID- 2696223 TI - Fibroadenoma. AB - The common breast fibroadenoma makes up between one-third and one-half of biopsies for benign breast disease. The contemporary view is that it is an abnormality of normal development and involution rather than a neoplasm. Various other benign conditions may be clinically indistinguishable, and histological confirmation was only obtained in 68% of 321 masses thought to be fibroadenomas. Short-term (13-24 mo) follow-up of 201 masses, thought to be fibroadenomas on clinical and cytological grounds, showed resolution in 31% and regression in a further 12%, this behavior being more common with single lesions; a further 32% increased in size. There have been no long-term studies, but it is likely that most regress toward the end of a woman's reproductive years. Aspiration cytology can differentiate malignant from benign disease with great accuracy, but had impaired sensitivity (87%) and specificity (76%) in differentiating fibroadenoma from other benign processes in an analysis of 244 successful aspirates. While these lesions may be safely left in women under 25 years of age, only 19 (27%) of 70 women of this age group chose this option and excision remains the most frequent treatment. PMID- 2696224 TI - Breast macrocysts. AB - Clinical macrocysts occur in about 7% of adult women. Modern terminology and understanding of benign breast disorders considers microcysts and macrocysts as specific clinical and pathological entities. The terminology and concepts of fibrocystic disease and its many alternative terms have been discarded. Cysts arise as an aberration of normal lobular involution (ANDI) associated with active secretion of apocrine epithelium under hormonal stimulation. They are readily managed in most cases by aspiration alone. Multiple recurrent cysts may constitute a considerable nuisance and justify short-term therapy with danazol. There is increasing evidence that multiple recurrent cysts are associated with a small, but significant increase in breast cancer risk. PMID- 2696225 TI - Periductal mastitis/duct ectasia. AB - Periductal mastitis/duct ectasia affects major breast ducts and is poorly understood. A variety of different terms have been used for this condition and these probably reflect different stages in one disease process. It appears to be responsible for 1-2% of all symptomatic breast conditions. Although the incidence is higher in postmortem studies, much of what is included as so-called "periductal mastitis" or "duct ectasia" in these studies is duct dilatation, which occurs as part of normal breast involution. Periductal mastitis appears to be the primary condition with duct ectasia being the outcome. The cause of this periductal mastitis is uncertain, although bacteria, particularly anaerobic organisms, appear to play some role. Clinically, this condition can present with noncyclical mastalgia, nipple discharge, nipple retraction, a subareolar breast mass with or without overlying breast inflammation, a periareolar abscess, or a mammillary fistula. Antibiotics effective against the organisms isolated from this condition are effective in resolving periareolar inflammation and are useful when combined with surgery in mammillary fistula. PMID- 2696226 TI - Benign disorders of the male breast. AB - Gynecomastia is the dominating problem of the male breast. Other diseases are rare but mimic the same conditions in women. Gynecomastia may occur at any age either as a primary event, when it is due to a minor hormonal imbalance, or secondary to other pathology (e.g., liver failure) or drugs. Treatment consists of assessment of cause and reassurance. In a minority of patients, treatment with drugs--such as danazol--or surgical resection is indicated. PMID- 2696227 TI - Benign breast disease in the postmenopausal woman. AB - Breast symptoms are surprisingly common in the postmenopausal period, especially (but not only) when taking hormonal therapy. All of the common conditions of the premenopausal period may be seen. Clinical examination is usually easier and more precise in the postmenopausal woman. The importance of accurate clinical observation is stressed, as a diagnosis can usually be made in this way, supplemented by mammography and aspiration cytology where reliable services exist. PMID- 2696228 TI - Management of nipple discharge. AB - In a series of 8,703 breast operations, nipple discharge was the presenting symptom in 7.4% of cases. It is even more common in the office and clinic since many discharges can be treated medically. To be significant, a discharge should be true, spontaneous, persistent, and nonlactational. Of the 7 basic types, i.e., milky, multicolored and sticky, purulent, clear (watery), yellow (serous), pink (serosanguineous), and bloody (sanguineous), the last 4 are the surgically significant ones. Of the 586 patients operated on for one of these types of discharge, the majority had a benign etiology, i.e., intraductal papillomata (48.1%) and fibrocystic changes (32.9%), but 14.3% were due to cancer and another 7.3% to precancerous mastopathy. In the 84 patients with cancers, the false negative rate for mammography was 9.5% and was 17.8% for cytology. There was no palpable mass in 13.1% of patients. There was an increasing likelihood of the discharge being due to cancer when the discharge was, in order of increasing frequency, yellow, pink, bloody, or watery, when it was accompanied by a lump, when it was unilateral and from a single duct, when the mammogram or galactogram and the cytology were positive, and when the patient was over 50 years of age. Milky discharges are usually treated medically unless they are due to a pituitary adenoma. If the cause cannot be found and eradicated, bromocriptine is the drug of choice. Multicolored sticky discharges are also treated medically, chiefly by nipple hygiene, except when advanced. Purulent discharges are treated with appropriate antibiotics but abscesses need drainage and a biopsy of the wall. Except in women under 35 years of age or in those anxious to have children, surgically significant discharges are treated by central duct excision. Good cosmetic results can be obtained with careful technique and the danger of a recurrent discharge is eliminated. PMID- 2696229 TI - Management of breast abscesses. AB - Hospital experience of breast abscess is changing as nonpuerperal abscess associated with periductal mastitis assumes increasing importance. Clinical presentation, bacteriology, and management differ notably from acute puerperal abscess, but the latter can still cause severe morbidity. The standard management of puerperal abscess by incision, breaking down loculi, and dependent drainage may still be used, but the author has shown that an alternative approach- curettage and primary obliteration of the cavity under antibiotic cover--can give equally good results with reduced morbidity. PMID- 2696230 TI - Aesthetic surgery for benign disorders of the breast. AB - Those benign breast disorders that are amenable to improvement by aesthetic surgery are discussed from the points of view of indications, techniques, and results. PMID- 2696231 TI - Perioperative antibiotic prophylaxis in cardiovascular surgery: a prospective randomized comparative trial of cefazolin versus ceftriaxone. AB - With a view of possible reduction in antibiotic dosage, several prospective randomized comparative trials performed in our institution showed that a 4-day prophylactic antimicrobial regimen with cefazolin was equally effective as a 2 day prophylaxis with cefuroxime and that the best regimen was equally as effective as a double dose of ceftriaxone prophylaxis in major cardiovascular surgery. In this prospective randomized comparative study, 1-day cefazolin prophylaxis (4 X 0.5 g intravenously) was compared with a single dose of ceftriaxone prophylaxis (2 g intravenously). Of the 900 patients enrolled in the study, 17 were subsequently excluded. Of the remaining 883 patients, 439 were in the cefazolin group and 444 were in the ceftriaxone group. The overall postoperative infection rate was 5.0% in the cefazolin group and 4.5% in the ceftriaxone group. In view of the almost identical infection rates in both groups, we considered that a single 2 g dose of ceftriaxone offers patients a reliable antimicrobial prophylaxis. The single-dose prophylaxis has the additional advantage of reducing the dosage administered and the costs of administration. PMID- 2696233 TI - [Important aspects in the rehabilitation of patients with rheumatic diseases]. PMID- 2696232 TI - Thyroxine suppressive therapy of benign solitary thyroid nodules: a prospective randomized study. AB - Patients with solitary thyroid nodules that are benign on aspiration biopsy are often treated nonsurgically. To find out if thyroxine therapy is effective, 74 patients were randomized to receive levothyroxine treatment or nothing. There were 8 males and 66 females. Their mean age was 39 years. The mean nodule size was 3.6 cm and the mean nodule duration was 11 months. All patients had normal serum thyroxine and thyroid stimulating hormone (TSH) levels, and positive thyrotropin releasing hormone (TRH) tests. The dose of thyroxine was adjusted until the TRH test was negative. Patients were followed at 6-month intervals in the first 2 years and yearly thereafter, with measurement of the nodule diameter. The mean follow-up period was 1.5 years. In the 37 patients receiving thyroxine therapy, 8 had disappearance of nodules, 6 had greater than 50% reduction in nodule size. In 19, the nodules were unchanged and in 4, the nodules were enlarged. In the 37 patients receiving no drug, 8 had disappearance of nodules, 5 had greater than a 50% reduction in nodule size, 17 had nodules unchanged, and 7 had enlarged nodules (p greater than 0.9). The mean reduction in nodule diameter at various follow-up periods was greater in the thyroxine group, but the difference did not reach statistical significance. Carcinoma was found in 1 patient in each group and both of them experienced nodule enlargement. We conclude that an adequate suppressive dose of levothyroxine does not alter the natural course of benign solitary thyroid nodules. An enlargement of the nodule or a change in its consistency should be further investigated to exclude malignancy. PMID- 2696234 TI - [Current trends in the development of rehabilitation following myocardial infarct]. PMID- 2696235 TI - [Management of diabetic patients--a life-long rehabilitation process]. PMID- 2696236 TI - [Rehabilitation of patients with vision disorders]. PMID- 2696237 TI - [Rehabilitation in advanced age]. PMID- 2696238 TI - [Symptoms of autonomic polyneuropathies]. PMID- 2696239 TI - [Differential use of atropine in premedication]. PMID- 2696240 TI - [The discovery of bacterial agglutinins and origin of serum diagnosis--a priority dispute from the history of medical microbiology. 1: Facts and data]. PMID- 2696241 TI - [Microbiologic diagnosis of diseases of the lung, bronchi and pleura]. AB - Microbiological examination of sputum specimens is of limited value and may give misleading results. On the other side, knowledge of aetiologic agents and corresponding antibiograms may be life-saving in nosocomial pneumonias, for instance. Bronchoalveolar lavages and invasive diagnostic procedures are necessary to obtain microbiological materials without contamination by oral germs. Blood cultures and pleural effusions are useful too. Further informations are given by CF, immunofluorescence (antibody or antigen), ELISA, CIE, latex agglutination and other modern techniques. Bacterial bronchitis should be treated on the base of calculated chemotherapy. Microbiological procedures are indicated only in the case of repeated therapeutic failure. Invasive diagnostic measures should be avoided in the case of bronchitis. Calculated chemotherapy is sufficient in most cases of community-acquired pneumonias too. Nosocomial pneumonias have a high mortality which only can be reduced by rapid aetiologic diagnosis. All efforts in this direction are of considerable value. Special problems are connected with aspiration pneumonia, atypical and viral pneumonias and pleural empyema. Besides pleural exudate pleural biopsies are useful to demonstrate some special microbes. PMID- 2696242 TI - [Surgery of large bullous emphysema--functional results]. AB - Forty eight patients suffering from a bulla compressing the rest of the lung tissue were examined before and after the resection of the bulla with the aim to estimate the degree of functional improvement and to find out criteria of indication for surgical treatment. The follow-up examinations included the clinical symptoms, functional data and the size of the bulla in an early phase and a late phase. The size of the bulla was determined on the basis of chest x ray by planimetry. The analysis of preoperative and postoperative functional data (bodyplethysmography, spirometry, blood gas analysis, ergometry, measurement of pulmonary artery pressure) were performed in consideration of the surgical method and the presence of chronic obstructive lung disease. The comparison of the preoperative and postoperative values showed an improvement of the respiratory function, the gas exchange and the degree of dyspnea. The size of the bulla and the degree of the functional restriction are the decisive criteria for surgical treatment. PMID- 2696243 TI - [The hemodynamics of the lung circulation of minipigs after experimentally-caused Sedlarik's pulmonary embolism. I. Sedlarik's pulmonary embolism model in comparison to existing embolism models]. AB - The necessity of a clinical relevant pulmonary embolism model is described because of the international importance and the consequence for certain special branches. The multifarious pathophysiologic mechanism in the human requires an approximation of the model. The pulmonary embolism model according to Sedlarik approaches these demands and it became the basis of this study. PMID- 2696244 TI - [The status of echocardiography within the scope of routine cardiologic diagnosis]. AB - In particular since the introduction of the two-dimensional approach, echocardiography as a non-invasive and easily repeatable bedside-technique without side-effects plays a central role within the diagnostic tools of cardiology. The following applications of cardiac ultrasound are commonly accepted and sufficiently validated: Assessment of the size of cardiac chambers including qualitative and quantitative evaluation of left ventricular function, detection of pericardial effusion, diagnosis of intra- and extracardiac tumors and thrombi, analysis of complex congenital diseases. Without the use of Doppler, valvular regurgitations can only be suspected by indirect parameters; in contrast, stenotic lesions as well as a variety of other valve abnormalities (calcifications/partial rupture/prolapse/vegetations) can be diagnosed with a high accuracy. Transesophageal echocardiography guarantees not only an optimal imaging quality in virtually all patients, in addition, the technique allows the routine visualization of the thoracic descending aorta and the left atrial appendage which is of importance for the diagnosis of aortic dissection and isolated left atrial appendage thrombi. Transesophageal echocardiography is also superior to the conventional precordial approach concerning the assessment of prosthetic valve malfunction (in particular in mitral position) and endocarditis associated abscesses. Today, the echocardiographic visualization of coronary arteries is without clinical relevance. PMID- 2696245 TI - [Color Doppler echocardiography--possibilities and limits of a new procedure]. AB - Color-flow-mapping (CFM) has added a new dimension to the echocardiographic diagnosis of heart disease. Typical characteristics of blood flow, i.e., flow direction, relative velocities, and degree of "turbulence" in the cardiovascular system are displayed within the two-dimensional echocardiographic image. This gives hitherto unknown insights into the physiology of blood flow velocity profiles. Pathological flow patterns in heart disease are easily recognizable and their display within the CFM image allows a straightforward diagnosis of the underlying heart disease. This feature is especially valuable in the diagnosis of heart disease with shunt and in valvular regurgitations in children, as well as in adults. CFM is also useful for optimal angulation in the assessment of gradients using the simplified Bernouilli equation. It is characterized by a remarkably high diagnostic sensitivity and specificity. However, quantitation of heart disease causing volume load is still limited by the lack of standardization in the process of color encoding of the Doppler data. Digital flow mapping (DFM) offers an opportunity for the standardized sampling of Doppler data offering development of an established modality for color encoding. Moreover, DFM offers the opportunity for calculation of angle-corrected velocities. Here a new non invasive way for a reliable calculation of cardiac output may present itself. PMID- 2696246 TI - [The value of nuclear cardiology procedures including nuclear magnetic resonance tomography in routine diagnosis]. AB - Nuclear-cardiological diagnostic methods require close cooperation between cardiology and nuclear medicine groups. This review article summarizes the advantages (non-invasive, quantitative, effect of exercise) and the disadvantages (limited resolution, limited specificity, radiation exposure) of the methods. Methods used routinely in the clinic are radionuclide ventriculography and myocardial scintigraphy with Tl-201. The indications for and limitations of these methods are discussed. The important advantages of nuclear magnetic resonance imaging (MRI) are the large field of view which includes extra cardiac structures, choice of slice width and orientation, good resolution and the simultaneous evaluation of morphology, functional parameters, flow phenomena and some differentiation between tissues. Presently, MRI is indicated in problem cases, e.g., aortic aneurysm, dissecting aneurysm, constrictive pericarditis, cardiac and paracardiac tumors. MRI also provides useful complementary information in valvular regurgitation, congenital malformations, cardiomyopathies and intracavitary thrombi. However, magnetic resonance imaging is still under development so that its overall value in the diagnosis of cardiac diseases cannot yet be definitely assessed. PMID- 2696247 TI - [Possibilities and limits of 2-dimensional echocardiography in quantitative image analysis]. AB - By two-dimensional echocardiography left ventricular volumes can be measured and ejection fraction can be calculated. But volume and ejection fraction determination are combined with a systematic underestimation despite high correlation in comparison to "true volume", whereas cineventriculography systematically overestimates true volume. This echocardiographic methodological problem is related not only to tangential scanning but also to low lateral resolution yielding a reduced endocardial border delineation. Meanwhile, advanced transducer technology and digital imaging techniques with zoom and cineloop possibilities have improved endocardial border detection. In comparison to cineventriculography, volume determination by two-dimensional echocardiography has improved significantly in comparison to results in 1983; this improvement was mainly due to a better determination of endsystolic volume. Similarly, left ventricular contrast echocardiography using color coding with statistical analysis of digitized images enhanced the accuracy of analysis of global and regional left ventricular function. Transesophageal echocardiography will be used when there is reduced image quality of transthoracic echocardiography, for example, in obese patients or those with pulmonary emphysema or mechanical ventilation. Transthoracic echocardiography has become a routine method for assessing global and regional left ventricular function. Echoventriculography can be used in patients with renal insufficiency, anaphylactic reaction to contrast medium, and poor left ventricular function. PMID- 2696248 TI - [Possibilities and limits of quantitative analyses using Doppler echocardiography]. AB - Blood flow velocities can be quantified using Doppler echocardiography if the angle is known. Systolic ventricular function can be evaluated by stroke-volume measurement (product of blood flow velocity over time), but individual data may depart significantly from invasive measurements. Information on the diastolic ventricular function is based on measurements in the ventricular inflow tract. These parameters are very sensitive, but not specific at all. The quantification of valvular stenosis is the domain of Doppler echocardiography. Pressure gradients can be obtained from the degree of the blood flow acceleration. The calculated valve area in aortic stenosis using the continuity equation and in AV valvular stenosis using pressure half-time measurements renders reliable, valuable, and clinically relevant information which is quite independent of cardiac output and additional valvular regurgitations. However, a detailed knowledge about the potential impact on the acquired data due to the specific methodology, the investigator, and the individual patient is mandatory. Out of the Doppler-derived intraventricular pressure indices, the determination of the systolic right ventricular and pulmonary artery pressures in patients with tricuspid regurgitation is widely accepted and has clinical implications. Several semiquantitative procedures to evaluate regurgitant volumes have been developed, at present, however, a definite and reliable quantification is not possible. PMID- 2696249 TI - [Possibilities and limits of quantitative image analysis using magnetic resonance procedures]. AB - Magnetic resonance imaging provides three-dimensional images of the heart with good spatial and temporal resolution. Therefore, right and left ventricular function can be assessed without assumptions regarding ventricular morphology. Depiction of intracardiac blood flow with gradient echo sequences permits estimation of the severity of valvular regurgitation. Using improved paramagnetic contrast media magnetic resonance imaging may be able to directly visualize regions of ischemic myocardium. Real-time imaging of the heart will be possible using echo planar techniques. Although quantification of cardiac parameters by MRI is still mainly a research tool, clinical applications will emerge in the near future. PMID- 2696250 TI - [Quantitative image analysis in nuclear cardiology as a decision aid in addition to visual assessment of findings]. AB - Quantitative analysis of nuclear cardiology procedures has stimulated tremendous work in the past and will continue to do so in the future. The impact on routine patient care has grown at a slower pace and should be assessed separately for tissue perfusion and for myocardial contraction. The current status will be presented, focusing on patients with coronary heart disease. In the preinfarct period myocardial scintigraphy with thallium-201 and emission computer tomography (ECT) is the preferred method. The procedure for quantitation includes transfer of all data into a standard polar map and comparing the numbers with a normal, gender-matched data base. The result reveals areas of reduced tracer uptake, color-coded according to the level of significance. Interpretation of these colored polar maps might appear simple, but in fact requires a substantial amount of knowledge to avoid overinterpretation of the results. This has led us to a restricted use of this quantitative tool: following an initial step of reading the original data in terms of short and long axes slices of the left myocardium, the polar map is utilized for verification and for suggestions of any additional lesions. This has to be confirmed by a second reading of the slices, and only this last step defines the lesions to be reported. Quantitation used in this dialectic approach avoids inclusion of artefacts, and at the same time is useful experience for trainees. Furthermore, it allows easy presentation during the clinical conference and statistical analysis of groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696251 TI - [Videometry and videodensitometry: possibilities within the scope of clinical angiocardiography]. AB - Videometry and videodensitometry was developed more than 20 years ago by the groups of E. H. Wood in Rochester, New York, USA and P. H. Heintzen in Kiel, West Germany. These techniques allow the extraction of quantitative parameters such as dimensions and volumes (videometry) and the concentration and distribution of contrast material (videodensitometry) from videoangiograms. Whereas videometric techniques have, in between, been implemented world-wide into clinical practice (e.g., for geometric measurement of heart chamber volume or the quantitative assessment of coronary morphology), videodensitometry has still been restricted to a small number of laboratories, mainly due to the technical requirements. Videodensitometry, however, offers an on-line frame-to-frame analysis of left and right ventricular volumes throughout the cardiac cycle, the measurement of valvular regurgitant fraction, the estimation of intracardiac shunts, as well as the measurement of blood flow and velocity in coronary arteries and the assessment of changes in myocardial perfusion due to interventions form clinical videoangiograms. Since the basic principles of these techniques can easily be applied to digital image processing, videodensitometry has gained new interest in a time of increasing distribution of digital cardiac imaging. PMID- 2696252 TI - [Functional angiocardiography]. AB - Recent development of powerful image processing systems provides computation of angiocardiographic image series. Thus, acquisition and display of specific cardiac and circulatory parameters has become feasible. The simplest processing mode utilizes repetitive image subtraction, for example for the documentation of left ventricular wall motion abnormalities. A qualitative aspect of organ perfusion (myocardium, lungs) is obtained by color coding of serial DSA-images. Quantitative studies of vascular perfusion, however, require complex parameter extraction techniques according to the theory of indicator dilution. Great advancements have been achieved for arterial flow distribution measurements to study peripheral vascular disease. The actual interest in cardiology concerns measurements of coronary flow reserve that are based either on perfusion time or contrast mass measurements. However, limitations in quantitative flow studies must be considered in relation to the physico-chemical effects of contrast media. PMID- 2696253 TI - [Influence of baroreceptors on hypertension, pharmacotherapy with conversion enzyme inhibitors]. AB - Baroreceptor reflex plays an important role in the pathophysiology of essential hypertension. Experiments in dogs could demonstrate that after complete denervation of sinoaortic and cardiopulmonar baroreceptors a long-lasting hypertension with labile blood pressure behavior occurred. The sympathetic tone was enhanced significantly when studied in denervated rats. In patients with essential hypertension no comparable conditions to the "neurogenic hypertension" of animals exist. Therefore, studies in patients after orthotopic heart transplantation are of interest because those patients develop severe hypertension even if cyclosporine is not administered. Preliminary results reported here support a participation of baroreceptors in hypertension of transplanted patients. A further reason of essential hypertension is found on baroreceptor resetting. Changed ion concentrations and/or wall thickness of the respective blood vessels could be the cause. The sympathetic system influences the renin-angiotensin-system and baroreflex activity by central and peripheral mechanisms. It, for example, attenuates Ang-II and the baroreflex via central actions. Converting-enzyme-inhibitors (CEI) act in part as peripheral vasodilators without affecting the heart rate significantly. This effect is possibly due to lacking Ang-II that is able to increase the sensitivity of baroreceptors. In the past it has been shown that the inhibition of tissue converting enzyme is more responsible for the antihypertensive effects of CEI than that of plasma-converting enzyme. The cardioprotective effects of CEI are suggested to be an important advantage in the treatment of hypertension and heart failure. These cardioprotective actions are partly due to accumulated bradykinin, just as are the hypotensive effects of CEI. The interactions between CEI and the sympathetic system should be differentiated into pre- and postsynaptic actions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696254 TI - [Diagnosis of extrarenal, secondary forms of hypertension]. AB - The secondary, nonrenal forms of hypertension principally include pheochromocytoma, hyperaldosteronism, hypercortisolism, iatrogenic hypertension following medication, and hypertension related to overindulgence. Other very rare secondary forms of hypertension will not be considered here. Pheochromocytoma is the most dangerous of all the forms of hypertension. Diagnosis of the underlying cause of endocrine-derived hypertension is achieved by hormone analysis. Due to the small size of endocrine tumors, their exact localization can often not be established by sonography, such that CT or MR are the examinations of choice. Scintigrams are only necessary in special cases. For tumor localization in Cushing's disease, hormone measurements from the petrosal sinus are occasionally required. Medication, and above all, continual alcohol consumption, play an increasing role in the etiology of hypertension. PMID- 2696255 TI - [Hypertension, the heart and physical activity (sports)]. AB - Cross-sectional analyses show a lower incidence of hypertension among endurance athletes compared to the general population, but not among strength athletes or high-performance swimmers. The favorable influence of increased physical activity of the endurance type on cardiovascular regulation is based on peripheral adaptation processes with a reduction in sympathetic tone and elevation of parasympathetic tone. The results are a reduction in catecholamine release, in heart rate, and in mean arterial pressure at the same exercise level. Following chronic strength training there is also a slight reduction in catecholamine levels at the same time the vagal activity decreases, so that no reduction in heart rate and pressure, and thus no economization of cardiac work results. Thus, endurance training is suited for prevention and also for the reduction of blood pressure in primary hypertension and for cardiac relief, while strength training is not. In the case of hypertension, physical activity may only be engaged in when the cardiac functional status and other organ impairments are known. The stages of cardiac adaptation and damage, particularly the differentiation between concentric and eccentric hypertrophy, are particularly important. Exercise ECG and echocardiography are therefore obligatory measures prior to initiating physical activity and for continuous monitoring of hypertension. In primary hypertension Stage I (70-80% according to WHO), in which no cardiac hypertrophy is present, endurance training may be started without drug therapy if diastolic pressure is not greater than 104 mmHg and systolic pressure up to 170 mmHg (mild hypertension). Additional drug therapy does not show any convincing advantages. Higher pressures require adjuvant drug therapy. In concentric cardiac hypertrophy (Stage II), there is clear indication for the use of hypotensive drugs. An endurance sport is to be recommended additionally after normalization of blood pressure; the regression of cardiac hypertrophy should be examined within one year. In eccentric hypertrophy (damage stage), "training" is not indicated in addition to drug therapy, but rather physical therapy according to defined exercise capacity. The selection of medications for reducing blood pressure in sportsmen must take into consideration that they have varying performance limiting effects, which may be an essential factor in compliance. PMID- 2696256 TI - [General, non-medicamentous treatment of arterial hypertension]. AB - This review focuses on the following aspects of nonpharmacological management concerning elevation of blood pressure: historical development, highlights and theses, possibilities of intervention, as well as favorable observations, advantages (in early diagnosis), disadvantages, fields of application, and integration of this form of treatment into a comprehensive strategy of hypertension control at a population level. A selection of detailed results is elaborated including: possible failure in primary classification of elevated blood pressure and its consequences, the reducibility of the hypertension problem if nonpharmacological measures are generally used, risk factor prevalences in medical and non-medical university cadres, blood pressure reduction in a spa, and hemodynamic changes induced by nonpharmacological or combined antihypertensive treatment simultaneously with drugs. Finally, reference is made to international results, as well as to the importance of the relation between diagnosing and treating blood pressure elevation concomitantly with a simultaneous management of other main risk factors that must be influenced in order to reduce the cardiac risk in hypertensives. PMID- 2696257 TI - [Long-term results following surgical treatment of tetralogy of Fallot]. AB - The few published long-term studies regarding survival after corrective surgery of tetralogy of Fallot are based on patients operated 15 to 30 years ago during the developmental phase of the corrective technique. Interpretation of the results and conclusions for the present time based on these interpretations are thus difficult. It should be possible, however, to improve the reported life expectancy of less than 90% after 15 to 30 years for those who survived corrective surgery. Preservation of myocardial function, especially that of the right ventricle is most important for the improvement of life expectancy. Influencing factors are - besides degree of severity and duration of preoperative overload - residual defects, sequela and complications. The classical residual defects such as ventricular septal defect or stenosis of the right ventricular outflow tract are rarely observed today. Cardiac complications such as AV-block and arrhythmia may not always be preventable; local and diffuse fibrotic alterations of the right ventricular myocardium are probably the cause, which in turn may be induced by ventriculotomy, infundibulectomy as well as pressure overload and hypoxemia. Duration of overload is most likely the main contributing factor. The most important sequela is the postoperative pulmonary insufficiency. The larger the volume overload the more pronounced is the impairment of right myocardial function. Allograft implantation appears to be the most promising technique to prevent pulmonary insufficiency at the present time. PMID- 2696258 TI - [Heart arrhythmia following surgery of congenital heart defects]. AB - As a result of the intraoperative trauma sinus node dysfunction and AV conduction defects have been observed. In addition bifascicular block (RBBB with LAH) may occur after repair of a ventricular septal defect. This electrocardiographic pattern indicates a high risk of developing a trifascicular block only in those patients with reversible AV block in the early postoperative period. After closure of an atrial septal defect, atrial fibrillation can develop as well as ventricular tachycardia and fibrillation after repair of a ventricular septal defect. The latter seems to be the underlying mechanism of sudden cardiac death occurring late after operation, especially in patients with Fallot tetralogy. In addition to the scar, persistent structural myocardial changes seem to be an important factor. Electrophysiological investigation is indicated in all symptomatic patients especially for detection and treatment of ventricular tachyarrhythmias. However, there is yet no proof that sudden death can be prevented by antiarrhythmic treatment of all ventricular premature beats in the endangered patients. PMID- 2696259 TI - [Pulmonary hypertension and pulmonary vascular disease in congenital heart defects]. AB - Pulmonary vascular disease (PVD) is a serious complication of several congenital heart defects (CHD). The post-tricuspid heart lesions, such as AVSD, VSD, PDA, TGA with VSD, Ao-pulmonary window, Truncus arteriosus, DORV and DILV (univentricular heart) with a high pressure and increased flow in the pulmonary circulation are earlier and more often the cause of PVD than such pretricuspid shunts as ASD or TAPVD. The pathogenesis of PVD is only partially known. The endothelial cell of the pre- and intraacinar arteries releases substances (eicosanoids and mitogens) which cause functional and structural changes in the wall of arteriols and precapillary arteries: media hypertrophy, intima proliferation, obliterations, and necroses. The number and size of small arteries is reduced. Advanced changes are irreversible. Subtle diagnostic tools are necessary to evaluate the clinical, hemodynamic and morphologic status of the pulmonary circulation. Clinical signs, ECG, echocardiogram, x-ray of the chest, cardiac catheterization and special angiograms of the lung vessels have to be performed and their results have to be viewed in a synopsis. The type of tapering of the small arteries in the wedge-angio, the transit time of contrast media in the digital function angio, and changes of pressure and flow under test conditions give further information. Biopsy and histologic studies are difficult and not without risk. Treatment means prevention of advanced changes of PVD. Earlier correction of operable defects, banding of the pulmonary artery in complex heart lesions can avoid the development of PVD. A potent dilator of the small pulmonary arteries, applicable orally and over a long time, is not available at present.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696260 TI - [The status of echocardiography imaging]. AB - After several decades of gradual technical improvement of echocardiographic imaging, these methods have now attained a level of performance that is not so much dictated by technical limitations as it is determined by constraints imposed by the underlying physical principles. Image quality of echocardiographic imagers is discussed in terms of the spatial, temporal, and graylevel resolution provided. The level of technical performance obtained recently improves essentially the clinical value of echocardiography. Application of contrast material requires new techniques of image display such as color superposition imaging. Image quality in Doppler or color flow imaging is essentially described in terms of spatial, temporal, and velocity resolution. Phantom studies are proposed for routine testing of the image quality provided by clinical echocardiographic instruments. We mention some expected developments concerning archival image storage and the integration of echocardiograms into cardiological databases or complete departmental information systems. PMID- 2696261 TI - [Principles and developmental status of scintigraphy and nuclear magnetic resonance tomography]. AB - Scintigraphy is performed by means of radiopharmaceuticals which accumulate in the target organ or remain in the intravascular space. Radiopharmaceuticals consist of radionuclides as atoms or ions, or of radionuclides incorporated in simple or complex compounds, or in labeled endogenic cells. The gamma rays or gamma quanta are detected by using gamma cameras. Precise localization and image formation is performed by collimation. Sensitivity decreases quadratically with increasing resolution owing to the imaging procedure. Planar scintigrams represent summation images showing a resolution of 5 mm when structures close to the detector are imaged, and a reduced resolution of 8 to 10 mm when structures at a distance of 10 cm are investigated. Usually scintigrams are stored in digital form in a computer. Investigation of cardiac function by means of radionuclide ventriculography requires ECG triggering. Cardiac function is visualized by a so-called representative cardiac cycle consisting of 16 to 32 planer images. In single photon emission computed tomography (SPECT or ECT), transversal tomograms are reconstructed from original data of 60 to 120 planar scintigrams which are recorded with the head of the gamma camera rotating around the long axis of the patient. Resolution is approximately 15 mm. Positron emission tomography (PET) utilizes positron emitting radionuclides. Positrons recombine with electrons after a short, free path of some millimeters. Consequently, two gamma quanta are emitted into opposite directions (almost 180 degrees) which are detected by means of a detector ring system and coincidence techniques. Resolution is as good as 5 mm. PET studies are performed most effectively in the close vicinity of a cyclotron that can produce the short-lived positron emitters with typical half-lives of only some minutes. The new imaging modality nuclear magnetic resonance tomography (MRT) allows for recording tomograms in arbitrary orientation in space from very weak electromagnetic resonance signals. The information of the images resembles the density of endogenic protons which is weighted with two relaxation times and modified by flow phenomena. Those tomograms show excellent soft tissue contrast. To date, resolution is 1 mm within 5-mm-thick slices. ECG triggering is mandatory for cardiac imaging. With spin echo mode, recording 8 to 12 parallel tomograms at 8 to 12 equidistant points in time within the cardiac cycle takes 5 to 8 min depending on heart rate. Applying gradient echo mode, up to 30 different tomograms can be recorded within the same acquisition time showing one slice or a set of parallel slices at successive, equidistant cardiac phases. Nuclear magnetic resonance spectroscopy provides metabolic investigations in vivo. PMID- 2696262 TI - [Status of the technic of angiography procedures]. AB - Angiocardiography continues to expand inspite of competitive non-invasive imaging techniques (echocardiography, CT, nuclear magnetic resonance). Only angiography yields images of sufficient spatial and temporal resolution as they are needed for coronary diagnostic work and interventional catheter therapy. Angiographic systems are mono- or biplane with high degree of mobility and flexibility for oblique and angulated projections. Currently available systems do not fulfill the requirements. Image resolution and contrast are today satisfactory, however, still not sufficient for interventional techniques. Only digital image processing will allow further improvement, thereby enhancing contrast and detail while reducing radiation dose (pulsed, high-contrast fluoroscopy, on-line image processing). Cine-filming seems not needed in all cases. In the future, angiocardiography will hardly be needed for study of cardiac chambers, valves or great vessels. Instead, specialized systems of extreme mobility and flexibility with high resolution and digital image processing for image improvement and documentation, radiation reduction for coronary and general arterial diagnostic and therapeutic interventions will be developed. PMID- 2696263 TI - [Differential diagnostic, prognostic and therapeutic aspects in geriatric patients with joint diseases]. AB - Diseases of the joints in the elderly are a frequent reason for disability. An initial assessment of the patient is important for selecting the appropriate hospitalization. Exclusion of infections is mandatory. The peculiarity of rheumatic diseases in the elderly, e.g., rheumatoid arthritis, polymyalgia rheumatica, is discussed, as well as the problem of osteoarthritis which shows a progressing disability in only half of the patients. Long-term nursing is required more for polymorbidity than for osteoarthritis. The optimal care is provided by a team composed of nurse, physio- and ergotherapist, and social attendant in close cooperation with the physician; the goal is self-sufficiency and hospital discharge for even the severely disabled patient. PMID- 2696264 TI - [Principles of multivariate memory diagnosis]. AB - In this study results from experimental research on aging memory serve as a basis for standardized memory assessment techniques. By analyzing the covariations of nine memory tasks a structural memory model is proposed, which is shown to be invariant across ages 60 to 90. Findings concerning the external validity of the outlined memory model are discussed. Factorial invariance of memory performance is a prerequisite for detecting therapy-induced changes: It is only on the basis of psychometric test procedures, which have been shown to transcend the factors of age and performance level, that comparative evaluations of individual therapy effects are possible. PMID- 2696265 TI - [Fatal synergism of viral-bacterial infections (a model of influenza streptococcal infections)]. AB - A model of virus-bacterial infection involving A (PR-8/34) influenza virus and group B streptococcus is proposed to demonstrate the cyclic manifestations of fatal synergism of the causative agents correlating with either the cyclic detection of influenza virus antigens in the infection focus on administration of avirulent streptococcal Fos4 strain, or with the time-course of activity shown by natural killers on administration of virulent streptococcal Fos8 strain. Based on the presented data on the cyclic character of fatalities, whose dynamics varies only slightly with the biological properties of the second agent, a conclusion has been derived on (1) the simultaneous influence of various factors in the formation of the mechanisms of infection transformation, (2) the capability of the cell receptor apparatus to respond to an external stimulus which is the most important of these mechanisms, and (3) the effects of the biological properties of the causative agents on the fatal effect manifestations. PMID- 2696266 TI - [Clinical and laboratory diagnosis of streptococcal infection]. AB - The problems related to the clinical and laboratory diagnosis of streptococcal infection at all levels of health service are analysed. The principles of microbiological streptococcal identification with the aid of express-systems and standard culture techniques are outlined. Particular emphasis is placed upon immunoassay of streptococci using a broad spectrum of extracellular products and antigens of the cell wall of group A streptococcus, and upon methodological approaches to solving certain clinical and diagnostic problems. PMID- 2696267 TI - [Comparative study of cell walls of group A Streptococcus and its non-adhesive phosphomycin-resistant mutant]. AB - The cell wall composition of nonadhesive fosfomycin-resistant mutant of group A streptococcus and highly adhesive wild strain have been studied. The cell wall of the mutant nonadhesive strain contained significantly reduced amounts of lipoteichoic acid and surface proteins as compared to the wild strain, did not contain surface lipoteichoic acid, and, possibly, differed in peptidoglycan polysaccharide bonding. No differences in the qualitative carbohydrate composition of the cell walls were found. The amino acid composition of the cell walls of these microorganisms differed only in alanine content, which correlates with the reduction of lipoteichoic acid content in the mutant strain. The structural similarity of peptidoglycans of the two strains is demonstrated. PMID- 2696268 TI - [Hydrophobic quality and the level of surface proteins in the cell wall of cultures of Streptococcus pyogenes isolated from clinically healthy children from an organized collective]. AB - The Str. pyogenes cultures isolated from clinically healthy children were found to have different hydrophobic properties and quantities of surface cell wall proteins, and to exhibit pronounced variability in these signs in time. Most studied cultures lacked a correlation between their hydrophobic properties and the quantity of surface proteins of the cell wall. PMID- 2696269 TI - [Streptococcal immunoglobulin Fc receptors as inductors of anti-immunoglobulins]. AB - The activity of IgG Fc-receptor was studied in 71 strains of serological group A streptococci isolated from streptococcal infection patients and carriers. The group of practically healthy subjects and those with diseases of non streptococcal origin were found to have almost identical streptococcal strain distribution for IgG FcR+ and IgG FcR- (42.4 and 57.6 per cent, respectively). In the strains isolated from streptococcal infection patients, IgG FcR+ strains made up 63.1 per cent. In rabbit immunization, the capacity of IgG FcR-positive strains that were isolated from patients to induce anti-immunoglobulin synthesis was revealed. The induced synthesis of anti-immunoglobulins was noted also in rabbit immunization with purified streptococcal IgG Fc-receptors of M15 streptococcus and rabbit IgG eluated with streptococcal Fc receptors. Possible mechanisms of anti-immunoglobulin synthesis in experimental immunization are discussed. PMID- 2696270 TI - [Comparative aspects of adhesion of group A and B streptococci to human epithelium]. AB - The international and original research data on the adhesion of group A and B streptococci are over-viewed. Based on the conducted studies, a conclusion has been drawn on the polyfactor pattern of pathogenic streptococci adhesions. The polyfactor pattern of adhesion is manifested in (a) different ranges of tissue sensitivity to streptococci adhesion, (b) a correlation between the adhesiveness and particular phenotypes (M(+)-M-; OF(+)-OF- in group A streptococci, TSA(+)-TSA in group B streptococci), (c) different sensitivity of adhesives to proteolytic enzymes, and (d) interaction with fibronectin. M-protein was found to be involved in specific pyogenic streptococcal adhesion to the pharyngeal epithelium, which opens up new vistas for the search of approaches to the prevention of mucosal colonization. The participation of lipoteichoic acid (LTA) in group A and B streptococci adhesion in different tissues was shown The involvement of proteins in group B streptococcal adhesion was suggested by indirect evidence, which needs to be confirmed by direct isolation of an adhesive. It is suggested, that different quantitative combinations as well as structural organization of protein complexes and LTA in the streptococcus cell wall may determine the strain and species specificity of pathogenic group A and B streptococci interaction with host tissues. PMID- 2696271 TI - [Fast and slow genome rearrangements: molecular and genetic mechanisms of changes in virulence]. AB - Different mechanisms of virulence changes at the molecular and populational levels are discussed. The methodology and mechanisms of Streptococcus pyogenes variability are analysed. The views of the adaptive role played by insertion sequences are developed, and the design of an epidemiologico-genetic experiment is proposed, which consists in obtaining highly virulent insertion mutants and testing their properties. PMID- 2696272 TI - [Identification of the gene of type A erythrogenic toxin in strains of group A Streptococcus]. AB - The article specifies the mechanisms of toxigenicity in clinical streptococci strains. The production of type A erythrogenic toxin is found to be related to the toxigenicity gene expression localized in moderate bacteriophage genome. The possibility of using DNA probes to assess the degree of toxigenicity is discussed together with the relationship between the toxigenicity and the gene dose. PMID- 2696273 TI - [Study of general principles of humoral immune response in viral infection by sample analysis of the properties of specific immunoglobulins]. AB - Humoral immunity in murine experimental influenza was specified using experimental mathematical modelling intended for further systemic analysis of dynamics of immunological processes. The methodology of the proposed approach was based on the choice of affinity as an indicator of the function of specific antibodies, and on the concept of discrete functional structure of the immune system. The data were obtained by calculating affinity and antibody heterogeneity indices and by evaluating the distribution of functions by affinity. The successions of active antibody subpopulations with affinities varying in the course of infection and the presence in the plasma of protein fractions capable of low-affinity binding with influenza virus in non-infected animals were demonstrated. The relationship between the detected plasma protein populations and corresponding antibody-producing cells was confirmed. The mathematical modelling results were verified by physicochemical and immunochemical methods. The mechanisms by which the observed phenomena may be realized were considered from the viewpoint of the current theory of immunity. PMID- 2696274 TI - Subtotal cystectomy and antirefluxing hepaticoduodenostomy for choledochus cyst in children. AB - Total cystectomy with Roux-en-Y hepaticojejunostomy for choledochus cyst often causes malabsorption and other problems as a result of jejunal biliary diversion bypassing the duodenum. Restoration of near normal anatomy can only return the normal physiological harmony and assure normality. A simple antirefluxing hepaticoduodenostomy has proved successful. PMID- 2696275 TI - Experimental free muscle transplantation to the anus using microsurgical technique--a new treatment for anal incontinence. AB - Experimental free muscle transplantations to the anus with microneurovascular anastomoses were performed in twenty-one dogs as a model of new treatment for anal incontinence. After undergoing subtotal external sphincterectomy, gracilis muscles were transferred to the anus with microneurovascular anastomoses in Group I (n = 9), without microneurovascular anastomoses in Group II (n = 6), and the muscle transfers were not performed in Group III (n = 6). The mean anal canal pressures decreased to 24.4% of preoperative pressure at one month after subtotal external sphincterectomy. But at six months after muscle transplantation they restored up to 80.7% of preoperative pressure in Group I, 54.7% in Group II and the pressure did not restore in Group III (p less than 0.001 Group I vs Group II and III). Electromyographic study of the graft showed the electrical activity in six of seven dogs (85.7%) in Group I and electrical activity of the graft were not recognized in Group II at six months after transplantation. Histologic study of the graft showed the normal pattern of the muscle fibers in 75-80% of the graft in Group I, and fibrotic degeneration in most areas of the graft in Group II at six months after gracilis muscle transplantation. PMID- 2696276 TI - [Experimental studies of the small intestine mucosa]. AB - The problems pertaining to the surgical therapy of the short bowel syndrome have not yet been solved despite numerous methods for the retardation of stool passage and the enlargement of the absorbent small intestinal surface. We therefore developed a model for the cultivation of neomucosa of endogenous origin on the perietal peritoneum of Wistar rats. In 191 young Wistar rats of each sex with a body weight of 200 to 500 grams, a loop of the small intestine was largely blocked off from the intestine with the help of Braun's anastomosis, opened up and thus sewed onto the parietal peritoneum of the laboratory animal. This led to the formation of a tube with two-thirds of the circumference consisting of small intestine and one-third of peritoneum. After the peritoneal part had been over grown by neomucosa, the original jejunal part was removed and a tube consisting of perietal peritoneum with a muscular portion was formed around the neomucosal island. After another 4-5 months, a mucosal tube with complete neomucosal lining had formed. It was demonstrated by histological, enzyme histochemical and electron microscopy methods that the neomucosa is indeed a functioning small intestinal mucosa. Intragastric administration of a prostaglandin E2 analogue resulted in accelerated neomucosal growth as well as an increase in the height of the villi and the depth of the cryptae and a decrease in the thickness of the granular tissue. Measurements of the accumulation of 14C glucose and its inhibition by ouabain confirmed the active transport of the 14C glucose in the cell of the small intestinal neomucosa. The cultivation of functioning small intestinal mucosa on the perietal peritoneum of rats was thus accomplished. PMID- 2696277 TI - Spontaneous oesophageal perforation in a newborn. AB - A case of spontaneous cervical oesophageal perforation forming a pseudodiverticulum in a 3.6 kg. neonate who presented with poor sucking and fever, is reported. The diagnosis was confirmed by chest x-ray. 83 reported cases of transoesophageal perforation were reviewed, pseudodiverticulum of the oesophagus was documented in 9 cases only; of the 83 reported cases, 14 had spontaneous oesophageal perforation. PMID- 2696278 TI - Gastric leiomyoblastoma in childhood--a case report and review of the literature. AB - A rare case of gastric leiomyoblastoma in a boy of 11 years of age is reported. The patient complained of abdominal pain and presented with a palpable mass. Ultrasonography showed a typical aspect with mixed solid and liquid components. At surgery simple excision of the tumour was sufficient for radical exeresis, and there was no recurrence after 2 years. 13 further cases in patients under 20 years of age were collected from the literature and briefly reviewed. PMID- 2696279 TI - Proceedings of the Cambridge meeting of the Society for Research into Hydrocephalus and Spinal Bifida. 1989. PMID- 2696280 TI - Facilitating and assessing progress toward independence: SPARX. AB - As children with spina bifida are thriving physically, a need for encouraging independent behavior has arisen. The dynamics of dependency undermine youngster's potential for autonomous functioning. As programs are being developed, there is a need to measure the dimensions which contribute to independent behavior. As an outgrowth of the SPARX independence-training program at Shepherd Spinal Center, Atlanta, such a tool is being developed. The Independent Behavior Inventory focuses on those dimensions contributing to development of independence, including problem-solving, communication, self-help, family support, etc. Although the sample is small, reliability and validity statistics have been computed, and look promising. Use of the instrument in clinical settings in encouraged. Professionals are encouraged to intervene early with families so that the dynamics of dependency can be undermined and independence facilitated. PMID- 2696281 TI - Conductive education--magic or myth? AB - Subjective reports on the results of conductive education (CE) in 18 groups of children in English schools, and in 16 children who had been to Hungary were examined. Although many improvements seem to be indicated, rigorous scientific methods were not used, and the verdict on CE must remain open. The newly established Foundation for Conductive Education in Birmingham may help to resolve current uncertainty. PMID- 2696282 TI - Comparison of intracranial pressure between spina bifida patients and normal subjects using a non-invasive pressure assessment technique. AB - A comparison of mean intracranial pressure (ICP) between 36 spina bifida patients and 24 patients with clinically normal ICP was undertaken. A new non-invasive method of assessing ICP was used throughout this study. The technique relates tympanic membrane displacement to ICP and has been shown to be a reliable measure of mean ICP by comparison with direct measures via ventricular catheters and reservoirs, subdural catheters and lumbar punctures. Using this non-invasive method the results of this study indicated that the patients with spina bifida and without a ventricular shunt have a higher than average mean ICP. The results demonstrated a significant difference (99.9%) in the measures of ICP between the spina bifida and normal populations. A significant difference (99.9%) in the ICP was also found between patients with spina bifida and with and without ventricular shunts, and thus presumably those with and without diagnosed hydrocephalus. It is suggested that patients with spina bifida and without ventricular shunts probably have higher than average mean ICP when compared with the normal population. PMID- 2696283 TI - Effects of ventricular shunt treatment of normal pressure hydrocephalus on psychological functions. AB - A prospective trial for diagnosis, treatment and evaluation of normal pressure hydrocephalus (NPH) was carried out in 30 consecutive patients (12 women, 18 men, mean age: 61 years, range 21-80). The clinical diagnosis was based on the presence of one or more of the three clinical elements of NPH: gait disturbance, incontinence and mental deterioration as well as radiological criteria of ventricular enlargement. Preoperatively, physical and radiological investigations and psychological tests were routinely performed. Cognitive functions such as fluency, selective attention and motor speed were re-examined within 24 hours after spinal tap of 40-50 cc. of CSF. Results of shunting were confirmed by CT scans and evaluated by means of psychological tests at least 3 months postoperatively. Psychological tests included IQ tests and tests for memory, selective attention and motor speed. Results indicate that spinal tap had no predictive value for the results after shunting as far as psychological functions are concerned. Shunt treatment showed an effect on cognitive functions of distractibility of attention and motor speed, but not on intelligence of memory. Three patients deteriorated, eleven remained stable and sixteen showed significant improvement on psychological tests, mainly those for attention, motor speed and memory, but rarely did any improvement of intelligence occur. PMID- 2696284 TI - Successful management of faecal incontinence using the enema continence catheter. AB - Faecal incontinence in the school age child is a social and educational handicap, and its relief can revolutionise the life of the family. Shandling and Gilmour have successfully managed this using their "enema continence catheter" for effective colonic lavage. We report our methods and experience using this technique. PMID- 2696285 TI - Faecal incontinence--Willis Home Bowel Washout Programme. AB - A simple procedure for managing bowel incontinence among children with spina bifida and other disabilities is described. The results of treatment offered to 100 children shows that the majority achieved reliable continence. PMID- 2696286 TI - Interaction between selenium and zinc in the pathogenesis of anencephaly and spina bifida. AB - We present preliminary evidence that Selenium (Se) enhances zinc (Zn) accumulation in cultured skin fibroblasts from fetuses with NTD. Zn accumulation was decreased in NTD cells compared to controls and was increased but remained below the basal levels of controls when a 3-fold dose of Se was added to the culture media for 48 hours prior to the addition of Zn. These studies at the cellular level are in agreement with the epidemiologic evidence suggesting a correlation between low levels of Se in the diet and higher incidence of NTD. PMID- 2696287 TI - Tethered cord syndrome: clinical signs and results of operation in 42 patients with spina bifida aperta and occulta. AB - The results of tethered spinal cord operations in 42 patients were evaluated. Over a period of 10 years, 20 spina bifida occulta (S.B.O.) and 22 spina bifida aperta (S.B.A.) patients were operated. In the S.B.O. group 6 patients were operated when young in order to prevent neurological deterioration. With a mean follow-up of 3 years they developed no new neurological symptoms. The clinical symptoms and the age at which the neurological deterioration occurred was quite similar in the S.B.O. and S.B.A. patients. Motor dysfunction and pain in back and/or legs were the most frequent symptoms. The postoperative complication rate was low. The purpose of surgery was to stop further neurological deterioration. The operative results were slightly better in the S.B.A. group than with the S.B.O. group. In both groups of patients it was evident that operation at an older age after a long period of complaints was associated with less favourable postoperative results. The surgical treatment of a tethered spinal cord syndrome in patients with spina bifida aperta is no more risk than an operation in spina bifida occulta patients. PMID- 2696288 TI - [Antibiotic therapy for odontogenic induced orofacial infections under office conditions]. AB - Due to the dominance of anaerobics in dentogen-induced orofacial inflammations the possibility of their treatment is restricted to a few groups of substances of different chemical structure (penicillins, lincosamides, nitroimidazoles, tetracyclins and macrolide antibiotics) for ambulant patients. The order of application for these different substances is determined by the local diagnosis and the pathophysiological state of the patient. The general anamnesis of disease, drugs and allergy as well as the knowledge of pharmacodynamics and pharmacokinetics of the substances to be applied are, therefore, indispensible for an optimal antimicrobial therapy. PMID- 2696289 TI - [Influence of two protective systems on the resin-metal bond]. PMID- 2696290 TI - [Pathogenesis of tendon-/muscle pain with special reference to posture--a concept related contribution to the understanding of generalized tendomyopathy]. AB - Tendomyopathies (TM) comprise two subgroups. Both are caused by the irritation of nociceptors (IN). Type I results from IN within muscles and tendons with the consequence of local pain, whereas type II refers to TM occurring at a site distant from IN anywhere in the body. Such TM-type II are understood to serve for the protection of the organism from further IN and depend on the regulatoric role of the central nervous system ("reflectoric TM"). Reflectoric shoulder pain emerging from arthritis in carpal joints (Hiemeyer et al.: Z. Rheumatol. 48, 1989, 139-143) is quoted as an example of such "regulatoric pain". Abnormal spinal posture (ASP) is believed to cause IN at various sites of the sceletomotoric system with the consequence of localized or generalized fibromyalgic syndromes (FS) of the type II subgroup. Now clinical signs of TM such as pain during motion, compression or stretching as well as muscular stiffness and fatigue are characteristic for so called primary FS; in addition, the majority of such patients exhibits ASP, especially increased thoracospinal kyphosis (Hiemeyer et al.: Akt. Rheumatol. 14, 1989, 193-201). For these reasons we arrive at the conclusion that ASP is a disposing factor for the development of FS. Therefore FS should not be called primary unless spinal posture has not been examined thoroughly. As a result of this concept we consider control of spinal posture by physiotherapy as an essential part in the causal treatment of FS. PMID- 2696291 TI - [Immunohistochemical studies of the synovial membrane in rheumatoid arthritis and osteoarthrosis for quantifying lysozyme and alpha-1-antitrypsin positive mononuclear cells]. AB - The exact number of lysozyme- and alpha-1-antitrypsin-positive macrophages in the synovial membrane in rheumatoid arthritis and osteoarthrosis was investigated by the PAP-technique. There is a positive correlation between the number of macrophages in the intima, as well as in the adventitia of the synovial membrane, and the local immunological activity of rheumatoid arthritis. However, there exist significantly less positive macrophages in osteoarthrosis. The significant increase of macrophages in cases of rheumatoid arthritis is an expression of immunopathological mechanisms that have a pathogenetic importance for the induction and recidivity of arthritis. These facts justify therapy with antirheumatica to influence macrophages. PMID- 2696292 TI - [Plasma and tissue concentrations of biphenylacetic acid following 1 week oral fenbufen medication and topical administration of Felbinac gel on the knee joint]. AB - In an randomised study 30 patients were treated during one week before undergoing an elective surgery of the knee joint with 1 or 2 g respectively of 3% Felbinac gel (biphenylacetic acid gel) or oral 300 mg Fenbufen thrice daily. Biphenylacetic acid (BPAA) is the therapeutically active metabolite of the non steroid anti-inflammatory drug Fenbufen. Plasma concentrations were measured before, during therapy and at the time of the operation. During the surgery of the knee joint specimens of synovial fluid and -membrane, of cartilage, muscle and tendons as well as of the skin and the subcutaneous fatty tissue were obtained and the BPAA concentrations measured. There was a large variance of the obtained values in all groups. It seems that mainly methodical problems are responsible for this. At the time of surgery, the plasma concentrations following oral administration were with 10,080 ng/ml 20 to 50 times higher than those after topical administration. The tissue concentrations reached 1/8 to 1/2 of the plasma concentrations. The relation of tissue concentrations to plasma concentrations of BPAA was smaller in patients treated with oral administration than in patients treated with topical administration. Therefore a partial direct penetration of Felbinac into the deeper tissue compartments can be assumed. There was no significant difference in plasma-, synovial- or tissue concentrations between the two groups treated with the topical administration. The tissue concentrations were 1 to 2 orders of magnitude lower than those after oral administration. Only in the skin the concentrations were with 9160 respectively 3830 ng/g higher than those obtained after oral application (2110 ng/g). PMID- 2696293 TI - [Topics rarely discussed with a dental technician]. PMID- 2696295 TI - [Contribution to the preinformed bite registration]. PMID- 2696294 TI - [Modification of the Berlin-universal-anchor]. PMID- 2696296 TI - [Clinical follow-up of adhesive bridges in the district of Pirna]. PMID- 2696297 TI - [Ultrasound detection of vascular rupture of the intestine following blunt abdominal trauma]. PMID- 2696298 TI - [Principle opening of the hernia sack in medial inguinal hernia?]. PMID- 2696299 TI - [Optimal treatment of complex ligament injuries and biomechanical aspects]. AB - Certain guidelines may be established for surgical treatment of complex lesions of genicular ligaments. Preferential treatment should be given to the central stabilizers, anterior and posterior cruciate ligaments. Suturing with autologous augmentation is the rule for the anterior cruciate ligament, whereas the posterior cruciate ligament should be stabilised by both suturing and relief, using a transosseous PDS cord. The main peripheral ligaments, internal and external ligaments as well as arcuatum complex, have to be sutured, once instability has been confirmed. In cases of complex injuries, lateral structures are more important than median peripheral structures. Sutures should be tied for good stability. Non-absorbable material is used in cases in which stability of anchorage should enable no-plaster after-care. Sutured ligaments should be tension-adjusted close to stretching position (Lachman position, for main ligaments) and with neutral rotation. Sutures in shortened position may undergo rupture and thus jeopardize suturing at all. Only sutures for the posterior cruciate ligament should be strained close to rectangular position, since this actually represents maximum tension of the posterior cruciate ligament. Knee joint luxation is usually based on damage to all three ligaments, though two ligament injuries are possible. Surgery is the optimum approach, since it is the only way to accomplish mechanically favourable adaptation of the central stabilizers. PMID- 2696300 TI - [Clinical diagnosis of fresh injuries of the knee joint]. AB - Clinical diagnosis has to registrate fresh injuries. These have to undergo immediate operation or further instrumental or radiological procedures respectively. This may be effected in almost all cases by systematic evaluation of informations on the anamnesis and general or special clinical diagnosis. Main symptom of the frequent, complete tear of the anterior cruciate ligament is the Lachman-test. In addition to the clinical tests for instability out-of-order proprioception may refer valuably to limited ligamentons tears. Results of early clinical diagnosis should be improved by close hospital and out-patient department cooperation and both collective workshops and interpretation of results as well. PMID- 2696301 TI - [Capsule-ligament lesions of the knee joint. Early diagnosis, primary therapy, results]. AB - Roughly ten per cent of the capacity of casualty surgery are absorbed by injuries of the knee joint which also account for 30 per cent of all sports injuries. Emergency arthroscopy should be indicated for any case of post-traumatic articular effusion. Primary treatment should be rendered within two or three days from the accident. This should be immediately followed by rehabilitation to preserve muscular strength. PMID- 2696302 TI - [82 arthroscopic meniscus refixations and results of follow-up]. AB - In 3,126 arthroscopies of the knee 82 menisci were sutured by the inside-outside technique. 52 patients were followed up. 42 patients had no or small disabilities. In 10 patients we performed a rearthroscopy. The suture of the meniscus includes more social and economic problems then the partial meniscectomy. It's well known, that the menisectomy induces arthrosis, and so should be tried to suture possible tears of the meniscus. PMID- 2696303 TI - [Basic aspects of the preventive use of antibiotics in general surgery]. AB - Antibiotics are administered prophylactically before operation (at induction of anesthesia) in order to achieve sufficient tissue concentrations when contamination happens. Antibiotic prophylaxis is usually given as a single dose. It is clearly indicated in abdominal surgery. It is also recognized in association with the use of prosthesis in cardiac, vascular, and bone surgery although there is no proven benefit. According to definition, administration of antibiotics in a perforated hollow viscus or an open fracture is not a prophylaxis. First and second generation cephalosporines are recommended for prophylactic use. In abdominal surgery, aminoglycosides too, combined with a drug directed against anaerobic bacteria are widely used. PMID- 2696304 TI - [Bacterial vaginosis]. AB - Bacterial vaginosis is the most prevalent microbiological cause of vaginal discharge. Sexual intercourse is considered as a main risk factor, however, bacterial vaginosis is not a true sexually transmitted disease and characterized as a dysbalance in the vaginal microbiological ecosystem. The diagnosis is based on the characteristic vaginal discharge, a pH greater than 4.5, a positive whiff test and on presence of clue cells. In therapy nitroimidazoles p.o. are considered as treatment of choice. Bacterial vaginosis is a significant risk factor for ascending as well as postoperative and pre- and post-partum genital infections. PMID- 2696305 TI - [The diagnosis of spontaneous intracerebral hemorrhage]. AB - A report is given on the diagnosis of spontaneous intracerebral haemorrhages, which points art that because of possibly occurring surgical consequences every acute occurrence of cerebral symptoms should be cleared up as soon as possible. In this diagnosis the computer tomography is well to the fore, which enables not only the recognition of the haematoma itself and its extent, but in particular also positional relations to important cerebral structures. In a number of cases, however, a representation of the cerebral vessels is nevertheless necessary. As an exclusive diagnostic measure in case of an intracerebral haematoma the angiography does not reach the value of information of computer tomography. PMID- 2696306 TI - [Pharmacological characteristics of an anti-convulsive drug Benzonal and the evaluation of its therapeutic effectiveness (review of the literature)]. PMID- 2696307 TI - Potency classification of topical corticosteroids: modern perspectives. AB - The effects of topical corticosteroid therapy upon human epidermal Langerhans cell surface markers were studied. The reduction in numbers of human leukocyte antigen-DR+/T6+ Langerhands cells proved to be a potency-related effect and Langerhans cell enumeration may therefore have some use as an adjunct in the assessment of steroid potency. Further studies showed that corticosteroid therapy also reduced the function of Langerhans cells in terms of epidermal cell alloantigen-presenting capacity. However, experimental variation and the high antigen-presenting potency of residual flow cytomterically sorted human leukocyte antigen-DR+/T6+ Langerhans cells following steroid application (1) mean that such functional assessments of epidermal cell alloantigen-presenting capacity cannot be recommended as an easily reproducible method for measuring steroid potency. PMID- 2696308 TI - The history of corticosteroids. AB - The development from the discovery of the structure of cholesterol, the precursor of all steroids, to the first application of a topically effective steroid in 1952 took about 20 years. Thereafter the development of more potent topically effective steroids accelerated and the third generation of potent steroids with a topical activity of about 10 to 20 times that of hydrocortisone was already available about 10 years later. Today the newly developed non-fluorinated non symmetric 16 alpha, 17 alpha-acetal derivate budesonide could perhaps be considered as the sixth generation. PMID- 2696309 TI - Epidermal cytokines. AB - The concept of the epidermis being a site for the initiation of immune responses has only been developed over the past decade. There is strong evidence that epidermal cells have immune functions. Accordingly the epidermis harbors dendritic cells having antigen presenting capacity and cells belonging to the T cell family. Moreover, keratinocytes are capable of secreting various immunomodulating cytokines or secretory regulins. Cytokines are glycoproteins which are synthesized and secreted by various cells, bind to specific receptors and regulate activation, proliferation and differentiation of immune as well as non-immune cells. Keratinocytes upon injury i.e. mechanical irritation, ultraviolet irradiation, tumor promotors, synthesize and release interleukin-1 alpha, -1 beta, -6, -8, colony stimulating factors, tumor necrosis factors-alpha as well as growth (transforming growth factor beta) and suppressor (epidermal cell-contra-interleukin-1) factors. Since there is strong evidence in support of a network of interacting cytokines maintaining a proper balance which only partially has been discovered, so far no causative role of a single cytokine has been established in any disease. However, excessive or insufficient production of these mediators may contribute to certain disease states, particularly those of infectious and autoimmune origins. Thus, cytokines appear to be promising candidates for the treatment of infectious, autoimmune, immunodeficiency and malignant diseases. Future studies are necessary to clarify the therapeutic efficacy of the combined application of different cytokines and more investigations are also needed to elucidate the lymphokine cascade in vivo. PMID- 2696310 TI - Immunology of atopic dermatitis. AB - Atopic dermatitis is a chronic eczematous skin disease which characteristically starts early in life and later tends to disappear. Genetic predisposition seems important for the development of the disease. The immune system is involved through a lymphocyte-mediated inflammation in the skin creating the eczema, and an increased incidence of type I and possibly type IV allergies induced by environmental allergens. Recent findings of a changed concentration of some interleukins in atopic patients support the evidence for an increased T lymphocyte activation and may explain the increased amount of polyclonal IgE in many of the patients. Hypothetically, atopic dermatitis can be considered to be due to an inborn error of the maturation of epithelial tissue. Maturation of epithelial tissue is essential for both the appearance of normal skin and for correct maturation of the cell-mediated immune system. The immune deviation is later more or less corrected through maturation which explains why the disease in most patients disappears in childhood. However, it still leaves a certain increased capacity for inflammation of the atopic persons. PMID- 2696311 TI - Immunology of contact dermatitis. AB - Allergic contact dermatitis is a classical type IV delayed hypersensitivity immune response. This cell-mediated response is also known as hapten-type delayed hypersensitivity. Allergic contact dermatitis may be viewed as hyperreactivity of the skin immune system. In the present view of allergic contact dermatitis, individuals are born in a state of tolerance to environmental haptenic allergens. During life, sensitization to any hapten(s) may occur. Subsequent elicitation of a sensitized individual then leads to dermatitis, often accompanied by severe pruritus. Human epidermal Langerhans cells play a central role during the sensitization stage. These antigen presenting dendritic cells, loaded with environmental haptens, continuously leave the epidermis through the lymph vessels and, upon arrival in the paracortical T-cell areas of the skin draining lymph nodes, they differentiate into interdigitating cells. There is now in-vitro evidence for such a maturation of human Langerhans cells into interdigitating cells. Any given individual may be sensitized to any particular hapten by this route. Allergic contact dermatitis is probably a skin-specific disease because of the capacity of Langerhans/interdigitating cells to induce relatively naive T cells to become memory T-cells. Factors determining the ultimate outcome in this continuous hapten presenting process, i.e. whether or not the original state of tolerance will persist, are still enigmatic. During elicitation, when the allergenic hapten is applied epicutaneously to a sensitized individual, a focal accumulation of immune response associated cells producing a wide variety of cytokines and inflammatory mediators ultimately results in the clinical condition of allergic contact dermatitis. Langerhans cells do not seem to play a major role during this stage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696312 TI - Patient subgroups and the inflammatory pattern in psoriasis. AB - Despite great numbers of recent studies on immunological parameters in psoriasis, the question whether psoriasis is an immunological disease is still open. Also, it is not clear how the three main abnormalities of this disease, i.e. the association with the human leukocyte antigen system, excessive epidermal new cell production and a unique neutrophilic infiltrate within the diseased epidermis, are linked together. Analysis of large patient cohorts has now shown that two types of non-pustular psoriasis exist: one showing early onset and linkage disequilibrium for human leukocyte antigen Cw6, B13, Bw57, the other type showing late onset associated with Cw2 and B27. The pathological features of increased cell proliferation and neutrophilic inflammation are likely to be regulated by potent peptide mediators some of which are mitogenic and/or proinflammatory. There are two powerful regulatory peptides (C5ades arg and neutrophil activating peptide-1), large amounts of which have now been isolated from psoriatic scale material. Both are able to stimulate other cells to migrate and to produce further signals. The initiating agent still remains an enigma. PMID- 2696313 TI - The immunology of cutaneous lupus erythematosus. AB - The immunologic mechanisms involved in cutaneous lupus erythematosus are closely tied to the histologic and ultrastructural changes seen at the dermo-epidermal junction. These alterations are reviewed and an attempt is made to interrelate them with the current ideas on pathogenesis and therapy. PMID- 2696314 TI - Immunopathological techniques in the diagnosis of bullous disorders. AB - Immunopathological techniques have become essential to the investigation and management of autoimmune vesiculobullous diseases. In this article the role and practical application of direct immunofluorescence, indirect immunofluorescence and complement C3 binding indirect immunofluorescence techniques, and their relevance to the diagnosis and management of the individual blistering diseases will be reviewed. The diagnostic value and limitations of the new split skin indirect method will also be described. Furthermore, the contribution of immunoelectron microscopy and immunoblotting studies to our knowledge of the pathogenesis of these diseases will be discussed. PMID- 2696315 TI - Inflammatory pathology of the genital tract and male infertility. A short review. AB - The relationship between non-specific infections of the male genital tract (i.e. infections other than gonorrhea and genital tuberculosis) and male or couple infertility/subfertility still reassess various problems related to this important subject and to complement it with some original observations from our clinical experience. The reader is also invited to refer to a previous paper by Gattuccio et al. (1988), which more specifically addresses the question of the inflammatory diseases of the prostate gland. PMID- 2696316 TI - Postoperative changes in lipid profile: their relations with inflammatory markers and endocrine mediators. AB - Postoperative changes in plasma lipid profile have been studied in six patients undergoing aortobifemoral bypass. The second day after surgery, significant changes were: decreased levels of high density lipoprotein (HDL) cholesterol (by 55%), non HDL cholesterol (by 60%) phospholipid (by 50%), pre-beta-lipoprotein (by 70%), beta-lipoprotein (by 50%), apolipoprotein A1 (by 60%) and apolipoprotein B (by 55%). The magnitude of these changes correlated positively with serum levels of transferrin and negatively with serum levels of C-reactive protein. Triglyceride levels also showed a significant decrease (by 60%) while free fatty acids increased by 70%. Changes in triglyceride levels were not correlated with serum transferrin and C-reactive protein but showed a significant negative correlation with insulin levels. Our results suggest that both inflammatory and endocrine mediators are likely implicated in the postoperative changes in lipid profile. PMID- 2696317 TI - Interest of face mask--CPAP in one case of severe accidental hypothermia. AB - We report one case of severe accidental hypothermia; rectal temperature was 25 degrees C. Hypoxemia unmodified by 100 O2 inhalation in an ordinary face-mask was easily corrected using a face-mask CPAP; a ventilation-perfusion mismatching could be implicated in the cold induced hypoxemia. Active rewarming (1.5 degrees C/h) was pursued from 25 to 37 degrees C, using non aggressive methods: warming blankets and a Bennett heated humidifier inserted in the CPAP system. Even in severe hypothermia successful results may be obtained without resort to sophisticated methods. PMID- 2696318 TI - Leprosy associated mycobacteria: implications. PMID- 2696319 TI - [Immunologic aspects of leprosy]. AB - Lepromatous leprosy is accompanied by a complex deficit in cell mediated immunity concerning Mycobacterium leprae. The physiological mechanism of this deficit remains unknown. According to some studies there may be, in those suffering from leprosy, a trouble in the macrophage and presentation of antigens. Other studies suggest an increase in the suppressive activity of lymphocytes. Recently some authors emphasized the deficit in the production of interleukin 2. It is difficult, for the time being, to find out whether such immunological abnormalities are primitive or secondary to the accumulation of the bacillus into the organism. PMID- 2696320 TI - Technical problems related to multidrug therapy in leprosy control. AB - About 40% of registered leprosy patients worldwide have been, or are being, treated with multidrug therapy (MDT) in accordance with the standard regimens recommended by WHO in 1981. The conclusions that can be drawn from such an extensive experience are discussed. The most significant of these are: (i) the MDT regimens recommended by WHO are non-toxic and well-accepted by patients; (ii) as regards the efficacy of these regimens, post-therapeutic relapses, in both multibacillary and paucibacillary patients, have been negligible when observed over periods of one to three years. The overall conclusion that at present emerges is that the MDT regimens for leprosy control, as recommended by WHO in 1981, should continue to be applied without any modification. PMID- 2696321 TI - Ultrasonography and radiography of the hip in infants. AB - Both hip joints in 156 children, aged 2 months to 2 years, were examined by ultrasonography (ultrasound) and radiography. Pathologic findings were based on an increased acetabular index, bony defects of the lateral acetabular rim, and lateral and/or proximal displacement of the proximal femur. Each hip was classified as normal, dysplasia, subluxation, or dislocation. The same diagnosis was reached by ultrasound and radiography in 303 of the 312 hips. The accordance was good in normal joints, in subluxation, and in dislocation. However in 7 of the 15 hips with radiographic dysplasia, ultrasound was normal. These patients were not treated, and spontaneous normalization or improvement occurred in all of them. One parameter only, the distance from the lateral margin of the ossification center of the femoral head to Perkins' line, was measured by both ultrasound and radiography; the correlation was high (r = 0.73). We recommend ultrasound as the primary imaging technique when congenital dislocation is suspected clinically. PMID- 2696322 TI - Occlusive clothing and ultraviolet radiation in hip surgery. AB - In a randomized study of 20 total hip arthroplasties, the staff wore shirts and trousers of a fabric impervious to bacteria underneath operating gowns of a non woven material. Volumetric air sampling demonstrated a low number of colony forming units with this clothing, further reduced by ultraviolet radiation to below 10 colony-forming units/m3, the upper limit of "ultraclean air," in all the cases (median 2.6, range 1.1-7.1). PMID- 2696323 TI - Surgical margin in soft tissue sarcoma. The Scandinavian Sarcoma Group experience. AB - Two-hundred and forty adult patients with a high-grade soft tissue sarcoma were treated surgically in 18 hospitals participating in the Scandinavian Sarcoma Group Protocol I. The patients were randomized to either postoperative doxorubicin or control; patients whose surgical margin was judged marginal also received radiotherapy. The outcome after different surgical margins was analyzed in 185 tumors of Grades III or IV in the extremities. The total cumulative local tumor control was 91 percent (168 of 185) after a median of 47 months. The cumulative local control rates in the surgical groups were: compartmental or wide amputation--37/37 (100 percent), compartmental local excision--23/24 (96 percent), wide local excision--77/84 (92 percent), marginal excision and radiotherapy--19/21 (90 percent), and marginal excision alone (reevaluated margin)--12/19 (63 percent, significantly lower than others). The risk of local recurrence was 13 times higher after marginal than after compartmental surgery (P = 0.02) and 3 times higher if the tumor was larger than 10 cm (P = 0.05). The treatment with doxorubicin did not influence the risk of local recurrence. The survival rates did not differ significantly in the groups. PMID- 2696324 TI - Early knee mobilization after osteotomy for gonarthrosis. AB - In a prospective study, 32 knees in 32 patients were randomized to either a cylinder plaster cast (17 knees) or hinged cast-brace (15 knees) after high tibial osteotomy for medial gonarthrosis. At 6 weeks, 3 months, and still 1 year after surgery, the range of motion was better in the cast-brace group. There was no difference in the other clinical results at 3 months and at 1 year after surgery, nor in changes of osseous correction or in the final knee alignment. All the patients in the cast-brace group were satisfied with early motion. PMID- 2696325 TI - Conceptualization in endonasal endoscopic reconstructive surgery of the naso paranasal cavities: imagination, realization and reformation. PMID- 2696326 TI - Disaster psychiatry and traumatic stress studies in Norway. History, current status and future. AB - The breakthrough of Norwegian disaster psychiatry and traumatic stress studies came when the "Board of Norwegian Doctors of 1957" carried out exceptionally thorough and comprehensive studies of former concentration camp prisoners. These studies convincingly demonstrated that chronic mental illnesses could develop in persons who had a harmonious childhood but who had been subject to extreme physical and psychological stress. During the seventies Norway became the first country in the world to have a University chair of disaster psychiatry. The scope of the field was broadened by the initiation of several studies on traumatic neurosis, industrial disaster and injuries. The support from the Joint Norwegian Armed Forces Medical Services, the University of Oslo, the Norwegian Research Council for Science and the Humanities, and later the Royal Norwegian Council for Scientific and Technical Research, was crucial for this development. Currently stress and disaster psychiatry has become an integrated part of the care of victims who have suffered individual or collective disaster. Disaster psychiatry is taught in medical schools and is part of the obligatory training for residents in psychiatry. PMID- 2696327 TI - Immune suppression in HTLV-I carriers: a predictive sign of adult T-cell leukemia. AB - Suppression of the cellular immune system appears to be a prerequisite for the manifestation of adult T-cell leukemia (ATL). In other words, ATL will develop when impairment of the immune system is caused by the infection of human T lymphotropic virus type I (HTLV-I). This defect of immune surveillance against virus-infected cells may be a result of the impairment of the function of cytotoxic T-cells (CTLs) specific for the HTLV-I-infected cells. The manifestation of ATL could be predicted by examining the function of CTLs in HTLV I carriers. A new strategy of prevention and therapy for ATL would include an attempt to restore and fortify the CTL function of the host. PMID- 2696328 TI - [Semiologic x-ray computed tomography patterns of benign tumors of the liver]. AB - Specific benign lesions may be suggested when appropriate c.t. findings are detected in the liver. Characteristic c.t. patterns which may contribute to the study of hepatic masses are described and the importance of their recognition to the differential diagnosis is referred. PMID- 2696329 TI - [Rehabilitation in oncology]. AB - The A.A. emphasize the importance of Physical Medicine and Rehabilitation in oncologic treatment. The most significant aspects of psychiatric therapy were analyzed in a special group on oncologic diseases, such as breast cancer, malignant tumors of the limb bones and in the inactivity-desuse syndrome. It is concluded that rehabilitation treatment could be generalized to a larger group of oncologic situations. PMID- 2696330 TI - [Oxygen free-radicals in medicine (2)]. AB - Free radicals are highly reactive molecules, and therefore transient, which have an odd number of electrons and are generated in vivo as byproducts of normal metabolism. In this review we survey basic concepts on the chemistry of oxygen free radicals, their cellular sources and the reactions they can undergo. We also discuss the cellular defenses against free radicals induced damage. The disfunction induced by free radicals may thus be a major component of several pathological conditions. The critical role played by free radicals in ageing, carcinogenesis, reperfusion injury and respiratory distress is reviewed. PMID- 2696331 TI - [A comparative study of gallbladder function using echography and HIDA-CCK]. AB - This paper compares two methods of evaluating gall-bladder function after stimulation with cholecystokinin (CCK); One, the echographic method, permits the gall-bladder contraction study by determining variations in face area of the organ. The other, the scintigraphic method (HIDA-CCK test), studies of the gall bladder emptying registering the decreases of activity by external counts. Out of 20 studies performed: 8 cases presented a contractile response and normal emptying; 7 had an abnormality late initial response (Ti) and contraction and emptying (defined by T1/2) slower than normal. In the 5 patients the gall-bladder traced with HIDA did not respond to CCK. Within this group, one patient had an incomplete painful contraction, evaluation by echography. The onset of pain or sub-costal discomfort was a variable finding within the different study groups. The linear coefficient correlation for the normal group and for the patients with late response was 0.8255 (x = 2.216 gamma-4.59). Based on these data and taking into account cheaper cost, patient comfort, and greater availability of equipment, the echographic method for studying gall-bladder contraction after administration of CCK, can be used instead of the HIDA-CCK procedure. PMID- 2696332 TI - [Meningeal carcinomatosis. A one year's case load; review of the literature]. AB - 10 cases of meningeal carcinomatosis treated in the Neurological Unit at the Instituto Portugues de Oncologia de Francisco Gentil in Lisbon are presented. Pertinent bibliography is reviewed, particularly the one concerned with physiopathology and treatment. Some research topics about biological response modifiers and drug transport systems are mentioned. PMID- 2696333 TI - [A myoelectric prosthesis for the forearm amputee]. AB - The authors make a revision of the principles of action of the myoelectric prosthesis for the forearm amputees and describe their components. The indications and contra-indications (French law) are also referred. We can say as a conclusion that the great progress made in prosthesis in the last years were possible on account of synthetic materials and the use of electronics and miniaturised computers. However, their functional possibilities are remote when compared with the human hand. The high costs of this prosthesis are one limitation to its prescription. PMID- 2696334 TI - [Harvey Cushing and Reynaldo dos Santos]. PMID- 2696335 TI - [Lipopolysaccharide-containing cytoplasmic membranes as immunostimulants of peritoneal macrophages]. AB - It was established that cytoplasmic membranes from the stable L-forms of E. coli WF+ induced a 4-5 fold increase of the number of peritoneal exudative cells in mice after single i.p. inoculation. The animals treated with membranes reacted with 4-5 fold higher number of these cells after an i.p. infection by parent form cells or L-form cells, as compared with the reaction of infected, nontreated by membranes mice. The macrophage bactericidal activity was 6-10 fold increased. Using electron microscopy, it was established that the phagosomes containing membranes and their remnants were localized in the peripheral part of the cytoplasm or near the nucleus, without neighbouring lysosomes during the 24-hour interaction. Single cases of phagolysosome fusion were observed. PMID- 2696336 TI - Electric field-induced fusion of yeast protoplasts. The role of different physical and chemical factors. AB - Electrofusion between cells of yeast strains with different genetic markers are investigated. The yield of fusion products depends strongly on the field conditions and the different compounds in the fusion media. PMID- 2696337 TI - [Language and ethics]. AB - The author proposes the hypothesis that there exists an essential link between language and ethics, beyond the obvious fact that the postulates of ethics have to be expressed in a verbal way. He chooses two ways for demonstrating his hypothesis: a phenomenological description of the substantive element of language, which is the word, and then an analysis of both the philo- and the ontogenetic origin of ethical experience. Making evident the essential characteristics of language, among which it is appropriate to outline its capacity to give existence to things (as it is deduced from the analysis of some poetic texts), the author gets to unveil its deep ethic sense in the religious word: gods show themselves through the revealed word, and men address to them with their prayers. Gods give norms that imitate afterwards. The second way allows the author to demonstrate that the step from nature to culture is done through the norm, and this is basically verbal; but at the same time it is possible to demonstrate how the word is found in the base of the individual ethical experience, in that very particular phenomenon that is the voice of the conscience. In short, language is in its essence ethical, and the ethical experience is indissolubly bound to the verb. PMID- 2696338 TI - Selection and evolution of bacteriophages in cellstat. AB - Objectives of this work were as follows: 1. to establish a laboratory experimental system utilizable in a biophysical approach to molecular evolution; and 2. to provide real world parameters to theories of molecular evolution, especially to Eigen's theory of quasi-species. Secretion type bacteriophage fd of E. coli, closely related phages and artificial chimera phages of fd, and a virulent phage Q beta of E. coli were cultured continuously in a specially designed fermenter called a "cellstat". A phage is cultured in a flow of host bacterial cells. Due to its high dilution rate, the mutant cell could not be selected in the cellstat. It was therefore recognized that the cellstat is suitable for study of the selection and evolution process of a bacteriophage under well-defined environmental conditions without interference from host cell mutations. Population dynamics of bacteriophages of various types in the cellstat were studied theoretically by computer simulation and experimentally. A genetically invariable pure population of phage behaves like an open non-linear chemical reaction system. An invariable mixed population shows a selection process, while a variable population generates an evolution process. Kinetic constants describing the dynamics were determined by curve fitting between the theoretical and the experimental curve obtained from competition experiments and from biological relaxation experiments. One of the most important kinetic parameters thus obtained was the selection coefficient, and its dependence on the base sequence of phage DNA. We drew a local landscape of the selection coefficient near the fd sequence on the base sequence space. From this landscape we were able to confirm the importance of slightly deleterious mutants in molecular evolution. We also confirmed the possibility of developing an evolutionary molecular engineering using a cellstat as an evolution reactor and fd phage as a working replicon. Novelties of this work were as follows: 1. the first stable continuous culture of a bacteriophage was achieved with a cellstat; 2. a local landscape of selection coefficient near the fd sequence on the sequence space was the first experimental drawing of such a map; 3. a biological relaxation method was realized to measure kinetic constants of a biological kinetic process, or molecular evolution; and 4. a practical engineering process of evolutionary molecular engineering was proposed. PMID- 2696339 TI - Molecular properties and biogenesis of phytochrome I and II. AB - Previously, phytochrome was thought to consist of a single molecular species. However, physiological and spectrophotometric evidence has accumulated to indicate that there are two phytochrome pools in tissues, one of which is predominant in dark-grown tissues and rather unstable in the light, and the other present in very low concentrations but stable, even in the Pfr form, irrespective of light condition. Recently, two immunochemically distinct phytochromes I and II, PI and PII, were found in both dark- and light-grown tissues, and their comparative amino acid sequences shown to be 64% homologous. This is crucial evidence for the presence of chemically different phytochrome apoproteins in a single plant species. However, it is still an open question as to which phytochrome, PI or PII, is a component of the photolabile and photostable pools of phytochrome. Our understanding of the molecular structure of phytochrome has been greatly improved by recent, rapid progress in the cloning and characterization of phytochrome genes. The expression of PI genes is photoreversibly inhibited by the photostable Pfr pool, while that of several other genes, like Cab, appears to be induced by PI in the Pfr form. It is suggested that autoregulation of phytochrome gene expression is not so simply governed in plants as thought earlier. If there are two different phytochromes in a plant cell, the most important physiological problem to be solved is which phytochrome triggers the numerous red/far-red reversible reactions reported in the literature. Photomorphogenetic mutants and transgenic plants with engineered phytochrome genes will probably help to solve this problem in the future, and preliminary work along this line has already introduced in this article. A model of the molecular structure of pea PI dimer was proposed on the basis of small angle X-ray scattering analysis, and the model then confirmed by rotary shadowing electron microscopy. Important questions are still open, such as: what is the nature of phytochrome's partner compounds in cells (phytochrome receptor)? How is/are the phytochrome-induced signal(s) transmitted in the signal transduction chain? PMID- 2696340 TI - Optical indications of electrical activity and excitation-contraction coupling in the early embryonic heart. AB - Complete understanding of the ontogenesis and early development of electrical activity and its related contraction has been hampered by our inability to apply conventional electrophysiological techniques to the early embryonic heart. Direct intracellular measurement of electrical events in the early embryonic heart is impossible because the cells are too small and frail to be impaled with microelectrodes. Optical signals from voltage-sensitive dyes have provided a new and powerful tool for monitoring changes in membrane potential in a wide variety of living preparations. With this technique it is possible to make optical recordings from cells which are inaccessible to microelectrodes. An additional advantage of the optical method for recording membrane potential activity is that electrical activity can be monitored simultaneously from many sites in a preparation. Thus, applying a multiple-site optical recording method with a 100- or 144-element photodiode array and voltage-sensitive dyes, we have been able to monitor for the first time spontaneous electrical activity in pre-fused cardiac primordia in early chick embryos at the 6- and early 7-somite stages of development; we have been able to determine that the time of initiation of the heartbeat is the middle period of the 9-somite stage. In the rat embryonic heart, the onset of spontaneous electrical activity and contraction occurs at the 3 somite stage. This article describes ionic properties of the spontaneous action potential and genesis of excitation-contraction coupling in the early embryonic chick and rat hearts. In addition, an improved view of the ontogenetic sequence of spontaneous electrical activity and its implications for excitation contraction coupling in the early embryonic heart are proposed and discussed. PMID- 2696341 TI - Principles of protein architecture. AB - The three-dimensional structure of a protein is governed by the thermodynamical principle established experimentally by Anfinsen, Isemura, and others. The rapidity of the folding process is another important key phenomenon. With these basics in mind an island model is proposed which requires a restricted folding pathway. A physicochemical method of the prediction of alpha-helices and beta strands is also discussed. By virtue of the long-range hydrophobic interaction and the specific interactions between hydrophobic residues which are determined by the basic idea underlying the island model, one can fold the polypeptide chain into a tertiary structure upon determination of the secondary structures. Several examples of folding are presented. In myoglobin the heme group must be considered to reach the correct final tertiary structure. In lysozyme and phospholipase, the disulfide bondings are necessary to fasten the polypeptide chain. The selection of proper cysteine pairs among other possible ones is carried out by drawing the lampshades (locus of H atom of SH) of cysteines. In flavodoxin and thioredoxin the formation of parallel beta-structure from beta-strands is considered. The formations of antiparallel beta-structure in lysozyme and phospholipase are also discussed. PMID- 2696342 TI - Ribonucleotide reductase--new twists in an old tale. AB - Although they are proliferatively quiescent, the cells in the intact adult rat liver express the gene coding for the M1 subunit of ribonucleotide reductase. But since they do not need deoxyribonucleotides, they promptly inactivate the 88 to 90 kDa M1 products and degrade them into 40 kDa fragments. Partial hepatectomy signals the remaining cells to start proliferating. Two hours before the onset of DNA replication, around 16 to 18 hr after partial hepatectomy, the cells start accumulating a large pool of functional ribonucleotide reductase M2 subunits. Near the end of the G1 build-up the cells step up M1 gene expression, stop inactivating, and reduce the degradation of the M1 products. The accumulating functional 88 to 90 kDa M1 subunits, each with more than one catalytic site, couple with functional M2 subunits to produce active ribonucleotide reductase holoenzyme which accumulates in the outer nuclear membrane from which they supply deoxyribonucleotide precursors to intranuclear replication enzymes. At the end of the S phase, the cell reduces M1 gene expression and resumes degrading 88 to 90 kDa M1 subunits. At least some of the 40 kDa M1 fragments are still active and can form partially active "holoenzymes" when mixed with a standard preparation of functional M2 subunits. The M1 control mechanism appears not to operate in hepatoma cells and Ehrlich ascites tumor cells, both of which maintain a pool of undegraded 88 to 90 kDa M1 components. PMID- 2696343 TI - The phospholipid- and calcium-dependent protein kinase as a target in tumor chemotherapy. AB - Evidence for a constitutive activation of protein kinase C (EC 2.7.1.37) in Ha ras transformed 3T3 cells is presented. Several compounds which inhibit protein kinase C in vitro have been studied with regard to their antiproliferative activity in cultured tumor cells. The following agents were investigated: 3 hexadecyl-mercapto-2-methoxy-methyl-propyl-1- phosphocholine (BM 41440); 1 octadecyl-2-methyl-sn-glycero-3-phosphocholine (ET-18-OCH3); quercetin, tamoxifen and staurosporine. All compounds decrease protein kinase C activity in vitro as well as in intact cells and inhibit cell multiplication within the same dose range. The results suggest a causal relation between the antiproliferative effects and the inhibition of protein kinase C. All inhibitors of protein kinase C synergistically enhance the antiproliferative activity of cis diamminedichloroplatinum(II). Available data suggest that the effects of protein kinase C inhibitors should be exploitable for tumor chemotherapy. PMID- 2696344 TI - Mechanisms of induction of enzymes that protect against chemical carcinogenesis. AB - A persuasive body of evidence indicates that substantial protection against chemical carcinogenesis can be achieved by induction of enzymes concerned with the metabolism of carcinogens. There are two classes of anticarcinogenic enzyme inducers: (a) monofunctional inducers (e.g., phenolic antioxidants, isothiocyanates, coumarins, thiocarbamates, cinnamates, 1,2-dithiol-3-thiones) that elevate Phase II enzymes (such as glutathione S-transferases, NAD(P)H:quinone reductase, UDP-glucuronosyl-transferases) in various tissues without significantly raising the Phase I enzyme, aryl hydrocarbon hydroxylase (cytochrome P1-450); and (b) bifunctional inducers (e.g., polycyclic aromatic hydrocarbons, flavonoids, and azo dyes) that induce both Phase I and Phase II enzymes of xenobiotic metabolism. Induction of Phase II enzymes appears to be a sufficient condition for achieving chemoprotection, and since certain Phase I enzymes are responsible for activating carcinogens to their ultimate reactive forms, selective Phase II enzyme inducers offer intrinsically safer prospects for achieving chemoprotection. Whereas induction of both Phase I and II enzymes by bifunctional inducers depends on the Ah receptor, induction of Phase II enzymes by monofunctional inducers is independent of a functional Ah receptor. Studies on the structural requirements for induction of quinone reductase [NAD(P)H:(quinone acceptor) oxidoreductase; EC 1.6.99.2] by monofunctional inducers in Hepa 1c1c7 murine hepatoma cells have revealed that such inducers contain a distinctive chemical feature (or acquire this feature by metabolism) that regulates the synthesis of this protective enzyme. The inducers are all Michael reaction acceptors characterized by olefinic (or acetylenic) linkages that are rendered electrophilic by conjugation with electron-withdrawing groups. Typical examples are alpha, beta-unsaturated aldehydes, ketones (including quinones), thioketones, sulfones, esters, nitriles and nitro groups. The potency of these inducers parallels their reactivity as Michael acceptors. These generalizations have provided mechanistic insight into the vexing question of how so many seemingly unrelated anticarcinogens induce chemoprotective enzymes. They have also led to the prediction of entirely new and unsuspected structures of inducers, with potential for chemoprotective activity. PMID- 2696345 TI - Growth and differentiation signals as determinants of cancer cell proliferation. AB - The development and the maintenance of a tissue involves the sequential differentiation of precursor cells along multiple intermediate stages of maturity. At these stages the cells can proliferate or differentiate depending upon the growth or differentiation signals they receive. Terminally mature cells lose their ability to proliferate. Alterations can occur at the level of the cell or the whole organism that lead to the sustained proliferation of incompletely mature cells. This process constitutes an oncogenic event, and the cellular and molecular changes that lead to its occurrence are surveyed in this review. PMID- 2696346 TI - Biochemical aspect of HMG CoA reductase inhibitors. AB - Subsequent to the discovery of compactin (ML-236B) as a specific inhibitor of HMG CoA reductase, a series of compactin analogs have been either isolated or synthesized. Several of these compounds, which include compactin, mevinolin (monacolin K) and CS-514, have been extensively studied. The inhibition of HMG CoA reductase by these compounds is reversible and competitive (Ki = approximately 1 nM). The 3', 5'-dihydroxypentanoic acid portion of the acid form of compactin analogs, which resembles the HMG portion of HMG CoA, plays a crucial role in inhibitory activity. These inhibitors block sterol synthesis both in cultured mammalian cells and in animals. Strong inhibition of sterol synthesis results in a marked increase in HMG CoA reductase activity both in vitro and in vivo. These compounds strongly lower plasma LDL-cholesterol levels in animals and humans. The lowering of LDL-cholesterol levels occurs by an inhibition of LDL synthesis and/or by an elevation of the receptor-mediated LDL catabolism in the liver. PMID- 2696347 TI - Molecular genetics of ornithine decarboxylase in human tumor cells. AB - As the molecular biology of mammalian ornithine decarboxylase is coming of age, more and more interesting features of this unique protein are being uncovered. Ornithine decarboxylase belongs to those 20 or so enzymes or binding proteins, the genes for which are easily amplified under suitable selection pressure. This also applies to the human enzyme. Gene amplification of ornithine decarboxylase is not the only means to acquire resistance to inhibitors of the enzyme, as its overproduction can occur through an enhanced transcription or even through a more efficient translation of normal mRNA amounts. The resistance in human tumors can likewise be acquired by activating other enzymes, such as arginase. In contrast to the multigene family in mouse, it appears that in the human genome only two ornithine decarboxylase genes are present mapping to the chromosomes 2 and 7. Out of these, at least the sequences in the short arm of chromosome 2 are transcriptionally active and amplifiable. Human ornithine decarboxylase also belongs to those proteins which show a positive correlation between gene hypomethylation and expression. The genes of human ornithine decarboxylase are methylated to varying extents and distinct hypomethylation is seen in certain malignant cells, most notably human lymphatic leukemia cells. The human ornithine decarboxylase gene is easily transferrable into other mammalian cells in which it is efficiently expressed. Some indirect evidence seems to indicate that overproduction of ornithine decarboxylase may confer a growth advantage to mammalian cells. A further piece of information suggesting an important role for the enzyme is the fact that the structure of the ornithine decarboxylase gene is extremely well conserved during evolution. This does not apply only to the coding region but also to the overall organization of the gene itself. PMID- 2696348 TI - Fungalbionics: a new concept of the etiology of gout, hyperuricemia and their related diseases. PMID- 2696349 TI - Controllable expression of an E. coli amidophosphoribosyltransferase (ATase) gene in ATase-deficient mammalian fibroblasts--a basic model for gene therapy. PMID- 2696350 TI - The renal cytochrome P450 system generates novel arachidonic acid metabolites. PMID- 2696351 TI - Prostaglandins, thromboxane and leukotrienes in the control of mesangial function. PMID- 2696352 TI - Interactions of platelet activating factor and prostaglandins in the glomerulus and in mesangial cells. PMID- 2696353 TI - Eicosanoids and platelet activating factor as possible mediators of injury in experimental nephropathies. PMID- 2696354 TI - Arachidonic acid metabolism during interactions between glomerular and bone marrow-derived cells. PMID- 2696355 TI - Eicosanoids: role in experimental renal disease. AB - Because of their vasodilator and vasoconstrictor properties, vasoactive prostaglandins and thromboxane A2 have been proposed as modulators of the hemodynamic changes that occur in experimental models of renal disease. Increased synthesis of vasodilatory prostaglandins (PGE2) and perhaps prostaglandin I2 (PGI2) play a role in the maintenance of renal blood flow and GFR during states of impaired perfusion. In contrast, thromboxane A2 has been implicated as the vasoconstrictor responsible for the reduction of renal blood flow and GFR in certain animal models of experimental renal disease. These products and other metabolites of arachidonic acid may also participate in the immunological events underlying the onset and/or progression of experimental renal disease. It is evident that the pathophysiologic role of eicosanoids in experimental renal disease is not fully understood. Additional studies and further understanding of the many other potential roles of eicosanoids on immunological events, hemodynamic states, mesangial cell physiology, etc. are needed to comprehend more fully the extent of the participation of eicosanoids in the pathogenesis and pathophysiology of renal disease. PMID- 2696356 TI - Abnormalities of glomerular eicosanoid metabolism in states of glomerular hyperfiltration. PMID- 2696357 TI - Diabetic nephropathy: pathophysiology, clinical course and susceptibility. PMID- 2696358 TI - The role of eicosanoids in human glomerular disease. PMID- 2696359 TI - Lipoxygenase products and their functions in glomeruli. PMID- 2696360 TI - Protein catabolic factors in patients on renal replacement therapy. PMID- 2696361 TI - Pharmacokinetic aspects of drug transport in continuous ambulatory peritoneal dialysis. PMID- 2696362 TI - Beta 2 microglobulin-derived amyloid in dialysis patients. PMID- 2696363 TI - Drug therapy during continuous arteriovenous hemofiltration. PMID- 2696364 TI - Lymphatic absorption during peritoneal dialysis. AB - These studies suggest that lymphatic absorption reduces net ultrafiltration by significant amounts and plays a major role in the overall ultrafiltration kinetics. Intraperitoneal drugs which decrease lymphatic absorption may increase net ultrafiltration, drainage volume, and solute clearances. Decreases in net ultrafiltration with drugs that decrease lymphatic absorption may provide an alternative means to increase net ultrafiltration with less use of hypertonic dextrose exchanges. PMID- 2696366 TI - Continuous arterio-venous hemofiltration: optimization of technical procedures and new directions. PMID- 2696365 TI - Glucose polymer as an osmotic agent in CAPD. PMID- 2696367 TI - Is continuous haemofiltration superior to intermittent dialysis and haemofiltration treatment? AB - 1. Mortality in cases of acute renal failure has increased from roughly 30% to roughly 70% in recent decades. 2. The rise paralleled the creation of intensive care units. In such units, more seriously ill patients reach the stage of acute renal failure. Before the advent of intensive care units, these patients died before acute renal failure could occur. 3. From a theoretical viewpoint, continuous haemofiltration (CH) has substantial advantages as opposed to intermittent dialysis and haemofiltration treatment. 4. No clinical proof of the superiority of continuous haemofiltration to the intermittent techniques has yet been provided. 5. In our own patient group, total mortality for acute renal failure patients decreased following adoption of continuous haemofiltration. During a selected period of use of continuous haemofiltration for patients with an unfavourable prognosis, however, the mortality with continuous haemofiltration was higher than that with the intermittent methods. PMID- 2696368 TI - Therapeutic apheresis update. PMID- 2696369 TI - Neutrophil activation during hemodialysis. AB - Oxidative metabolism of PMNs of uremic patients is enhanced due to unknown serum (plasma) factors which are removed during hemodialysis. Respiratory burst activity is diminished in both PMA-stimulated and unstimulated states compared to healthy controls. Hemodialysis normalizes stimulated and decreases unstimulated hydrogen peroxide production. Several authors found that resting and stimulated chemiluminescence (CL) during hemodialysis correlates with complement activation, whereas other authors describe CL using dialyzer membranes with only mild anaphylatoxin formation. Alterations of PMN carbohydrate metabolism in uremic patients improves during HD with polysulfone. HD with PMMA, however, activates glycogenolysis. These alterations may be responsible for disturbance in phagocytosis. Degranulation during HD also occurs in absence of complement activation. Calcium channel blockers decrease activation of PMNs using dialyzers with only little anaphylatoxin formation. PMID- 2696370 TI - Biocompatibility--a system approach. PMID- 2696371 TI - Treatment of uraemic anaemia with recombinant human erythropoietin. PMID- 2696372 TI - Carnitine supplementation in uremia. PMID- 2696373 TI - Pathophysiology and treatment of hypertension in dialysis patients. PMID- 2696374 TI - Adjustment of drug dosage to hemodialysis patients. PMID- 2696375 TI - Current status of allergen immunotherapy (hyposensitization). Report of a WHO/IUIS working Group. PMID- 2696376 TI - Fluid and electrolyte balance during a cool weather marathon. AB - Changes in blood, serum, and urine parameters that are usually associated with fluid and electrolyte balance were studied in 45 volunteers who ran the 1987 Pittsburgh Marathon. There were 39 males and 6 females. The mean age was 39.3 years. Their mean fluid intake was 1650 cc and the mean finishing time was 4 hours and 1 minute. The race was run in the rain with a temperature of 46 degrees F. When the prerace and postrace values of the runners were compared, significant increases were noted in the serum sodium, potassium, blood urea nitrogen (BUN), creatinine, uric acid, creatine phosphokinase (CPK), protein, plasma renin, vasopressin, and urinary potassium. Significant decreases were found in weight, blood pressure, and urinary sodium. No significant differences were noted in serum chloride, serum glucose, and hemoglobin/hematocrit. The mean weight loss of 1.9 kg was less than weight losses reported in marathons run under warmer conditions. PMID- 2696377 TI - Open meniscus repair. Technique and two to nine year results. AB - An average 4.6 year follow-up study has been done on 80 of 104 open meniscus repairs of unstable peripheral tears. Two of nine retears were treated in the acute stage and seven were treated in the chronic stage. Eight retears were medial, one was lateral (repair ratio, 1.5:1 medial to lateral), three occurred through the repair site, and six occurred in different areas. Retears occurred in 1 of 26 isolated repairs, 2 of 38 repairs done with an ACL stabilization procedure, and 6 of 16 repairs done in ACL deficient knees that were not stabilized. Standing radiographs revealed normal compartments in 40 of 41 repairs. PMID- 2696378 TI - An epidemiologic investigation of injuries affecting young competitive female gymnasts. AB - A prospective study of injuries affecting 50 highly competitive young female gymnasts was conducted over a period of 1 year. Many of the findings of this investigation were consistent with previous studies and suggest particular injury trends in women's gymnastics. These results included injury location, injury severity, nature of onset, event, and activity at the time of injury. Some of the descriptive results, however, provided information that was heretofore unreported or inconsistent with previous investigations. These findings involved injury rate, reinjury rate, time loss, injury type, hours of practice, and incidence of physician-seen injuries. Some of these findings were disturbing and echo concerns registered in the professional literature. In particular, the reinjury rate is alarming and points to the need for complete rehabilitation before return to full participation. The results of the analytic component of the study alluded to the potential role of competitive level and maturation rate in the profile of the injury-prone gymnast. Specifically, rapid periods of growth and advanced levels of training and competition appeared to be related to injury proneness. Pursuant to the descriptive and analytic results of the investigation, recommendations for injury prevention and continued research are made. PMID- 2696379 TI - Conservative management of a displaced medial clavicular physeal injury in an adolescent athlete. A case report and literature review. PMID- 2696380 TI - [Nasosinusal aspergillosis]. AB - The paper reports about a bilateral maxillary sinusitis and a right pansinusitis of this unusual disease. The allergic polyposis present in the second case is probably due to fungus sensitization (as Katzenstein's case). None of them have had dental problems, not even foreign bodies inside of the sinuses (quoted from other AA.). The diagnosis must be confirmed by both the pathologist and the bacteriologist. The treatment is surgery plus antifungal drugs. PMID- 2696381 TI - [Ketotifen in allergic rhinitis]. AB - Double-blind experiment (at random) comparative of the efficacy of ketotifen and Clemastina, for the treatment of periodic allergic Rhinitis. The study embraced 40 patients (21 men and 19 women) between 13 and 57 years old. The program was conducted on a fifty-fifty shares between both drugs. The clinic efficacy of ketotifen has been proved either as regards to clinic improvement or the less good results attained with the use of clemastine. The AA. guess on the prophylactic influence of ketotifen in asthmatic bronchial crisis among patients suffering allergic rhinitis. PMID- 2696382 TI - [Pulmonary edema secondary to acute obstruction of the upper airways. Apropos of a case of immediate recovery]. AB - The AA. inform on the case of a girl, 13, carrying an aortic prosthesis who some hours after the removal of a laryngeal dilator had an asphyctic syndrome during a meal. The emergency being overcome an acute pulmonary edema could be diagnosed without either objective valvular or left ventricular dysfunctions. In spite of the prior heart pathology the reporters belief in the coincidence of the case displayed with a pulmonary edema following the acute obstruction of the upper respiratory tract. They review the proposed physiopathological hypothesis as well as the Spanish literature upon the subject. PMID- 2696383 TI - Methods for the analysis of inositol phosphates. AB - Interest in the inositol phospholipids was stimulated by the simultaneous discoveries that the products of hydrolysis of these lipids could serve as messengers to activate to synergistic signaling pathways in hormonally responsive cells, namely, inositol 1,4,5-trisphosphate which causes the release of Ca2+ from intracellular stores and diacylglycerol which promotes the activation of protein kinase C. At the same time, Berridge and co-workers introduced relatively simple approaches to study the inositol phospholipid cycle. These included the use of [3H]inositol to label the inositol metabolites, all of which are confined to this cycle, and of Li+ to decrease the rate of degradation of the inositol phosphates. Water-soluble inositol phosphates and chloroform-soluble inositol phospholipids could then be separated by solvent partition and the inositol phosphates further separated by use of an anion-exchange resin. However, the subsequent application of high-performance liquid chromatography as a separation technique indicated the existence of many isomers of the inositol phosphates formed by different pathways of dephosphorylation and phosphorylation. Mapping of these metabolic pathways may be substantially complete, but novel pathways may still be discovered. We review both old and new methods of analysis of the inositol phosphates for the measurement of mass and radioactivity. Although the complexity of the cycle sometimes demands the use of sophisticated methods of separation and rigorous identification, older and inexpensive methods may still be useful for some purposes. PMID- 2696384 TI - Identification of covalently bound fatty acids on acylated proteins immobilized on nitrocellulose paper. AB - A general method for identification of fatty acids covalently bound to acylated proteins following their electrophoretic transfer onto nitrocellulose paper is described. As demonstrated for [3H]palmitoylated RAS1 protein of Saccharomyces cerevisiae and the acylated acyl carrier protein of Spirodela oligorrhiza, this procedure alleviates the need for elution of proteins from polyacrylamide gel slices. Fatty acid ligands of such proteins are hydrolyzed directly from their immobilized state on the nitrocellulose paper, then derivatized with p nitrophenacyl bromide, and finally resolved by reversed-phase high-performance liquid chromatography. The amount of acylated protein required for identification of acyl groups is minimized compared to that required for more conventional approaches by coupling a radioactive flow detector with the HPLC system. PMID- 2696385 TI - Detection of low-molecular-weight polypeptides on nitrocellulose with monoclonal antibodies. AB - An immunoblotting method to detect low-molecular-weight peptides with monoclonal antibodies that normally fail to demonstrate immunoreactivity using conventional blotting techniques is described. Detection of neurophysin, insulin, calcitonin, vasopressin, and beta-endorphin electroblotted on nitrocellulose membranes was optimized after introducing four modifications into the conventional procedure. These include renaturing the gels after sodium dodecyl sulfate electrophoresis, electroblotting the renatured gels in basic transfer buffer, fixing and/or heating the blots, and using avidin/alkaline phosphatase conjugates for antigen/antibody detection. This technique likely enables the denatured peptides to regain their native conformation and, therefore, restores antigenicity and recognition by highly structural specific monoclonal antibodies. Although the most dramatic improvement with this technique is with monoclonal antibodies, a modest improvement in sensitivity can be obtained when immunoblots are probed with polyclonal antibodies. The high resolution of this system will be useful in probing blots of partial proteolytic digests of proteins with both monoclonal and polyclonal antibodies. PMID- 2696386 TI - [Normal values of osteocalcin in the blood over the course of life]. AB - This study tends to settle the standard values of BGP circulating amount, which - attesting osteoblastic activity - varies according life periods. The lowest amounts are to be found in twenty five to forty five years adults; though varying all the day and night long, these amounts remain included between 3-7 ng/ml; particularly if the blood-test took place between 8 and 10 a.m. PMID- 2696387 TI - [Comparative study of 2 classical technics of coloration and an indirect immunofluorescent assay applied to research on Pneumocystis carinii in the bronchoalveolar lavage fluid and induced sputum in HIV+ patients]. AB - Two histochemical staining methods, eosine-methylene blue fast (RAL 555) and silver methenamine (modified Grocott's technique), and indirect immunofluorescence assay with an anticyst monoclonal antibody were used to detect Pneumocystis carinii in the broncho-alveolar lavage fluid and induced sputum from 58 HIV+ patients. Immunofluorescence disclosed the largest number of carriers (35 p. cent of examined patients). However, the histochemical staining techniques remain of interest and are the initial method of choice. They are inexpansive and rapid to achieve; less sensitive than immunofluorescence, positive results argue a high enough level of parasitism which leads to clinical manifestations. The increased sensitivity of immunofluorescence has considerably improved the ability to detect Pneumocystis in induced sputum. It allowed us to disclose 18 out 20 carriers (90 p. cent). However when a Pneumocystis is suspected, it is preferable to sample bronchoalveolar lavage fluid. Its examination is quick, easy and quantitative appreciation of results bring important diagnostic arguments. Other parasites, such as toxoplasmas, may also be detected. On the other hand, the examination of expectoration is time consuming and difficult to read and interpret. Therefore, sputum induction for the diagnosis of Pneumocystosis should be reserved to unequiped centers or insufficiently equiped centers (i.e., devoid of intensive care units). PMID- 2696388 TI - [The role of IgA and IgA antigliadin antibodies in the diagnosis and management of celiac disease]. AB - The authors reports the results of ELISA IgG and IgA antigliadin antibodies measurements in a study of 271 serum samples proceeding from celiac patients (with and without gluten containing diet) and control subjects. IgA antigliadin antibody measurement had the most specificity and positive predictive value, IgG antigliadin antibody measurement had the most sensitivity and negative predictive value. Our results point out that antigliadin antibodies are helpful in the diagnosis and management of celiac disease. Un the same manner, antigliadin antibodies are helpful to evaluate the adherence of patients to gluten-free diet. PMID- 2696389 TI - [Urinary tract infection in the newborn infant]. AB - Twenty-eight cases of urinary tract infection in newborns with positive urinoculture and suggestive clinical symptomatology are reviewed. The incidence was 0.24%, being most frequent in preterm and postterm newborns. Male neonates was more affected. Failure to thrive, excessive weight loss, poor feeding, diarrhoea, vomiting and jaundice are the most relevant clinical signs. E. coli and Klebsiella are the most frequent organism isolated, followed by Enterobacter and Candida. The presence of metabolic acidosis and leukocituria using a bag technique were the most accurate laboratory data to suspect a urinary tract infection. PMID- 2696390 TI - [Short term treatment of infantile pulmonary tuberculosis]. AB - Due to the scarcity of published articles on short-course chemotherapeutic regimens for pediatric pulmonary tuberculosis, the following study has been carried out: Twenty-five children diagnosed of pulmonary tuberculosis were administered a short course therapeutic regimen consisting of three tuberculostatics for the first two month (isoniazid, rifampicin and pyrazinamide) and only two (isoniazid and rifampicin) for the following four months. The results were compared with those obtained from a control group of twenty-five children receiving the "classical" therapy: two drugs (isoniazid and rifampicin) for a nine month period. The statistical analysis did not demonstrate any significant difference related to evolution, duration and complications of the disease, between both groups. Therefore, this short course therapeutic regimen could be accepted for pediatric pulmonary tuberculosis. PMID- 2696391 TI - [Diagnostic approach to a hemorrhagic syndrome in childhood]. PMID- 2696392 TI - Effects of low doses of lead on children's health. AB - An investigation has been carried out of the blood lead levels of children resident in three different municipalities of Umbria: Corciano, selected as a control area; Perugia, the largest town in Umbria (approx. 150,000 inhabitants), with intense automobile traffic; and Deruta a town in which there is a flourishing ceramic industry. The mean blood lead levels were found to be higher in children in Perugia (96 micrograms/l) and Deruta (97 micrograms/l) with respect to Corciano (83 micrograms/l); in Deruta the mean blood levels were raised in those children whose families are occupationally exposed to lead (107 micrograms/l). The concentration of lead in the air in Deruta was higher than in Corciano (0.19 vs 0.11 microgram/m3, respectively). The lead concentrations in house dust were higher in Deruta (2.8 micrograms/m2) than in Corciano (0.8 microgram/m2) and the difference was greater in the houses were the inhabitants were exposed to lead in factories (2.7 micrograms/m2) or in workshops which were adjacent to the houses (4.7 micrograms/m2). The blood lead levels of children included in this study have been compared with those obtained during a similar investigation in 1978. Over the last eight years primary school children in Corciano and Deruta have shown a marked reduction in blood lead levels (greater than 50%). This improvement should not lead to false optimism: in fact, it is impossible to establish the blood lead level at which no adverse effects are induced, especially in children. Numerous studies suggest that even sub-clinical levels of lead can cause alteration in heme synthesis, peripheral nervous system, kidney, immune system, skeleton and growth. Furthermore, with regard to the central nervous system, low blood lead levels can provoke neuropsychological deficits, which can result above all, in a decreased I.Q., and behavioural alterations. PMID- 2696394 TI - Clinical, analytical and pharmacokinetic aspects in cancer chemotherapy with platinum coordination compounds. AB - A survey of investigations performed by our group over the last few years whose goal was to obtain analytical, clinical and pharmacokinetic data concerning cancer chemotherapy with Pt-based drugs is reported. From this standpoint the use of inductively coupled-plasma atomic emission spectrometry for determining Pt levels in biological samples is discussed, particularly as regards: 1) the amelioration of sample introduction procedures into the torch in the case of micro-sampling and 2) the investigation of plasma drug distribution by means of liquid chromatography techniques. Clinical studies evaluated therapeutic response and toxicity during regional and systemic treatments with Cisplatin and Carboplatin against solid tumors in adults as well as in children. Several pharmacokinetic parameters such as plasma half-lives for free and protein-bound drug, tissues exposure as determined by AUC and urinary excretion are examined. PMID- 2696395 TI - Present possibilities for the determination of inorganic arsenic and organoarsenical compounds in biological fluids. AB - A survey is presented of the applicability of atomic spectrometry and other techniques for the quantitation of both inorganic and organic arsenic in biological fluids. Pretreatment of samples and speciation of the different As forms are particularly emphasized. The potential of inductively-coupled plasma spectrometry combined with high performance liquid chromatography separations is also highlighted. PMID- 2696393 TI - Zinc modulates the mitogenic activation of human peripheral blood lymphocytes. AB - In the present study we have investigated the effect of Zn salts on the mitogenetic activation of human peripheral blood lymphocytes (PBL). Our results show that Zn2+ enhances the level of DNA synthesis in human T lymphocytes stimulated by a mitogenic lectin, phytohemagglutinin (PHA); this effect seems to be mediated through an enhanced expression of both interleukin-2 (IL-2) and transferrin (Trf) receptors. We have also analyzed the mitogenic effect of Zn2+ alone on PBL, in the absence of other mitogenic stimuli. In this regard we have identified large light density T lymphocytes as the PBL population which is activated to proliferate by Zn2+. Finally, we showed that Zn2+ stimulates natural killer (NK) activity; this effect is apparently not due to a direct action on NK lymphocytes, but is related to endogenous cytokines released by accessory cells which in turn stimulate the cytolytic activity of NK lymphocytes. PMID- 2696396 TI - [Ungueal capillaroscopy in fasciitis with eosinophilia: a distinctive feature of systemic scleroderma. Apropos of 15 cases]. AB - Eosinophilic fasciitis (EF) is a recently described disease whose distinction from progressive systemic sclerosis (PSS) is still being discussed. PSS has a characteristic microcirculation pattern. We performed nailfold microscopy on 15 patients with EF and compared the results to those of 98 PSS patients and 75 normal control subjects. EF patients have a normal microcirculation pattern (13/15) or discrete, non-specific anomalies: none had the typical capillary pattern associated with PSS and associated diseases. The findings of this study justify making a distinction between EF and PSS and demonstrate that nail fold microscopy can be a useful tool for an early differential diagnosis between these two disorders. PMID- 2696397 TI - [Histopathologic aspects of polymyositis and dermatomyositis. Correlation with the clinical course. Study of 57 cases]. AB - Muscle biopsies from 57 patients with dermatomyositis or polymyositis were histologically evaluated and compared with the disease's clinical course. Perifascicular atrophy, perivascular infiltrates and tubular inclusions in endothelial cells were significantly more frequent in young patients with dermatomyositis. On the other hand, in adult polymyositis, which evolves more slowly, necrosis with slight muscular atrophy and perinecrotic infiltrates was observed. This division into two groups was clear when the clinical evolution and histological patterns were compared. The mean age of each group was different, but there was a large overlap. Two different pathogenetic mechanisms can be envisaged: primary involvement of muscle capillaries with muscle ischemia in young patients with dermatomyositis and primary involvement of muscle fibers in adults afflicted with polymyositis. PMID- 2696398 TI - [Antinuclear and anticytoplasmic antibodies in 24 cases of dermatomyositis. Value of western blotting]. AB - Antinuclear and anticytoplasmic antibodies were detected, using 4 methods, in 96% of the sera (23/24) from 24 dermato- or polymyositis patients, who were followed in the Rheumatology Department. Immunofluorescent (IF) labeling of Hep-2 cell smears was more sensitive than IF staining of liver sections (72 vs 67%), and the patterns observed were in agreement 20/24 times. Gelose precipitation is even less sensitive (29%), but enables a characterization of the antigens recognized: 3 anti-RNP, 3 anti-J01, 1 anti-PMScl, 1 anti-SSB and 1 anti-Ro; the latter two specificities were associated with a sicca syndrome. Western-blotting was the most informative method because it was highly sensitive (79%) and identified the principle antigen-antibody systems: anti-U1-RNP (33%) and anti-Scl70 (33%), both associated with myositis with an overlap syndrome (p less than 0.02); anti-J01 (25%) associated with various forms of myositis; and, more rarely, anti-SSB and anti-Ro (both 4%) when a sicca syndrome was present. Finally, non-identified specificities were observed in 37% of the cases. PMID- 2696399 TI - [Plasma exchange in dermatomyositis and polymyositis. Retrospective study of 38 cases of plasma exchange]. AB - In order to evaluate the efficacity of plasma exchanges (PE) in dermatomyositis and polymyositis, the case histories of 38 patients, who had undergone plasma exchanges between 1980 and 1986 in 10 French plasmapheresis centers, were studied. Large volume PE were performed in 34 patients after failure of conventional therapy and were part of the initial regimen for the 4 others. The initial activity of the muscle disease was acute in 27 patients and subacute or chronic in 11 cases. Clinical results were evaluated on a functional scale based on changes in muscle force: 24 patients improved (10 appreciably and 14 moderately) and 14 remained unchanged. PE were well tolerated in 23 patients. But side effects occurred in 15 patients, necessitating treatment withdrawal in 4 cases. PE seem to be more effective when the dermatomyositis is acute and evolutive than when it is chronic and insidious. The encouraging results of this exhaustive retrospective study prompt us to set up a prospective randomized trial. PMID- 2696400 TI - [Classification of myositis]. PMID- 2696401 TI - [Treatment of polymyositis and dermatomyositis]. PMID- 2696402 TI - [Autoimmune myasthenia and Lambert-Eaton myasthenic syndrome. Physiopathologic concepts]. AB - Physiopathological concepts concerning myasthenia gravis and Lambert-Eaton myasthenic syndrome are reported. Autoantibodies are present in both cases. In myasthenia gravis, they are directed against the acetylcholine receptor. The poorly understood physiopathological aspects of this disease are discussed: the lack of correlation between antibody titer and severity, the role of the thymus and the factors triggering the disease. In Lambert-Eaton syndrome, the autoantibodies are directed against the voltage-gated calcium channels of motor nerve terminals. These calcium channels are also present in a cell line derived from a small cell carcinoma, a tumor found in 60% of Lambert-Eaton syndrome patients. PMID- 2696403 TI - [Anatomopathology of cardiomyopathies]. PMID- 2696404 TI - [Scintigraphic study of myocardial perfusion in cardiac sarcoidosis]. PMID- 2696405 TI - [Pathogenic aspects of polymyositis]. PMID- 2696406 TI - [Guillain-Barre syndrome and extramembranous glomerulopathy. Apropos of a case]. PMID- 2696407 TI - [Arthritis caused by a sea urchin spine. A new case]. PMID- 2696408 TI - [Staphylococcal toxic shock of non-gynecologic origin]. PMID- 2696409 TI - [Complete inhibition of cyclic transmission by immunization against Plasmodium berghei Anka ookinetes]. AB - An antiserum raised against P. berghei Anka ookinetes binds specifically to ookinetes and zygotes surface as assessed by indirect immunofluorescence. The transmission blocking activity of this serum was assessed by feeding mosquitoes on immunized mice. A serum showing an antibody titer of 1/320 reached after 6 immunizations completely blocks ookinetes development. This immune serum might be used to screen P. berghei genomic or cDNA library in order to identify or clone sequences involved in the process of gametocyte infectivity. PMID- 2696410 TI - [Central precocious puberty]. AB - Diagnosis of the central origin of precocious puberty is easy in boys on the enlargement of the testes. In girls, conversely, diagnosis of central precocious puberty (CPP) may be difficult, as isolated development of the breast may initially be the only feature. Differentiation of CPP and premature thelarche is nevertheless essential, as CPP always requires neuroradiologic investigations to look for an intracranial space-occupying lesion and may indicate inhibitory treatment. CPP is usually idiopathic in girls and tumor-related in boys. Early secretion of sex steroids increases the rate of growth and bone maturation and may lead to final short stature. LHRH analogues represent a breakthrough in the treatment of CPP. PMID- 2696411 TI - [Malaria and pregnancy. Report of a case of congenital Plasmodium falciparum malaria]. AB - We report a case of congenital malaria due to a chloroquine-resistant strain of Plasmodium falciparum acquired in Mali. Ours is the first report of chloroquine resistant congenital malaria in this part of Africa. We recall the various pathophysiologic, diagnostic and therapeutic features of this disease that should be considered in every neonate born to a mother who may have malaria. Although such cases are infrequent, we also discuss the very serious problems, mainly therapeutic, that they raise in several countries where they are endemic (South East Asia and Africa particularly). PMID- 2696412 TI - [Specificity and indications of bone scan in non-neoplastic bone and joint disease in children. A study of seventy cases]. AB - We studied 70 bone scans in pediatric patients to define the indications of this procedure in non-neoplastic disease. Sensitivity of bone scans in infections proved outstanding except in children under one year of age. Eighty-nine per cent of children with pain and fever and a positive bone scan had either an infection or osteochondritis. The same symptoms with a negative bone scan indicated either transient synovitis of the hip or the absence of bone lesions in 83% of cases. Children with pain as the only symptoms and a negative bone scan consistently had either transient synovitis of the hip, or normal bones and joints (100% of cases). Eighty-two per cent of children with pain and a positive bone scan had an infection or osteochondritis. Indications of bone scanning vary according to clinical features and include all children with functional impairment, pain and fever, and isolated limps with no obvious cause. PMID- 2696413 TI - [Neonatal pleuropulmonary staphylococcal infection with multiple abscesses of the liver]. AB - We report the case of a neonate who developed septicemia due to a methicillin susceptible Staphylococcus aureus strain at six days of age. At eight days of age, physical evaluation revealed a tense, tender abdomen and further enlargement of the liver, and abdominal ultrasonography demonstrated multiple liver abscesses. On the following day, pleuropulmonary lesions developed and required mechanical ventilation. Recovery was achieved using parenteral vancomycin and fosfomycin for 15 days followed by oral pristinamycin for ten days. This case is unusual in that the infection was acquired by the digestive route probably as a result of lymphangitis of the breast in the mother, and multiple liver abscesses were associated with the pleuropulmonary localization. It provides further evidence of the value of ultrasonography for the diagnosis and monitoring of liver abscesses, including multiple abscesses. PMID- 2696414 TI - Congenital muscular torticollis: a spectrum of pathology. AB - Congenital muscular torticollis (CMT) is a disorder characterized by a shortening of at least one of the cervical muscles and tilting of the head to the opposite side. The most commonly affected muscle is the sternocleidomastoid (SCM) muscle. An unusual case is presented here: a CMT patient with involvement of the trapezius muscle in addition to the SCM muscle who has recently been treated at North Carolina Memorial Hospital. This patient still has a slight residual deformity despite two surgical procedures, physical therapy, and splinting. A review of 41 CMT patients who presented to this institution from 1952 to the present demonstrates that the disorder is extremely variable in terms of severity of deformity and response to various types of therapy. The condition will resolve spontaneously in the majority of patients by the age of 1 year, and if the condition has not resolved by then, it is unlikely to do so without surgery. We therefore believe that surgery should be postponed until after 1 year of age. Most of the patients requiring surgery are effectively treated by division of the involved muscle in at least one area with or without lengthening of the SCM muscle. Splinting and physical therapy are recommended postoperatively. A few patients such as the unusual one with involvement of the trapezius muscle resist our most aggressive therapeutic efforts. PMID- 2696415 TI - Cystic disease of the biliary tract. AB - Cystic disease of the biliary tract is rare in Western countries with an incidence of 1/2,000,000 live births. Five anatomical types are recognized. The majority (80%) become symptomatic before the age of 30 years. The cysts rarely have an intact epithelial lining and this often exhibits metaplasia. The risk of cancer developing in a choledochal cyst has been variously estimated at 2.5-28%. Malignancy is often associated with an abnormal pancreaticobiliary junction. Surgical treatment is indicated for types I-IV and is by excision rather than drainage. The treatment of Type V is difficult and should be conservative in the first instance. However, patients with severe symptomatic diffuse hepatic disease and progressive deterioration of liver function are best managed by hepatic transplantation. PMID- 2696416 TI - Gastric emptying of liquid meals. A study in 88 normal persons. AB - Using a gamma camera, gastric emptying of a nutrient liquid meal labelled with 99m-Tc-DTPA has been studied in 88 normal subjects in order to assess reproducibility and to establish the range for gastric emptying under standardized conditions. The emptying patterns were visualized as time-activity curves. The early phase (0-15 min) was characterized by a rapid emptying taking place during the first minutes and a subsequent period of almost no emptying (plateau) lasting for up to 20 minutes, followed by an almost constant emptying in the later phase (15-60 min). In the early and later phase mean percentages emptied were 13% (range, 0-30) and 49% (range, 9-79), respectively. The intraindividual variation was larger for repeated tests of months' than of days' intervals, the coefficients of variation in the early phase being on the average 72% (range, 29-175) and 37% (range, 13-128), respectively. During the later phase less variation was seen. Irregular deviations from the standard pattern were observed in the curves, indicating gastric contractions and duodenogastric reflux. Serial scintifotos revealed that the radionuclide labelled gastric content was not uniformly distributed within the stomach. This activity distribution, affected by the subject's position during emptying, seemed to occur instantaneously and to be completed within a few minutes. These findings allow the standardized radioisotope technique to be used for physiological, pathophysiological and pharmacological studies, when performing consecutive studies in the same individual within days or a few weeks. The wide reference interval for gastric emptying of this liquid meal invalidates the method as a clinical diagnostic tool. PMID- 2696417 TI - Nail versus screw fixation of femoral neck fractures. A 2-year radiological and clinical prospective study. AB - 137 recent femoral neck fractures were randomly allocated in a prospective study to internal fixation with either Nystrom nails or Scand screws. A radiological and clinical follow-up was conducted of all survivors one and two years postoperatively. Reduction was unsatisfactory in 15 of 87 patients included in the two-year follow-up study. 13 of them developed complications. The 44 Nystrom nailed fractures included in the two-year follow-up showed sliding of the nail in 22 cases, redisplacement/nonunion in 14, and late segmental collapse in 5. The results of clinical examination were excellent or good in 30 patients and fair or poor in 14. Among the 43 Scand-screwed fractures sliding of the screw occurred in 1 case, redisplacement/nonunion in 14, and late segmental collapse in 4. In 35 patients the result was graded as excellent or good and in 8 as fair or poor. No statistical difference between the groups was found with respect to the incidence of redisplacement, nonunion and late segmental collapse, nor with respect to the results of the clinical assessment at the one-year and two-year follow-up. There was a considerably higher incidence of extrusion of the internal fixation device among the nailed fractures than those treated with screws. The results indicate that Scand screws are a better alternative to Nystrom nails in the treatment of femoral neck fractures. If an adequate reduction cannot be achieved, primary hip replacement is recommended. PMID- 2696418 TI - Bacterial meningitis--a four year survey in a paediatrics unit. AB - The aim of this prospective survey was to study the clinical profile, the incidence among the various age groups, the bacteriology, sequelae and mortality in patients, with bacterial meningitis. Patients included in the study were 36 cases of bacterial meningitis admitted to the Paediatric Unit, Tan Tock Seng Hospital, Singapore, between the period January 1984 to December 1987. Of the total number of patients, 36% were in the neonatal age group. Positive bacterial cultures were obtained in 45% of cases in both the cerebrospinal fluid and blood. The incidence of neurological sequelae was about 10%. 14% of the patients died and the majority of deaths were patients in the neonatal age group. Among the patients studied, was one who had recurrent episodes of bacterial meningitis. PMID- 2696419 TI - Diagnostic management of solitary thyroid nodules. AB - The study attempts to assess the accuracy of radionuclide scan, ultrasonography and fine-needle aspiration biopsy as diagnostic tools in distinguishing malignant from benign nodular thyroid lesions in Singapore. The medical case records of 537 patients referred to the Department of Nuclear Medicine were analysed. 94% of the solitary thyroid nodules delineated on scintiscan were "cold". The incidence of malignancy in solitary "cold" thyroid nodules was 8%, and that in multinodular goitres was 2.3%. The sensitivity of both radionuclide scan and ultrasonography in detecting cancer was 100%, but the specificity was disappointingly low, i.e. 3.6% for radionuclide scan and 21% for ultrasonography. The sensitivity for fine needle aspiration biopsy was 85%, and the specificity 96%. Fine-needle aspiration cytology is indisputable as an accurate diagnostic tool in differentiating malignant from benign thyroid lesions, and should be the first test to be used in the diagnostic workup of nodular thyroid disease. However, both radionuclide scan and ultrasonography remain crucial in the subsequent management of patients with thyroidectomy done for thyroid cancer. The other major roles are in the management of thyroiditis, thyrotoxicosis and confirmation of ectopic thyroid tissue. PMID- 2696420 TI - Adenocarcinoma associated with chronic anal fistula. AB - Adenocarcinoma in association with chronic anal fistula is a rare disease entity with a male preponderence in most reported series. The patient typically presents with a long history of perianal disease. Diagnosis is often delayed because of failure to obtain biopsy evidence of the condition. A chronic anal fistula may become malignant. However, despite delay in diagnosis, complete removal which usually entails abdominoperineal resections with wide excision of perianal skin and ischiorectal fossa is necessary to achieve good results. We relate our experience with two such rare cases and a literature review on the current views on the relationship between adenocarcinoma and the occurrence of anal fistula is presented. PMID- 2696421 TI - [Complete bladder retention secondary to a herpetic genital infection. Report of a case. Review of the literature]. AB - The authors report their experience of acute urinary retention due to genital herpetic infection. The data gathered by physical examination and laboratory investigations are of great diagnostic value. The urodynamic investigation provides a better comprehension of the pathogenesis of the phenomena. Bladder drainage is urgent. Complete resolution within a few days to three weeks is the general rule. PMID- 2696423 TI - [Cure of complex post-irradiation uro-genital fistulae]. AB - The authors report two cases of complex radiation induced urogenital fistulae (vesicovaginal and combined rectovaginal), which were closed successfully at the second attempt with complete restitution of bladder function, without any urinary diversion using colpocleisis in one patient. They mention the necessity of bringing a new source of blood supply into the fistula repair area. Then, they review the different extensive procedures used to ensure this result: small bowel graft, omentopexy to reinforce the suture lines, fibroadipose tissue from the labia majora (Martius' operation). Lastly, basedow their experience and a review of the literature, they propose a therapeutic strategy based on a transperitoneovesical approach with the combined used of isolated small bowel and omental pedicle graft. PMID- 2696422 TI - [Meatal polyp in women]. AB - The authors analyse the pathophysiology of pseudo-tumours of the female urethra and present the clinical signs and diagnostic traps associated with these lesions. Treatment is essentially medical by means of a combination of anti infectious and anti-inflammatory agents and local oestrogens. PMID- 2696424 TI - [A case of intra-scrotal and extra-testicular Leydig cell tumor]. PMID- 2696425 TI - Approaches to antiviral chemotherapy. AB - Most of the drugs used today in the treatment of viral infections in man are purine-pyrimidine antimetabolites that interfere with viral replication. Work at Southern Research Institute has identified a number of compounds of this type with promising antiviral activity in both cell culture and rodent test systems. By far the most active and selective agents are carbocyclic nucleoside analogs in which the oxygen of the furanose ring is replaced by a methylene group. The effects of this change on the metabolism and antiviral activity of these compounds is discussed below. PMID- 2696426 TI - DNA hybridization assay for detection of gypsy moth nuclear polyhedrosis virus in infected gypsy moth (Lymantria dispar L.) larvae. AB - Radiolabeled Lymantria dispar nuclear polyhedrosis virus DNA probes were used in a DNA hybridization assay to detect the presence of viral DNA in extracts from infected larvae. Total DNA was extracted from larvae, bound to nitrocellulose filters, and assayed for the presence of viral DNA by two methods: slot-blot vacuum filtration and whole-larval squashes. To test the assays, neonate larvae were fed droplets containing a known concentration of L. dispar nuclear polyhedrosis virus and observed for up to 10 days to determine the percentage of infected larvae. The average percent mortalities were 88.0, 60.7, 26.0, and 5.3% for larvae fed droplets containing 4.0 x 10(4), 1.0 x 10(4), 2.5 x 10(3), and 6.25 x 10(2) polyhedral inclusion bodies (PIBs) per ml, respectively. Other larvae treated with the same virus concentrations were frozen at 2, 4, and 6 days postinoculation and examined by the hybridization techniques. The average percentage of slot blots containing viral DNA equaled 81.0, 58.0, 18.0, and 6.0% for larvae blotted 4 days after treatment with 4.0 x 10(4), 1.0 x 10(4), 2.5 x 10(3), and 6.25 x 10(2) PIBs per ml, respectively, and 89.9, 52.1, 26.6, and 6.0%, respectively at 6 days postinoculation. Thus, the hybridization results were closely correlated with mortality observed in reared larvae. Hybridization of squashes of larvae frozen 4 days after receiving the above virus treatments also produced accurate measures of the incidence of virus infection. PMID- 2696427 TI - Presence of the fish pathogen Vibrio salmonicida in fish farm sediments. AB - The persistence of the fish pathogen Vibrio salmonicida in fish farm sediments was studied by use of fluorescent-antibody techniques. The specificities of the monoclonal antibodies and polyclonal rabbit serum used in the study were tested against a number of Vibrio strains, including 4 isolates from intestinal tracts of healthy fish and 98 isolates from sediments. V. salmonicida was detected in sediment samples from diseased farms several months after an outbreak of the disease. The bacterium was also detected in a sediment sample from a disease-free fish farm. No V. salmonicida could be detected in sediments not influenced by fish farming. The number of positive samples was generally higher with application of rabbit serum as opposed to use of monoclonal antibodies, indicating that the rabbit serum may cross-react with other bacteria. PMID- 2696428 TI - Membrane fatty acid and virulence changes in the viable but nonculturable state of Vibrio vulnificus. AB - The nonculturable state of Vibrio vulnificus and, for comparison, that of Escherichia coli were studied in artificial-seawater microcosms at 5 degrees C. Total cell counts were monitored by acridine orange epifluorescence, metabolic activity by direct viable counts, and culturability by plate counts on selective and nonselective media. Whereas total counts remained constant, plate counts of V. vulnificus suggested nonculturability by day 24. In contrast, direct viable counts indicated significant cell viability throughout 32 days of incubation. As an indication of the metabolic changes that occurred as cells entered the state of nonrecoverability, membrane fatty acid analyses were performed. At the point of nonculturability of V. vulnificus, the major fatty acid species (C16 and C16:1) had decreased 57% from the T0 level, concomitant with the appearance of several short-chain acids. Although the bacteria were still recoverable, a similar trend was observed with E. coli. Electron microscopy of nonculturable V. vulnificus showed that the cells were rounded and reduced in size and contained fewer ribosomes. Mouse infectivity studies conducted with these cells suggested loss of virulence. PMID- 2696429 TI - Standardized method for evaluation of hand disinfection by surgical scrub formulations. AB - A standardized protocol for the evaluation of hand disinfection by surgical scrub formulations was applied to volunteers in a multicenter trial. Povidone iodine (PVI), chlorhexidine (CHX), and a nonmedicated soap (NMS) were tested. The scrubbing procedure involved three daily hand washings for five consecutive days; surviving bacteria were counted daily after being collected in a suitable neutralizing solution. Immediate efficacy (IE), cumulative efficacy (CE), and remanent effect (RE) were calculated by reference to the control hand. Statistical analyses of IE, CE, and RE showed significant differences among the three scrub formulations. IEs of PVI and CHX were equivalent and different from IE of NMS; CE and RE of CHX were higher than those of PVI and NMS. On the basis of the statistical analysis, the population size required for further studies aimed at detecting significant differences between surgical scrub formulations could be estimated. PMID- 2696430 TI - The cystic fibrosis gene. PMID- 2696431 TI - Arteriovenous malformations involving the vein of Galen. PMID- 2696432 TI - Diet and faecal flora in the newborn: breast milk and infant formula. AB - This study examined the faecal flora on days 4, 14, and 28 of 17 breast fed babies and 26 bottle fed babies receiving a modern infant formula based on demineralized whey. Generally among breast fed babies bifidobacteria and staphylococci were the predominant organisms, whereas in the formula fed babies the predominant organisms were enterococci, coliforms, and clostridia. Despite the extensive modification of cows' milk to make an infant formula resemble human breast milk, the results are very similar to those previously reported with unmodified cows' milk baby feeds. The exact dietary factor responsible for these microbiological differences is unclear and in succeeding papers we have looked at the effects of protein quality, in particular the content of whey proteins, casein, and lactoferrin. PMID- 2696433 TI - Diet and faecal flora in the newborn: lactoferrin. AB - The faecal flora of breast fed babies differs from that of bottle fed babies. We have shown that the use of a whey predominant formula rather than a casein predominant one induced a faecal flora generally closer to that of breast fed babies but substantial differences remained. The whey proteins of breast milk include much more lactoferrin than is found in cows' milk. Observations both in animals and in vitro suggest that lactoferrin could be responsible for some of these differences between bottle and breast fed babies. This study was designed to determine the effects on faecal flora of the addition of bovine lactoferrin to the diet of bottle fed babies while holding other qualities of their diet constant. As lactoferrin is an iron binding protein three test formulas were used: (a) no added iron and no added lactoferrin (basic), (b) no iron but added lactoferrin (L), and (c) added iron and lactoferrin (LF). The addition of lactoferrin had little effect upon the faecal microflora and did not move the pattern of the faecal flora in the direction of the breast fed baby. The addition of iron to the formula had more effect on the faecal flora than did lactoferrin. At day 4 it encouraged Escherichia coli and discouraged staphylococcal faecal colonisation. At day 14 the addition of iron to the formula discouraged bifidobacteria. The reasons why bovine lactoferrin was ineffective in vivo in this study are discussed. PMID- 2696434 TI - Changes in leg length and height during treatment with somatotropin. AB - Knemometry has been used in a short term double blind placebo controlled trial in 13 patients with normal variant short stature receiving treatment with somatropin to assess the power of the change in lower leg velocity at one month to predict the increase in height velocity at six months. Used in this way the method has a positive predictive value and sensitivity of 90% and a negative predictive value and specificity of 50%. Although not a perfect discriminatory test, knemometry is a more reliable and less invasive way of analysing the likely value of a growth promoting treatment than metabolic assays in individual patients. Given the possible future rapid expansion of the use of somatropin in short stature of various aetiologies there is a need for a relatively simple and inexpensive means of evaluating response to treatment. PMID- 2696435 TI - Laterality and prematurity. AB - Lateral preferences were determined by postal questionnaire for 240 children, without major neurological impairment, who were born at less than 31 weeks' gestation to examine the association between neonatal brain injuries and later lateral preference. Left hand preference was reported in 64 (26.7%) children at a median age of 52 months (range: 24-104 months). Left foot preference was shown by 70 (29.2%) and left eye preference by 86 (35.8%). Significantly more preterm children were left handed compared with parents or siblings in whom expected frequencies of left handedness were found. All index children had serial neonatal cerebral ultrasound examinations, of which 95 were abnormal. Left preference occurred at similar frequencies in those with normal neonatal scans (26.9%), bilateral lesions (28.3%), left sided lesions (23.8%), and right lesions (23.8%). Lateral preference appears to be unaffected by the side or extent of neonatal brain injury in children without major impairments. PMID- 2696436 TI - Fever--the fire of life. PMID- 2696437 TI - Practical management of sickle cell disease. PMID- 2696438 TI - Neonatology--then and now. Anaemia of prematurity (1962). PMID- 2696439 TI - [Paratesticular angiosarcoma. Immunohistochemical confirmation. Review of the literature]. AB - We report a case of paratesticular angiosarcoma. To our knowledge, no well documented case involving this site has been reported in the literature. The anatomopathological features of the present case are described, highlighting immunohistochemical analysis. The outstanding clinical features of this aggressive tumor type are discussed. PMID- 2696440 TI - [Value of ultrasound in the diagnosis of acute rejection of a kidney transplant]. AB - To determine the usefulness of ultrasound in the diagnosis of acute renal graft failure, 48 renal transplants were retrospectively studied. The characteristic morphologic signs of acute rejection (AR) were compared with the histologic analysis of the graft using material obtained from percutaneous renal biopsy and/or transplantectomy. From the ultrasound scanning performed at the time the histologic specimens were taken, the following four easily identifiable signs were used for the assessment: 1) increased size, 2) increased volume and echo negativity of pyramids, 3) sinus compression, and 4) patchy cortex/sinus destructuring. Correlation of each sign with the anatomopathological data revealed a high sensitivity and predictive value but low specificity for ultrasound in the diagnosis of AR. Its true predictive value will depend on the demonstration of various signs simultaneously, with the advantage that, unlike other techniques, it is noninvasive and can be performed serially. PMID- 2696441 TI - [Ultrasonic diagnosis of the complications of renal transplantation]. AB - To evaluate the usefulness of ultrasound in the diagnosis of urologic complications in renal transplants, we reviewed the ultrasonographic studies performed in 107 renal transplants. Ultrasound disclosed 13 perirenal collection of fluid without hydronephrosis, 4 hydronephrosis without perirenal mass, 2 hydronephrosis from a perirenal fluid mass, 2 urinomas from polar infarction, 1 subcapsular hematoma, and 1 graft vascular atrophy. Ultrasound proved to be the most efficient technique in the diagnosis of hydronephrosis and perirenal fluid collection. Although it does not distinguish the nature of the latter, it permits control of diagnostic or therapeutic (75%) puncture. Moreover, it is useful in controlling percutaneous nephrostomy in transplant obstruction and permits its noninvasive follow-up. PMID- 2696442 TI - [Acute urinary retention caused by hematocolpos associated with uterus didelphys and ipsilateral renal agenesis]. AB - Acute urinary retention from compressive hematocolpos is an uncommon form of presentation of the multi-malformation syndrome arising from failed fusion of the Mullerian ducts and is characterized by uterus didelphys, vaginal duplication (one with hematocolpos), and unilateral renal agenesis. A case is reported and the literature reviewed. PMID- 2696443 TI - [The 450th anniversary of printing in Mexico: cardiology works in New Spain]. PMID- 2696444 TI - [Electrovectorcardiographic manifestations of supraventricular ectopic rhythms (an interpretive hypothesis)]. AB - When a low right atrial rhythm is present, P waves are negative in the low leads, they are variable in a VR and positive in a VL and LI. The figure eighth PF loop is located in the first quadrant, the PH loop has a counterclockwise rotation, and the PS can rotate in either direction. In the presence of upper left atrial rhythms, P waves are positive in the low leads and negative in a VL and a VR. The PF and PH loops can be found in the third quadrant of both planes with a clockwise rotation. If the rhythm originates in low left atrial regions, negative P waves are recorded in left precordial leads and positive ones in a VR and a VL. The PF loop has counterclockwise rotation or its branches superimposed and is situated in the second quadrant; PH with clockwise rotation is registered in the third quadrant; PS with either counterclockwise or clockwise rotation develops above and slightly ahead of the E point. When a nodal rhythm exists, P waves are negative in the low leads. The P loops show a counterclockwise rotation or a figure eight morphology. In the absence of atrial enlargements, the PF loop can be recorded in the first quadrant and the PH in the first or the fourth quadrant. PMID- 2696445 TI - Influence of the diabetic state on digitalis-induced cardiac arrhythmias in rat. AB - The present study was undertaken to determine the effect of diabetes on the manifestation of digitalis cardiotoxicity in whole animal model. Animals after 4, 8, 12 and 16 weeks of streptozotocin treatment (60 mg/kg i.v.) were anesthetized (45 mg/kg alpha-chloralose and 500 mg/kg urethane), chest opened and instrumented for the recording of EKG, carotid pressure, left ventricular pressure and dp/dt. Ouabain was infused at a fixed rate (0.4 mg/kg/min) via the femoral vein. Animals at all stages of diabetes had sinus bradycardia, but the basal mechanical function was found to be depressed only after 12 weeks of streptozotocin treatment. After 16 weeks of streptozotocin injection, 40% of the animals showed some spontaneous arrhythmic activity, which lasted only a few seconds, and prolonged QTc (QT interval corrected for heart rate). In response to ouabain infusion, diabetic animals showed less maximal inotropic effect (30-40% reduction from the weight-matched control rats) and required at least 3-fold more ouabain for the initiation of cardiac arrhythmias than the nondiabetic rats (24.031 +/- 1.52 mg/kg vs 8.05 +/- 1.3 mg/kg). The reduced sensitivity to ouabain could not be explained by the presence of bradycardia. Response to a toxic dose of ouabain was restored to the nondiabetic state on treatment with insulin. These observations suggest that the diseased diabetic myocardium shows diminished sensitivity to digitalis toxicity. PMID- 2696446 TI - [Analysis of concepts, conditions and aims of replications]. AB - There are different positions regarding the definition and the function of replication which lead to several alternatives when setting out to repeat a study. Classifications proposed for replications are of heuristic value but they do not take into consideration all the important conditions. Often replications are regarded as a means to control for errors or as a means for generalizing findings. But these aims of replications are only of secondary importance to the main function of replications: the demonstration of "scientific facts". Only direct or "identical" replications may serve this purpose well. PMID- 2696447 TI - [Multiple exostoses disease (observations in 21 reported cases)]. AB - With reference to 21 cases the authors describe the clinical, radiological and anatomo-pathological findings of multiple exostoses disease. The indications for the surgical treatment are discussed; they are, however, the same to the solitary osteochondroma. PMID- 2696448 TI - [Osteo-articular involvement in microdrepanocytic anemia]. AB - Drepanocytosis is a hereditary hemoglobinopathy which is particularly common in Blacks; in its homozygote form there is constant general involvement of the osteoarticular system with clearly recognisable clinical and radiographic pictures. Microdrepanocytosis (double heterozygotosis) is instead more difficult to recognise. Based on their observations the authors report several specific aspects of the disease of orthopaedic interest. PMID- 2696449 TI - [Classification of acetabular fractures]. AB - Morphologic classification of fractures, however analytical they may be, is not sufficient to give precise indications as to the most adequate management decision for the various types of fractures of the acetabulum. The authors therefore find it necessary to typify these fractures on the basis of some anatomical and radiographic elements that may cause the prognosis to vary from case to case even in the same type of fracture. Two of the most important typifying factors are: articular congruity and the damage to the weight-bearing dome. The authors point out that such factors are necessary elements in the choice of a logical management decision and consider illogical an aprioristic approach whether surgical or not. PMID- 2696450 TI - [Osteoid osteoma of the olecranon fossa. Presentation of a clinical case]. AB - We report one case of osteoid osteoma of olecranon fossa in a female with pain and functional limitation of the elbow. The articular variety of osteoid osteoma is relatively uncommon and its diagnosis is very difficult. Conventional radiology, tomography and scintigraphy are employed for diagnosis, however computed axial tomography is particularly useful for diagnosis and correct treatment of osteoid osteoma of olecranon fossa. PMID- 2696451 TI - [A rare case of massive osteolysis (Ghoram's syndrome)]. AB - The authors report a case of massive osteolysis of the right shoulder in a woman aged 53 years, characterised by progressive evolution with spontaneous arrest 8 months after onset. The diagnosis of Ghoram's syndrome was based on a histologic examination revealing evident vascular neoformation, radiographic and clinical evolution. PMID- 2696452 TI - [The heart and diabetes. An anatomo-clinical study]. AB - We performed a retrospective study in 72 autopsies of diabetic patients (DMP) selected out of 2,239 adult autopsies, comprehending the period between 1966 to 1982. In order to analyse the possible Diabetic Cardiomyopathy, the DMP were divided into 8 groups according to the presence or the absence of Myocardial Fibrosis (MF) and Congestive Heart Failure (CHF). The Diabetes Mellitus (DM) incidence according to the race, sex, age and the presence of Kimmestiel-Wilson (KW) were in agreement with the literature data. The majority of the deaths occurred after the sixth-decade and we did not find any DMP with Malignant Hypertension. Hypertension and Coronary Artery Disease (CAD) increased the frequency of anatomical cardiac alterations, as follows: 1. MF was more associated with CAD, 2. Hypertension was more frequent in DMP with KW in the nodular form; 3. Hypertension increased the frequency of left ventricular hypertrophy; 4. Myocardial Infarction occurred in the absence of occlusive vascular phenomena. The Myocardial Fibrosis (MF) observed in DMP without ACD and without hypertension may be final anatomic demonstration of a gradual metabolic functional process, and not the basic mechanism of the CHF in the possible Diabetic Cardiomyopathy. PMID- 2696453 TI - [Magnesium and acute myocardial infarction: therapeutic implications]. PMID- 2696454 TI - The functions of blood vessel wall cells in atherogenesis and coronary artery disease. PMID- 2696455 TI - [Hemoculture in patients with infective endocarditis. Current patterns and our experience]. PMID- 2696456 TI - [Structure of the plica vocalis in the human]. PMID- 2696457 TI - Augmentation of labour: does oxytocin titration to achieve preset active contraction area values produce better obstetric outcome? AB - The value of quantifying active contraction area to guide oxytocin titration in augmentation of labour was investigated by a randomised trial. Sixty-eight nulliparae with slow progress of labour had oxytocin titrated to achieve preset "optimal" active contraction area or "optimal" frequency of contractions in a randomised manner. There was no difference in maternal characteristics of age and height, pre-augmentation period of observed labour or cervical dilatation at the onset of augmentation between the 2 groups. The maximum dose of oxytocin, post augmentation period and the number of operative deliveries were similar. There was no difference in the mean birth weight of neonates, or in the number of neonates who had low Apgar score or acidotic cord arterial blood pH. Our results suggest that there may be no advantage in oxytocin titration to achieve preset "optimal" active contraction area compared with "optimal" frequency of uterine contractions in nulliparae with slow progress of labour. PMID- 2696458 TI - The development of sleep-wakefulness cycle and its correlation to other behavior in the human fetus. AB - Fetal rapid eye movements (REM), breathing movements (BM), and trunk movements (TM) were observed through the use of 3 ultrasonic real-time scanners. Each movement was recorded with the event marker and quantitatively analyzed in relation to the development of the sleep-wakefulness cycle by a computer-assisted system. The results were as follows: The number of REM increased with gestational age. The appearance rate of REM reached a certain level after 32 weeks of gestation. REM-non-REM rhythm was distinguished after 32 weeks. The relationship between REM and BM increased with gestational age. The occurrence of each TM has no correlation to that of REM when it was analyzed in short-term units, but the incidence of TM was high in REM periods. These results demonstrate the course of the development of sleep-wakefulness cycle in human fetuses. PMID- 2696459 TI - Current treatment concepts in arthritis. AB - Some forms of arthritis cause few symptoms and little or no disability, while others cause severe pain, deformity and loss of function, and may even be fatal. Management must vary accordingly between the simple and the complex, the latter necessitating the use of potentially toxic agents. This article highlights some therapeutic approaches and emphasises the factors that influence the decision making process. Some areas of difficulty are discussed, particularly the treatment of dyspepsia in chronic arthritis. PMID- 2696460 TI - Pain management for the elderly. AB - Pain management for the elderly is based on the same principles as for all other age groups. There is no evidence that the elderly patient and the young patient perceive pain differently. Pain management should aim at achieving a specific diagnosis and a specific treatment with the appropriate choice of analgesic used in the optimal regimen and should give attention to all other factors contributing to the patient's suffering. Geriatric medicine uses an essentially multidisciplinary approach to treatment of medical problems, and this doctrine should apply to treatment of pain. PMID- 2696461 TI - Narcotics in acute pain. AB - Opioids are the mainstay of therapy for acute pain for both medical and surgical conditions. An understanding of their actions and a basic knowledge of pharmacokinetics and pharmaceutical preparation will enable a doctor to optimise the treatment of acute pain. If the basic principles are taken into account there is no reason now to allow patients to be distressed by inadequate analgesia. PMID- 2696462 TI - The pain of RSI. The central issue. AB - In this paper RSI (repetition strain injury) is used to refer to those diffuse neck and arm pain syndromes that appear to be directly related to occupational factors; for example, occupational overuse syndrome (OOS) and occupational cervicobrachial disorder (OCD). The author examines the clinical evidence that suggests the involvement of neural tissues in the pathogenesis of these conditions. He also speculates on the possible underlying pathophysiological mechanisms that may explain their development and persistence. PMID- 2696463 TI - [A promising search for substances, suppressing the development of the human immunodeficiency virus, among natural and semisynthetic antibiotics]. AB - Perspectives of search, among natural and semisynthetic antibiotics, for inhibitors of different stages of the human immunodeficiency virus replication are discussed. The compounds which inhibit the virus absorbtion, reverse transcription, viral mRNA synthesis, viral protein translation or viral glycoprotein processing are presented. PMID- 2696464 TI - [Mechanisms of transcutaneous absorption. Pharmacologic and biochemical aspects]. AB - Known and potential mechanisms of transcutaneous permeation or resorption of drugs are discussed. The relatively well documented transcellular route is passable for compounds with a low molecular mass (up to about 2000 Da) and sufficient lipid as well as water solubility. Because of the limited absorption capacity of the skin and the slow progress of absorption systemic effects of cutaneously applied drugs with the mentioned properties may be expected only, if they are acting in low concentrations and if a retarded onset of action is tolerable. Further compounds which do not fulfil these conditions sufficiently may be transported through the skin under the aid of exogenic factors such as permeation enhancers. Advantages, disadvantages and limitations of transdermal drug therapy as compared with other routes of application are discussed. Finally the question is dealt with, if the transcutaneous route can be opened also for polar compounds with a higher molecular mass. The permeation of such compounds could take place through intercellular clefts, which are reported to have dimensions permitting the passage of compounds with a molecular mass greater than 2000 Da. The transfer through the masses filling the clefts may require, however, the aid of sorption enhancers. PMID- 2696465 TI - [Physicochemical and toxicologic aspects of partial glycerides as carrier systems for transdermal systems]. AB - Lipid containing carrier systems are increasingly important for an intercellular transport of drugs. Out of the numerous lipids, triglycerides and partial glycerides of medium chain fatty acids have become of particular interest as absorption promoters. Their chemical and physical properties as well as their analysis are described. Being lipids which are endogenous or very similar to those, they are distinguished by a very low oral and dermal toxicity and a good tolerance. Also at mucous membranes no morphological changes occur. PMID- 2696466 TI - [Aspects of tolerance to transdermal systems from the dermatologic viewpoint]. AB - If active drugs are required to penetrate the skin in order to reach the systemic circulation the integrity of the skin has to be impaired. The nature of the horny layer which, as the uppermost barrier takes over the main part of the protective function of the skin against all locally applied substances, is shortly outlined. It is demonstrated that inactive ingredients of transdermal therapeutic systems should induce only the minimum irritation of the horny layer which is absolutely necessary for the action of the system. A good tolerance seems to be granted only if an occlusion at all events is of a short duration, and the sebum deficiency and the vulnerability of the aging skin as well as the xerosia and residual syndets in the horny layer after frequent washing, baths or showers are taken into account. Furthermore, the potential risk for skin sensitization is discussed as each patch application can primarily induce a sensitizing potential for the applied active or inactive ingredient, which possibly may cause a contact eczema on repeated therapy. However, only a wide application and unfortunately not the clinical trial will supply detailed information on this aspect of risk. PMID- 2696467 TI - Antiviral effects of recombinant interferon alfa and clinical experience in viral infections. AB - Alpha interferons act virostatically by influencing several cellular enzymes involved in virus replication. The success of treatment with biosynthetic recombinant interferon alfa-2b (rIFN alfa-2b) has been confirmed in numerous clinical studies. Following intralesional injection, up to 56% of condylomata acuminata were totally eradicated. Laryngeal papillomatosis responded favourably to systemic therapy with various alpha-interferons, demonstrating complete remissions of up to 88%. Preliminary therapeutic trials using rIFN alfa-2b in chronic viral hepatitis (B, Delta, non-A, non-B) consistently showed beneficial effects on the disease-related biochemical, virological and histological parameters. Interferon alfa-2b proved particularly effective in the early stage of AIDS-associated Kaposi's sarcoma. PMID- 2696469 TI - Categories of large-scale containment for manufacturing processes with recombinant organisms. PMID- 2696468 TI - Malaria vaccines: overview and perspective for developing countries. PMID- 2696470 TI - Bacillus brevis, a host bacterium for efficient extracellular production of useful proteins. PMID- 2696471 TI - Fermentation monitoring and control: a perspective. PMID- 2696472 TI - The acetone-butanol-ethanol fermentation: recent progress in technology. PMID- 2696473 TI - Microbiological inventions and the patent law--international developments. PMID- 2696474 TI - Animal cell culture collections and the supply of authenticated cultures and services for industry and research. PMID- 2696475 TI - Immobilized biosystems in research and industry. PMID- 2696476 TI - Comparison of two chemical cleavage methods for preparation of a truncated form of recombinant human insulin-like growth factor I from a secreted fusion protein. AB - We have produced a naturally occurring variant of human insulin-like growth factor I, truncated by three amino acids at the amino terminus. The polypeptide is obtained as a fusion protein in Escherichia coli. The fusion partner is a synthetic IgG-binding peptide. During fermentation the fusion protein is secreted into the medium, and is purified on IgG--Sepharose prior to cleavage. Two different genes for the fusion protein were used, allowing chemical cleavage at either a tryptophan linker or a methionine linker between the fusion partner and the growth factor, using N-chlorosuccinimide (NCS) or cyanogen bromide (CNBr) respectively. A partial CNBr cleavage yielded the native peptide, whereas the NCS cleavage yielded a product in which the single methionine had been oxidized to the sulfoxide. The forms from both cleavage methods exhibited biological activity and were characterized after purification to homogeneity. Both cleavage methods gave products having correct N- and C-terminal ends. The purified product had a biological activity equal to that of corresponding material from natural sources, 15 000 U/mg. Modified forms of truncated IGF-I were also identified, purified and characterized. Modifications such as proteolysis and misincorporation of norleucine for methionine occurred during biosynthesis, while oxidation of methionine took place during both fermentation and chemical cleavage. PMID- 2696477 TI - The role of phosphorylation in the action of nerve growth factor. AB - Although there is a great deal of information available about the biological effects of nerve growth factor, the detailed mechanism(s) by which it works is still not known. Some general outlines, however, are becoming clear. It is known that a number of second messenger systems are recruited and there is evidence that this recruitment has functional consequences. There is also increasingly strong evidence that nerve growth factor causes the activation of parallel pathways of phosphorylative cascades leading to changes in the phosphorylation and, consequently, in the function of key proteins throughout the cell. It can be suggested that changes in the phosphorylation of nuclear proteins initiate the alterations in gene expression known to occur after nerve growth factor treatment, which underlie the dramatic changes in the overall biology of nerve growth factor-responsive cells. PMID- 2696478 TI - Non-redox roles for iron-sulfur clusters in enzymes. AB - In recent years a number of enzymes have been discovered which, contrary to prior expectations, contain FeS clusters but do not participate in redox reactions. In all cases but one, where the FeS cluster in these enzymes has been identified, it is a [4Fe-4S] cluster. In mammalian aconitase a single Fe atom of the [4Fe-4S] cluster participates in catalysis of hydration-dehydration reactions by direct ligation to the substrates. A number of hydrolyases containing FeS clusters have now been identified. In Bacillus subtilis glutamine phosphoribosyl-pyrophosphate amidotransferase the [4Fe-4S] cluster is essential for the active structure of the enzyme, but probably does not participate directly in catalysis. Rather, the cluster may serve as part of a mechanism of oxidative inactivation of the enzyme in vivo, which is followed by its intracellular degradation. The role played by a [4Fe-4S] cluster in Escherichia coli endonuclease III is at present completely unknown. Thus, a number of novel roles for FeS clusters in enzymology and protein structure have been discovered, and more novel findings must be anticipated. PMID- 2696479 TI - Nerve growth factor in human amniotic and cerebrospinal fluid. AB - Nerve growth factor (NGF) is a polypeptide hormone involved in development of the sympathetic and central nervous systems. The detection and measurement of NGF in clinical samples would be useful in evaluating its role in various disease states. In this report, NGF activity and protein levels have been investigated in human amniotic fluid and cerebrospinal fluid samples. In amniotic fluid, NGF activity was found at levels ranging from less than 10 pM to nanomolar. The activity in all samples was blocked by polyclonal and monoclonal antibodies to mouse NGF. The finding of NGF in clinically obtainable samples raises the possibility of correlating NGF levels with a variety of disorders in which changes in NGF levels or activity have been implicated. PMID- 2696480 TI - Present status of tumor immunology in clinical gynecology. AB - The function of the immune system is to protect the body from damage caused by invading microorganisms, that is, bacteria, viruses, fungi, and parasites. The humoral mechanism functions through plasma cells producing antibodies that control bacterial infections. Viruses, fungi and parasites are controlled through the thymus dependent T lymphocytes. It is now clear that cancers also invoke immunologic reactions in their hosts. Cancer cells, like bacteria and viruses have their own characteristic antigens. An antigen is defined as a substance, usually a protein or polysaccharide, that the body recognizes as foreign, and to whose presence it reacts by forming antibodies. Antigenic differences represent the first known qualitative distinction between cancer cells and their normal counterparts. These qualitative differences between normal and cancer cells had escaped other methods of investigation, but were revealed by immunological techniques that take advantage of the extraordinary power of discrimination of the immune defense mechanism itself. This mechanism is capable of distinguishing even minute differences between protein molecules, probably one different amino acid in a chain of several thousand. Burnet's clonal selection theory has become the central dogma of immunology. It can be summarized by saying that lymphocytes have been destined from time immemorial to identify a specific antigen. When the lymphocyte encounters that antigen it becomes a sensitized lymphocyte, and on contact with similar antigens again produces an immune response including the production of very potent pharmacologic agents called lymphokines. Immunodeficiency diseases are identified by increased frequency of infections in patients. The impaired immunity decreases the patient's protection against developing a malignancy. Autoimmunity is the reaction of the immune system against the body's own tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696481 TI - Similarities between immunoregulation in pregnancy and in malignancy: the role of prostaglandin E2. PMID- 2696482 TI - Feed that burn. James Ellsworth Laing prize-winning essay for 1989. PMID- 2696483 TI - Management of partial skin thickness burn wounds with Inadine dressings. AB - In a prospective randomized trial, 213 consecutive patients with less than 10 per cent BSA partial thickness burns were treated as outpatients with either Bactigras (n = 102) (tulle gras dressing with 0.5 per cent Chlorhexidine Acetate B.P.) or Inadine (n = 111) (rayon dressing with 10 per cent povidone iodine ointment). Inadine caused less bleeding on dressing removal but not significantly less. Inadine treated patients required less analgesia, a reduced treatment time, a smaller number of hospital visits and less time off work/normal activities (P = 0.01). Inadine should be more widely used in the management of partial thickness burn wounds. PMID- 2696484 TI - T cell repertoire selection during development. PMID- 2696485 TI - Cellular mechanisms of self-tolerance. PMID- 2696486 TI - Cyclosporin A: recent developments in the mechanism of action and clinical application. PMID- 2696487 TI - Immunoadjuvants and analogs of immunomodulatory bacterial structures. PMID- 2696488 TI - The influence of diet and environment. AB - I have reviewed a small fraction of the vast literature on the influence of diet, food antigens, and environment on the immune response and would like to emphasize three points. Excess dietary lipid is thought to have a crucial role in inducing obesity and many age-related diseases including cardiovascular disease, malignancy and autoimmune diseases. Micronutrients are involved in protecting the functional integrity of the immune system, particularly to overcome the anti oxidant deficiency present in refined diet components. Finally, environmental influences such as UV radiation or air pollutants may have an adverse effect in the modification of immune functions when combined with dietary and nutritional factors. It appears that future studies should be directed to understanding the overall interactions of diet and environmental factors, including those of food and viral antigens, and the impact that these have on the maintenance and gene expression of an active and vigorous immune system in healthy and diseased states. PMID- 2696489 TI - Immune response. PMID- 2696490 TI - Immunomodulation. PMID- 2696491 TI - Early development and cell commitment. PMID- 2696492 TI - Transdifferentiation in animals. A model for differentiation control. PMID- 2696493 TI - Genomic activation in differentiated somatic cells. PMID- 2696494 TI - Neoplastic cells. Modulation of the differentiated state. PMID- 2696495 TI - Fate and nuclear localization of germinal vesicle proteins during embryogenesis. PMID- 2696496 TI - Genomic imprinting in the mouse. PMID- 2696497 TI - Developmental regulation of the heat-shock response. PMID- 2696498 TI - The history of photocoagulation. PMID- 2696499 TI - Ivermectin treatment of onchocerciasis. AB - Ivermectin is a recently developed macrocyclic lactone that has widespread antiparasitic activity. A series of clinical trials has shown that ivermectin is safe and effective in the treatment of human infection with Onchocerca volvulus. Although it is rapidly microfilaricidal, it does not cause a severe reaction as is seen with diethylcarbamazine treatment. The drug also temporarily interrupts production of microfilaria but has no known long-lasting effects on the adult worms. In patients with onchocerciasis, a single oral dose of ivermectin (150 micrograms/kg) repeated once a year leads to a marked reduction in skin microfilaria counts and ocular involvement. At this dose, ivermectin causes minimal side effects and appears to be sufficiently free of severe adverse reactions to be used on a mass scale. Its use promises to revolutionise the treatment of onchocerciasis. PMID- 2696500 TI - Dystrophin abnormalities in Duchenne/Becker muscular dystrophy. PMID- 2696501 TI - ras p21 protein promotes survival and fiber outgrowth of cultured embryonic neurons. AB - Although evidence obtained with the PC12 cell line has suggested a role for the ras oncogene proteins in the signal transduction of nerve growth factor-mediated fiber outgrowth, little is known about the signal transduction mechanisms involved in the neuronal response to neurotrophic factors in nontransformed cells. We report here that the oncogene protein T24-ras, when introduced into the cytoplasm of freshly dissociated chick embryonic neurons, promotes the in vitro survival and neurite outgrowth of nerve growth factor-responsive dorsal root ganglion neurons, brain-derived neurotrophic factor-responsive nodose ganglion neurons, and ciliary neuronotrophic factor-responsive ciliary ganglion neurons. The proto-oncogene product c-Ha-ras also promotes neuronal survival, albeit less strongly. No effect could be observed with truncated counterparts of T24-ras and c-Ha-ras lacking the 23 C-terminal amino acids including the membrane-anchoring, palmityl-accepting cysteine. These results suggest a generalized involvement of ras or ras-like proteins in the intracellular signal transduction pathway for neurotrophic factors. PMID- 2696502 TI - A molecular framework for the actions of glucocorticoid hormones in the nervous system. PMID- 2696503 TI - Small inhibitory cerebellar interneurons grow in a perpendicular orientation to granule cell neurites in culture. AB - When explants or reaggregates of small neurons from early postnatal mouse cerebella are plated on a mixture of laminin and poly-D-lysine, one observes small cells with an orientation of processes largely perpendicular to the direction of granule cell neurites after several days. These cells first have a bipolar morphology and then elaborate a rich dendritic arbor-like structure opposite a long, thin axon-like process. Several lines of evidence suggest that these cells are the small inhibitory interneurons of the cerebellar cortex: They take up GABA, express high levels of the embryonic form of N-CAM, do not express L1, the oligodendrocyte marker O4, or the glial marker vimentin, and display ultrastructural features reminiscent of stellate and/or basket cells in vivo. These observations suggest that the elaboration of directional positioning of small inhibitory interneurons can be studied in culture, thus offering the possibility to elucidate the cellular and molecular mechanisms underlying the orientation of particular neural cells with regard to others. PMID- 2696504 TI - Selective modulation of NMDA responses by reduction and oxidation. AB - Electrophysiological responses to the glutamate analog N-methyl-D-aspartate (NMDA) measured in three different central neuronal preparations are subject to a novel modulatory mechanism: they are substantially potentiated after exposure to the disulfide reducing agent dithiothreitol, while oxidation with 5-5-dithiobis-2 nitrobenzoic acid decreases the magnitude of the response. Modification of the NMDA response by either oxidation or reduction does not appear to affect the pharmacological properties of the receptor-channel complex. Since we observe that the redox state of the native receptor-channel complex varies widely among neurons, an in vivo mechanism that can strongly regulate NMDA-activated functions by either reduction or oxidation may exist. In addition, these results suggest that it may be possible to design specific redox agents for characterizing the NMDA receptor-channel complex. PMID- 2696505 TI - A randomized comparison of labetalol and nitroprusside for induced hypotension. AB - In a randomized study, labetalol-induced hypotension and nitroprusside-induced hypotension were compared in 20 patients (10 in each group) scheduled for major orthopedic procedures. Each patient was subjected to an identical anesthetic protocol and similar drug-induced reductions in mean arterial blood pressure (BP) (50 to 55 mmHg). Nitroprusside infusion was associated with a significant (p less than 0.05) increase in heart rate and cardiac output; rebound hypertension was observed in three patients after discontinuation of nitroprusside. Labetalol administration was not associated with any of these findings. Arterial PO2 decreased in both groups. It was concluded that labetalol offers advantages over nitroprusside. PMID- 2696506 TI - Onset of action between bupivacaine 0.5% and bupivacaine 0.5% plus fentanyl 75 mcg. AB - This study tested the hypothesis that the addition of fentanyl 75 mcg to bupivacaine 0.5% at the onset of epidural anesthesia for cesarean section reduces the onset time for T4 sensory blockade. The study was conducted in a randomized, double-blind fashion. The same observer performed sensory testing using pain to pinprick. Fourteen ASA I patients scheduled for elective cesarean section had epidural catheters placed. Group 1 (n = 7) received bupivacaine 0.5%, and group 2 (n = 7) received bupivacaine 0.5% plus fentanyl 75 mcg. Patients 5'0'' to 5'4'' in height received 15 ml, and patients 5'5'' to 5'9'' received 20 ml of bupivacaine. There were no adverse effects on the neonate or clinically important changes in maternal hemodynamics. The maternal age, height, weight, and bupivacaine dose did not differ between groups (p greater than 0.05). For group 1, the mean times for sensory loss at T7, T6, T5, and T4 were 13.1 +/- 3.8 minutes, 15.0 +/- 4.0 minutes, 16.9 +/- 4.3 minutes, and 19.3 +/- 4.9 minutes, respectively; for group 2, the mean times were 8.1 +/- 0.9 minutes, 9.9 +/- 1.1 minutes, 11.3 +/- 1.5 minutes, and 12.7 +/- 2.0 minutes, respectively. Two-factor analysis of variance between groups 1 and 2 showed a significant difference (p less than 0.0001), representing a 35% reduction of mean onset time. The coefficient of variation of the mean onset times for group 1 subjects was 26.6% +/- 1.7% and for group 2 subjects 12.7% +/- 2.2% (p less than 0.001), representing a 50% reduction in between-subject variation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696507 TI - Partial attenuation of hemodynamic responses to rapid sequence induction and intubation with labetalol. AB - The effectiveness of labetalol (a combination nonselective beta and alpha-1 adrenergic receptor antagonist) in modifying hemodynamic responses associated with rapid sequence induction and tracheal intubation was evaluated. In a double blind study, 24 ASA physical status I or II male patients scheduled for elective surgery were given either IV labetalol, 0.25 mg/kg (n = 8) or 0.75 mg/kg (n = 8), or a saline placebo (n = 8). Five minutes later, patients were given oxygen by mask and IV vecuronium, 0.01 mg/kg. Ten minutes after giving labetalol or placebo, cricoid pressure was applied and anesthesia was induced with IV sodium thiopental (4 mg/kg) and succinylcholine (1.5 mg/kg) 1 minute prior to intubation. The mean duration of laryngoscopy was 17 +/- 3 seconds. Prior to induction, the 0.25 mg/kg and 0.75 mg/kg doses of labetalol significantly (p less than 0.05) reduced mean arterial pressure by 4.4 +/- 1.9 and by 8.6 +/- 2.0 mmHg, respectively, but did not significantly alter heart rate or cardiac output. The 0.75 mg/kg dose of labetalol also significantly (p less than 0.05) decreased total peripheral resistance by 10.1 +/- 3.0%. Within 30 seconds after intubation, patients in all three groups exhibited increases in heart rate, mean arterial pressure, total peripheral resistance, and rate pressure product and a decrease in stroke volume. However, patients in the 0.25 and 0.75 mg/kg labetalol groups, compared to those in the placebo group, had significantly lower increases in peak heart rate (33 +/- 2 and 27 +/- 3 vs. 44 +/- 7 beats/minute), peak mean arterial pressure (38 +/- 6 and 38 +/- 7 vs. 58 +/- 7 mmHg), and peak rate pressure product (7,726 +/- 260 and 7,215 +/- 300 vs. 14,023 +/- 250 units). The results show that these doses of labetalol significantly blunt, but do not completely block, autonomic responses to rapid sequence induction and intubation. PMID- 2696508 TI - Perioperative subcutaneous emphysema: review of differential diagnosis, complications, management, and anesthetic implications. AB - Subcutaneous emphysema is not an uncommon anesthetic complication, but it often occurs unexpectedly. It is usually self-limited, but mediastinitis can occur with mortality as high as 50%. A case of subcutaneous emphysema occurring during dental surgery is reported here. The diagnosis, management, complications, and pathogenesis are discussed. PMID- 2696509 TI - Crystalloid or colloid: does it matter? AB - The modern version of the crystalloid-colloid debate has continued for more than 25 years, and a current appraisal of the debate is presented here. Although the effect of crystalloids and colloids on intravascular volume is important, their effect on interstitial fluid volume after hemorrhage and hemorrhagic shock is central to the debate. If reduced, crystalloids are appropriate as part of the resuscitation regime; if increased, colloid therapy is more logical. A brief review of the distribution of crystalloids and currently used colloids (albumin, polygeline, dextran 70, and hydroxyethyl starch) is presented. The problems of pulmonary and peripheral edema also are presented, as is an appraisal of adverse reactions to colloids together with a cost comparison of crystalloids and colloids. The results of a survey of attitudes at the major Australian anesthetic departments are given, and a personal approach to fluids in resuscitation is outlined. PMID- 2696510 TI - Expression of the fibronectin gene. AB - Fibronectin (FN) is an extracellular matrix protein that acts as a substrate for cell migration and adhesion during development. FN adheres to cells through a dimeric membrane protein, the FN receptor. Antibodies to FN and synthetic peptides that inhibit FN-receptor interaction inhibit gastrulation, block neural crest cell migration, arrest cardiac development, and block the fusion of myoblasts to form myotubes. FN and its receptor also appear to be important for lung development, where their expression coincides with the onset of branching morphogenesis, but drops to barely detectable levels in adult lung, indicating developmental specificity. FN expression is generally low in most adult tissues. However, synthesis is drastically increased during injury and wound healing, a process that in many ways mimics development. FN synthesis is also drastically increased in fibroproliferative lung lesions associated with major architectural changes in the lung. Expression of FN is regulated by a variety of growth factors and hormones. Several of these inducers (cAMP, transforming growth factor-beta, epidermal growth factor, platelet-derived growth factor, glucocorticoids, and vitamin D3) have themselves been implicated in developmental processes, and both cAMP and transforming growth factor-beta are known to stimulate expression of other matrix genes. One role of these hormones and growth factors in development may be to control expression of matrix genes, thereby controlling cell migration and adhesion. In the following report, the effect of hormones and growth factors on expression of the FN gene is reviewed. PMID- 2696511 TI - Collagen gene expression. AB - Collagens are extracellular matrix proteins that play important structural roles in many tissues and organs. Thirteen types of collagen, the products of 23 genes, have been described. Most of the collagen genes are developmentally regulated; a given tissue or cell type expresses only a subset of the collagen genes. Type I collagen, the most abundant protein in vertebrate connective tissues, is produced by most cells of mesenchymal origin except hyaline cartilage. Each tissue or cell type expresses the type I collagen genes at a characteristic rate. Maintenance of the normal synthetic rate appears to be important for preservation of normal tissue structure and function. Fibrotic lesions are characterized by increased production of type I collagen. The mechanisms that determine both the normal tissue-specific pattern of type I collagen gene expression and the elevated expression in fibrosis are complex. Both transcriptional and post-transcriptional mechanisms have been described, with modulation of mRNA stability being perhaps the most important post-transcriptional mechanism. Several sequences have been identified in the promoters of the type I collagen genes which are required for transcriptional activity; in addition, transcriptional enhances have been identified within the first introns of the genes. Type I collagen gene expression is also regulated both positively and negatively by a variety of exogenous factors, including inflammatory response mediators. The specific combination of such exogenous factors available in a given tissue probably determines the net rate at which the genes are expressed. PMID- 2696513 TI - Transepithelial transport of immunoglobulins: a model of protein sorting and transcytosis. PMID- 2696512 TI - Increased expression of PDGF-B (c-sis) mRNA in rat lung precedes DNA synthesis and tissue repair during chronic hyperoxia. AB - Several aspects of tissue response to injury, including cell proliferation, cell migration, and deposition of extracellular matrix, have been attributed to platelet-derived growth factor (PDGF)-like cytokines. Because these responses play key roles in lung injury, PDGF-B (c-sis) gene expression was measured by Northern blot analysis of lung total RNA prepared after oxidant injury was induced by chronic exposure of rats to 85% oxygen for zero, 1, 3, and 7 days. Constitutive but low levels of PDGF-B mRNA (4.0 kb) were observed in the lungs of control animals exposed to 21% oxygen. Steady-state levels of PDGF-B mRNA in lung were elevated 2.5-fold by day 3 of hyperoxia and remained so up to at least day 7. The early increase in PDGF-B mRNA expression after 3 days of hyperoxic exposure preceded several other aspects of the reparative response. DNA synthesis measured by in vivo incorporation of [3H]thymidine into lung DNA was unchanged at day 3 but markedly elevated by day 7. A similar increase in extractable lung RNA implies a quantitative or qualitative change in extractable RNA at this later phase of tissue injury. Subtle changes in actin mRNA expression were also noted late in the course of lung injury. The content of cytoplasmic (beta,gamma) actin mRNA (2.1 kb) in lung was doubled after 7 days of hyperoxia (P less than 0.05). In addition, increased expression of an actin cDNA-hybridizing mRNA, which co migrates with muscle-specific alpha-actin mRNA (1.7 kb), was detected on day 7, suggesting hyperplasia of smooth muscle and myofibroblasts. These data show that PDGF-B transcripts are constitutively expressed in rat lung tissue. The expression of PDGF-B mRNA increases early in the course of hyperoxic lung injury and precedes an increase in DNA synthesis and other responses that reflect tissue remodeling. These results suggest that the production of PDGF-like cytokines by cells within the lung itself initiates or modulates various aspects of lung injury and repair. PMID- 2696514 TI - PAF--a perspective. PMID- 2696515 TI - Eosinophils and fibroblasts: the medium in the mesenchyme. PMID- 2696517 TI - Immunopathology of experimental bronchiectasis. AB - In human bronchiectasis, the bronchial wall is the seat of abnormal mononuclear cell infiltration, which suggests the presence of a cell-mediated immune reaction. The histopathology of a recently devised animal model of experimental bronchiectasis resembles that of the human disease. We have investigated its immunohistology to validate the similarity to that of human bronchiectasis in order to provide a model for the study of cellular immune aspects of the pathogenesis of bronchiectasis. The immunohistology of the bronchial wall mononuclear cell population in experimental rat bronchiectasis was compared with that in control and normal rats. The control rats did not develop bronchiectasis, and the composition and distribution of mononuclear cells in the bronchial wall were similar to those of normal animals. In the rats developing bronchiectasis, there was infiltration of T lymphocytes, macrophages, and dendritic cells (as defined by monoclonal antibodies) in all compartments of the lung, particularly in the bronchial wall and around vessels. The bronchus-associated lymphoid tissue was disrupted by heavy infiltration of T cells, and follicular aggregates of T lymphocytes were seen deeper in the lung parenchyma. Expression of Ia antigen increased in the bronchial epithelium and in large numbers of mononuclear cells throughout the lung. These findings suggest that a cell-mediated immune response appears during the development of experimental bronchiectasis in this rat model. This cellular immune response is similar to that described in human bronchiectasis and may enable this animal model to be used in defining the role of cellular immunity in the pathogenesis of bronchiectasis. PMID- 2696516 TI - Human lung fibroblast-derived granulocyte-macrophage colony stimulating factor (GM-CSF) mediates eosinophil survival in vitro. AB - Tissue eosinophilia has been reported to occur in pulmonary fibrosis, a disease characterized by chronic inflammation and lung fibroblast proliferation. We have examined the in vitro interaction of these two cell types by determining the in vitro survival of human peripheral blood eosinophils co-cultured with human lung fibroblasts. Survival of eosinophils cultured alone was 10% at day 3 and less than 1% at day 7. In contrast, survival of eosinophils that had been co-cultured with fibroblasts was 98, 90, 73, and 69% at days 3, 7, 10, and 14, respectively. Fibroblast-conditioned medium (CM) elicited a similar result in a dose-dependent fashion. Survival of eosinophils cultured with CM which had been preincubated with a monoclonal-neutralizing antibody to human GM-CSF was inhibited in a dose dependent manner. Human recombinant-derived GM-CSF supported eosinophil survival in the dose-dependent fashion. Survival at day 7 of eosinophils treated with one single dose of GM-CSF (10 U/ml) was 64%. The effect of fibroblast-CM on eosinophils likely represents true survival since eosinophil proliferation as determined by [3H]thymidine incorporation did not occur. We also report that freshly isolated eosinophils had normal ultrastructural, scanning and transmission electron microscopy characteristics, and were normodense. In contrast, eosinophils co-cultured for 7 days with fibroblasts acquired irregular shapes and became hypodense and partially degranulated. Thus, our results indicate that human lung fibroblast-derived GM-CSF mediates the in vitro survival of human eosinophils.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696518 TI - Nucleic acid probes in the diagnosis and study of avian nononcogenic viral disease. PMID- 2696519 TI - Advances in stunting and runting syndrome research. PMID- 2696521 TI - Long-term evaluation of direct repair of traumatic isthmic aortic transection. AB - Direct repair of traumatic aortic isthmic transection eliminates the late complications of prosthetic graft repair. This study evaluates the long-term fate of direct aortic repair to which little attention has been paid. Among 32 patients operated upon from 1965 to 1987, 27 (84%) underwent direct repair. The tear was circumferential in 15 patients and partial in 12. Multiple traumatic lesions were present in 26 patients, including intracranial injury in 19. Partial cardiopulmonary bypass was used in 15 patients and simple aortic cross-clamping in 12. No paraplegia was observed. There were 4 deaths from associated lesions among the 14 patients operated upon for acute traumatic isthmic transection and no deaths in the others. Among the 23 survivors, 4 were lost to follow-up; the other 19 patients have excellent clinical results. Intravenous digital aortic angiography performed in 14 patients at a mean delay of 5 years 3 months showed excellent aortic reconstruction in all cases. Technically more demanding and faster than a graft interposition, direct repair is recommended as the procedure of choice in the surgical treatment of traumatic isthmic transection, particularly in young patients, the group most at risk from this lesion. PMID- 2696520 TI - Molecular biology of Newcastle disease virus. PMID- 2696522 TI - Systolic and diastolic interaction in the assessment of left ventricular function following surgical cardioplegia. AB - Using regionally implanted sonomicrometry crystals, we have evaluated a new index of regional function (normalised systolic shortening [NSS]) which integrates the systolic and diastolic properties of the left ventricle. Eight dogs (group I) were subjected to standard cardiopulmonary bypass and 45 min of hypothermic (10 degrees C), hyperkalaemic (25 mEq) crystalloid cardioplegia. Seven dogs (group II) underwent occlusion of the left anterior descending (LAD) coronary artery 5 min prior to initiation of cardiac arrest. The occlusion was released after 20 min, before the second cardioplegia infusion. Sarnoff left ventricular (LV) function curves were performed pre-arrest and 20, 40 and 60 min after removal of the cross-clamp. Regional assessment of myocardial function showed 55% +/- 3%, 70% +/- 3% and 70% +/- 5% recovery in the LAD region and 52% +/- 2%, 83% +/- 3% and 88% +/- 4% recovery in the circumflex (Cx) region of group I. In group II the LAD region recovered 27% +/- 1%, 31% +/- 3% and 38% +/- 3% and the Cx region showed 61% +/- 3%, 55% +/- 1% and 65% +/- 5% recovery. Comparison of the new index of ventricular function to standard indices of regional and global function demonstrate that the latter underestimate the degree of myocardial dysfunction after cardioplegic arrest, particularly in situations of acute regional myocardial ischaemia and uneven myocardial protection. The utilization of this index should provide a better standard for the more accurate assessment of interventions designed to decrease myocardial injury during cardioplegic arrest. PMID- 2696523 TI - Primary mediastinal liposarcoma. A report of a case and review of the literature. AB - A case of primary liposarcoma of the mediastinum with a review of the literature is presented. Liposarcomas may attain a large mass and exhibit various kinds of clinical symptoms according to their localisation. Histological typing is very important in determining the type and extent of therapy. Surgical excision of the tumour is the therapy of choice in all cases. Radiotherapy may be of value for the palliation of unresectable cases. PMID- 2696524 TI - Cardiac catheterization in a freestanding setting. AB - Cardiac catheterization, originally performed only in hospital settings, is currently undertaken in hospital ambulatory and freestanding settings. Although use of the hospital ambulatory setting is accepted, questions have been raised about the safety and effectiveness of cardiac catheterization when performed in a freestanding setting. Critics have claimed that use of freestanding centers subjects patients to additional risk of complications without affording significant benefits. Proponents maintain that selected cardiac catheterization procedures can be performed in freestanding settings without exposing patients to increased risk. Available data on complication rates indicate that freestanding centers perform catheterizations with morbidity and mortality rates substantially lower than those reported in the literature for inpatient procedures. Although questions have been raised about the validity of these data, they suggest that cardiac catheterization can be performed in a freestanding setting with acceptable safety and effectiveness. PMID- 2696525 TI - Rapid MR imaging of renal perfusion: a comparative study of GdDTPA, albumin (GdDTPA), and magnetite. AB - MR contrast agents injected intravenously reach the kidney very rapidly. Modification of a gradient recalled echo sequence allowed acquisition of 32 sequential MR images each 3.9 s apart on a 1.5 T clinical imager. This sequence was then used to observe the renal accumulation of contrast agent following an intravenous bolus of 100 microns/kg GdDTPA, 60 microns/kg albumin-(GdDTPA) or 9.6 and 40 mg/kg of 0.7 mu magnetic latex microspheres in rats or rabbits. Serial changes in image intensity were obtained with 3.9 s temporal and 0.08 ml spatial resolution. The renal cortical response to GdDTPA was similar to changes in blood 1/T1, but the medulla showed first a signal enhancement owing to the initial increased T1 relaxation followed by loss of signal as increased concentrations caused T2 relaxation to become predominant. Changes in intensity caused by magnetite and albumin-(GdDTPA) correlated with the 1/T1 changes observed in blood samples consistent with the predominantly intravascular location of these two agents. We conclude that MRI provides high spatial resolution with sufficient temporal resolution to record tissue response to an intravenous bolus of MR contrast agents. PMID- 2696527 TI - Neonatal and pediatric ultrasonography. PMID- 2696526 TI - Cranial sonography: congenital anomalies. PMID- 2696528 TI - Liver diseases and portal hypertension. PMID- 2696529 TI - The biliary tract. PMID- 2696530 TI - Pediatric renal anomalies and infections. PMID- 2696531 TI - Pediatric and adolescent genital abnormalities. PMID- 2696532 TI - Infant hip. PMID- 2696533 TI - Pediatric Doppler applications. PMID- 2696534 TI - Cranial sonography: intracranial hemorrhage, periventricular leukomalacia, and asphyxia. PMID- 2696535 TI - Abdominal masses. AB - In summary, sonography plays an indispensable role in the evaluation of abdominal masses in infants and children. With meticulous scanning one can, in most instances, obtain sufficient information for accurate diagnosis and follow-up evaluation and thereby obviate the need for more invasive studies. PMID- 2696536 TI - Gastrointestinal tract. PMID- 2696537 TI - Fetal syndromes. PMID- 2696538 TI - Diagnosis and therapy of fetal anomalies. PMID- 2696539 TI - Fetal intrathoracic and gastrointestinal anomalies. PMID- 2696540 TI - Common fetal urinary tract anomalies. AB - The role of ultrasound in detecting fetal anomalies in general and genitourinary tract anomalies in particular has undergone, and continues to undergo, remarkable changes. The diagnostic process began with a focus on the structural nature of anomalies and now has moved forward to include a detailed assessment of the functional nature and sequelae of these lesions. Concurrent with this shift in diagnostic emphasis has been the development of the role of ultrasonography in guiding invasive diagnostic procedures, such as percutaneous fetal blood sampling and fetal urine aspiration, and in guiding therapeutic procedures, such as chronic in utero vesicoamniotic shunt placement. These changes are occurring against a background of the role of ultrasound in assessing pathophysiology of the anomaly and assignment of prognosis, two decisions that profoundly influence pregnancy management. The challenge for the perinatal ultrasonographer is now not only to recognize the lesion, but also to institute the further investigative steps upon which a rational management plan may be based. As illustrated in this brief review of the more common genitourinary tract anomalies, the range of outcome and the pathophysiologic progression of the disease are both wide and complex. Continued improvements in ultrasound technologies and application hold the key to the ultimate reduction in the clinical significance of these common fetal diseases. PMID- 2696541 TI - The prenatal diagnosis of skeletal dysplasias. PMID- 2696542 TI - The placenta. PMID- 2696543 TI - The use of sonography for the antenatal detection of aneuploidy. PMID- 2696544 TI - Sonography of the fetal cranium. PMID- 2696545 TI - Invasive fetal therapy. PMID- 2696546 TI - Hydrops fetalis. AB - Sonography has a major role in the identification, evaluation, and treatment of the hydropic fetus. Although the prognosis of the NIH fetus is generally poor, the IIH fetus can frequently be treated effectively by transfusions performed by percutaneous needling of the umbilical vein. In addition, sonographic guidance of percutaneous umbilical vein sampling affords an accurate assessment of the etiology of NIH by facilitating karyotyping of the fetal blood. PMID- 2696547 TI - Neural tube abnormalities. PMID- 2696548 TI - Fetal echocardiography in the diagnosis and management of fetal heart disease. PMID- 2696549 TI - Fetal anatomy in ultrasonography. PMID- 2696550 TI - Soft tissue trauma: a randomised controlled trial of the topical application of felbinac, a new NSAID. AB - Two hundred and thirty-one patients with acute soft tissue injuries were treated in a double-blind placebo-controlled study of felbinac (biphenylacetic acid) gel applied three times daily to the injured site. Those treated with felbinac had significantly greater improvement at Day 4 (p less than 0.001) and Day 7 (p less than 0.02) than those who received placebo. Patients' self-assessment diary cards confirmed superiority of the active treatment as early as Day 2 of the study. Local skin reactions were few (three per cent), mild and recovered spontaneously. Felbinac is an effective management for acute soft tissue injuries and because of its topical application may be safer than oral non-steroidal anti-inflammatory drugs for the treatment of these conditions. PMID- 2696551 TI - Fulminating encephalopathy associated with Shigella flexneri. PMID- 2696552 TI - Localization of foetal antigen 2 (FA-2) in foetal and adult human skin. AB - Foetal antigen 2 (FA-2) is a connective-tissue-associated antigen isolated from second trimester human amniotic fluid. FA-2 has an alpha-electrophoretic mobility and is a single-chain molecule with a molecular weight of 26 kDa as determined by polyacrylamide gel electrophoresis (PAGE). Using indirect immunofluorescence and the immunoperoxidase technique, FA-2 was found to be in the lamina densa/sublamina densa region of the basement membrane zone (BMZ) in adult as well as in foetal skin. FA-2 was found throughout the dermis in foetal skin, whereas in adult skin it was found to be associated with the BMZ and around the blood vessels, hair follicles and eccrine glands. Intracellular FA-2 antigen was demonstrated in proliferating fibroblasts by the indirect immunoperoxidase technique and immunoelectron microscopy of the fibroblasts revealed staining of the antigen in the cisternae of the rough endoplasmatic reticulum at the trans side of the Golgi complex as well as in vesicles close to the plasma membranes. FA-2, a hitherto undescribed antigen associated with human BMZ, is probably being synthesized by proliferating fibroblasts. PMID- 2696553 TI - Clinical and photobiological characteristics of xeroderma pigmentosum complementation group F: a review of cases from Japan. AB - A 61-year-old female patient with xeroderma pigmentosum (XP), registered as XP46KO, was assigned to complementation group F by the cell fusion complementation method. The XP46KO fibroblasts in culture exhibited a defective DNA repair capacity of 10-15% unscheduled DNA synthesis and a 3-fold sensitivity to the lethal effect of 254 nm ultraviolet light compared with normal cells. The patient had mild clinical symptoms consisting of numerous pigmented freckles and a small number of seborrheic keratosis-like papules. She had no skin cancers in the sun-exposed areas of the skin and so far no neurological abnormalities. A review of 11 Japanese group F patients revealed very mild skin symptoms with no ocular or neuro-psychiatric abnormalities. Single skin cancers occurred in only 3 of the 11 patients with an average age of 52 years for their first skin malignancy. PMID- 2696554 TI - A double-blind, placebo-controlled trial of topical I,25-dihydroxycholecalciferol in psoriasis. AB - In a double-blind trial of topical I,25-dihydroxycholecalciferol in 47 patients with psoriasis no benefit was shown compared with placebo. PMID- 2696555 TI - Linear IgA dermatosis with severe arthralgia. PMID- 2696556 TI - [Isolation and study of the properties of specific antisera to [leu]enkephalin]. AB - The immunogenic conjugates of [leu]enkephalin and bovine serum albumin (BSA) with bisdiazobenzidine and 1,4-benzoquinone as bifunctional reagents have been synthesized. The antisera with high titer of antibodies to [leu]enkephalin have been obtained at rabbit [correction of rat] immunization by both conjugates. The antiserum obtained at immunization by conjugate [leu]enkephalin-benzoquinone-BSA possesses the high affinity and sensitivity to [leu]enkephalin. PMID- 2696557 TI - Immunocytochemical studies of aromatase in early and full-term human placental tissues: comparison with biochemical assays. AB - An immunocytochemical method for visualizing the aromatase P450 enzyme with a specific monoclonal antibody has been developed for use with unfixed, frozen tissue sections. We compared both monoclonal and polyclonal aromatase-specific antibodies and found that placental aromatase was consistently and exclusively located in the syncytiotrophoblast layer of chorionic villi. The monoclonal antibody had the highest affinity, with negligible associated background stain. Fixation was found to impair stain reaction. Examination of first trimester and term placentae revealed identical immunostaining patterns of similar intensity in 9 of 10 samples. The immunostain reactions of first trimester and term placentae were compared with their respective microsomal aromatase activity, determined simultaneously by both indirect radiometric tritiated water (3H2O) assay, and direct product isolation by HPLC, using [1, 2, 6, 7(-3)H] androstenedione as substrate. The two assays were found to be comparable for enzyme activity estimates of term placental specimens. However, when first trimester specimens were analyzed, the direct-product measurements were significantly larger than the corresponding 3H2O assay results. Nonetheless, biochemical aromatase activity was found to correlate positively with immunostain reaction. Although 17 beta hydroxysteroid dehydrogenase activity was not directly measured, differences in the estradiol:estrone product ratio (2.49 +/- 0.68 first trimester vs. 0.89 +/- 0.15 term) suggest differential control of this enzyme at the two stages of pregnancy. One first trimester specimen with an atypical, patchy immunostain distribution also had extremely low aromatase activity. The results indicate that both antibodies recognize functional aromatase enzyme and suggest that immunocytochemical detection is a sensitive, qualitative technique for investigating this important steroidogenic enzyme. PMID- 2696559 TI - Horse diversity through the ages. PMID- 2696558 TI - Neonatal treatment of male rats with a gonadotropin-releasing hormone antagonist results in altered function of the pituitary-testicular axis in adult age. AB - In most mammals, pituitary-testicular hormone secretion is very active during the perinatal period, but the physiological significance of this function for later pituitary-gonadal interactions and sexual maturation is largely unknown. Short term neonatal treatment with gonadotropin-releasing hormone (GnRH) antagonist results in delayed sexual maturation and infertility in male rats. We have now extended our earlier findings and studied in more detail the pituitary-gonadal function in adult rats after such neonatal treatment. In this study, the pituitary-testicular activity of newborn male rats was temporarily blocked by treatment with a GnRH antagonist analogue (N-Ac-4-Cl-D-Phe1, 4-Cl-D-Phe2, D-Trp3, D-Phe6, des-Gly10-GnRH-D-alanylamide; Organon 30039; 2 mg/kg s.c. twice daily) on Days 1-5 of life. Timing of puberty was slightly delayed in the treated rats (average: 2 days, p less than 0.05), as determined by the age of the balano preputial separation. In adult rats (90-110 days), only 3 of the 17 rats treated neonatally with GnRH antagonist were fertile (14 of 17 controls, p less than 0.01), despite normal circulating androgen levels. Pituitary and serum follicle stimulating hormone (FSH) levels were slightly but consistently elevated (20-30%; p less than 0.05) in antagonist-treated animals, whereas luteinizing hormone (LH) levels (both immunoreactive and bioactive) were unaffected. The pituitary contents of GnRH receptors were increased in antagonist-treated animals 85 +/- 6.6 (mean +/- SEM, n = 19) vs. 58 +/- 4.1 fmol/gland in controls (n = 20; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696560 TI - Do insects really have a homeostatic hypotrehalosaemic hormone? AB - Since trehalose in insects, in contrast to glucose in mammals, does not enter the haemolymph directly from the digestive tract, but is all synthesized by the insect itself, and furthermore an increased trehalose synthesis during stress and flight does not lead to significant increases in haemolymph trehalose, there seems to be no physiological need for an insect homeostatic hypotrehalosaemic hormone. Experiments in which tissue extractions were found to lower haemolymph trehalose can not prove the existence of such a hormone, while all insect species which so far have been submitted to a trehalose-tolerance test, decrease their haemolymph trehalose concentrations at a rate which can be accounted for by the metabolic use of trehalose. These results therefore indicate the absence, and not the presence, of a homeostatic hypotrehalosaemic hormone. This is also true for blowflies, from which an insulin-like immunoreactive peptide has been isolated. It seems therefore unlikely that this insulin-like peptide is a homeostatic hypotrehalosaemic hormone. The physiological mechanism by which this insulin-like peptide would have to act to function as a hypotrehalosaemic hormone is also an unlikely one. It therefore seems justified to conclude that so far, homeostatic hypotrehalosaemic hormones have not been demonstrated in insects. Furthermore, it may well be that they do not exist. PMID- 2696561 TI - Wild mice in the cold: some findings on adaptation. AB - The house mouse, Mus domesticus, can thrive in natural environments much below its optimum temperature. Thermogenesis is then above that at more usual temperatures. In addition, body weight, and the weights of brown adipose tissue and the kidneys, may be higher than usual. In free populations of house mice cold lowers fertility and may prevent breeding. Other possible limiting factors on breeding are food supply, shelter for nesting and social interactions. In captivity, wild-type house mice exposed to severe cold (around 0 degrees C) at first adapt ontogenetically by shivering and reduced activity. But raised thermogenesis is soon achieved without shivering; nest-building improves; and readiness to explore may be enhanced. Endocrine changes probably include, at least initially, a rise in adrenal cortical activity and in catecholamine secretion. Some females become barren, but many remain fertile. The maturity of fertile females is, however, delayed and intervals between births are lengthened; nestling mortality rises. A limiting factor during lactation may be the capacity of the gut. Similar adaptive changes are observed during winter in some species of small mammals that do not hibernate. But neither the house mouse nor other species present a single, universal pattern of cold-adaptation. Wild-type mice bred for about 10 generations in a warm laboratory environment (20-23 degrees C) change little over generations. In cold they become progressively heavier and fatter at all ages; they mature earlier, and nestling mortality declines. The milk of such 'Eskimo' females is more concentrated than that of controls. If 'Eskimo' mice are returned to a warm environment, they are more fertile, and rear heavier young, than controls that remained in the warm. Despite the heavier young, litter size is not reduced: it may be increased, probably as a result of a higher ovulation rate. Parental effects have been analyzed by cross-fostering and hybridizing. Survival, growth and fertility are all favourably influenced by the intra-uterine and nest environments provided by 'Eskimo' females. 'Eskimo' males are also better fathers. Hence after ten generations the phenotype of cold adapted house mice shows the combined effects of (a) an ontogenetic response to cold, (b) a superior parental environment and (c) a change genotype. The secular changes in the cold that lead to this phenotype give the appearance of evolution in miniature; but it is equally possible that they represent a genetical versatility that allows rapid, reversible shifts in response to environmental demands.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2696562 TI - Mycetocyte symbiosis in insects. AB - 1. Non-pathogenic microorganisms, known as mycetocyte symbionts, are located in specialized 'mycetocyte' cells of many insects that feed on nutritionally unbalanced or poor diets. The insects include cockroaches, Cimicidae and Lygaeidae (Heteroptera), the Homoptera, Anoplura, the Diptera Pupiparia, some formicine ants and many beetles. 2. Most mycetocyte symbionts are prokaryotes and a great diversity of forms has been described. None has been cultured in vitro and their taxonomic position is obscure. Yeasts have been reported in Cerambycidae and Anobiidae (Coleoptera) and a few planthoppers. They are culturable and those in anobiids have been assigned to the genus Torulopsis. 3. The mycetocyte cells may be associated with the gut, lie free in the abdominal haemocoel or be embedded in the fat body of the insect. The mycetocytes are large polyploid cells which rarely divide and the symbionts are restricted to their cytoplasm. 4. The mycetocyte symbionts are transmitted maternally from one insect generation to the next. In many beetles (Anobiidae, Cerambycidae, Chrysomelidae and cleonine Curculionidae), the microoganisms are smeared onto the eggs and consumed by the hatching larvae. In other insects, they are transferred from mycetocytes to oocytes in the ovary, a process known as transovarial transmission. The details of transmission in the different insect groups vary with the age of the mother (adult, larva or embryo) at which symbiont transfer to the ovary is initiated; whether isolated symbionts or intact mycetocytes are transferred; and the site of entry of symbionts to the egg (anterior, posterior or apolar). 5. Within an individual insect, the biomass of symbionts varies in a regular fashion with age, weight and sex of the insect. Suppression of symbiont growth rate and lysis of 'excess' microorganisms may contribute to the regulation of symbionts (including freshly-isolated preparations of unculturable forms) are used to investigate interactions between the partners. However, some methods to obtain aposymbiotic insects (e.g. antibiotics and lysozyme) deleteriously affect certain insects and aposymbionts may differ from the symbiont-containing stocks from which they were derived. 7. The mycetocyte symbionts have been proposed to synthesize various nutrients required by the insect. The symbionts of beetles and haematophagous insects may provide B vitamins and those in cockroaches and the Homoptera essential amino acids. The role of symbionts in the sterol nutrition of insects is equivocal. 8. Mycetocyte symbionts may have evolved from gut symbionts or guest microorganisms. The association is monophyletic in cockroaches but polyphyletic in many groups, including the sucking lice, beetles and scale insects.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2696563 TI - Correlation of erbB-2 gene amplification with low levels of estrogen and/or progesterone receptors in primary breast cancer: do erbB-2 products delineate hormone-independent tumors? AB - We analyzed erbB-2 gene amplification in 170 primary breast carcinomas. Thirty one percent of tumors exhibited additional copies of erbB-2 gene. Chi-square analysis did not elicit any association between gene amplification and either menopausal or node status. A slight trend was observed with respect to the SBR grading. In contrast, significant correlation was associated with the age of patients and we found a strong relation with the intratumoral steroid receptor status. ErbB-2 amplification significantly occurs in tumors whose estrogen receptor and progesterone receptor were below the cut-off value or absent and tumors with dissociated estrogen receptor and progesterone receptor status were revealed as entities similar to both estrogen receptor and progesterone receptor negative tumors. PMID- 2696564 TI - Transforming growth factor-alpha and human cancer. AB - Human transforming growth factor-alpha TGF-alpha, a polypeptide growth factor which causes reversible transformation of normal cells, is composed of 50 amino acid residues, has a 30 to 40% amino acid homology to epidermal growth factor (EGF), and binds the EGF receptor. In human cancers, studies are beginning to show that TGF-alpha could serve as a tumor marker and as a marker for the malignant potential of a tumor. Thus far, the types of carcinomas with which abnormal TGF-alpha expression has been associated include liver, gastrointestinal, breast, skin, lung, brain and ovarian cancers. TGF-alpha may play a role in the processes involved with tumor initiation and tumor growth. In cell lines, TGF-alpha has been found to be associated with autocrine and paracrine types of cellular growth initiation and with increased levels of oncogene expression. In summary, the evidence concerning human TGF-alpha are that TGF-alpha could serve as a marker for human cancers and that an understanding of the basic actions of TGF-alpha could help to explain the self-sustaining nature of tumors. PMID- 2696565 TI - Postoperative wound scoring. AB - Assessing postoperative wound sepsis rates is important from both an economic and an audit point of view. Most definitions of wound sepsis are too narrow and too subjective and wound scoring systems that have been developed to counteract these deficiencies suffer from a lack of objectivity, making valid comparisons between wound sepsis rates in different institutions impossible. The ASEPSIS scoring system is a definite advance in this area and its proven reproducibility makes it invaluable in multicentre trials assessing wound sepsis. However, it has limitations, mainly associated with the underlying assumption regarding the linearity of the ASEPSIS index. It is felt that by closely examining ASEPSIS wound scores from a large number of patients it may be possible to improve this scoring system. PMID- 2696566 TI - Thalidomide for the therapy of graft-versus-host disease following allogeneic bone marrow transplantation. AB - The immunosuppressive effects of the sedative drug thalidomide have been utilised in a variety of immune disorders. In the present study, 6 patients were treated who developed graft-versus-host disease (GvHD) following allogeneic bone marrow transplantation (BMT) with thalidomide and in a dose range of 200-600 mg daily. Two of 3 patients with chronic GvHD showed clear improvement, whereas none of the 3 patients with acute GvHD derived unequivocal benefit. Although based on a small number of patients, these data suggest that thalidomide may find a useful place in the therapy of GvHD, perhaps specifically in the chronic form of this disorder. PMID- 2696567 TI - Extension of multiple drug resistant Plasmodium falciparum malaria in Africa: report of a Central African case. AB - A 24-year-old Caucasian male, living in the Central African Republic, presented with fever due to Plasmodium falciparum infection, although he steadily took chloroquine and sulfadoxine-pyrimethamine chemoprophylaxis. Despite treatment with the same drugs at high doses, the parasitaemia persisted. Clinical and parasitological recovery was obtained by the use of quinine. Chloroquine resistant Plasmodium falciparum strains have spread in all tropical areas. Multiple drug resistance, already described in Asia, has also begun to appear in Africa. PMID- 2696568 TI - Speciation and bifurcations. AB - The interrelations of physics and biology are discussed. It is shown that Darwin can be considered as one of the founders of the important field of contemporary physics called physics of dissipative structures or synergetics. The theories of gradual and punctual evolution are presented. The contradiction between these theories can be solved on the basis of molecular theory of evolution and on the basis of the phenomenological physical treatment. The general physical properties of living systems, considered as open systems being far from equilibrium, are listed and simple non-linear mathematical models describing gradual and punctual speciation are suggested. The usual pictures which present these two kinds of speciation can possess physico-mathematical sense. Punctuated speciation means bifurcation, a kind of non-equilibrium phase transition. PMID- 2696569 TI - Puerperal fever in eighteenth-century Britain. PMID- 2696570 TI - Rethinking the origins of the Red Cross. PMID- 2696571 TI - The United States Public Health Service and International Health, 1945-1950. PMID- 2696572 TI - Germs with legs: flies, disease, and the new public health. PMID- 2696573 TI - The early medical studies and practice of Dr. David Hartley. PMID- 2696574 TI - Is Alzheimer's disease an anterograde degeneration, originating in the brainstem, and disrupting metabolic and functional interactions between neurons and glial cells? AB - A novel hypothesis is suggested for the pathogenesis of Alzheimer's disease, i.e. that a degeneration of adrenergic neurons in locus coeruleus and/or of serotonergic neurons in the raphe nuclei leads to impairment in metabolic and functional interactions between neurons and astrocytes (in the cerebral cortex and hippocampus as well as in nucleus basalis magnocellularis), and that a resulting deficient supply of substrates and failing energy metabolism in both neurons and astrocytes causes neuronal cell death in these areas and thus interference with additional transmitter systems. The hypothesis is based on (1) the topographical distribution of ascending pathways from locus coeruleus and the raphe nuclei; (2) the peculiar termination of many of these fibres in varicosities, from which released transmitter molecules reach their targets by diffusion, rather than in genuine synapses, suggesting a partly non-neuronal target; (3) the effects of locus coeruleus lesions in experimental animals; (4) the emergence of new knowledge in cellular neurobiology, indicating profound metabolic and functional interactions between neurons and astrocytes; and (5) the effects of adrenergic and serotonergic agonists upon metabolism and function in rodent astrocytes and neurons. These compounds influence energy metabolism, membrane transport of potassium and production of growth factors in astrocytes, and glutamate release from glutamatergic neurons. They thus influence essential metabolic interactions between neurons and astrocytes, as well as neuronal astrocytic interactions in potassium homeostasis at the cellular level. Obviously, neither the individual findings alone, nor their combination into a conceptual framework, prove the correctness of the hypothesis. However, they do provide a basis for further experimental work, using postmortem brain tissue from Alzheimer's patients and lesion studies in rodents, which can confirm or refute the hypothesis. PMID- 2696575 TI - The dental health of a group of adults approaching retirement age in Hertfordshire, England. AB - A socio-dental investigation involving a clinical examination and structured interview was carried out during 1986 on a sample of 83 people aged between 55 and 64 years in Hertfordshire. The sample was not representative of the population; subjects were employed on the staff of two retailing chains. The main purpose of the study was to estimate likely future needs of older people in such a sample. The clinical examination showed a proportion of individuals with natural and heavily restored teeth. Most subjects had one or more exposed non carious root surfaces. The periodontal condition of the sample was favourable. Problems could occur in the future as this group ages if their currently favourable dental health deteriorates and root surfaces become carious in large numbers or the periodontal condition worsens. Conservative treatment, if required in the future, especially for housebound people, may be a problem unless domiciliary services are planned to this end. A preventive approach may help to limit operative requirements. PMID- 2696576 TI - A trial of a capitation system of payment for the treatment of children in the General Dental Service. Final report. Dental Health Services Research Unit, University of Manchester. September, 1989. AB - A 3-year clinical trial comparing capitation and fee-for-service remuneration systems for general dental practitioners for the treatment of children has been successfully completed. Capitation dentists restored carious teeth at a later stage in the disease process than fee-for-service controls, and carried out more preventive treatment and advice. However, the disease experience of their patients was little different from that of patients treated under fee-for service. Capitation dentists saw their patients less frequently and took fewer radiographs than their fee-for-service colleagues. The prevalence of both fissue sealants and arrested caries was low in both groups, as was the prevalence of teeth extracted as a result of caries. Levels of oral cleanliness were similar under both systems. Private treatment was rarely prescribed for children, but was more prevalent for patients of fee-for-service dentists. The profession felt that capitation offered greater clinical freedom and more financial stability to dentists, but a greater temptation to under-prescribe treatment. The profession lacked commitment to capitation as a method of remuneration for the treatment of children in the General Dental Service. Fee-for-service dentists appeared to be more innovative, expressed a greater allegiance to their patients and felt a greater temptation to over-prescribe than capitation dentists. The parents had a high opinion of the service for children, irrespective of the remuneration system, and the children found the service very acceptable. Parents had a stronger allegiance to the fee-for-service than the capitation dentists. The study revealed several short-comings in the capitation model tested, but solutions to all of these became apparent. A capitation agreement of more than 12 months would simplify administration and reduce costs, as would a reduction in the number of forms. The need to notify parents when a dentist was replaced in a practice created considerable difficulties and increased expense. The treatment of trauma and extractions for orthodontic purposes should have been items excluded from the capitation fee. The need for information on dentists' activity in capitation was accepted but should be kept simple and relevant. Monitoring quality of care under capitation can be carried out from the routine data collected for administrative purposes. Capitation does not appear to increase participation. Costs of administering capitation are little different from those for fee-for-service. More resources were spent per dentist and per patient under capitation than fee-for-service. In the clinical trial fee-for-service was more cost-effective than capitation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2696577 TI - Nanophthalmos in sisters, one with exfoliation syndrome. AB - In a consanguineous family of two siblings, both with nanophthalmos, one was found to also have bilateral exfoliation syndrome. This combination of conditions has not, to our knowledge, previously been reported and has not had any apparent negative consequences. Her sister has manifested typical complications of nanophthalmos, including angle-closure glaucoma initially and, eventually, severe uveal effusion after cataract surgery. PMID- 2696578 TI - The experimental basis for the role of nitroso compounds in human cancer. PMID- 2696579 TI - Mechanisms of action of N-nitroso compounds. AB - There is ample evidence from studies in experimental animals that N-nitroso compounds are carcinogenic because in the body they form potent electrophilic alkylating agents. These reactive intermediates are formed by spontaneous decomposition in the case of nitrosoureas and related compounds, or by metabolic activation in the case of N-nitrosamines. The electrophiles subsequently react with DNA of target tissues to form altered bases which leads to the initiation of carcinogenesis. There is now convincing evidence that the biological activity of N-nitroso compounds in humans does not differ substantially from that in experimental animals. We can therefore predict with a high degree of confidence that N-nitroso compounds including nitrosamines are carcinogenic in man. PMID- 2696580 TI - Environmental exposure to preformed nitroso compounds. AB - In the human environment, nitrosatable amine precursors to N-nitroso compounds and nitrosating species such as nitrite and oxides of nitrogen are abundant. As a result, the formation of N-nitroso compounds and human exposure to these compounds show a rather complex pattern. The largest known human exposures to exogenous N-nitrosamines occur in the work place. This is particularly evident in the rubber and tyre manufacturing industry and in metal cutting and grinding shops. Nearly all industries which are concerned with the production and/or use of amines have a related nitrosamine problem. Outside the industrial environment, commodities such as cosmetics, pharmaceuticals, rubber and household products, which are either prepared from amines or contain high concentrations of amino compounds, may be subject to contamination by low concentrations of N-nitroso compounds. This contamination may result from the use of contaminated starting materials, in particular amines, or from the formation of N-nitroso compounds during manufacturing processes. A similar problem exists with agricultural chemicals. As our knowledge of the occurrence and formation of N-nitroso compounds in the environment increases, preventive measures can be introduced, particularly in manufacturing industries, to reduce the levels of human exposure to nitrosamines in the work place and to protect the consumer from nitrosamine exposure from household commodities. PMID- 2696581 TI - The relevance of tobacco-specific nitrosamines to human cancer. PMID- 2696582 TI - Preformed N-nitroso compounds in foods and beverages. AB - Most western-style foods have been analysed for the presence of volatile N nitrosamines. Relatively few foods consistently contain detectable (greater than 0.1 microgram/kg) amounts of volatile N-nitrosamines. The major known contributors to dietary volatile N-nitrosamines are nitrite-cured meats, particularly fried bacon, and beer. The amount of volatile N-nitrosamines in these foods has declined in recent years. Average dietary intakes of preformed volatile N-nitrosamines have been calculated from these data and indicate that dietary exposure for consumers of western-style foods amounts to 0.5 to 1.0 microgram/day/person. Asian foods have not been surveyed to the same extent but preliminary data indicate a somewhat higher and more frequent volatile N nitrosamine content, in part due to differences in fish intake and preparation. Indirect evidence suggests that the non-volatile content of some foods may be one to three orders of magnitude higher than volatile N-nitrosamine content. PMID- 2696583 TI - Mechanisms of endogenous nitrosation. AB - Endogenous formation of N-nitroso compounds has been demonstrated in both humans and experimental animals. The extent of this process has been estimated by measurement of urinary N-nitrosoproline and has been shown to be modulated by dietary precursors and inhibitors. It is now also recognized that other (non gastric) pathways of endogenous nitrosation, including those catalysed by bacteria and mammalian cells, may exist. The mammalian cell catalysed pathway utilizes arginine as a precursor for the nitrosating agent and may occur in macrophages or endothelial cells. The estimated contribution of this pathway to normal basal endogenous nitrosation is approximately 20 nmol of N nitrosoproline/day. PMID- 2696585 TI - Chemistry and biology of nitrosated peptides. AB - All peptides undergo nitrosation at the terminal primary amino group to generate a diazopeptide and at the peptide N-atoms to produce an N-nitrosopeptide. With acidified nitrite, diazopeptides usually form more readily than N nitrosopeptides, but quickly decompose. Diazopeptides form rapidly at neutral pH from gaseous nitrogen oxides and are relatively stable under these conditions. N nitrosopeptides are more stable than diazopeptides at both acidic and neutral pH. Because of their availability as substrates, peptides are probably involved in endogenous nitrosation associated with the diet and from the inhalation of nitrogen oxides as in tobacco smoking. Both diazopeptides and N-nitrosopeptides are cytotoxic, but a causal role for these compounds in human cancer has yet to be demonstrated. PMID- 2696584 TI - Human exposure to endogenous N-nitroso compounds: quantitative estimates in subjects at high risk for cancer of the oral cavity, oesophagus, stomach and urinary bladder. AB - A sensitive procedure to quantitate human exposure to endogenous N-nitroso compounds (NOC) has been developed. It is based on the excretion of N nitrosoproline (NPRO) and other N-nitrosamino acids in the urine, which are measured as an index of endogenous nitrosation, following ingestion of precursors. The NPRO test has been applied to human subjects in clinical and epidemiological studies, and the kinetics and dietary modifiers of endogenous nitrosation have been investigated. Results obtained after application of the NPRO test to subjects at high risk for cancers of the stomach, oesophagus, oral cavity and urinary bladder are summarized. In most instances, higher exposures to endogenous NOC were found in high-risk subjects, but individual exposure was greatly affected by dietary modifiers or disease state. Vitamin C efficiently lowered the body burden of intragastrically formed NOC. The results point to an aetiological role of NOC in these human cancers and provide an interpretation of epidemiological findings that have shown protective effects of fruits and vegetables against several malignancies. PMID- 2696586 TI - Mutagens and carcinogens produced by the reaction of environmental aromatic compounds with nitrite. AB - A variety of foodstuffs including soy sauce, vegetables and smoked foods showed direct-acting mutagenicity in bacteria upon nitrite treatment. From these foodstuffs, several nitrosatable mutagen precursors were isolated and their structures were found to be aromatic compounds such as phenol and indole derivatives, but not alkylamides. Many phenol and indole derivatives present in our environment were also demonstrated to form mutagenic nitrosated compounds. The direct-acting mutagenic products of phenolic compounds with nitrite were all diazo derivatives, and those from indole compounds with nitrite were N-1 and/or C 3 nitrosated products. Relatively high amounts of nitrite were necessary for the formation of diazo compounds from phenolic compounds. By contrast, indole reacted very rapidly with nitrite, even at low, physiologically feasible concentrations such as are found in the human stomach. Piperine, aminoimidazoquinoline and butylated hydroxyanisole also reacted with nitrite and produced compounds showing mutagenicity in bacteria without metabolic activation. Besides having activity in bacteria, two nitrosated products, diazo and nitrosoindole compounds, were demonstrated to be mutagenic in cultured mammalian cells. They also formed DNA adducts and induced ornithine decarboxylase and replicative DNA synthesis in rat stomach. Furthermore, the diazo compound formed from tyramine with nitrite was proved to be carcinogenic in rats. PMID- 2696587 TI - Nitrosation of dietary precursors. AB - The diet contains a large number of constituents which can be nitrosated in the gastrointestinal tract (especially in the stomach) to potentially carcinogenic nitroso compounds (NOC). The nitrosation of food mixtures has been investigated with a number of assays, such as chemical analysis or detection of alkylating potential, mutagenicity and carcinogenicity. Relatively good information is available on the formation of stable nitrosamines using high nitrite concentrations. Little is known, however, about the formation of chemically unstable NOC at low nitrite concentration and their genotoxicity in target cells. A comparison of the precursor classes, alkylamines, aromatic amines, amino acids, amides and peptides, ureas and guanidines, reveals a vast range, both with respect to daily intake (10(5)-fold) and nitrosation rate (10(4)-fold both for 1st and 2nd order nitrite dependence). A total span of 10(8) results for the relative yield of NOC in the stomach. The endogenous NOC burden from dietary ureas and aromatic amines may represent as large a hazard as the intake of preformed NOC. Recent evidence also indicates that heterocyclic amines and phenols must be considered and that the half-life of nitrosated alpha-amino acids can be much longer than that of nitrosated primary alkylamines. In these classes, more information should be collected on dietary concentrations, on the nitrosation under realistic conditions and on the genotoxicity in stomach lining cells. Within a chemical precursor class, a wide range is seen with respect to alkylating potency. It cannot, therefore, be excluded that individual precursors within the top ranking classes might become more important than single preformed NOC. Not considered in the above analysis but probably just as important for a risk evaluation in a population is the knowledge of the nitrosation conditions and target cell susceptibility in individuals. PMID- 2696588 TI - N-nitroso compound formation in human gastric juice. AB - The gastric formation of N-nitroso compounds probably constitutes a major source of human exposure to this important class of environmental carcinogens. Following reduction of nitrate to nitrite by oral or gastric bacteria, reaction with nitrogenous constituents of gastric juice can occur leading to the in situ formation of N-nitroso compounds, probably primarily derived from amides, ureas or aromatic amines. While gastric nitrite concentrations are raised in the achlorhydric relative to the normal stomach, the latter, owing to its acidity, offers a particularly favourable environment for the formation of N-nitroso compounds, as indicated by the finding of greatly increased gastric concentrations of N-nitroso compounds following an oral dose of nitrate. This illustrates the importance of the dynamic nature of the relationships between the various parameters involved in the formation of N-nitroso compounds. While in principle the same is true of the process of inhibition of nitrosation by reducing agents such as ascorbic acid (since, depending on the relative concentrations of reducing agent, nitrite and oxygen, inhibition or catalysis of nitrosation can occur), ingestion of 1 g ascorbic acid brings about a significant reduction in the gastric concentration of N-nitroso compounds. PMID- 2696589 TI - Are nitrates a significant risk factor in human cancer? AB - This article focuses on the relationship between exposure to nitrates in the environment and subsequent risk of human cancer. The question of whether or not nitrates represent a cancer hazard is one of the most important public health issues arising from research into N-nitroso compounds. The reason for concern results from the endogenous reduction of nitrate to nitrite and subsequent nitrosation of amines, amides and proteins to give rise to carcinogenic N-nitroso compounds. The human evidence relating nitrate exposure to cancer, especially gastric cancer, has been largely based on geographic correlation studies, a relatively weak form of epidemiological methodology. In sum, this evidence and that from a small number of individually based studies does not support the hypothesis of a straightforward cause and effect association between nitrate exposure and cancer risk. Because many other factors besides nitrate are involved in the endogenous formation of N-nitrosation compounds, it is possible that exposure to nitrate is not a rate-limiting factor in most circumstances. This makes the setting of regulatory standards for nitrate exposure from the environment a complex issue. PMID- 2696590 TI - Epidemiological evidence for the role of nitroso compounds in human cancer. AB - Human exposure to N-nitroso compounds (NOC) is not to single compounds but to highly complex mixtures such as food or tobacco products which may contain various NOC, NOC precursors and modulators of NOC metabolism in addition to other known carcinogens. Aetiological models also stress the importance of other cofactors. The interrelationship of these cofactors with relevant NOC exposures and the possible influence of confounding factors need to be considered in order to evaluate the risk related to NOC. This task is made more difficult because the levels of human NOC exposure are often low, and some of the relevant exposure is likely to be from endogenously formed NOC. Nonetheless, current hypotheses reviewed here propose a role for NOC in the aetiology of tobacco-related cancers and of cancers of the bladder, stomach, oesophagus and brain. Data implicating tobacco-specific nitrosamines in the aetiology of cancers of the oral cavity among snuff dippers is most convincing. Evidence from epidemiological studies in support of other NOC/cancer hypotheses is circumstantial and much work remains to be done to define the role of NOC and develop strategies for prevention of these tumours. PMID- 2696591 TI - Detection of adducts arising from human exposure to N-nitroso compounds. AB - Humans are exposed to carcinogenic nitroso compounds (NOC), which are likely to result in the formation of DNA adducts. DNA adducts can be detected in human samples using a range of different analytical methodologies, including high pressure liquid chromatography (HPLC)-fluorescence, immunoassays and gas chromatography-mass spectrometry. Immunohistochemical studies offer the possibility of detecting adducts in single cells, but require further development for human studies. Sensitive 32P-postlabelling methods, in conjunction with HPLC separation, allow the detection of NOC-derived alkylated nucleotides in small samples of DNA derived from human tissues such as lymphocytes and placenta. In many studies, adducts have been detected in human DNA, but are often present, to a similar extent, in control and exposed subjects. In a number of studies, exposure to NOC has been inferred from the presence of characteristic alkyl adducts. In subjects from high risk areas for oesophageal cancer, DNA from target tissue contained higher levels of 0(6)-methyldeoxyguanosine than controls. The analysis of adducts in 'surrogate' DNA from peripheral lymphocytes appears promising as an accessible measure of alkylation damage. Also, the measurement of excreted levels of alkylpurines has the potential to be a noninvasive indication of short-term exposure to NOC. Endogenous synthesis of NOC can occur by a number of possible pathways in humans, and measurements of adducts will be a means of detecting the resulting alkylating agents, since their direct detection would be extremely difficult. PMID- 2696593 TI - [Thin-needle aspiration biopsy under ultrasonic control. The examination technic]. AB - Based on experience with 298 aspiration biopsies (156 from the liver, 100 from the pancreas, 42 from other organs) made under ultrasonic control, the authors present a detailed description of the examination technique. At the same time they publish their own results with a mean sensitivity of 88%, specificity of 100% and diagnostic yield of 92%. PMID- 2696592 TI - Variations in lymphokine generation by individual lymph nodes draining human malignant tumors. AB - Individual lymph nodes draining tumors vary in their degree of immunological activity. Cell suspensions from tumor-free nodes located relatively near to tumors are spontaneously less reactive and respond poorly to exogenous stimulation by mitogens and lymphokines. Diminished spontaneous uptake of tritiated thymidine by lymph node cells not exposed to exogenous stimulation suggests that tumor-proximate immune suppression exists in vivo and is not purely a laboratory artefact. The present study was undertaken to explore that possibility further. Fluid in which cell suspensions from tumor-free nodes were prepared, and supernatants from short-term cultures of nodes located at different distances from tumors were compared for their capacity to inhibit the in vitro migration of the human lymphoblastoid cell line QIMR-WIL. Inhibitory activity of fluids from individual nodes was related to their position relative to the tumor and their immune competence, assessed by the responses to mitogens of cell suspensions prepared from them. Cell suspension fluids from 92/111 nodes (83%) significantly inhibited the migration of QIMR-WIL, at a level similar (44 +/- 14%) to that induced by the supernatants of mixed lymphocyte cultures (43 +/- 17%). Fluids from the nodes of melanoma patients were more inhibitory than those from breast cancer patients (49 +/- 12% and 37 +/- 13%, respectively, P = 0.003). The inhibitory activity of the different nodes of individual node groups varied significantly in 25 of 33 patients (76%), the node nearest the tumor generating least inhibitory activity (indexing the greatest immune suppression) in 20 of these 25 patients (80%). The strength of migration-inhibitory activity was concordant with the responsiveness to mitogen stimulation in up to 14 of 18 patients (78%). Studies of molecular size and heat stability indicated that the inhibitory factors had characteristics consistent with common migration inhibitory lymphokines such as leukocyte-migration-inhibitory factor, macrophage inhibitory factor and interleukin-2. Our findings further support the hypothesis that lymph nodes nearest to tumors are relatively immune-suppressed in vivo. PMID- 2696594 TI - [Percutaneous transthoracic aspiration biopsy: the reliability of cytological diagnosis of intrathoracic tumors]. AB - The authors evaluated percutaneous aspiration biopsies of intrathoracic lesions in 348 patients where the obtained cytological results were compared with the histological finding from resections or post-mortem preparations. In 274 patients malignant and in 74 benign disease was confirmed. In the differentiation of malignant and benign disease the sensitivity of cytology was 84.3%, the specificity 91.9% and the accuracy 85.9%. The type of bronchogenic carcinoma was correctly diagnosed by cytological examination in 69.5%, in squamous cell carcinoma in 76.8%, in small-cell carcinoma in 80% and in adenocarcinoma in 59.1%. The same cytological finding as in the primary tumour was recorded in 73.5% of the patients with metastases in the lungs. Less favourable results as regards assessment of the type of tumour were obtained in other tumours, in particular in lymphogranulomas and non-Hodgkin lymphomas. In 25% it proved possible to assess by cytological examination the type of benign lung tumour. PMID- 2696595 TI - [An outbreak of diarrhoea in newborns caused by EIEC]. AB - An outbreak of 18 acute infant diarrhoea cases caused by enteroinvasive E. coli O152:K? and O112ac: K66 were reported in a nursery in the obstetrics department of a hospital in Huangshi city in 1987. Among them 2 cases died. Epidemic state, etiology biochemical and serological tests, clinical feature and resistance to drugs were discussed. The importance of the management of nurseries and stool examination for the pathogens in intestinal tract in puerpera were emphasized. PMID- 2696596 TI - [Prospects for the elimination of poliomyelitis from the earth]. PMID- 2696597 TI - Theory for epithelial-mesenchymal transformation based on the "fixed cortex" cell motility model. PMID- 2696598 TI - Nucleus-basal body connector in Chlamydomonas: evidence for a role in basal body segregation and against essential roles in mitosis or in determining cell polarity. AB - In the unicellular biflagellate green alga Chlamydomonas reinhardtii each basal body is linked to the nucleus by a fibrous nucleus-basal body connector (NBBC) that contains the calcium-binding protein centrin. (Wright et al.: Journal of Cell Biology 101:1903-1912.; Salisbury et al.: Journal of Cell Biology 107:635 642; Huang et al.: Journal of Cell Biology 107:121-131). In order to explore the cellular function of the NBBC we used antiserum directed against centrin to examine a number of mutants known to be defective for basal body assembly and/or localization. Of three variable flagella-number mutants examined, one, vfl-2, is dramatically defective with respect to the NBBC in that 1) the union between basal bodies and nucleus is very labile, 2) there is no detectible centrin in the NBBC region, and 3) total cellular centrin levels are reduced 75-80% relative to wild type. The existence of these defects in a mutant incapable of maintaining normal flagellar number supports the view that the NBBC plays an important role in determining proper basal body localization and/or segregation. In contrast to vfl-2, the mutants vfl-1, vfl-3, uni-1, and bald-2 contain approximately normal levels of centrin and possess stable NBBCs. The observation of NBBCs in the mutant bald-2, which lacks all but very rudimentary basal bodies, indicates that the assembly of the NBBC does not require fully formed basal bodies and that such assembly may not require basal bodies at all. Finally, the possibility that the NBBC is required for induction of gene expression following deflagellation was tested by examining vfl-2 for such induction. Results indicate that the connector does not play a necessary role in the induction process. PMID- 2696599 TI - Correlated distribution of actin, myosin, and microtubules at the leading edge of migrating Swiss 3T3 fibroblasts. AB - The formation of lamellipodia in migrating cells involves dynamic processes that occur in a cyclic manner as the leading edge of a cell slowly advances. We used video-enhanced contrast microscopy (VEC) to monitor the motile behavior of cells to classify protrusions into the temporal stages of initial and established protrusions (Fisher et al.: Cell Motility and the Cytoskeleton 11:235-247, 1988), and to monitor the fixation of cells. Multiple parameter fluorescence imaging methods (DeBiasio et al.: Journal of Cell Biology 105:1613-1622, 1987; Waggoner et al.: Methods in Cell Biology, Vol. 30, Part B, pp. 449-478, 1989) were then used to determine and to map accurately the distributions of actin, myosin and microtubules in specific types of protrusions. Initial protrusions exhibited no substructure as evidenced by VEC and actin was diffusely arranged, while myosin and microtubules were absent. Newly established protrusions contained diffuse actin as well as actin in microspikes. There was a delay in the appearance of myosin into established protrusions relative to the presence of actin. Microtubules were found in established protrusions after myosin was detected, and they were oriented parallel to the direction of migration. Actin and myosin were also localized in fibers transverse to the direction of migration at the base of initial and established protrusions. Image analysis was used to quantify the orientation of actin fibers relative to the leading edge of motile cells. The combined use of VEC, multiple parameter immunofluorescence, and image analysis should have a major impact on defining complex relationships within cells. PMID- 2696600 TI - Epidemiology of shoulder problems. PMID- 2696601 TI - Glenohumeral instability. AB - Glenohumeral instability is an important cause of shoulder pain and disability in an active population. An awareness of the prevalence of recurrent instability, either in the form of dislocation or subluxation, is particularly useful in the assessment of the young athlete presenting with shoulder pain. Young adults presenting with rotator cuff tendinitis may have an underlying instability as the primary cause of their problem. A careful clinical examination should determine whether the instability is voluntary or involuntary, of traumatic or atraumatic onset, and the primary direction of the instability, as these factors have important implications with regard to treatment. Anterior glenohumeral instability is most common and the incidence of recurrent instability following on from an initial dislocation is high in the young active patient. An intensive rehabilitation programme is indicated for all initial dislocations or subluxations but surgery may become necessary after failure of conservative treatment. Care must be taken to determine accurately those patients with voluntary or multi-directional instability and a longer trial of conservative treatment is indicated here, as results of operative treatment in those cases are less favourable. Conservative treatment should be directed at strengthening the dynamic stabilizers of the shoulder joint, notably the rotator cuff muscles. Additional X-ray views are needed to demonstrate all the radiological changes associated with recurrent instability and further evaluation with examination under anaesthesia and arthroscopy is beneficial in the assessment of these patients. Arthroscopic surgery also has a role in the treatment of patients with symptomatic labral pathology and is now being used to perform stabilization procedures in selected cases. Many operative procedures have been described for stabilization of the shoulder and these should be directed at correcting the pathology present. Restoration of the patient's flexibility and strength postoperatively is essential, especially in the athlete in order to allow a full return to sporting activity. PMID- 2696602 TI - Rotator cuff disorders. AB - Rotator cuff problems present with shoulder pain on repetitive overhead activity. Chronic irritation may develop into impingement tendonitis, with weakness of abduction and external rotation and night pain. Conservative management with rest, anti-inflammatory medicine and physiotherapy resolves the majority of symptoms. If these persist, surgical decompression affords good relief of pain. PMID- 2696603 TI - Frozen shoulder. PMID- 2696604 TI - Arthritis of the glenohumeral joint. PMID- 2696605 TI - Sports injuries of the shoulder. AB - Much strain is placed on the shoulder joint in all sports. Sports injuries may be caused by a single, violent incident. Fractures of the clavicle, acromioclavicular and sternoclavicular traumas, isolated fractures of the greater tuberosity and shoulder dislocations are frequent clinical pictures which today can be managed by well established procedures. Other sports injuries, however, involve over-use of the shoulder which, through repetitive harmful movements, can bring about microtraumatic lesions of the rotator cuff, glenoid labrum, acromioclavicular joint and certain peripheral nerves around the suprascapularis. In all cases, a programmed, comparative, clinical examination and complementary, sequential examinations will indicate suitable curative and preventive treatment. PMID- 2696606 TI - Osteonecrosis of the humeral head. PMID- 2696607 TI - [Ultrasonic study of residual urine in women with surgery for urinary incontinence]. PMID- 2696608 TI - [Antidepressives 1988]. PMID- 2696609 TI - [A reminder of the legacy of Sigmund Freud]. AB - In September 1989 fifty years elapsed since the death of Sigmund Freud, the founder of psychoanalysis. The authors recall selected topical ideas from the work of Freud. At the same time they draw attention to the importance of his studies for the left-wing student movement in Czechoslovakia between the two world wars. Initial attempts of a close association of psychology with the nervous substrate did not succeed but led later to the original explanation of converse mechanisms. In his own way Freud anticipated contemporary bio-psycho social concepts. Gradually subconsciousness was conceived as Freud's most important discovery. Energy for mental life was sought in the sphere of instincts, in particular the sexual instinct, Freud extrapolated his reflections into the social sphere and elaborated his understanding of group psychology, using mechanisms of the individual psychic make-up. From this he derived regulatory mechanisms of civilization. Freud believed in reason represented to him by science. He considered religion illusionary happiness and warned also against the so-called chemical path. He denounced war unequivocally and had his own ideas how to reduce its probability. PMID- 2696610 TI - [General situation of the study of traditional Chinese medicine and Western medicine in bile reflux gastritis]. PMID- 2696611 TI - Effect of 8-anilino-1-naphthalene sulfonic acid (ANS) on the interaction between thyroid hormone and anti-thyroid hormone antibodies. AB - Effect of 8-anilino-1-naphthalene sulfonic acid (ANS) on the interaction between thyroid hormone and anti-thyroid hormone antibodies was examined. Addition of 5.1 x 10(6) or 6.3 x 10(6) molar excess of ANS, respectively, enhanced the binding of 125I-T3 or 125I-T4 to their respective autoantibodies. However, further increase in ANS concentration resulted in a decrease in binding. These results suggest that the optimum concentration of ANS for the detection of anti-thyroid hormone antibodies is 5 approximately 6 x 10(6) molar excess of ANS to 125I-T3 or 125I T4. On the other hand, addition of 10(4) molar excess of ANS concentration decreased the binding of 125I-insulin to anti-insulin antibodies. It was therefore suggested that the effect of ANS could be a nonspecific one and likely due to its negative charge. PMID- 2696612 TI - [Non-invasive sonography and ultrasound-guided puncture of suspected malignant facial and neck masses]. AB - 102 patients with malignomas of the face and neck were examined by palpation, sonography, and in some cases also computed tomography. In 79 patients the cervical lymph nodes had to be removed surgically. Intraoperative and pathohistological findings were compared to the examination results before treatment. Sensitivity values were 100% for sonography, 85% for palpation, and 80% for CT. For a differentiation between benign and malignant space occupying lesions sonographic structures, shapes, and sizes of non-tumorous lymph nodes were compared to those of metastasizing ones. However, non-invasive sonography alone was not sufficient for a reliable diagnosis about the nature of the tumor. Therefore a first report is presented on ultrasound-guided fine needle puncture and aspiration biopsy of suspected malignant face and neck masses. PMID- 2696613 TI - [State of the art of oral and maxillofacial surgery in the 13th century]. AB - A report is given on the level of knowledge achieved in the treatment of oral and maxillofacial diseases in the 13th century under the influence of arab medicine. PMID- 2696614 TI - [A case of "pure" progressive autonomic failure with impairment of cerebral blood flow autoregulation]. AB - A 43-year-old male with "pure" progressive autonomic failure ("pure" PAF) was admitted to our hospital in June 1988, with a chief complaint of recent syncopal attacks while standing. Since the age of 35. He has noticed dyshidrosis on his left side. The family history was negative. Neurological examination showed dyshidrosis on his left side and profound orthostatic hypertension. No other neurological abnormalities were noted. Autonomic function tests revealed sympathetic and parasympathetic dysfunction as follows: Adrenaline administered subcutaneously gave a hyperactive pressor response from 136/82 mmHg to 190/116 mmHg with the pulse increasing from 54 to 150 beats per min. Hidrosis was observed on the right side of the body in response to heat. However, it was observed over the whole body in response to pilocarpine. In the studies of pupillary response to instillation of 1.25% epinephrine, both pupils were unchanged in diameter; after 5.0% tyramine, both pupils were dilated from 3.5 mm to 5.0; and after 2.5% methacholine, the right and left pupils, each originally 4.5mm were constricted to 3.5 mm and 4.0 mm, respectively. From the above data, this case was diagnosed as "pure" PAF. 133Xe inhalation method. The mean regional CBF (F1) values were reduced from 91 to 53 ml/100 g brain/min by postural change from supine to sitting position, associated with a decrease in mean arterial blood pressure (MABP) of 28 mmHg (from 103 to 75 mmHg). This result shows the impairment of CBF autoregulation in this patient. This case adds further evidence to the hypothesis that the autonomic nervous system plays a role in CBF autoregulation. PMID- 2696615 TI - [Neurotrophic effect of ceruletide and LH-RH on ventral spinal cord in culture]. AB - This experiment was undertaken in order to study the probable trophic effect of ceruletide and LH-RH on cultured ventral spinal cord. The ventral spinal cord from 13-14-gestational day rat embryos were explanted, following a conventional culturing method. Explants in the culture medium were fed ceruletide and LH-RH at different concentrations. An equal volume of PBS was administered to the control explants. For quantitative analysis of the trophic effect of ceruletide and LH RH, a numerical score from 0 to 4 was determined at the 7th culture day, based on the length and extension of neurite growth estimated. The presence of ceruletide, the neuritic extension of ventral spinal cord exceeds control values 3.5-6.3 times. The growth zone of the spinal cord explants increases in the ceruletide treated culture, LH-RH treated culture, on the other hand, had no promoting effect on neurite growth. The possible mechanism of trophic effect of ceruletide on cultured ventral spinal cord was briefly discussed. These experimental observation have important implications regarding to potential therapeutic effects of ceruletide n amyotrophic lateral sclerosis. PMID- 2696616 TI - Prospective analysis of eosinophilia in spontaneously diabetic BB rats: correlation with islet inflammation but not with diabetes development. AB - A prospective analysis of eosinophil counts in diabetes prone BB rats showed that eosinophilia (greater than 5%) occurred between 70-100 days of age. The presence of eosinophilia did not predict diabetes onset because persistently normoglycaemic animals developed eosinophilia as well. Nevertheless a correlation with the disease process in BB rats was found. Eosinophilia decreases a few weeks after diabetes onset but persists in non diabetic rats. Histological analyzes showed that eosinophilia correlates with eosinophil infiltration of islets (p less than 0.005) and the latter correlates with severe insulitis (p less than 0.005). These findings indicate that eosinophilia is associated with a late stage of islet inflammation in diabetes prone BB rats independent of whether the animals develop diabetes or not. PMID- 2696617 TI - Effect of a glycoprotein biosynthesis-blocker on insulin secretion. AB - The effect of tunicamycin, a glycoprotein biosynthesis-blocker, on insulin secretion was studied using rat isolated pancreatic islets. Islets cultured with tunicamycin during 24 hr released significantly less insulin in response to 11 mM glucose than the corresponding controls. This inhibitory effect of tunicamycin was not significant in the presence of 3.3 mM glucose. The culture of these islets for a second 24 hr period in a medium devoid of tunicamycin did not remove the blocking effect of the drug on the glucose-induced insulin secretion, as demonstrated by measuring the concentration of insulin in the second culture medium or its release during a 60 min incubation period. Fresh isolated islets incubated for 60 min only with tunicamycin also released during this period less insulin in response to 16.6 mM glucose than the corresponding controls. These results might suggest that some islet glycoproteins participate in the mechanism of insulin secretion. PMID- 2696618 TI - Massage-enhanced insulin absorption--increased distribution or dissociation of insulin? AB - Massage over the site of a subcutaneous insulin injection markedly enhances the absorption of insulin. To investigate whether this reflects an increased dispersion of insulin in the tissue, the area of distribution of radioactivity at 125I-insulin (10 U) injection sites in thigh was determined in eight healthy volunteers by external scanning on a day with standardized massage and on a control day. Insulin absorption (first order disappearance rate constants and appearance of serum immunoreactive insulin, IRI) and plasma glucose were determined concomitantly. The area of distribution of 125I increased 30 +/- 15% (p less than 0.05) on the massage day, which was not significantly different from the change during control (12 +/- 10%). The rate constants for 125I-insulin increased markedly (237 +/- 74%) on the massage day and much less (49 +/- 15%) on the control day (p less than 0.01). Peak IRI levels were 49 +/- 8 mU/l on the massage day and 17 +/- 2 mU/l on the control day (p less than 0.01). The glucose lowering effect was also more pronounced on the massage day. These results indicate that the marked enhancement of insulin absorption induced by massage of the injection site is not directly related to expansion of the insulin depot in the subcutaneous tissue. PMID- 2696619 TI - Treatment of insulin-dependent diabetes using an injection pen: control, problems and patient preferences. AB - Twice-daily insulin injections do not always provide good glycaemic control in insulin-dependent diabetes (IDDM) and impose restrictions on patients' lifestyles. Basal/prandial insulin schedules require four injections per day but are feasible using a self-contained injection pen. In 26 patients with IDDM a basal/prandial schedule (using ultralente and soluble insulins) was compared with twice-daily injections. Measurements of mean blood glucose, M-value, mean amplitude of glycaemic excursions and glycated haemoglobin showed no improvement in glycaemic control on the basal/prandial regimen. Patients liked the regimen, however, 21/23 opting to stay on it after the trial, and believed themselves to be better controlled on this schedule (p less than 0.001). They especially appreciated the flexibility of meal timing, ease of injection and portability. As the basal insulin, ultralente was associated with problems of unheralded, severe hypoglycaemia and of difficulty with injections; isophane or lente formulations would be more suitable. PMID- 2696620 TI - Susceptibility of clinical isolates of Candida spp. to terconazole and other azole antifungal agents. AB - Terconazole is a triazole ketal derivative with potent, broad-spectrum antifungal activity. We investigated the in vitro activity of terconazole, miconazole, and clotrimazole, against 94 clinical isolates of Candida spp.: C. albicans (n = 68), C. tropicalis (n = 18), and C. parapsilosis (n = 8). In vitro susceptibility testing was performed using a broth microdilution method. The minimal inhibitory concentrations of terconazole were less than those of miconazole against C. albicans and C. parapsilosis but higher against C. tropicalis. Terconazole was more active than clotrimazole against C. parapsilosis and less active against C. albicans and C. tropicalis. Terconazole inhibited the uptake of 14C-labeled glucose, leucine, and hypoxanthine into C. albicans and caused the rapid release of intracellular K+. Based on these studies, terconazole has promising anticandidal activity and warrants further in vitro and in vivo investigation. PMID- 2696621 TI - Nocardia infection in the acquired immunodeficiency syndrome. AB - A case of Nocardia asteroides pneumonia in a patient with the acquired immunodeficiency syndrome who was intolerant of sulfadiazine is described. On cefuroxime, the patient had a complete resolution of his Nocardia pneumonia. Disk diffusion and broth microdilution antibiotic susceptibility testing (MIC less than or equal to 2 micrograms/ml) strongly supported the use of cefuroxime as treatment in this patient. Susceptibility testing with newer cephalosporins should be considered for all significant Nocardia isolates. PMID- 2696622 TI - Rapid identification of Candida albicans using 4-methylumbelliferyl N-acetyl-beta galactosaminide. AB - Rapid identification of Candida albicans is performed mainly by the germ-tube test. However, recent reports have suggested that up to 5% of C. albicans species can give false negative results. We describe the use of 4-Methylumbelliferyl N acetyl-beta-D-galactosaminide (4-MAG) conjugate as an alternative to the germ tube test. Our results indicate that, in comparison to the germ-tube test, the 4 MAG test has a sensitivity of 100% and a specificity of 92%. Candida tropicalis can give false-positive results, and that a further screening test is required to identify this species. Problems reading end-points were not encountered. PMID- 2696623 TI - [Contemporary methods of imaging injuries of the spine and spinal cord]. AB - A review of current methods of visualization of injuries of the axial organ on the basis of the literature from the last decade, including also the author's own experience, has been done. The techniques of visualization accessible in Poland have been discussed more widely. PMID- 2696624 TI - [Isolated fractures of the pisiform bone]. AB - The literature has been discussed and two patients followed up for this injury have been presented. The patients were treated conservatively. Good results were obtained. PMID- 2696625 TI - [Achievement, development and problems in the practice of public health in China]. PMID- 2696626 TI - Obstructive sleep apnea: preventing complications. PMID- 2696627 TI - Corneal astigmatism after cataract surgery. AB - 206 Consecutive cataract patients were at random divided into three groups according to the way the cataract incision was closed: virgin silk 8-0, interrupted nylon 9-0, and double running nylon 9-0. The nylon, whether interrupted or continuous, yielded in the majority of cases a postoperative astigmatism with the rule, whereas virgin silk caused in nearly all patients a postoperative astigmatism against the rule and therefore behaved like an absorbable suture. Silk is chemically non-absorbable, but in virgin silk a natural worm-produced polymer is still present, which provokes a tissue reaction. Softening of tissue diminishes the tensile strength of the suture. With respect to the postoperative astigmatism, the suture material (nylon or virgin silk) seems a more important factor than the way in which it is used (interrupted or continuous). PMID- 2696628 TI - Effect of timolol on the amplitude and dynamics of accommodation. AB - There is still debate about whether the ciliary muscle is innervated by the sympathetic nervous system. We investigated the amplitude and the dynamics of accommodation under influence of the non-selective beta-blocker timolol. For this purpose the variations in thickness of the human lens during step-like changes in accommodation were measured with high-resolution A-scan echography. Results showed that the dynamics of accommodation, expressed in the time constants of the response, were affected as well as the amplitude. PMID- 2696629 TI - [Transforming potential of DNA from solid tumor of human gastric carcinoma]. AB - The NIH-3T3 and Rat-1 recipient cells were transfected with DNA from solid tumor or metastatic tissue of 8 gastric carcinoma patients by the method of calcium phosphate precipitation or G418 co-transfection. Seven of them were shown to have transforming potential. After the third round of transfection, a series of transformants were obtained which showed malignant phenotype, growth ability in soft agar culture, tumorigenicity in nude mice and retaining of human Alu repeat sequence. Through Southern hybridization of DNA from the secondary transformant, H-ras oncogene was demonstrated with the same length as in the human cells. PMID- 2696630 TI - [Mitoxantrone containing multi-drug chemotherapy in the management of malignancies. Collaborative Group for Clinical Trial of Mitoxantrone]. AB - 182 patients with various malignancies treated by mitoxantrone containing multi drug chemotherapy are reported. Sixteen cancer patients treated with adriamycin or epirubicin combined with other drugs during the same period served as control. Of these 182 patients, there were 171 evaluable patients. Fourty-four had complete remission, 64 partial remission, 38 stable lesions, and 25 progressive lesions with response rate of 63.2%. Fifty-five breast cancer patients treated with mitoxantrone, methotrexate and 5-fluorouracil gave a response rate of 52.7%; 82 malignant lymphoma patients who received cyclophosphamide, mitoxantrone, vincristine and prednisone regimen gave a response rate of 81.7%; 29 patients with gastrointestinal carcinoma as treated by UFT, mitoxantrone, mitomycin C lead to a response rate of 31.0% and 5 patients with other malignancies gave a response rate of 60.0%. Of the control group, there were 15 evaluable patients. 10 of 12 malignant lymphoma patients responded, while no effect was observed in 2 breast cancer and 1 gastric cancer patients. Acute and subacute toxicities in the two groups were observed and the factors influencing the therapeutic effects were analysed. PMID- 2696631 TI - The relevance of peroxisome proliferation and cell proliferation in peroxisome proliferator-induced hepatocarcinogenesis. PMID- 2696632 TI - Assessing human health risks from exposure to di(2-ethylhexyl)phthalate (DEHP) and related phthalates: scientific issues. PMID- 2696633 TI - Metabolism of di(2-ethylhexyl)phthalate. PMID- 2696634 TI - A review of di(2-ethylhexyl)phthalate (DEHP) risk assessments. PMID- 2696635 TI - Metabolism of DEHP: effects of prefeeding and dose variation, and comparative studies in rodents and the cynomolgus monkey (CMA studies). PMID- 2696636 TI - Carcinogenicity of general-purpose phthalates: structure-activity relationships. AB - There does not appear to be any evidence that other GP phthalates pose higher level risk than DEHP. There is evidence that a very significant fraction of GP phthalate production capacity is devoted to turning out products which may have about the same carcinogenic potency as DEHP, and that another significant fraction of that capacity is devoted to turning out products with less potency. Public and private risk control choice takers considering this family of products need to be aware of this evidence, its limitations, and the means for upgrading certainty. PMID- 2696637 TI - Possible mechanisms in hepatocarcinogenesis by the peroxisome proliferator di(2 ethylhexyl)phthalate. PMID- 2696638 TI - Composite diastema closure. PMID- 2696639 TI - Bilateral dentigerous cysts in the child patient. Report of a case and review of the literature. PMID- 2696640 TI - Oral sedation in dentistry. AB - This review of oral sedation in dentistry will examine the objectives, indications, advantages and disadvantages of oral sedation and will present some of the basic guidelines for its safe use. It will also review the properties, precautions and contraindications (both absolute and relative) of some of the currently popular sedative agents. PMID- 2696641 TI - Periodontics: a perspective and an overview for general practitioners. PMID- 2696642 TI - An outline of anti-emetic treatment. AB - With the advent of new chemotherapeutic agents, and their well-known side effect of emesis, the need for a greater facility with anti-emetics has emerged. As well as the common problem of chemotherapy-induced emesis, other problems have become apparent such as delayed emesis and anticipatory emesis. The control of such emetic problems may be affected by certain patient characteristics, such as a history of chronic high alcohol intake, and age. Blockade of the different types of neuroreceptors can lead to effective emetic control. Dopamine receptor blockers such as the phenothiazines, butyrophenones and substituted benzamides have been among the most effective agents. However, newer agents, such as ondansetron, which specifically bind to serotonin receptors, may preserve the anti-emetic efficacy of the dopamine-blockers, but without the associated extrapyramidal side effects of these agents. PMID- 2696643 TI - [Pyrimidines]. PMID- 2696644 TI - [The role of conformational changes in serum albumin and its interaction with drugs]. PMID- 2696646 TI - The rationale for arterial and venous shunting in the management of limb vascular injuries. PMID- 2696645 TI - [Histamine. Its action on the heart and vessels]. AB - The literature data on the effect of histamine on the heart and vessels in different species of animals and man were analyzed. Nonheterogeneity of histamine effect can be presumably explained by a strong representation of various types of receptors to which this biogenic amine is bound (H1, H2, H3) in the organs and tissues, their unequal location on the pre- and postsynaptic membrane, the differences in their physiological functions. PMID- 2696647 TI - Ultrasound screening of the abdominal aorta in patients with intermittent claudication. AB - The presence of abdominal aortic dilatations and aneurysms (AAA) among 372 patients (302 men and 70 women) who originally presented with intermittent claudication was studied. The cohort was analysed in two ways, first retrospectively from the date of diagnosis of intermittent claudication until 1st of August 1985 (mean follow-up time being 70 months), second those alive at that date and who had not been operated on were offered ultrasound screening of their aorta. Retrospectively nine male patients were found to have had an operation for an aneurysm, one because of a rupture. Of the 110 patients who died and had not had surgery, 88 (73 men, 15 women) were autopsied and AAA was found at autopsy in six males and one female. Two males died of rupture. Ultrasonographic screening of the abdominal aorta was performed in 183 patients (147 men and 36 women) and dilatation was found in 25 patients (24 men, 1 woman). In the male part of the total material (n = 257) there were 39 patients (15%) with aneurysm or dilatation. Male patients with AAA or dilated aortas were significantly heavier, with a lower ankle arm index and higher serum cholesterol values than patients without AAA or aortic dilatation. PMID- 2696648 TI - Local versus general anaesthesia in carotid surgery. A prospective, randomised study. AB - A randomised, prospective study was performed to compare local (LA) and general anaesthesia (GA) in carotid surgery with special emphasis on complications and the need for intra-operative shunting. Fifty-six patients were randomised to LA and 55 to GA. Eight patients in the LA group required a GA for various reasons. During the same period 14 patients were not randomised. Seven perioperative neurological deficits occurred (5.6%), four in the LA group, two in the GA group, and one in the non-randomised group (NS). Selective shunting was used, in the Ga group according to stump pressure or in cases with a previous stroke and in the LA group according to the appearance of neurological symptoms. In the GA group 25 patients were shunted and in the LA group five patients (P less than 0.001) needed a shunt. If strict pressure criteria for shunting had been used in the LA patients, ten would have been shunted and three of the patients who developed symptoms during clamping would not have been shunted. During surgery the highest recorded systolic pressure was significantly higher in the LA group (210 mmHg versus 173 mmHg, P less than 0.001). LA for carotid endarterectomy is comparable with general anaesthesia regarding peroperative complications but produces significantly higher blood pressures than general anaesthesia. On the other hand it allows the possibility of neurologic monitoring of the patient and leads to significantly less use of an intra-operative shunt. PMID- 2696649 TI - Surgical thrombectomy versus conservative treatment for deep venous thrombosis; functional comparison of long-term results. AB - It is known that deep venous thrombosis (DVT) of the ilio-femoro-popliteal axis is frequently associated with irreversible damage to valvular competence of the veins and consequently with varying degrees of chronic venous insufficiency. Because preservation of the valvular function of deep veins can play an important role in preventing the postphlebitic syndrome we analysed and compared the long term functional outcome of two equally large cohorts of patients treated either surgically for restoration of venous patency and valvular function (24 patients) or medically with heparin, oral anticoagulants and compression stockings (25 patients). The study was also intended to examine the impact of duration and extent of DVT as predictive factors of late outcome. Follow-up time was 7.6 and 7.9 years respectively, operative mortality nil. Assessment of venous function was based on clinical observations as well as on measurement of haemodynamic parameters. Non-fatal pulmonary embolism after onset of treatment occurred in both cohorts with an equal frequency of 13%. Patients operated on for ilio femoral DVT were with few exceptions totally independent of any form of adjunctive hosiery which was in sharp contrast to the conservatively managed group. If onset of DVT had occurred more than 3 days earlier and extended from the ilio-femoral axis to the popliteo-crural level, surgery usually failed and patients were no better off than in the comparable medical group. The same pattern of late outcome was found for all other clinical and haemodynamic parameters; i.e. clinical signs of venous hypertension, valvular competence as judged by sonography, patient's self-assessment and the expelled volume and refilling time measured by dynamic plethysmography after standardised leg work. The mean expelled volume was 1.1 +/- 0.5 ml/100 g/min. for the surgical group treated early for ilio-femoral DVT and 0.7 +/- 0.5 ml/100 g/min for the corresponding medical group (P = 0.05). Recovery or refilling time was 50 +/- 21 s for the surgical group and 28 +/- 26 s for the medical group (P = 0.03). Thus, the clinical and haemodynamic effect of surgical thrombectomy was significantly superior to conservative management in ilio-femoral thrombosis treated within 3 days. For extensive thrombosis treated early the advantage of surgical thrombectomy was also evident, but the difference between the two treatment groups was not significant. The advantage of surgery was however totally lost in patients operated on for extensive DVT of long duration (i.e. greater than 3 days).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2696650 TI - Intravascular ultrasonic imaging: histologic and echographic correlation. AB - The feasibility of assessing arterial wall characteristics with an intravascular 40 MHz ultrasonic imaging device was determined in vitro. Ten autopsy specimens of human arteries, with and without atherosclerosis, were studied. A close relationship was observed between the histologic section and the corresponding ultrasonic cross-section with regard to the location, maximum plaque thickness and extent of the atherosclerotic lesion along the circumference of the vessel wall. Based on echogenicity of the atherosclerotic lesion, ultrasound could distinguish four basic types of atherosclerotic plaque components: 1. hypoechoic: a reflection of lipid deposits; 2. soft echoes: reflective of fibromuscular tissue; 3. bright echoes: representative of fibrous tissue; 4. bright echoes with shadowing behind the lesion: representative of calcium deposits. It is anticipated that development of such a catheter-tip imaging system combined with recanalisation methods will be of immense benefit for the precise localisation and identification of vessel wall pathology, precise positioning of a recanalisation instrument (laser device, atherectomy catheter) and subsequent use of this recanalisation procedure and for assessing the effect of recanalisation. PMID- 2696651 TI - Identical achondroplastic twins born to normal parents: a case report and review of the literature. PMID- 2696652 TI - [Gold-colored lamination of cast prosthesis with titanium nitride]. PMID- 2696653 TI - [Perfecting prosthetic occlusion using SR-Orthotyp sections]. PMID- 2696654 TI - [From casting to finishing]. PMID- 2696655 TI - Fibronectin content of the annulus fibrosus in diabetic and non-diabetic sand rats. AB - Annulus fibrosus of intervertebral discs from diabetic and non-diabetic sand rats were examined by microspectrophotometry for fibronectin content. This was higher in the diabetic animals both in the dorsal and ventral parts and in the outer and inner lamellae of the annulus. It is suggested that diabetes-related changes in fibronectin are similar to changes in annular collagen observed in species other than sand rats. PMID- 2696656 TI - Age-related changes in fibronectin in annulus fibrosus of the sand rat (Psammomys obesus). AB - Fibronectin stains were carried out and evaluated by microspectrophotometric techniques in annuli fibrosi of vertebral discs of sand rats (Psammomys obesus) of both sexes and two age groups, 13-18 months and over 2 years of age. The distribution of fibronectin in the annulus shows a centripetal gradient from the outer to the inner laminae. Fibronectin was significantly more abundant in the annuli of old than of young animals of corresponding sex. Sex differences were not significant. The dorsal segment contained more fibronectin than the ventral, but the difference was statistically significant only in the aged females. The outer laminae of the annuli appeared consistently higher in fibronectin content than the inner laminae. PMID- 2696657 TI - [Role of mycobacteria in Crohn's disease]. PMID- 2696658 TI - Effect of jejunal infusion of nutrients on gastrointestinal transit and hormonal response in man. AB - The effects of jejunal infusion of nutrients on gastric emptying and secretion, intestinal transit and hormone release were studied in human volunteers. Two caloric loads, 1.3 and 3.3 kcal/min, of a nutrient solution consisting of 18 percent protein, 27 percent lipids, and 55 percent carbohydrates were tested. These were first used in random order in 6 subjects to assess the effects on intestinal transit. For the study of gastric emptying, jejunal infusion was started 1 h after intragastric instillation of a 490 kcal, 400 ml, homogenized meal. Intestinal transit time and gastric emptying half-time increased with the rate of nutrient infusion into the jejunum. Postprandial gastric secretion was reduced. The two caloric loads induced significant rises of plasma cholecystokinin and gastric inhibitory polypeptide concentrations. Plasma motilin decreased in relation to the jejunal caloric load. The other peptides were essentially not affected by jejunal nutrient infusion in fasting subjects. We conclude that in man, gastric emptying rate, gastric secretion, and intestinal transit are regulated by the presence of nutrients in the jejunum. PMID- 2696659 TI - [Comparative efficacy of famotidine and ranitidine in the treatment of acute phase duodenal ulcer. A French comparative therapeutic trial]. AB - This multicentric, double-blind and prospective study, which involved 41 French Gastroenterology Units, was designed to evaluate the efficacy and safety of famotidine, 40 mg at bedtime, compared to single dose ranitidine, 300 mg, in promoting the healing of duodenal ulcer. Two hundred and ninety-six patients with endoscopically proven duodenal ulcer were randomly allocated to 2 treatment groups: 148 were treated with famotidine, and 148 with ranitidine. Patients were treated during 4 weeks and then controlled by endoscopy. Unhealed patients at 4 weeks were treated again by the same drug for 2 weeks and then endoscopically controlled. One hundred and nine patients were evaluable in the famotidine group and 111 in the ranitidine group. Groups were well-matched for age, sex, alcohol and smoking habits, and duration of ulcer disease. At 4 weeks of treatment, 86 of the 109 patients treated with famotidine had healed (79 percent) and 74 of the 111 patients treated with ranitidine healed (67 percent). At 6 weeks of treatment, 104 patients had healed in the famotidine group (95 percent) and 101 in the ranitidine group (91 percent). Results were significantly different between the 2 groups at 4 weeks of treatment only (p = 0.039). Among smoking patients, no statistical difference was observed between the 2 groups at 4 and 6 weeks of treatment. By contrast, in non smoking patients, famotidine appeared more effective (83 percent healed) than ranitidine (67 percent) (p = 0.014) at 4 weeks. Both treatments were well tolerated and severe adverse effects were scarcely observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696660 TI - [Ultrasonic diagnosis of biliary ileus. Apropos of 2 cases]. PMID- 2696661 TI - [Aggravation of dysphagia of the megaesophagus revealing pemphigus vulgaris]. PMID- 2696662 TI - [Can the risk of recurrence of the initial disease after liver transplantation be evaluated?]. PMID- 2696663 TI - [Interobserver and intercenter agreement of gastro-esophageal endoscopic signs in cirrhosis. Results of a prospective multicenter study]. AB - Because of the diagnostic and prognostic value of gastroesophageal endoscopic signs in cirrhosis, we studied their interobserver and intercenter agreement. Fifty cirrhotic patients without previous digestive bleeding were included in this study. The gastroesophageal endoscopic examinations of these patients, recorded on video tape, were independently viewed by 12 observers belonging to different hospitals. Agreement was evaluated by the kappa index (k), the values of which were given with p less than 0.001. Agreement was good for the presence (k = 0.40) or the size (k = 0.51) of esophageal varices as well as for red signs on the mucosa overlying esophageal varices, but it was poor for the color (k = 0.10) or the extent (k = 0.20) of esophageal varices. Agreement was poor for all gastric signs: fundic varices (k = 0.35), red spots (k = 0.28), associated lesions (k = 0.27), mosaic pattern (k = 0.27), gastropathy (k = 0.11). The mean diameter of esophageal varices, evaluated without any scale, varied from 3.5 +/- 1.4 to 7.5 +/- 4.0 mm between the 12 observers (p less than 0.001). Agreement was maximum for the more developed grade of a sign and minimum for the intermediate grade. The value of kappa indexes in this intercenter study was compared to that obtained in a previous study from one institution: interobserver agreement was significantly better within one center than between different centers. In conclusion, intercenter agreement is good for the size of esophageal varices and the presence of red signs, and poor for all the other signs. The millemetric measurement of esophageal varices diameter, without any scale, appears to be unreliable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696664 TI - [Spontaneous mutation of leu2 in Saccharomyces cerevisiae]. AB - The data obtained indicate that spontaneous mutations in Saccharomyces cerevisiae are formed during DNA replication. With no DNA replication in the lag-period, in the stationary growth phase, spontaneous mutations are not formed in cell culture during the G1 phase of cell cycle. Experimental data show the absence of primary spontaneously occurring DNA lesion accumulation in the cell G1 phase. Spontaneous mutations of yeasts are formed in the S phase of cell cycle, apparently as DNA replication errors. It is established that the frequency of spontaneous reversions of the leu2 gene in Saccharomyces cerevisiae strain NA3-24 increases when the cells are cultivated on the culture medium with different concentrations of leucine. PMID- 2696665 TI - [Disclosure of ancient medical tests and its problems--the Corpus Medicorum Graecorum et Latinorum. Accomplished and planned goals]. AB - The interacademical project "Corpus Medicorum Graecorum", started in 1907 in Berlin, reflects the evolution of the classical philologists' approach to ancient medicine. The Corpus was meant to make available reliable critical editions of the ancient medical texts to historians of science as indispensable tools for their research work. The work done to realize this purpose has shown, however, that the whole primary and secondary tradition of these texts must be taken into consideration. The translations into modern languages and the commentaries included in the more recent volumes should help to make accessible the ancient texts to as many interested persons as possible. PMID- 2696666 TI - [Tissot and the concept of scientific medicine of the 18th century]. AB - The notion of enlightened medicine was conceived by an elite group of eighteenth century medical scholars to which Tissot belonged. This elite group sought to create an identity separate from its counterpart, that is to say popular medicine as defined by this group. The distinctive characteristic of this enlightened medicine was its critical rationalism based on observation and experiment as well as their numerical evaluation. This article describes how Tissot, influenced by Fr. Boissier de Sauvages, Albrecht von Haller and J.G. Zimmermann, understood observation and experiment in medicine. This study shows that learned medicine, as portrayed by our author, seems to have originated today's modern scientific medical approach. PMID- 2696667 TI - [Medical history without purpose? On the medical history aspects of Theophile de Bordeau (1764)]. AB - Theophile de Bordeu (1722-1776) published in 1764 a large Medical History. He used it for a discussion of the pros and contras of smallpox inoculation by giving the hypothetical opinions of ancient physicians who could not have known that new method. As he was at that time unjustifiedly involved in a theft scandal, he used his book also for ridiculising his enemies among his colleagues. PMID- 2696668 TI - The history of dietetics. 1941. AB - Henry E. Sigerist's paper on the history of dietetics covers the entire development of dietetics since the emergence of the human species. Originating in early man's food-seeking instinct, dietetics had become an empirical science by the time of the ancient Greeks. They stressed the dietetic treatment of illness and began to formulate numerous rules. Regimina sanitatis, manuals containing precise dietetic prescriptions for the maintenance of good health, were widely circulated in the Middle Ages. In addition to new impulses initiated by Paracelsus, the author emphasizes the clinical and experimental studies pursued, from the 17th to the 19th centuries, by such scientists as Thomas Sydenham, Justus von Liebig, Carl von Voit and Gustav von Bunge. The author concludes by pointing out that, despite enormous progress, more than one half of the world's population still suffers from malnutrition. For this reason, he regards the social application of dietetic findings as the most urgent task facing us in the future. PMID- 2696669 TI - History of psoriasis and parapsoriasis. AB - Parapsoriasis is not a disease entity. It is an auxiliary term introduced in 1902 to group several dermatoses with a faint similarity to psoriasis. The historical development leading to the creation of the term parapsoriasis is outlined and the history of psoriasis is briefly reviewed. PMID- 2696670 TI - Evaluation of a single intravitreal injection of 5-fluorouracil in vitrectomy cases. AB - To evaluate the efficacy and toxicity of 5-fluorouracil (5-FU) after pars plana vitrectomy, 51 eyes were followed in a prospective and randomized clinical trial in which, upon completion of surgery, 26 eyes received 10 mg intravitreal 5-FU and 25 control eyes did not receive 5-FU. The only possible sign of 5-FU toxicity was prolonged corneal epithelial edema. Visual acuities of 20/200 or better were obtained in 67% of the 5-FU group and 56% of the control group. Successful macular reattachment was obtained in 60% of the 5-FU group and 77% of the control group. None of the eyes in either group developed substantial intraocular proliferation or membranes. The findings indicate that a single 10-mg intravitreal injection of 5-FU is well tolerated without permanent toxic damage. PMID- 2696671 TI - Effect of postoperative subconjunctival 5-fluorouracil injections on the surgical outcome of trabeculectomy in the Japanese. AB - A controlled study was carried out to evaluate the effect of postoperative subconjunctival 5-fluorouracil (5-FU) injections on the surgical outcomes of trabeculectomy in the Japanese (a total of 196 eyes in 157 patients). The eyes that had undergone trabeculectomy with postoperative 5-FU (5-FU group) included 36 eyes with primary open-angle glaucoma (POAG) and 17 with secondary glaucoma (SG) undergoing their first or second trabeculectomy. There were also 34 eyes with refractory glaucoma. The eyes that had had trabeculectomy without postoperative 5-FU (control group) included 46 POAG and 31 SG eyes undergoing their first or second trabeculectomy and 24 refractory glaucoma eyes. The surgical techniques and postoperative care were virtually identical between the two groups, except that the control group did not receive 5-FU. The results were analyzed by means of a life table method and a postoperative intraocular pressure (IOP) level equal to or less than 20 mmHg was adopted as the criterion for successful IOP control. In the 5-FU group, the success probability (%) at the 3 year follow-up was 93.9 +/- 4.2 (SE) for POAG eyes, 93.8 +/- 6.1 for SG eyes, and 86.7 +/- 5.6 for refractory glaucoma eyes. In the control group, it was 55.0 +/- 7.9, 37.2 +/- 13.5, and 16.1 +/- 7.4, respectively. The difference in success probability between the 5-FU and control groups was highly significant (P less than 0.001 or 0.01). In the POAG and SG eyes, the mean postoperative IOP was significantly lower in the 5-FU group than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696672 TI - Neuroglial choristoma presenting as congenital lid tumor. AB - A 12-month-old boy presented with a diffuse solid tumor of the nasal portions of the lower lid, which had caused almost complete narrowing of the interpalpebral fissure since birth. Clinically, it was suspected to be a mesenchymal tumor. Radiological studies revealed no bony defects in the orbit. The computerized tomographic (CT) scan disclosed a porencephalic cyst in the ipsilateral cerebral hemisphere. Excisional biopsy of the lid tumor revealed ectopic neuroglial tissue. The immunocytochemical demonstration of glial fibrillary acidic protein (GFAP) was consistent with the electron microscopic findings that disclosed fibrillary astrocytes with an abundance of typical 9- to 10-nm glial filaments. Heterotopic neuroglial tissue should be part of the differential diagnosis of congenital lid tumors; its occurrence may be associated with other anomalies of cerebral organogenesis. PMID- 2696673 TI - [Current prerequisites for the development of algorithms for common hygienic standardization of combined effects of environmental factors]. PMID- 2696674 TI - The Mildred Scheel 1988 memorial lecture. A biologist's view of human cancer. PMID- 2696675 TI - Immunologic subclassification of acute lymphoblastic leukemia in childhood and prognosis (modified BFM protocol). PMID- 2696676 TI - Leukemia cytogenetics in children: results of the German therapy studies. PMID- 2696677 TI - Stromal-hematopoietic interrelationships: Maximov's ideas and modern models. PMID- 2696678 TI - Growth and development of haemopoietic cells: a deterministic process? AB - The in vitro methods used to study haemopoiesis fall into two distinct categories. Short-term colony forming assays have identified a number of potent soluble factors capable of maintaining survival, proliferation and differentiation of haemopoietic cells but not their self-renewal. In contrast, in long-term bone marrow culture, extensive self-renewal occurs in the absence of exogenous factors and direct physical contact between haemopoietic cells and cells of the adherent stromal layer seems to be important. Obviously, LTBMC more closely resembles the situation in haemopoietic tissues but the potency of growth factors imply that they too play a role. Our data suggest that this may be at an earlier stage of haemopoietic development than previously appreciated. Primitive multipotent cells have the potential to respond to CSFs which were previously thought to stimulate only committed progenitor cells. This response is only seen, however, when the cells are exposed to a combination of factors which include either IL-1 or G-CSF. Thus, a combination of factors is able to recruit cells which are not already committed and determine the lineage along which they will differentiate. While it remains to be conclusively demonstrated that growth factors regulate normal "steady state" haemopoiesis in vivo it is clear that contact with stromal cells is important. The mechanisms by which the adherent layer influences haemopoietic development, however, are less obvious. We have shown that a component of stroma, heparan sulphate, is able to bind growth factors and present them to haemopoietic cells in a way that stimulates haemopoiesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696679 TI - Establishment of a leukemic cell line MT-ALL with multilineage differentiation potential. PMID- 2696680 TI - Preleukemia in experimental leukemogenesis. PMID- 2696681 TI - RAS mutations in preleukaemias. PMID- 2696682 TI - Species-specific therapy of acute lymphoid leukemia. AB - In the past 10 years immunophenotyping of ALL has been demonstrated to be useful for selecting and scheduling chemotherapy. Different drug regimens are now used for T-cell and B-cell ALL than for non-T non-B ALL with the result that survival and cure of T-cell and B-cell ALL have been considerably improved. The use of different drug regimens for different immunophenotypic varieties of non-T non-B ALL is being tested. "Prognostic factors" of ALL are artifacts of data analysis and treatment and should no longer be used for guiding treatment. The administration of all-inclusive multiple-drug therapy to all patients with ALL regardless of species should also be abandoned. Minimally effective drugs can interfere with dosage and continuity of more effective drugs, and can result in side effects and sequelae that increase the mortality and morbidity of treatment. Since acute leukemias are genetic disorders of hematopoiesis the future direction of leukemic therapy is toward genetic targeting. PMID- 2696683 TI - Disorders of the expression of the multichain IL-2 receptor in HTLV-I-associated adult T-cell leukemia. PMID- 2696684 TI - Molecular analysis of rearrangements in Philadelphia (Ph1) chromosome-positive leukemia. PMID- 2696685 TI - c-myc and c-myb oncoproteins during induced maturation of human myeloid and erythroid leukaemic lines. PMID- 2696687 TI - Close localization of the genes for GM-CSF and IL3 in human genome. PMID- 2696686 TI - Current issues and future directions in marrow transplantation. PMID- 2696688 TI - Oncogene cooperation and B-lymphoid tumorigenesis in Emu-myc transgenic mice. PMID- 2696689 TI - Analysis of c-raf oncogene expression in gastrointestinal tumor cells. PMID- 2696690 TI - The use of long-term bone marrow cultures (LTBMC) to detect hematotoxic side effects of purging methods. AB - With a view to the establishment of purging methods it is necessary to investigate complete-remission bone marrow as the real target of purging, rather than bone marrow from healthy donors. The results of LTBMC are superior to those of GM-CFC where the hematopoietic recovery of bone marrow is concerned. One-stage LTBMC after bone marrow manipulations may reflect mixed hematopoietic/stromal effects. The use of two-stage LTBMC allows the evaluation of the stem cell recovery without the possible influence of a damaged microenvironment. PMID- 2696691 TI - Human endogenous retrovirus-like sequences. PMID- 2696692 TI - Fantasy of a "virus" from the inorganic world: pathogenesis of cerebral amyloidoses by polymer nucleating agents and/or "viruses". PMID- 2696693 TI - Clinicopathological features and prognostic implications of immunophenotypic subgroups in childhood ALL: experience of the BFM-ALL Study 83. PMID- 2696694 TI - Targeted plasma drug concentration: a new therapeutic approach to relapsed nonlymphoblastic leukemia in children. PMID- 2696695 TI - Use of all-trans retinoic acid in the treatment of acute promyelocytic leukemia. PMID- 2696696 TI - [Schauta-Amreich expanded total vaginal excision in cervix cancer in relation to historical development]. AB - After a historical outlook on the development of radical vaginal hysterectomy, our own results and complications in 51 cases of stages I and II during the years 1968-1983 are reported. The 5-year survival rate was 98.04% with no primary mortality. PMID- 2696697 TI - [Blood flow measurements of the utero-placento-fetal unit]. AB - Examination techniques suitable for evaluating uteroplacental blood flow are of vital clinical interest. Whereas flow measurement using radioisotopes only catches the maternal side of the placenta, pulsed ultrasound Doppler technique makes it possible to examine the maternal and fetal side of the uteroplacental unit. The results of the examination show a good correlation to the newborns' birth weight. PMID- 2696698 TI - [Current treatment concepts in ovarian cancer]. AB - Surgery plays an important role in the therapeutic procedure in ovarian cancer. An exact staging laparotomy in the early stages and debulking in advanced stages are necessary. In stage I/a respectively I7b (G1), chemotherapy can be avoided. Otherwise cisplatin or carboplatin-containing regimes give the best results. In low peritoneal tumor burden, or in microscopic residual disease intraperitoneal chemotherapy may be an alternative treatment. No clear therapeutic strategy can be given after second-look surgery. In such cases prospective randomized studies are necessary. PMID- 2696699 TI - [Immunoscintigraphy in oncology exemplified by ovarian cancer]. AB - Diagnostic and therapeutical work increasingly uses immunologic and nuclear medical methods, which is especially true in oncology. Recently tumor localization has gained much from immunoscintigraphy, a noninvasive method combining immunologic and nuclear medicine techniques. After application and accumulation of radiolabelled tumor-associated monoclonal antibodies, it is possible to obtain malignant tumor sites by scintigraphy. In the following a short introduction of the method and its use in ovarian cancer patients is presented. PMID- 2696700 TI - [Is stepwise patient education sensible?]. PMID- 2696701 TI - [The patient education document]. PMID- 2696702 TI - [Education of patients before gynecologic interventions]. PMID- 2696703 TI - [Surgery by physicians during residency]. PMID- 2696704 TI - [The legal position of the obstetrician in relation to the pregnant patient, the father and the child as well as the expert witness]. PMID- 2696705 TI - [Fetal hypoxia and legal consequences. A contribution to defining responsibility for documentation and assessment of findings]. PMID- 2696706 TI - [The responsibility of settlement courts and expert commissions]. PMID- 2696707 TI - [Status and responsibilities of the expert in malpractice procedures]. PMID- 2696708 TI - Epidemiology of leukaemia. AB - The history of the epidemiology of leukaemia provides us with models which are very useful even today and their implications for the future are still more important. Thus, in the present study, we shall review the history and present state of the epidemiology of leukaemia, as well as its future prospects. In the fifth century B.C. Hippocrates already advocated studying the climatic, geographical and physical environment as well as the behaviour of individuals and of their eating and drinking habits in order to understand the origin of a disease. At present, the epidemiology of leukaemia is still based on these ancient precepts. PMID- 2696709 TI - The effect of human recombinant granulocyte-macrophage colony stimulating factor on the proliferation and differentiation of myeloid progenitors in congenital agranulocytosis marrow cells. AB - Congenital agranulocytosis is a rare and frequently fatal infantile disease characterized by recurrent bacterial infections, persistent absence of neutrophils in the peripheral blood and an arrest of myeloid maturation at the promyelocyte/myelocyte stage. The effect of human recombinant Granulocyte Macrophage colony stimulating factor (GM-CSF) alone and in combination with retinoic acid, dimethylsulphoxide or actinomycin-D on the proliferation and differentiation of bone marrow cells from a child with congenital agranulocytosis was studied. Cells were treated at a concentration of 1 x 10(5) per ml in in vitro culture with GM-CSF alone and in combination with retinoic acid, dimethylsulphoxide or actinomycin-D for 7 days at 37 degrees C in humidified incubator containing 5% CO2 in air. GM-CSF showed a profound stimulatory effect on the proliferation of myeloid progenitors from the child bone marrow and restored colony numbers in the retinoic acid-, dimethylsulphoxide- and actinomycin-D-inhibited cultures. PMID- 2696710 TI - [Prevention of cystoid macular edema with diclofenac eyedrops in intracapsular cataract extraction using the Choyce Mark IX anterior chamber lens]. AB - Diclofenac is superior to other nonsteroid anti-inflammatory drugs (NAD) with respect to its antiphlogistic properties, as demonstrated in laboratory animal experiments. The antiphlogistic action of diclofenac eyedrops versus placebo eyedrops in the prophylaxis of cystoid macular edema (CME) and postoperative inflammatory symptoms was therefore tested in a prospective randomized double blind study. A total of 179 patients with intracapsular cataract operations and Choyce Mark IX anterior chamber lens implantation received 2 drops 5 times preoperatively and 1 drop 5 times postoperatively until they were discharged, and then subsequently for 6 months they used 1 drop of diclofenac or placebo eyedrops 3 times. To evaluate the CME, fluorescence angiography was carried out on all patients on the day of discharge, 6 weeks later, and after 6 months following the operation. The patients who completed the study according to plan numbered 112. With diclofenac eyedrops, significantly less CME occurred in comparison with treatment with placebo eyedrops (p = 0.03). Visual acuity improved faster and the postoperative inflammatory symptoms receded more quickly in the diclofenac group. PMID- 2696711 TI - [Evaluating the postoperative depth of the anterior chamber in primary extracapsular cataract extraction and intraocular lens implantation]. AB - To evaluate the depth postoperatively of the anterior chamber, a second biometry by ultrasound was done in 100 eyes 6-12 months after cataract extraction and IOL implantation (sulcus fixation). The aim was to compare the depth of the anterior chamber preoperatively with that measured postoperatively. The measurement showed a middle anterior chamber depth of 3.42 mm preoperatively and 3.67 mm postoperatively. This means that there was a mean increase in the anterior chamber depth of 0.25 mm. PMID- 2696712 TI - [Degenerative, regenerative and adaptive reactions to local damage of the retina]. AB - Retinal ganglion cells can respond to local lesions due to mechanical trauma or photocoagulation with degeneration, adaptation or regeneration. Animal experiments show that under natural conditions the kind of reaction is dependent on the age at onset and on the degree of destruction caused by the lesion. In early postnatal life directly severed cells undergo fast degeneration while indirectly affected cells show adaptive changes (dendritic reorganization in the neighborhood of retrogradely degenerated retinal areas). This kind of reaction is not observed in adulthood. In contrast, in the adult retina there is a greater resistance to lesion effects and surviving cells show signs of axonal regeneration. Such attempts at regeneration, however, do not lead to successful reentry of axons into the optic nerve. In addition, at the very borders of photocoagulator lesions we observe both in early postnatal and adult animals signs of dendritic plasticity (redistribution of dendrites away from the lesion and towards the normal retina). The dendritic changes are aimed at retaining function and at reducing lesion size. They are characterized by a redistribution of dendritic volume towards the intact retina. While spontaneous intraretinal axonal regeneration does not appear to be beneficial for the system, the dendritic phenomena can be interpreted as attempts to limit the actual damage. PMID- 2696713 TI - [Acute retinopathy of prematurity: shift of the manifestation risk to extremely premature infants by neonatal intensive care medicine]. AB - A total of 381 surviving prematures (birthweight less than or equal to 2500 g) at the heidelberg University Children's Hospital were examined ophthalmologically between January 1986 and June 1988. Of the 762 eyes, 112 (14.7%) showed acute retinopathy of prematurity (ROP). In our study, a correlation between birthweight, gestational age and retinopathy of prematurity was confirmed. In addition, the results concerning severity, differences between the right and left eye, and the incidence in twins and multiple births were demonstrated. Data were compared with the data in 29 papers dealing with the prevalence of acute ROP since 1968: 12,468 preterm infants were investigated in all papers; 2,087 of these infants (16.7%) showed ROP. In the literature, 8.4% of the premature babies with a birthweight of 1501 to 2500 g were found to have ROP. In our group with the same birthweight, only one baby (birthweight 1510 g) had retinopathy (0.6%). The fact that the average ROP prevalence has not changed significantly indicates that the risk of having retinopathy of prematurity has switched over to the more immature preterms, whose prognosis of survival has improved in the last few years as a result of the improvement in neonatal care. PMID- 2696714 TI - [Mesectodermal leiomyoma of the ciliary body--clinical aspects, surgery and immunohistochemistry]. AB - The clinical, surgical and light microscopical features of a mesectodermal leiomyoma of the ciliary body are presented. Slit-lamp examination of a 63-year old woman strongly suggested a malignant lesion of the ciliary body and the peripheral choroid. Following cryoretinopexy and argonlaser-photocoagulation, the tumor and the adjacent portion of the cornea, angle structures, iris, ciliary body, choroid and sclera were removed en bloc. The defect was covered by a corneosclerotransplant 14 mm in diameter. Histological examination revealed a well circumscribed tumor of the ciliary body, consisting of sheets of fusiform cells. Intracytoplasmatic filaments gave a positive reaction to an actin antibody (Actin HHF 35 MA 931), demonstrating the smooth muscle origin of the ciliary body tumor by immunocytochemical means. PMID- 2696715 TI - [New radiotherapy approaches in the treatment of malignant choroid melanoma]. AB - Today the best radiotherapeutic procedure for treating small choroidal melanomas involves the application of rhutenium 106, thereby sparing the bulbus, or application of iodine 125 in larger tumors. In extensive tumors, the additional use of local hyperthermia promises further enhancement of brachytherapy with applicators. In the foreseeable future, therapeutic concepts primarily for the palliative treatment of advanced, metastasing melanomas might include the use of antimetabolites or therapy with monoclonal radioactively changed antibodies. PMID- 2696716 TI - [Tumor markers in malignant choroid melanoma]. AB - Antibodies against tumor-associated antigens ("tumor markers") can be used for the diagnosis of malignant tumors. Eight different monoclonal antibodies, that can recognize tumor-associated antigens of dermal melanomas, were tested in cryostat sections of uveal melanomas. The uveal melanomas showed antigenic differences (e.g., gangliosides) and common antigens (e.g. high molecular weight melanoma-associated antigen) in comparison to dermal melanomas. The implications of these results for diagnosing and even treating uveal melanomas are discussed. PMID- 2696717 TI - [Recent developments and technics in eyelid-orbit surgery]. AB - The advances in lid and orbital surgery are due to the improvements made in diagnostic equipment and to technical refinements. Modern imaging techniques now provide exact preoperative analyses, especially for orbital disorders. New suture and implant materials have been introduced, and the use of the operating microscope and of various types of lasers has broadened the spectrum of therapeutic possibilities. Surgical procedures have been developed that pay more attention to the specific anatomy, function and pathogenesis of the lids, especially for involutional disorders and loss of tissue. PMID- 2696718 TI - [The value of digital subtraction dacryocystography]. AB - Dacryocystography is a standard technique for the visualization of the lacrimal pathways. In 1974, Lloyd et al. first described manual subtraction of dacryocystograms. Digital subtraction dacryocystography has definite advantages compared to the conventional dacryocystograms and manual subtraction. Besides the clearly superior topographic display, it also provides information about the functional status of the nasolacrimal pathway. Even though slightly more time consuming, this examination is well justified by the superior quality of the depiction of fine topographic details. Other advantages are the kinetic evaluation of tear flow, digital image analysis and the relatively low radiation dose. PMID- 2696719 TI - [Fluorescence perfusion scintigraphy. A new method for quantifying ocular circulatory disorders]. AB - A new clinical method, fluorescence perfusion scintigraphy (FLUPS), had been developed that permits high-resolution measurement of the circulation time between the carotid artery and the retina. A bolus, consisting of 0.5 ml Na fluorescein (20%) and 0.5 ml 99mTc-DTPA (20 mBq) is injected into the antecubital vein. The bolus is detected first by a transdermal gamma emission detector overlying the carotid artery with 5 measurements per second. The subsequent appearance of the bolus in the eye is simultaneously recorded with a scanning laser ophthalmoscope that permits high-resolution angiograms. A picture analysis system measures the increase in the intensity of the fluorescence over the optic disc. The temporal difference between the time concentration curves obtained with these techniques is the carotid-retina circulation time. The carotid-retina time of both eyes of 15 patients with unilateral central retinal vein and branch vein occlusion was measured in order to detect interocular changes in the circulation time. The carotid-retina time, as determined by FLUPS in normal eyes, ranged between 0.7 and 2.3 s. Patients with central retinal vein occlusion showed a carotid-retina time that was significantly (p less than 0.05) delayed by 3 to 150%. These data demonstrate that FLUPS is a valuable tool for monitoring defects in the ocular circulation. PMID- 2696720 TI - [Histopathology of the eye--recent technics]. AB - The histopathology of the eye is especially suitable for demonstrating the necessity and advantages of a close clinicopathological correlation. It should therefore be performed by a clinical ophthalmologist who is especially trained in histopathology. During recent years it has been realized more and more that metabolism and function in a living organism are only possible in relation to intact morphological structures. This led to a "renaissance" of morphology in general and of human histopathology and ophthalmopathology in particular. The workup of ophthalmopathologic specimens includes careful dissection of the globe, its macroscopic examination under the stereomicroscope, photographic documentation of interesting findings, and the application of all modern techniques of histopathology, such as light microscopy, electron microscopy, scanning electron microscopy, freeze-fracture techniques, and immunohistochemistry. The above methods are briefly discussed. PMID- 2696721 TI - Resolution of apparent growth hormone-dependent growth failure during puberty: a case report. AB - A prepubertal boy with apparent growth hormone (GH)-dependent growth failure displayed a marked increase in growth velocity, normal GH responses to arginine/insulin infusion and a fourfold increase in spontaneous 24-hour GH secretion following the onset of normal puberty. The case supports earlier observations of a transient form of GH insufficiency in some short prepubertal children, but represents the first evidence that puberty restores spontaneous as well as stimulated GH secretion in such patients. PMID- 2696722 TI - [Relationship between bacterial envelope barrier and resistance of E. coli, S. aureus to rifamdine]. AB - The Rifamdine (RFD) resistant strains were obtained from wild types of S. aureus NCTC 6571, E. coli NCTC 10418 and Proteus vulgaris by drug concentration gradient plate. The experiment indicated that the growth inhibition of resistant cells induced by synergism of EDTA acting with RFD. Such results did not occur effectively if EDTA or RFD was added separately. The amount of 3H-RFD incorporated into cells of susceptible and resistant strains of E. coli and S. aureus was compared. The amount of 3H-RFD incorporated into susceptible cells was much greater than that of the resistant strains in E. coli cells. Ultrastructure comparison of sensitive and resistant cells showed that the surface of resistant cells was coarser and shorter, the outer membrane thickened and electron density increased. These results have shown that there is a close relationship between the resistance of bacteria induced by RFD and the decrease in the permeability of cell envelope barrier to the drug. PMID- 2696723 TI - [Observation on enhanced adhesion to dentin by amino acid]. AB - An amino acid was adopted to pretreat the surface of dentin. The bond strength between GP adhesive and dentin mediated by the amino acid was enhanced after the pretreatment. Furthermore, the longer the stored time of extracted tooth was, the better the effect of adhesion was. This pretreatment will benefit the adhesive restoration for dead tooth or low activity tooth clinically. PMID- 2696724 TI - [Renal function in chronic cor pulmonale monitored with beta 2-microglobulin]. AB - Serum and urine levels of beta 2-microglobulin (beta 2-MG) were measured with radioimmune assay in 40 chronic cor pulmonale patients (52 episodes) and 26 normal controls. The results showed that the serum and urine levels of beta 2-MG were 2.01 +/- 0.47 mg/L and 0.10 +/- 0.08 mg/L respectively, in the normal controls, while in the cor pulmonale group 3.86 +/- 1.58 mg/L and 0.66 +/- 0.34 mg/L respectively, with statistical significance (P less than 0.001, less than 0.005). It was shown that there was a positive correlation between the levels of serum and urine beta 2-MG and PaCO2 and a negative correlation between the levels of serum and urine beta 2-MG and PaO2. The results indicated that determination of serum and urine beta 2-MG could be used in the early detection of the renal impairment in chronic cor pulmonale. The predisposing factors of renal dysfunction in cor pulmonale were also discussed. PMID- 2696725 TI - Normal human immune peritoneal cells: phenotypic characteristics. AB - Normal human peritoneal cells (PC) collected from patients with calculous cholecystitis without clinically detectable inflammatory changes were characterized morphologically, histochemically and phenotypically by means of monoclonal antibodies. The PC consisted of 45% of monocytes/macrophages (M718 + cells). Thirty-five per cent of PC were esterase-positive and 23% acid phosphatase positive. Forty-five per cent of PC adhered to glass surface. In the lymphocyte population, 2% of CD22 B lymphocytes (M738 +) and 42% CD2 T lymphocytes (M720+) were found. CD4/CD8 ratio was 0.4. There were 8% of Leu7 + cells. The PC did not reveal interleukin 2 (OKT26a +) and transferrin receptors (OKT9 +) on their surface. No blast cells were detected in the PC suspension. Approximately 49% of the PC expressed Ia antigens (OKIa1 +). Two per cent of S100 positive dendritic cells (Z311 +) were found. Peritoneal fluid contained 9% of granulocytes, mostly neutrophils. Two per cent of PC were free mesothelial cells (M717 +). We conclude that human peritoneal cavity contains a cell population significantly differing from that which is present in peripheral blood, which strongly suggests a non-random cell accumulation in the peritoneum. Lack of any activated cells indicates that under normal conditions the peritoneum lavage fluid contains a steady-state population. We conclude that the normal peritoneal fluid cells represent a heterogeneous population capable of reacting to various antigens entering the cavity from the gut. PMID- 2696726 TI - Study of human epithelial cell detachment and damage: development of a model. AB - Detachment of epithelial structures from underlying basement membrane (BM) represents an important component of a number of human disease processes e.g. airway and alveolar diseases, gastrointestinal ulceration, and retinal diseases. This study describes a method of evaluating human epithelial cell detachment from BM that is simple, rapid, inexpensive, quantifiable and which, because it utilizes BM rather than tissue culture plastic, more closely mimics the in vivo situation than other methods. In this model human amnionic epithelial cells attached to their underlying BM are isolated from fresh placentae and mounted in a multi-well chemotaxis assembly. These membranes can be studied with the epithelial cell monolayer intact. Protease-induced detachment of the epithelial cells from the underlying BM was readily quantifiable using light microscopy and spectroscopy. Following removal of the native amnionic epithelial cells, immunoperoxidase staining for the BM attachment proteins laminin, fibronectin, and type IV collagen demonstrated that these molecules remain intact. The BM could also be used as an attachment surface to reconstitute other epithelial cell monolayers. Cultured human amnionic cells and human respiratory epithelial cells were both able to attach to the denuded BM in the absence of serum (% attachment = 85 +/- 15% and 92 +/- 8% respectively, P = 0.8). Natural BM was a better substrate for epithelial cell attachment than tissue culture plastic in that, in the absence of serum, cultured epithelial cell attachment to tissue culture plastic was 20 +/- 4% of the value for BM (P less than 0.05). Furthermore, cells attached to plastic adhered less effectively than to BM in that trypsin concentrations required to induce 50% cell detachment were 0.72 +/- 0.4 for plastic and 62 +/- 13 BAEE U/ml for BM (P less than 0.001). In view of the complex protein interactions known to be involved in the anchorage of human epithelial cells to BM, it is likely this model will be a useful tool for evaluating the mechanisms underlying human epithelial cell attachment and detachment in a variety of normal and disease situations. PMID- 2696727 TI - Differences in the phenotypes of cells mediating anti-tumour immunity at various stages of tumour progression in mice. AB - In Winn assays, T cells from donors immunized by tumour excision, or from mice with small tumours, mediate rejection of the metastasizing murine fibrosarcoma MC 2. As the mean size of primary tumours in spleen donors increases, the strength of anti-tumour activity declines, until it is frequently undetectable in spleen cells from mice with very large tumour burdens. Loss of splenic anti-tumour activity is coincident with the appearance of cells capable of suppressing an otherwise protective anti-tumour response in Winn assays. This paper defines the phenotypes of T cells mediating immunity against MC-2. Eleven or more days after tumour inoculation the proportions of tumour-bearer splenic leucocytes expressing Ly 1.2 (CD5), Ly 2.2 (CD8a) or L3T4 (CD4) surface antigens were significantly less than similar preparations from normal animals. Depletion of Ly 1.2+ or L3T4+ cells from spleen cells of donors with small tumours, or from donors immunized by tumour excision, diminished protection in the Winn assay. Depletion of Ly 2.2+ cells from these donors had no effect on immunity. In contrast, spleen cells taken from donors with large tumors lost all anti-tumour activity if pretreated with any one of anti-Ly 1.2 or anti-Ly 2.2 or anti-L3T4 antibodies in the presence of complement. These results suggest that cells bearing the Ly 2.2 marker may be important to weak immunity remaining in the spleens of mice with large tumours, but are not critical to strong immunity generated early in tumour growth, nor to that following tumour excision. That is, in addition to an Ly 1.2+, Ly 2.2-, L3T4+ spleen cell subset also seen early in the growth of the MC-2 tumour, a cell population which expresses the Ly 2.2 marker and which is important to anti-tumour immunity emerges late in tumour growth. PMID- 2696728 TI - Overweight: fat distribution and health risks. Epidemiological observations. A review. AB - Several expert panels have recommended the use of a body mass index (BMI = weight/height2) to assess obesity. Excessive risks of chronic diseases and mortality are clear when BMI exceeds 30 kg/m2. Probably more important in assessing the health risks of excessive fat stores is the distribution of fat over the body. Accumulation of fat in the abdominal cavity (mesenteric and omental fat) predisposes to important metabolic aberrations and leads to an increased incidence of diabetes mellitus, cardiovascular disease, and stroke. Importantly, the increased risks associated with abdominal obesity are seen in obese as well as in non-obese individuals. PMID- 2696729 TI - Objective measurement of testicular volume by ultrasonography: evaluation of the technique and comparison with orchidometer estimates. AB - Ultrasonography of the scrotum is a valid and safe method for differentiating testicular and extratesticular disease. In the present study the accuracy and reproducibility of ultrasonographic estimation of testicular volume was evaluated. A high correlation (r = 0.992) between actual testicular volume (measured by weighing and water displacement) and the volume determined by ultrasonography was found on examination of 14 tests from patients at autopsy without any systematic under- or over-estimation. The ultrasound method proved to be highly reproducible with a coefficient of variation of 7.0 +/- 0.7%. Using different ultrasound scanners did not significantly influence the results obtained. The comparison of Prader orchidometer measurements, performed by four different clinical investigators, and ultrasonography in 256 patients revealed a significant correlation of 0.91, but the degree of correlation was dependent on the investigator's clinical experience. Volume estimates by comparative palpation appear to be valuable in most clinical settings. Ultrasonography provides an excellent tool for determining testicular volume when objective, accurate and reproducible measurements of testicular volume are required. PMID- 2696730 TI - Patterns of Doppler recordings and its relationship to varicocele in infertile men. AB - Incompetence of the testicular vein appears to be the basic pathology of testicular dysfunction in varicocele. Doppler recording is a very sensitive method for detecting this reflux even when varicocele is not evident clinically. One hundred and seventy-eight men with infertility were studied. The presence of reflux in the pampiniform plexus as demonstrated by Doppler recording was compared with clinical varicocele. Reflux patterns were recorded on graph paper and various grades of reflux were observed. The three grades of reflux identified varied between a momentary reflux during vigorous Valsalva manoeuvre to significant reflux on minimal increase in intra-abdominal pressure brought about by normal respiration and deep breathing. Ninety-four per cent of the patients with clinical signs of varicocele had refluxes of grade 2 and 3 on Doppler study. Forty per cent of the patients without clinical evidence of varicocele were found to have reflux of grade 1 and 2 in the testicular veins. PMID- 2696731 TI - Quality of life: individualism or holism? A critical review of the literature. AB - For persons with mental handicaps or with other disabilities, quality of life (QOL) as a subject of inquiry is closely linked with the principle of integration. A critical review of the literature presented in this paper shows that (1) studies of QOL follow a sharp dichotomy between subjective and objective approaches, and that (2) QOL as a phenomenon does not lend itself to dichotomies but calls for a holistic approach. Selected studies which have opted for a transcendental approach are also discussed and were found to fall short of developing a holistic approach. This study contends that the prevalence of the notion of the individual as a distinct and autonomous being has forestalled attempts to construct a holistic model of QOL. In this paper, QOL is understood in terms of dynamic integration of the individual into the society. This insight emerges from a discussion of rituals which highlights the point that integration is a complex process requiring continual regeneration of individuals as well as society. PMID- 2696732 TI - Muscular, respiratory and cardiovascular responses of quadriplegic persons to an F. E. S. bicycle ergometer conditioning program. AB - Seven quadriplegic subjects participated in F. E. S. bicycle ergometry, three times per week, over an eight week period. Left thigh girth measured at 20 cm above the knee increased from 44.4 cm pre-training to 46.5 cm post-training (p less than 0.05), and right thigh girth increased from 44.3 cm to 46.2 cm (p less than 0.05). Forced vital capacity increased from 3.23 liters (pre-training) to 3.42 liters (post-training) and was significant at the p less than 0.05 level. Forced inspiratory capacity increased for 3.30 liters, pre-training, to 3.42 liters, post-training (p less than 0.05). FEV1 (liters) increased from 2.77, pre training to 3.07 post-training (p less than 0.05). All three respiratory parameters were 55%-60% of that predicted for normals. Significant changes were also found in resting cardiovascular data. Mean resting heart rate, pre-training, was 51.4 beats per minute compared to 54.5 beats per minute, post-training, (p less than 0.05). Resting cardiac output, pre-training was 4.14 L/min. compared to 4.47 L/min., post-training (p less than 0.05). Further analysis of the cardiovascular data showed that the increased heart rate post-training was associated with a decrease in the P-R interval from 0.186 sec., pre-training to 0.170 sec., post-training (p less than 0.05). Also, the increase in cardiac output, post-training was matched by an increase in the cardiac index from 2.21 L/min./M, pre-training, to 2.36 L/min./M, post-training (p less than 0.05). A statistically significant difference in the heart rate response to the cold pressor test was demonstrated (p less than 0.05) and a similar difference in the amount of heart rate response was seen during the tilt table test (p = 0.05). PMID- 2696733 TI - The phantom phenomenon: a critical review. AB - Although phantom sensations and phantom pain are quite common sequelae of amputation and other related surgical procedures, these phenomena are not well understood. There are many, often conflicting theories which attempt to explain their nature and causes, and to provide a foundation for more effective treatment. This paper reviews recent literature on this topic. The review encompasses information about the prevalence and nature of phantom phenomena; evidence from empirical studies concerned with identification of possible predictors; and various psychological and neurophysiological theories that have been proposed in an attempt to explain why phantom sensations and pain are experienced. It is concluded that the fragmented approach adopted in the past has resulted in pockets of knowledge that are not too well integrated. There is therefore an outstanding need for a general theory to synthesise the knowledge gained to date about the multiplicity of factors associated with phantom phenomena. In this context, Melzack and Loeser's (1978) concept of "pattern generating mechanisms" may offer the most useful model for future research. PMID- 2696734 TI - Amblyopia revisited: evidence for the heterogeneity of the syndrome. AB - Functional amblyopia has been considered as a homogeneous syndrome for the last decade or so, mainly on the basis of animal experiments. Recently, important differences have been shown to exist between strabismic and anisometropic as well as deprivation amblyopia. Even strabismic amblyopia may be subdivided in different classes. These statements are supported with experimental and clinical data. Clinical relevance of the heterogeneity of amblyopia is discussed particularly in the view of the concept of its cure. PMID- 2696735 TI - Hamartoma of the tongue. AB - Hamartomas of the tongue are rare. A case of a 6-year-old girl with hamartoma at the base of the tongue is reported. The diagnosis was confirmed by a histopathologic examination of the mass after removal in a wedge fashion by the CO2 laser under general anesthesia. The literature is reviewed and discussed. PMID- 2696736 TI - Combined colonic and biliary surgery: assessment of risk in elderly patients. AB - From 1982 to 1986, routine preoperative ultrasound examination of the gallbladder and the liver was performed in all patients undergoing colonic surgery. A decision was made to do a cholecystectomy and intraoperative cholangiography when gallstones were found preoperatively. According to this prospective protocol, 20 patients had biliary surgery performed in conjunction with colonic resection. The mean age of these patients was 70 years (median, 70 years; range, 53-83 years). There was no death in this study group and only three nonfatal complications. Despite the fact that our operative strategy increases the average duration of the operation, it avoids the risk of postoperative cholecystitis and the possible need for a second operation in these elderly patients. PMID- 2696737 TI - Andean biology in Peru. Scientific styles on the periphery. PMID- 2696738 TI - Isis current bibliography of the history of science and its cultural influences. 1989. PMID- 2696739 TI - Glucocorticoid dexamethasone reversibly complements EJ-RAS oncogene to transform mouse embryo BALB-3T3 cells. AB - EJ-A is a Balb-3T3 transfectant cell line that bears a small number of EJ-ras oncogene copies/cell, has low EJ-ras expression, and resembles the parental cell line in displaying a non-transformed phenotype. The glucocorticoid hormone dexamethasone reversibly induces transformation traits in EJ-A cells, namely: 1) morphological transformation; 2) increased growth rate and saturation density; 3) reduced G1 length; and 4) independence of the FGF requirement to initiate DNA synthesis. Western blot analysis revealed that dexamethasone does not increase the p21ras protein intracellular level. beta-IFN, added to the culture medium, does not suppress the dexamethasone-induced growth stimulation and morphological transformation. Therefore, glucocorticoid hormones can complement low EJ-ras expression to transform Balb-3T3 cells, by a mechanism that is likely to be independent of p21ras increase and beta-IFN decrease. PMID- 2696740 TI - DryLab computer simulation for high-performance liquid chromatographic method development. II. Gradient elution. AB - Computer simulation (DryLab software) as an aid for the development of gradient high-performance liquid chromatographic methods is reviewed. Several examples of its application are presented and the accuracy of such predictions is discussed. PMID- 2696741 TI - Rapid determination of methandrostenolone in equine urine by isotope dilution liquid chromatography-tandem mass spectrometry. AB - Urine samples were spiked with [17-methyl-2H3]methandrostenolone as internal standard and extracted with a mixture of dichloromethane and cyclohexane. The organic phase was concentrated and injected onto a short octyl-silica column (30 mm x 4.6 mm I.D.) for separation of methandrostenolone and 17 epimethandrostenolone. The effluent from the column was connected to a Sciex TAGA 6000E triple quadrupole mass spectrometer equipped with an atmospheric pressure ion source for sampling of ions generated by a heated pneumatic nebulizer with corona discharge ionization. This ion source produced abundant [M + H]+ ions and a weak fragment ion due to loss of water. The protonated molecular ions at m/z 301 and 304 for methandrostenolone, 17-epimethandrostenolone and the internal standard were transmitted to the second quadrupole for collision-induced dissociation. Quantification was obtained by selected reaction monitoring of three daughter ions. Methandrostenolone and 17-epimethandrostenolone were separated by liquid chromatography, but gave identical mass spectra. The method detection limit by injection of a urine extract corresponding to 2.8 ml urine was 180 pg/ml at the 99% confidence level. The precision (relative standard deviation) was 3% at the 16 ng/ml level and the linear dynamic range was at least 3 orders of magnitude. Screening for unknown metabolites in urine after administration of methandrostenolone to horses and humans was accomplished by a parent ion scan of m/z 121, a fragment corresponding to the intact A-ring of the steroids. PMID- 2696742 TI - Freiberg's infraction of the second metatarsal head with formation of multiple loose bodies. AB - Freiberg's infraction is an osteonecrotic disease process that most often involves the head of the second metatarsal. Establishing a diagnosis can be difficult early in the disease course, mimicking such pathologic processes as stress fracture, septic joint infection, tumors, metatarsalgia, various arthritic diseases, etc. A review of the literature reveals many treatment options and many theories of its etiology. The clinical signs and symptoms, review of the etiologies, radiographic presentation, and conservative and surgical treatments of this disease are presented. A case history and treatment summary of a patient afflicted with Freiberg's infarction involving the second metatarsophalangeal joint of the right foot is presented. Treatment consisted of evacuation of multiple loose bodies from the joint, resection arthroplasty of the diseased joint, and insertion of a total joint prosthesis. PMID- 2696743 TI - Rheumatoid arthritis with forefoot reconstruction. AB - Rheumatoid arthritis is a systemic disorder affecting joints as well as organ systems. The disease sequellae may result in complete loss of functional capacity. Surgical intervention including reconstruction of the forefoot may provide the patient with the opportunity to return to more activities of daily life. PMID- 2696744 TI - Total dislocation of the talus. AB - A 24-year-old male Caucasian gymnast suffered from a total anterolateral dislocation of the talus during a training session. The injury was treated conservatively. The functional result was good 26 months after the trauma, although the athlete was not training any more. Isolated total talar dislocation is a rare injury, and only 73 cases have been so far described. A literature survey concerning mechanism of injury, diagnosis, treatment, and possible complications is presented. PMID- 2696745 TI - Nonclostridial gas gangrene. AB - Podiatric physicians must realize that the presence of crepitus, and/or radiographic evidence of gas in the subcutaneous tissue, does not necessarily mean anaerobic clostridial gas gangrene. This is especially true in the diabetic where other gas producing organisms have been isolated. The authors provide a literature review, and case study, of nonclostridial gas gangrene. PMID- 2696746 TI - Dorsal bunions: a review. AB - The authors present a review of the literature on dorsal bunion and describe its classification, etiology, predisposing factors, and different methods of treatment. The deformity is functionally limiting during ambulation and cosmetically undesirable for the patient. It is a progressively disabling deformity that requires surgical management. PMID- 2696747 TI - Intratendinous ganglionic cyst. AB - The authors present a review and case presentation of an intratendinous ganglionic cyst. This rare entity is discussed with emphasis on its pathogenesis, microscopic anatomy, and clinical occurrence to aid in the differential diagnosis with other cystic type lesions that may occur in the foot. A case report is presented to demonstrate this unusual lesion, and the surgical approach used to excise the affected peroneus brevis tendon. PMID- 2696748 TI - Intra-articular fractures of the calcaneus: a review. AB - Intra-articular fractures of the calcaneus can result in prolonged or permanent disability. The systematic approach to analysis based on anatomy, mechanism of injury, and x-ray films allows determination of the various elements of the lesion. Management is difficult because treatment is not standardized, and, even when good reduction has been achieved, long-term complications are commonplace. The authors review different types of intra-articular calcaneal fractures, various methods of treatment, and examples of possible complications. PMID- 2696749 TI - Development of oligodendrocytes. Studies of rat glial cells cultured in chemically-defined medium. AB - Oligodendrocytes are macroglial cells that synthesize and maintain myelin in the central nervous system. Oligodendrocytes in rodent brain are formed postnatally from glial progenitor cells. These progenitors cells are bipotential and differentiate in a later stage of development into type-2 astrocytes. Recent studies with cultured cells indicate that growth factors such as platelet-derived growth factor and ciliary neurotrophic factor are instrumental in the control of these events. This paper discusses various methods for the isolation of oligodendrocytes and for their maintenance in culture. We use cerebra or spinal cords from one-week old rat pups to prepare glial cultures that are enriched in oligodendrocytes (60-80% or greater than or equal to 90%, respectively). After one day in serum-containing medium the cells are kept in chemically-defined medium, supplemented with the hormones insulin, T3 and hydrocortisone. The activities of astrocyte-and oligodendrocyte-specific marker enzymes were measured to evaluate the influence of these hormones on the differentiation of the oligodendrocytes. Finally, glial energy metabolism and the utilization of ketone bodies and of fatty acids are discussed briefly. PMID- 2696750 TI - Dehiscence with evisceration: a rare complication of diagnostic peritoneal lavage. AB - Diagnostic peritoneal lavage (DPL) is a well-established procedure for evaluating the patient suspected of having intraabdominal injury secondary to blunt abdominal trauma. Its accuracy and safety have been clearly documented; however, the procedure does have the potential for morbidity. This paper reports on the occurrence of a rare complication, dehiscence with evisceration, and reviews the literature regarding complications of DPL. PMID- 2696751 TI - Traumatic laceration of pericallosal artery resulting in interhemispheric subdural hematoma: a case report. AB - Interhemispheric subdural hematoma (IHSDH) usually manifests itself in a delayed fashion after trauma as a slow neurological deterioration with signs of the falx syndrome (paresis or seizures of the lower extremity contralateral to the hematoma). Several etiologies of IHSDH have been described, with tearing of bridging veins being especially associated with trauma. We present the second reported case of IHSDH due to traumatic arterial laceration. This lesion demonstrates a benign and delayed initial presentation. Conservative observation has been employed in the past with mixed results. Patients receiving early definitive surgical treatment have a lower mortality rate then those treated similarly having convexity SDHs. This review of 31 cases discusses the salient aspects of this clinical entity, emphasizing the need for prompt diagnosis and treatment, despite the patient's seemingly stable neurological status. PMID- 2696752 TI - Superwarfarin poisoning. AB - Superwarfarins consist of two classes of compounds, the 4-hydroxycoumarins and the indandiones. These compounds have replaced warfarin as an anticoagulant rodenticide. This article is a summary of the clinical effects produced by accidental and deliberate ingestions of superwarfarins. Most accidental ingestions occur in childhood and result in a benign outcome. Deliberate overdoses usually involve repeated ingestions of large quantities of superwarfarins that have resulted in prolonged laboratory evidence of interference with clotting; serious bleeding has been rare. This article suggests an approach to the management of patients with accidental and deliberate anticoagulant rodenticide ingestions. PMID- 2696753 TI - Pneumatosis cystoides intestinalis and intramural intestinal gas. AB - Gas in the bowel wall is an unusual but important finding on an abdominal radiograph. The so-called "benign form," pneumatosis cystoides intestinalis, may be asymptomatic or may cause a variety of symptoms and can result in a bowel obstruction or a sterile pneumoperitoneum. On the other hand, intramural intestinal gas may represent severe underlying disease such as necrotizing enterocolitis or mesenteric vascular occlusion. This finding should be sought when examining abdominal radiographs. A thorough appreciation of the clinical significance of this unusual entity is necessary to make timely therapeutic decisions. PMID- 2696754 TI - Current concepts in pathophysiology and diagnosis of compartment syndromes. AB - A compartment syndrome is a neurovascular compromise resulting from an increased local tissue pressure. Compartment syndromes can have many etiologies and may arise in any area of the body that has little or no capacity for tissue expansion. The sequelae are severe in the absence of immediate diagnosis and treatment. The diagnosis is usually a clinical one but compartment pressure measurements are often helpful. Many methods of treatment have been investigated, but definitive treatment consists of immediate removal of the constricting force, most often accomplished with surgical fasciotomy. PMID- 2696755 TI - "What you need is a doctor". PMID- 2696756 TI - Discourses of desire: sexuality and Christian women's visionary narratives. AB - This article compares and contrasts two autobiographical accounts by seventeenth century Italian religious women: Benedetta Carlini of Pescia, and Maria Domitilla Galluzzi of Pavia. Both were visionaries, highly regarded by their communities, but subject to suspicion and close scrutiny by ecclesiastical authorities. The trial records of Benedetta Carlini relate a series of sexual contacts with her young assistant, while no overt sexual expression is evident in the life of Maria Domitilla Galluzzi. This article questions the relationship between the categories of scholars and the sexual self-understanding of figures in their own historical context. It suggests that "lesbian nun" is too simplistic a dichotomy, and that in comparison to the life of Maria Domitilla, Benedetta Carlini's sexuality revolved around an elaborate organic connection between the spiritual and the sensual. PMID- 2696757 TI - Pastoral counseling and homosexuality. AB - The Judaeo-Christian religious tradition has generally been mistrustful of sexuality, wherein homosexuality is not even a legitimate discussion. The psychological tradition has been heterosexist and homophobic. It is argued that only a creation-centered spirituality and a transpersonal psychotherapy can be truly supportive of gay men and lesbian women. A transpersonal model is presented that is integrated with creation spirituality. This model is applied to specific situations of gay men and lesbians with clinical examples. In this inquiry, the special gifts of homosexuals are noted. PMID- 2696758 TI - Judaism and homosexuality: the traditionalist/progressive debate. AB - This article critically reviews modern Jewish teaching on Judaism and homosexuality. The historical prohibition of homosexual acts is grounded in a world-view that views heterosexuality as natural and heterosexual marriage as the only route to religious and personal fulfillment. Progressive Jews have begun in recent years to question the underlying premises of traditional Jewish teaching on sexuality. Employing the categories of covenant theology and applying the interpretative methodology of liberal Judaism, the author argues for the valuation of the person as homosexual as a legitimate expression of human and Jewish covenantal obligation. PMID- 2696759 TI - No longer invisible: gay and lesbian Jews build a movement. AB - The organized movement of lesbian and gay Jews took root in the mid-1970s when groups of Jewish homosexuals in the United States, England, and Israel began gathering for religious, educational, and social purposes. After centuries of denial, the Jewish community was faced with the reality of this increasingly visible and vocal minority. By 1989, nearly 30 groups of Jewish gay men and women throughout the world were part of the World Congress of Gay and Lesbian Jewish Organizations, an international body devoted to community education about homophobia and support for both member and newly emerging gay Jewish groups. PMID- 2696760 TI - A critique of creationist homophobia. AB - In 1978, the United Presbyterian Church in the United States of America prohibited the ordination of "practicing homosexuals" to the church's ministry. In this prohibition, by providing a pivotal role for homophobic interpretation of Genesis 1-3, Presbyterians linked up with the exclusionist policies of both the Roman Catholic and fundamentalist communions. The following article submits this use of the biblical narratives of creation to critical examination and provides an alternative liberationist perspective. PMID- 2696761 TI - Aminoglycoside resistance patterns in clinical isolates of E. coli and Klebsiella sp. from Czechoslovakia and the United States. AB - Resistance of gram-negative bacilli to aminoglycoside antibiotics differs by region and country. Previous studies have demonstrated predominance of the nucleotidyltransferase ANL(2") as the mechanism of enzymatic resistance to gentamicin in the United States and many European countries (Federal Republic of Germany, Switzerland, Greece, Turkey) whereas the acetylating enzymes AAC(6') and AAC(3) were the principal causes of resistance to aminoglycosides in Japan and Chile. In the present comparison of 18 drug resistant isolates of E. coli and Klebsiella sp. from Czechoslovakia and the United States, with aminoglycoside inactivating enzymes, ANT(2") characterized the most strains from both countries. In a higher number of isolates from Czechoslovakia however, the aminoglycoside resistance was mediated by AAC(3). In the majority of strains a simultaneous occurrence of two gentamicin-inactivating enzymes i.e. ANT(2"), plus AAC (2'), or AAC(6') or AAC(3) was observed. In amikacin resistant E. coli strains the mechanism of resistance was represented by production of AAC(6') or AAC*--an acetyltransferase with uncommon substrate profile. In all E. coli and K. pneumoniae strains from the United States apart from ANT(2") also AAC(2') was detected. This represents a broadening of the host range of aac(2') gene, the occurrence of which has been limited only to Providencia and Proteus strains. PMID- 2696762 TI - Roxithromycin--a new macrolide derivative. AB - This ether oxim derivative of erythromycin A is an easy to absorb oral antimicrobial somewhat less effective in vitro than erythromycin. At relatively low MIC's it is active against staphylococci, streptococci, pneumococci, branhnamella and chlamydiae, higher concentrations are needed against enterococci and some strains of H. influenzae. Roxithromycin is also reported to have a very good effect on campylobacters, many anaerobic bacteria, Toxoplasma gondii, Treponema pallidum, Mycoplasma pneumoniae and Legionella pneumophilla. Its half life in the serum of healthy individuals ranges from 9 to 16 hours. Maximum serum concentrations at 2 oral doses of 150 mg a day are reached at 3 to 4 days and vary from 5.5 to 11.1 mg/l. The distribution of roxithromycin in body tissues is excellent. In a group of 57 patients treated for various infections of clear etiology the positive therapeutic effects resulting in the state of bacteriological negativity was reached in 86% of cases. Roxithromycin can be recommended as a drug of choice in mild or less severe cases of infection caused by agents sensitive to this antimicrobial. Its excellent tolerance makes it especially well suited for use in pediatric practice. PMID- 2696763 TI - [Surgical repair of vascular ring with aberrant brachiocephalic artery]. AB - The vascular ring causes tracheal and esophageal compression and some cases need the surgical intervention. We report a rare case of vascular ring with aberrant brachiocephalic artery. A nine-month-old boy had suffered from progressing stridor and was admitted to our hospital due to the stridor. The digital subtraction angiography revealed the aberrant brachiocephalic artery which compressed the trachea from anterior aspect. The compression of the trachea was released by tacking forward the aberrant brachiocephalic artery to the sternum with the aid of two stitches. The postoperative course was uneventful. The stridor almost disappeared at one year after the operation. PMID- 2696764 TI - [A case report of intravenous leiomyomatosis of the uterus with extension into the right pulmonary artery]. AB - Intravenous leiomyomatosis (IVL) is a rare neoplastic disease which is defined as the extension into venous channels of histologically benign smooth muscle tumors arising either from a uterine myoma or from the walls of a uterine vessel. We report a case of IVL originating from the uterus, growing up in the inferior vena cava, and extending into the right pulmonary artery. The patient was a 42-year old woman, who was admitted to our hospital with clinical signs of right-side heart failure and syncope in December 1987. Her medical history included a total hysterectomy in August 1986. On examination, two dimensional echocardiography showed a freely floating tumor in the right atrium and right ventricle, which protruded via the inferior vena cava. Cavography confirmed the above findings. Because of the clinical disability caused by the tumor localized in the right heart, emergency operation was performed, extracorporeal circulation was instituted through the femoral vein, the superior vena cava, and the femoral artery. Opening the right atrium confirmed that a white sausage-like mass quite free from the wall extended into the right ventricle, and the head of the tumor was adherent to the right pulmonary artery. After detaching the head of the tumor from the right pulmonary artery, the remaining tumor in the inferior vena cava was also successfully pulled out. The operative specimen was measured 55 cm in length, but the basal end of the tumor was supposed to be left in place. Two months later, the second-stage operation for the remaining tumor was carried out through a median laparotomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696765 TI - [A case of adrenal myelolipoma]. PMID- 2696766 TI - [Sensitivity and specificity of temporal Doppler in Horton's disease]. AB - 170 patients with suspected temporal arteritis underwent Doppler investigation before temporal artery biopsy. Doppler study included the large cervical trunks, the ophthalmic system and analysis of the terminal branches of the external carotid with recording of the temporal territory on 3 points. Biopsy confirmed the diagnosis of temporal arteritis in 48 cases; it was negative in 122 cases. Doppler study and histological examination agreed in 137 patients (80%). There was disagreement in 33 cases (20%). The Doppler signal was pathological in 43 of the 48 cases of temporal arteritis (90%). There were 5 false negatives (10%). In subjects free from temporal arteritis, the Doppler examination was normal in 94 cases (77%), and was pathological in 28 cases (23%). The sensitivity of Doppler examination in the diagnosis of temporal arteritis was 90%, its specificity was 77%. The predictive value of a positive Doppler vis-a-vis the condition was only 61%. On the other hand, the predictive value of a normal examination was very high (95%). The high level of false positives is explained by technical problems, but especially by a high incidence of sometimes very stenosing senile arteritis. Finally, 3 of the 28 false positives (11%) subsequently developed authentic inflammatory arteritis. The authors conclude that a positive Doppler examination does not allow reliable prediction of the presence of temporal arteritis. On the other hand, a normal examination almost always allows the diagnosis of temporal arteritis to be excluded with a risk of error of less than 5%. PMID- 2696767 TI - [Role of Doppler in the diagnosis of ophthalmic complications of Horton's disease]. AB - A study of the eyeball was carried out using a double frequency Doppler transducer in 31 patients suffering from histologically confirmed temporal arteritis. These patients were divided into 3 groups depending on the results of the ophthalmological examination: group A: 20 patients; normal ophthalmological exam, group B: 5 patients; non specific ocular anomalies, group C: 6 patients; ocular lesions specific to temporal arteritis (ischemic optic neuropathy with amaurosis, dysoric nodules). Doppler examination demonstrated normal curves in the patients in groups A and B. The mean amplitude of systolic peaks was 7.9 mm in group A and 10.3 mm in group B (P = NS). These data did not differ from those of a control population of 22 subjects not suffering from temporal arteritis. On the other hand, group C demonstrated important anomalies on Doppler examination: lack of ophthalmic signal in one case; marked dampening of curves in 4 cases; zones of turbulence in one patient. The mean amplitude of systolic peaks was drastically decreased (1.8 mm). After steroid treatment, a significant increase in blood velocity was seen leading to a normalization of tracings in the majority of cases, including the patients in group C. Doppler examination would appear capable of reliably assessing the risk of ophthalmic complications of temporal arteritis when blood flow anomalies exist. On the other hand, patients with normal Doppler curves may be considered to be at little risk. Subjects at high risk should be urgently treated with high doses of steroids and can be regularly monitored by repeated Doppler examination. PMID- 2696768 TI - [Significance of arterial Doppler in Horton's disease. Prospective study of 59 case reports]. AB - Several preliminary studies drew attention to the value of Doppler examination in temporal arteritis. This study involving 59 cases aimed to define the value of Doppler examination in the diagnosis of the disease, evaluation of ophthalmic risk and in the monitoring of treatment. The study involved 59 patients and 47 controls with no evidence of temporal arteritis, but of comparable mean age. The following arteries were investigated before treatment: arteries of limbs, subclavian, vertebral, carotid, temporal, occipital, facial and ophthalmic recorded via the internal nasal branch and also transocularly. The results were expressed in the form of a score from 0 to 3 describing the degree of deterioration of the curves. A mean score corresponding to the mean of the scores of the cephalic arteries was calculated for each patient and each control. The specificity and sensitivity of the investigation were studied, based on this mean score by ROC analysis. The progression under treatment was monitored for more than 24 months in 20 patients divided into 3 groups: group I: 6 patients cured; group II: 6 patients with late recurrence of temporal arteritis after steroid withdrawal; group III: 8 patients with progressive disease. 81.5% of temporal arteries were pathological, including 60% with tight stenosis (score 2 and 3). Morphological anomalies in the curves were also noted at the level of the occipital arteries (69%), facial arteries (80%), as well as the ophthalmic artery at both recording sites (internal nasal: 84.5%, transocular: (73%) (table I).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696769 TI - [Epidemiology of Horton's disease. Is there an environmental factor, infective in particular?]. AB - Epidemiological studies of temporal arteritis have essentially only been reported in the English literature. The authors of this study were concerned with this aspect of temporal arteritis in the Loire-Atlantique region of France over a period of 10 years (1970-1979). The high prevalence in white races has been confirmed. The annual incidence in France is comparable to that seen in Northern Europe and the USA. The incidence of the disease is especially high between 70 and 80 years. The apparent female predominance is related to the greater life expectancy in women. The study of several conjugal cases does not suggest the intervention of an infectious agent. The same is true for isolated cases where the responsibility of a bacterial or viral agent has not been demonstrated. Other environmental factors (sun exposure, life-style, socio-professional classification) do not affect the incidence of the disease. The genetic background would seem to be of particular importance. This study found a significantly higher prevalence of HLA DR4 antigen, confirming the results of American and British studies. However, in contrast to previous studies, this series did not confirm an increase in HLA B8 antigen. PMID- 2696770 TI - [Immunogenetics of Horton's disease and of rhizomelic pseudo-polyarthritis]. AB - The etiopathogenesis of temporal arteritis and rhizomelic pseudo-polyarthritis still remains undefined. A genetic predisposition would seem probable in view of epidemiological data (higher frequency in white caucasian races and in certain countries), the existence of rare familial forms (25 families reported), and the significant increase in incidence in unconnected cases with HLA DR4 antigen (6 studies). Environment may intervene as a precipitating factor in the condition and the role of an infectious agent, to account for the seasonal incidence of this disorder and the rare existence of cases in non consanguineous couples, has been suggested but remains unproven. Disordered immune function probably plays an essential role in the creation of the vascular histological lesions characteristic of the condition. The disordered function involves cellular immunity (fall in OK T8. in blood) and especially humoral immunity with the very frequent presence of circulating immune complexes in the serum and deposition of immunoglobulins and complement at arterial wall level. PMID- 2696771 TI - [Treatment of Horton's disease]. AB - 716 cases collected from 9 recent studies published between 1981 and 1985 served as a basis for a general review of the current treatment of temporal arteritis. Steroid therapy was instituted as first intention in 652 cases, high dose treatment was continued for between 8 days and 3 months but the majority of authors started a reduction in the dosage from the 4th or 5th week. There was no overall agreement regarding the duration of maintenance therapy nor the criteria allowing its discontinuation, and withdrawal was not possible before the 25th month on average. The ideal initial dosage, in the absence of randomized studies, remains to be defined: generally around 0.5 mg/kg/d in milder forms, the dosage may be increased to 1 mg/kg/d in the presence of complicated temporal arteritis. Besides cortico steroid therapy, other treatments are successively envisaged: synthetic anti-malarials (SAM), non steroidal anti-inflammatories (NSAI), dapsone... while these are generally used as back-up treatment, David-Chausse used SAM as first intention, combined in 17 cases with NSAI in 61 of his 66 patients, with very promising results which require confirmation in other studies. In this review the cure rate was around 25% and the relapse rate 38%; complications related to the disease occurred in 19%, while almost one patient in two--47%--developed iatrogenic complications. Blindness dominates the prognosis, and occurred in 15% of cases, most often as an inaugural event, it very rarely regressed on steroid treatment. Although death occurred in 18% of cases, the prognosis of temporal arteritis generally remains favorable, with a 5 year survival curve identical to a control population. PMID- 2696773 TI - [Intermittent claudication of the jaw in temporal arteritis]. AB - Stiffness of the jaw was noted in the first descriptions of temporal arteritis. It was only in 1944 that Horton used the term intermittent claudication and related this sign to effort ischemia due to thrombosis of facial arteries. The introduction of ultrasound techniques has enabled the permeability of facial arteries to be confirmed in spite of induration and absence of pulsatility clinically. Anatomical studies have defined the preponderant role of the internal maxillary artery in the vascular supply of the masseter muscles and have enabled the localization of an appropriate and reliable site for ultrasound study: the pterygo-maxillary fossa. The velocimetric data thus collected confirm that the internal maxillary artery is affected and define the etiopathogenesis of intermittent jaw claudication during temporal arteritis. This sign is observed on average in one patient in three suffering from temporal arteritis. While several cases of intermittent jaw claudication have been described in severe atheromatous stenosis of the common carotid or external carotid arteries, or in relation to other causes (rheumatological, neoplastic, psychological ...), the observation of this syndrome in a suspicious clinical and paraclinical context constitutes an excellent orientation sign in favor of temporal arteritis. PMID- 2696772 TI - [The history of Horton's disease or ... 10 centuries of a fascinating adventure]. AB - In 1932, Horton, Magath and Brown reported two cases of a "new form of arteritis affecting the temporal vessels ... which probably represents a new clinical syndrome". In reality, several publications, devoted to the same pathology already preceded this article. The most ancient is that of an ophthalmologist from Baghdad, Ali Ibn Isa (940 to 1010). In his memories, translated and published in english in 1936, the author states that "he undertook excision and cauterisation of arteries to treat patients who were suffering from heat and inflammation of their temporal muscles and which sometimes ended in loss of vision ...". In 1890, J. Hutchinson, an English surgeon, reported a case "... of inflammed and swollen temporal arteries ...". This article was only brought to light in 1946. In 1930, M. Schmidt, published a probable case of temporal arteritis, subsequently reported in 1947. In 1934 and 1936, Horton published new cases of temporal arteritis and defined the clinical characteristics of the disease and its histology. In 1938, Jennings made a particular contribution in reporting the first case of blindness. From this time on, cases of temporal arteritis became increasingly common in the literature. The first French case was described by J. Paviot et al. in 1934, but remained largely unrecognized until 1942. In 1936, J. Chavany was the first to describe the pillow sign, but more particularly in 1948, he prescribed the first treatment with steroids, with spectacular results. It was only in 1950 that R.M. Shick et al. published the effects of steroid therapy in temporal arteritis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696774 TI - [A family with x-linked hydrocephaly followed for 20 years: echographic prenatal diagnosis; elective abortion]. AB - In a Bickers-Adams family followed up for almost 20 years, authors report pregnancies of two propositus' sisters: echographic diagnosis of (normal) girls, of normal or affected boys and selective abortion in a case of dizygotic twin pregnancy with a normal girl and an affected boy. PMID- 2696775 TI - Plasma vasopressin, renin and catecholamines during nitroprusside-induced hypotension in the newborn lamb. AB - The circulating levels of vasopressin, catecholamines and renin activity before, during and following a 10-20% fall in mean arterial blood pressure induced by sodium nitroprusside were measured in six chronically catheterized lambs during the first week of life. No significant changes in pHa, PaO2, PaCO2, Plasma sodium or osmolality were observed during or following the infusion of sodium nitroprusside at an average of 12 g.kg-1.min-1 (table I). However, the fall in blood pressure at the end of 60 minutes infusion, was associated with significant increases in the plasma levels of vasopressin from a control value of 2.4 +/- 0.57 to a maximum of 35.1 +/- 16.3 pg/ml (p = .002), renin activity from 6.7 +/- 1.56 to 27.4 +/- 11.44 ng.ml-1.hr-1 (p = .003), and catecholamines from 189.3 +/- 42.15 to 543.3 +/- 100.52 pg.ml-1 (p = .0001). The increase in vasopressin is lower, while that of PRA was higher and catecholamines similar to those found in the ewe. Plasma renin activity (PRA) and catecholamine levels remained elevated for at least 30 minutes following the end of the infusion while the mean blood pressure rose significantly above control levels and remained elevated for twenty minutes. We speculate that the persistent elevated levels of vasoactive mediators are responsible for the prolonged rebound hypertension following the cessation of the nitroprusside infusion and is the result of an immaturity of either a feedback process or metabolism of the vasoactive mediators or a combination of both mechanisms. This rebound hypertension could have adverse effects particularly in the very immature neonate. PMID- 2696776 TI - Prenatal ultrasonographic diagnosis of thoracopagus conjoined twins. AB - Conjoined twins are a rare obstetric event occurring 1/50,000 to 1/60,000 deliveries as a result of incomplete fission of the embryonic disc before the third week of pregnancy. They belong to the monochorionic-monoamniotic type of monozygotic twins and are classified according to the area of union, the most common site being the chest and upper abdomen (thoracopagus). Reported are two cases of thoracopagus twins in which the diagnosis was made prenatally by ultrasound in the second trimester of pregnancy. The most significant ultrasound findings included the demonstration of a single cardiac activity, the inability to separate the fetal bodies at their ventral portion, and a face-to-face fetal position. The pregnancies were allowed to continue until term with no significant prenatal complications, and an elective cesarean section was performed to avoid a traumatic delivery. In both cases the infants died during the first week of life because of cardiorespiratory insufficiency. The ultrasound criteria for the antenatal diagnosis of conjoined twins are reviewed, concluding that the careful ultrasound examination of all identified sets of twins, specially in those cases in which no separating membrane is demonstrated, is the cornerstone in making the prenatal diagnosis. In addition, ultrasound plays a crucial role not only in the diagnosis, but also in establishing the degree of conjoining, which is essential for planning an appropriate obstetrical and perinatal management. PMID- 2696777 TI - Ultrasonic evaluation of the normal uterus in the neonate. AB - Using real-time ultrasound, a study was undertaken to evaluate the morphology of normal uterus in the neonate delivered at term. The uterus was visualized in 41 (89.1%) of the 46 neonates. The cervical volume (CE-V) was 3.65 +/- 1.36 cm3, the corporeal volume (CO-V) 1.18 +/- 0.42 cm3, and the CE-V was significantly larger than the CO-V (p less than 0.001). The uterine volume (U-V) was 4.83 +/- 1.57 cm3, and U-V showed a good correlation with birth weight (r = 0.42, p less than 0.01). The endometrial echo was constantly depicted as a mixed echo of a highly echogenic line and/or a myometrial halo. These normal values and the morphology of the neonatal uterus provide useful information for distinguishing a possible pathologic pelvic mass and screening of congenital genital disorders. PMID- 2696778 TI - Sonographic detection of echogenic amniotic fluid and its clinical significance. AB - It has been suggested that meconium-stained amniotic fluid can be detected in the antepartum period by means of ultrasound, based on the following findings: (1) a diffuse echogenic pattern throughout the amniotic cavity, (2) a clear contrast between the amniotic fluid and the umbilical cord, and (3) layering in the more dependent areas. Reported is a case in which a similar picture was obtained in a third trimester, high-risk pregnancy, but representing vernix instead of meconium. We are aware of six cases, including ours, of sonographic detection of echogenic amniotic fluid. The review of these cases indicates that the findings refer more often to a considerable amount of vernix rather than meconium, and it is not necessarily associated with postmaturity. If echogenic amniotic fluid is identified in an obstetrical ultrasound, we recommend: (1) rule-out meconium by amniocentesis or amnioscopy, or (2) study fetal well-being by means of nonstress test and/or biophysical profile. Thus, a false positive diagnosis of fetal distress in these cases could be easily avoided. PMID- 2696779 TI - Intrauterine treatment of severe fetal erythroblastosis: intravascular transfusion with ultrasonic guidance. AB - Twenty intrauterine, intravascular transfusion were performed in six patients under ultrasound guidance, the earliest one in the 19th week of gestation. In all twenty attempts we were able to insert the needle into the umbilical vein, transfuse between 12 and 80 ml of packed red blood cells, and raise the hematocrit (HK) up to 57% maximally. In two cases the fetal hydrops and the ascites completely disappeared. There was one complication in case 6. Fetal bradycardia developed after transfusion of 70 ml packed red cells in the 30th week. An immediate Caesarean sections was performed. The fetus was in a good condition and developed normally. All other fetuses were born by Caesarean section between 33 and 36 weeks of gestation and have had normal development up to now. These results show that the intrauterine, intravascular application of red blood cells is superior to the intraperitoneal approach. By the direct insertion into the cord the risk of fetal lacerations is minimal. On the other hand overtransfusion may occur more easily. PMID- 2696780 TI - Prenatal diagnosis of Wiedemann-Beckwith syndrome. AB - We report the prenatal diagnosis of Wiedemann-Beckwith syndrome in the 28th week of pregnancy in a primigravida. The cause of hospitalization was severe polyhydramnios with premature labour. Sonography revealed macrosomia, nephromegaly, cysts of adrenal glands and a striking macroglossia with opened mouth in all controls. The combination of all these symptoms suggested the prenatal diagnosis of Wiedemann-Beckwith syndrome, which could be confirmed post partum after a normal delivery in the 33rd week of pregnancy. The newborn (2700 g, 48 cm) exhibited typical features of this syndrome as moderate hypoglycemia and polycythemia in addition to the sonographic finding. Pathogenetic aspects and differential diagnosis of macrosomia are discussed. PMID- 2696781 TI - Ultrasound diagnosis of fetal annular pancreas. AB - A case of fetal "duodenal" obstruction was brought to our attention at 37 weeks gestation. The patient was referred to our Prenatal Diagnosis Center with an ultrasound finding of "double bubble" in the abdominal area of the fetus. We submitted the patient to an aimed ultrasound examination in order to establish the etiopathogenetic mechanism and to perfect the diagnosis. The ultrasound scans of the epigastric region strongly suggested the presence of annular pancreas. The diagnosis of duodenal stenosis due to annular pancreas was confirmed at birth and the infant underwent corrective surgery: duodeno-jejunostomy was successfully performed. We would like, in this context, to stress again the powerful diagnostic value of ultrasound investigation, when dealing with complex fetal malformations. The present report shows that high resolution echographic equipment and the ever-increasing qualification of medical staff make it possible to envisage the presence of annular pancreas already in prenatal life. PMID- 2696782 TI - Fetal cerebellar measurements in second trimester ultrasonography--clinical value. AB - During routine ultrasound examination of 178 normal pregnant women at 17-24 weeks, several biometric measurements were performed including transverse cerebellar diameter, cavum septum pellucidum, anterior and posterior horns of cerebral ventricles and nuchal soft tissue. The transverse cerebellar diameter is easy to obtain at this gestational age even in occiput posterior position and seems to be independent of head shape and inter-individual constitutional discrepancies. Transverse cerebellar diameter seems to be a good marker for gestational age compared to other clinical and biometric parameters. PMID- 2696783 TI - Contribution to the recognition of iniencephaly on the basis of a new case. AB - A child at term had been delivered by means of Caesarean operation because of its I. dorso-superior transverse position. The not viable, female newborn had a malformation causing an extremely retroflexion of the head. After intensive pathological and anatomical study the main diagnosis was iniencephaly and heart malformation. A large number of further results, also of malformated brain anatomy is given to contribute to the knowledge of the malformation sequence. The chances for early detection of the malformation are discussed. PMID- 2696784 TI - [Deoxyribonucleic acid sequence effects on molecular structure]. AB - The deoxyribonucleic acid (DNA) duplex shows polymorphism depending on the base sequence and the environment. The base sequence dependent variations in conformational properties of the synthesized oligonucleotides are studied by X ray analysis and several physico-chemical techniques. The possible structures in solution were proposed by molecular dynamics (MD) simulation. 1) The several oligonucleotides which include the adenine or adenine-thiamine tract, have unique conformational characteristics with the base sequence dependent property. The junction-model structure for DNA bending was proposed by the combined method of nuclear magnetic resonance (NMR) observations and MD calculation. 2) The two different hydrogen bonding schemes of inosine-adenine base-pairing, anti/anti and anti/syn forms, are adopted in B-DNA structure. The preference of these forms depends on the base sequence. The MD calculation could offer the models consistent with NMR evidence. 3) Oligonucleotides containing cyclonucleosides with a high-anti (intermediate between anti and syn) glycosidic conformation adopt left-handed double-helical structures. A suitable model of this left-handed duplex was proposed by calculation with energy minimization. PMID- 2696785 TI - Short limb and the ball-and-socket ankle deformity. AB - Congenital ball-and-socket ankle deformity is a complex pediatric orthopedic deformity that usually is associated with a short limb, a short fibula, distal tibial dysplasia, rearfoot coalition, and ray deficiency. The author reviews the literature on this orthopedic complex, presents two cases, and discusses the practical clinical management of this syndrome. PMID- 2696786 TI - Potential complications of nonsteroidal anti-inflammatory drug therapy. AB - Since indomethacin was first marketed, some 40 years ago, the class of nonsteroidal anti-inflammatory drugs has grown larger than any other drug class in history. At present, there are at least 25 such drugs being used in the US and abroad, both clinically and in research. Despite their widespread use, their implications to health care are just beginning to be understood. The authors review updated theories on the mechanism of action, side effects, and drug interactions of nonsteroidal anti-inflammatory drug therapy. Proposed guidelines for monitoring their use are given. A more thorough understanding of the risks-to benefits ratio is provided in an effort to achieve maximum patient satisfaction and safety. PMID- 2696787 TI - Renal cell carcinoma and osseous metastases. Case report and literature review. AB - Renal cell carcinoma is one of the great mimics in medicine. The diagnosis is complicated by clinical presentations involving a multitude of symptoms, often associated with the sites of metastasis. A high percentage of renal cell carcinomas have metastasized at the time of initial presentation, and symptoms associated with this metastasis may actually initiate the diagnosis. Because the site of tumor origin is frequently unknown, a diagnostic strategy for identifying the primary source has been proposed. The prognosis for renal cell carcinoma with metastasis is poor, with fewer than 9% of patients surviving at 5 years. Consequently, treatment is directed primarily at palliation of painful symptoms and stabilization of bony structures. With these goals in mind, treatment modalities run the gamut from radiotherapy, to curettage with polymethyl methacrylate augmentation, to amputation. In the case reported here, renal cell carcinoma was diagnosed in the course of evaluation of a painful lytic lesion of the foot. Treatment alternatives and associated risks and complications were discussed at some length and the patient chose curettage and packing with polymethyl methacrylate in combination with radiotherapy. This approach was successful in palliation of pain and maintenance of walking ability and independence. PMID- 2696788 TI - Medicare payment reform: policymakers at work. PMID- 2696789 TI - [Activated charcoals: properties--experimental studies]. PMID- 2696790 TI - Treatment of intoxications using single and repeated doses of oral activated charcoal. PMID- 2696791 TI - Liver lymphoma in systemic lupus erythematosus. AB - Systemic lupus erythematosus (SLE) has been associated with an increased incidence of lymphoma. We describe the occurrence of hepatic lymphoma, which was likely primary in origin, in a patient with SLE and discuss the etiologic and diagnostic implications. PMID- 2696792 TI - Successful pregnancy after scleroderma hypertensive renal crisis. AB - A patient with scleroderma and a history of hypertensive renal crisis who had been withdrawn from converting enzyme inhibitors became pregnant and delivered a healthy child without a flare of the hypertensive renal failure. Though no broad implications can be made from a single case report, it is clear that a history of hypertensive renal crisis is not an absolute contraindication to pregnancy. PMID- 2696793 TI - Identifying a metastatic choroidal tumor: a case study. AB - Amelanotic lesions of the eye are more commonly seen in metastatic disease, whereas melanomas are usually melanotic and are not associated with pain. Metastatic tumors exhibit medium to high reflectivity pattern on ultrasound A scan, whereas melanomas usually display a low to medium pattern. A patchy, diffuse interocular mass with episcleral and/or orbital involvement is consistent with metastatic tumor of the eye, whereas melanomas tend to be more localized. PMID- 2696794 TI - Molecular and epidemiologic study of multiresistant Escherichia coli infections in Kaohsiung area. AB - Totally 70 Escherichia coli (E. coli) isolated strains from patients in Chang Gung Memorial Hospital, Kaohsiung Medical College affiliated Chung Ho Memorial Hospital and the Navy General Hospital of the Republic of China, all in Kaohsiung, were collected during the period of July 1986-August 1987 and examined for their susceptibility to several antimicrobial agents as well as for their plasmid contents. The isolates tested showed a high level of resistance to ampicillin (Ap) (90.4%), piperacillin (Pip) (89.0%), tetracycline (Tc) (88.7%), streptomycin (Sm) (87.7%), chloramphenicol (Cm) (78.4%), kanamycin (Km) (72.6%) and sulfamethoxazole/trimethoprim (Sxt) (54.2%). Observations of the resistance patterns revealed that the dominant type was Ap-Tc-Cm-Sm-Pip-Km. The results of plasmid curing and transfer experiments indicated that three plasmids with molecular weights 49.2-51.6 Mdal, 69.8-178 Mdal and a third one with molecular weight larger than 178 Mdal carried resistance determinants for Gm-Nn, Sm-Km-Tc and Tc-Cm-Km, respectively. PMID- 2696795 TI - [Early diagnosis of carcinoma of the pancreas with emphasis on utility of ultrasonography]. AB - Early diagnosis by detecting small tumors is essential for improving therapeutic effects on carcinoma of the pancreas. Recently, diagnostic modalities of the carcinoma have greatly advanced, but the clinical usefulness of them has not been elucidated clearly in the early diagnosis. So, we assessed the diagnostic capability of such modalities as ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), X-ray computed tomography (XCT) and angiography in 59 patients with carcinoma of the pancreas surgically resected. Gross- and micro-pathological findings of the resected tumors were studied in all the patients. The tumors were divided into two groups according to the size; the one consisted of 19 tumors sized 2 cm or less and the other did of 40 tumors larger than 2 cm. All the tumors in the small size group were located in the pancreatic head. The detection rate of abnormality about the carcinoma in these modalities was so various in the small size group, while it was almost similar each other in the large size group. Above all, US exhibited the highest capability in detecting small tumors of the pancreas and making the early diagnosis. In conclusion, it may be said that the use of US in combination with laboratory tests of pancreatic enzymes, followed by ERCP when necessary, is the most effective for early diagnosis of pancreatic carcinoma. PMID- 2696796 TI - [A case of ectopic gastric mucosa in the cervical esophagus]. PMID- 2696797 TI - Sex determination from human somatic cells. AB - The method and its reliability for sex determination by examining X-chromatin in the nucleus of hair root cell and buccal mucosa cell are presented: 1) X chromatin in the nucleus of hair cortex cell was stained by Feulgen reaction after bleaching melanin granules and the frequency of X-chromatin was calculated under a ordinary microscope. An another method, fluorescent Feulgen reaction with acriflavine using a fluorescence microscope, was attempted. The results obtained from both methods indicated significantly higher values in the female samples than those in the male ones. 2) The other hand, the frequency of Y-chromatin was determined after quinacrine staining using a fluorescence microscope, and was also distinguishable between the male and female samples. 3) Using a single specimen, sex determination from the frequency of X- or Y-chromatin was practicable through combined treatment of quinacrine staining and fluorescent Feulgen reaction. 4) These methods were available during 16 to 64 weeks at least regarding samples kept dry. It is concluded that sex determination from frequency of sex chromatin after treatment described above is reliable. PMID- 2696798 TI - [Estimation of urinary excretion rate of guanidinoacetic acid in essential hypertension]. AB - 78 patients with essential hypertension (17 with borderline hypertension and 61 with hypertension) and 13 normal controls were examined to evaluate the relation between the urinary excretion rate of guanidinoacetic acid/creatinine (U-GAA/Cr), beta 2-microglobulin/creatinine (U-BMG/Cr), radio-sensitive microalbumin excretion rate/creatinine (U-AER/Cr), N-acetyl-D-glucosaminidase/creatinine (U NAG/Cr) and renal function. There was no significant difference among these groups in creatinine clearance (Ccr), serum creatinine (Cr) or in U-BMG/Cr, U NAG/Cr and U-AER/Cr. In hypertensive patients U-GAA/Cr was 49.2 +/- 16.7 mg/gCr, which was much lower than in controls (78.1 +/- 13.4) (p less than 0.001). The Ccr has a significant relation with U-GAA/Cr (r = 0.29, p less than 0.01) but not with U-AER/Cr, U-BMG/Cr nor U-NAG/Cr. In 44 patients, all of the above factors were investigated for 24 weeks during 4 kinds of anti-hypertensive treatment (10 with an angiotensin-converting enzyme inhibitor: A group, 11 with a beta adrenergic blocker: B group, 12 with a Ca entry blocker: C group and 12 with diuretics: D group). In A and C group, U-GAA/Cr was elevated during therapeutic course. However, in B and D group it declined during treatment. These findings suggested that urinary excretion of GAA may be a more sensitive marker than AER, BMG or NAG in hypertension and angiotensin-converting enzyme inhibitor and Ca entry blocker can be useful in the treatment of patients with essential hypertension with renal damage. PMID- 2696799 TI - Intravitreal drug therapy. AB - The treatment of many ocular disorders is hampered because of poor penetration of systemically administered drugs into the eye. The tight junctional complexes (zonulae occludens) of the retinal pigment epithelium and retinal capillaries are the site of the blood-ocular barrier. This barrier inhibits penetration of substances, including antibiotics, into the vitreous. Over the last 18 years we have evaluated the nontoxic doses of various drugs. These include antibiotics and antifungals for treatment of bacterial and fungal endophthalmitis, antivirals for treatment of viral retinitis (specifically, when medication with these drugs poses the threat of toxicity to other organs). Intravitreal antineoplastic drugs have been studied to prevent cell proliferation in the vitreous cavity after retinal attachment surgery, which can lead to proliferative vitreoretinopathy (PVR). Furthermore, we evaluated the anti-inflammatory action of dexamethasone and cyclosporine A to reduce intraocular inflammation after intraocular surgery or in uveitis. Because these studies had been performed in the presence of the vitreous, which can slow down the diffusion of the drugs toward the retina, it was necessary to reevaluate the concentration of drugs which could be administered intravitreally in the vitrectomized eye. The nontoxic dose of numerous drugs when added to vitrectomy infusion fluid has also been evaluated. Furthermore, the role of vitrectomy in the treatment of bacterial fungal endophthalmitis has been studied and the role of vitrectomy in this ocular disorder is defined. PMID- 2696800 TI - Preretinal membrane formation in rabbit eyes after intravitreal transplantation of cultured astrocytes. AB - Astrocytes were cultured from the cerebral cortices of newborn rabbits and were so confirmed by staining of the glial fibrillary acidic protein (GFAP). In Experiment I, the astrocytes of newborn rabbits of both sexes from one mother were pooled and suspended in a culture medium, and approximately 1-2 X 10(4) cells were injected into the vitreous cavity of one eye and the culture medium alone was injected into the fellow eye of the mother rabbit. In Experiment II, the astrocytes cultured from the cerebral cortex of a single newborn rabbit of known sex were injected into both eyes of the mother or father rabbit. In the 24 eyes receiving the astrocyte injection, 22 eyes developed preretinal membrane in 2.5 to 14 weeks: 11 eyes developed traction retinal detachment. In the 12 control eyes receiving the culture medium injection, preretinal membrane was seen only in one eye. The preretinal membrane consisted predominantly of spindle-shaped cells positively stained by the peroxidase-antiperoxidase method for GFAP staining. Electron microscopy showed that the major component cells of the preretinal membrane were astrocytes with characteristic intermediate filaments; no retinal pigment epithelial cells were observed. In Experiment II, the average frequency of sex chromatin detection was 4.6% and 55.2% in the male and female astrocyte cultures, respectively. Three groups of experiments were made, A) the female astrocytes injected into the mother's eyes, B) the male astrocytes injected into the mother's eyes and C) the female astrocytes injected into the father's eyes. The sex chromatin was found in the cells of the preretinal membrane at the average frequencies of 63.5%, 34.4% and 55.5% in Groups A, B and C, respectively. It was concluded that the astrocytes injected into the vitreous cavity proliferated and formed the preretinal membrane to a degree that caused traction retinal detachment, without involvement of the retinal pigment epithelial cells. It was also thought that the astrocytes from the retina of the adult host eyes participated to some extent in the preretinal membrane formation. PMID- 2696801 TI - Intractable epilepsy in infancy with hyperfolic acidemia, not associated with megaloblastic anemia. PMID- 2696802 TI - [The cause of paradoxical growth of intracranial tuberculomas during anti tuberculous chemotherapy]. AB - A case of multiple intracranial tuberculomas diagnosed by enhanced brain CT scan and MRI, which developed during the course of miliary tuberculosis under anti tuberculous chemotherapy was experienced. Chemotherapy with an increased dose of each agent and corticosteroid was administered, and eventually intracranial tuberculomas nearly disappeared. After 1970, there have been 29 reported cases of intracranial tuberculomas in Japan, which were diagnosed by brain CT and treated with anti-tuberculous agents. Among them, 27 evaluable cases were classified into 3 groups. Group A: Intracranial tuberculomas were proved by CT before chemotherapy in 7 cases. Four of them enlarged during chemotherapy. Group B: During chemotherapy of tuberculous meningitis, neurological symptoms worsened or prolonged, and finally intracranial tuberculomas were found by CT in 9 cases. In 5 of them, after meningitis was improved by chemotherapy, neurological symptoms worsened and intracranial tuberculomas were found. Group C: During chemotherapy of pulmonary tuberculosis or miliary tuberculosis, neurological symptoms appeared and intracranial tuberculomas were found by CT in 11 cases (including our own case). Getting 3 groups together, intracranial tuberculomas seem to have worsened during chemotherapy in 24 out of 27 evaluable cases. In view of response to chemotherapy, these 24 cases can be divided into 2 categories: 1) non-responders to chemotherapy; 2) cases finally cured by chemotherapy ("transient worsening").(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696803 TI - [A case of multiple cavities on chest film with high titer of serum cryptococcal antigen]. AB - A 26-year-old man admitted to Nishinomiya Municipal Hospital for further evaluation for abnormal shadows on the chest film in a mass examination. He had no subjective complaints; for example, cough, sputum or dyspnea. His past history and physical examinations yielded no significant findings. The chest film revealed the multiple cavities accompanied with a little infiltration throughout several lobes bilaterally. The inflammatory reactions; such as, CRP and ESR, were all intact, but the titer of the serum cryptococcal antigen was high. He was not immunocompromised. Although bronchoscopy and transbronchial lung biopsy were performed twice during admission, they revealed no pathogenic findings both bacteriologically and histologically. The elevation of the serum cryptococcal antigen titer suggested that this disease is the primary pulmonary cryptococcosis. The titer decreased with spontaneous disappearance of the abnormal shadows on the chest film. This test has a sensitivity of 90% for cryptococcal infection, but in rheumatoid arthritis, a small percentage of false positive results have been reported. Therefore, if the rheumatoid factor is eliminated, the test is more specific for cryptococcal infection. On the other hand, some authors have reported the false positive results in Trichosporon beigelii infection by this method. But this disease is negligible for its frequency in clinical features in our country. We emphasized that this non invasive test is more useful for the diagnosis of the primary pulmonary cryptococcosis. PMID- 2696805 TI - [What hides behind the diagnoses angina follicularis and lacunaris? A contribution to the differentiation of tonsillitis]. AB - An one-year examination of 315 children shows that under the diagnosis of follicular tonsillitis or lacunar tonsillitis many aetiological different diseases are summarized. More frequently than previously assumed adeno-, respiratory syncytial-, influenza A-, entero-, herpes simplex- and probably other viruses are the cause. It is shown to what extent the critical general evaluation also of discrete clinical data enables a differentiation. The usual general penicillin therapy of the patients with tonsillitis can be dispensed with. PMID- 2696804 TI - [Testicular cancer]. AB - A dramatic improvement in the survival of patients with testicular cancer has been witnessed in the 1970s. These advances are in the areas of diagnosis, staging, and monitoring of patients with this disease. The thrust of improvement includes the finding of sensitive and specific markers, the introduction of CDDP, and utilization of CT. Also, the finding of the efficacy of multidisciplinary treatment consisting of intensive chemotherapy and surgery has played a decisive role in the management of patients. This paper is devoted of a discussion of the basic sciences related to testicular cancer and the diagnosis and management of this tumor. PMID- 2696806 TI - [Transplantation of small segments of the pancreas with microvascular connections as one of the methods of treatment of diabetes mellitus]. AB - Analysed were 3700 case records of the patients suffering from diabetes mellitus in order to establish direct indications for transplantation of small pancreatic segments. In procurement of the pancreas from 86 cadavers, it was established, that the subjects at the age under 40 were the ideal donors. In 34 experiments, the possibility of the performance of adequate conservation of the pancreas up to 6-8 h by the perfusion-free hypothermic method, intraorganic normothermal perfusion, transplant placing into the continuously oxygenated perfluoran solution or diluted blood, or in combined use of the two latter methods is shown. The results of 40 experiments on the dogs indicate that preservation and transplantation of 1/4-1/8 of the pancreatic mass are sufficient for maintaining normoglycemia. PMID- 2696807 TI - [Occlusive pancreatojejunoanastomosis in pancreatoduodenal resection]. AB - A technique for creation of occlusive pancreatojejunoanastomosis (OPJA) in pancreatoduodenal resection was used in 7 patients. Uncomplicated course of the postoperative period was noted in 6 of them. The indications for formation of the OPJA are substantiated by the experience with 32 pancreatoduodenal resections with pancreatojejunoanastomosis formation, and 47--with occlusion of the pancreatic stump. PMID- 2696808 TI - [Moulages for teaching students various practical skills]. PMID- 2696809 TI - [The role of cholelithiasis in the etiology and pathogenesis of acute pancreatitis]. PMID- 2696810 TI - [Splenic rupture as a complication of pancreatitis]. PMID- 2696812 TI - [Emergency echography in the diagnosis of acute pancreatitis]. PMID- 2696811 TI - [Pancreaticojejunostomy in traumatic transverse rupture of the pancreas]. PMID- 2696813 TI - [Problems of the history of medicine on the pages of the journal "Klinicheskaia khirurgiia"]. PMID- 2696814 TI - [Strengthening the cooperation between Transcarpathian surgeons and surgeons of the Eastern-Slovak region of Czechoslovakia]. PMID- 2696815 TI - [Foreign body migration in the vascular channel]. PMID- 2696816 TI - [Carcinoid tumors of the gastrointestinal tract (review of the literature)]. PMID- 2696817 TI - [Anton Grigor'evich Brzhozovskii (on the 120th anniversary of his birthday)]. PMID- 2696818 TI - [Historical information on acute appendicitis (a centennial of teaching on appendicitis)]. PMID- 2696819 TI - [Calendar of anniversary dates of history of surgery in 1990]. PMID- 2696820 TI - [Ultrasonic diagnosis of aneurysms of the abdominal aorta and its state after reconstructive surgery]. AB - The article generalizes the results of examination of 44 patients for diagnosing aneurysms of the abdominal aorta and its complications with the use of the ultrasonic method. Aneurysms were detected in 27 patients, dissecting aneurysm was found in 7 of them and rupture of the aneurysm in one patient. Operation was carried out on 16 patients, all of them were kept under dynamic observation beginning from the 3rd-5th postoperative day. Various postoperative complications were noted in 4 patient in different periods. PMID- 2696821 TI - [Doppler sphygmomanometry in the diagnosis of obliterating atherosclerosis]. AB - The diagnostic possibilities of regional systolic pressure measurement was appraised in examination of 76 patients with various localization of the occlusive lesion and stages of the disease. The indices of regional systolic pressure (IRSP) were compared for precise comparative analysis. The indices of changes of systolic pressure (ICP) between the measurement zones were calculated for comparison of pressure changes along the length of certain limb segments. The malleolar systolic pressure index is of highest diagnostic importance in identifying the occlusive lesion, whatever its type. IRSP changes at different levels give a precise idea of the hemodynamic conditions of each type of occlusive lesion. The ICP should be accepted as the criterion of the spread of the occlusive process in arteries below the inguinal ligament. The suggested method makes it possible not only to detect the occlusive process, but to differentiate an aorto-iliac and femoropopliteal blockade or their combination. PMID- 2696822 TI - [Treatment of vesicorectovaginal and rectovaginal fistulae via omentoplasty]. PMID- 2696823 TI - [A simplified technic for omentoplasty treatment of large x-ray-induced and traumatic vesicovaginal fistulae]. PMID- 2696824 TI - [Sclerosis of the bladder neck]. PMID- 2696825 TI - [Continent urinary diversion following cystectomy in bladder carcinoma]. PMID- 2696826 TI - [The role of splenectomy in surgical hematology]. AB - The authors review the literature on the importance of splenectomy in hematologic diseases, its indications, contraindications and complications. Classification of diseases of definite importance in surgical hematology, for which splenectomy is considered, is presented. PMID- 2696827 TI - [Modification of the technic of subthrombic sclerectomy]. AB - Subthrombic sclerectomy for the surgical treatment of glaucoma was proposed in 1975. The present modification comprises introduction of a third, additional stitch for fixing the scleral border in order to block the limbo scleral fistula by the implanted patch of the thrombus. It comprises also injection of air into the anterior chamber through the limbo-scleral fistula. Additional surgical actions reduce the excessive filtration and facilitate the reformation of the anterior chamber at the end of the operation. PMID- 2696828 TI - [Hemophilia and AIDS]. PMID- 2696830 TI - [Clinico-morphological criteria of diagnosis of dysentery and Salmonella infections]. AB - Clinical symptoms and laboratory findings have been evaluated for 108 patients with intestinal infection associated with apparent colitic syndrome. Differential diagnosis between dysentery and salmonellosis was not an easy task even though clinical signs of the diseases appeared different. Dysentery ran with tenesmus, sigmoid pain and spasms. Symptoms of gastritis, intoxication, dehydration, hepatomegaly predominated in salmonellosis. In obscure cases colonic biopsy can be helpful due to high sensitivity of immunofluorescence in histological sections. Morphological diagnostic criteria comprise intensive microbial invasion, pronounced immunomorphological reaction in superficial epithelium of the colon for dysentery and macrophagal affection of the colonic mucosa plate for salmonellosis. PMID- 2696829 TI - [Utilization of glucose and the blood levels of insulin, C-peptide, triglycerides and cholesterol during hemofiltration in patients with acute renal insufficiency]. PMID- 2696831 TI - [Characteristics of thrombohemorrhagic syndrome in patients with acute intestinal infections]. PMID- 2696832 TI - [Lesions of the liver in patients with alimentary-constitutional morbid obesity]. PMID- 2696833 TI - [N.I. Pirogov and the development of vascular surgery]. PMID- 2696834 TI - [Contribution of Russian scientists and physicians of the second half of the 19th century to the study of the normal and pathological structure and function of the spleen]. PMID- 2696835 TI - [Thomas Sydenham (on the 300-th anniversary of his death)]. PMID- 2696836 TI - [Pathogenetic properties of Campylobacter pylori]. PMID- 2696837 TI - [Search for diagnostic methods in chronic pancreatitis]. PMID- 2696838 TI - [Reaction of the endocrine system to continuous and intermittent electromagnetic fields]. AB - This paper reviews Soviet and foreign data about the effects of low frequency electromagnetic fields of continuous and intermittent generation on the endocrine system of animals and humans. It has been shown that the pituitary-adrenal, pituitary-thyroid and reproductive systems are sensitive to these effects. It is postulated that the endocrine responses to electromagnetic effects are similar to the general adaptive reactions to various pathophysiological exposures. PMID- 2696839 TI - [AIDS: in order to know more about it]. PMID- 2696840 TI - [Hildegard medicine--confirmed 800 years later]. PMID- 2696841 TI - Mechanisms of normal and malignant breast epithelial growth regulation. AB - In this presentation we review information highlighting the multiple roles of both steroidal and polypeptide regulators of mammary epithelial cell growth with some additional emphasis on the work of our laboratory. The effects of both classes of hormones are complex and involve multiple interactions with epithelial components (malignant or normal) and the stromal compartment. Estrogens induce growth regulatory polypeptide growth factors which are responsible for many of the induced phenotypic effects in hormone-dependent breast cancer. Progression of hormone-dependent breast cancer to hormone independence probably involves multiple genetic mechanisms of oncogene activation, loss of the estrogen receptor, or loss of hormone responsivity of other gene products. Initial carcinogenesis and progression of mammary epithelium to cancer probably also requires both proliferative stimuli (estrogen, polypeptide growth factors) and genetic damage, leading to qualitatively different hormonal responses (hormone responsive cancer). New therapeutic strategies based on these biological considerations are emerging, including a variety of approaches which interfere at multiple points with ability of ligand to induce receptor signaling. PMID- 2696842 TI - Approaches to studying the role of growth factors in the progression of breast tumours from the steroid sensitive to insensitive state. AB - Progression from steroid sensitive to autonomous proliferation can be modelled in several cultured mammary tumour cell lines by long-term withdrawal of steroids. A feature of all the four systems studied thus far is that the basal growth in the absence of steroid increases with duration of steroid withdrawal until it reaches that obtained in the presence of steroid. It cannot be assumed that the increased proliferation in the absence of steroid is modulated by the same pathways as those stimulated by steroids in sensitive cells. Therefore, we feel that mechanisms of progression can best be studied via cell behaviour in the absence of steroid. With both the mouse S115 and human T-47-D systems, changes in sensitivity to several growth factors accompany progression; responses to TGF beta 1 are of particular interest in the T-47-D cells where this growth factor becomes stimulatory in the steroid insensitive state. This is accompanied by upregulation of TGF beta 1 mRNA. This upregulation of TGF beta agrees with the finding that ER - PR - primary human breast tumours contain more TGF beta 1 than do ER + PR + tumours; TGF alpha has the opposite pattern. Furthermore, only 40 and 30 kDa TGF beta species have been detected within cultured cells and primary tumours; TGF alpha exists in a 30 kDa form. The functions of these large forms of TGF alpha and TGF beta are unclear. Our conclusions from these experiments is that the increased proliferation in the absence of steroid accompanying progression may not be mediated by the same pathways as those perturbed by steroids in sensitive cells. Furthermore, TGF beta 1 may have different effects in steroid responsive and unresponsive cells. PMID- 2696843 TI - Prognostic factors for recurrence and survival in axillary node-negative breast cancer. AB - The question of which node-negative breast cancer patients should be treated with adjuvant systemic therapy is a debatable topic. Our approach in San Antonio is to examine the risk profile for an individual patient and attempt to classify the patient into a good risk group or a high risk group in terms of disease recurrence. Features such as small tumor size (less than 2 cm), diploid tumors with low proliferative rate, and nuclear grade I, all indicate a good prognosis with a disease-free survival of approx. 90% at 5 yr. Examination of the cost vs benefits in this category of patients suggest that routine treatment with systemic adjuvant therapy is not appropriate. PMID- 2696844 TI - Comparative studies on the effects of steroidal and nonsteroidal oestrogen antagonists on the proliferation of human breast cancer cells. AB - Pure and partial agonist antioestrogens, exemplified by ICI 164,384 and tamoxifen or 4-hydroxytamoxifen (4'-OHT) respectively, differ in their capacity to inhibit the growth of MCF-7 human breast cancer cells. Under basal conditions which maintain but do not permit proliferation of MCF-7 cells, growth rate was enhanced by oestradiol, Phenol Red, insulin and 4'-OHT but not by ICI 164,384. Oestradiol and insulin together enhanced cell growth rate synergistically. 4'-OHT, but not ICI 164,384, similarly increased insulin-stimulated cell growth in the absence of oestradiol. ICI 164,384 blocked the stimulatory action of 4'-OHT. The stimulatory effect of the peptide growth factors TGF-alpha and IGFI on MCF-7 cells were attenuated by ICI 164,384 and 4'-OHT; ICI 164,384 was more effective than 4'-OHT. The antiproliferative action of ICI 164,384 on oestradiol or growth factor stimulated MCF-7 cells was only weakly inhibited by TGF-beta antibodies. PMID- 2696845 TI - LH action in the Leydig cell: modulation by angiotensin II and corticotropin releasing hormone, and regulation of P450(17) alpha mRNA. AB - Luteinizing hormone is the major regulator of Leydig cell differentiation and steroidogenic function. A number of hormones produced by the Leydig cell (e.g. estrogen, angiotensin, CRF, vasopressin) and the tubular compartment (inhibin, TGF beta), can influence both acute and long-term actions of LH. Conversely, hormones produced in the Leydig cells modulate tubular function (e.g. androgen, beta-endorphin, oxytocin). The LH stimulatory event can be negatively influenced by the action of angiotensin II through the guanyl nucleotide inhibitory unit of adenylate cyclase. We have recently discovered an action of corticotrophin releasing hormone through specific high-affinity low-capacity receptors in the Leydig cells which involves a pertussis toxin insensitive guanyl nucleotide regulatory unit with interaction between signalling pathways and resulting inhibition of LH induced cAMP generation and consequently of steroidogenesis. In contrast to other tissues the CRF receptor in the Leydig cells did not couple to Gs. CRF action is exerted through direct or indirect action of protein kinase C, at the level of the catalytic subunit of adenylate cyclase. Physiological increases in endogenous LH cause positive regulation of membrane receptors and steroidogenesis, while major elevations in circulating gonadotropin can induce down-regulation of LH receptors and desensitization of steroid responses in the adult cell. Gonadotropin-induced desensitization in adult rat tests include an estrogen mediated steroidogenic lesion of the microsomal enzymes 17 alpha hydroxylase/17,20-desmolase. For further understanding of the regulation of this key enzyme of the androgen pathway the rat P450(17) alpha cDNA was cloned and sequenced. This cDNA expressed in COS-1 cells 17 alpha-hydroxylase/17,20 desmolase activities. From the deduced amino acid sequence, two transmembrane regions were identified, a signal peptide for insertion in the ER, and a 2nd transmembrane region separated from the first by 122 amino acids. The carboxy terminal non-transmembrane region possesses 4 hydrophobic clefts, of which cleft II would contain the putative steroid binding site for both hydroxylase and lyase activities. The rat cDNA was employed to evaluate the hormonal regulation of mRNA levels in adult and fetal Leydig cells. Low dose hCG treatment caused an early increase in mRNA levels followed by a return to control values at later times, while with higher desensitizing doses the initial increase in mRNA was followed by a marked reduction in mRNA at 24 h and a small recovery at 48 h. Fetal rat Leydig cells treated with E2 showed a 70% decrease in P450 mRNA levels, and testosterone production closely followed the changes in mRNA.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2696846 TI - Possible underlying mechanisms of sexual dimorphism in the immune response, fact and hypothesis. AB - It is a confirmed fact that in females both the humoral and cell mediated immune response is more active than in males. A large amount of information supports the view that hormones of the endocrine system are intimately involved in this immunological dimorphism. Such hormones include the gonadal steroids, the adrenal glucocorticoids, growth hormone (GH) and prolactin (Prl) from the pituitary, thymic hormones, and substances generated by activated lymphocytes. It is suggested that a complex medley of these hormonal interactions effect both developing lymphocytes within the microenvironment and regulate adult effector cells. The most important of these hormonal interactions leading to immunological dimorphism are the effects elicited by estrogen (E) elaborated at elevated levels from the female ovary after puberty. Elevated E leads to basal GH secretion, increased Prl, and increased thymosin release, all of which are hypothesized to effect lymphocyte development and stimulate adult T- and B-cell function in females. Interactions of hormonal regulatory axes involving the hypothalamus, pituitary, gonads, adrenals, and thymus are also thought to be involved. Factors elaborated by activated immune cells including IL-1 and IL-2 may also play a role in down regulation of these responses. Finally, genetic components are also considered pertinent especially under conditions of pathological disequilibrium leading to autoimmune disease. While the benefits provided by immunological dimorphism are still not entirely clarified, since sex hormones are intimately involved in immunological regulation it is quite possible that the increased immune response in females allows them to compensate for the increased physiological stress which accompanies reproduction. The final outcome would thus be the assurance of reproductive success of the species. PMID- 2696847 TI - Hormonal influence on the secretory immune system of the eye: endocrine impact on the lacrimal gland accumulation and secretion of IgA and IgG. AB - The objective of the current investigation was to explore the processes underlying the androgen control of tear IgA and to determine whether hormone exposure also modifies tear IgG content. In addition, studies evaluated the impact of diabetes on the androgen regulation of secretory immunity in the eye. Tears and lacrimal glands were collected from age-matched, adult male rats, which had undergone hypophysectomy, selective ablation of the anterior pituitary, streptozotocin-induced diabetes, sham-surgery and/or orchiectomy and had been exposed to vehicle or physiological amounts of testosterone for varying periods of time. Our findings demonstrated that testosterone administration selectively increased the accumulation of IgA, but not IgG, in tears and lacrimal glands of orchiectomized rats. This hormone effect was associated with a 2-fold enhancement of the IgA transfer from lacrimal tissue to tears; IgA movement was against a gradient. In contrast, androgen exposure had no significant influence on the lacrimal gland/tear transfer of IgG, which was down a 90-fold gradient. Testosterone action on the lacrimal gland appeared to involve an increase in IgA production, but not a consistent alteration in the total number of IgA-containing cells. Similarly, androgen exposure had no impact on the population of IgG containing lymphocytes in lacrimal tissue. Of interest, ablation of the anterior or entire pituitary in orchiectomized rats, which procedure inhibits testosterone induced stimulation of tear IgA levels, significantly reduced the total number of IgA-containing cells in the lacrimal gland. Induction of diabetes by streptozotocin injection to orchiectomized rats resulted in diminished tear IgA content and decreased numbers of lacrimal IgA-positive lymphocytes, but did not prevent the testosterone-associated rise in IgA antibody content. In summary, our findings demonstrate that androgens increase the lacrimal gland production and secretion of IgA, but not IgG. PMID- 2696848 TI - Evidence for a direct effect of estrogen on bone cells in vitro. AB - Although the beneficial effects of estrogen in the treatment of postmenopausal osteoporosis are well documented, such effects were difficult to demonstrate in in vitro models. However, recent improvements in bone cell culture models (better defined osteoblastic cell populations, omission of Phenol Red from culture media) enabled several investigators to show albeit small, but reproducible, direct effects of estradiol in various osteoblastic cell types. Such findings were supported by the identification of low numbers of high-affinity estrogen receptors in bone cells derived from different mammalian species. The likely physiological relevance of the in vitro results is indicated by the specificity for 17 beta-estradiol, and the requirement for nanomolar concentrations of the hormone, consistent with a Kd of 0.6 nM for estradiol binding to its receptor [56]. In bone in vitro, estradiol may have anticatabolic effects by decreasing parathyroid hormone responsiveness, and anabolic effects by stimulating matrix synthesis and cell proliferation. Insulin-like growth factor-I is likely to be an autocrine/paracrine mediator for the anabolic effects and may, when associated with its binding proteins, effectively act in the bone compartment. PMID- 2696849 TI - Progesterone receptor concentration differences in the chick oviduct cells and apparent down-regulation by ligand. A semiquantitative immunohistochemical study. AB - A semiquantitative immunohistochemical technique was developed for identification of chick progesterone receptor (PR). The mouse monoclonal antibody PR6 was used. The nuclear PR concentration was analyzed with Leitz Orthoplan MPV-3 light microscope. The target tissue was chick oviduct, with epithelial, glandular, mesenchymal, smooth muscle and peritoneal cells analyzed separately. PR concentration varied between different cell types and also from cell to cell within a single cell type. A significant decrease of PR concentration, as noted by decrease in staining, was also observed in all studied cell types, 6 h after a single injection of progesterone. This technique allows for histological identification of biochemical events that should help lead to the understanding of the role of PR changes in a variety of experimental situations. PMID- 2696850 TI - Aromatase inhibition by R 76713: experimental and clinical pharmacology. AB - R 76713 is a new non-steroidal compound which inhibits aromatase in vitro and in vivo with a potency of at least 1000-fold that of aminoglutethimide. In male cynomolgus monkeys peripheral conversion of labeled androstenedione to estrone is decreased by 85%, 4-5 h after a single intravenous dose of 0.003 mg/kg of R 76713, without altering steroid metabolic clearance rates. In rats fed a sodium depleted diet for 3 weeks, plasma levels of aldosterone and plasma renin activity remain unchanged 2 h after a single oral dose of up to 20 mg/kg of R 76713. This confirms previous data on the selectivity of R 76713 for aromatase inhibition as compared to inhibition of other enzymes involved in steroid biosynthesis. In male volunteers, a single oral dose of 5 or 10 mg of R 76713 lowers median plasma estradiol levels from 70 pM to the detection limit of the assay (30 pM) 4 and 8 h after intake, whereas no important changes are detected after placebo administration. In 15 premenopausal female volunteers receiving a single oral dose of 20 mg of R 76713, mean plasma estradiol levels decrease from 415 pM (before) to 179, 149 and 185 pM respectively 4, 8 and 24 h after intake whereas they remain above 380 pM after placebo (n = 7). PMID- 2696851 TI - Steroid synthesis in rat brain cell cultures. AB - Primary cultures derived from neonatal rat forebrains were established and cultured for several weeks. They grow entirely as glial cultures composed of oligodendrocytes and astrocytes. Glial cells undergo maturation and differentiation in culture. This was shown by measuring the oligodendroglial enzyme 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase), a specific marker for expression of oligodendrocyte differentiation. CNPase activity increased from days 10-21 of culture. Both cell types were characterized by indirect immunofluorescence staining using monoclonal antibodies to galactocerebroside (Gal C) and myelin basic protein (MBP) for oligodendrocytes, and glial fibrillary acidic protein (GFAP) for astrocytes. Using the above criteria, we measured about 60% oligodendrocytes and 40% astrocytes after 3 weeks of culture. Oligodendrocytes, expressing Gal C and MBP, were highly immunoreactive to monospecific polyclonal antibodies to the cytochrome P-450scc, enzyme involved in the synthesis of pregnenolone from cholesterol. After incubation of glial cultures with [3H]mevalonolactone in the presence of mevinoline and trilostane, biosynthesis of [3H]cholesterol, [3H]pregnenolone (P) and [3H]pregn-5-ene-3 beta, 20 alpha-diol (20-OHP) was demonstrated. Steroid biosynthesis was related to oligodendroglial differentiation, as the initial and rapid rate of increase in CNPase activity was found to occur at the same time as the onset of steroid synthesis. Both reached a maximum at 3 weeks of culture and remained stable for several weeks. Steroid synthesis was increased by dibutyryl cAMP (0.2 mM), as well as by dexamethasone (10 nM). When aminoglutethimide, a potent inhibitor of cytochrome P-450scc, was added during the incubation of cells with [3H]mevalonolactone, [3H]cholesterol accumulated in the cells. After the release of aminoglutethimide blockade, [3H]20-OHP was the major steroid produced and released in the culture medium. The demonstration of de novo steroid biosynthesis and of the cholesterol side-chain cleavage cytochrome P-450 in normal rat glial cells brings additional support to the concept of "neurosteroids". PMID- 2696852 TI - Biosynthesis of adrenal corticosteroids by the sesterterpene pathway via 23,24 dinor-4-cholen-3-one. AB - Rat adrenal gland preparations were incubated with 23,24-dinor-5-cholen-3 beta-ol (Guneribol), a proposed intermediate in the sesterterpene pathway for steroid biosynthesis. Steroids were isolated, purified by thin layer and high-performance liquid chromatographies and crystallized to constant specific activity. These preparations converted the substrate to 23,24-dinor-4-cholen-3-one. Radioactive 23,24-dinor-4-cholen-3-one was synthesised and incubated with further tissue preparations and shown to be converted to corticosteroids. These findings suggest that 23,24-dinor-4-cholen-3-one is an intermediate on the sesterterpene pathway for steroidogenesis. PMID- 2696853 TI - [Insulin--its past, present and future]. AB - Since the invention of insulin and further, the numerous research workers have been trying to get the hormone in the most possible purest form and to make it more convenient for the treatment. By gel-filtration and ion-exchange chromatography can be obtained maximum purified insulin the so-called monocomponent insulin which possesses considerably less antigen characteristics than the conventional insulins. The human insulins obtained by semisynthesis and biosynthesis through genetic engineering the further progress in the treatment of diabetes mellitus by insulin. The intensified insulin therapy is applied nowadays by repeated injections of insulin, through application of insulin pumps in the so called open systems and by application of artificial pancreas in the so-called closed systems. The complete normalization of glycemia can be achieved only by means of the closed system and that is the system which would work at the principle of glucose-insulin feed back. Unfortunately, these devices are very big and their use for nowadays in everyday practice is not possible yet. PMID- 2696854 TI - Aerobic and resistive exercise modify risk factors for coronary heart disease. AB - An awareness of the health-related benefits of regular physical activity, prudent diet, and cessation of cigarette smoking are some of the mechanisms by which risk factors for coronary heart disease (CHD) and the incidence of complications of atherosclerosis have declined in the American population. Exercise training is associated with improvements in lipid and glucose metabolism that are manifested by enhanced insulin sensitivity, improved glucose tolerance, increased high density lipoprotein cholesterol levels, reduced triglyceride and low density lipoprotein cholesterol levels, and reductions in blood pressure. In addition to reduced risk factors for atherosclerosis, physically conditioned individuals have better cardiovascular function at rest and during exercise than their inactive peers. Thus, exercising training reduces morbidity and mortality from atherosclerotic complications through both direct (cardiovascular) and indirect (risk factor modification) mechanisms. Many studies demonstrate a strong association between regular physical activity and reduced risk for CHD. This article provides a review of risk factors for CHD and the potential health benefits of aerobic and resistive exercise. The time seems apt for the institution of multifactorial cardiovascular risk prevention programs in which aerobic and resistive exercise are combined with prudent diet therapy and smoking cessation to reduce risk factors for CHD. PMID- 2696855 TI - Psychological effects of resistive weight training: implications for cardiac patients. AB - Cardiac patients' perceptions of their physical capabilities ("self-efficacy") often exert greater influence over their return to normal activities than does their actual medical status. The first part of this review explains how self efficacy perceptions are formed and how participation in resistive weight training can promote adherence to safe and effective exercise. The second part of the paper reviews data showing how exercise contributes to emotional well-being and reports changes in self-efficacy and negative affect that recently have been found to accompany strength gains achieved in circuit weight training. PMID- 2696856 TI - Effects of resistive training on lipoprotein-lipid profiles: a comparison to aerobic exercise training. AB - A recent surge of cross-sectional and longitudinal studies dealing with resistive training and lipid profiles have produced conflicting results. The majority of cross-sectional studies demonstrate a reduced HDL cholesterol level or elevated total cholesterol to HDL ratio in strength trained athletes as compared with endurance trained athletes. Because of selection biases from many of these studies, there is a lack of control for factors that may influence lipids and lipoproteins, such as age, body composition, diet, and anabolic-androgenic steroid use. Most investigators have reported improved lipoprotein-lipid profiles from resistive training programs. However, many of these studies have design flaws or limitations that make their conclusions questionable. The most serious design flaws include the combination of no control group and only one blood sample taken before and after training, the use of subjects who have low risk profiles, and the lack of control for dietary effects. In a recent study in which we attempted to control for these factors, no changes in lipid profiles were observed after 20 wk of resistive training among individuals at risk for coronary heart disease (CHD). A group serving as reference controls who participated in aerobic-type exercise training during the same time period reduced their plasma triglyceride levels but did not alter their cholesterol or lipoprotein levels. No changes in any lipids or lipoproteins were observed in a group of inactive controls. Thus, resistive training does not appear to alter lipoprotein-lipid profiles among individuals at risk for CHD. PMID- 2696857 TI - Effects of resistive training on left ventricular function. AB - Although several studies have evaluated the effects of endurance training on left ventricular (LV) function, few studies have looked at resistive training effects. Acute isometric exercise increases blood pressure and has little effect on LV function, causing only mild increases in ejection fraction and stroke volume index. However, acute isometric exercise does increase LV diastolic diameter to a lesser extent than dynamic exercise. Most studies of resistive training on LV function have been cross-sectional or short term (10 to 12 wk) training studies on athletes and suggest that increases in LV wall thickness and mass are dependent upon the intensity and duration of training. Most resistive training studies show no increase in left ventricular volume, as can be seen in endurance trained athletes. Despite the increase in LV mass with resistive training, indices of LV systolic and diastolic function do not change. In hypertensive and cardiac patients with normal LV function at rest, resistive training increases LV mass index without deleterious effects on LV systolic and diastolic function. However, in patients with abnormal resting LV function, resistive training can have adverse effects on LV systolic function. Overall, moderate levels of resistive training can be a useful adjunct to cardiac rehabilitation programs, with the caveat that it be used with caution in patients with abnormal LV function at rest. PMID- 2696858 TI - Hepatitis B virus gene products as immunological targets in chronic infection. AB - The pathogenesis of hepatitis B virus (HBV) infection is variable and can result in the development of acute and chronic hepatitis, cirrhosis and primary hepatocellular carcinoma (PHC). In this review, the relationship between the patterns of virus gene expression, host immunological responses, and liver pathology in chronic infection will be discussed. Available evidence suggests that the virus is not directly cytopathic to liver cells and that the pathologic sequelae to infection are mediated by both humoral and cellular immune responses against one or more virus gene products. In addition, chronic liver disease might also be mediated by autoaggressive immune responses that may be stimulated by the direct action of virus gene products upon host gene expression, by the lysis of infected hepatocytes by virus specific host immune responses, or by both. Given the complex and variable outcome of HBV infection, the lack of adequate treatment for chronic liver disease, and the fact that long-term infection dramatically increases the risk of developing PHC, the future provides challenges for devising new models to study, understand and successfully manipulate the pathogenesis of chronic HBV infection. PMID- 2696859 TI - Regulation of virulence genes in Shigella. AB - Shigella pathogenicity is a multi-genic phenomenon involving the participation of genes on both the 230 kilobase virulence plasmid and the chromosome. A key feature of the regulation of Shigella virulence is its response to growth temperature. Genes in the virulence regulon are fully expressed at 37 degrees C, the normal temperature of Shigella's mammalian host, and the regulon is repressed at lower temperatures. Virulence gene expression is regulated in both a positive and a negative fashion by several plasmid-encoded activators and at least one chromosomally encoded repressor. The use of a variety of molecular tools including gene fusions, cloning, complementation, DNA sequencing and mRNA analysis, has provided a more complete understanding of how various, unlinked genetic loci contribute in a co-ordinated fashion to the pathogenic phenotype expressed by Shigella. PMID- 2696860 TI - Genetics and molecular pathogenesis of Legionella pneumophila, an intracellular parasite of macrophages. AB - In addition to providing a powerful approach for identifying bacterial factors required for full infectivity and disease production, genetic analysis of Legionella pathogenesis should also lend critical insight into the biology of the macrophage and into the pathogenesis of other intracellular parasites. The interaction between L. pneumophila and the macrophage exhibits many features found in a wide variety of prokaryotic and eukaryotic intracellular human pathogens. For example, binding to complement receptors has been shown to occur for Mycobacterium tuberculosis, M. leprae, Leishmania donovani, Leishmania major and Histoplasma capsulatum. Coiling phagocytosis has been observed during entry of L. donovani. Phagosomes that contain Toxoplasma gondii or M. tuberculosis fail to fuse with lysosomes and, in the case of T. gondii, have been shown to remain close to neutral pH. Although the molecular bases for these phenomena are unknown, their functional similarities to the L. pneumophila-macrophage interaction provide optimism that generally applicable principles are involved. The genetic techniques reviewed here will provide the molecular tools with which such questions of a general biologic nature can be framed and eventually answered. Together with more traditional methods in biochemistry, microbiology and cell biology, molecular genetics offers a robust means toward identifying and understanding the bacterial factors involved in the pathogenesis of Legionnaires' disease. Molecular studies of L. pneumophila can also help address questions concerning the epidemiology, diagnosis and prevention of disease. For example, the distribution of virulence factors might help explain and predict the attack rates of different L. pneumophila strains or Legionella species. Moreover, bacterial genes/factors that are shown to be conserved in Legionella strains could be used to develop such diagnostic tools as DNA probes. Novel types of vaccines consisting of genetically constructed, avirulent L. pneumophila strains or subunit vaccines based on the molecular characterization of virulence factors might be developed and tested as protective immunogens. In this way, the capacity to analyze and to manipulate L. pneumophila genetically may facilitate the use of Legionnaires' disease as a model infection for studying protective cell-mediated immunity. Apart from its clinical significance as the etiologic agent of Legionnaires' disease, L. pneumophila may be a key to broader understandings in microbial pathogenesis and human cell biology and immunology. Although the extremely complex processes of bacterial infection and virulence are best understood when a variety of experimental approaches are employed, we believe that the evolving molecular genetic techniques reviewed here will be critical elements in many important breakthroughs in the future. PMID- 2696861 TI - [Anticardiolipin antibodies in autoimmune rheumatic diseases]. AB - In this study, ELISA and VDRL tests have been employed in order to detect ACL antibodies in sera samples obtained from 105 patients with SLE, RA, scleroderma, dermatomyositis, primary Sjogren's syndrome, vasculitis and pulmonary thromboemboli; Using by IFAT, AMA-type 5 and other autoantibodies, RIA anti-DNA antibodies were also tested in SLE patients. In sera obtained from the patients with RA; autoantibodies and RF have been investigated. In SLE cases, ACL antibodies were found to be positive in 55.5% of the patients. In RA cases the rate of ACL antibodies were found to be 51.7%. In SLE cases, the presence of IgG ACL antibody was found to be in association with thrombosis and fetal loss; while IgM-ACL antibody was found to be in association with fetal loss only. Serologic parameters such as VDRL and AMA type 5 were significantly connected with the presence of ACL-IgG and IgM antibodies (p less than 0.05). In cases of RA connection was detected only between IgG-ACL antibody and thrombosis. Concerning the other rheumatic autoimmune diseases; ACL antibodies were detected in cases: 4 patients out of 11 scleroderma, 1 patient out of 7 vasculitis, 2 patients out of 5 primary Sjogren's syndrome, and 3 patients out of 6 pulmonary thromboemboli. PMID- 2696862 TI - [The distribution of clostridia in soil samples from Bursa]. AB - In the soil samples taken from different places of Bursa, distribution of the Clostridia were searched by anaerobic jar and immunofluorescence reaction (FAT). In our study, 122 bacteria belonging to 11 Clostridium species were isolated in 35 soil samples. These strains were identified by studying morphological and biochemical properties, lecithinase C and lipase activities, toxin neutralization characteristics. In addition, FAT were used for 4 Clostridium species. PMID- 2696863 TI - [Postoperative wound infections]. AB - Between July 1987 and October 1988, 400 postoperative wound infection material sent to Microbiology Laboratory from various surgery clinics were examined bacteriologically. Staphylococcus aureus was the predominant organism. E. coli and coagulase negative Staphylococci were second and third in frequency respectively. PMID- 2696864 TI - [Lyme disease]. AB - Lyme disease, which is caused by the tick-borne spirochete Borrelia burgdorferi, usually begins with a characteristic skin lesion erythema chronicum migrans (ECM), that may be followed by neurological or cardiac abnormalities and is accompanied by malaise, fatigue, fever, myalgia, headache, lymphadenopathy and is often followed by arthritis. The disease takes its name from Lyme, Connecticut, where the full spectrum of illness was first described in 1975. It is known to be a multisystemic infectious disease. Because culture and direct visualisation of spirochetes are often negative in Lyme disease, serological testing has been the only practical laboratory aid in diagnosis and primarily clinical findings. PMID- 2696865 TI - [Viral encephalitis]. AB - Acute viral and other infectious causes of encephalitis usually produce fever, headache, stiff neck and alterations in consciousness, focal neurologic signs and seizures. A large number of viral and nonviral agents can cause encephalitis. Arthropod-borne viruses peak in summer, the tick-borne infections occur in early summer, enterovirus infections in later summer and mumps in the winter and spring. PMID- 2696866 TI - [Distribution of Cryptococcus neoformans in pigeon feces]. AB - C neoformans has been investigated in fecal droppings obtained from pigeon coops that placed in several suburbs of Bursa City. In sixteen of the 115 samples (13.9%), C neoformans strains has been isolated and studied their morphological and biochemical properties. But no isolation has been obtained from 8 soil samples and 14 samples of chicken dung. PMID- 2696867 TI - [Antibiotic susceptibility of group A beta hemolytic Streptococcus]. AB - In this study, we researched the susceptibility of group A Beta-hemolytic Streptococcus to antibiotics which are isolated from 218 Aydinlikevler primary blind boarding school students aged between 7-16 and a group of patient's throat and nose culture with acute and chronic upper respiratory tract infection. The susceptibility to 9 antibiotics of (100) group A Beta hemolytic Streptococcus which were isolated 52 from throat, 48 from nasal discharge were examined by the method of disc diffusion test after determination of the colony, hemolysis and staining characteristics also the sensibility to optochine and bacitracin (0.04 U) discs colonies. The antibiotic resistance ratio are observed as 24%. For Penicillin-G, 59% for Ampicillin, 17% for Amoxicillin, 31% for Methicillin, 22% for Cephalexin, 33% for Carbenicillin, 77% for Lincomycin, 60% for Trimethoprim/Sulphamethoxazole, 26% for Chloramphenicol. This finding shows that group A Beta hemolytic Streptococcus are getting being resistant to this 9 antibiotics. Also this results indicate that the treatment after antibiotic susceptibility test of group A Beta hemolytic Streptococcus is more effective. PMID- 2696868 TI - Renal size in healthy Malaysian adults by ultrasonography. AB - Two hundred and five healthy Malaysian adults were scanned for the length of their kidneys and the cortical thickness by both the sector real time and linear array static B-scan diagnostic ultrasound. The length of the left kidney was found to measure 105 (98-111) mm for males, and 100 (94-106) mm for females on average from the sector scan and the static B-scan. The right renal length was 102 (96-119) mm for males, and 98 (92-103) mm for females on the average from readings of both scans. The left kidney is longer in length than the right kidney in males and females on both scans. The cortical thickness at the equator of the kidneys of males and females ranges from 12-14 mm. In both sexes, the lengths of the kidneys may be estimated by the distance between the first to the fourth lumbar transverse processes when there is no scoliosis. PMID- 2696869 TI - The stethoscope and the transfer of bacteria in the neonatal nursery. PMID- 2696870 TI - A clinical trial of tissue adhesive (histoacryl) in skin closure of groin wounds. AB - The use of tissue adhesives has been widely studied since the 1960s. Since then they have found use in specialties like plastic surgery, neurosurgery, ENT surgery and dental surgery. Several papers have reported their safe use, both clinically and experimentally, particularly of the newer homologue n-butyl/2 cyanoacrylate (Histoacryl). In this study 43 patients (46 wounds) whose operations involved a groin incision were randomised into two groups for skin closure either with Dexon subcuticular suture (23 wounds) or Histoacryl glue (23 wounds). We found that both sets of wounds healed well with no wound infections or excessive inflammation when assessed at one week and four weeks. However the glued wounds had consistently better cosmesis scores (mean score 4.71 at four weeks) compared to the subcuticular Dexon wounds (mean score 4.00 at four weeks) and P value of less than 0.05. We feel that there is a place for tissue adhesives in skin closure for some general surgical wounds. PMID- 2696871 TI - 5-Fluorocytosine resistance in clinical isolates of Cryptococcus neoformans. AB - Thirty six clinical isolates of Cryptococcus neoformans were tested for their susceptibility to 5-fluorocytosine and amphotericin B by the determination of minimum inhibitory concentrations and minimum fungicidal concentrations. 22.2% of the isolates were resistant to 5-fluorocytosine and 36.1% indicated 5 fluorocytosine tolerance. All strains were sensitive to amphotericin B. PMID- 2696872 TI - A study on perennial rhinitis in Kelantan. AB - Ninety five patients with perennial rhinitis were examined clinically and various investigations were done in order to find out the common allergens and to assess the value of various tests in perennial rhinitis. In this study group 94% of cases were proven to be cases of allergic rhinitis. Cat fur was found to be the commonest allergen. Grass pollen which is a common allergen in European countries was found in only 18% of cases in the present study. X-ray of the paranasal sinuses as a routine investigation was not found to be of much use in perennial rhinitis. There was significant correlation between results for allergens tested by enzyme immunoassay and skin prick test. PMID- 2696873 TI - Intracellular calcium and neurotoxic events. AB - Calcium is important in many intracellular regulatory processes. However, the maintenance of low levels of this cation within the cytosol is essential for maintenance of cell viability, in view of the large concentration gradient of ionic calcium across the plasma membrane. The expenditure of energy is needed to maintain intracellular calcium concentration [Ca2+]i at normal levels. In addition, the integrity of the limiting membrane is also vital for this function. Thus, any disruption of membrane characteristics or of mitochondrial anabolic processes may lead to deleterious levels of [Ca2+]i. The toxicity of a wide range of unrelated agents may, therefore, be in part due to elevation of cytosolic calcium. This general event may synergize with the more selective harmful properties of a compound, thus adversely affecting cell metabolism. The capacity now exists to measure levels of [Ca2+]i in isolated cells or organelles such as synaptosomes. The use of such in vitro models can be of value in the evaluation of the neurotoxic potential of compounds. This method, in conjunction with the use of pharmacological agents known to act at specific sites, and with the use of radioactive calcium in translocation studies, also has utility in the delineation of the biochemical mode of action of neurotoxic agents. PMID- 2696874 TI - Lead-impaired neurodevelopment. Mechanisms and threshold values in the rodent. AB - Mechanisms underlying the cognitive deficits arising from chronic low level lead exposure are viewed as a consequence of impaired neurodevelopmental events. These events are exemplified within the cerebellum which is formed completely after birth and, therefore, encompasses all major epochs of development. Further, the unique pharmacokinetic distribution of juvenile blood lead levels is developmentally regulated and can be correlated to the periods of impaired structuring and threshold values indicating no-effect levels established. Here, the endpoint value is related to lead-induced dysfunctioning of a morphoregulator -the neural cell adhesion molecule (NCAM). During final synaptic structuring its normal developmental sequence is perturbed when blood lead levels exceed 20 micrograms/dl. These events are similar, and compared to, those seen in the cerebellum of the staggerer mouse mutant (sg/sg) where the selection of circuits to be preserved from those transiently overproduced during development is impaired. PMID- 2696875 TI - Chemical induction of brain tumors in rats by nitrosoureas: molecular biology and neuropathology. AB - Nitrosourea-induced rat brain tumors are among the best investigated experimental systems for neuropathological, biochemical, diagnostic and therapeutic research in neurooncology. This review summarizes data concerning molecular biology, neuropathology, in vitro studies, transplantation models and antigen expression of experimental gliomas in inbred rat strains. Systemic application of nitroso compounds, i.e., ENU and MNU, leads to the alkylation of DNA bases, which, due to a specific repair deficiency, persist in the nervous system remarkably longer than in other organs. The hypothesis is that alkylated bases cause base mispairing and point mutations followed by uncontrolled expression of oncogenes and growth factor receptors, resulting in permanent cell proliferation. Thus, nitrosoureas are considered to be biological hazards, especially as potent endogenous and exogenous neurotoxins. Neuropathology and growth characteristics of these experimental tumors are comparable to human malignant gliomas. Similar to the human WHO grade III and IV tumors, they reveal cellular pleomorphism, elevated mitotic activity, proliferation of blood vessels, blood-brain barrier disturbances, necrosis and invasiveness. Nitrosourea-induced brain tumors have been used in investigations concerning glioma growth and regression, brain edema, glioma immunology, metabolism, regional biochemistry, and experimental therapy. The studies included conventional morphology, immunohistochemistry, cytochemistry and -electronmicroscopy, morphometry, cell culture, hybridoma technology, tumor transplantation and regional imaging by autoradiography, bioluminescence, magnetic resonance and immunoscintigraphy. PMID- 2696876 TI - Critical issues in the study of the acute effects of solvent exposure. AB - The acute effects of exposure to solvent vapour can be studied under highly controlled conditions in laboratory experiments on volunteers or in quasi experimental field studies on occupationally exposed workers. Although these two types of investigations can provide valuable information on the neurotoxicity of solvents, their accomplishment encounters theoretical and practical difficulties. In the present paper the independent, the extraneous and the dependent variables of these studies are described, and both the research strategy and the methodology of these types of investigations are presented and discussed. PMID- 2696877 TI - Experiences with the Milan Automated Neurobehavioral System (MANS) in occupational neurotoxic exposure. AB - It is known that in neurobehavioral toxicology, the data obtained by means of psychological testing can acquire sense only when testing conditions and procedures, among others, are kept under rigorous control. This demand, together with the diffusion of multicentered studies aimed at finding mutual agreement on the parameters to be measured and the interpretation criteria to be adopted, has determined our decision to convert six out of the seven tests of the WHO-NCTB into a computer-aided system (MANS). The choice of one of the two systems depends on the characteristics of the testing situation and on the different requirements of clinical, epidemiological and experimental studies. The validation of MANS, as to its reliability and sensitivity, is ongoing but some data have already been collected which show a high correlation of the computer-administered test results with the paper and pencil form as well as a good degree of discriminating power in different testing situations. The experience, made in the past three years, seems to show that the goal of having a simple, easy to handle and reliable instrument to be used and, if necessary easily adapted to a variety of situations and cultures, has been met. Further work is to be carried out to confirm its validity in the early detection of neurobehavioral impairments due to neurotoxic agents. PMID- 2696878 TI - Antidotal therapy of severe acute organophosphate poisoning: a multihospital study. AB - Out of 859 consecutive cases treated for exposure to organophosphate (PO) insecticides, 53 were included in the study. Criteria for inclusion were severe OP poisoning necessitating artificial ventilation, intensive care monitoring and treatment according to a standard protocol. The protocol was based on relatively high doses of obidoxime, relatively low doses of atropine and overriding with a pacemaker in cases of ventricular arrhythmias and prolonged Q-T interval. Seven patients died during hospitalization. Thirty-two patients (60%) had major central nervous system (CNS) involvement. Five (9.4%) presented severe psychiatric sequelae. Twenty-two patients (41.5%) presented cardiac arrhythmias. Five (9.4%) had liver dysfunction. High frequency of cardiac arrhythmias was observed in patients who received high cumulative doses of atropine and obidoxime; impairment of liver functions was significantly higher in patients who received high cumulative doses of obidoxime. We conclude that each drug should be titrated separately: atropine dosage should be adjusted to the severity of tracheobronchial secretions and bronchospasm, while full doses of obidoxime are justified for the period before "aging" sets in. PMID- 2696879 TI - [Occult carcinoma of the breast presenting as an axillary node enlargement]. AB - The authors discuss ten cases of occult carcinoma of the breast which presented initially as the axillary node enlargement. All cases were proven as adenocarcinoma. Both mammography and ultrasonography revealed the tumor in 3 cases, while in the remaining 7 cases malignant lumps were not visualized. Multiple studies to detect an extra mammary site proved to be negative. A concealed carcinoma of the breast was found in 9 patients with careful sectioning of the resected breast specimens. Only one patient in whom carcinoma of the breast could not be detected has survived well for 6 years after the mastectomy. Parasternal node involvement was not identified in all 7 patients of who had received an extended radical mastectomy. Three patients died of the disease within 45 mo. Seven patients are free of recurrence for 1 to 10 years (average 6 1/2 Y). Prognosis of the patients in this group are as good as and/or sometimes better than those of the patients with axillary nodes pathologically positive. PMID- 2696880 TI - [Adrenal incidentaloma--report of 14 operated cases and analysis of 4-year autopsy series of Japan]. AB - During the last 7 years, operation was performed for 94 cases of adrenal tumor in our series, of which 14 were incidentally found by abdominal computed tomography or echography. They included 9 cases of pheochromocytoma, 1 of Cushing's syndrome, 3 of ganglioneuroma and 1 of cortical adenoma. Five of 9 pheochromocytoma cases were devoid of hypertension, but all 9 cases had abnormally high levels of urinary catecholamines and/or their metabolites. The 4 year autopsy series of Japan (1980-1983) included about 153,000 cases. Except the metastatic tumors, the following lesions were incidentally found in the adrenal gland: 310 of cortical adenoma, 153 of cortical hyperplasia, 39 of pheochromocytoma and 17 cases of neurogenic tumors. Some of the cortical adenomas are presumed to be more than 1 cm in diameter. So, they are expected to be found incidentally, more frequently in the future. Surgery is not necessary for most of them, except for functioning tumors. Most of the pheochromocytomas are presumed to be hormonally active, and should be treated surgically. It is probable that these functioning tumors had been missed clinically, especially in the elderly persons. Neurogenic tumors and myelolipomas may be left in place, when malignancy can be ruled out. PMID- 2696881 TI - [Horizontal stress of abutment. Particularly regarding difference in removable partial denture design]. AB - Prosthesis with removable partial denture is a daily clinical procedure for compensating the morphological loss and hypofunction of teeth and various gnathostomatic system. The removable partial denture not only comprises of many elements such as denture base, abutment and clasp but accordingly has to undergo morphologically complicated operative process, thus posing many factors concerning the functional stability coping with diverse masticatory motions. However, from the fact that retention and stability of the denture at it's functioning are obtained basically from it's connection with abutment, assessments in multiple aspects have been made regarding the influence exerted on abutment by difference in the structural elements, i. e. clasps, which transmit the movement of denture directly. There were the assessments by means of the displacement, measuring system by the use of microdial gage, stereoscopic camera, eddy currents transfer, and magnetic resistant element, and deformation measuring systems such as photoelasticity method, holography, moire method and strain gage method. However, these systems are the methods for assessing abutment as subject but not the assessing system including all the basic structural elements of denture. Therefore, the author has made observation of the influence exerted on the dynamics of abutment by the difference between clasps in 2 kinds and by cross arch stabilization by designing aker's clasp and RPI clasp for the abutment by the use of cast frame standardized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696882 TI - [Experimental studies of the pathomechanism of portal encephalopathy. II. Monoamine oxidase (MAO) activity in the rat brain after porta- caval shunt using 2 different methods]. AB - The authors present effect of the end to side portacaval shunt (E-S PCS) and side to side portacaval shunt (S-S PCS) on monoamine oxidase (MAO) activity in brain cortex and cerebellum of rats. There were significant differences between two experimental models of PCS. Our results show greater increase in MAO activity after end to side portacaval shunt. PMID- 2696884 TI - [Endoscopic endoprosthesis in the palliative treatment of carcinoma of the pancreas]. AB - Perendoscopic treatment of cancer of the pancreas may be carried out through bilionasal drainage or bilioduodenal drainage. These techniques are indicated for preventing choledochic stenosis due to cancer of the head of the pancreas and should be considered as palliative techniques in inoperable patients. The present paper particularly examines the role of biliary endoprosthesis, with special attention to the results obtainable in terms of improvement to the quality of life in patients with inoperable gallbladder-obstructing cancers. PMID- 2696883 TI - [Effect of histological technics on the volume and weight of various brain structures of rats at the early stages of life]. AB - The aim of the studies was to elaborate technical procedure of material preparation for quantitative studies and determination of correction coefficients of morphometric parameters in dependence on histological procedures. Moreover, volume changes of the rat substantia nigra and striatum (structures degenerating in Parkinson's disease) during the first half year of life were estimated. As fixatives 4 and 8% formaldehyde in 4 and 20 degrees C were used. Irrespective of applied variant of fixation formaldehyde produced during first 48 hrs rapid increase of the brain weight and volume up to 52% of that of the fresh brain, which was followed by slow decrease of brain weight of about 1-3%/24 hrs. The most pronounced changes caused 4% formaldehyde in 20 degrees C. The best conditions for morphometric studies were obtained with the use of 8% formaldehyde in 20 degrees C. Dehydration in ethyl alcohol produced violent decrease of brain volume and weight (from 32% up to 39% of the fresh brain weight). Clearing in methyl bensoesane increases again the brain weight by a few percentage. The obtained results make possible to estimate error size in morphometric studies conducted on the formaldehyde-fixed material. It was stated also that the above histological procedure causes more pronounced changes in fetal rat brain and in brain of 1-2-day-old rats. Stabilization of changes caused by histological procedure is achieved between first and sixth months of rat life. PMID- 2696885 TI - [Diagnostic peritoneal lavage in abdominal traumatology. Review of the literature]. AB - This paper presents an exhaustive review of the literature on diagnostic peritoneal lavage (indications, contraindications, technique and results), since nowadays this constitutes the simplest and most reliable diagnostic procedure for internal and open abdominal trauma. PMID- 2696886 TI - [Echographic study of the popliteal region]. AB - The paper reports an echographic study of the popliteal region designed to assess the utility of ultrasonography in the differential diagnosis of the various popliteal pathologies. In a year, 459 soft tissue samples were examined; 250 concerned the knee 138 patients gave negative results, while 112 cases presented this pathology with the following diagnosis: 94 cysts (21 appeared duplicated and monolateral, 28 duplicated and counterlateral), 2 aneurysms, 3 hematomas, 10 solid tumefactions (9 were benign, 1 malignant), 1 venous thrombosis and 2 chondromatosis. Of these 112 cases, 25 had been operated on, and the surgical reports quoted 15 cysts, 9 benign and 1 malignant neoplasm. The results of the study, when compared with the existing literature, highlight the essential role of ultrasound in the diagnostic approach to the pathology of the popliteal region. PMID- 2696887 TI - [Spontaneous cholecysto-cutaneous fistula. Observation of a case and review of the literature]. AB - A case of spontaneous gallbladder-cutaneous fistula is reported with emphasis on the rarity of this lesion after the introduction of cholecystectomy. PMID- 2696888 TI - [Results of endoscopic treatment of choledochal calculosis and cicatricial stenosis of the papilla]. AB - The results obtained with endoscopic papillo-sphincterotomy in the treatment of gallstones and cicatricial stenosis of the papilla are reported. The treatment proved effective in 91.3% of patients with papillary stenosis and the incidence of side-effects (cholangitis, pancreatitis, bleeding, perforation) was 7.5%. Endoscopic PST hitherto restricted to cases judge inoperable due to serious concomitant pathologies may be a valid alternative to surgery wherever total sphincter dysfunction can be ascertained. PMID- 2696889 TI - [Treatment of acute cholecystitis and its complications]. AB - Forty cases of acute cholecystitis and its complications have been reviewed. Examination of the literature and a study of the personal series leads to a discussion on the need or otherwise for early surgery, particularly in those patients in whom a more unfavourable course for the clinical picture can be objectively presumed. PMID- 2696890 TI - [Antibiotic prophylaxis in major surgery of the neck and head]. AB - Twenty-two patients undergoing major head and neck surgery were included in a randomized trial to value the efficacy and side effects of parenteral short-term antibiotic prophylaxis of post-operative infections. Two different antibiotic regimens were compared: group A, ceftazidime i.v. (2 g) in three doses (half an hour before surgery, 8 and 16 hours, from the first dose); group B, netilmicin (100 mg) plus clindamycin (600 mg i.v.), following the same chronological schedule. Overall infection rate was 18% (4/22): all post-operative infections occurred in group A patients, including one case of wound infection and 3 mixed infections (wound infection associated with lung infection), with a significant reduction of post-operative infection rate in group B patients (p = 0.045; Fisher's exact test). PMID- 2696891 TI - [A new case of gallbladder agenesis]. AB - On the basis of a case of agenesis of the gallbladder personally observed the most significant epidemiologic, etiopathogenetic, diagnostic and therapeutic aspects of this rare anatomic anomaly are analyzed. Finally, the validity of explorative laparotomy for both an accurate diagnosis and intra-operative evaluation of the surgical measures to be taken is confirmed. PMID- 2696892 TI - [Verneuil's peri-anal suppurative hidrosadenitis. Considerations on 2 clinical cases]. AB - Two cases of perianal Verneuil's disease personally observed are described. It is a rare chronic inflammation of the apocrine sweat glands in several skin areas. The exasperating chronicity and the propensity to extend of the disease involve complicated problems of diagnosis and therapy. A squamous cell carcinoma can rarely complicate long lasting hidrosadenitis. The treatment consist in a radical surgical excision of the involved areas. The patient must be controlled for a long time since the evolution of this disease cannot be foreseen. PMID- 2696893 TI - [AIH and AID. Review of the literature: results and observations]. AB - The literature on homologous artificial insemination and artificial insemination by donor is reviewed. In AIH the importance of the seminal factor and the influence of the induced superovulation are taken into account in determining the success of insemination. The important factors in AIH are: the type of sperm used (fresh or frozen), the characteristics of the female recipient, the method of insemination and its timing in relation to superovulation, and unwillingness to continue therapy. In line with other studies, it is emphasised that the factors involved in insemination must be standardised and defined according to recognised statistical principles in order to allow a meaningful comparison of data reported in the literature. PMID- 2696894 TI - [Beta-mimetic tocolysis: maternal and fetal side-effects]. AB - The literature on materno-foetal effects of the administration of beta-mimetic tocolytics has been examined. Data and series observed show a certain number of unwanted maternal and foetal effects of a metabolic and cardiocirculatory nature. Although these are usually reversible, they may, in conditions of latent pathology, turn into serious accidents. Critical evaluation of research carried out makes it possible to reiterate the usefulness of these drugs, always providing that the absolute need to use them can be demonstrated, and that their use is preceded by careful evaluation of the patient's cardiocirculatory and metabolic condition. PMID- 2696895 TI - Cellular aspects of brain development. AB - The formation of the central nervous system begins early in development with the induction of the neural ectoderm on the dorsal surface of the embryo. Subsequently, the neural ectoderm plate changes its shape to form a neural groove and eventually, a neural tube. The wall of the neural tube is composed of germinal cells, collectively called the neuroepithelium, that produces neurons and glia throughout the central nervous system (CNS). Three points will be made about cellular production in the CNS: (1) The neuroepithelium forms expansions (brain vesicles), folds, and lobules characteristic of particular CNS regions. The hypothesis that neuroepithelial "anatomy" is a blueprint for proper anatomical development of the CNS will be discussed. (2) Using tritiated thymidine autoradiography in the developing rat, we have found that the neuroepithelium generates neuronal populations according to specific timetables during CNS organogenesis. Some populations are produced early in a 1-2 day period, others are produced later during a 5-7 day period, while still others are produced after birth for periods of a few weeks. (3) By exposing perinatal rat pups to low level X-irradiation, we find that killing neuronal precursors and young postmitotic neurons results in permanent reductions in the number of cells that constitute the targeted neuronal populations. Even though some development continues after the X-ray exposures, there is no compensatory increase in cell proliferation to replace the lost cells. The implications of this finding will be discussed in light of the permanence of neurotoxic insults during human CNS development. PMID- 2696896 TI - Manipulating peak blood alcohol concentrations in neonatal rats: review of an animal model for alcohol-related developmental effects. AB - Fetal alcohol syndrome (FAS) is now well documented, but factors that affect the severity of the accompanying central nervous system damage are still not well understood. In a series of experiments, artificially reared neonatal rats were exposed to alcohol during postnatal days 4-10 (during the brain growth spurt of the rat) to evaluate the consequences of various patterns of alcohol consumption in contributing to the severity of alcohol-related brain damage. In the first experiment, groups of rat pups were given different doses of alcohol (6.6 to 9.8 g/kg) in a milk formula in eight 15-min feedings over each 24 hr. Measures of brain weight on day 10 indicated an inverse relationship between dose and brain weight. Re-evaluating the results with respect to blood alcohol concentration (BAC) revealed an even stronger correlation between BAC and microencephaly. A series of experiments followed in which various doses of alcohol were condensed into fewer and fewer hours each day. Condensing the dose produced higher BACs for a given dose and produced more severe microencephaly, greater neuronal loss, behavioral hyperactivity and impaired spatial navigation. Some of these effects were permanent with females more affected than males on some measures. These data suggest that patterns of alcohol consumption that produce high BACs, such as binge drinking, may be especially harmful to the brain of the developing fetus. PMID- 2696897 TI - Lead toxicity in neuroglia. AB - In this article we evaluate evidence that neuroglia (astroglia and oligodendroglia) are primary targets for lead toxicity in the central nervous system or mediate its pathogenesis. An integrated overview of morphologic and biochemical evidence from clinical cases, experimental animals, and cell culture models is attempted. Our review encompasses both high-level lead exposure that produces lead encephalopathy and low-level lead exposure that is associated with cognitive deficits. We also discuss the selection of toxicologically relevant lead doses for cell culture studies. The evidence is compelling that both astroglia and oligodendroglia respond directly or indirectly to lead exposure in ways that could impair brain function. However, at this time more is understood about the responses of astroglia than those of oligodendroglia. Though oligodendroglia appear sensitive to lead in cell culture, as measured by loss of viability and enzyme activity, it is not clear whether their responses to Pb exposure in vivo are primary or secondary to other tissue and cell damage. Astroglia show a definitive primary response in vivo and in vitro to high-level lead exposure, the uptake and storage of Pb intracellularly, possibly by Pb- binding macromolecules. Astroglia also exhibit reactive gliosis, but probably as a secondary response to other tissue damage by high lead levels. The hypothesis that astroglia serve a protective function in the brain by acting as a lead depot in encephalopathy is well supported by several whole animal and cell culture studies. In addition, alterations of glutamine synthetase activity, which have been reported in the astroglia of animals chronically exposed to low levels of lead, bear further investigation. PMID- 2696898 TI - Prenatal radiation risk to the brain. AB - The Central Nervous System (CNS) exhibits a high sensitivity to ionizing radiation from conception until after birth. X-irradiation damage of the nervous system during development has been well documented and exposure to ionizing radiation above approximately 10 cGy during perinatal development is contraindicated. Shielding of the embryo or fetus usually prevents gross malformations but high energy irradiation of the pregnant female may result in embryonic growth retardation. This may be especially true when the irradiation is coupled with an ethanol-induced reduction in SOD activity. The synergistic interactions between other drugs and ionizing radiation also have been demonstrated. However, the concentration of endogenous compounds such as histamine and serotonin may be increased in the maternal circulation following irradiation and reach the fetal CNS through a blood-brain-barrier that is more permiable than normal. The introduction of histamine and/or serotonin into the fetal circulation may result in fetal hypotension, edema, cerebral ischemia, and damage to the developing CNS. PMID- 2696899 TI - Effects of opiates on brain development. AB - Perinatal morphine administration affects neuronal growth in the developing animal. Neuronal packing density was reduced by morphine treatment in both primary somatosensory cortex and preoptic area of the hypothalamus. However, glial packing density was increased, but only in hypothalamus, which could reflect greater severity of opiate-induced neurotoxicity in hypothalamus. Cortical pyramidal neurons show morphine-induced reduction of basilar dendritic growth limited to late-developing terminal branches. This effect is completely reversed by concurrent naltrexone administration. This selective effect could be caused by morphine acting at opiate receptors to inhibit extrinsic determinants of dendritic growth (e.g., afferent supply). The ontogeny of opiate receptors is also affected by perinatal morphine administration in a regionally-dependent manner. Mureceptors are downregulated by morphine in hypothalamus, but not in cortex. Differential maturity of receptors in these regions could be a factor in such differential drug effects. Therefore, different critical periods for opiate action in different regions of the developing brain could exist. PMID- 2696900 TI - Neural and behavioral alterations after early exposure to phenobarbital. AB - Mice who were exposed to phenobarbital prenatally (B mice) had at adulthood deficits in the hippocampal eight-arm maze, spontaneous alternations, and water maze behaviors. Morphological studies revealed neuronal losses in the hippocampus. The surviving neurons had reductions from control in the number of dendritic branches, area and spine density, but wider fission angle than control. Neurochemical studies on the hippocampus revealed the following alterations: (a) decrease in NE level and the number of the NE cell bodies (b) no change in the serotonergic system (c) an increase in muscarinic receptors Bmax in the hippocampus; (d) no changes in GABA and benzodiazepine receptors. However, neonatal phenobarbital exposure caused an increase in the Bmax of GABA and benzodiazepine receptors. Transplantation of fetal septal cholinergic neurons into the hippocampus of B mice reversed most of the deficits in eight-arm maze behavior, while transplantation of noradrenergic cells did not affect the performance of B mice. In further studies on cholinergic mechanisms, the dopaminergic innervations in the septum (originating from A10), which are known to indirectly inhibit the activity of the septohippocampal cholinergic pathways, were destroyed by 6-OHDA. B mice treated with 6-OHDA had an increase in hippocampal ChAT activity and improved their eight-arm maze performance. Thus, understanding of the mechanism of a particular behavioral deficit enables one to correct it despite the nonspecific action of the neuroteratogen. PMID- 2696901 TI - The fetal alcohol syndrome: a multihandicapped child. AB - The effect of intrauterine exposure of the fetus to ethanol has been appreciated since Biblical times. An article by Lemoine (1968) describing the effects and long term prognosis was virtually ignored until 1973. At that time Jones and Smith described a constellation of anomalies in infants born to alcoholic women and labeled this condition the Fetal Alcohol Syndrome (FAS). The evolution of this syndrome over the last 15 years is reminiscent of the congenital rubella syndrome with its continuum of handicapping morbidity. Even if there is no facial dysmorphia and the child has a normal IQ, the stigma from intrauterine ethanol exposure persists. Visual-motor perception and performance IQ are lower and receptive and expressive language are delayed. Distractibility persist. The child with Fetal Alcohol Syndrome remains a multihandicapped child. PMID- 2696902 TI - Prenatal narcotic exposure: perinatal and developmental effects. AB - Infants prenatally exposed to narcotics become passively addicted in-utero and may undergo neonatal abstinence at birth. Methadone maintenance in conjunction with intensive prenatal care for pregnant narcotic dependent women can reduce the incidence of intrauterine death, neonatal death, prematurity and its concomitant problems. However, methadone exposed infants have consistently been found to have smaller birthweights and head circumference than non-drug exposed infants. Although neonatal abstinence can be treated successfully with pharmacotherapy, the effects of in-utero narcotic exposure in the developing central nervous system are not fully understood. Infants exposed to narcotics in-utero have been found to have slit-like ventricles with smaller lateral ventricle and intracranial hemidiameter measurements during the first month of life. The incidence of strabismus is also greater in infants exposed to narcotics in-utero than the general population, but this appears to be related to lower birth weight, rather than a direct consequence of narcotic exposure. There does not appear to be developmental sequelae associated with prenatal narcotic exposure. After abstinence has abated, infants function well within the normal range of development during the first two years of life, although developmental scores may be lower than non-drug exposed comparisons groups. There are a myriad of confounding medical, pharmacological and environmental variables within this population and the relative importance of prenatal narcotic exposure in a continuum of risk factors needs to be more clearly delineated before the etiology of perinatal and developmental effects can be determined. PMID- 2696903 TI - New York State's health care system. Selected major problems and recommended solutions. PMID- 2696904 TI - A New York initiative in medical education. PMID- 2696905 TI - Dietary changes and the decline of scurvy and tuberculosis in 19th century Europe. PMID- 2696906 TI - Treatment of dolichoectasia of the middle cerebral artery with bypass and exclusion. PMID- 2696907 TI - Hemolytic uremic syndrome and verotoxin producing E coli. PMID- 2696908 TI - [Epidemiology of malignant melanoma in West Germany in an international comparison]. AB - The incidence and mortality of malignant melanoma (MM) has markedly increased in the Federal Republic of Germany. The data available show a doubling of incidence in the past 15 years and a doubling of mortality in the past 30 years. Germany holds a middle range in the incidence list of MM compared to worldwide data: 6-8 MM were registered per 100,000 inhabitants and year in Germany during the mid eighties, whereas 5 x higher incidences where reported from Australia and the southern states of the USA; incidences higher than 6-8/100,000 where found in the Scandinavian countries. While sun exposure is regarded as the most important risk factor in the international epidemiology of MM, a relationship between sun exposure and increasing risk of MM could not be clearly established for the German population. In contrast, the total number of melanocytic nevi (MCN) and the occurrence of dysplastic nevi where found to be significant markers of an increased relative risk for developing MM in the German population. The increase of the relative risk was 16 x for persons with greater than 60 MCN compared to individuals with greater than or equal to 10 MCN and there was an additional 7 x increase of the relative risk for persons with greater than or equal to 1 dysplastic nevus. The course of the disease is lethal in most cases of metastatic malignant melanoma. 90% of all patients in the Federal Republic of Germany, however, were first diagnosed in clinical stage I (= primary tumor alone) and the average 10 years survival rate was 70% in the time period since 1970. Multivariate regression analysis revealed that the most important prognostic factors in stage I MM were tumor thickness and sex. This finding should be taken into consideration for a prognostic classification of stage I MM. PMID- 2696909 TI - [Clinical recognition of early forms of malignant melanoma]. AB - The clinical diagnosis of malignant melanoma (MM) is based on the subjective evaluation of objective measurable parameters (criteria). The accuracy of melanoma diagnosis by dermatologists is only 75%. Particularly difficult is the diagnosis of precursors or early stages of MM. Therefore, we have studied on the one hand the intra- and interindividual reproducibility of the clinical diagnosis of pigmented lesions, and on the other hand the clinico-histopathological correlation. In addition, we have conducted a preliminary investigation designed to evaluate whether image analysis (objective and reproducible) could be used as an auxiliary instrument to differentiate between benign and malignant melanocytic lesions. In the clinical study, the intraindividual reproducibility of the combination of criteria was 69%. The interindividual reproducibility of single criteria even exhibited a range of up to 36%. Histologically "atypical/dysplastic" melanocytic lesions were considered to require excision as frequently as histologically regular melanocytic lesions. Using image analysis (single threshold segmentation, standard deviation of intensity distribution, ratio of area to circumference, Fourier analysis), we could show that it may be possible to differentiate between benign and malignant melanocytic lesions. Therefore, image analysis may be very helpful in determining the dignity of melanocytic lesions. PMID- 2696910 TI - [Treatment of stage I malignant melanoma. Open questions and recommendations]. AB - The excision of malignant melanomas is accepted worldwide as a therapy of choice but there are controversies concerning resection margins, prophylactic lymph node dissection, isolated hyperthermic perfusion of extremities and adjuvant therapy in high-risk patients. The relevant literature is analyzed with regard to these aspects, and based on this analysis and our own experiences in more than 3,600 melanoma patients, recommendations for therapy of primary malignant melanomas and follow-up are given. PMID- 2696911 TI - [Step-wise expression of melanoma-associated antigens in tumor progression]. AB - Selection of monoclonal antibodies for differential reactivity with benign and malignant melanocytic lesions has led to the identification of molecules which may be involved in the development of metastases. Based on the observed alterations in the antigenic profile we propose a scheme representing the tumor progression of melanocytes to metastatic melanoma. PMID- 2696912 TI - High-dose chemotherapy with autologous bone marrow support in advanced malignant melanoma. AB - Eight patients with advanced malignant melanoma were treated with high-dose melphalan (80-90 mg/m2) and BCNU (600-800 mg/m2). In all patients autologous bone marrow preservation was performed prior to therapy. Bone marrow was stored for 48 h in a refrigerator at 10 degrees C and reinfused 48 h post-therapy. Three patients had a complete response (CR), 1 a partial response and 4 patients no response. Two patients with CR died 4 and 5 months after therapy. One had an interstitial pneumonitis and 1 patient died from unknown cause. The third patient had a relapse 12 months after therapy. Major side effects were severe nausea/vomiting and a mild mucositis. Two patients suffered from BCNU-related encephalopathy. All patients had a full hematologic reconstitution after 6 weeks. High-dose chemotherapy with autologous bone marrow support achieves a high response rate. Long-term disease-free survival, however, was not seen with this approach. PMID- 2696913 TI - [Chromosome instability in patients with malignant melanoma of the skin]. AB - The certainty of a strong genetic predisposition to malignant melanoma was first established over 35 years ago. Since it has been shown that constitutive chromosomal instability is significantly correlated with the familial occurrence of cancer, we have studied spontaneous micronucleus rates in fibroblast cultures from 44 melanoma patients, 44 healthy probands and 78 patients with bronchial carcinoma. Here we report a significantly (p = less than 0.0005) increased spontaneous chromosomal instability in patients with cutaneous malignant melanoma compared to healthy controls and other tumor patients (bronchial carcinoma). PMID- 2696914 TI - [Immunomodulation by cryosurgery in malignant melanoma]. AB - Cryosurgery is a well-known, established method for the local destruction of tumor tissue by freezing. The assumption that, in addition to a physical and blood vascular phase, an immunological phase exists, has been discussed by many authors and tested using animal models. These results can only be transferred to humans in a limited sense. During the last year, we initiated a randomized study "Cryosurgery versus Conventional Surgery", whereby the peripheral blood and the normal skin from the areas surrounding the resection were compared. We were able to demonstrate in the peripheral blood of 8 cryosurgery patients a postoperative increase in the total and helper T-cells, HLA-DR-positive cells, and the ratio helper/suppressor T-cells in comparison to preoperative values. In the 8 patients treated with conventional surgery, these parameters decreased slightly or remained the same. The differences were highly significant (p = 0.001) to significant (p = 0.01). The results from the first 16 are patients studied presented and discussed here. PMID- 2696915 TI - Microvascular access to the uveal tract in the rabbit eye for ocular pharmacologic studies. AB - Drug delivery to the eyes is quite inefficient regardless if the drugs are administered topically or intravenously. It is known that less than 1% of topically instilled drug can be absorbed into the eyes while even less of intravenously injected drugs reach the eyes. A research model has been developed in this study which allows delivery of drugs effectively to uveal and anterior structures of the eye. This experimental model allows drugs to be delivered to the eye via cannulation of and retrograde flow through the valveless vortex veins. In addition, the superficial branch of the vortex vein (draining the ciliary body and iris) or the deep branch (draining the choroid plexus of the retina) can be selectively cannulated to suit the researcher's needs. Finally, this procedure minimizes systemic drug actions which otherwise would complicate interpretation of experimental results. This model can be used for in vivo laboratory studies on (a) metabolic and physiological processes of the uveal tract in the eye, and (b) drug delivery to selective tissues of the uveal tract in the eye. Dose-response relationships of pilocarpine and timolol to lower intraocular pressure were demonstrated with this model. PMID- 2696916 TI - South African field strains of Haemonchus contortus resistant to the levamisole/morantel group of anthelmintics. AB - A strain of Haemonchus contortus from the Pietermaritzburg district of Natal was found to be resistant to levamisole (geometric mean efficacy 76.5%), morantel (41.9%), the benzimidazoles (oxfendazole: 33.7%) and rafoxanide (82.0%), but apparently fully susceptible to closantel and disophenol. In the case of ivermectin, a mean of 5.2% of the H. contortus was not removed at a dosage of 200 micrograms kg-1 live mass. A second strain of H. contortus, from Amsterdam in the south-eastern Transvaal, showed reduced susceptibility to levamisole (80.8%) and morantel (46.2%), the only 2 drugs tested. This is apparently the first report of resistance to the levamisole/morantel group of anthelmintics in sheep in South Africa. PMID- 2696917 TI - The biochemical differentiation between Salmonella and Citrobacter. AB - A number of bacterial isolates which could not be identified as either Salmonella or Citrobacter by conventional biochemical tests and could not be typed as Salmonella with available antisera, were further examined biochemically and by lysis with phage Felix 0.1. Glycerol-positive salmonellae and lysine-positive citrobacters were encountered, which could be confused with the other genus, but when the reactions of such strains were examined in the other tests, accurate identifications could be done. Of the tests examined, glycerol fermentation, the beta-galactosidase test, lysine decarboxylation, sorbose fermentation, galacturonate fermentation and lysis by the phage could be used in the differentiation. These tests in combination, rather than 1 or 2 single tests gave reliable and conclusive differentiation. PMID- 2696918 TI - An outbreak of contagious bovine pleuropneumonia in the Owambo Mangetti area of South West Africa/Namibia: microbiological, immunofluorescent, pathological and serological findings. AB - An outbreak of contagious bovine pleuropneumonia (CBPP) in the Owambo Mangetti area of South West Africa/Namibia in 1982 led to the slaughter of 3,153 cattle. The lungs of 266 of these animals were scrutinized for gross lesions of CBPP and samples of lung tissue, sequestral contents or pleural fluid were submitted to the Veterinary Research Institute (VRI), Onderstepoort for microbiological, immunofluorescent and pathological examination. Immunofluorescence proved to be the most successful method of diagnosis producing 96% of positives, while mycoplasma isolations were only positive in 64% of the 55 specimens processed in parallel. This clearly demonstrated the value of the former technique in the accurate as well as rapid diagnosis of CBPP. The impression smear technique employed, using Eriochrome black counterstaining proved most satisfactory and easy to interpret. The isolation of M. mycoides was influenced by the transit times and temperature of the samples on arrival at the VRI. No pathogenic bacteria were found in routine aerobic bacterial cultures from 27 of the samples submitted. Complement fixing antibodies were present in the sera of 16 cattle and titres varied between 10 and 320. Animals in which antibodies were absent included those with early lung lesions and some with sequestra. PMID- 2696919 TI - Cytokines and inflammation: modified "Miles-Wilhelm" criteria for assessing the likely roles of these substances in vivo. AB - Cytokines (including lymphokines, interleukins, tumour necrosis factors, interferons and hemopoietic colony-stimulating factors) are a loose group of endogenous proteins which are presently being investigated for an increasingly wide range of bioactivities. Recently, cytokines have been suggested to mediate various aspects of inflammation, but the data on which these suggestions are based are often fragmentary and derive from limited experimental in vitro and in vivo models of inflammation. Therefore, the roles of cytokines in the mediation of naturally occurring inflammatory lesions in man and animals remain unclear. This article traces the development of notions of endogenous mediators of inflammation over the last hundred years and reviews previously published ways of assessing the relevance of experimental data concerning mediators of inflammation to naturally occurring inflammatory lesions. Emphasis is given to the "criteria" advanced for this purpose by Miles and Wilhelm in the 1950s and 1960s, and additional criteria appropriate to the assessment of data concerning cytokines as mediators of inflammation are discussed. PMID- 2696920 TI - The controversial role of dietary cholesterol and hypercholesterolemia in coronary heart disease and atherogenesis. PMID- 2696921 TI - Successful lyophilization of Campylobacter pylori and spiral organisms from the stomachs of animals. PMID- 2696922 TI - [Histogenetic considerations on mucinous cystomas of the ovary based on histochemical and immunohistochemical findings]. AB - Mucinous cystomas of the ovary, according to a new proposed classification (I.A.P., Dublin 1988), are classified in three types: endocervical, intestinal and mixed. Their histogenesis is still controversial, thus requiring further investigations. There are two main theories on this matter: a teratomatous theory based on the assumption that the mucinous cystoma is allegedly a teratoma having a monophyletic development where only the endodermal gastrointestinal component remains. The second theory, currently the most widely accepted one, maintains that mucinous cystomas derive from Muller duct residues or, more generally, from introflections of the coelomic epithelial lining through a Muller-type metaplastic process. Some authors also accept both theories. A group of 117 mucinous cystomas were investigated by histochemical methods (PB/KOH/PAS; PAT/KOH/Bh/PAS), to demonstrate the presence of O-acetylated sialomucin variants in goblet cells of intestinal type component. Endocervical type mucinous cystomas have always presented as PB/KOH/PAS negative, whereas mixed type mucinous cystomas presented as positive according to the following percentage: benign forms, 31%; borderline, 67%; malignant, 50%. These data should confirm the hypothesis that intestinal type cystomas may derive from the surface coelomic epithelium of the ovary, through a gastrointestinal metaplastic process. This hypothesis is further supported by the data obtained from the observation on two cases of intestinal metaplasia of endocervical glands, kindly supplied by Dr. Trowell. In one of them, a weak O-acetylated sialomucin secretion was identified, in addition to the presence of argentaffin cells. Furthermore, out of 38 adenocarcinomas of the endometrium and 15 adenocarcinomas of the endocervix, one case of endocervical adenocarcinoma was found, characterized by a mucous secretion rich in O-acetylated sialomucins. Moreover, immunohistochemically, by means of anti-chromogranin A monoclonal antibodies, endocrine cells were found in benign, borderline and malignant mucinous cystomas of mixed type. These data do not seem to confirm the assumed correlation between neuroendocrine cell presence and biologic behaviour of the neoplasm nor do they clarify tumor histogenesis. Another immunohistochemical study with BD5 monoclonal antibody demonstrated that this marker was present in the intestinal type epithelium of mixed mucinous cystomas. The histogenetic teratomatous hypothesis of ovarian mucinous cystomas was confirmed by reviewing 100 ovarian teratomas, in which O-acetylated sialomucins were found in the epithelial component of one mucinous carcinoid and in the intestinal type epithelium of 9 mature cystic teratomas.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2696923 TI - Home diagnosis of streptococcal pharyngitis: moving the art in which direction? PMID- 2696924 TI - Dexamethasone in bacterial meningitis: increasing evidence for a beneficial effect. PMID- 2696925 TI - Can parents do a throat culture? AB - Throat swabs for Group A beta-hemolytic Streptococcus were obtained from 98 patients, ages 4 to 17 years, both by their parents and by physician investigators. Compared with results obtained by physicians, there was a false negative rate of 32% (P less than 0.001) for the parents. The discrepancy was greater in the youngest age group (38% false negative rate in the 4- to 8-year olds) compared with older children (P less than 0.001). The overall sensitivity and negative predictive value for the parent-obtained swabs were 68 and 45%, respectively. In the 4- to 8-year-old group, these values were 62 and 37%, respectively. Because there were no false positives the positive predictive value was 100%. We conclude that the false negative rate for untrained parents obtaining throat swabs is too high to warrant the implementation of home testing for Group A streptococci. PMID- 2696926 TI - Clinical signs that predict death in children with severe pneumonia. AB - It is important to define clinical signs that can be used to identify children who have a high risk of dying from pneumonia so that these children can be given more intensive therapy. We prospectively studied 748 children in Papua New Guinea who had severe pneumonia, as defined by the World Health Organization. There was a very high mortality in children with a prolonged illness, severe roentgenogram changes, cyanosis, leukocytosis, hepatomegaly or inability to feed, and there was a trend toward a higher mortality in children with grunting or severe chest indrawing. Afebrile malnourished children had a particularly high mortality, but afebrile children had an increased mortality only if they were malnourished, and malnourished children had an increased mortality only if they were afebrile. Mortality was not increased in very young children or in children with tachypnea or tachycardia. The World Health Organization has suggested that most children with pneumonia in developing countries can be treated with penicillin but has recommended that children who are cyanotic or too sick to feed be treated with chloramphenicol because of their high risk of dying; our findings confirm that children who are cyanotic or too sick to feed have a very high risk of dying from pneumonia. PMID- 2696927 TI - Rapid detection of respiratory syncytial virus by a biotin-enhanced immunoassay: test performance by laboratory technologists and housestaff. AB - A biotin-enhanced enzyme immunoassay (EIA) for respiratory syncytial virus (RSV) antigen detection (TESTPACK RSV) was prospectively compared with virus isolation in cell culture and immunofluorescence. Of 156 nasopharyngeal swab specimens from infants with respiratory symptoms, 81 (52%) yielded RSV in culture. Compared with culture the sensitivity of the EIA was 95% and specificity was 92%; the specificity increased to 97% with a blocking assay. Compared with immunofluorescence the sensitivity of EIA was 92% and specificity was 93%. In order to assess the performance of TESTPACK RSV as a bedside test, nasopharyngeal swabs from 49 children were tested by EIA at the bedside by housestaff and by immunofluorescence in the laboratory; the sensitivity of the EIA was lower (78%) while specificity remained high (95%). Inclusion of older children may have resulted in diminished sensitivity. The TESTPACK RSV is a simple, rapid test that performs well and is easily adaptable to an office setting. Further evaluation of the test in older children may be required. PMID- 2696928 TI - Severe pseudomembranous enterocolitis in a child: case report and literature review. AB - Antibiotic-associated pseudomembranous enterocolitis (PMC), an inflammatory gastrointestinal disease mediated by toxins produced by Clostridium difficile, is increasingly recognized in the pediatric population. We report a case of fulminant PMC in an otherwise normal 2 1/2-year-old child after antibiotic therapy given for a routine childhood illness. The patient had debilitating colitis marked by severe diarrhea, a generalized electrolyte derangement, an extreme protein-losing enteropathy state, rectal prolapse, ascites, pleural effusion, varicella and multiple relapses. The child required specific antimicrobial therapy as well as aggressive supportive care to achieve recovery. A review of the literature for pediatric cases of PMC revealed reported cases in all age groups; the youngest was 5 days old. There were 9 deaths in 43 cases for a mortality rate of about 20%. All but 2 of the cases were associated with antibiotic therapy. The antibiotics most frequently implicated were ampicillin (15), penicillin (11), cephalosporins (7), amoxicillin (6) and clindamycin (5). The onset of symptoms of PMC can begin at any time while the child is taking an antibiotic or up to 21 days after it is discontinued. Children with underlying gastrointestinal motility disorders such as Hirschsprung's disease are predisposed to PMC. Fulminant PMC is a serious but uncommon infectious disease of infancy and childhood, occurring as a complication of routine antibiotic therapy for common childhood illnesses. PMID- 2696929 TI - Brain edema, intracranial pressure and cerebral blood flow in bacterial meningitis. PMID- 2696930 TI - Current management of bacterial meningitis. PMID- 2696931 TI - New antibodies as adjunctive therapies for Gram-positive bacterial meningitis. PMID- 2696932 TI - [Should toothpastes foam? Sodium lauryl sulfate--a toothpaste detergent in focus]. AB - Sodium lauryl sulfate is one of the most widely used synthetic detergents in toothpaste. Generally, surface active agents lower the surface tension, penetrate and loosen surface deposits and emulsify or suspend the debris which the dentifrice removes from the tooth. The concentration in dentifrices usually ranges from 0.5-2.0%. It has previously been shown that sodium lauryl sulfate has the potential to initiate hypersensitivity to metal ions. Furthermore, the mucosal permeability will be increased to oil and water soluble compounds. Experiments from this laboratory indicate that sodium lauryl sulfate will interact with the deposition of fluoride on dental enamel. It is furthermore suggested that this interaction may have the potential to decrease the cariostatic effect of fluorides. Clinical studies from Denmark give support to this statement. In conclusion, sodium lauryl sulfate has some side effects, and future work should therefore be concentrated on finding other possible toothpaste detergents without these side effects. PMID- 2696933 TI - [Treatment of obstructive sleep apnea syndrome]. AB - The results of the treatment of the obstructive sleep apnea syndrome with tracheostomy (68 patients), continuous positive airway pressure (67 patients) or uvulopalatopharyngoplasty (14 patients) have been presented. The best results were after tracheostomy or during continuous positive airway pressure application, worse results gave uvulopalatopharyngoplasty. PMID- 2696934 TI - [Structural aspects of pulmonary gas exchange. I. Introduction. The structural unit of gas exchange--the interstitium of the alveolar septum]. PMID- 2696935 TI - [Occurrence of early-morning hyperglycemia (dawn phenomenon) in patients with diabetes mellitus type 1 and 2]. AB - The aim of the work was to determine the frequency and conditioning of early morning hyperglycaemia called "dawn phenomenon". From the period 1974-1983, the year 1982 was randomized, when in the hospital there were 125 women and 82 men with diabetes. They were classified in two groups: group I in which glycaemia on an empty stomach exceeded 11.1 mmol/l 200 mg/dl and at 3.30-7.8 mmol/l 130 mg/dl, and group II with lower values of glucose level in the blood. The two groups were then divided again into subgroups: A--in which the disease appeared before 30 years of age--type 1, and subgroup B--when the disease appeared after 30 years of age--type 2. All the subgroups were compared with respect to the treatment of diabetes, complications in small and large vessels and additional administering other drugs: steroids and beta-blockers. In patients with early morning hyperglycaemia the authors found a slightly longer duration of the disease in case of its later appearance type 2, more frequent insulin injections once in 24 h, and higher medium values of day glycaemia in late diabetes type 2, higher frequency of simple retinopathy in early diabetes type 1 and higher frequency of increased level of creatinine in the serum in late diabetes type 2. The results obtained show that uncontrolled diabetes is very important in the mechanism leading to "dawn phenomenon". PMID- 2696936 TI - [Comparison of the results of sclerotherapy of esophageal varices using a rigid esophagoscope and fiber-optics esophagoscope]. AB - The authors compared the results of 20 emergency and 100 elective varicosclerotisations with rigid esophagoscope and the same number of obliterations with the use of esophagofiberoscope. Haemorrhage was stopped in 90% of patients injected through the rigid esophagoscope and in 80% of patients in whom esophagofiberoscope was used. Hospital mortality rate in patients with bleeding esophageal warices was 25% in both groups. Complications were seen in 4.2% of procedures carried out with the rigid esophagoscope, and 5.8% of obliterations with esophagofiberoscope. The authors recommend rigid esophagoscope for emergency sclerotherapy and for the initial 2-3 series of injections in patients with large varices. Esophagofiberoscope is prefered in case of repeated, elective varicosclerotisations, first injections and recurrence of esophageal varices following obliterative therapy. PMID- 2696937 TI - [A controlled trial of prevention of recurrence of gastroduodenal ulcers with proxybarbital]. AB - During 3 years, the usefulness of proxibarbal (Ipronal "Polfa") for gastro duodenal ulcer recurrences prophylaxis has been studie in 62 patients in 7 clinics. A history of the gastro-duodenal ulcers, physical examinations, X-ray, and endoscopy consisted diagnostic and evaluation criteria. The drug was tested with double blind trial; 33 patients received proxibarbal in tablets of 50 mg and 29 persons received placebo tablets. Tested substances were administered for 3 years, six weeks every quarter, i.e. one tablet twice daily. No recurrences of the disease were seen in 20 out of 33 patients treated with proxibarbal and in 14 out of 29 patients receiving placebo. This result has not a statistical significance and so does not confirm the earlier report of Gamski and Tyminski on the usefulness of proxibarbal in the prevention of gastro-duodenal ulcer recurrences. PMID- 2696938 TI - [Tumors of the retroperitoneal space]. PMID- 2696939 TI - [Clinical results of the treatment of bacterial infections in children with ceftazidime]. AB - Ceftazidime (Fortum-Glaxo) was administrated to 19 children with urinary tract infections and to 21 children with pneumonia. Clinical symptoms of the infections resolved in 17 children (89%) with the urinary tract infections treated with ceftazidime within 4 days. The remaining children (11%) recovered after 7 days of therapy. Clinical symptoms of pneumonia resolved in 19 children (90%) within 7 days of the treatment. A significant improvement was achieved in the remaining 2 children after 10 days of the treatment. PMID- 2696940 TI - General principles of grading lesions in diagnostic histopathology. AB - The principles behind grading histological samples by any method describing them is outlined. The estimation of the variation of measurement allows the number of falsely graded cases to be estimated, and thus makes it possible to compare grading methods in respect to their sensitivity, specificity, and efficiency. The approach is especially suitable for situations in which measurements are made on histological sections, but can also be applied in traditional subjective grading. The approach also makes it possible to estimate the grading performance by such methods as DNA-cytometry, flow cytometry, immunohistochemistry, and nucleic acid in situ hybridisation. PMID- 2696941 TI - Sources and nature of variation in DNA analysis of follicular thyroid adenoma. AB - We investigated the sources and nature of variation that may occur in the DNA analysis of thyroid adenomas from cytological and histological samples. Imprints and smears gave identical results. However, the nuclear area was higher in smears where the optical density of the nuclei was lower. In measuring imprints, the interactive selection of nuclei was preferred to the automatic, because the risk of measuring nuclear fragments or undesired objects was thus avoided. The reproducibility and the variation of the DNA measurements depended on the degree of observer training in quantitative pathology, the method of field selection, and the type of instrumentation. Biological variation in the spatial distribution of nuclei with different ploidy values in some adenomas seemed to hide the influence of section thickness on measurements. Our data seem to suggest that it is best to apply a constant section thickness and 5 micron sections seem acceptable. PMID- 2696942 TI - Tissue distortion in three-dimensional reconstruction of wax or plastic embedded microscopic structures. AB - Three-dimensional reconstruction at the light microscopic level depends on obtaining reliable serial sections without "distortion" i.e., expansion and compression during section preparation. We have studied the extent of such distortion in serial sections from paraffin and resin embedded blocks of brain, kidney, liver and lung, using an IBAS 2000 Image Analyser. We found that, taking the uncut block as 100%, the section area, perimeter and minimum diameter varied by no more than 8%, except for the lung sections which varied up to 14%. There was no progressive compression due to knife bluntening. Resin sections also varied up to 8% (16% for lungs) but in addition creasing was a problem. We conclude that, provided the serial sectioning is carefully standardised for block shape and orientation, floating out temperature and time, serial paraffin sections are more suitable for three dimensional reconstruction than resin sections. PMID- 2696943 TI - A method of image registration for three-dimensional reconstruction of microscopic structures using an IBAS 2000 image analysis system. AB - Registration of histological tissue sections is a longstanding problem in three dimensional reconstruction. Our solution is to insert rigid straight narrow birefringent structures namely cactus spines as artificial registration points (ARPs) into the tissue block before embedding in wax or resin. The microscopic image of the tissue section with ARPs in situ is presented to an IBAS 2000 Image Analyser and digitised. Registration is performed in two stages using the ARP nearest to the area to be reconstructed as the principle reference point for alignment. The automatic stage is then used to align the structure under reconstruction. These reconstructions are more accurate than those produced without the use of ARPs. PMID- 2696944 TI - A simple cytologic method for predicting the malignant potential of intraocular melanoma. AB - The malignant potential of 100 intraocular uveal melanomas was assessed by determining the mean of the ten largest nucleoli (MTLN). On a single standard microslide from each tumor, the maximum diameter of the ten largest nucleoli was measured using a manually operated micrometer. For comparison, three additional histopathologic parameters were determined for each case: Standard deviation of nucleolar area (SDNA), Callender cell type (CT), and largest tumor dimension (LTD). Of these four parameters, MTLN and SDNA were most highly correlated with death from ocular tumor. Furthermore, repeat measurement of all 100 cases revealed a level of reproducibility for MTLN similar to that for SDNA. Of greatest importance, the micrometer technique employed in this study has substantial cost and labor advantage over the computer-controlled system required to measure SDNA. PMID- 2696945 TI - A simple "expert system" for morphometric evaluation of cells in pleural effusions. AB - Quantitation in diagnostic pathology serves to improve both diagnostic reliability and the prognosis of various malignant tumors. Unfortunately, flexible, user-friendly, reasonably priced and compatible morphometric systems are hardly available on the market. A modular Apple II PC-based system was therefore developed in-house. It records stereologic, planimetric and digital image analysis data and calculates secondary parameters. Detailed statistical analyses can be performed, after data transfer, on larger computers. A typical application of diagnostic morphometry is to determine whether, and with which probability a patient with an unclear histopathologic finding can be assigned to one or more groups of patients with known diseases and prognoses. To this end morphometric data of the patient under investigation are compared with other patient data stored in an expert system. This paper describes the concept of an expert system carried out on the Apple II PC system mentioned above and outlines the evaluation procedures. Invariant moments were used to describe nucleus textures. Results obtained from the cytological analysis of pleural effusions demonstrate that with this approach it is possible to differentiate between normal mesothelium, mesothelioma and metastases of adenocarcinomas. PMID- 2696946 TI - A computer based handbook and atlas of pathology. AB - The Diagnostic Encyclopaedia Workstation (DEW) is a computerized handbook of pathology intended for use in diagnostic practice. It consists of a combination of a personal computer (PC), a video disc player (VDP), for which a specially developed disc is used, two monitors, a mouse and software. The hard disc of the computer contains textual information on diagnoses in categories such as macroscopy, common histology, immunopathology, clinical observations and prognosis and case histories. This information is frequently illustrated by pictures on a video disc which is automatically addressed by the computer software. All pictures, at present some 3000, pertain to case histories which are included in the system. Also integrated are classification aids in two categories: diagnostic criteria and differential diagnosis. Advantages of DEW over the use of conventional manuals are 1) the extensive volume of text, 2) the large number of high quality illustrations, 3) the immediate access to cross references and 4) the potential for continuous revision. PMID- 2696947 TI - Data processing and analysis in the Multicenter Morphometric Mammary Carcinoma Project (MMMCP). AB - In the Multicenter Morphometric Mammary Carcinoma Project (MMMCP), the prognostic value and reproducibility of routinely assessed quantitative pathological parameters in breast cancer is prospectively studied in approximately 3000 patients. Considering the high number of patients and the fact that many laboratories and hospitals throughout the Netherlands participate in this project, data acquisition, processing and analysis is an important component of the project. The data collection scheme, the structure of the database and the processing of data are described. PMID- 2696948 TI - The Multicenter Morphometric Mammary Carcinoma Project (MMMCP). A nationwide prospective study on reproducibility and prognostic power of routine quantitative assessments in The Netherlands. AB - The Multicenter Morphometric Mammary Carcinoma Project (MMMCP) has been set up to investigate prospectively the prognostic value and reproducibility of routine assessments of the morphometric Multivariate Prognostic Index (MPI) and other quantitative parameters in comparison with classical prognosticators and steroid receptors in breast cancer patients. In this project, 34 hospitals participate, divided over six geographically different regions. Of each patient entering in the study, multiple clinical and classical pathological parameters (including tumor size and lymph node status) as well as several quantitative parameters such as mean nuclear area, DNA index and mitotic activity index will be evaluated. Of all patients, the MPI will be assessed with tumour size, lymph node status and mitotic activity index. The quantitative assessments are performed in all consecutive breast cancers which enter the participating pathology laboratories, and all measurements are controlled in Amsterdam. The patient intake time will be from January 1, 1988 until January 1, 1990. It is expected that 3000 patients will enter in this study. Follow up data will be gathered up to 10 years. However, two to five years after the initiation of the Project, a first evaluation of the reproducibility and prognostic significance of routine MPI and other assessments in breast cancer patients will be possible. A detailed description of this project is given. PMID- 2696949 TI - Automated cell analysis for DNA studies of large cell populations using the LEYTAS image cytometry system. AB - Image cytometry by means of LEYTAS features analysis of both fresh and archival cellular material. Although not as accurate in ploidy determination as flow cytometry, LEYTAS cytometry incorporates extensive artefact rejection algorithms, thereby allowing detection of low frequency cells. This feature is very useful for the search of rare cells, as e.g. in cervical screening, or for the quantitation of the number of high DNA content cells in the total cell sample. LEYTAS main components are an automated microscope (Autoplan) and a Modular Image Analysis Computer (MIAC), both from Wild Leitz (W-Germany). This paper discusses LEYTAS instrumentation and cell analysis by means of programs especially written for LEYTAS. PMID- 2696950 TI - Hand-mirror (HM) cells in acute lymphoblastic leukaemia (A.L.L.). An attempt at cellular classification by morphometric analytical parameters using the S.A.M. (Shape Analytical Morphometry) system. AB - A morphometric study of the nuclear and cytoplasmic shape of a blastic population in a case of HM-A.L.L. was performed by comparing the two differently shaped populations with and without HM configuration. The results obtained using analytical size-independent parameters created by the S.A.M. work-station enable us to characterize the shape of both blastic cell populations quantitatively, and strongly suggest the existence of shape modulation from one cellular type toward the other. Thus a possible sequence from blastic cells (having regular, rather round nuclei) to HM cells (characterized by high distortion of both nucleus and cytoplasm) was proposed. PMID- 2696951 TI - Vascular architecture of melanocytic skin tumors. A quantitative immunohistochemical study using automated image analysis. AB - The present study examines the distribution of blood vessels in melanocytic skin tumors. Fresh frozen sections of 11 cases each of benign nevocellular nevus, primary malignant melanoma and metastatic malignant melanoma were stained with the endothelium-specific monoclonal antibody BMA 120 and evaluated by an automated image analysis system. Additionally, the proliferative activity was assessed in parallel sections using Ki 67 monoclonal antibody. There were only slight differences between the diagnostic groups as to the vascular distribution in the tumor center, but there were remarkable differences in the connective tissue at the base of the lesions: The area occupied by small vessels (minimum diameter less than 20 microns) was 0.3 +/- 0.05% in benign nevi, 0.6 +/- 0.05% in primary malignant melanoma, and 1.2 +/- 0.10% in metastatic malignant melanoma (U test: p less than or equal to 0.05). The proliferative activity within each lesion showed a strong positive correlation with the number of small vessels at the base of the tumor (linear regression analysis: r = 0.86; p less than or equal to 0.0001). The findings demonstrate that neovascularization in malignant melanocytic tumors takes place predominantly in the surrounding host tissue and is closely related to the proliferative activity. PMID- 2696952 TI - Methodological aspects of DNA image cytometry in formalin-fixed paraffin-embedded material from pancreatic adenocarcinoma. AB - Deparaffinized and disintegrated material from conventionally formalin-fixed and paraffin-embedded surgical specimens of 100 cases of ductal adenocarcinoma of the pancreas was Feulgen-stained, and the cytochemical DNA distribution patterns of at least 100 single tumour cells and 50 "control" cells (fibrocytes) were assessed by means of image cytometry (ICM). In 77 cases a sufficient number of neoplastic cells could be obtained for these DNA assessments. The fairly high number (23) of cases that had to be excluded due to too small amounts of disintegrated cells or cell nuclei may be explained by the high content of connective tissue stroma in these pancreatic adenocarcinomas. The tumour cell nuclei in 76 of these 77 cases showed cytochemically a clear-cut "non-diploid" DNA distribution pattern. This observation reflects the well-known highly malignant growth potential of this carcinoma. Despite the fact that about 1/4 of the tumours had to be excluded, the main result of our methodological study is, after all that conventionally formalin-fixed paraffin-embedded specimens of most pancreatic adenocarcinomas can be successfully used for the deparaffinization disintegration procedure preceding the nuclear DNA assessments by means of ICM. Additional studies are, however, required to obtain the diagnostic and prognostic impact of the results of such cytochemical analyses of the DNA distribution pattern in adenocarcinomas of the pancreas. PMID- 2696953 TI - Quantitative immunohistologic and histomorphometric diagnostic criteria for Sjogren's syndrome. AB - Sjogren's syndrome (SS) is a chronic auto-immune exocrinopathy, especially affecting the lacrimal and salivary glands. The aim of this study is to improve the diagnostic possibilities of the sublabial salivary gland (SSG) biopsy. The SSG biopsies of 19 patients with SS and 65 healthy control subjects were used in a quantitative immunohistologic and histomorphometric study. Statistical analysis of the immunohistochemical data resulted in a diagnostic criterion, which is based on the percentages of IgA- and IgG-containing plasma cells. Statistical analysis of 3 immunohistologic and 6 histomorphometric features resulted in a combined immunohistologic and histomorphometric criterion, which is based on 2 immunohistologic parameters (the percentages IgA- and IgG-containing plasma cells) and 3 histomorphometric parameters (the volume percentages of acini, intralobular ducts and diffuse lymphoplasmacytic infiltrate). The immunohistologic diagnostic criterion has a specificity of 95.4%, a sensitivity of 100% and an overall percentage of misclassification of 3.6%. The combined diagnostic criterion has a specificity of 98.5%, a sensitivity of 100% and an overall percentages of misclassification of 1.2%. Furthermore it reduces the number of false positive diagnoses with a factor 6 from 9% to 1.5%. PMID- 2696954 TI - Sensitivity of bone histomorphometry in the diagnosis of metabolic bone diseases. AB - Diagnostic sensitivity of bone histomorphometry was assessed in different metabolic bone diseases, after fixing the specificity at 75%, 90% and 95% reference levels. Sensitivity was particularly high in cases with greatly increased osteoid and/or resorption features, as in renal osteodystrophy (ROD). All the remodeling indicators were highly sensitive toward advanced or severe forms of mixed ROD (mROD). Osteoid indicators were the most sensitive parameters in ROD with predominant osteomalacia (oROD). Osteoclastic and several osteoid indicators were very sensitive in all grades of ROD with predominant hyperparathyroidism (hROD). Sensitivity was generally low in uremic patients without bone changes (wROD) and also in patients with idiopathic osteoporosis (OP). It is our recommendation, however, that for each individual patient the definite diagnosis should be based on both morphological, clinical and metabolic parameters. PMID- 2696955 TI - [Indications and contraindications for analgesics and antibiotics in pediatric dentistry]. AB - A general overview upon most used products in odontopediatrics is presented; the factors which influence the determination of the adequate doses in children and some useful recommendations in dental clinical practice are described. The most prescribed products in pediatric odontology are summarized into two groups: a) benzodiazepine, for anxiety and lidocaine, aspirin and acetaminophen, dipirone and naproxen, for pain; and b) penicillin, erythromycin, for treatment of infections. Doses, pharmacologic effects, clinical indications, side effects and contraindications of the chemicals mentioned are described. Also, the article presents some of the aspects which justify the use, in our country, of certain medicaments prescribed in other nations reporting, the recommendations in order to prevent the use of other chemicals because of their lack of therapeutical advantages over the ones of first choice. PMID- 2696956 TI - [Condition of the periodontium in patients with fixed dentures]. AB - The authors examined 29 patients with fixed prostheses. They investigated the condition of the periodontium of pillar teeth of these dentures and examined the vestibular and oral dental surfaces, the adjacent gingiva and the presence of microbial dental plaque. They recorded also the period of use of the denture. The periodontium was evaluated by Russel's according to Silness-Lo. In 16 dentures the assessed values ware compared with intact teeth on the contralateral side of the same jaw. The values of periodontal indices in pillar teeth of fixed prostheses are higher than in teeth without prosthetic treatment and they are proportional to the standard of hygiene and the period for which the prosthesis has been used. PMID- 2696957 TI - The prevention and conquest of scurvy, beri-beri, and pellagra. AB - I have described how many years of research were needed to overcome three nutritional diseases that occurred throughout the world. When human beings migrated from tropical and subtropical regions to the temperate zone, they lost their year-round supplies of vitamin C, and scurvy began to occur. The emergence of beri-beri had a mechanical basis; the introduction of milling, which prevented the rancidity of rice and wheat, also removed the essential vitamin B1. The circumstance leading to the third deficiency disease was reliance on maize, without supplementing it with "protective" foods, such as meat, milk, and vegetables. Under conditions of poverty, the protective foods became expensive, and pellagra appeared. Synthetic chemistry, together with improvements in the diet and in education, largely overcame scurvy, beri-beri, and pellagra, but deficiencies of vitamins A, C, and folic acid still occur widely in economically disadvantaged populations, and this is a challenge to those who wish to improve public health. The brilliant prophesies of Casimir Funk, made in 1912, were fulfilled within 25 years. Today, his word "vitamin" is universally familiar. The account of the discovery, identification and synthesis of the vitamins is the story of how human beings have overcome nutritional deficiencies that were imposed by cultural and economic disadvantages or just plain ignorance. These discoveries were a triumph of science and technology. Much of the research depended on the use of experimental animals: guinea-pigs, rats, dogs, monkeys, and chickens. Vitamins are now added to the diets of both animals and human beings. PMID- 2696958 TI - Determination of partial amino acid sequence of lipoate acetyltransferase of rat pyruvate dehydrogenase complex. AB - The partial amino acid sequence of rat lipoate acetyltransferase was determined using the intact protein and the peptides derived from a digest with Achromobacter protease I. The results showed the amino-terminal sequence of the mature enzyme to be (N) Ser-Leu-Pro-Pro-His-Gln-Lys-Val-Pro-Leu-Pro-Ser- Leu-Ser Pro-Thr-Met-Gln-Ala-Gly-Thr-Ile-Ala-Arg-Trp-Glu-Lys. In addition, the sequences of two possible lipoyl-binding sites in the subunit, which are very similar to each other, were established. PMID- 2696959 TI - High sequence conservation between isocitrate lyase from Escherichia coli and Ricinus communis. AB - The deduced amino acid sequences of isocitrate lyase (EC 4.1.3.1) from Escherichia coli and Ricinus communis (castor bean) were compared and regions of high homology between the two enzymes were identified. The castor-bean enzyme had a 14 amino acid amino-terminal, and a 25 amino acid carboxy-terminal extension and a 102 amino acid central insertion compared to the E. coli enzyme. Enzymatic data were used to attempt to identify specific amino acids in the active site. Comparisons with putative peroxisomal/gloxysomal targeting sequences were made and a region including part of the central insertion of the castor bean enzyme was tentatively identified. PMID- 2696960 TI - Aberrant chromatid separation and aneuploidy. PMID- 2696961 TI - Centromere separation and aneuploidy in human mitotic mutants: Roberts syndrome. PMID- 2696962 TI - Chromosome nondisjunction in a temperature-sensitive mammalian cell mutant. PMID- 2696963 TI - Centromere separation and aneuploidy: a lesson from multicentric chromosomes. AB - Premature centromere separation somehow nullifies the deposition of kinetochore proteins in multicentric chromosomes, is associated with early DNA replication of the centromere and the pericentric region and results in a lack of functionality of the centromere. It is conceivable that monocentric chromosomes which show premature separation, like the X chromosome as found in elderly human females (Fitzgerald et al, 1975), may have similar properties which result in a failure of centromere function and, hence, aneuploidy. This may be one of the general mechanisms by which chromosomes malsegregate. PMID- 2696964 TI - Conditional dicentric chromosomes in yeast. PMID- 2696966 TI - Microtubules modify kinetochore fiber organization and function: a new aspect of mitosis. PMID- 2696967 TI - The attachment of chromosomes to the mitotic spindle and the production of aneuploidy in newt lung cells. PMID- 2696968 TI - Genetic approaches to microtubule function. AB - To date, the experiments in yeast have been successful primarily in distinguishing what is not important. Divergent tubulin sequences are functionally interchangeable, interesting domains of tubulins can undergo dramatic alteration without affecting substantially the function of the protein, and the cells can assemble sufficient microtubule organelles from half the normal amount of tubulin. These results are with a few genes, in one organism, and the extent to which they can be extrapolated to other organisms with more complex complements of tubulin genes--in particular, metazoa--is not known. It is extremely unlikely that all of the suggestions that tubulin sequences and tubulin quantities participate in regulating microtubule function are erroneous. But the yeast system does offer us the opportunity to look past these obvious regulators, and to detect more subtle interactive elements that may be crucial for normal function. That is the immediate goal of our next experiments. PMID- 2696969 TI - Assessment of aneuploidy in human sperm karyotypes. PMID- 2696970 TI - A model that explains the varying frequency of aneuploid children with maternal age (J-shaped curve) as well as aneuploidy of paternal origin. AB - A compromised microcirculation could account for aneuploidy incidence in women of any reproductive age, the frequency varying with the probability of events leading to reduced development and/or function of the critical perifollicular capillary bed. This would explain the J-shaped curve of changing frequency of Down syndrome children with maternal age (Erickson, 1978). The seminiferous tubule of the testis, like the follicle, has no internal circulation, so small localized regions of reduced circulation could occur and result in aneuploidy. From all that we know about the deficiency of regional microcirculation in tumors (see Hall, 1978), it is reasonable to speculate that reduced pH could be responsible for some of the aneuploidy that is seen in practically all advanced tumors. As a first step in testing the model proposed here, we are beginning studies with mouse oocytes, on the assumption that ovarian conditions are responsible for the maternal age effect rather than uterine conditions (reduced rejection of trisomic fetuses). Should our model for aneuploidy induction in both germ and somatic cells prove to be correct, the molecular mechanism(s) would still have to be ascertained. PMID- 2696965 TI - Microtubule dynamics and the movement of chromosomes. PMID- 2696971 TI - Age-related non-disjunction, spindle formation and progression through maturation of mammalian oocytes. PMID- 2696972 TI - Chromosomal aneuploidy in Saccharomyces cerevisiae. PMID- 2696976 TI - On the mechanisms of induced aneuploidy in Aspergillus nidulans and validation of tests for genomic mutations. PMID- 2696975 TI - Detection of mitotic and meiotic chromosome malsegregation. PMID- 2696973 TI - Chromosome interactions and number of centromeres per cell are important to chromosome stability in yeast. PMID- 2696974 TI - Meiotic multivalent orientation and cell developmental delay. AB - In the heterozygote for the combination of an interchange (662W;3R/6R) and a Robertsonian split (3R) of rye, one type of adjacent orientation leads to trisomy in the progeny. Pollen mother cells with adjacent orientation of the translocation quinquivalent or with a trivalent and a bivalent were delayed in their development and appeared at prometaphase and metaphase later than cells with alternate quinquivalents. Delay in cell development is ascribed to unfavorable (early) prophase positioning of chromosomes. PMID- 2696977 TI - The centromere and aneuploidy: I. Caffeine-induced detachment and fragmentation of kinetochores of mammalian chromosomes. PMID- 2696978 TI - Human centromere structure: organization and potential role of alpha satellite DNA. PMID- 2696979 TI - The role of nonhistone proteins in the structural organization of chromosomes. PMID- 2696980 TI - AMPA, kainic acid, and N-methyl-D-aspartic acid stimulate locomotor activity after injection into the substantia innominata/lateral preoptic area. AB - The substantia innominata/lateral preoptic area (SI/LPO) is a subpallidal region which has been shown to regulate the hypermotility produced by drugs acting in the nucleus accumbens. Evidence has been presented that the SI/LPO contains glutamatergic nerve terminals and receptors for excitatory amino acids. The purpose of this study was to determine the effects of the activation of excitatory amino acid receptors in the SI/LPO on locomotor activity following the direct injection of excitatory amino acids into this brain site. It was found that the bilateral injection of alpha-amino-3-hydroxy-5-methyl-isoxazole-4 propionate (AMPA), kainic acid, and N-methyl-D-aspartic acid into the SI/LPO produced marked dose-dependent stimulations of locomotor activity which resembled the effects of these agents after their injection into the nucleus accumbens. The effect, however, was bell-shaped in that at high doses, the locomotor activity values decreased from their peak values. The coinjection of gamma glutamylaminomethylsulfonate (GAMS) with AMPA into the SI/LPO was found to inhibit the hypermotility response to AMPA at doses that were unable to produce a significant inhibition of the hypermotility responses to kainic acid or N-methyl D-aspartic acid. The injection of 6,7-dinitroquinoxaline-2,3-dione (DNQX) into the SI/LPO inhibited the hypermotility responses to AMPA or kainic acid while having no significant inhibitory effect on N-methyl-D-aspartic acid stimulated locomotor activity. The injection of D-alpha-aminoadipic acid into the SI/LPO produced a significant inhibition of the hypermotility response produced by N methyl-D-aspartic acid at a dose that did not produce a significant inhibition of the hypermotility response produced by AMPA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696981 TI - Dissociation between biochemical and behavioral recovery in MPTP-treated mice. AB - Injection of a low dose of haloperidol, that has no obvious behavioral effects in normal mice, produces akinesia, catalepsy, and somatosensory neglect in MPTP treated mice. These neuroleptic-induced sensorimotor impairments are exhibited soon after MPTP treatments and coincide with a decrease in both striatal DA and DOPAC levels. DA and DOPAC content gradually return to near-control levels over a 3-5 month period. Interestingly, while the haloperidol-induced somatosensory deficits declined in parallel with the rise in DA and DOPAC levels, the motor deficits persisted for up to 5 months after MPTP administration. These data suggest subtle differences in the neurochemical mediation of these behaviors and that the persistence of neuronal impairments may not necessarily be revealed by near-normal transmitter levels. PMID- 2696982 TI - A novel NMDA antagonist, MK-801, impairs performance in a hippocampal-dependent spatial learning task. AB - N-Methyl-d-aspartate (NMDA) receptors have been implicated with the triggering of long-term potentiation, a currently studied physiological model of learning and memory. The compound (+)-5-methyl-10,11-dihydro-5H-dibenzo [a,d] cyclohepten-5,10 imine maleate (MK-801) has recently been classified as a potent and selective NMDA antagonist acting at the associated ion channel. After determination of the highest intraperitoneal dose of MK-801 at which increases in activity (measured in photocell activity cages and 3-arm maze) were not observed (0.2 mg/kg), rats that had been previously trained to obtain food pellets in an 8-arm radial maze up to criterion were tested with 0.1 and 0.2 mg/kg doses. Dose-related decreases in "efficiency" in the task were found. The present findings support the suggestion that NMDA antagonists cause impairments in "working memory" and also support the status of long-term potentiation as a physiological model of memory. PMID- 2696984 TI - Systemically administered N-methyl-D-aspartate interferes with acquisition of a passive avoidance response in rats. AB - The effect of several doses of systemically administered N-methyl-D-aspartate (NMDA) was studied on step-through passive avoidance (PA) retention in rats. Retention of single trial PA was significantly reduced by preacquisition (30 minutes) doses of NMDA (3, 10, 30, and 50 mg/kg SC). Preacquisition amnesia was found when NMDA (30 mg/kg SC) was administered between two and 60 minutes. At shorter and longer pretreatment times (0.5 and 180 minutes) NMDA (30 mg/kg SC) did not disrupt retention testing. Across the same dose range and pretreatment times, NMDA failed to interfere with PA retention when given after acquisition or before retention testing. The results suggest that systemic NMDA administration can interfere with the acquisition of a PA response but does not alter consolidation of information or retrieval. PMID- 2696983 TI - Smoking history, instructions and the effects of nicotine: two pilot studies. AB - In Study 1, ten never-smokers, ten ex-smokers and nine current smokers received nicotine (2 mg) and placebo gum hourly for 4 hours on 2 consecutive days in a randomized, double-blind, cross-over protocol. Dysphoria from nicotine was greatest in never-smokers, intermediate in ex-smokers, and least in current smokers (p less than 0.05). On the third day, subjects were given concurrent access to the same gums and told to chew ad lib. Across all subjects, nicotine was an aversive stimulus (i.e., self-administered less than placebo). Nicotine was avoided most in never-smokers, intermediate in ex-smokers and least in current smokers (p less than 0.05). Study 2 used a similar protocol and compared the nine current smokers in Study 1 who were not told they would receive nicotine with eight informed smokers, i.e., smokers told they would receive nicotine. Although nicotine appeared to be a reinforcer more often in the informed smokers than in the uniformed smokers (63% vs. 22%), this result was not statistically significant. Our results suggest 1) past drug history can influence the stimulus effects of nicotine and 2) the effects of instructions on the response to nicotine may be less in experimental settings than in therapeutic settings. PMID- 2696985 TI - [Diagnostic value and significance of photoplethysmography in venous insufficiency]. AB - In this study, including 62 patients, or 104 lower extremities, the author demonstrates first, with the chi-2 test, that the method based on Photoplethysmography has a good diagnostic value (sensitivity: 92%, specificity: 88%). Then, with the Student t-test, he demonstrates that the advantage of Photoplethysmography in venous insufficiency is to differentiate easily normal subjects from subjects affected with valve insufficiency, and to establish the differential diagnosis between superficial valvular insufficiency and deep valvular insufficiency. On the contrary, in analyzing the discrepancies between clinical examination and the results of Photoplethysmography, he demonstrates that the diagnosis obtained with Photoplethysmography is limited in the presence of edema, isolated varicose veins, Phlebitis and arterial disease, or during an ineffective compression of the reflux of the superficial venous system. Finally, the author suggests an approach in patients with chronic venous insufficiency, based on clinical examination, Doppler examination and Photoplethysmography. PMID- 2696986 TI - [The saphenous clip]. AB - The purpose of the saphenous clip is to prevent two major factors in the course of varicose vein disease: the haemodynamic factor and the parietal factor, the latter being the cause of post-surgical recurrences. Positioning of the clip is only imaginable after thorough mapping of the sapheno-femoral junction by Doppler and ultrasonography. They offer a precise and selective surgical indication, preserving healthy vessels. The first results confirm its efficacy on these two essential factors. However, the reflux is not always controlled while recurrences are not always occurring after 4 years. PMID- 2696987 TI - [Normal and pathological compression of the venous system]. AB - A study of 190 female patients was carried out at the level of the solar ring, the crural arch, the left ilio-caval junction and the vena cava ring of the diaphragm, in order to determine whether these represent, per se, critical areas, which may cause compression and hinder the venous return as a result of the narrowing and the poor distention of their structures. Sonotomography alone or associated with the pulsed Doppler were selected for this study. The action of the various components (bone, muscle, tendon, vessels and nodes) on the venous system is each region, was analyzed. The overall results have demonstrated two types of compression: a) intermittent, b) permanent. The former is considered as a hemokinetic mechanism, especially at the level of the solar arch and the vena cava ring of the diaphragm. They represent a major element of the pump and the vis-a front respectively. The permanent compression was considered as pathological, and could be related to a venous displacement occurring as an adaptation mechanism to the extrinsic compression. The data obtained in all four regions, have demonstrated that their various components are in a precarious balance, but they do not constitute a true obstacle to the venous return, even if in some postures or respiratory movements they may cause an intermittent venous compression. PMID- 2696988 TI - Sanguinarine, a phototoxic H2O2-producing alkaloid. AB - Sanguinarine chloride, a quaternary salt of a benzophenanthrene alkaloid, was phototoxic to catalase-deficient strains of Escherichia coli but not to Trichoplusia ni (cabbage looper moth larvae), an insect with high levels of catalase activity. Chemical analyses confirm that sanguinarine is an efficient producer of H2O2. This differential toxicity suggests that the mode of phototoxic action involves production of H2O2 which could be detoxified in many organisms by catalase. PMID- 2696989 TI - Photobiological properties of a novel, naturally occurring furoisocoumarin, coriandrin. AB - The photobiological properties of a novel, naturally occurring furoisocoumarin isolated from coriander and named coriandrin are described. Photosensitized lethal and mutagenic effects in bacteria indicate that it is more active than psoralen. It is a weak frameshift mutagen in the dark. Mammalian cells in tissue culture are photosensitized more actively with coriandrin than with psoralen even though preliminary evidence from interrupted radiation experiments and DNA analysis suggest that coriandrin does not form DNA interstrand crosslinks. Sister chromatid exchanges were induced with a unit dose of 1.1 x 10(-2) with coriandrin; the value for psoralen is 3 x 10(-3). Coriandrin appears to be metabolized more rapidly than furocoumarins by liver mixed function oxidases. Skin photosensitizing activity is very weak compared with psoralen, a surprising observation considering its potency in biological test systems. PMID- 2696990 TI - Action spectra and chromophores for lethal photosensitization of Candida albicans by DNA monoadducts formed by 8-methoxypsoralen and monofunctional furocoumarins. AB - The red-shift of furocoumarin action spectra, compared with their absorption spectra, has been investigated. An action spectrum for 8-methoxypsoralen (8-MOP) monoadduct formation in the yeast Candida albicans has been determined. The yeast cells were initially exposed to sublethal doses of monochromatic UVA at different wavelengths. Monoadduct formation was monitored by growth inhibition induced, after washing out any unbound 8-MOP, by re-irradiation with a constant second (non-lethal) dose of 330 nm radiation. A comparison between this action spectrum and the absorption spectrum of the dark complex of 8-MOP and DNA was made. In addition, the action spectra of monoadduct formation of five monofunctional compounds including a coumarin derivative have been determined. These action spectra were compared with their respective DNA dark complex absorption spectra. In general, the peaks of the furocoumarin DNA dark complexes show a red-shift when compared with the free furocoumarin molecule and the action spectra show peaks which correspond with the peaks of the dark complexes. Such data indicate that the DNA dark complex is the chromophore for growth inhibition in yeast rather than the free furocoumarin. The similarity of the 8-MOP monoadduct formation action spectrum and 8-MOP action spectra suggests that spectral dependence for the photobiological effects (including the red-shift) is dependent on monoadduct formation rather than, as previously suggested by several authors, crosslink formation. The action spectrum for the coumarin derivative 4-methyl N ethylpyrrolo (3,2-g) coumarin (PCNEt) correlated well with the free molecule absorption spectrum rather than DNA dark complex indicating that the free molecule is the chromophore.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2696991 TI - Photochemical charge separation in photosynthetic reaction centers. PMID- 2696992 TI - The triplet state as a probe of dynamics and structure in biological macromolecules. PMID- 2696994 TI - Vibrational spectra of rhodopsin and bacteriorhodopsin. PMID- 2696993 TI - Recent advances in psoralen phototoxicity mechanism. PMID- 2696995 TI - Symposium on models for the study of human photoaging: American Society for Photobiology. PMID- 2696996 TI - Recent books on photochemistry and photobiology. PMID- 2696997 TI - [Intro- and extraversion in patients with neuroses as factors differentiating the effect of diazepam on psychomotor function]. AB - The influence of various diazepam doses on selected psychomotor functions in neurotic patients was studied with regard to introversion and extraversion. The group consisted of 110 patients randomly selected into diazepam group (60 cases) and placebo group (50 subjects). In each group introvertics (24 treated with diazepam and 13 with placebo) as well as extravertics (15 subjects receiving diazepam and 12 placebo) were selected. Further analysis excluded 36 ambivertics. Results did not suggest substantial dependence between introversion and extraversion, and effect of diazepam on psychomotor functions. Only the negative effect of certain diazepam doses on visualmotor coordination in introvertic patients, as well as such influence on time of reaction with choice was found. It regards to diazepam doses of 10 mg t.i.d. after 7-10 days of treatment, and also the influence of single dose of 10 mg diazepam after 3-4 hours on visual-motor coordination as well. PMID- 2696998 TI - [Central dopaminergic mechanisms and the effect of ethyl alcohol]. PMID- 2696999 TI - [Depression and reversible dementia in old age]. PMID- 2697000 TI - [Cognitive theories of depression. I. Beck's theory and the theory of susceptibility of Brown and Harris]. PMID- 2697001 TI - [Psychiatric aspects of the new codification of civil law in Poland]. PMID- 2697002 TI - [Sympathy and empathy in medical practice]. PMID- 2697003 TI - [Simulation of mental illness by Jozef Pilsudski with subsequent escape from the St. Nicholas the Thaumaturge Hospital in St. Petersburg]. PMID- 2697004 TI - Stress-responsive neurohormonal systems and the symptom complex of affective illness. AB - The role of stress in the natural history of major depression has been a subject of intense scrutiny, particularly in light of the 20th century discoveries of some of the biological mediators of stress responses. In this paper we present evidence suggesting the hypothesis that an abnormality in the counterregulation of generalized stress responses underlies critical aspects of the pathophysiology of major depression. In particular, we focus on the role of inadequate glucocorticoid restraint of the central nervous system (CNS) components of the adrenocortical and adrenergic systems, i.e. the corticotropin releasing hormone (CRH) components of the adrenocortical and adrenergic systems, i.e. the corticotropin releasing hormone (CRH) and locus ceruleus-norepinephrine (LC-NE) systems. We believe that this hypothesis not only helps explain many of the observed abnormalities in the syndrome of major depression, but also provides a biological basis for subtyping this syndrome. PMID- 2697005 TI - Immune correlates of stress and depression. AB - This paper reviews the evidence for alterations in immunity associated with depression and stressful events. The reviewed studies examine a variety of immune parameters (e.g., mitogen response, natural killer cell activity and number, T cell, and T-cell subpopulations) in relation to depression and in relation to a number of stressful events (e.g., death of spouse, examinations). There is considerable variability in the findings of the available studies. However, the review finds considerable evidence for an association between a variety of stressful events and lowered immunity and between severe depression and lowered immunity. The clinical relevance of these psychoimmune relationships remains in question. PMID- 2697006 TI - Diagnostic criteria for dysthymic disorder. AB - The DSM-III (American Psychiatric Association 1980) criteria for dysthymic disorder selected a heterogeneous group of patients who overlapped with major depression and personality disorders in ways that were difficult to interpret. DSM-III-R (American Psychiatric Association 1987) revised the dysthymia criteria by (1) distinguishing early from late age of onset; (2) providing separate designations for primary and secondary states of dysthymia; (3) including a category of chronic major depression; and (4) revising the specific content of criteria. The performance characteristics of the new criteria set are yet to be tested--a necessary next step to inform the discussions that will culminate in DSM-IV. The remaining areas of greatest controversy are whether (1) early onset, primary dysthymic disorder should be redefined as depressive personality and placed on Axis II; (2) "double-depression" represents a real clinical phenomenon or a definitional artifact; and (3) the content of the diagnostic criteria can be made more specific for chronic depressions. The implications of possible changes and the workings of the DSM-IV Affective Disorders Work Group are discussed. PMID- 2697007 TI - The influence of diagnosis and family treatment on acute treatment response and short term outcome in schizophrenia. Treatment Strategies in Schizophrenia Collaborative Study Group. PMID- 2697008 TI - Dopaminergic mechanisms in self-inflicting biting behavior. AB - Dopaminergic mechanisms involved in self-inflicting biting behavior (SBB) were investigated in two animal models: monkeys with unilateral ventromedial tegmental (VMT) lesions of the brainstem and rats with unilateral 6-hydroxydopamine (6 OHDA) lesions of the nigrostriatal dopamine (DA) neurons. The administration of mixed D1/D2 DA agonists to some monkeys with unilateral VMT lesions of the brainstem elicits SBB of the forelimb digits contralateral to the lesion and spasticity of the contralateral hindlimb. This behavior is prevented by pretreatment with the selective D1 antagonist SCH 23390 and with the D1/D2 antagonist fluphenazine. The combined administration of the D1 DA agonist SKF 38393 with the D2 DA agonist quinpirole produces SBB at doses that were ineffective when these drugs were administered individually. The intrastriatal (middle ventrolateral area [MVL]) microinjection of the D1/D2 DA agonist apomorphine (Apo) to rats with unilateral 6-OHDA lesions elicits SBB. This behavior is not prevented by systemic administration of SCH 23390 and partially prevented by the selective D2 antagonist raclopride. However, the combined administration of SCH 23390 and raclopride completely prevents the Apo-induced SBB. Thus, the pharmacological characteristics of the DA agonist-induced SBB in monkeys with unilateral VMT lesions of the brainstem seem to differ from those induced by intrastriatal (MVL area) administration of DA agonists into rats with 6-OHDA lesions of the nigrostriatal DA neurons. The role of DA neuronal systems in the expression of SBB in Lesch-Nyhan syndrome and in some patients with mental retardation, as well as the link between hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency and abnormal dopaminergic function in Lesch-Nyhan syndrome, is discussed. PMID- 2697009 TI - Dopamine deficiency in self-injurious behavior. AB - Based on the report that patients with Lesch-Nyhan Syndrome (LNS) have a central deficiency of dopamine similar in magnitude to that seen in Parkinsonism, the age at which dopaminergic neurons are disrupted was proposed to explain the differing symptoms observed in these two disorders. To investigate this hypothesis, brain dopaminergic neurons were lesioned in neonatal and adult rats with 6-hydroxy dopamine (6-OHDA). Results demonstrated that neonatally lesioned rats had learning deficits and elevated levels of serotonin in the striatum- characteristics observed in LNS. Administration of L-dopa produced self-injurious behavior (SIB) in neonatally lesioned but not adult lesioned rats. Subsequent studies revealed that the SIB induced by L-dopa was dependent upon activation of D1 receptors. The elevated susceptibility of neonatally lesioned rats for SIB was demonstrated further by the enhanced occurrence of SIB when muscimol was administered into the substantia nigra reticulata (SNR). Other studies demonstrated that adenosine agonists could antagonize SIB, suggesting that the reduced adenosine observed in LNS may contribute to this symptom. The basic work being performed should be relevant to LNS and to other developmental disorders exhibiting SIB. PMID- 2697010 TI - The differential diagnosis of self-injurious behavior in mentally retarded people. AB - Self-injurious behavior (SIB) is sometimes presented as if it were a unitary behavioral entity. It is this assumption that leads to impunity in clinical trials of SIB patients, who are thought to be a homogeneous group. In fact, nothing could be further from the truth. SIB is no more than the occasion for a neuropsychiatric differential diagnosis; first to consider environmental and medical circumstances that may induce SIB; then specific, diagnosable conditions from neurology and psychiatry; then specific syndromes like Lesch-Nyhan and Cornelia de Lange; and then for "idiopathic" cases, the alternative neuro chemical hypotheses. The goal of differential diagnosis is not only to guide treatment, but also to improve subject homogeneity in clinical trials. PMID- 2697011 TI - Neurochemical studies of violent and nonviolent suicide. AB - Considerable data have been reported indicating that there is a relationship between suicide or more serious suicide attempts and alterations in indices of serotonin (5-HT) function in patients. The fact that these data are based on studies of both suicide completers as well as more serious suicide attempters and involve a range of experimental techniques spanning biochemical assays of postmortem brain tissue as well as neuroendocrine challenge tests and platelet studies strengthens this finding. However, whether altered serotonin indices are specifically associated with violent compared to nonviolent suicide remains less clear. The relationship may be with some other aspect of suicidal behavior such as the overall lethality of the suicide method, impulsivity, or degree of planning. Suicide method appears to be related to modeling effects or to the relative availability of different methods of suicide, which argues against a predominant role for biological factors in selecting suicide methods. The relative importance of biological vs. modeling and sociological factors in determining suicide method will require more comprehensive studies in which the contribution of all of these factors is assessed simultaneously in the same patient population. PMID- 2697012 TI - Pharmacotherapy in posttraumatic stress disorder: historical and clinical considerations and future directions. AB - Posttraumatic stress disorder (PTSD) has long been recognized as responsive to drug and somatic treatments. Clinical characteristics and patterns of treatment response were well described in the 1940s. Recent studies indicate that tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) have specific ameliorative effects on PTSD symptoms, but further work is needed in this regard. Goals of drug therapy are provided and future directions suggested. PMID- 2697013 TI - Neurohypophyseal dysfunction: implications for the pathophysiology of eating disorders. AB - Vasopressin (AVP) and oxytocin (OT) are hypothalamic neuropeptides having distinct peripherally and centrally directed cell populations. While principally responsible for the regulation of osmotic equilibrium, AVP also participates in stress-mediated adrenocorticotropic hormone (ACTH) release, and in consolidation and retrieval of aversively conditioned behaviors. OT is principally known for its role in parturition and lactation, but also has effects opposite of AVP, antagonizing stress-mediated ACTH release and impairing the consolidation and retrieval of aversively conditioned behaviors. Our group has demonstrated novel peripheral osmoregulatory defects in underweight anorexics, coupled with hypersecretion of AVP into the cerebrospinal fluid (CSF). Conversely, a relative reduction of CSF OT is seen in underweight anorexics. Speculatively, these reciprocal changes in neurohypophyseal peptides in the underweight anorexic may enhance the observed neuroendocrine and cognitive abnormalities. In addition, the alterations in CSF OT may occur as a consequence of the abnormal gastrointestinal function present during the acute stages of anorexia nervosa. PMID- 2697014 TI - Meal-related cholecystokinin secretion in eating and affective disorders. AB - The satiety-inducing effects of centrally and peripherally administered cholecystokinin (CCK) in experimental animals have been well documented. Recently, studies in humans showed that CCK is released into plasma following food ingestion, a phenomenon postulated to promote meal-related satiety. To explore whether abnormal CCK secretion during feeding may be related to pathophysiological mechanisms in disorders associated with appetite abnormalities, we report here studies of the plasma CCK response to a test meal in patients with bulimia nervosa, as well as seasonal (hyperphagic) and melancholic (anorexic) depression. Compared to controls, bulimic patients had impaired meal-related CCK secretion, correlated with an impaired sense of postprandial satiety. This defect resolved with tricyclic antidepressant-induced amelioration of bulimic behavior, suggesting that deficient CCK secretion may constitute a fundamental pathophysiologic derangement in this disorder. In contrast to patients with bulimia nervosa, hyperphagic patients with seasonal affective disorder failed to show abnormal meal-related CCK secretion. Preliminary evidence shows robust meal-related CCK secretion in melancholic depression with anorexia. We have also begun to explore the dynamics of CCK secretion into cerebrospinal fluid (CSF) utilizing an indwelling lumbar catheter. From studies in humans, we note that this peptide is secreted into the CSF in large (ng/ml) quantities in an episodic fashion that may bear some relationship to food ingestion. Further study of this parameter in volunteers and patients is now underway. PMID- 2697015 TI - Ensuring data quality in a multicenter clinical trial: remote site data entry, central coordination and feedback. AB - In an ongoing multicenter clinical trial, "Treatment Strategies in Schizophrenia," the five participating sites have the capacity to perform a variety of tasks or study functions independently. These tasks include (a) verification of diagnostic eligibility through the use of computerized decision algorithms; (b) assignment of patients to treatment based on prognostic indicators using a computerized randomization algorithm; (c) entry of data into a microcomputer using a clinical trial data management system that performs simple range and missing data item checks; and (d) regular transfer of all data to the central coordinating team. The clinical trial data management system employed allows for both independent site functioning and assurance of consistency across sites. The integration of a variety of software outside the main data management system provides the central coordinators with the tools to monitor critical data as it is collected, as well as the capacity to assess the flow, quality, and uniformity of the ongoing trial. PMID- 2697016 TI - Potassium channels activated by sodium. AB - Na+-activated K+ currents have been reported in snail neurones, crayfish giant motoneurones, cardiac myocytes, and in ganglion cells and brain stem cells from chick embryos. Such currents are seen in voltage-clamp experiments, following depolarization-induced Na+ influx. A variety of experiments have shown that the currents through the conductance pathways are indeed carried by K+ ions and that they are quantitatively dependent upon Na+ influx into the cells. Theoretical calculations indicate that such currents must make a substantial contribution to action potential repolarization. The conductances are activated by Li+ in invertebrate neurones, but not in the embryonic vertebrate neurones. Single channel recordings from vertebrate brain stem cells reveal channels with conductances of about 50 pS, activated by Na+ concentrations in the 10-100 mM range. PMID- 2697017 TI - Some aspects of the neuromuscular system of Ascaris. AB - 1. The structure and physiological properties of the somatic neuromuscular system of the nematode Ascaris lumbricoides var. suum are discussed taking into account early work from this laboratory, the results of other workers, and experiments in progress. 2. Anatomically, the central feature of the somatic musculature is the presence of a specialized muscular, but not contractile, structure: the syncytium or sarcopile, formed by the terminal processes of the muscle cell arms that contact the nerve cord. In this region, they are electrically coupled to one another and form chemical synapses with the nerve fibres. 3. The syncytium serves, primarily, as a nerve-muscle manifold, or device which allows the neural control of the muscle fields with great economy in the amount of nervous tissue, numbers of chemical junctions and quantities of synaptic transmitters. 4. The structure of the syncytium is being studied with the scanning electron microscope. The results reveal the convergence of the arms on discrete sites as they approach the cords, as well as a longitudinal arrangement of the terminal processes as they course over the cords, at least in the posterior region of the animal. 5. The characteristics of the electrical coupling between the muscle cells are being investigated. A pattern has been observed that is dependent on the position of the cell pairs with respect to the longitudinal axis of the animal. 6. A study of signal propagation in the arms has revealed that the morphology of the muscle cells contributes to the extent and preferential direction of propagation. PMID- 2697018 TI - Assessing some dynamic properties of the living nervous system. PMID- 2697020 TI - Growth and synapse formation by identified leech neurones in culture: a review. AB - Within hours after identified neurones have been isolated from the CNS of the leech, they begin to sprout and to form synapses. Electrical recordings made by loose-patch clamp show that the tip of the isolated neurone has distinct properties with a high density of sodium channels. Neurites grow out from this tip after about 30 min and continue to grow for the next few days. The extent of growth, the branching pattern and the distribution of calcium channels all depend critically upon the molecular composition of the substrate. The tip of the neurone also represents a preferred region for synapse formation. For example when the tips of two serotonin-containing neuromodulatory neurones, the Retzius cells, are placed in contact, chemical synapses develop within about 6 h. These chemical synapses are bidirectional and become stronger over the next 2 days. Electrical synapses between the two Retzius cells develop more slowly and appear only after about 20 h. When the tip of one Retzius cell is apposed to the soma of another, chemical transmission develops more slowly. When other regions of these same cells are placed in contact, electrical transmission can appear before chemical. Together these results show that specialized areas of neuronal membrane are involved in neurite extension and in the formation of specific synaptic connections. PMID- 2697019 TI - The school of Bernard Katz. London, 5 April 1989. Proceedings. PMID- 2697021 TI - A cell-culture approach to the study of seizure activity. PMID- 2697022 TI - Ecological causes for the evolution of sexual dimorphism: a review of the evidence. AB - Can sexual dimorphism evolve because of ecological differences between the sexes? Although several examples of this phenomenon are well known from studies on birds, the idea has often been dismissed as lacking general applicability. This dismissal does not stem from contradictory data so much as from the difficulties inherent in testing the hypothesis, and its apparent lack of parsimony, in comparison to the alternative explanation of sexual selection. The only unequivocal evidence for the evolution of sexual dimorphism through intersexual niche partitioning would be disproportionate dimorphism in trophic structures (e.g., mouthparts). This criterion offers a minimum estimate of the importance of ecological causes for dimorphism, because it may fail to identify most cases. A review of published literature reveals examples of sexually dimorphic trophic structures in most animal phyla. Many of these examples seem to be attributable to sexual selection, but others reflect adaptations for niche divergence between the sexes. For example, dwarf non-feeding males without functional mouthparts have evolved independently in many taxa. In other cases, males and females differ in trophic structures apparently because of differences in diets. Such divergence may often reflect specific nutritional requirements for reproduction in females, or extreme (sexually selected?) differences between males and females in habitats or body sizes. Ecological competition between the sexes may be responsible for intersexual niche divergence in some cases, but the independent evolution of foraging specializations by each sex may be of more general importance. If ecological causation for dimorphism can be demonstrated in so many cases, despite the inadequacies of the available criteria, the degree of sexual size dimorphism in many other animal species may well also have been influenced by ecological factors. Hence, it may be premature to dismiss this hypothesis, despite the difficulty of testing it. PMID- 2697024 TI - Bond strength of three dentinal adhesives on recently extracted versus aged teeth. PMID- 2697023 TI - Principles of occlusion for implant prostheses: guidelines for position, timing, and force of occlusal contacts. PMID- 2697025 TI - The bonded amalgam restoration. PMID- 2697026 TI - [Study of SR-Orthotyp sections posterior tooth blocks]. PMID- 2697027 TI - Society struggles with mental disorders. PMID- 2697028 TI - [At the roots of the imaging tree. Notes on the original personalities in radiology]. PMID- 2697029 TI - [High-risk focal breast lesions in echography and mammography]. AB - Proliferative breast diseases include a group of lesions which occupy an intermediate position between benign and malignant lesions and are extremely likely to develop into carcinomas. The authors studied 81 patients who had been surgically biopsied on the basis of mammographic and/or US findings. In 33/81 (40.7%) of them proliferative lesions were diagnosed at histology. Mammography was able to identify 18/33 lesions (54.5%) versus US 26/33 (81.8%). On the basis of these findings, a group of patients at risk for cancer could be identified. As a matter of fact, proliferative lesions, especially those presenting with atypical hyperplasia, are associated with a higher risk of developing into carcinomas than those presenting with typical features. For these patients, the authors suggest more frequent clinical and instrumental screening. PMID- 2697030 TI - [Doppler color in the echographic study of hyperplastic parathyroid glands]. AB - The sonographic examination of hyperplastic parathyroid glands is a well-known and appreciated technique. However, its diagnostic contribution is still somehow inadequate, due to the difficult differential diagnosis of the various solid hyperechoic nodular structures in the neck and to the presence of frequently ectopic glands. The combined use of B-mode and color-Doppler US allows the vascular features of suspicious parathyroid nodules to be satisfactorily demonstrated. Higher sensitivity and specificity than conventional US are the main advantages of this technique. Still, further research is needed for B-mode color-Doppler US to actually replace fine needle biopsy in confirming the diagnosis. PMID- 2697031 TI - [The nephrotoxicity of ionic and nonionic contrast media in urography. An evaluation with immunoenzyme technics and monoclonal antibodies]. AB - The nephrotoxicity of ionic and nonionic contrast media (cm) was evaluated in 52 patients undergoing pyelography. The contrast media were i.v. injected in 30'. Urine samples were collected before, 2 and 48 hours after the injection. Urinary albumin (alb) and retinol binding protein (RBP) excretion was evaluated by immunoenzymatic methods; alb and RBP were considered as indicators of glomerular permeability and of tubular reabsorption, respectively. The urinary excretion of brush-border antigen of proximal tubule (BBA) was also measured, as an indicator of microtissue damage, by a sensitive double-antibody ELISA with monoclonal antibodies. The results demonstrate ionic cm to have greater functional effects than nonionic ones, as suggested by the increased urinary excretion of both alb and RBP. However, tubular damage seemed to be more severe with nonionic agents, as suggested by BBA excretion. Although toxic damage had little significance for the patients' health, long-term effects are not to be excluded. PMID- 2697032 TI - [Quantitative analysis of the lung CT in normal subjects and in patients with noncardiac pulmonary edema]. AB - A quantitative analysis was performed of the CT images relative to 7 normal human subjects and to 22 patients affected with ARF (Acute Respiratory Failure). The CT scanner image quality was investigated, and the unit was checked with quality control procedures, in order to assure reliability and reproducibility. In every patient the lung was scanned at 3 different levels--basis, hilum and apex. The frequency distribution of CT numbers was studied. The lung areas were calculated for the different conditions, and the data correlated with functional lung data. A method was then tested to evaluate lung weight; the data obtained did not differ from literature data. All the patients were treated with different positive and expiratory pressure (PEEP). For different PEEP values, the quantitative data from CT analysis were correlated with morphofunctional indices. PMID- 2697033 TI - ["Indirect" radioisotope cystography after the furosemide test: its diagnostic efficacy compared to "direct" study]. AB - The diagnostic efficacy was investigated of "indirect" radionuclide cystography after a furosemide test in the detection of vesicoureteral reflux. A single i.v. injection of 99mTc-diethylenetriaminepentacetic acid (DTPA) was administered during sequential renal scintigraphy. "Direct" radionuclide cystography with 99mTc-DTPA was assumed as the "golden standard". Thirty-three patients, 24 of whom in pediatric age, were examined with "indirect" radionuclide cystography after a furosemide test: the method had 32% sensitivity according to restrictive positivity criteria versus 59% according to less restrictive ones. In conclusion, "indirect" radionuclide cystography, in spite of the advantages coming from the use of the diuretic, cannot be considered as an efficient technique to recognize vesicoureteral reflux, especially when the latter is present at a low degree. PMID- 2697034 TI - [Echographic observation of a fetus with mucoviscidosis]. PMID- 2697035 TI - [The joining of the hepatic ducts at the duodenal papilla. A case report]. PMID- 2697036 TI - [Segmental ischemic testicular infarct. The echographic and histological correlations]. PMID- 2697037 TI - An acid-etched bar-supported denture. PMID- 2697038 TI - The retention of gold crowns on human dentine preparations--a comparison of eight cements. AB - Experiments were carried out to compare the retentive properties of eight dental luting cements, using gold crowns cemented onto human dentine. The order of retention of the cements was: 1 Composite (Panavia-Ex, J & S Davis); 2 Glass ionomer. (AquaCem, DeTrey); Glass-ionomer (Ketac-Bond, Cottrell); and Polycarboxylate (Bondalcap, Vivadent); 3 Polycarboxylate (Poly F Plus, DeTrey); Zinc phosphate (DeTrey); and Zinc phosphate (Phosphacap, Vivadent); and 4 Zinc oxide/eugenol, alumina, EBA (Opotow, Teledyne Getz). PMID- 2697039 TI - [The dilemma of the 2d primary molar]. AB - Extensive carious lesions in primary molars often confront the dentist with a dilemma: extraction or restoration. The primary molar constitutes an important element in the development of the dentition. If extraction is considered, the dentist should be aware of the possible risks towards malocclusion or malposition. In order to understand these consequences a brief summary of normal dentition development is given, followed by a description of factors influencing development of dentition after premature extraction of a second primary molar. Premature extraction causes a disturbance in the eruption of the successor and migration of the neighbouring teeth. The eruption of the bicuspid can be delayed or accelerated according to the stage of root formation. The rate, amount and direction of migration depends on the extracted element, time of loss, spacing or crowding, eruption sequence, dental relationship, intercuspation, interaction of soft tissues and dental arch, supra-occlusion and the leeway space. To conclude the treatment modalities of pulp pathologies in primary molars are outlined. In children with deep carious lesions a treatment plan involves the child's medical history and social development as well as orthodontic, preventive and restorative aspects. PMID- 2697040 TI - [Early orthodontic treatment]. AB - Several preventive procedures are recommended for the interception of early malocclusion. Therefore some important characteristics of normal dental development are mentioned. This preventive approach is focused around selected topics as forced bite, midline diastema and retarded eruption. This influence of functional disturbances on dentofacial morphology is discussed. An overview of possible therapy by the general dentist is presented for problems, aroused by thumb- and fingersucking, agenesis of upper lateral and mandibular second premolars as well as early loss of deciduous molars. Finally, the possible indications for serial extractions are examined. PMID- 2697041 TI - [Permanent retention: a justified orthodontic compromise?]. AB - The conditions on which an orthodontic case should be treated to become as stable and as self-retaining as possible are briefly discussed. The correct indications for permanent retention could be found in certain types of malocclusion in which these principles cannot be applied. They are mainly encountered in the treatment of adults and functionally deviating patterns. Moreover, some major problems and disadvantages of permanent lingual retention are mentioned. The terminal responsibility of this procedure towards the referring general practitioner is evaluated and warned for. A short overview of the technical evolution in the field of lingual retention leads to the presentation of a new, more durable modification of the flexible wire system. Some cases treated with this "meshflex retainer" are presented. PMID- 2697042 TI - [Functional appliances. Possibility of correction of a class II malocclusion]. AB - In this article the most common types of functional appliances are briefly presented. This overview might enhance the understanding of functional therapy by the general practitioner. Timing of treatment with functional appliances should be individualized by the occurrence of pubertal growth spurt. The overall clinical effect must be regarded as a combination of skeletal and dento-alveolar changes. Some clinical tips are demonstrated for appropriate application. Indications and contra-indications are generally examined. It definitely can be concluded that functional appliances constitute specific method of therapy among orthodontic corrective procedures for class II malocclusions. PMID- 2697043 TI - [Intrusion of the definitive incisors]. AB - Intrusive luxations make up about 5% of the dental traumata on permanent front teeth. Clinical and radiological findings are described. Practical guidelines are given for the treatment of intruded teeth, with or without completed root formation, based on literature findings and clinical experience. Much attention is given to the question whether one should prefer orthodontic extrusion or choose for surgical reposition followed by immobilisation in cases of intrusive luxation of teeth with closed apices. Clinical cases are presented. PMID- 2697044 TI - Clinical and pathological features of Aspergillus fumigatus infections in poultry in southern Nigeria. AB - This study was undertaken to supply information on Aspergillus fumigatus infection of poultry in Nigeria. The disease in broiler chicks was characterized by gasping, droopiness, emaciation and heavy mortality while affected grower chickens showed emaciation, weakness, diarrhoea and 17 per cent mortality. The disease was sporadic in laying flocks. Granulomatous nodules were observed in birds that died in each outbreak. The nodules were numerous and affected mainly the lungs and thoracic air sacs in the broiler chicks while only few large nodules were observed mainly in the abdominal air sacs in the layers. PMID- 2697045 TI - Intra-uterine growth: a comparison of longitudinal and cross-sectional approaches. AB - The great majority of the fetal growth curves are constructed through a cross sectional approach. Before the use of ultra-sonography, fetal growth was first evaluated from birthweights of infants born at different gestational ages. More recently, curves were established for different ultrasonographic parameters which combination can provide an immediate but imperfect evaluation of fetal weight. All the curves used as standards of normal growth derive from cross-sectional studies. Several longitudinal studies of fetal growth exist, with two aspects. The first method is to make serial measurements at special intervals, among a group of fetuses with known dates of conception, in order to determine average longitudinal curves. The aim of the standards of fetal growth is obstetric management and the threshold of a percentile, for instance the tenth, of an ultra sonographic parameter can define the intra-uterine growth retardation. The result of the fetal growth is evaluated with the standards of birthweight which define the small for gestational age infant. Another longitudinal approach is the use of a mathematical growth model to establish an individual growth curve, each fetus is then its own control. This last approach still belongs to the research field. PMID- 2697046 TI - Mathematical models for the study of individual growth patterns. AB - The analysis of longitudinal growth data requires specific methodological approaches. One of the main goals of longitudinal growth studies is to establish individual growth patterns and to estimate, so-called, biological parameters of the growth curve, such as the timing and intensity of the adolescent growth spurt, for example. These features are providing us with information about the shape of the growth curve, rather than telling us what size is attained at a particular age. A basic technique to establish the continuous growth process from a set of discrete measurements of size in function of age is provided by curve fitting. Various models have been proposed to achieve this goal. They can mainly be subdivided into nonstructural and structural models. This paper deals with a description of some of the most commonly used models in the analysis of human growth data, emphasizing on their applicability in certain age periods and on the merits and limitation of the various approaches. Attention is also paid to a special type of nonstructural models based on longitudinal principal components analysis. PMID- 2697047 TI - Biosocial longitudinal research into antisocial behavior. AB - This paper reviews all longitudinal studies of antisocial and criminal behavior which have employed both biological and social measures. Psychophysiological measures which are particularly important in the prediction of antisocial behavior include reduced frequency of skin conductance orienting responses, poorer skin conductance conditioning, and lower resting heart rate levels. Two general themes emerge from this review. Firstly, where antisociality is of a mild or non-violent form, biological factors predispose to antisociality when the individual has experienced a benign home background. Secondly, where violence or seriously recidivistic crime is concerned, biological factors predispose to such behavior in those who have experienced adverse early rearing conditions. It is argued that this difference between mild and severe antisociality is in part a result of the differential contributions of genetic and perinatal factors to these sub-types of crime. PMID- 2697048 TI - A plasmid-borne virulence region (2.8 kb) from Salmonella typhimurium contains two open reading frames. PMID- 2697049 TI - Nosocomial bacterial pneumonias. AB - Pneumonia is the third most common nosocomial infection and the most difficult to prevent. Fifteen percent of all deaths occurring in hospitals are caused by nosocomial pneumonias. Nosocomial pneumonias prolong hospital stays over 4 days, resulting in at least $3,000 to $5,000 in extra charges per infection. Most cases of nosocomial pneumonias are caused by bacteria, especially gram-negative bacilli. The majority of nosocomial pneumonias appear to result from aspiration of bacteria that have colonized the oropharynx. Additional risk factors include colonization of the oropharynx with gram-negative bacilli, thoracic and upper abdominal surgery, continuous mechanical ventilation, extremes of age, and severity of underlying diseases. Prevention revolves around an effective infection control program, preventing colonization and aspiration, and improving host defense mechanisms. Further research is needed to clarify the role of topical antibiotics and to develop strategies to alter host defenses to prevent or eliminate colonization of gram-negative bacilli. PMID- 2697051 TI - The prevention of severe lower respiratory infections in chronic bronchitis. AB - Chronic bronchitis remains as a serious medical problem for many adults and a smaller proportion of children in the United States. The frequency of severe lower respiratory infections in patients with chronic bronchitis is quite variable. The infectious agents most likely responsible for severe lower respiratory disease include pneumococci, nontypable Haemophilus influenza, Mycoplasma pneumoniae, and Branhamella catarrhalis among the bacteria, and influenza A and B viruses, with parainfluenza and adenoviruses less common. Prophylactic antibiotics, particularly tetracycline and derivatives, were the only drugs suggesting efficacy in controlled trials for decreasing exacerbation, but many studies failed to show efficacy. Killed influenza vaccines should be used annually in any patient with chronic bronchitis. Pneumococcal vaccine has had questionable benefit for bronchitics but should nevertheless be considered for use because of its low cost and proven safety. The antiviral drug amantadine may be useful in bronchitics unable to take influenza vaccines. PMID- 2697050 TI - Nosocomial viral respiratory infections. AB - Nosocomial infections with respiratory tract viruses, particularly influenza and respiratory syncytial viruses, account for the majority of serious nosocomial viral disease. Chronically ill, immunocompromised, elderly, and very young hosts are especially vulnerable to potentially life-threatening involvement of the lower respiratory tract. Effective preventive strategies are based upon early accurate viral diagnosis and an appreciation of the epidemiology and mechanisms of transmission for each viral agent. Influenza viruses spread via airborne dispersion of small particle aerosols, resulting in explosive outbreaks; control measures emphasize immunization and chemoprophylaxis of susceptible patients and personnel, and isolation of those already infected. Transmission of respiratory syncytial virus, in contrast, seems to require closer contact, with virus passed on hands, fomites, or in large droplets inoculated into the eyes and nose at close range. Strategies for control of nosocomial respiratory syncytial virus are designed to interrupt hand carriage and inoculation of virus onto mucous membranes. PMID- 2697052 TI - Pneumococcal vaccine. AB - Pneumococcal infections are common and serious infections, and their control is an important public health priority. A multivalent pneumococcal vaccine was introduced several years ago, but there is still controversy about its effectiveness in United States populations. One randomized controlled study in high-risk veterans did not demonstrate efficacy. The study has been criticized because the case definitions used for pneumococcal infection had uncertain specificity. Two large case control studies done in Pennsylvania and Connecticut hospitals have compared vaccination rates in patients with pneumococcal bacteremia with controls matched for disease severity and age. Bacteremic immunosuppressed patients who were unlikely to have responded to pneumococcal vaccine were excluded. These studies showed vaccine efficacy rates in the 60% to 70% range as did a prospective randomized controlled French trial that used episodes of pneumonia as an end point. Pneumococcal vaccine is effective when given to patients likely to respond immunologically and who are at increased risk from pneumococcal infection. PMID- 2697053 TI - Amantadine and rimantadine for the prevention of influenza A. AB - Influenza is a leading cause of morbidity and mortality in the United States, particularly among persons with cardiac and/or pulmonary disease and those over age 65. Vaccine is effective but not completely protective. Prophylaxis with one of the antivirals, amantadine or rimantadine, has proven efficacy against influenza A virus infections. It should be considered for high-risk patients both in the community and in health care facilities where these subjects are concentrated. Prophylaxis also has potential benefit in the home when an index case of acute influenza has been identified. The dose of drug that is most appropriate is under study. Based on observations made in young patients, it is hoped that rimantadine will be better tolerated by the elderly than has been the case with amantadine. Assessment of efficacy in outbreaks caused by viruses of different antigenic make up and elevation of the significance of drug resistance will be important in judging the true value of prophylaxis of influenza with either of these antivirals. PMID- 2697054 TI - Prophylaxis of Pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus type 1. AB - Immunosuppression due to human immunodeficiency virus type 1 (HIV) infection has led to a marked increase in Pneumocystis carinii pneumonia (PCP). Prophylaxis against PCP is standard practice in pediatric cancer patients but is associated with unique problems in HIV-infected patients, including the need for lifelong therapy, adverse reactions, and drug interactions. HIV-infected patients at highest risk for PCP are those with a prior episode of PCP and/or a CD4 lymphocyte count of less than 200 cells/microL. A combination of trimethoprim and sulfamethoxazole is effective prophylactically, although a significant rate of adverse reactions makes long-term prophylaxis difficult. Other oral medications such as dapsone and a combination of pyrimethamine and sulfadoxine are promising but not yet adequately tested. Inhalation of aerosolized pentamidine is an effective and safe means of prophylaxis if the proper dose and nebulizer are used. The only common adverse effects with the latter are airway irritation manifested by cough or wheezing. Zidovudine appears to have a synergistic benefit in further reducing the attack rate of PCP when used with aerosolized pentamidine. PMID- 2697055 TI - Prevention of tuberculosis. AB - Tuberculosis (TB) continues to be a major cause of morbidity and mortality throughout the world. One billion people are infected with the tubercle bacillus, and there are 8 million new cases and 3 million deaths annually. Existing methods of preventing TB are effective, but due to economic and societal constraints, have not been applied throughout the world. Examples of primary prevention include case management and contact investigation, environmental control and vaccination. Secondary prevention is achieved by chemotherapy. The efficiency and use of these various methods will be reviewed, and areas for future study will be discussed. PMID- 2697057 TI - Nutritional aspects of wound healing. PMID- 2697056 TI - Wound healing: an overview. PMID- 2697058 TI - The healing of open wounds. PMID- 2697059 TI - The effects of dressings and bandages on wound healing. PMID- 2697060 TI - The effects of cancer and cancer therapies on wound healing. AB - Based on experimental evidence in rodents, most of the antineoplastic agents will affect wound healing. With most of the agents, this impairment is not sufficient to produce increased morbidity based on the clinical reports in humans. Radiation therapy appears to inhibit healing in both experimental animals and during clinical trials. In spite of this, it is reported that wounds in animals will heal when they are receiving radiation therapy after surgery. Based on the information presented here and experience at the University of Missouri, the decision to use adjuvant therapy should depend on the surgery performed. With a single incision that had no increased tension, there should be no hesitation to use adjuvant therapy. If removal of the tumor required reconstructive surgery, no radiation or chemotherapy should be used until the wound has healed. PMID- 2697061 TI - Wound healing in the gastrointestinal tract. PMID- 2697062 TI - Wound healing in the urinary tract. PMID- 2697063 TI - Healing of muscle, ligaments, and tendons. AB - The function of muscle, tendons, and ligaments is to transmit tensile forces. Healing by scar tissue compromises this function because scar tissue is weaker and more elastic than the tissue it replaces. First intention healing is promoted by suturing with strong, inelastic materials (eg, monofilament nylon, polyesters, etc) in a locking loop or three-loop pulley pattern to prevent gap formation, maintain vascularity, and decrease adhesions. Postoperative care should include restriction of active motion to avoid rerupture or gap formation across the suture line during tensile loading. However, immobilization for 6 weeks results in a wound with approximately 50% the normal tensile strength for tendons and ligaments and "significant weakening" of muscles. Earlier tension across a muscle, ligament, or tendon wound orients the healing fibers and results in stronger healing. For example, medial collateral ligaments of canine stifles sutured with polyester suture in a locking loop pattern and immobilized for 3 weeks, followed by active motion, resulted in valgus-varus laxity 1.5 times of controls and in strength, 92% that of controls. In comparison, 6 weeks of immobilization resulted in valgus-varus laxity three times that of controls and in strength, 14% that of controls. Canine tendons immobilized for 3 to 6 weeks after surgery also have sufficient strength to allow active motion. Current knowledge of healing muscle, tendons, and ligaments suggests that postoperative immobilization for 3 weeks will allow acceptable return to function while minimizing the risk of rerupture. However, the amount and type of exercise allowed immediately after immobilization devices are removed should be severely limited, and increased gradually as time passes. PMID- 2697064 TI - Bone healing. AB - Bone is a tissue composed of organic (cells and matrix) and inorganic (mineral) components. When the mechanical strength of bone is exceeded, fracture occurs. Healing progresses through inflammatory, reparative, and remodeling phases similar to other tissues, but, unlike other tissues, bone possesses the unique capability to completely regenerate and return to pre-injury strength. The bone healing process is influenced by many factors, including mechanical stress, biochemical mediators, bioelectric and piezoelectric properties, and neural and endocrine influences. In short, any factor capable of altering the metabolism of osteogenic cells can influence bone healing. PMID- 2697065 TI - Stereotactic aqua stream and aspirator for hypertensive intracerebral hematoma. AB - The stereotactic aqua stream and aspirator (SAS & A) is a modification of the aqua stream and aspirator (AS & A) designed for stereotactic evacuation of intracerebral hematoma. The needle of the new instrument is inserted into the brain through a burr hole by a conventional stereotactic technique and its tip is directed to the center of the hematoma. The hematoma is broken up with a stream of saline solution from a nozzle. Fragments of clot and fluid can then be aspirated piecemeal through the suction tube. The postoperative CT images show successful evacuation of the hematoma, and the clinical evaluation also showed satisfactory results. This instrument can be used safely, without any complications, early after the stroke. PMID- 2697066 TI - [Jude Turiaf]. PMID- 2697067 TI - Cellular control of renin secretion. PMID- 2697068 TI - Transferrin as a muscle trophic factor. AB - Muscle cells grow by proliferation and protein accumulation. During the initial stages of development the participation of nerves is not always required. Myoblasts and satellite cells proliferate, fusing to form myotubes which further differentiate to muscle fibers. Myotubes and muscle fibers grow by protein accumulation and fusion with other myogenic cells. Muscle fibers finally reach a quasi-steady state which is then maintained for a long period. The mechanism of maintenance is not well understood. However, it is clear that protein metabolism plays a paramount role. The role played by satellite cells in the maintenance of muscle fibers is not known. Growth and maintenance of muscle cells are under the influence of various tissues and substances. Among them are Tf and the motor nerve, the former being the main object of this review and essential for both DNA and protein synthesis. Two sources of Tf have been proposed, i.e., the motor nerve and the tissue fluid. The first proposal is that the nervous trophic influence on muscle cells is mediated by Tf which is released from the nerve terminals. In this model, the sole source of Tf which is donated to muscle cells should be the nerve, and Tf should not be provided for muscle fiber at sites other than the synaptic region; otherwise, denervation atrophy would not occur, since Tf provided from TfR located at another site would cancel the effect of denervation. The second proposal is that Tf is provided from tissue fluid. This implies that an adequate amount of Tf is transferred from serum to tissue fluid; in this case TfR may be distributed over the entire surface of the cells. The trophic effects of the motor neuron have been studied in vivo, but its effects of myoblast proliferation have not been determined. There are few experiments on its effects on myotubes. Most work has been made on muscle fibers, where innervation is absolutely required for their maintenance. Without it, muscle fibers atrophy, although they do not degenerate. In contrast, almost all the work on Tf has been performed in vitro. Its effects on myoblast proliferation and myotube growth and maintenance have been established; myotubes degenerate following Tf removal. But its effects on mature muscle fibers in vivo are not well understood. Muscle fibers possess TfR all over on their cell surface and contain a variety of Fe binding proteins, such as myoglobin. It is entirely plausible that muscle fibers require an amount of Tf, and that this is provided by TfR scattered on the cell surface.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697069 TI - [Brazilian purpuric fever. Fast characterization of invasive strains of Haemophilus aegyptius]. AB - Strains of H. aegyptius isolated during outbreak of Brazilian Purpuric Fever (BPF) in Brazil were characterized antigenically by slide agglutination test utilizing antiserum produced with a H. aegyptius strain isolated from blood culture from a patient with BPF. By means of this method, it were identified H. aegyptius strains responsible for outbreaks of conjunctivitis with identical antigenic characteristics to strains isolated from BPF. The sensitivity and specificity of slide seroagglutination test was 97.7% and 89.6% respectively; therefore this assay was efficient to be used as a screening method in the studies of purulent conjunctivitis for detecting high risk populations for BPF, and to implement measures that will increase the efficiency of epidemiologic surveillance. PMID- 2697070 TI - [Human hydatidosis: field echography for the determination of groups at high risk in the evaluation of a control program]. AB - The development of small ultrasonographic equipment has permitted to incorporate this technique to the methods of early detection of Human Hydatidosis. 689 echographies were carried out in this experience, and 5.51% of compatible images in the whole population, and 12.24% in groups of risk (those living together with the operated ones) were found. It was observed a significant decrease in the infection percentages in man in the whole population of areas under Control Program, using the echographic screening. In conclusion, echography might be incorporated to the epidemiologic surveillance system of human Hydatidosis. PMID- 2697071 TI - Erysipelothrix endocarditis with previous cutaneous lesion: report of a case and review of the literature. AB - This report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis. PMID- 2697073 TI - Laboratory procedures for: placement of the prefabricated Thompson dowel rest for distal extension removable partial dentures. PMID- 2697072 TI - Posterior palatal seal additions. PMID- 2697074 TI - Simple accurate crown temporization. PMID- 2697075 TI - Implant bridges using the castable telescopic screw attachment. PMID- 2697076 TI - A glossary of attachment terms. PMID- 2697078 TI - Periodontally- and tooth-friendly attachments. PMID- 2697077 TI - Adaptation of new vacuum-pressure denture processing system to dental implant fabrication. PMID- 2697079 TI - Dental porcelain alloys: a review. PMID- 2697080 TI - Nonparallel bridge following bone resorption. PMID- 2697081 TI - Biomedical principles in the design of crowns for removable partial dentures. PMID- 2697082 TI - [Acute leukemias in humans. I. Definition, etiology, and pathogenesis of acute leukemias. Classification of acute myeloid leukemia]. AB - The present knowledge of acute leukaemias is critically reviewed. Acute leukaemias are clonal malignant neoplastic diseases which do not originate from transformation of totipotent haematopoietic stem cells, but of progenitors committed to myeloid, T-lymphatic or B-lymphatic differentiation lines. The transforming event seems to be associated with a nonrandom aberrant DNA rearrangement. Although leukaemic population is clonal, originating from a single cell, it exhibits phenotypic, and sometimes even karyotype heterogeneity. In the proposed human acute leukaemias classification leukaemic cells are allocated to a particular differentiation cell line on the basis of a positive finding of the lineage specific differentiation marker. Criteria for common types of acute myeloid leukaemias are described and possible existence of several other types is discussed. PMID- 2697083 TI - Safety of ketoprofen in the elderly: a prospective study on 20,000 patients. AB - Safety is a major concern in drug therapy in the elderly. NSAIDs are often used in the elderly and may induce side-effects. With a view to monitor the safety profile of ketoprofen, 19,880 patients greater than 60 years of age were enrolled in a large scale open study. They received a 200 mg sustained release tablet once a-day for one month, in almost all cases for osteoarthritis. Patients mean age was 72.2 +/- 6.7 years. At the end of treatment, overall efficacy was rated as excellent or good in 70.7% of cases by patients and 74.2% by physicians. Tolerability was judged excellent: 60.8%; good: 24.0%; moderate: 8.7%; and poor: 5.1%. Side-effects related to ketoprofen occurred in 15.3% of patients and led to withdrawal in 4.5%. The most frequent side-effects were related to the G.I. tract (13.5% of total patients). Severe G.I. side-effects (ulcer, melena) occurred in 0.03%. Skin side-effects occurred in 0.7% and were always benign. No relationship was found between the incidence of side-effects and age or dosing time. In contrast, a higher incidence of side-effects was demonstrated in women, in case of associated disorders or concomitant therapy and in patients previously treated with other NSAIDs. In conclusion, in this very large population of elderly patients, ketoprofen had a good risk/benefit ratio. PMID- 2697084 TI - [A simple vibratome for brain slice]. AB - A simple vibratome was fabricated using double-function electric shaver and microscopic platform. Spontaneous discharge of neurons in hippocampal and hypothalamic brain slices (in 300-400 microns thick) prepared by the vibratome could kept above 12 hours in artificial cerebro-spinal fluid. PMID- 2697085 TI - [A statistical study of autopsies performed on cases of oral cancer: with reference to distant metastasis in tongue cancer]. AB - 1. A statistical survey of oral-cancer (tongue, maxilla, and mandible) patients on which autopsies were performed by the 2nd. Department of Pathology of Tokyo Dental College from 1964 to 1987 was carried out. Of a total of 18 autopsies in cases in which death resulted from tongue carcinoma, 11 subjects were male and 7 female. Average age was 63.4 years. This cancer occurred most frequently in individuals in the age group of 60 to 69 years. The lung was the most common (50%) site of distant organic metastasis; the next most common sites were the liver, the thyroid gland, and the diaphragm (11.1% each). Submandibular and cervical lymph nodes were the most common sites of lymphatic metastasis in cases of tongue cancer. These data were similar to those in previous reports. 2. An autopsy on a 57-year-old man who died of tongue cancer revealed a number of distant metastases in both organs and lymph nodes were reported. 3. The report includes a review of literature on distant metastasis in cases of tongue cancer. PMID- 2697086 TI - [Investigation of etching and bonding on the inner surface of free enamel. SEM observation and thermal cycling test for pigment invasion]. AB - The purpose of this study is to examine adhesive condition on the inner surface of free enamel. If it was possible to use an adhesive composite resin to reinforce free enamel, it would be unnecessary to remove the free enamel entirely. To this study, we have used a visible light-cured and adhesive composite resin for the inner surface of free enamel. At the first, we carried out SEM examination of adhesive condition on the inner surface of free enamel. Then we performed thermal cycling test for pigment invasion. Results 1. SEM observation found tag-like extensions on the inner surface of free enamel. These extensions were of 2 shapes: horseshoe and beehive. 2. Thermal cycling test for pigment invasion showed practically no difference in marginal leakage between the experimental free-enamel cavities and control box cavities. 3. As a result of observation of adhesive conditions on the inner surface of free enamel, we believe that a certain degree of reinforcement of that enamel can be expected from composite resin. PMID- 2697087 TI - [Actual problems of diabetes mellitus]. PMID- 2697088 TI - [Rapid methods of detection of bacteria in the bile]. AB - Rapid methods are described for assessing the bacterial contamination, using direct phase-contrast microscopy, triphenyltetrazolium chloride (TTC) test, and a standard loop 3 mm in diameter, or by the detection of the biliary 'active' leukocytes and the microflora sensitivity to antibacterial drugs with the use of the TTC test and turbidimetric technique. These methods permit getting an answer in 4-24 hrs, are simple, and do not require special bacteriologic equipment, this recommending them for routine clinical studies. PMID- 2697089 TI - [Perforated diverticulitis of the colon]. PMID- 2697090 TI - [The role of minipress in hypertension]. PMID- 2697091 TI - [Treatment of erosive-ulcerative lesions of the upper segments of the gastrointestinal tract in decompensated liver cirrhosis]. PMID- 2697092 TI - [Effect of calcium gluconate on pancreatic function in chronic pancreatitis]. PMID- 2697093 TI - [Evaluation of the effectiveness of cytoprotective drugs in the treatment of duodenal ulcer]. PMID- 2697094 TI - [A bio-psycho-social approach to acute hypertensive disease in pregnancy]. AB - In this paper, the approach to the genesis of the acute hypertension of pregnancy, uses a conceptual and methodological perspective adjusted to its multifactorial nature; a set of questions with epidemiologic focus is proposed, in order to vinculate psychosocial factors with the biologic processes characteristic of this health problem. PMID- 2697095 TI - [Immunoenzymatic evaluation of serum IgE in onchocerciasis in Chiapas, Mexico]. AB - Concentrations of total serum IgE were measured by an immunoenzymatic assay (Phadezym-PRIST) in 60 mexican onchocerciasis patients. In order to detect IgE antibodies against adult Onchocerca volvulus antigens, separately six onchocerciasis sera were depleted of IgE antibodies by using a mixture of Onchocerca gutturosa, Ascaris suum and Fasciola hepatica antigenic extracts coupled with sepharose 4B. Additionally, the sera were incubated with an adult O. volvulus antigenic extract coupled with sepharose 4B. The differences found between the IgE levels before and after incubation with heterologous antigens show that the median IgE value against O. volvulus adults antigens varies between 20 and 65 percent of the total serum IgE. PMID- 2697096 TI - [Organ transplantation as a health priority in developing countries]. AB - The epidemiology profile of developing countries is in transition. While the prevalence of infectious and preventable diseases, malnutrition, and in general the health problems traditionally associated to the poor, is still high, the characteristic health profile of industrialized countries (i.e. chronic and degenerative diseases, accidents, violence, social pathology) is beginning to surface. This paper focuses on the need to consider organ transplantation as a health priority in developing countries, as an important element in the global strategy to cover both aspects of the health care demand. PMID- 2697097 TI - [Dilemmas of health financing]. AB - The economic crisis had had a profound effect on the finances of health services in Mexico. The expenditure on health has decreased, both in absolute terms and in relation to the national gross product. Funding problems have been aggravated by inequities in budget distribution: social security institutions have been favored; geographical distribution of resources is concentrated in the central areas of the country and in the more developed states, and curative health care has prevailed over preventive medicine. Administrative inefficiency hinders even more the appropriate utilization of resources. Diversification of funding sources has been proposed, through external debt, local funding, and specific health taxing. But these proposals are questionable. The high cost of the debt service has reduced international credits as a source of financing. Resource concentration at the federal level, and the different compromises related to the economic solidarity pact have also diminished the potentiality of local state financing. On the other hand, a special health tax is not viable within the current fiscal framework. The alternatives are a better budget planning, a change in the institutional and regional distribution of resources, and improvement in the administrative mechanisms of funding. PMID- 2697098 TI - [Anopheles pseudopunctipennis and its relation to malaria in the Mexican republic. 1931]. PMID- 2697099 TI - Posterior composite restorations: a review of the literature. PMID- 2697100 TI - Cementifying fibroma of the right maxilla. PMID- 2697101 TI - Technique to disguise the metal margin of the metal/ceramic crown. AB - When it is necessary to place casting margins subgingivally, it is important that they not violate the biologic width. A technique utilizing nonmedicated retraction cord during preparation is described which has several advantages. It results in bloodless, trauma-free tooth preparation and concealment of the metal margin without biologic width impingement or gingival recession. A resilient, unattached gingival margin free of inflammation is critical for the success of this technique. The physical and chemical properties of healthy gingival collagen and ground substance are briefly discussed along with the disadvantages of using this technique in the presence of gingival inflammation. PMID- 2697102 TI - Developmental toxicity of urethan. PMID- 2697103 TI - [Surgical sutures--survey and recommendations for application to stomatology]. AB - The stomatologue is supposed to apply with his every day's practice surgical suture material in case of need according to indication. Placing numerous, novel materials at disposal, the knowledge of biological and physical parameters of materials that can be applied sometimes cannot suffice. The survey is aimed at orientation on the selection and recommendation of the suited suture materials. PMID- 2697104 TI - Traveler's diarrhea-I. Definition, etiology and epidemiology. AB - With the development of rapid and convenient means of transportation, several million persons travel from industrialized countries to developing countries every year. From USA alone, approximately 4 million persons visit Mexico annually. These travelers are at risk to develop several infections during their stay abroad, but the most commonly experienced illness is diarrhea. The attack rate of diarrhea in travelers may be as high as 25 to 50 percent; 30 percent of those who get diarrhea are ill enough to be confined to bed and another 40% have to change their scheduled travel plans. The disease affects all ranks and it has achieved worldwide fame by its several euphemisms. Various epithets used to describe this illness include GI trots, Aden gut, Barsa belly, Turkey trot, Delhi belly, Hongkong dog, Montezuma's revenge, gyppsy tummy and turista. There have been considerable advances in our understanding about the etiology and epidemiology of this disease in the last two decades and the purpose of this review is to highlight some of this new information. PMID- 2697105 TI - Intrahepatic biliary lithiasis: its findings and current problems. PMID- 2697106 TI - Carcinoma oesophagus in a 14 year old child: report of a case and review of literature. AB - A 14 year old boy with well differentiated squamous cell carcinoma of the upper oesophagus is being presented because of its rarity. The patient presented with dysphagia for 8 months. Barium swallow and endoscopy revealed a narrowing in the upper oesophagus with a proximal dilatation diverticulum. No definite aetiologic factor could be demonstrated. The case was treated with definitive irradiation with excellent immediate response. PMID- 2697107 TI - [A dynamic fitness test and a new method to measure the thickness of film using the digital subtraction system of X-ray photographic density]. AB - It is impossible to show the dynamic fitness conditions of a denture base using White Silicone or other fitness test materials. In the present paper, materials and the measuring method for the dynamic fitness test were investigated. In order to choose the suitable materials for the dynamic fitness test, various kinds of ready made materials, such as wax or dynamic impression materials, were examined by load test and investigated the change on standing of flow character. EXPERIMENTAL WAX was made for dynamic fitness test, and was examined by load test and clinical test. EXPERIMENTAL WAX consists of DISCLOSING WAX (KERR), as a basic material, and the contrast medium. Extending the system of the conventional measuring method for White Silicone, DIGITAL SUBTRACTION SYSTEM (DSS) was developed as a new method of quantitative analysis for the thickness of wax film. In this system, thickness of wax film is measured from the X-ray photographic density and it's digital subtraction management. Accuracy of this system was also investigated. The summary of results is shown below. 1. It became evident that ready made materials had no useful characters for the dynamic fitness test. 2. EXPERIMENTAL WAX showed similar load effects with White Silicone when the load was 5 or 10kg. 3. Dynamic fitness and the mobility of the denture base during function were able to be shown by EXPERIMENTAL WAX, but it's operation was more complicated than White Silicone. 4. DIGITAL SUBTRACTION SYSTEM (DSS), a new method of quantitative analysis for the thickness of wax film, was developed. 5. Resolving power and measuring range of DSS were effected by quantity of subtraction. 6. DSS is not only useful to measure the thickness of EXPERIMENTAL WAX, but also has wide applications. PMID- 2697109 TI - Bibliography of biomedical ultrasound. 1986. PMID- 2697108 TI - Antibodies to mycobacteria in healthy and tuberculous badgers from two English counties. AB - Sera obtained from 2 groups of badgers removed in bovine tuberculosis control operations have been examined for antibodies to 11 species of mycobacteria. From animals without post mortem evidence of tuberculosis, levels of antibodies to mycobacteria were found to increase with age, and different patterns of antibodies were found in animals coming from 2 different places. Some animals (5 out of 60) without evidence of progressive infection had antibodies suggesting contact with tubercle bacilli. Animals found to have tuberculosis at post mortem had increased levels of antibody to common mycobacterial antigen, as do humans with that disease. Only 2 of the 12 tuberculous animals had markedly more antibody binding to Tuberculin than to the other reagents. There was no evidence of greater specificity of antibody binding than was shown by sera of healthy badgers. The suggestion is made that contact with environmental mycobacteria might be a major factor determining distribution of tuberculosis amongst badgers. PMID- 2697110 TI - Reference list of biomedical and clinical publications. Uppsala 1988. PMID- 2697111 TI - Development of inhibitors of pyrimidine metabolism. AB - Benzylacyclouridines were developed as specific and potent competitive inhibitors of uridine phosphorylase with Ki values in the nanomolar range. These compounds have no activity against thymidine phosphorylase, uridine kinase, thymidine kinase and orotate phosphoribosyltransferase. Benzylacyclouridines potentiate the chemotherapeutic effect of FdUrd. Coadministration of uridine phosphorylase inhibitor with FdUrd caused selective toxicity against tumors with low or no thymidine phosphorylase, but not against the host tissues which have thymidine phosphorylase, and thus retain the capacity to cleave FdUrd, and hence overcome its toxicity. There are distinct differences between uridine phosphorylase and thymidine phosphorylase. Benzylacyclouridines competitively inhibit the nucleoside transport of mammalian cells. The structure-activity relationship of inhibitors of uridine phosphorylase showed that a large hydrophobic pocket exists where C-5 of uracil binds, and that it is necessary to have the 3'-hydroxyl group and syn-configuration around the N-glycosidic bond for the nucleosides or their analogs to bind. Dihydrouracil dehydrogenase was found to be widely distributed among mammalian cells, where it was previously believed to be present only in the liver and the kidney. The structure-activity relationship of its inhibitors revealed benzyloxybenzyluracil and 2,6-pyridinediol as most potent. Also identified for orotate phosphoribosyltransferase was 2,4-pyridinediol. PMID- 2697112 TI - Exogenous surfactant replacement therapy of hyaline membrane disease in premature infants. AB - We conducted a clinical trial to assess whether surfactant-TA given within the first six hours of life could improve oxygenation and reduce the ventilatory support in premature infants with hyaline membrane disease (HMD) during the first 24 hours of life. Eight premature infants with severe HMD requiring ventilation were treated, at a mean age of 2.72 hours, with a single intratracheal instillation of surfactant-TA (120 mg/kg). Arterial oxygenation improved dramatically as reflected by the increase of the a/A PO2 ratio and PaO2 to about 2 times the pretreatment values within 3 hours after surfactant treatment. And thus, oxygen concentrations (FiO2) could be reduced and remained significantly lower than pretreatment values during the first 24 hours after treatment. Infants given surfactant-TA required lower mean airway pressure (MAP) and had a significantly decreased ventilatory index (VI) during the first 24 hours after treatment, which reflect the decreased requirement for ventilatory support. Chest radiograph scores significantly improved within 24 hours after treatment compared with pretreatment scores. In this trial, we found that a single intratracheal dose of surfactant-TA given to infants with HMD resulted in improved respiratory status and radiographic findings during the first 24 hours after treatment. PMID- 2697113 TI - Pilar sheath acanthoma--report of a case with review of the literature. AB - A 52-year-old male presented with a solitary asymptomatic, skin-colored nodule with a central pore on the skin of the left cheek of one year duration. An excisional biopsy was performed. The skin biopsy finding showed the typical histological picture of pilar sheath acanthoma. A description of the lesion and a review of the literature are given. PMID- 2697114 TI - [Synopsis of the results of some studies of the pathogenesis and clinical aspects of chronic gastritis in relation to stomach ulcer]. AB - A review is given of our own results concerning gastric mucosa biopsy and gastritis classification. Moreover, results regarding the gastritis-induced influence upon the gastric mucosa barrier in the form of histotopochemical investigations of gastric mucus substances are briefly presented. By means of measurements of gastric motility (own method of evaluation), the results of the influence upon gastric motility in atrophic antrum gastritis are discussed. PMID- 2697115 TI - [Lysozyme and lactoferrin in normal and inflammatory changes of the gastric mucosa]. AB - A total of 238 randomly selected gastric biopsies were examined with polyclonal antibodies from rabbits (antihuman-lysozyme and antihuman-lactoferrin) using the Peroxidase-Antiperoxidase-method according to Sternberger. The preparations were evaluated by comparing the intensity of the staining as well as the quantity and distribution of positive cells within the mucosa. The results show that lysozyme can be demonstrated constantly in the glandular neck zone and in the mucoid glandular body within the normal non-inflamed mucosa of the antrum, whereas in the normal corpus mucosa only a small amount of lysozyme appears focally and inconsistently in the neck area of the glands. A substantial increase in the intensity of lysozyme presentation due to inflammatory changes as related to the chronic superficial gastritis of the antrum cannot be discovered. On the contrary, the presentable amount of lysozyme decreases in line with the progressing inflammation and, in case of chronic-atrophic gastritis with intestinal metaplasia is restricted to the Paneth cells. A distinct and constant presentation of lysozyme can be achieved in the glandular neck zone, in the lower gastric pits and partially in the upper glandular body of the corpus mucosa in cases of chronic inflammatory processes. Obviously lysozyme is formed in the epithelial cells and not taken up from other cells. Furthermore it can be concluded from the findings that to a large extent lysozyme formation is linked to the proliferation activity of the epithelial cells. Lactoferrin cannot be found in normal non-inflammatory mucosa neither of the antrum nor of the corpus. But it can be found among most of the biopsy specimens with inflammatory changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697116 TI - [Ranitidine protects the human stomach and duodenal mucosa against low-dose acetylsalicylic acid]. AB - In a randomized double-blind study the gastroduodenal tolerability of 300 mg ASS daily has been evaluated in the presence of 150 mg ranitidine bid or placebo in 20 healthy volunteers using upper GI-endoscopy. The treatment period lasted 14 days. Endoscopic controls were performed at entry, and repeated at day 7 and day 14. At entry, the mean endoscopic score averaged 0.8 +/- 0.1 in the ASS/placebo group and 1.0 +/- 0.0 in the ASS/ranitidine group. 300 mg ASS daily induced in the placebo experiments marked gastroduodenal alterations both at day 7 and day 14 (4.7 +/- 1.2 and 6.5 +/- 2.1, respectively). Concomitant administration of 150 mg ranitidine bid afforded almost full protection against 300 mg ASS daily both on day 7 and day 14 (1.9 +/- 0.6 and 2.1 +/- 0.8, respectively) (p less than 0.05). Our data suggest that coadministration of ranitidine 150 mg bid reduces almost completely gastroduodenal lesions evoked by acetylsalicylic acid 300 mg daily. PMID- 2697117 TI - [Somatostatin in ulcer hemorrhage?]. PMID- 2697118 TI - Prof. Ambrus Abraham (1893-1989). PMID- 2697119 TI - TMJ internal derangement and arthrosis, 1985. PMID- 2697120 TI - Lasers in periodontics: a review of the literature and a preliminary report using the portable carbon dioxide laser in gingival surgery. PMID- 2697121 TI - HLA and disease in Oceania. AB - HLA-A, -B and -DR gene frequency distributions in populations of Australia, Melanesia, Micronesia and Polynesia are examined in relationship to known HLA and disease associations in other populations. With the exception of a correlation between Reiter's syndrome and B27, other HLA and disease associations are markedly absent. Recombinant DNA and cellular subtyping analyses suggest that the HLA-DR subtypes predominating in susceptibility to several autoimmune disorders in Caucasoids are rare in Oceania. The high frequency of serum complement component C4A deficiency in Australian Aborigines may explain the high prevalence of systemic lupus erythematosus in this group. PMID- 2697122 TI - The genetic basis of hyperreactive malarious splenomegaly. AB - Hyperreactive malarious splenomegaly (HMS) represents an abnormal immune response to recurrent malaria, characterized by excessive production of both IgM and IgG antibodies. It has both a racial and a familial distribution in various parts of the world. Immune responses to many foreign antigens, including those of malaria, are under genetic control of the major histocompatibility locus (MHC), through the influence of HLA antigens on regulatory T-lymphocyte activity. It is therefore likely that this region also contains the genetic determinants for HMS, which would be reflected in associations between HMS and particular HLA antigens or haplotypes. Genetic studies of the Watut people of Papua New Guinea have not shown any association between HMS and a wide range of red cell and serum polymorphisms. However, HMS in this group is associated with the class II HLA antigen DR2, and with high levels of HLA heterozygosity. Formal genetic analysis of family data also points to a sex-linked gene as a further determinant of overresponsiveness to malaria in the Anga. These findings suggest that more than one genetic system may be involved in the development of HMS, and that the combined effects of several genetic determinants may be responsible for the extraordinarily high frequency of HMS found in the Upper Watut Valley. PMID- 2697123 TI - HLA heterozygosity and hyperreactive malarious splenomegaly in the Upper Watut Valley of Papua New Guinea. AB - Hyperreactive malarious splenomegaly (HMS) represents an abnormal immune response to recurrent malarial infection. In the Upper Watut Valley of Papua New Guinea, where over 80% of adult inhabitants are known to develop the disease, human leucocyte antigen (HLA) studies have demonstrated an association between the antigen DR2 and gross splenomegaly. To test the hypothesis that the magnitude of the individual immune response to malaria is also influenced by the number of different HLA antigens present, we have studied the correlation of the level of observed heterozygosity at HLA-A, -B, -C and -DR loci with the degree of splenomegaly in adult Watut subjects. Heterozygosity per se provides additional antigens for the formation of complexes between HLA and foreign antigenic epitopes, considered crucial to mounting an immune response. Multiply heterozygous individuals were found to exhibit more intense immune responses to recurrent malarial infections than did individuals with low multiple-locus heterozygosity. On the basis of the analysis presented here, we suggest that the degree of immune response to malaria is also influenced by the level of HLA heterozygosity, although the exact mechanisms remain unclear. PMID- 2697124 TI - [Concerns with adhesive bridges--report of an experiment]. AB - In the dental hospital Munster 25 adhesive bridges have been incorporated for the last two years by the Silicoater method, which has been developed by Kulzer with the assistance of Musil and Tiller. All 25 bridges were still in situ at the recall. In the text above this practicable method is explained and compared to the conventional procedures. PMID- 2697125 TI - [Realtime sonography]. AB - Between March 1985 and March 1988 109 patients with tumours of the oral cavity and the oropharyngeal region underwent 123 examinations by orthopantomography and realtime sonography for primary staging and/or diagnosis of a recurrent disease. In 105 cases the preoperative results could be compared to intraoperative and histopathological findings. Realtime sonography as a noninvasive, inexpensive and efficient method offered the ideal diagnostic adjunct to the orthopantomogram. Not only size, shape and structure of the soft tissue tumour could be accurately defined; whatsmore it was possible to demonstrate its relation to bony structures and to a high degree of sensitivity cortical invasion and periosteal reaction. The limitations of the method especially the risk of false positive findings after invasive diagnostic and therapeutic procedures are pointed out. PMID- 2697126 TI - [Today's position on etiology and pathogenesis of periodontal diseases]. AB - Page and Schroeder (1982) introduced a preliminary classification of the marginal periodontitis. Destructive forms like prepubertal, juvenile and rapidly progressive periodontitis seem to be associated with functionally defects of the leucocytes and monocytes. Some authors assign these different forms a specific subgingival microflora, although is seems to be too early, to name single microorganism as causative bacteria for different forms of marginal periodontitis. The destruction of the marginal periodontium during acute bursts might also be caused be an imbalance between the host response and the composition of the subgingival microflora. PMID- 2697127 TI - [Demands for quality and planning standards for model casting]. PMID- 2697128 TI - [Relining prostheses]. PMID- 2697129 TI - Isolated cochlea preparation for the study of cellular vibrations and motility. PMID- 2697130 TI - [The incidence of tumors of the nasal cavity and the paranasal sinuses in the district of Biella, 1970-1986]. AB - The district of Biella in Piedmont (NW Italy) has one of the largest concentrations of the textile industry in Italy, traditionally manufacturing high quality wools. The present paper describes a survey of primitive cancers of the nasal fossae and paranasal sinuses diagnosed among residents of this area from 1970 to 1986. This study is a preliminary step in a case-control study aimed at investigating the association with occupational exposure in the textile industry. Seven cases were diagnosed in the 1970-75 period and 25 in the following ten years 1976-1986. The cut-off point corresponds to the year when the Hospital Admission and Discharge Registry became operative in Piedmont and Lombardy. The 1970-75 annual incidence rates (X 100,000, world standardized) were 0.5 both among males and females. Corresponding figures in 1976-86 were 1.2 and 0.2. Out of 32 cases, 16 were adenocarcinomas or adenoid-cystic carcinomas. Eleven cases are reported in the clinical record as wood or leather workers and seven as textile workers. Occupation was not reported for six cases. A case-control study is in progress. PMID- 2697131 TI - Anxiety syndromes in childhood and adolescence. AB - Anxieties are very widespread in children and adolescents, they only rarely to lead to the need for medical care. Physiological anxieties as phenomena dependent on maturity are differentiated from anxiety syndromes typical to age according to the degree of severity or the persistence of the signs and symptoms. Typical forms of age-typical syndromes are fear of separation, childish phobias, anxiety syndromes with shyness, going into one's shell, avoidance behaviour as well as school phobias. These confront the generalized anxiety disorders and the phobias as anxiety syndromes, which occur in children, adolescents and adults. The various anxiety syndromes were discussed in this order, information concerning anxiety symptomatology in the framework of depressive syndromes and other psychiatric illnesses in children and young people are to follow. Besides descriptions of the signs and symptoms, in particular concerning differential diagnosis and ..reflections are described. PMID- 2697132 TI - [Evaluation of disorders of portal and total hepatic blood flow in patients with chronic diffuse liver diseases]. AB - The total hepatic blood flow measured with radioactive colloidal gold and the portal blood flow with the echo-Doppler method were investigated in 19 healthy examinees and 63 patients with chronic diffuse liver diseases. In the group of healthy examinees, the average values of the total hepatic blood flow was 1254 +/ 231 ml/min and of the portal one 1104 +/- 227 ml/min. The lowest blood flow values were obtained in patients with decompensated cirrhosis, especially in the hepatic (704 +/- 186 ml/min) and the portal blood flow (562 +/- 198 ml/min). In all the groups of examinees, registered values of the total hepatic blood flow were significantly higher than the values of the portal blood flow. The relations of the values obtained by both methods, among groups, were similar. By both methods decreased values are not obtained in liver steatosis and chronic persistent hepatitis in relation to the normal values. In patients with more serious forms of chronic diffuse liver diseases (cirrhosis and chronic active hepatitis) significantly lower blood flow values than the normal ones were obtained. Both methods contribute to the investigation of liver circulation disturbances, liver function damages, and to the follow-up of the liver disease course. The possibility of an indirect evaluation of the arterial hepatic blood flow from the difference of hepatic and portal blood flows may mean a new approach to the investigation of pathophysiological liver occurrences. PMID- 2697133 TI - Doppler flow velocity in assessment of peripheral arterial disease in the lower limbs. AB - In 74 patients with the chronic obliterative arterial disease of the lower limbs, the systolic perfusion pressure and the ankle systolic pressure index were measured using CW-Doppler ultrasound on the dorsalis pedis and posterior tibial arteries. At the same time Doppler flow velocity recordings were made at the femoral, popliteal and pedal levels. Peak foreward velocity and peak reverse velocity were measured directly from the tracing, while blood acceleration and deceleration as well as the acceleration/deceleration index were calculated using simple arithmetics. Patients with obliterative arterial disease had a significantly lower systolic pressure and ankle systolic pressure index in both pedal arteries than healthy volunteers constituting the control group. Peak forward velocity, acceleration and deceleration had a great accuracy in evaluating the peripheral circulatory status in affected persons, while peak reverse velocity and the acceleration/deceleration index were reproducible only at the high femoral level. Doppler velocity tracings appeared to be as useful in evaluating the peripheral arterial circulation as the previously used systolic perfusion pressure and ankle systolic pressure index. PMID- 2697134 TI - Food sources of dietary copper. AB - Large scale surveys of nutrient intakes of human populations groups generally have not included estimations of dietary copper intakes. Because of a lack of accurate tables of copper contents of foods, until recently, this could not be accomplished. Copper intakes of Americans are thought to be lower than in the past because of a rise in popularity of consumption of highly processed foods but this conclusion may be the result of over-estimation due to less sensitive methods of copper analyses which were used in the past. PMID- 2697135 TI - Modulation of long chain fatty acid unsaturation by dietary copper. AB - Research over the past 20 years into the effect of copper on fatty acid profiles in several species suggests that copper has a unique effect on long chain fatty acid metabolism. Copper supplementation in the pig and rat and copper deficiency in the rat, mouse and human indicates that inadequate copper intake (or genetic copper deficiency in the brindled mouse and in Menke's disease) impairs the ability to monounsaturate long chain saturated fatty acids and that, conversely, copper supplementation (greater than 150 mg/kg diet) usually increases monounsaturated fatty acids. Several recent studies of copper deficiency in the rat suggest that our interpretation of these effects needs to be more refined since membrane fatty acid profiles do not appear as sensitive to the effects of copper depletion as triglyceride fatty acid profiles. This suggests that changes in long chain fatty acid metabolism other than desaturation may also be affected by copper. PMID- 2697136 TI - Ischemic heart disease as copper deficiency. AB - Atherosclerosis is a complex process beginning early in life and often leading to death from ischemic heart disease in middle age. Hundreds of factors are said to contribute to this risk. More than 50 similarities between animals deficient in copper and people with ischemic heart disease have been identified. Some of the more important characteristics of this illness have been produced in experiments in which men and women were fed diets low in copper. Diets with similarly low amounts of copper are readily available to the population at large. More aspects of the anatomy, biochemistry, chemistry, epidemiology, pathogenesis and pathophysiology of ischemic heart disease can be explained by considering this illness to be a problem of copper deficiency than by considering any of several other explanations that have been offered. PMID- 2697137 TI - Stable isotope studies of the effect of dietary copper on copper absorption and excretion. PMID- 2697138 TI - Effect of copper on immune function and disease resistance. AB - Recent evidence suggests that copper exacts an important role in the maintenance of immunocompetence. Copper deficiency results in decreased humoral and cell mediated, as well as nonspecific immune function. Impairment of immune function may be highly correlated with an increased incidence of infection and higher mortality rates observed in copper-deficient animals. The actual mechanisms by which copper is involved in immune processes are not well defined. This review addresses the copper-immune function interaction and discusses possible immunomodulatory roles for copper. PMID- 2697139 TI - Influence of ascorbic acid, zinc, iron, sucrose and fructose on copper status. PMID- 2697140 TI - Copper absorption as affected by supplemental calcium, magnesium, manganese, selenium and potassium. AB - Effects of feeding supplements of calcium, magnesium, manganese, selenium and potassium on dietary copper bioavailability of humans were investigated. Results indicated that the calcium supplements depressed fecal copper losses and improved body copper retention as did potassium supplements. Magnesium and selenium supplementation of diets resulted in increased apparent fecal losses of copper while no effect of manganese supplementation was found. It may be that the unexpected positive effect of calcium on copper utilization was due to its neutralizing effect on the relatively high level of ascorbic acid provided by the constant background diet. Ascorbic acid is known to inhibit the absorption of copper. PMID- 2697141 TI - Factors affecting copper absorption in humans and animals. PMID- 2697142 TI - Shot biopsy in view of muscular disorders in pigs. AB - Although a number of problems in connection with the use of shot biopsy have yet to be solved, it can be stated that by this technique biopsy samples of sufficient quantity (up to 1.5 g) can be obtained from the musculus longissimus dorsi of pigs of about 80 kg liveweight. The technique offers data on the metabolic status (biophysical and biochemical values) of muscles, provided that the postmortal processes have been simulated (incubation of bioptate). The use of sensitivity tests on isolated subcellular fractions of the bioptate can lead to more precise results and consequently, to a remarkable reduction in the incidence of PSE syndrome (pale, soft, exudative meat). The first results achieve under conditions of Slovakia (Czechoslovakia) in testing boars show that this method could find a permanent use in the practice. Research institutions in a number of countries are now investigating possibilities of using shot biopsy for prediction of skeletal muscle disorders in pigs and it is excepted that many new results will be published soon. PMID- 2697143 TI - Traditional and new concepts in protein evaluation of feeds: a review. AB - The purpose of protein evaluation of a diet is to determine its value for meeting amino acid requirements of animals. The early recognition that proteins can be utilized by different efficiency rates has promoted extended research to reveal quality differences and their reasons. A brief historical overview is given in this review about the development of concepts and theories in protein evaluation. Recent developments have focused attention on determination of available quantities of essential amino acids. In vitro chemical assays and dye-binding procedures are relatively fast and provide data without access to animals, however they do not always correlate well with biological estimates. Enzymic digestion methods and microbiological assays for prediction of availability of essential amino acids have the potential for serial determination in quality control, however they are constrained by a lack of information about the availability of peptides liberated and utilized during in vivo digestion of proteins. Animal growth assays and balance experiments can provide valuable estimates of available quantities of essential amino acids. However, the interpretation of data is complicated by the many factors affecting in vivo protein utilization, by the endogenous amino acid excretion and the effects of microflora of the alimentary tract. The search for reliable assays remains a worthwhile objective also in the future. PMID- 2697144 TI - Characterization of Pasteurella haemolytica strains isolated from goats in Hungary. AB - Thirty-five Pasteurella haemolytica strains were isolated in Hungary from goat carcasses sent for postmortem examination from two farms with large goat flocks. All strains belonged to biotype A and with the exception of one strain of serotype A8 they belonged to serotype A2. No untypable strains were found by the indirect haemagglutination test. PMID- 2697145 TI - Immunization of calves with live and inactivated whole-cell vaccines against Salmonella typhimurium infection. AB - Eight calves were immunized with live auxotrophic Salmonella typhimurium mutants (aro -SL 1479, gal E 3821) and twelve calves with phenol-killed whole-cell S. typhimurium vaccine, respectively. The clinical status of the animals was followed and serial reisolation of vaccine and challenge strains from faeces was attempted. The immunization of calves with the live aro- auxotrophic S. typhimurium SL 1479 mutant proved to be unsuitable due to the death of calves after revaccination. The calves immunized with live auxotrophic gal E S. typhimurium CCM 3821 mutant proved to be protected against challenge with virulent S. typhimurium 4/5 strain administered orally at a dose of 10(6) colony forming units (CFU). The postvaccination complications showed serious shortcomings. The immunization of calves with three doses of whole-cell inactivated vaccine containing 5 strains of S. typhimurium was effective against oral challenge with virulent S. typhimurium 4/5 at a dose of 10(6) CFU. PMID- 2697146 TI - Effect of intraruminal butyrate infusion on the plasma insulin level in sheep. AB - After intraruminal infusion of butyrate to sheep at dose rates of 0.25, 0.5, 1 and 2 g sodium n-butyrate per kg body mass, butyrate concentration of the rumen fluid and total secreted insulin rose in direct proportion to the butyrate dose infused. The half-life of butyrate in the rumen was always longer than that of insulin. At 90 min after the infusion of 1 g butyrate per kg body mass, butyrate concentration in the ruminal papillae reached the level corresponding to an extracellular concentration that reduced cell division by 50% in vitro. It can be concluded that butyrate may be present in the ruminal papillae in concentrations inhibiting cell proliferation, simultaneously with the presence of blood plasma insulin concentrations stimulating the proliferation of ruminal epithelial cells. PMID- 2697147 TI - Recent findings and future perspectives of digestive physiology in rabbits: a review. AB - The rabbit is one of the most common laboratory animals. Consequently, there is an enormous number of publications concerning its physiology. The present review is restricted to a special field and deals with the new findings of the rabbit's digestive physiology. For the sake of better intelligibility the most important antecedents are also given. First the particularities of feed intake regulation are demonstrated. The strong control mechanism can be disturbed by feed antinutritives, mycotoxins and high environmental temperature. Caecotrophy depends on three main factors: stimulation of rectal mechanoreceptors, perception of the specific odour of the soft faeces, and the inner motive determined by the blood level of metabolites and hormones. The species characteristics of proportions, pH conditions, microflora and -fauna of the rabbit's digestive tract are given. The digestion and absorption of dietary nutrients are discussed. Special sections deal with the sorption of electrolytes and VFAs in the gut, the caecal digestive process, the formation of hard and soft faeces and the role of the caecotrophy in stomachal carbohydrate degradation. A relatively new area, i.e. the development and maturation of the gastrointestinal tract, is also shown. The postnatal evolution of digestive enzyme activity is also summarized. The main endogenic factors (breed, sex, age, stress, caecotrophy, presence of hairball in the stomach) influencing the digestion of dietary nutrients are also described. The probable future trends are given, too. PMID- 2697148 TI - [A 1-year study of the management of fetal breech presentation by monitoring follow-up during second-stage labor instead of using external version, x-ray pelvimetry and ultrasonic assessment of fetal weight]. AB - The authors studied 246 parturients with breech presentation of the fetus. All women were examined by an obstetric monitor. Cesarean section was performed on 33 women/ = 13.41% of women with breech presentation). Perinatal morbidity and mortality were the same as those of women with vertex presentation. The frequency of cesarean section was 11.98% of multiparas and 31.57% of nulliparas. According to the authors careful observation of advancement of delivery as well as the state of the fetus (by an obstetric monitor) could lead to management of delivery with breech presentation just as that of vertex presentation. This management of breech presentations should reduce the fear of delivery, which is observed in most parturients with breech presentation of the fetus. PMID- 2697149 TI - [The structure and function of an automated system for predicting neonatal body weight (the Sinodeta P/1)]. AB - The structure and function of an automated nosometric system, created by the authors, for prognosis of the risk of delivery of a child with low weight is described. The system is designed for health services, which give direction to parturient (public health sectors) and obstetric wards without technique and specialists for management of such children. The summarized extract is made on 883 cases, but verification--on 463 cases. The total effectiveness of the system is 82.1% against 66.25% of exact results during intuitive prognosis. PMID- 2697150 TI - [Ultrasonic follow-up of ovarian follicles in sterile women]. AB - The authors examined 39 women with sterility varying in time. Their ovaries were follow-up during 68 menstrual cycles. Linear growth of the follicle, which detached the egg cell, was established. The size of the follicle varied between 15.4-21.4 mm during the separation of the egg cell. The follicles remained static in anovulation, after which they became regressive or formed follicular cyst with various measures. PMID- 2697151 TI - [Echographic diagnosis of ovulation in healthy women]. AB - Dynamic echographic changes in measures of the uterus, uterine mucosa, ovaries and dominant follicle during normal ovulatory menstrual cycle were established in 16 multiparas and 17 nulliparas. All measures undergo characteristic changes as they increase during follicular phase of the cycle and reach their maximum paraovulatorily. For establishment of ovulation the changes in anterior-posterior size of the uterus, uterine mucosa, diameter of the dominant follicle and qualitative changes, occurring in it, are of the greatest significance. Mathematical models are made, which allow a comparison and prognosis of the changes in the internal genital organs of a woman in respect to the ovulation. PMID- 2697152 TI - [Histologic and light-microscopic cytomorphometric studies of the tissue reparative processes in complete wound dehiscence after obstetrico-gynecologic surgery]. AB - The authors carried out comparative histological and light microscopic cytomorphometric studies on tissue material, obtained during fixation of secondary sutures on complete wound dehiscences after obstetric and gynecological operations, prepared for therapy only by helium-neon laser irradiation. Densities of the power of helium-neon laser irradiation 90,70 an and 50 mW/cm2 were investigated at exposition time of the field of 1.5 min. The number of irradiations was 7-9 (after applied density of the power of 90, and 70 mW/cm2) and 9-12 (after irradiation with densities of the power of 50 mW/cm2). Histological and light microscopic cytomorphometric studies showed that the applied density of the power of laser irradiation of 90 mW/cm2 stimulated most actively the processes of tissue repair in complicated operative wounds. A considerable slowing of the processes of tissue repair was established after irradiation with densities of the power of 50 mW/cm2. PMID- 2697154 TI - [Clinical aspects of chlamydial genital infections in women]. PMID- 2697153 TI - [A clinical trial and use of triziston-R as a contraceptive agent]. PMID- 2697155 TI - Pathophysiology of malignant hyperthermia. AB - Malignant hyperthermia (MH) is a pharmacogenetic disease in man and animals. It primarily involves skeletal muscle tissue, but other tissues might be affected to a lesser degree. Calcium homeostasis in muscle cells is upset in susceptible individuals, so that various agents and circumstances can increase the free, ionised intracellular calcium concentration to damaging levels. The primary defect is not known at present, but is believed to involve an abnormally sensitive calcium-induced calcium release mechanism. Thus small, localised increases in calcium concentration releases more calcium so that a vicious cycle is triggered. The increased calcium concentration causes multiple effects in the muscles by stimulating contraction and a hypermetabolic state, clinically observed as rigidity and fever. If demands on the homeostatic mechanisms to lower the calcium concentration become exhausted, and metabolism is insufficient to supply enough phosphocreatine and ATP, membrane potentials cannot be maintained, and permeability of the cell membranes increase. This causes loss of phosphate and H+ as well as K+ and Mg++, and later myoglobin and creatine kinase. Thereby oxidative metabolism is further impeded with formation of lactate as a result. The ensuing acidosis stimulates sympathetic innervation, resulting in tachycardia, high blood pressure, and vasoconstriction. Hyperkalemia causes arrhythmia. Dantrolene inhibits the release of calcium and can halt the process if given before depletion of the energy rich phosphates is too advanced. PMID- 2697156 TI - [Management of a patient with malignant hyperthermia susceptibility during anesthesia and daily living]. AB - Death from malignant hyperthermia (MH) still occurs in France. However, anaesthesia of the MH susceptible (MhS) patient is quite possible without any more risk than for patients who are not MhS. Guidelines have been worked out: "trigger" drugs such as volatile anaesthetics (halothane, enflurane, isoflurane) and depolarizing muscle relaxants must be imperatively avoided; "non-trigger" drugs should be used, such as nitrous oxide, barbiturates, benzodiazepines, propofol, opiates, non-depolarizing muscle relaxants, amide or ester local anaesthetics at the usual doses without adrenaline. Moreover, dantrolene should be available in all hospitals, 12 bottles being a minimum at hand, or, better, 30 (about 10 mg.kg-1). In some cases, such as emergencies, an unprepared operating theatre, or an unprepared ventilator, the patient should be premedicated with 2.5 mg.kg-1 dantrolene intravenously. The ventilator, the circuit and the operating theatre should not contain any trace of halogenated vapour. The usual parameters, as well as temperature and expired CO2 concentration, should be closely monitored. MhS patients must also be given counselling. This includes explanations about MH, its genetic features, the main laboratory tests used to detect susceptibility, as well as advice about lifestyle, the use of drugs other than general and local anaesthetics, and a discussion concerning the association of MH with other diseases. This counselling is not always easy to provide, because many answers are not, as yet, definitive. PMID- 2697157 TI - [Treatment of malignant hyperthermia crisis during anesthesia]. AB - Malignant hyperthermia (MH), triggered by anaesthesia, is a rare and potentially fatal condition. It requires immediate and specific treatment. This review focuses on anticipation and organisation of treatment. Anticipation means that dantrolene should be available, that an anaesthetic machine should be kept free from all vapours of halogenated anaesthetics, and methods of cooling should be planned. A prompt availability in all operating theatres of dantrolene and the required machines is emphasized. Treatment of a MH episode includes stopping the administration of triggering agents, administering dantrolene, correcting metabolic and respiratory acidosis, and cooling. Different aspects of the cardiovascular pharmacology of dantrolene are discussed. Other drugs are seldom required if proper treatment is started soon enough after the crisis. Complications may arise during a fulminant episode. They are difficult to treat, and may lead to sequelae. A rational approach to the treatment of hyperkalaemia, circulatory and renal failure is discussed. After the crisis, dantrolene should be continued for a short time. Finally, the nonspecific signs which can give the earliest diagnosis possible of MH are discussed: an early diagnosis and early treatment with dantrolene are essential in reducing the mortality of malignant hyperthermia. PMID- 2697159 TI - Etiology of hypertensive crisis during the intraoperative period. PMID- 2697158 TI - [Anesthesia in patients with Duchenne muscular dystrophy]. PMID- 2697160 TI - [The Fuenlabrada study: smoking habits in children and adolescents. Effect on various cardiovascular risk factors]. AB - We studied 1,274 healthy children of both sexes from 10 until 18 years of age, in Fuenlabrada, Madrid. We knew the tobacco consumption by means of direct asking to the children, without the presence of their parents. We studied the smoking habit of their parents by means of inquiries. The percentage of smoker children was 30% (24% of them had smoker parents, and 6% did not). We studied the tobacco influence in several parameters of cardiovascular risk; it was found that C-HDL levels in the smoker children were 5 mg/dl lower than the non-smokers, and the ratio C-LDL/C-HDL in the smokers was 1,2 times greater than in the non-smokers. PMID- 2697161 TI - [The Fuenlabrada study: normal values of arterial pressure in children and adolescents]. AB - We have studied 1,939 healthy children of both sexes (1.003 boys and 936 girls), aged from 4 to 18 years, of the city of Fuenlabrada (Madrid). The following parameters were determined: blood pressure, weight, height, triccipital folds, the rohrer index, total cholesterol, triglycerides, lipoproteins, blood sugar and uric acid. The results of the blood pressure have been expressed by means of percentiles in relation with age, weight, and height. The correlation coefficients have been statistically significant for the height, weight, age, triccipital skinfolds, triglycerides and C-VLDL. We have relationed our results with other national and international studies. PMID- 2697162 TI - [The Fuenlabrada study: lipids and lipoproteins in children and adolescents]. AB - We studied in 2,153 children of both sexes from birth until 18 years of age, in Fuenlabrada, Madrid, the following parameters: the height, weight, tricipital and subscapular skinfolds, blood pressure, lipids, lipoproteins, glycemia, uric acid and smoking habits. We obtained the next mean values: Total cholesterol (TC), 166 +/- 36 mg/dl; triglycerides, 63 +/- 39 mg/dl; HDL-C, 53 +/- 13 mg/dl; LDL-C, 102 +/- 34 mg/dl; VLDL-C, 13 +/- 6 mg/dl. TC, HDL-C and LDL-C levels did not present any significant differences with respect to sex until 12 years of age. But they were significantly higher in girls than in boys in adolescence. In contrast, TG and VLDL-C levels were higher in girls than in boys until 12 years of age, they did not present any difference in adolescence. The significant change of the lipoproteinic pattern in adolescence is connected with the hormonal distribution that is produced in puberty. PMID- 2697163 TI - [Prevalence of breast feeding and its relation to cardiovascular risk factors in the pediatric population of Fuenlabrada]. AB - The infant nutrition is surveyed on 1893 children of both sexes, aged from 0 to 18 years, in Fuenlabrada, Madrid. The percent of children with breast feeding has strongly decreased (47%) during the period 1965-1983, so its endurance has shortened (15%). The kind of feeding is related to the age mother and her smoking habit. The statistical correlation between the newborn intake and the cardiovascular risk factors is studied; no significant differences are found, excepting a temporary increase of the total cholesterol during the first quarter of life. PMID- 2697164 TI - [The value of granulocyte elastase in the early diagnosis of infantile meningitis]. AB - Elastase-alpha 1-proteinase inhibitor complex (E-alpha 1-PI) was evaluated in blood and cerebrospinal fluid in 176 patients between 1 month and 15 years old. They were divided in three groups: group 1 (n = 61) children without meningitis, group 2 (n = 69) non bacterial meningitis and group 3 (n = 46) bacterial meningitis. The CSF values of E-a 1-PI complex (P50: P2.5; P97.5) (micrograms/L) were (2.85: 0.1; 19.1) in group 1 (31.5: 0.88; 735) in group 2 and (247: 2.6; 10370) in group 3. Significant differences were found in it (p less than 0.001). We didn't find any differences between non bacterial meningitis group and bacterial meningitis group when the granulocytes count were below 100 X mm3. The blood values of E-a 1-PI complex (P50: P2.5; P97.5) (micrograms/L) were (1122: 337; 5005) in group 3, significantly greater (p less than 0.001) than in group 2 (346: 136; 1612). In CSF E-alpha 1-PI complex showed us a sensitivity of 89% and a specificity of 27.7% in the diagnosis of bacterial meningitis, while in blood stream, it was 85.3% and 85.4 respectively. PMID- 2697165 TI - [Menkes syndrome: study of 2 new cases]. AB - The authors describe two new cases of Menkes' syndrome, both of which belong to the same family. Clinically, one of them began with a convulsive encephalopathy and the most significant features observed in the other were psychomotor delay and changes in the hair. In both cases, the quantity of copper and ceruloplasmin was very low. A description is given of the clinical, electroencephalographic and radiological findings and a microscopic study of the hair. One of them died at the age of 16 months and the other is at present 2 5/12 years old and demonstrates a serious psychomotor delay. Given the inefficiency of the treatment, genetic counsel and prenatal diagnosis are the only useful alternatives for the control of this phenomenon. PMID- 2697166 TI - [Stevens-Johnson syndrome associated with pneumonia caused by Mycoplasma pneumoniae]. PMID- 2697167 TI - Epidemiologic and toxicologic evidence of occupational cancer in metalworking and transportation equipment industries. Undercounting occupational disease. PMID- 2697168 TI - Occupational safety and health standards. AB - If we are to approach developing a safe and healthful workplace in a more timely fashion, a more generic approach must be considered and applied instead of developing recommendations and standards simply on a substance-by-substance basis, an approach that has been the most prominent. Some examples in which developing generic standards may be appropriate are: cholinesterase-inhibiting substances, neurotoxic agents, reproductive hazards, cold environments, and vibration syndrome, to name but a few. It is important to recognize that developing standards based on individual substances often does not allow for the role of synergism, a reaction that has had little study, but it is important in controlling occupational disease and injury. These concerns can be addressed in several ways. One is to look at processes or conditions found in the workplace; for example, coke oven emissions that OSHA has promulgated into a standard and, as NIOSH has done in their recommendations to OSHA for foundries, coal tar products, the manufacture of paint and allied coatings, field sanitation, hazardous waste management, hot environments, and confined spaces. Another is to address groups of similar substances such as NIOSH has done with alkanes, benzidine-based dyes, diisocyanates, dinitrotoluenes, and glycol ethers. A third comprehensive approach is to look at general categories of hazards, such as the generic carcinogen policy, and the hazard communication rule. Finally, risk must be considered in the development of any standard. Nelson Rockefeller once said in relation to an incidence involving a radiation hazard that, "you can't have a riskless society." I would amend this to say that you cannot have a reckless society either. Safety and health regulations are essential and must be designed, promulgated, and then enforced so that a reckless society is avoided or controlled, with a riskless society being the ultimate aim. PMID- 2697169 TI - Occupational health sciences and practice in the 1990s. International perspectives. PMID- 2697170 TI - Current magnitude of occupational disease in the United States. Estimates from New York State. AB - The data from our study indicate that the magnitude of occupational disease in New York State is considerable, and that a detailed and comprehensive plan must be initiated and implemented if occupational disease is to be controlled. New York State contains slightly less than 10% of the nation's workforce. A direct linear extrapolation of findings in New York State cannot be made to derive estimates of the national burden of work-related illness. Nevertheless, a crude estimate of the national magnitude of occupational disease can be derived from the New York experience. Such extrapolation provides a crude estimate of 50,000 70,000 deaths each year from occupational disease and of 350,000 new cases of occupational illness. These numbers are distressingly similar to the annual estimates of 100,000 deaths and 400,000 cases of occupational illness developed almost 15 years ago by Ashford. Clearly substantial progress remains to be made. PMID- 2697171 TI - Occupational diseases: new workforces, new workplaces. PMID- 2697172 TI - Risk assessment and occupational health. Conceptual problems. PMID- 2697173 TI - Immunologic effects of extended-wear contact lenses. AB - All worn contact lenses are coated with materials from the tear film and the environment. Antigens are included in this complex and ever-present coating on the front and back surfaces of the worn contact lens. These deposited materials lead to insult of the conjunctival surface that influences mucus production and conjunctival-related comfort in the wearing of contact lenses. PMID- 2697174 TI - [Jean Albert Gautier (l903-87)]. PMID- 2697175 TI - [Study of blood cyclosporine after kidney or bone marrow transplantation. Comparison of immunofluorescence and radioimmunoassay]. AB - The apparition of cyclosporine, immunodepressive drug, has largely improved the organ transplantations. However, the range of blood concentrations must be defined to allow the efficacity of cyclosporine therapy and to avoid toxic reactions, because there are very important variations for a same dosage according to the individuals and the diseases. Relative to the low concentrations to be determined (about one hundred ng/ml), the most useful methods for cyclosporine measurement are based on immunochemical assays. This work compare the two methods: radioimmunoassay (RIA) and fluorescence polarization immunoassay (FPIA) simultaneously performed on several hundred samples. A very significant correlation exists between the two techniques (r = 0,80). The advantages of immunofluorescent assay consists in rapidity, sensibility and facility to realize emergency analysis. PMID- 2697176 TI - [Influence of the autonomic nervous system on the diameter and compliance of the brachial artery in normotensive subjects and hypertensive patients]. AB - Studies based on non-invasive methods, using a pulsed Doppler flowmeter technique, show that, in hypertensive patients, the brachial artery reacts actively to posture changes and to a norepinephrin perfusion: in the latter situation, there is an abnormal constriction, and its vasodilation is more marked when the lower extremities are raised in a patient in decubitus. These modifications occur in the absence of any significant variation of the blood pressure and the heart rate, and the high output resulting from the vasodilation is not sufficient to explain these changes. According to the authors, the brachial artery reacts actively to alterations of the autonomous nervous system. Variation observed following elevation of the lower extremities would probably result from the stimulation of the mechanical receptors of a low pressure system. PMID- 2697177 TI - Antigenic heterogeneity of human brain tumors defined by monoclonal antibodies. AB - The antigenic profiles of human gliomas and in vitro established cell lines were investigated using the monoclonal antibodies (MABs) MUC 8-22 and MUC 2-63. The reactivity with tissue samples and cytospin preparations obtained from 45 brain tumors was estimated by the indirect immunoperoxidase technique. In addition, computer-assisted cytofluorometry was used to quantify the intensity and distribution of antibody-binding. Various degrees of antibody-binding among and within gliomas and glioma-derived cell lines were observed. The data show that a variable percentage of cells are not labeled with the employed MABs. The spectrum of reactivity of the selected antibodies was independent of the histological grading of gliomas. However, there were significant differences in various stages of subcultivation of glioma lines. In most cases, the heterogeneity of antigen expression decreased during successive in vitro propagation of glioma cells. The extent of variation in staining intensity values differed within cell populations and reflected the antigenic heterogeneity of human brain tumors. The findings presented here suggest that the use of MABs which recognize glioma-associated antigens facilitates the objective analysis of brain tumors and is of potential value for immunohistochemical application in surgical neuropathology. PMID- 2697178 TI - Epidermal growth factor stimulates colony formation and non-neuronal marker protein expression by human neuroblastoma in methylcellulose culture. AB - Growth of the human neuroblastoma IMR-32 in methylcellulose culture was studied. The number of colonies was proportional to the number of seeded cells in all conditions tested: control cultures (CT) and test cultures with epidermal growth factor (EGF), hydrocortisone (HC), combined EGF/HC, fibroblast growth factor (FGF) or nerve growth factor (NGF). A portion of IMR-32 cells formed colonies and all factors were without effect when tested individually. In contrast, the combination of EGF/HC at low cell densities enhanced the number of colonies two fold as compared to controls. Differentiation in IMR-32 colonies was examined by immunocytochemical detection of cell specific marker proteins. As determined by staining with different markers, at least two cells subpopulations could be established within the same colony. One of them expressed NSE (neuron specific enolase) and was designated as neuronal. The other subpopulation was called non neuronal since it consisted of vimentin and S-100 protein positive cells which were considerably enhanced in the presence of EGF or EGF/HC. In vitro, the IMR-32 neuroblastoma cell line contains pluripotent stem cells from which are derived distinct phenotypes sensitive to different extrinsic factors. Increasing time in culture enhanced neuronal differentiation. EGF, on the other hand, targeted preferentially the non-neuronal phenotype, and stimulated colony formation and its differentiation. PMID- 2697179 TI - Expression of the ras oncoprotein in gastric carcinomas and adjacent mucosa. AB - We have employed an immunohistochemical analysis to study the ras p21 oncoprotein in a total of 88 gastric carcinomas, which were associated (in 24 cases) with intestinal metaplasia. Our results suggest an association of the expression of ras p21 with metaplastic and neoplastic gastric mucosa. The comparative study showed that 58 of the 88 gastric carcinoma cases studied exhibited negative or equivocal staining (-/+). The remaining 30 were positive with moderate (+) or intense (++) staining. There was an agreement in that histologic type and tumor grade had a strict correlation with staining intensity. Intestinal metaplasia had a higher percentage of positively stained cells (+ or ++). Moreover, there was a selective positive staining in the parietal cells of the gastric fundus in sections from adjacent non-neoplastic mucosa. PMID- 2697180 TI - D.N.C.B. for malignant melanoma: significance in the treatment strategy. AB - 2-4 Dinitrochlorobenzene (D.N.C.B.) is a synthetic primary allergenic molecule which has proved to have at least two useful clinical applications as regards neoplastic conditions. As a diagnostic measure, it serves in the detection of global alterations of cellular immunity. As a therapeutical measure, its epicutaneous use has proved to stimulate immune defence reactions loco-regionally if not systemically. This second property finds an important field of application in the treatment of malignant melanoma (M.M.), the reason for this being that natural immune defence reactions seem to play an important role in the natural history of this type of tumor. This review collects literature data on the therapeutical use of D.N.C.B: which, together with personal cases, show that this type of treatment may be proposed as a palliative measure for the treatment of skin metastases or as an adjuvant measure for surgery in the treatment of M.M. with surgically accessible metastases. D.N.C.B. appears to be part of a new therapeutical group, the Biological Response Modifiers (B.R.M.), and would seem to have a place in future treatment protocols associating B.R.M. with other treatment methods (e.g. chemotherapy). PMID- 2697181 TI - The expression of EGF receptors, EGF-like factors and c-myc in ovarian and cervical carcinomas and their potential clinical significance. AB - The expression of the epidermal growth factor receptor (EGF-R) and the c-myc oncogene was investigated in different specimens of ovarian and cervical carcinomas. The EGF-Rs were analyzed by EGF binding assay, immunohistochemistry and Northern blotting. For analysis of c-myc expression, we used Northern blotting and immunohistochemistry. Furthermore, tissue concentrations of EGF-like factors (EGF-F) were measured in the same tumor and non-malignant specimens. The biochemical determination of EGF-R demonstrated that EGF specific binding sites were detected in 36% of ovarian (n = 140) and 81% of cervical carcinomas (n = 42). High amounts of EGF-R (greater than 10 fmol/mg specific binding) were found in 8% of the ovarian and 41% of the cervical carcinomas. Increased expression of EGF-R specific mRNA was detectable in 7/21 ovarian and in 5/7 cervical carcinomas. A positive correlation between the amounts of EGF-R mRNA, the EGF-R binding data and the staining index of EGF-R immunohistochemistry was found. The EGF-R immunohistochemistry demonstrates that only the tumor cells produce increased amounts of EGF-R, while the stromal cells are EGF-R negative. Low amounts of EGF-R specific mRNA were also detected in biochemically EGF-R negative tumors. The c-myc specific mRNA signal was found in all cases investigated. It is shown that the c-myc expression was increased in 10/21 ovarian and 5/7 cervical carcinomas. There was no positive correlation between the amounts of EGF-R and c myc mRNAs. The product of myc, as detected by immunohistochemistry, is found in tumor as well as in stromal cells. The levels of EGF-F were measured in extracts of 63 ovarian and 12 cervical carcinomas and in 21 non-malignant tissues. About 30% of the tumor extracts contained higher EGF-F levels (4-15 ng/mg) than those found in the non-malignant specimens. Tumors with high EGF-F levels expressed high amounts of c-myc RNA. The EGF-R status (n = 111) and the EGF-F levels (n = 63) were related to the prognosis of survival for patients with ovarian carcinomas. EGF-R positive (EGF-R(+)) ovarian carcinomas had a significantly higher response rate to chemotherapy. The survival time of the EGF-R(+) group is reduced compared to the EGF-R negative (EGF-R(-)) group if only patients in remission are used to construct survival curves. Furthermore, a poor prognosis for survival was noticed for ovarian carcinoma patients with high EGF-F levels. PMID- 2697182 TI - Effect of oncogene transfection or passage in vivo on malignant phenotypes of rat2 cells. AB - Rat2 cells are thymidine kinase-deficient derivatives from the immortalized rat embryo cell line Rat1. They show no phenotypic correlates of malignancy in vitro and produce tumors in syngeneic Fischer rats after long latency periods. We have investigated how transfection with oncogenes would alter the in vitro and in vivo behavior of Rat2 cells. Thus we have manipulated Rat2 cultures in various ways. The cell lines obtained were categorized as parental, in vitro subclones, untransfected in vivo derivatives, non-oncogene (neor and tk) transfectants, oncogene (mutated c-Ha-ras, polyoma middle-T, FBR v-gag-fos-fox) transfectants, and in vivo derivatives of transfectants. They were tested in vitro for morphotype, colony formation in soft agar, growth in organ culture, invasion in organ culture, and in vivo for latency period of tumor formation, tumor growth rate, invasiveness, and metastasis. Differences between the consequences of various manipulations were found in the number of malignancy-related phenotypic alterations. The following trend could be deduced from our data: induction of invasiveness in organ culture by all manipulations; morphotypic transformation and shortening of tumor-latency period by all oncogene transfections and by passage with tumor formation in vivo; growth in organ culture and increased tumor growth rate in vivo by transfection with ras-, or fos-oncogenes and by passage in vivo. Metastatic capability (present in parental Rat2 cell tumors) and colony formation in soft agar (absent in Rat2 cells) were not affected by the present manipulations. We concluded that differences between the oncogene-transfectants and the untransfected in vivo derivatives do not lie in the expression of malignancy-related phenotypes but in the time needed to acquire them. PMID- 2697183 TI - Human leukocyte antigen (HLA) frequency among patients with nasopharyngeal carcinoma in Taiwan. AB - In order to assess the association between human leukocyte antigens (HLA) and nasopharyngeal carcinoma (NPC), a total of 10 familial and 10 sporadic NPC patients and 171 unrelated healthy controls were studied. HLA typing was performed using commercial trays which defined 30 specificities of HLA-A, B and C loci and 10 specificities of HLA-D locus according to the method of Tiwari and Terasaki. HLA-A2, B16 and DR1 were found to be higher among patients with NPC than unrelated healthy controls with an odds ratio (OR) and a 95% confidence interval of 5.91 (2.1-16.6), 6.00 (2.0-18.0) and 6.89 (1.3-37.5), respectively. Further analysis showed that A2(+) B16(+) haplotype was significantly associated with a much higher risk of NPC (OR = 15.5) as compared with A2(-) B16(-) haplotype. No difference in frequency distributions of HLA-A, B, C and D antigens was observed between familial and sporadic NPC patients. PMID- 2697184 TI - Ruffling membranes in cultured human and rat glial cells. AB - We have previously described how mouse monoclonal antibody Mab S-11E10 specifically stained ruffling membranes and filopodia of cultured human glioma cells. We found that this antibody stains ruffling membranes, not only of human astrocytes and glioma cells, but also of rat astrocytes and rat C6 glioma cells. In addition, we newly prepared rabbit polyclonal antibody for the antigens, which were eluted by Mab S-11E10 affigel 10 (Bio Rad) affinity column chromatography from cultured rat C6 glioma cells. The polyclonal antibody detects 65KDa, 57KDa, 46KDa, 43KDa bands in Western blotting analysis and specifically stained ruffling membranes of human glioma cells on cell spreading. Using the polyclonal antibody, we studied the change of the distribution of the antigens during cell spreading and in fully spread cells. At the beginning of cell spreading, ruffling membranes were specifically stained, but 72 hours after plating the immunofluorescence was localized in membranes of supranuclear regions and small protuberances. Furthermore, we semi-quantitatively measured the contents of the antigens detected by the polyclonal antibody, using dot blotting immunoassay. The contents of the antigens rapidly increased at the beginning of cell spreading and thereafter gradually reduced. The change of the contents seemed to be time--and cell density--dependent and to relate to the extent of cell spreading. These results suggest that the antigens may play an important role in cell spreading of glial cells. PMID- 2697185 TI - Analysis of monoclonal antibodies for identification of antigens associated with tumours of the gastrointestinal tract. AB - The reactivity of a new anti-human gastric carcinoma antibody, GL-013 with gastrointestinal tissue sections, with subcellular membranes (both from normal and malignant specimens), and with a variety of purified tumour antigens, has been evaluated and compared with that of a panel of monoclonal antibodies. These include antibodies against carcinoembryonic antigen (CEA), normal cross reacting antigen (NCA) and the Y-hapten. The reactivity of GL-013 antibody was distinct from, but not superior to that of the existing reagents. Of these, the antibody against the Y hapten was the most discriminatory with respect to its preferential reactivity with tumours, and the target tetrasaccharide comprising the Y hapten determinant was identified upon a variety of cellular macromolecules, including glycoproteins, glycolipids and on epidermal growth factor receptors. This is in accord with its frequent association with tumours. PMID- 2697186 TI - Uptake, metabolism and antiproliferative effect of estramustine phosphate in human glioma cell lines. AB - The uptake, metabolism and antiproliferative effects of estramustine phosphate, a cytotoxic agent used in prostatic cancer, were investigated in the two human malignant glioma cell lines U-105 MG and U-251 MG. The primary metabolite estramustine had a dose-dependent inhibitory effect on cell proliferation within the concentration range 5-20 micrograms/ml. After incubation with 3H-estramustine phosphate in both cell lines, a progressive uptake of radioactivity was recorded during 24 hours. A significant metabolism of parent estramustine phosphate into estramustine and estramustine, which is a well known part of the metabolic pathway in man, was also demonstrated. In conclusion, certain cultured malignant glioma cells display significant uptake, retention and metabolism of estramustine phosphate and further studies are indicated to assess the clinical implications of these findings. PMID- 2697187 TI - Human serum steroid-binding proteins and malignancy (review). AB - Many steroid-binding proteins are normal constituents of human serum. They regulate the bioavailability of steroid hormones to receptors in target tissues, either by preventing the availability of unbound steroids, or by delivering them into cells, depending on the binding protein or the tissue considered. In this review three models describing these situations and a tentative unifying concept for the various possible roles of the steroid-binding proteins are presented. In some malignant situations, the serum concentrations of the normal steroid-binding proteins are modified, and in some cases some abnormal steroid-binding proteins appear in the serum. These situations seriously modify the normal steady state of steroid hormone delivery to target cells and might consequently play an important role in the development of these diseases. PMID- 2697188 TI - DNA methylation of the Ha-ras-1 oncogene in neoplastic cells. AB - The DNA methylation pattern of the human Ha-ras-1 oncogene and the levels of specific mRNA have been analysed in established tumor cell lines and in surgical biopsies. In long-term cultures, the Ha-ras-1 gene is hypomethylated at its 5' end and highly methylated at its 3' portion. The GCGC sites at the 5' end have been shown to become methylated only when E. Coli HhaI methylase is added to isolated DNA, while they remain unmethylated when the enzyme is added to chromatin. These data indicate that the 5' portion of this protooncogene is maintained physiologically unmethylated, possibly because it is necessary for gene transcription. Along the same line of evidence, when levels of mRNA and methylation of the gene were comparatively analysed in breast tumors and autologous normal mammary tissue, no appreciable differences in the degree of methylation were found despite significant differences in mRNA content. These findings show that the levels of Ha-ras- mRNA are independent of the DNA methylation state. PMID- 2697189 TI - CA-125 ovarian cancer associated antigen in cancer and pregnancy: interpretation of enzyme immunoassay and immunoradiometric assay. AB - Serum CA-125 concentrations were determined using both immunoradiometric assay (IRMA) and enzyme immunoassay (EIA) in 67 patients with various diseases including cancer and in 100 pregnant women with respect to the stage of pregnancy. Correlation of values obtained by the two methods was good except for the first and second trimester of pregnancy. However, IRMA concentrations were 80 200% higher than those obtained by EIA, the larger differences being observed in the critical range of 35-100 U/mL. Therefore, the alternate use of the two methods should be avoided and the cutoff levels should be redefined for each procedure. PMID- 2697191 TI - Chemotherapy consisting of cisplatin, doxorubicin and cyclophosphamide as an adjunct to surgery in stage Ic-II epithelial ovarian carcinoma. Gynecologic Oncology Group of the Comprehensive Cancer Center Limburg. AB - Twenty-five patients with stage Ic-II ovarian cancer (8 stage Ic and 17 stage IIb c) were treated with total removal followed by 6 cycles of chemotherapy consisting of cyclophosphamide, doxorubicin, and cisplatin intravenously on day 1, every 4 weeks (CAP-1). Of 18 patients in whom a second look was performed, 16 (89%) achieved a pathologically documented complete response and two patients had positive peritoneal washings at second look. Seven patients did not undergo second look laparotony, all of whom had clinically no evidence of disease. One patient with stage Ic relapsed and died after 40 months. Nine patients with stage II relapsed and died after a median of 29 months (range, 18-90 months). The overall relapse rate in all patients was therefore 40% (95% confidence interval: 21-61%). Median follow-up of all patients is 5 years (range, 40-90 months). The 5 year survival of patients with early stage ovarian cancer treated with cisplatin based chemotherapy appears to be at least as good as that reported with the use of postoperative irradiation or intraperitoneal radioactive phosphate. Optimal treatment of these patients remains to be further defined. PMID- 2697190 TI - Long-term survival of patients with advanced ovarian carcinoma treated with cisplatin-based chemotherapy regimens. AB - Long-term results of different studies employing cisplatin-based chemotherapy in advanced ovara in cancer are just beginning to be published. Available data suggest that the rate of relapse decreases but does not cease, and the question of whether cisplatin-based chemotherapy results in an improved cure in advanced ovarian cancer is still unanswered. The long-term survival results published so far are reviewed. Furthermore the impact of other drugs, especially doxorubicin, in addition to cisplatin is discussed. PMID- 2697192 TI - Transforming growth factor-beta in intestinal epithelial differentiation and neoplasia (review). AB - Transforming growth factor beta (TGF-beta is a multifunctional regulator of cell growth. It has become increasingly clear that TGF-beta action depends on the responsive cell types. Thus TGF-beta stimulates proliferation of mesenchymal cells and, in contrast, inhibits the growth of a large variety of epithelial cells. Recent studies, albeit controversial, support the notion that a gradient in mRNA transcripts encoding TGF-beta is maintained along the crypt-villus continuum of the small intestine in close correlation with the stage of differentiation of the enterocyte. Exogenous TGF-beta has been shown to inhibit the proliferation of a non-transformed rat jejunal crypt cell line. Additional salient findings have indicated that colon carcinoma cell lines recalcitrant to the restraining action of TGF-beta on proliferation are poorly differentiated, and that moderately differentiated colon tumor lines do retain, at least partly, their responsiveness to TGF-beta. To the best of our knowledge, no evidence is available pertaining to a contributory role of TGF-beta in the signalling mechanisms regulating growth and differentiation of normal colonic epithelial cells. In addition, we are ignorant of whether the interesting findings related to a functional relationship between TGF-beta and colon carcinoma cells lines (vide supra) are applicable to colonic preneoplastic and tumor cells in their natural habitat. In this review, we dwell on the available facts and missing observations, and present conceivable hypotheses pertaining to a putative role of TGF-beta in colon differentiation and neoplasia. PMID- 2697193 TI - Growth factors, growth inhibitors and cell cycle control (review). AB - Decisions about growth or quiescence are operated in the cells by a complex signal processing machinery. This machinery is built by a network of proteins that internalize these stimulatory signals from the extracellular environment across the plasmamembrane, through the cytoplasm and finally into the nucleus. Most of the information about the genes which encode the proteins that take part in this process have been obtained from studies of their aberrant alleles or oncogenes. It has become clear lately that the cell also processes negative feedback mechanisms to check this process so that it may operate error free. PMID- 2697194 TI - [Esophagogastroduodenitis in the newborn. Apropos of 32 cases]. AB - Inflammatory lesions involving esophagus, stomach and duodenum are frequent in neonates and run a benign course. Thirty-two cases of esophagogastritis associated with duodenitis in 28% of cases were studied. Presenting symptoms included nonspecific symptoms such as feeding difficulties (15 cases), G-I bleeding (14 cases), regurgitation (14 cases) and/or impaired weight gain (4 cases). No precipitating factor could be identified. The diagnosis was established by endoscopy. Gastro-esophageal reflux, which seemed to be secondary to the mucosal lesions, required an anti-reflux treatment, which led to a rapid clinical recovery. Repeat endoscopy invariably showed an improvement or complete recovery of the mucosal lesions which did not seem to be influenced by antacid treatment. The etiology and pathogenesis of neonatal esophagogastroduodenitis remain undetermined. PMID- 2697195 TI - [The accelerated phase of Chediak-Higashi syndrome]. AB - We have retrospectively analysed the clinical and biological features as well as the outcome of 18 accelerated phases having occurred in 11 patients with the Chediak-Higashi syndrome. This complication is very frequent and is characterized by a multi-visceral lymphohistiocytic infiltration with hemophagocytosis leading to pancytopenia, a bleeding disorder secondary to low fibrinogen level, hypertriglyceridemia and hemodilution. The accelerated phase of the Chediak Higashi syndrome is identical to the manifestations of familial erythrophagocytic lymphohistiocytosis and of the viral-associated hemophagocytic syndrome. The outcome was invariably fatal before the use of etoposide (VP 16) in association with steroids and intrathecal methotrexate. Complete remission with this management regimen was observed in 7/7 cases. However, remissions were only transient. HLA identical bone marrow transplantation appeared to be the only therapeutic strategy capable of curing the disease (3/3 patients). Non transplanted patients relapsed and died as well as one patient who received a HLA non identical bone marrow transplantation. Due to the frequency and the severity of the accelerated phase of the Chediak-Higashi syndrome, HLA identical bone marrow transplantation should be proposed as early as possible after the onset of the accelerated phase. PMID- 2697196 TI - [Primary neuraminidase deficiency with prenatal disclosure]. AB - The authors report a case of infantile sialidosis with hydrops fetalis and heart failure. At birth the baby presented a dysmorphic syndrome with histological anomalies. A storage disease with deficiency of neuraminidase activity, sialidosis type II, was confirmed. Amniocentesis with sialic-acid dosage or thin layed chromatography seems necessary in hydrops fetalis with heart failure of unknown origin. PMID- 2697198 TI - [Iconographic rubric. Acute lymphoblastic leukemia]. PMID- 2697197 TI - [Acute thyroiditis caused by Eikenella corrodens and abnormality of the left pyriform sinus]. AB - A case of suppurative thyroiditis is reported. The initial course was insidious and mimicked De Quervain subacute thyroiditis. The abscess was surgically drained. It contained numerous Eikenella corrodens bacilli. Fibroscopy of pharyngo-laryngeal region showed that the left pyriform sinus was abnormal. Surgical removal of a fistula of the fourth branchial pouch was performed in order to prevent recurrence of the thyroiditis. PMID- 2697199 TI - [A therapeutic trial of mazindol versus placebo in Duchenne muscular dystrophy. A one-year follow-up study of 14 children]. AB - A simple-blind therapeutic trial of mazindol (2 mg/d) versus placebo in 14 boys with Duchenne muscular dystrophy, 5 to 13 years old, for 12 months was conducted in order to analyse the efficacy of this drug on the natural history of the disease. Evaluation of muscle strength by manual testing, motor ability by functional testing and timed tests, weight, height, serum CK and pulmonary function were performed every two months. The differences in evolution between groups were significant only for weight and height. However comparison of muscle strength and of vital capacity expressed as percent of predicted at the beginning and at the end of the study suggested a beneficial trend in the mazindol-treated group. PMID- 2697200 TI - [Neutrophil chemotactic factor in lung injury produced by immune complexes]. AB - Our previous study demonstrated increased levels of C5a des Arg and increased numbers of neutrophils in bronchoalveolar lavage (BAL) fluids of patients acutely ill with hypersensitivity pneumonitis (HP), suggesting that complement fragments activated by immune complexes (IC) play a role in the early stage of disease. The present study was undertaken to clarify the mechanisms involved in lung injury produced by IC formed in the airway. Sequential changes of neutrophils and neutrophil chemotactic activities (NCF) in BAL fluids were evaluated in guinea pigs injected intratracheally with preformed IC. Our results were as follows: 1) There was an increased number of neutrophils in BAL cells within 48 hours of the intratracheal injection with preformed IC reaching a peak at 24 hours postinjection. 2) NCF in BAL fluids were potent at 2-6 hours postinjection and preceded an increase of neutrophils in BAL cells, indicating that NCF play a role in the accumulation of neutrophils in the lung. 3) A consequent increase of alveolar macrophages and macrophage chemotactic activities (MCF) in BAL fluids was observed but to a lesser extent. 4) Pretreatment with cobra venom factor of guinea-pigs reduced the increase of BAL cells, especially neutrophils and NCF to approximately 60% of comparable results, suggesting that complement fragments play a role in IC mediated lung injury. PMID- 2697202 TI - MEDLARS in Australia 1969 to 1989. PMID- 2697201 TI - [Wilson's disease. Hepatic manifestations]. PMID- 2697203 TI - Is 'disease model' an appropriate term to describe the alcohol dependence syndrome? AB - Caetano (Concepts of alcohol dependence: the two worlds of research and treatment. Alcohol and Alcoholism 23, 225-227, 1988) has suggested that in the U.S.A. opposition from the disease model has been the main reason for the limited application of the alcohol dependence syndrome. In Britain, the charge that the syndrome is a poorly disguised version of the disease model has had a similar effect. This paper describes the main features of the crude biomedical disease model, which critics equate with the alcohol dependence syndrome. It is concluded that the alcohol dependence syndrome does not conform to this, in that it is not presented by its proponents as a discrete entity identified by a core psycho biological pathology and carries no built-in assumptions about causal processes. It is argued that instead of setting-up and championing competing all-embracing conceptual models, both clinicians and researchers should be flexible and imaginative in their use of concepts. PMID- 2697204 TI - [Nursing role in hospital-acquired infections]. AB - In this brief review the course of the infections through the ages is described and the main discoveries that marked a turning point in the control of nosocomial infections are mentioned. The Nursing intervention and the role of the Nurse in the prevention and control of hospital acquired infections is also discussed. PMID- 2697205 TI - [Literature review of the toxicology of the fire-extinguishing agents halon 1301 and 1211 and their decomposition products]. AB - This review sums up the results of the examinations concerning the toxicity of the fire extinguishing agents Bromotrifluoromethane and Bromochlorodifluoromethane. Besides the toxicity of the pure substances decomposition products are subject to this paper. PMID- 2697206 TI - Stabilization and prevention--a theoretical framework for environmental hygiene. AB - A theoretical framework for research about problems of environmental hygiene and the conception of strategies for their solution is described. In this context experiences with environmental impact assessments are analysed and proposals for improvements of such assessments are worked out. The strategies for protecting and shaping environments are categorised in 3 groups: defensive, constructive and evolutionary. Conceptual schemas for man-environment and socio-environment systems are presented. Evolutionary strategies for the development of these systems are formulated analogue to evolution strategies of ecosystem development. The effects of destabilization on health risks in man-environment systems are partially tested in a longitudinal study on effects of shiftwork. The possibilities of destabilization, restabilization and prevention of health risks in socio-environment systems are discussed. PMID- 2697207 TI - [A combined chromogenic-fluorogenic medium for the simultaneous detection of coliform groups and E. coli in water]. AB - A comparison was made with different chromogenic and fluorogenic substrates, 4 methylumbelliferyl-beta-D-glucuronide (MUG), 4-nitrophenyl-beta-D-glucuronide (PNPG), 4-methylumbelliferyl-beta-D-galactopyranoside (MUGA), 2-nitrophenyl-beta D-galactopyranoside (ONPG), 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside (X-GAL), for the rapid and simultaneous enumeration of total coliforms and E. coli in water samples, based on 2 commercially available culture-media. The combination of the chromogenic compound X-GAL (for detecting coliforms) and of the fluorogenic compound MUG (for detecting E. coli) incorporated either into ECD agar or into lauryl sulfate broth proved to be most useful. The optimum concentration of the X-GAL/MUG supplement was (50 micrograms/ml/70 micrograms/ml) for the solid medium (EMX agar) and (60 micrograms/ml/70 micrograms/ml) for the fluid medium (LMX broth). As a result of the examination of 244 Enterobacteriaceae strains isolated from water samples and clinical material, it was shown that the use of EMX agar (LMX broth) had several advantages over conventional methods. A routine method for the analysis of water samples was proposed involving the EMX agar and the LMX broth. PMID- 2697208 TI - [The mutagenicity of organic microcontaminants in the environment. IV. The mutagenicity of volatile organic halogens in the SOS-chromotest]. AB - To determine the sensitivity and responsibility of microbial shortterm-tests for detection of the mutagenic potency of volatile halogenated hydrocarbons (OHC) 18 pure substances from the groups of halomethanes, -ethanes and ethylenes were examined with the SOS-Chromotest. The strain Escherichia coli PQ37 was used in the standard procedure (macro procedure) with and without metabolic activation by Aroclor 1254 induced rat-liver microsomes. Although the selected OHC were tested to high doses, none of the tested compounds showed mutagenic effects in Escherichia coli PQ37. Also those OHC's, which showed positive results in the Ames test or being suspected of carcinogenicity, showed no positive results in the SOS-Chromotest. Therefore, the standard procedure of SOS-Chromotest is not suitable to detect the mutagenicity of volatile organic and halogenated compounds. Supplementary investigations with modified methods are necessary to check the results, because there is a good correlation between Ames test and SOS Chromotest by testing other groups of compounds. PMID- 2697209 TI - Be aware of your parents' health insurance. PMID- 2697210 TI - Low-dose cyclosporin A therapy in cadaver renal transplantation in children. AB - Fifty-one pediatric patients undergoing a first cadaveric kidney transplantation were followed for at least 2 years after grafting. They were divided into two groups: those treated with methylprednisolone plus azathioprine (AZA) and those treated with methylprednisolone plus low-dose cyclosporin A (CyA; median dose 109 mg/m2 per day = 3.4 mg/kg per day after 1 year). The steroid dosage given was significantly lower in the second group. The 4-year graft survival rate was 68% for the AZA group and 78% for the CyA group. Renal function did not differ significantly in the two groups; after 1, 2, and 3 years, the median 24-h creatinine clearance was 79, 69, and 51 ml/min/1.73 m2, respectively, for the AZA group and 78, 63, and 68 ml/min/1.73 m2, respectively, for the CyA group. Linear growth was similar in the two groups. We conclude that in pediatric patients the results of low-dose CyA immunosuppression do not differ significantly from those obtained with AZA in terms of graft survival, renal function, or growth. PMID- 2697212 TI - Anti-idiotypic antibodies in reproductive immunology. PMID- 2697211 TI - The increasing importance of chronic rejection as a cause of renal allograft failure. AB - A consequence of reducing early graft failure due to acute rejection has been that more patients are at risk of chronic rejection, something which has become an increasingly important cause of graft loss. We examine the graft survival rates and reasons for failure in our unit from 1981 to 1986. Patients were divided into two series according to treatment of acute rejection episodes. From 1983 onwards, by treating acute vascular (poor prognosis) episodes with antilymphocyte globulin (ALG), we have significantly improved the 6-month actuarial graft survival rate. However, the percentage of total graft failure due to chronic rejection in this second series has significantly increased. The need for greater understanding of the aetiology of chronic rejection, together with its present unsatisfactory treatment, is discussed. PMID- 2697213 TI - Current status of anti-zona pellucida antibodies. AB - It is clear that the mammalian zona pellucida contains tissue-specific antigens that cross-react among certain species. Certain of these antigens generate antibodies that inhibit sperm attachment. Polyclonal antibody production may be an important aspect of this inhibition. In certain species there are other effects of anti-zona antibodies, such as direct action on the ovary. It is uncertain whether immunization with zona antigens will ever be a practical method of contraception in humans. Such vaccination might require unacceptable adjuvants or large amounts of antigen. The persistence and effectiveness of the antibody is not yet proven, and pregnancy has occurred in some despite presence of anti-zona autoantibodies. A safe and effective vaccine may still be found, however, given the large variety of zona pellucida antigens available. The cause of naturally occurring anti-zona pellucida antibodies in humans is unknown. The incidence of these antibodies depends on the assay used. The significance of positivity in a given individual is also uncertain. A number of patients will conceive if other concurrent fertility problems are treated. Positive results should be confirmed by a second method, preferably by testing the sera against human ova. Specific treatment by steroids or other immunosuppressive regimens remains controversial. PMID- 2697214 TI - The DREZ procedure: an update on technique. AB - The DREZ operation was first done in 1975 on a patient with arm pain following a brachial plexus avulsion. Since then approximately 500 patients have undergone the DREZ procedure under our care for treatment of various pain syndromes including deafferentation pain, post-herpetic neuralgia, and post-paraplegia pain. We report several modifications in instrumentation and technique. Currently, we use two types of electrodes for lesion production. The first is the standard 0.25 mm diameter, thermocouple, temperature monitoring electrode which has a 2 mm long tip for introduction into the spinal cord. A second type, recently modified from the original, is used only for lesioning the nucleus caudalis in patients with trigeminal post-herpetic neuralgia. Its tip is 3 mm long with insulation along the first 1 mm. This allows lesioning of the caudalis nucleus while sparing the more superficial spinocerebellar tracts. We no longer lesion only the dorsal root entry zones at each root level but include all the contiguous substantia gelatinosa between roots. With lesions only 1 mm apart this greatly increases the number of lesions and decreases the incidence of incomplete postoperative pain relief. In patients undergoing caudalis lesioning, we make two rows of lesions, one above the other, from C2 to slightly above the obex. This prevents sparing of the facial midline with resultant residual pain. Finally, lesions are made by heating the electrode tip to 75 degrees C for exactly 15 sec, thus allowing for a more uniform lesion. With these modifications, we have a decreased incidence of incomplete pain relief as well as a decreased incidence of complications, especially in patients undergoing caudalis lesioning. PMID- 2697215 TI - Intracranial haemorrhage from meningiomas: a report of five cases. AB - Intracranial haemorrhage from meningiomas is rare and carries a mortality of over 40%. The authors present five cases presenting with intratumoral, intracerebral, subarachnoid or subdural haemorrhage. The relevant literature is reviewed and the pathology and possible mechanisms of haemorrhage in these tumours are discussed. PMID- 2697216 TI - Familial glioma: a report of glioblastoma in identical twins and oligo astrocytoma in siblings. AB - The authors report two pairs of siblings who had intracranial gliomas. One pair of identical twins had glioblastomas and two siblings had mixed oligo astrocytomas. Genetic influences in the aetiology of glioma are discussed. PMID- 2697218 TI - Can pulmonary embolism be diagnosed by duplex ultrasound? a case study. PMID- 2697217 TI - Systemic metastasis from primary intracranial germinoma: a case report and literature review. AB - A case of systemic haematogenous metastasis occurring post-operatively from a primary suprasellar intracranial germinoma is reported. While local invasion and direct spread associated with surgical incision and shunt procedures are well known, haematogenous metastasis of these tumours is extremely rare. Problems associated with establishing this diagnosis are discussed. PMID- 2697219 TI - Principles and application of oximetry. AB - The evaluation of oxygen availability, transport, and extraction at the tissue level have become critical factors in managing the acutely ill. Oximetry, both arterial and venous, has contributed to oxygenation assessments. Despite some limitations, oximetry offers immediate continuous feedback that can alert practitioners to potential oxygenation problems. PMID- 2697220 TI - Advances in the treatment of oxygenation disturbances. AB - The treatment of oxygen transport parameters centers on improving any aspect of oxygen delivery that is threatened. The most important improvements center on improving cardiac output and oxygen carrying capacity, primarily through improving hemoglobin levels, and to a smaller extent, PaO2/SaO2 values. This article reviewed the highlights for improving the key components of oxygen transport while providing examples to aid clinical application. PMID- 2697221 TI - New modes of mechanical ventilation. AB - The new modes and techniques of ventilation provide much needed alternative ventilatory support for the critically ill patient. Reduction of airway pressure, improved oxygenation, recruitment of alveoli, and redistribution of ventilation are the major advantages of these new modes. Continued research and clinical application will help develop a mechanical ventilation system that optimizes the patient respiratory status with minimal adverse effects. PMID- 2697222 TI - Immune system function. Implications for critical care nursing practice. AB - The purpose of the immune system is to protect the body from invasion from microorganisms. Natural defenses encompassing epithelial surfaces and secretions, nonspecific phagocytosis and inflammatory process, and the acquired defenses of humoral and cell-mediated immunity work together to defend the internal environment of the body. If microorganisms penetrate the external surfaces and enter the body, the inflammatory process is triggered. During phagocytosis by monocytes/macrophages, the invading antigen is identified as nonself. The antigen is presented to the T4-lymphocyte. This cell line orchestrates the activation of B-lymphocytes and a humoral response of antibody or Ig production and initiates the cytotoxic cell-mediated T cell response. Following an appropriate level of response, T8 cells suppress immune system response to the antigen, but not before memory B and T cells have formed. These memory cells protect the body against future exposure to the antigen, thus creating immunity. As concepts of immunology are identified and validated by future research, the knowledge base of immune system function and dysfunction will continue to grow. Critical care nurses must incorporate new knowledge related to immune system function into their practice, as patients in the ICU are at risk for immunocompromise from their underlying disease state and the therapeutic interventions used in their treatment. Nurses must expand their physiologic data base to include a nursing assessment of the immune system. A framework for organizing the data collection process would include: (1) a survey of factors affecting immune system function in each patient, (2) assessment of the cells and structures of the immune system, (3) monitoring of the status of first line defenses, (4) observing for activity of nonspecific defenses, and (5) evidence of specific acquired immune responses. After complete immune system assessment has identified areas of risk for compromise or the presence of immunocompromise, specific individualized nursing care plans can be developed to provide nursing support to maintain and enhance the patient's defenses. PMID- 2697223 TI - Complications after cardiac transplantation. The role of immunosuppression. AB - Increased numbers of cardiac transplantations are being performed as a therapeutic option for end-stage cardiac disease. Immunosuppressive therapy combining multiple drugs to prevent rejection is essential to the success of this procedure. Although the patient's primary problem of heart failure is alleviated by a successful transplant, the secondary effect of immunosuppression causes many potential problems for this patient population. Infection from common pathogens or opportunistic microorganisms is the primary complication causing death in the post-transplant patient. Bacterial, viral, fungal, or parasitic infection may ensue during the postoperative period. Life-long immunosuppressive therapy places the patient at continuous risk for the development of infection. Nurses play an important role in the management of the cardiac transplant patient. A thorough knowledge of normal immune system function and the specific actions of each immunosuppressive drug on the immune system function is a prerequisite for providing care for these patients. Continuous monitoring of the patient to detect the signs and symptoms of infection or other side effects of the drugs is part of the nurse's role in caring for these patients. Maintenance of the patient's nonspecific host defenses is supported by specific nursing actions. In preparation for the life-long effects of the drugs, education of the patient and family regarding the implications of therapy with immunosuppressive agents is a crucial nursing function for the successful management of the cardiac transplant patient. PMID- 2697224 TI - Host defense mechanisms and compromises in the trauma patient. AB - Infection in multiple trauma patients remains the number one complication and the second leading cause of death in this population. Because each type of injury has its own intrinsic infection risks and the treatment of the injury necessitates the use of invasive therapy, the prevention of infection may not be possible. The most effective infection control measures may be continual nursing assessment of the patient, including observing for subtle changes that would indicate the presence of an infection. It is the early distinction of infection as the underlying mechanism of inflammatory responses and fever that best facilitates an expedient and appropriate course of therapy. Classic recommendations of infection control practices such as hand washing and meticulous aseptic technique during all procedures, plus an awareness of the many ways that microorganisms can contaminate and innoculate the patient are the best strategies for nursing care. Nursing actions must be guided by a clear understanding of the patient's host defense mechanisms and how they are jeopardized by both the injury and the therapy. This understanding facilitates the implementation of specific nursing care measures to promote the restoration of normal host defense mechanisms and to prevent further compromise of the trauma patient while in the ICU. PMID- 2697225 TI - Immunosuppression of the burned patient. AB - The burn patient is highly susceptible to infection due to the loss of the skin as a barrier to microorganisms. Immune defenses are activated in response to the burn injury; however, some of these defenses are altered. Neutrophil chemotaxis is compromised by decreased perfusion caused by hypovolemia and the formation of microthrombi. Chemotaxis and phagocytosis are dependent on complement components that are reduced in a large burn wound. Neutrophil intracellular killing power is reduced as oxygen delivery to the wound is decreased. Humoral immunity is altered with the drop in IgG levels. Cell-mediated immunity is depressed and T cell lymphocyte counts are deceased. Suppressor T cells are generated. Specific sources of infection for the burn patient include the patient's own bacterial flora; hospital personnel; respiratory equipment; and catheters, both urinary and intravascular. The best control for burn wound infection is the closure of the wound by early excision and grafting. When lack of donor sites prohibits this surgical therapy, control centers on the environment and wound care techniques. The selection of wound topical antibiotics on the basis of visual inspection and surface culturing assists in the prevention of burn wound sepsis. When wound sepsis does occur, systemic antibiotics are instituted. Although burn wound sepsis is an obvious cause of death for the burn patient, it is not the primary cause. Increasing sophistication in fluid resuscitation and in intensive care therapy has resulted in patients living beyond the initial insult and the following few days. Burn patient mortality is now associated with a syndrome presenting clinically as sepsis but without any identifiable septic source.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697226 TI - Immunosuppression in pediatric critical care patients. AB - The pediatric critical care patient not only ranges in age, size, diagnosis, and outcome but also in immunologic capability and function. The neonate, once thought to be devoid of any immunological function, is relatively immunocompetent in some areas and immature in immunologic function in other areas. The newborn's impaired immune function is a reflection of immature and inexperienced cellular interrelations rather than the absence or immature function of a single cell line. The exact time that an infant/young child's immune system becomes mature is not definitive. The maturational process of the immune system is complex and unpredictably long. Although some components of a mature immune function occur quickly following birth (for example, colonization and secretory functions of the skin and mucous membranes), other components may take years and occur sometime before the child reaches puberty (for example, adult levels of IgG, IgD, IgA, and IgE). The critically ill infant and child have both developmental aspects of immunocompromise but also the PICU situational or clinical stressors that may impede immune function. The long-term impact of the situational stressors on the development of immune system is unknown. The PICU nurse should recognize that the critically ill child is vulnerable to immunocompromise, and provide assessment and intervention to provide optimal immune function by preventing infection and promoting host defenses. PMID- 2697227 TI - Aging, immunity, and critical care nursing. AB - Age-related changes of the immune system along with underlying disease can reduce the elderly patients' chances of survival in critical care. Complications can be minimized when the health care team responds not only to the needs of the critically ill patient, but also to the needs specific to the elderly patient. PMID- 2697228 TI - Future expectations for critical care nurses. Competence in immunotherapy. AB - Immunotherapy is a promising therapy for the treatment of some forms of cancer. This research therapy uses normal immune system substances such as IL-2 to stimulate the immune system to kill tumor cells while sparing normal tissues. Many side effects of IL-2 have been identified. The most serious of these effects involves the cardiovascular, renal, and pulmonary systems. Patients who experience these IL-2-related toxicities are effectively managed in the intensive care unit. The critical care nurse has a major role in the monitoring and management of this patient population. Hospitals that participate in this research treatment for cancer are increasing. In the near future, competence in immunotherapy will be an expectation for many critical care nurses. PMID- 2697229 TI - Emil M. Mrak. PMID- 2697230 TI - Chemical and nutritional aspects of folate research: analytical procedures, methods of folate synthesis, stability, and bioavailability of dietary folates. PMID- 2697231 TI - Calcium in the diet: food sources, recommended intakes, and nutritional bioavailability. AB - Calcium nutritional status among some groups in the United States is suboptimal when judged by calcium intakes and the high prevalence of osteoporosis. Unfortunately, however, it is not clear that increases in calcium intake will have a significant impact on osteoporosis or other chronic diseases that have been linked to calcium nutriture. There is still considerable controversy surrounding the issue of calcium RDAs. The body's ability to adapt to varying levels of calcium intakes, the lack of sensitive indicators of calcium status, and the complexity and slow progression of chronic diseases such as osteoporosis make it very difficult to establish the role of diet in this regard. Great progress has been made in the study of calcium absorption. Much is known about the mechanisms involved in calcium absorption and its regulation. Thus, a rapidly advancing field and further developments will be invaluable to our understanding of the role of diet in calcium nutrition. Calcium bioavailability is affected by diet composition and the chemical form of calcium in foods. The calcium in dairy products is readily absorbed in the intestine. Lactose enhances calcium absorption efficiency under some conditions. Components of plants such as fiber, phytate, and oxalic acid may depress calcium absorption. High intakes of protein increase urinary losses of calcium but this effect may be partially offset by the phosphate association with most high-protein foods. Calcium absorption from salts used in supplement tablets is generally good. Absorption from salts such as calcium carbonate which require acid for dissolution may be poor in persons with achlorhydria unless the tablets are consumed with a meal. The practical significance of factors that may alter calcium bioavailability in normal mixed diets is difficult to assess. It may be a significant factor when calcium intakes are marginal or when absorption by the active transport, vitamin D-dependent process is impaired or not fully developed, i.e., it may be significant when vitamin D status is poor, in the elderly, and in young infants. PMID- 2697232 TI - Dietary and biochemical aspects of vitamin E. PMID- 2697233 TI - Oxidation of polyunsaturated fatty acids: mechanisms, products, and inhibition with emphasis on fish. PMID- 2697234 TI - Proteins in whey: chemical, physical, and functional properties. AB - There is abundant information concerning the functional behavior of whey proteins in model systems. The data on functional properties reported by different researchers, however, reveal wide discrepancies in values. For example, in the case of comparable whey preparations, apparent solubilities may range from 10 to 100%; strength of gels from 0.3 to greater than 10 N, foam overruns from 250 to 1500%, and foam stabilities from 0.5 to 30 min. Many of the data are of limited value in assessing the true functional characteristics of different preparations, treatments, or processing effects. Reports to date are useful in indicating the relative behavior of different proteins; however, the data do not always predict the performance of such proteins in actual food systems. This reflects the fact that in foods, extensive interactions with other components may occur, resulting in modified behavior of the proteins. Harper, (1984) has advocated the testing of these various preparations in simulated food systems which should validly relate the behavior to performance in commercial systems. Emphasis on standardization of specific protocols, with regard to order of addition in ingredients, temperature, pH control, and amount of energy input during mixing, homogenization, emulsification, etc. deserves serious consideration. While this approach is justifiable in terms of providing valuable data to commercial users, it does not minimize the importance of examining these proteins in model systems where the physicochemical basis of each functional attribute can be described in molecular terms (Kinsella, 1987). Such information is necessary to expedite appropriate methods of processing in order to control compositional variability, extent of denatauration, and possible protein modification. In addition, rapid, reliable tests for routine quality assurance that can provide practical information concerning functional applications would be of great value. Whey protein preparations vary immensely in functional behavior and are presently relegated to limited use as functional ingredients in the food industry. This need not be the case since conventional and new technologies permit rigorous control of production protocols, e.g., careful control of heat treatments can result in the production of whey protein preparations with consistent, reliable functional properties (deWit, 1981, 1984; Harper, 1984; Morr, 1985). As the market for functional proteins continues to expand, the whey industry must seek the means to refine whey protein products; determine useful functional properties; develop standardized manufacturing protocols; demonstrate the effectiveness of whey as a functional ingredient; promote, and then market, whey on the basis of performance at competitive cost. PMID- 2697235 TI - Horace Wells thanks you. PMID- 2697236 TI - Cellular and molecular biology of neuropeptide processing and packaging. PMID- 2697237 TI - Trophic factors and neuronal survival. PMID- 2697238 TI - The effect of pH-adjusted 2-chloroprocaine on the onset of epidural analgesia in pregnant patients in the lying and sitting position during the first stage of labor. AB - The purpose of this prospective, randomized, double-blind study was to compare the epidural onset time of 2% 2-chloroprocaine with pH-adjusted 2-chloroprocaine administered in either the sitting or supine position in pregnant patients during the first stage of labor. Patients in Groups I and III received the control solution in the sitting and supine position, respectively. Patients in Groups II and IV received the buffered solution in the sitting and supine position, respectively. The pH and pCO2 of the control and buffered solutions differed significantly. The pH and pCO2 of the control and buffered solutions were 4.38 +/ 0.01, 18.4 +/- 2.2 mm Hg and 7.70 +/- 0.04, 114.9 +/- 3.0 mmHg, respectively. A statistically significant reduction in the time of onset of analgesia in the pH adjusted groups was noted. Groups I and II had onset times of 4 +/- 1.2 and 4.3 +/- 1.0, whereas Groups II and IV had onset times of 2.6 +/- 0.9 and 2.7 +/- 0.6 min., respectively. There were no intergroup differences in the cephalad spread of analgesia or duration of analgesia. Position had no effect on the onset of analgesia at the S2-3 dermatomes nor on the bilateral cephalad spread of the epidural study solutions. Our results indicate that a pregnant patient may be dosed in the lateral supine position without adversely affecting the caudad or cephalad spread of plain or pH-adjusted 2% 2-chloroprocaine, which is clinically important because the incidence of aortocaval compression is increased in the supine position when compared with the lateral supine position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697239 TI - Effect of labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study. AB - Labetalol, a combined alpha 1- and nonselective beta-adrenergic blocking drug, was compared to lidocaine or saline to minimize the hypertensive and tachycardic response to intubation in a controlled randomized double-blind study in patients undergoing surgical procedures under general anesthesia. Forty adult patients were divided into four groups of 10 each: placebo (saline), lidocaine 100 mg, labetalol 5 mg, or labetalol 10 mg. The double-blind preparation was administered as an IV bolus just prior to induction and 2 min before the stimulus of laryngoscopy and intubation. Heart rate and blood pressure were measured at 1-min intervals for 2 min prior to induction of anesthesia and through 6 min following induction of anesthesia. Labetalol 10 mg prevented a rise in heart rate after intubation compared to patients who received placebo, lidocaine 100 mg, or labetalol 5 mg. The hypertensive response to intubation was similar in all four groups. Labetalol 10 mg IV just prior to induction of anesthesia is a safe and cost-effective means of preventing tachycardia but not hypertension in response to laryngoscopy and intubation. PMID- 2697240 TI - Comparison of propofol with thiopental and isoflurane for induction and maintenance of general anesthesia. AB - Propofol, a phenol compound with a short elimination half-life, was compared with thiopental and isoflurane for induction and maintenance of general anesthesia in 60 consenting ASA I, II, and III patients. The study was randomized and open label in design. Hemodynamically, the propofol patients showed a mean +/- SEM decrease in systolic blood pressure in comparison with the thiopental/isoflurane group at 2 (115.1 +/- 4.9 vs. 136.6 +/- 6.0 mmHg), 3 (125.7 +/- 5.1 vs. 149.4 +/- 5.6 mmHg), and 5 min (126.6 +/- 3.8 vs. 144.4 +/- 6.1 mmHg) postinduction and at intubation (135.2 +/- 4.7 vs. 157.8 +/- 6.0 mmHg) (p less than 0.05). The heart rate was lower in the propofol group throughout the induction period (p less than 0.05). Patients who received propofol were ready for discharge from the recovery room sooner (67.9 +/- 4.0 vs. 80.0 +/- 3.6 min) than the thiopental/isoflurane treated patients (p less than 0.05). Propofol is as safe and effective for induction and maintenance of general anesthesia as thiopental and isoflurane. PMID- 2697241 TI - Principles of ophthalmic anesthesia. AB - Ophthalmic surgery presents the anesthesiologist with many unique challenges. The exigencies of this subspecialty include a comprehensive knowledge of ocular physiology and pharmacology and an understanding of the anesthetic implications intrinsic to a wide variety of ophthalmic procedures. PMID- 2697242 TI - Fetal surgery and general anesthesia: a case report and review. AB - Fetal surgery, in utero, is now a viable option for some congenital conditions due to recent advances in ultrasound and microsurgical technology. Previous reports of anesthesia for such procedures have focused on spinal or epidural conduction techniques. General endotracheal anesthesia may have several advantages in this setting. In addition to maternal anesthesia, general anesthesia can provide fetal neuromuscular block (without direct fetal injection of blocking agents) and uterine relaxation. It may also blunt fetal response to surgical stimulation. PMID- 2697243 TI - Hepatotoxicity and inhalation anesthetics: views in the era of isoflurane. AB - The halogenated inhalation anesthetics continue to be an important group of drugs in current anesthesia practice. The purpose of this article is to discuss current concepts of the mechanisms of halothane-induced hepatotoxicity and to attempt to answer the question: Do all halogenated inhalation anesthetics share halothane's propensity to hepatotoxicity? PMID- 2697244 TI - Smoke inhalation: diagnosis and treatment. PMID- 2697245 TI - The pharmacology of propofol. AB - A review of the pharmacology of propofol, a new IV anesthetic agent, is presented. Solubilized in a soybean emulsion, propofol is one of a series of sterically hindered phenols that exhibit anesthetic activity. Induction of anesthesia with propofol may be associated with pain on injection, apnea, and a reduction in arterial blood pressure (BP) and cardiac output. Caution should be ascribed to its use in patients with coronary artery disease, where these effects may have the potential for producing myocardial ischemia. The hemodynamic responses to laryngoscopy and intubation are attenuated. The pharmacokinetic profile suggests suitability as an infusion for either maintenance of anesthesia or sedation. Use of propofol as an infusion during surgery may result in a further reduction in cardiac output, particularly with the concomitant administration of adjuvant increments of fentanyl. The ventilatory response to CO2 is depressed during such an infusion. The high clearance of propofol suggests that even after a prolonged infusion, recovery should be rapid. This finding has been confirmed in a series of studies establishing propofol as an ideal agent for use in a total IV anesthetic technique. Both the quality and speed of recovery, together with the absence of emetic sequelae, support the use of propofol in an outpatient setting. Propofol appears to have no long-term effect on adrenocortical function and appears safe for use in patients with acute intermittent porphyria and susceptibility to malignant hyperpyrexia. PMID- 2697246 TI - Biological and pharmacological modulations of fibroblast functions. AB - During recent years, considerable progress in the field of connective-tissue research has brought about detailed information on the behaviour of fibroblastic cells under culture conditions and in in vivo situations. Well-characterized biological functions of fibroblasts include cell migration, cell attachment, cell proliferation and biosynthesis as well as degradation of multiple connective tissue components. An exact control of these functions is essential in physiological processes of tissue development and repair, while, on the other hand, fibrotic diseases or poor wound healing are associated with functional deviances of fibroblasts. Therefore, the modulation of fibroblast functions has become the focus of ongoing research aiming to expand the pathophysiological understanding and therapeutic options in connective-tissue diseases. Discussing scientific approaches to investigate various fibroblast functions, this review surveys biological and pharmacological factors which affect the behaviour of fibroblasts. PMID- 2697247 TI - Migration of polymorphonuclear leukocytes in psoriasis. AB - A characteristic feature of the early and active psoriatic lesion is the intraepidermal penetration of polymorphonuclear leukocytes (PMN) with the formation of intraepidermal micropustules of Kogoj and microabscesses of Munro, localized in the stratum corneum. In pustular psoriasis the accumulation of PMN dominates the clinical picture. During the last decade our insight into the regulation of the migration of PMN has increased. The properties of the circulating blood PMN and the biochemical nature and biological effects of mediators of inflammation have been studied in detail. Several groups have demonstrated that the transdermal and epidermal migration of PMN following challenge with a chemoattractant is slightly diminished in the clinically uninvolved skin and profoundly decreased in the lesional skin of psoriatics, compared to the responsiveness in normal controls. The molecular nature of this process of tachyphylaxis has not yet been established. However, it has been hypothesised that some mediators of inflammation, cytochrome P-450, endothelial cell function, and protease inhibitors might be of relevance in this respect. This report is a review of the literature on transdermal and epidermal migration of PMN in normal and psoriatic skin. The aim of this review is to clarify further the position of the PMN in the pathogenesis of psoriasis and its role as a target for antipsoriatic treatments. PMID- 2697248 TI - The glenohumeral joint. PMID- 2697249 TI - The elbow and wrist. PMID- 2697250 TI - Articular disorders of the hip. PMID- 2697251 TI - Articular disorders of the knee. PMID- 2697252 TI - The foot and ankle. PMID- 2697253 TI - The temporomandibular joint. PMID- 2697254 TI - Nonarticular soft tissues. PMID- 2697255 TI - The solitary tumor or tumorlike lesion of bone. PMID- 2697256 TI - Bone marrow. PMID- 2697257 TI - Musculoskeletal trauma. PMID- 2697258 TI - Congenital and perinatal lesions. AB - Most congenital abnormalities can be traced to defects occurring at a specific stage during embryologic development. Anatomic deformities of the ventricular system and brain surface are visualized and myelination of the white matter is well evaluated on MR scans so that congenital abnormalities may be differentiated from perinatal lesions. MR imaging is often the only imaging modality required for complete assessment of abnormalities in the neonatal period. PMID- 2697259 TI - Head trauma. AB - Computed tomography is currently the modality of choice in imaging acutely traumatized patients. This is based upon CT's documented ability to detect surgically significant lesions. Furthermore, the use of MRI is limited by a lack of bone detail, the degradation of MR images in frequently uncooperative patients, and a limited supply of nonferromagnetic monitoring equipments. CT and MRI are largely equivalent in their ability to diagnose epidural hematoma, but CT is readily available and quick. MRI provides information in addition to that obtained by CT in many instances, such as subacute and chronic subdural hematomas, contusions, and intracerebral hematomas. PMID- 2697260 TI - Infectious diseases of the brain. AB - Magnetic resonance imaging is the modality of choice for the characterization of intracranial inflammation, by defining ependyma, white matter, gray matter, and leptomeningeal involvement. Hemorrhage is well shown, but calcification is difficult to identify. Intravenous Gd-DTPA is useful in the evaluation of B-b barrier abnormalities. Although it is not often possible to make a specific microbiologic diagnosis, MR appearances are usually helpful in excluding other abnormalities, such as neoplasm or infarction. Knowledge of the number and size of individual lesions is invaluable in monitoring therapy. PMID- 2697261 TI - White matter diseases. AB - White matter disease is imaged with great sensitivity and poor specificity on MRI. Congenital, vascular, infectious, and autoimmune diseases as well as those with many other causes, may create similar-appearing lesions on MR. A knowledge of disease patterns and pulse sequences may improve the diagnostic specificity, but there is no substitute for an adequate clinical history. PMID- 2697262 TI - Aneurysms and vascular malformations. AB - Intracranial aneurysms and vascular malformations are frequently detected following intracranial hemorrhages. A CT scan is the most sensitive method of detecting acute subarachnoid, parenchymal, and intraventricular hemorrhages. Small aneurysms are inconsistently visualized on MR scans. Angiography remains the standard for complete and accurate depiction of patent aneurysms, as well as of arteriovenous and venous malformations that have not thrombosed. Giant and thrombosed aneurysms present as mass lesions and are frequently detected when MR is used as a screening examination. Often MRI characterizes these lesions better than CT or angiography. Patients with vascular malformations who have focal neurologic symptoms without hemorrhage are best evaluated with MRI. Patent vascular malformations demonstrating flow void and other flow-related phenomena are readily demonstrated. Occult vascular malformations, including thrombosed arteriovenous, venous, and cavernous malformations and telangiectasia, are also best detected by MRI and are not visible on angiography. PMID- 2697263 TI - Brain ischemia. AB - The sensitivity of MRI to changes in water state and volume makes it the most desirable modality for imaging early brain ischemia. Its sensitivity is reflected in the ability to show ischemic changes in the white matter of the asymptomatic elderly, which are attributed to axonal loss, demyelination, and gliosis. In large infarcts, however, contrast enhancement with Gd-DTPA can be used to add specificity, should doubt exist as to the proper diagnosis. The ability of MR to image flow is a valuable adjunct, and MR angiography has the potential partially to replace invasive angiography. Applications of MR such as diffusion-perfusion studies, sodium imaging, and spectroscopy could all prove to be useful in the future. PMID- 2697264 TI - Active chromatin. PMID- 2697265 TI - Regulatory elements of the generic ribosomal gene. PMID- 2697266 TI - DNA repair and recombination. PMID- 2697267 TI - DNA replication. PMID- 2697268 TI - Gene amplification: an example of genome rearrangement. PMID- 2697269 TI - Control of gene expression in eukaryotic cells: lessons from class III genes. PMID- 2697270 TI - Pre-mRNA processing and mRNA nuclear export. PMID- 2697271 TI - Centromeres and telomeres: structural elements of eukaryotic chromosomes. PMID- 2697272 TI - Cytokinesis in animal cells. PMID- 2697273 TI - Bibliography of the current world literature. Nucleus and gene expression. PMID- 2697274 TI - Transport of proteins into mitochondria. PMID- 2697275 TI - Assembly of proteins in the endoplasmic reticulum. PMID- 2697276 TI - Topogenesis of plasma membrane domains in polarized epithelial cells. PMID- 2697277 TI - Membrane structure and dynamics. PMID- 2697278 TI - Bacterial membranes. PMID- 2697279 TI - Targeting and assembly of chloroplast proteins. PMID- 2697280 TI - Molecular pathologies of the hepatic endoplasmic reticulum. PMID- 2697281 TI - Uniport carriers for metabolites. PMID- 2697282 TI - The cotransport systems. PMID- 2697283 TI - Permeability through pores and holes. PMID- 2697284 TI - Bibliography of the current world literature. Membranes. PMID- 2697285 TI - Bibliography of the current world literature. Membrane permeability. PMID- 2697286 TI - Wound repair. PMID- 2697287 TI - Metastatic tumor cell interactions with endothelium, basement membrane and tissue. PMID- 2697288 TI - The plant extracellular matrix. PMID- 2697289 TI - Bibliography of the current world literature. Cell-to-cell contact. PMID- 2697290 TI - Bibliography of the current world literature. Extracellular matrix. PMID- 2697291 TI - Calcium-dependent cell adhesion molecules. AB - The adhesive function of Ca2(+)-dependent CAMS has in the past been studied only indirectly, mainly using immunological techniques. The molecular cloning and information about the primary structure of several CAMs has been an important step in a more detailed molecular analysis. If there is a homophilic interaction between CAMs of neighbouring cells, an important question concerns the specificity of each CAM-mediated adhesiveness. Has each CAM a unique specificity and can this specificity be linked to a defined amino acid sequence? It will be important to elucidate the molecular mechanism of how each CAM interacts with the other. The experiments of Volk et al. (1987) suggest that an interaction of two different CAMs can occur. Since during development a given cell can express more than one CAM such an heterophilic interaction could play some regulatory role. Alternative splicing mechanisms or different protein forms during development or on different cell types have not yet been observed for Ca2(+)-dependent CAMs. However, uvomorulin is assumed to have a slightly different function during development and in adult tissues. During development uvomorulin is involved in the condensation, the pattern formation, and the sorting out of cells. In these processes the uvomorulin-mediated adhesiveness should be controlled, since cells reorganize and migrate during development. For the maintenance of the histoarchitecture in adult tissues uvomorulin might act more as a glue. This argues for the existence of mechanisms to regulate the strength of adhesiveness, and the cytoplasmic domain might be involved in these processes. The association of the cytoplasmic domain of uvomorulin with catenins could be an important observation in this respect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697292 TI - Neural cell-to-cell adhesion and recognition. PMID- 2697293 TI - Glycoconjugates as mediators of cellular interactions during development. PMID- 2697294 TI - Lymphocyte homing: progress and prospects. PMID- 2697295 TI - Role of cell-to-cell interactions in T lymphocyte development and activation. PMID- 2697296 TI - Killer lymphocytes and how they kill. PMID- 2697297 TI - Cell-to-cell fusion. PMID- 2697298 TI - Proteinases and extracellular matrix remodeling. PMID- 2697299 TI - Basement membranes: molecular organization and function in development and disease. PMID- 2697300 TI - Differentiation of cartilage and bone. PMID- 2697301 TI - Matrix regulation of cell shape and gene expression. PMID- 2697302 TI - Aortic dissection: review of value and limitations of two-dimensional echocardiography in a six-year experience. AB - The utility of transthoracic two-dimensional echocardiography in patients with aortic dissection was assessed by retrospective analysis in 67 patients: 31 patients with DeBakey type I, 21 patients with type II, 10 patients with type III, and five patients with false-positive diagnoses. Aortic dissection was correctly identified by two-dimensional echocardiography in 49 patients; 13 had false-negative diagnoses. Therefore the sensitivity was 79%, and the positive predictive accuracy was 91%. Transthoracic two-dimensional echocardiography is a reasonable screening technique for diagnosis of aortic dissection. PMID- 2697303 TI - Evaluation of valvular regurgitation by color Doppler. PMID- 2697304 TI - Changes in Medicare reimbursement for echocardiographic procedures. AB - Medicare reimbursement for echocardiographic procedures is clouded by the fact that Medicare defines ultrasound services to be "radiologic." As such, a 40% limitation has been imposed in some states. In addition, as a result of the Omnibus Budget Reconciliation Act of 1987, a new radiology fee structure was negotiated with Medicare, without the input of internists and cardiologists, that may significantly affect reimbursement patterns for echocardiographic services. Those who perform and interpret cardiac ultrasound studies are again urged to use the medicine codes (90,000 series) rather than radiology codes (70,000 series). PMID- 2697305 TI - Anatomy, histology, and pathology of the major epicardial coronary arteries relevant to echocardiographic imaging techniques. AB - We are at the threshold of a new era of coronary artery imaging with the use of transthoracic, transesophageal, and intravascular ultrasound. Echocardiographic imaging has the capability of assessing changes of the lumen and walls of major epicardial coronary arteries. This article reviews certain anatomic, histologic, and pathologic observations of the major epicardial coronary arteries relevant to these various echocardiographic imaging techniques. PMID- 2697306 TI - Coronary artery abnormalities in children. AB - Although coronary artery abnormalities are somewhat rare in children, they constitute a population at significant risk for morbidity and/or mortality. The expeditious and accurate diagnosis of these lesions is imperative for optimum management. The ability of two-dimensional and Doppler echocardiography to accurately evaluate coronary artery abnormalities in children will be discussed under three headings: (1) major congenital coronary artery anomalies, (2) coronary artery anomalies associated with specific congenital heart lesions, and (3) acquired coronary artery abnormalities. PMID- 2697307 TI - New insights into the pathophysiology of coronary arteries by epicardial high frequency echocardiography. AB - Currently, the coronary angiogram remains the "gold standard" for the detection and quantification of coronary arterial disease. Clinical assessment of the arteriogram is usually based simply on the relative percent narrowing of the column of angiographic dye. However, such analysis oversimplifies and is not accurate for evaluating the extent and severity of coronary artery atherosclerosis. Recently a new generation of ultrasonic devices has become available for intraoperative evaluation of coronary arterial anatomy. These high frequency echocardiographic transducers use 12 MHz probes. The transducer is placed directly over the epicardium during open heart surgery to evaluate the coronary artery. With this technique, demonstration of coronary artery anatomy, including wall and cross-sectional lumen, is available in vivo. We have undertaken numerous validation studies in vitro and in vivo of animal and postmortem human heart preparations to show that this technique can be used to accurately measure luminal area, luminal diameter, and wall thickness. Subsequently in patients intraoperatively the extent of atherosclerosis using luminal diameter to wall thickness (LD/WT) ratios was compared with the routine angiographic evaluation of coronary arterial disease using percent stenosis measurements. LD/WT ratios from arterial segments with no visible angiographic disease but with angiographic lesions elsewhere in the same coronary artery showed marked variability. The majority were in the range of LD/WT ratios of those segments where high frequency echocardiography recording was made at the site of "angiographic" disease. This indicates that in vivo atherosclerosis is more widespread than the angiogram predicts and underlies the difficulties of using percent stenosis angiographically to determine the extent and severity of coronary arterial disease. In a second study we have demonstrated that there is marked variability and eccentricity in coronary plaque geometry, luminal morphology, and placement of the residual lumen with respect to the atherosclerotic plaque. This eccentricity results in some relatively "normal" coronary wall at the site of maximum atherosclerosis, theoretically preserving the ability to vasodilate and vasoconstrict. Studies with high frequency echocardiography are underway to study the capability of arteries with atherosclerosis to vasodilate. We have evaluated atherosclerotic remodeling of coronary arteries and found that remodeling occurs in an attempt by the artery to preserve its residual luminal size during encroachment on the lumen by the atherosclerotic plaque. This is the first in vivo demonstration of this process in human coronary arteries. Coronary arterial bypass grafts have been evaluated in animal models and at the time of intraoperative coronary anastomoses to evaluate the adequacy of graft anastomoses and compare vein grafts with internal mammary grafts.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697308 TI - Two-dimensional intravascular ultrasound: technical development and initial clinical experience. AB - This article reviews the development and current status of catheter-based, intravascular ultrasound imaging. The first section provides an introduction to some of the general technical issues encountered in the design of the catheter imaging systems and compares the potential merits of the multiple-element versus the mechanical approach. The second section of the article reviews the data from early studies correlating the intravascular ultrasound images with histologic sections (in vitro) and angiography (in vivo). The article concludes with a discussion of potential clinical applications and future technical developments. PMID- 2697309 TI - Intravascular ultrasound estimation of arterial stenosis. AB - The evaluation of the degree of reduction in the cross-sectional area of an artery has important pathophysiologic and therapeutic implications. Currently, no technique can easily provide this information. In this in vitro study we evaluated the potential of a new imaging technique, intravascular high frequency ultrasound angioscopy, in the estimation of percentage of cross-sectional area stenosis of an artery. To do this, we compared intravascular high frequency ultrasound to previously-validated external high frequency ultrasound and to anatomic estimation of arterial stenosis. Using a prototype intraluminal imaging catheter with a 20 MHz ultrasound transducer at its tip, we imaged 20 arterial segments of various size (15 to 90 mm2 lumen area by anatomy) in the control state and after experimental stenosis. These arterial segments were also imaged by external high frequency ultrasound. Lumen areas were measured from calibrated ultrasound images in the control state and after stenosis, and percentage of cross-sectional area stenosis was calculated. These data were compared to the percentage of area stenosis derived from calibrated anatomic photographs of the arteries taken in the control state and after stenosis. Both intravascular ultrasound angioscopy and external high frequency ultrasound yielded high resolution, two-dimensional, circumferential images of the arteries. Alterations in vessel area and shape were apparent after creation of stenosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697310 TI - Echocardiography and cardiac transplantation: a literature review and practical approach. AB - This article reviews the utility of noninvasive echocardiography in the detection of early cardiac transplant rejection before and after the use of cyclosporine. It addresses the use of Doppler and two-dimensional echocardiography in the routine cardiac evaluation of the heart-transplant patient, including the use of two-dimensional echocardiography in guiding the endomyocardial biopsy procedure. PMID- 2697311 TI - The role of the cardiac sonographer in the evaluation of the heart transplant recipient. AB - The sonographer should have a basic understanding of the indications, surgical technique, survival rate, electrocardiographic findings, chest radiographic findings, and complications for orthotopic cardiac transplantation. The sonographer should also have a thorough understanding of the normal echocardiographic and Doppler findings in these patients and the possible echocardiographic and Doppler findings during acute early rejection. This article has presented those findings in a review form to enable the sonographer to consult the information presented before the echocardiographic and cardiac Doppler examination is carried out. In addition, a sample echocardiographic and cardiac Doppler worksheet has been provided. PMID- 2697312 TI - Lung transplantation: the Toronto experience. PMID- 2697313 TI - Intrathoracic lobe of the liver. Case report and review of the literature. AB - A case of a heterotopic intrathoracic lobe of the liver connected through a normal diaphragm to the main organ by a vascular and biliary pedicle is described. Eight similar cases reported in the literature are reviewed and a comparative evaluation is undertaken to elucidate the correct clinical diagnosis and the indications for operative exploration. Because the occurrence of ectopic supradiaphragmatic hepatic tissue should be considered, it is believed that the preoperative evaluation of a solid, smooth lump in the diaphragmatic region should include gallium liver scans prior to invasive procedures. PMID- 2697314 TI - Aortocoronary bypass without extracorporeal circulation: why and when? AB - Thirty patients have been operated on since July 1986. The mean age was 55 years (range 32-68). Twenty-three simple and 7 double bypasses were performed. The internal mammary artery and 1 prosthetic conduit were used for the 29 left anterior descending (LAD) anastomoses and saphenous vein for the others [5 right coronary artery (RCA), 3 diagonal]. The use of an implantable Doppler probe for continuous monitoring during the 1st postoperative week confirmed patency and gave an estimated flow (mean: 79.23 ml/min, range 43.4). There were no deaths and no cases of infarction or ischaemia, but stress test performance improved. The main advantage of this rapid and safe technique was avoidance of morbidity of extracorporeal circulation (ECC) and limited operative myocardial ischaemia. Criteria of selection were unstable, permanent angina (14); unsuccessful PTCA (8) PTCA and failure (5 emergency cases), redo surgery (4); poor LV function (EF less than 20%) (3); fibrinolytic treatment or severe coagulopathy (2). The ideal patient has severe stenosis with or without retrograde filling of LAD with either RCA or circumflex (which require a lateral thoracotomy). PMID- 2697315 TI - Fibrinolytic treatment of acute prosthetic heart valve thrombosis. 5 cases and a review. AB - Acute thrombotic obstruction of prosthetic heart valves has usually needed an emergency operation and carries a high mortality. Over the past 16 years, sporadic papers have appeared reporting the successful use of fibrinolytic therapy with a low mortality. We report five consecutive cases treated in this way. The diagnosis of valve thrombosis was made on clinical, echocardiographic and cineradiographic grounds. Treatment consisted of streptokinase (SPK) in a loading dose of 250,000 units in one case and 500,000 units in the remaining four cases, followed by 100,000 units hourly. Rapid improvement in clinical state was seen in all five patients. Four patients recovered completely and have been followed up for a minimum of 3 years. One patient died of a retroperitoneal haemorrhage, a recognised complication of fibrinolytic therapy. A review of the literature is presented. Fibrinolytic therapy is recommended in the acute episode and should result in either a return to normal valve function or sufficient improvement in haemodynamics to allow semielective surgery at considerably lower risk. PMID- 2697317 TI - [Toxicity of antiepileptic drugs]. PMID- 2697316 TI - Therapeutic impact of eicosanoids in atherosclerotic disease. AB - Polyunsaturated fatty acid (PUFA) components of the diet, especially of the omega 3 variety, protect against atherosclerosis and its related thrombotic complications. Mechanisms involved probably involve the eicosanoids. Classic PGE1 has now found a role in the treatment of peripheral vascular disease. Prostacyclin (PGI2) discovered over ten years ago has also been introduced into clinical medicine; orally active analogs are being introduced with clinical potential in a variety of atherosclerotic and thrombotic disorders. "Endothelium derived relaxing factor (EDRF)" has been identified with nitric oxide, an active metabolite of the classic nitrodilator compounds, which (like NO itself) is synergistic with prostacyclins in inhibition of platelet activation, but without similar synergistic effects on vasodilation. This finding is of considerable importance both from physiological and therapeutic standpoints. The therapeutic efficacy of acetylsalicylic acid (ASA, aspirin) in the secondary prevention of myocardial infarction is now established. For primary prevention, it is probably inferior to diet (e.g. fish oil) and lifestyle changes due to increased incidence of cerebrovascular bleeding. The unfulfilled therapeutic promise of thromboxane synthesis inhibitors may be overcome by introduction of dual TX receptor/synthesis inhibitors. Recent advances suggest that PGE1, prostacyclin analogs and high dose fish oil could act beneficially against background nitrodilator therapy in preventing thrombosis and mitogen-stimulated restenosis following thrombolytic or surgical treatment of coronary artery occlusion. PMID- 2697318 TI - [Complications of epidural anesthesia]. PMID- 2697319 TI - Surface phagocytosis of Staphylococcus epidermidis and Escherichia coli by human neutrophils: serum requirements for opsonization and chemiluminescence. AB - We examined the serum requirements for surface phagocytosis of Staphylococcus epidermidis and Escherichia coli and for the subsequent chemiluminescent response of human neutrophils. Substantial surface phagocytosis of S. epidermidis occurred in the absence of opsonins, although the presence of 10% pooled or heat inactivated serum significantly increased phagocytosis. There was no significant difference between these opsonins, indicating that surface phagocytosis of S. epidermidis did not require complement. Unopsonized E. coli were not as readily phagocytized as S. epidermidis (33% versus 57%). In contrast to S. epidermidis optimal phagocytosis of E. coli required complement as 10% heat inactivated donor serum (HHS) was significantly less effective as an opsonin than 10% pooled healthy donor serum (PHS). The time kinetics for phagocytosis of each organism were similar, with most of the phagocytosis occurring in the first 10 min. The chemiluminescent response of neutrophils produced discrepant results. Maximal chemiluminescence was observed when neutrophils were stimulated with bacteria opsonized in PHS. The response to HHS-opsonized bacteria was less, and chemiluminescence to unopsonized bacteria was only marginally higher than the control, even though there was relatively good phagocytosis. These results define the opsonic requirements for surface phagocytosis of S. epidermidis and E. coli and indicate that although complement may not be required for phagocytosis, it is necessary for generation of a maximal oxidative burst, and thus may be essential for efficient intracellular killing. PMID- 2697321 TI - The role of speech language pathologists in the management of dysphagia, 1989. AB - Speech-language pathologists involved in the management of patients with dysphagia provide services that include evaluation, diagnosis, and rehabilitation. Dysphagia is a swallowing disorder that may be due to various neurological, structural, and cognitive deficits. While dysphagia can afflict any age group, it most often presents among the elderly. Rehabilitation efforts by the speech-language pathologist are undertaken after a medical diagnosis and referral have been made. The dysphagia evaluation begins with a bedside examination that is sometimes followed by a video-fluoroscopic study. The information obtained by the evaluation results in a feeding recommendation by the speech-language pathologist that includes appropriate diet level, amount of intake per swallow, positioning and other facilitating techniques, and swallowing exercises. Patients who are motivated, moderately alert, and have some degree of deglutition are appropriate candidates for dysphagia therapy. Elements of the therapy program can include thermal stimulation to heighten the sensitivity of the swallowing reflex, exercises to improve oromotor control, training in laryngeal adduction and compensatory swallowing techniques, positioning, and dietary modifications. Significant improvement in the swallowing disorder of appropriately selected patients cna be obtained in a rehabilitation program with properly trained and experienced speech-language pathologists. PMID- 2697320 TI - Salmonella typhimurium infection in high and low antibody responder mice: inverse correlation between antibody responsiveness and resistance to infection. AB - Susceptibility to Salmonella typhimurium infection was compared in H (high Ab responder) and L (low Ab responder) mice obtained by several selective breeding experiments (Selections I, II, III, IV and IV A). H mice were always much more susceptible to infection than their L mice counterparts within a continuous LD 50 variation range. In three of the selections (I, II and IV A) the low responsiveness character is known to result mainly from rapid Ag degradation in L mice macrophages. It was hypothesized that resistance to multiplication of intracellular pathogens could be related to an increased catabolic activity towards Ag. This was actually demonstrated, in F2 segregant hybrids of selection IV A, by the significant inverse correlation between capacity for Ab production and resistance to infection. PMID- 2697322 TI - The male pelvis. AB - Pelvic MRI yields images with excellent anatomic resolution because of limited motion and large signal differences (contrast) between fat, muscle, and organs containing fluid or mucous. Although MRI is not appropriate in screening for pelvic malignancies and is unreliable for tumor detection, it does offer superior delineation of the extent of disease and has become the procedure of choice for pelvic tumor staging. PMID- 2697323 TI - Abdominal MRI artifacts. PMID- 2697324 TI - Gynecologic tumor imaging. AB - Anatomy of the female pelvis is superbly delineated by MRI due to excellent soft tissue contrast. In patients with infertility, MRI is the best technique to evaluate suspected myomata. Since tumors are directly visualized, MRI can be an effective technique for staging cervical, uterine, and vaginal malignancies. PMID- 2697325 TI - Magnetic resonance imaging of the kidneys and adrenal glands. AB - A simple renal cyst will have low signal intensity on T1-weighted SE images with short TE and short TR because of the long T1 values of the cyst fluid. With increasing TE and TR, cysts demonstrate increased signal intensity due to the long T2 values of the cyst fluid. On T1-weighted images a complicated cyst will have higher signal intensity than a simple cyst; it may not be possible to differentiate these complicated cysts from solid masses. MRI seems to be useful in identifying simple cyst fluid and, therefore, has potential in characterization of cystic lesions considered complex by CT or ultrasound. Unfortunately, imaging techniques have not yet been optimized, diagnostic criteria are somewhat vague, and accuracy has not been established in a representative patient population. Solid masses often can be identified and differentiated from simple, uncomplicated cysts on MR images. The inability to differentiate among various types of solid tumors or to separate these from complicated cysts or inflammatory masses remains a limitation. Most lesions are more readily seen on contrast-enhanced CT than on MR images and therefore the role of MRI in the detection and diagnosis of renal cell carcinoma remains limited. Although the high detection rate of renal cell carcinoma is encouraging, CT is still more sensitive than MR in demonstrating solid lesions less than 3 cm in diameter. MRI cannot be used as a screening modality for renal tumors. MRI seems quite helpful in the staging of renal cell carcinoma. Macroscopic extension into the perinephric fat, tumor extension into the renal vein and the inferior vena cava, and macroscopic metastases to other organs are readily seen. Furthermore, differentiation between enlarged nodes and vessels is possible with MRI. Some authors recommended the use of MRI to stage renal cell carcinoma in patients with known contraindication to contrast, prior suboptimal bolus contrast enhanced CT scan, and equivocal CT findings. MRI can replace the inferior vena cavagram in the staging work-up and MR may be superior to CT for planning the surgical approach in Stage IIIA lesions by determining the upper extent of tumor thrombus within the inferior vena cava or the right atrium.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697327 TI - Sonography of malignant breast disease. AB - The greatest utility for ultrasound of the breast is in the differentiation of cysts from solid masses. After complete, high quality x-ray mammography, a palpable mass or nonpalpable mammographic abnormality may remain indeterminate in etiology, and ultrasound may be useful as an adjunctive diagnostic modality. However, present ultrasound technology is poor for visualization of small solid masses, particularly in fatty breasts, and it cannot reliably detect microcalcifications. Therefore, sonography has no role in screening for breast cancer. PMID- 2697326 TI - Ultrasound of benign breast conditions. PMID- 2697328 TI - Interventional breast ultrasonography. PMID- 2697329 TI - Breast pathology synopsis. PMID- 2697330 TI - Imaging the post-surgical breast. PMID- 2697331 TI - Computed tomography, duplex Doppler ultrasound, and magnetic resonance imaging in evaluating the breast. PMID- 2697332 TI - Mammography was lacking and fear of radiation-induced cancer. PMID- 2697333 TI - Ultrasound of the breast. PMID- 2697334 TI - Breast sonography: technique, equipment, and normal anatomy. AB - In order to interpret breast sonograms successfully, it is necessary to understand the technical factors that affect the image. It is especially important to be aware of the effects of focal zone, power, time gain compensation, and gray scale selection on cyst/solid differentiation, the primary indication for breast sonography. Adequate breast examinations can be performed with either high-frequency automated whole-breast ultrasound units or hand-held instruments with a transducer operating at 5 MHz or greater frequency, and with a depth of focus of no more than 3 cm. Familiarity with the normal breast sonogram, including the variations in the relative amounts of parenchyma, connective tissue, and fat that occur with increasing age and parity, is essential for the identification, characterization, and localization of abnormalities. PMID- 2697335 TI - The role of ultrasound in a breast imaging center. PMID- 2697336 TI - Computed tomography and magnetic resonance imaging of the normal anatomy of the temporal bone. AB - The high image quality provided by current high resolution CT bone algorithms in conjunction with the multiplanar and soft tissue imaging capabilities of MRI, provide exquisite anatomic detail of the temporal bone structures. This allows the radiologist to visually dissect this complex, three-dimensional structure, if a firm understanding of normal anatomy exists. In this way, the pathological processes involving the temporal bone can be better understood and correlated with the clinical setting. PMID- 2697337 TI - Congenital anomalies of the temporal bone. AB - Inner ear anomalies are a rare but important cause of sensorineural hearing loss. Combined external and middle ear anomalies are more common, causing conductive hearing loss and cosmetic deformity. The course of the facial nerve canal is altered in many temporal bone anomalies. Its location is of great importance when surgical therapy is anticipated. Vascular anomalies and bone dysplasias occasionally affect the temporal bone. High resolution CT, using thin sections and edge enhancement techniques, is capable of demonstrating the finer bony details of these temporal bone anomalies. PMID- 2697338 TI - Inflammatory diseases of the temporal bone: evaluation with CT and MR. AB - Contrast enhanced CT and MR are complementary studies in evaluating inflammatory disease of the temporal bone. CT should be performed in preference to MR as the initial examination because of its ability to detect and delineate both soft tissue and bony abnormalities. CT should always be performed if intratympanic pathology is suspected, even if the MR examination is normal. MR can be used to distinguish effusion and cholesterol granuloma from other soft tissue masses in the tympanic cavity. Noncontrast MR cannot differentiate between cholesteatoma and granulation tissue. The efficacy of gadolinium-DTPA in inflammatory disease of the temporal bone awaits further investigation. PMID- 2697339 TI - The radiologic evaluation of pulsatile tinnitus and the vascular tympanic membrane. AB - PT may be the only symptom signalling a need for imaging the temporal bone region. Since a wide variety of processes may be responsible for this symptom, the goal of the radiologist should be to ensure a complete, cost-effective work up. This evaluation is best directed by the type of tinnitus, objective v subjective, and the presence or absence of a vascular retrotympanic mass. HRCT is the initial examination of choice in the majority of instances. Normal vascular variants can be confidently differentiated from paragangliomas with this study. While angiography continues to play an important role in the initial evaluation of a select group of these patients, the role of MR should be adjunctive. PMID- 2697340 TI - Otosclerosis, diagnosis, and differential diagnosis. PMID- 2697341 TI - Temporal bone fractures. AB - This report has illustrated the variety of temporal bone fractures that involve the zygomatic, squamous, and petromastoid components of the temporal bone. Complications as they relate to each type of fracture have been emphasized. Although longitudinal and transverse fractures can be identified, temporal bone trauma usually creates unique fractures constellations that must be individually described. In each case, a careful inspection of the ossides, otic capsule (vestibule/cochlea), internal auditory, and facial nerve canal must be undertaken. When a patient presents with temporal bone fracture and facial nerve paralysis, identification of the site of facial nerve injury may now lead to surgical decompression of this area of the facial nerve canal and possible nerve grafting. PMID- 2697342 TI - The cerebellopontine angle. PMID- 2697343 TI - Plain film diagnosis of appendiceal perforation in children. PMID- 2697344 TI - The barium enema in the diagnosis of acute appendicitis. PMID- 2697345 TI - CT of appendicitis. PMID- 2697346 TI - Management of the periappendiceal inflammatory mass. PMID- 2697347 TI - Percutaneous management of appendiceal abscesses. PMID- 2697348 TI - An overview of graded compression sonography in the diagnosis of acute appendicitis. PMID- 2697349 TI - Ultrasound assessment of fetal well-being. PMID- 2697350 TI - Clinical assessment of fetal well-being. PMID- 2697351 TI - Computer-assisted, multiple-parameter assessment of fetal age and growth. PMID- 2697352 TI - Nonimaging methods for assessment of fetal well-being. PMID- 2697353 TI - The biophysical profile. PMID- 2697354 TI - Doppler assessment of the umbilical circulation. PMID- 2697355 TI - The radiologic role in diagnosis, staging, and follow-up of neoplasia of the brain, spine, and head and neck. PMID- 2697356 TI - Imaging in primary-lung cancer: the roles of detection, staging, and follow-up. PMID- 2697357 TI - Gastrointestinal cancer: diagnosis, staging, and the follow-up role of imaging. PMID- 2697358 TI - The diagnosis, staging, and follow-up of carcinomas of the kidney, bladder, and prostate: the role of cross-sectional imaging. PMID- 2697359 TI - The role of imaging in musculoskeletal tumors. PMID- 2697360 TI - [Issue dedicated to the memory of Prof. Rosendo Poch Vinals]. PMID- 2697361 TI - [An obituary and biographical note on Prof. D. Rosendo Poch Vinals]. PMID- 2697362 TI - [Rosendo Poch Vinals. An example and a way]. PMID- 2697363 TI - [Relapsing polychondritis. A case report]. AB - A case of evident bilateral relapsing auricular polychondritis is presented. The literature published on this subject is reviewed and the possibility of oligosymptomatic clinical presentations is considered. PMID- 2697364 TI - [Sonoinversion in animals]. PMID- 2697365 TI - [Meniere's disease today]. PMID- 2697366 TI - [The three fundamental stages in the historical evolution of the surgical treatment of laryngeal cancer and the creators or authors of these stages]. AB - This paper, written to honor the memory of one the greatest developers of ENT surgery, Professor R. Poch Vinals, presents a summary of what has been achieved in the surgical treatment of laryngeal carcinoma since the earlier attempts to eradicate this tumor up to the present time. These developments are written by someone who has lived and actively participated in the fight against this tumor from the time when really positive results were obtained up to nowadays. Currently, surgery still produces better results in the treatment of larynx malignancies than other therapeutic methods. However, we do not consider that the cancer cure results obtained with surgery are definitive. Therefore, physical and medical therapies should not be forgotten in our daily work since the latter--the only systemic treatment of cancer--is that in which we have our hopes. PMID- 2697367 TI - [Subtotal hemilaryngectomy]. AB - The technique of subtotal hemilaryngectomy developed by the author is described. It consists of: 1. Performing a lymph node excision as wide and extensive as necessary. 2. Removal of half (in a sagittal sense) of the thyroid and arytenoid, if necessary, from the side of the lesion. 3. Complete preservation of the cricoid cartilage. 4. Immediate closure of the larynx defect with pre-laryngeal musculature. PMID- 2697368 TI - [Modifications of the technic of endolaryngeal extirpation. The author's own functional technic of laryngectomy]. AB - A brief summary of the original technique will be made incorporating the following modifications and additions: glottis substituted by neoglottis muscles, sternohyoid or external perichondrium. Supraglottis substituted by remaining tissues of the epiglottis or neoepiglottis. Hypopharynx, section medium line of the pharynx constrictor. Suturing of cartilage with homologous donor cartilage. An evaluation will be made of the functional results. PMID- 2697369 TI - [Laryngeal paraganglioma]. AB - A case is reported of laryngeal paraganglioma observed among 49,959 patients. A comparison is made of the characteristics of paragangliomas in general to those of laryngeal paraganglioma, which are more common in males; the case presented is that of a woman. Microscopic dissection failed to reveal the paraganglia in the trajectories of the superior and inferior laryngeal nerves, but they were found in histological sections of these nerves and their images were equal to those of the tumor studied. The trajectory of these nerves was investigated in preparations of the Embrioteca de Bellaterra (Prof. Domenech Mateu) and the clumps of paraganglioma cells from which these tumors proceed have been found; we emphasize the concept of neural crest pathology to which they pertain. PMID- 2697370 TI - Symposium on the occasion of the retirement of Prof. Dr. R.Th.R. Wentges. Nijmegen, The Netherlands, October 13, 1989. Proceedings. PMID- 2697371 TI - The Dutch polymath. PMID- 2697373 TI - Diseases of the nasal region on ceramics of the Moche-culture in ancient Peru. PMID- 2697372 TI - Unanimity and diversity in nasal surgery. PMID- 2697374 TI - Differential diagnosis and management of cluster headache. PMID- 2697375 TI - Symposium: on the occasion of the retirement of Prof. Dr. R.Th.R. Wentges. Introduction. PMID- 2697376 TI - [Analysis of activated lymphocytes and antigen-present macrophage in human brain tumors using double immunofluorescence staining]. AB - Twenty-eight human brain tumors (18 gliomas and 10 metastatic brain tumors) were examined immunohistochemically using anti-Leu 1, -Leu 2 a, -Leu 3a + 3b, -LeuM 5, -HLA-DR, IL-2 receptor, -HLA-ABC and Ki-67 monoclonal antibodies (MoAb). Also, in the specimens, in which Leu 1+ cells and Leu M5+ cells infiltrate, simultaneous detection of Leu 2a, Leu 3a + 3b, or Leu M5 and HLA-DR, was performed by double immunofluorescence staining to analyze the T cell activation and antigen-present macrophage (M phi). Most of low-grade gliomas with low percentage of Ki-67+ cells showed only little lymphocyte and M phi's infiltration. THEre was a tendency toward a marked degree of T cell and M phi infiltration in malignant glioma with higher percentage of Ki-67+ cells. However, in metastatic brain tumors, M phi did not tend to infiltrate. IL-2 receptor+ cells was absent in the majority of brain tumors. Tumor cells and vascular endothelial cells also expressed HLA-DR antigens. The majority of tumor cells expressed HLA-A, B, C antigens. There were no correlation among the degree of T cell and M phi infiltration, MHC antigen expression, and percentage of Ki-67+ cells. Double immunofluorescence staining demonstrated that 42.4% of Leu 2a+ cells, 34.7% of Leu3a+ + 3b+ cells and 32.7% of M5+ cells are HLA-DR positive in glioma, and that 50.2% of Leu2a+ cells, 59.4% of Leu3a + 3b+ cells and 67.3% of LeuM5+ cells are HLA-DR positive in metastatic brain tumors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697377 TI - [Lobar intracerebral hemorrhage secondary to cerebral amyloid angiopathy: a clinicopathologic study of three operated cases]. AB - Three operated cases of lobar intracerebral hemorrhage (LICH) related to cerebral amyloid angiopathy (CAA) were studied clinicopathologically. They constituted about 8% of all LICH cases (n = 37) operated upon in our institute (DUSM) during the past 3 years. Case 1, 2 and 3 aged 71, 67 and 73 years, respectively. There were 2 males (Cases 1 & 2) and 1 female (Case 3). Only one case (Case 3) had both hypertension and dementia before hemorrhage. In all 3 cases, neurologic symptoms deteriorated after admission. The hematoma involved the right temporo-parietal in 1 (Case 1), the right parieto-occipital in 1 (Case 2) and the left fronto parietal region in 1 (Case 3). Case 1 developed a new hematoma in the right occipital lobe on the day following surgery. On CT, the hematoma was multilobular in shape and located very superficially extending to the subarachnoid space in all cases. There was no abnormal enhancement in and around the hematoma upon contrast infusion. Angiography showed only an avascular mass sign in case. At surgery, the hematoma was extruded onto the cortical surface in all cases. The surgical outcome was good in 2 (Cases 1 & 2) and fair in 1 (Case 3). Removed hematomas, solid nodular tissues and adjacent brain tissues were examined histologically using hematoxylin and eosin, Azan-Mallory, elastica van Gieson, silver and Congo red stains. Arteries in the hematoma wall, the subarachnoid space and the adjacent brain parenchyma were intensely stained with Congo red and showed birefringence on polarized light.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697378 TI - Communication disorders: planning a service to meet the needs. AB - This paper reviews the size of the speech and language-disabled population in the United Kingdom by client groups and attempts to determine (1) those for whom speech therapy might be appropriate, (2) what pattern and level of speech therapy is appropriate and (3) how many speech therapists are required to provide this pattern and level of speech therapy. It is concluded that under present patterns of speech therapy provision, approximately 26 qualified speech therapists may be required per 100,000 population. However, it is argued that speech therapy may be trying to do too much and may be venturing into areas in which little, if anything, is known about its effectiveness. In conclusion, the paper argues that solutions to the current problems of speech therapy provision must come from the demand and the supply sides of the speech therapy service. The importance of treatment evaluation and further knowledge about patterns of spontaneous recovery are also discussed. PMID- 2697379 TI - Parkinson's disease: a conceptualization of neuropsychological deficits within an information-processing framework. AB - Parkinson's disease patients are frequently impaired in a variety of neuropsychological tasks involving memory, perceptual motor performance and cognitive flexibility. Although various theories have been forwarded to explain specific impairments, few attempts have been made to account for all the deficits within a single theoretical framework. Furthermore, the frequent occurrence of dementia, the adverse side effects of medication and the motor symptoms of the disease tend to interfere with neuropsychological performance. This has hindered the clear delineation of the neuropsychological profile of Parkinsonian patients. The present paper examines the evidence for intellectual deficits in non-demented Parkinson's disease patients. A number of problems inherent in cognitive research on Parkinson's disease are discussed. The contribution of dementia, motor symptom severity and medication in the expression of these intellectual impairments is examined. It is suggested that many of the neuropsychological deficits described in Parkinson's disease may result from a common underlying deficit in some aspect of information processing. Although it is not possible to pinpoint the precise mechanism(s) involved on the basis of the available evidence, several possibilities are suggested by cognitive and electrophysiological data. PMID- 2697380 TI - In honor of David Bixler. Acknowledgment and comments. PMID- 2697381 TI - Terminology of craniofacial anomalies. PMID- 2697382 TI - Craniofacial manifestations of Ehlers-Danlos syndromes, cutis laxa syndromes, and cutis laxa-like syndromes. PMID- 2697383 TI - Molecular basis among hereditary dentinal defects: pathobiology of dentinal phosphophoryn. PMID- 2697384 TI - Craniofacial aspects of the Marfan syndrome. PMID- 2697385 TI - The prospective management of cervicomedullary compression in achondroplasia. PMID- 2697386 TI - The role of bacteriological services in the National Tuberculosis and Leprosy Programme in Tanzania. PMID- 2697387 TI - Acute promyelocytic leukaemia (APL): chemotherapy or bone marrow transplantation? PMID- 2697388 TI - A study of various antibiotic combinations for the empiric treatment of neutropenic febrile children. PMID- 2697390 TI - Prostaglandin E2 in the treatment of oral mucositis due to radiochemotherapy in patients with haematological malignancies. PMID- 2697389 TI - Prevention of gram-negative bacterial infection in granulocytopenic patients: a randomized study comparing oral norfloxacin with gentamycin. PMID- 2697392 TI - Aclacinomycin-A in the treatment of childhood acute leukaemia. PMID- 2697391 TI - Total body irradiation with or without lung shielding for allogeneic bone marrow transplantation. PMID- 2697393 TI - Prognostic factors and treatment of acute lymphoblastic leukaemia (ALL)--Istanbul experience. PMID- 2697394 TI - New developments in post-induction therapy for acute myeloblastic leukaemia. AB - 80-90% of patients with acute myeloblastic leukaemia under the age of 60 can presently expect to achieve a complete remission with modern chemotherapy. A minimum of two courses of consolidation treatment beyond CR is advised to achieve a state of "minimal residual disease". In an attempt at cure patients should receive either an allogeneic BMT (less than 50 years of age) or autologous BMT (less than 60 years of age) and we currently recommend the additional use of IL2 after ABMT. Beyond 60 autologous BMT is presently not considered justified until the safety of this intensive/experimental approach is clarified. We do advocate intensive induction (needing less support than less intensive treatment) followed by consolidation therapy. Further studies into the applications of cytokines will clarify whether the large numbers of older patients could also safely benefit from these approaches. PMID- 2697395 TI - Low-dose Ara-C in the treatment of myelodysplastic syndromes. PMID- 2697396 TI - Intensive chemotherapy for patients with myelodysplastic syndromes and acute myelogenous leukaemia younger than 65 years. AB - Intensive antileukemia treatment was evaluated in 22 patients with untreated secondary acute myelogenous leukemia (sAML) and 14 patients with bad prognosis myelodysplastic syndrome (MDS). Results of combination remission-induction chemotherapy were compared with 126 patients treated for primary AML. The duration of hypoplasia tended to be longer in the sAML and MDS patients when compared to de novo AML, but reached significance only for the duration of thrombocytopenia: 26 days versus 18 days (p less than 0.01). The complete remission (CR) rates were similar in primary AML: 67%, sAML: 62%, and MDS: 64%. The CR rates of patients younger than 45 years were 75% for de novo AML, 75% for sAML, and 71% for MDS. The number of hypoplastic deaths during remission induction chemotherapy of patients with sAML and MDS was low. Four of the 36 patients treated for sAML or MDS died during subsequent hypoplastic phases induced by remission-induction chemotherapy. The remission duration without bone marrow transplantation (BMT) was significantly shorter (p less than 0.03) in MDS and sAML, when compared with primary AML. Longlasting complete remissions in MDS and sAML were only obtained in 3 of the 6 patients treated with allogeneic BMT. Intensive antileukemic therapy should be considered in young patients with MDS and life-threatening cytopenias or patients with sAML or RAEBt. PMID- 2697397 TI - Low-dose Ara-C plus granulocyte/macrophage colony-stimulating factor for the treatment of myelodysplastic syndromes. EORTC Leukemia Group. PMID- 2697398 TI - Allogeneic bone marrow transplantation for secondary leukaemia and myelodysplastic syndromes. Leukaemia Working Party of the European Bone Marrow Transplantation Group (EBMTG). AB - This retrospective survey of the EBMT Leukaemia Working Parking describes 78 patients with myelodysplasia (MDS) or secondary acute myelogenous leukaemia (sAML) who were given an allogeneic bone marrow transplant (BMT). The status of underlying disease at the time of transplantation was prognostic for the two-year disease-free survival which was 60% for patients transplanted in complete remission. Similar results were obtained for those with less advanced MDS (50 64%) who had not received any prior intensive chemotherapy. The results were significantly less favourable for those with more advanced disease who only partially responded to prior intensive chemotherapy (18%) while none of those who either relapsed or were resistant to chemotherapy survived. Allogeneic BMT can therefore be considered as curative treatment for patients with MDS. Patients with sAML who have a histocompatible donor should be given chemotherapy intensive enough to induce complete remission. If this is achieved these individuals have a prognosis comparable to those with de novo AML in first remission after BMT. PMID- 2697399 TI - High dose cytosine arabinoside in the treatment of adult acute myelogenous leukaemia. PMID- 2697400 TI - Aclarubicin in the treatment of de-novo acute myelocytic leukaemia. PMID- 2697401 TI - Idarubicin in acute leukaemia. GIMEMA Group. PMID- 2697402 TI - New drugs in the treatment of acute and chronic leukaemia: current role of mAMSA. AB - Several new cytostatic drugs have entered clinical Phase I-II studies for treatment of leukemia: most promising are pyrimidine analogues such as 5 Azacytosine arabinoside, 5-Aza-2-deoxycytidine, 5-Azacytidine, cyclocytidine, and 2'-2'-difluorodeoxycytidine. They act on different biochemical levels towards DNA synthesis. Fludarabine is a purin analogue and seems very active in treating CLL. Tiazofurin is an antimetabolite counter-acting nicotinic acid with most promising activity in CML blast crisis. Other substances include deoxycoformycin, an adenosine analogue for treatment of T-cell neoplasias, 1, 25-dihydroxy vitamin D 3 as differentiation inducer, and homoharringtonine, an alkylating agent widely used for treating de novo AML in China. New anthracyclines are THP-adriamycin, fluoroadriamycin, and 4-demethoxydaunorubicin. Amsacrine (mAMSA) finally, is a synthetic aminoacridine with DNA-intercalating properties. The intact acridine ring appears essential for antitumor activity. The plasma clearance of both total amsacrine and unchanged parent species is biphasic. There is a considerable influence of hepatic and renal impairment on plasma clearance. Clinical toxicities include marked myelosuppression, gastrointestinal symptomes, phlebitis, mucocutaneous lesions, occasionally alopecia and neurotoxities. It is a very active drug, particularly in treating AML. Studies using mAMSA alone or in combination revealed comparable results to the anthracyclines. The E.O.R.T.C. Leukemia Cooperative Group has used successfully mAMSA in several trials: relapsed and refractory AML, intensive maintenance treatment during first remission in AML, and, still on-going, during intensive consolidation randomized against BMT in AML-patients under the age of 45 years, and randomized against standard consolidation between the age of 45 and 60 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697403 TI - Mitoxantrone in the treatment of refractory and relapsed non-lymphoblastic acute leukaemia. PMID- 2697404 TI - Prognostic factors and treatment of myelodysplastic syndromes. PMID- 2697405 TI - Post remission therapy in acute myeloid leukaemia (AML): the Medical Research Council experience in the UK. PMID- 2697406 TI - Post remission treatment in acute myelogenous leukaemia in first remission. The EORTC experience. EORTC Leukemia Cooperative Group. PMID- 2697407 TI - Comparison of intensive consolidation therapy and autologous bone marrow transplantation in acute myeloid leukaemia. The Leiden experience. PMID- 2697408 TI - Autologous BMT for AML without purging. PMID- 2697409 TI - Autologous BMT for ALL. PMID- 2697410 TI - Clinical studies of allogeneic marrow transplantation in patients with acute non lymphoblastic leukaemia. Seattle Marrow Transplant Team. PMID- 2697411 TI - IBMTR analysis of bone marrow transplants in acute leukaemia. Advisory Committee of the International Bone Marrow Transplant Registry (IBMTR). PMID- 2697412 TI - Bone marrow transplantation for leukaemia: the role of total body irradiation, graft vs host disease, and haemopoietic chimerism. PMID- 2697413 TI - Allogeneic BMT for AML in Zagreb. PMID- 2697414 TI - Allogeneic bone marrow transplantation for ALL in Zagreb. PMID- 2697415 TI - Treatment of acute leukaemia with intensive radiochemotherapy and autologous bone marrow transplantation--Zagreb experience. PMID- 2697416 TI - Combination of cyclosporine and methotrexate for prophylaxis of acute graft versus host disease after allogeneic bone marrow transplantation for leukaemias. PMID- 2697417 TI - Allogeneic bone marrow transplantation for myelodysplastic syndromes (MDS). AB - In the literature 63 patients with myelodysplastic syndromes (MDS) are reported who were treated with syngeneic or allogeneic bone marrow transplantation. 62 patients were prepared for BMT with TBI containing regimens or Busulfan/Cyclophosphamide. GvHD prophylaxis was heterogenous. 33/63 patients are alive and well between 4 and 132 months after BMT. 23/63 patients died due to GvHD (n = 6), interstitial pneumonitis (n = 6), other infections (n = 4), toxicity of the preparative regimen (n = 5) or graft failure (n = 2). 9/63 patients relapsed between 2 and 98 (in median 6) months after BMT. There seems to be a correlation between the subtype of the MDS and the relapse rate: only 1/18 patients with RA/RARS relapsed compared to 7/42 patients with RAEB/RAEB-T. These results indicate that marrow transplantation can induce long term survival and may result in cure of patients with MDS. PMID- 2697418 TI - Allogeneic bone marrow transplantation for multiple myeloma. AB - Seventeen patients received marrow transplants from their HLA-matched, MLC negative, sibling donors. Nine patients had progressive disease not responding to conventional treatments, while the other 8 patients were rated as responders. The most frequently used conditioning regimen consisted of total body irradiation and high-dose multi-agent chemotherapy with cyclophosphamide plus either oral melphalan (5 cases) or BCNU (1 case) on both these drugs (7 cases). Twelve patients were valuable for response to BTM: 7 of them (6 responders and 1 with advanced refractory MM) entered complete remission, while 5 had sustained decrease in tumor mass that ranged between 72% and 93%. Eleven patients died of transplant-related causes, 1 of them with signs of progressive disease. The remaining 6 patients are alive and 5 of them maintain a complete remission status 4 to 67 (median 36) months after BMT. PMID- 2697419 TI - VAMP followed by high dose melphalan and autologous bone marrow transplantation for multiple myeloma. AB - Fifty previously untreated patients with myeloma were entered into a 2-phase treatment programme: vincristine, adriamycin and methyl prednisolone (VAMP) followed by high dose intravenous melphalan (HDM) with autologous bone marrow transplantation where possible. The complete remission rate of 50% was associated with very good quality of life and the reversal of humoral immunosuppression. Complete remission is important in younger patients with myeloma as it represents a first step in achieving long, symptom- free survival. PMID- 2697420 TI - Choice of bone marrow transplantation as treatment for severe aplastic anaemia. AB - Bone marrow transplantation is the first line of treatment for all patients with aplastic anaemia who have an identical twin. Age is not an important consideration in these circumstances. For patients with an HLA identical sibling donor bone marrow transplantation should be offered as a matter of urgency to those patients with SAA under the age of 50. The most controversial issue is the use of unrelated volunteers, or non-sibling family members who are phenotypically matched or who have a minor degree of mismatch of the HLA system. A strong case could be made for offering this form of transplant to all patients under the age of 20 who have VSAA and using it as the second line of treatment in patients who fail to respond to ALG after 4 months if they have VSAA. PMID- 2697421 TI - Bone marrow transplantation in immunodeficiency and osteopetrosis. PMID- 2697422 TI - Bone marrow transplantation for severe aplastic anaemia (SAA): the Genova experience. PMID- 2697423 TI - Allogeneic bone marrow transplantation (BMT) for acquired severe aplastic anaemia (SAA) in children. AB - The SAA Registry of the EBMT now contains data on 171 children younger than 15 years of age with acquired SAA and undergoing BMT between 1970 and 1988. The overall actuarial survival is 63% at 10 years. In a multivariate Cox analysis, the year of transplant was the most important prognostic factor with a significant advantage for children grafted in 1984-88 (81%) vs 1981-83 (67%) and 1970-80 (41%) (p = 0.02). Cyclosporine A given for GVHD prophylaxis, no treatment before transplant and an interval less than 90 days from diagnosis to BMT were all favourable variables in univariate analysis. As regard to transplant procedures, the better results were obtained using Cyclophosphamide and Cyclosporine A (78%) followed by Cyclophosphamide plus irradiation plus Cyclosporine A (77%). Sex, etiology and the severity of the aplasia had no impact on survival in both uni and multivariate analysis. PMID- 2697424 TI - Unrelated donor bone marrow transplantation for severe aplastic anaemia and Fanconi's anaemia. PMID- 2697425 TI - The use of growth factors in severe aplastic anaemia (SAA). PMID- 2697426 TI - Somatic cell gene therapy: the model of adenosine deaminase deficiency. PMID- 2697427 TI - Bone marrow transplantation in primary disorders of the haematopoietic stem cell. PMID- 2697428 TI - Fractionated total body irradiation plus high-dose VP-16 prior to allogeneic bone marrow transplantation in children with poor risk acute leukaemias. AB - Nineteen children (median age, 13 years; range 4 to 18 years) with acute lymphoblastic leukemia/lymphoma (ALL) (10 patients) or acute nonlymphoblastic leukemia (ANNL) (9 patients) received allogeneic bone marrow transplants (BMT). Marrow was taken from HLA-identical sibling donors (16 patients) (pts), HLA identical unrelated donor (1 pt), or one-antigen-missmatched sibling donor (1 pt). Preparatory regimen consisted of fractionated total body irradiation and high-dose VP-16 (50-70 mg/kg body weight). At the time of BMT nine of the pts were not in complete remission (CR): seven pts were refractory to aggressive multiagent chemotherapy and two pts were in first relapse. Six pts were in second CR, one pt in third CR; three pts grafted in first CR carried additional risk factors; e.g. induction failure. Ten out of the nineteen pts are alive and free of disease between one and 53 months (median, 28 months) after BMT. The actuarial disease-free survival rate is 37% for pts with ANLL and 54% for pts with ALL. Six pts have died from BMT-related complications. Only three pts (1 pt with ALL, 2 pts with ANLL) have relapsed between day +106 and day +134 after BMT and subsequently died. The four-year actuarial relapse rates of 29% for ANLL and 14% for ALL, respectively, demonstrate that the combination of fractionated total body irradiation and high-dose VP-16 is an effective antileucemic regimen for children with advanced leukemias. PMID- 2697429 TI - Intensification of induction prior to intensification of consolidation and bone marrow rescue in disseminated neuroblastoma. PMID- 2697430 TI - Graft-versus-host disease: effects on long term disease free survival in marrow transplantation for haematological malignancies. PMID- 2697431 TI - Empiric antibiotic association in the management of febrile episodes in patients submitted to bone marrow transplantation. PMID- 2697432 TI - Autologous bone marrow transplantation (ABMT) in poor prognosis diffuse non Hodgkin's lymphomas (NHL). Report of Non-Hodgkin's Lymphoma Cooperative Study Group (NHLCSG). PMID- 2697433 TI - Graft versus host disease--clinical features and biology. AB - Since its first emergence as an unexpected and poorly understood phenomenon in experimental animals, GVHD has become much better characterised both clinically and biologically. Unfortunately prevention of GVHD has only been achieved at the price of an increased risk of graft rejection and leukaemic relapse and treatment of the established syndrome is only effective in a proportion of patients. It is to be hoped that the more detailed picture of the process now emerging will facilitate better immune manipulation of the bone marrow transplant so as to select recovery of only the beneficial aspects of donor immunity namely immunity against microorganisms and graft versus leukaemia reactivity. PMID- 2697434 TI - Long term effects and quality of life in children and adults after marrow transplantation. AB - These studies of late effects associated with marrow transplant preparative regimens demonstrate the need for continued long-term follow-up of these patients. Sequential studies of growth and development in children demonstrate that few endocrine function abnormalities occur after high dose CY, but multiple endocrine abnormalities occur after TBI containing regimens. Children may have decreased growth rates and abnormal development of secondary teeth. Most young adult patients who received CY only have normal gonadal function recovery and may be fertile. Neuropsychological abnormalities, cataracts and secondary malignancies may also develop. Although the marrow transplant preparative regimen may not be the treatment modality solely responsible for the various observed abnormalities, transplant recipients need to be evaluated carefully for many years to determine onset of abnormalities and to initiate appropriate therapeutic interventions which may improve the quality of life of these unique patients. PMID- 2697435 TI - Failure to immortalise human AML cells using human recombinant GMCSF in vitro and in vivo. AB - We have failed to find any evidence that human recombinant GM-CSF can immortalize human AML cells grown in liquid culture or as nodules in immune deprived mice. In previous clinical studies and a controlled trial currently underway there is no evidence of irreversible acceleration of the disease. PMID- 2697436 TI - Bone marrow transplantation for neuroblastoma: a review of 509 cases. EBMT Group. PMID- 2697437 TI - Retrospectives and perspectives in bone marrow transplantation. PMID- 2697438 TI - Results of autologous bone marrow transplantation for acute leukaemia. PMID- 2697439 TI - Allogeneic versus autologous bone marrow transplantation versus intensive post remission chemotherapy in acute leukaemias. PMID- 2697440 TI - T-cell depletion in allogeneic bone marrow transplantation for acute leukaemias. PMID- 2697441 TI - Actual role and perspectives of BMT in children. PMID- 2697442 TI - Cytogenetic analysis may improve BMT strategies in acute leukaemias. PMID- 2697443 TI - Purging procedures for acute leukaemias in autologous BMT. PMID- 2697444 TI - Cryopreservation of marrow cells for ABMT. Is there any effect on the harvested leukaemic cells? PMID- 2697445 TI - Italian survey on allogeneic BMT for chronic myeloid leukaemia. PMID- 2697446 TI - Cytogenetic monitoring in CML patients treated with BMT. PMID- 2697447 TI - [Academic elegy of Doctor Guy Verriest, titulary member]. PMID- 2697448 TI - Surveillance of an at risk population: assessment of postal urine cytology. AB - The urine postal cytology kit Urotel was assessed against our standard cytological method; 184 patients attending for routine surveillance cystourethroscopy provided free flow urine specimens. The urine cytology was reported blind. Comparison of the 2 tests showed similar specificity but significantly higher sensitivity with the Urotel kit. These kits may have a place in the surveillance of patients at high risk of recurrent tumour or those with carcinoma in situ, reducing the frequency of hospital attendance. PMID- 2697449 TI - Transrectal ultrasound scanning in urinary incontinence: the effect of the probe on urodynamic parameters. AB - A linear array real time transrectal ultrasound technique was used to screen the bladder and urethra of female patients with urinary incontinence during urodynamic investigation. There was no significant difference in any of the urodynamic measurements with or without the probe in situ. PMID- 2697450 TI - Early experience of the gittes "no-incision" pubovaginal suspension for stress urinary incontinence. AB - A series of 20 women with stress urinary incontinence underwent bladder neck suspension according to the method in which there are no suprapubic or vaginal incisions and no buttresses. Follow-up was between 9 weeks and 8 months. Twelve patients (60%) were cured, 2 (10%) were significantly improved and 6 (30%) were not improved; 3 patients had pre-operative detrusor instability; when they were excluded the failure rate fell to 23%. These results are inferior to those obtained in this unit using the Stamey procedure, although the difference is not significant. The operation is quick and easy to perform and was well tolerated with minimal complications; we believe it is worthy of further evaluation. PMID- 2697451 TI - Burch colposuspension or sling for stress incontinence? A prospective study using transrectal ultrasound. AB - Twenty-nine women with stress incontinence were treated surgically by Burch colposuspension or ox fascial sling. The operation was selected prospectively according to the transrectal ultrasound appearance of the bladder neck and urethra during stress. Two groups were defined according to the extent of bladder neck descent and posterior rotation during stress: Type I (minimal descent, i.e. less than 1.5 cm) and Type II (downward posterior rotational movement). Success rates of 76% are reported and the action of each procedure is discussed. PMID- 2697452 TI - Phase II study of carboplatin in locally advanced and metastatic transitional cell carcinoma of the urinary bladder. AB - Twenty-five previously untreated patients with measurable locally advanced and/or metastatic transitional cell carcinoma of the urinary bladder were included in a phase II study with carboplatin. Bolus injections were administered in 2 courses every 4 weeks at an initial dose of 400 to 450 mg/m2 with the option of increasing the dose to 450 to 500 mg/m2 in individual patients during the second cycle, depending on haematological toxicity. Two patients had a complete response (CR), 13 showed no change (NC) and 9 had progression of disease (PD), including 4 early progressions. There was no delay in treatment because of myelosuppression. Thrombocytopenia led to a reduction in drug dosage. No reduction in renal function was observed. Increased dosage did not increase the response rate. This study indicated the low effectiveness of single agent carboplatin in transitional cell carcinoma of the urinary bladder. PMID- 2697453 TI - Ultrasound and plain X-ray screening in childhood urinary tract infection. AB - A group of 309 children over the age of 2 years was investigated with ultrasound and plain X-ray for suspected urinary infection. In 29 cases there were abnormal findings and in 10 the abnormalities were confirmed with cystography and intravenous urography. Of 280 children whose ultrasound and plain X-ray findings were normal, 26 re-presented with further symptoms and investigation with cystography and urography showed abnormalities in only 4. The remaining 254 children have remained well and have been spared the uncomfortable and potentially dangerous examinations of cystography and urography. PMID- 2697454 TI - Supernumerary kidney. PMID- 2697455 TI - Treatment simulators. PMID- 2697456 TI - Impressions. PMID- 2697457 TI - Carey Franklin Coombs 1879-1932. PMID- 2697458 TI - Factors affecting chicken thrombocyte morphology and the relationship with heterophil:lymphocyte ratios. AB - 1. Thrombocytes were observed in a haemocytometer chamber and cells were classified into 5 morphological groups which were related to the extent of environmental stress. Thrombocyte morphology scores (TMS) were calculated for each blood sample. 2. Following exposure to social stress, chilling, or the injection of killed Escherichia coli, both TMS and heterophil:lymphocyte (H:L) ratios were increased. From maximum values 1 d after chilling H:L and TMS values returned to normal within 2 and 11 d respectively. 3. The addition of corticosterone (200 mg/kg) to the food resulted in increased H:L ratios whereas TMS were not affected. 4. The injection of an adrenal blocker, 1,1-dichloro-2,2 bis p-choro-phenyl ethane, resulted in decreased H:L values whereas TMS were not affected. 5. Resistance to E. coli challenge infection was not affected by TMS. PMID- 2697459 TI - Haloperidol reduction can be assayed in human red blood cells. AB - One metabolite of haloperidol present in plasma is "reduced haloperidol." This study demonstrates that human red blood cells are capable of converting haloperidol to reduced haloperidol in vitro. The reductase involved requires NADPH, as does haloperidol (ketone) reductase in human liver cytosol. PMID- 2697460 TI - Effect of dietary sodium intake on the pressor reactivity to angiotensin II in rats with experimental cirrhosis of the liver. AB - The present experiments were designed to evaluate vascular reactivity to angiotensin II in rats with experimental cirrhosis of the liver (induced with CCl4 and phenobarbital) before ascites appearance. The systemic pressor response to angiotensin II in conscious animals and the contractile effect of angiotensin II in isolated femoral arteries were studied. In addition, the effect of high sodium intake on these parameters was also analyzed. Both renin and aldosterone plasma concentrations were similar in control and cirrhotic rats on the normal or on the high sodium diet. Basal mean arterial pressure was higher in control rats than in cirrhotic rats on the normal sodium (116 +/- 4 vs. 101 +/- 4 mmHg (1 mmHg = 133.3 Pa), p less than 0.05) or on the high sodium diet (118 +/- 7 vs. 98 +/- 6 mmHg). No differences in plasma renin activity or plasma aldosterone were found between control and cirrhotic rats. Upon injection of angiotensin II, control rats show a dose-dependent increase in mean arterial pressure which is higher in high sodium than in normal sodium rats. Cirrhotic rats showed a lower hypertensive response to angiotensin II than their corresponding control rats. In addition, no difference between pressor responses to angiotensin II was observed when normal sodium and high sodium cirrhotic rats were compared. On application of angiotensin II, femoral arteries of control and cirrhotic rats exhibited a dose-dependent contraction. However, maximal contraction was higher in high sodium control rats (145 +/- 12 mg) than in normal sodium control rats (99 +/- 6 mg, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697461 TI - Effect of exogenous insulin on plasma free carnitine levels during exercise in normal man. AB - Preliminary data from our laboratory have shown that the decrease in plasma free carnitine levels normally found during prolonged exercise is blunted in type 1 diabetic man. This study was designed to test the hypothesis that this might be due to the sustained peripheral hyperinsulinemia seen during exercise in diabetics treated by subcutaneous insulin. Ten male subjects underwent 90 min of cycle ergometry at 60% of their maximal oxygen uptake capacity on two occasions, one with and the other without a constant 0.13 mU.kg-1.min-1 i.v. insulin infusion. Blood samples were taken at rest, during exercise, and after exercise for measurement of plasma glucose, insulin, C-peptide, free fatty acids, and carnitine. Plasma glucose dropped significantly (p less than 0.01) from basal during both infusions, but values at 30, 45, and 60 min of exercise were lower (p less than 0.05) during insulin infusion compared with the saline infusion. Exercise produced a significant (p less than 0.01) fall in plasma insulin in both infusions. However, from 30 to 90 min of exercise, the plateau insulin level was higher during the insulin infusion compared with the saline infusion (91.4 +/- 3.0 vs. 32.9 +/- 3.0 pmol/L; p less than 0.001). Plasma C-peptide decreased significantly (p less than 0.01) during exercise and recovery in both infusions, but values between infusions were not significantly different. Plasma free fatty acids increased significantly (p less than 0.01) at 90 min of exercise during the saline infusion, while during the insulin infusion this was noted during recovery only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697462 TI - Dopamine D1 and D2 receptors in spontaneously hypertensive rat brain striatum. AB - Since it has been reported that dopamine D2 receptors are elevated in the brain striatum of spontaneously hypertensive (SH) rats, and since both D1 and D2 receptors may interact with one another, we measured the densities of both these receptors in SH rat striatum, as well as those in the normotensive Wistar-Kyoto rat striatum. The D1 receptor density in both strains was virtually the same, 72.9 +/- 2.2 and 71.3 +/- 3.2 pmol/g, respectively (mean +/- SD). The D2 receptor densities were also almost identical, 16.3 +/- 0.6 and 16.8 +/- 1.0 pmol/g, respectively (mean +/- SD). Thus, these data do not support the concept of a dopamine receptor related role in spontaneous hypertension. PMID- 2697463 TI - Concerted mechanism of DNA replication and transcription. PMID- 2697464 TI - Interactions of the RAD7 and RAD23 excision repair genes of Saccharomyces cerevisiae with DNA repair genes in different epistasis groups. AB - The RAD7 and RAD23 genes of S. cerevisiae affect the efficiency of excision repair of UV-damaged DNA. We have examined the UV survival of strains carrying the rad7 and rad23 deletion mutation in combination with deletion mutations in genes affecting different DNA repair pathways. As expected, the rad7 delta and rad23 delta mutations interact epistatically with the excision repair defective rad1 delta mutation, and synergistically with the rad6 delta and rad52 delta mutations that affect the postreplication repair and recombinational repair pathways, respectively. However, the rad7 delta rad6 delta and the rad23 delta rad6 delta mutants exhibit the same level of UV sensitivity as the rad1 delta rad6 delta mutant. This observation is of interest since, in contrast to the rad7 delta or the rad23 delta mutations, the rad1 delta mutant is very UV sensitive and highly excision defective. This observation suggest that RAD6 and RAD7 and RAD23 genes complete for the same substrate during DNA repair. PMID- 2697466 TI - An improved host-vector system for Candida maltosa using a gene isolated from its genome that complements the his5 mutation of Saccharomyces cerevisiae. AB - The host-vector system of an n-alkane-assimilating-yeast, Candida maltosa, which we previously constructed using an autonomously replicating sequence (ARS) region isolated from the genome of this yeast, utilizes C. maltosa J288 (leu2-) as a host. As this host had a serious growth defect on n-alkane, we developed an improved host-vector system using C. maltosa CH1 (his-) as host. The vectors were constructed with the Candida ARS region and a DNA fragment isolated from the genome of C. maltosa. Since this DNA fragment could complement histidine auxotrophy of both C. maltosa CH1 and S. cerevisiae (his5-), we termed the gene contained in this DNA fragment C-HIS5. The vectors were characterized in terms of transformation frequency and stability, and the nucleotide sequence of C-HIS5 was determined. The deduced amino acid sequence (389 residues) shared 51% homology with that of HIS5 of S. cerevisiae (384 residues; Nishiwaki et al. 1987). PMID- 2697465 TI - A yeast telomere binding activity binds to two related telomere sequence motifs and is indistinguishable from RAP1. AB - Telomere Binding Activity (TBA), an abundant protein from Saccharomyces cerevisiae, was identified by its ability to bind to telomeric poly(C1-3A) sequence motifs. The substrate specificity of TBA has been analyzed in order to determine whether the activity binds to a unique structure assumed by the irregularly repeating telomeric sequences or whether the activity recognizes and binds to subset of specific sequences found within the telomere repeat tracts. Deletion analysis and DNase I protection assays demonstrate that TBA binds specifically to two poly-(C1-3A) sequences that differ by one nucleotide. The methylation of four guanine residues, located at identical relative positions within these two binding sequences, interferes with TBA binding to the substrates. A synthetic olignucleotide containing a single TBA binding site can function as a TBA binding substrate. The TBA binding site shares homology with the binding sites reported for the Repressor/Activator Protein 1 (RAP1), Translation Upshift Factor (TUF) and General Regulatory Factor (GRFI) transcription factors, and TBA binds directly to RAP1/TUF/GRFI substrate sequences. Yeast TBA preparations and the RAP1 gene product expressed in E. coli cells are both similarly sensitive to in vitro protease digestion. Affinity purified TBA extracts include a protein indistinguishable from RAP1 in binding specificity, size, and antigenicity. The binding affinity of TBA for the two telomeric poly(C1-3A) binding sites is higher than its affinity for any of the other binding substrates used for its identification. In extracts of yeast spheroplasts prepared by incubation of yeast cells with Zymolyase, an altered, proteolyzed form, of TBA (TBA-S) is present. TBA-S has a faster mobility in gel retardation assays and SDS-PAGE gels, yet it retains the DNA binding properties of standard TBA preparations: it binds to RAP1/TUF/GRFI substrates with the same relative binding affinity and protects poly(C1-3A) tracts from DNase I digestion with a "footprint" identical to that of standard TBA preparations. PMID- 2697467 TI - Organization of ribosomal RNA genes in Alternaria alternata Japanese pear pathotype, a host-selective AK-toxin-producing fungus. AB - DNA encoding ribosomal RNA (rRNA) of Alternaria alternata Japanese pear pathotype has been cloned in lambda replacement vector, lambda Fix. Restriction endonuclease mapping and Southern hybridization with the 18S and 28S rRNAs of Saccharomyces cerevisiae revealed the A. alternata rDNA to be tandemly repeating 8.15-kilobase pair unit. The restriction fragments of the unit were then subcloned in the plasmid vector Bluescribe M13- and partially sequenced. The determined sequences were compared with previously reported sequences of S. cerevisiae rRNAs and their genes. The locations of DNA sequences encoding the 5.8S, 18S, and 28S rRNAs were determined by homology search using reported sequences. The complete DNA sequence for 5.8S rRNA of the fungus was found to be highly conserved at more than 90% homology in the fungi analyzed. However, sequence diversities were observed in limited regions involved in a helix structure, the helix (e), found at position 116-137. PMID- 2697468 TI - A single nucleotide substitution at the rib2 locus of the yeast mitochondrial gene for 21S rRNA confers resistance to erythromycin and cold-sensitive ribosome assembly. AB - We have studied a mutation (cs23) in the mitochondrial gene for 21S rRNA that affects the peptidyl transferase center of the ribosome and conditionally blocks the assembly of the 54S ribosomal subunit. Strains carrying this mutation are resistant to erythromycin and cold-sensitive for growth on nonfermentable carbon sources (Singh et al. 1978) Mitochondria isolated from mutant cells grown on glucose at 20 degrees C, the nonpermissive temperature, were depleted of the 54S subunit and instead contained a novel 45S ribosomal particle. After mutant cells were shifted from 20 degrees C to 32 degrees C, 54S subunits were assembled, apparently from the 45S particles and pre-existing ribosomal proteins. DNA sequencing revealed that the mutant phenotype is a consequence of a C to A transversion at position 3993 of the 21S rRNA gene. Previously, C to U and C to G mutations have been identified at the same position in the 21S rRNA sequence. This position corresponds to C-2611 in the E. coli 23S RNA, a nucleotide that appears to be conserved in the large rRNA of all erythromycin-sensitive ribosomes. PMID- 2697469 TI - The diagnosis of breast pre-cancer by the chronobra--I. Background review. PMID- 2697470 TI - Biology of the protein kinase C family. AB - Protein kinase C (PKC) is composed of a family of isozymes that transduce signals of certain hormones, growth factors, lectins, and neurotransmitters. This review addresses the role of PKC in the regulation of cellular proliferation and its disorders. PKC is directly activated in vivo by the second messenger diacylglycerol, a lipid produced by phospholipase C-catalyzed hydrolysis of phosphatidylinositol and polyphosphoinositides. Diacylglycerol activates PKC by reducing the enzyme's requirement for Ca2+. Phorbol ester tumor promoters and related agents potently activate PKC by a mechanism analogous to that of diacylglycerol, providing evidence that PKC activation is a critical event in tumor promotion. However, the role of PKC activation in tumor promotion is not entirely clear. For example, bryostatin is a potent PKC activator that antagonizes phorbol ester-mediated tumor promotion, and mezerein is a second stage tumor promoter that potently activates PKC. In addition to studies concerned with tumor promotion, studies of oncogene action also indicate a role for PKC in carcinogenesis. A number of plasma membrane-associated oncogene products and related proteins are PKC substrates, and PKC activation leads to induction of the expression of oncogenes that code for nuclear proteins. PKC is implicated in human breast and colon carcinogenesis. Tumor-promoting bile acids activate PKC, and PKC expression studies in rat colonic epithelial cells and human breast cancer cells indicate a positive role for PKC in the proliferation of the cells. Altered expression of PKC in human colon and breast tumors indicates that PKC isozymes may be useful markers for these diseases. PMID- 2697471 TI - Hyperthermic modulation of macrophage-tumor cell interactions. AB - Hyperthermia in the febrile (less than or equal to 41 degrees C) or tumor therapeutic (greater than or equal to 42 degrees C) ranges is known to alter tumor-host interactions: there are reports of either inhibitory or enhancing effects on tumor metastasis and various host defense mechanisms. Historically, this has been an area of conflicting and often anecdotal reports, and there are still significant gaps in our knowledge of the effects of temperature on tumor host interactions. However, we believe that the tools are now available to further our understanding of the complex relationships between febrile episodes or therapeutically applied heat and various tumor-host cytotoxic mechanisms, and that potentially important and exploitable relationships can be defined. In this review we give an overview of the current status of this field and the factors that have shaped it. We also describe our recent experimental work with macrophages and their monokines, primarily tumor necrosis factor (TNF), which we feel offers new scientific and clinical opportunities for future studies. PMID- 2697472 TI - Kupffer cells and liver metastasis. Optimization and limitation of activation of tumoricidal activity. AB - Kupffer cells, tissue-fixed macrophages located in the sinusoids of the liver, represent the highest concentration of mononuclear phagocytes in the body. Their ability to act as scavengers of particulate material in the blood has given rise to speculation that they play a role in controlling hepatic metastases derived from blood-borne tumor cells. Circumstantial evidence for such a role has been obtained from animal studies where Kupffer cell function has been compromised or inhibited, and from anecdotal clinical observations. Current evidence suggests that Kupffer cells are capable of nonspecifically eliminating some circulating tumor cells from the circulation via phagocytosis. This surveillance mechanism would appear to be limited in capacity, and subject to a number of external factors. Recent studies have demonstrated that Kupffer cells can be activated to a tumoricidal state via the administration of biological response modifiers such as gamma interferon or muramyl peptides. The localization of liposomes within Kupffer cells after systemic administration has provided a considerable stimulus for the efficient targeting of macrophage-activating compounds to these cells. Such therapeutic intervention, while capable of inducing Kupffer cell tumoricidal activity in situ and inhibiting tumor growth, is limited with respect to the location of the tumor cells (sinusoidal versus parenchymal) and to the size of the metastatic nodule. Therapeutic intervention using liposomes containing macrophage-activating agents may only be of benefit in patients with minimal tumor load who are at risk for hepatic metastases, rather than those patients who already have clinically detectable liver tumors. PMID- 2697473 TI - The role of growth factors in haemopoietic development: clinical and biological implications. AB - Mature blood cells of all lineages are derived from a single class of cell, the haemopoietic stem cell. Stem cells are pluripotent and capable of almost limitless self-renewal. In the bone marrow they form part of a hierarchy that includes progenitor cells, which are more restricted in the lineages their progeny can adopt, and precursor cells, which are committed to differentiation. The mechanisms that regulate progression through this hierarchy are not fully understood, but evidence suggests that both bone marrow stromal cells and soluble growth factors have a role in controlling haemopoiesis. Four growth factors act on progenitor cells to promote their survival, proliferation, differentiation, and maturation: interleukin-3 (IL-3), granulocyte/macrophage-colony stimulating factor (GM-CSF), granulocyte-CSF (G-CSF), and macrophage-CSF (M-CSF). They can also activate the function of mature cells. Considerable overlap is found in the target cells for these four growth factors. We have found that growth factors acting in synergy can recruit more primitive cells than had previously been appreciated. These factors can also determine the lineage that the progeny of multipotential progenitors will adopt. Thus, colony-stimulating factors (CSFs) have the potential to regulate the development of primitive haemopoietic cells in vivo. The properties of CSFs have made them useful in treating malignant disease: G-CSF, in particular, has been used to reduce the period of neutropaenia that follows cytotoxic therapy for various malignancies. The success of these early trials gives ground for cautious optimism about the clinical use of these compounds. PMID- 2697475 TI - Asymptomatic bacteriuria in pregnant Nigerian patients. AB - One-thousand out of a total obstetric population of 3,548 patients seen between January and December, 1985, were screened for asymptomatic bacteriuria. During the first trimester, the observed incidence was 5.3 per cent while in the second and third trimesters it was 4.1 and 2.8 per cent, respectively. The overall pick up rate was 4.0 per cent. The significance of this observation was discussed. Escherichia coli was the predominant causative micro-organism, accounting for 45 per cent of cases. A seven-day sensitive antibiotic therapy eradicated all the positive cases. The qualitative culture method as described in this study is a simple, sensitive and reliable method of screening for bacteriuria in pregnancy, especially as it can be used for identification of the causative organism and its antibiotic sensitivity. PMID- 2697474 TI - Carcinoembryonic antigen: function in metastasis by human colorectal carcinoma. AB - Carcinoembryonic antigen (CEA) is a glycoprotein that has been useful as a tumor marker to predict recurrence in gastrointestinal malignancies, but whose biological function has not been elucidated. With the recent evidence that CEA is a member of the immunoglobulin supergene family, CEA may be involved in intercellular recognition and binding. This review examines the role that CEA plays in the development of metastases by colorectal carcinoma. PMID- 2697476 TI - Regulation of steroid synthesis and metabolism by growth factors. PMID- 2697477 TI - Parathyroid hormone-related protein in hypercalcaemia of malignancy. PMID- 2697478 TI - Effectiveness of computer-assisted perimetry in the diagnosis of pituitary adenomas. AB - Computer-assisted perimetry (CP) is a new method which quantifies the differential light sensitivity threshold and allows the statistical analysis of the data. It offers advantages as compared with manual methods. This study has been carried out in 27 patients with pituitary adenomas (four males and 23 females; 13 with prolactinomas; six with acromegaly, four with Cushing's disease and four with non-secreting adenomas). A skull X-ray and a computed tomodensitometry (CT), a manual Goldman perimeter and a computer assisted visual field examination were performed in all cases. The presence of a pituitary tumour was suggested by the X-ray and by the CT in 12 and 23 patients respectively out of the 27: the CT scan revealed a suprasellar extension in seven cases. Visual field defects were detected by means of the Goldman perimeter in six patients and by means of the computer-assisted technique in 25/27. The effectiveness of this new technique was proved by the concordance with the CT scan results in 21 cases and by the histological examination of the four adenomas which were not apparent at CT scan. A significant difference was found for both eyes (right eye, chi squared = 258, P less than 0.001; left eye, chi squared = 295.0, P less than 0.001) between patients and controls. No correlation existed between visual defects and the pituitary size apparent at CT scan. Six patients were evaluated with the CT and CP after 1 year of bromocriptine treatment; a slight reduction of size was documented with the CT in four cases, whereas a significant positive change in visual acuity was observed in five patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697479 TI - Hormones and hypertension. PMID- 2697480 TI - The management of Graves' ophthalmopathy. PMID- 2697481 TI - Diet-induced changes in sex hormone binding globulin and free testosterone in women with normal or polycystic ovaries: correlation with serum insulin and insulin-like growth factor-I. AB - The purpose of this study was to investigate the effect of calorie restriction on serum concentrations of sex hormone binding globulin (SHBG) in women with normal or polycystic ovaries (PCO) and to examine the possible role of insulin and insulin-like growth factor-I (IGF-I) in mediating changes in SHBG levels. Six normal subjects with mean (SD) body mass index (BMI) 25.5 (2.2) and five subjects with PCO (BMI 36.1 (3.7)) were studied before and after 2 or (PCO only) 4 weeks of a very low calorie diet (330 kcal/day; Cambridge Diet). In both normal women and patients with PCO there was a twofold increase in SHBG concentrations after 2 weeks and this was sustained in the PCO subjects for a further 2 weeks. The rise in SHBG was accompanied by a fall in free testosterone concentrations. There were parallel changes in serum insulin and IGF-I concentrations which decreased during the diet and there were significant negative correlations of SHBG with insulin in both normal subjects (r = -0.62) and women with PCO (r = -0.60). In addition, serum concentrations of an insulin-dependent small molecular weight (34 kDa) binding protein for IGF-I (IGF-BPI) increased significantly during dieting in both groups and were negatively correlated with serum insulin (controls, r = 0.56; PCO, r = -0.68) and positively correlated with serum SHBG levels (controls, r = 0.69; PCO, r = 0.63). In summary, these data indicate that in both normal subjects and those subjects with PCO, calorie restriction results in a highly significant increase in SHBG concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697482 TI - The derivation of a minimal model insulin sensitivity index from euglycaemic clamps in man. AB - We describe a computer program based on the minimal model of Bergman et al., which has been used to control euglycaemic hyperinsulinaemic clamps and to derive the insulin sensitivity index (Si) from clamp data. Clamps were undertaken on 33 subjects with a range of insulin resistance. The steady state glucose had an acceptable coefficient of variation (c.v.) and was close to the desired clamp level. The c.v. of the steady state glucose infusion rate was smaller than for other clamp programmes. The Si was correlated with metabolic clearance rate for glucose (MCR) divided by the change in insulin concentration. Our results suggest that the assumptions of the minimal model hold true in the euglycaemic hyper insulinaemic situation and demonstrate that a minimal-model-derived program can achieve acceptable clamping. PMID- 2697483 TI - Does non-enzymatic glycosylation affect complement function in diabetes? AB - We examined the role of non-enzymatic glycosylation in abnormalities of the complement system commonly found in Type 1 diabetes. Fourteen patients were found to have significantly increased levels of glycosylated C3 (p less than 0.001) and C4 (p less than 0.002) with levels of glycosylated C3 being higher than those of C4 (4.1 +/- 2.5% vs 0.8 +/- 0.8%). This correlated with the finding that in vitro, purified C3 was far more susceptible to this modification than C4. Autoradiography of limited trypsin digests of H3-glycosylated iC3 showed several sites were available for reaction. However, high levels of in vitro glycosylation had no significant effect on the haemolytic activity of C3 and C4, or the binding of iC3 to the CR1 receptor on erythrocytes. Further, IgG was similarly unaffected by non-enzymatic glycosylation in its ability to activate the complement pathway, or when present in an immune complex, to be dissociated from it by complement. We concluded that the immune complex-mediated damage implicated in some complications of Type 1 diabetes is unlikely to derive from any loss of complement function due to non-enzymatic glycosylation. PMID- 2697484 TI - Glucose tolerance and insulin response to glucose load before and after enzyme inducing therapy in subjects with glucose intolerance and patients with NIDDM having hyperinsulinemia or relative insulin deficiency. AB - We evaluated the role of insulin availability in the induction therapy of non insulin dependent diabetes mellitus (NIDDM). Plasma glucose (BG) and insulin (IRI) response to glucose loading (OGTT) was investigated before and after placebo and phenobarbitone (PB) therapy in patients with glucose intolerance and NIDDM treated with diet only, sulphonylureas (SU) plus metformin (M) or insulin. The antipyrine test was used to reflect the liver mixed function oxidase system. Therapy with PB, but not placebo, reduced fasting IRI and BG in subjects with glucose intolerance and improved the glucose tolerance, insulin response to glucose and antipyrine metabolism. The effects of PB on patients with NIDDM were dependent on the insulin availability and duration of the disease. Best responses were seen in hyperinsulinemic patients at the early phase of the disease. They had lowered fasting BG and IRI values, improved glucose tolerance, insulin response to OGTT and antipyrine metabolism after PB therapy. The SU plus M treated patients responded beneficially if they had high fasting and postglucose IRI values and were non-responders if they had relative insulin deficiency. Antipyrine metabolism improved among the responders and non-responders. The hyperglycemic patients treated with insulin showed improved glucose metabolism, an improved C-peptide response and antipyrine metabolism. The subjects could be classified into responders and non-responders by calculating the ratio of areas above the fasting level curve of insulin and glucose (sigma delta I-OGTT/sigma delta G-OGTT). These values for the former were 0.2-0.4 and the latter 0.03-0.04, as compared to healthy volunteers (1.0) and subjects with glucose intolerance (1.4). A PB type inducer improves insulin sensitivity but does not alter its production or secretion. The outcome of glucose metabolism is therefore dependent on insulin availability. PMID- 2697485 TI - Long-term treatment with active vitamin D (alphacalcidol) in middle-aged men with impaired glucose tolerance. Effects on insulin secretion and sensitivity, glucose tolerance and blood pressure. AB - There are specific receptors for the active metabolite of vitamin D on the pancreatic beta cells and severe vitamin D deficiency can inhibit insulin secretion. In the present study 14 middle aged men with impaired glucose tolerance and low glucose-stimulated insulin values received 2 micrograms alphacalcidol daily for 18 months. On treatment there was a transient increase of both the peak and the late insulin response to intravenous glucose while neither intravenous nor oral glucose tolerance were consistently altered. Nor was the peripheral insulin sensitivity, measured by the euglycemic clamp technique, significantly affected. In the untreated state there was a positive relationship (r = 0.77) between the tissue insulin sensitivity and the serum concentrations of 25-hydroxyvitamin D. There was also an inverse relationship (r = 0.61) between systolic blood pressure and the serum levels of 1,25-dihydroxy vitamin D. Although the subjects were normotensive and not overweight, treatment with alphacalcidol tended to lower both systolic (6 +/- 12 mmHg) and diastolic blood pressures (5.8 +/- 9.1 mmHg) and there was a small reduction (0.9 kg) in body weight. In conclusion, subjects with impaired glucose tolerance without vitamin D deficiency do not benefit from vitamin D supplementation, which however has some hypotensive action also in normotensive individuals. PMID- 2697486 TI - The effect of rapid cooling and culture on in vitro insulin release in cryopreserved rat islets of Langerhans. AB - It has been reported that isolated pancreatic islets are functionally viable following cryopreservation using fast cooling and that such conditions should be more efficient for the selective destruction of immunocompetent passenger lymphoid cells than techniques employing slow cooling. This study examines the effect of extended pre-freeze and post-thaw culture (72 hr) on the in vitro function of rapidly cooled (70 degrees C/min) rat islets of Langerhans. The viability of the islets was assessed by their ability to secrete insulin in response to stimulation by glucose and theophylline both statically during batch incubations and dynamically in a perifusion system. Extended tissue culture was found to be essential for the retention of insulin secretory function of rapidly cooled islets which showed slightly suppressed but comparable secretion indices compared with non-frozen cultured islets. PMID- 2697487 TI - Reference values for resting blood flow to organs of man. AB - The lack of a reliable quantitative description of blood flow in man has hampered the development of accurate biokinetic models of essential elements, drugs, imaging agents, and carcinogens. In this paper we review and analyse data on blood flow and identify representative percentages of cardiac output and absolute blood flow rates to organs and tissues of man for use as reference values for biokinetic models. To keep the review and analysis to a manageable size we have limited attention to the resting state and have suggested reference values for absolute and relative flow rates only for adult males and females. PMID- 2697488 TI - An automatic system for capturing and processing ultrasonic Doppler signals and blood pressure signals. AB - A totally automatic system for capturing and processing ultrasonic Doppler signals and blood pressure signals at pre-programmed intervals is described. The Doppler signals are Fourier transformed and a composite maximum frequency envelope extracted from the spectral data. The frequency envelope is split into individual cardiac cycles and a number of Doppler parameters calculated. All Doppler and blood pressure results are stored on disc, and the most important may be displayed in the form of trend graphs on a computer screen. The system has been used to study variations in middle cerebral artery blood flow velocity and systemic blood pressure in neonates over periods of several hours. PMID- 2697489 TI - Opportunities and risks in Philadelphia's capitation financing of public psychiatric services. AB - The city of Philadelphia was one of nine sites selected by the Robert Wood Johnson (RWJ) Foundation and the U.S. Department of Housing and Urban Development (HUD) to receive five-year funding to improve the delivery, quality and cost efficiency of public mental health services to its chronically mentally ill population. As part of the RWJ project, the city plans to restructure its delivery and reimbursement system, creating a not-for-profit central authority which will function as a health insurance organization (HIO) responsible for coordinating and managing psychiatric care to Medicaid clients. Operating under a model of capitation, the central authority will employ diverse funding mechanisms to finance and manage service delivery. This paper examines the benefits and risks inherent in the reorganization of Philadelphia's mental health service system under a capitation financing model. Issues considered include cost and utilization patterns, treatment outcomes, providers and their staffing patterns, service mix and the overall impact of capitation on clients. PMID- 2697491 TI - Legislation and the new public health: introduction. PMID- 2697492 TI - Screening alcohol & drug use in a general practice unit: comparison of computerised and traditional methods. AB - Systematic screening of patients for areas of health risk in their lifestyle has much potential for primary health care clinicians as a cost-effective and time saving means to identify 'at risk' individuals. In the area of alcohol and drug problems, such early identification increases the likelihood of successful intervention. The present study, conducted at a general practice unit, compared the use of a computer to screen for alcohol and drug use with the two more traditional assessment methods of face-to-face interview and paper and pencil questionnaire. It was found that levels of reported consumption were similar across assessment methods. Although the interview method was strongly preferred overall, patients' preference for the computer increased significantly after use. The computer was also found to be more acceptable to patients reporting non medical drug use, a potentially threatening and sensitive issue. There was a low refusal rate and most patients were willing to allow their doctor to see the assessment results. This indicates that screening for alcohol and drug use is acceptable to general practice patients, and that the computer can play a useful role as a prevention aid. PMID- 2697493 TI - Immunopathology and progression of experimental renal disease. PMID- 2697490 TI - The influence of racial factors on psychiatric diagnosis: a review and suggestions for research. AB - Research on race and diagnosis initially focused on black-white differences in depression and schizophrenia. Statistics showing a higher treated prevalence of schizophrenia and a lower prevalence of depression for blacks seemed to support the claim that blacks did not suffer from depression. Others argued, however, that clinicians were misdiagnosing depression in blacks. This article reviews empirical studies of racial differences in individual symptoms and summarizes the evidence on misdiagnosis. It argues that more attention must be paid to resolving two contradictory assumptions made by researchers working in the area of race and diagnostic inference: (1) blacks and whites exhibit symptomatology similarly but diagnosticians mistakenly assume that they are different; (2) blacks and whites display psychopathology in different ways but diagnosticians are unaware of or insensitive to such cultural differences. The article concludes with suggested research directions and a discussion of critical research issues. PMID- 2697494 TI - The natural history of inherited renal diseases. PMID- 2697495 TI - The natural history of hypertensive vascular nephropathy. PMID- 2697496 TI - Role of prostaglandins in experimental renal disease. PMID- 2697497 TI - Protein-restricted diet in early chronic renal failure. PMID- 2697498 TI - Controlled study of protein-restricted diet in chronic renal failure. PMID- 2697499 TI - Supplemented diet for severe chronic renal failure: some controversial points. PMID- 2697500 TI - Antihypertensive therapy and progression of renal failure. PMID- 2697501 TI - Control of hypertension and progression of chronic renal failure. PMID- 2697502 TI - Insulin in chronic renal failure: friend or foe? PMID- 2697503 TI - Amino acid imbalance in patients with chronic renal failure. PMID- 2697504 TI - Acute renal effects of protein and amino acids: the potential role of gastrointestinal hormones. PMID- 2697505 TI - The optimal protein intake in patients with early chronic renal failure. PMID- 2697506 TI - Dietary components and progression of renal lesions. PMID- 2697507 TI - Filtration surface area, salt intake and hypertension. PMID- 2697508 TI - Is chronic renal disease always progressive? PMID- 2697509 TI - The natural history of glomerulonephritis. PMID- 2697510 TI - Factors of progression in IgA mesangial nephropathy. PMID- 2697511 TI - The natural history of primary pyelonephritis. PMID- 2697512 TI - A morphometric analysis of the development of the rat lens capsule. AB - This study analysed patterns of growth of the lens capsule by measuring capsule thickness at 13, 16 and 19 days of embryonic development and 2, 21, 140 and 600 days of post-natal development. The major findings were that, at early stages of embryonic development, the posterior capsule was thicker than the anterior capsule. However, at later stages, the posterior capsule did not increase in thickness whereas the anterior capsule continued to thicken so that, by 2 days of post-natal development, the situation was reversed and the anterior capsule was significantly thicker than the posterior capsule. This trend continued and by 600 days post-natal development, the anterior capsule was 7.5 times thicker than the posterior capsule. In these older lenses the capsule tapered sharply in thickness from the anterior to the posterior equatorial region. These regional differences in thickness of the lens capsule, and the changes reported during development, may reflect changes in capsule production by epithelial and fibre cells as they differentiate. PMID- 2697513 TI - Differential distribution of interphotoreceptor retinoid-binding protein (IRBP) around retinal rod and cone photoreceptors. AB - Light microscopic immunogold cytochemistry was used to examine the distribution of interphotoreceptor retinoid-binding protein (IRBP) in the interphotoreceptor matrix (IPM) surrounding rod and cone photoreceptors. Silver enhancement of retinas reacted with anti-IRBP antibodies using the two stage labeling procedure showed dense staining of the IPM around rod photoreceptor outer segments and the apical region of the RPE. However, the IPM around cone photoreceptors was lightly labeled for IRBP. This region of light labeling extended from the RPE to the distal one-fourth to one-third of the cone inner segment. Although most of the area surrounding cone outer segments was lightly labeled, a dense band of label was seen along the margins of cone outer segments. This study confirms that heterogeneity exists in the distribution of IRBP in the IPM and provides new evidence that IRBP is not homogeneously distributed around rod and cone photoreceptors. PMID- 2697514 TI - [Radiologic analysis of 51 cases of neuroblastoma]. AB - The X-ray findings in 51 cases of neuroblastoma were analysed. The aim of plain film of abdomen is to search for fine sandy calcifications in the abdominal mass, paravertebral widening at lower thoracic region, and bone metastases. Displacement and deformity of kidney by extrinsic pressure seen in IVU are useful in differentiating an extrarenal tumor from intrarenal one. Ultrasound and CT are superior to IVU in localization diagnosis and defining the extent of abdominal neuroblastoma. Thoracic neuroblastoma usually manifests as a posterior mediastinal tumor associated with rib changes and the chest film remains valuable in diagnosis of this condition. It is mandatory to screen the patient for skeletal metastases radiographically and to investigate the bone marrow, and urine VMA whenever abnormalities are found in abdominal or thoracic imaging. The significance of combined imaging techniques in staging of neuroblastoma was discussed, and a simple diagnostic approach was proposed. PMID- 2697515 TI - [Clinical application of CT stereotactic device in biopsy of brain lesions]. AB - A new CT stereotactic device named version WL-86 was designed and manufactured by the authors. Phantom puncture and cadaver puncture tests showed that its accuracy is less than 1 mm. We have also made a new type of biopsy needle--the rotary and translational cutting biopsy needle. A definite pathological diagnosis was made in 93.7% (30/32) of patients by this technique: The practicability of the device, the indications and clinical value of CT-guided stereotactic biopsy were discussed. PMID- 2697516 TI - [Pericardial puncture under linear array real time ultrasound guidance]. AB - This article reported 14 cases of pericardial puncture under ultrasound guidance with total success and without any complications. This technique is safer and more accurate than conventional method. The localization of puncture site and the technique were introduced. A common linear array transducer coupled with a self made end-entering guide is the instrument needed which is simple and effective. PMID- 2697517 TI - [The clinical value of percutaneous puncture of pancreatic cysts guided by ultrasound]. AB - This article reported 11 cases of percutaneous puncture of pancreatic cysts guided by ultrasound. All were successfully punctured. The clinical value, indication and the procedure were discussed. Percutaneous puncture is not only valuable for diagnosis of pancreatic cyst, but also for therapy. Of ten cases treated by puncture aspiration, two cases with two cysts were followed for 2.5 years and 5.5 years respectively without recurrence of the cyst; in another case, the cyst was reduced to 62% of its original size after 4 years. PMID- 2697518 TI - [Neuroarthropathy (a clinico-radiologic analysis of 115 cases)]. AB - The clinical and radiological observations of 115 patients (163 joints) with neuroarthropathy (Charcot joint) were presented. The main clinical and typical X ray findings as well as the radiologic features of different joints were described: (1) In Charcot joint of the shoulder, the entire scapula bone may be disintegrated; (2) After cleaning and arthrodesis, fragmentation of bone may reappear at both ends of the affected long bone and even the lateral surface of diaphysis; (3) Fragmentation of articular surface and subchondral bone may be seen in non-weight bearing surface; (4) 32 cases in our series had spontaneous fractures without history of trauma or undue strain; (5) Follow-up observation in short period (two to six weeks) showed rapid progressive destruction. The authors were of the opinion that neurotrophic theory seems to be the important pathogenesis of Charcot joint. While bone resorption should be the primary change. Bone hypertrophy and proliferation are secondary changes. PMID- 2697519 TI - [Current status and prospects of the early diagnosis of gallbladder cancer]. PMID- 2697520 TI - Temporal organization--some reasons why it should not be ignored by biological researchers as well as by practicing oncologists. PMID- 2697521 TI - Chronobiology: a frontier in biology and medicine. AB - On the occasion of Franz Halberg's 70th birthday, some of his many achievements are reviewed. We provide a historical background to the development of chronobiology; offer insight into the current state of this new science; and sketch the promise of this discipline for health care and cure. As a tribute to Franz Halberg, in an era of fast-growing technology, an attempt is made to describe his perspective of tomorrow's medicine and biology. The many students he trained throughout his productive career face the challenge of deserving the trust he placed in them and of further implementing his vision. A leader in social pediatrics put it aptly: it will take several generations of researchers to study and master his life's work. PMID- 2697522 TI - Chronobiology in the clinical laboratory. AB - 'When to sample?' is a basic question in the clinical laboratory. After some considerations on the concept of biological time in laboratory medicine, the author discusses the implications of sampling time in laboratory tests, either they are performed for diagnosis and prognosis, monitoring therapy, prevention, assessment of risk or for legal reasons. PMID- 2697523 TI - Insects as novel models for research in chronobiology. AB - A need exists for novel models for chronopharmacological research. Insects could serve in this capacity since they are relatively inexpensive, short-lived and acceptable to the public. With the cooperation of Franz Halberg, tests which demonstrated that this was feasible were undertaken over an about 10 year span. Specifically, life span was shown to be different in different photoperiodic regimens for the codling moth and the face fly. Evidence was also found for a circaseptan rhythm as well as an about 3-day rhythm in the response to the photoperiodic shifts. These results are consistent with those reported by F. Halberg and others in mammals and a unicellular plant. The finding, in collaboration with F. Halberg and others, of a rhythm in melatonin in the heads of face flies suggests that biochemical as well as behavioural analogies between insects and other animals can be drawn when insects are used as models for research in chronopharmacology. PMID- 2697525 TI - Circadian and infradian aspects of the cell cycle: from past to future. AB - A review of some aspects of circadian and infradian rhythms of the cell cycle is given. The background is that the research of the last decade has given entirely new insights into the cell cycle as a dynamic process which occurs in waves. After some short historical notes on the development of methodology for study of cell kinetics, it is reviewed how the strong variability of this function was recognized from the 1960's. This again led to an increasing understanding of the rhythmic pattern of cell renewal in various tissues of the body. Conventional methods for studying cell population kinetics gave general insights into both circadian and infradian rhythms, but were hampered by several shortcomings. The techniques were time consuming, and usually one and only one parameter could be studied at a time. However, this general knowledge both had a strong impact on the understanding of cell kinetics and provided a basis for designing cancer chemotherapy. Today we are facing a new area in the study of cell population kinetics. New, rapid and automated methods for multiparameter studies of both cell kinetics and other biological properties of cell populations have given entirely new possibilities for cell kinetic research. Methods, mainly connected to analytical cytology, can discriminate subpopulations with varying kinetic properties, and also enable monitoring of cell proliferation in normal and malignant tissues of patients. Chronobiology has had a strong impact on the understanding of cell population kinetics in the body. In the light of the new developments in the fields of growth factors and their regulatory influences on the cell cycle, important and fundamental aspects of biological rhythms are now being elucidated. PMID- 2697524 TI - The effect of shift work on gastrointestinal (GI) function: a review. AB - Recent statistics suggest approximately 20 percent of the American work force is engaged in shift work. The evidence which is reviewed in this manuscript suggests that shiftworkers are at risk for the development of gastrointestinal diseases or disorders. The susceptibility to shiftwork related gastrointestinal complaints may be related to the disruption of the individual's time structure. Central nervous system and endocrine mechanisms which may contribute to the pathogenesis of digestive diseases/disorders in shift workers are discussed. PMID- 2697526 TI - [Duodenal ulcer and the insulin releasing level]. AB - Indirect pieces of evidences indicate the correlation between insulin level and pathogenesis of peptic ulcer. In the present study, serum insulin releasing level after glucose loading was determined in 16 patients with duodenal ulcer (DU) using radioimmunoassay, and was compared with that of normal controls. The peak insulin level (PIL) in DU patients was significantly higher than that of normal individuals (P less than 0.05), the measurements of gastric acidity, insulin level and the gastroscopic examination were carried out both before and after the treatment. The rebound phenomenon of gastric acidity (BAO) was correlated to that of PIL (r = 0.85). The possible relationship between insulin level and DU was discussed. PMID- 2697527 TI - [Clinico-epidemiologic study on the relation of ulcerative colitis and colonic cancer]. PMID- 2697528 TI - Tissue localization of photosensitizers and the mechanism of photodynamic tissue destruction. AB - This paper outlines our present knowledge of photosensitizer tissue distribution, derived from preclinical animal studies, and relates it to the observed biological response to photodynamic therapy (PDT). Emphasis is placed on porphyrins (haematoporphyrin derivative (HpD), Photofrin II) and phthalocyanines (aluminum phthalocyanine sulphonate AlPcS). In mice, both groups of sensitizers show multiphasic plasma clearance kinetics with an initial rapid decline followed by further slow reduction. Residual amounts of Photofrin II are detectable 75 days after injection. Drug elimination occurs through urine and faeces, but faecal elimination predominates for Photofrin II. Circulating sensitizer greatly influences the mouse ear-swelling response, but not the foot response. Tumours and normal skin can be destroyed by vascular damage, if illumination occurs at times of maximal plasma sensitizer concentration, with no detectable sensitizer accumulation in tumour cells. Organ retention for both photosensitizer groups is similar and persistent. Organs rich in reticuloendothelial elements (liver, kidney, spleen) accumulate and retain the highest levels, skin and muscle the lowest, while normal brain tissue excludes sensitizer. The adrenal and pancreatic glands, as well as urinary bladder, also retain high amounts of Photofrin II. Tumour/skin ratios of 1 to 3:1 and 2 to 7:1 have been reported for porphyrins and sulphonated phthalocyanines respectively. Tissue destruction upon light exposure is not always correlated with photosensitizer levels, as is exemplified by liver and pancreas. Stromal sensitizer localization usually predominates in tumour and normal tissue, and often determines tumour response. Certain compounds, such as monosulphonated tetraphenylporphyrin and AlPcS, may favour parenchymal localization. The formed blood elements remain free of photosensitizer, while mast cells and macrophages accumulate especially large amounts and, upon illumination, release an array of vasoactive inflammatory and immune mediators. PMID- 2697529 TI - Immunosuppression in phototherapy. AB - The successful use of phototherapy, especially psoralen plus UVA (PUVA) therapy, in the treatment of a variety of skin diseases is well known. Because the pathology of diseases such as vitiligo, alopecia and lichen planus is thought to involve immune mechanisms, the beneficial effect of PUVA may be due to immunosuppression. PUVA treatment can induce suppression in two ways. In the first (local suppression) psoralen is applied topically, the skin is irradiated with UVA and the contact allergen is applied directly to the irradiated skin. The induction of contact hypersensitivity (CHS) is suppressed and suppressor cells are found in the spleens of treated animals. Systemic suppression results from the injection of psoralen followed by exposure to UVA. The contact allergen is then applied at a distant non-irradiated site. CHS is suppressed and antigen specific suppressor cells are found in the spleens of treated mice. The ability to induce specific immunosuppression may provide novel methods of inhibiting unwanted immune responses. We have demonstrated that graft rejection and the induction of graft-versus-host disease can be suppressed in an antigen-specific manner by UV radiation. Thus phototherapy may provide promising new treatments for suppressing graft rejection and perhaps may be beneficial in the treatment of autoimmune disease and allergic reactions. PMID- 2697530 TI - Effects of porphyrins on skin. AB - Porphyrins and radiation induce activation of the complement system, release of mediators from mast cells, dermal accumulation of neutrophils, and activation of factor XII-dependent pathways. Recent studies have also shown that porphyrins and radiation have profound effects on the eicosanoid metabolism of mast cells, endothelial cells, macrophages and epidermal and dermal homogenates. In vitro, prostaglandin D2 (PGD2) was generated when mast cells were exposed to protoporphyrin and radiation. Exposure of cultured human umbilical vein endothelial cells or human omental microvascular endothelial cells to uroporphyrin or protoporphyrin and radiation resulted in predominant generation of PGF2 alpha, while PGE was generated after the exposure of macrophages to Photofrin II and radiation. Activities of epidermal eicosanoid-metabolizing enzymes in protoporphyric mice were suppressed following in vivo exposure to radiation, whereas activities of the dermal enzymes were enhanced 18 h after radiation. These effects of porphyrins on skin contribute to the development of porphyrin-induced cutaneous phototoxicity, which is seen in patients with porphyrias and as a consequence of photodynamic therapy. PMID- 2697531 TI - Photosensitizing compounds in the treatment of psoriasis. AB - Photosensitizers were first used to treat psoriasis 15 years ago when the phototoxic reaction of psoralens and UVA was found to induce remissions of the disease. The effect of this reaction on DNA, particularly the formation of cross links, was thought to be the decisive event. Strong cross-linking agents such as 8-MOP, TMP and 5-MOP are clinically effective whereas most compounds which produce only monofunctional adducts are virtually ineffective. Orally administered 8-methoxypsoralen (8-MOP) is the most widely used compound. 4,5',8 Trimethylpsoralen (TMP) is poorly absorbed from the intestine but has marked efficacy when applied topically. 5-MOP may be a useful alternative to 8-MOP because it is less erythemogenic and does not cause nausea. These three furocoumarins appear to be similar photochemically and may introduce similar risks. However, the photobiological properties of furocoumarins can be modified by altering one or more parts of the molecule. Such modifications might yield effective analogues with reduced cytogenetic hazards. Several psoralens and angular furocoumarins are being tested for effectiveness combined with fewest long-term side-effects, especially carcinogenesis. Encouraging preliminary results have been obtained with 7-methyl-pyridopsoralen and 4,6,4' trimethylangelicin. Other important approaches to increasing the safety of photochemotherapy may be the use of different photoactivating wavelengths or the introduction of new classes of photosensitizers. PMID- 2697532 TI - The chemistry, photophysics and photosensitizing properties of phthalocyanines. AB - Phthalocyanines (Pcs) and naphthalocyanines (Ncs) are being extensively studied as photosensitizers for photodynamic therapy (PDT) of cancer. They strongly absorb clinically useful red light, with maxima around 670 nm and 770 nm respectively. Chelated with appropriate diamagnetic metal ions, they exhibit high triplet yields and long triplet lifetimes. Energy transfer from the triplet dye to ground-state oxygen to yield singlet oxygen appears to be the main photosensitizing pathway in biological systems. Underivatized Pcs and Ncs can be incorporated in liposomes for in vivo administration. Sulphonation renders the dyes water soluble but also enhances dimerization to yield photochemically inactive aggregates. Tumour retention and cell membrane penetration of the dyes are strongly affected by the polarity of the macrocycle as well as the nature of the central metal ion and axial ligands. Among the sulphonated dyes, amphiphilic mono- and disulphonated derivatives exhibit particularly good cell membrane penetrating properties, although the more highly sulphonated dyes show better tumour retention in vivo. At least in vitro, Pc dyes are more photoactive than the corresponding Nc dyes, which probably reflects the lower photostability of the latter. PMID- 2697533 TI - Extracorporeal photochemotherapy in the treatment of cutaneous T cell lymphoma and autoimmune disorders affecting the skin. AB - Extracorporeal photochemotherapy (ECPCT) is a new form of chemoimmunotherapy which involves the ex vivo exposure of malignant peripheral blood cells to 8 methoxypsoralen (8-MOP) and ultraviolet A (UVA) radiation followed by reinfusion of the treated cells. This treatment has resulted in an unprecedented number of prolonged remissions in patients with therapeutically resistant forms of cutaneous T cell lymphoma (CTCL) characterized by the systemic dissemination of a clonal population of malignant helper T lymphocytes. Although the mechanism of the beneficial effect is uncertain, an immune reaction to the reinfused modified T cells probably results in tumour regression. Because the T cell antigen receptor (TCR) is an immunogenic structure and because an identical TCR is present on the entire clonal population of malignant T cells in each individual with CTCL, modification of this structure represents the most likely target for the effects of 8-MOP and UVA. Understanding of the precise events leading to tumour regression in CTCL during treatment with ECPCT may lead to the expanded use of this therapy for other lethal haemopoietic malignancies. PMID- 2697534 TI - Photoradiation therapy of brain tumours. AB - Present methods for treating cerebral glioma are inadequate and the possible benefit of using photosensitization therapy to obtain improved local control of the tumour has been studied in the laboratory and in clinical trials. The biological basis for photoradiation therapy and the laboratory studies and clinical trials using photoradiation to treat cerebral tumours are discussed. Photoradiation therapy results in selective tumour destruction in an intracerebral glioma model with an effect up to 1 cm in depth. Clinical studies using haematoporphyrin derivative and up to 260 J/cm2 of red light from laser sources indicate that the therapy is well tolerated and may be of value as an adjuvant treatment of cerebral tumours. PMID- 2697535 TI - What are the ideal photoproperties for a sensitizer? AB - For effective photosensitization of malignant tumours, a sensitizer should exhibit appreciable absorption at red to near-infrared wavelengths and generate cytotoxic species via oxygen-dependent photochemical reactions. These photosensitization mechanisms rely on the excitation of the sensitizer from its electronic ground state to the fluorescent singlet state, which is in turn transformed into the longer-lived triplet state. Efficient formation of this metastable state is required because it is the interaction of the triplet state with tissue components that generates cytotoxic species such as singlet oxygen. Measurement of fluorescence provides a useful means of probing the sensitizer, particularly because detection sensitivities for both the triplet state and the cytotoxic singlet oxygen are much lower. With the development of chemically well defined sensitizers, in vivo fluorescence detection has the potential to provide quantitative assessment of photoactive sensitizer distributions. The reactive properties of sensitizer triplet states and species such as singlet oxygen can result in significant sensitizer photodegradation, which may appear undesirable but can be exploited in vivo under certain conditions. PMID- 2697536 TI - Porphyrins as photosensitizers. AB - The porphyrins have two important roles in photobiology: in photosynthesis, which has evolved and is highly organized morphologically; and in the photodynamic effect, which is adventitious. The damage to tissue that results from photodynamic action is regarded as arising from a number of pathways, but singlet oxygen generation is a major route. Even for the latter mechanism, a number of target molecules are possible. Compared with photosynthesis, it is a very disorganized process. Since the mid 1970s there have been increasing efforts to turn the photodynamic effect to good use as the basis of a phototherapy for cancer. The field has been dominated by the photosensitizer haematoporphyrin derivative. This is a complex mixture of molecules, and although we are learning more about it, it seems unlikely that it will be possible to separate out a useful single substance. A second generation of porphyrin sensitizers is emerging, which, unlike haematoporphyrin derivative, is designed for the job in hand. Some of these photosensitizers, especially the hydroporphyrins, look quite promising. PMID- 2697537 TI - Photodynamic therapy: light delivery and dosage for second-generation photosensitizers. AB - With the development of new photosensitizers that have enhanced photoactivation at longer wavelengths than haematoporphyrin derivative, new considerations arise in the light source and delivery systems and in the techniques for physical dosimetry and in vivo optical measurements in photodynamic therapy. The limitations and future potential of solid-state laser sources are presented. The relationships between photosensitizer photoactivation characteristics and the effective photodynamic treatment volume are developed and discussed quantitatively. The problems in defining and measuring the photodynamic dose are examined, and potential techniques for measuring the factors involved in this are evaluated with emphasis on noninvasive approaches which may be used clinically. PMID- 2697538 TI - In vivo transport and pharmacokinetic behavior of tumour photosensitizers. AB - The mechanisms by which photodynamic sensitizers are transported in the bloodstream influence their distribution among normal and tumour tissues, as well as their partitioning among the various compartments of tumour tissues. Column chromatographic analysis and density gradient ultracentrifugation of sera obtained from both patients and experimental animals show that hydrophilic photosensitizers (e.g. haematoporphyrin, and tetrasulphonated porphyrins and phthalocyanines) are largely transported by albumin and globulins and mainly deposited in the vascular stroma of tumours. More hydrophobic photosensitizers (haematoporphyrin oligomers, porphyrin esters, monosulphonated or unsubstituted phthalocyanines) are preferentially incorporated in the lipid core of lipoproteins. Tightly aggregated dyes partly circulate as unbound pseudomicellar structures which can be entrapped in the interstitial regions of the tumour, localize in macrophages, or enter neoplastic cells via pinocytotic processes. Low density lipoproteins (LDL), which are endocytosed by neoplastic cells through a specific receptor-mediated pathway, display the most selective release of photosensitizers to tumours. The binding of the injected photosensitizer to LDL can be enhanced by preincorporation of the dye in liposomal vesicles which are in a quasi-solid state at the body temperature. PMID- 2697539 TI - Intracellular localization of photosensitizers. AB - The intracellular localization of photosensitizers can be studied by different methods. One method involves homogenization of the cells followed by differential ultracentrifugation which leads to fractions enriched in nuclear, mitochondrial, and microsomal material as well as a supernatant fraction. More detailed information can be obtained by electron microscopy of cells exposed to light in the presence of photosensitizers. This method is based on the assumption that damage is primarily induced at intracellular sites where the concentration of photosensitizer is high. By irradiating the cells at 6 degrees C, where biochemical reactions are slow, and then incubating them for different times at 37 degrees C, it is possible to follow the development of damage. The amount of photosensitized damage to enzymes or cell functions whose localization in the cells is known gives information about the intracellular localization of the sensitizer. Fluorescence microscopy is the most direct method and is widely applicable because most photosensitizers fluoresce. Lipophilic dyes generally localize in membrane structures. In future more attention should be paid to the localization of dyes in lysosomes, as suggested by early reports. Mitochondria, the endoplasmic reticulum and nuclear membrane are other important loci for intracellular localization of sensitizers. PMID- 2697540 TI - [The epidemiological investigation on diarrhea caused by bacteria in Fujian province]. AB - Surveillance of diarrhea was conducted in five villages of Fujian Province with a total population of 20,488 from May 1986 to April 1987 and 14,168 cases of diarrhea were reported during this period, averaging 0.69 time per person, and the incidence in children under five years old being 2.25 times higher. 16 kinds of pathogens were isolated. ETEC was the most common and Shigella the next. The isolation rate was 44.03%. It was shown that the incidence of diarrhea was closely related with income, education, sanitary conditions, family sanitation and health condition. PMID- 2697541 TI - [A review of 152 cases of acute poisoning of hydrogen sulfide]. AB - Clinical data of 152 cases of acute poisoning of hydrogen sulfide were analysed. Of these cases 5 were diagnosed as irritant reaction, 10 mild poisoning, 56 moderate, and 81 severe. Eight of the 152 cases died, with a fatality rate of 5.3%. 137 cases lost consciousness temporarily. The degree of disturbance of consciousness provided important basis for determining diagnostic grade. Recommendations for treatment were mainly comprehensive, supportive measures as well as first aid. Certain neuro-psychic sequelae were found in some of the 95 cases followed up for 1 to 10 years. PMID- 2697542 TI - [An analysis of 193 cases of congenital intraocular colobomas]. AB - In a survey of 26,512 children under 12 years of age, 2 cases (0.075%) were found to have congenital intraocular coloboma. Among 193 cases of the disease from 169 families reported by 50 hospitals of 21 provinces and cities, the disease affected boys more than girls. Bilateral colobomas of the uveal tract constituted majority of the cases, and the unilateral patients showed no predilection for either eye. The colobomas mostly occurred in the lower part of the eye, involving one or more tissues, depending on the shape, scope and location of the coloboma and whether other ocular deformities existed. Colobomas of the uvea, optic nerve and macula lutea were mostly sporadic. Earlier disruptions in the embryonal cleft resulted in more serious colobomas and complicating ocular deformities. PMID- 2697543 TI - Impact of prospective payment on the role of the diabetes educator. AB - This paper reports the results of a national survey undertaken to explore the impact of prospective payment on the role of the diabetes educator and on diabetes education. Responses were received from 903 individuals--756 diabetes educators and 147 hospital administrators. Study results indicate a need for diabetes educators to more aggressively shape their role and promote the provision of their services to better assure adequate education for those individuals diagnosed with diabetes. PMID- 2697544 TI - [A double-blind clinical trial--the effects of pantethine on serum lipids in patients with hyperlipidemia]. PMID- 2697545 TI - [Advances in the development of cardiovascular fiberoptic endoscopy and its application]. PMID- 2697546 TI - Oligodendrocyte progenitors isolated directly from developing telencephalon at a specific phenotypic stage: myelinogenic potential in a defined environment. AB - Oligodendroglia differentiate asynchronously in the developing central nervous system, passing through a series of stages identified by the sequential expression of specific differentiation antigens, culminating in the formation of the myelin sheath. In the work presented here, oligodendrocyte progenitors at a temporally narrow and well-defined phenotypic stage of development have been isolated in high purity and yield directly from postnatal rat telencephalon. This stage is identified by the expression of the O4 antigen, the earliest recognized surface marker specific for the oligodendroglial lineage, but the absence of the differentiation marker galactosylcerebroside (GalC). These O4+ GalC- progenitors first appear at birth (10(5)/telencephalon), 2-3 days before O4+ GalC+ oligodendrocytes. The work presented here demonstrates that a major subpopulation of O4+ GalC- progenitors (80%), which we have termed 'proligodendrocytes', is fully committed to terminal oligodendrocyte differentiation. A relatively small, maximal set of nutritional supplements are sufficient for proligodendrocytes to carry out the myelinogenic cascade of differentiated gene expression in a temporally normal manner, in quantitatively significant amounts, in normal ratios of myelin protein isoforms, and in a regulated relationship to the inclusion of myelin-specific products into myelin-like membrane sheets. An important corollary is that this step of myelinogenesis does not require contact with other cell types, in particular neurones and astrocytes, nor does it require unknown growth factors unique to these cell types. Additionally under these conditions, there exists a developmentally quiescent subpopulation (20%) of O4+ GalC- cells that may have significance for understanding the progenitors previously described in adult brain and suggested to be instrumental in remyelination under pathological conditions. PMID- 2697547 TI - The effects of phorbol ester on mouse blastomeres: a role for protein kinase C in compaction? AB - The effects of phorbol myristate acetate (PMA) and other activators of protein kinase C on the cytoskeletal organization of mouse oocytes and early embryos have been examined. The effects observed depended on the developmental stage on exposure to PMA. PMA had little effect on the cytoskeletal or microvillous organization of unfertilized oocytes. Interphase cells from embryos prior to compaction showed limited disruption and loss of microvilli when exposed to PMA and foci of polymerized actin remained visible in the cytocortex of embryos up to the early 8-cell stage. When compacted late 8-cell embryos were exposed to PMA, most microvilli were lost and little polymerized actin remained in the cytocortex. PMA also caused loss of microtubules from compact 8-cell embryos under some experimental conditions. Intercellular flattening was both prevented and reversed. The relevance of these observations to the rearrangement of cell cell contacts and cytoskeletal organization seen during compaction at the 8-cell stage is discussed and a possible role for protein kinase C in the generation of cell polarity proposed. PMID- 2697548 TI - fushi tarazu protein expression in the cellular blastoderm of Drosophila detected using a novel imaging technique. AB - The fushi tarazu (ftz) gene is essential for segmentation of the Drosophila embryo. This requirement is reflected at the cellular blastoderm stage of embryogenesis by seven transverse stripes of ftz expression. These stripes correspond to the missing segments of ftz mutant embryos. We describe here novel intermediate patterns of ftz protein expression which were detected in younger embryos by using anti-ftz antibodies and a sensitive fluorescence/immunoperoxidase technique ('filtered fluorescence imaging', FFI). Striped patterns of ftz protein evolved continuously, and the different stripes appeared in an ordered sequence, involving both anterior-posterior (A/P) and dorsal-ventral (D/V) progressions. Comparison of these patterns of ftz protein with those of ftz RNA suggests that these novel aspects of the patterning process involve post-transcriptional regulation in addition to the transcriptional control known to be involved in expression of this gene. PMID- 2697549 TI - [Monoaminoxidase and monoaminoxidase inhibitors]. PMID- 2697550 TI - Time and time perception. PMID- 2697551 TI - [Hyperglycemia in newborn infants. I. Transient hyperglycemia in the neonatal period]. PMID- 2697552 TI - Hydrogen excretion after ingestion of five different sugar alcohols and lactulose. AB - The breath hydrogen excretion was measured for 5 h after the initial rise on seven subjects who consumed randomly, and after 5 d of adaptation, equimolar amounts of sorbitol (10 g), mannitol (10 g), maltitol (19 g), Palatinit (19 g anhydrous), lactitol (19 g anhydrous), lactulose (19 g) in aqueous solution. The mean mouth-to-caecum transit time was 1.5 h, which was not significantly different from one carbohydrate to another, but varied significantly from one subject to another (0.7-2.4 h). Suprabasal increment of breath hydrogen after lactitol was significantly higher than that from the other polyols (P less than 0.001) over 5 h. Lactitol and lactulose, which are known to be totally undigested in the small intestine, gave the highest mean incremental area under the breath hydrogen curve, 327 p.p.m. H2 over 5 h and 224 p.p.m. H2 over 5 h, respectively. The values for the other test compounds ranged from 145 to 209 p.p.m. H2 over 5 h, which suggest that there had been only partial absorption in the small intestine. PMID- 2697553 TI - Small but healthy? Are we asking the right question? AB - This paper reviews the development of thinking about anthropometric measures within the nutrition community, suggests that this has led us into some serious misconceptions, and offers a plea for a reconsideration in the use and interpretation of such measures. It is suggested that the 'Small but Healthy?' debate is really the result of the misinterpretations and, as such, is distracting from the true issues. The paper also argues strongly against the notion of 'no-cost' adaptations, and argues instead that present status-quo accommodations may be achieved at the price of potential for change. PMID- 2697554 TI - Zinc absorption and achlorhydria. AB - Zinc absorption from 40 mumol of zinc in a water solution and from a test meal containing 22 mumol of zinc was studied in 8 patients with achlorhydria (no basal acid secretion and no secretion after pentagastrin stimulation). The test dose and the meal was labelled with 0.1 MBq of 65Zn and absorption was determined from measurement of the whole-body retention of the isotope. Zinc absorption was 68 +/ 16 per cent (mean +/- s.d.) from the water solution and 33 +/- 10 per cent from the test meal. The results did not differ from absorption in control subjects and indicate that achlorhydria per se does not affect zinc absorption. PMID- 2697555 TI - Turnover of plasma membrane in thyroid epithelium and review of evidence for the role of micropinocytosis. PMID- 2697556 TI - Dynamic changes of the cell wall surface of Candida albicans associated with germination and adherence. AB - The distribution of mannoproteins at the cell wall surface of Candida albicans was analyzed during the process of germination in conditions favoring adherence of germ tubes to a plastic matrix. Three cytochemical methods allowing the detection of concanavalin A binding sites, anionic sites and the enzyme acid phosphatase, respectively were used. All three methods gave similar results, indicating a spatial and temporal reorganization of some cell wall mannoproteins: a strong labeling was observed on blastoconidia; in contrast, as soon as the emergence of germ tubes took place, these reactions decreased dramatically at the surface of mother cells, whereas the germ tube surface was strongly stained. Some new components with multiple biological activities were detected at the germ-tube surface. Indeed, among mannoproteins responsible for an enhanced adhesion to plastic surfaces, two components with molecular weights of 68 and 60 to 62 kDa were shown to interact with laminin, fibrinogen, and C3d. This study therefore indicates that germination, and then adherence of germ tubes, imply a degradation of surface mannoproteins, and a simultaneous presentation of new molecules which can interact with their nonbiological materials or host proteins. PMID- 2697557 TI - Secretion of a precursor form of lysosomal alpha-glucosidase from the brush border of human kidney proximal tubule cells. AB - We have shown previously (R.P.J. Oude Elferink, E.M. Brouwer-Kelder, I. Surya, A. Strijland, M. Kroos, A.J.J. Reuser, J.M. Tager, Eur. J. Biochem. 139, 489-495 (1984)) that human urine contains considerable amounts of a precursor form of lysosomal alpha-glucosidase (about 50% of the total alpha-glucosidase activity present). We have now purified alpha-glucosidase from human kidney. Only about 5 to 10% of the total lysosomal alpha-glucosidase present in kidney comprises the precursor form of the enzyme. By means of immunocytochemistry using monoclonal antibodies, the precursor of alpha-glucosidase was detected in the brush border of the proximal tubule cells. Taking into account the amount of precursor alpha glucosidase excreted daily into the urine and the amount present in the kidneys, we conclude that extensive secretion of precursor alpha-glucosidase occurs from the brush border of the proximal tubules. PMID- 2697558 TI - Presence of peroxisomal membrane proteins in liver and fibroblasts from patients with the Zellweger syndrome and related disorders: evidence for the existence of peroxisomal ghosts. AB - The presence and intracellular localization of peroxisomal integral membrane proteins (PMP) were investigated in liver and cultured skin fibroblasts from control subjects and patients with the Zellweger syndrome and related disorders in which peroxisomes are virtually absent. Immunoblotting experiments showed that 22, 36 and 69 kDa PMPs were present and were confined to the membranous fraction both in the control liver and in the livers from the Zellweger patients. The 22 and 36 kDa PMPs were present in significantly lower amounts in the patients' livers than in the control liver. A reduced amount of the 69 kDa PMP was found in liver from one Zellweger but not in liver from another. The subcellular localization in fibroblasts of catalase and the 69 kDa PMP was studied by indirect immunofluorescence. A characteristic punctate fluorescence was seen in control cells incubated with either anti-(catalase) or with anti-(69 kDa PMP). Incubation of mutant cells with anti-(catalase) resulted in a diffuse fluorescence, whereas with anti-(69 kDa PMP) fluorescent particles were visualized which, in some cell lines, were larger and fewer in number than in control cells. Cryosections of control and mutant cells were examined by electron microscopy using immunogold labeling. Control cells contained small structures consisting of a single membrane enclosing a homogeneous matrix; the membranes reacted with anti-(69 kDa PMP) and the matrix with anti-(catalase). The mutant cell lines contained spherical or ellipsoidal structures whose membranes reacted with anti-(69 kDa PMP); no labeling was observed with anti-(catalase). We conclude that peroxisomal ghosts, the membranes of which contain the 69 kDa PMP, are present in peroxisome-deficient cell lines from all complementation groups studied so far. PMID- 2697559 TI - Intranuclear localization of insulin in rat hepatoma cells: insulin/matrix association. AB - Previous studies have documented nuclear insulin accumulation in a variety of cell types. The present investigation extends these observations by demonstrating that insulin associates with the matrix fraction of H35 rat hepatoma cell nuclei. Nuclei were isolated from [125I]insulin-loaded cells and extracted with DNase I, RNase A and high salt. The resulting matrix fraction was found to contain greater than 75% of the radiolabel initially present. Ultrastructural studies to confirm these findings were carried out using an agarose-encapsulated nuclear matrix preparation. Electron microscopic immunocytochemistry specifically detected insulin in matrices prepared from insulin-treated cells. No reaction was observed in matrices obtained from non-insulin-treated (control) cells. Further biochemical analysis revealed that matrix-associated insulin could be solubilized with 1% sodium dodecyl sulfate (SDS) or in the presence of high urea concentrations. Gel filtration analysis of urea-solubilized matrix material revealed the presence of apparently intact [125I]insulin and a higher molecular weight peak. It is hypothesized that the latter may represent a tightly associated complex of insulin with some matrix protein(s). PMID- 2697560 TI - Expression of vimentin and nuclear lamins during the in vitro differentiation of human promyelocytic leukemia cells HL-60. AB - We have reported previously that the human promyelocytic leukemia cell line HL 60, in its undifferentiated state, is devoid of cytoplasmic intermediate filament proteins and nuclear lamins A and C, but does express lamin B. Using immunofluorescence and immunoblotting techniques, we have further investigated the expression of vimentin and lamins A and C during differentiation of these tumor cells along the macrophage or granulocytic pathway in response to the inducing effects of the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) or dimethyl sulfoxide. Our results show that, while the expression of lamin B remains largely unchanged, the synthesis of vimentin and lamins A and C is dramatically enhanced during the maturation of HL-60 cells along both hemopoietic pathways. Northern blot analysis of cellular RNAs isolated from untreated and TPA treated HL-60 cell populations as well as from control HeLa cells was performed using two oligonucleotides, one complementary to the 5' region common to human lamin A/C mRNAs and the other to the 5' region of hamster vimentin mRNA. Very low but still detectable amounts of vimentin and lamin A/C mRNAs were found in untreated HL-60 cell population, in accordance with the detection of small quantities of vimentin and lamins A and C in these populations. This is probably due to the presence of a small number of spontaneously differentiating cells. On the other hand, strong signals comparable to those obtained with RNA from control HeLa cells were detected for the three mRNA species from TPA-treated cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697561 TI - Effect of insulin on growth and expression of smooth muscle isoactin in human breast gland myoepithelial cells in a chemically defined culture system. AB - Myoepithelial cells express both epithelial and stromal (smooth muscle) cell characters. Moreover, while separating the luminal (secretory) epithelial cells from the connective tissue in normal breast glands, myoepithelial cells apparently disappear in invasive carcinomas, or their phenotypic characteristics become down-regulated. In the present study we have used a chemically defined culture model system to study how expression of smooth muscle isoforms of actin in myoepithelial cells is influenced by insulin by using immunoblotting, immunofluorescence and electron microscopy. We show that in the absence of insulin, myoepithelial cells do not proliferate but exhibit a differentiated phenotype. Hence, they contain distinct bundles of actin filaments and also numerous caveolae at the cell surface. In contrast, with insulin in the medium, cell proliferation increases dramatically. Concomitantly the smooth muscle actin expression and the associated caveolae disappear within a week. However, other cytoskeletal proteins such as keratins and vimentin are expressed no matter whether insulin is absent or present. PMID- 2697562 TI - Patient follow-up after angioplasty: the problems of assessing restenosis. PMID- 2697563 TI - Ambulatory ST segment monitoring in the assessment of patients following PTCA. AB - In this article we discuss the place of ambulatory ST-segment monitoring in the investigation of the patient following coronary angioplasty. Particular attention is focused on the relationship between the results of exercise testing (the standard technique in the evaluation of the post-angioplasty patient) and ambulatory ST-segment monitoring, in order to assess whether ST-segment monitoring might contribute further information in the identification of residual or recurrent ischaemia. PMID- 2697564 TI - Holter monitoring after PTCA. AB - There are several potential causes for the occurrence of myocardial ischaemia after successful coronary angioplasty, but the role of ambulatory electrocardiographic monitoring, particularly in the detection of coronary restenosis, remains undefined in these patients. Previous studies have shown that ambulatory monitoring demonstrates ST-segment changes in only a minority of patients before, and rarely after, successful angioplasty. The presence of transient myocardial ischaemia, whether symptomatic or silent, on ambulatory electrocardiographic monitoring has not been shown to relate to the outcome, frequency of complications, or rate of restenosis in patients after successful angioplasty. Ambulatory electrocardiographic monitoring and exercise testing are complementary investigative techniques for the detection of myocardial ischaemia after successfully coronary angioplasty. Their roles will depend on the type of ischaemic syndrome present, its presentation and the pathophysiological mechanisms involved. PMID- 2697565 TI - Prevention of restenosis after coronary angioplasty: a pharmacological approach. AB - Evaluations of drugs for the prevention of restenosis after human coronary angioplasty have been disappointing. Heparin failed to reduce restenosis in a randomized study in Atlanta, Georgia, in patients maintained on heparin for 24 h. A randomized study in the same centre compared acetylsalicylic acid to anticoagulation with coumadin. Restenosis was slightly but not significantly less frequent in patients on acetylsalicylic acid. An American multicentre randomized study comparing a combination of acetylsalicylic acid and dipyridamole to ticlopidine and to placebo revealed no difference in terms of incidence of restenosis. Dipyridamole alone shows no effect against acute or late coronary artery restenosis. Two calcium antagonists (diltiazem and nifedipine) did not significantly diminish restenosis in randomized trials. Neither did a thromboxane A2 inhibitor. Only eicosapentaenoic acid (EPA), an n-3 fatty acid, significantly reduced restenosis in a randomized study using a high dose. But the same compound proved ineffective in a similar study using a somewhat lower dose. Despite scientific evidence for the inefficacy of virtually all tested compounds, I do not know of a single institution that does not continue to discharge its patients after coronary angioplasty on one or several of them. PMID- 2697566 TI - Weaning from mechanical ventilation in the elderly postoperative cardiac surgery patient. PMID- 2697567 TI - Coronary artery bypass surgery vs coronary angioplasty: from antithesis to synthesis. AB - Over the last two decades, revascularization therapy has greatly improved the management of patients with coronary artery disease. Coronary artery bypass graft (CABG) surgery has been proven by several randomized trials to alleviate symptoms, prevent myocardial infarction, and prolong survival in patients with moderately severe disease. Percutaneous transluminal coronary angioplasty (PTCA) has emerged as an alternative treatment for an increasing number of these patients. The use of coronary angioplasty has been expanding rapidly to include single-vessel and multivessel disease and acute ischaemic syndromes. Although the angiographic success rate in properly selected cases exceeds 90%, there are limited data regarding the long-term results with angioplasty in the treatment of patients with multivessel disease. Procedure-related mortality and restenosis rate remain major areas of concern. Several randomized clinical trials (CABRI, RITA, GABI, EAST, BARI) currently in progress are comparing PTCA and CABG in the management of patients with multivessel coronary artery disease. It is anticipated that these studies will provide a wealth of information, enabling physicians to construct a revascularization strategy that will maximally benefit their patients. PMID- 2697568 TI - Multicentre European trials: their design, execution and relevance. AB - Multicentre randomized clinical trials in Europe over the past decade have made a major contribution to the practice of cardiology and will increasingly do so when the Single Europe Act becomes a fact of life in 1992. The arguments for independent scientifically based research organizations and their role in the area of coronary artery disease are outlined. These include cost-benefit considerations, the science of clinical trials, data acquisition techniques and data management requirements. The role of the pharmaceutical industry in relation to the investigator-trialist is discussed. A critique of the current fashion 'Big is beautiful', with arguments against 'simplicity' and 'large size' and the need for 'credibility' is provided. Applicability of data from trials and their economic usefulness and validity in terms of sound pathophysiological hypotheses are also discussed and illustrated by using the CABRI trial as an example. PMID- 2697569 TI - Ultrasonic assessment of efficacy of radiotherapy in cases of carcinoma of the cervix uteri by using rectosonography. AB - To assess the efficacy of radiotherapy in carcinoma of the cervix uteri, we used transrectal radial scan ultrasonography with the purpose of making an objective evaluation. The subjects were 29 patients with carcinoma of the cervix uteri who had radiotherapy between October 1984 and October 1986. Six cases (non-effective cases) showed localized relapse within 2 years of the end of radiotherapy. Transrectal radial scans were performed before, during, and at the end of radiotherapy, as well as two and six months after the end of radiotherapy. The characteristic ultrasound findings in the non-effective cases after radiotherapy were as follows: 1) increasing width of the parametrial echo; 2) a band or massive type parametrial echo; 3) a high intensity parametrial echo; 4) a rough contour of the parametrial echo, and 5) an increase in the size of the uterine cervix. It is considered that rectosonography is a useful diagnostic method for checking the therapeutic effect of radiotherapy in cervical carcinoma, and for the early detection of patients with poor prognosis. PMID- 2697570 TI - Stage III carcinoma of the endometrium. Results of treatment. AB - The impact of treatment on survival was analysed in 45 patients with stage III carcinoma of the endometrium. Our results indicate that patients treated with a combination of surgery and radiation therapy did significantly better than those treated with radiation alone. The five-years survival was 57.3% and 17.5%, respectively (p = 0.01). Patients with clinical stage III (CS III) whose tumor could not be resected surgically did poorly than patients with pathological stage III (PS III). This difference, however, was not statistically significant (p = greater than 0.05). Treatment related complications were minimal. Overall survival of patients of 33.8% was directly attributable to increased pelvic and/or extra pelvic recurrences. PMID- 2697571 TI - Cervix uteri cancer and pregnancy. AB - It has been showed effectiveness of cytological screening among 4230 pregnant women for revealing early forms of the cervical cancer. It has been revealed that since the half of gravidity a prognosis of cervical cancer was getting worse. Variants for treatment of patients with combination gravidity and cervical carcinoma are regarded. PMID- 2697572 TI - Bilateral Brenner tumor. AB - A case of bilateral ovarian Brenner Tumor of above average size with smooth surface, is reported. The Authors describe symptomatology and diagnostics, considering the uncertainty and rarity that still surround this neoplasia. PMID- 2697573 TI - Comparison of cardiopulmonary variables with intermittent positive pressure ventilation and high-frequency jet ventilation during abdominal aortic operations. AB - Cardiopulmonary variables with intermittent positive pressure ventilation (IPPV) and high-frequency jet ventilation (HFJV) were compared in 8 patients undergoing elective abdominal aortic operations under fentanyl-nitrous oxide anesthesia. Hemodynamics were stable under the two methods of ventilation, and most of the corresponding hemodynamic variables were statistically indifferent from each other. Alveolar gas exchange was also adequate with either method and most of the corresponding respiratory variables were not statistically different. The peak airway pressure was significantly less during HFJV than during IPPV (p less than 0.01). Diaphragmatic excursions are less during HFJV than during IPPV, resulting in a quieter surgical field. Therefore, hemodynamic stability and gas exchange adequacy coupled with less diaphragmatic excursions and lower peak airway pressure make HFJV an acceptable alternative to IPPV during abdominal aortic operations. PMID- 2697574 TI - Progress in therapy of renal cell cancer. PMID- 2697575 TI - Interleukin-2 with or without LAK cells in metastatic renal cell carcinoma: a report of a European multicentre study. AB - Between October 1987 and November 1988, 95 European patients with metastatic renal cell carcinoma have been treated with recombinant interleukin-2 (rIL-2) (EuroCetus) at 18 X 10(6) IU/m2/day (equivalent to 3 X 10(6) Cetus Units/m2/day) according to the West schedule in two trials. 1. Forty-two patients received rIL 2 alone. Median time between initial diagnosis and metastases was three months. Eighty-one percent of the patients had at least two involved sites at inclusion and 86% underwent prior nephrectomy. Twenty-seven patients (64%) received two successive courses. Over 80% of the planned dose was administered in 69% and 44% of patients during courses 1 and 2, respectively. Fever, hypotension, weight gain, rise in creatinine level, hepatic disturbances, anaemia and thrombocytopenia were commonly observed but resolved promptly after completion of therapy. No toxic death was recorded. Two (6%) complete responses (CR), four (13%) partial responses (PR), four stable diseases (SD) and 22 progressive diseases (PD) were observed. The response rate is 6/32 (19%); the median progression-free survival time is not reached at 218+ days (92-394). 2. Fifty three patients received rIL-2 with lymphokine-activated killer (LAK) cells. Median time from primary diagnosis to metastases was three months. Eighty-five percent of patients had at least two involved sites though 73% had previously undergone nephrectomy. Forty patients (75%) received two successive induction courses. Most patients, i.e. respectively, 77% and 60%, were given at least 80% of the planned dose during courses 1 and 2. Median numbers of LAK cells infused were 13.1 and 11.6 X 10(9) nucleated cells per course, respectively. Toxicity was not different from that described above; no toxic death occurred; five CR (10%), nine PR (18%), 11 SD and 26 PD were observed. The response rate is 14/51 (27%) and the median progression-free survival time is not reached at 7.2+ months (3 13.1). In conclusion, rIL-2, with or without LAK cells, is obviously active on metastatic renal cell carcinoma. The difference in response rate between the two trials is not statistically significant but has to be paralleled with the difference in dose received by the patients rather than with the addition of a cellular therapy. Toxicity was always manageable and reversible. The association of rIL-2 with other lymphokines should represent a major issue to improve the response rate and will be considered in further European studies. PMID- 2697576 TI - Malignant melanoma--prognosis and actual treatment strategies with chemotherapy and biological response modifiers. AB - The prognosis of malignant melanoma (MM) depends on the level of invasion, vertical tumour size, location of the primary, clinical stage, and sex. Whereas MMs are potentially curable in the early stage of disease, the therapeutic possibilities are very limited in advanced and disseminated MM. Most chemotherapeutic agents lack sufficient activity in MM especially with regard to survival. Dacarbazine (DTIC) is the most effective drug in MM with response rates of 20-25% followed by other drugs such as melphalan with 15-20%, hydroxyurea and platin derivates. Multidrug regimens were not shown to be more effective than DTIC alone. Radiotherapy may be relevant in local treatment of metastases. With regard to the poor prognosis and limited therapeutic approaches in advanced and disseminated MM, new strategies are required. In this context immunotherapeutic strategies with biological response modifiers are of interest for adjuvant or palliative approaches. Earlier trials with Bacillus Calmette-Guerin (BCG) +/- DTIC as adjuvant or palliative treatment revealed no effect of BCG on the prognosis. Alpha-interferon (alpha-IFN) was shown to induce remissions in about 15% and gamma-IFN in about 10% of patients. A very interesting new approach is the induction and/or activation of autologous cytotoxic cells by systemic administration of recombinant interleukin-2 (rIL-2) with response rates of 20-25% and the in vivo propagation and transfer of so-called tumour infiltrating lymphocytes. Further trials combining rIL-2 with other cytokines, chemotherapy, tumour vaccination or monoclonals against melanoma cells are required. PMID- 2697577 TI - In vitro lymphocyte response to autologous melanoma: clues in designing new adoptive immunotherapy protocols. AB - Recent studies indicate that different types of antitumour lymphocytes (T and non T) can be generated in vitro and in vivo after exposure to recombinant interleukin-2 (rIL-2). In vitro it is possible to selectively expand the CD3 cells by using anti-CD3 monoclonal antibody and rIL-2. Adherence can select a minor subpopulation of lymphokine-activated killer (LAK) cells (A-LAK) endowed with a higher lytic activity. We have investigated whether melanoma-specific T lymphocytes can be obtained to be used for therapy or endogenously expanded in vivo by the appropriate use of limited amounts of rIL-2. Clonal analysis of lymphocytes obtained either from tumour lesions or from blood indicated the existence of melanoma-restricted T-lymphocytes, both with cytotoxic or helper function. Though a minority, these cells can be generated and expanded with low amounts of rIL-2 (3-30 Cetus U/ml) in the presence of autologous melanoma and B cells. The use of rIL-1 and rIL-4, together with rIL-2 at certain phases of T lymphocyte growth, can help in expanding more selectively the melanoma-specific cells. These T-cells are major histocompatibility complex-restricted in their killing but they also need to see adhesion molecules (ICAM-1) on the target cells. New clinical protocols can thus be conceived on the basis of some of these results. PMID- 2697578 TI - Sequential administration of recombinant human interleukin-2 and dacarbazine in metastatic melanoma. A multicentre phase II study. AB - Twenty-four evaluable patients with metastatic melanoma have been entered in a multicentre Phase II study of two induction cycles of human recombinant interleukin-2 (rIL-2) 18 x 10(6) IU/m2/day continuous i.v. bolus on days 1-5 and days 12-17. Dacarbazine (DTIC) 850 mg/m2 i.v. bolus was given on day 26. The cycle was repeated at five weeks. Maintenance therapy was scheduled three weeks after the completion of the induction treatment, consisting of rIL-2 18 x 10(6) IU/m2/day for five days alternating with DTIC 850 mg/m2 i.v., every three weeks, for a total of 18 weeks. Median age was 44 years (range 23-80), and Karnofsky index was 100 (range 80-100). One patient had received prior chemotherapy with hydroxyurea and one patient had prior radiotherapy. Six patients responded (25%): two had complete responses (CR) and four had partial responses (PR). Stable disease (SD) was seen in five patients. Responses occurred in the following sites: liver 2/9 (22%), lung 3/14 (21%), skin 2/11 (18%), and lymph nodes 3/12 (25%). Duration of CR was 11+ and 13 months. PRs lasted 2, 5, 7, and 11+ months. Of note, time to progression in patients with SD was similar to that of responders: 4, 4, 11+, 11+, and 14+ months. Toxicity included fever, skin rash, fatigue, anorexia, and diarrhoea in most patients. Two patients had a weight gain of more than 10%. Hypotension requiring vasoactive agents or interruption of rIL 2 occurred in four patients, creatinine elevations WHO grade 1-2 in seven patients, and bilirubin elevations WHO grade 1-3 in six patients. One patient developed transient ventricular tachycardia. It appears that rIL-2 and DTIC in this schedule is feasible and effective, but not clearly superior to rIL-2 alone. PMID- 2697579 TI - Sequential dacarbazine chemotherapy followed by recombinant interleukin-2 in metastatic melanoma. A pilot multicentre phase I-II study. AB - Between April 1988 and August 1989, 30 melanoma patients were entered in a multicentre Phase II study of dacarbazine (DTIC) 850 mg/m2 i.v. bolus on day 1, and recombinant interleukin-2 (rIL-2) (Cetus) 18 x 10(6) IU/m2/day i.v. continuous infusion on days 4-9. Six treatment cycles were given: the first two at an interval of 13 days, and further cycles at intervals of 20 days. Twenty patients are currently evaluable for toxicity and 18 for response. Two of these patients presented with metastatic intraocular melanoma. Median age was 48 years (range 18-83), and median Karnofsky index was 100 (range 80-100). Four patients had received prior radiotherapy and one had received prior immunotherapy. Seventeen patients received two cycles of treatment and nine patients received three or more cycles. Four patients responded (22%): two complete remissions and two partial remissions. Stable disease was seen in six patients (33%). Responses occurred in the lung, skin, spleen and lymph nodes. Seventy-five percent of the patients received the full dose of rIL-2 during cycle 1, whilst only 2 out of 9 (22%) received the planned dose on the third cycle. Rebound lymphocytosis of 5.3 x 10(3)/L (range 1.2-18.1) occurred 24-48 h after rIL-2, but was not predictive for response. Currently, there is no evidence that pretreatment with DTIC impacts negatively on the rIL-2-stimulated lymphocyte proliferation. The toxicity profile of this treatment regimen did not differ significantly from that already described for similar regimens of rIL-2. However, in this interim analysis, there was a trend for a higher percentage of patients (25%) to experience severe weight gain (greater than 10%). This study shows that this treatment regimen is active in metastatic melanoma, with acceptable toxicity. Further research will focus on using other chemotherapeutic agents and/or other biological response modifiers (e.g. interferons, tumour necrosis factor) in combination with rIL-2. PMID- 2697580 TI - Clinical parameters for evaluating biological response modifier therapy. AB - Evaluating response in cancer is a well established practice, depending on the recognition of complete response, partial response, stable disease and progressive disease. For chemotherapeutic drugs, only those patients achieving a complete response experience an increase in survival. Partial response merely indicates that the drug has some activity in that disease. What the patient wants is not active drugs but prolonged survival with good quality of life. It is well recognised that tumours may remain dormant for many years, and that even those patients with complete responses to chemotherapy usually have minimal residual disease. It is assumed that such minimal disease is controlled and held in check by a biological process. The principal aim of biological response modifiers is to enhance this effect so as to control an even larger tumour load. It therefore follows that removal of all tumour is not the only benefit, and that stable disease and even slower progression might translate to longer survival. Survival curves are the acid test and we should expect longer survival even for those patients failing to achieve complete response if we are to establish that life imprisonment is as effective in cancer treatment as capital punishment. PMID- 2697581 TI - The Merlini, Waldenstrom, Jayakar staging system revisited. AB - At present, none of the routinely used staging systems is entirely satisfactory, since all of them require some reconsideration to account for the most recent prognostic factors. Among these, serum beta-2 microglobulin (S-beta-2M) has proved to be a powerful prognostic test assessable in most centers. In order to improve the Merlini, Waldenstrom, Jayakar (MWJ) staging system, we have determined the prognostic significance of several factors in an independent population of 345 retrospective myeloma patients seen at our institution from 1973 to 1988. The Cox regression hazards method showed that S-Creatinine, S Albumin levels and percentage of bone marrow plasma cells accounted for 94% of total chi 2 achieved with all eight variables (including also: paraprotein index, S-Calcium, S-M-component, bone lesions and hemoglobin). The same analysis, applied to patients in whom S-beta-2M was available at presentation, selected S beta-2M, S-Creatinine and percentage of bone marrow plasma cells (accounting for 92% of total chi 2), followed by platelet count, S-Albumin and S-M-component. The best discriminatory level of S-beta-2M was found to be 4 mg/l. However, the prognostic power of S-beta-2M when used with binary values was remarkably reduced with respect to its application as a continuous variable. In patients with MWJ stage 1 and 2 disease, S-beta-2M had an independent prognostic significance. Grouping stage I and II patients with S-beta-2M less than or more than 4 mg/l presented a median survival of 70 and 40 months, respectively. In stage 3 patients S-beta-2M did not contribute additional prognostic information.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697582 TI - Monoclonal and biclonal immunoglobulin-producing disorders. AB - Monoclonal gammopathies are B lymphocyte-derived disorders producing a specific monoclonal immunoglobulin. The group includes multiple myeloma, Waldenstrom's macroglobulinaemia, monoclonal gammopathy of undetermined significance (MGUS) and heavy-chain disease. In 1% of the cases a double M-component is present which is referred to as a biclonal gammopathy. The pathogeneses of these disorders are unknown, but several possibly related environmental factors have been identified. In multiple myeloma, an increased incidence and mortality rate has been noted during the last 20 years. Strong lines of evidence are presented showing that, in monoclonal gammopathies, the cell clone consists of B lymphocytes in different stages of maturation. In most cases of biclonal gammopathy there is probably a common cellular origin. PMID- 2697583 TI - Therapeutic implications of myeloma staging. AB - Clinical staging, such as with the Durie-Salmon clinical staging method, remains the most easily usable available method to classify patients with untreated multiple myeloma. However, for the development of new treatment strategies and comparison with prior results, new and powerful prognostic factors are now available. Serum beta 2 microglobulin alone represents the most reliable prognostic factor in multiple myeloma. Beta 2 microglobulin alone allows simple and reproducible classification of patients into low grade myeloma with low serum beta 2 microglobulin versus high grade myeloma with high serum beta 2 microglobulin. Plasma cell labelling index is an additional factor which allows identification of patients with MGUS as well as subclassification of patients with low serum beta 2 microglobulin into those with relatively better or worse prognosis. For each grade of myeloma young (less than 63 years of age) patients have a slightly better survival. Independently of serum beta 2 microglobulin and labelling index, DNA content values allow the identification of a subset of patients with biclonal or hypodiploid tumors and high grade disease. New or more sophisticated methods for evaluating myeloma cells such as by immunophenotyping or assessment of multi drug resistance enable the development of specific approaches to treatment in individual cases. It should also prove possible to identify patients especially suitable for newer biologic agents such as alfa interferon, G or G-MCSF and the various interleukins. PMID- 2697584 TI - Melphalan/prednisone versus drug combinations for plasma cell myeloma. AB - Reports of 13 prospective, randomized clinical trials comparing standard treatment with melphalan and prednisone (MP) versus various drug combinations in the treatment of myeloma patients are presented. These studies reveal that patients with Durie-Salmon Stage III disease respond significantly more frequently to MP and drug combinations than those with Stage I and II. Drug combinations may be more effective in inducing objective responses. The response rates were significantly better for the drug combinations in 3 of the 13 comparisons. There was little evidence that either form of treatment was superior in prolonging survival, for in one study the patients treated with a drug combination lived significantly longer than those treated with MP, while in another the reverse was true, and there was no difference in the survival of the two groups in the remaining 11 studies. In the Vth MRC myelomatosis trial, patients treated with a combination of adriamycin, carmustine, cyclophosphamide and melphalan are living significantly longer than those treated with melphalan alone, and this survival advantage persists after correction for the most important prognostic factor, beta 2 microglobulin. Attempts to increase the intensity of treatment by using syngeneic, allogeneic or autologous marrow transplantation to rescue patients following otherwise lethal chemoradiotherapeutic treatments, have not yet demonstrated conclusively that the myeloma clone can be eliminated by this form of treatment. PMID- 2697585 TI - Induction treatment with alpha-interferon in multiple myeloma: an interim report from MGCS. AB - A randomized study comparing melphalan/prednisone (M/P) therapy with MP + natural alpha-IFN in untreated patients with multiple myeloma stages II and III started April 1, 1986. By March 1989, 78 patients were evaluable in the MP group and 80 in the MP/IFN group. 48% of the MP patients achieved a response and 66% in the MP/IFN group (p = 0.04). Stage II patients responded better to MP/IFN (76%) than MP alone (47%) (p = 0.02), while no statistically significant difference was noted for stage III patients. 90% of the IgA myelomas responded to MP/IFN and 52% to MP (p = 0.02). Both for IgG and BJ myelomas the response rates of MP/IFN were higher than of MP, although the differences were not statistically significant. The observation period is still short. There was no difference in total survival between the two treatment groups. However, in patients less than or equal to 65 years a tendency to a longer survival was seen for those receiving the IFN combination (p = 0.12). PMID- 2697586 TI - Maintenance treatment of multiple myeloma. AB - In multiple myeloma (MM), low-cost maintenance treatment has some attractions, since maintenance of a small tumor is usually compatible with a fairly healthy state. However, the great majority of the studies of maintenance treatment have failed to show any clinical benefit. Based on simple theoretical consideration, it is shown that in MM response duration and survival are affected primarily by the residual tumor mass after primary treatment, and by the kinetics of the tumor. Continuation of maintenance treatment is likely to have a moderate effect. The main cause of that is identified in the presence or in the development of a substantial proportion of drug-resistant cells. Preliminary data suggest that only alpha-interferon can be useful for maintenance, and that it can act by slowing down the kinetics of the tumor. PMID- 2697587 TI - High-dose chemotherapy and autologous bone marrow transplantation for myeloma. AB - In three studies we have attempted to increase the complete remission rate in a series of patients with multiple myeloma under the age of 69. A CR rate of 27% was seen in 63 patients treated with intravenous high-dose melphalan 140 m/m2 with or without the addition of high-dose methyl prednisolone 1 g/m2 for 5 days (in 22 patients). In a third study a CR rate of 50% was seen in 50 patients treated in a programme in which vincristine, adriamycin and methyl prednisolone was first given and patients then received high-dose melphalan 140-200 mg/m2 with an autologous bone marrow transplant where possible. Median remission duration in the first two studies was 19 months with a median survival of 5 years. A definition of complete remission in myeloma is proposed. PMID- 2697588 TI - Autologous bone marrow transplantation therapy for multiple myeloma. AB - We have begun an autologous bone marrow transplantation (ABMT) treatment protocol for patients with myeloma who achieve a minimal disease (less than 10% marrow plasma cells) status. Sites of bony disease are irradiated before BMT. Melphalan 70 mg/m2 on days 1 and 2 is followed by 1200 rads total-body irradiation administered in fractionated doses over 3 d. Autologous marrow which has been previously treated with anti-CALLA, B1, and PCA-1 monoclonal antibodies is then thawed and reinfused. 4 males and 2 females with median age of 46 yr (41-56) have been treated. Granulocytes greater than 500/mm3 and platelets greater than 20,000/mm3 were noted at 21 (12-46) and 23 (12-53) d post-transplant (PT), respectively. Acute mucositis and dermatomal Herpes zoster developed in 3 patients each; all patients are clinically well at 233 (30-807) d PT. All patients achieved pathologically normal marrows, but monoclonal plasma cells and marrow myelofibrosis were each noted in a single patient at 486 and 272 d PT, respectively. A single patient has responded to alpha 2 interferon therapy PT; all others have received no therapy. AMBT offers an exciting new treatment for myeloma; however, relapses post-ABMT suggest that improved ablative regimens and/or marrow purging methods may be required. PMID- 2697589 TI - Allogeneic bone marrow transplantation in patients with multiple myeloma. AB - 50 patients with a median age of 41 years (range 29-54) underwent allogenic bone marrow transplantation for multiple myeloma. 35 patients were on second-line treatment, and 15 on first-line treatment. 24 patients were considered refractory to previous treatment. 45 patients received marrow from HLA-matched sibling donors (3 of these from twin donors), and 5 from unrelated or related non-sibling donors. 21 patients entered complete remission, while 15 had persistent disease following repopulation of the marrow. 14 patients were not evaluable for remission status because of early transplantation-related death. The overall median survival from bone marrow transplantation was 27 months, with a projected long-term survival of 34%. Patients who were 40 yr of age or older had a survival that was not different from that of patients between 29 and 40 yr of age. The median disease-free survival of patients who entered complete remissions was 41 months. These patients tended to have a longer survival than patients with persistent disease following repopulation of the marrow. Allogeneic bone marrow transplantation appears to be a promising method for treatment of certain patients with multiple myeloma. PMID- 2697590 TI - Marrow transplantation for malignant plasma cell disorders: summary of the Seattle experience. AB - 28 patients with plasma cell malignancies received marrow transplants from identical twins (N = 8), HLA-identical family members (N = 15), HLA partially matched relatives (N = 3) or cryopreserved autologous marrow (N = 2). Treatment regimens included cyclophosphamide (CY) and total body irradiation (TBI) for 15 patients and busulphan (BU) and CY for 13 patients. 3 of 8 twins are alive, 2 without disease at 24 and 34 months, and 1 is alive and well at 116 months without evidence of disease except for at small residual monoclonal protein spike. 12 of the 18 allografted patients died of transplant-related causes and 2 died of progressive disease. 4 of 18 allograft recipients are alive; 2 are free of disease at 16 and 15 months, 1 is alive at 6 months without disease except for persistent monoclonal Kappa protein. 1 patient is alive with residual marrow involvement and a persistent IGA lambda monoclonal protein at 7 months. 1 of the 2 autograft recipients is alive 2 months after transplant and is not yet evaluable for tumor response and the other patient died early of transplant related complications. Both CY + TBI and BU + CY resulted in remissions in patients with advanced plasma cell malignancies. However, the optimal treatment regimen and timing of transplantation remain to be determined. PMID- 2697592 TI - Advances in biology of multiple myeloma: cell kinetics, molecular biology and immunology. AB - Bone marrow plasma cell proliferative activity has been evaluated in a large series of multiple myeloma (MM) patients. This kinetic parameter has been shown to be a useful tool for patient management, and contributes to a correct diagnosis and a selection of high-risk patients who can be offered high-dose chemotherapy. The role of ras oncogenes has been evaluated in the pathogenesis of MM. A point-mutated and activated H-ras oncogene, introduced in a human lymphoblastoid cell line, was able to induce neoplastic transformation and differentiation to plasma cell. Indeed, mutated alleles of ras genes have been detected in a high percentage of myeloma patients in relapse phase. Phenotypical and functional studies have been carried out in T-lymphocyte subsets and an impaired cellular immunity has been detected. Such an impairment was related to the disease status: marked alterations were detected in relapse phase, whereas a partial recovery was observed during remission phase. PMID- 2697591 TI - High-dose chemoradiotherapy and allogenic bone marrow transplantation in multiple myeloma. AB - 17 patients with multiple myeloma (MM) received marrow transplants from their HLA matched, MLC-negative sibling donors. 9 patients had progressive disease not responding to conventional treatments, while the other 8 patients were rated as responders. The most frequently used conditioning regimen consisted of total body irradiation and high-dose, multi-agent chemotherapy with cyclophosphamide plus either oral melphalan (5 cases) or BCNU (1 case) on both these drugs (7 cases). 12 patients were evaluable for response to BTM: 7 of them (6 responders and 1 with advanced refractory MM) entered complete remission, while 5 had a sustained decrease in tumor mass that ranged between 72% and 93%. 11 patients died of transplant-related causes, 1 of them with signs of progressive disease. The remaining 6 patients are alive and 5 of them maintain a complete remission status 4 to 67 (median 36) months after BMT. It is concluded that therapeutic benefits of transplantation in MM are still offset by the high mortality related to the procedure. A more accurate selection of patients who would most benefit from BMT and performing transplant at an earlier phase of the disease are warranted before major advances can be made in the cure of these patients. PMID- 2697593 TI - Biologic and clinical significance of cytokine production in B-cell malignancies. AB - Cytokines are a group of polypeptide hormones endowed with pleiotropic biological properties. Normal B lymphocytes produce a number of these factors that subserve important regulatory functions in the combined processes of proliferation and differentiation. Also neoplastic B cells can release cytokines and, simultaneously, respond to the same factors in an autocrine circuit that supports their malignant growth. In addition, tumor cells can make use of the factors released by normal cells, either spontaneously or under the influence of inductive signals from the neoplastic cells. Inappropriate or excessive release of cytokines may have an important role in the pathophysiology of some clinical features. Thus, neutralization of cytokine biologic activity in vivo could be a therapeutic strategy for treatment of human B-cell neoplasias. PMID- 2697594 TI - In vitro growth of myeloma cells. PMID- 2697595 TI - Chromosomes in plasma-cell malignancies. AB - Much less is known about the chromosome changes in MM than in other hematological malignancies. The prevalence of abnormal karyotypes is unknown, but there is no evidence for malignant plasma cells or their precursors to have a normal karyotype. The chromosome changes found may be early events, but karyotypic evolution occurs early and rapidly. No specific structural or numerical chromosome anomaly is associated with multiple myeloma or plasma-cell leukemia. The changes found are those already known to occur in other B-cell malignancies, particularly B-CLL and diffuse small cell lymphoma. A 14Q + marker is present in about 30% of all karyotypically abnormal cases, and in 50% of the cases this is due to a t(11;14) (q13;q32). In a minority of cases deletions of 6q are found, and sporadically other B-cell translocations can be present. Karyotypes are often very complex with numerous structural anomalies involving mainly chromosomes 1, 11 and 17, and numerical anomalies involving chromosomes 3, 7, 9 and 11. Finally, the presence of structural or numerical anomalies of chromosomes 5 and 7 may be heralding or may be indicative of therapy-induced leukemia. PMID- 2697596 TI - Plasma cell leukemia: a report on 15 patients. AB - Plasma cell leukemia (PCL) can be considered the leukemic variant of multiple myeloma. The diagnosis is based on hematological features, including a plasmacytosis exceeding 2 x 10(9)/l and any evidence of a clonal plasma cell proliferation. There are two forms of PCL: the primary form occurring in individuals without preceding multiple myeloma, and the secondary form arising as a late manifestation in patients with multiple myeloma. From 1974 to 1988 we diagnosed 8 primary PCL cases out of a total 301 multiple myeloma cases (incidence, 2.6%) and a total of 847 acute leukemia cases (incidence, 0.9%). During the same period we observed in 7 multiple myeloma patients a terminal PCL, for an incidence of PCL in myeloma of 2.3%. Most clinical characteristics were similar in both types of plasma cell leukemia. In particular we found no difference in the average age and in the incidence of bone pain, hepatosplenomegaly, lytic bone lesions. None of our cases showed a clinically relevant lymphadenopathy either as presenting symptom or during the course of the disease. The values for hemoglobin, leukocytes, plasma cells, serum creatinine and calcium did not differ significantly between the two groups of patients. The median survival was 7 months for patients with primary PCL and 1 month for patients with secondary PCL. 5 of the 8 patients with primary PCL obtained a response to conventional myeloma therapy including single alkylating agents, with a duration ranging from 7 to 44 months. Only 1 of the patients with secondary PCL had a partial response after combination chemotherapy. PMID- 2697597 TI - Bone marrow histology and serum beta 2 microglobulin in multiple myeloma--a new prognostic strategy. AB - Bone marrow biopsies of 720 patients with multiple myeloma (MM) were investigated from 1968-1989. Histologic variables were correlated with clinical parameters and survivals to determine prognostic factors. In 207 of these patients initial levels of serum beta 2 microglobulin (SB2M) were also measured for prognostic evaluation. Four tumour growth patterns were distinguished: interstitial (56%), interstitial/sheets (13%), nodular (15%) and packed marrow (16%) with median survivals of 46, 31, 22 and 16 months. When grouped according to the tumour cell mass in the biopsy, four histologic stages were recognized. Cellular characteristics were used to classify MM into 6 histologic types which were subsequently combined into 3 grades of malignancy: low, intermediate and high, analogous to the malignant lymphomas. With respect to tumour products, only SB2M proved to be a valuable prognostic indicator for staging and follow-up. Complications of MM such as anaemia, azotaemia, osteolytic lesions, hypercalcaemia and hypoalbuminaemia all predicted a poor prognosis, highly significant in the test statistics. We propose a new prognostic approach in MM, comprising 1) parameters defining the tumour itself, 2) the tumour products (SB2M) and 3) the tumour complications. This prognostic strategy combines information both on stage and malignancy of MM and enables definition of smouldering and of aggressive variants of MM at an early stage. PMID- 2697598 TI - Improvement of Durie & Salmon staging for multiple myeloma by adding platelet count as a stratifying variable: a multivariate regression analysis of 163 untreated patients. AB - The presenting clinical features of 163 previously untreated patients with multiple myeloma were correlated with survival duration using univariate and multivariate regression analyses. The univariate proportional hazard analysis ranked the parameters in the following order of importance: platelet count, haemoglobin level (Hb), tumour cell mass stage, lytic bone lesions, creatinine and age. When the individual contribution of each variable was assessed by multivariate regression analysis, platelet count was confirmed to be the dominant feature for prognosis, while clinical stage provided additional information. The introduction of platelet count could then be used to improve the discriminating power of Durie & Salmon staging, by allowing separation of the high-risk group (stages II and III) into a smaller subgroup (22%) of thrombocytopenic patients (less than 150 x 10(9) platelets/l) whose risk of death was actually very high (median survival: 9 months) and a larger subgroup (46%) of patients with normal platelet count and intermediate or standard risk (median survival: 48 months). PMID- 2697599 TI - [The therapy of acute blood loss in puerperae]. PMID- 2697600 TI - [The neurogenic mechanism of the regulation of cerebral circulation and the linking of blood flow-metabolism function]. AB - The neurogenic link of the CBF regulation provides the "microflow-metabolism function" coupling by means of external innervation of the brain vessels. According to the principle of regulation through input, the latter can be the level of emotional tension (excitement) and not the current metabolic demands. The neurogenic link cannot be the mechanism of the CBF local self-regulation. The regulation of adequate blood supply of the brain for maintenance of the "function metabolism-microflow" coupling is carried out by metabolic link of regulatory system. PMID- 2697601 TI - [Local circulatory regulation: the characteristics of the behavior of vascular smooth muscles]. AB - The general law of local regulation of the circulation and the "law of behaviour" of vascular smooth muscle are proposed on the basis of precise definition of hierarchically interrelated aims of the circulation: 1) stabilization of substances and heat fluxes through the tissue, 2) stabilization of the tissue environment at farthest points from the supplying vessels, and 3) minimization of circulating blood volume. The laws allow to unite modern theories of metabolic, myogenic and neurogenic regulation of vascular tone. A mathematical model of the vascular bed functioning in accordance with these laws, simulates the behaviour of real preparations in changes of arterial, venous or tissue pressure as well as of arterial blood composition and tissue metabolism. Sympathetic stimulation or denervation are also taken into consideration. PMID- 2697602 TI - [Structural-functional organization of the cerebral circulatory system in birds]. AB - The literature reference and own data on structural-functional organization of the cerebral circulation system in birds are summed up. The regularities of cerebral hemodynamics in alteration of the blood gaseous composition, arterial pressure and in rise of the body temperature are emphasized. Possible physiological role of the regulatory specifics of the cerebral circulation system of birds in diving and flying, is discussed. PMID- 2697603 TI - [A method for forming an isolated stomach in dogs]. PMID- 2697604 TI - Pathophysiology of vasopressin in edematous disorders. AB - Sodium and water retention is characteristic of edematous disorders including cardiac failure, cirrhosis, nephrotic syndrome and pregnancy. In recent years the use of a sensitive radioimmunoassay for plasma vasopressin has implicated the role of nonosmotic vasopressin release in the water retention of these edematous disorders. In experimental studies and studies in humans it has been found that the nonosmotic release of vasopressin is consistently associated with activation of the sympathetic nervous and renin-angiotensin-aldosterone systems. Moreover, the sympathetic nervous system has been shown to be involved in the nonosmotic release of vasopressin (carotid and aortic baroreceptors) and activation of the renin-angiotensin system (renal beta-adrenergic receptors). These findings have led to our proposal that body fluid volume regulation involves the dynamic interaction between cardiac output and peripheral arterial resistance. In this context neither total extracellular fluid (ECF) volume nor blood volume are determinants of renal sodium and water excretion. Rather, renal sodium and water retention is initiated by either a fall in cardiac output (e.g. ECF volume depletion, low-output cardiac failure, pericardial tamponade or hypovolemic nephrotic syndrome) or peripheral arterial vasodilation (e.g. high-output cardiac failure, cirrhosis, pregnancy, sepsis, arteriovenous fistulae and pharmacologic vasodilators). With a decrease in effective arterial blood volume (EABV), initiated by either a fall in cardiac output or peripheral arterial vasodilation, the acute response involves vasoconstriction mediated by angiotensin, sympathetic mediators and vasopressin. The slower response to restoring EABV involves vasopressin-mediated water retention and aldosterone-mediated sodium retention. The renal vasoconstriction which accompanies those states that decrease EABV, by either decreasing cardiac output or causing peripheral arterial vasodilation, limits the distal tubular delivery of sodium and water thus maximizing the water retaining effect of vasopressin and impairing the normal escape from the sodium retaining effects of aldosterone. The elevated glomerular filtration rate and filtered sodium load in pregnancy allows increased distal sodium and water delivery in spite of a decrease in EABV, thus limiting edema formation during gestation. PMID- 2697605 TI - Glucose regulation of insulin gene expression. PMID- 2697606 TI - Comparison of Monotard and Ultratard insulin at bedtime in a model of optimized insulin therapy in Italy. AB - The italian habit of having a low calorie breakfast suggests an insulin treatment made up of two daily injections of soluble insulin before lunch and dinner, adding at bed time an injection of retard insulin. Aim of this study was to verify whether Monotard or Ultratard proved more effective as retard insulin in this regimen. Sixteen insulin-dependent diabetics treated with the above mentioned insulin regimen were studied for 16 weeks. They were divided in two groups: group 1 was treated initially with Ultratard and group 2 with Monotard, with a cross-over after 8 weeks. The metabolic control achieved with the treatment was considered good with either retard insulin used. HbA1c, fructosamine, body weight and glycemic values measured after 8 and 16 weeds failed to reveal any differences between the treatment with Monotard on Ultratard. Either Monotard or Ultratard can be successfully used as bedtime retard insulin in this multiple injection insulin treatment. PMID- 2697607 TI - Early appearance of in vivo insulin resistance in adult streptozotocin-injected rats. AB - Hepatic glucose production and peripheral glucose utilisation were measured in vivo with the euglycaemic-hyperinsulinaemic clamp technique in rats rendered severely diabetics with streptozotocin (45 mg/kg) and in control rats. The rats were studied in the post-absorptive state while anaesthetised. The basal glucose production and glucose utilisation were significantly higher (p less than 0.05) in the diabetic rats as early as 1 day after the streptozotocin administration and remained elevated thereafter (P less than 0.01 on day 9 after streptozotocin). During the clamp studies, the suppression of glucose production by the liver induced by submaximal or maximal insulin levels was significantly less (p less than 0.05) effective in the diabetic rats as compared to control rats, as early as 1 day after streptozotocin. Following both submaximal or maximal hyperinsulinaemia, the glucose utilisation in the diabetic rats 1 day after streptozotocin was found to be not significantly different from the corresponding utilisation in the control rats. By contrast, in the diabetic rats 9 days after streptozotocin injection, glucose utilisation was significantly lower (P less than 0.01) following both a submaximal or a maximal hyperinsulinaemia as compared to control rats. Thus insulin deficiency and concomitant hyperglycaemia, as the consequences of streptozotocin administration in the adult rat, rapidly leads to the development of in vivo insulin resistance, first in the liver and later on in the peripheral tissues. PMID- 2697609 TI - [Cataract surgery in the diabetic]. PMID- 2697608 TI - Different levels of food restriction have opposite effects on adipocyte cellularity and lipoprotein-lipase activity in obese rats. AB - The effects of several levels of chronic energy restriction on epididymal and perirenal adipose tissue cellularity and lipoprotein lipase activity, serum glucose and insulin and hepatic enzyme activities were studied in lean Fa/- and genetically obese fafa rats. The restricted rats were compared to rats fed ad libitum 24/24h or 8/24h. Restricting time of feeding was associated with increases in fat cell number in the lean, increases in perirenal adipose tissue fat cell size and serum insulin in the obese and increases in lipoprotein lipase activity in both phenotypes. Mild food restriction (-25%) had similar effects in the obese: perirenal adipose tissue fat cell size and serum insulin levels were even higher but fat cell hyperplasia was reduced. Restriction by 50% normalized lipoprotein lipase activity and markedly reduced fat cell size in the lean; in the obese, lipoprotein lipase activity and insulin levels were similar to or lower than those of the corresponding ad libitum 24/24h group but fat cell hypertrophy was not particularly affected. Restriction by 75% in the obese prevented adipocyte hyperplasia. Furthermore, lipoprotein lipase activity in adipose tissue was normalized, serum insulin and lipids being within normal limits. However, these animals had large adipocytes and were still fat. PMID- 2697610 TI - Modulation of asialoglycoprotein receptor expression in liver by the endocytic compartment. PMID- 2697611 TI - Observation and significance of growth inhibition of Saccharomyces cerevisiae (A224A) by the anti-oestrogen drug tamoxifen. PMID- 2697612 TI - Effect of the Walker 256 carcinoma in rats on insulin-stimulated glucose metabolism in soleus muscle in vitro. PMID- 2697613 TI - Expression of recombinant horseradish peroxidase C in Escherichia coli. PMID- 2697614 TI - Metabolic responses of pregnant, lactating and control goats to a sustained glucose load. PMID- 2697615 TI - Microbial routes to lipids. PMID- 2697616 TI - Chemical reactions of oils and fats. PMID- 2697617 TI - Biomembrane structures. Fourier transform infrared spectroscopy and biomembrane technology. PMID- 2697618 TI - Effect of sugars on the phase behaviour of phospholipid model membranes. PMID- 2697619 TI - Effect of diacylglycerols on calcium-induced fusion of phosphatidylserine/phosphatidylcholine vesicles. PMID- 2697620 TI - Interaction of anthracyclines with plasma membranes from tumour cells: implications on drug resistance. PMID- 2697621 TI - Membrane/cytoskeletal interactions in blood platelets and leucocytes: structural and functional implications. PMID- 2697622 TI - Generation of multiple neural cell adhesion molecule proteins from a single gene. PMID- 2697623 TI - Structure, control and assembly of a bacterial electron transport system as exemplified by Paracoccus denitrificans. PMID- 2697624 TI - A review of the rational use of corticosteroids. AB - Understanding of the use of corticosteroids has been aided by knowledge of their effect on cellular protein synthesis and by an appreciation of how modification of their molecular structure alters their pharmacological action. Their ability to modulate the immune response and to diminish inflammation make them useful in rheumatology, respiratory diseases, allergies, endocrine and metabolic disorders, blood disorders, gastro-intestinal diseases, neurological and muscular diseases, renal diseases, cardiovascular disorders and skin diseases. They have been widely tried empirically and, sometimes, they have proved unequivocally effective. Often there has been a need for cooperative clinical trials to establish their efficacy, and initial enthusiasm for corticosteroids has been tempered by a better appreciation of their limitations, especially in infections and ophthalmology. Those areas where either controlled trials or other persuasive evidence has established a place for their use are reviewed. PMID- 2697625 TI - Inhaled terbutaline administered via a spacer fully prevents exercise-induced asthma in young asthmatic subjects: a double-blind, randomized, placebo controlled study. AB - The effects of inhaled terbutaline, a beta 2-adrenergic agonist, administered via a 750-ml spacer device were studied in young asthmatic subjects with exercise induced asthma. A double-blind, randomized, placebo-controlled study of the effects of inhaled 0.5 mg terbutaline and placebo was conducted in 10 asthmatic children (age range 6-16 years) with documented exercise-induced asthma. Forced expiratory volume in 1 s (FEV1) was measured at baseline, 15 min after inhaling terbutaline or placebo, and at intervals up to 60 min after exercising. Subjects exercised using a cycle ergometer for 5 min at a submaximal, constant work-load while breathing dry air at room temperature. Terbutaline induced bronchodilation at rest in all subject and fully prevented exercise-induced asthma in nine out of the 10 subjects; the exercise-induced fall in FEV1 was markedly reduced in the remaining subject. It is concluded that exercise-induced asthma can be inhibited by pretreatment with inhaled terbutaline, administered via a spacer, in a majority of young asthmatics. PMID- 2697626 TI - Modified release tizanidine: a review. AB - The pharmacokinetic and clinical properties of a modified release formulation of the alpha 2-adrenergic agonist tizanidine are reviewed. Therapy with conventional tizanidine tablets is effective in the relief of spasticity, but it has a short half-life, resulting in it having to be administered three or four times daily. The modified release capsules have retard characteristics which allow the drug to be given as a once-daily dosage. Single- and multiple-dose pharmacokinetic studies in healthy volunteers have shown that the relative bioavailability of the modified release formulation is similar to that of conventional tablets and is unaffected by food. Clinical studies have shown that modified release tizanidine improved spasticity and disability in approximately 94% and 79%, respectively, of spastic patients. Adverse effects were observed in about 33% of patients. Mild, transient muscular weakness was the most common effect, but it did not require termination of treatment. Body weight, blood pressure, heart rate and haematological or biochemical measures were not adversely affected. The initial recommended dose of modified release tizanidine is one capsule per day of 6 mg, which may be increased gradually to 24 mg. A daily dose of 12 mg modified release tizanidine was used in 50% of patients studied. PMID- 2697627 TI - Canrenone and androgen receptor-active materials in plasma of cirrhotic patients during long-term K-canrenoate or spironolactone therapy. AB - Plasma levels of canrenone and androgen receptor-active materials (ARM) were determined during long-term oral K-canrenoate or spironolactone therapy in cirrhotics with chronic recurrent ascites. Mean plasma canrenone level was approximately 3 times higher under K-canrenoate than under spironolactone treatment; moreover, the levels were not dose related. Either type of treatment did not affect plasma aldosterone and testosterone concentrations. Plasma ARM during K-canrenoate treatment did not change, whereas in the spironolactone group a 3-fold increase of ARM occurred (p less than 0.05). No dose-related effect was evident with the latter treatment. The lower incidence of gynecomastia in the K canrenoate group was not correlated with values of plasma canrenone or ARM (p greater than 0.05). Our study questions the traditional view that the mode of action of spironolactone is via its metabolite canrenone. The two antialdosterone drugs, although equally effective in clearing ascites from cirrhotics, appear to act through partially different metabolites. The lower incidence of antiandrogenic or estrogen-like side effects during K-canrenoate seems to be related to metabolites other than canrenone itself. PMID- 2697628 TI - [Establishment of the necessity for a review of the vascular endothelium: an introduction]. AB - The vascular endothelium despite of its relative small total mass is distributed all over the organism and is obligatory for nearly all vital processes. The following review will show, how many structural and functional properties of the endothelium are accessible to modern morphological research and will summarize results obtained by the authors of this review in context with the modern literature. The intentions of the authors are to contribute to a better understanding of morphological results and to find new access to scientific and clinical problems of endothelium. PMID- 2697629 TI - [Vascular endothelium--a review. I. General morphology of the vascular endothelium]. AB - The vascular endothelium as a monolayer interposed between blood/lymph and interstitial fluid realizes different functions as continuous circulation of blood/lymph, processes of clotting, fibrinolysis and antithrombotic surface properties, some aspects of defense, inflammation, different synthetic activities, and establishing of exchange pathways and barriers for several substances. This survey will be presented as a sequence of 6 single articles. The 1st one deals with the general morphology of vascular endothelium. Heteromorphism of endothelium means variability of shape and orientation as a result of different functional conditions, mediated by the cytoskeleton. "Contactons" are units of interconnected cells; each cell exhibits 4 zones of different structural and functional specialization: nuclear-, organelle-, peripheric-, and contact zone. Membrane associated structures of the surface are the glycocalix and the subplasmalemmal subcortical layer. Composition and function of these including the plasmalemma itself are explained. Structures formed by the endothelial plasmalemma are vesicles, fenestrations, pores, gaps, and microvilli. Arrangement, function, dynamics, and their relationships to the cytoskeleton are referred including TEM, SEM, and Freeze Etching techniques. Concerning interendothelial contacts, different types of junctions and 4 types of junctional fibrils are described. A short structural description of the basement membrane and of the organelles of endothelium is given. Some new informations of the endothelial cytoskeleton, concerning composition, structure, arrangement, properties, and relationships to other subcellular constituents are presented, completed by impressive SEM-photographs. PMID- 2697630 TI - [The rheological properties of the leukocytes and their participation in the blood microcirculation]. PMID- 2697631 TI - [Articles on hematology, transfusion science and biotechnology published in Soviet medical journals in 1988]. PMID- 2697632 TI - Network regulation of the immune response. AB - The immune network theory, elaborated by Jerne 15 years ago, has had a fundamental impact on our concepts of immune regulation. This theory depicts the immune system as a network of interacting idiotopes and anti-idiotopes. An idiotype is defined as the set of antigenic determinants, or idiotopes, present at or close to the antigen binding site of an immunoglobulin molecule which is able to elicit an immune response both at the cellular and humoral levels. These structures are encoded by immunoglobulin V-region genes and may be defined serologically. Recent observations suggest an important role of anti-idiotypic antibodies in regulation of the immune response and in the etiology of specific disease states, including allergic conditions. Additionally, considerable interest has been generated by their potential use as vaccines. PMID- 2697633 TI - Topical steroid therapy of atopic skin diseases. AB - The development of effective topical steroid preparations was a major advance in the therapy of atopic skin diseases. More recently, alterations in the hydrocortisone molecule have produced increasingly potent preparations with the associated risk of local and systemic side effects, including suppression of the hypothalamic-pituitary-adrenal axis. When used judiciously as part of a carefully planned therapeutic regimen including emollients and, when indicated, antihistamines and antibiotics, topical steroids can play an important role in the management of atopic skin diseases. PMID- 2697634 TI - Through the centuries with food and drink, for better or worse. III. PMID- 2697635 TI - A tribute to Murray Dworetzky, M.D., with nostalgic reminiscenses (AAAI Distinguished Service Award for 1989). PMID- 2697636 TI - Is CCAAT/enhancer-binding protein a central regulator of energy metabolism? PMID- 2697637 TI - Nucleotide sequence of the chloramphenicol acetyltransferase gene of Streptomyces acrimycini. AB - The nucleotide sequence of a gene (cat) encoding chloramphenicol acetyltransferase (CAT) in Streptomyces acrimycini was determined. The predicted amino acid sequence demonstrates extensive homology with those of CATs isolated from Gram-negative Enterobacteria, notably with the type III variant encoded by the IncK plasmid R387. Transcript mapping indicates a single cat mRNA with a 5' end coinciding with the AUG codon used for translational initiation in vivo. We also determined the extent of a spontaneous deletion in the 5'-noncoding DNA, which occurs when the gene is cloned in the BamHI site of pBR322 in a specific orientation and which results in constitutive cat expression in Escherichia coli from the tet promoter. PMID- 2697638 TI - Characterization of the prephenate dehydrogenase-encoding gene, TYR1, from Saccharomyces cerevisiae. AB - TYR1, the gene from Saccharomyces cerevisiae, which encodes prephenate dehydrogenase, one of the tyrosine biosynthetic enzymes, has been cloned by complementing a yeast tyr1 mutant strain. The DNA fragment containing the gene is part of a 45-kb cosmid clone which represents a region of chromosome II covering the genetically mapped tyr1 locus. The nucleotide sequence of a 3.1-kb region carrying the TYR1 gene and adjacent regions has been determined. The open reading frame contains 441 codons, corresponding to about 52.2 kDa for the encoded protein. The canonical NAD-binding domain is located within the first 45 amino acids of the protein. By primer extension, we show that there is one transcription start point. Presumably, the expression of TYR1 is not under the general GCN4 control. Instead, we find a dependence on the presence or absence of phenylalanine. These data were obtained by analysing CAT activity in constructs containing promoter fragments of TYR1 and the cat reporter gene. PMID- 2697639 TI - Yeast galactose permease is related to yeast and mammalian glucose transporters. AB - We have cloned and sequenced the GAL2 gene of Saccharomyces cerevisiae, which encodes galactose permease. The GAL2 protein is related to the yeast glucose transporter encoded by the SNF3 gene, and also to mammalian and bacterial sugar permeases. Like the other members of this protein family, GAL2 has twelve hydrophobic segments that are separated by loops of charged amino acids. A comparison of different members of this protein family shows that those parts of the polypeptides thought to be on the cytoplasmic side of the cell membrane, are more conserved than other parts of the molecules. PMID- 2697640 TI - Domains of the SFL1 protein of yeasts are homologous to Myc oncoproteins or yeast heat-shock transcription factor. AB - We identified a yeast suppressor gene for flocculation (SFL1), which complemented a newly isolated sfl1 mutant. This mutation causes asexual cell aggregation. SFL1 encodes a 767-amino acid protein which has two domains significantly homologous to Myc oncoproteins and the yeast heat shock transcription factor (HSTF). The Myc homologous region in SFL1 overlaps with the conserved region in a series of interesting proteins: MyoD1, Drosophila achaete-scute, twist, daughterless gene products and immunoglobulin enhancer-binding proteins. In addition, the N terminal region of the SFL1 gene product shows extensive homology to the DNA binding domain of HSTF. Mutational analysis of SFL1 demonstrates that it is required for normal cell-surface assembly in vegetative growth. We propose that the SFL1 gene product may be a transcription factor which is involved in regulation of the gene(s) related to yeast flocculation. PMID- 2697641 TI - Cloning and expression of the gene encoding a novel proteinase from Tritirachium album limber. AB - We have isolated the genomic and cDNA clones encoding a novel proteinase from the fungus Tritirachium album Limber, named proteinase T, synthesis of which is induced in skim milk medium. The coding sequence for this enzyme is interrupted by two introns in the fungal genome. The amino acid sequence of proteinase T as deduced from the nucleotide sequence is about 53% identical to that of proteinase K. Four cysteines are present in the mature proteinase, probably in the form of two disulfide bonds, which might explain the thermal stability of the proteinase. We have expressed the proT cDNA in Escherichia coli. The authenticity of the product has been characterized by Western blotting and N-terminal analysis of the recombinant product. PMID- 2697642 TI - Cloning of cDNA for a novel mouse membrane glycoprotein (gp42): shared identity to histocompatibility antigens, immunoglobulins and neural-cell adhesion molecules. AB - A full-length clone encoding a murine membrane glycoprotein, gp42, was selected from a mouse fibroblast cDNA expression library by screening with a polyclonal antiserum. The deduced amino acid (aa) sequence indicates that gp42 is a transmembrane protein of 273 aa with a large N-terminal portion exposed outside the cell and a short cytoplasmic domain. Computer assisted analysis shows that gp42 is distinct from previously characterized proteins, but shares a number of structural features with the class II histocompatibility antigens. The sizes of the extracellular domains of gp42 and of class II histocompatibility antigens are similar, the position of four cysteines and the location of several aa residues are conserved. Some of these conserved residues are also present in immunoglobulins (Ig) and in the neural-cell adhesion molecule, thus indicating that gp42 is a new member of the Ig superfamily. PMID- 2697643 TI - Synthesis of glia-derived nexin in yeast. AB - Glia-derived nexin (GDN) is a 43-kDa glycoprotein isolated from rat glioma cell cultures. It promotes neurite extension in cultures of neuroblastoma cells and chick sympathetic neurons. Moreover, GDN is a potent serine protease inhibitor (serpin), belonging to the family of protease nexins. We report here the expression of rat GDN in the Saccharomyces cerevisiae strain GRF18 under the control of the PHO5 promoter. We describe the purification of more than 6 mg total GDN from the cellular extract of 1 liter of yeast culture. The amino acid composition and the sequence of CNBr-fragments of the recombinant protein correlate with the values deduced from the rat GDN cDNA. We provide evidence that the recombinant GDN has exactly the same properties as the glioma-derived protein with respect to its protease-inhibitory activity and its ability to promote the extension of neurites from neuroblastoma cells. The large amounts of recombinant protein obtained from this expression system will allow further biochemical and physiological analysis of GDN and of the serpins in general. PMID- 2697644 TI - Definition of T-cell specific DNA-binding factors that interact with a 3' silencer in the CD4+ T-cell gene Rpt-1. AB - Analysis of the region 3' to the CD4+ T-cell gene Rpt-1 (encoding regulatory protein T-lymphocyte 1) led to the definition of a silencer element that inhibits heterologous gene expression in certain CD4+ T-cell lines but not in B-cell or non-lymphoid cell lines. Functional silencer activity in vivo was associated with the presence of a specific silencer-DNA-protein complex in electrophoretic mobility shift assays with T-cell extracts. Formation of this complex was selectively inhibited by the region in HIV-1 containing a silencer element. We discuss the possibility that DNA-binding factors may coregulate HIV-1 and Rpt-1 gene expression through a common transcriptional silencer element. PMID- 2697646 TI - Expression and secretion of biologically active echistatin in Saccharomyces cerevisiae. AB - A synthetic gene coding for a platelet aggregation inhibitor, echistatin (ECS), was inserted into a Saccharomyces cerevisiae expression vector utilizing the alpha-mating factor pre-pro leader sequence and galactose-inducible promoter, GAL10. Cleavage of the pre-pro leader sequence in vivo results in the secretion of a properly processed recombinant ECS with the native N-terminal glutamic acid residue. Recombinant ECS was recovered from yeast supernatants and purified by reverse phase high performance liquid chromatography. Recombinant ECS expressed and purified from yeast was identical to native ECS in its ability to inhibit platelet aggregation. PMID- 2697645 TI - Heterologous protein export in Escherichia coli: influence of bacterial signal peptides on the export of human interleukin 1 beta. AB - Expression plasmids carrying the coding sequence of mature human interleukin 1 beta (IL 1 beta) linked either to a Met start codon, or fused to different efficient Escherichia coli secretion signal sequences, have been constructed. In the latter case, we used signal peptides derived either from an outer membrane protein (OmpA) or from a periplasmic protein (PhoA). The synthesis of IL1 beta from these fusions was investigated in an otherwise strictly isogenic context using identical conditions of derepression and culture media. The Met-IL1 beta fusion produced a soluble cytoplasmic protein which could be released from the cells by osmotic shock whereas the OmpA and PhoA fusions were always insoluble. The extent of sOmpA-IL1 beta maturation was found to vary from 50 to 100%, mainly depending on the medium used, whereas no significant maturation of the signal peptide could be detected in the case of the sPhoA-IL1 beta fusion. Immuno electron microscopy revealed that the sOmpA-IL1 beta fusion was targeted to the inner membrane, whereas the sPhoA-IL1 beta fusion remained within the cytoplasm and thus did not appear to enter the secretion pathway. Amplifying the E. coli signal peptidase lep gene on a multicopy plasmid did not improve signal peptide removal from sOmpA-IL1 beta. Moreover, these E. coli secretion vectors allowed us to produce, in high levels, IL1 beta fragments which otherwise could not be stably accumulated within the cytoplasmic compartment. PMID- 2697647 TI - Growth at sub-optimal temperatures allows the production of functional, antigen binding Fab fragments in Escherichia coli. AB - Expression in Escherichia coli of recombinant genes coding for the kappa-chain and the Fd fragment of an antibody directed against carcinoembryonic antigen gives rise to Fab dimers. These Fab fragments possess antibody activity, as demonstrated by enzyme-linked immunosorbent assay as well as by ligand competition assay. Effective production of soluble Fab in Escherichia coli was achieved by a decrease in the growth temperature. Following a one step purification by anion exchange chromatography, the bacterially-produced Fab retains its activity at 4 degrees C for at least two months. The relatively simple methodology described in this study should be useful for the design and production of antibodies in bacteria. PMID- 2697648 TI - Historical perspective of normal tissue tolerance or stumbling along the pathway of dose response to necrosis and back. PMID- 2697649 TI - Time-dose considerations for normal-tissue tolerance. PMID- 2697650 TI - Modulation of the oncogenic potential of various anticancer modalities. PMID- 2697651 TI - Effects of irradiation on the human immune system. PMID- 2697652 TI - Normal-tissue effects of hyperthermia. PMID- 2697653 TI - Chemical modifiers of normal-tissue radiation injury. PMID- 2697654 TI - Normal-tissue tolerance to fast-neutron teletherapy. PMID- 2697655 TI - Normal-tissue tolerance in brachytherapy. PMID- 2697656 TI - Normal tissue tolerance to intraoperative radiation therapy. Experimental and clinical studies. PMID- 2697657 TI - Effect of radiation on normal tissues in the head and neck. Bone, cartilage, and soft tissue. PMID- 2697658 TI - Response of normal lung to irradiation. Tolerance doses/tolerance volumes in pulmonary radiation syndromes. PMID- 2697659 TI - Gastrointestinal tract radiation tolerance. PMID- 2697660 TI - Normal tissue tolerance to irradiation of the cardiovascular system. PMID- 2697661 TI - Bladder, testicle, and prostate irradiation injury. PMID- 2697662 TI - Radiation damage of normal tissues in the treatment of gynecological cancers. PMID- 2697663 TI - Clinical radiation tolerance of brain, spinal cord, and peripheral nerves. Laboratory and patient data as clinical guides. PMID- 2697664 TI - Pediatric patients. Tolerance levels and effects of treatment. PMID- 2697665 TI - Radiation carcinogenesis. PMID- 2697666 TI - Cell depletion and initial and chronic responses in normal tissues. PMID- 2697667 TI - Repair of 'sublethal damage': key factor in normal tissue tolerance to fractionated and low dose rate irradiation. PMID- 2697668 TI - Law and order of radiation sensitivity. Absolute versus relative. PMID- 2697669 TI - Morphologic patterns of radiation injury. PMID- 2697670 TI - Effects of radiation on the microvasculature. Implications for normal-tissue damage. PMID- 2697671 TI - The unique physiology of endothelial cells and its implications in radiobiology. PMID- 2697672 TI - [Hygienic studies of residential and public buildings in socialist countries]. PMID- 2697673 TI - [Effect of organomercury pesticides on the environment and human health]. PMID- 2697674 TI - Phenotype-related chromosome aberrations and stem cell involvement in acute myeloid leukemia. PMID- 2697675 TI - Congenital refractory anaemia with vacuolisation of bone marrow precursors, sideroblastosis and growth failure in a girl with normal endocrine pancreatic function. AB - The case is described of an 8-years-old girl with consanguineous parents. She was apparently well, apart, from growth retardation, until 18 months of age when she developed severe normocytic hypochromic anaemia. Bone marrow examination revealed vacuolisation of the erythroid and myeloid precursor, and electron microscopic studies showed striking sideroblastosis with ringed arrangement of the iron granules. Porphyrin metabolism was apparently normal, whereas blood levels of iron and ferritin were high. A careful study of the exocrine pancreas showed completely normal function. Vitamin B6 administration was unsuccessful. The patient is transfusion-dependent, and iron chelation treatment has produced good results. The case could be a new entity or a variant of congenital sideroblastic anaemia, since it has some features in common with the syndrome described by Pearson et al. PMID- 2697676 TI - Acceleration of autologous hematopoietic recovery by GM-CSF after allograft rejection. PMID- 2697677 TI - Preventing psychosocial impairment in siblings of terminally ill children. AB - A review of the literature provides the basis for a discussion of the impact of sibling death on healthy children whose emotional needs may be unattended both by parents and professionals. Factors which may deter hospice practitioners from delivering effective psychosocial care to siblings are identified and recommendations for preventive intervention are enumerated. PMID- 2697678 TI - A profile of hospice programs in Pennsylvania. AB - The annual survey reports by the Pennsylvania Hospice Network allow a longitudinal look at programs in Pennsylvania from 1985 to 1987. Comparisons are made of data on the programs, on hospice patients, on services provided, on bereavement care, and on volunteer involvement. Findings consistent over the three years suggest profiles of "typical" programs, patients, and care provision. Changes in reported data which may indicate trends are noted. Differences between programs which were Medicare certified or accredited by the Joint Commission for Accreditation of Hospitals are observed as are differences between certified or accredited programs and others. PMID- 2697679 TI - The impact of reimbursement: the case of hospice. PMID- 2697680 TI - Surface molecules involved in the activation and regulation of T or natural killer lymphocytes in humans. AB - The surface molecules that mediate activation of different subsets of T or NK cells have been reviewed. A suitable approach to the study of different lymphocyte activation pathways is provided by mAbs specific for these molecules. MAbs directed to the CD3 surface molecules mediate a polyclonal T-cell activation, whereas mAbs to "clonotypic" structures of TCR only trigger cells bearing the corresponding clonotypic determinant (thus mimicking the effect of antigen/MHC). MAbs directed to appropriate epitopes of CD2 molecules or to CD28 molecules mediate polyclonal T-cell activation, leading to triggering of the functional program of the cell (i.e. proliferation, lymphokine production or activation of the cytolytic machinery). Interaction of specific mAbs with CD3/TCR molecules leads to surface modulation of these molecules which lasts for 48-72 h. During this interval the cell is refractory to any further activation stimulus. No such refractoriness occurs following mAb-induced modulation of CD2 or CD28 surface molecules. The mechanisms by which CD3/TCR modulation results in the inactivation of T-cell function appears to involve the early metabolic steps of T cell activation, as neither Ca++ mobilization nor IP3 formation could be further induced by any stimulus. The surface molecules and mechanisms involved in the activation of TCR gamma/delta cells are similar to those of TCR alpha/beta + cells. TCR gamma/delta molecules are heterogeneous in size and charge mobility. MAbs directed to one or another form of TCR gamma/delta trigger the functional program of the cell (primarily cytolytic function). However, a receptor form composed of a heavy form (55 kD) of the gamma chain appears to be relatively inefficient in signal transduction upon binding with anti-TCR mAbs. Evidence has also been provided that TCR gamma/delta + cells are capable of (allo)antigen responses and that polymorphic determinants of class I can be recognized (specific lysis of P815 cells transfected with HLA-A24 allele). Although the mechanisms and the surface receptor molecules involved in (CD3-, CD16+) NK cell activation are still poorly understood, several surface molecules have been identified that mediate NK-cell triggering. These include CD2 and CD16 and the novel GL183 molecule which is selectively expressed by a fraction of NK cells and thus identifies a well-defined NK subsets. Under appropriate conditions, mAbs to CD16 or GL183 mediate an inhibitory effect on the NK cell activation. These data suggest that also NK cells are characterized by surface molecules capable of initiating distinct pathways of cell activation and that, similarly to T lymphocytes, mechanisms exist which regulate NK cell function. PMID- 2697681 TI - The LY-6 locus: a multigene family encoding phosphatidylinositol-anchored membrane proteins concerned with T-cell activation. PMID- 2697682 TI - Differential growth requirements and effector functions of alpha/beta and gamma/delta human T cells. PMID- 2697683 TI - Effects of prednisolone and dexamethasone on (pro)insulin biosynthesis and insulin release by rat islets of Langerhans. AB - Administration of either prednisolone or dexamethasone (10 mg/kg body wt/day/oral) to rats for 21 days resulted in inhibition of (pro)insulin biosynthesis and immunoreactive insulin release by isolated islets. A gradual reversal of prednisolone's effect was obtained after exposing islets to increasing glucose concentrations but glucose challenges failed to influence dexamethasone's effect. PMID- 2697684 TI - [Psoriasis-pemphigoid association. Description of a case]. AB - The paper describes a case of an 85-year-old woman affected by psoriasis for 30 years who developed bullous pemphigoid after UVB treatment. Immunological and histological findings were typical of bullous pemphigoid cell-poor type. Bullous eruptions cleared following combined therapy with betamethasone and azathioprine. The literature on the subject and pathogenetic hypotheses for this unusual association are discussed. PMID- 2697685 TI - Progesterone receptors in lymphocytes of liver-transplanted and transfused patients. AB - Previous data have shown that lymphocytes from pregnant women, but not from non pregnant individuals, displayed progesterone receptors. These receptors are inducible in normal human lymphocytes in vitro by mitogenic or allogeneic stimuli. The present study was designed to test the role of in vivo allogeneic stimulation in inducing progesterone receptors in lymphocytes from transplanted and transfused patients. Receptors were detected by immunohistology using a progesterone receptor-specific MoAb and avidin-biotin system. Peripheral blood lymphocytes from 56 healthy pregnant women, 8 liver-transplanted patients and 15 transfused patients contained significantly more receptor-positive cells (P less than 0.001) than those of non-pregnant individuals. In transplanted and transfused patients no correlation was found between the percentage of positive lymphocytes and age, sex or transplant survival. Our results show that in these three groups the percentage of receptor-bearing lymphocytes was higher than in normal subjects. PMID- 2697686 TI - Decreased cell replication and polyamine content in insulin-producing cells after exposure to human interleukin 1 beta. AB - Interleukin 1 (IL-1) has been suggested to cause the islet B cell destruction occurring during the development of insulin-dependent diabetes mellitus. One mechanism by which B cell loss can be compensated for is via de novo formation of new cells through replication. In the present study the replicatory activity of cells in isolated rat pancreatic islets and in the insulin-producing cell line RINm5F has been assessed by [3H]thymidine incorporation methods after exposure to 1-25 U/ml of human recombinant IL-1 beta (rIL-1 beta). In the rat islets [3H]thymidine incorporation was decreased by 20% 5 h after exposure to 25 U/ml rIL-1 beta. A similar inhibition was also observed in islets exposed to 2.5 and 12.5 U/ml rIL-1 beta. In the RINm5F cells there was a dose-dependent inhibition of the cell replication to approximately 50% of the controls in cells exposed to 25 U/ml rIL-1 beta for 48 h. This was also accompanied by an increased cell death, as measured by trypan blue inclusion (controls 13% and rIL-1 beta treated cells 25%). The insulin content of the RINm5F cells was reduced by about 40% after a 48-h exposure to 25 U/ml rIL-1 beta. When the exposure of the RINm5F cells to rIL-1 beta was decreased to 24 h there was no increased cell death, but a reduced replicatory activity was still observed. rIL-1 beta decreased the cellular content of the polyamines spermidine and spermine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697687 TI - Modulation of the expression of CD4 on HL-60 cells by exposure to 1,25 dihydroxyvitamin D3. AB - The CD4 molecule functions as a receptor for the binding and infectivity of the human immunodeficiency virus (HIV). It is of interest, therefore, to develop procedures for its down-regulation. In the present study, the effect of 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) on the expression of cell surface antigens of the HL-60 promyelocytic leukemia cell line was analyzed. Exposure of HL-60 cells to 1,25(OH)2D3 resulted in down-regulation of CD4 as assessed by their staining with the Leu-3a monoclonal antibody (MoAb). This treatment increased the staining of HL-60 cells with the monocyte-specific 63D3 MoAb. In contrast to the rapid elimination of cell surface CD4 by exposure of HL-60 to phorbol myristate acetate (PMA), the maximal reduction of CD4 by 1,25(OH)2D3 was attained within 48 h after the beginning of the exposure. PMID- 2697688 TI - Transferable trimethoprim resistance of shigellae encountered in Vellore (south India). AB - Shigella flexneri and Sh. shigae which are the two most common shigellae encountered in Vellore (south India) were found to exhibit resistance to trimethoprim and trimethoprim-sulphamethoxazole. Eighty four per cent of this was high level resistance. Transfer studies conducted with these strains indicated that this high level resistance is plasmid mediated. PMID- 2697689 TI - Relationship of C3 & C4 levels with filarial immune complexes in bancroftian filariasis. AB - C3 and C4 levels were determined by radial immuno-diffusion technique and filarial circulating immune-complexes by anti-C3 ELISA in microfilaraemic individuals and patients with clinical filariasis. Decreased levels of C3 and C4 were observed in both groups of filarial patients. Low levels of complement components were associated with low levels of circulating immune complexes. PMID- 2697690 TI - Efficacy & safety of glycine fortified oral rehydration solution in the treatment of acute dehydrating diarrhoea in children. AB - Efficacy and safety of glycine fortified oral rehydration solution (ORS) was compared with a standard ORS (WHO formula) in a randomized clinical trial in children aged between 4 months and 5 yr with moderate degree of dehydration owing to acute watery diarrhoea. No significant differences (P greater than 0.05) were observed in diarrhoeal stool output, duration of diarrhoea and intake of ORS between the study and control groups respectively. Thus glycine fortified ORS does not have any additional advantage over standard ORS. Moreover, two children developed hypernatraemia after receiving glycine fortified ORS in contrast to the control group. It is therefore suggested that glycine supplemented ORS should not be prescribed for the treatment of diarrhoeal dehydration in children. PMID- 2697691 TI - Hepatoprotective activity of silymarin against hepatic damage in Mastomys natalensis infected with Plasmodium berghei. AB - Silymarin, a flavolignan from the seeds of Silybum marianum, showed significant hepatoprotective activity in P. berghei-induced hepatic damage in M. natalensis, as assessed by changes in several serum and liver biochemical parameters. Changes in lipoprotein-X, GOT, GPT, alkaline phosphatase and bilirubin were found to be protected by silymarin at different doses. Maximum activity was observed at a dose of 5 mg/kg bw, po. Silymarin had no effect on parasitaemia. PMID- 2697692 TI - Modulation of immunosuppression in obstructive jaundice by Tinospora cordifolia. AB - A clinical study was undertaken to determine the immune status of patients with obstructive jaundice. Screening of 16 patients for phagocytic and microbicidal activity of polymorphonuclear cells (PMN) revealed a significant depression (21.2 +/- 3.7% phagocytosis and 20.85 +/- 4.5% intracellular killing) of these functions, as compared to normal values (30.37 +/- 5.1% and 26.41 +/- 4.3% respectively). An animal model of cholestasis was also established, using rats, in which a significant depression of activity of PMN and peritoneal macrophages was observed. These cellular abnormalities were found to precede and predispose to infection. The rats also showed an increased susceptibility to Escherichia coli infection (mortality rate 77.78%). A defect was detected in their serum responsible for depressing the function of phagocytic cells. An attempt was made to improve this immunosuppression by treating the rats with water extract of T. cordifolia 100 mg/kg for 7 days, following development of cholestasis. The extract improved the cellular immune functions. Mortality rate following Esch. coli infection was significantly reduced to 16.67 per cent. This study showed that cholestasis results in immunosuppression and therefore indicates the need for an immunomodulator in management of obstructive jaundice. The plant T. cordifolia seems to meet this need by consolidating host defence mechanism. PMID- 2697693 TI - Irritable bowel syndrome: therapeutic evaluation of indigenous drugs. AB - Among 169 patients with irritable bowel syndrome (IBS), standard therapy (with clidinium bromide, chlordiazepoxide and isaphaghulla), a compound Ayurvedic preparation (with Aegle marmelos correa plus Bacopa monniere Linn) along with a matching placebo were given in a double blind randomised trial for 6 wk. The Ayurvedic preparation in 57 patients was found effective in 64.9 per cent, while standard therapy (60 patients) was useful in 78.3 per cent. Patients on placebo (52 patients) showed improvement in 32.7 per cent only. Ayurvedic therapy was particularly beneficial in diarrhoea predominant form as compared to placebo. The standard therapy was more useful in the painful form of IBS as compared to placebo and Ayurvedic preparation. In gas predominant form the effect of standard as well as Ayurvedic therapy, was similar to placebo. Long-term follow-up (greater than 6 months) showed that both forms of therapy were no better than placebo in limiting the relapse. PMID- 2697694 TI - The evolution of trauma care in the United Kingdom. Gissane Memorial lecture 1989. PMID- 2697695 TI - Did Mozart have a chronic extradural haematoma? AB - When Mozart died at the age of 36, was he suffering from the belated complications of a calcified extradural haematoma? This theory took shape during the identification process of the skull owned by the Mozarteum, when the print of calcified extradural haematoma was discovered on the left inner temporoparietal calvarial surface of the skull. This print looks like a rosette, with three distinct concentric areas. The first outer area is striated, the second middle one is granular and scattered with bony deposits, the third central one is marked with vascular grooves. PMID- 2697696 TI - Clinical value of ultrasonography in the detection and removal of radiolucent foreign bodies. AB - A series of 39 consecutive patients with a suspected retained foreign body in the hand and in whom standard soft issue radiographs were negative were examined by real-time, high-resolution ultrasound scan. At operation 20 patients had radiolucent foreign bodies (18 wood, 2 thorns) removed. Ultrasound scan correctly localized 19 of the foreign bodies before surgery and failed to detect one. No foreign body was found in 19 patients. Ultrasound scan falsely predicted the presence of a foreign body in two of these cases. High-resolution ultrasound scanning is a sensitive, accurate technique for diagnosing foreign bodies which are otherwise difficult to demonstrate by conventional radiographic techniques, and provides accurate three-dimensional localization of the object which is of value to the surgeon at operation. PMID- 2697697 TI - Facets of wisdom: a theoretical synthesis. AB - Review of the past decade of literature reveals numerous attempts to construct a workable definition of wisdom. Some researchers bypass definition and opt for factor analytical studies of common opinions about attributes of the 'wise person'. Such factors as age, experience, intelligence, knowledge, intuition, common sense, and personality variables consistently emerge from the data, but no one has attempted to link these factors to construct a unified definition of wisdom. This article compares and synthesizes the various studies and concludes that they can be unified theoretically if we view wisdom as the recognition of and response to human limitation. PMID- 2697698 TI - Habituation theory and environment-aging research: ennui to joie de vivre? AB - Robert Kastenbaum posits that functional aging results in the overadaptation to our own routines and expectations, producing "hyperhabituation," mental stagnation, and novaphobic response orientations. This article examines the promise and implications of this notion for two areas of environment-aging research: psychological control and environmental comprehension. Possible causal and mediating links between control and habituation are considered, as well as the impact of habituation on environmental perception, cognition, and appraisal. Personal and situational characteristics of older people likely to be at risk for habituated responses are suggested. The article also speculates about individually- and environmentally-targeted interventions which might prevent and/or ameliorate tendencies toward hyperhabituated responses among older people who reside in highly ritualized and constant environments such as long-term care institutions. Interventions subject to future evaluations include modifications for the social, physical, and policy milieux and desensitization of novaphobic responses. PMID- 2697699 TI - A role-based approach to adult development: the triple-helix model. AB - The triple-helix role model presented in this article offers a synthesized developmental approach to the understanding and study of adulthood. It incorporates three major roles: family, work, and self, each powered by the drive for self-esteem. This conceptualization of adult development processes accommodates a wide range of possible patterns and varied timing of life events relative to career options, family and relationship choices, and emphasis on self development. Because it is becoming increasingly difficult to designate with certainty age-stage periods, the triple-helix role model is proposed as a different frame of reference for the perception of acceptable developmental progress. It could offer insight into the complexities of adults' lives and free us from the restriction of viewing the life journey as "on or off time," "in or out of harmony," "normal or abnormal." PMID- 2697700 TI - Carbohydrate metabolism in skeletal muscle: an update of current concepts. AB - We have reviewed carbohydrate metabolism in skeletal muscle with an emphasis on recent information. In this review a significant number of points have been made. These are summarized below. 1. CP and glycogen are concomitantly metabolized during short-term (less than or equal to 10 s) intense exercise. 2. Both epinephrine and contractile activity regulate glycogen use in muscle. 3. Glycogen sparing during exercise is promoted by fatty acids and probably glucose. 4. Glycogenesis increases during exercise in exercising muscle. 5. Ingested glucose is easily metabolized during exercise. 6. The heterogeneity in glucose uptake among muscles at rest and during exercise is likely not caused by blood flow differences per se. 7. Insulin binding, glucose transporters, glucose uptake, and glycogenesis are greater in ST than in FT muscles. 8. Acute changes in glucose metabolism are not always attributable to concomitant changes in insulin binding to its receptor. 9. Contractile activity alone will increase glucose uptake in muscle, and insulin is not required. 10. Insulin and contractile effects on glucose uptake are additive, suggesting that these stimuli mobilize different pools of glucose transporters. 11. Glycogen loss occurs in exercising and non exercising muscle; therefore this substrate is not an appropriate index of muscle contractile activity. 12. Carbohydrate mobilization does not appear to be strictly determined by need for this substrate nor by the rate of muscle metabolism. 13. Glyconeogenesis from lactate occurs in ST and FT muscles and is regulated by pH. PMID- 2697701 TI - Toxoplasmosis, old stories and new facts. AB - In this introductory paper some general opinions are presented regarding the parasite Toxoplasma gondii, toxoplasma infection and toxoplasmosis. The transmission of the parasite through oocysts and/or infected meat is discussed with regard to possible prevention. Old stories have been replaced by new facts in the epidemiology of toxoplasma infection. Veterinary measurements in the field of prevention are not likely to be accepted in the near future. It is stressed that laboratory diagnosticians should clearly differentiate between diagnostic support in suspected cases of clinical toxoplasmosis or screening for certain characteristics such as IgG antibodies to toxoplasma in a healthy population. PMID- 2697702 TI - Laboratory diagnosis of toxoplasmosis. AB - Acute infection with Toxoplasma gondii is diagnosed by (i) detection of the parasite directly in patients' specimens using histological or immunological methods, (ii) isolation of T. gondii from blood, body fluids or tissue by inoculation in laboratory mice or on tissue culture cells, or (iii) serological methods for determination of a significant, T. gondii-specific, antibody titre rise or of T. gondii specific IgM (or IgA) antibody. Because of their high sensitivity, specificity and relative ease of performance, serological methods are preferentially used for diagnosis of T. gondii infection. The diagnosis of acute, postnatally-acquired, primary toxoplasmosis is usually established by serological methods and will in general present few problems. However, diagnosis of congenital infections and their late sequelae or of reactivation of a latent infection in immunocompromised patients is often more troublesome because of the absence of a significant antibody titre rise or the lack of specific IgM antibody. In these cases a combination of various methods may be required for definitive diagnosis of T. gondii infection. PMID- 2697703 TI - Aqueous humor analysis as a diagnostic tool in toxoplasma uveitis. AB - Analysis of local toxoplasma antibody production to confirm a suspected clinical diagnosis of toxoplasma chorioretinitis is a valuable diagnostic tool. Determination of toxoplasma antibodies in the blood of the patient is of limited use. When blood toxoplasma tests are negative this indicates that toxoplasma as a causative organisms in the pathogenesis of uveitis is unlikely. A positive blood test is a sensitive test (100% patients positive) but not a specific test since so many healthy individuals already have undergone subclinical infection and have acquired humoral immunity against the parasite. We analysed 93 paired aqueous and serum samples for toxoplasma antibodies and total IgG and determined the Goldmann Wittmer coefficient. In patients retrospectively diagnosed as having toxoplasma chorioretinitis 16 out of 22 had a positive coefficient, indicating local parasite antibody production. In one patient with AIDS we also found a positive toxoplasma coefficient. Three out of 15 patients with posterior uveitis of unknown origin also had a positive coefficient. None of the cataract patients tested (n = 32) had a positive coefficient. Major drawbacks of aqueous humor analysis are that a false negative antibody coefficient can occur when a massive blood aqueous barrier breakdown has occurred. PMID- 2697704 TI - Congenital toxoplasmosis. A long-term follow-up of 20 years. PMID- 2697705 TI - Ocular toxoplasmosis; common and rare symptoms and signs. AB - The common and rare symptoms and signs of congenital, childhood and adult ocular toxoplasmosis are discussed together with the differential diagnosis of the retinal lesions. A choroidal coloboma in connection with congenital toxoplasmosis is described. The occurrence of an optic pit with congenital macular toxoplasmosis, growth of subretinal new vessels as well as disappearance of arteriolar and venular sheathing is demonstrated. PMID- 2697706 TI - Ocular toxoplasmosis in the immunocompromised host. AB - Disseminated toxoplasmosis is a well-known complication of immunodeficiency states, including those induced by malignancies, steroid and cytotoxic drug therapy, and AIDS. In immunodeficient patients, toxoplasmic infections of the eye are less common than toxoplasmic infections of other organs for unknown reasons. When ocular toxoplasmosis does occur in the immunodeficient host, or if immunosuppressive therapy is administered to patients with active disease, widespread tissue destruction by proliferating organisms may result. Immunodeficiency alone may not be sufficient, however, to cause reactivation of encysted organisms in retinochoroidal scars. Ocular toxoplasmosis in the immunocompromised host presents difficult problems in diagnosis and management. There may be a variety of clinical lesions, including single foci of retinochoroiditis in one or both eyes, multifocal lesions, or diffuse areas of retinal necrosis. The majority of lesions do not arise from the borders of preexisting scars, which suggests that they result from acquired infection or dissemination of organisms from nonocular sites of disease. Toxoplasma gondii may infect iris, choroid, and vitreous-tissues that are not usually infected in the immunocompetent host. Ocular lesions appear to respond to standard antiparasitic drug therapies, but continued treatment is probably necessary to prevent reactivation of disease in the most immunocompromised patients. The best treatment regimens have yet to be determined. Histopathologic studies show little retinal inflammation; therefore anti-inflammatory drugs, such as oral steroids, probably have no role in the management of infection. PMID- 2697707 TI - Recent developments in the prevention and treatment of congenital toxoplasmosis. AB - The manifestations of congenital toxoplasmosis vary considerably in degree, characteristics and time of onset. Options for prevention of the disease include the appropriate disposal of cat litter and the avoidance of ingestion of both contaminated food and undercooked meat by pregnant women. Immunisation of the domestic cat population is a consideration for the future. Alternatively, immunisation of sero-negative pregnant women awaits the introduction of an effective and safe reagent. Current treatment modalities are not universally effective and new drugs are the subject of active development and research. Screening of pregnant women or perhaps newborn infants are potential options but the cost effectivity has yet to be established in many countries and the results of treatment during pregnancy and early childhood are encouraging but are as yet unproven. The majority of patients with congenital toxoplasmosis eventually develop toxoplasmic retinochoroiditis. Current treatment options for this condition are outlined. Acquired immune deficiency syndrome (AIDS) may, in some cases, represent a recrudescence of congenital intracerebral infection. Current treatment strategies for this condition are discussed. PMID- 2697709 TI - Systemic vasculitis with renal involvement--a review. AB - Twenty five patients with renal vasculitis presenting over an eight year period were reviewed. Ten had microscopic polyarteritis, 6 classic polyarteritis, 5 overlap syndrome, 2 Churg-Strauss syndrome and 2 Wegener's granulomatosis. Clinical features included hypertension, pulmonary involvement, neurological involvement and arthralgia. Serum creatinine was over 500 umol/l in 13 patients, 10 of whom required dialysis. Visceral angiography was positive in 80% of those studied, Focal and segmental necrotising glomerulonephritis was the commonest renal lesion. Treatment consisted of corticosteroids and cytotoxic agents in most cases. Plasmapheresis was used for rapidly progressive renal failure, severe pulmonary haemorrhage or cerebral vasculitis. Improvement or stabilisation of renal function was seen in 68% of patients treated. There were 4 early deaths and one late death. The diagnosis, histology, treatment and outcome of renal vasculitis is discussed. The importance of early diagnosis and treatment is emphasised in this potentially reversible cause of acute renal failure. PMID- 2697708 TI - Therapy of ocular toxoplasmosis. AB - We performed a prospective multicentre study to evaluate the efficacy of therapeutic strategies currently used for ocular toxoplasmosis in a large number of patients (n = 106). Treatment was given for at least four weeks and consisted of three triple drug combinations: group 1, pyrimethamine, sulphadiazine and corticosteroids (n = 29); group 2. clindamycin, sulphadiazine and corticosteroids (n = 37); and group 3. cotrimoxazole (trimethoprim and sulphamethoxazole) and corticosteroids (n = 8). Patients with peripheral retinal lesions remained without systemic therapy (group 4, n = 32). Patients from group 1 received leucovorin 5 mg twice a week. No difference in the duration of inflammatory activity was observed between the treated and untreated patients or between the separate groups of patients. The most important factor predicting the duration of inflammatory activity was the size of the retinal focus itself, independently of the therapy given (P less than 0.05). We showed a reduction in size of the retinal inflammatory focus in 52% of the pyrimethamine patients as compared to 25% of untreated cases. However the most frequent side effects were also associated with pyrimethamine medication and included hematologic complications as thrombocytopenia and leucopenia despite leucovorin medication. PMID- 2697710 TI - Pylorus-preserving total pancreatectomy and segmental pancreas autotransplantation. AB - 12 patients affected by periampullary neoplasms underwent surgery consisting of modified pylorus-preserving total pancreatectomy. In 8 of these patients, a segmental pancreas autotransplantation was performed by anastomosing the splenic to the femoral vessels in the Scarpa's triangle. The pancreas was treated by irradiation to inhibit the exocrine function. Gastric emptying was studied in 9 survivors by upper gastrointestinal barium series. In 6 patients gastric emptying and pyloric function were also evaluated by radionuclide studies. In 3 patients the transplanted pancreas had to be removed within the second postoperative week because of graft thrombosis, infection or hemorrhage. In a mean follow-up of 16 months (range: 6-20 months) the remaining 5 transplants showed a good endocrine activity until the beginning of antiblastic treatment for hepatic metastasis (3 cases), pancreatic fibrosis (1 case) or the patient's death (2 case). At present no graft is still functioning. PMID- 2697711 TI - Endoscopic ultrasonography in a case of gastric leiomyoblastoma. AB - Endoscopic ultrasonographic diagnosis of a gastric leiomyoblastoma stemming from the gastric wall is reported. Transparietal echography and CT had indicated that this tumor arose form the right ovary. PMID- 2697712 TI - [Peripheral nerve lesions of experimental leprosy in monkeys. V. Histopathological finding of cutaneous nerves and cutaneous sensory organs]. AB - The skin samples of each palm side and dorsum side of finger, nose and peripheral nerves running under the finger skin at the area between proximal phalanx and distal phalanx of mangabey monkey A022 and rhesus monkey A125 were studied by histopathological methods (semithin section and light microscopic findings). Results found about this study were as follows. 1. In spite of the existence of a large amount of leprosy bacilli at the areas of corium and subcutis, some of Meissner's corpuscles, Vater-Pacinian corpuscles (or Golgi-Mazzoni's corpuscles) and Krauze's end bulbs-like structures were observed. 2. Occasionally, several intracytoplasmic foamy structures containing a large amount of leprosy bacilli were observed at the shallow and deep layers of stratum papillare of corium, where leprosy bacilli were not so remarkable as shown on Figure 4. So, it was thought that the affinity of leprosy bacilli to free nerve endings should be exist there. 3. Some of M. arrector pili were kept in good condition in spite of the existence of multiplying leprosy bacilli around the hair follicles. 4. It was thought that the histopathological findings of the fascicles of cutaneous nerves were classified to 4 patterns. The first pattern of histopathological finding of the cutaneous nerve was shown as A on Figure 25. In this pattern observed in almost of all the fascicles locating at the subcutis, no leprosy bacillus was observed inside the fascicles, and the nerve fibers were kept in good condition. The second pattern observed in almost of all the fascicles located at the corium, was shown as B on Figure 25. In this pattern, a large amount of leprosy bacilli were observed inside the fascicles, and the nerve fibers were often kept in good condition. The third pattern observed in almost of all the fascicles located at the deep layer of corium and subcutis, was shown as C on Figure 25. In this pattern, not only multiplying leprosy bacilli but also remarkable fibrosis were found inside one fascicle, and many nerve fibers disappeared by the existence of the bacilli and fibrosis. The final pattern observed in almost of all the fascicles located at the deep layer of corium and subcutis, was shown as D on Figure 25. In this pattern, remarkable fibrosis was observed inside the fascicles, and the nerve fibers often disappeared by the existence of fibrosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697713 TI - [Cell mediated immune response in leprosy lesions]. AB - Five biopsies from 2 leprosy patients, tuberculoid (TT), and polar lepromatous (LLp), were studies using immunoperoxidase procedures with monoclonal antibodies. Immunohistochemical patterns of them were remarkably different. In a TT patient, epithelioid cells and helper/inducer T (Leu 3a+) cells made the central core of a granuloma surrounded by suppressor/cytotoxic T (T8+) cells and B cells, indicating a possible immune-mediated cell response. The distribution of B cells suggests that not only T but also B cells may take part in the formation of the granuloma. In contrast, helper/inducer cells, suppressor/cytotoxic cells, and macrophages of a LLp patient were admixed uniformly at the site of the lesion, indicating a poor immune response. Although the ENL skin lesion of this LLp patient did not eliminate the bacilli, HLA-DR expression by keratinocytes and increased numbers of helper/inducer cells found in an ENL lesion, comparable to the findings of TT leprosy, suggests that a cell mediated immune response may play some role in the pathogenesis of ENL reaction. PMID- 2697714 TI - [Epidemiological immunological studies on leprosy in Okinawa. 6. Lepromin, lymphocyte transformation, FLA-ABS and leproagglutination tests in the in-and out patients with leprosy and the relationships among these tests and personal or family history or clinical findings of the patients]. AB - In- and out-patients with leprosy in Okinawa were surveyed by using the following immunological tests: cutaneous reaction to Mitsuda's lepromin (40 million bacilli/ml) (LPR), lymphocyte transformation test with Dharmendara's antigen (DL LTT), that with phytohemagglutinin (PHA-LTT), fluorescent leprosy antibody absorption test (FLA-ABS) and Leproagglutination test with cardiolipin-lecithin antigen (LAT). A correlation between two tests and a relationship between the test and personal or family history or clinical finding of the patients were evaluated by non-parametric statistics. Spearman's rank correlation coefficient was significant between LPR and DL-LTT, while a reverse correlation was found between LPR and FLA-ABS, DL-LTT and FLA-ABS, and DL-LTT and LAT, respectively. High reactivity in PHA-LTT was found in almost all of patients, irrespective of type and stage of leprosy, suggesting general immune responsiveness of leprosy patients in Okinawa. The other tests showed a significant difference in the mean rank of reaction values according to clinical findings such as type and stage of leprosy, property of skin lesion, loss of eyebrow, and bacteriological test. The use of LPR and DL-LTT for the study of cell-mediated immunity in leprosy was therefore confirmed. FLA-ABS was found useful for early serodiagnosis, while LAT for the study of autoimmunity in leprosy. None of these immunological tests showed significant difference among the subgroups of patients classified by the following items: presence or absence of consanguineous patient with leprosy, living place, place of onset, presence or absence of neural symptoms such as the enlargement of peripheral nerve, claw hand and facial palsy, ocular and nasal involvement, ENL in lepromatous and borderline leprosy and conditions in the treatment. On the other hand, LPR showed higher reactivity in female than in male, in the patients at home than those discharged, and in the patients with drop foot than those without. Higher reactivity of DL-LTT was also found in male than in female and in the patients with plantar ulcer than those without. FLA-ABS reactivity was significantly higher in the discharged patients than the inpatients, in the period of 5 to 9 years after onset than that of 20 or more years, but the reactivity was lower in the patients with drop foot than those without. LAT reactivity was significantly higher in the 30-39 years old patients than 0-19 years old, and in the patients with physical work than those with mental.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697715 TI - Laboratory monitoring of oral anticoagulant therapy. PMID- 2697716 TI - Dimeric dihydrodiol dehydrogenase in monkey kidney. Substrate specificity, stereospecificity of hydrogen transfer, and distribution. AB - Chemical cross-linking and NADPH binding studies suggested that the native dihydrodiol dehydrogenase from monkey kidney is a basic dimer having a molecular weight of 78,000 and one active site per the subunit. The enzyme oxidized specifically trans-dihydrodiols of benzene and naphthalene, whereas it catalyzed the reduction of dihydroxyacetone and dihydroxyacetone phosphate at a physiological pH, 7.4. The Km and kcat values for dihydroxyacetone phosphate were 5.0 mM and 4.3 s-1, respectively. The enzyme transferred the 4-pro-R hydrogen atom of NADPH to the carbonyl substrate. Immunochemical experiments using an antibody against the dimeric enzyme revealed the specific distribution of the enzyme in the kidney of this animal. By immunohistochemical staining with the specific antibody, the immunoreactivity was found in proximal and distal tubules of the cortex, and in the loop of Henle of the medulla. PMID- 2697717 TI - Hexagonal structure of two-dimensional crystals of the alpha 3 beta 3 complex thermophilic ATP synthase. AB - The highly dissociable alpha 3 beta 3 subunit complex (Mr = 319,582) of thermophilic ATP synthase was crystallized on a mercury surface under oxygen. The two-dimensional crystal was compared with that of TF1 (Mr = 385,351, alpha 3 beta 3 gamma delta epsilon subunit complex) by means of computer image processing. The crystals showed the same hexagonal lattice (a = b = 10 nm), despite the difference in their molecular weights. The color images of the two protein molecules were also hexagonal. However, there was an open hole in the image of the alpha 3 beta 3 complex, where small subunits (gamma, delta, and epsilon) of TF1 may have been located. The structure of this heterohexamer is consistent with that deduced from other physical parameters. PMID- 2697718 TI - Prediction of responses to required nutrients in dairy cows. AB - Nutritional science is developing from the calculation of requirements toward prediction of responses to nutrients. Responses are defined as the consequences of the animal's interaction with its feed and other aspects of its environment. For dairy cows the important responses to predict are yields of major milk constituents (fat, protein, and lactose), rates of changes of body fat and protein, and voluntary feed consumption. In order to make predictions of cow responses, equal weight needs to be given to quantitative descriptions of cow characteristics, feed characteristics, and relevant aspects of the environment. This paper presents a framework that allows quantitative descriptions of these various attributes to be combined for the purposes of response prediction. The nutrients of importance are those major end products of digestion, which act as substrates for the generation of animal products. Quantitative aspects of genotype include description of potential milk constituent yield, mature body size and composition, and rate of maturing, including a description of "labile" protein mass and animal capacities for ingestion of potentially constraining feed attributes. A variety of approaches is available to simulate nutrient supply and use for purposes of response prediction. The synthesis of such models adds both intellectual richness to the process of developing nutritional science and improved frameworks for testing theories through experiment. PMID- 2697719 TI - Immunology and fertility in the bovine. AB - Antibodies are powerful tools for unlocking normal physiological problems of both qualitative and quantitative nature that affect fertility. In addition, when antibodies are generated due to abnormal situations, fertility is depressed or completely inhibited for varying periods of time. Antibodies to sperm have demonstrated sperm membrane transformations that occur during spermatogenesis and spermiogenesis, the role of the blood-testis barrier, and the role of secretion and absorption in acquisition of sperm fertilizability. Antibodies to ovary have demonstrated factors controlling oocyte maturation, folliculogenesis, and the transudation of macromolecules into the follicle, Fallopian tubes, and uterus that affect capacitation, the acrosome reaction, sperm-oocyte interaction, fertilization, and implantation. Most hormone assays today are immune assays. Antibodies also can purposely suppress fertility (immunocontraception). Fertility problems can result from inappropriate antibody formation to sperm, oocytes, pregnancy products, or hormones. Fertility problems include auto-immune aspermatogenic orchitis, auto agglutination of sperm, autoimmune oophoritis, allergy to semen or egg yolk semen extenders, isoimmunization of female to sperm, fertilization failure, and embryo mortality due to maternal-fetal incompatibility. PMID- 2697720 TI - Vaccines against endogenous hormones: a possible future tool in animal production. AB - Vaccines have been widely used by the livestock industry to control and prevent disease. New technologies now permit development of vaccines against hormones that control reproduction, growth, and lactation in domestic farm animals. Results of research projects studying passive and active immunization against such hormones as estrogen, testosterone, LH, FSH, and somatotropin have demonstrated that reproductive efficiencies and growth can be altered through vaccination. Although immunizations against most of the hormones studied have proven effective in most cases, there remain problems related to longevity, consistency, and efficiency of response both within and between animals. When these areas have been clearly defined for individual hormones, standardized immunization regimens can be developed that will optimize antibody production in the animal, thus providing the animal agriculture industry with a powerful and profitable production tool. PMID- 2697721 TI - Immunological sexing of mammalian semen: current status and future options. AB - Although numerous schemes have been devised and promoted for the putative separation of X- and Y-chromosome-bearing spermatozoa, none has gained widespread acceptance. We have reexamined the possibility that Y-chromosome-bearing spermatozoa express a male-specific antigen on their plasma membrane, but that the same antigen is absent from X-chromosome-bearing spermatozoa. Immunohistochemical studies with high titer serologically detectable, male specific antiserum revealed that serologically detectable, male-specific antigen is present on approximately 50% of spermatozoa and is located on both the postacrosomal region of the head and the midpiece of the flagellum. Similar results have also been described by other investigators working with bull spermatozoa. These data renew the question of whether the expression of serologically detectable, male-specific antigen on spermatozoa is a result of Y chromosome-specific haploid gene expression. If so, then serologically detectable, male-specific antigen could possibly be targeted as a means of immunologically separating X- and Y-chromosome-bearing spermatozoa. PMID- 2697722 TI - Dermatologic overview of lupus erythematosus and its subsets. PMID- 2697723 TI - The subbasement membrane distribution of type IV collagen in normal human skin. AB - Samples of normal human skin were obtained from 48 sites in 26 subjects ranging in age from 2 to 85 years. The samples were examined by indirect immunofluorescence and immunoelectron microscopy using anti-human type IV collagen antibodies produced by immunizing rabbits with type IV collagen extracted from human placenta. Fluorescence was observed as granular or fine fibrous patterns, not only in the basement membrane at the dermo-epidermal junction, around the vessels, and the accessory organs of the skin, but also in the dermal regions in the vicinity of the basement membranes. This suggests the presence of type IV collagen in the dermis deep to the basement membrane. Ultrastructurally, the extrabasal lamina distribution of type IV collagen was noted as a partial distribution around the fibroblasts that existed close to the basal lamina. These findings are considered to be important in examining the function of this collagen in the dermis and the dynamics and metabolism of the basement membrane under normal and abnormal conditions. PMID- 2697724 TI - [Cryosurgery in the treatment of basal cell epithelioma of the eyelids]. AB - Modern cryosurgery, based on impedance measurement, is a valuable addition to excisional surgery and radiation therapy in the management of eyelid malignancies. The advantages of the procedure are the good cosmetic and functional results. For the management of basal cell carcinoma situated near the punctum lacrimale and lacrimal canaliculus, cryosurgery may be preferred to surgery and radiotherapy. We review principles, methods, clinical and histological presentation of cryosurgery and describe our preliminary results. PMID- 2697725 TI - [A multicenter randomized study of fusidic acid ophthalmic gel and rifamycine eyedrops in acute conjunctivitis]. AB - A total of 163 patients with acute, presumably bacterial, conjunctivitis were included in a randomized trial, comparing: 1% fusidic acid viscous eye drops, a new ophthalmic formulation of fusidic acid instilled twice daily with rifamycin eye drops, four times daily. Both drugs were given 7 days long. Bacterial origin of the conjunctivitis, mainly staphylococcal, was proved in 75% of the cases. Overall, at the end of the treatment, a satisfactory response, on bacteriological and clinical grounds, was recorded for 87.3 and 89.5% of the patients in the Fucidin gel and rifamycin groups respectively. 9 and 12% of the patients in each group respectively, had a clinical recurrence 15 days after the treatment. No significant difference between the groups clinically and bacteriologically was noted. Side effects, mainly burning and smarting were noted by the investigators in 8 and 11 patients treated by fusilic acid and rifamycin respectively. Two patients were taken out of the study in the rifamycin group because of allergy. The difference between the groups is not significant. The use of fusidic acid viscous eye drops as compared to rifamycin eye drops was judged significantly easier by the patients (P less than 0.02), especially because of the reduced number of applications, the lack of color, and the lase of application. PMID- 2697727 TI - Bibliography of the current world literature in hypertension. PMID- 2697726 TI - Morphological, physiological and biochemical parameters associated with cell injury: a review. AB - Various forms of cellular injury, whether induced by immune effector cells, aberrant metabolic processes, chemotherapeutic drugs or temperature shifts, result in common morphological changes consisting of the formation and shedding of membrane vesicles from the injured cell surfaces. This dynamic cell surface membrane behavior appears to be dependent on the disruption of cytoplasmic microtubules. Concomitant with the altered cell surface morphology certain physiological and biochemical events have been found to be associated with cell injury. These include changes in membrane permeability, elevated oxygen consumption rates and nuclear DNA fragmentation. However, it remains to be experimentally established which of these biological changes defines a state of irreparable cell injury. The objective of the present review is to compare and evaluate the cell injury process induced by effector lymphocytes with that caused by low temperature. The latter mimics most, if not all, the currently known criteria of immune effector cell mediated injury of target tumor cells. PMID- 2697729 TI - Oral calcium supplementation and blood pressure: an overview of randomized controlled trials. AB - Over the past few years, several trials on the effect of oral calcium supplementation on blood pressure have been undertaken both in normal subjects and in patients with high blood pressure. Of these, 15 randomized, controlled studies were reviewed: 10 included patients with high blood pressure, three studied normal subjects, and two used a low-calcium diet for comparison. The 15 studies reviewed investigated a total of nearly 400 peoples. No significant evidence for a supine blood pressure-lowering effect of oral calcium supplementation was found in the trials as a whole or in those trials carried out in hypertensives only. However, a small effect on standing blood pressure was detected. Our study indicates that the overall effect of oral calcium on blood pressure, if any, is very small and confined to standing blood pressure, it is, therefore, inappropriate to recommend oral calcium supplementation for the treatment of essential hypertension. PMID- 2697728 TI - Crossover design for the dose determination of an angiotensin converting enzyme inhibitor in hypertension. AB - In order to determine the dose regimen of new antihypertensive compounds, between patient trials are usually performed. However, the combined use of a crossover design and a precise methodology to measure blood pressure (BP) and biological effects can provide relevant data with a minimal number of patients, if there is no carryover effect which invalidates the experiment. Such goals were successfully achieved with just 25 hypertensive patients who were randomly allocated in double-blind fashion every 2 weeks to a new angiotensin converting enzyme (ACE) inhibitor, benazepril [10 mg once a day (o.d.), 20 mg o.d., 10 mg twice a day (b.i.d.) and 20 mg b.i.d.], or a placebo. The mean BP fall [systolic (SBP)/diastolic (DBP), measured in mmHg] just before drug intake was significantly greater with benazepril: -14/-9 (10 mg o.d.); -15/-8.5 (20 mg o.d.); -22.5/-14 (10 mg b.i.d.), and -21/-13 (20 mg b.i.d.) in comparison with placebo (-3/-3). Mean active plasma renin (measured in pg/ml), assessed by an immunoradiometric assay based on two monoclonal antibodies, increased significantly in a dose-dependent manner, by +0.7 (placebo), +15.0 (10 mg o.d.), +23.4 (20 mg o.d.), +44.4 (10 mg b.i.d.) and +78.8 (20 mg b.i.d.), whereas plasma ACE decreased (by 67 and 78% after 10 and 20 mg o.d., respectively, and by 91-92% after 10 and 20 mg b.i.d.). In the clinical development of an antihypertensive drug, the earlier use of such within-patient studies, with the random insertion of one placebo period between the active periods, should help in the dose response curve search.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2697730 TI - Review of the 4th annual symposium of the International Research Group for Immunoscintigraphy and Immunotherapy. PMID- 2697731 TI - Retroviruses and cellular oncogenes. PMID- 2697732 TI - Effects of inhibition of angiotensin converting enzyme and carbonic anhydrase on fluid production by ciliary process, choroid plexus, and pancreas. AB - Inhibitors of angiotensin converting enzyme (ACE) (1) and of carbonic anhydrase (CA) (2,3) decrease intraocular pressure (IOP) in conscious rabbits. We asked whether ACE inhibition decreases IOP through effects on CA-dependent flow of aqueous humor (AH) and whether ACE inhibitors decrease other CA-dependent secretions. We show in anesthetized rabbits (a) that topical inhibitors of ACE decrease both IOP and AH flow as much as systemic inhibitors of CA; (b) that the maximal effects of ACE and CA inhibition are not additive, therefore these treatments may affect one or more components of a single system for fluid production; and that (c) ACE inhibitors do not work through inhibition of CA. Looking at other fluid production systems, we find (d) that cerebrospinal fluid (CSF) production is increased after ventriculocisternal perfusion with a potent ACE inhibitor and (e) that flow of pancreatic juice (PJ) is increased after systemic ACE inhibition. PMID- 2697733 TI - Knowledge base design for decision support in respirator therapy. AB - A knowledge base is built for decision support applied to respirator therapy (the KUSIVAR project). The knowledge representation is object-oriented using frames to store multiple forms of knowledge: variable descriptions, transformation tables, rules and mathematical models. The system is data-driven, generating and displaying advice automatically triggered by changes in data from the respirator and the patient. The inferenceing mechanism is forward-chaining i.e. a rule is evaluated as soon as it's condition is satisfied. Temporal aspects of the reasoning are represented by a number of mechanisms, among others limited validity times for data, trend analysis and mathematical models. The knowledge base is organized according to disease groups and decision situation which simplifies knowledge acquisition and improves response times since it enables the system to focus on a limited set of rules in each situation. To test the feasibility of the system design a prototype has been built using Knowledge Engineering Environment (KEE) from Intellicorp on an Explorer workstation from Unisys. The production system, which is interfaced to a Siemens Elema Servo Ventilator 900C, is currently being implemented under the Microsoft Windows multitasking environment on a microcomputer based on an Intel 80386 processor. PMID- 2697734 TI - Antenatal evaluation of upper gastrointestinal dilatation complicated by non immune hydrops fetalis and polyhydramnios. AB - A case of upper gastrointestinal dilatation associated with fluid collection in the peritoneal cavity is reported where the prenatal diagnosis was made sonographically in a non-immunologic hydrops fetalis. Neither generalized edema nor pleural effusion were detected. Polyhydramnios was complicated. Almost complete drainage of the abdominal fluid was accomplished with rapid re accumulation of fetal ascites and no resolution of intestinal dilatation. After delivery by Cesarean section, the male infant died the next day due to respiratory distress syndrome. Postmortem histologic examination failed to confirm the ultrasonographic findings including ileal obstruction and subsequent hypoplasia in the colon. Despite the discrepancy between clinical and pathologic findings, the findings of this case would improve the etiology of hydrops where no possible cause is found. PMID- 2697735 TI - Active muscular relaxation techniques. Part I. Basic principles and methods. AB - New treatment methods are being incorporated into chiropractic care. These methods include muscular relaxation techniques which have their origins in physical medicine and osteopathic approaches developed in the late 1940s. They involve active participation by the patient and are, therefore, ideal introductions into self-care and rehabilitation. These active muscular relaxation techniques are complimentary to chiropractic adjustments. This article describes three different methods used to relax hypertonic musculature. The different types of muscle hypertonicity are described. These active procedures are compared to other passive methods such as spray and stretch and massage. PMID- 2697736 TI - Spinal manipulation and headaches of cervical origin. AB - The role of the cervical spine in headache remains controversial. Often confused as tension or common migraine headache, headaches arising from the neck pose a diagnostic and therapeutic challenge. Practitioners of spinal manipulation have reported very satisfactory results, although the only published randomized controlled trial did not demonstrate that manipulation was significantly helpful. This article reviews the published clinical studies of manipulation in the treatment of tension and migraine headaches. The topic of cervical headaches in general is reviewed and the current model of cervicogenic headache is critiqued. A representative case history is used to illustrate the thesis that the current model of cervicogenic headache may be too restrictive. The role of spinal manipulation as a trial of therapy in individual patients is also discussed. a retrospective diagnosis of cervical headache can often be confirmed by a successful outcome. PMID- 2697737 TI - Possible role of spinal joint dysfunction in the genesis of sudden cardiac death. AB - Disturbances in sympathetic and parasympathetic regulation of the heart are associated with increased vulnerability to sudden cardiac death. Destabilizing neural input to the vagus and cardiac sympathetic nerves may originate from mechanically irritated intervertebral joints. Asymptomatic spinal joint dysfunction can affect the autonomic nervous system and may activate potent somatocardiac reflexes. Aberrant neural impulses from vertebral dysfunction may adversely affect the electrical stability of the heart and increase susceptibility to ventricular fibrillation. Correcting the spinal joint dysfunction which activates these articulovisceral reflexes may have beneficial effects in decreasing vulnerability to sudden cardiac death. PMID- 2697738 TI - Thermographic imaging of pathoneurophysiology due to cervical disc herniation. AB - A patient suffering from cervical disc herniation as noted by magnetic resonance imaging was tested for presence of nerve irritation using infrared telethermography. The thermal findings and asymmetries observed followed a dermatomal pattern of hypothermia and decreased thermal emission. The neurophysiological information derived from the thermographic examination may be helpful in the diagnosis and management of cervical disc herniations encountered in clinical practice. PMID- 2697739 TI - Medical education and the role of computers--as seen through the eyes of a medical student. AB - The medical education system that currently exists depends more and more on the memory of the physician-in-training as the medical database expands. While the brain has been engineered to reason and conceptualize, its capacity to memorize is limited and remains unchanged as the growth of medical knowledge continues. While we are exploring the frontiers of modern medicine, we must also explore new methods of training. An educational system that is efficient and practical must be developed, and the computer should assume a vital role in replacing the memorization of seldom used, but clinically important information. This would enable students to focus on clinical applications, and advance the development of reasoning skills that are essential in medicine: MEDICAL EDUCATION AND COMPUTERS. PMID- 2697740 TI - A computerized kinematic diagnostic system. AB - This paper describes the instrumentation developed for a clinical system that measures upper extremity kinematics in normal and cerebral palsied children. The ability to diagnose cerebral palsy during early and midinfancy is influenced by the fact that movement and postural abnormalities become apparent only over time, and are not readily detectable until there is sufficient abnormality so that it can be viewed by gross inspection during clinical examination. The methodology presented here serves to discriminate normal from deviant movement at an earlier age than what is presently possible, and may also result in alternative therapeutic intervention. PMID- 2697741 TI - DMSS--a computer-based diabetes monitoring system. AB - This paper describes a microcomputer-based decision support system (DSS) for diabetes monitoring. The system's basic functions include a patient management subsystem, an electronic logbook, a nutrition and exercise module, a dictionary for diabetes-related terminology, a diabetic-physician data transfer module and an on-line help capability. DMSS (Diabetes Monitoring Support System) provides a data capturing capability, trend analysis, and nutrition/exercise decision support to improve the monitoring and maintenance of diabetes. It was designed to be used by both a physician and a patient and can also serve as a useful teaching aid for a new diabetic. Its basic advantages lie in its comprehensiveness and flexibility. It is also user-friendly, easy to operate, and does not require any previous computer experience. PMID- 2697742 TI - Congenital factor XIII deficiency: report of a case and literature review. AB - We described a five-year-old boy with congenital deficiency of factor XIII. He had bled from the umbilical and circumcision sites during the first week of life. He had frequent ecchymoses and hematomas within 12-24 hours after trauma. His parents are first cousins. The screening hemostatic tests of this patient and his parents were within normal limits. Factor XIII, known as "fibrin-stabilizing factor", is a transpeptidase that produces strong covalent bonds between soluble fibrin monomers formed during coagulation. Presumptive diagnosis of factor XIII deficiency was made with a clot solubility screening test and confirmation was accomplished by demonstrating the absence of factor XIII by latex agglutination. PMID- 2697743 TI - Polymerase chain reaction for the detection of Mycobacterium leprae. AB - A polymerase chain reaction (PCR) using heat-stable Taq polymerase is described for the specific detection of Mycobacterium leprae, the causative agent of leprosy. A set of primers was selected on the basis of the nucleotide sequence of a gene encoding the 36 kDa antigen of M. leprae. With this set of primers in the PCR, M. leprae could be detected specifically with a detection limit approximating one bacterium. This PCR appears to meet the criteria of specificity and sensitivity required for a useful tool in epidemiology and eventually for the control of leprosy. PMID- 2697744 TI - Cloning and expression of Treponema pallidum antigens in Escherichia coli. AB - A library of Treponema pallidum genomic DNA fragments produced by partial Sau3A digestion was established in Escherichia coli K12 using the plasmid vector pAT153. The library was screened using immune syphilitic rabbit serum and six recombinant phenotypes expressing eight treponemal polypeptides were detected. With two exceptions, all the recombinant gene products were the same size as polypeptides detected on Western immunoblots of T. pallidum. The genes encoding three novel gene products, with molecular masses in SDS-PAGE of 42, 17 and 15.5 kDa, which had not been cloned previously from T. pallidum were also identified. Monoclonal antibodies which reacted with four of the eight recombinant polypeptides were generated. PMID- 2697745 TI - Inhibition of biological activities of the aerobactin receptor protein in rough strains of Escherichia coli by polyclonal antiserum raised against native protein. AB - The aerobactin iron-uptake system of plasmid ColV-K30, genetically isolated from other plasmid determinants by molecular cloning, was sufficient to restore full virulence in a mouse peritonitis model to a clinical Escherichia coli isolate, D551 (O78:H-), whose resident aerobactin-encoding ColV plasmid had been lost by curing. Antiserum was raised in rabbits against live E. coli K12 cells expressing the outer-membrane aerobactin receptor protein and absorbed with an isogenic strain lacking the receptor. This antiserum inhibited binding of aerobactin, cloacin DF13 and bacteriophage B74K to the native protein in whole E. coli K12 bacteria expressing the receptor, or in membranes prepared from such organisms. However, it did not react with the native receptor protein in several wild strains unless lipopolysaccharide was first removed by treatment with trichloroacetic acid, nor did it protect mice in experimental infections with strain D551. Antisera raised in rabbits against partially or fully denatured forms of the aerobactin receptor reacted only in assays involving denatured protein; they showed no inhibition of the biological activities of the native receptor. PMID- 2697746 TI - Controlling the growth rate of Saccharomyces cerevisiae cells using the glucose analogue D-glucosamine. AB - By using competition between glucose and its analogue D-glucosamine, we have produced a system in which it is possible to vary the steady-state growth rate of populations of Saccharomyces cerevisiae cells without otherwise altering the composition of the medium or significantly affecting catabolite repression. We demonstrate that D-glucosamine inhibits the accumulation of glucose derived label and the phosphorylation of glucose by hexokinase (EC 2.7.1.1). PMID- 2697747 TI - The mechanism of intracellular acidification induced by glucose in Saccharomyces cerevisiae. AB - Addition of glucose or fructose to cells of Saccharomyces cerevisiae adapted to grow in the absence of glucose induced an acidification of the intracellular medium. This acidification appeared to be due to the phosphorylation of the sugar since: (i) glucose analogues which are not efficiently phosphorylated did not induce internal acidification; (ii) glucose addition did not cause internal acidification in a mutant deficient in all the three sugar-phosphorylating enzymes; (iii) fructose did not affect the intracellular pH in a double mutant having only glucokinase activity; (iv) glucose was as effective as fructose in inducing the internal pH drop in a mutant deficient in phosphoglucose isomerase activity; and (v) in strains deficient in two of the three sugar-phosphorylating activities, there was a good correlation between the specific glucose- or fructose-phosphorylating activity of cell extracts and the sugar-induced internal acidification. In addition, in whole cells any of the three yeast sugar kinases were capable of mediating the internal acidification described. Glucose-induced internal acidification was observed even when yeast cells were suspended in growth medium and in cells suspended in buffer containing K+, which supports the possible signalling function of the glucose-induced internal acidification. Evaluation of internal pH by following fluorescence changes of fluorescein-loaded cells indicated that the change in intracellular pH occurred immediately after addition of sugar. The apparent Km for glucose in this process was 2 mM. Changes in both the internal and external pH were determined and it was found that the internal acidification induced by glucose was followed by a partial alkalinization coincident with the initiation of H+ efflux. This reversal of acidification could be due to the activity of the H+-ATPase, since it was inhibited by diethylstilboestrol. Coincidence between internal alkalinization and the H+ efflux was also observed after addition of ethanol. PMID- 2697748 TI - Accumulation of sulphite by Saccharomyces cerevisiae and Zygosaccharomyces bailii as affected by phospholipid fatty-acyl unsaturation and chain length. AB - Analyses were made of the fatty-acyl composition of phospholipids from each of two strains of Saccharomyces cerevisiae and Zygosaccharomyces bailii grown aerobically. Residues of C16:0, C16:1 and C18:1 predominated in phospholipids from strains of the first yeast, while phospholipids from Z. bailii contained mainly C16:0, C18:1 and C18:2 residues. S. cerevisiae NCYC 431, grown anaerobically in media supplemented with ergosterol and C14:1, C16:1, C18:1, C18:2, C18:3 or C20:1 fatty acids, contained phospholipids enriched with residues of the exogenously provided acid, to a greater extent with shorter chain than longer chain acids. A plot of the permeability coefficient for sulphite, derived from Woolf-Eadie plots, against the degree of unsaturation in phospholipids (expressed as delta mol-1 value) showed that the coefficient was greater the lower the degree of unsaturation in the phospholipids. A plot of the permeability coefficient against values for the mean fatty-acyl chain length divided by the delta mol-1 value, which is an approximation of the cross-section surface area of a phospholipid molecule, showed that the permeability coefficient tended to increase the greater the surface-area value. PMID- 2697749 TI - Characterization of AAT1: a gene involved in the regulation of amino acid transport in Saccharomyces cerevisiae. AB - A new class of Saccharomyces cerevisiae mutants (aat1 - amino acid transport) has been identified. These mutants are unable to grow on rich medium or on minimal medium supplemented with certain amino acids (isoleucine, methionine, phenylalanine, tyrosine or valine). This phenotype is directly linked to the presence of the leu2 allele in these strains: aat1 LEU2 organisms grow normally on all media tested. Leucine uptake through the leucine-specific permease is inhibited to less than 35% of wild-type levels in aat1 cells preincubated in nonpermissive media, and the activity of the general amino acid permease is also low in these conditions. aat1 cells are therefore unable to grow on rich media because they cannot take up enough leucine to supplement their auxotrophic requirement. PMID- 2697750 TI - Thermotolerance and the heat-shock response in Candida albicans. AB - At elevated temperatures, yeast cells of Candida albicans synthesized nine heat shock proteins (HSPs) with apparent molecular masses of 98, 85, 81, 76, 72, 54, 34, 26 and 18 kDa. The optimum temperature for the heat-shock response was 45 degrees C although HSPs were detected throughout the range 41-46 degrees C. Protein synthesis was not observed in cells kept at 48 degrees C. Yeast cells survived exposure to an otherwise lethal temperature of 55 degrees C when they had previously been exposed to 45 degrees C. The thermotolerance induced during incubation at 45 degrees C required protein synthesis, since protection was markedly reduced by trichodermin. Mercury ions induced a set of three stress proteins, one of which corresponded in size to an HSP, and cadmium ions evoked one stress protein seemingly unrelated to the HSPs observed after temperature shift. PMID- 2697751 TI - Transformation in restriction-deficient Salmonella typhimurium LT2. AB - Stable restriction-deficient, modification-proficient galE (JR501) and F'galE+ (JR502) strains of Salmonella typhimurium were constructed and the effects of restriction on transformation by plasmid pBR322 were tested. Several factors which affect transformation efficiency were systematically examined to determine optimum transformation conditions and a simplified method is presented. PMID- 2697752 TI - Interaction of Candida albicans with murine gastrointestinal mucosa: effect of irradiation on adherence in vitro. AB - The aim of this study was to investigate the adherence in vitro of Candida albicans to various parts of the gastrointestinal (GI) mucosa from irradiated and non-irradiated mice and to attempt to inhibit this adhesion with a chitin derivative. Adhesion was assayed using 3H-leucine labelled yeast, to which GI tissue-disks removed from irradiated (400R Cobalt) and non-irradiated animals were exposed at various time intervals post-irradiation. In non-irradiated mice differences in adherence of C. albicans to various parts of the GI tract were observed, the highest adherence being to duodenal tissues. In irradiated mice, an increase in adherence to all parts of the GI mucosa was observed. Based on findings from previous studies that a chitin derivative (CSE) inhibits adhesion of C. albicans to various tissues in vitro and in vivo, we tested the effect of CSE on the adhesion of C. albicans to GI tissues. The results show that CSE inhibited the adhesion of C. albicans to GI tissues from both irradiated and non irradiated mice by 75-85%. The relevance of the findings to the pathogenesis of candidiasis is discussed. PMID- 2697753 TI - Structural degeneration of Aspergillus fumigatus after exposure to saperconazole. AB - Saperconazole is a newly synthesized triazole antifungal with potent activity against Aspergillus fumigatus. Exposure of spores inoculated into BHI agar medium to saperconazole doses as low as 35 ng ml-1, resulted in complete suppression of germination (hyphal outgrowth) when treatment started simultaneously with inoculation. Cultures which were grown for 24 or 48 h in the absence of drug and were then exposed to saperconazole showed a block in the development of hyphae, sporophores, vesicles, sterigmata and spores. Moreover, a substantial proportion of the pre-existent hyphae became necrotic during exposure to the drug. The latter was most obvious with the 70 ng ml-1 dose. Although treatment with lower doses yielded severely altered but non-necrotic cells, an abolishment of further outgrowth and differentiation was achieved. PMID- 2697754 TI - Current management of benign oesophageal strictures. AB - Benign reflux strictures most commonly result from gastro-oesophageal reflux but other causes must be excluded. Ambulatory pH monitoring is useful to confirm and quantitate the severity of reflux. Reflux strictures can be managed by dilatation and vigorous continued antireflux treatment but surgery offers a safe and more effective means of correcting the physiological dysfunction of the sphincter. Healthy patients should, therefore, be offered a permanent cure by surgery and conservative measures should be reserved for patients who are elderly, obese or unfit for surgical management. Before starting surgical treatment a full investigation is mandatory. Radiological, endoscopic, histological and cytological studies, pH monitoring, motility evaluation of the motor power of the oesophagus and sphincter and an assessment of gastric emptying are all necessary investigations for a complete evaluation of the dysfunction and effective surgical planning. PMID- 2697755 TI - Gunshot wounds then and now. AB - This review is a study of the development of the bullet and its effects, and the surgical treatment of gunshot wounds from John Hunter's time to the present day. PMID- 2697756 TI - Use of Mersilene mesh and a zip in the management of severe intra-abdominal sepsis. PMID- 2697757 TI - A cytotoxic monoclonal islet cell surface antibody from the NOD mouse. AB - Monoclonal antibody (Mab) 1.93B7 was obtained by fusion of spleen cells from a diabetic NOD mouse with P3X63Ag8.653 myeloma cells and screening for complement mediated lysis of rat insulinoma (RIN) cells. Immunofluorescence studies revealed that this Mab binds to RIN cells but not to the rat pituitary tumour line GH3. The binding of Mab 1.93B7 to RIN cells was abolished by trypsin but not by neuraminidase treatment of the cells, suggesting that the antigen recognized is a protein. Mab 1.93B7 bound to approximately 30% of mouse (BALB/c) and rat islet cells which had been subjected to trypsin digestion and incubated as a single cell suspension for 12h to allow reexpression of trypsin sensitive antigens. Since Mab 1.93B7 is potentially pathogenic, as suggested by its reactivity to primary islet cells and its complement fixing capacity, we injected it into BALB/c and NOD mice. Cytotoxic activity against RIN cells was detected in the serum of the animals injected with Mab 1.93B7, but the Mab did not exert a diabetogenic action and failed to reverse diabetes when administered at onset in NOD mice. No modification of the course of spleen cell mediated transfer of diabetes in NOD mice was observed when the Mab was administered from the time of spleen cell inoculation to the appearance of glycosuria. The implications of the lack of an effect in vivo of Mab 1.93B7 under the conditions employed are discussed. PMID- 2697758 TI - Response of humans to gamma-irradiated reference Escherichia coli endotoxin. AB - This study assesses the effect of gamma-irradiation of endotoxin given intravenously to healthy human volunteers. The national reference standard endotoxin derived from E. coli was placed in aqueous medium in sterile-sealed ampoules and divided into four groups. One group received endotoxin with no radiation while the other three received endotoxin with gamma-irradiation at doses of 0.18, 0.36, or 1.08 Mrad. These doses of radiation cause characteristic alterations to the endotoxin molecule, primarily to the O-polysaccharide moiety. Each of the four different preparations of endotoxin was given intravenously to four volunteers at a concentration of 4 ng/kg. The responses for clinical symptoms, cortisol, and growth hormone were significantly and progressively reduced by increasing the irradiation to the endotoxin. Most strikingly, no clinical symptoms were noted with the endotoxin exposed to the highest dose of radiation (1.08 Mrad). Fever, vital signs, white blood cell count, and differential exhibited no statistically significant differences among the groups, but the kinetics of change were altered by increasing doses of gamma-irradiation. Irradiated endotoxin was significantly more effective in decreasing the platelet count than untreated endotoxin. The fever index correlated significantly with maximum temperature, change in temperature, white blood cell count index, mature neutrophil count index, and the cortisol index. Thus, there is dissociation of biological activities for endotoxin in humans due to molecular changes primarily in the O-polysaccharide moiety from exposure to gamma-irradiation. PMID- 2697759 TI - The cellular biology of angiotensin: paracrine, autocrine and intracrine actions in cardiovascular tissues. AB - A growing body of evidence suggests that angiotensin II, the effector protein of the renin-angiotensin system, is intimately involved with cell growth in target tissues. Most recently, evidence has been provided to indicate that angiotensin II is capable of inducing a hypertrophic response in cultured arterial smooth muscle cells. At the same time, considerable evidence has been developed to indicate that local analogs of the systemic renin-angiotensin system exist in multiple tissues and, in particular, in the vascular wall and the heart. Finally, data have accumulated to indicate that local growth regulatory factors, in many instances operating through regulation of proto-oncogene transcription, are involved in the hypertrophic and hyperplastic sequelae of hypertension. Included amongst these growth factors is angiotensin II. Thus, accumulating data indicate that angiotensin II is a growth factor with potential implications for the development of the sequelae of hypertension. In addition, studies from this laboratory and others suggest that angiotensin acts at least partially through what we have called an "intracrine" mechanism to produce its effects. In these multiple actions, angiotensin may provide a paradigm for other peptide growth factors and hormones. PMID- 2697760 TI - Immunological alterations and chemical exposure. AB - The complex nature of the immune system with its multiple humoral and cellular components makes it an easy target for many drugs and chemicals. Immunotoxicology is defined as an adverse response of the immune system to a chemical or drug which may result in disease such as autoimmunity, immune suppression, allergy or other hypersensitivity states. Occasionally, immune enhancement is the end result. Because many of the immune system's cellular and humoral components can be isolated and studied in vitro, assays have been developed to study the immunotoxic effects of chemicals. Further refinement of these in vitro studies is required along with clinical investigations into the effects of chemicals on the immune system of humans. Extrapolating from the animal data to human effects has proven to be unsuccessful in many circumstances. Further definition and study of immunotoxic responses as contrasted with normal immune responses to neo-antigens are required to investigate actual disease causation. PMID- 2697761 TI - The use of chelating agents in the treatment of aluminum overload. AB - Desferrioxamine (DFO), traditionally used as an iron chelator has been shown to increase urinary aluminum output in humans and aluminum-loaded mice, rats and rabbits. However, major side-effects of DFO treatment have been observed and the drug may accumulate in dialysis patients receiving repeated doses. In recent years, it has been reported that some dicarboxylic or tricarboxylic acids such as succinic, malic or citric may be considered as possible alternatives to DFO in the management of aluminum accumulation. Ethylene-di-(o-hydroxyphenylacetic acid) like compounds may also have potential as alternatives to DFO in the treatment of aluminum accumulation and aluminum-induced toxicity. Investigation of new therapeutic agents with lower toxicity than DFO and clinical advantages in administration and cost is clearly encouraged. PMID- 2697762 TI - An analysis of clinical toxicology urine specimens using the KDI Quik test. AB - The KDI Quik test is a rapid qualitative method for detecting narcotics, cocaine, PCP, and amphetamines in urine. The accuracy of this test was evaluated by testing 106 clinical toxicology urine specimens. Three investigators independently reviewed the test results and compared them to results of standard toxicological analyses. Of 83 samples found positive by the reference technique, only 70 were correctly identified as positive on the Quik test; only nine of 23 truly negative controls were correctly identified as negative by the Quik test. The overall sensitivity of the test was 84.7% while the specificity was 39.1%. As inaccuracies of this degree could result in frequent clinical error, use of the Quik test is not recommended. PMID- 2697763 TI - 3,9-dinitrofluoranthene. PMID- 2697764 TI - 1,3-dinitropyrene. PMID- 2697765 TI - 1,6-dinitropyrene. PMID- 2697766 TI - 1,8-dinitropyrene. PMID- 2697767 TI - 6-nitrochrysene. PMID- 2697768 TI - 2-nitrofluorene. PMID- 2697769 TI - 1-nitronaphthalene. PMID- 2697770 TI - 3-nitroperylene. PMID- 2697771 TI - 2-nitropyrene. PMID- 2697772 TI - 4-nitropyrene. PMID- 2697773 TI - [Mothers and children moving in water and on land]. PMID- 2697774 TI - [S.P. Botkin's personality]. PMID- 2697775 TI - [S.P. Botkin in the memoirs of his contemporaries]. PMID- 2697776 TI - [S.P. Botkin and phthisiology]. PMID- 2697777 TI - [S.P. Botkin's views on the importance of studies on pathomorphology for general and clinical understanding of diseases]. PMID- 2697778 TI - [Medals in memory of S.P. Botkin]. PMID- 2697779 TI - [Evolution of psychosomatic medicine]. PMID- 2697780 TI - [Role of the brain stem in normal and pathologic conditions of the body]. PMID- 2697781 TI - [Indications and contraindications for the clinical use of hyperbaric oxygenation]. PMID- 2697782 TI - [Age-related characteristics of infectious diseases]. PMID- 2697783 TI - [S.P. Botkin and current medical problems]. PMID- 2697784 TI - [Effectiveness of broncholytics and positive end expiratory pressure in bronchial asthma]. AB - To improve treatment with bronchodilators, the study was made of 60 bronchial asthma patients' external respiration upon berotek administration and Positive end expiration pressure (PEEP). More distinct bronchodilatation was achieved with combination of the two modalities in aggravated asthma. IPPV, as allowing minimal drug administration, is recommended for use in rehabilitation. PMID- 2697786 TI - Ultrasonographic findings in subcutaneous rupture of Achilles tendon. AB - Twelve patients who had suffered a subcutaneous rupture of the tendo calcaneous underwent real-time ultrasonography using a 5 MHz sectorial probe. The main findings were the disappearance of the path of the tendon, haematoma formation, and alterations of the echogenicity of the Kager's triangle. PMID- 2697785 TI - [Relation of bronchial asthma and allergic bronchopulmonary aspergillosis]. AB - An allergological examination was conducted in 30 out of 83 (36.07%) patients showing symptoms of bronchial asthma. It was found that skin hypersensitivity to Aspergilla allergens coupled with a high serum IgE level. The appropriateness of such affection referral to a separate nosological entity (allergic bronchopulmonary aspergillosis) is under discussion. PMID- 2697787 TI - How vitamins affect performance. PMID- 2697788 TI - Legal advice, moral paralysis and the death of Samuel Linares. PMID- 2697789 TI - [Biological effects of artificial mineral fibers]. AB - The present review paper was prepared on the basis of 52 source-books devoted to experimental investigations. Principal conclusions emerging from the experiments described in the references quoted are as follows. MMMF retention in alveoli is conditioned mainly by the fibres size--for fibres of constant dimater retention increases proportionally to their length, while long and thin fibres undergo degradation in fluids much more easily than the short and thick ones. Fibrous effect of glass fibres and glass wool is less remarkable than that of chrysotile and crocidolite; after exposure to glass fibre and wool has stopped, no progress of fibrous changes in animals was observed. In animals exposed to grass fibre or mineral wool through inhalation, the increase in cancer rate was not statistically significant; glass fibres introduced into the pleura showed a weaker tendency to induce neoplasms than the same amount of asbestos fibres, while basalt and ceramic wool induced reaction similar to that provoked by asbestos. In the case of combined exposure glass fibres intensified the toxic effect of styrene in mice and enhanced the incidence of lung cancer in rats exposed to radon. In in vitro study the destructive effect represented the distribution function of fibres size--long fibres (less than 10 microns) and thin fibres (less than 1 micron diameter) demonstrated stronger toxic effect. Glass fibres provoked neither mutations in bacterial test, nor sister chromatid exchange in animal cells in vitro. However, they caused mitosis delay and structural changes in chromosomes. PMID- 2697790 TI - [Problems of the evaluation of occupational exposure in epidemiologic case control studies]. AB - The paper presents issues concerning collecting and assessing data on occupational exposure in case-referent studies. The authors discuss different opinions and methods for obtaining relatively trustworthy and valuable information regarding this subject. The system of combining data on profession and kind of exposure (the so-called occupational exposure system) and the method for constructing a job exposure matrix are paid much attention. Complexity of problems discussed, the absence of reliable methods and standardized instruments for case-referent study all require every caution in interpreting the data obtained in this type of examination. PMID- 2697791 TI - [A jubilee to honor Prof. Witold Zahorski]. PMID- 2697792 TI - [The 50th anniversary of the theory of natural foci of human diseases]. PMID- 2697793 TI - [Immunoenzyme analysis with corpuscular antigen in the study of zoonotic cutaneous leishmaniasis]. AB - Comparative study of sera from patients suffering from zoonotic cutaneous leishmaniasis by indirect immunofluorescence (IIF) and by enzyme immunoassay (ELISA) gave 72.4 and 89.6% positive results, correspondingly, with homologous antigen L. major. Good correlation of these methods was revealed--coincidence in 83% cases. Authors used ELISA with corpuscular Leishmania antigen. The test was superior to IIF in sensitivity and specificity. Creation of type-specific Leishmania test systems for ELISA opens new vistas in studies of the population immune structure in combined zoonotic cutaneous leishmaniasis and visceral leishmaniasis foci. PMID- 2697794 TI - [Chemotherapy, patient immune status and the outlook for immunocorrection in parasitic diseases (exemplified by natural-focus invasions)]. AB - Chemotherapy of parasitic infections and zoonotic helminthiasis in particular can be effective if the peculiarities of the parasite species specificities and the character of immunological condition of a host or groups of population of endemic foci are taken into account. The state of immunodepression and immune disregulation was found in migrants to a territory endemic for Opisthorchis felineus infection, suffering from acute and chronic stage of the disease. In aborigenes the signs of immunological tolerance were obvious. Hypersensitivity to praziquantel treatment in the former group and the good tolerance of the therapy in the latter were shown. The inhibitors of prostaglandins, especially in combination with mebendazole or albendazole, improved the tolerance of the treatment and enhanced parasitocidal effect. Low activity of interleukin-1, decreased level of interferon-alpha and almost normal level of gamma-interferon were found in patients with progressive course of hydatid disease with the lowering of these parameters after mebendazole therapy. In radically operated patients these parameters were normal. It seems that a higher level of gamma interferon is needed for benign course of echinococcus infection, and recombinant gamma-interferon or inducers of this cytokine will be beneficial for the improvement of chemotherapy and prevention of relapses of the disease. PMID- 2697795 TI - [Physiopathology of the edentulous crest. Possibilities of the pharmacologic inhibition of pre- and post-operative bone resorption]. AB - The biological causes of edentulous alveolar crest reabsorption are examined in the light of recent discoveries on the physiopathology of bone metabolism. The main techniques used for the classification of patients in terms of bone metabolism type are then described and the question of whether any currently available pharmacological treatment is capable of preparing for, supporting, preserving or even effectively replacing preprosthetic surgery is posed. PMID- 2697796 TI - [Ceramic canal pins]. AB - In restorative dentistry, any technique that employs retentive endoradicular pins can be associated with a simple technique that includes ceramization of the metallic surface of the pin, producing great adhesion to a composite resin by interposition of a silane coupling agent. The strong bond obtained using this technique between pin and filling material surrounding it prevents a dangerous concentration of mechanical forces around the pin itself and reduces the probability of breaks and consequent failure of the restoration. PMID- 2697797 TI - [Fibrous dysplasia of the jaws. The literature and a presentation of 2 cases]. AB - After an analysis of the literature, the clinical, roentgenographic, anatomopathologic and therapeutic features of fibrous dysplasia of the jaws have been described. Two cases have been presented: a fifteen-year-old boy affected by a monostotic form of the right maxilla and a nineteen-year-old girl affected by a craniofacial variety, restricted to the right zygomatic and maxilla bones. PMID- 2697798 TI - [Comparative evaluation of the retentive capacity of endodontic posts]. AB - The retentive capacity of certain endodontic posts was assessed in terms of: pin design, pin diameter and cement employed. The following commercially products were examined: Flexipost (Essential Dental Systems), Parapost Plus (Whaledent) and Dentatus (Dentatus) posts; Phosphacap (Vivadent) and Bondalcap (Vivadent) cements. PMID- 2697799 TI - [Psychosocial management in pediatrics. Do we really mean the patient?]. AB - Due to technological perfection of medical treatment there is an increasing concern about the patient (as a person). As the treatment-demands grow, treatment becomes dependent on the patient's tolerance to adapt to these demands. Instead of this dependence, general discussion focuses on the patient's "failure" or "non compliance". Without a critical reflection on this context psychological care for the "failing" patient is in danger to exclude the patient's individuality instead of integrating it into the whole treatment plan. It is not the patient who fails, but it is a treatment plan which reduces the patient's individuality to the question whether he complies, or not. It is especially true for the care of the chronically ill that the treatment plan has to be openly negotiated with the patient's individual experiences and purposes. PMID- 2697800 TI - [Acute, non-traumatic paraplegia syndromes in children]. AB - Acute, non-traumatic paraplegia is a very rare condition in childhood. Because of this the correct diagnosis is not recognized in time. We want to call attention to this illness by reporting on four patients we treated between the years 1984 and 1986. We put together and analyzed the literature on this disorder for the first time, and established guide lines-first, to recognize those causes of the disorder which by all means have to be treated in time, and second, how to proceed further diagnostically. PMID- 2697801 TI - [Non-Hodgkin's lymphoma of the descending colon in a 6-year-old girl]. AB - The most common site of non-Hodgkin lymphoma of the intestinal tract in children is the terminal ileum and the ileocecal region; boys are 5- to 10 times more frequently affected than girls, peak incidence is between 5 and 8 years of age. We present a 6-year-old girl with non-Hodgkin lymphoma of the descending colon. PMID- 2697802 TI - [Pheochromocytoma of the prostate: an unusual site]. AB - Pheochromocytomas of the prostate are rare, with only two cases reported in adults. We report the uncommon case of a pheochromocytoma of the prostate in a 8 year-old boy. PMID- 2697803 TI - [Analysis of functioning of ColE1 plasmid par-regions during various conditions of culturing]. AB - The functioning of the par-regions of the small multi-copied colicinogenic plasmids ColE1 and ColA has been analysed under the different conditions of plasmid-containing cells cultivation. The efficient cointegrate resolution of the multimeric forms of the plasmid ColE1 has been demonstrated in Escherichia coli K12 cells under the different conditions of cell cultivation. It took place at 30 degrees-42 degrees C on the minimal as well as rich medium, at the different stages of cell cycle in the presence or absence of antibiotic, under aerobic as well as semi-anaerobic conditions. PMID- 2697804 TI - [Electron microscope study of the plasmid DNA from various strains of Treponema pallidum]. AB - Electron microscopic investigation and electrophoretic analysis of DNA from two cultural strains of pale treponemes (Treponema pallidum VIII and Treponema pallidum Reiter) allowed us to identify the circular molecules of plasmid DNA their size evaluated as 7 to 8 MD. Side by side with the molecules of this size the electron microscopic pictures of the plasmid DNA of both strains of pale treponemes show small superspiralized molecules of plasmid DNA. According to electrophoretic data the size of this DNA is evaluated as two thousand base pairs. PMID- 2697805 TI - [Energy of the transmembrane DNA transfer in bacteria]. AB - The natural transmembrane DNA transfer in the course of the genetic transformation, transfection and conjugation is analyzed as well as the inducible transmembrane transfer affected by the different physicochemical factors. Different models for the transfer are discussed. Special attention is paid to the energetic aspects of the transfer. PMID- 2697806 TI - Phylogenesis and nutrition. AB - The evolution of man is connected with a life-style of hunting and gathering, and with the development and use of tools. The success of tools promoted the evolution of brain, thinking and skills. The food sources--animal and plant- remained the same during the whole of evolution. But the proportions of foods, preferences, preparations and the attainability changed. Evolution was a process continuously based on omnivorous nutrition. Compared to modern nutrition, paleolithic nutrition is richer in animal protein, vitamins, calcium, potassium and fibre, and poorer in fat and sodium. Saccharose, lactose and alcohol play no roles. The quality of the fat is marked by a high proportion of polyunsaturated fatty acids. This shift from a paleolithic diet to a modern diet caused nutritional risks, partly responsible for the dramatic increase in modern chronic diseases of heart, circulation and so on. Man's metabolism works in a stable genetic frame, derived during phylogenesis. We have to adapt our nutritional behaviour to its tolerances or we may succumb to disease and premature death. While our paleolithic metabolism is overdone with modern nutrition, our psychological heritages press in the direction of overdoing. PMID- 2697807 TI - The history of operating theatre rituals. PMID- 2697808 TI - Components of postural dyscontrol in the elderly: a review. AB - The concept of a generalized aging effect on a generalized balance mechanism is discussed, and an alternative, multicomponent approach to understanding the heterogeneity of postural dyscontrol in the elderly is presented. Neural sensorimotor components of normal postural control mechanisms are identified and discussed. The effects of Parkinson's disease, hemiplegia, cerebellar degeneration, peripheral vestibular loss, and other disorders on the components of postural control are summarized. Quantitative posturography is advocated to detect preclinical manifestation of multiple musculoskeletal and neuromuscular pathologies and reduced compensatory abilities in posturally unstable elderly adults. PMID- 2697809 TI - The prevalence of urogynecologic disorders. AB - Although the field of urogynecology spans a wide range of lower urinary tract disorders, urinary incontinence and urinary infections remain the two most common disorders of the urinary tract encountered by the health care provider practicing obstetrics and gynecology. Both problems have a higher prevalence in the older population, and in addition they both have a predilection for recurrence. Together they account for considerable personal and public expense, as well as untold individual emotional and physical distress. Much remains to be learned before significant measures can be initiated to prevent the problems. Urinary incontinence is particularly challenging because it is a manifestation of so many other disorders or their treatment. PMID- 2697810 TI - Anatomy and embryology of the lower urinary tract. AB - The anatomy of the lower urinary tract and the structures that surround it play an important role in our understanding of the urinary continence mechanism. This article discusses the functional anatomy of this region as it relates to gynecologic urology. PMID- 2697811 TI - Neurophysiologic control of lower urinary tract. AB - Current concepts in neurophysiology are discussed, with emphasis on neurotransmitters and electrodiagnosis. Specific neuronal mechanisms governing urine storage and expulsion are presented followed by clinical considerations of various neuronal dysfunctions. PMID- 2697812 TI - Neuropharmacology of the lower urinary tract in women. AB - One of the most common gynecologic complaints is urinary incontinence, which afflicts approximately one third of the female population. In urodynamic units, approximately 80 per cent of women with urinary incontinence have detrusor hyperreflexia as the sole reason for, or as a component of, their incontinence problem. Approximately 80 to 85 per cent of patients with detrusor hyperreflexia have a functional neuromuscular disturbance of their detrusor muscle. One to 2 per cent of the patients seen in our urodynamic unit have detrusor hyperreflexia caused by a neurogenic bladder. As our clinic's population ages, this type of functional neuromuscular disturbance--neurogenic bladder problem--will increase. The neuromuscular control of the lower urinary tract is complex and not fully understood, explaining why we are unable to treat the functional neuromuscular disturbance in some patients effectively and why we may have to try several drugs before finding one that is effective in other patients. Although patients may have the same symptoms and even the same urodynamic findings, the cause of the functional neuromuscular disturbance may be different. One patient may respond to drug A and not to drug B, and another patient with virtually the same symptoms and urodynamic findings responds to drug B and not to drug A. The main neurologic control of the lower urinary tract is through the sacral outflow of somatic and (mainly) parasympathetic nerve fibers. There appears to be an "on-off" control mechanism involving the urethrovesical unit wherein there is parasympathetic inhibition of the detrusor muscle and parasympathetic stimulation of the urethral smooth muscle and stimulation of somatic nerves to the urethral striated muscle at rest. Reverse action occurs when the patient voids. For this reason, cholinergic and anticholinergic drugs exert a powerful influence on the lower urinary tract. Adrenergic control through alpha 1- (and indirectly alpha 2-) and beta 2-receptors (with a preponderance of alpha-receptors in urethral smooth musculature and a preponderance of beta-receptors in the detrusor muscle) appears to modulate and modify parasympathetic action. This explains why adrenergic stimulant and blocker drugs, in most women, do not affect the lower urinary tract as much as parasympathomimetic-lytic drugs. However, adrenergic effect seems to be greater in some women than in others, explaining, for example, why some patients with detrusor hyperreflexia respond to beta 2-stimulatory drugs and not to anticholinergic drugs. Also inter-twined in the neuromuscular control of the lower urinary tract are the roles of prostaglandins and calcium-potassium channel changes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697813 TI - Mechanisms of continence and voiding, with international continence society classification of dysfunction. AB - The two functions of the lower urinary tract are storage of urine within the bladder and timely expulsion of urine from the urethra. Bladder filling occurs with little or no increase in intravesical pressure, despite large increases in urine volume. This process, called accommodation, results from viscoelastic properties of the bladder wall and reflex inhibition of detrusor contractility. Urinary continence is maintained at rest by outflow resistance generated by the urethral sphincteric mechanism. With increases in intra-abdominal pressure, urethral resistance is augmented by passive pressure transmission to the bladder neck and proximal urethra and possibly by reflex muscular activity within the urogenital diaphragm. Normal voiding is a reflex act under voluntary control that involves relaxation of the urethra and sustained contraction of the bladder until emptying is complete. The ICS has classified lower urinary tract dysfunction as disorders of the filling or storage phase and as disorders of the emptying phase. Although urodynamic testing is not always necessary, some evaluation of both bladder and urethral function in each phase is required for accurate diagnosis. PMID- 2697814 TI - Office work-up of lower urinary tract dysfunctions and indications for referral for urodynamic testing. AB - Multichannel urodynamic evaluation is indicated for the minority of patients with urinary incontinence in an unselected population. The majority of women with urinary incontinence can effectively and accurately be evaluated by the simple office procedures of phase I as described earlier. PMID- 2697815 TI - The urodynamic laboratory. AB - This article reviews some of the technical, philosophical, and procedural aspects of the workings of a clinical urodynamic laboratory. Specifically considered are four widely used tests (cystometry, urethral profilometry, uroflowmetry, and electromyography) and the measuring and recording systems used to generate them. The role of urodynamic testing in the overall evaluation of patients with lower urinary tract dysfunction is addressed. PMID- 2697816 TI - Cystourethroscopy in urogynecology. AB - Cystourethroscopy has become a basic tool in the investigation of female genitourinary problems. It provides the gynecologist with essential information regarding the presence of bladder or urethral pathology and documents ureteral patency. PMID- 2697817 TI - Genuine stress incontinence: pathophysiology and rationale for its medical management. AB - Genuine stress incontinence is a condition in which increments of intra-abdominal pressure produce involuntary urine loss. The condition occurs as a result of urethral sphincteric failure in the absence of involuntary detrusor contractility. Several aspects of this dysfunction are amenable to nonsurgical treatment. These interventions are worth trying prior to proceeding for surgery. PMID- 2697818 TI - The surgery of stress urinary incontinence. AB - The repertoire of procedures available for surgical correction of stress urinary incontinence is reviewed from a historical perspective. All of these procedures fall into three broad groups: transvaginal urethrocystopexies, retropubic cystourethropexies including needle suspension operations, and urethrovesical sling procedures. The difficulties and requirements of some procedures are discussed critically. Argument is made that the urogynecologist needs to be familiar with the technical aspects of all urogynecologic procedures. The choice of procedure or combination of operations in any one patient needs to be determined by the specific abnormalities, both urologic and gynecologic, that are present in that individual patient. PMID- 2697819 TI - Etiology and management of detrusor instability and mixed incontinence. AB - The cause of detrusor instability and mixed incontinence remains elusive. Although DI is most prevalent at the extremes of age, GSI becomes more common with aging and child bearing, and therefore mixed incontinence is common, especially after menopause. Cystometry is used to diagnosis detrusor instability, but urethral closure pressure profilometry is required for assessment of mixed incontinence. DI is managed initially by behavioral therapy, and if this is not satisfactory then FES should be used depending upon availability. Drug therapy should start with oxybutynin at 2.5 to 5 mg twice-daily and increased as necessary to control symptoms. If the effects of therapy are minimal or side effects are too great, other medications or medication combinations should be tried. When the patient does not respond to this level of therapy, transvesical phenol injections should be considered, or, alternatively, a sacral selective neurolysis or neurectomy should be considered. Finally, invasive procedures will have to be considered starting with bladder transection, especially for the patient showing response to medication but intolerant of side effects. Mixed incontinence should be approached with conservative measures for each component. FES or imipramine therapy may help both conditions. If conservative therapy is not beneficial, surgical correction for GSI should be undertaken, with the knowledge that 35 to 50 per cent of patients will also have cure of DI, while the remainder can be treated medically for the DI. PMID- 2697820 TI - Voiding dysfunction. AB - Voiding dysfunction in women results from either a failure of the bladder to contract appropriately or a failure of the urethra or bladder neck to relax during attempts at micturition. Complaints of urinary frequency and urgency most often accompany voiding dysfunction. Associated symptoms, which are not always present, include postvoid fullness, poor flow, hesitancy, and complete urinary retention. Obstructive uroflowmetry and elevated residual urine are suggestive screening tests; however, complete multichannel urodynamic evaluation is necessary to arrive at a specific diagnosis. Once a diagnosis has been made, therapy will be directed at either increasing vesical contractility or reducing bladder outlet obstruction. Acute urinary retention should be dealt with initially by bladder decompression via catheterization. Regardless of the cause of the voiding dysfunction, if further therapy is unsuccessful, clean intermittent self-catheterization may prove to be the best alternative. This can ensure maintenance of relatively low intravesical pressure and residual urine, thus reducing the risk of urinary infection. PMID- 2697821 TI - Urinary frequency and urgency. AB - This article reviews the common causes for urinary urgency and frequency in women. The normal aging process and its effect on lower urinary tract function is reviewed. A stepwise evaluation and appropriate diagnostic tests are described. In addition, a wide variety of therapeutic options are discussed. PMID- 2697822 TI - New approaches in the treatment of urinary tract infections. AB - Our increased understanding of the pathophysiology of urinary tract infections (UTIs) have not only challenged our past approaches to the management of UTIs but also have enhanced our skills to diagnose and control the great majority of UTIs simply, quickly, and cost-effectively. Single-dose treatment is increasingly replacing traditional 10 to 14 days treatment for UTIs. Recurrent UTIs are better understood and becoming more manageable. Newer antibiotics are proving to be very promising and effective with minimal risk of development of resistant strains. PMID- 2697823 TI - Urinary fistulas. AB - Urinary fistulas, although relatively uncommon, present a formidable challenge to the urogynecologist, general urologist, and general obstetrician-gynecologist. Current diagnostic modalities are reviewed and conservative and surgical therapies are outlined. PMID- 2697824 TI - Geriatric urogynecology. AB - Urinary incontinence, a common morbid, and costly phenomenon, is frequently viewed by both patient and clinician as an inevitable consequence of aging. However, we are learning that, with careful evaluation and therapy, incontinence can be improved or even cured in a high percentage of cases. The benefits of appropriate diagnostic and therapeutic programs to both patient and society are highly significant. PMID- 2697825 TI - Congenital and developmental cataracts and multimalformation syndromes. AB - Cataracts are often found in association with many systemic disorders. Some are congenital in origin but in other cases they develop in early infancy or later in life. They are found in association with disorders, connective tissue disorders, neurological conditions, chromosomal abnormalities and dermatological disorders. Some of these syndromes have a genetic basis but often it is uncertain whether they are hereditary and often their cause is unknown. PMID- 2697826 TI - [A method for the surgical treatment of paralytic unstable drop foot]. PMID- 2697827 TI - Diagnosis of thyroid mass due to intravenous digital subtraction angiography- does it play an important part in diagnosis of thyroid mass? AB - 33 patients with thyroid mass were studied by intravenous digital subtraction angiography (IV-DSA), thyroid scintigraphy (TS), ultrasonography (US), and computed tomography (CT). The detective rate of lesion by each diagnostic imaging was as follows: IV-DSA 71%, TS 70%, US 94%, and CT 76%. US was the most excellent and most sensitive diagnostic imaging of both benign and malignant lesions. As regards the thyroid cancer by IV-DSA, malignant findings were heterogeneity, an irregular contour, and an unclear contour of tumor stain. Specific diagnostic rate of each imagings was as follows: IV-DSA 88%, TS 100%, US 86%, and CT 75%. US was not so good imaging of a specific diagnosis for the thyroid mass. As regards the thyroid mass, influence of the common carotid artery and the internal jugular vein were investigated by the degree of compression of both vessels on IV-DSA. However IV-DSA could not reveal tumor invasion to these vessels. We learned present the limit of diagnosis of the thyroid mass due to IV-DSA, because IV-DSA was unable to reveal to us exactly information of both a sensitive and a specific diagnosis. We, however, think that IV-DSA is a useful diagnostic imaging as a mapping study which reveals a coronal image of a relationship between the thyroid mass and the common carotid artery and/or the internal jugular vein in surgery. PMID- 2697828 TI - [Evaluation of mechanisms regulating endolymph pressure in the internal ear. I/]. AB - The review of literature about the inner ear fluid circulation theory was presented. The creation and absorption of fluids were discussed as well as the role of endolymphatic sac in fluid pression regulation. PMID- 2697829 TI - [Organizational and scientific activities of Prof. Benedykt Dylewski in the field of phoniatry]. AB - Prof. dr hab. Benedykt Dylewski was one of the first phoniatrician in Poland. He was working on the fields of diagnosis and therapy of voice and language difficulties in children and school youngsters. The scientific and organizational successes of Dylewski in phoniatrics at the beginning of our century were described. PMID- 2697830 TI - Oxytocin and vasopressin in the gonads. PMID- 2697831 TI - Membrane remodelling during sperm maturation in the epididymis. AB - Identification of molecules or factors on spermatozoa that are involved in the recognition and binding to the zona pellucida of the egg is one of the central problems in current research on mammalian fertilization. This information is important, not just from the standpoint of scientific interest, but also for treatment of male infertility and design of future contraceptive technology. One of the most informative approaches to solving this puzzle has been to study the maturation of spermatozoa in the epididymis. The gradual development of motility and zona-binding capacity by spermatozoa after they leave the testis affords an opportunity to investigate what distinguishes a fertile from an infertile spermatozoon and what mechanisms are involved in the transformation from one state to the other. This chapter has reviewed some of the current information on sperm maturation in the epididymis and attempted to correlate it with concepts emerging from in vitro fertilization experiments. Emphasis has been placed on mechanistic aspects of maturation changes to the sperm plasma membrane, not only because in many species it is the surface membrane that encounters the zona and it is therefore likely to be the site of potential recognition molecules, but also because the plasma membrane influences many intracellular events and has a bearing on the maturation of the nucleus and axoneme as well. An example of the latter is shown by the induction of motility in demembranated testicular sperm by the addition of ATP and Mg2+ (Mohri and Yanagimachi 1980; White and Voglmayr 1986). This suggests that the motor apparatus for motility is essentially present in immature spermatozoa and that one of the requirements for it to become fully operative are subtle alterations to the permeability properties of the plasma membrane. A similar mechanism may also be true of the maturing sperm nucleus to which only passing reference has been made here. Very little is known about this aspect of sperm maturation beyond the increasing stabilization of the nucleoprotein by formation of disulphide bonds (Bedford 1975). The fact that isolated heads from immature spermatozoa fail to form pronuclei if injected directly into the egg (Uehara and Yanagimachi 1977) may explain, in part, the high embryonic mortality observed when not fully mature spermatozoa are induced to fertilize eggs (Orgebin-Crist et al. 1975). Thus maturation events within the nucleus are just as important as those on the surface membrane.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697832 TI - Mammalian sperm interaction with extracellular matrices of the egg. AB - One conclusion that may be drawn from the foregoing discussion is that examination of mammalian gamete interaction at a molecular level is underway. As yet, however, it would be premature to suggest a detailed molecular model to account fully for acrosomal exocytosis. Too many possibilities exist at present, not just for sperm but for virtually all other exocytotic systems studied. It is evident, however, that many elements of typical signal transduction pathways are present in sperm, and recent work supports the idea that such pathways may be used in AR triggering. Investigations at the cellular level provide sufficient data to formulate a sequence of gamete interactions that may apply generally to mammals. This sequence is summarized in Fig. 8.2. It is suggested that the cumulus ECM functions to restrict access of only primed (i.e., capacitated) sperm to the egg. Those sperm that undergo a spontaneous AR in the midst of the cumulus ECM are prevented from further participation in fertilization by adherence to cumulus cells. Thus, a select population of capacitated, acrosome-intact sperm arrive at the zona pellucida surface under the normal conditions of fertilization. Binding to the zona pellucida is initiated by plasma membrane receptors interacting with ZP3. This primary binding results in receptor clustering, which itself is the triggering event for acrosomal exocytosis. The signal is transmitted intracellularly via G proteins to effect fusion between the plasma and outer acrosomal membranes. As a result, proacrosin is exposed. Direct evidence for specific use of ZP2 in secondary binding has not yet been reported, but is inferred from results with mouse (Bleil and Wassarman 1986), and procine (Brown and Jones 1987; Jones et al. 1988; Topfer-Petersen and Henschen 1987, 1988) gametes. This secondary binding between ZP2 and proacrosin occurs together with pH-dependent autoactivation of proacrosin to acrosin. Limited proteolysis of the zona pellucida matrix by acrosin causes digestion and increases the affinity of freshly exposed proacrosin for the zona pellucida. This cycle continues, eventually generating the narrow penetration slit through the zona pellucida. Undoubtedly, other factors are at play here, particularly motility, and it is assumed that vigorously active ('hyperactive') sperm are the cells that participate in these events. This scheme can account for the many diverse observations made in different species if two factors, kinetics and affinity, are considered. In some species, FTU aggregation may occur spontaneously at a rate faster than in others, leading to a higher level of spontaneously acrosome reacted sperm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2697833 TI - Fecundity and natural fertility in humans. PMID- 2697834 TI - [The development of molecular human genetics and its significance for perspectives of modern medicine]. AB - The introduction of molecular human genetics has become a paradigma for the application of genetic engineering in medicine. The main principles of this technology are the isolation of molecular probes, their application in hybridization reactions, specific gene-amplification by the polymerase chain reaction, and DNA sequencing reactions. These methods are used for the analysis of monogenic diseases by linkage studies and the elucidation of the molecular defect causing these conditions, respectively. They are also the basis for genomic diagnosis of monogenic diseases, introduced into the health care system of the GDR by a national project on Duchenne/Becker muscular dystrophy, Cystic Fibrosis and Phenylketonuria. The rapid development of basic research on the molecular analysis of the human genome and genomic diagnosis indicates, that human molecular genetics is becoming a decisive basic discipline of modern medicine. PMID- 2697835 TI - [Social aspects of pediatric genetics]. PMID- 2697836 TI - [Invagination ileus--stages and progress of treatment]. AB - Result from the historic development of the treatment of the intussusception was given an epidemiologic study of the different kinds of possible treatment of infantile intussusception from 1963 to 1988 including 246 affected children. Correlations are established between the duration of anamnesis, the general condition, form of intussusception and possible therapies. Besides indications and contraindications are recommended for hydrostatic and operative evagination as well as for treatment by resection. Furthermore, some conservative methods of treatment are briefly introduced, such as hydrostatic reduction by means of barium enema under x-ray control or by means of visotrast under ultrasonic visualisation, as well as pneumatic reduction. PMID- 2697837 TI - [Clinico-pathology of salivary gland tumors of the head in children and adolescents]. AB - Tumours of salivary glands are rare in childhood and adolescence. Our material consists of 10 observations. The principles of classification of these tumours and the differences to the adults are reviewed. Nonepithelial tumours are diagnosed in a higher percentage in the first two decades of life. Epithelial neoplasms are often connected with doubtful or malignant behaviour. PMID- 2697838 TI - [Use and value of common European lactation-promoting medicinal plants (galactagogues)]. AB - Plant galactagogues can successfully help to stimulate lactation. A survey on the drugs most commonly used in Europe is presented, and their role in folk medicine as well as their efficiency in clinical tests are discussed. Recommendations for galactagogous teas to support breast-feeding are made. PMID- 2697839 TI - [Endogenous colony formation in mice with experimental pathology of the central nervous system]. AB - Models of endo- and exogenous clone formation were used to study colony formation in (CBA X C57B1)F1 mice in different periods after damage to the hypothalamic structures. The following dynamics of colony formation was revealed in the animals with hypothalamic damage in endogenous clone formation: intensified colony formation occurring 24 hours after injury to the brain structures was replaced by a tendency to decrease in 4 days, which was followed by marked inhibition of colony formation 8 days after injury to the hypothalamic structures. The effect of inhibition of colony formation was encountered in animals with damage to the posterior hypothalamic field. No essential changes were revealed in colony formation 4 and 8 hours after hypothalamic injury in exogenous clone formation. Comparison of the results of endo- and exogenous clone formation suggests that the inhibition of colony formation in late-term periods after injury to the posterior hypothalamic field may be due to inhibition of the migration of hematopoietic stem cells from the bone marrow. PMID- 2697840 TI - [Pathogenetic aspects of neutrophil-dependent reactions]. PMID- 2697841 TI - [Acute kidney failure (the participation of endotoxin in its pathogenesis)]. PMID- 2697842 TI - [Standard pathologic processes in the action of chemical environmental factors]. PMID- 2697843 TI - [The terminology and essence of protective reactions of the body to external influences]. PMID- 2697844 TI - [Pimafucin in the treatment of mycoses of the oral cavity in children with chronic blood diseases]. AB - 2.5% solution in the form of oral drops (Gist-brocades) has been used in the treatment of Candida albicans infections of the mucous membranes in children with chronic blood diseases. Out of 34 children 28 recovered completely which is 82.3% of all cases. The highest effectiveness of the preparation was found in the group of children with acute infections. In all cases of chronic candidiasis the improvement of the clinical condition was obtained. Only few children have not shown the growth of Candida albicans in the control investigations. PMID- 2697845 TI - [History of the development of the Polish Pediatric Society. II. Activities of the Governing Board]. PMID- 2697846 TI - [Historical outline of the development of pediatric surgery in Poland up to 1939. I. Hospitals, manpower and events]. PMID- 2697847 TI - [Diagnostic possibilities of echography of the pancreas in children with chronic diseases of the gastroduodenal and biliary systems]. AB - Echography of the pancreas in children suffering from chronic pathology of the gastroduodenal and biliary systems may reveal a considerable incidence and the gravity of pancreatic injuries. The relationship may be found between alterations in the pancreas and the gravity of the pathology in question as well as duration, process spreading, gastric secretion reduction, and the disease entity. The results derived well agree with the reported data on pathomorphology and laboratory diagnosis of pancreatic injuries in the above-indicated pathology and provide evidence in favour of the high information content of echography. A considerable incidence and the intensity of the echographic signs of pancreatic lesions in children suffering from chronic pathology of the gastroduodenal and biliary systems support the appropriateness of echographic studies of the pancreas in the given patients' group. PMID- 2697848 TI - [Evaluation of antibacterial action and synergistic effect of copper sulfate and antibiotics in respect to the main causative agents of chronic pyelonephritis in children]. PMID- 2697849 TI - [Blood lipoprotein, renin and cortisol contents in chronic pyelonephritis in children]. PMID- 2697850 TI - Good as gold: Sir Isaac Newton's alchemy. PMID- 2697851 TI - Founders of pediatric pathology: Le Tan Vinh. PMID- 2697852 TI - Renal transplantation in children. PMID- 2697853 TI - Pediatric liver transplantation: diagnostic pathology. PMID- 2697854 TI - Bone marrow transplantation in pediatrics. PMID- 2697855 TI - Heart-lung transplantation. PMID- 2697856 TI - Graduate education in nursing: route to opportunities in contemporary nursing 1989-90. PMID- 2697857 TI - Education for nursing: the diploma way 1989-90. PMID- 2697858 TI - Practical nursing career 1989-90. Information about NLN-accredited schools of practical nursing. PMID- 2697859 TI - Use of computer-assisted instruction in the health sciences. AB - Instruction and evaluation are two functions that computer-assisted instruction (CAI) handles very well. The computer brings many advantages to the classroom, even though it has some definite limitations. One of CAI's best features is that it can free the teacher to do things that teachers do best--such as one-to-one discussions with students. PMID- 2697860 TI - Pulpal effects of composite resin restorations. AB - This article reviews the literature concerning the pulpal effects of composite resin restorations. A number of aspects are addressed, including the composite resin materials themselves, bacterial leakage, acid-etch technique, and dentin bonding procedures. Guidelines for pulpal protection are discussed. PMID- 2697861 TI - Effects of glass ionomers on recurrent caries. AB - Glass-ionomer cements slowly and continuously release fluoride ions. The studies described in this article have shown that glass ionomers can therefore reduce the incidence and severity of recurrent caries. PMID- 2697862 TI - Evaluation of the ability of glass-ionomer cement to bond to glass-ionomer cement. AB - This study investigated the cohesive bond strengths of glass-ionomer cement at three setting and etching intervals and compared these bonds to the shear strength of the material itself. Bonded cylinders were created and then sheared using the Instron Universal Testing Machine. Analysis of bond values of glass ionomer added to glass ionomer indicate bond variability and low cohesive bond strength of the material. Bond values of unbonded glass-ionomer material indicate that the material itself is stronger than bonds established between bonded samples. PMID- 2697863 TI - Dentinal bonding after chemomechanical caries removal--effect of surface topography. AB - A study was carried out to determine whether or not the topography of the dentinal surface that is left after caries removal affects bond strength. The caries was removed either by a rotating instrument and a bur or by the chemomechanical method using D,L,2-aminobutyric acid. The bond strength appeared to be enhanced on those specimens treated by the chemomechanical removal since the surface was characterized by lack of a smeared layer and by open dentinal tubules and numerous undercuts. PMID- 2697864 TI - [Wit Maciej Rzepecki--physician, surgeon and teacher--on his 80th birthday]. PMID- 2697865 TI - [Structural aspects of pulmonary gas exchange. II. Alveolar epithelium. Endothelium of capillaries of the alveolar wall]. PMID- 2697866 TI - [Therapeutic problems of patients with diabetes mellitus after total pancreatectomy]. AB - Followed were 11 patients after total pancreatectomy (for carcinoma--6 patients, for sequelae of the chronic pancreatitis--5 patients), aged 52-62 years. The follow-up period ranged 5 months up to 4 years. All pacreatomized patients had diabetes needing insulin administration, although the need for insulin decreased with time down to 16-40 units/24 hours after one year. The diabetes was rather brittle with high incidence of hypoglycaemia. In 7 patients keeping exact records the incidence of hypoglycaemic events was 16-24 within the first month, 9-16 in the third month following pancreatectomy. In two patients death was due to the severe hypoglycaemia developing in the later postoperative period. The observations call for a necessary "intensive metabolic care" of every patient, totally pancreatomised. This intensive metabolic care must include not only careful instructing the patients but also his or her family how to behave in a totally different metabolic condition of the patient. Self-control, including blood sugar estimation several times a day gets special importance. PMID- 2697867 TI - [Functional capacity of pancreatic B cells in patients with diabetes mellitus type 2 with late true ineffectiveness of sulfonylurea derivatives]. AB - Fasting concentration of the C peptide in serum was estimated in 150 patients with type 2 diabetes treated with insulin because of the late, true ineffectiveness of the sulphonylurea derivatives. In 36 patients selected out of the total group at random the secretion of that peptide was measured after i.v. injection of 1 mg of glucagon. Only 9 patients showed trace amounts of that peptide at morning fast (Group A--0.17 +/- 0.08 nmol/l), in 69 the secretion was normal (Sub-Group B1--0.80 +/- 0.25 nmol/l), in 48 moderately elevated (Sub-Group B2--1.67 +/- 0.10 nmol/l) and in 24 markedly elevated (Sub-Group B3--4.54 +/- 2.57 nmol/l). The increments of the peptide C concentration after glucagon stimulation were parallel to its fasting concentration, which indicated a proper reactivity of the pancreatic beta-cells in patients with normal or increased basal secretion. The patients with only trace secretion of the peptide C differed from the other by their small, normal body mass and by a longer duration of insulin treatment. Very similar insulin needs must be stressed in the patients of the Groups A and B as well as within the Sub-Groups B. In patients with hyperactivity of the beta-cells (Sub-Group B2 and B3) no differences were found, as compared with the other patients, in the prevalence of chronic diabetes complications of the micro- or macroangiopathy type, also prevalence of hypertension was equal. The results presented show that in the most patients with type 2 diabetes, with the late, true ineffectiveness of the sulphonylurea derivatives the secretory function of the pancreatic islets beta-cells remains normal or is even increased. PMID- 2697868 TI - [Effect of insulin sensitivity on the occurrence of early-morning hyperglycemia in patients treated with insulin]. AB - The study was aimed at elucidation of the effect of insulin-sensitivity on the occurring of the dawn phenomenon. Diabetic patients were investigated in whom the fasting glycaemia was often higher than 17 mmol/l (300 mg%). In all patients the euglycaemic state was maintained by a continuous i.v. infusion of insulin using a micropump and a changing infusion of glucose using Biostator. A slight increase in the insulin-sensitivity was seen in the early morning in 3 patients in whom the glucose consumption during the constant insulin infusion was 4 mg/min/kg b.w. Among 7 patients with lower glucose consumption in 6 a markedly low insulin sensitivity was seen at down. The investigations allow to assume that the dawn phenomenon occurs mainly in patients with uncompensated diabetes which induces changes in insulin-sensitivity. PMID- 2697869 TI - [Lupus nephropathy. II. Treatment]. PMID- 2697870 TI - Hands on technique for the superveneer. PMID- 2697871 TI - [Development of epidemiologic studies of multiple sclerosis]. AB - The description of temporal trends of average, annual age-adjusted or crude multiple sclerosis mortality rates in Europe (1921-1984) was presented. The significance of long-run epidemiological surveys was discussed in the paper. PMID- 2697872 TI - [New trends in studies of the pharmacologic activity of microbial metabolites]. AB - A new broad concept and novel approaches in the search for bioactive microbial metabolites are discussed. Methodology of the screening systems and assay techniques for the pharmacological and immunopharmacological activity of these products is presented. The value of the preliminary target-selective screening procedures is illustrated with a number of the pharmacologically active microbial products, among which the enzyme inhibitors are extremely important. Products with immunopharmacological activity are developed for organ transplantation and antitumor therapy. Another question discussed in the paper is non-antimicrobial and non-antitumor applications of the antibiotics. PMID- 2697873 TI - [The role of inositol triphosphate and diacylglycerol as intracellular second messengers]. AB - The paper presents the mode of formation and action of inositol trisphosphate and diacylglycerol and their role as secondary messengers. PMID- 2697874 TI - [Thrombophilia]. PMID- 2697875 TI - [The structure of the cytoskeleton and its role during platelet activation]. PMID- 2697876 TI - [Metabolism of the connective tissue in generalized scleroderma]. AB - Scleroderma, a connective tissue disorder is characterized by vascular and interstitial reaction with deposition of matrix components. Abnormalities in collagen and glycosaminoglycan structure and metabolism, and regulatory processes of their biosynthesis in scleroderma are reviewed. PMID- 2697877 TI - [Applicator of thermoplasts and its use in dental prosthetics]. AB - The authors describe an apparatus of their own design for the melting and application of thermoplasts. They discuss its construction and possible use for the preparation of fixed and removable dentures. PMID- 2697878 TI - [Experience from a study visit in Denmark]. AB - The author paid a study visit at Dental Royal College in Aarhus, Denmark from 3rd September to 5th November 1987. The postgraduate course was devoted to progressive methods of fixed prosthetics. The author draws attention to some conceptual differences in Danish fixed prosthetics. In the preparation technique there are particularly differences in grinding the grinding of support teeth in metalloceramic works. In the impression technique preference is given to the method of double mixing with injection discharge of elastomer subgingivally and around the circumference of the prepared stump while using a bitumen individual spoon. In the laboratory technique they have been using the American PIN-DEX system of pull-out necks, modelling of buttress construction without relief and together with the construction, in addition to ceramic facet making to chemical facet-making by means of composite bitumen made by KULZER, trade mark DENTACOLOR XS, which polymerize in Ultraviolet light. PMID- 2697879 TI - [Rapidly growing mycobacteria that cause mycobacteriosis in humans]. AB - Rapidly growing mycobacteria of two species, i.e. M. fortuitum and M. chelonei caused in humans mycobacteriosis frequently similar in its manifestations to tuberculosis. The both mycobacterial species were resistant to the majority of antituberculous drugs and sensitive to amikacin, dioxycycline, sefmetazole and some sulfanilamides. It was shown that it was possible to identify the mycobacterial species with the routine tests and paper indicator systems. PMID- 2697880 TI - Simulated drought influences reproduction in male prairie voles. AB - The environmental factors that arrest breeding in prairie voles during the middle of the breeding season are unknown. The role of water availability on reproductive function was examined by limiting water intake to 50% of ad lib water consumption for 10 weeks. At autopsy, testicular, epididymal and seminal vesicle masses were reduced in water restricted males as compared to animals with ad lib access to water. Body mass was also reduced in water restricted males. Plasma testosterone levels and the number of testicular and epididymal sperm were significantly reduced in water restricted voles as compared to animals drinking water ad lib, but plasma levels of luteinizing hormone were unaffected. Taken together, these data suggest that reduced water availability can inhibit male prairie vole breeding. PMID- 2697881 TI - Glucose and insulin responses during mixed meals or infusion of glucose in pregnant and lactating rats. AB - We studied the glucose tolerance in freely moving rats throughout pregnancy and lactation and during the first week after weaning. Dioestrous virgin rats served as controls. Basal glucose and insulin levels were determined after a 2-hr fasting period. Subsequently, the changes of the insulin and the glucose levels were determined during ingestion of a mixed ad lib meal or a 2 g mixed test meal, or during infusion of glucose (7.4 mg/min for 20 min) into the vena cava. Basal glucose levels were high during early pregnancy, low during late pregnancy, and in the normal range throughout lactation and after weaning. Basal insulin levels were decreased at the end of lactation. The results of the ad lib meal and test meal experiments were essentially the same. Glucose tolerance during meals was somewhat decreased early in pregnancy. The corresponding insulin responses greatly increased during the last week of pregnancy. Glucose tolerance during IV infusion of glucose was normal during pregnancy, but increased during lactation. Insulin responses to the infusion were increased during pregnancy and decreased during lactation. We concluded that glucose tolerance is hardly affected by pregnancy and even increases in the course of lactation. This is effected by an increased responsiveness of the B-cells to glucose during late pregnancy and by an increased turnover of glucose during lactation. We discuss to what extent the actions of progesterone, placental lactogen and prolactin may explain these adaptions of maternal metabolism. PMID- 2697882 TI - [Splitting and ambivalence. On the therapeutic dilemma in treating patients with early damage]. AB - The article refers to the pathological problem of severe psychic disturbed patients (with: borderline syndromes/pathological narcism/character neurosis/basic faults and/or disorders of ego structure). The author refers to countertransferences and acting out of affects and reports on the changes and possibilities in the therapy of these patients. The therapists fundamental attitude will be described and supplemented by favouring a treatment in day hospital-settings. Basic literature has been compiled and is reported as survey. PMID- 2697883 TI - [Development of a medical management system for psychiatric patients in Prussia in the 1st half of the 19th century]. AB - In recent years, som noted authors have been reappraising the distinctive features of the history of psychiatry, setting out its relationship to social history. Trends and models, and the legal basic of psychiatric care are demonstrated, taking the early days of psychiatry in Prussia as an example. In the first half of the 19th century there was in Prussia an especially coherent development from the dual-purpose mental hospital/mental home arrangement (Neuruppin), through total separation of asylum from hospital from home for incurables (Siegburg, Leubus) inaugurated by Langermann, to the more or less linking of asylum with hospital with home for incurables (Nietleben) under Damerow. PMID- 2697884 TI - Born of animal magnetism: 150 years of psycho-physiology. AB - The historical beginnings of the scientific discipline of psychophysiology are traced back to the first published English definition by Dr. Samuel Adams, M.D. PMID- 2697885 TI - Autoimmune rheumatic disorders in childhood--a comparison with adult-onset disease. PMID- 2697886 TI - Long-term treatment of irritable bowel syndrome: results of a randomized controlled trial. AB - To examine the long-term management of irritable bowel syndrome we conducted a two-part controlled therapeutic trial on 28 patients who had recovered completely after four to six weeks of treatment with ispaghula husk and propantheline. In part I patients were randomly divided into two groups. Group A received a placebo capsule while Group B continued with treatment as before. After six months the response to treatment was assessed according to a scoring system. The overall relapse rate in Group B was 46 per cent compared to 82 per cent in group A. With continued treatment patients in Group B became asymptomatic from the fourth month while patients in Group A continued to deteriorate. In part II, patients who had relapsed whilst on placebo received active treatment. Six of the seven who agreed to continue with the study became asymptomatic within four weeks. However, all the patients who were asymptomatic while on active treatment relapsed on discontinuation and again recovered on reinstitution of active treatment. We conclude that irritable bowel syndrome is a chronic relapsing disorder and that treatment with a combination of ispaghula husk and propantheline is effective, both in relieving symptoms and in the maintenance of remission. PMID- 2697887 TI - Allosteric linkage-induced distortions of the prosthetic group in haem proteins as derived by the theoretical interpretation of the depolarization ratio in resonance Raman scattering. PMID- 2697888 TI - [On the 180th anniversary of medical education in Warsaw]. PMID- 2697889 TI - [Teaching of dermatology and venereology in Warsaw before the establishment of the first departments of these specialties in Poland]. AB - Teaching and scientific activities were discussed of the outstanding surgeons and internists lecturing on dermatology and venereology at the Academic Faculty of Medicine existing in the years 1809-1816 and at the Faculty of Medicine of The Warsaw University closed by the tsarist authorities after the November Insurrection in 1831. The academic school of medicine could begin its work after a pause of 25 years in 1857 as The Medical-Surgical Academy transformed in 1862 into The Medical Faculty of The Central School closed definitely in 1869 when a Russian university was founded in its place. Those who rendered the greatest services in the development of dermatology and venereology in Warsaw were, among others, Jozef Czekierski, Andrzej Janikowski, Antoni Le Brun, and Polikarp Girsztowt, and in the first place Bronislaw Chojnowski who raised it to the rank of a clinical discipline. After closing of The Central School the main center for the Polish dermatologists and venereologists was The St. Lazarus Hospital. PMID- 2697890 TI - [Academic teaching of dermatology and venereology in Warsaw 1869-1939]. PMID- 2697891 TI - [Various aspects of military dermatology in the light of 180 years of academic medical education in Warsaw]. PMID- 2697892 TI - Assessment of magnetic resonance contrast enhancement with Gd-DTPA: comparison with the uptake of Tc-99m-DTPA. AB - To compare the contrast enhancement of Gd-DTPA with the uptake of 99mTc-DTPA, a study was carried out in two steps. In the first step, images comparable in terms of data acquisition time and thickness were obtained after computer processing, and processed images of 99mTc-DTPA and Gd-DTPA enhanced MRI were compared from the morphological aspect. In the second step, the arterial blood concentration of Gd-DTPA and the effect of T2 shortening on signal intensity were studied. It was concluded that Gd-DTPA enhanced MRI can provide functional information analogous to that obtained from radionuclide studies, possibly enabling semiquantitative analysis of contrast enhancement to be performed. PMID- 2697893 TI - Inflammatory pseudotumor of the liver. AB - A rare inflammatory pseudotumor of the liver diagnosed by US-guided needle biopsy is reported. PMID- 2697895 TI - [Robespierre's mandible. (Reflections on a historic episode, in observance of the bicentennial of the French revolution)]. PMID- 2697894 TI - Clinical value of deconvolution analysis in radionuclide renal study. AB - Deconvolution analysis was applied to radionuclide renal study. The purpose of this study was to clarify the underlying renal physiology that determines the shape and values of the transfer function. Analysis of the renal models revealed that the initial height of the transfer function is the ratio of the radioactivity extracted by the kidney to that in the input function. In addition, the shape of the transfer function displayed the distribution of the transit times and enabled us to evaluate the percentage of nephrons having a particular transit time. Based on the relation between the input and output function, a new method for measuring GFR or ERPF was developed in which the input function was corrected by the plasma radioactivity at 5 min after injection of the tracer. As one of the advantages of the transfer function, it was proved clinically that the contribution of the blood background is automatically eliminated from the amplitude of the transfer function. From these findings, our method for the measurement of GFR was considered superior to that proposed by Gates and highly useful for routine radionuclide renal study. PMID- 2697896 TI - [Notes for the history of dentistry]. PMID- 2697897 TI - [Agnosia]. AB - The term agnosia defines an impairment of stimulus recognition, limited to one modality and not explainable in terms of sensory deficits or general mental deterioration. Visual object agnosia refers to the inability to recognize objects and prosopagnosia to the failure to recognize faces that are well familiar to the patient, when stimuli are visually perceived. Both deficits may appear in an apperceptive form, where it is the internal and external structure of the stimulus to be unrecognized and an associative form where the patient achieves a good percept, but cannot assign it a meaning. Apperceptive forms are preferentially associated with bilateral occipital damage, object associative agnosia with left occipital damage and associative prosopagnosia with right occipital damage. PMID- 2697898 TI - [Current problems in the study of aphasia]. AB - In the introductory part of the present survey the author provides a sketchy illustration of the main anatomo-clinical aspects of aphasia, focusing attention on the main patterns of language impairment and on the corresponding cortical localizations usually observed in patients with cerebro-vascular disorders of ischemic nature. In the second part of the paper, some more recent aspects of aphasiology (namely the subcortical aphasias and the so called slowly progressive aphasia) are shortly discussed. As for the first point, it is suggested that language disorders observed in patients with purely subcortical lesions may be due to a remote effect of these lesions at the level of the cortical association areas, rather than to the subcortical injury per se. As for the second point it is still not clear if the slowly progressive aphasia is a disease or a syndrome resulting from the selective affinity for the posterior association areas of the left hemisphere of degenerative disorders, such as Pick's or Alzheimer's disease. PMID- 2697899 TI - The concept of basic symptoms in schizophrenic and schizoaffective psychoses. AB - This paper presents the psychiatric aspects of the concept of basic symptoms (BS), especially history, actual position and tendencies of development of the doctrine of BS, phenomenology and clinical picture of basic stages, the Bonn Scale for the assessment of dynamic and cognitive basic deficiencies (BSABS) and the importance of this concept for early diagnosis, therapy, prevention and rehabilitation. The patients experience and communicate the BS as deficiencies and are able to cope with, adapt and compensate for them. The BS were termed as basic symptoms because they represent the basis of the productive-psychotic symptomatology. Follow-up studies of cases with the suspicion diagnosis "prodrome of schizophrenia" based on BSABS rating, revealed that the subgroup passing over in schizophrenic psychoses after an average of 6.3 years showed significantly higher scores of cognitive BS at the time of index investigation. It now seems possible to impede increase of cognitive BS already present in prepsychotic prodromal states before reaching the threshold of transition into productive psychotic symptomatology. Long-term development is more favorable if therapy commences as early as possible including the prepsychotic basic stages and also taking into consideration BS which were, until now, disregarded in DSM-III. Summarizing our findings of the last 30 years we suggest that the BS-concept may be an approach to overcome the dichotomy of negative and positive psychopathology in schizophrenia. PMID- 2697900 TI - [Involuntary movements]. AB - Any attempt to classify and to understand the basic mechanism underlying the neurological symptoms as pyramidal and/or sensitive, should start from the fundamental laws of nervous system functioning: 1) the law of reciprocal innervation of Sherrington; 2) the law of hierarchy of levels of Jackson and 3) the law of supersensitivity of deafferented structures of Cannon. Paresis on one side, Jacksonian jerks on the other side represent two opposite conditions known respectively as negative and positive symptoms of corticomotor involvement. Unluckly involuntary movements cannot be explained with these three laws. They are the clinical expression of the disorganization and disintegration of functions: a true disregulation unrespectful of laws and general principles. They must be considered as the result of conflicts of antagonist functions controlling each other, i.e. tremor, chorea, myoclonus, torsion spasm etc. The author emphasizes the clinical-descriptive aspect of the problem. PMID- 2697901 TI - [Amyotrophic lateral sclerosis. In search of its etio-pathogenic mechanisms]. AB - The etiological problem of ALS has still not been resolved although a large amount of work, more and more technical, has been devoted in the fields of immunology, virology, environment and genetics. This research is related to spinal amyotrophies in general--to motor neuron diseases--and it is only as an analogy or as a model that the results may be used in the specific case of ALS. The genetic hypothesis of ALS is suggested by family cases (in adults) and seems to be linked to Parkinson and Alzheimer diseases; all of these are 'degenerative' nervous diseases and there are examples of their association. Research is being done in anatomy, embryogenesis, neurochemistry, molecular genetics to investigate the pathophysiology of neuron considered the only way to develop a specific therapy. The treatment, although still symptomatic, is improving due to technical progress in management. PMID- 2697902 TI - [Pyramidal syndrome: its physiopathology and treatment]. AB - Is characterized by several various signs. One of these, spasticity, involves a velocity dependent increase in muscle stiffness during stretch and by hyperactive tendon jerks. When intense, spasticity impedes residual strength in antagonistic muscles and interferes with attempts to move, especially if complicated by clonus and/or spasms. Assessment of spasticity is multifactorial and implies clinical as well as instrumental methods. The pathophysiological mechanisms responsive for the hyperexcitability of the myotatic reflex can be studied by methods of clinical neurophysiology. It appears that there are various factors involved at the spinal level, involving reduction in both pre- and post-synaptic inhibitions. Although spasticity is not responsible for the major part of the disability imposed by upper motor neurone syndrome, it should be reduced. The therapeutic methods are medical, surgical or from physical medicine. In many cases, the results have been validated by blind studies. As paresis is the most disabling effect, it would be worthwhile to develop drugs able to reduce spasticity and increase muscle strength at the same time. Recent trials suggest than TRH-T may be effective in this regard. PMID- 2697903 TI - Current advances in research in Alzheimer's disease. AB - The pace of research into Alzheimer's disease has quickened remarkably in the last few years as it has entered the realms of genetics and molecular biology. The nature of the protein giving rise to the amyloid deposits in senile plaques has been identified together with its location on chrosome 21, which is also the chromosome (although at a different locus) on which the abnormality in the familial form of the disease is found. Together with previous neuropathological and neurochemical data implicating specific neuronal populations - particularly the basal forebrain cholinergic system projecting to the cortex - in cardinal clinical features of the disease such as memory loss, it would seem that scientists are on the verge of understanding the foundamental nature of the disease process. However, in the absence of any clues regarding the cause of the disease in the predominantly "sporadic" cases and of any effective clinical treatment, new insights are clearly urgently needed. The present review highlights currently active areas of research and attempts to outline unexplored areas where novel approaches are now required. PMID- 2697904 TI - Current trends in treatment of transient ischemic attacks. AB - Current trends in treatment of transient ischemic attacks (TIAs) are reviewed. Patients with TIAs should be treated individually, the main goals of therapy being to avoid cerebral infarction and vascular death. Management of risk factors includes control of high blood pressure, dyslipoproteinemias, diabetes mellitus, atrial fibrillation, cardiac arrhythmias, and overweight. A healthy diet, exercising and non-smoking are additional useful measures. The most commonly used antiplatelet drug is aspirin. Doses of 325 mg per day are as effective as doses of 1,300 mg per day but have fewer side effects. Ticlopidine seems the best antiplatelet drug currently available; it is given in doses of 500 mg per day for a month and then 250 mg per day for the rest of the patient's life. Anticoagulants have not shown their advantages over drugs that prevent platelet aggregation. However, when a patient under treatment with warfarin with an adequate dose range suffers recurrent TIAs, warfarin can be used in association with ticlopidine. On the other hand, if patients under treatment with ticlopidine have further TIAs, they should be switched to anticoagulants for 6 months and then back to antiplatelet drugs. With regard to surgery, an effective means of prolonging survival seems to be the treatment of coronary artery disease before carotid endarterectomy is considered. The effectiveness of carotid endarterectomy is being evaluated in ongoing multicentric, randomized, controlled clinical trials. PMID- 2697905 TI - Methods of evaluation of psychoactive drugs. AB - The classification of psychoactive drugs into minor tranquilizers (i.e. antianxiety drugs) and major tranquilizers (i.e. antidepressants, antimaniacs and antipsychotics) is based on clinical symptom rating scales. The group of symptoms in these scales of anxiety, depression, mania and schizophrenia has a shared phenomenology in the sense that the symptoms can be ordered from less to more severe. The inter-observer agreement when using these scales is adequate as agreement is of 80% or higher. By use of rating scales it has been found in controlled clinical trials that minor psychiatric disorders such as anxiety states without depression have a good outcome of placebo in 60 to 65%. In depressive disorders placebo has a good outcome in 20-45%, but in the elderly depressed patient the placebo effect is poorest (25%). Antidepressants have a good outcome in 60-75%, but in the elderly depressed patients only in 50%. In other words the drug-placebo difference is around 25%. In the major psychiatric disorders such as mania and schizophrenia the drug-placebo difference is around 50%. The use of clinical symptom scales in evaluating side-effects of psychoactive drugs is increasing. However, also non-clinical or laboratory tests have an important role in measuring side-effects, especially in motor skills related to car driving. The use of mentally healthy volunteers in measuring side effects of major tranquilizers seems inadequate. As yet no biological methods to measure clinical effects of the tranquilizers have been developed for practical use. PMID- 2697906 TI - Immune networks: getting on to the real thing. AB - After some ten years of faltering development, the network approach in immunology is finally heading toward steady ground. At a recent international workshop (*), experimentalists and theoreticians discussed some of the latest developments, including an impressive array of novel results and applications to fundamental properties of biological immune networks: connectivity, patterns of dynamic activity, ontogenesis, and tolerance. PMID- 2697908 TI - What don't we know about dendritic cells? PMID- 2697907 TI - Phenolic glycolipid-1 from M. leprae inhibits oxygen free radical production by human mononuclear cells. AB - We studied the effect of PGL1, a phenolic glycolipid unique to Mycobacterium leprae, on the activation of the phagocyte oxidative respiratory burst, by measuring the chemiluminescence (CL) generated by normal mononuclear cells. PGL1 induced a decrease in oxygen free radical production stimulated by mycobacteria (M. leprae, BCG and M. kansasii) or by phorbol myristate acetate, but did not prevent the binding or ingestion of fluorescein-conjugated mycobacteria. In contrast, mycoside A from M. kansasii, a structurally related compound, did not alter the CL response. In addition, treatment of M. leprae with anti-PGL1 antibodies failed to restore the response to this microorganism. PGL1 could act as an oxygen species scavenger and protect M. leprae from killing by toxic oxygen metabolites. PMID- 2697909 TI - Dendritic cell ontogeny. AB - Abundant evidence indicates that dendritic cells arise from the bone marrow. In vitro, precursors that differ phenotypically from mature dendritic cells divide several times to form functional dendritic cells. A soluble factor(s) produced in the supernatants of ConA-stimulated spleen cells enhances the production of dendritic cells. This factor(s) has not been fully characterized. Further maturation of dendritic cells occurs after they are released from the bone marrow; species differences exist. Interrelationships between various types of dendritic cells need to be elucidated. PMID- 2697910 TI - Dendritic leukocytes: features of their in vivo physiology. PMID- 2697911 TI - Immunocytochemistry of dendritic cells. A clue to their function? PMID- 2697912 TI - Structural and functional relationships between epidermal Langerhans cells and dendritic cells. AB - Langerhans cells are dendritically shaped MHC-class II-bearing leukocytes which reside in the epidermis. During short-term culture, they develop into cells that are virtually indistinguishable from lymphoid dendritic cells with respect to morphology and phenotype, as well as function. It is hypothesized that Langerhans cells in situ represent immature precursors of dendritic cells. PMID- 2697913 TI - Migration patterns of dendritic leukocytes. PMID- 2697914 TI - Dendritic cells in contact sensitivity. AB - Bone-marrow-derived DC, passing through the skin or residing there as LC, acquire antigen following epicutaneous exposure to contact sensitizer. They move as veiled cells in the afferent lymphatics and migrate to draining lymph nodes, where they become interdigitating cells of the paracortex. Here they initiate T cell responses; the cytotoxic T cells and antibody formation which develop may be able to target on DC as well as other antigen-bearing cells, so producing feed back mechanisms to switch off immune responses. Additional features include a systemic effect which leads to movement of DC without antigen into lymph nodes. What are the signals leading to this movement and what is its significance? There is evidence for synergy between directly haptenated DC and DC not directly acquiring antigen. How does this occur and how important is this effect in ensuring the potency of DC in presenting contact sensitizer to T cells? What is the importance of antigen processing by LC? Finally, dendriform cells which may be of T-cell origin are also present in the skin. What is their role in modulating the development of contact sensitivity? PMID- 2697915 TI - Dendritic cells: clinical aspects. AB - Clinical aspects of dendritic cells have yet to be studied intensively. One obstacle, that of isolating and identifying dendritic cells from human blood and other tissues like skin and tonsil, is being overcome, although the field would be facilitated by dendritic-cell-specific monoclonals or other probes. Many of the specializations that dendritic cells exhibit as antigen-presenting cells in other mammals are being verified in man. New properties, particularly their capacity to induce clonal expansion of T cells and to be infected with retroviruses, have become evident. Four areas where it may be productive to give more attention to dendritic cells are transplantation, protective T-cell immunity, autoimmunity and HIV-1 infection. PMID- 2697916 TI - Award of Merit in Retina Research. Matthew D. Davis, MD. PMID- 2697917 TI - Late bacterial endophthalmitis following retinal detachment surgery. AB - We report two cases of late postoperative bacterial endophthalmitis that occurred following retinal detachment repair. Both patients presented months after their scleral buckling procedures with a subacute uveitis. Over a period of one to two weeks, the inflammation gradually increased, until the classic clinical appearance of fulminant bacterial endophthalmitis was present. In an effort to treat the infection, a pars plana vitrectomy was performed in both cases. At the time of vitreous surgery, intrusion of the scleral buckling elements into the globe was observed, suggesting a possible means of entry for the infectious agent. Removal of the buckling elements, repair of the scleral defects, and injection of intravitreal antibiotics were performed as therapeutic interventions. Vitreous cultures were positive in both cases for Proteus mirabilis. Postoperatively the retina remained attached in both instances, and, in one case, the visual acuity returned to 20/20. PMID- 2697918 TI - The successful removal of a subretinal cysticercus by pars plana vitrectomy. AB - A 39-year-old woman from Belize presented with recent vision loss in her left eye due to a subretinal cysticercus located near the macula. We are reporting the use of standard vitrectomy instrumentation and techniques to successfully remove the subretinal cysticercus by a transretinal approach. Pars plana vitrectomy with transretinal removal of the cysticercus is a useful alternative to the traditional external sclerotomy. PMID- 2697919 TI - Combined hamartoma of sensory retina and retinal pigment epithelium. AB - We report two cases of combined hamartoma of the sensory retina and retinal pigment epithelium (CHR-RPE) in which apparent growth of the lesion was observed. In case 1, the eye was enucleated with a presumed diagnosis of juxtapapillary malignant melanoma. Histopathologically, the enucleated globe showed an elevated peripapillary mass containing disorganized retinal tissue intermixed with vascular and glial elements as well as tubules of proliferating retinal pigment epithelium. We have summarized the clinical features of 53 patients with CHR-RPE reported between 1952 and 1988 excluding the cases compiled by the Macular Society Collaborative Study. While the latter study found an equal sex predilection among their cases, we found a 70% male preponderance among the 53 patients. Of the 54 lesions observed in 53 patients, 76% were juxtapapillary, 17% were macular, and 7% were peripheral. Furthermore, periodic follow-up examination disclosed apparent enlargement of the mass in six patients, five of whom underwent enucleation of the globe for suspected melanoma. PMID- 2697920 TI - Radiographic diagnosis of esophageal diseases in dogs and cats. PMID- 2697921 TI - Canine gastric dilatation--volvulus update. PMID- 2697922 TI - Clinical pharmacology of antiemetic and antiulcer drugs. PMID- 2697923 TI - Pancreatic APUDomas. PMID- 2697924 TI - Diarrhea in the cat. PMID- 2697925 TI - Protein-losing enteropathy. PMID- 2697926 TI - Short bowel syndrome in dogs and cats. PMID- 2697927 TI - Constipation: pathophysiology, diagnostic approach, and treatment. PMID- 2697928 TI - [Psychiatric interconsultation: concepts and development]. AB - There has been an important development of consultation-liaison psychiatry in the last fifty years. Psychosocial factors and psychiatric symptoms which can be present in many somatic ilnesses have been considered as deserving of more specialized care. This could be achieved by a multidisciplinary team with the presence of a psychiatrist either permanently (consultation-liaison psychiatry) or episodically (psychiatric consultation). The Brazilian experience in this field can be illustrated describing the "Servico de Interconsultasa do IPQ HC FMUSP". Organized in 1979, this clinic has been rendering both psychiatric consultation and liaison work (which, from a practical point of view, are complementary services). The clinic is also involved with research and medical education. There is agreement that psychiatric care in a general hospital brings evident benefits to the patient, to the psychiatrist, to non-psychiatric physicians, and to other team members not only in terms of developing new professional opportunities, but also in terms of broadning the research field and improving medical education. PMID- 2697929 TI - [Hemodynamic and pulmonary effects of nifedipine]. AB - The authors reviewed the actions of nifedipine, a blocker of calcium channels, on the systemic and pulmonary circulation. The mechanism of action of the drug on the systemic and pulmonary circulation and on the gas exchange is discussed. The main effects of nifedipine on the coronary circulation and indications for therapeutic use of the drug are discussed on the topics of coronary insufficiency, systemic and pulmonary blood hypertension, acute respiratory failure, and Raynaud's phenomenon. PMID- 2697930 TI - [Cytologic diagnosis of tuberculous mastitis. Report of a case and review of the literature]. AB - A case of breast lump is reported in a 42-year old woman, clinically simulating carcinoma. A fine-neddle aspiration biopsy was performed, the cytology showing granulomatous inflammatory process and Mycobacterium tuberculosis. Review of the literature was undertaken and discussed with regard to incidence, clinical presentation, mode of infection, classification, treatment and diagnosis of tuberculous mastitis, focusing on the fine-needle aspiration biopsy as a diagnosis procedure and the cytologic examination findings in tuberculous mastitis. PMID- 2697931 TI - [Recurrent inguinal hernia: study of 87 cases]. AB - A retrospective analysis is made of the data of 87 patients with recurrent inguinal hernias operated at the Hospital das Clinicas of the University of Sao Paulo in a period of six years. As it happened with other authors, frequency of recurrence was: direct hernia (43.5%), indirect hernia (50%), the less often seen mixed form (3.9%), and crural hernia (2.6%). They discuss local and systemic etiopathogenic factors, strain in the early postoperative period being indicated as a major factor, responsible for 43.1% of the cases. More than half of recurrences (48/85) occurred in the first year, some occurring after a longer period of time (30.6% after three years). The mostly used repair techniques were modified Bassani's technique (suture of the transverse arch to the inguinal ligament) and the Lotheissen-McVay technique, in 46.1% and 42.5% of the cases, respectively. In 9 of the 85 cases, tightening the deep inguinal orifice was enough. Analysis of the rate of surgical failure was difficult, as patients did not routinely return for follow-up visits. PMID- 2697932 TI - [Schistosoma mansoni: quantitative aspects of the development of irradiated cercariae in the skin, lungs and portal system, in mice]. AB - The migration of Schistosoma mansoni (LE and SJ strains) has been studied in eight groups of outbred Swiss albino mice (Mus musculus), which were previously infected with ca 450 cercariae, transcutaneously. The infection of mice was performed with non irradiated cercariae (control groups), or with gamma irradiated cercariae, at the schedule of 3, 20 and 40 Krad. Regarding the skin, a progressive decrease was detected for the recovery rates, related to the time of infection. As far as the lungs and portal system are concerned, a significant inverse correlation was observed between the total recovery rate and the irradiation dosages. The dose of 20 Krad practically hinders the migration of the parasites (in both strains) from the lungs to the portal system, whereas the dose of 40 Krad prevents the migration of most of the parasites from the skin to the lungs. PMID- 2697934 TI - [Physiology and physiopathology of the coagulation system]. PMID- 2697933 TI - Enzyme linked immunosorbent assay: determination of anti-adenovirus antibodies in an infant population. AB - In order to define an accurate assay for anti-adenovirus antibody detection, a recently developed ELISA was compared with IFA and CF. On 58 sera, the ELISA was more sensitive than both CF and IFA, which showed relative sensitivities of 63% and 94%, respectively. It was not possible to determine the exact specificity of the tests because of the lack of a gold standard. Furthermore, the ELISA was used to define the prevalence of adenovirus antibodies in 116 infants between 1 and 24 months old (mean 7.28). The data showed that maternal antibodies waned by the age of 5 to 6 months and that more than 80% of the children had been infected by adenoviruses by the age of 10 months. PMID- 2697935 TI - [Relation between blood viscosity and ischemic pathology of an organ]. PMID- 2697936 TI - [Physiopathological suppositions in the therapy of acute cerebral infarction by hemodilution]. PMID- 2697937 TI - Defining foci of cellular alteration in short-term and medium-term rat liver tumor models. AB - Evaluation of foci of cellular alteration is utilized in short-term and mid-term rat liver models to assess chemicals for potential carcinogenic effects. Such foci are morphologically defined and readily identified by a variety of histological stains. No single morphological marker appears capable of identifying all foci because of their phenotypic heterogeneity. Since most rodent hepatocarcinogens induce an increase in the size and/or the number of foci prior to tumor appearance, foci are believed to be precursors to hepatic tumors. The size, number, phenotype and conversion rate of foci to tumors is chemical dependent. Despite certain limitations, the quantitation of rat liver foci provides a useful means to study the mechanism of action of selected chemicals and assess their carcinogenic potential. PMID- 2697938 TI - Testing statistical hypotheses about rat liver foci. AB - Tests of statistical hypotheses concerning treatment effect on the development of hepatocellular foci can be carried out directly on two-dimensional observations made on histologic sections or on estimates of the density and volume of foci in three dimensions. Inferences about differences in the density or size of foci from tests based on two-dimensional observations, however, can be misleading. This is because both the number of focus cross-sections observed in a tissue section and the percent area occupied by foci can be expressed in terms of the number of foci per unit volume of liver tissue and the mean focus size. As a consequence, a treatment difference may be caused by a difference in the density of foci, their average size, or both. Of more serious concern is the possibility that failure to detect a treatment effect may occur not only when there is no treatment effect but also when the density and size of foci differ between treatments in such a way that their product is unchanged. This can happen if the effect of treatment is to increase the number of foci and decrease their average size, or vice versa. A similar difficulty of interpretation is associated with hypothesis tests based on average focus cross-section area. Tests based on estimates of the number of foci per unit volume and mean focus volume allow direct inference about the quantities of interest, but these estimates are unstable because they have large variances. Empirical estimates of statistical power for the Wilcoxon rank sum test and the t-test from data on control rats suggest power may be limited in experiments with group sizes of ten and low observed numbers of focus cross-sections. If hypothesis tests based on estimates of the density and size of foci are to form the basis for a bioassay, then the power of statistical tests used to identify treatment effects should be investigated. PMID- 2697939 TI - Critical parameters in the quantitation of the stages of initiation, promotion, and progression in one model of hepatocarcinogenesis in the rat. AB - Critical parameters in the quantitation of altered hepatic foci (AHF) developing during multistage hepatocarcinogenesis in the rat include: 1) the enumeration of AHF induced by test agents as well as those AHF occurring spontaneously in livers of untreated animals; 2) the volume percentage or fraction of the liver occupied by all AHF as a reflection of the total number of altered cells within the liver and the degree of tumor promotion which has occurred; and 3) the phenotype of individual AHF as determined by multiple markers with serial sections. These parameters, especially the number of AHF, should be corrected by the presence of spontaneous AHF which increase with the age of the animal, more so in males than females. While accurate estimation of the background level of spontaneous AHF can be important in demonstrating that a carcinogenic agent does not possess the ability to increase the numbers of AHF above the background level, a better method to distinguish the effectiveness and relative potencies of agents as initiators or promoters is reviewed. The relative effectiveness of four different markers--gamma-glutamyltranspeptidase (GGT), a placental form of glutathione S transferase (GST), canalicular ATPase, and glucose 6-phosphatase (G6Pase)--was described for the chemicals C.I. Solvent Yellow 14 and chlorendic acid as promoting agents in males and females. C.I. Solvent Yellow 14 is a more effective promoting agent in females than males, and AHF exhibit extremely low numbers scored by GGT. On the other hand, the numbers of AHF present in livers of male rats promoted by this agent are more than twice those seen in livers of female animals, possibly owing to the effectiveness of this agent as an initiator in the male but not the female. Very few AHF, especially in the male, are scored by GGT during chlorendic acid promotion. The distribution of phenotypes with these markers also differs in the spontaneous AHF appearing in the livers of animals fed 0.05% phenobarbital on either a crude NIH-07 or AIN-76 purified diet. Such studies emphasize the extreme dependence of the promoting stage of hepatocarcinogenesis on environmental factors of sex, diet, and the molecular nature of the promoting agent itself. The hallmark of the final stage of progression in the development of hepatocellular carcinomas is aneuploidy, which may be reflected by phenotypic heterogeneity within individual AHF, termed foci in-foci. The implications of such quantitative analyses during hepatocarcinogenesis induced by specific agents in relation to the specific action of the agent at one or more of the stages of hepatocarcinogenesis are discussed. PMID- 2697940 TI - Significance of sequential cellular changes inside and outside foci of altered hepatocytes during hepatocarcinogenesis. AB - A variety of phenotypic cellular changes emerge in the liver of different species prior to the appearance of hepatocellular adenomas and carcinomas induced by carcinogenic agents (chemicals, radiation, hepadna viruses) or develop "spontaneously." Foci of altered hepatocytes have been studied most extensively in rats treated with chemical carcinogens; they are considered preneoplastic lesions and have been used in several laboratories as endpoints in carcinogenicity testing. The principles and problems of the morphological classification of foci of altered hepatocytes are presented. In addition to the 4 types of foci generally accepted (clear, acidophilic, basophilic and mixed cell foci), further subtypes (intermediate cell foci) or other types of foci, namely tigroid cell foci and amphophilic cell foci, have more recently been separated as distinct pathomorphological entities. Whereas the amphophilic foci might result from a modulation of clear and acidophilic cell foci, the tigroid cell foci apparently represent a stage in a separate cell lineage leading to hepatocellular adenomas. It remains open whether the tigroid cell foci may also progress to carcinomas. Extrafocal phenotypic changes of hepatocytes might also be involved in hepatocarcinogenesis. The cellular phenotypes within foci also depend strongly, among many other factors, on the dose and duration of the carcinogenic treatment. Cytomorphological, cytochemical, microbiochemical and stereological studies suggest that the predominant sequence of cellular changes during hepatocarcinogenesis leads from the clear and acidophilic cell foci storing glycogen in excess through mixed cell foci and nodules to basophilic cell populations prevailing in hepatocellular carcinomas. A multitude of metabolic aberrations is associated with the sequential cellular changes. Aberrations in carbohydrate metabolism are particularly prominent and might be causally related to the neoplastic transformation of the hepatocytes. PMID- 2697941 TI - The significance of chemically-induced hepatocellular altered foci in rat liver and application to carcinogen detection. AB - This review describes the pathogenesis and significance of chemically-induced hepatocellular altered foci in rat liver. The measurement of induction of foci can be used for carcinogen detection and the measurement of the modulation of foci by chemicals other than the inducing agent identifies enhancers or inhibitors of liver carcinogenesis. PMID- 2697942 TI - Documenting foci of hepatocellular alteration in two-year carcinogenicity studies: current practices of the National Toxicology Program. AB - Altered hepatocellular foci (AHF) can be reliably identified in hematoxylin and eosin (H&E)-stained sections of liver from interim and final sacrifice intervals in 2-yr carcinogenicity studies in rats. While most AHF can be categorized on the basis of a defined set of descriptive terms, viz., basophilic, eosinophilic, clear vacuolated, and mixed foci, exposure to hepatocarcinogenic agents may induce unique types of AHF which should be distinguished from those that occur more commonly. It is proposed that unique treatment-associated AHF be classified as atypical AHF and that they be completely described in the pathology narrative accompanying the study. Since profound changes in the number and size of AHF have been documented in Fischer 344 rats with mononuclear cell leukemia, it is recommended that liver focus data from leukemic animals be censored in assessing potential effects of treatment on AHF. At the present time, there are insufficient data to allow routine use of AHF in regulatory decision-making in the absence of a liver tumor response. However, such data may form part of weight of-evidence considerations used by regulatory bodies when accompanied by a concomitant liver tumor response. PMID- 2697943 TI - Evaluation and grading of rat liver foci in carcinogenicity tests. AB - The significance of rat liver foci in carcinogenesis testing received major attention following their description in the National Cancer Institute workshop of 1974. However, the biological nature of foci remains uncertain despite numerous studies during the past 15 years. That is, in part, because criteria to define foci have been inconsistent, and studies of spontaneous foci in rats have been very few. This symposium has demonstrated that the induction or enhancement of rat liver foci, per se, may not provide sufficient evidence to classify a test compound as a carcinogen. Evidence presented suggests that some types of rat liver foci may not be related to carcinogenesis, and there is, consequently, a basis to further subclassify these lesions. In cases where foci are considered to be a part of the neoplastic process, semi-quantitative grading of these lesions, as well as of tumors, according to the extent of their development or progression, may assist in the interpretation of equivocal carcinogenicity test findings. PMID- 2697944 TI - The documentation of Nazi medicine by German medical sociologists: a review article. AB - Research by medical sociologists, historians, and representatives of other disciplines in Hamburg, West Germany, is reviewed as an example of ongoing detailed exploration of health and social policies under the Nazis which resulted in devastating human consequences, and of a continuing impact on present official policies and actions. An almost total silence by organized West German medicine about its role during the national socialist regime, and the failure of many administrators, university researchers, and a large segment of the general public since then to deal with the past and its consequences conscientiously were turned into a focal charge during a congress on health held in Berlin in 1980 under the auspices of politically and socially concerned professional individuals. The resulting documentation of the facts and their publication in a series of books and articles is a part of the effort to allow Germans to face their past, and to relate it to the long shadows cast into the present. The Hamburg reports reveal details of specific past activities and illustrate the repeated failures to hold individuals accountable for their participation in irresponsible health administrative acts and medical practices as well as the denials of the persons concerned and their retention in public and professional roles. The ongoing general historical debates in West Germany concerned with the proper interpretation of Nazi history illustrate the significance of the specific research tasks adopted by these medical social scientists and historians. Though not further explored in this review, the theoretical implications of these reports for the systematic study of medical systems is illustrated by abstraction of basic issues addressed in these research efforts. PMID- 2697945 TI - Community health services and health care utilization in rural Bangladesh. AB - The study, which is based on data from two household level health surveys conducted in 1976 and 1987 in the Companiganj area of rural Bangladesh, examines the premise that the utilization of public health care services can be increased by increasing the availability and accessibility of effective medicines to the public and by improving the disease recognition and management by the health practitioners. The results of the study suggest that the availability and accessability of modern effective medicines through the provision of decentralized community-based rural health services, by a well-trained and well managed field personnel structure, had an incremental impact on the utilization of modern health care from a rural health center and its subcenters. The study further reveals that, in 1976 as well as in 1987, the overwhelming majority of the rural Bangladesh population were using modern Western medical practitioners, although most of these practitioners were informally trained or self-trained without any formal medical degrees or training. It is concluded that the persons responsible for health program planning and health program implementation need to ensure that the access to basic public health care services be made broad enough to cover the majority of the rural population through a system of decentralized curative and preventive services, as well as through a system of adequate training and deployment of health professionals, including training programs to improve the quality of medical services offered by the informal and self-trained practitioners of modern medicines. PMID- 2697946 TI - Epidemiological appraisal of the active role of women in the decline of infant mortality in Spain during the twentieth century. AB - This paper is concerned with the question of the role which the psycho-cultural development experienced by women in developed countries throughout this century may have played in the decline of infant mortality, taking in Spain between 1900 and 1979 as a basis for observation. We think that, by studying the psycho cultural development of women, included under the general concept of standard of living, we can take a step forward in explaining such a frequently investigated but nonetheless incompletely understood subject as is that of the marked decline of infant mortality which has taken place in this century in developed countries in general, and in Spain in particular. To this effect, we have attempted to demonstrate the need to consider socio-cultural factors, in addition to the already repeatedly studied economic and biomedical ones; the more so when we take into account the marked decline in infant mortality which occurred in Spain in the 1940s, in which period there was a pronounced stagnation in the economy. To this purpose, we have studied fertility, not only as a gauge of the biological risks which generate a certain reproductive pattern for infant mortality, but also as an indicator of the socio-cultural development of women. Similarly, and through a review of historical documents, we have analysed the role of women in birth control, their incorporation into more qualified jobs, their level of education, their growing awareness of their own situation in society, as well as pertinent legislative changes. All these processes affect the health of children through factors which, although they are very difficult to evaluate and quantify, have previously been described and examined in other studies. Our study has shown the probable relationship between the decline of fertility and the decrease of infant mortality, in view of the fact that there has been a pronounced decrease of parity and fertility in women belonging to the oldest fertile age groups. Similarly, the indications pointed out with respect to the processes mentioned above lead us to infer that in Spain the woman has played a significant role in the decline of infant mortality produced in this century, and especially in the first half of the century. We have embarked on a scantily developed line of investigation, and suggest the need for new studies on the subject. PMID- 2697947 TI - [Autotransplantation of bone marrow in acute leukemias. Possibilities of eliminating the minimal residual disease]. PMID- 2697948 TI - [Relevance of fibrinogen/fibrin degradation products in the study of thrombosis]. PMID- 2697949 TI - [Histidine-rich glycoprotein: modulator of coagulation and fibrinolysis]. PMID- 2697950 TI - [The aspects of the problem of systemic vasculitis open to discussion]. AB - Some controversial problems in the diagnosis of systemic vasculitis are discussed. The importance of the morphological studies is assessed. The data are provided on the interrelations between skin and systemic vasculitis, on the existence of the local forms of vasculitis, the presence of the crisscross, mixed and combined forms of vasculitis, and on the possibility of the primary chronic disease course. The data obtained are based on the results of the prolonged observation over 325 patients suffering from systemic vasculitis. PMID- 2697951 TI - [The effect of dimethyl sulfoxide on the thromboelastographic indices and the microcirculation in patients with rheumatic diseases]. AB - Using a blind method for assessing the results, a study was made of the effect of dimethylsulfoxide (DMSO) on fibrin formation and microcirculation in 42 patients with rheumatic diseases (rheumatoid arthritis, systemic scleroderma, Raynaud's syndrome). It has been shown that the therapeutic effect of DMSO in rheumatic diseases is determined to a definite degree by its normalizing action on fibrin formation and microcirculation. PMID- 2697952 TI - [The effect of pharmacological agents on pancreatic incretory activity in patients with chronic pancreatitis]. AB - In chronic pancreatitis with moderate derangements of carbohydrate tolerance (detected by the double glucose test), the basal concentrations of insulin and C peptide in blood are normal whereas in patients with secondary diabetes mellitus are lowered. Glucagonemia is increased in patients of both groups. Euphylline (applied as an inhibitor of nucleotide phosphodiesterase), calcium gluconate and the adrenomimetic drug isadrin consistently increased insulinemia and the blood level of C-peptide in patients with chronic pancreatitis both with moderate and appreciable derangements of glucose tolerance. In patients with secondary diabetes that developed in the presence of pancreatitis, these drugs did not influence glucagonemia. The clinical prospects of the making use of the stimulating action of euphylline, calcium gluconate and isadrin on the function of beta-cells of the pancreas in chronic pancreatitis patients are under discussion. PMID- 2697953 TI - [The laser therapy of rheumatoid arthritis]. AB - About 300 patients with rheumatoid arthritis (RA) underwent multimodality treatment including laser radiation of varying wavelengths. Use was made of helium-neon, infrared, argon and helium-cadmium lasers. A new method of combined laser therapy by radiation of helium-cadmium and helium-neon lasers is described. A scheme of optimal parameters and types of laser radiation recommended for the treatment of different clinical varieties of RA is provided. PMID- 2697954 TI - [The results of and prospects for research on lysosomal enzymes in pulmonology]. PMID- 2697955 TI - [The comparative results of a short course of nadolol and propranolol treatment of arterial hypertension patients (cooperative research). The Working Group of the Cooperative Program for the Study of New Preparations in Preventing Arterial Hypertension]. AB - The short-term continuous treatment with propranolol and nadolol, a long-acting nonselective beta-adrenoblocker without own sympathomimetic activity, conducted in two randomized groups of men with stable arterial hypertension (the diastolic AP greater than or equal to 95 mm Hg) has shown that by its hypotensive and negative chronotropic effects nadolol given in the mean dose 87 mg/day compared very favourably with propranolol administered in a dose of 144 mg/day. At the same time nadolol is more fit for patients since it may be taken once a day. The influence of both beta-blockers on the hemodynamic, metabolic parameters and external respiratory function was similar. Nadolol in doses of less than 200 mg/day did not lower the rate of glomerular filtration. On the use of the drug in doses of 240 and 280 mg/day the rate of glomerular filtration slightly decreased. PMID- 2697956 TI - [The importance of ultrasonic study of the right heart ventricle and pulmonary artery in the diagnosis of hypertension of the lesser circulation]. AB - The data obtained during ultrasonic examination of the right heart ventricle and pulmonary artery are compared to the data of venous catheterization of the heart in 30 patients with chronic pulmonary diseases. Significant direct relationship was established between the correlations of the right and left ventricle volumes, the end diastolic and systolic volumes of the right ventricle, the cross section area of the right main pulmonary artery as was an inverse relationship between the ejection fraction and systolic effective pressure in the right ventricle. In bronchopulmonary diseases, two-dimensional echocardiography is an informative enough method not only in the assessment of hypertrophy, dilatation and failure of the right heart ventricle but also in indirect diagnosis of pulmonary circulation hypertension. PMID- 2697957 TI - [The use of a computer for the diagnosis of comatose states in diabetics (a differential diagnostic algorithm)]. AB - An algorithm for differential diagnosis of comatose conditions in patients with diabetes mellitus has been devised. The algorithm is intended for the general practitioner and non-specialized department. The algorithm uses the minimum of the crucial signs of comatose conditions, ensuring their diagnosis under the conditions of any hospital. The algorithm can be applied to the recognition of the typical variants of comatose conditions in a "pure" form. The amount of algorithm steps is minimized. The program of differential diagnosis is written in the Fokal language and realized on the computer "Elektronika BK 0010". The program is run in the dialogue mode. The algorithm is used in clinical practice and in the training process, with its efficacy being independent of the professional skills of the user. PMID- 2697958 TI - Purification and characterization of an antibacterial and antineoplastic protein secretion of a sea hare, Aplysia juliana. AB - The fetid secretion of a sea hare, Aplysia juliana, was lethal to crabs and also inhibited the growth of bacteria. When the secretion was partitioned between water and n-hexane, only the n-hexane layer, which had a nauseating odor, was lethal to crabs. The water-soluble fraction showed strong antibacterial activity and inhibited the growth of both Gram-positive and Gram-negative bacteria. Antibacterial activity of the water-soluble fraction was destroyed by heating at 50 degrees C for 15 min, but was resistant to treatment with proteolytic enzymes. The active principle, named julianin-S, was purified by gel filtration and ion exchange chromatography. The purified specimen gave a single protein showing a mol. wt of approximately 67,000, as determined by gel filtration. Julianin-S inhibited the growth of Bacillus subtilis by 50% at a concentration of 70 ng protein/ml. It was also cytotoxic to murine tumor cells and inhibited in vitro growth of L1210 cells by 50% at a concentration of 8 ng protein/ml. PMID- 2697959 TI - [Results of the development and improvement of the technology for production of a vaccine against tick-borne encephalitis]. PMID- 2697960 TI - In vitro induction of swine peripheral blood monocyte proliferation by the fibroblast-derived murine hematopoietic growth factor CSF-1. AB - The addition of conditioned medium from murine L929 fibroblasts (MGF) to cultures of swine peripheral blood mononuclear cells (MNL) resulted in growth of cells of macrophage/monocyte lineage (MO). Glass-adherent swine MNL, shown to be greater than 95% phagocytic MO, grew in the presence of MGF, whereas swine blood granulocytes and lymphocytes were not MGF-responsive. Primary and secondary MO growth were directly dependent on MGF presence and concentration. MGF-stimulated MO synthesized DNA, as measured by cellular incorporation of tritium-labeled thymidine (3H-TdR). This mitogenic response was maximal by 5 to 6 days in primary MO cultures and declined thereafter to a lower magnitude in secondary MO cultures. In the presence of MGF, viable MO numbers increased with an approximate population doubling time of 5 to 7 days in primary culture. This growth rate was prolonged, to about 10 to 12 days, for MGF-stimulated MO in secondary cultures. MGF removal from primary and secondary MO cultures resulted in rapid growth cessation and cell death. MGF-stimulated MO could not be sustained in secondary culture beyond 7 weeks. MGF-cultured MO were positive for latex phagocytosis, non specific esterase, Fc-receptor expression, and could mediate antibody-dependent cell-mediated cytotoxicity. The MO-mitogenic principle of MGF was identified as the murine, macrophage-specific colony-stimulating factor, CSF-1 (M-CSF). The swine MO-proliferative response to MGF was inhibited by addition of monospecific goat antisera to M-CSF. Purified M-CSF stimulated the growth of swine MO from cultures of MNL and primary glass-adherent MO. PMID- 2697961 TI - ras p21 expression in ovine pulmonary carcinoma. AB - We have adapted an enzyme-linked immunoblot assay (ELIBA) for the detection of a c-ras proto-oncogene and oncogene protein products in human cell lines and tumors of 21,000 daltons molecular weight (p21ras) to studies of tissues derived from sheep. In the ELIBA, a double antibody system is used in which p21ras proteins are initially immunoprecipitated from protein extracts with monoclonal antibodies, and subsequently identified using additional anti-ras antibodies. Binding is identified with a non-radioactive enzyme-linked colorimetric detection system. In the present study, the ELIBA system was used to study twenty-seven ovine lung specimens, representing normal lung, inflammatory, and neoplastic lesions. We detected p21ras protein expression in every tissue examined, but the nature and amount of the protein product varied significantly among the tissues examined. Some tissues expressed multiple ras species. Broncho-alveolar carcinoma specimens were most likely to express c-Ki-ras proteins. Mutant proteins of c-N ras and c-Ki-ras were detected in several bronchoalveolar carcinoma specimens, based on migrational differences between mutant and normal proteins in 15% polyacrylamide gels. The results of this study demonstrate the utility of the ELIBA system for detection of c-ras expression in ovine lung tissues, and demonstrate the ability of the system to discriminate specific ras protein species. The prognostic significance of ras expression in sheep pulmonary carcinoma has yet to be determined. PMID- 2697962 TI - Humoral response in neonatal calves following immunization with Escherichia coli (strain J5): the effects of adjuvant, age and colostral passive interference. AB - Serologic responses in 61 calves 3 to 34 days of age following immunization with bacterins containing a heat-killed rough mutant, Escherichia coli 0111:B4 (strain J5) were determined by an enzyme-linked immunosorbent assay specific for the IgG isotype. Administration of either heat-killed bacteria or oil-based adjuvants alone failed to enhance serologic recognition of common core antigens when comparing to nonvaccinate controls. Increased titers were uniquely and specifically limited to calves receiving the antigen in an oil emulsion. In a second experiment, age and initial, passively acquired titer recognizing the vaccinal antigen were not found to have any effect on the magnitude of the humoral response of 57 calves following immunization. PMID- 2697963 TI - [The concept of hormesis in the problem of the stimulating action of low doses of physicochemical factors]. PMID- 2697964 TI - [Quantitative immunoenzyme determination of lactoferrin in the serum and plasma]. AB - A procedure for quantitative estimation of lactoferrin is developed using the "sandwich" type of immunoenzymatic assay. Preparation of lactoferrin was purified from women colostrum by means of ion exchange chromatography; the sorbent (a ligand-containing complex of lactoferrin) was synthesized; the antibody conjugate against lactoferrin and peroxidase from horseradish was prepared; optimal conditions of the immunoenzymatic assay were selected. Concentration of lactoferrin in donor blood serum or plasma constituted 0.5-3.3 mg/ml; distinct alterations of the lactoferrin content were not found in blood of patients maintained on artificial circulation or in the blood used for transfusion. PMID- 2697965 TI - [Comparative analysis of methods of determination of kallikrein and prekallikrein in the human plasma (review of the literature)]. AB - Main procedures developed for estimation of kallikrein activity and of content of its precursor are reviewed; critical comparative analysis of their principles is presented. Specificity, advantages and limitations of these procedures are discussed. General rules of enzymatic kinetics are considered in connection with development and application of these procedures. Some cautions are discussed considering wrong conclusions and recommendations, based on the data obtained by means of the inadequate methods. PMID- 2697966 TI - [A problem of creating a catalog of human erythrocyte membrane proteins]. AB - Properties of human erythrocyte membrane proteins are widely studied recently. Comprehensive data were obtained on two main membrane proteins responsible for essential membrane functions. Besides, high performance two-dimensional electrophoresis and a number of other procedures enabled to detect more than 100 minor proteins in the biomembranes. The latest advances in studies of proteins and their coding genes allowed to compile a catalogue for erythrocyte membrane proteins, which is of importance for investigations in the field of membrane molecular biology. Structural organization of the catalogue for human erythrocyte membrane proteins is discussed. PMID- 2697967 TI - [Principles of planning and financing scientific work at the research institutes of the Ministry of Public Health of the Ukrainian SSR under new management conditions]. PMID- 2697968 TI - [Symptomatic erythrocytosis (a review of the literature)]. PMID- 2697969 TI - [The role of V. P. Obraztsov and N. D. Strazhesko in the development of the ischemic heart disease problem]. PMID- 2697970 TI - [Results of radionuclide study of the single kidney remaining after nephrectomy in nephrolithiasis]. AB - Computerized dynamic gamma scintigraphy with indirect radionuclide angiography was carried out in 29 patients with a single kidney. It was found that patients with a single kidney show already at the stage of "intact" organ persistent disorders of intrarenal hemodynamic processes as well as chronic urostasis. This variant of radionuclide examination may be used in the prophylactic management of this category of patients. PMID- 2697971 TI - [The interrelationship of cholelithiasis and ischemic heart disease]. AB - Ultrasonic scanning of the gallbladder was realized in 234 patients with ischemic heart disease and results of 924 autopsy findings in those who died of myocardial infarction. A high incidence of concomitant cholelithiasis was found in patients with ischemic heart disease as compared with the general population. The data obtained by ultrasound examination were close to the results of autopsy findings. PMID- 2697972 TI - [Three new serotypes of Salmonella II]. AB - Eight cultures isolated from intestinal contents of reptiles were belonged to 3 new serotypes of Salmonella. They were all ducitol fermented, malonate utilized, but not attack lactose and salicin, no growth in KCN broth, ONPG negative. Therefore, they would be included in Salmonella II. They were all attacked by Felix phage O-I. Three represented strains were selected for antigen analysis. Their antigenic formula were identified as follows: S3194 Salmonella II 6,7:1,v:e,n,z15 S3196 Salmonella II 6, 7:y: e, n, z(1)5 S3195 Salmonella II 6, 8: e, h: 1,2 Among them, S3196 was indole positive belonging to a rare biotype. In addition, there were two other cultures as well as the formula of S3194, and three other cultures as well as the formula of S3196 (one of indole positive, two of indole negative). PMID- 2697973 TI - [Fractures of the acetabulum]. AB - Fractures in the region of hip acetabulum are an ever more frequent and difficult orthopaedic problem. Not infrequently the choice of the therapeutic method is determined by associated injuries occurring in half the cases and affecting practically any part of the body. Of essential importance for the diagnosis and treatment of these fractures is the radiological examination as described by R. and J. Judet and Le Tournel. For prevention of femoral head necrosis the coexistent hip displacement must be corrected within 48 hours. PMID- 2697974 TI - [60th anniversary of the discovery of vitamin C]. PMID- 2697975 TI - [Magnesium in acute pancreatitis]. PMID- 2697976 TI - [Early-morning hyperglycemia in patients with diabetes mellitus types 1 and 2]. AB - Early morning hyperglacaemia occurs in type I and II diabetes, and is characterized by increasing blood glucose level and/or increased requirements for insulin in early morning hours without preceding hypoglycaemia. The frequency and repeated appearance of the disturbance are not known, completely and no occlusions could be reliably put forward concerning the role of hormonal insulin antagonists. Early morning hyperglycaemia makes difficult the control of blood glucose level later on, especially in the hours 3.30-7.00. It has been observed with each type of therapy, but it can be controlled by corrections of the dose and type of the injected insulin and dosage timing. PMID- 2697977 TI - [Respiratory distress syndrome in adults]. AB - The pathogenesis of the adult respiratory distress syndrome is described discussing the present state of knowledge on this problem. The diagnostic problems and the modern therapeutic possibilities are mentioned. PMID- 2697978 TI - [Early (minimal) breast cancer and possibilities of its detection]. PMID- 2697979 TI - The Philip K. Bondy Symposium--recent advances in endocrinology and metabolism. May 5, 1989. PMID- 2697980 TI - Philip K. Bondy: an appreciation. PMID- 2697982 TI - Polyamines and their derivatives as modulators in growth and differentiation. AB - The polyamines and their derivatives are essential for life in eukaryotic and most prokaryotic cells, but their exact role in preserving cell function is not clear. These polyamines provide endogenous cations and thus participate in regulation of the intracellular pH; in addition, polyamine derivatives modulate cell growth and differentiation. The naturally occurring monoacetyl derivatives can induce increased activity of ornithine decarboxylase, the first enzyme in polyamine synthesis, and thus produce positive feedback to their production. The diacetyl derivatives of putrescine and of the synthetic analogue, 1,6 diaminohexane, induce differentiation and inhibit growth in many types of cells in vitro. In addition, they inhibit the proliferative and secretory response of normal B lymphocytes to B-cell mitogens and reduce production of antibodies in vitro. They also inhibit the proliferation of chronic lymphocytic leukemia cells (a B-lymphocyte leukemia). The parent polyamines are post-translational modifiers of proteins, and hypusine, a derivative of spermidine, is a covalently bound constituent of the eukaryotic protein synthetic initiation factor, eIF-4D. Although these various actions do not at present fall into a coherent pattern, they clearly indicate that polyamines and their derivatives play an important part in modulating cell proliferation and differentiation. PMID- 2697983 TI - The molecular biology of human renin and its gene. AB - The molecular biology of renin, prorenin, and the renin gene have been studied. A tissue-specific pattern of expression was found in rat and human tissues. In the human placenta, the transfected and endogenous renin promoters are active, and renin mRNA levels and transfected promoter activity are increased by a calcium ionophore plus cAMP. Cultured pituitary AtT-20 cells transfected with a preprorenin expression vector mimick renal renin release by converting prorenin to renin and releasing renin in response to 8Br-cAMP. Studies with mutant renin genes suggest that the body of renin directs renin to the regulated secretory pathway, and renin glycosylation affects its trafficking. Chinese hamster ovary cells were used to produce recombinant prorenin. Infused prorenin was not converted to renin in monkeys. Renin crystals were used to determine its three dimensional structure. Renin resembles other aspartyl proteases in the active site and core, but it differs in other regions that probably explain renin's unique substrate specificity. Based on structural and mutational analysis, a model for human prorenin was built that suggests lysine -2 of the prosegment interacts with active site aspartate residues, and that the prosegment inactivation of renin is stabilized by binding of an amino terminal beta strand into a groove on renin. PMID- 2697984 TI - Adrenal renin: a possible local regulator of aldosterone production. AB - Extrarenal renin has been identified in a number of tissues, including the brain, the submaxillary gland, uterus, ovary, vascular endothelium, testes, pituitary gland, and the adrenal cortex. In some tissues, including the adrenal cortex, all of the components of the renin-angiotensin system have been identified; however, no specific physiologic role has been clearly demonstrated for these extrarenal renin-angiotensin systems. We have studied the role of the renin-angiotensin system in the adrenal cortex of the rat and have found that renin is localized and synthesized in the zona glomerulosa cells. Its production can be influenced by alterations in electrolyte balance, as well as the genetic background of the rat. In adrenal capsular explant cultures, a converting enzyme inhibitor can lower angiotensin II production and reduce the stimulation of aldosterone by potassium, suggesting that this system is involved in the aldosterone response to potassium. In addition to rat adrenals, renin has been identified in human adrenal tissue and human adrenal tumors, including aldosteronomas, and a patient with hypertension has been reported to have an adrenal tumor that appeared to be secreting renin into the circulation. PMID- 2697981 TI - Mitogenic regulation of normal and malignant breast epithelium. AB - The multiple roles of both estrogenic and polypeptide regulators of mammary epithelial cell growth are reviewed in this article. Effects of both steroidal and peptide hormones are complex and involve multiple interactions with malignant cells and non-malignant host components. Initial carcinogenesis and progression of mammary epithelium to cancer probably require both proliferative stimuli (estrogen, polypeptide growth factors) and genetic damage. This condition may lead to qualitatively different hormonal responses (hormone-responsive cancer). Estrogens can be shown to induce growth-regulatory polypeptide growth factors and interact with them in hormone-dependent breast cancer. Progression of hormone dependent (estrogen-responsive) breast cancer to hormone independence probably involves multiple mechanisms, including oncogene activation, loss of the estrogen receptor, or loss of hormone responsivity of other gene products. One direction for further therapies may be blockade of hormonal stimulation and interference with necessary activated or induced components of malignant progression such as oncogenes or polypeptide growth factor-receptor systems. PMID- 2697985 TI - Obesity, metabolism, and hypertension. AB - The relationship between obesity and hypertension is complex and poorly understood. A developing body of information suggests that metabolic factors related to the obese state are importantly involved. The pertinent observations include: (1) Diet influences sympathetic nervous system activity. Fasting suppresses, while carbohydrate and fat feeding stimulate, sympathetic activity. (2) Dietary-induced changes in sympathetic activity contribute to the changes in metabolic rate that accompany changes in dietary intake. (3) Insulin-mediated glucose metabolism in the hypothalamus provides a link between dietary intake and sympathetic nervous system activity. And (4) hyperinsulinemia, a consequence of insulin resistance in the obese, is associated with hypertension. These observations have suggested the following hypothesis. Hyperinsulinemia results in sympathetic stimulation which drives thermogenic mechanisms, thereby increasing metabolic rate. The net result is a restoration of energy balance at the expense of hyperinsulinemia and increased sympathetic activity. Hypertension is thus the unfortunate consequence of hyperinsulinemia, which increases renal sodium reabsorption, and sympathetic stimulation of the heart, kidney, and vasculature. The data on which this hypothesis is constructed are reviewed and the implications discussed. PMID- 2697986 TI - Biosynthesis and regulation of the insulin receptor. AB - The insulin receptor is an integral glycoprotein of the plasma membrane in most mammalian cells. The gene encodes a 190 kDa proreceptor that undergoes a number of processing steps. The gene is constitutively expressed, but at least one form of regulation has been demonstrated. Glucocorticoids increase the number of insulin receptors on the surface of cultured human lymphocytes, a process which is accompanied by an increase in transcription of the gene. N-linked glycosylation and amide-linked acylation occur as co-translational events. Subsequently, the proreceptor is cleaved into alpha and beta subunits; the subunits then undergo an ester-linked acylation step and N-linked complex glycosylation. In addition, O-linked glycosylation has been recently described in the beta subunit. The mature insulin receptor is inserted into the plasma membrane as an alpha 2-beta 2 disulfide-linked heterodimer. The receptor can be further regulated on the cell surface by insulin binding and receptor-mediated endocytosis. The receptor concentration on the cell surface then becomes a function of the internalization rate and the receptor recycling rate. Receptor regulation is a relevant feature of many forms of clinical insulin resistance, and recently genetic mutations have been described that determine both the binding properties of the receptor and its translocation and processing properties. PMID- 2697988 TI - [Theophylline in the treatment of asthma: indications, use and side effects]. PMID- 2697987 TI - Molecular genetics of severe insulin resistance. AB - Leprechaunism and type A diabetes represent inborn errors of insulin resistance whose phenotypes suggested causation by mutations in the insulin receptor gene. Cells cultured from patients with leprechaunism specifically lacked high-affinity insulin binding. Partial but different degrees of impairment were observed in cells cultured from first-degree relatives. Different mutations in the insulin receptor's alpha subunit were proposed in different families (Ark-1, Atl, Minn, Mount Sinai) based on phenotype, cellular insulin binding, and insulin receptor structure. Molecular cloning and sequencing of mutant insulin receptor cDNA from family Ark-1 confirmed that the proband inherited a maternal missense and a paternal nonsense mutation in the alpha subunit and was a compound heterozygote. The insulin receptor was immunologically present on the plasma membrane of fibroblasts cultured from patients Ark-1 and Atl but was markedly reduced in cells from patients Minn and Mount Sinai. In cells from patient Minn, but not from patient Mount Sinai, the decreased number of insulin receptors was associated with reduced insulin receptor mRNA. In two families with the less severe form of insulin resistance, type A diabetes, mutations altered post translational processing of the insulin receptor molecule. At a cellular level, these mutations of the alpha subunit of the insulin receptor shared defective binding and impaired stimulation of sugar transport by insulin. In family Atl, however, glucose uptake was constitutively increased. Thus, genetic variation in the insulin receptor gene causes a spectrum of inherited insulin-resistant syndromes and altered cellular signaling. PMID- 2697989 TI - [Coping with stress by the aged--critical comments on an important concept]. PMID- 2697990 TI - [Odorless surface disinfection with peracetic acid]. PMID- 2697991 TI - [Legal aspects of guardian responsibility]. PMID- 2697992 TI - [The 125th anniversary of the death of Felix von Baerensprung]. PMID- 2697993 TI - [In memory of Johann Theodor Eller--26 November 1689 to 13 September 1760]. PMID- 2697994 TI - [The management of patients with polysymptomatic lymphedema]. PMID- 2697995 TI - [Modern aspects of the diagnosis and therapy of thoracic aneurysm of the descending aorta]. PMID- 2697996 TI - [Primary management of open and closed tendon injuries of the hand]. PMID- 2697997 TI - [Richard Bright--28 September 1789 to 16 December 1858]. PMID- 2697998 TI - [Clinico-diagnostic significance of enzyme activity determinations]. PMID- 2697999 TI - [Drug-induced syndromes of the locomotor system]. PMID- 2698000 TI - [Principles and results of pyeloplastic surgery]. PMID- 2698001 TI - [The quality of blood donation and its effect on subsequent preparation of coagulation active plasma fractions]. PMID- 2698002 TI - [Sergej Petrovic Botkin--17 September 1832 to 24 December 1889]. PMID- 2698003 TI - [Trends in the specialty of internal medicine: specialization and/or integration]. AB - The successes of modern medicine are results of the specialisation in medicine due to the technical development. With increasing specialisation several problems for education and training, for research and medical care develop, so, for instance, a total investigation of patients is not always given on a sufficient scale. Therefore it should increasedly be orientated to an education and training to a generalist both in the training of students of the subject human medicine and during the time of specialisation in the field of internal medicine. At the same time it appears necessary to discuss more intensely the integration and/or the specialisation with the internal specialists working in practice and in research, in order to develop at first a corresponding sense for the problems and to integrate the professional status of the generalist increasedly into the self appreciation of all specialists of internal medicine. PMID- 2698004 TI - [Internal medicine--status and perspectives]. AB - Catalysed by the scientific progress in medicine an increasing specialisation in internal medicine developed with the danger of a disunion of the specialty. Nowadays, the internal medicine is tripartite with the basis internal specialists and the subspecialist as the two poles of the care of patients in the field of internal medicine. The description of the status quo in internal medicine shows reserves in training and education of the students as well as of the physicians during the period of specialisation which must be closed. It is essential for a qualification of the physician's work that basis internal specialists and proper specialists unite in the sense of a partnership and formulate professional and health-political aims for internal medicine. PMID- 2698005 TI - [August Hoffmann--a pioneer in heart diagnosis]. AB - August Hoffmann was born in Munster on 2 June 1862. In 1891 he set up his medical practice in Dusseldorf as specialist for internal medicine and neurology. There in 1907 he became first professor in ordinary for internal medicine when the Academy for Practical Medicine was founded. Up to 1927 he was head of the medical clinic. On 17 February 1929 he died in Dusseldorf. At first Hoffmann used the X rays which were discovered in 1895 for the heart diagnostics, above all for the determination of the size of the heart. A general notoriety he obtained by publication of the monography about the paroxysmal tachycardia (type Bouveret Hoffmann) in 1900. After the preliminary works of Einthoven he belonged to the first German clinicians who dealt with electrocardiography (above all problems of arrhythmia). In 1914 he published the second ECG-book in German language. Hoffmann founded the Dusseldorf cardiologic tradition. PMID- 2698006 TI - [Streptococcus-induced syndrome of toxic shock (streptococcal toxic shock syndrome)]. AB - Report on the first case of streptococcal toxic shock syndrome in the GDR. The patient was a 54-year-old female. One week before admission to the hospital she cut her finger. The day before admission to the hospital she presented with a painful left shoulder. Demarcation followed, and Streptococcus pyogenes (group A streptococci) was isolated from this area. The temperature rose to more than 40 degrees C and she became confused, hypotensive and anuric. There was evidence for disseminated intravascular coagulation. She died 23 h after admission. Clinical course and laboratory parameters resembles staphylococcal toxic shock syndrome, except a diarrhoea. The streptococcal strain produced a large amount of erythrogenic toxin type B (more than 20 ng/ml), but not erythrogenic toxins A or C. Erythrogenic toxins of Streptococcus pyogenes seem to play the same role in the development of streptococcal toxic shock syndrome as the toxic shock syndrome 1 (TSST-1) in staphylococcal toxic shock syndrome. PMID- 2698007 TI - [Relation of interdigestive gastrointestinal motility and pancreas-bile secretion]. PMID- 2698008 TI - [Functional relation of the stomach and pancreas]. PMID- 2698009 TI - [Regulation of pancreas function by the proximal and distal small intestine]. PMID- 2698010 TI - [The clinical significance of hormone regulation of exocrine pancreas secretion in the human]. PMID- 2698011 TI - [Food controlled pancreatic secretion and adaptation]. PMID- 2698012 TI - [Pancreatic secretion in and following acute pancreatitis]. PMID- 2698013 TI - [Principles of selection, diagnosis and treatment of patients with vasorenal hypertension and ischemic heart disease at a surgical department]. PMID- 2698015 TI - [30 years of contemporary social orthodontics in SR Slovenia]. AB - Contemporary social preventive orthodontics in Slovenia has a special form as units all the aspects of the epidemiological, researching, professional and organisational characteristics. It has grown out of our society and has been tailored for our needs, which means that it is social and suitable for the tasks of social and preventive medicine. Our idea "healthy and functional teeth for all children" has been our current, periodical and final goal, its achievement being dependent on the generations of dental doctors and specialists in orthodontics: this means, however, that the progress cannot be urged. PMID- 2698014 TI - [Psychogenesis, neurosis and the cortico-visceral concept]. AB - Neurotic and psychosomatic aspects of psychogenesis problem are examined on the basis of author's data (experimental and clinical) and literature. At indubitable primate of psychogenic factor, the significance of risk factors is particularly accentuated in neuroses genesis. The thesis is acute and chronic visceral destabilization and neurotizing action as obligatory components. Possibilities of cortico-visceral conception at contemporary stage are critically analyzed. PMID- 2698017 TI - [Psychiatric aspects of sex chromosome aneuploidies]. PMID- 2698016 TI - [The assessment of social relations in 6 to 12-year-old children in a child and adolescent population in psychiatric consultation]. AB - Starting from Schmiedeck's "personal sphere model" we tried to develop a similar procedure for children (age range 6 to 12 years). It should enable us to analyze the social relationships of a patient from his/her point of view. We examined 85 children of child/adolescent-psychiatric population with the presented method. It focuses upon drawings of the children and assessment of their relationships. The number of closely related persons and the frequency of interpersonal/social contacts allow to estimate the degree of embeddedness of the child into his/her social context. Importance and significance of indicated partners of interaction can be determined by the attachment the child expresses and receives. These assessments give information about the likes and dislikes for the related persons. The range of social experience extends equally for boys and girls as they grow older. At all age levels girls have more social contacts than boys. The sibling relations of the girls show more inconsistencies than those of the boys. Younger children have the tendency to name only the mother as family member. Neurotic and emotionally disturbed children express fewer wishes. Children with social behaviour disorders suffer less from the loss of a closely related person than children with emotional disturbances. PMID- 2698018 TI - [beta-Phenylethylamine and amphetamine: similar aspects in their behavioropharmacological and neurochemical characteristics]. AB - The authors found there was behavioral sensitization induced by repeated intermittent treatments with beta-phenylethylamine (PEA), an endogenous trace amine, similar to the so-called reverse-tolerance phenomenon which persists long after the withdrawal. A series of behavioropharmacological and neurochemical studies on the PEA-sensitized rats were compared with that on the sensitization induced by amphetamines (AMP). The major portion of this review focused on an involvement of dopaminergic modifications in the reverse tolerance caused by both PEA and AMP. The enhanced stereotype in the PEA-sensitized rats was found to be accompanied by augmentation of presynaptic dopaminergic activity in nigrostriatal and mesocorticolimbic systems by means of regional dissected and in vivo dialysis methods. In particular, a simultaneous measurement of endogenous PEA levels in striatum led us to speculate that the DA terminals in sensitized animals are hyperresponsive to PEA, resulting in enhanced DA release. D2 receptor bindings in nucleus accumbens, not in striatum, also altered in PEA-sensitized rats. In addition, recent literature concerning changes in PEA levels in body fluids in psychiatric disorders are summarized. Lastly, the attractive reports regarding the possibility that central actions of AMP would be mediated by endogenous PEA and that PEA is co-localized with DA in the same neurons were reviewed, suggesting an important role of endogenous PEA in generating the psychostimulant induced and endogenous psychosis. PMID- 2698019 TI - [Studies on animal model of depression: review and perspective]. AB - Animal models have played an important role in the history of research on depression. Various models, such as spontaneous depression in natural environment, drug-induced deductive models and several stress models including "learned helplessness" and "forced-running model", were introduced. Conclusions from the models reviewed in this article would be (1) some, not all, individuals of some species possibly fall into depressive state as a result of certain conditions, such as separation, repeated stress and uncontrollable aversive stimuli; (2) such depressive stage can be reversed by antidepressant drugs; (3) disrupted functional activity of norepinephrine, especially in locus coeruleus, may be closely related with neurochemical background of animal models. Significance of other systems, like GABA or serotonin, is still less evident as compared with norepinephrine. In future studies on depression, there is a need for an experimental system in which interrelation between "endogenous" and "exogenous" factors in the etiology of depression can be studied. Animal models would be a useful strategy in this context. PMID- 2698020 TI - [Neuro-glia interaction by glia-derived neurotrophic factors]. PMID- 2698021 TI - [Cell-to-cell interactions between Purkinje and granule cells during cerebellar development. Some considerations on the hypoplastic cerebellum of Gunn rats]. PMID- 2698022 TI - [A possible molecular mechanism of the inductive interaction between organizer and the competent ectoderm]. PMID- 2698023 TI - [Nitrate and nitrite in the urine, saliva and blood of urologic patients]. AB - Nitrate and nitrite contents were determined in urine, saliva, and blood of 298 patients suffering from urological diseases. Crude values of nitrate and nitrite in morning urine without any correction due to density and creatinine are sufficient for epidemiological purposes. Significant correlations exist with vegetables intake and bacteriuria, but not with age, sex, disease, smoking, and medicaments. Neither nitrate nor nitrite may be considered to be general indicators of inflammatory processes in the urogenital tract. According to recent investigations nitrite formation during bacterial infections must be seen in connection with simultaneously occurring macrophage activation, as the latter one is catalyzing the formation of carcinogenic N-nitroso compounds from nitrite and secondary amines. PMID- 2698024 TI - [Acetylhydroxamic acid in the treatment of nephrolithiasis, caused by infection with urease forming microorganisms]. AB - Acetohydroxam acid (500-1000 mg/d) inhibit the activity of the bacterial urease successfully due to reduction of ammonia excretion and urinary pH value in the patients. Acetohydroxam acid should be used in patients after operative treatment of urolithiasis due to infection with carbamidesplitting bacteria. PMID- 2698025 TI - [The isolation and use of magnetic sorbents in methods for the immunological analysis of microorganisms]. PMID- 2698026 TI - [The detection of a choleriform thermolabile enterotoxin in clinical strains of Proteus isolated in different infections]. AB - The capacity of Proteus strains, isolated from patients with purulent inflammatory, urological and enteric infections, for the production of choleriform thermolabile enterotoxin was studied by means of the enzyme immunoassay (EIA) with the use of antitoxic serum to Escherichia coli enterotoxin. Out of 125 strains, 27 (21.6%) showed the capacity for producing choleriform thermolabile enterotoxin in EIA experiments. The results thus obtained indicate that EIA techniques can be used, in principle, for detecting the capacity of Proteus for the production of choleriform thermolabile enterotoxin. PMID- 2698027 TI - [The tentative identification of actinomycetes of the oral cavity by a complex of key morphophysiological signs]. AB - In this work the results obtained in the study of the morphology of 208 Actinomyces strains isolated from the oral cavity and a wide spectrum of their enzymatic activity are presented. The identification of these strains was carried out on the basis of chemotaxonomic criteria. Bacteria belonging to the same taxonomic group were found to have considerable similarity in their morphological and physiological features. On the basis of the data obtained in this study a simplified scheme of the tentative identification of fermentative Actinomyces, suitable for use by a wide circle of researchers, is presented. PMID- 2698028 TI - [AIDS: the oncological aspects]. PMID- 2698029 TI - [A comparative study of the biological properties of pyelonephritogenic Escherichia coli isolated at different times in the infectious process]. AB - The comparative study of the biological properties of E. coli cultures, isolated from the urine of 7 patients two times during the first 11 days from the beginning of clinical manifestations of the exacerbation of chronic pyelonephritis, was conducted. In most cases the strains obtained as the result of the inoculations of the first and second urine samples belonged to the same serological and enzymatic variants. Still bacteria isolated in the second investigation, in contrast to E. coli obtained by the earlier inoculation of urine samples, often had no hemagglutinins and showed low adhesive capacity with respect to uroepithelium. Only in one out of 4 patient E. coli with antigen K1+ could be detected not only after the first inoculation, but also after the second one. In 4 patients E. coli cultures obtained as the result of the second isolation of these bacteria had lower content of sialic acid. Besides, differences in the sensitivity of E. coli strains isolated from the same patients in the course of the infectious process to the action of nonspecific protection factors of the body were established. The results obtained in the course of this study give more precise understanding of the existing conception of the pathogenesis of pyelonephritis. PMID- 2698030 TI - [The etiological structure of shigellosis in the USSR in recent years]. AB - The characterization of etiological structure of Shigella infection in the whole of the USSR, in individual union republics and at a number of other administrative territories of the USSR in recent years is presented. S. flexneri has been shown to prevail at the territories with unsatisfactory water supply of the population, and S. sonnei prevails at the territories with good water supply. At the former territories S. dysenteriae and S. boydii retain their etiological importance, while at the latter ones their role is insignificant. At a number of territories the infectious process has stopped: no isolation of these shigellae from dysentery patients and carriers is observed any longer. Among the causative agents of Flexner's dysentery, S. flexneri 2a, 6 and 1b (in different combinations) play the leading role. PMID- 2698031 TI - [The immunoregulatory properties of reaferon]. AB - The influence of human recombinant alpha-interferon (reaferon) on cell-mediated and humoral immune response has been studied. Experimental facts on the blast transformation of lymphocytes, humoral immune response and the reaction of delayed hypersensitivity are presented. The study has shown that reaferon possesses the main immunoregulatory properties, characteristic of natural human leukocytic alpha-interferon. Manifestation of these properties depends on the dose of preparation and the time of its use. PMID- 2698032 TI - [The role of delayed hypersensitivity in the development of an experimental dysentery infection and vaccinal process]. AB - The results of experiments, indicating the development of cell-mediated delayed hypersensitivity (DH) skin reaction, its dependence on the virulence of Shigella flexneri 2a, the dose and the character of the antigen used for testing the reaction, are presented. One of the immunologically active components of S. flexneri virulent strain 2a No. 516 is a biologically active thermolabile factor detected in filtrate and supernatant fluid. These data suggest that the immunosuppressive action of the virulent strain is probably linked with the function of T-suppressors affecting the reaction at the period of its development (the induction phase). S. flexneri avirulent strain produced no such effect, developing DH being seemingly sufficient for activating T-cell-mediated immune response. PMID- 2698033 TI - [Social epidemiology--its basic goals and tasks]. PMID- 2698034 TI - [The mechanisms of the intraphagocytic parasitism of Legionella and other bacteria]. PMID- 2698035 TI - [Combined injuries to the nerves and vessels in children]. AB - It is shown on the basis of comparative analysis of 39 cases with combined injuries of the nerves and vessels in children that the main blood flow must be restored even in compensated circulation in the limb; this improves regeneration of the nerve and lessens the delay in the growth of the limb. The time of the intervention is determined by the degree of ischemia of the limb and the existence of special conditions. PMID- 2698036 TI - [Conclusions apropos the successes of the autotransplantation of human nerves]. AB - Good results of autotransplantation of nerves in 5 patients under unfavourable conditions are reported. The author puts the question as to how is it that in a much lesser number of newly-formed fibres in the peripheral segment after autotransplantation with loss of fibres at two levels, the clinical results may sometimes be excellent in relation to restoration of movements and trophicity. A conclusion is drawn on the need for further morphological examinations of the intratruncal structure and regeneration of nerves as well as biochemical studies revealing the mechanism of the action of the factor of nerve growth. The application of an epineural suture under control of a magnifying lens with the use of the suitable microsurgical instruments and suture material is still the method of choice in most cases with nerve injuries. PMID- 2698038 TI - Immunotherapy of allergic diseases: a forthcoming therapy. PMID- 2698037 TI - [The clinical picture and microsurgery of nerve damages to the extremities]. AB - Analysis of injuries to the nerves in 850 patients showed that epi- and perineural sutures do not compete with one another, there are definite indications for the application of each one. A group interfascicular suture is applied when the groups of fasciculi are well formed and measure more than 300 mcm in diameter and the diastasis of the nerve is less than 3 cm. A large number of small fasciculi without a clearly defined group pattern, as well as their monofascicular structure are contraindications for applying a perineural suture but indications for placing an epineural suture. Interfascicular autoplasty by means of a cutaneous nerve is advisable when the mobilized ends of the nerves cannot be approximated. The use of the suggested system of indications for suturing nerves by various methods, optic magnification, and microsurgical techniques produced a good result: nerve conduction was restored in 199 (97%) of 205 cases. PMID- 2698039 TI - Insulin like activity in (-) epicatechin. AB - Water extract of the bark of plant of Pterocarpus marsupium Roxb is used as an antidiabetic drug in indigenous medicine in India. (-) Epicatechin, its active principle, has been found to be insulinogenic. The present in vitro study reports some insulin like activities of (-) epicatechin. Like insulin, (-) epicatechin stimulates oxygen uptake in fat cells and tissue slices of various organs, increases glycogen content of rat diaphragm in dose-dependent manner with corresponding increase in U14-C glucose uptake, and inhibits theophylline induced lipolysis in isolated fat pads in dose-dependent manner. Experiments on competitive binding of 125I-insulin and (-) epicatechin to liver cell plasma membrane indicate that insulin does not share binding site with (-) epicatechin. (-) Epicatechin at a concentration of up to 1 mM does not effect the release of glucagon from the islets in vitro. Thus, (-) epicatechin has insulinogenic as well as insulin like properties. PMID- 2698040 TI - Influence of exogenous ATP on blood sugar, serum insulin and serum free fatty acids in short-term experimental hyperthyroid dogs and in euthyroid controls. AB - We studied the influence of ATP administration on blood sugar (BS), serum immunoreactive insulin (IRI) and serum free fatty acid (FFA) responses to glucose induced hyperglycemia in short-term experimental hyperthyroid (STEH) dogs and in euthyroid controls. Hyperthyroidism was induced by a 10-day s.c. treatment with 100 micrograms/kg body weight 1-thyroxine. Glucose challenge was performed by i.v. infusion (700 mg/kg body weight as a priming dose, followed by 20 mg/kg body weight/min for 60 min). ATP (1 mg/kg body weight/min) was infused for 100 min 40 min before and 60 min during glucose administration). Glucose-induced hyperglycemia was more prolonged in the hyperthyroid group. ATP treatment did not affect the BS profile of controls but raised that of STEH animals. In the normal controls the insulinemic response to hyperglycemia was enhanced during ATP infusion. By contrast, in the STEH dogs insulin levels during glucose infusion was lower than in controls and did not significantly increase when ATP was added. ATP infusion induced a significant elevation of serum FFA, which was more pronounced in hyperthyroid animals with a greater fall during glucose administration and a marked increase during the period of recovery from hyperglycemia. In conclusion, we postulate that short-term hyperthyroidism in dogs may inhibit adenylate cyclase function in pancreatic B-cells and chiefly stimulate the action of cAMP-phosphodiesterase activity, thereby affecting insulin secretion. PMID- 2698041 TI - Possible mechanism of inhibition of cartilage alkaline phosphatase by insulin. AB - The inhibition of alkaline phosphatase by insulin is a finding reported by many researchers but the mechanism of this inhibition has not been studied. Since alkaline phosphatase is an important factor in the mechanism of calcification and an impairment of mineralisation has been observed in diabetes mellitus, a study was carried out to assess the effect of the hormone on alkaline phosphatase measured in chondrocytes, in matrix vesicles and in a purified enzyme preparation. Enzyme activity was inhibited by insulin. The lowest active concentration was 10(-6) M and maximal inhibition was obtained at about 10(-4) M. The inhibition is of the uncompetitive type. Full recovery of the hormone inhibited enzyme was obtained with 10(-4) M 2-mercaptoethanol. Data suggest direct interaction between the alkaline phosphatase and insulin molecules, involving either disulfide cross linkages or the metal chelating activity of insulin. PMID- 2698042 TI - Some problems in the laboratory findings in multiple myeloma. AB - The clinical usefulness of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels in serum and pathogenetic mechanism of hypoalbuminemia and hypocholesterolemia in multiple myeloma (MM) were investigated. In cases of MM with a history of pathological fracture, the level of serum ALP was significantly higher than normal. Thus, elevated ALP in MM patients may be an indicator of the occurrence of a pathological fracture within the past 2 months. The levels of serum LDH in about 80% of the MM patients were within normal limits despite the presence of a malignant tumor. These patients showed a normal pattern of isoenzymes and more mature types according to the Greipp classification. In contrasts, the patients with elevated serum levels of LDH showed the tumor pattern of the isoenzymes and the plasmablastic type. The total cholesterol concentration was correlated with the total protein levels and the serum cholinesterase. These findings were the same as those in patients with nephrotic syndrome and polyclonal hypergammaglobulinemia without liver dysfunction. These results suggest that the decreased cholesterol in MM is due to a reduction in the synthesis of albumin in the liver. PMID- 2698043 TI - Chronic B cell lymphocytic leukemias: diagnosis and cytologic characteristics of their cells. PMID- 2698044 TI - Red cell ferritin--its biochemical and clinicopathological characterization. PMID- 2698045 TI - Interactions via eicosanoids between vascular and blood cells. PMID- 2698046 TI - Aplastic anemia. Immunosuppressive therapy in a multi center trial in Japan. AB - We evaluated the biologic characteristics and effectiveness of immunosuppressive agents in patients with a severe form of aplastic anemia in a multicenter study. Treatment with a bolus of methylprednisolone (mPSL) was associated with a good response and a partial response in 19.4% and 1.4% of the patients, respectively. In contrast, two kinds of antilymphocyte globulin (ALG) were effective for 9.4% and 15.6% of the severe form of aplastic anemia, and two kinds of antithymocytoglobulin (ATG) were effective in 30.8% and 37.2% of the patients, although the difference between ALG and ATG was not statistically significant. We recommend that patients diagnosed as having severe aplastic anemia should be referred as soon as possible for treatment with immunosuppressive agents or bone marrow transplantation, the latter depending on disease severity, age, and potential availability of an HLA-identical sibling donor. PMID- 2698047 TI - Prognosis of chronic thrombocytopenic purpura. AB - A multicenter prospective study on the treatment of chronic idiopathic thrombocytopenic purpura (ITP), conducted by the Idiopathic Disorders of Hematopoietic Organ Research Committee, the Ministry of Health and Welfare of Japan, is currently in progress. In this study we analyzed the clinical records of 256 patients with chronic ITP in order to define the prognostic factors. As of November, 1988 after a median observation period of 34 months, 174 of the 256 patients (68%) were alive, 11 (4%) dead and 71 (28%) lost to follow-up. Bleeding was a direct cause of death in only one patient. Assessment of the status of patients based on platelet count at the final observation revealed that 48% of patients were in remission, 21% showed improvement, and 31% remained unchanged or worsened. Univariate analyses identified 4 parameters associated with favorable prognosis: presenting platelet count less than 2 x 10(4)/microliters, platelet count greater than 10 X 10(4)/microliters after one-year follow-up, maximal platelet count greater than 10 X 10(4)/microliters during administration of the initial dose of corticosteroids and splenectomy. PMID- 2698048 TI - Expression of cytokine genes in hematological malignancies. AB - A substantial number of leukemic blast colonies were formed when conditioned medium of human bladder carcinoma cell line 5637 was added as a stimulator. Recombinant colony-stimulating factor (CSF) also stimulated leukemic blast cell proliferation, leading to colony formation. Furthermore, serum CSF levels in some patients with acute myelogenous leukemia (AML), as detected by sensitive enzyme linked immunosorbent assay (ELISA), were high. These observations prompted us to study further the expressions of hematopoietic growth factor genes. Granulocyte macrophage CSF (GM-CSF) mRNA was detected in the leukemic blast cells from about 30% of patients with AML by Northern blot analysis using strict hybridization conditions with or without in vitro blast cell enrichment. These findings suggest that the expression of cytokine genes including the GM-CSF gene reflects in vivo phenomena, although no clear relationship between expression of the genes and serum CSF level has been established. Gene encoding tumor necrosis factor alpha (TNF-alpha), lymphotoxin (LT) and transforming growth factor beta (TGF-beta) were sometimes expressed in some malignant hematological cell lines and also some fresh leukemic cells. PMID- 2698049 TI - Cytosolic calcium levels in vascular smooth muscle. AB - Increase in cytosolic Ca2+ level ([Ca2+] cyt) is prerequisite for smooth muscle contraction. Simultaneous measurements of [Ca2+] cyt and muscle tension give direct information for the Ca2(+)-regulation of smooth muscle. A fluorescent Ca2+ indicator, fura-2, is used for this purpose. Comparison between [Ca2+] cyt and muscle tension in vascular smooth muscle indicates that, although high K+ and receptor-agonists such as norepinephrine and prostaglandin F2 alpha induce sustained contraction by the sustained increase in [Ca2+] cyt, greater contraction is produced by receptor-agonists than high K+ at a given [Ca2+]cyt. Phorbol ester show similar effects as receptor-agonists, and it potentiates a high K(+)-induced contraction with little effect on [Ca2+]cyt. These results suggest that the contraction of smooth muscle is due to the increase in [Ca2+]cyt. Furthermore, receptor-agonists stimulate phosphatidylinositol turnover and generates diacyl glycerol which activates protein kinase C and may consequently increase the Ca2+ sensitivity of contractile elements. The [Ca2+]cyt -dependent portion of these contractions is inhibited by Ca2+ channel blockers such as verapamil by the decrease in [Ca2+]cyt. By contrast, increase in cyclic AMP by isoproterenol and forskolin inhibits smooth muscle contraction by the decrease in [Ca2+]cyt also by the decrease in the Ca2+ sensitivity of contractile elements. Increase in the cyclic GMP level by sodium nitroprusside show effects quite similar to those of cyclic AMP. Thus, contractility of vascular smooth muscle seems to be regulated by [Ca2+]cyt and also by Ca2+ sensitivity of the contractile elements. Furthermore, at least part of the receptor-mediated changes may be due to activation of protein kinase C. PMID- 2698050 TI - Ca2(+)-dependent protein kinase cascade of platelets. PMID- 2698051 TI - [The endothelium and antithrombotic substances]. AB - Thrombin is a component of the coagulation cascade which leads to the formation of fibrin. In platelets, thrombin promotes aggregation. Thrombin not only interfers with hemostasis, but also exerts profound vascular effects. In canine coronary arteries, thrombin leads to endothelium-dependent relaxations via the production of endothelium derived relaxing factor. Higher concentrations, however, lead to contractions. Without endothelium the relaxations are abolished whereas the contractions may be augmented. In ischemic coronary arteries same reactions could be observed. Antithrombotic substances like heparin or hirudin inhibit the vascular effects of thrombin. Heparin binds in the proximity of the catalytic sites, whereas the bindings sites for hirudin can be found in the anionic group of the enzyme. Furthermore, heparin interacts with platelets and fibrinolytic substances and may be inactivated. Recombinant hirudin, however, is a selective thrombin antagonist, does not influence vascular smooth muscle tonus and does not lead to bleeding. Thus, hirudin may be an ideal substance for treating thrombin-induced vasospasm in coronary heart disease. PMID- 2698052 TI - [Diagnosis and treatment of carotid artery stenoses]. AB - 20 to 30% of all strokes are caused by stenosing processes of the extracranial part of the carotids. The frequency and severity of cerebrovascular disease can be reduced by early diagnosis and treatment. Ultrasonography consisting of Doppler flow analysis and B-mode imaging sonography is an excellent diagnostic procedure for screening patients with suspected cerebrovascular disease so that morbidity and mortality are supposed to be lowered in future. This survey will briefly review different types of surgical and pharmacological therapy in the context of primary and secondary prevention of stroke. PMID- 2698053 TI - Analysis of eicosanoid formation in humans by mass spectrometry. PMID- 2698054 TI - Involvement of platelet-activating factor in renal processes. PMID- 2698055 TI - Geriatric day hospitals. PMID- 2698056 TI - [Accuracy of measurement of subretinal fluid volume using B-scan ultrasonography]. AB - Using a videoultrasonography and image computerized system, it was possible to measure the volume of subretinal fluid in eye models. The ultrasound probe was rotated 180 degrees upon eye models with retinal detachment and the scan images were recorded by a video cassette recorder. Each subretinal space in successive ultrasound image slices was calculated by image analyzer. There were 8 types of models which varied according to the volume or the shape of retinal detachment. As a probe rotating time 3 seconds, 5 seconds, and 8 seconds were employed for each eye model. The measurement error between the actual and the measured volume was -0.08 +/- 1.88% (mean +/- standard deviation, n = 48). The probe rotating time did not influence the measurement error. The results showed that the measurement system for subretinal fluid volume appears to be of clinical value. PMID- 2698057 TI - Clinical evaluation of medetomidine, a novel sedative and analgesic drug for dogs and cats. AB - Medetomidine, a potent alpha 2-adrenoceptor agonist, was investigated in open, multicenter clinical trials with patients of various canine and feline breeds (1736 dogs and 678 cats). The purpose of the study was to find an optimal dose of medetomidine for sedation and analgesia in clinical practice and to study how well the intended procedure could be performed under the influence of the drug. The mean dose (i.m.) of medetomidine used for examinations, clinical procedures and minor surgical interventions was 40 micrograms/kg, and for radiography 30 micrograms/kg. In cats the dose was 80-110 micrograms/kg. On the doses chosen, almost all animals were recumbent and 72% of the dogs and 85% of the cats were in a slight anaesthetic stage, unable to rise. The evaluation of the overall suitability of medetomidine (% of cases) in different indications was "very satisfactory" or "satisfactory" in 95% of dogs and 81-96% of cats. Side effects reported were limited almost exclusively to vomiting and muscle jerking in dogs (12% and 0.5% of the cases) and to vomiting in cats (65%). Medetomidine seems to suffice for pharmacological restraint of dogs and cats. The concomitant use of medetomidine (80-100 micrograms/kg) and ketamine (7 mg/kg) in cats (n = 295) provided a good anaesthesia (20-40 min). The recovery was smooth. The present study shows that medetomidine provides an effective level of sedation and analgesia for clinical use. PMID- 2698058 TI - The influence of flunixin on the response to Salmonella typhimurium endotoxin in calves. AB - The effects of intravenous injection of 0.5 microgram/kg body weight of Salmonella typhimurium endotoxin were studied in calves. The injection was followed by ruminal stasis and general dullness. The clinical signs disappeared within 24 hours. The injection was followed by a tremendous increase in the plasma level of 15-ketodihydro-PGF2 alpha, the main metabolite of PGF2 alpha. The injection was also associated with a profound leukopenia and significant decreases in the serum levels of iron, zinc and calcium. In order to study the role of prostaglandin (PG) for the development of endotoxin-induced changes a group of calves was pretreated with flunixin, a potent cyclo-oxygenase inhibitor, at a dose of 2.2 mg/kg body weight. Flunixin inhibited the PG release completely, but did not influence the other responses to endotoxin. The pyrogenic response to endotoxin was very moderate and it was suggested that fever is not the most suitable parameter for monitoring endotoxin effects in calves. The studied blood parameters (15-ketodihydro-PGF2 alpha, iron, zinc, calcium and the number of leukocytes) appeared to be much more sensitive. PMID- 2698059 TI - The in vivo lipolytic effect of Salmonella typhimurium endotoxin. PMID- 2698060 TI - [The influence of circulatory failure on fetal development in women with rheumatism]. AB - In the time-course of pregnancy the characteristic features of fetal development were studied in 149 females with rheumatic disease with the employment of ultrasonic fetometry. Certain features of growth in various anatomical structures of the fetus with regard to the stage of decompensation were identified Four staged impairments in the development of the fetuses were revealed in this contingent. PMID- 2698061 TI - [The diagnostic potentials of dopplerometry in the fetal growth retardation syndrome]. AB - Findings of conventional sonography and Doppler studies at 34-41 weeks of gestation have been compared in 210 women. Uteroplacental and fetal blood flows were evaluated in intrauterine growth retardation syndrome. Sensitivity, specificity and predictive value of these studies were assessed for fetal vessels, umbilical artery, uterine arteries and fetal measurements. Obstetric and neonatal outcomes were analyzed in relation to hemodynamic abnormalities in the maternal-placental-fetal system. PMID- 2698062 TI - [The importance of echography and hysteroscopy in the diagnosis and basis of a rational therapy for intrauterine pathology after labor]. AB - Echography with hysteroscopy has been employed in 40 mothers with a complicated postpartum period. Ultrasound diagnosis of intrauterine disease is technically simple, noninvasive and efficient in measurement of the uterus and identification of abnormal inclusions in the uterine cavity. Hysteroscopy allows characterization of the abnormal intrauterine inclusions and evaluation of the endometrium. In addition, hysteroscopy enables additional diagnostic and therapeutic procedures. This study resulted in a protocol of postpartum examination of patients using echographic and hysteroscopic diagnostic methods. PMID- 2698063 TI - [The use of echography for studying the developmental characteristics of the early period of pregnancy in miscarriage]. PMID- 2698064 TI - [The possibilities and outlook for the prognosis of puerperal mastitis by using a computer]. PMID- 2698065 TI - [New antibiotics in pediatrics]. PMID- 2698066 TI - [Thyroid autoimmunity in type I (insulin dependent) diabetes mellitus]. AB - 225 diabetic children aged 4-18 years, were screened for antithyroid antibodies. 120 of them were determined at onset of diabetes mellitus. In the remaining patients, duration of diabetes ranged from 6 months to 8 years. The overall prevalence of thyroid antibodies was 14.19% (21/148), while positive titres were found in 10.39% (8/77), at onset. Chronic lymphocytic thyroiditis was diagnosed in 16 patients. No growth retardation was observed. Thyroxine therapy was started in all hypothyroid cases. We conclude that antithyroid antibodies screening in well indicated in diabetic children in view of their high prevalence and strong association with chronic thyroiditis. PMID- 2698067 TI - [Symptomatic pericardial effusions in childhood]. AB - We present the clinical data and the management of twelve patients with symptomatic pericardial effusion (PE). The etiology of PE was: Chronic renal failure, viral infection, cardiac surgery, juvenile rheumatoid arthritis and chronic myelocytic leukemia. Four cases were diagnosed as idiophatic. PE in childhood is usually asymptomatic. When symptoms are present they are non specific and don't help to know the size of the effusion; therefore, it's necessary to practice an echocardiography to demostrate the presence of PE. The hemodynamic findings permit to diferentiate patients with and without cardiac tamponade. The treatment of first choice is aspirin. In patients with cardiac tamponade the treatment should be pericardiocentesis. PMID- 2698068 TI - [Pertussis syndrome: study of 74 cases]. AB - Pertussis syndrome controversy induced us to study 74 hospitalized patients, with pertussis cough and Bordetella sp isolation in 29, other bacteria in 24 and viruses in 21. The most frequently isolated bacteria in the patients with negative culture for bordetella were Haemophilus influenzae, Streptococcus pneumoniae and Branhamella catarrhalis. The viruses with highest incidence were respiratory syncitial viruses. The negative culture for bordetella, the lack of antibiotherapy previous to obtention of the sample (29/45 cases), the clinical differences and their different seasonal distribution in relation to the patients with positive culture for bordetella, permit us to suppose that the bacteria/viruses isolated could be the etiologic agents of pertussis syndrome. Although Bordetella sp occupies an important place in the pertussis cough etiology, it is advisable to investigate the presence of viruses and other bacteria in these patients. However the difficulties to isolate bordetella implies the necessity of performing adequate isolation techniques and to study larger numbers of patients including control groups. PMID- 2698069 TI - [Measurement and comparison of the rheumatoid factors class IgG, IgM and IgA in chronic juvenile rheumatoid arthritis]. AB - The rheumatoid factor (RF) was studied in 35 sera from 23 children with juvenile rheumatoid arthritis (JRA). The immunoglobulin class of RF was investigated and also its reactivity to both human and rabbit IgG. The RF of IgG class (IgG-RF) was more frequently positive than the IgM-RF and the IgA-RF. Nevertheless, against human IgG we found IgM-RF in the 51% of sera and IgA-RF in 48%, and against rabbit IgG in 65 and 37% respectively. All classes of RF were more frequent in rheumatoid patients than in normal controls (p less than 0.0005) although the IgA-RF increase was not significant in some groups. The specificity of the 5 RF types was always very high (92-100%). The sensibility ranged between 71% (IgG-RF against rabbit IgG) and the 37% (IgA-RF against rabbit IgG). Most sera simultaneously contained more than one class of RF. Against human IgG, the 37% had 2 classes. When we used rabbit IgG, the 31% had 3 classes and the 62% had 2 classes. The correlation of every RF class each other generally was very high (p less than 0.001). A correlation was also present in the seronegative and the systemic group, when we separately studied every clinic form. The ELISA allows detect positive IgG-RF and IgA-RF in seronegative cases by agglutination tests, therefore the seronegative concept must be reconsidered. The correlation among different RF classes are, frequently, very closed. PMID- 2698070 TI - [Neonatal pelvic ectasia]. AB - 54 neonates found to have pelvic dilatation on sonography are reported. They were studied by IVP, voiding cystography and renal function tests. Periodic sonography, urine cultures and DPTA furosemide in severe cases were performed during the follow-up (3-32 months). The ectasias were classified in 4 grades, found a good correlation with urography in grades I, III and IV. Neonatal pelvic dilatation is associated with: 1) urinary tract infection (17.4%); 2) vesicoureteric reflux (25.5%); 3) ureteropelvic obstruction (17.4%). During the follow-up 52% of ectasia disappeared (x: 6 months) and 11% will required pieloplasty (x: 10 months). It is noteworthy the high rate of initial and further urinary tract infection (53% of patients). PMID- 2698071 TI - [Pericentric inversion of the human Y chromosome]. AB - Pericentric inversion of the human Y chromosome has an estimated frequency of the one per thousand. This inversion is always inherited but also is possible a de novo presentation. Sometimes this inverted chromosome is associated with the Down, Klinefelter and other chromosomal syndromes. For the carriers of pericentric inversion the risk of the mental retardation or multiple abortion is not apparently increase and there is not relation with abnormal phenotypic features. For some authors the pericentric inversion of the human Y chromosome is only a rare chromosomal heteromorphism. PMID- 2698072 TI - [Adrenal abscess in a neonate]. PMID- 2698073 TI - [Cardiologic complications related to cocaine]. PMID- 2698074 TI - [Tumor necrosis factor. From theory to practice]. PMID- 2698075 TI - Defective calcium signal generation in a T cell subset that accumulates in old mice. AB - Table 2 outlines our current understanding of the bases for activation defects in T cells from old mice, with speculative ideas indicated by a question mark. Many, though not all, T cells from old mice show defects in the generation of Ca2+ signals within the first few minutes of exposure to a mitogenic lectin or to antibody to components of the T cell receptor. These defects seem to involve an increased resistance to changes in cytoplasmic free calcium ion concentration, perhaps though changes in the calcium extrusion pump. Diminished rates of uptake of calcium from extracellular sources also contribute to defective calcium signal generation. Some aspects of the activation process, including production of inositol phosphates, seem in contrast not to be altered by aging in mice. T cells with defects in Ca2+ responses seem to be contained preferentially within the PGP 1hi subsets of both the helper and cytotoxic lineages, subsets that accumulate dramatically in old mice. Since the PGP-1hi phenotype is thought to distinguish memory T cells from virgin thymic emigrants, we propose a model in which aging leads to the progressive conversion of virgin to memory T cells, which in turn gradually lose the ability to respond to activating stimuli. PMID- 2698076 TI - Platelet-activating factor and related ether lipid mediators. Biological activities, metabolism, and regulation. PMID- 2698077 TI - Molecular insights into Alzheimer's disease. PMID- 2698078 TI - Effects of calcium, ATP, and lipids on human erythrocyte sugar transport. PMID- 2698079 TI - Disease problems in the Third World. PMID- 2698080 TI - Strategies for genetic modification of parasites. PMID- 2698081 TI - Strategies for malaria control: realities, magic, and science. PMID- 2698082 TI - Antigenic variation in relation to vaccines. PMID- 2698083 TI - Strategies for vaccine development: schistosomiasis. PMID- 2698084 TI - Strategies for the development of vaccines for typhoid fever, shigellosis, and cholera. PMID- 2698085 TI - Health research in Africa: priorities, promise, and performance. PMID- 2698086 TI - Leishmaniasis and malaria: DNA probes for diagnosis and epidemiologic analysis. PMID- 2698087 TI - Biomedical science and the third world. Under the volcano. Trypanothione reductase. PMID- 2698088 TI - Biomedical science and the third world. Under the volcano. Recent studies on thymidylate synthase. PMID- 2698089 TI - Studies of cachexia in parasitic infection. AB - Cachexia and septic shock, syndromes associated with chronic and acute infection, respectively, are mediated by endogenous factors. The search for humoral mediators of cachexia led to the isolation of the cytokine known as cachectin/TNF. A biologic role for cachectin/TNF in cachexia has been identified: it induces a catabolic state in adipose and skeletal muscle cells in vitro, and animals persistently exposed to it in vivo become cachectic. Cachectin/TNF was also discovered to be a primary, essential mediator of septic shock. The acute administration of the recombinant protein causes shock, tissue injury, and derangements of metabolic homeostasis that mimic endotoxemia and septic shock syndrome. Anti-cachectin antibodies protect against the lethal effects of septic shock and cachexia, suggesting that this mediator has a central role as a trigger to the inflammatory and deleterious host responses to infection. Future investigations will undoubtedly be directed towards the effects of inhibiting cachectin/TNF in the treatment of the complications of infectious disease. PMID- 2698090 TI - Biomedical science and the third world. Under the volcano. Epidemiologic problems and prospects. AB - Rapid advances in the biomedical sciences are producing new means of intervention against many of the major tropical diseases. The discovery of new drugs, vaccines and diagnostic tests, however, is only the first, though important, step down an often long and difficult road to their effective deployment in disease control programs. The blossoming of interest in tropical diseases among those in the laboratory sciences has not been paralleled by the required expansion in the number of scientists undertaking field research in the areas where such diseases are endemic. In consequence, it may be difficult to ensure the proper evaluation of new interventions in realistic disease control situations. There is also a danger that some tools developed for research purposes may be uncritically introduced into control programs without adequate consideration of their true utility. Developing field research capacity in the tropical disease endemic areas is an urgent priority if the new tools and interventions are to be employed optimally. Some methods for achieving this are discussed and possible epidemiologic approaches to the evaluation of interventions against tropical diseases are outlined. PMID- 2698091 TI - Recent occurrences in the discovery and development of drugs to treat HIV infections. PMID- 2698092 TI - The influence of different sexual-contact patterns between age classes on the predicted demographic impact of AIDS in developing countries. AB - A model is developed to describe the spread of HIV within heterosexual communities and the demographic impact of AIDS. The model combines epidemiologic and demographic processes and is designed to mirror the impact of AIDS in sub Saharan Africa. Refinements on past work in this area include unequal probabilities for transmission from females to males and from males to females, the inclusion of an age- and sex-dependent sexual-partner choice function and distributed incubation plus infectious periods. Numerical studies suggest that unequal transmission probabilities (weighted to a greater probability from males to females than vice versa), and the tendency of males to choose sexual partners of the opposite sex younger than themselves, both act to increase the demographic impact of AIDS over that predicted with equal transmission between the sexes and partner choice restricted within given age classes. Analyses support the conclusions of past work that the epidemic will only have a small detrimental impact on the dependency ratio of a population (the ratio of dependents to working adults) even when a weighting is added to take account of the extra burden imposed by the care of adult AIDS patients. However, a small increase in the ratio can imply a significant rise in the number of dependents within the population. Stimulation studies of the impact of changes in behavior to reduce transmission highlight to the need to induce such changes as early as possible in the course of the epidemic in order to minimize its impact. Directions for future research are discussed emphasizing the need to acquire quantitative data on sexual habits and to construct models to represent heterogeneity in sexual behavior. PMID- 2698093 TI - Perspectives on research and diseases of the Tropics: an Asian view. PMID- 2698094 TI - Social science and the improvement of tropical disease control programs. PMID- 2698095 TI - Investments in women, economic development, and improvements in health in low income countries. PMID- 2698096 TI - Biotechnology and the Third World: development strategies in Cuba. AB - In March 1981, six researchers started production of natural interferon in a modest building adapted as a laboratory. By May the first yields of this protein were achieved. Applications of this interferon were already taking place in 1981 in the first clinical trial with the drug in the country. In June, the top level of the government decided to organize the Biological Group. In January, 1982, a new institution (CIB) began work with about 30 scientists and developed activities in gene manipulation, molecular virology, work with monoclonal antibodies, immunochemistry and tissue cultures. By 1983 interferon genes were cloned and expressed, and the group continued working, increasing the number of personnel. A decision was made in 1984 to build a new center, the CIGB. In July 1986, the center was officially inaugurated. Between 1986-89 important results were achieved by members of the biological group, among which was a vaccine against meningococcal meningitis. Three years later, in July 1989, the CIGB produced 15 new recombinant proteins, drugs, enzymes and antigens for diagnostic purposes. With the application of the most advanced technology, research has been conducted in areas such as gene regulation, bacterial and yeast genetics, protein structure and mammalian development. In addition, 43 types of monoclonal antibodies were produced as were 38 types of restriction enzymes (three of them recombinant), as well as several linkers, markers, and phages. Interferons, monoclonal antibodies, restriction enzymes, and epidermal growth factor, among others, are all being marketed. The CIGB became the leading institution in the country for work in modern biotechnology, generating new work styles in the country and developing a special selection procedure to include young scientists on the staff, simultaneously providing intense training in the center and abroad. This provided the stimulus of participating in the achievement of important results for the country, producing a positive feedback loop to maintain high standards. Interferon has been applied in more than 10,000 cases in the country. The diagnostic kit for AIDS based on recombinant proteins has been used in millions of tests and epidermal grow factor is already registered as a drug after fulfilling all the requirements of the preclinical and clinical testing with hundreds of patients in different clinical trials. A close connection with different institutions working in the field of biotechnology and with different universities has provided a greater strength for the work in modern biotechnology in Cuba. PMID- 2698097 TI - Biomedical research in Latin America: old and new challenges. PMID- 2698098 TI - Vaccinia virus expression vectors. PMID- 2698099 TI - Vitamin E: introduction to biochemistry and health benefits. AB - Free radical-mediated damage has been implicated in cellular changes that occur over time in the aging process and in development of degenerative diseases. Research results to date have demonstrated that vitamin E and the other antioxidants function to prevent or minimize peroxidative damage in biological systems and suggest that adequate antioxidant defense can protect the body from the high free radical concentrations that are unavoidable at the present time. PMID- 2698100 TI - Localization of alpha-tocopherol in membranes. PMID- 2698101 TI - Tocopherol stabilizes membrane against phospholipase A, free fatty acids, and lysophospholipids. PMID- 2698102 TI - Neuropathies in adults with or without fat malabsorption. PMID- 2698103 TI - The endogenous toxin hypothesis of the etiology of Parkinson's disease and a pilot trial of high-dosage antioxidants in an attempt to slow the progression of the illness. PMID- 2698104 TI - Prophylaxis of periventricular hemorrhage in preterm babies by vitamin E supplementation. PMID- 2698105 TI - Inhibition of oxidation of biomembranes by tocopherol. PMID- 2698106 TI - Oxygen free radical-mediated heart injury in animal models and during bypass surgery in humans. Effects of alpha-tocopherol. AB - There is evidence that oxygen free radicals play a role in myocardial ischemic and reperfusion injury. We investigated the effect of ischemia and reperfusion on glutathione status. Reperfusion after prolonged ischemia (60 min) induced an important release of reduced (GSH) and oxidized (GSSG) glutathione, concomitant with an increase of tissue GSSG and no recovery of mechanical function, indicating that reperfusion results in oxidative stress. These alterations are associated with tissue and mitochondrial calcium accumulation, loss of mitochondrial function, and membrane damage. We also determined the arteriocoronary sinus difference for GSH and GSSG of 16 CAD patients undergoing coronary artery bypass. Patients were divided in two groups according to the length of clamping period: 25 +/- 2 min (group 1), and 55 +/- 6 min (group 2). In group 1, reperfusion resulted in a transient release of GSH, GSSG, CPK, and lactate, with return to preclamping values in 10 minutes. In group 2, reperfusion determined a sustained and pronounced release of GSH, GSSG, CPK, and lactate during declamping, suggesting the occurrence of an oxidative stress. Using an in vitro model, administration of alpha-tocopherol bound with albumin showed protection of mitochondrial function, improved recovery of contraction, and reduced oxidative stress during reperfusion. PMID- 2698107 TI - The role of vitamin E and carotenoids in preventing oxidation of low density lipoproteins. PMID- 2698108 TI - Effect of vitamin E supplementation on immune responsiveness of the aged. PMID- 2698109 TI - Vitamin E, immune response, and disease resistance. AB - Vitamin E as a dietary supplement or as part of an adjuvant vaccine formulation increases humoral and cell-mediated immunity and disease resistance in laboratory animals, farm animals, and humans. Adjuvant administration has far greater effect than dietary supplementation. Vitamin E as an antioxidant protects the cells of the immune response from peroxidative damage; possibly through a modulation of lipoxygenation of arachidonic acid, vitamin E alters cell membrane functions and cell-cell interactions. The most pronounced effect of vitamin E is on immune phagocytosis. Dietary supplementation is beneficial to animals, especially under stress, in decreasing susceptibility to infections. Vitamin E adjuvant vaccines have provided greater immunoprotection against enterotoxemia and epididymitis in sheep than conventional vaccines. PMID- 2698110 TI - Products in vivo peroxidation are present in tissues of vitamin E-deficient rats and dogs. PMID- 2698111 TI - Vitamin E as an in vitro and in vivo antioxidant. AB - alpha-Tocopherol has near optimal activity as a chain-breaking antioxidant. Inherent antioxidant activity plays an important part in determining overall biological activity but the phytyl tail also exerts a very important influence. The new deuterated alpha-tocopherol/GC-MS technique is providing unprecedented insight into the importance of the stereochemistry of the phytyl tail in determining bioavailability, as well as helping to discover how rapidly and effectively absorption, transport, uptake, and loss occur. Measurements of rate of turnover in tissues indicate that differences exist between different types of animals. It is possible that these tissue differences may explain the diverse range of vitamin E deficiency symptoms observed across a wide variety of animals. It is not known what is responsible for the differences in biokinetic behavior. PMID- 2698112 TI - Tocopherol-binding proteins of hepatic cytosol. PMID- 2698113 TI - [Lichen planus and lichenoid eruptions. The 1889 Congress]. PMID- 2698114 TI - [From venereology to sexually transmitted disease]. PMID- 2698115 TI - [The cardiologist and AIDS]. AB - Since first individualized in Atlanta in 1981, the frequency of AIDS is constantly increasing and the risk groups (male homosexuals, heroin addicts, transfused hemophiliacs, Haitians and Africans) are no longer the only ones concerned. The progression of the disease in African heterosexuals foreshadows its probable course in the Western World. 8,000 AIDS cases were indexed in Europe as of June 1987; 45,000 are expected in 1989. Cardiologists are a priori much less concerned by this disease than infectious disease specialists, internists, dermatologists, respiratory diseases specialist or neurologists. However, under three circumstances they may have to become involved in this disease. 1) AIDS following blood transfusions: the greater the risk as the amount of blood transfused is important; patients undergoing ECC present an increased risk. As of June 30 1988, 320 cases of posttransfusion AIDS had been reported in France (7.82 p. cent of all reported AIDS cases). The mean incubation period, estimated at 54 months in 1986, would actually be much longer: distribution according to a Gauss curve with a period of 15 years +/- 5, which would lead to expect many cases in the years to come affecting patients who were transfused before August 1985, when systematic screening became mandatory. Since that time, the risk has markedly decreased but is not non-existent (pre-serology phase, contamination with HIV 2), resulting in a limitation of the indications of transfusions and restoring as often as possible to autotransfusion and normovolemic hemodilution. PMID- 2698116 TI - [Pathogenesis of atherosclerosis: an update on the three main theories]. AB - The causes and mechanisms of atherosclerosis remain incompletely understood. Almost all the present investigations are still connected with one of the main three historical theories of atherosclerosis: 1) the incrustation theory, as developed by von Rokitansky, has now led to the many studies on the roles of thrombosis and platelets; 2) the irritation theory, as opposed to the preceding one by Virchow and his school, is reviving through the rediscovery that leukocytes are present in the plaques, and that atherosclerosis (Virchow's endarteritis chronica deformans sive nodosa) has the features of a chronic inflammatory reaction; 3) the lipid infiltration theory, as initiated by the experiments of Anitschkov and Chalatov in rabbits fed a cholesterol enriched diet, motivates the huge mass of studies devoted to plasma lipids and their cellular metabolism. This article provides a brief update on each of these three complementary approaches of atherosclerosis. PMID- 2698117 TI - [Which thrombolysis in myocardial infarction?]. AB - Intravenous administration of thrombolytic agents in myocardial infarction is now preferred to the intracoronary route, which nonetheless is still used in some special indications. The dissolution of thrombi occurs at the same rate for the two routes of administration. The secondary reocclusion rate remains high and seems to be linked to the duration of action of the thrombolytic. The highest secondary reocclusion rates are seen with short-acting thrombolytics such as plasminogen activator. Anticoagulant therapy using heparin is used extensively in prevention of secondary reocclusion. Antiplatelet drugs, nonsteroidal anti inflammatories and prostacyclin analogs are currently being evaluated. All thrombolytics currently used limit the size of subsequent infarction, preserve left ventricular systolic function and reduce mortality. All are equally likely to result in hemorrhagic complications, regardless of whether or not they are specific for fibrin. The role of complementary revascularization after successful thrombolysis is becoming clearer. No additional improvement in left ventricular function or the rate of secondary reocclusion is achieved by immediate angioplasty, and more complications are seen. For this reason coronary arteriography and complementary revascularization should probably be delayed for a few days after thrombolysis. PMID- 2698118 TI - [Jet intravenous injection of erythromycin lactobionate. A possible cause of the occurrence of crisis in torsade de pointe]. AB - The authors report one case of torsade de pointe which occurred immediately after fast intravenous injection of a 1-gram dose of erythromycin lactobionate in a female patient who had undergone surgical replacement of the mitral and triscuspid valves 24 hours before. The responsibility of erythromycin was strongly suggested by the clinical data (syncope), electrocardiographic findings (electrocardiogram typical of torsade de pointe, slow rhythm and lengthened QT interval in the basal ECG) and the chronology of the sequence of intravenous injection of the antibiotic and the rhythm disorder. A literature search revealed six similar cases. Its seems that the arrythmogenic property of this drug is related to abnormally elevated serum levels following rapid administration. PMID- 2698119 TI - [Thoughts on the causes of seasonality of menarche]. AB - The pineal gland plays an important role in the production of melatonin and in the synchronization of the reproduction process in seasonal breeding animals. Changes in the duration of day length are the most important stimulatory factors. In humans the pineal gland may not only have a physiological role in the seasonality of maturation, but also concerning the simultaneously observable changes of serum hormone and serum melatonin levels as well as in regard of changes in hair colour in prepuberal children. Therefore the pineal gland seems to play an important physiological role in the timing of human maturation. PMID- 2698120 TI - Diffuse nephrocalcinosis and idiopathic renal hypercalciuria. AB - A 12 year old boy presented with primary nocturnal enuresis. Investigation showed extensive bilateral nephrocalcinosis of no obvious or recognised cause. Persistent severe renal hypercalciuria was confirmed by an intravenous calcium infusion. Idiopathic hypercalciuria is not a common cause of nephrocalcinosis and has not previously been described in a child. PMID- 2698121 TI - Management of asthma: a consensus statement. AB - In developing these international guidelines there were several unifying themes in the diagnosis and simple management of childhood asthma. For the purposes of the meeting, asthma was operationally defined as 'episodic wheeze and/or cough in a clinical setting where asthma is likely and other rarer conditions have been excluded'. In making a diagnosis of asthma, a full history is a prerequisite. Additional tests are only used to support clinical impression and to provide objective evidence for therapeutic recommendations. General features of a multidisciplinary approach include an appreciation of the importance of psychosocial factors, counselling, and education. Drugs should be prescribed in a rational sequence: beta 2-stimulants for mild episodic wheeze; sodium cromoglycate for mild to moderate asthma; inhaled steroids for moderate to severe asthma; with xanthines, ipratropium bromide, and oral steroids having their place in more persistent and severe cases. Children and their parents should be reassured that if asthma is properly controlled there is no reason why the child should not lead a normal and physically active life. The management of asthma is rewarding and return to 'normal' lifestyle is nearly always possible with active participation in sporting activities. PMID- 2698122 TI - IgG antibodies to Aspergillus fumigatus in cystic fibrosis. PMID- 2698123 TI - Group A streptococci revisited. PMID- 2698124 TI - Chemoprophylaxis of trypanosomiasis, due to Trypanosoma (Nannomonas) congolense, in rabbits using a slow release device containing homidium bromide. AB - The prophylactic activity of a subcutaneously implanted slow release device, containing homidium bromide, was assessed in rabbits, challenged with different stocks of T. congolense, and compared with the classical treatment of 1 mg homidium bromide/kg b.w. intramuscularly. The prophylactic activity of the intramuscular injection was less than a month, while the slow release device protected the rabbits against seven challenges with T. congolense during a period of more than 300 days. PMID- 2698125 TI - [The sensitivity to 12 antibiotics of 125 strains of Streptococcus group B isolated in a maternity home]. AB - Sensitivity of 125 strains of group B streptococci isolated from newborns, their mothers and personnel in a maternity home was studied with respect to 12 antibiotics: benzylpenicillin, ampicillin, methicillin, cephalotin, erythromycin, lincomycin, levomycetin (chloramphenicol), oxacillin, tetracycline, streptomycin, gentamicin and ristomycin. The method of serial dilutions in a solid medium was applied. All the strains were sensitive to ristomycin and erythromycin. The predominating number of the strains were sensitive to lincomycin, levomycetin and the beta-lactam antibiotics. Strains resistant or moderately resistant to benzylpenicillin, ampicillin, oxacillin, methicillin and cephalotin were detected. The majority of the strains were resistant to streptomycin, tetracycline and gentamicin. Multiple antibiotic resistance with 2-7 determinants was revealed in 11.2 per cent of the strains. The antibiotic sensitivity of the strains isolated from the newborns, their mothers and the personnel in the maternity home was on the whole similar or insignificantly differed. PMID- 2698126 TI - [The pharmacokinetic interpretation of the nephrotoxic effect of aminoglycosides and the influence of cephalosporins on the aminoglycoside nephrotoxic effect]. PMID- 2698127 TI - [The use in medicine of guanine compounds and the methods for their production]. PMID- 2698128 TI - [Clinico-morphological characteristics of extrahepatic pathology caused by the hepatitis B virus]. AB - The current literature and the authors data on the clinics and morphology of the extrahepatic (visceral) pathology provoked by the hepatitis virus are analysed. PMID- 2698129 TI - [A method for evaluating a diagnostic inflammatory focus by using the "cold test"]. AB - Clinico-morphological test for the quantitative evaluation of exudative and cell response in the diagnostical inflammatory focus in various forms of human pathology is developed. The values in practically healthy persons are established. The possibilities of the test use for the prognosis of disease and the development of postoperative complications in patients with cold trauma are shown. PMID- 2698130 TI - [Leonid Iosifovich Smirnov (on the centenary of his birth)]. PMID- 2698131 TI - [Pathology of the digestive organs and systemic endotoxinemia]. AB - The intestine being a natural depot of the gram-negative bacteria, may be the source of the systemic endotoxinemia in various pathologic processes followed by the increase of bacteria death, mucous membrane damage, pancreas endocrine function deficiency, liver barrier function depression, decrease of the portal circulation speed or its shunting. At the same time, the systemic endotoxinemia in itself may be one of the most important etiological factors of the various digestive organs injury. The authors observations and the literature suggest an important role of the endotoxin-positive granulocytes in the pathogenesis of the haemorrhagic infarct of the intestine, mesenteric vein thrombosis, destructive appendicitis and cholecystitis. PMID- 2698132 TI - [Cardiac insufficiency: current aspects of treatment]. PMID- 2698133 TI - [Treatment of mild and moderate hypertension with the use of captopril alone or combined with hydrochlorothiazide. A multicenter study]. AB - The efficacy of captopril 25 mg/day as monotherapy or when necessary, in association with hydrochlorothiazide 25 mg/day, was studied during three months in 472 patients, average age 45 (17-59) years, 51% males with mild (73%) 95 less than PAD less than 104 mmHg, and moderate (27%) arterial hypertension 104 less than PAD less than 114 mmHg. Were included in the study hypertensive patients with previous antihypertensive therapy or when in the course of any previous antihypertensive treatment (52.4%) blood pressure control were not observed and side effects compromised patient's compliance. Captopril 25 mg/day was used once a day as single dose or subdivided in two daily doses (12.5 mg b.i.d.), during 30 days. If blood pressure was not normalized or dyastolic blood pressure drop was not equal or bigger than 10% after this period, it was added hydrochlorothiazide 25 mg/day. After three months under treatment, 411 (87%) patients normalized their dyastolic blood pressure DBP (less than 90 mmHg), from them, 273 (57.6%) had received only captopril and the others 138 (29.4%) with the addition of hydrochlorothiazide. The drop of mean arterial pressure, MAP = 2 DBP + 1 SBP was in average, 17.3 mmHg, in the 3 patients whose blood pressure normalized with captopril alone, and in average of 18.5 mmHg in those patients requiring addition of hydrochlorothiazide (difference without statistical significance). A small decrease of body weight, but with statistical significance (p less than 0.001) were observed during the use of captopril as monotherapy. Expressive reduction of side effects were observed during the period under captopril related to the period with previous antihypertensive therapy. PMID- 2698134 TI - [Cardiomyoplasty. A therapeutic alternative in advanced cardiomyopathy?]. PMID- 2698135 TI - [The incorporation of color flow mapping in echocardiographic practice]. PMID- 2698136 TI - [Development of the atrioventricular junction in humans]. PMID- 2698137 TI - [Diabetes mellitus and the heart]. PMID- 2698138 TI - [Efficacy of captopril in the treatment of mild and moderate hypertension in patients over 60 years of age]. AB - The response to the use of converting enzyme inhibitor (captopril) either alone or associated to hydrochlorothiazide was evaluated during three months in 128 patients over 60 years old, with mild (79.7%) and moderate (20.3%) hypertension. Seventy (55%) were female and 58 (45%) male, being 64.8% white, 33.6% non-white and 1.6% asiatic. All patients received initially either a single dose of 25 mg of captopril or twice 12.5 mg, and after 1 month those in which hypertension was maintained 25 mg of hydrochlorothiazide was associated. During this period the analysis of the results showed a significant reduction of systolic and diastolic blood pressure (DP), however, there was a marked reduction during the first month. Thus, DP decreased from 101 +/- 8.8 (control) to 93 +/- 8.7 in the first month, to 89.6 +/- 8.2 in the second and 86 +/- 8.2 in the third, all significant at p less than 0.001. Similar distinction with previous treatment were observed when ranges on DP were analysed in patients receiving isolated or associated captopril. There was a small but significant weight and heart rate fall in patients receiving only captopril. Reduction of side effects was observed in 79% of the patients, as compared to previous treatment there being distinct improvement, while 21% showed no alterations and none showed complications. Therefore, we may conclude that use of captopril in elderly hypertensive patients was efficacious in the control of arterial blood without influence on quality of life. PMID- 2698139 TI - The role of the kidney in the maintenance of water balance. AB - This chapter shows how the mammalian kidney is able to regulate the excretion of water independently from that of solutes. For this function, which derives from several evolutionary steps among vertebrates, it takes advantage of the diluting ability of the thick ascending limb to produce osmotic energy which is then used to concentrate solutes in the urine. This concentration is permitted by a highly sophisticated architecture of nephrons and vessels in the renal medulla, combined with special permeability characteristics of the different nephron segments and specific hormonal regulation. Two different types of loops of Henle and several well-insulated vascular compartments contribute to this process. The major nitrogenous waste product, urea, is concentrated by an indirect process involving a transfer of osmotic energy from the outer to the inner medulla. As known for several decades, concentrating function is primarily regulated by the effect of antidiuretic hormone (ADH) on water permeability of the collecting duct. However, as discovered more recently, it is also largely dependent upon the effect of the same hormone on urea permeability in the terminal collecting duct. In addition, recent investigations have revealed a much more complex hormonal regulation of the concentrating process than previously thought. ADH itself acts on many other structures in the kidney, and many other hormones and mediators, the secretion of which is not thought to be influenced by the water status, do affect urine concentration either directly or by their interaction with ADH. Rodents display a wide spectrum of morphological and functional renal adaptations improving water conservation. Their study has brought a better understanding of the significant steps and anatomical structures that contribute to the concentrating process. Finally, it is also apparent that the capacity to concentrate urine is influenced in individual animals of a given species by the availability of water, by specific feeding patterns, and by the protein content of the diet. PMID- 2698140 TI - Regulation of vasopressin secretion. AB - With the development of sensitive and specific radio-immunoassays to measure the low circulating concentrations of vasopressin there has been a quantum leap in our understanding of the physiological processes involved in the regulation of its secretion. The results of Verney's pioneering studies in dogs led to the concept of 'osmoreceptors'. It is now appreciated that osmoregulation of vasopressin release is of principal importance in the maintenance of water balance. Functional characteristics of the osmoregulatory system have been defined clearly by independent laboratories, and more recently the physiological influences that can subtly alter this very finely controlled system have been described. Non-osmotic factors that release vasopressin have been recognized for many years. Secretion of vasopressin in response to haemodynamic influences has been characterized, and significant hypotension and/or hypovolaemia are potent stimuli to hormone release. Other non-osmotic factors--nausea/emesis, hypoglycaemia--may play important roles in disturbances of water balance. Vasopressin should not, however, be regarded as a stress hormone, since recent careful studies in a variety of species indicate that secretion is not enhanced following a series of different noxious stimuli. PMID- 2698141 TI - Control of blood and extracellular volume. AB - Blood and extracellular fluid volume are maintained within narrow limits despite considerable daily variations in the intake in salt and water. As summarized schematically in Figure 15, the urinary excretion of salt and water responds to changes in blood volume and arterial pressure. Volume-sensitive receptors located predominantly in the cardiac atria and arterial tree sense acute changes in the filling of the blood volume compartment, and urinary sodium excretion is adjusted in response to these detector mechanisms by virtue of alterations in both glomerular filtration rate and tubular sodium reabsorption. The reabsorption of sodium by the tubule responds to changes in extracellular fluid volume as well as to changes in filtered sodium load. Glomerular filtration rate and tubular reabsorption of sodium are influenced importantly by physical properties of the plasma in glomerular and peritubular capillaries and by the composition of the tubular fluid. The renal arterial perfusion pressure is a major factor regulating tubular reabsorption of sodium and water as signalled via changes in renal interstitial hydrostatic fluid pressure. Renal nerves and a variety of systemic and local hormones also influence tubular reabsorption of sodium and water directly by effects on transepithelial sodium transport and/or indirectly by altering renal medullary haemodynamics and the pressure-natriuresis-diuresis relationships. Thus, utilizing a variety of overlapping effector mechanisms that influence renal sodium and water excretion, mammalian organisms have achieved a high degree of stability of body fluid volumes. The fundamental relationship between arterial pressure and renal excretion appears to be the major mechanism which provides for the long-term control of body fluid volume. The sensitivity of the pressure-natriuresis-diuresis relationship is modified by the efferent pathways of the rapid-acting reflex and mechanoreceptor detectors of volume. Working together, these mechanisms provide a remarkable degree of rapid and long term extracellular and blood volume stability. PMID- 2698142 TI - The importance of thirst in maintenance of fluid balance. AB - Plasma osmolality is maintained within very narrow limits by the control of water intake via thirst and water output via secretion of vasopressin. Osmoreceptors are situated in the brain, but on the blood side of the blood-brain barrier in a circumventricular organ. These regions are stimulated by an increase in plasma osmolality and form the most important input to cause thirst and drinking. Cardiopulmonary and arterial baroreceptors sensitive to blood volume and blood pressure also can be important, so hypovolaemic events such as haemorrhage can stimulate thirst. Both raised plasma osmolality and reduced blood volume contribute to thirst and vasopressin secretion following water deprivation. The importance of the nucleus medianus in the neural circuitary involved in integrating thirst should be emphasized. Mechanisms which stop drinking are different from those which initiate it, and oropharyngeal metering of the volume of fluid consumed provides the important input. There are a number of situations in humans where thirst thresholds and sensitivities are altered. The elderly have higher thirst thresholds and this can cause symptoms of dehydration. Increased drinking is seen in congestive heart failure, renal hypertension and certain cerebral lesions. Thirst thresholds are set at lower levels in pregnancy and in the luteal phase of the menstrual cycle and may contribute to fluid retention in these situations. PMID- 2698143 TI - The renin-angiotensin-aldosterone system in volume control. PMID- 2698144 TI - Volume homeostasis and osmoregulation in human pregnancy. AB - This chapter reviews alterations in volume and sodium homeostasis and osmoregulation during human pregnancy. Pregnant women undergo extracellular and plasma volume increases of 50-70%, and these changes accompany marked cumulative sodium retention shared by both mother and fetus. Pregnancy alters several factors with opposing effects on renal salt handling; however, mechanisms by which gestational sodium accumulation and volume expansion are achieved remain obscure. Furthermore, despite substantial increases in absolute blood volume, considerable uncertainty exists as to how this volume is sensed, particularly in late pregnancy when a rapid increase in volume is associated with decreases in peripheral resistance and blood pressure. Attempts to assess 'effective' intravascular volume suggest that pregnant women sense their volume as normal. Osmoregulation is also changed. Body tonicity and the osmotic thresholds for AVP release and thirst decrease by about 10 mosm/kg. The mechanisms responsible for the osmoregulatory changes are obscure. Haemodynamic stimuli such as decrements in blood pressure and of 'effective circulating volume' do not seem to account for them. Of the many increments in hormone levels known to accompany gestation, only hCG has so far been implicated in these changes. Pregnant women experience three- to fourfold increments in AVP disposal rates between early and mid pregnancy; this may be caused by the striking rise in circulating cystine aminopeptidase (vasopressinase) which also occurs during this period. The increments in MCR may be one reason why the hormonal response to a given osmotic stimulus appears to decrease in late pregnancy. All these alterations permit speculation on the manner in which the decrease in Posm occurs and is maintained within narrow limits. Lowering the osmotic threshold to drink stimulates a rise in water intake and dilution of body fluids. Since AVP release is not suppressed at the usual level of hypotonicity, AVP continues to circulate at levels sufficient to permit water retention. Posm continues to decline until it decreases below the new osmotic thirst threshold, when a new steady state is established. At this point water turnover, too, resembles that in the non pregnant state. The change in MCR and the marked increment in plasma vasopressinase may explain certain observations regarding disordered water metabolism during late pregnancy. These are the transient DI syndromes due either to subclinical hypothalamic disease or to a disorder peculiar to pregnancy which is AVP-resistant but dDAVP-responsive; the latter analogue resists degradation by vasopressinase. PMID- 2698145 TI - Polyuric states in man. AB - This chapter reviews the pathophysiological basis for the mechanisms of polyuria and discusses the causes in detail. A small proportion of patients with CDI are of the idiopathic type, with the majority of causes due to trans-spenoidal surgery, head injury following road traffic accidents, and an autoimmune variant. Indirect methods of investigating polyuria are inaccurate in a significant proportion of cases, and the incorporation of measurements of plasma AVP into a water-deprivation test or hypertonic saline infusion can improve diagnostic accuracy. Non-osmotic tests of AVP secretion are of no value in the differential diagnosis of polyuria. Most patients with CDI can maintain water homeostasis with adequate fluid intake, but desmopressin is a convenient, effective and safe therapy which is recommended on both social and medical grounds. Treatment of NDI remains problematic, as neither thiazide diuretics or indomethacin can completely abolish polyuria, and fluid intake remains of primary importance. PMID- 2698146 TI - Hyponatraemia. PMID- 2698147 TI - Growth factors and the regulation of pre- and postnatal growth. AB - Peptide growth factors represent a largely paracrine level of intercellular communication that is basic to the process of life. Growth factors are present in the ovum and are amongst the first products expressed by the embryonic genome. They function as both signals and progression factors for embryonic tissue growth, induction, differentiation, maturation and function. While a widespread tissue expression is demonstrable during fetal development, and in certain postnatal tissues such as the epiphyseal growth plate, growth factor presence in the adult is restricted to tissues sharing rapid cellular turnover such as ovary. However, a transient re-expression of peptide growth factors occurs during adult tissue repair. In addition to mitogenic peptides such as IGFs or EGF, the family of growth factors also includes physiological growth inhibitors such as TGF beta and certain neuropeptides. Insulin is mitogenic in the early embryo and evidence is presented to support a continuation of this role, under defined nutritional conditions, in late gestation. The importance of insulin to pre- and postnatal growth has prompted an expanding literature dealing with the interactions of nutrients, hormones and growth factors during the growth and functional maturation of the islets of Langerhans. While the expression of growth factors in the early embryo is apparently autonomous, some, such as IGFs, become increasingly dependent on nutrient, insulin and GH availability during fetal development and in childhood growth. This has resulted in circulating IGF I and II determinations becoming useful diagnostic markers of endocrine-based growth disorder and nitrogen balance. PMID- 2698148 TI - Development of the thyroid. AB - The fetal hypothalamic-pituitary-thyroid axis develops autonomously of maternal influence. System ontogenesis begins with the appearance and histological development of the thyroid and pituitary glands followed by development of the hypothalamus and the pituitary portal vascular system. Hypothalamic-pituitary control of thyroid function matures during the last half of human fetal development. Thyroid hormones undergo several types of biochemical transformations in tissues, including deiodination, side-chain metabolism, and conjugation with sulphate or glucuronide. Enzyme-mediated monodeiodination is the most important pathway. The first step in T4 metabolism is either outer-ring monodeiodination to active T3 or innerring monodeiodination to inactive rT3. Most T4 is metabolized to rT3 in fetal tissues and/or placenta and rT3 is the major circulating T4 metabolite in the fetus. Selective tissues, such as brain, can monodeiodinate T4 to T3, and this T3 is available for local action. Nuclear thyroid hormone receptors mature at different times in different tissues. Receptors appear earlier in brain than in liver and local T3 production and action may be important in fetal brain development. Most thyroid hormone actions, however, appear in the perinatal period, and infants with thyroid agenesis appear normal at birth and develop normally with prompt neonatal diagnosis and treatment. Premature infants, particularly those less than 30-32 weeks' gestational age, have an immature thyroid system and manifest a state of transient hypothalamic-pituitary TSH deficiency. This does not require treatment. Infants with primary hypothyroidism, either due to thyroid dysgenesis or to thyroid dyshormonogenesis, by contrast, require prompt diagnosis and treatment. Rarely an infant is born with permanent TSH deficiency with or without other pituitary hormone deficiencies. These infants also require prompt treatment. Mothers with thyroid disease or a history of thyroid disease and with IgG autoantibodies to thyroid gland TSH receptors may deliver infants with hypothyroidism or hyperthyroidism due to transplacental passage of the receptor blocking or receptor-stimulating autoantibodies. These infants also require careful evaluation and management. PMID- 2698149 TI - Endocrine control of electrolyte balance during development. AB - The endocrine control of electrolyte balance during development is reviewed. It is suggested that the high urinary sodium excretion observed in premature infants may be secondary to the immaturity of the adrenal gland to adequately increase the secretion of aldosterone (Sulyok et al, 1979b), and to the inability of the distal tubule to respond appropriately to a rise in circulating aldosterone levels (Sulyok et al, 1979a). On the other hand, the elevated plasma aldosterone levels observed in term newborn infants may play an important role in the blunted response of the newborn kidney to saline loading (Sulyok et al, 1979a; Spitzer, 1982). The ability of ANP to induce a natriuresis and to contribute to fluid and electrolyte homeostasis during development has been investigated. It has been found that the immature kidney is less responsive to ANP than later in life (Chevalier et al, 1988; Robillard et al, 1988). On the other hand, it has been suggested that a rise in plasma ANP during the first five days of life may contribute to the physiological weight loss associated with the extracellular volume contraction occurring shortly after birth (Tulassay et al, 1987). The role of glucocorticoids, prostaglandins and the kallikrein-kinin system in regulating electrolyte balance during development is also reviewed. PMID- 2698150 TI - Development of endocrine pathways in the regulation of calcium homeostasis. AB - The mammalian fetus is maintained hypercalcaemic relative to its mother by the action of a calcium pump believed to be located at the basement membranes of the epithelial cells of the fetal chorion. It has recently been demonstrated that the activity of this putative pump is stimulated by a new fetal hormone, parathyroid hormone-related protein, described originally as the product of a human BEN cell line which was derived from a lung tumour associated with hypercalcaemia of malignancy. Whereas the circulating level of immunoreactive parathyroid hormone in the fetus is very low, in keeping with the hypercalcaemia, the plasma concentrations of bioactive parathyroid hormone and parathyroid hormone-related protein can be measured using a sensitive cytochemical bioassay and the separate concentrations assessed by pre-incubation with appropriate antisera. The total plasma concentration of both hormones is inversely related to the prevailing calcium ion concentration but the set point of parathyroid hormone-related protein is probably higher than that for parathyroid hormone. Probably as a result of the hypercalcaemia, the circulating concentration of calcitonin is also higher than in maternal plasma and may serve to limit bone resorption to favour net bone accretion as part of the overall growth of the fetus. Vitamin D and its most active metabolite, 1,25(OH)2D, can pass across the placenta in either direction, in contrast to most peptide hormones. In addition to the supply of some 1,25(OH)2D by the mother to her fetus, the fetal placenta and fetal kidneys can all synthesize 1,25(OH)2D. The relative concentrations circulating in maternal and fetal plasma pools vary with the species, presumably as a result of differing importance of the three sources of supply to the fetus and the relative concentrations of vitamin D-binding protein circulating in mother and fetus. The importance of parathyroid hormone-related protein derived from fetal parathyroid glands has been clearly demonstrated in the fetal sheep. Such animals develop rickets following the removal of their parathyroid glands, despite the demonstration of this substance in fetal placental membranes. However, the relative importance of the parathyroid glands versus the placenta and its membranes as the principal source of parathyroid hormone-related protein remains to be elucidated and may vary with species. PMID- 2698151 TI - Functional maturation of the adrenal medulla and peripheral sympathetic nervous system. PMID- 2698152 TI - The pre- and postnatal development of hormonal circadian rhythms. PMID- 2698153 TI - Hormonal control of lung maturation. PMID- 2698154 TI - Endocrine function of the placenta. PMID- 2698155 TI - Birth: outcome of a positive cascade. PMID- 2698156 TI - Hormonal effects on circulatory changes during the perinatal period. PMID- 2698157 TI - Control of fetal and neonatal glucose metabolism by pancreatic hormones. PMID- 2698158 TI - The endocrinology of feeding in the newborn. AB - During the last 20 years there has been an explosion of interest in and knowledge of hormones and regulatory peptides manufactured by specialized cells in the gut. Evidence has been presented in this chapter to suggest that these substances have essential roles to play in the effective utilization of food in the human adult, and that they also have an essential role to play in the differentiation and functional development of the fetal gut. It is, perhaps, during the days immediately following birth that they have their greatest and most important influence, in determining the successful adaptation to postnatal enteral feeding. There is good evidence to show that the initiation of enteral feeding is an important environmental trigger which provokes massive surges in the concentrations of these peptides in the first postnatal days in both premature and full term infants. The mode of administration and the composition of feeds have further influences, whilst deprivation of enteral feeding prevents the appearance of postnatal hormonal surges. In view of the fact that sub-nutritional volumes of milk are capable of inducing these surges, the concept of minimal enteral feeding in seriously ill premature and full term infants and even the therapeutic use of regulatory peptides warrants further investigation. Finally, it is evident that much more study is required to define the ontogeny, regulation of secretion, interaction and mechanism of effect of these fascinating substances. PMID- 2698159 TI - The endocrine control of the onset of thermogenesis at birth. AB - The experimental studies in the fetal sheep demonstrate that the central hypothalamic mechanisms for responding to a cold stress have differentiated well before birth. There are several major determinants of the initiation of maximal thermogenesis at birth. These are cutaneous cooling, oxygenation and separation from the placenta. Firstly the stimulation of cutaneous cold receptors regulates sympathetic nervous system activity, primarily local noradrenaline release from sympathetic nerve termini to the brown adipocyte adrenoreceptors. Circulating catecholamines, the euthyroid state and other hormones also play a role. Secondly an increase in oxygen delivery to brown adipose tissue through increased oxygen content and increased blood flow is required. Finally, our observations suggest that separation from the placenta is necessary for maximal nonshivering thermogenesis. The effects on thermogenesis of interrupting and reestablishing placental flow are rapid and reversible. Umbilical cord occlusion is the signal for a rapid increase in thermogenesis, while the release of cord occlusion is followed by an equally rapid fall in thermogenesis. This strongly suggests the presence of a placental inhibitor of brown adipose tissue thermogenesis. The problem of the regulation of growth and recruitment of brown adipose tissue in the fetus despite the lack of thermal stress in utero may be resolved by this evidence for an inhibitory factor of thermogenesis produced by the placenta. The withdrawal of the inhibitor at birth by separation from the placenta will allow the rapid initiation of thermogenesis in response to sympathetic nervous system stimulation of the brown adipose tissue. PMID- 2698160 TI - Selective per-operative cholangiography and scoring method for selection. AB - A prospective clinical study was undertaken over a period of 3 years on a series of 210 consecutive cases of gall stones to review a selective policy for per operative cholangiography (PC). All patients had elective cholecystectomy and routine PC. A scoring method (SM) based on pre and per-operative surgical criteria was adopted to determine the necessity of PC before this was attempted. The study revealed that PC was indicated in 64 cases (30.5%) only. Of these 64 patients 20 had abnormal cholangiograms of which 18 proved positive on exploration. There were two false positive results (0.95%) of PC but no false negative result. Of 146 patients (69.5%) not clinically indicated for routine PC, 145 had normal cholangiograms and one had a small (5 mm diameter) silent stone (0.47%) in the Common Bile Duct (CBD). The scoring method failed to predict this case of silent stone. PC was technically unsatisfactory in 4 cases (1.9%). Thus by adopting the selective policy X-rays could have been avoided in 69.5% cases in which only a small silent stone would have been overlooked. However, this stone could have passed into the duodenum spontaneously or else it could have been removed by endoscopic sphincterotomy had it caused any symptoms. It is concluded that routine PC is not always necessary, a selective policy may be preferred and a scoring method may be used as a guide for selection of the cases. PMID- 2698161 TI - [Retention and biomechanics of "retention complexes" 2. Retention complexes of Akers, Roach and Ney]. AB - The authors describe the different "retentive complexes" proposed by the Akers, Roach and Ney schools and analyse their biomechanical validity. PMID- 2698162 TI - [The polymerase chain reaction and infection by human immunodeficiency virus (HIV)]. PMID- 2698163 TI - [Flow cytometry in immunology and hematology: some essential practical aspects]. AB - Flow cytometry, supported by monoclonal antibodies, has widely contributed in the cellular identification, notably in the clinical and haematological fields. This technique has found several applications since the qualitative phenotyping and the quantitative analysis of the immune system's cell populations are helpful in the diagnosis and the therapy. Besides, these indications require an appropriate knowledge of several methodological aspects including factors related to the sample donor: age and sex; sampling: time and quantity; and the sample preparation conditions. References values, needed for the results interpretation, have a meaning only if they are defined within these validity limits. Previous trials have been done in order to define a biological value representative of the immunological status, such as the CD4/CD8 ratio. Unfortunately this ratio is not justified in the scope of new knowledge concerning the cellular interactions and the functional heterogeneity of cells involved in the immune system. PMID- 2698164 TI - [Proteolytic, procoagulant activity and electrophoretic characterization of the proteins of 2 toxic extracts of Loxosceles laeta venom]. AB - Some biochemical properties and proteic components of the brown spider (Loxos celes laeta) venom were studied. The electrophoretic profiles of glandular venom and venom obtained through electrical stimulation were compared using two electrophoretic systems. The first, using a polyacrylamide gel with SDS in tubes, and the second, using an acrylamide gradient on slides. The glandular venom presented 20 and 35 bands respectively, while the venom obtained through electrical stimulation presented 19 and 24 bands. The molecular weight of the proteins detected ranged from 13.5 Kd to 220 Kd. A thermolabil proteolitic activity of casein was detected, and was optimum at pH 9. The effects of the divalent ions, calcium and magnesium, as well as that of chelating agents upon the proteolytic activity of the venom were analyzed. The venom had a procoagulant effect upon citrated human plasma, and was not able to activate the Factor X of the coagulation system in vitro. PMID- 2698165 TI - [Endoplasmic reticulum: anatomy of a biologic membrane]. AB - Endoplasmic reticulum (ER) is a large membranous network containing a wide variety of lipid and protein constituents which play important roles in cellular physiology. In this review, selection of experimental results are presented which have shaped our concepts of the molecular organization of ER. The morphological approach--electron microscope examination of ultra-thin sections of a variety of cells--led to the dualistic distinction between rough ER and smooth ER. Consequently, various attempts were made to separate the 2 entities and to demonstrate that they are endowed with distinct functional properties. Studies on the biogenesis of ER showed that enzymes associated with this organelle turn over independently, which was interpreted in terms of ER being biochemically organized as a mosaic. The results of isopycnic centrifugation of rat liver microsomes led us to conclude that the ER is comprised of three biochemically distinct domains and that the distribution of integral proteins in the lateral plane of the membrane (lateral topography) is primarily determined by their transmembrane disposition. Data on the transverse topography and the mode of biogenesis of ER enzymes are confronted with the predictions of this model. PMID- 2698166 TI - Effects of a long-lasting hyperinsulinemia induced by insulin infusion on the subcellular distribution of liver insulin receptors in the rat. AB - Acute hyperinsulinemia in rats have been shown to cause enhanced endocytosis of liver insulin receptors with little or no change in the total receptor number. To determine whether a similar phenomenon occurs in long-lasting hyperinsulinemia, the subcellular distribution of liver insulin receptors has been studied in rats infused continuously with insulin (0.4 and 0.2 U/h) for 4 days. In rats in which plasma insulin concentration was maintained at 15-20 ng/ml, there was, from 3 to 24 h, a 2-fold decrease in insulin binding to plasma membranes (PM), along with 2 to 4-fold increase in insulin binding to the light (GEI), intermediate (GEi) and heavy (GEh) Golgi-endosomal fractions; concomitantly, there was a 10-fold increase in the insulin content of Golgi-endosomal fractions. After 24 h, the changes in insulin binding to PM and GEI were maintained, but the increase in both insulin binding activity and insulin content of GEi and GEh became progressively less marked, although plasma insulin concentration remained elevated. Throughout infusion, insulin binding to the total particulate fraction was unchanged. In rats, in which plasma insulin was maintained at 6-8 ng/ml, insulin binding to PM was decreased to a lesser degree and insulin binding to Golgi-endosomal fractions was unchanged (GEh) or decreased (GEI and GEi), although the insulin content of these fractions remained high. These results suggest that, while an enhanced receptor endocytosis accounts for the decrease in cell surface receptors observed at an early stage of the hyperinsulinemia, additional regulatory mechanisms are probably involved at a later stage. PMID- 2698167 TI - [Transport processes through the blood-brain barrier]. AB - The existence of the blood-brain barrier is due to tight junctions between endothelial cells preventing the passage of liquid and solute material at the capillary level. Substances can thus pass across the blood-brain barrier if they are lipophilic or if they have transport systems in the membranes of endothelial cells. The luminal membrane brings metabolites needed for the brain function, the abluminal one plays an important part in removing substances from brain, this can happen against a concentration gradient and thus needs energy. Ions are transported differently by the 2 membranes. Sodium and chloride have carriers and potassium is transported very actively by the sodium-potassium ATPase of the abluminal membrane. Blood-brain glucose influx is very important and happens by carrier transport at the 2 membranes. Efflux seems to use the same transport system as the influx. Transport of ketone bodies seems to happen only from blood to brain, the carriers being reversibly used for brain-blood transport of pyruvic and lactic acid. Amino-acid transport is very different on the luminal and abluminal membranes. On the luminal membrane there are 2 transport systems, one for basic amino acids, the other one, the L system, for neutral amino-acids. All neutral amino-acids are transported through the abluminal membrane by the L, A and ASC systems. There exists a system of transport for basic amino-acids, and a very active one for acid amino-acids. Some systems for the transport of hormones, vitamins and for some peptides exist also at the blood-brain barrier which thus plays a very important role in the regulation of brain metabolism. PMID- 2698168 TI - [The placental barrier: structure, resistance, asymmetry]. AB - The concept of placental barrier has been evaluated using recent advances in ultrastructure and in transport physiology. On a structural basis, the barrier effect is grounded by the syncytiotrophoblast continuity, and by basal and plasma membrane's electrical charges and by basement membrane porosity. The aqueous phase continuity for diffusion operates through intercellular gap, fenestrations (rat, rabbit) and transcellular channels (guinea pig). However, these connections are not apparent in the human syncytiotrophobast. For the molecular size selectivity, the hemochorial placentas with a pore radius of 10 nm appear much less selective than the epitheliochorial ones. The metabolic capacity of the placental cells (trophoblast, macrophages) participates to the barrier effect by metabolizing or by converting some substrates. Similarly, trophoblast asymmetry in the location of enzymes, carriers and receptors on outer (maternal side) and on basal (fetal side) plasma membranes, and in the release of secretory products, contributes to maintain separate fetal and maternal compartments. The functional polarity of trophoblast is expressed in metabolism (corticosteroids), nutrients (amino acids) and ions (iron) transport, and most of its secretions (hPL, hCG, SP1). PMID- 2698169 TI - [Short bowel syndrome and glucose tolerance]. AB - There are different signs after extended small bowel resection. The length of the resected small intestine (size of resection), the location of the removed part (type of resection), the time after operation (stage of adaption) and the age of the patient define the severity and nature of complaints following small bowel resections. We examined the dynamics of glucose- and insulin level after oral and intravenous glucose administration to recognize the relation to the size of resection. We found a decreased basal insulin concentration and a diminished response of insulin after intravenous glucose load in patients with extensive small bowel resection. This reduced response after parenteral administration of glucose load we did not find in the ileum-resected group compared to control group. We can conclude, it is possible to get information about the size of small bowel resections by the intravenous glucose tolerance test. PMID- 2698170 TI - [The diagnostic value of serum PABA determination in pancreatic disease and in relation to anticholinergic medication]. AB - PABA-serum and urine-concentration were studied in patients with normal, pathologic and pharmacologically inhibited pancreatic function. Secretin pancreozymine test was selected as reference method. In patients with normal pancreas function and volunteers, PABA-serum-concentration was characterized by a rapid increase during the first 1 1/2 hours. A maximum increase of 32.42 +/- 10.04 mumol/l was reached after 90 minutes. In patients with exocrine pancrease insufficiency, difference to the control group was greatest after 30, 60, 90, and 120 min. Pharmacologic inhibition of the exocrine pancreas using pirenzepine also resulted in a significantly reduced PABA-serum-concentration after 30, 60 and 90 min. In correspondence to the delayed and smaller serum PABA increase, urine-PABA concentrations were also diminished. Our results indicate that the optimal interval to differentiate between normal and impaired pancreas function with use of serum PABA determination is at 90 min after test begin. PMID- 2698171 TI - [Vitamin A and the liver--current knowledge]. AB - A short survey of metabolism and effects of vitamin A as well as of the role of Ito cells is presented. The Ito cells of the liver represent a special form of fibroblasts, about 80% of the vitamin A (VA) content of the normal liver is stored in these cells. Following to the absorption of VA in the intestine, VA (retinol) is transported in chylomicrons and their remnants, and taken up by hepatocytes through receptor-mediated endocytosis. Along with retinolbinding protein VA is transported from the hepatocytes to the Ito cells where is is being stored as lipid droplets. The VA content of the liver tissue in chronic, especially alcoholic liver disease is distinctly lowered. The VA deficiency of the chronic alcoholic liver disease is caused by an accelerated microsomal metabolism of VA. Furthermore, investigations elucidating the therapy of VA deficiency in liver diseases are explained. PMID- 2698172 TI - The pathogenesis of acute biliary pancreatitis: a controversial issue. Part II: The concepts of duodenopancreatic reflux and of obstruction of pancreatic exocrine secretion. AB - Acute pancreatitis associated with the passage of gallstones through the sphincter of Oddi might be caused by obstruction of pancreatic exocrine secretion or by duodenopancreatic reflux. Possible complicating factors are discussed, which are necessary in order to turn the interstitial edematous inflammation caused by pancreatic duct obstruction into hemorrhagic necrotizing pancreatitis. Furthermore, clinical and experimental data are reviewed concerning a possible collapse of the protective mechanisms which usually prevent contact of duodenal contents and pancreatic tissue. PMID- 2698173 TI - Child abuse and neglect--dentistry's intervention. PMID- 2698174 TI - Traumatic dental injuries in children. Part I. Evaluation of traumatic dental injuries and treatment of injuries to primary teeth. PMID- 2698175 TI - The "5-R's" for non-surgical periodontal treatment in the general practice. PMID- 2698178 TI - Transcription in vaccinia virus. AB - Transcription of poxvirus genes is temporally regulated and takes place in the cytoplasm of the infected cell. Virus-encoded enzymes produce capped, methylated and polyadenylated mRNA. The virus transcriptional apparatus recognises promoter sequences within the virus genome which bear little resemblance to either eukaryotic or prokaryotic promoter regions. mRNA's produced late in infection possess 5'poly (A) sequences which are not encoded in the genome. The process of transcription in poxviruses is reviewed using vaccinia virus as the prototype. PMID- 2698179 TI - [Yeasts associated with spontaneous fermentation processes in wines from Ribeiro. Analysis of homo/heterothallism and the killer system of S. cerevisiae strains]. AB - A taxonomic analysis has been carried out concerning the different yeast species involved in spontaneous fermentations of Ribeiro wine. The results revealed the presence of 15 species belonging to 7 genera: Saccharomyces, Torulaspora, Dekkera, Saccharomycodes, Debaryomyces, Kloeckera and Candida. Within the genus Candida a high number of species was detected. The 28 isolated strains of S. cerevisiae showed with some exceptions, a remarkable sporulation ability and viability of the meiotic products. All the strains were homothallic. Among all S. cerevisiae strains, 6 exhibited killer K2 activity with higher isolation percentages in intermediate fermentations than in late fermentations. PMID- 2698181 TI - Dentists struggle to improve Medicaid. PMID- 2698180 TI - When trimming an impression, begin at the base of both types of models. PMID- 2698177 TI - The bag cell neurons of Aplysia. A model for the study of the molecular mechanisms involved in the control of prolonged animal behaviors. AB - Egg laying in Aplysia involves a well-characterized series of behaviors that can last for several hours. The behaviors are controlled by two bilateral clusters of peptidergic neurons in the abdominal ganglion. Following brief stimulation, these neurons, which have been termed the bag cell neurons, undergo a sequence of changes in their excitability lasting many hours. The bag cell neurons have served as a model system for studying the molecular mechanisms involved in the synthesis, processing, and release of neuroactive peptides and in the regulation of prolonged changes in neuronal excitability. PMID- 2698182 TI - Adhesive bonds amalgam to dentin. PMID- 2698183 TI - Congress investigates Medicaid dental. PMID- 2698176 TI - VIP: molecular biology and neurobiological function. AB - In the mammalian brain, a major regulatory peptide is vasoactive intestinal peptide (VIP). This 28 amino acid peptide, originally isolated from the porcine duodenum, was later found in the central and peripheral nervous systems and in endocrine cells, where it exhibits neurotransmitter and hormonal roles. Increasing evidence points to VIP's importance as a mediator or a modulator of several basic functions. Thus, VIP is a major factor in brain activity, neuroendocrine functions, cardiac activity, respiration, digestion, and sexual potency. In view of this peptide's importance, the mechanisms controlling its production and the pathways regulating its functions have been reviewed. VIP is a member of a peptide family, including peptides such as glucagon, secretin, and growth hormone releasing hormone. These peptides may have evolved by exon duplication coupled with gene duplication. The human VIP gene contains seven exons, each encoding a distinct functional domain on the protein precursor or the mRNA. VIP gene transcripts are mainly found in neurons or neuron-related cells. VIP gene expression is regulated by neuronal and endocrine signals that contribute to its developmental control. VIP exerts its function via receptor mediated systems, activating signal transduction pathways, including cAMP. It can act as a neurotransmitter, neuromodulator, and a secretagog. As a growth and developmental regulator, VIP may have a crucial effect as a neuronal survival factor. We shall proceed from the gene to its multiple functions. PMID- 2698184 TI - [Possible activation of human prorenin by contact with the cell membrane]. AB - Semipurified human kidney prorenin was exposed in vitro to a mixture of lipids mimicking the composition of the inner leaflet of the cell membrane, in the presence of semipurified human angiotensinogen at a concentration of 1/4 Km. Prorenin was activated in a time-dependent manner over a period of 60 min. This lipid-dependent activation was completely reversed thereafter. Pre-incubation with anti-renin serum completely prevented this activated prorenin-dependent generation of angiotensin I. Our data suggest that human prorenin can be reversibly activated by contact with the cell membrane. PMID- 2698185 TI - Pulsed field gel electrophoresis. PMID- 2698186 TI - Purification of supercoiled plasmids from crude cell lysates using high performance anion exchange chromatography. AB - High performance liquid chromatography is of increasing importance in the purification of nucleic acids. Recently, a new anion exchange column called Gen Pak FAX has been introduced for this purpose. Previously, it has been used in the purification of restriction fragments and oligonucleotides. In this paper we present the use of the Gen-Pak FAX column for the purification of plasmids from crude E. coli lysates. The different conformational forms of the plasmid can be well separated and collected with high recoveries of both mass and activity. Up to 50 micrograms of supercoiled plasmid can be purified in a single 30 min run with up to 98% purity. PMID- 2698187 TI - A rapid and selective method for generating deletions, insertions and clustered point mutations. PMID- 2698188 TI - MacConkey agar as an alternative to Xgal in the detection of recombinant plasmids. PMID- 2698189 TI - Analyzing immunoglobulin functional anatomy with monoclonal anti-immunoglobulin antibodies. PMID- 2698190 TI - Message amplification phenotyping (MAPPing): a technique to simultaneously measure multiple mRNAs from small numbers of cells. AB - A rapid and highly sensitive technique (MAPPing: message amplification phenotyping) has been developed to simultaneously analyze the array of messenger RNAs made by small numbers of cells. The technique incorporates a micro-procedure for isolating RNA, reverse transcription of total cellular RNA to produce cDNA, and enzymatic amplification of cytokine-specific DNA fragments using the polymerase chain reaction. In this study, the technique has been applied to the analysis of cytokines produced by lymphoid cells ranging in number from a single cell to 10(6) cells. The technique should be applicable to virtually any tissue or cell type. PMID- 2698191 TI - Optimized use of the firefly luciferase assay as a reporter gene in mammalian cell lines. AB - The enzymatic activity of firefly luciferase provides a sensitive, rapid means to assay transcriptional activity of regulated activation sequences of DNA when fused to the protein coding sequence of the luciferase gene. We have developed several modifications of the luciferase assay and have characterized certain parameters of the assay, resulting in optimization of conditions for the preparation and storage of cell lysates and establishment of substrate concentrations. These findings should be useful to investigators interested in applying the luciferase assay to studies of the transcriptional activity of test DNAs incorporating the luciferase reporter. PMID- 2698192 TI - Effects of electroporation pulse wave on the incorporation of viral RNA into tobacco protoplasts. AB - The uptake and expression of cucumber mosaic viral (CMV) RNA by tobacco protoplasts was examined using both square wave and exponential wave electroporation pulses. These electropulses, when supplied at sufficient field strength for a critical duration, enabled RNA to be incorporated and expressed in more than 60% of the surviving protoplasts. The results of experiments using these two electroporation wave forms showed significant differences in RNA uptake and expression. The number of viable protoplasts and cells showing expression of RNA was higher over a much broader range of experimental conditions using the square rather than exponential wave generator, even when both machines were optimized for maximal performance. However, at a narrow range of low field strengths the exponential wave pulse generated a higher percentage of transformants than did the square wave pulse. It was shown that after an electroporation pulse from either wave form, there were viable cells which expressed foreign RNA at predictable levels. PMID- 2698193 TI - Screening mutants by a modified Sanger's dideoxy sequencing method in 96-well microtitre trays. PMID- 2698194 TI - Rapid purification of plasmid DNA following acid precipitation of bacterial proteins. PMID- 2698195 TI - Three-dimensional imaging techniques in electron microscopy. PMID- 2698196 TI - Scanning tunneling microscopy with applications to biological surfaces. AB - Each major advance in the field of microscopy has eventually been translated into major advances in the biological and medical sciences. The scanning tunneling microscope (STM) offers exciting new ways of imaging biological surfaces with resolution to the sub-molecular scale. Rigid, conductive surfaces can readily be imaged with the STM with atomic resolution. Unfortunately, few biological surfaces are sufficiently conductive or rigid enough to be examined directly with the STM. At present, non-conductive surfaces can be examined in two ways: 1) Sufficiently thin molecular layers attached to conductive substrates so that tunneling can occur through the molecules; or 2) coating or replicating non conductive surfaces with metal layers so as to make them conductive, then imaging with the STM. We present images of biological and organic molecules obtained with these techniques that demonstrate the possibilities and limitations of each. Future advances leading to atomic resolution STM of biological surfaces depend on significant progress in the art and science of making biomaterials compatible with the restrictions of the instrument. PMID- 2698197 TI - Comparison of two different hybridization systems in northern transfer analysis. PMID- 2698199 TI - Gel electrophoresis assays for DNA-protein interactions. PMID- 2698198 TI - Transformation of Streptomyces protoplasts in the presence of low melt agarose. PMID- 2698200 TI - Method for cloning single-stranded oligonucleotides in a plasmid vector. AB - A method for cloning single-stranded oligonucleotides in a plasmid vector has been developed. The method relies on ligation of the oligonucleotide into suitable restriction enzyme sites of the cloning vector such that the site at the 5' end has a 5' overhang [for example, a Bgl II site (A decreases GATCT)], and the site at the 3' end has a 3' overhang [for example, a Sac I site (GAGCT decreases C)]. This arrangement allows the oligonucleotide to anneal to the single-stranded ends of the vector and to be covalently joined by T4 DNA ligase. The complementary strand can be synthesized in vitro to generate a double stranded plasmid, or the partially single-stranded molecule can be used as a target for site-directed mutagenesis. The subsequent transfer of the oligonucleotide to test plasmids or excision for other manipulations, such as band shift experiments to identify protein binding sites, is facilitated by cloning of the oligonucleotide into a polylinker containing multiple restriction enzyme sites. For this purpose, the plasmid vector, pKP59, which is a 2.0 kB derivative of pBR322 lacking "poison sequences" and containing 16 cloning sites, has been the most satisfactory. PMID- 2698201 TI - The use of DNA probes in preimplantation and prenatal diagnosis. AB - DNA probes are now widely used for prenatal diagnosis, but the prospect of preimplantation diagnosis of genetic disorders requires the development of sensitive genetic tests that can be performed on small numbers of cells removed from a preimplantation-stage pre-embryo. The sensitivity of molecular tests can now be increased by specifically amplifying the target DNA with the polymerase chain reaction. In situ hybridisation with chromosome-specific DNA probes to repeated sequences also permits the detection of particular numerical chromosome aberrations or the distinction of male and female pre-embryos when only a few interphase nuclei are available. We have used in situ hybridisation to a Y chromosome-specific DNA probe to sex preimplantation-stage pre-embryos and to sex fetuses from samples of chorionic villus cells, amniotic fluid cells, and fetal blood. These two approaches (amplification of target DNA and in situ hybridisation) provide suitable tests for improving prenatal diagnosis particularly when few cells are available and they offer the possibility of tests suitable for preimplantation diagnosis. PMID- 2698202 TI - Cytoskeleton-associated cell contacts. PMID- 2698203 TI - Muscle proteins and muscular dystrophy. PMID- 2698204 TI - Cytoplasm and cell motility. PMID- 2698205 TI - Structural principles of actin-binding proteins. PMID- 2698206 TI - The spectrin membrane skeleton: emerging concepts. PMID- 2698207 TI - The plant cytoskeleton. PMID- 2698208 TI - Intermediate filaments. AB - It is likely that future studies involving a molecular biology approach, similar to those described in [7,27,28], will yield fruitful information regarding properties and cellular roles of IF. At this point, our knowledge of the properties and expression of IF remains in stark contrast to our lack of understanding of their biological functions. As pointed out by Franke et al. [29], several lines of investigation have suggested that IF do not serve a general cellular function (i.e. 'housekeeping duties'). Instead, the roles of IF and their constituent proteins are probably related to specific functions of the differentiated cell. Our search for these specific roles will be difficult, but exciting. In the meantime, it is rewarding that IF typing of cells and tumors has already yielded practical information useful in histology and cytology [30]. PMID- 2698209 TI - The function of the major cytoskeletal components of the brush border. PMID- 2698210 TI - Mitosis: basic concepts. PMID- 2698211 TI - Microfilament-based motility in non-muscle cells. PMID- 2698212 TI - Cell locomotion and chemotaxis. PMID- 2698213 TI - Growth cone formation and navigation: axonal growth. PMID- 2698214 TI - Mechanisms behind the organization of membranous organelles in cells. PMID- 2698215 TI - Determination of right ventricular ejection fraction by two-dimensional echocardiographic single plane subtraction method. AB - Right ventricular ejection fraction is a useful measurement for evaluating right ventricular function in various states, including coronary artery disease, chronic obstructive pulmonary disease, and both congenital and valvular heart diseases. The right ventricular geometry has made it difficult to evaluate right ventricular ejection fraction by simple echocardiographic methods. In this study 36 consecutive patients were examined by two-dimensional echocardiography within 4 hours of radionuclide-determined right ventricular ejection fraction to test a simplified method for calculating right ventricular ejection fraction by two dimensional echocardiography. Echocardiographic measurements were independently determined in the subcostal and apical four-chamber views. Correlation with first pass radionuclide right ventricular ejection fraction was r = 0.89 and 0.84. Right ventricular ejection fraction could be calculated from one of two views in 92% of patients studied. This technique for determination of right ventricular ejection fraction offers a simple noninvasive method of evaluating right ventricular function. PMID- 2698216 TI - Intracardiac myxomas: twenty-year echocardiographic experience with review of the literature. AB - We reviewed the echocardiograms of 35 patients with intracardiac myxomas. Patient data were combined from two geographically distant laboratories. No significant variations in the patient profiles were encountered. Most patients were white (33 of 35) with a mean age of 45 years. The diagnosis was suspected on clinical grounds alone in only six of 35 patients before the echocardiogram was done. M mode recordings were the primary echocardiographic modality available in the first 16 patients, whereas two-dimensional studies were also done in the others. Continuous and pulsed wave Doppler echocardiography were added in eight of the most recent studies. In one patient color flow imaging from both transthoracic and esophageal approaches was possible to better visualize a large left atrial tumor. Thirty-three patients had solitary tumors (29 left atrial, three right atrial, and one left ventricular), and two had multiple tumors. The most characteristic finding, as expected, was the demonstration of abnormal mass echoes produced by the myxoma tissue. Several interesting features not previously emphasized in the literature included abnormal notching of the interventricular septum and posterior left ventricular wall probably produced by displacement from the larger mobile left atrial tumors dropping into the mitral sleeve. This was best appreciated by the M-mode recordings. In one patient with an associated atrial septal defect, movement of the tumor into the defect appeared to alter the expected downward displacement into the mitral orifice. In the patients who were studied by two-dimensional, Doppler, or color flow imaging, tumor movement was evidenced by abnormal frequency shifts, and dispersion of flow around the tumor mass was readily appreciated. Surgical removal was performed in all patients. Follow-up echocardiograms were done postoperatively ranging up to 17 years. Recurrent tumors occurred in two patients, both of whom had congenital myxomas. Echocardiography is proving to be an unparalleled tool in the diagnosis of intracardiac tumors. PMID- 2698217 TI - Transesophageal echocardiography. PMID- 2698218 TI - Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. AB - We have presented recommendations for the optimum acquisition of quantitative two dimensional data in the current echocardiographic environment. It is likely that advances in imaging may enhance or supplement these approaches. For example, three-dimensional reconstruction methods may greatly augment the accuracy of volume determination if they become more efficient. The development of three dimensional methods will depend in turn on vastly improved transthoracic resolution similar to that now obtainable by transesophageal echocardiography. Better resolution will also make the use of more direct methods of measuring myocardial mass practical. For example, if the epicardium were well resolved in the long-axis apical views, the myocardial shell volume could be measured directly by the biplane method of discs rather than extrapolating myocardial thickness from a single short-axis view. At present, it is our opinion that current technology justifies the clinical use of the quantitative two-dimensional methods described in this article. When technically feasible, and if resources permit, we recommend the routine reporting of left ventricular ejection fraction, diastolic volume, mass, and wall motion score. PMID- 2698219 TI - Expression of tumor necrosis factor-alpha and transforming growth factor-beta 1 in acute liver injury. AB - Tumor necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta 1 (TGF-beta 1) have a number of in vitro functions that could be important in vivo in acute liver injury and repair. Therefore, we investigated these two cytokines in acute liver damage. Northern blots of RNA isolated from rats sacrificed at various time intervals after a single oral dose of CCl4 revealed that TNF-alpha mRNA levels were elevated within 6 hr of CCl4 administration and returned to control values by 24-32 hr. In contrast, TGF-beta 1 mRNA levels started to rise significantly at 24 hr, peaked at 48 hr, and approached baseline levels by 72 hr. Identical changes in TNF-alpha and TGF-beta 1 mRNA levels were also seen with D galactosamine-induced hepatotoxicity. Immunohistochemical analysis using a TGF beta 1 antibody demonstrated increased hepatic staining in CCl4-treated rats, at times corresponding to the increases in TGF-beta 1 gene expression. Therefore, there is a differential expression of these cytokines in acute CCl4 and galactosamine hepatotoxicity with an early rise in TNF-alpha, suggesting that this cytokine may affect inflammation and cell toxicity, while TGF-beta 1 peaks later, when it may regulate hepatocyte proliferation and extracellular matrix repair. PMID- 2698220 TI - In vitro studies of human prostatic epithelial cells: attempts to identify distinguishing features of malignant cells. AB - Recent advances in culture techniques have enabled routine establishment and propagation of epithelial cells derived from normal and malignant tissues of the human prostate. Comparative studies of the responses of normal and cancer-derived cell populations to various growth and differentiation factors in vitro were undertaken to examine the possibility that cancer cells might respond differentially. Clonal growth assays in serum-free medium demonstrated that optimal proliferation of normal as well as cancer cell strains was generally dependent on the presence of cholera toxin, epidermal growth factor, pituitary extract, hydrocortisone, insulin, and high levels of calcium in the culture medium, and on the use of collagen-coated dishes. Only one cancer strain responded aberrantly to epidermal growth factor and hydrocortisone. Putative differentiation factors (transforming growth factor-beta and vitamin A) inhibited the growth of all normal and cancer strains. The origin of a cancer-derived cell strain that responded similarly to normal strains was verified by positive labeling with a prostate cancer-specific antibody, validating the conclusion from these studies that normal and cancer prostatic epithelial cells are not distinguishable on the basis of responses to the tested factors. PMID- 2698221 TI - Characteristics of Mongoloid populations and immunogenetics of various diseases based on the genetic markers of human immunoglobulins. AB - A clear genocline has been found for the distribution of Gm ag, Gm ab3st, and Gm afb1b3 haplotypes among the Mongoloid populations scattered in the world and characterized by the presence of four Gm haplotypes. Mongoloid populations are divided into two groups by an analysis of genetic distances and parametric multidimensional scaling: one is a northern group which is characterized by a high frequency of Gm ag and Gm ab3st and an extremely low frequency of Gm afb1b3 haplotype, and the other a southern group characterized by a remarkably high frequency of Gm afb1b3 and a low frequency of Gm ag and Gm ab3st haplotypes. The origin of the Gm afb1b3 characteristic of southern Mongoloids must exist in the Yunnan and Guangxi areas of southwest China. The origin of the Gm ab3st characteristic of northern Mongoloids must exist in Siberia, most likely in the Baikal area. The data which suggest the presence of Gm-associated pathogenic polygenes were obtained in the various diseases. PMID- 2698222 TI - Polymorphisms of human immunoglobulins: Gm, Am, Em and Km allotypes. AB - A brief review of the polymorphisms of human immunoglobulins (Ig) is presented here as the introductory paper of this special issue on Ig allotypes. The different allelic forms of the Ig genes for the heavy chains of IgG1, IgG2, IgG3, IgA2 and IgE and for the kappa light chains, which give rise to the G1m, G2m, G3m, A2m, Em and Km allotypes, respectively, are discussed. Until now, 24 allotypes have been described and confirmed by other investigators: 4 G1m, 1 G2m, 13 G3m, 2 A2m, 1 Em and 3 Km allotypes. The alleles of the heavy chain genes are inherited in haplotypes because these genes are located close to each other on chromosome 14. The variations in haplotype frequencies in different populations and the occurrence of isoallotypes in IgG and IgA subclasses are discussed. Applications of Ig allotyping and new developments in this field are mentioned with reference to the other papers in this issue. PMID- 2698224 TI - Prostaglandin receptors in the cardiovascular system: potential selectivity from receptor subtypes or modified responsiveness. PMID- 2698223 TI - Immunoglobulin allotypes in rheumatoid arthritis. AB - The HLA region of chromosome 6 may account for as little as 20% of the genetic contribution to rheumatoid arthritis (RA). Previous studies have shown associations with immunoglobulin heavy chain allotypes (Gm) coded for by genes on chromosome 14. We review evidence that G1m(x)-bearing haplotypes are associated with DR4-positive, but not DR4-negative RA. A differing Gm association has been reported in two studies of RA patients with circulating antibodies to native type II collagen, which might constitute a specific genetic subgroup. A family study has shown no evidence for genetic linkage between Gm allotypes and susceptibility to RA. It is possible that Gm (or linked 14th chromosomal genes) may influence susceptibility to RA by interacting with different genes within the HLA region. Immunoglobulin light chain allotypes (Km) coded by genes on chromosome 2 show no consistent association with RA. PMID- 2698225 TI - Measurement of thromboxane biosynthesis in man. PMID- 2698226 TI - [Prevention and treatment of cerebral ictus]. PMID- 2698227 TI - Microbial lectin cofunction with lytic activities as a model for a general basic lectin role. AB - Lectins are ubiquitous proteins, which exhibit a specific and reversible sugar binding activity. They react with glycosylated macromolecules and cells and may coaggragate them and lead to their lysis or alterations. Various lectin biological effects are well known, but their basic biological function is considered as yet unknown. In the present review, an experimental evidence and theoretical considerations are forwarded for supporting our suggestion that the general basic lectin or lectinoid (lectin-like protein) function in microorganisms, plants and animals is a cofunction enabling the activities of key lytic enzymes (lysins: glycosidases, proteases, esterases, phosphatases, hemolysin, etc.). The lectin service is: homing onto glycosylated receptors, anchoring to them and induction of cooperative conformational effects which enable their counterpart lysin activity on exogenous or endogenous target molecules and cells. The 'lectin-lysin' pair may reside in the same molecule, or in linked subunits. It may also be formed by cofunction of two separate entities originating from one or two (homogenous or heterogenous) cell sources. The lectin and lysin may be free or cell-bound components located intra or extracellularly. The final result of their cofunction is practically irreversible; either cell and macro-molecule lysis for nutrition, homeostasis and protection or cell alteration, reorganization and new productivity. Our suggestion emphasizes the prominent analogy of lectins to lytic enzyme positioning sites (LEPS), immunoglobulins and polypeptide hormones. The lectin analogy to LEPS and immunoglobulins is exhibited in the lectin-dependent cell and macromolecule lysis for nutritional and homeostatic purposes or for protection, respectively. The hormone-like lectin activity is exhibited in the lectin-dependent cell alterations. In addition to similar functions and effects, the analogy also includes the properties and behavior of these proteins. The suggested hypothesis is based on experimental evidence from microorganisms, plants and animals. It envisions the lectin and lectinoid function in cell attacks on glycosylated molecules or cells, cell-substratum and cell-cell interactions (fusion, invasion, etc.), cell transformation and formation of special structures. All of them according to a developmental program, or special (especially unfavourable) environmental conditions. The lectin resistance to proteolysis and unfavourable pH or temperature is in accord with the suggested hypothesis. PMID- 2698228 TI - The fermentation pathways of Escherichia coli. AB - Under anaerobic conditions and in the absence of alternative electron acceptors Escherichia coli converts sugars to a mixture of products by fermentation. The major soluble products are acetate, ethanol, acetate and formate with smaller amounts of succinate. In addition the gaseous products hydrogen and carbon dioxide are produced in substantial amounts. The pathway generating fermentation products is branched and the flow down each branch is varied in response both to the pH of the culture medium and the nature of the fermentation substrate. In particular, the ratio of the various fermentation products is manipulated in order to balance the number of reducing equivalents generated during glycolytic breakdown of the substrate. The enzymes and corresponding genes involved in these fermentation pathways are described. The regulatory responses of these genes and enzymes are known but the details of the underlying regulatory mechanisms are still obscure. PMID- 2698229 TI - Microbial metabolism of short-chain unsaturated hydrocarbons. PMID- 2698230 TI - Peptidases and proteases of Escherichia coli and Salmonella typhimurium. AB - A number of peptidases and proteases have been identified in Escherichia coli. Although their specific physiological roles are often not known, some of them have been shown to be involved in: the maturation of nascent polypeptide chains; the maturation of protein precursors; the signal peptide processing of exported proteins; the degradation of abnormal proteins; the use of small peptides as nutrients; the degradation of colicins; viral morphogenesis; the inactivation of some regulatory proteins for which a limited lifetime is a physiological necessity. Some of these enzymes act in concert to carry out specific functions. At present, twelve peptidases and seventeen proteases have been characterized. The specificity for only a few of them is known. The possible roles and the properties of these enzymes are discussed in this review. PMID- 2698231 TI - Microbiological methods for the cleanup of soil and ground water contaminated with halogenated organic compounds. AB - There is growing interest in the enhancement of microbial degradative activities as a means of bringing about the in situ cleanup of contaminated soils and ground water. The halogenated organic compounds are likely to be prime targets for such biotechnological processes because of their widespread utilisation and the biodegradability of many of the most commonly used compounds. The aim of this review is to consider the potential for microbiological cleanup of haloorganic contaminated sites. The technologies available involve the provision of suitable environmental conditions to facilitate maximum biodegradation rates either in the subsurface or in on-site bioreactors. Methodologies include the supply of inorganic nutrients, the supply of oxygen gas, the addition of degradative microbial inocula and the introduction of co-metabolic substrates. The potential efficiencies and limitations of the methods are critically discussed from a microbiological viewpoint with respect to substrate degradability and population responses to supplementation. PMID- 2698232 TI - [Dependence of the recA gene for the replication of the bacterial chromosome initiated by the integrated F' plasmid in Escherichia coli]. AB - Mutant strain dnaA46 of Escherichia coli can be integratively suppressed by the F' plasmid. Upon introducing the recA56 mutation through transduction the suppressive integration strain (Sin) becomes unable to grow at 40 degrees C. By means of experiments of marker transfer, acridine orange sensitivity test, F' curing and mini-chromosome transformation it is concluded that the F' plasmid is always in an integrated state in the Sin strains and that the initiation of the replication of the bacterial chromosome is carried on by the integrated F' plasmid. The biosynthesis of DNA and protein of the Sin recA+ and Sin recA- strains at different temperatures were compared. It is concluded from the experimental results that the recA gene functions at the level of DNA replication. The recA gene is known to be the key gene in DNA recombination and SOS repair of DNA damage. The works reported here throw some light on the understanding of the function of the recA gene. PMID- 2698233 TI - [A preliminary study on mechanism of respiratory deficiency of mutagenesis in S. cerevisiae]. AB - The results of ethidium bromide treatment for two different strains of S. cerevisiae were reported here. The recovery of respiratory competence was discovered when cells were treated with EB under non-growing condition. However, this recovery can be inhibited by caffeine. It was not observed when cells were treated with EB under growing condition. Similar results were obtained when cells were treated with EB during their exposure to KCN. The formation of at least one intermediate state [rho-] was proposed. The process of formation of respiratory deficiency could be expressed by rho+ in equilibrium [rho-]----rho-. The different concentrations of sucrose supplemented to the culture of S. cerevisiae resulted in certain influence in the experiment. PMID- 2698234 TI - [Genetic polymorphism of the second component of human complement (C2) in the Han Nationality in Wuhan district of China]. AB - A total number of 231 unrelated Chinese (Han Nationality) were investigated for C2 polymorphism by hemolytic overlay technique after polyacrylamide gel isoelectric focusing on plasmas. The following phenotype distributions were observed: C2C, 216; C2BC, 9; C2AC, 5; and C2A, 1. The gene frequencies calculated from these phenotypes were as follows: C2*A, 0.015; C2*B, 0.019; C2*C, 0.965. The C2 phenotypic frequency distributions were in agreement with those expected from Hardy-Weinberg equilibrium. PMID- 2698235 TI - [Aberrant internal carotid artery in the middle ear]. AB - An aberrant internal carotid artery in the middle ear is rare. We present a new case with a red mass behind the eardrum. The diagnosis must be established by radiology and angiography. The consequences of injury and surgical intervention are serious. The purpose of this paper is to review the literature on the subject of vascular anomalies of the middle ear and to discuss the diagnosis and management of this lesion. PMID- 2698236 TI - [Descriptive study of cancer of the cavum, especially of epidermoid carcinoma (III)]. AB - Five-year survival (5-YS) a) Age: 77, 45, 35, 35 y 28%. The 65 and 50% arise to 15 and 18 m. b) Gender: 5-YS was higher for women (31%) than for man (22%). c) Age groups: 0-40 y (52%), 41-60 y (40%), older than 60 y 14%. d) Stage (tumor): T 1 + T-2: 92, 69, 61, 61 and 46%. T-3 + T-4: 61, 22, 17, 11 and 11%. Nodal Neck: N 0 + N-1: 70, 45, 35, 35 and 17%. N-2 + N-3: 93, 53, 53, 40 and 40% e) Hazard function: is greatest for T-3 + T-4 than T-1 + T-2 (3.2-3.5: 1). f) Histological subtypes: The 5-YS was higher for undifferentiated than squamous carcinoma (p greater than 0.05). g) Recurrences and distant metastases: The greatest survival was noted for patients with recurrences while the poorest was in the metastases. PMID- 2698237 TI - [Embryonary rhabdomyosarcoma of the middle ear. Apropos of a case]. AB - The subject presented for its rarity is a case of rhabdomyosarcoma embryonal ear in girl patient 6 years old. Her clinic first gave a wrong diagnosis of chronic otitis of the middle ear with otorrhea and facial paralysis. A malignant tumour was suspected during the operation. A histopathology study confirmed the diagnosis of rhabdomyosarcoma. A review of the literature is made and details given of how often it occurs, and incidence, histopathology types, treatment and prognosis. PMID- 2698238 TI - [Ethmoido-frontal mucocele. Apropos of a clinical case]. AB - We presented a case of a 60 years old woman, with a previous history of an intervention upon the frontal sinus 35 years ago, who was diagnosed and operated at our service from mucocele of frontal sinus. We profit this occasion to carry through a revision of bibliography, to contribute at better knowledge of mucoceles about their clinic, pathogenic, diagnostic and therapeutic aspects. PMID- 2698239 TI - [Invasive nasosinusal aspergillosis: apropos of a case]. PMID- 2698240 TI - Chronic leukaemias: can they be cured? Part II: Chronic lymphocytic leukaemia. AB - Despite improved understanding of the chronic lymphoid leukaemias, the long-term outcome for the majority of patients remains dismal. An alkylating agent, usually chlorambucil, with or without prednisone, remains the standard palliative treatment for chronic lymphocytic leukaemia. More recently, two new drugs have emerged, 2'deoxycoformycin and alpha-interferon, which appear to offer substantial benefit to patients with hairy cell leukaemia. PMID- 2698241 TI - An open multiple dose study of Optrex Eye Lotion in eye irritation due to hayfever. AB - Twenty-four patients consulting their general practitioner with eye irritation due to hayfever entered a seven-day open, multiple dose study of a newly formulated Optrex Eye Lotion. Patients self-administered Optrex by irrigation into their left eye three times daily for seven days, with an option to use the same preparation in their right eye if they thought this to be of benefit. Assessment was by means of daily diary cards completed by the patient each evening for the seven-day period. Following the first instillation, the treated eye felt significantly better at 20 seconds and at four minutes when compared with the untreated eye. Differences between the eyes for degree of redness, comfort and clearness of vision were not significant, but 15 patients (63 per cent) optionally used Optrex in their right eye. Seventeen patients (71 per cent) reported that they derived overall benefit from the use of Optrex Eye Lotion during the study period. Two patients reported side effects during the study but, in each case, the investigator did not consider the event to be therapy related. One patient withdrew on Day 7 of the trial due to worsening of their allergic conjunctivitis. It can be concluded that some subjective benefit was gained by the majority of patients in that a considerable number of them chose to treat both eyes for the duration of the study. PMID- 2698242 TI - Calcium antagonists in cardiovascular disease. PMID- 2698243 TI - Tamoxifen--the story so far. PMID- 2698244 TI - Improvement in wall motion after pindolol: a mechanism for the preservation of left ventricular function in coronary artery disease. AB - 1. In order to evaluate the mechanism by which beta blockers with intrinsic sympathomimetic activity preserve left ventricular systolic function at rest, 46 patients with coronary artery disease were studied by right and left heart catheterization and left ventriculography. Patients were studied using a double blind, randomized protocol before and after a single intravenous dose of 3 mg propranolol (N = 22) or 0.5 mg pindolol (N = 24). 2. Mean right atrial pressure increased similarly after both drugs. Mean pulmonary artery pressure, left ventricular end-diastolic pressure, mean aortic pressure, and peripheral vascular resistance did not change significantly after either drug. Cardiac index (before: 3.0 +/- 0.7 (mean +/- SEM); after: 2.8 +/- 0.2 1 min-1 m-2) and heart rate (before: 78 +/- 15; after: 72 +/- 12 bpm) decreased only after propranolol administration. 3. Ejection fraction decreased only after propranolol (48 +/- 16 to 41 +/- 15%). Improvement in segmental wall motion abnormalities was noted (23 of 47 segments) only after pindolol. The total left ventricular wall motion score improved after pindolol and worsened after propranolol (P less than 0.05). In patients with impaired left ventricular function, pindolol administration resulted in improved resting ejection fraction. 4. Thus, the acute hemodynamic consequences of pindolol administration differ from those of propranolol owing to the preservation of left ventricular systolic function which seems to be related to the intrinsic sympathomimetic effect of pindolol on areas of reversible wall motion abnormality. PMID- 2698246 TI - Metabolic abnormalities in lead toxic children: public health implications. PMID- 2698245 TI - Iron and learning potential in childhood. AB - Cognitive function. There is reasonably good evidence that mental and motor developmental test scores are lower among infants with iron deficiency anemia. Although the research on cognitive function in iron deficient older children and adults is sparse and diverse, it suggests that there may be alterations in attentional processes associated with iron deficiency. Iron therapy has not yet been shown effective in completely correcting many of the observed disturbances. Although some aspects of cognitive function seem to change with iron therapy, lower developmental. I.Q., and achievement test scores have still been noted after treatment. The behavioral effects of iron-deficiency anemia may be due to changes in neurotransmission. However, the biochemical bases are not yet completely understood. Noncognitive disturbances. A variety of noncognitive alterations during infant developmental testing has also been observed, including failure to respond to test stimuli, short attention span, unhappiness, increased fearfulness, withdrawal from the examiner, and increased body tension. Exploratory analyses suggest that such behavioral abnormalities may account for poor developmental test performance in infants with iron deficiency anemia. These studies indicate the fruitfulness of examining noncognitive aspects of behavior such as affect, attention, and activity, in addition to specific cognitive processes. Activity and work capacity: There has been a steady accumulation of evidence that iron-deficiency anemia limits maximal physical performance, submaximal endurance, and spontaneous activity in the adult, resulting in diminished work productivity with attendant economic losses. The relative importance of central and peripheral mechanisms underlying these effects, the extent to which anemia or iron deficiency separate from anemia is responsible, and the counterpart in infants and children remain to be established. This essay has examined recent evidence from research on central nervous system biochemistry and from human studies that iron deficiency adversely affects behavior by impairing cognitive function, producing noncognitive disturbances, and limiting activity and work capacity. The body of research taken as a whole provides increasingly persuasive arguments for intensifying efforts to prevent and treat iron deficiency anemia. PMID- 2698247 TI - Genetic influences on susceptibility to atherosclerosis in the young. PMID- 2698249 TI - The roles of nature and nurture in childhood obesity. PMID- 2698250 TI - Newer methods in education: computer assisted instruction. PMID- 2698248 TI - Nutritional aspects of pediatric hypertension. PMID- 2698252 TI - History of sports medicine in The Netherlands. PMID- 2698254 TI - Modalities of cisplatin administration to brain tumors. PMID- 2698253 TI - Metabolic and renal changes in two athletes during a world 24 hour relay record performance. AB - Metabolic parameters and renal function were studied in two subjects before, during and after they established a world two-man 24 hour relay record. During the race, the athletes expended an estimated 37.747 and 42.880 kJ running at 54 and 61 per cent of maximum oxygen consumption (VO2max). Rectal temperatures reached maxima of 38.6 and 39.2 degrees C respectively during the race. Serum free fatty acid levels peaked at 2108 and 1875 mumol ml-1 after 24 hours; blood glucose levels varied from 4.3-6.5 and 4.9-8.5 mmol.l-1 respectively. Plasma insulin levels fell from 42.9 and 22.7 microU.ml-1 to 11.5 microU.ml-1. Plasma urea, creatinine, beta 2-microglobulin and C-reactive protein concentrations were elevated at the end of the race (to 9.0 and 8.0 mmol.l-1, 119 and 102 mumol.l-1, 3.508 and 3203 micrograms.l-1 and 2.7 and 3.9 mg per cent respectively). Plasma osmolality was altered from 293 and 304 to 302 and 280 mosmol.Kg-1 during the race but increased to 312 and 318 mosmol.Kg-1 the following day probably due to intercompartmental fluid shifts. Plasma creatinine concentration was increased by 38 and 26 per cent due to reduced urinary excretion. Urine flow rate increased 40 and 123 per cent respectively during the race, but creatinine clearance decreased by 38 and 40 per cent. Urine osmolality decreased by 38 and 65 per cent and osmolal clearance decreased by 15 and 16 per cent respectively. Urine sodium excretion was greatly reduced (85 and 90 per cent) on the post-race days (by 88 and 92 per cent on day 2). Both urine total protein and beta2-microglobulin excretion increased during the race (by 89 and 35 per cent and by 334 and 136 per cent respectively), but owing to the increased beta2-microglobulin production renal clearance was unaltered. The changes in renal function were temporary and some aspects of renal tubular function were enhanced during the post-race days. We conclude that, although C-reactive protein concentrations increased sooner and were higher than other shorter events and although creatinine, urine excretion and urine osmolality decreased markedly, the intermittent nature of the event, the mild environmental conditions, the moderate percentage of VO2 max maintained by the well conditioned subjects and a high fluid intake enabled a rapid return to normality and indeed to enhanced renal tubular function. The only moderate increases in body temperature would be due to the same factors. PMID- 2698255 TI - Differential gene expression in human cancer cells resistant to cisplatin. PMID- 2698256 TI - [Ultrasonographic manifestation and evaluation of imaging diagnosis of chronic pancreatitis]. AB - The ultrasonographic data of 50 patients with chronic pancreatitis are presented. Ultrasonographic manifestations were described as follows: Pancreatic focal or diffuse enlargement in 70% of these cases, reduced its size in 2%, retained its normal size in 28%, inhomogeneously increased echogenicity in 68%, coarse, focal dense echoes in 8%, decreased echogenicity in 20%, normal echogenicity in 4%, irregular contour in 40%, pseudocyst formation in 6%, abnormal pancreatic duct in 44%, dilated common bile duct in 20% and focal pancreatic mass in 14%. Patients in the study had a normal sonogram only in 4%. Abnormal ultrasonographic findings, especially pseudocyst and pancreatic calcification may be considered as important diagnostic evidence. In the diagnosis of chronic pancreatitis, the coincident rate of ultrasonography, ERCP and CT was 80%, 75% and 81%, respectively. Their diagnostic value was evaluated and compared. CT was the most sensitive and accurate. Ultrasonography was simpler and non-invasive, it may be used as a method of choice. Combination of using these various imaging techniques may increase the diagnostic accuracy. The diagnostic coincident rate of combined ultrasonography and CT was 91%, and that of combined ultrasonography and ERCP was 91%. PMID- 2698257 TI - [Clinical observations on 100 cases of malignant malaria treated with artesunate tablets]. PMID- 2698258 TI - [Experience in mid-operative detection of intrahepatic biliary calculus]. PMID- 2698259 TI - [Advances in research on colony-stimulating factors]. PMID- 2698260 TI - [The ceramic-tooth margin in ceramometal prosthesis. A comparative study of three fabrication procedures]. AB - This study of the ceramicbutt joint in metal-ceramic prosthesis permits to compare three different laboratory procedures. With the results obtained with two reading processes (numerical measurement and direct measurement of image replicas of S.E.M. to evaluate the marginal gap, it is possible to confirm that: the gold foil method gives the thinnest gap (between 32.7 and 44.7 micrometers) with presence of overcontoured margins. The ceramicbutt joint made by duplicate method, in refractory material, proves to be larger (between 57 and 67.8 micrometers) with overhanging margins, and damaged by sandblasting. The direct elaboration method, on a plaster model, proves to be less precise (gap between 74.6 and 80.4 micrometers) with a round but glossy ceramic margins. PMID- 2698261 TI - [From joint to neuromuscular, from mechanics to electronics: the concept of neuromuscular compatibility]. AB - The development of devices to record the functional mandibular kinetics, has permitted the physiological analysis of the masticatory cycles. Therefore, it is possible to consider a functional integration of the corrections, by addition or subtraction to the occlusal surfaces of the teeth. For this purpose, we have established the conditions of a physiological concept of occlusion taking into account the efficiency of the masticatory apparatus through a velocity analysis. This is the N.M.C. concept or concept of Neuro-Muscular Compatibility. This concept has led us to define the ISCA (Intra-Cuspid Spatial Angle), represented by the angle defined in the three spatial planes, by the trajectory of the occlusal contact point of a cusp liding over its opposite, in any excursive opportunity. We have shortly reported the studies by Levin on the SIROGNATOGRAPH and the prospects resulting from these studies. Then, we have studied in greater details the Saphon VISI TRAINER III developed by HOBO and described the various potentials of its use in the GBM Laboratory in Vienna (France), with Francois DURET. We have also analyzed the specific points which seem to represent the weaknesses of this device and have outlined some solutions to this problem. This approach, within a clinical context, may at term give rise to a complex analyser expert-system intends to facilitate the establishment of a reliable diagnosis and to control the physiological integration of our procedures. The establishment, at term, of parameters and constants of this function, will guide this progression towards success. PMID- 2698262 TI - [The anatomy of the maxillary and mandibular retromolar area. Effect on complete dentures. 1. The retrotuberosity space]. AB - Located at the border between vestibule and palatine area, the retrotuberosity space plays a major role in full dentures, as it involves the lateral portion of the posterior palatine joint. The arrangement of the pterygo-maxillary complex determines the morphology of this space and its use in full prosthesis. In most cases, the pterygo-mandibular ligament originates at a distance of the tuberosity, leaving a small mucosal fold, posterior to the tuberosity. This element, often mistaken with the origin of the ligament, should neither be released at the prosthetic border, nor be considered as a negative index. On the contrary, the presence of compressible submucosal glandular tissue, could be used when the posterior joint is prepared. PMID- 2698263 TI - [Acrylic denture base materials in dentistry. The influence of immersion of bases on the palatal gap]. AB - The method of experimental design, we used, is versatile enough to allow the study of immersion in water at 37 degrees C during 15 days after curing, as a new parameter able to influence the deformation of denture bases, without any additional experiment. According to the experimental conditions used to make up denture bases, this parameter can, in some cases, modify appreciably the deviation in the palate region. PMID- 2698264 TI - [Anticipated complete removable bridge]. AB - When planning a fixed prosthesis, in some case it may be indicated to prepare a continuous ledge to be able to face a failure on one or several abutments. Thus, a partial denture can easily be adapted to the fixed bridge without major modifications. The continuous ledge will be covered with a cast continuous bar, intended to restore the lingual crown morphology. This continuous bar is waxed either directly on the fixed prosthesis, or on a duplicated model, the first way being more precise. This technique permits to protect the metal surfaces. The advantage of this procedure is obvious from a mechanical as well as an aesthetic standpoint. PMID- 2698265 TI - Kinetic properties of 7 alpha-hydroxysteroid dehydrogenase from Escherichia coli 080. AB - Results on the kinetics of 7 alpha-hydroxysteroid dehydrogenase 7 alpha-HSDH showed that this enzyme could oxidize all bile acids having an -OH group at the C 7 position. Lineweaver-Burk plots showed Michaelis constant (Km) values of 0.83 and 0.12 mM for cholic acid and chenodeoxycholic acid, respectively. The effect of enzyme concentration on the reaction velocity showed a constant increase in the enzyme activity with increase in enzyme-protein concentration. 7 alpha-HSDH was activated by Na+, K+, Ca2+, and Mn2+ ions and by reducing agents having a thiol group (dithiothreitol, 2-mercaptoethanol). Co2+, Hg2+, Fe3+, Mg2+, Zn2+, Ba2+, and Cu2+ ions, chelating agents (potassium oxalate, heparin, EDTA) oxidizing agents (sodium perchlorate, sodium periodate, sodium persulphate), and detergents (Tween 20, Tween 40, Tween 80, Triton X-100, sodium lauryl sulphate) were inhibitory to 7 alpha-HSDH activity. PMID- 2698266 TI - Use of electron microscopy to characterize the surfaces of flocculent and nonflocculent yeast cells. AB - The surfaces of flocculent and nonflocculent yeast cells have been examined by electron microscopy. Nonextractive preparative procedures for scanning electron microscopy allow comparison in which sharp or softened images of surface details (scars, etc.) are the criteria for relative abundance of flocculum material. Asexually flocculent budding-yeast cells cannot be distinguished from nonflocculent budding-yeast cells in scanning electron micrographs because the scar details of both are well resolved, being hard and sharp. On the other hand, flocculent fission-yeast cells are readily distinguished from nonflocculent cells because fission scars are mostly soft or obscured on flocculent cells, but sharp on nonflocculent cells. Sexually and asexually flocculent fission-yeast cells cannot be distinguished from one another as both are heavily clad in "mucilaginous" or "hairy" coverings. Examination of lightly extracted and heavily extracted flocculent fission-yeast cells by transmission electron microscopy provides micrographs consistent with the scanning electron micrographs. PMID- 2698267 TI - Depression in Turkey in the 1980s: epidemiological and clinical approaches. AB - A review is presented of knowledge about the following issues in Turkey: prevalence of depression, suicidal attempts and suicide, clinical picture of depression, and etiological factors responsible for causing depression. Epidemiological studies of depression are reviewed and their results are discussed in detail, with special emphasis on conclusions with valid generalizations. As in almost all countries, depression, though exhibiting some differences clinically, is a major public health problem in Turkey. The point prevalence rate for depressive symptoms is nearly 20% and clinical depression has a rate of approximately 10%. Besides, about one-third of depressive patients are chronically ill. Specific risk groups for depression by various sociodemographic characteristics include women, widowed persons aged 40 years and over, close relatives of depressive persons, and members of lower socio-economic classes. An increase in the prevalence rates of depression in Turkey is expected due to changes in public attitudes, which do not consider depression a medical disorder at present; increase in life expectancy; rapid changes in socio-economic, cultural environments; and in family structures and lifestyles. PMID- 2698268 TI - Pharmacology of amineptine: synthesis and updating. AB - Amineptine is a tricyclic antidepressant agent with the unique capacity to decrease selectively the uptake of dopamine (DA) without affecting the uptake of noradrenaline (NA) and serotonin (5HT). The effect is obtained both in vitro and in vivo by the use of suitable methodology. Amineptine can be differentiated from amphetamine both on the basis of pharmacological as well as biochemical parameters. In vivo, amineptine increases striatal homovanillic acid without affecting the levels of other metabolites of DA, namely, 3, 4, dihydrozoxyphenylacetic acid (DOPAC) and 3-methoxytyramine (3MT). However, by using relatively high doses of amineptine, the extracellular DOPAC level- assessed by the use of pulse voltammetry--was decreased preferentially in the nucleus accumbens but not in the striatum. Chronic treatment with amineptine, as with other antidepressant agents, induces a down-regulation of beta-adrenergic receptors. Amineptine enters the brain and its pharmacological effects are likely due to the unchanged drug rather than to its two main metabolites. PMID- 2698269 TI - Pharmacokinetics of amineptine after single-dose, repeated treatment and study of the at-risk populations. AB - In this paper, three different studies are discussed. First, pharmacokinetics of the tricyclic antidepressant amineptine (Survector) and its main metabolite were investigated in young healthy adults. Amineptine was rapidly absorbed. Mean peak plasma concentrations of amineptine and its metabolite occurred 1 and 1.5 h, respectively, after drug administration. The mean apparent volume of distribution was large: 2.4 L/kg. Elimination was rapid. T 1/2 (half-life) was 0.8 h for amineptine and 2.5 h for the metabolite. The mean apparent plasma clearance of amineptine was high (124.8 L/h). In a second study in young patients, no change in pharmacokinetic parameters was observed after a 10-day course of repeated treatment with the drug. Finally, pharmacokinetics of amineptine and its main metabolite were studied in elderly patients on day 1 and after a repeated administration for 15 days. There was no significant age-linked change in the pharmacokinetics of amineptine even if half-life and area under the curve of the metabolite were all greater in the elderly subjects than in young adults. Pharmacokinetic parameters of amineptine and its metabolite were not affected by repeated administration over 15 days. The pharmacokinetic characteristics of amineptine in elderly subjects do not necessitate any dosage alteration for this population. PMID- 2698270 TI - A multicenter Italian study of amineptine (Survector 100). AB - This study reports the antidepressant efficacy and the safety of amineptine (Survector 100) in a national multicenter open clinical trial (32 hospital centers). Three hundred twenty-four patients with depressive disorders, selected according to DSM-III Diagnostic Criteria and INSERM classification, were treated with amineptine (200 mg/day) for 40 days (mean). Amineptine proved to be significantly effective with a rapid onset of action (beginning on the 7th day) on depressive symptoms, as shown by the decrease in the Hamilton Depression Rating Scale total score. The assessment of the results in the different diagnostic subgroups confirmed the wide-spectrum antidepressant activity of amineptine. Particularly in reactive and neurotic depression (nonpsychotic depression according to INSERM) and dysthymic disorders according to DSM-III, amineptine induced an improvement in 90% of patients. Nevertheless, amineptine was also effective in psychotic depression (INSERM) and in major depressive episodes (DSM-III), in which improvement occurred in 76% of patients. The low frequency of side effects and the remarkable acceptability (clinical, biological, and cardiovascular) of amineptine were also confirmed. PMID- 2698271 TI - The beneficial effects of amineptine (Survector 100) in the treatment of depression: preliminary results of an Indian multicenter trial. AB - A multicenter study of the efficacy and safety of amineptine in the treatment of depression has been performed in India. Patients fulfilling the DSM-III criteria for depression were included in this open clinical trial and treated with amineptine for 6 weeks. They received one 100-mg tablet or two (100 mg) tablets of amineptine per day. Efficacy of treatment was assessed using the Hamilton Depression Rating scale on D0, D7, D14, D21, D35, and D42. Liver function and cardiovascular function were examined on D0 and D42 to assess possible adverse effect of treatment. The preliminary results in 32 patients showed that amineptine was effective as soon as the 7th day of treatment and that this effect improved continuously throughout the study. Amineptine was found to be safe. PMID- 2698272 TI - A double-blind comparative study: amineptine (Survector 100) versus imipramine. AB - The aim of the study was to compare the antidepressant effects of amineptine with imipramine in depressive illness. According to the DSM-III criteria, 33 patients diagnosed as having depressive illnesses were given either imipramine or amineptine, 50-100 mg and 100-200 mg, respectively, per day on a double-blind basis over a period of 2 months. Both groups presented steady improvement of the symptoms of depression during treatment, as scored on the Hamilton and Montgomery and Asberg Depression Rating Scales and Clinical Global Impression Scale. Amineptine produced fewer anticholinergic effects than imipramine. The results show that amineptine, as well as imipramine, is well suited for treating depressed patients. PMID- 2698273 TI - The efficacy of amineptine in the treatment of depressive patients with irritable bowel syndrome. AB - Patients with irritable bowel syndrome (IBS) often suffer from depression. In view of this, the effect of amineptine on the psychopathological condition of depressive patients with IBS was studied. Forty patients who satisfied the criteria for irritable bowel syndrome and had a Hamilton 24-item score above 15 were randomly assigned to receive either amineptine 200 mg/day or placebo in a double-blind clinical trial. Patients on amineptine were more improved at the end of the trial than patients on placebo (total Hamilton score). Amineptine was more effective on depressive mood, retardation, and cognitive dysfunction. Although these findings should be interpreted with caution because the baseline scores were higher in the amineptine than in the placebo group, they provide some evidence that amineptine may be a useful tool for the management of depressive patients with IBS. PMID- 2698274 TI - Evaluation of the efficacy of amineptine in a population of 1,229 depressed patients: results of a multicenter study carried out by 135 general practitioners. AB - To assess the efficacy, tolerance, and safety of amineptine in ambulant treatment of depressive states, an open multicenter trial was performed by 135 general practitioners in a large number of depressed patients (1,229) with different nosologies and living in all areas of Portugal. The protocol included criteria of inclusion and exclusion and the full methodology was discussed with the practitioners in previous meetings coordinated by a psychiatrist. Daily dosage was 200 mg (two tablets); other psychotropic drugs were associated rarely and only when strictly necessary. Assessments were made at day 0, 7, 28, and 56, using the Clinical Global Impressions (CGI), Hamilton Depression Rating Scale (HDRS), diagram HARD, and a list of side effects. Results were analyzed statistically with calculation of statistical significance. The calculation of the correlation coefficients between the different measurement instruments was also made. There were 84 dropouts mainly due to missed appointments and intolerance of the medication. It is worth noting that 50% of the patients were treated with monotherapy, and that other psychotropics used were almost always anxiolytic drugs. Efficacy of amineptine was very good and rapid since there was a statistically significant difference in all observations with the different instruments of measurement used. Results were good in all types of depression, mainly in the neurotic and reactive ones. Moderate or severe side effects were seldom observed and transient. The acceptability was good or very good in 97.1% of the cases. PMID- 2698275 TI - Depression in elderly people treated with amineptine (Survector 100): a synopsis. AB - Aging is one of the most important current problems. In fact, according to statistics, the elderly population of the world is continuously increasing, and depression represents the most frequent psychiatric problem in the aged. It is well known that the antidepressive treatment of the aged imposes particular problems because of the frequent presence of cardiovascular problems, ocular hypertension, and prostatic hypertrophia. Amineptine (Survector 100) is devoid of anticholinergic and cardiotoxic effects. For this reason we have studied it in the treatment of elderly depressed patients. This study comes from a multicenter clinical trial (32 hospital centers) in which 324 patients were recruited; it includes 63 depressed patients over the age of 60 years. The diagnosis of depression was stated according to DSM-III diagnostic criteria and INSERM classification, and assessed by Hamilton Depression Rating Scale (HDRS) (26 items). The patients were treated with amineptine (200 mg/day) for 39.3 days (mean). The overall clinical efficacy was positive in 68% of cases; the clinical judgment was confirmed by a decrease in the mean score of HDRS (after the 7th day). The good acceptability (clinical, cardiovascular) was also confirmed. The different biochemical parameters were generally not modified during the treatment. Amineptine appeared to be an antidepressant treatment that combines efficacy and a very good level of safety, essential qualities for the treatment of elderly depressed patients. PMID- 2698276 TI - Condylar displacement in patients with TMJ dysfunction. PMID- 2698277 TI - [Prediction of fetal hypoxia using the fetal biophysical profile]. AB - In a prospective investigation the authors assessed the diagnostic accuracy of the biophysical profile in the detection of fetal hypoxia. They made 126 tests in 104 risk pregnancies during the 33rd-42nd week of gestation. By means of a scoring system they evaluated six biophysical parameters: non-stress test, fetal breathing movements, fetal movements, fetal tone, volume of amniotic fluid and maturity of the placenta. Ninety-six patients were delivered of a baby within seven days after the test and in these patients the course of childbirth and the condition of the fetus was evaluated. In case of a pathological biophysical score the pregnancy was terminated in 83.3% by Caesarean section, whereby the weight of the fetuses was by 48% lower (1693 g) and the height by 8 cm (41.8 cm) smaller than when the biophysical score was normal. In the detection of an adverse outcome of pregnancy, under which they included an Apgar score of 7 or less during the 5th minute, the first capillary pH less than 7.20 and perinatal death, the biophysical profile had a sensitivity of 68.8%, a specificity of 97.5%, a predictive value of the positive test of 84.6% and a predictive value of the negative test of 94%. PMID- 2698278 TI - [The EIA and the RIA in the diagnosis of pregnancy]. PMID- 2698279 TI - [The number of ovulating follicles and genetic factors]. PMID- 2698280 TI - [The effect of histological processing on the binding of lectins]. AB - Binding of FITC labelled lectins of LCA, PNA, and HPA in fundus, jejunum, liver and kidney of rabbit, guinea pig, rat and mouse had been studied with the use of three different methods of histological processing of the organs. The findings in cryocut postfixed sections, shortly dehydrated and in paraffin embedded samples and with common paraffin technique treated organs were compared. Results demonstrate that the influence of compared histological methods on lectin binding is not univocal. In some cases (e.g. fundus, rabbit, LCA and PNA) the binding of lectins is not modified by processing of tissue, in other cases (e.g. liver, rabbit, LCA) great differences between cryocut sections and sections of dehydrated and in paraffin embedded material were found. Generally it could be stated that common paraffin technique is not a very suitable method for lectin histochemistry. PMID- 2698281 TI - [Preparation technic and possibilities of use of histological whole-body sections of small laboratory animals]. AB - A preparation technique for whole-body sections of small laboratory animals (mouse, rat) is introduced comprising, cutting, drying and fixation of sections, staining and mounting. Sections can be used for whole body autoradiography as well as for histochemical, immunohistochemical, anatomical, pathological and distributional analytical evaluations. PMID- 2698282 TI - [The beginnings of the history of atherosclerosis in mental disorders]. AB - Atherosclerosis and its relationship with mental disorders, in particular in advanced age, arouses vivid interest of specialists at home and abroad. In their paper the authors focused attention on the historical development of the term dementia in the work of European doctors, starting in the second century after Christ, on the genesis of the term atherosclerosis and some discoveries associated with disease. Special attention is devoted to circumstances of the nosological differentiation of atherosclerotic mental disorders. The authors emphasize the importance of Binswanger's and Alzheimer's work in this area and draw attention to progressive elements in the work of K. Kuffner. PMID- 2698283 TI - Comparative study of complete and incomplete Freund's adjuvants for immunization of a drug immunogen using enzyme immunoassay methods. AB - Highly sensitive and accurate enzyme immunoassays (EIAs), a sandwich EIA for mouse immunoglobulin G (IgG) and an enzyme linked immunosorbent assay for mouse antibody specific to viomycin (VM), were developed. Accuracy and specificity of the assay results were confirmed before their application. The changes of total IgG and antibody specific to VM in mice, immunized with a VM-immunogen with or without two types of Freund's adjuvants under various conditions, were assessed by means of the newly developed EIA methods. Both methods were very useful tools to follow the immunization processes of mice, and complete and incomplete Freund's adjuvant were found to have similar adjuvant activities for production of antibody specific to VM, judging from the amounts of anti-VM antibody formed. It seems to be important that too many booster injections should be avoided in the immunization of mice with a hapten immunogen. PMID- 2698284 TI - Properties of a new alkaline proteinase from Aspergillus niger. AB - A. niger LCF 9 synthesizes a new aspergillopeptidase of potential interest in therapeutics. The properties and operating range of the enzyme were determined. It is a semi-alkaline aspergillopeptidase (EC 3.4.23.4) with one endopeptidase activity. Its pI is 4.10, its molecular weight is 21000 Da and its A1%(1 cm) at 280 nm is 9.75. It rapidly hydrolyzes casein and hemoglobin. Its optimal pH is 7.8 and optimal temperature is 45 degrees C. It is thermally labile above 40 degrees C but can be stabilized by adding calcium ions. It is inhibited by phenylmethylsulfonyl fluoride (PMSF), by ethylenediaminetetraacetic acid (EDTA) and by certain metals ions, e.g. copper, manganese and cobalt ions. It has no dipeptidase or tripeptidase activity and its esterase activity is weak. It has a high collagenase activity and is to our knowledge the only aspergillopeptidase that is active towards benzoyl-arginine p-nitroanilide (BAPNA). PMID- 2698285 TI - [Surgical treatment of gastroesophageal reflux in the child using Dor's anterior partial fundoplication procedure. Report of 37 cases]. AB - A retrospective study of 37 children with gastroesophageal reflux, treated by Dor's anterior partial fundoplication procedure, objects a good clinical result in a rate of 95%. The late radiologic examinations confirm a good result in 84%, without gastroesophageal reflux or fundoplication alteration, with a mean follow up of 6 years. The late efficiency of the partial fundoplication is assured by a safe fixation of the abdominal oesophagus and the partial fundoplication to the diaphragnatic crus. PMID- 2698286 TI - [Surgical indications for hydronephrosis discovered antenatally]. AB - The authors report series of 82 hydronephrosis (in 70 infants), detected antenatally by ultrasound. The cases were classified in 3 groups according to the severity of pelviureteric junction obstruction. Only the more severe cases are operated at once. In the remaining cases the observation help to decide the indications. In this series 35 renal units among 82 have been operated at date. The 47 remaining are annually followed up by ultrasound. PMID- 2698287 TI - [2,8-dihydroxyadenine lithiasis. 2 new pediatric cases of this misdiagnosed metabolic abnormality. The value of extracorporeal lithotripsy]. AB - Inherited adenine phosphoribosyltransferase (APRT) has a recessive transmission. When it is very important, adenine can't be restored into nucleic acids pool and will changed into 2,8-dihydroxyadenine (2,8-DHA) by xanthine oxydase. To date in all countries but Japan, 2,8-DHA urolithiasis is observed only into homozygotic subjects with complete APRT deficiency. Commonly, its onset is observed in childhood often dramatically. The authors report two new pediatric cases in two new french families. First a 8 year old boy with spontaneous elimination of two lithiasis after right lumbar pain. Secondly an infant (nineteen months) who has presented an acute renal failure with anuria. Bilateral lithiasis incluted into pyeloureteral junctions have been pulled out by bilateral surgical pyelotomy. In each case, lithiasis were radioluscent and diagnosis made by ultrasonography. The uric acid metabolism was normal and it is the infra red spectrophotometric study of stones that had recogniseed the 2,8-DHA component. In the second case, bilateral residual lithiasis have been broken by piezoelectric extracorporeal lithotrypsy with good tolerance and favorable result. The two children received permanent preventive treatment. After 36 and 19 months they have no recurrence. In the literature, the frequency of 2,8-DHA lithiasis is very more low than the theorical incidence of homozygotics in population (1/100,000). The common confusion with uric lithiasis is one possible explanation. So spectorophotometric study of radioluscent stones was meant to be realised when uric metabolism is not disturbed. Prevention associates alimentary diet without purins and permanent treatment by allopurinol (10 mg/kg/day in a child). Not used to date, piezo electric extracorporeal lithotrypsy seems to take a place for treatment of initial, residual or recurrent 2,8-DHA lithiasis like for our young patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698288 TI - [The multiseptate gallbladder. A rare malformation of the biliary tract]. AB - Multi-septate gallbladder is a very rare anomaly. In this 13-years-old girl with a complaint of nausea, vomiting and abdominal pain, sonographic examination and oral cholecystogram demonstrated a normal size gallbladder with many thin septa. The longitudinal section of the removed gallbladder revealed multiple inter communicating lobules divided by many thin septa. She has been free of the previous complaints after surgery. Only two pediatric cases have been reported previously. Our case illustrates the main features of this entity. PMID- 2698289 TI - [Neonatal pulmonary fibrosarcoma]. AB - The authors report a case of pulmonary fibrosarcoma in a newborn. The respiratory distress imposed an urgent thoracotomy at the fifth hour of live. A lobectomy was performed. Three months later a relapse occurred. A second thoracotomy permitted an incomplete resection. The total involution was achieved after 6 months of chemotherapy. Actually no recidive is shown after 20 months of follow up. Its an exceptional case. A unique one was published in 1977. PMID- 2698290 TI - [The association of pigmentary retinopathy and Coats' syndrome. Apropos of a case]. AB - A 31 years old woman with retinitis pigmentosa and a coats syndrome is studied. The vasculopathy is unilateral, complicated by vitreous haemorrhage, rubeosis iridis and macular oedema. Cryotherapy was inefficace. PMID- 2698291 TI - [Orbital varices. Apropos of a case]. AB - The authors report on a typical case of orbital varix, which was operated on by neurosurgical way. Orbital varices are rare venous anomalies, easily suspected on the clinic. The diagnosis is usually made on ultrasonography, CT Scan, and orbital venography. Conservative treatment is the rule except when complications have happened. PMID- 2698292 TI - [Treatment of opacification of the posterior crystalline capsule after extracapsular extraction: surgery or laser?]. AB - 32 Nd: Yag Laser posterior capsulotomy were compared to 30 surgical decisions. The visual recovery was complete in 56.2% of Yag Laser and in 76% of surgical cases. This results are debated and compared to anterior studies. PMID- 2698293 TI - [Subacute sclerosing panencephalitis. Van Bogaert's disease. Apropos of a case]. AB - Presentation of a case of Van Bogaert, and discussion telling about clinical aspect and ocular complications. PMID- 2698294 TI - [Ocular disorders and Hashimoto's thyroiditis]. AB - The authors remind some essential notions on Hashimoto's thyroiditis, and sum up the recent data on the physiopathology of the main auto-immune thyroid disturbances. One case of Hashimoto's thyroiditis diagnosed through out atypical ophthalmological symptoms, leads the authors to formulate different hypothesis integrating all the elements of this case in a single nosographical system, following a review of the literature on thyroid ophthalmopathy. PMID- 2698295 TI - [Crow-Fukase syndrome]. AB - In Japan, Crow-Fukase syndrome is a target of active research because of many cases reported. Therefore, the following three topics regarding this syndrome were discussed. 1) Etiology of Crow-Fukase syndrome. Even in reported cases of Crow-Fukase syndrome with monoclonal protein or polyclonal immunoglobulins and no apparent multiple myeloma, there were plasmacytomas in the lymph node or other tissues, and symptoms became improved after removal of these tumors. Therefore, plasma cells seem to be involved. According to recent studies, impairment of the pituitary function may play some role. 2) New pathological findings in the lymph node histology. In the lymph node of patients with this syndrome, we found in its germinal center a peculiar abnormality called angiosclerosis, in which branching tortuous capillaries with thickened wall including many cells were prominent, which may be different from those of Castleman's disease. 3) Nerve conduction studies using a new collision technique. Crow-Fukase syndrome is associated with marked slowing of even the maximal motor and sensory conduction velocities. Therefore, in order to understand its pathophysiology better, submaximal conduction velocities should be measured using the new collision technique because this technique is different from Hopf's method that is affected by the refractory period of nerve fibers. PMID- 2698296 TI - [Contribution of MPTP to studies on the pathogenesis of Parkinson's disease]. AB - Progress in the research on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is reviewed, and the impact given by MPTP to the studies on Parkinson's disease is discussed. Our data on the mechanism of the neuronal degeneration in MPTP induced experimental parkinsonism are also presented. We studied the effects of the 1-methyl-4-phenylpyridinium ion (MPP+) on mitochondrial respiration. Mitochondria were prepared from mouse brains, and oxygen consumption was measured polarographically. Activity of Complex I was measured after the incubation of the mitochondria with NAD(+)-utilizing substrates in the TCA cycle and ADP. MPP+ significantly inhibited the state 3 respiration supported by glutamate. Amount of ATP synthesized was also significantly reduced by MPP+. Activity of Complex I was significantly inhibited by MPP+. This inhibition was observed with 0.05 mM of MPP+ when intact mitochondria were used. These observations suggest mitochondria as the most probable site of the action for MPP+. It appears to be important to search for endogenous or exogenous toxic substances with similar pharmacological properties as MPTP to elucidate pathogenesis of Parkinson's disease. In addition, studies on mitochondrial functions in Parkinson's disease seem to be also important. Some preliminary data are shown. PMID- 2698297 TI - [Tetrahydroisoquinolines in connection with Parkinson's disease]. AB - Tetrahydroisoquinoline (TIQ) derivatives have been assumed to be substances closely related to parkinsonism because of their structural similarity to MPTP, which induces parkinsonism. TIQ and 1-methyltetrahydroisoquinoline (1MeTIQ) could be detected in human brains. The 1MeTIQ content in the frontal lobe of parkinsonian cases was markedly reduced than in non-parkinsonian cases. In addition, it could be recognized that 1MeTIQ content was decreased with aging both in the control and parkinsonians. It can be presumed that 1MeTIQ plays a role in protecting the brain from parkinsonism or aging processes. TIQ and 1MeTIQ were also present in a number of foods. It can be pointed out the possibility of TIQ intake from some foods. Metabolism of TIQ was defective in female DA, rat an animal model of a poor debrisoquine metabolizer. The female DA rat showed significantly higher brain accumulation of TIQ. These results suggest that the metabolic detoxication process is depressed and TIQ accumulation in the brain is enhanced in a poor debrisoquine metabolizer, which may be one possible explanation for poor debrisoquine metabolizers being susceptible to Parkinson's disease. PMID- 2698298 TI - [Central acetylcholinergic systems in the normal aged and in the patient with Alzheimer-type dementia (ATD)]. AB - Since the function of the brain is considered to be a sum of synaptic transmission phenomena, information on both neurotransmitters and receptors are needed. In addition, experiments of behavioral pharmacology to determine whether the neuron network is in operation or not are indispensable. Acetylcholine (ACh) is difficult to measure in the postmortem brain because of rapid postmortem degradation, and thus the activity of choline acetyltransferase (CAT), a synthetic enzyme, is determined. Receptors for ACh system are classified into muscarinic ACh receptors (MCR) and nicotinic ACh receptors (NCR). Since ACh and MCR/NCR are contained in different neurons, their regional distributions mismatch. Therefore, to evaluate the relationship between the ACh neuronal system and aging or dementia, information on all steps of CAT, receptors, memory and learning experiments are needed. Both in the normally aged brain and ATD brain, the ACh neuronal system at all steps is decreased except an increase in ACh degradation enzyme (acetylcholinesterase) in the normally aged brain. In animals, the decreased ACh neural system associated with aging can be normalized by drugs, showing that the aged brain still has plasticity. On the other hand, autoradiography of MCR in the ATD brain demonstrated destruction of the laminar structure of the cerebral cortex. This suggests that drugs to increase only ACh are not effective for treating ATD. In ATD, treatment methods that prevents structural destruction or its progression should be developed. PMID- 2698299 TI - [Approach to the dementia research]. AB - Main causes of dementia in the elderly are vascular dementia and Alzheimer's dementia. Vascular dementia is related to both amounts and localization of lesions. Recently incidence of diffuse vascular leukoencephalopathy (Binswanger type, leukoaraiosis) and amyloid angiopathy are increasing. In Alzheimer's protein chemistry of amyloid (beta protein, A4 protein) revealed its precursor APP and its gene (chromosome 21), which produces protease inhibitor in the brain of Alzheimer and Down's brains. APP is considered as an membrane protein (receptor) and appears abundantly in the cerebral cortex. Immunohistochemical study showed that beta protein is observed also in normal aged brain. On the other hand, tau protein (main component of Alzheimer's neurofibrillary tangle, PHF) appeared as abnormal sprouting of neurites in Alzheimer's brain. The latter may related to dementia and neural death. In Alzheimer's dementia, several neurotransmitters, including acetylcholine, are reduced in the brain and related structural changes are observed. Recently olfactory bulb and mucosal changes are remarked as one of pathogenesis of this disease. Delayed neuronal death is a new phenomenon of nerve cell death of vascular origin and should be studied in human vascular dementia. PMID- 2698300 TI - [Molecular genetic approaches to neurologic diseases]. AB - Recent advances of molecular biology has brought neurologists new and powerful approaches for the studies of neurologic diseases. The molecular genetic approaches have been successfully applied for the elucidation of molecular mechanisms of Gaucher disease, a sphingolipid storage disease. First a full length cDNA clone for glucocerebrosidase, the missing enzyme in Gaucher disease, was isolated, which enabled us to isolate the mutant as well as normal glucocerebrosidase genes. With detailed nucleotide sequence analysis of mutant genes, we have discovered two single base mutations within exons of glucocerebrosidase genes, one in type 2 and the other in type 1 Gaucher disease. Screening of the mutations among three phenotypes of Gaucher disease, it has been shown that there is a good correlation of occurrence of each mutation with the phenotypes. Moreover, we have shown that we have successfully restored glucocerebrosidase activity in Gaucher fibroblasts by retrovirus-mediated transfer of a normal human glucocerebrosidase cDNA. The results indicate that current molecular biology techniques can be utilized not only for the study of molecular mechanisms of neurologic diseases but also for the development of treatment of devastating neurologic diseases. PMID- 2698301 TI - Assessment of the role of the immunoglobulin isotypes in the development of diabetic nephropathy in untreated streptozotocin-induced diabetic rats. AB - Thirty of 45 (67%) streptozotocin-induced male Sprague-Dawley diabetic rats developed microalbuminuria that progressed to overt proteinuria with increased concentrations of IgG in their urine. 33% (15/45) never developed albuminuria or IgG proteinuria. These percentages did not correlate with glucose control since none of the animals were treated with insulin and all demonstrated the same degree of hyperglycemia. Indirect immunofluorescent antibody staining of frozen tissue sections from the kidneys of rats that developed overt proteinuria stained for IgM (67%), C3 (93%), IgG2b (93%) and IgG2c (60%). Non-proteinuric diabetic kidneys stained for IgM (80%), C3 (67%) IgG2b (67%) and IgG2c (87%). Control kidney sections demonstrated no consistent staining pattern. The occurrence and concentration of the different immunoglobulin isotypes, eluted from frozen sections with immune complex dissociating buffers, mimicked that which was observed by immunofluorescence. When urine or serum from the same rat or a rat of a different group was incubated with kidney sections eluted of all immunoglobulin, indirect immunofluorescent staining demonstrated antibody activity corresponding to the original staining pattern observed for each animal group prior to elution. The most consistent observation was that the diabetic rats that developed proteinuria were positive for IgG2b staining in their kidney sections; whereas, those that did not develop proteinuria stained predominantly for IgG2c. From this data, we suggest that the progression of diabetic nephropathy may depend on whether a specific IgG subclass response is elicited. PMID- 2698302 TI - Determination of islet cell surface antibodies in first-degree relatives of type 1 diabetic patients using rat insulinoma cells. AB - Titre of islet cell surface antibodies (ICSA) in 114 sera from healthy control probands and 177 sera from first-degree relatives of Type 1 diabetic patients was determined by indirect immunofluorescence using rat insulinoma (RIN) cells as target. All sera were tested at four dilutions (1/40-1/320). 10(5) RIN cells were incubated with 100 microliters diluted serum overnight at 4 degrees C followed by a 45 min-incubation with a FITC-labelled goat anti-human globulin. Titre curves were calculated by double logarithmic regression. ICSA titre was defined as the serum dilution producing cell surface fluorescence on 40% of RIN cells. Based on these data a serum is defined as ICSA positive when the ICSA titre calculated is higher than 1:142, quantil Q (0.97). Twenty-five out of 177 (14%) sera of first degree relatives of Type 1 diabetes were ICSA positive with a mean titre of 1/393, range 1/145-1/1,740, while 2/114 (1.7%) control sera were weakly positive for ICSA. These data demonstrate the significantly increased ICSA prevalence in first-degree relatives of Type 1 diabetic patients. The present study suggests that RIN cells may represent a useful tool for standardization of ICSA assay. PMID- 2698303 TI - Low-molecular-weight proteinuria in insulin-dependent diabetes mellitus: a study of the urinary excretion of beta 2-microglobulin and retinol-binding protein in alkalinized patients with and without microalbuminuria. AB - The urinary excretion of two low-molecular-weight proteins (beta 2-microglobulin and retinol-binding protein) was measured in 12 insulin-dependent diabetic patients with persistent microalbuminuria and an equal number with normal albumin excretion; reference ranges for the excretion of beta 2-microglobulin (beta 2M) and retinol-binding protein (RBP) were also obtained in 40 non-diabetic subjects. To ensure the stability of beta 2M in urine a urinary pH greater than or equal to 7 was achieved by giving oral sodium bicarbonate. beta 2M and RBP excretion was significantly higher in the diabetics than in the controls (p less than 0.01), but no higher in microalbuminuric than non-albuminuric diabetics. In the diabetics as a group a significant correlation was found between the excretion of beta 2M and RBP (r = 0.53, p less than 0.01), but more patients had an abnormal excretion of beta 2M than RBP (p less than 0.001). No significant correlation was found between the urinary excretion of either low-molecular-weight protein and duration of diabetes, insulin dose, HbA1, urinary glucose excretion or systemic blood pressure. Measured under appropriate alkaline conditions beta 2M appears to be more sensitive than RBP in detecting an abnormality of the renal proximal tubule which may be an early feature of diabetic renal involvement not characterized by microalbuminuria; microalbuminuria may have glomerular and tubular components. PMID- 2698304 TI - Effects of streptozotocin-induced diabetes on glucose utilization that was stimulated by various agents in rat thymocytes. AB - Post receptor insulin resistance has been demonstrated in insulin sensitive tissues from streptozotocin induced diabetic animals. Insulin deficiency itself or metabolic derangements of diabetes seem to contribute to this insulin resistant state. However, the mechanism is presently unknown. Using largely insulin insensitive rat thymocytes, we have studied glucose oxidation stimulated by agents that mimic insulin action but that work independently of the insulin receptor. Glucose oxidations stimulated by these agents were markedly diminished in the thymocytes from streptozotocin induced diabetic rats. These findings as well as our finding that the thymocytes from diabetic rats possess a normal complement of insulin receptor provide further evidence that post insulin receptor impairment of glucose metabolism occurs in streptozotocin diabetes. Thus although thymocytes are not sensitive to insulin, they are useful for the investigation of the impaired glucose metabolism. PMID- 2698305 TI - Defective insulin-mediated splanchnic glucose regulation and glucose clearance: early glucose homeostatic defects in nondiabetic, young offspring of patients with noninsulin-dependent diabetes mellitus. AB - Nondiabetic, young offspring of noninsulin-dependent diabetic (NIDDM) patients manifest insulin insensitivity. The pathophysiologic implications of the insulin insensitivity are uncertain since such subjects are usually normoglycemic. We have, therefore, studied isotopically the glucose turnover fluxes (D(3-3H) glucose technique) during postabsorptive state and after a physiological solid mixed meal ingestion for 240 min in 13 nondiabetic offspring and eight age-, sex- and weight-matched controls. Mean fasting serum glucose (84 +/- 3 vs. 78 +/- 2 mg/dl) and insulin (13.9 +/- 1.5 vs. 5.3 +/- 0.8 microU/ml) were significantly (p less than 0.05) greater in the offspring vs. controls. After the mixed meal ingestion, both serum glucose and insulin levels rose to significantly higher levels throughout the study period in the offspring vs. controls. Basal (2.04 +/- 0.73 vs. 1.84 +/- 0.76 ng/ml) and peak (5.72 +/- 0.65 vs. 6.47 +/- 0.40 ng/ml) serum c-peptide levels were not significantly different between the offspring and controls, respectively. Mean basal hepatic glucose output was significantly (p less than 0.05) higher in the offspring vs. controls (79 +/- 6 vs. 66 +/- 6 mg/m2.min). Following the mixed meal ingestion, the total splanchnic glucose appearance was significantly greater and qualitatively different in the offspring vs. controls. This occurred in the presence of identical intestinal carbohydrate absorption rates in both groups as assessed by simultaneous D-xylose test. Despite higher serum insulin levels, basal and post-meal metabolic clearance rates of glucose were similar in the two groups. We conclude that in nondiabetic offspring, greater basal and post-meal serum glucose and insulin levels occur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698306 TI - [Computer-assisted tissue analysis for cancer detection in breast ultrasound- significance of reference values]. AB - Due to the inhomogeneous and very variable structure of healthy tissue of the female breast it is often very difficult to detect a carcinoma via computer-aided sonography. The present study based on preoperative measurements in 29 woman patients with carcinoma of the breast aimed at finding out to what extent it would be possible to circumvent this problem by means of additional reference measurements in healthy tissue. For this purpose, relative image parameters were determined besides absolute ones from measurements in tumorous and healthy reference tissue. These relative image parameters are much more suitable for subsequent decision analysis on account of their narrower range of variation. The results obtained in this manner could be improved further by additional optimization or extension (such as analysis of other combinations of parameters, by enlarging the field of measurement and hence the data available per tissue sample, use of higher or even different ultrasound frequencies). PMID- 2698307 TI - Lead systems for the abdominal fetal electrocardiogram. AB - The literature on abdominal FECG has been studied for design principals of a lead system for recording FECG signals at the maternal abdomen. The indications are compared, contrasted, and combined with the results obtained from basic FECG data collected in a recent study on the modelling of the FECG. PMID- 2698308 TI - STAN--the Gothenburg model for fetal surveillance during labour by ST analysis of the fetal electrocardiogram. AB - Waveform analysis of the fetal ECG for fetal surveillance is regaining widespread interest. This paper presents our present knowledge on ST waveform analysis during human labour. A unipolar scalp lead with the maternal thigh as reference makes it possible to identify the T wave and at the same time decrease signal noise. The development of an ECG analyser (STAN) has enabled us to collect 201 ECG recordings during labour on which ST analysis could be undertaken. The data indicate that waveform analysis of the fetal ECG improves fetal surveillance during labour. PMID- 2698309 TI - Power spectral analysis of the heart rate of the human fetus at 26 and 36 weeks of gestation. AB - The fetal electrocardiogram (ECG) was recorded from the maternal abdomen together with sonographic detection of fetal states in four pregnant patients at 26 and 36 weeks of gestation. Computerised algorithms obtained a good recognition of maternal ECG and fetal ECG. The corresponding power spectral density (PSD) was estimated during epochs of quiet or breathing movements for 256 consecutive heart beats. At 36 weeks of gestation the PSD analysis showed heart rate variability components similar to an adult heart. A low frequency component was observed together with a high frequency component in the range of fetal breathing movements. This high frequency component (0.6 - 0.9 Hz) disappeared from the PSD analysis during epochs of apnea. To our knowledge this is the first demonstration of such a mechanism in the human fetus in utero. At 26 weeks no respiratory component was observed in the PSD analysis. The maturation of control mechanisms could be responsible for this difference. PMID- 2698310 TI - Bioactive factors in bone development and repair. Part I. A conference held in honor of Dr. Marshall R. Urist. Kerrville, Texas, May 15-18, 1988. Proceedings. PMID- 2698311 TI - Bioactive factors in bone: Marshall R. Urist, M.D. May 1988 Kerrville, Texas. PMID- 2698312 TI - The next frontier: molecular biology of extracellular matrix. PMID- 2698313 TI - The nature and significance of osteopontin. AB - Osteopontin is an acidic glycoprotein of about 41,500 daltons that has been isolated from rat, human and bovine bone. It is rich in aspartic acid, glutamic acid and serine and contains about 30 monosaccharides, including 10 sialic acids. Several types of data suggest that the carbohydrate is present as 1 N-glycoside and 5-6 O-glycosides while the phosphate is present as 12 phosphoserines and 1 phosphothreonine. The cDNA sequence indicated the presence of a Gly-Arg-Gly-Asp Ser- (GRGDS) amino acid sequence identical to a cell binding sequence in fibronectin, and suggested that osteopontin might function as a cell attachment factor. This conclusion is supported by a number of studies showing that the protein promotes attachment and spreading of fibroblasts and osteoblasts to substratum, and that this attachment is inhibited by RGD-containing peptides. Despite this evidence that it contains an RGD recognition sequence and probably interacts with the family of receptors known as integrins, it appears that osteopontin does not possess a collagen-binding domain. Osteopontin is synthesized by preosteoblasts, osteoblasts and osteocytes, is secreted into osteoid and is incorporated into bone. The expression at an early developmental stage is an indication that osteopontin is an important component in the formation of bone. The level of synthesis of osteopontin by osteoblasts in culture is increased by treating these cells with 1,25-dihydroxyvitamin D3 and TGF-beta. The effect of these agents is at the transcriptional level. In addition to bone cells, osteopontin is synthesized by extraosseous cells in the inner ear, brain, kidney, and deciduum and placenta. It is also synthesized by odontoblasts, certain bone marrow cells and hypertrophic chondrocytes. Studies with several fibroblast and epithelial-derived cell lines in culture indicate that secretion of osteopontin can be dramatically increased when these cells are treated with phorbol esters, growth factors and hormones. However, osteopontin does not appear to be expressed by mesenchymal cells, fibroblasts, epidermal cells or by most epithelial cells in vivo. PMID- 2698314 TI - Role of transforming growth factor beta in bone remodeling: a review. PMID- 2698315 TI - Fibronectin and glycosaminoglycan synthesis by fibrotic pig fibroblasts in primary culture. AB - Synthesis of fibronectin and glycosamingoglycans (GAGs) was studied in fibroblasts from pigs with post-irradiation subcutaneous fibrosis. Fibrosis was developed in the femoral muscle by local gamma irradiation with a dose of 60 Gy. Normal fibroblasts were obtained from the healthy skin of the same animal. To measure GAG and fibronectin synthesis fibrotic and normal fibroblasts were labeled with 3H-glucosamine, 35S-sulfate and 35S-methionine. Fibrotic fibroblasts synthesized 2.5 times as much fibronectin as normal skin fibroblasts but total protein synthesis did not change. Parallel enhanced secretion of hyaluronic acid and dermatan sulfate into the cell culture medium were also observed. GAGs from the pericellular layer of trypsin-digested fibrotic fibroblasts exhibited increased 3H incorporation, but reduced 35S-sulfate incorporation. The largest reduction in the latter was observed for heparan sulfate. These results indicate that the fibroblasts from the well developed fibrotic tissue maintain enhanced synthesis of matrix macromolecules in primary cultures. Structural and/or metabolic changes in secreted GAGs, combined with the stimulation of tissue repair by growth factors may be responsible for the excessive deposition of collagen in post-irradiation fibrosis. PMID- 2698316 TI - The influence of verapamil on theophylline serum concentrations. AB - The effect of verapamil on steady state levels of theophylline were studied in 10 healthy volunteers. Sustained release theophylline 3 mg/kg/day was administered 3 days prior to, and during a 7 day treatment of verapamil 80 mg three times daily. Steady state theophylline levels were measured before giving verapamil and on days 3, 5, and 7 of verapamil. Blood for theophylline assay was drawn one hour before the morning theophylline dose. The results showed no statistically significant difference in theophylline levels before and after verapamil. We conclude that oral verapamil does not affect the disposition of oral theophylline at the dose studied. PMID- 2698317 TI - Sex and species differences in glutathione S-transferase activities. AB - Glutathione S-transferases (GSTs) are one of the important enzymes in terms of not only drug metabolism but also physiological functions. The marked sex difference in GST activity has been found in rat and mouse liver cytosol, and such differences in rat liver are suggested to be primarily due to the differences in the subunit composition of GSTs in both sexes. In addition, GST activities of rat liver cytosol are known to be largely influenced by treatment with inducers such as phenobarbital and 3-methylcholanthrene and various hormones. GSTs are widely distributed in mammalian species, and multiplicity of GST has been demonstrated so far. The present review also describes multiple forms of GST from the viewpoint of enzymology and immunology. PMID- 2698318 TI - Possible reactive intermediates in the oxidative biotransformation of hexachlorobenzene. AB - In this review the biotransformation of hexachlorobenzene is discussed, with special reference to the possible generation of reactive metabolites or intermediates during this process. Evidence is presented for the direct involvement of certain cytochrome P-450 isoenzymes in the major toxic effect of hexachlorobenzene, hepatic porphyria. The in vivo biotransformation is discussed and compared with in vitro experiments (microsomal and cell culture studies). The possible reactive metabolites and intermediates and their mechanisms of formation are presented. Special attention is directed to a very reactive metabolite, tetrachloro-1,4-benzoquinone, which has a high capacity to efficiently react with protein, thus possibly linking the oxidative biotransformation of hexachlorobenzene and the molecular mechanism of enzyme inactivation leading to hepatic porphyria. PMID- 2698319 TI - Ultrastructure and possible processes involved in the invasion of host epithelial cells by Candida albicans in vaginal candidosis. AB - Ultrastructural studies of Candida albicans in its invasive form obtained from lesions of patients with vaginal candidosis confirm that growth is intracellular. The invading hyphae show well defined organelles including a denticulate double layered plasma membrane, nuclei, cristate mitochondria, endoplasmic reticulum and storage granules, especially when osmium tetroxide was used as the sole fixative for electron microscopy. The invasion of host epithelial cells is probably brought about by a combination of enzymatic, physical and mechanical processes. PMID- 2698320 TI - Identification of product-substrate pattern for erythrocyte membranes self digestion using the original two-dimensional electrophoretic technique. AB - Ghost proteins immobilized in polyacrylamide gel after SDS-PAGE (first dimension) were degraded by endogenous membrane proteases. Fragments of the gels were submitted to SDS-PAGE (second dimension). Undigested proteins appeared on a diagonal, whereas products of proteolysis were evident below the substrates on electropherograms. The typical product patterns for spectrin, band 3, 4.1 and 4.2 proteins for human and bovine ghosts, are described. PMID- 2698321 TI - Localization of the beta-like globin gene cluster and the genes for parathyroid hormone and c-Harvey-ras 1 to region q14----q21 of rabbit chromosome 1 by in situ hybridization. AB - The rabbit beta-like globin gene cluster (HBBC), comprised of epsilon-, gamma-, delta-, and beta-globin genes (HBE, HBG, HBD, and HBB, respectively), has been mapped to chromosome 1, region q14----q21, by in situ hybridization using probes for rabbit HBE and HBG. Probes for the human parathyroid hormone gene (PTH) and the Harvey-ras 1 protooncogene (HRAS1) also localize to this region by in situ hybridization. Thus, these genes are syntenic in lagomorphs as well as four other mammalian orders (primates, rodents, carnivores, and artiodactyls). The mapping data in rabbits provide further evidence that this synteny is strongly conserved in the evolution of mammalian chromosomes. PMID- 2698322 TI - The sex-determining zinc finger sequences in XY females of Akodon azarae (Rodentia, Cricetidae). AB - Wild populations of Akodon azarae comprise females with a karyotype indistinguishable from that of males. These individuals were formerly assumed to be Xx, the x being an X chromosome with a deletion of most of its long arm. By using a DNA probe derived from the testis-determining region of the human Y chromosome (comprising a candidate gene for the testis-determining factor, Y linked zinc finger [ZFY]), we demonstrate that A. azarae gonosomally variant females are XY and not Xx. The ZFY sequences in A. azarae are amplified and located in two different families of EcoRI fragments derived from Y-chromosome DNA. No rearrangement or change in the state of methylation of ZFY or ZFX (X linked zinc finger) sequences were found in XY females. We propose that sex reversal in A. azarae may be mediated by a gene or genes other than ZFX or ZFY. PMID- 2698323 TI - Nonmodal chromosome gain and loss in human fibroblast cultures. PMID- 2698324 TI - [Which occlusal concept for complete edentulism?]. AB - Complete edentulous patients have lost a part of their "body shema". Must one re build the missing teeth according to a purely theoretical concept called "bilaterally balanced occlusion"? Or should one reproduce natural occlusion through "canine protection" or "group function" arrangement of prosthetic teeth? We will attempt to find an answer to this question in referring to a bibliographical review and in analysing the different arguments. PMID- 2698325 TI - [Preprosthetic composite resin coronal reconstruction: which bur to use?]. PMID- 2698326 TI - [1699-1791-1892. Three dates that made French dentistry]. PMID- 2698327 TI - [Surgery and dentistry in the revolutionary period]. PMID- 2698329 TI - Managing gingiva key to exact impressions. PMID- 2698328 TI - [19th century dentistry]. PMID- 2698330 TI - Dentin treatment stirs up dispute. PMID- 2698331 TI - When to use posts. PMID- 2698332 TI - Cast restorations often need gingival retraction. PMID- 2698333 TI - An historical perspective of blacks in American dentistry. PMID- 2698335 TI - Visual field testing with reduced sets of test points. A computerized analysis. AB - A computerized analysis of visual fields is described. In a second step these results are condensed into a 'reduced' set of test points so constructed that if testing is limited to 6-8 points nearly all defective visual fields would have been spotted with at least one defective point. The 'reduced' set involves the testing of few points several times in a session rather than spending very few trials on a great number of points. This is a new approach which merits further investigation. PMID- 2698334 TI - Hysterical symptoms in ophthalmology. AB - Ophthalmologic symptoms are often not sufficiently accounted for by organic pathology. The complaints of these patients have been labeled hysterical, psychogenic, non-organic, or functional. The psychiatric nosology in this area may be the most confusing in the whole field of clinical medicine. The Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) offers a classification designed to reduce non-empirical concepts and ideology to a minimum. On this background, we discuss the hysterical symptoms encountered in clinical ophthalmology with special emphasis on psychogenic amblyopia and blepharospasm. Motor symptoms are commonly not of psychogenic origin. It is suggested that ophthalmologists are most likely to treat patients with psychogenic symptoms, using suggestion, patience, and reassurance. Few patients require psychiatric consultation and a specific psychiatric therapy. The association of hysteria with organic brain disease and the issue of symptom lateralization are briefly discussed. Eventually, we reject the psychoanalytic approach and suggest that the concept of abnormal illness behavior and the neurobiological models involving corticofugal inhibition, primitive reflex mechanisms, and an attention disturbance, serve best to understand the nature of the phenomenon hysteria. PMID- 2698336 TI - MRI in eye tumors. AB - Thirty patients with intraocular tumors were examined with MRI. A clear demarcation was seen between the melanomas and other intraocular structures such as sclera, vitreous and ciliary body. Retinal detachment, hemorrhage or choroidal retinal layer could be seen separated from the tumor. In all our patients investigated with MRI the absence of extraocular melanoma tissue was confirmed by histopathology or by the findings during surgery. The demarcation between tumor and sclera seemed more sensitive in MRI than in ultrasonography in establishing extrascleral extension. Our study showed that MRI can be a valuable addition to ultrasonography in detecting intraocular tumors or tumor simulating lesions. PMID- 2698337 TI - [The effect of mutation in the beta-subunit of Escherichia coli RNA polymerase on the selectivity of complex formation with T7 DNA promoters]. PMID- 2698338 TI - [Specificity of action of metalloproteinases from buckwheat seeds. Hydrolysis of insulin beta-chain]. PMID- 2698339 TI - Clindamycin and tetracycline as immunomodulating agents: an in vivo study. AB - The present study was undertaken to determine the effects of clindamycin and tetracycline, both intravenously administered, on antibody response to thymus dependent antigen (PC-KLH) in BALB/c mice. The immunological parameters evaluated were: DPFC/spleen (direct plaque forming-cells), antibody secretion median rate (PC50), heterogeneity index (Hi), number of total splenic lymphocytes and cellular viability. The results showed that clindamycin (i.v.) increased the humoral response; 28 mg/kg was the dose that showed the greatest enhancement (+73%). The PC50 was not affected by clindamycin but Hi decreased at 28 mg/kg and increased at 2.8 mg/kg doses, although neither result was statistically significant. When tetracycline was given i.v., a slight decrease in the anti-PC DPFC number was observed. Although the PC50 was greater at 10 mg/kg (p less than 0.05), Hi was smaller at the 1 mg/kg dose (p less than 0.05). PMID- 2698340 TI - Accuracy and porcelain shear bond strength for two different types of non precious alloys used in fixed prosthodontics. PMID- 2698341 TI - [Endodontics: mechanical or manual methods? Preparation and cleaning of root canals]. AB - Neither with mechanical nor with manual methods is it possible to achieve a preparation of the entire root canal in all wall areas. A reasonable combination of hand instruments with engine-driven, sonic or ultrasonic units certainly has advantages in preparing, cleaning and irrigating the root canal. What is more important than the question of mechanical or manual preparation of root canals is that the operator should work meticulously and have a thorough knowledge of the root canal anatomy. While it is well possible to do without mechanical instruments in preparing root canals, manual instruments are indispensable. As far as efficiency is concerned, some recent developments are promising. PMID- 2698342 TI - [Preparation of hard tooth structure with Excimer lasers]. AB - In this study the possible application of photoablation with an Excimer UV laser for the creation of retentive surfaces was studied as an alternative to conventional enamel conditioning methods using acids. Surfaces of untreated enamel and of prepared cavities were irradiated with an argon fluoride Excimer laser at a wavelength of 193nm and evaluated in a scanning electron microscope. The bond strength of composites to these surfaces was measured in tear tests. "Laser conditioning" left the surfaces similarly roughened as chemical etching. The variable extension of the laser field allows a sharp delineation of the area to be conditioned. The tear tests with human tooth enamel showed bond strength values corresponding to approx. 75% of those obtained by acid etching techniques. The question if these bonds are durable is the subject of current studies. PMID- 2698343 TI - [Comparison of the frequency and intensity of vibrations of dental drive systems in tooth preparations ]. AB - During high speed cavity preparation the vibration burden of human teeth was evaluated in comparison between turbine- and micromotor-driven handpieces. The acceleration spectra of different burs showed an advantage of the air-driven handpiece. PMID- 2698344 TI - [Influence of die spacer on the marginal gap of partial crowns]. AB - The effect of die spacer in the fabrication of partial crowns was examined in an in vitro study. Even with good overall expansion of the investment material it is impossible to prevent tight spots in the areas of the box form or clasp retentions. These have to be removed by grinding. Accurate application of die spacer may improve the marginal fit significantly while reducing the amount of grinding necessary. PMID- 2698345 TI - [Classification for partially endentulous arches]. AB - The currently known classifications for partially edentulous arches lack completeness of major findings relevant for planning prosthodontic therapy. A classification to assess the remaining function of the partially endentulous arch will be proposed, based on the number of teeth and position and length of the interdental connections. PMID- 2698346 TI - [High frequency sonography in periodontal diagnosis]. AB - In a preparatory series of experimental studies on anatomical preparations of the skull, the components of the bony periodontium have been identified by frontal and horizontal scans. First experimental studies on sheep periodontal have been conducted using a high resolution 20 MHz ultrasound unit. B scans provide a clearly defined image of the periodontal structures of the alveolar arch, the gingiva and the periodontal membrane. Without an additional A scan, however, a quantitative evaluation is impossible. PMID- 2698347 TI - [Influence of smear layer removal and acid etching on the sealing potential of various cavity liners]. AB - Dye penetration experiments were conducted to test the sealing of dentin cavities with cavity liners. Dye penetration was greatest for zinc phosphate cement (Harvard) and smallest for a plastic reinforced calcium hydroxide compound (Care). PMID- 2698348 TI - A suitable method to monitor inhibition of cholinesterase activities in tissues as induced by reversible enzyme inhibitors. AB - A radiometric method has been used to estimate in vivo activities of cholinesterases in various tissues in the presence of reversible inhibitors. Determination of the samples was performed with the lowest possible degree of dilution to avoid reactivation of the enzyme which would prevent reliable calculation. Dose-response curves and concentration-response curves were performed using physostigmine and tetrahydroacridine, two reversible anticholinesterases in clinical use. Specific inhibition of acetyl- and butyrylcholinesterase was performed using BW284C51 and iso-OMPA, respectively. PMID- 2698349 TI - Cardiovascular and neurohumoral responses to behavioral challenge as a function of race and sex. AB - Cardiovascular and hormonal responses to a structured interview, an electronic video game, a cold pressor test, and exercise on a bicycle ergometer were assessed in eighty-three 25- to 44-year-old normotensive Black and White men and women. Blacks showed significantly greater diastolic blood pressure (DBP) responses than Whites during the cold pressor test, which were not accounted for by an increase in plasma catecholamines. Exercise produced reliably greater systolic blood pressure (SBP) increases in Black women than in Black men or White women. Men showed significantly greater SBP and DBP changes than women during the video game. These findings suggest that the pattern of physiological reactivity elicited by challenge is related to the race and sex of the subjects. PMID- 2698350 TI - The effects of N-methyl-D-aspartate antagonists on the development of vestibular compensation in the guinea pig. AB - In order to investigate the possible role of the N-methyl-D-aspartate (NMDA) receptor in the development of the behavioural recovery which occurs following unilateral labyrinthectomy (vestibular compensation) in the guinea pig, we administered systemically the specific NMDA receptor/channel antagonists MK801 and CPP (3-((+/-)-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid) during the compensation process. MK801 disrupted the development of ocular motor compensation when administered at 18-22 h post-op (1.0 mg/kg i.p.). CPP had a smaller but still significant disruptive effect when injected at this time (1.0 or 5.0 mg/kg i.p.). We conclude that NMDA receptors may contribute to the development of ocular motor compensation in the guinea pig. PMID- 2698351 TI - Neuroendocrine mechanisms of hypertensive states developing during chronic emotional stress. AB - This paper discusses central neuroendocrine mechanisms involved in the development of hypertensive states during emotional stress with reference to the data published in the literature and obtained by the author. The experimental results are used to identify the structural and functional organization of the central nervous system that provides integration of nervous and hormonal factors in the pathogenesis of hypertensive states in response to emotional stress. The hypothesis about the trigger role of posterior hypothalamic nuclei which activate neuroendocrine mechanisms of the development of hypertensive states during emotional stress is documented. Mechanisms of MBRF's participation in the realization of emotional stress are clarified. PMID- 2698352 TI - The insulin response to oral glucose, concentrations of total cholesterol, triglycerides and uric acid in women with idiopathic hirsutism. AB - The glucose and insulin responses to an oral glucose tolerance test, concentrations of total cholesterol, triglycerides and uric acid were evaluated in women with idiopathic hirsutism (IH). Clinical data and laparoscopy of the ovaries were used in diagnosis. According to body weight the patients were divided into two groups: obese (OB-IH) and non-obese (NO-IH). In the IH and NO-IH groups the glucose response was significantly greater than in the control group (p less than 0.05). The insulin response to oral glucose was significantly higher in the IH and OB-IH groups compared with the control group (p less than 0.01). The concentrations of total cholesterol and triglycerides were significantly increased in the IH and OB-IH groups compared to those of normal women (p less than 0.01). All groups had significantly higher levels of uric acid compared with the control group (p less than 0.01). The results of our study suggest that alterations of carbohydrate, lipid and uric acid metabolism are present in patients with IH and further studies are needed to establish their mechanisms. PMID- 2698353 TI - Effect of acute hyperthyroidism on insulin removal in the rats. AB - The aim of this work was to study secretion and removal of insulin in hyperthyroidism. The experiments were carried out on two groups of male Wistar rats: control and hyperthyroid. Acute hyperthyyreosis was induced by administration of L-thyroxine (Fluka A.G.) 0.8 mg/kg for 21 days. Each group was divided into three subgroups: fed, fasted 24 h, fasted 24 h-treated with glucose. The insulin concentration was determined in the portal and aortal blood and a difference between the two concentrations was considered as reflecting insulin removal. The plasma insulin concentrations in both vessels of fed as well fasted hyperthyroid group were higher from the respective values in the control one. The removal of the hormone in the fed rats was similar in the both groups. Fasting reduced insulin removal only in the control group. Treatment of the fasted rats with glucose abolishes this difference. The liver glycogen content was similar in the two fasted groups but the blood glucose level was higher in the hyperthyroid than in the control rats. The latter factor could account for the difference in insulin removal between the two groups. It is concluded that hyperthyroidism increases insulin secretion but does not affect its removal. PMID- 2698354 TI - Decreased plasma C-peptide to insulin molar ratio after oral glucose in elderly subjects. AB - To evaluate the effect of aging on hepatic extraction of insulin, peripheral plasma insulin and C-peptide levels after an oral glucose ingestion were measured in 39 non-obese healthy subjects with normal glucose tolerance test. The subjects were divided into two groups. One age group was below 30 years (n = 17) and another was above 50 years (n = 22). Blood glucose level was significantly higher in elderly subjects than in young at 30 and 60 min, and insulin level was also significantly higher in elderly subjects than in young subjects at 60 min after glucose ingestion. C-peptide response after glucose ingestion was similar in both groups. The molar ratio of C-peptide to insulin after glucose ingestion in elderly subjects was slightly lower than that in young subjects, and the difference between the incremental areas of C-peptide and insulin divided by the incremental area of C-peptide were significantly lower in elderly subjects. These results suggest that hepatic insulin extraction after glucose loading is decreased in elderly subjects and this may partly be responsible for the slightly altered glucose metabolism in elderly subjects with normal glucose tolerance test. PMID- 2698355 TI - Persistence of anti-islet ADCC after manifestation of type-1 (insulin-dependent) diabetes. AB - ADCC (antibody-dependent cellular cytotoxicity) against xenogenic islets in vitro has frequently been found with mononuclear blood cells and heat inactivated autologous serum from newly diagnosed Type-1 diabetics. Anti-islet ADCC, as measured by enhanced 51Cr-release of islets after a 6h-incubation, leads to functional alteration of islets such as a decrease in insulin content and in leucine incorporation. In a follow-up investigation over at least three years it was demonstrated that anti-islet ADCC in vitro disappears, if there is no more C peptide secretion in vivo. Furthermore, anti-islet ADCC has also not been found in long-term Type-1 diabetics who had no C-peptide secretion but an acutely stimulated immune system due to infectious diseases. An acute immunocytolytic process against pancreatic beta cells in vivo seems to be the precondition for anti-islet ADCC in vitro. PMID- 2698356 TI - Whole body glucose metabolism in experimental insulin-dependent diabetes after initiation or termination of insulin administration. AB - To investigate the kinetics in glucose metabolism, diabetic dogs were infused with double labelled glucose either when they were connected to an artificial beta cell after overnight insulin withdrawal (study I) or when they were disconnected from insulin supply after excellent metabolic control (study II). Fourteen hours after the last insulin injection, the animals had three-fold elevated rates of appearance Ra and of disappearance Rd of glucose in relation to non-diabetic controls; the metabolic clearance rate was reduced, glucose carbon recirculation was slightly elevated, and the % lactate from glucose was not altered. Glucosuria contributed approximately 30% to the elevated glucose turnover. In study I, Ra was normalized within 45 min after insulin supply but Rd increased transiently before returning to normal. In study II, plasma insulin was zero 30 min after termination of insulin supply. Ra increased immediately; Rd decreased slightly but increased thereafter. Lactate was elevated under all conditions. Its production from glucose increased slightly after initiation of insulin action. Glucose carbon recirculation was reduced to subnormal values when the animals were euglycemic but hyperinsulinemic.--It is concluded that even short intervals of relative lack of insulin action followed by restoration of glucose homeostasis, may induce wasting of substrates. PMID- 2698357 TI - Computer based communication can facilitate continuing education. PMID- 2698358 TI - The nursing simulated laboratory comes of age. PMID- 2698359 TI - Duke-Elder lecture. Prevention and perspective in retinal detachment. PMID- 2698360 TI - The benefit of early trabeculectomy versus conventional management in primary open angle glaucoma relative to severity of disease. AB - One hundred and sixteen patients with newly diagnosed primary open angle glaucoma were selected for a randomised, prospective, multicentre trial if the untreated intraocular pressure was over 25 mmHg and there was field loss characteristic of glaucoma. Conventional management of medical therapy followed by trabeculectomy in unsuccessful cases was compared with trabeculectomy at diagnosis followed where necessary by supplementary medical therapy. At a mean follow-up of 4.6 years there was no significant difference in visual acuity between the groups but the conventional management group had significantly greater loss of visual field which occurred during the unsuccessful attempt at medical control. The eyes which lost most visual field were those with least field loss at diagnosis and this paradox was attributed to a prolonged attempt at medical control in these eyes because they were thought to have a lower risk of visual field deterioration. PMID- 2698361 TI - The role of MRI scanning in neuro-ophthalmology. AB - The role of high resolution magnetic resonance imaging (MRI) in the assessment of optic atrophy, chiasmal compression, and posterior fossa lesions is demonstrated. Good spatial resolution, absence of bony artifact and multiplanar imaging are significant advantages over CT scanning in these areas, as is the ability to detect areas of demyelination. Orbital MRI offers future potential but at present we think that CT scanning provides better spatial resolution and is more cost effective for the orbit. PMID- 2698362 TI - Treacher Collins prize essay. The significance of nystagmus. AB - Nystagmus occurs in a very wide range of circumstances, each type showing characteristic clinical, pathological and electrophysiological features, and analogies between them can be identified by comparing and contrasting nystagmus of different kinds. The effect of altered visual and vestibular conditions on nystagmus, and the features of its waveform, indicate the relationship between eye movements and vision, and the influence of visual and vestibular input in stabilising steady fixation. Ultimately, the significance of nystagmus is that it indicates the state of the mechanisms underlying this stabilisation: in physiological nystagmus they are operating successfully, and in pathological nystagmus they are disturbed. More than this, investigation of nystagmus has shown that the visual system is not divided in a clear-cut way into sensory and motor poles, but that between them there exists a neural region where a 'copy' of the visual world is matched with a programme of potential eye movements, and where sensorimotor information exists indivisibly. Long feedback loops, involving occipital cortex and extraocular muscle proprioceptors, and short ones within the cerebellum and integrator, emphasise the great precision involved in eye movement control, enabling the visual cortex to make optimal use of the resolution capabilities of the fovea. Nystagmus always reflects an asymmetry in the output of the eye movement generators, and it has been shown that the inappropriate movement which is responsible for pathological nystagmus is the slow movement. This may arise because of an intrinsic defect in that part of the generator called the neural integrator, or because of 'tonic imbalance' in its input. Nystagmus occurring with identifiable acquired central nervous pathology can, to some extent, be understood mechanistically, but idiopathic congenital nystagmus poses greater difficulties. Analysis of its waveform suggests that an intrinsic fault in the integrator can explain the clinical and electrophysiological findings in CN, but the cause of the high gain instability in the integrator remains to be explained. The integrator is adaptable, or self-tuning, adjusting its output by visual feedback. Circumstantial evidence suggests that the original disorder in idiopathic CN may occur higher than the integrator, detuning it by conveying an inappropriately organised visual input. In particular if the organisation of the visual system into fields is defective, the gaze generators, whose output is orientated according to field, will have a less accurate 'copy' of the world from which to formulate their movements.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2698363 TI - [Recent data on the regulation of glucose transport and glucose transporters in insulin-sensitive tissues]. AB - This review concerns the acute and long-term regulation of glucose transport. In insulin-sensitive tissues, the acute effect of insulin on this process occurs mainly through the translocation of glucose transport proteins (glucose transporters) from an intracellular pool to the plasma membrane. Some other factors are also able to modify acutely glucose transport by the translocation mechanism. However, recent data are reported which indicate that in addition, modifications of the glucose transporters activity are involved. The long-term regulation of the glucose transport capacity has been less studied. In different types of cultured cells, a role of two factors, glucose and insulin, has been clearly shown. The availability of cDNA probes encoding for glucose transporters, has given the opportunity to study the molecular regulation of glucose transport. However, it appears that different sub-types of glucose transport proteins exist which might be regulated in a specific manner depending on the cell-type and the regulatory factor. The existence of an insulin-sensitive glucose transporter is strongly suggested. The regulation of this protein, which could be specifically involved in insulin resistant physiopathological situations, remains to be studied. PMID- 2698365 TI - [Insulin pharmacokinetics in insulin-dependent diabetics. Mathematical models]. AB - The study of insulin pharmacokinetics must help for a better understanding of clinical phenomenons commonly observed among diabetic patients, when insulin therapy is administered either intra-venously (I.V.), or subcutaneously (S.C.). We realized this work in a population of insulin-dependent diabetics. None of the subjects had significant levels of anti-insulin-antibodies. We analysed the absorption profiles (SC(t] of radio-iodine labelled insulin after a subcutaneous injection, the plasmatic profiles (P(t] after an intra-venous bolus of cold insulin. We demonstrate that, using a convolution calculation, it is possible to predict the plasmatic in insulin kinetics after subcutaneous injection or during S.C. infusion, even if the infusion rates are varying. An estimation of the proportion of insulin which is degraded at the injection site can easily be done. This model may be useful for a better understanding of the kinetics of insulin among diabetics, but also to evaluate new modes of insulin administration. PMID- 2698364 TI - Inter and intra individual variability of acute insulin response during intravenous glucose tolerance tests. AB - To analyze the inter- and intra-individual variability of acute insulin response to intravenous glucose (AIRG), 41 healthy volunteers underwent an intravenous glucose tolerance test (IVGTT) and 29 of them a second IVGTT 1 to 9 months later. Basal glycemic, insulin (IRI), and C-peptide values were similar for both IVGTTs. Different indices were used to estimate AIRG. A great inter-individual variability of AIRG (CV around 60%) was detected. AIRGs were not statistically different between the two IVGTTs, and the within-subject variation was fair at the group level (CVs approximately 30%). However, individual coefficients of variation ranged from 2 to 60% between the two tests. Moreover, subjects considered as "low" responders during test 1, returned to "normal" values during test 2. Conversely, other subjects dropped to a "low" response in IVGTT 2. Insulin peak (IRI max) occurred between 1 and 3 minutes after glucose infusion in 85% of the control population, but time points of IRI max were different for 45% of the population between the two IVGTTs. These results suggest that AIRG during IVGTTs are reproducible at the group level, but that AIRG has to be interpreted with caution in individual early detection of pre-insulin-dependent diabetes mellitus because inter- and intra-individual variability could be high even for some normal subjects. PMID- 2698366 TI - Action of a semi-synthetic human insulin preparation (30/70 NPH insulin Organon): comparison with another 30/70 NPH (Actraphane Novo). AB - The action of a new semi-synthetic insulin preparation (30% soluble, 70% NPH insulin from Organon Laboratories Eragny sur Epte France) was studied in 6 healthy male volunteers using the euglycemic clamp technique (Biostator GCIIS) and compared with another 30/70 NPH (Actraphane Novo). Insulin levels, inhibition of C peptide secretion and glucose consumption were determined. There was a time lag between the maximum glucose need (167 +/- 18 mg/Kg/15 min at the 195th minute after the injection) and the peak plasma insulin level (98.3 +/- 8.5 uu/ml at the 105th minute following the injection). The maximum glucose need was followed by a slow fall in insulin levels with a duration of action of 17 hours. The total glucose need was the same as for Actraphane, although Actraphane had a slower action with a lower peak glucose need (144 +/- 18 mg/Kg/15 min at the 280th minute after injection). The two preparations had the same duration of action. PMID- 2698367 TI - Culture of islets of Langerhans from an infant with intractable neonatal hypoglycemia: cytochemical and radioimmunological studies. AB - Extralobular islet of Langerhans cells were isolated from the pancreas of an infant with intractable neonatal hypoglycemia (nesidioblastosis) by digestion with a mixture of trypsin and collagenase, and subsequent purification on a gradient of fetal calf serum. These islet cells cultured in Eagle's medium containing 20% fetal calf serum formed confluent endocrine cell monolayers within 15 days. These endocrine cells were studied immunocytochemically, and their secretion products were assayed by radioimmunological methods. The large numbers of beta, alpha and delta cells present in the islets before explanation remained functional in the cultures for 30 days. The beta cells secreted large amounts of insulin throughout this period, and secretion was stimulated by raising the glucose concentration in the medium from 5.6 to 16.8 mM. Initially there was little secretion of glucagon, but this increased during the subsequent 10 days in culture. It was not inhibited when the glucose concentration was raised from 5.6 to 16.8 mM. Somastostatin secretion remained stable throughout the period of culture, but tended to rise when the glucose concentration was increased. These results show that the culture of pancreatic cells from infants with nesidioblastosis provides an interesting in vitro system for studying the biological and biochemical characteristics of endocrine cells in the human pancreas. PMID- 2698368 TI - [Studies on oncogene and its products of human nasopharyngeal carcinoma]. AB - Oncogene of nasopharyngeal carcinoma (NPC) by means of external origin DNA transfection experiment and its gene products by immunohistochemical method have been studied. These DNAs were isolated from human primary poorly differentiated NPC tissues and were transfected into NIH/3T3 mouse fibroblasts to induce the foci of the morphologically transformed cells in the culture, while DNAs of normal placenta tissues failed to do so. The DNAs were extracted from the primary and secondary transformed cells to analyse human sequence with human Alu sequence probe. The human sequence has been detected in the DNAs of the primary and secondary transformed foci cells, while none of the human sequence was detected in the DNAs of the control. The results indicated that human transforming sequences had been integrated into transformed cells. The malignant properties of the transformed foci cells were evidenced by tumorigenic experiment of nude mice. The transformed foci cells were inoculated subcutaneously in the nude mice and induced fibrosarcoma in vivo. The tumorigenic rate was 87.5%. It was further demonstrated that DNAs from human NPC possessed carcinogenicity and induced malignant transformation. The primary result revealed that the transforming gene of NPC may be homologue to Ha-ras oncogene. The expression of Ha-ras gene products-p21 has been studied in human NPC tissues. The primary results showed a positive expression of p21 in human NPC tissues by immunohistochemical method. The positive rate was 90.4%. PMID- 2698369 TI - [Comparative study of outer envelope protein and LPS of five strains of leptospires by SDS-PAGE and 2D-PAGE]. AB - We applied SDS-PAGE, 2D-PAGE and Western blot to analyse the outer envelopes protein and LPS of five strains of leptospires. The work would lay foundations for taxonomy, the development of vaccination regimens and the elucidation of pathogenic mechanisms. The outer envelope proteins of leptospires were analyzed by SDS-PAGE and silver staining. We found that the protein profiles of the pathogenic leptospires were basically identical. A comparison of the protein profiles of the pathogenic L. with those exhibited by two nonpathogenic L. indicated that there was no obvious relationship between these organisms and any of the L. interrogans strains examined. The quantity of 21.5 kd protein of strain 017 was greater than that of strain 601 and 156. Approximately 200, 225, 238 distinct polypeptides were detected in the strain 017, 601 and 156 in 2D-PAGE by silver staining respectively. The profiles of 2D-PAGe showed obvious differences in pI. The pI of strain 017, 601 and 156 were mainly 6.68-7.4, 6.55-6.9, 5.85-7.1 respectively. The 21.5 kd protein of strain 017 was made up of six polypeptides. Our immunoblots revealed that McAb (LB1) reacted with a 41 kd antigen, which was common to the three virulent leptospires tested. SDS-PAGE profiles of silver stained outer envelope LPS of pathogenic L. differed greatly from those of the nonpathogenic L. There was a distinct differences between strain Patoc I and 3055. Our studies showed that each of the five strains of leptospires possessed characteristic outer envelope LPS, which may be used to identify the genus, species and serovars of a strain of L. PMID- 2698370 TI - [A study on the promotion of adhesion properties of adhesives to metals treated by positive oxidation]. AB - The adhesion to three alloys: Durabond, GH30 and soft Co-Cr, by PE adhesive was investigated. The surfaces of metals were treated by polishing, sand-blasting, positive-oxidation and complex processing in order to test the tensile bond strengths between metals and PE adhesive; to study the effects of the surface treatment of metals on adhesive properties; and to compare the tensile strength with that from the control experiment with EB composite resin and Panavia-EX resin under the same conditions. The results showed the mean tensile bond strengths between PE adhesive and Durabond, GH30 and soft Co-Cr alloys after the treatment of sandblasting and positive oxidation were 214.65 +/- 51.68 kg/cm2, 372.88 +/- 21.88 kg/cm2 and 349.21 +/- 48.32 kg/cm2 respectively, displaying better adhesive properties and stability of resistance to water. PMID- 2698371 TI - [A survey on Campylobacter jejuni high infection in a nursery]. AB - An epidemiologic survey on Campylobacter jejuni infection in a nursery was made in April 1987. It was found that there was a spread of C. jejuni high infection. Two cooks affected by enteritis of C. jejuni were considered to be a reservoir of the infection. Stool cultures were positive for C. jejuni in 43 out of 187 children, with a positive rate of 23%. Eight of the 43 had diarrhea and the others were asymptomatic carriers (24.3%). Controls were set up in another nursery with 238 healthy children and 201 non-diarrheal outpatients; C. jejuni was positive for 11.4% and 7.5%, respectively. The difference was quite significant (P less than 0.005). Results of biotyping on the strains isolated from the two cooks and the children in the nursery showed that all were of C. jejuni biotype 1, except two (4.7%) of the strains from the children, which were E. coli. The authors have suggested that transmission of C. jejuni in the nursery may be caused by contaminated food or person-to-person contact. PMID- 2698372 TI - Evolution of the modern dental office. PMID- 2698373 TI - 1865-1920--our heritage takes shape. PMID- 2698374 TI - 1920-1940--an era of challenge. PMID- 2698375 TI - 1940-1960--for the good of the people. PMID- 2698376 TI - 1960-1989--the stage for tomorrow. PMID- 2698377 TI - Malignant bone tumours in pregnancy (a report of two cases and review of literature). AB - Two cases of malignant bone tumours in pregnancy are reported. The optimum management is not clearly defined due to the rarity of the condition and limited individual experience. Our patients delivered healthy babies without any signs of maternal malignant disease. Cancer chemotherapy was instituted during the postmortem period. Pregnancy did not appear to exacerbate the tumour growth nor in any way affect the ultimate outcome of the patients. PMID- 2698378 TI - Medulloblastoma in adults--clinical observations and results of treatment. AB - Ten cases of medulloblastomas, in patients above the age of 15 years, were treated during a 11 year period. These constituted 18 percent of all medulloblastomas and 1.2 percent of all primary brain tumours in adults during the same period. The majority of patients (80%) were between 16 and 25 years of age, and 80 percent were male. Half the patients presented within three months of the onset of symptoms. The usual clinical presentation was with features of raised intracranial pressure and cerebellar involvement. A lateral location of the tumour and its desmoplastic variant were common. Three patients survived more than five years. The desmoplastic variant and a gross total resection of the tumour favourably affected the prognosis. Posterior fossa recurrence was the chief cause of therapeutic failures. All the recurrences developed within three years of the initial diagnosis, and were fatal within six months of their detection. PMID- 2698379 TI - Ewing's sarcoma of metacarpal. A case report and review of literature. AB - The radiological features of a rare case of Ewing's sarcoma of right fourth metacarpal in a twenty-five years young male are described. An up date review of literature is also presented. PMID- 2698380 TI - [Psoriasis and bullous pemphigoid. Description of 3 clinical cases]. AB - Three cases with coexisting psoriasis and bullous pemphigoid are reported and the possible etiopathogenetic relationships between the two diseases are discussed. PMID- 2698381 TI - [Sweet's syndrome]. AB - The authors describe a clinical case of Sweet's syndrome in a 41-year-old man. From the clinical-instrumental tests carried out a paraneoplastic syndrome is excluded. PMID- 2698382 TI - Directory of on-going research in cancer epidemiology. 1989/90. PMID- 2698383 TI - Oral clonidine: an effective growth hormone provocative test. AB - Twenty normal statured healthy children (8 M; 12 F) aged 9-16 years were subjected to growth hormone (GH) provocative tests. The mean basal GH level was 2.0 +/- 0.42 ng/ml (+/- SEM). The mean peak levels of GH were 11.9 +/- 2.19 ng/ml (+/- SEM) after exercise, 9.82 +/- 2.81 ng/ml (+/- SEM) after insulin and 15.2 +/ 2.54 ng/ml (+/- SEM) after oral clonidine. A significant rise (peak level greater than 7 ng/ml) of serum GH was found in 70, 80 and 85% of children after exercise, insulin and oral clonidine tests, respectively. The observation in the present study indicates that oral clonidine test, a safer, easier and more economical test than insulin hypoglycemia, is equally potent and can be done in out patients. PMID- 2698384 TI - Neonatal hypertension. PMID- 2698385 TI - Cerebellar syndrome in malaria. PMID- 2698386 TI - Cerebellar ataxia in malaria. PMID- 2698387 TI - Congenital malaria. PMID- 2698388 TI - [Gingivitis in children. Morphological, bacteriological and immunological particulars]. PMID- 2698389 TI - [Periodontal regeneration. History and current status]. PMID- 2698390 TI - [Bonding of a fracture fragment to an anterior tooth]. PMID- 2698392 TI - [Some definitions for better understanding of piezography]. PMID- 2698391 TI - [Centenary of the first international dental congress]. PMID- 2698393 TI - [Assessment instruments used in rehabilitation]. AB - Nowadays the word assessment is commonly used in the field of health, but what aspects does it cover in rehabilitation medicine? This paper presents conceptual and operational approaches to the assessment of patients suffering from functional limitation. These systems of assessment either represent a global approach--considering patients' activities of daily living--or have been specifically elaborated for a category of patients such as those with quadriplegia. However, such instruments pose problems of validity, construct validity, sensitivity and easy use. While advanced approaches exist for improving assessment of clinical follow-up in rehabilitation, we have also to consider the difficulty of combining objective assessment of functional abilities with measurement of perceived or felt handicap from the treated patient's point of view. PMID- 2698394 TI - Microvascular angina and panic disorder. AB - Recent cardiac studies have suggested that patients with chest pain and angiographically normal coronaries have "microvascular angina" (MVA). In contrast, prior psychiatric studies have shown that some of these patients have panic disorder (PD). We compared the clinical and psychologic characteristics of fifteen patients with MVA and fifteen patients with panic disorder (PD), and examined response to lactate infusion in a subgroup of MVA patients. Although 40 percent of MVA patients met criteria for PD and had chest pain following lactate infusion, there were psychologic and symptomatic differences between the MVA and PD groups. These results reflect either co-morbidity of MVA and PD in some patients or two types of MVA, one of primary cardiac origin and one a centrally mediated epiphenomenon of the increased autonomic arousal seen in PD. PMID- 2698395 TI - Measuring arm impairment and disability after stroke. AB - This is a review of the problems of assessing impairments and disabilities affecting the arm after stroke, and of the various published measures already available. In routine clinical practice, motor impairment is best assessed using grip strength or the Motricity Index, and dexterity disability is best assessed using the Nine-Hole Peg Test or Ten-Hole Peg Test. No measures of sensation and tone are specifically recommended, primarily because validity and reliability has not been well established for the measures available. Other more complex tests appropriate for more detailed use in planning treatment or in research are discussed. PMID- 2698396 TI - Mechanisms of the ultraviolet light response in mammalian cells. PMID- 2698397 TI - Polymerase chain reaction. AB - The PCR, like recombinant DNA technology, has had an enormous impact in both basic and diagnostic aspects of molecular biology because it can produce large amounts of a specific DNA fragment from small amounts of a complex template. Recombinant DNA techniques create molecular clones by conferring on a specific sequence the ability to replicate by inserting it into a vector and introducing the vector into a host cell. PCR represents a form of "in vitro cloning" that can generate, as well as modify, DNA fragments of defined length and sequence in a simple automated reaction. In addition to its many applications in basic molecular biological research, PCR promises to play a critical role in the identification of medically important sequences as well as an important diagnostic one in their detection. PMID- 2698399 TI - [Cast composite veneers]. AB - No matter the reason, patients will no longer tolerate any malformation or staining of anterior teeth. One can not ignore the fact, that with time, esthetics and a pretty smile have become important issues for most individuals. When indicated and properly placed, composite veneers can probably rectify these situations (at least as a temporary measure due to their moderate cost and the minor amount of tissue which has to be destroyed). Professor Francoise Roth, who was one of the first individuals to study this procedure, allows us to profit from her experience with the assistance of Doctor Michel Gouvernet. PMID- 2698398 TI - Distribution of anti-F(ab')2 antibodies and the 16/6 idiotype in systemic lupus erythematosus (SLE) probands and kindreds. AB - Levels of serum anti-F(ab')2 antibodies and expression of the 16/6 anti-DNA idiotype were studied in 103 sera from first-degree relatives of 17 systemic lupus erythematosus (SLE) kindreds. Among healthy SLE relatives, 35.9% showed anti-F(ab')2 elevations and 24%, Id 16/6 expression. Forty-three and two-tenths percent of healthy SLE relatives with elevated anti-F(ab')2 also showed expression of 16/6; when Id 16/6 was positive, 16 of 25 relatives (64%) showed parallel elevations of anti-F(ab')2. However, within individual families, distribution patterns of elevated anti-F(ab')2 and Id 16/6 often did not coincide. Affinity-isolated anti-F(ab')2 from four members of a single SLE kindred showed relative enrichment for Id 16/6 in only two of the four individuals studied. Moreover, none of the isolated anti-F(ab')2 antibodies within this kindred or another kindred showing 16/6 Id expression reacted directly with 16/6 Id. Our studies suggest that whereas both anti-F(ab')2 and Id 16/6 are increased within SLE kindreds, expression of the two does not always coincide. Furthermore, anti-F(ab')2 antibodies do not show direct reactivity with Id 16/6. A number of anti-DNA idiotypic markers may play a role in idiotypic networks among such SLE kindreds. PMID- 2698400 TI - [A new enamel-dentin adhesive. Method of use]. AB - This article reviews instructions for the use of a new enamel-dentin bonding agent, Scotchbond 2 from the 3M company. Precise recommendations relative to cervical lesions are presented and discussed. PMID- 2698401 TI - [Gingival recession: what to do?]. AB - The qualitative and quantitative character of the marginal gingiva is not the only cause of root exposure, as mechanical factors can favorize and/or aggravate gingival recession. Suggested therapy is dependent on patient motivation and the evolution of the lesions. Even though there are multiple possibilities for the treatment of gingival recession, one must remain prudent when restoring areas of root exposure, as no protocol exists today which can assure constant success. PMID- 2698402 TI - [Hepatitis B: what you always wanted to know]. AB - More than two million individuals die each year as a result of infection from the hepatitis B virus, either directly from fulgurant hepatitis, or in the majority of cases, from the long term after-effects. The high risk groups, the reasons for cross contamination, the various ways of transmitting the disease, the rate which individuals are being vaccinated against hepatitis B, the vaccines and the recommendations for controlling transmission are some of the subjects related to in the article. The dentist and the dental team must function with a viable asepsis protocol. PMID- 2698403 TI - ["Infection control of laboratory items" a myth?]. AB - Impression materials and impression trays must be cleaned and disinfected before being used and adjusted in the mouth, or sent to the laboratory. This article reviews some of the practical recommendations for dental offices and laboratories. PMID- 2698404 TI - [Choice of antibiotics in periodontology]. AB - For periodontal treatment, the use and choice of antibiotics is a controversial matter. There are many medical reasons for prescribing antibiotics before, during and after periodontal treatment. The purpose of this paper is to review the indications and reasons for antibiotherapy in periodontics. Research is not very advanced in this domain and there is a need to understand the indications for antibiotherapy in periodontics. PMID- 2698405 TI - Measuring the kinetics of membrane phase transitions. AB - This article presents a brief review of literature on the physical chemistry of lipid phase transitions with emphasis on their kinetic properties. The theoretical foundations of perturbation techniques, and specifically the volume perturbation technique are discussed in some detail. These are presented as a rationale for, and introduction to, a volume-perturbation kinetic calorimeter that we have constructed for measurement of the kinetics of lipid phase transitions. The instrument has been applied to study the gel-liquid crystalline phase transition in a variety of phospholipid bilayer systems. The design and implementation of the volume-perturbation calorimeter are presented along with a discussion of the techniques of data analysis. Finally, we present typical results obtained with this methodology for a multilamellar vesicle dispersion of dipalmitoylphosphatidylcholine. PMID- 2698406 TI - Power staple fixation in hallux valgus surgery: a preliminary report. AB - The authors describe a relatively new power staple device for foot surgery. Their preliminary review has been very favorable, as studied in 40 cases of hallux valgus repair. Their discussion includes the indications, contraindications, and potential for future use in the foot. PMID- 2698407 TI - Use of ceftazidime-impregnated polymethyl methacrylate beads in the treatment of Pseudomonas osteomyelitis. AB - Antibiotic-impregnated polymethyl methacrylate beads have been used in other countries to treat osteomyelitis. The drug of choice for this has historically been gentamicin. The authors have chosen ceftazidime to treat iatrogenic Pseudomonas aeruginosa osteomyelitis in rabbit femurs. After implanting the beads, the rabbits were killed at various times in the treatment period. Rabbits were killed at 15 days and later showed no signs of current osteomyelitis, including cultures and histologic examination. Blood antibiotic levels were measured at euthanasia and were minimal for all animals. It appears that ceftazidime may be an effective alternative to gentamicin, especially in treating gentamicin-resistant P. aeruginosa. PMID- 2698408 TI - Choledochal cyst. PMID- 2698409 TI - Neonatal diarrhoea and oral rehydration therapy. PMID- 2698411 TI - [Chemical synthesis of RNA and its application to molecular biology]. PMID- 2698410 TI - [Biochemical studies of enzymes involved in prohormone processing]. PMID- 2698412 TI - Cross index of synonyms and trade names in volumes 1 to 46. PMID- 2698413 TI - From exodontia to oral and maxillofacial surgery: the evolution of a specialty. PMID- 2698414 TI - Twenty-five years in oral and maxillofacial surgery. PMID- 2698416 TI - Medicinal treatment of periodontitis. PMID- 2698415 TI - Dental hygiene's heritage: 1927-1970. AB - Original manuscripts published in the Journal of the American Dental Hygienists' Association (JADHA), (now JDH) from 1927-1970 provide a historical perspective on dental hygiene's professional development. While many of the problems facing hygiene today are not new, there is evidence of progress in addressing them. The problems considered are: (1) hygiene's unique occupational role, (2) independent practice, (3) baccalaureate education, and (4) responsibility for licensure and practice. Support is provided regarding hygiene's unique contribution to society's oral health needs. Further, the article documents progress toward assuming professional responsibility as expressed in hygiene's relationship with dentistry, and in the expansion of hygiene's educational base and research efforts. PMID- 2698417 TI - [Synthetic cephalosporins. V. Synthesis and antibacterial activity of 3-alkylthio 7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-(O-substituted oxyimino)acetamido]cephalosporins and related compounds]. AB - 3-Alkylthio-7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-(O-substituted oxyimino)acetamido]cephalosporins (6 and 7) and the 3-methoxy analogues (10) were prepared by coupling diphenylmethyl 7-amino-3-alkylthio-3-cephem-4-carboxylate (1 and 2) or diphenylmethyl 7-amino-3-methoxy-3-cephem-4-carboxylate with (Z)-2-(2 tritylaminothiazol-4-yl)-2-(O-substituted oxyimino)acetic acid (4), followed by deprotection and subjected to examination of antibacterial activities. The pivaloyloxymethyl esters (8 and 9) of the compounds (6 and 7) were also prepared and oral activities of these esters were compared with those of the parent compounds (6 and 7). The cephalosporins (6a-j and 7a-c) had potent and wide antibacterial spectra against Gram positive and Gram negative bacteria which were comparable to those of cefixime or cefteram. Among them, the cephalosporins (6f and 7c) and the pivaloyloxymethyl esters (8b and 9b) had good in vivo efficacy in mice against infections of Escherichia coli No. 29 and especially 8b showed high urinary recovery in mice. PMID- 2698418 TI - [Determination of isepamicin in the eluates from the dried blood spots on filter paper for monitoring of blood levels in a guinea-pig]. AB - In general, collection of serial blood samples from small experimental animals is difficult in terms of sampling site and operation technique. To overcome these problems, a simple reproducible method has been improved by the use of filter papers. Whole blood obtained by venipuncture from the ear vein of guinea-pig was spotted onto a filter paper. Isepamicin in the dried blood spot was extracted with 0.5 M Na2HPO4 buffer by incubation and determined by fluorescence polarization immunoassay. Linearity was established over the range of 5-150 micrograms/ml by using only 100 microliters of whole blood. Consequently its accuracy and precision were good, with mean coefficient of variation of less than 5%. The method described here correlates well with a conventional sampling method and could be used for the pre-clinical study of isepamicin blood levels of individual guinea-pigs. This method is suitable for the simultaneous measurement of aminoglycoside antibiotics or physiological parameters after the administration of aminoglycoside antibiotics for the pharmacokinetics study. PMID- 2698419 TI - [Human tympanic membrane temperature]. PMID- 2698420 TI - [Airway responsiveness measured by body plethysmograph connecting a circuit of an inhalation system of serially concentrated bronchoconstrictant]. AB - We developed a new methodology to examine the bronchial response to the bronchoconstrictants, acetylcholine and methacholine. An inhalation device was connected to the body plethysmograph circuit so that a minute inhalation of serially concentrated bronchoconstrictant could be quickly switched to the circuit of the measurement of the airway resistance. The following were calculated: airway responsiveness in terms of sensitivity, provocative dose to increase the airway resistance up to 35% from the baseline. PC35 or PD35 and the reactivity, the slope of the declining specific airway conductance and %delta SGaw. The airway responsiveness was examined in asthmatics, COPD outgrew childhood asthma patients and normal subjects. These three groups were categorised differently from each other in both sensitivity and reactivity. PMID- 2698421 TI - [Two cases of primary racemose hemangioma of the bronchial artery]. AB - Two cases of primary racemose hemangioma of the bronchial artery are reported. The first case was admitted because of massive hemoptysis after transbronchial biopsy in another hospital. Bronchoscopic examination revealed a polypoid tumor of the left B4 bronchus, which was resected and diagnosed as racemose hemangioma. The second case was admitted because of massive hemoptysis. Bronchoscopic examination revealed polypoid tumor in the left B3b bronchus, which was resected and diagnosed as racemose hemangioma. PMID- 2698422 TI - [A cured case of adult respiratory distress syndrome caused by septicemia of Staphylococcus aureus]. AB - A 33-year-old woman was admitted as an emergency case because of shock condition after delivery. Physical examination revealed fever, cyanosis and coarse crackles throughout the entire chest. Laboratory data showed leukocytosis and increase of CRP value. Adult respiratory distress syndrome (ARDS) was diagnosed based on progressive severe hypoxemia and bilateral diffuse alveolar shadows on chest X ray film. The cause of ARDS was considered to be septicemia as staphylococcus aureus was cultured from lochia. The patient was intubated, then artificially ventilated employing PEEP. Chemotherapy using three different kinds of antibiotics was started, combined with the administration of corticosteroid and a protease inhibitor, Urinastatin. The patient finally recovered completely. PMID- 2698423 TI - [A case of thoracic kidney]. AB - An asymptomatic 37-year-old woman visited our outpatient clinic for evaluation of an abnormal shadow of the right thorax detected by a mass roentgenographic survey. P-A chest roentgenogram showed a round homogeneous mass with a convex superior margin in the posterior portion of the right thorax. The CT with contrast enhancement and intravenous pyelography demonstrated the ectopic high location of the right kidney. Renal arteriography showed the right renal artery originated from the abdominal aorta at a normal level. Renal function tests showed no abnormality. PMID- 2698425 TI - Dental care and management of the aging dental patient. PMID- 2698426 TI - Tennessee Dental Association. Directory and Membership Roster 1989- 1990. PMID- 2698424 TI - Thymic abnormalities and autoimmune diseases. AB - Autoimmune diseases such as ulcerative colitis (UC) and myasthenia gravis (MG) are frequently associated with thymic abnormalities. Thymus hyperplasia and/or thymoma have been demonstrated in all cases with both of these two diseases by pneumomediastinography (PMG). In the diseases of digestive organs from which we can easily obtain the local information through the endoscopic observation and biopsy specimens, lots of immunological abnormalities have been accumulated. Antibody-dependent cell-mediated cytotoxicity mechanism has been demonstrated to play an important role in the mucosal destruction in UC. In the peripheral blood level of this disease, immunological abnormalities have been demonstrated such as the presence of lymphocytes sensitized by certain antigens, autoantibodies and disturbances of lymphocyte subpopulations. In the level of the thymus, the retrovirus has been detected in the thymus epithelial cells. The supernatant of thymus epithelial cell culture (STEC) has the capability of differentiating human bone marrow cells and of facilitating disease-specific immune abnormalities. Moreover, the serum factors (thymus growth factor) discovered in the patients with UC and MG, have been demonstrated to alter the thymic environments. Therefore, it is postulated that thymectomy is beneficial to exclude these abnormalities and it has been evaluated to be very effective in UC and MG clinically. From these observations, it is thought to be important to investigate the immunological abnormalities of autoimmune diseases from the viewpoints of three immunological levels, the level of disease-specific organ, the peripheral blood level and the level of the thymus. And it is important that the therapeutic plans should be decided in the consideration of the abnormalities in each immunological level. PMID- 2698427 TI - Publication of the 50th volume of Mechanisms of Ageing and Development. PMID- 2698428 TI - Non-enzymic post-translational modification of proteins in aging. A review. AB - Various non-enzymic post-translational changes to proteins occur in vivo and some of these progress with aging. These changes are reviewed and linked to a number of age-related diseases, and to alterations in the charge distribution on protein surfaces. Modification by cyanate and by glucose 6-phosphate causes a partial unfolding of proteins, with loss of tertiary structure but retention of secondary structure. These products are reminiscent of the intermediate state observed during folding and unfolding of some proteins. PMID- 2698429 TI - A new method for characterization of low grade gliomas using ultra low field magnetic resonance imaging. AB - Low grade gliomas were studied with ultra low field magnetic resonance imaging (ULF MRI). The tumors exhibited high tissue contrast in both T1 and T2-weighted images as compared to normal brain tissue. Moreover they were sharply delineated towards the surrounding brain tissue. When compared with X-ray computed tomography the tumors were more readily detected and delineated by using ultra low field magnetic imaging. A computer-assisted classification procedure was used to define new regions of interest for relaxation time estimations. By using this procedure more accurate estimations of the T1 and T2 values were obtained. PMID- 2698430 TI - A method for MR quantification of flow velocities in blood and CSF using interleaved gradient-echo pulse sequences. AB - The aim of this study was to establish a rapid method for in vivo quantification of a large range of flow velocities using phase information. A basic gradient echo sequence was constructed, in which flow was encoded along the slice selection direction by variation of the amplitude of a bipolar gradient without changes in sequence timings. The influence of field inhomogeneities and eddy currents was studied in a 1.5 T interleaved sequences for calibration and in vivo flow determination were constructed, and flow information was obtained by pairwise subtraction of velocity-encoded from velocity non-encoded phase images. Calibration was performed in a nongated mode using flow phantoms, and the results were compared with theoretically calculated encoding efficiencies. In vivo flow was studied in healthy volunteers in three different areas using cardiac gating; central blood flow in the great thoracic vessels, peripheral blood flow in the popliteal vessels, and flow of cerebrospinal fluid (CSF) in the cerebral aqueduct. The results show good agreement with results obtained with other techniques. The proposed method for flow determination was shown to be rapid and flexible, and we thus conclude that it seems well suited for routine clinical MR examinations. PMID- 2698431 TI - A comparative study of the accuracy of ultrasound, X-ray CT and low field MRI in the demonstration of cervical and uterine malignancy. PMID- 2698432 TI - Magnetic resonance imaging of the menstrual cycle. PMID- 2698433 TI - [Reflexotherapy (the history of its development)]. PMID- 2698434 TI - [The history of medical philanthropy in Russia]. PMID- 2698435 TI - [Comparison of empirical treatment with antibiotics in community acquired lung diseases]. AB - From December 1984 to June 1986, a prospective clinical trial was carried out in 48 patients with acute community-acquired pneumonia, comparing 2 possible therapeutic schemes: one, using only one antibiotic (roxithromycin: RXT) presumptively active on most of the germs usually involved. In a second group, the identification of the germs involved was attempted on the basis of clinical, epidemiological and radiological data, followed by treatment with the antibiotic/s (ATB) known to be more active against the suspected organisms. The dosage of RXT was 300 mg/day, orally during an average of 9 days. The mean duration of treatment in ATB group was 12 days. In both groups, the following microorganisms were identified: RXT group: St. pneumoniae (13 cases), H. influenzae (1), B. catarrhalis (1); mixed infections: St. pneumoniae + H. influenzae (2); Mycoplasma pneumoniae (3) and 4 patients with unidentified germ; in ATB group: St. aureus (3), St. pneumoniae (5), H. influenzae (2), B. catarrhalis (1); mixed infections: St. aureus + Enterobacter + E. coli (1); Mycoplasma pneumoniae (2) and 10 patients with unidentified germ. The therapeutic results were satisfactory (curation rate: 92%) and similar for both groups of treatment, concluding that both schemes are comparable. Therefore, the choice for one or the other scheme should be based on other reasons, such as easy administration and cost of the treatment. PMID- 2698437 TI - [Pharmacokinetic interaction of ketoconazole, isoniazid and rifampicin]. AB - Eight male tuberculous patients, between 20 and 60 years of age, were given Isoniazid 5 mg/kg and Ketoconazole 200 mg, first one at a time and then associated. Plasma concentrations were measured 0, 2 and 5 hs after taking the drugs. Isoniazid was measured by spectrophotometry and Ketoconazole by the microbiologic method with Candida albicans as test microorganism. When both drugs were given simultaneously Ketoconazole plasma concentration decreased 75% at 2 hs (p less than 0.025) and 85% at 5 hs (p less than 0.05), whereas that of Isoniazid remained unchanged (Table 1). Mean half-life of Isoniazid was 3.9 +/- 1.4 hs in 7 slow acetylators and 1.1 hs in one fast acetylator when given one at a time and 4.4 +/- 1.5 hs when given simultaneously. A similar study was conducted on 11 tuberculous patients who were given Rifampicin 10 mg/kg and Ketoconazole 200 mg, one at a time and concurrently. Rifampicin was measured by high pressure liquid chromatography. When Rifampicin and Ketoconazole were given concurrently plasma concentration of both drugs was reduced: Ketoconazole decreased 85% at 2 hs (p less than 0.025) and 98% at 5 hs (p less than 0.025) whereas Rifampicin decreased 45% at 2 hs (p less than 0.005) and 40% at 5 hs (p less than 0.005) (Table 2). Mean half-life of Rifampicin was 3.5 +/- 0.8 and 4.2 +/- 1.1 hs, respectively, when it was given alone and concurrently. Studies on chemical interactions between Isoniazid and Ketoconazole and between Rifampicin and Ketoconazole yielded negative results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698436 TI - [Evaluation of the interleukin 1 production by adherent cells in patients with diabetes type II]. AB - We have studied the comitogenic activity of IL 1 produced by cultures of mononuclear adherent cells obtained from Diabetes Mellitus (DM) type II or non insulin dependent diabetic patients. This activity was measured by the incorporation of 3H Thymidine into cultures of C3H/HeJ mice thymocytes in the presence of phytohemagglutinin (PHA). We have observed that IL 1 from patients with DM type II did not produce a synergistic effect with PHA, since the lymphoproliferation levels were similar to those obtained in the absence of this lectin. This lack of comitogenic activity (P less than 0.001) in relation to the response obtained with IL 1 from normal subjects plus PHA, could be due to the release of one or several soluble substances capable of blocking glycosylated receptors to mitogens or of impairing the cellular activation process. PMID- 2698438 TI - [Anatomy of the nicotinic receptor]. PMID- 2698439 TI - [Usefulness of biological tumor markers for early detection of neoplastic changes in the bladder of persons exposed to aromatic amines]. AB - Industrial exposure to aromatic amines may result in bladder cancer, especially in persons characterized by a slow acetylation phenotype. What is particularly important in neoplastics therapies is an early detection of neoplastic changes. Prophylactic and prognostic examination suggest that determination of neoplastic markers may contribute to an early detection of these changes. From the results gathered it emerges that carcinoembryonal antigen (CEA) and tissue polypeptide antigen (TPA) are most useful for an early detection of bladder cancer. It seems reasonable to examine the most seriously exposed ones using methods for CEA and TPA determination. Such an examination performed twice or three times in this group should help to early detect hyperplasia of urinary bladder epithelium. PMID- 2698440 TI - [Results of the exposure to ethylene oxide with special reference to its carcinogenic and hematotoxic effects]. AB - The aim of the present paper is to present a review of the effects of exposure to ethylene oxide. Carcinogenic and genotoxic effects of this gas are particularly dangerous for medical staff employed at nonthermal sterilizing of medical equipment. In these workers ethylene oxide induces various chromosomal aberrations, an increased sister chromatid exchange frequency and leukemias, alimentary tract tumors and urogenital malignancies incidence. Moreover, in patients dialysed using ethylene oxide sterilized equipment, anaphylactoidal reactions were observed. Ethylene oxide increased incidence of brain tumors, stomach cancer and malignancies of hemopoietic tissue in experimental animals. Additionally, ethylene oxide caused a decrease in stem cell number in mice spleen, disturbances in the mitotic cycle of bone marrow cells and alkylation of hemoglobin in erythrocytes. An increase in the total number of peripheral blood leukocytes accompanied by the elevation of neutrophil percentage and a decrease in the proportion of lymphocytes represent another aspect of the effect of ethylene oxide. PMID- 2698441 TI - [Unemployment and psychiatric disorders: etiologic hypotheses and empiric evidence of the psychopathologic effects of the suspension of employment]. AB - Many European countries have been affected by mass-unemployment, which in Italy has reached an incidence of 13% of the population. Although the social and economic costs of unemployment are common knowledge, we still know little about its effects on mental health. This seems to be due more to the lack of interest in this aspect among physicians, psychiatrists and psychologists than to the lack of meaningful results. This paper is a critical review of the scientific literature on the topic since 1945 and is proposed as a basis for further discussion and investigation. The results and methodology used in field studies are analysed, as well as the most widely accepted theories on stress coping mechanisms. PMID- 2698442 TI - [Evaluation of the relative potency of carcinogens: a critique of the HERP index]. AB - In 1987 researchers from Berkeley (CA), proposed an index (HERP) for ranking human carcinogens. The index was derived from human exposure data and rodent carcinogen potency. They concluded that the risks for the US population from man made industrial carcinogens are trivial compared with the risks from naturally occurring carcinogens in the diet. Analysis of the assumptions and data upon which the HERPs were based revealed major limitations and we concluded that such a simplified approach is inappropriate given the underlying uncertainties. However, when we made a comparison consistently based on estimates of average daily exposure to common carcinogens, the HERP scores of man-made pollutants were comparable to those of naturally occurring carcinogens. PMID- 2698443 TI - [Elements of probability calculation--II]. AB - This is the second part of an introduction to probability calculation and covers basic concepts such as conditional and simple probabilities and independent events and also a definition of two fundamental laws, those of addition and multiplication, which permit a correct combination of probabilities. Explanation of probability concepts and ideas is illustrated with the aid of examples from the field of screening tests. Bayes theorem is derived by applying the addition and multiplication laws to conditional and simple probabilities. PMID- 2698444 TI - The compression of morbidity: near or far? AB - Compressing the period of infirmity into an ever-shorter period between the onset of morbidity and death might reduce the nation's illness burden; for this to occur, age-specific incidence of morbid states must decrease more rapidly than age-specific mortality rates. Recent data demonstrate that the onset of some major chronic illnesses is now being postponed and that increases in females' life expectancy have slowed. Large randomized controlled trials have shown an impact of primary prevention on morbidity exceeding that on mortality. These and other trends provide evidence for some degree of current compression of morbidity and suggest types of public health strategies required for further progress, including successful aging programs. PMID- 2698445 TI - The end results of health care: Ernest Codman's contribution to quality assessment and beyond. AB - E.A. Codman's conception and development of the "end result idea" in the 1910s are unduly neglected in the history of health care assessment. The "idea" entailed following patients long enough to determine if treatments proved successful and taking comprehensive measures to prevent new failures if outcomes were undesirable. Codman's work anticipated contemporary approaches to quality monitoring and assurance, establishing accountability, and allocating and managing resources efficiently, among other assessment features. Complexity and ambiguity in health care objectives, decision making, and role responsibilities as well as costs today hinder full application of his vision, but refinement of these factors proceeds in the directions Codman set forth. PMID- 2698446 TI - Improving drug prescribing in primary care: a critical analysis of the experimental literature. AB - Seven percent of all health expenditures in the United States in 1987 was allocated for medications. Accurate prescribing decisions thus have crucial implications for both economic and clinical aspects of health care. A review of 44 empirical studies indicates that different strategies to improve the prescription practices of primary care physicians have proved effective to varying degrees; administrative reminders and feedback systems appear to be suitable for group practices, while one-on-one educational interventions may work well in less-structured office settings. Better-controlled trials and quasi experimental designs, together with cost-benefit analyses, are still needed to enhance the efficacy and efficiency of prescribing practices. PMID- 2698447 TI - Studying the cost of HIV-related illnesses: reflections on the moving target. AB - Although medical care costs of the HIV epidemic by 1991 may reach $6 billion, or 1.2 percent of all estimated personal health care expenditures in the United States, costs per patient of treating AIDS appear to be declining. Calculating the epidemic's costs is difficult, however, in that data are lacking on health care expenditures for HIV-infected persons other than those with AIDS, intravenous drug users, women, and children. Shifts in demographic segments affected, changes in medical treatments, and diffusion beyond initial urban centers will alter the economics of AIDS. Prospective studies at both national and local levels are needed to gauge the epidemic's costs and demands on health services. PMID- 2698448 TI - [Vertebral hemangioma with neurologic signs. Clinical presentation, results of a survey by the French Society of Neurosurgery]. AB - 45 cases of vertebral hemangiomas with neurologic involvement are reported. This series corresponds to the french experience between 1969 and 1988 (series of the "Societe Francaise de Neurochirurgie" (S.F.N.)). In this report the clinical presentation and the results of the radiological examination are detailed. Local vertebral pain was present in half of the cases. The neurological symptoms were related to spinal cord compression in 33/45 of the patients and to radicular suffering in the other cases. Evolution of the neurological symptoms appeared to be slow: the mean evolution time before diagnosis was of 10 months. Hemangioma involved the thoracic column in 73% of the cases. Neurologic symptoms was due to a diffuse narrowing of the spinal canal in 28.8% of the cases, to a local bony expansion in 60% of the cases. Hemangioma was found to involve the whole vertebra in 44.4% of the cases, the vertebral body alone in 24.4% of the cases and the posterior arch alone in 22.2% of the cases. An incomplete involvement of both vertebral body and posterior arch was found in 6.6% of the cases. 2.2% of the cases corresponded to pure epidural hemangioma. Preoperative diagnosis was established in 58% of the patients. In these cases, the diagnosis was based on standard radiography and CT datas. Results of the S.F.N. serie are compared with those of the main series of the literature. PMID- 2698449 TI - [Radiologic evaluation of an isolated vertebral hemangioma]. AB - CT scan and M.R.I. features have been evaluated in case of compressive (H.V.C.) and asymptomatic (H.V.A.) vertebral hemangiomas. The main datas observed in H.V.C. are: 1) thoracic localization; 2) whole vertebral body involvement; 3) extension to the pedicles; 4) irregular trabeculation; 5) swelling of bone contours with 6) epidural and perivertebral extension. H.V.C. always exhibit at least three of these six datas while H.V.A. are associated with 2 or less. Also H.V.C. frequently present intravertebral contrast enhancement on CT and low signal intensity on T1 weighted and high signal intensity on T2 weighted M.R.I. PMID- 2698450 TI - [Primary tumors of the spine. Initial oncologic aspects: epidemiology, anatomo prognostic and therapeutic classification]. AB - Primary tumors of the vertebral column are rare: 20 per cent of all primary tumors of the spinal column. The distribution by type of tumor shows that the three most frequent primary tumors considered to be "radio and/or chemo resistant lesions" are the chordoma (15.5 to 24.5%), the chondrosarcoma (20%) and the giant cell tumor (10%). A second group with "chemo and/or radiosensitive lesions" include the Ewing sarcoma, primary lymphoma and plasmocytoma (5%). We consider a third group with the benign tumor: osteochondroma, chondroma, osteoid osteoma, osteoblastoma, aneurysmal bone cyst, hemangioma and eosinophilic granuloma (2 to 3%). The last tumoral group agrees with sarcomatous tumors: osteogenic sarcoma, fibrosarcoma, malignant fibro-histiocytoma, angiosarcoma and hemangio-pericytoma (1 to 3% of primary tumors of the vertebral column); they are most frequently secondary to Paget's disease, giant cell tumor or to radiation therapy and their prognosis is poor. PMID- 2698451 TI - [Primary tumors of the spine. A multicenter cooperative study]. AB - This chapter incorporates 206 observations from the different neurosurgery units which replied to the questionnaires on primary tumours of the vertebral column. A homogeneous data bank, analysed and processed using the Excel database, was established by retranscribing each observation into 32 sections. The majority of the sample population (fig. 1) was male and included 42 observations of subjects under the age of 18 years, thereby constituting one of the largest series in this age range. The global histological distribution demonstrates a predominance of malignant tumors in the adult (65%) with no sexual bias. In children, malignant (19 cases) and benign (23 cases) tumours are more homogeneously distributed (fig. 3 and 4). The different histological types encountered are listed in table I in order of frequency. In order to make it easier to read the following tables, the numerical code given to each histological type is indicated in table II. Chordomas (code 14), which most authors classified among the malignant tumours, are situated in a transitional zone between benign tumours (from 1 to 13) and malignant tumours (from 15 to 37) on the various graphs. Histological distribution in adults (fig. 5) demonstrates the existence of two peaks in the malignant tumor zone: the highest peak correspond to the chordomas, the other to solitary myelomas. In children (fig. 6), distribution is different: the benign osteoblastoma and the aneurysmal bone cyst are the most common benign tumors, and the most common malignant tumor observed is Ewing's sarcoma. The different tumor sites along the spinal axis are reported in figures 7, 8, 9, 10 and 11.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698452 TI - [Primary tumors of the spine. Radiotherapy and chemotherapy]. AB - Complete surgical excision of a primary spinal tumor without contamination of the surgical wound is not always possible, and adjuvant therapy by chemotherapy and/or radiation therapy is important to improve local and survival disease free. The efficacy of radiation therapy is limited above L2 because of the risk of radionecrosis of the spinal cord if one exceeds 45 Gy over 4.5 weeks. According to drugs and radiation sensitiveness, three groups can be distinguished: i) malignant tumors with low sensitiveness: chordoma, osteo-, chondro-, and fibro sarcoma; ii) malignant tumors with high sensitiveness: Ewing's sarcoma, plasmocytoma, and non Hodgkin lymphoma; iii) benign tumos, occasionally aggressive like giant-cells tumor. For each type of tumor, a literature review and our personal experience is presented. PMID- 2698453 TI - The dose-effect relationship of 0.5, 1.0 and 1.5 mg fluspirilene on anxious patients. AB - To investigate the dose-effect relationship, 106 patients received for 6 weeks under double-blind conditions randomly either 0.5 (n = 35), 1.0 (n = 35) or 1.5 mg (n = 36) fluspirilene per per week. Two patients dropped out. The main result of this study was the verification of a clear dose-effect relationship. There is a difference between all three dosage groups after 6 weeks. Improvement with 0.5 mg fluspirilene was far more seldom (17 of 35) than with 1.0 mg (25 of 33) and very much more frequent with 1.5 mg (30 of 36). This was confirmed with the three scales of the Hamilton Anxiety Scale. The clear dose-effect relationship was also shown on the subjective 'Eigenschaftsworterliste' scales of elation, self confidence, introversion, anxiety, vulnerability and depression. The tolerance of all doses in this study was good and did not differ. Nevertheless, the findings from earlier studies were reproduced, according to which a poorer tolerance is combined with a poorer therapeutic efficacy. It was worked out in the discussion that patients who improved subjectively and according to the physician's assessment after 14 days of treatment also showed a good response after a longer period of treatment. PMID- 2698454 TI - Personal protective equipment. Buyers guide. PMID- 2698455 TI - Hypnotherapy: a history. PMID- 2698456 TI - Can chronic bulbar hypotony be responsible for uveal effusion? Report of two cases. AB - We describe two patients with a unilateral uveal effusion syndrome characterized by spontaneous ciliochoroidal and retinal detachment, shallow anterior chamber, poorly reactive pupil, and bulbar hypotony. A space-occupying substance of high molecular weight (sodium hyaluronate), injected into the anterior chamber, raised the intraocular pressure of these patients to 24 mm Hg. Within 24 to 72 hours the uvea flattened, and later the retina settled completely. Satisfactory clinical stability has continued in the follow-up period. Because a rheologic study of the aqueous humor revealed hyposecretion and hypotony in the apparently unaffected fellow eye, it is suggested that a primary bulbar hypotony can trigger a uveal effusion syndrome in an otherwise normal-sized eye with no structural abnormality. PMID- 2698457 TI - Repair of the "microdehiscence" to correct postkeratoplasty astigmatism. AB - A common peripheral abnormality, which I call "microdehiscence," can in some cases cause the progressive central astigmatism that commonly follows penetrating keratoplasty. The results of a small clinical study show that placing additional suture(s) in this situation can permanently correct such astigmatism. PMID- 2698458 TI - [Surgical treatment of stage II and III dislocation of the acromial end of the clavicle]. PMID- 2698459 TI - [A method of bloodless surgical treatment of habitual shoulder dislocation]. PMID- 2698460 TI - Visual conversion reaction in children. AB - Visual conversion reaction (VCR) is a psychosomatic illness that will occasionally be seen by optometrists and ophthalmologists. This paper discusses some of the possible aetiologies and manifestations of the condition. Investigation and management of children with suspected VCR is discussed. Four case histories are presented in which signs of VCR included amblyopia, reduced accommodation and a deterioration in handwriting. The visual field defects presented include a static quantitative anomaly. Such a defect has not previously been reported. PMID- 2698462 TI - Adult respiratory distress syndrome. PMID- 2698461 TI - Captopril treatment in rheumatic heart disease with congestive heart failure. A preliminary report. AB - A small scale controlled trial of captopril (ACE inhibitor) was conducted in 8 children with congestive heart failure due to rheumatic mitral regurgitation with or without mild mitral stenosis. The age of the patient ranged from 5.5 to 13 years (mean 9.3 years). Four children, served as control group, received digitalis and diuretics as standard treatment; while the other 4 children also received 2 x 12.5 mg of captopril in addition to standard treatment. The effect of both regimens were measured by using changes of left ventricular function as seen on the echocardiogram performed before treatment, and then 3, 7 and 14 days thereafter. Definite conclusion cannot be made because of the small number of patients; but it is apparent that some improvements of left ventricular functions in the captopril group were more evident when compared with that of the control group of standard treatment. Side effects of captopril were not found. PMID- 2698463 TI - [Chronic obstructive lung disease and ischemic heart disease]. PMID- 2698464 TI - [Role of pulmonary surfactant in the pathophysiology of the respiratory system]. PMID- 2698465 TI - [Peripheral androgen resistance syndrome]. AB - Two main topics of 5 alpha reductase deficiency and androgen receptors defects have been considered. Particularly, the differential diagnosis among the different syndromes of androgen resistance and the important issue of sex assignment are discussed. PMID- 2698466 TI - [Disseminated intravascular coagulation in children. Therapeutic problems]. AB - The AA, after discussion on physiopathological and clinical aspects of DIC in childhood, focused their attention mostly on the utilization of AT III concentrates. PMID- 2698467 TI - [Acute diarrhea: recent etiopathogenetic findings]. AB - Acute diarrhoeas in children represent still now a very serious problem for Public Health either in developing or in industrialized Countries. In the last years great progress has been made in the aetiology and epidemiology of this disease. The most important results, which are worth recording, obtained in this field are: the detection of Rotavirus as a more common agent causing infectious enteritis in children; the "rediscover" of some pathogenic agents (Campylobacter and Yersinia) ignored since some years ago and now emerging; a renewed interest for "old" etiological agents (Giardia lamblia, that seems to be more frequent in industrialized Countries, and E. Coli, from which various pathogenetic mechanisms are now known). Either remarkable are the recent acquaintances on pathogenic mechanisms developed by the agents causing enteritis (production of cytotonic and cytotoxic toxins, invasion and adhesion of intestinal mucosa). PMID- 2698468 TI - [Gianotti-Crosti acrodermatitis. Description of a case of rare etiology]. AB - Originally described in 1955, papular acrodermatitis is considered a rare disease whose manifestations are mainly cutaneous. The disease is characteristically associated to a non icteric hepatitis with B serologic tests positive. We recently observed a case whose etiology is unusual and, therefore, in our opinion worth of a brief description. PMID- 2698469 TI - [Arrhythmogenic dysplasia of the right ventricle-- clinical picture in view of the literature and personal experience]. AB - The author discusses arrhythmogenic dysplasia of the right ventricle, a disease of unclear etiology characterized by the replacement of right ventricular muscle with the connective tissue and ventricular cardiac arrhythmias. Clinical symptoms, available diagnostic techniques and treatment are reviewed. Four case reports illustrate arrhythmogenic dysplasia of the right ventricle. PMID- 2698470 TI - [Mechanical relationship of heart ventricle function and its significance in myocardial infarction]. PMID- 2698471 TI - Immunotoxins, ligand-toxin conjugates and molecular targeting. AB - Biotechnology provides tools for therapeutic exploitation following advances in the elucidation of protein-to-cell and cell-to-cell interactions. Molecular targeting of bacterial and plant toxins to the desired district of action can be achieved through effector molecules like monoclonal antibodies or protein ligands. Biochemical conjugation of these effectors to SO-6, a single-chain Ribosome Inactivating Protein from Saponaria officinalis, yielded powerful cytotoxic agents that are attractive candidates for therapeutic evaluation. Cloning of the gene for this plant toxin has been achieved. Technologies for expression of protein ligands, such as apolipoproteins or several growth factors, are available in recombinant microorganisms, providing adequate partners for the assembly of targeted chimaeras. Domain engineering of structural and functional regions in effector proteins is now possible and will be carried out with the available technologies to improve existing therapy. PMID- 2698472 TI - Superoxide dismutase: possible therapeutic use in cardiovascular disease. AB - Superoxide dismutase (SOD) for parenteral administration is in clinical use in several European countries, where it is prescribed principally for treatment of musculoskeletal inflammation, especially osteoarthritis. However, new possibilities for its usefulness are arising from recent progresses of the pathophysiology of several diseases. From the beginning of this decade there has been a virtual explosion of the available informations about the mechanisms and control of free radical-mediated tissue injury. This progress has led us to the threshold of what will probably be broad clinical applications in the next future. Taking into account the mortality and morbidity caused by cardiovascular injury, the most promising application of SOD in human therapy seems to relay in the protection against ischaemia and post-ischaemic reperfusion damage of various organs and tissues but, particularly, of the myocardium. A large body of evidence suggests that myocardial damage following both global or regional ischaemia can be ameliorated by the blockade of free radical mediated injury. SOD has been proposed as a protective agent in various experimental models. The premises of this action, and the available results will be reviewed. PMID- 2698474 TI - Pharmacology of neuronal gene expression. AB - Pharmacological treatments were used to estimate trans-synaptic regulation of opioid peptide gene expression occuring at specific neurotransmitter receptors. In vitro and in vivo studies have shown that different signal-transduction mechanisms regulate the transcription of proenkephalin, proopiomelanocortin and nerve growth factor mRNA. The activation of receptors coupled to adenylate cyclase elicited the increase of proenkephalin and nerve growth factor gene expression. Therefore, a cAMP-dependent mechanism was suggested to be involved in such regulation. However, the temporal delay between the elevation of the intracellular cAMP content and the increase in nerve growth factor and proenkephalin mRNAs prompted us to investigate whether additional mechanisms associated with the second messenger were operative in the regulation of the expression of these two genes. We report evidence that a protein(s), probably functioning as a trans-acting factor, might be involved in the regulation of nerve growth factor gene transcription. The characterization and isolation of these DNA regulatory proteins will provide the pharmacologist with valuable information for the development of new compounds in the therapy of mental disorders. PMID- 2698473 TI - In situ hybridization histochemistry as a tool to study gene expression and its regulation in the central nervous system. AB - The recent application of in situ hybridization histochemistry to neuroanatomy, neuroendocrinology, and neuropharmacology has permitted explorations into the regulation of gene expression in the central nervous system (CNS) at the level of single neurons. Although cDNAs were the first probes to be used in hybridization studies, cRNAs and synthetic oligonucleotides have been recently employed because of the many advantages these single-stranded probes offer compared to the cDNAs. Using synthetic oligonucleotides, we described the distribution of the calmodulin mRNA and the regulation of proenkephalin mRNA in the rat brain. The results reported show the specificity of the hybridization and that the levels of calmodulin mRNA are more abundant in the cerebral cortex than in the striatum. Furthermore, we demonstrated that the administration of 6-hydroxydopamine in early postnatal life induces an increase in the expression of striatal proenkephalin mRNA measured at postnatal day 32. PMID- 2698475 TI - [Biological methods of air purification (review of the literature)]. AB - Biological methods of air purification are reviewed, which can be applied to deep air purification of complex multicomponent mixtures from harmful, toxic and odorous substances at room temperature and atmospheric pressure. Microbiological and technological aspects of the problem are discussed. Operation characteristics of biofilters, bioscrubbers and trickle bed bioreactors are compared. Prospects of air biopurification are considered. PMID- 2698476 TI - Effect of sodium artesunate on malaria infected human erythrocytes. AB - Oxidative stress in malaria infected human erythrocytes is augmented and the anti oxidant system is attenuated as compared with normal RBC's. Exacerbation of intra erythrocytic oxidative stress might provide a means to kill the parasites. Sodium artesunate (SA), an effective Chinese anti-malaria drug, markedly increased the levels of active oxygen species and production of malonyldialdehyde in normal red blood cells and, to a greater extent, in malaria infected red blood cells. SA caused a remarkable decrease of unsaturated fatty acids content in normal red blood cell membrane. These suggest that the anti-oxidative system in red blood cells infected with malaria is jeopardized. Certain active oxygen species generated and accumulated in such red blood cells might in turn kill the parasites. SA augmented intracellular O2-. and H2O2 production, and this may partly account for its antimalaria action. PMID- 2698477 TI - Studies of qinghaosu and its active derivatives in biological materials and their pharmacokinetics. PMID- 2698479 TI - [The role of psychotherapy in patients with epilepsy]. PMID- 2698478 TI - [Mechanism of the psychotropic action of carbamazepine]. PMID- 2698480 TI - [The role of life events in affective diseases and schizophrenia]. PMID- 2698481 TI - Personality disorders: issues in assessment. AB - The multiaxial system adopted in DSM-III (American Psychiatric Association 1980) has fostered much research in the area of the assessment of personality disorders. This paper will address issues and controversies that have an impact on the assessment of personality. Topics to be discussed in this paper include (1) a review of and comparison between categorical and dimensional approaches to personality classification; (2) discussion of differing viewpoints regarding the most appropriate way to conceptualize Axis II diagnoses, with emphasis on their relationship with Axis I and II conditions; and (4) a review of between Axis I and II conditions; and (4) a review of different assessment instruments. PMID- 2698482 TI - Pharmacotherapy of borderline personality disorder: a review. AB - Pharmacotherapy has emerged as a beneficial adjunct to psychotherapy in the overall treatment regimen for patients with borderline personality disorder. The authors review controlled and uncontrolled studies of neuroleptics, antidepressants, anxiolytics, anticonvulsants, and lithium carbonate in the treatment of this disorder. Although no one medication has emerged as the treatment of choice, patterns of response can be identified. These patterns may be helpful in guiding clinical choice of pharmacotherapy as well as directing research to an understanding of the etiological mechanisms underlying this complex disorder. PMID- 2698483 TI - Phenelzine, imipramine, and placebo in borderline patients meeting criteria for atypical depression. AB - In planning psychopharmacologic treatment of patients with borderline personality disorder (BPD), three partially validated subtypes should be considered. The validity of the schizotypal subtype is supported by their favorable response to neuroleptics as well as by familial and genetic studies. The validity of emotionally unstable character disorder (EUCD) is supported by the presence of neurological soft signs, their negative response to antidepressants, and their positive response to chlorpromazine and lithium. The data presented in this paper suggest that some patients who meet borderline criteria and have atypical depression (patients meeting DSM-III-R criteria for major depression or dysthymia who have reactive mood and any atypical symptoms) clearly benefit from treatment with antidepressant medication. Although some patients with atypical depression who meet borderline criteria will improve with tricyclic therapy, a significantly greater proportion will improve with the monoamine oxidase inhibitor (MAOI), phenelzine. PMID- 2698484 TI - Rationale for clinical trials of opiate antagonists in treating patients with personality disorders and self-injurious behavior. AB - A subgroup of patients with personality disorders from the DSM-III-R (American Psychiatric Association 1987) "flamboyant" cluster is characterized by repetitive self-injurious behavior (SIB) apparently not motivated by suicidal intent. After describing the clinical and demographic characteristics of these patients, the clinical and preclinical evidence suggesting the involvement of endogenous opiate systems in this behavior is reviewed. Patients with personality disorders and SIB have been found to have elevated levels of plasma beta-endorphin. However, the available evidence is not sufficient to show whether this is a cause of or a consequence of SIB. Behavioral stereotypies resulting in self-injury in animals and SIB in mentally retarded patients have been shown to be abolished by opiate antagonist administration in a significant proportion of both groups. The available evidence suggests that clinical trials of oral opiate antagonist drugs should be undertaken because of the promise such drugs have in the treatment of this sometimes life-threatening disorder. PMID- 2698485 TI - Measurement of change in personality disorders. AB - The nature of personality disorders introduces a number of issues that have implications for the measurement of change. This article provides an overview of issues that should be considered in the assessment of change in personality disorders, including assessment of pervasiveness and impairment, behavior sampling issues, sources of information, problems associated with comorbidity with Axis I and other disorders, and problems with subject compliance. PMID- 2698486 TI - [HIV infection--a sexually transmitted disease]. AB - In the light of literature reports and own experiences and observations the most important epidemiological aspects of HIV infection acquired through sexual contacts are discussed, including the likelihood of infection during heterosexual or homosexual intercourse, factors increasing the infection risk in homosexuals intercourse and the more or less safe forms of sexual intercourse. The combination of HIV infections with infections with other sexually transmitted diseases is discussed on the basis of own observations which showed that HIV infection was acquired much more frequently by homosexuals treated in outpatient clinics for venereological diseases (19.7%) as compared to other homosexual groups (2.7%), and the risk was even lower in heterosexuals treated in these clinics for sexually transmitted diseases (0.2%). Over half the patients infected with HIV had or had had syphilis. HIV infection was sought for in Warsaw prostitutes, and 0.6% of them were found to be infected, two-thirds of the infected ones were drug addicted prostitutes. The importance of the sexual route of infection in drug addicts and transmission of this infection to the heterosexual population are considered. The principles of prophylaxis, the directions of health education, and the importance of screening for HIV infection prevention are considered. Attention is called to the harmful effects of all types of restriction of the infected people which lead to trials of infection concealment. PMID- 2698487 TI - [Alcohol and arterial blood pressure. The role of alcohol as a risk factor of arterial hypertension]. PMID- 2698488 TI - [Programs of immunosuppressive and anti-inflammatory therapy of primary idiopathic glomerulonephritis. II. Membranous, membrano- proliferative and mesangial glomerulonephritis]. PMID- 2698489 TI - [A different view of Sykstus Lewkowicz]. PMID- 2698490 TI - [General concepts on the possibilities offered today by subperiosteal implantology]. PMID- 2698491 TI - [The treatment of impressions in complete removable dentures]. PMID- 2698493 TI - [Swaging in cast metal and Spence composition]. PMID- 2698492 TI - [Colored waxes. Esthetic management of a smile with precise study of wax models]. PMID- 2698494 TI - [Built-up ceramic. 1]. PMID- 2698495 TI - [Removable partial denture: prepared crowns for clasp support. 1]. PMID- 2698496 TI - [Ceramometal reconstruction of devitalized teeth intended for nonmetal crowns. 1]. PMID- 2698497 TI - [A new metallurgic procedure for ceramometal restorations]. PMID- 2698498 TI - [Partial removable denture. Prepared crown support of clasps. 3]. PMID- 2698499 TI - [Casting of pure titanium: the O'Hara System and its dental application]. PMID- 2698500 TI - [Cellular localization, half-life, and secretion of peptide YY]. AB - Tissue and plasma concentration of peptide YY (PYY) were measured by means of a radioimmunoassay (RIA) developed in our laboratory, using a specific PYY antiserum generated in New Zealand white rabbits against synthetic PYY, and dextran-coated charcoal to terminate the assay. Cellular localization of PYY was studied immunohistochemically using the peroxidase-antiperoxidase (PAP) technique. The highest tissue concentration of PYY was found in the mucosa of the terminal ileum and colon. PYY-containing secretory granules were primarily found in the basal pole of open-type endocrine cells. Basal plasma concentration of PYY was 70 +/- 9 pg/ml and rose to 357 +/- 30 pg/ml during the IV administration of PYY at 400 pmol/kg-h. A significant correlation was found (r = 0.94, p less than 0.05) between dose of PYY (12.5, 25, 50, 100, 200, 400 pmol/kg-h, IV) and plasma concentration of PYY. The calculated half-life of PYY in plasma was 8.3 +/- 1.9 minutes. Plasma concentration of PYY during the intraduodenal administration of sodium oleate (150 +/- 20 pg/ml) or long-chain triglyceride (187 +/- 37 pg/ml) was similar to plasma concentration of PYY obtained during the IV administration of PYY at 100 pmol/kg-h. Plasma concentration of PYY raised (126 +/- 10 pg/ml) after the administration of bombesin (400 pmol/kg-h, IV). Bile enhanced release of PYY. The present study suggests a hormonal role for PYY. PMID- 2698501 TI - [Polychemotherapy in multiple myeloma. The COMPA protocol]. AB - Ninety three patients with multiple myeloma (MM) were treated with cyclophosphamide, vincristine, melphalan, prednisone and adriamycin (C.O.M.P.A.). Their median age was 60.9 years and sixty five were males. Seven patients were in stage I-A; 25 in II-A; 33 in III-A and 28 in III-B. Complete remission (CR) was achieved in 61 (65.6%), partial remission (PR) in 18 (19.3%) and no response in 14 (15%). At present, the mean survival of the CR group, is 32.3 months (10 to 78), and of the PR 11.2 months (6 to 18). The actuarial survival of the CR group is 37.9 months. A hemoglobin level lower than 8.5 g/dL, serum creatinine higher than 2.0 mg/dL, and stage III disease were factors that together negatively influenced in both response to treatment and survival. Proteinuria did not affect response, but it was a negative factor for survival. Thirty percent of deaths were due to infection, and 24.5% to myeloma activity associated with infection. We conclude that this five drug combination (C.O.M.P.A.) achieves a high percentage of complete remissions, but does not differ significantly from other reported schemes in the mean survival obtained for multiple myeloma. PMID- 2698502 TI - [Control of oral anticoagulation. Current concepts]. AB - The main objective of this short review is to bring into focus the most relevant of the recent advances in prothrombin time standardization and analyze the recommendations of the World Health Organization (WHO) for monitoring patients with thrombotic disorders under treatment with oral anticoagulant drugs. The prothrombin time (PT) is indicative of the proper therapeutic range in patients receiving oral anticoagulant drugs; however the reliability of the results will depend on the source and nature of the thromboplastin used. Different normal and therapeutic rangers are frequently observed when different brands of thromboplastin reagents and/or methods are used. The WHO, in conjunction with the International Committee of Thrombosis and Hemostasis and the International Committee of Standardization in Hematology, has recommended a calibration scheme for thromboplastin standardization with special reference for anticoagulant monitoring. Instead of reporting patient values, either in seconds or percent activity, WHO recommends the PT results in terms of an international normalized ratio (INR). This is obtained by formula: INR = RC in which R is the patient's PT and C is the international sensitivity index (ISI) of the thromboblastine employed. The INR represents the PT that would be obtained if it were performed with the WHO thromboplastin reference preparation. We suggest that these new concepts should be implemented by both laboratory and clinical professionals with the purpose of improving the effectiveness and safety of oral anticoagulation. PMID- 2698503 TI - [Methodologic evaluation of the relation of blood pressure and skinfold thickness: an epidemiologic approach]. AB - The empirical evidence concerning the relationship between blood pressure and anthropometric characteristics (triceps skinfold, adiposity, and arm circumference) was assessed by means of meta-analysis. Different studies were evaluated critically for strength of design, methods and associations. It was found that the association between blood pressure and triceps skinfold holds for three different demographic categories. The question as to the independence of these associations remained unsolved. The effect of arm adiposity on the measurement of blood pressure was also discussed. Recommendations are give in order to standardize blood pressure measurements in clinical and research settings. PMID- 2698504 TI - [Glue solvents: abuse and adverse effects on health]. AB - In Brazil, glue sniffing has been of growing concern due to the increasing number of abusers, most of them children and teen-agers of low socio-economic level. This review article presents some aspects of this kind of abuse, with special emphasis on the deleterious effects of acute and/or chronic solvent inhalation (glue-sniffing). PMID- 2698505 TI - Orthostatic tolerance training of stroke patients in general medical wards. An experimental study. AB - In order to initiate early activation and counteract the negative effects of bed rest, 71 patients acutely admitted to hospital with a confirmed stroke were randomized to either training or control wards. Sixty-three persons participated in a first orthostatic tolerance test on days 5-7 after admission, which was replicated on days 10-12. A third test was performed three months later. Regular stand-ups were initiated on days 1-2 after admission to hospital and were continued for 1-2 weeks. The trained group had a lower increase in heart rate during tilting and a lower proportion of severely disabled patients on days 5-7 compared with the control group. This difference was statistically significant but cannot be proved to be a result from the regular stand-ups. Still, this minimum type of early activation can be recommended for acute stroke patients, mainly those with a cerebral infarction, who are able to cooperate with the nursing staff. PMID- 2698506 TI - Ultrasound sector scanning used to define changes in muscle configuration. AB - Dynamic configurational changes in the rectus femoris muscle were examined using a real time ultrasound sector scanner in ten normal subjects. The angle of passive knee flexion was varied as transverse ultrasound scanning was performed at the mid-transverse thigh. Configurational changes in the rectus femoris were computed from a traced outline of the muscle and the geometric center of the mass was calculated at all degrees of knee flexion. The geometric center of the mass varied with knee position. The anterioposterior dimensions and cross sectional areas of the rectus femoris and vastus intermedius remained constant, however, despite changes in knee position. The pattern of change observed was reproducible and reflects consistent changes in muscle configuration. The technique and instrumentation should have value for non-invasive dynamic and static observation of individual muscles. PMID- 2698507 TI - Oral contraception and post-operative thromboembolism: an epidemiological review. AB - It has been stated that oestrogen-containing oral contraceptive medication should be discontinued one month prior to surgery, to avoid an increased incidence of post-operative thromboembolism. Others have suggested that the risk of post operative morbidity is low compared with the risk of pre-operative pregnancy, and that in most cases no such action should be taken. The evidence from clinical investigation is reviewed, with particular reference to study design. It is found that all studies so far conducted are subject to sources of bias or confounding which render their results inconclusive. There is a need for a randomised control trial comparing the effects of discontinuing or continuing oral contraception prior to surgery. Meanwhile, with a post-operative risk inferred but not conclusively demonstrated, if oral contraception is to be withdrawn prior to surgery, great care must be taken to reduce the risk of ensuing pregnancy to as near zero as possible. PMID- 2698508 TI - [Determination of secretion of ABO group antigens using a immunohistochemical method]. AB - In the assessment of secretor status in deceased subjects in recent years efforts focused on immunohistological examination of those orangs the secretions and epithelial cells of which contain group substances in secretors. By means of the immunofluorescent method group substances A and B were estimated in the secretion of mucinous cells of the sublingual salivary glands of the trachea and Becher cells of the trachea. In 19 of 20 examined subjects in the above glands activity was detected suggesting secretor status, corresponding to the blood group. Using the saturation method, concurrently with same results, group substances A a B were detected in bile. PMID- 2698509 TI - [State of fetal and uteroplacental blood flow in uncomplicated pregnancy and gestoses. Methods of evaluation]. PMID- 2698510 TI - [A system of morphologic prognostic criteria in malignant tumors]. PMID- 2698511 TI - [Clinico-diagnostic significance of rheumatoid factors of different classes in rheumatoid arthritis]. AB - Enzyme immunoassay was used to measure the content of rheumatoid factors (RF) of the M, A, and G classes in the blood sera of 111 patients with rheumatoid arthritis, 30 patients with osteoarthrosis deformans, and 60 donors. The ranges of normal values for each RF class were defined. The levels of all the three RF classes were significantly higher in the patients with rheumatoid arthritis vs. the reference groups. IgM, IgA, and IgG RF were regularly elevated in the patients with rapidly progressing rheumatoid arthritis and with visceritis, whereas IgM and IgG RF levels were increased in those with the maximal activity of the disease. RF of various classes are more often detectable by the enzyme immunoassay than by the Vaaler-Roset's or latex agglutination tests. PMID- 2698512 TI - [Possibilities of ultrasonic studies in the diagnosis of extra-organ tumors of the small pelvis]. PMID- 2698513 TI - [Ultrasonic diagnosis of tumorous lesions of the liver]. PMID- 2698514 TI - [State of the pancreas in malabsorption syndrome in children]. PMID- 2698515 TI - [Early antibiotic therapy following urodynamic examination. Results of a randomized, controlled study]. AB - Forty-three young men from the Italian army underwent urodynamic tests following the diagnosis of enuresis. Of these, 37 were included in an assessment trial to define the rationale for early anti-bacterial therapy following the test. The subjects were subdivided into two groups: one group received 500 mg Cinoxacin b.i.d. for 5 days, and the other group was not treated. The comparison of results revealed a high incidence of irritative disorders in both groups (78.9% of treated subjects and 88.9% of untreated subjects) but the most significant complications were observed in the untreated group (feveret in 27.7% and one case of septic fever). Early anti-bacterial therapy following standard urodynamic tests therefore seems to be a ration tool in urological practice. PMID- 2698516 TI - Social Security Bulletin. Annual statistical supplement, 1989. PMID- 2698517 TI - Intramuscular delagil therapy in malaria. AB - The effectivity of intramuscular Delagil therapy with that of oral treatment in malaria patients are compared. On the basis of the therapeutic results of 8 malaria patients each it has been concluded that the cessation of fever and parasitaemia occur within a somewhat shorter time in the intramuscularly treated patients than in the orally treated ones. Finally, the usefulness of intramuscular Delagil therapy as an antimalarial medication has been assessed. According to the opinion of the author oral treatment has to be preferred in general in uncomplicated malaria cases. The indication fields of intramuscular Delagil therapy are the following: 1. Unconsciousness, cerebral or other complications. 2. High fever, poor general condition requiring rapid action; in the latter two cases the above-mentioned frequent application of lower doses is recommended. 3. Relatively good general condition but abundant vomiting and/or diarrhoea. PMID- 2698518 TI - Coronary care unit. PMID- 2698520 TI - Initial attempts with injection therapy in Hungary. PMID- 2698519 TI - Captopril (Tensiomin) in the treatment of chronic heart failure of ischaemic heart disease patients. AB - The authors used Captopril (Tensiomin, Egis Pharmaceuticals, Budapest) therapy in seven patients suffering from chronic heart failure of ischaemic etiology. As controls, seven patients with dilated cardiomyopathy were involved in the study. All 14 patients received digitalis, diuretic, and isosorbide dinitrate therapy but their condition aggrevated in spite of the therapy. The above-mentioned therapy was completed with daily 3 x 12.5-mg or 3 x 25-mg oral Captopril doses. Significant improvement proved by chest X-ray, echocardiography, and clinical data was observed in four of the ischaemic heart disease patients and three of the dilated cardiomyopathic patients. In other two patients each the improvement was temporary, after 6 weeks of therapy deterioration of the disease was observed. Notable change was not observed in response to Captopril in one ischaemic and two primary cardiomyopathic patients. Tensiomin may be considered as one of the drugs of primary importance in the treatment of chronic congestive heart failure. PMID- 2698521 TI - Current treatment of retinoblastoma. AB - Based on personal experience with 324 children with retinoblastoma who were managed on the Ocular Oncology Service at Wills Eye Hospital between 1974 and 1988, the authors review their current management of this tumor, emphasize common misconceptions in management, and describe the recent research related to the genetics of retinoblastoma. It is pointed out that the optic nerve should not be clamped at the time of enucleation. Photocoagulation should only be used to treat small tumors strictly confined to the retina and it is contraindicated if there is vitreal or choroidal invasion. The tumor should not be directly photocoagulated but rather surrounded by photocoagulation to destroy its blood supply. Cryotherapy should generally be applied to small peripheral tumors and should not be attempted if there is evidence of vitreous seeding of the tumor. External beam irradiation should employ an anterior as well as a lateral portal. Carefully selected radioactive plaque therapy, when it can be used, has distinct advantages over external beam radiotherapy. PMID- 2698522 TI - Otosyphilis: a practical guide to diagnosis and treatment. AB - The diagnosis and management of patients with suspected treponemal infection of the temporal bone pose some challenges. The following points deserve emphasis: 1) the MHA-TP or FTA-Abs is recommended over the reagin serologic tests (VDRL, RPR); 2) one should regard this process as an attempt to define a subgroup of patients with sensorineural hearing loss who will benefit from a combination of antibiotics and steroid therapy rather than explicitly diagnosing infection of the temporal bone. The response rate to therapy is limited; but, otosyphilis, as one of the few treatable causes of sensorineural hearing loss, must be suspected in the differential diagnosis of a wide range of otologic patients. PMID- 2698523 TI - Neutron beam therapy in the treatment of advanced head and neck malignancy. AB - Patients with advanced head and neck cancer continue to present a difficult management problem for the otolaryngologist-head and neck surgeon. This paper discusses the principles of radiation therapy with emphasis on neutron beam therapy as an effective treatment option for advanced malignancy of the head and neck other than squamous cell carcinoma. PMID- 2698524 TI - The utility of diagnostic testing for acoustic neuromas in patients with asymmetrical sensorineural hearing loss. PMID- 2698525 TI - Cervical necrotizing fasciitis: two case reports and review of the literature. AB - Necrotizing fasciitis is a rapidly progressive mixed-organism infection that, in the neck, involves the superficial and deep cervical fascia. Underestimation of this complication of a "minor head and neck infection" can delay diagnosis and treatment of this often fatal disease process. Thirty-five cases of necrotizing fasciitis involving the neck have been reported previously. Two new cases of cervical necrotizing fasciitis and a review of previously reported cases are presented. Management is discussed. Early diagnosis is critical. Antibiotic therapy and prompt, aggressive surgical intervention are appropriate. PMID- 2698526 TI - Hypoglossal nerve paralysis. AB - The hypoglossal nerve is frequently involved in head and neck afflictions as a result of its long course. Hypoglossal nerve paralysis, rarely occurs as the initial presenting symptom. Clinical situations, where the hypoglossal nerve paralysis was an early symptom, are discussed. The anatomy of the nerve from the brain stem to the tongue is elaborated upon. PMID- 2698527 TI - Esthesioneuroblastoma: problems with diagnosis and management. AB - Esthesioneuroblastoma is an uncommon tumor arising from the olfactory epithelium of the nasal cavity. Since most cases present clinically with non-specific findings such as unilateral nasal obstruction and intermittent epistaxis, esthesioneuroblastoma is often mistaken for other diseases of the nasal cavity. Histological confirmation of the disease can also be difficult. The aggressive nature of esthesioneuroblastoma is evidenced by frequent local recurrences and occasional distant metastases--further complicating the management of this tumor. The otolaryngologist should possess a high index of suspicion for this rare, but devastating malignancy. Guidelines for the evaluation and treatment are presented. PMID- 2698528 TI - [Hormone-protein interactions and functional activity of the adrenal cortex during adaptation to pressure chamber hypoxia]. AB - Blood plasma and adrenals of rats subjected to the exposure of deep pressure chamber hypoxia are studied. The method of high-performance liquid chromatography is used to determine the content of corticosterone and deoxycorticosterone as well as the binding ability of transcortin relative to hydrocortisone and corticosterone before and after ectomy of endogenic hormones. It is shown that hyperactivation of adrenals occurs already the first 20 min of the experiment, which is preserved during the whole experiment lowering, to some extent, by 150, 240 min. The binding ability of transcortin considerably lowers in the acute phase of stress and after the prolonged hypoxic exposure due to a 1.5-1.9-fold decrease in the number of the binding sites in the protein. The equilibrium redistribution is revealed in the plasma between free corticosterone and corticosterone bound to transcortin at the different stages of the hypoxic exposure. PMID- 2698529 TI - [A method of solid phase immunoenzyme analysis using antigen molecules immobilized on membranes]. AB - The enzyme-linked immunoassay modification has been worked out. The method combines advantages of membrane technology of antigen immobilization which is used in the enzyme immunosensory technique and of conventional enzyme-linked immunosorbent assay. The nitrocellulose and polypropylene membranes are used as a solid-phase. The purified rabbit immunoglobulin G is immobilized on the surface of membranes as the first layer. The competitive immunoassay is employed. The immunoglobulin G concentration range is 1-1000 ng/ml. The membranes with the immobilized antigen can be repeatedly used after incubation in 0.1 M glycine buffer, pH 2.5. The dry membrane with the immobilized antigen can be used after keeping for 6 months in refrigerator at 4 degrees C without changing the concentration range measured. PMID- 2698530 TI - Master index. Volumes 21-30. PMID- 2698531 TI - [A method of selective proximal vagotomy]. PMID- 2698532 TI - [Modern methods for correcting thrombocytic hemostasis]. PMID- 2698533 TI - [The healing of a large intestine anastomosis]. AB - Three types of colonic anastomosis were experimentally studied on 19 mongrel dogs. Best results were obtained when using precise three-row sutures with the restoration of the intestinal mucosa which was confirmed by histological investigation of the zone of colonic anastomosis. Clinical observations during operation on the colon in 58 patients when using the two-row and precise sutures are in keeping with experimental findings and show advantages of the precision anastomosis. PMID- 2698534 TI - An evaluation of techniques used for the detection of anthelmintic resistance in nematode parasites of domestic livestock. AB - In vitro and in vivo techniques used for the detection of anthelmintic resistance are reviewed in terms of their versatility, reliability, accuracy, cost and simplicity. The faecal egg count reduction test is considered the most suitable for field screening of resistance but the larval development assay is likely to prove a valuable adjunct in such investigations. Other in vitro techniques, such as egg hatch tests, larval motility and tubulin binding assays are recommended as suitable only for research investigations. Similarly, in vivo procedures such as the critical and controlled anthelmintic efficacy tests are considered to be appropriate only for specific research purposes because of the costs involved in such studies. PMID- 2698535 TI - [Antioxidants in the pathogenesis and treatment of periodontal diseases]. PMID- 2698536 TI - [The diagnostic value of immunoenzyme analysis in pseudotuberculosis]. PMID- 2698537 TI - [Dynamic clinico-laboratory indices of physical and mental work capacity in pseudotuberculosis]. PMID- 2698538 TI - [The present status of aphrodisiacs]. PMID- 2698539 TI - [Health of the stomatognathic system in old people]. AB - For obtaining detailed average data on the state of teeth and oral hygiene 2022 subjects aged over 50 years were examined collecting data on their socioeconomic status and stomatological characteristics, including the condition of teeth, the condition of prosthetic replacements and the pathological and physiological features of the mouth. In women and men the condition of teeth was not satisfactory. On the average, the studied subjects had only about 30% of full dental arches, e.g. in the group 50-55 years 49% had full dentition. Despite such high loss of teeth about 33% of these subjects were not wearing any prosthetic appliances. The obtained data show an evident correlation between the condition of teeth, wearing of prosthetic appliances and the availability of stomatological health care, distance form the place of residence to the nearest stomatological care unit and the demand for such care which was not expressed by a considerable proportion of these subjects. The unsatisfactory oral hygiene in the examined population was due to insufficient awareness of the need for prophylactic and therapeutic measures which could be related to insufficient information received prior to the age of 50 years. This conclusion was based on the results of interviews conducted with these subjects. PMID- 2698540 TI - [Calcium channel blockers and their administration in respiratory diseases]. PMID- 2698541 TI - [Therapeutic management of acute febrile states in children]. AB - Long-lasting body temperature over 41 degrees C may constitute a death risk without regard to its cause. Such high fever is associated with functional and organic changes in many organs. The management includes, apart from early diagnosis and causative treatment, also emergency symptomatic therapy with continuous monitoring of the basic vital functions. Treatment undertaken for reducing high body temperature must take into account all elements of thermoregulation. With normally functioning hypothalamic thermoregulation physical methods of cooling are effective. In case of impaired heat transference to the surface of the body drugs dilating the cutaneous vascular bed are helpful. Many pharmacological agents decrease effectively body temperature through a central mechanism, they have, however, numerous side effects. PMID- 2698542 TI - [Acute renal failure during alcohol-induced rhabdomyolysis]. AB - In the light of literature data and own observations the pathogenesis, clinical manifestations, treatment and prognosis are described in acute renal failure caused by alcohol-induced rhabdomyolysis. PMID- 2698543 TI - [Neurological aspects of AIDS]. PMID- 2698544 TI - [Drownings]. AB - The epidemiology of drowning is described discussing the pathological mechanism of death during drowning, mentioning the characteristic types of drowning and outlining the main principles of treatment of drowned subjects. PMID- 2698545 TI - [The psychiatric hospital in Warta during World War II]. PMID- 2698546 TI - [Use of the bioelectric properties of the skin for diagnosing organ diseases]. PMID- 2698547 TI - [The use of markers for determination of the activity of microsomal enzymes connected with cytochrome p-450]. AB - The mixed-function oxidases, among them cytochrome P-450, are participating in the metabolism of many xenobiotics. Using marker drugs it is possible to assess the induction or inhibition of these oxidases. The paper described the usefulness of use of certain drugs metabolised by this system in various liver diseases. Data from the literature are presented concerning the use of marker drugs labelled with C14 and determination of the effectiveness of the mixed-function oxidases by measurement of 14CO2 activity in exhaled air. PMID- 2698548 TI - [Antibacterial action and clinical use of aminoglycoside antibiotics]. PMID- 2698549 TI - [The effect of not smoking on the course of arteriosclerotic circulatory disorders of the legs]. PMID- 2698550 TI - [Effect of maternal smoking in pregnancy on physical and mental development of the school child]. PMID- 2698551 TI - [Biochemical study procedures for verifying non-smoking: evaluating the usefulness of biochemical indicators of exposure to cigarette smoke]. PMID- 2698552 TI - [Smoking and occupational pollutants as competing causes of lung diseases]. PMID- 2698555 TI - [The history of epidemic environmental lead poisoning]. AB - For more then 2000 years mankind daily meet with the heavy metal lead. The sources of epidemic lead intoxication changed with cultural development as revealed by findings in historic literature. In the present time the danger for human health is caused mainly by using petrol with lead addition. PMID- 2698553 TI - [Increasing the effectiveness of medical decisions and treatment by considering the correlation of legal rights and morals]. PMID- 2698554 TI - [The discovery of bacterial agglutinins and origin of serodiagnosis--a priority battle from the history of medical microbiology. 2: Biographical sketches of the contenders Max v. Gruber (1853-1927), Richard Pfeiffer (1858-1945), Herbert Edward Durham (1869-1921) and Fernand Widal (1862-1929)]. PMID- 2698556 TI - [Public health and medicine--a leading article by Friedrich Oesterlen in 1860]. AB - The position of hygiene in medicine before the foundation of the first hygienic institute in Germany (1865) is supported by extracts from the leading article of the review "Zeitschrift fur Hygiene, medizinische Statistik und Sanitatspolizei". In the following, some sections of this article will be joined, going a very topical evidence. PMID- 2698557 TI - [A new orientation in surgical education in Berlin at the turn of the 18th to the 19th century]. AB - The new approach to surgical education is described by means of the educational programmes at the turn of the 18th to 19th century in Berlin. The typical authorities of academic medicine with naturalphilosophical views at the Charite of the 18th century a few decades later were opposed by academical educated surgeons and lecturers, who introduced the era of the scientifically oriented surgery by practical exercises, independent autopsies, scientific experiments and libraries. Thus, in Berlin the virtual development of the surgical medicine started - a development from a manual to a scientific discipline. PMID- 2698558 TI - [Henry Ernest Sigerist (1891-1957)--the founder of sociologic-oriented medical history. An introduction to his essay "Life in the shadow"]. PMID- 2698559 TI - [Life in the shadow]. PMID- 2698560 TI - [Human hepatitis experiments in the 2d World War]. AB - During the Second World War a hepatitis epidemic spread across wide areas of Europe, leaving no doubt about the previously questioned infectious nature of the disease. The losses to the German forces due to hepatitis, presented a challenge to several German scientists to identify the infective agent via animal trials and experiments with humans. Kurt Gutzeit, the "Beratende Internist beim Heeres Sanitats-Inspekteur" was in charge of the hepatitis research in the army. Under his guidance, two co-workers conducted experiments on non-voluntary subjects: in 1941, Hans Voegt infected psychiatric patients from the mental hospital in Breslau, and in 1944, Arnold Dohmen carried out experiments on jewish children in the Sachsenhausen concentration camp. In the Nurnberg trials, Gutzeit had denied his and Dohmen's responsibility. Further investigation into the hepatitis research which was carried out by German scientists during the Second World War, especially Gutzeit's group, is regarded necessary. PMID- 2698561 TI - [Treatment of stress-induced and spontaneous myocardial ischemia in coronary disease patients with slow-release gallopamil--preliminary results of an open study]. AB - We studied the effects of slow-release gallopamil two-times 100 mg on exercise induced ST-segment depression, as well as on the incidence of spontaneous myocardial ischemia detected by long-term ECG monitoring for 48 h in patients with coronary artery disease and stable angina pectoris. Three out of nine patients included in this study had to be excluded (because of frequent ventricular extrasystoles, paroxysmal atrial fibrillation, and development of instable angina pectoris). In all of the remaining six patients, the substance led to a doubling of working capacity (watts X min) evaluated by bicycle ergometry, paralleled by an increase of exercise duration until the occurrence of ST-segment depression greater than or equal to 0.1 mV. The number of spontaneous episodes of myocardial ischemia during long-term ECG recording, ranging 1-13 during control, decreased in all patients, paralleled by a decrease of the mean duration of ischemic episodes. On the other hand, no significant negative chronotropic effect was observed. Therefore, these preliminary results of this open-study protocol confirm the antischemic effects of slow-release gallopamil given 100 mg two times daily; on the other hand these promising results need to be confirmed in a doubleblind, placebo-controlled trial. PMID- 2698562 TI - [Can the progression of coronary heart disease be modified by calcium antagonists?]. AB - Experimental atherosclerosis in animals preferentially induced by cholesterol rich food can be successfully suppressed by calcium channel blocking agents such as verapamil, nifedipin, nicardipin, and diltiazem. The question whether calcium channel blockers can favorably influence atherosclerosis in humans remains a matter of debate. A few observational investigations in the past showed positive results of calcium channel blocker therapy in patients with angiographically proven coronary artery disease (CAD). At present three prospective randomized clinical trials are under way (INTACT-study, FIPS-study, study from the Montreal Heart Institute). Target variable is the severity of coronary atherosclerosis assessed by angiography both at entry into the study and after 2-3 years of treatment. 445 patients after coronary bypass surgery were included in the FIPS study (Frankfurt Isoptin Progression Study) and were randomly allocated to either verapamil 120 mg t.i.d. or placebo treatment. Extent of coronary atherosclerosis, assessed by repeat angiography 1 and 3 years after randomization, is expressed by scores with separate evaluation of non-bypassed vessels, segments distal to the peripheral bypass insertion, bypassed segments and grafts. The 1-year follow-up was completed for 162 patients (Group A = 80 patients; group B = 82 patients). There was a homogeneous distribution in both groups for all clinical variables, graft patency rates (76%/75%), and the incidence of clinical events (myocardial infarct, need for cardiac surgery or PTCA, cardiac death: 5%). The overall progression of atherosclerosis in the first year after bypass surgery was small. Thus, the question of whether calcium channel blockers can retard progression of coronary atherosclerosis cannot be answered before completion of the aforementioned trials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698563 TI - [The spectrum of side effects of gallopamil in comparison with other calcium antagonists]. AB - Severe adverse effects associated with the use of calcium channel blockers do not occur very often. Sometimes nifedipin produces hypotension, tachycardia, and headache, whereas verapamil, gallopamil, and dilitiazem show more negative chronotropic effects such as bradycardia or sinuatrial and atrioventricular nodal conduction disturbances. Gastrointestinal side effects are constipation after verapamil and stomach problems after gallopamil. PMID- 2698564 TI - [Anti-arrhythmia effects of calcium antagonists]. AB - Calcium antagonists such as verapamil/diltiazem predominantly delay av-nodal conduction. Thus, the most important clinical indications for their application are the av-nodal-reentrant-tachycardia as well as the slowing of rapid ventricular response in intraatrial tachyarrhythmias. To reestablish sinus rhythm in atrial fibrillation, verapamil should be combined with chinidin. Usually, ventricular arrhythmias cannot be suppressed by calcium antagonists, but they may be indicated in exercise-induced ventricular arrhythmias and tachycardias arising from the right ventricular outflow tract. Verapamil/diltiazem are effective in ischemia-induced tachyarrhythmias, especially ventricular fibrillation, because of the reduction of ischemia-related conduction delay in the ischemic zone. The effectiveness of calcium antagonists in the secondary prevention of myocardial infarction can not yet be definitively defined. PMID- 2698565 TI - [Ventricular arrhythmia in silent myocardial ischemia--diagnosis and clinical relevance]. AB - Silent myocardial ischemia and ventricular arrhythmias were known to be independent risk factors in patients with coronary artery disease. This has become more important since the technique of Holter monitoring has been improved and has demonstrated a high incidence of silent myocardial ischemia in the majority of patients with coronary artery disease, as well as a close relation to the occurrence of sudden cardiac death. Unfortunately, prospective data on the interaction of both risk factors are missing. We therefore studied patients undergoing exercise-testing, percutaneous transluminal angioplasty and 24-h Holter-monitoring to assess such an interaction. During exercise testing the total incidence of ventricular arryhthmias in patients with asymptomatic ST segment depression was 42%; 6% of patients had frequent ventricular arrhythmias, 6% had ventricular pairs, and 1% had ventricular tachycardia. The incidence was similar to patients with symptomatic ST depression, but was 3.2-times higher as compared to patients without ST segment depression. During 103 attempts of percutaneous transluminal angioplasty, in 26 patients ventricular arrhythmias occurred, the incidence of ventricular tachycardia was 1-3%. No difference was observed for symptomatic and asymptomatic attempts. In 36 patients with severe coronary stenosis (greater than 90%) 24-h-Holter-monitoring showed 145 episodes of myocardial ischemia with a total duration of 967 min; two-thirds of episodes were asymptomatic. The incidence was similar in patients with symptomatic and asymptomatic episodes of myocardial ischemia, but 30 to 50-times higher as compared to the interval with ischemia. In summary, episodes of myocardial ischemia have a higher risk of ventricular arrhythmias, however, there is no difference between symptomatic and asymptomatic myocardial ischemia. PMID- 2698566 TI - [Dose-response relation of gallopamil in comparison with nifedipine, diltiazem and tiapamil in patients with coronary heart disease]. AB - For effective treatment of coronary heart disease with calcium antagonists, knowledge of both the dose-response relationship of a remedy and equipotent dosage for comparison of different drugs is necessary. We performed controlled studies to evaluate the influence of single oral doses of calcium antagonists on ischemic ST-depression (calculated as the mean of all exercise and recovery minutes = mean ST-depression) in exercise ECGs of patients with proven CHD and stable angina pectoris. Ergometries were carried out under constant conditions, particularly with individually constant work load and duration. All calcium antagonists reduced ischemic ST-depression during ergometry dose-dependent when compared to placebo. Diltiazem: 90 mg: 6% (n.s.), 120 mg: 19% (n.s.) und 180 mg: 26% (p less than 0.025); gallopamil: 25 mg: 19% (n.s.), 50 mg: 34% (p less than 0.01) und 100 mg: 57% (p less than 0.0025); nifedipine-Cps.: 5 mg: 17%, 10 mg: 33% und 20 mg: 42%; nifedipine-Tbl.: 20 mg: 8% (p less than 0.05), 40 mg: 23% (p less than 0.057 und 60 mg: 31% (p less than 0.05); tiapamil: 300 mg: 30% (p less than 0.05) und 600 mg: 60% (p less than 0.01). As the result of our findings, comparable antiischemic effects can be expected with 120 mg diltiazem, 50 mg gallopamil, 20 mg nifedipin as capsule or 60 mg nifedipin as tablet and 600 mg tiapamil. PMID- 2698567 TI - [Effects of gallopamil on iodine-123-phenyl-pentadecanoic acid and thallium 201 uptake in patients with coronary heart disease]. AB - Numerous experimental and clinical studies indicated that in the presence of coronary artery stenoses, myocardial thallium-201 and free fatty acid uptake in poststenotic regions is reduced during exercise. The aim of this study was to investigate the effect of the calcium antagonist gallopamil on myocardial thallium-201 and free fatty acid uptake in patients suffering from coronary artery disease. In 6 patients with angiographically proven coronary artery disease--2 patients with 1-vessel, 2 patients with 2-vessel and 2 patients with 3 vessel disease--as well as good left ventricular performance and stable, exerciseinduced angina, quantitative double-tracer scintigraphy was performed. Patients were investigated after a placebo period of 1 week, after oral gallopamil medication for 4 weeks (3 X 50 mg gallopamil daily), and after a double-blind period of 1 week. During symptom-limited exercise, 2 mCi thallium 201 and 5 mCi iodine-123 phenyl-pentadecanoic acid (IPPA) were simultaneously injected intravenously. Immediately after exercise, as well as 1 and 4 hours later, planar images were obtained in ap, 30 degrees LAO and 60 degrees LAO projections. By means of a newly developed computer algorithm, global and regional myocardial tracer uptake as well as IPPA clearance were evaluated. - Gallopamil provoked a decrease of global myocardial thallium-201 and IPPA uptake due to a reduction of myocardial oxygen consumption. Regional thallium-201 and IPPA uptake as well as myocardial IPPA clearance in poststenotic areas tended to rise following gallopamil medication. Thus, in the presence of coronary artery disease, gallopamil provokes an improvement of regional perfusion (dilatation of larger coronary arterioles) as well as an enhanced free fatty acid utilization in reversibly ischemic myocardial regions. PMID- 2698568 TI - [Effect of 75 mg retard gallopamil on stress-induced myocardial ischemia]. AB - In a randomized, double-blind, placebocontrolled study 40 patients with exercise induced ischemic ST depression were given 75 mg gallopamil in slow release form twice daily. The study had 2 periods. After a 3 day run-in-period and a 14 day open therapy period exercise stress-tests were performed on a bicycle ergometer. 5 patients were dropped from this study. 25 of the remaining 35 patients were "responder" defined as a greater than 30% reduction of the ischemic St depression by gallopamil. These patients were randomly assigned to gallopamil or placebo. At the end of the first open period gallopamil significantly reduced the mean ischemic ST depression by 47% from 0.15 to 0.8 mV (p less than 0.0005). Compared with placebo control, the decrease of the ST depression remained unchanged during gallopamil (0.7 mV). In contrast a statistically significant increase of the ischemic St reaction was observed during placebo. Gallopamil significantly improved exercise tolerance. No side effects or adverse reactions were observed. This study demonstrates that gallopamil slow release is a potent calcium antagonist in reducing exerciseinduced myocardial ischemia and improving stress tolerance. PMID- 2698569 TI - [Therapeutic coronary effectiveness of retard gallopamil following repeated administration in comparison with placebo]. AB - The aim of this randomized double-blind crossover trial was to evaluate the therapeutic efficacy of 100 mg slow-release gallopamil compared to placebo. The results of multistage exercise tests with computer-assisted ECG were analyzed in 16 patients (14 men and two women) aged 39 to 66 years who fulfilled the angiographical evidence of coronary heart disease with stable angina pectoris. All cardioactive medication was withdrawn for the duration of the study except for the trial medication and sublingual nitroglycerin as required. Patients began the therapy with a 5-day placebo run-in period. After this regimen, they were randomized to placebo or slow-release gallopamil (200 mg/day) in two divided doses for 7 days, at the end of which time each patient crossed over to the alternate regimen. Exercise testing was repeated at the end of the run-in period and after 1 week of placebo or active drug therapy. At highest comparable load the ST-segment depression was reduced about 70% before the morning administration (i.e., 12 h after the evening administration) and 6 h after the morning administration. The work load (W x min) increased in 54% or 61% at the maximal possible load. The number of angina pectoris attacks under bicycle ergometer exercise decreased in about 50%. PR-interval was prolonged from 0.14 to 0.15 s. QRS- and OTc-intervals were not influenced. No clinically relevant changes in heart rate and blood pressure were observed. The results indicate great antianginal efficacy and a good toleration of slow-released gallopamil. PMID- 2698570 TI - [Randomized comparison between gallopamil and diltiazem in angiography verified coronary heart disease]. AB - In a randomized study 30 patients (age 59 +/- 7) with angiographically confirmed coronary artery disease were treated with either gallopamil (15 patients) or diltiazem (15 patients). After a 48-h-run-in period of treatment with nitrates the gallopamil group was treated with 3 X 60 mg/day, and the diltiazem group was treated with 3 X 50 mg diltiazem/day. As criteria for the efficacy of therapy the anginal frequency, the nitroglycerin consumption, and exercise tolerance were monitored. During exercise the blood pressure in the 50-watt-level, the product of blood pressure, and pulse rate at 50 watts and at the maximal workload level, the ischemic index was calculated as the product of blood pressure, pulse rate, and ST-segment depression/Watt. Later the exercise tolerance and the difference of the exercise tolerance before and after the drug period was measured. The following parameters improved under gallopamil therapy: the gallopamil group showed a significant reduction of the anginal frequency/week (10 +/- 8 down to 3 +/- 2, p less than 0.001), the nitroglycerin consumption (1.4 +/- 1.4 down to 0.3 +/- 0.6, p less than 0.001), the ischemic index (from 63 +/- 24 down to 46 +/- 17, p less than 0.01), and the exercise tolerance (740 +/- 610 up to 1140 +/- 670, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698571 TI - [Effectiveness of retard gallopamil in patients with stress-induced ST-segment depression and silent myocardial ischemias]. AB - At a dosage of 75 mg b.i.d., gallopamil retard represents a suitable medication for the treatment of both symptomatic and asymptomatic ischemic episodes, as could be demonstrated in patients with coronary heart disease ascertained by angiography, positive exercise testing, and more than five ischemic episodes in Holter monitoring over 48 h. The results of our study furnish proof that more than 60% of ischemic episodes recorded in patients with stable angina pectoris during Holter monitoring over 48 h, have been asymptomatic, i.e., silent. It must thus be postulated that effective antianginal therapy must be able to suppress both symptomatic and asymptomatic ischemic episodes. This should be documented by Holter monitoring over 48 h. It has not been established yet which criteria: duration of ST-segment depression, frequency of ischemic episodes, or area integral of ST-segment depression, furnish the most adequate parameters for assessment of ischemia. Assessment of the three criteria, taken together, is likely to be most reliable and should thus, in particular, be adhered to in evidencing efficacy in an antianginal drug trial. PMID- 2698572 TI - [Implant prostheses in edentulous atrophic mandible]. PMID- 2698573 TI - Surveillance of triplets with umbilical artery velocimetry waveforms. AB - Doppler arterial velocimetry waveforms was used as a method of antenatal surveillance for triplets. Six sets of triplet pregnancies were studied. Each fetus was identified by real-time-ultrasound scanning and the peak systolic/end diastolic (S/D) ratio was calculated. In one set of triplets two fetuses showed absent end diastolic flow. Both subsequently suffered from necrotising enterocolitis and had major bowel resection. The five other sets of triplets maintained a normal S/D ratio. Three had a normal outcome and two delivered prematurely. PMID- 2698574 TI - Evaluation of zygosity diagnosis in twin pairs below age seven by means of a mailed questionnaire. AB - The mothers of a consecutive series of 125 same sexed pairs of twins aged 6 months to 6 1/2 years completed a mailed questionnaire concerning the physical similarity of the twin partners. Zygosity diagnoses were first determined blindly on the basis of the answers given by the mothers, who did not know the result of the blood group test when fulfilling the questionnaire. Next, the results were compared with the zygosity determination based on examination of erythrocyte-, serum- and enzyme-groups. It turned out that a few simple questions distinguished well enough between MZ and DZ pairs, with a frequency of misclassification of 4%, leaving 5% as unclassifiable. It is concluded that twin zygosity can be estimated by a simple questionnaire with sufficient accuracy even in very young twin pairs. This has relevant implications for more extensive twin studies where the use of a wide spectrum of serological characters would imply too high expenses. PMID- 2698575 TI - Does the respiratory distress syndrome in twins and singletons run different risks of persistent ductus arteriosus? AB - The incidence and evolution of patent ductus arteriosus (PDA) was evaluated in twins and preterm singletons with birth weight less than or equal to 1750 g admitted to our Department in 1987 for respiratory distress syndrome (RDS). Screening by echocardiography and Doppler-flow studies (AT MK 600) was performed on the third day of life. Out of 91 neonates who needed intubation and ventilation during this 12-month period (23.8% of admissions), 40 weighed less than 1750 g and of these 40, 14 were twins (35%). Hemodynamically significant PDA was documented in 13 patients; of these, only 5 were preterm singletons and 8 were twins. Two twins weighing less than 1000 g received no therapy for ductus closure; one ductus closed spontaneously, the other had an early demise. Three twins and 2 preterm singletons received indomethacin; one of the twins needed a second cycle for definitive ductus closure. Three twins and three preterm singletons underwent surgery, while one twin died on the 10th postoperative day. Screening and early therapy of PDA during RDS could be of great clinical importance. Twinning seems to play a role in the incidence and evolution of PDA and this needs to be evaluated in further studies. PMID- 2698576 TI - Listeriosis, man-made? PMID- 2698577 TI - Taxonomic position of Listeria strains. PMID- 2698578 TI - Overview of listeriosis in countries of the Mediterranean Zoonoses Control Programme (a review). PMID- 2698579 TI - Latent listeriosis--its diagnosis by bacteriology and serology in five cases. AB - The failure of agglutination tests in the diagnosis of latent listeriosis (chronic and asymptomatic) are partly due to the fact that deficient antigens in general use have discredited the serology in this infection. However, using good live antigens or antigens devitalized at moderate temperature and conserved by lyophilization, excellent diagnostic results may be obtained by indirect immunofluorescence (IIF). We could confirm this again in five women with a history of pregnancy disorders. All had a positive or strongly positive IIF. Listeria monocytogenes could be isolated by cultivation of the cervico-vaginal exudate, cerebrospinal fluid and from the placenta. After one year and more, these mothers continued to have positive IIF, proving that L. monocytogenes does not disappear from infected persons, even after a long-lasting treatment. PMID- 2698580 TI - Latent listeriosis may cause habitual abortion intrauterine deaths, fetal malformations. When diagnosed and treated adequately normal children will be born. AB - We endeavoured to prove latent listeriosis (LL), a chronic and asymptomatic infection, in women who suffered from repeated accidents in their pregnancies. By the reduction of immune defences in the pregnant woman, the latent infection may break out again, affecting thus the fetus and causing abortion, stillbirths or malformations. In such women the diagnosis of LL is urgent right from the start of pregnancy, and so is the antilisteria treatment to protect the fetus. Antilisteric antibodies are readily detected by indirect immunofluorescence (IIF), using live antigen or antigen not inactivated by high temperatures of inadequate conservation, as is frequent in currently used agglutination test reactives. Out of the 309 women, 207 had a total of 334 abortions, 67 prematures, 75 stillbirths, 43 malformed living or dead offsprings. High positivity of IIF was the only aetiologic date to explain these accidents. Treatment of new pregnancies of a part of these IIF-positive women led to birth of 152 normal children, negative by IIF for listeriosis. The search for LL at the onset of any pregnancy, same as done in various infections (lues, toxoplasmosis, etc.) is therefore warmly recommended. PMID- 2698581 TI - Listeria: ecology in the food chain (a review). PMID- 2698582 TI - Physical and chemical effects damaging listeriae (a short review). AB - This very brief summary attempts to review some of the more recent information on the physical and chemical conditions affecting survival and/or growth of listeriae in foods. PMID- 2698583 TI - Species of the genus Listeria. PMID- 2698584 TI - Serological diagnosis of listeriosis in man, sheep and rabbit by immunoperoxidase technique. AB - Due to the already demonstrated specificity and usefulness of Listeria intracellular antigen in paraffin-embedded tissues for the direct diagnosis, we have used an indirect immunoperoxidase technique for the serological diagnosis of listeriosis in man, sheep and rabbit. This technique has been compared with other immunoperoxidase techniques (PAP) using the same antigen, and with other serlogical techniques--ELISA and microplate agglutination test--using two kinds of Listeria antigens, live formalinized and heat at 100 degrees C for one hour whole cells. PMID- 2698585 TI - Listeriosis--a worldwide issue. PMID- 2698586 TI - Measurement of local haematocrit, energy metabolism and haemodynamics in cerebral ischaemia with positron tomography. PMID- 2698587 TI - Randomized clinical trials of hemodilution in acute ischemic stroke. AB - The effects of hemodilution in acute ischemic stroke have been investigated, first in a single-center, then in a multicenter trial. Patients with hematocrit levels of 38-50% were randomized, within 48 h of onset of symptoms, to treatment with repeated venesections (total 250-1000 ml) and concomitant dextran 40 administration, or to a control group. The single-center study, performed in a research-oriented stroke unit, involved 102 patients. Case fatality rate was not grossly affected by hemodilution. In survivors, hemodilution improved neurological outcome. More hemodiluted patients were independent in walking and more were at home 3 months after the stroke. The ensuing multicenter trial involved 383 patients in 15 Scandinavian centers. Three-month case fatality rate was 16% in hemodiluted and 12% in control patients. Neurological scoring and ADL performance at 3 months was not improved by hemodilution. No subgroup with beneficial effects was discerned. It is concluded that the present standardized hemodilution regime cannot be recommended for general use in patients with ischemic stroke. PMID- 2698588 TI - The influence of haematocrit on the cerebral circulation. PMID- 2698589 TI - Doppler velocimetry measured in retrochorionic space and uterine arteries during early human pregnancy. AB - The natural course of uterochorionic vascular resistance during the first trimester of pregnancy is described. We performed a weekly study using a pulsed Doppler in 25 normal pregnancies, with a total of 191 examinations made. The flow velocity waveform was studied simultaneously in the retrochorionic area as well as in the uterine arteries. Different velocimetry indices were analysed, which demonstrated the feasibility of the (D/S) x 100 index for study of the retrochorionic vessels and of the Pourcelot index (S-D/S) for the uterine arteries. A gradual weekly decrease in flow resistance was found, with significant differences before [(D/S) x 100 = 52.01 +/- 8.33; S-D/S = 0.83 +/- 0.09] vs after the 9th week [(D/S) x 100 = 58.9 +/- 8.78; S-D/S = 0.72 +/- 0.10]. Further evaluation of its predictive and diagnostic value in gestational pathology is necessary. PMID- 2698590 TI - First trimester diagnosis and early in utero treatment of obstructive uropathy. AB - The earliest diagnosis and treatment of obstructed fetal bladder is reported. Placement of vesico-amniotic shunt at 14.5 weeks of gestation enabled preservation of bilateral renal function and maintenance of normal amniotic fluid volume with normal pulmonary development. The shunt functioned adequately for more than 12 weeks. At birth, a mild 'prune' belly was the only deformity noted. PMID- 2698591 TI - Comparison of induced versus non-induced labor in post-term pregnancy. A randomized prospective study. AB - OBJECTIVE: To determine the proper management of pregnancy in uncomplicated cases going beyond 42 weeks. DESIGN: Randomized controlled trial of induction of labor at or shortly after the 42-week limit, versus close monitoring without induction except when indicated for medical reasons. SETTING: Hospital's obstetrical department STUDY POPULATION: 188 pregnant women, randomly allocated to two groups with 94 in each. INTERVENTIONS: Induction of labor by stripping of membranes and i.v. oxytocin infusion, with artificial rupture of membranes when the cervical opening was 3 cm or more in diameter. The control group was followed with clinical, biochemical and electronic tests, intervention being applied according to needs. END POINTS: Frequency and modes of operative delivery, maternal and perinatal morbidity and mortality. MAIN RESULTS: The distribution of gestational age (in weeks) at birth was almost identical in the two groups, but there were more operative deliveries in the control group than in the induction group (64 versus 48, p less than 0.05). Maternal complications and perinatal morbidity rates were equally distributed between the groups. There was one perinatal death in the induction group and two deaths among the controls. CONCLUSION: With due reservation for small numbers, routine induction after term may result in fewer operative deliveries. No other advantage has been demonstrated when compared with close monitoring and intervention when medically indicated. PMID- 2698592 TI - [Borelli: De Motu Animalium. A first treatise on biomechanics]. AB - De Motu Animalium seemingly constitutes the very first treatise on biomechanics. The author, Giovanni Alfonso Borelli (1608-1679), was professor of mathematics in Pisa, where he worked with Malighi who was professor of theoretical medicine and focused Borelli's interest on the movements of living creatures. The work consists of two parts. In the first part Borelli analyses the action of the muscles, the movements of the limbs, and the activities of man and animals, including skating, running, jumping, swimming and flying. The second part deals with what is now called physiology, considered from the point of view of a mechanist: heart, blood circulation, breathing, separation of urine from blood in the kidneys, liver function, reproduction, fatigue, thirst, hunger, fever, and so on. The book shows Borelli to be a genial precursor. He expresses his opinion as a mathematician on problems which afterwards further stimulated the curiosity and endeavors of many generations of researchers. PMID- 2698593 TI - Effects of 5-fluorouracil on thymidylate synthase activity and development of bone marrow grafts in spleens of irradiated mice. AB - The effects of 5-fluorouracil (5-FU) on thymidylate synthase activity and development of myelopoietic tissue in spleens of recipient mice grafted with bone marrow collected from untreated mice, treated with phenylhydrazine or phenylhydrazine and 5-FU were investigated. One dose of 5-FU (100 mg/kg body weight) reduced development of bone marrow grafts from all donors. The activity of thymidylate synthase sharply declined during the first three days after irradiation irrespective of bone marrow transplantation. Next, during consecutive 3 days the activity of the enzyme sharply increased both in mice untreated and treated with 5-FU. The highest thymidylate synthase activity was found in spleens of mice grafted with control bone marrow and next treated with 5-FU. That high enzyme activity appeared in spite of further reduction of spleen weight. Thus, 5 FU prevented completely development of bone marrow grafts in spleens but increased thymidylate synthase activity in a paradoxical manner. Thymidylate synthase in myelopoietic tissue developed from bone marrow, collected in the state of hyperproduction of that enzyme induced with phenylhydrazine and 5-FU, did not show increased resistant to 5-FU. PMID- 2698594 TI - [Neuropsychic sequelae of deportation to Nazi concentration camps during the Second World War]. AB - The main neuropsychic sequelae in adults of deportation to World War II nazi concentration camps: KZ syndrome, survivor syndrome-persecution syndrome and psychogenic schizophrenia, are described. Functional, organic and psychogenic etiologic conceptions of these syndromes are presented. An interpretation of these sequelae is proposed. PMID- 2698595 TI - [A case of toxic psychosis caused by bromocriptine]. AB - We present a short review of literature concerning the problem of bromocriptine induced psychosis A case of toxic psychosis following treatment on bromocriptine in an acromegalic patient who had previously undergone hypophysectomy is also reported. On two occasions after having received low doses of bromocriptine for several months, the patient developed a psychotic syndrome characterized by violent behaviour, auditory hallucinations, paranoid misinterpretation, threatening delusions and depersonalization, which lasted several weeks. On treatment with neuroleptics, the symptoms gradually remitted. In the context of the reviewed literature, an outstanding feature of the case is the absence of psychiatric history, which is not frequent, but not unlikely in the published case-reports. This reassures the authors' on the unespecificity of psychiatric syndromes, broadly discussed in our own and other colleges' references. PMID- 2698596 TI - [Computerized EEG and personality]. AB - The ordinary EEG, on only showing qualitative malfunction of abnormal graphoelements in the tracings, proves itself insufficient to go into the analysis of psychological and psycho-pathological problems. Since computerised studies of EEG permit quantitative comparisons, we tried to apply them in correlation with the characteristics of the personality classified also with quantitative criteria, such as those offered in the personality inventory 16 PF; from which have been chosen the so-called factors of the second order, and the subjectivity-objectivity factors. The test was carried out on 100 voluntary subjects from Almeria (Spain), all with High School grades, between 18 and 40 years of age, of both sexes, all right-handed, without neuro-psychiatric history, and with normal ordinary EEGs. From the statistical analysis of the results one could deduce that there are significant specific relationships from the computerised EEG, with those secondary polar values of 16 PF: high and low anxiety, extroversion-introversion. Subjects with low anxiety presented a significant increase of the alpha band opposed to the subjects with high anxiety. There is a significant differences in power of the frontal areas between extrovert and introvert subjects. The extroverted subjects have a greater power of the right side and the introverted subjects a greater power of the left. PMID- 2698597 TI - Replacement of the early-control IVU after ureteral reimplantation by ultrasonography. AB - Many intravenous urographies (IVU) are still made shortly after ureteral reimplantation as a routine procedure to evaluate the function of both kidneys and to exclude a severe distal ureteral obstruction known as a complication of the operation (Broaddus et al., 1978). By studying two groups of patients we present an evaluation of the use of this IVU and the possible replacement by ultrasonography (US). The first group consisted of 119 cases with 155 reimplanted ureters. All of the patients underwent an IVU within two weeks and again three months after the operation. The second group included 35 patients, who underwent 55 reimplantations: US of the kidneys was performed within two weeks and three months and also one year after operation. In the first group three patients needed a second reimplantation because of a developed distal ureteral stenosis after three months. The second IVU showed severe dilatation in all of them. In two patients of the second group we also saw an increase in dilatation during follow-up within three months, for which a ureteral reimplantation was indicated. There was not a single case in which the outcome of the early IVU or US gave rise to a serious change in postoperative management. Our conclusion is that the early postoperative IVU, should be replaced by US of the kidneys, the result of which should function as a baseline for further follow-up studies. PMID- 2698598 TI - [Congenital cardiopathy in a series of 53,578 children born in Oviedo (1976 1985)]. AB - A diagnosis of congenital heart disease was carried out in the 5.2/1,000 of 53,578 live neonates who were born in the Hospital "Nuestra Senora de Covadonga" from 1-1-1976 to 12-31-1985. A relatively high and low incidences of ventricular and atrial septal defects were respectively found. The 69.1% of heart diseases were identified in the first month of life. PMID- 2698599 TI - [Hypertension in children]. PMID- 2698600 TI - [Pulmonary sequestration with esophagobronchial fistula. Presentation of 2 cases and a review of the literature]. AB - Pulmonary sequestrations communicating with the gastrointestinal are very uncommon respiratory malformations. We report two personal cases and review 33 more previously published of which 24 were intralobar and 11 extralobar. We demonstrate that this malformation can hardly be separated from "classical" pulmonary sequestrations (ie, those without g.i. communication) a fact attesting their common embryologic origin. In extralobar sequestrations there were no differences in sex, side or associated malformations. In intralobar cases there were female (83%) and right side (67%) predominances, that are not observed in sequestrations without g.i. communication. We call the attention on the great variety of anatomic forms and on the great difficulty to reach an accurate anatomic diagnosis preoperatively. PMID- 2698601 TI - Aspergillus nidulans as a test organism for the detection of chemically-induced mitotic crossing-over and chromosome malsegregation. AB - The genetic systems developed in the mould Aspergillus nidulans to study the chemical induction of mitotic genetic segregation were used to investigate the mechanism of aneuploidy induction by the main benzene hydroxy metabolites. Detailed genetic analysis of mitotic segregants produced by individual colonies revealed the simultaneous occurrence of both whole chromosome segregants and mitotic cross-overs, i.e. a pattern not compatible with the induction of numerical abnormalities as the primary event. Confirmatory evidence was obtained in a haploid strain, thus demonstrating the possible secondary origin of aneuploidy following the induction of structural chromosome damages. Furthermore, mutagenic, lethal and growth-arresting properties of a series of chlorinated hydrocarbons were quantitatively estimated and compared to a series of physico chemical descriptors of the molecules to assess the possible role of unspecific physical interactions in their mechanism of action. The analysis of the interrelationships among these variables highlighted a possible correlation among physico-chemical descriptors and toxic properties and a dissociation of the aneugenic activity with the other chemical and biological descriptors. PMID- 2698602 TI - Risk of carcinogenesis from exposure to dietary mutagens. AB - Epidemiological studies revealed the crucial role of dietary habits in human cancer. This review will summarize literature data on naturally occurring mutagens and carcinogens. The risk of carcinogenesis related to dietary mutagens will be discussed. PMID- 2698603 TI - Occupational exposure to antiproliferative drugs in health care workers. AB - A survey is presented of the information available on the occupational hazard caused by exposure to anticancer drugs. Emphasis is laid on the need for stricter and safer measures to protect the sanitary personnel, who should also be constantly and thoroughly informed on the risk run when manipulating antiproliferative agents. Possible strategies for effectively preventing occupational diseases in this field are finally outlined. PMID- 2698604 TI - [Present knowledge of the taxonomy, distribution and biology of genera of Trichinella (Nematoda, Trichinellidae)]. AB - The Trichinella genus, considered monospecific till 1972, is now composed of at least seven gene pools. The Soviet authors identified four of them as good species: T. spiralis, T. nativa, T. nelsoni and T. pseudospiralis. The biochemical approach identified three new taxonomic groups called Trichinella T3, T5, T6 on the operational level. Each gene pool has a well-defined distribution. T. spiralis only has a ubiquitous distribution due to passive importation caused by man. The life cycle of these nematodes unfolds inside of a single warm blood host. The ingested muscle larvae penetrate inside the columnar cells of the small intestine epithelium and develop into adult worms in four days. The females mate and produce 200-1500 larvae (newborn) according to the species from the 5th-6th day. Through the lymphatic vessels, the newborn larvae reach the thoracic duct and get to the parenteral niche. The larvae, reaching the striated skeletal muscles, penetrate the muscle cells and begin a parenteral life. During the first 20 days the larvae increase from 80 microns to 1 mm. After this rapid growth, the larvae, growing infectious, survive in the muscle cell awaiting ingestion into a new host. PMID- 2698605 TI - [Epidemiology of trichinellosis in Italy and in neighboring countries]. AB - In Italy Trichinella infection is present only in sylvatic animals, especially the fox. Nevertheless, the prevalence of this vulpine infection in Northern Italy decreased from 32% in 1960 to 4% in 1988. Other wild and synanthropic animals also promote the survival of the parasite in nature (in the wolf, bear, stray dog and cat, wild boar, Norway and black rats). At present, human infections are caused mostly by wild boar meat (11% of all cases) and by imported horse meat (43%), whereas pork does not cause infection in man, as a result of a considerable reduction in foraging swine. T. spiralis is absent in our country: only Trichinella sp. 3, less pathogenic in man, is present here. The domestic cycle disappeared in France, while the human infection caused by horse meat consumption now represents an important new health problem. In Switzerland there are no human infections due to consumption of local meat; at present the parasite infects only wild animals. The domestic cycle also disappeared in Austria and at present the parasite survives only in wild mammals especially the fox and the wild boar. On the other hand, in Yugoslavia there are many human cases caused both by domestic and sylvatic cycles. PMID- 2698606 TI - Pathophysiological aspects of Trichinella infection in man. AB - The author presents significant elements of the pathomechanism of general disorders resulting from trichinellosis. Moreover, the pathophysiology of the gastrointestinal phase is also outlined while special emphasis is put on disorders in the early stage of invasion, in the acute stage of the disease associated with other clinical symptoms, and disturbances after other clinical symptoms have subsided. The pathophysiology of muscle invasion deals also with the essential morphological changes within muscle fibers and with biochemical and bioelectric disturbances in muscle tissue. An outline of cardiopathophysiology in the course of trichinellosis is also presented. PMID- 2698607 TI - [Immunology of infection by Trichinella spiralis sensu stricto]. AB - The different aspects of immune response to the nematode Trichinella are considered. The enteral and parenteral phases of infection are evaluated in detail as regards the contribution of different participants: cells (mast cells, lymphocytes, eosinophils, neutrophils, macrophages), antibodies, complement, inflammation mediators, interleukins etc. The genetic regulation of the immune response, the modulation of the immune system by the parasite and finally the situation as regards vaccination are discussed. PMID- 2698608 TI - Recent acquisitions on chemotherapy and chemoprophylaxis of malaria. AB - The most recent acquisitions on chemotherapy and chemoprophylaxis of malaria are reviewed. With regard to chemotherapy, candidate antimalarial compounds have been divided into four groups, according to their stages of development. Mefloquine and the combination of mefloquine with sulfadoxine/pyrimethamine belong to the first group: they have completed clinical trials and have been registered in several countries for routine clinical use. The second group is characterized by chemical compounds which are in an advanced stage of development, including clinical trials. The compounds considered in this group are: a) the 9 phenanthrenemethanols, among which halofantrine is the most promising one; b) the sesquiterpene lactones such as Qinghaosu, artemether, artesunate, artesunic acid and arteether which must be further tested in order to find more effective drug regimens capable of eliminating recrudescences and for the completion of toxicity studies; c) pyronaridine, which appears to be a promising antimalarial, effective also against chloroquine-resistant P. falciparum, but still requiring further investigations on resistance and cross-resistance, as well as its pharmacokinetics, tolerability and bioavailability; d) enpiroline, another promising compound, which needs to be further studied in Phase II and Phase III investigations with naturally acquired malaria. The third group is composed of seven chemical classes of compounds that are in an advanced pre-clinical development, namely: the 4-aminoquinolines, such as dabechin, piperaquine, hydroxypiperaquine, tripiperaquine, dichlor-quinazine and the Mannich base compounds, the 8-aminoquinolines, the 4-quinolinemethanols, the quinolones, the naphthoquinones, the quinazolines and the dihydrotriazines. Among the many antimalarial compounds of interest, which can be considered at the moment as leads for further studies, only the acridandione derivatives such as floxacrine, the antibiotics, antifungal agents or their metabolites, plant substances such as Yingzhaosu A and quassinoids have been mentioned. Malaria chemoprophylaxis, especially in chloroquine-resistant P. falciparum areas, has become a real problem. The attempts to secure protection under these circumstances with the utilization of amodiaquine, the combination of sulfadoxine/pyrimethamine (Fansidar), sulfalene/pyrimethamine (Metakelfin), of pyrimethamine/dapsone (Maloprim), with or without chloroquine, had to be abandoned or to be used with caution in view of the severe complications following the weekly administration of these drugs. The combination of chloroquine with proguanil or chlorproguanil, which could be recommended on theoretical bases, did not meet the expectations when tested in the field. (ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2698609 TI - [The contribution of V. N. Zhedenov to comparative anatomy]. PMID- 2698610 TI - [The immune system and age]. AB - Basing on numerous facts, obtained during last years at investigation of the immune system organs, a definite idea has been formed on peculiarities of their structure during certain stages of human ontogenesis. The immune organs appear early in embryogenesis and by birth they have reached their morphological maturation. This is evident as formation of diffuse lymphoid tissue in lymphoid noduli, that can have germinative centers, where young cells of the lymphoid line are formed. The immune system organs develop especially quickly after birth during first years of the postnatal ontogenesis. The peak in development of the organs of immunogenesis, amount and size of the lymphoid noduli occurs during the childhood and adolescent age. Each immune organ has its peculiarities that are determined by their place in the organism, value and intensity of antigenic effect. Beginning from the adolescence and youth amount of the lymphoid tissue and lymphoid noduli in the organs decreases, in their place connective and adipose tissue grows out. PMID- 2698611 TI - [Age-related characteristics of the stromal-parenchymal relations of the human thymus]. AB - In 155 thymuses and in 57 capsules of the organ, distributed according to 12 age groups, beginning from fetuses of 5 months up to 90 years, age transformations of stromal-parenchymatous relations of the human thymus have been studied and quantitatively estimated. During the postnatal ontogenesis the thymic capsule and its intraorganic connective, tissue frame together with the parenchyma undergo certain phase reorganizations, specific for each age period. The greatest development of the thymic connective tissue frame reaches at the age of 1-3 years and during sex maturation period. The thymic lymphoepithelial tissue exists during all age periods. In the thymic adipose body foci of extramedullary lymphopoesis are revealed, beginning from the first mature up to the elderly age. PMID- 2698612 TI - Primary cerebral lymphoma: presentation of eight cases and review of the literature. AB - Eight cases of primary cerebral lymphoma (PCL) are presented, being the largest Australian series of this rare condition reported to date. The clinical, radiological, anatomical and histological features were found to be comparable with those of patients reported in other series between 1954 to 1986. The precise treatment of PCL remains undetermined due to its rarity and apparent heterogeneity. Whole brain irradiation forms the basis of therapy although the role of prophylactic spinal irradiation, surgery and chemotherapy have not been defined. Response to corticosteroids and chemotherapy has been documented. Reported cases associated with the acquired immune deficiency syndrome (AIDS) are discussed. With an anticipated increase in the number of cases of AIDS, the incidence of related PCL will also increase. Large, multicentric trails are required to further delineate optimal treatment. PMID- 2698613 TI - Localised diffuse histiocytic lymphoma. PMID- 2698614 TI - Acute appendicitis in pregnancy. AB - Acute appendicitis is the commonest nongynaecological surgical problem occurring during pregnancy. Almost 10 year's experience at a large teaching hospital is supplemented with an extensive review of the literature to offer guidelines for diagnosis and management. Symptoms, signs and investigations are unhelpful in diagnosis. The overwhelming message is that because perinatal mortality rises from less than 3% in both uncomplicated appendicitis and negative laparotomy, to 20% in perforated disease, the maxim regarding acute appendicitis--if in doubt, take it out--is never more true than in pregnancy. PMID- 2698615 TI - Effect on pregnancy on gallstone formation. AB - An ultrasound study was carried out to determine the incidence of gallstone formation during pregnancy. One hundred and thirty seven pregnant women attending antenatal clinics were studied; 70 women were primigravidas and 67 were 1 para or more. An ultrasound of the gallbladder was carried out at 20 weeks or less of gestation and a repeat of ultrasound examination was performed soon after delivery. Five women had gallstones diagnosed before pregnancy; 1 of these was a primigravida, the other 4 were para 1 or more. None of the women developed gallstones during pregnancy. This finding suggests that pregnancy is unlikely to be an important factor in gallstone formation. PMID- 2698616 TI - Trauma during pregnancy--a review of management. AB - The assessment and management of 22 pregnant patients who were admitted after trauma to Westmead Hospital between July, 1987 and October, 1988 was reviewed. Thirteen of the 22 patients were victims of motor vehicle accidents. Despite the fact that an injury research unit, responsible for the clerking and review of all trauma patients, is well established at our institution, only 6 patients in this series had been assessed in this fashion. Although a number of important obstetric investigations (albeit uncommon in the accident and emergency room situation) are well described in the literature, these were not performed in a number of patients. A protocol for the management of such patients is recommended so that more standardized and appropriate care might be given to the injured pregnant patient. PMID- 2698617 TI - The polycystic ovary syndrome. PMID- 2698618 TI - Ureteric endometriosis: 3 case reports and a review of the literature. AB - Endometriosis involving the ureter is a relatively rare phenomenon but at least 121 cases have been reported previously. The 3 cases presented in this report emphasize some important facets of this condition: the lack of symptoms leading to late diagnosis, the presence of severe renal damage with very localized pelvic disease, how an incomplete initial operation may lead to further major difficulties, and the failure of medical therapy to halt its progress. The potentially lethal nature of ureteric endometriosis is stressed, and the different treatment modalities for patients of different ages and parity discussed. Surgical management, either conservative or radical, is suggested as the modality of choice, and where conservative operation is undertaken very careful continuing observation of renal function is a necessity. PMID- 2698619 TI - [Catalytic activity of conjugates of peroxidase with progesterone in aqueous and micellar media in the presence of antibodies against progesterone]. AB - At 22 and 41 degrees C the horseradish peroxidase (HRP) conjugates with progesterone, HRP-PROG-1 and HRP-PROG-2, were obtained by HRP reaction with N hydroxysuccinimide ester of 3-O-carboxymethyloxime of progesterone. The interaction of these conjugates and unmodified enzyme with antibodies against progesterone was studied in phosphate-citrate buffer pH 3.6 and in the reversed micelles of Aerosol OT and Triton X-45 in heptane. Catalytic function of conjugates in buffered solutions and in reversed micelles increases as result of the conjugates' interaction with antibodies. The free progesterone in reversed micelles competes with HRP-PROG-1 for antibody binding, which may be the basis for homogeneous enzyme-immunoassay of progesterone, depending on the micelle composition, the antibody concentration and temperature. PMID- 2698620 TI - [Covalent labelling of the Klenow fragment of DNA-polymerase I from E. coli]. AB - Incubation of the Klenow fragment of E. coli DNA polymerase I with [alpha-32P] dNTP (or NTP) results in the covalent radiolabelling of the enzyme, the bond being stable in acid (pH 2) and alkaline (pH 12) conditions and nucleophiles, such as beta-mercaptoethylamine, efficiently inhibiting the labelling. It is suggested that radiolabelling of the enzyme is the result of formation of chemically active products of the radiolysis of [alpha-32P]NTP (which are likely to be radicals). Non-radioactive NTP hinder the labelling, whereas Mg2+ and polynucleotide do not affect it. Cleavage of the enzyme by hydroxylamine and cyanogen bromide and analysis of gel-electrophoretic patterns of the cleavage products led to conclusion that 32P-label is located between Gly-544 and Met-647. PMID- 2698621 TI - [Synthesis of 2-acrylamidoethylglycosides of 3-O-(beta-D- glucopyranosyluronic acid)-alpha-L-rhamnose and 3-O-(alpha-L- rhamnopyranosyl)-beta-D-glucopyranuronic acid and copolymeric artificial antigens based on them]. AB - The synthesis of disaccharide repeating units, D-GlcA-(beta 1----3)-L-Rha (fragment A) and L-Rha-(alpha 1----3)-D-GlcA (fragment B), of the K54-antigenic polysaccharide from uropathogenic Escherichia coli 06:K54:H10 is described. Essential stages of the synthesis of fragment A involved the glycosylation of methyl 2,4-di-O-benzoyl-alpha-L-rhamnopyranoside followed by acetolysis of the methyl bioside obtained and further transformation into 2 (benzyloxycarbonylamino)ethyl glycoside; deprotection and, finally, conversion into 2-(acrylamido)ethyl glycoside. Selective opening of lactone ring in 2 azidoethyl 2,4-di-O-acetyl-beta-D-glucopyranoside-6,3-lactone was used for deprotection of 3-OH group in the synthesis of fragment B. Rhamnosylation of the glucuronic acid derivative thus obtained followed by transformation into 2 (acrylamido)ethyl glycoside and deprotection gave fragment B. Both fragments A and B were converted into artificial antigens of copolymer type. PMID- 2698622 TI - Heat production and growth kinetics of E. coli K12 from flow calorimetric measurements on chemostat cultures. AB - The heat production of E. coli K12 growing aerobically in glucose limited chemostat cultures is determined in the range of specific growth rates mu (= dilution rates D) from 0.058 h-1 to 0.852 h-1 for two different glucose concentrations Se in the instream of the chemostat, namely Se1 = 0.3182 g.l-1 and Se2 = 0.6364 g.l-1. Heat production Q and biomass production P per unit of culture volume show well correlated patterns for Se1 and Se2. For Se1 the highest value Q actually measured is 443.10(-3) W.l-1 at D = 0.74 h-1 with P = 0.068 g.l 1.h-1; and for Se2 593.10(-3) W.l-1 at D = 0.497 h-1 with P = 0.108 g.l-1.h-1. Heat production QB per unit of biomass appears to be independent of Se at least up to D = 0.5 h-1. At higher D there is strong indication that QB possesses a real maximum. The highest value of QB actually measured is 4.8 W.g-1 at D = 0.74 h-1. For Se1 and Se2 there were significantly higher specific growth rates verified in chemostat culture than mu Batchmax = 0.717 h-1 which is the maximum specific growth rate in comparable, unlimited batch cultures. The real maximum of QB is estimated to be in the vicinity of mu Batchmax. This suggests the hypothesis of a maximum principle for the growth in batch culture. For Se1 a closed analytical expression is derived for the relationship between mu and the substrate concentration S. mu[S] features a S-shaped characteristic with mu Chemostatmax = 0.905 h-1; 1/2 mu Chemostatmax is reached at S = 2.85.10(-3) g.l 1. Three basic parameters which characterize the overall metabolism of the cells, namely the heat released per unit of substrate consumed, Qs, the effective yield of biomass, Yeff, and mu Chemostatmax are identified to depend on Se. PMID- 2698623 TI - The ability of ethanolic extract of propolis (EEP) to protect mice against gamma irradiation. AB - Ethanolic extract of propolis (EEP) was tested as a protective agent against gamma irradiation in mice. The mice were exposed to 6 Gy gamma irradiation from a 60Co source, and were treated intraperitoneally with EEP, administered before and after their irradiation. While the non-treated mice expired within 12 weeks, the mice that received a series of EEP treatments survived the irradiation, and their leucocyte count as well as their spleens' plaque-forming activity returned to normal. It is suggested that an antioxidant and a free radical scavenger in the EEP are responsible for the radiation protective effect of the extract of this natural product. PMID- 2698624 TI - Swarming phenomena, basis of a method to identify motile bacteria densitometrically. AB - The swarming phenomenon of 18 strains was tested with the intention to identify motile, swarming bacteria. Not all bacteria which are motile in liquid are able to swarm on semisolid nutrient broth, but all swarming bacteria show characteristic swarming developments, resulting in different swarming zones which could be scanned densitometrically. The densitograms are fully reproducible for the same strain and show similarities between strains of one species. PMID- 2698625 TI - Influence of some carbohydrates and concanavalin A on the adherence of Candida albicans in vitro to buccal epithelial cells. AB - The influence of some carbohydrates and of a lectin, Concanavalin A on the in vitro adherence of ten C. albicans strains to buccal epithelial cells has been assessed. D-glucose, D-galactose and sucrose significantly (p less than 0.005) enhanced the adherence and so did D-mannose (p less than 0.025). Incubation with D-xylose, D-ribose, D-fructose, maltose, lactose and raffinose did not influence adherence. Pretreatment of the fungal cells or epithelial cells with glucose and mannose did not enhance adherence. Concanavalin A significantly inhibited the adherence of fungal cells to buccal epithelial cells both when it was added to the test medium (p less than 0.005) and when the fungal or epithelial cells were pretreated with it (p less than 0.001). PMID- 2698626 TI - Cytotoxicity of Mycoplasma mycoides subspecies mycoides for cultured endothelial cells. AB - Toxic effect of 5 SC- and 4 LC-type strains of Mycoplasma mycoides subspecies mycoides has been demonstrated in cultured endothelial cells. The SC strains are agents of contagious bovine pleuropneumonia and presumably specific for cattle although occasionally isolated from goats. The LC strains produce an acute septicemic disease in goats and a few strains have been reported in cattle. The tissue culture cytotoxic dose causing 75% cell death (TCCD75) was calculated for each strain. Cytotoxicity ranged from 0.9 X 10(9) to 12.0 X 10(9) when strains were tested in bovine endothelial cells with the SC strains being twice as cytotoxic as the LC strains on average. Strains G175/78 and D44 representing the most cytotoxic SC and LC strains respectively, were selected for comparative experiments using bovine, caprine and porcine endothelial cells, bovine embryonic lung fibroblast cells (BELF) and the bovine cell line Madin-Darby kidney cells (MDBK). Strain G175/78 was significantly more cytotoxic for bovine endothelial cells than caprine and porcine, suggesting that the cytotoxicity reflects specificity for the bovine species. This strain was also cytotoxic for BELF but not for MDBK cells indicating that not all bovine cells are susceptible. Conversely, cytotoxicity of strain D44 was not significantly different in any of the endothelial cells tested, although cytotoxicity for BELF was significantly different, the cytotoxicity of the LC strains seems to be of less specificity. PMID- 2698627 TI - Adherence of Mycoplasma mycoides subspecies mycoides to cultured endothelial cells. AB - The LC- and SC-type strains of Mycoplasma mycoides subspecies mycoides were examined for adherence to guinea pig erythrocytes and bovine and caprine endothelial cells. The LC-type strains but not the SC-type strains adsorbed guinea pig erythrocytes and caprine endothelial cells. Difference in cytoadherence was observed between strains of the LC-type. The interaction between the most adherent LC-type strain and caprine endothelial cells was examined by transmission and scanning electron microscopy. PMID- 2698628 TI - A comparative assay of epidemiological markers for Acinetobacter strains isolated in a hospital. AB - A comparative assay for epidemiological evaluation of three different Acinetobacter typing procedures, i.e. biotyping, phage-typing, and the analysis of the bacterial envelope protein profiles, was carried out using sixty-four multiresistant Acinetobacter strains isolated from clinical specimens. The antibiotic susceptibility of the strains was also considered. After geno-species identification, biotyping allowed the recognition of a relatively large and long lasting presence, at an Intensive Therapy Unit, of two A. baumannii biotypes. Phage-typing and the analysis of the susceptibility to antibiotics allowed for the differentiation of strains belonging to different geno-species and biotypes, and in some cases also to the same biotypes. On the contrary, the analysis by polyacrylamide gel electrophoresis of the cell-envelope proteins failed to show any diversity not only within, but also between some of the biotypes of A. baumannii, the most prevalent species of the genus in the hospital environment. PMID- 2698629 TI - Rainbow trout metallothionein gene structure and regulation. PMID- 2698630 TI - Transgenes as molecular probes of mammalian developmental genetics. PMID- 2698631 TI - The mammalian beta-adrenergic receptors. PMID- 2698632 TI - Tissue factor regulation and gene organization. PMID- 2698633 TI - Fish antifreeze protein genes and their use in transgenic studies. PMID- 2698634 TI - [Behavior of the section and arterial suture site in growing subjects]. AB - In order to investigate the possible unwanted late effects of vessel cicatrization during growth, especially after the section and terminal-terminal arterial anastomosis, a study was carried out in 28 piglets using three different surgical anastomosis techniques as well as three different types of sutures. Results show that the smaller the diameter of the vessel and when for its surgical correction suture techniques using separate and combined stitches are used, in addition to non absorbent material, a greater amount of suppression is seen at the site of anastomosis during arterial growth. Less suture material is recommended (of lesser thickness) as well as continuous suture techniques as the diameter of the vessels to be sutured decrease. PMID- 2698635 TI - [Meningitis caused by Bacteroides fragilis in children]. AB - Bacteroides fragilis is an obligated anaerobic bacillus which forms part of the normal intestinal flora of the colon and is often seen as a common pathogen in intraabdominal infections. It is an infrequent pathogen in cases of meningitis; a review of the literature reports only eight cases of this disease in children, especially in neonates with conditioning factors such as abdominal sepsis, chronic middle ear otitis and atrial-ventricular derivations. A case of a newborn baby girl with lumbosacral myelomeningocele is reported. After the defect was surgically corrected, the wound became infected, the stitches opened, the child began to have fever, became irritable and suffered convulsions. The spinal tap showed changes compatible to bacterial meningitis, the bacteria was grown on Shaedler medium. The child was treated with cefotaxime and amikacin showing no satisfactory improvement. Afterwards, a second spinal tap showed Bacteroides fragilis. PMID- 2698636 TI - [Bronchial mucoepidermoid carcinoma in a child]. AB - A case of mucoepidermoid carcinoma in a seven year old girl is reported. This represents the eleventh case of this bronchial neoplasm seen in pediatric ages. For our knowledge this is first case which corroborates by immunohistochemistry, it originates from the salivary bronchial glands. The poor knowledge of this illness frequently delays its diagnosis. We are obligated to report these types of cases in order to have a better understanding of the clinical and pathological presentation of the lesion. PMID- 2698637 TI - [Intestinal trichobezoar: differential diagnosis in children with an abdominal mass]. AB - Due to it's rare appearance, the intestinal trichobezoar is usually not considered as a differential diagnosis of abdominal masses seen in children. A case of a 10 year old girl with a five month evolved inferior hemi-abdominal mass is cited. The girl appeared severely ill and within 24 hours of her physical examination, showed signs and symptoms of an intestinal obstruction. She was admitted to surgery with the diagnosis of a non Hodgkin lymphoma. Due to its' presentation, we may have even supposed it to be a case of Rapunzel syndrome which grew within the intestine causing obstruction or which may have initially grown in the terminal ileum. The medical literature is reviewed. PMID- 2698638 TI - [New approaches in the prevention of diarrhea caused by Escherichia coli]. AB - This article reviews the possibility of preventing diarrhea in young children by knowing how the different enteropathogenic or enterotoxigenic strains of Escherichia coli cause the disease. New approaches on the prevention of diarrheal disease associated to the colonization of these bacteria are discussed based on the response evoked by some of the antigens from maternal milk fed to children with a risk of falling ill at a young age. PMID- 2698639 TI - Molecular basis of complement deficiencies. AB - Genetically determined human complement deficiencies and genetic deficiencies of the corresponding proteins in other species have been recognized for many years. In the past decade, molecular cloning methods have been utilized to deduce the complete primary structure of most of the complement proteins, determine the structure and chromosomal localization of many complement genes, and to define the basis for complement genetic variants including null alleles. PMID- 2698640 TI - Hyper immunoglobulin E syndrome. AB - The Hyper Immunoglobulin E(HIE) Syndrome is a rare disorder of unknown etiology associated with extremely high serum IgE levels, serious recurrent infections and chronic dermatitis. The current paper will review the clinical and laboratory manifestations of the HIE Syndrome and discuss them in relationship to underline immunologic abnormalities found in this syndrome. PMID- 2698641 TI - Hereditary and acquired deficiencies of C1 inhibitor. AB - Angioneurotic edema results from acquired or genetic deficiency of C1 inhibitor (C1 INH), a member of the serpin family of protease inhibitors. C1 INH is the only plasma protease inhibitor of activated C1r and C1s, the serine protease subcomponents of the first complement component. It is also the major inhibitor of plasma kallikrein and of coagulation factor XIIa. C1 INH consists of a single polypeptide chain of 478 amino acid residues. It is the most heavily glycosylated plasma protein; a large portion of the carbohydrate is O-linked to serine and threonine residues. Hereditary angioneurotic edema (HANE) occurs in individuals heterozygous for deficiency of C1 INH. Most patients have absolute deficiency of C1 INH (type 1 HANE), while others (15% of kindred) synthesize a dysfunctional C1 INH protein. The molecular genetic defects in the C1 INH gene in both type 1 and type 2 HANE currently are being defined. Acquired angioneurotic edema (AANE) also is of two types. One of these occurs in individuals with B-cell lymphoproliferative disorders (type 1) and the other is characterized by the presence of autoantibodies directed toward the C1 INH molecule. PMID- 2698642 TI - Cytotoxic T lymphocytes in HIV-induced disease: implications for therapy and vaccination. AB - The immune response to HIV in infected humans leads to the production of HIV specific cytotoxic T lymphocytes (CTL) which circulate in high frequencies. The presence of these CTL and their eventual protective activities have been studied by various laboratories, and correlations have been made with certain immunopathological manifestations of HIV infections. It seems probable that HIV immune CTL participate in the induction of certain disorders by initiating inflammatory reactions in the lungs, central nervous system and lymph nodes. Various virus antigens recognized by HIV-immune CTL on the surface of the infected cell have been identified, and molecular definition of the epitopes recognized is well under way. Likewise, numerous HLA transplantation antigens that regulate HIV antigen recognition by CTL have been identified. These data are discussed with regard to the eventual development of a vaccine and of functional immunotherapies. PMID- 2698643 TI - Clinical and immunologic aspects of Kawasaki disease. AB - Kawasaki disease (KD) is an acute febrile disease of infancy and early childhood characterized by diffuse vasculitis. Although the disease is generally self limited, 15-25% of children with KD may develop coronary artery aneurysms, and sudden death due to cardiovascular complications can occur. The acute phase of KD is characterized by marked activation of the immune system, increased cytokine production by immune effector cells, and the generation of cytotoxic antibodies directed against vascular endothelial cells stimulated with cytokines. High-dose intravenous gammaglobulin (IVGG) treatment is effective in preventing the occurrence of coronary artery disease in KD. Treatment of patients with IVGG results in a significant increase in circulating suppressor T cells, a decrease in circulating activated helper T cells, and a decrease in spontaneous IgG and IgM synthesis. These observations suggest that IVGG reduces the vascular injury in KD by suppressing the marked immune activation associated with this disease. PMID- 2698644 TI - The use of HLA-non-identical T-cell-depleted marrow transplants for correction of severe combined immunodeficiency disease. AB - Since the introduction of methods for depleting T lymphocytes from human allogeneic marrow grafts in 1980, such transplants have been increasingly used as a source of lymphoid progenitors for the curative treatment of patients with lethal genetic disorders of immunity who lack an HLA matched sibling donor. This review of the results of HLA-haplotype disparate T-cell depleted marrow grafts applied to the treatment of severe combined immunodeficiency (SCID) indicates that such transplants can lead to durable engraftment and successful reconstitution of immune function without severe graft vs. host disease in a high proportion of cases. Resistance to engraftment and selective abnormalities of B cell development and function in the post transplant period constitute major obstacles to the success of these transplants. However, considerable progress has been made towards the elucidation of the cellular mechanisms responsible for graft resistance, graft-host tolerance and either the full or limited immunologic reconstitutions achieved. PMID- 2698645 TI - AIDS vaccines: concepts and first trials. AB - Two categories of obstacles impede the development of an AIDS vaccine. Virological obstacles are due to lentiviruses, to which HIV and SIV belong, having developed strategies to escape the immune responses of infected hosts and establish persistent infection. These strategies are based on two mechanisms: latency corresponding to restriction of viral gene expression that renders the virus antigenically invisible, and variability, the consequences of which are antigenic shift and permanent adaptation to selective pressures. Immunological obstacles are linked to a central unanswered question: is the global effect of the immune response against HIV beneficial or deleterious to the host and, if beneficial, is it able to resist the virally induced immunosuppression? These obstacles are difficult to overcome theoretically and empirical trials are necessary; live attenuated or recombinant vaccines, inactivated vaccines, subunit vaccines, anti-idiotypes, and synthetic and chimeric vaccines are currently being tested in animals or in humans. At present, promising results have been obtained with inactivated virus vaccines with the use of macaque monkeys infected by SIV as a model. PMID- 2698646 TI - Intravenous immunoglobulin: a review. AB - Intramuscular immunoglobulin products developed for the prophylaxis of viral diseases and used in replacement therapy in immunodeficiency diseases have been superseded by products suitable for intravenous administration. Modified and intact immunoglobulin preparations are available for therapeutic use; only the intact products express full Fc-mediated function and the biological half-life of IgG (3-4 weeks). While adverse reactions to intravenous immunoglobulin (IVIG) do occur, they are infrequent. Rare clusters of non-A, non-B hepatitis after the use of some lots of IVIG have been reported. Transmission of HIV has never been documented. The administration of IVIG in replacement therapy in primary immunodeficiency syndromes and in secondary immunodeficiencies, as well as for the prevention and treatment of infectious diseases, is discussed, and reports of the use of IVIG for immune modulation in autoimmune and immune-complex disease are summarized. PMID- 2698647 TI - [Adherence of Candida albicans to acrylic dentures used in our area]. PMID- 2698648 TI - Molecular cloning of sequence-specific DNA binding proteins using recognition site probes. AB - Genes encoding sequence-specific DNA binding proteins can be isolated by screening lambda gt11 expression libraries with recognition site DNAs. This strategy is derived from that developed for the isolation of genes using antibody probes. Many different genes encoding transcriptional regulatory proteins have been cloned using this strategy. The DNA binding domains of these regulatory proteins contain different structural motifs including the helix-turn-helix, the "zinc finger" and the "leucine zipper". Various aspects of the screening strategy are evaluated and a detailed protocol is provided. In addition to binding site DNAs, protein and nucleotide probes have been successfully used to screen expression libraries. Therefore ligand based expression screening may be quite general in scope. PMID- 2698649 TI - Efficient site-directed in vitro mutagenesis using phagemid vectors. AB - Several methods have been developed that enhance the efficiency of in vitro, site directed mutagenesis. Kunkel (8,9) has developed a method which uses a strong selection for the mutated strand and, hence, is highly efficient, but yet simple and rapid. This method originally used M13 phage as the vector. In this paper, we describe a refinement of this method using phagemid vectors, which combine the advantages of plasmids (such as high copy number and stability of cloned DNA) with the single-stranded DNA generating capability of M13 phage. We demonstrate that high efficiency of mutant production can be obtained with these vectors. We also analyzed by sequencing 11 mutated clones and found no second-site mutations, suggesting that alterations other than the site-directed mutation rarely occur in our system. PMID- 2698650 TI - A calcium-dependent antibody for identification and purification of recombinant proteins. AB - We report a straightforward methodology for purification of recombinant proteins by incorporating a short hydrophilic peptide marker segment at their N-termini. A calcium-dependent antibody that reacts primarily with the first three amino acids of this peptide segment was used to affinity purify the fusion proteins in a single chromatographic step. The marker peptide could subsequently be removed by proteolysis with the enzyme enterokinase. PMID- 2698651 TI - Computer-aided mapping of specific neuronal populations in the human brain. AB - Antibody-staining methods and computer-aided microscopic systems have been used to generate high-resolution panoramic maps of specific neuronal populations in the human brain (4,6,11). This report focuses on the problems inherent in attempting high-resolution mapping of large brain sections, and describes how they are solved by computer-aided mapping. Further applications of computers to the study of brain structure are considered. PMID- 2698652 TI - REFERENCE UPDATE and REFERENCE MANAGER: personal computer programs for locating and managing references. AB - REFERENCE UPDATE (a trademark of Research Information Systems, Inc.) is a diskette-based service which provides subscribers with a weekly update on the latest publications in biology and medicine. REFERENCE MANAGER (a registered trademark of Research Information Systems, Inc.) is a microcomputer-based software package developed to manage selected references for quick retrieval and bibliography generation. These two systems allow scientists to build and update a personalized data base of references. The following article gives an overview of REFERENCE UPDATE and REFERENCE MANAGER and provides a description of the various functions each system offers. PMID- 2698653 TI - PCR and DNA sequencing. AB - Specific DNA segments defined by the sequence of two oligonucleotides can be enzymatically amplified up to a millionfold using the polymerase chain reaction (PCR). One of the most significant uses of this technique is for generation of sequencing templates, either from cloned inserts or directly from genomic DNA. To avoid the problem of reassociation of the linear DNA strands in the sequencing reaction, ssDNA templates can be produced directly in the PCR or generated directly from dsDNA by enzymatic treatment, electrophoretic separation or affinity purification. By combining PCR with direct sequencing, both the amplification and the sequencing reaction can be performed in the same vial. Finally, use of fluorescently labeled terminators or sequencing primers will allow the whole procedure to be amenable to complete automation. PMID- 2698654 TI - Graphic representation of long DNA sequences by the method of H curves--current results and future aspects. PMID- 2698655 TI - Rapid generation of subclones for DNA sequencing using the reverse cloning procedure. AB - A fast and reliable procedure for generating subclones necessary for sequencing long stretches of DNA has been developed. The reverse cloning procedure involves cloning a fragment of DNA into a single-stranded plasmid or phage vector containing a polycloning region; synthesizing variable lengths of double-stranded DNA using a "Universal Primer"; isolating the double-stranded DNA; and force cloning the double-stranded DNA fragments into a complementary vector with the polycloning region in the reverse orientation. The resulting clones can be sequenced, using the same Universal Primer and T7 DNA polymerase, to provide overlapping DNA sequences. The reverse cloning procedure can be used to construct deletion mutations. PMID- 2698656 TI - Amplification of large RNAs (greater than 1.5 kb) by polymerase chain reaction. PMID- 2698657 TI - A streamlined, low ionic strength DNase I footprinting reaction. PMID- 2698658 TI - A rapid method for large-scale isolation of plasmid DNA by boiling in a plastic bag. PMID- 2698659 TI - Inexpensive micro-electroelution apparatus for extracting DNA from acrylamide and agarose gels. PMID- 2698660 TI - A convenient method to increase the number of readable bases in DNA sequencing. PMID- 2698661 TI - Sequence analysis of a human gene responsible for drug resistance: a rapid method for manual and automated direct sequencing of products generated by the polymerase chain reaction. AB - We developed a system for rapid, manual and automated sequence analysis by utilizing and modifying methods used in conjunction with the polymerase chain reaction (PCR). We are using these techniques to detect single base mutations in the dihydrofolate reductase (DHFR) gene giving rise to methotrexate (MTX) resistance of tumor cells obtained from patients with malignancies. Amplifying in vitro both genomic DNA and transcripts of the human DHFR we are able to reproducibly generate single-stranded templates. Utilizing [alpha-35S]dATP and both the universal and reverse sequencing primers we obtain sequence information from either strand. The methods described have been successfully used for automated sequencing with the Applied Biosystems Model 370A Sequencer using both modified T7 DNA polymerase and Taq I. DNA polymerase for dideoxy-termination sequencing. The use of this methodology to detect a single base change in a human colon carcinoma cell line, HCT-8, is illustrated. PMID- 2698662 TI - Automated methods for single-stranded DNA isolation and dideoxynucleotide DNA sequencing reactions on a robotic workstation. AB - Automated procedures have been developed for both the simultaneous isolation of 96 single-stranded M13 chimeric template DNAs in less than two hours, and for simultaneously pipetting 24 dideoxynucleotide sequencing reactions on a commercially available laboratory workstation. The DNA sequencing results obtained by either radiolabeled or fluorescent methods are consistent with the premise that automation of these portions of DNA sequencing projects will improve the reproducibility of the DNA isolation and the procedures for these normally labor-intensive steps provides an approach for rapid acquisition of large amounts of high quality, reproducible DNA sequence data. PMID- 2698663 TI - A system for on-line detection and resolution of radiolabeled DNA molecules and its application to automated DNA sequence analysis. AB - We describe a system for the real-time detection of radioactively labeled DNA molecules in gel matrix, and we demonstrate the application of this system to DNA sequence analysis. DNA sequencing reactions prepared by the Sanger chain termination method are resolved by electrophoresis on 8% polyacrylamide gels. During electrophoresis the 32P-labeled DNA fragments are detected by solid state detectors positioned 22 cm from the top surface of the gel. This system is able to resolve a DNA sequence of 300 bases or greater. Optimized protocols that allow sequence information to be obtained from single stranded and double-stranded templates are described. A linear relationship exists between the input dpm and the integrated peak values over a 20-fold range indicating that accurate DNA quantitation is also possible using this system. PMID- 2698664 TI - Site-directed deletion mutagenesis using phagemid vectors and genetic selection. AB - Oligonucleotide-directed mutagenesis was used along with the dut and ung genetic selection method of Kunkel to introduce large site-specific deletions into cDNAs cloned into phagemid vectors. We find that large deletions can be achieved with an efficiency equal to that of single point mutations, with a very low frequency of aberrent clones. To facilitate screening of clones, E. coli strain DH5 alpha was used as the recipient host cell to genetically select for deletion mutants. Comparisons were made to deletion mutagenesis without genetic selection, and to reactions utilizing two oligonucleotide primers simultaneously. The low frequency of deletion mutants observed without genetic selection renders random screening for deletion mutant clones cumbersome. The results provide representative expectations and a useful guide for those contemplating the construction of deletion mutants. PMID- 2698665 TI - A new oxygen-regulated promoter for the expression of proteins in Escherichia coli. AB - Several properties of a new oxygen-regulated promoter, OXYPRO, were tested in small-scale Escherichia coli cultures. Using OXYPRO, maximal activity of a reporter gene encoding chloramphenicol acetyltransferase (CAT) occurred in cultures that were tightly capped immediately after inoculation. This is probably a result of the reduced oxygen concentration attained in capped cultures, a condition known to be required for OXYPRO induction. CAT levels were significantly higher when the cells were grown in a glycerol-based medium. Similar levels of CAT expression were obtained when OXYPRO was compared to the trp-lac (tac) promoter. In addition, regulated expression of CAT occurred in a wild type strain of E. coli, suggesting that OXYPRO will be useful in most E. coli strains. Thus, OXYPRO provides a simple, inexpensive, and unobtrusive method to achieve high levels of cloned protein expression in most strains of E. coli. OXYPRO is available in a high copy plasmid with a convenient multiple cloning site for the insertion of genes for direct expression in E. coli. PMID- 2698666 TI - Localizing distribution of beta-glucuronidase in individual cells. PMID- 2698667 TI - A safe and efficient method of loading radiolabeled probe into blotting bags. PMID- 2698668 TI - Cell surface receptors for polypeptide hormones, growth factors and neuropeptides. PMID- 2698669 TI - Immune regulation and haemopoiesis. PMID- 2698670 TI - Inositol lipids and phosphates. PMID- 2698671 TI - Protein kinase C and tumor promoters. PMID- 2698672 TI - Regulation of calcium in non-excitable cells. PMID- 2698673 TI - Cyclic nucleotides and disease. PMID- 2698674 TI - Protein phosphorylation and dephosphorylation. PMID- 2698675 TI - Mechanisms of cell toxicity. PMID- 2698676 TI - The Escherichia coli chromosome and its replication. PMID- 2698677 TI - Yeast cell cycle. PMID- 2698678 TI - The cell cycle in lower eukaryotes. PMID- 2698679 TI - DNA replication and its control. PMID- 2698680 TI - Temporal regulation of gene expression during the mammalian cell cycle. PMID- 2698682 TI - Bibliography of the current world literature. PMID- 2698681 TI - Oncogenes. PMID- 2698683 TI - [Giant axonal neuropathy. Presentation of 2 familial cases]. AB - A review of 20 cases of giant axonal neuropathy (4 of them familial) described in the literature, and two new cases in brothers whose parents had no consanguinity is reported. A recessive autosomic pattern of inheritance is suggested. Curly hair, a typical phenotypic feature, was not initially present in our cases. This feature developed, however, later in the older brother. Clinical manifestations include an early predominantly motor polyneuropathy, subsequently involving the central nervous system. Clinical course is progressive and gait becomes impaired by the age of 10 to 13 years. Electrophysiologic studies show an axonal polyneuropathy with decreased evoked potential amplitude in motor and sensitive conduction speed. Diagnosis is achieved through a sural nerve biopsy showing an axonal thickening. Electron microscopy shows this to be related to a neurofibrillar accumulation. PMID- 2698684 TI - [The mechanism of mutation in relation to evolution and radiation]. PMID- 2698685 TI - A new gene responsible for an energy-transducing system in Escherichia coli. AB - A mutant strain (ttr-3) of Escherichia coli was originally isolated as a strain resistant to tributyltin exhibiting temperature-sensitive depressions of growth and ATP synthesis on succinate plates at 42 degrees C. The ttr gene was mapped between the pyrE and dnaA genes (in the 82-83 min region) on the chromosome by P1 transduction experiments. Comparison of proline transport and oxygen uptake by membrane vesicles of the wild-type transductant and the mutant (ttr-3) transductant showed that membrane vesicles of the mutant exhibited temperature sensitive decrease of proline transport and increase of oxygen uptake at the restrictive temperature (42 degrees C), compatible with depression of growth of the mutant at this temperature. Therefore, the ttr gene seems to code for some factor involved in the respiratory chain that is present in the inner membrane of Escherichia coli. PMID- 2698686 TI - Composition of eukaryotic gene loci regarding gene conversion units and the presence or the absence of intralocus reciprocal recombination. AB - In Sordaria fimicola, the g-locus is composed of a single convertron and does not show intralocus reciprocal recombination. On the contrary, the i-locus is composed of multiple convertrons and shows genuine intralocus reciprocal recombination. PMID- 2698687 TI - [Clinical investigation must always be possible...]. AB - The author reports his Research Group and the Iberian Multicentre Group experiences in order to find a therapeutical solution for the rupture of the ventricular free wall (WR) in acute myocardial infarction (AMI). The study includes seven phases. In a 1st phase of the study it was confirmed, by retrospective analysis, that the WR in AMI was a frequent event. In the 2nd phase of the investigation proceeding it was decided to set up a prospective anatomical and clinical protocol to evaluate this entity. Necropsic studies were performed in 71% of the patients who died in UTIC and we verified an incidence of 26% of WR in AMI. The WR were not uniform, in what concerns necropsic and clinical findings. The 3rd phase of the study consisted in the discrimination not only of the anatomo-pathological pictures but also of the clinical ones of this entity. Under the morphological point of view four types of rupture were described and the patient profile with AMI who has WR risk was defined. During the 4th phase of the study the progressive WR was identified and defined which was found in approximately 50% of the cases, corresponding the WR to a terminal accident with an average duration of 4 hours in the so called type 2, and of 10 h 50 min in the so called type 3. In the 5th phase of the study the objective consisted in the evaluation of the importance of the Ecocardiography and of the Hemodynamical Examinations with Swanz-Ganz catheter in the WE diagnosis. Based on the referred criteria it was possible to operate on 37 cases in Madrid (57% of mortality) and 6 cases in Lisbon (2 deaths). We are now in the 6th phase of the study. It consists in the diffusion of a medical and surgical approach fluxogram of patients with WR in AMI. In the end of this Editorial the author discusses the role of arterial hypertension, physical activity, anticoagulant and fibrinolitic therapeutics, microcirculation characteristics haemorheological changes in the WR genesis during AMI. PMID- 2698688 TI - [Intraventricular thrombi in acute myocardial infarct. Clinicoanatomic study carried out in 193 consecutive cases]. AB - AIMS: To determine the incidence of intraventricular thrombi in patients who died of acute myocardial infarction, as well as to define the clinico-anatomical parameters of the population with thrombi. CONCEPT OF THE STUDY: To apply a clinical as well as an anatomical protocol of prospective study, in patients who died of acute myocardial infarction. The clinical protocol contemplates 64 parameters and the anatomical protocol contemplates 34. in the anatomical study were used very discriminative technics, already presented in previous papers. PLACE OF THE STUDY: The study took place in a CCU and pathological department of an University Hospital. MATERIAL AND METHODS: 193 patients who died successively of acute myocardial infarction in a CCU between 1983 and 1986. The only criteria for the inclusion in the study was the possibility of doing a necropsy study, which was done in 77% of the patients who died in that period. The study was a prospective one, being excluded only the patients in whom the anatomical study didnt confirm recent myocardial infarction. The clinical data were observed during the stay in the CCU using a protocol developed for this study. In the anatomical study a protocol developed by the authors was applied, using very discriminative anatomical quantification technics of the infarct size as well as of the coronary obstruction degree by atherosclerotic plaques. All data were stored and treated in a computer program developed for this study. RESULTS: From the 193 cases that have been studied, 88 (43%) presented thrombus in at least one of the ventricular cavities, 38 (26%) only in left ventricle, 15 (8%) only in right ventricle and 35 (18%) in both ventricles. The set with thrombus has presented a few characteristics which granted it some individuality. Thus, this group presented: a higher delay between the beginning of acute myocardial infarction and the admission in the CCU (and so in the beginning of the anticoagulant therapy), lower prevalence of diabetes, higher prevalence of left ventricular failure (Killip class III or IV), higher prevalence of cardiogenic shock and so a higher need of inotropic therapy, higher heart weight, higher prevalence of auricular thrombi and bigger infarct size when evaluated by a QRS score. In the group with left ventricular thrombi, the anterior infarct was more frequent and in the group with right ventricular thrombi the right ventricular infarct was also more frequent. The systemic embolism was uncommon in this group (1 case in 193 patients). CONCLUSIONS: 1. The intraventricular thrombi occurs in about half of the patients who died of acute myocardial infarction. 2. The group with thrombi has presented some characteristics which makes it different from the group with no thrombi. 3. The delay in the beginning of the anticoagulant therapy seems to be a risk factor of intraventricular thrombosis. PMID- 2698689 TI - [CD-ROM. The appearance of a new papyrus]. AB - The emphasis given to specialized information is referred, specially in what social development, particularly in biomedicine, is concerned. MEDLINE on CD-ROM is defined in ways of functioning, targets and basic skills of exploitation, in order to render profitable the potentialities in the bibliographic search. Finally, the advantages of MEDLINE on CD-ROM are stressed when compared with the online search. PMID- 2698690 TI - [Diabetes mellitus and coronopathy]. AB - Diabetes Mellitus represents an important public health problem in the most developed industrialized countries. Clinical presentations of diabetes are strongly related to the cardiovascular system, namely, coronary disease and angiopathic renal failure. Diabetes modifies the clinical course of arteriosclerosis by carrying the angiopathic process to a microvascular level, where typical microangiopathic lesions can be observed. The risk of developing atherosclerotic disease is 2-3 fold higher in diabetics than in nondiabetics and arterial hypertension reaches a prevalence of 40 to 80%. Authors analyse Arterial Hypertension in the context of Diabetes putting focus on the underlying pathophysiological mechanisms. Where considering the coronary disease (CD), its high prevalence among the diabetics is also emphasized, which is expressed by an increase of morbidity and mortality when compared to normal subjects. In diabetics not only the incidence of Acute Myocardial Infarction is higher, but also the long term prognosis is more complicated, a reality that the authors try to explain by anatomic and metabolic factors. The association of Diabetes plus hyperlipidemia represents undoubtedly one of the major factors that justify the worsening and progression of CD. Briefly, some interesting points that allow the understanding of this topic are described, pointing the pathogenic differences of types I and II and the clinical implications of their knowledge. Finally, the approach of Diabetes as a cardiovascular risk factor is discussed in a prophylactic perspective. PMID- 2698691 TI - [Variant angina]. PMID- 2698692 TI - [Anthracycline cardiotoxicity. Review of the literature and presentation of a study protocol]. AB - Anthracyclines are drugs with widespread applications on the chemotherapy of cancer. Cardiotoxicity is an important side effect of these drugs, well known for doxorubicin, the most representative of this group of drugs. Dysrhythmias and heart failure are the most important among the toxic effects of anthracyclines and are dependent on cumulative doses reason why WHO established maximal doses for the different anthracyclines. Pathogenic hypothesis about the mechanism of the myocardial lesion induced by anthracyclines include the production of free oxygen radicals, alterations of energetic metabolism and disturbances of calcium and sodium exchange at membrane level. Early detection of the toxicity of these drugs is of utmost importance. Electrocardiography has low sensitivity and specificity. Echocardiography gives specific information about previous cardiac pathology and enables the detection of complication of the basic neoplastic disease. However, detection of early changes of left ventricular function is not accomplished so well, as it is with equilibrium radionuclide angiography. Left ventricular ejection fraction is the method of choice in the early detection of cardiotoxicity of these drugs, and its frequent evaluation enables to individualize the doses in each patient, and so, a most accurate use of the therapeutic potential of the anthracyclines. Radionuclide angiography has some important indications on the selection of patients for treatment with anthracyclines, namely: to identify patients that must be excluded from the treatment; select patients at risk of congestive heart failure; to decide the appropriate moment to stop the drugs; change the therapeutic schema, etc.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698693 TI - [Hemorrheologic aspects of congestive heart insufficiency]. AB - Congestive heart failure is characterized by increased blood volume and abnormal salt and water retention behind one or both ventricles and restricted systemic blood perfusion. Blood hyperviscosity, as one of the two major determinants of the overall resistance, also contributes significantly to the lowering of blood flow in the macrocirculation and microcirculation. The observed loss of the red cell deformability together with higher plasma viscosity and suggested increase on the aggregation of red cells, might be important factors determining blood hyperviscosity, therefore contributing for pathological situations of hypoperfusion or intravascular stagnation. PMID- 2698694 TI - [Thrombolysis in acute myocardial infarct]. PMID- 2698695 TI - [Difficulties in the diagnosis of silent myocardial ischemia using continuous ambulatory electrocardiographic monitoring--the Holter method]. AB - After a retrospective review of the silent myocardial ischemia (SMI) clinical interest and the technical evolution that enabled SMI detection and valuation over the last few years, the author reports the generic limitations of the Ambulatory Electrocardiographic Monitoring (AEM) and its specific difficulties in relation to the SMI, considering: 1. patient inherent difficulties; 2. patient ECG difficulties and 3. technical difficulties. Finally, a critical comparison between AEM and stress test utilities in the SMI setting is done and a strategy for the selection of the patients is proposed. PMID- 2698696 TI - [Anticoagulant therapy in acute myocardial infarct and unstable angina]. PMID- 2698697 TI - [Valve insufficiency. Evaluation using color Doppler]. AB - Color Doppler is undoubtedly in the last years main breakthrough in the non invasive definition of regurgitant flows. The detection and quantification of the regurgitant streams, the study of their spatial distribution, the appraisal of their relationships, to anatomical structures, meant a new sight of the physiopathology of valvular insufficiencies. Although this method has an immediate quantitative and qualitative clinical diagnostic interest, its limitations and pitfalls need further investigation. This improvement of technical quality of the equipment and the lowering of its price will surely extend its application beyond its actual limits making color Doppler a routine diagnostic tool in the evaluation of the cardiac patient. PMID- 2698698 TI - [Myocardial infarct after the acute phase--the risk of arrhythmia]. AB - Upon the development, divulgation and improvement of the Ambulatory Electrocardiographic Monitoring (AEM) techniques, the problem of the arrhythmias after an acute myocardial infarction (AMI) has acquired a new acuteness. Its importance becomes clearly evident from the fact today recognized that about 10% of the patients die within the first year after AMI and that the great majority of them dies suddenly. The prognostic value of certain types of ventricular arrhythmias is now well proved to be an independent risk factor respecting to the late complications of AMI, namely the sudden death issue. In this paper, after referring the prognostic criteria for the ventricular arrhythmias, the Author proposes an AEM execution calendar for the AMI patients, since the late hospital phase (hospital discharge). Afterwards, the controversial therapeutic problem of the ventricular arrhythmias is approached, quoting the pharmacological set-backs and pointing out the AEM limitations in regard to the selection and efficacy confirmation of the anti-arrhythmic drugs. At last, a few conclusions of the "Cardiac Arrhythmia Pilot Study" (CAPS, 1986) are mentioned and an other ongoing multicenter study is referred, whose conclusions will be of capital importance to define the anti-arrhythmic therapy utility in the setting of the post-AMI patients. PMID- 2698699 TI - [Congestive heart insufficiency as the end-stage of several nosologic entities]. AB - Heart failure is the final state of virtually all forms of primary or secondary heart disease. In this abnormal pathophysiological syndrome, a wide spectrum of clinical physiological cardiac states (congenital, valvular, rheumatic, hypertensive, coronary and cardiomyopathic) as well as some hyperkinetic circulatory/metabolic states leads to a low, normal or even high cardiac output- inadequate, however, in front of the requirements of the metabolizing tissues. In this revision article the A.A. successively consider the main causes of cardiac circulatory failure, pointing out, at the end, the usefulness of recognizing the underlying and the precipitating causes of heart failure, in order to rapidly establish the appropriate therapeutic and preventive approaches. Four clinical cases are presented illustrating some of the underlying "treatable" causes of heart failure systemic hypertension, iatrogenic hypophosphatemia, chronic alcoholism and hemochromatosis. PMID- 2698700 TI - [Congestive heart insufficiency. Prophylactic aspects]. AB - Since the therapeutic advances prolong survival of many patients suffering from cardiovascular pathology--the prevalence of chronic heart failure (CHF) had just doubled, being a common entity in a world whose individuals present a great increase in longevity. These considerations justify the renewed interest in this particular syndrome. Concepts, pathophysiology and compensatory mechanisms are briefly summarized, putting emphasis on the advantage of pharmacologically interrupt the vicious loop of the compensatory mechanisms, that could play a deleterious role in the syndrome. Neurohormonal responses and the "pivotal" role of angiotensine II in CHF pathology are also discussed, emphasizing the benefits of angiotensin converting enzyme inhibitors (ACEI) when treating patients presenting heart failure. Questions addressed to its prescription at an early stage, (classes II and III of NYHA--to prevent the progressive exhaustion of the failing heart) are also considered. When approaching the preventive measures in a wide perspective, primary, secondary and tertiary types of preventive options are described. ACEI use for the least advanced clinical stages of CHF (class II and III) would represent a tertiary type of CHF prevention. PMID- 2698701 TI - [Large trials in hypertension]. AB - Arterial Hypertension is an important public health problem due to its high prevalence, and consequences in terms of strokes, particularly in Portugal. The benefits of medical treatment of moderate and severe arterial hypertension are well documented. Some doubt persist in relationship to the indications to treat mild hypertension. This arises from the contradictory results of the great clinical trials. Some recent data suggests that the use of thiazide in low dosage, and cardioselective betablockers, in smokers, offers some hope. PMID- 2698702 TI - [Who should be treated? How should they be treated? What has changed in arterial hypertension therapy?]. AB - The author briefly revises the paradoxical changes that occurred in hypertension treatment, according the answers to the two following questions: Who to treat? How to treat? Emphasizes the main importance of non-drug treatment for the preservation of the hypertensive's quality of life and hyperadrenergic responses control. Concludes that the hypertension treatment is so individualized as conditionated by a lot of factors (drug efficacity in lowering blood pressure levels, concomitant risk factors and cardiovascular diseases, own patient's adherence or preference, etc.). PMID- 2698703 TI - [Role of the systolic time interval in evaluating left ventricular dysfunction]. AB - The systolic time intervals (STI) and specially the PEP/LVET ratio, can be used as noninvasives indexes of left ventricle performance. They can provide effective informations about left ventricle disfunction in situations such as acute myocardial infarction. So we emphasize the estimate of evolution of STI in the same patient more than its comparison with normal values. The measurements of STI proved to be simple and can be repeated serially. We conclude that this is an useful method for the monitoring of cardiac function and the evaluation of the impact of therapy on its course. PMID- 2698704 TI - [Significance of the exercise test in studying patients with heart insufficiency]. AB - Assessment of functional capacity of patients with heart failure by means of exercise tests has recently become a new field of investigation for this diagnostic technique, constituting an incursion into an area so far out of its domains. It has been demonstrated that the functional capacity of these patients has a diagnostic and prognostic value, in addition to being the most accurate method to evaluate therapeutic effects. In patients with valvular disease, the performance of an exercise test, especially if other techniques are simultaneously being used, both invasive (catheterization) and non-invasive (respiratory parameters, isotopic angiography), yields very precise information, as regards for instance the determination of the correct timing for surgical repair, as well as prognostic information in some situations, such as aortic insufficiency. PMID- 2698705 TI - [Congestive heart insufficiency. Evaluation using isotopic methods]. AB - Radioisotopic cardiac studies became, on the last decade, one of the more useful non-invasive methods for the diagnostic evaluation and follow-up of patients with heart disease. Such a contribution of nuclear cardiology is specially noticeable on ischemic heart disease: radionuclide angiography (RNA) allows quantification of left and right ventricular dysfunction, and therefore stands as an ideal technique for the prognostic approach of congestive heart failure. As to diagnosis, RNA is useful in the analysis of regional wall motion abnormalities of ischemic heart disease and detection of ventricular aneurysms. Clinical examples are given of these specific situations. In dilated cardiomyopathies RNA gives not only a measure of ventricular dysfunction, but also a diagnostic information, often definitive, of the diffuse involvement of all left ventricle, and commonly of the right ventricle. Ischemic heart disease, on the other hand, displays different degrees of segmental wall motion impairment together with areas of normal contractility. These aspects are documented with cases of our Registry. Also discussed is the inotropic stimulation technique for the evaluation of the functional reserve of left ventricle in patients with severe rest L.V. dysfunction. Focus is given to the clinical value of isotopic studies for the quantification of valvular regurgitations and pre-operative serial studies in order to define an optimum surgical timing. An attempt is done to grade the practical importance of the different exams of Nuclear Cardiology on the diagnostic and prognostic evaluation on heart disease patients, with a cost benefit relation perspective and comparing with other methods, classic of recent ones, available for the management of patients with heart failure. PMID- 2698706 TI - [Cardiovascular effects of familial amyloidotic polyneuropathy of the Portuguese type]. PMID- 2698707 TI - [Hyponatremia--new concepts and therapy. Apropos of a clinical case]. AB - The therapeutic approach of hyponatremia is reviewed, and the authors describe their recent experience of a clinical case of a woman with acute hyponatremia. After analysing the main publications of the last years, they conclude that the way of correcting hyponatremia largely depends of its acute or chronic character. Chronic hyponatremia must be corrected with slow rate infusion of sodium chloride (0.5 mmol/l/h), and acute hyponatremia with a rapid (2 mmol/l/h) or intermediate (1-1.5 mmol/l/h) rate of infusion of the same solution. This is the current advisable approach, until a new better orientation will virtually be clarified by further prospective studies. PMID- 2698708 TI - [Role of hemodynamic studies in evaluating left ventricular insufficiency in acute myocardial infarct]. AB - Left ventricle (LV) disfunction is the main cause of death in patients suffering from acute myocardial infarction (AMI) who are admitted to Coronary Care Units. Therefore, it is easily understandable that the study of LV performance is of paramount importance in the choice and evaluation of the efficacy of therapy, as well as in the prognosis of patients with AMI. In the first section of this paper, the authors analyze the physiopathology of LV disfunction during AMI; in the second section, based upon a study of 480 patients, they value the contribution of hemodynamic examination with the Swan-Ganz catheter in the evaluation of the cardiac function and in the prognosis of patients with AMI. PMID- 2698709 TI - [From cardiac catheterization to the study of left ventricular function. Importance of relaxation and diastole in ischemic cardiopathy]. AB - Some of the most recent developments on left ventricular function derived from Brutsaert's work on triple control of contraction and relaxation, and on the new division of the different phases of the cardiac cycle, are reviewed. This allows a re-assessment of the different hemodynamic parameters obtained from cardiac catheterization, which were then applied to relaxation and diastole and to coronary artery disease. PMID- 2698710 TI - [Myocardial biopsy]. AB - After a short historical introduction the indications for myocardial biopsy are discussed with focus on the more controversial among them. The probable directions of development of its indications are then analysed and finally its complications are reviewed pointing out their extreme rarity specially the more severe ones. PMID- 2698711 TI - [Alcohol and the heart]. AB - Alcohol, above certain levels in blood, becomes a depressor of myocardial fiber. Excessive intake of alcoholic drinks is responsible for disrhythmias, congestive heart failure, thromboembolic phenomena and, sometimes, sudden death. Dilated cardiomyopathy is the usual clinical presentation of these patients. More than 60 gr daily of ethanol may be an important factor in the etiology of high blood pressure. Yet, not everything is negative as far as alcohol and heart are concerned. Moderate consumption of ethanol decrease the risk of coronary heart disease, but, regarding the medical and social implications of alcoholic habits, they shall not be encouraged. Finally, it must be emphasized that in cases of disrhythmias, hypertension and deteriorated left ventricular function (ejection fraction below 35%) the use of alcoholic beverages must strongly discouraged. The same applies to patients taking anticoagulants or sedative drugs. PMID- 2698712 TI - [Computerized precordial mapping--the Mapcard system]. AB - A computerized Data Acquisition System conceived and built by LNETI/DEE in cooperation with Department of Cardiology of Hospital Santa Cruz, and its application to processing and representation of cardiac precordial maps (MAPCARD SYSTEM), was described. A description was made about the evolution on cardiac maps, their main areas of interest, pointing to future ways. With this economic and easy to use system, important perspectives of hospital utilization are opened, in the fields of non invasive diagnostic and clinical research technics. PMID- 2698713 TI - [Role of echocardiography in cardiac insufficiency]. AB - Several clinical cases are presented showing that Echocardiography (M-mode, 2D and Doppler) may give us a complete picture of the heart anatomy and the physiopathology associated with heart failure, as well as the functional status of the left ventricle. With this useful information (presence, location and degree of the abnormality) that can be obtained at bedside in a non-invasive way, the cardiologist may take, without delay, the most correct therapeutic choice (surgical and/or medical). Echocardiography should be used as a first line diagnostic test (after ECG and Chest X Ray) in all patients presenting with heart failure. PMID- 2698714 TI - [Non-digitalis inotropic agents in the treatment of congestive heart insufficiency]. AB - The action mechanisms of the inotropic agents are reviewed: adrenergic stimulants, dopaminergic agents, phosphodiesterase inhibitors direct adenylcyclase stimulants. The hemodynamic effects of these drugs are compared. According with the items proposed by Braunwald e Colucci the inotropic agents are classified. The therapeutic effect is concluded from the published randomized trials placebo. The value of these drugs on the therapy of Congestive Heart Failure is discussed. PMID- 2698715 TI - [Current status of the pharmacologic treatment of heart insufficiency. Role of diuretics]. AB - The pharmacologic properties of diuretics were reviewed with a special emphasis on their action at the renal tubule level. Afterwards their role in the treatment of cardiac failure was evaluated and it was concluded that they have an indisputable place in the management of that syndrome at any stage of its evolution. Their side effects were analysed and it was stressed that on the long term the risk benefit ratio was very favorable in terms of therapy of cardiac failure. Finally the so called diuretic resistance appearing with chronic therapy is discussed. PMID- 2698716 TI - [Notes on vascular impedance]. AB - The main knowledge on vascular impedance is preceded by the necessary mathematic and biophysic notions to the comprehension of the phenomena which determine the interpretation of the obtained results. Some physiopathologic applications are exemplified. PMID- 2698717 TI - [Role of nitrates in the pharmacologic treatment of heart insufficiency]. AB - Following a brief historical synopsis on the role of nitrates in clinical practice, their intracellular and general mechanisms of action are reviewed, pointing out the current views on the problem of nitrate tolerance. The present indications for nitrate therapy and their future trends are then discussed. Finally, nitrate formulations, doses and routes of administration are presented and the need of their cautions selection is stressed in order to get the last therapeutic result in each particular clinic setting. PMID- 2698718 TI - [Role of calcium antagonists in the pharmacologic treatment of heart insufficiency]. AB - There has been increasing interest in the use of calcium antagonists as arterial vasodilator agents in the management of patients with congestive heart failure. Because congestive heart failure is mostly secondary to coronary artery disease, calcium antagonist drugs seem particularly appealing because of their anti ischemic properties. The potent vasodilating action of calcium antagonists decreases impedance and improves ejection phase indexes of left ventricle function. However, these drugs interfere with calcium availability for myocardial contraction, and concern has been expressed about their potential depressant effect on myocardial performance. The net hemodynamic effect depends on the relative vascular versus myocardial potency of each calcium antagonist and on the indirect effects of reflex sympathetic activation. Balance between these factors is still influenced by the intrinsic status of left ventricle of the patient. Generally, the negative inotropic direct effect of the calcium antagonists is counteracted by the beneficial influence of the decrease of systemic vascular resistance. Because of its relatively more pronounced negative inotropic action, verapamil is not advisable in patients with left ventricular failure. Limited experience with diltiazem show no significant negative inotropic action. Nifedipine has been studied in its acute and long term effects. The use of sublingual nifedipine is established in the emergency management of acute pulmonary edema, specially in patients with arterial hypertension, or when acute ventricular dysfunction is associated with mitral or aortic insufficiency. Patients with chronic congestive heart failure have shown after nifedipine an increase in stroke volume and cardiac index at rest and during exercise, as well as decreases of pulmonary capillary wedge pressure during exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698719 TI - [Congestive heart insufficiency and angiotensin converting enzyme inhibitors]. PMID- 2698720 TI - [Indications and limitations of echocardiography in evaluating aortic valve insufficiency]. AB - Echocardiography (Echo) is the best non-invasive technique to study aortic regurgitation (AR). The authors (AA) start reviewing the place of M-Mode (MM) and two-dimensional (2D) Echo on the identification of AR and its cause, as well as on the assessment of left ventricular function. Secondly, the AA study the role of Doppler (Dp) techniques--pulsed (PDp), continuous (CDp) and colour coded (CCDp)--analysing their relative advantages and complementarity. They conclude that AR is best identified by PDp and MM Echo, its cause may be recognized by MM and 2D Echo, and its importance is correctly judged by CDp and CCDp Echo. Left ventricular function is best appreciated by 2D Echo, helped by CDp and CCDp Echo. The AA also state that, in AR, an haemodynamic study is injustifiable, unless Echo is technically incomplete, there is pluri-valvular disease insufficiently clarified, or coronarography is necessary. PMID- 2698721 TI - Age and 5HT 2-receptor blockade with ketanserin in essential hypertension. AB - Platelet derived serotonin (5HT) contributes to blood pressure elevation and the development of thromboembolic complications. Among the pathophysiological mechanisms involved in these vascular events, derangements in 5HT kinetics and exaggerated platelet response to 5HT may be part of the major triggering factors. An age-dependent attenuation platelet 5HT kinetics was revealed in normotensive control subjects but not in patients with essential hypertension. In older hypertensive patients, particularly in men, platelet 5HT uptake was decreased. In parallel, platelet reactivity was increased with advancing age as shown by a greater 5HT induced platelet aggregation and higher plasma concentration of beta thromboglobulin. Antihypertensive treatment with the 5HT2-receptor antagonist ketanserin attenuated platelet 5HT turnover and inhibited 5HT induced platelet aggregation; the latter was more pronounced in older patients. The clinical efficacy and tolerability of ketanserin 20-40 mg twice daily given as mono- or combination therapy was evaluated in 188 patients with mild to moderate essential hypertension for a period of 12 weeks. A greater fraction of patients greater than or equal to 60 years achieved diastolic target pressure of less than or equal to 95 mgHg. Complaints related to the central nervous system or the peripheral circulation were greatly reduced in patients older than 60 years. In older patients, over and above the antihypertensive effect, 5HT2-receptor blockade may play an important role in the prevention of thromboembolic complications by inhibition of 5HT induced platelet activation. PMID- 2698723 TI - Emil Thomas Kaiser 1938-1988. PMID- 2698722 TI - [Arrhythmia and sudden death in congestive heart insufficiency]. AB - The author emphasizes the current reawakening of interest of clinicians and investigators in congestive heart failure (CHF) as a consequence of the known bad prognosis of this syndrome and the new diagnostic techniques and drugs they may use in patients with this syndrome. The central topic of the paper deals with the relation between arrhythmias and sudden death (SD) in patients with CHF and is subdivided in five points: 1. Prevalence of SD in patients suffering from CHF; 2. Prevalence of ventricular arrhythmias in patients with CHF; 3. Prognostic value of ventricular arrhythmias on survival in patients with CHF; 4. Effect of antidysrhythmic drugs on survival in patients suffering from CHF; and 5. Different repercussion of drug therapy on rhythmic profile of patients with CHF. The analysis of these five points is supported by a revision of the literature on this subject and leads to some final comments, in which the author tries to do the state-of-the-art of the problem of the relation between arrhythmias and SD in patients suffering from CHF. PMID- 2698724 TI - Phagocytic cell responses to Aspergillus fumigatus. PMID- 2698725 TI - Phagocyte-derived oxidant and protease in mineral dust-related lung disease. PMID- 2698726 TI - Host responses during infection in newborn lambs. PMID- 2698727 TI - Recent advances in the study of associations between infection and genetic markers. PMID- 2698728 TI - The ABO, Lewis and related blood group antigens; a review of structure and biosynthesis. AB - Numerous studies have shown that the antigenic determinants of the ABO blood group system are closely related in biochemical terms to the antigenic determinants of the Hh, P, Lewis and Ii blood group systems. The blood group antigens of each of these systems are formed by the addition of specific sugars to an oligosaccharide precursor chain which may be bound through sphingosine to fatty acids (glycolipid) or through serine or threonine to a peptide chain (glycoproteins). The direct gene products of each of these blood group systems are the glycosyltransferase enzymes which catalyse the addition of the specific sugar thus conferring the specified blood group activity to the glycolipid or glycoprotein molecule. The antigenic determinants of the ABO and Lewis systems in addition to red cells also exist in the body secretions in soluble form when the relevant genes are expressed in the phenotype. The antigens expressed on both the red cells and in the secretions are determined by the interaction of Hh, Sese, ABO and Lele genes. PMID- 2698729 TI - The role of ABO blood groups and secretor status in host defences. AB - Epidemiological studies on the associations between ABO blood group antigens, secretor status and susceptibility to infectious agents are summarized. Evidence for association of non-secretion with some autoimmune diseases for which infectious aetiologies have been proposed is also given. Several hypotheses are proposed to explain the host-parasite interactions underlying the epidemiological observations, and evidence to support or refute them is presented. PMID- 2698730 TI - Blood group, secretor status and susceptibility to bacterial meningitis. AB - Epidemiological evidence is summarized for associations of ABO blood group and secretor status with susceptibility to invasive disease due to capsulate organisms responsible for the majority of bacterial meningitis. Host-parasite interactions that might underly these findings are proposed and evidence to support or refute them provided. PMID- 2698731 TI - Characterization of Escherichia coli strains isolated from urine of secretors and non-secretors. AB - Strains of Escherichia coli isolated from urine of secretors (242) and non secretors (121) were compared for their serotype and their ability to express mannose-sensitive (MS) haemagglutinins and mannose-resistant (MR) haemagglutinins and to produce haemolysin. The results of the survey refuted our hypothesis that strains with characteristics associated with virulence, those with MR haemagglutinins and/or haemolysins, would be isolated more frequently from non secretors. MR haemagglutinins were detected among 36.4% of isolates from secretors and 27.3% of isolates from non-secretors. Haemolysin production was detected among 19.8% of isolates from secretors and 12.5% of isolates from non secretors. Both MR haemagglutinins and haemolysin were detected only on 12.4% of strains from secretors and 6.7% of strains from non-secretors. PMID- 2698732 TI - ABO blood group and secretor status in the spondyloarthropathies. AB - The postulated role of infectious agents, genetic susceptibility of the host to infection and their interaction in the pathogenesis of ankylosing spondylitis, other spondyloarthropathies, and the associated primary (non-arthritic) diseases are reviewed. Compared with a local control population there is a significantly increased prevalence of non-secretors amongst different groups of patients with spondyloarthropathy: ankylosing spondylitis, reactive arthritis and psoriatic arthropathy. No differences between secretor and non-secretor patients with respect to serum and salivary IgA levels, the occurrence of eye lesions or peripheral joint disease have been found. There is no evidence that ankylosing spondylitis or other spondyloarthropathies are associated with any particular ABO blood group. The association between non-secretion and ankylosing spondylitis strengthens the hypothesis that ankylosing spondylitis has an infective aetiology. It also suggests several pathogenetic mechanisms which may be relevant to the initial host-parasite interactions in the spondyloarthropathies. PMID- 2698733 TI - An infectious aetiology of insulin-dependent diabetes mellitus? Role of the secretor status. AB - Studies of patients with insulin-dependent diabetes and their families have shown increased incidences of HLA markers B8, B15, DR3 and DR4. While these genetic predispositions are obviously important, additional factors such as environmental influences are presumed to trigger the events leading to the development of diabetes. Infectious triggers, in particular several viruses, have been suggested. The evidence from epidemiological and in vitro studies for a viral aetiology is summarized here. The significance of the recent finding of an increased proportion of non-secretors among patients with insulin-dependent diabetes is discussed in the context of other 'autoimmune' diseases for which infectious aetiologies have been proposed. PMID- 2698734 TI - [Descriptive study of cancer of the cavum, especially of epidermoid carcinoma (II)]. AB - On study the clinical findings and its anatomic relationship. The relationships between tumor and nodal necks was preferentially T-2 with N-1 or N-3 incidence of local and neck recurrences was 37% (40% primary site, 43% nodal neck and 17% both sides): the incidence of distant metastases was 27% of the cases. The distribution of cases according to extent of the adenopathy with any T was as follow: N-0 26%, N-1 23%. T-2 33%, T-3 16% and T-4 63%. Not significative difference in the mean interval from onset of symptoms until initial patient evaluation was found, in stage III and IV. The distribution of histological subtypes were as follow: squamous 42%, and undifferentiated 46%. On study the different radiotherapy treatments, and their major and minor complications. PMID- 2698735 TI - [Chondrosarcoma of the thyroid cartilage. Presentation of a case and review of the literature]. AB - We present a case of Thyroid cartilage Chondrosarcoma with growing out, without injury of intralaryngeal noble structures and whose symptom of presentation was a cervical tumour. We review the cases of thyroid cartilage Chondrosarcomas in the literature. PMID- 2698736 TI - [Chondrosarcoma of the larynx: review of the Western literature and presentation of a new case]. AB - We present the case of a 70 year old man with cricoid chondrosarcoma treated with total laryngectomy. This report reviews the occidental literature, with nine cases reported by national authors in the las 25 years. We have recollected 104 laryngeal chondrosarcoma, in all. Clinical and diagnostical data, location, and treatment were analysed and compared with our case. PMID- 2698737 TI - [A case of Klippel-Feil syndrome]. AB - We would like to present a case of Klippel-Feil Syndrome in which it is associated with multiple cervical vertebra synostosis, short neck, cervical rib, congenital sclerosis, platybasia, spina-bifida and deafness. We are revising the case history of this syndrome. PMID- 2698738 TI - [Intracranial invasion of a tumor of the ear]. AB - A 55 years old woman with a neoplasm originating in ceruminous glands of the external auditory canal, with temporal bone and intracranial invasion, mimicking a glomus jugulare tumor. This group of neoplasms, rare in man, are best treated by and aggressive wide "en bloc" temporal bone and contiguos structures resection. In our review few similar cases are found. PMID- 2698739 TI - Liver-associated large granular lymphocytes: morphological and functional aspects. AB - Large granular lymphocytes (LGLs) differ from other lymphocytes in their recirculation pattern and are distributed preferentially in nonlymphoid organs such as the liver and lung. The liver-associated LGLs adhere strongly to the sinusoidal endothelium and show a natural killer (NK) cytotoxicity against incoming metastatic tumor cells; this reaction occurs very rapidly because, in contrast to the immune response, it does not require complex processes in the lymphoid tissue. They have been extensively studied morphologically in terms of pit cells. LGLs have two characteristic cell organelles which participate in the NK cytolysis, i. e., dense granules and rod-cored vesicles. The former are lysosomes derived from multivesicular bodies and contain pore-forming proteins. The latter are the secretory vesicles exclusively seen in LGLs and are markedly increased in number when the NK function is augmented by biological response modifiers. These two structures are believed to be exocytosed in the space between LGL and the conjugated tumor cell. The microenvironment of the liver sinusoids, which includes Kupffer cells, endothelial cells and other lymphocytes, is considered to regulate the function of the liver-associated LGLs. Liver associated LGLs, as well as Kupffer cells, are intrinsically involved in the defense system of the liver under various physiological and pathological conditions. PMID- 2698740 TI - The effect of fixatives and paraffin embedding on the histochemical reactivity of a monoclonal antibody against human type IV collagen (JK-199). AB - A new monoclonal antibody (JK-199) was found to react with basement membranes on paraffin-embedded tissue sections without prior enzyme digestion. JK-199 was shown to react with isolated type IV collagen treated by any of four different fixatives--PLP, 4% formalin, modified Zamboni's (0.2% picric acid, 4% paraformaldehyde in 0.1 M phosphate buffer, pH 7.4) or Bouin's--applied for 6 h at room temperature and incubated at 60 degrees C for 30 min to simulate routine tissue processing. None of the fixatives was able to alter the reactivity of JK 199 with isolated type IV collagen. In the human placenta, specific and intense staining of basement membranes was demonstrated on paraffin sections fixed with any of the four fixatives. In human skin, basement membranes were fully demonstrated on paraffin sections fixed by PLP fixative or by 4% formalin, but only partially on sections fixed by picric acid-containing fixatives. Optimal results, i.e., with the least non-specific or incomplete staining, were obtained on PLP-fixed paraffin-embedded tissues. In PLP-fixed paraffin sections of the kidney, skeletal muscle, and small intestine, all basement membranes were stained intensely by this antibody (JK-199) at the expected locations. The results indicate that JK-199 may be widely applicable for the analysis of basement membrane kinetics, including developmental processes or pathological conditions. PMID- 2698741 TI - A histological and experimental study on the fate of an increased number of lymph follicles produced in the mouse popliteal lymph node by exogenous antigen stimulation. AB - Eight-week-old female C57B1/6 mice were injected with endotoxin LPS and/or other antigens into the left hind footpad, and then the number of lymph follicles in the draining popliteal lymph nodes was examined. In untreated mice each popliteal node contained 10-12 lymph follicles at both 8 and 15 weeks of age. Animals given 50 micrograms of LPS at 8 weeks of age showed an increase in the number of lymph follicles 3 weeks later, but this number returned to normal levels by 15 weeks after the LPS injection. After a 2-micrograms-LPS injection at 23 weeks of age, the number of lymph follicles in the draining lymph node was unchanged, but that in animals given the 2-micrograms-injection 15 weeks after the 50-micrograms-LPS injection was significantly increased. In animals receiving 2 Lf of diphtheria toxoid, instead of the 2-micrograms-LPS, at 15 weeks after a 50-micrograms-LPS injection, the number of lymph follicles per draining node was within the normal range. In one group of mice, the initial injection of 50-micrograms-LPS at 8 weeks of age was followed by injections every third week of several kinds of antigens which had been shown to be ineffective in inducing follicle formation. Here, the number of lymph follicles in the draining popliteal node was kept to significantly increased levels at 25 weeks of age. The present results suggest that, while most lymph follicles normally developing in the lymph node are maintained for a long time under normal conditions, many lymph follicles induced by antigenic challenge have a limited life span and undergo atrophy unless they are periodically activated by additional antigenic stimuli, and that atrophied follicles finally become unable to respond to antigenic stimulation. It is also suggested that antigenic materials which trigger the formation of lymph follicles in the primary challenge can evoke follicle formation more efficiently in the secondary challenge. PMID- 2698742 TI - Polar presentation of coronary angiography and thallium-201 single photon emission computed tomography. A method for comparing anatomic and pathologic findings in coronary angiography with isotope distribution in thallium-201 myocardial SPECT. AB - Individual results of coronary angiography were compared with tomographic myocardial scintigraphy (SPECT) in 99 patients. Coronary angiography findings were transferred to polar maps. Borders between arteries were assigned angles in a coordinate system constructed as a compass-rose. Areas perfused by different arteries were described by sectors. Findings were visually compared with the perfusion defects in a polar presentation of thallium-201 SPECT also described by angles. The mean values and SD for the angles representing arterial borders and perfusion defects were presented. The left ventricular myocardium was perfused by 3 coronary arteries in 92/99 patients. Dominant left artery was present in 7/99 patients; 79 perfusion defects were related to 118 arterial sectors 84 per cent had totally or partially matched stenotic arteries. Inter-individual differences in distribution of coronary arteries influence the localization of perfusion defects in myocardial SPECT and can be estimated with this polar presentation method. PMID- 2698743 TI - Diagnosis of deep venous thrombosis by duplex sonography. AB - In a prospective study 90 patients with clinically suggested lower limb deep venous thrombosis (DVT) were examined with duplex ultrasonography (US) prior to venography. No attempts were made to examine the calf veins. Five ultrasound examinations were inconclusive. Thirty-four patients had DVT diagnosed at US with a sensitivity of 97 per cent and a specificity of 96 per cent. Compressibility of the vein as assessed by the real-time image was in the acute phase an easy and fast test for DVT, whereas the Doppler data failed to add to the diagnostic accuracy. Twenty-seven patients with DVT were followed during anticoagulant treatment, but only 16 regained fully compressible veins within the observation period of 3 to 6 months. Duplex sonography was useful in monitoring the changes in vein patency during anticoagulant treatment. PMID- 2698744 TI - Assessment of digital chest radiography using stimulable phosphor. AB - In this pilot study, conventional and digital radiography of the chest was compared in 170 patients. Two digitized radiographs, one frequency modified and one simulating the conventional film-screen combination, and the conventional films were reviewed independently by 5 radiologists with different experience. In spite of the smaller size and lower spatial resolution of the digitized compared with the conventional radiograph, only slight differences were revealed in the observation of different pulmonary and mediastinal changes. Digitized radiography is therefore considered suitable for chest examinations. PMID- 2698745 TI - Small bowel barium examination in children. Diagnostic accuracy and clinical value as evaluated from 331 enteroclysis and follow-through examinations. AB - The indications for small bowel barium examination, the radiologic findings, and the clinical outcome were compared retrospectively in 331 children, aged 0 to 15 years. Sixty examinations (18%) were pathologic, which is in accordance with adult materials. The most common indications for referral were inflammatory bowel disease (48%) and small bowel obstruction (25%). The examinations were positive in 19 per cent and 17 per cent, respectively. Indications for referring patients with non-specific symptoms led to a low frequency of pathologic findings. A therapeutic or diagnostic procedure was performed in 38 of the 60 pathologic radiologic examinations (63%). In 18 patients (30%) a pathologic finding caused no change in therapy. No consistent difference in sensitivity, specificity or predictive values of a positive or negative result was found concerning enteroclysis or elective follow-through examination. For screening purposes of the small bowel in children follow-through examinations give adequate radiologic information and should be used instead of enteroclysis. PMID- 2698746 TI - Angiosarcoma. Diagnosis and clinical course. AB - The findings at radiography, computed tomography and angiography and the clinical course of 30 cases of angiosarcoma were reviewed. The variety of primary sites results in a multitude of findings but the most common finding was that of a hypervascular soft tissue mass seen on CT and angiography. Additional findings of well demarcated cortical defects in long bones were also frequently noted. The general clinical behavior of these aggressive malignant tumors was also reviewed and it was noted that they had a deceptively benign presentation. PMID- 2698747 TI - Clinical comparison of 99Tcm-HMPAO labelled leucocytes and 99Tcm-nanocolloid in the detection of inflammation. AB - Forty-five patients with various inflammatory diseases were imaged with 99Tcm HMPAO labelled leucocytes and 99Tcm-nanocolloid within 7 days. The overall sensitivity of 99Tcm-leucocytes was 97% and that of 99Tcm-nanocolloid 59% and both agents had a 100% specificity. The 99Tcm-leucocyte method showed reliable results in various inflammatory and infectious conditions, and seems suitable as a primary imaging method. On the contrary, 99Tcm-nanocolloid cannot be recommended for use in inflammatory bowel diseases, soft tissue abscesses or prosthetic vascular graft infections. However, 99Tcm-nanocolloid gave reliable information in inflammatory and infectious bone and joint diseases in which it had a 90% sensitivity and 100% specificity. In those lesions the 99Tcm nanocolloid method may be useful, because it is simple, fast and cheap. Yet, further evaluation is needed. PMID- 2698748 TI - Influence of urography on renal function in children. A double blind study with metrizoate and iohexol. AB - Thirty-two children were given either metrizoate or iohexol for urography in a double blind study. Mild to moderate adverse reactions were observed in all patients receiving metrizoate (15/15) and in 4 receiving iohexol (4/17). Alkaline phosphatase in urine was significantly increased 4 hours after the injection of both media, but had returned to pre-injection levels 16 hours later. The excretion of beta 2-microglobulin and albumin was not altered. In 9 children in the metrizoate group and 11 in the iohexol group the glomerular filtration rate (GFR) was determined before urography by the single injection 99Tcm-DTPA technique and 3 to 4 hours after urography by measuring the plasma disappearance of the contrast medium with the x-ray fluorescence technique. No reduction of GFR was observed. PMID- 2698749 TI - [Resonance effect of coherent millimeter-band electromagnetic waves on living organisms]. AB - A survey is presented of Soviet and foreign theoretical studies contributing to understanding the mechanism of acute resonance effect of high frequency coherent electromagnetic radiations of low power on the living organisms and the role of these radiations in the functioning of the latter. PMID- 2698751 TI - Long-term maintenance of improvements achieved with (abortive) pharmacological and nonpharmacological treatments for migraine: preliminary findings. AB - This report presents the first prospective comparison of the long-term maintenance of reductions in recurrent migraine headaches achieved with (abortive) pharmacological and nonpharmacological (combined relaxation training and thermal biofeedback training) treatments. Nineteen of 21 (90%) successfully treated patients (50% or greater reduction in headache activity) were contacted for follow-up evaluation 3 years later. Migraine sufferers who had been treated with ergotamine were less likely to still be relying on the treatment they had received and more likely to have additional medical treatment for their headaches and to be using prophylactic or narcotic medication than were migraine sufferers who had been treated with relaxation/biofeedback training. However, daily headache recordings revealed that patients in both treatment groups continued to show lower headache activity at 3-year follow-up than prior to treatment. Although preliminary, these findings raise the possibility that improvements achieved with nonpharmacological treatment are more likely to be maintained without additional treatment than are similar improvements achieved with abortive pharmacological treatment. PMID- 2698750 TI - The mystery of phantom pain: growing evidence for psychophysiological mechanisms. AB - The direct, and much of the indirect, evidence supporting the existence psychophysiological mechanisms for phantom limb pain is reviewed. Phantom pain is shown to be a symptom class composed of different, but similarly described problems, each having its own underlying mechanisms. At least some descriptive types of phantom pain probably have mainly peripheral, as opposed to only central, origins. Although much of the direct data are preliminary, burning phantom pain is probably related to decreased blood flow in the residual limb, while cramping phantom pain is mainly related to spikelike muscle spasms in the major muscles of the residual limb. Little support is provided for psychological causes for phantom pain, but the expression of phantom pain does appear to be influenced by psychological mechanisms similarly to the ways other chronic pain conditions are influenced. The importance of a careful psychophysiological assessment of patients to treatment success is discussed. Because several different mechanisms are involved, no one treatment is likely to be effective for all of the different types of phantom pain. Appropriate combinations of self regulation strategies aimed at controlling the underlying physiological problems are likely to be effective in reducing the incidence and severity of burning and cramping types of phantom pain. PMID- 2698752 TI - Assessment of immunity. AB - An approach to the assessment of the immune system primarily from the vantage point of the general physician is presented, indicating the clinical situations where analysis is most likely to yield informative results. Preliminary screening by the primary physician is discussed, followed by a brief description of measures which are employed in referral centers. A definitive diagnosis should be possible in nearly all cases. With the rapid advances in recombinant DNA technology and bone marrow transplantation, a cure can be expected for most patients, particularly if the diagnosis is made early. PMID- 2698753 TI - Autoimmunity in pectic ulceration. PMID- 2698754 TI - Autoimmune insulin syndrome. AB - Initially described in Japan, the autoimmune insulin syndrome is caused by the presence of anti-insulin antibodies in patients who have never received insulin. This syndrome accounts for spontaneous or reactive hypoglycaemia with very high levels of total immuno-reactive insulin. Discordance between the levels of immunoreactive insulin and C peptide indicate the possible presence of anti insulin antibodies; this can avoid an incorrect diagnosis of insulinoma. These autoimmune hypoglycaemias often present a difficult diagnostic problem in distinguishing them from factitious hypoglycaemia. The course of the autoimmune insulin syndrome is usually favourable, with a spontaneous rapid diminution of the levels of anti-insulin antibodies. The reasons for the appearance of anti insulin antibodies and the exact mechanisms of the hypoglycaemia remain uncertain. However, the frequent association of the autoimmune insulin syndrome with certain autoimmune diseases suggest a common immune dysfunction. Drugs containing a sulphydryl group have been implicated in the aetiology of this syndrome. PMID- 2698755 TI - Peripheral self-tolerance and autoimmunity: the protective role of expression of class II major histocompatibility antigens on non-lymphoid cells. AB - Immunologic self-tolerance is achieved mainly during development by clonal deletion in the thymus of T lymphocytes with receptors specific for self-antigens and with associated T-cell markers CD4/CD8. However, T cells expressing a low level of these markers are allowed into the periphery still bearing their autospecific receptors. Such clonal deletion, induced by cells bearing the class II antigens coded for by major histocompatibility complex (MHC) in the thymus, does not remove all autoreactive T cells specific for antigens of differentiated tissue expressed extrathymically. However, these autoreactive T cells are silent in the periphery. Peripheral non-lymphoid cells (e.g., endocrine cells) can induce antigen-specific unresponsiveness in T cells and can specifically suppress production of autoantibody against their antigens when the non-lymphoid cells express class II MHC antigens on their surface. This class II MHC expression is induced by interferon-gamma produced by T cells as a result of various immune responses, such as autoimmune reaction. Thus, the expression of class II MHC antigens on non-lymphoid cells may serve as a peripheral mechanism for the induction and maintenance of self-tolerance in autoreactive T cells that escape negative selection in the thymus or that are specific for extrathymic tissue antigens, in a fail-safe mechanism against autoimmunity. Some autoimmune diseases, especially organ-specific ones, might be caused by a defect in this fail-safe mechanism. PMID- 2698756 TI - Recombinant human erythropoietin in nephrology. AB - rEPO therapy provides a unique opportunity to correct anemia in end-stage renal failure patients. Complete correction of the anemia, although possible, has some obvious disadvantages over a partial correction with a target hemoglobin of 10-13 g/dl or a hematocrit of 30-35%, respectively. Unresponsiveness to rEPO seems to be rare; in most cases the predicted hemoglobin increase could be seen as soon as an underlying iron deficiency was treated adequately. Blood loss and aluminum toxicity are the next most frequent reasons for an inadequate response to rEPO. Hypertension (and its complications) as well as fistula clotting are the most important side-effects which require close attention when patients at risk for these complications are treated with rEPO. PMID- 2698757 TI - Rapid evaluation of tetanus immunity by a haemagglutination test in the injured at a hospital emergency unit. AB - A turkey red blood cell haemagglutination assay (TRBC HA) allowing rapid measurement of the antibodies against tetanus has been set recently. Its feasibility was evaluated in injured patients admitted into an emergency unit during summer 1987. TRBC HA was performed by the same physician who questioned the patient on his/her previous vaccinations and evaluated his/her immunization status. The rapid HA test practiced in emergency was controlled by TRBC HA and ELISA measurement of antibodies carried out in the laboratory. Each method was compared to the others: the results were fitted and no significant difference was found. The preventive procedures which would have followed the antibody measurement by immediate TRBC HA were compared to the decision resulting from clinical evaluation. The immunoprophylactic attitude would have been the same in 82% of cases. TRBC HA is a reliable test, and feasible in an emergency: it could help in making the appropriate decision for immunoprophylaxis to be applied to the injured and other patients at risk of tetanus. PMID- 2698758 TI - Heterogeneity of progesterone receptor expression in epithelial cells of immature and differentiating quail oviduct. AB - The localization of progesterone receptor (PR) in the quail oviduct was investigated before and after the onset of sexual maturation using an immunohistochemical technique. PR was revealed exclusively in nuclei of target cells whatever the hormonal state of the tissue (immature or not, pretreated or not with progesterone). In the immature or ovariectomized quail oviduct, PR was principally localized in the undifferentiated epithelial cells; some mesothelial cells and a very few stromal cells expressed the PR. Only 40-45% of the epithelial cells were immunoreactive. These positive cells were mainly localized in the furrows of the villi where further evagination of the epithelium will occur to form the tubular glands. The onset of sexual maturation was accompanied by an increase of the proportion of positive epithelial cells and stromal cells. In estradiol-treated animals, more than 90% of the tubular gland cells were strongly stained while only 40% of the luminal epithelial cells were immunoreactive. Our results show that there are two subpopulations of epithelial cells: those expressing the PR before the onset of sexual maturation even in ovariectomized quails (constitutive expression) and those expressing the PR during sexual maturation or after estrogen injection (inductive expression). These results, associated with previously published studies dealing with the cytodifferentiation of epithelial cells during natural development or after various hormonal treatments in ovariectomized animals, suggest that the first are the progenitors of tubular gland cells, and the second the progenitors of ciliated and goblet cells. In stromal cells, PR expression is also inducuible. PMID- 2698759 TI - Are close contacts between astrocytes and endothelial cells a prerequisite condition of a blood-brain barrier? The rat subfornical organ as an example. AB - The microvessels of the rat subfornical organ (SFO) are heterogeneous: those of the caudal part lack a blood-brain barrier (BBB) unlike those of the rostral part. The astroglial environment of these microvessels has been studied by combining an immunocytochemical technique employing an anti-GFAP (glial fibrillary acidic protein) antiserum with the morphological detection of a barrier to the protein-silver complex. All the SFO microvessels are surrounded by astrocytes characterized by a tumescent aspect; however, the relative proximity between the astrocytic feet and the endothelial cells varies considerably. The capillaries provided with a barrier (rostral SFO) are contiguous with the astrocytes from which they are only separated by a basement membrane. The capillaries devoid of BBB (caudal SFO) are surrounded by a pericapillary space that keeps the astrocytes at a short distance (capillaries with a very rich vesicular endothelium) or at a long distance (capillaries with a fenestrated endothelium). The astrocytes are absent in the choroid plexus where all microvessels are fenestrated and lack a barrier. These data suggest that the astrocytes release one or more signals which in their vicinity inhibit the expression of endothelial morphological characteristics (fenestrations, vesicles) responsible for the leakage of plasmatic proteins from the blood to the cerebral parenchyma of the circumventricular organs. PMID- 2698760 TI - Benzoxazinone derivatives: new fluorescent probes for two-color flow cytometry analysis using one excitation wavelength. AB - A new class of fluorescent dye which upon excitation at 488 nm turns red is shown to be probe-suitable for using in flow cytometry alone or in conjunction with fluorescein derivatives. 7-dimethylamino 3-(p-formylstyryl) 1,4 benzoxazin 2-one is suitable for rendering microorganisms, such as Plasmodium merozoites and cells detectable by flow cytometry, allowing a dual fluorescence analysis when the cells are labelled with suitable fluoresceinylated ligands such as fluorescein labeled neoglycoproteins or antibodies. The synthesis of the new benzoxazinone derivatives is described: p-[beta-(7-dimethylamino 1,4 benzoxazin 2-one 3-yl) vinyl]-phenylpropenoic acid can be easily activated as a hydroxysuccinimide derivative and linked to amino groups of polypeptides. Hydrophilic polypeptides such as poly-L-lysine or glycosylated polymers combined with this new fluorescent dye are shown to be helpful in analyzing cell surface receptors, in dual fluorescence flow cytometry analysis, using a single excitation wavelength and two sets of compounds labeled with the new benzoxazinone derivative and with fluorescein isothiocyanate, respectively. The new benzoxazinone derivative has a high molar absorbance, a good quantum yield fluorescence when it is bound to hydrophilic polypeptides and its fluorescence intensity is not dependent on pH in the physiological pH range. PMID- 2698761 TI - Infection and rheumatic diseases: a review (Part 1 of 2). PMID- 2698762 TI - [The calcium signal in the regulation of insulin secretion]. AB - In the submitted review the author pays attention to mechanisms of control of insulin secretion and the mutual interaction of other messengers (cAMP, calcium and inisitol triphosphate) with special attention to the calcium signal which plays a most important role in the stimulation of the excitable B cell. The trigger of the two-stage insulin secretion is cyclic accumulation of calcium in the cytosol of the B cell and the mutual harmony between calcium of the intra- and extracellular compartment. In the early stage of insulin secretion in particular the intracellular compartment is the source of calcium; from there the ion is released due to the action of inositol triphosphate (IP3) activated by phospholipase C. Calcium of the extracellular compartment is mobilized also in the early secretory stage by opening of the depolarization-dependent calcium channels, it plays, however, a more important part during the second stage. Activation of the other messengers, incl. the calcium signal, depends on the type of secretagogue stimulus. During systemic changes of calcium homeostasis in vivo the calcium signal of the B cell is activated or inhibited in different ways. In the course of hypercalcaemia, in particular if acute, the direct influence of calcium ions on insulin secretion is modulated by further factors, e.g. somatostatin, calcitonin, cholecystokinin, glucagon, adrenocortical hormones, opioids and other substances released into the blood stream. In chronic hypercalcaemia which is the result of primary hyperparathyroidism or vitamin D intoxication the action of calcium on the metabolic and hormonal response is enhanced by the ionophoretic action of parathormone or active vitamin D metabolites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698763 TI - [350 years of Harvard]. PMID- 2698764 TI - [Apheresis today]. AB - The paper is a review of contemporary medical and technical possibilities as regards treatment by plasma-pheresis, its pitfalls and shortcomings. The author discusses perspectives of the method with regard to recent discoveries. PMID- 2698765 TI - [Rubella screening using a radial hemolysis test with whole blood]. AB - The authors present the results of examination of 121 probands by the rubella test of radial haemolysis (RH), using capillary blood (direct test), as compared with the use of serum from venous blood in correlation with the rubella haemagglutination inhibition test. The diameter of the haemolytic zone, 7 mm, was as compared with the haemagglutination inhibition test in both modifications in 95% and the diameter 8 mm was seropositive in 100%. Haemolytic zones up to 6 mm must be considered seronegative even when some of the bloods or sera have bonder line haemagglutination inhibition titres. Seronegativity was expressed in the direct test of radial haemolysis by larger haemolytic zones. The specificity of the direct test of radial haemolysis, even when serum was used, was 87.5%, the sensitivity 88.2% and 88.4% resp. The reliability of positive diameters of haemolytic zones (7 mm+) is 99%, while that of negative ones (2-6 mm) only 35%. The less laborious direct test of RH proved equivalent to the radial haemolysis test using serum, as far as screening with the purpose of aimed immunization against rubella is concerned. PMID- 2698766 TI - [New findings on enteroinvasive strains of E. coli]. AB - The group of enteroinvasive strains of E. coli (EIEC) comprises at present eleven serogroups. Diarrhoeal diseases caused by EIEC strains are found sporadically or epidemically. It was found that the pathogenicity of EIEC strains is coded in plasmids. So far the plasmid was proved in serogroups 028 a, c, 029, 0124 and 0143. The incidence of EIEC strains is recorded also in the CSSR. PMID- 2698767 TI - [Directed ultrasonography in the diagnosis of abscesses and cysts of the breast]. AB - Based on 1,301 examinations the author refers to the contribution of aimed ultrasonography in the diagnosis of abscesses and cysts of the breast. The aimed ultrasonography is a simple, fast and exceptionally sensitive and reliable method of examination in their detection and differentiation from solid homomorphcus processes depicted on mammograms. Its importance grows in the examination of fibroglandular tissue which cannot be differentiated on the mammogram. It reduces or completely suppresses invasive methods of examination, enables aimed diagnostic and therapeutic puncture and enables a long-term observation of abscesses and cysts of the breast without any risk. PMID- 2698768 TI - [Ultrasonography of echinococcosis, toxocariasis and cysticercosis of the liver]. AB - The diagnosis of tissue parasitoses has remained complicated until the present time for variability of clinical picture. Their incidence been increasing due to aimed and accidental findings of foci in parenchymal organs employing new methods of visualization such as computer tomography and especially ultrasonography whose advantage is a good detection rate, availability and a possibility to follow the dynamics of parasitosis development. The authors present a survey of ultra sonographic findings of the liver in cases of tissue parasitoses occurring in Czechoslovakia, while using their own image documentation. If a focal affection in the liver is established the differential diagnosis considerations should also take into account a tissue parasitosis, whose ultrasound picture may be nonspecific. PMID- 2698769 TI - [Experimental and clinical studies on the pathogenicity of extracellular proteinases of Streptomyces thermohygroscopicus in farmer's lung]. AB - Streptomyces thermohygroscopicus is a thermoactinomycetes which has been found recently to be related to farmer's lung in China. In the present study, a model of acute farmer's lung was successfully developed with extracellular proteinases of streptomyces thermohygroscopicus (EPST) in the rabbit, and the precipitating antibodies against EPST were detected in the sera from the patients with farmer's lung or bagassosis. Lack of cross reactivity was also showed between EPST, T. vulgaris antigen, and M. faeni antigen. PMID- 2698770 TI - [Liver cirrhosis and hypoxemia]. PMID- 2698771 TI - Purification and characterization of befunolol reductase from rabbit liver. AB - An enzyme (befunolol reductase) which catalyzes the reduction of befunolol to dihydrobefunolol was purified from the cytosolic fraction of rabbit liver to homogeneity by various chromatographic techniques. Befunolol reductase had molecular weights of 29000 on sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis and 34000 on gel filtration. The enzyme required reduced nicotinamide adenine dinucleotide phosphate (NADPH) as a cofactor and showed an optimal pH of 6.5. The apparent Km and Vmax values of the enzyme for the reduction of befunolol were 1.7 mM and 4.4 units/mg, respectively. Flavonoids, sulfhydryl reagents, heavy metals and coumarins strongly inhibited the enzyme. The enzyme catalyzed the reduction of a variety of aromatic ketones. In addition to befunolol, some ketone-containing drugs such as daunorubicin and levobunolol were efficiently reduced by the enzyme. On the basis of substrate specificities for steroids, befunolol reductase purified from the cytosolic fraction of rabbit liver appeared to be a 3 alpha-hydroxysteroid dehydrogenase. PMID- 2698772 TI - The term preceptor: its interpretation in South African nursing colleges and international nursing literature. AB - The purpose of this study was two-fold, namely: 1) to obtain clarity on the meaning of the term preceptor, and 2) to establish how the term preceptor is interpreted in the nursing colleges of the RSA and to ascertain whether this interpretation is consistent with the general connotation of the term in contemporary nursing literature. Dictionaries and relevant contemporary nursing literature formed the unit of analysis for obtaining clarity on the meaning of the term preceptor, while the unit of analysis for the second section of the study comprised responses of nursing college principals to a questionnaire. The data obtained in the investigation indicate that the term has acquired a specific connotation within the international nursing context and that specific defined attributes distinguishes it from the broad and general definition found in standard dictionaries. Within the South African nursing context the term preceptor has not yet acquired a specific connotation, but appears to mean different things to different people. PMID- 2698773 TI - [Homonymous lateral quadranopsia disclosing cerebral toxoplasmosis in a patient with AIDS]. AB - A case of Homonymous lateral quadranopsia revealing cerebral toxoplasmosis is reported in AIDS patient. Neuro-ophthalmologic manifestations must be explored by neuro-radiologic examination. Nuclear magnetic resonance would rather be performed than CT scan. Frequencies of cerebral and ocular toxoplasmosis localisations are compared. Severity of toxoplasmosis localisation justifies an early diagnosis based on immunological assay detecting the infection. Prophylactic treatment has to be instored. PMID- 2698774 TI - [Microphthalmos in Pierre Robin syndrome. Clinical and x-ray computed tomographic study]. AB - The Pierre Robin Syndrome is characterized by three defects (8,9): micrognathia, cleft palate and glossoptosis responsible for respiratory failure. The new definition of this syndrome associates retrognathia, cleft palate and respiratory distress. This respiratory distress is mixed: obstructive due to glossoptosis, and central, secondary to brainstem immaturity (1,2). The main ocular manifestations associated with the syndrome are congenital glaucoma, high congenital myopia and retinal detachment. Microphtalmia has already been reported, but is infrequent. We present a clinical case of a major microphthalmia in a Pierre Robin Syndrome, confirmed by CT scan exploration. PMID- 2698775 TI - [Coats' syndrome and retinitis pigmentosa. Apropos of a case]. PMID- 2698776 TI - [Listeria endophthalmitis: an uncommon etiology]. AB - Listeria monocytogenes is an uncommon cause infections: to our knowledge this is the seventh case of human endophthalmitis isoleted. An early diagnosis and therapy allowed an excellent functional recovery when compared to the reported cases of the literature. PMID- 2698777 TI - [Value of electroretinography and early echography in severe eye injuries]. AB - We tested Dawson-Trick-Litzlkow (DTL) fiber electrode as the active electrode in electroretinogram associated with an B echography in important ocular trauma. The advantages are its atraumatic characteristic and the good quality of the electroretinogram. PMID- 2698778 TI - Ultrasonic evaluation of cervical lymph node metastasis of squamous cell carcinoma in oral cavity. AB - Forty-four patients with oral cancer were examined by ultrasonography to detect cervical lymph nodal metastases. The lymph nodes, which were histopathologically or clinically confirmed to have cancer metastases, showed the following characteristic echogram findings: distinctive nodal boundary, posterior echo enhancement and an increased ratio of the shortest and the longest diameters of the node. It is suggested that these three peculiar ultrasonographic findings are considered to be important items for the differential diagnosis of benign nodes from the cervical metastasis of oral cancer. PMID- 2698779 TI - An introduction to body composition models used in nutritional studies. AB - Chemical analysis of cadavers has led to the definition of 'reference' man but diseases may result in significant changes in body composition. By measuring body composition in patient groups the nature of disease progression can be followed and management regimens evaluated. Various techniques are available which attempt to measure body composition in vivo. Several models of body composition have evolved with the introduction of new measurement techniques. A description of these models is presented. The limitations of the models and the techniques adopted for their measurement are discussed. PMID- 2698780 TI - Comparison of speed of sound and ultrasound attenuation in the os calcis to bone density of the radius, femur and lumbar spine. AB - Broadband ultrasonic attenuation (BUA) between 0.1 and 0.6 MHz and speed of sound (SOS) were measured on the os calcis in normal women (n = 40), and women who had mild osteoporosis (n = 36). Comparisons were made between the ultrasonic properties and bone mineral densities (BMD) obtained using photon absorptiometry on the lumbar spine, proximal femur and radius shaft. In the osteoporotic women, whose spine BMD was significantly reduced, BUA and SOS were lower, to about the same degree of significance as radius BMD; ROC analysis demonstrated that for discrimination of spinal osteopenia, the area under the ROC curve was similar for radius BMD, SOS, and BUA. There was a modest correlation (r about 0.65) between either SOS or BUA on the os calcis and BMDs of the spine and radius. Correlations of the SOS and BUA with femoral neck BMD were lower (r about 0.4 to 0.5). The standard error of estimate for both spine and femoral neck BMD was too high (about 0.14 g cm-2) for os calcis measurements to be substituted clinically for densitometry at these fracture sites. PMID- 2698781 TI - Interrelationships between the imprinting potential and biological activity of insulin derivatives: studies on Tetrahymena and Chang liver cells. AB - Insulin dimers deprived of biological activity by linking with suberic acid symmetrically in position B29 or B1 were not able to induce imprinting. Lack of N terminal phenylalanine or even of five C-terminal amino acids did not interfere with imprinting, regardless of whether or not it was associated with an activity loss. It appears that while hormonal imprinting is closely associated with the hormone's ability to bind to the receptor, it may be related as well as unrelated to the hormone's biological activity. The imprinted Tetrahymena and Chang cells bound the insulin and its derivatives in a similar manner. PMID- 2698782 TI - Does membrane-associated DNA play a role in the establishment of hormonal imprinting in the unicellular Tetrahymena? AB - Treatment of Tetrahymena with DNase considerably reduced the FITC-insulin binding capacity of the unicellular organism, but a normalization of the binding value followed after 24 h. DNase equally prevented imprinting in Tetrahymena when applied before or after insulin. It appears that membrane-associated DNA plays an important role in the hormone binding of Tetrahymena, and also presumably in the development and/or stabilization of hormonal imprinting. PMID- 2698783 TI - [Esophagoplasty in caustic stenosis in children. Apropos of 28 cases]. AB - 28 cases of oesophagectomy for caustic stenosis in children are reported. The authors discuss the technical modalities and the evolution of ideas, especially the importance of the oesophagectomy, in front of the risk of a secondary cancerisation. This severe complication becomes accentuated with the years and prescribes in children more systematic oesophagectomy concomitant or secondary to the oesophagoplasty. PMID- 2698784 TI - [Therapeutic problems of intra-abdominal liposarcoma]. AB - Intra-abdominal liposarcomas are very rare tumors. We present our personal experience with one case of mesenteric liposarcoma which had perforated into the peritoneal cavity, occurring in a seven-month pregnant female patient. Seven years later, the patient is doing well. The authors have carried out a review of the literature. In addition to liposarcomas of the mesentery and the mesocolon, they observed some cases of liposarcoma localized in the omentum and the stomach; other abdominal localizations occurred sporadically. Radical surgical excision was the choice treatment. Both the propensity for locoregional spread and the histological diversity set the conditions for prognosis; the latter seemed minimally influenced by either radio- or chemotherapy. PMID- 2698785 TI - [Leiomyosarcoma of the esophagus. Apropos of a case with a review of the literature]. AB - The authors report a new case of leiomyosarcoma of the oesophagus, and a review of the literature since 1960 (during this period almost every case has been resected). Four macroscopic aspects are observed: polypoid, mediastinal, intra mural and infiltrating. The accurate diagnosis is difficult and was established before the operation only in half cases. It is based on barium swallow examination and esophagoscopy, that reveal different appearances depending on the anatomical type, and on the biopsy. The interpretation of the biopsy may be difficult because of the superficial nature of the sampling, frequently taking only mucosa or necrotic tissue. It is necessary to remove the necrotic tissue to discover the tumoral tissue, or to perform a wide diathermic snare biopsy. The diagnosis of malignancy is mainly based on the mitosis count, and interpretation of the peroperative pathologic examination is difficult. The surgeon may have to decide on an esophageal resection, according to the gross appearance. Esophagectomy is the most logical treatment; adjuvant radiation therapy could have some efficiency. PMID- 2698786 TI - [Nutritional therapy in chronic renal failure and its future trends]. PMID- 2698787 TI - [Mechanisms of bacterial resistance to antibiotics and changes in drug resistance]. PMID- 2698788 TI - [Advances in research on the repair of articular cartilage defects]. PMID- 2698789 TI - [Hepatic resection guided by B-mode ultrasonography]. AB - From December 1987 to July, 1988, ultrasonically guided hepatic resection was performed for primary liver cancer in 12 cases and benign liver tumor in 11 cases. No patient died on table and in 30 days after the operation. Among postoperative complications were hepatic coma in one case, pleural effusions in 3 and bile leaks in 2. Our results showed that the intraoperative B-mode ultrasound could not only demonstrate the number, size and boundary of the lesions but also locate the course of the intrahepatic conduit system and its 3-dimensional relation with the lesions. It was, therefore, very helpful in dealing with the intrahepatic blood vessels and biliary ducts. PMID- 2698790 TI - [Advances in research on mechanisms of hepatic encephalopathy]. PMID- 2698791 TI - [Treatment of 10 cases of multiple organ failure]. AB - From 1985 to 1987, 10 cases of multiple organ failure (MOF) caused by severe infection, major surgery, and trauma were treated in our hospital. The sequence of the organs that came to a failure varied with different diseases. The diagnosis was made on the objective index and numbers of the failed organs. All patients were monitored and treated with modern medical equipment including hemodialysis, plasma-exchanging technique, and artificial heart-lung machine. It was found that the increase of curative rate lay on the intensive care and comprehensive treatment. Five patients in this group survived, and the diagnosis of MOF was finally confirmed by autopsy (heart, lung, liver, kidney, brain, and GI tract) in three cases. Based on the pathological findings, the authors suggested that patients with MOF could only be cured when the disease was on its first, second, or early third stage. PMID- 2698792 TI - [Asymptomatic renal cell carcinoma and small renal cell carcinoma]. AB - Of 151 patients with renal cell carcinoma 12 were asymptomatic and 13 were small in size. The patients with asymptomatic renal cell carcinoma were incidentally discovered by B ultrasonography or IVP. Most of asymptomatic renal cell carcinomas were of lower stage than suspected, but a few were advanced. The patients with small renal cell carcinoma, which were all classified into stage One, Simple hematuria or pain is not only the manifestation of advanced carcinoma but also early stage. It is termed early diagnosis that the renal cell carcinoma without capsule invasion and metastases is detected. B ultrasonography should be the first choice for early diagnosis of renal cell carcinoma. PMID- 2698793 TI - [The reaction of a population of redbacked voles (Clethrionomys glareolus) to pollution of the biogeocenosis by 137Cs]. PMID- 2698794 TI - Beta-lactamase stability and antibacterial activity of cefpirome alone and in combination with other antibiotics. AB - The antibacterial activity of cefpirome (HR810), a new cephalosporin, was compared with that of other "third-generation" cephalosporins, as well as cefuroxime, piperacillin and gentamicin. Cefpirome was the most active beta lactam antibiotic against Gram-negative bacteria. The MIC90 for Enterobacteriaceae was always less than 0.5 ml/l except for Enterobacter species. The MIC90 against Pseudomonas species was 2 mg/l, which was equal to that of ceftazidime and gentamicin. Cefpirome was also more active than the other beta lactam antibiotics against Staphylococcus aureus. A relatively high frequency of synergy was observed when cefpirome was combined with aminoglycosides against both Gram-positive and Gram-negative bacteria. No antagonism was detected. This antibiotic was very stable to both plasmid- and chromosomally-mediated beta lactamases. It was more resistant to Enterobacter cloacae P99 enzyme than ceftazidime, cefotaxime and cefotetan. Its stability to the Klebsiella K1 beta lactamase was more than that of cefotaxime and ceftriaxone but slightly less than that of ceftazidime and latamoxef. MBC90 values for cefpirome were generally less than twice the corresponding MIC values. PMID- 2698795 TI - "Mycelial vaginal test" and Candida susceptibility. AB - We have investigated the possibility of vaginal liquids affecting the transition from a yeast form (Y) to a mycelial one (M) in C. albicans and the possible relation to microbial flora, pH and glycogen. The C. albicans Y----M conversion, "mycelial vaginal test", in 250 specimens of vaginal liquid shows a 70% positivity rate against a test Candida strain. Results of the vaginal test are not related to bacteria, flora and pH, but to Candida infection and to glycogen concentration. Using a Y----M good-responder Candida strain in the vaginal test it is possible to have a global index of the factors affecting the Candida filamentation in the host. It can be advisable to utilize the vaginal test as a virulence test for Candida strains and as an indicative test of phenotypic drug resistance. PMID- 2698796 TI - Comparative effects of three beta-lactam antibiotics on anti-PC direct plaque forming cells. AB - Penicillin G, cefotaxime and clavulanic acid administered intravenously were studied for their immunomodulating properties. BALBC/c mice were immunized using PC-KLH as thymus-dependent antigen at the same time as the antibiotic was injected. The effect on antibody response was evaluated 5 days after immunization. Critical immunological parameters such as direct antibody-producing cells, Ab-secretion median rate, secretion rate heterogeneity and cellular viability, were studied. The most stimulatory effects were with penicillin G at the 4 x 10(6) IU/kg dose (+73%), cefotaxime at the 366 mg/kg dose (+80%) and clavulanic acid at 1 mg/kg (+218%). The experiments using inhibition of plaque formation with free hapten demonstrate that all the drugs studied decreased the antibody secretion rate and this parameter appeared more heterogeneous when cefotaxime and clavulanic acid were given; however, with penicillin this parameter was more heterogeneous at 2 x 10(5) mg/kg and 1 x 10(3) IU/kg respectively. When clavulanic acid was injected, the number of lymphocytes per spleen, size and friability of the spleen were increased versus the control mice. The present data show that all of the drugs studied present immunostimulating effects on humoral response, against thymus-dependent antigen, but have differently pronounced enhancements. PMID- 2698797 TI - Modifications of oogenesis and development in marsupial frogs. PMID- 2698798 TI - Ontogeny of immunoglobulin expression in the Mexican axolotl. AB - The ontogeny of immunoglobulin (Ig) synthesis was followed at both cellular and serological levels in the Mexican axolotl (Ambystoma mexicanum) using polyclonal antibodies recognizing all Ig molecules and a set of monoclonal antibodies (Mabs) specific for the C mu and Cv heavy Ig chain isotypes and for the light chain constituents shared by IgM and IgY molecules. Clusters of IgM- and of IgY synthesizing lymphocytes, often located in separate sites, are first present in spleen sections of 7-week-old 25 mm larvae, about one month after differentiation of the spleen anlage (stage 39-40). In 12-week-old 30-35 mm larvae, the relative proportion of IgM- and IgY-synthesizing cells in the spleen is the same as that in adult animals. However, a marked enhancement of the spleen B cell compartment occurs from 5 to 9 months when Ig-positive cells represent about 88% of the lymphocytes population compared to 60% in adults. No structures equivalent to B cell germinal centers were observed at any stage of the spleen differentiation and cells, although often clustered in small groups, remain dispersed in the entire organ. The relative proportions of IgM and IgY B cells throughout the spleen remain constant during development (about 1 IgY+ cell for 5-6 IgM+ cells) and IgM molecules are first detected in the serum of 2.5-month-old larvae. The enhancement of the serum IgM level correlates well with the absolute number of IgM+ cells in the growing spleen. IgY molecules cannot be detected in the serum before the 7th month but their level quickly increases to reach about 60% of the adult value at 10 months. Thyroxine-induced metamorphosis or hyperimmunization of 4- to 6-month-old larvae had no effect upon the temporal expression of the Ig classes in serum. PMID- 2698799 TI - The induction of oocyte maturation: transmembrane signaling events and regulation of the cell cycle. PMID- 2698800 TI - Myonuclear birthdates distinguish the origins of primary and secondary myotubes in embryonic mammalian skeletal muscles. AB - Myotubes were isolated from enzymically disaggregated embryonic muscles and examined with light microscopy. Primary myotubes were seen as classic myotubes with chains of central nuclei within a tube of myofilaments, whereas secondary myotubes had a smaller diameter and more widely spaced nuclei. Primary myotubes could also be distinguished from secondary myotubes by their specific reaction with two monoclonal antibodies (MAbs) against adult slow myosin heavy chain (MHC). Myonuclei were birth dated with [3H]thymidine autoradiography or with 2 bromo-5'-deoxyuridine (BrdU) detected with a commercial monoclonal antibody. After a single pulse of label during the 1-2 day period when primary myotubes were forming, some primary myotubes had many myonuclei labelled, usually in adjacent groups, while in others no nuclei were labelled. If a pulse of label was administered after this time labelled myonuclei appeared in most secondary myotubes, while primary myotubes received few new nuclei. Labelled and unlabelled myonuclei were not grouped in the secondary myotubes, but were randomly interspersed. We conclude that primary myotubes form by a nearly synchronous fusion of myoblasts with similar birthdates. In contrast, secondary myotubes form in a progressive fashion, myoblasts with asynchronous birthdates fusing laterally with secondary myotubes at random positions along their length. These later differentiating myoblasts do not fuse with primary myotubes, despite being closely apposed to their surface. Furthermore, they do not generally fuse with each other, as secondary myotube formation is initiated only in the region of the primary myotube endplate. PMID- 2698801 TI - Fungal tremorgens: the mechanism of action of single nitrogen containing toxins- a hypothesis. AB - Tremorgenic mycotoxins are fungal secondary metabolites with a specific effect on the central nervous system (CNS). Except for a few toxins that are produced by Claviceps paspali, a plant parasitic fungus, most tremorgenic mycotoxins are synthesized by common saprophytic moulds of the genera Penicillium and Aspergillus. Since these compounds produce sustained tremor in the abscence of other neurotoxic effects, several authors have suggested that they are the causative agents of a number of naturally occurring incoordination syndromes in ruminants. The nature of the tremor produced by these compounds in laboratory animals is clinically indistinguishable from that occurring naturally. In particular, the most implicated tremorgenic mycotoxins are those that contain a single nitrogen atom in their molecules. Although individual compounds within this group are produced by unrelated fungal species, they all contain a similar biologically active chemical moiety. To date, their mechanism of action is unknown, and their role in neuropharmacology has not yet been defined. However, the presence of a GABA-like conformation within their active nucleus and the limited torsional flexibility of this moiety suggest that they are partial agonists of GABA (gamma-aminobutyric acid). A hypothetical mode of action of these toxins at the GABA receptor sites is presented and discussed. PMID- 2698802 TI - Assessing the impact of computer workload on operator stress: the role of system controllability. AB - This paper considers the impact of working with computer-based systems in terms of mental workload and the well-being of operators. In particular, the paper focuses on issues of controllability in human-computer systems as they relate to operator stress. Through the adoption of a state control model of stress regulation, it becomes apparent that while general usability criteria are necessary for the design of controllable systems, they may not be sufficient to guarantee controllability. The implications for research and system design are discussed, with reference to the assessment of operator workload, controllability and stress. A methodology for assessing computer stress is described, based on the analysis of stressful computer-related episodes and their accompanying affective and cognitive states. This technique allows the relationship between workload and controllability to be studied in particular computer work environments, in relation to individual work goals and coping strategies. PMID- 2698803 TI - Immunological detection and definition of minimal residual neuroblastoma disease in bone marrow samples obtained during or after therapy. AB - Immunological staining by the alkaline phosphatase/anti-alkaline phosphatase (APAAP) technique has been used to recognize low levels of neuroblastoma cells in bone marrow mononuclear cells. Immunological phenotyping with 11 well characterized monoclonal antibodies was performed on 16 children with neuroblastoma and BM involvement during or after therapy. Neuroblasts were detected in 11 of 16 patients (0.1-5%), whereas BM biopsies on six of these patients were classified as normal. Aspirates, stained conventionally, were positive for pathological cells in three patients only. The comparison of the phenotype of the neuroblastoma cells at the time of diagnosis to the phenotype of the residual cells within one patient revealed differences. The phenotype of residual disease in different patients on the other hand showed a unique pattern. The above mentioned results lead to the conclusion that the immunological procedure is particularly suitable for the analysis of minimal residual neuroblastoma since the technique allows very minor cell populations to be identified in BM samples. PMID- 2698804 TI - Effect of methylprednisolone sodium succinate on quality of life in preterminal cancer patients: a placebo-controlled, multicenter study. The Methylprednisolone Preterminal Cancer Study Group. AB - The effectiveness of an 8-week, 125 mg/day intravenous course of methylprednisolone sodium succinate (MPSS) for improving quality of life in patients with preterminal cancer was investigated in a double-blind, placebo controlled, multicenter study. Quality of life was assessed using the Nurses' Observational Scale for Inpatient Evaluation (NOSIE), the Linear Analog Self Assessment Scale (LASA), and the Physicians' Global Evaluation. A total of 403 patients were enrolled: 207 were treated with MPSS and 196 were treated with placebo. MPSS was significantly more effective than placebo in improving quality of life as judged by the changes from baseline in the NOSIE and LASA total scores. (P less than 0.05) and by the Physicians' Global Evaluation (P less than 0.001). The mortality rate was similar between MPSS-treated males (40.2%), placebo-treated males (35.5%), and MPSS-treated females (40.0%). However, the mortality rate of 27.7% for female placebo-treated females was significantly lower than for their MPSS-treated counterparts. The reason for lower mortality among placebo-treated females is unknown and warrants further study. PMID- 2698805 TI - Non-Hodgkin's lymphomas of follicular center cell type in Osaka, Japan. AB - Five hundred and nineteen patients with follicular center cell (FCC) tumors in Osaka, Japan were selected for study from 1000 patients with non-Hodgkin's lymphoma (NHL). They were admitted to hospital during 1964-1987, which was divided into three periods 1964-1972 (I), 1973-1979 (II), and 1980-1987 (III) to examine the time trend of FCC tumors. The median age of patients rose from 51 to 55 years of age with an increase in female and extranodal disease patients. The frequency of nodal FCC tumors among all nodal NHL increased from 37.5 to 51.5% (P less than 0.05), but that of extranodal types decreased from 82.9 to 56.8% (P less than 0.01), although the total number showed little change. When the cases were categorized as diffuse type and follicular type, the diffuse type predominated through the period in both nodal and extranodal sites. The frequencies of follicular type among all NHL were 10.2, 6.3, and 8.4% during the periods I, II and III, respectively. These results showed that follicular lymphoma was a minor constituent of NHL in Japan compared to Western countries, and the frequency did not increase from 1964 to 1987. The frequency of FCC tumors in the present series was rather higher than that in Western countries, therefore it is concluded that FCC tumors in Japanese have much less potential for forming a follicular structure than those in patients from Western countries. PMID- 2698806 TI - Hormone replacement therapy in women treated for breast cancer. AB - We must still maintain the conventional advice that unopposed low dosages of oestrogen should not be used for the treatment of menopausal symptoms in women treated previously for breast cancer. There is, however, epidemiological, laboratory and clinical evidence that certain combinations of oestrogen and progestagen are more likely to be beneficial than harmful, in respect to the risk of reactivating subclinical residual breast cancer or causing progression in premalignant lesions. It is no longer justifiable to deprive a woman with a history of breast cancer treatment of a hormonal therapy capable of safely relieving symptoms which are making her life intolerable. A clinical trial of such treatment is reported. PMID- 2698807 TI - Cancers of the breast, endometrium and ovary: geographic correlations. AB - Patterns of incidence of breast, endometrial and ovarian cancer show strong similarities in both international and inter-regional comparisons, similarities readily confirmed by the calculation of coefficients of correlation. Migrant studies suggest that environmental factors are more important than genetic differences between populations. Correlation studies have shown that dietary factors can explain much of the international variation, and most suspicion has fallen on dietary fat. Differences in fertility between populations also correlate with the variations in incidence. For breast cancer, the latter may be an important determinant of variation within countries in the pre-menopausal age group, with dietary differences accounting for variations in post-menopausal rates internationally. There is scope for improving upon earlier studies, and for investigating the relative contributions of diet and fertility to the geographic patterns of endometrial and ovarian cancers. PMID- 2698808 TI - Multiple primary cancers of the breast, endometrium and ovary. AB - The association between cancers of the breast, endometrium and ovary is reviewed, using mainly population-based data from the cancer registries in Denmark and Connecticut, U.S.A. Breast cancer patients had an approximately three-fold increased risk of developing a cancer in the contralateral breast. The risk of breast cancer was also elevated following cancers of the corpus uteri and ovary, with relative risk (RR) estimates of about 1.5 from 1 to 4 years after the diagnosis of the first primary cancer. An increased risk of cancer of the corpus uteri subsequent to breast cancer was found in Connecticut, but not in Denmark. After an ovarian cancer, the risk of cancer of the corpus uteri was also elevated (RR = 1.6-2.3). An increased risk of ovarian cancer was observed subsequent to breast cancer (RR = 1.3-1.7), whereas the ovarian cancer risk decreased with time since the diagnosis of a cancer of the corpus uteri, probably reflecting treatment involving oophorectomy. PMID- 2698809 TI - Reproductive factors and cancers of the breast, ovary and endometrium. AB - In contrast to cancers of non-hormone-dependent sites, cancers of the breast, ovary and endometrium show a slowing down of the rate of increase in incidence at around age 50, as if ceasing menstrual activity reduced risk. Also nulliparous women appear more prone to these three cancers as compared to parous women, thus suggesting that pregnancies also represent a 'protected' time. Epidemiological studies on breast cancer, the only ones sufficiently large to try to disentangle meaningfully the effects of collinear reproductive variables such as parity and ages at first and last birth, show, however, that the effect of pregnancy is not simple and depends on how many births take place and at what age. Larger population-based investigations able to obtain with greater precision information not only on reproductive factors but also on possible confounding variables (e.g. socio-economic status, dietary habits, etc.) are mandatory, particularly as regards ovarian cancer and endometrial cancer. The lesson from the recent studies on pregnancy-related events and breast cancer is, however, that initially a decrease of old certainties must be expected to derive from the accumulation of new, better epidemiological data. PMID- 2698810 TI - Nutritional factors and cancers of the breast, endometrium and ovary. AB - From an overview of epidemiological evidence on nutrition, diet and cancers of the breast, endometrium and ovary, the following indications can be drawn: Overweight and obesity are causally related to endometrial and post-menopausal breast cancer, and may account for as much as one third of the cases of endometrial and one tenth of breast cancer in Europe. It is not known whether obesity or overweight early in life has any role on breast cancer risk, nor whether obesity influences ovarian carcinogenesis. Overweight tends to be associated with an unfavourable prognosis for breast cancer. Despite extensive research, the available knowledge on diet and breast cancer is largely inconsistent, and the results from ecological and individual-based studies are contradictory in relation to fat, proteins, total energy, alcohol, etc. There are only scanty data on diet and endometrial or ovarian cancer, which tend to suggest role for fat (or animal fat) in the risk of these neoplasms. The evidence on diet and breast, ovarian and endometrial carcinogenesis is still too scanty or inconsistent to be of any practical preventive value. Thus, the only clear indication for prevention is that a reduction of overweight would avoid a substantial number of cases of endometrial and post-menopausal breast cancer. PMID- 2698811 TI - The role of exogenous hormones in the epidemiology of breast, ovarian and endometrial cancer. AB - This review focuses on the effects of oral contraceptives (OC) and estrogen replacement therapy (ERT) on the risk of breast, ovarian and endometrial cancer. The relationship between OC and cancer risk is first placed in a historical perspective. Since 1960, when OC were introduced, the hormonal composition of OC as well as the characteristics of the OC user have changed considerably. Studies conducted in the 1970s were generally reassuring, but it was not until the 1980s that studies could evaluate the effect of prolonged OC use after an extended follow-up period. Although the relationship between breast cancer and OC has been investigated in about 40 studies, the issue still remains essentially unresolved. Most studies report no association between ever use of OC and breast cancer risk. Several studies find increased risk for prolonged use and other studies report elevated risks for women who used OC very early in their reproductive years. The inconsistent results of recent studies are attributed to bias or to geographical variation in latency period elapsed, types of OC preparations, or prevalence of other risk factors. In contrast, the use of combined OC has consistently been shown to reduce the risk of ovarian and endometrial cancer. The risk further decreases with increasing duration of use and the protective effect seems to persist in ex-users for at least 5 years. Some evidence indicates that higher parity reduces the protective effect. Though studies relating ERT to breast cancer are far from consistent, overall, there is evidence for a moderately increased risk with high dose and/or long duration. The effect seems to be modified by mode of administration (injections vs. pills) and by type of ERT, but this needs confirmation. The number of adequate studies on the relationship between ERT and ovarian cancer is too small to draw firm conclusions. The positive relationship between ERT and endometrial cancer is now well established. The ERT effect is dose- and duration-dependent and is characterized by a short latency period. The cyclic addition of progesterone (greater than 10 days/cycle) may reduce the risk increase. PMID- 2698812 TI - Control of cell proliferation in senescent cells. Introduction. PMID- 2698813 TI - Antecedents of cell aging research. AB - Our observation that normal human and animal cells have a limited capacity to divide and function in vitro overturned a dogma held since the turn of the century. The dogma held that cultured normal cells are immortal and gerontologists interpreted this to mean that aging, therefore, could not be the result of intracellular events. We concluded that longevity and aging do result from intracellular events, and, in the subsequent 30 years, the validity of our finding has been widely confirmed. Other major findings have been made: (a) The number of population doublings and functional events that a cultured normal cell can undergo is inversely proportional to donor age and, probably, directly proportional to species longevity; (b) the limit on cell division and function also occurs in vivo when normal cells are transplanted seriatim; (c) as cell doublings or functional events reach their limit, changes occur in hundreds of variables from the molecular to the whole cell. Most importantly, many of these changes are identical to those seen in intact humans and animals as they age; (d) WI-38, the first widely distributed normal human cell strain has retained its memory of population doubling level during 27 years of cryogenic storage. This is the longest time that any normal human cell has ever been preserved. Evidence that longevity is determined by genetic events is overwhelming but evidence that age changes are the result of gene expression is not. Normal age changes must be distinguished from disease. Because few feral animals ever become old, natural selection could not have favored the development of a genetically programmed aging process. In the 2 or 3 million years of human existence, too few old humans existed to have provided a selective advantage favoring the development of a genetic program that would determine age changes. The selective advantage of maintaining physiological vigor for as long as possible in order to insure maximum reproductive success may be the essential indirect determinant of longevity. Natural selection has provided sexually mature animals with extraordinary reserve capacities in virtually all organs. After sexual maturation, animals continue to function by utilizing the reserve capacity that evolved to insure that they would attain reproductive success. The magnitude of reserve capacity is the essential element in determining postdevelopmental longevity. Thus "Why do we age?" may be the wrong question. The right question may be "Why do we live as long as we do?" PMID- 2698814 TI - Replication control and cellular life span. AB - Cell proliferation involves both control of progress through the current cell cycle and coordination of successive cell cycles. We have focused our attention on the events that trigger traversal of the G1/S boundary of the cell cycle. A protein kinase activity was found in preparations of the DNA-replicative complex from the budding yeast Saccharomyces cerevisiae. The activity phosphorylated only a few of the proteins present in the replicative fraction, and it displayed a marked preference for a 48-kDa polypeptide. Most importantly, the protein kinase activity was heat-sensitive in replicative fractions from cdc7 cells, a mutant that arrests at the G1/S boundary at restrictive temperature. The results suggest that phosphorylation of components of the replication machinery may play a role in control of initiation of DNA replication during the cell cycle. We have also begun an analysis of cellular aging in yeast, as a means of addressing the problem of coordination of successive cell cycles. Yeast cells have a finite life span defined by reproductive capacity. With age, the generation time of yeast cells lengthened. The cell cycle of the daughter cell was under the control of the mother. This control was transient, and the daughter cell began dividing at the rate characteristic of its own age within three divisions of its birth. This suggests that the senescent phenotype, as manifested by lengthened generation time, is a dominant feature in yeast cells, and that it is determined by a diffusible cytoplasmic molecule(s) that undergoes turnover in young cells. In a search for this putative senescence factor(s), we are cloning genes that differentially expressed during the yeast life span. Several such genes have been isolated and partially characterized. Our goals are to determine whether the expression of one or more of these genes is casually associated with cell longevity. We propose the Cell Spiral model to describe the relationship between the cell cycle and cellular aging. PMID- 2698815 TI - Aging and defective lymphoid cell activation. AB - Activation of lymphocytes for proliferation is a crucial process in the immune response. Age-related deficiencies in this cellular response strongly correlate with deficiencies in the immune system response, with concomitant increase in disease severity and mortality. Defects associated with the transmission of the initial activation signal and with IL-2 production contribute to the depressed response, but defects in the IL-2 response mechanism also play important roles. A major factor in this area is the inability of the nuclei of these cells to respond to the intracellular factor ADR, which plays a crucial role in the initiation of DNA replication. These cells produce normal levels of ADR; thus, either the nuclei cannot bind ADR in a productive manner or the defect lies beyond the point of ADR binding, perhaps in one of the other proteins of the initiation complex. An interesting contrast to the age-related failure of nuclei to respond to ADR is the failure of neoplastic nuclei to respond to the ADR inhibitor. This inhibitor, found in the cytoplasm of quiescent cells, suppresses both the activation of quiescent nuclei by ADR and the ongoing DNA synthesis in isolated nuclei from activated cells. Nuclei from spontaneous proliferating cell lines were not affected by this inhibitor, which may be an important factor in the uncontrolled growth seen in neoplastic cells. The investigation of ADR has given hints that perhaps two of the fundamental questions in biology, namely why some cells don't proliferate and why some others won't stop proliferating, may be two sides of the same coin. PMID- 2698816 TI - Expression of carbohydrate binding protein 35 in human fibroblasts: comparisons between cells with different proliferative capacities. AB - Carbohydrate Binding Protein 35 (CBP35) is a galactose-specific lectin found in the nucleus and cytoplasm of mouse 3T3 fibroblasts. In these cultures, the level of expression and nuclear localization of CBP35 was correlated with the proliferative state of the cells. CBP35 is also found in human fibroblasts. We have compared the expression and localization of CBP35 in human fibroblasts of different replicative capacities: young (passage 11), intermediate (passage 19), and old (passage 33) SL66 cells, and fibroblasts derived from a patient with Werner's syndrome. The results indicate that the expression of CBP35 in cells with either age-acquired or congenital replicative deficiencies was unresponsive to serum stimulation, in contrast with that found in young normal human fibroblasts and in 3T3 cells. PMID- 2698817 TI - Patients' decisions about continuing with therapy in chronic illness: a study of hyperbaric oxygen therapy in multiple sclerosis. AB - The criteria which may be employed by chronically ill people in their decision about whether to continue with therapy were investigated in the context of a clinical trial of hyperbaric oxygen therapy for multiple sclerosis. An open-ended question about reasons for continuing or discontinuing treatment obtained data from 48 trial participants on completion of the trial and six months later. Physical factors were the most commonly cited reasons for continuing treatment; stabilization of the condition was mentioned as well as improvement. Lack of effectiveness was more commonly given as a reason to stop therapy six months after the trial. Social and practical reasons were also cited as reasons for discontinuing therapy and there was implicit evidence of a high level of social support enabling patients to continue therapy. Most problems appeared to have surfaced by the end of the trial. Epistemological reasons provided rationales for the decisions taken and referred particularly to the time required to make an informed judgement about the effectiveness of treatment. Personal experience and knowledge of the effects of hyperbaric oxygen on others were more significant to the decision than anticipation of the trial's formal results. The participants in the trial were sophisticated and responsible decision-makers even though their judgements would not always have coincided with medical opinion. PMID- 2698818 TI - Life events, vulnerability and illness: a selected review. AB - In this review we examine the links between life stress and illness and the research approaches and methodologies which have been used to study them. Evidence is presented of causal relationships between adverse life events and illness onset and we discuss ways in which these events may be detected and measured. The notion that 'moderating variables' may affect both an individual's vulnerability to the effects of adversity and the coping strategies adopted to deal with life stress is emphasized. Typically, research has focused on the effect of a single psychosocial variable on the correlation between life events and illness. We conclude that research aimed at eliciting factors associated with successful coping is of more importance if primary care physicians are to identify vulnerable patients and make therapeutic interventions to minimize the damaging effect of stress and adversity. PMID- 2698819 TI - [The role of the adrenoreceptors in regulating the blood coagulation system]. PMID- 2698820 TI - Computers: the best friends a human genome ever had. AB - Mapping and sequencing the human genome will generate large amounts of data, which must be sorted, analyzed, and stored for rapid retrieval to complete this enormous task. Computers and their software programs provide the most important tool to the molecular biologist today. A discussion of current capabilities and future needs in computer hardware and software for the human genome project is the topic of this paper. The use of computer programs to generate restriction maps, manage clone libraries, manage sequence projects, and generate consensus sequences is presented. The use of computers to communicate useful information rapidly to scientific colleagues is also mentioned. The role of both GenBank and BIONET is central to the dissemination and analysis of sequence information. The capabilities of electronic communication worldwide for assisting this project is available on the BIONET National Computer Resource, using existing networks. PMID- 2698821 TI - Biotechnology and the Third World: the missing link between research and applications. AB - A United Nations University study investigated the activities of four major United Nations agencies that focussed on helping developing countries gain advanced capabilities in biotechnology. Relevant program and project documents were scrutinized at agency headquarters and managers were interviewed. Then, projects underway in three case countries (Egypt, Thailand, and Venezuela) were examined. The resulting information was used to assess whether United Nations projects were fulfilling these countries' needs and (or) advancing their capabilities in biotechnology. The minute, United Nations originated assistance available was directed solely at increasing capabilities in research and thus benefited bioscientists and their institutes. However, as virtually no linkage exists between the research establishment and the industrial--marketing sector, results from indigenous research does not reach industrialists or health workers. Consequently, biotechnology is neither advancing economic development in the case countries nor helping solve national problems. This situation is likely to persist because corrective systemic changes will be difficult to implement. Major implications of these findings are discussed, particularly as they bear on the United Nations system. PMID- 2698822 TI - Evolving strategies for making physical maps of mammalian chromosomes. AB - Two types of physical maps are described: restriction maps made by top down approaches using enzymes that cut the genome infrequently, and complete libraries, made by bottom up approaches using fingerprinting of randomly selected cloned DNA. Construction of such maps for mammalian chromosomes is complicated by the mosaic nature of mammalian genomes, and extensive polymorphisms at the cleavage sites of most enzymes that yield large DNA fragments. However, it appears that both of these potential difficulties can be turned into advantages by new mapping strategies. When combined with yeast artificial chromosome cloning and polymerase chain reaction amplification methods, these approaches should soon yield complete maps of many human chromosomes. PMID- 2698823 TI - Constructing chromosome- and region-specific cosmid maps of the human genome. AB - A chromosome-specific ordered set of cosmids would be a significant contribution toward understanding human chromosome structure and function. We are developing two parallel approaches for creating an ordered cosmid library of human chromosome 19 and other selected subregions of the human genome. The "bottom up" approach is used to establish sets of overlapping cosmids as islands or "contigs" along the chromosome, while the "top down" approach, using pulsed-field gel electrophoresis and yeast cloning, will establish a large-fragment map and close the inevitable gaps remaining from the "bottom up" approach. Source DNA consists of a single homolog of chromosome 19 from a hamster--human hybrid cell and human fragments cloned in yeast artificial chromosomes. We have constructed cosmid libraries in a vector that facilitates cloning small amounts of DNA, allows transcription of the insert termini, and contains unique sites for partial-digest mapping. Computer simulations of cosmid contig building suggest that near-optimal efficiency can be achieved with high-density restriction fragment digest schemes that can detect 20-30% overlap between cosmids. We developed the chemistry and data analysis tools to compare the ordering efficiencies of several cosmid restriction digest fingerprinting strategies. Restriction fragments from a four cutter digest are labeled with a fluorochrome, separated by polyacrylamide gel electrophoresis, and detected after laser excitation as they traverse a fixed point in the gel. We have also developed the software to rapidly process the output signal to define and analyze the fragment peaks. Up to three cosmids (or three different digests of the same cosmid) plus a size standard are analyzed simultaneously in a single gel lane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698824 TI - Linkage maps of human chromosomes. AB - Finding the chromosomal location of human genes that heretofore have been defined solely by phenotypes, in particular clinical phenotypes that are transmitted in Mendelian fashion in families, is an early and often crucial step in the process of identifying the molecular basis of a disease. Recent progress in construction of chromosomal maps of genetically linked DNA markers has made almost the entire human genome accessible to linkage studies in families that are segregating genetic defects. Construction of linkage maps requires a panel of three generation families for genotyping, a large number of polymorphic markers, and sophisticated computer programs for analysis of genotypic data. After a locus harboring a deleterious mutation has been identified by linkage to a mapped marker, a high-resolution map of the region can be constructed with new markers derived from cosmid libraries, to narrow the search for the gene in question. For example, this strategy has been pursued in the effort to characterize the gene responsible for familial adenomatous polyposis. When a target region has been narrowed to about 1 centiMorgan, corresponding to roughly a million base pairs in physical distance, other techniques of molecular biology can be brought to bear to isolate and clone the actual gene. PMID- 2698825 TI - New technologies for large-genome sequencing. AB - Interest in DNA sequencing has increased in recent years and research into new instrument systems to optimize and automate the process has been intensified. A number of commercial devices, from Europe, Japan, and the United States, which instrument aspects of (mainly) the Sanger method, are now available and several new DNA sequencing techniques have been reported. This review briefly describes current methods of DNA sequencing and provides an account of systems presently available or under development for instrumenting the technology. The problems of automation for large-scale DNA sequencing are discussed. PMID- 2698826 TI - Genetics and the unity of biology. Proceedings of the XVIth International Congress of Genetics. Dedicated to the memory of Professor Sewall Wright. August 20-27, 1988, Toronto, Canada. PMID- 2698827 TI - Phenotypic expression of primary lesions of genetic material in Saccharomyces yeasts. AB - "Illegitimate" mating of yeasts (alpha x alpha), either spontaneous or induced by uv light or ethyl methanesulfanate, in a selective system for "cytoduction" revealed that about 95% of cytoductants expressed their original (alpha) mating type. Inducing the mating by treating the recipient of cytoplasm with uv light reached two orders of magnitude. An additional copy of MAT alpha in the alpha recipient almost completely eliminated the effect, which means that nonheritable mating type changes observed are formally recessive and are localized within MAT alpha complex. About 1% of cytoductants obtained were nonmating types and some of them were identified as mat alpha l mutants. Radl8 mutant as a recipient showed a considerably elevated spontaneous frequency of illegitimate hybridization and cytoduction. The cytoductants also preserved the original mating type. These facts suggest that nonheritable changes of mating type are due to repairable primary (premutational) lesions in MAT alpha genetic material. The significance of these results for understanding the mechanism of nonheritable variability is discussed. PMID- 2698828 TI - Tissue-specific activity of the pro-opiomelanocortin (POMC) gene and repression by glucocorticoids. AB - The gene encoding pro-opiomelanocortin (POMC) is specifically expressed in two different cell types of the pituitary gland. We have defined the regulatory DNA sequences of the POMC gene that are responsible for this cell-specific expression. In addition, we have defined a regulatory element, located in the proximal region of the POMC promoter, that confers glucocorticoid repression in the anterior pituitary. Using DNA-mediated gene transfer into transgenic mice and tissue culture cells, the POMC regulatory sequences required for cell-specific expression and glucocorticoid repression were localized within a 543-bp fragment in the 5'-flanking region of the gene. Multiple regulatory elements that bind nuclear proteins are present within this region. In particular, a sequence that binds the glucocorticoid receptor and behaves as a "negative glucocorticoid response element" (nGRE) also binds nuclear proteins of the COUP (chicken ovalbumin upstream promoter) family of transcription factors. Thus, glucocorticoid repression of POMC transcription may result from the mutually exclusive binding of the glucocorticoid receptor and the COUP transcription factor to the POMC nGRE. PMID- 2698829 TI - Recombination in yeast and the recombinant DNA technology. AB - The development of methods to isolate eukaryotic genes, alter these genes in vitro and reintroduce them into the cell has had a major impact on the study of recombination in the yeast Saccharomyces cerevisiae. In this paper we discuss how recombinant DNA techniques have been employed in the study of recombination in yeast and the results that have been obtained in these studies. PMID- 2698830 TI - Proteins of the inner and outer centromere of mitotic chromosomes. AB - We have used immunocytochemistry and molecular cloning methods to identify and characterize structural polypeptides of the centromere. These studies permit us to resolve two distinct regions: the inner and outer centromere. (i) Components of the outer centromere: autoantibodies from certain patients with rheumatic disease identify a family of three immunologically related polypeptides that we have designated CENP-A (17 kDa), CENP-B (80 kDa), and CENP-C (140 kDa). CENP-B has been cloned and sequenced. DNA sequence analysis indicates that this polypeptide possesses two large regions with extraordinary concentrations of acidic residues (region I: 61 residues with 79% glu + asp; region II: 31 residues with 87% glu + asp). Despite this concentration of negative charge, immunocytochemical experiments suggest that CENP-B may be a DNA binding protein. In these experiments, the levels of CENP-B are seen to vary reproducibly from chromosome to chromosome. The role of CENP-B in vivo is unknown. However, it is unlikely to bind directly to the spindle microtubules since it is found at an inactive centromere that apparently does not attach to the spindle. (ii) Components of the inner centromere: we have injected mice with the whole chromosome scaffold fraction to elicit production of monoclonal antibodies. One such antibody identifies two structurally related polypeptides (the INCENP antigens, 135 and 155 kDa) that are preferentially located between the sister chromatids at the centromere. The INCENP antigens undergo dramatic movements from the chromosomes to the central spindle during mitosis. They are ultimately sequestered in the midbody and discarded. Several lines of evidence suggest that the INCENP polypeptides may be involved in the regulation of sister chromatid separation at the metaphase-anaphase transition. PMID- 2698831 TI - Recognition and elongation of telomeres by telomerase. AB - Telomeres stabilize chromosomal ends and allow their complete replication in vivo. In diverse eukaryotes, the essential telomeric DNA sequence consists of variable numbers of tandem repeats of simple, G + C rich sequences, with a strong strand bias of G residues on the strand oriented 5' to 3' toward the chromosomal terminus. This strand forms a protruding 3' over-hang at the chromosomal terminus in three different eukaryotes analyzed. Analysis of yeast and protozoan telomeres showed that telomeres are dynamic structures in vivo, being acted on by shortening and lengthening activities. We previously identified and partially purified an enzymatic activity, telomere terminal transferase, or telomerase, from the ciliate Tetrahymena. Telomerase is a ribonucleoprotein enzyme with essential RNA and protein components. This activity adds repeats of the Tetrahymena telomeric sequence, TTGGGG, onto the 3' end of a single-stranded DNA primer consisting of a few repeats of the G-rich strand of known telomeric, and telomere-like, sequences. The shortest oligonucleotide active as a primer was the decamer G4T2G4. Structural analysis of synthetic DNA oligonucleotides that are active as primers showed that they all formed discrete intramolecular foldback structures at temperatures below 40 degrees C. Addition of TTGGGG repeats occurs one nucleotide at a time by de novo synthesis, which is not templated by the DNA primer. Up to 8000 nucleotides of G4T2 repeats were added to the primer in vitro. We discuss the implications of this finding for regulation of telomerase in vivo and a model for telomere elongation by telomerase. PMID- 2698832 TI - Polymerases and UV mutagenesis in Escherichia coli. AB - Evidence for and against the involvement of the known nucleic acid polymerases in UV mutagenesis in Escherichia coli is reviewed. There is no evidence that rules out the participation of any of them when they are present but only one, the alpha subunit of DNA polymerase III holoenzyme (polC gene product) has been shown to be essential. It is argued that the PolC protein that functions in UV mutagenesis may not be immediately recognizable as one of the normal cellular polymerases or polymerase complexes. PMID- 2698833 TI - Mutational specificity and the influence of excision repair: insights into the mechanisms of error-avoidance and error-fixation. AB - The excision repair process controlled by the uvrABC gene in Escherichia coli is the major pathway for the repair of a diverse series of DNA damages. To achieve a better understanding of the mechanics of this repair pathway and its impact upon mutagenesis, we have applied a recently developed technology by which the nature of mutation is determined at the DNA sequence level. A comparison of the classes and distribution of mutation in excision-repair-proficient and excision-repair deficient strains of E. coli reveals that the absence of excision repair can alter both the nature of the mutations recovered as well as their distribution. This can occur in one of several ways. For example, under some circumstances the action of the UvrABC pathway can lead to interruptions of DNA strand continuity and an enhancement of both frameshift and deletion events. Such an effect is seen following damage by psoralen plus near UV (PUVA) treatment that produces crosslinks in the DNA. In comparison, several other treatments produce similar distributions within the classes of mutations recovered but demonstrate an alteration in site specificity. Such is the case following UV irradiation. In this case, the data indicate that while the premutagenic lesions may be the same, mutation fixation in the presence and absence of excision repair may involve different mechanisms. Similarly, evidence from the repair of damage by ethylating agents indicates that while the nature of the mutations recovered is not altered, the preferred location of these events is altered in the absence of excision repair. These results indicate that local DNA sequence can affect on the efficiency of excision repair.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698834 TI - The structure and function of RAD6 and RAD18 DNA repair genes of Saccharomyces cerevisiae. AB - The RAD6 and RAD18 genes of Saccharomyces cerevisiae are required for postreplication repair of discontinuities occurring in newly synthesized DNA following exposure to uv light. In addition, rad6 mutants are highly defective in mutagenesis induced by uv and other DNA damaging agents and in sporulation. RAD6 encodes a protein of 172 amino acids with a highly acidic carboxyl terminus. Deletion of the carboxyl terminal 23 residues, 20 of which are acidic, has little or no effect on uv sensitivity or uv mutagenesis, but sporulation is greatly reduced. Addition of the first four residues of the polyacidic tail restores sporulation to 50% the level observed in RAD+/RAD+ diploids. RAD6 protein has been previously shown to be a ubiquitin-conjugating (E2) enzyme that attaches ubiquitin to histones H2A and H2B in vitro. Our experiments show that deletion of varying lengths of the polyacidic tail of RAD6 protein greatly reduces its ubiquitin-conjugating activity. The RAD18 encoded protein contains features which suggest that it binds DNA and nucleotides. Ten of the 12 cysteine residues occur in regions that could form zinc finger domains for nucleic acid binding. The other interesting feature in RAD18 protein is the presence of a putative nucleotide binding sequence. The possible in vivo functions of the RAD6 and RAD18 proteins are discussed. PMID- 2698835 TI - Preferential repair of damage in actively transcribed DNA sequences in vivo. AB - My colleagues and I have discovered intragenomic heterogeneity in DNA repair in mammalian cells. Consequences of unrepaired DNA damage depend upon the precise location of the damage with respect to relevant genes. It is therefore important to understand rules governing accessibility of specific DNA sequences in chromatin to damage and repair. The efficiency of removal of pyrimidine dimers has been determined in the active dihydrofolate reductase (DHFR) gene in Chinese hamster ovary (CHO) cells. Repair within the gene was shown to be much more efficient than that in nontranscribed downstream sequences or in the genome overall. Preferential repair of active and essential genes such as DHFR may account for the fact that rodent cells are as uv-resistant as human cells in spite of their much lower overall repair efficiencies. In repair-proficient human cells the rate of repair in the DHFR gene is greater than that in the overall genome or in nontranscribed alpha-DNA sequences. The efficiency of removal of pyrimidine dimers is much higher in the transcribed than the nontranscribed DNA strands of the DHFR gene in both CHO and human cells. An excision-repair complex may be directly coupled to the transcription machinery to ensure early removal of transcription-blocking lesions in active genes. Sequences in the active c-abl proto-oncogene are repaired much more efficiently than are sequences containing the inactive c-mos proto-oncogene in Swiss mouse 3T3 cells. Tissue-specific and cell-specific differences in the coordinate regulation of proto-oncogene expression and DNA repair may account for corresponding differences in the carcinogenic response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698836 TI - Molecular mechanisms of regulation of HTLV-1 gene expression and its association with leukemogenesis. AB - Human T-cell leukemia virus type 1 (HTLV-1) has two trans-acting regulator genes, tax and rex, in the pX region. The tax gene is a trans-acting transcriptional activator of the long terminal repeat (LTR) and also of the cellular gene for IL 2R alpha. The latter seems to explain initiation of abnormal growth of HTLV-1 infected cells. The rex gene is a posttranscriptional regulator accumulating gag and env mRNA and also indirectly suppressing the transcription. The regulation requires two cis-acting elements, the LTR sequence at the 3' terminus and 5' splice signal, suggesting a novel mechanism of RNA processing in the nucleus. These two trans-activator genes are essential for efficient replication of HTLV-1 and also explain its poor replication competence and tendency to be latent in vivo. PMID- 2698837 TI - 125 years of experimental heat shock research: historical roots of a discipline. AB - The history of experimental heat shock research over the last 125 years is briefly, outlined. Starting with reports on the upper temperature limits of plant survival (1864) and on the spontaneous regression of skin cancer after a severe local inflammation (1866), studies on the heat shock response today are a major field of modern cell biology and include all types of prokaryotic and eukaryotic organisms. PMID- 2698838 TI - Expression of members of the Saccharomyces cerevisiae hsp70 multigene family. AB - The hsp70 multigene family of Saccharomyces cerevisiae is a complex multigene family, composed of members exhibiting complex patterns of regulation. Expression of some members is induced after a heat shock, whereas expression of others is repressed. Some members of the family are expressed during exponential growth. One gene, SSA3, shows an unusual pattern of expression during approach to stationary phase. While most RNAs decrease in abundance, SSA3 RNA levels dramatically increase. The constitutive expression of SSA3 in cells lacking adenylate cyclase activity suggests that cAMP modulates SSA3 expression. PMID- 2698839 TI - The genomics of long tandem arrays of satellite DNA in the human genome. AB - At least 10% of DNA in the human genome consists of long arrays of repeated sequences, arranged in tandem head-to-tail arrays in a number of discrete, highly localized chromosomal regions. Different families of these so-called "satellite DNA" sequences have been defined, organized in diverged subsets on different chromosomes. The molecular, cytogenetic, and evolutionary analysis of the hierarchical organization of such sequences in the human and other complex genomes encompasses a variety of approaches, including chromosomal mapping, in situ hybridization, genetic linkage analysis, long-range restriction mapping, and DNA sequencing. Investigation of the organization of satellite arrays constitutes a necessary first step towards eventual elucidation of the origin, evolution, and maintenance of these sequences and their contribution to the structure and behavior of human chromosomes. PMID- 2698840 TI - The role of a conserved dodecamer sequence in yeast mitochondrial gene expression. AB - All mRNAs on the yeast mitochondrial genome terminate at a conserved dodecamer sequence 5'-AAUAAUAUUCUU-3'. We have characterized two mutants with altered dodecamers. One contains a deletion of the dodecamer at the end of the var1 gene, and the other contains two adjacent transversions in the dodecamer at the end of the reading frame of fit1, a gene within the omega+ allele of the 21S rRNA gene. In each mutant, expression of the respective gene is blocked completely. A dominant nuclear suppressor, SUV3-1, was isolated that suppresses the var1 deletion but is without effect on the fit1 dodecamer mutations. Unexpectedly, however, we found that SUV3-1 blocks expression of the wild-type fit1 allele by blocking processing at its dodecamer. SUV3-1 has pleiotropic effects on mitochondrial gene expression, affecting RNA processing, RNA stability, and translation. Our results suggest that RNA metabolism and translation may be part of a multicomponent complex within mitochondria. PMID- 2698841 TI - Risk estimation based on germ-cell mutations in animals. AB - The set of mouse germ cell mutation rate results following spermatogonial exposure to high dose rate irradiation have been presented as the most relevant experimental results upon which to extrapolate the expected genetic risk of offspring of the survivors of the Hiroshima and Nagasaki atomic bombings. Results include mutation rates to recessive specific-locus, dominant cataract, protein charge, and enzyme-activity alleles. The mutability as determined by the various genetic end points differed: the mutation rates to recessive specific-locus alleles and enzyme-activity alleles were similar and greater than the mutation rates to dominant cataract and protein-charge alleles. It is argued that the type of mutation event scored by a particular test will determine the mutability of the genetic end point screened. When the loss of functional gene product can be scored in a particular mutation test, as in the recessive specific-locus and enzyme-activity tests, a wide spectrum of DNA alterations may result in a loss of and a higher mutation rate is observed. When an altered gene product is scored, as in the dominant cataract and protein-charge tests, a narrower spectrum of DNA alterations is screened and a lower mutation rate is observed. The radiation doubling dose, defined as the dose that induces as many mutations as occur spontaneously per generation, was shown to be four times higher in the dominant cataract test than the specific-locus test. These results indicate that to extrapolate to genetic risks in humans using the doubling-dose method, the extrapolation must be based on experimental mutation rate results for the same genetic end point.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698842 TI - Implications of the Hiroshima-Nagasaki genetic studies for the estimation of the human "doubling dose" of radiation. AB - Since 1946 a continuous effort to evaluate the potential genetic effects of the atomic bombs has been sustained. Observations on children born in Hiroshima and Nagasaki include sex ratio, congenital malformations, stillbirths, survival of liveborn infants, chromosomal abnormalities (sex chromosomal abnormalities and balanced chromosomal rearrangements), mutations altering protein structure or activity, and physical growth and development. There are no statistically significant differences between the children of parents who received increased amounts of radiation at the time of the bombings and those whose parents did not. However, the difference between the two sets of children is consistent with the hypothesis of a genetic effect of the exposure, but its magnitude suggests humans are not as sensitive to the genetic effects of radiation as projected from the mouse paradigm. PMID- 2698843 TI - Evolutionary principles and the regulation of engineered bacteria. AB - The introduction of engineered bacteria to the environment is being overregulated, on the basis of several assumptions: (i) the danger from deliberate introduction on a large scale is much greater than that from accidental release; (ii) the more distant the source of the DNA the greater the risk; (iii) novel organisms are likely to cause unexpected ecological damage, like that seen with native organisms transplanted to a novel location; (iv) even if the probability of harm is very small, great care must be taken because the harm might be large; (v) products of recombinant DNA must be treated differently from products of classical genetic manipulation; and (vi) our unlimited power to manipulate DNA implies an unlimited power to refashion organisms. Evolutionary principles contradict all these assumptions. Moreover, our increased power of genetic manipulation must be recognized as an expansion of the biotechnology of domestication; and unlike the physical technologies, the long history of domestication has not adventitiously created harmful by-products. I propose that in dealing with such novel and unpredictable developments it would be better to respond with speed and resilience to problems as they arise, rather than to hamper advances by clumsy regulations based on unsubstantiated guesses. PMID- 2698844 TI - Societal problems in human and medical genetics. AB - The applications of human and medical genetics raise many societal and ethical problems. This paper deals with a variety of such issues posed by current and future developments in genetic counseling, genetic screening, prenatal and predictive diagnosis, and gene therapy. The promise and problems of behavioral genetics are discussed. Problems of privacy, decision making, societal pressures, stigmatization, and informed consent to genetic study are raised. Use of genetic data by insurance companies or other public groups is discussed. The rapid unfolding of genetic information affecting human health and disease is producing difficult dilemmas. New problems are likely to surface, but human ingenuity and rationality is likely to find just and compassionate solutions in most settings. PMID- 2698845 TI - From Daedalus to Mengele: the dark side of human genetics. AB - Until recently, the role of scientists in society has been considered sacrosanct. Wherever scientists had been involved in crimes, either the crimes or the quality of science was denied (that is, the science was considered merely pseudoscience). As a result it has been claimed that science can only flourish in democracies but is doomed in other states. So far experience contradicts this opinion. In this paper I discuss the origins of the view that scientists and geneticists in particular, are sacrosanct. I trace it back to the earliest mythological scientists, such as Daedalus and Dr. Faustus. I view the well-known Dr. Mengele as a successor in this tradition. PMID- 2698846 TI - The politics of human heredity in the USSR, 1920-1940. AB - After the Bolshevik revolution of 1917, Iurii Filipchenko (in Petrograd) and Nikolai Koltsov (in Moscow) created centers of genetic research where eugenics prospered as a socially relevant part of the new "experimental" biology. The Russian Eugenics Society, established in 1920, was dominated by research-oriented professionals. However, Bolshevik activists in the movement tried to translate eugenics into social policies (among them, sterilization) and in 1929, Marxist geneticist Alexander Serebrovsky was stimulated by the forthcoming Five-Year Plan to urge a massive eugenic program of human artificial insemination. With the advent of Stalinism, such attempts to "biologize" social phenomena became ideologically untenable and the society was abolished in 1930. Three years later, however, a number of eugenicists reassembled in the world's first institute of medical genetics, created by Bolshevik physician Solomon Levit after this return from a postdoctoral year in Texas with H.J. Muller. Muller himself moved to the Soviet Union in 1933, where he agitated for eugenics and wrote Stalin in 1936 to urge an artificial insemination program. Shortly thereafter, Muller left Russia, several of his colleagues were shot, and the Institute of Medical Genetics was disbanded. During the next three decades, Lysenkoists regularly invoked the Soviet eugenic legacy to claim that genetics itself was fascist. PMID- 2698847 TI - Eugenics and American social history, 1880-1950. AB - Eugenics, the attempt to improve the human species socially through better breeding was a widespread and popular movement in the United States and Europe between 1910 and 1940. Eugenics was an attempt to use science (the newly discovered Mendelian laws of heredity) to solve social problems (crime, alcoholism, prostitution, rebelliousness), using trained experts. Eugenics gained much support from progressive reform thinkers, who sought to plan social development using expert knowledge in both the social and natural sciences. In eugenics, progressive reformers saw the opportunity to attack social problems efficiently by treating the cause (bad heredity) rather than the effect. Much of the impetus for social and economic reform came from class conflict in the period 1880-1930, resulting from industrialization, unemployment, working conditions, periodic depressions, and unionization. In response, the industrialist class adopted firmer measures of economic control (abandonment of laissez-faire principles), the principles of government regulation (interstate commerce, labor), and the cult of industrial efficiency. Eugenics was only one aspect of progressive reform, but as a scientific claim to explain the cause of social problems, it was a particularly powerful weapon in the arsenal of class conflict at the time. PMID- 2698848 TI - Eugenic sterilization: a preliminary comparison of the Scandinavian experience to that of Germany. AB - The paper argues that historical analysis and explanation of eugenics in Germany can benefit much from systematic comparison to Scandinavia. Common cultural background and quite similar development up to 1933 provides a background for isolating salient causes in Nazi population policies. This comparison will also help a more precise understanding of the mutual dependence between science and politics in the case of eugenics. The author holds that many of the geneticists who participated in the eugenics debates of the 1930's and 1940's had a clearer grasp of the distinction between science and politics than most present day historiographers of eugenics. PMID- 2698849 TI - Politics of heredity--Germany 1900-1940, a brief overview. AB - The paper gives a brief overview of the main stages of development of eugenics and race hygiene in Germany between 1900 and 1940. Two main stages can be differentiated: one, the formation of the eugenics movement and its development parallel to quantitative population policy before and after World War I, and the second beginning toward the end of the Weimar Republic (1919-1933) when the financial crisis of the public health system favored eugenic schemes implemented by an authoritarian government, such as the Nazi regime. PMID- 2698850 TI - Development of genetic research in the USSR. AB - Two periods of the development of genetic research in the USSR with reference to its current trends of plant and animal genetics, cytogenetics, and molecular genetics are reviewed. A short list of priority areas is established: the maintenance and use of unique gene pools of plants and animals; the domestication of animals and cultivation of new plants; the development of programmes for mathematical treatment of genetic data banks. It is suggested to consider them within the framework of international projects. The idea is to promote the collaborative efforts of scientists on an international scale. PMID- 2698851 TI - Automated DNA sequencing and the analysis of the human genome. AB - The Human Genome Initiative is a complex, multifaceted, international effort to establish a massive data base of map and sequence information for humans and other organisms. The success of this initiative is dependent upon the development of new technologies for the analysis of genomes. In this paper, an overview of the Human Genome Initiative is presented, and the current status of efforts to automate large-scale DNA sequence analysis is reviewed. PMID- 2698852 TI - Transgenic mice. AB - Stable integration into the mouse genome of exogenous genetic information has become, over the past few years, a very potent approach for different aspects of biology. It is a common feature that the integrated exogenous gene (the transgene) is expressed properly both spatially and temporally. Constructing different lines of transgenic mice carrying various versions of a gene, therefore, permits cis acting DNA sequences involved in the specificity of expression to be defined, in the context of the developing animal. This in turn opens the way to a variety of experiments in which a given gene product is targeted to one or another cell type, thus offering some insight into the physiological role of this product. Such a strategy has been used, for example, to address the questions of the role of oncogenes in malignant transformation. The insertion of foreign DNA per se may disrupt the function of endogenous genes, thus creating an insertional mutation. The corresponding affected genes may subsequently be cloned, using the transgene as a tag. Finally, the ability to perform homologous recombination, recently demonstrated with embryonic stem cells that can colonize the germ line of a foreign embryo, should constitute in the near future a unique way to analyse in detail the functioning of the mammalian genome. PMID- 2698854 TI - Cloning of sheep and cow embryos. AB - The results of experiments aimed at cloning of sheep and cattle embryos are described. Two experimental approaches were used to study the developmental potential of blastomeres from sheep and cow embryos: (i) blastomere separation followed by culture and (ii) fusion of isolated blastomeres with enucleated eggs followed by culture. Both approaches allow embryos to be cloned, but whereas blastomere separation allows only a relatively small number of genetically identical animals to be produced, nuclear transplantation will probably open the way for large-scale cloning of livestock. PMID- 2698853 TI - The molecular manipulation of milk composition. AB - The introduction of cloned genes into the mouse germ line is now routine. Although more difficult technically, gene transfer has been accomplished in farm animals and offers the potential for genetic improvement. In this regard, we have been investigating the use of transgenic animals as production vehicles for high value proteins in milk. We have shown that DNA sequences derived from the gene encoding sheep beta-lactoglobulin mediate efficient and specific expression in the mammary gland. A fusion gene comprising beta-lactoglobulin sequences and those encoding antihemophilic human factor IX has been constructed. This construct has been introduced into sheep; it is expressed in the mammary gland, and the corresponding protein is secreted into milk. PMID- 2698855 TI - Liposomal amphotericin-B in the control of experimental aspergillosis in mice: Part I--Relative therapeutic efficacy of free and liposomal amphotericin-B. AB - An animal model system for aspergillosis in BALB/c mice has been developed to evaluate the therapeutic efficacy of liposomal Amphotericin-B (Amp-B) and commercial Amp-B (Fungizone). Amp-B was intercalated into liposomes composed of egg phosphatidylcholine, phosphatidylethanolamine and cholesterol in a molar ratio of 6:1:3. A single dose (0.5 mg/kg body wt) of Amp-B both alone as well as in liposomal preparation was injected (i.v.) into animals infected with Aspergillus fumigatus. An increase in survival rate of animals and decrease in fungal count in lung, the most affected organ, were observed with liposomal formulation. Inclusion of Amp-B into liposomes also reduced the toxicity of the drug. Tissue distribution analysis of Amp-B by HPLC showed an increase in concentration of the drug in lung for both free and liposomal Amp-B in infected animals as compared to normal. Use of liposomal Amp-B increased the concentration of the drug in the disease affected organs such as lung, spleen. A longer persistence of the drug in the infected organs was also observed. The results suggest that inclusion of Amp-B in liposomes decreases its toxicity and improves therapeutic efficacy which at least in part could be due to more deposition and longer persistence of the drug in infected tissues. PMID- 2698856 TI - Hepatic low density lipoprotein receptor binding and lipid profile in Mastomys natalensis during Plasmodium berghei infection. AB - Plasmodium berghei infection to Mastomys natalensis showed hyper beta lipoproteinemia. The increase in serum cholesterol is associated with decreased uptake of low density lipoprotein (LDL) by the liver through receptor mediated endocytosis. The membranes prepared from infected M. natalensis exhibit up to 50% decline in high affinity binding sites for human 125I-LDL. Significant increases in serum lipids, cholesterol, triglyceride and lipid peroxide (LPO) contents of liver membrane were observed. Effects of lipid constituents and LPO content of liver membrane in relation to LDL catabolism and other possible mechanisms have been explained. PMID- 2698857 TI - Beta-lactamase gonorrhoea with penile streptococcal ecthyma. PMID- 2698858 TI - Natural killer cells. PMID- 2698859 TI - Protection to testicular activity by a combination of 5-hydroxy L-tryptophan with a thiol compound in whole body gamma irradiated rats. AB - Radiation induced changes in testicular activity were studied by estimating sialic acid content in plasma and testis and 17-ketosteroids in 24 hr urine samples of male Sprague Dawley rats following 8 Gy whole body gamma ray exposure with and without pretreatment with 2-aminoethylisothiuronium bromide hydrobromide (AET) or with a combination of 5-hydroxy L-tryptophan (5-HTP) and AET. Combination of 5-HTP with AET or AET alone in optimum radioprotecting dose has significantly modified the radiation damage to the testis. PMID- 2698860 TI - Development of improved media for axenic cultivation of Acanthamoeba culbertsoni, Singh and Das 1970. AB - Several varieties of peptone supported growth of A. culbertsoni to different extents reaching a maximum cell density of 1-2 X 10(6)/ml. Proteose peptone and tryptone also yielded good growth when combined with thiamine and vitamin B12. A combination of proteose peptone with glucose, yeast extract and salts promoted excellent growth of A. culbertsoni with cell density reaching 1-2 X 10(7) cells/ml; tryptone and one of the indigenous peptones also yielded comparable growth when substituted for proteose peptone in this medium. Casamino acids also supported good growth of amoebae and requirement of yeast extract could be met by a combination of thiamine, vitamin B12 and biotin. Bacto peptone did not support good growth of this amoeba but supplementation of peptone with casamino acids or amino acid mixture improved the growth supporting capacity of the medium. Development of several media with or without glucose will aid in cultivation of A. culbertsoni, studies on its metabolism as well as screening of potential drugs. PMID- 2698861 TI - Lupus nephritis--light, electron and immunofluorescent microscopy (a clinicopathological study). AB - Kidney biopsy specimens from nine patients of systemic lupus erythematosus were studied for the purpose of correlating the findings of light and electron microscopy and immunofluorescent studies with the kidney functions and the presence of proteinuria. Morphologically, three were mesangiocapillary glomerulonephritis, three mesangioproliferative glomerulonephritis and one membranous nephropathy. Subendothelial deposits were observed in eight cases, subepithelial deposits in seven cases and mesangial deposits in eight cases. Four cases with massive subendothelial deposits had massive proteinuria and decrease in renal functions. Most of the patients with mild subendothelial deposits were considered to be useful in assessing the prognosis and severity of lupus nephropathy, in addition to the morphologic types of lesions, as mesangial pattern had shown insignificant proteinuria. Study of semithin sections by light microscopy could demonstrate the deposits which were observed on electron microscopy and immuno-fluorescent microscopy. PMID- 2698862 TI - Evaluation of CIEP and ELISA in a rodent malaria model. AB - Circulating antigens could be detected by both ELISA and CIEP in the sera of mice infected with Plasmodium berghei. However, ELISA was positive for circulating antigen even though the Giemsa stained smears did not show significant parasites. Hence, ELISA can have a diagnostic value for detection of antigens as a marker of active infection. PMID- 2698863 TI - Usefulness of imprint and fine needle aspiration cytology (FNAC) in diagnosis of lymphadenopathies and other tumours. AB - Fifty cases of enlarged lymph nodes and fifteen cases of other tumours were selected and fine needle aspiration cytology (FNAC) and Imprint cytology was performed both as outpatient and pre-operative procedure. The aim of the study was to evaluate the accuracy of these methods of diagnosis. It was found that they are a rapid, easy and dependable method of diagnosis for all practising surgeons especially in semi-urban and small hospitals. PMID- 2698864 TI - Papillary cystadenoma of seminal vesicle. A case report. PMID- 2698865 TI - Dr. Ronald Ross and his achievements. PMID- 2698866 TI - Fetal surgery at the crossroads. PMID- 2698867 TI - Studies in mental illness and other psychiatric deviances among contemporary Jewry: a review of the literature. AB - This paper reviews selected research on mental disorders which include Jewish subjects from large scale epidemiological surveys to clinical studies and psychoanalytical studies conducted up to the late 1980's. These studies were primarily conducted in the United States, which has the largest Jewish population in the world, and in the State of Israel. In view of the fact that Jews are a heterogeneous group the findings have not always been consistent, however, certain trends have been observed. Jews were found to undergo more psychotherapy than any other group. While the prevalence rate of schizophrenia seems to be lower, neurosis seems to be higher than among non-Jews. Because Jews tend to internalize aggression, they are less likely to be paranoid. There is some evidence that the Jews' strong attachment to their ethnic group and family solidarity seem to have a positive effect on their mental health. When Jewish alcoholics, drug addicts and criminals were studied, it was found that they had psychiatric problems. The author concludes that more effort should be devoted to the study of the psychopathology of the Jewish population around the world. PMID- 2698868 TI - Artistic expression in spontaneous paintings of depressed patients. AB - A false belief exists that depressed patients are not creative. On the contrary, they have an urge to create--the creative spells are equivalent to the depression. They express themselves more easily through painting than through speech. They express their repressed feelings and ideas of sin and affect, suicidal tendency, etc., and in some cases, the spontaneous paintings have prophetic meaning. It is much easier for them to express their feelings through universal signs and symbols such as: face, posture; church, tower, bell, cross; coffin, tomb, cemetery, grave; skeleton, skull, bones; tree, mountain, boat, chair. PMID- 2698869 TI - [Pathologic femoral neck fractures and para-articular beta 2 microglobulin amyloidosis in long-term dialysis patients: an increasingly frequent disease picture]. AB - Beta-2-microglobulin (beta 2-M)-amyloidosis is caused by retention of beta 2-M by dialyzing membranes and by deposition as an atypical amyloid in synovia, bone and tendons. Ten patients under long-term hemodialysis (13 +/- 2.7 years) were treated because of hip pain and cystiform skeletal alterations. First typical joint affections appeared nine years after start of hemodialysis. Five fractures of the hip neck due to large cystiform bone lesions occurred in four subjects. In all cases a total joint replacement was performed. PMID- 2698870 TI - [Long-term results following aorto-femoral Y bypass. Doppler ultrasound pressure measurement, real-time ultrasound, CT and i.v. DSA]. AB - Five to seven years after aortoiliac prosthetic reconstruction 29 patients were examined by sonography (Doppler and real-time), CT and intravenous DSA. Doppler sonography showed findings due to occlusion, stenosis and severe arteriosclerotic changing. By DSA these changing could be shown and exactly localised. CT demonstrated marginal thrombosis of the bypass lumen, aneurysms and fine paravascular fibrosis. So Doppler-sonography and DSA both bring functional and morphological, real-time sonography and CT morphological informations. The methods are complementary. PMID- 2698871 TI - The behavior during pachynema of a normal and an inverted Y chromosome in Microtus agrestis. AB - The pachytene behavior of the chromosomes of Microtus agrestis (L.) (Rodentia, Arvicolidae) males carrying either the standard, or the pericentrically inverted Lund Y chromosome have been examined by electron microscopy of microspread spermatocytes. There is no synapsis between the X and either the standard or the Lund Y chromosomes during any substage of pachynema. Since synapsis is generally considered a prerequisite for crossing over, there appears to be no opportunity for crossover or chiasma formation between the X and Y in this species. The G-, C and NOR-banded mitotic karyotypes of animals carrying the standard and Lund Y are also presented. PMID- 2698872 TI - Absence of synapsis during pachynema of the normal sized sex chromosomes of Microtus arvalis. AB - The pachytene behavior of the chromosomes of males of Microtus arvalis (Pall.) (Rodentia, Arvicolidae) was examined by electron microscopy in microspread preparations of spermatocytes. There was no synapsis between the axes of these two chromosomes during this period. Since synapsis is universally considered a prerequisite for crossing over and chiasmata formation, disjunction of the sex chromosomes in this species prerequisite for crossing over and chiasmata formation, disjunction of the sex chromosomes in this species must be presumed to be achiasmatic. Unlike previously examined species with no synapsis or crossing over between the X and Y, the sex chromosomes of M. arvalis are of normal size: the X chromosome is of an "original" X size and the Y is a small acrocentric. C band studies of M. arvalis mitotic metaphase reveal no blocks of heterochromatin on the sex chromosomes. The implications of these findings are discussed. PMID- 2698873 TI - Breathing management: a simple stress and pain reduction strategy for use on a pediatric service. AB - A review of the pediatric literature on pain and stress reducing strategies is followed by a description of a breathing management and relaxation technique. Its use as a pain coping method is illustrated by two cases on a pediatric service. The positive responses of stress affected patients suggests that this approach can be effective in reducing feelings of panic and anxiety as a reaction to pain and the anticipation of pain. PMID- 2698874 TI - Home or hospital care for the child with end-stage cancer: effects on the family. AB - Despite the fact that many children are cured from cancer, this illness remains the leading cause of death among children due to disease. When the likelihood of death is confronted, decisions regarding how best to provide care must be made. Research regarding what factors influence this choice and the effects that different modalities of care may have on the family system are discussed. This discussion and review of the literature will assist the pediatric nurse in guiding the family to an appropriate choice for the care of their child. Pediatric nurses must be aware of the many technical, economic, and theoretical issues which confront a family prior to making this very difficult decision. PMID- 2698876 TI - Interleukin-3: molecular biology and biologic activities. AB - IL-3 is one of the primary factors capable of supporting the growth and development of hematopoietic cells in culture. In comparison with the other hematopoietic growth factors, IL-3 preferentially supports the proliferation of early multilineage progenitors or progenitors at early stages of development within the different lineages. Subsequently, the developing cells lose responsiveness to IL-3 while acquiring dependence on the later acting factors: GM CSF, G-CSF, M-CSF, or Ep. In addition, IL-3 has been demonstrated to exert biologic effects with other target cell populations. These activities include the potentiation of the IL-2-dependent growth of normal T cells; the potentiation of the IL-2-dependent secretion of IgG by activated B cells; and the potentiation of the activities of eosinophils, basophils, and monocytes. The importance of any of these activities of IL-3 in vivo in either normal or stressed animals remains to be determined. Initial experiments in primates with IL-3 have yielded results consistent with its role as a regulator of early hematopoietic cell development. Although administration of IL-3 alone has relatively little effect on the levels of circulating blood cells, this treatment primes the animals to become hyper responsive to subsequent administration of the later acting factors GM-CSF and Ep. Thus combinations of factors, at least in some situations, can provide a more potent stimulation of hematopoiesis than provided by the individual molecules, a finding that should greatly expand the utility of the different hematopoietins to more indications in the clinic. PMID- 2698875 TI - Clinical role of granulocyte-macrophage colony-stimulating factor. AB - The activity of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) for increasing leukocyte production and enhancing mature neutrophil function has been clearly demonstrated in phase I clinical trials in patients with a variety of hematologic and malignant diseases. The focus of current studies includes determination of optimal administration schedules and its use in combination with myelosuppressive chemotherapy, radiation therapy or antimicrobial agents. The utility of GM-CSF as a stimulant of host defense against infections and tumors is also under study. PMID- 2698877 TI - Effects of hemopoietic growth factors on stem cells in vitro. AB - The central feature of hemopoiesis is the lifelong, stable cell renewal. This process is supported by hemopoietic stem cells, which in the steady-state appear to be dormant in cell cycling. The entry into cell cycle of the dormant stem cells may be promoted by such factors as IL-1, IL-6, and G-CSF. Available evidence indicates that the effects of IL-1 on stem cells are indirectly mediated in part by IL-6 and G-CSF. Once the stem cells leave G0 and begin proliferation, the subsequent process is characterized by continued proliferation and differentiation. While several models of stem cell differentiation have been proposed, micromanipulation studies of individual progenitors suggest that the commitment of multipotential progenitors to single lineages is a stochastic (random) process. The proliferation of early hemopoietic progenitors appears to be supported by IL-3, IL-4, and/or GM-CSF. Once the progenitors are committed to individual lineages, the subsequent maturation process appears to be supported by late-acting, lineage-specific factors such as Ep (for erythropoiesis), G-CSF (for neutrophil production), and IL-5 (for eosinophilopoiesis). Thus, hemopoietic proliferation appears to be regulated by a cascade of factors directed at different developmental stages. PMID- 2698878 TI - Megakaryocyte colony-stimulating factor and thrombopoiesis. AB - Although megakaryocyte differentiation and proliferation is understood to be regulated by "humoral" factors, the molecular identities of such factors have, until recently, been obscure. The "two factor" model of megakaryocytopoiesis/thrombopoiesis is critically reviewed. In this model, "Megakaryocyte Colony-Stimulating Factor" (Meg-CSF) determines the early differentiational events of megakaryocytopoiesis, and "Thrombopoietin" (Tpo) is held responsible for the maturation of the megakaryocyte and the biochemical/cytological events in platelet formation and release. To date, neither of these growth factors have been molecularly cloned. When this occurs, the clarification of the roles Meg-CSF, Tpo and other secondary modulators (such as IL-3 and GM-CSF) play in platelet formation in health and disease will be made manifest. PMID- 2698879 TI - Clinical promise of new hematopoietic growth factors: M-CSF, IL-3, IL-6. AB - Hematopoietic growth factors are reaching maturity in clinical trials. There is a wide spectrum of disorders of bone marrow dysfunction that can be effectively treated by currently available hematopoietic growth factors. Newer growth factors are entering clinical trials. rhM-CSF has a variety of biological activities. It may be useful in hematology/oncology and infectious disease settings. Recombinant human interleukin-3 (rhIL-3) has undergone extensive trials in nonhuman primates that suggest that this hematopoietin is a potent stimulus of bone marrow function following chemotherapy and may be synergistic with other growth factors, such as rhGM-CSF. Other pleotrophic hematopoietic growth factors, such as interleukin-6, are currently being developed and may exert a wide spectrum of activities in disease states. PMID- 2698880 TI - Hemopoietins for eosinophils. Glycoprotein hormones that regulate the development of inflammation in eosinophilia-associated disease. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-3 (IL-3), and interleukin-5 (IL-5) are T lymphocyte-derived glycoproteins that stimulate the development of eosinophils from bone marrow precursors. These eosinophil hemopoietins also regulate functions of mature eosinophils, enhancing their ability to infiltrate tissues and to secrete biologically active substances at the tissue site. In these ways, the eosinophil hemopoietins have a major impact on the development of eosinophilia-associated disease. PMID- 2698881 TI - Torsades de pointes--proarrhythmia. PMID- 2698882 TI - Eosinophilic cystitis. AB - A case of eosinophilic cystitis characterized by profuse haematuria and spontaneous recovery is being reported. This is probably the first case report in Indian literature. PMID- 2698883 TI - Abdominal aortic aneurysm with Leriche syndrome. AB - An interesting and unusual case of abdominal aortic aneurysm with Leriche syndrome that presented with multiple vasculopathies and peptic ulcer is being reported. PMID- 2698884 TI - Spontaneous remission of insulin dependent diabetes mellitus. PMID- 2698885 TI - Microbes and muscles. PMID- 2698886 TI - A study on tropical splenomegaly syndrome and chloroquine prophylaxis. AB - Forty-two adults (22 males, 20 females) with tropical splenomegaly syndrome (TSS) were studied. Majority (88.1%) presented with complaints related to grossly enlarged spleen (greater than 10 cm). The duration of splenomegaly was 1 to 5 years in 54.8%. In 80.9% there was anaemia (Hb less than 10 g%). None of the patients had a macrocytic blood picture. Evidence of portal hypertension was observed in 56.7% and almost a similar number (58.1%) had raised intrasplenic pressure. The liver histology was entirely normal in only 8.8%. T-cell lymphopenia with B-cell lymphocytosis was a prominent feature. IgM values were raised in 73.8% and malarial antibody titres in 91.7% patients. Sixty-nine per cent of cases showed a distinct clinical and biochemical improvement after chloroquine chemoprophylaxis. Though a malarial origin in the development of TSS is favoured its precise aetiology is as yet speculative. PMID- 2698887 TI - Cerebral malaria in pregnancy. AB - Three cases of cerebral malaria during pregnancy are described. One patient had intrauterine foetal death and died, one patient delivered a dead baby and the other had severe postpartum haemorrhage. Cerebral malaria worsens the outlook both for the mother and for the foetus. PMID- 2698888 TI - Comparative bioavailability of two brands of carbamazepine. Reply from the authors. PMID- 2698889 TI - Mechanically cut mitotic spindles: clean cuts and stable microtubules. AB - We have discovered an easy way to cut through the mitotic spindle at any desired place. Spindles of demembranated cricket or grasshopper spermatocytes were severed with a microneedle between the chromosomes and one pole, and the cut-off polar piece was swept away. Spindle structure and microtubule dynamics in cut spindles were studied by anti-tubulin immunostaining and electron microscopy. The cut is clean: all microtubules are severed and only a few extend beyond the others. This provides the basis for a clear test of whether traction fibers pull chromosomes to the pole in anaphase, because the putative traction fiber is cleanly severed. Cutting creates new plus ends on microtubules in the cut-off polar piece and new minus ends on microtubules in the main spindle body. The microtubules with new plus ends are unstable, as expected from the dynamic instability of microtubules. However, the microtubules with new minus ends are as stable as uncut microtubules in the same spindle. Our mechanical method of cutting microtubules very likely creates native, reactive ends, and therefore the surprising stability of new minus ends is genuinely interesting, not an artifact of cutting. PMID- 2698890 TI - Characterization of mitotic motors by their relative sensitivity to AMP-PNP. AB - The relative sensitivities of the motors for mitotic chromosome movements and saltatory motion were compared using a nonhydrolyzable analog of ATP, AMP-PNP. K+AMP-PNP was microinjected into PtKl cells at the time of nuclear envelope disassembly or at anaphase onset. To produce a dose-response curve for the effect of AMP-PNP on the rate of movement, the intracellular concentration of AMP-PNP in individual cells was measured. The volume injected into each cell was determined by adding dextrans labeled with Lucifer Yellow to the injection buffer, measuring the injected cell's fluorescence intensity, and then comparing the value with the fluorescence intensity of known volumes of Lucifer Yellow dextran solution. AMP PNP produced a 50% inhibition of spindle elongation at 0.2 mM, of saltatory motion at 0.8 mM, and of chromosome movement at 8.6 mM. Prometaphase chromosome movement and anaphase chromosome-to-pole movement were similarly inhibited by AMP PNP. Equivalent volumes of injection buffer containing 1% Lucifer Yellow dextran had no effect on chromosome movement, spindle elongation or saltatory motion. Although AMP-PNP occasionally produced shorter anaphase spindles, tubulin immunofluorescence revealed the presence of abundant spindle microtubules. Metaphase cells treated with very high cell concentrations of AMP-PNP had spindles with unusually long astral microtubules; thus microtubules are stabilized rather than broken down by AMP-PNP. In conclusion, spindle elongation is four times more sensitive than saltatory motion to AMP-PNP and 40 times more sensitive than chromosome movement. When these sensitivities to AMP-PNP are considered with the results from other studies, it can be concluded that the molecular motors for spindle elongation, chromosome movement and saltatory motion are different. PMID- 2698891 TI - Induction of repressible acid phosphatase by unsaturated fatty acid in Saccharomyces cerevisiae. AB - We studied the induction of acid phosphatase (APase) by fatty acids in Saccharomyces cerevisiae. S. cerevisiae has two types of APase: constitutive and repressible enzymes. The synthesis of the latter APase is normally derepressed by depletion of inorganic phosphate (Pi) in the incubation medium. Of the saturated and unsaturated fatty acids tested, linoleic, linolenic and arachidonic acids induced the synthesis of APase even in the presence of a high concentration of Pi, whereas palmitic, stearic and oleic acids did not. De novo protein synthesis but not stimulation of secretion of the enzyme was required for the induction. Genetic analyses using plasmids carrying the genes, PHO5 and PHO3, that code for repressible APase and constitutive APase, respectively, showed that linolenic acid induced the formation of repressible APase. Linolenic acid inhibited the uptake of exogenous 32Pi and simultaneously lowered the intracellular level of Pi. These circumstances indicate that linolenic acid-induced derepression of repressible APase is primarily caused by a fall in the intracellular level of Pi. However, cells that had been preincubated in the presence of a high concentration of Pi produced APase shortly after the addition of linolenic acid. It is, therefore, suggested that, as well as a normal regulatory mechanism for derepression of repressible APase, a mechanism independent of the external level of Pi participates in the induction of repressible APase by linolenic acid. PMID- 2698892 TI - Soluble proteins as modulators of the exocytotic reaction of permeabilised rat mast cells. AB - This study addresses the question of the role of cytoplasmic proteins in exocytosis from permeabilised rat mast cells. We have used two different methods of cell permeabilisation (ATP4- and streptolysin O) to regulate the size of the plasma membrane lesions, and thus to dictate the rate and extent of efflux of the cytosolic proteins, and compared the secretory response of the two preparations. We report evidence for the existence of two factors present in the cytosol, which affect the exocytotic mechanism in opposing manners. One of these is required for the maintenance of cell responsiveness; it is retained for more than 120 min by ATP4- -permeabilised cells but lost within 60 min from cells permeabilised by streptolysin O. The other factor, which leaks immediately from cells treated from streptolysin O, but only gradually from cells treated with ATP4-, has the effect of suppressing the affinity for both Ca2+ and guanine nucleotide in the exocytotic reaction. PMID- 2698893 TI - [Esthetics in periodontal surgery: description and discussion of an incision and suture technic]. AB - One of the main aspects from a patient's standpoint regarding periodontal therapy is esthetics; the clinician who wants to control the disease by pocket elimination may underestimate this fact. This article describes a conservative surgical approach and a type of modified vertical mattress suture which allows repositioning of soft tissues to a preoperative level. A discussion follows on how such a conservative approach respects the philosophy of modern periodontal therapy. PMID- 2698894 TI - A clinical trial of intraligamentary anesthesia. AB - The effectiveness of the periodontal ligament injection in providing anesthesia for routine extractions and the possible mechanisms of action of the periodontal ligament injection in producing dental anesthesia were investigated in a clinical trial. Periodontal ligament injections were administered under strong pressure with lidocaine on 14 teeth, with epinephrine on seven teeth, and with normal saline on another seven teeth. The anesthesia attained was evaluated by: response of the teeth to an electric pulp tester, gingival probing around the teeth, and the ability for teeth to be extracted without pain. The results demonstrated that periodontal ligament injections with lidocaine were effective in providing adequate anesthesia for the performance of dental extractions. Lidocaine periodontal ligament injections were statistically and clinically more effective in attaining anesthesia than were epinephrine or saline injections. Epinephrine periodontal ligament injections resulted in a slight but statistically significant increase in the stimulus necessary to produce a patient response, when the teeth were stimulated with an electric pulp-tester. Saline injections produced no change in response to the stimulus tested. It appears, based on the results of the saline and epinephrine injections, that hydrostatic pressure had no direct effect on the production of anesthesia with the periodontal ligament injection. PMID- 2698895 TI - Effect of visco-elastic behavior on stress development in a metal-ceramic system. AB - We developed an analytical model to calculate transient stress and gap displacement during cooling of a porcelainized semicircular arch with a gapped diametral segment. Constant cooling rates were assumed after the specimens were slowly cooled (with power terminated to the furnace) from the porcelain firing temperature. The analytical model incorporates linear visco-elasticity and structural relaxation effects. We calculated transient and residual gap displacements and stresses for a semicircular arch specimen (composed of an experimental opaque porcelain and a Ni-Cr-Be alloy) for six thickness ratios at a cooling rate of 3 degrees C/min. Residual gap displacements were measured for metal-porcelain arch specimens of six thickness ratios. Compared with measured values, calculations based on the visco-elastic theory overestimated gap closure for porcelain/metal thickness ratios below 1.5, and underestimated gap closure at thickness ratios above 1.5. PMID- 2698896 TI - Demonstration of physiological barrier between pulpal odontoblasts and its perturbation following routine restorative procedures: a horseradish peroxidase tracing study in the rat. AB - Vascular injection of the macromolecular tracer, horseradish peroxidase (HRP), was used to study the permeability of the odontoblast cell layer in developing and mature rat molar teeth, and to investigate the effect of cavity preparations on the permeability of this epithelioid cell layer in adult animals. HRP injected into the vascular system of normal animals 28 days of age and older was localized histochemically (from 5 to 90 min after injection) throughout the extracellular spaces of the maxillary dental pulps; however, the tracer did not penetrate beyond the tight junctions at the apical region of the odontoblast cell layer, and was absent from the predentin and dentin. In contrast, HRP injected into very young neonatal animals (e.g., day 3) resulted in free passage of HRP between odontoblasts and into the overlying predentin and dentin. When Class V cavities had been prepared in adult maxillary molars after HRP was injected into the blood stream, HRP reaction product penetrated the predentin and dentin immediately beneath the cavity preparation; however, adjacent, untraumatized areas of predentin and dentin in the operated teeth were devoid of reaction product. These results provide evidence that: (1) a physiological barrier develops between the distal segments of odontoblast cell bodies in normal rat molar teeth between days 15 and 28 of postnatal life, and this barrier prevents the passage of macromolecules from the pulp into the predentin and dentin; and (2) this barrier is perturbed following routine restorative procedures in adult animals. PMID- 2698897 TI - Ego analysis and the relativity of defense: technical implications of the structural theory. AB - We suggest that it is recognition of the relativity of defense, of the fact that the same content can be either defense or wish, rather than recognition of unconscious defense, that distinguishes the structural from the topographic theory. The structural theory did not simply add to the topographic theory the recognition that defense can be unconscious; it represents a radical shift in the concept of defense and of the relation between defense and wish. Accordingly, ego analysis, as the technical approach generated by the structural theory, is not complementary or preliminary to id analysis, the technical approach generated by the topographic theory. We attempt to demonstrate that the two theories represent antagonistic paradigms, both theoretically and technically. We suggest that "defense before drive," the structural formula for interpretation, made ego syntonicity a crucial determinant in formulating interpretations, and assumed the relativity of defense. Accordingly, the structural revision made possible an equidistant position between defense and wish, reducing reliance on suggestion and establishing interpretive neutrality, which we distinguish from behavioral neutrality. PMID- 2698898 TI - On structures. AB - Some of the metapsychology involving the concept of structure is briefly reviewed, together with some difficulties presented by it. The concept of structure is defined, for purposes of the paper, and various kinds of structures are delineated. The author confines herself to the "microstructures," such as memories, cognitive structures, affect structures, defenses, identifications. Possible factors related to the development and maintenance of structures are discussed. In addition, the concept of structural change is taken up. It is suggested that an essential in such change is conscious review, however brief. The author proposes that structure formation and change is a fruitful area for mutual work by psychoanalysts and basic scientists. PMID- 2698899 TI - Recent contributions to the theory of defense mechanisms: a comparative view. AB - Some of the most recent contributions to the theory of defense mechanisms are critically reviewed including theories of complex motivational properties of the ego (Schafer, 1968; Kris, 1984), a functional theory of defense (Brenner, 1982), an object-representational theory of defense (Kernberg, 1976), a "two-person" theory of defense (Modell, 1984) and a self-psychologically based theory of defense (Kohut, 1984). These recently proposed theories of defense mechanisms utilize differing levels of analytic observation and theoretical discourse. One of the major differences among theorists involves the variety of referents of defense mechanisms (i.e., what is being defended against) including impulse, drive derivative, object loss, or environmental failure. Another fundamental difference involves the variety of ways theorists regard the relation between internal homeostasis and the external world. Questions are raised about the recent tendency in psychoanalytic theory to develop or invoke different theories of defense to explain a broad range of clinical phenomena. PMID- 2698900 TI - Comparison of three assays to detect enterotoxigenicity of Aeromonas isolates from patients with diarrhoea in Vellore, south India. AB - Fifty strains of Aeromonas spp, isolated from patients with diarrhoea, were tested by three different assays to detect their enterotoxigenicity. Culture filtrates of the isolates were tested for their ability to produce haemolysin and to produce cytopathic changes in Vero cells and for their effects in the suckling mouse assay. The data indicated that biotypes alone are not adequate indicators of pathogenicity of different groups of Aeromonas isolated from patients with diarrhoea. No significant differences were observed in the results of the three assays for the detection of enterotoxigenicity. PMID- 2698901 TI - Enterohaemorrhagic E. coli O157:H7 in central Australia. PMID- 2698902 TI - Are the phlebotonic properties shown in clinical pharmacology predictive of a therapeutic benefit in chronic venous insufficiency? Our experience with Daflon 500 mg. AB - In 3 controlled clinical trials, double blind versus placebo, the activity of Daflon 500 mg, a new micronised flavonoid fraction, has been evaluated on venous tone using venous plethysmography. A double-blind, randomized cross-over Phase II pharmaco-clinical trial has shown that Daflon 500 mg is statistically more effective than placebo on pathological legs, as well as normal legs. In this study, which included 20 patients suffering from post-thrombotic syndrome, Daflon 500 mg decreased: 1) venous capacity (p less than 0.001); 2) venous distensibility (p less than 0.001); 3) venous outflow time, measured by the two parameters total emptying venous time (p less than 0.001) and T2p (p less than 0.001). These modifications have been observed 2 hours after administration without any significant change in T50 outflow, cardiad index, capillary filtration index, blood pressure, cardiac or respiratory rate. The same acute effect of increasing venous tone has been demonstrated in another pharmacoclinical trial, 1 and 2 hours after ingestion in 3 groups of 10 women suffering from venous insufficiency: group I without varicose, group II during pregnancy and group III with a post-thrombotic syndrome. Finally, in a Phase III clinical trial, in 2 parallel groups of 20 patients each with functional chronic venous insufficiency, Daflon 500 mg has been compared to placebo. It was then demonstrated after 1 and 2 months treatment an improvement in the functional symptoms and edema accompanied by a statistically significant increase of the venous tone. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698903 TI - Double blind study of the pharmacodynamic and clinical activities of 5682 SE in venous insufficiency. Advantages of the new micronized form. AB - A randomized double blind multicenter trial was performed to study the pharmacodynamic and clinical activities of 5682 SE, in comparison with diosmin (active principle) well recognised for many years. 5682 SE is a purified micronized flavonoid fraction containing 450 mg of diosmin and 50 mg of hesperidin per tablet. 90 patients with chronic venous insufficiency of the lower limbs stabilized for one year entered the study. They received either 2 tablets of 5682 SE or 900 mg of diosmin a day during two months. The following parameters were studied: functional clinical symptoms in the legs, ankle and calf circumferences measurements, strain-gauge plethysmographic parameters with 20, 40 and 60 mmHg venous occlusion, clinical and biochemical acceptabilities. In both groups of patients, the data showed statistically significant changes. But the improvement in the clinical symptoms and the decreases in the venous outflow parameters were more substantial with 5682 SE than with diosmin. The clinical and laboratory acceptabilities were equal in both groups. Due to its pharmacodynamic and clinical activities which are more considerable than those of non-micronized diosmin, the results of this study show the therapeutic advantage of 5682 SE in chronic venous insufficiency. PMID- 2698904 TI - Microvascular permeability, venous stasis and oedema. AB - Microvascular permeability to fluid and hydrophilic solutes is restricted to channels between the endothelial cells and through the fenestrations when these are present. The channels have a molecular filter which appears to be a lattice of fibrous molecules reinforced by plasma proteins. The quantitative description of blood-tissue fluid movements is complicated by plasma protein permeation which leads to a non-linear steady state relation between fluid filtration and microvascular pressure. When fluid filtration is low it can be balanced by lymph flow but at high pressures oedema develops. Microvascular pressure rises less than expected with increments of venous pressure owing to local vasoconstriction of the arterioles. The sluggish flow which results from this vasoconstriction and high venous pressure leads to a haemoconcentration which reduces oedema formation but favours leucocyte and platelet sequestration within the microcirculation. PMID- 2698905 TI - [Enhancement of enamel crystallinity with gel method during orthodontic treatment. The 1st report: Application of electron probe X-ray microanalyser]. AB - This paper is to review the gel method of strengthening tooth enamel substance around bonded brackets and morphological observations and elemental analyses of the chopped cross section of the three below-mentioned groups were carried out by electron probe X-ray microanalyser (EPMA) for a relative review. Group I: bracket bonded extracted tooth enamel in application of the silica-hydro gel method. Group II: bracket-bonded extracted tooth enamel in application of the gelatin gel method. Group III: bracket-bonded extracted tooth enamel in application of neither method. The results obtained were as follows: 1) As a result of making morphological observations through secondary electron image and back scattered electron image, the adhesive condition of the brackets and the state of the chopped cross sections were favorable and these combined observation proved effective as a supplementary method of elemental analysis. 2) Through qualitative analyses, Ca, P, F, O, Na, Mg and Cl were recognized as content elements on the experimental side (the non-bracket side) as well as on the control side (the bracket side) from group I through III. 3) In making ultrahigh-speed wide-area surface analyses (elemental concentration map), the incorporation of F was recognized from enamel cuticle to approximately 200 microns in group I and to 50 100 microns in group II, and the distribution of Ca was totally consistent, and P showed the slight downward trend from enamel cuticle to dentoenamel junction. 4) The incorporation of F was acknowledged to be until 150-200 microns on the experimental side of group I and to be until 80 microns on the experimental side of group II by line analyses. 5) As regards F on the experimental and the control side in group I as well as in group II through a quantitative analysis, the experimental side clearly revealed a high concentration of F and acknowledged 1% level to be a significant distinction. From the foregoing results through the electron probe X-ray microanalyser, strengthening tooth enamel substance in vitro by application of the gel method proved to be effective, and the silica-hydro gel method was indicated to be superior to the gelatin gel method. PMID- 2698906 TI - The occurrence of ectopic pregnancy with and without clomiphene citrate use in assisted and nonassisted reproductive technology. AB - An eleven-year review of treatment records of patients who became pregnant as a result of infertility treatment (n = 3692) was conducted. All records were examined to determine whether clomiphene citrate (CC) was used in the cycle of conception and whether or not an ectopic pregnancy occurred. Data were additionally analyzed for the incidence of ectopic pregnancy with and without assisted reproductive technology (ART). The incidence of ectopic pregnancy was similar between CC (3.4%) and non-CC (3.4%) treatment groups receiving non-ART treatment. For non-ART treatments, tubal disease and severe endometriosis resulted in an increase in ectopic pregnancies independent of CC use. The incidence of ectopic pregnancy in patients receiving CC + human menopausal gonadotropin (hMG) for in vitro fertilization (5.4%) and gamete intrafallopian transfer (3.1%) was similar compared to ART treatments with hMG alone. The incidence of ectopic pregnancy was more closely associated with infertility diagnosis rather than CC use. PMID- 2698907 TI - Uniform assessment of success rates with assisted reproductive technology. PMID- 2698908 TI - The constitution and the rights of the mentally ill. An analysis and proposal. PMID- 2698909 TI - The National Childhood Vaccine Injury Act of 1986. Can congressional intent survive judicial sympathy for the injured? PMID- 2698910 TI - New NLRB rules on collective bargaining units in the health care industry. PMID- 2698911 TI - Computer-assisted imaging techniques. PMID- 2698912 TI - Uncoupler resistance in Escherichia coli: the role of cellular respiration. AB - Bioenergetic properties of a mutant strain of Escherichia coli K12 designated TUV, which is resistant to the protonophoric uncoupling agent 4,5,6,7-tetrachloro 2-trifluoromethylbenzimidiazole (TTFB) have been compared with those of its non resistant parent, E. coli K12 Doc-S. Strain TUV grew and respired some 20-30% faster than strain Doc-S, and was cross-resistant to carbonylcyanide p (trifluoromethoxy)phenylhydrazone and triphenyltin, but not to 2,4-dinitrophenol. Phosphorus nuclear magnetic resonance demonstrated the TTFB-mediated collapse of the transmembrane pH gradient at identical rates in starved cells of both strains, indicating that uncoupler access and function were unimpaired in the mutant under these conditions. Strain TUV displayed enhanced uncoupler resistance and maintained intracellular pH and ATP levels only when respiring. On the other hand, strain TUV also showed increased resistance to novobiocin, implying that its outer wall permeability had been lowered. We suggest that the active resistance of strain TUV results from the exclusion of uncoupler by the interaction of inner and outer membrane components in a manner modulated by the degree of cellular energization. PMID- 2698913 TI - Mutants of Escherichia coli O9:K30 with altered synthesis and expression of the capsular K30 antigen. AB - Escherichia coli K30 produces a thermostable group I capsular polysaccharide. Two classes of mutants were isolated with defects in the synthesis or expression of capsule. The most common mutant phenotype was acapsular (K-), with no K-antigen synthesized. A second class of mutants, termed Ki or intermediate forms, produced colonies which were indistinguishable from those of acapsular forms yet K antigenicity was expressed. Previous studies had demonstrated that E. coli strains that produce K30 antigen synthesize a lipopolysaccharide (LPS) fraction that is recognised by monoclonal antibodies against the K30 antigen. Synthesis of this LPS fraction was not affected in Ki forms. The results of morphological examination, LPS analysis and phage sensitivity studies are consistent with the interpretation that the defect in Ki strains results from an inability to polymerize the K30 antigen. Using plasmid pULB113 (RP4::mini-Mu), mutations resulting in both K- and Ki phenotypes were localized near the his region of the chromosome. PMID- 2698914 TI - Role of glutamine aminotransferase in glutamine catabolism by Saccharomyces cerevisiae under microaerophilic conditions. AB - The involvement of glutamine aminotransferase activity in glutamine catabolism by Saccharomyces cerevisiae under microaerophilic conditions was studied. We were able to show that there are at least two different glutamine aminotransferase activities that are differentiated genetically, by their substrate specificity (pyruvate and glyoxylate dependence), and their different modes of regulation. The pyruvate-dependent glutamine aminotransferase activity plays a major role in glutamine catabolism under microaerophilic conditions since the wild-type strain S288C showed a 10-fold higher activity in static cultures than in agitated ones. The same strain also had 3-fold higher glutaminase B activity in agitated cultures than in static ones. Pyruvate-dependent glutamine aminotransferase activity is not regulated directly by O2 itself since a rho- strain showed a high activity regardless of the extent of aeration of cultures. Finally, we were able to isolate a mutant, strain CN20, derived from the rho- strain and unable to utilize glutamine as the sole nitrogen source, which was severely affected in pyruvate-dependent but not in glyoxylate-dependent aminotransferase activity. PMID- 2698915 TI - A system for insuring success of long-term supportive periodontal therapy. AB - The article describes a program of supportive periodontal therapy (SPT) for patients who have been treated for periodontal disease. Emphasis is placed on identifying the specific supportive therapy needs of periodontally treated patients as distinct from the needs of patients who are not at risk for periodontal disease. The critical components of SPT for clinical practice are defined and discussed. The parameters necessary for a through clinical and radiographic assessment are outlined. The use of assessment data to direct therapy is explained. Implementation of site-specific therapeutic measures as well as the use of evaluative procedures to assure appropriate long-term care are defined. PMID- 2698916 TI - The effect of professional and home subgingival irrigation with antimicrobial agents on gingivitis and early periodontitis. AB - The purpose of this investigation was to study the effect of a professionally applied subgingival antimicrobial agent (stannous fluoride) delivered at periodontal prophylaxis, combined with home personal subgingival delivery of an antimicrobial agent (iodine) on patients with gingivitis and early periodontitis. A control group of 32 individuals was instructed to use dental floss and a sulcular toothbrushing method as a regular oral hygiene regimen. The test group of 42 subjects received professional subgingival irrigation with a 1.64% stannous fluoride solution delivered after scaling. These subjects were also instructed in the home subgingival delivery of an iodine solution along with the use of dental floss and sulcular toothbrushing. Subjects were clinically evaluated at baseline and again after eight weeks. Individuals in the test group, when compared to the control group, had a significantly lower gingival index score at eight weeks. In addition, the test group had significantly lower bleeding and gingival index scores at eight weeks when compared to baseline. Professional subgingival irrigation with stannous fluoride, when combined with home subgingival delivery of an iodine solution, was effective in improving gingival health for patients with gingivitis and early periodontitis. PMID- 2698917 TI - The placental and mammary transport of [14C]menaquinone-4 in rats. AB - The transfer of menaquinone-4 (vitamin K2(20] to the fetus and milk was studied in pregnant and lactating rats, respectively, after oral administration (4 mg/kg) of [3'-14C]menaquinone-4. Intestinal absorption of menaquinone-4 was rapid and the highest level of radioactivity in each tissue except guts of fetal rats was observed at 4h after dosing. The level in the fetal homogenate was low. At that time, the concentration of menaquinone-4 in the fetal liver was 84 ng/g, corresponding to 9% of the value found in the placenta. Therefore, we conclude that the transfer of menaquinone-4 to the developing rat fetus is restricted by the blood-placenta barrier, but that a sufficient amount of menaquinone-4 (more than the essential amount of vitamin K to ensure full carboxylation) can be transferred into the fetal liver. It was also observed that the radioactivity was transferred to milk after oral administration to lactating rats. Milk/blood concentration ratios at 6 and 24h after dosing were 13.8 and 65.1, respectively. The elimination half-life of radioactivity in milk was about 17h. Eighty-four percent of milk of radioactivity was due to menaquinone-4. These results suggest that the prophylactic maternal oral administration of menaquinone-4 may be efficacious for a prophylaxis of neonatal and infantile vitamin K deficiency. PMID- 2698918 TI - Effects of vitamin E deficiency on the functions of splenic lymphocytes and alveolar macrophages. AB - This study has been done to determine the effect of vitamin E deficiency on the functions of splenic lymphocytes and alveolar macrophages (AM) in rats. Vitamin E deficiency did not cause any changes of body weight, spleen and thymus weights, and numbers of splenocytes and AM compared with those of control rats. And also, we could not find any significant changes of lymphocyte responses to mitogens (PHA, Con A, and LPS) and natural killer cell (NK) activity except for AM function in vitamin E-deficient rats. In vitamin E-deficient rats, AM showed a higher phagocytosis than that of control rats. After in vitro treatment with a macrophage-activating factor (MAF) for 4 h at 37 degrees C, AM from control rats showed a greater enhancement (167%) of phagocytic activity compared with that of AM from vitamin E-deficient rats. When the effect of MAF prepared from splenic lymphocytes of rats from control or vitamin E-deficient rats on phagocytosis of AM was studied, MAF from control rats showed an about 150% increase of phagocytic activity in a 1/250 dilution of MAF. However, MAF from vitamin E-deficient group had almost no effect on phagocytosis of AM in the same dilution of MAF as control rats. These results may suggest that vitamin E deficiency induces the higher phagocytic function of AM responsible for host defense in the lung, but their enhancement is not due to the activation by MAF from lymphocytes. PMID- 2698919 TI - Increased response to growth factors of skin fibroblasts from newborn spontaneously hypertensive rats. AB - Skin fibroblasts were isolated from newborn spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) and cultured with 10% fetal calf serum. The growth rate, determined by the culture dish DNA content, was significantly higher in cells from SHR than from WKY in the presence of 10 and 15% serum. Re-initiation of DNA synthesis by serum and insulin was assessed by 24-h 3H-thymidine incorporation in quiescent cells. Serum (5, 10 and 15%) and insulin (1 microgram/ml) induced a marked stimulation of 3H-thymidine incorporation, and the cell response was significantly higher in SHR than in WKY for both agonists. These results indicate that the hyper-responsiveness to growth factors evident in newborn SHR skin fibroblasts is a genetic defect independent of haemodynamic changes. PMID- 2698920 TI - Production of endothelin by cultured porcine endothelial cells: modulation by adrenaline. AB - Cultured porcine endothelial cells derived from aortas spontaneously released immunoreactive endothelin into the medium in a time-dependent manner. This release was completely inhibited by cycloheximide and is, therefore, directly related to de novo protein synthesis. The endothlin-induced release was further stimulated by adrenaline. Adrenaline-induced stimulation was completely inhibited by the alpha-adrenergic blocker phentolamine and was not inhibited by the beta adrenergic blocker propranolol. Cycloheximide completely prevented the adrenaline stimulated as well as the basal release. These results suggest that cultured endothelial cells release endothelin slowly but continuously and that this release can be stimulated by adrenaline via alpha-adrenergic receptors. We speculate that the endothelium generates vasoconstrictor signals through endothelin production, thus contributing to the regulation of vascular tone. PMID- 2698921 TI - Actions of endothelin on adrenergic neuroeffector junction. AB - The effect of endothelin, a novel vasoconstrictor peptide, on the adrenergic neuroeffector junction was investigated in isolated perfused rat mesenteric arteries. The vasoconstrictor responses to periarterial nerve stimulation and exogenous noradrenaline were determined. Infusion of endothelin-1 (10(-14) to 10( 8) mol/l) increased the baseline perfusion pressure dose dependently. Subpressor doses of endothelin-1 (10(-11) and 10(-10) mol/l) enhanced the pressor response to noradrenaline, and 10(-12) to 10(-10) mol/l endothelin-1 attenuated the pressor response to periarterial nerve stimulation. Endothelin-1 also caused a dose-dependent inhibition of [3H]-noradrenaline release during the periarterial nerve stimulation. However, higher doses of endothelin-1 (3 x 10(-10) to 10(-8) mol/l) enhanced the pressor response to stimulation. These results suggest that endothelin potentiates adrenergic vasoconstriction postjunctionally while it inhibits adrenergic neurotransmission. Thus endothelin may have actions on the neuroeffector junction in addition to its direct vasoconstricting effect. PMID- 2698922 TI - Vasoconstrictor actions of endothelin-1 in human resistance vessels. AB - The contractile response to endothelin-1 was studied in isolated human resistance vessels in the presence and absence of extracellular calcium. Endothelin-1 was 1000-fold more potent than noradrenaline, with an ED50 of 6.5 +/- 1.26 x 10(-9) mol/l compared with 2.1 +/- 0.7 x 10(-6) mol/l. Calcium depletion by repeated stimulation with noradrenaline in a calcium-free medium attenuated but did not prevent a sustained contraction in response to endothelin-1 (30% of control). On re-adding calcium to the bath a full contraction immediately occurred. These experiments suggest that an endothelin-1-induced contraction is largely dependent on the presence of extracellular calcium, but a partial contraction can be induced in a calcium-free medium and this may be dependent on mobilization of intracellular calcium from a store not affected by repeated noradrenaline stimulation. PMID- 2698923 TI - Combined intrarenal renin-angiotensin blockade alters renal function and this is reversed by angiotensin II. AB - All the components of the renin-angiotensin system are present within the kidney and intrarenal effects have been demonstrated. We have previously shown that intrarenally confined doses of angiotensin II (Ang II) decreased renal excretory and haemodynamic function. In the present study we investigated an increase in renal excretory and haemodynamic function in response to intrarenally confined doses of the renin inhibitor ACRIP to inhibit renin, teprotide to inhibit the angiotensin converting enzyme (ACE) and saralasin to block Ang II receptors. We studied the effects of combined intrarenal blockade of the renin-angiotensin system in five female uninephrectomized conscious dogs on a sodium metabolic balance of 5 mmol/day. We infused ACRIP, teprotide and saralasin combined over 30 min in doses confined to the kidney, and again with an intrarenally confined dose of Ang II. There were no changes in renal function during the control study. During the combined infusion (ACRIP + teprotide + saralasin), the urine flow rate increased from 0.4 +/- 0.1 to 0.9 +/- 0.1 ml/min (P less than 0.001), urinary sodium excretion increased from 6.4 +/- 0.4 to 30.2 +/- 2.5 mumol/min (P less than 0.0001), the glomerular filtration rate increased from 29.3 +/- 0.7 to 42.0 +/- 1.2 ml/min (P less than 0.0001), renal plasma flow increased from 60.3 +/- 0.8 to 139.6 +/- 1.8 ml/min (P less than 0.001) and the fractional sodium excretion increased from 0.1 +/- 0.01 to 0.5 +/- 0.04% (P less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698924 TI - Does age influence the blood pressure and sodium excretion responses to sodium depletion in rats? AB - Experiments were performed in 3- and 24-month-old male Wistar rats in order to assess the influence of age on the response by systolic blood pressure and sodium excretion to abrupt sodium restriction. In response to the sodium deprivation, urinary sodium excretion was markedly reduced in all animals; however, the cumulative sodium excretion (from days 1 to 6 of depletion) was significantly higher in aged rats (1299 +/- 243 mumol) than in young rats (757 +/- 70 mumol). After 6 days of a low-sodium diet, the systolic blood pressure was similar in both groups. Plasma renin activity was higher in young compared with aged rats (27 +/- 5 versus 14 +/- 3 ng/ml per h). These results indicate that ageing is associated with a significant disturbance in the renal but not the systemic response to an abrupt restriction in sodium intake. PMID- 2698925 TI - Non-invasive renal artery duplex ultrasound and computerized nuclear renography to screen for and follow progress in renal artery stenosis. PMID- 2698926 TI - Do weak mineralocorticoids affect the pathogenesis of hypertension in Cushing's disease? AB - Few studies have examined the effect of the weak mineralocorticoids corticosterone, 18-hydroxycorticosterone and 18-hydroxydeoxycorticosterone on the pathogenesis of hypertension in Cushing's disease. Therefore we measured plasma levels of these mineralocorticoids together with plasma aldosterone, plasma renin activity and the aldosterone secretion rate in 12 patients with Cushing's disease and in seven patients with essential hypertension. Plasma levels of aldosterone, corticosterone, 18-hydroxycorticosterone and 18-hydroxydeoxycorticosterone and the aldosterone secretion rate were similar in both groups of patients. Plasma renin activity, determined after 4 h of ambulation, was significantly higher in Cushing's disease than in essential hypertension. We conclude that it is unlikely that either aldosterone or the weak mineralocorticoids corticosterone, 18 hydroxycorticosterone and 18-hydroxydeoxycorticosterone play a specific role in the pathogenesis of hypertension in Cushing's disease. PMID- 2698927 TI - Reduced adrenal secretory mass after unilateral adrenalectomy for aldosterone producing adenoma may explain unexpected incidence of hypotension. AB - In a prospective study of 37 patients who had unilateral adrenalectomy for an aldosterone-producing adenoma, five of 33 (15%) were symptomatically hypotensive after at least 1 year, and eight of 29 (28%) who were observed 3, 6, 12, 18 and 24 months after the operation showed 2-year blood pressures below the fifth percentile for age- and sex-matched controls. Postoperatively, plasma aldosterone was lower, and plasma renin activity higher than in controls, these differences being more marked in the hypotensive group. Pre-operatively elevated atrial natriuretic factor fell to levels lower than in controls. These serial changes in volume-regulatory hormones are consistent with chronic hypovolaemia, due to relative hypoaldosteronism. Plasma cortisol was lower 6 months after the operation and plasma adrenaline levels fell by half. A reduced adrenocortical (aldosterone and cortisol) and adrenomedullary (adrenaline) secretory mass may play a role in the hypotension observed after unilateral adrenalectomy. PMID- 2698928 TI - Local generation of angiotensin II in the isolated rat aorta. PMID- 2698929 TI - Renin in the bovine eye. AB - Recently, high levels of prorenin were found in human vitreous and subretinal fluid. In this study we attempted to identify and quantitate renin and prorenin in the bovine eye. Both these substances are present in the bovine eye in concentrations that cannot be explained by plasma contamination. Concentrations of total renin, i.e. renin plus prorenin, are highest in the posterior uveal tract [15.4 ng angiotensin (Ang) l/g per h]; in the anterior uveal tract the total renin concentration was 10.1, in plasma 6.3, in vitreous fluid 5.7 and in the retina 5.1 ng Ang l/g per h. Vitreous fluid contains mainly prorenin (99%), whereas the retina, and the anterior and posterior uveal tract contain less prorenin (respectively, 78, 47 and 32%). The absence of renin in vitreous fluid is consistent with the general finding that extrarenal renin synthesis is often associated with the release of mainly or exclusively prorenin into the extracellular fluid. Synthesis of renin and prorenin may take place in the eye. PMID- 2698930 TI - Inhibitors of rat renin and their use in experimental hypertension. AB - Hydroxy-ethylene dipeptide analogues (Leu[CH(OH)-CH2]Leu and Leu[CH(OH)-CH2]Val) of human substrate peptides are potent in vitro inhibitors of rat renin with IC50 values as low as 0.8 nmol/l. When given to renal hypertensive rats they lower blood pressure and suppress both plasma renin and angiotensin II. There was a divergence between the rapid rebound of renin and blood pressure which remained suppressed. PMID- 2698931 TI - In vivo production of plasma angiotensin I: is plasma renin sufficient? AB - Production and metabolism of angiotensin I (Ang I) were studied during a constant intravenous infusion of mono-iodinated 125I-Ang I in seven patients with essential hypertension taking 50 mg captopril twice a day. The elimination of arterially delivered 125I-Ang I reached 80% in the kidneys, 45% in the forearm, 58% in the leg and 95% in the hepatomesenteric vascular bed. Despite the high level of elimination of Ang I, plasma levels of Ang I in the leg, forearm and renal vein were not different from that of arterial plasma. In the hepatic vein the plasma level of Ang I was 50% lower than in the aorta. Thus, 50-90% of endogenous Ang I in the veins is derived from new regional production. The blood transit time through the kidneys, limbs and hepatomesenteric region is too short for plasma renin activity to account for the measured new Ang I production. Our results indicate that a high percentage of plasma Ang I may be produced locally in the tissues, and not in circulating plasma. PMID- 2698932 TI - Solution of methodological problems in measurement of inactive renin in rat plasma using trypsin activation, and the effect of nephrectomy and sialo adenectomy on inactive plasma renin. AB - Trypsin activation of rat plasma destroys angiotensinogen and generates a tetradecapeptide-like material, verified by high performance liquid chromatography, which interferes with the measurement of inactive renin. Using an assay based on removal of the material by a cation-exchange resin and the addition of exogenous angiotensinogen, the plasma concentration of inactive renin in intact conscious male rat was 0.48 GU/l (range 0.28-0.67 GU/l, n = 20). Inactive renin comprised about 70% of the total plasma renin. The level of inactive renin was unchanged 24 h after bilateral nephrectomy and 7 days after submandibular sialo-adenectomy. Bilateral nephrectomy of previously sialo adenectomized rats decreased the level of inactive renin significantly. Our findings are in contrast to the marked increase, reported by several other investigators, in inactive plasma renin in rats following bilateral nephrectomy, and do not support the previously suggested, mainly extrarenal, origin of inactive plasma renin. PMID- 2698933 TI - Blood pressure elevation caused by inhibition of brain glutathione reductase. AB - The effect of brain glutathione reductase activity on blood pressure regulation was investigated. The intravenous administration of the glutathione reductase inhibitor, nitrofurantoin (0.1-0.3 mg/rat), to seven normotensive Wistar rats caused dose-dependent rises in blood pressure and the heart rate (delta mean blood pressure 17 +/- 1 mmHg; delta heart rate 89 +/- 7 beats/min for 0.3 mg). Rats treated with 0.3 mg nitrofurantoin showed a 50% decrease in glutathione reductase activity with a twofold increase in the ratio of glutathione disulphide to reduced glutathione in the hypothalamus and brainstem, and a 1.5-fold increase in plasma noradrenaline and plasma renin activity compared with controls. These nitrofurantoin-induced effects were totally abolished by pretreatment with a sympathetic ganglion blocker (4 mg pentolinium tartrate, administered subcutaneously) except for the increased ratio of glutathione disulphide to reduced glutathione and the decreased glutathione reductase activity in the brain. These results suggest that the blood pressure elevation caused by inhibition of brain glutathione reductase activity occurs through activation of the sympathetic nervous system and the renin-angiotensin system. PMID- 2698934 TI - Chlorthalidone does not increase the hypotensive effect of nifedipine in essential hypertensives: a crossover multicentre study. AB - To determine whether the combination of nifedipine + chlorthalidone exerts an additive antihypertensive effect when compared with single-drug treatment, we studied 66 uncomplicated essential hypertensives, with diastolic blood pressure of greater than 100 and less than 115 mmHg. At the end of a 1-month washout placebo period, using a double-blind crossover design, the patients were randomly allocated to nifedipine (20 mg twice a day), chlorthalidone (25 mg once a day), the two drugs combined at the same doses and the corresponding placebo. Compared with the randomly allocated placebo, the three active treatments significantly reduced blood pressure without changing the heart rate or body weight. Both the absolute and percentage decreases in mean blood pressure induced by nifedipine and the combination compared with placebo were similar and significantly greater than those induced by chlorthalidone. Taken together, these data show that the combination of nifedipine + chlorthalidone does not exert any additive antihypertensive effect compared with nifedipine alone. This finding indicates that the combination of a dihydropyridine calcium antagonist + a thiazide diuretic is probably devoid of any particular clinical significance in the treatment of uncomplicated essential hypertensives. PMID- 2698935 TI - Hypercholesterolaemia in treated hypertensives: a controlled trial of intensive dietary advice. AB - We evaluated dietary counselling by dietitians in hypercholesterolaemic hypertensives over 6 months. A total of 141 patients were randomly assigned to intensive advice or usual care. Body weight fell significantly in the intervention group, but did not in the controls. There was a modest but significant fall in total cholesterol from 7.1 to 6.8 and 7.1 to 6.9 mmol/l in the diet and the control groups, respectively (4 and 3%). A similar pattern emerged from the triglyceride measurements. Low-density lipoprotein fell in both groups, but only achieved significance (P less than 0.05) in the intervention group. High-density lipoprotein did not change. There was a more marked change in cholesterol when serum levels during the study were compared with the previous annual review. These falls occurred after selection for the study but before random allocation to groups. They are unlikely to reflect regression to the mean as the lipids were stable for 2 or more years before the study, but may reflect spontaneous changes in diet after the patients were labelled hypercholesterolaemic. Dietary advice can lower total cholesterol but the magnitude of this decrease is small. Additional approaches are likely to be required to reduce plasma cholesterol to a normal range. PMID- 2698936 TI - Effects of two beta-antagonists (dilevalol and propranolol) on retinal blood flow: a double-blind placebo-controlled study. PMID- 2698937 TI - Massive regional differences in the vascular effects of endothelin. AB - Endothelin was infused into seven anaesthetized open-chest rabbits during three 10-min periods, so that cumulative doses of 0.01, 0.1 and 1 nmol/kg were achieved. Endothelin increased blood pressure and caused systemic vasoconstriction only at the highest dose, but decreased the myocardial contractile force (measured with a strain-gauge) at all doses. In contrast to the modest systemic haemodynamic changes, vascular effects (measured with tracer microspheres) were found at each dose level and varied greatly from vasodilator (hepatic artery), through biphasic (spleen) to pure vasoconstrictor (adrenals, pancreas, stomach, colon) effects. Systemic circulatory parameters poorly reflect the regional vascular activity of endothelin. PMID- 2698938 TI - The effects of endothelin on renovascular resistance and renin release. AB - In the isolated perfused rat kidney, endothelin inhibits renin release and reduces the renal perfusate flow. The half-maximally effective concentrations were 30 and 50 pmol/l, respectively. Both effects are slow in onset and in washout. The calcium channel antagonist nimodipine (2 mumol/l) completely blocks the vasoconstrictor and renin secretion response of a median inhibitory concentration (IC50) of endothelin, indicating that entry of external calcium may play a role. Vasoconstriction and inhibition of renin release by endothelin are attenuated in the presence of a protein kinase C inhibitor, staurosporine, which suggests that protein kinase C helps to mediate the effects of endothelin on renin secretion and vascular resistance. PMID- 2698939 TI - Etozolin monotherapy and combination with verapamil in essential hypertension. AB - A total of 1337 patients with mild to moderate essential hypertension were included in an open, multicentre trial to assess the response rate to the diuretic etozolin (200 mg once a day) and to verify whether the addition of the calcium antagonist verapamil (120 mg twice a day) in non-responders may have a favourable effect. Etozolin lowered diastolic blood pressure to below 95 mmHg in 67.8% of patients after 4 weeks of treatment and in 62.4% of patients after 12 weeks. The patients who failed to respond to etozolin were given verapamil (120 mg twice a day), and 72.8% of these patients showed a good response to the combined treatment. Normalization of blood pressure was achieved in 83.6% of the total patients. The incidence of side effects was 14.3%; withdrawal due to side effects was reported in 2.5% of patients. Abnormalities on the ECG were recorded in 5.5% of patients. No consistent metabolic or electrolyte change was observed. In conclusion, etozolin given at a dose of 200 mg once a day seems to be an effective and safe antihypertensive agent. Its antihypertensive effect remains unaltered for 12 weeks at least. The combination with verapamil may be effective in those who do not respond to etozolin alone. PMID- 2698940 TI - Haemodynamic parameters in hypertensive patients: changes induced by lacidipine and nifedipine. AB - We conducted a randomly allocated, double-blind study in 16 essential hypertensive patients, eight of whom were treated with nifedipine and eight with lacidipine. The antihypertensive efficacy was evaluated and any modifications to peripheral haemodynamic parameters were observed in the brachial artery by a mechanographic method and B-mode scanner with a 10-MHz probe. Statistically significant reductions in blood pressure from basal values were observed after 1 and 6 months' treatment. Enhanced compliance (P less than 0.005), reduced characteristic impedance (P less than 0.001) and lower peripheral resistances (P less than 0.01) were also noted. Variations in pulse wave velocity and mean blood pressure showed a statistically significant correlation as early as the first month of treatment (P less than 0.01). Our results suggest that therapy with nifedipine and lacidipine allows an improvement in peripheral haemodynamics in hypertensive patients. This response is maintained in chronic treatment, even just before the next dose administration at the end of the longest dose interval. PMID- 2698941 TI - Potassium channel stimulation in normal subjects and in patients with essential hypertension: an acute study with cromakalim (BRL 34915). AB - We studied the acute effects of the potassium channel opener cromakalim on blood pressure, the renin-angiotensin-aldosterone system and renal function in eight patients with essential hypertension and five normal subjects. In the hypertensive patients, blood pressure decreased significantly from 2 to 6 h after treatment with cromakalim 1.5 mg compared with placebo, but was unchanged in the normotensives. In both groups, the heart rate and plasma renin activity increased after the administration of cromakalim compared with placebo; however, plasma aldosterone was unchanged. There was no significant change in urinary electrolyte excretion in either group; urine flow decreased after the administration of cromakalim compared with placebo in normal subjects, but not in patients with essential hypertension. Cromakalim lowers blood pressure acutely in patients with essential hypertension but not in normotensive subjects. This may be due to a greater reflex response in the normal subjects or to specific effects of cromakalim on mechanisms causing the high blood pressure. PMID- 2698942 TI - First Bjorn Folkow Award lecture. The role of cardiac output in the control of blood pressure. AB - Vascular hypertrophy occurs in both primary and secondary hypertension. The degree of hypertrophy is related to the level of blood pressure and its presence can be detected in borderline hypertensives. Hypertrophy causes an increase in resistance to blood flow which is most apparent during exercise. Its presence exaggerates the responses to vasoconstrictor and dilator stimuli and this makes it impossible to estimate vasomotor tone in man. The baroreflex controls variations in blood pressure and, to some extent, the blood pressure level by modifying cardiac output. PMID- 2698943 TI - Antihypertensive efficacy and influence on physical activity of three different treatments in elderly hypertensive patients. AB - The antihypertensive efficacy and subjective and physical tolerability of three different pharmacological treatments (metoprolol, captopril and the combination of hydrochlorothiazide + amiloride) were compared with placebo in 36 elderly hypertensives (aged 61-79 years), according to a Latin-square double-blind design. The placebo and the active treatments were administered for 2 months. Seated blood pressure was significantly reduced by all the pharmacological treatments compared with placebo, but only metoprolol significantly reduced the heart rate. No haematological or biochemical changes were observed during the study. Physical fitness, evaluated as endurance in a standard cycle ergometer exercise test, was slightly decreased after the treatment with metoprolol and the diuretic combination and slightly improved after treatment with captopril. Subjective tolerability, evaluated by a check-list of symptoms, was better during the active therapies, and in particular during the captopril treatment, than during the placebo treatment. Our results indicate that all three active treatment regimens significantly reduce blood pressure in elderly hypertensives and that captopril appears slightly better tolerated physically and subjectively. PMID- 2698944 TI - Renin inhibition with A-64662: effect on blood pressure and hormonal response in man. AB - We studied the effects of intravenous injections of the renin inhibitor A-64662 on blood pressure, plasma renin activity (PRA), angiotensin II (Ang II) and aldosterone levels in patients with essential hypertension. While PRA was completely suppressed with doses as small as 0.001 microgram/kg, blood pressure was affected only in a few instances in doses of 0.4-1.0 mg/kg. In the six patients in whom Ang II and aldosterone results were available these hormones were concomitantly reduced with PRA, although the PRA inhibition lasted much longer (up to 24 h). There was little relationship between the blood pressure changes and plasma levels of renin activity, Ang II and aldosterone, suggesting that the plasma pool of these variables may not be the crucial factor determining blood pressure responses in patients with essential hypertension. PMID- 2698945 TI - Effects of endothelin on isolated ischaemic rat hearts during ramiprilat, bradykinin and indomethacin perfusion. AB - In isolated ischaemic rat hearts, endothelin induced a short transient increase, followed by a lasting decrease in coronary flow and an increase in the left ventricular dp/dt max in a concentration-dependent manner. Both enzyme activities and lactate output were increased in the venous effluent. Myocardial tissue levels of glycogen, ATP and creatine phosphate were reduced. Endothelin aggravated post-ischaemic reperfusion arrhythmias. Perfusion with ramiprilat and bradykinin increased coronary flow and left ventricular dp/dt max and reduced reperfusion arrhythmias; enzyme activities and lactate output were significantly reduced and in the myocardial tissue glycogen and energy-rich phosphates were preserved. In comparison, indomethacin prolonged reperfusion arrhythmias, decreased coronary flow and increased the enzyme activities with no changes in myocardial metabolism. When ramiprilat and bradykinin were combined with endothelin, reperfusion arrhythmias and the enzyme activities were reduced but the decrease in coronary flow could not be fully blocked. Indomethacin aggravated the endothelin-induced coronary flow reduction, enzyme release and reperfusion arrhythmias but had no effects on the other parameters. PMID- 2698946 TI - Short-term effect of captopril and nifedipine on micro-albuminuria induced by exercise in hypertensive diabetic patients. AB - Physical exercise can induce micro-albuminuria, a urinary albumin excretion rate of 20-200 micrograms/min, in diabetics without micro-albuminuria at rest (stage II of diabetic nephropathy). The aim of the present study was to evaluate the acute effects of captopril, an angiotensin converting enzyme (ACE) inhibitor, and nifedipine, a calcium channel blocker, on exercise-induced micro-albuminuria in hypertensive diabetics with stage II nephropathy. Eleven hypertensive World Health Organisation (WHO) stages I-II non-obese diabetics (five insulin-dependent diabetics, six non-insulin dependent diabetics) underwent five submaximal cycloergometric tests, the first two in basal conditions, the other three after 24-h administration of captopril (25 mg twice a day), placebo (1 tablet twice a day) or nifedipine AR (20 mg twice a day) according to a randomized double-blind design. Our results demonstrate that despite a lower reduction in exercise blood pressure, captopril is more effective than nifedipine in blunting diabetic exercise-induced micro-albuminuria. PMID- 2698947 TI - An evaluation of ketanserin therapy for the hypertensive diabetic patient. AB - Hypertension may accelerate the development of the vascular complications of diabetes but many conventional antihypertensive agents have adverse effects on glucose tolerance or peripheral perfusion. To investigate the potential of ketanserin as an antihypertensive agent for hypertensive diabetics we performed a randomly allocated, double-blind, placebo-controlled trial in 17 patients. A range of peripheral blood flow responses was determined using laser Doppler flowmetry, and diabetic control was assessed at the time of allocation to groups and after 8 weeks' therapy (20 mg twice a day for 2 weeks; 40 mg twice a day for 6 weeks). The mean decrease in standing blood pressure was 14.1/9.3 mmHg (ketanserin treatment) versus 7.1/5.9 mmHg (placebo). The maximum skin blood flow and a posturally induced vasoconstriction of the foot skin were unaffected by the therapy, and glycaemic control was unchanged. Ketanserin was well tolerated. These studies suggest that ketanserin may be a useful agent for the treatment of hypertension in the diabetic patient. PMID- 2698948 TI - Angiotensin converting enzyme inhibition lowers blood pressure in patients with primary autonomic failure independently of plasma renin levels and sympathetic nervous activity. AB - The haemodynamic and neurohormonal responses to the angiotensin converting enzyme (ACE) inhibitor captopril were studied in 12 patients with primary autonomic failure; seven had multiple system atrophy and five had pure autonomic failure. Basal supine mean arterial blood pressure was higher in the patients with multiple system atrophy than in those with pure autonomic failure and the normal subjects. Basal plasma noradrenaline levels were normal in the patients with multiple system atrophy, but lower in those with pure autonomic failure. Captopril lowered the mean arterial pressure in the patients with multiple system atrophy and pure autonomic failure but not in the normal subjects. In the patients with multiple system atrophy and pure autonomic failure, captopril lowered the cardiac output and the stroke volume. Forearm vascular resistance was unchanged. No significant changes occurred in the normal subjects. Plasma renin activity was unchanged after captopril in the patients with autonomic failure, but rose in the normal subjects. Plasma noradrenaline was unchanged in all groups after the administration of captopril. We conclude that captopril lowers the mean arterial pressure in patients with multiple system atrophy and pure autonomic failure. After the administration of captopril there is a reduction in cardiac output, secondary to a fall in stroke volume. The vasodepressor response to captopril in patients with autonomic failure is not related to the basal level of plasma renin activity or sympathetic nervous activity, indicating that the hypotensive effects of bradykinin or prostaglandins, or both, may contribute. PMID- 2698949 TI - Attenuation of neurogenic hypertension by chronic converting enzyme inhibition. AB - We compared the effects produced by acute and chronic administration of captopril in sinoaortic denervated rats. In conscious undisturbed rats acute administration of captopril (10 mg/kg intravenously) produced acute transient reductions in mean arterial pressure of 16 and 26%, 6 h (mean arterial pressure 148 +/- 4 mmHg) and 24 h (133 +/- 3 mmHg) after the sinoaortic denervation, respectively. Chronic captopril treatment (30 mg/day orally) produced a permanent attenuation of the hypertension induced by sino-aortic denervation, as shown by a beat-to-beat analysis of arterial pressure for 80 min. The attenuation was 11% (131 +/- 7 versus 148 +/- 4 mmHg) and 24% (103 +/- 9 versus 133 +/- 3 mmHg) in rats studied 6 and 24 h after the sinoaortic denervation, respectively. Chronic captopril administration produced no alteration in the tachycardia, nor in the heart rate variability of the sinoaortic denervated rats; the latter was lower than that of normotensive rats. These data show that while acute administration of captopril in sinoaortic denervated rats produced a rapid hypotensive response, chronic administration produced a long-lasting attenuation of hypertension, presumably by interference with sympathetic cardiovascular control. PMID- 2698950 TI - Current knowledge regarding the genetics of human hypertension. AB - Observations over 11 years from the University of Utah Cardiovascular Genetics Research Clinic and published data from other studies are reviewed to illustrate research approaches, developing results and prospects for future studies. Strong associations with hypertension have been found for several biochemical tests that show substantial genetic determination. Suggestions of recessive major gene effects and significant polygenic background determinations have been found for several variables, including urinary kallikrein excretion, intracellular sodium concentration, sodium-lithium countertransport and sodium-potassium cotransport. Each of these variables is related in some way to sodium or potassium metabolism, or both, and may help to improve the understanding of a possibly inherited susceptibility to hypertension that is related to dietary electrolyte intake. A second major group of factors involving familial predisposition to hypertension include lipid abnormalities (increased very-low- and low-density lipoprotein cholesterol and decreased high-density lipoprotein cholesterol); increased fasting insulin levels or insulin resistance, or both; obesity (especially central or upper body obesity); and multiple environmental factors influencing these metabolic systems, including dietary fat, carbohydrate and calorie intake; physical exercise; and certain antihypertensive medications that adversely affect lipid metabolism and glucose tolerance. Some studies even suggest a possible link between these two large groups of factors (electrolyte metabolism and lipid insulin metabolism). Hypertriglyceridaemia and hyperinsulinaemia are both significantly correlated with increased levels of several cation-flux tests. It is recommended that studies of human hypertension apply these biochemical profiles to study sibships with two or more hypertensive siblings as a cost effective initial approach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2698951 TI - Changes in peripheral venous distensibility and blood pressure modifications in borderline hypertension: evidence against a primary role for the renin angiotensin-aldosterone system. PMID- 2698952 TI - [Flavonoids as medicines]. AB - Although flavonoids have been used for a long time, many medical practitioners and pharmacists know very little about them. This article gives a few particulars of some flavonoids and plant extracts: rutin, water soluble derivatives of rutin, citroflavonoids, anthrocyanins, procyanidins, silymarin, Ginkgo biloba, Chrysanthellum indicum and Lespedeza capitata. PMID- 2698953 TI - [Drugs of plant origin and the vascular system]. PMID- 2698954 TI - In vitro studies on long-term stability of R plasmids in Escherichia coli K12. AB - The maintenance and stability in an E. coli K12 host of environmental isolates of R plasmids encoding gentamicin resistance during multiple passages in antibiotic free and antibiotic-containing broth were investigated in regard to the conferred resistance phenotypes and the respective EcoRI digestion patterns. Only two plasmids belonging to the IncM group maintained stable endonuclease digestion patterns over a 15-month period in both of the media applied. Other members of this group revealed a considerable variability in their EcoRI digestion patterns, but a stability in their resistance determinants. Two IncM plasmids and an IncK plasmid exhibited partial resistance loss under nonselective conditions. The complete segregation of resistance determinants from IncOF plasmids resulted in a stably maintained cryptic core plasmid. PMID- 2698955 TI - Characterization of new resistance plasmids belonging to incompatibility group IncQ. AB - New IncQ R plasmids, pIE639 and pIE723, are characterized and compared to the prototype IncQ plasmid RSF1010. Additional resistance determinants not common on other R plasmids are located on small stretches of DNA interspacing essential regions at different positions in an otherwise unchanged core of IncQ plasmid DNA. The contribution of IncQ plasmids to resistance evolution in bacteria is discussed. PMID- 2698956 TI - Characterization of yeasts with high L[+]-lactic acid production: lactic acid specific soft-agar overlay (LASSO) and TAFE-patterns. AB - Only few yeast strains are known for the high level production of L[+]-lactate. We report indications for the conspecifity of Kluyveromyces thermotolerans (formerly Saccharomyces veronae) strain CBS 4728 with Stamm 42 (formerly Saccharomyces pretoriensis, RADLER 1984). We suggest that Stamm 42 has little, if any relationship to Saccharomyces cerevisiae. Furthermore, we have optimized the method of Subden et al. (1982) for the detection of lactate producing microorganisms. Using this method in a screening with 100 yeast strains of our institute collection, we could not find additional strains with high L[+]-lactate production. This method may provide a useful tool for the molecular cloning of the unique yeast L[+]-LDH1) gene (s). PMID- 2698958 TI - [Current classification of periodontal diseases]. AB - Since the last 15 years, tremendous progress have been made on epidemiology, microbiology, natural history, immunology, and periodontal tissue response to different treatment modalities. Thus, we are able to suggest today a relatively new classification of the different periodontal diseases far from the one based on the concept of "the periodontal disease". This article aims to help clinicians in understanding the classification of such diseases allowing better treatment and eventually better results. PMID- 2698957 TI - Nutritional status of men under hypokinesia. AB - Hypokinesia (diminished muscular activity) elicits substantial changes in energy and nutritional requirements in humans. The objective of this investigation was to determine the nutritional status of six physically healthy men aged 19 to 21 years under 95 days of hypokinesia without the use of any preventive measures. For the simulation of the hypokinetic effect the men were placed under 95 days of an ad libitum bed rest regimen. During the background period, that is, prior to exposure to hypokinesia, the caloric value of the diet was 3124 kcal per day; under hypokinesia, the caloric value was 2745 kcal per day. In calculating the nutritional requirements of men under hypokinesia, several biochemical parameters were measured. Effects of hypokinesia demonstrated included certain changes in the enzymatic activity of glands; increased excretion of nitrogenous compounds in the urine; increased blood cholesterol content; changes in the amount of blood sugar; changes in acid-base balance; increased elimination of fluid, calcium, and phosphorus; impaired supply of vitamins to the organism; and increased energy expenditure. It was concluded that the nutritional status of men underwent substantial changes under conditions of diminished muscular activity. PMID- 2698959 TI - [Cellular competition and healing]. AB - Different therapeutic solutions have been tried to obtain a new attachment. Several animal experiments have studied cellular colonization of radicular surfaces exposed to the disease then planed. Only the cells from the periodontal ligament seem to be able to form a new attachment. The interposition of a membrane seem to prevent gingival and osseous tissues to interfere with the periodontal ligament. The periodontal ligament cells colonize then the radicular surface. PMID- 2698960 TI - [Nonsurgical treatment: a long-term study]. AB - This retrospective study was carried out on 20 patients with periodontal lesions treated by the same operator by scaling root planing. The investigation was designed to study the variability of the level of attachments through different charts of probing before and after treatment over a period of 5 years maintenance. Through efficient scaling and root planing different results were obtained according to sites of different localisations and depth. It shows the uncertain and occasional characteristics of periodontal lesions, and gives useful informations for treatment choices and regular maintenance program. PMID- 2698961 TI - The role of neutrophils and free radicals in the ischemic-reperfused heart: why the confusion and controversy? PMID- 2698962 TI - The role of the neutrophil and free radicals in ischemic myocardial injury. PMID- 2698963 TI - Captopril and ramiprilat protect against free radical injury in isolated working rat hearts. AB - The protection of angiotensin converting enzyme (ACE) inhibitors, captopril and ramiprilat, against free radical-mediated myocardial injury were studied in isolated working rat hearts. Free radicals were generated by electrolysis of Krebs-Henseleit solution with 10 mA direct current for 1 min. Both captopril (360 mumol/l) and ramiprilat (12.5 mumol/l) significantly reduced the decrease of left ventricle dP/dt'max, coronary flow (CF), myocardial superoxide dismutase (SOD) and creatine kinase (CK) activities and the elevation of S-T segment of epicardial ECG as well as the rise of myocardial malondialdehyde (MDA) content caused by electrolysed perfusate. Captopril afforded a dose-dependent protection on cardiac functions with various concentrations of 45, 90, 180 and 360 mumol/l. Iloprost (30 nmol/l), a stable mimetic of prostacyclin, could also alleviate free radical-mediated myocardial injuries. All the beneficial effects of ramiprilat (12.5 mumol/l) were abolished by the administration of indomethacin (5 mumol). In contrast, captopril (90 mumol/l) still exhibited significant protective effects after indomethacin (9 mumol) was administered, though these protective effects were insignificantly weakened. In order to assess the role of sulfhydryl (-SH) group in the effects of captopril, a SH-containing drug S8 and a disulfide DG4, both are deficient in ACE inhibitory properties in vitro, were examined. Data showed that S8 (180 mumol/l) provided a significant protection while DG4 showed no protective effect. It is concluded that ACE inhibitors can protect against free radical-induced myocardial damage. Ramiprilat, a non-SH-containing ACE inhibitor, inhibits free radical-induced damages mainly by stimulation of prostacyclin synthesis and/or release. In addition to this effect, captopril, a SH-containing ACE inhibitor, may exert additional anti-free radical effects by a mechanism which is probably related to the sulfhydryl group. PMID- 2698964 TI - Effect of single-administration captopril on plasma and urinary vasopressin in normotensive subjects and patients with essential hypertension and primary aldosteronism. AB - Effects of a single administration of captopril on plasma and urinary vasopressin (AVP) were examined in 8 normotensive (NT) female volunteers, 17 patients with essential hypertension (EHT) and 2 patients with primary aldosteronism (PA). Orally-administered captopril (25 mg) had no effect on plasma AVP levels in the three groups. However, urinary excretion of AVP decreased significantly after use of captopril in both NT and EHT subjects (-57% and -67%, respectively), and also in PA subjects. The magnitude of reduction in urinary AVP was significantly correlated with the pretreatment levels of plasma renin activity (r = 0.85) and plasma aldosterone concentration (r = 0.88) in NT subjects. Such correlation was not found in EHT subjects. These results suggest that captopril decreases AVP secretion in both normotensive and hypertensive subjects, but the relation of the magnitude in AVP reduction by captopril to the peripheral renin-angiotensin system might be different. PMID- 2698965 TI - An outbreak of amebiasis in an institution for the mentally retarded in Japan. AB - The results of an epidemiological survey in a 190-patient institution for mentally retarded were reported. Twenty percent of the patients had either cysts or trophozoites of Entamoeba histolytica in their stools, and 38% were positive serologically. The amebic outbreak revealed a sex-independent but age-dependent distribution; younger patients had more serious symptoms in cases invasive amebiasis. A high prevalence of amebic infection was found in the heavily retarded patients, and the positive cases tended to concentrate in certain training classes. Further demographic analysis suggests that the amebic infection was possibly caused by abnormal behavior of heavily retarded patients. PMID- 2698966 TI - Contribution of postural muscle tone to full expression of posture and locomotor movements: multi-faceted analyses of its setting brainstem-spinal cord mechanisms in the cat. AB - In this minireview, I have summarized and discussed our results concerning the neuronal mechanisms of postural suppression, and our thoughts about contribution of postural muscle tone to the full expression of locomotion. The identified brainstem-spinal cord system is schematically illustrated in Fig. 1 with its neuronal constituents (A). When cells of origin of this system (cells in the nucleus reticularis pontis oralis), or the pathway descending from these cells (DTF area) are tonically activated, cells in the nucleus reticularis gigantocellularis (gc cells) are also tonically activated, and with this process the system as a whole exerts generalized or non-reciprocal tonic inhibitory effects upon alpha-motoneurons innervating hindlimb extensor and flexor muscles. In consequence, postural muscle tone, especially that of the hindlimbs, is tonically suppressed and results in sustained suppression of postural support both in acute decerebrate cats (locomotor preparation) and in awake, freely moving cats, terminating locomotor movements. Since postural control and locomotor control are not separate phenomena, our results indicate that interaction of the above-described two control systems should be studied at each level of the brainstem and the spinal cord. In fact, contribution of brainstem neurons and of spinal interneurons has already been studied. It may also be interesting to elucidate supra-pontine structures which activate the identified brainstem-spinal cord inhibitory system. Such a study may elucidate the neuronal structures related not only to the termination of on going movements but also to the muscular atonia observed during active sleep. As demonstrated, even for the understanding of the brainstem-spinal cord system involved in postural suppression, multi-faceted and mutally related analytical approaches have been necessary as suggested by Brookhart, and these approaches allowed us to approach a much better understanding of the problem one faces. They were neuroanatomical analyses of plausible neuronal structures, electrophysiological analyses of their synaptic organizations, the neuropharmacological analyses of their putative neurotransmitters, and finally the most important, behavioral analyses. For a thorough understanding of the dynamics of postural and locomotor control systems, the problems we are now concerned with are to identify both the "hardware" and the "software" of these two systems. Understanding of the hardware requires an elucidation of the neuronal circuits including synaptic organizations, and that of the software an identification of the putative neurotransmitters that set the identified neuronal circuit to work, so that the systems as a whole exhibit a meaningful external manifestation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2698967 TI - Complicated central effects of endothelin on blood pressure in rats. AB - The role of endothelin (ENT) in the control of systemic blood pressure (BP) was examined in conscious rats. Intracerebroventricular (i.c.v.) administration of ENT (0.002 or 0.2 micrograms, i.e., 0.78 or 78 pmol/2 microliters 0.9% saline) to conscious rats had complicated effects on BP. A significant fall in BP occurred in the initial 2-4 min after administration; and then after recovery toward the control level, BP decreased again within 17 min, following which a constant rise in BP occurred. In addition to the changes in BP, 3 of 9 rats which received 0.2 micrograms lapsed into severe barrel rotation-like behavior only to die 6-8 min after i.c.v. injection. It was therefore assumed that ENT had central effects on BP regulation and motor activity. PMID- 2698968 TI - Differential sensitivity to hypoxic inhibition of respiratory processes in the anesthetized rat. AB - To estimate the sensitivity to hypoxic inhibition of various regulatory processes for respiration, changes in breathing pattern during hypoxic ventilatory depression (HVD) were analyzed in the halothane-anesthetized spontaneously breathing rat using a "progressive isocapnic hypoxia test." In the carotid sinus nerve (CSN) intact rats, ventilatory augmentation was followed by depression due to reduction in respiratory frequency (f) at end-tidal PO2 (PETO2) levels below 50-60 mmHg despite increased afferent activities from the carotid chemoreceptors. After CSN section, ventilation was progressively depressed at PETO2 lower than normoxic level with simultaneous decreases of f and tidal volume. An increase in CO2 stimulus or the prevention of arterial hypotension during hypoxia by infusing a vasoconstrictor agent (phenylephrine) inhibited the occurrence of ventilatory depression in both the CSN intact and denervated animals. In all cases studied, the reduction in f resulted mainly from the prolongation of expiratory time (TE). The results suggest that in the anesthetized rat the effect of respiratory stimulation from carotid chemoreceptor afferents becomes inadequate to offset the prolongation of TE due to the central hypoxia at lower PETO2, and that the neural process for regulating TE is the major site of deterioration during central hypoxic inhibition. Roles of CO2 stimulus and systemic circulatory conditions in the generation of HVD were also discussed. PMID- 2698969 TI - [Role of polymorphonuclear leukocytes in the pathogenesis of ischemic heart disease]. PMID- 2698970 TI - [Therapeutic use of sodium chloride substitutes in circulatory insufficiency]. PMID- 2698971 TI - [Current status of surgical treatment in post-infarction aneurysms of the heart]. PMID- 2698972 TI - [Clinical aspects, diagnosis and indications for surgery in anastomotic aneurysms occurring after reconstructive operations of the thoracic aorta]. AB - Twenty-three patients who had had thoracic aorta surgeries for its coarctation (15 patients), arch kinking (4), traumatic aneurysm (2), non-specific aortoarteritis (1), and Type III dissecting aneurysm (1) were examined and operated on. In addition to conventional examination tools, the authors applied Doppler ultrasonography, volume sphygmography, electrocardiography, esophageal contrast X-ray in three projections, radiopaque angiography. All the surgeries for anastomotic aneurysms required thoracic aorta prosthesis. Eighteen patients had benefits from the surgery. PMID- 2698973 TI - [Mathematical approach to the problem of early diagnosis in heart failure]. AB - A tool set for early detection of heart failure (HF) and its criteria for mass population survey in the polyclinic setting was developed. A two-stage screening programme was carried out. At the first stage, patients with cardiac abnormalities were detected. At the second stage, the patients underwent a complex instrumental study. Fourteen most informative signs of HF were identified. A programme was developed for analysis of their baseline values and adoption of solutions by applying a procedure for inhomogeneous sequential statistic recognition, significantly promoting the diagnosis by employing diagnostic tables. PMID- 2698974 TI - [Mechanism of the action of helium-neon laser irradiation in the treatment of trophic ulcers and wounds nonhealing for a long time]. PMID- 2698975 TI - [The volume of vision in computerized static perimetry in the diagnosis and observation o f glaucoma]. AB - The authors present the influence of glaucoma on the volume of vision for 62 points evenly situated in the range of the 30 degrees parallel with exclusion of the points to 10 degrees and points from the macular sphere. Investigations have been carried out by means of a computerized system of static perimetry PERS. The comparison included 250 patients with defects of the visual field typical for various grades of glaucoma and a control group consisting of healthy persons. The analysis of results suggests that the volume of vision constitutes a parameter facilitating the comparison of prints of the visual field as well as the evaluation of field defects in glaucoma. PMID- 2698976 TI - [Use of Betaxolol in patients with glaucoma and chronic nonspecific diseases of the respiratory system]. AB - Betaxolol is a new antiglaucomatous drug which is blocking solely the beta 1 receptors and in contrast to Timolol may be applied in persons with spastic conditions of the bronchi. It has been given twice daily to 9 persons with glaucoma and long standing bronchial asthma. In the period of observation (1.5 6.5 months) neither of the examined patients showed any deterioration of the spirometric indexes nor bradycardia. In a part of the patients the intraocular pressure was normalized only by application of Betaxolol; over one half of them however needed additionally the use of miotics. PMID- 2698977 TI - [Simultaneous surgical procedures on the horizontal and vertical muscles in the treatment of convergent strabismus]. AB - In convergent squints the vertical component is very often accompanying the horizontal deviations. This phenomenon is mostly accentuated in congenital squints and in squints very early aquired (onset of squint before the 1st year of life). If after the operation the binocular vision has to be secured indispensable is a surgical procedure which liquidates simultaneously the horizontal as well as the vertical deviation. The operation should be minimally traumatizing; the use of the microscope is most advisable. Preoperative, minute analysis of the motility of the eyes may be performed not earlier than after the child is 2.5 years old. The over mentioned conclusions have been drawn on the basis of analysis of 460 operated cases observed 1 to 5 years. PMID- 2698978 TI - [The quality of our drugs: aluminum in plasma components]. PMID- 2698979 TI - Milestones in lymphology. PMID- 2698980 TI - Recent advances in the laboratory diagnosis of filariasis. AB - The specific laboratory diagnosis of filariasis depends either on the demonstration of circulating microfilaria in the peripheral blood or various stages of the parasite in tissue sections. Various morphological characteristics of the parasite will normally assist in its identification to the genus and specific level. Concentration techniques, especially those using the polycarbonate membrane filtration of a ml or more of heparinised blood, can detect the parasite in those with very low microfilaria counts. Serological techniques using the indirect fluorescent assay with microfilaria and adult worm antigens can assist in confirming a clinical suspicion of filaria infection when the parasite is not demonstrable. The development and use of specific monoclonal antibodies for the detection of circulating antigens in the enzyme-linked immunosorbent assay will probably increase the specificity of the assay. Presently available specific DNA probes for filariasis are probably not as useful for patient diagnosis as they are for epidemiological purposes. PMID- 2698981 TI - Recent advances in the laboratory diagnosis of malaria. PMID- 2698982 TI - Dispersal of bacteria by an electric air hand dryer. AB - The potential risk of an electric air hand dryer contributing to airborne infection in a hospital was investigated using a strain of Serratia marcescens and a strain of coagulase-negative, streptomycin-resistant Staphylococcus. Dispersal of marker bacteria by the air dryer was demonstrated within a radius of about 3 feet from the dryer and to the investigator's laboratory coat. When paper towels were used for hand drying, no dispersal of marker bacteria was demonstrated. It is suggested that air hand dryers are unsuitable for use in critical patient care areas as they may contribute to cross infection either via airborne dissemination or via contaminated personnel. PMID- 2698983 TI - Diagnosis and surveillance of dengue virus infections: gold standards and new directions. PMID- 2698984 TI - A tale of three cities. The correspondence of William Sharpey and Allen Thomson. PMID- 2698985 TI - Acute respiratory failure with autoPEEP--report of one case. PMID- 2698986 TI - Cystine exodus from lysosomes: cystinosis. PMID- 2698987 TI - Isolation of physiologically responsive secretory granules from exocrine tissues. PMID- 2698988 TI - Transport of nucleotides in the Golgi complex. PMID- 2698989 TI - Transport of alanine across hepatocyte plasma membranes. PMID- 2698990 TI - Transport in isolated yeast vacuoles: characterization of arginine permease. PMID- 2698991 TI - Sugar transport in normal and mutant yeast cells. PMID- 2698992 TI - [Vectors for constructing representative genome libraries]. AB - The general methodology for constructing genomic libraries of different types of vectors is discussed. Various ways of selection against non-recombinant molecules in generated libraries are considered. The general features of well-known vectors (lambda EMBL3, lambda EMBL4) and of new ones (lambda Ch40, lambda SK5, lambda FIX, pWE and other) are presented. A special attention is paid to vectors lambda SK9 and SK18 that have the features of lambda and M13 phages and of plasmids (diphasmids). Data on phasmids (lambda pMYF131 and lambda pSL51) and hyphages MC18 and MC19 are also presented. PMID- 2698993 TI - [Various aspects of structural studies of aspartate proteinases]. AB - The paper is a brief account of aspartic proteinases' structural studies developed in V.A. Engelhardt Institute of Molecular Biology during the last 3 years. The work on porcine pepsin has been finalized after the refinement of the monoclinic crystal form at 1.8 A resolution performed in collaboration with the group of protein structure and function studies of the University of Alberta in Canada. An important structural property of chymosin which explains the enzyme specificity has been found. Protein engineering work on chymosin is being developed. The structural template for aspartic proteinases has been elucidated and on the basis of this template the model of HIV-1 protease molecule has been built. Some approaches to the design of HIV-1 protease inhibitors were elucidated. PMID- 2698994 TI - [Study of coenzyme reorientation in the active center of tryptophanase by linear dichroism method]. AB - Tryptophanase from E.coli was oriented in a compressed slab of polyacrylamide gel and its linear dichroism (LD) and absorption spectra were measured. The free enzyme displays four LD bands at 305, 340, 425 and 490 nm. Two bands at 340 and 425 nm belong to the internal coenzyme-lysine aldimine. The 305 nm band apparently belongs to an aromatic amino acid residue; the sign and form of this band are changed upon the enzyme reaction with substrate analogs. The 490 nm band is present in the LD spectra of holo- and apoenzyme and disappears after treatment with NaBH4. It is suggested that the 490 nm band belongs to a quinoid enzyme subform. The reaction of tryptophanase with threo-beta-phenyl-DL-serine and L-threonine leads to formation of the external aldimine with a strong absorption band at 420-425 nm. The reduced LD (delta A/A) in this band is one order of magnitude greater than that in the 420 nm of the free enzyme. The complex with D-alanine is characterized by an intermediate LD value in the 425 nm band. In the presence of indole this complex displays the same LD as that observed with beta-phenylserine. The reaction of tryptophanase with L-alanine and oxindolyl-L-alanine leads to formation of the quinoid intermediate with a 500 nm absorption band. The LD value in this band differs from those in the absorption bands of the free enzyme. It is concluded that reorientations of the coenzyme occur in the course of the tryptophanase reaction. PMID- 2698995 TI - [The tRNA anticodon is recognized by aminoacyl-tRNA-synthetase]. AB - Data concerning the regions of tRNA molecules recognized by cognate aminoacyl tRNA synthetases and obtained recently by the new methods (the synthesis of mutant tRNA genes and their transcription in vitro, chimeric suppressor tRNA, RNA engineering) are briefly discussed. The results of several laboratories are in full agreement with the hypothesis proposed earlier on the role of a tRNA anticodon as a specific region by which the enzyme identifies various tRNAs. More than half of tRNAs belong to the group recognized by the aminoacyl-tRNA synthetases by this mechanism. The behavior of natural and artificially constructed tRNAs which contain modified anticodons, but conserve amino acid specificity in the reaction of aminoacylation, indicates that in some tRNAs the role of the anticodon in the tRNA identity is minor if any. This group of tRNA is recognized by the aminoacyl-tRNA synthetases predominantly via the double helical region of the molecule. The authors discuss the significance of the absence of topographic conservatism in the mechanism by which tRNAs are recognized by the aminoacyl-tRNA synthetases. PMID- 2698996 TI - [Immune electron microscope determination of the localization of tryptophanyl tRNA-synthetase in bacteria and higher eukaryotes]. AB - Localization of tryptophanyl-tRNA synthetase (TRS) was studied on ultrathin (UT) sections of Escherichia coli cells and of rat fibroblasts fixed with glutaraldehyde and embedded in "Lowicryl K4M" resin at -35 degrees C. The UT sections were treated with the complexes of monoclonal and/or polyclonal antibodies against TRS with colloidal gold 15 and 8 nm in size. In both types of the cells cytoplasm was the most intensely labelled. In fibroblast cytoplasm, zones with a greater amount of ribosomes were mainly labelled, the gold particles being found over both the cysternae of granular endoplasmic reticulum and the areas of localization of free ribosomes. In the zones of microfilament localization TRS was not detected. A great amount of TRS was found in mitochondria and in the fibroblast nuclei. In the latter case, the label was concentrated over the diffuse chromatin localization regions, a minimal binding being observed over compact chromatin. The number of particles observed over diffuse chromatin equals to 50-80% against the label in fibroblast cytoplasm. In contrast, the label used to be absent over the E. coli nucleoid. The presence of TRS in the fibroblast nucleus may evidence in favour of a possible regulatory role of TRS in eukaryots. PMID- 2698997 TI - Production and characterization of monoclonal anti-CD18 anti-idiotype antibodies. AB - Three leukocyte adhesion receptors have been described which mediate intercellular binding of leukocytes: LFA-1 (CD11a/CD18), Mac-1 (CD11b/CD18), and p150/95 (CD11c/CD18). We have previously reported the production of several monoclonal antibodies against the common subunit of these receptors (CD18). We have describe the production of monoclonal anti-idiotype antibodies against one of the anti-CD18 antibodies (H52) which has been shown to inhibit potently the function of leukocyte adhesion receptors. Three IgG1 and two IgM anti-idiotype antibodies were derived which recognized private idiotopes on the H52 molecule. Two of these antibodies blocked the binding of H52 to purified LFA-1 and to cell surface expressed antigen. One of the antibodies (AIM.6) was shown to be an internal image-type (Ab2 beta) antibody based on inhibition of its binding to H52 by purified LFA-1 and by its ability to induce Ab3 which recognize LFA-1 when used as immunogen. The AIM.6 Ab2 beta antibody was tested for recognition of leukocyte adhesion ligands in LFA-1-mediated leukocyte adhesion and activation assays. The AIM.6 antibody did not block intercellular adhesion of leukocytes or mitogen stimulation of T cells, functions which were completely inhibited by low concns of H52. AIM.6 Ab2 beta antibody bound to H52 very well at 0 degrees C but bound very poorly or not at all at 37 degrees C. Binding studies on a panel of anti-CD18 monoclonal antibodies showed that the idiotope defined by AIM.6 was unique to H52 and an antibody recognizing the same epitope on CD18 (H5B9). This result showed that inhibitory anti-CD18 monoclonal antibodies utilize at least two distinct paratopes in binding to CD18. The above results are in contrast to those obtained in other systems in which Ab2 beta antibodies against receptor specific Ab1 antibodies recognize receptor ligands and are discussed in the context of ligand recognition by leukocyte adhesion receptors. PMID- 2698998 TI - Social implications of health care in contemporary perspectives: essays in honor of Helen Rehr. PMID- 2698999 TI - Social implications of health care in contemporary perspectives: essays in honor of Helen Rehr. PMID- 2699000 TI - An economist looks at the future of health policy. PMID- 2699001 TI - Patient compliance with therapeutic advice: a modern view. AB - Considering all the hurdles between the advice to take medication and the taking of it, that patients comply as well as they do is remarkable. It is all the more remarkable when physicians ask patients who are well to take costly and unpleasant medications or diets (for example, for hypertension or hyperlipidemia), day after day, to prevent low-probability events many years in the future. The problem of noncompliance will remain with us; it is, after all, part of the human condition. It will not be, and probably should not be, conquered altogether. Because many prescribed medications are not powerful over and above their placebo effects, noncompliance often does no harm. When patients refuse to do what physicians advise, as expressions of their own informed free will, it is also unclear that harm has been done. What we, as a health-care community, should be most concerned about is the noncompliance that arises for other, less ambiguous reasons: failure of communication or lack of opportunity. The main issue, as I see it, is to find ways to reduce unnecessary and harmful noncompliance--that is, noncompliance that occurs because of misunderstanding about what has been suggested and what is at stake, or because of poverty and other logistic problems. Therefore, I have emphasized those aspects of compliance in this review. Compliance with medical advice is far too complex, especially these days, to reduce to a simple yes-no dichotomy. A great deal of wisdom is called for, both on the patient's and on the physician's side, when medical advice is given. PMID- 2699002 TI - Education for health social work practice: reconciling past, present, and future. PMID- 2699003 TI - Fungal infections during neutropenia: the role of prophylaxis. AB - Fungal infections are seen predominantly in patients with neoplastic diseases. Autopsy studies revealed that 30 to 50% of decreased patients with hematologic neoplasms have histopathologically documented invasive fungal infections. The rationale for fungal chemoprophylaxis is the high incidence of fungal disease in these patients (5), the high mortality (29), the difficulty in diagnosing (28), and the severe side effects of systemic antifungal therapy with amphotericin B (3). Endogenous sources such as oropharyngeal and digestive mucous membranes and exogenous pathways such as air (e.g.aspergilli) or food have to be considered. Therefore, prophylaxis has to comprise both aspects:Prevention of acquisition through nonspecific hygiene measures (5), reduction of colonization (non absorbable antifungals or systemic chemoprophylaxis) (20). Antifungal prophylaxis of candidosis with both non- and absorbable drugs has not been convincing in terms of reduction of proven fungal infections. Prevention of aspergillosis consists mainly of the control of room air. PMID- 2699004 TI - [Ballistic approach in head injuries caused by missiles]. AB - If the missile head injury treatment is relatively well codified, wound ballistic, on the other hand, is not well known of neurosurgeons. Different means of study and tissue simulants are being listed. In face of numerous contradictory results, we shall only retain the M.L. Fackler method with 10% gelatin. Experimental results will depend on: 1. Missile parameters. For instance, in soft homogeneous tissue, one can discern shells with an uncertain path, full jacketed bullets which tumble after a variable "neck", and non jacketed missiles which cause wound through "mushrooming" and/or fragmentation effect. Buckshot wounds obey the rule "all or none". 2. Body reactions, particularly the clash with a hard material like bone, which can overturn everything described in soft tissues. These wound ballistic notions have lead us to formulate two pathogenic hypothesizes, allowing us to understand sometime case reports which had first seemed paradoxical: the brain structure, enclosed in the skull will not able to survive any major temporary cavity, the more or less deep missile pathway through the skull will be very different according to the type and energy of the missile, and to the hardness of pierced bone. PMID- 2699005 TI - [Spinal cord lipoma. Apropos of 3 cases]. AB - Intramedullary lipomas are rare, benign tumors of the spinal cord. (1% of all primitive intramedullary tumors). Three cases are reported in this work. The clinical presentation and neuroradiological findings, specially C.T. scan have led in the three cases to a diagnostic of compressive myelopathy secondary to hypodense process situated intradurally in the cervico-thoracic region. The surgery was limited to decompression with biopsy (in 2 cases) and a partial removal in one case. The histologic examination showed a mature lipoma in the three cases. The evolution was good. The literature review allowed us to know that the opinions about surgical management of these tumors are very different. The operation which is always recommended in the evolving clinical cases is more controversial in other cases. It must be conservative, limited to a partial excision of the tumor, and even to a decompression biopsy when the anatomical conditions make it necessary. PMID- 2699006 TI - [Sciatica and nerve root anomalies. Apropos of a series of 20 cases]. AB - We present 20 operative cases of lumbar nerve root anomalies, divided into 6 anatomical types: nerve roots with common dural emergence (4 cases), contiguous dural emergence (6 cases), with common dural sheath (4 cases), splited nerve roots (2 cases), anastomosis between roots (3 cases) and plexiform nerve roots (1 case). 14 cases are associated with a discal hernia. 10 cases presented with unilateral but biradicular sciatica. The asymmetry of emergence is the best symptom of the pre-operative radiological evaluation on the CT scan, moreover on the myelography. The management led to an enlargement of the surgical field by hemilaminectomy to recognize the anomaly and make easier the discectomy. In 3 cases, the anomaly was recognized in patients who had been previously operated on. There are only 53% of satisfactory final results. We present a review of the main publications concerning this subject. PMID- 2699007 TI - [Immunopathology of glomerulonephritis with mesangial IgA deposits]. AB - IgA nephropathy is the most frequent type of glomerulonephritis in France. Its definition is on renal pathology. Mesangial IgA deposits are dimeric or polymeric and probably from secretory origin. Circulating IgA molecules correspond to immune complexes with unknown antigens. The IgA subclass remains still controversial: exclusive IgA1 versus IgA1 and IgA2. The pathogenesis of the disease is based on an immune defect specific of the secretory IgA system and eventually of the serum IgA system. The human disease can be experimentally reproduced. Nevertheless, numerous unknown explanations persist in this disease. PMID- 2699008 TI - [Familial cases of Berger's disease or of Berger's disease and rheumatoid purpura. Cooperative study of the Societe Francaise de Nephrologie]. AB - Several instances of familial Berger's disease have been reported and suggested the possible role of genetic factors in the etiology of the disease. In order to show that familial cases are not a rare finding, a french cooperative study was initiated. It revealed 34 families with 2 or 3 relatives with biopsy-proven Berger's disease. The male predominance (77%) as well as the severity of the evolution (12 out of 69 patients in terminal renal failure) in this series of familial cases are similar to those found in isolated cases. However, the young age at onset (47% being 16 years old or less) deserves to be noted. The number of familial cases is perhaps higher since 90 other families with one patient with Berger's disease and relatives either having urinary abnormalities or terminal renal failure were collected. Although in many of these last patients, clinicians strongly suspected Berger's disease, this diagnosis could not be proven in the absence of immunofluorescent study. This cooperative study has shown that two different glomerular diseases could be encountered in the same family. The association of Henoch-Schonlein purpura and Berger's disease was noted in 4 of these 34 families as well in 11 other and may represent a supplementary argument in favor of a relationship between the two diseases. However, the multiple occurrence of cases in a family may be due to chance or may be the consequence of common environmental factors and does not demonstrate the presence of genetic factors. The use of genetic markers in the families would be helpful to prove the role of these factors in Berger's disease. PMID- 2699009 TI - The relationship between glomerular structure and function in insulin-dependent diabetes. AB - Diabetic nephropathy affects up to 40% of insulin dependent patients for reasons that are unclear. This review briefly describes the methodology of histological quantitative morphometry as applied to the human renal glomerulus and what the results tell us about the glomerular structural determinants of GFR. A case is made for the use of renal biopsy as an important part of studies of the diabetic kidney. PMID- 2699010 TI - [Arterial hypertension with renin hypersecretion secondary to pyelo-ureteral syndrome. Cure after corrective surgery]. AB - In a 22 years old woman with recent hypertension, a timed intravenous pyelogram revealed an asymptomatic obstructive ureteropelvic junction. Preoperative renal vein catheterization demonstrated excessive renin release from the diseased kidney and low release from the other one, suggesting that corrective ureteral surgery should return blood pressure to normal levels. Moderately impaired glomerular filtration rate improved after surgery as a consequence of suppressed hydronephrosis and bilateral renal ischemia. Thus we conclude that in young people, asymptomatic unilateral hydronephrosis can lead to hypertension and renal failure like renal artery stenosis. In the other cases of urinary flow obstruction, secondary hypertension remains to be explained by both inappropriate production of renin and water chronic retention. PMID- 2699011 TI - [Comparison of the use of classic diazoanalgesia in surgery and an applicative variant with buprenorphine]. AB - The authors have compared two different techniques of anaesthesia: the classical anaesthesia with benzodiazepine-analgesic (diazepam and fentanyl) and one of its variant obtained by using flunitrazepam and buprenorphine. The 45 patients submitted to gynaecological surgery were causally divided in two groups in connection with the two different anaesthesiological techniques. The clinical and statistical analysis of the collected data demonstrated the real validity of this anaesthesiological variant: either for premedication by perfect anxiolysis and sedation, or for the maintenance by low incidence on cardiocirculation system and perfect analgesia that extended its effects for many hours after surgical operation. PMID- 2699012 TI - [Effects of the nutritional status on the respiratory system]. AB - Mechanically ventilated patients are at high risk for malnutrition, and it is now accepted that nutrition can influence the respiratory function. In particular, malnutrition can adversely affect lung function and the adverse effects of such malnutrition include: decreased ventilatory drive, decreased respiratory muscle function, alterations of lung parenchyma and depressed lung defense mechanisms. Therefore, nutrition support should be considered if a patients has a severe chronic pulmonary disease or an acute respiratory disease. Recent studies showed that malnourished patients have a reduced respiratory muscle strength and that nutritional intervention can return muscle ventilatory function to normal levels. Furthermore, it seems very likely that the ventilatory drive can be influenced by dietary intake of amino acids and glucose. The structure of the pulmonary parenchyma can be affected by starvation and the pulmonary defense mechanisms are depressed in malnourished patients. The incidence of post-operative pneumonia or atelectasis is higher in protein-depleted patients. in comparison with well nourished patients. In conclusion, the importance of nutrition support in the management of patients with respiratory failure, particularly those mechanically ventilated, is stressed in the paper. PMID- 2699013 TI - [Mechanical ventilation and pulmonary vascular resistance: comparison of IPPV, CPPV, CPAP, and PSV in decompensated chronic obstructive bronchopneumopathy with pulmonary hypertension]. AB - Alterations of pulmonary vascular resistance were studied using four different methods of mechanical ventilation. A Servo Ventilator 900 C respirator was used for three of these techniques (IPPV, CPPV and PSV); CPAP was performed using a continuous-flow system because of the latter's advantages compared to demand-flow systems. Five patients (aged 64-75) affected by BPCO uncompensation and pulmonary hypertension (PAP 40 +/- 8 mmHg) were included in the study. A complete hemodynamic test was performed in each patient for each of the methods used by inserting a Swan-Ganz catheter through the right-hand internal jugular vein; intrapleural pressure were also measured using an esophageal balloon. The results of the study revealed a low level of tolerance to CPAP. Of the other methods, PSV was found to be particularly useful since it produced significant constant reductions of PVR and increased levels of CO compared to other techniques. These positive hemodynamic effects may be explained by the pattern of intrapleural pressures and the possibility of "self-adjustment" which this method allows. PMID- 2699014 TI - Steroids: reactions and partial syntheses. PMID- 2699015 TI - Pyrrolizidine alkaloids. PMID- 2699016 TI - Coumarins. PMID- 2699017 TI - Recent advances in the use of enzyme-catalysed reactions in organic synthesis. PMID- 2699018 TI - [Current trends in the determination of the tasks in the surgical treatment of eye wounds]. AB - On the grounds of the analysis of literature data on the question of reception and rendering aid different conditions to sufferers from mainly of bullet wounds and on the basis of a many year experience of work at the Clinic of Eye Diseases of the Kirov Higher Army Medical College in this field a conclusion is made about the necessity to review the methods of a so-called surgical treatment of eye wounds. A high technical level of modern diagnostic methods allowing at early terms to rather precisely judge about the volume of the injury as well as very high possibilities of microsurgical technique of operation have created conditions for extending the rational volume of a specialized aid to the sufferers from a (primary) treatment, limited by the most urgent tasks, to an exhaustive one (ideally, conducted at one stage). PMID- 2699019 TI - [Morphological research on different ways of joining the rectus muscles of the eye]. AB - The paper analyses results of comparative clinico-morphological studies of two methods for ocular rectus muscles a sutural and a loop methods used in 8 rabbits (16 eyes). Histologic examination of specimens of eye made 4-6 months after surgical intervention has shown that a loop method provides preservation of the structure of muscular tissue to a much greater degree than a sutural method. The results obtained allow to consider the loop method to be a method of choice for the usage in clinical practice as being less traumatic. The effectiveness of the operation was recorded in 15 patients with monolateral convergent paralytic strabismus. The follow-up period ranged from 6 months to 2 years. PMID- 2699020 TI - [The clinical characteristics of the pupil, its size and reactions to light and convergence in emmetropia and ametropia]. PMID- 2699021 TI - Fetal motor activity and spine development. AB - The Authors, on the basis of previous data obtained by ultrasonography, analysed more closely the quantitative and qualitative correlations between movements and spine development in the human fetus. The bending angles of cervical lordosis and thoracic kyphosis showed a trend directly and inversely proportional, respectively, to the trend of the overall motility of the fetus, measured as the percentage of time employed by the fetus in motor activity. The trend of the lumbo-sacral angle, that appears later, seemed to be less related to the motor behaviour of the fetus, while the bending angle of lumbar lordosis increases very rapidly when also the fetal motility shows an increase at 25-30 weeks. The significance that the developmental stages and the actions of the muscles involved in early fetal motility, and particularly in spine movements, have in the ossification and in the postural attitude of the axial skeleton, was finally discussed. PMID- 2699022 TI - Effects of a phorbol ester on cell proliferation, cytoskeleton and chromosomes in 3T3 T proadipocytes. AB - Tumour-promoting 12-0-tetradecanoylphorbol-13-acetate (TPA) showed a biphasic effect on cell proliferation of BALB/3T3 T proadipocytes. TPA (100 ng/ml) inhibited cell proliferation after 6-18 h of treatment but stimulated it during the next 3 d. Cultures treated with TPA for 24 d showed a 3.3 times higher saturation density compared with those without TPA treatment. TPA-induced morphological alterations were studied by immunofluorescence and scanning electronmicroscopy. In addition, detergent-extracted whole mount cell observations were carried out with or without immuno-electronmicroscopy. The results showed that TPA induced a rapid and reversible assembly of actin filaments and redistribution of microtubules which commenced as early as 15-20 min, but did not influence the frequency of sister chromatid exchange. PMID- 2699023 TI - [Efficiency of pulmonary ventilation and capability of exertion]. PMID- 2699024 TI - [Leghemoglobins and leghemoglobin genes]. PMID- 2699025 TI - [Proteins and peptides binding heavy metals]. PMID- 2699026 TI - [Biosynthesis and transport of phosphatidic acid in animal cells]. PMID- 2699028 TI - [Seventy historical years of activity at the Marceli Nencki Experimental Biology Institute]. PMID- 2699027 TI - [Control of L-phenylalanine ammonia-lyase activity and red pigment level in higher plants by 1-amino-2-phenylethylphosphonic acid]. PMID- 2699029 TI - [Data bases in biochemistry--applications to analysis and prediction of protein properties and function]. PMID- 2699030 TI - [Interaction of calmodulin with its target proteins]. PMID- 2699031 TI - [Calmodulin and its role in the regulation of plant cell metabolism]. PMID- 2699032 TI - The synergistic effect of NADPH and NADH on P450 function in processing premutagens. PMID- 2699033 TI - Sepsis/septic shock in adults and children. PMID- 2699034 TI - Development of immunotherapeutic strategies for the treatment of malignant neoplasia. AB - The utility of biologics and BRMs in cancer therapeutics can be considered with a cautious optimism predicated on the progress that has occurred to date and the specific indications that can now be identified. Although to date BRMs have shown only limited activity in restricted subsets of patients which may be viewed as dissuasion to some investigators; nonetheless, it should also be a stimulus to conduct careful, basic, and clinical experimentation aimed at verifying the promise from preclinical studies and to obtain further fundamental information on the BRM mechanism of action that would provide a basis for the ultimate utilization of these agents as well as the identification-development of appropriate analogs predicted on the deficiencies observed to date with the BRM. PMID- 2699035 TI - Epidemiologic aspects of childhood mesothelioma. AB - Our calculation provides the first population-based incidence rate of childhood mesothelioma in the United States. Based on these data and on our pathology review, we conclude that mesothelioma occurs rarely in children and that this diagnosis is difficult to establish. A more systematic approach to identifying mesothelioma cases in children, as well as adults, will be facilitated by increasing state surveillance of cancer incidence and by the proposed addition of a unique code for mesothelioma in the Tenth Revision of the ICD. There is a critical need for histopathological verification of mesothelioma cases. The increased use of a uniform, reproducible histopathologic classification and mesothelioma panels should address this problem. A thorough microscopic study of individual cases needs to be supplemented by a careful assessment of the clinical findings and environmental factors. The available data thus far do not support an association between childhood mesothelioma and asbestos exposure. However, the ubiquitous nature of asbestos exposures, the known association of asbestos with adult mesothelioma, the unreliability of the diagnosis, and the lack of adequate data regarding asbestos exposures, all indicate that asbestos involvement cannot be categorically ruled out, especially in older children with the potential for a longer duration of exposure and a plausible induction period. Mesothelioma in children, as well as in adults, is likely to have a multifactorial etiology. Radiation, prenatal medications, and genetic factors are all possible etiologic agents in childhood mesothelioma. In addition, other, as of yet unspecified environmental factors may play a role in this disease. When cases are diagnosed, the physician should inquire about the history of exposure to asbestos or other hazardous materials in the patient's environment, prior radiation exposure, medication exposure pre- and postnatally, prior cancer diagnoses, and a family history of cancer. An interdisciplinary approach, combining the diagnostic skills of the pathologist and the analytic skills of the epidemiologist, will be of value and of special relevance in the study of mesotheliomas. PMID- 2699036 TI - Topical fluorides. AB - Fluoride is currently conceived as acting for the most part topically, reducing dissolution and enhancing remineralization of the enamel. The introduction of small amounts of fluoride into the mouth as often as possible is therefore important. Regular use of fluoride toothpastes is the most practicable way of maintaining elevated fluoride concentrations at the plaque-enamel interface. The importance of fluoride toothpastes as the basic caries preventive method requires emphasizing. For those who need additional fluoride therapy, frequent rinsing with dilute fluoride solutions or topical applications of concentrated fluoride solutions, gels or varnishes are the commonest alternatives. None of these methods is superior to any other. Thus, choice of method depends on costs, convenience, patient acceptance and safety. PMID- 2699037 TI - Radiation doses and risks in dento-maxillofacial radiology. AB - Radiation doses and risks in dento-maxillofacial radiology are discussed. The basic processes of interaction between X-rays and living tissue are described and the quantities and units used in dose estimates are defined. Experimental values for doses absorbed by various organs/tissues, mainly in the head and neck region, are presented. The effects of proper collimation and shielding on dose values are demonstrated. Examples from the literature are given. The necessity for and methods for radiation protection in dento-maxillofacial radiography are discussed. PMID- 2699038 TI - Characterization, cloning, curing, and distribution in lactic acid bacteria of pLP1, a plasmid from Lactobacillus plantarum CCM 1904 and its use in shuttle vector construction. AB - A small 2.1-kb plasmid called pLP1 was extracted from Lactobacillus plantarum CCM 1904 (ATCC 8014) and cloned into the Escherichia coli pUC19 plasmid. As determined by DNA-DNA Southern hybridization with a pLP1-radioactively labeled probe, other lactic acid bacteria such as L. curvatus, L. sake, Carnobacterium, and Leuconostoc mesenteroides harbor pLP1-related plasmids. Shuttle vectors based on the pLP1 replicon were constructed by inserting the erythromycin-resistance gene from pVA891 into the various pUC19-pLP1 constructions. pLP1-based shuttle vector transformation efficiencies (TE) by electroporation were compared to TE of a broad-host-range plasmid pGK12 in different lactobacilli strains. Expression of the pUC19-pLP1 plasmids in Escherichia coli maxicells showed that pLP1 encodes for a 37,000 MW protein which can act in trans allowing the replication of plasmids in which this protein is truncated. The pLP1-based shuttle vectors producing this protein replicate in lactobacilli and also in Bacillus subtilis. A pLP1-free strain was obtained by incompatibility with a pLP1-based shuttle vector introduced in L. plantarum CCM 1904 by electroporation. The absence of pLP1 has no incidence on the strain phenotype suggesting that pLP1 is not essential for the strain in our laboratory conditions. PMID- 2699039 TI - Two mechanisms necessary for the stable inheritance of plasmid RP4. AB - Plasmid RP4 is stably maintained in strains of Escherichia coli and other Gram negative bacteria. Inactivation of the plasmid primase gene (pri) or removal of the PstIC fragment gave RP4 derivatives that are slightly unstably maintained in E. coli. Removal of the Tn 1 multimer resolution system (res and tnpR) did not lead to any detectable plasmid loss. Removal of all three of these regions, however, gave rise to pNJ5000 which is lost at high frequency. We have dissected the mechanisms causing this phenomenon. In contrast to RP4, pNJ5000 accumulates significantly as plasmid multimers in a Rec+ host; in a recA host, multimers are not seen and the plasmid is stably maintained. Multimers therefore appear to form by recA-mediated homologous recombination and cause plasmid instability, perhaps by interfering with partition. We demonstrate a mechanism provided by the PstIC fragment which acts on multimers analogously to the Tn1/3 resolution system on plasmid cointegrates, being effective only when cloned in cis. The loss of pri, on the other hand, can be complemented in trans. Our results are consistent with the view that primase prevents multimers forming (rather than resolving them once formed), perhaps by binding specifically to single-stranded regions of the plasmid and preventing homologous pairing. PMID- 2699040 TI - CoIV plasmids pCoIV-B188 and pCoIV-K30: genetic maps according to restriction enzyme sites and landmark phenotypic characteristics. AB - The CoIV plasmids are large virulence plasmids of the incompatibility group IncFI. We have obtained the genetic maps of two of the most studied CoIV plasmids, pCoIV-B188 and pCoIV-K30, according to restriction enzyme sites and landmark phenotypic characteristics such as colicin V, the aerobactin iron uptake system, the transfer region, replication regions, and repeated sequences. Although the two plasmids differ in size (pCoIV-B188 is 80 kb and pCoIV-K30 is 144 kb), the maps reveal many regions which are apparently identical or very similar. PMID- 2699041 TI - Introduction of a Micrococcus plasmid in Escherichia coli. AB - A 6-MDa plasmid (pMQV10), carrying cholesterol hydroxylase and streptomycin resistance genes, from a gram-positive strain of Micrococcus sps., (RJ6) has been successfully transformed in gram-negative Escherichia coli K12 C600. pMQV10 is maintained stably and expresses its drug resistance in the new host. PMID- 2699042 TI - Lack of expression of RP4-specified beta-lactamase in Azospirillum brasilense. AB - Plasmid RP4, which normally confers resistance to ampicillin (Apr), tetracycline (Tcr), and kanamycin (Kmr) to its hosts, failed to express enhanced Apr when transferred from Escherichia coli to Azospirillum brasilense which has its own intrinsic beta-lactamase. Even in a beta-lactamase-deficient mutant, A. brasilense RG-D16, no increase in beta-lactamase or significant Apr appeared following transfer of RP4. However, A. brasilense RG (RP4) and A. brasilense RG D16 (RP4) did exhibit Tcr Kmr. When RP4 was transferred back from A. brasilense to E. coli all three drug resistances and beta-lactamase activity were fully expressed. PMID- 2699043 TI - Nutritional composition of fats in seafoods. AB - Public interest in the health benefits of seafood lipids, or of fish oils, is a most unusual phenomenon because for once the recommendations of health authorities to "eat more fish" are in accord with newer and popular attitudes. Media exploitation of the more sensational health aspects is also generally in favor of more consumption of seafood. The public is however still confused by the multitude of species of fish and shellfish available, and in a quandary over whether fatty fish are risky in terms of calories or cholesterol, or of more benefit than lean fish in terms of omega-3 fatty acids. Most direct questions on how much omega-3 fatty acids are useful in the diet of an average individual may never be answerable until long term studies with humans are carried out. It does appear that marine fish can be broken down into four convenient categories: lean (including shellfish), low fat, medium fat and high fat; and in this review it is suggested that these could contribute, per 100 grams, respectively about 250, 750, 1000 and 2000 mg of total C20 + C22 omega-3 fatty acids. This intake can compare favorably with the alternative of commonly available fish oil capsules. Moreover this survey shows that at present the composite of total omega-3 fatty acids in fish and shellfish may contain roughly equal proportions of the functionally effective eicosapentaenoic acid, and of docosahexaenoic acid with its as yet unknown long-term biochemical effects, or be biased in favor of more of the latter. To assist the public, nutritionists, dietitians, and researchers this review discusses the distribution of fat in edible fish muscle, the classes of lipids encountered, and the major fatty acids of health interest. Included are limited numbers of analyses from parts of the world other than North America. PMID- 2699044 TI - Fish and the cardiovascular system. PMID- 2699045 TI - Anti-nutritional effects of soyabean: a review. AB - Inclusion of raw soyabean in diets considerably inhibits the growth of young animals. This is due to interference with normal gut and systemic metabolism, particularly of pancreas, liver and muscle. Pancreatic hypertrophy and hyperplasia occur in the young of a number of species given soyabean. In the rat, this enlargement, which is primarily a result of interference with CCK-mediated feedback control of exocrine pancreatic secretion, persists upon prolonged feeding and leads to a susceptibility of the pancreas to carcinogens and an increased incidence of neoplasia. In contrast, with pigs or dogs, in which feedback regulation is primarily mediated via secretin, no increase in pancreas enlargement results from consumption of soyabean. Dietary soyabean or trypsin inhibitors do however alter pancreatic secretion in humans. It is at present unclear how this response is mediated. The growth inhibition and interference with intestinal and systemic metabolism observed upon soyabean feeding is due to the presence of trypsin inhibitors, lectin and anti-nutritional factors, devoid of trypsin inhibitory or lectin activity, in the seed meal. The effects of these dietary factors are additive and possibly synergistic. Most of the anti nutritional effects of soyabean can be abolished by proper aqueous heart treatment. However, with a proportion of calves, pigs, lambs and humans even heat treated soyabean has deleterious effects. These can only be eliminated by hot aqueous-ethanol extraction of the meal. PMID- 2699046 TI - Nutritional impacts of an increasing fuelwood shortage in rural households in developing countries. AB - Developing countries face the problem of an increasing fuelwood shortage. For rural households, fuelwood is the main source of energy. As energy is essential to make food suitable for human consumption by means of cooking, the present fuelwood crisis could jeopardize the nutritional situation of rural households. This article reviews and analyses available data and information on the relationship between the availability of fuelwood and the nutritional situation of rural households. Based on analysis of emperical studies, three main strategies evolved by rural households, especially by the women within these households, to cope with a shortage of fuelwood can be distinguished: (i) increase in time and energy spent on fuelwood collection, (ii) substitution of fuelwood by alternative fuels and (iii) economizing on the consumption of fuelwood and alternative fuels. These coping-strategies affect food supply, food preservation, preparation and distribution, income generating activities and food consumption, all of which result in a decrease in quality and quantity of food consumed and in a deterioration of physical condition, especially women and their young children. Available data on fuelwood availability and nutrition are rather diffuse and incomplete. The presence of several confounding variables in the studies analysed make it difficult to establish the nutritional impact of a growing shortage of fuelwood. Nevertheless, it is concluded that a shortage of fuelwood plays at least an important role in changes in nutritional situation of rural households. If current trends continue, this role will become more important and evident. The impact of a growing fuelwood shortage should be a point of concern for rural development. PMID- 2699047 TI - Effects of aging on responses to furosemide. AB - Furosemide causes both diuretic and non-diuretic changes in renal function. We compared responses to intravenous furosemide 0.5 mg.kg-1 in 38 subjects (30 males, 8 females) aged 18 to 30 with those in 14 subjects (9 males, 5 females) aged 50 and over. There were no consistent differences attributable to gender. Older persons showed greater natriuresis (47 percent in males and 26 percent in females) but their increment in plasma renin activity was markedly reduced. The urinary excretion of thromboxane B2 was elevated in older subjects (58 +/- 10 vs. 30 +/- 4 ng/4 h, p less than 0.05 for males; 48 +/- 7 vs. 29 +/- 4 ng/4 hr, p less than 0.05 for females) while that of 6-keto prostaglandin F1 alpha was not different. While differences in the diuretic response to furosemide may be due to pharmacokinetic differences, the non-diuretic response differences may reflect age related changes in renal prostaglandin synthesis. PMID- 2699048 TI - A sectional denture as the optimal prosthesis. AB - A case is described where because of various local factors--anterior ridge loss, Class III skeletal relationship, survey lines, appearance, retention and support problems--a sectional prosthesis was found to be the optimal restoration. PMID- 2699049 TI - [Endodontic microbiology: antimicrobial canal medications]. AB - Medicaments used for reducing or eliminating microorganisms from infected root canals include: irrigating solutions, such as sodium hypochlorite, urea peroxide and hydrogen peroxide, chloramine, iodine-potassium-iodide solution, and chlorhexidine solution. In addition, various intracanal drugs, such as calcium hydroxide and antibiotics, are in use. The characteristics of these drugs are discussed. PMID- 2699050 TI - [Casting of titanium. 2]. PMID- 2699051 TI - [Biliary lithiasis]. AB - We have reviewed our experience with 2,430 cases of lithiasis of the biliary tract, 500 of them located in the common bile duct and 104 corresponding to residual lithiasis. We have made a general reflexion on the problems aroused by this very common al condition, which has an imprevisible, some times severe, outcome. The recent acquisition of new conservative methods, as disolvents and lithotrix, and the diagnostic and therapeutic role of endoscopy have revolutionated the state of the art and have introduced controversial points still unsolved. As it is common in clinical practice, biliary lithiasis should be approached in a multidisciplinary fashion, employing the most convenient diagnostic procedure for the clinical situation of the patient; a priori no accredited procedure should be disregarded. PMID- 2699052 TI - [Diagnosis of choledocholithiasis and residual lithiasis. Ultrasonic postcholecystectomy]. AB - 246 patients with proven common bile duct stones at surgery were studied in order to establish the accuracy of ultrasound scanning in detecting choledocholithiasis and to compare the sensitivity of real-time examinations with those performed by a static scanner. The detection of choledocholithiasis by real-time ultrasound was 45.6% compared to 26.3% for the examinations performed with a static scanner. A dilated common bile duct was detected in 83.6% using real-time scanning compared to 70.3% using a static scanner. When the common bile duct was not dilated ultrasound was unable to detect the stones. Real-time ultrasound detected 66.6% of the patients with residual choledocholithiasis compared to 23.5% of patients examined by a static scanner. Our results show that real-time ultrasound scanning is a very useful screening method in detecting choledocholithiasis and residual lithiasis. PMID- 2699053 TI - [Acute pancreatitis: etiopathogenesis, physiopathology and clinical aspects]. AB - Acute pancreatitis is a serious clinical problem. Many of the etiopathogenic mechanisms are not clear and its pathophysiology is very complex, with multisystemic implications. The outcome may be severe, and there is no general agreement on the therapeutic approach. In the present paper we review the newest etiopathogenic and physiopathologic concepts on acute pancreatitis as well as the diagnostic criteria on this condition. PMID- 2699054 TI - [Surgery of cancer of the rectum]. AB - Surgery of the distal half of the rectum has changed considerably in the last decades; new technical procedures have made possible the conservation of the sphincters in a considerable number of patients. We present the most significant factors of this change in surgical approach. The supporting pilars of the change have been the possibility of automatic sutures (staplers), the reduction of the distal margin and the fact that the rate of complications is similar to that of the abdomino-perineal resection. We review the complications of the surgical treatment (stenosis and fistulas) and the advantages and disadvantages of the instrumental sutures and new surgical procedures. PMID- 2699055 TI - [Reye's syndrome in adults. Presentation of a new case and review of the literature]. AB - This is the case of a 29 year-old woman, admitted because of diarrhea and incoercible vomiting; later in the course of the disease she developed signs and symptoms of encephalopathy. The diagnosis of Reye's syndrome was made after death. PMID- 2699056 TI - [Relapsing polychondritis: report of 4 cases]. AB - Four cases of Relapsing Polychondritis followed in the Hospital do Servidor Publico Estadual de Sao Paulo, since 1985, are reported and discussed. Relapsing Polychondritis, an auto-immune disease that destroys the pinnal and nasal cartilage has been observed occasionally around the world. Since it was first defined and described, in 1923, about 250 cases have been reported. PMID- 2699057 TI - [Results of vestibular neurectomy in the treatment of vertigo. Apropos of 38 cases]. AB - We present a series of 38 patients, operated by vestibular neurectomy, during 1968-1987, for peripheral vertigo intractable to medical therapy of different origin. This study includes a retrospective analysis of the results on vertigo, hearing, tinnitus and postoperative complications. Then, the operative indications and surgical approaches are discussed. PMID- 2699058 TI - [Application of an immunofluorescent technique on a guinea pig cochlear section for the study of endocochlear pathologies]. AB - Experimental evidence suggests the existence of autoimmune mechanisms in the appearance of cochlear pathologies. Following a recall of studies made previously by different authors, we will present an immunofluorescent technique on a guinea pig cochlear section applied to the study of 22 serums of patients with endocochlear pathologies. The goal of this test is to identify the patients with immunologic disorders in order to adapt treatment using immunosuppressive medication. The findings show the existence of antibodies directed against the cell nuclei, or against the endothelium of the cochlear vessels, or against the endosteum of the inner ear. The importance of these findings has yet to be established. PMID- 2699059 TI - [Magic, medicine and dentistry in pharaonic Egypt. 2]. AB - Many discoveries have been made on the existence of dentistry during the pharaonic time in Egypt. Several hypotheses have been brought, but nothing has been proven definitely. Magic and medicine have been the basis of this medical science but regarding dental artwork, a doubt still remains, concerning surgery and prosthodontics. PMID- 2699060 TI - [Modifications of occlusal and axial morphology in removable partial denture]. AB - The axial and occlusal preparation of the teeth is necessary to the sustentation, the stabilization and retention of a removable partial denture. The preparations by subtraction concern the axial and occlusal surfaces. The creation of guided surfaces within the enamel of the proximal surfaces, always start before the realisation of the occlusal boxes. The preparation by addition using composites present an esthetic and economic solution to the remodeling of the axial contour of the teeth. This promising technique has however no long term results. PMID- 2699061 TI - [Invisible orthodontics: lingual orthodontics]. AB - After an historical, a description of the appliance and the problems met in lingual orthodontics, the authors show that it has come to maturity. Indirect bonding is one of the main elements contributing to success. A large iconography illustrates the different stages of the laboratory and presents an overview of the clinical possibilities of lingual orthodontics. PMID- 2699062 TI - [Stress-breaking framework in removable partial dentures]. AB - The "TOURTET stress breaking framework" is an evolution in the prosthetic therapy for partial edentations. All clinical cases could be treated, however, it will be necessary to respect a precise protocol to disconnect the saddle from the rigid framework. The advantages are: the preservation of the abutment teeth and the maxillary bone without the need of rebning. The implicity of this technique is depending however on the amortic thinking. PMID- 2699063 TI - [The role of the tongue during orofacial functions]. PMID- 2699064 TI - [Tongue disturbances in jaw abnormalities. Classification and therapeutic concepts]. PMID- 2699065 TI - [Automated diagnosis and planning in orthodontics]. PMID- 2699066 TI - [Effect of the environment on the development of respiratory allergies]. AB - Allergy reactions may be regarded as resulting from exposure to allergens of subjects who are genetically predisposed to synthesize IgE. The presence of allergens in the environment is necessary to acquire sensitization. With some allergens, sensitization seems to develop very rapidly. The introduction or presence in the environment of certain allergens, such as house dust mites, may increase the prevalence of asthma. Despite conflicting reports, in atopic subjects exposure to pet animals also is a risk factor. Introducing foreign proteins prematurely into infant's food has been considered a factor that facilitates the development of allergic diseases. Contact with occupational allergens results in allergic manifestations in less than one-third of the subjects exposed, which suggests that genetic factors play a predisposing role. Beside exposure to allergens, non-specific environmental factors, such as chronic inhalation of tobacco smoke or atmospheric pollutants (e.g. ozone, SO2, NO2, particles of burnt fuels) might contribute to sensitization. The part played by viral infections (RSV or influenza virus) in the triggering of allergic diseases has often been reported. Interactions between irritants and allergens may encourage the development of respiratory allergy. PMID- 2699067 TI - The liver as a self-organizing system. I. Theoretics of its representation. AB - The liver is described as a composite system consisting of a set of operative creodic microunits open to a continuous flow of matter, energy and informations. Its dynamics depend on two interactive and interrelated subsystems with actions described as homopoiesis and homeorhesis, making it an autoisodiasostic system. The system's emergent (equifinal) or emergence states, operative potential, diffusion and reaction phenomena and compensation states are also formally described. For readers not familiar with the language of general system theory, of system dynamics and of categorical analysis, a glossary of some terms is provided. PMID- 2699068 TI - [Anhydrous theophylline in micropellets with prolonged action in asthmatic children]. AB - The present study was realized to evaluate the effectiveness, security and tolerability of slow release micro pellets theophylline, in a group of 168 asthmatic children, between 2 and 15 years old. The improvement of the symptoms was obtained, since the treatment began. The final evaluation was considered excellent and good in 86.90% of the cases, and the tolerability, excellent and good in 94.64% of the patients. In conclusion the slow-release micro pellets theophylline is a very effective and secure drug, with a very good tolerability for the treatment of the asthmatics in pediatric age. PMID- 2699069 TI - Papers dedicated to Benni Nerstrom on the occasion of his sixtieth birthday. December 16th 1989. PMID- 2699070 TI - Rationals for optimizing bladder cancer treatment and control. AB - Improvement in survival of patients with bladder cancer has despite much effort in optimizing treatment schedules been limited (21). Patients seem to present with a bladder tumour that has a biological potential which it is difficult to alter by treatment. Bladder tumours seem either to possess or lack the biological potential for invasion. Non-invasive (Ta) bladder tumours do not kill the patient, and survival of patients with invasive tumours is localized to the bladder or present with regional and/or distant metastases (26). PMID- 2699071 TI - Bladder tumour treatment in the aarhus region. 25 years of experience. AB - We report on the clinical studies of bladder tumours carried out at the centre for oncology in the Aarhus area and describe the experience and results of the past three decades. The 1960's saw the replacement of intracavitary techniques with external megavoltage irradiation. In the 1970's a large-scale regional trial was conducted assessing irradiation, which was now the dominant treatment principle, at all stages of the disease. In the 1980's a country-wide randomized trial was designed to compare the effect of cystectomy and definitive irradiation and to address the quality of life question. The report also mentions several associated projects on epidemiology, diagnostics (urinary cytology, DNA distribution) and factors pertinent to treatment (radioprotective agents, CT based dose planning). Finally, we describe a country-wide randomized trial on the use of adjuvant chemotherapy scheduled for the 1990's. PMID- 2699072 TI - Quality of life in patients with advanced bladder cancer. A randomized study comparing cystectomy and irradiation--the Danish Bladder Cancer Study Group (DAVECA protocol 8201). AB - The "quality of life" after treatment for advanced bladder cancer was investigated. The study was part of a randomized trial comparing the effect of preoperative irradiation (40 Gy) and cystectomy with radical radiation therapy (60 Gy) and salvage cystectomy. Patients answered a mailed questionnaire on psycho-social aspects. The first was filled in 6 months after treatment and was answered by 107 patients. The second was sent out 12-18 months later and was answered by 68 patients. From a general point of view, there were no consistent differences between the two treatment groups. In the first questionnaire, patients treated with radical irradiation and salvage cystectomy expressed a slightly more pessimistic outlook than patients treated with pre-operative irradiation and cystectomy. There was not such difference in the second questionnaire, but the latter group reported the largest reduction of social (sports, hobbies, etc.) and sexual activities. In conclusion, pre-operative information about treatment and post-operative life is an important but often neglected issue. PMID- 2699073 TI - Transabdominal ultrasonography plus urine cytology in control of benign bladder tumours. AB - Transabdominal ultrasonography can detect bladder tumours down to 5 mm in diameter, and in combination with urine cytology it is a potential alternative to cystoscopy for control of bladder tumour patients. This modality was compared with cystoscopy in 260 investigations on patients with previous non-invasive tumours. Of 153 negative ultrasonographies 55 (21%) were false negative, overlooking 15 tumours above 5 mm (including 5 flat papillomatous areas), 30 tumours 5 mm or less and 10 flat dysplastic lesions (diagnostic sensitivity 64%). In 14 of the false negative ultrasonographies urine cytology was abnormal, increasing the combined diagnostic sensitivity to 73%. Most overlooked tumours above 5 mm were in bladder neck, anterior wall and dome. Of 89 positive ultrasonographies 15 were false positive (diagnostic specificity 83%). Two patients developed invasive tumours in the study period. One was detected by ultrasound and urine cytology, the other - a flat muscle invasive tumour - was not. Ultrasonography plus urine cytology is only acceptable for control of patients with very little risk of invasive and few non-invasive recurrences, i.e. patients with previous Ta, grade I or II transitional cell tumours and no recurrences after 1 or 2 control cystoscopies. PMID- 2699074 TI - DNA replication in experimental rat bladder tumours: immunohistochemical detection of bromodeoxyuridine labelled nuclei. AB - With the purpose of studying DNA replication activity and location in normal and malignant tissue, bladder tumours were induced in ten rats by the intravesical installation of N-Nitroso-N-Methyl-Urea. Ten rats were installed with the NMU solvent and served as controls. The animals were injected intraperitoneally with 1 mg bromodeoxyuridine/100 g weight one hour prior to sacrifice. An indirect immunoperoxidase method using mouse monoclonal anti-bromodeoxy-uridine antibody was used on tissue sections of normal urothelium and bladder tumours to visualize labelled nuclei. Labelling indices were calculated and correlated to the grade of atypia. We found that normal urothelium had very little proliferative activity. The labelling index of tumours increased with increasing grade of atypia, being highest in invasive tumours. Only cells located to the basal cell layer were labelled in normal and grade I urothelium. In grade II and III tumours labelled cells were found in the intermediate cell layer as well as in the basal cell layer. Areas of squamous metaplasia showed high labelling indices, however the proliferative cells were restricted to the basal cell layer. The bromodeoxyuridine labelling index thus increases with increasing grade of atypia. PMID- 2699075 TI - Mesonephroid adenocarcinoma in urethral diverticulum treated with diverticulectomy. Case report and review of the literature. AB - A case of mesonephroid adenocarcinoma in an urethral diverticulum treated with diverticulectomy in a 53 year old female is reported. To our knowledge 26 cases of similar tumours have been reported in the literature. A review of symptoms, management and possible relationship to nephroid metaplasia is presented. PMID- 2699076 TI - Studies of heart development in normal and cardiac lethal mutant axolotls: a review. AB - The morphology of developing hearts in axolotls, Ambystoma mexicanum, has been studied by scanning electron microscopy in order to provide a chronology of morphogenesis that can be correlated with ongoing biochemical and immunocytochemical studies. In addition to normal embryos we have studied homozygous recessive cardiac lethal mutant axolotls. The mutant myocardium undergoes aberrant sarcomere development and lacks a normal heartbeat. Morphogenesis of mutant hearts appears to be nearly normal with respect to myocardial cell shape changes, epicardial formation, and the distribution of extracellular matrix fibrils in the cardiac jelly. This suggests that the deficient arrangement of contractile proteins in mutant myocardial cells does not prevent the normal organization or function of cytoskeletal isoforms of these proteins in the developing myocardium and epicardium. The implications of biochemical and morphological investigations of axolotl hearts are considered in the context of the entire developmental history of the cardiogenic mesoderm. PMID- 2699077 TI - [Rate-dependent blocking effect of class I antiarrhythmic drugs]. PMID- 2699078 TI - [The mechanism involved in the central pressor effects of angiotensin II]. PMID- 2699079 TI - [New recognition of the homeostasis concept]. PMID- 2699080 TI - [Determination of erythrocyte deformability]. PMID- 2699081 TI - [The renin-angiotensin system in the heart]. PMID- 2699082 TI - Gametocytocidal effect of primaquine in a chemotherapeutic malaria control trial in North Sumatra, Indonesia. AB - The effect of primaquine as a gametocytocidal drug was investigated in 218 P. falciparum (Pf) malaria cases detected during passive case detection (PCD) from August to December 1985 in two coastal villages of North Sumatra, where chloroquine-resistant and Fansidar-sensitive Pf was prevalent. Sulfonamide + pyrimethamine (SP) in combination with primaquine (Pr) was administered in Kuala Tanjung village and SP alone in Nana Siam village. Parasitologically confirmed Pf cases were followed up to observe the fluctuation of gametocytemia after the treatment. In 87 cases treated with SP alone, no significant change was observed in gametocyte positivity rate (GPR) and density on day 2 and day 7. In 131 cases treated with SP and Pr, no significant change was found on day 2 but significant reduction was observed in GPR and density on day 7. The gametocyte positive cases on day 7 were followed up weekly until gametocytes disappeared. SP alone did not reduce GPR from day 0 to week 2, then afterward GPR began to decline but was still 11.5% at week 5. On the other hand, SP with Pr reduced GPR from 77% on day 0 to 30% on day 7, after which GPR declined further to 7% at week 3. Reduction of parasite rate was observed in Kuala Tanjung after the PCD activities, reflecting a reduction in Pf prevalence rate from 18.6% in August 1985 to 2.9% in January 1986. These data indicate that a single dose of Pr 45 mg with SP was partially effective in reducing gametocytes and reducing malaria prevalence rate when administered through PCD activities. PMID- 2699083 TI - Mefloquine sulfadoxine pyrimethamine (MSP) combination delays in vitro emergence of mefloquine resistance in multiple drug resistant Plasmodium falciparum. AB - Sulfadoxine-pyrimethamine-resistant and chloroquine resistant, but mefloquine sensitive (MIC 5 x 10(-9] isolates of Plasmodium falciparum were used to study the emergence of mefloquine resistance. The continuously cultured isolates which were exposed intermittantly to varying concentrations of mefloquine alone became insensitive to the drug at 1 x 10(-7) M after 12 months, whereas the culture line exposed to the combination of mefloquine, sulfadoxine and pyrimethamine became only slightly insensitive to mefloquine (MIC 2 x 10(-8]. Thus, the efficacy of mefloquine may be prolonged through use in combination with sulfadoxine pyrimethamine. PMID- 2699084 TI - Giving bednets "fair" tests in field trials against malaria:a case from Sabah, East Malaysia. AB - Insecticide-impregnated bednets appear to be a potentially cost-effective intervention against endemic malaria in the tropics, but this has yet to be confirmed by field trials. There are two aspects to consider in assessing such trials: (1) the extent to which subjects use nets regularly and properly, and (2) the effectiveness of nets which are truly used regularly and properly in reducing malaria transmission. The second aspect is currently of primary concern, to determine if human-vector relationships for a particular at-risk population are such that bednets can be effective. But to give bednets a "fair" test in this regard requires regular and proper use in the first place. The study described here suggests they did not get a "fair" test in one field trial in Sabah, East Malaysia. The study also strongly suggests that direct observations, rather than post hoc questioning of subjects, may be essential to accurately gauge bednet usage rates. Accurate usage rates are required to determine what proportion of a population needs to use nets to reduce malaria transmission, and to evaluate the effectiveness of promotional programs over time. Direct observations can also yield valuable data on night-time activities that increase malaria risk, such as television viewing that keeps people awake and out of bednets. PMID- 2699086 TI - A comparison of the ELISA with other serological tests in the serodiagnosis of amoebiasis. AB - The sera of 78 patients with invasive amoebiasis were tested for antiamoebic antibodies by the techniques of enzyme-linked immunosorbent assay (ELISA), indirect haemagglutination (IHA), indirect fluorescent antibody (IFA) and counterimmunoelectrophoresis (CIEP). Results showed that the ELISA compared favourably with IHA and IFA tests in terms of sensitivity and specificity. ELISA, IHA and IFA detected 97.4%, 96.2% and 98.7% of the patients respectively. CIEP was the least sensitive of the 4 serological methods with a sensitivity of 88.5%. The advantages and disadvantages of the 4 serodiagnostic procedures are discussed. PMID- 2699085 TI - Assessment of putative tests for protective immunity to falciparum malaria. AB - Sera from clinically immune individuals comprising 10 hospitalised patients (Group I), 30 persons residing in a malaria endemic area in Thailand (Group II) and 8 persons from a hyperendemic area in Ivory Coast (Group III) were tested by the parasite growth inhibition (PGI), indirect fluorescent antibody test of ring infected erythrocyte surface antigen (RESA-IFA), urease-ELISA and Western blot. Paired sera from patients recovering from malaria (Group IV) as well as sera from blood donors were also tested. In the PGI test, sera were tested against three uncloned isolates of P. falciparum comprising SO, I4 and AE9 (PGI-SO, PGI-I4 and PGI-AE9 respectively). When growth inhibition of greater than or equal to 30% against any one of the three isolates was considered positive, the positive rate for the combined Groups I, II and III was 78.7%. Further analysis showed that the positive rates for PGI-SO, PGI-I4 and PGI-AE9 were 63.8%, 59.5% and 59.5% respectively and were not significantly different (p greater than 0.05). Comparison between PGI-SO, PGI-I4 and PGI-AE9 activities of Groups I, II and III sera showed no significant differences in any comparison groups except with PGI AE9 in which Group III sera were more frequently positive than Group II sera (p = 0.004). Follow-up of PGI-SO and PGI-AE9 activities in Group IV patients showed mostly a decrease or no change in the activities of the convalescent sera taken 63 days later. RESA-IFA positive rate in the combined Groups I, II and III sera was 91.7%. There were no significant differences either in the seropositive rates or in the geometric mean antibody titers (GMT) between Groups I, II and III sera. Follow-up in Group IV patients showed no change in antibody titers in 64% of cases, decrease and increase in titers in 29% and 7% of cases respectively. The urease-ELISA seropositive rate in the combined Groups (I, II and III) was 89.5% which is not significantly different from that of RESA-IFA (p greater than 0.05). Comparison between individual Groups (I, II and III) likewise showed no significant differences in both GMT and seropositive rates. Follow-up in Group IV sera showed either no change or a decrease in antibody titers in 55.6% and 44.4% of cases respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699087 TI - Counterimmunoelectrophoresis test on human Clonorchis sinensis infection. AB - A counterimmunoelectrophoresis test was used to detect antibodies against the adult worm antigen of Clonorchis sinensis in sera from 70 clonorchiasis patients, 20 uninfected healthy persons and 7 patients infected with other helminths. A constant voltage of 10 V/cm and a running time of 30 minutes was chosen in carrying out detection. Antibody titers of 1, 1:2 and 1:4 were obtained from 35, 21 and 14 clonorchiasis patients, respectively. Significant correlation was observed between worm burden in patients and antibody titer, the higher the antibody titer in patients, the more eggs per gram feces in their stool. Although cross reaction was observed with toxocariasis and angiostrongyliasis in this study, high (100%) sensitivity made it possible to screen the subjects in endemic areas to shorten the survey period. PMID- 2699088 TI - Acute cholecystitis and Fasciola sp. infection in Thailand: report of two cases. AB - Two cases of fascioliasis gigantica from Northeast Thailand presenting with cholecystitis and gall stones were reported. Both cases complained of abdominal pain. On laparotomy the worms were found. In one case five worms were recovered during bile duct exploration and bile drainage; eggs were also revealed in the bile. In the other case of ectopic fascioliasis one young adult worm was found in a nodule which adhered to liver and diaphragm. The parasites were identified as Fasciola gigantica. PMID- 2699089 TI - Study of mechanisms of post-transfusion hypertension in thalassaemic patients. AB - Post-transfusion hypertension, convulsion and cerebral haemorrhage is a serious complication that may occur in the thalassaemias. In this study we evaluated the effect of blood transfusion on blood pressure, plasma renin activity (PRA), blood viscosity, and urinary vanillylmandelic acid (VMA) and catecholamines in 11 beta thalassaemia/haemoglobin E patients. The results showed that after each unit of blood transfusion the blood viscosity was increased and correlated with the increased in haematocrit level. At the same time the PRA level was significantly decreased and tended to return to the normal level in a few days after the transfusion. There was no alteration in the urinary VMA and catecholamine levels. During the study two patients developed hypertension and headache. Their PRA were still lower than the pre-transfusion levels and the blood pressure returned to the normal pre-transfusion levels within 30-90 minutes after the intravenous injection of furosemide. PMID- 2699090 TI - [The beginnings of abdominal surgery in Bohemia]. PMID- 2699091 TI - [70 years' surgery in the Society of Czech Physicians]. PMID- 2699092 TI - [50 years since the death of the Mayo brothers]. PMID- 2699093 TI - [A half century since the death of Harvey Cushing (1869-1939)]. PMID- 2699094 TI - [Biochemical evaluation of generalized meningococcal infection]. PMID- 2699095 TI - [Prostaglandins and cyclic nucleotides in the gastrointestinal form of yersiniosis]. AB - In spite of the resemblance of the clinical picture of gastrointestinal yersiniosis and acute dysentery, material differences underlie the pathogenesis of these diseases. Yersiniosis is marked by the predominance of an increase in the content of PGF2 alpha, whereas acute dysentery by an increase in the content of PGE, which may be accounted for by greater intensity of the allergic manifestations in yersiniosis patients as compared with dysentery. Shigellosis runs its course in the presence of the prevailing influence of the guanylate cyclase system, whereas yersiniosis in that of the adenylate cyclase. This is likely to be related to graver destructive lesions in the colonic mucosa in acute dysentery. PMID- 2699096 TI - [Clinical assessment of electrolyte metabolism and the renin-aldosterone system in patients with liver cirrhosis and ascites]. PMID- 2699097 TI - [The normal digestion of protein-containing food products by gastric juice and in pathology of the gastrointestinal tract]. AB - The authors describe a method designed by them for assessing gastric juice proteolysis relative to different protein-containing foods, commonly used in nutrition (beef, pork, mutton, etc). Investigations involved the use of gastric juice from healthy persons and patients with chronic gastritis associated with low secretory gastric function and ulcer disease. The proteolytic activity of gastric juice turned out to be different both in healthy persons and in patients with ulcer disease. In patients suffering from chronic gastritis associated with low secretory gastric function, proteolysis of protein-containing foods was reduced to a different degree in respect to a concrete food. Out of all foods investigated, egg yolk, beef liver and mintai were assimilated better whereas egg white and mutton to a worse degree. Addition of hydrochloric or citric acid raised the proteolytic activity of gastric juice. PMID- 2699098 TI - [Characteristics of the endoscopic diagnosis of peptic ulcer and chronic gastritis associated with Campylobacter pylori]. PMID- 2699099 TI - [The importance of immunofluorescence and cytologic indices in the diagnosis and prognosis of the course of dysentery]. PMID- 2699100 TI - Clinical evaluation of a pasteurized factor XIII concentrate administration in Henoch-Schonlein purpura. Japanese Pediatric Group. AB - Arthral, abdominal and renal symptoms in Henoch-Schonlein purpura (HSP) were scored. Coagulation factor XIII (F XIII) activity was determined in fifty-six children with HSP and the correlation with the severity score of the clinical symptoms was investigated. As a result, it was found that the decrease in F XIII level was correlated with the severity score of clinical symptoms, particularly abdominal symptoms. Based on the results, a controlled study was performed in 24 cases with moderate symptoms divided into a group treated with F XIII concentrate and a non-treated group to investigate clear-cut efficacy as a next study. In three days after the administration the symptoms were improved remarkably in accordance with the increase of F XIII level compared with non-treated group and scoring of clinical symptoms was confirmed to be useful for assessing the application of the F XIII concentrate to HSP. PMID- 2699102 TI - Failure of endothelin to influence in vitro platelet responses. PMID- 2699101 TI - Influence of plasma protease activation on electroimmunoassay and nephelometry of plasma fibronectin in sepsis. AB - In vitro experiments have shown that proteases such as trypsin, kallikrein and plasmin may split plasma fibronectin, yielding changes in apparent mass concentration, i.e.: a decrease when using immunonephelometry (IN), and an increase when using electroimmunoassay (EIA). In the present in vivo study, plasma from 49 patients with severe infections was assayed for fibronectin by IN and EIA, and for prekallikrein, plasminogen and antithrombin. In patients with normal prekallikrein (n = 26) and plasminogen (n = 23), the agreement between the two fibronectin assay methods was good (ratio EIA/IN = 0.99 +/- 0.06); a similar good agreement was found in 45 healthy blood donors (ratio 0.97 +/- 0.02). In contrast, the 20 patients with low prekallikrein showed fibronectin values that were significantly higher by EIA than by nephelometry (ratio 1.27 +/- 0.10, p less than 0.01). Similarly, the 26 patients with low plasminogen had a significantly increased ratio (1.21 +/- 0.09, p less than 0.05). No such difference was seen, however, between patients with low or normal antithrombin. Thus, kallikrein and plasmin activation in vivo appear to increase the fibronectin concentration measured by EIA, possibly due to the formation of small fragments with increased electrophoretic motility. PMID- 2699103 TI - On-line plasma exchange for sepsis in neonates and infants. AB - The present study was designed to assess the effectiveness of on-line plasma exchange (on-line P.E.) between septic infants and healthy adults using septic puppies. The plasma separation system consisted of a membrane plasma separator and a plasma treatment system, KM-9027 (Kurarey Co.) equipped with small 2 channel blood and plasma pumps. 5 X 10(9) CFU/ml/kg of E. coli with endotoxin was injected intravenously into 22 puppies and they were divided into 4 groups, namely untreated group (n = 7), on-line P.E. group (n = 5), P.E. group (n = 5), sham group (n = 5). In the on-line P.E. group, about 80 ml/kg of plasma in septic puppy was replaced during 2 hr with fresh plasma simultaneously obtained from healthy adult dog. As the results, 4 of 5 survived in the on-line P.E. group and 1 of 5 survived in the P.E. group, while all other puppies died within 24 hr. In the P.E. group and on-line P.E. group, mean blood pressure and urinary output were significantly improved (p less than 0.05) by the treatment. The numbers of E. coli and endotoxin concentration in the blood were reduced significantly (p less than 0.05) only in the treatment with on-line P.E. opsonic activity recovered significantly (p less than 0.05) in P.E. group. This system appears to be effective and applicable for sepsis in infants and neonates. PMID- 2699104 TI - Effect of porcine pancreastatin on endocrine function of canine pancreas. AB - Controversial results concerning the modulation of insulin release with pancreastatin prompted us to investigate the effect of this peptide upon the endocrine function of the pancreas using an in situ perfusion method in dogs. Administration of porcine pancreastatin into the pancreaticoduodenal artery in a dosage of 0.34 micrograms/kg of body weight during arginine infusion increased slightly plasma insulin and lowered minimally plasma glucagon in the pancreaticoduodenal vein. Pancreastatin infusion in a dosage of 500 ng/min did not modify glucose-induced insulin release and glucagon suppression by glucose. Theophylline infusion induced a slight increase in plasma insulin and glucagon in the pancreaticoduodenal vein. Pancreastatin infusion accelerated slightly these changes in plasma insulin and glucagon following theophylline infusion. From the present experiment it is concluded that porcine pancreastatin did not inhibit glucose-induced insulin release from the canine pancreas, inconsistent with the first report on insulin release from the rat pancreas. Alternatively, porcine pancreastatin rather stimulated insulin release during arginine infusion or following theophylline administration. PMID- 2699105 TI - A microtestplate-immunofluorescence assay for anti-Trypanosoma cruzi antibodies. AB - A new microassay method for the detection of anti-Trypanosoma (T.) antibodies was developed by using Terasaki's microtestplates, and T. cruzi or other parasites were immunofluorescently labeled with polyclonal or monoclonal anti-T. cruzi antibodies. The fluorescence intensity of immunofluorescently stained parasites was assessed by either visual observation or quantitative analysis using a microscopic spectrophotometer. Although the sensitivity of the microtestplate assay was nearly equal to that of the conventional glass slide assay or ELISA, this method is easier in the assay procedures and spares the amount of antibodies and the number of target parasites requisite to the assay. PMID- 2699106 TI - Production and characterization of monoclonal antibodies against Trypanosoma cruzi-associated antigens. AB - Nine monoclonal antibodies (mAb) recognizing characteristic antigens in Trypanosoma (T.) cruzi were obtained from hybridomas which had been established by a fusion between mouse myeloma cells and the spleen cells of a mouse immune to the epimastigote form of T. cruzi (Tulahuen strain). Antigen specificities of these mAb were assessed by an indirect immunofluorescence (IIF) method using T. cruzi in different life cycles (amastigote and trypomastigote) and other members of the Trypanosomatidae. The mAb were classified into 3 groups from their reaction patterns to different parasites: 1) The strain specific mAb that reacted only with T. cruzi Tulahuen epimastigote, 2) the species specific mAb that reacted with all T. cruzi strains but not with other species of parasites, and 3) the mAb that were cross-reactive with other species of Trypanosomatidae. Most mAb were specific to epimastigote form of T. cruzi, but some reacted weakly with trypomastigote and amastigote form of the parasites. Immunoblotting and glycolipid analyses of the membrane fraction of homogenized parasites using the mAb identified at least 3 distinct antigenic molecules; those of protein nature having Mr. 43,000 and 58,000 and Mr. 43,000 and 62,000 and molecule(s) of glycolipid nature. PMID- 2699107 TI - Technical considerations in evaluating the adhesion of leukocytes to aortic endothelium of the rat. AB - Comments on techniques for characterizing leukocytes adhered to the aortic endothelium of the rat are given. Alpha-naphthyl acetate esterase positive leukocytes were studied by optical microscopy of en face intima-media preparations. Results indicate 1) 1% paraformaldehyde-2% glutaraldehyde is a better fixative than formalin-calcium or 4% paraformaldehyde with or without 1.5 mM CaCl2; the latter produces distortion of leukocytes, endothelial desquamation and enzymate inhibition, 2) washing the aorta with phosphate-buffered saline for 90 sec prior to fixation-perfusion produces a notable decrease in the number of leukocytes adhered, 3) diazotized parasaniline is better than fast blue RR salt as coupling agent in the esterase reaction, and 4) counterstaining with 1% methyl green for 1 min, before or after the esterase reaction, is not adequate because of limited contrast and the heavy staining of smooth muscle. Counterstaining with Gill's hematoxylin No. 3 for 90 sec is adequate only when done before the esterase reaction. Inhibition of endothelial esterase activity by hematoxylin decreases background, favors contrast of adhered leukocytes and makes it possible to observe nucleus-cytoplasm relations. PMID- 2699108 TI - Elimination or reduction of wrinkles in semithin epoxy sections by vacuum drying. AB - Vacuum drying, under appropriate conditions, diminishes the warping and buckling of epoxy semithin sections and enhances visualization with light microscopy. Treatment of sections with chloroform or variations in the drying times or temperatures did not reduce wrinkling. PMID- 2699109 TI - An improved method for studying grass leaf epidermis. AB - Leaf epidermis of grasses is elaborate and important in the systematics of the Poaceae at subfamily and genus level. Most available techniques used in preparing leaf epidermis for microscopic studies are time-consuming and often produce preparations inadequate for studying histological detail. A combination of the hand scraping and maceration methods with modifications is proposed in this paper to prepare epidermal peels comparatively rapidly. One epidermal layer was scraped off and the mesophyll tissue removed from the epidermis to be studied by maceration in HNO3. The recovered epidermal peel was neutralized in NaOH and stained with malachite green or safranin O. Preparations made by this technique are suitable for studies of epidermal features, measurements of special structures and determinations of trichome indices. This method has been used in a study investigating intraspecific variation in southern African pasture grasses. PMID- 2699110 TI - A technique for fluorescence microscopy in semithin sections. AB - We describe here a procedure to improve contrast and resolution in fluorescence microscopy of sectioned tissues. Tissue fragments were fixed in ethanol-glacial acetic acid, embedded in diethylene glycol distearate, and semithin sectioned. This method maintains tissue antigenicity while preserving the structure of cells and tissues. The thinness of the sections eliminates scattered and emitted light from tissue structures outside the plane of focus. The procedure is simple and quick, and works excellently with fluorescein-conjugated lectins and antibodies. PMID- 2699111 TI - Simple, reliable detection of latex microspheres in high quality tissue sections. PMID- 2699112 TI - A quick and standardized giemsa stain for wet-fixed cytological material. PMID- 2699113 TI - Automatic selection of macromolecules from electron micrographs by component labelling and symbolic processing. AB - A new solution to the problem of extracting images of individual biological macromolecules from electron micrographs is described. There are three distinct steps in the process. The initial stage of low-level image processing consists of noise suppression and edge detection. An intermediate stage of component labelling and feature computation bridges the gap between the iconic (low-level) processing and the final phase of symbolic (high-level) processing. Simple symbolic objects (bounding boxes) are derived from the edges, and are easily represented and manipulated in the decision-making process. The efficacy of the algorithm is demonstrated using electron micrographs of ribosomes and ribosomal subunits. The hierarchical nature of the analysis embodies a reduction in the amount of data and a change in its nature. Initially, thousands of pixels of continuous gray levels must be dealt with. After component labelling, there are fewer than a hundred bounding boxes whose manipulation can easily be defined and articulated by an expert. The software package that has been written can thus serve as a basis for applying artificial intelligence methodologies to analysis of electron micrographs. PMID- 2699114 TI - [Treatment of pandactylitis]. PMID- 2699115 TI - [Surgical methods in the treatment of patients with acute thrombosis of hemorrhoids]. PMID- 2699116 TI - [Development of the philosophical aspects of normality and pathology in medicine]. PMID- 2699117 TI - [Use of siloxane films in the treatment of contracture of the knee joint]. AB - The siloxan film with programmed physiochemical characteristics possessing antimicrobial properties is proposed for the prevention of cicatrization in the knee joint area. Using this film as a pad after mobilizing operations on the knee joint has shown its high efficiency and considerably improved results of treatment. PMID- 2699118 TI - [Treatment of various forms of acute appendicitis]. PMID- 2699119 TI - [Foreign bodies of the retroperitoneal space and its organs]. PMID- 2699120 TI - [Reconstructive surgery in complicated trauma of the thoracic and lumbar segments of the spine]. AB - The article presents an analysis of reconstructive operations on the spinal cord in 176 patients with traumas of the thoracic and lumbar parts of the vertebral column. The operative treatment in acute period consisted in end-to-end anastomosis of the horse's tail roots, in late period of trauma disease of the spinal cord--in reconstruction of the spinal cord defects with intercostal nerves by the type of "collateral anastomosis" or free transplants from the peripheral nerve. The operations performed resulted in an improvement of sensitivity, movement, functions of pelvic organs in part of the patients. PMID- 2699121 TI - [Surgical tactics in gunshot wounds of the spine and spinal cord]. AB - Based on literature data and personal experiences with treatment of patients with this pathology the author considers the sequence of diagnostic measures, describes his experience with contrast examinations of the vertebral canal in the acute period. The volume of the infusion-transfusion therapy was determined. Details of the surgical tactics were outlined with a reference to the character of the injury. A brief analysis of lethality during first six months after injury is given. PMID- 2699122 TI - [Plastic surgery of penetrating defects of the eyelids]. AB - A method of plasty of perforating defects of eyelids is described which restores its cilium edge with a combined bridge-like pedicle and represents a flat thin duplication of the skin and mucous membrane freely transplanted into its wound surface. PMID- 2699123 TI - [Postinfection immunity in influenza]. PMID- 2699124 TI - [Antigenic analysis of tick-borne encephalitis virus group using monoclonal antibodies and immunofluorescence]. AB - The study included 18 monoclonal antibodies (MAb) to E- or NS1-antigens tested by immunofluorescence with tick-borne encephalitis (TBE) complex viruses. MAb were induced to 3 strains of TBE virus: the pathogenic 4072 strain isolated from a patient; the Skalica strain of low pathogenicity; and the Neidorf strain isolated from ticks. According to their reactivity to complex viruses, MAb comprised 3 groups: monospecific for TBE virus (T6, T15) which detected tick-borne encephalitis virus alone; widely cross-reactive with 4-6 viruses of the complex (NEK, KEN, T7, T9); and partially complex-reactive (T11, T12, T13, T33/3) and bound to 2-3 viruses of the complex. T13 and T33/3 MAb reacted with the Omsk hemorrhagic fever virus to the same degree or stronger than with TBE virus. The cross-reactivity was more marked in anti-E-than in anti-NS1 MAb. The similarity of the Langat viruses and the Skalica strain was confirmed. Using anti-NS1 MAb in tests with non-fixed cells, the release of NS1-antigen was found to begin at hour 18 (time of observation). The results of the study may be useful for improvement of laboratory diagnosis of TBE and evaluation of the capacity of a vaccine to induce cross immunity to viruses of the TBE complex. PMID- 2699125 TI - [Recombinant proteins synthesized in bacteria: the use in the diagnosis of virus diseases]. PMID- 2699126 TI - [Current aspects of the pathogenesis and therapy of anemia in chronic kidney failure]. PMID- 2699127 TI - [Multiple bilateral parapelvic kidney cysts]. AB - 8 patients, 2 men and 6 women, 42 to 67 years of age, with bilateral multiple cysts of the renal sinus are described. 3/6 patients had macroscopic hematuria, pyelonephritis, 5/8 patients were with arterial hypertension and 4/8 patients were with renal failure. All patients were examine by ultrasound once more after a greater diuresis was achieved in order to differentiate from hydronephrosis. The isotopic nephrographic curves were normal in 2/8 patients and were disturbed in the remaining 6 patients. Hydronephrotic type curves were not found. Urography was performed to 4 of the patients and in 2 of them the diagnosis was polycystosis and in the other 2 patients it was bilateral parapelvic cysts. Possible mistakes in the diagnosis of bilateral parapelvic cysts are discussed. The reported cases with superimposed pyelonephritis and renal failure point to the need of prophylactic medical examinations of such patients. PMID- 2699128 TI - [Insulin receptors in diabetes mellitus]. PMID- 2699129 TI - [Evaluation of arterial supply to the legs by noninvasive methods in elderly patients with diabetes]. AB - Rheographic investigations and segmental measurements of pressure by Doppler method were done in 49 patients with type II diabetes or with impaired glucose tolerance who had chronic ischaemia of lower extremities in all stages, after Fontaine. The diagnostic usefulness of both methods was demonstrated, similarly as the correlation of their results with clinically determined progression of arterial ischaemia of the lower extremities. Parallel application of both methods was particularly useful in diabetic since it made possible detection of Monckeberg's arteriosclerosis and evaluation of collateral circulation development. PMID- 2699130 TI - [Adverse effects of aminoglycoside antibiotics]. PMID- 2699131 TI - [New data on some parasitic invasions in fish]. AB - The author gives a review of new literature data from the 80-ties. The following problems are considered: etiology of swim bladder inflammation in carp (SBI), development of parasites of the class Myxosporea, overgrowth of parasitic kidney disease (PKD) in salmonid fishes, details of development of Myxobolus cerebralis and Ichthyophtirius multifiliis, and the new systematics of the Diplozoidae. PMID- 2699132 TI - [Surgical treatment of the male genitalia]. AB - Skin diseases of the male genitalia have a serious psychological impact. The clinical diagnosis is often difficult, and histological diagnosis is, therefore, of utmost importance. Nearly all surgical operations can be made under local or regional block anesthesia. Comparatively simple techniques allow the closure of defects even after excision of large lesions, thus resulting in a good functional and cosmetic outcome. PMID- 2699133 TI - [Disseminated granuloma anulare--regression with PUVA therapy]. AB - We report on a 48-year-old female patient suffering from disseminated granuloma anulare. Treatment with PUVA resulted in complete remission. The possible actions of PUVA on granuloma anulare are discussed in detail. PMID- 2699134 TI - [The Ro/SSA antigen-antibody system. Studies of the effect of UVA-/PUVA irradiation and fibroblast activity on immune reaction with autoantibodies]. AB - The Ro/SSA antigen-antibody system is of great importance with regard to the cutaneous manifestations and the photosensitivity of patients suffering from lupus erythematosus (LE). On account of in vitro investigations on cultured fibroblasts taken from psoriatic skin, we evaluated both the effect of UVA/PUVA irradiation and that of the metabolic activity of cells on this antigen-antibody system. We found that UVA irradiation is able to demask Ro/SSA. Thus it becomes accessible so subsequent antibody binding, which can be seen as nuclear fluorescence positive for IgM. Incubation of vital cells with these autoantibodies and subsequent irradiation resulted in a high degree of cytoplasmic fluorescence (IgG, IgM) in part of the fibroblasts exposed to UVA. Regarding the clinical application of light protective agents in LE patients with antibodies to Ro/SSA, UVA light--aside from UVB--should be taken into consideration. PMID- 2699135 TI - [Idiopathic edema in the female]. AB - Idiopathic oedema in women is due to a disturbance in capillary permeability with increased protein porosity. This leads to generalized pre- or mild oedema which, although it is frequently not recognizable clinically, gives rise to marked sensations of tension and heaviness with impaired physical performance. Diagnosis must exclude all other possible forms of oedema. However, not only oedema that presents in generalized forms must be considered. Optimum therapy consists of manual Vodder-Asdonk lymphatic drainage in conjunction with compression therapy. This results in a marked improvement. At present there is no known safe pharmaceutical treatment, diuretics are not indicated. PMID- 2699136 TI - [Risk of breast cancer]. AB - The factors that influence the risk of breast cancer are vitally important when collecting information on woman particularly at risk from cancer for screening and for advisory care in breast clinics. On the basis of the experience gathered over the last 150 years (since Rigoni-Stern in 1842), these should be divided up into I. confirmed (carcinoma of the breast, mastopathy with cytological atypia, women whose mother and sisters already had breast cancer), II. probable (childlessness, late first birth, miscarriage, early menarche and late menopause, overweight, elevated socio-economic status), and III. improbable risk factors (paranchyma samples according to Wolfe, the contraceptive pill, nicotine, coffee, alcohol and drugs). PMID- 2699137 TI - [Detection of lymph vessel changes in venous diseases of the leg using imaging procedures]. AB - Chronic venous insufficiency reveals both functional correlations with the lymphatic system of the limbs as well as pathological-anatomical. The functional correlation initially consists in an enhancement of function as a manifestation of a compensation mechanism of lymphatic drainage in relation to the insufficient venous system. Finally, if the lymphatics are themselves damaged in their further course, a safety valve insufficiency occurs with resulting lymphostasis. Apart from this participation, regional damages to the lymphatic fascicles play a role in chronic venous insufficiency in trophic disorders, as for example leg ulcer and atrophy. However, these are far less significant for the overall function of lymphatic drainage. As a role, they show a pronounced collateralization, and thus good possibilities of functional compensation. In particular indirect lymphography with water-soluble contrast medium is suitable as imaging technique in diagnostics with regard to the morphology. Isotope lymphography is suitable with regard to investigating the function of lymphatic drainage and for circumscribed local disorders. As native techniques, xeroradiography and computed tomography are very suitable to analyse tissue damage of the cutis and subcutis resulting from chronic venous insufficiency and from lymphostasis and to make indirect inferences from this with regard to the chronicity of this disease process. PMID- 2699138 TI - [Tuberous iododerma from solutan]. AB - The literature data on this condition are reviewed and a 22-year-old female patient with solutan-induced tuberous iododerma is described. PMID- 2699139 TI - [Hemispheric asymmetry and the problem of typology of schizophrenia (a review)]. PMID- 2699140 TI - [Significance of subjective symptoms and diagnostic criteria in initial forms of cerebral circulation insufficiency]. AB - Piracetam was applied to the treatment of 60 patients with initial manifestations of brain circulation failure and stage I circulatory encephalopathy. The drug exerted a beneficial therapeutic effect by reducing high brain vascular resistance (both extra- and intracranial) and by increasing the lowered volume of pulse fluctuations. It made fibrinolytic blood activity and aggregation of formed elements of the blood return to normal. An appreciable antiatherogenic effect was discovered as well. It should be taken into consideration that in patients with a dramatic lowering of pulse fluctuations, the use of piracetam in a dose of 1.6 g/day may enhance headache. In such cases the dose should be reduced. PMID- 2699141 TI - [Pathomorphosis of mental disorders: types and causes]. AB - Pathomorphism is viewed as relatively steady changes in the pathogenetic mechanisms and manifestations of the disease. Phenomena of positive and negative pathomorphism, the levels, the classification and causes of pathomorphism of mental diseases are discussed. Proceeding from the etiological criterion three types of pathomorphism of mental diseases are distinguished: 1) biological, 2) social and 3) mixed--social and biological. The author believes that the main causes of pathomorphism of mental diseases include the evolutionary development of man, pathomorphism of somatic diseases, and the influence of socio-cultural, demographic factors and prolonged pharmacotherapy. PMID- 2699142 TI - [Scientific-metric analysis of structure and age of references in the Soviet and foreign journals on neuropathology, neurosurgery and psychiatry]. AB - A scientometric analysis was performed on bibliographical references of the articles published in two Soviet and two foreign (British and Romanian) journals on neuropathology, neurosurgery and psychiatry in 1983. The averaged ages of references were different in different journals and different specialties. Both were related to the country from which the referenced works originated. Two variants of distribution curves were determined for reference ages dependent on different rate of development of the disciplines in various countries. PMID- 2699143 TI - [Infantile spasms (a review)]. PMID- 2699144 TI - [Typology of paranoid psychopathy (a review)]. PMID- 2699145 TI - The role of gonadotropin releasing hormone (Gn-RH) in the regulation of gonadal functions of birds. Review article. AB - Gonadotrop hormone secretion is regulated by the central nervous system through the hypothalamus. This neuro-hormonal regulation was first verified in birds by Follett /21/ who was able to increase the LH secretion of hypophysis in vitro by crude extract of quail hypothalamus. His results supported the indirect statements of earlier neuroendocrine studies and emphasized the importance of bird hypothalamus in the regulation of gonadal function /1, 62/. A neurohormone fundamental in the central regulation of gonadic function, luteinizing hormone releasing hormone (abbreviated earlier as LH-RH, but recently, and, thus, hereinafter as Gn-RH) has first been isolated from porcine hypothalamus in Schally's Laboratory /41/, and, following the determination of its amino-acid sequence, it has been synthesized in the same year /42/. It has been stated that this peptide, consisting of 10 amino acids (p Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro Gly-NH2), increases the LH and FSH secretion of the hypophysis both in vitro and in vivo. One year later, a decapeptide, similar in its structure to porcine Gn-RH was produced from sheep hypothalamus. Investigations of the two teams suggested that decapeptide containing arginine on place 8 was the physiological Gn-RH of mammals. PMID- 2699146 TI - [Significance and prognosis of positive surgical section margins in surgery of laryngeal cancer]. AB - During the surgical treatment of head and neck cancers the surgeon may have to face the problem of deciding what measures to adopt when the tissue at the margin of the surgical sections proves histologically to be cancerous. Many factors may influence the decision for supplementary therapy; among these, of primary importance are stage and site of the tumor, the effectiveness of non surgical therapy, and the psychophysical status of the patient. In order to better consider this problem a retrospective study, limited to laryngeal surgery, and a review of the literature have been carried out. Review of the patients undergoing surgery from 1972 to 1988 has revealed that histological examination of section margins during or after laryngeal surgery was performed in 56 cases: 10 stripping vocal cords, 11 cordectomies, 2 frontolateral laryngectomies, 2 hemilaryngectomies, 20 horizontal supraglottic laryngectomies, 10 total laryngectomies and 1 subtotal laryngectomy with cricohyoidopexis. The margin was negative in 35 cases while tumor lesions of various types were present in 21 cases. An invasive tumor was present in 14 patients and in 7 an 'in situ' tumor or premalignant diskeratosis was found. A policy of abstention was adopted in all but one of the cases. All cases of 'in situ' cancer and of invasive premalignant change were grouped together as they have in common base membrane integrity and the fact that the second lesion is to be considered precancerous. The following results were obtained: in 14 cases of invasive cancer at the section margin there were 8 recurrences (57.1%) 4 after total laryngectomy; 6 patients showed no evidence of disease (NED) after from 3 to 7 years. In the 7 cases of 'in situ' cancer and premalignant lesions at the surgical margin, 4 showed recurrence (57%) and of these 2 underwent surgery. The 3 other cases have been NED for 3 to 5 years. On the other hand, even in the group of 35 margin free patients 8 developed recurrences (22.3%) and of these 3 underwent surgery and 1 radiotherapy. It appears evident that in conservative surgery of the larynx the presence of tumor cells at the surgical margin does not necessarily lead to a recurrence; such recurrences vary from 18% to 60% depending on the study. Nonetheless, it is certain that a real possibility of recovery exists in 50% of these patients. It is, however, impossible to specify which patient manifesting a positive margin actually runs the risk of developing a recurrence.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699147 TI - [Prognostic value of tumor markers in the follow up of malignant neoplasms of the head and neck]. AB - A group of 54 patients with previously untreated ENT malignancies were studied and findings regarding five markers generally associated with cancers (CEA, SCC, TPA, CA 50 and ferritin) are presented. The specificity of these markers always proved to be greater than 95% while their sensitivity ranged from 13% to 43%, reaching 72% as a combination of all five markers. The results obtained during follow-up on 21 randomized patients was not satisfactory due to poor sensitivity. In the opinion of the authors, the five markers assayed appear to have no distinct function in monitoring ENT cancers. The sole exception to this is SCC which presents a moderate correlation (60%) with tumor growth. PMID- 2699149 TI - Frank M. Huennekens. A leader in current issues in chemotherapy. PMID- 2699148 TI - Postpartum IUD contraception--a review of an international experience. AB - Postpartum insertion of intrauterine contraceptive devices (IUDs) performed while women are still in hospital has a number of advantages. Earlier reports, however, generally associated this procedure with high expulsion rates. Recent studies, on the other hand, have shown that if IUDs are inserted immediately (within 10 minutes) after placental delivery, it is safe and effective. In some experienced centers, fairly low expulsion rates are reported. In this paper the experiences with postplacental IUD insertions from international studies are reviewed, the lessons we have learned from these experiences summarized, and future research directions suggested. PMID- 2699150 TI - Critical issues in chemotherapy. Proceedings of the international conference. La Jolla, California, January 28, 1989. Dedicated to Frank M. Huennekens. PMID- 2699151 TI - Selective resistance of L1210 cell lines to inhibitors directed at the subunits of ribonucleotide reductase. AB - L1210 cell lines were generated which were resistant to specific ribonucleotide reductase inhibitors. Hydroxyurea-resistant L1210 cells (HU-7) were cross resistant to IMPY but sensitive to deoxyadenosine and deoxyguanosine. Deoxyadenosine-resistant L1210 cells (Y-8) were cross-resistant to 2 fluorodeoxyadenosine and showed only a small increase in resistance to hydroxyurea or IMPY. L1210 cells which were generated in the presence of deoxyadenosine/EHNA/IMPY/Desferal were markedly resistant to deoxyadenosine, deoxyguanosine and 2-fluorodeoxyadenosine with moderate increases in resistance to IMPY. The HU-7, Y-8 and ED2 cell lines were sensitive to the inhibitory effects of MAIQ and HAG-IQ. The HU-7 L1210 cell line had elevated levels of ribonucleotide reductase activity and this activity showed normal inhibition by hydroxyurea, IMPY, dATP, dGTP and dTTP. The Y-8 L1210 cell line did not have elevated levels of ribonucleotide reductase activity, but had altered allosteric properties relative to dATP. The ED2 L1210 cell line had elevated levels of ribonucleotide reductase activity and had altered allosteric properties relative to dATP. These data show that resistance to ribonucleotide reductase inhibitors is specifically generated in response to the particular drug. The biochemical basis can be related to either increased levels of ribonucleotide reductase activity or loss of feedback control by dATP or both. PMID- 2699152 TI - An anomaly in the active site region of thymidylate synthase. AB - A putative thyA gene from Escherichia coli was cloned into a high expression vector and the thymidylate synthase produced was purified to homogeneity. Comparison of the monomer molecular weight of this protein with that of authentic E. coli thymidylate synthase revealed the two to differ, suggesting that they were derived from different sources. This was confirmed by Ochterlony immunodiffusion analysis, which revealed that while the unknown thymidylate synthase formed a precipitin band with guinea pig antibody to the putative E. coli synthase, pure E. coli TS did not. In addition, the specific enzyme activity of the purified unknown thymidylate synthase was about 4-fold higher than that of the pure authentic enzyme. Sequence analysis of the active site peptide revealed that the amino acid linked to the carboxyl end of the active site cysteine was valine. The only instance where this has been found in the 11 thymidylate sequences reported so far is in the thyP3 sequence of the Bacillus subtilis phage 3T. In all the other cases, a histidine has been found in this position. Amino end group sequence analysis of the unknown synthase for about 30 residues confirmed the close identity of this protein to that of the B. subtilis phage thymidylate synthase. To determine whether the replacement of the active site histidine with a valine enhances the activity of the resulting thymidylate synthase, we affected this change in T4-phage thymidylate synthase by site directed mutagenesis and found that instead of an increase in activity there was an 80 percent decrease. PMID- 2699153 TI - Future directions for antifolate drug development. AB - We have discussed potential ways by which new antifolates could be designed and utilized to effect both sensitive and resistant cell/tumor inhibition. Targeting of alternative folate-dependent enzymes and increasing net intracellular accumulation (transport) and polyglutamation of antifolates should be useful approaches. In addition, antibodies to and cloned cDNAs of the transport components (e.g., folate transport proteins) will allow better characterization and understanding of de novo and acquired antifolate resistance states and may provide insights into new drug development. PMID- 2699154 TI - Crystal structure of Escherichia coli thymidylate synthase with FdUMP and 10 propargyl-5,8-dideazafolate. AB - The crystal structure of an E. coli TS ternary complex containing FdUMP and PDDF has been determined and refined at 2.3A resolution. Each of the two chemically identical subunits folds into a three-layer domain anchored by a large six stranded mixed beta sheet. The backside of one sheet is juxtaposed against the corresponding face of the equivalent sheet in the second protomer creating a beta sandwich. In contrast to other proteins of known structure in which aligned beta sheets stack face to face with a counterclockwise rotation, sheets in the TS dimer are related by a clockwise twist. The substrate binding pocket is a large funnel-shaped cleft extending some 25A into the interior of each subunit and surrounded by 28 amino acids, 26 from one subunit and 2 from the other. FdUMP binds at the bottom of this pocket covalently linked through C6 to the sulfur of Cys-146. Up-pointing faces of the pyrimidine and ribose rings are exposed to provide a complementary docking surface for the quinazoline ring of PDDF. The quinazoline inhibitor binds in a partially folded conformation with its p aminobenzoylglutamate tail exposed at the entrance to the active site cleft. Ternary complex formation is associated with a large conformational change involving 4 residues at the protein's carboxy-terminus that close down on the distal side of the inhibitor's quinazoline ring, capping the active site and sequestering the bound ligands from bulk solvent. PMID- 2699155 TI - Critical issues in chemotherapy with tiazofurin. AB - Some of the current critical issues in the tiazofurin treatment of end-stage leukemia were presented and discussed. 1. Tiazofurin infusions (daily X 10 to 15) provided remissions in 50% of end-stage leukemic patients. The remissions, of 1 to 10 months' duration, varied from antileukemic effect or hematologic improvement to complete response and complete remission. The total survival of the responding patients was from about 1 to 15 months. 2. Our administration of tiazofurin in a 60-min infusion by pump decreased the incidence and severity of toxicity. 3. It was shown that tiazofurin dose does not need to be escalated at each relapse. Depending on the biochemical and hematological response in this novel protocol, 2,200 to 4,400 mg/m2 tiazofurin appeared to be sufficient to provide remissions. 4. A new role was identified for allopurinol, originally given to decrease uric acid in the plasma. Allopurinol markedly increased plasma hypoxanthine concentrations which competitively inhibited the activity of the salvage enzyme, guanine phosphoribosyltransferase, in the blast cells. Thus, the elevated hypoxanthine plasma levels inhibited guanine salvage. To maintain high hypoxanthine levels allopurinol (100 mg) was given every 4 to 6 hr. This provided combination chemotherapy with tiazofurin which inhibited IMP dehydrogenase activity and blocked the de novo biosynthesis of guanylates in the blast cells. 5. Preliminary evidence was obtained in the patients that tiazofurin induced differentiation of the bone marrow. Recent studies also showed that tiazofurin down-regulated the expression of the c-Ki-ras oncogene in K562 erythroleukemic cells. Therefore, tiazofurin treatment provides an impact by chemotherapy, induced differentiation, and, if applicable, through down-regulation of the ras oncogene. 6. Novel aspects of tiazofurin treatment include rational targeting and a continuously monitored trial by measurement of the activity of IMP dehydrogenase and of GTP and TAD concentrations in blast cells and of tiazofurin and hypoxanthine in plasma. 7. Since tiazofurin has not yet achieved lasting remissions in patients nor terminal differentiation of leukemic cells it probably will be advantageous to combine tiazofurin with other drugs to provide synergism. In preclinical tissue culture studies in HL-60 cells synergy was observed with retinoic acid. This may be of interest because retinoic acid also caused differentiation and down-regulation of the myc oncogene. PMID- 2699156 TI - The theory of five elements in acupuncture. AB - The theory of five elements is extensively used in traditional Chinese medicine. It is proposed that the theory of five elements was developed on the basis of the theory of elements, the law of contagion and the law of similarity which were prevalent in that era. The theory of elements spread in various forms all over the face of the globe. The law of contagion stated that objects, which at one time had been in continuity or juxtaposition, continued to exert an effect one upon the other. The internal organs were coupled probably on the basis of the law of contagion. The law of similarity stated that objects or circumstances which bear apparent similarity in form, shape, color or sequence of events, were considered to be fundamentally related. On the basis of the law of similarity the coupled internal organs were classified into five elements and the theory of five elements was compared with various things like seasons, color, tastes, emotions, etc. The theory of five elements is probably the earliest documented evidence correlating physiology with pathogenesis of diseases and a guideline for treatment of diseases. PMID- 2699158 TI - The five cosmic elements as depicted in Indian and Chinese cosmologies. AB - Indian and Chinese cosmologies are compared, each containing five cosmic elements. The Indian elements are Akasha, Air Fire, Water, and Earth. Akasha connotes Creative energy. As depicted it is substituted by reproduction projected as creation. Hence the male and female generative organs as Lingam-Yoni, already recognized in Hinduism as symbolizing the source of creative energy, have been depicted as such. The other four elements represent creation proper. In Chinese cosmology the full term is "Yin-Yang Wu-Hshing." Wu-Hshing signifies Five=Cosmic elements and these are Wood, Fire, Water, Earth, and Metal. They are taken from Iran. Since there is no element to represent creative energy this is expressed by the term Yin-Yang, or Black and White in lieu of male-female or Lingam-Yoni of Indian cosmology. The organs of reproduction have been projected as the opposites that generate creative energy. Virtually Yin-Yang=Lingam-Yoni=Creative energy generators. PMID- 2699157 TI - Effects of moxibustion on cellular immunocompetence of gamma-irradiated mice. AB - The effects of moxibustion on cellular immunocompetence of gamma-irradiated mice were investigated in this study. A total of 240 male young mice (ICR strain), 6-8 weeks of age, were chosen and divided into three groups. Group A was the normal control. Group B, the experimental control, was treated with 400 rad whole body gamma-irradiation. Group C, the experimental group, was treated with moxibustion (MT) after being exposed to gamma-irradiation. Six to eight mice from each group were sacrificed on days 1, 5, 12, 19, 26 and 33 post-irradiation. The body and splenic weights of mice in each group were measured. The cellular immunocompetence was measured by 3H-thymidine uptake in each experimental mouse. The results revealed that 400 rad of gamma-ray irradiation inhibited the increase of body and splenic weights, and exerted a pronounced inhibitory effect on the incorporative rates of 3H-thymidine after being stimulated by mitogens such as PHA, PWM, Con A and LPS in the splenic lymphoid cells. MT seemed to help the recovery of the cellular immunocompetence in the gamma-ray irradiated mice. PMID- 2699159 TI - Institut Pasteur v. United States: the AIDS patent dispute, the Contract Disputes Act and the international exchange of scientific data. AB - In the case of Institut Pasteur v. United States, the Institut Pasteur (Pasteur) claimed that the National Cancer Institute (NCI) had breached express and implied contracts to share research on AIDS virus samples provided to NCI by Pasteur. NCI scientists allegedly used the samples to acquire information which allowed NCI to file patent applications for an AIDS blood test kit. The United States Claims Court dismissed the complaint by holding that the Institut Pasteur had not complied with certain administrative procedures required by the Contract Disputes Act before bringing its suit. The United States Court of Appeals for the Federal Circuit reversed the decision of the Claims Court by holding that the disputed contracts did not fit within the scope of the Contract Disputes Act. Soon after the Court of Appeals decision, President Reagan and Prime Minister Chirac announced a settlement agreement whereby the lawsuit was to be dropped, American and French scientists were to share credit for having discovered the AIDS virus, and both parties to the suit were to share the patent rights for the AIDS blood test kit. This settlement suggest that international legal disputes involving urgent scientific and medical matters may require dispute resolution techniques that serve as alternatives to national courts. PMID- 2699160 TI - Patenting human beings: do sub-human creatures deserve constitutional protection? AB - The availability of patents for genetically altered animals raises questions about the patentability of human beings. Genetic research will produce beings who fall halfway between what we currently think of as "animal" and "human." It is unclear on which side of the legal line these creatures will fall. In April 1988, Congress revised the Patent Act with a statement that human beings are not to be considered patentable subject matter. Congress, however, failed to supply a definition of the term "human being." A definition will clarify the legal status of sub-human creatures. The author addresses this problem and proposes a definition of "human being" as an amendment to the Patent Act. PMID- 2699161 TI - Abortion counseling: to benefit maternal health. AB - This Note examines how both the law and the health care profession neglect women's needs for abortion counseling before, during and after an abortion. Part I analyzes the health care profession's view of counseling, the psychological effects of abortion and how counseling both positively and negatively influences those effects. Part II reviews Supreme Court cases and state law regarding abortion counseling, critizing both the Court's narrow view of counseling and the states' failure to use the legislative process to create laws which benefit maternal health. Part III recommends an expanded role for abortion counseling, in which the counselor can provide emotional support from before the day of an abortion until a woman emotionally recovers from an abortion. This expanded role would be state-mandated, but would remain within constitutional boundaries by providing flexibility for counselors to give individual treatment while respecting a woman's privacy. PMID- 2699162 TI - Cognitive development, types of logic, and psychoanalytic theory. PMID- 2699163 TI - Attachment theory as an alternative basis of psychoanalysis. PMID- 2699164 TI - Pathological fear of death, panic attacks, and hypochondriasis. AB - The article has presented a concept of the pathological fear of death as a categorically defined phenomenon and outlined its distinguishing features. In an attempt to account for the origin of the pathological fear of death, most weight has been given to developmental and structural abnormalities in the regulation and control of the primary and disruptive forms of anxiety. The additional contributing factors have also been taken into consideration: a defect in the defensive and symbolic representation of death, and a general collapse of defensive functioning, with regression to a state of infantile helplessness and revival of the infantile death cognitions. A role of the cognitive abnormalities in the genesis of the pathological fear of death has been examined in the panic attacks and hypochondriasis, while a developmentally determined, pervasive mistrust in the bodily functioning and bodily worth has been stressed as a factor that crucially predisposes to the pathological fear of death in hypochondriasis, and to the respective type of hypochondriasis as well. A relationship between panic disorder and hypochondriasis has been examined in the light of the pathological fear of death that they often share. Finally, the article has briefly dealt with the relevance of the pathological fear of death for diagnostic assessment and psychotherapy of patients with panic disorder and hypochondriasis. The concept of the pathological fear of death requires further study and refinement in the area of its descriptive demarcation, psychogenesis, and clinical application. PMID- 2699165 TI - Problematic lesions of the craniofacial bones. AB - Osseous lesions of the craniofacial bones, such as osteosarcoma, often have different microscopic features than their counterparts in other bones. For craniofacial fibro-osseous lesions, the radiographic findings are usually more diagnostic than the microscopic observations. It requires clinical findings to arrive at a definitive pathologic diagnosis for abnormalities characterized by a fibro-giant cell background. Radiographic and clinical findings in patients with lesions of any bone are important, but in patients with craniofacial lesions, they are especially critical for arriving at the best pathologic diagnosis. PMID- 2699166 TI - Problems in the interpretation of liver biopsies after liver transplantation. AB - As more liver transplants are performed and we realize that biopsy is the best means to diagnose rejection, the surgical pathologist has gained prominence as part of the transplant team. The surgical pathologist now plays a pivotal role in the day-to-day management of liver transplant patients. Diagnosis of rejection is a major task; however, other processes, particularly infectious ones, are also important causes of liver dysfunction that must be distinguished from rejection. Rapid and accurate diagnosis of acute rejection is possible if attention is paid to diagnostic criteria. The biopsy is also valuable to assess efficacy of therapy and provide prognostic information. The histological diagnosis of chronic rejection remains difficult, if not impossible. In all cases, and especially in the assessment of chronic rejection, close cooperation with the clinical staff is essential for proper patient management. PMID- 2699167 TI - Surgical pathology of the syndrome of primary sclerosing cholangitis. AB - The diagnosis of primary sclerosing cholangitis (PSC) is based on the characteristic cholangiographic manifestations of the condition. Surgical biopsy specimens from extrahepatic bile ducts are not diagnostic. They should be obtained only if the presence of bile duct carcinoma must be ruled out. If liver transplantation is anticipated, even that procedure may be contraindicated. Gallbladder disease in PSC is common but again, histologic findings are not diagnostic. Intrahepatic cholangiectases in combination with bile duct obliteration are characteristic for PSC, but tissue samples with these lesions usually are unavailable during work-up of patients. Histologic changes in routine needle or wedge biopsy specimens from the liver may strongly support the diagnosis of PSC. The most important histologic abnormality is the absence of interlobular bile ducts in some portal tracts (ductopenia), which often coexists with evidence of ductal proliferation in other portal tracts. Portal edema and ductular proliferation frequently accompany these changes. Liver biopsy study in PSC is recommended not only for diagnostic purposes but also because the procedure allows staging of the liver disease and thus helps to determine the prognosis of patients, contributes to the decision-making process for liver transplantation, and facilitates therapeutic trials. PMID- 2699168 TI - Dysplasia, in situ carcinoma, and progression to invasive squamous cell carcinoma of the upper aerodigestive tract. AB - Invasive squamous cell carcinoma (SCC) in the upper aerodigestive tract (UADT) is usually preceded by severe keratinizing dysplasia, a manifestation of intraepithelial neoplasia. Despite the presence of surface maturation (keratosis), severe keratinizing dysplasia has a higher frequency of progression to SCC than full-thickness classic carcinoma in situ (CIS) as defined in the gynecologic tract. For this reason, we recommend that severe UADT dysplasia be combined with CIS under the rubric of "squamous intraepithelial neoplasia (SIN) grade III" to convey to the clinician the prognostic importance of these two diagnoses. Microinvasive carcinoma in the UADT includes a microfocus of submucosal invasion within 1-2 mm of the overlying epithelial basal lamina that is completely surrounded by nonneoplastic tissue. This conservative definition of microinvasion has a low risk, or no risk, for regional metastatic spread. Immunohistologic demonstration of basal lamina components is often absent in severe intraepithelial neoplasia (SIN III). Paradoxically, basal lamina is often observed in invasive SCC, especially neoplasms forming large cohesive aggregates and cords of invasive tumor. This finding negates the usefulness of basal lamina to identify microinvasive carcinoma, but its presence does appear to correlate with a low rate of progression of SCC invading with large cohesive tumor cords. PMID- 2699169 TI - The pancreas. Nonneoplastic alterations. AB - The normal development and microanatomy of the pancreas are summarized, and brief comments are made regarding current concepts of the control of exocrine functions. Pathologic alterations of acinar cells (including degranulation, nuclear changes, and cytoplasmic vacuolization) are fairly common, but they are often overlooked. Dilatation of acini, loss of acinar cells, and apparent increases in centroacinar cells and intercalated ductal cells also may occur. Changes in the larger ducts include epithelial atrophy, hyperplasia, and metaplasia; in addition, some relationships to age, ductal obstruction, and ductal carcinoma may exist. However, the majority of the alterations are nonspecific. The major types of chronic pancreatitis are illustrated, especially the irregularity of the pancreatic involvement that is so common. In an attempt to better understand the early stages of acute pancreatitis, foci of acute localized pancreatitis have also been studied. PMID- 2699170 TI - Co-expression of CA 19-9, DU-PAN-2, CA 125, and TAG-72 in pancreatic adenocarcinoma. AB - Various tumor-associated antigens have been reported in pancreatic adenocarcinoma tissue. This study examines the incidence and co-expression of CA 19-9, DU-PAN-2, CA 125, and TAG-72 in serum and cancer tissue from patients with pancreatic cancer. In tissue, 83% of the cases demonstrated co-expression of three or more antigens. The incidence of antigen expression was comparably high for CA 19-9, DU PAN-2, and TAG-72; however, significantly more cancer cells within each sample demonstrated CA 19-9. Serologic co-expression of elevated antigen levels was less common; only 39% of the patients showed increased circulating levels of three or more antigens. The predictive value of tissue immunoreactivity for elevated circulating levels of antigen was strongest for CA 19-9. Immunoreactivity patterns in cancer tissue suggest that the epitopes for these antigens are distinct, and DU-PAN-2 antigen was identified in patients who could not manufacture CA 19-9 (a sialylated Lea antigen). However, a strong correlation between circulating levels of CA 19-9 and DU-PAN-2 supports the contention that these two antigens are incidentally expressed on the same mucin molecule. PMID- 2699171 TI - [Echographic morphometry of the fetal septum pellucidum in term pregnancy and in cases of congenital malformations]. AB - The echographic morphometry of the fetal cerebral cranium includes a series of measurements and structural evaluation of the most important anatomical formation of the central nervous system (cns). Echographic anatomical relations of septum pellucidum were studied antenatally in 43 physiologically progressing pregnancies at term as well as in 13 pregnancies with congenital malformations of the fetus during the second and third trimester. It was established that at term pregnancy the transverse measurement of septum pellucidum reached values, forming 8.28 8.93% of the value of the fetal biparietal diameter. Its morphological examination proved that it has rectangular form during scanning of the fetal cranium at the level of "thalamus", interrupting the middle echo of the dividing line between the I and II thirds. In the group of pregnancies with malformations this structure was not discovered in neither case with congenital anomaly of cns as well as in cases with multiple malformative syndromes, involving intracranial content. The role of this parameter in early prenatal diagnosis of malformative fetopathies is discussed. PMID- 2699172 TI - [Congenital leukemia in a fetus. A description of a case and review of the literature]. PMID- 2699173 TI - [The problems of vaginal candidiasis. I. The sources and predisposing factors of the infection]. PMID- 2699174 TI - [Hematoma of the adrenal glands and heparin]. AB - The diagnosis of adrenal haemorrhage complicating heparin therapy is often delayed, despite computed tomography (CT). Moreover, its pathogenesis is not clear. Adrenal haemorrhages are often seen in cases where there is no unduly excessive anticoagulation, and can be accompanied by a paradoxical thrombosis of the central adrenal vein. Symptoms usually occur within the first 8 to 12 days after starting heparin. The difficulty in establishing the diagnosis stems from the fact that symptoms are rather nonspecific: abdominal pain and backache, nausea, vomiting, lethargy, weakness, hypotension, hyperpyrexia. To confirm the diagnosis, both hormonal proof of adrenal failure and anatomic evidence of haemorrhage must be found. Early CT scans may show the haemorrhage. Several possible causes have been put forward to account for these adrenal haemorrhages. The degree of anticoagulation did not seem to be a prerequisite, 30 to 50% of patients showing no evidence of other bleeding or coagulation tests outside the therapeutic range. Capillary fragility of old age might be a factor. Stress would seem to be an important factor predisposing to adrenal haemorrhage. Many authors consider the paradoxical central vein thrombosis as a result of the haemorrhage rather than its cause, whereas other conclude the opposite. Unfortunately, to date coagulation studies are often incomplete; platelet counts were missing in most reports published before 1985. Since that date, a heparin induced thrombosis thrombocytopaenia syndrome (HITTS), in which thrombosis may occur in any vascular bed, has been recognized with increasing frequency. Nine cases of adrenal haemorrhage associated with HITTS have been reported. It seems highly likely that a proportion of cases of heparin-related adrenal destruction are due to HITTS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699175 TI - [Continuous monitoring of mixed venous oxygen saturation in anesthesia in pulmonary surgery]. AB - The multiplicity of potential causes of variations in mixed venous oxygen saturation (SvO2) during one lung ventilation (OLV), including a constant ventilation/perfusion mismatch, explains that it has been suggested as a routine monitoring procedure. To assess its usefulness, 12 adults undergoing OLV were monitored during surgery with an Oximetrix pulmonary catheter, placed on the side opposite to the surgical field under fluoroscopic control. Seventy two complete sets of haemodynamic measurements were obtained at 6 different times during surgery. We studied the ability of changes in SvO2 to predict changes in arterial oxygen saturation (SaO2), cardiac output (CO), and venous admixture (VA) by calculating sensitivities (Se), specificities (Sp) and predictive values with regard to these variables. There were no complications due to the protocol. However left-sided catheter placement failed in four cases. Correlation between optical and measured SvO2 was very strong (r = 0.94; p less than 0.001). SvO2, oxygen consumption (VO2) and the rate of oxygen extraction remained constant throughout the procedure, even when CO, mean arterial pressure, VA, SaO2 and PaO2 varied. Clamping the pulmonary artery returned VA, SaO2 and PaO2 values to those found before OLV, but produced a significant decrease in CO. SvO2 had low Se and Sp for changes in other variables (CO: 76 +/- 7, 48 +/- 9; PaO2: 79 +/- 6, 59 +/- 9; VA: 54 +/- 7, 48 +/- 7 respectively). In this type of surgery, alterations in variables related to oxygen are probably balanced by haemodynamic changes. In fact, according to Fick's formula, SvO2 is almost completely determined by SaO2 and CO, when VO2 and haemoglobin remain stable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699176 TI - [Monitoring of mixed venous oxygen saturation in aortic surgery: value and limits]. AB - This study aimed to determine perioperative changes in mixed venous oxygen saturation (SvO2) in patients undergoing aortic surgery. Continuous SvO2 monitoring was carried out using an Oximetrix pulmonary catheter. Fourteen patients were randomly assigned to 2 groups, group I (n = 7) patients being given a thoracic epidural anaesthetic with a supplementary general anaesthetic, and group II (n = 7) a general anaesthetic as usual. In both groups, SvO2 increased at induction. In group I patients, SvO2 decreased during surgery to less than 60% (n = 2) and less than 70% (n = 4). This fall was corrected by volume loading and intravenous ephedrine. The intraoperative decrease in SvO2 occuring in 2 group II patients was due to a fall in haematocrit in one, and a propranolol infusion in the other. Although patients in group I were all extubated early after the end of surgery (85 +/- 35 min), the lowest value of SvO2 after extubation was always greater than 60%. Patients undergoing aortic surgery under thoracic epidural anaesthesia can be extubated early, without markedly depressing peripheral reserves in oxygen extraction. PMID- 2699177 TI - [Factors influencing mixed venous oxygen saturation in intensive care]. AB - Changes in mixed venous blood oxygen saturation (SvO2) were studied in 2 groups of patients. Group I patients (n = 10) were all hypoxaemic, suffering from acute respiratory failure, requiring that FIO2 be maintained at 1 throughout the study; respiratory and haemodynamic conditions were improved using PEEP and cardiovascular support. On the other hand, Group II patients (n = 13) were non hypoxaemic patients with circulatory shock in whom FIO2 was gradually increased, and the haemodynamic status was improved using positive inotropic drugs (dopamine, dobutamine, adrenaline, amrinone). All 23 patients had a Swan-Ganz catheter set up for monitoring; all the usual haemodynamic and respiratory parameters were measured. Haematocrit values were kept at the same level throughout the study. Haemodynamic parameters were measured each time a new therapeutic procedure was carried out. No close relationship between SvO2 changes and changes in cardiac index or O2 consumption were found. However, a close relationship existed between changes in SvO2 and changes in O2 extraction (EAO2): SvO2 = -EAO2 + 102 (Group I; r = 0.90, n = 54); SvO2 = -1.2 EAO2 + 103 (Group II; r = 0.93, n = 66). A strong relationship was also found between changes in SvO2 and in FIO2 in each patient of Group II. In the complicated physiological set-up of an intensive care patient, SvO2 reflects oxygen extraction. A fall in SvO2 is related to an altered oxygen demand: oxygen supply ratio. In the most seriously ill patients, there is no relationship between changes in SvO2 and cardiac index. PMID- 2699178 TI - RBE for deterministic effects. A report of a Task Group of Committee I of the International Commission on Radiological protection. PMID- 2699179 TI - [A psychopathologic conflict in the 18th century in the East Indies Squadron]. AB - The authors first give a psychological evocation of the Bailli de Suffren, a great captain who vastly contributed to improve the image of the French Navy after the appalling seven years war, but whose character showed, nevertheless, originality, authoritarism, violence, sometimes vindictiveness and often negligence. The quarrels he had with most of his subordinates culminated as he was in command of the East Indies Squadron, applying sometimes exaggerated punishments. Chevalier de Tromelin was hierarchically just under him; this Chevalier had a character as chilly and stiff as the Bailli was the opposite; both were ambitious and deserving officers, the Chevalier being as much conformist as his "adversary" was fiery and bold. The shouts and rancours of the Bailli, when confronted to the rigidity and cold technicity of the Chevalier, marked their relationship. More than objective reasons arising from their duties, the fundamental incompatibility of their characters, explain their conflicts. Suffren played a double-game with his immediate subordinate; not lacking verbal smoothness, he nevertheless abused him in such a way in his reports to the authorities, that when Chevalier de Tromelin, being ill, asked to return to France, he learned that he had been dismissed of the Navy without having ever been heard or able to attempt to defend himself. He then spent his time trying to claim for a hearing without ever obtaining it, writing justificatory reports. He was "rehabilitated" in 1793 and died in half-exile in 1815. The authors were struck by the fact that for 200 years, no historian of the Fast Indies has ever taken into account the Squadron's distinctive features and the personality of Suffren. Thanks to their research in family documents, in the National and especially Navy Archives, they are able to show the importance of this psychological, not to say the psychopathological, aspect. One can only be struck by the silence of the various historians who worked on the subject, misjudging this "conditioning" which explains excessive punishments and long-harboured grudges. It is possible that Tromelin was the most affected because he was hierarchically the nearest. As the various documents or testimonies show, no fault or error could ever be retained against him that he could non justify. A detailed study of the handwritings of the two protagonists is presented in the text. Such conflicts are rather common within the Administration, but they seldom are of such duration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699180 TI - [Joint meeting of the Medico-Psychological Society and the Pierre Janet Society dedicated to: Pierre Janet on the occasion of the 100th anniversary of psychological automatism. 22 May 1989]. PMID- 2699181 TI - The approaches to the study of human disorders in food ingestion and body weight maintenance. PMID- 2699182 TI - The microstructure of ingestive behavior. PMID- 2699183 TI - Mood- and nutrient-conditioned appetites. Cultural and physiological bases for eating disorders. PMID- 2699184 TI - The modern history of anorexia nervosa. An interpretation of why the illness has changed. PMID- 2699185 TI - The economics of hunger, thirst, satiety, and regulation. PMID- 2699186 TI - Impact of nutrition on the pharmacology of appetite. Some conceptual issues. PMID- 2699187 TI - Microdialysis studies of brain norepinephrine, serotonin, and dopamine release during ingestive behavior. Theoretical and clinical implications. AB - This minireview deals with the possible roles of monoamines in feeding and feeding disorders. The introduction sketches the results of earlier studies with local drug injections and selective neurotoxins which provided pharmacological evidence that monoamines can influence food intake and body weight. A table summarizing this evidence is used to list monoamine changes that could underlie anorexia or hyperphagia. It is apparent that abnormalities in the monoamines, along with their cotransmitters, could cause many forms of feeding disorder. It is proposed as a working hypothesis that several varieties of hyperphagia leading to obesity have a common element. This common factor is a change in excitability of a lateral hypothalamic reinforcement system as manifested in self-stimulation at a stimulation-bound feeding site. Understanding this feeding reward-aversion system helps us understand hyperphagia and anorexia. The neurochemistry of reward and aversion involves the monoamines. This paper focuses on dopamine and serotonin. The data support the hypothesis that dopamine systems projecting to the nucleus accumbens and other forebrain areas from the mid-brain ventral tegmental area (VTA) are important for approach and positive reinforcement in ingestive behavior and self-stimulation. Serotonin is hypothesized to facilitate satiety and inhibition of feeding reward in the hypothalamus. The next section abstracts our recent experiments that measured pharmacological and physiological release of the monoamines in the hypothalamus and nucleus accumbens during ingestive behavior and self-stimulation. In vivo microdialysis in freely moving rats suggested the following: (1) Norepinephrine was released in the paraventricular nucleus during the active, feeding period of the circadian cycle. (2) The serotonin metabolite 5-HIAA also increased in the PVN at the same time if there was food to eat. (3) Amphetamine infused into the lateral hypothalamus (LH) by reverse dialysis increased synaptic dopamine, norepinephrine, and serotonin. (4) The anorectic drug d-fenfluramine increased synaptic serotonin in the LH and also increased the dopamine metabolite DOPAC, suggesting that serotonin and dopamine in the LH might contribute to fenfluramine-induced satiety. Local d fenfluramine injection into the LH or local infusion by reverse dialysis again increased serotonin and decreased 5-HIAA and interfered with local dopamine metabolism as reflected in decreased DOPAC and HVA. (5) Tryptophan, a serotonin precursor, given systemically at an anorectic dose, increased extracellular serotonin in the LH, but this effect was only detectable in food-deprived rats. This was seemingly pH independent (between 5.8 and 8). The passage other cations through CFo is strictly suppressed (even at pH 8 and with 300 mM NaCl in the medium).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699188 TI - Opioids. Are they regulators of feeding? PMID- 2699189 TI - The regulation of food intake by peptides. AB - Historically, nutrients and related metabolic signals were considered to control the onset and offset of meals. Recent research has focused upon the roles of peptides found in the gastrointestinal tract and brain as alternate controllers of these processes. During a meal, the gut secretes a variety of peptides as part of the digestive process. Some of these substances, acting as hormonal or as local signals, may also provide information which is relayed to the central nervous system, causing eating to stop and producing the sense of satiety. When administered to animals or people before a meal, exogenous cholecystokinin (CCK), the most studied of the putative satiety peptides, reduces food intake in a dose dependent manner. Recent findings support the concept that endogenous CCK acts during meals to limit meal size, and evidence is reviewed suggesting a possible pathophysiological role for CCK in bulimia. Adiposity is also regulated via peptide hormones, especially insulin. Insulin is secreted in direct proportion to adiposity, and blood-borne insulin gains access to brain areas important in the regulation of feeding. The administration of insulin into the brain causes reduced eating and weight loss. PMID- 2699190 TI - Taste responses from the entire gustatory apparatus. PMID- 2699191 TI - Oral factors in appetite and satiety. PMID- 2699192 TI - Dietary-induced overeating. PMID- 2699193 TI - Stress-reducing effects of ingesting milk, sugars, and fats. A developmental perspective. AB - A developmental approach to the study of feeding is proposed that considers social complexity and its biological mediation as core determinants of later ingestive patterns. Evidence is presented for opioid-mediated influences of milk and its major constituents and for nonopioid-mediated channels for contact comfort. Consideration of these factors might help us better understand some of the determinants of human feeding disorders such as bulimia and anorexia nervosa. PMID- 2699194 TI - Orosensory self-stimulation by sucrose involves brain dopaminergic mechanisms. AB - The most convincing body of evidence supporting a role for brain dopaminergic mechanisms in sweet taste reward has been obtained using the sham-feeding rat. In rats prepared with a chronic gastric fistula and tested with the cannula open, intake is a direct function of the palatability of the solution offered as well as of the state of food deprivation. Because essentially none of the ingested fluid passes on to the intestine, negative postingestive feedback is eliminated. Thus, the relative orosensory/hedonic potency of the food determines and sustains the rate of sham intake; long periods of food deprivation are not required. In this way, the sham feeding of sweet solutions may be considered a form of oral self-stimulation behavior and afford a preparation through which the neurochemical and neuranatomical substrates of sweet taste reward may be identified. The results obtained in the series of experiments summarized in this paper clearly indicate that central D-1 and D-2 receptor mechanisms are critical for the orosensory self-stimulation by sucrose in the rat. In conclusion, I suggest that such investigations of the roles of brain dopaminergic mechanisms in the sucrose sham-feeding rat preparation may further our understanding of normal and aberrant attractions to sweet fluids in humans (see Cabanac, Drewnowski, and Halmi, this volume), as an innate, positive affective response of human neonates to sucrose and the sustained positive hedonic ratings for glucose when tasted but not when consumed have demonstrated. PMID- 2699195 TI - Depression, antidepressants, and body weight change. AB - The excessive weight gain observed during treatment of depression with antidepressant medications is caused in part, at least in some persons, by reductions in resting metabolic rate. Such problematic weight gain appears unrelated to clinical recovery, weight change during the depressive episode, prior weight, or other related factors. Preliminary results suggest that increased energy efficiency (of about 16-24%) during treatment with tricyclic antidepressants could promote weight gain even in the absence of a change in caloric intake. This is not a property of all antidepressants, as demonstrated by the increase in metabolic rate and associated weight loss observed during treatment with the monocyclic antidepressant compound fluvoxamine. Should these serotonergic compounds continue to be effective antidepressants, they may be better accepted by patients, and their use help avoid medication noncompliance. In considering energy balance and weight change, our focus has been drawn to altered metabolic rate. Continuing studies do not suggest an effect of antidepressants on appetite, particularly the presence of "carbohydrate craving," either during treatment or during a depressive episode. Certainly, a notable preference for highly palatable foods (rich in fats and carbohydrates) occurs during the depressive episode, but not during treatment. These foods cannot be labeled carbohydrates. PMID- 2699196 TI - Palatability of food and the ponderostat. PMID- 2699197 TI - The functions of taste and olfaction. PMID- 2699198 TI - Quantifying palatability in humans. PMID- 2699199 TI - Disorders of food selection. The compromise of pleasure. PMID- 2699200 TI - Sensory-specific satiety in anorexia and bulimia nervosa. PMID- 2699201 TI - Taste responsiveness in eating disorders. PMID- 2699202 TI - Is there an eating disorder in the obese? PMID- 2699203 TI - Gastric function in eating disorders. PMID- 2699204 TI - Long-term perspectives on the study of eating behavior. PMID- 2699205 TI - The anorexia of the elderly. PMID- 2699206 TI - Animal models of human eating disorders. PMID- 2699207 TI - Nutrient imbalances in depressive disorders. Possible brain mechanisms. AB - We examined the utility of d-fenfluramine, a serotonin-releasing drug previously shown to diminish carbohydrate craving and weight gain in obese people, in treating patients with seasonal affective disorder (SAD), a variant of depression that occurs each fall and winter and is usually associated with hyperphagia and carbohydrate craving. Eighteen patients participated in a double-blind, placebo controlled study in 1986-1987, each receiving, in random order, d-fenfluramine (15 mg p.o. twice daily) or a placebo for four weeks, separated by a two-week washout period. Symptoms of SAD were assessed before and after each treatment period using clinical interviews by a psychiatrist, and the Hamilton Depression Rating Scale (HDS) with a special SAD addendum (ADD). Subjects were also weighed. Patients' depression scores (mean +/- SEM) were identical before treatment with drug (20.9 +/- 1.3, HDS: 13.3 +/- 0.8 ADD) or placebo (21.4 +/- 1.2, HDS; 13.2 +/ 0.6 ADD). During placebo treatment, HDS scores declined by 22.6% (p less than 0.02) and ADD scores by 9% (p greater than 0.2). During d-fenfluramine treatment, HDS scores fell by 71% (p less than 0.0001) and ADD scores by 73% (p less than 0.0001). Thirteen of the subjects (72%) demonstrated complete reversal of their abnormal test scores on d-fenfluramine. In two others, test scores fell to normal levels with both the drug and its placebo; one subject responded only to placebo; and two failed to show therapeutic responses to either drug or placebo treatment. The group as a whole lost weight (1.2 kg) on d-fenfluramine (p less than 0.033) but not on placebo. A subsequent study on nine of the responders showed that improvements persisted for the full three-month duration of the SAD season. These results indicate that d-fenfluramine, a drug not previously identified as an antidepressant, may be useful in treating SAD. Moreover, since d-fenfluramine acts specifically to enhance serotonin-mediated neurotransmission, the data further suggest that serotonin is involved in both the affective and appetitive symptoms of SAD. Indeed, the carbohydrate craving of these patients may constitute a kind of substance abuse in which the nutrient is eaten precisely for its serotonin-mediated psychotropic effects. PMID- 2699208 TI - Metabolic rate and feeding behavior. AB - According to the ischymetric hypothesis, hunger is induced by the decrease of overall metabolic rate. In order to assess such a mechanism, it was necessary to monitor the muscular contraction-free metabolic rate designated "metabolisme de fond" (MF) in rats that were either resting or moving. MF was then examined in relation to either spontaneous or induced feeding patterns. A computerized open circuit gas analysis system allowed us to monitor MF and behavior and to show that the onset of a spontaneous meal was preceded by a decrease of MF and its termination is preceded by a rebound of MF. Pharmacological blockade of utilization of both glucose and lipids enhanced feeding only to the extent that it reduced MF. These findings apply to pharmacotherapy because the anorexigenic effect of dexfenfluramine results from the enhancement of MF induced by the capacity of this drug to mobilize endogenous fat reserves and to so provide an endogenous meal that inhibits the exogenous meal. The ischymetric mechanism of hunger does not exclude important modulatory input from hormonal, circadian, and environmental factors in the control of feeding. PMID- 2699209 TI - [Diagnostic value of the combination of echography-plethysmography in deep venous thromboses of the legs]. AB - The association of two non invasive methods: real time ultrasonography and plethysmography was studied prospectively for the diagnosis of deep vein thrombosis (DVT) in 70 patients. Their results were compared to contrast venography considered to the reference procedure. Venography showed DVT in 32 patients. Ultrasonography had a sensitivity of 69% and a specificity of 98%. The false negative results were related to iliac or calf vein thrombosis. Plethysmography had lower results than US (Se = 57%, Sp = 90%). In this study the sensivity of the two methods, either isolated or associated was not sufficient to allow their substitution to venography. Their association in all cases did not give better results than US alone. Because of its high specificity US can be performed first in cases of suspicion of DVT, especially in high risk patients. Plethysmography seems not to be necessary for the diagnosis. PMID- 2699210 TI - [MRI study of parathyroid adenoma. Value of T2-weighted sequences]. AB - The authors report a series of 22 patients operated for primary hyperparathyroidism. The parathyroid adenoma was located preoperatively by MRI and ultrasonography. Measurement of the relaxation time was performed in vitro at 37 degrees C in a 0.47 Tesla field during the 30 minutes following resection. The relaxation times obtained at a precession frequency of 20 mHz were 0.844 +/- 0.16 sec for T1 and 0.082 +/- 0.025 sec for T2. MRI had a sensitivity of 73% and a specificity of 88% for the localization of the parathyroid adenoma, while ultrasonography had a sensitivity of 73% and a specificity of 98%. PMID- 2699211 TI - [Radiotherapy and cerebral stereotaxis. Examples of dosimetry with 3D reconstruction]. AB - External stereotactic radiotherapy allows to irradiate a small and carefully delimited intracranial volume according to the spatial definition of the target. To determine the distribution of the dose in the volume irradiated, we developed a dosimetric programme adapted to our particular treatment conditions (arc therapy in the frontal and oblique planes converging onto the centre of the target volume with circular beams 8 to 20 mm in diameter using 18 MV X photons). The principle of the programme is a 3D reconstruction based on ten transverse CT slices. This reconstruction, related to the stereotactic coordinates defined during stereotactic localization, visualises the outline of each oblique frontal treatment plane and the outline of the three perpendicular reference planes passing through the centre of the target volume (i.e. transverse, sagittal, coronal). The isodose distribution is then calculated in the planes defined by these reconstructions. Under treatment conditions, we use the parameters measured for each beam with their additional collimation. We present an evaluation of this software performed on a phantom consisting of a skull containing a defined target. PMID- 2699212 TI - Intraoperative radiotherapy in the multidisciplinary management of soft tissue sarcomas. PMID- 2699213 TI - Intraoperative radiation therapy of miscellaneous malignant tumors. A multicentric experience: preliminary results. PMID- 2699214 TI - [Ultrasonic diagnosis of fibrous pseudotumor of the testicular adnexa. Apropos of 2 cases]. AB - Fibrous pseudotumor of the testicular appendices is a rare, benign tumour which, because of its site, frequently simulates a malignant testicular tumour. Ultrasonography establishes the diagnosis of benign extratesticular tumour based on a number of arguments in favour of this entity, allowing local excision instead of unnecessary orchidectomy. PMID- 2699215 TI - [Cancer of the breast and ultrasonographic nodule of the liver]. AB - Metastases and angiomas are lesions which, because of their frequency, can be discovered in the liver on ultrasonographies performed on patients followed for breast cancer. This study was based on 109 patients with breast cancer and ultrasonographic nodules of the liver, generally corresponding to metastases (71 cases) or to angiomas (40 cases). The echogenicity of metastases (hypoechogenic) is so different from that of angiomas (hyperechogenic) that, in the great majority of cases, they can be distinguished on the basis of ultrasonography alone, thereby avoiding the systematic need for other complementary diagnostic investigations. PMID- 2699216 TI - [Congenital absence of a pedicle of the thoracic vertebrae. A new case]. AB - The authors report a case of congenital absence of pedicle in the thoracic spine which is uncommon. The lesion may occur at three stages of vertebral development: membranous, cartilaginous or osseous. Careful examination of the X-rays allows visualisation of pedicle aplasia or hypoplasia, associated with controlateral and posterior arch lesions, confirming the congenital origin. Computed tomography scan allows careful analysis of the lesions and eliminates others causes of absence of pedicle, avoiding invasive and expensive explorations. PMID- 2699217 TI - [Study of the composition of cell wall of group A Streptococcus after hydrolysis using muramidase from Streptomyces levoris]. AB - The aim of the experiment was to study the lysis products of cell walls of group A streptococci resulting from exposure to N-acetylmuramidase. It was shown that for isolating surface proteins free of polysaccharide and peptidoglycan fragments it was necessary to treat the streptococcal cell walls with endo-beta-N acetylmuramidase for no more than 30 minutes. Prolonged hydrolysis with muramidase led to the presence of polysaccharide and the peptidoglycan fragments in the protein fractions, intracellular wall proteins covalently bound to the peptidoglycan fragments and polysaccharide being also released. PMID- 2699218 TI - [Cytokines--polyfunctional regulators of protective reactions in normal and pathological states]. PMID- 2699219 TI - [Interleukins as drugs and objects of pharmacological action]. PMID- 2699220 TI - [Current trends in using silver-containing antiseptics]. PMID- 2699221 TI - [Malaria in Ile de Sainte Marie in 1988. Epidemiological approach. Chloroquine sensitivity of Plasmodium falciparum]. AB - The Malaria Research Unit of the Madagascar Pasteur Institute and the local health authorities carried out a study in the Sainte Marie Island in August 1988. Epidemiological results were in agreement with those previously reported in areas of endemic malaria. Parasite and splenomegaly rates were 34.6 and 35.9% respectively, by both active and passive cases detection. Analysis of parasite densities and clinical symptoms in the various age groups demonstrates that protective immunity is absent in infants and young children, and appears by the age of 2 to 9 years. An in vivo study of the sensitivity of Plasmodium falciparum to chloroquine was conducted in 41 patients. 39% of the infections were normally sensible (S) to WHO standard therapy (25 mg chloroquine/kg in 3 days), while 32% of the patients presented with a thick blood smear negative by D7, but positive by D14 (S/R1). Parasite resistance was observed in 29% of the infections: in 10% at the R1 level, and in 19% at the R2 level. Frequency and level of resistance to chloroquine are higher than those we observed in the East Coast in 1983 and 1985. However, chloroquine consistently achieves a high reduction in parasite densities and is still clinically active. PMID- 2699222 TI - [Antimalarial serology in 1987-1988 in the Highland Plateaux, the East coast and the South of Madagascar]. AB - We studied 521 serum samples collected in 1987-88 in the Highland Plateaux and the East coast of Madagascar, two areas presenting different levels of malaria endemicity. Total anti-Plasmodium falciparum antibodies were investigated by an indirect immunofluorescence assay (IFA). Antibodies directed to the ring-infected erythrocyte surface antigen (RESA) were investigated by a modified IFA (MIFA). Results were analysed in regards to malariological parameters (parasite and splenomegaly rates) collected simultaneously. IFA appears as a good epidemiological tool as it closely parallels the classical malariological parameters. In selected studies, the presence of P. falciparum parasites in blood was less frequent in individuals presenting with anti-RESA antibody, as detected by MIFA, than in the other individuals were consistently lower in subjects with anti-RESA antibody than in others. PMID- 2699223 TI - [The treatment of Plasmodium falciparum malaria in the Malagasy Highland Plateaux. Development of fever and parasite density. Clinical aspects]. AB - In 1988, the sensitivity to chloroquine was investigated by the standard WHO in vivo test in 91 Plasmodium falciparum-infected individuals from the Highland Plateaux of Madagascar. As compared to the previous years, the level of resistance to chloroquine was increased, R2 resistant strains being present. This study also allows to define a policy for chloroquine therapy of patients. Following the malaria diagnosis by microscopy at DO, a single blood smear on D4 may indicate the parasitological cure for sensitive strains. However, 2 additional blood smears, on D7 and D14, are needed due to the presence of SR1, R1, and R2 strains. In all cases, a thick blood smear is required for microscopic observation, as the thin smear possess an insufficient threshold of sensitivity. PMID- 2699224 TI - [Development of antibiotic resistance of type 1 Shigella dysenteriae strains (Shiga bacillus) isolated in Tananarive on the East coast of Madagascar]. AB - From November 1988 to March 1989, 804 Malagasy children stools were studied and 37 Shigella strains isolated. 5 Shigella dysenteriae type 1 from Malagasy East coast (Mananjary), presented a multiply resistance to ampicillin, carbenicillin, streptomycin, chloramphenicol, tetracycline, sulphonamides and trimethoprim. This last resistance has recently appeared in this area. PMID- 2699225 TI - [The plague in Tananarive (from its start in 1921 to its reappearance in 1979)]. PMID- 2699226 TI - [Malaria in 1988 in a village of the Malagasy Highland Plateaux. Epidemiological findings]. AB - In 1988, the Malaria Research Unit of the Madagascar Pasteur Institute settled an out-patients clinic in Manarintsoa, a village of the Highland Plateaux where epidemic malaria appeared recently. 2776 consultants presented between January and June. In addition, the 200 schoolchildren were examined thrice. For each individual, clinical examination and thick and thin blood smears were performed. In the out-patients, parasite rates were above 50% each month and in each age group; the mean parasite rate being 74%. Splenomegaly rates were above 60% in individuals less than 15 years of age, and around 20% in adults. In schoolchildren, parasite and splenomegaly rates are consistently above 50%. Gametocyte indexes were 7.5% and 7% in May and October, respectively. Plasmodium falciparum is the most encountered species (in 85% of the cases), but P. vivax and P. ovale are also present. P. malariae is very rare. Early diagnosis and adequate therapy were very effective against mortality. During the high transmission time, monthly mortality rates varied from 12% before our arrival to 0.66% after. The number of malaria attacks was estimated at 2 per man and per year. In this area of unstable malaria, presence of fever appears to be of poor predictive value of the malaria infection. Systematic chloroquine therapy of fevers would be adapted to only 43% of the cases. PMID- 2699227 TI - Hypoglycaemia associated to vaginal insulin placement in rats. AB - The effect of vaginal placement of insulin was ascertained in rats by measuring plasma glucose levels. A rapid and sustained decrease of plasma glucose levels at 30, 60, 90 and 120 minutes after vaginal insulin administration was observed, returning to basal levels by 240 minutes. Thus, rapid insulin absorption was not curtailed by vaginal mucose. The effect was independent of the rat oestrous cycle phase. PMID- 2699228 TI - Non-immune hydrops fetalis: rapidity of onset and usefulness of prenatal ultrasonography. AB - Non-immune hydrops fetalis (NIHF) has become more common than immune hydrops fetalis as a cause of fetal hydrops and its contribution to the total perinatal mortality rate has increased from 0.1% to 3.0% for the 10 years to 1979. A case is reported where an antenatal ultrasonograph performed within 24 hours of delivery showed hydrops was not present, however, at birth the infant was grossly hydropic and died despite intensive management. This case shows the rapidity of onset of NIHF and the devastating effect of this disorder. A review of two large series of NIHF revealed that in only 11.4% and 16.3% respectively, a significant uncorrectible associated major malformation may have been missed by antenatal ultrasonography. Hence, if prenatal ultrasonography fails to reveal a major malformation a viable fetus with NIHF should be regarded as salvageable. Pulmonary hypoplasia occurred in over 90% and is probably due to compression from serous cavity effusions. Thus to improve survival the ultrasonographer needs to watch for the development of serous cavity effusions so that a pregnancy complicated by NIHF can be terminated before the fetus develops pulmonary hypoplasia. PMID- 2699229 TI - Sonographic appearance of hepatic hydatid disease. AB - The sonographic appearance of 25 proved cases of hepatic hydatid disease was characterized and correlated with surgical and pathologic findings. Sonography has a very high accuracy in detecting the type, size, number and location of hepatic hydatid cysts. It also indicates whether they are live (Type I, IR, II) or dead (Type III). The presence of hydatid cysts in the rest of peritoneal cavity and their complications can also be detected. It is of immense help in the selection of cases in which urgent surgery is needed e.g. contained (Type IR), communicating and direct rupture of hydatid cysts. When hydatid cysts are infected, they lose their characteristic sonographic appearance and become hyperechoic. This article details the findings and emphasize the criteria for recognizing hepatic hydatid disease. PMID- 2699230 TI - A short illustrated history of magnetic resonance imaging. AB - The principles of Magnetic Resonance Imaging (MRI) evolved during the late 1970s and early years of the following decade. The author was fortunate in being able to visit many of the pioneer research projects in the U.K. and U.S.A. and attend two conferences. This paper briefly describes these projects and their role in the evolution of the present technology, illustrated by photographs obtained from colour slides taken during these visits. PMID- 2699231 TI - The early career of a Dog & Goat Act radiologist. PMID- 2699232 TI - Haemorrhagic pseudocyst of the adrenal in an adult (a case report). AB - An adult female patient presenting with a cystic abdominal mass and intermittent fever, was found at surgery to have a large cyst of the left adrenal gland. The imaging findings and pathology of this uncommon entity are discussed. PMID- 2699233 TI - Microcystic adenoma of the pancreas--an incidental finding. AB - Microcystic adenoma of the pancreas is a rare benign pancreatic tumour usually occurring in elderly females. These tumours have characteristic radiological appearances that should allow their differentiation from the potentially malignant macrocystic adenoma as well as other cystic lesions of the pancreas. A case of a large micro-cystic adenoma of the pancreas found incidentally in a patient with carcinoma of the kidney is presented. PMID- 2699234 TI - A modification of "sail-sheet" culture technology. PMID- 2699235 TI - A one step, quick step, mini prep. PMID- 2699236 TI - Isolation and characterization of cell membranes. AB - The steps outlined above should provide a framework for developing and evaluating a scheme for isolating a particular membrane system of interest. Further characterization often focuses on the specific research interests of an investigator. Most subsequent techniques will probably involve biochemical analyses of protein and lipid components and biophysical analyses of membrane properties. The techniques to be used, such as SDS gel electrophoresis, enzyme kinetics, receptor binding, protein purification, etc. are not unique to membrane systems and will not be described in detail. However, it is likely that the functional relevance and success of subsequent analyses will be aided if the starting membranes are as homogeneous and well-characterized as possible. Even if some of the fractionation steps are bypassed, such as might occur if a specific membrane protein is detergent-extracted, purified, and reconstituted directly from a crude homogenate, a full understanding of membrane protein function will probably require complementary studies on intact cells and isolated membranes. PMID- 2699237 TI - Extraction and fractionation of lipids from biological tissues, cells, organelles, and fluids. PMID- 2699238 TI - Extraction and isolation of glycoproteins and proteoglycans. AB - A number of diverse approaches have been devised to bring about the efficient extraction and isolation of glycoproteins and proteoglycans from biological tissues. Many of these approachs are general procedures that can also be used for the extraction of nonglycoproteins from cells or tissues. Others, such as lectin affinity chromatography, take advantage of specialized structures found only on discrete sub-classes of glycoproteins. Unfortunately, the development of a protocol suitable for the purification of a given glycoprotein of interest remains largely empirical. This article presents a general overview of some of the potential strategies that can be utilized in the development of new isolation procedures and attempts to point out some of the possible pitfalls that may be encountered. PMID- 2699239 TI - An efficient and site-specific gene trimming method. AB - Trimming a DNA strand into a precisely determined fragment can be carried out efficiently by an improved method involving a site-specific trim-primer and a single-stranded DNA template which is generated from a multifunctional vector, pTZ18R, and linearized by using an Eco RI-pTZ18R splinter. A complementary DNA strand is synthesized by DNA polymerase I (Klenow), and the 3'-end of the template upstream from the annealed primer is trimmed by subsequent T4 DNA polymerase reaction. An ATG translation initiator codon or a termination codon can be incorporated into the trim-primer, providing versatility to this single stranded DNA-initiated gene trimming method that can be applied to subcloning and expression of any DNA fragment with known terminal sequences. PMID- 2699240 TI - The CTAB-DNA precipitation method: a common mini-scale preparation of template DNA from phagemids, phages or plasmids suitable for sequencing. AB - This report describes a common method of obtaining template DNA from phagemids, phages and plasmids. The strategy is based on the use of the cationic detergent cetyl-trimethylammonium bromide (CTAB) for DNA precipitation. By avoiding phase separation, many manipulation steps are reduced. A time-saving modification to perform double-stranded DNA sequencing directly after alkaline-denaturation is also introduced. The protocols described here allow the researcher to obtain template DNA from a variety of initial sources, thus giving reproducible sequencing results when using T7 DNA polymerase. PMID- 2699241 TI - Endothelial lesions, dietary composition and lipid peroxidation. AB - The vascular endothelium can be regarded as a widely distributed organ with a pluripotent function in homeostasis and lipoprotein metabolism. There is now increasing evidence that the vascular endothelium is susceptible to oxygen radicals (oxidative stress). These radical molecules are capable of degrading the polyunsaturated acyl chains of membrane phospholipids (lipid peroxidation), hereby inducing pathologic changes in the underlying tissue. Since the fatty acid composition of our diet is reflected in the composition of cellular membranes, it is conceivable that their may be a relation between the dietary fatty acids and the tissue (endothelial) susceptibility towards lipid peroxidation. In addition, the occurrence of dietary antioxidant molecules (e.g., vitamin E) and trace elements (Se) may be important denominators of tissue protection against peroxidative processes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699242 TI - Regulation of Escherichia coli adenylate cyclase activity by the phosphoenolpyruvate:sugar phosphotransferase system. PMID- 2699243 TI - Fructose-specific phosphoenolpyruvate dependent phosphotransferase system of Escherichia coli: its alterations and adenylate cyclase activity. PMID- 2699244 TI - Glucose transport in Escherichia coli. PMID- 2699245 TI - The beta-glucosides metabolism in Erwinia chrysanthemi: preliminary analysis and comparison to Escherichia coli systems. PMID- 2699246 TI - Regulation of sugar uptake and efflux in gram-positive bacteria. PMID- 2699247 TI - Regulatory functions of the phosphocarrier protein HPr of the phosphoenol pyruvate-dependent phosphotransferase system in gram-positive bacteria. PMID- 2699248 TI - Current studies on the bacterial phosphotransferase system in the Saier laboratory (La Jolla, California, summer, 1988). PMID- 2699249 TI - Fructose uptake by Escherichia coli--'the odd man out' of the phosphotransferase system. PMID- 2699250 TI - Sialic acid, serendipity, and sugar transport: discovery of the bacterial phosphotransferase system. PMID- 2699251 TI - Periplasmic binding protein dependent transport system for maltose and maltodextrins: some recent studies. PMID- 2699252 TI - Genetics of the PTS components in Escherichia coli K-12. PMID- 2699253 TI - The role of the PEP: carbohydrate phosphotransferase system in the regulation of bacterial metabolism. PMID- 2699254 TI - Molecular mechanisms of bacterial chemotaxis towards PTS-carbohydrates. PMID- 2699255 TI - [The effect of composition and ionic strength of external solution on the aspartate-ammonia lyase and fumarate hydratase activity in Escherichia coli cells]. AB - It was found that the nonspecific effect of ionic strength of the external solution on the enzymatic activity of E. coli cells consists in rapid changes in the permeability of cell membranes interacting with the substrate. This effect depends on the initial substrate concentration, i.e., ionic strength of the external solution, and is maintained for some time as the substrate concentration decreases. Chloramphenicol, a protein synthesis inhibitor, and sodium azide, a respiration inhibitor (300 micrograms/ml and 200 microM, respectively) do not change the enzymatic activity of E. coli cells during the synthesis of L-aspartic and L-malic acids from fumaric acid. The kinetic equations of L-aspartate and L malate synthesis are described by equations of zero and intermediate (between zero and first) order, respectively. PMID- 2699256 TI - [Mysteries of mitochondrial protein synthesis]. AB - Mitochondria possess an endogenous system of translation, in which all constituent components are unique. An electrophoretic analysis of mitochondrial translation products revealed that the content of polypeptides in mitochondria is two times as high as that of mitochondrial DNA genes. The electrophoretically determined molecular mass of proteins synthesized in mitochondria is much less than that calculated from gene sequencing data. The average amino acid composition of the proteins synthesized in mitochondria differs significantly from that encoded by the nucleotide sequence of corresponding mitochondrial genes. These enigmas of mitochondrial protein synthesis await further solution. PMID- 2699257 TI - [Stimulation of immunogenesis by neurotensin, pentagastrin and thymopentin and ways of its realization]. AB - In experiments on mice and in vitro the influence of neurotensin pentagastrin and thymopentin on the immune response, the phagocytosis of staphylococcus aureus by polymorphoneutrophil leucocytes and enzymatic activity of these cells by NBT-test were investigated. It was shown that neurotensin and thymopentin increase enzymatic and phagocytic function of polymorphoneutrophil leucocytes. Pentagastrin, as well as thymopentin stimulates the immune response, enzymatic but not phagocytic function of polymorphoneutrophil leucocytes. Immunostimulating effect of the studied peptides was realized by facility differentiation of mouse bone marrow cells into T-lymphocytes and by the interaction of the peptides with T-cells. PMID- 2699258 TI - [Lowering of bactericidal activity of mouse peritoneal macrophages under combined use of staphylococcal enterotoxin type A and endotoxin]. AB - The present study investigated the effect of staphylococcal enterotoxin type A (SEA) and endotoxin Serratia marcescens (LPS) on the phagocytosis and killing of Staphylococcus aureus by mouse peritoneal macrophages. Two hours after enterotoxin intraperitoneal injection phagocytic and bactericidal activity were depressed. 24 hours later there was increased functional activity of macrophages by SEA and LPS, apart. But when two toxins were administered together (LPS four hours later enterotoxin) marked inhibition of bacterial killing was observed. When peritoneal macrophages were treated in vitro for 24 hours with the same toxins they were also markedly suppressed in bactericidal activity. PMID- 2699259 TI - [Age-related changes in fibronectin of the eye outflow drainage system]. AB - The content of the fibronectin, an extracellular glycoprotein in the drainage outflow system of human eyes was determined by the indirect immunoperoxidase staining technique. The degree of fibronectin accumulation in ocular tissues was evaluated by quantitative morphometric analysis. It was shown that the fibronectin level was elevated in ageing. Increased deposit of fibronectin in trabecular tissues, mainly, in the inner wall of Schlemm's canal and juxta canalicular zone was demonstrated along with ageing. Comparison of fibronectin accumulation in glaucoma and ageing support the idea that ageing is a risk factor of glaucoma. PMID- 2699260 TI - Effects of triiodothyronine on insulin release from cultured neonatal and adult rat islets. AB - Insulin secretion from neonatal and adult rat islets maintained in culture for 7 9 days in the absence or in the presence of 10 nM T3 was measured. In both neonatal and adult islets T3 treatment tends to inhibit insulin secretion only in the absence or in the presence of low glucose concentrations. PMID- 2699261 TI - tRNA-rRNA sequence matches from inter- and intraspecies comparisons suggest common origins for the two RNAs. AB - 1. Comparisons were made of the results of searches within and among different species of organisms for sequence matches between transfer RNAs and ribosomal RNAs. The purpose was to determine whether the matching sequences might result from selection acting on the two RNAs within a common cellular environment. 2. The results indicate that most matches do not reflect such selection. The matches described were more frequent than those found in searches among randomized sequences and the frequency of intraspecific matches was not significantly higher than that of interspecific matches. 3. The matches are thought to identify conserved vestiges of a molecule or molecules ancestral to both classes of RNAs (Bloch, D.P., McArthur, B. and Mirrop, S. (1985). BioSystems, 17: 209-225). The matching sequences are interpreted as homologies. PMID- 2699262 TI - Monoclonal antibodies generated against activated B-cells: unexpected specific reactivity to T-cells. AB - Monoclonal antibodies (Mabs) were produced against C57B1/6 "nude" lymphoblast cells. They are IgG2a and do not react with mouse serum proteins. Five Mabs were characterized functionally by immunohistochemistry and immunofluorescence in spleen, lymph nodes and Peyer's patches from nude and normal mice, and normal mouse thymus. Two Mabs reacted with regions containing B-cells as indicated by immunoperoxidase staining, another recognized T- and B-cell sites and two specifically stained T lymphocyte-containing areas. Immunofluorescence studies confirmed the sites identified above by immunohistochemistry. PMID- 2699263 TI - [Eulogy of Raymond Mande (1910-1988)]. PMID- 2699264 TI - [Eulogy of Guy Vourc'h (1919-1988)]. PMID- 2699265 TI - [The development of surgical therapeutic concepts of acute severe pancreatitis]. AB - The actual surgical concepts concerning the treatment of acute pancreatitis are described. Owing to sonography and above all to computed tomography, constantly compared with clinical data, the surgical decisions can be more easily conducted. In acute pancreatitis of biliary origin, endoscopic sphincterotomy is mandatory in a great number of cases, followed by complete de-obstruction of the common bile duct. That procedure has the advantage of reducing notably mortality and morbidity. In idiopathic pancreatitis, 4 therapeutic behaviours which correspond to 4 different clinical types, are to be faced: --or after 5 to 6 days, division of the left hypochondrium with performing of a meticulous cleaning, followed by a large drainage lavage, --if all reanimation measures have failed, earlier surgery, often of the last chance, consisting in necrosectomy as extended as necessary, --in right away appearing pancreatic phlegmon, a very large drainage, -or, a more expecting attitude in cases in which resorption of the necrotic spots appears to be very slow on CT-Scan, but without any clinical abnormality. Figures support these concepts and prove their warranty. PMID- 2699266 TI - [Dysmorphisms related to autosomal chromosome aberrations in children and adults]. AB - Some of the characteristic dysmorphic features seen in autosomal anomalies remain unchanged throughout a patient's existence and keep their whole semiological value. Others, however, change with time and result from the interaction of the patient's specific genome and the imbalance created by the chromosomal imbalance. PMID- 2699267 TI - [A survey of carcinogenic chemical agents and their dangers in modern life]. PMID- 2699268 TI - [Carcinogenesis in humans: a multistage and multifactorial process]. AB - Experimental and epidemiological studies concur to show that carcinogenesis is a multistep process. Over fifty years ago, two steps were identified which were termed initiation and promotion. Initiation is caused by a defect in the cellular genome which is generally provoked by a genotoxic agent. Promotion generally involves epigenetic mechanisms. In those human cancers in which detailed studies have been carried out, the number of steps appears to be generally greater than 2, from 3 to 6. Epidemiologic studies have underlined the long duration and the complexity of human carcinogenesis and show that non gene-toxic agents may play an important role in progression from a premalignant to a fully malignant cell. A large proportion of human cancers have a multifactorial origin. Important advances have been made recently. They have emphasized the usefulness of close cooperation between basic research and epidemiologic studies for the elucidation of the mechanisms involved in the origin of human cancer. PMID- 2699269 TI - [Nutrition: its history and history]. PMID- 2699270 TI - [Blood, the control and guide of history]. PMID- 2699271 TI - [Blood loss during the surgical treatment of neurologic scolioses. The place of controlled hypotension]. PMID- 2699272 TI - [Effects of halogenated anesthetic agents on the liver]. PMID- 2699273 TI - [Sensitivity of Plasmodium falciparum to different antimalarials. A study in 1988 in a village in the Hauts-Plateaux of Madagascar]. AB - Since a few years, malaria has reappeared in the Central Highland Plateaux of Madagascar. From 1983 to 1987, Plasmodium falciparum resistance to chloroquine remained stable, with a low frequency of R2 therapeutic failures. In 1988, a study was conducted in the village of Manarintsoa, 15 km from Tananarive. Ninety one WHO in vivo standard tests were performed. In vitro efficacy of amodiaquine and quinine was also studied. In vitro, the efficacy of chloroquine, quinine, and mefloquine was measured against 104, 64, and 23 P. falciparum isolates, respectively, by an isotopic semi-microtest. PMID- 2699274 TI - Schistosomiasis of the spinal cord in a Yemeni boy. A report of a case with brief review of literature. AB - A 13-year old Yemeni boy who presented with flaccid paraplegia was thought to have a spinal cord tumor on myelography. Microscopic examination of surgically excised material revealed bilharzial granulomas. Brief review of relevant literature on schistosomiasis of the spinal cord, with particular reference to the Middle East, is presented. PMID- 2699275 TI - [Human life at high altitudes: myths and realities]. AB - Life at high altitude presents very interesting biological and medical aspects. For countries such as the Andeans, it also has socio-economical implications. The most important towns of Bolivia are situated between 3,000 and 4,850 m. It's to say that a great percentage of the population is permanently staying there. Moreover owing to the improvement of the roads and transport, an extensive migration (professional life, business, tourism, sport) developed some years ago. At 3,000 to 4,850 m, an oxygen arterial pressure (PaO2) between 40 and 70 mm Hg is resulting from the environmental hypoxia. The adaptation to hypoxia takes place in two phases: --that incomplete, observed at short time in people who recently arrived, --that at very long time, observed in the native. The rapid arrival at more than 3,000 m, exposes the traveller to an hypoxic ventilatory stimulus which produces a hyperventilation response to increased PaO2. This hyperventilation brings out a decreasing of carbon dioxide arterial pressure (PaCO2) and alkalosis of the blood. This respiratory alkalosis seems to be responsible for most troubles which are present in the Acute Mountain Sickness linked to the CO2 role in cerebral blood circulation. At the same time but more slowly the classical high altitude polycythemia develops which permits compensate partially the hypoxic effect in 3 to 4 weeks. In the native the adaptation implies physiological variations of some parameters concerning the individual development. The principal studies showed that the native present a notable hyposensitivity to hypoxia and also to the stimulus CO2-H+. The Chronic Mountain Sickness patients have a less sensitivity to the same stimuli than the natives. PMID- 2699276 TI - Leprosy diagnosis: a device for testing the thermal sensibility of skin lesions in the field. AB - A handy device for testing the thermal sensibility of skin lesions has been developed and field tested in various centres in Africa and India. The instrument performed satisfactorily and its use made testing for thermal sensibility in the field practicable and straightforward. Analysis of the results of testing 260 persons, most of whom exhibited a few lesions that were characteristic of early leprosy, showed that the rate of diagnosis of sensory impairment of such skin lesions, and hence the diagnosis of leprosy, would be about 15-25% more if thermal sensibility testing using this device were added to the other tests of sensibility routinely carried out in the field. Regular use of the device in the field would help to bring more leprosy patients under treatment than at present. PMID- 2699277 TI - Evaluation of serological diagnostic indices for mucocutaneous leishmaniasis: immunofluorescence tests and enzyme-linked immunoassays for IgG, IgM and IgA antibodies. AB - The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of immunofluorescence (IF) and enzyme-linked immunoassays (ELISA) for IgG, IgM and IgA antibodies were assessed on sera from mucocutaneous leishmaniasis patients and controls. The sensitivity of the IgG-ELISA test was 93.3% with 95% confidence interval higher than what could be due to a random test not associated with the disease. The specificity of all tests, except the IgM ELISA, gave indices that could not have been due to chance. The IgG-ELISA and IgG IF had the highest positive predictive value and the kappa statistic showed that the strength of agreement between the disease and the test was strongest for IgG ELISA. The IgG-ELISA had a negative predictive value with 95% confidence limits that were not due to chance alone. Efficiency was highest for IgG-ELISA and IgG IF. These results were obtained using sera from patients with severe or long standing disease and from controls in whom the disease was ruled out by a negative Montenegro skin test. In field surveys where the differences between cases and controls are less easy to define the diagnostic indices of these tests may vary with the disease prevalence. PMID- 2699278 TI - Airport malaria: a review. AB - Cases of malaria occasionally arise among individuals who have never visited a malarious area. Such patients, who also lack a history of blood transfusions or intravenous drug abuse, are usually shown to have "airport malaria". Most reports of airport malaria consist of case histories, although some epidemiological reviews have also appeared. The clinical and epidemiological features of 29 cases of airport malaria that were reported in Europe from 1969 to 1988 are reviewed here. Although airport malaria is rare, the apparent absence of risk factors for the disease in a patient's history can result in delays in diagnosis and appropriate treatment. Tests to exclude malaria should therefore be carried out on patients who work at or live near an international airport and who present with acute febrile illnesses. PMID- 2699279 TI - [Malaria situation in China, 1988. Advisory Committee on Parasitic Diseases]. AB - In 1988, the number of malaria cases reported was 134.2 thousand (Taiwan Province not included). Comparing with 210.6 thousand cases reported in 1987, a decrease of 36.3% was noted. Based on data reported by each county in the country, about 950.7 million people in 2,541 counties/cities were living in areas where malaria incidence was less than 0.1 per 1,000 (including originally malaria-free areas as well as areas free from the disease); 96.6 million people in 207 counties/cities with an incidence of 0.1-1.0 per 1,000; 30.4 million in 79 counties/cities with an incidence of 1.1-10.0 per 1000, and 0.4 million in 4 counties with an incidence of above 10.0 per 1,000. While the incidence decreased markedly in most endemic areas, it fluctuated in the southern part of China due to the increase in the floating population, shortage of insecticides, and natural calamities in some areas. In Hainan province the incidence increased by 21.1% over 1987; increase in incidence and focal outbreaks also occurred in some areas of Yunnan, Guangdong, Guangxi, Guizhou provinces/autonomous region. In the provinces of Anhui, Jiangsu, Henan and Jiangxi, the major endemic areas in central China, the incidence decreased by 43.6-71.4% over last year, there were 57 thousand cases, accounting for 42.6% of the total cases recorded in the country. Downward trends of incidence continued in other provinces, autonomous regions and municipalities. The distribution of falciparum malaria was confined to 63 counties of 6 provinces/autonomous region, while non-indigenous falciparum malaria cases were found in 88 counties of 8 provinces due to the population movements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699280 TI - [Observation on the development of Plasmodium falciparum in Anopheles dirus]. AB - This paper is a record of our observation on the stages of development of Plasmodium falciparum in Anopheles dirus. The malarial parasites were derived from 5 infected patients living in Guizhou Province and used to infect 8 batches of An.dirus. The morphology of various developmental stages studied under light microscope and their average size were as follows: Microgametes were filament shaped, 13.31 +/- 2.22 microns; macrogametes and zygotes oval or round, 4.36 +/- 0.59 microns and 3.39 +/- 0.39 microns respectively; ookinetes banana shaped, 13.56 +/- 0.80 microns x 2.90 +/- 0.48 microns; oocysts ovoid or spherical in shape, the smallest one being 7.086 microns in equivalate diameter (2 days old) and the largest one 72.60 microns (11 day old); slender sporozoites measured 10.625 +/- 0.82 microns x 1.179 +/- 1.3 microns. The late sporogonic stage of P. falciparum was observed with scanning electron microscope. The sporozoite buds developed on the surface of the sporoblast bodies, being round or elliptic or irregular-shaped. The anterior end of sporozoites was truncate and sometimes a micropyle could be seen at a distance 1/3 from the anterior end. A description was given of the different characteristics of the macrogametes and zygotes, together with the arrangement of the pigment granules of oocysts. PMID- 2699281 TI - [Further study on in vitro culture of third-stage larvae of Wuchereria bancrofti and Brugia malayi]. AB - This paper reported on improved in vitro culture system of human lymphatic filarial larvae. Four culture systems were used. Third-stage larvae of Brugia malayi were best maintained, developing and molted twice in the medium containing modified RPMI-1640 medium, supplemented with 20% newborn calf serum and human embryonic kidney cell line as feeder layer. This culture system kept larvae alive up to 54 days. Brugia malayi third-stage larvae began to moult on the 8-10th day and again on the 32-36th day. Wuchereria bancrofti third stage larvae grew and developed to the fourth-stage and juvenile and survived to 57 days. They began to moult on the 12-18th days and again on the 32-44th day. This culture system was thought to be useful for studies on morphology and sensitivity to drugs. We also studied several cell-free culture systems. Among them, Best survival, growth and development were obtained in 1:1 mixture of modified RPMI-1640 and TC199 medium supplemented with 20% newborn calf serum. Both Wuchereria bancrofti and Brugia malayi third-stage larvae grew and developed to the fourth stage larvae and juveniles and survived to 36 days and 42 days respectively. The availability of such culture systems for human filariasis would facilitate studies of biochemistry, immunology, production of monoclonal antibodies and vaccine. PMID- 2699282 TI - [Assessment of intracutaneous test in longitudinal surveillance for lymphatic filariasis]. AB - In order to evaluate the usefulness of intracutaneous test (IT) in longitudinal surveillance of filariasis, two administrative villages selected from Queshan County, Henan Province of China, endemic for Wuchereria bancrofti, were surveyed in 1982, 1983 and 1987 respectively, by IT with antigen FPT derived from Dirofilaria immitis. The result showed that the original level of IT to antigen FPT in the population was consistent with the data of either etiological or entomological investigation before chemotherapy. When the microfilaraemia rate and natural filarial infection rate of mosquitoes in a village were high, the positive rate and frequency of strong positivity (skin wheel diameter greater than or equal to 1.3 mm) for immediate hypersensitivity reaction would be high too; and the reverse was true. It is suggested that both criteria of IT mentioned above may be useful in assessing endemicity of lymphatic filariasis before mass chemotherapy. The speed of negative conversion of IT in both groups, the previously microfilaraemic patients and the microfilaraemic inhabitants positive to immediate hypersensitivity reaction before chemotherapy, were different, the former being significantly slower than that of the latter after mass and selective chemotherapy with diethylcarbamazine. All of the three criteria for immediate hypersensitivity, positive rate, frequency of strong positivity and positive conversion rate, decreased gradually after a mass and selective DEC treatment. Until 1987, the 5th year after the chemotherapy, the average positive rate in the two villages dropped to 20.0% from 55.4% in 1982, the frequency of strong positivity to 2.8% from 23.8% in 1982, and the positive conversion rate to 9.7% (1984-1987) form 19.2% (1982-1983).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699283 TI - Interaction of amine oxides and quaternary ammonium salts with membrane and membrane-associated processes in E. coli cells: mode of action. AB - The antimicrobials (1-methyldodecyl)dimethylamine oxide and (1 methyldodecyl)trimethylammonium bromide affect the cytoplasmic membrane of E. coli. The interaction results in release of intracellular material (K+, 260nm absorbing material), an effect on dehydrogenase enzyme activity and inhibition of respiration. The final effect of both substances is the same; they differ only in their dynamics. The effect of the membrane was correlated with parameters characterizing these surfactants i.e. critical micelle concentration (c.m.c.) minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) over the concentration range of 10(-4) to 10(-1) mmol/dm3 of active substance. The three stage mode of action model can be summarized as follows: 1 polar (coulombic) interactions, 2-polar and hydrophobic interactions, 3 hydrophobic interactions (extraction and solubilization). The polar and hydrophobic interactions (1st and 2nd stage) are discussed also in relation to model membranes. PMID- 2699284 TI - Isolated perfused liver technology for studying metabolic and toxicological problems. AB - The isolated perfused liver system is a versatile model for investigating the effects and mechanisms of action of hepatotoxins and the metabolism of endogenous and exogenous compounds. The interpretation of metabolic data and apparent toxic events is dependent upon the viability and reproducibility of the model. In this study, a new approach has been undertaken to assess the viability of isolated liver preparations. This has involved the continuous monitoring of multistage processes namely, the synthesis and secretion of radiolabelled proteins, glycoproteins and lipoproteins on the one hand and the uptake of macromolecules by receptor-mediated endocytosis on the other. The consistency of these complex integrated processes from one liver to another and in particular the steady-state rate of production of radiolabelled macromolecules over 6h perfusion periods suggests that this model can be used with confidence for metabolic/toxicological investigations. The selectivity of the responses to chemical challenge(s) shows that this system can be exploited for (a) screening potential hepatotoxins; (b) identifying areas of metabolism which are affected and (c) advancing basic knowledge of liver biochemistry. PMID- 2699285 TI - Structural requirements of microsomal N-oxygenations derived from studies on amidines. AB - A short description of the chemical and pharmacological properties of amidines is followed by a comprehensive discussion of investigations on the N-oxidative biotransformations of amidines. The results of these investigations have confirmed the author's hypothesis, based on mechanisms, that N-oxygenation by the cytochrome P-450 enzyme system is observed particularly when N-dealkylation is not possible because of the absence of hydrogen atoms on the carbon atoms adjacent to the nitrogen atom, alpha-H-atoms. The results obtained with amidines are discussed in their relationship to other microsomal N-oxygenations both by cytochrome P-450 and flavine-containing monooxygenase. Attempts are made to deduce a scheme for predicting N-oxygenations. PMID- 2699286 TI - [Recent progress in the ophthalmology in China]. PMID- 2699287 TI - Chronic cor pulmonale. AB - Chronic cor pulmonale is defined as right heart hypertrophy and/or chronic right heart failure. There are many etiologies, but the common cause is increased right heart work from pulmonary hypertension. Etiology can be conveniently discussed by assuming two prototypes, the asphyxial or hypoxic type and the vascular obliterative type. A common cause of the asphyxial type is chronic obstructive pulmonary disease, and the obliterative type is represented by chronic pulmonary thromboembolic disease or primary pulmonary hypertension. Pathology is discussed, emphasizing the cardiac manifestations of chronic cor pulmonale including data of specific cardiac chamber size. An overview of hemodynamics is given, and the use and limitation of electrocardiography and chest x-rays are discussed. The exciting potential use of echocardiography for the serial non-invasive measurement of anatomical and pathophysiological features is outlined, along with the value of a careful physical examination and the proper utilization of laboratory tests in the diagnosis of chronic cor pulmonale. In the patient with the asphyxial type, the treatment of pulmonary infectious exacerbations, the role of corticosteroids, digoxin, diuretics, phlebotomy, bronchodilators (theophylline, beta adrenergic agonists, and anticholinergics), and long-term oxygen therapy is noted. The controversy surrounding the use of vasodilators and calcium blockers in these patients is discussed. Treatment aspects of the vascular obliterative type, including the role of vasodilators, calcium blockers, prostacyclin, anticoagulants, and overall strategy are discussed. A brief note is mentioned of the promising role of surgical therapy in chronic thromboembolic disease causing chronic cor pulmonale. PMID- 2699288 TI - Disposition of ethmozine in cerebrospinal fluid and plasma of rabbits. AB - The concentration-time profiles of ethmozine, a newly introduced anti-arrhythmic drug, in the cerebrospinal fluid (CSF) and plasma of six rabbits (New Zealand white rabbits of both sexes, 4.0-5.0 Kg) were studied after intravenous bolus administration. CSF samples at various intervals were obtained while the animal was lightly anaesthetized with intravenous thiopentone (40 mg Kg-1) and blood samples at other intervals were taken while the animal was conscious. Blood samples (1 ml) were collected from the implanted cannula of the ear artery while CSF samples (0.3 ml) were obtained from the cisterna magna. The plasma concentrations of ethmozine in six rabbits declined rapidly after intravenous injection for up to 30 min. then slowly over 12 h. Using non-compartmental analysis, the mean (+/- S.E.M.) elimination half-life, mean residence time, plasma clearance and volume of distribution at steady state were 13.9 +/- 9.2 h, 19.9 +/- 13.4 h, 2.3 Lh-1 and 26.8 +/- 7.9 L respectively. The mean CSF-plasma concentration ratios for ethmozine at 0.5, 1.0, 2.0, 4.0, 8.0 and 12.0 h were 0.17, 0.14, 0.16, 0.16, 0.23 and 0.22 respectively. The results suggest that ethmozine is able to penetrate into the CSF from the general circulation and this may be related to its adverse effects on the central nervous system. PMID- 2699289 TI - Cyclosporine pharmacokinetics and effect in the type I diabetic rat model. AB - Recent clinical studies have demonstrated the potential benefit of the T-cell specific immunosuppressant, cyclosporine, in the treatment of Type I insulin dependent diabetes. In the present study, steady-state cyclosporine pharmacokinetics, fasting glucose and insulin levels and renal function were examined in stable insulin-dependent diabetic rats and compared to non-diabetic rats. Mean creatinine clearance 30 days following diabetes induction was not significantly different from saline controls. Cyclosporine treatment (5 mg/kg/day i.v. for 13 days) did not significantly alter creatinine clearance in either group; however, renal function of vehicle-treated diabetic rats was markedly reduced compared to other groups. Serum insulin concentrations were significantly greater in diabetic rats treated with cyclosporine compared to the control group (35.1 +/- 22.7 vs. 16.0 +/- 8.1 microU/ml; P less than 0.05). Glucose levels were proportionately reduced in diabetic rats treated with cyclosporine. Area under the concentration-time curve, half-life and volume of distribution of cyclosporine were significantly reduced in diabetic rats compared to non-diabetic controls. In summary, the pharmacokinetics and pharmacodynamics of cyclosporine were significantly different in the insulin-dependent diabetic rat model compared to normal controls. Furthermore, short-term cyclosporine therapy reduced the extent of experimental diabetic nephropathy observed in this model. PMID- 2699290 TI - Model of pulmonary extravasation as an effect of neutropenia in endotoxic shock in guinea pigs. AB - A guinea pig model was developed to document the association of polymorphonuclear neutrophils (PMN) decrease with pulmonary leakage after a sublethal infusion of endotoxin (LPS Escherichia coli 0111:B4, 5 micrograms/min/kg). A control group was prepared in the same manner and given an infusion of vehicle alone. Severe leukopenia developed, mostly expressed in the neutrophil population. There was a decrease in RBC catalase and fibronectin. Plasma leakage in the lung followed the endotoxin infusion, which could indicate endothelial cell damage. The results from the present study suggest an activation of PMN in endotoxin-infused animals, degranulation and release of toxic oxygen species, resulting in pulmonary plasma extravasation. PMID- 2699291 TI - Expression of hepatitis B virus large envelope protein in Escherichia coli and Saccharomyces cerevisiae. AB - The gene coding for hepatitis B large envelope protein was cloned under the lac promoter in bacterial vector pUC-8 and under the ADH1 promoter in yeast expression shuttle vector pVT103-U, and expression of HBsAg in bacteria and yeast was determined. The strongest expression of large envelope protein was obtained after transformation of the protease-deficient yeast strain BJ1991. The recombinant large envelope protein did not form complex 22-nm particles and was not secreted into medium. PMID- 2699292 TI - Computer-aided three-dimensional reconstructions of biological objects using simple facilities. AB - An analysis of serial sections is an important method applied in all fields of biology studying objects divided into sections, especially at light and electron microscopy levels. It affords a qualitative and quantitative information on spatial organization of tissues, cells and organelles. This study describes simple and cheap ways of obtaining computer-aided three-dimensional reconstructions of biological objects from serial sections. PMID- 2699293 TI - A suppressive mechanism counteracts the production of anti-idiotype antibody. AB - BALB/c mice were repeatedly, at two-week intervals, immunized with monoclonal antibody against hepatitis B surface antigen and their sera were titrated for anti-idiotype antibody. The highest titres appeared after 1-4 immunizations. Further immunizations led to fast disappearance of the anti-idiotype antibody. These data suggest that anti-idiotype antibody production is a rather complicated process in which some suppressive mechanism is involved. PMID- 2699294 TI - [Contributions to the knowledge of amebiasis through experimental studies in hamsters]. PMID- 2699295 TI - [The surgeon beyond the specialties]. PMID- 2699296 TI - [Transposition and transplant of epiploon to the brain and spinal cord. Experimental investigation. Current knowledge and perspectives for clinical application]. PMID- 2699297 TI - [Scientific journals in Mexico]. PMID- 2699298 TI - [Aplastic anemia]. PMID- 2699299 TI - [Foreign influences on Mexican medicine]. PMID- 2699301 TI - [The Medical Section of the Scientific Commission after 125 years. The origin of the current National Academy of Medicine. Its foreign founders]. PMID- 2699300 TI - [Thyroid hemiagenesis. Report of 3 cases and review of the literature]. AB - The absence of one lobe of the thyroid gland is named thyroid hemiagenesis, the left is affected more frequently (80 percent), in the 50 percent is associate with isthmus agenesis. Predominant in the women, with relation 3:1, the oppose lobe may be of big size and in the 38-47 percent have alteration in the function, of which the hyperthyroidism is more frequently. In 1896 Handfield-Jones reported the first case, having in this moment 118 cases in the world literature, we reported three more, one of which is the second associated with hyperparathyroidism and other is the third with hypothyroidism. The diagnosis was made with I-131 thyroid gammogram and neck echosonography that which evidence the hemiagenesis, and was not necessary to realize the thyroid gammagram with thyroid stimulation hormone. In different series of surgery, necropsis or by thyroid illness the frequency of thyroid hemiagenesis is estimate below 1 percent. PMID- 2699302 TI - [Women in the medical sciences]. PMID- 2699303 TI - [Current trends in medical training]. PMID- 2699304 TI - [Current concepts on cholesterol and its clinical importance]. PMID- 2699305 TI - [Growth of the child in relation to health status]. PMID- 2699306 TI - [Inflammation and anti-inflammatory treatment. A challenge of all times]. AB - It was not until a relatively short time ago, that inflammation was considered as a "defence" mechanism of the body. During the last century, Hunter pointed out that instead of being a disease, inflammation was a nonspecific reactive process of the body, which most of the times instead of making harm was beneficial. Now a days, the inflammatory response is recognized as a complex process of reactions, in which chemical mediators, enzymes, different cells and their substances take an important place in the body homeostasis. The increase of knowledge has been helping in the better understanding in the mechanisms and actions that these substances exerts, and through them, to be able to control inflammation and avoid irreversible damage. In the clinical practice the search for an effective and better tolerated anti-inflammatory must include several points: its pharmacokinetics, efficacy, doses, pharmaceutical presentation, tolerance, patient acceptance and cost. The relevance of knowledge of all the different pathways of inflammation in one hand, and the utility of different anti inflammatory drugs who can assure the efficacy in the inflammatory response on the other has been a challenge in the past, and still is a challenge of our era. PMID- 2699307 TI - [Epilepsy. Recent advances in the knowledge of its physiopathology]. PMID- 2699308 TI - In vitro culture of erythrocytic stages, including gametocytes of Plasmodium berghei (NK 65 strain) using candle jar method and a newly designed continuous medium flow apparatus. AB - Three methods have been described for cultivation of erythrocytic stages, specially gametocytes of P. berghei NK65 strain, (1) by using vial candle jar where the cultures were subcultured by addition of fresh erythrocytes, (2) a newly designed simple and compact continuous medium flow apparatus, where medium was continuously perfused but fresh erythrocytes were not added and (3) where the subcultures were also done using simple and compact continuous medium flow apparatus for comparison. The maximum percentage of parasitized erythrocytes obtained by these methods was 24.3, 27.1 and 26.4% respectively. Parasites in vials could survive for more than 10 days with 3 to 4 subcultures with maximum 1.96% gametocytaemia. However, the gametocytaemia in continuous medium flow apparatus, where subcultures were not made reached 2.2% compared to that of 2.7% in this apparatus where subcultures were done. The asexual as well as sexual stages of this parasite survived for about 16-18 days in compact continuous medium flow apparatus, where at least 7 subcultures were done. PMID- 2699309 TI - Impact of freeze drying on drug resistance pattern of few Escherichia coli strains. AB - Drug resistant strains of E. coli were freeze dried for long term preservation. Certain drug resistance markers were maintained after freeze drying while others were not. Streptomycin and sulphonamide resistance markers resisted freeze drying. Ampicillin, cephelaxin and neomycin resistances developed very frequently and except gentamicin all the markers were lost in varying percentage after freeze drying. PMID- 2699310 TI - Anti-idiotype antibodies: an alternative approach to tumor immunotherapy. AB - Studies presented in this paper examined the tumor-specific cellular and humoral immunity induced by anti-idiotype antibodies (Ab2s) 2F10 and 3A4. A panel of Ab2s was made against a monoclonal anti-L1210/GZL lymphoma, 11C1. The Ab2s were screened for their ability to block 11C1 binding to tumor, to induce tumor specific DTH and CTL responses and to induce an anti-tumor humoral response. Two Ab2s, 2F10 and 3A4, were found to have similar fine specificity and to induce similar cellular and humoral responses. These were then examined for their ability to elicit tumor-protective immunity. Only preimmunization with 2F10 Ab2 protected animals from live tumor challenge, and in this paper the possible causes of this difference in otherwise similar Ab2s is discussed. PMID- 2699311 TI - Measles in India: epidemiology and control. PMID- 2699312 TI - Allergen immunotherapy in allergic respiratory disease in childhood. PMID- 2699313 TI - Direct radionuclide cystogram (DRCG) and urine flowmetry (UFMT) in the evaluation of patients with vesicoureteral reflux (VUR) and/or associated obstructive or neurogenic pathology of the lower urinary tract. PMID- 2699314 TI - Spina bifida occulta: radiographic and operative correlation. AB - The clinical and myelographic evaluation in 24 children with spina bifida occulta has been correlated with the operative findings. Myelograms were done using Myodil in 11 patients and Metrizamide in 13 patients. The diagnostic quality of myelograms done with Metrizamide was comparatively better. Myodil myelography failed to demonstrate diastematomyelia in one case and a dural sac in 3 cases of lipomeningomyelocele, whereas, Metrizamide failed to demonstrate a sac in one case of lipomeningomyelocele only. Worsening of the neurological status was observed in only 3 cases in whom myelography was done with Myodil. The radiographic and operative correlation has been discussed. PMID- 2699315 TI - Acute cyproheptadine poisoning. PMID- 2699316 TI - Flavobacterium meningosepticum meningitis in a neonate. PMID- 2699317 TI - Mental retardation--a clinician's approach to the diagnosis of aminoacidopathies. PMID- 2699318 TI - Domperidone. PMID- 2699319 TI - Antenatal sonographic diagnosis of omphalocele. PMID- 2699320 TI - Prenatal diagnosis of duodenal atresia at 30 weeks. PMID- 2699321 TI - Susceptibility of clinical isolates to cephalosporins. PMID- 2699322 TI - Effects of long-term, moderate exercise on body composition and serum lipid profile: a controlled study in middle-aged Swiss men and women. PMID- 2699323 TI - Role of vitamin E as nitrite scavenger and N-nitrosamine inhibitor: a review. AB - This review covers the following three aspects: 1. In vivo and in vitro inhibition of N-Nitrosamine formation. 2. Inhibition of N-Nitrosamines in food model systems by vitamin E. 3. Synergistic influence of vitamin E and C, and vitamin E and selenium on N-Nitrosamine synthesis. Vitamin E is effective in preventing the nitrosation of amino substrates under physiological conditions. Both vitamins (E and C) together have a stronger inhibiting effect on the formation of N-Nitrosamine. Data of this review strongly suggest that alpha tocopherol, when ingested simultaneously with food, may reduce human exposure to carcinogenic N-Nitrosamine. PMID- 2699324 TI - The role of insulin in prenatal growth. PMID- 2699325 TI - Ontogeny of fetal adenylate cyclase; mechanisms for regulation of beta-adrenergic receptors. AB - Transmembrane second messenger signalling systems regulate differentiation, growth and homeostatic responses during fetal development. The beta-adrenergic adenylate cyclase system is the best studied of these and has been used as a model to investigate the control of developmental processes. In tissues such as lung, heart and parotid, beta-adrenergic responsiveness of adenylate cyclase increases during development. In the developing fetal lung beta-receptor concentration increases during gestation or after glucocorticoid treatment, but cannot fully explain enhanced adrenergic responsiveness. To probe developmental and hormonal effects on beta-receptor function, we asked if advancing gestation or glucocorticoid treatment alters beta-receptor-Gs interactions in fetal rabbit lung membrane particulates. Before 25 days gestation, 1-isoproterenol competes for 3H-dihydroalprenolol (DHA), a radiolabelled beta-antagonist, with a single low affinity, later in gestation, high and low affinities of isoproterenol for the beta-receptor are present which can be shifted to the lower affinity by addition of guanyl nucleotide. High affinity binding is precociously induced in 25 days--fetal lung particulates as early as 3 h after maternal betamethasone treatment, but beta-adrenoreceptor concentration in treated fetuses was increased over controls only after 24 h of treatment. Cholera toxin catalyzed ADP ribosylation of membrane particulates showed cholera toxin substrate (Gs) was not altered by glucocorticoid treatment. Stimulation of adenylate cyclase activity with isoproterenol (100mM) and GTP (100mM) resulted in no incremental increase over that produced by GTP (100mM) alone in glucocorticoid treated or control particulates, either early or late in gestation. These data demonstrate that beta receptor-Gs interactions are not sufficient to produce full agonist responses. Although both beta-adrenergic receptors and Gs are present in fetal rabbit lung early in gestation, interaction of these two adenylate cyclase components appears subsequently. This developmental event can be rapidly induced by maternal betamethasone treatment. PMID- 2699326 TI - Rise in intracellular pH is concurrent with 'start' progression of Saccharomyces cerevisiae. AB - Intracellular pH (pHi) was determined during arrest and recovery of temperature sensitive-cell division cycle mutants of Saccharomyces cerevisiae. In all mutants, pHi decreased during arrest; but when the mutants were released from arrest a rapid increase in pHi ensued in only cdc28- and cdc37-arrested cells. Both of these mutations cause arrest at 'start', the sole regulatory point in the S. cerevisiae cell cycle. In cells with cdc4 or cdc7 mutations, which arrest past start, pHi remained constant and exhibited a decrease, respectively, upon recovery of growth. The activity of plasma membrane ATPase decreased during the first 30 min of recovery of cdc28-arrested cells, concomitant with the rise in pHi. During the same period, there was no significant change in activity in cdc4 bearing cells, whereas an increase was observed for cdc7-bearing cells. Increase in pHi may be used as a specific signal by S. cerevisiae for start traversal and commitment to a new cycle. PMID- 2699327 TI - In vitro adherence of Candida albicans strains to murine gastrointestinal mucosal cells and explants and the role of environmental pH. AB - Two in vitro adherence assays involving isolated mucosal cells or mucosal explants were used to study the adherence of five Candida albicans strains to murine gastrointestinal mucosal surfaces. Adherence was found to be dependent on the strain used, and on the cellular arrangement, as well as the site of origin of the mucosal surface. Adherence of strains NCPF 3436 and 3310 to stomach and jejunal surfaces was affected by the pH of the medium. Binding between the C. albicans strains and stomach mucosal cells fluctuated as the pH was raised from pH 1.2 to pH 3.4. However, adherence increased with a rise in pH when the strains were incubated with stomach mucosal explants. Optimal adherence by both strains to jejunal mucosal surfaces occurred at neutral pH. PMID- 2699328 TI - Leaky pantothenate and thiamin mutations of Salmonella typhimurium conferring suphometuron methyl sensitivity. AB - The herbicide suphometuron methyl inhibits the utilization of pyruvate and 2 ketobutyrate by the branched-chain amino acid biosynthetic enzyme acetolactate synthase. Eighteen insertions of the transposon Tn10 into the genome of Salmonella typhimurium LT2 caused hypersensitivity to this herbicide. Five of these insertions conferred a partial auxotrophic requirement. Concurrent herbicide sensitivity and heat-labile pantothenate auxotrophy was due to panD::Tn10 mutations, while coincident sulphometuron methyl sensitivity and thiamin auxotrophy was attributable to thiA::Tn10 mutations. The phenotypes of these mutations suggested that coenzyme A and thiamin pyrophosphate availability modulated the cells' response to sulphometuron methyl. A model suggesting a key role for 2-ketobutyrate accumulation in herbicide action is supported by the function of thiamin pyrophosphate in 2-ketoacid metabolism and the known role of a 2-ketoacid in coenzyme A synthesis. PMID- 2699329 TI - Comparative antigenic analysis of Treponema pallidum laboratory and street strains. AB - The polypeptide and antigenic profiles of Treponema pallidum Nichols strain and two other more recently isolated 'street' strains of T. pallidum have been compared. PAGE and immunoblotting identified a 34.5 kDa polypeptide present in the Nichols strain which was absent from one of the other street strains. This polypeptide was shown to be associated with the axial filament in T. pallidum. Three other axial-filament-associated polypeptides of 37, 33 and 30 kDa were present in all strains examined. Axial filaments of all three strains were morphologically identical and all three strains were equally motile. PMID- 2699330 TI - Role of antibodies against outer-membrane proteins in murine resistance to infection with encapsulated Klebsiella pneumoniae. AB - In the assessment of immunity to the encapsulated virulent strain of Klebsiella pneumoniae and its avirulent mutant defective for capsular polysaccharide (CPS), killed bacterial vaccine of both strains could protect mice equally against challenge with 100 x LD50 of encapsulated wild strain. Antisera to each strain conferred the same level of protection on naive mice upon transfer; the protective anti-mutant serum was highly capable of opsonizing the encapsulated bacteria. In addition to the common antigenic components shared by both strains, the wild strain had antigen(s) unrelated to the mutant since the protective capacity of the anti-wild serum was not affected by preabsorption with the mutant strain; the protection conferred by the anti-mutant serum was mediated by antibodies against non-capsular antigens since the antiserum did not contain antibodies against purified CPS detectable by ELISA. As possible candidates among the non-capsular antigens, outer-membrane proteins (OMPs) extracted from the mutant strain were examined for their immunogenicity. Immunoblotting of the protein-containing fraction and ELISA using LPS-free OMP suggested that a number of proteins were involved in the immune response evoked by K. pneumoniae. Furthermore, mice immunized with OMP or anti-OMP serum could overcome a lethal challenge with the wild strain. These results indicated that OMPs of K. pneumoniae are implicated as the protective antigens and may pave the way for the development of non-capsular, proteinaceous vaccines. PMID- 2699331 TI - Putative role of a 70 kDa outer-surface protein in promoting cell-surface hydrophobicity of Serratia marcescens RZ. AB - Serratia marcescens RZ has been previously shown to possess pronounced cell surface hydrophobicity, as evidenced by its affinity for hydrocarbons and polystyrene. The present report suggests the involvement of a 70 kDa protein, serraphobin, in this phenomenon. The 70 kDa protein was recovered from both the cell surface and culture supernatant of hydrophobic wild-type cells, but was either totally absent or present in minor quantities in hydrophobicity-deficient mutants. Similarly, loss of hydrophobicity of RZ cells following growth at 39 degrees C was accompanied by loss of the protein. Serraphobin was capable of binding to hexadecane droplets following a brief mixing procedure, and could be desorbed by solidifying and melting the hexadecane phase. PMID- 2699332 TI - Comparison of Vero-cytotoxin-encoding phages from Escherichia coli of human and bovine origin. AB - Phages encoding production of Vero cytotoxins VT1 or VT2 were isolated from strains of Escherichia coli of human and bovine origin. Two human strains of serotype O157: H7 produced both VT1 and VT2 and each carried two separate phages encoding either VT1 or VT2. The phages were morphologically similar to each other and to a VT2 phage previously isolated from a strain of serotype O157: H-; all had regular hexagonal heads and short tails. The phages had similar genome sizes and DNA hybridization and restriction enzyme digestion showed that the DNAs were very closely related. This contrasts with another report that one of the strains tested (933) released two clearly distinguishable phages separately encoding VT1 and VT2. The O157 phages differed from a VT1 phage isolated from a bovine E. coli strain belonging to serotype O26: H11 and from the reference VT1 phage isolated previously from a human strain, H19, of serotype O26: H11. The two O26 phages were morphologically similar with elongated heads and long tails. They had similar genome sizes and DNA hybridization indicated a high level of homology between them. Hybridization of an O157 phage DNA probe to DNA of the O26 phages, and vice versa, showed there was some cross-hybridization between the two types of phage. A phage from a bovine strain of serotype O29: H34 had a regular hexagonal head and short tail resembling those of the O157 phages. The DNA was distinguishable from that of all the other phages tested in restriction digest patterns but hybridized significantly to that of an O157 phage. Hybridization of the phage genomes with VT1 and VT2 gene probes showed that sequences encoding these toxins were highly conserved in the different phages from strains belonging to the three serogroups. PMID- 2699333 TI - Effects of vaccination against systemic Serratia infection. AB - Host defense against Serratia marcescens in experimental infection in mice was enhanced by vaccination with formalin-killed bacteria of the same strain. The enhancement appeared within 24 hr after vaccination, reached a peak seven days later and lasted four weeks. The enhanced resistance to Serratia infection was also observed in the early phase (within seven days) after vaccination with killed Escherichia coli or other Gram-negative strains, but the efficacy on Day 7 was inferior to that with killed S. marcescens. Phagocytic activities of both circulating neutrophils and peritoneal macrophages were measured by the chemiluminescence (CL) response, and the activity of tissue macrophages was evaluated by the carbon clearance test. The activities were significantly elevated in the early phase, that is, within two or three days for neutrophils, seven days for peritoneal macrophages and at least 14 days for tissue macrophages, after vaccination with killed Gram-negative bacteria. These results suggest that the enhancement of host defense in the early phase is dependent on phagocytic functions that are non-specifically activated by dead bacteria. In the late phase after vaccination, specific immunity might have been involved in the defense mechanism. However, transfer of high titer specific antiserum, in itself, did not render mice resistant to Serratia infection. PMID- 2699334 TI - Some economic aspects of the demand for health services. AB - The first section of the paper discusses some of the basic concepts that economists utilize when considering the demand for goods and services. These concepts are then applied in the development of alternative models of the demand for health and medical care services. Following the theoretical discussion, attention is focused on the empirical problems associated with estimating the demand for health and medical care. Such issues as the effect of health status on the demand for health services and the impact of provider influence on utilization are considered. A review of empirical research indicates that health service demand is inelastic with respect to price and income. The elasticity of the time price of health care (the price of waiting time and travel time) is low in an absolute sense but clearly important. Other research findings are also discussed. The demand for health insurance and its role is an overall health demand model is also considered. Among other things, health insurance both reduces the net price of medical care and stimulates additional demand for services. PMID- 2699335 TI - [An elderly case of Crohn's disease complicated with internal fistula and mass formation with a review of the Japanese literature]. AB - A case of Crohn's disease in the elderly complicated with internal fistula and mass formation was reported. A 62-year-old woman was admitted to National Toyohashi Hospital on August 16, 1986, with complaints of abdominal pain, pyrexia and diarrhea for two months. Physical examination revealed a goose-egg sized mass in the left lower quadrant of the abdomen. Barium meal examination of the small intestine showed strictures and fistula formation of the jejunum. Angiography showed narrowing and irregularity of the vessels. Malignant tumor of the small intestine could not be ruled out, so that an exploratory laparotomy was done on October 14, 1986. At operation, the jejunum, 70 cm from the ligament of Treitz, formed a 5 x 7 cm mass with adhesion and fistula formation. There was a skip lesion at the terminal ileum. Forty cm of the jejunum and 60 cm of the ileum were resected, and both of the resected specimens showed longitudinal ulceration, cobblestone appearance and thickening of the wall. Histological examination showed noncaseating granulomas with epitheliod cells and giant cells in the tunica muscularis. Since the report by Komi et al. in 1970, 13 cases of Crohn's disease in the elderly have been reported in Japan up to 1988. We summarized the characteristic findings of Crohn's disease in the elderly in Japan as follows; 1) Clinical symptoms and radiographic findings were similar to those in younger patients. 2) Small bowel involvement was reported in 54%. 3) Surgery was performed in 46%. 4) Preoperative diagnosis was only made in 46% of the elderly patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699336 TI - A case of mixed gonadal dysgenesis (MGD)--with a review of MGD patients reported in Japan. AB - A 17-year-old patient with mixed gonadal dysgenesis (MGD) showing ambiguous genitalia and hypergonadotropic hypogonadism was described. By intraabdominal exploration, a poorly developed uterus with a fallopian tube and a streak gonad was found on the right side and a poorly developed testis with epidydimis and vas deferens on the left. Chromosomal analysis on cultured peripheral lymphocytes and bone marrow cells showed 45,X karyotype, while among the majority of 45,X cells small numbers of 46,X+ mar cells (3-23%) were found in cultured fibroblasts from the abdominal skin and various organ tissues. We compared our patient with the Japanese patients with MGD reported in the literatures. PMID- 2699337 TI - Adult xanthogranulomatous intracranial lesion involving familial hypercholesterolemia. AB - A 35-year-old man was admitted because of loss of hearing in the left ear. The patient had been known to have familial hypercholesterolemia for at least 12 years. Computerized axial tomography of the brain showed a large tumor occupying in the left mastoid region. Surgical intervention revealed xanthogranuloma, histologically. Xanthogranuloma is classified as a kind of normocholesterolemic xanthomatoses. Hypercholesterolemia with adult xanthogranuloma (AXG) is extremely rare. Moreover intracranial involvement with AXG has been reported in only one previous case. We wish to report on the possibility of a new syndrome that has characteristics common to primary xanthomatoses, entities which have heretofore been considered etiologically distinct. PMID- 2699338 TI - Neuropeptides--introduction. PMID- 2699339 TI - [Evaluation of the effect of nifedipine in patients with chronic congestive heart failure]. AB - 18 patients with II NYHA class chronic congestive heart failure (CCHF) had been given nifedipine (Cordipin) 54.4 +/- 12.0 mg (day) for 6 weeks (group I). In 25 patients with III--IV NYHA class CCHF after 2-week optimal improvement of a clinical state with digoxine (D) and furosemide (F), nifedipine (N) had been added for 2 weeks/mean daily dose -- 40.8 +/- 12.8 mg (group II). Estimation of a left ventricular function using 2-DE and a submaximal effort tolerance as well as clinical examinations were carried out initially, after 2 and 6 weeks in group I, whereas in group II post D, F 2-week therapy and after next 2 weeks of combined D, F, N treatment. Nifedipine significantly increased ejection fraction from 44.2 +/- 13.0% to 49.0 +/- +/- 12.6% and decreased myocardial oxygen demand factor from 23.36 +/- 9.81 to 21.08 +/- 7.55 X 10(3) (p less than 0.05). Nonsignificant but marked increase of diuresis, cardiac and stroke indices as well as body weight loss were observed. Nifedipine addition to D and F neither improved nor deteriorated examined parameters in patients with III-IV NYHA class CCHF. Nifedipine did not also improve the submaximal exercise tolerance in both groups. PMID- 2699340 TI - [Creating models of the development of a computer-assisted system of cardiovascular services]. AB - In the paper computer aided method is described which can be applied for scenario generation of the health care system for cardiovascular diseases treatment. The real life system is represented in the form of patient flows in the network of diagnostic and therapeutic medical services. The adequate computer system with certain requirements for input data is then prepared. The alternative projections can be automatically calculated and evaluated by the expert teams for scenario generation. Selected preliminary scenarios obtained for ischemic heart disease are presented. PMID- 2699341 TI - A fractal model of chromosomes and chromosomal DNA replication. AB - With the aim of clarifying topological problems involved in the process of chromosomal DNA replication, a fractal model of chromosomes was built based on the assumption that a part of a chromosome, e.g. a radial loop, is similar in shape to a whole chromosome and each radial loop represents structures in the lower-order organization (an assumption of self-similarity). Several other assumptions used include (i) one continuous DNA fiber makes a whole chromosome (a unineme hypothesis), (ii) in situ DNA exists in the form of a double duplex or a tetraplex which is made of two duplex DNAs, although a duplex DNA may appear transiently in S-phase (multi-strandedness hypothesis) and (iii) torsional stress on a DNA fiber causes the fiber to supercoil and thus stabilizes chromosome structure (torque-based stabilization). This model allowed to calculate of a fractal dimension of a representative metaphase chromosome (e.g. d = 2.34), to predict the mode of replication of double duplex and to furnish a topological basis for the decondensation unit hypothesis. It must also be admitted that all the arguments in this report except for the possible existence of split telomeres hold true without assuming a tetraplex organization of chromosomes. Implications of this model was discussed and the importance of the fractal dimension as a measure of chromatin condensation stressed. PMID- 2699342 TI - Decidual ectopy on the uterine cervix. The diagnostic and clinical considerations. AB - On the basis of our clinical experience and literary data there were presented views on etiopathogeny of decidual transformations of the uterine cervix. Localization and colposcopic pictures of these lesions were discussed, and according to our clinical data discrimination between four forms of decidual ectopy was carried out. The vessel pattern of these changes, visible in colposcopic picture was characterized as well as its differentiation from vascular picture of malignant lesions. Possibility of cytological diagnosis in cases of decidual ectopy was also noted. On the basis of many years clinical experience there was showed the importance of colposcopic diagnosis of decidual ectopy in evaluation of early pregnancy and its complications. PMID- 2699343 TI - Flow cytometry in clinical oncology: cell cycle and DNA ploidy in assessing tumor behavior. AB - The basic principles of flow cytometry with special emphasis to cell cycle analysis and DNA ploidy measurements are described. The concept of separation of various subcompartments of cell cycle, distinguished by simultaneous determinations of DNA versus RNA and DNA versus protein contents is presented. Based on DNA ploidy patterns, human tumors were divided into two groups designated as diploid range and non-diploid (aneuploid). Since it has been proposed that diploid range tumors have generally better prognoses than non diploid tumors, the value of DNA ploidy patterns as a prognostic factor is discussed in major groups of human cancers. PMID- 2699344 TI - Serum pancreatic polypeptide and glucagon immunoreactivity in fasting healthy and diabetic children. AB - Serum pancreatic polypeptide (hPP) concentrations ranged in normal children from 45 pg/ml to 525 pg/ml with mean value at 185 +/- 49 pg/ml. Both hPP and glucagon immunoreactivity (IRG) levels showed age-dependent decrease during childhood. In diabetic children plasma IRG concentrations were significantly increased in comparison with the healthy subjects while hPP concentrations were only slightly elevated. The age dependence of the hormones levels was completely effaced in diabetics. No significant serum hPP norm IRG values dependence on the duration of diabetes was found. IRG/hPP relations correlated with age in healthy children despite those in diabetic ones. PMID- 2699345 TI - Current concepts on myocardial depressant factor. AB - In the present work the authors have tried to offer a vast and detailed summary of theories and questions concerning the role of the MDF in shock. One of the major problems that surrounds this molecule is the myocardial contractility depression, the solution of which could allow a more rationalistic therapeutic approach to that which remains one of the most complex and delicate clinical framework. PMID- 2699346 TI - Doctor Janusz Korczak (1878-1942)--a physician, educator, fervent protector of children. PMID- 2699347 TI - Apothecaries in the Royal Service. Part I. PMID- 2699348 TI - Privileged apothecaries of the first Poland. Servitors. Part II. PMID- 2699349 TI - [Treatment of mycobacteriosis]. AB - At present the increased incidence of infections with mycobacteria other than tuberculosis and leprae bacilli seems to be correlated with several causes: improved diagnostic techniques, prolonged life expectancy, immunodepression. Rational chemotherapy depends upon the identification of the etiologic mycobacterium and the determination of its drug susceptibility. Besides the "classic" treatment with 3 or 4 antituberculous and, sometimes, nonantituberculous chemotherapics, clinical trials are in progress to assess the effectiveness of new molecules: rifamycin derivatives, fluorinated quinolones, anti-lepromatous drugs, and the latest macrolides. Yet at present, national and international data do not permit to define a standard treatment for every mycobacteriosis; in fact, the drug resistance is high and varies not only between different strains but also within the same strain; moreover, there are discrepancies between in vitro and in vivo results. When possible, appropriated surgery for circumscribed disease is recommended. PMID- 2699351 TI - [Diagnosis and treatment of chronic constipation]. AB - Constipation is a symptom caused by several different pathogenetic mechanisms; it may be secondary to other diseases or be in itself a disease. All patients should perform investigations deemed to exclude or identify known causes of constipation and, in the presence of megarectum, anorectal manometry to detect ultrashort Hirschsprung's disease. In idiopathic constipation, diagnostic work up should attempt to identify alterations of defecation, with defecography, and of colonic propulsion, with gastrointestinal transit time measurement. Evaluation of large bowel segmental transit time, using radiopaque corpuscolate markers, may discriminate patients according to different modalities of transit. Based on a correct diagnostic evaluation the therapeutical approach can be finalized to well defined subgroups of patients. The treatment comprises several types of therapy which may be used alone or in association in the individual patient: bowel training, high residue diets, physiotherapy, bio-feedback, pharmacological therapy, psychiatric therapy, surgery. PMID- 2699350 TI - [Isolated systolic hypertension in the elderly]. AB - Isolated systolic hypertension (ISH) is a very common condition in the elderly, even more than diastolic hypertension. Several studies indicate that ISH is a considerable cardiovascular risk factor in the elderly but the benefit of antihypertensive treatment has not been proved. Data in the literature on prevalence, pathophysiology, prognostic meaning and treatment of ISH are critically reviewed. PMID- 2699352 TI - [Nephrology]. AB - Advances in biomedical technology have contributed effectively to the resolution of basic and clinical problems in Nephrology. Most of our insights on glomerular diseases come from animal models. Antibodies against components of the extracellular matrix have been shown to induce glomerular changes in vivo and the non-collagenous NC1 domain of type IV collagen has been demonstrated to contain the Goodpasture antigen. New pathogenetic mechanisms of glomerular injury are suggested by studies on the interaction of antibodies with glomerular cell surface antigens. Gp330, a glycoprotein expressed at the surface of glomerular visceral epithelial cells, has been recognized to be the most relevant antigen of Heymann nephritis. Antibodies able to crosslink gp330 bind to the antigen at the base of foot processes and the resulting immune complexes are shed into the subepithelial space where they form electron dense deposits. The complement membrane attack complex (C5b-9) is likely to be directly responsible for epithelial cell injury and proteinuria in this model. Other cell surface antigens of the glomerular capillary wall, such as dipeptidyl dipeptidase IV, podocalyxin, podoendin, have been characterized. A novel model of glomerular injury comes from the demonstration that a non-complement fixing monoclonal antibody to a surface sialo-glycoprotein (SGP-115/107) binds to glomerular visceral epithelial cells and causes morphological changes which appear epitope-specific and complement and leukocyte-independent. The mechanisms responsible for the progression of renal disease to glomerular sclerosis have been extensively explored in the last years. Among the hemodynamic factors intraglomerular hypertension has been established to play an important part, at least in some models.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699353 TI - Microvascular effects of endothelin-1. AB - In the present study we examined the microvascular actions of endothelin (ET-1) in rat cremaster arterioles. Pentobarbital (35 mg/kg) anesthetized, five to six week old rats were prepared for in vivo observation and measurement of microvascular control dimensions and changes in diameter, in response to the topical administration of ET-1 (1 x 10(-11) to 5 x 10(-10) M). The effects of ET 1 were determined before and after the administration, by suffusion upon the cremaster muscle, of either indomethacin (IND, 10 micrograms/ml) or methylene blue (MB, 5 microM). Third order arterioles; 13-25 microns in diameter, were selected for study. The administration of ET-1 evoked a biphasic response of cremaster arterioles, an initial small, fleeting increase in diameter (14 to 26%) followed by a dose-dependent, longer lasting decrease in diameter (20 to 77%). The administration of either MB or IND had no effect on the arteriolar dilator and constrictor responses to ET-1. These results suggest that ET-1 is more potent a constrictor than dilator agent in this vascular bed and that the dilator component of the response is not mediated by either prostaglandins or EDRF. By virtue of its actions and potency, we conclude that ET may be an important factor in the regulation of vascular tone and local blood flow. PMID- 2699354 TI - Apomorphine-induced alterations in cortical EEG activity of rats. Involvement of D-1 and D-2 dopamine receptors. AB - EEG activity after activation of dopamine receptors of D-1 and/or D-2 type was studied by using telemetric recordings in rats. Apomorphine, a preferential D-2 agonist, produced a characteristic increase in the power of alpha-1 band (7.00 9.50 Hz) when given in doses mediating stereotypies (0.2 or 0.5 mg/kg s.c.). Low doses produced a general increase in the power of all of the bands except beta-2. In particular, delta activity was enhanced which seems to be in correspondence with the sedation observed after these doses (0.02 and 0.05 mg/kg). Haloperidol in a dose which is assumed to block both D-1 and D-2 receptors (0.1 mg/kg i.p.) completely antagonized the alpha-1 activation produced by apomorphine (0.5 mg/kg). A similar, although not complete inhibition of alpha-1 activation was found after administration of a large dose of the selective D-1 antagonist SCH 23390 (0.2 mg/kg i.p.). The selective agonist at D-2 receptors quinpirole (1.0 mg/kg s.c.) produced a less pronounced activation of the power in the alpha-1 band than apomorphine. In general, there was found to be a good correlation between the activation of the alpha-1 activity and stereotyped behaviour. The results suggest that for the full expression of alpha-1 activation, a pronounced activation of D-2 receptors and at least a minimal activation of D-1 receptors, for instance by the endogenous dopamine, is necessary. PMID- 2699355 TI - Influence of capsaicin-induced denervation on neurogenic and humoral control of arterial pressure. AB - (1) The influence of capsaicin-sensitive afferent neurones on the regulation of blood pressure by reflex noradrenergic responses and by activation of the renin angiotensin system was investigated in the rat anaesthetized with pentobarbital. (2) Lowering the pressure in the carotid sinus through unilateral carotid occlusion caused a reflex rise in mean systemic blood pressure which was less marked in capsaicin-pretreated rats than in controls, although an equal drop in mean pressure in the carotid sinus region was observed in both groups. Occlusion of the second carotid artery caused an additional increase in mean systemic blood pressure which was identical in the two groups. (3) Pharmacological blockade of the renin-angiotensin-system with captopril induced a more pronounced hypotonia in capsaicin-pretreated than in control rats. Yet, this difference was based on the impaired noradrenergic counterregulation in capsaicin-pretreated rats, because both groups showed identical responses to captopril following guanethidine-induced adrenergic blockade. (4) Plasma renin activity was increased by a factor of 2 following guanethidine treatment of awake animals. It reached levels 5-7 times higher than those observed in awake animals during pentobarbital anaesthesia. This anaesthesia-induced increase in plasma renin activity was not altered by guanethidine pretreatment. There was no difference in plasma renin activity between controls and capsaicin-pretreated rats under all the conditions tested. (5) These results show that the immediate reflex adjustment of blood pressure is impaired in the capsaicin-pretreated rat, possibly because of an impairment of sensors for low perfusion pressure in the carotid sinus. On the other hand, the renin-angiotension-system remains unimpaired after neonatal capsaicin-pretreatment. PMID- 2699356 TI - Effects of endothelin on the cardiovascular system and on smooth muscle preparations in different species. AB - (1) The actions of porcine endothelin (ET), an endothelium-derived vasoconstrictor peptide, have been investigated in several in vitro smooth and cardiac muscle preparation as well as on the blood pressure of anaesthetized rats and rabbits. (2) In isolated visceral smooth muscles (guinea pig ileum, rat colon and uterus, rabbit jejunum) ET caused a long-lasting contraction which persisted after repeated rinsing. ET did not interfere with the spontaneous phasic activity of the rabbit jejunum or with contractions evoked by histamine or carbachol. (3) ET contracted isolated blood vessels (portal vein of guinea-pig and rat). In isolated perfused organs (rabbit ear, guinea-pig lung, rat mesentery and hindpaw) ET led to a long-lasting vasoconstriction. In the isolated perfused guinea-pig lung ET caused vaso- and bronchoconstriction. (4) ET produced a long-lasting positive inotropic effect in spontaneously beating isolated guinea-pig atria. The positive inotropic action of strophanthin was augmented in the presence of ET. (5) In the isolated perfused guinea-pig and rat hearts the prominent effect of ET was a long-lasting coronary vasoconstriction. (6) Pithed rats responded to i.v. injection of ET with a long-lasting increase in blood pressure. In pentobarbitone anaesthetized rats pretreated either with atropine, with guanethidine plus atropine, or with guanethidine plus atropine plus indomethacin, the long-lasting increase in blood pressure was smaller than in pithed rats whereas the initial short-lasting decrease in blood pressure was more pronounced; in pentobarbitone anaesthetized rabbits endothelin caused bronchoconstriction, a decrease in blood pressure and a pronounced increase in central venous pressure possibly resulting from pulmonary or coronary artery constriction or a combination of both effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699357 TI - [Measurement of blood flow of the portal system in liver cirrhosis using the Doppler method]. AB - Portal and splenchnic blood flow was studied in a group of 31 patients with hepatic cirrhosis and splenic veins. The authors used Acuson 128 with sector head 3,5 MHz enabling a simultaneous Doppler examination by means of impulse wave. A control group consisted of 50 healthy volunteers. Two patients had regressive flux in the portal vein, one patient had a reflux in the splenic vein. It was found that portal blood flow was significantly lower in the group examined than in the control group, and the splenic one was significantly higher. The sensitivity and specificity of the method of measuring the blood flow in the portal vein was 80%, and 88.2% respectively. 67.7% of patients had a different shape of the Doppler spectrum in the portal vein. That spectrum did not show the normally seen waves due to the heart beats. The authors' examinations show that the measurement of blood flow in the portal and splenic veins by means of the method using Doppler phenomenon provides valuable information on the haemodynamics of the portal system. PMID- 2699358 TI - [Clinical significance of false tendons of the heart]. PMID- 2699359 TI - Essential fatty acids and the skin. PMID- 2699360 TI - Hormonal correlates of sexual behavior and ovulation in male-induced and postpartum estrus in female prairie voles. AB - The purpose of the present study was a description of hormonal profiles in female prairie voles (Microtus ochrogaster) in estrus that was induced by male exposure versus postpartum estrus. Hormonal profiles are reported in sexually naive females and in sexually experienced females, as a function of varying amounts of coital stimulation and as a function of time since male exposure. Ovarian estradiol levels, uterine weights and uterine protein levels increased in virgin females after exposure to a male, were highest in females that showed lordosis, declined slowly when estrous females were isolated from males and decreased sharply following mating. Ovarian progesterone levels increased more rapidly following mating in females in male-induced estrus than in females in postpartum estrus. Serum progesterone levels did not increase significantly within 24 hr following mating, but were elevated by 72 hr after mating. These findings are discussed as they relate to the hormonal control of female sexual behavior. PMID- 2699361 TI - Mechanoelectrical transduction by hair cells of the bullfrog's sacculus. AB - Hair cells of the internal ear respond to excitatory mechanical stimulation of their hair bundles by the rapid opening of poorly cation-selective transduction channels. These channels, which are located near the bundles' tips, may be gated by forces applied through elastic linkages between adjacent stereocilia. PMID- 2699362 TI - Afferents and efferents of the vestibular nuclei: the necessity of context specific interpretation. AB - A synopsis of physiological and anatomical results is presented that leads to the conclusion that experimental data have to be interpreted in a context meaningful for the system investigated. For example, since there is an obvious spatial relationship between semicircular canals and extraocular muscles, the interdependence between the three-neurone-arc circuitry, and vestibular and visual signals follows quite naturally from a common geometry inherent in the sensory and motor periphery. It is emphasized that signals related to compensatory eye movements have to be interpreted within a vestibular/eye muscle frame of reference. By the same argument, when dealing with the head-neck movement system, the appropriate reference frame will have to be applied to arrive at a meaningful interpretation of related sensorimotor functions. Thus, in general terms, each system has to be interpreted within its own meaningful biological context. PMID- 2699363 TI - How visual inputs to the ponto-bulbar reticular formation are used in the synthesis of premotor signals during orienting. AB - The primate superior colliculus (SC) is known as a structure subserving the transformation of visual information into "commands" for orienting eye movements. Collicular burst neurons discharging with short lead times in relation to visually triggered or spontaneous saccades are supposed to be the output elements linking the SC to immediately premotor pattern generators. In this paper we summarize some data available for the cat's SC neurones, identified as tecto reticulo-spinal projection cells (TRSN), and reticulospinal neurones (RSN), identified as receiving excitatory collicular input. Some TRSNs respond to visual stimuli in the absence of orienting movements and, hence, their signals cannot be regarded as motor "commands", in spite of their proven connections with premotor pools in the brain stem and with the spinal cord. Moreover, a small fraction of RSNs belonging to polysynaptic descending collicular pathways also displays visual responses dissociated from movement, in addition to discharges related to the performance of orienting eye-head synergies. The processes of visual to motor transformation, assumed by current models as being definitively accomplished in the SC, appear thus to be partially performed in the reticular network incorporating the overlapping collaterals of tectal projection cells and their target neurons in the reticular core. It is concluded that, at least as for visuomotor transformations underlying orienting movements in the cat, the deep division of the SC and the brain stem reticular formation represent an ensemble, rather than a sequence of hierarchically arranged levels of processing. PMID- 2699364 TI - Open-loop and closed-loop optokinetic nystagmus in squirrel monkeys (Saimiri sciureus) and in man. AB - Horizontal optokinetic nystagmus (OKN) was measured in 3 normal Squirrel monkeys by means of the electromagnetic search coil technique. Binocular and monocular stimulation of each eye to the left and right by moving vertical stripe patterns of 2.37 or 15 degree period were applied at angular velocities of 0.5 to 400 deg/s. After measurement of horizontal OKN under normal conditions, open-loop OKN gain was determined by monocular stimulation of an eyeball immobilized by means of retrobulbar injections of 11 units botulinum toxin (BoTx type A) and compared with the pre-injection data or with monocular stimulation of the other eye, which remained mobile. In normal Squirrel monkeys gain of optokinetic nystagmus reached values between 0.8 and 0.97 at angular velocities below 1.5 deg/s. Gain under these conditions was related to stimulus angular velocities Vs, i.e. Ge = Ve/Vs. A slightly higher gain was found for binocular than for monocular stimulation. No significant differences were found in OKN when monocular stimulation in the naso temporal and in the temporo-nasal direction was applied. The upper cut-off angular velocity (-3 dB-point) reached values of 180-230 deg/s, significantly above those observed in man under similar stimulus conditions. Monocular optokinetic stimulation of an immobilized eye led to vigorous optokinetic nystagmus and OKAN of the other eye, whereby maximum gain (Gi = Ve/Vr) was found to be between 20 and 30 at lower retinal stimulus velocities (2-5 deg/s). Gain was related to retinal stimulus velocity Vr. Increase in Vr above 10 deg/s led to a decrease in gain with a slope of about 20 dB per decade. Measurement of gain of closed-loop OKN related to retinal stimulus velocity Vr (which was determined by the difference between Vs and Ve) led to a similar dependence of OKN as in closed loop stimulus conditions. Differences in sensitivity between the temporal and the nasal visual hemifield stimulation evoking horizontal open-loop OKN are described. Directional selectivity appeared in these experiments. Open-loop OKN data from a human subject are reported. With highly attentive horizontal optokinetic gaze nystagmus, Ve depended on the duration of the pursuit phases of OKN. Ve accelerated with the duration of the individual slow phase of OKN and was reset by each backward saccade (of the covered mobile eye). OKN gain was considerably smaller when the subject intentionally pursued as many stripes as possible of the 1.15 degree period stripe pattern (gain related to Vr about 1.5 3).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699365 TI - The vestibulo-ocular reflex: an outdated concept? AB - Traditionally, the vestibulo-ocular reflex (VOR) is described as a distinct, phylogenetically old oculomotor subsystem, which serves to stabilize gaze direction. It is supposed to act as a stereotyped reflex with definite input output relations, which can be measured by rotating a subject passively in darkness, and which are kept at an ideal level by adaptive, parametric adjustments. This paper argues that such a view is not realistic: (1) the VOR in darkness does not have an ideal, or even well defined, gain; (2) a fixed, automatic VOR is not appropriate in most behavioural situations, and would need continuous conditioning by other subsystems. As there is no compelling phylogenetic, physiological or anatomical evidence for an independent VOR subsystem, a more fruitful hypothesis may be that vestibular signals are just one of many inputs to a spatial localization process, which computes the relative position (and motion) between the subject and a target of his choice. The VOR in darkness may represent no more than a default operation, based on incomplete information, of this larger, multiple input gaze control system. Likewise, adaptation phenomena of the VOR in darkness may be merely an epiphenomenon of adaptation of gaze control with vision active. PMID- 2699366 TI - Possible functions of transmitter-controlled plateau potentials in alpha motoneurones. AB - An increasing number of vertebrate central neurones has been shown to possess complex membrane properties. However, the functional significance of such properties is unclear. The aim of the present paper is to review some old and new findings in this field from this laboratory. First, a bistability in alpha motoneurones in reduced preparations is described. Thereafter we present some new data on a bistable behaviour in motor units in unrestrained intact animals during posture. Finally, the possible role of motoneuronal bistability in locomotion and in spasticity is discussed. Recently a bistable firing behaviour in motoneurones was described in the unanaesthetized decerebrate cat. This behaviour is generated by a plateau potential, which causes long-lasting excitability increase and can be initiated and terminated by short-lasting synaptic excitation and inhibition respectively, and is contingent upon activity in descending noradrenergic and serotonergic systems. In an in vitro preparation of the turtle spinal cord the plateau potential was shown to be serotonin dependent and generated by a voltage dependent non-inactivating calcium conductance. In order to elucidate possible functional consequences of a bistable firing behaviour in the intact animal, the firing pattern of individual soleus motor units was studied by means of chronic EMG registration in awake unrestrained rats during quiet standing. Implanted electrodes allowed the delivery of excitatory and inhibitory stimulus trains to the motoneurones. It was found that short-lasting synaptic stimulation could induce maintained shifts between two stable levels of motoneurone firing frequencies, as in the decerebrate cat. Spontaneous shifts between the same two levels were also present. It seems most likely that plateau potentials are responsible for this bistable firing property in intact animals. The role of plateau potentials in locomotion is difficult to study. At present there are no clear indications of the utilization of plateau potentials in locomotion in intact animals. However, "clamped frequency" bursts which are observed in fictive locomotion in spinal cats might be explained by plateaus. The existence of plateau potentials in motoneurones may also be of importance in spasticity. Therefore, the development of spasticity in two spinalized cats was followed for 3 weeks. Acute experiments demonstrated plateau potentials in some motoneurones in this preparation. PMID- 2699367 TI - Distribution of recurrent inhibition in the cat forelimb. AB - This chapter reviews experiments on the distribution of recurrent pathways from motor axon collaterals to alpha motoneurones in the brachial enlargement of the cat. In anaesthetized cats intracellular recording from identified forelimb motoneurones was used to reveal the pattern of recurrent inhibition or excitation following stimulation of muscle nerves. The recurrent connections of the motor nuclei acting on the elbow follow the tight mechanical agonism of the muscles involved. Extensive bidirectional recurrent inhibitory connections were found between motor nuclei innervating elbow and wrist muscles. It is suggested that one group of these connections supports the organization of limb extension, the other group organization of limb flexion. The supinator and the pronator teres motornuclei have identical recurrent connections. Co-convergence from elbow flexor and extensor motornuclei in one and the same motoneurone is frequent. It is suggested that this pattern may serve the stabilization of the radio-ulnar plane. Neither homonymous nor heteronymous recurrent actions were observed in the radial motornuclei acting on the digits, which suggests a lack of recurrent axon collaterals in these nuclei. These results draw attention to the fact that recurrent inhibition is not evenly distributed between all limb motor nuclei. PMID- 2699368 TI - Do Renshaw cells tell spinal neurones how to interpret muscle spindle signals? AB - In vertebrates many alpha motoneurone pools are subjected both to recurrent inhibition via Renshaw cells and to proprioceptive feedback via muscle fibres and proprioceptors, particularly spindles. In these cases, the two feedback loops have a common input (alpha motoneurone output) and a common target (alpha motoneurones). This implies that the target alpha motoneurones receive a compound information dispatched by the source alpha motoneurones, but processed in different ways via the two feedback paths. Since the Renshaw cells monitor the input to skeletal muscle, and the spindles (and Golgi tendon organs) monitor certain aspects of muscle output, both feedback paths in conjunction contain information about the mechanical state of skeletal muscle. Based on these interrelationships the following hypothesis is discussed. At a micro-level, muscle spindles might provide information about motor unit contractions to the homonymous alpha motoneurones. This information is filtered and enhanced by recurrent inhibition via Renshaw cells. This is effected by correlation of the signals which are propagated through the two feedback loops after having been initiated by firing of the same alpha motoneurone(s). The effects of the correlation can be strengthened by (a) topographical order in the feedback connections, (b) heterosynaptic modulation, and (c) tendencies towards synchronous discharge between motoneurones. The information about the unfused contractions of a muscle unit (or a small group of them), thus retrieved from the barrage of signals delivered by proprioceptive afferents, could then play a role in shaping the precise discharge pattern of the innervating motoneurone. This in turn may be of importance for mechanisms of optimal force production during muscle fatigue. PMID- 2699369 TI - A neuronal system of movement control via muscle spindle secondaries. AB - A recently discovered spinal interneuronal system of movement control is briefly described. It includes a population of midlumbar interneurones with a predominant monosynaptic input from secondary muscle spindle afferents but supplied with information via several other afferent and descending neuronal systems as well. The neurones are in direct contact with both motoneurones and other interneurones. The evidence in favour for their involvement in locomotion is briefly summarized. PMID- 2699370 TI - Peripheral and descending control of neurones mediating non-monosynaptic Ia excitation to motoneurones: a presumed propriospinal system in man. AB - Evidence for a non-monosynaptic Ia excitation of wrist flexor and quadriceps motoneurones (MNs) in man has been provided while using two independent methods: construction of post-stimulus time histograms (PSTHs) of voluntarily activated motor units and the spatial facilitation of the H-reflex. This non-monosynaptic Ia excitation has a long central latency (3-6 ms) and a very low threshold. Neurones mediating this effect seem to receive a strong descending excitation at the onset of voluntary movement and it is argued that they might mediate part of the descending command to MNs. In contrast, increasing the afferent input produces an inhibition of the transmission in this pathway. Several characteristics of the non-monosynaptic excitation and its depression bear resemblance to those of the C3-C4 propriospinal system in the cat, which is used as a model for the discussion of the present results. PMID- 2699371 TI - Mechanisms underlying the serotonergic modulation of the spinal circuitry for locomotion in lamprey. AB - The central nervous system of the lamprey contains serotonergic (5 hydroxytryptamine, 5-HT) neurones both in the spinal cord and in the brainstem. Endogenously released 5-HT from these systems modulates the pattern of fictive locomotion induced in the in vitro preparation; the burst rate is lowered and burst discharges become longer and of higher intensity. Local application of 5 HT, mimicking activation of the 5-HT systems, has a specific effect on the late phase of the afterhyperpolarization (AHP) in motoneurones and interneurones. 5-HT markedly reduces the amplitude of the late AHP without affecting passive membrane properties or the shape or threshold of the action potential. This 5-HT effect appears to result from a direct action on the calcium-dependent potassium channels underlying the late phase of the AHP. A reduction of the amplitude of the AHP will result in altered spike discharge characteristics, with potentiation of the response (discharge rate) to a given excitatory input in all neurones influenced by 5-HT. It is suggested that the modulatory effect of 5-HT on fictive locomotion can be attributed to its action on the late AHP and thereby to the potentiation of excitability in excitatory and inhibitory interneurones in the generator circuitry. This has been further corroborated in computer simulation studies of a network model, where the action of 5-HT was simulated by decreasing AHP amplitude, resulting in a slowing of the rhythm analogous to the effect demonstrated experimentally. PMID- 2699372 TI - Relationship of noradrenergic locus coeruleus neurones to vestibulospinal reflexes. AB - The electrical activity of presumably noradrenergic locus coeruleus (LC) neurones was recorded in decerebrate cats during roll tilt of the animal at 0.15 Hz, +/- 10 degrees, leading to sinusoidal labyrinth stimulation. Among the tested units, some of which projected to the lumbosacral spinal cord, 56.7% responded to animal tilt. Most of these neurones were activated during side-up and depressed during side-down tilt of the animal, while a smaller proportion of units showed the opposite response pattern. This predominant response pattern of LC neurones and coeruleospinal (CS) neurones to animal tilt was opposite in activation polarity to that of vestibulospinal (VS) neurones projecting to the same segments of the spinal cord. Both the VS and the CS neurones exert a direct excitatory influence on ipsilateral limb extensor motoneurones. However, VS neurones excite corresponding Renshaw (R) cells, though due to activation of limb extensor motoneurones and their recurrent collaterals, the CS neurones may inhibit them. It appears, therefore, that during side-down animal tilt, the motoneurones innervating the ipsilateral limb extensors are excited by the increased discharge of VS neurones, while the corresponding R-cells are disinhibited due to the reduced discharge of CS neurones. The functional coupling between ipsilateral limb extensor motoneurones and the corresponding R-cells would then increase, just at the time in which these motoneurones are driven by the excitatory VS volleys, thus limiting the response gain of limb extensors to labyrinth stimulation. This hypothesis is supported by two facts: (1) R-cells linked with limb extensor motoneurones discharge during side-down tilt, thus firing in phase with the excitatory VS volleys, and (2) functional inactivation of the noradrenergic LC neurones increases the gain of the vestibulospinal reflexes acting on limb extensors. PMID- 2699373 TI - Comparison of neck muscle activation patterns during head stabilization and voluntary movements. AB - The motor system that controls the neck musculature serves two major functions: stabilization of the head in the face of external perturbations or body movements, and generation of voluntary or orientating head movements. Typically the latter are thought to be mediated by complex pathways involving cerebral cortex and superior colliculus while stabilization is thought to be mediated by simple short-loop pathways that generate vestibulocollic and cervicocollic reflexes (VCR and CCR). Our work has been directed towards evaluating the extent to which the VCR and CCR are in fact responsible for head stabilization, and to determining how the motor patterns produced by these reflexes compare with those produced by the voluntary head movement system. To address these questions we have analysed the dynamic and spatial (kinematic) properties of the head movement system in cats and humans. PMID- 2699374 TI - Discharge patterns of gamma motoneurone populations of extensor and flexor hindlimb muscles during walking in the thalamic cat. AB - Two monopolar recordings of the whole activity in a fine nerve branch innervating the gastrocnemius lateralis (GL) or the sartorius medialis (SM) muscle were obtained during spontaneous walking in thalamic cats. Using a special electronic device, the potentials of several groups of efferent (alpha and gamma) and afferent (I and II) fibres constituting the whole nerve activity were separated. In the present paper we compare the data obtained for an ankle extensor (GL) and a hip-knee flexor (SM) during the step cycle. In both muscles the gamma motoneurone population is activated in parallel with the alpha motoneurone population. Usually, between the cyclic locomotor discharges, the GL gamma neurones are tonically active whereas the SM gamma neurones are silent. During muscle contraction, the group I and II afferent discharges are both length and gamma dependent, but the prevailing factor is the muscle shortening for the GL afferents and the cyclic gamma drive for the SM afferents. Both dynamic and static fusimotor efferents appear to be activated during muscle contraction, but on indirect evidence it is suggested that dynamic action prevails in GL spindles whereas static action dominates in SM spindles. PMID- 2699375 TI - Organization of posture controls: an analysis of sensory and mechanical constraints. AB - We analyse two components of posture control in standing human subjects: (1) the mechanical properties which constrain the body's ability to execute stabilizing postural movements and (2) the mechanical and neural properties which constrain the ability of the vestibular system to sense changes in body orientation. Rules are then proposed to describe the central organization of posture controls within the sensory and mechanical constraints. The organizational rules and knowledge of constraints are combined to predict the effects of selective semicircular canal and utricular otolith lesions on postural stability and the patterns of body and head movements used to maintain balance. Our analysis leads to the prediction that semicircular canal and otolith deficits destabilize patients at different frequencies, and force them to use different patterns of body and head movements. These predictions are compared to posture controls observed in patients with different types of vestibular deficits. The additional steps required to prove or disprove the theory are discussed. PMID- 2699376 TI - What is the role of the supplementary motor area in movement initiation? AB - The hierarchical position of the supplementary motor area (SMA) relative to the primary motor cortex is discussed on the basis of neurological observations and of animal experiments. In the last 10 years evidence has accumulated, especially from studies on the human brain, that the supplementary motor area is a hierarchically superior structure involved in the processes of movement initiation. Single unit studies in subhuman primates also revealed neuronal populations related to aspects of movement preparation rather than to the movement per se. However, we report that a surprisingly large subpopulation of SMA neurones has features classically found in the primary motor cortex (MI). These MI-like neurones precede movement onset by a relatively short interval. The occurrence of such "short-lead neurones" was somewhat higher in MI, but the histograms of lead-times were completely overlapping in the two areas. Taken together with the fact that the SMA is microexcitable and is part of the origin of the pyramidal tract, these findings suggest that the SMA functions also in parallel with MI as concluded by Woolsey and coworkers (1952). Finally, the SMA and MI are reciprocally interconnected, a situation which is not unlike that of the cortical visual areas. PMID- 2699377 TI - Physiological properties of tandem muscle spindles in neck and hind-limb muscles. AB - Although tandem muscle spindle complexes are found in small but significant numbers in most muscles, experimental investigation of their properties has been problematic because of the difficulty of distinguishing their afferents from those of "normal" single spindles. Of particular interest are the afferents from b2c capsules of tandem spindles, which unlike normal spindles contain only a static b2 nuclear bag fibre and some nuclear chain fibres. The absence of a dynamic b1 nuclear bag fibre from b2c spindles has engendered much speculation as to their response properties and their possible role in motor control. We have recently developed a method for the identification of afferents from b2c spindles in electrophysiological experiments, using infusion or topical application of succinylcholine (SCh). SCh causes the contraction of the dynamic b1 and static b2 nuclear bag intrafusal fibres, and paralyses the nuclear chain fibres. Afferents from b2c spindles are characterized by a strong "biasing" of their discharge rate to about 100 impulses per second (i.p.s.) when activated by SCh (reflecting the contraction of the static b2 fibre), while primary afferents from normal b1b2c spindles show a large increase in dynamic sensitivity as well as "biasing" (reflecting the contraction of both dynamic b1 and static b2 bag fibres). Histological examination of tenuissimus spindles activated by SCh has confirmed this relationship between the pattern of activation by SCh and the number of intrafusal nuclear bag fibres in the spindle. In this paper we review the value of SCh as a means of testing spindle afferents for functional inputs from sensory terminals on the nuclear bag fibres, and discuss the properties of b2c afferents from tandem spindles in the context of their possible function. PMID- 2699378 TI - [Use of immunohistochemistry in detecting the primary site in neoplasm metastasis]. AB - The aim of the present study is to demonstrate the sensitivity, specificity and applicability of several tissue markers in the determination of the primary sites of metastatic tumors. The immunoperoxidase technique was used in 19 metastatic tumors from breast (6), gastrointestinal tract (6), thyroid (3), prostate (1), ovary (1), pancreas (1) and melanoma (1). Polyclonal antisera against thyroglobulin and prostatic specific antigen were used. The following monoclonal antibodies were employed: BRST-1, BRST-2, CAR-3, BD-5 and HMB-45. BRST-1 and BRST 2 are considered to be breast cancer markers, while CAR-3 and BD-5 gastrointestinal markers. HMB-45 was described as a melanoma marker. Breast markers were positive for 3 out of 6 breast metastases. BRST-1 was also positive for metastases from melanoma and prostate. CAR-3 and BD-5 were positive for 5 out of 6 gastrointestinal metastases. CAR-3 also presented focal positivity for 4 out of 6 breast metastasis, 1 out of 3 thyroid metastasis and for metastasis from ovary, prostate, pancreas and melanoma. BD-5 was also positive for prostate metastasis. Thyroglobulin and prostatic specific antigen were only positive for thyroid and prostate metastasis, respectively. In conclusion, immunocytochemistry and monoclonal antibodies are useful tools in the detection of the primary sites of metastatic tumors of unknown origin. In some of the fields, the results are already satisfactory. Nevertheless, further studies should be carried out to improve this promising technique. PMID- 2699379 TI - [Wandering spleen in children: report of 4 cases]. AB - The occurrence of a wandering spleen is rarely referred to in the pediatric surgical literature. In the last three years we treated four patients with this anomaly. The first case had an acute abdominal problem associated to a wandering mass with spleen characteristics. The ultrasonography has confirmed the absence of spleen from its proper place. In the second case it was detected a mass with the same features of the first patient associated with choledochal cyst. In this case the ultrasound has demonstrated that spleen was the referred mass. In the third case a patient was submitted to a surgery with the preoperative diagnosis of ovarian torsion. The patient had an associated osteogenesis imperfecta. During the operation it was found that spleen was the referred mass. In the fourth patient the preoperative diagnosis was "abdominal mass". It is given an emphasis to the preservation of the spleen in wandering spleen, mainly in childhood, due to its immunological importance. PMID- 2699380 TI - [Clinical evaluation of loperamide (Imodium)]. AB - The clinical usefulness of loperamide (Imodium) was studied. The preparation was given to 35 patients with acute diarrhoea and 34 with chronic diarrhoea. A good effect was obtained in symptomatic treatment of acute and chronic diarrhoea. The best effects were noted in the treatment of diarrhoea due to functional disturbances. PMID- 2699381 TI - [Various psychological aspects of diabetes mellitus]. PMID- 2699382 TI - [Various aspects of lipid metabolism in the human body with special reference to the role of carnitine]. AB - The principles of energy metabolism in human organism during physical exercise of varying intensity are described calling attention to the effect of exercise duration on mobilization of energy reserves in fatty acids. The particular role of carnitine in the metabolism of long-chain fatty acids is discussed pointing to its content in natural diet and to the possibilities of its supplementation. PMID- 2699383 TI - [Caffey-De Toni-Silvermann syndrome]. PMID- 2699384 TI - [An autopsy record dated 1808]. PMID- 2699385 TI - Synergistic activity for high-proliferative-potential colony-forming cell (HPP CFC) development, stable to trypsin digestion, present in pregnant mouse uterus and placenta extract. AB - In this paper we describe a crude pregnant mouse uterus and embryo extract (PMUE) prepared from CFW/ep mice which was able to stimulate the proliferation of high proliferative-potential colony-forming cells (HPP-CFC) of bone marrow of normal mice, in vitro, in semisolid agar culture system. The development of that primitive murine progenitor cells requires the presence of a macrophage stimulating factor (CSF-1) plus a synergistic factor (SF). The biological activity of both factors was present in our extracts. The higher SF activity was found in uterine plus placental tissues extracts. The SF was precipitated over 45 per cent ammonium sulfate saturation, and behaved as a nondialyzable substance, remained unaffected by trypsin digestion, and was heat-stable (70 degrees C for 15 min). PMID- 2699386 TI - [Neuroendocrine and psychopharmacologic aspects of the pineal function. Melatonin and psychiatric disorders]. AB - The development of psychiatric thought has always been in close association with the pineal gland. The importance of a relationship between pineal, and mental functions was stressed by Descartes when he placed the seat of rational thought as well as the confluence of body and soul in this organ (Cf. Descartes, L'Homme, 1664). His writings exerted such a strong influence that, quite soon indeed, physicians started regarding this gland as being the source of many mental disorders. In an attempt to find and explain a possible link between mental abnormalities, and the discovery of calcified pineals in necroptic studies, many theories were put forward during the 18th, and the 19th century. Afterwards, the importance of the gland went almost unnoticed until 1920, when Becker treated psychotic patients with pineal extracts. An up-to-1950 review by Kitay and Altschule (1954) reported 17 cases where pineal extracts were successfully injected to psychotic patients. In the present review, the author tries and summarizes several reports dealing with the influence of the pineal function on affective disorders, schizophrenia, sleep cycle, Parkinson disease, etc., as a contribution to future research work in this field. PMID- 2699387 TI - [Evolution of the diagnosis and treatment of hyperthyroidism]. PMID- 2699388 TI - [Metabolic radiotherapy of hyperthyroidism]. PMID- 2699389 TI - [Surgical treatment of nodular hyperthyroidism]. PMID- 2699390 TI - [Chronic splenic tuberculosis. Description of a case]. AB - The authors report a case of chronic splenic tuberculosis. They underline the diagnostic difficulties, notwithstanding the remarkable progresses in radiological technics, essentially related to the rarity of this tubercular site and they outlined the exact surgical indication to the splenectomy. PMID- 2699391 TI - [Care and rehabilitation of colostomized patients]. AB - The enterostomies represent the result of a surgical operation that we have been carrying out more frequently in the last few years both on account of the neoplastic and inflammatory pathology of the large bowel; in fact about 40,000 colostomies are effectuated in Italy every year. On the basis of what has been said, the problem of assistance and of rehabilitation of the patients with colostomy assumes great importance. Therefore the authors have examined the various phases of the assistance (pre, intra and post-operatory) and they have underlined the rehabilitation of such patients. They conclude by affirming that it is indispensable to have a multidisciplinary collaboration to insure a correct assistance and rehabilitation, which involves the surgeon, the radiotherapist, the enterostomist, the psychologist and the oncologist; only in this way will they be able to restore to society these patients capable of living the rest of their lives if not happy at least serenely. PMID- 2699392 TI - A tribute to Lester J. Reed. PMID- 2699393 TI - 2-Oxo acid dehydrogenase multienzyme complexes: domains, dynamics, and design. PMID- 2699394 TI - Molecular studies of mammalian branched-chain alpha-keto acid dehydrogenase complexes: domain structures, expression, and inborn errors. AB - We have cloned cDNAs encoding the E1b-alpha, E1b-beta, and E2b subunits of the bovine and human branched-chain alpha-keto acid complexes. The deduced primary structures indicate that the mammalian E2b contains a lipoyl-bearing, an E3 binding, and an inner core domain that are linked in series by two flexible hinge regions. The observed conservation among E2 proteins in each of the three folded domains strongly suggests that the structural cores of alpha-keto acid dehydrogenase complexes are evolutionarily related. We have expressed bovine pre E2b in E. coli. The lipoate-free precursor protein is enzymatically active and appears to assemble into a 24-mer structure. Studies with deletion mutants support the proposal that the antigenicity in pre-E2b is associated with the flexible proline-rich hinge region. We have observed five distinct molecular phenotypes in maple syrup urine disease (MSUD) cells, according to the pattern of the branched-chain complex protein subunits and mRNAs present. The results have demonstrated a high degree of genetic heterogeneity in MSUD and have identified the affected genes which must be characterized. PMID- 2699396 TI - Regulation of the pyruvate dehydrogenase complexes in plants. PMID- 2699395 TI - Biochemical and molecular genetic aspects of pyruvate dehydrogenase complex from Saccharomyces cerevisiae. PMID- 2699397 TI - The role of Ca2+ in the hormonal regulation of the activities of pyruvate dehydrogenase and oxoglutarate dehydrogenase complexes. PMID- 2699398 TI - Intermediates in reductive transacetylation catalyzed by pyruvate dehydrogenase complex. PMID- 2699399 TI - Regulation of the mitochondrial multienzyme complexes in complex metabolic systems. AB - During the past two decades, I and the members of my laboratory have enjoyed very much contributing to the body of knowledge concerning the alpha-keto acid dehydrogenase complexes. We would hope that some of our work has allowed those interested in this area a perception as to how these interesting enzyme complexes are regulated in intact metabolic systems. And last, but certainly not least, I have treasured both my professional relationship and my personal friendship with Lester Reed. His work and his presence in this field of inquiry serve as a gold standard for all of us. PMID- 2699400 TI - Thoughts on the role of branched-chain alpha-keto acid dehydrogenase complex in nitrogen metabolism. PMID- 2699401 TI - Insulin, phospholipase, and the activation of the pyruvate dehydrogenase complex: an enigma. PMID- 2699402 TI - Studies into the mechanism whereby insulin activates pyruvate dehydrogenase complex in adipose tissue. PMID- 2699403 TI - The role of regulation of tissue pyruvate dehydrogenase complex activity during the starved-to-fed transition. PMID- 2699404 TI - Molecular genetic basis for inherited human disorders of branched-chain alpha keto acid dehydrogenase complex. PMID- 2699405 TI - Properties of lipoamide dehydrogenase and thioredoxin reductase from Escherichia coli altered by site-directed mutagenesis. PMID- 2699406 TI - Structure, expression, and protein engineering of the pyruvate dehydrogenase complex of Escherichia coli. PMID- 2699407 TI - The Na-K-Cl cotransporter in the kidney. PMID- 2699408 TI - Structural modifications of higher level computer languages for elementary education. PMID- 2699410 TI - Ceftazidime in the treatment of acute severe infections in children and adults. PMID- 2699409 TI - [The immunogenic capacity of soluble "vaccinia" antigen (fractionated smallpox vaccine) administered simultaneously with inactivated typhoid vaccine and with purified and concentrated tetanus anatoxin]. AB - In this study we have investigated the immune humoral response in the associated vaccination with smallpox, tetanus and typhoid fractionated vaccine (trivaccine) administered in two series at 1 month interval, by dermojet, in a group of young people of 18-20 years old. The results were comparatively estimated with those obtained in two groups of young people of the same age (control group), separately immunized with two components of the tri-vaccine: fractionated smallpox vaccine and tetanus toxoid, following-up the humoral response to the two vaccine components. It was find that, at the end of the surveillance period, similar results were obtained for the testing group and control group, the antibody titers (in geometric mean) presenting very close values: 1/1,140,463 for the testing group, and 1/1,053,583 for the control group against vaccinia component, and 1/1,86,880,586 for the testing group and 1/79,900,431 for the control group, against the tetanus component. The results obtained entitle us to propose this vaccination scheme for the vaccination practice. PMID- 2699411 TI - [Approach to adolescent asthma]. PMID- 2699412 TI - [Paraparesis due to gout]. AB - A case of a 23 year-old-man with a history of polyarthritis and chronic tophaceous gout is reported. He developed a crural paraparesis caused by sodium urate deposits in the spinal canal. Decompressive laminectomy and removal of urate-laden ligamentum flavum was performed without improvement. According to the literature there are nine cases previously reported. PMID- 2699413 TI - [Plurimucosal cicatricial pemphigoid. A case with involvement of the gingival, vulval and vaginal mucosa]. AB - We have studied a 62 years old woman with the infrequent involvement of the gingiva (desquamative gingivitis), vulvar and vaginal mucouses in benign mucosal pemphigoid. The clinical features and pathology are exposed and we debate differential diagnosis principally with pemphigus and lichen planus. PMID- 2699414 TI - [The influence of the chemo-mechanical removal of the smear-layer and the use of a dentin adhesive on microleakage of composite resin restorations]. AB - We present an "in vitro" study of microfiltration in composite resin restorations with a perimetral seal placed totally in cement. We compare the sealing capability of a dentin adhesive (ScotchBond I) used in two ways: habitual, without conditioning dentin and conditioning it by means of the Caridex system. This produced no increasing of sealing capability under the study conditions. PMID- 2699415 TI - [The Bridgelok system for additional retention of bonded prostheses]. AB - The partial protesis with metal carving and cemented with composite resin is used frequently as a reversible method in order to substitute teeth, due to the light preparation necessary for the original teeth. Recently, a new system (Bridgelok) with pins has been proposed as safer for this kind of protesis. This paper studies if this new system originates a higher resistance compared to other system without pins. PMID- 2699416 TI - [Retention and biomechanics of retentive complexes. 3. The Kratochvil school and current retentive complexes]. AB - The authors analyse the biomechanical bases of the Kratochvil "retentive complex" and show how they have induced the nowadays north-american propositions (RPI & RPA). They compare them to the european ones (Nally-Martinet). PMID- 2699417 TI - Synthesis of benzimidazole derivatives as potential antimicrobial agents. AB - Three novel series of benzimidazol derivatives were prepared. Namely; 2-alkyl-1 (4-substituted-4H-1,2,4-triazole-5-thion-3-yl)methylb enzimidazoles; 2-alkyl-1-(5 substituted amino-1,3,4-thiadiazol-2-yl)methylbenzimidazoles; and 2-alkyl-1-[(3,4 disubstituted thiazolin-2-ylidene)hydrazinocarbonyl] methylbenzimidazoles. The antimicrobial testing of the prepared compounds as well as of the key intermediate thiosemicarbazides was performed. PMID- 2699418 TI - Marginal seal comparisons between resin-bonded Class II porcelain inlays, posterior composite restorations, and direct composite resin inlays. AB - The microleakage of indirect porcelain and direct composite resin-bonded inlays was compared with that of posterior composite resin restorations using Class II preparations of extracted molar teeth. The resin-bonded inlay restorations provided a better marginal seal at the cervical restoration/dentin interface than did the composite resin restoration. The efficacy of this marginal seal varied with the particular treatments and materials used. Resin-bonded porcelain inlays had a higher incidence of cervical excess from the composite resin luting agent than did the posterior composite resin restorations. PMID- 2699419 TI - Custom-fabricated interfaces for intermittent positive pressure ventilation. AB - Patients with chronic respiratory insufficiency resulting from paralysis of respiratory muscles have been supported most commonly by mechanical ventilation via a tracheostomy. Acute and long-term morbidity and mortality have been associated with tracheostomy. Noninvasive alternatives for providing mechanical respiratory support include negative pressure "body ventilators" and positive pressure ventilation via a nasal, oral, or oronasal interface. Intermittent positive pressure ventilation via the nose, mouth, or oronasal combination is effective and convenient for the majority of patients when the interface is sufficiently airtight and comfortable to permit effective long-term use. Construction of custom-fabricated interfaces for the administration of assisted ventilation is presented. These interfaces provide better fit for greater interface seal and comfort than commercial masks. They allow more patients to benefit from assisted positive pressure ventilation in the home without resorting to a tracheostomy. PMID- 2699420 TI - Reappraisal of the physics of denture retention. AB - Theories of denture retention have suffered from confusion of model, algebraic errors, and misapprehension of the physics of capillarity, adhesion and cohesion, as well as the role of atmospheric pressure. The rheology of some simple models is set out in context, and the dynamic nature of the problem is emphasized. The importance of a well-fitting denture base is confirmed. A number of points for further investigation are identified. PMID- 2699421 TI - Psychomotor patient training to enhance retention of complete dentures. AB - A training device is used in conjunction with an exercise program to teach muscle control for retention of a mandibular denture. The training instrument consists of a shellac record base connected with string to an extraoral spring balance scale. Instructions are given in the use of the tongue, lip, and cheek muscles for denture retention. The patient is then asked to displace the seated record base by pulling on the scale. Higher measurements on the scale indicate increased resistance to displacement of the denture base. The process is repeated and increased resistance is obtained. There appears to be a substantial positive transfer of skills derived from use of the training device to successful function with the completed prosthesis. PMID- 2699422 TI - Extensive fixed partial dentures on mandibular canine teeth: a 5-year recall study. AB - Twelve patients were followed for 5 years after treatment with a 12-unit cantilever fixed partial denture on the mandibular canines opposed by a complete maxillary denture. Two fixed dentures had to be removed, one because of an abutment tooth root-fracture and one because of rapid marginal bone loss in a terminal stage of leukemia. Caries and periodontal lesions were rare, but other complications, principally related to endodontics, occurred. All complications were amenable to standard treatment procedures. Extensive mandibular cantilever fixed partial dentures may be used in the rehabilitation of patients with a very reduced dentition and a history of difficulties in adapting to removable dentures. PMID- 2699423 TI - Facial rests for a Kennedy Class IV removable partial denture. AB - A technique is presented in which acrylic resin extensions from the labial surface of the anterior tissue base of a Kennedy Class IV removable partial denture are used as retentive elements to minimize motion around the axis of rotation. The labial rests, formed by extending the base material of the prosthesis onto the mesiobuccal surfaces of the anterior abutments, act as guiding planes, preventing rotation of the prosthesis. The rests also improve esthetics by covering the interdental spaces often found between the prosthesis and the abutment teeth. The technique has been used successfully with 26 patients over a 3-year period. PMID- 2699424 TI - Adding a posterior palatal seal to a metal-based prosthesis. AB - A method of adding an acrylic resin posterior palatal seal to a cast base metal palate of a maxillary complete denture is presented. The technique may be used to create the original posterior palatal seal or to enhance an existing seal. The advantages and disadvantages of the metal palate are discussed. The clinical technique is presented along with the representative laboratory metal etching information. PMID- 2699425 TI - Immunity to fungi. PMID- 2699426 TI - Immunity to protozoa. PMID- 2699427 TI - Mononuclear phagocytes and the human immunodeficiency virus. AB - Macrophages are an important in vivo reservoir for HIV. Conclusive evidence that CNS, pulmonary, lymph node and blood-derived mononuclear phagocytes harbor and support HIV replication is supported by numerous independent studies. HIV variants which preferentially replicate in macrophages have been recovered from infected individuals, suggesting that these cells and variant viruses are involved in the establishment and progression of HIV-related disease. PMID- 2699428 TI - Iatrogenic immunodeficiencies. PMID- 2699430 TI - Immunodeficiency. PMID- 2699429 TI - Immunity to infection. PMID- 2699431 TI - Signal transduction in hamster fibroblasts overexpressing the human EGF receptor. AB - Human EGF receptors (HERs) were expressed in CCL39 hamster fibroblasts, a cell line responding only weakly to EGF despite the presence of 10-20,000 EGF receptors per cell. High expression of HERs (800,000 per cell) conferred EGF responsiveness. In these cells EGF is a potent mitogen, induces strong receptor autophosphorylation, phosphorylation of cellular substrates on tyrosine, activates the Na+/H+ exchanger, and weakly stimulates phosphoinositide (PI) turnover. Activation of PI turnover by a mitogen activating a receptor tyrosine kinase has not been observed previously in CCL39 cells. We present evidence, however, that the activation of this signaling pathway which is insensitive to pertussis toxin does not mediate the proliferative response. Unlike NIH 3T3 cells, CCL39 fibroblasts overexpressing HERs are not transformed nor can a transformed phenotype be observed in response to EGF or TGF alpha. PMID- 2699432 TI - Receptor downregulation and DNA synthesis are modulated by EGF and TPA in cells expressing an EGFR/neu chimera. AB - EGF was used to stimulate a chimeric receptor consisting of the epidermal growth factor receptor (EGFR) extracellular, transmembrane, and protein kinase C substrate domains linked to the intracellular tyrosine kinase and carboxyl terminal domains of the rat neu protein in NIH/3T3 cells. EGF-induced rapid and delayed morphological changes consisted of membrane ruffling, increased pinocytosis, extension of lamellar actin-containing footpads at the cell periphery and partial reorganization of the actin stress fibers in the cells. EGF bound to the cells was rapidly internalized in a complex with the EGFR/neu protein, as shown by loss of EGF binding and EGFR antigens from the cell surface. The movement of the EGFR/neu protein was followed with indirect immunofluorescence into a vesicular intracellular compartment using antibodies against both EGFR and neu protein domains. Metabolic labeling and pulse-chase experiments indicated that the receptor was degraded soon after its internalization. EGF treatment also induced the junB transcription factor mRNA and a dose-dependent stimulation of DNA synthesis in cultures expressing the chimeric receptor. The tumor promoter TPA led to a transient loss of cell surface receptors and prevented EGF stimulation of DNA synthesis but did not completely abolish junB mRNA induction or increase degradation of the chimeric receptor. These results show that the chimeric EGFR/neu receptor undergoes typical downregulation upon ligand binding and TPA pretreatment and is capable of transducing an EGF-induced mitogenic signal. PMID- 2699433 TI - An autocrine activity capable of substituting for serum in cell cultures. AB - Provided that high cell densities (above 10(6)/ml) are maintained, a factor dependent murine hemopoietic progenitor cell line (FDC-P1) will proliferate in serum-free medium. The conditioned medium (CM) from high-density FDC-P1 cells permits the serum-free survival of FDC-P1 cells even at low density, indicating the existence of a diffusible autocrine factor. The requirement of FDC-P1 for a colony-stimulating factor (either IL-3 or GM-CSF) is not abrogated by culturing the cells at high cell density or in the conditioned medium. Furthermore, the CM from FDC-P1 enhances the mitogenic stimulation of normal human skin fibroblasts (HSF) by epidermal growth factor (EGF): i.e., the lag period before entry into the cell cycle is shortened by up to 6 hr. The fibroblasts themselves secrete an activity into serum-free medium that appears to be required during mitogenic stimulation by EGF. The HSF-CM also allows FDC-P1 cells to survive and proliferate serum-free at low cell densities. Low concentrations of fetal calf serum or human plasma (0.2-2%) have the same effect as FDC-P1-CM and HSF-CM. We have tested many of the known growth factors, and none of them mimicked the autocrine serum replacing activity (ASRA). The activity in human plasma elutes from a gel-filtration column with an apparent molecular weight of 60,000. It appears as if cultured normal cells and cell lines produce molecules capable of complementing the growth factors required for the survival and proliferation of a range of cells in serum-free cultures. PMID- 2699434 TI - Thermography for indications other than breast lesions. AB - Thermography is the measurement of self-emanating infrared radiation revealing temperature variations at the body surface. The two commonly employed methods demonstrating such changes are telethermographic infrared detector/imagers and heat-sensitive cholesterolic liquid crystal systems. Both methods sense body temperature and demonstrate areas of differing heat emission by producing brightly colored patterns. Each color represents a specific temperature level. Interpretation of color patterns in dermatomes or other anatomic distributions are proposed as an aid in diagnosing and evaluating a vast array of diseases. Information obtained from the literature, responses to a Federal Register notice of this assessment, PHS agencies and medical specialty groups failed to support claims of efficacy of thermography as a useful diagnostic modality for non-breast indications. Rather, it suggested that thermography lacks sensitivity, specificity, or predictive value. Unassailable data are lacking to indicate that thermography provides a useful guide to monitor the effect of treatment of any disease entity. The evidence suggests that thermography may only confirm the presence of a temperature difference, that other procedures are needed to reach a specific diagnosis, and that thermography may add little to what physicians already know based on history, physical examination, and other studies. PMID- 2699435 TI - Real-time cardiac monitors. AB - Real-time cardiac monitors (RTCMs) are portable computerized devices that use programmed algorithms to perform rapid, readily available online analysis and processing of electrocardiographic (ECG) data. RTCMs are primarily applied for long-term monitoring of ambulatory cardiac outpatients for the purpose of detecting transient abnormal ECG events. A wide variety of RTCM devices is available ranging from limited capacity intermittent recorders that store only selected ECG data, to 24-hour full-disclosure systems that provide ECG complex and to replay this data for subsequent review. Critics of RTCMs suggest that the best algorithms are imperfect and may lead to errors involving potentially lethal arrhythmias, while proponents argue that real-time cardiac monitoring is sufficiently reliable for clinical use. Available data suggest that the devices are safe and particularly with regard to detecting ventricular arrhythmias, clinically reliable. Currently available algorithms cannot analyze atrial fibrillation, pacemaker rhythms, isolated P-waves, junctional rhythms, and atrial ventricular blocks. The advantages and limitations of RTCMs are well described. Their use can be applied to provide satisfactory results in the diagnosis, prognosis, and therapeutic amangement of selected patients. PMID- 2699436 TI - [The regulation of DNA synthesis by fibronectin and its proteolytic products in the skin fibroblasts of healthy donors and patients with systemic scleroderma and rheumatoid arthritis]. AB - To study the effect of fibronectin isolated from plasma and culture media and the effect of its tryptic hydrolyzates on DNA synthesis, cultured skin fibroblasts of healthy donors and these of patients with systemic scleroderma (SSD) and rheumatoid arthritis (RA) were employed. It was shown that both fibronectin and total products of its proteolysis markedly stimulated DNA synthesis only in skin fibroblasts of patients with SSD. Fibronectin fragments inhibited DNA synthesis in all fibroblast strains studied. The effect of fibronectin and all its Gel fragments on the DNA synthesis in skin fibroblasts of patients with SSD was dose dependent. The activity of total fibronectin tryptate, Gel-fragment-free tryptate, and Gel fragments themselves depended on the duration of fibronectin proteolysis, i. e. on the size of the fragments obtained. Culture media collected after treatment of fibroblast monolayer with trypsin and subsequent removal of fibronectin Gel fragments had mitogenic effect on skin fibroblasts, especially on those of patients with SSD and RA. It is supposed that fibronectin Gel fragments are inhibitors of growth factors produced by fibroblasts. The results suggest that fibronectin and its fragments have an important regulatory role in fibroblast proliferation. PMID- 2699437 TI - [The effect of bacterial antigens on lymphocyte immune receptors in mice]. AB - It has been shown that the treatment of a suspension of lymphocytes obtained from spleens in mice by LPS S. sonnei as well as by exotoxins Cl. tetani and Cl. botulinum has led to a notable reduction in the number of luminescent cells by comparison with control samples. The action of tested remedies was found to increase with their concentration. These was complete correlation between these results and the data obtained by the immunity rosette formation method. A reliable reduction was also noted in the number of lymphocytes forming rosettes with the sheep erythrocytes. It has been inferred that the bacterial products tested possessed a marked capacity for blocking the immune receptors of lymphocytes. PMID- 2699438 TI - [The dynamics of thymalin localization in human thymus cells in embryogenesis]. AB - Immunofluorescence methods were applied to study the localization of the thymalin containing cells in human thymic epithelium of 6-23-wk-old fetus and 2-3-yr-old infants. The study of the fetal thymus (6 weeks) showed the presence of thymalin in reticuloepithelial framework. These cells were present in both in the cortex (in subcapsular regions) and in the medulla; Thymalin-containing cells presence- in the Hassall's corpuscles (23 weeks). The same results were obtained with the infants thymus (3-yr-old). PMID- 2699439 TI - [Epidermoid carcinoma of the kidney]. AB - Epidermoid carcinoma of the kidney is a rare malignant tumor, characterized by high invasiveness, poor prognosis, and the association of renal stone and renal infection. Very little reports about its sonographic appearance were mentioned in the literature. We present a case of epidermoid carcinoma of the kidney. Its ultrasonography showed a heterogeneous renal mass with perirenal and pararenal invasion, destruction of the renal pelvis, and preservation of enlarged reniform outline. Although this tumor should be differentiated with renal cell carcinoma, transitional cell carcinoma, renal metastatic tumor, renal lymphoma, renal infarction, focal bacterial nephritis, and xanthogranulomatous pyelonephritis etc., we think we should put epidermoid carcinoma of kidney into consideration when a renal tumor mass presents with perirenal and pararenal invasion, destruction of the renal pelvis, and preservation of enlarged reniform outline in sonography, and hypovascularity in angiographic study. PMID- 2699440 TI - Quantitation of renal blood flow by contrast ultrasonography: preliminary results. AB - Contrast ultrasonography, employing tracers behaving like red blood cells, is a promising technique to study regional blood flow distribution. Aim of this note is to quantitate renal blood flow in the dog using contrast ultrasonography. Mathematical formulae derived from the classical dye-dilution theory are applied. Ten different renal blood flow levels (ranging from 16 to 125 ml/min) were obtained by means of mechanical (stenosis and reperfusion) and pharmacological interventions (iv infusion of adrenaline, noradrenaline and fenoldopam). Renal blood flow was measured by electromagnetic flow-meter and contemporary calculated by contrast ultrasonography. The correlation coefficient between measured and calculated flow was 0.92 (p less than 0.01). Contrast ultrasonography is a technique capable of measuring renal blood flow at a wide range of different flow levels. PMID- 2699441 TI - [The scientific research of Dr. Otakar Kutvirt (in memory of the 60th anniversary of Kutvirt's death)]. PMID- 2699442 TI - [Depression in childhood and adolescence]. PMID- 2699443 TI - Effects of different insulin administrations on plasma amino acid profile in insulin-dependent diabetic patients. AB - It has long been recognized that diabetes mellitus is characterized by alterations in amino acid metabolism. Our aim was to evaluate the fasting amino acid concentrations in insulin-dependent diabetic subjects treated with different kinds of insulin therapy and with respect to the resulting different metabolic control. Four groups of patients were studied: Group 1: eight type 1 diabetic patients with two daily insulin injections; Group 2: eight type 1 diabetic patients with continuous subcutaneous insulin infusion; Group 3: five type 1 diabetic patients with continuous intraperitoneal insulin infusion; Group 4: six patients with total pancreatectomy. In all patients fasting amino acid profile was determined. Group 1 was also studied after 24 hr insulin withdrawal and after acute normalization of glycaemia. Our data demonstrated that the patients with a mild hyperglycaemia showed a significant increase in plasma amino acid levels. The continuous subcutaneous or intraperitoneal insulin infusion normalized amino acid profile at the expense of peripheral hyperinsulinemia, suggesting the presence of insulin resistance with regard of amino acid metabolism. The acute normoglycaemia demonstrated that plasma branched chain amino acid levels are more sensitive than plasma glucose to insulin action. Moreover, the amino acid pattern of euglycaemic total pancreatectomized patients suggested that a basal level of glucagon is essential in regulating glycogenic amino acid plasma concentrations. PMID- 2699444 TI - The suppressive effect of cyclophosphamide on low-dose streptozotocin-induced diabetes in mice. AB - We found that low-dose streptozotocin (SZ)-induced diabetes in mice is suppressed by cyclophosphamide (CY) and studied the mechanisms of this suppression. Male CD 1 mice were injected intraperitoneally with SZ (40 mg/kg) for five consecutive days (group SZ). In addition, CY (200 mg/kg) was injected on the first day (group CY-1) or on days 1 and 5 (group CY-2). In group SZ, all mice developed diabetes within nine days after the first injection of SZ. Group CY-1 did not develop hyperglycemia for 14 days and group CY-2 did not develop it throughout the experimental period (40 days). Insulitis was suppressed slightly in group CY-1 and completely in group CY-2. The number of spleen cells did not change in group SZ compared with that before cyclophosphamide treatment. They decreased significantly on days 3 and 7 in both groups CY-1 and CY-2 (p less than 0.01 or p less than 0.05), but then increased significantly on days 14 and/or 21 (p less than 0.01 or p less than 0.05) compared with those before cyclophosphamide treatment. The Thy 1.2- and L3T4-positive cells increased significantly in group SZ but they decreased on days 3 and 7 in both groups CY-1 and CY-2 (p less than 0.01) compared with the controls. These results suggest that (1) this large reduction of lymphocytes at the beginning of SZ treatment may lead to the prevention of hyperglycemia and insulitis, and (2) T-cells, especially L3T4 positive cells may play an important role in the pathogenesis of this type of diabetes. PMID- 2699445 TI - Modulation by sodium butyrate of the differentiated status of a clonal pancreatic B-cell line (RIN). AB - RINmRH cells are a cloned cell line derived from a transplantable rat insulinoma. These cells display only some of the differentiated structure/function features of native pancreatic B-cells. In particular, they do not efficiently or reproducibly express islet B-cell surface antigens, which would otherwise render them useful for screening for the presence of anti-islet cell surface antibodies in the serum of suspected diabetic patients or their relatives. This study examines whether sodium butyrate can enhance expression of B-cell differentiation antigens on RIN cells. RIN cells were exposed to 1,2 or 4 mM butyrate for nine days, and cell growth followed. At 1 mM, butyrate inhibited cell growth by 90%. At the higher concentrations, there was a net loss in the number of cells per culture dish. Exposing the cells to 1 mM or 2 mM butyrate for two days, resulted in a 50% increase in cellular insulin content at the expense of a partial (1 mM) or complete (2 mM) loss of stimulated insulin release in response to glyceraldehyde or serine. A concentration of 1 mM butyrate was therefore used for subsequent studies. The binding to RIN cells of a panel of monoclonal antibodies (mAb's) known to bind native islet cells (R2D6, A2B5, A1D2, 3G5) as well as of serum from a diabetic patient known to carry anti-islet cell antibodies, was screened by cytofluorography or by a radio-binding assay. The relative binding affinity of the mAb's was 3G5 greater than A1D2 greater than A2B5 greater than R2D6. Only 2-3% of the cells were bound by the diabetic patient serum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699446 TI - A regional register of early childhood impairments: a discussion paper. The Steering Committee of the Oxford Region Child Development Project. AB - A regional register of preschool children with cerebral palsy, severe vision loss and sensorineural deafness has been complied. Case definition, the threshold for including or excluding a case and a standard method for describing a case have been predefined. In order to achieve complete ascertainment, multiple sources of information were used and account was taken of population movement, and loss of cases through death. The optimal age of case ascertainment poses a particular problem and counting of definite cases was delayed until age three years with a further review at age five years. The register can be used to estimate prevalence of impairment, as a basis for aetiological and interventive studies and for service planning. It fills an important gap in the information currently available on childhood morbidity. PMID- 2699447 TI - [Treatment of dysfunction of the knee joint in rheumatoid arthritis by fascial interposition]. AB - A surgical treatment method consisting in sewing on of the fascia lata on the cartilageless, loaded and needing painless sliding parts of the joint has been presented. In order to transform the fascia into the painless fibrous cartilage, it is necessary to begin early postoperative rehabilitation as soon as at 4-7 days after operation and continue until maximal function and efficiency of the knee is achieved. The follow-up was up to 4 years and full function was found in 11 patients, improvement after partial patients, and no improvement in 6 patients. Better results were obtained after partial rather than total interposition. Poor results were found in the patients with great contracture and muscular atrophy before operation and with difficulties in rehabilitation caused by other joints. Thus, interpositions is contraindicated in late age, great deformations and difficulties in rehabilitation. This method may fill the empty place in the treatment methods between synovectomy and alloplasty of the knee. PMID- 2699448 TI - [Surgical treatment of instability of the ankle joint caused by inveterate injuries of the ligaments of the lateral malleolus]. AB - The results of surgical Chrisman-Snook reconstruction of the lateral malleolus ligaments in 9 patients, aged 19-37 years, have been discussed. The follow-up ranged from 2 to 4 years. In all the patients, good functional results were obtained. Among many methods of reconstruction of the lateral malleolus ligaments, the Chrisman-Snook method distinguishes itself because of simplicity of procedure and furthermore, it can be used for reconstruction of injuries of the tarsus ligaments in the region of the malleolus. It can be recommended in the treatment of patients with the symptoms of instability of the talocrural joint. PMID- 2699449 TI - [Significance and modulation of production of tumor growth inhibitor derived from human embryonic myofibroblasts]. AB - In this report, the production and modulation of tumor growth inhibitor (HFDI) derived from human embryonic myofibroblasts were studied. HFDI was obtained from 3/30 cultures of human embryonic myofibroblasts, which was obviously lower than the incidences of Australia Caucasian's myofibroblast (6/6) and adult's skin fibroblast (4/6). It is suggested that the inheritance play certain role in HFDI production. Calf serum had a significant effect on HFDI production, though without any linear relationship. It seems that HFDI is not derived from calf serum but the factors influencing the production of HFDI are in the calf serum. HFDI could be induced by inactivated BCG from non- or low-producing myofibroblasts. It is indicated that the production of HFDI is related to bacterial contamination (in vitro) or infection (in vivo). The hypothesis is proposed that tumor inhibitors be induced by bacterial infection from the fibroblasts. HFDI-like activity was identified in 4 healthy donors' sera suggesting that HFDI could enter the blood. PMID- 2699450 TI - [Morphology and immunohistochemistry of true histiocytic lymphoma--report of 4 cases]. AB - True histiocytic lymphoma (THL) is a rare malignancy of histiocyte. It is difficult to diagnose by light microscopy alone. In this paper, 4 cases of THL were reported basing on light and electron microscopic examination, and immunohistochemical study. Histiocytic lymphoma was of Langerhans cell origin in one case and of interdigitating reticulum cell origin in the other. The other 2 patients probably belonged to neoplasm of macrophage or dendritic reticulum cell origin. The differential diagnosis between the true histiocytic lymphoma and other tumors or diseases was briefly discussed. PMID- 2699451 TI - Thyroid hormone transcriptional regulatory region of the growth hormone gene. AB - By deletion-transfection analysis, a region of the rat growth hormone gene has been identified which directs accurate, thyroid hormone responsive transcriptional initiation in vivo. In addition, a thyroid hormone-responsive DNase I hypersensitive domain containing three discrete hypersensitive sites has been identified near the GH promoter. One site is coincident with the TATA homology, and the others lie approximately 150 nucleotides 5' and 3' of this sequence. The TATA and 5' flanking DNA hypersensitive sites are located in the region of the gene which promotes hormone-responsive gene transcription. Based on these results, it is possible that the molecular basis for thyroid hormone induction of GH gene transcription includes binding of the occupied receptor to chromatin sites flanking the TATA homology, promoting binding of the TATA activating protein to this sequence. Together, these events may enhance the rate of RNA polymerase II initiation at the promoter. PMID- 2699452 TI - Thyroid hormone receptors and action: the 5'-flanking region of the rat growth hormone gene can mediate regulated gene expression. PMID- 2699453 TI - Coding nucleotide sequence of rat malic enzyme mRNA and tissue specific regulation by thyroid hormone. AB - A nearly full length ME cDNA has been obtained and sequenced. The identity has been established by comparison of the translated nucleotide sequence with the amino acid sequence of 7 tryptic peptides from purified ME. Northern analysis with this cDNA shows that ME mRNA consists of two different messages of about 27S and 21S. The size difference between two ME mRNAs (approximately equal to 27S and 21S) is attributed to the differences in the 3' noncoding regions. The relative ratios of the two ME mRNAs differ in various tissues examined (liver, heart, kidney, brain, lung, spleen, and testis). Their regulation by T3 is tissue specific with coordinate stimulation of both mRNAs in liver, heart and kidney, suggesting a single promoter for both mRNAs and no stimulation of either in the other tissues. T3 regulates ME mRNA synthesis via a dual-tissue specific mechanism by increasing the rate of transcription in liver and heart and stabilizing nuclear ME RNA sequences only in liver. PMID- 2699454 TI - Inappropriate secretion of TSH. PMID- 2699455 TI - Direct triiodothyronine (T3) action by a primary mitochondrial pathway. PMID- 2699457 TI - Percutaneous aortic valvuloplasty. PMID- 2699456 TI - The syndrome of generalized resistance to thyroid hormone (GRTH). PMID- 2699458 TI - [Echocardiographic study in heart transplantation]. PMID- 2699459 TI - [Psychological aspects before and after transplantation]. PMID- 2699460 TI - [The effect of him mutations characterized by enhanced induced mutagenesis on the spontaneous mitotic recombination in the ADE2 gene in Saccharomyces cerevisiae]. AB - We have studied the influence of him1, him2, him3 and himX mutations on the frequency of spontaneous mitotic gene conversion in the yeast Saccharomyces cerevisiae using the set of heteroallelic combinations in the ADE2 gene. Data obtained on the HIM/HIM, him/him homozygotes and HIM/him heterozygotes indicate that the him1 mutation is recessive with respect to conversion, whereas the him2, him3 and himX mutations are semidominant. Gene conversion was increased in the majority of heteroalleles of mutant diploids him1/him1. On the contrary, the him2, him3 and himX mutants have hypo-rec phenotypes on mitotic conversion. The him mutations do not affect some heteroalleles, moreover, for some heteroalleles, the effects of the him mutations was opposite. On the basis of the sum of genetical data and, particularly, of conversion event pattern in the him mutants, we suggest that him mutations analysed affect the repair pathway for mismatch correction. PMID- 2699461 TI - [Subarachnoid anesthesia in cesarean section]. AB - The use of subarachnoid anesthesia in Cesarean section in spite of its long history only now gains popularity. It is due to better knowledge of physiology and anatomy of a pregnant woman an the use of new local anesthetics and better needles for spinal anesthesia in clinical practice. Analgesia comprising segments Th4-S5 of the spinal cord provides painless operation and good muscle relaxation. In spinal anesthesia, unless there is arterial hypotension, intervillous flow increases. It is very important to prevent the syndrome of inferior caval vein by means of sloping the operating table by 15-20 degrees to the left, proper hydrating the patient, putting a wedge under the right hip, shifting the uterus to the left or putting the patient on right or left side. Analgesia consists in administering a local anesthetic into subarachnoid space. In this kind of analgesia the time elapse between the incision of skin and that of uterus muscle does not have a significant influence on the condition of newborns, which is contrary to general anesthesia. The time elapse between the incision of uterus muscle and extracting the fetus is a very significant factor both in spinal and general analgesia. The course of analgesia is very much influenced by preventing hypotension. It is done by fast infusion of 1500-2000 ml of electrolyte fluids within about 20 min., and the use of ephedrine. The prophylaxis of headaches consists in the use of very thin needles in spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699462 TI - [Usefulness of measuring the levels of estrogens and progesterone in the saliva during pregnancy]. AB - In recent years there have appeared reports on the usefulness of marking steroid hormones in the saliva to evaluate the function of ovaries and degree of threat to pregnancy. Many authors studied the correlation between the concentration of estrogens and progesterone in the blood and saliva both in physiological and pathological pregnancy. It was found that the concentration of steroids in the saliva reflects free steroids circulating in the blood, not bound with proteins, marking of which supplies more reliable clinical information. Opinions on determining hormones in the saliva and their importance in monitoring fetal placental unit are controversial. On the other hand, availability, non invasiveness and easiness of collecting saliva increases an interest in this biological material. PMID- 2699463 TI - Therapy with growth hormone--old and new indications. AB - Pituitary dwarfism with severe growth hormone deficiency (GHD) represents the classical indication for treatment by recombinant human growth hormone (hGH). With continuous GH replacement and early start of treatment, normal adult height can be achieved. During puberty the dosage of hGH administered should be increased. Numerous growth disorders do not coincide with major GHD as determined by provocative tests but only with diminished spontaneous hormone secretion. Typical examples are constitutional delay of growth and adolescence and growth retardation after irradiation of the skull. Also in these disorders treatment by recombinant hGH in replacement doses renders favorable results. The more normal the spontaneous GH secretion is, e.g. in familial short stature and in skeletal dysplasias, the higher doses of GH are needed to stimulate growth. For treatment of patients with Turner's syndrome a combined therapy with high doses of GH and with oxandrolone has proven rather effective. With endogenous and exogenous hypercortisolism the metabolic balance is shifted towards catabolism and spontaneous GH secretion is depressed. In such situations, e.g. after severe traumas, operations, infections and combustions, administration of GH can be rather helpful. Recent trials in children with stunted growth due to chronic renal insufficiency show that it is possible also in this condition to effectively stimulate growth by hGH. PMID- 2699464 TI - Protective effects of prostaglandins against nonsteroidal anti-inflammatory drug induced gastrointestinal mucosal injury. AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) are an integral part of the therapy of rheumatic diseases. All NSAIDs have the potential to cause damage to the gastrointestinal (GI) tract and have been implicated as a cause of peptic ulceration and massive life-threatening bleeding, often without warning symptoms. The basis of the damaging actions of NSAIDs on the GI tract is believed to be a consequence of two events: depletion of endogenous prostaglandins (PGs) and a direct damaging action on the mucosal integrity. Current evidence indicates that PGs play an important role in maintaining the integrity of the GI tract against ulcerogenic stimuli and are therefore ideally suited to counteract the NSAID induced deleterious actions on the mucosa. With the exception of synthetic prostaglandins, the current therapeutic interventions used for the treatment of NSAID injury are not ideal. Misoprostol, a synthetic E-prostaglandin analogue, has been found to prevent and heal GI lesions induced by NSAIDs. The basis for the protective effect of prostaglandins is a consequence of their gastric antisecretory and mucosal protective properties. The mucosal protective effects of misoprostol are multifactorial and include, in part, the stimulation of mucus and bicarbonate secretion, an increased or sustained mucosal blood flow and the stabilization of the barrier function of the stomach. Misoprostol represents a major new advance in our therapeutic armamentarium for the treatment and prevention of NSAID-induced GI mucosal injury. PMID- 2699465 TI - Fluoxetine compared with amitriptyline in elderly depression: a controlled clinical trial. AB - Twenty-eight elderly inpatients suffering from major depressive episodes (diagnosed according to DSM III) received randomly, on a double-blind basis, amitriptyline (75 mg/die) or fluoxetine (20 mg/die) for five weeks. There were four drop-outs in the amitriptyline group and two drop-outs in the fluoxetine group. Both groups showed a significant amelioration at the end point for Hamilton Rating Scale of Depression scores compared to the baseline value. Anticholinergic side-effects were significantly more severe in the amitriptyline group. Weight gain was detected only in patients receiving amitriptyline. PMID- 2699466 TI - Treatment of reversible chronic airways obstruction with doxofylline compared with slow-release theophylline: a double-blind, randomized, multicentre trial. AB - A multicentre, double-blind, randomized trial was carried out in 11 Italian Pneumologic Clinics to investigate the therapeutic efficacy and tolerability of doxofylline compared with slow-release theophylline in 139 patients (86 males, 53 females) aged 17-77 years suffering from reversible chronic airways obstruction. The two groups of 69 patients on doxofylline and 70 patients on theophylline did not differ in their baseline clinical and functional parameters. After one week of wash-out, the two drugs were administered orally at a dose of 400 mg twice daily of doxofylline and 300 mg twice daily of theophylline. The treatment and follow-up lasted 28 days. Inhaled salbutamol on demand was allowed in the wash out week and throughout the trial. The average serum levels at day 14 and 28 were: doxofylline 7.5 and 8.5 micrograms/ml; theophylline 10.4 and 7.95 micrograms/ml respectively. Both drugs significantly increased spirometric parameters (p less than 0.001 for all tests) and significantly reduced salbutamol consumption (p less than 0.001 for both drugs). Doxofylline was better tolerated than theophylline considering either the number of unwanted side-effects: (doxofylline 12; theophylline 37) or number of drop-outs due to side-effects (doxofylline 5; theophylline 10). From these results doxofylline seemed to be a good alternative to theophylline in the treatment of reversible chronic airway obstruction in view of its better safety profile. PMID- 2699467 TI - Cytotoxic proteases in blister fluid of pemphigus and pemphigoid patients. AB - Investigation of blister fluid (BF) from 49 pemphigus vulgaris and 27 bullous pemphigoid patients revealed direct interrelation between proteolytic and cytotoxic activities of BF. Human epidermal keratinocytes proved to be more sensitive to the cytolytic effect of BF as compared to human endotheliocytes and fibroplasts. Epidermal keratinocyte cultivation in patients' BF led to proteolytic activity enhancement in culture supernatant. Inasmuch as cytotoxic and proteolytic activity of BF sharply decreased under the effect of inhibitors of serine proteinases only, it was concluded that proteolytic enzymes of this class play the role of a "cytotoxic factor" causing the lysis of epidermal cells in pemphigus and pemphigoid. PMID- 2699468 TI - Research methods for obtaining primary evidence. AB - The use of new therapeutic and diagnostic technologies has become commonplace in modern medical practice. To avoid both clinical disappointment and the waste of money, health, and lives, the introduction of these technologies will have to be based on evidence that these technologies will do more good than harm. The evidence supporting their use should be derived using research methods designed to deal with placebo effects, confounders, and biases. Some of these methods, and the rationale for their use, are discussed in this article. Although the value of evidence derived from randomized controlled trials is stressed, the importance of reviewing critically the methodological details of such trials and interpreting their results with caution is emphasized. The benefits and risks of relying on case-control and cohort studies are reviewed. PMID- 2699469 TI - Selection and evaluation of empirical research in technology assessment. AB - Technology assessment involves application of the scientific method to the practice of medicine. Finding all of the assessment reports in a given field is not an easy task. Proper evaluation of those assessments requires the conduct of a prospective experiment in which the sources and results are blinded when the choice is made of papers to exclude and to include, and the process should be carried out in duplicate. There are several available data bases for carrying out the search, but because of indexing problems they should be supplemented by reference to the bibliographies of pertinent published articles. Clinical trials included in meta-analyses should be graded by quality and thus facilitate sensitivity analyses. Attention must be paid to the possibility of publication bias. Finally, the advent of meta-analysis makes it desirable to begin randomized controlled trials in areas of uncertainty, even when there is no possibility that individual investigators will encounter enough patients to draw valid conclusions. PMID- 2699470 TI - Eliciting and combining subjective judgments about uncertainty. AB - Frequently, health care decisions must be made before compelling and unequivocal evidence is available about the benefits, risks, and costs of a proposed new health technology. It is common for decision makers to seek the advice and opinions of experts to supplement the available evidence. This article reviews some of the methods used or recommended for eliciting the opinions of experts about uncertain events and for combining these opinions with those of others and with available empirical evidence. PMID- 2699471 TI - Giving, receiving, repaying. Gamete donors and donor policies in reproductive medicine. AB - Current practices of donor recruitment for medical fertilization procedures are analyzed in the light of Marcel Mauss' essay on the gift in primitive societies. In this perspective, donor policies seem primarily designed to spare infertile recipients the obligation to recognize the donor's contribution to these procedures, thus avoiding the kinship issues that they raise. Questions of meaning concerning donation, social recognition of the donor's role, and clarification of the relational issues underlying fertilization procedures are nevertheless essential elements in establishing their social legitimacy. PMID- 2699472 TI - Test of a noninvasive instrument for measuring hemoglobin concentration. AB - A colorimetric instrument for the noninvasive quantification of hemoglobin, designed using color shades resembling those observed in the conjunctiva, was tested. The instrument's colors are contrasted against the color of the conjunctiva to measure hemoglobin content. Sensitivity, specificity, negative predictive value, and false-negative value were estimated to test the instrument's accuracy; kappa coefficients were used to estimate inter- and intraobserver variability. Physician field evaluations of conjunctiva color for the screening of anemia, reported in the literature, have had sensitivities and specificities as high as 70%. Readings with the instrument demonstrated a 63% sensitivity, 72% specificity, and 38% false negatives for screening hemoglobin values of less than or equal to 13 g/dl. The interobserver kappa coefficients for three pairs of readers were good to excellent for the same hemoglobin screening value. Statistically significant differences were noted, however, between observers during the reliability test. The instrument can be used by unskilled personnel to improve their decision-making about whom to send for further care or for supplementation with iron. PMID- 2699473 TI - Alpha thalassemia. PMID- 2699474 TI - Beta-thalassemia repository. PMID- 2699475 TI - In memoriam Richard M. Goodman 1932-1989. PMID- 2699476 TI - Chairside custom impression tray. PMID- 2699477 TI - Ultrasound demonstration of endocaval extension of tumour thrombus from renal cell carcinoma. PMID- 2699478 TI - Insulin absorption in renal proximal tubules: a quantitative immunocytochemical study. AB - The purposes of the present study are mainly biological concerning proximal tubular handling of insulin: we will study the intracellular transport to subcellular compartments involved in insulin degradation, the specificity and saturability of the luminal endocytic absorption of insulin, the visualization of transtubular transport, and finally, if possible, the evaluation of the relative distribution (accumulation) of insulin in endocytic vacuoles and lysosomes. The second part is methodological: application of quantitative immunocytochemistry to endocytosis, quantitation of the effect of particle size and antigen density on labeling density on tissue sections, labeling at very low antigen densities, and effect of fish gelatin on background. Isolated renal proximal tubules were perfused with native insulin, 125I-insulin, or [leucineB-25]-insulin (2% receptor binding ability and full immunoreactivity) or exposed to native insulin from the basolateral membranes. In conclusion, the luminal uptake of insulin is of low specificity, as native and [leucineB-25]-insulin were accumulated to the same extent. Endocytic uptake is of high capacity and the mechanism is saturable. Insulin accumulated in endocytic vacuoles and lysosomes, thus following the classical degradation pathway. No other subcellular compartment is associated with insulin degradation. It was not possible to detect the basolateral uptake, indicating loss of immunoreactivity after binding to its receptor. Absolute quantitative immunocytochemistry is applicable in studying endocytosis. The labeling density increases nonproportionally with antigen density probably caused by steric hindrances. Reduction of the particle size (16 to 6 nm) increased the labeling density 17.6 times. PMID- 2699479 TI - The aetiology and treatment of needle phobia in the young patient--a review. AB - This Paper reviews current concepts regarding the aetiology and treatment of needle phobias in young patients. PMID- 2699480 TI - Advanced carotid stenosis in TIA and minor stroke as a predictor of coronary heart disease: a 3-year follow-up. AB - Eighty-six patients with transient ischemic attacks (TIA) or minor stroke from the carotid artery territory, examined in the extracranial carotid arteries by duplex ultrasound, were prospectively followed for 3 years to find out whether a higher degree of carotid stenosis in these patients might predict mortality and morbidity in myocardial infarction (MI). Thirty-three of these (38%) had carotid stenosis greater than or equal to 50% on one or both sides. In these patients, 36% (12/33) suffered MI during follow-up compared to 7% (4/53) in the patients with lesser degree of stenosis. 75% (12/16) of the MI's were fatal. The total mortality in MI was 30% (10/33) in patients having a stenosis greater than or equal to 50%, in TIA-patients it was 24% (12/51) and in patients with TIA + greater than or equal to 50% stenosis it was 36% (10/28). It is suggested that the presence of high degree stenosis in the carotid arteries might predict mortality and morbidity in MI among TIA and minor stroke subjects. PMID- 2699481 TI - Results of thrombolysis in the treatment of arterial ischemia of the limbs according to mode of administration. AB - After reviewing the principles, results and complications of thrombolytic therapy with "classical" agents (Streptokinase and Urokinase) used via intravenous, intraarterial route, or intraoperatively, and with more "modern" agents (APSAC, scuPA, tPA), we discuss the future of thrombolysis in the treatment of arterial ischemia of the limbs. Several items need to be clarified: --indication of thrombolysis among other treatments, mainly surgery, of arterial ischemia depends on the clinical staging of ischemia, its causes and the site of arterial obstruction; --method of delivery of the thrombolytic agent must provide the highest local concentration and the lowest systemic side effects; --efficacy of each thrombolytic agent must be analyzed when used in peripheral arterial ischemia, but also in other diseases such as myocardial infarction. PMID- 2699482 TI - Evolution of carotid atheromatous lesions in endarterectomized patients. AB - A noninvasive follow-up using duplex ultrasonography was conducted in 128 patients who had undergone carotid endarterectomy from January 1987 to December 1988. Repeated scans of the operated area revealed a distinct increase in thickened ultrasonographic features (32% vs 8%), and a stenosing lesion was detected in 8 patients. There was also a parallel increase in the number of subjects with thicknesses of the intima adjacent to the endarterectomy area exceeding 2.5 mm. In 7% of cases, dilatation was detected in the operated area and in 27% the margin of the area was raised. The study also dealt with the contralateral carotid artery, where a progression of atheromatous involvement was observed with an increased number of cases of hemodynamically significant stenosis and 3 cases of occlusion. Periodic duplex ultrasonography in endarterectomized patients proves useful for the early detection of hemodynamically significant stenoses or of structural features potentially capable of generating emboli. PMID- 2699483 TI - Accuracy of the simplified Bernoulli relationship in measuring pressure gradients across stenosis. AB - In order to test the validity of the modified Bernoulli equation in predicting pressure gradients across stenotic regions, we have constructed an in-vitro model and studied the influence of the length and of the severity of the stenosis. Under physiological conditions, simultaneous pressure gradients are estimated by both Doppler and direct pressure manometer techniques. Measurements of the pressure gradients (in the range 10-150 mmHg) by the two techniques show that the Doppler estimation using the modified Bernoulli equation underestimated the pressure transducer gradient measurements for every length of stenosis, this underestimation being greater than 45% for very severe stenosis. PMID- 2699484 TI - Echodensitometry: a methodologic approach to the non-invasive diagnosis of carotid atherosclerotic plaques. AB - The ultrasound image of the fibroatheromatous plaque has to date been unable to reveal the presence or absence of complications as shown by histology, such as thrombosis and intraplaque hemorrhage. We propose a novel densitometric method for determining the composition of the plaque at the echotomography, along with a new classification based on mathematical models drawn from the optical density distribution curve. This approach avails of an extremely high sensitivity. Percent areas occupied by thrombosis, intraplaque hemorrhage and atheroma in histologic sections have been shown to correspond to hyporeflecting areas in echotomographic images, whereas those occupied by calcium and fibrous tissue correspond to reflecting areas with or without acoustic shadow, respectively. This method may prove to have an important role in the non-invasive monitoring of even slight changes during progression or regression of the fibroatheromatous plaque. PMID- 2699485 TI - Transcervical ultrasound-guided intrafallopian placement of gametes, zygotes, and embryos. PMID- 2699486 TI - Sperm cryopreservation: state of the art. PMID- 2699487 TI - The origins of dentistry in America. PMID- 2699488 TI - Comparison of therapeutic efficacy of continuous ambulatory peritoneal dialysis between diabetic and non-diabetic patients: three years of experience. AB - To evaluate the therapeutic efficacy of continuous ambulatory peritoneal dialysis (CAPD) in diabetic uremic patients and compare it with that of non-diabetics, this study presents the results obtained from CAPD usage in a 3-year period. From December 1984 through December 1987, 12 non-insulin dependent diabetic patients (3 men and 9 women aged 65.5 +/- 3.4 years and with a treatment duration of 12.8 +/- 2.7 months, M +/- SE) and 11 non-diabetics (6 men and 5 women aged 45.0 +/- 5.3 years and with a treatment duration of 9.8 +/- 1.9 months) received CAPD treatment. In most of the patients, diabetes was complicated by significant cardiovascular diseases. None of them exchanged the CAPD bag by themselves. After CAPD treatment, subjective improvements were noted in both groups of patients but were more marked in the non-diabetic group. The BUN and creatinine levels were kept in an acceptable range except that higher creatinine levels were noted in the non-diabetic patients. Serum cholesterol levels rose mildly while triglyceride levels rose markedly in the diabetic patients. Albumin levels returned to normal in the non-diabetic group but remained low in the diabetic group. All patients except for one used the traditional subcutaneous route of insulin administration and blood sugar control was poor. The electrolyte profile was improved in both groups. The BP could be controlled but medication was still necessary. After CAPD most of the non-diabetic patients returned to their previous work while the diabetic patients remained dependent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699489 TI - Causal bacteria of pyogenic liver abscess. AB - This is a review of bacteriologic data on 175 patients with pyogenic liver abscesses seen over a period of 8 years at Veterans General Hospital, Taipei, Taiwan. Positive cultures were obtained from liver aspirates in 151 of the 163 patients in which cultures were taken. One hundred and twenty patient specimens grew one isolate and 31 specimens grew two or more isolates. A total of 149 aerobic gram-negative rods, 25 aerobic cocci and 29 anaerobes were isolated. Ninety of the 159 patients from whom blood was taken had positive cultures. In 11 patients, two or more isolates were grown concurrently from the blood. A total of 87 aerobic gram-negative rods, 7 aerobic cocci and 10 anaerobes were isolated. Klebsiella pneumoniae was the most common microorganism, accounting for 50.8% of the cases. Other major pathogens were Escherichia coli (27.4%), anaerobes (15.4%), and viridans streptococci (6.2%). PMID- 2699490 TI - Evaluation of methotrexate containing chemotherapeutic regimens in the treatment of childhood undifferentiated non-Hodgkin's lymphoma and B cell acute lymphoblastic leukemia. AB - From September 1983 to October 1988, 13 undifferentiated non-Hodgkin's lymphomas (NHL) of Burkitt's or non-Burkitt's type and 3 B cell acute lymphoblastic leukemias were treated with various multiagent chemotherapy regimens containing modest to high dose methotrexate (HDMTX) infusions. All were children between the ages 2 years 8 months and 14 years 1 month. The group included 13 boys and 3 girls. The lymphomas were located primarily in the head and neck, 5; abdomen, 7; and lymph nodes, 1. The clinical stages at diagnosis were stage I, 1; stage II, 6; stage III, 3; and stage IV, 3. The MTX infusion dosage ranged from 300 to 4,285 mg/M2, and the total cumulative dose per patient ranged from 750 to 30,168 mg/M2. Citrovorum Factor Rescue was given following all MTX infusions, except for 62 of the 300 mg/M2 infusions. The serum MTX levels were monitored following all HDMTX. The chemotherapy related toxicities were graded and analysed. The clinical characteristics, which might predispose to HDMTX-related toxicities, were identified and are discussed. Our data reveals the inpatient and interpatient variations in the kinetics of MTX. There were no drug-related deaths, and the overall outcome of the patients was satisfactory. We conclude that MTX infusion continues to play an important role in the current management of childhood B cell malignancies; however, obstacles still remain, especially for those with widespread B cell disease. PMID- 2699491 TI - In vitro fertilization, gamete intrafallopian transfer and combined IVF-GIFT results: three-year experience at Chang Gung Memorial Hospital. AB - A review is presented summarizing the IVF-ET, GIFT and combined IVF-ET-GIFT experienced at Chang Gung Memorial Hospital. Since the building of an aseptic dust free laboratory next to the operation room, the clinical pregnancy rate has been 12.2% per embryo transfer in IVF-ET, 16.7% in the GIFT program and 30.0% in the combined IVF-GIFT program. The overall clinical pregnancy rate was 14.9%. The overall pregnancy rate appeared to be independent of the causes of infertility, be it tubal factor, endometriosis or unexplained infertility. It was lower in couples with male factor or combined factors. The different regimens for follicular stimulation were hMG-hCG, clomiphene-hMG-hCG and FSH-hMG-hCG. No one regimen showed a better pregnancy rate than the others. The methods of oocyte retrieval were laparascopy, laparotomy, transbladder ultrasound-guided, and transvaginal ultrasound-guided retrieval. There were 4.53 oocytes retrieved pertreatment cycle. The transvaginal ultrasoundguided oocyte retrieval has greatly simplified the procedures in the IVF-ET program. The patient selection was important not only for the indications but also for the methods of IVF-ET, GIET and combined IVF-GIFT. PMID- 2699492 TI - Intrauterine diagnosis of short-limbed dwarfism. AB - Ten short-limbed fetuses caused by skeletal dysplasia were diagnosed prenatally from September 1984 through July 1988. The final diagnosis was thanatophoric dwarfism in 7 cases and osteogenesis imperfecta congenita in 3 cases. The diagnosis was based on sonographic findings in all cases and postnatal radiography was performed in 3 cases for further confirmation. Sonographic examinations revealed markedly shortened limbs and other associated abnormalities, including abnormal skull appearance, pear-shaped chest with protuberant abdomen, polyhydramnios and hydrops in fetuses with thanatophoric dwarfism. Fetuses with osteogenesis imperfecta congenita were characterized by fractures of the long bones. These findings were helpful in making the specific diagnosis of short-limbed dwarfism. According to our experience, sonographic examination is effective in the prenatal diagnosis of short-limbed dwarfism. PMID- 2699493 TI - Use of an improved liquid drop retainer for combining immunofluorescence and peroxidase-antiperoxidase techniques. AB - An improved "liquid drop retainer" was made by gluing a circular cover glass within a selected ceramic ring of a serological ring slide. One to three small sections of tissue mounted within corresponding circles on an ordinary microscopic slide could be immunostained with primary antisera when placed upside down on the liquid drop retainer. After rinsing in the buffer, the sections were placed upside-down over the liquid drop retainer containing fluorescein isothiocyanate-conjugated immunoglobulin and photomicrographs were taken by placing the inverted sections over the liquid drop retainer. After taking the photomicrographs, the sections were incubated in peroxidase-antiperoxidase complex and placed upside-down over the liquid drop retainer. These liquid drop retainers provided the following advantages in immunocytochemical staining: (1) greatly reduced volumes of antibody solutions to micro-amounts (0.08-0.12 ml); (2) allowed simultaneous localization of different antibodies in adjacent serial sections on the same slide; and (3) allowed immunofluorescence and peroxidase antiperoxidase techniques to be done on the same section without any damage by immunofluorescence photography before using the peroxidase-antiperoxidase technique. PMID- 2699494 TI - Diltiazem as monotherapy in treatment of mild to moderate essential hypertension. AB - The effectiveness and safety of diltiazem monotherapy was evaluated in 29 patients with mild to moderate essential hypertension (diastolic pressure between 95 and 115 mmHg). There were 16 men and 13 women, ages ranged from 29 to 58 years (mean 43). After a 2-week placebo period, each patient was given a 60 mg diltiazem tablet three times a day for 8 weeks. Blood pressure and heart rate were determined at weekly clinic visits. Three patients were withdrawn from the study because of a skin rash, palpitation and a frequent loose stool, respectively. In the remaining 26 patients, the mean systolic and diastolic blood pressures were reduced significantly in 2 weeks of therapy and thereafter. At the end of the 8-week treatment the mean supine blood pressure decreased from 158/103 at baseline to 139/94 mmHg, the mean sitting blood pressure from 156/104 to 136/93 mmHg, and the mean standing blood pressure from 151/104 to 134/96 mmHg. The heart rate did not change significantly before or during diltiazem treatment. In 16 (61.5%) of the 26 patients, diltiazem consistently reduced the diastolic blood pressure more than 5 mmHg throughout 2 to 8 weeks of treatment. The left ventricular mass and ejection fraction assessed with M-mode echocardiograms were normal before diltiazem treatment, and remained unchanged 8 weeks after the treatment. By using treadmill exercise tests, there was a significant increase in exercise duration and a significant reduction in the peak heart rate at 8 weeks after the treatment. The peak systolic blood pressure did not change significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699495 TI - In vivo action of alpha-amylase inhibitor from cranberry bean (Phaseolus vulgaris) in rat small intestine. AB - An alpha-amylase inhibitor prepared from cranberry bean (Phaseolus vulgaris) was examined for its in vivo action on pancreatic alpha-amylase in rat small intestine. For this purpose, postprandial changes not only in intraluminal alpha amylase activity but also in plasma glucose and insulin concentrations were measured at various times after administration of 2 g of 10% polyethylene glycol containing experimental diets with and without the inhibitor. No considerable increase was observed in the levels of intraluminal alpha-amylase activity, blood sugar, and plasma insulin in the animals given the inhibitor at a dose of 10 mg each. These results suggest that the purified preparation from cranberry bean serves in fact as a potent inhibitor of rat pancreatic alpha-amylase. PMID- 2699496 TI - Of sales, services, and warranties: is the prosthodontist a purveyor of goods under the Uniform Commercial Code? AB - The Uniform Commercial Code (UCC) governs various commercial transactions. Article Two of the Code deals with sales of goods and, historically, has not applied to the provision of goods incident to rendering professional services. Recently, some courts have held professionals liable for economic or personal injuries caused by faulty medical devices and prostheses. Liability, when found, has been based on one or more of the UCC Article Two warranties. This article discusses these warranties and those cases in which hospitals and doctors have been held liable under them. While the number of such cases is small, there are arguments that suggest that liability under these circumstances could increase in the future. An understanding of the Article Two warranties and how they have been used in lawsuits against health professionals should help minimize the chances of successful litigation against dentists. PMID- 2699497 TI - Military dentist. AB - Although there have been no cases in which a court has been concerned with the malpractice of a military dentist, there have been cases involving military physicians. The principles of law that have been applied to these physicians also apply to military dentists. Laws have been passed to resolve the problems of malpractice liability of military dentists, and these, as well as court decisions, are reviewed. PMID- 2699499 TI - Lyme disease--a new disease in southern Africa? AB - Lyme disease is a recently-described zoonotic disease occurring widely in the U.S.A., Europe and Asia. The causative organism, Borrelia burgdorferi, is transmitted predominantly by ticks of the genus Ixodes and infects a wide host range. The infection in humans causes the human disease syndrome erythema chronicum migrans resulting in arthritis, neurological symptoms and/or cardiac abnormalities. Similar clinical signs have been described in domestic animals. The status of Lyme disease in southern Africa is presently unknown but preliminary evidence indicates that the disease may occur in humans in the Republic of South Africa. The abundance of hosts and tick vectors would favour the establishment of the infection in Africa. PMID- 2699498 TI - Bombay experience in intensive respiratory care over 6 years. AB - The experience of the intensive respiratory care in 930 cases treated from 1983 for 4 years and in 404 cases over the next 2 years is reported. The background operational problems are stressed. Those between age 10 and 50 years did significantly better (p less than 0.05). The survival over the first 4 years in IPPR cases was 16.3% and in non IPPR group 71.8%; over the next 2 years, the former group, survival was 32.4 and 36.3%. The survival in asthmatic patients was high (76%). In cases with organophosphorus poisoning (without IPPR), survival was 81% while in IPPR group it was 29%. In 1988, the results in this group were better due to more aggressive management. In autopsy data on 85 cases, infection was not a major feature in those dying within 24 hours. The survival in COPD cases showed significant relation to age (p less than 0.05), initial arterial pO2 below 60 mm (p less than 0.01) and arterial pH below 7.3 (p less than 0.01). In cases with pneumonia (also asthma) younger cases did better (p less than 0.05) as also those with pneumonia and initial pO2 above 60 mm (p less than 0.01) and pH above 7.3 (p less than 0.001). When pneumonia was community acquired, survival (64.8%) was better than when it was hospital acquired (24%; p less than 0.01). Only the need for IPPR affected survival in trauma group. The major cause of death was infection with Klebsiella, Pseudomonas, Staphylococci and other gram- ve organisms. It is concluded that with proper planning and training, the IRCU does provide a useful mode of treatment in selected patients with respiratory problems. PMID- 2699500 TI - The role of anaerobic bacteria in bovine mastitis: a review. AB - Routine bacteriological diagnosis of bovine mastitis does not provide an index to the obligate anaerobic flora involved. No anaerobic bacteria were recovered from cows with normal quarters or those with latent facultative anaerobic or aerobic udder infections as diagnosed according to the criteria of the International Dairy Federation. Simultaneous isolation of anaerobic bacteria from udder quarter abscesses and mastitic milk from the same quarter occur in some lactating dairy cows. In most dairy herds there are cows with anaerobic udder infections. Anaerobic bacteria have been isolated from lactating as well as from dry cows. Most anaerobic bacteria were isolated concurrently with facultative anaerobic bacteria except in aseptic mastitis cases. The polymicrobial nature of udder infections shows that multiple anaerobic as well as facultative anaerobic species colonise and act together. In spite of antibiotic therapy, anaerobic bacteria were still isolated from mastitic quarters. Gram-positive anaerobic bacteria were mostly sensitive to penicillin-G but most of the Gram-negative anaerobic bacteria were resistant and some Bacteroides fragilis strains produced beta-lactamase. Nearly all the aminoglycosides display consistently poor activity against anaerobic bacteria. A high degree of resistance against tetracyclines was also demonstrated. Anaerobic Gram-positive cocci and rods were sensitive to common antibiotics. The pathogenicity of several pure cultures of anaerobic bacteria has been demonstrated by their ability to induce clinical mastitis in healthy lactating udders. Anaerobic bacteria may act as mastitis pathogens probably in a primary and/or secondary role because clinical mastitis could be induced in normal quarters under experimental conditions. Their high prevalence of anaerobic bacteria in mastitic quarters and the ability of some strains to produce heparinase also suggests a pathogenic role. The handling of udder abscesses and the therapy of mastitis where anaerobic bacteria may be involved, is fully discussed. PMID- 2699501 TI - [A historical perspective of human-animal interaction as a field of study]. AB - A chronological review is given of the most important people, publications, scientific gatherings and societies which have contributed to the development and recognition of human-animal interactions as a field of study. Lorenz is recognised as the founder of this new field of study. His contribution was to emphasise the role of humans who have to have a thorough knowledge of animal behaviour and he also pointed out the fact that modern man needs to keep contact with nature. Other pioneers were Levinson who pointed out the therapeutic benefits of companion animals and the Corsons who used animals in hospital settings. The explosion of knowledge in this particular field took place during the 1980's. The first world congress on the subject was held in 1980 in London. Societies involved in this new study field, were established in the United Kingdom, Europe, United States of America, Australia, Canada and South Africa. In South Africa the interest in this field emerged during the 1980's with articles published in veterinary periodicals. It has since developed into a multi disciplinary approach. A new chair was furthermore inaugurated to teach human animal-interactions as part of the veterinary curriculum. There is no doubt that the new study field has important implications for the veterinary profession. PMID- 2699502 TI - Ultrasonography and 99mTc-DISIDA cholescintigraphy in the diagnosis of choledochal cyst in children. AB - Eighteen children with choledochal cyst have underwent abdominal ultrasonography and 99mTc-DISIDA (di-isopropylphenylcarbamoyl-methylimidodiacetic acid) cholescintigraphy before surgery. All patients had typical sonographic findings of a large cystic mass in the porta hepatis with direct continuity to the biliary system. The gallbladder could be easily recognized and distinguished from the cystic mass in every except one case. Dilatation of the intrahepatic ducts was noted in 12 patients (67%). Coexisting biliary stones were found in 3 patients (17%). On the cholecintigrams, 14 patients (78%) had characteristic findings of a round or ovoid photon-deficient area in the porta hepatis with delayed filling and stasis of the tracer in the same area. Three infants (17%) showed a persistent round photon-defect over the porta hepatis without visualization of gallbladder or bowel radioactivity, which was thought to suggest a choledochal cyst with obstruction. A combination of ultrasonography and cholescintigraphy can provide a very accurate preoperative diagnosis of choledochal cyst. PMID- 2699503 TI - [Gallstone ileus--the diagnostic and surgical problems]. AB - After a brief review of the literature the authors discuss in an analytical and critical aspect the clinical manifestations, diagnosis and operative problems in biliary-calculus ileus. Three personal clinical observations are reported in women at mean age 68 years and a history of biliary calculosis dating many years back, associated with other accompanying diseases. Proceeding from available data in the literature and from their personal experience the authors consider the unsolved problems for operative management, both of the complications and of the underlying disease--the gall bladder calculosis and the biliodigestive fistula. The first to be radically solved by operation is the complication, while the operative treatment of the underlying disease depends upon the following factors: severity of the ileus, patient age, local finding, hepatobiliary zone, accompanying diseases etc. PMID- 2699504 TI - [A comparison between clinical and echographic staging in bladder tumors]. AB - In a series of 94 consecutive unselected patients with bladder tumors the authors determined the tumor infiltration stage (tumor staging) by two methods. In all patients the echographic stage was previously and independently established by transurethral echography. The clinical staging was subsequently made according to the requirements of the International Union for Cancer Control (IUCC). The results obtained by the two methods were compared and a high degree of coincidence (81 per cent) was found. The lack of coincidence in the borderline stages between superficial and infiltrative lesions is discussed. The ultimate staging in bladder tumors is recommended to be based on the complex data of all methods: echography, computer axial tomography and clinical examination. PMID- 2699505 TI - [Retrograde ejaculation following transurethral surgery for bladder neck sclerosis]. AB - A brief review of the literature on the physiology of ejaculation and the causes and treatment of retrograde ejaculation is made. Retrograde ejaculation following transurethral resection for bladder neck sclerosis is discussed in detail. Seventy four patients were under control for a period of 5 years--69 after transurethral resection and 5 after transurethral incision of the bladder neck. Retrograde ejaculation was observed in 8.6 per cent of the patients. The possibility to solve the fertility problems in young men, as well as to avoid this complication is discussed. Inferences are made and recommendations given for establishing the diagnosis, treatment and prophylaxis of this complication. PMID- 2699506 TI - [Functional disorders of cardiac pacemakers--their diagnosis and treatment]. AB - Implantation of artificial pacemaker has proven invaluable in the treatment of patients with heart block and other arrhythmias. It has been found that, however seldom, this device may function inadequately after implantation. This malfunction is secondary to alteration in the previously assigned rate, to irregular pacing and failure of sensing, impaired capture or depolarization and/or various combinations of these events. The welfare of patients with pacemaker depends on the adequate investigation and interpretation of the malfunction and its proper management. The numerous signs of pacemaker malfunction are associated with changes in the output of impulses and inadequate pacing. It is believed that in the future the developing technology will provide more refined pacemaker device, and the incidence of pacemaker malfunction with fall to a reasonable limit. PMID- 2699507 TI - Lymphomagenesis in Emu-myc transgenic mice does not require transgene rearrangement or mutation of myc exon 1. AB - In most human Burkitt's lymphomas, translocation of the myc oncogene to an immunoglobulin locus is associated with loss of myc exon 1 or with mutations near its 3' border, a region where myc transcription is attenuated and translation of a larger myc polypeptide initiates. Emu-myc transgenic mice, which bear the three myc exons coupled to an immunoglobulin enhancer, provide a model for the development of such lymphomas, because their lymphomagenesis appears to require events other than expression of the transgene. To determine whether myc rearrangement or exon 1 mutation is a necessary tumorigenic event, we examined the transgene structure and myc exon 1 sequences in Emu-myc B lymphoid tumours. Southern blots revealed no transgene rearrangements in 20 of the lymphomas, and only two tumours showed amplification (2 to 5-fold). To search for exon 1 alterations, the exon 1 mRNA region was amplified from five tumours by polymerase chain reaction and sequenced, but no mutations were found. Hence, neither excision nor mutation of exon 1 is necessary to render myc tumorigenic. The sequence analysis across the exon 1-exon 2 boundary unexpectedly revealed an ambiguity in myc splicing that predicts a variant form of the larger myc polypeptide lacking a single amino acid residue. PMID- 2699508 TI - Embryonic stem cell culture and gene targeting in transgenic mice. AB - Genetically altered embryonic stem (ES) cells re-injected into mouse blastocysts take part in the formation of all tissues, including the germ line, thus generating transgenic offspring. This approach in combination with the homologous recombination technology offers the possibility of altering ES cells in a controlled manner and therefore of generating transgenic mice with a predetermined genome. We summarize here advances in mouse embryology and genetics that have led to this exciting development. PMID- 2699509 TI - Analysis of milk protein gene expression in transgenic mice. PMID- 2699510 TI - Detection of new mutation disease in man and mouse. AB - Recent developments in molecular biology technology have greatly facilitated the methods for detection of mutations responsible for genetic disorders in both humans and animals. In this article we review some of these new methods and present a diagnostic algorithm that facilitates the routine and rapid diagnosis of any genetic disorder for which the defective gene has been isolated. PMID- 2699511 TI - Genetic ablation in transgenic mice. AB - The study of mammalian development has very quickly moved from a largely descriptive endeavour to one in which very precise mechanistic questions can now be formulated and answered. Undoubtedly, advances in this area have been the result of a strong foundation in experimental embryology, the application of molecular genetic techniques to the isolation and analysis of genes of developmental interest, and the ability to manipulate genetically the embryo through transgenic mouse technology. Perhaps the most dramatic illustration of the power of these new technologies is the potential ability to generate mice either that carry mutations in virtually any gene in the germ line through gene targeting in totipotent embryonic stem (ES) cells or that lack specific cell types through the genetic ablation technology reviewed here. Together, these two approaches have made it possible to knock out either a specific gene or a specific cell type in an intact animal and thus offer almost unlimited possibilities for addressing questions concerning the molecular and cellular biology of development. As well, animal models for various human diseases such as dwarfism, immunodeficiencies and demyelination can now be generated. It is clear that further refinements in both gene targeting and genetic ablation technologies are necessary before the full potential of either approach will be realized. Further development of conditional or inducible ablation strategies, coupled with a more precise definition of the cis-acting sequences, responsible for directing gene expression in fully differentiated and more primitive cells, will greatly broaden the range of questions that can be addressed by this approach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699512 TI - Potential for genetic manipulation of mammals. AB - The development of a new mammalian genetics in which specifically designed gene alterations of pre-existing endogenous genetic loci may be achieved via tissue culture of stem cells is described. At present this technology is rapidly emerging for mice by gene targeting in cultured embryonic stem cells, isolation of the desired cell clone and re-constitution of germ-line chimaeric animals. Results to date and strategies for gene targeting and isolation of the required cell clones are discussed. This new genetic technology is likely to have a major impact both in genetic studies and, especially if it can be extended to larger mammalian species, in practical applications. PMID- 2699513 TI - [Antimalarial chemoprophylaxis in children]. AB - In early age, drugs without side effects are required for malaria chemoprophylaxis. Several regimens are available for drug-resistant plasmodium spp in many countries. PMID- 2699514 TI - [Dental changes in children with malabsorption]. AB - The paper reviews existing reports on relations between pathologies leading to malabsorption and dental lesion in children. The following dental alterations are reported in the literature: delayed eruption of deciduous teeth, hypoplasia of enamel and dental caries. These lesions have been observed in gastrointestinal pathologies, for example, coeliac disease, chronic diarrhea and recurrent vomiting, intolerance of cow's milk protein, Crohn's disease and salmonellosis. The delayed eruption of deciduous teeth and hypoplasia of the enamel are certainly correlated to malabsorption and maldigestion, especially if these are protracted over time. Dental caries may be due to poor oral hygiene, poor diet and to the presence of modified calcification. Only a comparative study with a control group will enable the effective prevalence to be assessed. PMID- 2699515 TI - [Schonlein-Henoch syndrome in children. Clinico-epidemiologic analysis of 170 cases]. AB - The clinical and epidemiological data of 170 patients aged between 8 months and 13 yrs 9 months hospitalised for Schonlein-Henoch syndrome in the period 1976-87 have been analysed. There were more females than males (78/92); a triggering event, usually inflammation of the first airways, was identified in 58% of patients. In 60% of cases onset was autumn-winter. Extrarenal symptoms infrequently take on a certain degree of clinical gravity. Nephropathy is observed, at onset (30%) or some time later from one month to 3 years and 3 months (7.6%), is seen in 37.6% of patients. In all, 7/64 (11%) of patients were at stage D of nephropathy at the end of follow-up. 2 of these began with IRA, 2 with nephritic syndrome, 2 with hypertension and one with monosymptomatic microhaematuria. The latter figure suggests that this symptom should not be underestimated at onset and its course should be followed closely. The mesangium was the primary localisation in the 6 patients biopsied. Finally, there do not appear to be any substantial differences between patients treated and those not treated with corticosteroids and/or anti-platelet aggregators, in agreement with what most authors state. PMID- 2699516 TI - [Methodologic approach to the therapeutic problem of infant and childhood obesity. Review of the literature and personal experience]. AB - Notwithstanding the high prevalence and morbidity, current knowledge of obesity is rather rudimentary. Nevertheless recent findings have enabled us to surmount anachronistic nosographic generalizations whereby excess weight was attributed only to inappropriate and excessive food intake and the lack of physical exercise. Various studies indicate that there are complex interactions in determining weight excess: genetic, psychosocial, cultural but also biochemical factors are incriminated and it is now recognised that the aetiology of obesity is multifactorial and that, consequently, there are different types of obesity. However, in most studies concerning the therapeutic approach, it is noted that the same type of treatment is applied to groups of subjects that are probably highly heterogeneous for type of obesity. No easy or final solution to the problem is proposed as for the moment no ideal treatment exists. What is suggested is the need to attempt to identify possible factors linked to weight excess before commencing the therapeutic approach. For each single case, this could permit the use of the most appropriate treatment and make therapeutic results less frustrating. PMID- 2699517 TI - [Defects of thyroid hormone synthesis: nosographic study and proposal for a protocol for differential diagnosis]. AB - In addition to the forms of congenital hypothyroidism caused by dysgenesis of the thyroid gland (agenesia, ectopy), this phenomenon may be caused by enzyme deficiencies of the thyroid hormone synthetic process. These defects, which are hereditary and transmitted as recessive autosomic characters, are clinically manifest in homozygotic subjects in the form of goitres which appears during the neonatal age or, as in more common, during later infancy. At present, mass neonatal screening allows this phenomenon to be diagnosed during the first days of life. The diagnosis of hypothyroidism caused by enzyme deficiency is made on the basis of radioisotopic and ultrasonic studies, and by the assay of plasma levels of thyroglobulin. The exact definition of the specific enzyme activity which is lacking in each case is more complex and has still to be resolved. This study describes the biochemical and pathogenetic characteristics of the different thyroid hormone synthesis defects and includes the findings of previously published diagnosis tests in order to identify the missing enzymatic activity. Lastly, a protocol for the differential diagnosis of the various types of defect is outlined. A specific etiological definition of the altered thyroid metabolism, while providing further insight into the physiopathology of the thyroid and the epidemiology of enzymatic hormone synthesis defects, should not be a motive for delaying the start of substitutive therapy at the earliest possible stage. PMID- 2699518 TI - [Echographic finding of a liver mass in the first years of life]. AB - On the basis of personal experience of echographic finding of liver mass in the early years of life, the origin is recalled and symptomatology with ultrasounds outlined: 1) they may be occasional findings without corresponding clinical signs (cystic dysplasic forms); 2) they may be metastases of known tumours (neuroblastoma); 3) they may be primary neoplasias (haemangiomas); 4) they may be signs of a state of immunodeficiency (abscess foci). It is stated that the data supplied by echography are often aspecific or permit diagnosis only if integrated with elements provided by other techniques and/or by clinical and biohumoral data. PMID- 2699519 TI - [Cohen syndrome. Description of a new case and study of the central nervous system using nuclear magnetic resonance]. AB - The Cohen syndrome is characterized by dysmorphic face, obesity, narrow hands and feet and mild mental retardation. So far only 42 cases have been described in literature. The Authors describe a patient who presented some cerebral anomalies at the MRI examination. In particular the MRI showed a large sellar cavity compared to the size of the hypophysis. PMID- 2699520 TI - [Isolation and characteristics of a recombinant pOV13 plasmid as a vector for DNA cloning in a broad range of bacterial hosts]. AB - The hybrid plasmid pOV13 proposed as a potential vector for DNA cloning in a broad bacterial host range has been constructed on the basis of the broad host range plasmid RSF1010 and a shortened derivative of RP4, the plasmid pVZ115 serving a marker DNA fragment. The plasmid pOV13 contains the genes for streptomycin, kanamycin and tetracycline resistance and single cleavage sites for restriction endonucleases BamHI, BgIII, SalI, SmaI, PvuII, XhoI, as well as double cleavage sites for restriction endonucleases PstI and HindIII permitting one to clone DNA with insertional inactivation of genes. The physicogenetical map of the birepliconed plasmid pOV13 is presented. PMID- 2699521 TI - [Value of Doppler ultrasonography in the diagnosis of minor and moderate changes of the internal carotid arteries]. AB - Using contrast and Doppler ultrasonic diagnostic methods the authors examined 78 internal carotid arteries in 67 patients with cerebral circulatory disturbances. Ultrasonographic assessment of the blood flow in the internal carotid arteries was done in direct study of these arteries, and indirect study through the periorbital branches of the ipsilateral ophthalmic arteries. The results of USG-D examinations of internal carotid arteries were compared with their angiograms showing in 15 cases uneven outlines of the lumen, in 24 cases arterial loops, in 29 minor narrowing (21-40%), in 10 - moderate narrowing (41-70%). In the group of arteries with uneven lumen outlines USG-D examination showed impaired blood flow in 86.7% of cases, in the group of arterial loops--in 91.7% of cases, in the group of minor narrowing--in 86.2%, in the group of moderate narrowing--in 100% of cases. In all, out of 78 internal carotid arteries with angiographically confirmed abnormalities in 70 cases (89.7%) Doppler study suggested presence of lesions. In 24 cases (30.7%) disturbances of blood flow dynamics in the internal carotid artery caused an atypical result of the carotid compression test carried out during examination of opthalmic arteries. The obtained results indicated a high usefulness of Doppler test in the diagnosis of minor and moderate abnormalities of the internal carotid arteries. PMID- 2699522 TI - [Current views and studies of brain edema]. PMID- 2699523 TI - [The centenary of the birth of Mieczyslaw Minkowski]. PMID- 2699524 TI - Hypoglycemic effect of liposome-entrapped insulin administered by various routes into normal rats. AB - We entrapped insulin into liposomes using one combination of lipids comprising egg lecithin-cholesterol-stearylamine (7:2:1 molar ratio). The efficiency of entrapment was about 20% with unsonicated liposomes (LMV), and around 5% with sonicated liposomes (SUV). LMV-, SUV- and free-insulins were administered via different routes into male, non-diabetic Wistar rats in order to change the glycemia. When administered parenterally all preparations acted in a similar manner, reducing the glycemia after 2 h in the range of 75% to 85% in case of iv administration, and 43% to 67%--after sc administration. Only liposome insulin acted via intragastric route, and SUV-insulin-via buccal--or nasal route. PMID- 2699525 TI - [Ossifying fibroma: report of two cases]. AB - Because information on this condition is scarce, there is still some controversy as to its diagnosis and treatment as a specific entity, separate from the rest of the so-called fibro-osseous lesions of the maxillae. This paper submit two cases histories of ossifying fibroma and a review of the literature. PMID- 2699526 TI - [Aging and the oral cavity]. AB - Like all tissues in the human body, those within the buccal cavity undergo changes with ageing, which are observable in clinical practice. Such changes include the appearance of lingual varicosities, glossitis, atrophy of the taste papillae and of the salivary glands, with variable degrees of xerostomia, periodontal disease and predisposal to develop malignancies. Dental units may also be affected, with occurrence, among other processes, of abrasion, attrition, caries and lowered dentarian sensibility, phenomena of interest for the odontologist in handling geriatric patients. PMID- 2699527 TI - [Median mandibular cyst. Report of a case]. AB - This is a case report of a median mandibular cyst in a 30 years-old male, treated at the Maxillofacial Service of the "Hospital de Especialidades del Centro Medico La Raza", I.M.S.S. It includes clinical, radiological and histological features plus a review of bibliography, in order to analyze the established parameters and arrive at a diagnosis. PMID- 2699528 TI - [Rhinitis]. AB - Acute rhinitis is an acute inflammatory disease affecting nasal mucous membranes, most frequently caused by viral infections. Complications include secondary bacterial invasion. Treatment is mainly symptomatic. Antibiotics should be prescribed only when significant bacterial infection is demonstrated. Local vasoactive drugs should not be used but occasionally their oral administration can be effective. Hypertrophic and atrophic forms may be differentiated among chronic rhinitis. Hypertrophic forms include congestive, hiperplastic and allergic lesions of nasal and sinus mucous membranes. Allergic rhinitis should be treated with antihistamines, descongestants and avoidance of allergen. The atrophic forms with crust formation and foul breath are usually managed with local flushings of 9% sodium chloride in water followed by instillation of fluid vaseline, but in some resistant cases reduction of intranasal space by surgical insertion of acrylic pieces is recommended. Nasal obstruction, foul odor, dryness sensation and headache are usually controlled in 90% of these surgically treated patients. PMID- 2699529 TI - [Some recent determinants of breast feeding in Chile]. AB - Four factors that could explain in great part breast milk production difficulties in Chilean mothers are analyzed according to recent studies. Maternal nutritional status, positively influences breast milk volume and duration, thus adequate weight increment during pregnancy should be encouraged. Maternal work has been negatively correlated with breast-feeding duration in various local studies, by the contrary post-partum rest and direct care of infant show protective effects. Mothers that smoke during pregnancy and lactation have shorter breast-feeding periods than non smokers, meanwhile the latter have lower malnutrition rates. Elimination of health team practices that interfered with physiological lactation have increased breast-feeding time. New programs in this regard are encouraged. The presence at the national level of each of the four determinants is discussed according to available data. PMID- 2699530 TI - [Use of phase contrast microscopy in periodontology]. AB - Dark field microscopy and phase contrast microscopy allow subgingival microbial plaque examination to differentiate healthy state and pathogenic stages of periodontal disease. These microbial technics are appropriate to inform the patients about the bacterial etiology of their periodontitis and motivate them for a better oral hygiene. PMID- 2699531 TI - [Asbestos and bronchogenic carcinoma: a search for fibers in the pulmonary tissue of 3 patients with bronchogenic carcinoma]. AB - Based on the highly suspicious radiological findings of exposure to asbestos (case 1) or on a positive occupational history (cases 2 and 3), the authors looked for the presence of fibers in blocks of lung tissue removed in autopsy or surgical biopsies of three cases of bronchogenic carcinoma. The blocks were submitted to sodium hypochloride digestion followed by fiber identification in phase contrast light microscopy. The authors were able to demonstrate the presence of fibres in the three cases. The likelyhood of those carcinomas being caused by exposure to asbestos is very high, as two out of the three cases showed pulmonary fibrosis (cases 1 and 2) and the other case showed typical parietal pleural plaques at thoracotomy. PMID- 2699532 TI - [Myasthenia gravis and pregnancy: review of the literature and report of 6 cases occurring in 5 patients]. AB - The authors report six cases of myasthenia gravis during pregnancy. Three patients experienced increasing severity of their disease and one death occurred in the puerperium. The infants were born with no evidence of neonatal myasthenia. The patients should be closely monitored during labor and puerperium. This disease is characterized by unpredictable exacerbations, and the association of myasthenia gravis and pregnancy increases the risk for the patient. PMID- 2699533 TI - [Pathogenesis of central nervous system infections and the cerebrospinal fluid. Critical analysis of the diagnostic contribution]. AB - Considering data on cerebrospinal fluid (CSF) composition in infectious diseases of the central nervous system (CNS), an evaluation of the pathogeny of CNS infections is made. Basic factors considered in the evaluation are those related to the blood-brain barrier and to immune phenomena. The analysis supports the distribution of infectious diseases of the CNS according to different models: inside model, outside model, and intermediate model. The inside model occurs in three types of presentation: acute, chronic, and repetitive. Impairment of the immune system may induce changes in the presentation of the models. CNS infections usually run nonparametric paths in this circumstance, and conditions related to AIDS are discussed. Diagnostic contribution of pathogenic aspects evaluated are analyzed. PMID- 2699534 TI - [Immunity and infection after splenectomy]. PMID- 2699535 TI - [Recurrent lupus nephritis in kidney transplantation]. AB - A case of recurrent lupus nephritis involving a renal allograft in a 28-year-old woman is described. The transplant was made after 2 years of hemodialysis. The allograft function remained stable for 2 years after the transplant. Clinical course, serologic tests, and renal histopathologic findings at the time of recurrence paralleled those seen in the patient's primary disease. There were no changes of transplant rejection. One year of follow-up shows a stable allograft renal function despite the histological and clinical recurrence of systemic lupus erythematosus. PMID- 2699536 TI - [Cerclage of the cervix uteri via a transabdominal route: report of 2 cases]. AB - The authors present two cases of transabdominal cervicouterine cerclage using Benson and Durfee's technique. In both cases the surgery was successful and the patients gave birth at 37 and 40 weeks, respectively, to healthy newborns. The technique is recommended by the authors since technical details are observed. PMID- 2699537 TI - [New trends in image diagnosis of rheumatoid spondylitis]. PMID- 2699538 TI - [Importance of parallel crown preparation and the length of prepared surfaces for retention of bridges]. PMID- 2699539 TI - [CAD/CAM in dentistry]. PMID- 2699540 TI - Effect of captopril on urinary excretion of prostaglandins and renin-angiotensin aldosterone system in normal subjects. AB - The effect of captopril on urinary excretion of prostaglandin E2, 6-keto prostaglandin F1 alpha, thromboxane B2 and renin-angiotensin-aldosterone system was studied in 13 healthy volunteers during normal and low sodium diet. Angiotensin converting enzyme inhibition led to marked increase in plasma renin activity during both dietary periods without significant modification of plasma aldosterone during normal sodium diet. Prostaglandin E2 significantly increased after captopril during both sodium intakes. Captopril did not change significantly urinary excretion of 6-keto prostaglandin F1 alpha and thromboxane B2. The results indicate that the hypotensive response to captopril in normal subjects is related to the state of sodium balance. Although renin-angiotensin aldosterone system is the major contributor to this response, it is possible that prostaglandin E2 mediates at least partly the hypotensive and diuretic response to captopril. PMID- 2699541 TI - [The role of guide planes in the retention of removable partial dentures]. AB - Modern understanding of the retention mechanism of partial denture assumes that the path of insertion and the path of displacement of denture form a definite angle. The denture is possible to insert in a given direction only after forming guide planes which, in the same time, possible take part in retention of denture. The aim of this work was to test the hypothesis that the preparation of guide planes and bending of models in the surveyor brings, the rigid parts of framework to increase the ability of denture to be kept on supporting tissue. The research was performed on the frameworks of denture which were of same design and models with and without preparation guide planes. Total of 60 framework removings from the vertical direction were made under the different conditions of the measurement, using universal electronic machines. PMID- 2699542 TI - [Root surface caries]. AB - Review of the current knowledge related to the etiology, clinical picture, treatment, and prevention of root surface caries (RSC) is presented. The prevalence of RSC rates vary from 20 to 40 percentage depending on the age of the population studied and the definition of RSC applied. Prevention of RSC requires oral hygiene instructions and dietary advices as well as drinking of optimally fluoridated water combined with the appropriate use of topical fluoride agents. Glass ionomer cements are considered the best and the most successfully used filling material for root surface cavities. Epidemiologic data indicate that RSC increases with age and becomes a major health problem in dentistry. Since our present knowledge about root caries is insufficient, more research is needed in every aspect of the disease. PMID- 2699543 TI - [Intracellular potassium in normal and pathological pregnancy. I. Regulation of transport and concentration]. AB - Potassium is the most represented intracellular cation. Its concentration is regulated by active and passive mechanisms: cellular capacity, diffusion, channels and active transport. The relationships among Potassium and other cell cations may be involved in the pregnancy adaptation, and in the pathogenesis of some diseases, among which hypertension and diabetes. PMID- 2699544 TI - [Effectiveness of a topical medical treatment following diathermic coagulation: controlled clinical study]. AB - A controlled clinical study has been conducted on the efficacy of a topic therapy. Kanamicine sulphate daily for 6 days and altered to polidesossiribonucleotide for the following 24 days were given after cervical cauterization for ectropion with or without AnTZ. Treated patients were 148 and untreated ones were 155. Subjective and objective parameters were evaluated. Among the former only bloody discharge (more frequent among the treated patients) and ill-smelling discharge (more frequent among the untreated patients) showed significant differences. Colposcopy instead showed better (or faster) healing of the treated group, with 83.6% vs 62% iodine dark cervices at Schiller test and 87.9% vs 59.7% SCJ at the external os or inside (P less than 0.01). Also disepitelized areas or areas with frail epithelium were less common among the treated patients. PMID- 2699545 TI - [Antifungal effects in vitro of jasmon and some similar compounds. Structure activity relationship]. AB - The antimycotic activity in vitro of jasmon and 6 closely related substances has been tested against four different dermatophytes, Candida albicans, Pityrosporum ovale and Aspergillus fumigatus. Jasmon had the highest activity. Among the other substances tested only thiazolidines with a carbonyl function developed antifungal properties against dermatophytes. 2,4 thiazolidinedione at 450 ppm inhibits the growth of Trichophyton rubrum. PMID- 2699546 TI - [Shockwave lithotripsy: energy needed for fragmenting calculi]. AB - Based on the experience with the Dornier HM-3 lithotripter, the author analyzes herein the adverse effects caused by extracorporeal shock wave lithotripsy. Although admittedly empirical, an attempt is made to establish the number of shock waves and pressure required to achieve stone fragmentation without causing injury to the kidney. The effects of lung, stomach, colon, and skin or muscle contusions, hematoma, renal scarification, decreases in renal function, elevations in liver enzymes, and pancreatitis are reported, as well as systemic effects such as hemoglobinemia and hemoglobinuria, hearing change, and potential excessive radiation exposure, etc. The estimate of shock wave energy is discussed, highlighting the importance of the number of shock waves over the energy of the shock wave, and attention is focussed on the concept of stone fragility. Although we can nearly define the upper limits of energy related to safety, the author concludes that currently many questions remain unanswered. PMID- 2699547 TI - [Influence of the lithiasic surface on the strategy: complications and results in the treatment of kidney calculi]. AB - Stone mass is a fundamental parameter that determines the approach to reno ureteral lithiasis. Reference to stone size based on a single diameter gives us an imprecise idea about stone volume. For this reason, we recommend using the term "stone surface" to express stone mass. Stone surface is obtained by multiplying the longitudinal by the transversal diameter expressed in millimeters, using the plain film for radiopaque and the urogram for radiolucent calculi. Stone surface is a parameter which can be determined easily and is a more reliable way to determine stone volume. In 1,500 renal units with reno ureteral calculi treated by ESWL and percutaneous techniques, we corroborated that the surface of calculus is directly associated with the number of shock waves required for fragmentation. Thus, as stone surface increases, more shock waves will be required to achieve fragmentation. The surface area of the calculus correlates very significatively with urinary tract obstruction post-ESWL. As the surface of the fragmented stone increases, there exists a higher incidence of obstruction. Obstruction is more severe and more ancillary maneuvers to remove obstruction are warranted. The incidence of renal colic post-ESWL is significantly influenced by the surface area of the calculus. There is a higher incidence of reno-ureteral colic following fragmentation of large stones. Furthermore, stone surface significantly determines the rate at which fragments are passed, and the persistence of stone sand at 3 months. Thus, as stone surface increases, there will be more fragments that can and cannot be spontaneously passed following treatment with ESWL. Finally, it must be emphasized that stone surface is a fundamental parameter that determines the combination of ancillary techniques prior to ESWL and significantly influences the efficacy of the approach in the treatment of reno-ureteral calculi. PMID- 2699548 TI - [Extracorporeal shockwave lithotripsy in children]. AB - Upper urinary tract lithiasis is a rare condition in children in comparison to its incidence in the adult population. The distribution of lithiasis in children has been reported to be 56% for idiopathic lithiasis, 20% for metabolic lithiasis, and 25% for lithiasis associated with uropathy. Extracorporeal shock wave lithotripsy (ESWL) has become the treatment of choice for upper urinary tract calculi in the adult patient as well as in children after minor changes and complementary material had permitted the utilization of the Dornier HM-3 lithotripter in these small patients. The reported 3-month success rates range from 47% to 83%, according to the number of patients or kidneys free from calculi. The series reported in the literature have a mean of about 60% completely stone-free kidneys evidenced on the X-ray of the abdomen without preparation at 3 months. Its indications and results are comparable with those of ESWL in the adult. However, the long-term results have as yet not been evaluated and, to date, its hypothetical effects on renal growth or arterial pressure have not yet been elucidated. PMID- 2699549 TI - [New surgical classification of renoureteral lithiasis]. AB - The authors suggest a change in their surgical classification of renal calculi to conform the description to the new techniques in the treatment of renal calculosis. Category "C" describes the morphology and topography of renal stones in five degrees (C1-C5); small letters "p", "s", "m", "i" indicate the pelvis, superior, middle, inferior calyces; "n" and "a" symbolize a stone having a size similar to or exceeding normal shaped renal cavities. "Cu" indicates ureteral calculi; small letters, "l", "i", "p" indicate lumbar, iliac, pelvic ureteral stones. "N" describes the nature of the calculi. Category "E" stands for the excretory tract: "+" and "-" indicate the presence or absence of dilatation; the small letters "e", "i" show the extra or intrarenal position of renal cavities; "no" and "o" indicate absence or presence of intrinsic obstruction of the excretory tract. "R" points out the number of surgical recurrences. Category "P" indicates the function of the parenchyma; numbers 1, 2, 3 refer to normal renal function, moderate or serious insufficiency. "U" stands for unique functional or anatomical kidney; "I" indicates the presence of infection. PMID- 2699550 TI - [Complications of extracorporeal shockwave lithotripsy]. AB - The authors reviewed treatments performed worldwide using extracorporeal shock wave lithotripsy since its introduction in West Germany in 1980 to determine the efficacy of this treatment modality and its potential risks. The prevention of complications related to patients or shock wave energy are discussed, as well as the cardiovascular complications related to immersion, prevention of lesions to nearby organs, treatment of ESWL-induced bleeding, treatment of post-ESWL ureteral obstruction, prevention and treatment of infection, and long-term biological effects. Currently, less than 5% of patients are excluded from treatment with ESWL due to technical reasons or increased risk of periprocedural complications. Patients with cardiac pacemakers have been treated safely. Calcifications of the ipsilateral renal artery or aorta are considered only relative contraindications. However, certain technical limitations exist; i.e., the Dornier HM-3 cannot support patients weighing more than 135 kg., and patient height is also a limiting factor. There is an impressively low incidence of complications related to the energy of the shock wave. The severity and extent of damage are dose- and pressure-dependent. The potential for induction of cardiac arrhythmias secondary to the shock wave exists; however, effective prevention is achieved by coupling the shock wave discharge to the electrocardiogram. Complications of immersion are also extremely rare and can be avoided by careful preoperative evaluation. Damage to nearby organs such as pulmonary, gastric, duodenal or colonic contusions, constitute a very infrequent complication. Elevations of liver enzymes have also been noted post-lithotripsy. However, all these changes were transient and had no significant clinical consequences. Management of post-ESWL ureteral obstruction is by endourological procedures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699551 TI - Skeletal growth and chondroid tissue. AB - Membranous and endochondral ossification processes are insufficient to describe all the aspects observed in the growing skeleton. The presence of chondroid tissue that we have identified by means of all modern histological techniques, including those able to detect the different types of collagen, has also to be explained. Present in the mandibular symphysis of either the human or cat fetuses, chondroid tissue has also been observed in the other parts of the mandible, in the sutural areas of the skull and in all the bones of both axial and appendicular skeleton. The differentiation of the mesenchyme into chondroid tissue could probably be related with mechanical forces exerted simultaneously in opposite directions or with a transient ischemia. PMID- 2699552 TI - [The fundamental works of G. Conti on the subject of male impotence]. PMID- 2699553 TI - [Calcitonin: properties and methods of production]. AB - Calcitonin structure, biological activity, formation in organism and methods of production including isolation from natural sources, chemical synthesis and genetic engineering methods are reviewed. PMID- 2699554 TI - [Osteosarcoma of the jaw. Report of a case and review of the literature]. AB - A maxilla osteosarcoma with a clinico, radiologic and pathologic (optic and electronic microscopy) study is presented. The late admission of the patient to a specialized centre and inadequate dental extraction reduced the possibility of making an early diagnosis see the tumour reached the inoperable stage. It is to be noted the importance of an early diagnosis as the only way to the effective therapy. PMID- 2699555 TI - Binswanger's disease (Part II): Pathogenesis of subcortical arteriosclerotic encephalopathy and its relation to other dementing processes. AB - Subcortical arteriosclerotic encephalopathy (SAE) is a common though infrequently recognized dementia of the elderly. The unique vascular anatomy of the subcortical white matter and central brain stem probably predisposes those regions to chronic ischemia and incomplete infarction in the presence of various cardiovascular and hemodynamic insults. Recent studies have begun to define the risk factors for SAE, and others have shown it to be a condition frequently comorbid with the dementias of Alzheimer's disease, the multi-infarct state, and normal pressure hydrocephalus. Recent research into the etiologies of these disorders suggest certain pathogenetic links between them, strongly implying that they are not neatly distinct disease entities, as is commonly believed, and accounting for some of the overlap between these dementing illnesses seen clinically. PMID- 2699556 TI - Fluoxetine versus trazodone in depressed geriatric patients. AB - A total of 27 subjects began active treatment in this double-blind study comparing the efficacy and safety of trazodone and fluoxetine in geriatric depressed patients, but only 13 completed 6 weeks on study medication. Both agents were effective according to weekly and endpoint analyses, and there was no evidence of significant effects on blood pressure, pulse, or weight. Separate analysis of patients who had received an adequate trial of medication indicated a trend toward relatively more fluoxetine-treated patients meeting clinical criteria for resolved depression. PMID- 2699557 TI - [Cementation of provisionals in two sessions]. PMID- 2699558 TI - [Rebasing with hydrophilic resin]. PMID- 2699559 TI - [An original space maintainer]. PMID- 2699560 TI - [An upper partial without palate]. PMID- 2699561 TI - [Guided tissue regeneration]. PMID- 2699562 TI - [Phonetic functional impression]. PMID- 2699563 TI - [How to obtain a myofunctional impression]. PMID- 2699564 TI - [Palatal vault: phonetics and morphology]. PMID- 2699565 TI - [Restoration with original fragments]. PMID- 2699566 TI - [Anatomo-functional gingival waxing in "completes"]. PMID- 2699567 TI - Encephalocraniocutaneous lipomatosis. Report of two cases and a review of the literature. AB - We describe 2 patients with unilateral facial and cerebral malformations consistent with encephalocraniocutaneous lipomatosis. The characteristic facial appearance seems to develop with age, possibly as a consequence of increased intracranial pressure. However, the clinical data suggest that this condition arises as a result of a disruption of cephalic neural crest and anterior neural tube. PMID- 2699568 TI - Direct demonstration of an autocrine mechanism in EMS-induced, tumorigenic mutants of the growth factor-dependent hemopoietic cell line, FDC-P1. AB - A growth factor-dependent hemopoietic cell-line, FDC-P1, was treated with a chemical mutagen, EMS, and a number of growth factor-independent variants isolated. Six lines have been extensively analyzed with respect to their growth kinetics, morphology, karyotype, tumorigenicity, and hemopoietic growth factor production. Four lines produced at least one growth factor, subsequently demonstrated to be GM-CSF, while two lines showed no evidence of hemopoietic growth factor production. The observation that the autonomous proliferation of those EMS-derived cell lines that produced GM-CSF can be inhibited by incubation in growth media containing 10-50 microM anti-sense GM-CSF oligonucleotides demonstrated directly that the autonomous behavior of these cells is based on an autocrine mechanism. The induction of the expression of the GM-CSF gene represents a rare class of EMS-induced mutants, and is strongly suggestive of repressor inactivation rather than promoter activation. PMID- 2699569 TI - Growth factor-induced phosphorylation of c-ras p21 in normal hemopoietic progenitor cells. AB - Normal murine hemopoietic progenitor cells (colony-forming cells, CFC), representing 0.2% of the bone marrow cell population, were purified to homogeneity by fluorescence-activated cell sorting. CFC require the presence of the murine hemopoietic regulator, granulocyte-macrophage-colony stimulating factor (GM-CSF) for survival, proliferation, and differentiation along the myeloid pathway. An analysis of protein phosphorylation in GM-CSF-stimulated CFC over a 20-hr period demonstrated three phosphoproteins of approximate MW 21 kd and pI 6.2, 5.7 and 5.2 p21-6.2 persisted for 14 hr, while p21-5.7 and p21-5.2 were only detected during the first 5 hr of the analysis. The phosphate turnover time in all three p21 proteins was less than 3 hr and p21-5.2 contains an alkaline-resistant phosphorylation site. Low levels of p21-6.2 were also detected in unstimulated CFC. The observation of these phosphoproteins led us to investigate c-ras p21 in CFC. Immune precipitation with the anti-Ha/Ki-ras p21 monoclonal antibody (Y13-259) showed that expression of c-ras p21 in CFC was independent of GM-CSF stimulation, but that phosphorylated c-ras p21 was present only after GM-CSF stimulation. CFC contained one-tenth of the amount of phosphorylated c-ras p21 per cell compared with v-Ha-ras-transformed fibroblasts. It is possible that the phosphorylation of c-ras p21 in CFC has a significant role in the growth factor-directed molecular cascade responsible for normal hemopoietic development. PMID- 2699570 TI - Interleukin 4 induces cellular adhesion among B lymphocytes. AB - We here report that interleukin 4 (IL-4) alone is able to induce cellular adhesion among mouse lymphocytes, and together with lipopolysaccharide (LPS), it increases the adhesion induced by LPS. The adhesion was inhibited by antibodies against IL-4. IL-4 appears to be acting mainly on B lymphocytes, since the response caused by IL-4 alone was much less sensitive to depletion of adherent cells than the LPS response. Depletion of T cells had no effect on IL-4- or LPS induced adhesion. IL-4 could together with Con A, but not alone, induce adhesion among T cells. Cell clusters, which were formed after 2-3 days of LPS plus IL-4 stimulation, could be completely dissociated, and when the cells were recultured in medium, they readily started to reaggregate. The adhesion molecule lymphocyte function-associated antigen 1 (LFA-1) is, at least in part, involved in LPS plus IL-4-induced adhesion. Antibodies against LFA-1 inhibited the adhesion, but antibodies against other cell surface molecules were without inhibitory effect. Adhesion induced by IL-4 alone may involve other adhesion molecules than LFA-1. PMID- 2699571 TI - [Clinical test of two toothpastes of different composition]. AB - In two series of clinical tests, the effect of two toothpastes of differing formulation were examined in respect of their plaque removal efficiency and their influence on inflammatory reactions of the periodontal margin. The remarkable improvements in the oral health of a group of "non-dentists" compared to "dentists" are certainly attributable to personal motivation and instruction on oral hygiene with brush and toothpaste, but also to the formulation of the paste which may have influenced these results. PMID- 2699572 TI - [Comparative clinical study of efficacy of three multi-tufted short top toothbrushes with different bristle bed designs]. AB - Three multi-tufted short-head toothbrushes were compared on 15 test persons, with respect to their efficiency in removing the plaque from margo gingivae and from the interdentium. With a different design of the bristle bed, all three brushes evidenced very little difference in the cleaning effect which, on the basis of the deliberately prescribed short cleaning time at the gingival margin, can be considered as good in respect of all teeth sections and as satisfactory in the approximal area. In individual cases, a slanted bristle bed can lead to better cleaning of the side teeth area. PMID- 2699573 TI - [Saliva--the undervalued protection system (2)]. AB - This work gives a comprehensive overview of the repair and defence capacity of saliva. The separate chapters deal with the production and composition of the mouth fluid, with its chemical characteristics as well as its mechanical, chemical and biological functions. Pointers to the practical uses of the knowledge presented conclude the work. PMID- 2699574 TI - [Comparison of flow rate of sulcus fluid after 30 seconds and 3 minutes test times]. AB - Within the framework of a gingivitis study the sulcus fluid flow rate (SFFR) at the lower and upper premolars of 9 subjects was determined with the assistance of Periotron 6000. The measurements were conducted at days 0, 7, 14 and 21 with the aim to compare the SFFR after 3 minutes (Loe and Holm-Pedersen 1965, Rudin et al. 1970) with the measurements of Lamster et al. (1985a, b) at 30 seconds. The increase of the SFFR at 30 seconds, as well as at 3 min was significant on all measurement days, but no proportional dependance of SFFR on the measurement time was seen. On the basis of these results it is justified to restrict the SFFR to 30 seconds, to reliably determine the grade of infection of gingiva. PMID- 2699575 TI - A new method for mechanically denuding the endothelium of small (50-150 microns) arteries with a human hair. PMID- 2699576 TI - [20 years of the pharmacy school at Charles University: thanksgiving and meditation]. PMID- 2699577 TI - [The importance of ultrasonography in the diagnosis of intraabdominal hemorrhage]. AB - On the basis of the author's 31 observations the paper deals with the contribution of ultrasonography for the detection of intraabdominal bleeding. Advantages of the method such as its rapidity, non-invasiveness, reliability, general availability and particularly the possibility of application even in severe conditions secure that ultrasonography keeps a dominating position among all visualization methods in the determination of intraabdominal bleeding. PMID- 2699578 TI - [Ultrasonography in the diagnosis of testicular tumors]. AB - Ultrasonographic examination of scrotum has become a stable part of urological practice. A palpation finding of scrotum or a condition when it cannot be examined by palpation represent the most frequent indications, followed by search for primary tumour, etc. The technique of water sac is useful and rapid. The examination may differentiate intratesticular processes, mostly of tumorous origin, e.g. seminoma, embryonal carcinoma and teratocarcinoma from extratesticular processes, e.g. a large hydrocoele, hematocoele, spermatocoele, epididymal cyst, orchitis, etc. Even though the ultrasonographic picture of the testis tumours are not specific, there is a possibility to hypothesize their histological structure in some cases. Ultrasonographic examination represents an unquestionable diagnostic progress. PMID- 2699579 TI - [Approach to the examination of patients with suspect portal hypertension using duplex ultrasonography. I. Quantitative evaluation of flow in the portal vein]. AB - The paper deals with the application of duplex real-time ultrasonography in the area of portal vein system. The attention is centered to the method of quantification of the flow. The author first analyzes the methodology and refers to some main technical factors influencing validity of the results obtained. The author then draws attention to basic ultrasonographic symptoms of portal hypertension. Having analyzed literature data he refers to limited importance of measuring the portal vein flow for the diagnosis of portal hypertension, draws attention to the contribution of respiratory changes in the area of portal vascular bed and the changes in blood flow velocity for this diagnosis. Finally, attention is paid to the possibility of suitable combination of these two signs by creating s. c. "congestive index" (18). PMID- 2699580 TI - The opening of the Sutherland Dental School and Newcastle upon-Tyne Dental Hospital--Saturday, 29th May 1948. PMID- 2699582 TI - A history of dentistry and diet in the Falkland Islands. Part 2. PMID- 2699583 TI - Blood group, secretor status and oral carriage of yeasts among patients with diabetes mellitus. AB - The inability to secrete the water-soluble glycoprotein form of the ABO blood group antigens is a genetic characteristic associated with susceptibility to superficial fungal infections and also insulin-dependent diabetes mellitus (IDDM). As oral carriage of Candida albicans in healthy adults is associated with non-secretion, we examined oral carriage of yeasts among 275 patients attending diabetic outpatient clinics, 137 with IDDM and 138 with non-insulin dependent diabetes mellitus (NIDDM) with reference to ABO blood group, secretor status and yeast species. Of the 166 yeast isolates, 109 (66.7%) were C. albicans, a lower proportion compared with 94% reported for healthy individuals. There was no association between ABO blood group and carriage. There was no increase in the proportion of non-secretor carriers of C. albicans among patients with IDDM; but among those with NIDDM, 44% of non-secretors were carriers compared with 21% who were non-carriers (p less than 0.01). The results are discussed in the context of host-parasite interactions influencing colonization. PMID- 2699584 TI - Different percentages of CD8+ lymphocytes in long-term type 1 diabetics with and without residual beta cell function. AB - About 15% of Type 1 diabetics display residual beta cell function after more than 10 yr duration of diabetes, indicating that the disease mechanisms have stopped before all beta cells are destroyed. Peripheral blood lymphocytes were studied from such patients, 11 females and 12 males, 29 +/- 1 yr old, who had had diabetes for 14 +/- 1 yr. A completely matched group of 23 Type 1 diabetics with the same disease duration, but without residual beta cells, were also studied together with a healthy control group. Lymphocytes were marked with monoclonal OKT antibodies and examined by flow cytometry (FACS). There was no difference between the three groups in the absolute number of lymphocytes and helper T-cells (CD4+:40.2 +/- 1.3 vs. 40.4 +/- 1.3 vs. 41.1 +/- 1.8%). In respect of CD8+ (suppressor/cytotoxic) T-cells, the diabetics without beta cells showed 25.9 +/- 1.0%, significantly less than both the patients with preserved beta cell function (29.0 +/- 0.9%, p less than 0.02) and the controls (29.5 +/- 1.3%, p less than 0.02). CD3+ (pan) T-cells showed parallel changes (67.8 +/- 1.5 vs. 71.0 +/- 1.4 vs. 72.2 +/- 1.4%, p less than 0.05). The metabolic state was similar in the two patient groups, and there was no correlation between metabolic and immunological parameters. It is unknown whether the normalization of the T-cell subpopulation, especially the CD8+ lymphocytes, in patients with residual beta cell function at a point when the disease process is apparently at rest, is of causal significance, or of only marker significance. PMID- 2699585 TI - C-peptide but not insulin concentrations are related to the serum lipoprotein levels during insulin treatment of non-insulin-dependent diabetes mellitus (NIDDM) patients. AB - In 21 non-insulin-dependent diabetic patients with secondary drug failure, once daily long-acting insulin lead to a moderately improved metabolic control. At the conclusion of the study (eight months) the fasting blood glucose and HbA1c concentrations were significantly decreased, but the postprandial blood glucose concentrations in the afternoon were unaltered. The peripheral insulin sensitivity, as measured by the intravenous insulin tolerance test, and the lipoprotein lipase activity in adipose and skeletal muscle tissue had increased. After initiation of insulin therapy there was a transient decrease of the fasting and glucagon-stimulated C-peptide concentrations. The very low density lipoprotein lipids and apolipoprotein B, A-I and A-II were also reduced transiently. The only significant difference in lipoprotein composition at eight months compared with on admission, was an increased cholesterol and decreased triglyceride concentration in the high density lipoproteins. There were significant relationships between the C-peptide, but not the peripheral insulin, concentrations and the serum lipid concentrations. This may indicate that high peripheral insulin concentrations after administration of exogenous insulin may affect the hepatic lipoprotein production less than the portal insulin concentrations mainly derived from endogenous production. PMID- 2699587 TI - Bonded retainers need preparation. PMID- 2699586 TI - A microfluorometric viability assay for isolated human and rat islets of Langerhans. AB - A microfluorometric viability assay for isolated human and rat islets of Langerhans has been developed using the fluorochromes fluorescein diacetate and propidium iodide. Fluoroscein diacetate causes live cells to fluoresce green under blue light excitation (490 nm); propidium iodide causes dead cells to fluoresce red under green light excitation (545 nm). The fluorescence intensity from the live and dead cells within a single islet was selectively measured by photometry using 520 nm and 610 nm barrier filters with blue and green light excitation respectively. All measurements were corrected for background fluorescence. It was necessary to incubate single islets with the fluorochrome mixture for 105 min in order to achieve maximum fluorescence intensity. It was found that when 50 microliters of a fluorochrome mixture containing 0.67 mumol/l fluorescein diacetate and 4.0 mumol/l propidium iodide was incubated with a single islet and the fluorescence from live (blue light excitation) and dead (green light excitation) cells measured, then the proportion of dead cells within the islet was equal to the (propidium iodide fluorescence)--(0.04 x fluorescein fluorescence) divided by the sum of the (fluorescein fluorescence) and (propidium iodide fluorescence--(0.04 x fluorescein fluorescence]. The proportion of dead cells within single human or rat islets measured by microfluorometry was found to correlate highly significantly (r = 0.99, p less than 0.001) with the proportion of dead cells measured by dissociating the same islet into a single cell suspension and counting the actual proportion of dead cells. This assay therefore provides a rapid, accurate and objective measurement of the proportion of dead cells within isolated human and rat islets. PMID- 2699588 TI - Pulpal healing after luxation injuries and root fracture in the permanent dentition. AB - Pulpal healing patterns were studied in a clinical material of 637 luxated and 95 root-fractured permanent incisors followed routinely for up to 11 years. It was found that pulpal healing patterns could generally be divided into 3 groups according to the degree of injury sustained by the pulp: little, moderate or severe. Thus after luxation injuries, pulp survival could be without radiographic change (PS), with pulp canal obliteration (PCO) or nonhealing (pulp necrosis (PN]. After root fracture, similar healing patterns could be observed: healing by hard tissue union of fragments (HT), by connective tissue union of fragments (CT) or by nonunion due to interposition of granulation tissue between fragments (GT) resulting from PN of the coronal fragment. In both trauma situations, healing or nonhealing could be determined by type of luxation injury, stage of root development and type of fixation used (forceful application of orthodontic bands vs. passively applied acid-etch fixation). Pulpal healing complications (PN or GT) were based on clinical findings (coronal discoloration, loss of pulpal sensibility) and radiographic findings (resorption processes of the lamina dura at the root apex or at the level of the root fracture). However, in both injury groups the same changes could also be seen to be intermediate steps in the pulpal healing process. Based on findings from these studies, hypotheses for the mechanics of pulpal healing are proposed as well as guidelines for acute and later treatment of dental luxations, root fractures and the diagnosis of healing complications. PMID- 2699589 TI - Adhesion of a glass ionomer cement to bleached and unbleached bovine dentin. AB - Cylinders of Fuji Type II glass ionomer restorative cement were bonded to the superficial dentin layer of young bovine incisor teeth that had previously been subjected to 4 different treatments: 1) teeth immersed in 35% hydrogen peroxide for 60 min and etched with 37% phosphoric acid gel for 60 s; 2) teeth immersed in saline for 60 min and etched with 37% phosphoric acid for 60 s; 3) teeth etched with 37% phosphoric acid for 60 s and immersed in 35% hydrogen peroxide for 60 min; or 4) teeth etched with 37% phosphoric acid for 60 s and immersed in saline for 60 min. Specimens were stored in water at 37 degrees for 1 and 7 days, prior to tension and shear testing. A total of 128 teeth were tested: 8 teeth in each group for each day and for each test. Statistical analysis of the results indicated that there was a highly significant reduction in bond strength of the cement when dentin was exposed to hydrogen peroxide as compared with saline. SEM examination of randomly selected fractured test specimens indicated that bond failure was cohesive in nature, suggesting that the hydrogen peroxide treatment adversely affected the setting process of the glass ionomer cement. PMID- 2699590 TI - Progress towards a molecular vaccine against malaria. PMID- 2699591 TI - Incrimination of Anopheles dirus as a vector of malaria in Dibrugarh district, Assam. AB - Anopheles nigerrimus, A. vagus, A. dirus, A. karwari and A. kochi were the most abundant species among 12 anopheline species collected during the course of entomological studies carried out from July to September, 1988 in an area endemic for malaria under Tengakhat PHC of Dibrugarh district, Assam. Sporozoites were detected in the salivary glands of one specimen of A. dirus, Peyton & Harrison (A. balabacensis) which constituted about 18.11 per cent of the total anopheline collection. PMID- 2699592 TI - Computer-aided differential diagnosis of oral radiographic lesions. AB - A program called ORAD was designed using Bayes' theorem to evaluate the radiographic and clinical features of patients with intrabony lesions in order to assist in their identification. Ninety-eight jaw lesions were described by their prevalence and their distribution by age, sex, race, presence of pain, number, size and location of lesions, association with teeth, expansion, locularity, borders, contents and impact on adjacent teeth. The user follows a menu of 16 questions in order to characterize a specific lesion. The program output is a list of the lesions in order of their estimated probability. In addition, an estimate of the extent of match between the lesion in question and the typical appearance of each lesion in the knowledge base is calculated. Preliminary trials indicate that ORAD is useful in assisting clinicians in formulating a differential diagnosis. PMID- 2699593 TI - MacCeph: orthodontic computer database and diagnostic generator. PMID- 2699594 TI - Metabolic characteristics of bacterial cells entrapped in beaded calcium alginate and/or pectate gels. AB - A mixture of heterotrophic bacteria and collection strains of Escherichia coli and Pseudomonas fluorescens were immobilized in calcium alginate or pectate gels. Comparison of respiratory activity, substrate uptake and biosynthetic capacity of immobilized cells showed that both types of carriers permit a prolonged preservation of metabolic activity but the transfer of substances through the gel is faster in the pectate. Morphological changes include some intracellular structures, partial shrinkage of the plasma membrane of immobilized cells, and transformation of a rod-like cell shape to an oval one. PMID- 2699595 TI - Genetics in the journal Human Biology. PMID- 2699596 TI - A study of twins with special reference to heredity as a factor determining differences in environment. 1934. PMID- 2699597 TI - The blood-group frequencies of European peoples, and racial origins. 1940. PMID- 2699598 TI - Inbreeding coefficients of the Ramah Navaho population. 1953. PMID- 2699599 TI - A demographic study of a Dinka village. 1956. PMID- 2699600 TI - Some possibilities for measuring selection intensities in man. 1958. PMID- 2699601 TI - The study of natural selection in primitive and civilized human populations. 1958. PMID- 2699602 TI - The wave of advance of an advantageous gene: the sickle cell gene in Liberia. 1960. PMID- 2699603 TI - Metabolic polymorphisms and the role of infectious diseases in human evolution. 1960. PMID- 2699604 TI - Evolution of the immunologic species specificity of human serum proteins. 1962. PMID- 2699605 TI - The estimation of inbreeding from isonymy. 1980. PMID- 2699606 TI - [Minoxidil. Objectivity and criticism]. PMID- 2699607 TI - [Pemphigus herpetiformis. Description of a case]. AB - The Authors report a case of pemphigus herpetiformis pointing out the importance of direct immunofluorescence studies in the diagnosis of this dermatosis. PMID- 2699608 TI - [Use of an MAO inhibitor in the treatment of psoriasis vulgaris]. AB - Thirteen patients suffering from psoriasis vulgaris of middle-high severity, were treated with tranylcypromine (5 mg once a day) or with placebo during a four months period, following a double-blind randomized trial. Results were evaluated with a statistical analysis of the data obtained with a PASI method. Tranylcypromine, an MAOI drug, appears to be effective in reducing the extension and severity of lesions. PMID- 2699609 TI - The changing philosophy in the search for anti-rheumatic drugs: a personal overview. AB - A mini-review to mark the presentation of the Inwin Prize during the 3rd Interscience World Conference on Inflammation at Monte Carlo in March 1989 and to gratefully acknowledge my many co-authors. For this reason this article is devoted to some aspects of the work from this department over the past three decades. PMID- 2699610 TI - Serum interleukin-2 receptor levels measured by enzyme immunoassay in heart and kidney transplanted patients. AB - IL-2R serum concentrations were assayed by a sandwich enzyme immunoassay method in order to ascertain if the measurement of the soluble form of IL-2R can be considered a useful marker of allograft rejection in heart and kidney transplanted patients. Serum IL-2R levels increased significantly compared to pre operated values (1129 +/- 215 U/ml vs. 592 +/- 209 U/ml, p less than 0.01) in six heart-transplanted patients during acute rejection crises documented by clinical findings and endomyocardial biopsy, and returned to baseline levels after successful treatment (544 +/- 395 U/ml vs. 1129 +/- 215 U/ml, p less than 0.01). Moreover, we observed that severe bacterial (n = 5) or viral (n = 2) infections were also accompanied by a significant increase of IL-2R serum levels in heart transplanted patients (1076 +/- 263 U/ml vs. 486 +/- 146 U/ml, p less than 0.01 in bacterial, and 1290 +/- 368 U/ml vs. 370 +/- 85 U/ml in viral infections). In the six patients with renal transplant, the mean pre-operative IL-2R level was also elevated (1507 +/- 203 U/ml). A 1.5-4 fold increase of IL-2R levels has been observed at the beginning of both acute rejection and clinically evident infection. Our data show that the serum concentration of IL-2R is increased in heart and kidney transplanted patients during allograft rejection crisis. However, the information gained with this assay must be cautiously interpreted because an increase of IL-2R concentrations can also indicate bacterial or viral infections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699611 TI - Necrotizing sialometaplasia: review of 127 cases. AB - A review of 127 documented cases of necrotizing sialometaplasia is presented, mainly focusing on 96 palatal lesions. Necrotizing sialometaplasia is a benign, self limiting inflammatory lesion of the minor salivary glands. The cause is unknown but it may be related to oral trauma, tobacco use or inadequate blood supply. Male (mean age 49.8 yrs) to female (mean age: 36.3 yrs) ratio is 2.31:1. Because the clinical and histologic features mimic malignancy, proper diagnosis is of utmost importance in order to avoid unnecessary and extensive surgery and radiation therapy. The lesion heals spontaneously, regardless of therapy in two to eight weeks. PMID- 2699612 TI - [Treatment of chronic primary open-angle glaucoma. Long-term functional results]. AB - The functional results of the treatment of primary open angle glaucoma (POAG) were analysed. A retrospective study was undertaken on 437 eyes from 282 patients (137 women, 145 men) followed in Saint Joseph's Hospital (Paris). The mean follow up was 9.7 years (4-22 years). 265 eyes received only medical treatment, 83 eyes argon laser trabeculoplasty (ALT) and 89 eyes surgery (66 trabeculectomies - 23 cataract-glaucoma combined operations). At least twice a year, intraocular pressure (IOP), visual acuity (VA) and mean total visual capability (TVC) on the Friedmann analyser were recorded on a computer. The severity gradient (SG) was calculated from the evolution gradient of TVC versus IOP with time for each group (medical, ALT, surgery) before and after treatment. Medical SG was not significantly different from ALT SG or surgery SG (trabeculectomy or combined surgery). For each group, SG before treatment was not significantly different from SG after treatment. For tonometric failures after ALT or surgery, SG before treatment was not different from SG after treatment. Nevertheless, after trabeculectomy, in the cases of clear tonometric success (IOP less than or equal to 16 mmHg), SG was significantly improved (p less than 0.001). On the other hand, no positive influence was noted on visual field evolution in cases of a commonly admitted good tonometric control (IOP less than or equal to 21 mmHg). Visual acuity loss after trabeculectomy was greatest during the first year (6/20). The cataractogenic role of trabeculectomy was statistically confirmed. The incidence of cataract at 5 years was 46%. This cataractogenic effect occurred significantly more after 55 years. We discuss tonometric effect on TVC evolution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699613 TI - [Contribution of the argon laser in iridotomy using the Yag laser]. AB - Yag laser iridotomy was performed immediately after argon laser application in 59 eyes with chronic angle closure glaucoma, occludable angle and secondary glaucoma. Postoperative intraocular pressure was elevated temporarily more than 5 mmHg on 86.4% of patients. Iris haemorrhages occurred in 17% of cases when laser Yag iridotomy was carried out with a power of 4 to 6 mJ. Prior argon laser seemed to prevent iris haemorrhages. PMID- 2699614 TI - [Proteins of the lens]. PMID- 2699615 TI - Randomized double blind study of Curcuma domestica Val. for dyspepsia. AB - Curcuma domestica Val. is a medicinal plant. It has been claimed to be effective for dyspepsia. The studies done so far showed no toxicity due to consuming Curcuma domestica Val. The plant has been found to contain volatile oil and curcuminoids which are believed to be the active ingredients. The objective of the study was to test the efficacy of Curcuma domestica Val. rhizome for treatment of dyspepsia compared with a placebo and flatulence in a multicenter, randomized, double-blind trial carried out in one provincial and 5 community hospitals. One hundred and sixteen adult patients who had acid dyspepsia, flatulent dyspepsia, or atonic dyspepsia were included in the study. Forty-one (41) patients were in the placebo group, 36 and 39 were in the flatulence and Curcuma domestica Val. groups respectively. Each patient received 2 capsules of placebo or study drugs 4 times a day for 7 days. Each patient was then assessed for symptoms response, side effects and satisfaction. Ten patients did not participate in the follow-up. The baseline characteristics of the patients among the three groups were not significantly different. Fifty-three (53) per cent of the patients receiving placebo responded to the treatment whereas 83 per cent of the patients receiving flatulence and 87 per cent of patients receiving Curcuma domestica Val. responded to the treatment. The differences in efficacy between placebo and active drugs were statistically significant and clinically important. Mild and self-limited side effects were observed at similar frequency in the three groups. About 50 per cent of the patients in each group were satisfied with the treatment they received.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699616 TI - Atomistic lattice simulation of high Tc oxides. PMID- 2699617 TI - Molecular dynamics simulations of halide glasses. AB - Halide glasses have been extensively studied in recent years because of their potential application as infrared transmitting fibre optic materials. They are believed to be more ionic than glasses based on silica and should therefore be more amenable to molecular dynamics simulation using simple two-body potentials. Here the main features of structural models derived using such techniques are described and compared with available structural data. Possible future applications of this approach are outlined. PMID- 2699618 TI - Computer simulation of liquid crystals. AB - We review recent progress in the computer simulation of liquid crystals, with special emphasis on hard particle models. Surprisingly, the simplest molecular models, taking account only of molecular size and shape, are sufficient to generate a wide variety of liquid crystalline phases, closely analogous to those observed in real life. Thermodynamic stability of different phases is very sensitive to shape, and presumably will also be sensitive to further details of intermolecular interactions as they are incorporated into the model. Realistic atom-atom potential models of liquid crystals are available, but the associated simulations are quite expensive. Thus, while idealized models may be used to study quite general, fundamental properties of mesophases, the modelling of specific liquid crystal systems in a realistic way remains a great challenge. Progress continues to be made on both these fronts. PMID- 2699619 TI - MRI in the diagnosis of so-called pituitary apoplexy: seven cases. AB - The authors describe seven cases of pituitary adenoma with acute neurological symptoms (the so-called pituitary apoplexy), which were examined by magnetic resonance imaging (MRI). Four patients underwent surgery and the diagnosis of pituitary adenoma was histologically confirmed. In 3 patients, conservative treatment was decided and serial MRI examinations showed progressive decrease in size of the tumour, leading in one case to an empty sella. Computerized tomography (CT) was positive in all 7 cases, but less contributive than T1 weighted MRI images both for tumoral volume determination and detection of intratumoral haemorrhage. Although theoretical problems may arise concerning the diagnosis of acute intratumoral bleeding at an early stage, the authors emphasize the value of MRI in showing the extension of the tumor into the retroclival cistern and the cavernous sinus, especially when surgery is not performed in the acute period. PMID- 2699620 TI - The blood-brain barrier. AB - The blood-brain barrier (BBB) is present on three sites: the brain vessels, the choroid plexus and the arachnoid membrane. It is made of non-fenestrated endothelial or epithelial cells interconnected by tight junctions. Biochemically, the BBB is formed by bimolecular layers of phospholipids into which globular proteins are inserted. Exchanges through the BBB depend on whether the substances exchanged are soluble in water or in lipids. Hydrosoluble substances are largely excluded from the brain by the BBB; liposoluble substances pass the barrier easily by passive or active mechanisms. Water movements through the BBB are related to variations in osmolality. These data are of the utmost importance in all brain diseases with rupture of the BBB and in all neuroradiological procedures using contrast media. PMID- 2699621 TI - Serological diagnosis of trichinosis by enzyme linked immunosorbent assay (ELISA). PMID- 2699622 TI - Toxoplasma gondii antibody in patients of lepromatous leprosy. AB - Sera from 140 lepromatous leprosy patients (test group) and 120 normal persons, who showed no clinical signs of acute or chronic toxoplasmosis (control group), were studied for the presence of Toxoplasma gondii antibody by indirect hemagglutination and indirect-immunofluorescent antibody tests. Both tests showed a high incidence of Toxoplasma antibody in the test group in comparison with the control group. IgM and IgG classes of antibody responses were observed in both the groups, which signified recent as well as past infections in them. PMID- 2699623 TI - [Event-related potentials and cognitive information processing: issues on the studies of selective attention]. AB - Following considerations for some general issues of ERP research on human information processing, recent advances in this field are elaborated by reviewing the literature on selective attention. Sections in this review deal with following subjects: (1) two landmark contributions of Hillyard, Hink, Schwent, & Picton (1973) and Naatanen, Gaillard, & Mantysalo (1978); (2) the endogenous, attention-related negativity ("Nd" wave), which is considered to consist of three possible components, a modalityspecific Nd, a centrally-maximal, controlled search negativity, and a frontally-focused Nd; (3) the spatial attention effects on the exogenous components in visual and somatosensory modalities; and (4) the organizations of stimulus selection processes indicated by the latency and interrelations between those ERP components. PMID- 2699624 TI - Consequences of alcohol addiction. AB - Abnormal alcohol consumption commonly leads to medical, psychiatric, neurologic, traumatic, neoplastic and sociologic sequelae. Adequate prevention or treatment of these conditions requires recognition of alcohol as a primary etiological or precipitating agent. The consequences of alcohol addiction must be separated from the alcoholic's actual motivation or drive to use alcohol. Alcohol reinforces and perpetuates its own use with psychosocial stressors not required to produce addiction in the biologically vulnerable. Psychosocial stressors may stimulate alcohol consumption, but not necessarily addiction in the nonvulnerable. The consequences of drinking do not produce the abnormal drinking. A major life problem associated with alcohol use may lead to a presumptive diagnosis of alcohol addiction, but definitive diagnosis is based upon the presence of a preoccupation with the acquisition, compulsive use of and relapse or recurrent use of alcohol. PMID- 2699625 TI - [Effect of isosorbide dinitrate on neutrophil migration in vivo]. AB - The influence of isosorbide dinitrate on polymorphonuclear neutrophils migration into a sterile inflammatory focus was evaluated in 12 patients with ischemic heart disease. The number of neutrophils migrated into the "skin window" increased significantly during treatment with isosorbide. Also granulocyte clearance increased in comparison with control investigation. Possible clinical implications of this phenomenon are discussed. PMID- 2699627 TI - Ha-ras oncogene product in human oral squamous cell carcinoma. AB - The expression of Ha-ras oncogene product (Ha-ras p21) in the biopsy or operation materials derived from 70 oral squamous cell carcinomas, 10 oral leukoplakias and 10 normal oral mucosae was examined immunohistochemically using anti-Ha-ras p21 antibody. Ha-ras p21 was detected in 43 (61%) of 70 carcinomas, 3 (30%) of 10 oral leukoplaskias and 3 (30%) of 10 normal oral mucosae. Patients with Ha-ras p21-positive carcinomas had a significantly worse prognosis than those with Ha ras p21-negative carcinomas. These observations strongly suggest that the expression of Ha-ras p21 is a common event in oral squamous cell carcinomas, and that Ha-ras p21 serves as a tissue tumor marker for determining the prognosis of patients with oral squamous cell carcinomas. PMID- 2699626 TI - [Primary reninism--a rare cause of hypertension]. PMID- 2699628 TI - The Easy Tray System: custom tray fabrication made simple. PMID- 2699629 TI - [A male with normochromic plaques and papules on the back]. PMID- 2699630 TI - [Papulopustular eruption in intestinal inflammatory disease]. AB - We report a patient that fulfills the clinical features of inflammatory bowel disease (Crohn) who develops papulopustular lesions, some of which evolve into erythematous plaques with pustules and other into superficial ulcers. The different cutaneous manifestations of inflammatory bowel disease, are reviewed, an entity which includes Crohn's disease and ulcerative colitis, as well as the previously reported cases which developed papulopustular lesions emphasizing their similarities and their differences to our patients and also its probable relationship to malignant pyoderma. PMID- 2699631 TI - [Pruritus in chronic kidney insufficiency]. AB - Itching is the dermatologic symptom more often found in patients with chronic renal failure. We have studied 80 patients with end-stage renal disease; itching was present in 56.3% of the cases. We didn't detected in this study any correlation between itching, long term hemodialysis, high calcium, phosphorus, alkaline phosphatase or phosphocalcic product levels. We have seen: 1. Those patients with itching were older than the rest. 2. Itching was important in those patients with residual diuresis less than 500 ml/day (p greater than 0.01). 3. Those men without itching had higher hematocrit levels (p greater than 0.01). 4. Histologic findings on optic and electronic microscopy were more frequent in patients who presented this symptom. PMID- 2699632 TI - [Sneddon's syndrome. 2 case reports]. AB - Two patients with idiopathic generalized livedo reticularis and associated cerebrovascular disease are reported. In one of the cases (case no. 1) skin vascular lesions were present in two members of the family, thus suggesting the existence of a possible predisposition to systemic vascular affection. The need of prevention of the neurological symptoms in patients with generalized livedo reticularis, through the exclusion of the nocive agents which can cause vascular damage is emphasized. PMID- 2699633 TI - [Gianotti-Crosti syndrome in an adult]. AB - A 31 years old woman had an exanthematic eruption of small and acral distributed papules. At the same time she suffered a clinical and biological hepatitis B. This case is described attending to the clinic, histopathology and direct immunofluorescence. By the way the Gianotti-Crosti syndrome is reviewed. PMID- 2699634 TI - [Mal perforans and spinal dysraphia and lumbar stenosis syndromes]. AB - The mal perforans is a chronic ulcer that is the result of pressure over anesthetic zones. This is a review of two neurological syndromes, the spinal dysraphism and the lumbar stenosis syndrome, in which the mal perforans can appears as a complication. PMID- 2699635 TI - [Plasma exchange in dermatology: apropos of a case of dermatomyositis]. AB - We present a 45 years old male with dermatomyositis refractory to eight months of standard treatment who responded to plasma exchange. The efficacy of the procedure is estimated from clinical follow-up (increase in strength) and serum creatine-kinase activity (decrease from 3,380 to 44 u/ml.) after five sessions of plasma exchange. The therapeutic indications for PE are reviewed in dermatological diseases with emphasis on cases where the response to steroids or cytotoxic drugs is inadequate. PMID- 2699636 TI - [Mycosis fungoides associated with chronic myelomonocytic leukemia with specific skin lesions]. AB - A 77 year old man, who presented cutaneous T cell lymphoma, was treated with polychemotherapy and cyclosporine. After one year, erythemato-papulonodules were seen on the face, neck and trunk. Histologic examination showed specific infiltration myelomonocytic, bone marrow examination revealed the same characteristics. The patient died one month after the diagnosis. We comment the association between these two hemoproliferative processus. PMID- 2699637 TI - [Bullous ichthyosis. A particular form of epidermolytic hyperkeratosis]. AB - We report three familial cases of a particular type of ichthyosis bullosa. The clinical picture is different from bullous congenital ichthyosiform erythroderma, but the histologic and ultrastructural features are those of epidermolytic hyperkeratosis. PMID- 2699638 TI - [Ultrastructural study of a case of argyria]. AB - The authors studied by transmission electron microscopy a case of cutaneous argyria. Found round and oval forms into which there are a silver granules forming rings. Those images sequencied permit hypothesized that the winning of the solved silver by phagocytes into which are precipitate and eliminate out of the cell. PMID- 2699639 TI - [Pilomatrixoma. A series of 18 surgically treated cases. A sign for its diagnosis]. AB - We present a personal casuistic of 18 cases of pilomatrixoma. We make a reference of the clinical and histological situation of our patients. We remind that even if it isn't a frequent pathology, it possesses however, in almost every cases, certain characteristics very typical that permit to arrive to a correct diagnosis. We bring out a sign that made possible this diagnosis: the palpation of a tumor with a rocky consistency where united planes forming salient angles like a stone with many facets are evident: "Faceted stone sign". All the cases were treated surgically with complete extirpation of the tumor and up to now we haven't observed any relapses. The palpation of the sign of the "faceted stone" is pathognomonic of pilomatrixoma. PMID- 2699640 TI - [Metastatic Crohn disease of the scrotum]. AB - We report herein a rare case of metastatic Crohn's disease involving the penile and scrotal skin in a 56-year old man. We review the literature about this rare entity and describe its clinicopathological characteristics. PMID- 2699641 TI - [Multiple pilomatrixomas associated with myotonic dystrophy and medullary carcinoma of the thyroid]. AB - A case of multiple pilomatrixomas associated with myotonic dystrophy and medullary carcinoma of the thyroid is reported. We fail to found any patient in the literature that additionally associates medullary carcinoma of the thyroid as our patient. PMID- 2699642 TI - [Piezogenic nodules]. AB - We make a brief bibliographic revision of the entity. We observe three cases with piezogenic pedal nodules, wrongly named painful piezogenic pedal papules; as they not always have that localization and symptomatology. An easy treatment is proposed, with an effective result to calm the pain when it appears. PMID- 2699643 TI - [Rhinozygomycosis. Apropos of a case]. AB - The report of a case of rhinozigomycosis (Rhinoentomophtoromycosis) in a forty years old male patient is presented. Full recovery was observed after one year treatment with potassium iodide (saturated solution). PMID- 2699644 TI - [Nickel, chromium and cobalt release from a metal prosthesis in metal-sensitive patients]. AB - Six rejected stainless steel hip prostheses that had been removed from 15 metal sensitive patient were immersed in different solutions in various containers and maintained at 37 degrees C in complete darkness. Two months later by means of atomic absorption spectrophotometric studies we were able to determine the amount of nickel, chrome and cobalt released in a saline solution. When the chromium oxide passivation coat of the metal prostheses is damaged by orthopaedic surgical implantation procedures the prostheses may rust, releasing metallic ions. PMID- 2699645 TI - [Oral hairy leukoplakia]. AB - At present HL: should be considered a marker of immunodeficiency, though not necessarily associated with HIV infection. In eight patients with HL it was confirmed that this lesion, in male homosexuals, in a precursor and marker of AIDS. The diagnosis of HL warrant all efforts to protect the immune system and avoid progression to AIDS. PMID- 2699646 TI - [The role of intracellular pool of polyamines in the regulation of metabolism in Escherichia coli during aerobic-anaerobic transitions]. AB - The transition from aerobic to anaerobic conditions of Escherichia coli cultivation is accompanied by a drop in the free pool of putrescine in the cell as well as in the medium and by a decrease in the intracellular concentration of spermidine. This process stems from at least two facts: (1) the activity of ornithine decarboxylase, a key enzyme in the synthesis of polyamines, falls down due to a decrease in the level of ATP in the cell; (2) the free pool of polyamines is bound to cell compartments, in particular, to nucleoid DNA. The results make it possible to consider the system of polyamine synthesis as a point in the regulatory interaction between the energetic and constructive types of E. coli metabolism. PMID- 2699647 TI - [The effect of substrates and irradiation with low intensity visible light on the rate of division of Escherichia coli]. AB - The effect of He--Ne laser irradiation (lambda = 632.8 nm, D = 4.10(3) J/m2) on the growth of Escherichia coli cultures was studied in a minimal medium containing glucose, glycerol of arabinose. The irradiated cultures immediately started to divide with a virtually identical specific growth rate (kappa = 0.78, 0.8 and 0.8 h-1) whatever the growth rate and the latent period of the parent cultures were. The ratio between cell numbers in the irradiated and non irradiated cultures was highest 1 h after the irradiation: 1.25, 1.3 and 1.5 for the glucose, glycerol and arabinose cultures, respectively. Apparently, the irradiation with visible light of a low intensity creates an additional proton gradient and thus stimulates a new replication and division cycle in the population of cells whose membranes do not have delta pH necessary for the initiation of these processes. The system under study can serve as a model for studying the delta pH-dependent stages in the regulation of cell division. PMID- 2699648 TI - [Relative competitiveness of haploid and diploid yeast cells growing in a mixed population]. AB - Saccharomyces cerevisiae was grown in a rich medium under the conditions of "quasi-continuous" cultivation and, after 200-300 generations, its diploid cells almost completely displaced haploid cells from the original mixed "haploid diploid" population where the ratio between diploid and haploid strains was either 1:1 or 1:100. The cultivation at 40 degrees C did not change the relative competitive ability of haploids and diploids. When cells were cultivated in a rich medium at 6 degrees C or in a minimal medium at 30 degrees C, none of the strains showed an advantage over others for about 200 generations. Haploid cells had an advantage over diploid cells during "quasi-continuous" growth in the minimal medium at 30 degrees C. When the temperature was elevated to 40 degrees C, diploid cells displaced haploid cells from the mixed population. No advantage was found for diploid or haploid cells grown in a medium with an elevated KCl content (1.5 M). Haploid cells had an advantage over diploid cells when Pichia pinus was cultivated in a minimal medium. The results are discussed using the hypothesis about the diploid phase being fixed in the course of biological evolution. PMID- 2699649 TI - [The effect of initial bioenergetic state on the cryostability of yeast cells]. AB - The cryostability of Saccharomyces cerevisiae cells decreased when they were cultivated under anaerobic conditions in a liquid growth medium YEPD as compared to the culture grown under aerobic conditions. The effect of cultivation conditions on the different cryostability of S. cerevisiae cells is discussed. The initial state of their bioenergetics was shown to influence the cryostability of yeast cells. PMID- 2699650 TI - [Biosynthesis of somatotropin in a recombinant strain of Escherichia coli]. AB - A recombinant Escherichia coli K-12 strain was grown in the regime of chemostat with glucose limitation at a different flow rate and in the regime of turbidostat. The stability of its population and the dynamics of somatotropin biosynthesis were studied. The plasmid-containing strain became less stable as the flow rate in the fermenter dropped down, which was due, apparently, to a greater limitation. The level of somatotropin biosynthesis was higher at a low dilution rate (D = 0.075, 0.17 and 0.34 h-1). Possible factors responsible for this phenomenon are discussed. PMID- 2699651 TI - The treatment of hypertension in patients with diabetes mellitus. PMID- 2699652 TI - Hypertension in patients with diabetes mellitus: prevalence, aetiology and consequences. PMID- 2699653 TI - Comparison of two different high doses of metoclopramide in the prevention of chemotherapy-induced emesis. AB - A randomized double-blind study was conducted to compare the anti-emetic efficacy of 1 mg/kg vs 2 mg/kg metoclopramide, administered 5 times over a period of 8.5 h in 50 cancer patients treated with platinum-containing regimens (cisplatin, ethylenediamine platinum II malonate or spiroplatin). Twenty-six patients were treated with combination chemotherapy, mainly consisting of cisplatin and 5 fluorouracil. No statistically significant differences were observed with respect to the protection against nausea and vomiting between the two dose levels of metoclopramide. However, in the group of patients who received a high dosage of cisplatin (70-100 mg/m2), or ethylenediamine platinum II malonate (800-900 mg/m2), there was a significant difference in nausea and vomiting between patients who had and those who had not received prior chemotherapy, most probably due to anticipation. No difference in the severity of the side effects was observed with the 2 metoclopramide dose levels. Considerable interpatient variation was present in serum metoclopramide levels. No clear correlation was observed between serum metoclopramide levels and prevention of platinum-induced emesis. We conclude that 1 mg/kg of metoclopramide is just as effective as 2 mg/kg as an anti-emetic agent in patients receiving platinum-based chemotherapy, and that metoclopramide serum levels are not related to the anti-emetic effect. PMID- 2699654 TI - Weight reduction with a high protein, low carbohydrate, calorie-restricted diet: effects on blood pressure, glucose and insulin levels. AB - A clear relationship exists between obesity and hypertension. In this study, blood pressure was examined in 215 obese patients. Significant positive correlations were demonstrated between the mean arterial pressure (MAP) and age, body weight, body mass index (BMI), fasting and 2 h postprandial glucose and postprandial insulin concentrations. Using a stepwise multiple regression analysis, it was clear that body weight, age and glycaemic parameters were the most important determinants of arterial blood pressure. During a period of 6 months, 113 patients were treated with a high protein, low carbohydrate, calorie restricted diet. This resulted in a mean weight loss of 17 +/- 7.9 kg and a considerable drop in MAP, and in fasting and postprandial glucose and insulin concentrations. None of the patients who were hypertensive before treatment (n = 17) remained so afterwards. We can conclude that: (1) changes in blood pressure are always accompanied by changes in the same direction of one or more of the parameters of glucose homeostasis, which suggests a common link; (2) The dietary approach to obesity therapy successfully lowers blood pressure and helps to rectify the abnormalities in glucose metabolism. PMID- 2699655 TI - Gastrointestinal lesions during treatment with non-steroidal anti-inflammatory drugs (NSAIDs). AB - Probably all non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of gastrointestinal (GI) mucosal injury. Not only gastric and duodenal but also oesophageal, small bowel and colonic lesions have been reported. Gastroduodenal lesions are seen most frequently and of these, gastric erosions in the prepyloric region are most prominent. NSAIDs also increase the incidence of peptic ulcers although it is not yet clear whether more gastric or duodenal ulcers are produced. GI symptoms are prevalent during NSAID treatment but there is no correlation between symptoms and lesions. Clinical presentation may, therefore, vary considerably: many symptomatic patients will have no lesions whereas others will present with complications but no symptoms. Blood loss is the most frequent complication of NSAID induced GI lesions. Bleeding is usually silent and occult, the incidence of overt haemorrhage, although rare, is also increased. Other complications such as penetration and perforation may also occur. Endoscopy is the diagnostic method of choice as most mucosal lesions are superficial. However, because of the lack of correlation between symptoms and lesions it is difficult to select patients at risk and to avoid unnecessary procedures. Results of studies performed show that treatment of NSAID induced gastroduodenal lesions with conventional anti-ulcer therapy is probably effective. There are also indications that preventive therapy is effective. PMID- 2699656 TI - [Osteopetrosis: description of 2 cases, non-familial, of the fatal infantile form and of a case of the mild adult form. Impossibility of performing early prenatal diagnosis]. AB - Two non familial cases of the juvenile lethal form of osteopetrosis and one case of the mild adult type are reported. In one case at risk of lethal osteopetrosis an early prenatal diagnosis was attempted, after informing the parents about the extreme difficulty to obtain conclusive results by such investigation. Although several ultrasonographic and one radiological examinations showed an apparently normal foetus, the newborn was affected by the lethal form of osteopetrosis. PMID- 2699657 TI - [Alobar holoprosencephaly. Prenatal diagnosis and autopsy findings in 2 cases]. AB - We report two patients with alobar holoprosencephaly and cebocephaly: one, a fetus at 20th week of gestation; the second, a new born who died at seven days of age. Its very important U.S.G. in the prenatal diagnosis. Patients with holoprosencephaly and extracephalic malformation warrant chromosome analysis, because the incidence of chromosomal anomalies is very high. In the first foetus the brain and the face anomalies were associated with omphalocele, ureteropathy, bifid and horned uterus. In the second child karyotype analysis was normal. Cranial C.A.T. scan is important in the new born for the differential diagnosis holoprosencephaly from hydranencephaly, ventriculomegalia and Dandy-Walker cyst. The encephalon autopsy of both patients showed the presence of a single ventricule, the absence of interhemispheric fissure, of the corpus callosum and arrhinencephalia. This malformation complex is causally heterogeneous group. Chromosomal, autosomal recessive, autosomal dominant, and multifactorial mechanism have been invoked in humans; in animals it can be produced easily by a multitude of teratogenic agents. The two children reported are the first observation in the family. The etiology is presently unclear. PMID- 2699658 TI - Gamma knife radiosurgery for intracranial arteriovenous malformations in childhood and adolescence. AB - Eighteen children or adolescents with intracranial arteriovenous malformations (AVM) underwent stereotactic radiosurgery using the first North American gamma knife. This closed-skull, single-treatment therapy, utilizing 201 ionizing beams of gamma-irradiation, was used as an alternative to microsurgical removal in these selected patients (aged 34 months to 18 years, mean 12.3 years) beginning in August 1987. No significant perioperative morbidity occurred, and no patient rebled or died in the follow-up interval ranging between 7 and 19 months. Computed tomography (CT) and magnetic resonance imaging (MRI) were used to monitor the response to treatment and to determine when postoperative angiography was indicated. Of seven AVMs examined with cerebral angiography 1 year after treatment, three were completely obliterated; three others were significantly smaller, and their complete obliteration is anticipated by 2 years after treatment. Follow-up CT or MRI confirmed attenuation or signal changes suggestive of edema surrounding the treatment volume in 3 patients; 1 had transient worsening of a preexisting neurological deficit. Although a more long-term perspective is still required for this new technology now available in the United States, we believe that gamma knife stereotactic radiosurgery is a safe and effective method to obliterate AVM deemed too risky for microsurgical removal. PMID- 2699659 TI - Stereotactic surgery in children. AB - Stereotactic biopsy has been popularized over the last decade since the advent of newer, more sophisticated instrumentation and technology. However, less than 300 cases of pediatric stereotaxy are recorded in the literature and few reports emphasize the necessary modifications required in children. Sixty-six stereotaxic procedures were performed on 62 children using the Brown-Roberts-Well (BRW) apparatus at our institutions. The mean age was 9.0 years (range 5 months to 18 years). The indication for the technique was diagnostic in 36 cases and therapeutic in 9 cases; location was a factor in 21 children with the lesion involving a 'deficit-prone' area of the brain. The BRW technique was applicable in 61 procedures (93%). Inability to enter cysts or biopsy of necrotic tissue and tumor capsule occurred in 5 cases. One patient had a transient increase in cerebral edema, for an overall complication rate of 2%. It appears that the BRW stereotactic technique is equally effective in children and adults and will no doubt play an ever increasing role in the future of pediatric neurosurgery. PMID- 2699660 TI - Ependymomas in two sisters and a maternal male cousin with mosaicism with monosomy 22 in tumour. AB - A family with two sisters and their mother's male cousin had ependymomas. Of note is the fact that chromosome analysis on the tumour of the younger sister showed two cell lines, one a normal female line, the other with monosomy of chromosome 22. PMID- 2699661 TI - Effect of maternal cocaine use on the fetus and newborn: review of the literature. AB - The recent epidemic of cocaine abuse, especially among young individuals, has caused increasing concern about the potential hazards of prenatal cocaine exposure on the developing fetus and newborn. Although large-scale epidemiologic studies and long-term data are lacking, a review of the literature suggests strongly that the popular belief about the relative safety of cocaine is unfounded and that maternal cocaine abuse during pregnancy may be associated with increased perinatal morbidity and mortality. PMID- 2699662 TI - [The effects and properties of sodium nucleinate as a pyrogen working standard. 6. Pyrogen inactivation by incubation with blood serum or blood plasma]. AB - The 24-h storage of horse serum at 4 degrees C to which bacterial lipopolysaccharide (P) or sodium nucleinate (NN) was added, did not change the pyrogenic effect of these mixtures. Even after 2-h incubation at 37 degrees C changes could not be clearly detected. 24-h incubation at 37 degrees C leads to a clear, but only in case of NN, statistically significant reduction of pyrogenic effect. 24-h incubation of human heparin plasma at 37 degrees C, to which P or NN was added, in both cases resulted in statistically significant reductions of pyrogenic effect. Thus, when incubated with horse serum or human heparin plasma, the pyrogenic effect of NN is reduced in principle as well as that of P treated in the same way. PMID- 2699663 TI - [The biochemical basis of pharmaceutical chemistry. 5. Peptide hormones]. PMID- 2699664 TI - [The ethical views of Antoni Kepinski. II]. PMID- 2699665 TI - [We desire to walk in his footsteps (Ludwik Hirszfeld)]. PMID- 2699666 TI - [For health to Jaworz]. PMID- 2699667 TI - [The face. Esthetic considerations]. AB - The author summarizes the general rules of the facial harmony. These measurements and proportions are an aid to the reader to rapidly evaluate a face and detect any anomaly. No sophisticated devices are necessary. The study of profile photographs following the Charles Baud-principles (circular sectors) is detailed as is a simplified cephalometric study. PMID- 2699668 TI - [Leukoplakia of the oral cavity]. AB - The definition of oral leukoplakia is presently under revision. Most authors do not include anymore the clinical conditions known as cheek and lip biting, frictional keratosis, actinic cheilitis, smoker's palate and other lesions attributed to tobacco, e.g., snuff dipper's lesion. An epidemiological review reveals a prevalence ranging from 0.2 to 11.7% among various population groups. As malignant transformation rate of leukoplakia increases up to 17.5% with time, there is a need for continued observations no matter how long the lesions have been present. Among the aetiological factors, smoking is probably the most important, but industrial hazards in certain factories are responsible for a high prevalence of oral leukoplakia. The tongue and the floor of the mouth are predilection sites for carcinomatous transformation. A histological examination is essential to the diagnosis or confirmation of this premalignant lesion. PMID- 2699669 TI - [Gypsum-bonded investments for the ringless casting (Part 1). The mechanical properties of the experimental investments]. PMID- 2699670 TI - [Gypsum-bonded investments for the ringless casting (Part 2). Improvement of the experimental investments and measurement of the deformation on castings]. PMID- 2699671 TI - [An anthropologic reflection on genetic epidemiology. On the need of a multidisciplinary approach]. AB - Historically, Epidemiology arose from the need to take steps in forming health care policy, and up until a few decades ago, its interest has centred on illnesses caused by infectious agents. Recent developments in Medicine and Biology have permitted the evaluation of the behaviour of genetic material in vital processes. From these advances arose Genetic Epidemiology which researches the relationship between heredity and illness among human populations defined by their biosocial characteristics. Its primary field of application is in complex aetiology illnesses in which the genotype and the environment interact. Its complexity has inevitably converted it into a multi-disciplinary science. The basic parametres of the population structures, such as parentage and consanguinity, which is what physical anthropologists have been researching in recent years in Spain, form an important data base which must be integrated into future Genetic Epidemiology studies; these studies will result in its natural progression. Significant success is being obtained in this direction in many advanced countries, therefore it is advisable for our health care authorities to do the same and encourage this type of multidisciplinary work which will serve as a basis for a modern and efficient health care policy. PMID- 2699672 TI - Perceptual and intellectual development in infancy. AB - The conventional view of development in human infancy is that objective awareness of the surrounding world is gradually constructed during the first 2 years through the infant's actions on the environment. However, recent work on the perceptual abilities of young infants indicates that even newborns perceive objective properties of their surroundings, detecting depth and displaying perceptual constancies that have hitherto been attributed only to older infants. In consequence it is necessary to revise our model of infant development. Since evidence points to objective perception from birth there is no need to postulate developmental processes that lead to its construction during development. However, as infants gain new capabilities for acting on the world, they have to develop knowledge of how these actions relate to the perceived world. It is suggested that this sort of knowledge is constructed through active experience. PMID- 2699673 TI - Airborne bacteria and viruses. AB - Coughing, sneezing, talking, bed-making, turning pages of books, etc. all generate microbial aerosols which are carried and dispersed by air movements. Inhalation of these particles may cause allergic responses but whether or not infectious disease ensues depends in part on the viability and infectivity of the inhaled microbes and their landing sites. Desiccation is experienced by all airborne microbes; gram-negative bacteria and lipid-containing viruses demonstrate phase changes in their outer phospholipid bilayer membranes owing to concomitant changes in water content and/or temperature. These changes most likely lead to cross-linking reactions of associated protein moieties principally at mid to high relative humidity (RH). For lipid-free viruses these reactions of their surface protein moieties occur most rapidly at low RH. Radiation, oxygen, ozone and its reaction products and various pollutants also decrease viability and infectivity through chemical, physical and biological modification to phospholipid, protein and nucleic acid moieties. The extent of damage and the degree of repair together with the efficacy of host defence mechanisms largely controls whether the causative microbes take hold and spread disease via the airborne route. At least indoors, where desiccation is the predominant stress, the general reversibility of membrane-phase changes by vapour-phase rehydration when coupled with efficacious microbial enzymatic repair mechanisms under genetic control, virtually ensures the spread of disease by the aerobiological pathway. PMID- 2699674 TI - Pathogenesis and treatment of chronic arthritis. AB - Inflammatory and 'non-inflammatory' forms of arthritis affect a large proportion of the population and these diseases can often lead to disability. Although the pain of arthritis can be relieved to some extent by the peripherally acting aspirin-like drugs, the progression of disease leading to joint destruction is largely resistant to current drug therapy. The synovial joints of patients with rheumatoid arthritis are infiltrated with neutrophils, macrophages and lymphocytes and the resident cells become activated to degrade the cartilage and bone. The inflammatory and destructive changes that occur are brought about by the action of mediators or local hormones which are produced by a variety of cell types. Lipid mediators, such as prostaglandins, contribute to the symptoms of arthritis while polypeptide cytokines, such as interleukin 1 and tumour necrosis factor, play a key role in joint destruction by activating the synovial cells and chondrocytes to release metalloproteinases, such as collagenase. Aspirin-like drugs inhibit the production of prostaglandins from inflamed tissues and thereby blunt the symptoms of arthritis. However, these drugs do not suppress the production of collagenase from connective tissue cells and, therefore, do not halt the degeneration of joint tissues. PMID- 2699675 TI - [Reinforcement of cores on porcelain jacket crowns. Influence of alumina powder properties on the cores]. AB - Various alumina particles were investigated for use as core reinforcement to strengthen aluminous-porcelain jacket crowns. The alumina particles were either spherical or nonspherical and were between 5.3 microns and 60 microns in size. Initially comparisons were made among such properties as particle-size distribution, apparent density, specific surface area, and flow. Then each alumina powder was mixed with feldspar at rates of from 10wt% to 70wt% at increments of 10wt%. Formed into columns, the powder was fired at 1350 degrees C for 5 minutes. The resulting feldspar-alumina composites were compared for shrinkage then cut and prepared into disc specimens. The disc-rupture test was employed to measure composite strengths. A scanning electron microscope was employed to observe alumina particles and composite cross sections. Results 1. Spherical alumina (average particle size 5.4 microns), spherical alumina (average particle size 28.9 microns), and nonspherical alumina (average particle size 58.0 microns) were higher in apparent density and flow rate but lower in specific surface area. 2. Feldspar-alumina composites shrank approximately 30%; shrinkage of 15-20% occurred only in composites involving spherical alumina (average particle size 5.4 microns). 3. Composites of feldspar and spherical alumina were observed to be stronger than those of feldspar and nonspherical alumina. Composites containing 50-60wt% (especially when the alumina particle size was 5.4 microns) were the sturdiest. 4. Increasing the amount of alumina proportionally increased composite strength. In composites containing nonspherical alumina, volume amount and strength were not always proportional. 5. Microscopic examination of composite cross sections showed uniform dispersion of spherical alumina but no dispersion of nonspherical alumina. In conclusion, spherical alumina (especially when average particle size is 5.4 microns) demonstrated the best powder properties as a reinforcing core material and therefore is most suitable for reinforcing the core of the porcelain jacket crown. PMID- 2699676 TI - Current concepts in the management of preterm labour. AB - Prematurity remains the major cause of perinatal mortality and morbidity in Singapore. Prevention of prematurity is therefore of vital importance. Epidemiological methods using historical variables have been superseded by ongoing pregnancy factors including work, exercise and cervical dilatation. PGF levels bear a positive correlation to duration and cervical dilatation but are not elevated at onset. PGE production is high in ruptured membranes. Progesterone and relaxin are potent inhibitors before labour. Infection must play an important role in developing countries as organisms not thought of to be pathogenic produce phospholipase A2. For prediction, cervical assessment and topography are proving important. In view of the dangerous side effects of tocolytic drugs and the difficulty in diagnosis of preterm labour, absence of fetal breathing is a useful index of progressive labour. In those labours that are advanced, whether to allow vaginal delivery or not will be determined by the presentation and condition of the fetus. The complementary role of other drugs to reduce morbidity from hyaline membrane disease and intraventricular haemorrhage is being studied. Fetal acidosis should be avoided and the infant delivered without trauma under optimal circumstances. In utero transfer to a facility with neonatal intensive care carries a better prognosis for the baby. PMID- 2699677 TI - Management of unexplained infertility. AB - Unexplained or idiopathic infertility means no cause can be found to account for the infertility. This depends on the enthusiasm to look for the subtle causes like luteal phase defect (LPD), luteinizing unruptured follicle syndrome (LUFS), abnormal prolactin secretion, psychogenic, environmental, nutritional and immunological factors. Sometimes, these subclinical conditions can be corrected. Failing to identify these treatable conditions, various empirical treatments, laboratory manipulation or assisted reproductive techniques (ART) can be attempted to achieve conception. PMID- 2699678 TI - The management of hypertension in pregnancy. AB - Hypertension in pregnancy is a common and sometimes serious complication of pregnancy. It is a major cause of preventable perinatal and maternal mortality and morbidity. The principles of management include the recognition of risk factors, early diagnosis, close maternal and fetal monitoring with prompt identification and treatment of complications, the use of anti-hypertensive and anti-convulsant drugs when indicated and the timely delivery of the baby. In order to achieve the optimal pregnancy outcome, a joint approach between the physician, obstetrician and neonatologist is of great importance. PMID- 2699679 TI - Fractured silver tracheostomy tube: a case report and literature review. AB - This report raises the question of the long term durability of tracheostomy tubes and describes a patient who inhaled part of a silver tracheostomy tube after it fractured. A review of the literature is presented, which compares the clinical presentations and methods of management described in previous reports. From this review frequent sites of tracheostomy tube fracture have been identified and a method of improvement in manufacture is suggested. PMID- 2699680 TI - [Energy imparted and effective dose equivalent in radiographic examination using panoramic and intraoral film techniques: a survey]. AB - Studies of energy imparted (mJ) and effective dose equivalents (mu Sv) following rotational panoramic radiography and intraoral full mouth surveys from the past 10 years are reviewed (Tables 1 and 2). Energy and dose values are compared. Factors influencing energy imparted and effective dose equivalents are discussed (measuring techniques, calculation principles, generator, kilovoltage, filtration and half-value layer, irradiated field, collimation, intensifying screens, film sensitivity, focus to object distance, sex and age of patients, inaccurate technical specifications, individual x-ray unit characteristics). In general it is concluded that one panoramic examination means less energy imparted to the patient and a lower effective dose equivalent than an intraoral full mouth survey. However, a number af factors are of influence, and the change of a single factor may have a dramatic effect and reverse the situation. When comparing individual cases all factors of known influence must be considered and general conclusions cannot be applicated without reservations. PMID- 2699681 TI - [King Erik Glipping's teeth]. PMID- 2699682 TI - [Copenhagen Dental School Department of Forensic Dentistry--25 years of activity]. AB - The Dept. of Forensic Odontology at the Royal Dental College of Copenhagen opened on 1 January 1964. The present article is a short survey of the case load handled over the following 25 years. Table 1 shows the distribution of single cases: the first two columns (U-D = unknown dead persons) in that a total of 444 postmortem dental descriptions were made (by oral autopsy) and that 255 of them led to dental identification; the next two columns (K-S = known missing persons) indicate that a total of 538 antemortem dental descriptions were established (mostly by extraction from private practitioners' records and radiographs), 255 of them being those that led to the already mentioned identifications. The column marked "B-M" shows the number of bite mark cases handled, while the column marked "A-E" concerns dental age evaluation of children adopted from or immigrated from areas with questionnable (if not totally missing) birth registration. The column marked "Var" lists a number of cases that did not fit into the other categories. Table 2 is a survey of the six airplane crashes and three hotel fires that occurred during the same 25 years: the first column shows the total number of victims, the second column the number of victims we were allowed to examine, and the third column the resulting number of dental identifications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699683 TI - [Therapeutic tooth extrusion: overview]. PMID- 2699684 TI - Status of the response of Plasmodium falciparum to chloroquine and mefloquine in Iran. AB - Malaria is still the most important parasitic disease in the southeastern part of Iran. The in vivo and in vitro studies of the response of Plasmodium falciparum to chloroquine in Sistan-Baluchestan and Hormozgan provinces (1985-1987) have shown resistance in Iran-Shahr and Bandar Abbas areas. However the parasite was sensitive in Minab area. From 38 chloroquine-resistant P. falciparum (CRPF) cases, found in the studied malarious areas, 13 cases were in Afghan immigrants, 3 in Pakistani and 3 in Iranians who had travelled to Pakistan. Also from 14 CRPF imported cases studied in Teheran, since 1984, four patients were Afghans, 2 Bangalese, one Pakistani and 2 Iranians returned back from India. These findings indicate the great role of migration in introduction and establishment of CRPF in the malarious areas of the southeastern part of Iran. The responses of P. falciparum to mefloquine in the above malarious areas were in general satisfactory. However in few sporadic cases, innate tolerance was observed. PMID- 2699685 TI - Value of C-reactive protein concentration in diagnosis and management of acute lower respiratory infections. AB - To determine the usefulness of the quantitative serum C-reactive protein (CRP) concentration as a tool in differentiating acute pneumonia from other acute lower respiratory tract infection (ALRI), and in assessing response to therapy serum CRP concentrations were measured in 30 children with pneumonia, 30 with acute bronchitis and 5 with bronchiolitis. All the pneumonia patients had a serum CRP level above 83 mg/l (mean 157; SD +/- 47 mg/l) whereas none of the acute bronchitis (mean 7.8; SD +/- 5.7 mg/l) or bronchiolitis patients and normal children (mean +/- 3.5 SD +/- 2.7 mg/l) had a level above 35 mg/l. The sensitivity and positive predictive value of CRP level greater than 35 mg/l for diagnosis of pneumonia was 100%. On serial monitoring a fall in CRP concentration also provided the earliest clue to therapeutic response, much before a fall in temperature, respiratory rate or ESR. PMID- 2699686 TI - [Charles Ledger and the Cinchona]. AB - Reading "The life of Charles Ledger", the book written by Gabriele Grammiccia, one notices immediately, what an extraordinary personality Ledger was. He was typically British and belonged to that generation for which, as he wrote himself, "the fact of being a British subject is in itself a reason of pride, including as such a definite obligation to serve the country." This blinding patriotism of even modest British people all over the world, gave the City, as well as the British Empire, a remarkable place in the world trade. The history of Ledger's life, derived from the most authorized sources, is a real adventure novel. At the age of eighteen, he goes to Lima (Peru), in order to find a job. It takes him but a few years to build up his own import-export business. In Tacna, in the very South of Peru, near the Chilean and Bolivian borders (the region where he lived), alpaca wool and quinquina bark are some of the most traded goods. These two products will determine his further life. The principles of his commercial policy were as follows: to buy first quality products, and pack the goods in such a way that they reach the British or European customers in perfect condition, thereby always giving a preferential treatment to the Commonwealth. The quinquina bark trade is hampered by the fact that there is a very great quantity of varieties, each having a different concentration of alkaloids in its bark. To buy the best species, Cinchona calisaya, one needs a perfect knowledge of these trees. The expertise is only to be obtained by visiting the regions where the quinquina tree grows and finding one's way with the help of willing "cascarilleros", the Indians collecting the quinquina bark. During one of his exploration trips, Ledger was fortunate enough to enjoy the service of a Bolivian called Manuel, who faithfully assisted him and his family for years. Together they ranged, at great pains, across every possible region, even the most remote ones; they succeeded in identifying the richest collections of quinquina trees and signing buying contracts on the spot. The most beautiful trees are usually unsuitable for any form of exploitation. In order to understand the special atmosphere that made the solving of the quinquina problems so arduous in the course of time, it seems best to place them in a historical perspective.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699687 TI - Endolymphatic hydrops--fiftieth anniversary. AB - The histopathological picture in Meniere's disease was described for the first time in 1938, in two independent reports. One was by Hallpike & Cairns in Great Britain, and the other by Yamakawa in Japan. Selections of illustrations from these two reports have been compiled and compared.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699688 TI - Analysis of optokinetic nystagmus in patients with localized lesions of unilateral visual cortices. AB - Optokinetic nystagmus (OKN) asymmetry in 4 patients with localized lesions of the unilateral visual cortices (2 in the right hemisphere and 2 in the left hemisphere), confirmed at autopsy or by CAT scan, was detected by computer analysis. The ENG recordings showed typical asymmetry of OKP: lower amplitude in the contralateral optokinetic pattern (OKP) than on the side with the visual cortex lesion. Analysis of this asymmetry revealed lower amplitude, remarkably impaired slow-phase velocity, and mildly impaired fast-phase velocity, with a slight difference in number of OKN. The findings suggested that asymmetry of OKP in patients with localized lesions of the unilateral visual cortices is primarily caused by the impaired slow-phase velocity of the contralateral OKN because of a slight change in number of OKN. PMID- 2699689 TI - A computer analysis of typical CCG patterns in 1,021 neuro-otological patients. AB - A set of 1,021 patients who were investigated at our Department over the last few years was investigated in this study. Each patient underwent Cranio-Corpo-Graphy, and other related investigations. The patients' CCG's were quantified using a specially developed computer scanning method, and a computerized spreadsheet databank was thus created. Also included in the study were their clinical profiles, as charted using the NODEC III questionnaire. The isolation and comparison of various data subsets enables us to draw broad correlations between clinical and CCG findings, and permits us to establish 'normal values' for various parameters. It is seen that cranio-corpography is a reliable screening method for the topodiagnosis of vertigo. PMID- 2699690 TI - Immunofluorescent study of the endolymphatic sac in Meniere's disease. AB - Immunofluorescent and light microscopic studies were performed on 21 small endolymphatic sac specimens biopsied during endolymphatic sac drainage surgery. The biopsies were taken from the extraosseous portions of the lateral side of the sac. Of the 21 specimens, only 5 displayed prominent histologic signs, including 1 with brown pigmentation and 4 with positive immunofluorescent reactions to either IgG, IgA, or IgM. No such histologic signs were seen in any of the other 16 specimens, although severe fibrous tissue change was found. One of the 4 specimens showing immunofluorescent reactions displayed a triple-layered ring structure in which the outer layer was IgM positive, the middle layer IgG positive, and the inner layer IgA positive (case 1). This ring-like structure, located in the fibrous tissue, appeared to be an occluded blood vessel. Another specimen showed positive reactions to IgG and IgA in a section which appeared to be part of the lumen, and which contained a macrophage-like cell and a lymphocyte. These results tend to support the idea that certain types of Meniere's disease are caused by immunologic injuries to the endolymphatic sac. PMID- 2699691 TI - Immunoglobulin in inner ear fluids. PMID- 2699692 TI - [The "retention complex" and its relationship to abutments: what is today's thought?]. AB - Based up on a review of the literature, the authors have tried to define the possible responsibility of each component of a retention complex (occlusal support--cross-piece--locking arm--retention arm) in the mechanical mobilisation of abutment teeth supporting partial removable prostheses (Kennedy, Class I and II). Taken separately, all these components are intrinsically able to mobilise the teeth. However, no "modern" retention complex (Nally & Martinet--R.P.I.- R.P.A.--"equipoise"...) should jeopardize the abutments, as long as they have been correctly prepared as well as the entire prosthesis. PMID- 2699693 TI - [Recent concepts on amelogenesis: towards a molecular understanding of the pathology of human enamel]. AB - Recent studies concerning amelogenesis demonstrate the key role of ameloblasts in the elaboration of mature enamel; this highly differentiated epithelial cell elaborates a specific extra-cellular proteic matrix, secondarily mineralized and participating in the elaboration of mature enamel. While the matrix of immature enamel is essentially made of two main classes of proteins--amelogenins and enamelins--specific proteins are found in mature enamel, the tuft proteins as well as enamelin-type proteins. In light of recent results concerning enamel proteins, we will review the different pathological processes of human enamel. In fact, the clinical observation of various forms of imperfect amelogenesis enables to recognize several aetiological mechanisms. This could either be a pathological process of genetic nature originating in the ameloblast--imperfect, mendelian type amelogenesis--or secondary abnormalities of the calcification process, without anomalies of the genes responsible for the protein framework, which could be called post-ameloblastic pathological process. PMID- 2699694 TI - [A rare facial disorder: cherubism]. AB - A rare disorder involving primarily the maxillary region of the face, cherubism has a special place in the galaxy of osteolytic maxillary tumors. This disease is genetically transmitted and its pathogenesis is unknown at present. Its prognosis is considered as favorable since it progresses toward phases of regression and then disappearance--at least partial--of lesions. The main sequelae involve the teeth since agenesis often occurs which--as in the case presented here--is not very easy to correct. PMID- 2699695 TI - [Surgical sutures. Principles and materials]. AB - This article begins by a brief review of the advantages and modalities of the sutures. Then, the choice of the instrumentation (needle-holders, pliers and scissors) will be discussed. The suture material by itself (needles, threads) is studied. A description of the physical and biological properties of the different threads allows their comparison. The author's choice is the conclusion of this paper. PMID- 2699696 TI - [The role of cellular immunity in gingival inflammation through a study of the cells of Langerhans]. AB - The purpose of this semiquantitative study was to evaluate the number of Langerhans cells in correlation with gingival inflammation and the use of two antisera: anti-T6 and anti-HLA/DR reacting with two different membrane antigens. Results indicate that HLA/DR is a better functional marker, and that the number of Langerhans cells is higher in the moderate inflammation of the gingiva (G.I. 1 to 2). PMID- 2699697 TI - [Goethe and the intermaxillary bone]. PMID- 2699698 TI - [The face in the "Margarita philosophica" (1503)]. AB - What was, during the Renaissance, the general formation of those who in the Faculty of Arts were getting ready for medical school? What were they taught in terms of facial anatomy or the physiology of the mastication apparatus? This is what we learn from a repertory, famous in the XVIth century, and which, fifty years after the discovery of printing, had the honor of being richly calligraphed in miniature, (1455). PMID- 2699699 TI - [Focus on osseous allografts in periodontal therapy]. AB - This review of the literature emphasizes the following points: Bone allografts in periodontology seem to have an osteogenic potential comparable to that of autografts; Taking of a graft on the patient is avoided, but it is necessary to resort to a bone bank for the preparation (lyophyllized bone) or the preservation (bone preserved at low temperatures) of the graft material; The clinician has available an amount of material enabling to treat all types of lesions; The role of bone grafts in healing phenomena is still controversial. For some, it promotes bone neoformation and the formation of new attachments. For others, it encourages ankylosis which is only avoided by interposition of a long junctional epithelium. The research in progress should specify the influence of bone allografts on regeneration of the periodontium. PMID- 2699700 TI - [Suture technics and their application in periodontal surgery]. AB - On account of the diversity of the periodontal therapy, the operator must be able to use for each interventions, the adapted suture technic. This article studies the different knots, modalities and sutures. These basics elements are then considered in different surgical case types. This study emphasizes that usually we dispose of several technics for each type of periodontal surgery. The clinician must choose in function of the nature of the material that he uses, as well as his experience, and his skill. PMID- 2699701 TI - [Bonding and enamel prisms. Importance of cavity margin preparation for posterior composites]. AB - Preparation of the cavo-surface margin for fillings with "composites resins" is an important operative step. The good peripheral fit of the restoration and the stability of the bond between tooth and material depend on that preparation. How should the "bevel" be shaped? Scan electron microscopy of long bevels and rounded bevels show that the former seem more favorable to the fit of the filling. The section of enamel prisms is clean. The aprismatic surface area disappears. This enables to etch the cristallites in a more favorable axis as opposed to the rounded bevel. PMID- 2699702 TI - [Maintenance of removable dentures. Nonexhaustive review of methods and current products]. AB - The authors review various methods advocated to clean and disinfect removable prostheses. The effectiveness of most commercial preparations is quite relative, and some of them present definite risk for the appliance. Regular brushing of the prostheses remains absolutely necessary; it may be made easier but cannot be replaced. PMID- 2699703 TI - [Influence of heat treatment on silver-palladium alloy microstructure]. AB - Cast dental alloys, even those made of precious metals, are not homogeneous. In order to ensure a high-quality cast, it was necessary to determine optimal casting temperature and additional heat treatment to allow for homogenization of the cast in the microarea of the dendritic structure to occur which, in turn, implies chemical inertia of the metal construction to the organic medium of the mouth. A number of melting, homogenizing and aging tests showed the optimal regimen for bringing an Ag-Pd alloy to the level of hardness of the tooth enamel (about 330 HV 0.1) to consist of a technological treatment involving the following procedures: casting at 1100--1150 degrees C, homogenization at 850 degrees C, quenching in water and 20-min precipitation at 350 degrees C. PMID- 2699704 TI - [Anatomical and histological characteristics of proximal surfaces of abutment teeth]. AB - When the guide planes are formed on the proximal surfaces of abutment teeth the part of enamel is removed. Thickness of enamel and inclination of tooth are the factors that limit the possible tooth reduction. In this report anatomical and histological characteristics of proximal surfaces of the abutment teeth are analysed. Thickness of the enamel has been measured using the optical microscope for 280 prepared teeth. Measurements were performed on four zones of tooth's proximal surfaces, on the different distances from the top of enamel edge. Undercut of 420 proximal surfaces of tooth have been determined by micro-analyser with accuracy of 0.05 mm. By comparing the mean values of enamel thickness, in occlusal thirds, and undercut of proximal surfaces, it is possible to conclude that the formed guide plane remains in the enamel even after the removing of all natural undercuts. PMID- 2699705 TI - [Changes of retention force of CEKA intraoral anchors caused by repeated removal]. AB - A retainer should provide force capable of securing the position of the partial denture an still not damaging the periodontium of the abutment teeth. It's almost generally accepted that the retentional force should not be greater than 10N nor weaker than 5N. This study was designed to measure the forces required to disconnect parts of CEKA intracoronal anchors initially and repeatedly up to 50000 cycles. The results are compared with suggested values. It was found that the initial force exceeded 10N. After repeated removals retentional force decreased, but never under values of 5N. PMID- 2699706 TI - Etiology and risk factors of melanoma. AB - Epidemiologic and etiological research about the pathogenesis of melanoma remains a controversial issue. The dominant cause appears to rest on the relation between the genetically determined susceptibility of the host and ultraviolet radiation (UVR). Basic to the understanding however is the knowledge about the clinical and histopathological, the genotypical and phenotypical heterogeneity of this tumor entity. In terms of the multistage concept of carcinogenesis, melanocytes, atypical or normal, are exposed to a mutagenic event, predominantly UVR, initiating malignant growth in a genetically altered and susceptible genome. The initiation could also occur spontaneously or as the result of other insults such as chemical carcinogens, viral infections, ionizing radiation etc. Promotion through the stage of melanocytic dysplasia or de novo from an altered skin, follows additional exposure to UVR or cocarcinogens and is likely to be modulated by ethnic, dietary, endocrine but also protective factors and concomitant disease. In terms of descriptive epidemiology, melanoma may be caused by exposure to intermittent and intense sunlight on unacclimatized skin. The mechanism of this association such as the wavelength responsible, effects of total dose, intensity of dose rate, latency period between exposure and the clinical incidence of disease finally the stage of carcinogenesis affected by UVR and other initiating factors and the impact of any specific modulation for the pathogenesis and clinical course of the disease remain to be elucidated. PMID- 2699707 TI - [Cutaneous melanoma. Pathological anatomy, review and update]. PMID- 2699708 TI - [Early diagnosis of cutaneous melanoma]. PMID- 2699709 TI - [Surgical treatment of cutaneous melanoma]. PMID- 2699710 TI - [Medical therapy of malignant melanoma]. PMID- 2699711 TI - [Critical reflections on differentiated carcinoma of the thyroid: difficulties, doubts and differential-diagnosis problems]. AB - This work reviews the problems associated with the diagnosis of well differentiated carcinomas of the thyroid (follicular and papillary), which anatomically and clinically can show characteristics not readily distinguishable from those found in thyroid hyperplasia and adenomas. Some features of atypical adenomas and Hurthle cell tumors are detailed, in particular the borderline malignancy of the latter. We have examined the histological parameters useful in diagnosis of follicular carcinoma (cellular polymorphism and size variability with increased and atypical mitoses, invasion of the capsule and vessels, metastasis to lymph nodes and distant organs) and of papillary carcinoma (true papillae, large and crowded nuclei displaying a "ground glass" appearance with grooves and cytoplasmic inclusions and psammoma bodies). The limitations of these parameters are discussed with emphasis on frozen section examination when the lack of time limits examination to few and small tissue fragments. Invasion of the capsule and vessels is not easily detected and the "ground glass" nucleus and presence of grooves are not evident. The biological behavior of well differentiated carcinomas is discussed and, although unpredictable and variable in the single case, is generally that of a slow growing tumor. It is partially influenced by the age of the patient, size and stage of the tumor, invasion of the capsule and vessels and metastatic spread. We have observed that the biological behavior, apparently different in the follicular and papillary forms, appears identical for both tumors when a large number of cases are analyzed. Mention is made of the various surgical choices (total thyroidectomy, subtotal thyroidectomy, lobectomy, different surgical procedures which take into account the various risk factors). No statistically significant differences in recurrences and metastatic spread are obtained by electing more or less aggressive surgery with or without extensive dissection of cervical lymph nodes. PMID- 2699712 TI - [Correlation between post-cholecystectomy syndrome and biliary reflux gastritis. Endoscopic study]. AB - Experimental reports have proved that bile acids damage the gastric mucosa. Moreover it is now accepted that duodenogastric reflux occurs in 20-30% of cholecystectomized persons. The Authors, with the purpose of defining a correlation between gastric mucosa damage by duodeno-gastric reflux and postcholecystectomy syndrome have taken into consideration two groups of 14 patients each. To the first group belonged cholecystectomized patients, who had episodic, often postprandial pain, constant heart burn, with associated vomiting and Hypochromic anemia. To the second group belonged asymptomatic patients with previous cholecystectomy. All these patients were endoscoped (EGDS), and their endoscopic biopsy specimens were surveyed. 99Tc HIDA cholescintigraphy was performed in all the groups of patients, after endoscopy. In 85% of symptomatic patients we found, during endoscopy, reflux of bile into the stomach with associated reddish and inflammatory change of antral mucosa vs. 7.14% of the control group. Atrophic chronic gastritis was found in 71.43% of endoscopic biopsy specimens of Symptomatic vs. 14.28% of asymptomatic patients. Superficial chronic gastritis was found in 28.57% of symptomatic vs. 50% of asymptomatic patients. At last we found active atrophic or superficial antral gastritis (Whitehead) in 90% of symptomatic patients vs. 0% of asymptomatic people. The Authors conclude that there is a positive correlation between duodenogastric reflux and postcholecystectomy syndrome when biliary reflux is correlated with an histological finding of antral active chronic gastritis. PMID- 2699713 TI - [Biliary ileus: review of the literature and presentation of 7 cases]. AB - The authors report 7 cases of gallstone ileus out of 452 intestinal obstructions corresponding to an incidence of 0.04%. The late references on the subject show that gallstone ileus is an unusual condition which gives rise to surgical approach problems and operating mortality since it is a typical seniors' disease. Some Authors support the "one stage" repair for cholecystoduodenal fistula and gallstone ileus, whereas others suggest firstly to resolve the gallstone ileus with the enterolithotomy and then to perform the operation for gallstone disease. The authors treated six cases with the enterolithotomy and one case with the "one stage" procedure, both the treatments were successful as all the patients survived even if affected by easily controlled complications. PMID- 2699714 TI - [Endoscopic study in reflux esophagitis. Our experience]. AB - One hundred twenty one cases of oesophagitis by gastroesophageal reflux were observed through a retrospective study of 1250 endoscopies of the upper digestive tract. The oesophagitis was staged according to Savary-Miller classification. The prevalence (93.3%) of cases were in I and II stage. The Authors found that the most frequent associated diseases with oesophagitis by gastroesophageal reflux were: hiatal hernia, gastric and duodenal peptic disorders, gastric resection according Billroth II and biliary disorders. In 86.7% of cases, endoscopic diagnosis was confirmed by histological findings. From these data and from those reported in literature the authors can ascertain that endoscopy, associated with histological findings has an important role in diagnosing oesophagitis and in monitoring medical and surgical treatment used. PMID- 2699715 TI - [Studies on the solubility rate and pharmacokinetics of traditional Chinese medicinal preparations]. AB - This paper reviews recent developments in the research of solubility rate, bioavailability and pharmacokinetics of Chinese medicinal preparations. The significance of these developments for prescription improvement, dosage form selection, technological formulation and rational drug-taking has also been discussed. PMID- 2699716 TI - Semisolid ophthalmic vehicles. AB - The present review is concerned with some essential formulative and therapeutic aspects of semisolid ophthalmic vehicles. The history and the most recent developments of the traditional lipophilic vehicles (ointments) are first outlined. The hydrophilic vehicles (hydrogels) based on synthetic polymers (polyacrylates, PEG, PVA, Pluronics, etc.), semisynthetic polymers (cellulose derivatives) and natural polymers (hyaluronic and polygalacturonic acid, alginates, etc.) are then examined. Some recent formulations of particular type are finally described. PMID- 2699717 TI - Evaluation of proteolytic enzymes in effervescent tablets. AB - A procedure for the evaluation of proteolytic enzymes in effervescent tablets is reported. A proper chromatographic step followed by enzymatic activity assay allows to overcome the interferences due to the high salt content of such formulations as well as to chromophores eventually present in the tablet components. PMID- 2699718 TI - [Cavernous hemangioma of the larynx in the adult. Apropos of a case]. AB - We present a case of cavernous hemangioma located in the supraglottic area in an adult, whose clinical debut was airway obstruction. We remark on the singularity of this case, because the great majority are present during the first year of life, located in subglottis. A review of the literature and current modes of treatment of hemangiomas is also presented. PMID- 2699719 TI - [Clinical considerations concerning a new case of laryngeal chondroma]. AB - A new case of a chondroma of the larynx is reported discussing the diagnosis and its treatment. Also a brief review of the literature is presented. Scattered calcification observed by CT is considered as a pathognomic finding. Finally, biopsy is the only method for establishing the positive diagnosis. PMID- 2699720 TI - [Current surgical indications for tonsillar pathology]. AB - Tonsillectomy is one of the most controversial topics in otolaryngology. Today the immunologic role of the lymphoid tissue allows to clarify the surgical indications. Chronic bacterial tonsillitis, obstructive hypertrophic tonsils, peritonsillar abscess, suspicious of malignancy and fever convulsions produced by tonsillitis are the absolute indications for tonsillectomy. We review the literature on this topic. PMID- 2699721 TI - [Comparative study between an easy coagglutination test and traditional cultures for the detection of group A beta-hemolytic streptococci in the oropharynx]. AB - The authors make a comparative study of the conventional culture media and a commercially available coagglutination test for detection of streptococcus beta haemolyticus. They draw attention to the simplicity and quickness of the coagglutination test and to their high value of prediction. PMID- 2699722 TI - [Acceptability of the Hemoccult test in general medical practice. Results of a pilot study]. AB - In view of preparing a controlled trial to assess the efficacy of screening for colorectal cancer by fecal occult blood testing in reducing cancer mortality, a pilot study was performed to evaluate the acceptability rate of the Hemoccult test in non selected subjects consulting in a general practice. 566 subjects aged 45 to 74 years from two small towns, Neuville-aux-Bois (Loiret) and Vicherey (Vosges) were included in the study. The screening test was proposed by GPs to 89.2% of their patients; of these, 5.6% refused the test and 9.4% did not return it. Of the tests carried out, 80.8% were performed spontaneously, and 19.2% after a recall letter. Acceptability depended neither on age or on sex. The patients' confidence in his GP was the most important acceptability factor (60%), followed by explanations the GP had provided, and ease of application. The results suggest that after receiving the correct information, a GP will succeed in prescribing the Hemoccult test to most high-risk subjects and that acceptability then proves excellent. Experience drawn from the pilot study has been very useful in conceiving the on-going controlled trial in Burgundy. PMID- 2699723 TI - Identification of the putative first cellular step of chemical hepatocarcinogenesis. AB - A first cellular step of chemical hepatocarcinogenesis is characterized by identifying hepatocytes with preneoplastic properties: positivity for glutathione transferase-P or GST-P+, cell proliferation marked by bromodeoxyuridine or BUDR+, resistance to hepatotoxins and persistence. Hepatocellular doublets, both GST-P+ and BUDR+, are located immunohistochemically 4 days after a single dose of diethylnitrosamine, 25 mg/kg, using antibodies bound to different chromogens. GST P+ hepatocytes proliferate after selection for resistance to 2 acetylaminofluorene, and persist in the absence of selection for 6 weeks. The actual probability of the same cell being GST-P+ and BUDR+ is 200 times the expected value implying close links between cell proliferation and GST-P expression at initiation. PMID- 2699724 TI - Identification of a novel 80 kDa antigen associated with cell proliferation. AB - Exploiting the immunomasking method, a polyclonal antibody has been developed in mice for identification of a novel 80 kDa antigen (P80) in KB cells. The P80 was not detected in normal resting cells but was present in appreciable amount in malignant cells. In a comparative Western transfer the antisera to the immune complexes identified a 80 kDa peptide absent in normal cell extracts. When growth of KB cells were arrested by 48 h of serum starvation the P80 was not detected but after refeeding with serum containing medium, the P80 reappeared within 1 h. This result indicates that the P80 is associated with cell proliferation and appears early in the GI-S phase of the cell cycle. PMID- 2699725 TI - Interleukin 2 production in lymphocyte cultures: a rapid test for cancer associated immunodeficiency in malignant cervical neoplasia. AB - Peripheral blood lymphocytes of patients with malignant cervical neoplasia were studied for their capacity to produce interleukin-2 (IL-2) upon in vitro mitogen stimulation. Patients with early disease (Stage I/IIA) showed levels comparable to normal controls but those with advanced disease showed reduced levels, the reduction increasing with tumour load. These findings excellently correlated with our previous observations on a depressed cellular immunity in these patients. On follow up of the patients it was noticed that those who developed recurrent disease showed sustained lower levels of IL-2 production compared to those who remained disease free. These results stress the importance of a deranged immune system in these patients and also shows the clinical and prognostic value of such an assay. PMID- 2699726 TI - [Substances in the Echinaceae family which are potential antiviral agents and immunostimulants]. PMID- 2699727 TI - Critical electrolyte concentration of heterochromatin and euchromatin in cells of starved animals. AB - The critical electrolyte concentration (CEC) of chromatin, considered to be the salt concentration at which the phenomenon of metachromasy is completely abolished, when using toluidine blue as the cationic dye and Mg2+ ions as inorganic cations, was determined for the euchromatin and chromocentral heterochromatin of cells from starved animals. The objective was to determine variations in CEC induced by the starvation stress, which could be related to structural alterations and/or to the composition of these chromatin types. The cells investigated were from Triatoma infestans Malpighian tubules and mouse liver. It was found that the CEC values were affected both by fasting and by refeeding, the effect varying according to chromatin type and the cell system under consideration. PMID- 2699728 TI - Interaction between cortisol and microbial proteases. AB - Binding (or interaction) of cortisol with microbial molecule(s) was observed by employing Bio-Gel HTP affinity chromatography and subsequently by fluorescence spectrophotometry. Molecule(s) in the crude extract of baker's yeast and in other microbial proteases exhibited varied degrees of cortisol-binding. Bacterial protease (type IX) had highest, while the type XXVI enzyme had the lowest, binding capacity. In addition, these two proteases exhibited a distinct difference in the alterations of ultraviolet spectra due to interaction with cortisol. Using casein as a substrate, cortisol, CTP, trypsin inhibitor or leupeptin appreciably inhibited type IX protease at low concentrations of Ca2+. However, thyroxine had no effect on this protease. PMID- 2699729 TI - Characterization of intermediate filament proteins in astroglia of hamster cerebellum. AB - This investigation was initiated to determine whether the organization of intermediate filament (IF) proteins is affected in the central nervous system of polymyopathic hamsters, as the Duchenne muscular dystrophy gene is normally expressed in the nervous system, in addition to cardiac and skeletal muscle, and changes in cell shape and cytoplasmic organization can serve as the regulators of growth, gene expression and cellular differentiation. The cerebellum of dystrophic hamster (CHF 146) was selected as the model system with the CHF 148 hamster providing the control for normal cerebellum. Using immunofluorescence microscopy for IF proteins, no difference could be detected in the cerebellum of dystrophic and normal hamsters. However, the glial fibrillary acidic protein and an IF-associated protein (J1-31 antigen), are lacking in Bergmann glia of the molecular layer. Moreover, vimentin persists in the cerebellum, its presence being most pronounced in a subset of Purkinje neurons in the adult hamster. These results are in contrast to those obtained in the rat cerebellum which has been extensively studied in respect to the organization of IFs. PMID- 2699730 TI - [Instrumental diagnosis in shoulder instability]. AB - The authors call attention to the pathology caused by glenohumeral instability and, in particular, to painful shoulders in athletes which so often cause problems in diagnosis. An instrumental protocol for diagnosis is suggested, based on several specific radiographic views, Ct scan and arthro-Ct scan, with double contrast medium, the latter having the task of determining lesion which would not otherwise be able to be studied. PMID- 2699731 TI - [Normal development of human fetal skin]. AB - Over the past few years, the use of fetal skin biopsies for prenatal diagnosis of severe inherited skin diseases has illustrated the practical importance of the structural and antigenic knowledge of normal human fetal skin. During the first 10 weeks of gestation the basic structure and antigenicity of epidermis is built up and at about 18 weeks gestation, the period in which fetal skin biopsy is usually carried out, most of the structural and antigenic markers are fully formed and usable for prenatal diagnosis: the dermal-epidermal junction is complete with hemidesmosomes and anchoring fibrils; type IV collagen and laminin are already demonstrable and useful for dermal epidermal junction mapping; other monoclonal or polyclonal markers such as GB3 or LH 7:2 are already present. At this time pilosebaceous units are present and keratinization is well developed in follicular epidermis; interfollicular keratinization, in contrast, does not begin before 24 weeks of gestational age. The appearance of sweat glands on general body surface occurs only after 24-27 weeks gestation. PMID- 2699732 TI - T.l.c. enantiomeric separation of amino acids. AB - Resolution of enantiomers is very important particularly in the fields of asymmetric synthesis, mechanistic studies, geochronology, studies of structure function relationship of proteins, pharmacology, and medicine. Various chromatographic methods have replaced the classical fractional crystallization, seeding and enzymatic procedures. Of these, t.l.c. provides a direct, simple, and inexpensive method for resolution of enantiomers of amino acids and their derivatives. Ligand exchange, ion exchange, and molecular inclusion complexation have been the basis of t.l.c. resolution of enantiomers of amino acids and their derivatives. The innovation of new plate types, and methods of development and detection have renewed interest in the direct resolution of enantiomers of amino acids, their derivatives and a variety of other compounds by t.l.c. The present report provides an overview of some of the more recent approaches to the direct t.l.c. resolution of amino acids and their derivatives together with special advantages and scope of t.l.c. PMID- 2699733 TI - Regulation of the cell cycle timing of mitosis. AB - Considerable advances have been made recently in our understanding of how the cell cycle timing of mitosis is regulated. This has come about because links have been established between two independent areas of research, one based on a genetic approach using the fission yeast Schizosaccharomyces pombe and the second based on a biochemical approach using Xenopus and starfish oocytes. In this chapter we review work that has identified a number of the mitotic regulating genes in fission yeast and has established links with controls operative in multicellular eukaryotes. PMID- 2699734 TI - Control of G2 delay by the rad9 gene of Saccharomyces cerevisiae. AB - In response to DNA damage, Saccharomyces cerevisiae cells arrest the cell cycle in the G2 phase. Arrest is defective in rad9 mutants; rad9 cells divide and die without repairing the damage. Several cell cycle mutants that are defective in DNA replication arrest in G2 at the restrictive temperature; this arrest is due to the RAD9 control function. Thus RAD9 is responsible for the fact that mitosis is normally dependent upon DNA replication, a function we term a 'checkpoint'. Four additional genes have been identified that are also components of the RAD9 checkpoint. PMID- 2699735 TI - The mammalian cdc2 protein kinase: mechanisms of regulation during the cell cycle. AB - Recent experimental evidence has demonstrated the central role of the cdc2 protein kinase in the transition from G2 to M phase in eukaryotic cells. We shall review our knowledge of the mechanisms which coordinate activation of the kinase with cell cycle-specific events in mammalian cells. PMID- 2699736 TI - NSP1, a yeast protein located at the nuclear periphery, is required for the cell cycle of Saccharomyces cerevisiae. AB - Proteins located at the nuclear periphery and required for nuclear and cell division are not known in yeast. We recently identified a novel nucleoskeletal like protein in Saccharomyces cerevisiae, which is in close proximity to the spindle pole body and the nuclear membrane. NSP1 has an essential function, since haploid yeast cells with a defective NSP1 gene cannot grow. In this report, we demonstrate that yeast cells which carry the NSP1 gene under the regulatory GAL10 promoter exhibit abnormal cell morphology both under conditions where the level of NSP1 expression is greatly increased (the GAL10 promoter is induced) or limited (the GAL10 promoter is not induced). This result suggests that NSP1 is required for the coordinated cell cycle in S. cerevisiae. PMID- 2699737 TI - Analysis of the Cdc28 protein kinase complex by dosage suppression. AB - In the interest of identifying components of the Cdc28 protein kinase complex, dosage suppression analysis was performed on temperature-sensitive and dominant negative CDC28 mutations. Dosage suppression is based on a rationale in which elevated expression of wild-type genes can rescue mutations in a target gene as a result of interaction between the respective encoded proteins. Three sequences capable of rescuing a temperature sensitive cdc28 mutation were isolated from a library of wild-type genomic DNA segments in the high copy vector YEp13. Two of these, named CLN1 and CLN2 were found to encode closely related proteins with homology to cyclins. The third, CKS1, encodes an 18K (K = 10(3) Mr) protein that has been shown to be a component of the Cdc28 protein kinase complex and is a homolog of the suc1+ product of fission yeast. A number of dosage suppressors of the CDC28-dn1 dominant negative mutation have been isolated. The one analyzed to date encodes a truncated subunit of the mitochondrial enzyme succinyl-CoA synthetase. The basis for suppression in this case remains to be elucidated. PMID- 2699738 TI - Maturation-promoting factor and the regulation of the cell cycle. AB - Maturation-promoting factor (MPF) is a cell cycle control element able to cause metaphase when injected into amphibian oocytes or when incubated with nuclei in a cell-free system. Highly purified MPF consists of a complex between a 34K (K = 10(3) Mr) serine/threonine protein kinase, identified as a Xenopus homolog of the cdc2+ gene product, p34cdc2, and a 45K substrate, identified as a Xenopus B-type cyclin. p34cdc2 is also present in purified preparations of chromatin-derived growth-associated histone H1 kinase from Novikoff hepatoma cells. p34cdc2 is active when dephosphorylated and inactive when phosphorylated during oocyte meiotic cell cycles and in mitotic cell cycles following egg activation. Analysis of the substrate specificity of p34cdc2 indicates a consensus sequence for phosphorylation of (K/R)S/TP(X)K/R. Among substrates identified with this consensus are histone H1 and the pp60c-src proto-oncogene, which is known to be activated and phophorylated in mitosis. MPF injection into oocytes activates ribosomal protein S6 kinase II, which is also a lamin kinase. The mechanism of activation is indirect, possibly involving the c-src proto-oncogene. Continued analysis of regulation of MPF activation/inactivation and characterization of substrates for phosphorylation will have important implications for cell cycle and cell growth control. PMID- 2699739 TI - Organization of the nuclear pore complex in Saccharomyces cerevisiae. AB - Fractions enriched for nuclear pore complexes (NPCs) have been isolated from Saccharomyces cerevisiae. The sequential extraction of nuclei with detergent, nucleases, and salt reveals an organization of the yeast NPC similar to other eukaryotes. Yeast NPCs contain a 30-nm "ring" structure not previously described in other organisms. This structure appears to organize 10-nm filaments into an assembly which exhibits an eight-fold rotational symmetry. Some proteins in the NPC fraction are capable of forming intermediate-sized filaments. These studies suggest that some component of the nuclear pore complex organizes an interaction between nuclear and cytoplasmic networks of intermediate filaments. PMID- 2699740 TI - [The bases of genetic therapy]. PMID- 2699741 TI - [Animal models of gene therapy]. AB - Somatic gene therapies are based on the introduction of genes in somatic cells in an attempt to correct a gene defect, to induce a resistance or to add a particular activity. In their principle, they are not very different from organ grafts and do not set specific ethic problems. Their application to human therapy has to be subjected to a critical evaluation of their harmlessness and efficiency. For this purpose, animal models of somatic gene therapy are essential. Such therapy have been tried in bone marrow and endothelial cells, in fibroblasts, keratinocytes hepatocytes, but also by direct transfer of genes in the organism. These different approaches are briefly reviewed and compared in this article. PMID- 2699742 TI - [Genetic mapping of chromosome X: known localizations]. AB - To be a linkage between the clinician and the molecular biologist is the aim of this paper. All the known genes on the X chromosome are usually reported in most of the human gene mapping catalogs. Here, X-linked diseases precisely mapped on the X chromosome are classified by systems. Gene mapping of the phenotypes is given for each system. PMID- 2699743 TI - [Ultrasonic prenatal diagnosis of the Jarcho-Levin syndrome]. AB - The Jarcho-Levin syndrome is an autosomal recessive disease characterized by spinal and rib malformations (spondylocostal dysplasia). The case reported concerns a fetus with a dorsal spine angulation noted at the 15th week of gestation. A more accurate ultrasound study performed at 20 weeks revealed shortness of the neck and thorax, irregular ribs and vertebrae and absence of other visceral abnormalities. The karyotype was normal. Therapeutic abortion proposed was finally accepted by both parents at 27 weeks. The diagnosis was confirmed by post mortem radiography. No parental consanguinity was noted. PMID- 2699744 TI - Prenatal diagnosis using sonographic guided cordocentesis. AB - Cordocentesis has been practiced as a diagnostical tool for prenatal diagnosis of intrauterine infections, hematological disorders, metabolic status of the fetus and rapid cytogenetic analysis. The performance of 198 cordocentesis is presented over 3 years of experience. A 21 gauge spinal needle is inserted via the optimal point on the maternal abdomen under real-time ultrasonic guidance into the insertion of the umbilical cord in the placenta. Successful cordocentesis were achieved in 98.5% of the cases. Termination of pregnancy was directly related to the procedure in only 1%. Hematoma surrounding the puncturing site was demonstrated in one case, but without damage to the fetus. In our series the main indication for performing cordocentesis was the need for rapid karyotyping. The use of fetal lymphocytes for chromosomal analysis offers a rapid and a reliable method for routine clinical demands. The availability of a rapid chromosomal analysis offers a considerable advantage in pregnancies of advanced gestational age. In those pregnancies it appears to be most important to have a rapid diagnosis where anatomical structural anomalies are associated with chromosomal malformations in up to 30%. The metabolic status of the fetus is considered in either acute distress or in cases of suspected sub-optimal metabolic hemostasis, where IUGR or oligohydramnios are demonstrated. Cordocentesis, even though is a new technique, turns to play a major role in modern perinatology. The possibility of a direct rout to fetal blood vessels early during the pregnancy bears the tremendous potential of early diagnosis and treatment. PMID- 2699745 TI - Evaluation of fetal heart rate artifacts, hemodynamics and digoxin treatment in fetal tachyarrhythmia by Doppler measurement of fetal blood flow--case report of a pre-excitation syndrome. AB - A fetal cardiac arrhythmia may cause misleading fetal heart rate tracings with unreliable signs of fetal distress. Assessment of such artifacts and of the hemodynamic relevance of a fetal arrhythmia by alternative methods is necessary for management and therapy. A 28-year-old healthy woman was referred at 30 weeks of gestation because of fetal tachy-brady-arrhythmia, but cw-Doppler assessment of umbilical artery blood flow revealed periods of pseudobradycardia during bigeminal and trigeminal fetal pulse. FHR turned to regular tachycardia, and transplacental digitalization was started. Between 32 and 34 weeks the patient discontinued her digitalis intake, and a fetal pericardial effusion indicated subsequent cardiac failure. Serial pulsed Doppler measurements of fetal aortic blood flow were performed and imminent heart failure was recognized after the digitalis was discontinued and before a pericardial effusion occurred. Furthermore, improvement of fetal cardiac performance secondary to restarting digitalis and also prior to resolution of the pericardial effusion. After spontaneous delivery a Wolff-Parkinson-White syndrome was diagnosed, and continuation of digoxin treatment was indicated. Cw-Doppler assessment of umbilical artery blood flow was a suitable method to evaluate questionable FHR recordings, and pulsed Doppler allowed monitoring of the therapeutic effect of transplacental digitalization by serial measurements of fetal aortic blood flow. PMID- 2699746 TI - Biochemical timing of peri-intraventricular hemorrhage assessed by perinatal CPK BB isoenzyme measurements. AB - Precise diagnosis of peri-intraventricular hemorrhage (PIVH) requires brain real time ultrasound imaging procedure (US). However, maximal diagnostic efficiency of US lies between day 4 and 14 since fresh blood may initially appear sonolucent. Because of this supposed interval required for clot formation to become visible on US, serum CPK-BB estimations were performed in the first 60 hours of life to determine precise biochemical timing of PIVH. A group of 50 preterm infants less than 1500 g birth weight (1120 +/- 320 g) and 34 weeks gestation (30 +/- 3.7 weeks) was studied. Serial CPK-BB measurements were performed in serum immediately after birth (T0), then serially at time T1 (6-10 h), T2 (20-30 h), T3 (40-60 h). The incidence of PIVH diagnosed on the third day of life was 30%. Total CPK-BB values at T0 in infants who developed PIVH were significantly higher than those of patients without cerebral bleeding (70.8 +/- 30.5 vs 20.9 +/- 10.7 U/l) (p less than 0.05). The same statistically significant results were not observed analysing the CPK-BB values at T1, T2 and T3. These results suggest that most pathological conditions responsible for enzyme release occur in the pre- or perinatal period. PMID- 2699747 TI - Beta-2-microglobulin in the assessment of renal function in full term newborns following perinatal asphyxia. AB - In order to evaluate the clinical usefulness of serum and urinary beta 2 microglobulin (beta 2-m) determination as a marker of renal damage following perinatal asphyxia, twenty asphyxiated and twenty healthy full term newborns were studied. Renal function was monitored on the first and third day after birth by traditional tests such as creatinine (Cr), endogenous creatinine clearance (Ccr), and fractional Na excretion (FeNa), as well as by serum and urinary beta 2 microglobulin. The value of different tests for the diagnosis of oliguria and of acute renal failure was determined. Eleven asphyxiated neonates developed oliguria and five ARF in contrast to none of the controls. Both traditional tests of renal function, and determinations of beta 2-m with the exception of serum beta 2-m, were significantly different (p less than 0.01) between controls and asphyxiated neonates. When stratified analysis was performed, only serum cr, urinary beta 2-m/cr ratio, and Fe beta 2-m were able to discriminate oliguria from preserved diuresis on the first day of life. For ARF, only Ccr and Fe beta 2 m were different, again on the first day of life. Urinary beta 2-m/creatinine ratio and Fe beta 2-m appear to be more sensitive and specific for the early detection of proximal tubular renal dysfunction following perinatal asphyxia than usual tests of renal function. PMID- 2699748 TI - Determination of light-chain myosin in pregnancy and under tocolysis. AB - Cardiac toxicity of tocolysis containing hexoprenaline (0.3 microgram/min) and the beta 1-blocking agent metoprolol (0.01 mg/min) was investigated using a recently developed monoclonal antibody arised against light-chain myosin in 15 patients and compared with the results in 51 control subjects. There was an increase in the median and 80th percentile values 2, 6, 12 and 24 hours after the beginning of tocolysis but no statistically significant difference between these values and the normal ones could be shown. PMID- 2699749 TI - Stereoselective reduction of acetohexamide in cytosol of rabbit liver. AB - The stereoselective reduction of acetohexamide, an oral antidiabetic drug, was studied by using the cytosol of rabbit liver. A major metabolite of acetohexamide was isolated in 41.5% yield from the enzyme reaction mixture, and identified as ( )-hydroxyhexamide by techniques including the melting point, thin-layer chromatography, infrared spectrometry and optical rotation. The enantiomeric purity of (-)-hydroxyhexamide was determined on the basis of the proton nuclear magnetic resonance (400 MHz) spectrum of ester (diasteromer) derived by the reaction of (-)-hydroxyhexamide with (R)-(+)-alpha-methoxy-alpha trifluoromethylphenylacetyl chloride. The (-)-hydroxyhexamide isolated from the enzyme reaction mixture was almost 100% in that enantiomeric form. The metabolic reduction of acetohexamide in the cytosol of rabbit liver appeared to be catalyzed by some enzymes with the same stereoselectivity. PMID- 2699750 TI - Calcium absorption in man: some dosing recommendations. AB - The absorption of calcium involves a saturable (active) and a nonsaturable (passive) component. The work of several investigators indicates that an inverse relationship exists between calcium intake and absorption efficiency. Human calcium absorption data from the literature were analyzed using a model which included both an active and a passive absorption component. Simulations were provided to illustrate the suitability of this model, and another previously reported model, to fit the data and to estimate the absorption efficiency of calcium when using different dosing regimens. Comparisons of the values predicted in this study with some literature values are provided and some assumptions and potential limitations associated with the use of this method are discussed. The division of the daily dose into equal increments taken at equally spaced intervals over the course of the day is recommended as a useful procedure for increasing the absorption efficiency and efficacy of calcium. PMID- 2699751 TI - Pathologic findings after recession and resection of extraocular muscles in rabbits. AB - A study on the pathologic findings after recession and resection of extraocular muscles in rabbits was performed. Fibrosis of the extraocular muscles increased with time, which showed no difference between the recessed and resected muscles. Inflammation and foreign body reaction decreased with time, which showed no difference between the recessed and resected muscles. Adhesions of extraocular muscles to the sclera were observed from one month after the operation. The resected muscles showed milder adhesion to the sclera than the recessed ones. The operated extraocular muscles showed atrophies at one month, which showed no difference between the recessed and resected muscles. According to our results, when reoperation is needed, fibrosis of the extraocular muscles after recession and resection should be considered when making a decision on the amount of muscle to be recessed and resected. PMID- 2699752 TI - Implantation of posterior chamber intraocular lenses by suture fixation without capsular and zonular support. AB - We implanted sulcus-fixated posterior chamber intraocular lenses (PCL) in three cataractous, six aphakic, and four eyes during penetrating keratoplasty due to corneal opacity in the absence of capsular and zonular support. This technique has been successfully performed in all cases and produced good visual outcome in 12 eyes (93%). In four eyes which had penetrating keratoplasty and the fixation of PCL, one developed vitreous hemorrhage and one developed corneal graft rejection. PMID- 2699753 TI - Characterization of a Trypanosoma cruzi genomic fragment complementary to several species-specific mRNAs but different from the spliced leader sequence. AB - We have isolated a clone of Trypanosoma cruzi genomic DNA, lambda 3b2-5, which contains sequences that are reiterated in the genome. Northern blot analysis showed that clone 3b2-5 hybridizes to 1,200-5,000 bases different mRNA species. The number of mRNAs species hybridized to clone 3b2-5 exceeds its coding capacity showing that this clone carries sequences that are common to several mRNAs species and conserved in the poly A(+) RNA. These sequences are not homologous to the T. cruzi spliced leader sequence, since clone 3b2-5 does not hybridize to a synthetic 20 nucleotide complementary to the spliced leader sequence. Clone 3b2-5 does not hybridize to DNA and RNA from several genera of Trypanosomatidae and other Trypanosoma species indicating that it carries T. cruzi species-specific sequences. PMID- 2699754 TI - Ultrastructural studies of the hemocytes of Panstrongylus megistus (Hemiptera: Reduviidae). AB - Ultrastructural analyses revealed the presence of six hemocyte types in the hemolymph of Panstrongylus megistus, partially confirming our previous results obtained through light microscopy. Prohemocytes: small, round hemocytes with a thin cytoplasm layer, especially rich in free ribosomes and poor in membranous systems. Plasmatocytes: polymorphic cells, whose cytoplasm contains many lysosomes and a well developed rough endoplasmic reticulum (RER). They are extremely phagocytic. Sometimes, they show a large vacuolation. Granulocytes: granular hemocytes whose granules show different degrees of electrodensity. Most of them, have an internal structuration. Coagulocytes: oval or elongated hemocytes, which show pronounced perinuclear cisternae as normally observed in coagulocytes. The cytoplasm is usually electrodense, poor in membranous systems and contains many labile granules. Oenocytoids: large and very stable hemocytes, whose homogeneous cytoplasm is rich in loose ribosomes and poor in membranous systems. Adipohemocytes: large cells, containing several characteristic lipid droplets. The cytoplasm is also rich in glycogen, RER and large mitochondria. The total and differential hemocyte count (THC and DHC) were also calculated for this reduviid. THC increases from 2,900 hemocytes/mm3 of hemolymph in the 4th instar to 4,350 in the 5th and then, decreases to 1,950 in the adults. Plasmatocytes and coagulocytes are the predominant hemocyte types. PMID- 2699755 TI - Search for Trypanosoma cruzi in anal glands of naturally infected dogs. PMID- 2699756 TI - The cause of Chiari II malformation: a unified theory. AB - The cause of the Chiari II hindbrain deformity in children born with a myelomeningocele can be explained by the lack of distention of the embryonic ventricular system. Defective occlusion and an open neural tube precludes the accumulation of fluid and pressure within the cranial vesicles. This distention is critical to normal brain development. The small posterior fossa, cerebral disorganization, and luckenschadel are the result. PMID- 2699757 TI - Pseudocysts of the abdomen associated with ventriculoperitoneal shunts: a report of twelve cases and a review of the literature. AB - Shunt complications are reported to occur at a rate of approximately 26%. One of the less frequent but important complications is that of the pseudocyst. Since Harsh's first mention of a periumbilical cyst associated with a shunt in 1954, 44 cases have been reported in the literature. These are reviewed in addition to 12 cases of our own. From the collected series several features about the etiology and management become apparent. The most common presentation is that of abdominal distension and/or pain rather than shunt malfunction. Diagnosis is then readily made with ultrasonography. Etiologically, it is evident that an inflammatory process is a frequent predisposing factor. In our series 16% had acute infection, 41.6% had a past history of CSF infection (6 months to 6.2 years), and 16% had CNS tumor although tumor cells were not isolated from the peritoneal cysts. Our management of the cyst itself was different from that reported in other series; it was found that the cyst reabsorbed spontaneously without excision or aspiration once the CSF was diverted. The peritoneal cavity could then be used for shunting once the cyst had reabsorbed. This sometimes required conversion to an atrial or pleural shunt before reutilization of the peritoneal cavity. There were no problems with cyst recurrence despite the conversion of 58% of the shunts to ventriculoperitoneal shunts with follow-up ranging from 3 months to 4 years. The mode of management of both the cyst and the hydrocephalus is reviewed. PMID- 2699758 TI - Peptidergic control of the autonomic regulation system in the orofacial region. AB - Many biologically active peptides are localized in autonomic nerves of the orofacial region. Substance P and calcitonin gene-related peptide (CGRP) are released from capsaicin-sensitive afferents and are candidates as mediators of plasma protein extravasation and antidromic vasodilatation. Vasoactive intestinal polypeptide (VIP) and peptide with N- and C-terminal histidine (PHI) are released together with acetylcholine from parasympathetic nerves. VIP and PHI may be involved in both non-cholinergic vasodilatation and enhancement of cholinergic exocrine secretion (especially protein content). Neuropeptide Y (NPY) is coreleased with noradrenaline from perivascular sympathetic nerves. NPY exerts prejunctional inhibitory actions on noradrenaline release and may also mediate non-adrenergic sympathetic vasoconstriction. A variety of both anticholinergic and sympathoactive drugs influence not only the classical transmitters acetylcholine and noradrenaline but also the respective coexisting peptides VIP and NPY. PMID- 2699759 TI - Blood flow regulation in masticatory muscles. PMID- 2699760 TI - Micropuncture measurements of interstitial fluid pressure in the rat periodontal ligament. AB - The interstitial fluid pressure (IFP) or so-called tissue pressure in the periodontal ligament (PDL) has been suggested to play a role in tooth position and affect periodontal blood flow. However, few investigators have actually measured the tissue pressure in the PDL and measurements in the PDL of rat continuously erupting incisors are lacking. The present study was aimed to develop the micropuncture technique for measurements of IFP in the PDL. The PDL of rat incisors was exposed by partial removal of the crown, the coronal pulp was removed. Viewed through a stereomicroscope, a cavity was drilled until the vessels of the PDL were visible through a thin layer (20 microns) of root cement. The cavity was covered with saline and the PDL punctured with glass micropipettes, diameter 2-6 microns, through tiny cracks of the root cement. The periodontal tissue pressure (IFP) was measured by connecting the micropipette to a servocontrolled counter-pressure pump system (Wiederhielm 1964). Mean IFP in 22 Sprague-Dawley rats was 15.2(SD +/- 3.6) mmHg and simultaneously measured systemic arterial pressure (PA) averaged 125 mmHg. Intravenous administration of an antiflogisticum, indomethacin (15 rats), did not change IFP significantly (mean 14.3, SD +/- 4.2 mmHg). Increased blood volume in the PDL, induced by bilateral clamping of the jugular veins, resulted in an immediate rise in IFP, whereas reduced blood volume due to cardiac arrest arrest resulted in an abrupt fall in IFP, indicating low compliance in the rat PDL. It is concluded that the measurements with the present micropuncture technique are relatively atraumatic and thus it seems to be a reliable method for recordings of IFP in the PDL. PMID- 2699761 TI - Intracellular events associated with autonomic stimulation of salivary secretion. AB - Stimulation of salivary acinar cells by muscarinic and alpha-adrenergic agonists results in a complex series of intracellular and ion transport events which ultimately result in the secretion of salivary fluid. The full functional significance of many of these events and the way in which they are coordinated to produce the final secretory response is currently under active investigation. PMID- 2699762 TI - Autonomic control of salivary secretion. AB - The view is generally held that the secretory elements of the major salivary glands are supplied with parasympathetic (cholinergic) nerve fibres, while the extent of the sympathetic (adrenergic) innervation varies considerably not only between different species but also between the glands of the same species. Parasympathetic stimulation evokes a copious flow of saliva. In contrast, sympathetic stimulation produces either a small flow, which is rich in protein, or no flow at all. In recent years it has become evident that secretion of saliva may not be elicited only by cholinergic or adrenergic agonists but also by peptides, injected into the bloodstream, and further, that the salivary secretion in response to stimulation of the parasympathetic innervation is not always completely abolished by the muscarinic receptor blocker atropine (and adrenoceptor antagonists). The present communication focuses on this "atropine resistant" parasympathetic influence on the salivary glands and on a possible role for neuropeptides in mediating "atropine-resistant" parasympathetic responses in the glands. Immediate effects as well as long-term trophic effects are considered. PMID- 2699763 TI - Autonomic mechanisms in oral sensations. AB - Sympathetic fibres reach the oro-facial region by several routes, the main one being via the carotid nerve and the trigeminal or facial nerves. Sensory receptors in this region may be affected non-specifically by activity in these fibres as a result of, for example, changes in local blood flow or contraction of pilo-erector muscles. There is evidence that the responses of intradental receptors and periodontal mechanoreceptors may change during stimulation of the cervical sympathetic trunk, but these effects are probably not due to specific modulatory mechanisms. There is no evidence that the parasympathetic nervous system affects the properties of oral receptors. Patients with Horner's syndrome appear to have no sensory abnormalities, apart from pain which is sometimes associated with the onset of the condition. Reflex sympathetic dystrophy seems to be rare in the oro-facial region. PMID- 2699764 TI - Interaction between the autonomic and sensory nerves in the dental pulp. AB - The function of intradental sensory receptors is strongly affected by activation of the sympathetic nerves. This effect is most probably indirect and due to changes in pulpal blood flow. Also, in inflamed teeth the sensitivity changes of pulp nerves seem to be closely related to changes in the blood flow. Such inflammatory mediators as histamine, bradykinin and serotonin affect the sensitivity of intradental receptors in pulpal inflammation. In addition, many neuropeptides, for example substance P (SP) and calcitonin gene-related peptide (CGRP), seem to be involved and may interact with histamine or bradykinin. Recent studies indicate that intradental nerves with their neuropeptides may play a significant role in the inflammatory and defence reactions of the dental pulp. PMID- 2699765 TI - Autonomic and somatosensory interactions: physiological and pathophysiological implications. AB - Painful or tissue damaging stimuli produce complex sensory, vascular, and neuroendocrine responses. These responses are adaptive in the sense that they provide a warning signal (i.e. pain) and prepare the organism to deal with the threat. Responses to painful stimuli do not occur independently of each other and many of the physiological responses to painful stimuli may act to diminish the perception of pain. Experimental findings are reviewed supporting the hypothesis that vascular responses which stimulate baroreceptor afferents engage central pain inhibitory networks. The importance of cardiovascular and somatosensory interaction as they relate to adaptive and maladaptive conditions will be discussed. PMID- 2699766 TI - Autonomic control of sensory responsiveness. AB - This paper discusses some recent evidence concerned with interactions between the sympathetic nervous system and sensory processing. There is some evidence for a direct inhibitory influence of sympathetic nerves on C-fibre somatic afferents. However, the effects are often masked by other actions which are secondary to sympathetically induced local vascular changes. In addition, in certain pathological pain states sympathetic activity does appear to enhance activity in C-fibres. Centrally induced changes in sensory responsiveness and in the pattern of ongoing sympathetic activity are fundamental components of certain behavioural states, such as aggression or sleep. Even though these changes occur in concert, there is as yet no unequivocal evidence for a common central control mechanism. The central control of the sympathetic outflow and sensory afferent input appear to be mediated independently. In contrast, increased visceral afferent input to the central nervous system, e.g. from cardiopulmonary baroreceptors, may lead to a decreased responsiveness to noxious input indirectly by enhancing centrally the activity in descending pain control pathways. PMID- 2699767 TI - Intermediate filaments in biology and disease. AB - Intermediate filaments comprise a large heterogenous family of proteins in animal cells. Distinct from microfilaments and microtubules, they are a major component of the cytoskeleton and nuclear envelope. The expression of intermediate filament protein types is developmentally regulated and relatively cell type specific. Although there are at least five distinct classes of intermediate filament types, all the subunit proteins have similar structural features and appear to have envolved from some common gene ancestor. The cytoplasmic intermediate filaments exhibit a complex organization, forming associations with components of the nucleus, plasma membrane, and potentially other cytoplasmic structures such as microtubules. The specific function of this prominent cytoplasmic structure is currently unknown. However, the organization or expression of intermediate filaments is known to be altered in association with a variety of human diseases. Currently, specific antibodies to individual intermediate filament proteins are being used as an immunohistochemical aid for tumor typing in diagnostic pathology. PMID- 2699768 TI - [Consensus agreement on the control of blood cholesterol in Spain]. PMID- 2699769 TI - [Phlebotomus in Spain]. AB - The importance of leishmaniases in human medicine, on a global as well as a national level, is a matter that offers no doubts. The problems caused by these illnesses are what cause increased attention to the vector insects: the phlebotomos. This article offers an overview of the most significant aspects of the species to be found in Spain. Apart from mentioning the highlights of the studies which have been carried out in our country concerning these insects, an analysis is also made of the distribution throughout the entire country, giving a map which shows the species captured in each province. Mention is also made of the morphological characteristics of greatest taxonomic importance, including 3 illustrations on this subject, and finally, the article gives the most important data on its biology, be it in the pre-imaginal stages (eggs, larva, pupa), or in the adults. PMID- 2699770 TI - [The consensus conferences come to our country. A rational instrument for evaluating and disseminating medical technology]. PMID- 2699771 TI - Transport of SCFA across the large intestinal epithelium of guinea pig. PMID- 2699772 TI - Short chain fatty acids as metabolic regulators of ion absorption in the colon. AB - Between 50%-80% of sodium absorption in the colonic mucosa is dependent upon CO2 generation from SCFAs derived from the colonic lumen. Lumenal starvation leading to diminished SCFAs levels in the colon greatly reduce the absorptive capacity of the colonic mucosa. Mechanisms whereby SCFAs regulate sodium absorption in the colon include 1) an enzyme induced adaptive regulation of SCFA-oxidation in colonocytes, 2) a flexible CO2 supply from SCFA depending upon stimulation or suppression of fatty acid oxidation., 3) the variable sidedness of Na(+)-H+ and Cl(-)-HCO3- exchange pumps in colonic epithelial cells, and 4) colonic epithelial cell membrane synthesis from SCFAs. Precise details of these regulatory mechanisms need to be elucidated by further experimental investigation. PMID- 2699773 TI - Mechanisms of absorption of short chain fatty acids--coupling to intracellular pH regulation. PMID- 2699774 TI - New aspects of magnesium transport in ruminants. PMID- 2699775 TI - The absorption of calcium and phosphate from the rumen. PMID- 2699776 TI - Electrolyte and water absorption in the hind gut of herbivores. PMID- 2699777 TI - Adaptation of the ruminant digestive tract to diet. PMID- 2699778 TI - Food utilization in relation to gut structure and function in wild and domestic birds and mammals. PMID- 2699779 TI - Sufficient fermentation and rapid passage of digesta. A problem of adaptation in the hindgut. PMID- 2699780 TI - Functions of the flow of urine and digesta in the avian lower intestine. PMID- 2699781 TI - Control of ovine parotid and mandibular salivary gland secretions. PMID- 2699782 TI - Quantitative estimates of fermentation in the hind gut of man. PMID- 2699783 TI - Microbial digestion in the large intestine in relation to monogastric and polygastric herbivores. PMID- 2699784 TI - Evolution of vertebrate herbivores. PMID- 2699785 TI - [2 cases of brief asystole following premedication--a possible connection with Thalamonal?]. AB - Two cases of cardiac arrest about 30 min after intramuscular administration of premedication are analyzed. The patients were two young men without serious diseases in the history. The premedication consisted of Thalamonal (Innovar) and atropine. The cardiac arrest responded readily to treatment and there were no further problems. The indication for Thalamonal for premedication is critically analyzed; our conclusion is that it should be used only with caution. PMID- 2699786 TI - [Cannulation of the internal jugular vein using 2 ultrasonic technics. A comparative controlled study]. AB - The internal jugular vein (IJV) is a common access route to the central venous system. Anatomical landmarks (group I) are normally used for localization of the IJV. We have compared this method with two other methods based on ultrasonic waves to identify the IJV and the carotid artery (CA) (even in atypical positions). We employed an ultrasound Doppler device in group II and a real-time ultrasonograph in group III. Central venous catheters were placed into the right IJV by the Seldinger technique. The IJV could be located in all patients with both ultrasound methods, but the course of the IJV could only be identified by ultrasonography. For this reason, the direction of the IJV was classified as "typical" in 80% of group I, in 85% of group II, but in only 45% of group III. No intergroup differences were found with respect to the number of punctures (mean value 1.6 +/- 0.83) and the incidence of complications. The time required to locate the site and direction of puncture increased with technical sophistication. There was, however, no difference in the total time for catheter placement, because puncture was performed faster when aided by sonography. In four patients in groups I and II, in whom attempts to puncture the IJV had not been successful, this could subsequently be achieved with ultrasonographic aid. One patient (group I) displayed a hematoma following inadvertent puncture of the CA. In one patient in group II the IJV and CA could not be distinguished as one was overlying the other. The echocamera provided improved localization of the IJV and the CA in comparison with the Doppler ultrasound.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699787 TI - [Short term effects of ketoconazole in Cushing's syndrome]. AB - The effects of Ketoconazole (600 mg/day) were evaluated in 10 patients with Cushing's syndrome during a mean period of 4.5 weeks (range 1-12). The urinary free cortisol excretion (UFC) decreased by 21 +/- 15% (mean +/- SEM) (p less than 0.01) on day 1; 54 +/- 8% (p less than 0.0001) on day 2; 60 +/- 15% (p less than 0.0001) on day 3 and 87 +/- 3% (p less than 0.0001) on day 8 compared to baseline. Salivary cortisol at 0800 h decreased similarly. On day 3, 7 patients showed normal UFC values and on day 8, only 1 patient, with the ectopic ACTH syndrome, had persistent hypercortisolism. The cortisol decrease was associated with an increase in desoxycorticosterone values (p less than 0.01) and a decrease in dehydroepiandrosterone sulfate (p less than 0.001), delta 4 androstenedione (p less than 0.05) and testosterone (p less than 0.05). No significant variations were observed in ACTH, 11 desoxycortisol, aldosterone, plasma renin activity, corticosteroid-binding globulin and sex hormone-binding globulin. Side effects were few: mild clinical adrenal insufficiency (n = 5), oedema (n = 3) and reversible hepatic toxicity (n = 1). We conclude that Ketoconazole is an effective inhibitor of cortisol and androgens synthesis. It is well tolerated, rapidly effective and its efficacy persists unchanged for at least one month in all forms of Cushing's syndromes. For these reasons Ketoconazole may be a valuable drug for preoperative treatment of Cushing's syndrome. PMID- 2699788 TI - [Effect of sodium depletion on the renin-angiotensin-aldosterone system and prostaglandins in patients with insulin-dependent diabetes mellitus]. AB - The effects of 5 days sodium-free diet associated with furosemide administration were studied in 12 diabetic patients with insulin-dependent diabetes mellitus and 12 healthy control subjects. Plasma renin activity was significantly lower in diabetics compared with that of normal subjects. Plasma aldosterone was similar in both groups. Urinary excretion of prostaglandin E2 was significantly lower in diabetics before and after sodium depletion in comparison with normal subjects. Urinary excretion of 6-keto prostaglandin F1 alpha and thromboxane B2 was similar in both groups. It is concluded that the lower excretion of prostaglandin E2 in diabetics is related to the decreased activity of renin-angiotensin system. Decreased production of prostaglandin E2 may contribute to the development of arterial hypertension in the diabetes mellitus. PMID- 2699789 TI - [Historical and current concept of benign intracranial hypertension]. AB - The concepts of serous meningitis, pseudotumour cerebri, hypertensive meningeal state and otitic hydrocephalus have not been considered historically as synonyms nor can they be superimposed on what is currently known as Benign Intracranial Hypertension (BIH). BIH is a syndrome of intracranial hypertension with no clinical, radiological or analytical evidence for the existence of focal or general neurological lesions or hydrocephalus, and which has a self-limiting "benign" development. At present, the diagnostic criteria usually accepted are: 1. Symptoms and signs of intracranial hypertension. 2. Absence of focal neurological symptoms and signs. 3. Absence of radiologically verified cerebral lesion. 4. C.S.F. of normal composition and high pressure. The requirement of other criteria for the diagnosis of BIH, such as angiography, to eliminate the possibility of thrombosis of venous sinuses, or continuous monitoring of C.S.F. pressure, is controversial. PMID- 2699790 TI - Role of Ca2(+)-calmodulin and protein kinase C in the secretory action of heat labile enterotoxin of Escherichia coli in mice. AB - The mucosal-to-serosal and serosal-to-mucosal fluxes of Na+ and Cl- were carried out in control and heat-labile enterotoxin treated mice in the presence or absence of Ca2(+)-ionophore A23187, the activator of Ca2(+)-calmodulin or Phorbol 12-myristate-13-acetate (PMA), the activator of Protein kinase C (PKC) or 1-(5 isoquinolinyl sulphonyl)-2-methyl piperazine (H-7), an inhibitor of PKC. There was net secretion of Na+ and Cl- in experimental group in comparison to net absorption in control group. The addition of ionophore or PMA resulted in net secretion of Na+ and Cl- in control group. In experimental group ionophore increased the net secretion of Na+ and Cl- while, PMA could not cause any change in Na+ and Cl- fluxes in experimental group. Calmodulin activity remained unaltered in heat-labile enterotoxin treated mice as compared to control. H-7, reversed the effects of PMA and heat-labile enterotoxin. These studies demonstrate that heat-labile enterotoxin primarily involves PKC in its action. PMID- 2699791 TI - Relationship between fluidity and L-alanine transport in a fatty acid auxotroph of Saccharomyces cerevisiae. AB - The influence of the physical state of membrane on L-alanine uptake has been investigated in Saccharomyces cerevisiae KD115, an unsaturated fatty acid auxotrophic mutant. By monitoring the unsaturation index and steady state fluorescence polarization of 1,6 diphenyl hexatriene (DPH), it was observed that at mid log phase the membrane fluidity increased with an increase in the number of double bonds of supplemented fatty acid. Arrhenius plots of the velocities for L-alanine transport in cells grown on palmitoleate, oleate, linoleate and linolenate were biphasic and dependent on supplemented unsaturated fatty acid. Results illustrate a correlation between membrane fluidity and shift in transition points. Further, results confirm the role of fatty acyl milieu in regulation of transport activity of S. cerevisiae. PMID- 2699792 TI - Studies on the accessibility of nascent non-helical peptide chains on the ribosome. AB - The accessibility of nascent polypeptides with special structural elements to the ribosome was investigated. Poly(C), poly(C, U) and poly(C, A) mRNAs were translated by E. coli ribosomes in vitro. The resulting peptides which were rich in prolines, remained on the ribosomal particles or were released after addition of puromycin. A protease from Aspergillus oryzae hydrolyzed the released peptides rapidly, whereas the degradation of the unreleased ones was only slightly affected. This result shows that the nascent peptides were protected against proteolytic attack by the ribosomal particles. Interestingly, the protease completely degraded the 30S particles whereas the 50S ones remained intact, even after prolonged incubation. PMID- 2699793 TI - Inhibition of glycolysis induced by diethylstilbestrol in anaerobically grown yeast. AB - In anaerobically grown yeast cells which lack functional mitochondria, the presence of diethylstilbestrol (DES) depressed glycolysis. The addition of the inhibitor markedly increased the cellular concentration of glycolytic intermediates which are formed prior to the pyruvate kinase step as well as to bring about an increase in the [ATP]/[ADP] ratio. Under these conditions an 18 fold decrease in the mass action ratio for pyruvate kinase [( pyruvate] [ATP]/[phosphoenolpyruvate] [ADP]) was noted, however, there was little if any effect on the other glycolytic enzymes. These results suggest that the depression of anaerobic glycolysis caused by DES results from a blockage at the level of the regulatory enzyme pyruvate kinase through a modification of its intracellular environment. PMID- 2699794 TI - High-molecular-mass proteases (possible proteasomes) in Escherichia coli K12. AB - Two high-molecular-mass proteases have been detected in E.coli K12 and isolated from the periplasmic fraction released by osmotic shock. The two proteases, designated Protease peri7 and Protease peri8, have similar molecular masses (greater than 2000 kDa) and degrade alpha- and beta-casein, but not insulin B chain. Protease peri7 is a metalloprotease activated 3-6 fold by ATP, dATP and GTP but inhibited by AMP. Nucleotide hydrolysis occurs during protein breakdown. Protease peri8, in contrast, is a serine protease unaffected by nucleotides or metal chelators. The two proteases appear by electron microscopy to be ring shaped particles of approximately 125 A degrees in diameter. These proteases appear to be very similar to the multi-protease complexes (Proteasomes) detected in a variety of eukaryotic cells. PMID- 2699795 TI - [Pharmacokinetics: yesterday, today, tomorrow]. PMID- 2699796 TI - Induction and early amphibian development. PMID- 2699797 TI - Cell lineage and lineage markers. PMID- 2699798 TI - Muscle cell differentiation. PMID- 2699799 TI - Terminal differentiation of epidermal keratinocytes. PMID- 2699800 TI - Adipocyte differentiation and gene expression. PMID- 2699801 TI - Gene regulation through messenger RNA stability. PMID- 2699802 TI - Translational control: the ferritin story. PMID- 2699803 TI - Regulatory mechanisms in translational control. PMID- 2699804 TI - Protein carboxyl methylation in eukaryotes. PMID- 2699806 TI - Bibliography of the current world literature. Cell differentiation. PMID- 2699805 TI - Signal peptidases in protein biosynthesis and intracellular transport. PMID- 2699807 TI - Bibliography of the current world literature. Post-transcriptional processes. PMID- 2699808 TI - Etienne-Louis Arthur Fallot and his tetralogy: a new translation of Fallot's summary and a modern reassessment of this anomaly. AB - As this translation of Fallot's conclusions makes clear, he emphasized the clinical diagnostic usefulness of his findings because of the high frequency of this malformation in cyanotic congenital heart disease. Terming this anomaly "tetralogy," he clearly and simply delineated its four cardinal features. He stated that cyanosis was not due to a patent foramen ovale. He attributed the morphogenesis of the tetralogy to an intrauterine pathologic process at the level of the pulmonary valve leaflets and the subpulmonary infundibulum. The tetralogy and Fallot's contribution are reassessed in the light of present understanding. PMID- 2699809 TI - Early surgical results in the treatment of endomyocardial fibrosis. A Brazilian cooperative study. AB - This report summarizes the surgical experience and early results obtained at four surgical centers in the northeast and south of Brazil. From December 1977 to September 1986, 95 operations were performed on 93 patients, ages 11-59. Bilateral lesions occurred in 42 patients, right lesions in 39, and left lesions in 12. Ventricular decortication and removal of thrombi were performed in all. In right-sided lesions, the tricuspid valve was substituted by a bioprosthesis in 34 cases, and substituted by a tilting disk valve in 1 case. In 4 patients, the valve could be preserved. The left-sided lesions led to valve substition by a bioprosthesis in 11 cases, and preservation of the valve in 1. The bilateral lesions needed bioprosthesis in the mitral position in 37 patients, and a disk valve in 2. In these 39 instances, the valvular procedure was insertion of a tricuspid bioprosthesis. Three tricuspid and three mitral plasties were performed. The overall mortality was 20% (26.2% for bilateral lesions, 14.6% for the right-sided lesions, and 20% for the left-sided lesions). The main cause of death was low cardiac output. Aside from a variable degree of right and left ventricular failure, many other non-fatal complications clouded the postoperative course. Complete AV blocks occurred in 10 cases, with the need for permanent pacing in 7 survivors. The mortality and morbidity in the present series is in keeping with the results reported in current literature. Regarding the advanced stage of their patients' disease, the authors agree with the recommendation for earlier surgical intervention. PMID- 2699810 TI - Acquired coarctation due to calcified thrombus in atherosclerosis of the descending thoracic aorta. Two cases and a review. AB - An extremely rare manifestation of atherosclerosis is described. Two women, aged 57 and 55, presented with upper extremity hypertension and diminished femoral pulses. Plain radiography and total angiographic visualization of the aorta demonstrated focal highly obstructing intraluminal masses containing heavy flocculent calcification in the upper descending thoracic (case 1) and the thoracoabdominal aorta (case 2) producing a significant pressure gradient. The acquired coarctation due to calcified thrombus was relieved by resection and graft replacement in one and placement of a thoracoabdominal bypass graft in the second patient. PMID- 2699811 TI - Diagnosis and management of the coronary-subclavian steal syndrome. AB - A patient is presented with recurrent angina due to a coronary-subclavian steal syndrome 3 years after left internal mammary to left anterior descending coronary artery bypass grafting. Myocardial ischaemia could easily be provoked by selective exercise of the left upper limb. Coronary angiography showed reversal of flow in the left internal mammary artery. Suggestions are given for prevention of the coronary-subclavian steal syndrome by identification of patients who are at risk of developing subclavian artery occlusive disease. Performance of coronary and brachiocephalic angiography is indicated in recurrence of angina in patients with internal mammary artery bypass grafts. Doppler spectral analysis may be a valuable technique for detection of a haemodynamically significant stenosis of the left subclavian artery. Carotid-subclavian bypass grafting is the procedure of choice for management of the coronary-subclavian steal syndrome. PMID- 2699812 TI - Early clinical evaluation of Tenure and Scotchbond 2 for conservative restoration of cervical erosion lesions. PMID- 2699813 TI - The use of an argon laser for polymerization of composite resin. PMID- 2699814 TI - Dentin bonding systems: the latest generation. PMID- 2699815 TI - The resin inlay bridge. PMID- 2699816 TI - Resin adhesive systems: in vitro evaluation of dentin bond strength and marginal microleakage. PMID- 2699817 TI - In vitro evaluation of fluoride and non-fluoride releasing orthodontic adhesives on bracket bond strength. PMID- 2699818 TI - Esthetics and practice development. Dentin bonding in esthetic practice building. PMID- 2699819 TI - Establishing cuspid-guided occlusion with bonded porcelain. PMID- 2699820 TI - Castable ceramic veneers. PMID- 2699821 TI - Conservative restoration of the fractured incisor crown. PMID- 2699822 TI - Ultrastructural aspects of the final stage of hemoglobin biosynthesis. AB - 1. Electron microscopic observations on rabbit embryo, adult rabbit, guinea pig, and human immature erythroid cells showed characteristic hemoglobinized organelles distinguishable from mitochondria by their highly dense matrix, two or three longitudinally arranged double lamellae, and smaller diameters. 2. The presence of hemoglobin (Hb) within these organelles was also demonstrated by electrophoresis of the concentrated supernatant from the isolated, washed and osmotically lysed organelle fraction. The term hemosome has been suggested for these organelles because of their Hb content. We propose that they are the sites of heme integration into the four polypeptide globin chains. 3. The frequency of hemosomes is higher in the peripheral blood erythroid cells of embryos than in the liver erythroid cells, coinciding with the higher Hb synthesis rate in peripheral blood than in the liver. 4. Peripheral blood reticulocytes of rabbits with anemia induced by bleeding presented a lower hemosome frequency than normal reticulocytes. The decrease paralleled the decay of Hb biosynthesis activity. Moreover, Hb biosynthesis induced in HeLa cell and epithelial cell tissue cultures was always associated with the formation of hemosomes. 5. Hemosomegenesis was studied in epithelial tissue culture cells experimentally induced to synthesize Hb, allowing the identification of several stages of hemosome formation in erythroid cells. The morphological data suggest that mitochondria are successively modified to lamellated bodies, prehemosomal vesicles, prohemosomes and hemosomes. These organelles have also been detected in erythroid cells of representative specimens from other vertebrate classes. PMID- 2699823 TI - A simple simulated public speaking test for evaluating anxiolytic drugs. AB - 1. We evaluated the feasibility of using a simulated public speaking (SPS) test to assess the activity of anxiolytic drugs. SPS was achieved by requesting subjects to present a speech to an audiocassette recorder. Thirty volunteers were randomly assigned to one of three groups treated with 10 mg diazepam, 10 mg buspirone or placebo, under double-blind conditions. One h after drug administration, subjective states were measured by the Visual Analogue Mood Scale (VAMS), the State-Trait Anxiety Inventory (STAI) and by a Bodily Symptoms Scale (BSS). Heart rate and blood pressure were also recorded. 2. SPS induced both physiological and subjective changes characteristic of anxiety. Moreover, diazepam attenuated experimentally induced increases in excitement (as measured by VAMS) and agitation (as measured by BSS). Therefore, SPS using an audiocassette recorder is sensitive to a prototypical anxiolytic and may thus be a useful test for evaluating putative anxiolytics. 3. No effect was observed with the new anxiolytic drug buspirone. However, the present negative result may be explained by clinical data indicating that patients may experience a longer lag period before the onset of the anxiolytic effect of buspirone. PMID- 2699824 TI - [Comparison of blood sugar and insulin reactions of obese and non-obese patients with NIDDM]. PMID- 2699825 TI - [Cytologic examination of colonic hypertrophic lesions using ultrasound-guided fine-needle aspiration]. PMID- 2699826 TI - ["Endo-prosthetic" preparation of curved roots]. AB - During the tooth preparation for root posts, all must be attempted to avoid weakening of the root. This "must" is rather easy for straight roots, but the same is not true of curved roots. The authors have used the method described by BRAMANTE et al. to study the effects of various techniques of instrumental sequences of endodontic preparation, and of two instrumental sequences of root post preparation. From this studies, it results that: --the respect of the canal path during the endodontic phase conditions the respect of the internal wall of the curvature, during drilling. --among the four endodontic techniques studied: MM 3000, Step-Back, Anti Curvature Filling and Canal Finder System, the last two seem to allow more respect of the canal path. --the instrumental sequence using Largo drills to prepare a canal, presents two types of drawbacks: * Excessive abrasion of the convex (internal) wall of the canal system. It seems that the blunt point rests against the concave portion of the canal and pushes the drill toward the internal wall, therefore weakening it. * Inadequate match between the size of the drill and that of the prepared canal. --the Parapost drills, on the contrary, respect the endodontic path, and may even be used beyond the curvature (2 mm). Besides, the diameter of the prepared canal is similar to that of the instrument used. These two factors permit to obtain a better retention of the post as well as a lesser weakening of the root. PMID- 2699827 TI - [The new magnets for dental prostheses]. AB - With the introduction of metallic alloys based on rare earth, the dental prothesis disposes of new magnets as a method of denture retention whose retentive force is 20 to 50 time superior to the conventional magnets. There are two main types of magnets: the open field magnets as the Dyna and the closed field magnets as the Gillings and the Jackson. The latters have been devised to avoid propagation of the magnetic field in the living tissues, the harmlessness of this propagation being argued by the researchers. The magnets present several advantages tied to the conservation of the roots as the maintenance of the proprioception, the conservation of the socket bone, the strengthening of the remaining teeth and the psychological comfort for the patient, others tied to the technique itself as the simplicity of realization, the easiness of insertion and removal of the prothesis and the absence of wear. As far as terminology is concerned, we consider a magnet as a magnetic axial attachment. PMID- 2699828 TI - [Acrylic materials for denture bases in dentistry. Study of measurement variations and the influence of three new parameters on construction of bases and their deformation]. AB - A further study of the variance of deviation measurements of denture bases in the palate region shows that the variability of measurements is not essentially due to measuring, but also to the variability of denture processing. No more than the other previously studied parameters, the heating and cooling rates as well as the mode of insertion of resin in the cast have no effect on the dimensional accuracy of denture bases after curing. PMID- 2699829 TI - [Determination of the vertical dimension of occlusion]. AB - It is generally accepted that some anatomical sites, facial as well as oral, remain stable throughout the life of a human being. In this study, a population of 191 dentulous subjects without clinical symptoms and a mean of 21 years and 4 months, was selected. The first part attempts, from facial landmarks, stable with time, to establish statistics that could provide norms for subjects without teeth and aid clinicians in evaluating the Vertical Dimension, in the treatment of edentalous patients. Mac GEE conducted a similar study without, however, any detail concerning the number and the age group of the sample population. Our conclusions do not contradict the study of this author and give additional details, namely: -14% of the population studied presents the following identical distances: . interpupillary distance, . distance: nasal spine/submental region (in maximum intercuspation), . distance: glabella/nasal spine, . distance: bipupillary line/stomion. -69% of the population studied presents three measurements out of four, which are identical. PMID- 2699830 TI - Structure of a neutral polymer isolated from the lipopolysaccharide of the reference strain for Serratia marcescens serogroup O18. AB - A neutral polymer (the putative O antigen) has been isolated from the lipopolysaccharide of the reference strain for Serratia marcescens serogroup 018. From the results of spectroscopic and degradative studies, the repeating unit of the polymer was identified as a linear tetrasaccharide having the structure shown. ----2)-alpha-L-Rhap-(1----2)-alpha-L-Rhap-(1----6)-alpha-D- GlcpNAc-(1---- PMID- 2699831 TI - Structure of the O-specific galactan from the lipopolysaccharide of the reference strain for Serratia marcescens serogroup O24. AB - The putative O-specific polysaccharide for Serratia marcescens serogroup O24 is a galactan with a branched, trisaccharide repeating-unit of the structure shown. The structure of the backbone is identical to that of the linear galactans isolated from the reference strains for S. marcescens serogroups O16 and O20, presumably accounting for the serological cross-reactions observed. (Formula: see text) PMID- 2699832 TI - Vasoactive intestinal polypeptide (VIP) as a cholinergic co-transmitter: some recent results. AB - The neuropeptide vasoactive intestinal polypeptide (VIP) copurifies with mammalian brain cholinergic synaptosomes when these are separated from the total brain synaptosome fraction by an immunoadsorption procedure based on an antiserum to a cholinergic-specific antigen. VIP must therefore be reckoned to be a cholinergic co-transmitter in brain. In electromotor and myenteric neurones the two transmitters are differently packaged. The frequency-dependence and pharmacology of release show that the intracellular dynamics of the storage and release processes are quite different for the two neurotransmitters. However in the ileum a portion of the vesicle-bound acetylcholine is recovered in the VIP storing particles and this might indicate a precursor-product relationship for the two types of vesicle in this system analogous to that which has been proposed for electron-dense and electron-translucent vesicles in noradrenergic nerves. PMID- 2699833 TI - Acetylcholine compartments in skeletal muscle. AB - I studied acetylcholine compartments in skeletal muscle with the aim to find their anatomical origin, and, in addition, their correlation with functional compartments, i.e. the pools in which synthesis, storage and release take place. PMID- 2699834 TI - Presynaptic regulation of acetylcholine release in the CNS. AB - The release of ACh appears to be under the control of autoreceptors localized on cholinergic nerve terminals. Moreover, the process can be regulated by transmitters other than ACh or by modulators either through receptor-mediated or carrier-mediated mechanisms. In this chapter we report on our recent results concerning the regulation of the release of ACh by ACh itself, 5-HT and GABA in the rat hippocampus. In particular it will be shown: 1) that the release of the cholinergic transmitter can be inhibited through muscarinic receptors of the M3 subtype; 2) that 5-HT can interact with ACh by depressing ACh release through the activation of receptors of the 5-HT1B subtype; 3) that the release of ACh can be enhanced by GABA by a novel mechanism involving a selective penetration of the amino acid into the cholinergic terminals. PMID- 2699835 TI - Sodium-activated potassium channel in avian sensory neurons. PMID- 2699836 TI - Secretory organelles of neurons and their relationship to organelles of other cells. PMID- 2699837 TI - The synaptic vesicle membrane: origin, axonal distribution, protein components, exocytosis and recycling. AB - The paper discusses functional and molecular aspects of the synaptic vesicle membrane during its life cycle. The distribution of the synaptic vesicle membrane compartment in an entire cholinergic neuron is monitored using colloidal gold labelling and a monoclonal antibody against the synaptic vesicle membrane protein SV2. This provides new insights concerning vesicle origin and fate in the various compartments of the neuron. A new synaptic vesicle membrane protein (svp25) of Mr 25,000 with properties similar to synaptophysin as well as a synaptic vesicle binding phosphoprotein of the presynaptic membrane (Mr 92,000) likely to be involved in vesicle exocytosis are described. The membrane compartment recycled on induced transmitter release contains synaptic vesicle but not plasma membrane markers and encloses both newly synthesized transmitter and a sample of extracellular medium. PMID- 2699838 TI - [New findings on drugs derived from plants. 4]. PMID- 2699839 TI - [Nocturnal asthma]. PMID- 2699840 TI - [Pathological study of 936 cases of smooth muscle tumor in the alimentary tract]. AB - 936 cases of smooth muscle tumor were analysed, including 198 cases in esophagus, 354 in stomach, 243 in small intestine, and 141 in the large bowel. Pathological diagnosis revealed, that there were 468 cases of either leiomyoma or leiomyosarcoma, and the leiomyosarcoma cases had been further divided into three grades. The follow-up data of 191 leiomyomas showed that except 15 patients who died of irrelevant reasons, all the rest survived. Of 252 leiomyosarcoma patients, 138 are still alive and 114 died. The survival rate was 36.1% for 5 years and 30.1% for 10 years. Factors having an effect on the prognosis include sites, sizes, grades of the tumor and the number of mitotic figure in leiomyosarcoma. The authors suggest that mitotic figures (greater than or equal to 2/25HPF); cell anaplasia; density of tumor cell; tumor size (greater than 6cm); presence of necrosis and cystic change and infiltration of tumor cells into the neighbouring tissue may be considered as the criteria for the diagnosis of malignant smooth muscle tumors of the alimentary tract. PMID- 2699841 TI - [Ultrastructure and immunologic pathology of membranous glomerulonephritis of 91 cases]. AB - 91 cases of membranous glomerulonephritis were investigated with light, electron and immunofluorescence microscopy. The findings indicated that 12 of 91 renal biopsies in membranous glomerulonephritis showed mesangial cell proliferation in various extent. The mesangial cell proliferation, segmental sclerosis and glomerular capillary adhesion to Bowmen's capsule were related to the stages and evolution of membranous glomerulonephritis. Granular immunofluorescence staining for IgG was a consistent finding, but the positive rate of C3 was lower than that of IgG. The relationship of immunofluorescence between different stages of membranous glomerulonephritis was not significant. In some cases, the subepithelial deposits were partially resorbed in stage 2 or stage 3, suggesting that early stage membranous glomerulonephritis could recover or turn to a favorable condition. PMID- 2699842 TI - [Quantitative analysis of DNA content and its application in tumor pathology]. PMID- 2699843 TI - [Single-stage excision anastomosis of left colonic obstruction excision treated as an emergency]. AB - The results of four different types of operation were compared retrospectively in terms of mortality, morbidity, duration of hospital stay. Eighty-eight consecutive patients suffering from left colonic obstruction underwent emergency surgery from December 1976 to January 1988. There were 36 male and 52 female patients, aged from 41 to 93 years (mean 71), 25% of them being 78 or older. Carcinoma was the most frequent lesion (75/88, 85%). 1) One-stage resection and anastomosis was carried out in 23 patients with only one temporary ileostomy; there were two fatalities (8.7%) and one clinical anastomotic leak (4%) treated conservatively with success; mean hospital stay was 21.5 days. 2) Thirty-six patients underwent a Hartmann procedure, with four fatalities (11%) and a mean hospital stay of 23.0 days; 17 of the surviving 32 (53%) later had the second stage procedure, with no fatality, one clinical leak (6%), and mean stay of 20.7 days. 3) Twenty-six patients had simple decompressing colostomies with nine fatalities (35%); eight of the surviving 17 (47%) had colectomy and colostomy closure during the same hospitalization, with one fatality (6%); mean hospital stay was 41.4 days. 4) Finally, subtotal colectomy imposed by caecal ischemia (twice) or a previous right colectomy (in one instance) was performed three times with no death. Since january 1986, resections and primary anastomoses have been performed 20 times for 26 consecutive obstructions (77%). Our overall results in terms of mortality, morbidity and duration of hospital stay appear to favor resection and primary anastomosis in the treatment of selected cases of left colonic obstruction. PMID- 2699844 TI - [Virus-induced subacute spongiform encephalopathy (Creutzfeldt-Jakob disease): a report of 10 cases with clinico-pathologic study]. AB - This article is a report of clinico-pathological study of 10 cases, including 6 cases from Western Australia and 4 cases from Beijing and Qingdao of China. In all the 10 patients there were typical clinical features. Prodromal duration varied from 1.5 to 3 months and the dementia duration from 1 to 9.5 months. The clinical manifestations consisted of rapidly progressive dementia, myoclonic jerks. Pyramidal, extrapyramidal tract signs and cerebellar signs and periodic EEG findings. Neuropathological changes of this disease were spongiform changes, neuronal degeneration and loss of the ganglia cells and hypertrophy and hyperplasia of astrocytes. 2 of the 10 patients had brain biopsy and the other 8 had autopsy. Typical membrane bound vacuoles were shown under electron microscope. The frontal temporal and occipital lobes were more seriously affected than the parietal lobe and particularly the pre and postcentral gyri. The small and medial size ganglion cells were more seriously involved than large neuronal cells. Pyramidal cells were only mildly. In cases with a short duration, (less than 5 mouths), the spongiform changes were marked, but in those with a longer duration more than 6 months, they were mild. Neuronal loss and hypertrophy and hyperplasia of the astrocytes were mild in cases with short duration but were marked in those with longer duration. The clinical diagnosis, EEG findings, neuropathological features etiology and prognosis of this disease are discussed. PMID- 2699845 TI - [Stereotaxic surgery in mental disorders]. PMID- 2699846 TI - [Experimental study of hemodynamic changes following obliteration of the vertebral artery and surgical treatment]. AB - This experiment on dogs was to compare the hemodynamic changes following ligation of the carotid artery on one side and the first segment of vertebral artery on both sides, with that after restoration of the cut-off circulation through anastomosing the previously ligated carotid and vertebral arteries. The hemodynamic changes after obliteration and following restoration of circulation, both in vessels and cerebellum, were monitored by ways of regional clearance of hydrogen, Doppler velocimetory of blood flow, angiography of vertebral artery and blood gas analysis. The difference of results in each paired sample was statistically very significant. These models worked with success in 20 out of 24 dogs, a rate of 83%. Following re-establishment of circulation by means of vascular anastomosis, blood flow and blood supply to the ischemic cerebellum increased to normal or nearly normal. It suggests that this kind of surgical procedure may be of value in clinical treatment. PMID- 2699847 TI - [Treatment of intervertebral disk displacement with colchicine]. PMID- 2699848 TI - [Recent advances in cardiology and angiology in China]. PMID- 2699849 TI - Transfer of persistent chemicals in milk. PMID- 2699850 TI - Do humoral factors mediate cancer chemotherapy-induced emesis? PMID- 2699851 TI - Computer-assisted development of modified-release dosage forms. PMID- 2699852 TI - The molecular basis of positional signalling: introduction. PMID- 2699853 TI - Steroid hormone receptor homologs in development. AB - The steroid/thyroid receptor superfamily are ligand-dependent transcription factors which consist of distinct functional domains required for transcriptional control of a network of genes. Members of this superfamily are beginning to be studied for their contribution to embryogenesis. Two human receptors for the vertebrate morphogen retinoic acid have been isolated and further characterized on model promoters. Moreover, the presence of homologs of these receptors in Drosophila reveals that members of this superfamily predate the divergence of the vertebrates and invertebrates. One locus is knirps-related (knrl), whose product is closely related to that of the gap segmentation gene knirps (kni). knrl is one of the most diverged steroid receptor-like molecules and displays a spatially restricted blastoderm pattern. PMID- 2699854 TI - Models for positional signalling with application to the dorsoventral patterning of insects and segregation into different cell types. AB - Models of pattern formation and possible molecular realizations are discussed and compared with recent experimental observations. In application to the dorsoventral patterning of insects, it is shown that a superposition of two pattern-forming reactions is required. The first system generates the overall dorsoventral polarity of the oocyte, the second generates the positional information proper with a stripe-like region of high concentration along the ventral side of the embryo. A single reaction would be insufficient since the two reactions require different parameters. The model accounts for the orientation of the DV axes of the oocytes in the ovary of Musca domestica and Sarcophaga, independent of the DV axis of the mother, for the formation of several ventral furrows in the absence of the primary gurken/torpedo system in Drosophila, as well as for the good size regulation of the dorsoventral axis as observed in some insect species. Segregation of a homogeneous cell population into different cell types requires autocatalytic processes that saturate at relatively low concentrations and nondiffusible substances responsible for the autocatalytic feed-back loops. Thus, these loops can be realized directly on the gene level via their gene products, for instance, by the mutual repression of two genes. A balance of the two cell types is achieved by a long-ranging substance interfering with the self-enhancing process. This substance is expected to have a more or less homogeneous distribution. This model accounts for the reestablishment of the correct proportion after an experimental interference and the change of determination after transplantation. Applications to the segregation of pre-stalk and prespore cells in Dictyostelium and of neuroblast cells from the ventral ectoderm in Drosophila are provided. PMID- 2699855 TI - Positional information revisited. AB - Positional information has been suggested to play a central role in pattern formation during development. The strong version of positional information states that there is a cell parameter, positional value, which is related to position as in a coordinate system and which determines cell differentiation. A weaker version merely emphasises position as a key determinant in cell development and differentiation. There is evidence for boundaries and orthogonal axes playing an important role in positional systems. A positional signal is distinguished from an inductive interaction because the former specifies multiple states, confers polarity, and can act over a long range. A gradient in a diffusible morphogen is just one way of specifying position. There is now good evidence in several systems for substances which may be the morphogen for positional signalling. The product of the bicoid gene in early Drosophila development is the best prospect. Retinoic acid is unique in its ability to alter positional value and may also be a morphogen. The best evidence for positional value, a concept fundamental to positional information, remains a biological assay based on grafting. The idea of positional value uncouples differentiation and position, and allows considerable freedom for patterning. It is not clear whether positional value or differentiation involves a combinatorial mechanism. Interpretation of positional information remains a central problem. There is good evidence that cells can respond differentially to less than a two-fold change in concentration of a chemical signal. It may be that interpretation involves listing the sites at which a particular class of cell differentiation will occur. The problem is made less severe when blocks of cells are specified together as in mechanisms based on an isomorphic prepattern. Isomorphic prepatterns could establish repeated structures which are equivalent and which are then made non-equivalent by positional information. This would enable local differences to develop. The combination of these two mechanisms may be wide-spread. There is evidence that positional signals within a single animal and in related animals are conserved. It is not clear just how wide this conservation is, but it is at phylotypic stages, rather than in eggs, that similarity might be expected. It is nevertheless impressive that the polar coordinate model can be applied to regulation in systems as diverse as insects, vertebrates and protozoa. The molecular basis of positional signalling is just becoming accessible; the molecular basis of positional value is still awaited. A brief personal history of positional information is provided in an appendix. PMID- 2699857 TI - Genetics of intercellular signalling in C. elegans. AB - Cell-cell interactions play a significant role in controlling cell fate during development of the nematode Caenorhabditis elegans. It has been found that two genes, glp-1 and lin-12, are required for many of these decisions. glp-1 is required for induction of mitotic proliferation in the germline by the somatic distal tip cell and for induction of the anterior pharynx early in embryogenesis. lin-12 is required for the interactions between cells of equivalent developmental potential, which allow them to take on different fates. Comparison of these two genes on a molecular level indicates that they are similar in sequence and organization, suggesting that the mechanisms of these two different sets of cell cell interactions are similar. PMID- 2699856 TI - Cortical rotation of the Xenopus egg: consequences for the anteroposterior pattern of embryonic dorsal development. AB - We first review cortical-cytoplasmic rotation, a microtubule-mediated process by which the Xenopus egg, like other amphibian eggs, transforms its polarized cylindrical symmetry into bilateral symmetry within the first cell cycle after fertilization. This transformation, the earliest of many steps leading to dorsal development, involves the displacement of the egg's cortex relative to its cytoplasmic core by 30 degrees in an animal-vegetal direction. As rotation is progressively reduced by microtubule-depolymerizing agents, embryos develop with body axes progressively deleted for dorsal structures at the anterior end. With no rotation, ventralized embryos are formed. In an effort to comprehend this progressive effect on embryonic organization, we go on to review subsequent developmental process depending on rotation, and we propose, with evidence, that reduced rotation leads to a reduced number of vegetal dorsalizing cells, which induce during the blastula stage a Spemann organizer region of smaller than normal size. The reduced organizer then promotes a reduced amount of cell rearrangement (morphogenesis) at gastrulation. Reduced morphogenesis seems the proximate cause of the incompleteness of axial pattern, as shown further by the fact that embryos that are normal until the gastrula stage, if exposed to inhibitors of morphogenesis, develop body axes that are progressively less complete in their anterior dorsal organization the earlier their gastrulation had been blocked. We discuss why axial pattern might depend systematically on morphogenesis. PMID- 2699858 TI - Short-range positional signals in the developing Drosophila eye. AB - Positional signals provided by immediate neighbours appear to direct developmental decisions in the eye of Drosophila. By a combined genetic and molecular approach the biochemical bases of the signal and reception mechanisms are being systematically dissected. Three key gene products have now been identified. sevenless is a transmembrane tyrosine kinase probably transducing positional signals that direct the R7 cell to its fate. The bride of sevenless gene product is on the signalling side of the mechanism and is required in R8 for R7 to develop. The type of protein bride of sevenless encodes is not yet known. The rough gene encodes a transcription factor on the signalling side required in R2 and R5 for positional signals to be transmitted to neighbouring cells. PMID- 2699859 TI - The decapentaplegic gene: a TGF-beta homologue controlling pattern formation in Drosophila. AB - The type beta transforming growth factor (TGF-beta) family of secreted factors encompasses a wide range of structurally related proteins that control the state of determination or differentiation in a wide variety of cell types. For all members of the family that have been studied at the protein level, the active moieties arise as dimers of the C-terminal approximately 110 amino acid fragment derived from much longer precursor polypeptides. The hallmark of the family is a series of 7 completely conserved cysteine residues in the C-terminus; other conserved amino acid sequences generally cluster in the vicinity of 6 of these 7 cysteines. This report focuses on our current understanding of the genetic structure and developmental role of the decapentaplegic (dpp) gene in Drosophila, the only member of the TGF-beta family thus far identified in invertebrates. The dpp polypeptide bears a sufficiently close relationship to two bone morphogenesis proteins (BMP-2A and BMP-2B) identified in mammals (Wozney et al. 1988, Science 242, 1528-1534) to warrant the suggestion that dpp and the BMP-2s are the descendants of a common ancestral gene. The protein-coding information for dpp is contained within a 6 kb DNA segment. An elaborate cis-regulatory apparatus, encompassing a greater than 55 kb DNA segment, has evolved to control expression of the dpp gene, which is required for determination of dorsal ectoderm in the early embryo, for normal distal outgrowth of the adult appendages, and for sundry other developmental events, which are currently less well-defined. Studies of chimeric individuals and observations of transcript accumulation in situ have demonstrated that the dpp gene is expressed along the A/P boundary of the imaginal disks. A possible role of dpp in elaborating positional information in imaginal disk development is discussed. PMID- 2699860 TI - Morphogen hunting in Dictyostelium. AB - A highly regulative pattern of prestalk and prespore tissue is formed during Dictyostelium development, starting from separate amoebae. Potential morphogens controlling this process have been hunted biochemically, using bioassays to monitor activity. All those discovered to date are low MW diffusible compounds: cAMP, adenosine, NH3 and DIFs 1-3. The DIFs are assayed by their ability to induce isolated amoebae to differentiate into stalk cells and have been identified as a family of chlorinated phenyl alkanones. The diversification of amoebae into prestalk and prespore cells seems to be brought about by cAMP and DIF-1. cAMP is necessary for both pathways of differentiation but DIF-1 specifically induces the differentiation of prestalk cells while suppressing that of prespores. When DIF-1 is added to intact slugs, it causes a substantial enlargement of the prestalk tissue at physiological concentrations in the time previously shown to be required for pattern regulation. DIF-1 is a dynamic molecule and we have found that it is metabolized along a pathway involving at least 8 compounds. Metabolism is developmentally regulated and may be important in producing DIF gradients or other effector molecules from DIF. Although we almost certainly have some of the central actors, it is difficult to formulate a satisfactory theory of pattern formation in Dictyostelium at the moment. We suspect that at least one important actor is missing. PMID- 2699862 TI - The influence of religion on scientific research: Galileo and the inquisition. PMID- 2699861 TI - Role of the neuropeptide head activator for growth and development in hydra and mammals. AB - In hydra, HA is produced by nerve cells and released into the intercellular space bound to large-molecular-weight carrier(s). By additional interaction with extracellular matrix components and selfinactivation by dimerisation, a local action is ensured. HA acts as a mitogen on all dividing cell types in hydra forcing them to pass through G2, divide, and either start a new round of cell division or terminally differentiate. In addition, HA is required for head specific determination and differentiation processes. To become a head-specific nerve cell, for example, an interstitial stem cell requires HA in early S-phase to become determined to the nerve cell pathway, in late G2 to progress through mitosis, and/or in G1 to differentiate to a head-, and not to a foot-, specific nerve cell. HA (with identical amino acid sequence) occurs in other animals including mammals. In mammals, it is produced by nerve or endocrine cells and it probably acts, as in hydra, on nerve-precursor cells. On the neural cell line NH15-CA2 and on the pituitary cell line AtT20, HA acts as mitogen by stimulating cells arrested in G2 to enter mitosis. The presence of HA early in neural development and in abnormal neural development, such as in brain and neuroendocrine tumors, are consistent with a function in growth control for HA in mammals. PMID- 2699863 TI - Nickel hypersensitivity reactions in orthodontic patients. A literature review. PMID- 2699864 TI - The antioxidants as protectors of host stress organ injury in mice infected with Plasmodium berghei. AB - A study has been made of counteracting the stress organ injury in Plasmodium infection by means of antioxidants on the premise that free radicals are responsible for causing the injury to stress organs. This was evidenced by drastically altered biochemical parameters in liver and spleen of the host in terms of elevated levels of lipid peroxides and xanthine oxidase (XO) activity, and a fall in superoxide dismutase activity coupled with other drastic biochemical changes. The cardinal factor responsible for the above was considered to be XO which engenders free radicals purportedly responsible for the stress organ (biochemical) injury. Results demonstrate a lowering of lipid peroxide levels, xanthine oxidase activity, liver weight and modulation of protein level in liver of the host (mouse) in Plasmodium infection when treated with catechin, glutathione and propylgallate. PMID- 2699865 TI - Ultrastructural comparison of erythrocytic stages of experimentally selected drug resistant strains of rodent malaria parasite P. berghei with its susceptible strain. AB - Studies on ultrastructure of drug-resistant strains of Plasmodium berghei have been mostly restricted to the experimentally selected chloroquine and pyrimethamine resistant strains. Study of the morphology of mefloquine and quinine resistant strain of P. berghei has been carried out to demonstrate some differences between normal and drug-resistant strains. The main differences are concerned with a complex physiological process i.e., food ingestion and digestion. E.M. studies reveal that in the sensitive strain of P. berghei the trophozoites possess numerous rod-shaped malarial pigment particles which lie within a vesicle. In the trophozoites of resistant parasites the malarial pigment particles are rarely visible. Trophozoites of the sensitive strain have only one large food vacuole while the trophozoite of the resistant parasite contains 2-3 smaller vacuoles. PMID- 2699866 TI - Laboratory diagnosis of malaria infection and its natural history in an urban pocket of Hyderabad City. PMID- 2699867 TI - [Critical review of lining materials and technics for fillings. 1]. PMID- 2699868 TI - [Periodontal osseous defects treated with tricalcium phosphate]. AB - A five year clinical research, dealing with advanced periodontal disease, leads the author to assert that periodontal pocket grafts with the so called "osteogenic" material tricalcium phosphate results in unsuccessful outcomes, especially if compared to the success of simple non surgical procedures, consisting of repeated scaling and curettage. PMID- 2699869 TI - [MK6: a computerized diagnostic system for mandibular movement]. AB - The authors describe the use of a new computerized diagnostic system MK6 by Myotronics Inc., Seattle, for the cranio-mandibular disorders. The conclusion of an anamnestic questionnaire, of an extraoral and intraoral standardized analysis and the computerized tridimensional tracings allow a precise and accurate diagnosis of the occlusal and neuromuscular pathology. PMID- 2699870 TI - [Oral implantology: historical-scientific relationship. 4]. PMID- 2699871 TI - [Magnets and orthognathodontics. Biological-clinical overview. 1]. AB - A review of the physical properties of the magnetic fields is reported. Particular attention has been paid to the biological and clinical aspects of the electromagnetic fields applied to living structures of cells and bone tissue both susceptible to this exposition. PMID- 2699872 TI - [Critical review of lining materials and technics for fillings. 2]. PMID- 2699873 TI - [Hygiene and high velocity aspiration]. PMID- 2699874 TI - [Prosthetic and surgical rehabilitation after operations for neoplasia]. PMID- 2699875 TI - [Clinical use of GIC: indications and limits]. AB - Due to high cariostatic activity, glass ionomer are irreplaceable component in restorative armamentarium. Clinician needs to stock several types of material since characteristics (film thickness, radiopacity, viscosity, colors, ecc.) are adapted for specific uses. PMID- 2699876 TI - [Conscious sedation in dentistry. Oral sedation. 2]. PMID- 2699877 TI - Biochemical markers of periodontal tissue destruction. PMID- 2699878 TI - Well differentiated metastasizing ameloblastoma--report of a case with review of literature. PMID- 2699879 TI - [Enamel abrasion and enamel tears by porcelain brackets]. AB - Orthodontic brackets manufactured of poly- or monocrystalline alumina ceramics are aesthetically appealing, but unfortunately show disadvantages for clinical application primarily causing (1) Abrasions of the enamel of antagonistic teeth, and (2) Tear-outs of the underlying enamel through debonding. To determine whether hardness and/or textural and structural qualities of the ceramics (as characterized by SEM investigations) are responsible for the deleterious clinical effects of abrasion, the amount of decrease of the height of human enamel-molar cusps was measured. Enamel loss was shown to be significantly more than 100 microns at 10 min. operating time in an abrasive testing device. Also debonding of the ceramic brackets proved to be problematic. Whereas metals and polymeric brackets allow some deflection of the material in addition to the tensile stress, separating the bracket from the enamel at the bracket-to-adhesive interface, or within the adhesive composite, the lacking workability in the ceramic brackets may induce a shift of the break-line during debonding to the adhesive-enamel interface or even into the dental enamel. Development and clinical application of ceramic brackets should improve safety for the enamel. Regardless of ceramic brand the abrasiveness endangers enamel through ceramic/enamel interferences. To avoid tear-out defects, brackets should debond at the ceramic-adhesive interface. PMID- 2699880 TI - Cytoskeletal rearrangement by oxidative stress. AB - The cytoskeleton is susceptible to oxidative stress and this occurs prior to membrane blebbing and cell lysis. Vimentin intermediary filaments in rheumatoid synoviocytes are more susceptible than in normal synoviocytes and this may have pathological significance. They are however no more susceptible to heat shock than other cell types. PMID- 2699881 TI - Evaluation and comparison of radioimmunoassay methods using monoclonal or polyclonal antibodies for the assay of cyclosporine in blood samples. AB - Results obtained measuring blood Cyclosporine A (CsA) concentrations in transplanted patients (124 samples of cardiac, 20 samples of liver, and 10 samples of kidney transplanted patients) by the use of two monoclonal radioimmunoassay (RIA) methods have been compared with those found using the HPLC technique (considered as the reference method) and two polyclonal RIAs. In addition, results on quality control samples collected in a multicentre collaborative study for CsA assay from the users of the same monoclonal and polyclonal RIAs were analysed to evaluate the performance of the methods under study. Polyclonal RIAs, which measure both the parent molecule and its metabolites, produced results 1.5-3 times higher than HPLC or monoclonal RIAs. On the contrary the two RIAs, which use monoclonal antibodies specific for CsA, show a better correlation with HPLC; these RIAs, which measure the intact drug molecule only, are recommended when the monitoring of the native molecule of CsA is requested. As far as the reproducibility is concerned, the four RIAs (both polyclonal and monoclonal) exhibit an unsatisfactory degree of between-assay and between-lab precision, since the coefficients of variation (CVs) ranged from 19.4% to 23.1%. PMID- 2699882 TI - Tolerability profile of the antiinflammatory compound imidazole salicylate: a metanalysis of safety data in 1408 patients. AB - In order to evaluate the incidence of side-effects (S.E.), the withdrawal rate and the type of S.E. of the new antiinflammatory agent imidazole salicylate, we performed an analysis of 33 clinical trials involving 1408 patients treated with 750 mg t.i.d. (tablets or solution) or 1000 mg b.i.d. (granulated powder), taking into account all the factors (treatment duration, pharmaceutical form, indications, etc.) that could influence the type and incidence of S.E. Slight and transient episodes of pyrosis or epigastric pain represented the great majority of S.E. The overall rate of withdrawal was 1.8%. According to the duration of therapy, the incidence of S.E. was: 2-3 days, 3.3%; 5-7 days, 5.6%; 10-14 days, 8.8%; 30 days, 10.2%. The pharmaceutical forms, the treated pathologies and the various experimental designs adopted (double-blind, open, etc.) did not influence the S.E. rate. With imidazole salicylate the overall incidence of S.E. was always lower than other NSAID's ranging from 10% to 64% of that observed with the reference drugs (other salicylates, ibuprofen, naproxen, flurbiprofen, piroxicam, diclofenac). In conclusion, this analysis showed a linear relationship between S.E. and exposure time up to 10-12 days, followed by a clear trend toward a plateau of 10% of S.E. with treatments up to 30 days. Therefore the risk-benefit ratio, particularly when compared with that of the reference drugs, seems to be very favourable. PMID- 2699883 TI - Teaching parents to conduct behavioral relaxation training with their hyperactive children. AB - Three boys meeting multiple criteria for hyperactivity received Behavioral Relaxation Training (BRT) in their homes from their parents, under the supervision of the experimenter. BRT involved modeling, prompting, token reinforcement, and praise, for ten overt relaxed behaviors. All children learned to relax to a criterion of at least 80% on the Behavioral Relaxation Scale (BRS), an objective measure of relaxation. Frontalis EMG levels were correlated with BRS scores for two children. Proficiency was maintained at one and three-month follow ups. All children were removed from medication by follow-up. Parent ratings of hyperactive behavior on two standardized questionnaires showed improvements from baseline to follow-up. Teacher ratings of problem behavior were less consistently positive. The concept of relaxation as a skill rather than a state, and its implications as an alternative to medication therapy, are discussed. PMID- 2699885 TI - [Value of angiography in the surveillance of choroid melanoma treated by cobalt disk]. AB - Conservative management of choroidal melanoma by radioactive plaques or protonbeam is widely used since 1968. The treatment of these tumors at Curie Institute has been done with cobalt plaques since 1968. Indications were first monophthalmic patients but are now much wide. We have been treating since 1981 all patients with tumor diameter less than 17 mm and tumor height less than 12 mm. The technic includes general anesthesia to place the disc with localisation of the tumor by transillumination or by indirect ophthalmoscopy. A dose of 70 to 90 grays is delivered to the apex of the tumor. We report two cases of patients treated by cobalt 60 plaque for choroidal melanoma. The first patient has a 5 mm high choroidal melanoma temporal to the macula. After treatment by cobalt plaque, he showed no echographic changes but angiograms revealed an hypofluorescent zone in the central part of the tumor. The second patient has an 8 mm tumor that after plaque showed only angiographic changes. Evolution after treatment of choroidal melanoma by radioactive plaque is variable. Echographic changes are very low and it is frequent to observe no modification in the height of the tumor for a long time for this reason, repeated angiograms can be very useful in the follow up of these patients. They frequently show hypofluorescent spot in the central part of a tumor that was hyperfluorescent before treatment. Sometimes there is diffuse lowering of the fluorescence. We think that these modifications of fluorescence can be due to diminution of the vascularisation of the tumor or may be to central necrosis of the tumor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699884 TI - [Optic nerve pits: clinical and therapeutic review of 21 cases]. AB - A retrospective study of optic nerve pits in patients referred to our clinic during the last 15 years was conducted. The study included 21 eyes in 19 patients. The optic pit was associated with a serous macular detachment (SMD) in 19 eyes (90%). Various treatments of the SMD were used depending on the time period. Systemic corticosteroids were used in five patients. The SMD did not respond to this treatment. Argon laser photocoagulation was applied to the temporal side of the optic disc in five patients. Intravitreal injection of pure gas was used as an adjunct to photocoagulation treatment in eleven eyes. Pure SF 6 was used in 8 eyes, and C 3 F 8 in 3 eyes. The follow-up after treatment was over 6 months in 10 patients who underwent photocoagulation or the combination of photocoagulation and gas injection. The SMD remained unchanged in two eyes which underwent photocoagulation treatment without gas injection. In the group of patients treated by photocoagulation in association with SF 6 injection, the SMD totally reattached in one eye, decreased in 2 eyes and remained unchanged in 2 eyes. Total resorption of subretinal fluid and permanent retinal reattachment occurred in the 3 eyes treated by intravitreal injection of pure C 3 F 8 as an adjunct to photocoagulation treatment. Further clinical investigations on large series of patients are required to determine whether prolonged retinal tamponade by C 3 F 8 gas in association with photocoagulation treatment is a valuable method in the management of SMD complicating optic nerve pits. PMID- 2699886 TI - [Use of a fibrin glue (Tissucol) for treating perforated or pre-perforated corneal ulcer]. AB - Treatment of perforated and preperforated corneal ulcers is a difficult task. As emergency penetrating keratoplasty results in poor visual outcome, surgical glue has been suggested as an alternative solution, but poor corneal tolerance for cyanoacrylate made this treatment non satisfactory. We treated 15 corneal ulcers (11 perforations, 2 descemetoceles and 2 deep ulcers) with a fibrin glue. Cicatrisation was obtained in 14 cases by this technic. In one case, cicatrisation was not satisfactory and penetrating keratoplasty was performed 3 days later. This method permits healing of the corneal perforation without the necessity of performing penetrating keratoplasty either if the perforation is distant from the visual axis or if penetrating keratoplasty is contraindicated. In other cases it permits a later penetrating keratoplasty to be performed an a quiet eye. We think this technic can be useful in corneal perforations less than 2 mm in diameter and in chronic deep ulcers difficult to heal. PMID- 2699887 TI - [Macular holes]. PMID- 2699888 TI - Preoperative evaluation of rectal carcinoma invasion using transrectal ultrasonography: preliminary experience of 30 patients. AB - Transrectal ultrasonography was used to examine and to preoperatively evaluate rectal carcinoma invasion in 30 patients. Satisfactory sonography pictures were obtained in 23 patients. Four stages of tumor invasion were identified in our study. The sensitivity of preoperative evaluation in this study was 91%. In order to verify the correspondence between the ultrasonographic findings and the actual histo-anatomic condition of rectum, 10 resected rectal specimens were studied by in vitro ultrasonography. We conclude that the appearance of the muscularis propria layer of rectum as a homogeneous hypoechogenic band can be stably defined with transrectal ultrasonography and is crucial for accurate evaluation of cancer invasion. Although lymph node enlargement was shown as hypoechogenic nodules on the sonographic pictures, the existence of cancer metastasis could not be differentiated in this study. PMID- 2699889 TI - Cranial and orbital growth in Chinese fetuses. AB - We assess Chinese fetal orbital growth by biparietal diameter (BPD) in normal pregnancies. One hundred and ninety-six normal fetuses, whose gestational periods ranged from 14 weeks to term, were measured by prenatal ultrasonography. Orbital parameters measured included orbital diameter (OD), biorbital distance (BOD), and interorbital distance (IOD). At the same time, fetal BPD was measured. The results show that orbital growth correlates well with BPD; OD versus BPD (r = 0.94, p less than 0.001), BOD versus BPD (r = 0.96, p less than 0.001), and IOD versus BPD (r = 0.83, p less than 0.001). Polynomial regression analysis demonstrates that the best-fit model for orbital parameters versus BPD was the first-order linear regression. From the above analysis, the 5th, 50th and 95th confidence limits of OD, BOD, and IOD were computed for specific growth values of BPD, and these can serve as a reference for prenatal diagnosis of fetal orbital malformations when menstrual age is not defined. PMID- 2699890 TI - [Relationship between thyroid echogram and thyroid function in Hashimoto's thyroiditis]. AB - Seventeen cases of untreated Hashimoto's thyroiditis were selected from the files of the Taipei Municipal Jen-Ai Hospital during the period from Jan. 1985 to Jan. 1986. All the cases were confirmed by a physical examination, determination of thyroid antibodies and fine needle aspiration cytology. Thyroid function was also determined. According to the echogenicity of the thyroid, they were divided into 2 groups, group A (8 cases) and group B (9 cases). In group A, homogeneous hypoechogenicity of the thyroid was noted and was lower than that of the adjacent muscles. In group B, heterogeneous echogenicity of the thyroid with equal or higher echogenicity than that of the adjacent muscles was noted. Group A showed a significantly lower serum T4, T3 and a higher serum TSH in comparison with group B. Five cases in group A presented hypothyroidism clinically while only 1 in group B presented. In conclusion, in the cases of Hashimoto's thyroiditis, the homogeneous hypoechogenicity of the thyroid echogram suggested the possibility of hypothyroidism. Statistically, the sensitivity was 83.3%, specificity 72.8%, positive prediction value 62.5% and the negative prediction value was 88.9%. PMID- 2699891 TI - Cloning of the Serratia marcescens recA gene and construction of a Serratia marcescens recA mutant. AB - A recombinant plasmid, pSM2513, containing an 8.5 kb DNA insert was isolated from a genomic library of Serratia marcescens by using interspecific complementation. This plasmid conferred resistance to methyl methanesulphonate and UV irradiation upon recA mutants of Escherichia coli and enhanced recombination proficiency, as measured by Hfr-mediated conjugation, in recA mutants of E. coli. Furthermore, when recA mutants of E. coli harbouring pSM2513 were subjected to UV irradiation, filamentation of the cells was observed. This did not occur upon UV irradiation of the same mutants harbouring the cloning vector alone. These results imply that the S. marcescens recA gene on pSM2513 is functionally similar to the E. coli recA gene in several respects. Restriction enzyme analysis and subcloning studies revealed that the S. marcescens recA gene was located on a 2.7 kb Bg/II-KpnI fragment of pSM2513, and its gene product of approximately 39 kDa resembled the E. coli RecA protein in molecular mass. Using transformation-mediated marker rescue, a recA mutant of S. marcescens was successfully constructed; its proficiency both in homologous recombination and in DNA repair was abolished compared with its parent. PMID- 2699892 TI - Biological attributes of colony-type variants of Candida albicans. AB - Twenty 'commensal' oral or 'pathogenic' vaginal isolates of Candida albicans were examined for colony morphology on malt/yeast-extract and serum-based agar media. Diverse and variable colony morphology was seen on serum agar. In 17 strains, selective subculture of morphologically atypical colonies produced progeny which had reverted to the morphology of the majority of parental colonies. However, in one strain, a highly stable colony variant was isolated which did not revert on subculture. In two further strains, variants were isolated which could be maintained with at least 99% homogeneous colony type by selective colony subculture, but reversion to the parental type or switching to other morphologies occurred at rates of 10(-2) to 10(-4): a rapid switching phenomenon. The relative proportions of mycelial or yeast forms were the main determinants of colony morphology. The variants were biotyped using a selection of biochemical tests. The stable variant differed from its parent in several characters, including rate of production of a proteinase enzyme. The pathogenicity of variants was compared in mice, and both stable and switching variants differed in virulence from their parental strains. Colony-type variation on suitable media is thus a powerful tool in the isolation of mutants or variants of C. albicans which differ from 'isogenic' parents in significant biological properties. Such variants may aid identification and characterization at the molecular level of determinants of, for example, pathogenicity and morphogenesis. PMID- 2699893 TI - Comparison of the uptake systems for the entry of various BtuB group colicins into Escherichia coli. AB - Colicins A, E1, E2 and E3 belong to the BtuB group of colicins. The NH2-terminal region of colicin A is required for translocation, and defects in this region cannot be overcome by osmotic shock of sensitive cells. In addition to BtuB, colicin A requires OmpF for efficient uptake by sensitive cells. The roles of BtuB and OmpF in translocation and binding to the receptor of the colicins A, E1, E2 and E3 were compared. The results suggest that for colicin A OmpF is used both as a receptor and for translocation across the outer membrane. In contrast, for colicin E1, OmpF is used neither as a receptor nor for translocation. For colicins E2 and E3, the situation is intermediate: only BtuB is used as a receptor but both BtuB and OmpF are involved in the translocation step. PMID- 2699894 TI - Escherichia coli molybdoenzymes can be activated by protein FA from several gram negative bacteria. AB - Six Gram-negative bacteria (Klebsiella pneumoniae, Erwinia chrysanthemi, Proteus vulgaris, Serratia marescens, Salmonella typhimurium, and Pseudomonas aeruginosa) were shown to contain an FA-type protein capable of activating aponitrate reductase, apotrimethylamine N-oxide reductase and apoformate dehydrogenase of Escherichia coli. Protein FA activity was highest in Erwinia chrysanthemi and lowest in Pseudomonas aeruginosa. All the species also contained the low-Mr (less than or equal to 1500) heat-resistant material previously reported to be necessary for the protein-FA-dependent activation of E. coli chlB nitrate reductase. PMID- 2699895 TI - Xylene. PMID- 2699896 TI - Cyclohexanone. PMID- 2699897 TI - Dimethylformamide. PMID- 2699898 TI - Morpholine. PMID- 2699899 TI - 1,2-Epoxybutane. PMID- 2699900 TI - Some glycidyl ethers. PMID- 2699901 TI - Phenol. PMID- 2699903 TI - Titanium dioxide. PMID- 2699902 TI - Antimony trioxide and antimony trisulfide. PMID- 2699904 TI - Occupational exposures in paint manufacture and painting. PMID- 2699905 TI - Some petroleum solvents. PMID- 2699906 TI - Toluene. PMID- 2699907 TI - [New possibilities in the hormonal therapy of metastatic carcinoma of the prostate]. AB - The application of estrogens in cases of prostatic cancer was widely accepted due to the discovery that they decreased the serum testosterone level. Yet, it was soon evident that their application did not always lead to the expected therapeutic effect, and thus the scientists kept on searching for the substances which would overcome the drawbacks of estrogen therapy. The paper describes the mechanisms of the activity of the three new groups of drugs which could be taken as the alternative to the estrogen therapy or castration in cases of advanced prostatic cancer. PMID- 2699908 TI - [Sclerotization of the parathyroid glands--description of a method]. AB - The method of ultrasonically guided percutaneous 95% ethanol injection of enlarged parathyroid gland is presented. Treatment was performed on the patient who has been treated with chronic hemodialysis for eight years and developed the symptoms of secondary hyperparathyroidism and who has had one enlarged parathyroid gland detected with ultrasound and confirmed by cytology. One month later the symptoms subsided, the laboratory findings improved and ultrasound examination revealed the decreased volume of the parathyroid. The paper points out the value of this method in the treatment of hyperparathyroidism. PMID- 2699909 TI - [Autologous bone marrow transplantation--a new approach in the treatment of neoplastic hematologic diseases. I. Scientific principles and methodology of the treatment]. AB - This first part of the review deals with fundamental knowledge, rationale and methods for the use of autologous bone marrow transplantation in the treatment of neoplastic diseases. Use of high-dose chemo- and radiotherapy in the treatment of neoplastic diseases is limited by side effects on haemopoietic tissues. Bone marrow transplantation offers a possibility to escalate the dose of cytotoxic therapy, but this possibility is limited by two main factors: need for matched allogeneic donor, and patient age below 45 years. This has led to application of autologous BMT for the treatment of older patients and those without compatible marrow donors. Samples of bone marrow collected before intensive myeloablative treatment are stored by means of cryopreservation. Viability and clonogenicity of stored bone marrow stem cells prior to reinfusion into the patient are tested by in vitro bone marrow culture (usually CFU-GM). Treatment of marrow samples in vitro by monoclonal antibodies and/or cytotoxic drugs are used in order to cleane ("purge") the marrow of residual neoplastic cells. PMID- 2699910 TI - [Oncogenes in acute myeloid leukemia]. AB - The role of oncogenes in carcinogenesis is intensively studied. Certain oncogenes are often found in some kinds of tumors. In acute myeloid leukemia (AML), of all oncogenes presently known, only those belonging to the ras group are activated in a larger number of cases. In single cases myc, myb, sis, and ets oncogenes have been found. It is possible that a disorder in regulation of myc and myb protooncogenes exists in AML. PMID- 2699911 TI - [Ultrasonic diagnosis in obstetrics]. PMID- 2699912 TI - [The 70th anniversary of the holding of the 8th All-Russian Conference of the Russian Communist Party (Bolshevik)]. PMID- 2699913 TI - [Radioimmunologic determination of growth factors. I. Determination of somatomedin C]. AB - The authors' first experience in the determination of plasma somatomedin C concentration by the radioimmunologic method without extraction was put forward. The method itself was checked up through the routine indicators and the range of normal limits was established by the determination of this concentration in the plasma of 15 healthy persons. Values of plasma and serum determination greatly differentiated. By the determination of somatomedin C concentration and growth hormone during the insulin test in 8 persons it was shown that somatomedin C concentration did not change by the abrupt and short changes in growth hormone concentration. A good correlation was made by the comparison of sometomedin C and growth hormone basal concentration in 16 samples whereby the regulatory role of growth hormone in somatomedin C excretion was confirmed. In conclusion, radioimmunologic determination of sometomedin C in diagnostics and the therapy of growth disturbance was emphasized. PMID- 2699914 TI - [The importance of beta-2 microglobulin determination in the urine in the detection of tubular proteinuria]. AB - In 38 patients with the positive finding of protein in the urine the determination of beta-2 microglobulin concentration was made in addition to the simultaneous determination of albumin, IgC and transfer in the urine and the calculation of differential protein clearance values for the identification of tubular proteinuria. Only 4 (10.53%) patients had proteinuria of tubular type, 16 patients had proteinuria of glomerular type, while proteinuria of the mixed glomerulo-tubular type was found in 18 (47.37%) patients. The safe separation of tubular proteinuria from that of glomerular type was made possible by the determination of beta-2 microglobulin concentration in the urine in the framework of detailed investigation. PMID- 2699915 TI - [Effective revaccination against tetanus in adults]. AB - Immunologic response in persons revaccinated against tetanus was dealt with in this paper. Out of 35 examined patients with the mean age of 47.4 years on the day of revaccination 20% of them had titres of antitetanus antibodies on the lower limit which guaranteed antitetanus protection (0.01-0.02 i.j./m.). Values of titre were below 1.00 i.j./m. in one third of patients. A high degree of negative correlation was statistically established between the age of patients and the height of titre (p less than 0.001). Mean geometric titre (GMT) of the patients amounted to 1.32 i.j./ml on the day of revaccination. Seven days following revaccination GMT was 10.41 i.j./ml and it was the best illustration of immunity "eruption" induced by one dose of Te Al vaccine a 0.5 ml. Optimal values of the titre (over 1.00 i.j./ml) occurred in all examined patients. Dependence of revaccinated titre upon age was of less significance (P = 0.01). A high degree of dependence of revaccinated titre upon the values on the day of revaccination was statistically established (p less than 0.001). It was concluded that by revaccination of persons with the lowest protective titre as well a safe antitetanus protection was provided in a 7-day period. This conclusion also necessitated obligatory immunization against tetanus at an older age too whereby a more expensive active-passive treatment of injured persons would de avoided. PMID- 2699916 TI - [Lipid peroxides and their importance in an organism]. AB - The paper reviews recently obtained data on the origin and role of lipid peroxides and their secondary decomposed products in the organism. Polyunsaturated fatty acids are the basic substrate of lipid peroxidation caused either by the insufficiency of the defense mechanisms or by their influx exceeding the requirements of the organism. The increased formation of lipid peroxides is associated with a number of disorders, specially with the onset of atherosclerosis. Mechanisms which help lipid peroxides to influence the process of atheroma plaque formation with special regard to the role of oxidized LDL particles are discussed. PMID- 2699917 TI - Pancreatology, past, present and future. PMID- 2699918 TI - Chronic calcifying pancreatitis: epidemiology and current concept of the lithogenesis. AB - The exact aetiology of chronic calcifying pancreatitis is unknown; several factors that lead to the development of this well-defined disease have been identified. Epidemiologic studies and careful analysis of nutritional data played an important role in precising the risk represented by alcohol consumption and dietary habits, and characterized the geographical distribution of the disease. At the same time, biochemical modifications of the pancreatic juice were described in alcoholics; later on, a new family of pancreatic secretory protein, the so-called "Pancreatic Stone Protein" was discovered. While its secretory form (PSP S2-5) prevents calcium crystal formation from the supersaturated pancreatic juice, its partially degraded form (PSP S1) is insoluble and probably the main protein of intraductal and intraacinar precipitates. Recent studies have confirmed that in chronic calcifying pancreatitis patients the mRNA encoding the synthesis of PSP S2-5 is decreased, and the protein is diminished both in the zymogen granules and in the pancreatic juice. PMID- 2699919 TI - Metabolism of glycoconjugates in human gastric mucosa a review. AB - Glycoconjugates, viz. glycoproteins, glycolipids and proteoglycans, play an important role in the protection of human gastric mucosa against pepsin and hydrochloric acid. The biosynthesis and catabolism of these compounds in the human gastric mucosa have been studied. We isolated and identified the majority of the intermediates and isolated some enzymes, taking part in the biosynthesis of glycoconjugates in the human gastric mucosa, and have demonstrated that the human gastric mucosa is able to release reducing sugars from glycoconjugates and shows some glycosidase activity. PMID- 2699920 TI - Short term treatment of type II hyperlipoproteinaemia with silymarin. AB - In a seven-month open clinical study on 14 type-II hyperlipidaemic outpatients, the effects of silymarin (Legalon), an antioxidant and hepatoprotective agent, were investigated. Blood lipid, lipoprotein and apolipoprotein concentrations, as well as liver and renal function parameters were measured. After determining baseline values, patients were treated with 420 mg Legalon daily for three months. After a two-month placebo period, the treatment was repeated with Legalon for a further month. In respect to the serum lipid and lipoprotein concentrations, there were no remarkable changes except that the total cholesterol and HDL-cholesterol levels slightly decreased. At the 12th week, in all cases, the apolipoprotein levels were somewhat decreased compared to the baseline values. By the significant decrease of both apo A-I and A-II values, a decrease of the total structural protein amount of HDL, and thus a relative increase in the proportion of cholesterol in HDL fraction was suggested. There were minor changes in serum protein concentration and liver function tests, but all values remained within the normal range. All of the renal function parameters remained unchanged during both treatments and the placebo periods. An additive role of Legalon in the therapy of secondary hyperlipoproteinaemia resulting from different liver diseases is discussed. PMID- 2699921 TI - [CEFOBID in the treatment of respiratory tract infection (preliminary report)]. AB - The therapeutical efficacy of CEFOBID (Pfizer) a third generation cephalosporine (natrium cephaperasone salt) was studied in 10 patients with acute respiratory infections including 6 with pneumonias. The therapeutical effect was arbitrarily judged according to the applied three point scale--"good", "satisfactory", "lack of effect". A "good" effects was seen in 6 patients, in 2 "satisfactory", in further two "lack" of effect was observed. Thus CEFOBID proved to be of beneficial effect in eight out of ten patients. One should stress that in the group that responded to treatment were all cases of pneumonia. CEFOBID was well tolerated. In this preliminary study the beneficial therapeutical effect in Gram negative opportunistic infections is stressed. PMID- 2699922 TI - [Various new data on steroid-induced myopathy]. PMID- 2699923 TI - [Lymphoid interstitial pneumonia]. PMID- 2699924 TI - [Male hypogonadism in children and adolescents: diagnostic assessment and therapy indications]. AB - Testicular hormones, produced by hypothalamic-pituitary-gonadal axis activation, induce male development during embryogenesis and sexual maturation at puberty. As a consequence, any lesion at different levels of the axis is responsible for different clinical alterations, depending on the phase of life in which it develops, from early gestation to adult life. The evaluation of a hypogonadic male is complex and often diagnostic procedures only discriminate the level of damage but not the cause. Standardized and widely accepted therapies for specific forms of hypogonadism are briefly exposed. Three cases of hypogonadotropic hypogonadism are reported. PMID- 2699925 TI - [Growth and puberal development in males with adreno-genital syndrome]. AB - Growth patterns of eleven male subjects affected by congenital adrenal hyperplasia (CAH) due to 21 hydroxylase deficiency were studied and correlation with treatment was evaluated. All patients had completed their growth and were divided into two groups according to the age of diagnosis; group A: treated before 6 months of age (5 patients), group B: treated after 3 years of age (6 patients). Besides the pattern of growth, mean parental age, genetic target, onset and completion of puberty were considered. Regardless of the age at diagnosis, the patients of both groups had an anticipated and stunted final height vs. general population, but correlated with mean parental height. In all patients pubertal spurt failed and height velocity slowed down after twelve years of age. We conclude that pattern of growth of patients with CAH is deeply influenced by genetic and constitutional factors and by negative effects of glucocorticoid therapy. Actually an excellent glucocorticoid treatment of CAH is not available as yet and careful clinical and laboratory evaluations are necessary to minimize negative influences on growth. PMID- 2699926 TI - [Neutrophil chemotaxis. I. Physiology aspects and study methods]. AB - Neutrophil chemotaxis is a complex orchestration of biochemical and morphologic events that requires the integrity and coordination of a complicated series of cellular functions. Different substances (both endogenous and exogenous) with chemotactic activity for human neutrophils were described; their interaction with specific receptors on neutrophil cell membrane is requested to induce a directional motility. The ligand-receptor interaction causes the activation of intracellular metabolic pathways and the modification of cytoskeletal structures involved in the chemotactic response. Neutrophil chemotaxis may be studied, for clinical purpose, by in vitro and in vivo methods. The two approaches of investigation are complementary, and, if properly used, they may give a valuable help in defining the nature of the chemotactic defect. PMID- 2699927 TI - [Extrapulmonary respiratory sounds in newborns: classification and iconographic contribution]. AB - The extra-pulmonary stridors of the newborn represent a frequent and difficult diagnosis pathology for the radiologists and the neonatologist. After an introduction about the most important anatomical dates, A. reviews the reasons of the neonatologic stridor, and emphasizes the vascular congenital anomalies, most important for a early differential diagnosis. Concluding, are reported radiologic findings of this shifty pathology. PMID- 2699928 TI - [Neonatal hypoxia and hemocoagulative changes]. AB - Coagulation abnormalities with and without haemorrhagic manifestations have been frequently reported in newborn-infants affected by hypoxia. Particularly in postmature-infants and in those ones with acute asphyxia at birth, respiratory distress syndrome (RDS), intra-uterine growth retardation (IUGR) and cyanotic congenital heart disease (CCHD). A reduction of synthesis or a consumption of blood coagulation factors are the main causes of these abnormalities. The anomalies of platelet number and of their function, of haemostasis global tests, of coagulation factors and physiologic inhibitors levels, of fibrinogenesis and fibrinolysis are examined, including authors' studies and a review of literature too. The authors think platelet count, PT, PTT, fibrinogen, factor V and VIII, and PDF determinations are necessary laboratory investigations for newborn infants with RDS or acute asphyxia for about the first week of life, because of the risk of consumption coagulopathy. In the other hypoxic newborns (IUGR, CCHD, postmature infants) platelets count, PT, PTT and serum PDF determinations could be enough in order to value any coagulation abnormalities presence. PMID- 2699929 TI - [Use of immunomodulators in pediatric pulmonology]. AB - This review describe the current state of knowledge and the clinical application of immunomodulating drugs in pediatric pulmonology. Some of those drugs are able to stimulate the macrophages, even in an aspecific way, via the gut associated lymphatic tissue (GALT), that is in connection with the bronchial associated lymphatic tissue (BALT). The most important field of application of the immunomodulating drugs in pediatric pulmonology is the child with recurrent upper respiratory tract. PMID- 2699930 TI - [Evaluation of the locomotor system during pediatric health examinations and elements of kinesitherapy]. AB - The pediatrician, being a primary health care physician, has the task of bringing the small patient and his parents to the resolution of all those problems which are erroneously referred to a subspecialist. With this in mind, the authors believe that even common orthopedic problems must be evaluated by the pediatrician. He would decide if and when to refer the child to an orthopedic specialist. Certain problems such as congenital hip dysplasia or scoliosis require specific treatment, whereas others (tibial bowing, genu varum-valgum, flatfoot, metatarsus varus) resolve themselves over time. The authors therefore emphasize the role of the pediatrician in preventing any iatrogenic pathology due to inappropriate treatment. PMID- 2699931 TI - [Echography of the hip in dislocation disease in newborns and infants]. AB - At present, ultrasounds represent the most reliable investigation with images for early C.H.D. diagnosis. This test is innocuous so it can be repeated and furnishes, especially in the first months of life, all those informations the traditional radiology cannot give us. In this work the authors report a clinical and ultrasonographic study of 1116 children (2232 hips); 127 of these were newborns and they have been followed-up from their birth to 7th month of life with ultrasound test at 1.-3.-5.-7. month of life. U.S. investigation has proved itself very sensitive and specific. PMID- 2699932 TI - Characterization of intermediate species during the molecular assembly of aspartase. AB - Molecular assembly of aspartase (L-aspartate ammonia-lyase, EC 4.3.1.1) from Escherichia coli was studied during the reversible denaturation. Although previous studies [Tokushige, M., Eguchi, G., and Hirata, F. (1977) Biochem. Biophys. Acta 480, 479-488] were unable to identify intermediate species during the course of reversible denaturation of aspartase, temperature-controlled HPLC and cross-linking with dimethyl suberimidate of the renaturation products showed that monomeric, dimeric and trimeric species occupied over 80% of the total oligomeric molecules below 13 degrees C; unlike the tetramer, these intermediates were without the activity. The degree of active tetramer formation was a linear function of the restoration of the activity below 18 degrees C, while above 23 degrees C, the activity regain was less than 70% restoration of tetrameric molecules. Upon examination by fluorescence spectroscopy, structural changes during reconstitution exhibited such complex kinetics that the rapid formation of structured oligomers proceeds first with a half-time of less than 10 sec, followed by slow subunit association. These results strongly suggest that the tetramer formation is an essential prerequisite, though not sufficient for the active enzyme. PMID- 2699933 TI - [Mycoplasma pneumoniae: epidemiologic and clinical characteristics, pathogenesis, diagnosis and treatment]. AB - Mycoplasma pneumoniae is a constant and very frequent causative agent of the acute respiratory infections, especially of pneumonias. Common etiologic, epidemiologic and clinical characteristics of this agent are described through a general review. New knowledge about pathogenesis and immunity is reported. Diagnostic procedures, treatment and prevention of the disease are mentioned as well. PMID- 2699934 TI - [Ultrasound in the diagnosis of pulmonary and pleural diseases]. AB - Ultrasound as a method in evaluation of pleural diseases, peripheral pulmonary infiltrates and tumors has already been accepted throughout the world. However we haven't yet been applying it widely. In this work the possibilities of ultrasound as a method in pleural and lung diseases diagnostics have been described, together with the typical findings and examination technique. Indications of thoracic ultrasound which along with unavoidable X-ray examinations represent a new increase of quality in the diagnostics of pleural and lung diseases are specified. PMID- 2699935 TI - [Ambulatory treatment of asthma in adults]. AB - In the introduction the approach to the treatment of asthma has been classified into preventive measures and drug therapy. By both methods especially by drugs the inflammation in the airways should be decreased. According to the modern concepts of pathogenesis of asthma the bronchial hyperresponsiveness might be reduced together with the causes of the symptoms of asthma. For the preventive treatment of all but mild forms of asthma in most asthmatics the therapy of three parallel ways should be applied: bronchodilators in aerosol and/or perorally, anti-allergic inflammatory drugs as well as corticosteroids in aerosol only in exceptional cases per os. According to the clinical effect and lung function (measurement of PEF at home) the drugs and doses are changed. In acute aggravation of asthma when bronchodilators are not sufficient the corticosteroids should be added parenterally in high doses with special attention on beta agonists in inhalation of increased doses after the corticosteroids had been applied. PMID- 2699937 TI - Psychological and sexual aspects in different types of bladder dysfunction. AB - Different types of dysfunctional voiding are described and correlated with psychological characteristics and sexual dysfunctions. Motoric as well as sensoric urge incontinence seems to be more frequently associated with psychological problems than stress incontinence and a psychosomatic therapy often results in cure without any surgery. A multidisciplinary approach to the problem is stressed. PMID- 2699938 TI - Recent advances in the role of pharmaceutical agents in impotence. PMID- 2699939 TI - Transgenesis: the challenge for the reproductive biologist. AB - The last decade has witnessed dramatic developments in molecular biology to a point where it is now possible for genetic engineers to consider programmes aimed at isolating and cloning specific genes from any genomic source for introduction into the germ line of other organisms. The impact of this technology on livestock breeding is potentially revolutionary. PMID- 2699940 TI - Annotated bibliography. PMID- 2699936 TI - Depression in schizophrenia: current guidelines to treatment. AB - Depressive symptoms and syndromes in schizophrenia are common but heterogeneous with respect to etiology, presentation, course, and treatment. Based on a comprehensive differential diagnosis that identifies ten clinical subgroups, the authors review relevant treatment studies and offer current treatment guidelines. The clinical recommendations focus on addressing underlying problems such as medication side effects and substance abuse, attempting to identify and treat medication-responsive syndromes, and preventing suicide. The categories and treatments presented here are expected to evolve as researchers continue to elucidate clinically meaningful syndromes and to develop specific treatments. Nevertheless, current knowledge suggests that many schizophrenics with depression and depression-like symptoms can be treated effectively. PMID- 2699941 TI - ATP and 2,3-bisphosphoglycerate: models of metabolites for the regulation of intracellular protein degradation. AB - The main question in protein turnover is what determines the susceptibility of a given protein molecule to proteolytic degradation. Much evidence supports a role for the structural characteristics of individual proteins in determining their specific degradation rates. However, changes in the environment can influence these characteristics and thus the degradation rates. Since intracellular proteins in vivo are in a natural environment, substrates, products, cofactors and other low molecular weight compounds are often bound to the proteins, and probably contribute thereby to the vastly different half-lives of proteins. This paper reviews recent results from the authors' laboratory on the possible regulation of intracellular protein degradation by low molecular weight components. We have centered our studies on 2,3-bisphosphoglycerate and ATP, which modify, in opposite directions, the proteolytic susceptibility of specific mitochondrial and cytosolic proteins to lysosomal and non-lysosomal proteases. As shown, these metabolites can also modify the microautophagic uptake of certain proteins as well as the degradation rate of proteins in cultured cells. PMID- 2699942 TI - Antioxidants and the influence of free radical damage to proteins on proteolysis in and around mammalian cells. AB - The hypothesis that free radical damage to proteins accelerates overall protein catabolism in and around mammalian cells is discussed. It is concluded that most cells are in possession of sufficient antioxidants to control protein damage, so that changing radical fluxes do not greatly change intracellular protein turnover rates. Exceptions exist however, and may be relevant to specialised cells, and to certain pathologies, where free radical damage to proteins may occur outside cells. The cases of inflammatory disease and atherosclerosis are mentioned, and it is argued that therapies based on anti-oxidant supply may be valuable in these cases. PMID- 2699943 TI - Proteolysis and cell death. AB - Cell death can occur by a number of different mechanisms, some of which are associated with significant protein degradation. L-cells in monolayer culture were labelled with 14C-leucine and 3H-thymidine and placed in a cold chase medium for each experiment. General cellular necrosis, induced by either repeated freeze thawing or NaCN, rapidly disrupted cellular structure, but produced only small amounts of acid soluble 14C over a period of 24 h. Selective cell death was produced by adding 5 mM thymidine to growing tissue cultures. With such treatment, cell death became manifest only after a 24 h lag period and progressively more intense in the next 48 h. The process was characterized first by cellular enlargement and protein accumulation, followed by the formation and release of eosinophilic hyaline bodies from cell cytoplasm. These bodies were often found adjacent to the plasma membranes of viable cells, as well as within cellular vacuoles. Biochemical studies indicated that proteolysis was significantly increased; this proteolysis, but not cell death, was prevented by NH4Cl. Cell death, formation of eosinophilic hyaline bodies, and proteolysis were prevented by cycloheximide. Cell cultures that manifest cell turnover, i.e. selective cell death, apoptosis-type, will show increased amounts of vacuolar proteolysis, which may be confused with accelerated protein turnover occurring in the vacuolar system. PMID- 2699944 TI - Proteolytic enzymes in mitochondria. AB - The current interest in mitochondrial proteases is based on the recognition that these enzymes are actually involved in very important regulatory and metabolic roles inside the organelle. It has been formerly assumed that functions such as limited proteolysis, continuous turnover to regulate protein levels and selective elimination of defective and/or exceeding protein molecules, which have been clearly demonstrated in the intact cell, are likely to be operative within the physical boundaries of a well delimited organelle as the mitochondrion is. Consistent evidence has gradually accumulated on the existence of intramitochondrial proteolytic systems and this has led to a systematic search for the responsible proteases. The present discussion gives a brief up-to-date account of the existing information on mitochondrial proteolysis and describes the contribution to this field made by our own research. PMID- 2699945 TI - Proteolytic control over formation of enzymic complexes of the mitochondrial inner membrane. AB - Assembly of enzymic complexes of the mitochondrial inner membrane is an intricate process involving import of protein precursors from the cytosol and from the mitochondrial matrix, proteolytic processing of the precursors, covalent and noncovalent attachment of prosthetic groups to apoproteins, diffusion of proteins in the membrane in search of their partners, etc. The aim of the present communication is to draw attention to that, concurrent with all these events, proteolysis of mitochondrial inner membrane proteins occurs, which in some cases is rapid and can play a prominent part in correcting polypeptide compartmentation, subunit stoichiometry in complexes, overall amounts of proteins and mutual arrangement of complexes in the membrane. PMID- 2699946 TI - [Natural history of hip necrosis in sickle cell disease. Apropos of 104 necroses]. AB - The authors have followed 140 patients with sickle cell disease anemia (101 cases) or related hemoglobinopathies (39 cases). Among them hip involvement was noted in 55 (104 hips). Forty three times the hip involvement occurred in childhood and twelve times in adult life. When the necrosis appeared in childhood (84 hips) the average age was twelve. The deformity involved the femoral head (coxa plana, coxa magna) as well as the neck (short neck, coxa vara). After an average follow-up of nineteen years, clinical and radiological examinations evidenced 64 functional impairments and 25 arthrosis, 10 of which have already been operated on. The necrosis appearing during adult life (20 hips) had the same outcome as idiopathic necroses, leading rapidly to arthrosis after collapse of the sequestrum. It seems that the etiology of the necroses is linked to rheologic disorders, the deformity of the red cells causing arteriolar thromboses. In this series the hip disease was correlated with sickle cell retinopathy as defined after angiography. On the contrary there was no correlation with the severity of anemia, its treatment, the ethnical origin of the patient. PMID- 2699947 TI - [The locked pin: a simple method to avoid migration in slight osteosynthesis]. AB - The authors propose to broaden the principle of the pin lock in slight osteosyntheses. The purpose of the inserted tip device is to prevent the forward migration of the pin, the skin perforation by retrograde and to ease its removal after bone union. PMID- 2699948 TI - [Jacques Michon (1921-1989)]. PMID- 2699949 TI - [Turbine noise damages the hearing, however, it is limited damage]. PMID- 2699950 TI - [Allergic reactions caused by orthodontic appliances and metal prosthesis]. PMID- 2699951 TI - IgA nephropathy and mucosal immune system. AB - IgA-containing immune complexes may play a major role in IgA nephropathy, and the author emphasizes that impairment of their clearance and of hepatobiliary transport has etiological significance. In addition, an abnormality of the phagocytic system, such as mesangial cells, may lead to mesangial deposition of preformed circulating IgA-containing immune complexes. The IgA bound to the glomerular mesangium is polymeric IgA to microbial or dietary antigens in the mucosa. Mesangial cells and endothelial cells in the glomeruli may play an important immunoregulatory role in IgA nephropathy. PMID- 2699952 TI - Short term effect of lactulose therapy in patients with chronic renal failure. AB - Effect of lactulose therapy was examined in patients with chronic renal failure (CRF) prior to hemodialysis (HD). Twenty three patients were included in this study. Ten out of the 23 patients were continuously treated with lactulose at a dosage of 18 g/day for eight weeks. However, 12 out of the 23 patients dropped out because of nausea and/or watery diarrhea during the therapy. One patient was transfered to HD one month after the beginning of lactulose therapy. Ratios of guanidinosuccinic acid (GSA) in plasma after eight weeks were significantly lower than those before treatment. Cessation of treatment was significantly related to worsening of the GSA (p less than 0.01). It seems that lactulose therapy could be useful in the treatment of CRF if compliance of the therapy is maintained after reducing some adverse effects. PMID- 2699953 TI - [Clinical examination of provisory dental crown and bridgework plastics with special consideration of the matrix method]. AB - Comparing several clinical methods for making temporary crowns and bridges the matrix method has proven advantageous. The clinical and technical-laboratory working procedure is described. Using this method three temporary resins for crowns and bridges (Protemp, Dentalon plus and Scutan) were evaluated and compared concerning clinical usefulness. PMID- 2699955 TI - [Diagnosis of diseases in the maxillo-facial region]. AB - The clinical diagnosis of 3,943 patients was examinated, only in 45% of the cases the diagnosis was correct, in 23% we found a false diagnosis specially in tumor like lesions and diseases of the oral mucosa but too in dental infections and zysts. This study mediates centres of gravity in the medical training and further education. PMID- 2699954 TI - [Trommsdorff and his relations to dentistry]. AB - In the mirror of the publication "Kallopistria oder die Kunst der Toilette fur die elegante Welt" (1805) the scarcely noticed relations to dentistry in the total work of the Erfurter university professor and dispensing chemist J. B. Trommsdorff (1770-1837) are represented. Thw new details og the correlation pharmacy-dentistry at the beginning 19th century are presented. PMID- 2699956 TI - [Long-term experiences with large bridge-work after partial resection of the lower jaw]. AB - In a period of 12 years 121 bridging plates were implanted for the reconstruction of madibular defects following radical tumour surgery. 60 (49.6%) of these implants had to be removed prematurely due to: 1. postoperative perforation of the plate through either skin or oral mucosa, 2. implant fracture, 3. infection of the graft bed, 4. postoperative dehiscence and remaining fistula. Inadequate soft tissue coverage of the bridging plate is discussed as the main reason for the above mentioned complications. PMID- 2699957 TI - [Spectrophotometric examinations of the chlorhexidine content in the disinfected synthetic material of prosthesis]. AB - The investigation showed that each acrylic plate adsorbs on its surface 41.62 46.78 micrograms of chlorhexidine. PMID- 2699958 TI - [Changeable bridge-work prosthesis. Proposal for solution]. AB - A newly developed solution is introduced, which makes it possible to design artificial bridges conditionally variable. Thus the frame is fixed on tangential bridges--departing from common techniques--by means of lateral assembled barriers. PMID- 2699959 TI - [Methodology of resilience telescope in seriously reduced gaped set of teeth]. PMID- 2699960 TI - [Multicentric retrospective study on the carcinoma of lips and oral mucosa. Analysis of coherence between pre- and posttherapeutical categories of classification]. AB - The coherence between prae- and posttherapeutical TNM findings had been checked up in a multicentrically registered patient material of 2,481 non-praetreated plate epithelium carcinomas of the lips and oral mucosa. Whereas the extension of the tumour has in the main been the same, the findings on lymph nodes had a trend showing essential deviations. In a two-dimensional examination of 851 histologically prepared preparations of lymph nodes, a prognostic relevance acc. to metastases had been registered for the characteristics palpation finding of the lymph node, tumour extension, tumour infiltration. Multidimensional analyses have to be realized. PMID- 2699961 TI - [New method of diminishing cyst cavities]. AB - For diminishing the cyst cavity after cystectomia the following method is being suggested: The cyst sack is removed as usual after forming a trapezium-like muco periostyle soft flat tissue by means of a vestibular bone opening. Foremost and furthest to the opening other openings are bored into the bone. Then "U" like stitches are being made through them and the edges of the muco-periostyle flat tissue, their loose ends being tied over a tampon. The tampon presses over the muco-periostyle tissue at the place of the bone defect thus diminishing it. PMID- 2699962 TI - [Clinical and construction of combined fixed and removable prostheses in the lacunar set of teeth]. AB - Decisive for a long-term maintenance of the structure of the oral tissues for the prosthetic providing by combined fixed and removable prosthesises are the preparation of the residual set of teeth according to the therapy, the periodontally supported coupling by suitable connecting elements, and the scaffold construction corresponding to a suitable saddlekinematies. The basis for all that are a rather fixed connection with the residual set of teeth and simultaneously the consideration of perioprosthetic constructive principles. The coupling may be done by casting cramps, telescopes or debris, having a different valency. PMID- 2699963 TI - [The Stefan S. Nicolau Institute of Virology of Bucharest: 40 years of activity]. PMID- 2699964 TI - [The SSPE model: suggestions for an explication of viral persistence]. AB - The detection of a latent viral flora intrinsic to the central nervous system (CNS) raises the problem to know if some neuropathogenic strains have the property of initiating persistent infections or if the persistence is the result of the immune response particularities at the CNS level. A review is done of the pathogenic explanations of virus persistence in SSPE, followed by the discussion about two pathogenic alternatives issues from the author's studies: the antigenic "drift" hypothesis and the one of the defective interfering particles preferential synthesis. PMID- 2699965 TI - [Research on arbovirus infections]. AB - The author presents the results of researches done at the "Stefan S. Nicolau" Institute of Virology in Bucharest on the infections induced by arboviruses. The characteristics of three tick encephalitis virus strains (two strains isolated from Ixodes ricinus and Ixodes persulcatus ticks and one from a patient with encephalitis symptoms) are given. Most of the report is devoted to the results of serological survey conducted in a human population, in several domestic birds and mammals from some districts of Romania, as well as in migratory birds from the Danube delta, with regards to the incidence of some Toga-, Bunya- and Reoviruses. PMID- 2699966 TI - [Research on antiviral chemotherapy at the Stefan S. Nicolau Institute of Virology in 1984-1989]. AB - The paper is a review of researches done at the "Stefan S. Nicolau" Institute of Virology, in Bucharest, the last five years, in the antiviral chemotherapy field, as well as of the chemotherapeutical implications of studies conducted about other aspects of virology. PMID- 2699968 TI - [Prof. Nicolae Cajal on his 69th birthday]. PMID- 2699967 TI - [Research conducted at the Stefan S. Nicolau Institute of Virology of Bucharest in the area of nucleic acids and genetic engineering]. AB - A brief review is done of some of the most important studies realised by the "Stefan S. Nicolau" Institute researchers in the field of nucleic acids. It is worth mentioning among these the investigations about interactions between nucleic acids and some biologically active substances, the recombinant DNA, as well as the most recent works on DNA-DNA hybridization in the avidine-biotine system. PMID- 2699969 TI - [Cultural history of dentistry. 1. A hard fight of dentists to achieve respect and recognition]. PMID- 2699970 TI - Excess iodide inhibits the thyroid by multiple mechanisms. PMID- 2699971 TI - Thyroid-stimulating hormone: structure and function. PMID- 2699972 TI - Integrated regulation of growth and of function. PMID- 2699973 TI - Regulation of growth and differentiation in follicle cells. PMID- 2699974 TI - Transducing systems in the control of human thyroid cell function, proliferation and differentiation. PMID- 2699975 TI - Thyroid specific gene expression. PMID- 2699976 TI - What controls thyroid growth--that is, thyroid size? PMID- 2699977 TI - [Hemodynamic factors in septic heart disease]. PMID- 2699978 TI - [Regulatory mechanism of gonadotropins and prolactin: role of the pineal gland and of the central catecholamines]. PMID- 2699979 TI - [Extrecorporeal renal litofragmentation: current practice and application]. PMID- 2699980 TI - [Surgical treatment of secondary hyperparathyroidism in uremic patients]. PMID- 2699981 TI - [Human life in the dramatic works of Lope de Vega]. PMID- 2699982 TI - [Demonstration of PGE2 by immunofluorescence in the wall of radicular cysts]. AB - The present study gives the first evidence, through immunofluorescence, of the prostaglandins PGE2 in radicular cysts. The results are in agreement with literature. In addition, the immunofluorescence technique has also demonstrated the localization of prostaglandins inside the cyst cavity. In opposition to previous data, the present study also shows that epithelial cells seem to synthesize more PGE2 than fibroblasts and mononuclear components of the external connective tissue. PMID- 2699983 TI - Cytoskeleton and calcium. A review. AB - The aim of the present paper was to summarize the main features about cytoskeleton in order to understand the possible interactions between this system of filamentous, microfilaments structures (including microtubules, intermediate filaments, microfilaments) and calcium in mesenchymal cells of the oral cavity. PMID- 2699984 TI - [The status of the neonate with a birthweight over 4000g and his development in the first year of life]. PMID- 2699985 TI - Hypertensive intracerebral haemorrhage: is there a role for surgery? PMID- 2699986 TI - Optimal exchange volume and dialysate flow rate in peritoneal dialysis. A clinical study. AB - To find the optimal exchange volume and dialysate flow rate for use in peritoneal dialysis, 24 adult patients with acute or acute on chronic renal failure were studied. Based on the exchange volume and duration of one cycle, patients were randomly divided into 4 equal groups. Peritoneal clearances for urea and creatinine were calculated at 2, 8 and 14 hours during dialysis. Increase of dialysate flow rate improved the peritoneal clearance of various solutes, and for the same flow rate 2 liter exchange volume gave better results than 1 liter exchange volume. PMID- 2699987 TI - Role of ultrasonography in non-visualised gallbladder on oral cholecystography. AB - Real-time ultrasonography was done in 30 cases of non-visualised gallbladder on oral cholecystography. Surgico-pathological correlation revealed that a specific diagnosis indicating true pathology is possible preoperatively on ultrasonography. PMID- 2699988 TI - Non-Hodgkin's lymphoma with unusual clinical presentation. PMID- 2699989 TI - Campylobacter pylori detection by rapid urease test. PMID- 2699990 TI - [Aortic flow patterns in normal neonates with patent ductus arteriosus: evaluation by Doppler color flow imaging]. AB - Serial Doppler echocardiography was performed in 12 normal neonates (0.5-4.0 hrs after birth) to evaluate flow patterns through the ductus arteriosus, and in the aorta and brachiocephalic artery. At the initial examination, flow through the ductus arteriosus was bidirectional in eight of the 12 neonates and continuously left-to-right in the remaining four. The bidirectional ductal shunts became continuous left-to-right flows within 11-21 hrs after birth in seven of the eight neonates and resolved by 29-47 hrs after birth. In the remaining four neonates, the continuous left-to-right shunts disappeared 14-36 hrs after birth. Systolic ejection flow patterns in the aorta and brachiocephalic artery had a triangular shape with the peak velocity in early systole, followed by a minimal flow reversal in all sites examined. Diastolic flow patterns in each arterial site were as follows: 1. In the ascending aorta, there was slow and sustained diastolic forward flow, which did not change with increasing age. 2. In the brachiocephalic artery, there was a pan-diastolic flow reversal in the neonates with bidirectional ductal flow (7/8). This pattern changed to slow pan-diastolic forward flow when the ductal changed to continuous left-to-right flow or when the ductal closure was confirmed. Most (3/4) of the remaining four neonates with continuous left-to-right ductal flow exhibited pan-diastolic forward flow. Another showed a pan-diastolic flow reversal 2 hrs after birth, which changed to pan-diastolic forward flow in the second examination 6 hrs after birth. 3. In the distal aortic arch, there was a pan-diastolic forward flow in all the neonates, and the velocity decreased when a closure of the ductus was confirmed. 4. In the descending aorta, there was a pan-diastolic flow reversal in neonates with bidirectional ductal flow (7/8). This reversal changed to pan-diastolic forward flow, when the ductal flow changed to continuous left-to-right flow or when the ductal closure was confirmed. In the remaining four neonates with continuous left to-right ductal flow, two showed a pan-diastolic flow reversal at the initial examinations 2 to 3 hrs after birth. This became a pan-diastolic forward flow at the second examinations 6 and 12 hrs after birth. In the other two, there was a pan-diastolic forward flow which did not change. This pan-diastolic flow reversal observed in the brachiocephalic artery and descending aorta was closely related to the bidirectional ductal flow.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2699991 TI - [Usefulness and limitations of myocardial scintigraphy at present]. AB - There are three major techniques of myocardial imaging in the field of nuclear medicine at present: (1) myocardial perfusion imaging, (2) myocardial infarct avid imaging, and (3) myocardial metabolism imaging. Although myocardial infarct avid imaging with Tc-99 m pyrophosphate is useful for diagnosing myocardial infarction when other laboratory evidence is not obvious, it is of limited diagnostic value because of the delayed appearance of the positive images after infarction and occasional false positive cases. Indium-111-labeled antimyosin may be substituted by Tc-99 m pyrophosphate in the near future. Myocardial perfusion imaging with Tl-201 is the most widely accepted procedure in nuclear cardiology. Exercise Tl scintigraphy is superior to the electrocardiographic exercise test for detecting myocardial ischemia. Better results may be obtained by the quantitative analysis of the Tl-201 washout rates. However, the physical characteristics of Tl-201 are not ideal for myocardial imaging because of low energy photopeaks and its relatively long half-life. Therefore, the usefulness of Tc-99 m isonitriles, N-13 ammonia and Rb-82 as substitute radiopharmaceuticals is now being widely investigated. Myocardial metabolism imaging is a promising new technique for estimating myocardial viability. Application of this technique to fields other than myocardial ischemia is also anticipated. Unfortunately, its clinical usefulness is limited by the expensive instrumentation at present. PMID- 2699992 TI - [Long-term survival of a patient with pseudoaneurysm of the left ventricle following myocardial infarction]. AB - A 76-year-old man had an extensively calcified left ventricular pseudoaneurysm which was a sequela of acute myocardial infarction suffered 22 years ago. He experienced acute anterolateral myocardial infarction in January 1964. In March 1964, the presence of a left ventricular aneurysm was suspected by chest radiography and fluoroscopy. He was, however, in good health since then. In April 1986, when he was admitted for treatment of acute bronchitis, a large calcified density was found in the left ventricular region on chest radiography. The electrocardiogram was compatible with an old anterolateral myocardial infarction. Two-dimensional echocardiography showed an immobile portion of the left ventricle which contained "moya-moya" (sluggish, smoky) echoes. A saccular aneurysm of the left ventricle was confirmed by radioisotope cardiac pool scans, reconstruction CT and left ventriculography. Due to the poor general condition of the patient, we followed his course without surgery. He died in October 1986. At autopsy, the pseudoaneurysm was markedly calcified, and its wall was adherent to the parietal pericardium. Histologically, the pseudoaneurysmal structure turned out to be a pseudoaneurysm since the saccular wall contained only scar tissue but no myocardial cells. This is a very rare case of a patient with a left ventricular pseudoaneurysm who survived for 22 years after its occurrence. PMID- 2699993 TI - Protein catabolism in cultured kidney cells. PMID- 2699994 TI - Early therapy of renal bone disease with calcitriol: a prospective double-blind study. AB - The value of calcitriol administration in the management and prevention of renal bone disease was studied in a prospective double-blind manner in 16 patients with chronic renal impairment (creatinine clearance 20 to 59 ml per min). They were given either calcitriol at a dose of 0.25 to 0.5 micrograms daily (eight patients), or placebo. Transiliac crest bone biopsies were performed before entrance into the study and after 12 months of experimental observation. None of the patients were symptomatic or had biochemical or radiological evidence of bone disease. Of the thirteen patients who completed the study, initial serum 1,25(OH)2D levels were low in seven patients and parathyroid hormone levels were elevated in seven patients. Bone histology was abnormal in all patients. Calcitriol treatment was associated with a significant fall in serum phosphorus concentrations and alkaline phosphatase levels as well as with histological evidence of an amelioration of hyperparathyroid changes. In contrast to previous reports, no deterioration of renal function attributable to the treatment occurred, perhaps because a modest dose of calcitriol was employed combined with meticulous monitoring. Further investigation is required to determine whether alternative therapeutic strategies (smaller doses or intermittent therapy) may avoid the potential for suppressing bone turnover to abnormally low levels in the long term. PMID- 2699996 TI - Insulin secretion in uremia: effect of parathyroid hormone and vitamin D metabolites. AB - Insulin resistance is almost universal among uremic patients. There are, however, two different subgroups of uremic patients with regard to glucose tolerance. About half of uremic patients can augment their insulin secretion in response to glucose loads to overcome the insulin resistance and maintain glucose tolerance. In the other half of uremic patients, insulin secretion following glucose loads is not different from normal values so that glucose intolerance results. There is recent evidence that hyperparathyroidism or vitamin D deficiency may inhibit insulin secretion in uremia. Parathyroid hormone (PTH) concentrations correlated inversely with glucose tolerance in adolescents with chronic renal insufficiency. Insulin hypersecretion in response to glucose loads occurred only in uremic patients with normal PTH concentrations. Surgical correction of hyperparathyroidism in uremic patients on hemodialysis led to the resolution of glucose intolerance with an increase in insulin secretion and no change in insulin resistance. However, the role of vitamin D repletion was not separately assessed since these patients were supplemented with vitamin D post-operatively. Medical correction of hyperparathyroidism by high-dose phosphate binders and vitamin D led to similar changes in glucose metabolism in children with chronic renal insufficiency. Glucose intolerance resolved, insulin secretion increased, and insulin resistance persisted. In the latter study, plasma 1,25 dihydroxycholecalciferol (DHCC) increased significantly following phosphate restriction. Recently, a preliminary study showed that intravenous 1,25-DHCC acutely restored glucose tolerance and increased insulin secretion in uremic patients on hemodialysis without simultaneous changes in serum PTH, ionized calcium, phosphate, magnesium or potassium concentrations. Thus, 1,25-DHCC, independently of PTH and calcium, may be important in the control of insulin secretion in uremic patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2699995 TI - Polypeptide growth factors and the kidney. AB - Various polypeptide growth factors can act on different cell types in an autocrine, paracrine or endocrine manner. These bio-active peptides regulate molecular and cellular events that culminate in DNA synthesis and cell division. While, one or more polypeptides might be implicated as playing a predominant biological role in the kidney, in a given in vitro or in vivo situation, a network and cascade of events determines the final pattern of cell growth and response to injury. Elucidation of these molecular events and mechanisms of action of growth factors in the kidney is of fundamental importance to our understanding of both the normal development and disease states of the kidney. PMID- 2699997 TI - Effect of dialysate composition on the lipid response to L-carnitine supplementation. AB - Cumulative carnitine losses through dialysis membranes may worsen hyperlipidemia during long-term hemodialysis. However, carnitine supplementation has not shown a consistent beneficial response in hyperlipidemia. We have compared in a double blind, cross-over study the effect of dialysate buffer composition (acetate or bicarbonate) on the serum lipid response to L-carnitine supplementation during hemodialysis. We studied nine patients (mean age, 19 years; range, 14 to 23) with hyperlipidemia undergoing maintenance hemodialysis. Plasma levels of carnitines and lipids, including total and HDL cholesterol (HDL-C) and triglycerides (TG), were measured at baseline and monthly intervals after receiving 2 grams of L carnitine or placebo added to dialysis bath for three months. One month of carnitine supplementation in acetate hemodialysis significantly reduced plasma TG (230 +/- 95 to 136 +/- 20 mg/dl; P less than 0.05) and elevated HDL-C (50 +/- 12 to 71 +/- 26 mg/dl; P less than 0.05). However, this effect was no longer observed at the end of three months of supplementation. Bicarbonate hemodialysis had lower baseline TG values, but carnitine supplementation did not modify plasma lipids (TG:144 +/- 87 to 158 +/- 115 mg/dl; HDL-C:50 +/- 23 to 50 +/- 19 mg/dl). Both groups had a significant increase in plasma carnitine levels after carnitine supplementation. These results suggest that bicarbonate hemodialysis may add a protective effect in hyperlipidemia by reducing requirements of carnitine supplementation. On the other hand, carnitine supplementation should be considered in patients with hyperlipidemia undergoing acetate hemodialysis. The observed difference in response between acetate and bicarbonate hemodialysis may be due to enhanced formation of acetyl-CoA and fatty acid synthesis during acetate hemodialysis. PMID- 2699998 TI - Role of dietary lipids and renal eicosanoids on the progression of renal disease. AB - Alterations in lipid metabolism occur in patients with chronic renal disease and in patients with the nephrotic syndrome and may have a role in the progression of renal disease in such patients. Evidence accumulated over the last few years indicates that increased ingestion of cholesterol accelerates the development of glomerulosclerosis in guinea pigs, rats and rabbits, and in rats with endogenous hyperlipidemia due to the nephrotic syndrome. Lowering the levels of serum lipids ameliorates the progression of renal disease in obese rats, rats with a remnant kidney and rats with the nephrotic syndrome produced by the aminonucleoside of puromycin. Changes in dietary fatty acids also influence the progression of renal disease. Several eicosanoids influence the progression of renal disease in experimental animals. Maneuvers that decrease the production of thromboxane A2 ameliorate renal disease in rats with a remnant kidney and in mice with lupus nephritis. Increasing the production of vasodilatory prostaglandins (PGE2, prostacyclin) seems to have a beneficial role in the progression of renal disease. The mechanisms by which dietary lipids and/or renal eicosanoids affect the progression of renal disease remain to be defined. PMID- 2699999 TI - Metabolic response of neutrophils to uremia and dialysis. AB - Oxidative metabolism of polymorphonuclear leukocytes (PMNs) in uremic patients is enhanced due to unknown serum or plasma factor(s) which are removed during hemodialysis. Respiratory burst activity is diminished in both PMA-stimulated and unstimulated states compared to healthy controls. Hemodialysis treatment normalizes stimulated hydrogen peroxide production and decreases unstimulated hydrogen peroxide production. Several authors found that resting and stimulated chemiluminescence (CL) during hemodialysis correlate with complement activation, whereas other authors describe the development of CL using dialyzer membranes with only mild anaphylatoxin formation. Alterations in PMN carbohydrate metabolism in uremic patients improve during HD. These alterations may be responsible for disturbances in phagocytosis. Degranulation during HD also occurs in the absence of complement activation. Calcium channel blockers decrease activation of PMNs when dialyzers with only little anaphylatoxin formation are used. Acute renal failure and sepsis induce activation of PMNs. Hemodialysis with membranes made of cuprophan leads to further activation of these PMNs and may contribute to granulocyte dysfunction. PMID- 2700000 TI - Possible involvement of vasopressin and urine concentrating process in the progression of chronic renal failure. AB - This paper reviews experimental findings which support the concept that vasopressin (VP) and the process of urine concentration may be involved in the progression of chronic renal failure (CRF). The influence of dietary protein intake on the progression of CRF may also involve VP and the operation of the concentrating process. VP receptors have been identified in glomeruli and VP is able to constrict mesangial cells as does angiotensin II. Acute VP infusion increases the glomerular transcapillary hydraulic pressure difference, and chronic VP infusion increases GFR. In rats with CRF (induced by 5/6 nephrectomy), VP levels were found elevated. In rats with 5/6 nephrectomy, we increased experimentally water intake in order to decrease circulating VP levels, urine concentration, and free water reabsorption. Several indices of progression of CRF, including proteinuria, hypertension and glomerulosclerosis, were significantly reduced, thus suggesting a contribution of VP in progression. Lowering protein intake in CRF could be beneficial because proteins, but not carbohydrates or lipids, produce metabolic end products (mainly urea, ammonia, protons, etc.) that are excreted by the kidney, and concentrated in the urine. In healthy subjects (man or rat), high protein (HP) intake favors urine concentration and causes changes in kidney function and morphology very similar to those induced by chronic VP infusion or water restriction. These changes involve an increase in transport activity of the thick ascending limb (where the initial active step of the concentrating process takes place) and may affect filtration rate and/or glomerular hemodynamics secondarily, by decreasing salt concentration at the macula densa and depressing tubuloglomerular feedback.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700001 TI - Reciprocal creatinine slopes often give erroneous estimates of progression of chronic renal failure. AB - In 10 of 22 observation periods (lasting an average of 15 months) in 17 patients with moderate to severe chronic renal failure (GFR 4 to 23 ml/min), rates of progression as estimated from the linear regression on time of reciprocal plasma creatinine concentration (multiplied by average 24 hr creatinine excretion) (b2) differed significantly from rates of progression as estimated from the regression on time of urinary clearance of 99mTc-DTPA (b1), during all or part of the period of observation, b2 exceeded b1 in six cases and was less than b1 in the other four. Owing to these changes, measurements of reciprocal creatinine concentration gave erroneous impressions of the rate or existence of progression, during all or a portion of the period of observation, in nearly half of these patients. However, in the 22 studies as a group, using the entire periods of observation, b2 indicated nearly the same mean rate of progression as b1, and had the same variance. We conclude that sequential plasma or serum creatinine measurements in individual patients are often misleading as measures of progression and should, when feasible, be replaced by urinary clearances of isotopes in following patients with chronic renal failure. PMID- 2700002 TI - The role of the forensic pathologist in pediatric pathology. PMID- 2700003 TI - Cancer of the colon: medicolegal considerations. PMID- 2700004 TI - Medical-legal analysis and considerations in product liability cases involving pharmaceutical companies. PMID- 2700005 TI - Defensive medicine--friend or foe? PMID- 2700006 TI - Peer review: the struggle goes on. PMID- 2700007 TI - Medicolegal and bioethical responsibilities in triage. PMID- 2700008 TI - Economic considerations in decisions to treat. PMID- 2700009 TI - Emerging opportunities for physician-attorneys in the purchaser-driven health care industry of the 1990s. AB - The litigation explosion of the past decade-and-a-half has provided physician attorneys with a seemingly endless source of opportunities for full- and part time employment. For this and other reasons, physician-attorneys in the late 1980s still devote a substantial part of their professional time to activities directly or indirectly related to medical litigation. Nevertheless, the winds of change are blowing and soon will reach hurricane force. The excesses of the medical and legal systems (best exemplified by the litigation explosion) have sown the seeds of their own ultimate destruction during the 1990s. As a result of the substantial provider glut, the purchasers of health care are now in charge. To the extent that purchasers determine that professional liability premiums, legal costs, and defensive medical practices increase their health benefit costs, they will redesign benefit programs to provide appropriate financial incentives to channel subscribers to both the high quality, cost-effective providers and alternative medical dispute resolution options other than litigation. As the percentage of lawyers' and law firms' revenues attributable to medical litigation diminishes, one of the first expenses to be cut will be that previously allocable to physician-attorneys for expert medicolegal review and case evaluation. Medical care value purchasing is rapidly becoming the centerpiece of the emerging purchaser-driven health care industry of the 1990s. This should give way to an unprecedented demand by purchasers and providers alike for medical care evaluation, health data analysis, and the implementation of systems to measure and monitor the quality and cost-effectiveness of health care delivery. Providers, especially physician-leaders, can and should play critically important roles in helping purchasers and themselves to evaluate and improve the overall quality and cost-effectiveness of health care services. It is this increasingly important area of expert endeavor in which physician-attorneys can and should find the majority of their long-term professional opportunities. However, to capitalize on this, physician-attorneys must effect a major redirection in their primary emphasis. Although they have a distinctive training advantage in the emerging quality-driven industry over that of physician-M.B.A.s, most physician attorneys have continued to use these skills in the reactionary world of litigation, which will rapidly go the way of the dinosaur in the 1990s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700010 TI - Anesthetic death investigation. PMID- 2700012 TI - Close-up medical photography: forensic considerations and techniques. PMID- 2700011 TI - The role of forensic scientists in the documentation of human rights abuses. PMID- 2700013 TI - ["On the Care of the Teeth" by Dr. Vojislav Isakovic]. AB - Dr. Vojislav Isakovic in the second edition of his booklet "On Taking Care of Teeth" has written the instructions for the population both on taking care of teeth and protecting them from diseases. The first and second edition of this booklet have been issued in Veliki Beckerek. According to the author, both editions and their contents have been written "in the hope that they will be useful for the honoured readers". In brief understandable points I tried to consider the question on taking care of teeth with the sacred goal in front of my eyes "To Help Painful Mankind". PMID- 2700014 TI - [Dr. Stefan Preradovic--physician and friend of Vuk S. Karadzic]. AB - Vuk S. Karadzic was in correspondence with Dr. Stefan Preradovic a physician from Sombor--about his transition to his place of work in Sombor. Letters written by this physician to Vuk pointed to his disagreement with the shrewd Duke Milos. Therefore, Dr. Preradovic spent his short lifetime in Budim and Sombor where he was professor as well. PMID- 2700015 TI - Hypopituitarism following a direct bullet injury to the pituitary. A case report. AB - A 29-year old man was referred for hypogonadism. At 14 years of age he was struck by a gun bullet in the head, receiving a frontomedial open fracture with leakage of cerebral tissue. The bullet could not be extracted at the operation. At 16 years of age he noticed a stop of pubertal development, weight gain and a fall in visus on the left eye. The clinical examination and the endocrinological data (low F-T4 and F-T3; low plasma cortisol and testosterone; normal plasma prolactin; sub-normal pituitary response to intravenous administration of insulin, GnRH, TRH and GRF) demonstrated that the patient was hypopituitaric. A radiological skull X-ray showed that the bullet was lodged in the sellar and parasellar region. This seems to be the seventh case of hypopituitarism following a direct injury to the pituitary region described in the literature so far. PMID- 2700016 TI - Evidence for a diffusional model of Alzheimer amyloid A4 (beta-amyloid) deposition during neuritic plaque formation. AB - A recent study reported that Alzheimer senile plaques immunostained with monoclonal antibodies against the A4 (beta-amyloid) region of the amyloid precursor protein show gradients of density (Majocha R. E., Benes F. M., Reifel R. L., Rodenrys A. M. and Marotta C. A., Proc. natn. Acad. Sci. U.S.A. 85, 6182 6186, 1988). Although more than one explanation was suggested for this observation, the possible involvement of a diffusional process during plaque maturation was considered. In order to examine this hypothesis, specimens from prefrontal cortex, entorhinal area and hippocampal formation were immunoprocessed in a similar fashion and subjected to quantitative microdensitometric analyses of A4 amyloid reaction product. All plaques in the three brain areas examined showed a curvilinear relationship between the area of amyloid reaction product (expressed in pixel counts) and optical density (expressed as each of six grey scale levels). There was an increase in the area of amyloid at progressively lower density levels. When the area of amyloid reaction product at each density level was correlated with the overall size of individual plaques, it was found that there was a striking increase in the correlation coefficients at progressively lower grey scale levels, with r = 0.853 at the lowest level examined. When a second order derivation of these correlations was performed by expressing individual r-values with respect to an optical density index, an asymptotic relationship resulted with the lowest density levels showing an increasingly sharp rise toward unity. These data are consistent overall with a model for plaque maturation that involves diffusion of amyloid protein through the extracellular space from focal regions of high density where synthesis and/or release may occur. PMID- 2700017 TI - [Poisoning caused by chronic exposure to volatile anesthetics. Molecular mechanisms and risk anesthetics]. AB - The possible molecular mechanisms potentially inducing occupational disease among operating room personnel were examined; and the really dangerous anaesthetic agents were identified. As concerns the molecular mechanisms of parenchymatous injury, we surveyed: those connected with free radicals and biological reactive intermediates produced during halothane and nitrous oxide biotransformation; those coming from inorganic fluoride produced during biotransformation of any halogenated anaesthetic agent, and from inorganic bromide released during halothane metabolism; and, finally, those linked to vitamin B12 inactivation from nitrous oxide. Halothane and nitrous oxide can be considered as really dangerous anaesthetic agents for operating room personnel, and enflurane as an agent with marginal toxic power. On the contrary, isoflurane is a safe, useful compound, totally devoided of viscerotoxic effects. From data examined it is possible to conclude that an isoflurane-oxygen-air anaesthesia is safe for operating room personnel more than a balanced anaesthesia with intravenous drugs and nitrous oxide as maintenance. PMID- 2700018 TI - Molecular biology and Pauling's immunochemistry: a neglected dimension. AB - This paper argues that there is a substantial overlap between the history of immunology and the history of molecular biology, an overlap manifested in the researches on antibodies during the 1930s and 1940s. This common ground is a product of intellectual developments, as well as institutional trends. Viewed from an intellectual vantage point of the 1930s and 1940s, molecular biology was essentially the study of the biological specificities of the so-called 'giant protein molecules'. Within the conceptual framework of early molecular biology, which was rooted in the protein view of life, the concepts of protein template, autocatalysis, and heterocatalysis were central in explaining the protein syntheses of genes, viruses, enzymes, hormones, and antibodies. Immunochemistry and serological genetics were at the heart of that research agenda. This paper also shows that the immunochemistry program of Linus Pauling, which focused on molecular mechanisms of antibody structure and function, and the projects in serological genetics at Caltech's biology division were supported by the Rockefeller Foundation under the aegis of its molecular biology program. Based on the close examination of intellectual and institutional factors, the histories of molecular biology and immunology in the pre-DNA era are seen as closely linked. PMID- 2700019 TI - The immune system: a key concept for the history of immunology. AB - The definition of immunology as the science of the immune system that emerged in the 1960s provides a sound basis for both reconstructing its past and constructing its future. The choice of this point in time of course involves important consequences, on the one hand, sociological and institutional, epistemological and conceptual on the other. I will attempt to demonstrate that this perspective allows us to assess the history of immunology in an innovative way while elucidating in the process some of its theoretical paradoxes. PMID- 2700020 TI - [The Anonymus Londinensis and medicine of South Italy]. AB - Can the five doctors from Southern Italy and Sicily, whose theories are described in the famous Anonymus Londinensis (P. Lond. 137), be said to have belonged to an actual 'school of medicine'? Although this article stops short of such a conclusion, it is indicated that, positioned on the fringe of the West's scientific world, they remained aloof from the new medicine, embodied by Hippocrates. PMID- 2700021 TI - Tallow and the time capsule: Claude Bernard's discovery of the pancreatic digestion of fat. AB - In 1848, Claude Bernard discovered that pancreatic secretion could emulsify and saponify fatty substances. He would eventually attribute these reactions to an enzyme that was later named 'pancreatic lipase'. This essay has three goals: 1) to examine Bernard's previously overlooked research on the pancreas; 2) to explore the equally ignored history of lipid digestion and metabolism; 3) to reconstruct Bernard's discovery of pancreatic lipase through a parallel analysis of his laboratory notebooks and his publications. This method reveals a discrepancy between the sequence and motivation of events as they were reported by Bernard in his publications and as they appear in his laboratory notebooks. PMID- 2700022 TI - [Auguste Bohner's death. Chronicle of a medical scandal, its background and its historical significance]. AB - When the 15-year-old Auguste Bohmer, daughter of Caroline Schlegel and stepdaughter of August Wilhelm Schlegel, died on 12th July 1800, Friedrich Wilhelm Joseph Schelling was accused of being responsible for this tragic event, because he tried to treat her according to the medical system of John Brown. The ensuing scandal became a symbol for the danger of every progressive movement of that time: the Romantic literature, the natural philosophy of Schelling and Brownianism in its German version, represented by Andreas Roschlaub. An attempt is made to analyse the social and political background of the scandal and to argue the historical meaning as a fight against a fundamental reform of medicine. PMID- 2700023 TI - Rheumatoid arthritis: diagnostic imaging. PMID- 2700024 TI - Connective tissue diseases: classification, clinical features and diagnostic imaging. PMID- 2700025 TI - Imaging of septic arthritis. PMID- 2700026 TI - Recent trends in the pathophysiology of osteoarthritis. PMID- 2700027 TI - Degenerative disease of the vertebral column: correlation between radiological and biochemical findings. PMID- 2700028 TI - Diffuse idiopathic skeletal hyperostosis. PMID- 2700029 TI - Reflex sympathetic dystrophy syndrome. PMID- 2700030 TI - Arthrography in rheumatic diseases. PMID- 2700031 TI - [The aging process of the nervous system]. PMID- 2700032 TI - [Progress in permanent cardiac electrostimulation]. PMID- 2700033 TI - [Right ventricular infarct--a rarely diagnosed site]. AB - RVI is usually associated to a left ventricular (postero-inferior) myocardial infarction. Its occurrence as an isolated entity is extremely infrequent. Clinical signs suggesting the diagnosis are: predominance of right ventricular failure, Kussmaul's sign and rupture of the interventricular septum. The most sensitive diagnostic method is 2D-ECHO (51% sensitivity), followed by nuclear angiocardiography (37%) and right heart catheterization (26%). Electrocardiographic evidence of RVI is obtained only by routine recording of right precordial leads in patients with transmural postero-inferior left ventricular infarctions. Specific therapeutic measures include use of plasma expanders in order to achieve an increase of cardiac output. Agents that augment left ventricular emptying, as sodium nitroprusside dopamine or dobutamine are useful in cases with coexisting left ventricular disfunction. Avoidance of diuretics administration, in spite of evidence of right ventricular failure is essential to the preservation of a normal cardiac output. PMID- 2700034 TI - [Standardized scale instruments for evaluating the relational meanings of motivation, pathogenesis and care in alcoholism]. AB - The authors give synthesis of five scale methods for alcoholism (Alcoholism Severity Scale, Mac Andrew Scale, Bell Alcoholism Scale of Adjustment, Manson Evaluation and Iowa Alcoholic Intake Schedule), four scale means of the type of Psychological tests (Alcadd Test, Michigan Alcoholism Screening Test, Mortimer Filkins Test and Essential Reactive Alcoholism Dimension) and three procedures of the type of personality inventory and questionnaire (Drinking Behaviour Interview, Alcoholism Assessment Interview and Alcoholism Use Questionnaire) tools that were at the basis of the construction of a "Scale of Estimating Medical Implications in Alcoholism" conceived experimented and validated in the psychiatric clinic of Iasi. PMID- 2700035 TI - [Clinical observations of treatment with Lyorodin-depot (Jenapharm)]. AB - According to the indications of fluphenazin decanoate in the long-term treatment in schizophrenia the authors analyse the findings of a simple blind study of Lyorodin-depot on a sample of 20 inpatients. The drug was administered at intervals of 21 days for 18 weeks under clinical surveillance. The method consisted of patients' follow-up on an itemized card, psychological checkups and para-clinical investigations. The analysis of clinical findings reveals the amelioration of symptoms at the parameters accounted for, the favourable evolution low incidence of the side effects that confirms its clinical efficiency and tolerance. PMID- 2700037 TI - [The medical world from a century ago]. PMID- 2700036 TI - [Historiographic aspects of the development of psychiatric care in Tirgu-Mures]. AB - Based on certain data collected from archives and publications, the authors show the evolution of psychic patients' care delivery in Tirgu-Mures, underlying the beginnings of charity care of the institutions operated during the 13th, 14th and 17th centuries. Social advance and the action of a progressive thinking have prepared the way to a modern medical stand which gradually witnessed the separation of psychiatry into the modern clinic of psychiatry. Along the sequences of this evolution the authors review medical and scientific personalities up to the present-day organization and activity of the clinic of psychiatry with its programme of didactic, research and care activities. PMID- 2700038 TI - [The prevention of mental discomfort in gnathoprosthetic treatment]. AB - The investigation of a series of patients following a treatment at the Clinic of Gnathoprosthetics of Iasi made possible an evaluation of their general emotional state in relation with their dental problems. According to the obtained results, the emotional discomfort induced by the numerous specific and unspecific gnathoprosthetic factors was avoided by means proper to each category of patients. PMID- 2700040 TI - [Imperatives and possibilities in informatics of the therapeutic decision in oncology. I]. PMID- 2700039 TI - [General research modalities with traditional remedies of plant origin with a view to their introduction into pharmacotherapy]. AB - The literature had suggested some schemes of tests and procedures to be employed in the scientific investigations and pharmaceutical evaluation of the traditional plant remedies. The present paper is intended to be a critical review. PMID- 2700041 TI - Contact dermatitis to the sap of fig-tree. PMID- 2700042 TI - [Leiomyosarcoma of the small intestine]. AB - The authors present a case of leiomyosarcoma, a particular type of small intestine tumor. A review of the literature is also made. PMID- 2700043 TI - Idiopathic spontaneous pneumothorax. Present knowledge and recommendation for treatment. PMID- 2700044 TI - [Transcranial Doppler exploration of the brain stem vascularization in neurological pathology]. AB - The hemodynamic alterations in the vertebrobasilar system arteries of 1051 patients are discussed. The aspects revealed by transcranial Doppler are classified as obstructions, stenoses and atherosclerotic type lesions. Their prevalence compared with the clinical diagnosis or through other investigation methods is commented upon, an etiological classification of such alterations in hemodynamics in the basilar and vertebral arteries being attempted. Multiple defect theory seems to be, in such cases as well, the clinical expression accounting for the pathogenic phenomena and response to drug tests. PMID- 2700045 TI - [Criteriological evolution in psychopathology]. AB - Any theoretical direction in psychiatry takes into account a definition of the illness, and of the state of health and their limits, as well as the relationships between these two different states in their psychobehavioral expressiveness and within the relational system of personality. The states which are taken as deviations from what is generally considered and accepted as normal state, have always been identified and form the so-called major mental pathology, but one cannot ascertain the same thing about the so-called borderline states, and the representation of normality. It is also true that within the two international systems of classification, WHO and DSM-III one can find the difficulty and even the hesitation of using the term "mental illnesses" instead to use "mental disorders". These are the reasons that made the author consider useful the illustration of the diagnostic criterion through the classification of the concepts on mental illness--an evolution illustrated by the contribution of syndrome concepts, i.e. an anatomoclinical state according to the evolution of the symptoms, psychopathological criteria and generally the dimensional and categorical criteria. Thus, the criteriological investigation remains a theoretical actual approach and at the same time applicable for the psychiatric care. PMID- 2700046 TI - [The effect of captopril on the coronary circulation in a clinical and experimental study]. AB - Taking into account the well-known angiotensin II-induced coronary constriction, in a first series of experiments the effects of captopril were studied upon the rabbit, guinea pig and rat coronary circulation during perfusion with oxygenated Krebs-Henseleit solution at 37 degrees C under constant pressure and variable flow according to the Langendorf technique. The inhibition of angiotensin I to angiotensin II conversion enzyme with captopril (5-500 microgr./ml) resulted in a coronary dose dependent dilation as a consequence of a reduction in the basal coronary tonus. Testing the coronary distensibility by using pressure and flow variations revealed a significantly increased distensibility when the conversion enzyme was specifically blocked with captopril. The anginal threshold of the atrial electrostimulation was increased after captopril (25-50 mg i.v.) in 15 out of 18 patients with coronary insufficiency by a mean value of 17%, white the systolic dynamics was significantly better. The obtained results bring new arguments in favour of the intrinsic renin-angiotensin system participation in maintaining the basal vascular tonus and of the increased coronary distensibility in the presence of captopril as an inhibitor of the local synthesis of the vasoconstrictor angiotensin II. PMID- 2700047 TI - [Current developments in sarcoidosis: the macrophage]. PMID- 2700049 TI - [The history of medicine in Iasi. The personality of Prof. Vladimir Butureanu]. PMID- 2700048 TI - ["Biloma": its diagnosis and treatment by percutaneous echo-guided evacuation]. AB - The term "biloma" describes an intra-abdominal bile collection secondary to traumatic or iatrogenic injury of the biliary tree. We present a case of biloma treated by guided percutaneous needle aspiration. PMID- 2700050 TI - [Tuberculous infection and cancer]. PMID- 2700051 TI - Hemorrhage into fibrous dysplasia following minor head injury--effective decompression for the ophthalmic artery and optic nerve. AB - We performed an effective optic canal decompression in a patient with ethmoid and sphenoid fibrous dysplasia and visual impairment following minor head trauma. On admission, the patient's left visual acuity consisted only of light perception, and the left ophthalmic artery was not visible by angiography. A hematoma and fibrous dysplasia tissue in the sphenoid sinus were excised and the left optic canal was decompressed. The vision was markedly improved to an ability to count fingers in the following 2 weeks. The left ophthalmic artery was fully opacified in the postoperative angiogram. PMID- 2700052 TI - The proliferative activity of neurilemomas. AB - Twenty-one patients with neurilemomas (15 intracranial and 6 intraspinal) received a 1-hour intravenous infusion of 5-bromodeoxyuridine (BrdU), 200 mg/m2 before tumor removal, to label S-phase tumor cells. Excised tumor specimens were stained by the indirect immunoperoxidase method with anti-BrdU monoclonal antibodies to determine the BrdU labeling index, or percentage of S-phase cells. The BrdU labeling index ranged from 0.1% to 3.1% (mean, 0.9%). The BrdU labeling index was greater than 1.5% in four of the 21 tumors (three trigeminal and one spinal). One acoustic tumor in a patient with neurofibromatosis type 1 had a labeling index of 1.3%, which was the highest among the acoustic tumors. The BrdU labeling indices did not correlate with the patient's age, tumor size, or the duration of signs and symptoms. There was no significant difference between the BrdU labeling indices of Antoni type A and Antoni type B tissue. The low BrdU labeling index of most of the intracranial neurilemomas coincides well with the slow growth of these tumors. As the BrdU labeling index may reflect growth potential of individual tumors, it could be used to guide the follow-up patients with incompletely resected tumor. PMID- 2700053 TI - Chemical meningitis in ruptured intracranial dermoid. Case report and review of the literature. PMID- 2700054 TI - Chronic epidural hematoma--report on eight cases and review of the literature. AB - The authors report eight cases of chronic epidural hematoma, classified according to macroscopical operative findings and histological studies of the hematomas. Clinical, radiological, and pathological findings are described. A review of 63 cases of the literature is presented, and the accepted concepts for classification and management of these lesions are discussed. PMID- 2700055 TI - Lymphocytic adenohypophysitis: report of two cases. AB - Two women with lymphocytic adenohypophysitis not related to pregnancy are reported on. In obtaining a differential diagnosis of lymphocytic adenohypophysitis preoperatively, it is useful to note swelling of the anterior hypophyseal tissue and the existence of a posterior pituitary lobe on sagittal sections of magnetic resonance imaging scans. Hypofunction of the anterior hypophyseal gland is more severe in lymphocytic adenohypophysitis than in pituitary adenomas. Marked adhesion of fibrotic pituitary capsule to the dura is a characteristic observation during surgery for lymphocytic adenohypophysitis. PMID- 2700056 TI - Photopheresis: a new therapeutic concept. AB - Photopheresis, the process by which peripheral blood is exposed in an extracorporeal flow system to photoactivated 8-methoxypsoralen (8-MOP), is a new treatment for disorders caused by aberrant T lymphocytes. It is now a standard therapy for advanced cutaneous T-cell lymphoma and shows promise in the treatment of two autoimmune disorders, pemphigus vulgaris and progressive systemic sclerosis (scleroderma). Additional diseases for which clinical trials are in progress include multiple sclerosis, organ transplant rejection, rheumatoid arthritis, and AIDS. The mechanism of action appears to involve a "vaccination" against the pathogenic T cells, in a clone-specific manner. Photoactivated 8-MOP initiates a cascade of immunologic events by forming covalent photoadducts with nuclear and cell surface-adherent DNA and possibly with other cellular molecules. For reasons not yet fully clarified, but probably related to enhanced cycling of the T-cell receptor for antigen, photopheresis increases the immunogenicity of the irradiated T cells so that their reinfusion induces a therapeutically significant immunologic reaction that targets unirradiated T cells of the pathogenic clone(s). The specificity of the induced immunologic reaction probably results from the extremely disproportionate expansion of the pathogenic clone(s), relative to the several million other clones of normal T cells. PMID- 2700057 TI - Molecular aspects of extracorporeal photochemotherapy. AB - 8-methoxypsoralen (8-MOP), activated upon exposure to long-wavelength ultraviolet radiation, is used therapeutically to treat the diseased blood cells of cutaneous T-cell lymphoma patients. The factors responsible for the efficacy of this therapy are reviewed. Primary among these are the plasma level of 8-MOP at the time of irradiation and the effective dose of UVA. 8-MOP plasma levels determined in a series of six patients demonstrated that the drug is absorbed at a highly variable rate (122 ng/ml +/- 67). A new liquid form of 8-MOP is absorbed with a modest increase in plasma levels (170 ng/ml) but with no improvement in the variability (+/- 163). An examination of the dose-response relationship between 8 MOP concentration and UVA dose indicated that properties such as 8-MOP photoadduct formation and PHA response are proportional to the combined doses of these two factors. A new molecular target for 8-MOP photomodification, cell membrane DNA, is described. PMID- 2700058 TI - Experimental murine and primate models for dissection of the immunosuppressive potential of photochemotherapy in autoimmune disease and transplantation. AB - This paper reviews the results achieved in murine and primate models of autoimmune disease and transplantation. These studies have attempted to clarify the nature and specificity of the response induced by reinfusion of phototreated immunoactive lymphocytes. Results obtained in murine lupus have demonstrated that some of the disease features related to the abnormal proliferation of inducer T cells can be inhibited both prophylactically and therapeutically by exposure to photoinactivated autoimmune splenocytes. Radiolabeling studies performed in normal syngeneic mice have shown that, if immunoactive cells are phototreated and injected, their recirculation pattern is altered, and increased sequestration in the spleen, bone marrow, and kidney is noted. These studies suggest that reinfused, phototreated, antigen-activated lymphocytes may localize in sites where they are available for induction of immune responses. Primate cardiac xenotransplantation models have demonstrated that reinfusion of phototreated autologous leukocytes, administered with cyclosporine A and steroids, mediates enhanced specific suppression of both the cellular and humoral host response to foreign tissue. Taken as a whole, the experimental models suggest that photopheresis may provide a means of inducing specific suppression of immunoactive T cells. This form of therapy may have a role as an immunosuppressive agent in both autoimmune disease and transplantation. PMID- 2700059 TI - The future of intrauterine contraception. PMID- 2700060 TI - Techniques of sperm selection, improvement and separation in an in vitro fertilization program. AB - The Authors present a review of the various techniques used for improving the fertility potential of sperm within the context of an in vitro fertilization (IVF) program. After a brief description of the mechanisms leading to normal in vivo fertilization, they discuss the different methods of selecting and improving sperm for IVF. They conclude that centrifugation on discontinuous Percoll gradients would seem to be the most efficient separation method from all points of view, while the addition of pharmacological agents to improve sperm quality and motility lead to extremely unsatisfactory results. PMID- 2700061 TI - Infertility in advanced reproductive age. Results of in vitro fertilization and embryo transfer according to the woman's age. AB - The Authors discuss the phenomenon of the gradual decline of a woman's fecundability with the passing of time and particularly the potential causes of infertility in advanced reproductive age and the most efficient therapeutic management. They conclude that more advanced aided conception techniques such as IVF/ET, GIFT, ZIFT and IPI should be preferred to surgery for women over a certain age, especially where the infertility problem is of more than five years standing, and discuss the effect of the subject's age on the various stimulation techniques available. The Authors then report their experience with IVF/ET in 806 induction cycles using five different stimulation protocols at the Foundation for Studies on Human Reproduction in Palermo. PMID- 2700062 TI - Polycystic ovary syndrome: obesity, insulin resistance, hyperandrogenism. AB - The authors submitted 24 patients affected by polycystic ovary syndrome to an oral glucose tolerance test (OGTT) and determined glucose, insulin and C Peptide levels. Patients were divided in four groups according to the degree of obesity and androgenic blood levels. Eight non hirsute women with normal ovulatory function, matched for height and weight, served as controls. The authors pointed out that insulin levels were greater in the obese and hyperandrogenic PCO women than in only the obese PCO women or only the hyperandrogenic PCO women. Obese patients with PCO had higher insulin levels than obese control group. Patients with PCO nonobese and nonhyperandrogenic had higher insulin levels than nonobese control group. Insulin levels did not differ in obese PCO and hyperandrogenic PCO women. These findings suggest that at least a component of insulin resistance which is found in PCO women is independent from body weight. PMID- 2700063 TI - [Etiopathogenesis and biodynamics of closed laryngo-tracheal injuries]. AB - The blunt laryngotracheal trauma, once quite a rare phenomenon, has become quite relevant today, particularly because of the great increase in automotive traffic. It was, therefore, felt knowledge of the etiopathogenesis and biodynamics of this form of trauma is important for proper diagnosis and treatment. After having noted that the literature in this regard is generally incomplete and fragmentary, the authors felt it worth compiling the various etiopathogenesis and biodynamic factors involved; characteristics of blunt laryngotracheal trauma. Three basic elements of this form of trauma were studied. These are: trauma subject, trauma forces and impact plane. The biodynamic mechanisms responsible for the damage caused to the laryngotracheal skeleton and its soft parts have been analyzed. Finally, a case study was made including 99 cases drawn from international literature and 23 cases which had come under observation by the authors. The purpose of this analysis was to determine the frequency of various etiologies in relation to trauma type and site. The difficulties involved in drawing these simple data from the literature is underlined. This stems from the fact that often the various authors report overall data failing to give the etiology and site of individual cases. Traffic accidents have proved to be the cause of 80% of all such traumas and 90% of those with fracture, dislocation or separation of the laryngotracheal skeleton. The most serious lesions are to be seen in cases of frontal trauma. In the elastic cartilage of young people, the elastic snapback is of particular significance in the genesis of damage to the soft tissues. The most frequently encountered lesion is fracture of the thyroid cartilage alone while fracture of the cricoid alone is quite unusual. Fractures or detachment within the cricoid-tracheal area is quite common. In 85% of the cases cricoid cartilage involvement is associated with that of the tracheal cartilage. The authors assert that, due to a question of resistance, cricoid fracture traumas almost always involve the trachea while thyroid cartilage fractures act as a relief, letting off and absorbing the forces, thus preventing cricoid involvement. On the basis of these considerations the authors feel it fitting to classify the blunt laryngotracheal traumas into three groups according to topography: supraglottic laryngeal trauma with or without involvement of the glottis; subglottic laryngeal trauma, generally associated with the trachea and only rarely involving the glottic region; isolated trauma of the cervical trachea. PMID- 2700064 TI - [Serratia marcescens infections in a hospital: typing of isolated strains]. AB - Ninety six strains of Serratia marcescens were isolated from one hospital. Strains originated from various sources: pressure transducer head (14), arterial catheter tip (4), blood (33), sputum (12), bronchial aspirate (10), urine (10), wound (8), miscellaneous (5). Most of the blood strains were isolated on the intensive care unit (ICU). Contaminated pressure transducer heads seemed to be involved in a nosocomial epidemic. All strains were characterized by serotyping, antibiotic resistance pattern, plasmid profile typing and biotyping. It was demonstrated that the epidemic strain was of serotype O14H4, biotype A5, carrying one plasmid coding for the resistance against gentamicin, streptomycin and sulfamethoxazole. The epidemic type was encountered with the majority of blood isolates (26/33) and with all the transducer head isolates from the ICU (11/11). Isolates from catheter tips (2/4), bronchial aspirate (3/10) and urine (1/10) belonged also to the epidemic type. Within the non-epidemic strains, the most prevalent serotypes were O14H12 (39%) and O14H4 (36%), corresponding well with the distribution of serotypes from a national survey study: O14H12 (36%), O14H4 (24%). Two biotypes were predominant within the non-epidemic strains: A5 (46%) and A8b (32%). Plasmid carriage was observed with 46% of the non-epidemic strains. A plasmid, similar to the epidemic plasmid, was detected in 7 strains, differentiating from the epidemic strain by the serotype and/or the biotype. PMID- 2700065 TI - [Patient-oriented package inserts for drugs. Historical overview and current status]. AB - After a short note on terminology, in this review article a survey is given of former and existing initiatives concerning the Patient Package Insert (PPI) in the USA and in Western Europe, with emphasis on the situation in Belgium. Arguments in favour of and against the PPIs are given, based upon the literature. The need for drug information for the general public is illustrated by a number of studies. Content and presentation of the PPI as a source of drug information are discussed. Studies on the impact of PPIs on satisfaction, knowledge, compliance, adverse drug reactions emotions, risk/benefit-decisions etc. are reviewed. Finally, attention is drawn to remaining problems and to the needs for further research. PMID- 2700066 TI - Effects of phenobarbital on hepatic glucose metabolism and NADPH production in Zucker rats. AB - The effect of phenobarbital, a known inducer of drug-metabolizing enzymes, on hepatic glucose-metabolizing and NADPH-producing enzymes was evaluated in obese and lean female Zucker rats. Plasma glucose was slightly reduced and plasma insulin increased after one week of phenobarbital therapy. The induction clearly increased the activities of liver glucokinase in lean but not in obese animals. Hepatic glucose-6-phosphate phosphohydrolase activity, on the other hand, was reduced after phenobarbital, especially in obese rats. Thus phenobarbital affected the activities of hepatic enzymes modulating the intermediary metabolism in several ways: liver glucose phosphorylation was increased and glucose output reduced after enzyme induction in lean and obese Zucker rats, respectively. Phenobarbital also increased the activities of glucose-6-phosphate dehydrogenase and malic enzyme in lean animals indicating an increased NADPH generation. PMID- 2700067 TI - Implications of an intracorporeal glucose sensor in the management of diabetic patients. AB - Long-term hyperglycemia is the main cause of diabetic late complications (angiopathy, neuropathy). The problem of lifelong management of diabetes is to guarantee near-normal glycemia. Since the introduction of self-monitoring of blood glucose by means of extracorporeal devices on the basis of strips, an important improvement of metabolic management of diabetic patients has become possible. In order to further improve the control of glycemia, the following steps of an evolving system of electrochemical glucose sensing and monitoring should be envisaged: (1) fast-acting extracorporeal glucometers for incidental analyses, (2) intracorporeal sensors for short-term but easily repeated use to follow any kind of open-loop insulin therapy and to provide appropriate hypoglycemia-warning signals, (3) intracorporeal sensors as an essential part of automated feedback-controlled systems for insulin delivery. Approximately 4000 patients per million of the population might benefit from the latter version of intracorporeal glucose sensors. In closed-loop blood glucose control, however, pathophysiological problems may arise from the sole application of negative feedback control in the glucose-insulin algorithm. PMID- 2700068 TI - Strategies for calibrating a subcutaneous glucose sensor. AB - The calibration of the glucose sensor is a critical issue for the subcutaneous implantation of such devices, since it allows from the sensor output the estimation of the prevailing subcutaneous glucose concentration. This study has compared estimations of subcutaneous glucose concentration in rats, calculated from the sensor's signal by using calibration parameters (sensitivity coefficient and background current) determined either under in vitro or in vivo conditions. The in vitro calibration was performed in phosphate buffer at 37 degrees C. The in vivo parameters were calculated by comparing changes in the sensor output current to concomitant changes in blood glucose concentration, induced by intravenous insulin injection and glucose infusion. The apparent subcutaneous glucose concentration, calculated with in vitro parameters, remained much lower than the concomitant blood glucose levels throughout the experiments. By contrast, when it was calculated with the calibration parameters determined in vivo, either in the hypoglycemia or hyperglycemia range, the apparent subcutaneous glucose concentration well reflected blood glucose levels with a five min time lag. We conclude that it is the two-point in vivo calibration procedure which allows the calculation of an apparent subcutaneous glucose concentration best reflecting blood glucose levels. PMID- 2700069 TI - Interaction between phage G13 and its oligosaccharide receptor studied by equilibrium dialysis. AB - The reversible binding of phage G13, a phi X174-like single-strand DNA phage, to a 3H-labelled nonasaccharide from the lipopolysaccharide of its natural host Escherichia coli C was studied with equilibrium dialysis. The binding constant (Ka) was determined to 1.3 x 10(7) M-1 in Scatchard and Lineweaver-Burk plots. Approximately one saccharide bound per G13 phage particle which suggests that only one of the 12 spikes in each G13 virion was engaged in the phage/receptor saccharide interaction. Equilibrium dialysis inhibition experiments with saccharides from lipopolysaccharides of an isogenic series of Salmonella typhimurium mutants showed that hepta- and pentasaccharides from two G13 sensitive bacteria, i.e., with efficiencies of plating of 0.1-1.0 compared to E. coli C, were efficient inhibitors with Ka-values greater than or equal to 1.2 x 10(7) M-1. The octa- and hexasaccharides from two G13 resistant strains, with efficiency of plating less than or equal to x 10(-4), were either greater than 1000-fold or greater than 15-fold less efficient as inhibitors with Ka-values less than or equal to 8.8 x 10(5) M-1. The results show that phage G13 binds in a specific and reversible way to penta-, hepta-, and nonasaccharides from G13 sensitive bacteria with the specificity residing in the hexose and heptose region of the core lipopolysaccharide. PMID- 2700070 TI - The conformation of core oligosaccharides from Escherichia coli and Salmonella typhimurium lipopolysaccharides as predicted by semi-empirical calculations. AB - The preferred conformation of the hexose and heptose regions of core saccharides from Enterobacteriaceae lipopolysaccharides was calculated. The Hard Sphere Exo Anomeric (HSEA) approach was used and the minimum energy conformation of the Salmonella typhimurium and Escherichia coli R1, R2, R3, R4 and K12 cores calculated. The results indicate that most of the cores are sterically crowded, with small degrees of freedom, and that the hexose and heptose parts form two separate regions. The core structures exhibit a 'front'-side and a 'back'-side, the former being similar for all the structures and the latter being characteristic for each core type. PMID- 2700071 TI - Definition of the phage G13 receptor as structural domains of trisaccharides in Salmonella and Escherichia coli core oligosaccharides. AB - The interaction between phage G13 and different bacterial and synthetic oligosaccharides has been studied using equilibrium dialysis inhibition. The results, and conformational analysis of the oligosaccharides, make us conclude that the phage G13 carbohydrate receptor is a conformational domain involving three sugar residues. The following trisaccharide elements contain the domain: alpha-D-Galp-(1----3)-[alpha-D-Galp-(1----6)]-alpha-D-Glcp, alpha-D-Manp-(1----3) [alpha-D-Manp-(1----6)-alpha-D-Manp , and alpha-D-Glcp-(1----3)-[L-gly-alpha-D man-Hepp-(1----7)]-L-gly-alph a-D- man-Hepp. Thus two structures, either a hexose substituted with alpha-D-glycopyranosyl groups in the 3- and 6-positions, or a heptose substituted with such groups in the 3- and 7-positions are functional G13 binding sites. Such domains are present in several cores of lipopolysaccharides from Salmonella and Escherichia coli species. Some cores, e.g. those from S. typhimurium chemotypes Ra, Rb1 and Rb2, contain two such domains. The identification of two G13 receptor domains within different core saccharides could explain the broad host range of this phage. PMID- 2700072 TI - [Association of anatomists]. PMID- 2700073 TI - [Placental passage of macromolecules: transport pathway and mode]. AB - In vivo and in vitro data have recently shown that macromolecules cross the hemochorial placenta. This feature contrats with the size selectivity of the sheep placenta which exclude molecules of 0.45 nm radius. Macromolecules moves by diffusion or endocytosis. In addition to size selectivity, the electrical charges of the macromolecules might be involved in placental transfer. The main resistance to placental transfer lie in the trophoblastic layer and the pathways of specific or unspecific transcytosis are not elicited. Membrane or fluid phase markers (peroxydases), carrier molecules (LDL, transferrin...), hormones and growth factors (insuline, EGF) are internalized by endocytosis into the trophoblast and further degraded or recycled. Immunoglobulins G, which are protected from degradation, reach the fetal circulation. The endothelial layer looks less selective and permits passage either by interendothelial diffusion or transcytosis. PMID- 2700074 TI - [Update on lymphatic resorption of cerebrospinal fluid after review of the literature]. AB - The intention of this article is to review and to comment some of the historic and recent informations regarding the lymphatic drainage of brain and cerebrospinal fluid, and to try to specify the different pathways of this drainage. PMID- 2700075 TI - [Application of new methods to the anatomical study of the human and animal placenta]. PMID- 2700076 TI - [Experimental methodology on pharmacological studies on crude drugs]. AB - Properties of crude drugs are different from those of a pure synthetic compound which is prepared as a candidate for a newly developed drug in that; crude drugs are composed of innumerable ingredients and have at least some therapeutic efficacies. Accordingly, a pharmacological study of crude drugs resembles studying of a sample such as a complex combined preparation and a lot of problems upon pharmacological examination arises from properties inherent in crude drugs. In this review, these problems are discussed, being based on pharmacological studies which have been performed in several crude drugs. PMID- 2700077 TI - [Studies on chemical analysis of mycotoxin (XX). Chemical analysis of aflatoxins in corn and corn-products]. AB - The investigation was carried out to analyze aflatoxins contaminated corn. 1) Methanol, chloroform and acetonitrile were used as the extraction solvents for aflatoxins added to corn. As the result, the method using acetonitrile was found to be effective to extract and detect aflatoxins. 2) The Rapid detection of aflatoxins was made possible by using the affinity column (containing monoclonal antibodies against aflatoxins bound onto agarose) and the mini-column. The detection-limit was 20 ppb of aflatoxins in samples. PMID- 2700078 TI - [Studies on the quality of enzyme preparations (IX)--kallidinogenase preparations]. AB - Kallidinogenase preparations were investigated with a view of comparing their quality by the enzymological method. These studies were carried out on 13 types of preparations (tablet: 7 kinds, capsule: 3 kinds, ampoule: 3 kinds) of commercially available kalliginogenase preparations. The kinin-liberating activity per one international unit (IU) of kallidinogenase was approximately 400 ng bradykinin/min/IU. The contents of other enzymes, i.e., kininase, trypsin and protease, were determined as the impurities. Kininase, trypsin and protease activities in the preparations for injection were very low. However, one preparation for internal use contained large amounts of these enzyme as impurities. It was presumed that contamination with large amounts of kininase, trypsin and protease have an adverse influence upon the assay and stability and efficacy of these preparations. PMID- 2700079 TI - [Mutagenicity of steviol: an analytical approach using the Southern blotting system]. AB - Steviol is the aglycone of stevioside, which is a non-caloric sugar substitute commonly used in Japan. Our previous studies and Pezzuto et al. have demonstrated that steviol is mutagenic after metabolic activation in the forward mutation assay using Salmonella typhimurium TM677 (TM677), whereas it is non-mutagenic in the reverse mutation assay (Ames test) using S. typhimurium TA 100, TA98, TA102 and TA97. There is the possibility, therefore, that activated steviol selectively induces a deletion or insertion of more than one base pair which cannot be detected by strains commonly used in the Ames test. In this study, we confirmed first that the 8-azaguanine (8-AG) resistance of the TM677 mutants appears to reside in the chromosomal gpt gene, since it can be complemented by the gpt gene of E. coli (Ecogpt). The chromosomal DNA of TM677 and TM677 mutants were digested by several restriction enzymes: BamHI, Sau3AI, AluI, TaqI, HaeIII, HpaII and RsaI, and analyzed by the Southern blot hybridization technique with a probe to the gpt gene DNA of E. coli. No significant differences in DNA fragment length, however, were formed between the wild type and spontaneous or steviol-induced mutants. PMID- 2700080 TI - [Report of 2 cases with sarcoid pericardiac effusion]. AB - Two cases of sarcoidosis with pericardial effusion were reported. They had the typical presentation of sarcoidosis with bilateral hilar and mediastinal lymph node enlargement, reticular pattern in chest X-ray examination and increase of SACE. Biopsy of the scalene lymph nodes confirmed the diagnosis of sarcoidosis and Kveim test was also positive in one subject. The unusual manifestation was their pericardiac effusion confirmed by x-ray and UCG examination. The amount of pericardial effusion remarkably decreased after treatment with oral steroids. In this paper we reviewed the literatures and discussed the clinical features, diagnostic procedures, pathologic changes, treatment and prognosis of sarcoidosis complicated with pericardial effusion. PMID- 2700081 TI - [Proteases, their inhibitors and lung diseases]. PMID- 2700082 TI - [Classification and mechanisms of cell death]. PMID- 2700083 TI - Further studies on the cytoskeleton of resident, stimulated and activated macrophages. AB - The three-dimensional organization of the cytoskeleton of resident, thioglycolate elicited and activated macrophages was studied by indirect immunofluorescence microscopy and by transmission electron microscopy of platinum-carbon replicas of Triton X-100 extracted cells and whole extracted cells critical point dried. Examination of the replicas showed with great clarity the organization of cytoplasmic filaments and microtubules. Cytoskeletal preparations revealed filamentous structures around the centrioles, and dense granules dispersed within the lattice of filaments of activated macrophages. X-ray microanalysis showed that they concentrate osmium. Indirect immunofluorescence microscopy revealed filamentous and/or dispersed tubulin, actin, vimentin and myosin-containing structures in the cytoplasm of the macrophages. PMID- 2700084 TI - Immunocytochemical localization of serotonin in the pineal gland. AB - The localization of serotonin (5HT) in the rat pineal gland during daylight conditions was investigated by light and electron microscopy using a polyclonal antibody to 5HT and the immunocytochemical method of peroxidase-antiperoxidase (PAP). Thin varicose 5HT fibers were found distributed in the gland at light microscopy level. Ultrastructural observations revealed the presence of terminal endings containing 5HT and localized mainly in the perivascular spaces, labeled with dense diaminobenzidine (DAB) deposits. PMID- 2700085 TI - [Changes in the pool of polyamines [correction of polyvitamins] during transition from anaerobic to aerobic conditions and localization of enzymes for their synthesis in Escherichia coli cells]. AB - The content of intra- and extracellular polyamines and the activity of enzymes mediating their synthesis change depending on the regime of cell aeration. The pool of putrescine rises abruptly upon the transition from anaerobic to aerobic conditions owing to its liberation from the bound state as well as due to an increase in the activity of ornithine decarboxylase; as a result, the structural functional organisation of membranes is restored. The free pool of cadaverine appears because, presumably, its binding to membranes is upset and the activity of lysine decarboxylase rises. The localisation of the enzymes for polyamine synthesis in the cell seems to be determined by the specific action of their products on particular cellular structures and metabolic processes in Escherichia coli cells. PMID- 2700086 TI - [Thrombolytic activity of Bacillus mesentericus at different conditions of nitrogen nutrition of a culture]. AB - The work is concerned with studying the effect exerted by different sources of nitrogen nutrition on the biosynthesis of proteinases with a thrombolytic activity by a variant of Bacillus mesentericus, strain 64, obtained with the aid of analytical selection. Protein substrates taken as a nitrogen source stimulate the synthesis of proteinases by the bacterial culture. These enzymes have a high caseinolytic and thrombolytic activity, and the level of their activity correlates with the amount of a protein substrate added to the medium. Ammonium acetate and succinate are the best stimulants for the formation of proteinases when the salts of mineral and organic acids are used as a source of nitrogen nutrition. In that case, the enzymes have a high thrombolytic activity and a low caseinolytic activity. A semi-synthetic medium with the aforementioned nitrogen containing compounds as a source of nitrogen nutrition is proposed for the synthesis of thrombolytic proteinase by the variant of B. mesentericus. PMID- 2700087 TI - [Relation between the damaging effect of surface-active compounds on Escherichia coli cells and the phase of culture growth]. AB - The techniques of cell electrophoresis and electro-orientation spectroscopy were used to study the effect of sodium dodecyl sulfate (SDS) and cetyl trimethyl ammonium bromide (CTAB) on Escherichia coli K-12 cells from the culture at the exponential and stationary growth phases. SDS (2 x 10(-4) M) considerably damaged cells at the exponential phase, particularly at pH less than 6.0, whereas cells at the stationary phase were damaged to a less degree and only at pH less than 5.3 or after their treatment with Trilon B. The damaging effect of SDS decreased in an isotonic medium (0.25 M sucrose) as compared to a hypotonic medium (distilled water). CTAB also damaged cells at the exponential phase more than those at the stationary phase, and its damaging action decreased with pH. Mg2+, Ca2+, and Sr2+ cations diminished the degree of cell damage with CTAB, but did not exert any noticeable protection in the case of SDS. The different sensitivity of cells at the exponential and stationary growth phases may be associated with changes in their surface electric charge and with the existence of hydrophobic regions on the cell surface. The higher electric charge of cells at the stationary growth phase is presumed to stem from a rise in the amount of surface lipopolysaccharides which bear a negative electric charge. PMID- 2700088 TI - Cell proliferation kinetics of tumours in relation to cancer therapy. AB - Cell proliferation kinetic differences exist between tumours and their normal tissue of origin, or the normal tissue within which they grow. These differences may help or hinder the therapist in his efforts to eradicate the tumour without excessive harm to the patient. Some aspects of the influence of cell kinetic parameters on therapeutic response and of the therapy on cell kinetic balances are outlined, both for radiotherapy and chemotherapy. PMID- 2700089 TI - [Ultrasonographic examination of the adrenal glands for detection of lung cancer metastasis]. AB - Adrenals are second as to the frequency of localization of the remote lung cancer metastases. The detection of lesions is possible by application of CT and USG method. In the period of 1986-1988, 126 USG examinations of patients with lung cancer have been performed; in 11 cases metastases to the one or both adrenals have been present. The smallest detected lesion had 18 mm in diameter. The technique of examination is presented. The features of USG imaging of adrenal lesions and their differentiation are discussed. Attention is called to the importance of exact analysis of the adrenal region in the course of routine examination of the abdominal cavity of patients with neoplasms. USG examination should be a routine examination in patients with lung cancer. PMID- 2700091 TI - [Breast cancer screening 1988]. AB - Recent state of investigations concerning the efficacy of breast cancer screening is presented. Opinions expressed in different conferences and symposia supporting the necessity of introducing in adequately organized societies the breast cancer screening on population scale is presented. The problem of screening methods and models is discussed. Some objections concerning the problem of breast cancer screening on national scale are also discussed. PMID- 2700090 TI - [Use of Tc-99m sulfur microcolloid for lymphoscintigraphy of neoplasms of the lymphatic system]. AB - The usefulness of examination of lymphatic nodes with Technetium labelled microcolloid for assessment of lymphatic nodes in patients with non Hodgkin's lymphomas and Hodgkin's disease is discussed. Examination has been applied in 60 cases. The criteria of performance of the examinations in physiologic and pathologic conditions are described, together with comparison with other methods of examination. In the own material significant concordance of lymphoscintigraphic examinations with lymphography and CT has been found, whereas fairly big discrepancies resulted when lymphoscintigraphic and USG examination have been compared. PMID- 2700092 TI - Phototherapy for neonatal hyperbilirubinemia. AB - New light has recently been shed on the way phototherapy reduces bilirubin concentration in icteric infants. The introduction of a high-performance liquid chromatography technique led to the discovery of new photoisomers of bilirubin, the configurational and structural isomers with high and low quantum yields, respectively, and to a renewed interest in the photochemical properties of bilirubin in vitro and in vivo. Circular dichroism and absorption spectroscopies have then shown that bilirubin behaves like a bichromophoric system, with the 2 halves of the molecule strongly interacting in the excited state. This coupling mechanism makes the quantum yields of bilirubin photochemistry wavelength dependent, with marked effects in the long wavelength edge of the bilirubin absorption spectrum. The photochemistry of bilirubin is substantially similar in icteric rats and babies, and is consistent with what is observed in vitro. However, the metabolism of bilirubin photoproducts in rats sometimes differs quite significantly from that in babies. In particular, only the low quantum yield structural isomer, lumirubin, is efficiently excreted by babies. Although the relative role of the bilirubin photoprocesses in the therapy of hyperbilirubinemia is not yet known with certainty, the structural photoisomerization is generally assumed to represent the main route of bilirubin elimination. As a consequence, the determination of the spectral band that optimizes the process of formation of lumirubin in neonate may represent an important step in the improvement of the clinical protocol of phototherapy. Therefore, in addition to reviewing the most recent data on bilirubin photochemistry and the metabolism of bilirubin products, this article presents a computation of the optimal light for lumirubin formation. The combined effects of long-wavelength photochemistry of bilirubin and skin attenuation show that the optimal spectral range should be between 480 and 510 nm. PMID- 2700093 TI - [Some parameters of hemostasis in diabetic patients]. AB - Parameters of blood coagulation and fibrinolysis in diabetic patients chronically treated with oral hypoglycaemic agents and insulin have been analysed. All examined patients were divided into four subgroups: I-treated with biguanides, II treated with sulfonylurea derivatives, III-sulfonylurea and biguanide derivatives simultaneously, IV-treated with insulin. Observed decrease in haemostasis parameters and activation of fibrinolysis in patients treated with only biguanides seemed associated with favourable effect of these agents on the decrease in the risk of the thrombotic complications in diabetes mellitus. PMID- 2700094 TI - [Use of ultrasound for evaluating structural changes of the renal parenchyma in chronic primary glomerulopathies]. AB - Ultrasound was used to measure echogenesis, renal cortex thickness and kidney length in 59 patients with various types of the primary glomerulonephritis. The obtained results have shown that the measured parameters correlated with the progress in renal failure. An increase in the intensity of echo from the cortex, thinning of the renal cortex, and the decrease in renal length are typical signs of the advancement of renal failure. As renal function deteriorates in the consequence of destruction of its parenchyma, ultrasound examination might be an illustration of the pathological changes in the kidney. Considering the fact that ultrasound is perfectly safe, it may be used in monitoring of the disease progress and the results of treatment. PMID- 2700095 TI - The multicatalytic proteinase complex. AB - The multicatalytic proteinase is a soluble nonlysosomal proteinase of Mr congruent to 700,000. It is composed of at least ten different types of subunit arranged as a stack of four rings in a hollow cylindrical structure. It is similar, if not identical, to prosomes and has also been referred to as the proteasome. The proteinase degrades some protein, peptide and synthetic peptide substrates. It is inhibited by thiol-reactive reagents and by peptide aldehydes. Results of studies with these inhibitors and of mixed-substrate experiments suggest that the proteinase molecule has at least two distinct types of proteolytic sites which have different specificities for peptide substrates. Antibodies raised against the native proteinase precipitate the complex but do not inhibit its proteolytic activities, and recognize only a few of the subunits on Western blots. PMID- 2700096 TI - Lysosomal degradation of microinjected proteins. AB - In this article we summarize evidence for a pathway by which cytosolic proteins can be selectively taken up and degraded within lysosomes. Serum deprivation of cells in culture activates this pathway, and only proteins that contain peptide sequences related to KFERQ (lysine, phenylalanine, glutamic acid, arginine, glutamine) are degraded at enhanced rates. Approximately 30% of intracellular proteins contain such peptide sequences, and we speculate about the physiological relevance of the selective degradation of these proteins in response to serum withdrawal. Several rat tissues also contain proteins with peptide sequences related to KFERQ, and the amount of these proteins is reduced in response to starvation. Finally, we present recent results suggesting that this selective uptake of cytosolic proteins by lysosomes is not through classical macroautophagic pathways. Instead, the selective uptake may be similar to other protein sorting pathways such as protein translocation through the endoplasmic reticulum or protein import into mitochondria. PMID- 2700097 TI - Mechanisms and regulation of lysosomal proteolysis. AB - We have determined the sequence of cDNAs encoding the precursors of rat cathepsins H and L. In order to understand the mechanism and regulation of expression and processing of these genes we have also determined the genomic restriction maps and the genomic structures in the extension sequences of the 5' regions. We have found that the intracellular locations of cathepsins B, H and L in various cells and organs are different. Lysosomes are shown to have different amounts of cathepsins B, H and L and this heterogeneity may reflect their different functions in autophagy and heterophagy. The intracellular role of cystatins, endogenous inhibitors of cathepsins, in suppressing intralysosomal proteolysis has been clarified. Electron microscopic studies of islet cells of the pancreas using double gold particle immunostaining for insulin and cystatin beta, indicate that cystatin beta is located in the insulin secretory granules. We propose the following hypothesis for the mode of action of cystatin beta: cystatin beta is secreted from its primary location in the secretory granules and is then taken up by target cells which direct it into lysosomes for the regulation of intralysosomal cathepsin activities. The inhibitory activity of cystatin beta is controlled by formation of a mixed-disulfate with glutathione and cysteine at position 3: the free form is active and the "glutathionated" form is inactive. The changes in glutathione balance (oxidized/reduced) in cells may regulate the inhibitory activities of cystatin beta. Further, the regulation of cathepsins under various nutritional and hormonal conditions, as well as the abnormal expressions of cathepsins in various pathological conditions, are discussed. PMID- 2700098 TI - Quantitative aspects of cellular autophagocytosis. Morphometric and cell fractionation studies. AB - The mode of action of agents and treatments known to induce the appearance of autophagic vacuoles (AV) were studied in mouse liver, pancreatic and seminal vesicle cells by morphometric evaluation of the time-dependent changes in the volume fraction of AVs following suppression of sequestration by cycloheximide. Rapid decrease of the AV compartment was observed in cells of animals pretreated with agents including Triton X-100, pilocarpine, leupeptin and estron acetate. The half-life of AVs, estimated from the decay, range between 5.3 to 8.7 min, which does not deviates from normal steady state values. In contrast, no regression or very slow decay was seen in cells of animals pretreated with methylamine, chloroquine and vinblastine (VBL). We think that the main mechanisms responsible for the enlargement of the AV compartment in these experiments are: stimulation of the sequestration under the effect of agents which maintain the half-life of AVs within the physiologic range of 5-10 min and accumulation of AVs due to their prolonged lifetime under the effect of acidotropic agents and VBL. However, our data suggest than in addition to the accumulatory effect on AVs, stimulation of sequestration may also play a role in the enlargement of the AV compartment after treatment with VBL. While it was not possible to isolate a relatively pure fraction of early AVs from the liver, a light and a dense AV fraction was successfully purified in our laboratory from the pancreas treated with either VBL or neutral red. Preliminary enzymological and morphological evidence is presented that the light AVs are of autophagosomal, whereas the dense ones are of autolysosomal nature. PMID- 2700099 TI - Crinophagy as a means for degrading excess secretory proteins in rat liver. AB - A method is presented for isolating crinosomes from rat liver, a subclass of secondary lysosomes. To this end, vinblastine was given to rats. Vinblastine blocked exocytosis of secretory granules at the cell border. Later on, characteristic granules containing lipoprotein particles were present allover the hepatocytes. These organelles were designated crinosomes. Immunolabelling showed that they contained albumin. The crinosomes were isolated on a sucrose gradient. They contained marker enzymes for both the Golgi complex and lysosomes. The crinosomes were also histochemically positive for acid phosphatase. They were proteolytically and lipolytically active. It is concluded that crinosomes develop from fusion between lysosomes and secretory granules--when the synthesis of secretory proteins exceeds the exocytotic capacity of the hepatocyte--and that they are active in degrading the retained secretory material. PMID- 2700100 TI - [In memoriam Prof. Agostinho Bettarello]. PMID- 2700101 TI - [The life and work of Prof. Agostinho Bettarello]. PMID- 2700102 TI - [Treatment of gastric ulcer with ranitidine: comparison of a single 300 mg dose at night with 150 mg twice a day]. AB - Twenty five patients with endoscopically diagnosed gastric ulcer, were randomly allocated to treatment with ranitidine 300 mg at night or ranitidine 150 mg twice daily. After six weeks, ulcer healing was observed in 7 out of 14 patients (50%) treated with ranitidine 300 mg nocte and in 7 out of 11 (63.6%) receiving 150 mg bid. Cumulative healing rates at 12 weeks were 64.2% and 81.8%, respectively. There was no statistically significant difference between these two groups. No adverse events were reported by any patient. Ranitidine 300 mg administered at night was effective and a safe regimen for the treatment of gastric ulcer. PMID- 2700103 TI - Is the inhibition of nocturnal gastric acid secretion the most important factor in duodenal ulcer treatment? A comparison between the effectiveness of single morning and nocte doses of ranitidine 300 mg. AB - Fifty-five patients with an endoscopically confirmed duodenal ulcer were randomly allocated to receive ranitidine 300 mg either in a single morning or a single nocte dose (26 and 29 patients respectively). They were endoscopically examined at the end of the second week and when the ulcer was still active, the patient was treated for another two weeks, when endoscopy was repeated. Patients with ulcers still active at four weeks were considered treatment failures. The healing rate observed when ranitidine 300 mg was given in the morning was 10/26 (38%) at the end of the second week and 17/26 (65%) at the end of the fourth week. The healing rates after the 300 mg nocte treatment was 12/29 (41%) at the end of the second week and 20/29 (68%) at the end of the fourth week. No side effects were observed in any of the 55 patients, although one patient in the morning regimen bled at the end of the second week and was withdrawn from the study. Our results showed that ranitidine 300 mg in a single morning dose is as effective as when given in a single night dose. This finding is suggestive that reduction of nocturnal gastric acid secretion is important, but not essential for the healing of duodenal ulcer. PMID- 2700104 TI - [Chronic pancreatitis: clinical characteristics, complications and association with other diseases]. AB - The clinical aspects, complications and association with other diseases were investigated in 407 patients with chronic pancreatitis. The most frequent symptoms were abdominal pain (93.6%), weight loss (91.6%), diabetes (37.8%) and malabsorption (31.7%). Pancreatic cysts (32.6%), ascites and/or pleural effusion (12.5%), pancreatic necrosis (11.2%), gastrointestinal bleeding (12.8%) and pancreatic abscess (7.3%) were the most frequent complications. The symptoms and complications observed are discussed and their incidences compared to those reported from other countries. PMID- 2700105 TI - [Spontaneous remission of pancreatic cysts in patients with chronic pancreatitis]. AB - Thirty one alcoholic patients with pancreatic cysts were studied by ultrasonographic scanning with the purpose to observe the evolution of the cysts. The mean time of the follow-up was 15.6 +/- 9.2 months; the patients were aged 40.2 +/- 9.3 years (male = 93.5%; female = 6.4%) the average pure ethanol intake was 288.3 +/- 185.9 ml for a period of 20.8 +/- 9.3 years. In 21 of the 31 patients (67.7%) the ultrasonographic examination showed total spontaneous resolution of the cysts within a time span of less than 18 months. The majority of the parameters studied (age, time and volume of ethanol intake, pain, diabetes, calcifications and previous cyst drainage) had no relation with the evolution of the cysts. In 11 patients (52.3%) the cysts showed an initial enlargement before decreasing in size. The cysts located in the pancreatic head showed less tendency to spontaneous resolution. Complications were observed in two patients: intra-cystic haemorrhage in one and rupture into the peritoneal cavity in the other. Our observations suggest that patients with pancreatic cysts secondary to chronic alcoholic pancreatitis should be controlled with periodical ultrasonography. Surgical approach should be reserved for patients with complications. PMID- 2700106 TI - [Echographic study of cystadenoma and cystadenocarcinoma of the pancreas]. AB - The ultrasonographic aspects of cystadenomas and cystadenocarcinomas of the pancreas were studied in 14 patients. The tumors were cystic, solid or of mixed type. The ultrasonographic differences between the benign and malignant lesions are discussed, as well as changes concerning the splenic vein and biliary system. Ultrasonography is of help for the differential diagnosis of cystic tumors of the pancreas and for indication of the best therapeutic procedure. PMID- 2700107 TI - [Non-surgical treatment of biliary lithiasis]. AB - The usefulness of the treatment of the biliary lithiasis with chenodeoxycholic and ursodeoxycholic acids is discussed, including the selection of patients, optimal doses, adverse effects and recurrence of stones. New treatment with methyl tertiary butyl ether and extracorporeal shock wave lithotripsy (ESWL) is evaluated. Endoscopic procedures, eventually combined with ESWL, represent the preferred treatment for patients with bile duct stones. PMID- 2700108 TI - [Autoantibodies in the diagnosis of autoimmune diseases of the liver]. AB - In recent years a considerable knowledge concerning the use of autoantibodies as diagnostic markers in clinical hepatology, has been accumulated. The present article reviews the most important autoantibodies such as anti-smooth muscle, antimicrosomal of the liver and kidney, antimitochondria and antinuclear antibodies. PMID- 2700109 TI - [Clinical treatment of portal hypertension]. AB - In spite of a great number of published papers on the clinical treatment of portal hypertension, some controversies still exist. The role of propranolol for the elective treatment is not established as the prospective trials have shown conflicting results. The vasoconstrictive drugs associated or not to vasodilating ones have an efficacy comparable to that of balloon tamponade. As to the prophylactic use of propranolol, few papers have been published, but three prospective randomized trials showed that the drug is superior to the placebo, particularly in patients without ascites. PMID- 2700110 TI - [Chylomicron metabolism]. AB - The liver is known to play a central role in the chylomicron metabolism. It synthesizes apolipoproteins (e.g., apo A I, apo C II, apo E), lecithin cholesterol acyltransferase, hepatic lipase and is responsible for the chylomicron remnant removal. Not surprisingly then the chylomicron metabolism is compromised in liver diseases such as acute hepatitis, cirrhosis and cholestasis. The authors reviewed the normal features of the chylomicron metabolism which are essential for a better understanding of the lipoprotein disturbance in liver diseases. PMID- 2700111 TI - [Changes in the brain content of the gonadotropin releasing hormone (GnRH) in caribe colorado, Pygocentrus notatus, during the reproductive cycle]. AB - Immunoreactive gonadotrophic hormone-releasing hormone (ir-GnRH) was detected in extracts from optic tectum, cerebellum and brain stem of the Venezuelan freshwater fish "caribe colorado", Pygocentrus notatus by means of radioimmunoassay. Like most fishes from the area P. notatus, has a reproductive cycle closely related to environmental conditions changes. Our results show a correlation between gonadal maturation, express as Gonosomatic Index (GI) and the beginning of the rainy season (April-May) in males and females of this species. Fluctuations in the ir-GnRH levels that depend of the reproductive state and environmental conditions occurred in the optic tectum and cerebellum extract obtained from female fish. On the other hand, in males no striking variation were found in any of the structures mentioned, except for the optic tectum, were a significant increase in the ir-GnRH content was observed in May. PMID- 2700112 TI - Production of intracellular alpha-glucosidase in brewery waste by Saccharomyces carlsbergenesis. AB - Saccharomyces carlsbergensis strain ATCC 9080 was grown on acid hydrolyzed brewery waste. The substrate contains 22 mg/ml of total carbohydrates of which approximately 60% represents reducing sugars such as maltose and glucose. Optimal conditions for substrate hydrolysis were 1.5% w/v sulfuric acid, 20 minutes and temperature of 110 degrees C. Maximum enzyme production was obtained in a medium containing 0.05% w/v yeast extract at 35 degrees C and at an initial pH of 6. Addition of nitrogen sources was unnecessary. Optimal conditions for alpha glucosidase extraction from yeast included pH 7.5, 30 degrees C, and 10 minutes of sonication. Maximum hydrolysis of PNPG occurred at pH 7.5, temperature between 30 degrees C and 25 minutes of incubation. Michaelis-Menten constants and Vmax were 1 mM, 0.56 mol/min/mg of protein on P-nitrophenly-alpha-D-glucophyra-noside and 5 mV, 5 mol/min/mg of protein on maltose respectively. PMID- 2700113 TI - [Effect of beta blockers with intrinsic sympathomimetic activity on blood pressure and blood lipids in patients with essential hypertension]. AB - The aim of this study was to compare the effects of a beta-blocker (mepindolol) with intrinsic sympathomimetic activity (ISA) to a beta-blocker (metoprolol duriles) without ISA. Hypertensive patients with more than 50 years of age were selected and randomly allocated to receive either 5 mg/day mepindolol (Group A, 10 patients), or 200 mg/day metoprolol duriles (Group B, 9 patients), or placebo (Group C, 10 patients). They were submitted to clinical exam, stress testing and plasma lipids dosage before and after four weeks of treatment. At rest, there were a significant reduction of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) in all groups. The mean values for SBP, DBP and HR at rest after treatment were respectively: 154.0, 95.5, 73.7 (Group A); 148.8, 94.4, 70.1 (Group B); 153.0, 96.0, 77.8; (Group C). During stress testing, there were a significant reduction of SBP, HR and double product (DP). The DBP remained unchanged. The mean values for SBP, DBP, HR and DP during stress testing after treatment were respectively; 198.0, 115.5, 124.3, 246.9 (Group A); 198.8, 114.4, 144.6, 283.2 (Group B); 202.2, 119.0, 143.5, 283.4 (Group C). Total cholesterol, HDL-cholesterol, and LDL-cholesterol, have not changed with both beta-blockers. There were a significant increase in plasma triglycerides and VLDL cholesterol levels after treatment with beta-blockers. In conclusion, both mepindolol and metoprolol were similarly effective in reducing arterial blood pressure of hypertensive patients. There were not significant differences between the beta-blocker with or without ISA in regard to their effects on plasma lipids. PMID- 2700114 TI - [Principal mechanisms involved in coronary spasm]. PMID- 2700115 TI - Microleakage of composite resin restorations. A status report. PMID- 2700116 TI - [Investigation into the effect of citric and phosphoric acids on planed root surfaces using S.E.M]. AB - The aim of the present study was to evaluate the effect of citric and phosphoric acid conditioning the diseased root surface on periodontally extracted teeth. Citric acid pH1 and 50 per cent phosphoric acid were topically applied to thoroughly scaled and planed root surfaces for one to three minutes. The specimens were then processed for scanning electron microscopy (S.E.M.) Root surfaces that had received acid treatment after root planing exhibited no smear layer and the overall surface appeared to have an undulating morphology. Whereas, examination of nonacid-treated specimens showed the presence of a smear layer. Furthermore, phosphoric acid treated surfaces demonstrated more irregularity with increasing application time. PMID- 2700117 TI - [Photoelastic stress analysis of fixed-removable partial denture which had bar and Ceka-Anchor attachment]. AB - In our study, we constructed fixed-removable partial prosthesis, which are supported by teeth and tissue for patients who exhibited extensive tissue loss. In these prosthesis the localization of the precision attachments on the bar and the stress conducted to the abutment teeth by changing the number of splinted teeth and inclination of the bar were compared with photoelastic analyses and the results were evaluated. The photoelastic material used was Araldite/B and its catalyst was HT 901 fitalic anhydrate. The models constructed with these materials were examined in photoelastic polariscope and fringes occurred due to the force applied were photographed and analyzed. PMID- 2700118 TI - [Use of endodontically treated teeth in removable partial dentures]. AB - In our study, cases where teeth with excessive crown loss served as abutments, where examined in Kennedy Class II modification 1, that have tooth and tissue support on removable partial dentures which were constructed with the same design. Our study aims to examine, how vertically directed forces are transmitted to the supporting tissues by using photoelastic method. Teeth with case post and core appliances were used as abutments for removable partial dentures. Vertical loading procedure following the construction of removable partial dentures with the same design, revealed distribution of force over dentulous and edentulous ridge areas. When a comparison between endodontically treated and sound abutment teeth, was made, we had the conclusion that teeth with excessive crown loss can successfully serve as abutments for partial dentures, because the results of our finding exhibited no significant difference. PMID- 2700119 TI - [Subjective evaluation of major connector designs for mandibular removable partial dentures]. AB - The dentist himself is responsible for the design of the removable partial denture, because he must know and apply the biomechanical principles also. Two mandibular removable partial dentures, one with a lingual bar and the other with a lingual plate as the major connector were constructed for 7 men and 9 women patients who had mandibular Kennedy class I edentulous area. Patients used each type of prothesis for one month. At the end of this period, speeching, chewing and comford of partial dentures were evaluated according to the patients subjective impression. In general, patients adapted best to major connectors that covered soft tissues least was better. As a result, generally patients preferred lingual bar type denture. PMID- 2700120 TI - [Effect of dowel space preparation on the integrity of the apical seal]. AB - Fifty-six single-rooted maxiller teeth obturated with amalgam, N2 and AH26 were tested in vitro to determine if dowel space preparation had an effect on apical seal. Dye penetration was evaluated using 210 UV Spectrophotometer and it was observed that the use of AH26 with or without gutta-percha to seal the root was the most suitable technique on apical seal and dowel space preparation did not influence the sealing ability of it. PMID- 2700121 TI - [Antibacterial properties of some adhesive agents that are used to prevent marginal leakage]. AB - In this research, antibacterial effects of two cavity varnishes (Copalite and Espe), two bonding agents (Scotchbond and Adaptabond), and Delton fissure sealent, on the various microorganisms that are predominant in the oral bacterial flora, has been investigated invitro. The maximum antibacterial effect upon all the tested microorganisms has been found with Scotchbond. The other agents listed in decreasing order of effectiveness were, Copalite, Espe varnish and Adaptabond. Delton fissur sealent found to have the least measurable antimicrobial action. PMID- 2700122 TI - [Experimental use of dentin bonding agents and a cavity varnish to reduce marginal microleakage in high copper amalgam restorations]. AB - The effects of a cavity varnish and two bonding agents on marginal microleakage at the interface of amalgam restorations and cavity walls in extracted teeth is investigated with a dye penetration technique. Marginal microleakage associated with amalgam restorations can be greatly reduced by paintings a bonding agent on the inner wall of the cavity. PMID- 2700123 TI - [Infection control, a constant obligation in human practice]. PMID- 2700124 TI - [Experimental comparative analysis of two replication materials (empty)]. PMID- 2700125 TI - [Research on corrosion resistance]. PMID- 2700126 TI - [Rigid or mobile? Types of retention for edentulous spans]. PMID- 2700127 TI - [Comparison of all ceramic systems. Work plan aspects]. PMID- 2700128 TI - Insights and innovations. PMID- 2700129 TI - Bonded porcelain crowns. PMID- 2700130 TI - Bonding to tooth structure: a rational rationale for a clinical protocol. PMID- 2700131 TI - [Surgical procedures to improve cleansing of the root surface and reduce pocket depth]. AB - In recent years numerous reports have appeared in the dental literature comparing different methods of treating periodontitis. These researches have not indicated that surgical procedures have particular advantages over thorough hygiene therapy. This review considers several relevant hypotheses and the results of clinical research into this topic. Particular note has been taken of the research of Ramfjord et al. (1987) whose conclusions are typical of many others. This review discusses such conclusions from several standpoints and shows that there is a need for further research. It is derived from a review by the same authors in the journal of the Swedish Dental Association, Tandlakartidingen. PMID- 2700132 TI - [Hyperlipoproteinemia associated acute pancreatitis complicating with pregnancy- a case report]. AB - Hyperlipoproteinemia associated with acute pancreatitis is a rare complication during pregnancy. Acute pancreatitis may occur when physiologic hyperlipoproteinemia of pregnancy superimposes on primary or secondary hyperlipoproteinemia. In the meantime, acute pancreatitis may unmask hyperlipoproteinemia and the pattern of lipoprotein electrophoresis may evolve from Fredrickson type III to type IV or type V during acute pancreatitis. We reported a case and reviewed the literature. A 28 years old woman, G4P3, was admitted to our hospital in the sixth month of pregnancy because of epigastralgia and vomiting for 10 days and respiratory distress for one day. Laboratory examination revealed amylase 551 U/L, lipase 1073 U/L, blood sugar 873 g/dl, triglyceride 1298 mg/dl and cholesterol 1044 mg/dl. Abdominal sonogram revealed diffuse edematous change of the pancreas and minimal ascites. The symptoms and signs subsided gradually after supportive treatment that included nothing per os, fluid and electrolyte balance, antacid and analgesics. Unfortunately , intrauterine fetal death was found on the twentieth day after admission. The blood levels of triglyceride and sugar were still elevated 3 weeks after discharge. The most important observation was a broad beta lipoprotein band found in lipoprotein electrophoresis in the acute stage of this case. The broad beta band disappeared and Fredrickson type IV was found in the late stage of pancreatitis. The pattern of lipoprotein electrophoresis changed to Fredrickson type V 3 weeks later. PMID- 2700133 TI - Dental amalgam: a review of the literature. AB - Since the 1800s, dental amalgam has been the most commonly used dental restorative material. Each year, dentistry in the United States uses over 100 tons of mercury, continuing a controversy regarding mercury's safety for patients and dental personnel. PMID- 2700134 TI - [B-mode sonography of odontogenic maxillary sinus lesions]. PMID- 2700135 TI - [Homologous collagen implants in oral surgery in hemorrhagic patients]. AB - In 154 hospitalized hemorrhagic patients 883 oro-surgical procedures were done under continuous anticoagulation. Human collagen material combined with fibrin adhesive offered a safe hemostatic effect. A total of 12, mostly minor, postoperative bleedings occurred, which did not lead to delayed wound healing. Good tissue tolerance towards both homologous partners and healing by primary intention should be emphasized. These observations are to be corroborated by further clinical trials. Human collagen can make surgical treatment in hemorrhagic patients safer yet. PMID- 2700136 TI - [Preoperative irradiation, cisplatin sensitization and radical surgery of primarily operable carcinomas of the oral cavity. Results of a prospective DOSAK treatment study]. AB - 165 patients with carcinomas of the oral cavity or oropharynx, clinically appearing operable, were treated between 1985 and 1987 within the framework of a prospective multicenter study. The treatment concept consisted in preoperative irradiation with 32 Gy, cisplatin sensitization with 5 X 20 mg per m2 body surface area and subsequent radical removal of the primary tumor and the regional cervical lymph nodes. Regarding recurrence and survival rates the patient data were analyzed using one- and multi-dimensional statistical methods. The observed survival rates were compared with those assessed with the aid of the treatment dependent prognosis index TPI (Platz et al. 1982). After 1 years the survival rates under the selected combination therapy were 12% and after 2 years 19% above the assessed survival rates under radical surgery alone. PMID- 2700137 TI - [Osseointegrated implants for the retention of restorative jaw prostheses and facial prostheses for functional and esthetic rehabilitation following tumor surgery]. AB - To restore the masticatory function after tumor surgery, 110 transmucosal intraoral implants have been inserted in 21 patients, and 26 percutaneous implants in a total of 9 patients for the stabilization of facial prostheses. While 12 of the intraoral implants had to be removed for lack of bony integration, the losses of the percutaneous implants for the stabilization of facial prostheses were exclusively due to tumor recurrences in the direct vicinity of the implants. Our previous results in the use of osseointegrated implants for the retention of restorative maxillofacial prostheses show a limited incidence of complications and give reason to expect long-term success in functional and esthetic rehabilitation. This method provides a decisive improvement in the quality of the life of tumor patients compared to the procedures used up to now. PMID- 2700138 TI - Premenstrual syndrome. AB - The term premenstrual syndrome is often used to describe several clinical conditions. Only a full history covering not only reproductive but also psychological and social factors, combined with daily diaries which are kept prospectively for at least two months, can help clarify the problems the patient experiences. As it is the timing rather than the type of symptoms which is essential to a diagnosis, diaries are used to assess symptoms, make a diagnosis and monitor the effectiveness of therapy. Patients with premenstrual syndrome should therefore always keep a diary and bring it to every consultation. We do not know if patients complaining of premenstrual syndrome are at one extreme of a spectrum disorder or if they are a 'specific group'. Such patients may have classical premenstrual syndrome, perimenstrual distress, benign idiopathic oedema, dysmenorrhoea, cyclical benign breast disease or mood symptoms which are not significantly related to the menstrual cycle. There are many aetiological theories--biological, psychological, environmental and social, the syndrome being a complex psychosomatic disorder. For appropriate management an accurate diagnostic formation is required. Reassurance, stress management techniques, an improvement in general mental and physical well-being, information and education are the mainstays of therapy. Symptomatic relief of symptoms is often helpful. Many other managements have been tried with the aim of correcting the underlying aetiological case. These include vitamins, prostaglandin inhibitors and endocrine therapies. As the disorder is long-term, the safety of treatments should be carefully considered. PMID- 2700139 TI - Eating disorders. PMID- 2700141 TI - Infertility and assisted reproduction. AB - The inability to have children is a considerable cause of human distress. There is little evidence to suggest that the vast majority of infertile couples differ in their premorbid psychological make-up from their fertile contemporaries. There is understandable grief in response to their loss of the ability to have children and in vulnerable people this may be profound. There is little known of the long term outcome of such couples, but it seems likely that for some it will be a devastating experience that will affect their life-time mental health. There are a large proportion of couples with unexplained infertility, but there is little evidence that this diagnosis is particularly associated with psychological factors, although research continues into possible links between stress and hormones that affect the reproductive system, such as prolactin. Artificial insemination and IVF have particular problems, not only due to conception occurring out of normal sexual intercourse. In artificial insemination using donor sperm the problems of a genetically different father has similarities with the debate about egg donation for IVF. These technical procedures are undoubtedly stressful but generally, as for other treatments, if they are successful the rewards appear to outweigh any misgivings of the couples involved. There is a need for further research as to whether psychological factors are causative in infertility as the absence of any link might indeed be reassuring to couples. We would also benefit from knowing the long-term outcome of couples for whom treatment is not successful. PMID- 2700140 TI - Psychological aspects of gynaecological surgery. PMID- 2700142 TI - The loss of early pregnancy. AB - It is often assumed that early loss of pregnancy is not followed by emotional distress. When such distress does occur, it often goes undetected. Early loss of pregnancy is frequently followed by typical grief such as that occurring after any bereavement. Most recent studies have shown that although social termination of pregnancy in the first trimester has few adverse psychological sequelae for most women, there are vulnerable women who do experience significant emotional distress afterwards. Risk factors for poor psychological outcome include poor social support, past psychiatric history and ambivalence about the termination. The procedures used for second trimester terminations of pregnancy are likely to be a particular source of distress. Psychiatric disorder may also follow if termination is refused. Careful assessment of all women before social termination will identify vulnerable women who may benefit from counselling and support afterwards. After spontaneous abortion or miscarriage, many women experience significant emotional distress, which persists for several months. Guilt and anger are common. Some women are particularly vulnerable to developing psychiatric disorder after spontaneous abortion, for example women with a past psychiatric history, poor social support, previous spontaneous abortion and personality traits such as neuroticism. Many women would benefit from follow-up and support afterwards; extra support and reassurance are often needed during the next pregnancy. Termination for fetal abnormality is more likely to induce grief than relief for many women; these pregnancies are usually wanted, second trimester terminations are distressing, and there is often guilt at destroying a life and/or opting out of rearing a handicapped child. Recent research has demonstrated substantial levels of psychiatric morbidity after termination for fetal abnormality, particularly in those with a past psychiatric history, those with poor social support, and those who feel they have opted out of bearing a handicapped child. Women receive little support of follow-up after such terminations, yet many would benefit from it. Such women are in particular need of reassurance and support during a subsequent pregnancy. PMID- 2700143 TI - Normal emotional changes in pregnancy and the puerperium. AB - There is tremendous individual variation in the response to the inherent emotional, psychological and cognitive changes that take place during pregnancy and puerperium, particularly in first-time mothers. Although the psychological changes, particularly in terms of emotional and behavioural changes, have probably been overstated in pregnancy, there are undoubtedly marked changes in such aspects of functioning following delivery. Women should be aware of these changes and be prepared for them, and obstetricians and midwives should incorporate them into their management of patients. All women have valid psychological needs during pregnancy and in the puerperium, and these must be met in order to ensure maternal and infant health and maximum satisfaction with the experience. Antenatal and postnatal care should not result in a struggle for power and control between patient and obstetrician. Emotional reassurance and support can only follow upon adequate information. The best antenatal care and management of delivery requires a spirit of mutual trust and active participation on the part of the patient in the decision-making process. There is ample evidence to support the theory that continuity of care and the continuous supporting role of the midwife, particularly during delivery, exerts a favourable outcome in mothers and children. PMID- 2700144 TI - Sexual behaviour in pregnancy, after childbirth and during breast-feeding. AB - Sexual and marital relationships change throughout marriage and the transition to parenthood can be seen as a psychosocial crisis. Recent studies do not support the finding of Masters and Johnson (1966) that there is a mid-trimester rise in sexual responsiveness. Sexual behaviour decreases towards the end of pregnancy and a number of studies have found that in the majority of mothers there is only a slow return to pre-pregnancy levels in the first postnatal year. Some of the factors influencing the rate of return are discussed. Breast-feeding is important because of the hormonal changes it produces and it has been said to stimulate sexual feelings in both mother and baby. There is some evidence that breast feeding has an adverse effect on sexuality in the first postnatal year. It is not clear whether this could be related to differences in hormone levels or differences in feeding behaviour. Fatigue and contraception have largely been ignored in studies of factors influencing postnatal sexual behaviour. Women who went on to breast-feed were found to be very similar on antenatal measures of sexual behaviour to those who went on to bottle-feed. The method of feeding is the major influence on the hormonal status, and the experience of painful intercourse reported by breast-feeding mothers may be related to low oestrogen levels. Breast-feeding persistence is influenced by both social and psychological factors and its effect on sexual behaviour is discussed. PMID- 2700145 TI - Postpartum psychosis. PMID- 2700146 TI - Postnatal depression: a serious and neglected postpartum complication. PMID- 2700147 TI - Endocrine aspects of postnatal mental disorders. AB - Biological research in postnatal mental illness has only a short history and few encouraging data have yet emerged. The most promising positive findings are perhaps preliminary evidence for an increase of postnatal depression in women with postpartum thyroid dysfunction, some evidence for an enhanced sensitivity to changes in progesterone levels in postnatal depression, and the presence of an opioid peptide with unknown function in the cerebrospinal fluid of women with puerperal psychosis. Although steroid hormones are generally thought to be aetiologically relevant since they freely enter the brain and are known to interact with central monoamine neurotransmitter systems, attempts to demonstrate abnormal levels in postnatal disorders have been disappointing. An important reason for this outcome may be the usually employed approach of isolated hormone measurements. Ovarian steroid levels show marked interindividual variations. Thus significant between-group differences may only be obtained when large numbers of subjects are tested. Since only the unbound fraction can enter the brain, its measurement should be included in such studies. In the case of cortisol, single values are insufficient because of the pulsatile nature and the circadian pattern of its release. Thus serial sampling over 24 hours is more appropriate to detect secretory abnormalities. Measurements of circulating peptides are difficult to interpret since the amount reaching the brain is at best small. What is needed here are estimations of peptides in the cerebrospinal fluid which, however, pose ethical problems. Another explanation for the dearth of consistent positive data may be that women with postnatal mental disorders react to normal postnatal changes differently to women who remain well after childbirth. There is already evidence that patients at high risk of puerperal manic-depressive illness develop a hypersensitivity of central D2 receptors which may be related to the effects of oestrogen withdrawal on the function of DA systems. Further investigations of central neurotransmitter function are needed. In many ways postnatal mental disorders provide a unique opportunity for psychosomatic research since their onset can almost be predicted and follows an event which is associated with changes in many physiological systems. Results of recent neuropharmacological and behavioural investigations into the central effects of steroid and peptide hormones provide the basis for a multitude of pathogenetic hypotheses to be tested in postnatal mental disorders and research in this area may see exciting times ahead. PMID- 2700148 TI - Psychological strategies in the prevention and treatment of postnatal depression. AB - Prevention or treatment of most postnatal psychological disorders currently demands the manipulation of psychosocial not biological variables. How we treat women matters in terms of the emotional outcome of pregnancy and ultimately the family outcome. This is confirmed by two types of studies. Firstly, there are the controlled trials of psychological strategies aimed at the prevention or treatment of postnatal mood disturbance. Secondly, there are the studies of the relationship between the type of obstetric and midwifery care and emotional well being following the birth. There have been far too few of either type of study. Since the rapid advances in medicine which relate to physical outcome have peaked, with mortality rates at an all-time low, the 1990s should see more clinical and research effort devoted to psychological outcomes. Perhaps some progress can now be made in reducing postnatal psychiatric and psychological morbidity. PMID- 2700149 TI - Management of major mental illness in pregnancy and the puerperium. PMID- 2700150 TI - The effects of postnatal depression on the infant. PMID- 2700151 TI - Perinatal death. PMID- 2700152 TI - Non-enzymatic glycation of phosphoglucoisomerase. AB - Incubation of yeast phosphoglucoisomerase for 14 days at a high concentration (100 mM) of D-glucose was found to cause the non-enzymatic glycation of the enzyme. The kinetic properties of the glycated and control enzymes were similar in terms of specific activity, affinity for D-glucose 6-phosphate, isotopic discrimination between D-(U-14C) glucose 6-phosphate and D-(2-3H) glucose 6 phosphate, intramolecular 3H transfer from the latter substrate, and anomeric specificity. It is proposed that the quantitation of glycated phosphoglucoisomerase in distinct cell types may be used as an index for the non enzymatic glycation of cytosolic proteins. PMID- 2700153 TI - The role of endothelium in the pathogenesis of vascular diseases. AB - In connection with the increasing importance of the endothelium in understanding the pathogenesis of vascular diseases, new types of mediators originating in the endothelium are described, such as EDRF and endothelin. The method of endothelial cell cultivation has contributed to their detection. Besides such analytical methods, a more global in vivo aspect of endothelial function is dealt with by the method of counting circulating endothelial cell carcasses in blood applicable also clinically. The increase of endothelaemia goes hand in hand with both the tendency to thrombosis and increased permeability. Similarly, the main atherosclerotic risk factors, smoking, hypertension and hypercholesterolaemia could be effective by producing an endothelial perturbation as indicated by increased endothelaemia. PMID- 2700154 TI - Diagnosis of ischaemic heart disease based on data of precordial mapping. AB - To increase the efficacy of electrocardiographic diagnosis of ischaemic heart disease (IHD), the authors searched for new ECG parameters using the method of precordial mapping and computer map analysis. The study was made in a group of 95 IHD patients, with diagnosis confirmed with the use of visual methods (coronary angiography and left ventriculography). On 12-lead ECG, the signs of focal cicatrization were found in none of examined patients, and ischaemic changes were present in 23% only. 98 practically healthy people were used as controls. With the aid of mathematical methods including the step-wise discriminant analysis, a classificatory function was construed enabling to increase the sensitivity of IHD diagnosis to 83% at an 85 percent specificity. PMID- 2700155 TI - [Comparison of three pigment production media with CAMP and hippurate hydrolysis tests for the identification of beta-streptococcus group B]. AB - Three pigment production media were compared with CAMP and hippurate hydrolysis tests for the identification of beta-Streptococcus group B. A total of 129 clinical isolates of beta-Streptococcus group B and 287 beta-Streptococcus non group B were tested. The results show that sensitivities are: pigment medium, 99.2%, DMS medium, 95.6%, Columbia agar, 92.8%, CAMP test, 96.3%, hippurate hydrolysis test, 97.6%. As for specificities results show: CAMP test, 99.7%, the other tests, 100%; respectively. Pigment medium is a simple, convenient methodology. PMID- 2700156 TI - [MAC-ELISA for the detection of IgM antibodies to dengue type I virus (rapid diagnosis of dengue type I virus infection)]. AB - The commercial rapid diagnostic reagents for Dengue virus infection is still not available at present. An ABC MAC-ELISA (Avidin Biotin Complex IgM Antibody Capture Enzyme Linked Immunosorbent Assay) for the detection of Dengue type I virus infection has been described. IgG purified from high titer (HI = 2560) human anti-flavivirus serum is labelled with biotin for the rapid diagnosis of Dengue type I virus infection. 389 serum specimens of suspected Dengue Fever patients including 226 HI(+) paired sera and 163 HI(-) paired sera which were collected from 1 to 150 days after onset of the disease in 1988 have been assayed for IgM antibodies to Dengue type I virus. Cut off value is based on the mean of OD490 of 162 Dengue negative serum specimens plus 4 SD. The positivity of IgM antibody increased as the viremia disappeared and IgM antibody for Dengue-1 serum specimens collected 9 days after onset of the disease is 100% detectable. PMID- 2700157 TI - Enteric group 17 in clinical isolates. AB - The Enteric Group 17, a new group of Enterobacteriaceae, has been classified (by the Centers for Disease Control, Atlanta, Georgia, U.S.A.) based on its positive methyl-red test as well as its negative response to Voges-Proskauer, motility, rhamnose and melibiose fermentation tests. The isolation rate of Enteric Group 17 among 500 clinical isolates of Enterobacteriaceae in Taiwan is 1.8% (9/500). This finding recommends that Taiwan's hospital laboratories should pay particular attention to the possible presence of this bacteria when an isolate has reactions similar to that of Enterobacter cloacae or other members of the Enterobacter species. PMID- 2700158 TI - [Metachronous bronchial neoplasm. 20 cases surgically treated]. AB - The authors present a series of twenty metachronous lung carcinomas operated upon in the Thoracic Surgery Unit of Nancy between 1975 and 1987. These lesions occur after a first lung tumor resected for stade 1 TNM in 19 cases, with a 59 month's mean free interval and they are surgically treated by 14 controlateral lobectomies and 6 completion pneumonectomies. In spite of 4 post-operative deaths, the survival rates reach 51% at 3 years and 32% at 5 years. This study with a review of the literature emphasize the relatively high incidence of metachronous lung carcinomas in the patient resected for a tumor of good pronostic factors, their occurrence after a prolonged interval, the difficulty to prove their primary nature and the justification of a surgical approach because the long-term results are comparable with that of patients operated upon for a single carcinoma. PMID- 2700159 TI - [Results of the surgical treatment of gastric cancer. A retrospective study of 247 cases]. AB - Controversies still exist regarding the surgical treatment of gastric cancer. The therapeutic value of lymphoadenectomy (staging or curative) and the amount of the stomach exeresis for the lower third location are particularly debated. The authors discuss about their experience on 247 patients with gastric cancer of which 148 treated with exeresis (total and subtotal gastrectomy). In the greater number of patients (130 cases) a R2/R3 lymphadenectomy was performed. The global 5-years survival rate was 26.5%. Concerning the lower third localization the 5 years survival rate was 33.5% for total gastrectomy and 24.5% for subtotal gastrectomy with no significant difference (chi-square test: p = .6235). In 31 patients in which there was N2 involvement the 5-years survival rate was 19.2%. They conclude that this result confirm the opportunity to perform a R2/R3 lymphoadenectomy whose value can be considered curative in the cases with N2 involvement and of staging in the N3 positive. They underline that the possibility to perform a less aggressive lymphoadenectomy (R1/R2) in the early gastric cancer, must be considered after an objective evaluation of the depth of tumor invasion in the gastric wall. PMID- 2700160 TI - [Fulminant and subfulminant hepatitis treated by orthotopic transplantation of the liver. Apropos of 10 cases]. AB - In the period between 15/12/1987 and 15/08/1989, ten patients with either fulminating or subfulminating hepatitis have been treated by orthotopic liver transplantation (O.L.T.). Six patients are doing well in the post-operative period with a mean follow-up of 12 months (7-23 months). No evidence of neurological sequelae has been observed and recurrence of HB virus infection was absent from the three cases who survived hepatitis B transplantation. Four out these ten patients died after initial successful O.L.T... One patient succumbed 7 days after O.L.T. from sepsis or early super-acute rejection, the second 21 days after O.L.T. from neuromeningeal listeria, the third 43 days post O.L.T. from acute rejection, while the fourth developed cytomegalovirus pneumonia and died 61 days after O.L.T. Orthotopic liver transplantation has become the treatment of fulminating hepatitis. It is an emergency which is usually accompanied by successive difficulties in decision making: indication criteria, then acceptance or refusal of ABO incompatible grafts (5/10) and of suboptimal donors. Orthotopic liver transplantation for fulminating hepatitis is technically easy to perform, but usually requires the use of extra-corporal veno-venous circulation. Accompanying intensive medical care is essential and usually includes one or multiple plasmaphereses to correct existing coagulopathy without any fluid or sodium overload to the circulation. PMID- 2700161 TI - [Imaging and hepatic injuries. Development of a therapeutic strategy and role of non-surgical treatment. 33 cases]. AB - Among 67 blunt hepatic traumas treated during a 4 years period, 34 required an emergency surgery for reasons of severe bleeding, with 16 deaths of which 11 were directly due to the liver injury. 33 patients, whose hemodynamic stability contrasted with major hepatic lesions (5 deep fractures, 28 central hematomas combined with 5 subcapsular hematomas and 3 multiple parenchymatous fractures), were subjected to nonoperative management. One patient died from sudden hemorrhage and a second one underwent further drainage for a residual pelvic abscess. In the 32 alive patients, a close watch over with ultrasound and CT scan gave prominence to a complete disappearance of the lesions within 4 to 24 weeks. The nonoperative management of such hepatic injuries may be a safe and reasonable alternative to a high risk surgery, as far as the hemodynamic condition or associated visceral lesions do not require an emergency surgery. PMID- 2700162 TI - [Initial results of a new method of pancreatic transplantation]. AB - A new method of intraperitoneal transplantation of the whole pancreas as donor pancreaticoduodeno/recipient-cholecystostomy is described. The pancreas with duodenal segment is placed into the dorsal peritoneal cavity and the portal vein is anastomosed with the subhepatic vena cava and the long aortic segment of the graft with the distal aorta of the recipient. An anastomosis between the donor's duodenal segment and the recipient's gallbladder ensures exocrine pancreatic secretion drainage. PMID- 2700163 TI - [Intra-operative precautions and a proposition for a postoperative monitoring protocol in hepatic hydatidosis]. AB - In the expectation of new biological technics, immunoelectrophoresis is currently the most valuable one owing to its very high specificity. Precipitation line 5 which develops usually disappears after surgery, provided there is no recurrence. However, it may persist in many cases despite repeated negative check-ups. In view of such observations, there is some concern about the peroperative sampling methods commanded for the test, as well as regarding the postoperative follow-up procedure and schedule considering costs that are involved. PMID- 2700164 TI - [Retro-rectal cystic tumors of developmental origin in adults. Apropos of 2 cases]. AB - Two cases of recto-rectal congenital developmental cysts are described in young women (37 and 38 years). One was a duplication cyst of the rectum in association with two epidermoid cysts detected by US exploration in an asymptomatic woman, during pregnancy. The other case was a Tailgut cyst revealed by a retro-rectal abcess. In two cases, a pelvic CT Scan with rectal barium instillation for contrast and MRI exploration, revealed relationships and components of the developmental cysts. The treatment was a complete surgical excision via a Karske's approach, with coccygeal resection. PMID- 2700165 TI - The clinical utility of the foveal electroretinogram: a review. AB - The historical development of the foveal electroretinogram is reviewed. The factors required to obtain a local cone electroretinogram with a small focal source of illumination against a lighted background are discussed. From these considerations and various studies of macular degeneration, the optimal size of the foveal source is found to be 5 degrees diameter or less. Applications of the foveal electroretinogram in various diseases are summarized. The foveal electroretinogram is abnormal with reduced acuity in age-related macular degeneration, juvenile macular degeneration (Stargardt's disease), retinitis pigmentosa, and diabetic retinopathy. Normal foveal electroretinograms are found in optic atrophy, amblyopia, and optic neuritis. Foveal electroretinograms are normal or abnormal in Best's disease, central serous retinopathy, and several other diseases discussed. PMID- 2700166 TI - [Advances in research on the pathogenesis of hypertension and mechanism of action of insulin]. PMID- 2700167 TI - The paradox of butadiene epidemiology. PMID- 2700168 TI - Quantitative risk approaches for formaldehyde. AB - Formaldehyde presents unique data that highlight significant issues in the extrapolation of animal studies to human risk assessments. Formaldehyde causes rare nasal cancer in rats at 15 ppm, but not at lower levels of 2 ppm and 0.5 ppm in the range of human exposures. Mice and hamster studies even at high levels have results similar to low dose rats. Higginson et al. reviewed the human epidemiology studies and concluded that no excess cancer risk was observed; and if a risk exists, it is very low. Formaldehyde is a natural metabolite--the human body turns over 51 g/day. Cells, therefore, have detoxification and other defence mechanisms to formaldehyde. Recent CIIT biomechanism results elucidate these factors. These data raise two issues: First, the appropriateness of linear quantitative risk methodology given the non-linear nature of the biological data. Either a non-linear (threshold) statistical model or NOEL approach are appropriate risk assessment techniques for formaldehyde. Second, the rare nasal cancer observed in rats also occurs in control animals. A comparison of relative risk between background and low formaldehyde exposures has been calculated for both groups. Non-linear (MLE) 5 stage multistage models estimate 0 per million risk from both background and 1 ppm of formaldehyde exposure. Linear or upperbound (95%) estimates are 7,200/million from background and 5,000/million from 1 ppm formaldehyde. These estimates have a significant impact on formaldehyde regulatory programs for warning labels and "safe" exposure levels. PMID- 2700169 TI - Considerations of the chemical complexity of ETS with regard to inhalation studies. AB - Any inhalation study that investigates environmental tobacco smoke, ETS, is considering a very complex entity. ETS contains numerous chemicals that are continuously changing both in their absolute concentration, in the ratio of concentration between one and another, and even in their particulate to vapour phase distribution. Moreover, when considering ETS in real-life situations, many of the chemical components of ETS will be present as a result of sources other than tobacco smoking. This paper emphasises that the chemical and physical nature of ETS must be considered in the design and interpretation of any inhalation study on ETS, and illustrates the difficulty in defining precisely what constitutes ETS in such studies. PMID- 2700170 TI - Theory (or model) of the joint influence of occupational exposure to carcinogenic dust and to cigarette smoke and occupational lung cancer. AB - The model seeks to explain the substantial number of occupational health studies that find that the relative risk for lung cancer for exposed versus unexposed smokers is less than the relative risk for exposed versus unexposed non or never smokers. PMID- 2700171 TI - Functional culture of hamster and human airway epithelial cells and its application to pulmonary toxicology. PMID- 2700172 TI - Dust overloading causes impairment of pulmonary clearance: evidence from rats and humans. AB - There is increasing evidence, principally from experiments involving diesel exhaust particles, that pulmonary clearance becomes impaired after exposure to high dust concentrations. This effect is discussed here as a function of the exposure methodology as well as dust concentration. Metal oxide particles do not demonstrate this effect until higher exposures, presumably due to some solubility. Limited data suggesting impaired clearance at high dust loadings in humans is discussed. Thus, impairment may affect all materials and species if deposited in the lung at sufficient rates. PMID- 2700173 TI - Seven quick ways to deal with dental office stress. PMID- 2700174 TI - Medicare and dentistry: a bad combination? PMID- 2700175 TI - Patients are people. PMID- 2700176 TI - Parameters affecting in vitro bond strength of composites to enamel and dentin. AB - In vitro tensile bond strengths of Photo Clearfil Bright (PB) and Clearfil Photo Posterior (CP) with Clearfil Photo Bond to human enamel and dentin were determined by a truncated cone bond test. Parameters tested were: four substrates (etched enamel; unetched dentin, D1; dentin conditioned with 10% polyacrylic acid, D2; and dentin etched with phosphoric acid, D3); two techniques (bonding agent prepolymerized, and bonding agent and composite polymerized together); and two storage times in 37 degrees C water (one day and one week). Bond strengths of PB and CP to enamel ranged from 15 to 25 MN/m2 and 19 to 24 MN/m2, respectively. Bond strengths of PB to dentin ranged from 10.2 to 13.6 MN/m2 for D1, 8.2 to 10.5 MN/m2 for D2, and 5.5 to 7.8 MN/m2 for D3. Bond strengths of CP to dentin ranged from 7.6 to 12.3 MN/m2 for D1, 6.8 to 9.5 MN/m2 for D2, and 4.6 to 6.7 MN/m2 for D3. Bond strengths were higher to enamel than to dentin. The highest bond strengths to dentin were to unetched dentin, followed by conditioned dentin, and then etched dentin. Polymerization techniques and storage times did not affect the bond strengths. PMID- 2700177 TI - Effects of etching and rinsing times and salivary contamination on etched glass ionomer cement bonded to resin composites. AB - This study investigated the effect of salivary contamination on glass ionomer/resin-composite bond strength after establishment of an appropriate etching and rinsing time for the glass-ionomer cement. Three hundred and thirty samples of glass-ionomer cement (Ketac-Fil) were injected into cavities prepared in acrylic molds. Groups containing 15 samples each were etched for 0, 15, 30, or 60 sec, after which Scotchbond and either Silux or P-30 were applied and polymerized. The samples were stored under water for 24 hr at 37 degrees C and were then tested in shear. A 30-second etching time was found to be optimal when Silux and P-30 were considered together. In a similar manner, a 20-second optimal rinsing time was determined. Samples of glass-ionomer cement were then contaminated with saliva, dried, and bonded to composite resins and tested in shear as before. Significantly lower bond strengths resulted than with the uncontaminated controls. Efforts to clean contaminated samples by rinsing or re etching failed to increase the bond strength obtained with the contaminated samples. PMID- 2700178 TI - Dentin perfusion effects on the shear bond strengths of bonding agents to dentin. AB - The effect of pulpal pressure on the shear bond strength of Scotchbond and Gluma was evaluated in the presence and absence of smear layers. There was no statistically significant difference in bond strength for either Scotchbond or Gluma on dentin with a smear layer in the presence or absence of 32 cm of hydrostatic pulpal pressure. When no pulpal pressure was present and the smear layer was removed, the bond strength of Scotchbond fell while that of Gluma nearly doubled. When 32 cm of pulp pressure was applied, the bond strength of Scotchbond/Silux fell 86% and that of Gluma fell 75% in 24 hours. PMID- 2700179 TI - Bonding glass-ionomer cements to chemomechanically-prepared dentin. AB - The aim of this investigation was to compare the shear bond strengths of two commercially available glass-ionomer cement base materials to remaining dentin: (1) after conventional caries removal and polyacrylic acid conditioning; (2) after chemomechanical caries removal (Caridex); and (3) after chemomechanical caries removal and polyacrylic acid conditioning. Ninety freshly extracted carious teeth were randomly assigned for caries removal with either the chemomechanical technique (N = 60), or with conventional mechanical drilling (N = 30). Caries removal was continued until the remaining dentin surfaces were judged sound. The remaining dentin in 30 of the teeth prepared with the chemomechanical technique, and in all of the teeth prepared with mechanical drilling, was treated with 10% aqueous polyacrylic acid for 10 seconds. Groups of 15 teeth were assigned for bonding with either Ketac-Bond or Shofu Glasionomer Base Cement. All bonded specimens were stored in a humidor at 37 degrees C for 24 hr. Shear bond strength was tested by means of a mechanical testing machine at a cross-head speed of 0.05 cm/min. Analysis of variance indicated no significant difference (p greater than 0.05) in the mean bond strength among the groups. PMID- 2700180 TI - Shear strength and filler particle characterization of Maryland (acid etch) bridge resin cements. AB - The shear strengths of Maryland (acid etch) bridge cements were investigated and ranged from 44 to 70 MPa. The bulk shear strength of the resin cements is sufficient; the weak link in the system (other than the technique sensitivity) is the interface at or adjacent to the resin and metal or the resin and enamel. The resin cements were polished and etched, and scanning electron micrographs were taken and digitized to illustrate the filler particle sizes and distribution. PMID- 2700181 TI - Void formation by axial expansion of a gypsum-bonded investment. AB - The lengths of castings have been found to be dependent, in part, on the length of the ring lining material relative to the length of the casting ring. Five MOD inlay wax patterns were invested individually in open metal, in closed metal, and in plastic casting rings 35 mm or 42 mm long and 28 mm in diameter. The gingival walls of the wax patterns were placed either 8 mm or 15 mm from the uppermost ends of the rings. Specimens were broken in a mesiodistal direction, and the voids at the gingival walls were measured. The largest voids (139 microns) occurred in 42-mm-long plastic rings with the gingival walls 8 mm from the uppermost ends of the rings. The smallest voids (20 microns) occurred in the 35 mm-long closed metal rings. The boundaries between the investment and the voids were curved rather than accurately reflecting the straight gingival walls of the wax patterns. PMID- 2700182 TI - The heat generated on the external root surface during post space preparation. AB - The heat generated on the external root surface of human premolar teeth during post space preparation was measured in vitro. The rise in temperature was recorded at a point 6 mm from the apex of the tooth using a thermocouple attached to a chart recorder. The temperature rise was greatest when the removal of gutta percha was combined with post channel preparation. Temperature rises of up to 31 degrees C were recorded. Instruments that only removed gutta-percha did not generate the same amount of heat. The results from this study suggest that the use of engine-driven drills to prepare post channels in teeth may generate temperature rises that may cause periradicular tissue damage, and caution should be exercised during their use. PMID- 2700183 TI - Evaluation of dowel space preparation on the apical seal using an image processing system. AB - The effect of post preparation on the apical seal of endodontically treated specimens was studied. The canals prepared in bovine bone were instrumented and obturated using five obturation techniques: the silver point technique, the lateral condensation of gutta-percha technique, the warm vertical condensation of gutta-percha technique, the Hygenic Ultrafil injection system and the Obtura technique. In addition to these five control groups, the five experimental groups were also subjected to post preparation. In the latter group, the gutta-percha was removed with an engine-driven root canal reamer 48 hours after obturation. Both the control and experimental groups were suspended in a 0.5 per cent crystal violet solution for 48 hours. After dye penetration, the specimens were immersed in liquid nitrogen and then split longitudinally. Linear measurements of the resultant apical dye leakage were determined by image processing. For each obturation technique, all specimens in both the control and experimental groups were recorded if they showed leakage. Using Fisher's exact probability test, it was shown that there was no significant difference between the obturation techniques used. PMID- 2700184 TI - Ureteral blockage by Candida in a patient with urinary derivation type Camey. AB - A study of ureteral blockage by Candida in a patient suffering from urinary derivation is presented. It has been favourably resolved by medical treatment and nephrostomy. The increasing medical importance of urinary infections by fungi, especially in weak patients and catheter carriers, makes it important to employ more aggressive treatment. Regarding urinary derivation and Candida infection, in the case of urinary blockage the possibility must be considered that blockage may be due to fungi, since it can be successfully treated medically without the need of surgery. PMID- 2700185 TI - Carcinoma in situ in testicular biopsies. AB - Carcinoma in situ of the testis is an abnormality of the seminiferous epithelium characterized by aneuploid cells with clear cytoplasm located along the tubular basement membrane or in the lumina of tubules. Morphological, cytogenetic, and histochemical features of this anomaly are presented. An adequate fixation of testicular tissue samples is necessary for correct diagnosis. The fact that approximately 50% of carcinoma in situ may develop into malignant germ cell tumours of the testis in 5 years and the investigations of the testicular tissue adjacent to these tumours support the malignant nature and invasive potential of testicular carcinoma in situ. The incidence of carcinoma in situ in persons at risk is reviewed. PMID- 2700186 TI - Correlative changes of plasma renin activity and serum testosterone in human internal spermatic vein after single administration of human chorionic gonadotropin. AB - To study changes in renin secretion from the human testis at various days after hCG treatment, plasma renin activity in the internal spermatic vein (ISV) and cubital vein (CV) was measured at the time of surgical repair of varicocele in 79 patients. Sixty-five of them were given a single administration of hCG (10,000 IU/m2) 1 to 10 days before operation. Although the mean PRA levels in CV in both treated and untreated groups were similar, the mean PRA levels in ISV obtained 1 to 5 days after hCG treatment were significantly higher than that in the untreated group. However, the mean PRA levels in ISV returned to that in the untreated group 6-10 days after treatment. Serum testosterone levels in the same ISV were also much higher 1 to 6 days after hCG treatment, compared with those in the untreated group. On the basis of these results it is concluded that (a) the secretion of renin from the testis into ISV can be demonstrated for 5 days after hCG treatment; (b) the parallel increases in PRA with testosterone in ISV seem to suggest a possible influence of androgen on renin production in Leydig cells of human testis. PMID- 2700188 TI - Multiple congenital epulides in a newborn: with special reference to reported cases in Japan. AB - This report describes a case of multiple epulides which simultaneously occurred on the maxilla and the mandible of a 6-day-old female baby. The clinical findings, diagnostic procedure, surgical treatment, histopathology, and 2-year follow-up of this case are presented. Based on the clinicostatistical and histopathologic investigations with special reference to the pertinent Japanese literature, a possible histogenetic etiology of this entity is discussed. Any odontogenic component might play an important role in the development of this tumor. This case of multiple epulides is considered to be very rare. PMID- 2700189 TI - [Rapid compression of maxillary molar region, and its effects on sutures of the cranio-facial bones]. AB - Twenty young hybrid dogs were classified into 5 groups: the control, the group examined immediately after 2 weeks compression (3.52 mm), and those examined at 2, 4 and 8 weeks retention. In those animals undergoing compression 4 times, Dentaurum expansion screws (#602-813) were placed between the left and right fourth dento premolar. when rapid compression was used interruptedly, local synostosis was only seen in the palatine suture, but following retention for 8 weeks, this phenomenon almost completely disappeared. The internal mechanical force of the adjoining sutures had disappeared within 4 weeks of retention. In conclusion, this clinical application causes no permanent damage. PMID- 2700187 TI - Hyperlipidaemia in uraemic patients under chronic haemodialysis. Correlation with serum lipoprotein lipase and insulin levels. AB - Hyperlipidaemia is implicated in vascular complications of uraemic patients on haemodialysis. In this work serum lipids, serum lipoprotein lipase (LPL) and insulin levels were measured in 45 chronic uraemic patients on haemodialysis and 44 healthy volunteers. A significant rise in total lipids (TL), cholesterol and triglycerides (TG) was detected in the haemodialysis patients, but no changes were found in either serum phospholipids or high density lipoprotein cholesterol (HDL-chol.). The rise in TL, TG and cholesterol was positively correlated with the duration of dialysis but not with age or sex. On the other hand, a significant rise was also observed in serum LPL and insulin levels but with no correlation between any of them and the lipid levels. From this study it may be apparent that other factors rather than LPL abnormalities may be implicated in hyperlipidaemia in uraemic patients under haemodialysis. PMID- 2700190 TI - [Mandible function in taking construction bite for activator]. AB - Functional effects of construction bite for activator (Andresen type) especially on lateral pterygoid muscle, as well as the positional changes of the mandible, hyoid bone and surface EMGs from bilateral anterior temporal (TA) and masseter (MM) muscle, were studied on the electric force scale, MKG, EMG and cephalometric radiographs in 14 subjects with anterior cross bite in mixed dentition. The cephalometric radiographs were taken at the start of each patient's treatment. One was taken with the mandible in the intercuspal position and one was also taken with the activator in the mouth at the overjet improvement. The activator patients were divided into two groups because of differences in the direction of movement of the hyoid bone in the FH plane. In group O (7 patients), the movement of the hyoid bone was at an oblique angle to the FH plane, while in group D (7 patients) the movement ot the hyoid bone with nearly direct below angle to FH plane. The patients were further divided into three types because of differences in the distance between the hyoid bone and mental spine, and combined with the groups OA (3 patients), OB (2 patients), OC (2 patients), DA (5 patients), DB (2 patients) and DC (Naught). The results obtained were as follows: The forces for the construction bite for groups O and D were 2.71 Kg and 2.72 kg, respectively. Type OC required significantly heavier force. (p less than 0.05) In the condylar test, O group was significantly smaller at the start of treatment, but not after overjet improvement. Type OA and OB were also significantly smaller at the start of treatment. (p less than 0.05) Velocity of opening for group D was significantly (p less than 0.05) faster at the start of treatment, but not after that. There was no significant difference in EMGs between the groups, with activator in the mouse D group much increased as it EMGs. The EMGs M/T ratio for both groups was approximately 100% at the start of treatment for overjet improvement. In cases with no or slight lateral shift in the recorded path of closure or in the incisal region, no large differences were recorded laterally. Large EMGs differences were recorded with lateral shift in the incisal region, especially when taking the construction bite. PMID- 2700191 TI - An acoustic investigation caused by pontic formation. AB - Prosthetics for cases with large defects of alveolar bone often tend to be difficult. We researched the acoustic effects of various pontic forms to satisfy a patient's expectations for both phonetics and aesthetics. PMID- 2700192 TI - [Changes at sutures and pariodontium of fixed teeth due to application of rapid contraction force in maxillary canines in dogs]. AB - This study examines the histologic changes and the orthopedic effect, that might be expected after the application of an interrupted rapid contraction force with a skeleton type device, on the mid-palatal suture in the intercanine area, the sutures between the canines and the fixed teeth paradontium just after rapid contraction and after retention had been reached. Twenty young hybrid adult dogs, which were divided into five groups: a control group, a group of subjects just after rapid contraction, and retention groups at two, four and eight weeks. For the experimental groups, an expansion screw (No. 602-813), made by Dentaurum Co., was fixed between the maxillary canines and left there for two weeks to achieve a contraction with a total reduction of 3.52 mm. Measuring models, decalcified preparations (H.E. stain, Azan stain) and non-decalcified preparations (with hard tissue labeling medication) were used for the method of the study. The application of interrupted rapid contraction force at the maxilla produced a little body fusion on the mid-palatal suture only. However, the extent was very small, and disappeared during the retention. The fixed teeth showed tipping movements, but although there was a reduction of the maxillary width, it was still considered an indication and left a recognizable permanent complication. Thus the procedure is considered to be clinically valuable. PMID- 2700193 TI - [Application of a sectional denture with magnetic retention for disturbance of mouth opening]. PMID- 2700194 TI - [Adherence of Candida albicans to immobilized Concanavalin A]. PMID- 2700195 TI - [Analysis of temporomandibular joint function and dysfunction: computer-based evaluation of electromyography and kinesiography and its clinical application]. PMID- 2700196 TI - [Microbiological and serological investigation of periodontal disease activity]. AB - If disease activity in periodontal disease can be determined, the therapeutic measures of periodontitis may become diverse and different from patient to patient. The purpose of the present study was to evaluate the usefulness of microbiological and serological examination of periodontopathic bacteria in detecting destructive periodontal disease activity. One hundred and forty-eight sites in 52 subjects with moderate to severe periodontitis were studied clinically. Clinical parameters included plaque index, gingival index, probing depth, bleeding on probing and percent bone loss as measured radiographically. Subgingival plaque of whole sites was investigated microbiologically by means of indirect fluorescent-antibody technique with rabbit antibodies against Actinomyces viscosus, Actinobacillus actinomycetemcomitans (2 serotypes), Eikenella corrodens, Fusobacterium nucleatum, Bacteroides gingivalis and Bacteroides intermedius. The levels of serum IgG antibody to these organisms were determined by enzyme-linked immunosorbent assay with whole cell preparations. Thirty-two of 52 subjects were instructed in oral hygiene and received several sessions of scaling and root planing. The clinical, bacteriological and serological assessments were also performed after periodontal therapy. Active disease site was defined as the site of which clinical status did not be improved even after periodontal treatment. B. gingivalis, B. intermedius and A. viscosus were detected in 80% of periodontal lesions, and the proportion of B. gingivalis was the highest among six bacterial species tested. A. actinomycetemcomitans, E. corrodens and F. nucleatum were found only occasionally and in low numbers. The proportion of B. gingivalis was higher in severely inflamed sites than in clinically healthy sites. B. gingivalis and B. intermedius are rarely found in treated periodontitis sites, while the proportion of A. viscosus was slightly increased after treatment. Sera of the pre-treatment patients demonstrated significantly higher antibody levels to B. gingivalis and significantly lower levels to A. viscosus than those of healthy persons. Antibody levels reactive with other four species in the patients did not significantly differ from the levels in healthy persons. After periodontal therapy, antibody levels to B. gingivalis, B. intermedius and A. actinomycetemcomitans (serotype a) significantly decreased and the levels to A. viscosus increased to a slight degree. B. gingivalis was found more frequently in disease-active sites than in disease-inactive sites. The proportions of other bacterial species in disease active sites did not differ from those in disease-inactive sites. The results of the present investigation suggest that monitoring B. gingivalis in subgingival plaque and serum IgG antibody titer against this organism may aid in the description and adequate treatment of the periodontal disease. PMID- 2700197 TI - [Examination of periodontal disease with gingival crevicular fluid. Correlation between capacitance and clinical findings]. AB - An intimate relationship between the inflammatory state of the gingiva and the amount of gingival crevicular fluid (GCF) is well known. For the measurement of the volume of GCF, filter paper has been used in the past. In the present study, an electrostatic capacity measuring apparatus with sensor that is insertable into gingival sulcus was fabricated. Capacitance of GCF was measured in patients with periodontitis and the following results were obtained. 1. The measuring apparatus was controlled by a personal computer to obtain the data every 0.1 second. As the GI increased at the site of measurement, higher values were obtained, with longer persistence of the trend of increase in the measured value. 2. In view of the stability of the measured values, the amount of GCF appeared to be best expressed as the value obtained after 10 seconds. 3. The correlation between the capacitance and the clinical findings was evaluated at 500 sites. The correlation was the highest in GI followed by P1I, GBI and PD, suggesting the utility of this method in the detection of initial gingival inflammation. PMID- 2700198 TI - [Scaler sharpening. Effect of the cutting edge of scaler and the epoxy resin surface with several types of sharpening stones and strokes]. AB - The purposes of this study were to determine the characteristics of a sharpened scaler and planed epoxy resin surface under different sharpening conditions. Each scaler was sharpened with the following kinds of sharpening stones and sharpening strokes by using an originally designed sharpening machine: Stones: 1) Fine India stone (ISF) 2) Arkansas stone (AS) 3) Carborundum stone (CS) 4) ISF followed by AS (ISF + AS) 5) CS followed by AS (CS + AS). Strokes: 1) up strokes (PUSH) 2) down strokes (PULL) 3) up and down strokes (RE) Epoxy resin surfaces were planed (10, 20 and 40 strokes) by sharpened scalers. Before and after these sharpening procedures for each scaler, the cutting edge of each scaler was photographed with a scanning electron microscope (SEM) to determine its roughness and the number of wire edges. The epoxy resin surface was examined with the SEM and the surface roughness was analyzed with a profilometer. The following results were obtained: 1) ISF with three types of sharpening strokes produced the roughest cutting edge. 2) ISF and CS with three types of sharpening strokes produced the largest number of wire edges. 3) PUSH with the five types of sharpening stones showed the roughest cutting edge and the largest number of wire edges. 4) ISF and CS produced more surface roughness, and AS made a smoother surface. Epoxy resin surfaces were planed effectively after 10 strokes. However, no significant differences were found in the surface roughness after 10 to 40 strokes. PMID- 2700199 TI - [Basic studies on CaO-P2O5-MgO-SiO2-CaF system glass ceramics. 1. Morphology under the phase-contrast microscope and growth of cultured cells]. AB - In order to determine the biocompatibility of glass ceramics which is one of the new biomaterials, in vitro studies were carried out by a cell culture method using four established cell lines. Materials used were glass ceramic disks with a diameter of 3 mm, and polystyrene coverslips of the same size as controls of the growth curve. Cells of each line were inoculated into 24-well multiplates at an appropriate density onto glass ceramic disks, and examined by phase contrast microscopy on the 1st, 3rd, 6th and 8th day. In addition, doubling time and saturation density were calculated from the growth curve. The results obtained were as follows. 1) Phase-contrast microscopy revealed that cells of each line attached to the disk within 24 hours and their numbers increased with time. After 8 days of cultivation, all of them reached confluence. 2) Contact with the glass ceramics did not cause cellular death or degeneration. Furthermore, the cultured cells showed the same morphological features as the control cells. 3) According to the growth curves, doubling time of all cells cultured with glass ceramics was shorter than that of the control cultures. On the other hand, saturation density was reduced to a minimum of 80% of the controls. These findings led to the conclusion that glass ceramic materials do not prevent the growth of cultured cells. According to the above results, glass ceramics possess the characteristics needed for bone grafts and implant materials. PMID- 2700200 TI - [In vivo study of bacterial invasion in root planed and citric acid treated radicular surfaces of periodontally involved human teeth]. AB - The purpose of this study was to investigate whether plaque bacteria invade the exposed radicular dentin after root planing or chemical root treatment in vivo. Eighteen caries-free human periodontally involved teeth with hopeless prognoses were studied. Fourteen teeth were scaled and root planed with hand curette type scalers. The proximal surface of each treated tooth was designated as the RP surface. The remaining half of the proximal surface was treated with citric acid (pH 1.0) for 3 minutes and was designated as the CA surface. Four untreated teeth served as controls. After 4 weeks, the teeth were extracted, and were processed for light microscopy and for scanning electron microscopy concerning bacterial invasion into the supragingival radicular dentin. The following results were obtained. 1. Radicular cementum was present on most untreated tooth surfaces. However, bacteria were never seen in the dentinal tubules. 2. Bacterial invasion into the dentinal tubules was observed in five of the 10 proximal surfaces (50% of the RP surfaces) and in nine of the 10 proximal surfaces (90% of the CA surfaces). 3. The depth (9.5 +/- 24.1 microns vs 84.6 +/- 136.3 microns) and percentage (0.8 +/- 2.1% vs 20.3 +/- 17.3%) of bacterial invasion in the dentinal tubules of the RP surfaces was lower than that of the CA surfaces. 4. Cocci and short rods were present in the supragingival dentinal tubules. 5. Since CA surfaces may accelerate bacterial invasion the citric acid treatment might be harmful in patients with inadequate plaque control. PMID- 2700201 TI - Comparison of three core buildup materials used in conjunction with two post systems in endodontically treated anterior teeth. AB - Fifty extracted maxillary central incisors with the crowns removed 1 mm coronal to the labial cementoenamel junction were endodontically treated. Post spaces were made 7 mm into the roots prior to cementing a 13-mm post with zinc phosphate cement. Twenty-five of the teeth were restored using a #6 (0.060-inch) Para-Post, and the remaining 25 teeth were restored with a #6 Para-Post Plus. Three core buildup materials, Ketac-Silver, Miracle Mix, and Tytin alloy were used in conjunction with the posts. Cast gold copings 10 mm in height with 1 mm collar on the root were cemented to the buildups. The teeth were loaded to failure at 130 degrees to the long axis of the root from the lingual with an Instron testing machine. The mean failure load of all of the teeth in this study was 21.6 kg. All of the teeth failed when the posts dislodged from the canals. The Para-Post Plus was not significantly more retentive than the Para-Post. No failures occurred within the buildup materials. No significant differences were demonstrated between the mean failure loads of the different buildup materials. Increased buccolingual root diameter, however, had a positive correlation (r = 0.46) with higher failure loads which was statistically significant (p less than 0.001). PMID- 2700202 TI - Neurogenic mediators in control of pulpal blood flow. AB - In view of recent findings, classical nerve-released transmitters that modulate pulpal blood flow share their roles with novel vasoactive peptides. Noradrenaline coexists with neuropeptide Y in sympathetic nerves in the pulp and both substances contribute to a vasoconstriction. Vasoactive intestinal peptide has vasodilator effects and its presence in nerves in the pulp may represent a parasympathetic influence on pulpal vessels. Sensory nerves in the pulp contain a number of peptides which have vasodilatory effects. They are released and cause rapid increase in blood flow when the tooth is reached by an intense stimulus. A population of sensory nerves may thus play a role in instant defense reactions in the pulp. PMID- 2700203 TI - [Localization of the rabbit pharyngeal motoneurons and peripheral courses of their axons: a study by means of the retrograde HRP or fluorescent labeling technique]. AB - The localization of the rabbit pharyngeal montoneurons in the nucleus ambiguus and peripheral courses of their axons were investigated using injection of retrograde labeling tracers, i.e., HRP and nuclear yellow, into the individual pharyngeal muscles or using the injection in conjunction with intracranial severing of either the vagal or glossopharyngeal rootlets. The nucleus ambiguus of the rabbit was divided into four groups of neuron, of which the following two, the compact cell group (CoG) and the medial scattered group (SGm), were pertinent to the pharyngeal montoneurons. The CoG is a group formed by a compact arrangement of the smallest neurons and situated in the rostral half of the nucleus ambiguus. The SGm is a group formed by a scattered arrangement of slightly larger neurons in the rostral one-third of the nucleus and located medial to the CoG. The labeled stylopharyngeal motoneurons occupied the rostral portion of the SGm at a level from about 2800 to 3100 microns rostral to the obex. They were completely abolished by severing the glossopharyngeal rootlets, in contrast to no change of labeled neuron number when severing the vagal rootlets. Thus, all axons of the stylopharyngeal motoneurons were concluded to traverse the glossopharyngeal rootlets. The labeled palatopharyngeal motoneurons were found in the caudal portion of the CoG at a level from 500 to 1900 microns rostral to the obex, with their number being numerous at the caudal one-third of CoG, 500 to 1300 microns. All their axons traversed the vagal rootlets. The labeled pharyngeal constrictor motoneurons were found at almost all rostrocaudal levels of CoG, 500 to 2900 microns rostral to the obex, with their number being numerous in its middle one-third level. Although motoneurons of the superior constrictor, those of the middle constrictor, and those of the thyro and cricopharyngeal muscles composing the inferior constrictor overlapped rostrocaudally in location, their ranges of appearance had a tendency of arranging rostrocaudally in that order. At the middle one-third level of CoG, in which the CoG was subdivided into two subgroups, dorsomedial and ventrolateral, the superior and middle constrictor motoneurons were located in its entire portion. The majority of axons of the pharyngeal constrictor motoneurons traversed the vagal rootlets, though a few axons whose somata lay in the rostral portion of the CoG traversed the glossopharyngeal rootlets. PMID- 2700204 TI - Are Medicaid fraud control units the real fraud? Part 1. PMID- 2700205 TI - A veneering resin for stainless steel crowns. PMID- 2700206 TI - The role of arachidonic acid metabolite PGE2 on T cell proliferative response. AB - We have examined the role of cyclooxygenase and lipooxygenase-derived metabolites of arachidonic acid (AA) during T cell activation. One of the major products of cyclooxygenase activity is prostaglandin E2 (PGE2). As is known, macrophages (Mo) are the main PGE2 producer cells among the peripheral blood mononuclear cells (PBL) and can be induced to release PGE2 during T cell activation. On culturing PBL with T cell mitogens such as phytohemagglutinin (PHA) or monoclonal antibody OKT3, the levels of PGE2 produced by Mo were positively correlated with the entity of the T cell mitogenic signal. During T cell activation, subcellular factors able to provide positive or negative signals on the Mo PGE2 production are released in culture. We observed that recombinant IL2 strongly enhanced PGE2 synthesis in lipopolysaccharide (LPS) stimulated Mo culture, while recombinant interferon gamma (IFN-gamma) partially inhibited its production. Moreover, purified IL1 induced PGE2 synthesis in resting Mo and increased its production when Mo were activated by LPS. The PGE2 released during T cell activation seems to have no effect on T cell mitogenesis, since the addition of cyclooxygenase inhibitors did not influence the proliferative response of mitogen stimulated T cells. However, the addition of PGE2 to OKT3 stimulated PBL at the beginning of the culture period inhibited the proliferative response in a dose-dependent manner. Its addition had no effect on PHA-stimulated PBL cultures. The PGE2 dependent inhibition of OKT3-induced T cell proliferation declined progressively from about 50-10% as the addition of PGE2 was delayed from 0 to 24 hr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700207 TI - Production and characterization of monoclonal antibodies with diagnostic potential against Shigella flexneri. AB - Highly specific monoclonal antibodies (McAbs), 1aM3, 2aM1 and 2bM2 were produced and characterized against Sh. flexneri 1a, 2a and 2b respectively. IaM3 is an IgG3 (lambda) type antibody reactive against whole bacteria or the lipopolysaccharide (LPS) only; 2aM1 is an IgG1 (kappa) type antibody which reacts with the polysaccharide component of LPS; 2bM2 is an IgG3 (lambda) type antibody which binds with both the polysaccharide and protein/peptide components of the LPS. The results indicate that specific McAbs with diagnostic potential can be produced using acetone-killed and dried cells as antigen. Ascitic fluid produced in mice using the anti-Sh. flexneri hybridomas was found not to contain higher titres of McAbs against the bacteria. A "nutritionally-deprived" medium was, therefore, constructed which produced greater than five times the concentration of the McAbs than that could be obtained using normal culture fluid. PMID- 2700208 TI - [Analysis of movement in partial prostheses and abutment teeth with differences in retainer]. AB - When designing a prosthesis in a clinical setting that takes into consideration the protection of the abutment teeth and alveolar ridge, it remains difficult to carry out a method of connecting the abutment tooth and prosthesis based on objective grounds. This is because there are still many matters that remain unclear about dynamics of the stomatognathic system, including the prosthesis, when attached in the oral cavity. The author created the following three prostheses on a stimulation model of a tooth bone saddle that included an artificial mucous membrane and periodontal membrane: (1) A fixed bridge, (2) A telescopic denture (Konuskronen Telescope), (3) An Akers clasp denture. Following this, flat-controlled random noise was applied to each denture to create a dynamic load that exhibits a state closer to a clinical situation. Modal analysis was carried out with a laser doppler vibrometer and observations were made of the prosthesis and the abutment tooth apex to obtain visual clarification of dynamics, The following results were obtained. 1. As far modal resonant frequency, in mode #1, the bridge measured at 483 Hz and 561 Hz, the Telescope at 452 Hz and 600 Hz and the clasp at 581 Hz and 596 Hz. In mode #2 the bridge measured at 1,355 Hz and 1,370 Hz, the Telescope at 1,343 and 1,040 Hz and the clasp at 1,114 Hz and 1,079 Hz. In mode #3, only the bridge was detected and the recorded values 1,906 Hz and 2,026 Hz. 2. The influence on the modal resonant frequency due to the difference in abutment devices was limited. 3. Observation of animation indicated that the tendency for lateral movement of the abutment teeth increased going from the bridge to the Telescope to the clasp. 4. Displacement of the abutment tooth root apex decreased in reverse proportion to the strength of the connection between the abutment tooth and the abutment device. PMID- 2700209 TI - [Present and future of carcinogenic tryptophan pyrolysis products in the environment]. AB - Food has been considered an important factor for the genesis of cancer in man, as important as cigarette smoking. Diet influences the incidence of human cancer in many ways, directly and indirectly. Various kinds of carcinogens such as polynuclear aromatic hydrocarbons, N-nitro compounds and mycotoxins have been reported to be present in various foods. During the last decade, a new series of heterocyclic amines has been isolated as potent mutagens and later shown to be potent carcinogens in animals. Among them, carcinogenic tryptophan pyrolysates have been investigated from various points of view and useful pieces of information about them have been collected. Now, it is a matter of urgency to evaluate the effects of these carcinogens on humans. From this aspect, this review describes the information about carcinogenic tryptophan pyrolysates which has been collected and also future problems, especially those the hygienist will have to solve. PMID- 2700210 TI - [Role of soft tissue in orthodontic diagnosis. 1]. AB - The Authors propose a review of the soft-tissue cephalometric analysis, to show its diagnostic usefulness. PMID- 2700211 TI - [Lingual appliances: indirect application of lingual brackets. 2]. AB - The bracket must be placed on the tooth in order to reach its tridimensional control, in accordance with all the other teeth. So you must consider these parameters: height, torque, rotation, inclination, tooth slot-vestibular surface distance. Besides brackets direct and indirect application, we describe in this work other alternative ways: the Diamond pliers, the parallelometer Ormco, the jig, and the CreeKmore slot machine. PMID- 2700212 TI - [Craniofacial growth. 1. Critical review of the most authoritative current knowledge]. AB - After an analysis of the knowledge of today about the cranio-facial growth, the author presents a theory of the structural function as a proper conclusion of the change from a genetic hypothesis to a functional matrix. This theory will explain some skeletal modifications that before were incomprehensible. PMID- 2700213 TI - [A new orthodontic proposal: the vertical increment appliance]. AB - A new orthodontic device is proposed by the author: an alloy layer welded to first upper bicuspids bands. It's a matter of an an activator-like device being no obstructing for tongue, cheeks and lips. To alter vertical dimension in oral cavity, it is not difficult to use the last generation of bonding agents. PMID- 2700214 TI - [Tooth extraction in surgical orthodontic treatment of malformations of the facial mass]. AB - In the present article the Authors take under consideration the most important role of the presurgical orthodontic treatment from the point of view of the orthodontic techniques which aim to improve the occlusion. The authors, therefore describe the different faces, and they focalize the fact that the therapy may frequently require extractions to resolve serious crowdings of the teeth. They take also care of the maxillo facial skeleton alterations, to decide on extracting and about the ratio between the space available and required in the different cases. PMID- 2700215 TI - Host-parasite relationships in candidosis. AB - Candida albicans has several properties which allow it to colonize and invade host tissues, often resisting eradication. Two of these properties, adherence and acid proteinase production, seem to be genuine factors. Phenotypic switching and molecular mimicry may also provide the organism with an arsenal of mechanisms to evade host defenses. PMID- 2700216 TI - Candidosis: diagnostic tools in the laboratory. AB - The diagnosis of deep-seated candidosis still poses severe problems to the physician. While laboratory tests for a long time have been mainly based on the detection of antibodies to Candida and in particular Candida albicans the detection of Candida antigen in the blood gains more and more interest. When it comes to the evaluation of the various laboratory tests the correlation with autopsy data is most rewarding. The more specimens are analysed for the presence of hints at deep-seated candidosis in a given hospital setting the least frequent death due to deep-seated candidosis occurs. PMID- 2700217 TI - Clinical spectrum of oral candidosis and its role in HIV-infected patients. AB - Oral candidosis is a very frequent diseased state occurring mainly together with severe underlying disease. Clinical manifestation is variable. One can distinguish between oral thrush, denture stomatitis, angular cheilitis, leukoplakia and midline glossitis. Nowadays oral candidosis is also important in connection with HIV-infection. Here the clinical spectrum does not seem to be totally different. Apart from oral thrush (or pseudomembraneous type) a chronic atrophic type, a chronic hyperplastic type, papillary hyperplasia and angular cheilitis are distinguished. Oral candidosis is the most frequent opportunistic infection in HIV-infected patients. Frequency of overt disease is linked to the T4/T8 ratio. In patients with AIDS-related complex oral candidosis seems to be indicative of rapid progression. Candida albicans is the prevailing microorganism. There is, however, a change of biotypes during the course of HIV infection. There seems to be a selection of certain phenotypes as can be judged from the increasing resistance to 5-fluorocytosine. PMID- 2700218 TI - Oral candidosis and its role in immunocompromised patients. AB - The increased incidence of invasive candidosis in numerous categories of patients, including neonates, cancer patients, AIDS patients and patients who have undergone organ transplantation, is of great concern for the physicians involved. The manifestations of candidosis are numerous, and various clinical entities such as localized and disseminated infection have to be considered separately. All types of localized candidosis per se are usually not the main cause of disseminated disease. However, spreading of the mycotic pathogens in the gastrointestinal tract could induce disseminated candidosis. Prophylactic measurements in risk patients and consequent local and, if necessary, systemic treatment is recommended in these clinical entities. PMID- 2700219 TI - Pharmacokinetics of topical and oral antifungals. AB - By principle both topical and systemic antifungals are available for oral candidosis. As therapeutic results have not yet reached an optimum these modalities deserve further consideration. This especially applies to bioavailability. As candidosis in general very often is a disease confined to other tissues than blood especially to cutaneous and mucosal surfaces, it is helpful to determine the drug level found at these sites. Both total and free drug levels should be looked at. The skin blistering techniques make this possible. In vitro simulation of the level profiles of various antifungals including in particular ketoconazole found in the skin can be simulated in vitro using Grasso's model. If this is done only a very limited candidacidal effect is to be seen. Taking this fact into account as well as a limited clinical efficacy of conventional treatment protocols it looks rewarding to use conventional antifungal drugs such as ketoconazole at comparatively high doses. PMID- 2700220 TI - The role of Candida infections as an adverse effect upon head and neck cancer patients undergoing therapeutic radiation and the effect of antimycotic treatment. AB - Oral, pharyngeal and esophageal infections caused by Candida species occur very frequently when it comes to radiation therapy for head and neck cancer. In clinical terms oral candidosis is most often characterized by pseudomembranes or erythema. The erythematous form of oral candidosis has in particular to be distinguished from radiation mucositis. Candidosis of the oral and gastrointestinal tract often causes interruption of therapeutic radiation. Ketoconazole treatment is able to reduce the period of time during which the patient cannot be treated by radiation. Oral ketoconazole given at a daily dose of 200 mg is moreover superior to topical nystatin. To date, however, it is not yet clear if patients who have head and neck cancer in whom radiation therapy has to be started would profit from the prophylactic application of ketoconazole from start on. PMID- 2700221 TI - Oral and gastrointestinal candidosis: prophylaxis during immunosuppressive therapy. AB - Patients with acute leukaemia and malignant lymphomas often are severely affected by fungal infections. There is in particular growing concern about disseminated candidosis. Oral, gastrointestinal and systemic candidosis seem to be closely linked. Predisposing factors are damaged mucosal barriers due to chemotherapy, protracted periods of neutropenia, and prolonged use of antibiotics and steroids. Oropharyngeal candidosis is very frequent. This can be prevented or controlled by the application of topical antifungals such as nystatin. The systemic application of antifungals is an alternative for patients who do not respond. Both oral ketoconazole and intravenous amphotericin B have been proven effective. Candida oesophagitis is also an important problem. Oral nystatin suspension can be helpful in mild cases. In others oral ketoconazole and intravenous amphotericin B have to be used. A whole range of measures has to be taken to prevent spread of the disease, i.e. H2-antagonists should be used only if definitely needed. Specific antifungal prophylaxis has also been discussed. Oral amphotericin B seems to be helpful. The azole itraconazole might be especially promising. PMID- 2700222 TI - Change of causative organisms under antifungal treatment in immunosuppressed patients with HIV-infections. AB - Oral and esophageal candidosis are very common in HIV-infected patients. Due to the lack of efficacy of topical antimycotics in advanced stages of HIV-infection oral azoles are mainly used for treatment. Azoles most often used are ketoconazole and fluconazole. While Candida albicans clearly is the most frequently encountered yeast before and after treatment other species can be found somewhat less frequently after treatment. This especially applies to Candida glabrata. Candida spp. other than C. albicans obviously may cause manifest oral candidosis. This shift of microbes deserves the more interest as they are less susceptible to azole drugs. PMID- 2700223 TI - Risks involved in selective decontamination in immunocompromised patients. AB - Selective oral and systemic decontamination are widely discussed when it comes to the prophylaxis of bacterial and fungal infections in immunocompromised patients. The number of such patients is clearly rising due to the aggressiveness of modern medicine. Host defence is based on a variety of factors including the barrier function of mucosal surfaces as well as the phagocytic system provided by the blood. It seems helpful to distinguish between three different stages of immunodeficiency: "Minor immunodeficiency", "immunodeficiency" (in a stricter sense), "major immunodeficiency". When it comes to the choice of measures to be taken to protect the host, it is not only needed to consider the microbes already present but also the present state of defence mechanisms. When invasive fungal infections in particular have to be prevented, several drugs have to be discussed. As conventional antifungals have not met all expectations there is clear need for new drugs such as itraconazole. PMID- 2700224 TI - Safety aspects of ketoconazole, the most commonly used systemic antifungal. AB - Ketoconazole was first considered as a more or less safe drug. When used on a very large scale, however, it became obvious that this drug, as others mainly metabolized in the liver, can cause liver damage, i.e. chemical hepatitis sometimes even leading to death. Such very rare events seem to be linked to the protracted use of ketoconazole. Taking into account what is now known on the rational use of ketoconazole it still is a drug with a favourable benefit risk ratio. PMID- 2700225 TI - International Workshop on Oral and Gastrointestinal Candidosis: From Pathology to Therapy. Introduction. AB - Oral candidosis is the manifestation of candidosis earliest described. In fact pertinent cases are already to be found in the corpus hippocraticum. Exactly 150 years ago a fungus was found in lesions of orogastrointestinal candidosis by the German surgeon Langenbeck. For a long time, there was much dispute on the proper term for the most important causative organism of thrush and correspondingly for the proper name of the diseases caused. Today, Candida albicans is accepted by virtually everybody and the discussion on the name of the disease only focuses on the terms candidiasis and candidosis of which the latter seems preferable. Facing the scientific progress in the field of Candida and candidosis research and the permanent change of both the causative organism and the corresponding disease in the age of the HIV-infection (AIDS), it seems rewarding to review epidemiology, microbiology, nosology and treatment of oral and gastrointestinal candidosis. PMID- 2700226 TI - [Bonding strength of adhesive resin and calcium phosphate crystalline ceramics (CPCC)]. AB - The bond strengths of two adhesives, Panavia EX (PE) and Superbond C & B (SB), and calcium phosphate crystalline ceramics (CPCC) were examined. Two square pieces of CPCC were joined to each other using PE, and another two pieces were joined using SB at adhesion loads of 0.2kgf and 15.0kgf. The adhered specimens were left at 37 degrees C and 60 degrees C in thermostatically controlled purified water baths for 24 hours. The bond strength was determined by means of an apparatus to measure compressive shear and bond strength. Stress distribution on the interfaces with compressive shear where the adhesive was applied was also studied by a two-dimensional photoelastic experiment. The results were as follows. 1) The test pieces joined with PE at 0.2kgf and left at 37 degrees C provided the maximum bond strength, 69 +/- 16.8kgf/cm2, while those joined at 15.0kgf and left at 60 degrees C provided the minimum bond strength, 10 +/- 5.6kgf/cm2. 2) The test pieces joined with SB at 15.0kgf and left at 60 degrees C and those joined at 0.2kgf and left at 37 degrees C provided the maximum and minimum bond strengths: 179 +/- 36.8kgf/cm2 and 70 +/- 10kgf/cm2, respectively. 3) When the adhesion load was increased from 0.2kgf to 15.0kgf, the coat thickness for PE and SB were decreased from 45 microns (SD = 11.7) to 20 microns (SD = 2.8) and from 68 microns (SD = 24.5) to 18 microns (SD = 2.9), respectively. 4) The bond strengths of PE and SB for CPCC were decreased and increased, respectively, by an increase in adhesion load, i.e., a decrease in the thickness of the coat, and an increase in the temperature of maintenance after adhesion. 6) The photoelastic experiment revealed no differences in stress distribution or shear stress between the combinations of PE and SB adhesives and adherends of SUS304 and CPCC. 7) Shear stress was distributed to the area ranging from the site of load to the base of load on the interfaces with compressive shear where adhesive was applied. PMID- 2700227 TI - [Use of monoclonal antibodies to intermediate filaments in the diagnosis of cancer]. PMID- 2700228 TI - [Calmodulin, S-100 protein and oncomodulin in various proliferative syndromes]. PMID- 2700229 TI - [Adverse reactions to cisplatin in patients with malignant tumors]. PMID- 2700230 TI - [Desensitization in drug allergy]. PMID- 2700231 TI - [Various consequences of passive tobacco smoking]. PMID- 2700232 TI - [Acute adult respiratory distress syndrome]. PMID- 2700233 TI - [Phenotype of xenobiotic oxidation as a marker of sensitivity to respiratory tumors]. PMID- 2700235 TI - [A small anniversary for the Swinoujscie Medical School]. PMID- 2700234 TI - [Sleep apnea syndrome]. PMID- 2700236 TI - An improved technique for dental alloy etching with a potentiostatic device. AB - Since a good retention of direct bonded retainers onto abutment teeth is the primary requirement for the fabrication of etched fixed partial dentures, successful formation of a micromechanical retentive architecture on the bonding surface is one of the most important procedures. For creating such a retentive dendritic pattern on nonprecious metal, a 2-electrode electrolytic method has been used. This equipment consists of a low-voltage DC power supply and two electrodes, namely, a working and a counter one. However, the current and voltage should be monitored during the entire processing time and the etching area must be pre-estimated. A potentiostat has been used to automatically stabilize the voltage across the working electrode and reference electrode by adjusting the current, as commonly employed in electro-chemical technology. A 3-electrode corrosion device originally developed for laboratory research was adapted for dental retainer etching in this study. The results revealed that the etching of dental nonprecious metal (Ni-Cr-Be alloy) could successfully be performed by using the system with a potentiostat. Moreover, the working potential was found to be approximately 1.3 volts by taking the midpoint between the breakdown and the critical potentials for passivation on the potentiostatic anode polarization curves. The optimal exposure time has been found to be in a range of 3 to 5 minutes and 4 minutes to be ideal as determined by SEM microphotographic observation which showed a uniform dendritic pattern with regular lattice form of alternating ridges and valleys.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700237 TI - [An evaluation of the efficacy of treating rheumatoid arthritis with preparations for local use]. AB - Assessment was made of the efficacy of local therapy of rheumatoid arthritis patients with dimexide during a double blind method of investigation. The articular index, duration of constraint in the morning and the strength of the hand were taken as the leading criteria for objective assessment of the drug efficacy. Applications of a 50% solution of dimethylsulforoxide give a statistically significant favourable effect as compared to the conventional physiotherapeutic methods of treatment: ultrasound and phonophoresis with analgin. Addition of analgin to a 50% solution of dimethylsulforoxide intensifies its antiphlogistic and analgesic properties. PMID- 2700238 TI - [Ultrasonic dopplerography and photoplethysmography in the diagnosis of Raynaud's syndrome]. AB - Data on the studies of the blood flow in finger vessels in 45 patients with Raynaud's disease by means of ultrasonic dopplerography and photoplethysmography are given. The control group consisted of 30 persons. The use of a cryotest showed significant differences in arterial segmental blood flow of the hand fingers in patients with Raynaud's disease and in those of the control group. The mentioned methods are noninvasive, give sufficiently informative results providing an objective assessment of the nature of vascular disorders in Raynaud's phenomenon of different genesis. PMID- 2700239 TI - [The present-day treatment of systemic lupus erythematosus]. PMID- 2700240 TI - A simple, accurate & stable master model and die technique. PMID- 2700241 TI - Precision attachments: a procedure checklist. PMID- 2700242 TI - History of rhinology: anatomy of the paranasal sinuses. AB - The knowledge of the presence of the paranasal sinuses dates back to early mankind as well as attempts to treat their diseases. Apart from the sensory function of smell, however, little has been known about the function and especially the anatomy of the system till the end of the last century. Until the late middle ages sometimes obscure functions were attributed to the sinuses, like holding the "grease" for the movement of the eyeballs, or allowing the brain to "drain its bad spirits" to the outer world, bringing about names like "la cloaca del cerebro" by Sansovino in the 16th century. The old French expression of "rhume de cerveau" demonstrates these ideas having passed on into modern man's vocabulary. During the 17th and 18th century discussion was mainly about the function or purpose of the sinuses, and the rare anatomical studies were meant to support or prove one or the other "philosophies". Today's knowledge of the anatomy to a great deal goes back to the basic work of Emil Zuckerkandl of Austria, who starting from the 1870s described in subtile studies the anatomical and development details of the nose and the sinuses, opening an entire new field for scientific and surgical approach to the area. The decades around the turn of the century boost with studies on sectional and surgical anatomy, creating the specialty of rhinology and leading into our modern concepts of diagnosis and therapy of nasal and paranasal sinus diseases. Names like Grunwald, Onodi, Hajek and many others are closely linked with this creative period. Radiology, especially the development of conventional and computed tomography during the last two decades helped to "rediscover" the fascinating details and complex connections of the paranasal sinus system. Together with the development of the operating microscope and the endoscope this helped to open new ways for functional approaches and less radical microsurgery. PMID- 2700243 TI - [Interaction of iron, zinc and copper in the body of animals and humans]. AB - In the light of the pertinent literature the sites and mechanisms of interactions of iron, zinc and copper in the human and animal organism are discussed. Both low and high intake of any of them may influence the utilization and metabolism of both remaining ones. E.G. dietary copper deficiency impairs the mobilization of iron reserves from the liver, and its excess inhibits the intestinal absorption of iron and zinc. Iron in excess may antagonize copper and zinc in the intestinal mucosa. Zinc excess has an unfavourable influence on iron balance by reducing the bioavailability of copper, and zinc deficiency reduces the rate of protein synthesis impairing, among others, the transport of these elements with blood. The occurrence of interaction depends on the mutual proportions of components and their sum in the diet. Attention is called to these interrelationships which are of practical importance in human nutrition. PMID- 2700244 TI - Prevention of infectious complications in immunocompromised patients. Part II: Selective decontamination. AB - The method of selective decontamination of the gastrointestinal tract represents a new possibility of protection of immunocompromised patients against infectious complications with frequent lethal issue. The method is based on employment of such antibiotics and chemotherapeutical drugs that eliminate the aerobic gram negative microflora and yeasts preserving the anaerobic portion of the bowel microflora that is responsible for the so-called colonization resistance of the intestinal tract. Such a treatment provides patients with more resistance against infection and there is no need for strict reverse isolation. The theoretical exposition of the SD mechanism is given along with instruction on how to use this method and summarizing the hitherto clinical results of its employment. The authors' proper more than 6 year experience is compared with the world literature, and the SD method is stated to be a valuable import in preventing infections in hematological patients. Some unresolved problems and future prospects are also discussed. PMID- 2700245 TI - [New mucogingival surgical technics. 1. The subepithelial connective tissue graft. Review of the literature and report of a case]. AB - The Authors refer in this note about a new technic to recover root recessions particularly those wide and deep: the subepithelial connective tissue graft. PMID- 2700246 TI - [New mucogingival surgical technics. 2. The semilunar coronal flap. Review of the literature and report of a case]. AB - The Authors refer in this second note about the indications and surgery technic of the semilunar coronally repositioned flap. PMID- 2700247 TI - [Use of the Maryland bridge in periodontology]. AB - The authors have reported the investigations about the Maryland Bridge and its importance in periodontology. The Authors have suggested the clinical application of this kind of prosthesis and the Authors have reported about two clinical cases that have had first a periodontal treatment then a Maryland Bridge prosthesis. PMID- 2700248 TI - [Periodontal disease during pregnancy]. AB - The authors have reported three clinical cases of gingivitis during the pregnancy in the women. These gingivitis were noticed more frequently during the end of the second and the third quarter. The patients were educated to maintain a better oral hygiene and they were treated with scaling and root-planing to obtain the periodontal healing. PMID- 2700249 TI - [Salivary tests and clinical indexes in selection of caries risk groups. Critical review of the literature]. AB - The Authors briefly illustrate some recent findings about the selection of high caries risk groups. The aim of this study is to review some of the main contributes of the literature of the last years. The attention has been mainly focused on the used experimental design. From this review it can be concluded that it is necessary a better comparability of the results among the different groups of researchers working on this problem. It could also be suggested an improvement of the predictive value of the tests by their combined use. PMID- 2700250 TI - [The evolution of cervical traction]. AB - The authors in this note passed in review the literature data concerning cervical traction emphasizing its increasing importance since Cellier and Fox (1802) in our time. PMID- 2700251 TI - [Adhesion of dental resin to tooth structure--syntheses and adhesion to tooth structure of various aliphatic methacrylates with a carboxylic group]. AB - Twelve aliphatic methacrylates with a carboxylic group [succinate (2 MES, 5 MPeS and 10 MDS), methylsuccinate (2 MEMS, 5 MPeMS and 10 MDMS), maleate (2 MEM, 5 MPeM and 10 MDM) and citraconate (2 MEC, 5 MPeC and 10 MDC)] were synthesized by the addition of four dicarboxylic acid anhydrides to each of three different alkylene chain length hydroxy methacrylates to investigate the relationship between the methacrylate structure and its bonding to tooth. The bond strength of methacrylates to polished tooth surface decreased with increasing alkylene chain lengths under dry conditions, but water immersion reduced this change. The bond strength of succinate and maleate to polished tooth surface was higher than that of methylsuccinate and citraconate under dry conditions. All methacrylates showed high bond strength to etched enamel, with maleate showing the highest bond strength. On the other hand, the bond strength of 2 MEM and 5 MPeM to etched dentin was markedly high, and about 5 microns thick resin reinforced dentin at the interface between etched dentin and resin (2 MEM or 5 MPeM) was observed by SEM and EPMA analysis. PMID- 2700252 TI - [Relationship between graft polymerization onto model collagen and adhesion of MMA-TBB resin to dentin. Influence of pretreatment]. AB - A graft polymerization of MMA onto silk was carried out under several conditions and the relationship between the grafting and the bond strength to dentin was compared in the case of a MMA-TBB resin. Phosphoric acid, EDTA 5-0 and EDTA 3-2 pretreatments to silk decreased the degree of grafting. On the other hand, 10-3 pretreatment increased it. The conformation of silk peptides was changed by the pretreatments and it was responsible for the diffusion of MMA and sites of grafting. Ferric ion absorbed on the silk enhanced the graft polymerization of MMA. Pretreatment which gave higher grafting onto silk did not always promote the bond strength to the dentin pretreated by the same pretreatments. We concluded that the graft polymerization of MMA on collagen was not necessary for the adhesion of resin to dentin. PMID- 2700253 TI - [Ti-Ni shape memory alloy for dental use. Trial production of prefabricated straight-slit type posts by electric discharge machining]. AB - The possibility of dental application of Ti-Ni shape memory alloys was examined. To determine whether this material which is difficult to be machined could be processed by the electric discharge machining method (E.D.M.), the E.D.M. characteristics of this material were investigated. Trial straight-slit type posts were made by this material under an appropriate electric condition. The term of yield strength, retention force after cementing, and pressure of post when into a root canal filled unset cement were investigated. Ti-Ni shape memory alloy could be processed without a loss of shape memory effect by E.D.M. Hardenning layer in the machined surface was observed by both Ram-type and Wire type E.D.M., but a thinner hardening layer was observed by the latter method. The retention force after cementing of the trial straight-slit type post were the same or stronger than those of posts on the market. Especially, the dependence for the post's length on this strength was not strong in the trial posts. The pressure produced by inserting the trial post into the root canal filled with unset cement was very low compared with those of post on the market. The trial straight-slit type posts made of Ti-Ni shape memory alloy may be useful for dental application. PMID- 2700254 TI - [Effect of fluoride of copper and iron on polymerization of MMA/TBBO resin and adhesion to dentin]. AB - As a model experiment to understand the mechanism of adhesion of the MMA/TBBO resin to dentin, polymerization of MMA/TBBO was investigated in the presence of a collagen sheet treated with the aqueous citric acid (CA) solutions of copper fluoride (CF), ferric fluoride (FF), or ferric chloride (FC), which is usually used as a treating agent in bonding of the resin to dentin. The curing time of MMA/TBBO resin was considerably reduced in the presence of collagen treated with CF-CA or FF-CA solutions when compared to that with FC-CA solution. Molecular weight of PMMA depended on the site of polymerization; PMMA polymerized inside the collagen sheet was the highest and that polymerized outside was the lowest. Bond strength to dentin treated with CF-CA, FF-CA solutions was as strong as that treated with FC-CA solution. Treatment of dentin with CF-CA or FF-CA was as effective as that with FC-CA in bonding the MMA/TBBO resin. These results suggested that ferric compounds adsorbed to collagen are involved in polymerization of MMA and thus influence bond strength of the MMA/TBBO resin to dentin. PMID- 2700255 TI - [Production of denture by preform compression molding method. Part 3. Retentive strength of artificial teeth]. AB - A preform compression molding method to make a polysulfone denture has been reported. Retentive strength of artificial teeth to the denture base was examined to select artificial teeth for the compression molding method. Ceramic teeth with metal pins and polysulfone teeth heated at above 140 degrees C were retained to the denture base by useful retentive strength. Acrylic teeth on which the adhesive was used were also retained by useful strength. Each of the teeth, acrylic teeth, ceramic teeth and polysulfone teeth, could be used in the compression molding method. PMID- 2700256 TI - [Maintenance of teeth by a preventive strategy of prosthetic care]. AB - As a result of analyses of the oral health conditions and prosthodontics the demand for a preventive strategy is opposed to the traditional treatment. Its primary goal is not completing the rows of teeth in number, but structural conservation using prosthetic appliances. The possibilities are discussed by examples given by crown restorations, initial loss of teeth, interrupted and shortened row of teeth. The results of clinically controlled studies are presented for the assessment of the preventive effectiveness. PMID- 2700257 TI - [New lines of spontaneously transformed cells obtained from "precrisis" cultures of embryonic rat cells]. AB - A new approach to selection of lines of spontaneously transformed cells from the rat embryo "precrisis" cultures is described and their phenotypes at the initial and advanced stages during a long-term cultivation are characterized. The new selective system, referred to as 2T7, differs from the well known 3T3, 2T6 and 3T12 systems (Todaro, Green, 1963; Aaronson, Todaro, 1968). It is based on the maintenance of cultures under maximum cell densities. Such an approach facilitated and accelerated the start of the "crisis" stage (up to 3-8 passages) with the following gradual death of almost the whole normal senescent cell population, the colony formation resulting from the proliferation of single clonogenic cells. The frequency of clonogenic cells was about 6 x 10(-6). Six lines of spontaneously transformed cells from embryos of noninbred white rats (LRec-1--LRec-6) and one line from the Wistar embryos (LRec-7) were established. All the lines are characterized as diploid or near-tetraploid, with 1-4 different marker chromosomes formed from chromosome 7, as was reported elsewhere (Artsybasheva et al., 1988). The values of saturation densities and the time of population doubling for all the 7 lines differed from those for the rat embryo primary cultures cells. LRec-1--LRec-6 cells were unable to form the colonies in soft agar, while LRec-7 cells were able to grow in agar. The lines LRec became oncogenic for 1-2 day old rats after different periods of cultivation in vitro- from 3 to 7 months. The line LRec-7 Wistar appeared to be highly oncogenic from the very beginning after its selection. The histological analysis revealed that the LRec-1 tumors could be classified as polymorphocellular sarcoma. Up to 20 passages the LRec-1 line had numerous clonogenic cells (50-60%) in sparse cultures independently on the serum content in the media. By a 3-step selection of LRec-1 cells, on cultivation in media with lower serum contents (1-0.1-0%), a semisuspension of LRec-1sf subline (serum free) was established. This line was highly oncogenic for 1-2 day old rats, was easily cryopreserved and proliferated in the serum-free media for unlimited time, forming small colonies in agar. Thus, the new approach allows to establish with high effectiveness spontaneous lines of rat embryo cells with differently transformed phenotypes, i.e. preneoplastic and oncogenic ones.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2700258 TI - [The partial recA-lexA dependence of the adaptive response of Escherichia coli to exposure to methylmethane sulfonate]. AB - A study was made of the adaptive response to methylmethane sulfonate (MMS) in E. coli. (18 strains of B, WP2, and H/r30 groups, including three strains of bacteria with pKM101 plasmid). The adaptation of wild type cells and uvrA- and uvrB- mutants to non-lethal concentrations of MMS (10-30 mkg/ml during 90-120 min) leads to a significant increase in their resistance to lethal MMS concentrations (10-30 mM for 10-120 min): the dose modifying factor (DMF) being 1.5-1.8. In single recA or lexA mutants (or double recA uvr- and lexA uvr- mutants) the efficiency of adaptive response to MMS was significantly lower: the DMF being 1.1-1.2. In Bs-1 gamma R strain with intragenic suppressor of lexA gene the adaptive response efficiency was the same as in B/r (recA+lexA+) strain. There is no adaptive response to MMS in polA- strains. The adaptive response to MMS in E. coli is different from that to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and N-methylnitrosourea (MNM), because in these two cases it is absolutely lexA-recA dependent. It is supposed that a partial recA-lexA dependence of the adaptive response to MMS in E. coli may be due to a specific MMS-induced lethal damage that induces an adaptive repair non-related to the system of recA-lexA independent adaptive responses to MNNG and MNM. The presence of a plasmid of drug resistance pKM101 exerts no influence on the value, efficiency and recA-lexA dependence of the adaptive response of E. coli to MMS. PMID- 2700259 TI - [Clinical analysis of 18 cases of E. coli septicemia in children]. AB - A clinical analysis of 18 cases of E. coli septicaemia in children showed that 90% of cases were in infants aged up to 6 months, mainly in newborns. Half the cases developed in hospital. All strains with one exception were sensitive to gentamicin. In the whole complex of non-characteristic clinical manifestations loose stools were most frequent. In the laboratory investigations thrombocytopenia was the most characteristic abnormality. The mortality was 16.7%. PMID- 2700260 TI - [Certain aspects of pulmonary hypertension]. AB - The study concerned certain aspects of pulmonary hypertension. The most frequent factors in the aetiology of the syndrome are: 1) pressure rise in pulmonary capillaries and/or left atrium, 2) considerable rise of blood flow in the pulmonary artery, 3) reduced total blood flow in the pulmonary vascular bed. Pulmonary hypertension is divided into passive and hyperkinetic. Moreover, pulmonary hypertension of unknown aetiology exists, so called primary pulmonary hypertension, which may occur as one of three types of the disease: thromboembolic pulmonary hypertension, primary pulmonary arteriopathy, primary pulmonary thrombophlebitis. PMID- 2700261 TI - [Malaria among travelers to the tropics and modern methods of prevention]. PMID- 2700262 TI - [A case of purulent peritonitis treated by the "in the open" method]. AB - A 35-year-old man is described who had diffuse purulent peritonitis resulting from duodenal ulcer perforation. Due to the extent and progression of inflammatory changes the abdominal wall was not sutured and the peritoneal cavity was repeatedly controlled. The patient was operated on as an emergency case in the 49th hour after appearance of clinical symptoms. About 5 1 of pus was found in the peritoneum, with fibrin-caused adhesions between intestinal loops with their segmental occlusion. The hole in the duodenal wall was sutured with single sutures, the abdominal cavity was washed with about 10 1 of. 0.02% hibitane solution. Further controls of the abdominal cavity were done on days 3 and 5 after operation removing a small abscess between intestinal loops on the 3rd day and reducing recent ileus due to gumming up of loops on days 3 and 5. During the last control the Child-Philips procedure was done in anticipation of another ileus. After finding of complete absence of inflammatory peritoneal changes the abdominal wall was closed ith sutures. The patient was discharged on the 30th day with a healed surgical wound. Control examination after 7 months showed a very good general condition and linear scar at the site of duodenal perforation. PMID- 2700263 TI - [Jaundice of the subcortical ganglia in a newborn caused by E. coli infection]. AB - A case is reported of icterus of the subcortical ganglia in a premature newborn with total bilirubin level 7.42 mg%. The role of various risk factors in the aetiology of this icterus is discussed. PMID- 2700264 TI - [On the thirtieth anniversary of the act for tuberculosis control in Poland]. PMID- 2700265 TI - [Development and actual position of periodontical and oral-hygienic construction of cast partial dentures]. PMID- 2700266 TI - [Construction of fixed upper denture in presence of lower full denture]. PMID- 2700267 TI - [40 years socialistic politics of education and health. 40 years of professional training and development in the Halle district]. PMID- 2700269 TI - [Mucodynamic impression method]. PMID- 2700268 TI - [Theory and practice of castable glass ceramics]. PMID- 2700270 TI - [Arteriography in digestive hemorrhage]. AB - As it appears from a review of the literature of the last decade, arteriography is important in the diagnosis and management of gastrointestinal haemorrhage but its role has to be evaluated by a multidisciplinary approach. In fact, the role of arteriography in upper gastrointestinal bleeding is often therapeutic, because diagnosis is often made by endoscopy. In lower gastrointestinal bleeding, arteriography is mainly diagnostic and its role in treatment remains limited. Controlled studies are necessary to compare transcatheter embolization with other treatments. PMID- 2700271 TI - [Immunological aspects of lymphocytic gastritis]. AB - Diffuse and corporeal varioliform gastritis represent the usual endoscopic expression of lymphocytic gastritis. Referring to the work of other authors on varioliform gastritis, immunocytochemical studies have been made on the plasma cells of the lamina propria in two comparative series of lymphocytic and chronic atrophic gastritis. We could not demonstrate any significant variation in the number of IgE plasma cells between the two types of gastritis. In another study, the lymphocytic populations of the lamina propria and of the epithelium were characterized by peroxidase immunocytochemical methods on frozen sections. In agreement with other authors we confirmed that, in lymphocytic gastritis, the intraepithelial lymphocytes belong to the T group with a predominance of the T8 subgroup. In the lamina propria, the lymphocytes were mostly T with a slight preponderance of the T4 subgroup. B lymphocytes were scarce. The distribution of B and T lymphocytes was the same as that observed in coeliac disease. PMID- 2700272 TI - [Campylobacter pylori gastritis: review of diagnostic methods]. AB - The presence of Campylobacter pylori in gastric mucosa is a proof of active gastritis. Diagnostic methods are based on endoscopy: culture--histology- cytology--urease test, or on noninvasive tests: C14 urea breath test and serology. The principles, results (sensitivity--specificity), advantages and problems of each test are discussed as well as the choice of a diagnostic method. In practice, we recommend the use of two methods, a morphological one (histology or cytology) and another based on bacterial activity (urease test or culture). PMID- 2700273 TI - Campylobacter pylori as possible factor in peptic ulcer recurrence. AB - The author reviews the literature up to 1988 about the close association of Campylobacter pylori with chronic active gastritis, duodenitis and peptic ulcer disease. No firm data however demonstrate that Campylobacter pylori causes duodenal ulcer but long term eradication of this bacterium prevents duodenal ulcer relapse. PMID- 2700275 TI - Kawasaki disease complicated by gallbladder hydrops mimicking acute abdomen: a report of three cases. AB - Three cases of gallbladder hydrops associated with Kawasaki disease are presented. The initial manifestations were high fever, jaundice and distended abdomen with guarding. The first two cases received laparotomy under the impression of suppurative cholecystitis with peritonitis. A markedly distended acalculous, nongangrenous gallbladder was noted. A cholecystostomy for drainage was performed. Diagnosis of Kawasaki disease was made only when the clinical manifestations became full-blown postoperatively. Both patients led an uneventful postoperative course. The third case had apparent features of Kawasaki disease at admission though the abdominal symptoms were rather prominent. With supportive care, the patient stabilized by the sixth hospital day without complication and did not require surgical intervention. We suggest that the preferred treatment of abdominal symptoms in Kawasaki disease is medical, and surgical intervention is deserved only for the complications of the hydrops. Simple cholecystostomy seems to be safe and sufficient for such occasion. Ultrasonography is helpful for the correct diagnosis of gallbladder hydrops and can exclude dilatation of the intrahepatic biliary trees and cholelithiasis. PMID- 2700274 TI - [Adjuvant treatment in cancer of the stomach]. AB - Surgical excision remains up to now the first potentially curative treatment for patients who are suffering from stomach cancer. The encouraging results recently obtained in the survival of these patients are to be attributed essentially to the screening for this disease. Unfortunately, in the countries of the Western World, 80 to 90% of patients with a stomach cancer still consult their physician at an advanced stage of the disease. This makes it necessary to look for new efficient adjuvant treatments to be implemented after surgery. Numerous chemotherapeutic combinations have been studied. The FAM association is the best known among all these; results of these treatments are reviewed. Other encouraging perspectives come from the association of chemotherapy and biochemical modulators, chemotherapy and radiation-therapy, IORT and other adjuvant treatments. These results are also reviewed. PMID- 2700276 TI - [Neonatal group B streptococcal osteomyelitis: report of a case]. AB - A 31-day-old female infant was admitted through the Emergency Room, on account of a nodular mass over the left middle clavicle region for 2 weeks and swelling of right groin for one day. The physical examination showed a nodular mass (3 cm in diameter) on the left middle clavicle region, with swelling and tenderness on the right groin. Needle aspiration of the nodular mass on the left middle clavicle region yielded Group B beta--hemolytic streptococcus (GBS). X-ray showed fracture of the left clavicle bone with callus formation, and swelling of soft tissue of the right thigh. Tc99m bone scan showed hyperemic change at the middle of left clavicle bone and the right hip joint. Arthrotomy was done to drain a large amount of pus containing GBS. After five weeks of antibiotics treatment, the patients condition was stable. Neonatal GBS osteomyelitis almost always involves single bone. Reports of two bones involvement are few. The patient's clavicle and femur involvement was an unusual presentation. PMID- 2700277 TI - Pulsatile flow changes in the anterior cerebral arteries in infants with patent ductus arteriosus: measured with Doppler technique. AB - Cerebral hemodynamics were measured, using the Doppler ultrasound technique (directed toward anterior cerebral artery through the anterior fontanel), in 6 patent ductus arteriosus (PDA) patients with large left to right shunt and in 32 neonates before and just following functional closure of ductus arteriosus. PDA was confirmed by color echocardiogram and Doppler flow study. All 6 sick babies had prominent retrograde flow in the descending aorta during diastole. The value of pulsatility index (PI) derived from the components of peak systolic and end- diastolic frequency, was calculated. An obvious higher PI with simultaneous decrease in diastolic Doppler frequency in sick babies (PI = 0.89 +/- 0.05) were detected. On the contrary, the PI valves in the presence of opening of the ductus (PI = 0.65 +/- 0.07) in normal newborn infants didn't differ significantly with those just following functional closure (PI = 0.63 +/- 0.05). These data suggested that PDA might result in the physiologic consequence of ischemic cerebral injury if large left to right shunt occurred. PMID- 2700278 TI - [Prevalence of Chlamydia trachomatis infection in infants & children]. AB - To understand the prevalence of Chlamydial infection in children in the central area of Taiwan, 220 cases were surveyed in the hospital nursery and pediatric ward from September 1985 to June 1986. In these 10 months, using the enzyme immunoassay (EIA) method, the patients were divided into two groups. Group A included 98 newborn cases, in the nursery, whose conjunctival secretions were collected within two hours after birth. All cases were then treated with erythromycin ophthalmic ointment. Group B included 122 cases, from the pediatric ward, who suffered from symptoms of respiratory tract disease; aspirated secretions from the trachea-were studied. The antigen positive rate in Group A was 12.2% (12 cases), male to female ratio was 1:5. However, in Group B the antigen positive ratio was 26.2% (32 cases), with male to female ratio of approximating 5:3. Children under two years old had the highest incidence of infection, around 77.2% (34 cases). In conclusion, the younger is the case, the higher the positive rate is. However, most of them probably are carriers. Newborns weighed more than 3 Kg and infants older than one month were not treated by erythromycin, but with supportive methods, the clinical symptoms and signs still improved gradually. However in newborn with symptoms of respiratory problem antibiotic treatment is usually indicated, and at present erythromycin is very effective. PMID- 2700279 TI - [Child abuse: report of three cases]. AB - Child abuse, a clinical condition in young children who have received serious physical abuse, is a frequent cause of permanent injury or death. The first case is a 7-year-old boy suffering from abdominal distension and pain for 3 days. He was beaten by his mother as a result of inadequately learning his lessons. Sonogram and CT of the abdomen showed massive ascites and a pseudocyst of the pancreatic body about 3 x 3 cm in diameter. The second case is a 4-year-old girl who developed a semicomatose state after her father impulsively struck her with a chair. CT of the brain revealed subdural hematoma over the left fronto-temporal region and midline shift to the right. She expired 5 days later. The third case, a 2-year-old girl, suffered from headache, seizure, vomiting and general malaise. CT of the brain showed severe brain swelling over the right side and midline shift to the left. She expired 1 month later. Psychiatric factors are probably of prime importance in the pathogenesis of the disorder, but our knowledge of these factors is limited. Parents who inflict abuse on children do not necessarily have psychopathic or sociopathic personalities or come from borderline socioeconomic groups, although most published cases fall into one of these categories. It is clearly the responsibility of all physicians serving children to be aware of, to recognize, and to properly manage any child who has been the victim of abuse. PMID- 2700281 TI - [Basic experiments on denture rigidity at various types of palatal bars]. AB - The purpose of this study was to investigate the rigidity of removable partial denture with a palatal bar. A metal model with a Kennedy Class II-modification 1, was fabricated as a simulated dental arch. The model palate was adjustable to three different radii (17.5 mm, 20.0 mm and 22.5 mm) on the frontal section. MATERIALS: These were bending palatal bars and preformed plastic patterns. One of the bending palatal bars was 3.4 mm wide 1.4 mm thick, the other was 3.1 mm wide and 1.1 mm thick. Two other bars, 5.0 mm wide, 1.7 mm thick and 5.0 mm wide, 1.5 mm thick, were cast in Ticonium p-100 alloy from the plastic pattern. METHOD: The materials were fitted to the model and rigidity was measured by loading at various parts equivalent to the distal extension base. The experiments were performed with a 1 mm space between the frames and the model and again with a 1 mm thick sheet of mercaptan rubber-base impression material between them. RESULTS: 1. Cast palatal bars showed a smaller deflection than the bending palatal bars. 2. The bending palatal bars showed a large deflection of the distal extension base. So, care should be exercised when fitting a bending palatalbar in a distal extension case because of the incompressibility of the mucous membrane. 3. Bar deflection was only slightly different for the three types of palate. 4. Deflection of the palatal bar and distal extension base was smaller when the bar was thicker and wider. 5. The amounts of palatal bar and base deflection with the 1.0 mm space was in proportion to the load. 6. With the rubber-base sheet between, the amounts of deflection was not proportional to the load, and the amount of deflection under a 30 kg load was almost twice that of a 5 kg load. PMID- 2700280 TI - Antepartum diagnosis and management of idiopathic pericardial and pleural effusion: report of one case. AB - A case of an antenatal ultrasound diagnosis of pericardial effusion with pleural effusion is reported. Fetal pericardiocentesis, thoracentesis and amniocentesis were performed with real-time ultrasound guidance at 37 weeks of gestation. Laboratory investigations reported a rhesus-positive blood group, no atypical antibodies, negative serologic test for syphilis, and negative titers for toxoplasmosis. The laboratory data of the pericardial effusion showed: glucose 71 mg/dl, protein 3.7 gm/dl, LDH 73 U/L, CPK 53 U/L, negative culture for virus and bacteria. The pregnancy was terminated at 37 weeks of gestation by Cesarean section because of an edematously enlarged thorax. A 3540 gm male infant was delivered in a state of asphyxia with general cyanosis and an Apgar score of 3 and 4 at one and five minutes, respectively. His condition improved after endotracheal intubation and assisted ventilation. He was transported to the neonate intensive care unit, where chest roentgenogram confirmed pleural effusion over the left side. Chest tube was placed for 7 days. The infant was discharged on day 8, but the fluid reaccumulation over the left lung four months later. Chest tube was placed for five days. The infant subsequently has thrived with appropriated development for his age. We report herein because of successful technique of antepartal intervention. PMID- 2700282 TI - [Composition and morphology of oxides on porcelain fused to Ni-Cr alloys. Be containing alloys]. AB - Bonding strength between porcelain and Ni-Cr alloy for the porcelain fused-to metal crown in which Be is contained in the alloy is known to be higher than those in which Be is not contained. Since, bonding between porcelain and alloy is the reaction of oxides and porcelain, the bonding is thought to be influenced by the quality the oxides film which forms on the alloy surface. The purpose of this study was to determine the composition and morphology of the oxides formed on both Be containing and non-Be contained Ni-Cr alloys. The oxides analysis was done using an EPMA and Auger analysis. Also, the Porcelain/Ni-Cr alloy interface was observed by a scanning electron microscope (SEM). The following results are indicated from this investigation: 1. The oxides from the alloys not containing Be are corundum type Cr2O3 and spinel type NiCr2O4. These oxide layers are uniform, thick and porous and the adhesion to alloy is poor. 2. The oxides from alloy containing Be is BeO only. The BeO is uniform, thin and condensed. The adhesion to the alloy is good. 3. The oxide layer formed when the porcelain is fused to alloy containing Be is thin (1 micron average) and has good adhesion to alloy. 4. Be is selectively oxidized and controlled the form of Cr2O3 and NiO. PMID- 2700283 TI - [Dimensional change and deformation on stone dies for full cast crowns. Differences according to impression methods using vinyl silicone impression materials]. AB - In order to reconfirm the efficiency of an individual tooth tray, an apparatus and method were developed for measuring dimensional changes and observing over all deformation on a stone die for a full cast crown. The stone dies, which were made by combination impression methods I, II and double impression (individual tooth tray use) with vinyl silicone impression materials, were measured and compared. The results were as follows: 1. It made no difference what kind of vinyl silicone impression materials were used. 2. As to the dimensional changes: for combination impression method I, irregular results were found for the stone dies with the differences between +1 standard deviation (SD) and -1 SD being large. The variations of the other two methods were quite small, indicating that the stone dies were made accurately. 3. Observing to magnified images with the naked eye, there were no clear differences between the three methods on the marginal parts, but at the top corners of the stone dies there were good results with the double impression method. 4. It was possible to grasp easily the general aspect of dimensional changes in the stone dies using this newly developed measuring method. PMID- 2700284 TI - [Factors limiting and favoring communication and information in oncology]. AB - The authors discuss actual concepts about the transmission of information to the patient and his family in oncology. After the discussion of problems related to the emission and reception of information, they introduce the useful strategies designed in order to achieve an optimal transmission of information, and to improve doctor-patient communication. PMID- 2700285 TI - [The Freud Mahler encounter]. PMID- 2700286 TI - [The French classification of mental disorders in children and adolescents: presentation of an expert system, JPSY]. PMID- 2700287 TI - [Suicidal alcoholic patients: profile, risk factors and review of the literature from 1955 to 1988]. AB - Alcoholism and suicide are two Public Health problems which are linked at the epidemiological and clinical levels. Research over suicide risk factors among alcoholic subjects has developed mainly among medicalized psychiatric populations. Suicide occurs late among alcoholic patients, and affects particularly men and socially isolated subjects. The main risk factors relate to the decrease of the socio-economic status. loss of job and of income-, to the interpersonal loss--i.e. family bereavement or breach of relation, to the existence of a suicidal ideation often communicated or of suicidal antecedents, to a degradation of the physical state or the presence of some affections like gastro-duodenal ulcer. The identified factors are of little specificity. It is difficult to assess their interrelations and their respective true values. The reliable prediction of a later suicide remains presently impossible. Progress in analytic research over the alcoholic patients' suicide could result from the standardization of populations and of studied factors and from the use of multivariate analysis statistical methods. PMID- 2700288 TI - [Mutagenic activity of organic esters are likely to form from bromo-2 ethanol generated during fumigation using ethylene oxide]. AB - The mutagenic potencies of 13 bromoethyl esters of natural organic acids, have been studied, by Ames's test (strains TA 98 and TA 100, with and without system of metabolisation, S9 mix). None of the 8 bromoethyl esters of linoleic, oleic, palmitic, stearic, lauric, myristic, cinnamic and fumaric acids is genotoxic. On the other hand the 5 others derived from gallic, oxalic, tartric acids (strain TA 100 with and without S9 mix), malic and citric acids (strain TA 100 with S9 mix) are mutagenic, the ester of gallic acid giving still a doubtful mutagenic response; their mutagenic potencies are 2 to 3 times smaller than that of bromo-2 ethanol. This observation, complemently with the mutagenicity of some organic esters of the chloro-2 ethanol, proves the potential danger of ethylene oxide used for the fumigation of foods or vegetables and medicinal plants containing much chloride and/or bromide. PMID- 2700289 TI - [Myopathy associated to human immunodeficiency virus (HIV) infection]. AB - Myopathy associated with HIV infection is rare and generally appears before the manifestations of other symptoms of AIDS. Its first symptoms are proximal weakness and myalgias, together with increased CPK. Electromyographic studies show either a myopathic pattern or the mixed pattern characteristics of inflammatory myopathies. Histologically they can be classified into three groups: 1) cases which present only with necrosis and regeneration of fibers; 2) those which associate to the above findings, inflammatory infiltrates, and 3) cases whose predominant characteristics is the presence of nemaline structures, with or without inflammation. The etiology of the AIDS associated myopathy is unknown, but most factors indicate an autoimmune mechanism in the pathogenesis of the disease. PMID- 2700290 TI - [Specific treatment of neurologic manifestations of HIV infection]. AB - Zidovudine (AZT, Retrovir) is the only product which has been so far released for use in the specific treatment of HIV infection. Together with a reduction in the mortality rate, an improvement in the quality of life and a reduction both in the frequency and the severity of opportunistic infections. Zidovudine has shown an outstanding therapeutical action in the neurological pathological pictures associated to AIDS. This action is even stronger in syndromes initially considered as demential. The effects of Zidovudine are demonstrated not only by the improvement of the patients suffering those symptoms, but by the fall in the number of patients with demential pictures within the seropositive groups handled during the early stages of the infection. PMID- 2700291 TI - [Neurologic complications of drug addiction. General aspects. Complications caused by cannabis, designer drugs and volatile substances]. AB - When a patient presents a neurological disorder, it is important to consider drugs is a possible cause. The risk to suffer neurological complications by drugs is unknown. It is difficult to calculate the number of drug addicts or the number of occasional drug users. It is important take into account that some patients are using more than one drug. The acute use of cannabis induces important changes in cognition and psychomotor performance. No signs of neurotoxicity were found in chronic marihuana users. Some "designer drugs" can induce neurotoxicity. MDMA, that have hallucinogenic activity, is a neurotoxin in animals. MPTP kill dopaminergic neurons in the substantia nigra, inducing Parkinson's disease. Volatile substances containing toluene or n-hexane are usually abused by young people. They can produce neurological damage when are used chronically (p. ex. cerebral atrophy or peripheral neuropathies). PMID- 2700292 TI - [Neurologic complications caused by use of cocaine, amphetamines and sympathomimetics]. AB - Drug abuse has become a social and medical problem. Amphetamine and cocaine have a potent sympathicomimetic action, so they have important effects on the Central Nervous and Cardiovascular Systems. Their neurological complications are principally: psychic alterations, seizures and stroke (hemorrhagic and ischemic). The latter are the most important in the clinical practice. Their capacity to produce transit arterial hypertension and cerebral vascular constriction could be the physiopathological substrate of such alterations. Angiographic studies have shown lesions suggesting vasculopathy. In the last ten years cocaine abuse has become an authentic epidemic. We have reviewed its neurological complications, particularly the vascular ones--42 hemorrhagic and 24 ischemic--and the following conclusions were drawn: it should be considered as a risk factor in the younger age group; a short period of time between the last drug dose and the clinical picture is frequently seen; clinical features may appear with the first drug administration; no characteristic lesion in relation to the way of administration or consumption time was elicited. PMID- 2700293 TI - [Etiopathogenesis of HIV infection]. AB - The knowledge of life's cycle of the acquired immune deficiency syndrome's virus (HIV) its complex genetic structure involving the interaction of positive and negative regulatory gene controlling the growth of the virus, its great genetic variability, the different pathogenic mechanisms, the cell-virus interaction, the different host-cells and the interaction of other pathogens, are all fundamentals facts for a better understanding of the various stages of infection by HIV until ultimate establishment of the Acquired Immune Deficiency Syndrome and also to explain the therapeutic difficulties until now. PMID- 2700294 TI - [Neurologic effects of alcoholism]. AB - The alcoholism is no hereditary but genetic factors can be involved and racial differences in alcohol susceptibility depend on break down rate of ethanol. The alcohol adaptation and tolerance and physical dependence appearance with symptoms and signs display after abstinence on people suffers with chronic intoxication, it would be related to changes caused by alcohol over molecules of neuronal membranes, especially proteins and receptors. An account is achieved about the various neurologic manifestations related to alcoholism, nutritional in origin or unknown pathogenesis. The results obtained looking over the admission along 1988 in Neurological Service ("La Paz" Hospital) allowed to take into account three groups of alcoholic patients (miscellaneous, abstinence syndrome-encephalopathy dementia-neuropathy, and stroke). It is analysed the results and it is afforded some conclusions about. PMID- 2700295 TI - [Neurologic complications of AIDS. Panoramic view based on a multicenter hospital study]. AB - Data concerning 292 neurologic complications of AIDS were supplied by ten Departments of Neurology of Spanish hospitals. The period of study was from june 1984 to june 1988. The most frequent complications were: Toxoplasmosis of the CNS (28%), subacute encephalopathy (17%), distal polyneuropathy (8%), tuberculous meningitis (7.5%) and cryptococcal infection of the CNS (6.5%). The most important risk factors for AIDS in this series were intravenous drug addiction (77%) and homosexuality in males (12%). The overall mortality among the reported complications was 54.7%. The main causes of mortality were toxoplasmosis (32% of the fatalities), subacute encephalopathy (19%), and progressive multifocal leukoencephalopathy (8%). These data are compared to those obtained from other European and American series. PMID- 2700296 TI - [Neuropathology of HIV encephalitis]. AB - Neuropathologic features of HIV encephalitis are described in 8 cases selected among 36 autopsies of AIDS patients. From an epidemiologic point of view, the author remarks that parenteral drug addict patients are as prone as male homosexual patients to get HIV encephalitis. The surprisingly low incidence of this illness, recorded in the epidemiologic bulletin of Health Ministry is pointed out. Clinicopathologically, the complex nosologic problem and terminologic confusion of AIDS dementia are discussed, as well as the different neuropathologic criteria used to define HIV encephalitis. The term "panencephalitis with multinucleated cells" is proposed to name the neuropathologic lesions of those patients with HIV dementia and who show multinucleated cells as histopathologic hall mark of HIV encephalitis on brain examination. Physiopathologic interpretation about how the HIV affects the CNS is analyzed. Recent etiopathogenic interpretations of HIV dementia are included. PMID- 2700297 TI - [AIDS dementia complex]. AB - The AIDS dementia complex (ADC) is the SNC complaint that appears most frequently in AIDS patients. ADC is characterized by a subacute onset of dementia accompanied by motor disturbance and changes in behaviour and is considered to be directly caused by HIV-1. Very frequent in advanced stages of AIDS, it can also be the way in which the illness appears. In 90% of the necropsies of these patients a diffuse demyelination of the white substance is observed with multinucleate cells appearing in 40% of the cases. Up to now, the factors triggering this disease are not well understood, nevertheless, the immunosuppression present in these individuals could act as a factor favouring the appearance of ADC. A specific marker does not exist and, therefore, the complementary studies can only help to eliminate other causes of neurological complaints. Successful tests of treatment with zidovudine have been made, although it would be necessary to carry out studies with a larger number of patients to be able to evaluate its long-term efficacity. PMID- 2700298 TI - [Natural history of HIV infection]. AB - There are several questions still unanswered about the infection caused by HIV. Therefore, any account of the disease's natural history should be approached with caution. However, our current knowledge allows us to depict a sequence of situations, starting with the acute infection. After acquisition of infection, patients go through a variable duration silent phase (asymptomatic infection), some of them developing persistent generalized lymphadenopathy. An unknown percentage of both groups will eventually progress toward AIDS (infections final stage). In this paper we dealt with the above topics, following the CDC suggestion, and we try to answer the following questions: Is it possible to eliminate the virus? How many infected patients will evolve towards AIDS? When? Is it feasible an individualized prognosis? PMID- 2700299 TI - [Spinal cord involvement by the human immunodeficiency virus. Vacuolar myelopathy]. AB - Vacuolar myelopathy is the most frequent spinal syndrome in patients infected with the human immunodeficiency virus, presently considered to be related to a direct action of the virus. The authors review the historical, clinical, pathological and etiopathogenetic aspects of this new entity, stressing the difficulties posed by its differential diagnosis and its scarce therapeutic possibilities. PMID- 2700300 TI - [The Idoneit line. Reconstruction and protection]. PMID- 2700301 TI - Clinically successful dentin and enamel bonding. AB - This manuscript highlights clinical applications of the Tenure dentin bonding agent. Research comparing diametral and bond strengths, and microleakage of Tenure and other dentin bonding agents is presented. The Light-cured Zionomer glass ionomer is shown to provide a superior dentin bond when compared to Vitrabond. PMID- 2700302 TI - Adhesion to enamel and dentin. AB - The physical and chemical properties of restorative materials and procedures that influence the extent of microleakage at the tooth/restoration interface are discussed. Adhesion to enamel is achieved and microleakage at the enamel/restoration interface has been controlled by acid etching enamel surfaces with orthophosphoric acid. The acid concentration and the duration of etching are reviewed. Adhesion to dentin and microleakage at the restoration/dentin (cementum) interface are more difficult. The development of dentin bonding agents and the tremendous advances made with these restorative systems are reviewed. Particular attention is directed towards the Gluma/Lumifor dentin bonding restorative system and the development of an experimental conditioning solution for both enamel and dentin. PMID- 2700303 TI - Assistants play an important role in fabricating tooth impressions. PMID- 2700304 TI - Alpha-1-antitrypsin deficiency: accumulation or degradation of mutant variants within the hepatic endoplasmic reticulum. AB - Recent molecular and biochemical analyses of several alpha-1-antitrypsin variants suggest that the severe deficiency or complete absence of this protease inhibitor from serum results predominantly from the retention of mutant variants within the hepatic endoplasmic reticulum where they can accumulate or undergo intracellular degradation. Additional studies have demonstrated that the accumulation of the insoluble PiZ variant within this subcellular compartment acts as an etiologic agent for the development of liver disease in transgenic mice. PMID- 2700305 TI - Discovery of the cystic fibrosis gene: the interface of basic science and clinical medicine. PMID- 2700306 TI - Cellular and molecular aspects of granulomatous inflammation. AB - Recent advances in cellular and molecular biology have provided important new avenues to assess mechanisms of granuloma formation/regulation. For example, current studies have identified various cytokines that can exert a powerful influence on both immune and non-immune cells and dictate inflammatory processes. Some of these cytokines are potentially active during the initiation and maintenance of chronic inflammation, including tumor necrosis factor, interleukin 1, and a novel class of chemotactic cytokines. This latter group of mediators belongs to a super-gene family of immune signals that play a key role in the selective recruitment of inflammatory cells to an area of inflammation. The coordinated synthesis of these cytokines is likely important to the development of the granulomatous response. The participation of molecular signals produced by non-inflammatory cells, fibroblasts, and epithelial cells, also warrants special consideration. These "bystander" cells appear to possess effector cell functions and likely serve an important role in inducing pulmonary granulomatous inflammation. Thus, a clear understanding of the cells and molecular signals involved in the initiation and maintenance of chronic pulmonary inflammation will be necessary to assess lesion development and design more selective/effective therapies. PMID- 2700307 TI - [Cerebellar hemorrhage: which treatment?]. PMID- 2700308 TI - [Cervicodorsal diastematomyelia in an adult]. AB - A 44-year-old male had paraparesis which had began at age 20 years; a cleft spinal cord (diastematomyelia) was discovered at cervicodorsal level. The patient had nevus and hypertrichosis in the skin overlying the dysraphic spinal cord malformation. Both computer-assisted myelography and magnetic resonance scan showed the spinal cord segmentation and other associated disorders: bone spicula projecting between the 2 cordal halves, vertebral fusion defect and syringomyelic cavity. We emphasize the rarity of this abnormality in a so high spinal cord level and the onset of symptoms at adult age. PMID- 2700309 TI - [Method of studying mononeuropathy of a cranial nerve pair]. PMID- 2700310 TI - [Standards for glass ionomer etching]. PMID- 2700312 TI - [Resuscitation and emergency medicine. A historical perspective]. PMID- 2700311 TI - [Nalbuphine versus pentazocine in the period following surgery of the digestive system in patients with cardiovascular disease]. PMID- 2700313 TI - [Anesthesia of a patient with the Fernand-Widal syndrome]. PMID- 2700314 TI - [The use of urapidil to control peroperative attacks of hypertension. 5 years' experience in West Germany]. PMID- 2700315 TI - [Pharmacology of urapidil]. PMID- 2700316 TI - The treatment of hepatic metastases from colorectal cancer with radiation therapy alone or combined with chemotherapy or misonidazole. AB - In summary, whole liver RT alone is generally well tolerated and, in most cases, offers some palliative benefit. It is difficult to determine its ultimate impact on survival since many patients treated with this single modality have extra hepatic disease. In addition, the dose of radiation which the liver can tolerate is not adequate to control gross disease. The addition of chemotherapy (systemic and/or intra-hepatic) appears promising. However, further follow-up and randomized trials need to be performed before this is known with certainty. The use of misonidazole in the dosages and techniques employed by the RTOG did not appear to enhance overall survival. More innovative techniques of delivering RT, including intraoperative brachytherapy, radiolabeled antibodies, and hyperfractionated external beam RT require further investigation in order to determine their efficacy. PMID- 2700317 TI - Extra-visceral soft tissue sarcomas in adults: local treatment with special reference to irradiation. PMID- 2700318 TI - Mohs micrographic surgery for skin cancer. AB - Mohs micrographic surgery is a reliable outpatient surgical method of removing skin cancer. The method includes tissue excision in thin layers, colour-coding of excised specimens, accurate orientation of excised tissue through construction of tissue maps, and microscopic examination of horizontal frozen sections. Selected basal and squamous cell carcinomas are treated most commonly by this method, however, a variety of less common tumors are also amenable to treatment. Mohs micrographic surgery offers the highest cure rates for selected malignancies while maintaining maximal preservation of normal tissue and important anatomic structures. PMID- 2700319 TI - The kinetics of CAZ-5, a novel SHV-related plasmid-mediated beta-lactamase with enhanced hydrolytic activity against ceftazidime. AB - The kinetic constants for "CAZ-5", a novel plasmid-mediated beta-lactamase with noticeable activity against third-generation cephalosporins and particularly ceftazidime have been determined. Two closely-related plasmid-mediated beta lactamases have also been studied: SHV-2 and PIT-2 (also known as SHV-1). These enzymes were synthesized constitutively; they were highly sensitive to the action of the inhibitors clavulanic acid and sulbactam and they lacked activity against the cephamycins and imipenem. PIT-2/SHV-1 had poor hydrolytic activity against the third-generation cephalosporins, SHV-2 was markedly active against cefotaxime and related compounds, whereas the new enzyme, which was also active against these cephalosporins, had a noticeably greater activity against ceftazidime. Aztreonam was slowly hydrolysed by CAZ-5 beta-lactamase, but demonstrated an unusually high affinity for this enzyme. PMID- 2700320 TI - A double-blind comparative study of ketanserin with atenolol in essential hypertension. AB - Sixty patients, with mild to moderate essential hypertension, were considered for a double-blind trial comparing the effects of ketanserin and atenolol. After 2 weeks of placebo, a group of 30 patients was given ketanserin 20 mg twice daily for 15 days and 40 mg twice daily for the subsequent 45 days, while the second group (30 patients) was given atenolol for 60 days at the dose of 100 mg once daily. Blood pressure and pulse rate in the supine and standing positions were evaluated every 15 days. After the beginning of treatment with ketanserin, there was a gradual but highly significant decrease of the diastolic and systolic blood pressure values. No important side-effects or significant alterations in the biochemical parameters considered were observed during treatment with ketanserin. PMID- 2700321 TI - Orally dissolved ketanserin in acute treatment of hypertensive patients: a controlled study. AB - The effectiveness of 40 mg ketanserin dissolved in the mouth in reducing blood pressure was studied in 17 hypertensive patients. Comparison with a placebo group has shown that in the first 10 min the blood pressure trend was similar for both groups; a significant fall was recorded 20 and 60 min after administration for systolic blood pressure and after 60 min for diastolic blood pressure. Therefore, orally dissolved ketanserin decreases blood pressure more rapidly than with standard oral consumption, and may be used when a rapid progressive decrease in blood pressure is required. This antihypertensive effect might be more rapid by administering more soluble tablets or ketanserin in solution. PMID- 2700322 TI - Long-term antihypertensive efficacy of ketanserin plus chlorthalidone. AB - The long-term antihypertensive efficacy of a combination of ketanserin (20 mg), an S2 antagonist with alpha 1 blocking activity, and chlorthalidone (25 mg), given o.d., was evaluated in fifteen patients with primary hypertension of mild to moderate degree, aged 45-65 years, up to a 12-month observation period. Systolic (SBP) and diastolic (DBP) blood pressure, and heart rate (HR) were measured by an automatic recorder (Sentron Bard Biomedical) twice at rest after 5 min in a supine position and after 2 and 5 min in an upright position, 24 h after the last antihypertensive dose. Thirteen patients completed the study whilst two were lost to the follow-up. A significant reduction was observed in both SBP and DBP at rest. In particular, SBP was reduced from 167 +/- 17 mmHg to 152 +/- 21 mmHg (p less than 0.01) after 1 month of therapy and was kept constant at this level throughout the observation period. DBP was also reduced from the first control [99 +/- 7 vs. 90 +/- 9 mmHg (p less than 0.01)] without any increase during the follow-up. HR was unchanged throughout the study. Four patients had dizziness and orthostatic hypotension after the first dose of the drug combination but were able to continue the study without further adverse reactions. These data support the conclusion that long-term treatment with the combination of a small dose of ketanserin and chlorthalidone is able to reduce systolic and diastolic blood pressure, without remarkable untoward side-effects. PMID- 2700323 TI - ACE inhibitors: antihypertensive treatment and renal function. AB - Much clinical evidence supports the use of angiotensin-converting enzyme inhibitors (ACE-I) as the first-step drugs in the treatment of essential hypertension. The acute and chronic effects of ACE-I on renal function are reviewed in this paper. The kidney is an important target organ of essential hypertension and some antihypertensive drugs have been shown to decrease renal haemodynamic parameters. In hypertensives with normal renal function, ACE-I were demonstrated to be safe drugs: after acute and chronic administration of these drugs, the drop in blood pressure was accompanied by unchanged or increased GFR and RPF, with decreased renal vascular resistance. Only in patients with renovascular hypertension, with bilateral stenosis or solitary kidney, was there a deterioration in renal function. PMID- 2700324 TI - [Crown margins and periodontium]. AB - This review is based on an extensive study of the literature, various investigations of clinical and dental materials, experience as well as long-term observations. Our understanding of the behavior of the gingiva at the margins of artificial crowns has been widely extended within the last two decades. Some of these findings are discussed. However, complete absence of inflammation at the gingival margins can hardly ever be expected. What is usually present is rather "an acceptable state of marginal periodontitis" (Ketterl). Continuous and deliberate oral hygiene on the part of the patients is a decisive prerequisite for an acceptable oral condition. PMID- 2700325 TI - [Fixed prosthetic restorations and the marginal periodontium]. AB - Our considerations are focussed on the problems of "the marginal periodontium and the placement of crown margins". Emphasis has been placed on the scientific basis for the periodontologists' postulation of a supragingival crown margin, the critical evaluation of the indications for subgingival crown margins and the possibilities of correcting unfavorable preprosthodontic situations. The evaluation of the mucogingival environment and the questions of the stability of the selected crown margin/gingiva relations are the subjects of further discussion. PMID- 2700326 TI - [Tensile tests of variably conditioned metal specimen glued with hybrid composite]. AB - The purpose of this research was to analyze simultaneously the effect of 4 factors (metal conditioning, bonding agent, metal silicoating and water storage) on the tensile behavior of a Bis-GMA-resin (hybridfilled) bonded Ni-Cr-Be alloy by analysis of variance with a multifactorial design. The results showed that water storage of 33 days and the presence of bonding agent had no effect. In contrary, electrolytical etching or silicoating influenced significantly and positively the tensile bond strength. In addition a significant factors interaction between metal surface conditioning (sandblasting vs. etching) and silicoating was detected. Metal sandblasting followed by silicoating reacted more favorably than the combination etching/silicoating. In all cases the mechano chemical adhesion (silicoating technique) resulted in a composite bond strength that was far superior to that of conventional pure mechanical bonding. PMID- 2700327 TI - [Accuracy of fit of veneer crowns with ceramic shoulders]. AB - Two different types of special ceramic shoulder powders were used for veneering 40 casted crowns. A total of 2400 measurements of the marginal defects provide information on the marginal qualities of the facially butted porcelain margins. Surfaces and shapes of the margins were compared by SEM and metallographic sections. Vita shoulder porcelain, with glazed surfaces and rounded edges of the facial margins, shows poor marginal adaptation. The veneers made of Ducera shoulder porcelain exhibit minor facial openings and high form stability during sintering. The higher content of aluminum oxide in this porcelain powder reduces sintering shrinkage but, at the same time, produces a rough surface. The use of a new experimental liquid failed to improve the results. PMID- 2700328 TI - [Studies on marginal fit of Dicor crowns]. AB - Dicor crowns may present marginal defects, among other reasons because they require preparation of a circular ledge with rounded internal line angles. In studying this problem, 21 teeth that could no longer be saved were prepared in vivo and provided with Dicor crowns in our hospital. After remaining in place for 3 months these teeth were extracted. Subsequently their marginal areas were studied by SEM and histological preparations were made and measured. The marginal defects of Dicor crowns revealed slightly less favorable values than the Hi-Ceram crowns investigated one year ago, but these values are still within the range of clinical acceptability. PMID- 2700329 TI - [Dicor glass ceramic crowns]. AB - Within a period of 36 months 103 Dicor glass ceramic crowns have been inserted. Total loss of function occurred in 8 of the restored teeth in the form of loss, partial or total fracture of the crown. In 15 cases a partial loss of function was observed due to esthetic damage, abrasions or cement washouts. Before treatment 73 teeth had been sensitive on probing, after restoration 4 of them required endodontic treatment. Many of the reasons for loss of function could be found. These results suggest that, although sensitive to technical errors, this technique provides highly qualified single tooth restaurations. PMID- 2700330 TI - [Prognosis of periodontally reduced abutment teeth under removable dentures]. AB - The extraction rate was studied in a group of 151 patients treated for periodontal and prosthodontic reasons. 29 of 588 abutments had to be extracted due to periodontal problems within a period of 6 years after prosthodontic treatment. The initial findings of the extracted teeth are correlated with the initial findings of all abutments. It can be shown that periodontally reduced teeth involve a higher risk of extraction; nevertheless, in the majority of the cases, they could be successfully used as abutments. PMID- 2700331 TI - [Effects of a modified Bonwill clasp on the marginal gingiva]. AB - The effects of a modified Bonwill clasp on periodontal health have been studied for an observation period of 2 years. The results indicate that oral hygiene is more important than the dimensions of the clasp. It was only in cases with less than 2 mm distance between clasp and gingiva that a direct effect could be recognized. At the same time, this modified clasp seems to have a splinting effect, due to the superior transmission of masticatory forces. Further studies on clasp dimensions and the indications for this modified Bonwill clasp will, however, be necessary. PMID- 2700332 TI - [Stabilizing splint versus relaxing appliances in the treatment of myofacial pain. Preliminary results of a prospective randomized study]. AB - Both stabilizing splints and relaxing appliances have been recommended for the treatment of myofacial pain. It was the goal of the present study to compare the therapeutic effect of these two types of appliances. 26 patients with myofacial pain, whose symptoms were not overshadowed by arthropathy and in whom previous physiotherapy had failed to bring about sufficient pain relief, were divided into two prospectively randomized groups. They received either a stabilizing splint or a relaxing appliance. The therapeutic effect was assessed with the aid of the patients' subjective reports and the Helkimo indices. In spite of the small number of patients the statistical evaluation of the results showed stabilizing splints to be significantly (p less than 0.03) superior to relaxing appliances in the treatment of myofacial pain. PMID- 2700333 TI - [Technology and progress in the use of information systems in the dental office]. AB - The numerous DP systems used in dental offices are designed for administrative work. Data storage and management is limited to accountancy applications, and the advantages of the flow of information are restricted to operational purposes. Data of medical use are available only to a moderate extent. It should be possible, however, to use these information systems for processing purely medical data, for the structured input of comprehensive diagnostic information, and to have these data available for specific decisions. The use of a "decision supporting system" has been tested in the documentation of dental diagnostic findings. PMID- 2700334 TI - [Technology and progress in scientific information systems]. AB - The development of modern information technology has brought about dramatic changes in the field of auxiliary instruments for scientific research, and by the same token, for research in dentistry. In the context of data acquisition literature data bases play an important part; in the evaluation of data emphasis is being placed on data bases, improved online measuring techniques and statistical systems. Text and graphics programs may facilitate and improve the mediation of scientific results. The value of expert systems for establishing diagnoses seems highly questionable. PMID- 2700335 TI - [Influence of luting cement on corrosion of crown-covered post and core systems (2nd publication)]. AB - This publication describes phantom experiments to determine the ohmic resistance of four luting materials (Harvard, Tenet, Durelon, Ketac CEM) and one root filling paste (Diaket) used to cement metal crowns on roots with cast post and core. A uniform cement layer of 2/10 mm was assumed. The electrolyte used to simulate the oral fluid was physiological NaCl solution. Under these selected conditions only two products showed a sufficiently high resistance to prevent corrosion currents. On the basis of these results attention should be paid under practical conditions to the proper selection of metals for post and core and crowns. If such conditions cannot be met, the cement gap must be of sufficient layer thickness and a luting material with high ohmic resistance and good resistance to humidity be selected. PMID- 2700336 TI - [Alternative principles for the construction of cast partial dentures with complicated minor connectors]. AB - Cast partial dentures often require modification after different periods of waring. To facilitate later alterations it is recommended to use a composite adhesive for attaching complicated minor connectors to the metal framework. These attachments are inexpensive, easy to dissolve, have a passive fit and, unlike soldered joints, are free from potential allergic effects. 21 dentures including this design feature among others have proven satisfactory over a period of 2 years. PMID- 2700337 TI - [Modes of anchorage of partial dentures using Silicoater adhesive attachments of titanium and Wiron 88]. AB - The results of the study presented suggest that the use of Silicoater adhesive attachments allows medium-term, minimum-invasive, esthetically satisfactory and inexpensive prosthetic rehabilitation of caries-free partially edentulous dentitions without the application of anesthesia. Despite its favorable mechanical properties, however, the high nickle content of Wiron 88, as it has been in use up to now, must be considered as a drawback, because it may produce allergic reactions in patients. Due to the positive properties of titanium, particularly its biocompatibility and its corrosion resistance, this material has been tested clinically in comparison to Wiron 88. PMID- 2700338 TI - Endodontic effects of root planing in humans. AB - Although the deliberate removal of cementum by root planing remains part of periodontal therapy, its scientific basis is under challenge. A potentially harmful effect of root planing is the exposure of dentinal tubules to the oral environment; this study investigated the short-term endodontic effects of root planing in humans. Ten teeth with significant loss of periodontal attachment had one proximal surface root planed; the other proximal surface was not root planed. After 10-14 days, the teeth were extracted and processed for light microscopic and SEM examination. Hypersensitivity to thermal stimuli was reported by 4 subjects after root planing. Chronic pulpitis was found in 3 pulps adjacent to the area of root planing. Bacterial penetration of dentin was observed, although the depth of penetration was less than reported by others. The results indicated that previous perceptions of the beneficial role of root planing in periodontal therapy require reconsideration. PMID- 2700339 TI - The evolution of challenges to researchers in health psychology. AB - One of the keynote addresses presented at the National Working Conference on Research in Health and Behavior. This address is a historical review of current challenges to researchers in health psychology. Current challenges discussed include (a) creation of physical pathology, (b) physical symptoms of physical pathology in the absence of true pathology, (c) increased or decreased vulnerability to infectious disease, (d) intensify, prolong, or diminish existing pathology, (e) individuals' preoccupation with illness or disease, (f) voluntarily engaging in health-threatening behavior (e.g., allowing toxic agents to enter the body or engaging in accident-prone behavior or high-risk sexual practices), (g) engaging in health-enhancing life-style behaviors, and (h) involuntarily becoming the victim of toxic agents. The shift in public health policy as related to psychological research--from mental health to physical illness--reflects societal support for such areas of research by health psychologists. PMID- 2700340 TI - Are sociodemographic variables markers for psychological determinants of health? AB - Argues that the robust associations between sociodemographic variables and the major causes of morbidity and mortality are due in part to correlated psychological factors. To make this case concrete, the article reviews the psychological determinants of morbidity and mortality that are correlated with educational attainment and sex. It discusses the importance of health psychologists' studies of age, sex, ethnicity, and educational/occupational status to understanding why, how, and in whom psychological factors are contributors to disease. PMID- 2700341 TI - Biobehavioral aspects of cardiovascular disease: progress and prospects. AB - Cardiovascular disorders pose a major health problem for industrialized societies in terms of excess morbidity and mortality. Hypertension (HT) is a major risk factor for coronary heart disease (CHD) and cerebrovascular disease. The impact of psychosocial factors, personality traits, genetic-behavioral interactions, sodium sensitivity, obesity, insulin metabolism, and psychophysiology on HT status is discussed. An understanding of pathophysiologic processes is needed to provide a better basis for risk factor reduction and other aspects of treatment. The study of myocardial ischemia appears to provide an important link between the development of coronary artery disease and the occurrence of CHD. Further studies are needed to assess the clinical significance of stress-induced myocardial ischemia as well as whether mental stress is predictive of future CHD. Associations have been made between behavioral risk factors and CHD, but the exact nature of the relationship remains to be clarified. Hostility has been identified as an important aspect of coronary-prone behavior, but considerable research will have to be completed before a comprehensive understanding of coronary-prone behavior and the manner in which it has an impact on disease can be fully understood. PMID- 2700342 TI - Psychoneuroimmunology: past, present, and future. AB - Provides a brief overview of the history and current status of behavioral immunology research, as well as speculation on likely future directions, and suggests that the field may have broad implications for basic biological sciences and medicine. In addition, the field has clear relevance for health psychology; its relevance to actual health outcomes, however, is not yet known. PMID- 2700343 TI - Health psychology's contribution to addressing the cancer problem: update on accomplishments. AB - Each year approximately 1.5 million Americans are stricken with or die from cancer. In recent years, more psychologists have begun study of the psychological and behavioral aspects of cancer, and the rate, quality, and integration of findings are accelerating. This article provides an update on the major areas of accomplishment, with the findings grouped into disease-relevant time points. PMID- 2700344 TI - Smoking research: basic research, intervention, prevention, and new trends. AB - Smoking is a behavior that is influenced by a variety of factors that cut across methodologies, disciplines, and content areas within health psychology. The present article is designed to show the diversity and richness of smoking research by examining smoking from four perspective: basic laboratory research, intervention, prevention and deterrence, and new directions in smoking research. Methodologies that were derived from such varied sources as psychopharmacology, behavioral pharmacology, behavior therapy, clinical psychology, public health and health promotion, and social and developmental psychology have been used to study the smoking problem. The subject populations in these investigations ranged from animal models, to the individual smoker attempting to quit, to communities involved in health promotion and public health approaches. Future research should seek to provide new and improved examples of interdisciplinary research within the field of health psychology to multidisciplinary approaches from the basic and applied sciences. PMID- 2700345 TI - Biobehavioral research on cardiovascular disorders. PMID- 2700346 TI - Issues in psychoneuroimmunology research. AB - Careful design of studies is crucial for meaningful progress in this area of inquiry. Along with systematic evaluation of immunologic factors, clear understanding of antecedent factors is also important. Age, sex, and other sociodemographic factors might play a major role in how an individual reacts to a given situation when compared with another individual. Assessment of the impact of these factors on the immune system might be further complicated by immunosuppressive viruses like HIV or by the use of many common medications such as beta-blockers for hypertension (Kiecolt-Glaser & Glaser, 1988). Longitudinal studies are needed to understand the process of change and the dynamic patterning of psychosocial and immunologic relationships over time. Additionally, use of multimodal measures to assess psychological events such as stress is imperative (Baum, Grunberg, & Singer, 1982). It will not serve our understanding of psychological influences on the immune system to jump to the conclusion that an event is "stressful" because it seems as if it should be. Finally, establishing a "core" battery of widely accepted immune tests will be important in establishing comparability across studies. The standardization and acceptance of specific biochemical measures will facilitate the infusion of talented clinical and basic scientists into the area of psychoneuroimmunology. PMID- 2700347 TI - Directions for a psychology research agenda in cancer. PMID- 2700348 TI - Health psychology and AIDS. PMID- 2700349 TI - [Early marginal infiltration and Class II cavities]. AB - The purpose of the present study was to evaluate the early marginal microleakage in 20 Class II MOD restorations made in association with conventional and sandwich technique. Human extracted third molars were used in the study. Multi incremental technique was used in all restorations. After finishing, the teeth were stored in dye solution for 12 hours, transversally sectioned at three levels and evaluated under optical stereomicroscope. Cervical sections showed the highest marginal leakage. Sandwich technique in association with glass-ionomer cements have showed a significant lower early microleakage with respect to the conventional technique. PMID- 2700350 TI - Determination of projections for subtraction radiography based on image similarity measurements. AB - The reliability of subtraction radiography strongly depends on the ability to obtain two identical projections. Generally this is done by connecting mechanically the X-ray source, the patient and the film. However, this method has certain disadvantages, which restrict its use to small groups of patients in other than routine clinical situations. A computer-aided radiographic imaging technique (tomosynthesis) brings the reconstruction of arbitrary projections within reach. This technique can be used to reconstruct the projection required for a proper subtraction. However, in order to do so, the coordinates of the source position of one projection, relative to the source positions of the set of projections used for fomosynthesis, has to be determined. A method is described based on similarity measurements, in pairs of images (expressed in the form of standard deviations) to achieve this. The coordinates of the unknown source position could be determined with an average accuracy of 0.513 degrees (range 0.000-1.289 degrees), which is well within the range of deviations tolerable for the clinical application of subtraction radiography. PMID- 2700351 TI - Removable partial denture occlusal rest seat repair with composite resin-glass ionomer. PMID- 2700352 TI - Using a dentin bonding agent for cementation of etched-metal resin-bonded fixed partial dentures. PMID- 2700353 TI - Pre-surgical treatment for cleft lip and palate infant. AB - This article described the over-view of pre-surgical treatment for cleft lip and palate infant in order to provide some ideas for general dental practitioners so that they can help such patients as much as possible. PMID- 2700354 TI - [Microbiological evaluation of initial preparation for adult periodontitis patients]. AB - The microbial flora from 46 adult periodontitis lesions of 23 patients and 18 sites in 9 healthy persons were examined and levels of serum IgG antibody to gram negative periodontal disease-associated bacteria were measured by enzyme-linked immunosorbent assay. Plaque samples and serum samples were taken 40-50 days after initial preparation consisting of scaling and root planing. To evaluate the effects of the therapy on 10 patients with adult periodontitis, changes in clinical parameters were compared with alterations of the microbial flora and serum IgG antibody levels. Black-pigmented Bacteroides species, mainly Bacteroides gingivalis, were found to be predominant in periodontitis lesions. A significant relationship was found between the prevalence of B. gingivalis and elevated titers of serum IgG antibody against the microorganism. No relationships between Bacteroides intermedius, Actinobacillus actinomycetemcomitans and elevated titers of serum IgG antibody to them were detected. The fact that there was no marked reduction of serum IgG antibody to B. gingivalis after initial preparation suggests that a more extended, longitudinal study is required. Although brushing resulted in a significant reduction of the number of total cultivable organisms in samples from periodontal pockets, no significant proportional changes in gram-negative bacteria in the lesional flora were found. Initial preparation was not effective in eliminating gram-negative bacteria from deep periodontal pockets. However, the microbiological shifts, especially the reduction in the proportion and frequency of detection of B. gingivalis in periodontal pockets, was paralleled by significant improvement in the clinical parameters. PMID- 2700355 TI - [In vitro study of bacterial invasion in radicular dentin]. AB - The purpose of this study was to investigate whether plaque bacteria invade exposed radicular dentin after root planing or chemical root treatment in vitro. Pieces of dentin were cut out from impacted third molars. The surface of all dentin pieces was treated with sandpaper (#240) so as to make the surface roughness of dentin pieces equal to that of the root surface after root planing (RP surface). Half of the dentin pieces were treated with citric acid (pH 1.0) for 3 minutes (CA surface). After sterilization, each dentin piece was incubated at 37 degrees C in a culture medium inoculated with either S. mutans or S. sanguis. After 1, 3, 7 and 28 days of incubation, the invasion of microorganisms into the dentinal tubules was histologically examined using a light microscope. The following results were obtained. 1. The invasion of S. mutans and S. sanguis into the dentinal tubules was observed at 1, 3, 7 and 28 days. The depth and number of bacterial invasion into the dentinal tubules were positively correlated with incubation time on CA surfaces but not with RP surfaces. 2. The depth and the number of bacterial invasion into the dentinal tubules were higher on the CA surfaces than the RP surfaces. 3. Since the citric acid treatment of scaled and root planed root surfaces may accelerate bacterial invasion from treated root surfaces, the use of citric acid might be harmful in patients with inadequate plaque control. PMID- 2700356 TI - [Connective tissue attachment to root surfaces in periodontal disease. Initial attachment of human gingival fibroblasts]. AB - We studied the effect of periodontal treatment (scaling, SC; root planning, RP; scaling followed by citric acid, SC + CA; and root planing followed by citric acid, RP + CA) of periodontally diseased root surfaces on the initial attachment of human gingival fibroblasts in vitro. Root slices were prepared from surgically extracted human normal and periodontally involved teeth. Each treated root slice was placed in a well of a 24-well plate containing a PBS-antibiotic solution (penicillin, 200 units/ml; streptomycin, 200 micrograms/ml) for 1 hr. at 4 degrees C. Then, to each well was added 1 x 10(4) cells in 1 ml of alpha-MEM, and the plates were incubated for 24 hr. After the root slices were fixed and stained, the morphological changes and the numbers of attached cells were determined under a dissecting microscope. The fibroblasts on the controls (untreated normal roots) and the RP-roots appeared spindle-shaped with a few cell processes. The cells on the SC-roots were rounded or slightly elongated. The cells on the roots treated with citric acid (SC + CA and RP + CA) had were flat and seemed well attached to the surface. The number of cells attached on RP- and RP + CA-roots was increased to the control level, but those on SC- and SC + CA roots were showed about 60% of the control. No significant differences in the numbers of cells were found between RP and RP + CA treatment or between SC and SC + CA treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700357 TI - [Application of ultrasonography to periodontal diagnosis. 1. Standardization of examination]. AB - Ultrasonic imaging equipment has been applied to periodontal diagnosis, but the standardization of this examination remains difficult. We found that a multiple reflected echo appeared on ultrasonography when the periodontal probe was inserted in the periodontal pocket. The purpose of this study was to investigate this multiple reflected echo as a reference point for ultrasonography and to measure the distances between the periodontal probe and alveolar crest in pigs by using ultrasonography. The multiple reflected echo disappeared under the following conditions: 1) when the change in horizontal position was more than 0.7 mm, 2) when the change in horizontal angle was more than 5 degrees, and 3) when the change in vertical angle was more than 20 degrees. The results in pig specimens showed that the difference in the distance from the top of the periodontal probe to the alveolar crest was less than 0.2 mm on ultrasonic and direct histological measurements. It was concluded that the multiple reflected echo of the periodontal probe can be used to standardize ultrasonographic examination. PMID- 2700358 TI - [pH determination in human crevicular fluids. Examination of the pH meter and evaluation of the correlation between pH level and clinical findings or the microflora in each periodontal pocket]. AB - The purpose of this study was to investigate the accuracy and reproduction of a microelectrode with a glass capillary, and to discuss the correlation between the pH level and the microflora in periodontal pockets or the clinical findings in the various stages of periodontal disease. The upper or lower anterior teeth of 34 patients with mild to severe periodontal disease were examined. Before the measurement, supragingival plaque was removed from each tooth. A special glass capillary was incorporated in the microelectrode to cover its tip, so that it would not touch the pocket walls or tooth surfaces during pH measurement. After the pH in the crevicular fluid was determined, subgingival plaque was collected with paper points from each periodontal pocket. This bacterial plaque was sonicated with saline solution, and examined under a phase contrast microscope with a calibrated eyepiece graticule to count and morphotype groupings of microorganisms as 1) coccoid forms, 2) rods, 3) filaments, 4) motile rods, 5) spirochetes or other cell types. Crevicular fluid flow measurements and clinical findings (pocket depth, and gingival inflammation) were also investigated. The following conclusions were drawn: The electrode with capillary was useful to determine the pH of the crevicular fluid clinically. A reduction in pH level was seen in deep pockets or severe gingival inflammation. A close correlation was seen between salivary and crevicular pH. The pH level was significantly positively related with the proportion of coccoid forms, but was negatively correlated with the proportion of motile organisms that are reported to be related with periodontal disease. PMID- 2700359 TI - [Application of local drug delivery system to periodontal therapy. 4. Comparison of the therapeutic effects of administration of a TC film or root debridement on human periodontal disease]. AB - In 8 patients with periodontal diseases under good supragingival plaque control, 22 test teeth each having a pocket not more than 4 mm deep were treated respectively with 3 consecutive administrations of tetracycline immobilized cross linked collagen film (TC film) at intervals of 1 week, with onceroot planing and with both of these. The therapeutic effects were compared both clinically and micro biologically. The results revealed improvements in clinical symptoms such as reduction in the depth of the pocket, bleeding on pocket probing and the like for each treatment group in 6-12 weeks. The second and third groups also showed remarked gingival recession. Further more, the density of intrapocket microorganisms showed a remarked decrease up to the 8th week for each treatment group and the population of spirochetes showed a decrease up to the 6th week for the first treatment group and up to the 8th-12th week for the second and third treatment group. The results show that both local application of the TC film and root planing are effective in periodontal treatment, but not the combined treatment. PMID- 2700360 TI - [Effectiveness of local delivery of ofloxacin using controlled-release strips (PT 01) in periodontal patients. Part 1. PT-01 application among treatment plans for periodontal disease]. AB - Three different sites which have more than 5 mm pocket were randomly selected in each periodontal patient and were divided into three groups: PT-01 treated site, placebo treated site and control site. After application of either PT-01 or placebo twice for two weeks, subgingval scaling and root planing were performed. Then PT-01 and the placebo were applied weekly to the periodontal pocket for four weeks and clinical and microbiological evaluations were made. The results obtained were as follows: 1. On clinical evaluation, significant improvement was found in the PT-01 treated site in comparison with the placebo treated and/or control site. 2. On microbiological evaluation, slight improvement was found in the PT-01 treated site, whereas there was no significant difference among the three sites. PMID- 2700361 TI - [Microbial flora of periodontitis and monitoring of the effect of initial preparation by immunofluorescence microscopy]. AB - The effect of initial preparation in adult periodontitis was evaluated by changes in clinical parameters and immunofluorescence microscopic counts of periodontal disease associated bacteria. Subgingival plaque samples were taken with sterilized paper points from 10 sites of 5 periodontally healthy persons and 44 sites of 23 adult periodontitis patients. Twenty-one diseased sites were periodically examined after plaque control and scaling, root planing. The direct immunofluorescence technique was used to detect Bacteroides gingivalis, Eikenella corrodens, Fusobacterium nucleatum and Treponema denticola, Bacteroides intermedius, Actinobacillus actinomycetemcomitans, Bacteroides forsythus and Wolinella recta were counted by the indirect immunofluorescence technique. The proportions of B. gingivalis, B. forsythus, F. nucleatum, E. corrodens, T. denticola and W. recta in periodontitis lesions were significantly higher than those in healthy sites. The proportions of B. gingivalis and T. denticola were significantly related to GI, PlI, BI and PD, those of B. forsythus and W. recta to GI, PlI and BI, E. corrodens to GI and PlI, and F. nucleatum to BI. Reduced proportions of T. denticola were found in samples taken after establishment of proper plaque control. Subgingival scaling and root planing resulted in the reduction of proportions of B. gingivalis, E. corrodens, T. denticola and B. forsythus in the samples. The samples from positive bleeding sites contained higher proportions of B. gingivalis, T. denticola, B. forsythus and W. recta than did resolved sites. The present study shows that the immunofluorescence technique which detects B. gingivalis, T. denticola and B. forsythus is useful in monitoring the efficacy of initial preparation. PMID- 2700362 TI - [Effectiveness of local delivery of ofloxacin using controlled-release strips (PT 01) in periodontal patients. Part 2. Successive delivery system and combination with scaling]. AB - Four different sites were randomly selected in each periodontal patient and divided into four group: PT-01-treated site (A), PT-01 treatment combined with scaling (S + A), placebo-treated site (P) and placebo treatment combined with scaling (S + P). PT-01 and the placebo were applied to the periodontal pocket weekly on days 0 to 28, and clinical and microbiological evaluations were made. The results obtained were as follows: 1. Weekly changes in plaque index, plus discharge and mobility of the tooth were not observed in any group. 2. In gingival index, bleeding on probing, pocket depth and gingival crevicular fluid, significant improvement was found in A in comparison with P and in S + A in comparison with S + P. 3. In total number of subgingival bacteria and in the ratio of motile rods and spirochetes to the total number of bacteria, significant reduction was found in A in comparison with P and in S + A in comparison with S + P. PMID- 2700363 TI - [Correlation between subgingival microflora and peptidase activity in periodontal pockets measured with synthetic substrates]. AB - The activity of peptidases in periodontal pockets of patients were examined by using four different synthetic enzyme substrates, and surveyed their correlation with the microbial populations of subgingival plaque and clinical symptoms. The substrates were (1) alpha-N-benzoyl-DL-arginine-beta-naphthylamide (BANA), (2) N carbobenzoxy-glycylglycyl-arginine-4-methoxy-beta-naphthylamide, (3) alpha-N benzoyl-L-arginylglycyl-L-phenylalanyl-L-proline-4-methoxy -beta-naphthylamide and (4) N-carbobenzoxy-prolyl-L-alanylglycyl-L-proline-4-methoxy-beta naphthylamide. Whereas substrates (1) and (2) were hydrolyzed more specifically by peptidases of mainly Bacteroides gingivalis and Treponema denticola, substrates (3) and (4) were susceptible to most of the strains of black-pigmented Bacteroides, Capnocytophaga and T. denticola. Correlation between the peptidase activity and the level of Spirochetes in the plaques were observed with the substrates (1), (2) and (3). Substrate (3) had the strongest correlation also with the level of the black-pigmented Bacteroides and with the depth of the periodontal pockets, suggesting that it is a better substrate for enzymatic diagnosis than BANA which is currently used as an indicator of oral Spirochetes and the black-pigmented Bacteroides. PMID- 2700364 TI - Timely Medicare article. PMID- 2700365 TI - PRO director on the review process. PMID- 2700366 TI - Medicare coercion. PMID- 2700367 TI - Surgery for angina pectoris--historical aspects. AB - The history of surgery for ischemic heart disease is presented beginning with procedures to ablate nerves to the heart in the early part of this century. The evolution of surgical techniques to primary coronary artery bypass grafting is illustrated. Included are subtotal thyroidectomy, pedicle grafting of muscle, omentum, lung, stomach, and jejunum to the pericardium and heart, cardiopericardiopexy, ligation of the great cardiac vein, grafting from aorta to coronary sinus, implantation of arteries into the myocardium, coronary artery bypass grafting, and percutaneous transluminal coronary angioplasty. PMID- 2700368 TI - The Federalist Papers: lessons for physicians. PMID- 2700369 TI - The geriatric patient: one- or two-visit complete denture construction technique. Part 1. AB - The next two articles will discuss the construction of quality complete dentures in one- or two-patient appointments. Material and techniques are presented for controlling costs by reducing laboratory expenses and dentist chair time. A block unit of 12 to 14 attached flat plane acrylic teeth, light cured denture base materials and modified techniques which incorporate multiple procedures are introduced. The procedure will be divided into two segments and described in two articles. The initial article will carry the technique through the completion of the maxillo-mandibular relations and articulation for the casts. The second section, described in the second article, will encompass the set-up of the teeth, try-in of the set-up, processing of the dentures and insertion of the case. PMID- 2700370 TI - The geriatric patient: one-visit quality complete denture construction technique. Part 2. PMID- 2700371 TI - Implants retained multisegmented harder-bar for complete denture. PMID- 2700372 TI - The reperfusion syndrome. AB - When major vascular occlusion is carried out in the presence of systemic shock and there has been obstruction to blood supply of an extremity, restoration of circulation is not without risk. Morbidity and mortality relate directly to the duration and the degree of ischemia and the mass of tissue involved. The initial problem following the onset of ischemia relates to acidosis and hyperkalemia when limbs are reperfused after several hours of ischemia. When ischemia has been present for more than six to eight hours, there will be death of tissue and reperfusion at this point results in the products of dead and devitalized tissue being washed into the systemic circulation. This produces intravascular coagulation and a diffuse inflammatory response with systemic vascular permeability. Respiratory distress syndrome will develop if the ischemic injury is severe. If patients are not adequately monitored and blood volume maintained, renal failure and multiple organ failure will develop in parallel. PMID- 2700373 TI - Mechanisms of cellular injury: potential sources of oxygen free radicals in ischemia/reperfusion. AB - Oxygen-derived free radicals have been implicated as a mediator of the microvascular and parenchymal cell injury associated with reperfusion of ischemic tissues. Xanthine oxidase and neutrophilic NADPH oxidase are commonly invoked to explain reperfusion-induced production of oxygen radicals. The strengths and weaknesses of evidence used to suggest the involvement of both sources are discussed. Evidence is also presented which suggests that xanthine oxidase and neutrophils are redundant yet interactive mechanisms that play an important role in reperfusion injury. PMID- 2700374 TI - Free radical mediated damage in skeletal muscle. AB - Skeletal muscle subjected to prolonged ischemia will develop significant injury, however it can withstand periods of ischemia that would be irreversible in other tissues such as brain and heart. Reperfusion injury has been measured and suggested to occur secondary to oxygen free radicals. The increases in vascular permeability and resistance following ischemia/reperfusion can be blunted using free radical scavengers. Also skeletal muscle necrosis can be reduced if these scavengers are provided in high concentration during reperfusion. Recently increases in hydroxy-conjugated dienes, a marker of lipid peroxidation, have been found in reperfused skeletal muscle, providing chemical evidence for free radical injury during reperfusion. These studies have provided some insight into ischemia/reperfusion injury in skeletal muscle, but more investigations are required to detail the mechanisms involved in this injury. PMID- 2700376 TI - Amniotic fluid embolism. PMID- 2700375 TI - Mechanisms of postischemic vascular dysfunction in skeletal muscle: implications for therapeutic intervention. AB - In 1981, it was first proposed that xanthine oxidase-derived reactive oxygen metabolites contribute to the microvascular and parenchymal cell damage which occurs when ischemic tissues are reperfused. Figure 1 summarizes a scheme that has been proposed to explain the interaction of xanthine oxidase-derived oxidants, neutrophil infiltration, and the microvascular dysfunction which occurs in postischemic tissue. According to this proposal, xanthine oxidase-derived oxidants, produced at the time of reperfusion, initiate the formation and release of proinflammatory agents, which subsequently attract and activate neutrophils. The activated granulocytes adhere to vascular endothelium, extravasate, and release cytotoxic oxidants and/or non-oxidative toxins (e.g. proteases) which contribute to tissue destruction. The objective of this review is to summarize the supportive evidence for this scheme in postischemic skeletal muscle and to identify the components of the mechanism that may be amenable to pharmacologic intervention. PMID- 2700377 TI - Lateral decubitus improves oxygenation during conventional ventilation in unilateral lung injury. PMID- 2700378 TI - [The Nervous System Disease Clinic of the Warsaw University during 1921-1939]. PMID- 2700379 TI - [Neurosurgery at the School of Medicine in Warsaw. Historical outline]. PMID- 2700380 TI - [Molecular-genetic studies of gene dislocations in the differential diagnosis of lymphomas and leukemias]. AB - Basing on literature data and personal experience, I described molecular-genetic methods for studying gene dislocations and possibilities of their use in differential diagnosis of lymphomas and leukemias. PMID- 2700381 TI - Retentive pin systems: a laboratory comparison of effectiveness of seating and other characteristics. AB - An evaluation in vitro of a number of currently available pin systems used for retaining direct restorative materials was made in this study. The criteria used for evaluation of the systems were completeness of pin seating in the prepared channels and overall effectiveness of the design of the shoulder-stop-style pins. There was a wide range of difference in the ability to seat pins completely, and the seating of the shoulder-stops on the dentin floor was quite inconsistent. PMID- 2700382 TI - Repair bond strength of glass-ionomer restoratives. AB - The repair bond strength of three different brands of glass-ionomer restorative was tested over time. In this laboratory study, immediate repair of glass ionomer was possible with all three brands; however, over time the repair bond strengths decreased at different rates for the different materials. PMID- 2700383 TI - The retention of titanium pins in high-copper amalgam and their influence on its fracture resistance. AB - The influence of titanium pins on the fracture resistance of amalgam and the retention of amalgam by titanium pins were compared to that of stainless-steel pins. The retention of stainless-steel pins embedded in amalgam to various depths was also evaluated. None of the pins had a significant influence on the compressive fracture resistance of amalgam. All pins embedded to standard depth in amalgam failed in tension, with titanium pins demonstrating the lowest resistance to tensile forces. Stainless-steel pins embedded 1.75 or 1.5 mm and loaded in tension caused failure in the amalgam, but at forces comparable to the retention of such pins in dentin. PMID- 2700384 TI - Inhibition in vitro of caries around amalgam restorations by bonding amalgam to tooth structure. AB - Class 5 preparations in human molars were restored with amalgam. In half of the restorations, an experimental resin liner capable of bonding amalgam to tooth structure was used. The restored teeth were incubated in a bacterial medium containing sucrose and a culture of Streptococcus mutans. Artificial carious lesions were produced around all restorations. The experimental liner inhibited penetration of the lesions along the cavity wall. This inhibition was more effective at the occlusal side. PMID- 2700385 TI - [Influence of pirenzepine on bronchial reactivity evaluated by the methacholine provocation test in a double-blind study of patients with bronchial asthma]. AB - A double blind study was carried out on the effect of pirenzepine on bronchial reactivity assessed by metacholine provocation. The study was carried out on 19 patients with bronchial asthma. Bronchial provocation tests was performed according to the method of Ryan et al using the DeVilbis 646 nebuliser coupled to the Rosenthal--French dosimeter. Spirometric parameters were assessed using Vitalograph. The results show a significant protective effect of pirenzepine on bronchial spasm induced by metacholine. PMID- 2700386 TI - [Regulation of respiration during exertion in healthy individuals]. PMID- 2700387 TI - Resin-bonded bridges for the pediatric patient. AB - The resin-bonded bridge is a relatively new clinical technique that has had favorable clinical reports. Recently, new materials and techniques have been developed which may improve the retention of resin-bonded bridges. This article reviews recent developments concerning resin-bonded bridges, present a case report, and give practical suggestions regarding the fabrication of resin-bonded bridges. PMID- 2700388 TI - [Diagnosis, prevention and treatment of endodontic exacerbations]. AB - Purpose of this paper is to undertake a bibliographical review on the diagnosis, prevention and treatment of pain in endodoncy, in order to provide the reader with an updated guide on the clinical control of pain of dental origin. PMID- 2700389 TI - Case #9. Benign mucous membrane pemphigoid. PMID- 2700390 TI - [Pathology of apical periodontitis]. AB - We review the bibliography about the pathogenesis of the periapical lesions. We state the difference between the acute and chronic lesions. PMID- 2700391 TI - [Ultrasonics in endodontics: mechanism of action]. AB - The present study, first of three dwelling with ultrasonics in endodontic therapy, is a review of the literature about mechanisms involved and appliance of some of the sonic and ultrasonic system. PMID- 2700392 TI - [Kidney glomerular hemodynamics in the rodent Calomys callosus]. AB - Renal function was characterized in Calomys callosus, a rodent which can participate in the transmission of several human diseases. The results showed that the pressures levels, hematocrit and plasmatic proteins were similar to rats submitted to the same experimental maneuvers. The corporal and renal weights, whole and single nephron glomerular filtration rates were similar to the mouse. This rodent presented a significant number of superficial glomeruli, allowing to evaluate glomerular hemodynamics and renal microcirculation parameters. Despite mean arterial pressure similar to the Munich-Wistar (MW) rats, mean glomerular capillary hydraulic pressure was lower in Calomys callosus, due to a lower post glomerular resistance in this rodent when compared to MW rats. The mean glomerular plasma flow rate was relatively elevated when compared with single nephron glomerular filtration rate, which in turn blunted the lower intraglomerular hydraulic pressure, and thus increased the single nephron glomerular filtration rate per g/kidney. The present work suggests that despite of the technical difficulties imposed by the reduced size of the Calomys callosus, the study of the renal function and glomerular hemodynamics is possible, establishing therefore, a model for the study such renal function. PMID- 2700393 TI - [Local anesthetics (LA). Introduction (1)]. AB - A brief historical review of man's attempts to produce pain relief is presented, from physical measures: compression, application of cold, to anesthetic gases and up to the introduction of cocaine and its synthetic derivatives. These offer us now a wide range of drugs with characteristics and properties of local anesthetics which are more and more effective and at the same time with fewer undesirable side effects. PMID- 2700394 TI - [Gingival hyperplasia in renal transplants treated with cyclosporin]. AB - Cyclosporine is a Metabolita produced by the Topocladium inflamatum fungus. This substance produces an immunosuppression of the selective type, which has been responsible for the increased use of this drug for immunological caused pathologies, especially in organ transplants to inhibit body rejection. One of its secondary characteristics or effects is gingival hyperplasia (in 30 por 100 of the cases noted) an effect which generally occurs on the level or in the area of the dental papilla. An anatomopathological study of these tissues shows an increase in collagens along with a large infiltration of plasmatic cells in different states of maturity. In this article, two cases of renal transplants using cyclosporine were monitored to evaluate its effect in any on the gingival tissues. PMID- 2700395 TI - [Guided regeneration of the periodontal tissues]. AB - The present communication discusses the regenerative potential of periodontal tissues in the reestablishment of new tissue attachment, by excluding the epithelium and connective gingival tissue using filters or membranes that covers the instrumented root surfaces. PMID- 2700396 TI - [Root surface biocompatibility]. AB - The optimal result of periodontal therapy is the regeneration of tissues previously destroyed by periodontal disease. In order for regeneration to occur, it is believed necessary to eliminate all root surface alterations. Preparation of the root surface include scaling and root planning, use of acids and other chemical and biological agents. Citric acid has been studied by several authors, but still remains in controversy the biological nature of its effects. In spite of this, the findings of some studies indicate that citric acid used on root surfaces results in: elimination of endotoxins; chemical, exposure of dentin collagen fibers; induction of cementogenesis by the exposed dentin; demineralization of root cementum; enhancement of fibroblast attachment when a plasma factor is used in addition to citric acid demineralization and influence on direction in which the epithelium initially starts to migrate. By the other hand root surface preparation by mean of scaling and root planning is an unpredictable procedure due to variables such as failure to remove the cementum on calculus debris in a clinical situation. New research is needed in order to obtain a predictable root conditioning procedure for a biological surface. PMID- 2700397 TI - [Fibronectin: a review of its properties and applications]. AB - The aim of the present review was to evaluate the benefit of coating root cementum of periodontitis involved teeth with an specific agent to promote connective tissue attachment. This agent was fibronectin, a glycoprotein which enhanced periodontal cell migration to previously scaled and demineralized root surfaces. PMID- 2700398 TI - [Periodontal regeneration]. AB - This review analyzes in the periodontal regeneration, main objective of the periodontal therapy, the effects of the mechanical and surgical procedures, the results of the conditioning radicular agents and of the biochemical mediators and, at last, the consequences of the exclusion of the gingival epithelium in the "guided tissue regeneration". PMID- 2700399 TI - [Lateralization of lesions in the carotid bed in patients with sudden cerebrovascular stroke]. AB - Statistical significance of different factors in laterality of lesions in the carotid bed was studied on a group of 170 patients indicated to ultrasound examination. These were factors contained in the patients' history, i.e. ischemic heart disease, arterial hypertension, diabetes mellitus, age and sex of patients as well as results obtained from auxiliary examinations--Doppler sonography, KAG, EEG and CT of the brain. A marked statistical predominance of lesions in the left side carotid bed was found, which was, however, true only for men, especially those after a completed stroke. The left-sided bed is, moreover, involved earlier, higher incidence of ischemic heart disease was also observed in left sided lesions as well as more severe findings obtained from Doppler sonography, angiography, EEG and CT of the brain. PMID- 2700400 TI - [Relation between serum levels of C-terminal fragment, beta 2 microglobulin and creatinine in patients with chronic nephropathies at different stages of the disease]. AB - The serum concentrations of the C-terminal fragment of parathyroid hormone, beta 2-microglobulin and creatinine were determined in 40 patients with chronic nephropathies at various stages of renal function impairment. Statistically significant positive correlations were found between the concentrations of creatinine and the C-terminal fragment (r = 0.6656, p less than 0.001), creatinine and beta 2-microglobulin (r = 0.7752, p less than 0.001) and beta 2 microglobulin and the C-terminal fragment (r = 0.6391, p less than 0.001). The authors believe that the concentration of the C-terminal fragment i the serum in chronic renal failure is not reflecting the degree of secondary hyperparathyroidism but is only an index of renal function failure. PMID- 2700401 TI - [The role of oxygen free radicals and antioxidants in toxic side effects of antineoplastic chemotherapy and their prevention]. PMID- 2700402 TI - [Alcoholism-induced zinc deficiency in mother and fetus]. PMID- 2700403 TI - [A case of foreign body in the parametrium]. AB - A case is reported of a foreign body (surgical needle) in the parametrium. The needle was left while suturing postpartum cervical rupture. After many years symptoms developed requiring surgical intervention. Conventional methods of needle removal failed and only after fluoroscopy application the foreign body could be removed. PMID- 2700404 TI - [Sanitary Committee of the City of Warsaw (1915)]. PMID- 2700405 TI - [Sagittal splitting with screw fixation in patients with mesial bite wearing dentures--planning surgery and prosthetic design]. AB - In fully or partially edentulous patients with mesial bite undergoing surgical correction, the possibilities for avoiding intermaxillary fixation were studied. For stable osteosynthesis of mandibular osteotomies preoperative prostheses are needed in these patients to keep the jaws in their proper relation during surgery. This requires cephalic adjustment of the maxillary cast and articular adjustment of the mandibular cast in the articulator. The mandibular cast is shifted along an aluminum wedge designed to match the inclination of the occlusal plane until the alveolar rests are in proper relation to one another. If the occlusal plane is neglected, uncontrollable tilting of the mandible may occur. This may favor relapses. As Slavicek (1984) showed the mean inclination of the occlusal plane relative to the hinge axis-orbital plane to be 12.87 degrees (scatter 5.99 degrees) with dorsal convergence in 1,213 patients, 3 aluminium wedges with different inclinations were designed. These are suited for 92.5% of all cases with tolerances of +/- 3 degrees. Mandibular casts are pasted to geometric paper and shifted along the aluminium wedge to the desired position; the distance they are shifted is read from the paper. This distance is transferred to the teleradiograph and the changes in profile are checked. Preoperatively, prostheses can then be tailored to match the desired alveolar crest relation. During surgery, these prostheses serve as splints for setting the mandible as designed in the model. The osteotomy fragments are then screwed together transbuccally with miniscrews and clawed washers. The latter provide for a firm seat of the traction screws in the mandible at a safe distance from the mandibular canal. Postoperative intermaxillary fixation can thus be avoided. PMID- 2700406 TI - [Free mucosal grafting--clinical experiences]. AB - Free mucosal grafting is a simple, safe and predictable procedure. It is indicated in the treatment of progressive recessions in patients with reduced attached gingiva, in recurrent traumatic marginal lesions inspite of correct tooth brushing, in refractory dental neck hypersensitivity and for cosmetic reasons in patients with recessions. In these situations advancement grafting is done as a secondary procedure. To prevent the potential occurrence of recessions free mucosal grafting may also be indicated prophylactically before orthodontic or prosthetic management. The management concept in patients with recessions as well as the indications of the procedure, the technique used at our department and aspects of planning surgery are discussed. PMID- 2700407 TI - [Bonded porcelain laminates--an alternative to anterior porcelain crowns]. AB - The trend towards esthetic dentistry, which originates in the USA, has added new dimensions to the treatment of anterior teeth. One of it is the porcelain laminate technique. Using composites, extremely thin, manually prepared porcelain laminates with a thickness of 0.3 to 0.5 mm are bounded to the labial aspect of front teeth or laterals. On account of the low laminate thickness very little enamel preparation is needed. The residual enamel mass and the translucency of the ceramic material produce a natural appearance and optimal cosmetic results. This technique enables the dentist to restore the shape and color of esthetically compromised teeth. PMID- 2700408 TI - [The use of modern ceramics for inlays and onlays]. AB - If ceramic inlays and onlays are considered in restorative work, some operations which, more than in other areas of dental engineering, decide upon the success or failure should be given special attention. During the preparation of ceramic inlays care should be taken to produce well rounded rather than rectangular edges approximally. In the case of onlays there should ideally be a smooth circular step rounded axially with a sharp-edged near-rectangular interface with the non ground tooth. Ceramic inlays and onlays are best inserted with the adhesive technique, which provides for an improved strength of the ceramic material, an adequate marginal adaptation and a satisfactory cosmetic appearance. As long-term results are not yet available, the use of ceramic inlays and onlays is still experimental. PMID- 2700409 TI - [Diagnostic limitations of isolated axiography interpretation]. AB - Axiographic images of eccentric condylar paths can be more reliably interpreted by considering the clinical function data, compression test results and the MPI. In the case presented the abnormal position of the right condyle would have gone unnoticed without such a combined approach to the problem. PMID- 2700410 TI - [Adhesive bonding system Wiron 88--Superbond--enamel, dentin. A study based on scanning electron microscopy and profile scanning]. AB - The components of the bonding system Wiron 88--Superbond enamel, dentin were examined by scanning electron microscopy and profile scanning. Wiron 88 was corroded electrolytically using Korolyt A in the Eltrokor system. At 400 mA/cm2 and an exposure time of 7 minutes an optimal microretentive surface morphology was seen on SEM. Both shorter and longer exposure times did not produce the desired results. Profile scanning of corroded Wiron 88 to determine vertical and horizontal surface changes showed that surface roughness increased as a function of increasing exposure times. On SEM of the Superbond material placed in contact with corroded metal and enamel, retentive structures were found to spread, thus producing a micromechanical bond. Phosphoric acid treatment increased the diameter of the dentin canals so that penetration of Superbond in corroded dentin was better than in non-corroded dentin. These results and several years of clinical experiences in adhesive denture work establish the usefulness of combining electrolytically corroded Wiron 88 and Superbond. PMID- 2700411 TI - [Periodontal aspects of removable partial dentures]. AB - Periodontal pre-treatment of patients receiving partial dentures should involve three phases: initial therapy; periodontal surgery; home care. For periodontal surgery and/or prosthodontic treatment using precision materials, e.g. telescope retainers, the API (approximal plaque index) should not exceed 30%. To prevent further loss of gingival attachment due to iatrogenic irritation by the dentures preparation of abutments should consistently the para- or supragingival. In patients with few residual teeth telescope retainers, which can be cemented for definitive fit if indicated, are the treatment of choice. PMID- 2700412 TI - [Oral manifestations of HIV infection]. AB - Skin and mucous membranes including the oral mucosa are among the preferential locations of opportunistic infections and secondary neoplasms in patients infected with the human immunodeficiency virus (HIV). Infections of the oral mucosa such as thrush occur in a high percentage of AIDS patients, patients with AIDS-related complex or HIV-seropositive individuals. The clinical appearance of the infections (herpes virus infection, periodontitis) is often marked by aggressive expansion, frequent recurrences or resistance to therapy. Oral "hairy" leukoplakia is considered to be a characteristic lesion in HIV-infected individuals. Tumors like Kaposi's sarcoma, squamous cell carcinoma and non Hodgkin lymphoma of the oral mucosa may cause marked morbidity in AIDS patients. Such oral lesions are frequently the first indication of an HIV-infection. Dentists should be aware of the oral manifestations of HIV-infection and initiate diagnostic and therapeutic measures in the interest of the patients and for epidemiologic reasons. PMID- 2700413 TI - [Synthesis and antifungal activity of N-(6,6-dimethyl-2-hepten-4-ynyl)-N-methyl alpha-substituted -1-(4-substi tuted) naphthalenemethanamines]. AB - Thirty (E)- or (Z)-N-(6,6-dimethyl-2-hepten-4-ynyl)-N-methyl-alpha-subst itu ted 1-(4-substituted)naphthalenemethanamines were synthesized for searching of more potent and less toxic antimycotic agents. All title compounds and most of the intermediates are new. Results of preliminary biological tests showed that most of the title compounds exhibited activity against the common pathogenic fungi such as Cryptococcus neoformnas, Candida albicans, Aspergillus fumigatus, Cladosporium carrionii, Sporothrix schenckii, Microsporum gypseum, Trichophyton rubrum and Epidermophyton floccosum. The antifungal activity of compound I1a was roughly comparable to clotrimazole, and was more active against Candida albicans than naftifine and terbinafine. Compound III1a was as active as terbinafine against all fungi tested. Some improvements for the synthesis of tert butylacetylene and the alkylating method of 1H-1,2,4-triazole and 1H-imidazole were made. Synthesis of 6,6-dimethyl-1-hepten-4-yn-3-ol and 2-alken-4-ynylamines were modified. PMID- 2700414 TI - [Synthesis and antimalarial as well as antitumor activities of 1-methyl-2,4 diamino-6-(N-methyl-substituted benzylamion) quinazolinium iodides]. AB - Fourteen 1-methyl-2,4-diamino-6-(N-methyl-substituted benzylamino) quinazolinium iodides (II) were synthesized by treatment of 2,4-diamino-6-substituted benzylaminoquinazolines with methyl iodide. Three compounds (II4,7,10) were shown to produce 100% suppression on Plasmodium berghei in mice at oral dose of 20 mg/kg and II4 was found to inhibit twice as much as methotrexate on L1210 Leukemia cells in culture. PMID- 2700415 TI - Cell-mediated immune response in human hepatic echinococcosis. Analysis of antigen-induced lymphoproliferation and NK activity. AB - In vitro cellular immune responsiveness was studied in 25 patients undergoing surgery for hepatic hydatid disease and in 22 matched healthy controls. Proliferation of peripheral blood mononuclear cells (PBMC) induced by phytohaemagglutinin (PHA) was not statistically different in the two groups, while proliferation induced by antigenic preparations obtained from the human commensal microorganism Candida albicans was depressed in patients as compared to healthy subjects. Confirming previous data, antigen specific proliferative response to hydatid cyst fluids was greatly enhanced in patients as compared to controls (P less than 0.01). On the other hand, natural killer (NK) activity was significantly reduced (P less than 0.005). Both impairment of NK activity and lymphoproliferation induced by commensal microorganisms suggest that patients following the parasitic infection present a condition of relevant hyporesponsiveness in cell-mediated defence. PMID- 2700416 TI - Advances in contraception. PMID- 2700417 TI - Barrier contraception. PMID- 2700418 TI - IUD: past--present--future. PMID- 2700419 TI - Reversal of sterilization. PMID- 2700420 TI - Oral contraception: risks and benefits. AB - Data on the risks and benefits of using the oral contraceptive continue to accumulate. Because of continuing changes in the formulation and dosage of both the estrogens and progestins, the medical community must constantly re-evaluate all older data when considering current risk/benefit ratios. The changes in pill formulation have led to increased acceptability with a reduction of both nuisance and serious long-term side effects. The risks must be balanced against the major contraceptive and non-contraceptive benefits that are provided by the pill. Although both the benefits and risks have been documented in the literature, both the physician and the patient are being overwhelmed by press reports stressing mainly the negative aspects of the pill. It is incumbent on all physicians to periodically review the sources and validity of all medical reports on the pill. While the benefits of the pill outweigh the risks, the physician must be constantly aware of the changing world literature in order to optimize his/her prescribing patterns. PMID- 2700421 TI - The new progestogens. PMID- 2700422 TI - Long-acting progestins--an update. PMID- 2700423 TI - Male contraception. PMID- 2700424 TI - Glucose tolerance and secretion of insulin in chronic pancreatitis. AB - Chronic pancreatitis (ChP) is the most frequent cause of pancreatogenous diabetes mellitus (DM). This kind of DM is a typical case of acquired insulin secretion deficiency. The group under scrutiny consisted of 122 patients with ChP. The average age of the 88 men was 42.9 and that of the 34 women was 54.4 years. According to pancreatography and to the presence of calcifications the patients were divided into four group by gravity of the morphological pictures at ERCP. The control group of healthy persons was made up of 15 men and 10 women. The presence of glucose intolerance was rated by the oral glucose tolerance test (oGTT) after 75 g glucose. The volume of endogenous secretion of insulin was studied by measuring IRI and C-peptide fasting and after stimulation. To measure the damage of pancreatic exocrine secretion we used function test (Spofagnost Pankenzan test). In our own group of 122 patients we found decreased glucose tolerance in 72 (59%). 41% were cases of DM, 18% suffered from impaired glucose tolerance (IGT). As the results of stimulated C-peptide tests suggest, practically all patients with ChP corroborated by morphological changes in the pancreatic duct system at ERCP have decreased endogenous insulin secretion compared with healthy persons, and that includes even those normal glucose tolerance rated by results of oGTT We were able to prove a statistically significant relationship between the degree of morphological changes in the pancreatic duct system and the values of C-peptide. The mean values of the Spofagnost test showed significant differences between patients with normal glucose tolerance and DM. PMID- 2700425 TI - ADSA: ten years of progress. PMID- 2700427 TI - Case studies in thoracic surgery. PMID- 2700426 TI - Modification of local anesthetic toxicity by vasoconstrictors. AB - We studied the effects of epinephrine or levonordefrin on the toxicity (convulsions) and lethality of four local anesthetics in mice. Appropriate doses of procaine, lidocaine, tetracaine or bupivacaine--either alone or in combination with 15 mcg/kg epinephrine or levonordefrin--were injected intravenously into the tail vein of male mice. Dose-response curves were constructed from the data obtained, and the CD50 and LD50 values for each local anesthetic alone and in combination with each of the vasoconstrictors were calculated by probit analysis. Both epinephrine and levonordefrin decreased the toxicity and lethality of procaine with respect to dose. Epinephrine, but not levonordefrin, increased the toxicity and lethality of bupivacaine as well as the lethality of tetracaine. Neither vasoconstrictor significantly affected the toxicity of lidocaine in mice but in rats epinephrine markedly increased lidocaine's lethality under identical conditions. Tight physical restraint decreased the LD50 values of all four local anesthetics and eliminated any modifying effect of the vasoconstrictor. PMID- 2700428 TI - Continent diversions: an overview. PMID- 2700429 TI - [Prosthetic reconstruction of the secondary deformed maxillary arch in a patient with congenital cleft]. AB - A case history of a bilateral cleft lip and palate male patient is presented. He was operated late at the age of his twelve, without any previous orthodontic treatment. Surgical reconstruction included, lip, hard and soft palate, removal of the premaxilla, and later on the pharingoplasty. At the age of twenty years he was prosthetically rehabilitated. Nine inner telescope crowns were made in "Palador" silver alloy, and nine outer in chrom-cobalt splinted together and connected with the skeletal frame. Intermaxillary relations were recorded and established in a manner used in the construction of complete dentures, and occlusion of the teeth, too. A complete obturation of the oronasal communication in the palatomaxillary section was achieved. The patient was followed up throughout next twenty years. PMID- 2700430 TI - [X-ray examinations in orthodontic diagnostics as a source of ionizing radiation]. AB - Orthodontics increasingly depends on X-ray examinations in the therapy and diagnosis of dento-facial anomalies. In the choice of roentgenologic diagnostic methods attempts are made to select a method that provides maximum information with the least irradiation of the patient. Insufficient knowledge of the biological effects of ionizing radiation may result in undue precaution by the doctor or utter indifference. Therefore, literature data were analyzed to cast more light on the risks of ionizing radiation. The following conclusions have been reached: orthodontists are obligated to expose their patients to a minimal possible radiation; it is not possible to define the safety threshold of X-ray radiation because of unpredictable stochastic effects, although the incidence of damage due to the lowest doses is negligible; the doses of radiation due to orthodontic X-ray examinations are within the range of natural, environmental doses. However, because of their cumulative effects, they should not be underestimated; stomatologic X-ray examinations account for 8 to 25% of all X-ray examinations, yet their contribution to genetically significant doses is the smallest; since the effects of genetically significant doses have not been scientifically elucidated to a sufficient extent, X-ray radiation should be maximally reduced, modern roentgenologic techniques should be used and the safety instructions should be strictly followed; if all safety measures are adhered to, it is not necessary to impose limitations with regard to the performance of orthodontic X-ray examinations; it is important to obtain from the patient history of his previous X-ray examinations; a favorable relationship should exist between medically warranted needs and possible damages to the patient; standardization of orthodontic X-ray diagnosis will facilitate recording of relevant data and the calculation of radiation doses. PMID- 2700431 TI - Mast cell-basophil system in tumor growth. PMID- 2700432 TI - Relationship between Sakita endoscopic stage and duration of treatment for duodenal ulcer healing. AB - 1. Endoscopic staging of peptic ulcer lesions according to Sakita will be a methodological improvement in therapeutic trials provided that the correlation between stages and the time spent in treatment is proved valid. 2. We describe a double-blind controlled randomized trial carried out to determine the efficacy of cimetidine in patients with duodenal ulcer in the H stage of Sakita endoscopic staging. Fifty-two patients with duodenal ulcer (H stage) were randomly allocated to receive either 400 mg cimetidine twice daily (N = 26), or placebo (N = 26) for two weeks; patients with unhealed ulcers continued the same treatment for an additional week. 3. Of the cimetidine-treated patients, 19 (73%) were healed after two weeks and 23 (88.5%) after three weeks of treatment, and of the placebo treated patients, 8 (31%) were healed after two and 13 (50%) after three weeks. 4. These differences indicate a natural tendency of the H stage lesions to heal faster than reported for the active (stage A) lesions and still faster if treated with cimetidine. These findings, by establishing a relationship between the ulcer stage and the time spent in treatment, may help the physician to treat duodenal ulcer patients and will enable the adoption of an important, uniform criterion for selection of duodenal ulcer patients for therapeutic trials, especially in multicenter trials. PMID- 2700433 TI - Participation of mannose receptors on the surface of stimulated macrophages in the phagocytosis of glutaraldehyde-fixed Candida albicans, in vitro. AB - We have evaluated the participation of mannose receptors on the surface of stimulated macrophages in the phagocytosis of Candida albicans in vitro. A dose dependent 8.6 to 88.3% reduction of phagocytosis was observed in the presence of 0.5 to 5.0 mg/ml of the mannose-rich glycoprotein invertase (either native or denatured) in the incubation medium. Macrophages plated onto substrates coated with poly-L-lysine-mannan also showed a 99% reduction of phagocytic activity toward Candida albicans, but phagocytosis of IgG-coated erythrocytes was not inhibited under the same conditions. These results indicate that mannose receptors are involved in one of the initial steps of phagocytosis of Candida albicans by macrophages. PMID- 2700434 TI - [Reinterpretation of the hepatic abscess, a new dimension in abdominal digestive surgery]. AB - Pyogenic abscess of the liver is viewed here as a surgical disease, which appears to raise doubts as to its actual identity. Though located in a given abdominal organ, such abscesses find it hard to recognize this as their exclusive setting and attempt to shrug off these traditional confines. They aspire, rightly or wrongly perhaps, to symbolize a splanchnic context, though, in actual fact, the latter--at least for contingent, doctrinal reasons--is confined to the bipolar liver-bowel system. This context presents its candidacy as playing a leading role in a disease of such importance as to be regarded almost as the "Caudine Forks" of the very process of "surgical" dying. Liver abscess and multiorganic or multisystemic organ failure (MOF or MSOF) might thus be viewed as the two opposite poles (taxonomically definable) of a single clinical condition, which fans out over a broad area and for the most part is only barely known to us. Though is characterized by its abdominal location, it would be all too simple to define the condition as abdominal. In this case, in fact, the abdomen speaks an unusual language, not the habitual, traditional, "spatial" language of location, but the as yet uncertainly articulated "biological" or, why not, even "biosurgical" language of mediation. Is this then a turning point in the pathological field? No, if by that we mean a new concept of the problem. In effect, the concept dates back several centuries and, moreover, darries a heavy burden of responsibility, such as, for instance, having induced the Nobel Prize winner Elie Metcknicoff (Metcknicoff E., The prolongation of life. London, Heinemann, 1907) to come up with theories appropriated and implemented surgically by Sir William Arbutnot Lane, gaining him nothing but sad notoriety (Gordon R., Great Medical Disasters, Hutchinson, London-Melbourne, 1983). "Concept" is a euphenism, and a more appropriate term might be simply "intuition". The real innovation lies in reviving this old intuition, reinterpreting it now, in fact, as a "concept". The code for this modern interpretation has barely been sketched out in its essentials, but is daily going from strength to strength.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2700435 TI - [Sale of duplicates at the Pierre Fauchard Museum]. PMID- 2700436 TI - [Bilateral mandibular histiocytosis X]. PMID- 2700437 TI - [Laboratory tests in periodontology]. AB - The dentist may prescribe biological examinations in periodontics in view of confirming the diagnosis of a general disease or preparing a therapeutical treatment. Biological tests are necessary to evaluate the activity of periodontal disease. Even if research is carried out at microbiological and immunological level and on the substances related to tissue wearing, only two examinations are possible today in clinics: optical microscopy, DNA probes. PMID- 2700438 TI - [New attachment formation with guided tissue regeneration. Review of the literature]. AB - Restoring gum epithelial-conjunctive attachment on calcified tooth surfaces is the main objective of every treatment program of periodontal lesions. Research works are resulting today in a better understanding of biological mechanisms involved in tissue healing or rebuilding processes. These scientific studies allow to control such new therapeutics that can create a biocompatible environment essential to the metabolism of regenerating cells. PMID- 2700439 TI - [Grinding for combination dentures]. PMID- 2700440 TI - [Therapeutic luxation: a way of fighting pain in the 18th century]. PMID- 2700441 TI - Puptrak 1.0--a new semiautomated system for pupillometry with the Octopus perimeter: a preliminary report. AB - A provisional, semiautomated version of a system for automated testing of the afferent pupillary reflex with perimetric methods under controlled conditions is described. The target projected onto the perimeter cupola is used as the stimulus for triggering the pupillary response. In a modification to the Octopus 201, the pupil is illuminated by two IR LED diodes, while the pupillary responses are recorded by the onboard IR sensitive TV camera built into the perimetric unit. Measurements of the pupillary area as a function of time and stimulus luminance have been performed and have resulted in consistent results. Here, one perimetric program, working with stimuli above the threshold for the afferent pupillary light reflex is described. The present setup works with system-specific software and standard hardware, the central data processing unit being a desk-top computer (IBM PC AT-03). The mating of an automated pupillary measuring unit to an automated perimeter may open the door for a more widespread evaluation of the value and the clinical application range of pupillary perimetry and may be of interest in other areas of visual and clinical psychophysics. The shortcomings of the present system, in particular insufficient temporal resolution and lack of full automation, are being removed at the present time. PMID- 2700442 TI - [The Caridex System for removal of dental caries. Clinical trial]. AB - The Authors show the results of clinical tests of the Caridex system performed on adults between the ages of 15 and 60 years under the treatments of the Hospital's Odontological Division of the Pavia University. On this ground, after considering the advantages and disadvantages that the chemo-mechanical removal offers to the patient, the Authors show the real indications asserting that this system, even if is not able to supplant the traditional methodologies, it can be helpful if mixed with them and, in limited cases, it can completely replace the drill. PMID- 2700443 TI - [TMJ and radiographic methods. Comparative analysis]. AB - The Authors take into consideration the complex and troublesome subject of instrumental radiological analysis applicable as a diagnostic aid in TMJ pathology. They therefore analyse, starting from their own experiences and after revising the pertaining literature, the pros and cons of the several radiological methodologies, both traditional and recently discovered as CAT and nuclear magnetic resonance. They do not only underline the possibilities and limits of the above mentioned methodologies, but ever define precisely how instrumental diagnostic techniques cannot, individually or variously combined, provide a complete diagnostic and aetiological view of the pathologies of TMJ without clinic information. PMID- 2700444 TI - [From perfect wax model to reproducible perfect fitting gold casting]. PMID- 2700445 TI - [Groove-shoulder-pin attachments. Systematic milling]. PMID- 2700446 TI - [Titanium casting using the Titaniumer. Casting technic is not yet final]. PMID- 2700447 TI - [Interchangeable resin-Reiter system in bar joint prostheses]. PMID- 2700449 TI - [Groove-shoulder-pin attachments. Milling apparatus and tools]. PMID- 2700448 TI - [Layering following the natural pattern of opaline, translucent ceramics]. PMID- 2700450 TI - [Sinterloy technic. Ceramic framework of metallic powder]. PMID- 2700451 TI - [An esthetic challenge. Highest demands are the norm]. PMID- 2700452 TI - [Preparation of Maryland bridges. Some thoughts on fabrication technic]. PMID- 2700453 TI - [One-piece model casting Olympiad. Battle with hindrances]. PMID- 2700454 TI - [How certain is an active bond between a ceramic restoration and dental enamel?]. PMID- 2700455 TI - [Critical thoughts on maxillary constructions]. PMID- 2700456 TI - Present and future aspects of materials in dentistry. AB - The success of most forms of dental treatment is dependent on the wise choice and good manipulation of materials. A vast range of new products has become available, leading to types of treatment that were not dreamed of a generation ago. This paper reviews those products and procedures. PMID- 2700457 TI - Effects of bonding agent types and incremental techniques on minimizing contraction gaps around resin composites. AB - In this in vitro study, large rectangular cavities were prepared on the proximal surfaces of human premolars with cervical margins placed beyond the cemento enamel junction. Before the insertion of resin composite, the cavity walls were treated with Bowen's system, Scotchbond, or Gluma combined with different bonding agents. Various incremental techniques were tested. The contraction gap was determined by use of the resin impregnation technique: After polymerization shrinkage, a low-viscosity resin with a fluorescent additive was applied to the cervical and occlusal margins to penetrate the contraction gap. After being ground, the width of fluorescent resin could be measured with a microscope. All combinations of materials and techniques produced contraction gaps at the cervical wall. The range for mean width of the impregnated gap at the cervical wall was from 5 to 13 microns. The lowest mean value was obtained for Gluma in combination with Clearfil Bonding Agent. Placement of the composite in two increments significantly reduced the gap width. No reduction was achieved when a three-step insertion technique was used. PMID- 2700458 TI - Comparison of microleakage of experimental and selected commercially available bonding system. AB - The microleakages of composite restorations bonded with two commercial and two experimental systems were observed. A high-viscosity condensable composite and a low-viscosity composite were used as the restorative materials. The bonding systems used were two widely accepted commercial brands and two experimental systems, one containing ferric oxalate and the other aluminum oxalate. Restorations were placed in cavities prepared in extracted human teeth and treated with the various bonding systems. These restorations were stored in 37 degrees C water for 24 hours and then polished. The restored teeth were subjected to seven days of thermocycling (5 degrees C-55 degrees C for 540 cycles per day). Microleakage was detected and scored from 0-4 according to the degree of stain penetration. The experimental systems had lower scores than the commercial systems. The high-viscosity composite restorations had microleakage scores higher than those of the lower-viscosity composite restorations. PMID- 2700459 TI - Effects of acid and cleansing agents on shear bond strength and marginal microleakage of glass-ionomer cements. AB - The aims of the present study were to evaluate the effects of various dentin chemical pretreatments (a) on the shear bond strength of five glass-ionomer cements (GICs) and (b) on marginal microleakage of the five GICs used in association with resin composites in Class V restorations. The dentin treatments were: three acid agents (polyacrylic acid, tannic acid, orthophosphoric acid), three cleansing agents (Tubulicid blue solution, hydrogen peroxide, and sodium hypochlorite), and an aqueous solution as control. After dentin treatment, the test specimens were stored in water at 37 degrees C for 24 hr. Shear bond strength was determined with a universal testing machine at a cross-head speed of 0.5 cm/min. Sodium hypochlorite and polyacrylic acid significantly improved the adhesion of GICs to a different degree in the various materials. Regarding microleakage tests, 320 non-retentive cavities were prepared at the cementum enamel junction in freshly extracted human teeth. The teeth were thermocycled, immersed in dye solution, and serial-sectioned longitudinally at three sites. Treatment with sodium hypochlorite was the most effective in reducing marginal leakage. The present results suggest that dentin treatment is an important step in all resin composite/GIC restorations. PMID- 2700460 TI - Tensile bond strength of dental adhesives to dentin and enamel. AB - This study compared the tensile bond strengths of an unfilled resin bonding agent and four proprietary dentin bonding agents to dentin and acid-etched enamel. Forty-eight hours after bonding, 10 dentin-bonded teeth and 10 enamel-bonded teeth for each material were loaded in tension in an Instron Universal Testing Machine until bond failure. The remaining specimens were stored in a water bath for six months and then tested in a similar manner. At the end of six months, Universal Bond and Tenure (3-step) had bond strengths significantly greater than those of the other agents. All bonding agents, except Tenure (3-step), showed a significant decrease in tensile bond strength to both dentin and enamel after six months (p less than 0.0001). PMID- 2700461 TI - Mesh monitor casting of Ni-Cr alloys: element effects. AB - A mesh monitor has previously been used for quantitative evaluation of the casting of dental alloys. A castability value, Cv was defined. For curve-fitting, a transformed castability value, Cv,t, was used. A series of alloys was selected so that effects of major elements on Cv, t and, hence, on Cv could be determined. Compositions were chosen so that correlated effects would be avoided. Assuming a linear dependence on the concentrations of individual elements, one may use the following equation to describe Cv,t: (Formula: see text) where each term employs an elemental concentration in weight percent, (Ei), and a coefficient, Ki, for the ith term. Because Ei's are constant for each alloy, Ki = fi (TA, TM) = gi (TC, TM). The temperature-dependent coefficients, Ki, were determined for seven elements and for the (Ni/(Cr) ratio. It was also found that Si and Be produce a synergistic effect. The results help our understanding of the casting behavior of Ni-Cr dental alloys; this approach may be useful in the design of dental alloys. PMID- 2700463 TI - Dentin surface roughness vs. bond strength of dentin adhesives. AB - The effects of differently prepared dentin surfaces on the bond strength mediated by five dentin adhesive/composite resin systems were investigated: Clearfil new bond/Clearfil Ray, Gluma/Lumifor, Scotchbond/Silux, Scotchbond 2/Valux, and Tenure/Silux. Bonding surfaces were produced either by wet-grinding of human teeth on SiC paper, grits 180, 240, 320, 400, 600, and 4000, respectively, or by cutting them with dental preparation instruments. The surfaces of the dentin were analyzed by a profilometer. Tensile bond strengths (TBS) were determined two min after light activation of the restorative systems. In spite of greatly different effective areas for bonding, ANOVA showed no significant differences on the 5% level between the TBS means of one material system recorded for the different dentin preparations. It was concluded that the dentin roughness produced by preparation has no significant influence on early bond strengths of bonding composite resin systems. PMID- 2700462 TI - Shear bond strength of visible-light-cured resin relative to heat-cured resin. AB - One promising clinical application of visible-light-cured (VLC) denture resin is for relining complete and partial dentures. Typically, a VLC resin would be used to reline an existing prosthesis fabricated from heat-cured resin (HCR). This study measured the shear bond strength of a VLC resin bonded to HCR specimens by different bonding agents. For comparison, we measured the shear bond strengths of VLC resin bonded to VLC resin specimens and of autopolymerizing resin (APR) to HCR specimens. Cylindrical specimens of HCR (n = 126) and VLC (n = 24) were thermocycled to simulate aging, and the bonding surfaces were prepared by being sanded to approximate clinical roughness. The specimens were divided into seven groups of approximately 20 each, and test materials were bonded by different bonding agents. Statistical analysis by ANOVA and the Student-Newman-Keuls test showed significant differences (p less than 0.05) among all groups except APR to HCR/no bonding agent, VLC to HCR/VLC bonding agent, or VLC to HCR/VLC and HCR bonding agent. The traditional bond of APR to HCR with HCR bonding agent was significantly stronger (p less than 0.05) than the strongest bond of VLC to HCR with HCR and VLC bonding agents. PMID- 2700464 TI - Saliva contamination vs. efficacy of dentin-bonding agents. AB - The efficacy of two dentin-bonding agents (Gluma and Scotchbond Dual Cure) was investigated in vitro with or without saliva contamination of the dentin before or after application of the adhesive. The efficacy of the bonding agents was evaluated by a shear-bond strength test and a cavity test. When the dentin surface was contaminated, either before or after application of one of the bonding agents, the shear bond strength was reduced, but the difference between contaminated and non-contaminated specimens was not statistically significant. In the cavity test, the width and the extent of the marginal contraction gap were markedly increased when the dentin was contaminated with saliva before the bonding agent was applied. If the contamination happened after application of the adhesive, the efficacy of Gluma was further reduced, while that of Scotchbond was significantly improved. (This phenomenon has been investigated in detail in an accompanying paper.) The clinical consequence of saliva contamination seems to be that when Gluma is used as dentin-bonding agent, the contaminated area must be removed operatively, and then each of the various bonding procedures must be repeated. PMID- 2700465 TI - Improved efficacy of some phosphate-based dentin-bonding agents. AB - The gap-reducing efficacy of four phosphate-based dentin-bonding agents was tested after various treatments of the dentin and/or the bonding agents. The investigation was carried out on extracted human teeth. One of the root surfaces was ground flat, and a cylindrical butt-joint cavity was prepared in the ground dentin surface. It was found that the efficacy of two of the adhesives, presumably being chloro-substituted phosphates, could be markedly improved if the primed dentin was rinsed with copious amounts of water, dried by compressed air, and a second layer of bonding agent applied. The mechanism behind this improvement is assumed to be the formation of hydrogen chloride, which dissolves part of the smear layer. PMID- 2700466 TI - Technical note: fluoride pre-treatment effects on microleakage of a resin bonding agent. AB - This pilot study reports the effect of fluoride pre-treatment of dentin and enamel on microleakage of a resin bonding agent. Pairs of circular class V cavities involving 50% enamel and 50% cementum were cut in 12 extracted third molars. Each tooth contained a control and a treatment cavity (matched-pair design). A stannous fluoride solution (0.717% SnF2, Gel-Kam, Scherer Laboratories, Dallas, TX) was applied to the entire treatment preparation of each tooth. A dentin resin bonding system (Scotchbond 2 with Scotchprep, a dentin primer, 3M Dental Products Div., St. Paul, MN) was applied per manufacturer's instructions. Silux resin (3M) was placed over the resin bonding agent, light cured, and finished. The teeth were subjected to 500 temperature cycles between 5 and 55 degrees C. A silver nitrate staining technique was used for evaluation of microleakage. The mean leakage for the control was 2235 +/- 1146 microns, and 2105 +/- 1052 microns for the fluoride treatment sites. It is concluded, from this pilot study with small sample size, that pre-treatment with fluoride of dentin and enamel prior to the placement of a resin bonding agent produced no significant change in microleakage (Student's t test for paired samples, p = 0.6492). PMID- 2700467 TI - Gingival response to a burnishing technique for preimpression tissue management. PMID- 2700468 TI - [Application of computer systems in perinatology. I. Review of computer systems]. AB - The main elements of the computer system used in medical practice are discussed. Typical application possibilities of microcomputers in perinatal medicine are described. PMID- 2700469 TI - [Application of computer systems in perinatology. II. Organization of computer systems in intensive care of the fetus and newborn]. AB - The main computer systems used in perinatal medicine are described, with particular reference to the systems of analysis of perinatal data, analysis of cardiotocogram, obstetric ultrasonogram, assessment of the heart function of the newborn, records of respiratory activity in newborns, and use of computers in parenteral alimentation of newborns. PMID- 2700470 TI - [Mathematical foundation for biophysical methods in fetal monitoring. I. Fetal electrocardiography]. AB - The authors discuss the foundations of mathematical analysis of fetal electrocardiograms, with particular reference to the obtaining of ECG signal by indirect method, and signal processing. PMID- 2700471 TI - [Mathematical foundations for biophysical methods in fetal monitoring. II. Cardiotocography]. AB - The principles of mathematical analysis of cardiotocographic records are described, together with the methods of calculation of the baseline, oscillations, short-term and long-term variability, and cardiotocographic analysis in frequency range. PMID- 2700472 TI - [Mathematical foundation for biophysical methods in fetal monitoring. III. Magnetocardiography, phonocardiography, polycardiography, and Doppler blood flow analysis]. AB - Magnetocardiography, phonocardiography, polycardiography and blood flow analysis based on Doppler phenomenon are described discussing the importance of these methods in fetal monitoring in pregnancy and labour. PMID- 2700473 TI - [Nausea and vomiting in pregnancy]. AB - Nausea and vomiting are frequent disturbances in the first trimester of pregnancy, sometimes they may take the form of hyperemesis, even life threatening. The authors survey the concepts of the aetiology and pathogenesis of the condition: hormonal, metabolic, psychological. Principles of management using simple methods reducing the ++ill being of the pregnant patients are presented, together with pharmacological management of hyperemesis. The suggested therapeutic methods seem to be relatively safe for the fetus and practically eliminate the necessity of pregnancy interruption for medical indications. PMID- 2700474 TI - A clinical study of effect of oral atenolol on normal intraocular pressure and systemic blood pressure. AB - Atenolol is a newer betablocker, widely used as an antihypertensive drug. It cause a large and rapid fall in IOP when used orally and topically. A total of 33 patients both having normal and raised IOP were included in the study. The drug was given in a dose of 50 mg. tab. orally once a day for 7 days at 8 A.M. and IOP recorded after 24 hours, 72 hours and on 7th day. It produces significant and sustained fall in IOP in both normal and raised IOP patients besides lowering of systematic B.P. and pulse rate. The IOP on patients with systemic hypertension with Atenolol will be reduced and stoppage of therapy may cause glaucoma damage. PMID- 2700475 TI - [A new hemostatic tampon made of natural collagen]. PMID- 2700476 TI - [Bicentennial of the death of Pierre Camper (1722-1789)]. PMID- 2700477 TI - The olfactory system and Alzheimer's disease. AB - Alzheimer's disease (AD) is considered to be the number one health problem and seems to be reaching epidemic proportion in the USA. The cause of AD is not known, a reliable animal model of the disease has not been found and appropriate treatment of this dementia is wanting. The present review focuses on the possibility that a virus or exogenous toxic materials may gain access to the CNS using the olfactory mucosa as a portal of entry. Anterograde and retrograde transport of the virus/zeolites to olfactory forebrain regions, which receive primary and secondary projections from the main olfactory bulb (MOB) and which, in turn, project centrifugal axons to the MOB, may initiate cell degeneration at such loci. Pathological changes may, thus, be initially confined to projecting and intrinsic neurons localized in cortical and subcortical olfactory structures; arguments are advanced which favor the view that excitotoxic phenomena could be mainly responsible for the overall degenerative picture. Neurotoxic activity may follow infection by the virus itself, be facilitated by loss of GABAergic terminals in olfactory cortex, develop following repeated episodes of physiological long term potentiation (which unmasks NMDA receptors) or be due to excessive release, faculty re-uptake or altered glutamate receptor sensitivity. Furthermore, a reduction in central inhibitory inputs to the MOB might then result in disinhibition of mitral/tufted neurons and enhance the excitotoxic phenomena in the MOB projecting field. Within this context, and in line with recent studies, it is believed that pathology begins at cortical (mainly olfactory) regions, basal forebrain neurons being secondarily affected due to retrograde degeneration. In addition, failure to produce a critical level of neurotrophic factors by a damaged MOB and olfactory cortex, could adversely affect survival of basal cholinergic neurons which innervate both regions. Support for these hypothesis is provided, first, by recent reports on pathological findings in AD brains which seem to involve preferentially the olfactory and entorhinal cortices, the olfactory amygdala and the hippocampus, all of which receive primary or secondary projections from the MOB; secondly, by the presence of severe olfactory deficits in the early stages of the disease, mainly of a discriminatory nature, which points to a malfunction of central olfactory structures. PMID- 2700478 TI - Field model of consciousness: EEG coherence changes as indicators of field effects. AB - Changes in EEG coherence patterns were used to test a field model that posits a common field of "pure consciousness" linking all individuals. In ten trials, EEG was concurrently measured from pairs of subjects, one practicing Transcendental Meditation (TM) and the TM-Sidhi technique of "Yogic Flying" (YFg)--said to enliven the proposed field of consciousness--and the other performing a computer task. Box-Jenkins ARIMA transfer function analysis indicated that coherence changes in the YF's 5.7-8.5 Hz band, the band sensitive to TM and YFg, consistently led coherence changes in the other subject's 4.7-42.7 Hz band. A clear relationship was seen among subjective reports, coherence patterns, and strength of intervention effects. These data support a field model of consciousness. Alternate explanations are explored. PMID- 2700479 TI - Epidemiology of bancroftian filariasis in a semi-urban community of Kerala State. AB - A community-based longitudinal study was initiated in 1983 in a semi-urban area, endemic for bancroftian filariasis to determine the incidence and prevalence, natural history and clinical pattern of filarial infection and also to study the impact of control measures on it. The base-line filariometric indices observed during the initial clinico-parasitological survey and entomological observations made during the first 12 months of this study are highlighted in this paper. 5.5 per cent of the examined population had microfilaraemia with average infestation of 8.1 per 20 cmm. The microfilaraemia found to have significant (P less than 0.001) relationship with age, but not with sex (P greater than 0.05). The filarial disease which had the prevalence of 3.6 per cent showed a significant (P less than 0.001) relationship to both age and sex. The youngest microfilaria (mf) carrier was of 2 years and with filarial swelling was of 6 years age. A significant (P less than 0.001) relationship of educational status and family size was observed with disease while it was non-significant (P greater than 0.05) with microfilaraemia. With the increase in per capita income of the individuals, a significant decrease in number of persons with microfilaraemia (P less than 0.01) as well as with disease (P less than 0.05) was noted. Culex quinquifasciatus, the vector for this infection was prevalent throughout the period of observation with highest density in September. Vector infection and infectivity rates ranged from 0 to 4.4 per cent and 0 to 2.2 per cent respectively. PMID- 2700480 TI - Filariasis control in rural areas through detection and treatment with diethylcarbamazine. AB - A pilot study for control of bancroftian filariasis through detection and treatment of microfilaria (mf) carriers and filaria disease cases with Diethylcarbamazine (DEC) undertaken in the rural areas of Srikakulam and Vizianagaram of Andhra Pradesh showed that this chemotherapeutic method of control of filaria in rural areas is feasible and acceptable to society. During first round of detection and treatment 20,300 mf carriers (90.6 per cent of detected) and 6,588 disease persons (86 per cent of detected) in Srikakulam and 7,097 mf carriers (94.8 per cent of detected) and 1,436 disease persons (93.4 per cent of detected) in Vizianagaram were treated with DEC tablets. These areas were again surveyed after five years and detected cases were treated with DEC with coverage of treatment ranging from 82.3 per cent to 95 per cent for both mf & disease cases and decline in mf and disease rate was noted to be 52.4 per cent and 50.9 per cent respectively in Srikakulam and 42.2 per cent for mf rate in Vizianagaram. The mf reduction was appreciably high (50 per cent or more) in 11 PHCs of Srikakulam and 4 PHCs of Vizianagaram. The mf rate reduction was the highest in the age group of 1 to 4 year indicating that the transmission has been cut down significantly. The vector infection rate showed reduction by 50 per cent during second round of detection and treatment as compared to first round, indicating significant reduction in transmission potential. PMID- 2700481 TI - Enterotoxigenic Escherichia coli from an outbreak with cholerigenic syndromes of gastroenteritis. AB - In an outbreak of food-poisoning, 76 out of 200 students who had dined in an Institute mess experienced acute cholerigenic syndromes of gastroenteritis. Processing of the seven stool samples of affected students and remnants of 4 out of 5 type of food for isolation of bacterial pathogen(s) revealed only the presence of Escherichia coli which were serotyped as 020, 026, 045, 053 and one untypable (UT). Enterotoxigenicity testing of these isolates revealed serotypes 020, 026 of E. coli to be heat-labile enterotoxin producer when subjected to Biken test, Latex agglutination test and co-agglutination test. Based on the laboratory findings there are good reasons to believe that serotype 020 was responsible for this episode. PMID- 2700482 TI - Localization of the focus of origin of resistance in Plasmodium falciparum. AB - An attempt has been made to identify the focus of origin of Plasmodium falciparum resistance. Several factors have been analysed and the importance of mean parasite recrudescence time (M.P.R.T.) in the identification of focus of origin of resistance is highlighted. PMID- 2700483 TI - Imaging of epileptic lesions in adults. The three-dimensional approach. PMID- 2700484 TI - Evaluation of stainless steel crowns luted with a glass ionomer cement. AB - This study evaluated the gingival response and ability of a glass ionomer cement to retain stainless steel crowns in primary molars. A total of 152 crowns were evaluated from 2 to 12 months. None of the crowns were lost or loosened during the evaluation period and no discomfort or adverse gingival response was noted or reported. PMID- 2700485 TI - The dental Medicaid program in Ohio. PMID- 2700486 TI - [Caries recurrence: descriptive, analytic and prospective clinimetric study]. AB - The purpose of the work is to study primary and recurrent caries through an epidemiological inquiry on the bucco-dental state of dental students at the University of Bordeaux II from 1986 to 1988. The first part describes the sample with mean and standard deviation; then histograms are constructed for each parameter with mean and median. A second, analytical part allows the study of the influence of time and research of risk factors and associated ones of primary and secondary caries, and evidence of a linear relationship between dental caries and quantitative factors. The last, prospective part leads to quantification of predictive value of risk factors with the calculation of sensitivity, specitivity and conditional probability. Results statistically show that risk factors predispose to dental caries and their recurrence for alpha = 10%. They, consequently, confirm particularity of the population about hygiene, treatment motivation and show trends to sugared food consumption, hygiene, salivary ph, yet setting the problem of sample representativity. PMID- 2700487 TI - [Comparative study of different imbedding materials for light histology of decalcified human teeth]. AB - Four embedding media were compared: paraffin, the mixing "paraplast-piccolyte", Technovit 7100, and JB 4. Each material embedding technic is described. Comparison criteria are: easiness in the technic and method, cutting and trimming qualities, staining, anatomy connections conservation. Results are compacted in a diagram and illustrated by microphotographs. Methacrylate resins, and particularly JB 4, gave us best results. PMID- 2700488 TI - [Standardization of the method of gastric emptying analysis]. PMID- 2700489 TI - [Clinical significance of recto-anal reflex recording]. PMID- 2700490 TI - [Primary chylopericardium. Diagnosis and therapy]. AB - Authors presented the first 3 described in Polish literature patients with primary chylopericardium. 2 of them underwent surgery. Literature review was performed based on presented till now 44 cases with this rare disease. Causes, diagnostics and therapy methods of chylopericardium were discussed especially emphasizing significance of the operation based on pericardium fenestration and supradiaphragmatic thoracic duct ligation. PMID- 2700491 TI - Nutrition and undergraduate medical education--international trends. PMID- 2700492 TI - Nutritional training in postgraduate medicine. PMID- 2700493 TI - Nutritional education in US medical schools. The Committee on Nutrition in Medical Education. PMID- 2700494 TI - [Agenesis of the upper lateral incisor: orthodontic therapy and replacement]. AB - In this paper the Authors outline an uneven prevalence of superior lateral incisors agenesis. The treatment of this situation can be accomplished by various methods. It is possible to obtain the complete closure of dental spaces or maintain the physiological space. The Authors present four cases of young patients in which they decided to maintain orthodontically the space and to put them adhesive bridges. PMID- 2700495 TI - [Documentation file of orthodontic clinical records. Plaster study models. 3]. AB - Cast models are to be considered a basic element of analysis in orthodontics. This work aims at describing the various operating phases which are necessary for obtaining successful results when preparing these diagnostic records. In fact the various steps are concurrently shown developing from the initial impressions to the polishing and final labelling especially emphasizing Tweeds' trimming method. PMID- 2700496 TI - [Orthodontic treatment and periodontal problems. 1]. AB - Because of the increasing frequency of orthodontic treatments of patients with periodontal problems, the authors evaluate effects deriving from orthodontic treatment on periodontal tissues and provide practical indications to manage such patients. Experimental and clinical studies on effects of trauma from occlusion on periodontal tissues in different clinical conditions are examined. The authors have also considered studies dealing with periodontal response to different orthodontic therapy items, with particular regard to gingival inflammation degree and likelihood of root resorption. From the results of such clinical and experimental studies, the authors have pointed out clinical indications to treat periodontal patients. PMID- 2700497 TI - [History of the Polish Pediatric Association. III. Division of the Polish Pediatric Society. Warsaw Division]. PMID- 2700498 TI - A role model of leadership in and advocacy for nursing. AB - Surely most nurses have heard her name. While in undergraduate nursing programs students dutifully study nursing leaders, trying to differentiate their theories and memorize their accomplishments. At the least, they recognize the names. But does the new generation of nurses understand the impact that one nursing leader can have on the profession? Unless one has been privileged to attend NYU, for example, I wonder if today's young nurse realizes what Martha Rogers has accomplished in her career. Does today's nurse know what her advocacy for nursing has meant to our profession? This paper addresses those issues and attempts to explain the leadership and advocacy roles that Martha Rogers has assumed in the practice of professional nursing. PMID- 2700499 TI - [Genetic analysis of lactose-fermenting Salmonella typhimurium isolated in Rio de Janeiro]. AB - Lactose fermenting Salmonella typhimurium are endemic in Sao Paulo, but not in Rio de Janeiro Two isolations are described from the latter city. These Rio de Janeiro strains have a plasmid of 7.4 megadaltons. These plasmids were not auto transferable, were thermostable and were not eliminated by acridine orange. One of these strains arose from a plasmid that had the lactose operon repressed, leading us to speculate about the evolution of the lactose fermenting character in Brazilian Salmonella. PMID- 2700500 TI - [Effectiveness evaluation of deltamethrin (K-othrin 50FW), in low doses, in the control of triatominae in Sao Sebastiao do Umbuzeiro, Paraiba]. AB - We tested deltamethrin (K-Othrine 50 FW) in the control of triatomine bugs, in an semi arid area with about 56.6% of houses bug infested. We used in 402 Domiciliary Units, 125, 75, 60 or 50 ml per pump of 10 liters, equivalent, if applied on 250 m2, to 25, 15, 12 and 10 mg/m2. The invasion, colonization and cumulative indices in the houses and the positivity index in shelters near houses were very low and similar in the four groups during the 15 months of evaluation, indicating that lower doses could replace 25 mg/m2. T. infestans, followed by T. pseudomaculata, predominated in and near the houses, after spraying. PMID- 2700501 TI - [Plasmodium falciparum infection and pregnancy. Case reports]. AB - In 1982 and 1985, an infant and a pregnant woman in the second trimester of her third pregnancy were respectively observed in Humaita County, State of Amazonas, Brazil. Both had been diagnosed as having Plasmodium falciparum malaria. The infant was a boy born in the State of Amazonas with malaria since the 10th day of life and was examined at one month of age. His mother was 19 years old, was born in the State of Amazonas and had shown primary malarial infection on the day of the delivery of this child, her second. The pregnant woman was 22 years old, was born in the State of Amazonas, had two children respectively aged 8 and 6 years and had suffered three previous bouts of malaria, the first in 1983 and the last in March 1985. Both the infant and the pregnant woman were treated with clindamycin and evolved satisfactorily to clinical and parasitic cure. The infant probably presented with congenital malaria in view of the short period of incubation, which may have been due to the fact that he did not receive maternal antibodies. PMID- 2700502 TI - [Negative carving: clinical applications]. AB - The objective of the negative carving technique is to develop properly the occlusal principles during fabrication of occlusal surfaces of temporary crowns or metalhi restorations. PMID- 2700503 TI - [Root resorption: preliminary considerations and case report]. AB - This article presents a review of the literature on the action of 5 (five) possible predisponent agents of root resorption (treatment time, amount of dental movement, amount of force used, individual susceptibility and trauma) during orthodontic treatment and describes a clinical case with pronounced overjet and overbite where, the presence of resorption in one traumatized tooth limited the mechanics to light forces only. PMID- 2700504 TI - [The indirect measurement of arterial pressure: a review]. AB - This study deals with the indirect arterial blood pressure measurement, particularly the American Heart Association recommendations for sphygmomanometry References are made regarding the ratio arm circumference/cuff width and the errors caused by inadequate cuff size. Several variables involved in the procedure of arterial blood pressure measurement are discussed. PMID- 2700505 TI - [Therapeutic test in trachoma: putting in place a study model and preliminary results]. AB - This study, performed in Atar and Nouakchott, has tested a new proceeding for biological diagnostic of trachoma (Chlamydia trachomatis direct specimen test, SYVA Merieux microtrak), and has controlled the efficiency of different therapeutic schemes against trachoma. An experimental pattern for subsequent studies is proposed. PMID- 2700506 TI - Spina bifida today: problems adults face. AB - Late deterioration is common in patients with a myelodysplasia. Most, possibly all, of this deterioration is preventable or correctable. It is not simply the natural history of the disease. Only through close follow-up by trained observers can these problems be anticipated and discovered early. Regularly scheduled evaluations of intellectual, musculoskeletal, and urinary systems are essential. When the clinician is familiar with the signs and symptoms of the various causes of deterioration and armed with ultrasound, myelography, CT, and MRI, the most likely cause can be identified and a treatment plan outlined. PMID- 2700507 TI - Neurosurgical considerations of cervical myelopathy. AB - Operative procedures on the cervical vertebral column and spinal cord must be selectively designed for the individual patient. Complete radiographic and neurophysiologic studies, including evaluation in various dynamic positions of the cervical spine (flexion, extension, and rotation), are necessary to define the most efficacious treatment method. No consensus exists regarding the exclusivity of a specific surgical procedure and all possible approaches should be considered, with the final decision based on detailed biomechanical considerations. PMID- 2700508 TI - Craniosynostosis. PMID- 2700509 TI - Management of subarachnoid hemorrhage. AB - SAH is an important and common form of stroke. Detection of SAH is now possible through the clinical syndrome and CT scanning. Angiography is required to pinpoint the site of the hemorrhage. Medical therapy to prevent complications is often effective. Surgical therapy to prevent recurrent hemorrhage is now effective and safe with modern microsurgical methods. Even with large and deep aneurysms or AVMs, indirect treatment by means of interventional radiology or radiosurgery may be effective in eliminating these life-threatening lesions. In a few cases, evacuation of intraparenchymal brain hematoma can be life-saving. SAH is common, readily identified, and treatable. All physicians should be able to recognize and institute appropriate management for this important subclass of stroke. PMID- 2700510 TI - Nonsurgical management of increased intracranial pressure. AB - CPP reflects perfusion problems related to increased ICP or inadequate MAP. CPP is a most helpful and practical management tool. The relationship of CBF and CPP depends on cerebral vascular resistance (flow equals pressure divided by resistance). At present, we do not have a practical method to measure vascular resistance or CBV. A close relationship between an increase in CBV and increase in ICP exists. However, the relationship between CBF and ICP is more complex. Whereas CBV is strongly dependent on vasodilation and venous return, CBF is influenced by CPP, vascular resistance, viscosity changes, and focally or diffusely increased ICP. For instance, in hypotensive shock one finds a low CBF with an elevated CBV (and ICP) from vasodilation related to hypercapnia, anoxia, or acidosis. Nevertheless, about two thirds of patients with increased ICP after head injury have increased CBF (hyperemia) and increased CBV. This frequent hyperemia is one rationale for the wide usage of hyperventilation to treat increased ICP. It must be recognized that a group of patients may have ischemia caused by excessive hyperventilation therapy for increased ICP. The PaCO2 must not be allowed to decrease to 20 mmHg or lower, but in some patients a PaCO2 level of 21 to 25 may be predisposing to ischemia. Strong consideration is thus given to monitoring CBF and cerebral oxygen metabolism (arteriovenous oxygen content difference [AVDO2], CMRO2) in states of coma and increased ICP. In such patients, continuous infusion of mannitol may result in improved CBF, and hyperventilation therapy can be less aggressive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700511 TI - Cerebellar tumors in children and their management. PMID- 2700512 TI - Neurosurgery of epilepsy. PMID- 2700513 TI - Stereotactic surgery: applications in neurologic disease. PMID- 2700515 TI - Boxing a complete denture impression with irreversible hydrocolloid. PMID- 2700514 TI - The fully edentulous case. Well placed implant abutments and low bone resorption levels bring crown and bridge tupe, fixed restorative solutions within reach of full denture patients. PMID- 2700516 TI - Successful orthodontic model preparation. PMID- 2700517 TI - Strategic planning for commercial dental laboratories. PMID- 2700518 TI - The single miss ng tooth: conventional fixed and removable solution capabilities are expanded with implant supported restorations. AB - Implants are a major emerging field in dental technology. And along with this emergence are different procedures required from dental laboratories. This article begins a five part series focusing on "Implant Supported Restorations." PMID- 2700519 TI - Occlusion fabrication procedures for fixed and removable prosthodontics. PMID- 2700520 TI - The small bridge case: implant and tooth supported bridges open new vistas and create modern challenges. PMID- 2700521 TI - The design team. AB - With implants emerging as a major field in dental technology, new demands are increasing, and different management procedures are required in the dental laboratory. This article focuses on one laboratory, and how it is successfully managing these demands by the dental profession for root-form restorations. PMID- 2700522 TI - Decrease your die preparation time with the Whip Mix P.D.Q. kit. PMID- 2700523 TI - Open up the bottleneck in your metal department. PMID- 2700524 TI - The new type full mouth rehabilitation: low numbers of natural abutments combined with implant abutments teach the meaning of precision. PMID- 2700525 TI - Oval ringless casting: simplicity, productivity, and accuracy without the health hazards of ring liners. PMID- 2700526 TI - How to bond acrylic to metal. PMID- 2700527 TI - Ageing and disorders of the locomotor system. AB - Many aspects of rheumatic disorders are specific for the elderly population. The prevalence of many chronic disorders increases with age and the incidence of some rheumatic disorders is highest in the elderly. The spectrum of rheumatic disorders of age-specific groups varies between levels of the health care system. The onset of many inflammatory rheumatic diseases is different and the clinical appearance may be further modified by other concomitant diseases in the elderly. Therapeutic approaches have to consider changes of drug metabolism and multipharmacy. Finally, the variation of organ function increases with age making "normality" more difficult to evaluate in the elderly. Decline of function may result in both overdiagnosis and underdiagnosis. PMID- 2700528 TI - Cognitive, behavioral and psychological issues in the rheumatological care of the elderly. AB - The ageing process is accompanied by changes in biological functions and the context of behavior. Biological changes are often thought to be the source of poor adaptation to the demands of ageing and disease; however, the data indicate environmental, psychological and social factors must be considered. Problems related to sensory-cognitive ageing, dependency, adherence, sleep disturbance, sexual functioning, psychological distress, family issues and ethics are discussed in terms of their impact on rheumatic disease management. Diagnostic measures developed for the elderly are reviewed and interventions from a behavioral approach are outlined. The chronic nature of rheumatic disease interacts with the changes associated with ageing leading to a complex situation requiring attention to biological, behavioral, environmental and psychosocial factors. PMID- 2700529 TI - Presidential address. PMID- 2700531 TI - Association of American physicians. PMID- 2700530 TI - Presentation of the George M. Kober Medal of the American Association of Physicians to Maclyn McCarty. PMID- 2700532 TI - Mechanisms and implications of cerebral vasoconstriction in chronic hypertension. PMID- 2700533 TI - [Clinical usefulness of serum beta2-microglobulin determination in patients with multiple myeloma]. AB - Serum concentrations of beta 2-microglobulin (beta 2M) were determined in 73 patients with various forms of multiple myeloma and in various phases of the proliferative process. These determinations showed that beta 2M may be a useful indicator of changes in tumour mass and proliferation activity, and also an important prognostic factor. In patients with active proliferation the serum beta 2M concentration was significantly higher than in the group with stable proliferative process, and particularly in remission. A correlation was found between the serum concentration of monoclonal protein and beta 2M concentration. In the group with the secretory form of myeloma significant differences were showed in the length of survival which depended on beta 2M concentration in serum. The median survival of patients with beta 2M concentration in serum below 5.0 mg/l was 52 months and that in those with this concentration above 8.0 mg/l was 24 months. PMID- 2700534 TI - [Prolymphocytic leukemia]. PMID- 2700535 TI - [Clinical use of cultured clonogenic leukemia cells in vitro in acute myeloid leukemia with particular reference to drug sensitivity]. PMID- 2700536 TI - Controversies on the subject of slave-raids in amazon ants (genus Polyergus). AB - The paper contains a polemic with the view expressed by Talbot, Wilson and Topoff and his co-workers, who maintain that the existence of scouts and their leading directing in slave-raids of the American Polyergus' species is fully proved. In particular we do not agree with Talbot's and Wilson's argument that following by the amazons of the scent-trail prepared from the crushed bodies of their nestmates indicates that the amazon raids follow the trails of scouts. Considering the results and notions of the above-mentioned authors, we maintain that the mechanism of slave-raids in the American amazons is far from clear. PMID- 2700537 TI - Trends and perspectives in nitrogen fixation research. PMID- 2700538 TI - Autotrophic nitrification in bacteria. PMID- 2700539 TI - Physiology, biochemistry and genetics of bacterial glycogen synthesis. PMID- 2700540 TI - Apomixis in Saccharomyces cerevisiae and other eukaryotic micro-organisms. PMID- 2700541 TI - Current trends in Candida albicans research. AB - Candida albicans is an opportunistic pathogen of human beings and other mammals. Two other features, besides its pathogenicity, have made it a popular organism of study. It exists in different cellular forms and can change from one form to another, depending on growth conditions. Thus, it is being used as a model system to study cellular differentiation. It can also heritably and reversibly switch its cellular and colony morphologies. The yeast is diploid and lacks a sexual cycle. Thus, it has not been possible to apply the powerful methods of genetic analysis to understand morphogenesis or pathogenesis. Few clinical isolates are haploid, but they do not form hyphae and are not yet well characterized. Recombinant DNA techniques are increasingly being applied to C. albicans to solve many of the unanswered questions of morphogenesis and pathogenesis. Genetic transformation and gene-disruption techniques were recently developed for the yeast. Thus it is possible to study the role of any cloned gene through directed mutagenesis. However, the difficulty is to clone the putative genes involved in morphogenesis or pathogenesis. Candida albicans exists in four different cellular forms, namely blastospores, pseudohyphae, hyphae and chlamydospores. Blastospore to-hypha conversion is well studied. A variety of conditions can induce this transition. It is not clear how cells sense such varied conditions and respond appropriately. In other systems where differentiation is well understood, regulatory genes which control differentiation have been uncovered. These genes cause differential expression of other genes, and ultimately differentiated phenotypes. Thus, it is likely that differential gene expression is involved in the bud-to-hypha transition in C. albicans. Certain proteins are expressed exclusively on the cell surface of hyphae. It should be possible to clone genes coding for these proteins. A study of the expression of these genes might allow us to identify the regulatory gene which determines differentiation. Another approach to understanding morphogenesis is to study how the difference in the shape of buds and hyphae is generated. This difference appears to be due to the differential activity of apical and general growth zones, which determine growth of the cell wall. Activity of these growth zones is apparently determined by actin localization. It remains a possibility that conditions which induce hyphae formation may directly affect actin localization or cell-wall growth zones and cause differences in cell shape. Candida albicans can also heritably switch its cellular phenotype. This has come to light from a study of colony-morphology switching. Some strains can switch their colony morphology, both heritably and reversibly.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2700542 TI - [Possibilities in biological diagnosis and therapy of neoplastic pathology of the oral cavity]. AB - After a brief summary of the role played by immunity in preventing the development of malignant neoplasms, the AA. in a speedy sequence treat of tumoral markers and their possibilities in diagnostic use. Then AA. make a precis of trials of different types of immunotherapy and as well of researches object of future therapeutic use. PMID- 2700543 TI - [Diagnosis of the active phase of periodontal disease. 2. Non-clinical parameters]. AB - A review of the Literature shows that a lat of (non-clinical) umoral markers have been suggested as indicators of periodontal disease activity. The advantage of simultaneous evaluation of different markers to obtain a profile of local disease activity has been highlighted in this work as an approach that may provide an usefull picture of the local destructive disease. PMID- 2700544 TI - [Effects of the use of removable partial dentures (RPD) on the integrity of dento periodontal structures. Review of the literature]. AB - In several clinical studies on removable partial dentures (RPDS), great attention was paid to the occurrence of reactions in periodontal tissue. In this article on causes of periodontal breakdown related to RPDS, the three main factors discussed were: 1) plaque and oral hygiene 2) coverage of the marginal gingival by parts of an RPD 3) occlusal forces that are transmitted to the remaining teeth and their periodontal tissues by the prosthesis. PMID- 2700545 TI - [The mandibular rest position: relation to the rest vertical dimension]. AB - The concept of the mandibular rest position and the clinical significance of the mandibular resting posture with respect to dental treatment are discussed. The controversy regarding the belief that mandibular resting posture is constant and inviolate is considered on the basis of clinical observations and scientific investigations. PMID- 2700546 TI - [Essential bone defects]. AB - The AA. describing the TBP and their etiopathogenetic, histopathologic, clinical, therapeutic aspects. PMID- 2700548 TI - [Toxicology of polycyclic aromatic hydrocarbons and the mutagenicity of the air]. AB - Toxicological properties of polynuclear aromatic hydrocarbons (PAH) and their derivatives concerning their carcinogenicity, embryotoxicity and phototoxicity are reviewed. The importance of the Ames test and biologically directed chemical analysis for identification of these mutagenic compounds is emphasized. Possible chemical reactions acting as sources of mutagenic PAH derivatives in the atmosphere are given. PMID- 2700547 TI - [The effects of subgingival irrigation with antimicrobial agents on periodontal disease]. AB - This report evaluates the role of local pharmacotherapy by subgingival irrigation to enhance clinical and microbiological periodontal status. This kind of chemical therapy is not a substitute to scaling and root planing, but possibly could increase its beneficial effects. PMID- 2700549 TI - [Diagnosis and treatment of carpal tunnel syndrome with special reference to the results of electrophysiologic study]. PMID- 2700550 TI - [Neurologic dysfunction of adenoma of the hypophysis]. PMID- 2700551 TI - [Adhesion, contribution to full denture retention: experimental research on resin surface energy]. AB - The authors propose a study of the surface energy of dental resins. The two liquids measure method, by means of water and alkanes enables to determine the dispersive and polar components of this energy and therefore to understand what types of bindings may be altered in the process of various physical or chemical treatments of the surface of the material. Treatment by alcoholic potash, or immersion of the resin in water, increase the polar component of surface energy by inducing a re-orientation of polymer molecules along the interface between P.M.M.A. and water. This improvement is not reversible. It reaches its maximum towards the eighth day of immersion in water. It cannot be obtained in saliva, a feebly polar medium. After a temporary increase towards the third day, the dispersive component of surface energy falls back approximately to its initial value. This treated resin can no longer be considered as a low energy solid. All comparative experimentation on the surface energy of prosthetic materials ought to be made on resin treated by water immersion. PMID- 2700552 TI - [Use of a retainer bar in lower full dentures]. AB - In subtotal mandibular edentations, the roots of remaining anterior teeth might be used to enhance the retention of a full denture in building a contramucosal retention bar. Based on a case-report, the authors present the fabrication in five clinical and laboratory sequences, of a maxillary full denture combined with a lower full denture and a retainer bar joining two cuspids. First sequence: Clinical. It mainly concerns: 1) Preparation and impression of the two cuspids for receiving the two posts on which the retention bar will be fixed. 2) The primary plaster impression of the soft tissues. In the laboratory, the coping are directly cast with gold without a core, topped with resin. The individual mandibular impression tray (IIT) presents two windows opposite the two preparations through which the tops of the two copings are showing. Second sequence: Clinical. If the maxillary impression is a classical one, the mandibular impression is peculiar and original. Overall, this provides a reliable working model on which the dental technician will be able to build, the entire prosthesis, not only the retainer bar but also the full denture. This is done in two stages: 1) Secondary impression of the soft tissues with copings in place. 2) Indexing of the copings to the impression tray with acrylic resin, pressing firmly on the rims of the IIT and simultaneously, on the tops of the copings to take into account the different depression of the tissues. In the laboratory, both impressions are boxed and cast, with in place.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700553 TI - [Removal of fixed prosthetics]. AB - Unscaling a fixed prosthesis can be dangerous for the supporting tissue. However a careful examination of the clinical situation and the proper use of correct technics described in the following article, may prudence a successful result most of the time. PMID- 2700554 TI - Roles of the kidneys and fluid volumes in arterial pressure regulation and hypertension. AB - The goal of this paper has been to show that the renal-fluid volume mechanism for control of the arterial pressure is an extremely powerful one, so powerful that it is either impossible or almost impossible for the arterial pressure ever to be adjusted to any other value besides the level dictated by this mechanism. The reason for the extreme potency of this mechanism for pressure control is that it never stops working until the intake and output of salt and fluid volume come to an exact state of equilibration. This occurs where the salt and water intake line, as illustrated in Figure 3, crosses the renal function curve which expresses the relationship between arterial pressure and fluid output by the kidneys. Some of the factors that make this renal-fluid volume mechanism such an excellent pressure regulator are the following: First, once the baroreceptor mechanism for pressure control has adapted, the systemic arterial pressure is affected greatly by the levels of extracellular fluid volume and blood volume. Second, the blood flow autoregulation mechanism further enhances the effect of slight changes in fluid volume on pressure, increasing the effectiveness of the pressure control system at least five times additional. Third, the renin angiotensin system also plays a major role in increasing the sensitivity of this pressure control system. When salt intake becomes very great, renal output of renin and subsequent formation of angiotensin both decrease drastically. This shifts the renal function curve back toward a lower pressure level, thus compensating for most of the increase in pressure that would otherwise occur as a result of the increased salt intake. Putting all the above factors together, one finds that very slight changes in the fluid volume level in the body can have drastic effects on pressure. And, conversely, very slight changes in arterial pressure above or below the normal level can initiate large changes in urinary output of salt and water, thus rapidly returning the pressure back to that level at which intake and output of water and salt are in balance. PMID- 2700555 TI - Practical approaches to scientific writing. AB - Scientific writings represent final products of scientific endeavors. A scientist communicates with others by his or her writings and oral presentations. In most universities, there are no formal courses on scientific writing and presentation. Students learn mostly by trial and error or by individual apprenticeship. This brief article presents a practical approach to writing a journal article, regardless of the language used. Scientific writing, as in any other writings, requires clear and concise expressions. In addition, scientific writing expects authors to (1) organize for quick access to specific sections; (2) describe experiments and findings in sufficient details so that they can be duplicated; (3) interpret data for the readers; and (4) summarize and discuss the significance of results and their relation to existing knowledge. This article will discuss the IMRAD format (Introduction, Methods, Results and Discussion). The focus will be on what should be included in each section of the format. PMID- 2700556 TI - Learning mnemonics: a preliminary evaluation of a computer-aided instruction package for the elderly. AB - Sixty-two normal elderly subjects averaging 71 years old were taught a common mnemonic device for recall of lists using a Computer-Aided Instruction (CAI) package. Improvement in list-learning after CAI training was not statistically different from a separate group of 218 elderly subjects who received instruction from a trainer in a normal classroom situation. Improvement in the CAI group was significantly related to higher scores on the Openness to Experience subscale of the NEO-Personality Inventory. CAI devices for memory training in the elderly may find a place in training selected elders on specific areas of memory loss. PMID- 2700557 TI - A bibliography of the neurobehavioral aspects of diabetes mellitus. AB - Several authors have proposed that diabetes may represent a form of accelerated aging and therefore may be useful as a general model for studying changes with age. It is the purpose of this bibliography to present those research articles which have considered the cognitive or neuropsychological correlates of diabetes mellitus as differentiated from the effects of medical and organismic variables. PMID- 2700558 TI - [Papulonecrotic tuberculide. Presentation of 4 cases]. AB - Four young patients simultaneously affected by morphological variations of papulonecrotic tuberculid and lymphnode and pulmonary tuberculosis (three cases) are reported. The clinical, therapeutic, histological and immunological aspects of papulous tuberculid are discussed and the different diagnostic approaches to this rare disease are evaluated. PMID- 2700559 TI - [Acanthosis nigricans in pregnancy]. AB - A case of Acanthosis nigricans developed in a pregnant 16 year old woman is reported. Laboratory studies disclosed an abnormal glucose tolerance and elevated levels of insulinemia with an insulin-resistant state. Two months after partum, the metabolic parameters became normal and parallel the complete resolution of acanthosis nigricans was observed. The possible pathogenetic role of pregnancy in the development of acanthosis nigricans is discussed. PMID- 2700560 TI - Pulmonary aspergilloma--radiological observations. AB - The radiological appearances of 49 cases of aspergilloma seen over a period of 6 years among 36,340 hospital admissions are described. All the 49 patients had pulmonary tuberculosis as underlying disease with 6 (12.2%) having bacteriologically active disease. One patient had concomitant allergic bronchopulmonary aspergillosis (ABPA). Upper zone distribution, large cavity size, moderately thick cavity wall and overlying pleural thickening were some of the prominent features observed. Two cases of multiple (3 each) and 4 of bilateral aspergilloma were seen. Of 57 aspergillomas 47 were round or oval, 7 oblong, 2 polypoidal and 1 lobulated. Positional movement was observed in 30 cases. Spontaneous lysis was seen in one case. Tomography and lordotic view were found to be very useful techniques when postero-anterior films were unrevealing. The radiologic diagnosis of aspergilloma was confirmed by demonstration of serum precipitins against aspergilli in 44 cases. PMID- 2700561 TI - Acute non-lymphoblastic leukemias in childhood. PMID- 2700562 TI - Prenatal diagnosis of inherited hemoglobinopathies. AB - This paper reviews the methodology available to make prenatal diagnosis of inherited hemoglobinopathies by DNA analysis and the strategy to be used for the large scale application of this procedure to high-risk populations. The most straightforward approach for prenatal diagnosis is nowadays based on the analysis of DNA enzymatically amplified by the polymerase chain reaction (PCR). The mutations, produced by gross structural rearrangement of the DNA and those affecting a restriction recognition site, are directly detected by visualization following ethidium bromide staining of the electrophoretic pattern resulting from enzymatic digestion of amplified DNA. The remaining ones are detected by dot blot analysis with allelic specific oligonucleotide probes. Because in each population a limited number of specific beta-thalassemia mutations are prevalent, prenatal diagnosis by DNA analysis may be carried out by a population-specific strategy based on the amplification of those regions of the beta-globin genes containing the mutations most frequently occurring in each population followed by dot blot analysis with allelic specific oligonucleotide probes. This approach has the great advantage of being very simple, because radioactive probes are not necessary, very rapid, the results being obtained within 24 hours from sampling and very sensitive, only a limited amount of DNA in the order of 50 ng being necessary. PMID- 2700564 TI - Pulmonary infections in immunocompromised children. PMID- 2700563 TI - Chromosome abnormalities in acute leukemia: its clinical implications and age of onset. PMID- 2700566 TI - Advances in insulin therapy for insulin-dependent diabetic children. AB - During the last two decades new forms of insulin and a better understanding of the physiological insulin secretion profile have led to great changes in insulin therapy. New insulin regimens mimicking the normal insulin secretory pattern, called intensive insulin therapy, and new insulin-delivery systems have been introduced. Self-monitoring of blood glucose levels and the use of glycosylated hemoglobin determination for objective evaluation of long-term control have made the achievement of near normoglycemia a practical goal for most patients taking insulin. 1. New forms of insulin: Beef and pork insulin were replaced by monocomponent pork insulin and now monocomponent human insulin is most popularly used. 2. Intensive insulin therapy: Intensified conventional insulin therapy, that is a multiple injection regimen and a twice a-day insulin regimen using a mixture of intermediate- and short-acting insulins has been commonly accepted. New devices such as pen-type injectors and jet-injectors have also been introduced for simplifying the multiple injection regimen. Continuous subcutaneous insulin injection (CSII) has also been adopted by adolescents and young adults. PMID- 2700565 TI - The epidemiology of diabetes in childhood with special reference to the Orient: implications for mechanism of beta cell damage. AB - Epidemiologic studies are providing important new insights into the etiology and clinical course of IDDM as well as providing critically needed data on the magnitude of the problem in different parts of the world. The development of national IDDM registries have documented extraordinary differences in diabetes incidence and prevalence, with the highest incidence figures in Finland (greater than 30/100,000/yr) and the lowest in the Orient with Korea reporting incidence rates below 1 and Japan between 1.0-2.4/100,000/yr. The great geographic variation in expression of diabetes in childhood is strongly supportive of environmental factors playing a major role in the etiology of disease. Our studies document a linear correlation between IDDM incidence and distance from the equator and a similar but inverse correlation with mean annual environmental temperature. Other workers find a direct correlation with dairy product consumption. Factors that may play a role in beta cell damage include viral infections, environmental toxins, nutrients and stress factors. Because of the low incidence of IDDM among children living in Asia it is most important to expand the current national registries in the Asian countries and begin a careful study of the environmental differences within Asian countries as well as comparison of studies between countries with very high incidence rates and those with the lowest rates. PMID- 2700568 TI - Physical exercise and insulin dependent diabetes in the young: general approaches. AB - Exercise is worth while for general health and well being; and is beneficial and safe for the young with IDDM as well. The patient must learn to adapt to insulin and/or diet, attending education and training program. The many examples of world class athletes and participants in the Olympic Games with diabetes serve as impressive evidence that in spite of being dependent on insulin, they are able to participate successfully and without complications in physical activities and high-performance sports. PMID- 2700567 TI - Immunological aspects on IDDM in children. AB - Diabetes mellitus in childhood is connected to several immunological phenomena which per se do not prove that immunological mechanisms do cause the beta cell destruction, as such mechanisms could be just secondary. However, there is now evidence which strongly supports the autoimmune hypothesis, like the beta-cell destruction in the transplant given from a healthy twin to the diabetic monozygotic co-twin, the effect in newly-diagnosed diabetes of immunosuppression, the passive transfer in experimental animals of an immune process creating diabetes etc. Several facts such as presence of activated T-cells in the insulitis indicate that the cell-mediated immunity is important, while it is still debatable whether humoral factors, and if so which, alone could be responsible for the beta cell destruction. Recently interleukins and other lymphokines have shown to be of great interest as well as the release of free radicals. This knowledge opens new views on the possibility to put an end to or even prevent the beta cell destruction. Rough immunosuppression with cytostatics or cyclosporin has such severe side-effects that such therapy is contra-indicated at least in children. Until more specific therapies are discovered e.g. vaccination with lymphoblasts or blocking the autoantigens with monoclonal antibodies, supportive measures to protect the beta cells may be one practical way. PMID- 2700569 TI - Hypoglycemia in diabetes among children and adolescents. AB - Hypoglycemia is one of the most common early complications in insulin-dependent diabetes mellitus (IDDM). Hypoglycemia in children may be considered a risk factor for brain damage and later intellectual impairment, and carries with it a high degree of child and parental anxiety. Recent studies have shown that in IDDM patients, and especially in those on intensive therapy, there is a defect in glucose counter-regulation, increased frequency of hypoglycemic episodes, loss of hypoglycemic awareness and responsiveness. Autonomic neuropathy, glucagon deficiency and low catecholamine response were implied in the pathogenesis of these disorders. In addition, uncontrolled IDDM patients show hypoglycemic symptoms at a higher blood glucose level. These recent observations may suggest that attempts to improve metabolic control may increase the risk of severe hypoglycemia. If so, some alterations in our therapeutic goals must be considered. PMID- 2700571 TI - [Hearing disturbances and occupational hearing loss in dentists]. PMID- 2700572 TI - [Determination of intermaxillary relations in immediate complete dentures (2)]. PMID- 2700570 TI - Can retinopathy be prevented? AB - Clinical retinopathy eventually develops in the majority of insulin dependent diabetics during several decades of metabolic abnormality. Early structural lesions short of clinical significance may occasionally be detected in children much more frequently, however, after puberty. Major factors modulating the development of retinopathy are duration of diabetes, glycemic control and blood pressure. PMID- 2700573 TI - [Sale of antique books and instruments]. PMID- 2700574 TI - [Hemorrhage in the dental office. Study of local hemostatic treatment]. PMID- 2700575 TI - [The vestibular key. Occlusal record for small posterior intercalated fixed restorations]. PMID- 2700576 TI - [Evaluation of the daily amount of fluoride ingested by children]. PMID- 2700577 TI - [Diagnostic wax models and direct impressions in prosthodontics. Importance, fabrication and utilization]. PMID- 2700578 TI - [From the pelican to the anatomic articulator]. PMID- 2700579 TI - Management of complete rectal prolapse. AB - There are two types of rectal prolapse viz, complete or procidentia and occult. Aetiology and management are usually different in children and adults. Control of prolapse by various methods of rectopexies, re-education of bowel habit and correction of sphincter dysfunction are the three phases of treatment in adults. Correction of malnutrition, digital reposition of the prolapse, submucous injection of 5% phenol in almond oil under general anaesthesia and lastly the Thiersch's operation are the methods of correction in children. PMID- 2700580 TI - [Exposed cementum and root surfacing]. AB - Plaque exposed cementum presents structure alterations and becomes cytotoxic. The purpose of this review is to synthetize the actual datas about these cementum modifications and treatment by root planing. It appears that root planing does not eliminate all the subgingival calculus. Endotoxins are rather easily removed but roots are not completely detoxified. Treatment of the exposed cementum could evaluate to a less severe root planing and completed by a detoxification with chemical agents. PMID- 2700581 TI - [Experimental study of a metronidazole gel inserted in periodontal pockets]. AB - The aim of this study was to evaluate the effects of a gel containing 4% metronidazole and collagen in periodontal pockets deeper than 4 mm. The treatment was utilized in 10 subjects with pocketing in the premolar-molar regions. The experimental design was as follows: one quadrant was treated with scaling and root planning (S), one with the metronidazole gel (M), one with scaling, root planning and metronidazole gel (S & M), and the last quadrant remained untreated. Pocket depths, gingival index (GI), sulcular bleeding index (SBI) and plaque indices were recorded at 7, 14 and 30 days after the experiment began. Significant improvement of the parameters studied was noted in the S & M quadrants. PMID- 2700582 TI - Recurrent glomerular diseases in kidney transplants. AB - Recurrent glomerular diseases are a very important consideration for all physicians who offer the possibility of transplantation to their patients. A knowledge of the rates of recurrence is important so that informed consent can be given by the parents and patients. Despite these considerations, the possibility of recurrent glomerular disease occurring in an allograft is rarely, if ever an absolute contraindication for transplantation. History has shown us that ESRD secondary to immunological renal diseases such as SLE that were originally considered nontransplantable is amenable to transplantation, and that recurrence of the original disease is not the problem it was once though to be. These enlightened clinical investigations have allowed us to offer renal transplantation to patients who would have otherwise died. It is important that we continue to allow logic and orderly clinical investigation to direct our therapies rather than relying on presumption. PMID- 2700583 TI - Clinical and immunological considerations in childhood lupus nephritis. PMID- 2700584 TI - Infantile hypertrophic pyloric stenosis: evaluation of sonographic criteria. AB - Sonography has become an important diagnostic adjunct in the evaluation of vomiting infants who are suspected to have infantile hypertrophic pyloric stenosis (IHPS). Two commonly used sonographic criteria, viz. pyloric diameter (D) and pyloric muscle wall thickness (T) were evaluated in 14 consecutive vomiting infants. The D and T were significantly larger in the IHPS group compared to the non IHPS group (1.40 +/- 0.34 cm vs 0.95 +/- 0.19 cm, p = 0.04; 4.4 +/- 1.1 mm vs 2.5 +/- 0.6 mm, p less than 0.01). By a combination of sonographic criteria (D greater than or equal to 1.2 cm & T greater than or equal to 3 mm), all the 4 non IHPS patients and 9 out of 10 IHPS patients were correctly diagnosed. The positive and negative predictive values were 1.00 and 0.80, respectively. However, using reported diagnostic criteria of D greater than or equal to 1.5 cm or T greater than or equal to 4 mm would have missed 60% and 20% of the IHPS cases, respectively. With proper choice of diagnostic criteria, sonography is a useful diagnostic tool in the evaluation of vomiting infants for IHPS patients. PMID- 2700585 TI - Ultrasonography in evaluation of urinary tract infection. AB - A 2 year (1986-1987) retrospective study was done to evaluate the usefulness of ultrasonography in the detection of urinary tract abnormalities in urinary tract infection. 107 patients who presented to the Paediatric Department of the Singapore General Hospital with urinary tract infection were studied. 79 patients underwent ultrasonography of which 17 (21%) were found to have abnormalities. Of these 3 (4%) were found to be false positives. Abnormalities detected include hydronephrosis (15 patients), hydroureter (1 patient) and ureterocoele (1 patient). 50% of patients with ureteric reflux were also detected on ultrasonography. The degree of false negatives could not be evaluated as patients with normal ultrasonography were not subjected to intravenous urography. PMID- 2700586 TI - Carbohydrate malabsorption in children. PMID- 2700587 TI - Portal hypertension. PMID- 2700588 TI - Cholestasis in infancy--a clinical approach. PMID- 2700589 TI - The problems of tonsils and adenoids. AB - The tonsils and adenoids are secondary lymphoid organs which have evolved to protect the human host against microbial invaders entering the body via the cephalic gateway of the body, i.e. the nasopharyngeal aperture. There are special epithelial cells and macrophages which modify the microbial antigens to present to the B and T-lymphocytes of the tonsils and adenoids. The lymphocytes produce immunoglobulins which are transported to the circulation and also topical secretory IgA which is secreted into the salvia and mucous secretions to protect the human host. The changes in these secretions as a result of recurrent tonsillitis and hypertrophy of the adenoids and tonsils are discussed. Because these are part and parcel of the defence system of the body, their surgical removal may deprive the human host of one of its defence systems. PMID- 2700590 TI - The control of schistosomiasis: epidemiological aspects of reinfection. AB - Current strategies for schistosomiasis control rely heavily on drug treatment intended to reduce morbidity and disease to an insignificant level of public health importance. This approach reduces but rarely, if ever, eliminates transmission. Indeed, snail infection rates may be little altered by such chemotherapy. Reinfection is inevitable. The mean human community prevalence usually returns rapidly to precontrol levels but the mean intensity of infection takes much longer, distorting the general relationship between the two. Because of the focality of schistosomiasis transmission, retreatment based on mean population prevalence is often too late to protect people living near active transmission sites. However, if suitable methods can be developed to examine man after treatment, they should simplify the detection of the main transmission sites, allowing the employment of alternative, focal control measures to consolidate the beneficial effects of mass chemotherapy. PMID- 2700591 TI - [Genetic aspects of Biomphalarias]. PMID- 2700592 TI - Molecular and biochemical studies of the cercarial proteinase of Schistosoma mansoni. PMID- 2700593 TI - Evolution and involution of hepatosplenic schistosomiasis. PMID- 2700594 TI - [Plants used as molluscacides: a critical view]. PMID- 2700595 TI - [Health education and schistosomiasis: a brief retrospection and a proposal]. PMID- 2700596 TI - [Composite resins--conceptual bases]. PMID- 2700597 TI - [Dental cements]. PMID- 2700598 TI - [A general outline of the role of internists in the history of Polish medicine in the 19th and 20th centuries]. PMID- 2700600 TI - [Pleural effusion of neoplastic origin]. PMID- 2700599 TI - [Alcohol-induced damage of the liver]. PMID- 2700601 TI - [Dentigerous cyst. Review of the literature and report of a case]. AB - A case of circumferential dentigerous cyst is presented, with a review of the literature. This lesion occurs when the tooth is exfoliated through the cystic epithelium surrounding a crown, so that the cyst remains within the cervical third. When these teeth are extracted without previous diagnosis, the cyst could become residual. In all dentigerous cyst, the microscopic features must be determined, since some reports mention their eventual transformation in an ameloblastoma or, even worse, in a squamous-cell carcinoma. PMID- 2700602 TI - Mechanisms of cellular adaptive sensitivity changes: applications to opioid tolerance and dependence. PMID- 2700603 TI - Mechanism of action of ethanol: initial central nervous system actions. PMID- 2700604 TI - Potential of monoclonal antibodies as pharmacological agents. PMID- 2700605 TI - [Use of composites and adhesives in temporary dentures]. PMID- 2700606 TI - Craniopharyngioma with extension into the cerebellopontine angle. Case report. AB - A rare case of craniopharyngioma which extended from the suprasellar region into the cerebellopontine angle (CP angle) is reported. This patient, a 18-year-old man who underwent two surgeries for suprasellar craniopharyngioma did not show recurrence during interval studies. However, nine years after the second surgery CT scan and MRI indicated a left CP angle mass when he was submitted to suboccipital craniectomy and tumor resection. He had been on human growth hormone (hGH) regimen for his pituitary dwarfism before tumor recurrence. The authors speculate retrospectively that the tumor growth in the left CP-angle was correlated with hGH therapy in this particular case. PMID- 2700607 TI - Blood pressure in newborn term and preterm infants. AB - Some physiological and pathophysiological aspects of blood pressure during the neonatal period are discussed in the present review as well as the growing diagnostic importance of its changes in term and preterm infants. The measurement methods, used at various clinics, are briefly summarized, drawing attention to concrete methods of reading blood pressure. The mean values of blood pressure in newborn infants are illustrated in tables according to age, weight at birth and some other factors indicated by various authors. Two pathological deviations of blood pressure are discussed in detail, namely-hypo- and hypertension in newborn infants according to the causes, clinical symptoms and their diagnostic prognostic significance, calling the attention of neonatologists and pediatricians to some aspects of hemodynamics, which have until very recently been uncoded and diagnostically and therapeutically neglected. PMID- 2700608 TI - A newly modified isolation method of single muscle fibers--especially useful in histological, histochemical and electron microscopic studies on branched fibers. AB - The nitric acid muscle fiber digestion method has generally been used to determine total numbers of muscle fibers and branched fibers. However, it is not suitable for further studies because nitric acid causes protein denaturation known as the xanthoproteic reaction which make it difficult to examine the fiber types and morphology of muscle fibers. Therefore, we attempted to modify this method to preserve the morphology of muscle fibers as much as possible. Our modifications were as follows: (1) samples were immersed in ion exchanged water before nitroc acid treatment; (2) mammalian relaxing solution was used as the post- incubation solution; (3) the temperature of nitric acid was maintained at 4 degrees C; and (4) the nitric acid concentration was reduced to 10% from 15%. The samples obtained by this method were stained with phosphotungstic acid hematoxylin and their striations were examined by a differential interference contrast method using light microscopy. The cell organella i.e. actin filaments, myosin filaments, T-tubules and mitochondria, were also examined electron microscopy. Actin and myosin filaments in these samples were also stained immunohistochemically to clarify the preservation of antigenicity. As a result, this modified method made it possible to examine actin and myosin filaments of a single muscle fiber light-microscopically and immunohistochemically and also to examine cell organella of a single muscle by electron microscopy. These results indicate that our method is useful for studies on branched muscle fibers such as stereological analysis and innervation of a single branched muscle fiber, in addition to obtaining muscle fiber numbers. PMID- 2700609 TI - [Clinico-endoscopic evaluation of the effectiveness of the treatment of uncomplicated gastroduodenal ulcers after local administration of solcoseryl and aevit]. AB - The complex of conservative measures for noncomplicated peptic ulcers included curative endoscopy in 105 patients, in 61 of them Aevitum was used as an application with additional injections of Solcoseryl around the ulcers. In 44 patients Aevitum was used along with Solcoseryl which was injected into the submucous layer around the pathological focus of the stomach and duodenum. The results obtained gave a convincing evidence of advantages of interstitial administration of Aevitum allowing to considerably shorten time of treatment (up to 10-12 days) of noncomplicated ulcers of the stomach and duodenum. PMID- 2700610 TI - [Spontaneous migration of a spiral intrauterine contraceptive device to the abdominal cavity]. PMID- 2700611 TI - [A treatment method of dumping syndrome after vagotomy]. PMID- 2700612 TI - [Surgical treatment of congenital spindle-shaped aneurysm of the internal jugular vein]. PMID- 2700613 TI - [One thing and another on the subject]. PMID- 2700614 TI - [Histological analysis of the instrumentation effectiveness in the furcation areas of the upper molars with curettes]. PMID- 2700615 TI - [Complementary treatment with anti-inflammatory drugs in chronic periodontal disease]. AB - Experimental studies have shown the ability of nonsteroidal anti-inflammatory drugs to reduce the rate of progression of alveolar bone destruction in animals with experimental periodontitis as a result of inhibition of biosynthesis of prostaglandin-sintetase metabolites. However, the long-term use of anti inflammatory drugs in the treatment in periodontal disease requires confirmation of experimental results in long-term prospective and independent trials in humans, and elucidation and control of possible side effects due to the inhibition of prostaglandin-sintetase. PMID- 2700616 TI - [Verruciform xanthoma. Report of a case]. AB - We review the general clinical and histological characteristics of Verruciform Xanthoma and report a case, presented in a female, 36 years-old, on the floor of mouth, an uncommon localization for this lesion. The Verruciform Xanthoma could be a reactional lesion to candida or another bacteria of oral mucosa, that need a surgical treatment. PMID- 2700617 TI - [Prosthetic loading considered in the biomechanical design of removable partial dentures]. AB - The prosthetic loads in removable partial dentures are analyzed. Different clinics and laboratory methods to make retain and support are discussed. From its study is infered a therapeutic prognostic. PMID- 2700618 TI - [Determination of the condylar trajectory using extraoral registration (the Axio Quick system), in comparison with intraoral registration in wax]. PMID- 2700619 TI - [Gingival hyperplasia induced by diphenylhydantoin. Clinical study of 106 cases]. PMID- 2700620 TI - [Removable partial denture. 2. Concepts and objectives]. PMID- 2700621 TI - [Ceramometal restorations with simple vestibular junction margins]. PMID- 2700622 TI - [Removable partial dentures. 3. Bases]. PMID- 2700623 TI - [Scanning electron microscopy study of acid etched enamel surfaces]. PMID- 2700624 TI - [Importance of psychological factors in periodontal disease]. PMID- 2700625 TI - [Removable partial dentures. 5. Connectors]. PMID- 2700626 TI - Adapting fixed prosthodontics principles to screw-retained restorations. AB - Implant restorations may be visualized clinically using a provisional fixed partial denture and in the laboratory with a fully contoured waxing on the master cast. The benefits of eggshell restorations for provisional restorations are as valid in implant prostheses as in conventional restorations. A technique is presented using the plastic laboratory sleeves to provide reliable anchorage as well as protection and preservation of the abutments. A fully contoured waxing on the master cast predictably determines the most appropriate design for screw retained restorations. When unfavorable implant placement would create compromised morphology, a retrievable auxiliary substructure is indicated. PMID- 2700627 TI - Component failure in removable partial dentures for patients with severe hypodontia. AB - Removable partial dentures (RPDs) are frequently used in the treatment of severe hypodontia. The failure rates and modes of failure of 138 such prostheses incorporating acrylic resin onlays were assessed in a retrospective survey. Failures primarily occurred either early or late in the life of the prostheses. Particular problems identified were the low wear resistance of acrylic resin onlays and poor fixation of resin components to metal bases, especially when space was limited. PMID- 2700628 TI - Invisible supragingival crown margins: an in vitro study. AB - A method of improving the esthetics and seal of porcelain crown margins using composite resin is described. The procedure includes a circumferential shoulder type preparation located entirely in enamel. To provide adequate space for a thin layer of composite resin to blend gradually into both tooth enamel and porcelain surfaces, the cervical enamel as well as the opposing porcelain butt joint are subsequently beveled. In this study, microleakage analysis and SEM evaluation of the marginal area indicate that the marginal design described can predictably produce an optimal esthetic appearance and marginal seal, contour, and integrity with supragingival ceramic restorations. PMID- 2700629 TI - Prefabricated metal intracoronal semiprecision attachments for removable partial dentures. AB - The inaccuracies of the casting and fitting processes associated with semiprecision intracoronal attachment systems may compromise the fit of the completed prosthesis. The objective of using metal prefabricated intracoronal semiprecision attachments is to improve the adaptation between the matching attachment surfaces used in the fabrication of removable partial dentures. In milled dovetail or waxed dowel rests, the attachment of one side is completed and the other is cast to match. The prefabricated attachment system presented uses a matching component cast directly against the precast metal rest-mandrel. This reduces the inaccuracies resulting from waxing, investing, and casting. PMID- 2700630 TI - Precision metal occlusal surfaces for removable partial dentures. AB - The prosthodontist is often limited in developing the desired occlusal pattern when integrating removable partial dentures with natural dentitions or fixed partial dentures. A technique that allows the development of an esthetic, accurate metal occlusal surface for a removable partial denture is described. The occlusion developed allows an occlusal harmony with the removable partial denture that is not possible with stock denture teeth or metal occlusal surfaces developed with stock denture teeth. PMID- 2700631 TI - Fine detail reproduction of very high viscosity poly(vinyl siloxane) impression materials. AB - Very high viscosity (putty) poly(vinyl siloxane) impression materials are used with both the conventional double-mix and single-mix putty/wash techniques. When the latter technique is used, portions of the impression of the prepared teeth may be made in the putty rather than the wash material. This study investigated the ability of ten different putty materials to reproduce fine detail. The American Dental Association stainless steel test die for Specification No. 19 was used. Two of the materials consistently reproduced the 20-microns groove. Three of the materials reproduced the 20-microns groove in one-half of the samples tested, while the remainder failed to do so. PMID- 2700632 TI - Bond strength of Panavia EX to dental amalgam. AB - The tensile bond strengths of Comspan (a conventional resin used with composite bonded prostheses) and Panavia EX (a newer adhesive bonding material) to different types of amalgam were determined. The results were compared with the tensile bond strengths of these resins to etched bovine enamel and properly prepared Rexillium III. The results showed that all of the resin-amalgam bond strengths were statistically less than those of bonding resin to etched bovine enamel or Rexillium III. Coverage of existing amalgam restorations by the metal framework with etched-metal resin-bonded retainers is contraindicated when using either the conventional bonding agent or the new adhesive bonding material, Panavia EX. PMID- 2700633 TI - Nonsurgical restorative treatment for the severely resorbed mandibular ridge. PMID- 2700634 TI - NASA scientist blazes path for dentistry in space. PMID- 2700635 TI - Particle size and composition of composite dusts. AB - Inhalation of respirable crystalline silica dusts (sized between 0.5 and 5.0 micrograms) causes silicosis. Crystalline silica fillers are used in some composites and fine dusts/aerosols generated during high-speed finishing of these materials may be regularly inhaled by clinical dental personnel. Due to the widespread use of composites, the potential of these dusts/aerosols for causing silicosis warrants concern. Six composites were polymerized, then abraded with diamond and carbide finishing burs to produce dusts in a manner simulating the clinical finishing of esthetic veneers. Dusts were collected on 0.8 micron filters using an air sampling pump. Six hundred particles of each dust sample were counted and measured using a light microscope. The respirable fraction of dust particles ranged between 57.2 and 85.7%. The diamond bur created more respirable particles than the carbide bur for each composite tested. The elemental composition of particles of each composite was determined by energy dispersive x-ray analysis. Silicon was detected in amounts ranging from 71-100%. Based on the composition and particle size distribution only, dusts generated during simulated finishing of composite resins containing quartz filler have the potential for causing silicosis in dental personnel. PMID- 2700636 TI - Non-sterile glove use: a review. AB - The increasing incidence of infections which may be transmitted from patient to dentist, and vice-versa, have brought about increased awareness of the cross infection control procedures necessary to prevent transmission of disease during dental treatment. The wearing of gloves is of primary importance in this respect. The problems associated with glove use are discussed in the light of recent research, and recommendations are made regarding their use. PMID- 2700637 TI - Shear bond strength of the Tenure Solution dentin bonding system. AB - A liquid solution of an oxalate bonding system containing NTG-GMA and PMDM has become commercially available. The bond strength of this oxalate adhesive (Tenure Solution) to dentin was determined by bonding composite resin cylinders to extracted teeth. The bond strengths obtained in this study are compared to the bond strengths obtained in earlier studies with the first and second generation oxalate adhesives whose components were supplied as powders and required mixing. The oxalate solutions developed significantly higher bond strengths than the original powder type systems. PMID- 2700638 TI - Tissue management with dental impression materials. AB - The coordination of perceptive tissue management, diligent tooth preparation and prudent selection of the impression material for specific clinical conditions ensures the success of cast and ceramic restorations. The introduction of a knitted cord (Ultrapak with Astringedent) has alleviated the arduous aspects of tissue displacement and the new impression materials have displayed exceptional accuracy but healthy tissue is fundamental. PMID- 2700639 TI - New adhesive resins. A status report for the American Journal of Dentistry. AB - Adhesive resins called 4-META and Panavia have been developed recently. These resins bond to various metals, porcelain, and tooth structure. They have become popular for cementation of unetched resin-bonded prostheses and various other clinical applications. This paper is a brief literature review of the composition, adhesive properties, and clinical uses of the new adhesive resins. PMID- 2700640 TI - Cervical enamel crazings associated with occluso-proximal composite restorations in posterior teeth. AB - Cervical enamel crazing lines were counted after preparing MODBL preparations in freshly extracted maxillary premolars. The teeth were restored with composite onlays. One-third of the restored teeth were left as is. In the second third MD intra-composite staples were prepared. The staples were prepared at 10, 20 and 30 minutes and 24-hour intervals. The craze lines were counted pre- and post restoratively. Intra-composite staples reduced craze lines substantially. There were no statistical differences between MD and MD-BL staples. Thirty minutes proved to be the maximum time to prepare these staples to have a reducing effect on the number of craze lines. PMID- 2700641 TI - Toothbrush bristle density: relationship to plaque removal. AB - A double-blind, parallel, controlled study was conducted to determine the effect of toothbrush bristle density (total number of bristles divided by the brush head area) in removing plaque from tooth surfaces. Ninety subjects (29 males, 61 females), aged 18-65, were randomly assigned to one of three groups using the Sensodyne Search 4-Rowa toothbrush modified to have the following bristle densities: A (4.5 bristles per mm2); B (8.3 bristles per mm2); or C (11.8 bristles per mm2). The average trim height of the bristles was 10.77 mm. Subjects brushed without any dentifrice once a day for 7 days in order for adherent deposits (salivary pellicle and plaque remnants) to accumulate on their teeth. On the eight day, examinations for stained deposits were performed according to the Global Scoring Index before and after one minute of brushing with a commercially available toothpaste. Percent reductions in deposits were highly significant for the eighty-seven subjects who completed the study. A paired t-test between the pre- and post-treatment scores (p = 0.005) demonstrated the following: Toothbrushes A, B and C had reductions in plaque of 45.5%, 51.9% and 56.8%, respectively. On an overall basis, the intergroup percent reductions were significantly different using ANOVA (p = 0.001), and demonstrated a relationship in terms of data clustering for percent plaque removal of toothbrushes with varied bristle densities. PMID- 2700642 TI - Microleakage of capsulated glass ionomer cements. AB - The purpose of this study was to compare marginal leakage in Class V preparations restored and finished within 20 minutes with two different capsulated and syringeable restorative glass ionomer cements. The materials were inserted and finished following manufacturer's specifications. Specimens were thermocycled 125x in fuchsin dye at 5 degrees C and 55 degrees C, mounted in acrylic and sectioned faciolingually. Microleakage was observed and rated on a scale of 0 to 3 at both enamel and cervical margins. The results of this study indicate that: 1) both materials exhibit marginal leakage at enamel and cervical margins, 2) no significant difference in microleakage was found between these materials, and 3) enamel margins leaked less than cementum/dentin margins with each material. PMID- 2700643 TI - The significance of gingivitis in the healthy patient. PMID- 2700644 TI - Chemotherapeutic mouthrinses in immunocompromised patients. PMID- 2700645 TI - [Impressions in orthodontic finishing]. AB - The authors review the subject and recommend a sequence to be followed during the impression taking, starting always in the lower arch, due to its comfort and less possibility of provoking nausea, this way acquiring the patient's trust. PMID- 2700646 TI - [Anterior open bite: characteristics and intrinsic and extrinsic factors]. PMID- 2700647 TI - Craniomandibular disorders: a controversy. AB - Clinical opinion varies greatly regarding the factors involved in craniomandibular disorders. Occlusion, trauma, cervical problems, orthodontic therapy and internal derangements are often cited as major factors. An examination of current research is provided to see if this is justified. PMID- 2700648 TI - Interproximal reduction: a restorative adjunct to orthodontic procedures: Part I. AB - A technique of interproximal reduction for posterior teeth using an air rotor has been devised and demonstrated. This involves the customising of commercially available tungsten carbide burs and using them to reduce enamel on the interproximal surfaces of posterior teeth. The surface of the tooth adjusted in this way is smoother than the surface obtained by adjusting with a finishing diamond. In addition, a marginal ridge form can be developed which allows for easy finishing with fine abrasive polishing discs, so as to leave a surface which approximates that of the original tooth surface for marginal ridge form and smoothness. PMID- 2700649 TI - Interproximal reduction: a restorative adjunct to orthodontic procedures: Part II. PMID- 2700650 TI - Anterior esthetics achieved with orthodontic therapy: a report of three cases. AB - The adult dental patient today, as a discerning consumer, is seeking the highest quality care in the realm of esthetic dentistry, and frequently these expectations can be met through the modalities of bonded composites, porcelain laminates, porcelain bonded to etched metal support structures or modified conventional crown and bridge prosthodontics. However, there are occasions where the individual tooth, teeth, or the arches are so aligned that the pulpal, gingival, or osseous tissues would be jeopardized by the conventional restorative intercession. The incorporation of accepted and routine procedures of acid etching and direct bonding of orthodontic appliances to the surfaces of the adult dentition to reposition malposed teeth offers the clinician a magnificent alternative or adjunct to the conventional dental material forms of treatment. This article will present several patient treatments that incorporated the use of acid etching and direct bonding of orthodontic appliances to the surfaces of the patient's teeth for the purposes of repositioning the teeth with or without the need for restorative interventions. PMID- 2700651 TI - Reverse Maryland bridges: clinical applications. AB - The "Maryland Bridge" or the etched metal-composite bonded retainer has experienced a variety of clinical applications since its inception as the etched enamel plastic-bonded Rochette periodontal splint. Through the evolutionary stages of different metals and framework preparation for composite bonding by electrolytic, chemical, and air-abrasive procedures and the improvements in bonding composites, the bridge has been in clinical use for approximately 9 to 10 years. Certain clinical and radiographic criteria must be satisfied prior to using the conventional Maryland bridge, but with the unique application of the basic bridge design modified and placed from the labial or buccal position some previously contraindicated uses of the bridge can be reversed by using a unique, if not provocative, application of the bridge design principles. This article presents two clinical case reports utilizing the Maryland bridge applied from the labial and buccal aspect. Both fixed partial dentures presented have been in place clinically for over 18 months, whereas others of this type have been successfully in place for over 6 years. PMID- 2700652 TI - In vitro evaluation of two new dentin adhesive systems. AB - Two new experimental dentin adhesive systems were evaluated to determine in vitro dentin bond strengths and marginal microleakage. Scanning electron microscopy examinations were also conducted on one of the systems that was designed to modify the smear layer. Mean shear bond strength for the two experimental systems were 6.77 +/- 1.94 MPa and 18.73 +/- 2.4 MPa. Marginal microleakage from the enamel margin was not observed and the experimental primer system limited leakage from the dentin margins. The SEM examinations showed that the primer did not significantly alter the smear layer on the prepared dentin surface. PMID- 2700653 TI - Periodontal and other soft tissue considerations in esthetic dentistry. AB - Esthetic considerations are playing a greater role in the treatment planning of dental care, especially in the restoration of anterior teeth. Much attention has been paid to both operative and prosthodontic techniques that are available in esthetic restorative dentistry. Less attention has been given to soft tissue esthetics, the shape of the face and position of the lips, and the contours, color, and overall appearance of the gingiva and associated soft tissues. This article reviews a basic approach to soft tissue esthetics, the appearance of the gingiva, the interrelationship of the gingiva, teeth, and restorations, and outlines several common soft tissue problems and their management. PMID- 2700654 TI - Insights and innovations. PMID- 2700655 TI - [Lymphoma of the oral cavity and face. Review of the last ten years literature]. AB - The paper examines a series of patients with primary oral and maxillo-facial non Hodgkin's lymphoma, reviewing cases and therapeutic protocols from 1977 to 1988. PMID- 2700656 TI - [A case of rapid palatal expansion treated with a double telescopic screw appliance]. AB - A case of maxillary hypoplasia with serious crowding in the upper arch, treated by the utilization of a special telescopic double screw permitting rapid expansion of the palate is described. PMID- 2700657 TI - Prof. Kazue K. McLaren Leadership Achievement Award: citation. PMID- 2700658 TI - Smoking among medical students in Hong Kong. AB - A survey was conducted among two classes of medical students (N = 293) at the University of Hong Kong to study their smoking habits and knowledge of and attitudes toward smoking. The response rate was 97.3%. There was only one daily smoker (0.4%) and 21 occasional smokers (7.4%). While the respondents regarded health and self-discipline as the main reasons for not smoking, the social taboo against smoking among young people might have also deterred this educated elite from smoking. Many of them failed to identify the major causal role of smoking in smoking related diseases. The potential of prevention in encountering a smoking patient seen for reasons unrelated to smoking was not fully realised. There was disagreement in the banning of cigarette advertising and in increasing the price of tobacco products. In the face of aggressive marketing by the tobacco industry in the Asia-Pacific region, every undergraduate medical curriculum should include organized instruction on smoking and its control. PMID- 2700659 TI - The Development of Health Services in the colonies--a study of British Malaya and Singapore. PMID- 2700660 TI - Optimum temporomandibular joint (TMJ) condylar position. AB - Controversy exists over the value of the TMJ condylar position in the fossa. Many clinicians associate the concentric position to the normal individuals and the retruded position to the dysfunctional condition. It is also recommended that therapeutically, the condyle should be placed on the posterior slope of the articulating eminence. Different groups of investigators claim that the condylar position, centric, retruded or protruded has little or no value and is not correlated with dysfunctional situations. This controversy is attributed to the inconsistency of research methodology. Using a large number of subjects, defining age and sex, careful selection of subject, using tomographic analysis with similar section locations and excluding individuals with disturbed occlusal condition are recommended for a research of this type. The conclusion is that the condylar position is an end product of many dynamic changes such as growth and remodeling, functional matrix activities, occlusal alteration, functional adaptation and individual variation. It is suggested that diagnosis and treatment of TMJ disorders should not be based solely on the radiographic position of the condyle. Consideration of general body conditions is an essential part of total patient management. TM joint condylar position has been explained as the position of the mandibular condyles in the glenoid fossa when teeth are in maximum intercuspation. Clinicians have based their diagnosis and treatment of temporomandibular joint disorder on this position. The optimal condylar position has been a controversial matter in dentistry for many years. The purpose of this paper is to review the literature pertaining to condylar position and to discuss its significance in clinical practice. PMID- 2700661 TI - Acute acral pustulosis. AB - We report a patient with a pustular eruption in an acral distribution that developed abruptly 4 days after a streptococcal pharyngitis. The histology showed an intraepidermal vesicle filled with neutrophils with an underlying lymphocytic vasculitis. Direct immunofluorescence demonstrated heavy deposition of C3 within the vessel walls. In addition, circulating immune complexes were found. PMID- 2700662 TI - Intra-epidermal neutrophilic IgA dermatosis with colitis. AB - We report the association of an intra-epidermal blistering disease of the skin with colitis. Both the skin and large bowel epithelium were infiltrated by neutrophils and eosinophils, and showed intra-epithelial deposition of IgA in an intercellular pattern. The colitis and the blisters responded well to treatment with dapsone. PMID- 2700663 TI - Lymphocytic lymphoma and acquired C1 esterase inhibitor deficiency. AB - We report a 59-year-old woman who had progressive symptoms of angioedema for 3 years, culminating in an attack of laryngeal stridor. C1 esterase inhibitor deficiency was confirmed and treatment with tranexamic acid produced considerable clinical benefit and improvement in complement levels. Two years later she developed clinical evidence of lymphocytic lymphoma. Splenectomy resulted in rapid correction of complement abnormalities. The patient received 6 months of chemotherapy after surgery and remained asymptomatic with normal complement levels 4 years later. PMID- 2700664 TI - Congenital epidermolytic hyperkeratosis associated with multiple malignancies. PMID- 2700665 TI - Binding of bullous pemphigoid and pemphigus vulgaris sera to SCaBER cell line in an ELISA. AB - Specific antibodies present in the sera of patients with bullous pemphigoid or pemphigus vulgaris were detected in an enzyme-linked immunosorbent assay (ELISA) employing a squamous carcinoma cell line, SCaBER, as substrate. Bullous pemphigoid sera bound preferentially to permeabilized cells, suggesting that the antigens are largely intracellular. The assay may prove to be a useful addition to current methods of detecting circulating antibodies in these patients. PMID- 2700666 TI - Dapsone as first line therapy for bullous pemphigoid. AB - In an open study, a total of 18 patients with proven bullous pemphigoid (16 new patients and two in relapse) were treated with a trial of dapsone (17 patients) or sulphonimide (one patient). Overall, eight patients were controlled on one of these agents as the sole treatment (44%). Six patients had a partial, but inadequate response, while four did not respond. The responses to the sulpha drugs were generally rapid, i.e. within 2 weeks, and the maximum doses used in any patient were 100 mg/day dapsone and 1.5 g/day of sulphapyridine or sulphamethoxypyridazine. Significant side-effects to dapsone occurred in six of the 17 patients. A trial of a sulphone or sulphonamide drug is warranted in bullous pemphigoid both as an initial treatment or in the treatment of relapse, particularly when there is a contraindication to the use of corticosteroids. Side effects are common and therapy needs to be closely monitored. PMID- 2700667 TI - [Graphic informatics and medical education. Computer assisted education. Application to the teaching of sphenoid bone anatomy]. PMID- 2700668 TI - Intragastric infection of germfree and conventional mice with Salmonella typhimurium. AB - The present study investigates the lethality of intragastric Salmonella typhimurium infection of germfree (GF) and conventional (CV, not germfree) mice. The introduction of only 10 viable S. typhimurium into the gastrointestinal tract of GF mice resulted in death of all animals within 8 days of inoculation. In contrast, the 50% lethal dose for CV mice was 4.7 x 10(3) viable organisms. The results demonstrate that resident microbes protect mice from the pathogenic effect of S. typhimurium infection. PMID- 2700669 TI - Vitamin E stimulates endotoxin-inhibited monocyte migration and phagocytosis in vivo. AB - Intravenous administration of E. coli endotoxin (LPS, 30 micrograms/kg, iv) inhibited thioglycollate-stimulated accumulation of monocytes into the rat peritoneal cavity, measured 48 and 72 h later, by about 40%. Pretreatment of animals with vitamin E (50 mg/kg, im) restored thioglycollate-induced monocyte migration in LPS-challenged rats to control levels. Vitamin E also partially reversed LPS-induced inhibition of monocyte phagocytosis in vivo. The results suggest that vitamin E could be beneficial in restoring leukocyte function in septicemic states. PMID- 2700670 TI - [Academic eulogy of Professor Francois Jaminet, native honorary member]. PMID- 2700671 TI - [Diagnostic models. 2. Fabrication]. AB - After describing in Part I the preparation of diagnostic cast, the authors describe the Wax Up preparation. Most of the definition of centric relation agree that the position of the mandible is slightly behind its position in centric occlusion. The Hinge axis position is used for mounting the cast on articulator. The final restauration must reconstruct both position and the occlusion should be established in front the centric occlusion. After equilibration anterior guidance is studied and restaured if necessary. After creating the different curve of occlusion, the final Wax Up is settled. The use of the diagnostic cast so obtained will be presented in Part III. PMID- 2700672 TI - [Sunrise gold foil jacket crown]. AB - This technique permits the preparation of ceramic jacket crowns made on Sunrise laminated precious metal alloy. The Sunrise foil is gold-colored, made of 99% of precious metals and is 50 microns thick. The die is prepared in order to display a moderate and regular undercut beyond the cervical limit. The margin will be underlined with a red pencil. The Sunrise foil is cut according to predetermined templates. Then the foil is applied without burnishing, according to the technique of jacket crowns on platinum foil only by finger pressure. The double folding on closure is preferably done distally or mesially. Then, the metal base is disinserted, sandblasted with 100 microns aluminum oxide, replaced on its die, and placed in a rubber casing before being placed in the isostatic press, to be subjected to a pressure of 2,000 TSI (14 kg par cm2). Sunrise's orange color reinforces rather subtetly the overall color, making these reconstructions particularly esthetic. The color of the Sunrise metal does not require, therefore a too thick opaque. Any ceramic intended to be fired on a metal base, may be used in respecting its firing protocol. Sunrise, as any other technique of this type, require a careful preparation with a shoulder that has a rounded gingivoaxial line angle. Bridges may be built on the "thimbles" crowns, fitted on Sunrise cores, the pontics being made as a ceramo-metal framework. PMID- 2700673 TI - [Mounting posterior teeth in complete dentures]. AB - The more common techniques for analysing the alveolar ridge in full dentures were examined. Both the linear analysis and the two-dimensional one, proposed by Pound, were described. The ridge-transfer method was found to be three dimensional, thus allowing the construction of full dentures which are more stable during each phase of mastication. PMID- 2700674 TI - [The implant denture in the laboratory]. AB - The authors analyzed the numerous devices and prosthetic kits currently available for implant prosthodontics. Existing systems can be classified into two fundamentally different categories: the gold ring cylinder (or its equivalent in resin for casting) and the prosthetic abutment core or post concept. The former is based on connection of two nearly flat, horizontal surfaces by means of a screw, which avoids problems of parallelism; the latter can be likened to insertion of one part into another, like a crown that slides along the vertical axis of an abutment, with connection being obtained by cementation and/or screwing. Prosthetic abutment core or post: Whether monoblock or multiblock, the implant core or post is very similar to a conventional metallic abutment. Construction of the implant prosthesis is generally no problem when parallelism has been respected during surgery; if problems are encountered with parallelism, options include: 1. Adjustment of the abutment core by grinding, 2. Use of a telescope to achieve parallelism, 3. Use of a bendable prosthetic abutment core, 4. Use of a prosthetic abutment core preangulated 10 degrees-20 degrees, 5. A combination of the above solutions. The implant prostheses may be screwed, cemented or clipped in position. Gold ring cylinder concept The gold ring cylinder (or its equivalent in resin for casting) theoretically eliminates problems of parallelism, but at the same time restricts the implant prosthesis to screw techniques. A special protocol is required for the impression and construction of the prosthesis. Impression with plaster is often the best method for total edentulism whereas "open" impression trays are advisable for partial prostheses. In the laboratory, use of a machined gold ring cylinder provides optimum precision, but intra-oral verification remains necessary. Implant prosthodontics unquestionably represent a new type of "know how": both the dentist and the dental lab technician must acquire the necessary training and adapt their work routines. PMID- 2700675 TI - A systemized approach for evaluation and adjustment of complete dentures. AB - Because of the vast numbers of potential symptoms and causes, a systematic method is needed to assess patient complaints about fit, esthetics, and feel of complete dentures, permitting the dentist to establish planned corrective procedures. One system is the SOAP method of problem-oriented record notations that defines a systematic way of dealing clinically with patient problems. PMID- 2700676 TI - Use of osseointegrated implants for replacement of single teeth. AB - This article uses clinical examples to show applications of single tooth replacements. With coordinated planning and efforts on the part of the surgeon and the restorative dentist, optimum results, both esthetically and functionally, can be achieved in treating these partially edentulous patients. PMID- 2700677 TI - Esthetics in periodontics: covering denuded root surfaces using free gingival grafts without citric acid, Part I. AB - In Part I of this series, the author summarizes the current diagnosis of and treatment techniques for covering denuded root surfaces with free gingival grafts for an esthetic result. The author reviews historical background and shares the philosophical differences within the periodontal community concerning the use of citric acid root conditioning in these cases. PMID- 2700678 TI - Geriatrics, emergencies, and visible light-cured dentures. AB - This article will cover several aspects involved with the routine prosthodontic care of an elderly patient. One of these patients is ambulatory and the other institutionalized. The article will also cover emergency treatment rendered to a patient requiring unexpected care because of trauma. PMID- 2700679 TI - The Transosteal implant in the prosthodontic reconstruction of the edentulous mandible. AB - It is the purpose of this article to review transosteal implants, specifically the Mandibular Staple Bone Plate and the Transmandibular Implant, in regard to their clinical prosthodontic applications. In addition, those aspects of prosthodontic treatment shared will be highlighted and the differences in the techniques will be reviewed. PMID- 2700680 TI - Arthroscopy of the temporomandibular joint. AB - Arthroscopy is a technique that allows direct visual examination of the internal surfaces of the joint. In the past decade, arthroscopy has become a major diagnostic and therapeutic tool in the treatment of articular disorders of the knee. The purpose of this report is to present a comprehensive overview of temporomandibular joint (TMJ) arthroscopy in order to familiarize the practitioner with this adjunct to temporomandibular disorder diagnosis and treatment. PMID- 2700681 TI - The use of multiple implant modalities in the management of the edentulous patient. AB - Management of the fully edentulous patient has historically been a problem for the restorative dentist. Adequate retention, esthetics, and function are often compromised by the loss of the natural dentition and the osseous and soft tissue changes that subsequently occur. Alveolar bone loss and elevated soft tissue attachments decrease the basal seat areas, which decrease the stability of a denture prosthesis. This article will discuss the use of multiple implant modalities when concerned with the edentulous patient. PMID- 2700682 TI - A method to identify and correct overextended denture borders. AB - This paper will present a method of correcting a processed denture for overextension and overwaxup in order to give the patient added comfort and the denture added retention. PMID- 2700683 TI - Cheilitis--part II. PMID- 2700684 TI - Salvaging fixed bridge abutments. PMID- 2700685 TI - Cheilitis--part I. PMID- 2700686 TI - Gingival response to lingual contours of bonded metal bridges: a 12-month study. AB - Overcontouring of cast metal on the lingual surfaces of teeth used as abutments in acid-etched bridges may be responsible for plaque accumulation and inflammation of the gingiva. The purpose of this study is to assess the gingival response in acid-etched bridge abutments during a period of 12 months. The parameters used for assessment are the gingival cervicular fluid flow, plaque and gingival indices, and the free gingival margin height for both the abutments and uninvolved controls. The results of both the experimental and control sites in 17 patients were similar with no significant differences (p less than .02). The study suggests that careful contouring of the ligual surfaces of acid-etched bridges does not adversely affect the health of the adjacent gingival tissues during a 12-months of follow up. PMID- 2700687 TI - Duplicating maxillomandibular relationships after craniomandibular dysfunction therapy with transitional dentures. PMID- 2700688 TI - The adhesion mechanism of dental adhesive resin to the alloy. Adhesive ability of dental adhesive resin to the cleaned metal surface obtained by hydrogen gas reduction method. AB - With the cleaned metal surface without passive film or an oxide layer, chromium, cobalt, and iron show excellent bonding strength, indicating values similar to 18 8 stainless steel. Therefore the existence of a passive film and oxide layer at the interface metal/resin is not essential for metal-resin bonding. The adhesive ability decreases in the order: Cr congruent to Co congruent to Fe greater than Cu greater than Ag greater than Au congruent to Ni greater than Pt greater than Pd. PMID- 2700689 TI - Comparison of rotational speeds and torque properties between air-bearing and ball-bearing air-turbine handpieces. AB - We examined the effects of air pressure on the free-running speed of air-bearing and torque-type ball-bearing air-turbine handpieces. The air pressure for the former should be kept at a certain high level to maintain the stable super-thin air-bearing film and to provide the quasi-constant speed of around 420,000 to 480,000 rpm. On the other hand, the air pressure for the latter could be adjusted to provide some varieties of speeds, ranging from about 150,000 to 320,000 rpm. Subsequently, to compare torque properties and cutting effectiveness between these two handpieces, weight-load cutting tests were conducted, using a glass ceramic workpiece and a commercial diamond point. It was confirmed that the air bearing handpiece had the lower torque power but exhibited better cutting effectiveness, compared with its counterpart. PMID- 2700690 TI - Analysis of abutment tooth movement utilizing mandibular kinesiography (MKG). Part 2. Effects of clasp design in unilateral free-end denture. AB - The three-dimensional dynamic movement of the abutment tooth was successfully analyzed on a simulation model utilizing the mandibular kinesiography. When the unilateral free-end denture retained by the RPA, RPI or Aker's clasp was subjected to various directions of loads, the abutment tooth was inclined mainly by the sliding displacement of the denture over the alveolar ridge and the lever action around the denture. The Aker's clasp assembly induced the largest tooth movement. The RPA clasp generally exhibited similar tendencies to the Aker's clasp, showing a larger tooth inclination in the disto-buccal direction. The RPI clasp seemed to be preferable for protecting the periodontal tissues from damage associated with unfavorable tooth movements since it induced less distal tooth inclination. PMID- 2700691 TI - Effect of the self etching dentin primers on the bonding efficacy of a dentin adhesive. AB - The efficacy of marketed and experimental self etching dentin primers which contained dicarboxylic acids or their esterified salts diluted in 35% hydroxyethylmethacrylate (HEMA) solution were studied by measuring the wall-to wall polymerization contraction of the light curing composite in the cylindrical dentin cavity and the tensile bond strength to the flat dentin surface. In both of the measurements, a marketed dentin bonding agent and resin monomer was applied after the treatment with experimental primers and a marketed primer, respectively. It was revealed that two experimental primers composed of the methacryloxyethyl-succinate or methacryloxyethyl-phthalate and HEMA, exhibited a remarkable effect on the bonding efficacy of a dentin adhesive employed in this study. A marketed primer which contained maleic acid and HEMA could not improve the bonding between the resin and dentin cavity wall although a significantly high bonding strength (11.9 +/- 5.7 MPa) was obtained after 24 hours. PMID- 2700692 TI - Asthma in childhood. PMID- 2700693 TI - [Infection control and dentures]. PMID- 2700694 TI - [Clinical study on the treatment of dyskinesia by L-stepholidine]. AB - 134 cases of dyskinesia caused by various CNS diseases were treated with a new type of DA blocker L-Stepholidine (1-SPD). Good response was obtained in 72% (29/40) of L-dopa induced abnormal involuntary movements in Parkinson disease, 79% (34/43) of Tourette syndrome, and 65% (15/23) of tardive dyskinesia through a short-term follow-up. No serious side effects were found within the therapeutic dosage of 50-225mg/day The results showed that L-SPD is a new type of anti dyskinesia agent deserving further pharmacological investigation. PMID- 2700695 TI - [Neuropeptides and seizures]. PMID- 2700696 TI - [Clinical aspects of poisoning by tricyclic antidepressants]. PMID- 2700697 TI - A dental school for San Antonio. An informal history. PMID- 2700698 TI - Briscoe Library. PMID- 2700699 TI - Cefuroxime axetil: a new oral cephalosporin. PMID- 2700700 TI - [New technologies in dental prosthetics]. PMID- 2700701 TI - [Biocompatibility of crown and bridge materials. 1. Substances in contact with dentin]. AB - It is mandatory that the materials and drugs used in restorative dentistry be free from side effects resulting in potential tooth loss or irreversible damage to vital dental tissues. Up to now there have been no reliable in vitro methods available for the evaluation of pulp reactions. Since numerous different materials and drugs are successively applied to prepared dentine, pulp reactions are caused by cumulative action, and the causative factors, except for extremely toxic substances, cannot be revealed by clinical and/or posttreatment studies alone. At present, the evaluation of pulp reactions must still rely on histologic studies using human or animal teeth. Reports on pulp reactions to materials and drugs are reviewed. Few dependable figures have been reported on pulp reactions to dentinal medication, "sterilization", disinfectants and on the biologic response to and effectiveness of varnishes, liners, desensitizing agents, smear layer removers, etc. Resins and composite materials seem to provoke acute reactions, mainly by the heat generated during setting, and chronic reactions due to the stimulation of bacterial growth. Except for glass ionomer cements, most of the publications show a high degree of agreement on the tissue reactions to luting agents. Regarding dentine bonding agents, however, it has not been possible to draw any conclusions, so far. PMID- 2700702 TI - [Antiphlogistic effect of bromelaine following third molar removal]. AB - A placebo-controlled double-blind study of 100 patients with impacted and/or dislocated lower wisdom teeth was conducted to examine the tolerance and antiphlogistic efficacy of bromelaine--a mixture of proteolytic enzymes from ananas comosus. Treatment was started 1 day prior to third molar surgery with a daily dose of 3 x 80 mg and was continued for a total of 6 days. On the 1st day following surgery, linear measurement (distance: tragus-pogonion) showed swelling to be 7.5% lower under drug treatment than in the placebo group. Two-dimensional image evaluation increased this difference to 15.9%, which however still failed to attain the significance level of 20%. Between the 3rd and the 7th postoperative day no differences were found between the two groups regarding the extent of soft tissue swelling or the speed of edema resolution. PMID- 2700703 TI - [Putting to the proof three-unit bonded bridges in practice]. AB - Control data of 52 three-unit bonded bridges were evaluated to verify the clinical value of an expanded treatment concept. With a total of 10% failures (5 loose retainers) after 45 months the results demonstrated that this concept involving the integration of cavities into the retainer design, the insertion of bonded bridges at an advanced age or into the posterior area, and the combination with crowns provides successful treatment alternatives in acid etched cast prosthodontics. PMID- 2700704 TI - [Mathematical simulation of the cooling and solidifying process in improving the quality of dental castings]. AB - CASTS-3D (Computer Aided Solidification Technologies) is a FEM software system for the simulation of heat transfer, melt flow and solidification problems for foundry purposes. This software system may basically be applied to dental castings as well--especially if the FEM software system is optimized and exact data on the thermophysical properties of the dental alloys are provided. PMID- 2700705 TI - [Effects of mold preheating temperatures and the time of melt casting on the structure of cast denture frameworks]. AB - At casting temperatures of 1330 degrees to 1530 degrees C and preheating temperatures of 900 degrees to 1100 degrees C, 28 cast denture frameworks were manufactured using the cobalt chromium alloy Biosil f (Degussa). The inner defects were detected by X-ray defectoscopy and the grain numbers of clasp, connector and basis elements determined by metallography. The best results for compact castings were observed at a temperature range of 1410 degrees to 1480 degrees C. Casting previous to the melting of the last alloy cube results in a structure of clasps and connectors with 100-200 grains/mm2 and a high amount of defects; exceeding the liquidus temperature of 1380 degrees C produces grain numbers of 20-30/mm2, while a casting temperature of 1530 degrees C results in 3 5/mm2. Overheating of the melt, also in connection with low preheating temperatures, is probably a cause for the premature loss of clasp retention and fracture of many denture frameworks. PMID- 2700706 TI - [Dynamic strength of cast endodontic post systems]. AB - Different endodontic post systems--Permador metal posts, GT posts, Para posts, and Erlangen posts--have been compared with each other in a study. After casting a Pd-Ag-Sn-In-alloy to the posts, these experimental post-retained cores were fixed with zinc phosphate cement in the prepared root canals of extracted premolars and subjected to fatigue tests. With the parameters selected, the forces could be reduced to 22.5N, thus approximating physiological conditions. This test was followed by a thorough inspection of the material (EDS analysis, metallographic preparations, SEM). The Permador post showed the highest dynamic strength, while the Erlangen post material was found to be unsuitable for casting to two different palladium-base alloys. PMID- 2700707 TI - [Three-dimensional representation of test specimens. A comparative study]. PMID- 2700708 TI - [Shear strength measurements for the clinical evaluation of bonded ceramic systems]. AB - The shear bond strength of dental ceramic (Dicor, Optec) and luting composite (Dicor, Optec, Dual-cement) bonded to dentin and to etched enamel was evaluated. The mean bond strength was 23.8 N/mm2 to enamel and 0.60 N/mm2 to dentin. Using the Optec dentinal bonding agents increased these values to 2.00 N/mm2. PMID- 2700709 TI - [Rocatec system--adhesion by tribochemical coating]. AB - The Rocatec procedure as a novel acrylic/metal bonding system is presented. This procedure is based on the tribochemical application of a layer of a ceramic bonding agent by sand blasting, followed by the application of a silane solution. Its particular advantages are the speed and accuracy of coating, the fact that the adhesive layer can be visually checked, and that thermal stresses to the metallic framework are avoided. Shear/compression and tensile tests reveal increased bonding strength values with the Rocatec bonding system than with mechanical bead retention, even after thermocycling and storage in water for one year. PMID- 2700710 TI - [Comparative study of acrylic veneer crowns depending on storage conditions]. PMID- 2700711 TI - [Testing metal/acrylic bonds for shear strength, axial tensile strength and maximum bending stress]. AB - The effects of thermocycling and water penetration on the bond strength of resin metal-systems and improvements using bonding agents have been tested by shear, bending and tensile tests. After 10,000 cycles within 10 days in different water baths with 5-37-55 degrees C, there is a decrease in bond strength by 40 to 60%. The use of bonding agents increases the adhesion of the resin to the metal by more than 100%. No significant differences were found between the three bonding agents Silicoater, Sebond MKV and OVS. PMID- 2700712 TI - [Finishing of cast titanium for crowns and bridges]. AB - The surface roughness of cast Titanium compared with a precious alloy (Au-Ag-Cu), two Pd-base alloys (Pd-Ag-Sn-In, Pd-Sn-Ga-Cu) and two base metal alloys (Ni-Cr Mo, Co-Cr-Mo) was determined by surface profile measurements after polishing with six different polishing pastes. The results revealed the best surface quality for Au-Ag-Cu followed by Ni-Cr-Mo, Co-Cr-MO, Pd-Sn-Ga-Cu and Pd-Ag-Sn-In. The highest but still acceptable surface roughness was found with Ti. PMID- 2700713 TI - [Material testing for the use of titanium in bonded prosthodontic restorations]. AB - The effects of chemically etching cast pure titanium to achieve a microretentive surface morphology were studied by SEM. Etching failed to produce an effective improvement of the retentive structures compared to air brushing with Al2 O3 of 50 microns grain size. The bond strength values of the Silicoater-treated retentive surfaces of titanium and Wiron 88 (bonding agent Comspan) determined by shear tests were considerably higher than those of the air-brushed or chemically etched surfaces (bonding agents Comspan, ABC-Zement, Superbond). The clinical use of the Silicoater procedure in bonded restorations seems to provide a suitable retentive mechanism for titanium frameworks. PMID- 2700714 TI - [Qualitative assessment of the marginal areas of bonded bridges followed up for 60 months]. PMID- 2700715 TI - [Homogeneity and corrosion resistance of cast dental precious metal alloys compared with uncast alloys]. AB - 60 cast crowns were manufactured in 6 different dental laboratories using 3 different alloys. The relative areas of cavities at the crown margins and the palatal crown surfaces were measured. Subsequently the crowns and uncast alloy plates were stored in artificial saliva and 1nHCl. After 30 days the dissolved amounts of Cu or, respectively, Ag were measured. All crowns exhibited cavities and porosities. The area of cavities at the crown margins was twice as high as that at the palatal surfaces. The copper ion concentrations measured for cast crowns of the PdCuGaIn-type Pd base alloy were increased by a factor of 20 (maximum) when compared to the uncast alloy. The solubility of the cast PdAgSnIn alloys was characterized by an only slight increase in the amount of dissolved silver. The results suggest that, in view of the inadequacies of dental casting, the use of alloys that may release toxic metal ions should be abandoned. PMID- 2700716 TI - [Development of the Arbeitsgemeinschaft fur Kieferchirurgie, a study group on maxillofacial surgery]. PMID- 2700717 TI - [Pathophysiology of orofacial pain]. AB - The pathophysiology of different kinds of orofacial pains is discussed. (a) Stimulus-induced pain may be elicited e.g. by surgical interventions at the teeth. Nociceptors stimulated by noxious stimulation induce not only pain sensations but contribute also to regulating the blood flow, directly by releasing vasoactive peptides, and indirectly by inducing sympathetic reflexes, (b) Inflammatory pain has its origin in an sensitization of nociceptor units by several kinds of endogenous neuro-vasoactive substances. (c) Chronic pains are either the consequence of motor or vegetative dysregulations or of neuropathic origin. The implications for different kinds of pain pathophysiology for therapeutic strategies are discussed. PMID- 2700718 TI - [Specific adhesive bonding of air-brushed alloy surfaces]. AB - In vitro test have been conducted to examine if NiCr, CoCr and PdAg alloys air brushed with aluminium oxide (grain size 250 microns) can be bonded in such a way that the bond resists humidity. After 150 days in water at 37 degrees C the high initial bond strength values of NiCr or CoCr alloys bonded with the modified bis GMA adhesive Panavia remained unchanged. In the PdAg alloy specimens bonded with Panavia, the initial bond strength were approx. 60% lower than those of the NiCr and CoCr alloys, and were further reduced by approx. 33% after 150 days. As soon as after 15 minutes, the modified bis-GMA adhesive is cured to such an extent that functional loading of the bond interface is possible. PMID- 2700719 TI - [Management and treatment of patients with atypical facial pain]. AB - The term "atypical facial pain" refers to a pain disease and should not be used for pain of peripheral origin. As a rule atypical facial pain is induced by a peripheral tissue trauma not necessarily associated with nerve lesions. The intensity of pain does not correlate with the measurable magnitude of the trauma. If treatment is possible, it will be the more successful the earlier it is started. Therapy comprises transcutaneous electric nerve stimulation, sympathetic nerve block, drug therapy and psychotherapy. PMID- 2700720 TI - [New imaging procedures]. PMID- 2700721 TI - [Sonographic TMJ imaging in different sectional planes]. AB - For topographic reasons TMJ arthrosonography is extraordinarily difficult. In a first series of experimental studies on the human skeleton skull the basic principles of ultrasonographic anatomy have been elaborated. To ensure the reproducibility of the results three spatial planes through the TMJ have been defined and--by their characteristic ultrasonographic structures--established as parameters for further studies. PMID- 2700722 TI - [Laser Doppler Flowmetry: microcirculatory studies in the dental pulp]. AB - Laser Doppler Flowmetry permits studies of the blood circulation in circumscribed tissue areas. This measuring method may also be applied to the dental pulp if a suitable experimental design is developed. Incisor teeth of rats are used as an example to illustrate that a quantitative analysis of changes in the blood flow is possible with the aid of suitable preparation procedures. PMID- 2700723 TI - [Evaluation of the relationships between abrasion and surface alterations after professional tooth cleaning]. AB - The effects of mechanical plaque removal on the enamel are compared in vitro by quantifying roughness and abrasion. The abrasion values after cleaning with ultrasound devices, polishing paste and abrasive blast units correlate with the roughness values measured. PMID- 2700724 TI - [Efficiency of follow-up programs in periodontal patients--review of the literature]. AB - Follow-up programs for periodontally treated patients may largely prevent loss of teeth and attachment. Consequently they are an indispensable part of periodontal treatment. The success of treatment hinges on the recall interval which should be determined individually (to 6 month for most patients), as well as on diagnosis and treatment, which need to be modified in accordance with the specific requirements of the follow-up. It is under discussion whether individual parts of the follow-up program should be handled by adequately trained assistant staff. PMID- 2700725 TI - [Risk factors for three-unit bonded bridges]. AB - Statistical methods of survival-analysis were applied to investigate the effects of anatomical factors and clinical procedures which determine the "life-time" of 3-unit adhesive bridges. Their influences were analyzed until the first loss of retention after insertion. Besides the therapist effect, increased mobility and macromechanical preparation of the abutments could be identified as significant variables. Bridges bonded to one non-mobile and one hypermobile abutment tooth were found to be especially threatened. Extensive macromechanical preparation of the hard tissues reduces the hazard of debonding remarkably; this effect may be replaced by improved retentive mechanism of retainers. PMID- 2700726 TI - [Surface changes of enamel, root cementum and fillings after treatment with tooth cleaning instruments]. AB - The effect of new, automatic tooth cleaning instruments on tooth surface and surfaces and margins of amalgam and composite fillings were studied by profilometric measurements and SEM and compared with each other. On the surfaces of teeth and fillings, in particular at the margins, ultrasound treatment resulted in the significantly highest maximum roughness values. These values were lower when turbin-operated scalers were used. Results demonstrate that during tooth cleaning direct contact between ultrasound and turbine-operated scalers and tooth and filling surfaces should be prevented. PMID- 2700727 TI - [Technology and progress in dental prosthodontics and dental materials]. AB - This publication describes and scrutinizes new technologies in the field of prosthodontics including functional analysis and therapy, fixed and combined fixed/removable prosthetics, and implant supported/relained dentures. In spite of all new developments with regard to digitized imaging (CT;NMR) of the TMJ as well as in spite of all electronic devices for recording the mandibular movement, new therapies have not been established. The clinical examination is still of primary importance. In fixed prosthetics the different ceramic and glass/ceramic systems represent aesthetic and hygienic alternatives to single, porcelain-fused-to-metal restorations. Titanium exhibiting good biocompatibility, sufficient strength, and a low price gradually becomes of greater importance. In combined fixed/removable prosthetics the various metal-resinbonding-systems as well as the spark erosion technique--the latter being used for precision attachment work utilizing base metal alloys--can be described as major achievements in our profession. In dental implantology, a great variety of different implant systems have been introduced to the market. Based on the clinical experience of the last decade, the following can be stated: The implantological prosthetic treatment of the lower jaw using two implants and a clip-to-bar retained denture shows the best cost-risque benefit ratio among all possible indications. In the future, more research should be directed to the prosthetic suprastructures and their influence on the long lasting success of implant supported retained constructions. PMID- 2700728 TI - [Testing of periodontal response to abutment teeth with tapered crowns or cast clasps using the Periotest instrument]. AB - 62 patients were examined on average 5.3 months after the insertion of removable partial dentures concerning changes of the periotest values of the abutment and control teeth. With help of the periotest procedure little parodontal reactions of the abutment teeth could be shown, which would not been recognized with normal clinical examination. PMID- 2700729 TI - [Lightweight construction--sense and nonsense]. AB - Lightweight construction techniques make sense as long as certain basic principles are observed. This requirement is best met by the shell construction technique. Lightweight constructions using the ultralite foil technique have considerable shortcomings, and it is only in rare cases that they may be used on a long-term basis. The assessment of the expected chewing forces as well as the shape and dimension of the bridge, limited by the given clinical conditions of the case, are the factors governing the decision for a specific framework construction. The design of the interproximal spaces requires particular attention. The most economical solution is a durable construction involving low material and production costs. PMID- 2700730 TI - [Effects of different tray types on the resulting impression]. AB - In addition to the impression material the type of the used impression tray influences the accurat dimensional transfer of the teeth position to the master cast. In total 80 impressions were taken from models of the upper- and lower jaw by using condensation silicone, hydrocolloid, solid and perforated stock trays and acrylic custom trays. After that the casts were measured. The highest conformity with the original could be achieved with a hydrocolloid stock tray. The custom tray for the upper jaw showed short differences to the original model. By using a custom tray for the lower jaw higher dimensional changes occurred. Besides the different impression material thickness, distorsions of the trays should be discussed. PMID- 2700731 TI - [System for correct placement of individual attachments]. PMID- 2700732 TI - [Functional concept of occlusal surfaces. Spherical segment-finished part of FGP technic]. PMID- 2700733 TI - [Preparation of fixed maxillary partial denture opposing complete lower denture]. PMID- 2700734 TI - [Cast ceramic crown system. Review of a clinical case]. PMID- 2700735 TI - [Use of non-precious alloys for removable partial denture construction]. PMID- 2700736 TI - [Mandibular reconstruction and anterior tooth esthetics]. PMID- 2700737 TI - [Electrochemical procedures optimize precious metal-ceramic bonding]. PMID- 2700738 TI - [Ergonomics of milling. Milling technic in 1989]. PMID- 2700740 TI - [Groove-shoulder-pin attachments. There must be some theory]. PMID- 2700739 TI - [Critical study of normal patterns for metal-ceramic restorations]. PMID- 2700741 TI - [Some critical remarks on theme of inlays and onlays]. PMID- 2700742 TI - Controlling active chronic periodontitis. PMID- 2700743 TI - Dentine adhesives and the interfacial gap. PMID- 2700744 TI - [Safety problems in the use of local anesthetics in the dental area]. AB - In the last few years particular attention has been given to the adverse reaction to loco-regional anesthesia now widely used in dental practice. It has seemed therefore interesting to investigate the different types of adverse reactions, with particular attention to the anaphylactic-anaphylactoid ones. Although uncommon, these are interesting for the uncertain pathogenesis, the severity of the clinical picture and the complexity of the treatment. In order to find their adequate prevention, a particular approach to risk patients has been suggested to identify the eventual previous anaphylactic-anaphylactoid reactions and the drugs responsible for it. A procedure based on progressive skin test confirmed by a negative incremental challenge test has been worked out. Moreover the need has been felt for a drug surveillance program capable of collecting computerized data which allows real-time investigation of adverse reaction incidence, their typology and finally the effectiveness of prevention. This procedure should further ensure safety in loco-regional anesthesia in dental practice. PMID- 2700745 TI - Osseointegrated implants in the treatment of partially edentulous patients: a preliminary study on 876 consecutively placed fixtures. AB - A total of 876 consecutively placed fixtures ad modum Branemark was followed in 268 partially edentulous jaws of 244 patients treated between April 1968 and the end of December 1988. A total of 24 of 712 fixtures exposed at the abutment connection was lost (3%); the continuous prosthesis stability rate was 98.7%, as only four of 293 prostheses were removed. The results of the study indicate the possibility for the Branemark osseointegration technique also to be used in the treatment of partial edentulism. PMID- 2700746 TI - Soft-tissue response to clinically retrieved titanium cover screws reimplanted in the rat abdominal wall. AB - Clinically retrieved titanium implant cover screws (Branemark implant system), rinsed in saline or subjected to ultrasonic cleaning and sterilization, as well as unused sterile screws were studied by scanning electron microscopy and implanted in the rat abdominal wall for 6 weeks. Irrespective of cleaning procedure, the heads of the clinically retrieved screws were covered by numerous contaminants not present on the unused screws. The reimplanted screws elicited a different tissue response than the unused screws. The tissue response to the contaminated screws was characterized by a significantly thicker fibrous capsule and by a significantly larger number of macrophages located close to the implant. Moreover, judging from their ultrastructure, studied with transmission electron microscopy, the macrophages appeared to be in a more active state when compared to those located adjacent to unused screws. PMID- 2700747 TI - Forces and moments on Branemark implants. AB - The placement of fixtures (implants) in relation to the geometry of a prosthetic restoration has a great influence on the mechanical loading of the implant. Based on theoretic consideration and clinical experiences with the Branemark System, this article gives simple guidelines for controlling these loads. The emphasis is on design rules that can be used in clinical practice. With the Class I lever as a reference, various clinical implant prosthesis situations are discussed and evaluated. PMID- 2700748 TI - [What is the future of guided tissue regeneration and the use of membranes?]. PMID- 2700750 TI - Palatal shelf anchorage. PMID- 2700749 TI - [Treatment of pain and dental disease in ancient Egypt]. PMID- 2700751 TI - Direct-bonded lingual retainer. PMID- 2700752 TI - Bonded pontics in orthodontics. PMID- 2700753 TI - Precision bracket placement instrument. PMID- 2700754 TI - Debonding ceramic brackets. PMID- 2700755 TI - Temporomandibular joint sounds: a critique of techniques for recording and analysis. AB - Sonography, or the graphic recording of sounds, has been proposed as an objective measure of various pathological conditions in the temporomandibular joint. Various electronic devices have been developed to enhance our ability to auscultate the joint, monitor the timing of the sounds with jaw movement, and analyze the characteristics of the sound; the intent of these devices is to diagnose the intracapsular condition "objectively." This review paper critically evaluates the advantages and limitations of this technique. Based on the existing literature, these instruments can record sounds; however, the origin of these sounds is uncertain, since room noise, skin and hair sounds, respiration, arterial blood flow, and cross-over noises from the opposite TMJ have not been excluded as possible artifacts of the recording. More important, the diagnostic specificity, as an indicator of each type of TMJ disease, has not been clearly and consistently demonstrated with the sonographic technique. PMID- 2700756 TI - "O" ring coping attachment for a telescopic prosthodontic appliance. PMID- 2700757 TI - History of the turbine dental handpiece. PMID- 2700758 TI - Stress--in sickness and in health. PMID- 2700759 TI - Modifying stress in cardiovascular patients: nursing intervention. PMID- 2700760 TI - Clinical application of relaxation, imagery, and music in contemporary nursing. PMID- 2700761 TI - [Use of implants and ankylosed teeth in orthodontics. Review of the literature]. AB - The clinical use of artificial implants or ankylosed teeth as orthodontic anchorage has been reported in the literature. The aim of this paper is to review the published material as a base for the development of the technique. PMID- 2700762 TI - [Guided tissue regeneration: ultrastructure of membranes and review of the literature]. AB - Guided tissue regeneration is an innovative new technique designed to encourage healing of the periodontium by blocking out gingival epithelium and connective tissue from the healing wound. The various types of membranes used in guided tissue regeneration are described and a scanning electron microscopic study of the membranes is presented. PMID- 2700763 TI - Stress dividers in posterior fixed prosthetics. PMID- 2700764 TI - [A roll of silicone sponge as an encircling element in the treatment of retinal detachment]. AB - Presented are the results of treatment of more severe retinal detachments (82 eyes); in which a fragment or fragments of a silicone sponge roll encircled the eye ball performing a role of an extrascleral invaginating implant. The anatomical reattachment of the retina was achieved in 85% of cases (70 eyes). Misting of the vitreous (17%) was the more substantial early complications; it passed after a general application of antibiotics. PMID- 2700765 TI - [Results of the treatment of retinal detachment by intrascleral buckling using the Schepens method]. AB - Fifty two patients (53 eyes) with retinal detachment were operated by Schepens' method with the intrascleral silicone implantation technique, differing from the classical Schepens' method particularly in cerclage operations. The tightening band nearly along its total course (except of the rectus muscles) runs intrasclerally. The authors achieved an anatomical reapposition in 79% of operated cases. PMID- 2700766 TI - [Evaluation of the cryosurgical treatment of retinal detachment]. AB - The authors present the results of retinal detachment surgery by means of cryopexy and Arruga's cerclage of the eye ball. Among 267 operated patients a favourable result has been obtained in 220, i.e. in 82.4%. A repeated retinal detachment in the late postoperative period occurred in 9.5% of the patients. PMID- 2700767 TI - The existence of a platelet-activating factor (Paf-acether)-like substance in blister fluid derived from patients with bullous pemphigoid as demonstrated by human platelet aggregation techniques. AB - We investigated the presence of a platelet-activating factor-like substance in blister fluid obtained from patients with bullous pemphigoid. Human platelet aggregation activity was present in blister fluids obtained from 4 out of 6 patients with bullous pemphigoid and in blister fluids obtained from 3 cases with contact dermatitis. Platelet aggregation activity of pemphigoid blister fluids was inhibited by pretreatment with lyso-PAF, which is a precursor metabolite of platelet activating factor. The activity of blister fluids obtained from patients suffering from contact dermatitis was not inhibited by precursor. Blister fluid obtained from burn lesions and blisters of normal skin induced in the suction revealed no platelet aggregation activity. These results suggest that platelet activating factor or a similar substance is present in the blister fluid obtained from suffered bullous pemphigoid. PMID- 2700768 TI - [Head posture in orthodontics: physiopathology and clinical aspects 2]. AB - The Authors review in orthodontic respects present knowledges about head posture involvement in craniofacial morphogenesis and pathology. Relationships between craniofacial morphology, craniocervical posture, craniomandibular posture, cervical spine curvature, hyoid bone position and posture of whole body in space are shown, in attempt to explain conditions such as "forward head posture", mouth breathing and some occlusal disorders. Main methods to evaluate craniocervical relations on lateral skull radiographs are analysed. Pathogenesis of pain syndromes associated with abnormal craniocervical and craniomandibular mechanics are also briefly treated. PMID- 2700769 TI - [Haemangiomas. Review and case reports]. AB - After reviewing the literature on haemangioma and vascular malformation, two cases of the latter condition are presented. A 40-year-old father shows a facial lesion and his 15-year-old son one of the tongue, the latter seemingly decreasing in size over the years. Because a vascular malformation, surgically removed, was present in the neck of the father's sister, a genetically (not Y-linked) determined coincidence is questioned. In studying its inheritance, the expression and penetrance of the anomaly has to be taken into consideration. PMID- 2700770 TI - [The development of the dental profession in The Netherlands in the beginning of the 19th century]. AB - In 1798 the French occupational forces in the Netherlands abolished all guilds. This created a vacuum for the Dutch dentists in the field of dental education, examination and controlling the dental practitioners, because this belonged to the task of the guilds. New legislation in 1804 filled this vacuum only partially and until 1865 there was no sufficient legislation for the dental profession. A brief survey about the social and educational situation of the profession can give the beginning of an answer to the question why the legislation payed no attention to the dentists. In 1865 dentistry became a part of general medicine and could only be practiced by physicians. In 1876 a threatening shortage of dentists resulted in a new law in which the dentist again received his place in health care. In the same year the first dental school in the Netherlands was founded and from that time the dental profession started to develop. PMID- 2700771 TI - [Dental treatment need of the edentulous patient]. AB - The gradually decreasing percentage of adults wearing complete dentures in The Netherlands might easily lead to misunderstandings concerning the future prosthetic treatment need. If the percentage edentulous people aged 65 years and older, for example, would be the same as in 1983, then as a consequence of the ageing of the population, the number of edentulous persons in 2020 will be 2.3 million (in 1983: 1.4 million). It is, therefore, concluded that the prosthetic treatment need will not diminish in the next 40 years, but probably will increase strongly. PMID- 2700772 TI - [Dimensional accuracy and stability of the complete denture impression tray]. AB - When recording final impressions for complete dentures, the dimensional stability of the tray material is of significance for the final result. The aim of this study was to measure the dimensional changes in different tray materials prior to and after border moulding. Self-curing acrylic, thermoplastic acrylic and shellac were measured at fixed intervals with the aid of a measuring microscope. The trays were constructed on metal master models with respectively nine reference points for the upper tray and eight points for the lower tray. Self-curing acrylic produces the most contraction as a function of time, followed by thermoplastic acrylic. Shellac exhibits the least contraction c.q. dimensional change. Thermoplastic acrylic material proved to be the most stable after border moulding. Shellac was totally unreliable due to the major changes following border moulding. PMID- 2700773 TI - Pharmacologic provocation and dexamethasone suppression test sensitivity. AB - In expectation of improving sensitivity, the standard 1-mg dexamethasone suppression test (DST) was given to 10 depressed inpatients and repeated with theophylline or caffeine and again following 3 days of lorazepam with abrupt discontinuation. Two patients showed nonsuppression on the standard DST; 2 suppressors changed to nonsuppression after lorazepam discontinuation, and 1 also changed after theophylline. This increase from 20 to 40% sensitivity remains significantly less than a desirable minimum 80% sensitivity (p less than 0.001), which suggests that a consistent DST sensitivity of 80% in melancholia is unlikely to be attained. PMID- 2700774 TI - Efficacy of tianeptine in anxious-depressed patients: results of a controlled multicenter trial versus amitriptyline. AB - 265 adult outpatients with dysthymic disorder (DSM-III) associated with clinically manifest anxiety (according to FDA criteria) were included in a multicenter, randomized double-blind study. The trial consisted of three phases: placebo pretreatment phase and inclusion in the trial, treatment phase, placebo posttreatment phase. Patients were treated in monotherapy for 42 days with a mean dosage of 3 tablets per day corresponding to 37.5 mg/day of tianeptine or 75 mg/day of amitriptyline respectively. The following assessment instruments were used: the Montgomery and Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HARS), and the Check-List for the Evaluation of Somatic Symptoms of J.D. Guelfi and C.B. Pull (CHESS 82). Analysis of MADRS total scores showed an important and rapid improvement in tianeptine and amitriptyline groups, reaching statistical significance as soon as D7. At the end of the 6-week treatment period the tianeptine group reached a decrease of 64% in the initial MADRS total score versus 69% in the amitriptyline group. 78% of patients treated with tianeptine and 83% of patients treated with amitriptyline were considered as treatment responders. There was no difference in drop-out rates between the two groups. HARS scores showed a decrease in psychic as well as somatic anxiety in both groups. The action of tianeptine on anxious-depressive symptomatology was confirmed by the concomitant improvement of global clinical rating and patients' self-rating (HSCL). Statistical comparison of all clinical rating-scale scores in patients having completed the trial failed to show any significant group differences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700775 TI - Effects of captopril on locomotor activity, passive avoidance behaviour and spatial memory tasks in the trimethyltin-treated rat. AB - The potential neuroprotective/cognitive enhancing actions of captopril were investigated in the trimethyltin (TMT)-induced neurotoxicity rat model. Acute exposure to TMT produces alterations in locomotor activity, passive avoidance behaviour and spatial memory tasks. Captopril treatment given in combination with the single acute injection of TMT reversed the deficits in spatial memory tasks in 8 out of 25 trials. While post-treatment of TMT-treated rats with captopril brought about a significant improvement in 3 out of 25 trials, pre-treatment of rats for 3 weeks with captopril did not reverse the behavioural deficits produced by TMT in the Morris maze test. Captopril treatment did not block the characteristic hyperactivity or the deficits in passive avoidance behaviour of TMT-treated animals. PMID- 2700777 TI - The expression and function of a Bacteroides gingivalis hemagglutinin gene in Escherichia coli. AB - Eight Escherichia coli JM 109 transformants generated from a clone bank of Bacteroides gingivalis 381 genomic DNA, were found to express B. gingivalis antigens. Quantitation of antigen expression by ELISA indicated that isopropyl beta-D-thiogalactopyranoside (IPTG) was not necessary for antigen expression for any of the clones but that expression in 2 of the clones, ST 2 and ST 3, was increased in cells grown in the presence of IPTG. Western blot analysis revealed that the expressed protein of clone ST 2 has a molecular weight of 125,000 Dal. and that clone ST 3 contains multiple bands of 30 to 50 kdal which react with the anti-B. gingivalis antiserum. Three of the transformants were found to agglutinate sheep erythrocytes. Polyclonal monospecific antiserum to one of the transformants, clone ST 2, was found to react to 2 major bands of MWs 43,000 and 38,000 and minor bands of 115,000, 105,000, 32,000, and 30,000 Dal. present in B. gingivalis cell lysate preparations. Adsorption of anti B. gingivalis antiserum with cells of clone ST 2 reduced the hemagglutination inhibition activity of the antiserum 4-fold whereas antiserum to the clone itself inhibited B. gingivalis hemagglutination at a titer of 8 times that of normal rabbit serum. Immunoelectronmicroscopic studies using the antiserum to clone ST 2 indicate that the product of the cloned gene (hemagglutinin) is located on the B. gingivalis cell surface. A restriction map generated of the cloned B. gingivalis DNA fragment confirms the insert to be 3.2 kbases and indicates the possibility of a repeated sequence in the fragment. PMID- 2700776 TI - Immunocytochemical alpha-1-antichymotrypsin localization in the experimental brain tumors and at their periphery. PMID- 2700778 TI - Transfer of plasmid pE5-2 from Escherichia coli to Bacteroides gingivalis and B. intermedius. AB - A unique shuttle plasmid, pE5-2, previously constructed to mediate gene transfer from Escherichia coli to colonic Bacteroides spp. has also been transferred via conjugation from E. coli to isolates of Bacteroides gingivalis and B. intermedius. The transfer occurred at a frequency of 1.4 to 2 x 10(-7) per recipient. The presence of the plasmid in transconjugants was verified by hybridization of the total DNA of B. gingivalis recipients with sequences of the pE5-2 plasmid, as well as by standard plasmid isolation techniques. PMID- 2700780 TI - The history of cavity preparation in dental schools in North America. PMID- 2700779 TI - A comparison of antibody levels to Bacteroides gingivalis in serum and crevicular fluid from patients with untreated periodontitis. AB - The levels of IgG antibody to Bacteroides gingivalis were measured in serum and sequential samples of crevicular fluid from healthy and diseased sites in patients with untreated periodontitis using ELISA. All subjects had detectable serum titres but there was a wide variation in titre between subjects. Moderate to strong correlations were found between serum and crevicular fluid levels of IgG. A statistically significant difference was observed between sequential samples of crevicular fluid. There was no difference in the level of specific IgG to B. gingivalis in crevicular fluid between healthy and diseased sites within the same individual. PMID- 2700781 TI - Temporomandibular disorders in children. PMID- 2700782 TI - [Prof. Bronislaw Filipowicz]. PMID- 2700783 TI - [Protein kinases and their structural and functional similarities and differences]. PMID- 2700784 TI - [Properties of protein-tyrosine kinases (minireview)]. PMID- 2700785 TI - [The structure and properties of casein kinases]. PMID- 2700786 TI - [Heterogeneity of protein kinase C]. PMID- 2700787 TI - [Protein kinase C and signal transmission in the cell (minireview)]. PMID- 2700788 TI - [The effect of phorbol esters on cell functions]. PMID- 2700789 TI - [The role of protein phosphorylation in the organization of the neuronal cytoskeleton]. PMID- 2700790 TI - [The role of spectrin-like peptides in the regulation of the initiation of protein synthesis in rabbit reticulocytes]. PMID- 2700791 TI - [The effect of postsynthetic phosphorylation on the structure and function of histone Hl in the chromosomes (minireview)]. PMID- 2700792 TI - [Mechanism of transphosphorylation in the catalysis of nonspecific phosphomonoesterases]. PMID- 2700793 TI - [Separation of phosphoproteins on immobilized iron ions]. PMID- 2700795 TI - [Identification of teeth in anthropology]. AB - Since the nineteenth century, the science of Anthropology, and consequently Odontology as well, has been strengthening with the increasingly varied discoveries which day to day are accomplished in its field. As time advances, anthropologists engage in a lively competition to unearth ever more ancient fossil evidences of what were presumably the direct ancestors of genus Homo sapiens. This paper deals with the identification and tracing of such fossil dental components from the anthropological standpoint. PMID- 2700794 TI - [Molecular polymorphism of collagen: collagen types VI-XII]. PMID- 2700796 TI - [Use of the computer in the dental office]. AB - Remote as it once seemed that dental surgeons would some day be interested in introducing computers in their daily practice, the degree of motivation now increasingly impulsing dentists to apply this technology in their offices is indeed amazing. The object of this article is to offer some helpful information to those who are contemplating or have recently adopted the computer in their dental practice. PMID- 2700797 TI - [An in vitro evaluation of the antimicrobial effect of auxiliary agents in the instrumentation of root canals]. AB - An in vitro evaluation of the antimicrobial effect of some substances employed during the instrumentation phase in endodontics, was performed. Agents subjected to study were: AMOSAN, RC-PREP and LARGAL ULTRA. The last two possess chelating properties. Microorganisms used were: Staphylococcus aureus, Staphylococcus salivarius, Streptococcus salivarius, Escherichia coli, Staphylococcus faecalis and Candida albicans. Evaluations were performed after 24 and 48 hours, and did not reveal any bacterial growth in any of the cultures. PMID- 2700798 TI - [Importance of biopsy in dental practice 2]. AB - Biopsy is a valuable aid in oral clinical diagnosis; it consists of obtaining a specimen of living tissue in order to study its structure, both macro and microscopically. This procedure makes it possible to confirm or deny a diagnosis, as well as to determine the nature and characteristics of the lesion and to establish a final diagnosis. Oral biopsy is a simple procedure, which in most cases can easily be performed by the odontologist. Indications and contraindications are relative. In general terms, the following criteria are candidates for biopsy: suspicious lesions present in the area, any tissue removed for any reason, and positive exfoliative cytology. As to contraindications, it is usually advisable to avoid biopsies on necrotic areas, as well as incisional biopsy of pigmented lesions. Methods most often used for obtaining a biopsy include: excisional, incisional and transoperatory, always following certain principles for obtaining a representative specimen. PMID- 2700799 TI - [Current status of esthetic dentistry]. AB - In aesthetic odontology with adhesive materials, a close liaison between manufacturers and dentists is a much-needed prerequisite. Now more than in the past, when restorations were done on nobler materials, techniques and procedures involving composite materials must be performed with extreme precision, since such techniques are very sensitive. PMID- 2700800 TI - [The bone system and weightlessness]. PMID- 2700801 TI - Measurement of negative symptoms in schizophrenia. AB - This article focuses on the measurement of 'negative symptoms'. Standardized scales used to rate negative symptoms are reviewed and compared, as are the individual items which comprise them. The overlap of negative symptoms, akinesia, and depression is explored, and means are suggested to improve the precision of defining and measuring negative symptoms. Flat affect is the only item present in all negative symptom scales and may overlap with depression and akinesia. Inappropriate affect and attentional disturbance should not be considered negative symptoms. Poverty of speech and anhedonia lack unified definitions, and in some scales, they can also be confounded with depression and akinesia. The psychometric properties of most scales have not been sufficiently studied. The lack of long-term studies of stability of the supposedly enduring negative symptoms is especially worrisome. Carpenter's deficit syndrome consisting of non secondary negative symptoms lasting more than one year is a promising new step to try and address some of these problems. PMID- 2700802 TI - The sexual differentiation of social play. AB - Sex differences in social play are quantitative and not qualitative, referring to frequency and not the form of the behaviors. Whereas increased perinatal exposure to exogenous testosterone masculinizes social play, experimental manipulations of androgen levels after this period (i.e. following critical periods for neuronal differentiation) apparently have no effect on the expression of social play. This effect appears to involve, at least in part, androgen receptor occupancy in the amygdala. In the rat, there is a prominent sex difference in nuclear-bound androgen receptors in the amygdala during the sensitive period for the masculinization of play-fighting. Moreover, testosterone implants directly into the amygdala during this period masculinize social play in females. Progesterone exposure reduces play-fighting in male rats, as does corticosterone. This latter effect may be mediated by corticosteroid receptors in the limibic brain. Perinatal androgen exposure may also be important in humans, since girls born with congenital adrenal hyperplasia diagnosed and treated at birth still show male-like patterns of play. Theories concerning the function of sex differences in social play emphasize either the social or motor learning functions. Juvenile male primate social rank correlates with number of peer social interactions, which predominantly take the form of play-fighting. Females on the other hand appear to spend less time play-fighting and spend more time waiting and competing for interactions with infants, i.e. play-mothering, whereby they acquire the motor skills necessary for handling infants. Such differences may reflect socio biological and developmental cascades that are, in some way, initiated by perinatal hormonal events. PMID- 2700803 TI - Gingival crevicular fluid analysis as an adjunct in periodontal diagnosis: case review. PMID- 2700804 TI - Magnets in dentistry. PMID- 2700805 TI - Assessment of periodontal disease progression: application of new technology to conventional tools. PMID- 2700806 TI - Phenomenological questions about obsession and delusion. AB - The problem of the relationship between obsession and delusion is dealt with from descriptive, anthropoanalytical and purely phenomenological points of view. The main differential aspects are focused. The phenomenological concept of the progressive fading of the 'feeling of Ego activity' is proposed as the functional bias at the basis of the continuum linking obsessive symbolic awareness to delusional perception. PMID- 2700807 TI - Improved esthetics for anterior removable partial dentures: a case report. PMID- 2700808 TI - Inflammatory control: theory and practice. PMID- 2700809 TI - Root canal therapy and post and core fabrication--a single-visit technique. PMID- 2700810 TI - Transmission of disease in dogs by toothbrushing. PMID- 2700811 TI - Comparative evaluation of three resin inlay techniques: microleakage studies. PMID- 2700812 TI - Parallel soldered pins for improved macromechanical retention of adhesive fixed partial dentures--procedures and clinical experiences. PMID- 2700813 TI - Intramucosal inserts--time for a reevaluation? PMID- 2700814 TI - The effect of dentinal pretreatment on microleakage in Class V composite resin restorations with two dentinal adhesive systems. PMID- 2700815 TI - Tube impressions: an alternative technique for taking difficult crown and bridge impressions with minimal gingival trauma. PMID- 2700816 TI - Comparative microleakage study between the sandwich and conventional three increment techniques. PMID- 2700817 TI - Clinical techniques for intraoral repair of fractured porcelain when metal is exposed. PMID- 2700818 TI - A light cured resin for precision plastic dowels and cores. PMID- 2700819 TI - The esthetic hybrid resin-bonded bridge. PMID- 2700820 TI - Retentive strength of anterior etched porcelain bridges attached with composite resin: an in vitro comparison of attachment techniques. PMID- 2700821 TI - [Technic for remounting complete dentures]. PMID- 2700822 TI - [Can flame silanization change dental alloy joints?]. PMID- 2700823 TI - A three part sectional denture. AB - A case is described in which a three-part sectional denture design was used to overcome the problem of severely instanding lower premolar and molar teeth. The design combined the use of a two-part cobalt-chromium lingual plate bolted together by an anterior flange which replaced missing lower anterior teeth. PMID- 2700824 TI - The unstable lower full denture--a practical and simple solution. AB - Advanced resorption of the mandibular residual ridge produces a flat or even concave base, which is characteristic of the "difficult lower jaw". The provision of dentures for such patients using conventional techniques often leads to an unstable and unsatisfactory result regardless of the accuracy of the fit of the denture base. PMID- 2700825 TI - The current status of composite materials and adhesive systems. Part 1: Composite resins--review and recent developments. AB - This series of articles reviews the current status, clinical techniques and developments in tooth coloured restorative materials and adhesive systems. PMID- 2700826 TI - [Mechanical instrumentation]. PMID- 2700827 TI - [Technical method for isolation and counting of leukocytes in the gingival sulcus]. AB - A new technique for cell counting, which allows to determine the concentration of leukocytes in the internal gingival sulcus, is presented. A method of extraction of fluid from the sulcus, with micropippetes, is used. Concentration of leukocytes is determined by the application of the technique of New Bauer chamber. This method has been already applied, successfully, in two investigative works. PMID- 2700828 TI - Concerns of noise and visible light exposure in the dental environment. PMID- 2700829 TI - Bruxism in prison. PMID- 2700830 TI - [Current types of ceramics available or in use]. AB - For years, dental profession tried, to find an ideal material and technique, for improving esthetic and functions. The use of porcelain fused to metal crowns, offered the opportunity to build up esthetic crowns on anterior and posterior teeth; however the metal substructure of porcelain fused to metal crown prevent us in many cases to achieve an ideal esthetic, as far as translucency is concerned. The ceramic built up on an alumina core, and the new castable ceramics seam to eliminate this problem, but the laboratory procedures are time consuming and complex, and their mechanical strength are still questionnable. PMID- 2700831 TI - [Cervical limits and contour forms as a function of material technology]. AB - The objectives of tooth preparation for porcelain crowns are emphasized in this article. The forms of contour described by Gonon, LE Huche, Poggioli and Leibowitch are reviewed in the first part. In the second part, the profile of the cervical limits and their evolution are described, according to the materials used. The importance of the marginal fit, in relation to microleakage and esthetics, is related in the third part. PMID- 2700832 TI - [Codification of kinematic properties of prefabricated precision attachments]. AB - In classifying by numbers their fundamental movements, one can expect, on the basis of certain principles, to give with precision the kinematic proprieties of a particular attachment. This method to describe prefabricated attachment, is concise, clear, explicit and comprehensive internationalLy. It facilitates the choice of attachment and allows further mutual understanding between practionner and technicians. PMID- 2700833 TI - [The encyclopedia of Etienne Binet (1621), medicine and dentistry]. AB - This jesuit, humanist devotee is the author of many spiritualism written works and of an "Essay des Merveilles de Nature" (Essay on Nature's Marvels), original book of personal observations. Concerning Odontology, BINET still belongs to Middle-Age, failing to recognize anatomy and esthetics, in spite of Renaissance. PMID- 2700834 TI - [Oral manifestations of acquired bullous dermatoses]. AB - The authors suggest studying the principal oral manifestations of acquired bullous dermatosis, such as malignant pemphigus, bullous pemphigoid, cicatricial pemphigoid, bullous polymorphe erythema, pluri-orificial ectodermosis, Lyell's syndrome, bullous toxidermia, bullous lichen planus and porphyria. These diseases will be described for the following aspects: clinical manifestations, diagnosis, evolution and treatment. PMID- 2700836 TI - [Computer assisted cephalometry: a program of unedited specifications]. PMID- 2700835 TI - [Gemination of a maxillary lateral incisor: report of a case and review of the literature]. PMID- 2700837 TI - [Conservative treatment of a globulomaxillary cyst]. AB - The successful treatment of a cystic lesion identified as a globulomaxilary cyst determined a revision of the literature on this type of cysts. The final conclusion, based on clinical and histopathological data from leading authors, is that the so-called globulomaxillary cysts are not anymore considered a separated clinical or pathological entity. PMID- 2700838 TI - [Compression indicator paste. Its role in diagnosis]. PMID- 2700839 TI - Prosthodontic management of head and neck cancer patients. PMID- 2700840 TI - Total mesencephalic "locked-in" syndrome. A case report and review of the literature. AB - A 63-year-old man suddenly fell in a state of apparent coma. An electroencephalogram (EEG) performed at a local hospital revealed the maintenance of a reactive alpha rhythm over the posterior regions of the scalp, allowing a diagnosis of alert coma. The persistence of minimal degrees of alertness and ability to communicate made the clinical picture classifiable as a "locked-in" syndrome (LIS). Bilateral ptosis and complete ophthalmoplegia oriented towards a total mesencephalic form of LIS. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain showed pathological findings at mesencephalic level. Such findings were insufficient to explain the clinical picture. PMID- 2700841 TI - [Lennox-Gestaut syndrome: therapeutic aspects]. AB - The Lennox-Gastaut Syndrome is one of the most refractory form of epilepsy and a variety of compounds, such as traditional antiepileptics, "new anticonvulsants" and non-anticonvulsant drugs has been tested. ACTH and, among the traditional antiepileptics. Clonazepam and Sodium Valproate showed the most favorable effects. The immediate (within 6 months) therapeutic response to ACTH and Clonazepam is satisfactory, with a more than 50% reduction of seizures in about one half of patients; after one year, however, only a small percentage of cases (7-10%), rather close to that with spontaneous remission, shows some therapeutic benefit. Valproate, when used as a single drug, produces a decrease in seizures (greater than 50%) in 25-30% of pts. A list of compounds, such as amphetamine, taurine, amantadine, allopurinol and, among the new putative antiepileptics, cinromide and gamma-vinyl-GABA, has been tested with some occasionally observed improvement in seizure control. None of these compounds, however, is of really proven efficacy. An acquired general rule of treatment is to avoid complex polypharmacy and overdose; there is in fact good evidence that making the child drowsy will greatly increase the number of fits. PMID- 2700842 TI - What financial resources are available for ventilator dependent quadriplegics who have no medical insurance and who are not veterans? PMID- 2700843 TI - Detection of Plasmodium falciparum using a cloned DNA probe: a simple procedure suitable for field application. AB - A simple procedure was developed for spotting blood samples directly onto nylon membrane filter, without the necessity to treat samples with pronase or proteinase K, followed by hybridizing with 32P-labelled DNA probe, pUNK1-45. This probe detected specifically P. falciparum DNA and did not cross react with DNA from man, P. knowlesi, P. chabaudi or P. cynomolgi. The probe was sensitive to detect a parasitemia of 0.001% in 20 microliters of blood. PMID- 2700844 TI - Dot-immunobinding assay (DIBA) with integral Plasmodium falciparum as antigen in immuno-diagnosis of falciparum malaria. AB - Among the available immuno-diagnostic methods of parasitoses, dot-immunobinding assay (DIBA) has been proved to be promising for its high sensitivity and specificity, easy performance, lack of need of special equipment, and consequently its practical usage in field work. In previously reported tests, soluble antigen was used, thus a sonicator and an ultracentrifuge were required to produce the antigen. This paper reports the application of integral P. falciparum as antigen in DIBA to detect antibodies in falciparum malaria cases. Of 52 sera from falciparum malaria patients tested, 49 (94.2%) showed positive reactions, which was similar to the result using soluble antigen in DIBA (96.2%) and was higher than that in IFA (86.5%) and ELISA (80.8%). No false positive was revealed in 48 control sera from healthy individuals and sera from visceral leishmaniasis, paragonimiasis, fasciolopsiasis and schistosomiasis patients. PMID- 2700845 TI - Isolation of dengue viruses from hospitalized patients in the Philippines, 1983 1986. AB - Between 1983-1986, 336 strains of dengue virus were isolated from 1,911 patients who had been hospitalized with clinically suspected DF/DHF in Manila and nearby areas. Multiple serotypes were present every year. Although DEN 3 was the most common serotype isolated (40%) over the entire study period, DEN 2 and DEN 1 were more frequently isolated in 1983 and 1984, respectively. DEN 4 was consistently the least common serotype recovered. During 1984, geographic differences in the pattern of serotypes isolated were found for two heavily populated areas located only 70 km apart. A higher proportion of DEN 2 isolates were recovered from patients with gastrointestinal bleeding compared to DEN 1 and DEN 3. A higher proportion of DEN 1 and DEN 3 isolates came from patients experiencing a 1 degree infection compared to DEN 2, and the mean homologous HI antibody titer of the sera that DEN 2 was isolated from was significantly higher than the homologous titers of sera from which DEN 1 and DEN 3 were isolated. PMID- 2700846 TI - [Prosthetic rehabilitation of a young patient after surgical-radiation treatment]. AB - The surgery and radiumtherapy injuries able to reduce neoplastic lesions can determine very dreadful deformities on the younger patient's face. The peculiar treatment aim at achieve a real and sure abridgement of the aforesaid chronic lesions. To hit this target is necessary a therapeutic plain carry out, in fallow periods, by no a single but a whole of specialized doctors. The Authors report a very interesting observation concerning a very younger boy that, following a personal method, had reached a very well adaptations of the present injuries. PMID- 2700847 TI - [Current trends in therapy of periodontal disease]. AB - A comprehensive literature review on biological principles guiding present research lines of Periodontal Therapy has been carried out, focusing mainly on the repair potential of the periodontal tissues. PMID- 2700848 TI - [Antiinflammatory drugs in periodontology. Therapeutic perspectives]. AB - The authors, through a critical review of the literature, describe the effects of antiinflammatory drugs on periodontal disease as they result from experimental trials and epidemiological observations. Furthermore the authors emphasize the possible application of such pharmacological substances in the near future as an additional instrument in the therapy of periodontal disease. PMID- 2700849 TI - [The effect of plasma nitriding on tungsten burs]. AB - The authors have experimented the nitriding's effects on some cilindrical burs carbide utilized in dentistry after disamination on the applications methodics on plasma nitriding in neurosurgery, orthopedic surgery and in odontotherapy. This reacherys point out that nitriding plasma a durings increase and cutis greater capacity establish. PMID- 2700850 TI - [Scanning electron microscopy evaluation of wear of turbine rotary instruments]. AB - A wear test was conducted to evaluate carbide and diamond dental burs, in air turbines at 400,000 r.p.m., by using a dentine-enamel substrate. There is less variability within each bur type. All of the burs showed a decreased ability to make a standard cut with succeeding trials. Generally, a linear dulling rate was observed with a progressive reduction of cutting effectiveness, except for middle grain burs, that showed better characteristics among tested burs. PMID- 2700851 TI - A one-year study of short span resin bonded fixed bridges. PMID- 2700852 TI - [Experimental study of the effect of intermediate substances on the margin seal of amalgam restorations]. AB - In the preceding study Class-I-cavities in extracted human molars and premolars were restored using amalgam following diverse pretreatment methods. The teeth were stored in synthetic saliva for 7 days during the short-term test and for 6 months in the extended test. The tightness of the cavity seal was examined using a dye penetration test. The results show that the intermediate substances which may be applied have greatly divergent effects on the tightness of the seal around amalgam restorations. PMID- 2700853 TI - [Indications and materials for fissure sealants]. AB - Due to long-term results with high success rate, pit and fissure sealing is recommended as approved method to prevent caries of pit and fissures. Therefore teeth should be sealed as early as possible--when the tooth can be sufficiently isolated from moisture. The dentist should prefer the approved composite sealers to glass ionomer cements. PMID- 2700854 TI - [Titanium in adhesive bridge technic: adhesive-metal-bond]. AB - The application of titanium as bridge and crown metal suggests itself because of its suitable mechanical qualities and its stability against corrosion. The frequent use in medicine proofs its excellent biocompatibility. Because of the problematical casting requirements titanium has not been used very often in dentistry. As these problems had been solved recently, the question is whether titanium is suitable as resin- bonded bridge material. We compare different surface conditioning systems such as silicoating, tin plating and corrosion. The investigation shows that these surface pretreatments give stable bond strengthes. PMID- 2700855 TI - [Articulator programming with the office computer and the String-Condylocomp LR 2]. PMID- 2700856 TI - [New construction principles for Silicoater-cast maxillary prosthesis]. AB - A problem often seen in the dentist's practice is the relining of a removable Cr Co-prosthesis in the reduced maxillary arch. For this reason we have developed a prosthesis that has its base completely surrounded with acrylic. This modification is nearly as stable as a total Cr-Co-prothesis. The results on 15 patients restored with this new prosthesis were very positive. PMID- 2700857 TI - [Computer-supported analysis of occlusion using T-Scan system. First report]. AB - We got first experiences with a computer-aided apparatus for occlusion-analysis. This apparatus is able to measure times of beginning and pressure of each occlusion-contact by a special foil. There is also the possibility to record functional movements on a film. Each measure result appearing on the screen, can be documented by an installed printer. The T-Scan-System can either be used for diagnosis or for medical attention in all domains of occlusion and articulation. PMID- 2700858 TI - [Plastic prosthesis for tooth gaps]. AB - Long term observations show, that acrylic partial denture find at the abutments with hook clasps cause more trauma to the periodontal tissues and the denture bearing area than other removable partial dentures. In this connection it must be considered, whether the acrylic partial denture being a temporary prosthesis, is planned, prepared and manufactured with the same dental and technical accuracy as a definite removable prosthesis. Presuming that the planning, manufacturing, and the shaping of the acrylic partial denture follows the principles of stabilizing function and periodontal hygiene, less trauma on the structures of the masticatory system and therefore an extended indication seems to be possible. To make this evident, the following essential rules of treatment and design are presented: functional impression of the denture bearing mucosa, bite registration, extension of the prosthesis, clasps and recall. PMID- 2700859 TI - [Slowing of turbine under different pressures (torque)]. AB - A comparative examination of in vivo measured revolutions proves that turbines with torque have a 100% wider usable revolution band than conventional ones. The resulting increased grinding capacity may seen at first sight as a positive effect, but is combined with a more than proportional increasing heat development. Literature, research and own considerations allow the statement, that revolutions used today and the possible pressures make a sufficient cooling of the grinded surface a problem. In order to reduce the recent distinct increase of preparation damages, a reduction of the possible exerted pressure as well as the current level of revolutions must be called for. In the same way as usual in the production industry the optimum rate of grinding capacity to heat development should be determined for each grinding instrument. In this respect not only the turbine is a step into a wrong direction. PMID- 2700860 TI - [Adhesive dentistry in the concepts of the periodontologist]. PMID- 2700861 TI - [Is the T-scan system a relevant diagnostic method for occlusal control?]. AB - The T-Scan system has recently been introduced to the market as a computer-aided device for direct monitoring and documentation of individual occlusal patterns. To receive first assessments of diagnostic relevance of this method, sensitivity and planar resolution capacities of the T-Scan system was tested in an in-vitro study, that showed a lack in the resolution capacity and an excessive variation in sensor sensitivity. Therefore the clinical use of the system is very limited. PMID- 2700862 TI - [Gerber registration with functional impressions--a significant alternative in fabrication of complete denture?]. AB - Gross occlusal discrepancies are noted frequently in complete dentures following registration which often necessities a new set up of posterior teeth. An examination was carried out to determine the extent to which these inaccuracies could be eliminated when a Gerber's registration was carried out with the help of functional impressions. It was found that occlusal relationships in dentures fabricated after registration with functional impressions and TMJ orientated mounting of the models to an articulator, could only slightly be improved as compared to the occlusal conditions observed in dentures fabricated after a manually assisted check bite. However, with regard to the attainment of an accurate and bilaterally balanced articulation, the described method proved significantly superior to an average set up resulting from a check bite. PMID- 2700863 TI - [Comparative analytic occlusal study of clinical use of T-scan systems]. AB - Occlusal corrections are dependent on a precise registration. The T-Scan system has recently been presented to the market as an innovative, computer-aided device, capable of providing exact information regarding position, strength and frequency of occlusal contacts. The diagnostic validity of this technique was tested in a comparing study on 16 patients. The occlusal situation of these patients was analyzed by use of the T-Scan system and the markings compared with those obtained from UV-sensitive articulation foil. The results show that the diagnostic possibilities of the T-Scan system are very much limited. The use oft he T-Scan system as the only means of occlusal analysis cannot be recommended. The main reason for this is an often misleading reproduction of occlusal contacts, caused by the T-Scan-sensor-foil being too thick and too inflexible and therefore creating an uncontrollable shift of the mandibula when closing the bite. However, the T-Scan system seems to be a valuable tool for education of both students and patients, as the on-screen coulour display of occlusal mechanisms are really impressive. PMID- 2700864 TI - [Problems and procedures in ceramic-acrylic bond--ceramic-repair system, Silistor]. PMID- 2700865 TI - [Health and sickness in the mirror of the times]. PMID- 2700866 TI - [Cultural history of dentistry (2). Rough battle for respect and notice]. PMID- 2700867 TI - [Cultural history of dentistry (3 and final). Rough battle of dentist for respect and notice]. PMID- 2700868 TI - [Adhesive bridges routinely?]. PMID- 2700869 TI - [Emperor's illness as a sign of God's anger]. PMID- 2700870 TI - [Nutrition and caries--consensus conference]. PMID- 2700871 TI - [History of treatment of pain]. PMID- 2700873 TI - VIT 75 years! 1914-1989. PMID- 2700872 TI - [Metal ceramics, mechanical bond strength in corrosive solution]. PMID- 2700874 TI - The development of tropical medicine in Leiden. PMID- 2700875 TI - A hospital for seamen and tropical diseases: the role of the Harbour Hospital in Rotterdam in the study of tropical medicine. PMID- 2700876 TI - [Lymph node excision in cancer of the stomach]. PMID- 2700877 TI - [Sexually transmitted diseases: yesterday and today]. AB - A review of the history of the sexually transmitted diseases is outlined, emphasizing the pathways of their diffusion throughout the world, their impact on the sexual customs and the history of the attempts to know their etiopathogenesis before the scientific discoveries of the second half of the 19th century. PMID- 2700878 TI - [Colposcopic evaluation of cervical epithelium during oral contraception. A controlled clinical study]. AB - The Authors report the results of a controlled clinical study by means of colposcopy, cytology and target biopsy on 525 oral contraceptive (O.C.) users and 519 controls. Except for age class 31-35, more iodine dark cervices are found in cases, more iodine light (AnTZ and/or ectropion) in controls. The difference, although not statistically significant, suggests a protective role of O.C. on cervical epithelia. In 34 women (15 cases and 19 controls) CIN has been diagnosed. O.C. users show a more favorable situation, except for ages over 30 exposed to O.C. for less than 24 months. The Authors hypothesize a protective role of O.C. in younger women. While women aged 30 or more still appear protected when exposed to O.C. for more than two years (possibly from younger ages), these results suggest some caution in beginning oral contraception after the 30th year of age. PMID- 2700879 TI - [Epidemiology of spontaneous abortion: a review of the literature]. AB - Spontaneous abortion is the commonest complication of pregnancy. Its reported incidence appears to be constant in developed countries but the frequency of subclinical fetal loss is largely unknown. There is a well known relationship between fetal loss and advancing maternal age. Trisomic fetuses occur more commonly in older women and most are aborted but old women are also at greater risk of aborting a chromosomally normal fetus. Recent epidemiological data have demonstrated a significant association between maternal cigarette smoking and spontaneous abortion. A role of gravidity, early age at menarche, alcohol and methylxanthine consumption has been recently claimed, but epidemiological evidence is scanty and largely controversial. The present paper reviews the epidemiological data on spontaneous abortion. PMID- 2700880 TI - [Onset of and survival in adenocarcinoma of the prostate. Analysis of 48 consecutive cases studied over 10 years]. AB - Four hundred and thirty-eight men with histologically confirmed prostatic adenocarcinoma were diagnosed consecutively and followed up closely for up to ten years. The mean age at presentation was 72.5 years and ranged from 45.3 to 91.0 years. Half of the total presented with symptoms of increasing urinary outflow obstruction and a quarter with acute urinary retention. One fifth of the total were diagnosed incidentally and these men had markedly less risk of progressing to skeletal metastases than those with localised, but clinically detectable disease. Most (60%) had locally advanced or metastatic disease at the time of diagnosis and the prevalence of skeletal metastases was seen to increase with local tumour stage. 40% had skeletal metastases at diagnosis and less than half of these patients survive two years. High grade tumours were associated with poor outcome, with a five year survival of less than 20% when the Gleason sum score was greater than seven. PMID- 2700881 TI - [Therapy of cancer of the prostate in stage C]. AB - For stage C tumors that are not large, radical prostatectomy and immediate hormone therapy are advocated. For very large tumors or those not amenable to complete excision because of tumor location, preoperative hormone therapy for 3 to 4 months is advocated to reduce tumor mass. Thereafter surgery can be performed and hormone therapy continued post-operatively. Because few patients are diagnosed with stage C and D1 tumors in Spain, these cases should be referred to a limited number of hospitals in the interest of acquiring more data and experience. PMID- 2700882 TI - [Use of LHRH agonists in the therapy of advanced cancer of the prostate]. PMID- 2700883 TI - [Diagnosis of the active phase of periodontal disease. 1. Clinical parameters]. AB - Review of the literature shows that the common clinical parameters used in practice are inaccurate in assessing periodontal disease activity. Radiographs and probings are, instead, relatively accurate in retrospectively assessing periodontal disease activity. Currently more sophisticated radiographic techniques are being developed to diagnose ongoing periodontal disease activity. PMID- 2700884 TI - [Use of antibiotics during periodontal disease]. AB - Authors consider the possibility to use antibiotics to control periodontal disease. More used antibiotics are exposed systematically and topically administered. PMID- 2700885 TI - [Saliva: an important factor in retention of complete dentures]. AB - The saliva plays a profound role in a removable prosthodontic treatment in edentulous patients. Indeed the presence of a thin salivary film is essential to the comfort of the mucosa. The saliva also plays pivotal role for the stomatitis of prothesic etiology, found in significant numbers of complete and partial denture wearers. Additionally, saliva in cause in calcolus deposition and in anomalous hue of removable denture. PMID- 2700886 TI - [Effect on cellular and tissue metabolism of induced electrical currents]. AB - The authors give a review of literature about the effects of c.e.i. on the metabolism of the cell and tissue. Particularly are studied the mechanism of action of c.e.i. on the bone metabolism, especially the precipitation of hydroxyapatite and the effects on the vascular system. PMID- 2700887 TI - [Hyperbaric oxygen therapy in the treatment of osteoradionecrosis: a review of its use and efficiency]. AB - In this work, the AA. speak of the use of hyperbaric oxygen therapy in the treatment of osteoradionecrosis, with particular reference to enforcement of this therapeutic technique in the mandibular necrosis caused by irradiation of tumour of cervical-facial region. PMID- 2700888 TI - [Chlorhexidine in the prevention of periodontal disease]. AB - Authors considering microbiological and clinical characteristics of chlorhexidine pointing out its notable capacity to inhibit bacterial plaque formation and analyze possible collateral effects by its use. PMID- 2700889 TI - [Burning mouth syndrome]. AB - The analysis of etiopathogenetic and clinical aspects of burning mouth syndrome, allow to suppose the participation of more factors in the determinism of disease. Consequently, also the therapy, might to require the presence of many specialist. PMID- 2700890 TI - Evidence of acute inflammation in the periodontal ligament subsequent to orthodontic tooth movement in rats. AB - Experimental orthodontic tooth extrusion can result in red cell diapedesis through the PDL vascular wall. Diapedesis is an early sign of acute inflammation. At the ultrastructural level, red cell migration is demonstrated occurring through the endothelial junction of a postcapillary-sized venule. This phenomenon is considered to be indicative of unphysiological tooth loading. PMID- 2700891 TI - [Fixed bonded bridges]. PMID- 2700892 TI - Evaluation of a chairside gingival protease test for use in periodontal diagnosis. AB - Collagen degradation is a major factor in the destruction of diseased periodontal tissues. Evidence from several investigations indicates that this connective tissue breakdown process may be associated with elevated levels of proteolytic activity in gingival crevicular fluid. A rapid, chairside assay for neutral proteases in biological fluids was evaluated clinically for reproducibility and an indicator of periodontal disease status. This colorimetric test is based on the use of an insoluble, covalently linked dye-collagen substrate. Enzymatic activity is monitored by estimating the production of soluble dye-labeled collagen fragments resulting from the action of sample fluid proteases on the test substrate. Gingival fluid samples were collected on three successive days from 366 interdental sites in 34 volunteers, with and without periodontal disease. Results demonstrate that the assay is reproducible with 98.6% of sampled sites remaining stable throughout the 3-day study. Furthermore, the highest percentage of elevated neutral protease activity (NPA) values and the highest NPA values were found in patients clinically diagnosed as having advanced periodontal disease. PMID- 2700893 TI - Sanguinarine and the controversy concerning its relationship to glaucoma in epidemic dropsy. PMID- 2700894 TI - Long-term effects of Listerine antiseptic on dental plaque and gingivitis. AB - Chemotherapeutic mouthrinses are useful adjuncts to normal oral hygiene and regular professional care for patients whose mechanical plaque removal is less than optimal. Recognizing this, the American Dental Association Council on Dental Therapeutics published guidelines for evaluating the safety and efficacy of products for the control of gingivitis. Four 6-month or longer controlled clinical trials have shown Listerine to be significantly effective in helping prevent the development of both supragingival plaque and gingivitis. Two microbiology studies have demonstrated that no resistant microorganisms, opportunistic microorganisms, or presumptive oral pathogens emerge as a result of long-term, daily Listerine use. Listerine is the first nonprescription mouthrinse to receive the Council on Dental Therapeutics Seal of Acceptance as safe and effective in helping to prevent and reduce supragingival plaque accumulation and gingivitis when used in a conscientiously applied program of oral hygiene and regular professional care. PMID- 2700895 TI - Antimicrobial action of sanguinarine. AB - Sanguinarine is a benzophenanthridine alkaloid derived from rhizomes of Sanguinaria canadensis L. (bloodroot). It is a cationic molecule which converts from an iminium ion form at pH less than 6 to an alkanolamine form at pH greater than 7. Sanguinaria extract is composed of sanguinarine and five other closely related alkaloids. The safety profile of both sanguinarine and sanguinaria extract provide a broad margin for their safe use in oral health products. Sanguinarine has broad antimicrobial activity as well as antiinflammatory properties. In vitro studies indicate that the anti-plaque action of sanguinaria is due to its ability to inhibit bacterial adherence to newly formed pellicle, its retention in plaque being 10-100 times its saliva concentration, and due to its antimicrobic properties. The MIC of sanguinarine ranges from 1 to 32 micrograms/mL for most species of plaque bacteria. Long term use of sanguinaria containing toothpaste and oral rinse products does not predispose users to detrimental shifts in oral flora. Electron microscopic studies of bacteria exposed to sanguinarine demonstrate that bacteria aggregate and become morphologically irregular. Sanguinarine-containing slow release polymer systems are currently being developed for use in periodontitis treatment applications. PMID- 2700896 TI - Food allergy. PMID- 2700897 TI - Drug allergy, immunotherapy, immune complexes and anaphylaxis. PMID- 2700898 TI - Allergy testing. PMID- 2700899 TI - The molecular structure of autoantigens. PMID- 2700900 TI - Self-tolerance and localized autoimmunity. PMID- 2700901 TI - MHC genes in HLA-associated disease. PMID- 2700902 TI - Idiotypes and autoimmunity. AB - The reports discussed above have increased our knowledge of idiotypes, mainly with respect to additional CRI on autoantibodies and to a relatively new aspect of 'pathogenic idiotypes'. It is obvious that much remains to be discovered about the normal role of idiotypes and how they might be involved in the pathogenesis of autoimmune disorders. The relationship of the idiotypic network to tolerance is a matter of speculation; tolerance implies the ability to distinguish between 'foreign' and self-antigens and it is important to remember that antibody V regions are also self-antigens. Several mechanisms have been proposed to explain immunological tolerance. Originally, it was envisaged that the repertoires of both T and B lymphocytes were in some way purged of potentially self-reactive clones. However, it is now evident that self-reactive lymphocytes do exist but are normally held under control. Finally, it may be that certain self-antigens are simply never exposed to immune surveillance. It seems that the control of self-reactive lymphocytes is central to the question of tolerance. In the absence of autoimmune disease, autoantibodies can be produced, for example, after many infectious diseases or vaccinations. However, this type of perturbation of the immune system is associated with the short-term production of low titres of low affinity antibodies, generally of the IgM isotype, which are thought to represent germline gene products. Homeostasis is soon re-established, possibly by regulatory T cells interacting with autoreactive B cells through their idiotypic receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700904 TI - Rheumatoid arthritis and related conditions. PMID- 2700903 TI - The pathogenesis of autoimmune diabetes mellitus. AB - There is increasing evidence that both DP and DR BB rats fail to clonally delete autoreactive T cells in the thymus that are important in the development of autoimmune IDDM. The DP BB rat also has a defect in its ability to generate a regulatory (RT6+) T-cell population that would prevent the onset of diabetes and, therefore, it becomes spontaneously diabetic. The DR rat develops autoreactive T cells, but does not express diabetes because of the concurrent development of a regulatory (RT6+) T-cell population. We suggest that in the BB rat, the initial immunological lesion is orchestrated by an APC in close proximity to pancreatic islet beta cells, and may be specifically directed to the beta cell itself. The release of cytokines in the vicinity of the beta cell destroys this highly susceptible target, causing the release of beta cell 'autoantigens'. These autoantigens, in turn, target autoreactive T cells to the beta cells, allowing a focal destructive process to spread throughout the pancreas. The ultimate destruction of the islets and the development of diabetes result from a cascading effect of this process, with the recruitment of other non-specific immune mediators. A similar process may also be initiated by APC within the thyroid of the rat, resulting in thyroiditis. The fact that the thyrocyte does not die is unexplained, but it could relate to the relative insensitivity of this cell type to various cytokines. PMID- 2700905 TI - The role of the MHC and T-cell receptor in susceptibility to multiple sclerosis. PMID- 2700906 TI - Autoimmune thrombocytopenia and AIDS-related thrombocytopenia. PMID- 2700907 TI - Atopic allergy and other hypersensitivities. PMID- 2700908 TI - Autoimmunity. PMID- 2700909 TI - Successful staff meetings call for careful planning, leadership skills. PMID- 2700910 TI - [Mouth diseases and acquired immunodeficiency syndrome]. AB - The purpose of this article is to describe oral manifestations of AIDS, specially opportunistic infections, hairy leukoplakia and Kaposi's sarcoma. Fungal infections, viral infections, salivary glands disturbances and neoplasms are related. Treatment and epidemiology in Argentine are included. PMID- 2700911 TI - [Preventive dentistry--actually more than 100 years old]. AB - The purpose of this study was to show that an intensified prevention in dentistry is not new to the 20th Century, but rather that man for more than 100 years considered the positive influence of prophylaxis on oral health to be extremely important. Three publications from Suersen (1867), Detzner (1830) and Jantzen (1865) document impressively that nothing has changed today with regard to the actuality of the questions and problems they raised. As one reviews these studies, one is astonished what profound knowledge all three authors already had regarding the etiology, origin, and consequences of caries and gingival disease. PMID- 2700912 TI - Effect of microinjected catalytic fragment of protein kinase C on morphological change in Swiss 3T3 cells. AB - Although phorbol esters can enhance formation of an active, catalytic domain of protein kinase C (PKC) in intact cells, little is known about the actual importance of the proteolytic pathway in mediating cellular responses to the phorbol esters or other PKC activators. To explore this issue, we examined the effect of microinjected catalytic fragment of PKC on Swiss 3T3 cell morphology. In contrast to the dramatic, rapid response upon phorbol ester treatment, catalytic fragment microinjected in the presence of bovine serum albumin or normal goat immunoglobulin G as carrier protein had no effect. A morphological response similar but not identical to the effect of phorbol ester treatment was obtained, however, if catalytic fragment was microinjected in the presence of normal rabbit immunoglobulin G rather than the usual carrier proteins. The normal rabbit immunoglobulin by itself was inactive. Although the mechanism remains undefined, normal rabbit immunoglobulin but not other carrier proteins modulated PKC activity in vitro. We conclude that the generation of free catalytic fragment of PKC cannot account for the morphological response of Swiss 3T3 cells to the phorbol esters; secondary factors may, however, potentiate its action. PMID- 2700913 TI - Mechanism of the induction of the differentiation of HL-60 leukemia cells by antifolates. AB - The classic inhibitor of dihydrofolate reductase (DHFR), methotrexate (MTX), has been shown to be an effective inducer of the differentiation of HL-60 promyelocytic leukemia cells (Bodner A.J. et al.; J. Natl. Cancer Inst. 67:1025 1030; 1981). We have obtained evidence that induction of the differentiation of these cells by MTX, as well as by other folic acid antagonists, is the result of the effects of these agents on purine and thymine nucleotide biosynthesis. Thymidine (10 microM) completely blocked both the cytotoxicity and induction of differentiation produced by the specific inhibitor of thymidylate synthase (TS), N10-propargyl-5,8-dideazafolic acid (CB-3717). Thymidine also blocked the acute cytotoxicity caused by MTX and trimetrexate (TMQ); the induction of differentiation and the loss of proliferative capacity, however, were only partially prevented by thymidine. Hypoxanthine (100 microM), which completely restored antifolate-depleted purine nucleotide levels, had no effect on either the cytotoxicity or the induction of maturation produced by these agents. The growth inhibitory effects and the induction of differentiation caused by dideazatetrahydrofolic acid (DDATHF), which acts on de novo purine nucleotide biosynthesis rather than on DHFR or TS, was completely prevented by hypoxanthine. Hypoxanthine also completely prevented the inhibition of cellular replication and induction of differentiation by MTX and TMQ when combined with thymidine. The findings suggest that the depletion of intracellular thymine nucleotide levels by the antifolates, MTX, TMQ, and CB-3717 is the primary event involved in the maturation of HL-60 leukemia cells produced by these agents and that maturation occurs concomitantly with a high level of cytotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700915 TI - Oral and maxillofacial surgery: the state of the art in early medieval Europe. PMID- 2700914 TI - Changes in messenger RNA levels for the subunits of ribonucleotide reductase during the cell cycle of leukemia L1210 cells. AB - Ribonucleotide reductase consists of two non-identical protein subunits that are required for enzyme activity. These subunits are encoded by different genes and are not expressed coordinately as the cells pass through the cell cycle. Using specific cDNAs for the non-heme iron (NHI) and the effector-binding (EB) subunits the levels of the mRNAs for these two subunits were determined in leukemia L1210 cells during the transition from the G0/G1 phase to the S and G2/M phases of the cell cycle. Synchronized populations of L1210 cells were obtained either by ethylene glycol-bis(beta-aminoethyl ether) N,N,N',N'-tetraacetic acid (EGTA) treatment or by enrichment by elutriation centrifugation. The changes in the levels of the mRNAs for NHI and EB subunits were compared with the changes in the levels of the mRNAs for actin, p53, c-myc, thymidine incorporation into DNA, and DNA content by flow cytometric measurements. Synchronization of the cells by the two methods resulted in quantitative differences in the responses. The EGTA synchronized L1210 cells showed maximal increases of 9.3- and 5.7-fold in the mRNAs for the NHI and EB subunits, respectively. The peak level of the NHI mRNA was observed at 12 hr after the addition of calcium ions. The peak increase in the level of the mRNA for the EB subunit was observed between 12 and 15 hr after the addition of calcium ions. The rate of increase for the mRNA for c-myc was greater than the increase in the mRNA for the NHI subunit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2700916 TI - History of maxillofacial prosthodontics. PMID- 2700917 TI - Tooth transplantation: an idea whose time has past. PMID- 2700918 TI - Classics in dental history. Alfred C. Fones--father of the dental hygiene movement. PMID- 2700919 TI - How it evolved. The plugger. PMID- 2700920 TI - Antique book collector's corner. Buchan's domestic medicine. PMID- 2700921 TI - The mandibular prognathism of the Spanish Habsburgs. PMID- 2700922 TI - Surrogate dentist: domestic medical guides and oral health care in the nineteenth century. PMID- 2700923 TI - Is regeneration of the periodontium an achieveable goal? PMID- 2700924 TI - Development of cast-glass ceramics restorations and the effect of topical fluorides on them. A review of the literature. PMID- 2700925 TI - [Retrospective multicenter study on carcinomas of the lips and oral cavity. The role of multiple malignancies]. AB - In a retrospective multicenter study the role of multiple cancer has been assessed in 2481 patients with carcinomas of the lips and oral cavity. In 3.2% of the cases the malignancies developed outside the maxillofacial area. In the majority of cases two malignant neoplasms were found. Most of them were histologically carcinomas. The bronchi and stomach were common localizations in patients with lip carcinomas, whereas patients with oral carcinomas exhibited mainly cancers of the breast, stomach and uterus. Sex-limited multiple cancers associated with oral carcinoma occurred predominantly in women. Surgery is the most common form of treatment. The prognosis for patients with lip carcinomas is significantly poorer when multiple cancers are present. PMID- 2700926 TI - [Congenital melanotic tumors]. AB - Congenital melanotic tumors are among the very rare tumors of early childhood. Their histogenesis and biological significance are still controversial today. The ideas of an odontogenic origin and of a neuroectodermal pathogenesis of these tumors range among the most frequently advocated hypotheses. Until about 1970 this type of tumor was almost always referred to as benign. Meanwhile there has been a change in the assessment of the character of congenital melanotic tumors. Above all, this is due to the fact that malignant cases have been repeatedly reported since 1970. Apart from an extensive review of the literature, 2 own cases are described which were treated surgically. The histological evaluation of the tumor material supports the assumption that these tumors are of odontogenic origin. PMID- 2700927 TI - Francis Hay Thomson--a man of art and science. PMID- 2700928 TI - A Tudor blacksmith's simple dentistry. PMID- 2700929 TI - Dental treatment of the early 19th century: how effective was it? PMID- 2700930 TI - Frederick Breese and the Leigh family. PMID- 2700931 TI - Approaching the asymptote? Evolution and revolution in immunology. PMID- 2700932 TI - TCR recognition and selection in vivo. PMID- 2700933 TI - Implications of the diversity of the immunoglobulin gene superfamily. PMID- 2700934 TI - Selection of lymphocyte repertoires: the limits of clonal versus network organization. PMID- 2700935 TI - Templated, targeted sequence diversification displays a similar choreography in different organisms. PMID- 2700936 TI - Generating binding activities from Escherichia coli by expression of a repertoire of immunoglobulin variable domains. PMID- 2700937 TI - A combinatorial system for cloning and expressing the catalytic antibody repertoire in Escherichia coli. PMID- 2700938 TI - The importance of antigen processing in determinant selection and of the cell membrane as a reservoir of processed antigen. PMID- 2700939 TI - Intracellular colocalization of molecules involved in antigen processing and presentation by B cells. PMID- 2700940 TI - Antigen binding and processing by B-cell antigen-presenting cells: influence on T and B-cell activation. PMID- 2700941 TI - Mutants of HLA-A2 in the analysis of its structure and function. PMID- 2700942 TI - Model for the interaction of T-cell receptors with peptide/MHC complexes. PMID- 2700943 TI - Use of mutants to analyze regions on the H-2Kb molecule for interaction with immune receptors. AB - MHC variants isolated both in vivo (by tissue graft rejection) and in vitro (by antibody selection) were utilized to study sites on the H-2Kb molecule involved in interaction with antibodies and with the TCR. Kb mutants selected by antibodies were found to have single point mutations, which when analyzed in the context of the three-dimensional structure of a Kb molecule modeled from HLA-A2 coordinates showed that the altered residues were localized mostly to the alpha 1 and alpha 2 helices. The side chains of the variant amino acid residues pointed upward and away from the antigenic site. Analysis of the altered amino acids in the previously described tissue-graft-selected Kb mutants showed that the side chains of the variant residues occur either in the alpha-helical regions or in the beta-pleated-sheet floor of the antigen groove, but every mutant contained at least one and sometimes several acid side chains projecting into the antigen binding groove. Monoclonal antibody studies showed that the available monoclonal antibodies mapped to discrete domain-specific sites. Analysis of CTL recognition sites using cloned mutant anti-parent or allogeneic combinations showed that all CTL clones examined interacted with amino acid side-chain residues on both the alpha 1 and alpha 2 helices. Thus, we concluded that the CTLs must simultaneously interact with the amino acid residues in both the alpha-helical stretches of the alpha 1 and alpha 2 domains. Our analyses with the point mutants imply that the TCR must interact with the MHC molecule over a relatively large surface area in such an orientation that it interfaces with the two alpha helices, as well as with the foreign or self-peptide in the antigen-binding site between the helices. These findings, together with the observation that several of the in vivo Kb mutants induce strong alloreactions yet have changes only in the bottom of the antigen-binding groove and no alterations in the alpha-helical residues, are consistent with the hypothesis that in some cases alloreaction can be the result of T-cell recognition of an altered pattern on the MHC molecule due to a changed peptide in the antigen groove. PMID- 2700944 TI - Diversity of class I HLA molecules: functional and evolutionary interactions with T cells. PMID- 2700945 TI - Class I MHC-restricted cytotoxic responses to soluble protein antigen. PMID- 2700946 TI - Molecular definition of a mitochondrially encoded mouse minor histocompatibility antigen. PMID- 2700947 TI - Genes coding for T-cell-defined tum transplantation antigens: point mutations, antigenic peptides, and subgenic expression. PMID- 2700948 TI - Immunosurveillance of virus-induced tumors. PMID- 2700950 TI - How important is the direct recognition of polymorphic MHC residues by TCR in the generation of the T-cell repertoire? PMID- 2700949 TI - Developmental analysis of the mouse hematolymphoid system. PMID- 2700952 TI - Radiologic examination of the swallowing impaired child. PMID- 2700951 TI - Cough, choke, sputter: the evaluation of the child with dysfunctional swallowing. PMID- 2700953 TI - Respiratory consequences of dysfunctional swallowing and aspiration. PMID- 2700954 TI - Dysphagia due to cervical osteophytes: a controversial entity revisited. AB - Although cervical osteophytes have been reported to cause dysphagia, most remain clinically silent. A case of osteophytic dysphagia is reported in which an unusually large osteophytic ridge caused marked deviation and narrowing of the cervical esophagus. The subject of osteophytic dysphagia is reviewed. PMID- 2700955 TI - Physiology of swallowing. PMID- 2700956 TI - Prosthodontic management of swallowing disorders. PMID- 2700957 TI - Making the grade: the history and structure of dental school accreditation. PMID- 2700960 TI - [New concepts in attachments]. PMID- 2700958 TI - Xeroradiography and its application to dentistry. AB - Xeroradiography is a highly accurate electrostatic imaging technique. In this technique a conventional single-phase dental x-ray unit is used as an x-ray source, but instead of a silver-halide film image, a uniformly charged selenium alloy plate housed in a light-proof cassette is used. In this article the equipment, procedure, properties and artifacts related to the xeroradiographic technique are described. An evaluation of the xeroradiographic images is also presented. Xeroradiography, which requires only about one-third of the dose required for conventional radiographs, is a valuable alternative to conventional radiography for detecting carious lesions, calculus deposits and periodontal disease. It is also of value in interpreting periapical structures. PMID- 2700959 TI - Pretreatment: setting up the complicated case for routine treatment. PMID- 2700961 TI - [Aphthae of the oral cavity 2]. PMID- 2700962 TI - [An implant-prosthetic solution to a Class III case]. AB - When the surgeon operates a patient, he must be in a state of absolute serenity with regard to law and his own conscience. This aim can be achieved only when the patient is completely conscious of the type of operation which will be performed, as well as of all possible consequences which may occur afterwards. The balanced occlusion, in restaurations by total subperiosteal technique of serious cases of edentulism of maxillae, seems to be the only possible solution for the duration in time of the two sub-structures. PMID- 2700963 TI - [Cements for fixed prostheses. Traction resistance force]. AB - The cementation is a basic step in the fixed prosthesis rehabilitation. Therefore, it is very important to know the main chemical, physical and biological properties of luting cements. The tensile strength of some dental cements for fixed cast restorations has been studied. Results obtained showed that glass ionomer and zinc oxide-eugenol with Eba are better than the other dental cements. The difference between the data obtained showed to be statistically significant. PMID- 2700964 TI - [Osseointegrated implants. Core-Vent and Screw-Vent]. AB - 51 variously edentolous patients have been treated by placing 143 Core-Vent and Screw-Vent osteointegrated implants. The follow-up ranges from 8 to 20 months. Just one implant was removed. The Authors explain their surgical method and their considerations about the two different kinds of implants. Some clinical cases are reported. PMID- 2700965 TI - [Dentin adhesives and the traction test. Comparative evaluation]. AB - This study evaluated the shear bond strength of six dentinal bonding agents and one unfilled enamel bond in association with a microfilled composite resin. Eight specimens were prepared for each product. All the bonded samples were stored at 37 degrees C for 24 hours in a humidifier. Bond strength was measured with a universal testing machine. A statistically significant difference was found between the various products. The new dentinal bonding agents gave the highest bond value. PMID- 2700966 TI - Osseointegrated implants--principles and practice: 3. Case treatments with the Nobelpharma implant system. AB - In this series of three articles the authors describe some of the principles and practice of osseointegrated implants. Part 1 gave a detailed description of the surgical techniques to establish osseointegrated implants (with special reference to the Branemark system), guidance on patient selection and treatment planning. Part 2 described prosthetic rehabilitation using osseointegrated implant fixtures. This article concludes the series by presenting a number of case studies. PMID- 2700967 TI - Treatment planning for the ageing patient. AB - Proper planning of a course of treatment for the older patient will form the basis of success. Treatment planning is a stringent test of clinical acumen: requiring consideration of what the patient desires, what the patient can tolerate and what can be achieved. In this article the authors outline the principles of treatment planning for the ageing patient. PMID- 2700968 TI - The role of overdentures in gerodontics. AB - As more people keep their teeth later in life, more and more patients in the future will still be partially dentate at an age when, previously, the edentulous state was the norm. The overdenture has a part to play in restorative dentistry for these patients. It can be a relatively simple, inexpensive prosthesis; but, like so many other aspects of dentistry, will provide long-term success only if the patient and the mouth have been assessed with care and a rigorous after-care programme instituted. PMID- 2700969 TI - Osseointegrated implants--principles and practice: 2. Prosthetic rehabilitation with osseointegrated implants. AB - In this series of three articles the authors describe some of the principles and practice of osseointegrated implants. Part 1 gave a detailed description of the surgical techniques required to establish osseointegrated implant fixtures (with special reference to the Branemark system), and gave guidance on patient selection and treatment planning. Part 2 now considers prosthetic rehabilitation techniques with osseointegrated implants for complete dentures, complete overdentures, partial bridges, and single tooth replacement cases. Part 3 will conclude the series by presenting a number of case studies. PMID- 2700970 TI - Global changes in caries prevalence and dental manpower requirements: 3. The effects on manpower needs. AB - A Joint Working Group of the WHO and FDI was formed in 1981 to investigate the dramatic decrease in caries in children and young people that had been observed in a number of industrialized countries in the 1970s. The results of this investigation are reported in this series of three articles. Parts 1 and 2 described the assembly and analysis of all available data on the decrease, and identified the widespread availability of fluoride toothpaste as the most probable cause. Inevitably in developed countries with declining caries incidence there will be a decreased need for dental services, and hence a change in the need for dental personnel. This third article will examine the likely effects on staffing needs and outline a suggested methodology for manpower planning. The lack of adequate data makes prediction a precarious procedure, and this review indicates the urgent need for regular dental health monitoring and better manpower planning in all countries. PMID- 2700971 TI - Microleakage in MOD resin composite with three dentin bonding agents. AB - The extent of microleakage under MOD composites was studied when an aluminum oxalate dentin bonding agent (Tenure), a phosphonated resin bonding agent (Bondlite), and a glass-ionomer cement (Ketac Silver) were used. Three groups of 10 extracted molars were prepared with MOD cavities; one box ended on enamel, the other on cementum. In Group 1, Bondlite was applied to dentin and etched enamel before the sample was restored with a light-cured hybrid composite. In Group 2, a 2-mm increment of Ketac Silver was placed in each box before Bondlite and composite. In Group 3, Tenure was applied to dentin before being restored. Teeth were thermal-cycled, stained in silver nitrate, sectioned, and scored for microleakage. Microleakage along the gingival floor was significantly less at enamel margins than at cementum margins in all three groups. All groups showed severe marginal microleakage on cementum. PMID- 2700972 TI - Dentin smear layer: an asset or a liability for bonding? AB - Despite concerns and claims that the smear layer on dentin is undesirable for bonding, supportive evidence is lacking. The clinical efficacy of various agents for smear layer removal and the effect of smear layer removal on the bond strengths of a glass-ionomer cement and three representative dentin bonding agents were examined. For all but one dentin bonding agent (Gluma), a 15-second treatment with 17% EDTA caused a reduction in bond strength. For Gluma, no significant bond was obtained without EDTA treatment. While Gluma probably bonds via dentinal collagen, the other materials interact primarily with dentinal calcium. Removal of the smear layer for adhesives reliant on the presence of calcium is therefore undesirable. The clinical effects of some agents proposed for smear layer removal were examined by SEM of replicas. PMID- 2700973 TI - Microleakage of indirect composite inlays. AB - The purpose of this in vitro study was to evaluate the microleakage of indirect composite inlays and to compare leakage of inlays with directly placed composite restorations. Standardized MOD preparations were cut in 50 extracted human molars. One gingival margin was placed in enamel above the CEJ, and the other was placed in dentin below the CEJ. Two groups of teeth were directly filled with composites (P-30 and Heliomolar) after being etched, and dentin bonding agents were applied. Two groups of teeth were restored with composite inlays that were fabricated on stone dies. The inlays were made and luted with the same two composites. The last group of teeth was restored with Heliomolar inlays luted with Dual cement. The specimens were thermocycled 300 times between 5 and 50 degrees C. Microleakage was evaluated by use of the silver-nitrate staining technique. The depth of leakage was measured microscopically after the teeth were sectioned. Both direct restorations and inlays showed substantial leakage at gingival-dentin margins; however, there was only superficial leakage at enamel margins. P-30 inlays and Heliomolar inlays cemented with Dual leaked less than direct restorations at the gingival-dentin margins. There was no difference in leakage of enamel margins of inlays and direct restorations, except that direct Heliomolar restorations leaked more than the others. There was no difference in leakage between Heliomolar restorations luted with light-cured or dual-cured cement. PMID- 2700974 TI - Early marginal microleakage in Class II resin composite restorations. AB - The aim of this study was to evaluate in vitro the early marginal microleakage around conventional and sandwich Class II (MOD) restorations. Ten different combinations of dentin bonding agents, glass-ionomer cements, and posterior resin composites were used. Class II cavities were prepared in freshly extracted third molars whose root surfaces had previously been coated. All gingival margins were prepared at the cementum-enamel junction. Teeth were filled by use of a multi incremental technique, finished with discs, and immediately immersed in 2% erythrosin B for 12 h at 37 degrees C. Three transverse sections were made at 0.5 mm, 2 mm, and 3.5 mm over the cementum-enamel margin and evaluated under a stereomicroscope. Microleakage was scored linearly along the dentin/enamel restoration interface. Sections at the cementum-enamel level showed significantly higher microleakage than the other two. Significant differences were observed between the various combinations of materials. Early marginal microleakage in Class II restorations depends not only on filling technique and on dentin bonding systems but also on the resin composite. Glass-ionomer cements significantly reduce early marginal microleakage in Class II restorations. PMID- 2700975 TI - Effects of self-etching primers on dentin. AB - The effects of self-etching dentin primers on the hardness of dentin was evaluated by determination of the Vickers Hardness of both untreated dentin and dentin treated with different primers. Several experimental primers were prepared by dilution of dicarbonates or their esterified salts with different ratios of HEMA to obtain ratios of 5% and 35% by weight. Methacryloxyethyl succinate (MES) and Methacryloxyethyl phthalate (MEP) experimental primers caused less softening of dentin than did maleic acid diluted with HEMA or a commercial dentin primer (Scotchprep, 3M). A high correlation was observed between the pH of a primer and the hardness of dentin treated with the primer. A correlation was also observed between the hardness of treated dentin and the wall-to-wall polymerization contraction of a light-curing microfilled resin (Silux, 3M). PMID- 2700976 TI - Investigation of self-etching dentin primers. AB - In order to simplify the dentin bonding procedures by combining the dentin cleansing and dentin primer steps, we investigated the efficacy of the four acidic monomers--monomethacryloxyethyl succinate (MES), dimethacryloxyethyl phosphate (DMEP), tertiary butylacrylamide sulfonic acid (TBAS), and 4 methacryloxyethyl trimellitic anhydride (4-META), diluted in 35% hydroxyethyl methacrylate (HEMA) solution--by measuring the maximum contraction gap of the visible-light-curing composite (Silux 3M, St. Paul, MN, USA) in the cylindrical dentin cavity mediated by the bonding agent (Clearfil New Bond, Kuraray Co., Osaka, Japan). More than five of the ten specimens which were pre-treated with an aqueous mixture of 35% HEMA and four functional monomers at the concentrations of 0.1 M, 0.2 M, and 0.3 M showed a complete marginal adaptation, and this result was the same as in the control group in which the cavities were cleansed and pre treated with 0.5 M EDTA and 35% HEMA, respectively. Moreover, the procedures were simpler. Therefore, these four monomers are considered to be effective as self etching primers. PMID- 2700977 TI - Microleakage of five dentin bonding systems. AB - Class V preparations were placed in the buccal surfaces of 60 extracted human teeth such that approximately half of the preparations were above the CEJ and half below. The teeth were restored with Gluma/Pekalux, Tenure/Perfection, Scotchbond 2/Silux Plus, XR bond/Herculite XR, and Optec/Pentrafil 2 according to manufacturers' instructions. The sixth set of teeth was restored with a combination of XRbond/Silux Plus. The teeth were thermocycled and stained in silver nitrate. They were then scored for dye penetration. Scotchbond 2 showed the least dye penetration but not statistically less than the XR bond/Silus Plus combination. XR bond/Silux Plus showed significantly less dye penetration than XR bond/Herculite XR. PMID- 2700978 TI - Bonding to resurfaced posterior composites. AB - Despite significant improvements in the wear resistance of posterior composite restorations, they still undergo occlusal wear, color change, and surface staining with time. One method of repairing these restorations is re-surfacing the old composite. This study investigated the bonding of new composite to the corresponding old composite material by several different mechanical conditioning steps, chemical conditioning steps, primer conditioning steps, and four posterior composites. Aged composite surfaces were conditioned, re-bonded to new composite, stored in artificial saliva for seven days at 37 degrees C, and tested in shear. The mean shear strength for unrepaired composites was 27 MPa. Optimal re-bond strengths were 88% (Estilux), 77% (Ful-Fil), 92% (Occlusin), and 102% (P-10) of original bulk shear strengths. General linear modeling revealed that the best combination tested was roughening with a D830 diamond bur, conditioning the surface with water, and priming with Scotchbond-1 dentin bonding agent. PMID- 2700979 TI - When to replace faulty-margin amalgam restorations: a pilot study. PMID- 2700980 TI - Root resorption: a review of the causes and treatment. PMID- 2700981 TI - Managing dental impressions and casts of patients with communicable diseases. PMID- 2700982 TI - Ultrasonic endodontic instrumentation. PMID- 2700983 TI - Use of Branemark system implants for orthodontic anchorage: report of a case. AB - Branemark System implants were used for orthodontic anchorage to correct a cross occlusion relationship between a mandibular canine and a maxillary lateral incisor. PMID- 2700984 TI - Osseointegration: its impact on the interrelationship of periodontics and restorative dentistry. II. PMID- 2700985 TI - Effect of crown margin location on plaque and periodontal health. PMID- 2700987 TI - Clinical management of ceramic brackets. PMID- 2700986 TI - Clinical evaluation of resin bonded retainers. PMID- 2700988 TI - Evaluation of the use of surface electromyography in the diagnosis, documentation, and treatment of dental patients. AB - The use of electromyography as an aid in the differential diagnosis and treatment of dental patients is carefully examined in this literature review. Electromyography has been advocated for the establishment of rest and occlusal positions, and for the detection of muscle hyperactivity and hypoactivity, spasm, fatigue, and muscle imbalance. However, these claims were often based on studies that failed to include a control group when comparing various clinical parameters and EMG activity of the muscles of mastication. When a control group was incorporated, the authors usually failed to match the patients by such variables as age, sex, facial morphology, and history of bruxism. These variables have a significant influence on the level of EMG activity and may account for the high degree of variability observed between groups. Controlled trials evaluating the efficacy of biofeedback using electromyography found significant reductions of diurnal parafunctional activity during treatment, but the low symptom levels were not maintained after cessation of biofeedback. Based upon this extensive literature review, there is no convincing evidence to support the use of electromyography in the diagnosis or treatment of dental patients except in the treatment of parafunction. PMID- 2700989 TI - Sleep-related bruxism and sleep variables: a critical review. AB - Relationships between sleep-related bruxing, electroencephalographic phenomena, and other physiologic variables are reviewed. Bruxing occurs during all sleep stages but occurs disproportionately during stage 2 and REM. Bruxing during deeper sleep stages frequently is followed by a transition to lighter sleep. Bruxing occurs in conjunction with K-complexes in the EEG, tachycardia and peripheral blood volume changes, and gross body movements; however, the exact nature of the relationship between bruxing and "arousal" is unknown. Methodological problems are pervasive. On-line computer-based event recording is called for along with time series analyses of moment-to-moment psychophysiologic data. PMID- 2700990 TI - Temporomandibular joint clicking: a literature overview. AB - In view of the literature, it can be stated that too little is known about the prognosis of TMJ clicking, factors determining the need for treatment, and long term results of therapy. Consequently, there is a need for more standardized research, leading to classification of the various types of clicking and knowledge about changes in the course of time. PMID- 2700991 TI - [Comparative study of efficacy of focal photocoagulation in diabetic macular edema according to the wave length used]. AB - We have studied the efficacy of the different wavelengths in the treatment of focal macular edema of diabetic retinopathy. For this purpose, we evaluated the evolution of visual acuity and that of the eye fundus, six months after the treatment in 20 eyes of 20 patients treated with blue-green argon laser, in 20 eyes of 20 patients treated with monochromatic green argon laser and in 20 eyes of 20 patients treated with yellow dye laser. The best results were obtained in the group treated with yellow Dye laser after six months of follow-up (p less than or equal to 0.05). The efficacy on the reabsorption of exudates was similar for the three types of laser. PMID- 2700992 TI - [Irradiation treatment of choroidal hemangiomas]. AB - Therapeutic results obtained following the treatment of 24 cases of choroidal hemangiomas (21 solitary and 3 in a Sturge-Weber syndrome) treated with 60Co applicators or an accelerated proton beam were analyzed. The observation period was less than 2 years for 4 cases, 2 to 5 years for 10 cases, 5 to 10 years for 7 cases and more than 10 years for 3 cases. Reabsorption of retinal detachment without any recurrency was obtained for all the cases. The V.A. was increased in 16 cases, did not change in 4 cases and decreased in 4 other cases. Final V.A. was 6/7.5 or more in 9 cases (37.5%), 6/60 a 6/7.5 in 6 cases (25%), and 6/60 or less in 9 cases (37.5%). None of the cases we treated presented complications induced by radiotherapy (actinic papillitis, circulatory disturbances in the macular area, or neovascular glaucoma). The comparison of the results we obtained with cases treated by photocoagulation or external radiotherapy demonstrated a slight advantage in favour of the focalized radiotherapy, which is not statistically significant because of the small number of cases included in the studies. Meanwhile, contact radiotherapy and irradiation with an accelerated proton beam seems to be a substantial alternative for the treatment of large hemangiomas and tumors invading the macula. PMID- 2700993 TI - [Clinical aspects of leukemic infiltration of the choroid and the optic nerve]. AB - A case of presumed leukemic infiltration of the choroid and two cases of leukemic involvement of the optic nerve are presented. These complications are rarely observed clinically. Leukemic infiltration of the choroid may cause a serous detachment of the retina, which is often bilateral. The fluoroangiographic aspect is similar to what is observed in acute choriocapillaris occlusion. Leukemic involvement of the optic nerve first appears as papilledema. In more advanced cases the optic disc and the peripapillary retina are covered by a white yellowish infiltrate which protrudes into the vitreous. The diagnosis is confirmed by CT scan of the orbit and the cerebro-spinal fluid often contains leukemic cells. As optic nerve infiltration is often associated with CNS involvement the prognosis is usually poor. Intrathecal chemotherapy has little effect on the intraocular manifestations, which however respond to orbital radiotherapy. PMID- 2700994 TI - Molecular features of the H-2 class I and Qa antigens expressed on Gross virus induced AKR leukaemias. PMID- 2700995 TI - The effect of reinforcing fibres in denture acrylics. AB - Since the early 1970's, various fibre reinforcement systems have been used to enhance the mechanical properties of denture base acrylics. The research conducted to date on fibre reinforcement systems for use with Poly(methylmethacrylate) (PMM) denture base material is reviewed and evaluated. PMID- 2700996 TI - An overview of the osseointegration of dental implants. PMID- 2700997 TI - Complete denture treatment: a case report. PMID- 2700998 TI - "Remembrance of things past". E.W. Mayo. 2. PMID- 2700999 TI - The use of dentinal etching with endodontic bleaching procedures. AB - The removal of the smear layer from dentinal surfaces has been shown to increase significantly the permeability of dentin in both vital and endodontically treated teeth by opening the orifices of the dentinal tubules. This knowledge has led to the practice of acid etching the intracoronal dentin of endodontically treated teeth prior to nonvital bleaching procedures in order to increase the speed and effectiveness of the bleach. In this study extracted human teeth, which had been stained in vitro, were used to compare the effects of dentinal etching of the pulp chambers with no acid etching in conjunction with "walking bleach" procedures. In one experimental group, the pulp chambers were acid etched with 50% phosphoric acid for 1 min to remove the smear layer prior to insertion of the 30% hydrogen peroxide/sodium perborate bleaching agents. The second group had the same chamber preparation except the acid etching was deleted. Evaluators were unable to distinguish a significant difference between the effectiveness of the bleaching procedures in the two experimental groups. PMID- 2701000 TI - Post removal prior to retreatment. AB - Removing posts from root canals prior to endodontic retreatment is often a challenge. The Gonon post removing system (Thomas Extracteur De Pivots; FFDM Pneumat, Bourges, France) is safe and efficient and can be used for anterior, bicuspid, and even molar teeth. The Gonon system is illustrated with one clinical case. PMID- 2701001 TI - The relative frequency of periapical lesions in teeth with root canal-retained posts. AB - This study was concerned with the relation between technical quality of root filling seal in teeth with posts and radiographic status of the periapical tissues. Full-mouth series from 298 randomly chosen patients were examined by two observers. Endodontic treatment had been performed in 852 roots and posts were observed in 424 of these. Periapical radiolucencies were judged to be present in 16% of roots with posts and in 13% of roots without posts. Roots with posts in which the remaining root filling was shorter than 3 mm showed a statistically significant higher frequency of periapical radiolucencies (p less than 0.01). It was found that an improper seal was more unfavorable in roots with posts (p less than 0.05). The findings in this study indicate that the placement of a post will not per se decrease the probability of periapical healing. It also suggests that the remaining root filling must not be shorter than 3 mm. PMID- 2701002 TI - Clinical evaluation of low-temperature thermoplasticized injectable gutta-percha: a preliminary report. AB - An injectable thermoplasticized gutta-percha system (Ultrafil) was used to fill 50 teeth which were monitored radiographically over a period of 24 months. An equal number of teeth were filled with the lateral condensation technique and used as controls. Radiographic evidence of success was determined at a 24-month recall. The results were subjected to a 2 x 2 analysis of variance (control versus experimental/before and after treatment. There was a significant amount of repair irrespective of obturation procedure (p greater than 0.0001). Thirteen teeth in the experimental group randomly filled with sealer showed that the sealer did not influence repair. PMID- 2701003 TI - New Jersey Dental Association. 1989-90 Directory. PMID- 2701004 TI - Influences on periodontal disease: II. PMID- 2701005 TI - Dilantin hyperplasia: a review of the literature. PMID- 2701006 TI - Stress and periodontal disease: a review of the literature. PMID- 2701007 TI - Past, present and future. PMID- 2701008 TI - [Technical, clinical and economic aspects of automatic cardioverter-defibrillator implants]. PMID- 2701009 TI - [Minipress in the treatment of arterial hypertension in light of results from a multicenter study. I. 3-month treatment: monotherapy versus combination treatment]. AB - Multicenter study of the effectiveness and safety of prazosin (Minipress) in patients with arterial hypertension was carried out in 15 medical centers. Of 366 patients who entered the study, 328 persons satisfying all the protocol conditions were included into the final analysis. The treatment lasted 3 months. Highly significant decrease of systolic and diastolic blood pressure was obtained in all periods of observation. In about two-thirds of patients Minipress was effective as a single drug and in the remaining persons the decrease of blood pressure was achieved using prazosin in combination with other antihypertensive drugs. Patients requiring combination therapy were almost 2 years older (however, the difference was not significant), had higher initial blood pressure and greater body mass. Mean daily doses of Minipress in the monotherapy and combination treatment were 5.6 and 10 mg, respectively. Side effects were observed in 27% of patients, but only in 5% they were the cause of drug withdrawal. PMID- 2701010 TI - [Minipress in the treatment of arterial hypertension in light of results from a multicenter study. II. Results of long-term monotherapy]. AB - Of 218 patients with arterial hypertension, who responded to monotherapy with prazosin (Minipress) during the first 3 months, 178 persons completed the 12 month treatment according to the study protocol. In 9 patients (4.1%) treatment was discontinued because of increase of blood pressure and/or side effects. In the remaining cases patients did not apply for the control examination or the obtained records were incomplete. During all periods of treatment the mean values of systolic and diastolic blood pressure were significantly lower than the corresponding initial values. No significant symptoms of drug tolerance were observed. Mean daily dose of Minipress after 12 months was 5.9 in comparison with 5.6 mg after 3-month therapy. Normal systolic and diastolic pressures at the end of treatment were found in 114 (64%) and 153 (86%) patients, respectively. Full normalization of blood pressure (less than or equal to 140/90) was achieved in 105 (59%) patients. It was found that an important factor determining the antihypertensive effectiveness of Minipress is the initial blood pressure. The inverse correlation between the decrease of systolic pressure and age was found, whereas the age did not affect requiring the drug withdrawal occurred in 27 (14.4%) patients; they were usually the efficacy of Minipress in relation to diastolic blood pressure. Side effects not of moderate intensity and transient character. PMID- 2701011 TI - [Titanium prosthesis: example for clinical use of pure titanium]. PMID- 2701012 TI - [Silane adherence of synthetic resins on various metal surfaces]. PMID- 2701013 TI - [Prosthetic concerns of partially edentulous jaw--treatment concept of the 90s]. PMID- 2701014 TI - [Silicoater procedures for adhesive bridges (1). Clinical and laboratory procedures]. PMID- 2701015 TI - [Silicoater procedures for adhesive bridges (2). Clinical and laboratory procedures]. PMID- 2701016 TI - [Dental pellicle (2). Ultrastructural variety as expression of complex formation and maturation]. PMID- 2701017 TI - [Functional analysis of a surgical-prosthetic treated prognathism--10-year results (2)]. PMID- 2701018 TI - [Use of implantation for prosthetic care of patients with reduced periodontal support]. PMID- 2701019 TI - [Pure titanium: material properties and working technologies of a dental metal]. PMID- 2701020 TI - [Bonded bridge: its place in current dentistry]. AB - Prevention and Adhesion are the two pillars in which the present Dentistry rests. Great changes are observed in the daily professional practice, fundamentally visible in Operative Dentistry. It does seem, however, that these changes may happen in Prosthodontics, fixed or removable. Careful attention and suitable study are not given to adhesion in connection with Prosthodontics. The Adhesive Prosthetics, practised since 1970, has improved a lot during the 1980 decade. Cast structures to be bonded to enamel surface are being treated in different ways with abrasions or retentions of high relief. Microscopic retentions got through electrolytic bonding, oxidizations, metallizations or simply sand blastings are obtained these seem to affect not only nickel chrome alloys but also to noble alloys, similar to those of type IV. New and modern designs, in which the classical anchorages for inlays are combined with those used in this type of prosthetics, give determined conditions of permanency and longevity. The development of adhesive cements to metallic structures adds new benefits with regard to th e practice of this type of prosthesis, impossible to forget in this time of considerable scientific and technical improvement. PMID- 2701021 TI - [Ultrasonics in endodontics. 2. Clinical applications]. AB - The present study, second of three dwelling with ultrasonic in endodontic therapy, is a review of the literature about clinical applications of some of the sonic and ultrasonic system. PMID- 2701022 TI - [China and India. Superstition and therapy for mouth diseases]. PMID- 2701023 TI - [Therapeutic guidelines in oral cancer]. PMID- 2701024 TI - [Retainers for bonded bridges]. PMID- 2701025 TI - [Ischemic coronary artery disease in menopause]. AB - Women show a lower incidence of Coronary Artery Disease (CAD) and probably a better prognosis than men. However better survival rate of women tended to be obscured because they were more likely to have histories of hypertension and diabetes and to be older than men. In this paper, incidence, clinical presentation, and prognosis of CAD in women are examined. Furthermore the conflicting reports concerning the effect of estrogen use on morbidity from CAD are reported. Finally the syndrome of angina with a normal coronary arteriogram, sometimes referred to as "Syndrome X" is analyzed. PMID- 2701026 TI - Acute intermittent porphyria. A 1988 review of data, theories, and problems. PMID- 2701027 TI - [Case in point: allergy, intolerance or pseudoallergy to chocolate?]. AB - Chocolate is traditionally considered as allergenic for predisposed subjects although many immunologic reactions are erroneously evaluated as allergic, due to misleading procedures. Therefore the term intolerance has been more properly employed. After summarizing the negative effects of chocolate, especially in children, we stress that the diagnosis of chocolate intolerance should be based upon reliable studies, including elimination/provocation tests in a double-blind fashion. PMID- 2701028 TI - [Aspects of organ-specific autoimmunity in cluster headache]. AB - Fourty-eight cluster headache patients have been studied. Twenty-nine of them were affected also by rhythm cardiac abnormalities, and the other 19 by associated conjunctival hyperaemia. The presence of organ-specific autoantibodies was investigated by immunofluorescence. High titers of antibodies against cardiac antigenic determinants was found. The study of leukocyte subpopulations revealed a parallel increase in blood and in conjunctival mucosa of Leu7+ and LeuM3+ cells. These outcomes confirm the immunopathological theory of cluster headache. PMID- 2701029 TI - [Radioimmunologic analysis of insulin (IRI) in glucose metabolism in uremic patients]. AB - Glucose intolerance in uremic patients is often reported in literature. This condition is characterized by an unbalance between production and utilization of glucose as for a trouble of the mechanism of gluco-metabolic regulation. Insulin radioimmunoassay (IRI) is measured to know the amount of hormone incretion and to verify its efficacy in the glucose utilization. The glucagon load and the double glucagon load are tests employed to study IRI response and glucose metabolism in uremia. With the double administration of glucagon is possible to assess the degree of glycogenolysis, but also the neo-glycogenesis stimulated by the first glucagon injection. This aspect is important because it reflects the sensitivity for the agent of counter-regulation hormonal (especially glucagon). The test performed by double glucagon load produces in uremic subjects IRI curves characterized by two peaks and unbalance amount between the 1st and the 2nd area correspondent to glucagon loads. Both the phases are higher than phases of normal subjects and the ratio 2nd/1st is 1.5. The behaviour of all the responsive IRI curves is similar and sufficiently homogeneous to permit its representation by medium values observed step by step in the group. The plasma glucose responses are dishomogeneous and it is possible to emphasize different types of involvement in the glucose intolerance. PMID- 2701030 TI - [Clinical evaluation of doxofylline sachets in a pediatric population]. AB - Therapeutic efficacy and tolerability of doxofylline 200 mg sachets, were evaluated, in a pediatric population in comparison with placebo. After double blind randomization, 11 patients aged from 6 to 12 years, were treated for 14 consecutive days. Doxofylline was administered at the daily dose of 12 mg/kg in two times. In the doxofylline group the authors observed a significative improvement of the evaluated spirometric paramethers (FEV1, FCV, FEF, FMF, PEF, MVV); in the placebo group there were only casual modifications. None of the patients treated complained of any side effect. PMID- 2701031 TI - [Some aspects of the history of dentistry in Cuba]. AB - Some aspects that are wanted to outline in relation to the history of stomatologic teaching and practice in Cuba, during its conquer and colonization, as well as during the mediated republic and revolutionary stage, are briefly reviewed. PMID- 2701032 TI - [Clinical validation of the caries preventive effect of mouth rinses with a mineralizing solution on the recently erupted permanent dentition]. AB - This research was performed with the purpose of learning about effect of oral rinsing, every two weeks, with mineralizing solution (Minersol) on recently erupted permanent dentition. Reduction obtained in the incidence of caries at one year term ranged between 49.2 and 82.1% for first molar teeth and 23.4 and 36.3% for second molar teeth; both differences were significant, but no reduction was obtained in the incidence of caries in the bicuspid teeth. Preventing effect obtained is attributed to ionic incorporation in enamel superficial levels, which decreases the diffusion of acids acting in demineralization. It is concluded that the use of mineralizing solution in those ages of eruption of permanent dentition reduces incidence of caries and, therefore, its use as preventing method is recommended. PMID- 2701033 TI - [Prostaglandin E2 (PgE2) in normal and inflamed gingiva. Clinical assay. Literature review]. AB - The role of prostaglandins (Pg) in the pathogeny of periodontal disease is analyzed. For that purpose, 92 samples of gingivae were taken to the same number of patients (48 women and 44 men) aged 17-74 years, and were clinically classified according to Loe gingival index. Presence of prostaglandins was determined by thin layer chromatography. Presence or absence of PgE2 was related to sex, age, Loe gingival index and degree of inflammatory infiltrated. Although correlation between Loe gingival index and degree of inflammatory infiltrate has not an exactly correspondence, the first one offers a useful initial clinical orientation. To patients with higher degree of inflammation corresponded higher PgE2 concentrations. Possibility of using prostaglandin inhibiting drugs in the treatment of periodontal disease is stated. PMID- 2701034 TI - Placebo responses to medical device therapy for pain. AB - Placebo response to a functionless machine was tested in 58 patients with chronic pain. Thirteen discontinued treatment before the planned trials were complete: 5 did so because sham therapy worsened their pain. Forty-five patients completed three trials of treatment with a magnetic device, one trial of which was a sham. Thirteen percent of patients undergoing sham therapy experienced relief of pain, improved range of motion, and decrease in muscle spasm. Eleven percent of the sham trials resulted in significant increase in pain. The placebo/nocebo response to sham therapy with a device is similar to that previously reported for prolonged drug treatment, but is lower than the placebo rate for short-term medication trials. PMID- 2701035 TI - Relief of epilepsy by radiosurgery of cerebral arteriovenous malformations. AB - 129 patients with inoperable cerebral arteriovenous malformations (AVM) were treated by stereotactic proton beam irradiation. Symptomatic epilepsy was present in 29 patients (22.5%) before the treatment. It was markedly relieved by the radiosurgery leading to cessation of the seizures in 16 patients, the persisting seizure-free follow-up period ranging from 2 to 8 years (mean 4.5 years). In no case was the epilepsy worsened by radiosurgery. The positive effect on epilepsy was not strictly dependent on the angiographic result, suggesting that the ionizing radiation by itself could lead to inhibition of epileptic activity around the AVM. PMID- 2701036 TI - Stereotactic radiosurgery for fractionated radiation: a proposal applicable to linear accelerator and proton beam programs. AB - A stereotactic radiosurgery technique is described which allows stereotactic radiation therapy to be easily fractionated on a daily or weekly basis. This permits adequate and safe radiation therapy to lesions larger than 2.5 cm, such as large arteriovenous malformations, and possibly safer radiation to smaller lesions near crucial intracranial structures. The technique utilizes external scalp landmarks and avoids the need for standard stereotactic head devices. PMID- 2701037 TI - Magnetic resonance and computed tomographic image-directed stereotaxy for animal research. AB - Current stereotactic frames for animal experimentation presume normal intracranial anatomy for atlas-directed probe placement. This is an invalid assumption for animal brain tumor models, where distortions of cerebral anatomy make image-directed stereotaxy necessary. To address this need, an accurate and reproducible magnetic resonance and computed tomographic compatible image directed stereotactic apparatus for animal experimentation is presented. PMID- 2701038 TI - [Wincenty Styczynski--physician and social worker]. PMID- 2701039 TI - [Effect of the treatment with propranolol and pindolol on selected hemodynamic parameters in patients with primary arterial hypertension]. AB - On the basis of echocardiographic investigations changes were analysed of certain haemodynamic parameters in 40 patients aged 21-50 years, mean 44 years, with primary arterial hypertension in stage II according to WHO classification. All patients were randomly chosen to receive for 6-9 weeks propranolol 120-480 mg daily, mean dose 280 mg, or pindolol 10-35 mg daily, mean dose 22 mg daily. The changes developing during the treatment with both drugs in relation to the initial values included the mean arterial blood pressure, the heart rate, the index of cardiac output and the systolic left-ventricular tension. In the studied patients treated with propranolol the heart rate and the ejection volume were decreased more than during pindolol treatment. Propranolol increased evidently the total peripheral vascular resistance and decreased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol decreased slightly the peripheral vascular resistance and increased the ejection fraction and the mean velocity of shortening of the circumferential fibres. Pindolol, in relation to propranolol, had a more favourable effect on haemodynamics in patients with primary hypertension. PMID- 2701041 TI - [Campylobacter pylori in diseases of the stomach and duodenum]. AB - Campylobacter pylori is an organism living under mucus layer in the stomach and on the places of gastric mucosa metaplasia. It is known to be responsible for the development of gastritis, probably also it participates in the pathogenesis of dyspepsia without ulcer, while its role in the development of gastric and duodenal ulcer has not yet been explained completely. The authors present a characteristics of the organism and the methods of its detection. A number of investigations are discussed which demonstrate its clinical importance. In summary, it is shown that the present state of knowledge on Campylobacter pylori is insufficient for serving as a rationale for antibacterial treatment of peptic ulcer. PMID- 2701040 TI - [Clinical value of ultrasonographic assessment of fetal hypotrophy and the effects of its treatment]. AB - The clinical usefulness was assessed of ultrasonography in the study of fetal hypotrophism determining the parameters BIP, THQ and placental parameters. Fetal growth was assessed and in case of hypotrophism adequate therapeutic management was undertaken. The study was carried out on 56 pregnant women referred for diagnosis and treatment of fetal hypotrophism in the period 1983-1985. The control group comprised 56 women with physiological pregnancy. The study was carried out with examinations at weekly intervals from the 24th week of pregnancy till labour using a Hellige-Panavista unit with a 2.5 MHz probe. The BIP and THQ dimensions were calculated a together with placental parameters. The oestriol level was determined in 24-hour urine. The underlying disease and fetal hypotrophism were treated. The most valuable indicator for the determination of asymmetrical and symmetrical type of hypotrophism and for its monitoring was the BIP/THQ index. Ultrasonography makes possible a rapid and accurate diagnosis of fetal condition and control of its treatment. Ultrasonographic observation of the placenta is a source of valuable information for the obstetrician. Oestriol determination is without any greater significance for monitoring of fetal hypotrophism. PMID- 2701042 TI - [The HELLP syndrome as a severe complication of EPH gestosis]. AB - On the basis of a literature review the extremely severe form of EPH gestosis- the HELLP syndrome is described. In the clinical manifestations of the syndrome a symptom triad predominates: haemolytic anaemia, raised values of hepatic enzymes and thrombocytopenia. The only causative treatment saving the life of the mother and fetus is possibly early termination of pregnancy and adequate supplementation of blood deficiency. The pathophysiology, clinical manifestations, differential diagnosis and treatment of the HELLP syndrome are discussed. PMID- 2701043 TI - [Will cyclosporin A be used in the treatment of refractory nephrotic syndromes?]. AB - In the treatment of nephrotic syndromes complicating primary glomerulonephritis anti-inflammatory and immunosuppressive action of glucocorticoids is used most frequently. Cases refractory to corticotherapy are a difficult clinical problem and lead, most frequently, to renal failure. Recently trials have been carried out of replacing glucocorticoids with the immunosuppressant which is devoid of the dangerous side effects of cytostatics, i.e. cyclosporin A. Theoretical and experimental data relevant to the use of cyclosporin A in the treatment of glomerulopathies are presented and the results of clinical studies carried out as yet, and therapeutic prospects are discussed. PMID- 2701045 TI - [Theory and practice of adhesive bridges with special regard to development of educational aids for continued professional training to a dental technician]. PMID- 2701044 TI - [Current views on the pathological changes in the nervous system of persons chronically exposed to organic solvents]. AB - On the basis of a review of the pertinent literature the author discusses pathological changes present in subjects with chronic exposure to organic solvents. The author describes the most frequent symptoms and signs constituting clinical syndromes--neurosis-like, encephalopathic and polyneuropathic. A number of observations of subjects with long-term exposure to benzine and benzene homologues are quoted. Diagnostic investigations of the nervous system are described which are used in cases of suspected chronic poisoning with organic solvents. PMID- 2701046 TI - The past and the future of experimental gerontology. AB - This paper is based on a lecture on the history and the perspectives of experimental gerontology at the symposium in Nurnberg on the occasion of the 10th year jubilee of the Institute of Gerontology of the University of Erlangen. The discussion links the studies and ideas of the founders of gerontology as an interdisciplinary science (Metchnikoff, Korenchevsky, Bogomolets, Verzar) with some modern trends in experimental gerontology and ageing-related fields of biotechnology. PMID- 2701047 TI - Poly(A) metabolism and aging: a current view. AB - Polyadenylation of mRNA is a key step in post-transcriptional control of gene expression. Therefore, age-dependent changes in poly(A) synthesis have to play a crucial role in the course of cellular aging. In this review, the importance of the signal sequence, poly(A), in determining mRNA stability and intracellular distribution of mRNA during aging is discussed. PMID- 2701048 TI - A 12-month clinical study comparing four glass ionomer cements for the cementation of orthodontic molar bands. AB - Four different glass ionomer cements were evaluated in vivo as luting agents for orthodontic molar bands. A sample of 199 patients with full fixed appliances (Begg Light Wire) were monitored over a period of 12 months during active treatment for loose molar bands. Failures for each cement were: Fuji I, 2.5 percent, Fuji II, 4.5 percent, Ketac-Cem, 4.0 percent and Hy-Bond Luting, 3.0 percent. Chi squared tests showed no statistical difference in failure rates for each cement. PMID- 2701049 TI - New developments in genioplasty: functional versus cosmetic. AB - Since the orthodontist is frequently the first clinician to be consulted for dentofacial deformity, an awareness of potential surgical procedures available to correct such deformities is imperative. Despite the fact that isolated genioplasty is becoming rare, the role the procedure plays in corrective jaw surgery is not diminished. Functional and cosmetic aspects must be considered in case planning and the flexibility of the procedure lends itself well to deformity correction in all three dimensions. PMID- 2701050 TI - Ankylosis of permanent teeth: a case report and literature review. AB - A case report describing an ankylosed permanent maxillary canine which was brought into the arch by a combination of surgery and orthodontics is used as a basis to review the literature concerning many aspects of the management of ankylosed permanent teeth. The literature indicates surgical luxation is a two edged sword, that is, it may cause ankylosis if used with surgical exposures but it can also be the only means of treating ankylosis. The treatment of the canine which is the subject of this case report resulted in damage to the tooth. Vanarsdall's recent contributions in this field are detailed. PMID- 2701051 TI - [Marginal leakage in dental restorations]. AB - We make a review of the factors contributing to microleakage around dental restorations and the biological effects that this produces. We also make an evaluation of the existing methods for its research. We analize the behaviour of the different restorative materials, in relation to microleakage, and we set the rules to minimize this inevitable event that affects so much the longevity of dental restorations. PMID- 2701052 TI - [Restoration of canine guidance using bonded prostheses]. AB - The aim of this paper is to offer an easy, accurate and aesthetical solution to the problem of the loss, by wastage, of anterior guides in those patients who show facets in initial stages of bruxism (central of peripheral). Using the acid etch non-precious metals(Cr-Ni-Be) technique we make a metalic plaque covering the posterior face of the upper canines, on which we place a porcelain incisal rim. All of this is fixed with a composed material. PMID- 2701054 TI - [Removable partial dentures. 4. Clasps]. PMID- 2701053 TI - [Analgesia in dentistry]. AB - Antiinflamatories, antipiretics and analgesics of normal use with special interest in the salicylates that we considered analgesics of first election, excepting counter-indications are exposed. We expressed our conduct in the handling of the pain with the different alternatives according to the cases, to revitalise the use of aspirin in its different presentation forms, as an effective analgesic. PMID- 2701055 TI - [Arachidonic acid metabolism in periodontal disease]. PMID- 2701056 TI - [Odontogenic mediastinitis]. PMID- 2701057 TI - [Removable partial dentures. 6. Planning]. PMID- 2701058 TI - [Epidermoid carcinoma of the lip]. PMID- 2701059 TI - Auxiliary substructure for screw-retained prostheses. AB - A double framework system is indicated when implant location could result in an overcontoured or compromised metal ceramic prosthesis. Precise design of the auxiliary substructure should provide for all necessary reorientations and corrections before constructing the metal ceramic framework. The additional cost and complexity of this technique must be weighed against the esthetic and morphologic requirements of the patient. PMID- 2701060 TI - Dimensional accuracy of two denture base processing methods. AB - The mucosal surfaces of maxillary complete dentures processed using the SR-Ivocap injection technique and the Lucitone heat-polymerized compression molding technique were compared to a metal master impression to determine if one method of denture processing produced a more accurate denture base. Comparisons were made before and after polishing the prepared bases to determine if changes occur as a result of this procedure. The dental comparator, described by Rupp and others in 1957, was used to compare selected points on the palatal surface of the denture bases. No statistical differences were found in the accuracy of the denture bases processed using either of the two techniques. PMID- 2701061 TI - Failure of maxillary canine retainers for fixed prostheses. AB - A statistical survey of fixed prostheses with failed retainers, combined with information on the arch distribution of abutment teeth, supports the clinical impression that retainers on maxillary canines have a disproportionately high failure rate. The probable contributing factors are the form of the canine clinical crown, the distribution of occlusal force, and the paths of abutment tooth displacement. These factors are discussed and clinical techniques for countering their adverse effects are described. PMID- 2701062 TI - Developments in glass-ionomer cements. AB - The performance of glass-ionomer cements has been improved since their introduction, and many of the initial disadvantages have been overcome. This article reviews the development of glass-ionomer cements, the problems involved, their solution, and their relation to underlying scientific principles. It describes improvements in mixing and setting characteristics, aesthetics, strength, and adhesion to tooth material. New bonding agents and resin-modified glass-ionomer cements are described. PMID- 2701063 TI - Influence of surface preparation on the strength and surface microstructure of a cast dental ceramic. AB - The effect of three surface preparations on the flexural strength of a cast glass ceramic (Dicor) was studied. The microstructure of the external and fracture surfaces was evaluated using electron microscopy. It was found that there was no difference in strength for the "as-cast/cerammed," acid-etched, or glazed shading porcelain specimens. A significant increase in strength (twofold) was observed when the "ceram layer" was mechanically removed from the surface of the ceramic. Scanning electron microscopy revealed that the "ceram layer" was 25 to 100 microns thick and consisted of crystal "whiskers" oriented perpendicular to the external surfaces. It was observed in both the laboratory and the clinically failed specimens that a zone of strength-limiting porosity was associated with this "ceram layer." Potential origins of the crystal "whiskers" and the porosity were discussed. PMID- 2701064 TI - Regaining pleasure and success with complete denture services. AB - The techniques used by Earl Pound for denture construction are stated, and their application to contemporary denture construction and implant-based prosthodontics is discussed. Positioning the anterior teeth using the mandibular movements of speech, the use of lingualized occlusion, and the fabrication of diagnostic provisional removable complete dentures--all hallmarks of the Pound technique- are described. It is the author's experience that many patients are content with properly fabricated conventional dentures and do not require dental implants for retention, comfort, and stability of their prostheses. PMID- 2701065 TI - Adhesive monomers for porcelain repair. AB - The purpose of this investigation was to test the bond strengths of several adhesive systems intended for intraoral resin-to-porcelain and resin-to-metal bonding. All measurements were compared with resin bonding to etched bovine enamel. Based on these data and the authors' own clinical experiences, protocols for intraoral porcelain repair are presented for fractures in porcelain only, fractures with both porcelain and metal exposed, and fractures with all metal exposure. PMID- 2701066 TI - The use of warm solutions for more rapid disinfection of prostheses. AB - The barrier system of specific sequential steps for cleansing and disinfecting dental prosthesis as they enter and leave the laboratory was tested by comparing the use of room-temperature disinfectants for 10 minutes with warmed chlorine based disinfectants at decreased immersion times. There were no statistically significant differences between 1- or 2-minute disinfection times using warmed 5.25% sodium hypochlorite, Alcide Expore, and Tetravalent Oxident, and using room temperature Sporicidin for 10 minutes. PMID- 2701067 TI - Disinfection of prosthodontic impression materials: a literature review. AB - With the steadily growing frequency of AIDS, many dental researchers and clinicians have become more interested in disinfection and sterilization procedures. Impressions made in the clinic are potential contamination pathways. All patients may be considered as potentially infectious and the impressions must be treated the same as those made on so-called high-risk patients. Zinc oxide eugenol, polysulfide and silicone rubber, and probably polyether materials are compatible with effective disinfectant solutions. The solutions do not substantially diminish the dimensional stability and the sharpness of surface detail reproduction of these impression materials. Impression compound as well as reversible and irreversible hydrocolloid, however, are not compatible with effective disinfectant solutions. PMID- 2701068 TI - Preliminary functional impression for the mandibular complete denture. AB - A technique for producing a preliminary impression of a resorbed edentulous mandibular ridge is presented. A 2-mm metal wire is adapted to the curve of the mandibular arch. A high-viscosity impression material is then formed to the wire and placed in the patient's mouth. Speech movements are used to functionally shape the material. Following polymerization, additional material is added to create extensions not captured in the first impression. A final wash using a low viscosity silicone or polysulfide rubber material completes the impression. The resultant preliminary impression has the advantage of not being distorted by an ill-fitting stock tray or artificially manipulated by the clinician. PMID- 2701069 TI - Prosthetic management and rehabilitation of an extensive intraoral and facial defect. AB - As with all maxillofacial prostheses, the management of large combined oral and facial prostheses require preoperative planning and cooperation between the surgeon, prosthodontist, and dental technician. Improvisation is particularly necessary during the early phases of treatment. Treatment objectives are to restore the skeletal defect, teeth, masticatory function, and appearance--all of which contribute to the patient's morale. Clinical care for a patient with a large intraoral and facial defect is presented. PMID- 2701070 TI - Resin denture bases: review of accuracy and methods of polymerization. AB - Traditional compression molding and heat-activation methods for polymerization of denture base resins have been widely used. Studies have shown that stresses introduced during processing can lead to the distortion of denture bases. Chemical-, microwave-, and light-energy activation, and various combinations (including polymerization under pressure) have been offered as alternative ways to make dentures. These methods have been attempts to improve the accuracy of fit of the dentures, but sometimes the goal has also been to provide a more convenient laboratory technique. This extensive review covers studies that have investigated the accuracy of acrylic and other types of resins for making dentures using the known range of fabrication methods. PMID- 2701071 TI - Fracture resistance of four core materials with incorporated pins. AB - This study investigated the influences of pin type (stainless steel or titanium), number of pins (0, 2, or 4), and pin orientation (parallel or perpendicular to tensile forces) on the fracture resistance of four core materials: amalgam, composite resin, and two alloy-reinforced glass-ionomer cements. Analysis of variance revealed significant differences among materials, number of pins, and pin orientation. The fracture resistance of amalgam was reduced most by pins, followed by composite resin. The least strength reduction was found in alloy reinforced glass ionomers, and in some pin orientations, fracture resistance was doubled compared to the controls. The most favorable pin orientation was parallel to tensile stresses. As the number of pins incorporated in amalgam was increased, fracture resistance decreased. PMID- 2701072 TI - Bond strength of ceramics and resins using Silane coupling on dental alloys. PMID- 2701073 TI - [A low copy number mutant of pUC-derived plasmid]. AB - A low copy number mutant of ColE1-like plasmid of Escherichia coli was reported in this paper. The recombinant plasmid pPGVT3 derived from the vector pUC4 was unstable in the E. coli host strain DF2145. No transformant could be obtained at 40 degrees C when DF2145 was transformed with pPGVT3. By in vitro mutagenesis of pPGVT3 plasmid DNA with hydroxylamine which induces point mutations, a mutant plasmid pPGVT3HA was obtained, which was stable in DE2145. The mutation site was localized within the pUC moiety of pPGVT3HA. The copy number of the mutated pUC vector and its derivatives were found to be reduced. The effect of low copy number mutation on the stability of the recombinant plasmids was discussed. PMID- 2701074 TI - [Determination of the apical limits of instrumentation by subtraction using the paralleling radiographic technic. (Study contribution)]. AB - The objective of the present work was verifying the apical position of the file when a technique based on subtraction and parallelism principle is used for determining the actual length of instrumentation. For this purpose, 24 natural teeth, in a total of 51 root canals, were used from patients under treatment in Endodontics Course of the Fundacao para o Desenvolvimento Cientifico e Tecnologico da Odontologia. The teeth were previously radiographed with the parallelism technique. For each canal it was subtracted 3 mm in cases of vital pulp and 1.5 mm in necrotic form the length seen in X-ray. This measure was transferred to the endodontic instrument and with the file in the interior of the canal another X-ray was taken. The distance between the tip of the instrument and the root radiographic apex was measured. The results showed the presence of distortion in the original value with the greatest index to those teeth with necrotic pulp. PMID- 2701075 TI - [Power-arm adaptation in canine bonded brackets]. AB - The author develops a method of Power-Arm adaptation in canine bonding brackets. Technical steps and its clinical use are described in the present report. PMID- 2701076 TI - [Supplementary innervation of lower teeth. Review of the literature]. AB - When pain persists after a successful injection of the inferior alveolar nerve, the professional must think on the possibility of supplementary nerve supply of the region. This review updates the current knowledge of this supplementary innervation. Not every patient will require this kind of anesthesia, however, the dentist must be aware of its existence. PMID- 2701077 TI - [Comparative study of three materials used for filling perforations made during intra-radicular dowel preparation]. AB - Fifteen extracted human teeth were used in which after root canal treatment post preparation was made. During this preparation the middle third of the roots was perforated intencionally. These perforations were filled with three different materials: Silver amalgam, Lumicon, N-Richert Cement, associated in five groups (Lumicon; Lumicon Plus Silver Amalgam; N-Rickert Cement; N-Rickert Cement Plus Amalgam; Silver Amalgam). After this, the teeth were prepared for S.E.M. analysis. The photomicrographics were analysed by 20 observators with the purpose to the determine the filling of the material on the borders of the cavity. The best results were achieved with Lumicon Plus Silver Amalgam. PMID- 2701078 TI - [Technics for fabrication of provisional restorations]. PMID- 2701079 TI - [Living history of some events relating to the beginning of the University of Antioquia Dental School]. PMID- 2701080 TI - Mechanisms of drug resistance to inhibitors directed at the individual subunits of ribonucleotide reductase. AB - Ribonucleotide reductase consists of two non-identical subunits, non-heme iron subunit (NHI) and effector-binding subunit (EB), that are encoded by different genes and that can be specifically and independently inhibited. L1210 cell lines were selected for resistance to hydroxyurea (HU-7), deoxyadenosine (Y-8), or the combination of pyrazoloimidazole and deoxyadenosine (ED2). The gene for the NHI was amplified in the HU-7, Y-8, and ED2 cell lines; there was no amplification of the gene for the EB. The mRNA for the NHI was increased in the HU-7, Y-8, and ED2 cells, but there was no change in the mRNA levels for the EB. Reductase activity was increased in the HU-7, ED2 cells, but not in the Y-8 cells. The reductase activities in the Y-8 and the ED2 cells were not subject to feedback inhibition by dATP. These data show that the mechanisms of resistance to inhibitors directed at this reductase are varied and do not require increased enzyme activity. Further, gene amplification or increased mRNA levels did not necessarily result in increased levels of cellular enzyme. PMID- 2701082 TI - Introduction: a history of the progress of anticancer chemotherapy. PMID- 2701081 TI - mRNA levels for human nucleolar protein P120 in tumor and nontumor cells. AB - A monoclonal antibody to a human tumor nucleolar 120 kD protein was developed by Freeman et al. (Cancer Res. 48: 1244-1251, 1988). Its complementary DNA (cDNA) has been isolated and sequenced (Fonagy et al., submitted). To determine the relative messenger RNA (mRNA) level for protein p120, cellular mRNA was extracted, slot-blotted onto nitrocellulose filters, and hybridized to radioactive p120 cDNA fragments. Human tumor cells contained 15-60 times more p120 mRNA than human term placenta. The rat Novikoff hepatoma ascites cell mRNA hybridized to the p120 cDNA probes, but the p120 monoclonal antibody did not react with the Novikoff hepatoma proteins. Novikoff hepatoma mRNA contained 8 times as much p120 mRNA as normal rat liver. As a control, a cDNA was used for protein B23, an abundant nucleolar protein; there were 3.5, 29, and 14 times more B23 mRNA than p120 mRNA in normal rat liver, Novikoff hepatoma ascites cells, and HeLa cells, respectively. Whereas the increased levels of the mRNA and protein B23 reflect increased activity of the nucleolus for any increment of nucleolar function, the increased levels of p120 mRNA and the p120 protein reflect the activity of the G1 phase of the cell cycle. The elevated level of p120 mRNA in tumors may reflect the heightened G1 cascade in transformed cells. PMID- 2701083 TI - Cancer treatment trials--past failures, current progress and future prospects. AB - Randomized trials are usually too small to provide decisive evidence on the effectiveness of cancer therapy, and most therapeutic developments have been based on studies of tumour response. This approach, together with survival comparisons using historical controls, has led to the development of effective chemotherapy for a few very responsive tumours, but not for most common cancers, where the impact of treatment on survival is quite small. It is difficult to distinguish effective and ineffective innovations in the treatment of such cancers, and consistent progress, in which the more effective treatments are developed and the less effective ones discarded, cannot be achieved without comparisons based on large numbers of randomized patients. The combined evidence on adjuvant therapy for breast cancer and colorectal cancer is reviewed, and a new meta-analysis of published chemotherapy trials in advanced ovarian cancer is presented. The evidence that certain adjuvant regimens can prolong survival is conclusive for breast cancer and quite strong for colorectal cancer, and there is suggestive evidence that cis-platinum prolongs survival in advanced ovarian cancer. Such results illustrate the importance of large randomized trials in evaluating and improving the treatment of common cancers. The major difficulty in achieving large patient entry to randomized studies is the reluctance of many oncologists to participate in collaborative clinical research. The reasons underlying this reluctance, and the way in which such collaboration should be organized to meet these objections, are also discussed. PMID- 2701084 TI - Problems in the design of anticancer agents. AB - Theoretically, two predominant paths for obtaining more selective anticancer agents may be envisaged. These are: (a) to make compounds which distribute only or preferentially in cancer cells; (b) to make compounds that are able selectively to kill or to differentiate cancer cells. Although in the last two decades research into new anticancer drugs has not produced satisfactory results, there is solid ground on which novel strategies can be developed, mainly based on a much greater biological knowledge of human tumours. This article does not review all the possible approaches that may be followed, but simply discusses some ideas and problems mainly taken from the current research of our laboratory. PMID- 2701085 TI - Pharmacokinetic determinants of the activity and toxicity of antitumour agents. AB - Pharmacokinetic-pharmacodynamic relationships in cytotoxic cancer chemotherapy are reviewed. In all classes of established cytotoxic drugs there is now good evidence that pharmacokinetics are a major determinant of drug toxicity and, in some instances, activity. Attempts are now being made to exploit these relationships to improve the therapeutic utility of established cytotoxic drugs and initial results are promising. In addition, there is evidence that the early clinical evaluation of new drugs may benefit from the application of pharmacokinetic information. PMID- 2701086 TI - Lymphomas: the impact of chemotherapy on survival. AB - Hodgkin's disease and non-Hodgkin's lymphoma are among the most sensitive tumours to chemotherapy. Response, even if complete, does not invariably result in cure. Chemotherapy has had a major impact on survival for patients with advanced Hodgkin's disease and in patients with both early and advanced high grade lymphoma. However, even in these two categories only 30-50% of patients can expect to be cured. Chemotherapy has had a major influence on the palliation of disease in patients with low grade lymphoma; however, it has not much influenced the long natural history of this group of diseases and no patients are cured by this or any other modality. PMID- 2701087 TI - Chemotherapy in adenocarcinoma of the lung. AB - Adenocarcinoma of the lung (ACL) attracts increasing attention because of the fast rising incidence. Systemic chemotherapy with cytostatic agents has been widely used for patients with inoperable ACL, but a standard treatment has not yet been defined. A review of the literature revealed that the highest response rates observed for single agents and combination chemotherapy in ACL in randomized studies were 22% and 38%, respectively, while the longest median survivals were 35 weeks and 34 weeks. Independent prognostic factors for survival in ACL patients were performance status, prior non-radical resection, liver metastases, white blood cell count and serum values of lactate dehydrogenase and aspartic aminotransaminase. Using logistic regression analysis, the only significant predictor of response was measurable disease parameter, while 26 other variables were not significant. Response to chemotherapy was not a major prognostic factor for survival, probably because of the low rate of complete responses (4%). Chemotherapy in ACL remains experimental and the prognosis for these patients is poor. High priority should therefore be given to the identification of new agents or combination regimens with appreciable activity. The knowledge of prognostic factors should be used for optimal design of trials and interpretation of the results. PMID- 2701088 TI - Chemotherapy in ovarian carcinoma. AB - Chemotherapy in ovarian carcinoma has changed from single agents through combinations without cisplatin to combinations including cisplatin. First-line treatment should be as potent as possible and thereby prolong the progression free interval and the overall survival and increase the cure rate. This has been obtained with cisplatin, but new active agents are needed to improve the results. The present non-invasive response evaluation methods such as tumour markers, abdominal computed tomography or ultrasound scans are unsatisfactory with a false negative rate of about 50-60%. In view of this and the experimental nature of chemotherapy in ovarian cancer, a second-look laparotomy cannot be avoided to assess the efficacy of a treatment. Salvage therapy with well known drugs has only a restricted indication, as the overall results are generally poor. In addition, a common international prognostic index would be of great value for the comparison of the results of the different trials. PMID- 2701089 TI - Has chemotherapy anywhere to go? AB - The methods used in the past to detect anticancer agents should be replaced by new approaches, where the aim is specifically to find treatments for the common solid cancers. Programmes have now been introduced which allow the rapid preclinical development and clinical trial of new classes of chemical. Provided sensitive markers of tumour response can be developed, new types of anticancer agent with activity against solid cancer should be discovered. PMID- 2701090 TI - The effect of head posture on muscle contact position: the sliding cranium theory. AB - The effect of head posture on initial occlusive contacts has been studied extensively by researchers in the basic sciences, dentistry, and physical medicine. The purpose of this paper is to review their theories and propose a new mechanism that attributes the effect of head posture to a change in the upper to lower jaw relationship. This mechanism is referred to as the sliding cranium theory. To understand how head posture alters initial tooth contact or muscle contact position, the arthrokinematics of the occipital-atlantal joint are covered in detail. The implication of the proposed new theory have relevance for dentists concerned with occlusal function and the treatment of temporomandibular joint dysfunction with temporomandibular repositioning, as well as for physical therapists who effect a change in head posture through mobilization procedures and therapeutic exercise. To conceptualize the proposed theory two easily performed tests are described. The sliding cranium theory presents a mechanical model that explains the interrelationship between the head-neck complex and the craniomandibular system in a way that has not been previously done. PMID- 2701091 TI - Current concepts concerning the etiology and treatment of trigeminal neuralgia. AB - Trigeminal neuralgia (tic douloureux) was first identified over three hundred years ago. Only recently have the causes of the disorder begun to be recognized and understood. The first attempts at treatment involved the neurotomy of peripheral branches of the trigeminal nerve. This procedure, along with neurectomy, ganglionectomy, rhizotomy, tractotomy, and injections of toxic substances into the ganglion and nerve branches were the main treatment modalities in years past. Although they exhibited marked success, they are fraught with complications, such as relapse, loss of facial sensation and motor control, infection, deafferentation pain, and a fairly high rate of mortality from the procedure. The current treatment modalities that result in a predictable success with minimal risk are microvascular decompression, percutaneous retrogasserian thermal rhizotomy, and percutaneous retrogasserian glycerol rhizotomy. Other procedures, such as balloon compression of the gasserian ganglion, cryotherapy, acupuncture, and drug therapy, are also being used with marked promise. PMID- 2701092 TI - Objective measures of swallowing in patients with primary Sjogren's syndrome. AB - Primary Sjogren's syndrome (SS) is an autoimmune disorder primarily affecting salivary and lacrimal glands. Durational measures of the oral phase of swallowing were obtained on 34 patients with primary SS and 34 age-matched controls from analyses of ultrasound scans. Two conditions were examined: a basal (BA) swallow (only endogeneous secretions present in the subjects' mouths) and a 10 ml water bolus (WB) swallow. The patients with SS produced swallowing durations significantly longer (p less than 0.05) than those of the controls for each of the two conditions. Moreover, unlike normals, over 40% of the patients with SS produced WB swallows that were longer than their BA swallows. For further analyses, patients with SS were classified into two groups based on the difference in duration between their BA and WB swallows. These two groups differed from each other on clinical evaluations of oral motor function and presenting complaints. No significant differences were found between these two groups for salivary function or immunologic profile. These findings support the hypothesis that dysphagia can result from conditions leading to salivary gland dysfunction and document the need for the assessment of swallowing function in patients with Sjogren's syndrome. PMID- 2701093 TI - Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observations. AB - Preliminary results of an investigation that synchronizes the videotaped output of ultrasound camera and the analog data from physiological measurements of swallowing and ventilation in normal and cerebral palsied (CP) children are presented. Four cerebral palsied children and three control children undertook a single sip-swallow of 5 ml of liquid and a solid mastication-swallow sequence on three occasions according to a defined protocol. The CP children exhibited much more variability and less control of the liquid bolus than did the controls. The ultrasound image clearly demonstrates the lack of control of the posterior of the tongue in many CP children. Some parts of the sequence of oral swallow and the time to achieve maximum anterior displacement of the hyoid bone appear to be slowed. The sequential events of swallowing show less variability as the sip swallow proceeds from the oral voluntary to pharyngeal and lower involuntary phases. This study also identified a short-latency apnea that appears to accompany a saliva (protective) swallow and a long-latency apnea that accompanies semi-solid or liquid bolus (alimentary) swallows. Further investigations of normal and CP children utilizing a combined diagnostic imaging-physiological measurement approach will follow this initial study. PMID- 2701094 TI - Effects of intraoral prosthetics on swallowing in patients with oral cancer. AB - The swallowing patterns of four patients with oral cancer with intraoral palate reshaping/lowering protheses were studied with and without their prostheses 3 months postoperatively. The prostheses resulted in improved swallow efficiency, increased duration of tongue contact to the pharyngeal wall, and improved speed of movement of the bolus from the valleculae to the pyriform sinus. These results emphasize the effects of the tongue on the pharyngeal as well as oral stage of the swallow. PMID- 2701095 TI - Experimental basis for the management of dental resorption. AB - Current evidence indicates that the mechanisms by which the mineralized tissues, bone and dentin, are resorbed are similar. Osteoclasts and dentinoclasts are possibly indistinguishable cell types that both resorb mineralized substrata. The principles of treatment of both dental and osseous resorptions should therefore have much in common. This article discusses the basis of hard tissue resorption and explores the rationale for experimental approaches towards the management of dental resorption. PMID- 2701096 TI - Islet cell antibodies and complement fixing islet cell antibodies in blood serum of patients with chronic adrenal insufficiency (Addison's disease). PMID- 2701097 TI - [Ultrasonographic and scintigraphic studies of "hot" autonomic thyroid nodules]. AB - Scintigraphic and gammagraphic (gamma-camera) techniques have been applied in diagnosing "hot" non-TSH dependent thyroid nodules. On the basis of frequent uneven accumulation of isotopic tracer observed in scintigraphic studies it was concluded that the structure of these nodules is heterogeneous. In some cases paradoxical patterns have been obtained following the dynamic tests of suppression and stimulation of the thyroid: after the administration of thyroid preparations paranodular thyroid tissue appears, while TSH administration causes an increase in the iodine uptake by the nodule. Ultrasonographic and gamma-camera studies have been carried out in 50 cases of "hot" autonomic thyroid nodules previously diagnosed by scintigraphy. Ultrasonographic studies revealed a weaker echogenicity in some cases and an intensified echo in the other. Sometimes by using this technique it was possible to demonstrate the occurrence of heterogeneous structures suggesting a cystic degeneration of the nodule. Paranodular thyroid tissue, invisible in scintigraphic scanning, could usually be observed by applying gamma-camera. It was concluded that both gamma camera and ultrasonographic studies confirm heterogeneous structure of intranodular tissue producing paradoxical patterns in scintigraphic scanning, with the latter technique usually aiding the detection of paranodular thyroid tissue without the necessity of application of the TSH test. PMID- 2701098 TI - Osseointegration: its impact on the interrelationship of periodontics and restorative dentistry. Part 3. Periodontal prosthesis redefined. PMID- 2701099 TI - Posterior porcelain inlay: clinical procedures and laboratory technique. PMID- 2701100 TI - Esthetic restoration of the maxillary anterior region: a case report. PMID- 2701101 TI - Rehabilitation of partially edentulous patients using cantilever bridges: a retrospective study. PMID- 2701102 TI - Osseointegration--beyond tooth replacement: the intramobile cylinder (IMZ) as a stabilizing abutment in periodontal-prosthesis. PMID- 2701103 TI - Evaluation of comprehensive treatment planning for the patient with advanced periodontal disease in a private practice. PMID- 2701104 TI - [Retinal angiomatosis in association with Stargardt's disease. A case report]. AB - We present what we believe to be the first reported association between retinal angiomatosis and Stardgardt's disease (Gass type 3). We have had the opportunity of following photographically a patient for the last eleven years. The earliest photos showed the macular problem whilst the latter shots showed the presence of a capillary angioma involving the temporal part of the optic disc and the adjacent retina of the left eye. We believe that this tumour arose in previously normal tissue. Examination and investigation of the patient revealed a peripapillary choroidal rupture at the site of the angioma, thalassaemia minor, retinitis pigmentosa, mildly dilated lateral ventricles, hepatic angiomata and a negative family history apart from a younger sister who was mildly retarded and showed an identical fundal picture of Stargardt's disease. Later examination revealed a small peripheral angioma inferiorly in the same eye. The diagnostic and management problems will be discussed. PMID- 2701105 TI - Biology of temperature: the mammalian fetus. PMID- 2701106 TI - Factors affecting gas transfer across the placenta and the oxygen supply to the fetus. AB - The factors that affect placental gas exchange are reviewed, with particular reference to recent measurements of the effect of changes in one or more of these factors on O2 delivery to the fetus and on fetal O2 uptake. Fetal or maternal placental blood flows and blood O2 capacities can be altered by 50% without any major change occurring in fetal O2 uptake: umbilical venous O2 content and fetal O2 delivery fall, but the O2 consumption of the fetus is maintained by increasing the fractional extraction of O2 from the blood. There is evidence that the fetus can also cope with a reduction in blood O2 affinity resulting from replacement of fetal with maternal blood. The critical level of O2 delivery is about 0.6 mmol.min-1.kg-1 in the fetal sheep. When O2 delivery is reduced below this level, by decreasing maternal placental blood flow, raising or lowering fetal haematocrit, decreasing maternal O2 capacity, or decreasing fetal O2 affinity, fetal O2 uptake tends to fall. The resultant tissue hypoxia and inability to maintain oxidative metabolism is reflected in a lowering of arterial blood pH and base excess. Whilst the results of short-term experiments suggest that there exists a large reserve for placental O2 transfer and fetal O2 supply, there is evidence that fetal O2 uptake is more tightly linked to O2 delivery when the latter is reduced for a period of days or weeks. In the long term, restriction of the supply of O2 and nutrients leads to a reduced rate of fetal growth and a reprogramming of tissue development. PMID- 2701107 TI - Improved method using a bubble-free adhesion technique for the preparation of semi-serial undecalcified histologic sections containing dental implants. AB - The preparation technique, with the minimum of artifacts for the semi-serial undecalcified histologic sections containing dental implants, is presented in this study. The sections enabled finer light-microscopic observations to be made. A formalin-fixed tissue block containing a dental implant was dehydrated in ethanol and acetone, and then embedded in polyester resin under 76 cm Hg reduced pressure. The embedded block was trimmed by a cutter and ground by abrasive paper. In a 1.5 Kg f/cm2 pressurized chamber, its polished surface was bonded to a methacrylate slide by means of ethylcyanoacrylate used in an adhesion loading device. This meant that no bubbles could arise in the interface between the slide and the block. The slide-block was then attached to an adsorptive specimen-holder of a hard-tissue cutting machine and cut to a thickness of approximately 50 microns, with use of a diamond blade. The slide-section was ground to 15-40 microns with wet-type abrasive paper and film on a polishing table. Etching with weak acid and surface staining with toluidine blue and methylene blue/basic fuchsin/light green were performed on the section. PMID- 2701108 TI - The mandibular full subperiosteal implant--a ten-year review of 202 cases. PMID- 2701109 TI - Evolutionary aspects of pituitary hormones. PMID- 2701110 TI - [Growth of the fetal cerebellum in normal pregnancy]. AB - An ultrasonographic study was carried out in 203 physiological pregnancies whose menstrual gestational age (MGA) was between 20 and 40 weeks. The following biometric parameters were determined: transversal cerebellar diameter (TCD), biparietal diameter (BPD), occipito-frontal diameter (OFD) and head circumference (HC). The data analysis gave the optimal mathematical models with the following relations: 1) TCD/MGA (R2 = 0.904; SD = 2.6 mm); 2) MGA/TCD (R2 = 0.924; SD = 1.7 wks); 3) BPD/TCD (R2 = 0.914; SD = 4.3 mm); 4) HC/TCD (R2 = 0.919; SD = 14.3 mm), which are graphically and tabularly presented. Also the variability in the determination of MGA from TCD is calculated before 26 weeks (2 SD = 2.6 wks) and after 26 weeks (2 SD = 3.5 wks). TCD can be practically applied in cases where it is difficult or impossible to measure BPD, or in cases where it is unsuitable because of the expressed moulding of the head, since the cerebellum is not liable to changes in forms and its size is in correlation with MGA and BPD. The use of TCD is also important in the detection of congenital malformations which are manifested in the posterior cranial fossa. The potential importance of TCD in the diagnosis of the fetal intrauterine growth retardation is based on the assumption that the cerebellum is not liable, or at least not considerably liable, for growth retardation. PMID- 2701111 TI - [Interventional ultrasound in obstetrics and gynecology]. AB - During 1988 there were 1029 invasive obstetrical and gynecological ultrasonically guided procedures: 788 early amniocenteses and 84 late amniocenteses, 26 chorion villi sampling, 24 by transcervical and 2 by transabdominal route, 74 fetal blood sampling (chordocenthesis) mainly for fetal karyotyping, in 9 cases the assessment of the fetal acid-base status was the main indication for the procedure. There was one patient with the increased risk of epidermolysis bulosa in whom fetal skin biopsy was performed. Prostaglandine was administered intraamnially under ultrasound control in 44 cases, in which the second trimester termination of pregnancy was indicated for medical reasons. In 3 cases a huge polyhydramnion was evacuated and in one case of several fetal hydrocephaly, craniocentesis and aspiration of the cerebral fluid were performed. There was one selective fetocide in twin pregnancy with a large meningomyelocele in one twin. In one case of a nonimune fetal hydrops at the 27-week gestation, the aspiration of the accumulated fluid and the intraperitoneal injection of albumin at 27 and 34 weeks, respectively, were performed. A total number of 6 gynecological invasive ultrasonically guided procedures was done. Three of them were punctures of ovarian follicles as part of IVF programme, one puncture of a large simple ovarian cyst, and two aspirations of extrauterine pregnancy with the administration of Metotrexate. PMID- 2701113 TI - [Development of endocrinology in Bosnia and Herzegovina over the past 20 years (1969-1989)]. PMID- 2701112 TI - [Personal experience in the therapy of diabetes mellitus]. AB - Our aim was to investigate and establish the methods and therapeutic procedures as well as their efficiency and success in the diabetic patients in the community of Tuzla and region of north-east Bosnia. We found that 61,32% percent of our patients were treated with oral antidiabetic medicines; 23,68% percent by the special diet and only 14,16% percent of diabetics were treated by insulin. The treatment was successful in 73,65% percent of our patients and without any effect in 26,35% percent. We found different causes of unsuccessful treatment and some of them are: the low cultural and educational level of the inhabitants, inadequate dietal nutrition, unregular and insufficient control and self-control of the patients and also inadequate treatment: 1. refusal of insulin therapy and 2. insufficient usage of antidiabetic medicines. PMID- 2701114 TI - [History of the development of some ophthalmologic instruments by Carl Zeiss]. AB - Starting with the corneal microscope of 1898, numerous ophthalmological instruments have been developed at Zeiss in cooperation with important eye doctors. Examples are retinal cameras, slitlamps, the photo slitlamp, the keratometer, surgical microscopes and the photocoagulator. As an optical feature, some of these instruments exhibit parallel beam paths making easier the construction of modular systems. PMID- 2701115 TI - Provisional restorations. (Part III) Partially edentulous with osseointegrated implants. PMID- 2701116 TI - Removable partial denture therapy. The secondary impression. PMID- 2701117 TI - Mandibular denture stabilizer. Report of a pilot project. PMID- 2701118 TI - Osteoradionecrosis: its pathophysiology and treatment. A review of new concepts. PMID- 2701119 TI - Multiple forms of proteases of Bacteroides gingivalis and their cellular location. AB - Protease of Bacteroides gingivalis ATCC 33277 was found in intracellular membrane free, intracellular membrane-bound and extracellular fractions. The insoluble form of proteases was solubilized with a detergent. The elution patterns of proteases on gel filtration in each fraction were rather different. However, enzymatic properties of the proteases separated by gel filtration were very similar. PMID- 2701120 TI - Immunolocalization of Streptococcus mutans sr gene product in recombinant Escherichia coli. AB - A direct post-embedding immunogold method was used to determine the subcellular localization of the expression product of Streptococcus mutans sr gene in Escherichia coli cells. Immunolabelling was principally localized in the cytoplasm and was absent in the periplasmic space and extracellular compartment. We observed no difference in the localization of the labelling between bacteria originated from solid or liquid cultures. No difference in saliva binding could be observed between recombinant E. coli or control E. coli cells. These results showed that the cloned SR protein was not accessible at the surface of the host cell. PMID- 2701121 TI - [Reflection on the past 20 years since the last congress held at Kanazawa--a review and an overview of the future]. PMID- 2701122 TI - [Influence of impressions' border formation on retention of lower complete dentures]. AB - Examinations of the retention of lower individual trays without formation of borders and with borders shaped of wax for impressions have been carried out in 32 patients with toothless mandible. The retention of impressions and lower complete dentures has also been examined. The examinations have been demonstrated that formation of lower individual impression trays' borders increases the retention of lower complete denture. The formation of borders in the anterior region of sublingual fovea influences the retention of lower complete dentures most. Simultaneous formation of borders in the anterior regions of sublingual salcus and oral cavity vestibule ensures the greatest retention of the dentures. The retention of lower complete dentures shows positive correlations with the retentions of impression trays and impressions and that is why the estimation of the impression's retention of the toothless mandible should be done each time to determine the recommendations for the end of the procedure or performance of suitable corrections. Carrying lower complete dentures for 1-4 weeks doesn't influence the retention force of these dentures. PMID- 2701123 TI - [Individual tray composed of two parts for functional impressions in case of pterygoid defects]. AB - The authors have presented the way of performing an individual impression tray composed of two parts utilized in case of pterygoid defects of maxilla and mandible and when taking impressions for performing immediate dentures (transit to toothlessness). The tray of this type enables to perform functional impression by one sort of mass. The separation of the labial part of the tray before model's relief from the impression protects plaster teeth against damage. PMID- 2701124 TI - [Application of thermosetting plastics to eliminate undercuts]. AB - The author proposes to utilize the properties of thermosetting plastics used in other fields to use them in prosthetics in order to eliminate undercuts. Application of extra equipment in claspograph in the form of studs of three dimension makes formation of undercuts' blockade easier improving the result of work at the same time. PMID- 2701126 TI - [Device used for mounting retaining pins in split models for fixed dentures]. AB - Fixed dentures carried out by current laboratory method require to create potentialities of accurate separation of the working part of the model from its base preserving reciprocal parallelism of abutment elements. Modern engineering has at its disposal two methods of parallel location of stabilizing pins in model by means of devices produced in west European countries. Instructive needs and shortage of the appliance of this type on our market have made us elaborate our own design. In the design optical and mechanical elements available in the country are used and it meet exactly the requirements particular about devices of this type. PMID- 2701125 TI - [Possibilities of combined maxillary-orthopaedic and prosthetic treatment of malocclusion in adult patients]. AB - The possibilities of an efficient and safe maxillary--orthopaedic intervention in adult patients in order to eliminate or diminish the intensification of some malocclusion have been discussed in the paper. It enables to achieve the full functional--esthetic effect of the prosthetic treatment. The results of the combined treatment of the patients with common defects, i.e. hypodontia of lateral incisors and deformities towards the front, that create disturbances in prosthetic treatment planning have been given as an example. PMID- 2701127 TI - [Laser in dentistry. 2]. AB - A synthesis is made of the literature from the USSR, about the use of laser radiation in stomatology, its biological effects on the tissues, and the results of experimental research in vitro and clinical trials with Soviet-made helium Neon (HeNe) and carbon dioxide lasers. No comments are made about the parameters of the laser radiation used, since the objective of this article is to provide general information in relation to the advances achieved with this treatment method by the USSR. PMID- 2701128 TI - [Semiprecision attachments]. AB - This article brings a historical view and main characteristics of the semiprecision attachments. A descriptive analysis is done, in which classification and properly indication are treated. More over, semiprecision attachments are compared with both conventional retention systems and precision or prefabricated attachments. PMID- 2701129 TI - [Treatment of primary and secondary cleft palate]. PMID- 2701130 TI - [Perspectives on sophrology and dental sophrology]. PMID- 2701131 TI - [Interleukin 2. Biochemical aspects of structure and function. Review]. AB - During the last several years, the important progress has been achieved in studying activation and proliferation processes altogether with differentiation of mononuclear cells and regulatory course of immune response. In addition to molecular biology, also the biochemical characterization of interleukins, mainly Interleukin 2 (IL 2), is of a substantial import. IL 2 is actionning as an amplificator of T and B immune cellular reactions, and it influences the production of lymphokines, i.e., gamma interferon as well as participates in antitumorous immunity. IL 2 belongs to the range of products being secreted by T lymphocytes following the specific antigenic or polyclonal mitogenic simulation of cells. It can be classed as a growth factor of cells and regulatory factor of immune responsiveness. The human IL 2 was isolated as a protein with Mr 16 kD. On the basis of complementary DNA, the molecular weight has been determined for IL 2 as 15.4 kD. The IL 2-related human gen is localized on 4th chromosome and the product of the respective gen is a protein composed of 133 amino acids. This very protein undergoes glycosylation on the 3d position having alpha-helicoid conformation. The murine IL 2 occurs rather as a dimer composed of two protein chains with Mr 16-18 kD. Variable degrees of glycosylation involve the heterogeneity and pI differences in isolated forms of IL 2. Actions of IL2 are triggered by its interaction with specific receptor, which appears on the T cells no sooner as they are activated by the antigen or mitogen. Following the IL 2 with receptor interaction, the hydrolysis of phosphatidylinositolphosphate occurs intracellularly as well as activation of proteinkinase C and a track of other biochemical reactions non-elucidated till now, which lead up to the transcription regulation of genes and transfer of mitotic apparatus from G1 into S phase of cellular cycle and of division of cells. PMID- 2701132 TI - [The oral hygiene, dental health and prosthetic care of old age home pensioners and geriatric patients. A study at the Adullam Foundation in Basel]. AB - To determine the current state of oral hygiene, dental health and prosthetic appliances among residents of nursing homes and geriatric hospitals, 100 nursing home residents and 53 hospital patients with an average age of 82 were interviewed and examined in the Adullam Foundation in Basle. Only about 30% of those questioned expressed problems related to chewing, and only about 15% were dissatisfied with their dentures. Hardly any material other than toothbrush and toothpaste was used for dental hygiene. Only 38% of the nursing home residents and as few as 15% of the hospital patients brushed their teeth three times daily. A good 46% of the nursing home residents still possessed at least one original tooth. The incidence of plaque was categorized as high. In more than 86% of the cases, flaws were determined in removable prosthetics. Dental treatment was considered immediately necessary in 2% of the cases and necessary in 41%. In order to improve oral hygiene and dental care among aged nursing home residents in Switzerland, a list of suggestions has been compiled. PMID- 2701133 TI - [Root caps in hybrid prosthesis. Suggestions for the design and construction of root caps for hybrid prostheses]. PMID- 2701134 TI - [Extracoronal bonded anchorages. Extracoronal bonded anchorages in cast-molded prosthesis: an esthetic extension of the geriatric denture reconstruction spectrum]. PMID- 2701135 TI - [Burning mouth syndrome]. AB - The Authors describe the Burning Mouth Syndrome or B. M. S., a disorder that is characterized by stomatopyrosis, glossodynia " sine causa" with a specific psychological and ormonal condition. Furthermore they deal with the aetiopathogenetical hypothesis and the diagnostic and therapeutic protocol of B. M. S. PMID- 2701136 TI - [Radiographic examination in periodontology: evolution and prospectives]. AB - Dental radiography has long been considered useful in the diagnosis of periodontal disease, it was employed in epidemiological studies in longitudinal studies, in the morphological and volumetrical evaluation of bone lesions and in the diagnosis and prognosis of periodontitis. However the radiographic technique and its interpretation were not always accurate. We can divide the evolution of the radiographic interpretation of periodontitis in three periods: the first period is comprised from the early years of the periodontal science to the seventies; in this period in spite of the evolution of the radiographic technique, there wasn't a standardization of the diagnostic criteria because of the un-understanding of the etiopatogenesis of periodontitis. In the second period, that is comprised from the seventies to the present, the understanding of the etiopatogenesis and of the evolution of periodontal breakdown, made possible the standardization of trials and diagnostic criteria and the fixation of limitations and indications of the radiographic interpretation of periodontitis. The third period, that is a prospect for the future as clinical application, at the present has application only in research. In this period use of new techniques, as scintigraphy and computerized analysis of radiographic image, made possible an higher sensibility of the radiographic technique. PMID- 2701137 TI - [Role of endotoxins in periodontal disease]. AB - The Authors, through a review of the literature, analyzed the role played by Endotoxins in the pathogenesis of the periodontal lesions. It is furthermore considered the therapeutic problem of the necessity of a complete removal of such substances from the dental root in arder to obtain a radicular surface which could allow a good healing of the periodontal lesions. PMID- 2701138 TI - [Clinico-therapeutic considerations in a serious case of amelogenesis imperfecta]. AB - The Authors present a case of a young female patient affected with a serious hypoplasic form of Amelogenesis Imperfecta, involving all the teeth which has been completely restabilished using composite resin. The therapy used has been developed thanks to the chemical-physical qualities of last generation of composites, which allow the compete reconstruction of teeth. Such a therapy has not to be considered definitive, however it has been used as a temporary solution, waiting for final prosthetic rehabilitation. The Authors estimate that such a temporary long term treatment, that utilize composite resins, represent the ideal therapeutical choice thanks to its characteristics of endurance, cost and benefice. In our opinion this therapy prevents tooth deterioration, secures a better mastication, a partial reduction of the teeth sensibility, facilitates teeth cleaning and solves the esthetical problems with great psychological advantage. PMID- 2701139 TI - [Influence of surgical knots on physical characteristics of atraumatic sutures]. AB - Some specimens of atraumatic sutures (silk and multifilament polyster) have been tested after multiple knottings in order to evaluate the physical features in a situation more similar to clinical procedures. The results showed the knots did not interfere with the tensile strength. PMID- 2701140 TI - Obituary: Professor Sir Robert Macintosh. PMID- 2701141 TI - [The U.D.A. system. A fixed prosthesis with major preservation of remaining tooth structure]. PMID- 2701142 TI - [Acute circumscribed premaxillary cellulitis]. PMID- 2701143 TI - [Titanium implants of Branemark type for oral rehabilitation of partially edentulous patients]. AB - This paper describes the principles for different types of partial reconstructions using tissue integrated titanium fixtures, according to the Branemark technique, as abutments for fixed bridges. The implant-supported bridges can be designed either in separate units (Type I) or integrated into tooth-supported reconstructions (Type IIA and Type IIB). The different designs of the fixed bridge-work are illustrated by a number of patient presentations. PMID- 2701144 TI - [Use of microwave energy for wax burnout prior to casting]. PMID- 2701145 TI - Prenatal diagnosis and management of chondrodysplasias. AB - Thorough ultrasound examination of fetal limbs and fetal movements allows us to recognize several types of osteochondrodysplasia, both in high risk pregnancies (with a family history of chondrodysplasia) and up on routine screening. Correct diagnosis of growth retardation requires nomograms for bone length, and we have developed our own standards for the humerus, ulna, femur and tibia. Since some types of osteochondrodysplasia are compatible with life and others not, it is important to make the correct diagnosis using several differential diagnostic criteria. Only in this way can we decide the further management of a pregnancy. At our Prenatal Diagnosis Centre 8 cases of osteochondrodysplasia have been diagnosed. We discuss the differential diagnosis and the pregnancy management for some of these cases. PMID- 2701146 TI - New possibilities of recognizing early endometrial changes. AB - Ultrasonographic examinations completed by electron microscopic study were made with transvaginal head in 15 cases. According to the authors, the combined use of these two methods can improve the chances of detecting and recognizing early hyperplasia, preblastoses as well as endometrial tumours. PMID- 2701147 TI - [Historico-social roots of medicine, dentistry and healing]. PMID- 2701148 TI - A preventive approach of the postmenopausal bone loss. AB - In countries where osteoporosis in the ageing process tends to be a major problem, this phenomenon is of particular interest. The consequences of the osteoporosis in an ageing population, especially in the coming decades could create serious problems for the health authorities. It would be very interesting to see that in an early stage i.e. at menopause it could be influenced by prophylactic treatments. In a few countries the prophylactic approach of the menopausal osteoporosis has been already introduced. But it will take a long time before prophylaxis of postmenopausal osteoporosis could be considered as a standard and routine procedure. PMID- 2701149 TI - Endocrine factors in the neonatal adaptation. AB - In this review an attempt has been made to summarize our current knowledge on the involvement of various endocrine systems in the adaptation of the neonate to extrauterine life. Clinical and experimental evidence has been provided to indicate the role of catecholamines, glucocorticoids, prostaglandins, vasopressin, endorphins and the renin-angiotensin-aldosterone system in the cardiovascular and respiratory adaptation. Furthermore, the contribution of prolactin, vasopressin and the renin-angiotensin system to the redistribution of the body fluid compartments after birth and to the regulation of neonatal salt and water metabolism has been demonstrated. It has been concluded that the endocrine reactions induced by birth process and perinatal pathological events are important regulators of successful transition. PMID- 2701150 TI - Treatments for inducing superovulation and the endocrine aspects of cycle diagnostics in connection with the in vitro fertilization program. AB - On the basis of literary data and of own experience the author deals with protocols concerning hyperstimulation in the in vitro fertilization and embryonic transfer cases as well as with the endocrine monitoring of superovulatory cycles. The IVF and ET programs widen our knowledge most spectacularly in the fields of follicle maturation, cycle endocrinology, and early processes of reproduction. When discussing the theoretical and practical aspects of various superovulatory treatments, the principal differences between the natural and hyperstimulatory sexual cycles are emphasized. Because of these differences and of the nature of the IVF-ET procedure, the importance of the traditional cycle diagnostics is necessarily limited. More important diagnostic possibilities are the daily quick hormone measurements by RIA methods, the hemagglutination tests, ELISA, and ultrasound examinations. PMID- 2701151 TI - [Possible incidental factors in the treatment of noise sensitivity]. AB - On the basis of Eysenck's theory, the authors were assuming that a favorable response was likely to be elicited from dysthymic subjects when treated for their noise susceptiveness by means of relaxation techniques, while hystheric subjects were unlikely to be responsive to treatment. The four-session treatment was administered to a noise susceptive volunteers sample. After a pre-, and post treatment comparison among individual noise susceptiveness curve were drawn, and an analysis was performed on the variables crossing point, it was found out that, contrary to the authors' hypothesis, the highest inciding variance factor on treatment results was the noise annoyance level sample subjects evidenced. PMID- 2701152 TI - [Elastic system in human gingiva in health and periodontal disease]. AB - We processed 28 samples of human gingiva in health or paradential illness, of 15 patients between 20 to 67 years old. In 306 histologies cuts we made different staining to light microscope. We analyzed presence, distribution, diameter and relations of the elastic, elaunin and oxytalan fibers. The patron of distribution fibrilar of the elastic system gingival was different than other zones of the body. The description had made in three zones of the gingival connective tissue: deep, subpapilar and papilar zones. The elastic fibers had less numerous and larger diameter than the elaunin y oxytalan ones. Their repair was irregular. The elaunin followed the colagen fibers. The oxytalan formed delicates nets in the lodge of connective tissue, inflamatories infiltrates and interfibrilar spaces. They came to the basal membrane perpendicularly or oblicualy, isolated or in little bundles. The fibers of elastic system increased principaly in inflamed gingiva of teeth with overburden, though they supported the low proportion that exist at health gingiva. They appeared at the little vases wall and were increased at zones next to edentate spaces. The analogy and close entail between the elaunin and oxytalan fibers to colagen ones, made think in a relation of reenforcement of colagen, increased at paradential illness. PMID- 2701153 TI - [Morphogenesis of the cranial base]. AB - The literature on normal morphogenesis and growth of the human cranial base was reviewed. The development of the cranial base was considered in three overlapping phases: membranous, cartilaginous and osseous. Special interest was focused on the osseous phase. The role of the synchondroses, sutures and bone remodelling in normal development was analysed. The cranial base was described as a buffer structure and as a template for the final form of the face. PMID- 2701154 TI - [Upper and medial alveolar nerves. Study of their frequency and point of origin in 100 cases]. AB - The existence, frequency and origin of the middle superior alveolar nerves was studied in 100 cases. 40 dried bones and 40 formaldehyded bones with the nerves in situ, were observed by transilumunation; and 20 hemi sectioned heads were disected with the help of transilumination. The middle superior alveolar nerve was found in 57 cases, in 35 arose from the Maxillary nerve trunk in the infraorbital canal and in 22 arose from the Maxillary nerve trunk in the tuberosity face of the maxillary bone, very near of the beginning of the infraorbital canal. A enlarged review of the literature and the comparison with our findings, was made too. PMID- 2701155 TI - Review of terminology, classifications, and indices of developmental defects of enamel. AB - A wide variety of terms and definitions are used to describe various developmental defects of enamel. Some are simple descriptive clinical terms, and others are linked with the causative agent or the histopathology of the defect. Some confusion exists as to the most appropriate type of index to use to measure defects of enamel due to fluoride ingestion (dental fluorosis). This is primarily due to difficulties some researchers have in distinguishing between defects of fluoride and non-fluoride origin. This problem has resulted in the development of specific fluorosis indices and purely descriptive indices. The main fluorosis indices are those of Dean, Thylstrup and Fejerskov, and the TSIF Index. Dean's Index does not provide adequate information on the distribution of fluorosis within the dentition and is not sensitive at high fluorosis levels. The Thylstrup and Fejerskov Index is related to the histology of florosis; however, the initial minute changes observed on dry enamel surfaces are of little esthetic importance. The TSIF Index does overcome some of the limitations of Dean's Index. The DDE Index has replaced the Al-Alousi Index as the main descriptive index. The DDE Index is time-consuming, and the analyses of data are complicated. Modifications have now been proposed to make it simpler to use and the data more meaningful. Further research needs to be carried out into both the validity of the fluorosis indices and making the DDE Index more universally acceptable. PMID- 2701156 TI - Developmental enamel defects in primary teeth in children with cerebral palsy, mental retardation, or hearing defects: a review. AB - Developmental enamel defects in primary teeth have been found at least twice as frequently in children with cerebral palsy or mental retardation as in control children, and frequently also in children with sensori-neural hearing deficits. The developing tooth germ is sensitive to a range of systemic disturbances, some of which may also affect neurologic development. Because the enamel cannot recover once it is damaged, it may provide a repository of information on the timing and nature of insults potentially affecting other ectodermally derived structures, including the brain. This paper reviews the literature on developmental defects of enamel in primary teeth, asking whether these might be useful as biological markers of the timing and in some cases the nature of insults. Among systemic factors related to development of enamel that might also have implications for neurologic development are certain genetic disorders including tuberous sclerosis, premature birth, neonatal nutritional disturbances (especially hypocalcemia), viral infections (such as rubella and cytomegalovirus during gestation), thyroid disorders, and maternal diabetes. It is concluded that further research is warranted concerning whether developmental defects of dental enamel can be useful markers for the timing of intra-uterine or perinatal events associated with certain neurologic and sensory disorders of children. PMID- 2701157 TI - Fluoride and enamel defects. AB - The concentration of fluoride in drinking water is the major determinant of the prevalence and severity of dental fluorosis in a community. Fluorosis is more prevalent and discernible in permanent teeth than in primary teeth; the intensity can range from barely perceptible, whitish striations in enamel to confluent pitting and dark staining. The traditional belief is that fluorosis is produced only during the secretory stages of ameloblastic activity. Some recent reports suggest that the maturation stages of enamel development are as important as or even more important than the secretory stages as the time when fluorosis can be produced. The question of timing remains unresolved. Many questions also remain about general and individual physiologic variations in relation to susceptibility to dental fluorosis. Good criteria for differential diagnosis exist to distinguish dental fluorosis from non-fluoride enamel opacities. An increasing number of reports indicates that the prevalence of fluorosis may be increasing among children in fluoridated and non-fluoridated communities. Reasons for the increases may relate to misuse of dietary fluoride supplements, ingestion of fluoride toothpastes, or increasing amounts of fluoride in foods or the atmosphere. The intensity of the increased fluorosis is in the milder categories and is not generally unsightly. It should be recognized that a small amount of fluorosis may be an alternative to a greater prevalence of dental caries, a disease that may produce cosmetic problems and sequelae worse than those produced by fluorosis. PMID- 2701158 TI - Effect of prenatal and postnatal fluoride on the human deciduous dentition. A literature review. AB - Fluoride passes from the mother to fetal teeth. Much of the fluoride is taken up in secretory enamel, probably by the forming mineral apatite crystals. Some is retained with residual proteins. The low concentration of fluoride in the inner enamel is incorporated mainly during the secretory stage, while the enhanced concentration in the surface enamel is produced during the much longer maturation stage. Mature, hard enamel is generally absent during fetal life. The clinical question is whether prenatal fluoride imparts an additional benefit to the universally accepted effect of postnatal fluoride. In general, surface enamel fluoride levels of deciduous teeth increase with increasing pre- and postnatal fluoride administration. A consistent level of caries protection has been reported with pre- and postnatal administration of fluoride unrelated to the acquisition of fluoride in the surface enamel. Many children develop enamel opacities in their deciduous dentition related by various factors to enamel mineralization disturbances in drinking water areas even low in fluoride. Accumulation of fluoride due to an increased fluoride intake is a feature of fluorosed enamel in the deciduous as well as permanent dentition. The resulting mature fluorosed enamel retains a relatively high proportion of immature matrix proteins onto the crystal surface. The degree of fluorosis of the deciduous dentition is less compared with that of the permanent dentition, due probably to a partial protection afforded by the maternal loss of fluoride, formerly known as the "placental barrier". PMID- 2701159 TI - Enamel proteases in secretory and maturation enamel of rats ingesting 0 and 100 PPM fluoride in drinking water. AB - Dental enamel formed during ingestion of high levels of fluoride in drinking water has an increased organic content in the maturation stage, which may be due to a delay in the breakdown of amelogenins during the early-maturation stage of enamel formation. This delay in the breakdown of amelogenins in fluorosed enamel suggests an effect of fluoride on enamel proteases which hydrolyze the early secreted enamel proteins. In this study, we compared the proteases present in fluorosed and control secretory-stage and maturation-stage enamel. Enamel was demineralized and separated in SDS gels containing 0.1% gelatin. After incubation in 100 mmol/L Tris-HCl, pH 8, with 10 mmol/L CaCl2, the gels were stained with Coomassie Blue, and proteases were seen as clear zones of degraded gelatin. Similar bands of proteolytic activity were seen in fluorosed and in control enamel. In the maturation stage, more proteases were present than in the secretory stage of enamel formation. Less digestion of gelatin substrate occurred in several proteases found in the fluorosed maturation-stage enamel as compared with the control maturation-stage enamel. This suggests that the amount of protease secreted or the activity of the proteases may be altered in fluorosed maturation-stage enamel. PMID- 2701160 TI - Dental enamel hypoplasias in prehistoric populations. AB - Recent years have witnessed an impressive increase in research on enamel hypoplasias in archaeological populations. By reviewing a series of studies of enamel hypoplasias at Dickson Mounds, Illinois, North America (950-1300 A.D.), a prehistoric site involved in the transition from gathering-hunting to agriculture, this paper provides an illustration of this type of research. The location of linear hypoplasias on labial tooth surfaces of 111 adults was studied with a thin-tipped caliper, and this location was converted to an age at development. Most defects developed between two and four years of developmental age. Hypoplasias increased in prevalence from 45% in the pre-agriculture group to 80% in the agricultural group (p less than 0.01). The transition to agriculture occurred at a cost to infant and childhood health. Defects are associated with decreased longevity. Individuals with defects have a life expectancy of nearly ten years fewer than those without defects, suggesting that the development of a defect marks a significant and lasting health event. Enamel hypoplasias occur most frequently on anterior teeth, polar teeth in developmental fields, and the middle developmental thirds of teeth. Analysis of these data suggests that enamel may be differentially susceptible to growth disruption and that susceptibility varies both within and among teeth. The study of enamel defects at Dickson provides insights into the health and nutritional consequences of the economic change from hunting and gathering to agriculture. More generally, with the availability of teeth from genetically homogeneous populations, studies of enamel hypoplasias in prehistory should provide a useful complement to research on this condition in contemporary peoples. PMID- 2701161 TI - Developmental defects of enamel--historical and present-day perspectives of their pathogenesis. AB - Developmental defects of enamel are visible deviations from the normal translucent appearance of tooth enamel resulting from enamel organ dysfunction. In the past, information about the activities of the ameloblasts has determined the terminology used to describe the lesions. Advances in our understanding of the complicated secretory and maturation phases of amelogenesis have required a re-appraisal of the concepts of defect formation. The phase of ameloblast activity, the duration of the disturbance, and its severity leading to temporary or permanent inactivity of the cells determine the appearance of the three common types of lesions--hypoplasia, and diffuse and demarcated opacities. PMID- 2701162 TI - Human placentae: view from an immunological bias. AB - Human placentae form a major part of the interface between maternal and embryonic tissues. Placentae are morphologically complex organs that are lined with a trophoblastic tissue that provides anatomical constraints over which flows maternal blood. Maternal antibodies and immune cells thus contact the lining syncytiotrophoblast, and this paper considers some of the antigens that maternal immune components might encounter. The antigens have been grouped into those of unknown function, major histocompatibility antigens, and antigens of suspected function. The paper also details certain antigens of cytotrophoblasts. We discuss consequences of maternal immune responses to extraembryonic antigens and present evidence for amplification of these responses through the activation of hemostasis and fibrinolysis within the placenta and placental bed. PMID- 2701163 TI - Amniochorion: immunologic aspects--a review. AB - Exploration of trophoblast cell gene expression may assist in elucidating the mechanisms responsible for allowing genetically disparate maternal and fetal cells to coexist during pregnancy. In the extraplacental membranes, chorionic cytotrophoblast cells are in direct contact with maternal cells. In theory, paternally derived major histocompatibility antigens (HLA) expressed by the chorion cells should stimulate a graft rejection response by the mother, yet there is no evidence for lymphocytic infiltration of the membranes. The results of recent in situ hybridization, Northern blotting, and other molecular studies suggest that failure of maternal immune cells to attack the membranes may be due to the ability of chorion cells selectively to transcribe class I HLA genes and/or to process the products of those genes differently from other types of cells. Inasmuch as some tumor cells exhibit patterns of class I HLA that are similar to those of trophoblast cells, regulation of class I HLA expression may be a general mechanism used by cells expressing non-self antigens (paternally derived HLA, tumor-specific antigens) to establish residency in host tissues. PMID- 2701164 TI - Macrophages in human uteroplacental tissues: a review. AB - Macrophages are major cellular components of the uterus, the placenta, and the extra-placental membranes throughout pregnancy. Many macrophages in normal uteroplacental tissues are in an activated state as evidenced by their expression of class II major histocompatibility antigens. Activated macrophages are capable of synthesizing and releasing an impressive array of potent "monokines" and other molecules with dramatic effects on receptive cells. Macrophage activation levels can be further enhanced by exposure to either endotoxin from gram-negative organisms or to interferon-gamma from stimulated lymphocytes. Since prostaglandin E2 is one of the products of activated macrophages and can stimulate contraction of smooth muscle, macrophages may be responsible in part for the induction of preterm labor in cases of infection. Thus, understanding the conditions of uncomplicated pregnancy as well as the consequences of local infections requires exploration of the temporal, spatial, and functional characteristics of macrophages residing in uteroplacental tissues. PMID- 2701165 TI - Pathology of intrauterine growth retardation. AB - Uteroplacental vasculature is described and resultant placental pathology in intrauterine growth retardation (IUGR) discussed. The historical basis for suggesting an immunological role in IUGR is reviewed. Recent developments in cytogenetic studies that may have relevance in the IUGR are presented. PMID- 2701166 TI - Immunological role for seminal plasma in insemination and pregnancy. AB - Insemination confronts the female with paternally derived alloantigens and represents an immunological challenge preceding fertilization and implantation. Current evidence suggests a role for seminal plasma in regulating maternal immunity for insemination and pregnancy. In vitro seminal plasma has been shown to suppress T- and B-cell proliferation, neutrophil and macrophage phagocytic activity, as well as killer cell activity. Seminal plasma interacts with complement components C1 and C3 and contains factors that specifically bind the Fc region of IgG. These in vitro findings suggest possible seminal plasma suppressive effects on female alloimmune responses after insemination. Seminal plasma also contains allotypic TLX antigens that could prime mothers prior to fertilization. Such priming effects for pregnancy acceptance are supported by improved implantation rates in controlled clinical trials using timed vaginal exposure to semen during in vitro fertilization or gamete intrafallopian transfer treatment cycles. PMID- 2701167 TI - Expression of epidermal growth factor receptor and transferrin receptor by human trophoblast populations. AB - Epidermal growth factor (EGF) has several roles, including stimulation of cell division and differentiation. EGF receptor (EGFR) has been localized to villous syncytiotrophoblast, but expression by other human trophoblast populations has not been reported. EGFR expression was examined in normal and pathological placental tissues using a streptavidin-biotin-peroxidase technique; results were compared with expression of transferrin receptor (Tf-R) in similar tissues. EGFR was detected on villous syncytiotrophoblast in early and term pregnancy with labelling of the apical membrane, focal cytoplasmic reactivity, and patchy labelling of the trophoblast basement membrane. In contrast with other reports, EGFR was also consistently localized to villous cytotrophoblast, chorion laeve, and extravillous trophoblast populations in maternal uterine tissues. Maternal decidua showed diffuse labelling of stromal cells, particularly in the superficial zones. The reaction pattern in ectopic tubal pregnancy was similar to that in early intrauterine pregnancy. In molar pregnancy, EGFR was detected on villous syncytiotrophoblast and cytotrophoblast. In contrast, in normal, ectopic, and molar pregnancies labelling for Tf-R was confined to syncytiotrophoblast and to the proximal portions of the cytotrophoblast columns. Expression of EGFR by all trophoblast cells may represent a mechanism of placental growth and proliferation control. EGFR may also be involved with establishment of differentiated trophoblast functions including hormone secretion. PMID- 2701168 TI - Allogeneic recognition and rejection reactions in the placenta. AB - One of the major questions in medicine is how human extraembryonic tissues escape rejection by maternal immune responses, because these tissues are allogeneic and should stimulate allogeneic recognition and rejection reactions. Evidence for maternal allogeneic recognition of extraembryonic tissues in chorionic villi, basal plate, and spiral arteries is presented. Extraembryonic membranes seem always to stimulate maternal allogeneic recognition and rejection reactions, and abnormal pregnancies appear to be associated with a simple quantitative increase of the same placental immunopathological lesions found in normal pregnancies. PMID- 2701169 TI - Activation of 3,3'-dichlorobenzidine: enzymic basis and toxicological consequences. PMID- 2701170 TI - Transdermal absorption and skin metabolism of viprostol, a synthetic prostaglandin E2 analogue. PMID- 2701171 TI - Human placental xenobiotic and steroid biotransformations catalyzed by cytochrome P450, epoxide hydrolase, and glutathione S-transferase activities and their relationships to maternal cigarette smoking. PMID- 2701172 TI - Age-specific mortality rate analysis: a new paradigm for risk assessment. PMID- 2701173 TI - Effect of manual compared with reference point superimposition on image quality in digital subtraction radiography. AB - The aim of this study was to compare a new subtraction program based on positioning of reference points (RP) in the two images with the classic manual (M) superimposition of the images during recording. The experiments were performed on 22 dry mandibles from domestic pigs. A bone chip was prepared from the cortex with seven edges: 0.26, 0.30, 0.36, 0.42, 0.49, 0.55 and 0.72 mm thick respectively. Each mandible was radiographed at 0 degrees vertical angulation without the bone chip. The bone chip was then fixed to the lingual plate for a series of radiographs during which the vertical angulation was varied from 0 degrees to 10 degrees at 1 degree intervals. After completion of this series of exposures, amalgam fillings were placed in the two molars on the right side and a second series obtained. The radiographs were digitized (512 x 512 x 8 bit resolution), stored in a personal computer and then subtracted in a random order by the two methods. The RP method was found to be superior to the M method for all the angulations evaluated; as the images were more homogeneous as shown by the smaller SD in the grey-scale histogram. The best results were obtained on images with amalgam-filled teeth. Significantly more bone edges were seen with the RP method, especially when amalgam fillings were present. The RP method may therefore be superior to the M in clinical trials using subtraction radiography. PMID- 2701174 TI - Premaxillary hyperdontia in medieval Norwegians: a radiographic study. AB - An excavation of a part of the graveyard of St Olav's church, Trondheim, Norway, uncovered 389 tombs from the medieval period (1100-1600). Radiographic examination of 140 skulls with an intact premaxilla revealed hyperdontia in the form of a mesiodens in two (1.4%) cases. This is within the same range as similar medieval and present Nordic populations. Change in functional pattern does not seem to influence the prevalence. PMID- 2701175 TI - A comparison of meditation-relaxation and cognitive/behavioral techniques for reducing anxiety and depression in a geriatric population. PMID- 2701176 TI - Fallacy and danger of "public service". AB - Given their professed self-image as public servants, it is impossible for professional health-care associations to argue consistently against their membership's engulfment by Medicare, against the encroachment on our practices by governmentally empowered third parties, against the violation of our inalienable right of association, and against the growth of governmental agencies that seek to control the distribution of the "nation's health-care resources." If we are to reverse the trend toward total government control of health care in the name of "The Public," doctors must learn to defend their absolute, natural right to their own lives. Doctors must learn why providing health care is a right of doctors, not a privilege that they should have to bargain with politicians for. A necessary step is to learn what the public-service principle actually leads to and why it is such a destructive concept. PMID- 2701177 TI - Partial proteolytic digestion of the mammary prolactin receptor: identification of smaller prolactin binding fragments. AB - Partial proteolytic digestion of the mammary prolactin (PRL) receptor was used to generate receptor fragments and analyze their immunoreactivity and PRL binding properties. Tryptic digestion of the PRL receptor produced two immunoreactive fragments (Mr approximately 30,000 and approximately 15,000) that reacted with a monoclonal anti-PRL receptor antibody and still specifically bound PRL, while the complete immunoreactive PRL binding unit (Mr approximately 42,000) disappeared. Neither chymotrypsin nor V8 protease were able to generate any immunoreactive receptor fragments. These receptor fragments may represent smaller PRL binding receptor form(s) of biological significance. PMID- 2701179 TI - [Assistance to patients with AIDS]. PMID- 2701178 TI - Electrophysiological studies of visual word perception, lexical organization, and semantic processing: a tutorial review. AB - Visual word recognition requires the matching of an orthographic unit to its meaning via a phonological unit in the mental lexicon. The nature and the speed of this process are affected by "bottom-up" factors (e.g., the manner in which the phonology is represented by the orthography) and by "top-down" factors (e.g., network connections between related words in the lexicon, and contextual semantic information). Event-related potentials (ERPs) provide a relatively new tool that complements behavioral measures of word recognition. ERP components recorded during word perception tasks have been found to be sensitive to orthographic, phonological, and semantic manipulations. They go beyond behavioral measures by providing continuous information about the activity of the cognitive system from stimulus onset to the occurrence of the response. In addition, ERPs enable the researcher to examine word perception and reading in more natural situations, without time constraints and overt responses. Finally, intra-cranial ERP recording in humans and modern analytical techniques may shed light on the relations between cognitive linguistic processes and brain structures. Collaboration between cognitive psychologists, linguists, and ERP researchers will be necessary to exploit the great potential of these electrophysiological techniques. PMID- 2701180 TI - [Retrospective sero-epidemiologic survey on dengue virus in the municipalities of Cienfuegos and Palmira]. AB - A retrospective seroepidemiologic survey is made in the municipalities of Cienfuegos and Palmira to determine the presence of neutralizing antibodies to Den-1 and -2 virus in the population. It was found that 21.4% of the population studied had antibodies to Den-1, 12.3% to Den-2, and that 5.5% had been infected by the two serotypes (secondary infection). It became apparent that in the Palmira municipality the percentage of infection due to Den-1 was higher and it was found that in 1980-1981 there was a late dengue (Den-1) outbreak. Therefore, this municipality was probably the only in the country with 2 epidemic outbreaks due to two dengue serotypes (1 and 2) in a 6 month interval. The potential relationship between this fact and the high lethality of hemorrhagic dengue fever in this municipality is established. The influence of environmental, social, and sanitary factors on the risk of infection is suggested. It was found that Whites and Blacks are equally infected and that infection is not a random phenomenon, instead it is favored by the presence of vectors in and around the housing. PMID- 2701181 TI - [Monitoring of the treatment effectiveness in patients with leprosy using solid phase immunoenzyme assay]. AB - Serum samples from 184 lepers are studied by means of solid phase ELISA with the semisynthetic antigen disaccharide-bovine albumin analogous of phenolic glycolipid I of Mycobacterium leprae. Patients are grouped according to the clinical presentation of the disease and course of time elapsed since the institution of therapy. Bacilloscopic examinations were made also in 116 patients who were positive at diagnosis. For serologic testing, absorbance values over 0,160 were considered positive. Results in multibacillary patients showed a gradual and significant decrease both of mean absorbance values and in the seropositive ratio in connection with the length of treatment. It was also found that phenolic anti glycolipid antibodies increased with the value of the bacteriologic index. This system is useful in monitoring the effectiveness of chemotherapy in multibacillary leprosy. PMID- 2701182 TI - [Population density of intermediary hosts of tropical diseases in watercress beds]. AB - A study of the density of river mollusks in six watercress groves is made. It is seen how densities of F. cubensis, intermediate host of fascioliasis in Cuba, is maintained with relative stability. The poor effectiveness of P. duryi as an agent of biologic control is demonstrated. The high density of P. cubensis, which seems to exert a certain regulatory effect on F. cubensis--particularly in the months of reproductive peaks (August and September)--is emphasized. Densities of B. havanensis and B. helophila may be affected by the density of F. cubensis and P. cubensis, which may exert certain influence in the decrease of pulmonate density. F. cubensis and P. parvulus are morphometrically compared and a high correlation between length and width of the shell (r = 0.9) is emphasized; such correlation was smaller in P. parvulus (r = 0.7). PMID- 2701183 TI - [Single dose mebendazole for the treatment of Trichuris trichiura and Necator americanus in chemotherapeutic control campaigns in the communities]. AB - A study of intestinal parasitism is made in "Argelia Libre" community, Isle of Youth, by means of four coproparasitologic techniques: Kato Kratz, Ritchie, Direct, and Willis. Patients with geohelminths are divided into two groups of treatment: Group A, treated with 500 mg mebendazole in single doses and group B, treated with the classical scheme of 100 mg every 12 hours for three days. Results of treatment are expressed in terms of cure rates and percentage of egg count reduction. When comparing schemes A and B, no significant differences are found (p less than 0.05). Due to its lower cost and easier administration, the single dosage scheme is recommended for massive chemotherapy of geohelminthiasis in the community. PMID- 2701184 TI - [SUEROS: data-generating package on paired sera of respiratory infection viruses]. PMID- 2701185 TI - [Application of the Moore swab method to the isolation of Aeromonas spp. from residual waters]. AB - The Moore swab technique was applied in waste water from three different areas of the "Pedro Kouri" Institute of Tropical Medicine, with the view to isolate organisms of the genus Aeromonas. Swabs were placed once a week, in the wards of Medicine, Screening, and Diagnostic Laboratory. Of 13 swabs placed in the Medicine ward, 8 were positive. Of 15 swabs placed in Diagnostic Laboratory, 8 were positive, and of 18 placed in the screening ward, 12 were positive. Of a total 46 swabs, 28 disclosed organisms of the genus Aeromonas. PMID- 2701186 TI - [Evaluation of the anti-influenza vaccine in students from basic high school]. AB - The anti-influenza vaccine was applied to a group of 217 students of "Batalla del Jigue" Secondary School which was compared to a group inoculated with the vaccine placebo with the view to evaluate the results of vaccine protection against the flue, as well as to determine its secondary effects in an adolescent population. There was a significant difference in the immunologic response in favor of the vaccine group as compared to controls for both strains of the antigenic contents of the vaccine Influenza A/Philippines/2/82 (H3N2)--A/Kiev/59/79 (H1H1). The local side effects found in the highest ratios in the group receiving the anti influenza vaccine were papules (51.0%) and erythema (44.0%) with statistically significant differences in relation to the group receiving placebo. Fever was the general reaction most frequently found, for 8.4% 48 hours after its application among immunized students. During the subsequent epidemiologic surveillance a greater incidence of influenzal patients was found in students not receiving the anti-influenza vaccine. These results may serve as a starting point for new investigations in our environment. PMID- 2701187 TI - [Socioeconomic status and hygiene habits of the members of a rural community from the province of Habana]. AB - A study is made of the socioeconomic conditions, environmental sanitation, and hygienic habits in the members of a rural community in Havana province. This was compared with the results of a stool culture analysis made to all inhabitants of this locality in order to determine the degree of infestation by intestinal parasites. It was found that sanitation conditions are good, which explains the low prevalence of helminths. The greatest proportion of parasitized people show inappropriate habits of personal hygiene, which explains that most of them are due to protozoa. PMID- 2701188 TI - [Presence of Tarebia granifera (Lamarck) (Mollusca: prosobranchia) in several fresh water bodies in the municipality of Sancti Spiritus]. AB - The distribution of T. granifera in bodies of sweet water in Sancti Spiritus municipality is studied. It was found that it is widely distributed and that it occupies very varied biotopes, except in places with a high organic contamination. PMID- 2701189 TI - [Rhinosporidiosis: a study of 33 cases diagnosed using biopsies at the Central Hospital of Maputo, since 1944 through 1986]. AB - A statistical review of the archives of the Laboratory of Pathologic Anatomy of Maputo Central Hospital is made with the view to determine the frequency of occurrence of rhinosporidiosis in biopsies in the years 1944-86. Diagnosis was made based on the specific microscopic picture shown by the lesions induced by Rhinosporidium seeberi. Of 91,000 reports only 33 cases of the disease were found, which accounts for 0.036% of the total biopsies made in the department. Tissular examinations showed that lesions always appear as polypoid masses lined with hyperplastic epithelium, with an intense inflammatory reaction involving the sporangia, which in slides appear as double-membrane spheres with the occasional rupture-freed spores. It was found that in the series studied the disease appeared most frequently in the period ranging from 10 to 19 years of age, with no sex prevalence. General statistics indicate that the greatest damage was found in bulbar conjunctiva and that location in nostrils was the most frequently found in the age group with the youngest people. PMID- 2701190 TI - [Pregnancy in women 40 years of age and over: analysis of variables in the mothers and newborn infants]. AB - Although pregnancy in women who are forty years old or more is considered a high risk pregnancy, it has occurred more frequently in recent years. This paper reports an analysis of 205 cases of patients over forty years of age seen at the Obstetrics Department of the Sao Paulo School of Medicine at the Sao Paulo Hospital. A control group of 1,153 pregnant women ages ranging from 20 to 29- such age range being considered the proper age for reproduction--was formed for the purpose of comparison. Data were stored in computer and lists of many variables were settled to provide a statistical overview through non-parametric testing based on the nature of the variables. 5% was the level of significance set to reject a null hypothesis. The results permit authors to conclude that pregnant women who are forty years old or over present inadequate biological characteristics for a proper obstetric development, based on the advanced age and on the association of many other adverse factors. PMID- 2701191 TI - [Chlamydia trachomatis in smears of irradiated uterine cervix: cytologic and immunocytochemical aspects]. AB - Some authors recently suggested the role of Chlamydia trachomatis as a potentiating agent of female genital tract neoplasias. Cervicovaginal smears of women with uterine carcinoma treated with radiotherapy are analyzed in the present work. A series of such smears showed morphological changes suggestive of Chlamydia infection with the Papanicolaou stain. Confirmation of the presence of such agent was done using an avidin-biotin-peroxidase technique. A higher prevalence of Chlamydia in the group of patients with carcinoma of the uterus treated with irradiation than in the population without ionizing treatment was verified. The presence of cells with radiotherapic changes infected by Chlamydia is a new finding in cytology. PMID- 2701192 TI - [Evaluation of the effects of ionizing radiation and cyclophosphamide on the bone marrow of mice, by counting non-nucleated and nucleated cells]. AB - Bone marrow injury after exposure to ionizing radiation and cyclophosphamide was evaluated by morphologic analysis and by the ratio erythrocytes/nucleated cells (NN/N). The authors show the efficiency of the method proposed, which can be determined in bone marrow samples of variable and unpredictable size. PMID- 2701193 TI - [Pulmonary hypertension in adult respiratory distress syndrome: review of the literature]. AB - This paper is a review of clinical and experimental studies on pulmonary hypertension in acute respiratory distress syndrome (ARDS) and its consequences on the outcome of such syndrome. The most probable causes: hypoxic pulmonary vasoconstriction, vasoconstriction provoked by vasoactive substances, extra and intraluminal occlusions are discussed. The authors also discuss the action of vasoactive drugs on the pulmonary circulation and on the pulmonary gas exchange. PMID- 2701194 TI - [Legionella pneumophila associated with acute respiratory insufficiency. 1st isolation in Brazil]. AB - Isolation of Legionella pneumophila sero-group 1 with serological evidence of present infection is reported from a 40 year-old male with serious respiratory infection which developed into acute respiratory failure. It was characterized by severe hypoxemia resistant to high inspired oxygen concentrations and radiographically by diffuse infiltrates in both lungs suggesting the clinical aspect of ARDS. Following the introduction of clindamycin, amikacin, ceftriaxone, volume-cycled ventilator and positive end expiratory pressure (PEEP) of 14 cm H2O, stabilization of clinical conditions and gradual recovery were achieved. Suspecting of legionellosis, blood and tracheal secretions specimens were collected for specific laboratory research. From tracheal secretion cultivated in BCYE medium, gran-negative bacilli were isolated and identified as Legionella pneumophila serogroup 1 through cultural and biochemical characteristics and direct immunofluorescence and slide agglutination tests. Serology (IFA) with blood samples collecting during the 1st, 3rd, 4th and 6th weeks of illness demonstrated antibody titers to the isolated microorganism of 128, 1024, 4096 and 8192, respectively. Definitive results were obtained during the patient's recovery. The authors emphasize: a) the demonstration of the presence of Legionella sp. as a pathogenic agent in Brazil; b) the importance of supportive care in the clinical outcome; c) the need of remembering this pathogen while making differential diagnosis of pneumonias and of continuing to pursue this etiology with specific laboratory methodology. PMID- 2701195 TI - Periodontal and pulpal conditions of abutment teeth. Status after four to eight years following the incorporation of fixed reconstructions. AB - In the present retrospective clinical study, 58 patients were examined 4 to 8 years (median 77 months) following the incorporation of a fixed reconstruction. No regular maintenance care had been provided during the interval period. The periodontal conditions represented by the Plaque Control Record (PCR), the Gingival Index (GI) and pocket probing depths were examined on 182 abutment teeth of 94 reconstructions. Pulpal vitality and periapical pathology were assessed clinically as well as radiographically. The periodontal parameters of the abutment teeth were compared with homologous contralateral uncrowned teeth. Significantly higher plaque prevalence, gingival indices, and pocket probing depths were found in the crowned teeth. Also, bleeding on probing was observed more frequently whenever the crown margins were located subgingivally. At the end of the interval period, 3.7% of the originally vital abutments had lost their vitality. A technical failure rate of 7.4% with no apparent differences between conventional and extension bridges was noted. This study indicates that even with precise marginal fit and in the absence of a regular maintenance program, the supragingival location of the crown margin is more favourable than the subgingival location for the maintenance of oral health. PMID- 2701196 TI - [Guided periodontal tissue regeneration. The technic, clinical observations and assessment]. PMID- 2701197 TI - [Subgingival curettage. A recall of the past and the current position]. PMID- 2701198 TI - [Systematic planning in the bonded denture]. PMID- 2701199 TI - [The usage of E.M.G. in the dental research and the clinical practice]. AB - The first part of this review, refers to the use of electromyography (EMG) in studying the stomatognathic system. EMG is used for the study of function and fatigue of the masticatory muscles, the recording of centric relation etc. The behavior of the masticatory muscles (especially of the masseter and the temporalis) in the cases of TMJ dysfunction are also reviewed. In the second part, there is a description of the use of EMG biofeedback in the treatment of TMJ dysfunction, myofacial pain and bruxism. Finally, there is reference to the portable modular EMG biofeedback units. PMID- 2701200 TI - [Prosthodontic treatment to patients with deep overbite]. AB - After a literature review concerning the special needs in the prosthodontic rehabilitation of patients with deep over-bite, the problems and solutions are described and discussed. The prosthodontic rehabilitation of two cases follows and is described step by step. PMID- 2701201 TI - [Microbial permeability of dentin]. AB - This is a review of the literature about the contemporary aspects of microbial permeability of dentin. They are discussed the factors that are responsible for this question and analytically: the structure of dentin, the composition of dentin in organic and inorganic ingredients, the response mechanisms of dentin, that is the irritation dentin and sclerotic dentin, the hypermineralized zone under carious lesions, the role of saliva and dentinal fluid, the role of pulp and its microcirculation against the invasion of microbes and, the role of smear layer. Also this article refers to the immunological reaction of the pulp and finally to the role of dentist in the permeability of dentin, because the more conservative is a tooth preparation the less is the permeability of dentin. In conclusion, the microbial permeability of dentin is a very complicated biological phenomenon that needs more study and further investigations. PMID- 2701202 TI - [Osseointegration and tissue-integrated prostheses]. AB - After surgical uncovering of the fixtures and abutment connection a preliminary impression of the entire ridge and surgical area is made. From the resultant cast an impression tray is fabricated for the final impression. At least 1 week should elapse after abutment connection before final impression is made. The presence of sutures and easily traumatized attached gingival tissues may complicate oral procedures. After the impressions have been made, jaw relationship has been recorded, casts have been mounted on an articulator, and tooth arrangements has been verified, a rigid metal framework is cast in gold or in silver-palladium alloy from a wax-acrylic pattern. The metal construction consists of at least 6 mm of vertical height and buccal-lingual width and sufficient rigidity of the cantileverded sections billaterally. The artificial dentition is then reassembled on the new frame in the predetermined position and examined in the mouth for confirmation of fit and appearance. The prostheses is then temporarily secured to the abutments using small gold screws for approximately 1 month as an adjustment period. PMID- 2701203 TI - Intracolonic bacterial metabolism. PMID- 2701204 TI - Control mechanisms of the large-intestinal microflora and its influence on the host. PMID- 2701205 TI - Influence of Lactobacillus in the gastrointestinal tract. PMID- 2701206 TI - [Oxygen transport and secondary hypoxic polycythemia]. PMID- 2701207 TI - [Arterial embolism of the extremities. Bases for its treatment]. PMID- 2701208 TI - [From Still's disease to chronic juvenile polyarthritis]. PMID- 2701209 TI - [Biomechanical retention system for complete and partial dentures]. PMID- 2701210 TI - Pros and cons of intra-arterial chemotherapy. AB - Pharmacological studies in humans and animals have documented increased local tissue and plasma concentrations of a number of different chemotherapy agents after intra-arterial chemotherapy administration. In addition, animal studies have shown superior therapeutic efficacy using this approach. While some clinical studies of intra-arterial chemotherapy have been negative, others have supported the contention that it is advantageous in some situations. It could potentially help preserve local organ function, palliate, and prolong survival. It would have the potential of increasing cure rates only for tumors that usually kill as a result of localized disease rather than as a result of metastases. On the negative side, it has not been unequivocally proven to be superior to systemic chemotherapy administration, it is technically difficult and expensive, and it can be exceptionally toxic. Further studies are warranted, but for most tumor types, it should still be considered investigational. PMID- 2701211 TI - More on the treatment of relapsed acute myeloid leukemia. PMID- 2701212 TI - Colony-stimulating factors in the treatment of HIV-associated non-Hodgkin's lymphoma. AB - Treatment results using standard chemotherapeutic regimens for patients with intermediate and high-grade non-Hodgkin's lymphoma have been disappointing. For patients with HIV-associated lymphoma, whose bone marrow tolerance is so limited, conservative dose combination chemotherapy has been the only realistic option. Now, however, the availability of recombinant colony-stimulating factors allows more dose-intensive therapy to be used. Both recombinant human granulocyte colony stimulating factor and recombinant human granulocyte macrophage colony stimulating factor have undergone Phase I testing and have been shown to reduce bone marrow toxicity following combination chemotherapy in non-HIV-infected patients. While this may be a promising lead for the treatment of HIV-infected patients also, it must be noted that until randomized trials are performed, no clear effects on survival or response can be verified. PMID- 2701213 TI - Issues in recruitment: what nurse managers can do. PMID- 2701214 TI - Structural diversity in domains of the immunoglobulin superfamily. PMID- 2701215 TI - Cross-linking and conformational change in T-cell receptors: role in activation and in repertoire selection. AB - TCRs undergo a series of interactions with ligands during development. We have characterized the interaction of a TCR with its ligand and the attendant co receptor and co-ligand structures. This characterization has led to the model in which the TCR not only binds to class II MHC, but also binds to CD4 co-receptors and co-ligands such as Mls. We have shown that both cross-linking and conformational change in the TCR are required for optimal T-cell activation. Finally, we have used the observation that a particular self-peptide found abundantly associated with class II MHC in the periphery is essentially lacking from thymic cortical epithelium to argue that positive selection for self-MHC recognition may occur by a novel process in the thymic cortex. A TCR recognizing class II MHC with low affinity could either be multiply cross-linked in the absence of conformational change, which here would be driven by a unique peptide, or could be conformationally changed without cross-linking due to the rarity of the individual high-affinity peptide on thymic cortical epithelial cells. Either proposal leads to a partial signal one delivered via the TCR, which we refer to as signal one-half. This signal one-half would induce the cell to repress its other co-receptor molecule and to undergo maturation events such as up-regulation in TCR expression. Such cells are then rigorously screened for activating interactions with autologous structures, such as Mls. The threshold for clonal deletion is set very low to avoid autoreactivity. By this combination of signaling events, a mature TCR repertoire is generated that has the functional characteristics observed in immune systems. PMID- 2701216 TI - T-cell tolerance to H-2 molecules: role of the thymus. PMID- 2701217 TI - Extrathymic acquisition of tolerance by T lymphocytes. PMID- 2701218 TI - Reactivity and tolerance of virus-specific T cells. PMID- 2701219 TI - Evolution, function, and utilization of major histocompatibility complex polymorphism in autoimmune disease. PMID- 2701220 TI - Models of B-cell unresponsiveness. PMID- 2701221 TI - Clonal silencing of self-reactive B lymphocytes in a transgenic mouse model. PMID- 2701222 TI - The new pragmatics of immunology. PMID- 2701223 TI - Carcinoid tumors and the carcinoid syndrome. PMID- 2701224 TI - [Estimation of the printing preparations from the gingival pockets on the styrophlex straps with application of telemicroscopy]. AB - Printing preparations from the gingival pockets coloured by means of Shorr's method and secretion of pocket fluid have been estimated in 33 patients before and after balneological treatment. A telemicroscope has been used to estimate the preparations. The preparations have been analyzed in the linear enlargement of 1500 times using a network consisting of 35 fields of the dimensions of 3 cm x 3 cm (20 microns x 20 microns in the preparation) marked on a monitor screen. It has been that the sample representative for the whole preparation is contained in the band lying along its centre long axis and it occupies 6.33% of the preparation surface. Correlation between the number of granulocytes and the number of fields with granulocytes and the height of the granulocytar infiltration and between the number of granulocytes in the printing preparation and the excretion of the pocket fluid has been demonstrated in patients before treatment. PMID- 2701225 TI - [Influence of intraoral douches over the parodontium state and leucocytes activity in patients treated in the sanatorium of Swieradow Zdroj]. AB - Using the following indices: gingival--GI, of gingivorrhoea--GBI, of parodontium- PI and of dental deposit--DI and the measure of the gingival pockets' depth and pocket fluid clinical estimation has been performed in 33 men with parodontium inflammation before and after the set 15 balneological procedures. Leucocytes and other morphotic elements in the pockets have been estimated on Styrophlex straps. Examinations of the peripheral blood have comprised NBT spontaneous test and stimulated by concanavalin, phagocytosis and chemotaxis. After treatment considerable clinical improvement, decrease in pocket fluid excretion reduction in the number of granulocytes and increase in epithelial cells' percentage in the gingival pockets as well as existence of disturbances in granulocytes function of the peripheral blood expressed by reduced chemotaxis and phagocytosis have been found. PMID- 2701226 TI - [Demineralization and remineralization of enamel in the light of the most recent literature reports]. AB - In the light of a review of the most recent literature reports the present views on demineralization and remineralization of enamel in vivo and in vitro are presented. Modes and conditions of the development of artificial enamel damage of the character of incipient caries are discussed. The possibility in stressed of cure of initial enamel damage after application of calcification-inducing solutions and human saliva. PMID- 2701227 TI - [Effect of gluten-dependent coeliac disease on the condition of oral cavity and teeth in children]. AB - After a review of the pertinent literature the effect is described of gluten dependent coeliac disease on the condition of the oral cavity and teeth in children. Attention is called to the condition of the parodontium on the occurrence of developmental abnormalities of hard dental tissuses and caries intensity. PMID- 2701228 TI - [Treatment of impacted upper central incisor]. AB - The impaction of the upper central incisor is a common problem for the clinical orthodontist. The correct diagnosis is a fundamental factor in trying of the alignment of this tooth in the dental arch. There are cases where treatment should be conservative and removing the responsible for the impaction factor is all need to be done, for the tooth to erupt. In other cases, however, surgical exposure and orthodontic traction are both necessary. Three cases with impaction of the upper central incisor are described as well as the treatment provided and a literature review of the above subject is presented. PMID- 2701229 TI - [Clinical use of osseointegrated two-phase implant systems]. AB - The Intramobile Cylinder (IMZ) two-stage osseointegrated implant system is unique. The IMZ implant system incorporates a Derlin, intramobile element (IME) which simulates the periodontal ligament of the natural tooth unit. This shock absorbing element distributes stress and functional load in a physiological manner so that the semi-edentoulous patient may be reconstructed by splinting to the adjacent natural teeth. This article discusses the IMZ implant system, its surgical insertion and its clinical use. PMID- 2701230 TI - [Radiologic techniques for the evaluation of the T.M.J]. AB - A large number of techniques are available for the soft and hard tissue evaluations of the temporomandibular joint. For an initial hard tissues examination conventional methods are indicated. If a more particular evaluation of the hard tissues is necessary conventional tomography, and especially hypocycloidal variety may be used. Of course modern tomographic techniques like computed tomography and magnetic resonance imaging afford more particular imaging of the hard mainly and the soft tissues of the temporomandibular joint. In cases where soft tissues (disc, posterior ligament) evaluation of the joint is necessary, arthrographic techniques as methods of choice are indicated. In addition computed tomography and magnetic resonance imaging may be used as they image hard and soft tissues synchronously, something which is important as the osteoarthritis frequency increases with meniscal disorders. In this study, we are discussing the radiologic techniques we use for T.M.J. radiologic evaluation and show cases that we have examined and diagnosed. PMID- 2701231 TI - [Radiologic evaluation of cervical metastatic adenopathy]. AB - A radiologic evaluation in nine patients with cervical adenopathy because of metastatic disease at a known or unknown primary site, inflammatory lymphadenitis or with masses simulating with cervical adenopathy was done. All patients were examined normally by an oral and maxillofacial or E.N.T. surgeon before the radiologic evaluation with CT, ultrasonography and/or sialography. CT was done in seven out of nine patients as the unique technique or in combination with ultrasonography and/or sialography, while ultrasonography was used in two of the cases as a unique imaging technique and in one case in combination with a CT examination, without any intravenous contrast administration. A primary site was diagnosed in five cases, while in a sixth case was not diagnosed. In an eighth case of submandibular nodal enlargement, the diagnosis of Hodgkin's disease was established after a biopsy. For the last two cases the diagnosis of tuberculous cervical lymphadenopathy was confirmed. From the above cases it is clearly shown that computerized tomography, especially with intravenous contrast administration, ultrasonography and sialography in some of the cases, are necessary as routine examinations, before a diagnosis of cervical metastatic disease is to be done. PMID- 2701232 TI - [Solitary plasmacytoma of the mandible]. AB - Solitary plasmacytoma of the bone is believed to be manifestation of the spectrum of diseases presented by the term plasma cell neoplasms and the lesion rarely involves the jaws. A case of solitary plasmacytoma of the mandible is presented, the diagnostic problem is posed and the method of treatment by peripheral osteotomy and radiotherapy discussed. PMID- 2701233 TI - [Reconstruction of the severely resorbed mandibular ridge using Branemark tissue integrated prostheses]. AB - Reconstruction procedure for the severely resorbed mandibular edentulous ridge has historically involved the use of a variety of surgical procedures and biologic and nonbiologic materials with limited success. The treatment of three patients with severe mandibular ridge resorption utilizing Branemark Osseointegrated Prostheses is described. PMID- 2701234 TI - Tissue response to different composite resin implants in albino-rats. PMID- 2701235 TI - [Pathogenic characteristics of Escherichia coli strains in cases of asymptomatic bacteriuria and symptomatic urinary tract infections]. AB - The aim of this study was to examine if E. coli isolated from asymptomatic bacteriuria differed in pathogenic features from strains isolated from symptomatic infections of urinary tract. In this study 130 strains of E. coli isolated from women having asymptomatic bacteriuria and 112 strains isolated from patients with symptoms of urinary tract infection were examined. It was shown that E. coli isolated from patients with symptomatic urinary tract infection showed the more frequently ability to cause mannose-resistant haemagglutination of human erythrocytes, resistance to bactericidal activity of serum and haemolytic properties than those isolated from asymptomatic bacteriuria. These strains showed also the higher ability to adhere to Vero cells in tissue culture. Among E. coli strains isolated from persons with asymptomatic bacteriuria the pathogenic features were most frequently found in strains from healthy women and the most rarely in isolated from diabetic women. PMID- 2701236 TI - [Diagnostic and clinical characteristics of mycotic vaginitis caused by Candida glabrata (Torulopsis glabrata)]. AB - In this study an evaluation of frequency of occurrence of C. glabrata, its diagnosis, sensitivity to antifungal drugs and its significance in pathogenesis of mycotic vaginosis was performed. Strains belonging to C. glabrata genus constituted 12.1% of total of 852 isolated strains and 39.2% of strains other than C. albicans. During fungal vaginosis caused by C. glabrata Lactobacillus sp. was present and normal pH values of vaginal secretion were seen. In direct preparations single or few leukocytes were observed and usually numerous blastospores were present. During evaluation of the sensitivity of C. glabrata strains to antimycotic agents a decreased sensitivity of these strains to clotrimazole and ketoconazole was found what speaks for their low usefulness in the treatment of mycotic vaginosis. Significance of C. glabrata in pathogenesis of mycotic vaginosis is not questioned since release of complaints and clinical symptoms in patients with positive therapeutic effect is seen and their persistence in a group of patients with treatment failure. PMID- 2701237 TI - [Bioelectric activity of the brain in insulin-induced hypoglycemia in children with growth deficiency]. AB - The somatotropin levels during insulin-induced hypoglycemia was assessed in 30 children with growth deficiency. The variation of glycemia and somatotropin activity were evaluated during 120-minutes recording of the bioelectric activity of the brain. In 90% of children generalized and paroxysmal abnormalities were found during insulin-induced hypoglycemia. The exacerbation of them was correlated with the maximal decrease of the glucose level. Early appearance of the abnormal EEG findings after the administration of insulin and the significant intensity of them was more common in younger children with marked growth deficiency and low somatotropin activity. PMID- 2701238 TI - [Side effects of cefoperazone (third-generation cephalosporin) in a child with acute lymphoblastic leukemia]. PMID- 2701239 TI - [History and activities of the Children's Friends' Association]. PMID- 2701240 TI - [Xerostomia and hyposalivation: clinical aspects]. AB - In stomatology, salivary function and dysfunction are seldom discussed in their biological and psychological aspects; too often, the terms are mistakenly used as synonyms. The importance of identifying these conditions not only involves direct therapeutic implications, as it can additionally influence global and systemic buccal conditions, as well as modify tissue response and psychological adaptation to dental, periodontal and prothesis therapy as currently performed in daily practice. The physiopathogenesis, etiology, the local and general clinical repercussions, as well as those on behavior, the methods of clinical evaluation and treatment/handling of hyposalivation and xerostoma, are presented and discussed. PMID- 2701241 TI - [Oral manifestations in patients infected with human immunodeficiency virus]. AB - This study describes the stomatological findings reported on 20 Peruvian patients infected by the human AIDS virus. Lesions occurring most frequently were: xerostoma (80%), pseudomembranous candidiasis (70%), commissural cheilitis (55%), atrophy of filiform papillae (40%), ulcerative lesions (30%), vellous leucoplasia (25%) and erithematose or atrophic candidiasis (25%). Prevalence of the diverse lesions detected was correlated with the clinical stage of the disease in order to identify those manifestations that could be considered as early signs or precursors of the Acquired Immuno-Deficiency Syndrome (AIDS). The present article includes a review of the literature related to those clinical, epidemiological and preventive aspects that the dental surgeon must understand if he is to perform diagnosis and treatment on this type of patients. PMID- 2701242 TI - [Immunotherapy and its possible application in malignomas of the orofacial region. Review]. AB - The authors give an account of the types of active and passive immunotherapy in malignomas. Based on data in the literature they evaluate its possibilities in clinically used and perspective methods. For practical use in the orofacial region they emphasize the necessity to follow up tumour markers. PMID- 2701243 TI - [Quality of marginal sealing of Evicrol fillings when using dental adhesives in vitro]. AB - The quality of the marginal sealing of fillings made from Evicrol in vitro was investigated by means of a couloured indicator. The close adherence of the composite filing to the surface of the tooth was ensured by the by micro retention treatment of the marginal enamel and different dentin adhesives. The thermal strain of filling materials and their combination with the tooth, corresponding roughly to conditions in the oral cavity, was modelled by cyclic temperature changes using a special apparatus designed by the authors. PMID- 2701244 TI - [Physiopathologic aspects of coronary occlusion]. PMID- 2701245 TI - [Surgery for myocardial revascularization]. PMID- 2701246 TI - [Coronary angioplasty: current status and perspectives]. PMID- 2701247 TI - [Dental prevention in the geriatric patient]. AB - Dental health depends on the behavior of the individual in a great measure and of the groups. To achieve a general improvement of the situation at this respect is necessary the application of efficient measures of sanitary education . Many obstacles oppose to the adoption of a positive concept of dental health in gerontology, among them it is to emphasize the belief so widespread that dental problems can not be helped and its prevention turns out to be impossible. The aim of preventive gerontology will be the maintenance of dental health. With this, we will contribute to the attainment of the greatest possible level of physical, social and mental health of the elderly. PMID- 2701248 TI - [Stomatologic vision of don Bernardino Landete]. PMID- 2701249 TI - [Overdentures supported by osseointegrated implants in the totally edentulous. Three years experience]. PMID- 2701250 TI - [Ameloblastic fibro-odontoma. Bibliographic review and report of a case]. PMID- 2701251 TI - [New concepts in adhesive dentistry. (1). Materials. Cavity preparation. Cavity lining]. PMID- 2701252 TI - [Elderly with remaining teeth without dentures]. AB - It has been carried out an inquest in a geriatric group in institutionalised regime, classifying people interviewed depending on dental health in three groups: Group I: Edentate ancients bearers of total prosthesis. Group II: Ancients with remanent pieces. Group III: Ancients with remanent pieces and bearers of prosthesis. In the present work, all findings related to oral health are detailed, referred uniquely to group II: "Ancients with permanent pieces". Obtained data let us get to some conclusions we consider must be of general diffusion for trying to understand and to solve the existing disputable in this segment of the population, so long forgotten and marginal. PMID- 2701253 TI - [Senor Sequoa: "He of the golden tongue"]. PMID- 2701254 TI - Post-orthodontics prosthodontics. PMID- 2701255 TI - [Perioprosthetics are one of the most sensitive fields of dentistry]. AB - The success of a prosthesis, in the past was related only to the perfectness of construction and the occlusion. Nowadays the criterion for the acceptance of a prosthesis is its good relation to the gingival tissues. It would be a great error to isolate some parts of the prosthesis and study their possible influence to the gingival tissues. Instead of this, prosthesis should be seen on its whole. The proceeding for the prevention of the periodontal damage is related to all the stages of the construction of a prosthesis beginning from the tooth preparation, the impression till the fixation of the temporary prosthesis. According to these, the present study deals with the elements of the prosthesis which may affect the gingival tissues. PMID- 2701256 TI - [Serotyping of 27 Cryptococcus neoformans strains isolated in Venezuela]. AB - Twenty seven autochtonous isolates of Cryptococcus neoformans from different parts of the country were studied. The analysis indicated the following serotype distribution: 63% Serotype A, 29.6% Serotype B, 3.7% Serotype D and 3.7% belonging to C. neoformans var gattii. PMID- 2701257 TI - [Karyotyping of Holochilus venezuelae (Rodentia, Cricetidae)]. AB - We studied the cariotype of Holochilus venezuelae from 28 individuals (14 males and 14 females). Chromosome preparations were obtained by applying colchicine to live animals, followed by hypotonic shock, acetic methanol fixation and Giemsa staining of bone marrow cells. Metaphase configurations were photographed with a M-20 Wild automatic photomicroscope, and 10 karyotype from each animal were prepared from enlarged prints. Idiograms were calculated from the mean length of each chromosome pair and expressed as percentage of the length of the haploid autosome set plus one X chromosome. Results indicate the presence of six karyomorphs and the most frequent karyotype, considered basic for the species, was 2n = 44 (NF = 56), which consists of seven pairs of metacentric chromosomes (five large, one small and one microchromosome), comprising 59.5% of the haplid set; fourteen acrocentric pairs (nine small and five microchromosomes) representing 32.0% of the set; and the sexual pair, which is acrocentric, represent 6% (X) and 2.5% (Y) of the haploid set. The chromosome polymorphisms can be interpreted as the result of Robertsonian changes (fusion) and from the presence of accessory chromosomes (supernumerary). The karyotypical characteristics of the population sample studied suggest the existence of reproductive isolation through chromosomal hybrid sterility with H. brasiliensis (2n = 56 and 2n = 50), which means that H. venezuelae can be considered an allospecie. PMID- 2701258 TI - Trypanosoma (Herpetosoma) rangeli Tejera, 1920: study of the effects of the parasite on the vector. AB - For evaluation of the possible pathogenicity of Trypanosoma (Herpetosoma) rangeli Tejera, 1920 to the triatomid vector, first-stage nymphs of laboratory-bred insects were engorged upon albino mice showing average parasitemias of 2 x 10(6) and 2 x 10(5) trypanosomes/ml blood. The vector strains were: Rhodnius prolixus ("New" strain), Triatoma pallidipennis, and Triatoma vitticeps. An "Old" strain of R. prolixus (maintained 30 years in the laboratory) was also employed to check the effects of laboratory breeding. Other lots of nymphs of the same vector strains were fed on healthy mice as controls. T. rangeli produced intense infections in the gut and hemolymph of all the vector tested, with later differentiation in the salivary glands to metatrypomastigotes that could be transmitted by the bite of the insect and establish infections in healthy mice. No statistically significant differences whatever between infected and control bugs were found for degree of engorgement, percentage or cause of mortality, molting time, oviposition/female, hatching time, percentage of hatching, or duration of life cycle. The possible role of experimental methodology in producing pathology in infected insects, and the epidemiological significance of a strain of T. rangeli non-pathogenic to the vector are discussed. PMID- 2701259 TI - [Protection of the dentino-pulpal organ]. PMID- 2701260 TI - [Morphological adaptations of the eyes of vertebrates: retinal trophism and the response to environmental stimuli]. AB - The results of many investigations on the morphology of the eyes of Vertebrates are proposed, comparing our personal data with the literature available on this argument. It is firstly taken into account the retinal nourishment: it takes place according to direct and indirect mechanisms (Scheme 1). The former (Scheme 2) consist of intraretinal blood vessels and are particularly rare among the Vertebrates; the latter are more numerous and can be classified as constant (choriocapillaris) (Schemes 3A, B), if they are present in all the species up today investigated, or unconstant [Muller cells increased in their number and size (Scheme 5A), papillary cone (Schemes 5B, 8B), membrana vascularis retinae (Schemes 6A, C), falciform process (Schemes 6B, 7A, B, 8B), pecten oculi (Schemes 8A, B)], if they can be demonstrated only in some species, even if belonging to different classes. Their structural and ultrastructural organization, likewise their embryological processes, are examined in detail. The effects of the cyclic changes of light and darkness during a 24 hrs period on the eyeball are then examined; quantitative and qualitative modifications of the mitochondria (Schemes 9A, B) and of the synaptic ribbons (Schemes 10A, B) in the outer plexiform layer, of the photosensitive disks of rods and cones, and of the secretory cells and of the excretory ducts of the Meibomian tarsal glands (Schemes 11A, B, 12A, B) are described. If the animals are exposed to prolonged darkness, no structural changes can be demonstrated; nevertheless, a dark environment can induce the differentiation of peculiar structural specializations, such as the retinal or choroidal tapetum lucidum (Schemes 13, 14, 15). On the contrary, the light, if prolonged or of high intensity, is able to induce irreversible lesions on the photoreceptors and on the pigment epithelium, according to similar mechanisms in all the animals up to now investigated (Scheme 16). In conclusion, it is confirmed the peculiar structural complexity of the eyeball in all the classes of Vertebrates, due to adaptation to the various environmental requests and developed either during the evolutionary processes or during the different steps of the life of a single animal. PMID- 2701261 TI - [Study on clinical standard consistency of the luting cement]. AB - Various properties of dental luting cement are influenced by powder/liquid ratio. The standard consistency of luting cement is determined in Japanese industrial standard and American dental association's specifications. However, it is not considered that a constant consistency is best for luting cement of all kinds. This study were performed on suitable consistency of individual cement with regard to bond strength and disintegration. Most suitable consistency was almost the same as standard consistency by the specification in the case of Zinc phosphate cement (GC's Elite cement 100). But, in the case of Polycarboxylate cement (Shofu's HY-Bond carbo cement) and Glass alkynoate cement (GC's Fuji ionomer Type I Liv), maximum bond strength can be obtained with a more powder/liquid ratio than standard consistency by the specification. Especially, Glass alkynoate cement shows this tendency strongly. Therefore, it must be manipulated quickly after mixing. PMID- 2701262 TI - [Rehabilitation of a central with a bonded bridge]. PMID- 2701263 TI - [Bonded bridges or "All Maryland"]. PMID- 2701264 TI - [Bonded bridges for dental agenesis]. PMID- 2701265 TI - [Monolateral prosthetic solution with OT cap attachments]. PMID- 2701266 TI - Morphological and immunohistochemical findings in dialysis-related amyloidosis. An analysis of 16 cases. AB - The morphologic features of amyloidosis associated with long-term hemodialysis for chronic renal failure were studied in a series of 16 patients in all of whom immunohistochemical evidence of beta 2-microglobulin-related amyloidosis was obtained. Osteoarticular involvement was present in 15 cases, as demonstrated in synovial biopsies, articular fluid sediments, three surgically obtained femoral heads, and 1 autopsied case. Amyloid was found in synovial membrane, articular cartilage and capsule. Osseous lesions due to amyloid infiltration were found in 2 cases with spontaneous fracture of the femoral neck. Thirteen patients had also amyloid in tissues obtained from carpal tunnel. Systemic involvement was demonstrated in 8 patients by means of rectal biopsies, abdominal fat aspiration biopsies, surgical specimens and autopsy. Deposition in the muscular layer of the gastrointestinal tract was found in 3 cases. Nodular subendothelial deposits in vessels of multiple sites seem to be characteristic of this type of amyloidosis. Immunohistochemical reactions for beta 2-microglobulin and P component were strongly positive in amyloid deposits of all cases. According to our results, abdominal fat aspiration biopsy has little value for screening purposes, whereas the study of articular fluid sediment is highly sensitive as a diagnostic method in patients with articular effusions. PMID- 2701267 TI - Lymph node interdigitating cell granuloma associated with non-Hodgkin's malignant lymphoma. A case report and review of the literature. AB - We report a new case of histiocytic proliferation, which histologically resembles histiocytosis X, in a lymph node affected by non-Hodgkin's malignant lymphoma. This brings the total number of such reported cases to 12. Histiocytosis X cells, with folded nuclei, expressed S100 protein and an antigen recognized by anti-CD1 monoclonal antibodies. Ultrastructural study did not show any Birbeck granules and demonstrated a morphology similar to that of interdigitating cells. In the absence of Birbeck granules, the term 'Langerhans' cell granulomatosis' is not correct and should be replaced by either 'interdigitating cell granuloma' according to immunohistochemistry and ultrastructure or 'histiocytosis X-like granuloma' according to optical morphology. The fact that some cells with folded nuclei were positive for lysozyme argues in favor of the existence of transitional cells between histiocytes hnd interdigitating cells. The 11 other reported cases were reviewed. In 6 cases, this type of granuloma was associated with B cell lymphoma. In 3 cases the lymphoma was also probably of B cell type. In 2 cases, no information could be found. We could speculate that these histiocytosis X-like lesions are reactive, resulting from immune disturbances due to the lymphoma and/or the treatment. PMID- 2701268 TI - [Combination of orthodontic and endodontic treatment]. AB - Many scientists and researchers have up to now been interested in the subject of the combination of orthodontic and endodontic treatment. The uncertainty of the orthodontic movement upon endodontically treated teeth tends to disappear after the conclusions of long lasting studies proving that the biological tissue reactions that happen during orthodontic movement of endodontically treated teeth are identical with those of healthy teeth which are under orthodontic treatment. In this study we were referred to the accessible bibliography on biological tissue reaction upon the combination of orthodontic and endodontic treatment and we have presented some our cases which are treated by combination of orthodontic and endodontic treatment. PMID- 2701269 TI - Recommended dietary amounts of magnesium: Mg RDA. AB - In developed countries, the recommended dietary amounts of magnesium have been set at 6 mg/kg day. The magnesium requirements for optimal health in the adult population depend on mesological and constitutional conditioning factors. They may intervene at every stage of magnesium metabolism: absorption, circulation, storage and excretion. The influence of other nutrients is more significant on magnesium absorption than on urinary excretion. Among the multiple interactions it is important to emphasize the maintenance of a Ca/Mg ratio close to 2 in the intake. Magnesium deficit and stress reinforce each other in a pathogenic vicious circle. The Bw35 allele of HLA typing and behavioural type A discriminate two constitutional factors increasing magnesium requirements. The effective passive regulatory mechanism for magnesium overload, the lability of the active regulatory mechanisms for magnesium deficit and the considerable need for exchangeable magnesium are factors which attribute special importance to balance studies in determining the magnesium intake which prevents negative magnesium balance and magnesium deficiency. Marginal primary magnesium deficit affects a large proportion of the population (15 to 20%), in keeping with a daily mean magnesium intake slightly over 4 mg/kg day versus the Mg RDA of 6 mg/kg day. A physiological oral magnesium load test, evaluated through non-specific and specific clinical and paraclinical items, constitutes the best proof that the clinical pattern depends on an insufficient magnesium intake, confirmed after one month of supplementation. Further research appears necessary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701270 TI - Epidemiologic assessment of adverse drug effects. PMID- 2701271 TI - Systemic contact-type dermatitis due to drugs. PMID- 2701272 TI - Photo-induced drug eruptions. PMID- 2701273 TI - Prevention of anaphylaxis. PMID- 2701274 TI - Drug-induced pemphigus. PMID- 2701276 TI - Magnetic resonance imaging of the shoulder. PMID- 2701275 TI - Iron in magnetic resonance imaging of cerebral hemorrhage. PMID- 2701277 TI - Magnetic resonance imaging of the orbit: current status. PMID- 2701278 TI - Biochemistry in vivo: an appraisal of clinical magnetic resonance spectroscopy. PMID- 2701279 TI - Potentials of quantitative image-localized human 31P nuclear magnetic resonance spectroscopy in the clinical evaluation of intracranial tumors. PMID- 2701280 TI - Magnetic resonance imaging of the liver. PMID- 2701281 TI - Magnetic resonance of the pediatric spine. PMID- 2701282 TI - Vascular applications of magnetic resonance imaging. PMID- 2701283 TI - Magnetic resonance imaging of the larynx. AB - Magnetic resonance imaging (MRI) is now considered the imaging modality of choice for the evaluation of the larynx. The most common indication for MRI of the larynx is to aid in the staging of patients with possible or known laryngeal carcinoma. This article presents the normal MRI anatomy of the larynx in three orthogonal planes. Respiratory maneuvers were also performed during imaging sequences to demonstrate their physiological effects and to examine the feasibility of performing such maneuvers during an imaging sequence. Included in this article is a brief discussion of the use of MRI in the staging and treatment of laryngeal carcinoma. PMID- 2701285 TI - Perfusion imaging by nuclear magnetic resonance. PMID- 2701284 TI - Biological effects and safety aspects of magnetic resonance imaging. PMID- 2701286 TI - Migraine: the platelet hypothesis after 10 years. AB - The proposal that migraine is a blood disorder and caused by a primary abnormality of platelet behaviour was first put forward in 1978. This paper outlines the basis on which the proposal was made and the way in which the platelet hypothesis can account for the many facets of the disorder. It also reports further studies of platelet composition and function which have been undertaken by a large number of independent workers during the past ten years. The results of their investigations provide strong additional support for the platelet hypothesis in migraine. PMID- 2701287 TI - The role of adenosine triphosphate in migraine. AB - Classical migraine is associated with two distinct phases; an initial vasoconstriction followed by vasodilatation. The "purinergic" hypothesis for migraine was originally put forward in 1981 as a basis for the reactive hyperaemia and pain during the headache phase. It was suggested that adenosine 5' triphosphate (ATP) and its breakdown products adenosine 5'-monophosphate and adenosine were strong contenders for mediating the vasodilatation following the initial vasospasm and subsequent hypoxia. ATP was also implicated in the pathogenesis of pain during migraine via stimulation of primary afferent nerve terminals located in the cerebral vasculature. Recent studies have shown that the ATP-induced cerebral vasodilation is endothelium-dependent via activation of P2Y purinoceptors on the endothelial cell surface and subsequent release of endothelium-derived relaxing factor (EDRF); and that the endothelial cells are the main local source of the ATP involved, although adenosine 5'-diphosphate and ATP released from aggregating platelets may also contribute to this vasodilatation. These findings have extended the "purinergic" hypothesis for migraine in two ways. Firstly, they have clarified the mechanism of purinergic vasodilatation during the headache phase of migraine. Secondly, they suggest that a purinergic mechanism may also be involved in the initial local vasospasm, via P2X-purinoceptors on smooth muscle cells occupied by ATP released either as a cotransmitter with noradrenaline from perivascular sympathetic nerves or from damaged endothelial cells. PMID- 2701288 TI - Reactive arthritis: an update. AB - Arthritides tend to move in the classification flow sheet in a characteristic way: inflammatory--reactive--postinfectious--infective. A distinction between reactive and postinfective arthritis is rarely made in clinical practice and does not have therapeutic implications. In Finland, they are routinely lumped together and termed reactive arthritis (ReA). Native or modified HLA-B27 molecules may be directly involved in the pathogenesis of ReA, perhaps as targets for cytotoxic cells. Individuals with inadvertently strong non-specific inflammatory responses may be particularly disease-prone. The occurrence of different ensuing triggering infections in individual patients further confirms the idea that activation of the immune response and the immunogenetic make-up rather than the type and location of causative microbes as such are relevant. It is also possible that antigen processing of several microbe species of different types ends up with identical cross-reactive epitopes to be presented. It has been and certainly will to an increasing extent be reported that microbial antigens can be demonstrated in the diseased joints. It is assumed that they are involved in the local immune inflammatory response manifesting clinically as arthritis. It has been shown that the cellular arm of the immune response is activated and for example that most of the local CD4 lymphocytes of chronic arthritides belong to the CDw29 helper inducer memory cell subset, perhaps responding briskly to antigens originating from the triggering micro-organisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701289 TI - Pathophysiological relevance of prostaglandins in oral diseases. AB - Prostaglandins (PGs) are a group of 20-carbon unsaturated fatty acids derived from arachidonic acid, one of the key components of phospholipids in animal cell membranes. Although PGs were originally named and discovered in the prostate gland of man and sheep, current evidence suggests that PGs are synthesized by nearly all mammalian cells. The biological and pathological functions of these compounds are extremely varied and complicated. This paper will first review the biosynthesis, metabolism, biological and pathological effects, and clinical applications of these naturally occurring substances in living organisms. The possibility that these compounds may mediate the pathophysiological functions of oral diseases is then discussed in detail. Prostaglandins have been demonstrated to be related to the pathogenesis of periodontal diseases, dental cyst, pulpal and periapical pathologies, wound healing, tooth movement, and oral cancers. Studies have shown that anti-inflammatory drugs block the synthesis of PGs, and antagonists competitively inhibit the action of these compounds in the body. The application of PG inhibitors and PG antagonists or analogues for prevention and treatment of oral diseases might thus be a promising research field for future development. PMID- 2701290 TI - [Follow-up study of bone grafts to the alveolar clefts]. AB - Clinical follow-up study after the grafting with fresh autogenous iliac bone to the alveolar clefts in cleft lip and palate patients was carried out up to 2 years post operation. Twenty two patients were examined, to whom grafts of iliac cortical or iliac marrow bone was carried out by the First or the Second Department of Oral Surgery, Kagoshima University Dental School from July, 1985 to April, 1988. Their cleft types were classified as 18 unilateral and 4 bilateral cleft lips and palates. The ages at bone grafting were ranged from 8 years 9 months to 17 years 6 months, and the average of which was 12 years 3 months. Nine of these patients were grafted with the cortical bone, and the other 13 were grafted with the marrow bone. The perforations at alveolar clefts were covered with the tongue flap in 10 clefts of 10 patients, while they were covered with the local mucous flap in 15 clefts of 12 patients. Among these patients, dental casts, X-ray radiograms and oral pictures of 15 patients were surveyed postoperatively. Results were as follows: 1) Contours of the alveolar clefts were well corrected in 9 patients, especially in those cases of pre-operatively expanded unilateral clefts, grafted with the marrow bone and covered with the local mucous flaps. 2) The viable rate of grafted bone was 100.0% for the marrow bone, while it was 62.5% for the cortical bone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701291 TI - SEM study on the dentin and cementum of oreodont teeth. AB - An SEM study on the dental hard tissue was conducted on the canines and molars removed from a fossil oreodont. The orthodentin was densely distributed with dentinal tubules measuring 2.2 microns in diameter; the tubules were filled with their related odontoblastic processes. They coursed in a parabolic fashion from the pulpal aspect towards the tooth surface. There were many fine lateral offshoots that branched from the tubules, such that the mantle dentin measuring 50 microns in thickness was mostly distributed with these terminal branches measuring 0.7 micron in diameter. However, they did not intrude into the enamel to form spindles and rods. SEM study indicated that the uneven surface of the tubular wall was due to a crisscross of the underneath dentinal matricial fibers, and the peritubular dentin was not observed. The superficial circumpulpal dentin was distributed with interglobular dentin, while the radicular dentin beneath the cementum was additionally distributed with a granular layer. We also observed concentric lamellae corresponding to incremental lines in the dentin, as well as a flat wavy dentinoenamel junction. We noticed the radicular dentin was covered with an acellular cementum except at the apical portion, where it was paved with cellular cementum. PMID- 2701292 TI - Histologic evaluation of tissue response to sintered lanthanum-containing hydroxyapatites subcutaneously implanted in rats. AB - Hydroxyapatite, lanthanum-containing hydroxyapatite, and lanthanum- and zirconium containing hydroxyapatite discs were implanted subcutaneously in the backs of rats. The implanted discs and surrounding tissues were removed at 5 and 12 hours, and 1, 3, 7, 14, 30 and 60 days after implantation, and fixed in paraformaldehyde. Tissue samples were dehydrated and embedded in paraffin. Paraffin sections were cut and stained with hematoxylin and eosin, van Gieson's, and Masson's trichrome. The early tissue reaction was exudative due to fibrin deposition and infiltration by polymorphonuclear leukocytes and macrophages. The later reaction was characterized by the formation of fibrous tissue without inflammatory cell infiltration. The tissue reaction to all three types of material was identical by two months after implantation. PMID- 2701293 TI - [Rapid palatal expansion. Monitoring of orthopedic effects with C.A.T]. AB - It has been made a check with TAC on 10 subjects, submitted to Rapid Expansion Palatal. The technique provided a direct and careful vision of the disiuntion, allowing to prove with scientific exactitude for the first time the diastase of ptherigoideis processes. PMID- 2701294 TI - [Tongue disorders and jaw deformities. Nosological aspects and therapeutic concepts]. AB - Tongue's disorders as abnormal volume, modified position and mobility can cause maxillary deformation. Nosological and therapeutic aspects are considered. PMID- 2701296 TI - Assessing the reinforcing properties of drugs. PMID- 2701295 TI - [Role of the orthodontist in surgical-orthodontic treatment: total osteotomies]. AB - The total osteotomies of the upper and lower jaw are considered with particular reference to the orthodontic treatment before, during and after surgery. Several clinical cases are presented. PMID- 2701297 TI - Interactions of the opioid and immune systems. PMID- 2701298 TI - Quantitative urine screening for the diagnosis and treatment of cocaine abuse. PMID- 2701299 TI - Urine testing during treatment of cocaine dependence. PMID- 2701300 TI - Desipramine treatment of cocaine abuse in methadone maintenance patients. PMID- 2701301 TI - Cocaine stimulates LH and decreases PRL in female rhesus monkeys. PMID- 2701302 TI - Intravenous cocaine infusions in humans: dose responsivity and correlations of cardiovascular vs. subjective effects. PMID- 2701303 TI - Human psychopharmacology of intranasal cocaine. PMID- 2701304 TI - Are smokers trying to stop and smokers not trying to stop the same experimental model? PMID- 2701305 TI - Preference for ethanol in males with or without an alcoholic first degree relative. PMID- 2701306 TI - A pilot study of a Neuro-Stimulator Device vs. methadone in alleviating opiate withdrawal symptoms. PMID- 2701307 TI - Effects of tramadol in humans: assessment of its abuse potential. PMID- 2701308 TI - Acute physical dependence in man: repeated naloxone-precipitated withdrawal after a single dose of methadone. PMID- 2701309 TI - Neurolectic correlates of nonsteroidal analgesia. PMID- 2701310 TI - Effect of dose on nicotine's withdrawal-suppressing, adverse and discriminative stimulus effects in humans. PMID- 2701311 TI - The effects of smoking deprivation on caloric consumption in women with bulimia nervosa. PMID- 2701312 TI - Zolpidem and triazolam in humans: behavioral effects and abuse liability. PMID- 2701313 TI - Physical dependence on and toxicity from caffeine. PMID- 2701314 TI - Contamination of clandestinely prepared drugs with synthetic by-products. PMID- 2701315 TI - Comparison of the behavioral effects and abuse liability of ethanol and pentobarbital in recreational sedative abusers. PMID- 2701316 TI - Subjective effects of methaqualone. PMID- 2701317 TI - Behavioral effects of alprazolam in chronic therapeutic users. PMID- 2701318 TI - Naltrexone in federal probationers. PMID- 2701319 TI - Metabolic effects of nicotine in smokers and non-smokers. PMID- 2701320 TI - The acute effects of codeine on human aggressive and non-aggressive behavior. PMID- 2701321 TI - Comparison of amantadine and desipramine combined with psychotherapy for treatment of cocaine dependence. PMID- 2701322 TI - Effects of food deprivation on subjective responses to d-amphetamine and marijuana in humans. PMID- 2701323 TI - Desipramine treatment for relapse prevention in cocaine dependence. PMID- 2701324 TI - Evaluation of treatment for cocaine dependence. AB - 1. At the Philadelphia VA Medical Center, veterans applying for treatment of cocaine dependence were significantly different from applicants dependent on opiates or alcohol without cocaine. The cocaine dependent patients were almost all black and they were mostly employed. Few were involved in crime and, for most, this was the first course of substance abuse treatment. Their use of cocaine began within the past three years and they had relatively few psychiatric, medical, employment or family problems when compared with other applicants for substance abuse treatment. 2. Completion rate for a course of outpatient treatment for cocaine dependence varies from a low of 37% in the general Day Treatment Program to 76% in a special Behavioral Treatment Program and 78% among methadone patients receiving an additional medication for cocaine dependence. Completion of a 28 day course of inpatient treatment was 86% whether the patient selected inpatient care or was assigned to it on a random basis. 3. Those outpatients who remained in treatment generally did well and refrained from cocaine use even during the course of outpatient, either day hospital treatment or behavioral treatment. When both inpatients and outpatients were re-examined four months after beginning treatment, there was significant improvement on almost all ASI categories. Both drop-outs and completers were re-examined. Despite the significantly greater completion rate for the patients assigned to inpatient treatment, both groups showed equal levels of improvements at the 4 month follow up point. 4. These preliminary results from five different treatment populations suggest that cocaine dependent patients can be engaged in treatment and that significant improvement is possible. PMID- 2701325 TI - Current status of alcoholism treatment outcome research. PMID- 2701326 TI - [Osseous choristoma of the peripapillary choroid]. AB - Two young women had an osseous choristoma of the juxtapapillary choroid. They were examined for a macular syndrome caused by a subretinal neovascular membrane with hemorrhage. The investigations led to the initial lesion: the osseous choristoma. Ophthalmoscopic findings, diagnosis and discussion are presented. PMID- 2701327 TI - [Advances in the medical treatment of bacterial endophthalmitis]. AB - Currently, the systemic antibiotics intraocular penetration's rate is low and we have to perform intraocular antibiotics injections to reach levels above the minimal inhibitory concentration of the bacterial agents found commonly in endophthalmitis. Authors try to specify a rational strategy based on pharmacokinetics and bacteriological aspects of a new class of antibiotics, the fluoroquinolones, using their own studies and those from other teams about the intraocular distribution of these antibiotics. Further investigation is mandatory to assess the safety and efficacy of our first clinical results. PMID- 2701328 TI - [A protocol for monitoring antimalarial treatment]. AB - We are showing a protocol to survey the treatment by APS, with a computer equipment that enable us to examine very shortly the central field of vision and the ERG; but that least investigation can be EOG or a PEV, according to the toxic pathology we are studying. PMID- 2701329 TI - [Treatment of keratoconus using non-freezing epikeratoplasty]. AB - Keratoconus may present a difficult therapeutic challenge when it becomes impossible to adapt Contact Lenses. Penetrating Keratoplasty is sometime difficult to perform and the result is often altered by important astigmatism. Other solutions have been tried with variable results. We treated 26 eyes with Keratoconus that were unadapted to CL bud didn't have central opacities, with Non Freeze Epikeratoplasty. 14 of them are analysed (more than 3 months after suture ablation). 13 increased visual acuity without correction. All of them increased best corrected VA. Medium astigmatism was 3 dioptries, always regular. No major complications were observed. The comparison with an equivalent group treated with Penetrating Keratoplasty showed that the results were equivalent. Epikeratoplasty can be a reasonable alternative in central or large KC without central opacities. It's extraocular and always reversible. The Non Freeze procedure is less aggressive for the graft tissue. PMID- 2701330 TI - [The eye and AIDS]. PMID- 2701331 TI - [Use of an immunoenzyme method with monoclonal antibodies in cytologic studies for the optimal diagnosis of non-Hodgkin's lymphoma in children]. AB - From January 1987 to April 1988 six children we studied cytologically with the use of alkaline phosphatase-anti-alkaline phosphatase (APAAP) method and monoclonal antibodies (MoP) in order to establish the diagnosis of Non-Hodgkin Lymphoma. (NHL). Cytologic studies concerned pleural fluid (3 patients) imprints of the lymph node (3 patients), bone marrow smears (2 patients) and cerebrospinal fluid (1 patient). We performed simultaneously routine cytologic and histopathologic studies of the lymph nodes. Antigen T6 (thymocytes) was present in blasts of all patients, which permitted us to classify the blasts as common stage II group according to Reinherz. In all cases we found at least two positive antigen detected by MoP pan T (CD2, CD3, CD5, CD7) in one case--no expression of antigen T3 (CD3) and in two cases no antigen detected by an antibody CD2. Antigen Ia was found in one patient, and weak expression of antigen CALLA (CD10) in one patients. In three patients we showed a simultaneous expression of antigens T4, T8, whereas in two patients they were not observed. One child possessed mature phenotype T4, T6. By using APAAP method with MoP in cytologic studies it was possible to diagnose T-lymphoblastic lymphoma in six children before the results of histopathologic examination of the lymph nodes. PMID- 2701332 TI - [Ultrastructural study of carcinoembryonic antigen (CEA) using the peroxidase antiperoxidase (PAP) complex technic in patients with breast cancer]. AB - In the studied material taken from 70 patients with the mammary carcinoma was tried to discover the presence of the CEA antigen in the cells on the ultrastructural level. In studies was used peroxidase-antiperoxidase method (PAP). The product of the immunocytochemical reaction was found on the surface of cell membrane. In 42 patients (60%) positive reaction was observed and in 28 (40%) reaction with PAP complex was negative. Just in 3 cases intracytoplasmic reaction was observed. PMID- 2701333 TI - [Ultrastructural evaluation of carcinoembryonic antigen (CEA) using an immunocytochemical method with the peroxidase-antiperoxidase (PAP) complex technic in patients with laryngeal cancer]. AB - Peroxidase-antiperoxidase complex method (PAP) was used to reveal the CEA antigen in the larynx carcinoma cells by means of electron microscope. Studies were carried out on the material taken from 8 patients with the larynx carcinoma. In all cases positive immunoperoxidase reaction has been observed. The product of the reaction has been found on the surface of the cells. In one case intracytoplasmic positive reaction has been noticed. PMID- 2701334 TI - [Metastasis from one tumor to another]. AB - Tumour in tumour metastasis. The occurrence of more than one primary tumour in the same person is uncommon, nevertheless metastasis of one tumour to another is an extraordinary event. The malignant tumour usually metastasizes in a benign tumour, however a metastatic deposit within a malignant tumour is described. In the present study the literature is briefly reviewed and 43 new cases are described: in 38 the host neoplasm is a benign one, and in 4 is a malignant tumour. In the last case the metastases are present both in a malignant and in a benign tumor. PMID- 2701335 TI - [Review of the presently accepted theories of teeth positioning in complete prostheses]. AB - The review paper describing the presently used principles of the theory of teeth positioning in complete prostheses. The author indicates their advantages and disadvantages, and the possibility of their application in general prosthetic practice. PMID- 2701336 TI - [Effect of the convergence angle of the ground tooth and the force of cast crown fastening using various types of cement]. AB - The authors measured the effect of the convergence angle of the ground tooth on the fastening of cast crowns. The study was carried out on phantom models of teeth made of stainless steel with abutement convergence angles from 1 to 10 degrees. The force of the connection was measured using the Instron testing device. The avulsing force acted along the long axis of the abutement. Additionally the fixing force of phosphate, polycarboxylate and ionomer-glass was compared. A fall of the force of crown fastening was observed with increasing value of the convergence angle of the abutement, especially for phosphorus and ionomer-glass cement. The crowns fastened with polycarboxylate cement showed a threefold smaller fall of the fastening force with increasing value of the convergence angle of the abutement. PMID- 2701338 TI - [Morphological study on differentiation between right and left of Indian lower incisor]. PMID- 2701337 TI - [Bacterial etiological factors of diarrhea in the stool of infants hospitalized in January 1987]. AB - The results are presented of the second part of the studies conducted for monitoring of the variability of bacterial factors causing diarrhoea in the youngest children. The presently reported study comprised 42 babies aged from 7 days to 18 months treated in hospital in January 1987. The number of children with diarrhoea hospitalized in this period was relatively smaller than in January 1985, while the incidence of enteropathogenic bacteria in stools was very similar. They included mainly Klebsiella and enteropathogenic Escherichia coli strains, especially in the youngest children. In only one case Salmonella arizonae was found while in 1985 a very high number of Salmonella agona strains were cultured, especially from newborns. In both parts of the study Campylobacter jejuni and Yersinia enterocolitica were never found in stools. In both parts of the study the course of bacterial diarrhoea was mostly moderately severe, loose stools continued usually for 3-4 days, but in the second part more cases of severe diarrhoea were noted, which, however, could not have been related to the bacterial species cultured from stools or to the presence of mixed bacterial flora. The importance is stressed of the carrier state of enteropathogenic bacteria which was observed in three-fourths of patients in January 1987, while in January 1985 this was present in nearly all cases without diarrhoea. PMID- 2701339 TI - [Studies on retention of denture base. 1. Viscosity of mediating fluid and palatine shape]. PMID- 2701340 TI - [Restoration of the "supporting zone" of the mandible in partially dentate mouth. 7. Influence of the mouth preparation and designs of the clasp retainers]. PMID- 2701341 TI - [Deviations in immune response. II. Immunological hypersensitivity]. PMID- 2701342 TI - [An episode of hospital infection due to Klebsiella pneumoniae in a neonatal department]. AB - Enterotoxin-producing Klebsiella pneumoniae was implicated in the induction of intrahospital infections in new-born babies. A total of 46 children and 4 adults (hospital personnel) were involved. Most of the subjects (82.6%) had median and light forms of gastroenterocolitis, and recovered following biological re equilibration. In 17.39% of the cases the evolution was more severe due to advanced dehydration and secondary dissemination of the infection. Two children (approximately 4%) died. Factors that favored the dissemination of the infection were hygiene deficiencies and ignorance of functioning rules of materno-infantile units, and these included: admission to the hospital of working personnel with acute phenomena of enterocolitis; administration of sweetened solutions that were prepared without control and stored at room temperature; the "critical" point represented by the special room for "the accommodation" of the newborns, a "key point" where infection was disseminated to other wards following dispersion of "adapted babies". PMID- 2701343 TI - [The incidence of E. coli O157H7 strains in causing hemorrhagic enterocolitis]. AB - The authors describe the evidencing of the O157H7 E. coli serotype--an enterohaemorrhagic strain of E. coli--for the first time in our country. This germ is incriminated in haemorrhagic enteritis of children and adults, accompanied or not by an uremic haemolytic syndrome. A total of 717 strains were investigated, obtained from cases of haemorrhagic enteritis (283), nonhemorrhagic enteritis (174), food poisoning (27), and a control lot of subjects without signs of enteritis (233). Identification of the strains was done with a screening method (McConkey) with D-sorbitol in place of lactose, and with anti-O157, and anti-H7 sera. The results obtained have indicated a total of 37 positive strains in haemorrhagic enteritis (69.8%), 12 strains in nonhemorrhagic enteritis (22.65%), and 4 strains in food poisoning (7.55%). No strain was isolated from the control group. The percentage of isolated O157H7 E. coli strains in our county is of 7.55% and this contributes to additional knowledge in the definition of the still unknown etiology of diarrhoeic disease in our country. PMID- 2701344 TI - [The microbiological diagnosis of chronic gastropathy associated with Campylobacter pylori]. AB - The efficiency was studied, in experimental and practical conditions, of media for the isolation of C. pylori, as well as criteria for diagnosis and identification. The highest sensitivity was obtained with Columbia gelose, and a lower sensitivity was achieved with Campy I. C. gelose, and with heart-brain gelose, prepared as chocolate gelose, and Columbia gelose with integral blood. Both variants of the Mueller-Hinton gelose, even in the chocolate formula, gave negative results. Of the fluid media, supplemented with blood or with serum, only broth for I. C. blood cultures, and the heart-brain broth permitted the development of small cultures, while the soya-tripticase broth and the Mueller Hinton broth remained sterile. None of the media, either solid or fluid, as such or supplemented with factors X, V, or X + V, did allow the development of C. pylori. In natural conditions, by inoculating 92 samples of gastric mucosa from patients with gastritis, with or without ulcers, confirmed histologically on Columbia chocolate gelose as such, or in a selective variant, 50 positive results were obtained with both variants, 9 positive results on the selective variant, and one positive result on the nonselective variant. The direct microscopic examination of samples from the mucosa disclosed the presence of C. pylori in all 60 samples that had also been confirmed by culture, as well as in another 21 samples from a total of 32 samples with negative cultures (88%). The direct urease test performed directly from the sample was done in 90 cases and was positive in 64 out of 79 samples that had been confirmed bacteriologically (77.2%), but in none of the 11 negative samples. The positive prediction index is thus of 100%, and the negative index is of 37.9%. Procedures for identification consisted in a definition of morphological characteristics, and in the cultivation, and biochemical features (including catalase and oxydase determination), which can define the Campylobacter genus, and the urease test, the sensitivity to cephalotine and the resistance to nalidixic acid for the differential species diagnosis. In conclusion cultivation of C. pylori presumes the use of media with superior quality peptones, supplemented with blood lactate in the gelose chocolate formula. The direct urease test is very useful as a procedure for diagnosis, and this can be done in the departments of gastroenterology. PMID- 2701346 TI - [Study of internal reaction on the maxilla by orthopedic force]. AB - For the purpose of analyzing deformations and movements in the maxilla loaded by orthopedic force to the maxillary first molar, a three dimensional finite element model of the maxilla was constructed. For modelling of the maxilla, the right side of an adult Indian skull was used. Constructed model was composed of 1,108 solid elements and 1,195 nodes. Materials of this model was composed of compact bone, cancellous bone, teeth and sutures. Constraint condition was fixed adjacent bone side surrounded by sutures. Load was directed from upward to downward 30 degree, changing every 30 degree reference to occlusal plane. Volume of load were weighed at 1 kg for each directions. Results 1. At upward load, stress was transmitted through the lateral wall of the maxillary sinus. The posterior portion of the maxilla was displaced more upward than anterior. Each process of the maxilla and the maxillary sinus was deformed, however, there was no stress on the orbitary surface. 2. At upward 60 degree load, the maxilla was compressed simply to the direction of load. At the upward 30 degree load, it was compressed backward-downward and rotated clockwise together with bending. 3. At backward load, the maxilla was moved backward and rotated clockwise. At downward 30 degree load, the maxilla was moved backward-downward and rotated clockwise. Both loads bended anterior portion of the maxilla and compressed posterior portion. The center of rotation or bending fell on the line joining the frontal process and the zygomatic process. 4. Of all five directions, backward load showed the maximum value of displacement and upward showed the minimum. Concerning with the absolute value of principal stress, backward load showed the maximum and upward 60 degree load showed the minimum. 5. Concerning with the principal stress value of sutures, compressive stress were distributed equally at upward load. However, as the load went to downward direction, it caused stress concentration. Especially, compressive stress in the pterygopalatine suture and transverse palatine suture, extensive stress in the midpalatal suture were especially great. PMID- 2701345 TI - [Immunobiological arguments for regional treatment in cancer]. PMID- 2701347 TI - [Case of a neurotic patient complaining about her facial disfigurement after prosthetic therapy]. AB - Problems accompanied with dental practice of a neurotic patient who complained about her facial disfigurement after prosthetic treatment were discussed. Through this discussion, the necessity of understanding mental state and personality of this kind of patient was pointed out. And the need of systematic study of these neurotic cases with relation to dental practice including the method of smooth liaison with a psychiatrist was suggested. Also, the process leading the patient to have a firm belief of having a disfigured face was discussed. PMID- 2701348 TI - Antimicrobial and immunomodulating effects of some phenolic glycosides. AB - Several phenolic glycosides, i.e. acteoside, desrhamnosyl acteoside, and purpureaside A, B and C, exerted weak antibacterial effects on Escherichia coli. Acteoside had antiplasmid effects, including F'lac plasmid elimination, and inhibited kanamycin resistance transfer in E. coli. Acteoside, desrhamnosyl acteoside and purpureaside A displayed antiviral effect on Aujeszky virus. All of the phenolic glycosides decreased some human leucocyte functions, including rosette formation, mitogen-induced blast transformation and phagocytic activity in vitro. The purpureaside C had significant proinflammatory action, however, other phenolic glycosides showed neither proinflammatory nor antiinflammatory effect on carrageenin-induced inflammation in vivo. PMID- 2701349 TI - Fear of AIDS: issues for health professional education. PMID- 2701350 TI - Minority AIDS prevention: moving beyond cultural perspectives towards sociopolitical empowerment. PMID- 2701351 TI - First comprehensive survey of worldwide anti-AIDS efforts published. PMID- 2701352 TI - The first international AIDS education directory. PMID- 2701353 TI - The Health Belief Model in understanding compliance with preventive recommendations for AIDS: how useful? AB - The Health Belief Model (HBM) has been applied to a variety of health conditions: most are less threatening and require less complex responses than those arising in the case of AIDS. The utility of the HBM in understanding preventive behaviors in AIDS is examined in a cohort of homosexual men at two different time points. Longitudinal analyses estimated the relationship of indices assessing susceptibility, severity, benefits, and barriers, as well as sociodemographic factors, to sexual behavior across the next 18 months. Analyses further defined these associations in specific subgroups of participants, such as those initially at lower or higher risk. In general, measures of severity and socioeconomic advantage had the most consistently beneficial effect on various measures of behavior. Little or no beneficial effect was observed for other components of the HBM, notably a measure of perceived susceptibility. These analyses suggest that the special features of AIDS may require development of more adequate theoretical frameworks. PMID- 2701354 TI - The impact of AIDS on state public health legislation in the United States: a critical review. AB - This article reviews and analyzes the current public health legislation in 17 states and the District of Columbia in the United States. These states were selected and grouped into high, medium, and low incidence based on their annual AIDS incidence rates. Data were collected through a combination of library research and direct communications with the various state health departments. Four major areas of legislation were reviewed: HIV antibody testing and reporting; confidentiality and partner notification; personal control measures: and AIDS antidiscrimination laws. In general, majority of the states have treated the AIDS epidemic as a public health problem and not as a moral or criminal issue. Some states with higher incidence such as New York and California have developed the least restrictive laws and responded with stronger AIDS antidiscrimination legislation. The states with medium incidence have more restrictive measures and the low incidence states have less legislation and fewer regulations related to AIDS. AIDS educators should be aware of the implications of the varied legislation and regulations on AIDS education and prevention. They should play a strong advocacy role in promoting the development and application of measures that will facilitate the prevention and control of AIDS. PMID- 2701356 TI - The evolution of cancer research. AB - The modern War against Cancer began in the United States in 1970 with the publication of the Yarborough Report, which set forth recommendations and delineated the "means and measures necessary to facilitate success in the treatment, cure and elimination of cancer--at the earliest possible date." If the architects of the Report had known more about the history of the conquest of diseases, we might by now have made a greater impact on the death rate from cancer. As many people have pointed out, the exercise was not that of mobilizing a vast amount of money and resources in order to apply an existing technology to a very limited goal--some special bombs for one or two airplanes and the support for a few astronauts. Quite the opposite, the problem required the development of a level of understanding and a technological base which would allow solutions to the cancer problem that are so inexpensive that they can be offered to 200 million people. PMID- 2701355 TI - Topographic mapping of EEG and evoked potentials in psychiatry: delusions, illusions, and realities. AB - This paper reviews the utility of topographic mapping of EEG and evoked potentials in psychiatry. Further, a wide variety of caveats related to this technique are reviewed including cerebral and extracerebral sources of artifact. Moreover, both questionable and legitimate uses of mapping in psychiatry are addressed and possible future applications of this technique are considered. Finally, multidisciplinary approaches to the study of the brain are discussed. PMID- 2701357 TI - Long-term bone marrow cultures: their use in autologous marrow transplantation. AB - When cultured together, hemopoietic cells and marrow stromal cells can support hemopoiesis in vitro in the absence of added growth factors. The continued production of stem cells, progenitor cells, and mature cells within these "long term bone marrow cultures" (LTBMC) requires their physical association with the stromal cells. For reasons that are not well understood, leukemic cells often fail to survive in such cultures. We and others have undertaken studies to examine whether LTBMC can be exploited as a way of purging the bone marrow of leukemia patients prior to autologous marrow transplantation. PMID- 2701358 TI - Tum- transplantation antigens, point mutations, and antigenic peptides: a model for tumor-specific transplantation antigens? PMID- 2701359 TI - The clonal nature of neoplasia. PMID- 2701360 TI - The reemergence of tumor suppression. PMID- 2701361 TI - Multidrug resistance in the laboratory and clinic. PMID- 2701362 TI - Modern views of metastasis. PMID- 2701363 TI - Private and public autocrine loops in neoplastic cells. AB - Autocrine growth factor loops ensure the continued growth of neoplastic cells. According to the traditional view of such autocrine loops, receptor binding and transduction of a mitogenic signal occur when a growth factor is secreted and subsequently interacts with its receptor on the surface of the secreting or neighboring cells. For several growth factors there is now evidence that the mitogenic signal may be transduced without factor secretion. In these instances, the growth factor appears to interact with its receptor intracellularly, creating in effect a "private" autocrine loop. We will discuss three growth factors that may operate by the latter mechanism, as well as two that rely instead on classical "public" autocrine loops, where the growth factor must be secreted and is therefore accessible to neighboring cells. We also consider the properties of these growth factor/receptor systems that may determine their involvement in either type of autocrine loop. PMID- 2701364 TI - Realizing the full potential of immunotoxins. AB - When conjugated with antibodies that bind selectively to tumor cells, natural toxins from plants and bacteria represent a potentially powerful form of cancer therapy. Over the last several years, much thought and research effort has been devoted to optimizing the specificity and activity of these hybrid molecules. Here we review some of the insights that have come from detailed analyses of the so-called "first-generation immunotoxins," and discuss how these insights have prompted ideas for more effective design of "second-generation immunotoxins." PMID- 2701365 TI - ras and its relatives. PMID- 2701366 TI - How many human genetic disorders affect cellular radiosensitivity? PMID- 2701367 TI - Integrins and tumor cell dissemination. AB - The ability of a tumor cell to metastasize is determined, in part, by its adhesive interactions with other cells and with components of the extracellular matrix. An ever-expanding family of cell surface receptors, the integrins, is an essential player in these interactions. Research efforts aimed at understanding the precise role of individual integrins in normal and transformed cells may offer a general framework for future therapeutic approaches. Here we review recent progress toward this goal. PMID- 2701368 TI - Cerebral hemodynamic and metabolic effects of chronic alcoholism. AB - The nervous system is particularly susceptible to the harmful effects of alcohol. These include Wernicke-Korsakoff syndrome, which is related to thiamine deficiency secondary to chronic alcohol abuse. Other neurotoxic effects of alcohol with cognitive impairments include delirium tremens, alcoholic seizures or "rum fits," and alcoholic neuropathies. It has become recognized in recent years that alcohol and its metabolites directly damage the nervous system even in the absence of nutritional deficiencies. Cerebral blood flow (CBF) measurements provide a noninvasive indirect monitor of cerebral metabolic activity. It has been shown conclusively that CBF measured by the 133Xe inhalation method is decreased in chronic alcoholism, correlating well with the amount of alcohol consumed. With abstinence, CBF returns toward normal levels provided the neurotoxic effects of chronic alcoholism are of recent onset. Clinical and pathological studies show significant loss of brain volume with ventricular dilatation after alcohol abuse even among young "social" drinkers. This toxic effect of alcohol is accompanied by varying degrees of cognitive impairments ranging from slight memory loss to frank dementia. Both the decrease in brain volume and the cognitive impairments, which occur with or without nutritional deficiency, are to a large extent reversible with abstinence and nutritional supplementation. Alcohol appears to accelerate age-related declines in CBF while nutritional deficiencies enhance the neurotoxic effects of alcohol. Measurements of local CBF (LCBF) and partition coefficients (L lambda) in deep cerebral structures, including the hypothalamus, thalamus, forebrain nuclei, and limbic system, can be achieved utilizing three-dimensional methods after inhalation of stable xenon as a contrast medium combined with serial computed tomographic imaging of the brain. Among chronic alcoholics, there are significant and diffuse reductions in cortical and subcortical gray matter CBF that are especially remarkable in hypothalamus and substantia innominata, which includes the nucleus basalis of Meynert, a major source of cholinergic input to neocortex and hippocampus. Reductions in LCBF are measurable in cognitively impaired patients with and without Wernicke-Korsakoff syndrome. Reductions of CBF include white matter and are more severe in patients with Wernicke-Korsakoff syndrome. Both types of encephalopathy improve with treatment, but recovery is usually more rapid and complete if nutritional deficiency is absent. Alcohol also appears to be a risk factor for stroke, possibly by depleting neuronal reserves and unfavorably influencing cardiovascular risks. PMID- 2701369 TI - Adenosine in the control of the cerebral circulation. AB - Adenosine has been proposed as a metabolic factor involved in the regulation of cerebral blood flow. The evidence in support of this hypothesis, presented in this review, includes information on the adenosine receptors associated with cerebral blood vessels, the synthesis and metabolism of adenosine, and the release of adenosine from the brain. Adenosine dilates cerebral blood vessels, acting at an A2 receptor. The critical evidence implicating an involvement of adenosine in cerebrovascular regulation is derived from experiments with adenosine antagonists and potentiators. The antagonists include methylxanthine adenosine receptor antagonists and the enzyme adenosine deaminase. Potentiators include transport inhibitors, enzyme inhibitors, and adenosine precursors. Adenosine has been implicated in vascular regulation during hypoxia/ischemia, hypercapnia, seizures, severe hypotension, and hypoglycemia. Adenosine possesses a number of properties that can be used to minimize neuronal degeneration during cerebral insults, such as ischemia, including vasodilatation, reduction of excitatory transmitter release, reduction of membrane calcium permeability, inhibition of platelets, and neutrophil aggregation. Several recent studies have demonstrated that manipulation of central adenosine tone can alter the extent of cerebral ischemic damage, indicating a potential new therapeutic approach for the treatment of stroke. PMID- 2701370 TI - Influence of haematocrit in the cerebral circulation. AB - Cerebral blood flow is inversely related to in vitro whole blood viscosity, the major determinant of which is haematocrit. Haemodilution increases cerebral blood flow in polycythaemic patients and in subjects with high normal haematocrit. There is now increasing evidence that this relationship reflects a homeostatic and physiological regulation of oxygen-carrying capacity. A high normal haematocrit proves to be a weak risk factor for stroke whilst stroke risk is clearly related to the target haematocrit in patients treated for polycythaemia rubra vera. Whilst venesection remains accepted prophylactic treatment against stroke and other vaso-occlusive events in the latter case, no large scale trial has formally assessed the role of haematocrit reduction in patients with early manifestations of cerebrovascular disease like transient ischaemic attacks or in the early stages of multi-infarct dementia. There are theoretical reasons why a high haematocrit might have adverse effects on the cerebral circulation in the presence of vessel occlusion. Thus, flow and therefore oxygen delivery would become constrained by high viscosity (haematocrit) in the maximally dilated ischaemic vascular bed, and secondary thrombosis would be encouraged by low flow rates, and increased cell-cell interaction. These arguments have led to two large multicentre clinical trials of haemodilution in acute stroke victims. Neither has revealed any clinical benefit in the treated group. The reasons for the failure of the trials are discussed. It is envisaged that haemodilution, as well as retaining a clinical role in the prevention of stroke in patients with polycythaemia, may be used as an adjunct to other therapy for the immediate sequelae of cerebral ischaemia. PMID- 2701371 TI - Local cerebral blood flow by xenon-enhanced CT: current status, potential improvements, and future directions. AB - A noninvasive technique for measuring local cerebral blood flow (CBF) by xenon enhanced x-ray transmission computed tomography (CT) was developed and reported on extensively in recent years. In this method, nonradioactive xenon gas in inhaled, and the temporal changes in radiographic enhancement produced by the inhalation are measured by sequential computed tomography. Time-dependent xenon concentration within various tissue segments in the brain is used to derive both the local partition coefficient (lambda) and CBF in each tissue volume (voxel) of the CT image. A comprehensive assessment of this method reveals that although it provides functional mapping of blood flow with excellent anatomic specificity and has several other significant advantages, there are distinct and important limitations. The assumptions underlying this methodology are examined and the advantages as well as the problems associated with applications of this technique are reviewed. Laboratory and clinical observations that have been made using this technique in recent years are summarized, and potential improvements as well as possible future directions are discussed. PMID- 2701372 TI - Cerebral acidosis in focal ischemia. AB - The discovery in the 1970s that hyperglycemia accompanying cerebral ischemia adversely affected survival led to a significant research effort on the biochemical, histological, and clinical consequences of cerebral acidosis. In this article, we review the methods used currently to measure cerebral pH and discuss the means the cell has to control its pH environment. We then discuss the influence of both normoglycemic and hyperglycemic cerebral ischemia on pH and conversely the effect of acidosis on cerebral blood flow (CBF), glycolysis, mitochondrial function, the blood-brain barrier, cellular volume control, the formation of cerebral edema, and the histological damage resulting from ischemia. We conclude with a discussion of how acidosis could worsen the derangement in calcium homeostasis known to occur as a consequence of ischemia, and review methods now available to counteract cerebral acidosis. PMID- 2701373 TI - Brain edema: a classification based on blood-brain barrier integrity. AB - Brain edema is a frequent complication of a variety of brain injuries and disorders. Two primary types of brain edema can be distinguished depending upon the integrity of the blood-brain barrier. With intact-barrier edema, the permeability of the blood-brain barrier is normal and brain edema results from a disturbance in ionic homeostasis. This type of edema is typically associated with swelling of the brain cells and a contraction of the extracellular space. In open barrier edema, the permeability of the blood-brain barrier is increased and brain edema results from the oncotic forces generated by an influx of serum proteins into brain. In this case, the edema fluid accumulates primarily in the extracellular space. To a greater or lesser extent, both types of edema occur simultaneously in the majority of clinical conditions; however, one form usually predominates and demands the attention of both the scientist and clinician. Furthermore, classification of brain edema based upon blood-brain barrier integrity is useful to focus research on common mechanisms for brain edema formation and to direct therapy. This review considers intact-barrier and open barrier edema with regard to their (a) histological features, (b) biophysical forces, (c) possible biochemical mediators, (d) mechanisms of resolution, and (e) implications for therapy. PMID- 2701374 TI - Cerebral ischaemia studied by nuclear magnetic resonance spectroscopy. AB - In this review, we assess the role of nuclear magnetic resonance (NMR) spectroscopy as a noninvasive method of studying metabolism in cerebral ischaemia. Phosphorus-31 NMR provides a monitor of intracellular pH and energy metabolites, including ATP, phosphocreatine, and inorganic phosphate, while other nuclei, including 1H, 13C, 19F, and 23Na can give additional information about several aspects of brain metabolism and physiology. For example, 1H NMR not only provides excellent images, but may also be used to monitor a range of metabolites, including lactate and several amino acids. Comparisons are made with the large body of information that is available from more traditional methods of studying metabolism. Emphasis is placed on the correlation of NMR data with parallel measurements of regional blood flow, tissue oxygenation, oedema, electrical activity, and tissue damage. Technical aspects of NMR are discussed where appropriate; for example, in relation to the range of metabolites that are accessible to study, the spatial resolution that is available for studies of focal lesions, problems arising from tissue heterogeneity, and quantification of metabolite levels. Applications in animal models and in humans are discussed; these primarily involve the 31P nucleus, but for the future it appears that 1H NMR studies offer particular promise. PMID- 2701375 TI - Free radicals and brain damage. AB - Although free radicals have been suggested to contribute to ischemic brain damage for more than 10 years, it is not until quite recently that convincing evidence has been presented for their involvement in both sustained and transient ischemia. The hypothesis is examined against current knowledge of free radical chemistry, as it applies to biological systems, and of cellular iron metabolism. It is emphasized that those advents have changed our outlook on free radical induced tissue damage. First, it has been realized that damage to DNA and proteins may be an earlier event than lipid peroxidation, perhaps also a more important one. Second, evidence now exists that the triggering event in free radical-induced damage is a disturbance of cellular iron metabolism, notably delocalization of protein-bound iron, and its chelation by compounds that trigger site-specific free radical damage. Third, methods have been developed that allow the demonstration of partially induced oxygen species in tissues, and scavengers have become available that can curb free radical reactions. As a result of these events, it has been possible to demonstrate formation of free radicals in oxygen toxicity, trauma, and ischemia, and their participation in the cell damage that is incurred in these conditions, particularly in causing vascular pathology and edema. It is suggested that in ischemia, free radical damage becomes pathogenetically important when the ischemia is of long duration, when conditions favor continued delivery of some oxygen to the ischemic tissue, and particularly when such partially oxygen-deprived tissue is reoxygenated. PMID- 2701376 TI - Protection against cerebral ischemia: the role of barbiturates. AB - Cerebral ischemia is a complex injury process that occurs when the nutrient blood supply to cerebral structures is reduced below critical levels. The causes of cerebral ischemia are protean, but the underlying pathophysiologic mechanism that leads to injury is a mismatch between the supply of nutrients to a given cell (or population of cells) and the demand of the cell(s) for those essential nutrients. Extensive research is ongoing in our attempt to find a treatment strategy and/or pharmacologic agent that might protect cerebral structures when exposed to ischemia. To date, few strategies or agents have proven themselves truly "protective." In this communication, the complexities of the cerebral ischemia injury process will be reviewed, the principles of cerebral protection (both practical and theoretical) will be outlined, and the merits of barbiturate anesthesia with regard to planned temporary cerebral ischemia will be discussed. PMID- 2701377 TI - Neuropeptides in the cerebral circulation. AB - The occurrence and distribution of peptide-containing nerve fibers to the cerebral circulation are described. Immunocytochemical studies have revealed that cerebral blood vessels are invested with nerve fibers containing neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), peptide histidine isoleucine (PHI), substance P (SP), neurokinin A (NKA), and calcitonin gene-related peptide (CGRP). In addition, there are studies reporting the occurrence of putative neurotransmitters such as cholecystokinin, dynorphin B, galanin, gastrin releasing peptide, vasopressin, neurotensin, and somatostatin. The nerves occur as a longitudinally oriented network around large cerebral arteries. There is often a richer supply of nerve fibers around arteries than veins. The origin of these nerve fibers has been studied by retrograde tracing and denervation experiments. These techniques, in combination with immunocytochemistry, have revealed a rather extensive innervation pattern. Several ganglia, such as the superior cervical ganglion, the sphenopalatine ganglion, the otic ganglion, and small local ganglia at the base of the skull, contribute to the innervation. Sensory fibers seem to derive from the trigeminal ganglion, the jugular-nodose ganglionic complex, and from dorsal root ganglia at level C2. The noradrenergic and most of the NPY fibers derive from the superior cervical ganglion. A minor population of the NPY-containing fibers contains VIP instead of NA and emanates from the sphenopalatine ganglion. The cholinergic and the VIP-containing fibers derive from the sphenopalatine ganglion, the otic ganglion, and from small local ganglia at the base of the skull. Most of the SP-, NKA-, and CGRP-containing fibers derive from the trigeminal ganglion. Minor contributions may emanate from the jugular-nodose ganglionic complex and from the spinal dorsal root ganglia. NPY is a potent vasoconstrictor in vitro and in situ. VIP, PHI, SP, NKA, and CGRP act via different mechanisms to induce cerebrovascular dilatation. The sympathetic, the parasympathetic, and the sensory systems appear to be involved in modulating cerebrovascular tone in hypertension and in conditions of threatening vasoconstriction, e.g., subarachnoid hemorrhage and migraine. PMID- 2701378 TI - Clinical radionuclide imaging of myocardial perfusion. PMID- 2701379 TI - Clinical radionuclide imaging of myocardial viability. PMID- 2701380 TI - Radionuclide bone imaging. PMID- 2701381 TI - Radionuclide imaging of the lung. PMID- 2701382 TI - Cerebral perfusion imaging. PMID- 2701383 TI - Positron-emission tomography in neuropsychiatric disorders. PMID- 2701384 TI - Radionuclide imaging of inflammatory processes. PMID- 2701385 TI - Radionuclide studies of the liver and hepatobiliary system. PMID- 2701386 TI - Tumor imaging with monoclonal antibodies and gallium-67. PMID- 2701387 TI - Imaging of the skeleton and soft tissue in children. PMID- 2701388 TI - Imaging of the brain in children. PMID- 2701389 TI - Imaging of the spine in infants and children. PMID- 2701390 TI - Pediatric genitourinary radiology. PMID- 2701391 TI - Pediatric gastrointestinal radiology. PMID- 2701392 TI - Pediatric lung disease. PMID- 2701393 TI - Pediatric cardiovascular imaging. PMID- 2701394 TI - Current advances in pediatric interventional radiology. PMID- 2701395 TI - Technical aspects of pediatric radiology. PMID- 2701396 TI - Nuclear medicine. PMID- 2701397 TI - Pediatrics. PMID- 2701398 TI - Microbiological safety of irradiated foods. AB - This paper attempts to summarize relevant information on microbiological safety of irradiated foods in the light of previous reports of expert committees and current literature references. After a brief survey of the relative radiation resistance of food-borne microorganisms, the importance of microbial load for dose requirement, and the role of post-irradiation conditions, it addresses the following questions: Could selective changes in the microflora, caused by non sterilizing radiation doses, make known pathogens more likely to occur, or bring into prominence unfamiliar pathogens? Is it probable that 'mutational' (including adaptive) changes might make pathogens more virulent, more harmful, or more difficult to recognize, and could new pathogens arise in this way? Is it possible that development of radiation-resistant strains might render the antimicrobial irradiation processes ineffective? The present survey of relevant scientific evidence related to these questions reaffirms the basic conclusion of earlier reviews, that microbiological safety of irradiated food is fully comparable with that of foods preserved by other acceptable preservation methods. Similar to other preservation processes, gains in microbiological or keeping quality attained by food irradiation can be and must be safeguarded by proper control in the food irradiation facilities and by proper care of the product before and after processing. PMID- 2701399 TI - Psychrotrophic, proteolytic and lipolytic properties of Enterobacteriaceae isolated from milk and dairy products. AB - Most of the Enterobacteriaceae strains (73 out of 75) isolated in a previous study (Wessels et al., 1988) were psychrotrophic on agar plates, with the exception of Enterobacter cloacae strains. The Enterobacteriaceae strains were largely non-proteolytic on milk agar medium although limited numbers of E. cloacae, Serratia rubidaea and Klebsiella oxytoca strains were capable of proteolytic activity at 25 degrees C. The E. cloacae and K. oxytoca strains positive at 25 degrees C were also proteolytic at 7 degrees C. Most of the species tested were non-lipolytic on Victoria blue butterfat agar. The majority of Serratia marcescens and Klebsiella pneumoniae strains and a minority of E. cloacae and K. oxytoca strains, however, were lipolytic on this medium. PMID- 2701400 TI - An NMR assessment of the rheological properties of blood and its constituents: a review. AB - This review assesses the progress of NMR in the field of hemorheology, i.e., the assessment of the mechanical and physical characteristics of flowing blood. The review deals with the intrinsic rheological properties of the red cell and its constituents (membrane, cytoplasm), which are dominant in the microcirculation, and a section concerns the investigation of the cell/cell interaction phenomenon, known to give rise to the complicated non-Newtonian behavior of blood under most of the flow conditions encountered in the blood circulation using NMR. PMID- 2701401 TI - Systemic therapy of locally advanced breast cancer: review and guidelines. AB - For patients with locally advanced breast cancer, mastectomy and/or radiation therapy achieve poor survival rates. However, the addition of cytotoxic chemotherapy optimizes outcome by treating micrometastases that are present at diagnosis. Current recommendations specify maximum doses of systemic therapy, preferably a doxorubicin-containing regimen, prior to local therapy with radiation and/or surgery. The authors review randomized studies of chemotherapy, radiation, and various combinations given pre- or postoperatively, as well as nonrandomized studies using combination chemotherapy regimens. They also discuss the possible future use of high-dose chemotherapy with autologous bone marrow rescue and the potential of manipulating growth factors which regulate breast cancer. PMID- 2701402 TI - Thromboembolism in patients with Gyn tumors: risk factors, natural history, and prophylaxis. AB - Venous thromboembolism is a frequent major complication in patients with gynecologic cancer. Risk factors include being elderly and nonwhite, having an advanced stage of malignancy, a past history of deep venous thrombosis, previous venous disease as evidenced by lower extremity edema, venous stasis changes, or varicose veins. Patients who have had pelvic radiation therapy, or who are more than ten percent over their ideal body weight are also at increased risk. Thromboembolism in gyn cancer patients most often occurs in the perioperative period. Prevention is dependent upon the recognition of the patient at risk and institution of effective prophylactic methods, prior to surgery, and continuing until the patient is fully ambulatory. Low-dose heparin postoperatively is ineffective, but more intense regimens of heparin and intermittent leg compression in the operating room and postoperatively are effective. PMID- 2701403 TI - Incidence, presentation and promising new treatments for malignant mesothelioma. AB - It is predicted that up to 80,000 cases of mesothelioma will occur in the next 20 years, and thus it is increasingly important to better understand this disease. There is much controversy over the best treatment, which ranges from supportive care alone to aggressive debulking surgery combined with radiation and chemotherapy. This article summarizes the results with these various regimens to date, and discusses promising new options for therapy that may ultimately lead to increased survival. PMID- 2701404 TI - Genetic counseling for cancer patients and their families. AB - Cancer survivors who have undergone chemotherapy, radiotherapy, or surgery worry about the impact of treatment on their future health as well as on their reproductive ability. Genetic counseling--focusing on the probability of later cancers, possible infertility, and the chance of having children who are affected -is vital for cured cancer patients. Since each type of cancer and each type of treatment has unique sequelae, genetic counselors must make a thorough review of the patient's environmental and family history. They must also be alert for cancer family syndromes, including cancers of the breast, ovary, and colon. PMID- 2701405 TI - A "significant" new drug for erosive esophagitis and gastroesophageal reflux disease. PMID- 2701406 TI - Vascular tumors of the head and neck: presentation, prognosis, and treatment dilemmas. AB - Vascular tumors of the head and neck are a heterogeneous group of neoplasms, ranging from such common, benign lesions as facial hemangiomas to rare malignant tumors such as angiosarcomas. Because many of these tumors are quite rare and may occur in areas unfamiliar to the non-otolaryngologist, such as the nasopharynx, larynx, and middle ear, their presentation and differential diagnosis may not be familiar to the general medical practitioner. In addition, the treatment of many of these lesions is still evolving, with the advent of preoperative embolization and laser excision improving the morbidity of what may still be a difficult surgical removal. The authors review the presentation, treatment, and prognosis of the more common vascular tumors of the head and neck. PMID- 2701407 TI - Optimal use of the Ommaya reservoir in clinical oncology. AB - A major obstacle to the effective systemic therapy of intracranial malignancies and infections, the bloodbrain barrier was overcome by the development of the Ommaya reservoir in 1963. Initially used in treating cryptococcal meningitis, this closed system for continued access to the ventricular spaces has a variety of applications. They include treatment of cancer pain, chronic or recurrent CNS infection, prophylaxis of CNS involvement in acute lymphoblastic leukemia, and treatment of leptomeningeal malignancy. The authors outline the rationale, latest indications, surgical technique, and potential complications arising from the use of the Ommaya reservoir and other such subcutaneous reservoirs. PMID- 2701408 TI - Clinical status of monoclonal antibodies in the treatment of colorectal carcinoma. AB - MoABs have demonstrated an antitumor effect and, in time, may lead to improved outcome in patients with colorectal cancer. The authors describe their experience in Sweden and summarize the results of other studies. Primarily, unconjugated mouse MoABs have been used--directed against tumor-associated antigens. More promising are hybrid antibodies composed of mouse and human elements (chimeric), or human MoABs. Such antibodies also can be used as carriers of a cytotoxic compound. The authors discuss two mechanisms by which MoABs induce their antitumor effect, and how cytokines combined with a MoAB can contribute to lysis. The potential roles of anti-idiotypic antibodies are outlined and the use of MoABs postoperatively is proposed. PMID- 2701409 TI - Stereotactic techniques in the management of cerebral neoplasms. AB - Stereotactic devices are being used by neurosurgeons for the diagnosis and treatment of both primary and metastatic brain tumors. Although stereotactic surgery has been performed for over forty years, a resurgence in its use, especially for the management of such anatomically definable lesions as brain tumors, has come about due to the wide availability of computerized imaging of the brain and the almost natural adaptability of stereotaxy to these diagnostic modalities. Stereotactic surgery is now being performed in over 100 centers throughout the United States. The author explains the basic principles of stereotaxy and discusses the broad range of its uses in the management of brain tumors. PMID- 2701410 TI - Incidence, diagnosis, and classification of salivary gland tumors. Part 1. AB - The diagnosis of salivary gland tumors is complicated by their relative infrequency, the limited amount of pretreatment information usually available, and the wide range of biologic behaviors seen with different histopathologic types. Most salivary gland neoplasms originate in the parotid, 10-15% arise from the submandibular glands, and the rest occur in the sublingual and minor salivary glands. The probability of a salivary gland neoplasm being malignant is inversely proportional to the size of the gland. The authors discuss two major theories of histogenesis, itemize the various benign and malignant varieties of tumor, discuss the presentation and prognosis for each type, and present a list of factors that influence survival. They also discuss the newest staging system. PMID- 2701411 TI - The National Marrow Donor Program: how it works, accomplishments to date. AB - As the use of bone marrow transplantation increases, the lack of a suitable matched sibling donor for approximately 60% of patients is a growing problem. Recently, marrow transplantation has been done successfully using HLA-matched unrelated donors. In an effort to provide more donors, the National Marrow Donor Program (NMDP) was established. It involves 50 blood banks and 20 marrow transplant centers throughout the United States. More than 20,000 HLA-typed apheresis donors from these blood banks have agreed to be listed in the NMDP registry. A preliminary search for donors has been carried out for 1,116 patients. Donors suitably matched for HLA-A and B antigens were located for 99% of the patients. PMID- 2701412 TI - Ewing's sarcoma: current status of diagnosis and treatment. AB - Ewing's sarcoma, second only to osteosarcoma as the most common malignant bone tumor of children and adolescents, can be cured in more than half of all cases. Combination chemotherapy and local irradiation is the most effective multimodality approach, with chemotherapy being initiated as soon as possible after diagnosis and work-up. The first Intergroup Ewing's Sarcoma Study, completed in 1978, demonstrated that adjuvant therapy with vincristine, dactinomycin was superior to VAC alone or VAC with pulmonary irradiation. The most recent treatment advance is the identification of a high level of activity of ifosfamide and etoposide in patients with recurrent disease. This combination will soon be tested in a collaborative group Phase III trial. PMID- 2701413 TI - Bladder cancer: deciding on appropriate surgery. AB - Over the last 40 years the role of surgery in the management of bladder cancer has evolved from being the only treatment option to part of a multimodality approach which utilizes intravesical and systemic chemotherapy. Throughout this evolution, surgery has remained the mainstay of staging and treatment. Currently, conservative bladder-sparing endoscopic surgery is possible in patients with superficial bladder cancer, and continent cutaneous or orthoptic diversions are improving the quality of life in many patients who require a radical cystectomy. Unfortunately, surgery alone is insufficient to cure advanced stages of bladder cancer. Continued research in systemic chemotherapy is necessary to significantly improve long-term survival rates. PMID- 2701414 TI - Current management of salivary gland tumors. Part 2. AB - The authors base their treatment of salivary gland malignancies on the size of the primary and the histopathologic diagnosis. Group 1 includes smaller tumors in the T1 and T2 classification with cell types that are associated with slow growth. A parotidectomy is usually sufficient therapy for tumors in this group. Group 2 contains T1 and 2 tumors with more aggressive behavior. Total parotidectomy is indicated here, with postoperative radiotherapy. T3 tumors and patients with nodal metastasis or recurrent tumors make up group 3. Radical parotidectomy with sacrifice of the facial nerve is usually required for a sufficient tumor-free margin in these patients, and postop radiotherapy is also necessary. Group 4 includes T4 lesions. Extent of disease dictates magnitude of excision and amount of postop radiotherapy. PMID- 2701415 TI - Esophageal cancer: is esophagectomy necessary? AB - A prospective randomized trial of primary surgery versus primary radiotherapeutic management of esophageal cancer has never been completed. Selection of the optimal modality for primary management of esophageal cancer is important to maximize local control, palliation and survival with minimal morbidity, mortality and cost. Chemotherapeutic agents are effective in esophageal cancer and some may act synergistically with radiation to enhance local control. When chemotherapy is given concurrently with low-dose radiation, about one-quarter to one-third of the patients have no evidence of cancer in the resected specimen and it is only in this group of patients that there are long-term survivors. Thus the author questions the need for esophagectomy. Nonsurgical management of esophageal cancer employing high-dose radiation and concurrent chemotherapy has produced high local control and palliation with median survival of 1 1/2 to 2 years. PMID- 2701416 TI - Counseling the cancer patient who wants to try unorthodox or questionable therapies. AB - More than half of all patients diagnosed with malignant disease eventually try an unorthodox treatment. In order to counsel their patients appropriately about alternative treatments, oncologists and other health professionals need to familiarize themselves with the most commonly used unorthodox therapies and the reasons why patients turn to these therapies. Patients often seek "alternative" therapies because of several widespread beliefs about American medicine, one being that determination and will can cure cancer, and another being that nutrition also may effect a cure. The concerned physician needs to explain why the unorthodox therapy will not be effective, and try to provide, in an acceptable way, that part of the unorthodox treatment which will not cause harm. Most importantly, physicians need to deal with their patients' interest in unorthodox therapies seriously, and to listen and answer questions, as these needs are unfailingly well met by unorthodox practitioners. PMID- 2701417 TI - Retinoblastoma: biology, presentation, and current management. AB - Retinoblastoma is an uncommon ocular tumor of childhood which accounts for 5% of childhood blindness. It serves as a prototype for understanding the genetics of childhood cancer. The identification of the retinoblastoma gene has provided an explanation for the differing features of hereditary and nonhereditary retinoblastoma, as well as the potential for secondary malignancies in the hereditary cases. Management decisions are based upon the potential for useful vision, and the extent of disease including whether one or both eyes are involved. As nearly all patients present with disease confined to the globe, local control is excellent and survival exceeds 85%. Goals of management are cure of the disease, preservation of vision, and early detection and treatment of secondary malignancies in the genetically susceptible group. PMID- 2701418 TI - Gastric cancer: current status of adjuvant therapy. AB - Western adjuvant trials following resection of gastric cancer have yet to demonstrate a reproducible survival advantage for treated patients. However, Japanese trials have suggested that beneficial treatments can be developed. Surgical adjuvant treatment must be based on an understanding of the routes of metastatic dissemination of stomach cancer, be designed to effectively reach each of the sites of metastasis, and offer a reasonable potential for complete destruction of residual tumor cells. The author discusses the status of Western studies and the possibility of adapting the promising new leads from Japan to Western patients. PMID- 2701419 TI - Systemic therapy of head and neck cancer: most effective agents, areas of promise. AB - The management of squamous cell cancer of the head and neck is a challenging problem. However, "induction" chemotherapy administered prior to surgery and radiation therapy in newly diagnosed patients is showing encouraging results for the preservation of organ function and is the focus of multi-institutional trials. Concurrent chemotherapy and radiation therapy is another approach with promise for unresectable disease. Recent studies combining cisplatin with radiation therapy have reported minimal enhancement of mucocutaneous toxicity and promising survival data. Other strategies which are just beginning to receive attention in clinical research trials include adjuvant chemotherapy in the disease-free patient and biologic response modifiers. PMID- 2701420 TI - Oncology nursing: five decades of growth. AB - Oncology nursing has evolved as a specialty over the past five decades. The focus of this article is the evolution of oncology nursing discussed within the context of historical changes in the definition of nursing, regulation of the profession, and educational preparation. The specialty has had an orderly progression from on the-job training to continuing education to academic preparation. The practical and progressive ways in which the professional organizations, oncology nurse educators, and oncology nurse researchers have responded to the needs of cancer patients and families are discussed. Oncology specialty organizations now have a combined membership of approximately 15,000, which attests to the viability of the specialty. PMID- 2701421 TI - Cell lineage and determination of cell fate in ascidian embryos. AB - A detailed cell lineage of ascidian embryos has been available since the turn of the century. This cell lineage was deduced from the segregation of pigmented egg cytoplasmic regions into particular blastomeres during embryogenesis. The invariant nature of the cell lineage, the segregation of specific egg cytoplasmic regions into particular blastomeres, and the autonomous development of most embryonic cells suggests that cell fate is determined primarily by cytoplasmic determinants. Modern studies have provided strong evidence for the existence of cytoplasmic determinants, especially in the primary muscle cells, yet the molecular identity, localization, and mode of action of these factors are still a mystery. Recent revisions of the classic cell lineage and demonstrations of the lack of developmental autonomy in certain embryonic cells suggest that induction may also be an important mechanism for the determination of cell fate in ascidians. There is strong evidence for the induction of neural tissue and indirect evidence for inductive interactions in the development of the secondary muscle cells. In contrast to the long-accepted dogma, specification of cell fate in ascidians appears to be established by a combination of cytoplasmic determinants and inductive cell interactions. PMID- 2701422 TI - Production of fibronectin and collagen types I and III by chick embryo dermal cells cultured on extracellular matrix substrates. AB - Dermal cells isolated from the back skin of 7-day chick embryos were cultured on homogeneous two-dimensional substrates consisting of one or two extracellular matrix components (type I, III, or IV collagen, fibronectin and several glycosaminoglycans (GAGs): hyaluronate, chondroitin-4, chondroitin-6, dermatan and heparan sulfates). The effect of these substrates on the production of fibronectin, of types I, III and IV collagen by cells was compared with that of culture dish polystyrene. Using immunofluorescent labeling of cultured cells, it was observed that, on all substrates, in 1-day and 7-day cultures, 85 to 95% of cells contain type I collagen in the perinuclear cytoplasm; label was absent from cell processes. Type I collagen was also detected in extracellular fibers extending between neighboring cells. By contrast, on all substrates, only 5 to 20% of cells produced type III collagen. Otherwise distribution of type III collagen was similar to that of type I collagen. With anti-type IV collagen antibody no staining of either cell content or extracellular spaces was detected. Staining with anti-fibronectin antibody revealed two types of distribution patterns. On polystyrene and on all but type I collagen substrates, labeling revealed clusters of short thick strands and patches of fibronectin-rich material in extracellular spaces. On type I collagen substrate, however, immunostaining revealed a delicate network of regularly spaced parallel fibrils of fibronectin extending between and along cells. Using quantitative radioimmunoassay of the culture media, it was shown that, after 7 days of culture, cells secreted more type I than type III collagen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701423 TI - Two dimensional gel human protein databases offer a systematic approach to the study of cell proliferation and differentiation. AB - Human cellular protein databases have been established using computer-analyzed 2D gel electrophoresis. These databases, which include information on various properties of proteins, offer a global approach to the study of regulation of cell proliferation and differentiation. Furthermore, thanks to the advent of microsequencing the databases make it possible to directly link protein and DNA information. PMID- 2701424 TI - The extracellular matrix and cell surface, mediators of cell interactions in chicken gastrulation. AB - This article reviews the factors that are involved in cell-cell and cell-matrix interactions during chicken gastrulation. The chemical nature of the extracellular matrix, the structure, composition, cellular origin and remodeling of the basement membrane, and the nature of the cell surfaces are successively analyzed in relation to a variety of cell biological processes, such as cell-to cell and cell-to-substrate adhesion, specific binding to biological macromolecules and to receptors of the cell surface, promotion of cell migration and positioning, transmembrane triggering of intracellular events, and modulation of cell shape. These processes are the cellular basis of morphogenesis in the chicken blastoderm. PMID- 2701425 TI - Initial GABAergic expression in embryonic amphibian neuroblasts after neural induction. AB - At the late gastrula-early neurula stage some embryonic neuroblasts from neural plate and neural fold present apparently as a consequence of neural induction, the capability to develop in vitro into different neuronal subpopulations (cholinergic, dopaminergic, noradrenergic, somatostatinergic and some other peptidergic subpopulations without ongoing influences from the chordamesoderm (Duprat et al., 1987). Using the same in vitro model system, the aim of the present work was to delineate the abilities of these neuroblasts to develop GABAergic traits. The initial appearance and development of GABAergic phenotype has been quantitated by assaying the activity of glutamic acid decarboxylase (GAD). GAD activity was undetectable at the early gastrula stage (stage 8a) and was slightly measurable at the early neurula stage (stage 14- onset of the culture). It increased subsequently over the next 14 days in vitro. The temporal pattern of appearance and development of GAD activity in culture was in agreement with that observed in vivo. Immunocytochemical studies showed that GABA-like immunoreactivity was expressed in vitro in a subpopulation of neurons. Thus the developmental program for GAD expression and GABA phenotype maturation is acquired at least in some neuronal precursors. These data together with previously reported results on the expression of cholinergic, catecholaminergic and peptidergic phenotypes demonstrate that different neuronal subpopulations emerge near the end of gastrulation i.e. immediately after neural induction. The embryonic origin of this neuroblast heterogeneity remains to be determined. PMID- 2701426 TI - Enzymatic hydrolysis of plant polysaccharides: substrates for fermentation. AB - The enzymatic hydrolysis of plant carbohydrate polymers is discussed with particular emphasis on lignocellulose. The polysaccharides include starch, inulin, cellulose and the hemicelluloses, i.e., the heteroxylans and glucomannans. Commercial operations exist for the enzymatic hydrolysis of starch and its fermentation into chemicals such as ethanol. Enzymatic hydrolysis of lignocellulose is more complex and the enzymes are rather expensive to produce, which currently precludes the commercial processing of lignocellulosic materials. The bioconversion of lignocellulose consists of 4 process steps: pretreatment, enzyme production, enzymatic saccharification and fermentation. Except for the last step, each of these process steps is discussed. The discussion is highlighted with examples of lignocellulosic waste materials (e.g., sugar cane and a hardwood and softwood sawdust) which are of potential use in a bioconversion process for providing sugar hydrolysates that can serve as fermentation substrates. PMID- 2701427 TI - Immuno-toxicology and -pharmacology. AB - 1. The new field of immunotoxicology may be expected to gain considerable importance in the assessment of possible toxic risks of chemicals. It is an applied science based on the considerable experience gained in basic immunological research within the last decades. 2. Some possibilities are discussed and procedures suggested for evaluating toxic effects induced by chemicals (including drugs) in experimental animals and man. 3. Original data are presented on thymus atrophy induced in the offspring of rats treated on day 10 of pregnancy with the virostatic drug acyclovir. 4. Experimental data are presented on the effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the distribution of lymphocyte populations (peripheral blood) in primates in vivo and in vitro, as determined with monoclonal antibodies as probes. PMID- 2701428 TI - Burnishability of a nickel and a cobalt base casting alloys. AB - A specially designed stainless steel split die capable of producing a total of 24 half cylindrical shaped wax patterns was used in this study. The burnishability of two non-precious casting alloys was evaluated following a proposed softening heat treatment technique. A practical easily applied burnishing tool was introduced. Results have shown that, both of the non-precious alloys were burnishable following softening heat treatment. However, nickel-chromium alloy was significantly more burnishable than the cobalt-chromium alloy. It is suggested that clinical implications of the developed technique in this study would be an important additive for more precision castings. PMID- 2701429 TI - [Calcium hydroxide in endodontic therapy. 2]. PMID- 2701431 TI - [Oral respiration. Diagnosis and physiopathology]. AB - The oral breathing can change the functional connections during the development of the facial bones of the children. All this causes an abnormal growth of the facial bones and of the dental structures. This work developed a new discipline to remove this problem. PMID- 2701430 TI - [Laser in dentistry. Characteristics and utilization]. AB - Authors present this review article in the beginning of an experimental study about lasers applications in dentistry. They also show the main characteristics of lasers involved in this kind of research. PMID- 2701432 TI - [Neuromuscular relaxation and CCMDP. The Zilgrei and Feldenkrais methods 2]. AB - The Authors show two neuromuscular release methods employed in the treatment of cranio-cervico-mandibular syndrome; these methods work at the place of origin of the pathology resolving the symptoms in different districts of the body. PMID- 2701433 TI - [A new computerized method for quantitative occlusal analysis]. AB - In this work the authors wanted to stress the importance of the occlusal analysis in the sphere of the dental clinic test considering the different methods. Moreover the characteristics of a new system computed for the remark of the occlusal contacts have been analysed with greater detail, debating advantages, limits and clinics applications. PMID- 2701434 TI - [Recurrent aphthous stomatitis. Clinical and therapeutic aspects]. AB - The Author discusses the most recent data on incidence, etiopathogenesis, clinical aspects and treatment of recurrent aphthous stomatitis. PMID- 2701435 TI - [Neuromuscular relaxation and CCMDP. Rolfing and applied kinesiology. 3]. AB - The structural and functional connection between stomatognatic system, rachid, pelvis and lower limbs are well known; it's obvious that an alteration in one of these districts influences the other ones. Rolfing and applied kinesiology, on this ground, work to resolve muscular pain in cranio-cervicomandibular syndrome. PMID- 2701436 TI - [Oral cavity and behavior. Relationship of mind and body]. PMID- 2701437 TI - [Problem of xerostomia in wearers of complete dentures]. AB - Xerostomia, jointed to local or general diseases or to drug therapy, is a very heavy problem for complete denture patients. Lack of saliva produces changes in the oral mucose membrane and instability of the complete denture. The Authors suggest a change in the complete denture consisting in small tanks full of solution making up for the lack of saliva. The new method proved to be good, easy to make, and very cheap. PMID- 2701438 TI - [Neuromuscular relaxation and CCMDP. Biofeedback and TENS. 4]. PMID- 2701439 TI - [beta-TCP and beta-TCMP osteoregenerators. New perspectives]. AB - The Authors present personal histological findings on a beta-tricalcium phosphate Mg substituted (beta-TCMP) prepared as sintered granules and unsintered powder. A mixture of these materials was used to fill bone cavities or defects in oral surgery. The beta-TCMP represents a biocompatible ceramic material able to accelerate and enhance bone repair of bone defects. It provides a completely biodegradable matrix for new bone growth as well as releasing mineral ions into the tissue during mineralization. Newly formed bone tissue is described in direct contact with residual beta-TCMP granules. No connective tissue layer is present between the new bone and the surface of the alloplastic material. PMID- 2701440 TI - [Subperiosteal implantology. Analysis of a complex case]. AB - The absence of occlusal and functional trauma of prothesis upon the subperiosteal supports, gives the maximun state of quiet to the implants. The stability of implants prevents the pathology of outwards exposures of the sub-structure. In fact, a balance is created between the defensive barrier and the inflammatory charge of plaque. The absence of outwards exposures of the implants prevents their loss. Prothesis is therefore the key for the stability of the subperiosteal implants and for their duration in time. PMID- 2701441 TI - [Fungi, their use for the control of insects of medical and agricultural importance]. PMID- 2701442 TI - The genetic engineering of baculovirus for foreign gene expression. PMID- 2701443 TI - [150 years of psychiatric care in Romania]. PMID- 2701444 TI - [The history of pediatric neuropsychiatry in Romania]. PMID- 2701445 TI - [The history of psychiatric education in Romania]. PMID- 2701446 TI - [The history of medical psychology in Romania; 55 years of activity]. PMID- 2701447 TI - [The development of psychiatric care in Romania over the last 50 years (1938 1988)]. PMID- 2701448 TI - [The Center for Pediatric Neuropsychiatry (1946-1973)]. PMID- 2701449 TI - [The forms of ambulatory and semi-ambulatory psychiatric care in Romania]. PMID- 2701450 TI - [Scientific research in Romanian psychiatry]. PMID- 2701451 TI - [The evocative signal: the Socola School of Psychiatry]. PMID- 2701452 TI - [Psychiatric Cluj. A short historical sketch]. PMID- 2701453 TI - [Psychiatry in a "new wave" perspective]. PMID- 2701454 TI - [The historiographic aspects of the development of psychiatric care in Tirgu Mures]. PMID- 2701455 TI - [Psychiatric care in Oltenia]. PMID- 2701456 TI - [Moments in the history of psychiatric care in Bucovina]. PMID- 2701457 TI - [The evolution of psychiatric care in Sibiu County (1863-1988) (abbreviated text)]. PMID- 2701459 TI - [Sapoca Hospital of Psychiatry and Neurology, Burzau County]. PMID- 2701458 TI - [The history of psychiatry in Bihor County]. PMID- 2701460 TI - [Alexandru Sutu, the founder of psychiatric education in Romania]. PMID- 2701461 TI - [Alexandru Obregia (1860-1937)]. PMID- 2701462 TI - [Alexandru Braescu]. PMID- 2701463 TI - [Constantin I. Urechia (1883-1955)]. PMID- 2701464 TI - [The contribution of C. I. Parhon to the development of psychiatry in Romania]. PMID- 2701465 TI - [Gheorghe Preda (1879-1965)]. PMID- 2701466 TI - [Leon Ballif]. PMID- 2701467 TI - [Florica Bagdasar, a promoter of neuropsychiatry in Romania]. PMID- 2701468 TI - [George Mileticiu (1853-1917), a pioneer in scientific psychiatry]. PMID- 2701469 TI - The biosynthesis of branched O-glycans. AB - The hypothesis put forward in this review is that the branching patterns at the core of Ser(Thr)-GalNAc oligosaccharides (O-glycans) determine the types of glycan that are synthesized and their functions. Biosynthetic pathways are presented for the four types of O-glycan core and for some of the more common glycans that are built on these cores. The four core types discussed are: (1) Gal beta 1-3GalNAc-alpha-Ser(Thr)-R, (2) Gal beta 1-3(GlcNAc beta 1-6)GalNAc-alpha Ser(Thr)-R, (3) GlcNAc beta 1-3GalNAc-alpha-Ser(Thr)-R, and (4) GlcNAc beta 1 3(GlcNAc beta 1-6)GalNAc-alpha-Ser(Thr)-R. General rules concerning the control of synthesis of these molecules are derived. PMID- 2701470 TI - Ion binding: patterns of 'affinity' depending on types of acid groups. AB - Bungenberg de Jong's sequences of cation binding to polymer-bound anionic sites established, over 40 years ago, that the most common cations, Na+, K+, Mg+(+) and Ca+(+), in biological materials behaved differently in the presence of the three most common polyanionic charges, carboxylate, diester phosphate and ester sulphate. He proposed a fundamental mechanism involving polarisability and polarising power, respectively, of the anionic electrons and the cation, which accounted for his observations. We generalised his mechanism to provide a relationship between the pK of the anion and the ion binding spectrum. Extracellular polyanions would be predicted to prefer K+ to Na+, in spite of the preponderance of Na+ in the extracellular space. It is suggested that this preference was important during biosynthesis inside the cell, where K+ is predominant. PMID- 2701471 TI - The effects of mucus and mucilaginous materials on ion-distributions at epithelial surfaces. AB - Mucous layers on epithelial surfaces may have a range of functions. One approach used to investigate these is to measure the distribution of ions within the mucous layers using ion-sensitive microelectrodes. The results of several studies are reviewed. It is clear that these layers do influence the distribution of ions at epithelial surfaces and by a variety of mechanisms. Processes such as active ion-transport and passive diffusion interact with the diffusional and ion exchange properties of mucus to produce complex distributions. PMID- 2701472 TI - Ions and mucoid substances in sensory organs--microanalytical data from insect sensilla. AB - In insect sensory organs, the receptor endings are surrounded by an extracellular subcuticular matrix, the sensillum lymph. This matrix provides the correct aqueous and ionic milieu around the sensory processes, plays a role in the generation of the receptor current, and is also important for stimulus transport and/or stimulus inactivation in chemoreceptors. Histochemical evidence indicates the presence of proteoglycans (probably hyaluronate and/or chondroitin sulfate) in the sensillum lymph. X-ray micro-analytical studies demonstrate a very low sodium content, whereas potassium is present in high concentrations, comparable to those in intracellular compartments. The total positive charges of cationic elements are not balanced by the negative charges of chlorine, but by polyanions of the mucoid substances present in sensillum lymph. These fixed negative charges probably play a key-role in the establishment of the non-neural transepithelial voltage of insect sensilla, which in turn is a major source of the receptor current. Moreover, the mucoid substances of the sensillum lymph are probably involved in water conservation, since sensilla are prone to water loss, because the overlying cuticle must be permeable to the chemical stimuli. Functional analogies are pointed out between insect sensillum lymph and vertebrate olfactory mucus and, in particular, the endolymph of the vertebrate inner ear. PMID- 2701473 TI - Oligosaccharides as recognition structures. AB - The diverse O-linked oligosaccharide structures of the glycoproteins in mucus have the potential for encoding a vast amount of biological information. A major challenge in modern cell biology is to devise ways of decoding the information in these and other oligosaccharide structures of N-linked chains and glycolipids. In this article, I highlight some studies of oligosaccharide antigenicity, and discuss the way the results are being interpreted with respect to oligosaccharide function. I conclude with a discussion of a new technology that is under development with the aim of investigating oligosaccharide recognition in diverse biological systems. PMID- 2701474 TI - Novel core, backbone and peripheral region sequences of the oligosaccharides of foetal gastrointestinal mucins present in human meconium. AB - Structural and conformational studies have been carried out of the oligosaccharide chains of foetal gastrointestinal mucins purified from human meconium. Combined GC, MS and 1H NMR analysis has been used to characterise the twenty-six major mono- to hexasaccharides. These show seven different core regions (including unsubstituted GalNAc-ol). Extended glycosylation occurs on both branches at C6 and C3 of GalNAc-ol and both repeating type 1, Gal beta 1 3GlcNAc, and alternating type 1/type 2, Gal beta 1-3GlcNAc/Gal beta 1-4GlcNAc, sequences are found. Backbone type 1 sequences are linked via a GlcNAc beta 1 3Gal bond whereas Type 2 sequences can be linked additionally via a GlcNAc beta 1 6Gal bond either in a straight chain or as a branch, GlcNAc beta 1-3[GlcNAc beta 1-6]Gal. Peripheral substituents include Fuc alpha 1-2 and GlcNAc alpha 1-4 linked to Gal. PMID- 2701475 TI - Unbranched polylactosamino-O-glycans on human skim milk mucins exhibit Gal beta(1 4)GlcNAc beta(1-6) repeating units. AB - Neutral O-glycans on human skim milk mucins exhibit unique structural features, which may be summarized as follows: 1) the carbohydrate chains comprise up to 16 (or more) monosaccharide units; 2) the core structures are of the common type 2 Gal beta(1-3)[GlcNAc beta(1-6)]GalNAc; 3) the poly-N-acetyllactosamine backbones of the major glycans are unbranched; 4) the repetitive N-acetyllactosamine units of the linear species are linked by the hitherto unknown sequence GlcNAc beta(1 6)Gal rather than GlcNAc beta(1-3)Gal; 5) another major portion of mucin O glycans represents branched isomers of the linear species containing except for their branching points at 3,6 disubstituted galactose residues the same structural elements as their unbranched counterparts; 6) fucosylation at various sites of the polyactosamine sequences yields mono-, di- and trifucosylated species; 7) fucosylation occurs predominantly at the subterminal GlcNAc and at the core-GlcNAc of the carbohydrate chain. PMID- 2701476 TI - Drug-mucus actions and interactions. AB - Although it has generally been accepted that the main structural component of mucus secretions is the high molecular weight glycoprotein it has now been established that other macromolecules are co-secreted. For example, lysozyme, lactoferrin and albumin are known to be secreted by the serous cells within the sub-mucosal respiratory glands: significantly the albumin is synthesised within the cell and is not derived from serum. The various cells within the gland respond differently to agonists and since goblet cells, apart from when they are in the crypts within the gastro-intestinal tract, do not appear to be innervated, they cannot respond to any agonist as yet identified. It is therefore probable that the changes which occur during disease may result from changes in the sensitivity of a particular cell type to an agonist as this can markedly affect the type of secretion that is produced. Since the products of the serous cell form part of the natural defence system then the reduction in their number which is observed in chronic obstructive airways disease could also be significant in the disease process. Within the gastro-intestinal tract, it has now been established that substances which reduce the mucus structure can produce damage to the underlying membrane. The endogenous surfactants produced in bile are good examples and co-secretion of phosphatidylcholine provides a defence against self digestion within the gut by the formation of mixed micelles. The importance of the mucus layer in the access of drug molecules to the absorbing epithelium has also been identified. The diffusion of water molecules is hindered even at concentrations below the gelling point (approximately 10-20 mg ml-1) and above this concentration a precipitate fall in diffusion coefficient is followed by a levelling off. This pattern is followed by low molecular weight drug molecules and a reasonable correlation between drug absorption and binding to mucus glycoproteins can be demonstrated. The agents which have been claimed to affect the quality and quantity of mucus secreted by the respiratory epithelium during conditions like chronic obstructive airways disease have been poorly understood. Recent studies have shown that compounds like bromhexine and S carboxymethylcysteine can block the activity of mucus secretagogues in the rat. Furthermore, it has also been demonstrated that such compounds can prevent the inflammatory response to cigarette smoke. However, their activity is not restricted to the respiratory epithelium and the cervical mucus barrier has also been shown to be compromised following systemic administration. PMID- 2701477 TI - Macromolecular and lipid constituents of bronchial epithelial mucus. AB - The physical and chemical properties of bronchial epithelial mucus depend on its special mix of macromolecules and lipid constituents: these are different in the normal airway under baseline conditions from one stimulated acutely, and show major modification in disease. Since the last conference, density gradient ultracentrifugation has been extended to the study of normal bronchial mucus in addition to that of sputum from patients with chronic bronchitis, cystic fibrosis and asthma, and has revealed striking differences between the chemical profiles of normal and hypersecretory mucus. Normal mucus represented individual bronchial aspirates, obtained at fiberoptic bronchoscopy from healthy human volunteers (non smokers), aspirates from normal dogs (before SO2 exposure in a canine model of SO2 induced bronchitis) and secretions released in vitro by human bronchial and canine tracheal explants. Mucus 'in transition' included aspirates from otherwise healthy smokers and from dogs early in irritation. Hypersecretory mucus included, besides those mentioned above, aspirates from dogs that had developed bronchitis and the excessive mucus produced by some patients with acute quadriplegia. Lipids. In normal mucus, human (unpooled) and canine, neutral lipids are the predominant species, with lesser amount of phospholipids: no glycolipids are detected. The first qualitative change on irritation, even before macromolecular yield increases, is appearance of glycolipids. In hypersecretory mucus, human (including quadriplegics) or canine, glycolipids are detected in appreciable amounts and often are the predominant species: they include complex forms such as sialic acid containing gangliosides. Organ and cell culture studies establish that these lipids are produced by airway epithelial cells. These lipids are important to gel formation. Glycoconjugates. A major recent advance is the recognition that normal mucus does not contain typical epithelial glycoprotein. Its glycoconjugate is of higher density with sugars typical of both glycoprotein (GP) and proteoglycan (PG) and with an amino acid profile more akin to PG (glycine greater than serine greater than threonine). In transition to hypersecretion, a 'mixed molecule' changes its sugar mix to produce a density typical of GP. In hypersecretion, the epithelial GP develops a typical buoyant density and amino acid profile (threonine greater than serine greater than glycine). Organ culture of bronchial explants, and more recently cell culture, establish that the PGs are major products of airway secretory cells. The normal airway is capable of producing glycoprotein on cholinergic stimulation. The range of glycoconjugates present in the secretion support the wide range of granule and cell features identified in vivo. Monoclonal antibody raised to a pure preparation of bronchial epithelial glycoprotein reacts with mucous cells in the surface epithelium and also in the submucosal gland in both human and canine airways.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2701478 TI - Studies on the peptide core of human bronchial mucus glycoprotein. AB - We have employed thiol-Sepharose chromatography following deglycosylation to analyze the protein core of bronchial epithelial mucus glycoprotein (MGP), isolated by a two stage density gradient ultracentrifugation. Deglycosylation using triflouromethanesulfonic acid resulted in loss of greater than 90% of carbohydrate. The deglycosylated core protein was reduced and the sulfhydryl residues activated with 2-2'dipyridyl disulfide. This preparation was then bound covalently to thiol-Sepharose, and eluted specifically with reducing agents. Our results demonstrate that bronchial MGP contains cysteine residues potentially capable of forming disulfide bonds. Pepsin digestion studies suggest that cysteine residues are present near both the heavily glycosylated region and the naked peptide region. Thiol-Sepharose chromatography resolved several mucin associated proteins (MAPS) that did not bind to the column. Amino acid analysis showed that the largest of these (200 kDa) is enriched in serine/threonine, like MGP that absorbed to the column: the two smallest (20 kDa and 60 kDa) are similar to the proline rich proteins reported in salivary mucin. These associated proteins, although not linked by disulfide bonds to the MGP, are, nevertheless, tightly bound to it, since they were only recovered after deglycosylation and thiol chromatography. PMID- 2701479 TI - Use of primary cell culture to study regulation of airway surface epithelial mucus secretion. AB - Airway mucus glycoproteins are produced by two different tissues, ie, surface epithelium and submucosa glands. Due to the coexistence of these sources in the same organ, it has been difficult to study the regulation of mucin synthesis and secretion from each source. We have recently developed and characterized a primary culture from tracheal surface epithelium which is highly enriched in secretory cells and produces authentic mucins. Mucins produced by the cultures are extremely hydrophobic. A pool of mucins is localized on the cell surface of secretory cells and these cell surface mucins are released by neutrophil elastase. The simplicity and the relatively rich secretory cell population of the present culture system will serve as a useful model in studying the cell biology of mucin as well as pharmacology of airway surface epithelial mucus secretion. PMID- 2701480 TI - Small intestinal mucin: polymerization and the "link glycopeptide". AB - Extensive polymerization of core glycopeptide subunits appears to be a constant feature of mammalian mucins when care is taken to avoid polymer disruption by high shear forces and proteases. Depolymerization by reducing agents releases a 118 kDa glycopeptide from small intestinal mucins, with features that suggest that one of its roles may be to link highly glycosylated glycopeptide subunits. "Link" peptides are widely distributed, have a similar amino and carbohydrate content, quite distinct from the major mucin glycopeptides and can be liberated by proteases which also depolymerize mucin. In collaboration with Dr. R. Specian, (Shreveport, Louisiana) we have used a monospecific antibody to the 118 kDa glycopeptide to show that it is localized in rat intestine to goblet cells, where it is distributed in a patchy fashion throughout the mucus granule population and is also present in the golgi cysternae. Secreted mucins are distinguished by a very high content of dimerized 118 kDa glycopeptide (200 kDa glycopeptide) which may play a role is selecting or facilitating mucin transport pathways. The 200 kDa glycopeptide may be a integral component of some polymerized mucin molecules since it can be released from intracellular mucins by controlled proteolysis with trypsin, and is subsequently converted to the 118 kDa glycopeptide by thiol reduction. PMID- 2701481 TI - Structure and macromolecular properties of cervical mucus glycoproteins. AB - The endocervical canal is filled with a mucus gel, the properties of which vary during the ovulatory cycle. At mid-cycle the amount of mucus increases, mainly owing to an oestrogen-induced increased hydration of the gel, mucus becomes less visco-elastic and the penetration of the spermatozoa is facilitated. In contrast, under the influence of progesterone during the luteal phase, mucus turns into a less hydrated, highly visco-elastic structure which acts as a barrier to sperm. The mucus gel is formed by very large and structurally complex glycoproteins perfected by evolution to tease and disunite the scientists engaged in unravelling their secrets. The macromolecules are referred to as the mucus glycoproteins or the mucins. Hydrodynamic studies show that cervical mucus glycoproteins (Mr 10-15 x 10(6] behave as random coils, which occupy large spheroidal domains in dilute solution. The predicted 'linear' structure is supported by evidence obtained with electron microscopy. By this technique, the macromolecules are visualized as 'threads' with a skewed and polydisperse distribution of contour lengths (number-average length, 1.5 microns; range 0.5-5 microns). The macromolecules may be cleaved into subunits (Mr 2-3 x 10(6] by reduction of disulphine bonds and these fragments can be divided into large glycopeptides (T-domains; Mr 300,000-400,000) by trypsin. Most of the carbohydrate, which accounts for approximately 80% by weight of the macromolecule and occurs as a heterogeneous population of oligosaccharides, is enriched within the T-domains. The high-Mr glycopeptides thus correspond to long (of the order 100 nm) stretches of protein covered with 100-300 oligosaccharides which protect the core from proteolysis. These regions of the macromolecule are referred to as oligosaccharide 'clusters' and subunits of cervical mucins contain, on average, 3 5 of these 'clusters'. Each 'cluster' is flanked by stretches of protein which are less substituted with carbohydrate and, consequently, more sensitive to proteolysis. There is evidence that these parts of the core, referred to as the 'naked' regins, are folded and stabilized by disulphide bonds. Cervical mucus glycoproteins may thus be viewed as a linear array of oligosaccharide-rich 'clusters' alternating with structures reminiscent of a globular protein. Little is known about how the mucus glycoproteins interact to form the gel. The classical 'Odeblad concept' postulates that the mucins form bundles ('micelles') which are then interconnected in a hormone-dependent way. In contrast, light scattering studies suggest that cervical mucus is an entangled net-work of long and flexible macromolecules.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2701483 TI - Invertebrate mucous secretions: functional alternatives to vertebrate paradigms. AB - Invertebrates use mucus in a far broader spectrum of functions than do vertebrates. Examples include: 1. Navigation. The slime trails of grastropods often contain directional information that is used in homing, mating, and predation. 2. Defense. Many invertebrates coat themselves with slippery, distasteful mucus secretions to ward off predators. 3. Desiccation resistance. Limpets and terrestrial snails use a thin barrier of dry mucus as a mechanism for minimizing desiccation. 4. Structural support. Mucus functions as a tensile structural element in feeding nets and mating ropes. A preliminary analysis of these structures indicates that tensile stiffnesses of 10(4)-10(5) N/m2 may be common. 5. Food. The production of mucus can account for up to 80% of the total energy expenditure of some invertebrates. Mucus is often used as a food source, and in some cases is used to enhance the growth of food items. 6. Locomotion. The adhesive locomotion of gastropods is dependent on the unusual mechanical properties of pedal mucus. These properties may set limits to the size and speed of snails and slugs. PMID- 2701482 TI - Changes in cervical mucus that prevent penetration by spermatozoa. AB - Two situations that result in the conversion of human mid-cycle cervical mucus from a sperm-receptive to a sperm-hostile form are described here: firstly, the addition of mucospissic agents, and secondly, the presence of antisperm antibodies. Two mucospissic biguanides were studied, chlorhexidine and Vantocil; both were totally spermicidal in the range 1-10 mg ml-1. Treatment of mucus with 1.5 microM to 1.65 mM Vantocil caused a dose-dependent increase in the dynamic storage modulus. The compatibility of the two biguanides with mucus was examined by measuring the rate of entry of diffusion of the [14C]biguanides into mucus. Chlorhexidine entered the mucus up to 0.53 mM, i.e. the highest concentration used, whilst Vantocil only entered at concentrations below 0.53 mM. This limited entry may be caused by the precipitation of mucus at the interface, producing a barrier of reduced permeability. The behaviour of purified mucin on ultracentrifugation was also altered after treatment with chlorhexidine. The s20 (at 2 mg ml-1 purified mucin) increased from 11.2 S to 19.3 S upon addition of 200 microM chlorhexidine. Further indication of structural alteration of biguanide-treated mucin was given by its loss of solubility in 0.22 M-sodium thiocyanate. The application of these biguanides to vaginal contraception is suggested. When antisperm antibodies are present in either the semen or cervical mucus, we suggest that an interaction can occur between galactose residues on the spermatozoa and galactose recognition sites on the antisperm antibody; in addition, binding can also occur between the Fc region of the antibody and cervical mucus. This process could therefore contribute to the binding of spermatozoa to the antibody and the immobilisation of this complex by the cervical mucus that is seen in immunological infertility. It was shown, by Immunobead binding, that immediate exposure of spermatozoa to D-galactose in the presence of chymotrypsin resulted in a considerable decrease or total loss of bound antisperm antibodies in males who had previously had a high titre of antibody. This reduction in the antibody level on the spermatozoa was accompanied by the appearance of the antibody level on the spermatozoa was accompanied by the appearance of the ability of the spermatozoa to penetrate cervical mucus in those couples examined. This pretreatment regimen for the ejaculate is suggested as a form of therapy for infertility related to the presence of antisperm antibodies. PMID- 2701484 TI - Identification of human tracheo-bronchial mucin precursors. AB - Bronchial mucin peptide chains were obtained by performing a two-step chemical deglycosylation of the highly glycosylated regions (or glycopeptides) which are the most characteristic part of bronchial mucins. The deglycosylated preparation was used to prepare an antiserum directed against mucin peptide epitopes. This antiserum reacted with the area containing rough endoplasmic reticulum of goblet cells and of mucous gland of human bronchial mucosa but not with secretory vesicles. The antiserum was used for immunoprecipitation of radiolabelled mucin precursors in pulse-chase experiments with explants of human bronchial mucosa. SDS-polyacrylamide gel electrophoresis followed by fluorography revealed precursors with a molecular mass in the range of 200 to 400 kDa as early as after 10 min pulse labeling with [3H]threonine. These results suggest that the mucin polydispersity previously visualized by electron microscopy may be explained by the synthesis of several respiratory mucin peptide precursors with different molecular sizes and/or that precursors with different amounts of carbohydrate are rapidly formed. PMID- 2701485 TI - Electrical charge properties of connective tissue in the insect central nervous system, with regard to ionic homeostasis of the nerve cell environment. AB - In the central nervous system of insects, a basement membrane (the neural lamella) covers the superficial glial layer (the perineurium) and further connective tissue coats the underlying glia and neurones. The neural lamella includes proteoglycans, glycoproteins and collagen fibrils. Recent studies to investigate extracellular ion-binding show that the lamella retains little ionic lanthanum, while experiments with radioisotopes indicate elevated levels of potassium, as in many other basement membranes. The sub-perineurial interstitium is composed principally of hyaluronate. It contains discrete sites which bind lanthanum, and efflux of radioisotopes indicates that it has cation/chloride ratios to be expected for a Donnan equilibrium. Proposed effects of negative charges upon ionic homeostasis are discussed. PMID- 2701486 TI - Microbial polysaccharides--a comparison with eukaryotic polymers. AB - Many microorganisms secrete exopolysaccharides, most of which are composed of monosaccharides widely found in non-microbial sources. Bacterial polysaccharides are frequently acylated or may contain phosphate esters but, with the exception of cyanobacterial material, appear to lack sulphate. They may contain a number of unusual or methylated sugars. The majority of microbial exopolysaccharides are composed of repeating units ranging in size from disaccharides to heptasaccharides. Some of these polymers are either identical to, or very similar to, polysaccharides found in eukaryotic tissues. In the microorganism, however, the function of the material is very different to that in the eukaryote. PMID- 2701487 TI - Naturally-evolved changes in bacterial polysaccharides. AB - Major roles suggested for extracellular polysaccharides are as antigens, 'phage receptor sites or for protecting cells against dehydration. The evolution of bacterial species has led to a large number of bacterial polysaccharides with complex chemical repeat units. There is growing evidence that such structures may be grouped into families of polymers differing in only small changes in chemical structure. Physico-chemical studies of such families are starting to reveal which variations are important in changing the functional properties of the polymers. PMID- 2701488 TI - Genetics of capsular polysaccharide production in bacteria. AB - Many pathogenic bacteria produce an extracellular capsule, composed of any one of a large range of polysaccharides, which plays a crucial role in the interaction with the host. Molecular techniques have been exploited to study the biosynthesis, export and cell surface assembly of these polymers. In the case of Escherichia coli a cassette of biosynthesis genes, unique and specific for a given polysaccharide and found only in bacteria producing this polysaccharide, is flanked on both sides by a cluster of genes which encode functions common to the production of chemically distinct polymers. On one side the DNA encodes products which function at some stage following the polymerisation of the sugar components of the polysaccharide. The nature of the reactions mediated by these products is unclear. To the other side of the biosynthesis cassette the DNA encodes five proteins for export of polysaccharide from the periplasm to the cell surface and its organisation into a capsule. PMID- 2701489 TI - Mucus glycoprotein, its biophysical and gel-forming properties. AB - The mucus glycoprotein molecules of mildly solubilised mucus have been called 'the first units into solution'. These are strand-like, randomly coiling macromolecules 0.5 to 50M. Dalton in molecular weight. Light scattering shows them to be Kuhn coils of a approximately 1000 A long, thin, linearly repeated segment built on a protein chain of about 1000 amino acids, the presumable gene product synthesized by the cell. Mucus, from all sources, involves this glycosylated (approximately 80% sugar) structural subunit, composed of two parts: a bare peptide part, B, and a heavily glycosylated peptide part, T, containing all the sugar in some 200 O-glycosidically linked side chains. The network required for the rheological functioning of mucus, the mucus gel, is built up of these units. A large number of cysteines occur in the bare protein region B. As the crosslink, therefore, either a direct intermolecular disulfide bond (B to B), or a disulfide bond stabilized lectin protein-to-sugar bond (B to T), is presumed to be involved. There may be two levels of crosslinking. Bonds entered into in nascent mucus may be labile, and a freshly secreted mucus blob swells easily. Later on the links seem to become more stable, no longer exchange with ease and there is little swelling. The gel network in mucus may not be infinite, but only an effectively entangled system of very large molecules. On normally functioning respiratory epithelia, indeed, the network may only be transient. Anything which destroys the bare peptide region, e.g. proteolysis, dissolves the network and yields T-domains. There is at most a side-to-side association of the individual glycoprotein subunits in the network strands and rather few branches. The lectin hypothesis for the crosslink would give the cell very easy control over the structural and rheological properties of the secreted product. In the context of the lectin hypothesis it is proposed that the so-called 'link' protein of intestinal mucus is a degraded part of the B+T subunit, the B part plus some of the adjacent T domain. The 'link' protein would thus contain the lectin and would stay bound until released by thiol reduction. PMID- 2701490 TI - Biological function of mucilages secreted by roots. PMID- 2701491 TI - Mucilaginous substances from macroalgae: an overview. AB - Macroalgae (seaweeds) produce a diversity of mucilaginous substances, some of which are of considerable commercial and biotechnological importance (e.g. alginate, carrageenan, agar). They are involved in vivo in conferring structural integrity as cell wall materials (alginate, agar, carrageenan), the prevention of desiccation (sulphated fucans), selective absorption of ions (alginate, sulphated fucans) and in bioadhesion (various glycoproteins and mucopolysaccharides). The current state of knowledge with respect to the structure, localization, biosynthesis and secretion of some of the more important of these substances is summarised. PMID- 2701492 TI - The relationship of mucoid substances and ion and water transport, with new data on intestinal goblet cells and a model for gastric secretion. AB - It is known from the physical chemistry that mucoid substances (glycosaminoglycans, proteoglycans, glycoproteins) constitute polyanionic gels with anomalous colligative behaviour and differential preference for binding some cations such as H+, K+, Ca2+. The mucus secreting membranes in animals also constitute ion and water transporting epithelia with morphologically characterised pericellular compartments. These pericellular compartments are not free-fluid spaces as is assumed in conventional physiological thought, but contain polyanionic mucoid matrices with a prevalence of sulphated varieties such as heparan sulphates. Measurements with electron probe X-ray microanalysis of cryosections (EPXMA) show that at the various pericellular sites the local dry mass of these matrices can vary from less than 5% to greater than 30% of the wet mass. EPXMA measurements in several epithelia from insects and from vertebrates (gastro-intestinal tract) also show that the total concentrations of the major chemical elements (P, S, Na, K, Mg, Cl) at these pericellular sites is distinct both from their concentrations in the cytoplasm and in the bulk mucosal and serosal compartments. In all the examples a particular role of pericellular polyanions in sequestering K+ and Ca2+, and excluding Cl- is indicated. It is proposed that the general K-sequestering ability of these pericellular mucoids conserves the K+ ions leaking out of the cells and thus reduces the energy load for active transport in the cells through a K-recycling mechanism. In the midgut caeca of the desert locust, Schistocerca gregaria a dense mucoid matrix (30% dry mass) in the luminal crypts (cristae) helps to maintain a high K+ activity at the mucosal surface of the absorptive cells, apparently necessary for a K-linked absorption of nutrients and water. In the electrically isolated apical cavities of the midgut 'goblet' cells of Manduca sexta larvae, a similar matrix provides fixed counter anions for the electrogenically secreted K+, thus enabling the gut to sustain, in vivo, a transepithelial potential (TEPD) of some 150 mV (lumen + ve). This TEPD is used for maintaining a high pH of 11-12 in the midgut lumen. A similar mechanism of maintaining a high TEPD for sensory perception is suggested in insect sensilla and in vertebrate cochlea. A much lower concentration (10% dry mass) of the matrix in the apical invaginations (canaliculi) of Calliphora salivary glands facilitates a fluid secretion of isotonic KCl at high rates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2701493 TI - [Plastic surgery in otorhinolaryngology: reconstruction flaps in oncologic surgery]. PMID- 2701494 TI - The biology of conditioning. PMID- 2701495 TI - Regulation of new fat cell formation. AB - The formation of new adipocytes occurs either at the stage of multiplication or differentiation or both. It seems possible that the formation of new fat cells is dependent on the average cell weight in a given adipose tissue depot, but there may also be other regional, local regulatory factors. Multiplication of fat cells has been suggested to be stimulated by 17-beta-oestradiol while the differentiation of adipocytes is stimulated by growth hormone, glucocorticoids, insulin, insulin-like growth factor and female sex hormones. There are, probably, other factors acting in circulation or locally. The factors promoting growth of new fat cells with overfeeding are at present unknown. Some hypothetical possibilities are discussed. PMID- 2701496 TI - Analysis of metal diffusion from crown to the human teeth. AB - Proton induced X-ray emission spectroscopy (PIXE) has been used to determine the intensity of metals from crowns in human teeth. In order to measure elements distribution across the tooth section, proton beam (3 MeV) has been collimeted to provide a spatial resolution of 300 microns. The samples were selected according to the time of insertion of crowns and the kind of alloys they were made of. The results show the intensities of gold, zinc and copper in abutment teeth. It was not found any intensity of paladium and amount of silver was not significant. PMID- 2701497 TI - [Microscopic analysis of gingival inflammatory infiltrate in periodontal disease]. AB - Twenty surgically treated patients (aged 14-67) were subject of analysis aiming to found localisation, intensity and cellular structure of gingival inflammatory infiltrate. Results of our research showed following characteristics of inflammatory infiltrate: location--30% superficial, 85% deep (focal) and 30% diffused infiltrate; intensity--15% weak, 40% moderate and 45% strong infiltrate; structure--60% mainly plasmocits, 20% plasmocitis and 20% mixed inflammatory infiltrate. In sulcular epithelium were very often found large amounts of granulocits and lymphocits. It can be concluded that periodotal type of gingival inflammation had local immunologic reaction. This process was mainly located in deep parts of gingival tissue and was also predominantly alterative. PMID- 2701498 TI - [Historical review of esthetic material attachment to metal support of crowns and bridges]. AB - Despite advantages and technological advances in the techniques of dental casts and ceramics attachment to metal, plastic materials for crown and bridge facetting are still of utmost importance for prosthetic procedures. In contrast to a hundred-year period of investigations of the ceramics-metal junction, the plastics-metal junction has been studied for not more than about 50 years. As the importance of this junction is being ever increasingly recognized, it may be expected to be optimized in the near future. PMID- 2701499 TI - Correlation between the degree of deformation of the stone die and the amount of the master die undercut. Part 1. Single tooth die. AB - In order to investigate the deformation the stone die depending on the amount of undercut, 5 kinds of undercut master dies were used to take impressions using 3 kinds of impression materials (addition type silicone rubber, polysulfide rubber, alginate). The stone dies were measured for dimensional changes in shape as projected to a two-dimensional plane by means of a newly devised apparatus. The results showed that deformation of the stone dies increased, in general, in proportion to the amount of undercut of the master die. The stone dies obtained from addition type silicone rubber impression material tend to be less deformed. In the case of the polysulfide rubber impression, the deformation was very small in stone dies in the case of non-undercut master dies, but it was very large in the case of undercut master dies. The alginate impression materials gave results with wider variations. PMID- 2701501 TI - Immunoglobulins, a short overview of an international symposium held in Amsterdam, March 14-16, 1988. PMID- 2701500 TI - A large degenerated subserous leiomyoma of the uterus: uncommon scintigraphic and ultrasonographic findings. AB - Bone imaging is commonly used as a sensitive indicator of metastatic bone diseases or other bone pathology. Furthermore, it is now generally known that technetium-99m (99mTc) phosphonates tend to concentrate in various tissues other than bones. Ultrasonography is also widely used for the evaluation of pelvic masses. Ultrasonography is especially useful for detecting a cystic mass. We present a case where the uptake of 99mTc phosphonate compounds occurred in the entire abdomen, and ultrasonography suggested a diagnosis of pseudomyxoma peritonei, but the condition was later proven to be degeneration of giant subserous leiomyoma of the uterus. We have found two interesting features in this case. One is the 99mTc phosphonate concentration in the large cystic and hyaline degeneration of subserous leiomyoma of the uterus without calcification, and the other is the sonographic finding of a large echogenic mass with innumerable small anechoic areas. To our knowledge, no cases of 99mTc phosphonate concentration in non-calcified leiomyoma of the uterus have been demonstrated. PMID- 2701502 TI - Cross-sectional imaging: present and future. PMID- 2701504 TI - Gastrointestinal tract. PMID- 2701503 TI - Chest. PMID- 2701505 TI - Radiologic diagnosis of emphysema. PMID- 2701506 TI - Imaging and staging of lung cancer. PMID- 2701507 TI - Computed tomography of the solitary pulmonary nodule and focal pulmonary disease. PMID- 2701508 TI - The chest radiograph in acquired immunodeficiency syndrome. PMID- 2701509 TI - Digital chest radiology. PMID- 2701510 TI - Magnetic resonance imaging of the chest. PMID- 2701511 TI - The esophagus, stomach, and duodenum. PMID- 2701512 TI - High-resolution computed tomography of diffuse lung disease. PMID- 2701513 TI - Small bowel. PMID- 2701514 TI - The colon. PMID- 2701515 TI - Imaging of the liver. PMID- 2701516 TI - Imaging of the biliary system. PMID- 2701517 TI - Current imaging of asbestosis. PMID- 2701518 TI - Interventional radiology of the gastrointestinal tract. PMID- 2701519 TI - Acquired immunodeficiency syndrome in the gastrointestinal tract. PMID- 2701520 TI - Cardiac radionuclide imaging. PMID- 2701521 TI - Indications for coronary angiography: diagnosis and interventional procedures. PMID- 2701522 TI - Conventional and ultrafast cine-computed tomography in cardiac imaging. PMID- 2701523 TI - Magnetic resonance imaging of the heart--morphology and function. PMID- 2701524 TI - Magnetic resonance spectroscopy of the heart. PMID- 2701525 TI - Conventional and digital radiography of the heart, aorta, and pulmonary vascularity. PMID- 2701526 TI - Angioplasty and angioscopy. PMID- 2701527 TI - The value of ultrasound examination in diagnosing breast disease. PMID- 2701528 TI - Early detection of breast cancer by mammography screening. PMID- 2701529 TI - Cardiac imaging. PMID- 2701530 TI - Breast. PMID- 2701531 TI - Renal masses. PMID- 2701532 TI - Modern approach to adrenal masses. PMID- 2701533 TI - Screening for carcinoma of the prostate: sound prophylaxis or harmful intervention? PMID- 2701534 TI - Imaging of the male pelvis. PMID- 2701535 TI - Imaging in women. PMID- 2701536 TI - Nuclear medicine in uroradiology. PMID- 2701537 TI - Contrast media for urography. PMID- 2701538 TI - Is urethrocystography necessary? PMID- 2701539 TI - Imaging in renal transplantation. PMID- 2701540 TI - Renovascular hypertension: miscellaneous papers of interest. PMID- 2701541 TI - Recent advances in the imaging of spinal disorders. PMID- 2701542 TI - Musculoskeletal trauma. PMID- 2701543 TI - Bone and joint infections. PMID- 2701544 TI - Soft tissue disease. PMID- 2701545 TI - Joint disease. PMID- 2701546 TI - Musculoskeletal manifestations of systemic disease. PMID- 2701547 TI - Orthopedic surgery. PMID- 2701548 TI - Neoplastic musculoskeletal disease. PMID- 2701549 TI - Miscellaneous reports of interest. PMID- 2701550 TI - Genitourinary system. PMID- 2701551 TI - Musculoskeletal radiology. PMID- 2701552 TI - Newer clinical and radiographic features of seronegative spondyloarthropathies. PMID- 2701553 TI - Genetics and immunology of the spondyloarthropathies. PMID- 2701554 TI - Infections in the seronegative spondyloarthropathies. PMID- 2701555 TI - Therapy for the seronegative spondyloarthropathies. PMID- 2701556 TI - Bacterial infections. PMID- 2701557 TI - Lyme disease. PMID- 2701558 TI - Mycobacterial, fungal, and parasitic infections. PMID- 2701559 TI - Viral arthritis in humans. PMID- 2701560 TI - Prosthetic joint infections. PMID- 2701561 TI - Immunodeficiency and arthritis. PMID- 2701562 TI - Rheumatic fever. PMID- 2701563 TI - Anticardiolipin antibodies and autoimmune diseases. PMID- 2701564 TI - Dysproteinemias and cryoglobulinemia. PMID- 2701565 TI - The seronegative spondyloarthropathies. PMID- 2701566 TI - Infectious arthritis and immune dysfunction. PMID- 2701567 TI - Microbiological and compositional status of Turkish white cheese. AB - Results of the chemical and microbiological examination of 38 Turkish white cheese samples are presented. On average, the cheese was characterized by a high moisture and salt content, 58.18 and 3.56%, respectively, and a pH of 4.68. Significant variation was found in these compositional factors, indicating the extreme diversity of manufacturing practices. Microbiological analysis revealed the presence of high numbers of coliforms, faecal coliforms and Escherichia coli, extremely high numbers of faecal streptococci, and a low level and incidence of Staphylococcus aureus, Salmonella and Clostridium perfringens were not isolated from the samples. There was no correlation between the levels of coliforms, faecal coliforms, E. coli and enterococci, suggesting that the enterococci count in Turkish white cheese may not be a good indicator of sanitary practices. PMID- 2701568 TI - The effect of phosphate, sodium chloride, sodium nitrite, storage temperature and pH on the growth of enteropathogenic Escherichia coli in a laboratory medium. AB - The effect of eight phosphates in combination with sodium chloride/nitrite mixtures on growth of mixed strains of enteropathogenic Escherichia coli over a period of 10 weeks at three pH values (5.6, 6.2, 6.8) and at seven temperatures ranging from 10 degrees C to 35 degrees C is reported. All eight phosphates inhibited growth to varying degrees in at least some of the conditions investigated. Instances of inhibition increased with concentration of sodium chloride/nitrite and were more frequent at lower temperatures and pH values. PMID- 2701569 TI - 19F MRS studies of fluoropyrimidine chemotherapy. A review. AB - 19F NMR spectroscopy (MRS) has been used to follow the metabolism of the fluoropyrimidine anticancer drug 5-fluorouracil and its derivatives non invasively, both in animals and humans. This review is concerned with the information that has been acquired concerning cytotoxicity and detoxification in relation to studies performed with conventional methods. The potential uses of 19F MRS of fluoropyrimidines in research, particularly concerning combination chemotherapy, and in monitoring therapy, are discussed. PMID- 2701570 TI - Current treatment of metastatic choroidal tumors. AB - Therapy of choroidal metastases depends on several factors, but conventional external beam irradiation using photons is the most common treatment. Proton beam irradiation has recently been used for selected lesions. The advantage of this method is that the dose can be localized to the tumor more accurately. Other therapies include chemotherapy, photocoagulation, or, in extreme cases, enucleation. The author discusses these treatment modalities, complications, and prospects for future therapies. PMID- 2701571 TI - Mitoxantrone: its development and role in clinical practice. AB - Mitoxantrone is an antitumor agent that was synthesized to try to develop a doxorubicinlike drug with a better therapeutic index. It has clinical activity for acute leukemias, breast carcinoma, non-Hodgkin's lymphoma, and ovarian cancers. There is some lack of cross-resistance to the anthracyclines. Its spectrum of toxicity is advantageous in that it causes less alopecia and can be administered for a slightly longer time than doxorubicin. For selected patients, mitoxantrone can be useful as a substitute for doxorubicin, but doxorubicin will remain the more widely used drug. PMID- 2701572 TI - Cancer of the pancreas: are chemotherapy and radiation appropriate? AB - Current treatment of pancreatic carcinoma is not adequate. Local recurrence and distant metastases result in disease progression and death in the majority of patients. The authors focus on the natural history of the disease, the results with currently available treatments and the future of combined modality treatment. Reviewing the literature in support of combined treatments, they observe that several potential benefits may result: Palliation of symptoms, prolongation of survival (albeit measured in months), and occasional long-term survival. Patients with carcinoma of the pancreas are appropriate candidates for investigational treatment protocols. PMID- 2701573 TI - Adjuvant therapy of colorectal cancer: where do we stand? AB - The value of adjuvant therapy for colon and rectal cancer has been studied extensively in clinical trials. Data from earlier trials suggested some potential benefit for rectal cancer patients but minimal if any benefit for patients with Dukes' B2, B3 or C colon cancer. More recent data demonstrate that combined irradiation plus chemotherapy is useful in rectal cancer and that postoperative chemotherapy may have a small benefit as adjuvant treatment in patients with adenocarcinoma of the colon. Whether the recently reported statistically significant results in the adjuvant therapy of colon cancer are clinically significant is still being debated. A number of clinical trials evaluating biological response modifiers, regional chemotherapy, and tumor vaccines are either still under way or in the process of evaluation. The results of these trials may significantly enhance the therapeutic options available to clinicians managing patients with resected large bowel cancer. PMID- 2701574 TI - Optimal management of nausea and vomiting in clinical oncology. AB - The exact mechanisms involved in chemotherapy-induced nausea and vomiting are not known. Therapies are largely empiric. There is no completely effective single agent or even combination-agent regimen. This paper identifies important factors in selecting antiemetic therapy, particularly the emetogenic potential of the chemotherapy and the fact that antiemetic drugs have differing sites of action. Regarding acute emesis, great strides have been made in the 1980s. Anticipatory and delayed symptoms remain a challenge and are a focus of this article. A key in the timing of pharmacologic intervention is pinpointed in each of these situations. PMID- 2701575 TI - Recent studies of anorexia and appetite stimulation in the cancer patient. AB - The complications of cachexia are the most common causes of death in cancer patients. Studies have shown that weight loss results not only from the effects of treatment but also from a combination of increased metabolic requirements caused by the tumor and decreased caloric intake by the patient. Understanding the basic metabolic abnormalities that affect food intake has helped medical personnel find ways to lessen if not eliminate the effects of cachexia. Positive results in the management of weight loss and anorexia have been achieved with hydrazine sulfate, metoclopramide, and megestrol acetate, as well as with nonpharmacologic approaches such as attention to the type of food presented and the ambience of the dining site. PMID- 2701576 TI - Problems in antiemetic trial design and interpretation. AB - Research in the control of chemotherapy-induced nausea and vomiting is a relatively new endeavor. Accurate assessment of clinical trial results assumes a sound study design, control for known variables, clear definitions, and reproducible assessment criteria. In most of these areas, antiemetic trials still lag behind cancer treatment trials. This paper reviews 44 antiemetic trials and discusses the state of the art in antiemetic research methodology, examining how a representative sample of investigators have addressed patient selection criteria, study design, and assessment parameters. Comparisons with the chemotherapy literature suggest approaches to improve the antiemetic literature and optimize our use of the data derived from it. PMID- 2701578 TI - Mast cells are that polymorphic! PMID- 2701577 TI - Humoral factors in the induction of prostaglandin E2-producing macrophages in vitro. AB - Bone marrow macrophages (M phi) from CBA/J mice were incubated 24 h in media enriched with normal mouse serum and then stimulated with calcium ionophore A23187, phorbol ester (PMA) or zymosan for 2 more hours. Prostaglandin (PG) E2 release promoted by each agent was almost 10 times higher than from control M phi cultured without serum or with sera from other species such as rat, bovine, rabbit and human. Maximum release of PGE2 was 520 ng/mg cell protein (A23187); no release of leukotriene C4 was detectable (less than 10 ng/mg). Cellular phospholipase A2 activity was significantly enhanced by serum. These enhancing activities of mouse serum were nondialyzable, inactivated by incubation at pH 2 for 24 h, sensitive to pepsin digestion, stable at 56 degrees C for 30 min, and could not be replaced by defined cytokines such as IL-1, IL-2, IL-3, IL-4, IL-6, IFN alpha/beta, IFN gamma, TNF alpha, CSF-1, or GM-CSF. The enhancing effects of mouse serum on both PGE2 release and phospholipase A2 activity were, however, significantly blocked by exogenously added GM-CSF. In contrast with marrow M phi, thioglycollate-elicited peritoneal M phi, which normally release only small quantities of PGE2, showed over 5-fold increases in PGE2 production following treatment with IFN gamma, IFN alpha/beta, or TNF, but not with other cytokines or mouse serum. These data show stable differences in eicosanoid metabolism between M phi which suggest, in turn, highly independent regulatory mechanisms in this pathway. The data also suggest a regulatory function of GM-CSF with respect to PGE2-producing M phi formation induced by mouse sera. PMID- 2701579 TI - The role of mucosal immunity in development of an acquired immunodeficiency syndrome (AIDS) vaccine: workshop summary. AB - As the AIDS pandemic spreads, the importance of developing effective vaccines against the human immunodeficiency virus (HIV) assumes increasing importance. Since prevention of any disease is a preferred goal, extensive efforts are being devoted to development of an effective vaccine capable of preventing HIV infection and/or disease. Although many investigators are studying the systemic immune response to HIV, relatively little is known about the mucosal immune response to HIV. A workshop was held to identify the basic research issues in mucosal immunity which need to be addressed in order to rationally design an effective vaccine against HIV. This summary emphasizes the salient points of the papers presented and identifies the unanswered questions. PMID- 2701580 TI - Is PDQ still only a partially developed quantity in cancer education? PMID- 2701581 TI - Computer-assisted instruction in cancer for third-year medical students using the Physician Data Query (PDQ) system. AB - During the third-year medicine clerkship, students were instructed in online computer Physician Data Query (PDQ) searches. Each student completed computer searches in at least one of five tumor topics. Students assigned to selected tumor topics performed significantly better on test questions in their assigned topic as compared to the scores of students who were not assigned that topic. Although students were encouraged to use the PDQ ad libitum, within three months of completing the clerkship, only 22 students (20%) had conducted additional searches. We conclude that PDQ instruction may enhance students' knowledge about cancer. Student instruction can be effectively completed with minimal computer time. The results from our program evaluation and the limited student use following completion of the clerkship suggest that we should identify another user group, such as senior housestaff, to generate greater interest and more frequent use of the PDQ. PMID- 2701582 TI - An unusual case of hip disability--(a case report). AB - An unusual case of postero-superior periarticular irritation of the hip joint of six months' duration due to an extension of a pre-sacral foreign body granuloma in an 18 year old unmarried girl is presented. Two wooden sticks which probably were inserted pervaginally by a village midwife to induce an abortion for an unwanted pregnancy had found its way to presacral region. The scanning of the vaginal fornix indicated a possible route through which the sticks might have been migrated. PMID- 2701583 TI - [Current therapy of gastrointestinal tumors. Abstracts of a symposium of the Oncology Internists Working Group held jointly with the Surgical Working Group in Oncology and the Radiologic Oncology Working Group]. PMID- 2701584 TI - [Agnathia, microstomia, synotia]. AB - The authors describe a case of plurimalformative syndrome, characterized by agnathia, microstomia, synotia and by cardiac and pulmonary maldevelopment. The case peculiarity consist in the rarity of this malformative occurrence; moreover, the authors underline the occurrence of familiarity with Seckel's Syndrome. PMID- 2701586 TI - Genetic testing. PMID- 2701585 TI - [Importance of osteologic collections in museums of pathologic anatomy as materials for study and comparison in paleopathology]. PMID- 2701587 TI - Preventive cardiology. PMID- 2701588 TI - Demands on the medical director in the 1990s. PMID- 2701589 TI - Consequences of rape: clinical and treatment aspects. AB - Sexual abuse has both short-term and long-term clinical repercussions, including eating disorders, substance abuse, sleep disturbances and psychiatric symptoms, e.g depression, anxiety, phobias and PTSD. This paper will describe short- and long-term responses, including PTSD, and it will consider treatment implications, emphasizing specific aspects of the approach to the sexual abuse victim. PMID- 2701591 TI - [Kneipps' applications]. PMID- 2701590 TI - Developmental trends in type A behavior as predictors for the development of somatic coronary heart disease risk factors. AB - Developmental trends in type A behavior and somatic risk factors of coronary heart disease were studied in 842 healthy adolescents and young adults. Type A behavior was measured using the AFMS and the somatic risk factors adopted were serum total cholesterol, LDL and HDL cholesterol, systolic blood pressure, diastolic blood pressure, pulse frequency and body mass index. The results showed that cross-sectionally somatic and behavioral risk indicators were independent, but longitudinally an increasing tendency towards type A behavior in boys was related to an increasing level of somatic risk. In boys type A behavior predicted also cross-sectionally a likelihood to be classified into the group where serum cholesterols increased according to age. In girls, no correlation was found. PMID- 2701592 TI - [From "Zahn der Zeit"]. PMID- 2701593 TI - [Material comparisons. 2. Conservation dentistry--rotating instruments/dry operating field]. PMID- 2701594 TI - [Cementation of crowns and bridges]. PMID- 2701595 TI - [Complete dentures, individualized and esthetic]. PMID- 2701596 TI - [New metalloceramic preparation procedures for improved esthetics and accurate fit--Sunrise metalloceramic system (1)]. PMID- 2701597 TI - [Ludwig's technic. 1. Pre-functional impression]. PMID- 2701598 TI - [Repeated preparation of fractured post and anchor tooth by supplementary finished casting]. PMID- 2701599 TI - [Swivel clasps for removable partial dentures]. PMID- 2701600 TI - [New metalloceramic preparation procedures for improved esthetics and accurate fit-Sunrise metalloceramic system (2)]. PMID- 2701601 TI - [PVD-layering in dental technic]. PMID- 2701602 TI - [Ludwig's technic. 2. Functional tray and bite plate]. PMID- 2701603 TI - [Palladium-based alloys in precision casting technic?]. PMID- 2701604 TI - [Occlusal concepts in complete dentures--new function-related appliance (1)]. PMID- 2701605 TI - [Titanium working in dental laboratory (2)]. PMID- 2701606 TI - [Occlusal concepts in complete dentures--new function-related appliance (2)]. PMID- 2701607 TI - [Titanium as dental material from example of patient case]. PMID- 2701608 TI - [Blended ceramic root post caps]. PMID- 2701609 TI - [Pure titanium as alternate metal in restorative dentistry. 1. Material and working it]. PMID- 2701610 TI - [Occlusal concepts in complete dentures--new function-related appliance (3)]. PMID- 2701611 TI - [Immediate model cast prosthesis--means of holding oral structure]. PMID- 2701612 TI - [Galvano bridges together with jet technic]. PMID- 2701613 TI - [Esthetic ceramic restorations with Wieland's ceramic technic and Shofu opal ceramic (2)]. PMID- 2701614 TI - [Pure titanium as alternate metal in restorative dentistry. 2. Titanium ceramic]. PMID- 2701616 TI - [The dental periodical in the Republic of Argentina]. PMID- 2701615 TI - [Notes for the history of dentistry. The 17th century (cont'd)]. PMID- 2701617 TI - [Charles Allen, the pelican and other birds]. PMID- 2701618 TI - [Dr Jaime Guillermo Dunster, pioneer dentist in South Argentina]. PMID- 2701619 TI - [Baltazar C. Branca and his vocations]. PMID- 2701620 TI - [The Revista Medica de Chile, 100 years ago]. AB - The september 1888 issue of the Journal contains an article by Luis Asta-Buruaga MD, "Ambulances in New York: a system to be instituted in Santiago. In addition to encouraging this project, the idea of establishing small hospitals in peripheral quarters of the city is discussed. Dr Asta-Buruaga was a graduate from Columbia University, NY. He was awarded de Harsen prize and worked as an intern at Roosevelt Hospital. He revalidated his medical licence in Chile in 1888. PMID- 2701621 TI - [Ultrasonics in the diagnosis of choledocholithiasis]. AB - The value of ultrasound in the diagnosis of choledocholithiasis is controversial, sensitivity figures ranging from 22 to 75%. We correlated the ultrasound study with operative findings in 38 patients. A diagnosis of common bile duct stone was made upon finding an echogenic image with or without acoustic shadow in the common bile duct; no attention was paid to the dilatation of the biliary tree. The sensitivity was 68% and the positive predictive value was 85%. Therefore, our results approach the highest reported figures for the value of this diagnostic technique. PMID- 2701622 TI - [Active forms of oxygen, oxidative stress and its pathologic significance]. AB - Chemically hyperactive forms of oxygen can induce a variety of functional and morphologic alterations in aerobic organisms. Defensive mechanisms against oxidative damage may be involved in the etiology of pathologic processes induced by oxidative stress. Different antioxidant substances are used in treatment of these conditions. PMID- 2701623 TI - [Serologic prevalence of Legionella pneumophila in a Chilean population]. PMID- 2701624 TI - [Otological aspects of Meniere's syndrome]. PMID- 2701625 TI - [Posture and posturography]. PMID- 2701626 TI - [Microcomputers and ENG: current status]. PMID- 2701627 TI - [Pharmacokinetics and metabolism of ipriflavone in humans. I]. PMID- 2701628 TI - [Pharmacokinetics of Chinoin-170 in rats and dogs]. PMID- 2701629 TI - [Pharmacokinetic and metabolic study of EGYT-3615 in rats]. PMID- 2701630 TI - [Novel biotransformation in the metabolism of N-benzyl acid amides]. PMID- 2701631 TI - Severe falciparum malaria: survival without exchange transfusion. AB - A case of severe falciparum malaria with trophozoites in 71% of the patients' erythrocytes is described. The patient was treated with high dose quinine and made an uneventful recovery. Exchange transfusion was not performed. PMID- 2701632 TI - Characterization of a model of malaria in the pregnant host: Plasmodium berghei in the white rat. AB - This study characterizes a Plasmodium berghei white rat model of P. falciparum malaria in the pregnant human. Seventy-day-old and 114-day-old female rats, given an infecting inoculum at time of mating, had higher parasitemias and a more severe anemia than age- and sex-matched controls. Under these experimental conditions, the parasitemia went to crisis in all animals and there were no fatal infections. In contrast, all animals died when the infection was initiated 7 days after conception, a timing that brought a coincidence of peak parasitemia and term. Pregnancy during the post-crisis subpatent period did not cause recrudescence. At the time of delivery, the parasitemia was consistently higher in the placental (crush smear) blood than in the peripheral (tail) blood. This difference was greatest in animals giving birth shortly before or 1-2 days after the parasitemic crisis. Very young, compact parasite forms predominated in the placental blood, whereas trophozoites predominated in the peripheral blood. PMID- 2701633 TI - A review of the geographic distribution and epidemiology of leishmaniasis in the New World. AB - A review of the epidemiologic aspects of the New World leishmaniases, including their known geographic distribution, etiologic agents, zoonotic reservoirs, and insect vectors, based on biological and molecular characterization of Leishmania isolates is presented. Data summarized in this paper on parasite taxonomy and geographic distribution come from our studies of greater than 1,000 New World Leishmania isolates identified by species-specific monoclonal antibodies using an indirect radioimmune binding assay and from scientific literature. PMID- 2701634 TI - [Immunoprophylaxis of carious disease. Historical outline, location of research groups, current status of anticaries vaccine use]. AB - The authors after giving some historical hints of vaccino-prophylaxis outline the various attempts made during the last twenty years, the present situation and the actual risks connected with the ways of administering of the antigen, in case of vaccination from a "public-health" point of view. PMID- 2701635 TI - [Critical analysis of the composition of endodontic cements]. AB - The AA. discuss the problem of composition of root canal sealers; they precise the role and utility of single ingredients. They conclude that root canal sealers contain many unnecessary or harmful compoundings, as paraformaldehyde; so it's necessary to reduce the amount of root canal sealers introduced in the endodontic system. PMID- 2701636 TI - [Conservative therapy of coronal fractures with reattachment of the original fragment: indications for periodontal treatment]. AB - The AA, analyse the relation between dental fracture and relative parodontal tissues. A clinical case, treated with an intervention of parodontal surgery and with sticking of the coronal fragment, is shown. PMID- 2701637 TI - [The immunological basis of vaccine prophylaxis of carious disease. Maternal fetal relations. Defense factors specific to the host]. AB - The authors discuss of the relation between mother-phoetus from an immunological point of view and the real protection at birth because of the passing through the placental philter of maternal immunoglobulins. Then the Authors discuss of oral tolerance and of the possibilities of administering by oral-enteric way and the immunity of the guest. PMID- 2701638 TI - [Cranial and facial sutures: embryological aspects, anatomy and effects on orthopedic treatment]. AB - In this work, the AA. have related the principal suture of the skull and the face, analysing the embryonal, functional and anatomic aspects, with particular reference to the times of end of growth and ossification. Furthermore, the AA. had explained the orthopedic appliances which influence, with their action, the activity of specific suture, emphasizing the growth period in which they are more efficient in the correction of the various dentofacial disharmonies. PMID- 2701639 TI - [Lupus erythematosus. 2. Systemic Lupus erythematosus: antibody symptomatology, other laboratory evidence, diagnosis, course and prognosis; discoid Lupus erythematosus; drug induced Lupus]. AB - The AA. in this note II report the most recent acquisitions about the clinical features, hematology and serology of Systemic Lupus Erythematosus. Moreover describe the main characteristics of Discoid Lupus Erythematosus and of Lupus due to drugs. PMID- 2701640 TI - An overview on interleukin-1 as a therapeutic agent. PMID- 2701641 TI - Interleukin-1, stromal cells, granulopoiesis, and the inflammatory response. AB - A number of in vitro studies carried out in our laboratory over the past ten years have led to some clarification of the role of mononuclear phagocytes in hematopoietic regulation. The results of these studies have demonstrated that mononuclear phagocytes produce proteins, notably interleukin-1 (IL-1), that induce the expression of multilineage hematopoietic growth factors by human vascular endothelial cells, fibroblasts, T-lymphocytes, and thymic epithelial cells. More recently we and others have identified these induced factors as G CSF, GM-CSF, IL-6, and IL-1. Although IL-1 seems to stimulate expression of these genes by inducing the accumulation of gene transcripts, interestingly the accumulation results from prolongation of mRNA half-life. We propose that the inductive capacity of IL-1 results from its activation of ribonuclease inhibitory activity in the cytoplasm of IL-1 induced cells and hypothesize that this may be a general mechanism by which IL-1 induces gene expression. PMID- 2701642 TI - The hematopoietic activities of interleukin-1. PMID- 2701643 TI - Role of interleukin-1 in 4-hydroperoxycyclophosphamide toxicity to bone marrow progenitor cells: a review. AB - We have demonstrated that in vitro preincubation with IL-1 or TNFa for 20 hours can protect human hematopoietic progenitors from lethal doses of 4-HC. On the other hand, preincubation with IL-6 or IL-3, in a similar fashion, did not provide any protection but in fact demonstrated a slight increase in 4-HC toxicity in the same experiments. The observation that IL-1 was still protective even when a purified cell population depleted of accessory cells was used is suggestive of a direct effect of IL-1. Our data also suggest that early progenitor cells including the replatable B;-CFC are the main target of that protection. We believe that using this in vitro assay system will enable us to investigate the possible mechanisms responsible for the protection of these primitive progenitors. From a clinical perspective, future studies should attempt to clarify whether protection by IL-1 is selective for normal hematopoietic cells versus malignant cells and whether these protected primitive progenitors represent the pluripotent stem cells responsible for engraftment of transplanted bone marrow by using an animal model system. PMID- 2701644 TI - Interleukin-1 is identical to hemopoietin-1: studies on its therapeutic effects on myelopoiesis and lymphopoiesis. AB - Conditioned medium from the human tumor cell line HBT 5637 possesses a unique hematopoietic activity, originally termed hemopoietin-1. Hemopoietin-1 alone does not stimulate bone marrow colony formation or proliferative responses in vitro, but rather potentiates responses to other hematopoietic growth factors, such as CSF-1 and GM-CSF. In studies designed to characterize the molecular nature of this factor, it was found by molecular, biochemical biological and serological criteria that all the hemopoietin-1 like activity could be attributed to IL-1 alpha. The therapeutic potential of IL-1 was then tested in a system where myelopoiesis is depressed by whole body irradiation. After 750 R irradiation, mice were administered IL-1 twice daily for the duration of the experiment. Mice which received IL-1 treatment had an accelerated recovery of marrow colony forming capacity which was also reflected by significantly higher blood neutrophil levels as compared to control irradiated mice. IL-1 treated irradiated mice also had a significant increase in resistance to bacterial challenge 14 days post irradiation. Thus, IL-1 treatment was effective in augmenting myelopoiesis following sublethal whole body irradiation. The effects of the IL-1 treatment on the recovery of lymphocyte numbers was also assessed. Here the IL-1 treated irradiated mice had fewer lymphocytes and depressed mitogen responses by spleen cells. Indeed the thymus of the IL-1 treated irradiated mice remained chronically hypoplastic for the duration of the experiment. Although IL-1 treatment increased myeloid progenitors in the bone marrow, it caused a decrease in the frequency of pre-B cells. Thus, IL-1 administration is an effective treatment for accelerating myeloid recovery following the cytoreductive effects of irradiation, but the myelopoietic augmentation may be at the expense of lymphoid recovery. PMID- 2701645 TI - Utility of interleukin-1 in therapy of radiation injury as studied in small and large animal models. PMID- 2701646 TI - Options for the treatment of serious infections with interleukin-1. AB - In this paper, the effects of recombinant human interleukin-1 (IL-1) on non specific resistance to infection are reviewed. In experiments in neutropenic mice, a single injection of a low dose of IL-1 (8-800 ng) appears to protect against death from lethal Pseudomonas aeruginosa and Candida albicans infections. In non-neutropenic mice protection can also be obtained with such dosages of IL-1 in infection caused by Klebsiella pneumoniae or Listeria monocytogenes. Low dosages of IL-1 are also able to prevent lethal cerebral malaria in mice. No effect has been found in murine cytomegalovirus infection. With the exception of C. albicans infection and malaria, protection is only obtained if IL-1 is given before the infection. The mechanism of protection has not been elucidated; in the Pseudomonas and Klebsiella infection, it could be demonstrated that survival was not due to a direct antibacterial effect of IL-1, not due to the action of granulocytes or increased hematopoietic recovery and not due to activation of macrophages and increased bactericidal mechanisms. In the experimental Listeria infection however, animals treated with IL-1 had lower bacterial counts in their organs. Since the cytokines interleukin-6 (IL-6) and tumor necrosis factor (TNF) are much less potent than IL-1 in these protection experiments, it is very unlikely that they are endogenous mediators of the protection induced by IL-1. The effect is not mediated via the cyclooxygenase pathway, since premedication with ibuprofen does not influence the protective effect of IL-1. Taking these data together, it is felt that IL-1 holds promise as a therapeutic agent in humans. PMID- 2701647 TI - Stimulation of hematopoiesis and antibacterial resistance by interleukin-1. AB - The beneficial effects of IL-1 and other cytokines on hematopoiesis and on resistance to infection are profound. IL-1 stimulates proliferation of bone marrow cells in normal mice and potentiates the recovery of peripheral blood neutrophils in mice with drug-induced neutropenia. Prophylactic cytokine administration provides an elevated level of natural resistance to infections which is correlated with increased numbers of phagocytic leukocytes. These studies suggest that IL-1 has potential clinical application as a therapy to limit bone marrow dysfunction and immunosuppression and to augment hematopoiesis and natural immunity. Further research will continue to elucidate the mechanisms whereby interleukins and colony-stimulating factors act, and interact, to promote restoration of leukocyte production and to enhance host resistance. PMID- 2701648 TI - Interleukin-1 alpha: its possible roles in cancer therapy. AB - Our studies on recombinant human IL-1 alpha polypeptide were summarized with respect to molecular cloning, production, quantitative assay systems, antitumor activity, myelorestorative activity and augmentation of host resistance to infections. Recombinant human IL-1 alpha (18 kDa) was produced through the expression of the cloned human IL-1 alpha cDNA in Escherichia coli and purified to an endotoxin-free homogeneous polypeptide. The human IL-1 alpha inhibited dose dependently the growth of syngeneic murine tumors transplanted in mice and completely regressed the tumors in some cases, and its antitumor activity was significantly enhanced in combination with indomethacin. The human IL-1 alpha accelerated the recovery of the numbers of peripheral leukocytes and neutrophils in a dose-dependent manner at a dose as low as 10 ng/mouse/day in myelosuppressed mouse model produced by administering anticancer chemotherapeutic drugs. The myelorestorative effect of IL-1 alpha was observed not only on leukocytes/neutrophils, but also on platelets in myelosuppressed mice. In addition, the human IL-1 alpha markedly augmented dose-dependently resistance of normal and leukopenic mice to various microbial infections. These results suggested that recombinant human IL-1 alpha might be useful for cancer therapy from the viewpoints of improving adverse effects such as myelosuppression caused by chemotherapy and/or radiation therapy and preventing infections. In addition, use of IL-1 alpha may permit more intensive chemo- and radiation therapies using higher doses. Finally, the antitumor activity of the IL-1 alpha itself may play an important role. PMID- 2701649 TI - Interleukin-1 as an adjuvant for tumor vaccines increases survival in mice. PMID- 2701650 TI - Interleukin-1 in the pathogenesis of and protection from inflammatory bowel disease. AB - Inflammatory bowel disease affects millions of people, some with fatal consequences. Little is known about the factors which contribute to its pathogenesis particularly regarding cytokine production and action. In this paper we summarize our recent findings using the rabbit model for immune complex generated experimental colitis, a model which is similar to ulcerative colitis in humans. Recombinant human IL-1 was perfused through rabbit colons and we observed elevated levels of PGE2, TxB2 and 6-keto-PGF1 alpha, the stable metabolite of PGI2. Using radioimmunoassays specific for rabbit IL-1 alpha and IL-1 beta, we induced immune complex colitis and measured the generation of these IL-1's in various tissues. Markedly elevated levels of IL-1 were detected only in inflamed tissues. The levels of IL-1 correlated with the degree of inflammation as judged by a blinded assessment of pathological changes. Similar to other disease models in which small doses of the agonist can afford protection or result in a state of "desensitization" when administered prior to the onset of the disease, we accordingly injected rabbits with a single, small (300 ng/kg) dose of IL-1 and observed a significant reduction in the inflammatory index and necrosis of immune complex colitis. However, unlike other models of IL-1-induced protection, in this model cyclooxygenase products were required since we prevented the IL-1-induced protection with a single dose of ibuprofen given at the same time as the IL-1. This correlated with the reduction in IL-1-induced PGE2. These results demonstrate that IL-1 plays a key role in the pathogenesis of inflammatory bowel disease in the rabbit and that the protection afforded by a low dose of IL-1 24 hours before the onset of the colitis requires IL-1-induced cyclooxygenase products. PMID- 2701651 TI - Structure-function relationship of interleukin-1 giving new insights for its therapeutic potential. AB - The pleiotropic activities of IL-1 have fostered a series of studies on the structure-function relationship in these proteins. In fact, the attempt to dissociate different biological functions of IL-1 should simplify its therapeutic use. About human IL-1 beta, which has been more extensively studied in this respect, enzymatic cleavage of the precursor protein to generate the mature polypeptide appears necessary for its full biological activity. The almost complete integrity of the mature IL-1 beta protein is also required for its ability to bind to the receptor and trigger cellular functions. However, by the use of monoclonal antibodies and recombinant or synthetic peptides, it has been possible to map some IL-1 beta regions important for different activities. Both N terminal and C-terminal fragments are important for receptor binding. A domain around amino acids 187-204 is apparently involved in the hyperalgesic effects of IL-1 beta. Finally, the fragment in position 163-171 appears to be responsible for a restricted series of the IL-1 beta activities, mainly directed to the immune system, although irrelevant for inflammation-related effects and unable of binding to the IL-1R. It is thus possible, within the sequence of a cytokine, to isolate selectively active domains. This will give us new tools for new therapeutic approaches. Thus, IL-1 might be the prototype of a new generation of cytokines developed with the goal of stimulating specific biological activities without activating the cascade effects which are typical for many cytokines. PMID- 2701653 TI - Asparagine-linked oligosaccharides associated with metastatic cancer. AB - Malignant transformation and tumor progression are often accompanied by structural changes in the carbohydrate components of glycoproteins and glycolipids. Studies with tumor cell glycosylation mutants and specific inhibitors of glycosylation indicate that expression of sialylated and beta (1-6) branched asparagine (Asn)-linked oligosaccharides are required for tumor cell invasion and metastasis. The initiation of the beta (1-6) antenna appears to be oncodevelopmentally regulated and may be associated with the aberrant expression of blood group and embryonic carbohydrate sequences in Asn-linked oligosaccharides of tumors. Although the function of these oligosaccharides in the metastatic process remains unclear, there is some evidence that expression of these structures on certain cell-surface glycoproteins may reduce tumor cell adhesion to extracellular matrix. These observations suggest that low-toxicity drugs that inhibit the biosynthesis of these structures may be useful in the treatment of metastatic cancers. PMID- 2701652 TI - Endocrine therapy of human breast cancer cells: the role of secreted polypeptide growth factors. AB - Endocrine therapy is an important modality in the treatment of breast cancer. However, the precise molecular mechanisms underlying the growth inhibitory effect of endocrine therapy are unknown. Recently, it has been shown that breast cancer cells express and secrete polypeptide growth factors that can regulate the growth of the cells through autocrine and/or paracrine pathways. These growth factors are thought to be involved in the response to endocrine therapy. Three different mechanisms have been suggested: (1) stimulation of growth inhibitory peptides; (2) repression of mitogenic peptides; and (3) stimulation of mitogenic growth factors in cells overexpressing the corresponding receptor. This article reviews the scientific evidence on which these hypotheses are based. PMID- 2701654 TI - Near-diploid tumor cell lines for cancer research. PMID- 2701655 TI - PET-based neuropharmacology: state of the art. AB - Positron emission tomography (PET) enables the study of neuropharmacological variables, such as regional receptor densities, alterations in receptor occupancy from endogenous neurotransmitters and exogenous drugs, and receptor plasticity in living human subjects. The purpose of this paper is to review the procedures currently used to study brain pharmacology based on the use of radioactive tracers and PET, and to identify open issues in this field. In particular, the article reviews methodology for tracer validation, including essential biochemistry and kinetic modeling, as well as present clinical applications of tracers used to study dopamine, opioid, benzodiazepine, and cholinergic receptors. PMID- 2701656 TI - 99mTc-D,L-hexamethylene-propyleneamine oxime (99mTc-HMPAO): basic kinetic studies of a tracer of cerebral blood flow. AB - The lipophilic 99mTc-D,L-hexamethylene-propyleneamine oxime (99mTc-HMPAO) has been developed for regional cerebral blood flow (rCBF) measurements by single photon emission computed tomography (SPECT). The molecule is unstable and converts rapidly from the lipophilic form, which passes the blood-brain barrier (BBB), to the hydrophilic form, which is unable to pass the BBB and is trapped in the brain. The rate-limiting step for this conversion is probably dependent on the reductant gluthathione. The lipophilic input to the brain can be estimated by rapid octanol extraction of lipophilic tracer from arterial blood. The input takes place during the first few minutes after tracer injection. The first-pass extraction from blood to brain E is high (0.72 at a CBF of 0.59 ml/g/min) in human studies as measured by the indicator dilution method. It is dependent on the CBF level and decreases when CBF increases. It is also dependent on binding to proteins and blood constituents. 99mTc-HMPAO is initially distributed like rCBF. In measuring the retention in the human brain after intravenous and intracarotid injection of 99mTc-HMPAO, an early back-diffusion (brain to blood) is seen. This lasts only 2-3 min. The back-diffusion is flow dependent, leading to a preferential loss of activity from the high flow regions of the brain. This can be corrected for by an algorithm. The effect of the algorithm is that the steady-state 99mTc-HMPAO distribution images obtained from 10 min to 2-3 h after injection of tracer agrees more closely with rCBF images as measured by reference CBF methods using SPECT and positron emission tomography (human studies) and quantitated autoradiography (rats). The retention in the brain is very stable when the early back-diffusion has ceased, and only a small loss of tracer amounting to 0.4%/h is observed in most human cases during the next 24 h. This review concludes that 99mTc-HMPAO is suitable for measurements of rCBF by SPECT. A few examples of clinical application are given. PMID- 2701658 TI - Rheumatoid arthritis. PMID- 2701657 TI - Double-label and conventional deoxyglucose methods: a practical guide for the user. AB - The autoradiographic deoxyglucose method is widely used to map functional activity in mammalian brain. Whereas the method is simple to use, the underlying kinetic model is complex. This paper reviews the deoxyglucose kinetic model and the relevant implications for the user who does not have extensive knowledge of tracer kinetics. In generally understandable terms, single-label and double-label deoxyglucose approaches are discussed. Experimental procedures are described in detail. The calculations required for qualitative and quantitative experiments are explained. The deoxyglucose method is compared to other methods that map functional activity in mammalian brain. PMID- 2701659 TI - Clinical therapeutics. PMID- 2701660 TI - Infection and rheumatoid arthritis. PMID- 2701661 TI - Assessment of disease activity in rheumatoid arthritis. PMID- 2701662 TI - Imaging techniques in joint disease. PMID- 2701663 TI - Diet therapy in rheumatoid arthritis. PMID- 2701664 TI - Stress, psychological factors, and rheumatoid arthritis. PMID- 2701665 TI - Methotrexate in rheumatoid arthritis and related diseases. PMID- 2701666 TI - The immunogenetic basis of rheumatoid arthritis. PMID- 2701667 TI - Future prospects for the treatment of rheumatoid arthritis. PMID- 2701668 TI - Therapy and mechanisms of nonsteroidal anti-inflammatory drugs. PMID- 2701669 TI - Toxicity of nonsteroidal anti-inflammatory drugs. PMID- 2701670 TI - Immunopathology of rheumatoid arthritis. PMID- 2701671 TI - Immunosuppressive drug therapy. PMID- 2701672 TI - Novel therapies: apheresis, total nodal irradiation, cytokines, and diet modification. PMID- 2701673 TI - Glucocorticoids. PMID- 2701674 TI - Therapy for skeletal disorders. PMID- 2701675 TI - Juvenile rheumatoid arthritis and the spondyloarthropathies in children. PMID- 2701676 TI - Rheumatic fever and rheumatic heart disease. PMID- 2701677 TI - Systemic lupus erythematosus, dermatomyositis, scleroderma, and vasculitic syndromes in children. PMID- 2701678 TI - Metabolic, systemic, and other childhood conditions affecting the musculoskeletal system. PMID- 2701679 TI - Congenital and genetic disorders affecting the musculoskeletal system. PMID- 2701680 TI - Orthopedic aspects and interventions. PMID- 2701681 TI - Gout and hyperuricemia. PMID- 2701682 TI - Calcium and miscellaneous crystal deposition disease. PMID- 2701683 TI - Biochemistry, cell biology, and immunology of osteoarthritis. PMID- 2701684 TI - Diagnosis and treatment of osteoarthritis. PMID- 2701685 TI - Clinical aspects and treatment of systemic lupus erythematosus. PMID- 2701686 TI - New developments in Sjogren's syndrome. PMID- 2701687 TI - Immunoglobulin VH genes in systemic lupus erythematosus. PMID- 2701688 TI - The functional role of complement genes in systemic lupus erythematosus and Sjogren's syndrome. PMID- 2701689 TI - Drug-related lupus. PMID- 2701690 TI - Experimental and induced animal models of systemic lupus erythematosus and Sjogren's syndrome. PMID- 2701691 TI - Lymphocyte, phenotype, and function in systemic lupus erythematosus and Sjogren's syndrome. PMID- 2701692 TI - Pediatric and heritable disorders. PMID- 2701693 TI - Crystal deposition diseases and osteoarthritis. PMID- 2701694 TI - Systemic lupus erythematosus and Sjogren's syndrome. PMID- 2701695 TI - Utilization of two improved enzyme immunoassays based on avidin-biotin interaction for the detection of Salmonella. AB - Based on a strong interaction between avidin and biotin, two enzyme immunoassays have been modified and tested for the detection of Salmonella typhimurium in foodstuffs. In both assays, the antigen containing sample was first reacted with antibody to Salmonella which was precoated on a polystyrene microtiter plate. The bound antigen was then allowed to react with an appropriate amount of biotinylated antibody. In the first procedure, the presence of Salmonella was quantified by using peroxidase-labeled avidin. In the latter, avidin acted as a bridge between the biotinylated antibody and the biotinylated peroxidase. Samples containing 10(3) and 10(4) cells/ml of the Salmonella virulent strain, respectively, were detectable by these two methods. The results thus compared favorably with the detection limit of the standard ELISA (10(5) cells/ml). The superiority of the modified ELISA's utilizing biotin/avidin interactions was also demonstrated for the detection of Salmonella in artificially contaminated food samples inoculated with only 2-5 Salmonella cells followed by two incubation steps. No significant interference of E. coli (up to 5 x 10(6) cells/ml) was observed in the quantification of Salmonella cells. PMID- 2701696 TI - Effect of accelerated natural lactic fermentation of infant food ingredients on some pathogenic microorganisms. AB - Accelerated natural lactic fermentation in mixtures of water and ground sorghum, millet and pigeon pea was obtained by gradual selection of lactic acid bacteria, through inoculum recycling. Weaning food prepared from ingredients fermented this way, contained approx. 0.7% lactic and 0.05% acetic acids and had a pH of about 3.8. In porridges, a pH of less than or equal to 4.0 was required to cause death of Salmonella typhimurium and Staphylococcus aureus. Several intestinal pathogenic bacteria were inoculated into sour porridge. The most resistant Salmonella sp. died at a rate of 1.2 log cycle/h; the most resistant Shigella sp. at 0.9 log cycle/h; and the most resistant Escherichia coli strain at 0.6 log cycle/h. A yeast, Candida albicans, could grow well in the sour product, whereas a bacteriophage (MS-2) was inactivated at a rate of 0.1 log cycle/h. In the acid sensitive bacterial cultures, no gradual adaptation to acid environments could be observed. The survival studies were carried out at 30 degrees C. PMID- 2701697 TI - Current treatments and trials in uveal melanoma. AB - Treatment options for uveal melanomas include radiation using brachytherapy or charged particle beams, photocoagulation, laser, eye wall resection, and enucleation. Goals of therapy are to avoid metastatic disease and, if possible, retain both the eye and good vision. Obviously, treatment options are controversial. Questions remain regarding enucleation vs other forms of therapy, and the author presents guidelines to consider in structuring clinical trials to answer them. They include: Will entry in a trial provide optimum clinical care for the patient? Does the trial ask a valid, important question? Does the trial produce significant answers in a short enough time so that the information is relevant? PMID- 2701698 TI - Radiotherapy vs intrathecal chemotherapy for CNS prophylaxis in childhood ALL. AB - Prophylaxis of the central nervous system against meningeal leukemia is a complex problem. There is no optimal solution that is universal for all patients. Instead, treatment must be individualized for the patient's age, prognostic group, and the concomitant systemic chemotherapy. Radiation, because of its CNS toxicity and potential carcinogenicity, is reserved for those in the highest risk groups. For these patients, 1,800 cGy cranial radiation plus intrathecal methotrexate during induction, consolidation, and maintenance therapy is recommended. For other patients, protection should be limited to systemic and intrathecal chemotherapy. Further studies are needed to compare the most effective intrathecal methotrexate prophylaxis with triple intrathecal drug therapy. PMID- 2701699 TI - Magnetic resonance imaging of tumors of the upper aerodigestive tract. AB - Magnetic resonance imaging is rapidly becoming the study of choice for evaluating tumors of the larynx and pharynx. It is superior to computed tomography because of its multiplanar imaging capability and greater soft tissue contrast resolution. Other advantages are that it is a noninvasive procedure, gives three dimensional images that are not degraded by bony or overshoot reconstruction artifacts, and is sensitive to flowing blood, thus obviating the use of x-ray techniques with IV contrast agents. MRI is particularly well suited to laryngeal and nasopharyngeal malignancies because the deep extent of these tumors is difficult to assess by clinical examination alone. PMID- 2701700 TI - Angioimmunoblastic lymphadenopathy with dysproteinemia: report of a case in infancy with review of literature. AB - A case of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) in infancy is reported. The disease had a mild onset with generalized lymphadenopathy, hepatosplenomegaly, thrombocytopenia, polyclonal hypergammaglobulinemia, and T-cell deficiency. The AILD course lasted more than 100 months, alternating clinical remission to recurrent relapses. Hepatitis B viral infection suddenly evolving to hepatic failure was the cause of death. From a rapid survey of the present knowledge, the nosology, immunological features, and therapy of AILD are discussed and a possible presumptive pathogenetic pathway is proposed. PMID- 2701701 TI - Congenital dysgranulopoietic neutropenia in two siblings: clinical, ultrastructural, and in vitro bone marrow culture studies. AB - Two siblings with congenital neutropenia are reported. The first patient, female, died after Pseudomonas sepsis. The second patient male, suffered from recurrent pyogenic infections, with a more benign course. Bone Marrow (BM) and Peripheral Blood (PB) analysis in the second patient revealed a reduced number of granules and myelin bodies in the PB neutrophils, suggesting a developmental defect of primary and secondary granules. BM promyelocytes were almost normal, but the myelocytes and metamyelocytes showed defective granulogenesis. The BM in vitro granulocyte-macrophage-colony-forming cell (GM-CFC) growth and the PB white blood cells (WBC) granulocyte-macrophage-colony-stimulating factor (GM-CSF) production, which were analyzed in the second patient, showed normal numbers of GM-CFC, with differentiation mostly toward monocytes and a defect in the GM-CSF production capacity. The second patient's PB mononuclear cells or serum did not inhibit normal GM-CFC when added to control BM cells. We suggest that in this specific form of congenital neutropenia, which is probably an autosomal recessive disorder, the abnormal neutrophil granule production and the defective provision of GM-CSF by PB WBC are unique pathognomonic characteristics, possibly associated with the overt neutropenia. PMID- 2701702 TI - Oncologic causes of precocious puberty. AB - Tumors are rare, but well-documented causes of precocious puberty in both sexes. The therapeutic and prognostic implications of a diagnosis of cancer require that the presence of a neoplastic process be ruled out in any case of precocious puberty. Granulosa-cell tumor of the ovary and Leydig-cell tumor of the testis are the most frequent gonadal tumors inducing precocious pseudopuberty in the two sexes. Adrenal tumors sustain a variety of endocrine syndromes, the most frequent one being virilization with or without hypercortisolism. Pure feminizing adrenal neoplasms have been described. For reasons not yet well understood, hypothalamochiasmatic glioma (beta-HCG) secreting tumors have almost never been described in association with female precocious puberty. Among these neoplasia, pineal germ-cell tumor inducing sexual maturation must be included. Hypothalamochiasmatic glioma and craniopharyngioma are the two cerebral tumors capable of inducing true precocious puberty. Even if equally distributed between both sexes, these tumors interfere with sexual maturation less frequently in girls than in boys. Hypothalamic hamartoma is considered a benign tumor, since it does represent a space-occupying mass. It more correctly could be called a malformation if its histologic characteristics are recalled. This cerebral lesion is now frequently described in children with true precocious puberty, probably because of improved diagnostic imaging methods. PMID- 2701703 TI - Pemphigoid gestationis: placental interactions. PMID- 2701704 TI - Polymorphic eruption of pregnancy. PMID- 2701706 TI - Perimenstrual eruptions: autoimmune progesterone dermatitis. PMID- 2701705 TI - Vulvar physiology. PMID- 2701707 TI - Drug prescribing during pregnancy. PMID- 2701708 TI - Vulvodynia and pruritus vulvae. PMID- 2701709 TI - Lichen sclerosus et atrophicus. PMID- 2701710 TI - Physiologic skin changes in pregnancy. PMID- 2701711 TI - The United States National Library of Medicine. PMID- 2701712 TI - An exchange of views regarding the dysplastic nevus controversy. PMID- 2701713 TI - "Doing things right": approach to the cutaneous pigmented lesion. PMID- 2701714 TI - Histopathologic considerations in the management of basal cell carcinoma. PMID- 2701715 TI - Neutrophilic dermatoses. PMID- 2701716 TI - Immunohistochemical techniques in non-neoplastic conditions. PMID- 2701717 TI - Spindle cell neoplasms of the skin: a comprehensive diagnostic approach. PMID- 2701718 TI - Lobular capillary proliferation: the underlying process in diverse benign cutaneous vascular neoplasms and reactive conditions. PMID- 2701719 TI - Technical developments in liver transplantation. PMID- 2701720 TI - Liver transplantation for metabolic disorders. AB - Liver transplantation for metabolic disorders continues to be an expanding field, both in the range of indications and patient numbers. In most large series it accounts for approximately 7% of all adult transplants and 29% of all childhood transplants. As the results of medical therapy are improved so too are the results of liver transplantation, and hence more patients are being considered for the latter therapy. The benefits of this treatment are not only the prolongation of and improvement in the quality of life for the patient, it has also given insight into the basic metabolic defects of many disorders. PMID- 2701721 TI - Techniques of organ procurement and preservation of liver and pancreas. AB - The continuously improving success rate in transplantation imposes an obligation to implement the treatment for the increasing number of waiting recipients. In consideration of the increasing number of waiting recipients, all suitable organs of one donor should be harvested, including both liver and segmental or whole pancreas. The supreme goal of multiple organ harvesting is to ensure that none of the organs are damaged during preparation, perfusion and removal of one of the other organs. In general, several surgical teams are involved in multiple organ harvesting. The procedure therefore has to be highly standardized. One of the most important aspects of the procedure described here is the well-defined division into individual preparatory phases, each with its specific objectives: Phase I: preparation of organs, including evaluation of their suitability and delineation of important anatomical structures. Phase II: special preparations immediately before start of perfusion. Phase III: perfusion. Phase IV: removal of organs. Phase V: additional procedures and preparation of donor's body. Phase VI: preparation of transplant outside of body. This chapter describes the procedure by which liver and whole pancreas can be harvested from one donor. The surgical technique represents a compromise between two extremes: excessive dissection before perfusion and perfusion as the first step. The procedure described herein is considered to be an effective, safe, rapid and reasonably standardized one, especially for the co-operative effort between different surgical teams. PMID- 2701722 TI - Immunosuppressive treatment in liver transplantation. PMID- 2701723 TI - Indication, selection of patients and timing for pancreatic transplantation. AB - For more than 20 years pancreas transplantation has been advocated as a therapeutic modality in patients with insulin-dependent diabetes mellitus. When successful, this procedure is the only method for attaining long-term normoglycaemia in diabetic recipients. However, because of the potential morbidity and mortality, pancreas transplantation should be restricted to diabetic patients in whom the complications of the diabetic state are more serious than those of surgery and chronic immunosuppression. Currently three recipient categories have been identified in which pancreas transplantation would seem justifiable. The first includes diabetic patients with end-stage nephropathy who are already obligated to life-long immunosuppressive therapy because of the kidney replacement. In this recipient category the main benefit of receiving a pancreas transplant in addition to a kidney is that the quality of life is markedly improved. In addition, it seems that a functioning pancreas transplant prevents the recurrence of diabetic nephropathy in the simultaneously transplanted kidney. Since the success rate with combined pancreas-kidney transplantations is approaching that of renal transplantation alone, there is little controversy about performing the combined procedure in diabetic uraemic patients. However, if the main objective of pancreas transplantation, namely to prevent the late diabetic microvascular complications, were to be fulfilled this intervention would have to be performed earlier in the course of the disease. Therefore, single pancreatic transplantations have recently been conducted in diabetic patients with early signs of clinical nephropathy which, currently, is the most powerful predictor of susceptibility to detrimental diabetic complications. Preliminary findings indicate that, in this second recipient category, single pancreatic transplantation and subsequent euglycaemia may prevent the progression of diabetic neuropathy and nephropathy; with regard to diabetic retinopathy the results remain obscure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701724 TI - Surgical techniques and results in pancreatic transplantation. AB - A major stumbling block preventing success with pancreatic transplantation has been the handling of the exocrine secretion from the pancreatic graft. As a consequence, numerous surgical techniques have been evaluated such as duct ligation, free intraperitoneal drainage, ductal filling with polymers, exocrine diversion to the urinary tract, to the bowel and to the stomach. Also, because of problems encountered with the duodenum, segmental body-and-tail pancreatic grafts have been used for many years. However, it seems today that mainly two different techniques for pancreatic transplantation remain. In both whole pancreaticoduodenal grafts are used with a vascular supply from the coeliac axis and the portal vein. The exocrine drainage is either to the urinary tract by means of a side-to-side anastomosis between donor duodenum and recipient urinary bladder, or to the bowel by a side-to-side anastomosis between donor duodenum and recipient proximal jejunum. With both these techniques the technical complications have been much reduced and as a consequence the graft survival rates are now approaching those obtained with the transplantation of the liver, heart and kidney. PMID- 2701725 TI - Metabolic control and effect on secondary complications of diabetes mellitus by pancreatic transplantation. AB - After successful pancreatic transplantation blood glucose can be normalized without exogenous insulin, although oral and intravenous glucose tolerance remains impaired in 10-45% of the patients. There is no significant deterioration of glucose control with time in most patients. Since most recipients of pancreatic grafts have far advanced secondary diabetic lesions and the observation time after grafting is rather short, the effects of pancreatic transplantation on these complications are difficult to interpret. However, the development of diabetic nephropathy can be prevented, skin microcirculation improves significantly, while autonomic and peripheral neuropathy and diabetic retinopathy remain stable or improve slightly in most patients. But these ameliorations may be in part due to elimination of uraemia, since in almost all patients combined pancreas/kidney transplantations were performed. It is concluded that pancreas grafting probably has to be performed much earlier in the course of diabetes, although the improvement in the quality of life is striking even in the end-stage diabetics studied so far. PMID- 2701726 TI - Bacteria and cancer--antagonisms and benefits. AB - There is considerable historical and recent evidence concerning the antagonisms between acute bacterial infections or their toxins and cancer and allied diseases. These data provide renewed incentives to undertake clinical programmes with mixed bacterial vaccines in many countries at the present time. PMID- 2701727 TI - Therapy of chronic myelogenous leukaemia with interferons. AB - Therapy of Philadelphia positive chronic myelogenous leukaemia (CML Ph1) with alpha interferon (IFN-alpha) resulted in a high frequency of haematological remissions. Effective suppression of the malignant Ph1 clone and concomitant partial or complete restoration of normal haemopoiesis is reproducibly noted in a proportion (30%-50%) of the patients. This and the low incidence of blast crisis underscore the profound effect this therapy has on the disease. Marked heterogeneity in the response to IFN-alpha was noted as well, and sensitivity or resistance to interferon was phenotypically indistinguishable. Studies of the IFN resistant disease failed to disclose alteration in IFN receptors or in IFN inducible genes and are suggestive, therefore, of a limited alteration in IFN induced intracellular pathways. PMID- 2701728 TI - The role of IFN-beta in cancer therapy. AB - IFN-beta has demonstrated unique effects on viral replication, the immune system and cell growth and differentiation. Clinical studies have suggested that it is the best tolerated interferon. Trials are in progress to determine if IFN-beta has a unique therapeutic role in cancer therapy. PMID- 2701729 TI - Tumour necrosis factor: clinical relevance. AB - The anticancer effect of tumour necrosis factor (TNF) in murine tumours and in vitro has stimulated great enthusiasm for investigating its possible therapeutic role in humans. Results have now indicated that 400-800 micrograms ng/m2 of TNF may be given to patients and further dose increases are limited by hypotension and hepatic damage. At this dose, no consistent anticancer effects have yet been seen and measurement of TNF serum concentrations suggests that these effects are less than those required to induce regression of mouse tumours. TNF as a single agent is unlikely to have a major role in the treatment of cancer in humans and further studies will explore combination with other agents. During the investigation of the clinical role of TNF, observations have clarified its biological role as a mediator of inflammation and shock, cachexia and organ dysfunction. PMID- 2701730 TI - Exogenous and endogenous tumour necrosis factor therapy. AB - Although tumour necrosis factor (TNF) is known as a tumoricidal cytokine, it is also important in maintaining homoeostasis in living organisms by inducing an inflammation-like state. We consider that this monokine may also regulate ontogenesis in animals, because we found that a considerable amount of TNF is secreted by mouse embryonal cells at various stages of development. We named the inflammation-like state in which the TNF concentration was high 'ontogenic inflammation'. Induction of endogenous TNF in the adult body as in ontogenic inflammation should restore homoeostasis in patients suffering from chronic diseases including tumours. We have established several methods for inducing sufficient endogenous TNF to cause tumour regression in patients. For more efficient tumour therapy by ontogenic inflammation, the localization of TNF around tumour lesions was found to be critical. By using a newly constructed rTNF S, which, like endogenous TNF, has a broader cytotoxic spectrum and fewer side effects than conventional rTNF, we developed a new therapy--exogenous/endogenous TNF therapy (EET therapy). With this therapy, exogenous and endogenous TNF can be targeted to and localized in tumours where they act synergistically. Our results suggest that ontogenic inflammation may be important, even in adults, for maintaining homoeostasis. The appropriate application of ontogenic inflammation should also be effective in treating other diseases, such as rheumatism. PMID- 2701731 TI - Endogenous cachectin/tumour necrosis factor-alpha production contributes to experimental cancer-associated cachexia. AB - Several lines of investigation suggest that the endogenous synthesis of cachectin contributes to the host changes that occur in cancer. Although serum appearance of cachectin in tumour-bearing animals and patients with cancer cannot be measured with current techniques, there is accumulating evidence to suggest that tissue macrophage production of cachectin is accelerated in organisms with tumours. Production of cachectin, coupled with the simultaneous synthesis of other cytokines that act synergistically with cachectin may explain many of the host changes in the absence of detectable circulating levels. PMID- 2701732 TI - The role of interleukin-2 in cancer therapy. AB - Despite the abundance of evidence from murine models suggesting a powerful immunological approach to the treatment of cancer, the available data on clinical response have not been as dramatic. The use of interleukin-2 (IL-2) either alone or in combination with lymphokine activated killer (LAK) cells clearly is therapeutic for some patients, albeit a minority. It does not appear from the available evidence that the regimens tested show major differences in antitumour activity, although there is a sense that higher doses may be slightly more effective. Nor is it clear that the addition of LAK cells significantly or sufficiently enhances clinical responses to warrant their widespread use. It must therefore be concluded that other patient and tumour related factors must have an undefined role in the ability to attain meaningful responses. Immunological response to IL-2 and tumour burden are factors which can be examined given the available clinical data. While animal studies have shown that antitumor effects are related to the dose and number of LAK cells given, this is not as clear in patient studies. Some reports have suggested a correlation between clinical response and the in vivo induction of LAK activity or the magnitude of the rebound lymphocytosis. Clinical trials at the University of Wisconsin have shown striking increases in both the number of peripheral blood lymphocytes and LAK induction in patients who showed no clinical response. This in vivo LAK induction, as expected, is not the sole determinant in achieving a measurable response. Whether it is a necessary biological response needed to achieve antitumour effects remains uncertain. The role of tumour burden in response to IL 2 remains elusive. In many trials, including our own, patients with bulky disease have responded to therapy that was ineffective in other patients with what appeared to be a minimal tumour burden. Despite the disappointment that initial expectations have not quite been met, something extremely important has occurred in the treatment of cancer. For the first time, the controlled activation of a patient's endogenous immune system has been shown to have some promise as an antitumour treatment. Clearly, if the response rates reported to date are the best attainable its role will be limited. This remains doubtful as investigators are actively exploring combinations of IL-2 with other biologicals, cytokines, monoclonal antibodies and chemotherapeutic agents. Preclinical data suggest enhanced antitumour effects will be mediated by these combinations. While the magic bullet has not yet been found, there has been a major step forward since IL 2 was first described. PMID- 2701733 TI - The therapeutic activity in cancer of IL-2 in combination with other cytokines. AB - Animal studies have been carried out to assess the antitumour efficacy of recombinant interleukin-2 (rIL-2) in combination with other cytokines. In several murine tumour models, rIL-2 in combination with recombinant alpha interferon (rIFN-alpha) elicits a potent antitumour response which is often greater than that which can be reached with the individual agents at non-toxic doses. By contrast, recombinant gamma interferon (rIFN-gamma) usually fails to potentiate the antitumour response to rIL-2. Recombinant alpha tumour necrosis factor (rTNF) can synergize with rIL-2 in some circumstances, but, as with the rIL-2/rIFN-alpha combination, the correct regimen is critical for generating a potent response without overt toxicity. Although appropriate cytokine combinations can lead to markedly enhanced tumour infiltration by lymphocytes, it is not clear that only a single type of lymphocyte is invariably involved in the antitumour response or, for that matter, the toxic side effects; nor has the mechanism of action of any of the cytokines in the therapeutic action been unequivocally elucidated. Finally, results of early clinical studies appear to be consistent with results in preclinical models: promising clinical responses to the combination of rIL-2 and rIFN-alpha have already been observed and further study is merited. PMID- 2701734 TI - IL-2 receptor expression in the haematologic malignancies: a target for immunotherapy. AB - Activation of resting T cells induces synthesis of IL-2 and expression of its specific high-affinity receptor. We have proposed a multichain model for the high affinity IL-2 receptor in which both a 55 kDa IL-2-binding peptide identified by the anti-Tac monoclonal antibody and a 70/75 kDa IL-2-binding peptide are associated in a receptor complex. The IL-2 receptor is proving to be an extraordinarily versatile therapeutic target, since it is expressed by the abnormal T cells in patients with certain lymphoid malignancies or autoimmune disorders and in individuals rejecting allografts, whereas it is not expressed by normal resting cells. Specifically, HTLV-I-associated adult T-cell leukaemia cells constitutively express large numbers of IL-2 Tac receptors. A 42 kDa tax protein encoded predominantly by the pX region of HTLV-I may play a part in directly or indirectly increasing the transcription of the 55 kDa Tac IL-2 receptor gene. To exploit the fact that IL-2 receptors are present on abnormally activated T cells but not on normal resting cells, clinical trials have been initiated involving patients with Tac-expressing haematologic malignancies. These patients are being treated with unmodified anti-Tac, with anti-Tac conjugated to truncated PE toxin, with isotopic (212Bi and 90Y) chelates of anti-Tac and with recombinant 'humanized' anti-Tac. Thus, the clinical application IL-2 receptor directed therapy represents a new perspective for the treatment of certain neoplastic diseases. PMID- 2701735 TI - Cytokines as autocrine growth factors in malignancies. AB - Interleukin 6 (IL-6) was originally characterized as a B-cell differentiation factor, responsible for the terminal maturation of activated B cells to immunoglobulin producing cells. Recent works reveal that IL-6 has a wide variety of biological functions on various cells. In particular, IL-6 has been shown to augment the growth of freshly isolated human myeloma cells, and the myeloma cells constitutively produce IL-6 and express IL-6 receptors. Moreover, it has been shown that anti-IL-6 antibody can inhibit the in vitro growth of the myeloma cells. This is direct evidence that an autocrine loop is operating in freshly isolated myeloma cells, and that a constitutive production of IL-6 and activation of the IL-6 gene could be involved in the oncogenesis of human myeloma. PMID- 2701736 TI - Future prospects and problems. PMID- 2701737 TI - [Malignant melanoma of the skin: current diagnostic and therapeutic approaches]. AB - The Authors claim that the treatment of malignant melanosis of the skin is a problem of undiminished topical interest owing to its highly aggressive characteristics. Risk factors and pre-neoplastic lesions are reviewed, and the signs of malignant transformation are described along with the appropriate treatment. The Authors stress the importance, for therapeutic and prognostic purposes, of accurate clinical staging and macro- and microscopic study of the primary tumour. They also describe their own therapeutic approach, which involves the use of a CO2 laser for resecting the primary tumour. They present their patient population and conclude by observing that the progress achieved over the past decade is due both to earlier diagnosis and to improvements in the various therapeutic means available. PMID- 2701738 TI - [Bullous emphysema of the lung (our experience)]. AB - Ten patients (9 males and 1 female; mean age: 44.8 yrs) with bullous lung disease were treated. Frequent patient-history findings were smoking and spontaneous pneumothorax. Nine cases were treated surgically either by bullectomy or atypical resection. In one case, an attempt at endobullous aspiration failed owing to the patient's very poor general condition. Among the postoperative complications in three cases we observed difficult pulmonary re-expansion and infection of the surgical wound with consequent pleural empyema in another. PMID- 2701739 TI - [Role of surgery in the treatment of pleural mesothelioma]. AB - The authors present a review of the cases of pleural mesothelioma diagnosed and treated in the Institute of Special Surgical Pathology of the University of Ancona. They confirm the causative role of asbestos in the aetiology of this disease and indicate that the surgical approach is the best diagnostic means available via open biopsy and that the only curative procedure is pleuropneumonectomy. Such surgery, however, is confined to patients properly studied according to the scheme proposed by Butchart, namely stage I patients in excellent physical condition. PMID- 2701740 TI - Kala-azar--an enigmatic disease. AB - Kala-azar (KA), an enigmatic disease has resurged in India since 1970's after about a lull of 20 years, displaying its pestering nature. Various aspects of KA such as epidemiology, parasitology, immunology, clinical features, diagnosis, treatment, vector relationship, control measures etc. have been discussed focussing enigmatic and controversial issues specially in Indian perspective. PMID- 2701741 TI - Glycosuria and insulitis in NOD mice expressing the HLA-DQw6 molecule. AB - To investigate HLA-linked genes controlling the susceptibility and resistance to insulin dependent diabetes mellitus (IDDM), HLA-DQ alleles of 45 Japanese patients with IDDM were analysed, using sequence specific oligonucleotide (SSO). DQA1*0301 and DQB1*04 were positively associated (R.R = 6.6, Pc less than 0.05 and R.R. = 4.7 Pc less than 0.01) and DQA1*0103 and DQB1*0104 were negatively associated (R.R. = 0.2, Pc less than 0.01) with IDDM. DQA1*0103 and DQB1*0104 were in strong linkage disequilibrium to encode for DQw6 molecule. Therefore, in a Japanese population, the DQw6 molecule seems to control the resistance to IDDM. To determine whether or not the DQw6 molecule itself can protect against glycosuria and insulitis in NOD mice, these animals were mated with HLA-DQw6 transgenic-C57BL/6 mice (DQw6-B6) and the F1 progeny expressing the DQw6 molecule were backcrossed with NOD mice. Eighty-five female backcross progenies were classified into four groups, according to the MHC classII phenotype; I-ANOD/I ANOD DQw6(-), I-ANOD/I-ANOD DQw6(+), I-ANOD/I-Ab DQw6(-) and I-ANOD/I-Ab DQw6(+). At the age of 16 weeks, 9.1% of the DQw6(-) I-Ab(-) mice had a glycosuria whereas none of the DQw6(+) I-Ab(-) mice had a glycosuria. At the age of 30 weeks 13.6% of the DQw6(-) I-Ab(-) mice had a glycosuria and 7.7% of the DQw6(+) I-Ab(-) mice had a glycosuria. Histological examinations of the pancreas were performed in the 30 week old mice or after the development of glycosuria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701742 TI - [Venous hum and innominate vein flow velocity in chronic anemia: a pulsed Doppler echocardiographic study]. AB - To assess the hemodynamic correlates of the cervical venous hum in patients with chronic anemia, 14 patients (mean age; 49 years, mean hemoglobin (Hb); 7.3 g/dl) and 14 control subjects (mean age; 50 years, mean Hb; 14 g/dl) without cardiac disease were studied by auscultation, phonocardiography and Doppler echocardiography in two positions (supine and sitting). Venous hum was detected in the sitting position in 11 of the 14 anemic patients whose Hb was less than 9 g/dl, and in six anemic patients in the supine position, while venous hum was absent in the control subjects in both positions. Pulsed Doppler echocardiography with the transducer in the supraclavicular fossa revealed significantly (p less than 0.01) higher peak velocity in the innominate vein in the 11 anemic patients with venous hum (supine; 71 +/- 12, sitting; 111 +/- 24 cm/sec, mean +/- SD) than in the control subjects (supine; 46 +/- 15 sitting; 76 +/- 27 cm/sec) in both positions. Intensity of venous hum increased concomitantly with increased innominate vein flow velocity when the body position was changed from supine to sitting. Peak velocity in the innominate vein correlated significantly with Hb in all study subjects (r = 0.65, p less than 0.01). In conclusion, the cervical venous hum in patients with chronic anemia is related to the hemoglobin concentration and flow velocity in the innominate vein. PMID- 2701743 TI - Plasma proteinase regulation during disease progression in murine models of SLE. AB - Analysis of plasma proteinase during disease progression in murine models of systemic lupus erythematosus revealed three different patterns of regulation. Female NZB/W mice exhibited no age-dependent alterations in plasma proteinase activity from 3-9 months of age. Animals at nine months of age exhibited splenomegaly, high titers of serum autoantibodies and evidence of kidney disease, but no disruption of plasma proteinase activity. Male BxSB mice exhibited elevations in plasma proteinase activity as a late-onset (greater than 20 weeks of age) feature of the disease process. The onset of proteinase dysregulation occurred after significant mortality was evident and therefore variables associated with the induction of elevated levels of plasma proteinase activity are not related to early mortality factors. In contrast, female MRL-lpr mice exhibited age-dependent induction of elevated plasma proteinase activity which correlated temporally with the onset of mortality and the previously described reticuloendothelial system activation (Hart, J. Clin. Lab. Immunol., 26, 129). Interestingly, male MRL-lpr mice, which live slightly longer than female mice of the same strain, exhibited a delayed onset of plasma proteinase dysregulation. These results indicate that induction of changes in plasma proteinase regulation during the natural course of disease varies between these three murine models of SLE. Assessment of plasma proteinase regulation in human disease may reveal subpopulations of patients with features analogous to the murine models, which in turn could influence the choice of therapeutic modalities in disease management. PMID- 2701744 TI - Double-blind placebo-controlled study of milnacipran in hospitalized patients with major depressive disorders. AB - Fifty-eight inpatients with a DSM-III diagnosis of major depressive disorder participated in a 5-week double-blind trial of milnacipran and placebo. Milnacipran was superior to placebo on all measures of depression. The first index of milnacipran superiority was the difference of dropouts due to treatment failure between milnacipran (10.3%) and placebo (55.2%). All patients were evaluated up to day 14. The improvement with milnacipran was statistically significant at day 14. Side effects were identical for milnacipran and placebo. PMID- 2701745 TI - Buspirone and diazepam: comparison of subjective, psychomotor and biological effects. AB - The effects of oral buspirone (BUS, 10 mg) and diazepam (DZP, 10 mg) were studied in 12 healthy women volunteers using subjective ratings, objective tests of psychomotor and cognitive functions and urinary dosage of catecholamine output. Drugs were randomly administered to the same subjects, in a crossover, double blind study, each drug administration being separated by at least 1 week. BUS subjective effects were less severe than those of DZP and not accompanied by feelings of sleepiness that characterized DZP sedative effects. Furthermore, BUS did not impair psychomotor functioning while DZP induced both an impairment of central sensory processing and, to a lesser extent, an impairment in delayed memory. PMID- 2701746 TI - [Effect of urapidil therapy on insulin, glucagon, gastrin and pancreatic polypeptide secretion in patients with idiopathic arterial hypertension]. PMID- 2701747 TI - [Effect of nifedipine on effective renal plasma flow, plasma renin activity and serum aldosterone, noradrenaline and adrenaline levels in healthy persons and in patients with primary moderate arterial hypertension]. AB - Blood pressure, plasma renin activity, and serum aldosterone, adrenaline and noradrenaline were investigated in healthy individuals and patients with the primary moderate hypertension following a single oral dose of 10 mg nifedipine. It was found that the drug is hypotensive in both healthy individuals and hypertensive patients. It does not affect the effective plasma flow throughout the kidneys as well as serum aldosterone and adrenaline whereas serum noradrenaline and plasma renin activity are increased. PMID- 2701748 TI - [Value of localizing examinations used in the diagnosis of primary hyperaldosteronism]. AB - Localizing examinations were performed in 115 patients with the clinical and biochemical signs of the primary hyperaldosteronism between 1975 and 1978. Adenoma of the adrenal cortex was diagnosed in 52 examined patients out of whom 42 underwent surgery, and 12 were classified for the operation. The remaining patients, in whom a cause of hyperaldosteronism was not found, are treated conservatively and followed-up. It was shown that CT-scanning and scintigraphy of the suprarenal cortex are the most convenient techniques in the localization of tumours in patients with the primary hyperaldosteronism. Ultrasound is less valuable diagnostically but may help in tumour localization in about 50% of patients. PMID- 2701749 TI - [Possibility of using TFX (thymus factor X) in the treatment of systemic lupus erythematosus]. AB - A case of a 32-year female patient with the systemic lupus erythematosus is presented. The patient was treated with prednisone in a daily dose of 40-60 mg. Due to the exacerbations of the symptoms and advanced renal disorders, the patient was given TFX together with corticotherapy. Thymus factor X is an extract of real thymus of immunorecorrective properties. It specifically acts on the lymphatic system, especially disordered mechanisms of both cellular and humoral immunity. Thymus factor X was given in the dose of 10 mg (one ampoule) i.m. for the three first months followed by one ampoule every three days for the next three months. The patient is given one ampoule of TFX once a week since the 6th months of therapy. Diminishment of the symptoms was observed. The patient is in remission since a one-year follow-up period. It was also possible to reduce the dose of prednisone to 15 mg a day. The patient is controlled every 3 months. Partial normalization of renal functioning and immunological mechanisms are seen. A decrease in antinuclear antibodies and immunoglobulins, normalization in complement components, an increase in T-cells percentage and conversion of the delayed skin reaction are noted. The authors conclude that TFX may be helpful in the treatment of the autoimmunological diseases, including the systemic lupus erythematosus. PMID- 2701750 TI - [Magnesium in the human body]. PMID- 2701751 TI - [Comparative effects of desiccated thyroid gland and sodium salt of L-thyroxine in the treatment of hypothyroidism]. AB - The studies comparing the actions of dried thyroid gland (Thyroideum-Polfa) with L-thyroxine sodium (L-T4) were carried out in 20 female patients with hypothyroidism, including 19 patients with the primary hypothyroidism and 1 patient with hypothyroidism secondary to pituitary deficiency. Administration of the dried thyroid gland did not normalize blood serum T4 an TSH in any patient. Normal serum T4 or even slightly increased was achieved in all patients treated with L-T4. Serum TSH was normalized in 17 patients with the primary hypothyroidism. The following conclusions have been drawn: 1. Dried thyroid gland (Thyroideum-Polfa) is ineffective in the treatment of hypothyroidism. 2. Serum TSH remains elevated despite normal serum T3 in cases of the primary hypothyroidism with decreased serum T4 levels. 3. Sodium salt of L-thyroxine should be used for the treatment of hypothyroidism. 1-Triiodothyronine sodium may be used as an adjuvant therapy. PMID- 2701752 TI - [Evaluation of danazol treatment of women with fibrocystic disease of breast]. AB - The results of treatment of 20 female patients with fibrocystic degeneration of the breast with danazol are discussed. Diagnosis was made with the aid of mammography. Danazol was administered in the dose of 200 mg twice a day for 2 months, followed by 100 mg thrice a day, and 100 mg twice a day for further 2 months. An improvement in the clinical symptoms, decrease in LH, FSH, estradiol and progesterone levels was produced by danazol. The drug did not change LH response to LH-RH stimulation while blockade of dopaminergic receptors with metoclopramide decreased PRL response. PMID- 2701753 TI - [New methods of diagnosing subepithelial bullous diseases]. PMID- 2701754 TI - [Assessment of the phagocytosis and intracellular killing of Candida albicans by granulocytes of patients with atopic dermatitis]. AB - Using morphological and radionuclide methods the ability of engulfing and intracellular killing of Candida albicans cells by granulocytes of patients with atopic dermatitis was tested. The patients had moderately intense lesions without secondary infections. The results obtained by the morphological method, that is the percent of phagocytizing granulocytes, the percent of C. albicans cells engulfed by the granulocytes and the percent of killed C. albicans cells in the group of 25 patients and in the group of 25 controls were not statistically significantly different. The radionuclide method with 51Cr labelling of Candida albicans failed to demonstrate differences between 15 patients and 25 controls in the intracellular killing of these cells. No significant effect of the serum of healthy subjects on the functions of the granulocytes and no effect of the serum of the patients on granulocyte functions of controls were noted. PMID- 2701755 TI - [Juan Jimenez-Vargas. A short reference note]. PMID- 2701756 TI - [Changes in the ovarian flow during the menstrual cycle: an echo-Doppler study]. AB - The results of the velocimetric evolution of the ovarian flow with pulsed Doppler in 15 normal ovulatory cycles are presented. During the follicular phase the blood flow velocity waveforms (FVW) of the dominant ovary presented a progressive albeit non significant increment of its conductance. This rise was not confirmed in the contralateral ovary. After the echographic ovulation the ovarian FVW showed qualitative and quantitative modifications that determine its "luteal conversion". The conductance index (D/S x 100) was significantly higher (p less than 0.001) during the luteal phase than during the follicular and in the contralateral ovary. The luteal conversion of the ovarian FVW is proposed as a new criteria of ovulation and luteal function. PMID- 2701757 TI - [Echography of the ovarian cycle]. AB - Using bidimensional echography 30 normal ovulatory cycles were evaluated. The following parameters were assessed: Ovarian volume; Volume of the dominant follicle; Corpus luteum volume; Residual follicular volume and Stromal volume. The maximum ovarian volume was reached in the dominant ovary the last day before ovulation: 11.68 +/- 0.52 cc, similarly the maximum volume of the dominant follicle: 3.60 +/- 0.36 cc, and the maximum stromal volume in the follicular phase: 7.98 +/- 0.41 cc. The maximum corpus luteum volume was seen on day +2 of the echographic ovulation, the maximum stromal volume was seen on day +7: 8.64 +/ 0.51 cc, in the dominant ovary. In the contralateral ovary the stromal volume did not show significant changes. The residual follicular volume in the dominant ovary, as in the contralateral, diminished gradually from the beginning of the follicular phase except by a slight postovulatory rise. The normal values are established and also the importance of its use in the diagnosis of the functional disorders of the ovary. PMID- 2701758 TI - [Development of utero-chorionic vascular resistance in early pregnancy]. AB - The physiologic evolution of the utero-chorionic vascular resistances during the first trimester of pregnancy is described. With the use of pulsed Doppler, 25 normal pregnancies were followed weekly, performing 288 scans between the 6th and the 12th weeks of pregnancy. The detection of the FVW was done at the level of the uterine and retro-chorionic vessels. There is a progressive decrease of the vascular resistances to flow, with significant differences (p less than 0.001) between the values before and after the 9th week. The physiologic implications and its possible application to the study of the gestational pathology are commented. PMID- 2701759 TI - Effect of feeding raw legumes on intestinal absorption: a short review. AB - This review summarizes some of our own results relating with the effect of feeding raw legume diets on the intestinal absorption of sugars and amino acids. As compared to control well-fed animals, both in vivo and in vitro intestinal transport of these substrates are significantly inhibited in legume-fed rats and chickens. PMID- 2701760 TI - A reappraisal of the nutritional utilization of legumes. AB - A survey of the physiological, biochemical and immunological changes found in growing mice, rats and chickens fed on raw legumes as the main source of protein from our experimental research is reported. Evidence is summarized about the fact that the inclusion of these vegetable proteins on animal diets brings about a number of undesirable effects such as stunting of growth, reduced protein deposition, altered digestibility and absorption of nutrients and impairment of the immune response, which have been attributed to the occurrence of various antinutritional factors and to a poor sulphur amino acid content. The possible role of tannins and phytates on some of those alterations is reviewed. PMID- 2701761 TI - [Role of the contact plasma system in human physiopathology]. AB - The possible implications of the plasma contact system in several human pathological conditions have been reviewed. The mechanism of activation and the biochemistry of the different components of this physiological system are described. The activation of the plasma contact system and its important physiological consequences are considered. The implication of the plasma contact system in the pathogenesis of different human and experimental pathological conditions (shock, disseminated intravascular coagulation, extracorporeal circulation...) is reviewed. A particular consideration is given to the pathogenesis of glomerulonephritis where the plasma contact system has been more directly implicated. PMID- 2701762 TI - [Difficulties of animal experiments in psychopharmacology. Punctual aspects of antidepressants]. AB - Animal psychopharmacological experimentation encounters great difficulty due to the lack of animal models for reproducing mental illness. This results from the greatly complex fashion of CNS, the lack of knowledge of biochemical and/or anatomical substrates of psychiatric pathology, and the difficulty in placing some CNS functions, such as memory and vice versa. The application of selective neurotoxins capable of specifically destroying a neuronal nucleus allows to advance in the knowledge of the CNS functions. Some easy experimental methods allow a quick investigation of certain pharmacological effects on CNS, though they have to be completed with more complex models. It is difficult to investigate the possible antidepressant effect because it is related to different mechanisms of action, it has an onset delay, and some trials which are positive to some drug with no antidepressant effect. In turn they have no right answer to other drugs with confirmed clinical efficacy. The forced swimming pool test that appears to be the most convenient for researching the possible antidepressant effect has been studied, although it should be completed with a spontaneous motility test. PMID- 2701763 TI - [Neurophysiologic bases and neuropsychological approach to the study of infantile hyperactivity]. AB - Hyperactivity is a common important group of childhood behaviour problems with great influence on the personal, familiar and social sphere, a better knowledge of which is important. Up to now several explanatory hypotheses have been pointed out. From some time ago, the physiopathological roots of this clinical description has been studied in depth. The authors make a review of the neurophysiological and neuropsychological bases of hyperactivity in children. PMID- 2701764 TI - [Physiopathology of ocular movements in infantile cerebral paralysis]. AB - Cerebral palsy is a permanent and non-progressive brain damage due to various causes affecting a child from the intrauterine life up to the first two years of life. Its most common cause is neonatal hypoxic encephalopathy. The cerebral damage is diffuse so that it is commonly associated with epilepsy, mental retardation, dysarthria, hearing loss and oculomotor abnormalities. Strabismus is found in 50% of children with cerebral palsy. This prevalence is significantly different from the 2% incidence of oculomotor abnormalities in the pre-school age, it is noteworthy that strabismus and refractive errors respond to the classical therapeutic measures. PMID- 2701765 TI - [Evaluation of diabetic vegetative neuropathy using non-invasive cardiovascular explorations]. AB - The alterations in autonomic nervous system due to diabetes mellitus are described. We propose a series of non-invasive methods to assess the autonomic function in this type of patients. PMID- 2701766 TI - [Immunotherapeutic management of juvenile diabetes mellitus]. AB - Differences between Type 1 and Type 2 Diabetes Mellitus are briefly outlined with special emphasis on the immune mechanism in the development of juvenile diabetes. Autoimmune nature of Type 1 diabetes is based on: association with genetic markers of histocompatibility mainly with the DR3 and DR4 haplotypes of the HLA system; anomalies of the humoral and cellular immunity present in a significant percentage of Type 1 diabetic patients, its association with other autoimmune diseases; the histological features of the affected pancreas and the prevention of experimental diabetes by immunosuppression. Trials on immunotherapy with immunosuppressors (Cyclosporine A and Azathioprine) and immunomodulators (Thymic hormone) were able to achieve a 50-60% index of clinical and functional remission for more than one year. With Thymic hormone and Azathioprine in combined administration the glycemic control and residual beta-cell function one year after stopping immunotherapy exhibited positive comparative results. Other trials on immunotherapy are outlined. Side effects of immunosuppression and future prospectives for immune approaches in Type 1 diabetes are commented. PMID- 2701767 TI - Results of the in vitro follow-up of immunotherapy. AB - With the advances made in allergological diagnosis, thanks to the application of various in vitro immunological techniques, we have also learnt more about the immunological modifications produced during the course of the immunotherapy. Among the techniques which will detect immunological changes is the histamine release test, which will show a decrease in antigen-specific histamine release. On the other hand, both total IgE and IgG4 are modified in the course of this immunotherapeutic treatment. PMID- 2701768 TI - [Changes in radiation lesions using platinum derivatives. Biological bases and clinical experience]. AB - The biological basis of radiation damage modulation with platinum derivatives are reviewed. Cisplatin and Carboplatin are cytostatic agents used increasingly in the treatment of different human tumours. In vitro and in vivo studies have established the interest of the simultaneous combination of platinum compounds and radiation in tumor cells and neoplastic tissue, describing potentiation, sensitization, and inhibition of sublethal damage repair effects from radiation. Clinical trials have been recently activated in order to explore a possible benefit from the biological modulation with platinum compounds of radiotherapy. In the frame of developmental therapeutic protocols in modern oncology, this approach might explore a positive effect on the therapeutic index of radiotherapy for malignant tumors. The initial clinical results reported indicate that the available platinum derivatives used in human oncology behave as radiopotentiating and radiosensitizing agents. PMID- 2701769 TI - [Immunobiology of materno-fetal relations]. AB - Normal development of pregnancy requires maternal immune system tolerance towards the fetoplacental allograft. Natural Killer (NK) cells can display spontaneous lytic activity against tumoral, and poorly differentiated cells, without a prior sensitization. Moreover this cytotoxic activity is not restricted by the Major Histocompatibility Complex (MHC). We investigated the existence of modifications in the NK activity mediated by peripheral blood mononuclear cells (PBMC) from pregnant women. A significant depression was found in this activity from the first trimester to the puerperium that cannot be ascribed to a defective number of NK cells among pregnant's PBMC. However this impaired NK activity can be reconstituted in vitro by incubation of PBMC with interleukin 2 (IL 2). Pregnancy is also associated with an absence of effectors and/or precursors which mediate other cytotoxic non MHC-restricted activities after long term incubation with IL 2, the so called Lymphokine Activated Killer (LAK) cells. PMID- 2701770 TI - Renal hemodynamics and the renin-angiotensin system in cirrhosis. AB - The interrelationship between renal hemodynamics and the renin-angiotensin aldosterone system in 28 nonazotemic cirrhotic patients has been studied. Patients were divided into three groups: A) Patients without ascites nor edema; B) Patients with ascites and a relatively high sodium excretion (41.9 +/- 12.9 mmol/day); and C) Patients with ascites and very low sodium excretion (4.8 +/- 0.6 mmol/day). Renin and aldosterone levels significantly increased in group C. A significant correlation was observed between plasma aldosterone concentration and urinary sodium excretion, and between plasma renin activity and aldosterone levels. There were no significant differences in urine flow, glomerular filtration rate, effective renal plasma flow, or renal blood flow between the three groups of patients, in spite of marked differences in renin and aldosterone levels. Renal perfusion was not related to plasma renin activity either in the overall sample of patients or in the individual groups. These results show that factors other than total renal perfusion are involved in renin secretion in cirrhosis. PMID- 2701771 TI - Effect of anabolic agents on muscle protein metabolism in growing rats treated with glucocorticoids: a short review. AB - This short review summarizes some of our own results on the effect of glucocorticoids and androgens on the rate of muscle protein turnover as measured by the urinary output of 3-methyl-histidine and 14C-tyrosine constant infusion methods. While high doses of glucocorticoids reduced muscle mass by both increasing protein breakdown and reducing protein synthesis rates, androgens do raise muscle protein by increasing protein synthesis. It is suggested that the anabolic action of androgens could be mediated by their interaction with the glucocorticoid-receptor complex. PMID- 2701772 TI - [Metal ions in the insulin-receptor interaction in human erythrocytes]. AB - The kinetics of insulin binding to its receptors on human erythrocytes suggests the existence of two types of receptors exhibiting negative cooperativity upon the binding of the hormone. Solubilized and purified receptors were associated to Zn++ or Cu++. The addition of these ions to erythrocytes or to purified insulin receptors from human erythrocytes resulted in an increase of specific insulin binding. Dialysis of solubilized or purified receptors against chelating agents such as EDTA or 1, 10-phenanthroline resulted in a decrease in specific binding of insulin. With the readdition of Zn++ or Cu++ to the medium an increase in specific binding was observed, and values much higher than those of the original preparations were obtained. Dialysis of purified receptors against chelating agents resulted in a decrease in the content of Zn++ and Cu++. These results suggest the possible involvement of a metal ion associated to the receptor in the formation of the insulin-receptor complex. PMID- 2701774 TI - Depression of energy metabolism in distant brain structures: studies with positron emission tomography in stroke patients. PMID- 2701773 TI - [Differences of males and females regarding the binding capacity of insulin to erythrocyte receptors]. AB - The analysis of insulin receptors in erythrocytes demands a relatively small blood sample, which justifies the interest in its use as an index of the cellular capacity for binding hormone. In order to establish criteria for normalcy, the capacity of erythrocytes for binding in vitro insulin labelled with 125I before increasing concentrations of cold insulin (from 0.5 to 10(3) ng/ml), was studied in a group of 41 healthy men and another of 35 women with normal menstrual cycles. In the female group the study was carried out in three different days of the same cycle (days 3, 12 and 21). The binding capacity in the male was higher than in the female (p less than 0.05) in the follicular phase (days 3 and 12) as well as in the luteal phase (day 21) and, among women, it was higher in the follicular phase than in the luteal one (p less than 0.05). The results indicate that progesterone, as well as prolactin and glucagon, may play an important role in the binding capacity of insulin to its receptor. To make the values comparable, it is suggested that blood extraction in women be carried out during the first five days of the cycle. PMID- 2701775 TI - Cerebrovascular disease: use of fluorodeoxyglucose. PMID- 2701776 TI - Epilepsy: the use of oxygen-15-labeled gases. PMID- 2701777 TI - Positron emission tomography in psychiatric and neuropsychiatric disorders. AB - PET is potentially the most powerful tool yet available for the direct, in vivo investigation of the biologic basis of psychiatric and neuropsychiatric disorders. The fulfillment of its potential rests on the development of methodologies and study design appropriate to psychiatric disorders. To date, findings in both schizophrenia and affective disorder, using protocols largely based on resting state data acquisition, suggest altered regional metabolism. These approaches need to be extended, particularly by the application of protocols that utilize PET to obtain longitudinal data under controlled experimental situations. In two conditions traditionally ascribed to psychologic causes, OCD and PD, there is intriguing evidence of specific biologic abnormalities, which, if confirmed, would lead to a fundamental revision of their nosologic status. In neuropsychiatric disorders PET findings, although preliminary in nature, offer an alternative paradigm to traditional clinicopathologic correlations by suggesting that clinical impairments relate to physiologic effects at sites distant from structural lesions. PMID- 2701778 TI - Positron emission tomography in dementia. PMID- 2701779 TI - Parkinson's disease: positron emission tomographic studies. PMID- 2701780 TI - Positron emission tomographic studies of the subcortical degenerations and dystonia. AB - Reported PET findings in subcortical and corticobasal degenerations, and in dystonia, are summarized in Table 3. It can be seen that, although PET is not a diagnostic technique, clinical examination combined with PET findings can help to distinguish between the various akinetic-rigid syndromes, with the proviso that pathologic validation of many PET studies is still awaited. More importantly, PET is now providing information about the functional effects of these various subcortical degenerations, and about dystonia. It is likely that more information will become available about the nature of the functional corrections between cortex, thalamus, and basal ganglia as increasingly sophisticated activation paradigms are designed for PET studies on movement disorders. PMID- 2701781 TI - Cerebellar diseases: studies with positron emission tomography. PMID- 2701782 TI - Cerebral perfusion and oxygen uptake studies in patients with intracranial tumors. PMID- 2701783 TI - [Detection of Chlamydia trachomatis in urethral samples by direct immunofluorescence]. AB - The presence of Chlamydia trachomatis was studied by the direct immunofluorescence test, as also was that of Neisseria gonorrhoeae, Mycoplasma and Ureaplasma by the standard methods, in 82 patients with urethral discharge. Ch. trachomatis was found in 19.5% (16) of the cases and in 11 of them (68.8%) there was association with the other bacteria investigated. This eleven patients presented a scanty gelatinous discharge. PMID- 2701784 TI - Effects of endothelin on porcine coronary arterial strips. AB - Endothelin, a novel endothelium derived 21-residue vasoconstrictor peptide synthesized by Peninsula Laboratories, provoked a concentration-dependent contraction of porcine coronary arterial strips. EC50 value for endothelin was 14 +/- SD 4 nmol/L (n = 6), and significantly lower than the values for 5 hydroxytryptamine (5-HT, 0.28 +/- 0.07 mumol/L, n = 6) and 15-methyl prostaglandin F2 alpha (15-methyl-PGF2 alpha, 4 +/- 3 mumol/L, n = 7). The maximal increase in tension caused by endothelin was 5.4 +/- 1.1 g, being much greater than that induced by 5-HT (3.7 +/- 0.8 g, P less than 0.05) and 15-methyl PGF2 alpha (3.7 +/- 0.6 g, P less than 0.01). The changes in tension provoked by endothelin (2-20 nmol/L) were attenuated significantly after pretreated with tetrodotoxin (TTX, 30 mumol/L, P less than 0.05 or 0.01). The results suggest that endothelin is one of the most potent vasoconstrictive agents, and its action is partially related to voltage-sensitive Na+ channel in the cell membrane. PMID- 2701785 TI - [Multivariate twin crossover design parallel line assay for estimating potency of insulin]. AB - Based on twin crossover design, a multivariate assay design was used in parallel line analysis to estimate the potency of insulin. This paper describes how to make the experimental design. After the analysis of variance according to assay, the potency and fiducial limits were calculated by the method (2.2). It has been applied by multivariate assay to estimate 80, 100 and 120% standard preparation and the recovery rate were between 94 and 108%. We also tested various batches and agent products. The average fiducial limits rates were less than 20%. In comparison with twin crossover analysis as usual, multivariate assay appeared to provide a more efficient utilization of experimental data, to increase weight of every animal for a more accurate estimation of potencies and to save on animal numbers 30-40%. PMID- 2701786 TI - [Chemico-microbiological parameters for diagnosis of periodontal disease]. AB - The authors examined the variations of periodontal markers in relation to severity of periodontal diseases. Furthermore they have considered the changes of bacterial flora in the periodontal disease, before and after removal of subgingival plaque. PMID- 2701787 TI - [Squamous cell epithelioma: retrospective analysis of a multidisciplinary approach with surgical treatment and periodontal treatment]. AB - Retrospective analysis of a multidisciplinary approach between surgery treatment a periodontal treatment. In our experience the surgery treatment of the squamous cell carcinoma has been completed by periodontal treatment to eliminate the secondary consequences such as bleeding and salivating++ from the labial chyme. PMID- 2701788 TI - [Lupus erythematosus. 3. Investigation of oral lesions: a) Epidemiology, b) Clinical picture, c) Histopathology, d) Ultrastructural aspects]. PMID- 2701789 TI - [Lupus erythematosus. 4. Investigation of the oral cavity: a) The antibody picture in studies of oral lesions, b) Immunopathology, c) S.L.E. and Sjogren syndrome; d) L.E. and collagen disease, e) The importance of oral lesions in L.E]. AB - The AA. in this note IV report the most recent acquisitions about hematology, serology and immunopathologic findings; describe the association and the overlap between oral lesions in Lupus Erythematosus and other diseases. Finally analysed the importance of establishing the diagnosis of oral manifestations of Lupus Erythematosus. PMID- 2701790 TI - [Vascular compression at the cerebellopontine angle and the decompression technic]. PMID- 2701791 TI - The mast cell in mastocytosis and pediatric dermatologic disease. PMID- 2701792 TI - Vascular neoplasms of the skin: a current perspective. PMID- 2701793 TI - The cutaneous manifestations of human Lyme disease: a widening spectrum. PMID- 2701794 TI - Sports-related skin injuries. PMID- 2701795 TI - Therapy of dermatologic disease with cyclosporin A. AB - Cyclosporin A is a potent immunosuppressive drug with almost a decade of clinical use. Due to its lack of bone marrow toxicity, it has assumed a leading role in organ transplant surgery. Likewise, it has shown remarkable efficacy in psoriasis and has shown potential usefulness in other dermatologic diseases, most of which are thought to have an autoimmune T-cell-mediated pathogenesis. There are many other inflammatory skin conditions in which T lymphocytes represent a majority of the cellular infiltrates, and theoretically such disorders may be responsive to CsA. Diseases such as lichen planus, allergic contact dermatitis, photoallergy, and vitiligo are potential areas of further study. The potential use of topical and intralesional CsA also warrants further clinical evaluation. There are reports of topical CsA showing effectiveness for alopecia areata and nickel contact sensitivity. Griffiths et al. treated six psoriatic patients with 2% CsA ointment twice daily for 4 weeks. The response to placebo or CsA at the end of the study was similar in all patients. Notably, there was no measured systemic absorption and no change in blood pressure or renal function. We had similar unimpressive results in several patients treated with a 10% solution of CsA; minimal to no response was seen. Of great benefit would be an effective topical preparation without systemic absorption or toxicity. Future studies will need to carefully evaluate the vehicle used and the strength of topical CsA employed. The role of CsA in dermatologic disease still needs much investigation, both at the clinical and basic science levels. The studies to date show dramatic and exciting results. Indeed, CsA may well represent a major advance in the understanding and treatment of psoriasis. However, the decision to use CsA for nonfatal diseases such as psoriasis will require a careful balance between efficacy and toxicity. If long-term side effects can be avoided or kept within reasonably safe, acceptable limits, CsA holds great promise for the treatment of psoriasis. It may at times be used as an acute intervention, with a relatively large, initial dose for a short period of time to quickly clear severe psoriasis. This could be followed by either a reduction to a lower and safer maintenance dose or a program of other treatments. Cyclosporin A may also prove useful alone in very low doses or in combination therapy, as with UVB or PUVA. Optimal dosing protocols are currently under investigation. PMID- 2701796 TI - Alopecia: histologic changes. AB - The major types of alopecia that can be diagnosed histologically are androgenic alopecia, alopecia areata, trichotillomania, inflammatory scarring alopecias, pseudopelade, and anagen and telogen effluviums. Important to recognize are the common histologic features in chronic alopecias, which include follicular plugging, decreased numbers of hair follicles, frequent increased fibrous tracts, and superficial changes of actinic damage. Specific helpful changes to be observed are (1) the presence of actinically damaged skin that would reveal a chronic alopecic condition, (2) the presence and site of the dermal inflammation, (3) whether there is a decrease in the numbers of hair follicles and the presence of a reversal of the anagen/telogen ratio, (4) miniaturization of the hair follicle, (5) evidence of involution, and (6) the presence of scarring as demonstrated with elastic fiber stains. By assessing these histologic changes, the dermatopathologist can make a reasonably specific diagnosis of alopecia. PMID- 2701797 TI - Synthetic skin. PMID- 2701798 TI - The meaning and significance of tissue margins. AB - The treating surgeon should be aware of the various methods of grossly sectioning and microscopically examining tissue. For tumors that are life threatening or difficult to cure, one should request careful examination of as much of the cut surgical margins as feasible. Whatever is done with the tissue, the physician should communicate adequately with the pathologist so that each will be aware of the other's limitations and what is actually being provided for the patient. Proper understanding of the terms cut surgical margins and pathologic margins and their general noncongruence will help to dispel confusion and lend credence to more carefully constructed studies in the future. PMID- 2701799 TI - Pyoderma gangrenosum and related disorders. PMID- 2701800 TI - Endemic pemphigus foliaceus (Fogo Selvagem). AB - Fogo selvagem presents our specialty with a unique situation. The disease is fundamentally identical to the pemphigus foliaceus that we are familiar with in North America, but there is impressive epidemiologic and circumstantial evidence that an environmental factor is producing this highly specific autoimmune phenomenon. If one can define this factor and investigate the mechanisms operative in the promotion of the disease, one would develop major new insights into both the normal function of the immune system and the specific disease state. Implications for understanding other autoimmune diseases are also obvious. However, to overcome the difficult logistics of studying these patients by modern techniques presents a formidable task. Hopefully, with the cooperation of interested investigators in both Brazil and the United States, these problems can be overcome. PMID- 2701801 TI - Calcium: a second messenger. PMID- 2701802 TI - GTP causes calcium release from a plant microsomal fraction. AB - Studies on a variety of animal cell types have revealed a GTP-specific calcium releasing mechanism in a non-mitochondrial, microsomal fraction. Here we report that GTP also induces rapid release of calcium from a zucchini (Cucurbita pepo L.) hypocotyl microsomal fraction. Maximal release occurs at 50 microM, and half maximal release at 8 microM GTP. GTP is highly specific in its effect, and may not be replaced by UTP, ATP, CTP, TTP, GMP, or by non-hydrolysable analogues of GTP. Reuptake of calcium after release does not normally occur; however, this may be induced by non-hydrolysable GTP analogues. Calcium release is also blocked by prior treatment with these analogues. PMID- 2701803 TI - Diffusion into the patch-clamp recording pipette of a factor necessary for muscarinic current response. AB - Ca-dependent K and Cl currents were measured in isolated cells from rat lacrimal glands using the tight-seal whole-cell recording method. Upon application of acetylcholine (ACh), both K and Cl-selective currents were activated. The size of the ACh-activated currents declined after a few minutes of whole-cell recording. The rundown curve was composed of an initial stable period followed by a rather rapid decline. Both the length of the initial plateau and the speed of the falling phase were dependent on cell size and recording pipette resistance. The results suggest that the rundown was due to washout of an unknown cytosolic substance. Another manifestation of washout was an increase in the delay of the response. Plots of the inverse of the delay as a function of time in whole-cell recording showed again an initial plateau and a falling phase, but the stable period lasted less than in amplitude plots. Analysis of the washout time course suggested that the cytosolic substance has a diffusion coefficient of 5.4 x 10( 6) cm2/s, corresponding to a molecular weight of 350. Washed-out cells were insensitive to GTP-gamma-S, but responded normally to an internal application of inositol-trisphosphate (InsP3), introduced through the pipette. Thus, the step of the response which is sensitive to washout is closely related to the production of InsP3. Addition of various exogenous water soluble substances failed to halt washout. Among the inactive substances were GTP (or a combination of Mg and GTP) and small water soluble precursors of InsP3. The results imply that the production of InsP3 by muscarinic agonists in exocrine glands requires the presence of a small molecular weight, water soluble substance. It is suggested that this substance is an unknown co-factor of phospholipase C or of Gp, the GTP binding protein governing the production of InsP3. PMID- 2701804 TI - Localization of VIP and PHI-27 messenger RNA in rat thalamic and cortical neurons. AB - Messenger RNA (mRNA) coding for vasoactive intestinal polypeptide (VIP) and peptide histidine isoleucine (PHI-27) were localized in cortical and thalamic neurons with synthetic DNA probes complementary to the PHI-27 and VIP exon coding sequence of the rat VIP precursor gene. Hybridization signal with these probes was found widely distributed in the thalamus, neocortex, and pyriform cortex, and the distribution of hybridization signal for each probe was identical. Furthermore, the distribution of each message was correlated closely with peptide distribution demonstrated immunohistochemically. Labeling of individual neurons with in situ hybridization histochemistry was characterized by a dense accumulation of silver grains in the cytoplasm of these cells with little or no label in the nucleus. Labeled neurons in the thalamus were observed in the ventrolateral, ventromedial, ventrobasal, and lateral reticular nuclei. In the neocortex, the distribution of labeled neurons was concentrated in layers II and III with scattered cells also apparent in deeper cortical layers. Hybridization signal was limited to nonpyramidal neurons in both the neo- and pyriform cortex. The coextensive distribution of immunoreactivity and mRNA coding regions for VIP and PHI-27 establishes that these peptides are synthesized from the same precursor mRNA in the same thalamic and cortical cell groups. Although the physiological role of these peptides in thalamocortical function remains unknown, these data provide an anatomical substrate which suggests that VIP and PHI-27 may be cotransmitters in thalamic and cortical neurons. PMID- 2701805 TI - What are the goals of magnetic resonance research? AB - Now that both magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) have reached their decadic majority, appropriate questions may be asked as to their accomplishments and prognostications for the future. This article emphasizes the approach of the metabolic biologists/physiologists to magnetic resonance biochemistry as indicated by the currently available multinuclear localized approaches. The viewpoint is emphasized that MRS is a critical care instrument where precipitious changes of oxidative metabolism lead to the well-known stroke, heart failure, liver failure, kidney failure, etc. Generally, the gradation between the classical metabolic steady state of life and the pathway leading to cell death is a narrow one and magnetic resonance in some cases is too finely tuned to delineate the gradations of stability and instability of cell metabolism. To this point, magnetic resonance can be supplemented by other modalities that sense tissue distress. An example of a most useful and predictive measure of hypoxic stress is optical spectrophotometry which uses time resolved ranging methods to measure optical path lengths to quantitate hemoglobin deoxygenation in tissues. With such a complement, the two methods emerge as one of general importance in diagnostic procedures. PMID- 2701806 TI - 1H spectroscopic imaging at high spatial resolution. AB - Spectroscopic imaging and single voxel localization are compared with respect to the signal to noise ratio per unit time and unit volume. It is shown experimentally that, when using the same experiment time and the same voxel size, both methods give similar results. In order to investigate the localization limits of spectroscopic imaging, lipid distribution in a single large cell was measured and correlated with gradient echo microscopy. PMID- 2701807 TI - Imaging of brain tissue pH and metabolites. A new approach for the validation of volume-selective NMR spectroscopy. AB - For the validation of volume-selective 1H and 31P NMR spectroscopy of the brain methods are required that allow high resolution quantitative mapping of tissue pH and metabolites on intact brain slices. The following techniques are proposed for this purpose. Tissue pH is imaged on cryostat sections of in situ frozen brains, using umbelliferone as a fluorescent pH indicator (Csiba et al, Brain Res 289, 334-337 (1983]. Regional tissue ATP content is measured in adjacent cryostat sections, using the luciferine/luciferase system of fireflies for evoking substrate-specific bioluminescence (Kogure and Furones Alonso, Brain Res. 154, 273-284 (1978]. Lactate content is imaged in a similar way by inducing substrate specific bioluminescence with lactate dehydrogenase and luciferase from vibrio Fischeri (Paschen, J. Cereb. Blood Flow Metab. 5, 609-612 (1985]. The spatial resolution of these techniques is better than 100 mu, as exemplified in experimental brain tumors and brain infarct of cats. The applicability of biochemical mapping for the validation of NMR spectroscopy was tested in a global brain ischemia model of cat by correlating surface coil 31P and 1H spectra with the corresponding regional biochemical data, measured in the sensitive volume of the coil. Correlation coefficients were r = 0.907, 0.852 and 0.924 for pH, lactate and ATP, respectively. These results demonstrate that the biochemical measurements obtained by bioluminescence and fluoroscopic imaging correlate closely with the NMR data and, therefore, are appropriate for the validation of more complex applications, such as volume-selective spectroscopy of brain infarcts or tumors. PMID- 2701808 TI - NMR studies of body fluids. AB - High resolution, high frequency, in vitro, proton NMR spectra of various body fluids, including urine, sweat, aqueous humour, amniotic fluid, seminal plasma, cerebrospinal fluid, synovial fluid and blood plasma are described and discussed. Applications include the detection of metabolic disorders, investigations of the biochemical basis of drug and xenobiotic metabolism, organ damage, and diagnoses for sick babies. The determination of metabolite concentrations is straightforward for fluids with a low protein content such as urine. In fluids with a high protein content such as blood plasma, it is possible to detect not only small molecules but also mobile regions of macromolecules, and to demonstrate the interaction of anions such as lactate with proteins. It seems likely that these methods will soon become established in modern pathology laboratories. PMID- 2701809 TI - Clinical magnetic resonance spectroscopy of brain, heart, liver, kidney, and cancer. A quantitative approach. AB - Clinical studies using 31P and 1H MRS with a whole body 2.0 T MRI/MRS system are described. In most cases, techniques to quantitate absolute molar concentrations of metabolites in various organs were used. In the brain, AIDS, chronic stroke, and white matter lesions were associated with alterations of brain 31P metabolites. Epilepsy was associated with increased pH in the seizure focus. In the heart, dilated cardiomyopathy was associated with increased PDE/ATP while PCr/ATP was unchanged. In the liver, alcoholic hepatitis and cirrhosis were associated with diminished hepatic ATP while alcoholic hepatitis had increased pH and cirrhosis had decreased pH. This allowed differentiation of normal liver, alcoholic hepatitis, and alcoholic cirrhosis without biopsy. In the prostate, malignancy was associated with increased PME/ATP and decreased PCr/ATP. The PME/PCr was greatly increased in malignant prostate with no overlap in normals. Other cancers outside the brain had increased PME and effective treatment was often associated with diminished PME. 1H MRS of the brain was performed using ISIS and outer volume suppression pulses for volume localization. Excellent high resolution 1H water-suppressed spectra were obtained at echo times as short as 30 ms, showing well resolved peaks for lactate, N-acetylaspartate, glutamate, choline, creatinine, and inositol. 1H MRS demonstrated that the uptake of ethanol by the brain was slower than the rise of ethanol in blood. 31P spectroscopic imaging of the brain with resolution of 2.25 x 2.25 x 2.5 cm produced metabolic images and high resolution spectra from desired regions of interest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701810 TI - Amplification or obfuscation: is localization improving our clinical understanding of phosphorus metabolism? AB - Localization techniques are considered an indispensable part of the clinical spectroscopy examination. The results are often a marked improvement in diagnostic information (amplification), but because of the introduction of new artifacts and the more prolonged examination time, some of the undoubted advantage is lost (obfuscation). There is thus an argument for continued development of more rapid methods of clinical spectroscopy and, if necessary, sacrificing some spatial information. PMID- 2701811 TI - Designs for efficient clinical trials. AB - This article reviews statistical designs for the conduct of efficient Phase II and Phase III clinical trials. Two stage designs for Phase II trials are tabulated which minimize the number of patients entered when the experimental treatment is inactive or not promising. Randomized Phase II trials for selecting the most promising of several experimental regimens are also described. Phase III designs are presented with simple early stopping rules for dropping experimental regimens. Inappropriate sequential analysis of interim data is a likely cause of many spurious claims of treatment effectiveness. General methods for the valid calculation of confidence limits for differences in treatment effectiveness based on sequentially accumulating data are described. Factorial designs for answering "two questions for the price of one" are also discussed. PMID- 2701812 TI - GM-CSF may hasten patient recovery while reducing costs. PMID- 2701813 TI - Cellular analysis of functional mononuclear cells from chronically inflamed gingival tissue. AB - Functional mononuclear cells from chronically inflamed gingiva of different stages of adult periodontitis (AP) were isolated by using a novel enzymatic dissociation method and extensively characterized at the single cell level. Fresh tissues obtained following surgery were cut into 1-2 mm3 pieces, washed free of residual blood cells and dissociated with the neutral protease enzyme Dispase. Mononuclear cells were then obtained by separation on a mini-Ficoll-Hypaque gradient. This procedure yields an average of 2 x 10(6) cells/400 mg of tissue. The viability of unfractionated cells immediately after enzymatic dissociation was greater than 94%, and after Ficoll-Hypaque gradient separation this was greater than 99%. The relative percentages of lymphocytes, plasma cells, monocytes (MN)/macrophages (M phi) and granulocytes were determined on cytospin preparations by Wright's-Giemsa staining. Cell differential analysis showed that lymphocytes and MN/M phi predominated at all stages of disease, while the frequency of plasma cells increased with the severity of disease. Numbers of plasma cells specific for IgG, IgA, or IgM were determined by immunofluorescence using fluoresceinated anti-heavy chain specific antibodies. The majority of Ig containing cells were of the IgG isotype, followed by significant numbers of IgA and few IgM-positive cells. IgG, IgA, and IgM secreting cells were also determined by the ELISPOT assay. Total numbers of spot forming cells (SFC) were measured in both the moderate and advanced stages of disease, and the major SFC isotype was IgG followed by IgA; essentially no IgM SFC were detected. Furthermore, higher numbers of IgG and IgA SFC were noted in the advanced stage when compared with the moderate stage of disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701814 TI - The immunogenic privilege of corneal allografts. AB - Corneal grafts enjoy the highest success rate of any form of organ transplantation. The low incidence of graft rejection is particularly impressive considering that human leukocyte antigen matching of donor and recipient is not normally performed. Although corticosteroids are applied topically, systemic immunosuppressive drugs are not routinely implemented for keratoplasty. The most widely accepted explanation to account for corneal allograft success suggests that the avascularity of the graft bed prevents corneal alloantigens from reaching the regional lymphoid tissues and therefore results in an "afferent blockade" of the immune response. However, recent findings suggest that the unique immunologic characteristics of the corneal graft itself may play a crucial role in determining the fate of the transplant. In particular, the presence and distribution of donor-derived Ia+ Langerhans cells can have a profound impact on graft immunogenicity and thus, graft survival even if the graft bed is initially free of lymphatic and blood vascular drainage channels. Thus, the immunologically unique characteristics of the corneal graft conspire with the avascular graft bed to produce an "immunologically privileged" environment that promotes graft survival. PMID- 2701815 TI - A view from the groove: peptide binding by MHC molecules and the implications for regional immune responses. AB - A significant event in immunology occurred in 1987 with the publication of the three dimensional structure of a class I major histocompatibility complex (MHC) product as determined by X ray crystallography. The crystal structure revealed a groove created by the first and second domains of the molecule which could be the antigen (Ag) binding site. Subsequent analyses have suggested that a similar groove exists in the class II molecule. The present view will focus on the implications of this new knowledge for understanding regional immune responses. In particular, we shall discuss how the occupation of the groove by different peptides in different tissues implies that a component of T cell recognition of MHC may be tissue specific. PMID- 2701816 TI - [Multi-glandular lesions in primary hyperparathyroidism. Late outcome of 86 consecutive patients treated with conservative surgery]. AB - Multiple gland enlargement (M.G.E.) in primary hyperparathyroidism (H.P.T.) is the presence of 2 or more enlarged glands weighing more than 50 mg. Conservative surgery (C.S.) consists of resecting the grossly enlarged glands without biopsying the normal glands. Some authors have suggested that C.S. might overlook minute hyperplasia, hence leading to late recurrences of H.P.T., or conversely result in the unnecessary resection of grossly enlarged, but not hyperfunctioning glands. 379 patients have been operated upon for H.P.T. 86 (22.7%) had M.G.E. including 13 (15.2%) M.E.N. cases, 8 (9.3%) familial cases and 65 (75.6%) seemingly sporadic cases (S.S.C.). 2, 3 or 4 glands (or more) were involved in 39.5%, 35% and 25.5% of cases respectively. 1 patient died post-operatively and 3 -all S.S.C. with hyperplasia--had to be reoperated upon within 1 year for persistent hypercalcemia. Pathological diagnosis was: double adenomas in 5.8%, hyperplasia in 36%, adenoma associated with hyperplasia in 46.5% and a normal second gland, on light microscopy findings in 11.7%. None of 13 deaths occurring during follow-up was related to H.P.T. 78 patients (90.7%) are available for follow-up (av. 85.3 months). 85.9% are normocalcemic (2.2 less than Ca less than 2.6 mmol/l), 5.1% hypocalcemic and 9% hypercalcemic. 61 had late i. P.T.H. assay; i. P.T.H. was appropriate to serum calcium in 78.7% and appropriate to normal serum calcium levels in 90.6% of 53 normocalcemic cases. PMID- 2701817 TI - [Blood transfusion, short perioperative intraportal chemotherapy and recurrence of colorectal cancer]. AB - Carcinomatous tumors usually have a rather slow proliferation rate. However, this process is sensibly accelerated as soon as immunodepressive phenomena occur. Blood transfusions may result in the appearance of a considerable mass of alloantigens and in simultaneous immunomodulation. On the basis of a series of 469 patients, we are able to realize that the intra-and postoperative administration of blood during the curative resection of colorectal cancers produced a poor prognosis. We also followed up subjects who had had chemotherapy via the portal system for one week but no blood transfusion. The prognosis was definitely better in these patients, and proved to be 2 to 3 times as favorable as for patients receiving blood transfusions without chemotherapy. The various results are thoroughly analyzed, the primary aim being the study of the effects of intraoperative portal chemotherapy. This leads to advocating the restriction of blood transfusions, and the use of autotransfusion or hemodilution if required. PMID- 2701818 TI - [Use of nitrates in the symptomatic treatment of pulmonary hypertension]. AB - Symptomatic treatment of pulmonary hypertension aims at reducing right ventricular afterload in order to delay the development of ventricular failure. First trials with nitrates in the treatment of various forms of pulmonary hypertension show positive results in some patients in whom a decrease in the pulmonary pressure and total pulmonary resistance was observed both in acute experiment and chronic nitrate administration. Further studies are required to determine a definite role of nitrates in the symptomatic treatment of pulmonary hypertension. PMID- 2701819 TI - [Possibility of quantitative evaluation of renal function based on the renography alone]. AB - Exploring the possibilities of the renal function evaluation on the basis of the renographic curve alone, a theoretical analysis and clinical investigations were carried out. As a result, some indicators of effective renal plasma flow and an indicator of mean transit time were developed. The methods of calculations may serve for a simplified, screening evaluations of renal function, using a simple two-scintillation probe set, as well as computerized camera. The said calculations might constitute a starting point for developing more precise quantitative methods. PMID- 2701820 TI - [Effect of Zovirax on the course of Varicella-zoster virus (VZV) infections in children with decreased immune response]. AB - In 21 children with weakened immune response++ (18 patients after immunosuppression and/or after radiotherapy because of neoplastic disease, 1 patients with diagnosed hepatitis chronica persistens, 1 patient with streptococcal septicemia and one infant with protein deficiency and severe anemia) Zovirax was applied in treatment of Varicella virus infection. Clinical observation showed a positive effect of Zovirax in treatment of VZV infection which was manifested by a milder course of the infection and disappearance symptoms. Better effects were obtained when the treatment was started in the first 72 hours of infection. PMID- 2701821 TI - [Studies of the mechanisms of spreading of epileptic discharges in the central nervous system]. AB - The process of spreading of epileptic discharges in central nervous system has to be discussed in two points of view; as a propagation of signals in neuronal networks and as a process of dynamics changes in neuronal circuits and nets. On the base of the spreading of afterdischarges between entorhinal cortex and both hippocampi we discussed time and space relations in spreading of epileptic discharges, and automatic analytical methods in localization of epileptic focus. Spreading epileptic discharge is not only the symptom of pathologic function of system but it simultaneously changes the dynamics of system in which it spreads and causes epileptic destabilization of neuronal circuits and nets. The above mechanisms after theoretical investigations play also important role in evaluation of secondary epileptic foci and posttraumatic epilepsy. PMID- 2701822 TI - [The role of reflexes from the coronary vessels in the regulation of the circulatory system]. AB - In the experiments on dogs was investigated participation of coronary vessels in the reflexive regulation of the circulatory system. Electrical, hemodynamic and metabolic heart functions, pressures, and flow in peripheral vessels were measured. Hemodynamic reactions obtained by changes of the perfusion pressure and gas composition of blood in the left coronary artery and in coronary sinus were compared with the activity of cervical baro and chemoreceptors. Results of this investigation indicate that responses initiated by the changes in coronary perfusion pressure were manyfold smaller. Occlusion or decrease of the pressure in the left coronary artery caused pressor effect, which was diminish by myocardial ischemia. Declamping or increase of the perfusion pressure in the left coronary artery was leading to decrease of systemic arterial pressure. This response was next replaced by the pressor effect caused by the rapid myocardial blood flow. In the systemic hypertension blood flow changes in the left coronary artery caused smaller effects than in the normotension. In the hypertension increase of the coronary perfusion pressure initiated significant pressor reaction. Opposite effect was observed with the decrease of coronary perfusion pressure. Decrease of coronary oxygen content moderate pressor reaction in the systemic normotension also in hypertension. In systemic hypotension the depressor reactions was observed. Elevation of the coronary sinus perfusion pressure was correlated with the decrease in the systemic arterial pressure with significant bradycardia. Additional coronary sinus blood arterialisation caused pressor effect in systemic pressure. It possible that the coronary vessels in dogs are the source of the circulatory reflexes which seems possess essential physiological role. PMID- 2701824 TI - [The proximally acting retention complex]. PMID- 2701823 TI - The effectiveness of EMG biofeedback in the treatment of arm function after stroke. AB - The study was designed to evaluate the effect of electromyographic (EMG) biofeedback on the recovery of arm function after stroke. Patients who had impaired arm function and were between 2 and 8 weeks after stroke were randomly allocated to receive either treatment incorporating EMG biofeedback or a control treatment in addition to their routine physiotherapy. The two groups of 20 patients were compared before and after 6 weeks of treatment and at follow-up 6 weeks later. There were no significant differences between the groups before treatment or at follow-up, but at the end of treatment those who received EMG biofeedback scored significantly higher on tests of arm function. Patients with severe impairment were shown to benefit most from EMG biofeedback but there was no difference in response to treatment according to patient's age or side of stroke. Men had higher arm function scores than women before and at the end of treatment, but not at follow-up. PMID- 2701825 TI - [Fluoridated amalgams. Bibliographic review]. AB - A review on fluoride containing amalgam is reported in this paper. The inhibitory effects of fluoride on dental caries are well known for many years. Thus, the incorporation of fluoride to an amalgam restoration prevents the occurrence of marginal caries. Other physical properties of fluoride amalgams such as compressive strength, dimensional changes, creep and corrosion are also reviewed in this paper. PMID- 2701826 TI - [Equipoise: complementation of the biomechanical principles of attachments and the retention complex]. PMID- 2701827 TI - [Study of composite resin adhesion]. AB - The adhesive resistance of the bonding between a same light-cured composite, was determined "in vitro" by a tensile stress test. The bondings were performed among two parts of same composite with and without resin-bonding agent. The variable used was the application or not of the resin bonding agent for enamel and dentin, over the adhering surface of the matrix, obtaining resistance values of 28-30%, compared with the cohesive resistance of the material used, when the resin bonding was utilized. On the other hand, using a composite without the resin bonding agent, the tensile stress resistance values decreased below 10% of the total cohesive resistance informed by the manufacturer. PMID- 2701828 TI - [Usefulness of trans-fontanel ultrasonography in the diagnosis of various pathological changes in the brain of infants. I. Comparison of diagnostic value of USG and CT]. AB - Diagnostic values of ultrasound and CT scan were compared in the group of 50 children with suspected pathologic cerebral lesions. On the ground of results obtained in the 2nd part of the study (118 children) an attempt was made to evaluate in which percentage of the unselected patients the CT scan might be left out and the diagnosis made only using the ultrasound examination. PMID- 2701829 TI - [2 cases of primary microcephaly]. PMID- 2701830 TI - [Outline of the development of pediatric neurology in Poland]. PMID- 2701831 TI - The role of oral rehydration solutions in the children of Europe: continuing controversies. AB - Controversy remains concerning ORS composition in Europe. This centres chiefly upon the sodium level. Solutions with a low sodium content continue to be widely used in Europe. ORS with Na 90 mmol/l when given correctly is safe and effective. However when this solution is prepared incorrectly there is a risk of hypernatraemia. In most of Europe mortality and morbidity from gastroenteritis is now very low. Therefore any change from current formulation must not carry any risk in this regard. The need for bicarbonate or indeed any base in ORS is also controversial. There is a clear need in Europe for controlled trials of ORS solutions of various composition to determine the ideal solution for the children of Europe who have acute diarrhoea. PMID- 2701832 TI - Optimising oral rehydration solution composition in model systems: studies in normal mammalian small intestine. AB - Small intestinal perfusion studies have been carried out in animals to evaluate the role of the individual constituents of oral rehydration solution (ORS), in order to draw some conclusions relating to the optimal composition of ORS. Two commercially available ORS, Dioralyte and Rehidrat have also been compared to the World Health Organisation (WHO) standard solution. Maximum rate of water absorption occurred with the WHO solution and least with Rehidrat. The findings of the perfusion studies suggest that in the normal small intestine, optimal water absorption occurs from a solution containing 60 mmol/l of sodium and 80-120 mmol/l of glucose. The addition of bicarbonate and citrate at concentrations present in ORS does not appear to have a significant effect on water absorption. The addition of glycine and diglycine to the standard ORS reduced the net rate of absorption of sodium and water, probably because of the effect of increased osmoality. PMID- 2701833 TI - Disease-related animal models for optimising oral rehydration solution composition. AB - To optimise the composition of oral rehydration solutions (ORS) for European children is not a simple task. Although controlled clinical trial is ultimately the only way to determine whether a new solution is superior to an established ORS, testing many different formulations is neither feasible nor ethical. Several groups of investigators have evolved the concept of using animal models to test new ORS formulations. Disease-related animal models using perfusion of cholera toxin-treated rat small intestine or experimental rotavirus infection of neonatal rats suggest that optimal water absorption will be obtained by using a hypotonic ORS with a sodium concentration of 50-60 mmol/l and a glucose concentration of 50 100 mmol/l. Addition of citrate or bicarbonate had no benefit with respect to the promotion of water absorption. PMID- 2701834 TI - The role of human perfusion techniques in the assessment of oral rehydration solutions. AB - Early human intestinal perfusion studies provided valuable information on gut transport procession in vivo. Subsequently, similar models have proved a useful means of assessing the efficacy of glucose-electrolyte oral rehydration solutions. In contrast to clinical trials they enable quantification of water and solute movement across the small intestine and, unlike animal studies, results are directly applicable to man. However, limitations exist, including the fact that a short, usually normal, segment of intestine is studied. Recent studies confirm the relationship between oral rehydration solution sodium concentration and sodium movement; the stimulatory effect of glucose on sodium and water movement; and the detrimental effect of high glucose content. Glycine, bicarbonate, citrate and acetate provide little additional benefit for water absorption when added to solutions containing glucose. Preliminary comparative studies of results obtained in the rat and in man show parallels between these models suggesting they may be complimentary methods of assessing new oral rehydration solutions. PMID- 2701835 TI - Optimising oral rehydration solution composition for the children of Europe: clinical trials. AB - Clinical trials testing different oral rehydration solutions (ORS) are reviewed. The effects of individual components and their concentrations are analysed in order to establish margins of safety for the composition of the ideal ORS for children in Europe. Glucose is the solute of choice for ORS and concentrations of 70-140 mmol/l are adequate. Glucose may be replaced by sucrose or glucose polymers. "Low" sodium concentrations (35-60 mmol/l) are advised for rehydration and maintenance in acute non-cholera diarrhoea, for children of all ages, including neonates, and for any degree of dehydration except shock. Although intended for children who are not malnourished, the European ORS should have an adequate potassium concentration (20-30 mmol/l), namely the same concentration as found in WHO-ORS. Chloride concentration depends upon other constituents of ORS, namely sodium and potassium, but the range of 30-90 mmol/l is considered to be adequate. Base or base precursors are not required for correction of acidosis except in the severe cases that always need intravenous replacement. A relatively low osmolality seems advisable. PMID- 2701836 TI - Overview of childhood acute diarrhoea in Europe: implications for oral rehydration therapy. AB - Infant mortality from acute diarrhoea has sharply declined in the last few decades throughout Europe. However, acute diarrhoea is still a very common occurrence in European children, who experience, in their first 3 years of life, approximately 1 episode/year. The commonest agent responsible for infectious diarrhoeas appears to be rotavirus, followed by campylobacter. Although water loss may be high, the mean sodium loss is close to 40 mmol/l of stool in rotaviral diarrhoea, and to 60 mmol/l in diarrhoeas due to invasive pathogens such as campylobacter and salmonella. Larger fluid losses but a somewhat lower sodium loss accompanies non-cholera secretory diarrhoeas, which appear to be commoner in infants than in older children. This evidence indicates that an ORS for European children should have a sodium concentration lower than 90 mmol/l which was primarily intended for use in developing countries. Clearly, the glucose concentration is crucial, as it is now evident that concentrations higher than the recommended 110 mmol/l may lead, particularly in rotaviral enteritis, to worsening of diarrhoea and development of hypernatraemia. Finally, it appears that in Europe the use of commercially available ORS is strikingly low, so that infants and children are often given a variety of "clear fluids", generally inadequate to ensure proper rehydration or maintenance of hydration. Thus an effort should be made not only to devise the "ideal" solution, but also to effectively implement its use. PMID- 2701837 TI - Homeostatic mechanisms in the regulation of plasma osmolality. PMID- 2701838 TI - The role of basal forebrain norepinephrine and the control of extracellular depletion-induced drinking. PMID- 2701839 TI - The role of brain ECF sodium and angiotensin II in sodium appetite. PMID- 2701840 TI - Renin in the control of drinking behaviour in the earliest stages of renal hypertension in the rat. PMID- 2701841 TI - Homeostatic actions of osmoregulatory hormones: clues derived from studies on avian osmoregulation. PMID- 2701842 TI - The molecular biology of circadian rhythms. PMID- 2701843 TI - Birdsong for neurobiologists. PMID- 2701844 TI - A brain-specific transcription activator. AB - We have identified a DNA binding protein, named BETA, that interacts with the same (B) transcriptional regulatory sequence as the known transcription factor NF kappa B. BETA is found only in gray matter throughout the brain, and not in a variety of other rat tissues. Two binding sites for BETA are present adjacent to the promoter of the rat proenkephalin gene. Transfection of primary brain cultures that express BETA, with a reporter gene driven by the SV40 promoter linked to BETA DNA binding sites, results in transcriptional activation. We infer that BETA is a brain-specific transcription activator. PMID- 2701845 TI - Localization and characterization of the binding site for the regulatory subunit of type II cAMP-dependent protein kinase on MAP2. AB - Microtubule-associated protein 2 (MAP2) binds, and is a substrate for, type II cAMP-dependent protein kinase. The structural domain in MAP2 that binds the regulatory subunit (RII) of protein kinase II was identified by expressing fragments of a human MAP2 cDNA in E. coli using the pATH11 vector. Fusion proteins were resolved by SDS-PAGE and transferred to nitrocellulose. The filters were probed with purified bovine heart or brain RII, anti-RII monoclonal antibodies, and 125I-labeled protein A. Binding of RII was localized to a 31 amino acid sequence near the N-terminus of the MAP2 molecule. Fusion proteins containing this fragment bound both heart and brain RIIs in a concentration dependent manner, but bound heart RII with a higher apparent affinity than brain RII. The amino acid sequence of this fragment (DRETAEEVSARIVQVVTAEAVAVLKGEQEKE) is totally conserved between human and mouse MAP2, suggesting an important role for the RII binding site of MAP2 in neuronal function. PMID- 2701847 TI - Characteristics and uses of IL-2 in immunotherapy. PMID- 2701846 TI - A comparison of the effects of chromate, molybdate and cadmium oxide on respiration in the yeast Saccharomyces cerevisiae. AB - Growth of Saccharomyces cerevisiae on non-fermentable medium was more sensitive to inhibition by chromate than growth on fermentable medium. Chromate was selectively toxic against oxygen uptake in cells grown in non-fermentable medium and also induced petite mutations. CdO demonstrated similar but lesser effects on growth and respiration. However, molybdate had little toxicity to yeast non fermentable growth and stimulated oxygen uptake in cells grown in fermentable and non-fermentable media. These results suggest that chromate, a carcinogen, may act more directly against the mitochondria of S. cerevisiae than related chemical species, CdO and molybdate. PMID- 2701848 TI - Regulatory affairs and biotechnology in Europe. II. The CPMP, "High Tech" and Multi-State procedures. AB - This paper describes the EEC regulatory requirements for the preparation and execution of a community concertation "High Tech" procedure and compares this "High Tech" procedure with the Multi-State procedure. According to a decision of the European Commission enforced in July 1987, medicinal products, derived from high technology methods have been grouped in two categories: A. and B. Category A. concerns biotechnology products made by R-DNA techniques and by manipulation of mammalian cells. Category B. comprises all other products made by high technology. Before applying for an EEC marketing licence (e.g. submission for registration) one must ascertain whether a product is most appropriate in Category A. or B. and one should contact a licencing authority at an early stage to discuss the planned submission. Various procedures for submission have to be followed: 1. for the so-called "High Tech" products and especially products derived from biotechnology with therapeutic applications (Category A.), it is mandatory that one of the Member States accepts the submission. 2. The "High Tech" procedure is derived from the so-called "2-country" (Multi-State) procedure, in which for the latter procedure a marketing licence in one of the Member States (except Portugal) is required before application in other Member States. The Multi-State and "High Tech" (other products: Category B.) procedures are optional. When the procedures are started, all Member States concerned are involved in evaluation of full or abbreviated dossiers through mediation of the European Commission represented by the CPMP (Committee for Proprietary Medicinal Products), Brussels, Belgium. No application for a marketing licence of Category A. products is allowed without mediation of the CPMP. For Category B. products the applicant may opt for a national submission in one or more of the Member States without using the "High Tech" procedure. However, after consultation with the competent authority in one of the Member States, a "High Tech" procedure for Category B. products might still be advisable, but the applicant is not required to follow this procedure. Both the "High Tech" and the Multi-State procedure are currently executed by the mediation of a rapporteur, who liaises with the applicant from the start of the "High Tech" procedure. Ideally, the applicant should contact a licencing authority some 6 to 9 months before an application is planned: to ensure that the near future submission is acceptable. The institution of a rapporteur (appointed by the licencing authority in the country from where the procedure has recently been established) is introduced for the Multi-State procedure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2701849 TI - Mechanisms of chiral recognition in xenobiotic metabolism and drug-receptor interactions. PMID- 2701850 TI - Implications of chirality and geometric isomerism in some psychoactive drugs and their metabolites. AB - Many drugs contain a chiral centre, or such a centre is introduced during metabolism of the drug in man and in animals. If a single chiral centre is present, the drug will normally exist as a mixture of two enantiomers, of which one may have quite different pharmacologic and/or toxic effects than the other. Chiral drugs that are used in psychiatry, and some other pharmacologically related drugs are identified, and the implications of the presence of one or two chiral centres in these drugs are discussed. Differences in pharmacologic properties of drug and metabolite enantiomers are identified and discussed. Also reviewed are the properties of some drugs used in psychiatry that both are chiral and display geometric isomerism. PMID- 2701851 TI - The development of concepts of chiral discrimination. AB - Pasteur's conjecture (1860) that biomolecular homochirality arose from a chiral natural force as yet inaccessible in the laboratory was supplanted by Fischer's (1894) "key and lock" hypothesis of stereoselection in enantiomer to diastereomer conversions, whether in the laboratory or in living organisms. Elaborations of the "key and lock" hypothesis by Haldane (1930) and Pauling (1948) have been illustrated and supported with modification by X-ray diffraction crystal structures of enzyme-substrate complexes over the past quarter century. Two types of mechanism for the product diastereoselectivity in the reactions of an enantiomer with an achiral reagent, early proposed, have recent support: one proposes a quasidiastereomeric structure for the enantiomer attacked in the ground state, the other for the corresponding transition state of the reaction. Approaches to the differential biological activity of two enantiomers postulate either the complete binding of each isomer to a chiral receptor site, resulting in diastereomeric complexes with inequivalent bioactivities, or the differential binding of the two isomers to a set of three sites, with which only one isomer is sterically congruent. Biochemical homochirality, based on the chiral stereoselectivity of both biosynthetic and metabolic reactions, derives from the evolutionary pressure for a progressive enhancement of the kinetic efficiency and economy of those reactions. Recently Pasteur has been vindicated in part, and the problem of the original prebiotic enantiomeric excess left outstanding by Fischer has been solved. The unification of the electromagnetic with the weak interaction provided a universal chiral natural force, the electroweak interaction, which favours the chiral series selected during the course of biochemical evolution, both the D-sugars and the L-amino acids. PMID- 2701852 TI - Polarimetric detection in high-performance liquid chromatography. AB - Chiroptical detection for HPLC is particularly useful as a selective detection method for chiral molecules, and in enantiomeric purity determination with partial chiral separation or without chiral separation. The recent development of laser-based polarimeters with microdegree sensitivity has increased the applicability of optical rotation detection in HPLC. The detection limit of these instruments is submicrogram on-column for many chiral compounds in analytical HPLC. A variety of applications of the selective detection of optically active molecules are reviewed. The use of polarimetric detection with partial chiral separation is considered, both as an aid to method development and for enantiomeric purity determination. Finally applications to enantiomeric purity determination without chiral separation are reviewed, with the dual use of nonchirally selective and chiroptical detectors to determine the total amount and optical purity of the analyte. Determinations of chiral purity for samples of high enantiomeric excess are described, which with laser-based instrumentation may give accuracies of better than +/- 1% with sample loadings of 50 micrograms on an achiral column. Applications to the study of enantioselective reactions are also considered, with determination of enantiomeric excess in near-racemates to better than +/- 0.1%. PMID- 2701853 TI - A review of current methods used in the United States for isolating Listeria from food. PMID- 2701854 TI - Serological analysis of the genus Listeria. Its values and limitations. PMID- 2701855 TI - Listeriocins (monocins). PMID- 2701856 TI - Methods to determine the virulence of Listeria strains. PMID- 2701857 TI - Method to determine virulence of Listeria strains. PMID- 2701858 TI - Adequate protection of the public against food-transmitted diseases of microbial aetiology. Achievements and challenges, half a century after the introduction of the Prescott-Meyer-Wilson strategy of active intervention. AB - No dramatic change in the approach to supplying microbiologically safe foods and meals to the consumer occurred immediately upon the introduction, in the 1930's, by S.C. Prescott and K.F. Meyer in the U.S. and Sir Graham Wilson in the U.K. of the principle of taking preventive remedial measures rather than merely examining final product samples. Thus morbidity and the economic impact of food-borne disease of microbial aetiology continued to rise and new food-transmitted pathogens continued to be identified. The 1930 strategy was not implemented until 1970 when food processing specialists in the U.S. launched a similar approach under the new acronym 'HACCP' (hazard analysis: critical control points). This relies on (i) identification, by meticulous ecological studies, of hazardous practices and locations, termed 'critical points' by the new generation; (ii) elimination of such hazards by developing processing techniques designed to control contamination and colonization of foods--also given an innovative term, viz. GMP; (iii) validation of the elaborated procedures by a new stem to the Science of Public Health: risk assessment, perhaps better termed Safety Science; (iv) upon introduction of the validated GMP's monitoring limited numbers of samples--which have become fully representative because of process management- for ecologically valid marker organisms, indicating incidental going-out-of control of manufacture or distribution. This implementation of the Prescott-Meyer Wilson maxim has been given the name longitudinally integrated safety assurance, charmingly acronymized to LISA. Introduction of LISA eliminates all previously existing or perceived difficulties about microbiological target values ('standards') for foods. These can henceforth be empirically assessed from surveys on samples obtained from factories or catering establishments previously inspected for adherence to LISA, deficiencies having, where necessary, been rectified prior to the examination of samples. Unfortunately, a more general adoption of the LISA maxim in food technology occurred at almost the same time as people became concerned about the perceived negative health impact of processing food for safety. This culminated in widespread rejection of foods decontaminated by low dose gamma irradiation. While behaviourial scientists seriously attempt to identify the mechanisms of this anxiety and devise means of reassurance, food scientists should continue to elaborate innovative LISA procedures. In this context three promising areas of research and development are briefly discussed. PMID- 2701859 TI - Drinking water microbiology--new directions toward water quality enhancement. AB - Drinking water microbiology has emerged from decades of relative complacency to recognize there can be major concerns with potable water quality. Many of these issues are a result of an explosion of information on new waterborne agents, treatment problems with raw-source water qualities, biofilm development in some distribution systems and specialized requirements in water quality unique to hospitals and industries. Protozoan cyst survival after some disinfection practices involving surface water impoundments and virus occurrence in poorly protected groundwaters have provided reasons for expanding minimum treatment of surface waters and for requiring disinfection of all groundwaters unless there is a demonstrative data base to support exceptions in treatment requirements. Official monitoring of small water supplies must be increased on a monthly basis and a rapid alert established to inform water plant operators of unsatisfactory water qualities. As an option, application of operational tests to analyse water quality in terms of chlorine residual, turbidity, total coliforms and heterotrophic bacterial counts in small water plant operations should be encouraged. This would provide the operator at remote locations with the opportunity to utilize the information to make necessary treatment adjustments or corrections in water distribution deficiencies promptly and be a supplement to the official regional monitoring program. Application of drinking water alternative sources (bottled water and water from point-of-use treatment devices) should be viewed by the health authorities as only a temporary solution, not as a permanent fix for a public water supply known to present some established health risk to consumers. The public must also recognize that bottled water is not frequently monitored by health laboratories for acceptable quality and the use of home treatment devices places the responsibility of proper maintenance on the user. Microbial quality improvements in drinking water to hospitals and food industries can frequently be achieved through a routine, systematic flushing program for building plumbing networks and associated attachment devices. In other situations, use of booster disinfection or point-of-use devices may provide the important special water quality requirements for certain industrial applications. In any event, these supplemental treatment measures will require careful in-plant monitoring and maintenance to prevent reversals in water quality enhancement. PMID- 2701860 TI - Costs of acute bacterial foodborne disease in Canada and the United States. AB - Bacterial foodborne disease is increasing in industrialized as well as developing countries. For Canada and the United States many millions of cases are believed to occur each year, based on extrapolations of survey data, human enteric isolations and reported foodborne disease cases. The economic impact of such a large number is probably in billions of dollars but the precise figure is difficult to calculate. Medical costs and lost income are easier to determine than losses to food companies, legal awards and settlements, value of lost leisure time, pain, grief, suffering and death. The evaluation of costs at the national level for Canada and the United States based on all available costs for 61 incidents showed that company losses and legal action are much higher than medical/hospitalization expenses, lost income or investigational costs. It was reckoned that on an annual basis an estimated 1 million cases of acute bacterial foodborne illness in Canada cost nearly $1.1 billion and 5.5 million cases in the United States cost nearly $7 billion. The value of deaths was a major contributor to the overall costs especially for diseases like listeriosis, salmonellosis, Vibrio infections, and haemorrhagic colitis. Salmonellosis is the economically most important disease because it affects all parts of the food system, unlike typhoid fever and botulism, which are largely controlled by public health authorities and the food industry. PMID- 2701861 TI - Present state of knowledge on staphylococcal intoxication. AB - Globally, staphylococcal intoxication remains a very common food poisoning. In this review, emphasis is being placed on epidemiological aspects of the problem and the effect of food environment on the survival and growth of staphylococci and production of enterotoxins. The high prevalence of staphylococci in raw foods of animal origin requires effective processing for safety. Man remains a major reservoir for post-process recontamination. The effect of the intrinsic characteristics of foods (pH, water activity, Eh, preservatives competing microbial flora, natural food) and extrinsic parameters of processing and storage (temperature, freezing, irradiation, dehydration, packaging, humidity) on staphylococcal survival, growth and enterotoxin production has been evaluated extensively. While staphylococci can be destroyed easily the enterotoxins can survive practically all food processing. While extreme levels of intrinsic variables can control enterotoxin production, yet the environment of most foods is conductive to staphylococcal growth. Rapid food cooling, refrigeration and consumer, food handler and processor education remain the key to staphylococcal food poisoning prevention. PMID- 2701862 TI - Magnesium status in chronically haemodialyzed patients: the role of dialysate magnesium concentration. AB - Serum magnesium concentration (sMg) increases in advanced renal failure, and in patients on regular dialysis treatment Mg status mainly depends upon the dialysate Mg concentration (dMg). In fact in uraemia, whereas the intracellular (muscle and blood cell) Mg content seems similar to that of normals and not to be influenced by dMg, the extracellular fluid Mg level as well as Mg content in some organs (skin, bone, etc) parallel the dMg. In the present paper, Mg status and its clinical implications in patients on regular dialysis treatment were therefore reviewed in an attempt to define an optimal dMg. Up to now, dialysis patients have been kept hypermagnesaemic on the assumption that a high sMg suppresses parathyroid hormone secretion (PTH), although this hypothesis has not been confirmed in later papers. On the other hand, more recent clinical studies suggest the possibility of noxious effects of Mg overload on various organs. Therefore, future trends should be towards reducing dMg to such values as will allow sMg to fluctuate across the normal range both in the interdialytic and intradialytic period. The more widespread use of Mg-containing phosphate binders implies the need of a further reduction of dMg which, however, carries the risk of symptomatic postdialytic hypomagnesaemia. Thus, since Mg is retained in uraemia and should be removed by dialysis, it is difficult to associate the use of Mg-containing drugs with an optimal dMg while avoiding severe hypermagnesaemia and hypomagnesaemia. PMID- 2701863 TI - Magnesium in pregnant women and the newborn. AB - In this article the importance of Mg for pregnant women and fetal outcome is reviewed. The physiological changes of Mg-containing body fluids and of tissues are discussed. Mg supplementation during pregnancy seems to be necessary and the efficacy on maternal health and on the newborn are reported. Serum Mg levels decrease during pregnancy and there is a 25% increase of renal Mg excretion. Mg supplementation has a positive effect, with reduced incidence of hospital admission and preterm labour, while the gestational age of the fetus is longer. Convulsions may occur in newborns with hypomagnesaemia. Hypermagnesaemia of the newborn following MgSO4 infusions to toxaemic mothers has been reported. PMID- 2701864 TI - Haemolytic uraemic syndrome and the Thomsen Friedenreich antigen. AB - In three children with haemolytic uraemic syndrome (HUS), evidence of red cell polyagglutinability due to Thomsen Friedenreich antigen (T-antigen) exposure was demonstrated. This was suspected after difficulties in ABO typing and was confirmed using specific antisera. Further supportive evidence included elevation of plasma sialic acid, alteration in red cell surface charge and evidence of T antigen exposure in the renal biopsy specimen of one patient. Although involvement of this antigen in the pathogenesis of HUS has been associated with a high mortality, all three children have made a complete recovery. With early recognition and subsequent avoidance of plasma products, prognosis of this condition may be improved. PMID- 2701866 TI - Renal lesions in young rats induced by Salmonella enteritidis endotoxin. AB - Sepsis in newborns and infants is a major pediatric problem often associated with renal dysfunction. The present report deals with changes in renal tissue induced by Salmonella enteritidis endotoxin in 10- and 28-day-old Sprague-Dawley rats. Our studies revealed a 90% lethality within 24 h of 0.1 mg/kg and 35 mg/kg S. enteritidis endotoxin injection in 10- and 28-day-old rats, respectively. The 10- and 28-day-old animals received a single intraperitoneal injection of the 90% lethality dose and were sacrificed at different intervals for histopathological evaluation of kidneys by light and electron microscopy. The glomeruli showed visceral epithelial and endothelial cell swelling and polymorphonuclear leukocyte and platelet accumulation in the capillary lumina. Cortical and medullary tubules showed edematous separation, mild focal epithelial cell damage and focal intertubular hemorrhage. Renal sections of 28-day-old experimental rats showed increased numbers of polymorphs in the glomerulus and enlarged mesangial matrix. These sections also showed an increase in the number of hemorrhagic foci in 10 x field compared with the 10-day-old experimental rats. Endothelial cells of renal vasculature showed cytoplasmic swelling, vacuolization, autophagic vesicle formation and presence of secondary lysosomes. Changes in the endothelial cells of peritubular microvasculature were extensive, resulting in focal degeneration and partial loss of endothelial lining. These studies show that infant rats are extremely sensitive to S. enteritidis endotoxin requiring 1/350 the dose given to young adults to induce histopathological changes in kidney; the endothelial cells of microvasculature appear to be the primary targets of endotoxic injury irrespective of age. PMID- 2701865 TI - Glomerulitis induced by cationized bovine serum albumin in the rat. AB - The effects of injected native and cationized bovine serum albumin (BSA- and BSA+ respectively) were evaluated in rats which subsequently received anti-BSA. Thrombocytopenia, low creatinine clearance (Ccr), increased proteinuria, capillary swelling, mild tuft necrosis and BSA+ deposits in glomeruli resulted within 24 h of BSA+ injection. Later BSA+ produced mesangial expansion glomerular capillary wall (GCW) thickening and deposits of BSA+ accompanied by rabbit anti BSA and rat anti-BSA which correlated well with small mesangial, subendothelial and subepithelial electron-dense granular accumuli. These latter enlarged considerably after the injection of anti-BSA. BSA- controls showed minimal or no lesions. The disappearance from the blood (t1/2) of a single dose of immune complexes (IC) prepared with chromatography-purified, radioiodinated anti-BSA - BSA- and BSA+ was determined in another group of rats. The t1/2 of BSA- anti-BSA was 42.8 h (95% confidence: 39.8-46.2) while that of BSA+ anti-BSA was 52.5 h (48.1-57.8). These results suggested that serum sickness glomerulitis developed only in rats injected with BSA+, due to in situ IC which presumably grew by accretion of foreign anti-BSA. Circulating IC may have developed and colocated with the latter, with dissociation and recombination at these sites. It is postulated that the functional-immunomorphological changes and the slow removal of cationized IC reported herein could be explained by the highly positive net charge of the injected antigen. PMID- 2701867 TI - Proteinuria in a child with sialidosis: case report and histological studies. AB - A 9-year-old body with sialidosis had nephrotic-range proteinuria. Histological studies demonstrated massive distension of renal cells, particularly glomerular visceral epithelial cells, by cytoplasmic vesicles which contained material reactive with concanavalin A and wheat-germ agglutinin. In addition, some glomeruli exhibited segmental mesangial thickening or glomerulosclerosis. Ultrastructurally, focal detachment of visceral epithelial cells from the underlying glomerular basement membrane was observed. We postulate that glomerular visceral epithelial cell dysfunction may underlie the proteinuria and focal glomerulosclerosis exhibited by this patient. Hyperfiltration, as suggested by the child's elevated creatinine clearances, may be a contributing factor. PMID- 2701868 TI - Immunosuppressive therapy in the nephrotic syndrome in children. AB - The high incidence of remission and prevention of relapse of minimal change nephrotic syndrome (MCNS) in children, produced by corticosteroids is reviewed. With the introduction of corticosteroids over 30 years ago and the increased expertise in their use, the mortality rate has been reduced to less than 5%. There is no justification for a clinical trial to test the effect of corticosteroids in inducing remission, but the need remains to evaluate methods of administration in order to achieve therapeutic benefit with minimum toxicity. Children with frequently relapsing, steroid-dependent MCNS will usually enter remission following treatment with an alkylating agent such as cyclophosphamide. In about 50% no further relapse in experienced. The results of recent experience using cyclosporin A immunosuppression suggest a beneficial effect associated with steroid responsiveness. Approximately 30% of children with focal segmental glomerulosclerosis enter remission following treatment with corticosteroids. Some 30% require dialysis and transplantation within 5 years of diagnosis and immunosuppressive therapy to prevent deterioration of renal function is probably justified. PMID- 2701870 TI - Urology. PMID- 2701869 TI - Carbohydrate metabolism in uremia. AB - Abnormalities of insulin and glucose metabolism, namely glucose intolerance, inhibition of insulin secretion and insulin resistance, are present in children with chronic renal failure. Insulin resistance is universal among children with end-stage renal disease and may be caused by uremic toxins accumulated because of reduced renal function. The normal response of the beta cell is to enhance insulin secretion to overcome the insulin resistance. In patients with secondary hyperparathyroidism, this increase in insulin secretion is inhibited, resulting in glucose intolerance. Presence of glucose intolerance may be responsive for the growth retardation in uremic children. Improvements in glucose tolerance correlate with improvements in linear growth in uremic children. Further research should be directed towards investigation of the mechanisms by which abnormal energy utilization may affect growth in uremia and development of indices of glucose metabolism as predictors of growth in uremia. PMID- 2701871 TI - Glomerular diseases in children. "The Iranian experience". AB - A total of 411 children, aged from 0.3 to 18 years, suffering from glomerular diseases, were studied by renal biopsy between 1976 and 1985. The clinical presentation included nephrotic syndrome (79% of cases), renal failure (43%), and arterial hypertension (38%). In all, 177 cases presented with primary nephrotic syndrome; all had complicated courses and most were either corticosteroid dependent or -resistant. Only 26.6% had minimal change disease on renal biopsy; 56.5% had focal-segmental sclerosis; and immunofluorescent deposits were observed in half of the group. Acute poststreptococcal (36 cases), mesangiocapillary (80 cases), and lupus (34 cases) glomerulonephritis occurred frequently; IgA glomerulopathy (10 cases) and haemolytic uraemic syndrome (6 cases) were uncommon. Glomerular crescents were observed in 71 cases. These observations illustrate the types of glomerular diseases seen in Iranian children. PMID- 2701872 TI - What is the value of determining the presence and measuring the level of circulating immune complexes in children with kidney disease and what methods should be used for their measurement? AB - What is the value of determining the presence and measuring the level of circulating immune complexes in children with kidney disease and what methods should be used for their measurement? PMID- 2701873 TI - Amoxicillin promotes vaginal colonization with adhering Escherichia coli present in faeces. AB - This study is aimed at a better understanding of the pathogenesis of urinary tract infection (UTI) by examining factors influencing the bacterial ecology of the genital tract. It comprises two sets of experiments in a monkey model. In the first the persistence and transmission between individuals of a P-fimbriated Escherichia coli (strain DS17) in faeces was examined and in the second we studied the influence of amoxicillin on the occurrence of this strain in the vagina. Orally administered E. coli DS17 was shown to spread to cage mates and to persist in the gut for at least 17-18 months. One of four monkeys so colonized developed three separate UTIs with the DS17 strain. The second set of experiments comprised four other monkeys, who either harboured the E. coli DS17 strain in the faeces and/or in small amounts in the vagina, probably through contamination during defaecation. Amoxicillin induced a persistent vaginal E. coli DS17 colonization in nine of ten experiments. The study thus shows that uropathogenic E. coli may persist for long time in the faeces and that, in this situation, amoxicillin may promote an abnormal, vaginal E. coli colonization similar to that characteristic of females prone to recurrent UTI and often preceding manifest urinary infections. PMID- 2701874 TI - Urology. PMID- 2701875 TI - Immunology. Active participation by visceral tissue in the immune response. PMID- 2701876 TI - Optic neuritis and its significance. PMID- 2701877 TI - The addition of bromocriptine to long-term dopa therapy in Parkinson's disease. AB - This open trial is a study of the effect of adding bromocriptine (BC) to the treatment of patients who had taken a dopa-containing preparation (LD) for many years. Sixty-five patients entered the trial at an average age of 66.6 years. The mean duration of Parkinson's disease was 12.74 years and LD had been taken by one half of them for more than 10 years and by an additional 27% for longer than 5 years. The duration of treatment with BC exceeded 2 years in 45% of cases and the average dose of BC was 19.27 mg/day. On the Hoehn and Yahr scale 70.8% of patients were classified as between stages II and IV, 24.6% were in stage I and 4.6% were in stage V. Dopa-induced involuntary movements were observed in 60% of patients at the beginning of the trial but were present in only 25% at the completion, due to the dopa-sparing effect of BC allowing a reduction of the dose of LD by an average of 34%. End-of-dose failure was reduced only slightly and on off oscillations were not influenced by the addition of BC to LD. Tremor, rigidity, akinesia and dysarthria improved in 22% of all patients but BC offered no beneficial effect on the various gait disorders of Parkinson's disease. The conclusion of the study is that 47.7% of patients felt that the addition of BC to LD had reduced their involuntary movements and the disabilities of their disease. PMID- 2701878 TI - Epilepsy in Gowers's understanding, a century ago. PMID- 2701879 TI - The Royal College of Surgeons of England. PMID- 2701880 TI - Fractures of the scaphoid. AB - We may think that we know all we need to know about fractures of the scaphoid. The reverse is true. Most of what we have been taught (and which we therefore believe we know) is unproved and much of it is actually untrue. Many of the key questions about diagnosis and management remain unanswered. PMID- 2701882 TI - [Endomyocardial fibrosis]. AB - Since the first case of endocardial resection I have performed in 1971, many similar cases have been operated on in the world, principally in Equatorian areas such as Africa, Northeastern Brazil and Southern India. In caucasian race, cases are less frequent but are similar to the other ones: in fact, endomyocardial fibrosis which was described by Davies in 1948 in Africa and Loffler's fibroplastie endocarditis, associated with hypereosinophylia (1936) are similar and respond to the same treatment. Our purpose in this paper is to present the long term results of the 34 cases operated at the Broussais Hospital in Paris since 1971. There were 21 males and 13 females, mean age 32 years (8 to 64), 22 were caucasians, 12 black africans. The sites of resection were 8 right ventricular, 4 left and 22 biventricular. Valve replacement was monovalvular in 11 cases and bivalvular in 23, mainly with bioprostheses. There were 7 early deaths and 6 late deaths, 2 after 30 months and 4 after 45, 60, 84, 85 months; only 2 of them were due to cardiac causes. We have not observed any case of recurrence. All surviving patients were in class I/II of N.Y.H.A. despite the fact that 4 have had valvular replacement due to alteration of the bioprosthesis. PMID- 2701881 TI - [Repair of cutaneous tissue loss of the arm. Development of the principles and technics]. AB - Few sectors of reconstructive surgery have evolved as quickly over the past few years as the use of skin flaps, especially those used to cover losses of substance in the upper limb. This development is due to the increasing concern of surgeons about: 1) ensuring selective coverage of higher quality (the teguments used for the hand must be supple, thin and sensitive); 2) having reliable techniques; 3) reducing operating times and the duration of treatment. PMID- 2701883 TI - [Epidemiology of leprosy]. PMID- 2701884 TI - [Murine leprosy]. PMID- 2701885 TI - [Some properties of suppressor macrophages induced with Mycobacterium leprae vaccine in mice]. AB - Splenic macrophages induced by intravenous injection of Mycobacterium leprae vaccine (ML-vaccine) consisting of heat-killed M. leprae (HK-ML; 6 x 10(8)/ml) and live M. bovis BCG (10 mg/ml) were studied for their suppressive activity against lymphoproliferative response to concanavalin A (Con A). Spleen cells (SPCs) of host mice received 0.1 ml of the vaccine 2 weeks before harvest showed markedly reduced Con A mitogenic response. Such phenomenon was seen also in the case of mice which were given live BCG (1 mg) alone, but was not in the case of injection with HK-ML (6 X 10(7) alone. When splenic macrophages which were cultivated on a microtiter well for a monolayer culture was studied for the suppressive activity against Con A mitogenic response to splenic T cells, potent suppressive activity was found in mice treated with ML-vaccine as well as live BCG alone, but not in mice given HK-ML alone. Activity of the suppressor macrophages per spleen in ML-vaccine-treated mice was nearly the same as in mice given BCG alone. However, the suppressor activity per individual macrophage was considerably higher in ML-vaccine-treated mice than in the case of BCG-injected mice. The two macrophages produced almost the same intensity of chemiluminescence in response to triggering by phorbol myristate acetate, and thereby, indicating that they were activated in a similar level. When resident peritoneal macrophages with a weak suppressive activity against lymphoproliferative response were incubated in the presence of ML-vaccine, their suppressor activities were markedly augmented.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701886 TI - Suppression of Con A response of mouse lymphocytes with unique M. leprae glycolipid. PMID- 2701887 TI - [My career in the outpatient treatment of leprosy]. PMID- 2701888 TI - [Clinical evolution of chronic lymphocytic leukemia in Richter's syndrome]. AB - Over a few year period chronic lymphocytic leukemia (CLL) is mainly characterized by stable course and only in the small per cent of patients it evolves into the aggressive form. Richter's syndrome has been diagnosed at our clinic in a patient who was for 6 years controlled and treated for CLL. In that period the patient was doing well and the out-patient treatment of CLL was being performed together with regular check-ups according to hematologic findings and clinical status of the patient. The patient was capable of work. Clinical investigation was undertaken because of the sudden aggravation of the general state and x-ray of the chest which pointed to the existence of tumorous shadow in the right lower pole of hilus. Although a complete CLL remission was established cytologic diagnosis of the newly formed tumour pointed to non-Hodgkin lymphoma of high malignity (centroblast lymphoma). Course of disease was terminated lethally very soon, because lymphoma of high malignity did not respond to polychemotherapy. PMID- 2701889 TI - [The neuroleptic malignant syndrome]. AB - Malignant neuroleptic syndrome (MNS) together with agranulocytosis represents a relatively rare but the most difficult idiosyncratic reaction to the therapy with neuroleptics. The most prominent symptoms are as follows: hyperthermia, muscular rigidity, vegetative dysfunction and disturbance in consciousness. MNS usually occurs unexpectedly and unpredictably during the first days of the treatment with neuroleptics and most frequently it takes a remarkably rapid course. About 15-20% of the cases are lethal. The aim of the successful treatment is the early recognition of MNS preferably in the prodromal phases which can by the employment of adequate therapy interfere the evolution into the full clinical picture, i.e. to the lethal outcome. Efficient therapy includes: 1) interruption in the administration of neuroleptics, 2) regulation of water disbalance and electrolyte metabolism, 3) application of drugs which activate dopaminergine transmission insufficiency (bromocriptine, predominantly) or other disturbances induced by it in other neuronal systems which is obtained by the administration of anticholinergic antiparkinsonics and benzodiazepines (GABA effect), and 4) electroconvulsion. All aspects of MNS from the standpoint of actual level of knowledge are presented in this paper. The authors' own experience with the nine MNS cases registered at their clinic is also set forth. By the improvement in diagnostic and therapy no death due to MNS has been observed over the last few years. PMID- 2701890 TI - [Multicenter study of the therapeutic efficiency of glycvidone (Beglynor)]. AB - Results of the multicentric investigation of therapeutic efficacy of glycvidon were presented in this paper. The investigation was performed in 15 centres and comprised 768 patients with type 2 diabetes mellitus. A considerable improvement in metabolic regulation was attained which led to the reduction in glycemia level on an empty stomach and after the meal, to the reduction or elimination of glycosuria and to the significant decrease in glycolized hemoglobin. A parallel improvement in serum lipid levels was also registered. Tolerance of glycvidon was good and hypoglycemic incidents were very rare and as a rule of mild degree. PMID- 2701891 TI - [Indications for CT examination of the head in infants and young children]. AB - 308 CT scans of the head in children below 3 years of age were analysed. 70% of children were younger than 1 year. The most common findings in this age group were subdural effusions (usually no wider than 10 mm) and hydrocephalus. The authors conclude that the indications to CT scan should be more rigorous because of the high dose of the ionizing radiation applied. Ultrasonography should be the initial investigation in the children with persistent fontanellae+ as it has a similar diagnostic efficiency without harmful effect to the child body. PMID- 2701892 TI - [History and activities of the Association of Children's Friends. II]. PMID- 2701893 TI - [Evaluation of nifedipine and captopril as adjuvant drugs in the standard treatment of chronic heart failure]. AB - A group of 25 patients in III-IV haemodynamic period of chronic stagnant circulatory failure (pzns) in clinical conditions for two weeks were administered digoxin and furosemide (DF), then for the following two weeks DF therapy was combined with nifedipine (N), in the following 4 weeks the DFN therapy was combined with captopril (DFNK), in the last two weeks DFN therapy was applied again. The authors used the following doses per 24 h: D--0.29 +/- 0.96 mg, F- 13.5 +/- 4.8 mg, N--40.8 +/- 12.8 mg and K 75.0 +/- 28.8 mg. Each cycle of the therapy was followed by a precise clinical evaluation, analysis of the function of the left ventricle by means of two-dimensional echocardiography, the evaluation of the tolerance of physical effort and the evaluation of chest radiograms. Besides, blood was studied for the concentrations of potassium, sodium, chloride, urea, creatinine, uric acid, haematocrit value and pH value. The addition of nifedipine to the classical therapy did not give significant improvement in the clinical condition, haemodynamic parameters and the tolerance of physical effort in patients with pzns. In comparison to DF period, the use of captopryl brought about a statistically significant increase (p less than 0.05) in ejection fraction (EF) from 43.0 +/- 15.3% up to 45.2 +/- 11.7%, in effort power from 36.5 +/- 16.4W up to 47.1 +/- 17.5W, in effort duration from 3.5 +/- 1.6 min. up to 4.5 +/- 1.8 min. and a significant decrease (p less than 0.05) in body weight from 68.1 +/- 13.8 down to 66.9 +/- 13.0 kg and heart volume from 1175.5 +/- 487.3 cm3 down do 1074.6 +/- 380.9 cm3. One could notice, though statistically not significantly (p greater than 0.05) an increase in stroke volume index and cardiae index. Besides, the authors noticed a tendency to an increase in potassium concentration in blood serum. Eliminating captopryl caused fast regression of positive haemodynamic effects, decrease in physical effort tolerance, and clinical condition resumed the condition observed in the period of DFN therapy. PMID- 2701894 TI - [Doppler measurements of blood flow in the portal system of healthy volunteers]. AB - A group of 50 healthy volunteers underwent the measurement of blood flow in the protal vein and in the splenic vein by means of the Acuson 128 sector ultrasound probe 3.5 MHz connected with the Doppler pulsation wave. The authors strictly obeyed the principle on directing the ultrasound beam at the vessel examined at an angle not larger than 25 degrees. The frequency spectrum obtained was used for calculating the medium speed of flow, and the diameter of the vessel found in the tw-dimension picture was used to calculate the surface of the cross section of a vessel. The blood flow was calculated by multiplying the medium flow speed by the surface of the cross-section of a vessel. The flow in the portal vein amounted to 853 +/- 130 ml/min., and the flow in the splenic vein amounted to 327 +/- 141 ml/min. The flow in the portal vein was best correlated with the body mass, and the flow in the splenic vein with the volume of the spleen. PMID- 2701895 TI - Intracellular fatty acid trafficking and the role of cytosolic lipid binding proteins. PMID- 2701896 TI - Cyclic fatty acids: natural sources, formation during heat treatment, synthesis and biological properties. PMID- 2701897 TI - Molecular immunology: gateway to the future. PMID- 2701898 TI - The cloning and characterization of interleukin-7. PMID- 2701899 TI - New concepts in the interaction between T cells and bacteria. PMID- 2701900 TI - Molecular analysis of primary T cell involvement in the idiotypic network utilizing immunoglobulin-derived peptides. PMID- 2701901 TI - Engineered antibodies: present and future. PMID- 2701902 TI - Improving on nature: antibody-targeted enzymes. PMID- 2701903 TI - Natural killer cells and tumor immunity. PMID- 2701904 TI - Structure and function of C3. PMID- 2701905 TI - The presentation of antigen by MHC class II molecules. PMID- 2701906 TI - The membrane attack pathway of complement. PMID- 2701907 TI - Structure of perforin and its role in cytolysis. PMID- 2701908 TI - Clinical developments in AIDS: 1988-89. PMID- 2701909 TI - Myasthenia gravis. PMID- 2701910 TI - Processing and presentation of antigens to class I restricted T lymphocytes. PMID- 2701911 TI - Experimental evaluation of the net "Dallop" covered with collagen as the dural substitute. AB - Evaluation of the usefulness of the net "Dallop" produced by Tricomed Lodz covered with collagen to the dural defects reparation was analysed. This new original product of Lodz Technical University was compared with widely used in neurosurgery "Zenoderm" produced by Ethicon and "Duratexol" produced by Czechoslovakia. The trial was conducted on 38 rabbits: 4 as a control group (just an original dura sutured after incision with Mersilk Ethicon sutures), 19 with implanted the net "Dallop" covered with collagen, 11 with the "Zenoderm" and 4 with the "Duratexol". Animals were sacrificed after 3, 14, 30 or 90 days after surgery. There were no significant differences between all analysed groups in clinical, macroscopical and morphological investigations. No negative local reactions in histopathological evaluation of the net "Dallop" covered with collagen were observed. The results of our investigations show that the net "Dallop" covered with collagen seems to be the "Zenoderm" and the "Duratexol" dural substitute. PMID- 2701912 TI - [Subarachnoid hemorrhage and intracerebral hematoma in injury of the middle meningeal artery (aneurysma spurium)]. AB - Traumatic lesions of meningeal arteries represent the typical cause of the acute epidural hematoma. Under certain circumstances, however, they may be the origin of space-occupying hemorrhages with only an intradural extent, e.g. subdural or intracerebral hematomas. We present a case of a temporal lobe hematoma with an additional subarachnoid hemorrhage. This gave rise to the suspicion of a spontaneously ruptured cerebral aneurysm that might have caused the patient's accident. Preceding the evacuation of the hematoma, cerebral angiography ruled out the suspected vascular malformation, but revealed a pseudoaneurysm of the middle meningeal artery close to a skull fracture. Intraoperatively, this lesion proved to be the source of the bleeding which was exclusively directed towards the intradural space. Presented is a review of the relevant literature regarding atypical hematomas secondary to meningeal artery lesions and traumatic aneurysms of these vessels. PMID- 2701913 TI - Brain abscess as a cause of infant hydrocephalus. Case report. AB - The authors report on a case of hydrocephalus caused by brain abscess in a four months-old girl. After repeated punctures and antibiotics administration extirpation of abscess was necessary. The child recovered with only slight neurological deficit. PMID- 2701914 TI - [Nicolai Guleke--the founder and pioneer of neurosurgery in Thuringia]. AB - After the representation of the biographical data and stages of development in the life of Prof. Nikolai Guleke (25th April 1878 to 4th April 1958) it is shown on the basis of his services as a director of the Surgical University Clinic in Jena how he deserved particularly well of the development of neurosurgery. Besides his skills in the surgical-technical field his close co-operation with the then director of the Neurological Clinic of the Jena University, Hans Berger, is appreciated as well as his scientific work, summarised in Volume III/1 of the ten volumes comprising surgical teachings by Kirschner "Interventions in the Cranium, Brain, at the Vertebral Column, the Spinal cord and the Branches of the N. trigeminus". Nikolai Guleke is considered to be an outstanding personality in the history of surgery of our country. PMID- 2701915 TI - Neonatal jaundice in infants of diabetic mothers. AB - 357 IDMs and 20 healthy newborns of non-diabetic mothers were examined at term for body measurements, red blood cell count, serum bilirubin, cord blood insulin and blood glucose during the first postnatal week. The stage of maternal diabetes did not influence the course of neonatal bilirubin levels, but the IDMs had prolonged and higher bilirubinaemia compared with the controls. Hyperbilirubinaemia was found to be most prominent in newborns with an increased birthweight/length ratio and was not simply related to macrosomia (LGA). These infants had significantly lower blood glucose concentrations immediately after birth, whereas cord blood insulin was found to be identical between the IDM sub groups. Bilirubinaemia in heavy for length infants was slightly correlated to haematocrit. For the pathogenesis of hyperbilirubinaemia in IDMs induction of heme oxygenase (due to a lack of energy provision following a phosphorylation disorder) is discussed. Nutritional support (early feeding, glucose infusions) does not affect the course of bilirubinaemia. PMID- 2701917 TI - Perspectives of neonatology. In honour of Bent Friis-Hansen. PMID- 2701918 TI - Disturbance of fluid and electrolyte transport in cystic fibrosis epithelia. AB - Studies of the disease CF suggest that the basic defect is related to impaired electrolyte movement in the epithelia of a variety of organs with exocrine function. The disturbances of electrolyte secretion in the organs classically involved in CF range from 1) a decrease in secretion- or uptake of chloride ions in all the organs studied; 2) an increase in sodium uptake in nasal airway epithelium and 3) a decrease in bicarbonate output of the pancreas. In this review an overview is presented of the expression of the CF defect, the abnormalities of fluid and electrolyte secretion in each CF affected organ are considered in more detail with particular emphasis on the hormonal and neuronal (dys)regulation of iron transport systems in epithelial cells. PMID- 2701916 TI - Postocclusive reactive hyperaemia of cutaneous blood flow in premature newborn infants. AB - Reactive hyperaemia, which occurs after a period of arterial occlusion is the result of an autoregulatory mechanism, involving local factors and autonomic nerve system control. To determine this autoregulatory mechanism in cutaneous blood flow in premature newborns measured the cutaneous reactive hyperaemia response after a 1 min occlusion, using a diode laser Doppler flowmeter applied to the skin. Twenty-four infants with a gestational age ranging from 25 to 37 weeks and a postnatal age of 0.3 to 72 days were studied. The reactive hyperaemia response is described by the parameters maximal cutaneous blood flow (Vmax), the time to reach maximal flow (tmax), the time taken for blood flow to return to baseline following Vmax (t(end)) and the % increase in cutaneous blood flow above preocclusional level (overshoot). A cutaneous reactive hyperaemia response could be elicited in all infants. Following occlusion the Vmax was 2,640 +/- 1,050 mV (mean +/- SD), the tmax was 7.6 +/- 3.9 sec (mean +/- SD), the t(end) was 35.6 +/ 14.6 sec (mean +/- SD) and the overshoot was 74.6 +/- 34% (mean +/- SD). A negative correlation was found between hematocrit and tmax (r = -0.62, p less than 0.01). No influence of postconceptional age, postnatal age, skin and rectal temperature, incubator temperature, weight, and transcutaneous oxygen tension on the reactive hyperaemia parameters could be found. We conclude that reactive hyperaemia of cutaneous blood flow can be elicited in premature newborn infants irrespective of postconceptional age, and that the hematocrit is inversely related to the time to reach maximal flow after occlusion. PMID- 2701919 TI - The molecular basis of chloride channel dysregulation in cystic fibrosis. AB - The opening and closing of chloride (Cl-) channels in the apical membrane of epithelial cells is regulated by hormones, neurotransmitters and enterotoxins (intestine) acting through a variety of intracellular messengers, including cyclic nucleotides (cAMP, cGMP), calcium (Ca) and diacylglycerol (DAG). The chloride impermeability of epithelial membranes observed in cystic fibrosis (CF) patients does not result from a defect in the Cl- conducting properties of the channel or in channel recruitment but stems either from a defect in a key regulator of the channel, presumably a phosphoprotein, or from the hyperactivation of a channel closing mechanism, presumably a protein phosphatase or a down-regulating protein kinase (i.e. protein kinase C). In vitro phosphorylation of isolated intestinal brush border membranes has revealed the existence of a 25,000 molecular weight proteolipid (p25) acting as cosubstrate for both cGMP- and cAMP-dependent protein kinases and cross-reacting with antibodies directed against the cytoplasmic tail of the band 3 anion exchanger from erythrocytes. The putative role of p25 in Cl- channel regulation and its relationship to an unidentified GTP-binding protein recently implicated in Cl- channel activation is discussed on the basis of a regulatory model indicating potential sites of the CF defect at a molecular level. PMID- 2701920 TI - Prenatal diagnosis and genetic counseling of cystic fibrosis. AB - The number of DNA markers at the chromosome 7-locus of the putative CF gene has markedly increased in recent years, also as a result of intensive research into the possible "candidate" gene. In studies of families with one or more affected children, 97.5% of families are now fully informative, allowing a prenatal diagnosis by chorionic villus sampling in the 10th week and DNA-analysis, which will usually give now a diagnosis with a remaining risk of less than 1%. The microvillar enzyme test in amniotic fluid after amniocentesis in the 18th week will remain an alternative for couples who have a high prior risk, but are either not informative at DNA analysis, or where no information on a (deceased) index case (previous affected child) is available. The risk for a wrong classification is in the order of a few percent (in a 1:4 prior risk case) and careful discussion of the limitations are needed when this test is applied to cases with a lower prior risk. The linkage disequilibrium established for a number of RFLP's (Restriction Fragment Length Polymorphisms), as detected by various probes and various restriction enzymes around the CF locus has opened the possibility to refine the risk estimation of heterozygosity for individuals outside families with CF-affected children. The presence of certain haplotypes may change the risk for being CF heterozygote from +/- 1:7 to 1:250, as compared to a population risk of +/- 1:25.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2701921 TI - Epithelial cell dysfunction in cystic fibrosis: implications for airways disease. AB - An important pathophysiologic factor in CF airways is the failure to clear poorly hydrated secretions. The water deficit in CF mucous secretions can now be ascribed to a fundamental defect of epithelial cell regulatory processes which promotes sodium reabsorption from surface liquids and interferes with chloride secretion onto the luminal surface. In addition, it is now known that CF airway epithelial cells oversulfate high molecular weight glycoconjugates, both secreted and cell surface-associated. Oversulfation of glycoconjugates may contribute to the altered clearance properties of CF airways mucus and in addition could favor colonization of airways by organisms such as P. aeruginosa. PMID- 2701922 TI - Endobronchial infection in cystic fibrosis. AB - In symptomatic patients with cystic fibrosis, the recovery of bacteria in an inflammatory exudate from the lower respiratory tract is strong evidence of endobronchitis. It is not known when this chronic infection begins, the etiologic agents during infancy or the mechanism of evolution from Haemophilus influenzae and Staphylococcus aureus to Pseudomonas aeruginosa. Antibiotic administration to "suppress" the infection in relatively well patients is an unproven benefit. During an exacerbation of bronchitis, administration of appropriate antibiotics decreases sputum bacterial density and is accompanied by decreased amounts of indicators of inflammation in sputum: pulmonary function improves, particularly that reflecting medium to small airway status. In the future aggressive diagnostic procedures will be followed by therapeutic and prophylactic antibiotic administration conducted in a manner to minimize emergence of antibiotic resistant bacteria. Adjunctive therapy, to minimize those aspects of the host response which inflict lung damage, will become standard. PMID- 2701923 TI - The pathophysiology of the pancreatic defect in cystic fibrosis. AB - Studies of the postnatal development of the pancrease in CF infants show a failure of acinar development and an increase in lumen volume with accumulation of secretory material within the pancreatic ducts. Our evaluation of functional changes within the exocrine pancreas are consistent with the pathologic findings. Impaired pancreatic fluid secretion appears to be a primary phenomenon of CF. We have shown that pancreatic secretions from CF patients also contain significantly higher concentrations of protein in comparison with pancreatic function-matched controls. Since total protein output is not increased, hyperconcentration of protein appears to be a direct result of a primary defect of fluid secretion. Protein hyperconcentration appears to predispose CF patients to protein precipitation and obstruction within small pancreatic ducts which, in turn, produces pancreatic acinar atrophy and fibrosis Our studies suggest that both bicarbonate and chloride transport within pancreatic ducts account for deficient fluid secretion in the pancreas of CF subjects. PMID- 2701924 TI - Hepatobiliary pathology in patients with cystic fibrosis. AB - Overt liver disease in cystic fibrosis is a rare condition. Only 1-5% of all patients show a severe disturbance of the liver cell function or portal hypertension. In contrast, liver architecture is much more often disturbed at post mortem examination. The experience is that liver pathology increases with age which will result in rising numbers of patients in the future parallel to the increasing life expectancy of the patients. Bile plugs are commonly found in the portal tract and probably represent the essential abnormality of the liver in CF. Recently new methods have been developed for the investigation of the bile synthesis which will be helpful in the understanding of the CF defect in the liver. PMID- 2701925 TI - Cystic fibrosis--from lung damage to symptoms. AB - Respiratory symptoms in cystic fibrosis are both local and systemic. The local symptoms include cough, sputum, wheezing, haemoptysis and breathlessness, while systemic symptoms of malaise and fever occur with pulmonary infection. There are also interactions between respiratory and gastrointestinal systems in producing symptoms of malaise and weakness and these also contribute to the secondary psychological and social problems that a number of patients with cystic fibrosis experience. These local respiratory symptoms can be attributed in part to lung damage, but are also a manifestation of the CF defect itself. Similarly, lung damage, allergy, haemodynamic and nutritional changes all contribute to the symptom of breathlessness. Further improvement in symptoms in the future will come not only from limiting the lung damage but also from therapy aimed at reversing the CF defect itself. PMID- 2701926 TI - Relation between essential fatty acid metabolism and gastrointestinal symptoms in cystic fibrosis. AB - Studies in our laboratory have supported the hypothesis, that the basic defect in cystic fibrosis increases the metabolism of essential fatty acids and thereby gradually gives rise to essential fatty acid deficiency, which is a well documented finding in most cases with this disease. Both the increased metabolism -giving high liberation of arachidonic acid and its metabolic products, i.e. different eicosanoids--and the subsequent essential fatty acid deficiency will cause gastrointestinal symptoms and the sequence of this development will mirror the natural history of the disease. Clinical data and results from animal research are discussed in relation to gastrointestinal symptoms and signs of cystic fibrosis. PMID- 2701927 TI - Strategies and perspectives in treatment of respiratory infections. AB - Bronchopulmonary infections in CF have a number of special features. The pathophysiology is determined by consequences of the basic CF defect and interactions with host defence systems, leading to chronic inflammation induced by Staphylococci and subsequently Pseudomonas. This results in lung tissue damage, various complications and eventually respiratory insufficiency. Policy of treatment is to combat infectious exacerbations and lung tissue destruction as much as possible. Factors in optimal treatment such as strategies, indications for therapy and selection of antibiotics are discussed. PMID- 2701928 TI - Gene mapping in cystic fibrosis and its clinical applications. AB - Current techniques in molecular genetics have permitted the localisation of the mutation causing cystic fibrosis to chromosome 7q31, and allowed isolation of very tightly linked markers. It is possible to offer early prenatal diagnosis, carrier testing, and alteration of risk of unaffected partners in most cases. However, community-wide definitive carrier testing and new methods of treatment await the isolation of the gene. PMID- 2701929 TI - Gastrointestinal dysfunction and its effects on nutrition in CF. AB - Prevention of malnutrition, a consequence of elevated energy requirements, increased losses and low caloric intake, is one of the main goals in the treatment of cystic fibrosis. Caloric stool losses, catch-up growth and an elevated energy expenditure, even in the absence of overt lung disease and malabsorption, have led to recommendations for a caloric intake of 120-150% of the recommended daily allowances. A high energy intake with a fat content of at least 40 calorie % and adequate pancreatic supplementation has shown to improve growth and median age of survival. As a rational treatment of the fundamental disturbance in cystic fibrosis, a decrease in chloride permeability across epithelia, is not yet available, treatment should be concentrated on adequate nutritional support in combination with optimal correction of those gastrointestinal abnormalities including faecal bile acid loss, small intestinal abnormalities, pancreatic insufficiency, hormonal abnormalities and disturbances in gastrointestinal motility, which may aggravate maldigestion and malabsorption. PMID- 2701930 TI - [Pharmacokinetics and antimicrobial effect of cefminox in serum and ascitic fluid for experimental purulent peritonitis in mice]. AB - An appropriate choice of antibiotics plays an important role in the treatment of purulent peritonitis. We examined the pharmacokinetics and antimicrobial effect of cefminox (CMNX) on experimental purulent peritonitis made by intraperitoneal injection of E. coli and/or B. fragilis in mice from elimination of bacteria in peripheral blood and ascitic fluid. 1) E. coli in blood and ascitic fluid decreased within one or two hrs after intravenous injection of CMNX or latamoxef (LMOX) in a dose of 25 or 100 mg/kg. The bacteria-elimination effect of CMNX was superior to that of LMOX. 2) Comparing with the effect of LMOX, B. fragilis in ascitic fluid acceleratively decreased in shorter period by the intravenous administration of CMNX. This indicated that peritoneal transfer of CMNX was better than that of LMOX. 3) Clearance of E. coli and B. fragilis from blood was accomplished by single dose (25 mg/kg) intravenous administration of CMNX, whereas it was not by the same dose of LMOX, resulting in LD50 of CMNX and LMOX were 5.0 and 39.3 mg/kg, respectively. Thus, we should select some antibiotics which shows good clearance of the causative organisms from blood and ascitic fluid as well as antimicrobial effect as a therapeutics for acute purulent peritonitis caused by E. coli and/or B. fragilis. PMID- 2701931 TI - Osteoclast-like giant cell tumor of the pancreas associated with cystadenocarcinoma. AB - Osteoclast-like giant cell tumor is a very rare type of pancreatic malignancy, and no more than 20 cases have been reported in the English literatures. A case of this tumor associated with cystadenocarcinoma is reported. This giant cell is undistinguishable on light microscopy from osteoclast of bone and correct diagnosis of this unusual tumor is important because of its relatively poor prognosis. PMID- 2701932 TI - Molecular characterization of the cysJIH promoters of Salmonella typhimurium and Escherichia coli: regulation by cysB protein and N-acetyl-L-serine. AB - The cysJIH promoter regions from Salmonella typhimurium LT7 and Escherichia coli B were cloned and sequenced. Primer extension analyses showed that the major in vivo transcription initiation site in S. typhimurium is located 171 nucleotides upstream of the cysJ start codon. Minor start sites were found 8 and 9 nucleotides downstream of the major site. In vivo transcription initiation in E. coli was found to occur at a single site 66 nucleotides upstream of the cysJ start codon. Primer extension studies also indicated that chromosomal cysJIH transcription is stimulated by sulfur limitation and repressed by growth on L cystine. Paradoxically, in strains carrying plasmids containing the S. typhimurium cysJIH region, the highest levels of primer extension products were found with RNA from cells grown on L-cystine, even though levels of the proteins encoded by cysJ and cysI were normally repressed. In vitro transcription runoff studies with DNA template from the S. typhimurium cysJIH promoter region showed synthesis of a product originating at the major in vivo start site, which was dependent on the presence of purified cysB protein and either O-acetyl-L-serine or N-acetyl-L-serine. N-Acetyl-L-serine was 10- to 30-fold more active than O acetyl-L-serine as an in vitro inducer of cysJIH transcription. PMID- 2701933 TI - Nucleotide sequence of a hop stunt viroid (HSVd) isolate from grapefruit in Israel. PMID- 2701935 TI - The nucleotide sequence of a human smooth muscle alpha-actin (aortic type) cDNA. PMID- 2701934 TI - Evidence for a class of very small introns in the gene for hypoxanthine-guanine phosphoribosyltransferase in Schistosoma mansoni. AB - The single copy gene for the hypoxanthine-guanine phosphoribosyltransferase (HGPRTase) of the parasitic trematode, Schistosoma mansoni, contains seven introns, the first four of which are only 31, 33, 42, and 32 bases in length. These are the smallest introns ever discovered in a non-viral nuclear gene coding for protein. These very small introns possess the canonical GT...AG splice site sequences but lack the branching sequence, the secondary structure, and the minimum size of approximately 50 bases believed to be required for the splicing of eucaryotic mRNA precursors. Evidently, a somewhat different splicing mechanism for the transcripts of these very small introns is necessary. Their discovery within the genes of helminths raises theoretical considerations for the evolution of introns in eucaryotes. PMID- 2701937 TI - Molecular defects in the non-expressed H-2 E alpha genes of the f and q haplotypes. AB - The expression and sequences of the mouse MHC class II genes, E alpha f and E alpha q, have been studied to determine the molecular basis for their defective expression. Previous work in our laboratory showed that H-2f and H-2q mice produce no detectable E alpha protein. Northern blot analysis confirms previous results showing normal amounts of E alpha f message and a 100-fold reduction in E alpha q mRNA. Despite that observation, the rates of transcription of both defective E alpha genes, measured by nuclear run-on transcription assays, are comparable to that of the normally expressed E alpha k gene. The nucleotide sequences of the E alpha f and E alpha q genes reveal mutations generating premature translation stop codons in both genes. A single base substitution has created the stop codon TGA at amino acid -2 in the E alpha f leader sequence. A nucleotide insertion at codon 64 in the second exon of the E alpha q gene results in a frame shift and a premature stop codon at amino acid residue 69 of a mature E alpha protein. The low steady state level of E alpha q mRNA may be correlated with the unusual size distribution of the RNA, possibly due to altered RNA processing. PMID- 2701936 TI - Avian tropomyosin gene expression. AB - Sequence analysis of overlapping fragments from a quail genomic library has revealed a tropomyosin gene consisting of 13 exons spaced over about 18 kilobase pairs of DNA. Skeletal muscle and smooth muscle transcripts share the same 5' untranslated sequence and may initiate from the same promoter. However, the regions encoding amino acids 39-80 and 258-284 are specific to each muscle type. The two sets of exons encoding these regions undergo mutually exclusive alternative splicing in a tissue-specific manner as determined by Northern blots and S1-nuclease protection. Similarly, the 3' ends of the transcripts are different in skeletal muscle and smooth muscle, and each contains two polyadenylation signals which appear to be utilized in vivo. The avian alpha tropomyosin gene is not expressed in cardiac muscle. The sequence of the gene shows great homology with other muscle-specific tropomyosins and includes a region homologous to the amino terminus of nonmuscle tropomyosins. PMID- 2701938 TI - Nucleotide sequence of human cDNA coding for a lipoprotein lipase (LPL) cloned from placental cDNA library. PMID- 2701939 TI - Nucleotide sequences of influenza A virus RNA segment 7: a comparison of five isolates. PMID- 2701940 TI - Rudimentary phosvitin domain in a minor chicken vitellogenin gene. AB - We have determined the nucleotide sequence and the derived amino acid sequence of the phosphoprotein-encoding region of the chicken vitellogenin III gene. The sequence of this minor vitellogenin could be aligned with exon 22 up to exon 27 of the previously sequenced major vitellogenin II gene (van het Schip et al., 1987). The exon 23 and 25 sequences are rich in serine codons (26% and 41%, respectively), and this region encodes at least one of the small egg yolk phosphoproteins. The major egg yolk phosphoprotein, phosvitin, is encoded by the analogous region in vitellogenin II. Comparison of the vitellogenin II and vitellogenin III sequences shows a great reduction in the size of the putative exon 23 of the latter (321 base pairs as opposed to 690). The number of serine codons is also drastically reduced from 124 in exon 23 of the vitellogenin II gene to 28 in vitellogenin III. The grouping of synonymous serine codons, as has hitherto been observed in sequenced vitellogenin phosphoproteins, has been maintained in vitellogenin III. A putative asparagine-linked N-glycosylation site which was conserved in the chicken vitellogenin II and the Xenopus laevis vitellogenin A2 gene, at the beginning of exon 23, is also present in vitellogenin III. The two chicken vitellogenins show a low conservation in the phosphoprotein-encoding region (average 33%, at the protein level) compared to that in the peripheral sequences (58% identity), which indicates that it is a rapidly evolving domain of the vertebrate vitellogenin gene. PMID- 2701941 TI - Amplification of the multidrug resistance gene in some chloroquine-resistant isolates of P. falciparum. AB - Resistance of Plasmodium falciparum to chloroquine shares features with the multidrug resistance (MDR) phenotype of mammalian tumor cells. We report here the sequence of pfmdr, the P. falciparum homolog of mdr. We show that pfmdr is amplified in some chloroquine-resistant parasites but not in any of the sensitive isolates examined and that pfmdr transcript levels are increased. The gene is located on chromosome 5, and in one chloroquine-resistant line with an amplified pfmdr gene, chromosome 5 is greatly enlarged. The chromosome heterogeneity is due to varying copy numbers of different-sized pfmdr-containing amplicons. The existence of an mdr gene in P. falciparum and its amplification in some chloroquine-resistant lines greatly adds to the circumstantial evidence that pfmdr mediates chloroquine resistance in these lines. PMID- 2701942 TI - A novel type of human alpha-amylase produced in lung carcinoid tumor. AB - A novel type of alpha-amylase was detected in a lung carcinoid tissue after surveying the cDNA library constructed from this tumor mRNA. Nucleotide sequence analysis showed that the amylase expressed in this carcinoid tumor has 13 and 6 amino acid substitutions when compared with salivary amylase (Amy1) and pancreatic amylase (Amy2), respectively. The nucleotide sequence homologies of cDNAs between this carcinoid amylase and amy1, amy2 are 97.5% and 98.2%, respectively. The nucleotide sequence comparison strongly suggests that this new amylase is the product of the amy3 gene that has been detected in human genome [Emi et al., Gene 62 (1988) 229-235] PMID- 2701943 TI - Alternative processing of mRNAs encoding mammalian chromosomal high-mobility group proteins HMG-I and HMG-Y. AB - The high-mobility-group protein HMG-I is a well-characterized nonhistone chromosomal protein that is preferentially expressed in rapidly dividing cells, binds to A. T-rich regions of DNA in vitro, and has been localized to particular regions of mammalian metaphase chromosomes. We isolated eight cDNA clones encoding HMG-I and its isoform HMG-Y from a human Raji cell cDNA library and detected blocks of nucleotide sequence rearrangements in the 5'-untranslated regions of these clones. In addition to this leader sequence variation, five of the eight cDNA clones had either a 33- or 36-base-pair in-frame deletion in their open reading frame (ORF); we found that this shortened ORF encodes the HMG-Y protein isoform. We present evidence that the 5'-untranslated-region and ORF heterogeneity of the cDNA clones is the result of alternative processing of RNA transcripts from a single functional gene. Several additional but probably nonfunctional HMG-I or HMG-Y gene copies exist in the human genome; we isolated and partially sequenced one of these pseudogenes and found that it is a processed HMG-Y retropseudogene. PMID- 2701944 TI - Structural organization of the gene for the alpha 1 chain of human type IV collagen. AB - The complete exon size and distribution pattern in the gene for the alpha 1 chain of human type IV collagen was determined. Clones covering 145 kilobases (kb) of genomic DNA including 100 kb of the gene itself as well as 25 kb upstream and 20 kb downstream of the gene sequences, respectively, were isolated from lambda phage and cosmid libraries. The overall gene structure was determined by endonuclease restriction mapping and R-loop analyses and all exon sizes by nucleotide sequencing. The characterized clones contained all the coding sequences except for exon 2 whose sequence was determined after its amplification by the polymerase chain reaction. There were four gaps in the intron sequences; the exact size of the gene is unknown. The entire gene is at least 100 kb in size and contains 52 exons whose size distribution is completely different from that of the genes for fibrillar collagens. In the -Gly-X-Y- coding region there are three exons of 99, 90, and 45 base pairs (bp) each and two exons of 27, 36, 42, 51, 54, 63, and 84 bp each. The rest of the exons have sizes between 71 and 192 bp in the collagenous region. About one-half of the -Gly-X-Y- repeat coding exons start with the second base for the codon of glycine, whereas the other half starts (with two exceptions) with a complete glycine codon. The distribution of split versus unsplit codons is uneven in that the first 19 exons of the gene start with a complete codon. The gene contains repetitive sequences in several regions. A 185-nucleotide segment containing 40 copies of CCT flanked by poly(C) and poly(T) sequences was shown to be located adjacent to an exon. The gene has previously been shown to be located head-to-head to the alpha 2(IV) collagen gene at the distal end of the long arm of chromosome 13, such that the first exons of the two genes are separated by as little as 42 bp (Poschl, E., Pollner, R., and Kuhn, K. (1988) EMBOJ. 7,2687-2695; Soininen, R., Huotari, M., Hostikka, S. L., Prockop, D. J., and Tryggvason, K. (1988) J. Biol. Chem. 263, 17217-17220). The results demonstrate that the human alpha 1(IV) collagen gene has a structure distinctly different from the genes for fibrillar collagens and also that it is considerably larger than any collagen gene characterized to date. PMID- 2701945 TI - Expression of cDNA clones encoding the thymocyte antigens CD1a, b, c demonstrates a hierarchy of exclusion in fibroblasts. AB - The CD1 gene family encodes at least three proteins: CD1a, CD1b, and CD1c, which are coexpressed on cortical thymocytes and a number of T cell leukemias. On thymocytes, CD1a forms noncovalent complexes with CD1b and CD1c, and a disulfide linked heterodimer with CD8. This report describes the isolation and characterization of cDNA clones encoding the CD1a, CD1b, and CD1c Ag. Cotransfection of the cDNA was used to investigate the formation of intermolecular heterodimers by CD1a with other members of the CD1 gene family and with CD8. No intermolecular heterodimers were observed during transient expression in COS cells. However, an exclusion hierarchy was observed between members of the CD1 gene family when two or more members of the family were cotransfected into COS cells. PMID- 2701946 TI - Nucleotide sequence of the human coronavirus HCV 229E mRNA 4 and mRNA 5 unique regions. PMID- 2701948 TI - Complete sequence of the bovine beta-lactoglobulin cDNA. PMID- 2701947 TI - Integral membrane protein located in the apical complex of Plasmodium falciparum. AB - We describe the cloning of a novel antigen of Plasmodium falciparum which contains a hydrophobic domain typical of an integral membrane protein. This antigen is designated apical membrane antigen 1 because it appears to be located in the apical complex. Apical membrane antigen 1 appears to be transported to the merozoite surface near the time of schizont rupture. PMID- 2701949 TI - Structure and partial genomic sequence of the human retinoblastoma susceptibility gene. AB - This report describes the genomic organization of the human retinoblastoma susceptibility locus. This gene spans approximately 200 kb of DNA within human chromosome 13, band q14. The previously determined cDNA sequence comprises 27 exons, ranging in size from 31 bp to 1873 bp, and 26 introns, ranging in size from 80 bp to 70,500 bp. We have mapped the positions of the exons and the positions of the recognition sites for six restriction endonucleases. We also present the sequence of 9.2% of the locus (18,335 bp), including approximately 200 bp of intron sequence immediately flanking each exon. This map of a wild-type allele will form the foundation for future studies of mutant, oncogenic alleles at this locus. PMID- 2701950 TI - Nucleotide sequence of the chloroplast large subunit rRNA gene from Chlamydomonas reinhardtii. PMID- 2701951 TI - Olfactory marker protein gene: its structure and olfactory neuron-specific expression in transgenic mice. AB - Olfactory marker protein (OMP) genomic clones were isolated from a Charon 4A phage lambda rat genomic library. A 16.5-kilobase (kb) fragment of the rat genome containing the gene was isolated and characterized. Sequence analysis of the gene showed the absence of introns and the lack of CAAT and TATA boxes in the 5' flanking region. The transcription initiation site was mapped, and two sites 55 and 58 base pairs upstream of the ATG were observed. The 5' flanking region is rich in G+C residues and contains a G+C-rich motif as well as direct and inverted repeats. Functional OMP regulatory sequences were demonstrated in transgenic mice. An 11-kb chimeric gene was constructed in which the coding region for OMP was replaced with that for Thy-1.1. In Thy-1.2 mice carrying this transgene, Thy 1.1 was expressed solely by olfactory receptor neurons and their axons and terminals in the olfactory bulb. PMID- 2701952 TI - Response of the human body to impact dynamics and vibration. PMID- 2701953 TI - Transient vibrations caused by heel strike. AB - Transient vibrations caused by heel strike and travelling vertically through the body have been monitored using accelerometers taped to the skin. A correction for skin movement based on the transmissibility function is described. The average velocity between the foot and the head for the heel-strike transient is 220 m/s. This velocity is greatest in the legs, 610 m/s, and least in the spine, 90 m/s. Shock absorption occurs mainly in the legs and to a lesser degree in the spine. PMID- 2701954 TI - Shock absorption by the spinal column in normals and in ankylosing spondylitis. AB - The transmission of heel-strike vibration using skin-mounted accelerometers was measured in normal subjects and subjects with ankylosing spondylitis. In normal subjects transmissibility was enhanced between 5 and 13 Hz and attenuated at frequencies above 15 Hz. In ankylosing spondylitis transmissibility was enhanced at 4 Hz but less so between 5 and 13 Hz and little attenuation was observed at the higher frequencies. This difference is expected in view of the pathological changes occurring in the spinal column in ankylosing spondylitis. The results support the hypothesis that the normal spinal column has to bend in order to absorb vibrations with a frequency greater than 15 Hz. PMID- 2701955 TI - Foot strike and the properties of the human heel pad. AB - Many force-plate records of human locomotion show an impulse (the foot strike) shortly after ground contact. The authors' hypothesis is that this results from the rapid deceleration of a mass (the 'effective foot') under forces which compress the heel pad. The quantitative implications are investigated through an illustrative calculation. The observations used are (a) the peak force reached in foot strike (b) the vertical velocity of the foot immediately before ground contact and (c) the properties of the heel pad in compression. Data for (a) and (b) are available in the literature; measurements for (c) are presented here. The deductions are: (a) the time taken to reach peak force is about 5.4 ms, which agrees with published measurements; (b) the mass of the effective foot is about 3.6 kg. The effective foot thus includes a substantial portion of the leg: this seems reasonable. The models used for the calculations clarify the relationship between the foot strike and the shock wave, which it generates. PMID- 2701956 TI - Biodynamics of the wrist in rheumatoid arthritis--the enigma of stiffness. AB - The wrist has been moved rhythmically in the horizontal plane by sinusoidal torques provided by a printed motor. Measurements have been made on normal subjects and subjects with rheumatoid arthritis. Both groups exhibited a resonance, the oscillations being greatest when the applied torque was of certain frequency. In both groups the resonant frequency fell to approximately the same constant value when the torque was raised. While the main relationships were similar a somewhat lower torque resulted in the lowering of resonant frequency in the patients. The relationship between applied torque and peak velocity at resonance was also studied. For a given torque the motion was greater in the patients. No objective signs of increased viscous or elastic stiffness were demonstrable at the wrist in patients with rheumatoid arthritis. PMID- 2701957 TI - A conjecture on the interface mechanics in fractures based on the interpretation of impulse vests. AB - Time-domain tests for monitoring fracture healing, undertaken by the authors and workers elsewhere, show a repeatable characteristic signal behaviour which is difficult to explain using the linear models prevailing in biomechanics. The paper proposes a simple non-linear model which, it is believed, will reproduce the observed signal behaviour and is consistent with the biphasic stiffness model previously identified in static mechanical testing for monitoring of fracture healing. This, in turn, correlates with the two stages of callus formation in the accepted biological model. PMID- 2701958 TI - A technique for quantitative assessment of three-dimensional motion with applications to human joints. AB - A technique is developed for quantitative measurement of general three dimensional motion, and this technique is applied to the kinematics of anatomical joints. The spatial locations of three orthogonal points representing coordinate frames on each member of the joint are measured during motion of the joint by photo encoders of a three-dimensional mechanical pointer. Kinematic calculations are used to derive, from the experimentally collected data, the six orthogonal components of the motion of one member relative to the other. The accuracy of this technique is presented. Applications to the knee and ankle are discussed. PMID- 2701959 TI - Non-linear three-dimensional finite element analysis of a cementless hip endoprosthesis. AB - In this finite element study the stresses between a stem component of a cementless hip endoprosthesis (Young modulus of Co-Cr-Mo) and the human femur were calculated for two different loading types. Linear and non-linear models were used to simulate the interface implant bone. Two models, a stem with a porous coated surface over the entire length and a stem with a porous coated surface in the proximal region were compared regarding the load transmission to the femur. An additional calculation of an 'isoelastic' stem (Young modulus of cortical bone) was done to show the influence of the stem stiffness. A porous coated surface over the entire length causes principal shear stresses up to 2.75 MPa in the distal-medial region during level walking. The highest compressive stresses were calculated in the proximal-lateral region as 1.5 MPa in cancellous bone. A more physiological load transmission is obtained by limiting the coated area to the proximal region. All stresses in the two models are lower than experimentally evaluated strengths in the interface between implant and bone. A strong influence of the Young modulus of the stem material on the interface stresses was found. An 'isoelastic' stem causes compressive stresses in the proximal-lateral region whose values exceed the experimental strength of cancellous bone. PMID- 2701960 TI - The geometry of the knee in the sagittal plane. AB - A geometric model of the tibio-femoral joint in the sagittal plane has been developed which demonstrates the relationship between the geometry of the cruciate ligaments and the geometry of the articular surfaces. The cruciate ligaments are represented as two inextensible fibres which, with the femur and the tibia, are analysed as a crossed four-bar linkage. The directions of the ligaments at each position of flexion are calculated. The instant centre, where the flexion axis crosses the parasagittal plane through the joint, lies at the intersection of the cruciates. It moves relative to each of the bones during flexion and extension. The successive positions of the flexion axis relative to a fixed femur and to a fixed tibia are deduced. The shapes of articular surfaces which would allow the bones to flex and extend while maintaining the ligaments each at constant length are calculated and are found to agree closely with the shapes of the natural articular surfaces. The calculated movements of the contact point between the femur and the tibia during flexion also agree well with measurements made on cadaver specimens. The outcome is a geometric simulation of the tibio-femoral joint in the sagittal plane which illustrates the central role played by the cruciate ligaments in the kinematics of the knee and which can be used for the analysis of ligament and contact forces. PMID- 2701961 TI - Synthesis and antiinflammatory/analgesic activities of N-heterocyclic carboxamides of thiopyrano-1,2-benzothiazine. AB - We report the synthesis of N-heterocyclic carboxamides of 5-methyl-4-oxo-2,3,4,5 tetrahydrothiopyrano [3,2-c][1,2]benzothiazine 6,6-dioxide, their antiinflammatory and analgesic activities and the attempts to obtain a corresponding sulfoxidate series. Compounds (II c) and (II l) showed a good antiinflammatory activity which is comparable to that of piroxicam. No compound showed any significant analgesic activity. PMID- 2701962 TI - First-derivative UV spectrophotometric assay of domperidone. AB - Domperidone in pure form and in a number of pharmaceutical formulations (Motilium) has been determined in 0.5-N sulphuric acid by employing first derivative at 294 nm and zero-order at 284 nm spectrophotometric modes. The results obtained by utilizing the first derivative procedure were 99.98 +/- 0.47, 101.70 +/- 0.53, 101.70 +/- 0.53 and 101.15 +/- 1.23 for the tablets, oral suspension, drops and suppositories respectively. In a similar way the results obtained for the zero order technique were 105.38 +/- 1.01, 101.70 +/- 2.57, 108.56 +/- 1.16 and 102.23 +/- 3.37 in the order. The standard addition method was adopted to evaluate the accuracy of the first derivative spectrophotometric mode. PMID- 2701963 TI - Diuretic agents related to indapamide. III--Synthesis and pharmacological activity of N-(4-chloro-3-sulfamoylbenzamido)-1,2,3,4-tetrahydroquinolines and 1,2,3,4-tetrahydroisoquinolines. AB - A series of N-(4-chloro-3-sulfamoylbenzamido)-1,2,3,4-tetrahydroquinoline++ + (IV 1) and isoquinoline (IV-2) have been synthesized and their diuretic and antihypertensive activities evaluated. While none of the test compounds was found to be provided with antihypertensive properties, most of them displayed a diuretic activity comparable to (IV-2 a) or higher (IV-1 a,b) (IV-2 c) than those of indapamide and clopamide, taken as reference drugs. PMID- 2701964 TI - Synthesis and antileukemic activity of 1-[(quinolizidinylalkyl)amino]4/7-R thioxanthen-9-ones. AB - Fifteen 1-(quinolizidinylalkyl)amino derivatives of thioxanthenone bearing different substituents on position 4 and 7 were prepared and tested in mice against lymphocytic leukemia P 388. These compounds were inactive or displayed only borderline activity (compounds 1, 10, 15). PMID- 2701965 TI - New derivatives of 5-nitroimidazole: synthesis and antiparasitic activity. AB - The synthesis and the antiparasitic evaluation of twelve new 5-nitroimidaole derivatives has been carried out. The most effective compounds were the less hydrophilic pyridinium and imidazolium salts (IV), (V) and (X), and above all the tetrahydropyridine derivatives (XII) and (XIII). PMID- 2701966 TI - Design and evaluation of a controlled-release theophylline tablet. Preliminary communication. AB - A 300 mg controlled-release theophylline formulation was developed as a tablet prepared by wet granulation using the acrylic resins Eudragit S 100R and Eudragit RSPMR. The tablet was compared with a marketed controlled-release capsule using in vivo and in vitro tests. The in vitro dissolution of theophylline from the tablets followed an apparent zero order kinetics. The in vivo comparison was performed in a cross over fashion in four healthy volunteers who received one tablet or capsule every 12 hours during seven days. The results showed no statistically significant differences in AUC, tmax and in plasma theophylline concentrations at the different times. Nevertheless, concentrations were lower after the administration of the tablets than when the volunteers received the capsules. On the other hand, the apparent elimination half lives obtained after the tablets were longer than with the capsules. An excessive retardation in the release of theophylline from the tablet could be responsible for this fact. PMID- 2701967 TI - Immunotherapy and immunity to cancer: cellular mechanisms. PMID- 2701968 TI - Tumor-associated macrophages. PMID- 2701969 TI - Evasion of host responses in metastasis: implications of cellular resistance to cytokines. PMID- 2701970 TI - Monoclonal antibodies in cancer diagnosis. PMID- 2701971 TI - Characterization and molecular biology of tumor-associated antigens. PMID- 2701972 TI - Monoclonal antibodies in cancer therapy. PMID- 2701973 TI - Prognostic factors in lymphomas: the contribution of immunophenotyping and molecular studies. PMID- 2701974 TI - Gonadotrophin vaccines. PMID- 2701975 TI - Safety of anti-fertility vaccines. PMID- 2701976 TI - Immunotherapy and fertility control by immunization against gonadotrophin releasing hormone. PMID- 2701977 TI - Development of vaccines targeting the zona pellucida. PMID- 2701979 TI - Sperm and seminal plasma antigens relevant to contraceptive vaccine development. PMID- 2701978 TI - Sperm surface antigens involved in mammalian fertilization: their role in contraceptive vaccine development for humans. PMID- 2701980 TI - Autoimmunity to sperm antigens. PMID- 2701981 TI - Autoantibodies, alloantibodies and reproductive success. PMID- 2701982 TI - The cytokine basis for cross-talk between the maternal immune and reproductive systems. PMID- 2701983 TI - Immunology of the neonate. PMID- 2701984 TI - Cancer. PMID- 2701985 TI - Reproduction. PMID- 2701986 TI - [Split line patterns in the mandible after transposition of the insertion of the masseter muscle in the adult rabbit]. AB - With the aim of studying in the fibrous structure of the compact bone, as revealed by the split-line technique, unilateral surgical transposition of the masseter muscle from the masseteric fossa to the central area of the mandibular body below the molar teeth was performed in seven adult rabbits. Six months later the animals were killed, their mandibles were removed, cleaned and then decalcified. Split-lines were made on the lateral surface of both the control and the operated side of the mandible. Myotransposition induced alterations in the split-line patterns; they showed to be entangled and disorganized, which mean structural changes in the bone itself. PMID- 2701987 TI - [Morphometric and stereologic study of changes in the submandibular gland of mice with hypervitaminosis A]. AB - Daily administration of 150 IU vitamin A/gram of body weight in mice, during 10 days, led the authors to observe: submandibular glands showed acini of slightly reduced size, with lower cells whose contours were not always sharp and containing smaller number of cytoplasmic granules. The nuclei of the acinar cells were reduced in volume. The granulose ducts were similar to those of the controls in size but showed signs of degeneration as well as cell nuclei of reduced volume. The striated ducts were smaller than those of the controls, while the excretory ducts were dilated, with lower cells and nuclei of reduced volume. General examination showed that the hypervitaminotic animals had more abundant connective stroma than the controls. The glandular structures were studied morphometrically and estereologically. PMID- 2701988 TI - ["In vitro" evaluation of the action of various cavity varnishes]. AB - The authors studied in vitro the capacity of FORP-USP cavity varnishes, COPALAINE (Prodonto), COPALITE (H. J. Bosworth Co.), CAVITINE (SS WHITE) and UNIVERSAL (SS WHITE) to promote impermeabilization. The tests were done by the use of filter paper and the impermeabilization was measured by the Rhodamine B stain infiltration. The FORP-USP cavity varnishes Copalaine and Copalite were more effective in promoting impermeabilization. PMID- 2701989 TI - [Some functional aspects of the temporomandibular joint]. AB - The authors emphasize the some functional characteristics of the Temporomandibular join, TMJ, and were made comparative study of the auscultatory and sphymografic techniques to TMJ examination. The findings shown that the auscultatory technique furnished important dates to preliminary diagnosis of the TMJ disfunction. PMID- 2701990 TI - [Loss of interproximal periodontal tissue. A clinical solution with construction of a removable acrylic resin appliance]. AB - One of the problems of difficult solution in clinic are the tissue lost from periodontic surgery procedures. The purpose of this survey is to help find the solution of this problem, and we show a case where the patient has great interdental tissue lost after surgery and was solucionated with an acrylic resin appliance. The clinic results prove the efficiency of the appliance, diminishing or having the hole esthetic and phonetic problem solucionated, besides the low cost of its confection and also allows the patient to have a good plaque control. PMID- 2701991 TI - [Reconstruction of laryngeal function after laryngeal operations. Report of 17 cases]. PMID- 2701992 TI - [Uses of pectoralis major flap in tumors of the head and neck region]. PMID- 2701993 TI - [Correlation of changes in compound action potential (CAP) tuning curves and cochlear lesion in guinea pigs after explosion]. AB - The purpose of the present study was to investigate the sensitivity of compound action potential (CAP) tuning curves to changes of the cochlear status in guinea pigs after explosion and their ability to reflect specific histological variations. The results were as follows: 1. The CAP tuning curves were abnormally broad and the Q 10 dB values were reduced by a factor of 1 after explosion, indicating wider tuning. 2. The degree of broadening of the CAP tuning curves seemed to increase as the hair cell loss increased. 3. After explosion, the tip of the tuning curve shifted to frequencies significantly higher or lower than that of the signal, it might be related to the location of hair cell loss in the cochlea. 4. In animals for which damage was restricted to only three rows of outer hair cells, changes of the CAP tuning curves were observed. It provides further evidence that the tuning properties of cochlear nerve fibers are dependent upon the integrity of the outer hair cells even though the great majority of fibers innervate inner hair cells only. PMID- 2701994 TI - [Glycerol opening of blood-labyrinth barrier using electron-opaque tracer ferritin]. AB - Fifteen guinea pigs were divided into three groups: the control, the ferritin and the glycerol-ferritin groups. In the first group, no any medication had been given; in the second group, ferritin 1 gm/kg was injected via the jugular vein; in the third group, 50% glycerol 3 ml/kg was injected 30, 60 and 120 minutes prior to the injection of ferritin. Striae were removed, fixed and embedded in Epon. Ultra-thin sections were cut and observed under electron microscope. No ferritin molecule was seen in the control group. In the ferritin group, the ferritin particles were seen in stria capillary only. In the glycerol-ferritin group, the ferritin molecules had entered the endothelial cells of stria capillary at 30 minutes. Ferritin molecules had got into stria vascularis and accumulated around the mitochondria at 60 minutes. The electron-opaque tracers had migrated to the apex of the marginal cells along microtubular system and permeated to the endolymphatic space through cell membranes and junctions. The ferritin particles appeared at the surface of marginal cells in the endolymphatic space at 120 minutes. The results indicate that glycerol can serve as an opener of blood-labyrinth barrier. PMID- 2701995 TI - [Influences of explosion on hearing threshold and acetylcholinesterase activity in inner ears]. AB - Fifty-seven guinea pigs weighting 200-400 g with normal Preyer's reflexes were randomly divided into five groups, one for control and the others studied 8, 48 hours and 7, 30 days after explosion. Cortical response threshold measurement and AchE histochemical observations were made. Histochemical sections were prepared as follows: under anesthesia, blood was washed out with Ringer's solution, then the animals were perfused with ice-cold neutral formol-calcium solution for 10 minutes. Temporal bones were removed and fixed in the same fixative for 24 hours. Fixed specimens were decalcified in 10% EDTA solution at 15 degrees C for one week. Tissue blocks were sectioned serially at 20 microns in a cryostat. Horizontal sections were obtained. Sections were then incubated in a substrate solution prepared according to Tsuji (1983) at 4 degrees C for 50 minutes, washed with 3 changes of distilled water and mounted in 25% gelatin. Inhibitory tests were carried out to non-specified chE or Pseudo-chE activity by using iso-OMPA during incubation. Control sections were incubated without the substrate. The results showed that explosion reduced the AchE activity of the cochlea and elevated cortical response threshold. Both showed a negative correlation. The significance of the results obtained had been discussed. PMID- 2701996 TI - [Mechanism of inner ear damage due to hyperlipidemia]. AB - Some clinical data concerning the relationship between hyperlipidemia and sensorineural hearing loss have been reported, however, definite mechanism causing pathological changes in the cochlea and hearing loss has not yet been clarified. We studied the mechanism of hearing loss due to hyperlipidemia in rabbits by ABR hearing examination, biochemical study of the sera, observation of the inner ear morphology by Sem and Tem. We suggest that the decreased blood supply in the inner ear during hyperlipidemia because of increased platelet aggregation and blood viscosity may be responsible for the inner ear damage. At the same time, a high lipid peroxide level in the serum and the inner ear, as well as the metabolic disorder of lipids in the inner ear may also contribute to the development of hearing loss. PMID- 2701997 TI - [Experimental study of Rhizoma drynariae (Gusuibu) in the treatment of streptomycin ototoxicity]. AB - According to Chinese traditional medical theory, kidney governs ear. Gusuibu is a kind of traditional Chinese drug which has nutritive effect to the kidney. The present study was intended to show whether Gusuibu could reduce streptomycin ototoxicity. Changes in cochlear hair cells, the Preyer's reflexes and auditory brain stem responses in guinea pigs were examined. Statistical analysis showed that hair cell loss in Gusuibu group was significantly milder then that in the control group; hearing threshold was also significantly different between these two groups. It was suggested that Gusuibu may have protective effect against streptomycin ototoxicity. PMID- 2701998 TI - [Measurement of inner orbital wall and its relation to surgical approach]. PMID- 2701999 TI - [Analysis of acute Streptococcus pneumoniae otitis media in relation to bacterial typing]. PMID- 2702000 TI - [Prediction of prognosis in sudden deafness]. AB - Factors influencing the prognosis of sudden deafness were studied in 70 cases. Clinical data were analyzed and three important factors have been found: 1. Among various factors concerning the prognosis, the most important one was the presence of 8 kHz hearing. If hearing in the 8 kHz level could be obtained, prognosis would be better; 2. The time between the onset of deafness and the initial examination was found to be in close relationship with the prognosis, i.e. the sooner the patient seeks for treatment, the better would be the result; 3. The rapidity of the development of deafness was closely related to the prognosis. The faster the development of deafness, the worse would be the prognosis. An optimal regression equation for predicting prognosis has been established. According to this equation, otologists would be able to estimate the prognosis of the patients suffering from sudden deafness. PMID- 2702001 TI - [Influence of acupuncture on human nasal mucociliary transport]. AB - The effect of acupuncture on human nasal mucociliary transport was studied by using both 99mTc tagged-particle method (detected by SPECT) and the saccharin method. Results showed that acupuncture on the Yingxiang and Hegu could increase the velocity of the mucociliary transport in chronic rhinitis patients, but not in normal persons. PMID- 2702002 TI - [Pathology and biologic behavior of laryngeal carcinoid]. AB - A case of carcinoid of the larynx was reported and other 8 cases collected from the literature were analysed. The average age of the patients was 66.8 years, which was 5-10 years older than that of patients with squamous carcinoma of the larynx. Carcinoid is rarely present in the larynx. The route of the spread is mainly through the blood stream rather than local infiltration. The prognosis for patients with carcinoid of the larynx is more favorable than that of squamous carcinoma of the larynx, but more serious than that of carcinoid of the lung and intestine. The 5-year survival rate was less than 50%. Histochemical study revealed that the carcinoid of the larynx was one of the foregut type, and might arise from neuroendocrine cells of the ectoderm. PMID- 2702003 TI - [Auditory brainstem response (ABR) and 40 Hz auditory events related potential (40 Hz AERP) in children with hearing loss]. AB - ABR were tested in 228 children with hearing loss, among them 76 cases also received 40 Hz AERP evaluation. ABR were positive in 77 ears (16.89%). In 152 ears, receiving 40 Hz AERP test 85 ears (55.92%) were positive. The 40 Hz AERP seemed to be a more sensitive method in evaluating residual hearing in children with hearing loss. PMID- 2702004 TI - [Organ culture system for inner ears]. AB - This paper reports an organ culture system using 2-hydroxyethylmethacrylate (HEMA) hydrogel as a substrate to study the development of otocysts and statoacoustic ganglions of the mouse embryos in vitro. Twelfth and thirteenth gestation-day otocysts and statoacoustic ganglions with otic sensory epithelium and/or rhombencephalon developed well on the HEMA hydrogel. Normal morphogenesis of the inner ears and cytodifferentiation of their sensory epithelia were noted. Neurons of the statoacoustic ganglions differentiated well with outgrowth of nerve fibers. The new organ culture system can be used for cultivating otocysts extracorporeally, facilitating investigation of the effects of various biologically active extracellular proteins, glycoproteins and glycosaminoglycans on statoacoustic ganglion-target tissue explants. PMID- 2702005 TI - [Ultrastructure of the human corpse Corti's organ]. AB - Human cochlea locates deeply in the petrous part of the temporal bone, which makes the specimen preparation for electron microscopic study very difficult. The authors had collected two cochleas from human corpses died of brain injuries in order to know if the method of specimen preparation conventionally used was adequate for the preservation of ultrastructures and to study the ultrastructural characteristics of the human Corti's organ. The results showed that the specimen dissected 1 hour after death, stored at 4 degrees C and perfused with glutaraldehyde 4 hours after death was good enough in terms of preservation of fine structures. The authors had also compared their findings with those reported by others and those found in the guinea pig. PMID- 2702006 TI - [Histochemical study of human nasal mucosa]. AB - The histochemical study of the fetal nasal mucosa collected from fetus of different months is reported. The concentration of succinic dehydrogenase and acid phosphatase in nasal epithelium kept pace with the fetal growth which explained a steady improving metabolism and secretory activity of the fetal nasal mucosa. On the other hand, activities of alkaline phosphatase in the mesenchymal cells, the fibroblasts and the glandular cells were getting weaker and weaker indicating the functional maturation of the fetal nasal mucosa. During the sixth month, mucins occur red in the glands, which showed the establishment of the secretory function in the nasal mucous glands. PMID- 2702007 TI - [Epidermal Langerhans cells in cholesteatoma]. AB - This article introduces an indirect immunologic fluorescent technique employing the monoclonal antibody OKT-6 to label and demonstrate Langerhans cells (LCs). These epidermal LCs were identified in normal tympanic membranes, canal skin and cholesteatoma. It was suggested that the only apparent difference among them was an increased number and distribution of LCs located at various levels within the epithelium in the cholesteatoma matrix. The LCs in the cholesteatoma matrix displayed morphologic features similar to those in contact hypersensitivity state. PMID- 2702008 TI - [Visual suppression test]. AB - The visual suppression test is one of the methods measuring the function of visual fixation. It is carried out by recording the caloric nystagmus by electronystagmography and comparing the maximum slow phase velocity of caloric nystagmus in the darkness and the slow phase velocity in the light with eyes opened. In 50 normal adults aged 16 to 31 years, the score of the visual suppression of the slow phase velocity of caloric nystagmus was 69.9 +/- 18.5%. Visual suppression was also studied in 125 cases with various kinds of vestibular diseases. The results showed that: 1. In cases with peripheral vestibular diseases, the visual suppression was normal (visual suppression over 50%). 2. In cases with cerebellar diseases, the visual suppression might be reduced (visual suppression 40%-10%) or abolished (visual suppression under 10%). It means that the flocculus or nodulus had been directly or indirectly impaired. 3. In brain stem lesions, the visual suppression might be reduced, abolished or the caloric nystagmus might even show augmentation in light (visual suppression negative). It means that the paramedian pontine reticular formation had been impaired. 4. In case of CP angle tumor, owing to compression to the vestibulo-cerebellum or brain stem, the visual suppression might be abnormal. 5. In case of congenital nystagmus, visual suppression varied from normal to abolished. Thus, the visual suppression test is useful in differential diagnosis of the central and peripheral vestibular diseases. PMID- 2702009 TI - [Midline peripheral T-cell lymphoma--an immunohistochemical and electron microscopy study]. AB - Twenty-six cases of nasal/nasopharyngeal midline peripheral T-cell lymphomas were studied clinically and pathologically with immunohistochemical markers and electronmicroscopy. A clearer understanding of the nature of midline malignant reticulosis has obtained. Immunohistochemical markers confirmed that except 5 small specimens which failed to show the monoclonal growth, 18 cases had peripheral T-cell lymphomas, 15 had TH, 3 Ts and 2 B-Cell lambda light chain and 1 HC. Morphological observations showed that 24 cases out of 26 exhibited middle and small polymorphic T-cells. This tumor had distinctive clinical features and was characterized by midfacial progressive necrosis, slow growth, local invasion and rarely metastasis, often with prominent granulomatous and vascular proliferation. Therefore, a discrimination of this disease from midline malignant reticulosis and midfacial destructive lesions is absolutely necessary. PMID- 2702010 TI - [Voice parameters in normal children measured with computer]. AB - Computer was used to measure and analyse voice parameters in 119 normal children aged 4-12 yrs. The values of pitch perturbations (Jitter) were 0.037 +/- 0.016 ms in the male and 0.044 +/- 0.017 ms in the female without significant difference among different age groups. In general, no remarkable significance was shown between both sexes (P less than 0.05). Percentages of jitter (JR) were 1.2 +/- 0.53% in the male and 1.45 +/- 0.56% in the female. JR values in the female were higher than those in the male, the difference of which became marked as ages went on. At the age of 12, the difference appeared to be significant (P less than 0.05). Amplitude perturbations (Shimmer) were 0.45 +/- 0.26 dB, no difference between both sexes was noted. The differences among age groups were significant (P less than 0.05 or P less than 0.01). Harmonics-to-Noise (H/N) ratio was 14.92 +/- 2.74 dB, there was no difference between the male and the female. Significant differences were present among different age groups (P less than 0.05). PMID- 2702011 TI - [Advances in otorhinolaryngology in children]. PMID- 2702012 TI - [Postmarketing surveillance of adverse reactions of drugs]. PMID- 2702013 TI - [Predictability of the anamnesis in pathology of the upper tract of the digestive system. Computerized analysis concerning 1000 subjects submitted to esophagogastroduodenoscopy]. AB - The ability of history taking to predict endoscopically verified pathology of the upper gastrointestinal tract was evaluated in a group of 1000 patients submitted to esophagogastroduodenoscopy (EGDS). The presence of one or more of the following symptoms at the time of EGDS or 4 weeks previously, was considered: epigastric pain, dysphagia, dyspepsia, gastrointestinal bleeding, pyrosis, anorexia and/or weight loss, nausea and/or vomiting. The results of this elaboration showed that the presence of recent symptomatology does not allow differentiation of patients with endoscopically verified pathology from those without it. The presence of an "at risk history" consisting of one or more of the following factors was also evaluated: smoking 10 cigarettes per day, drinking 100 g alcohol per day, previous diagnosis of upper gastrointestinal tract pathology, gastrointestinal-irritating therapy. Data analysis showed notable importance of the presence of an "at risk history"; in fact, when compared with subjects without this type of history, "at risk" patients were twice as likely to have a pathological condition diagnosed. Thus, when protocols for endoscopic examination are established the history of the patient and his lifestyle must be taken into consideration. PMID- 2702014 TI - [Transient loss of consciousness: a frequent and difficult problem in emergency service. Retrospective analysis of 391 cases]. AB - The present study was designed to evaluate the patients with transient loss of consciousness who are seen in the emergency room and the ways in which they are currently triaged and evaluated, to determine the risk factors influencing their prognosis, and to analyze the aspects of diagnostic evaluation that are most useful. We made a retrospective study of 391 patients with transient loss of consciousness seen at the emergency room of S. Martino hospital. The causes of loss of consciousness, admission decision, diagnostic tests ordered, initial and final diagnoses and mortality are evaluated. The admission decision was influenced by three factors: cause of loss of consciousness, presence of chronic disease, and patient age. The same factors were shown to influence mortality. Full concordance between initial and final diagnosis was only 50 per cent. In 18.6 per cent of patients the cause of loss of consciousness was not identified at dismissal. The history and physical examination were crucial elements in the evaluation of most patients, and only in selected cases did tests such as electrocardiogram, Holter monitoring, electroencephalogram, computerized tomography scan provide diagnostic information. PMID- 2702015 TI - Familial occurrence in cardiovascular diseases. Familial cardiovascular diseases (1). AB - Current knowledge and assumptions about inherited cardiovascular diseases are reported in this review. They are examined from two different points of view. In the first section (familial cardiovascular diseases) discussion will center on the main cardiovascular diseases that have a definite clinical and pathophysiological feature in which familial occurrence has been extensively demonstrated. The genetic aspects of the primary cardiomyopathies, mitral valve prolapse, arrhythmias and conduction disturbances, long QT syndromes and abnormalities of ventricular repolarization, cardiovascular malformations, coronary artery disease, essential hypertension and rheumatic fever will be examined. In the second section (cardiovascular involvement in genetic disorders) discussion will be confined to the inherited multisystem disorders involving the cardiovascular system that most frequently occur in clinical practice. Currently known cardiovascular findings in relationship to chromosomal aberrations, connective tissue disorders, metabolic and enzymatic disorders, neuromuscular disorders and other rarer syndromes will be reported. PMID- 2702016 TI - [Treatment of recurrences of duodenal ulcer: seasonal or long-term therapy?]. AB - Many recently published papers have focused on the problem of the treatment of recurring duodenal ulcers and time trends, given the rate of late recurrences observed with long-term protocol. The results of trials with seasonal protocols are therefore presented. Given the seasonal trends in duodenal ulcer recurrence, a stable oscillatory behaviour with fluctuations of 6-month periodicity was demonstrated with the use of conventional statistical methods. With the utilization of the more sophisticated spectral analysis of data from many centers in Italy, the time trends of this condition have been characterized in greater detail, and cycles of increased recurrences every 4, 6 and 12 months have been evidenced. On the basis of these data, a randomized controlled trial in 60 patients treated with cimetidine, 30 patients in long-term and 30 in seasonal treatment showed similar results: the recurrence rate was 30% in both groups over a 12-month period. Preliminary results of a new multicenter trial in 110 patients with the same protocol (cimetidine 400 mg nocte), confirm these results. In conclusion, the two trials tend to confirm the validity of preventive protocols that respect seasonal fluctuations. PMID- 2702017 TI - Left atrial myxoma simulating a systemic disease with pleural-pericardial effusion. Detection by two-dimensional echocardiography. AB - Clinical symptoms of cardiac myxomas are often very confusing. We observed a 46 year-old woman with a left atrial myxoma simulating systemic disease with pleural pericardial effusion. We think that like other systemic symptoms effusion (which to our knowledge has not been previously described in literature) can be attributed to the result of tumor secretion or necrosis. In fact, soon after surgical removal of the tumor, all pathological signs disappeared. PMID- 2702018 TI - [Cellular metabolism of sodium and hypertension]. AB - Essential hypertension develops from interactions between genetic and environmental components. Studies on cell membrane ions (in particular the sodium ion) transport in essential hypertension were originally carried out in order to better understand the roles these two components play in a less complex system than the overall organ system or the single organs involved in blood pressure regulation. The theory supporting this experimental approach is based on the observation that cell membrane function affects all the phenomena involved in blood pressure regulation. Receptor function, hormonal secretion, cell volume regulation, ion transport and ion composition of the cell are all regulated at the cell membrane level. However the problem of the relevance of cellular sodium metabolism in the pathogenesis of essential hypertension and of the interpretation of the many conflicting results has grown in complexity with the growing mass of data published in the literature. At least part of this complexity seems related to methodological problems but part is surely due to real differences among the various populations or subpopulations studied. This review analyzes the main sources of the discrepancies, the different ion transport systems and the end point of the overall transport system as well as the steady state intracellular cation concentration in both genetic animal models of essential hypertension and in man. PMID- 2702019 TI - Familial occurrence in cardiovascular diseases. Cardiovascular involvement in genetic disorders (2). AB - Current knowledge and assumptions about inheritance of cardiovascular diseases are reported in this review. They are examined from two different points of view. In the first section (familial cardiovascular diseases) discussion centered on main cardiovascular diseases with a definite clinical and pathophysiological feature in which familial occurrence has been extensively demonstrated. The genetic aspects of the primary cardiomyopathies, mitral valve prolapse, arrhythmias and conduction disturbances, long QT syndromes and abnormalities of ventricular repolarization, cardiovascular malformations, coronary artery disease, essential hypertension and rheumatic fever were examined. In this section discussion will be confined to the inherited multisystem disorders involving the cardiovascular system that most frequently occur in clinical practice. Currently known cardiovascular findings in relationship to chromosomal aberrations, connective tissue disorders, metabolic and enzymatic disorders, neuromuscular disorders and other rarer syndromes will be reported. PMID- 2702020 TI - [Occupational bronchial asthma: an emerging problem]. AB - The overall prevalence of occupational asthma is unknown. It has been estimated that 15% of all adult asthmatics suffer from asthma caused by occupational exposure. The prevalence of occupational asthma varies depending on the nature of the industrial agent, the concentration of exposure and working conditions. In Italy diisocyanates and flour dusts are the commonest causes (60%) of occupational asthma. The diagnosis of occupational asthma is made by confirming the diagnosis of bronchial asthma and by establishing a relationship between asthma and the work environment. History and measurement of non-specific bronchial hyperreactivity are useful to establish a clinical diagnosis, while skin (or serologic) tests with the appropriate extract may be useful in the identification of the responsible agent (high molecular weight compounds such as protein). With low molecular agents (e.g. diisocyanates, wood dust, colophony) the specific bronchial provocation test in hospital or the measurement of lung function tests at work ("stop-resume" test) are required. There are few follow-up studies of patients with occupational asthma; all of them show that only 40% (mean) of the patients completely recover after cessation of exposure. Atopy (one or more skin prick tests positive to common allergens) is not sufficiently discriminative for screening purposes when a person enters a new occupational environment where an occupational asthma agent is present. Preemployment screening is useful to define the higher risk workers: atopy may be used as an indication for more frequent or more strict monitoring in periodic medical surveillance. PMID- 2702021 TI - [Hypothyroidism in adults: a magnetic resonance study of cerebral and hypophyseal changes]. AB - The case of a 55-year-old woman with postpartum (at age of 22) hypopituitarism is reported. The patient, with signs of myxedema, was admitted to a psychiatric hospital for hallucinations. In addition to routine tests and measurements of thyroid hormones level, magnetic resonance imaging (MRI) of the brain and pituitary region was performed. The results of MRI showed cerebral atrophy and a large "empty sella". On the basis of clinical, laboratory and instrumental data, a diagnosis of panhypopituitarism with prevalent hypothyroidism was achieved. Many hypotheses could be made regarding its pathogenesis. Initially we considered the diagnosis of Sheehan's syndrome in which the sella turcica usually presents normal or reduced dimensions. However the presence of a large "empty sella" with thin walls, excludes this diagnosis. The delay of menarche and the short stature suggest the hypothesis of a preexistent pathological condition. It is possible that the patient had liquefied pituitary adenoma as a consequence of the postpartum shock or that she was hypothyroid, a condition in which the "empty sella" is very common. PMID- 2702022 TI - [Current concepts in a systemic-informatics study of feedback and blood volume homeostasis. Proposal of a mathematical reference model]. AB - Attention is drawn to the relationship between information and biological models in the study of problems of human physiology and physiopathology. The biomathematical principles, to which reference must be made for the elaboration of the expert systems, necessary in evaluating biological feedback in particular are analyzed. PMID- 2702023 TI - [New trends in the prevention of ischemic heart disease]. AB - In the past years several studies have confirmed the causal role of the three major risk factors, i.e. hypercholesterolemia, hypertension and cigarette smoking in the determination of atherosclerosis and its major complication, coronary heart disease (CHD). In particular the Lipid Research Clinics Primary Prevention Trial and, more recently, the Helsinki Heart Study, have demonstrated beyond doubt the effectiveness of dietary and pharmacological intervention in subjects affected by hypercholesterolemia. The mounting alertness derived from the results of these and other trials has generated the need for "codifying" strategies directed towards the prevention of CHD in the industrialized western world. The population strategy tends to modify cultural and environmental habits such as diet, cigarette smoking, alcohol abuse, physical exercise etc. The individual strategy is directed at identifying, within each population, those individuals who are probably carriers of a particular risk factor, for instance those affected by hyperlipidemia of genetic origin. The two strategies are intended to be two complementary moments in the ceaseless fight against CHD. PMID- 2702024 TI - [Results of splenectomy in 45 cases of idiopathic thrombocytopenic purpura: search of prognostic indices]. AB - We report on the effects of splenectomy in 45 consecutive patients affected by idiopathic thrombocytopenia who did not obtain lasting remission with prednisone therapy. None of the patients had serious complications after surgery, and only one died a year later from an infectious disease. Two years after surgery, 89% of the patients were in remission; 79% had no therapy after splenectomy, while 10% achieved remission in response to additional medical treatment. A significantly better response to splenectomy was obtained in the subjects under 50 years old (90% remission) and by the younger patients who had had a transient response to initial prednisone therapy (100% remission). All patients with thrombocytosis 15 days after surgery were in remission two years later. We were unable to identify parameters constantly associated with a poor response to splenectomy, since at least 25% of the patients with the worst prognostic features obtained lasting remission. PMID- 2702025 TI - Microcomputer-aided diagnosis in cardiology. An expert system based on clinical and phono-mechanocardiographic data. AB - A knowledge-based consultation system capable of making multiple diagnoses in noninvasive cardiology is presented here. The system, expressly designed for a personal computer, is able to provide assistance in the diagnosis of 49 disease entities. When tested in 52 retrospective cases (33 patients with one disease entity, 17 with two, 2 with three), it made 39 correct diagnoses (75%). The average score of the actually present disease-entities was 94 +/- 3.2 (mean +/- standard error of the mean), significantly higher than the highest score obtained by the incorrect diagnoses (87.2 +/- 3.1) (p less than 0.001). The system was able to correctly perform 1 triple diagnosis and 9 double diagnoses. The results obtained, comparable with those of well-known expert systems (MYCIN, INTERNIST 1), demonstrate the reliability of a microcomputer-based expert system for medical diagnosis in cardiology. PMID- 2702026 TI - The pathogenesis of chronic hepatitis. PMID- 2702027 TI - [Relations of gingival hypertrophy and blood levels of cyclosporin A in patients with renal transplants]. AB - Gingival overgrowth is defined as hyperplasia of gingival tissue due to local, systemic or drug-related causes. To see if the incidence and severity of this side-effect are related to cyclosporine A (CyA) dosage and/or blood levels BCyA), we analysed data from 24 renal transplanted outpatients, grouped as follows: controls (C, n = 3): patients on immunosuppressive therapy other than CyA; group 1 (G1, n = 10): patients with BCyA steadily 300 ng/mL (RIA); group 2 (G2, n = 11): patients with BCyA steadily between 301 and 650 ng/mL. BCyA averaged 290 +/- 21 in G1 and 481 +/- 100 in G2 (p less than 0.001): mean cyclosporine A dosage (mg/kg/die) was not significantly different: 4.1 +/- 1.4 in G1 and 4.97 +/- 2.4 in G2. However, six patients in G2 also received calcium antagonists known to increase CyA blood levels (diltiazem and nicardipine) for clinical purposes or deliberately to increase CyA bioavailability. Mean time from transplant was (in months) 19 +/- 11 in G1, 16 +/- 15 in G2 and 62 +/- 24 in C (G1 vs G2: NS; C vs G1 and 2: p less than 0.001). Mean GFR (mL/min) was 75 +/- 22 in C, 65 +/- 18 in G1 and 53 +/- 19 in G2 (NS). Dental hygiene, as assessed by scoring (0-3: absent, mild, moderate and severe) the bacterial plaque, was similar in all groups. Gingival overgrowth, was similarly scored (0-3) and was absent in C and in 20% of G1, mild in 40% of G1 and 33% of G2, moderate in 40% of G1 and 33% of G2 and severe in 0% of G1 and 33% of G2 (G1 vs G2: p less than 0.05). Our data suggest that the severity of gingival overgrowth in transplanted patients with similar oral hygiene is mainly related to CyA blood levels. PMID- 2702028 TI - [Epidemiology of osteoporosis in Apulia. A retrospective study on the prevalence of fractures of the wrist and femur in the population of the region]. AB - A study of femur and wrist fracture prevalence in a large population of Apulia was carried out. These kinds of fractures are closely related to osteoporosis in post-menopausal women and in the elderly, suggesting that a survey of their prevalence in the population could demonstrate the prevalence of osteoporosis itself. In this study a high prevalence of total fractures in young men was demonstrated. The same prevalence was observed for wrist fractures, while femur fractures showed a high prevalence in the young and in men aged 60 to 90 years. In women a high prevalence in the first decades of life was observed for both wrist and femur fractures and a progressive and higher increase after 50 years was observed with significantly higher values than those observed in men of the same age. Finally, first admissions to hospital for femur and wrist fractures (representing the complication of osteoporosis) in our region were 5.9% of the total admissions in the Orthopedic Departments in subjects aged over 50 years; these fractures accounted for 0.65% of the total Apulian population of the same age. This datum, although underestimated, could represent the prevalence of osteoporosis in Apulia. PMID- 2702029 TI - Hypoxia-induced pulmonary hypertension: nifedipine only temporarily reduces pulmonary artery pressure and vascular tone. AB - Fifteen patients affected by hypoxia-induced pulmonary hypertension were studied before and during (1st and 8th week) nifedipine (180 mg/die) treatment. Nifedipine reduced pulmonary pressure (33 +/- 4 vs 26 +/- 3 mmHg, p less than 0.02) after 1 week of treatment; this pulmonary hypotensive effect was due to a reduction of pulmonary vascular tone as assessed by a reduction of Y-intercept on the pulmonary pressure/flow plot drawn from invasive recordings of pulmonary pressure/cardiac output obtained during exercise. Oxygen breathing effects on pulmonary pressure were also measured with and without nifedipine. Oxygen significantly reduced pulmonary pressure only in the absence of nifedipine regardless of the severity of pulmonary hypertension. Therefore nifedipine is not suitable for long-term treatment of hypoxia-induced pulmonary hypertension and inhibits O2 capability to reduce pulmonary pressure. PMID- 2702030 TI - [Mechanisms of progression of glomerular sclerosis in chronic renal diseases in man]. AB - The available data indicate that in chronic renal failure (CRF) loss of renal function usually progresses at a constant rate toward end-stage renal disease. Although immunological events might be responsible for initiating most glomerular diseases, certain clinical and experimental observations suggest that the rate of progression of these diseases is influenced by several non immunological factors. These factors include systemic hypertension, proteinuria, hyperlipidemia, high protein intake, and probably conditions leading to glomerular hypertrophy. Interventions designed to minimize the potential contribution of these factors to the progression of renal insufficiency may halt or slow the loss of function at early and late stages of CRF. PMID- 2702031 TI - [Addison's disease: principal clinical associations and description of natural history of the disease]. AB - From 1967 to 1988 we studied 75 cases of Addison's disease (AD). An autoimmune etiology was found in 68%, while previous tubercular infection was demonstrated in 21% of the cases; minor causes were involved in 3%, and in 8% of the cases the disease remained of unknown origin. Autoimmune adrenalitis has become the most frequent cause of AD as a consequence of decreased tubercular infection. Autoimmune AD prevailed in children or in young people, and tubercular AD in adults. The finding of calcifications in adrenals and/or other organs was the specific diagnostic sign for the identification of tubercular forms. On the other hand, the finding of circulating adrenal autoantibodies (AA) and/or other organ specific autoantibodies was the fundamental diagnostic marker of autoimmune forms. In 72% of the cases autoimmune AD is associated with other organ-specific autoimmune diseases. Subjects with AA but without clinical signs of hypoadrenalism were considered to have "potential AD", because they showed a high risk of developing clinical hypoadrenalism. This condition develops over a long period characterized by different stages of subclinical adrenal hypofunction. Steroid cell autoantibodies (StCA) are frequently detectable in patients with autoimmune AD, in whom they are markers of autoimmune premature ovarian failure. The study of StCA-positive cases without hypogonadism will be important to clarify whether or not these autoantibodies could be markers of potential autoimmune hypogonadism. PMID- 2702032 TI - [Echographic aspects of kidney diseases and comparisons with needle biopsy]. AB - A study of 38 patients who underwent renal biopsy was designed to correlate the sonographic features of the kidney with the histologic changes in various renal parenchymal diseases. This research was performed in order to determine if sonography could be useful in the diagnosis and differentiation of renal parenchymal diseases. The ultrasound examination was based on the evaluation of some codified parameters: renal dimension, parenchymal thickness, cortical echogenicity and medullary dimension. There was no correlation between the specific sonographic features and the type of renal medical disease. In 28 patients (74%) with clinical and histological signs, sonography showed morphostructural alterations of the kidney. PMID- 2702033 TI - [A case of Sweet's syndrome with rheumatic onset]. AB - Sweet's syndrome (acute febrile neutrophilic dermatosis) is a disease characterized by the abrupt onset of red, tender, cutaneous plaques on the face, extremities and upper trunk accompanied by fever, arthralgia or arthritis and neutrophilic leukocytosis. Histologically, there are distinctive, dense, dermal infiltrates of neutrophils. This case report describes a case of Sweet's syndrome characterized by rheumatic onset, microhematuria and subcutaneous nodular lesions on the legs resembling erythema nodosum. The etiopathogenesis and relationship between Sweet's syndrome and infectious and non infectious diseases is discussed. The overlap between this peculiar syndrome and some aspects of inflammatory rheumatic diseases, namely seronegative spondyloarthritides, is suggested. PMID- 2702034 TI - [Acute progressive respiratory insufficiency caused by diffuse interstitial pulmonary disease in a diabetic patient with dilated myocardiopathy]. AB - This report describes the case of a 70-year-old female suffering from diabetes mellitus and dilatative cardiomyopathy with congestive heart failure. It is likely that alveolar-capillary membrane damage occurred apart from cardiac involvement. Diffuse interstitial pulmonary fibrosis subsequently occurred with consequent acute progressive respiratory failure and death. The cause of the damage to the alveolar-capillary membranes is still unknown and we thought that long-term administration of captopril might have contributed to the damage itself, since like all ACE-inhibitors, captopril is able to bring about tissular storage of both bradykinin and prostaglandins and therefore alter the pulmonary reactivity to phlogistic stimuli. PMID- 2702035 TI - Tumor resistance to therapy: a genetic or kinetic problem? AB - Chinese hamster V79 spheroids exposed to cisplatin for 2 hr daily for 3 weeks responded very similarly to tumors undergoing chemotherapy. Initially, the number of viable cells per spheroid decreased in a dose-dependent fashion but, after several treatments, the apparent effectiveness of the cisplatin decreased. At low doses, spheroid regrowth eventually occurred despite continued therapy. A detailed examination of the cellular basis for this response showed that the so called acquired resistance was not due to a change in cellular responsiveness to cisplatin but, rather, was the result of a marked increase in the cellular growth fraction in the treated spheroids. PMID- 2702036 TI - Analysis of somatic changes in human tumor DNA using synthetic oligonucleotide probes. AB - Like most hematologic malignancies, solid cancers may be associated with non random chromosomal abnormalities. Heterogeneity in the cell population in solid cancers and the chromosomal variations occurring among primary, explant, and passaged cells of a given tumor, however, present a major difficulty in assessment of their cytogenetic changes. Alternative approaches to identifying specific somatic changes in subtypes of solid cancers, without cell culture manipulations, must be developed. This report describes preliminary evidence indicating that oligonucleotide probes, homologous to short tandem repeats, that can determine individual identity, may also be useful tools with which to examine somatic changes in DNA which has been isolated directly from a tumor mass. Two, of the four, bladder tumors (transitional cell carcinomas) analyzed, exhibited oligonucleotide-based DNA fingerprint patterns that differed from those of corresponding constitutive or uninvolved tissue DNA. The changes that were observed included gain or loss of hypervariable DNA fragments or shifts in band intensities. PMID- 2702037 TI - Expression of O6-alkylguanine-DNA alkyltransferase in Mer+ and Mer- human cell extracts probed with specific monoclonal antibodies. AB - The response of human cells to the mutagenic, carcinogenic, and lethal effects of alkylating agents that produce O6-alkylguanine adducts in DNA is largely determined by the cellular content of O6-alkylguanine-DNA alkyltransferase. Because a subgroup of human tumor cell lines (termed Mer-) that are hypersensitive to such agents appears to lack the transferase activity, we questioned whether this DNA-repair protein is produced in a non-functional mutant form or is simply not expressed in such cells. Ten human cell lines were examined by immunoblot analysis of crude extracts with monoclonal antibodies specific for the human alkyltransferase. Four Mer+ cell lines, high in transferase activity, clearly expressed the protein. This repair protein, however, was immunologically undetectable in six Mer- cell lines. It should be feasible therefore to predict sensitivity to O6-guanine-alkylating drugs or carcinogens by immunohistochemical staining of tumor or tissue specimens. PMID- 2702038 TI - Calcium ionophores at concentrations mitogenic to normal murine T cells inhibit the proliferation of tumor cells in vitro. AB - The Ca2+ ionophores, A23187 and ionomycin, when used alone at 0.3-5 microM concentrations, were mitogenic to normal resting murine T cells. At these doses, the Ca2+ ionophores inhibited DNA synthesis and growth of a T cell lymphoma and several murine transformed cell lines. Treatment of tumor cells with either ionophore caused a rapid increase in intracellular Ca2+ [( Ca2+]i) followed by a decline and, thereafter, maintenance of a steady level that was slightly above the preactivation levels of [Ca2+]i. Cell cycle analysis revealed that each of the Ca2+ ionophores inhibited tumor cell transition from the G1 phase to the S phase of the cell cycle and, possibly, arrested cells already in the S-phase. These data suggest that an early activation signal such as increased [Ca2+]i may initiate surface to nuclear signals that are different in normal T cells than in transformed cells that may receive opposite effects. Our studies suggest that non specific activation of tumor cells by various stimuli may provide a useful approach to treat tumors in vivo. PMID- 2702039 TI - Antiproliferative activity of liposome-encapsulated transforming growth factor beta against MDA-MB-435 human breast carcinoma cells. AB - We determined whether transforming growth factor-beta (TGF-beta) could be encapsulated in phospholipid liposomes and then would mediate antiproliferative activity against the sensitive, human breast cancer cell line, MDA-MB-435. TGF beta was encapsulated in multilamellar liposomes consisting of phosphatidylcholine (PC) or PC and phosphatidylserine (PS) at a 7:3 molar ratio. It was captured in both the aqueous phase and the bilayer lipid (hydrophilic and lipophilic association) and was stable for at least 24 hr of incubation at 37 degrees C in medium that contained 5% fetal bovine serum. In calcium- and magnesium-free Hanks' balanced salt solution, TGF-beta in the internal aqueous compartment was stable for at least five days, even in the presence of trypsin and ethylenediamine tetraacetic acid. TGF-beta (type 1 or 2) in liposomes was active as free-form TGF-beta in mediation of antiproliferative effects. The lipophilic nature of TGF-beta, which resulted in a high capture ratio in liposomes, coupled with exceptional stability, suggested that liposomes could be a carrier for the in vivo use of TGF-beta. PMID- 2702040 TI - Alteration of nickel-binding proteins in nickel-resistant cells. AB - Proteins from wild-type and nickel-resistant cells (Balb/c-3T3 and B200, respectively) were studied by one- or two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis and detected either by standard protein staining or by fluorographic analysis of [63Ni] binding. Wild-type cells contained three major nickel-binding proteins with molecular masses of 68 kDa (p68), 55 kDa (p55), and 48 kDa (p48). The p55 was present in high concentrations in the microsomal fraction, whereas the p68 nickel-binding protein predominated in the cytosolic fraction. We were unable to demonstrate that p48 was localized in any subcellular fraction. Both the p55 and p48 proteins appeared to be present in similar amounts in wild-type and nickel-resistant cell lines, based upon silver staining of two-dimensional gels, yet in the nickel-resistant B200 cells, these proteins could not be visualized by [63Ni] binding. This suggested that if nickel binding to these proteins were important for nickel toxicity, then nickel resistance in the B200 cells would be associated with the observed loss of metal binding to these proteins. In addition to the changes in [63Ni]-binding proteins, the total concentration of a 44 kDa protein was increased in B200 cells, but its ability to bind nickel could not be established due to its rapid degradation. Among the nickel-binding proteins studied, the p55 contained nickel-binding sites that were the most resistant to exchange by excess nickel ions. The microsomal fraction that contained the highest concentration of p55 also had the highest nickel-binding activity when standardized for protein concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702041 TI - Differential increases in glutathione S-transferase activities in a range of multidrug-resistant human tumor cell lines. AB - Modified glutathione S-transferase (GST) activity was detected in MCF-7 cell lines selected in vitro for modest levels of resistance (2.6- to 13.7-fold) not only to Adriamycin but also to Novantrone, vincristine (VCR), and etoposide (VP 16). Western blot analysis revealed a qualitative increase in the expression of the pi class GST isozyme and some apparent down regulation of the mu class in these resistant lines relative to the parental line. Overexpression of GST pi protein was also observed after in vitro exposure of MCF-7 cells to fractionated x-irradiation, which resulted in a subline that exhibited 5-fold resistance to VCR and 3-fold resistance to VP-16. Northern blot analysis provided qualitative evidence that these changes in GST pi and mu appeared to be at the transcriptional level in these VCR- and VP-16-resistant MCF-7 sublines. In contrast, similarly selected VCR-resistant, VP-16-resistant, and x-ray-pretreated resistant sublines, derived from the SuSa cell line established from a human testicular teratoma, did not exhibit significant alterations in GST isozyme profiles compared with their parental cell lines. All parental and resistant SuSa lines that were studied expressed the GST pi isozyme constitutively. Total glutathione content and glutathione peroxidase activities were not modified in parallel with the GST alterations in these human tumor drug resistant sublines. These data suggest that the increased cellular GST activity was associated with selection of resistance to many of the drugs associated with the multidrug resistant phenotype in MCF-7 sublines but that this was not the case for the other human tumor cell line (SuSa) tested. PMID- 2702042 TI - Proliferation-related nucleolar antigens P145 and P120 associated with separate nucleolar elements and differences in tissue distribution. AB - Nucleolar antigens p145 and p120 are associated with proliferating cells (Freeman, J.W.; McRorie, D.K.; Busch, R.K.; Gyorkey, P.; Gyorkey, F.; Ross, B.E.; Spohn, W.H.; Busch, H. Cancer Res. 46:3593; 1986 and Freeman, J.W.; Busch, R.K.; Gyorkey, P.; Gyorkey, F.; Ross, B.E.; Busch, H. Cancer Res. 48:1244; 1988) and are not detectable in normal resting cells. Recent immunoelectron microscopic studies (Ochs, R.L.; Reilly, M.T.; Freeman, J.W.; Busch, H. Cancer Res. 48:6523; 1988) suggest that the two antigens have overlapping nucleolar localizations. In this study the nucleolus was physicochemically and biochemically studied to determine whether p145 and p120 were associated with a common nucleolar component. Antigen p145 was associated with 40-80 S ribonucleoprotein particles (RNPs), and the p145 antigen was not detected in HeLa cells following in situ RNAse digestion. P120 was found in a 40-80 S, RNAse resistant complex. Sequential extraction of HeLa nucleoli showed that most of antigen p145 was extractable in 10 mM Tris with 0.2% deoxycholate, whereas p120 was found in a nucleolar residue fraction requiring DNAse and high salt treatment for optimal extraction. Neither antigen p145 nor p120 was detectable in normal resting tissues. Antigen p145 was detected in all proliferating tissues examined, including a variety of malignant tumors (ten of ten), benign tissues including adenomas and hyperplasias (eight of eight), and in normal proliferating cells such as colonic epithelium and spermatogonia of the testes. Antigen p120 was not detected in all tumors, being absent in three of seven lymphomas and in one melanoma examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702043 TI - Genetic aspects of myopathy. PMID- 2702044 TI - Metabolic and mitochondrial myopathies. PMID- 2702045 TI - Treatment of polymyositis and dermatomyositis. PMID- 2702046 TI - Advances in muscle physiology. PMID- 2702047 TI - Myositis and malignancy. PMID- 2702048 TI - Genetic and environmental factors in scleroderma. PMID- 2702049 TI - Immunologic aspects of scleroderma. PMID- 2702050 TI - Connective tissue metabolism including cytokines. PMID- 2702051 TI - Raynaud's phenomenon. PMID- 2702052 TI - Sentinel signs and symptoms of systemic sclerosis. PMID- 2702053 TI - Localized scleroderma. PMID- 2702054 TI - Treatment of systemic sclerosis. PMID- 2702055 TI - Other fibrosing syndromes. PMID- 2702056 TI - Overlap syndromes, mixed connective tissue disease, and eosinophilic fasciitis. PMID- 2702057 TI - Endocrine disorders with rheumatic manifestations. PMID- 2702058 TI - Sarcoidosis. PMID- 2702059 TI - Rheumatic manifestations of neoplasia. AB - The important association of neoplasia and rheumatic disease was reviewed. The literature in the last year included case reports of neoplasia, particularly hematologic, causing arthritis by direct joint involvement. Immunocytologic techniques may help in the diagnosis. The evidence linking dermatomyositis and polymyositis to malignancy was reviewed, although analysis of the literature was hampered by poor documentation and lack of control subjects. HOA may occur secondary to mediastinal or pulmonary metastases from nonbronchogenic malignancies. The important association of hematologic malignancy with vasculitis was highlighted. PMID- 2702060 TI - Hematologic disorders with rheumatic manifestations. PMID- 2702061 TI - Myositis and myopathies. PMID- 2702062 TI - Raynaud's phenomenon, scleroderma, overlap syndromes, and other fibrosing syndromes. PMID- 2702063 TI - Systemic disorders with rheumatic manifestations. PMID- 2702064 TI - Oral mercaptopurine in childhood leukemia: influence of food intake on bioavailability. AB - Plasma concentrations of 6-mercaptopurine (6-MP) were determined by gas chromatography-mass spectrometry. Ten children (nine with acute lymphatic leukemia) were studied on 2 consecutive days after oral intake of 6-MP. On one day the drug was administered in the fasting state and on the other (in random order) together with breakfast. The peak plasma concentrations of 6-MP after the dose intake with breakfast in percent of that in the fasting state (meal in % of fasting for each individual) varied between 33 and 181% (mean 111), and the area under the plasma concentration-time curve varied between 47 and 186% (mean 103). Thus, there were considerable variations among patients, but, for the group as a whole, there were no statistically significant differences between the two experimental conditions. This study cannot therefore form the basis for a recommendation as to whether 6-MP should be administered on an empty stomach or together with food. PMID- 2702065 TI - Vitamin K-dependent coagulation parameters during the first six days of life: incidence of PIVKA II in newborns. AB - The vitamin K-dependent carboxylation of the prothrombin precursor PIVKA II (protein induced by vitamin K absence analogous to Factor II) is essential for the synthesis of prothrombin. The noncarboxylated precursor is found in peripheral blood in the presence of vitamin K deficiency. In this study prothrombin time, Factor II and Factor VII activity, and PIVKA II were investigated in 57 newborns without vitamin K prophylaxis in order to assess their vitamin K status. Two-dimensional immunoelectrophoresis demonstrated the presence of PIVKA II in 21% of the newborns, predominantly on the second day. The PIVKA-II positive group showed significantly lower prothrombin times than the PIVKA II-negative group. An oral dose of 3 mg vitamin K (Konakion) was administered to 35 healthy newborns in a second group with the first feeding. On the second day of life, these infants showed significantly higher vitamin K dependent laboratory parameters than the group not given vitamin K; only 9% of the treated infants were positive for PIVKA II. PMID- 2702066 TI - Immunohistochemical detection of post-therapy residual testicular lymphoblasts in childhood acute lymphoblastic leukemia (ALL). AB - The aim of this study was to evaluate the diagnostic value of immunohistochemistry with monoclonal antibodies (MoAbs) in detecting residual blast cells in testicular biopsies from children with acute lymphoblastic leukemia (ALL). In a prospective study of 26 patients, testicular biopsies were performed after completion of therapy, and the average follow-up after biopsies was 29 months. After immunostaining, seven patients with negative biopsies on routine histology showed scattered, strongly calla-positive cells as well as cells reacting with anti-B (CD22) MoAb. Among these seven patients with residual blast cells, four had relapsed either in testes (n = 1), bone marrow and testes (n = 1), or in the bone marrow (n = 2). In contrast, among the 15 patients without residual blast cells, all but 1 remained in complete remission. In four other cases no definite conclusion was possible after immunohistochemical study. Four testicular biopsies from patients with occult infiltration were used as positive controls. Negative controls consisted of testicular biopsies from children with testicular ectopia and postmortem testicular tissue specimens. Results suggest that the risk of relapse is significantly higher in patients with positive immunohistochemical findings indicating persistent residual blast cells. However, the predictive value of these findings requires confirmation on a larger number of cases to have therapeutic implications. PMID- 2702067 TI - Allogeneic bone marrow transplantation versus chemotherapy in children with acute leukemia in Sweden. AB - All children in Sweden who underwent bone marrow transplantation (BMT) with an HLA-identical sibling during a 5-year period were compared to those who were treated with chemotherapy and survived at least 3 months after remission. All patients were observed for more than 2 years after diagnosis or relapse. All 11 children with acute myeloid leukemia in first remission who underwent BMT survived compared to only 1 of 15 treated with chemotherapy (p less than 0.001). In children with acute lymphoblastic leukemia (ALL), those relapsing while on chemotherapy and treated with BMT in second to fourth remission (n = 16) had a 5 year survival of 43% compared to 16% for those treated with chemotherapy (n = 53, p less than 0.05). In children with ALL relapsing after cessation of therapy, 4 year survival was 33% for BMT (n = 6) and 55% for chemotherapy (n = 15), p = 0.05). PMID- 2702068 TI - School-related behavior in children with cancer. AB - Ninety-one children with cancer (thirty-seven with leukemia and fifty-four with solid tumors)--school aged (elementary and middle school), residing in Emilia Romagna Region (Italy), and receiving treatment at the Department of Pediatrics (III), University of Bologna, from August 1973 to April 1987--took part in a study of school behavior as perceived by the teacher. The research was carried out through a 29-item forced-choice questionnaire based on the questionnaire proposed by Deasy-Spinetta for a similar study in the U.S.A. Results revealed that children with cancer have a school behavior scoring at levels significantly lower than controls. There are more difficulties for children attending middle than elementary school, for children on therapy than off therapy, and for children with leukemia than with solid tumors. In conclusion, the main obstacle to school performance seems to be lower attendance, which is mainly due to treatment and clinic visits and probably in part to an overprotection and an excessive concern on the part of physicians and parents. PMID- 2702069 TI - Meetings with parents after the death of their child from leukemia. AB - There is a growing interest in the emotional status of parents and siblings after the death of a child with chronic disease. For the past 7 years physicians at our center have systematically contacted parents who lost a child because of leukemia within the first few months after the death. From this experience it appears that most parents needed to talk at least once with the physicians who took care of their child. As expected, some parents and siblings were found to have significant psychological problems and to need psychologic support. We suggest that the opportunity to talk with a physician of the attending staff should be provided routinely to parents shortly after the death of a child from leukemia. PMID- 2702070 TI - Nutritional vitamin B12 deficiency in infancy: three case reports and a review of the literature. AB - Three cases of vitamin B12 deficiency that occurred during infancy are presented. These cases appeared to be the result of pre-existing maternal deficiency. All three infants demonstrated evidence of neurodevelopmental delay at presentation, and one had sustained loss of milestones and developed involuntary motor movements. Prior to the initiation of therapy, all three infants were anemic: one was thrombocytopenic and one pancytopenic. In all three cases the hematologic and neurologic abnormalities were corrected with vitamin B12 therapy. The literature is reviewed and discussed with respect to the mechanism of the infants' vitamin B12 deficiency and neurodevelopmental manifestations. PMID- 2702071 TI - Effects of 3-deazaadenosine, an inducer of HL-60 cell differentiation, on human blood cells in vitro. AB - The adenosine analogue 3-deazaadenosine (c3 Ado) induces differentiation of human promyelocytic leukemia HL-60 cells in vitro. c3 Ado affects in vitro viability and growth of cells involved indirectly (cytokine-producing cells) and directly (transformed myeloid cells) in leukemic cell differentiation. Growth inhibition of proliferating cells is achieved at c3 Ado concentrations between 10-100 microM. Concentrations higher than 100 microM affect viability of proliferating and nonproliferating cells. PMID- 2702072 TI - Malignant histiocytosis involving pancreas at initial presentation. AB - A 10-year-old boy with malignant histiocytosis presented with fever, hepatosplenomegaly, and diffuse pancreatic enlargement, mimicking acute pancreatitis. Although malignant histiocytosis involving pancreas at initial presentation is exceptional, this entity should be included in the differential diagnosis of acute pancreatitis, especially when hepatosplenomegaly and pancytopenia are present. PMID- 2702073 TI - Chromosome 2 abnormalities (+Der 2) in two cases of childhood rhabdomyosarcoma. AB - Chromosome analysis was performed in two cases of rhabdomyosarcoma (RMS): one embryonal RMS and one alveolar RMS. Analysis showed number and structural abnormalities of chromosome 2. The relationship between these findings and published reports of karyotypes from RMS is discussed. PMID- 2702074 TI - Neuroblastoma cells circulate in peripheral blood. PMID- 2702075 TI - Detection of minimal disease in bone marrow of neuroblastoma patients by immunofluorescence. AB - Indirect immunofluorescence studies were compared with conventional smear cytology in 82 paired bone marrow samples from children with neuroblastoma using monoclonal antibodies (MAbs) BW 575 (neuroblastoma-associated 95 kD glycoprotein) and BW 625 (ganglioside GD2) and tetanus toxin labeling. Congruent results were obtained in 70 of 82, or 85% (positive/positive; negative/negative). In 12 of 82 (15%) patients, bone marrow infiltration was demonstrated by immunofluorescence but not by conventional cytology. As few as 0.01% neuroblastoma cells were reliably detected--in some cases even fewer. Because of antigen heterogeneity, false negative results were obtained in five cases with MAb BW 625, in two cases with MAb BW 575, and in no case with tetanus toxin. No antibodies showed any cross-reactivity to hematopoietic cells in either bone marrow of infants or during regeneration after chemotherapy. We conclude that this panel of antibodies is highly sensitive and specific to detect minimal disease in bone marrow of neuroblastoma patients, which has major implications for the staging procedure, monitoring treatment, early detection of relapse, and assessment of bone marrow status before autologous bone marrow transplantation. PMID- 2702076 TI - Committed erythroid progenitors and erythropoietin levels in anemic children with lymphomas and tumors. AB - In order to investigate the pathogenesis of anemia in childhood malignancy, we studied erythroid cell proliferation responses with bone marrow erythroid cultures and serum erythropoietin (Ep) levels in 32 children with lymphomas and malignant tumors. The erythroid colony formation from 20 normal controls (mean 68.8 colony-forming-unit erythroid [CFU-E] and 32 burst-forming-unit erythroid [BFU-E] derived colonies/10(5) mononuclear cells), was higher than that seen in children with lymphomas (mean 45.9 CFU-E and 20.7 BFU-E/10(5) cells, p less than 0.01) but similar to the values obtained from children with tumors (mean 65.1 CFU E and 28.1 BFU-E/10(5) mononuclear cells). The degree of anemia in children with lymphomas correlated negatively (r = -0.7, p less than 0.01) with serum Ep levels. In contrast, a weak positive correlation (r = 0.3, p greater than 0.1) was observed between the degree of anemia and Ep values in the group with tumors. We suggest that the decreased number of committed erythroid progenitors in lymphomas may be the main factor for anemia in these patients, while the abnormal response of Ep to the degree of the anemia suggests a defect in erythropoiesis in children with tumors. PMID- 2702077 TI - What is the cause of hypertension in children with coarctation of the aorta? PMID- 2702079 TI - Clinical quiz. Renal tubular acidosis (RTA). PMID- 2702080 TI - Is renal biopsy useful to determine the prognosis and management of children with congenital nephrotic syndrome? PMID- 2702078 TI - The immune system in minimal change nephrotic syndrome. AB - Numerous examples of abnormal immune responsiveness have been described in minimal change nephrotic syndrome (MCNS). The of MCNS with allergy and with certain genetic markers of immune responsiveness, as well as the excellent response of proteinuria to immunomodulatory agents, has suggested a causal relationship between the immunological and renal abnormalities. However, the nature of this relationship is uncertain. Before it can be clarified, the basic mechanism(s) involved in disturbed immunity in patients with MCNS must be better characterized. Studies of humoral and cellular immune function support the hypothesis that immune regulation is abnormal. However, conclusive evidence of participation by a defined immunoregulatory system in the events leading to immune dysfunction has not been obtained. Thus, considerable work remains to be done in determining the nature and cause of abnormal immunity in MCNS prior to investigating its potential role in the pathogenesis of proteinuria. PMID- 2702081 TI - Estimation of glomerular filtration rate in anorectic adolescents. AB - Severe malnutrition has been associated with a decrease in fat and lean body mass, as well as in renal function. This study was designed to evaluate the estimation of glomerular filtration rate (GFR, ml/min per 1.73 m2) in malnourished teenagers, by using the formula GFR = kL/Pcr (where L is body height, Pcr is plasma creatinine concentration and k is a proportionality constant relating muscle mass to body size that has been found to equal 0.7 in adolescent boys and 0.55 in girls). Body composition was estimated using anthropometric measurements and urinary creatinine excretion (UcrV). Malnourished female patients showed depletion of fat and muscle, whereas males had primarily decreased muscle mass. There was a good correlation (r = 0.74) between anthropometric [arm muscle volume (AMV)] and chemical UcrV estimates of muscle mass. However, our previously validated estimate of GFR did not give reliable results in this group of malnourished teenagers, probably because their muscle mass was so greatly altered by the severity of malnutrition. Therefore, we used anthropometric measurements and Pcr, to estimate GFR by multiple linear regression. The best prediction was obtained by using AMV/Pcr and the observed/expected (for age, height and sex) weight ratio (WR): GFR (ml/min) = 0.06 AMV/Pcr + 131 WR - 79, r = 0.82, n = 13. We confirm that malnutrition in adolescents is associated with decreased GFR and conclude that the resulting variability in body composition limits the possibility of estimating GFR from Pcr and height.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702083 TI - What is the prevalence of asymptomatic microscopic haematuria and how should such children be managed? PMID- 2702082 TI - Creatinine, body size and renal function. PMID- 2702084 TI - Major histocompatibility complex antigens in steroid-responsive nephrotic syndrome. AB - An increased frequency of specific major histocompatibility complex (MHC) class I, II and III antigens in children with steroid-responsive nephrotic syndrome (SRNS) has been reported. This frequency distortion, in some cases, is thought to affect the outcome of the disorder. We studied the phenotypic frequency of HLA antigens -A, -B, and -DR, as well as complement proteins Bf and C4 in an unrelated population of 25 SRNS children. Complete MHC haplotypes were also derived for four families in which 8 individuals developed SRNS. HLA-DR8, with a relative risk of 4.8, showed the strongest association with SRNS. Nonetheless, the 95% confidence intervals of this and the relative risks for all other antigens fell below 1.0. No common haplotype was found in SRNS patients in whom complete family studies were available, and disease and inheritance of the MHC were discordant in two of these families. In this study of well-characterized SRNS patients we were unable to discover a clear association between this disorder and the MHC. PMID- 2702085 TI - Renal cystic disease of infancy: results of histochemical studies. A report of the Southwest Pediatric Nephrology Study Group. AB - Histochemical techniques utilizing Tetragonolobus lotus (proximal tubules), Arachis hypogaea (distal nephron, i.e., distal convoluted tubules and collecting ducts), and antibodies against Tamm-Horsfall protein (thick ascending limbs of Henle) were used to determine the site of origin of renal cysts in five children with autosomal recessive polycystic kidney disease (ARPKD) and three patients with glomerulocystic disease (GCD) presenting in the 1st year of life. The findings support a distal nephron origin for the cysts in the children who had ARPKD, whereas the majority of cysts in the children with GCD were confirmed as having a glomerular origin. Tamm-Horsfall protein was identified in the cysts of both ARPKD and GCD; this finding suggests free communication between some of the cysts with the thick ascending limb of Henle. An unexpected finding was the frequent presence of cysts surrounded by muscle fibers. We suggest that these cysts are of collecting duct origin. PMID- 2702086 TI - Has the basic metabolic defect of cystinosis been discovered? PMID- 2702087 TI - Autosomal recessive polycystic kidney disease. AB - The clinical features of 55 cases of autosomal recessive polycystic kidney disease (ARPCKD) have been reviewed. Each had evidence of ARPCKD. The outcomes of 87% were known; 24 had died. Twenty-four of 31 were seen between 1980 and 1986; 7 could not be traced. Forty-five percent presented under 1 month; 38% between 1 month and 1 year; and 9 cases over 1 year. Hyponatraemia occurred in 15 out of 19 aged less than 3 months; hypertension occurred in 65%; splenomegaly in 47% of those surviving more than 3 months. Portocaval shunts were done in 5 aged 2-12 years. Thirteen died of renal failure, 6 under 1 year, and 7 between 1 year and 13 years. Life-table survival rates calculated from birth revealed that 86% were alive at 3 months, 79% at 1 year, 51% at 10 years, and 46% at 15 years. Calculations based on patients who survived to 1 year of age showed that 82% were alive at 10 years and 79% at 15 years. These results reveal an improved prognosis for a condition once assumed to be fatal. PMID- 2702088 TI - Infantile chronic tubulo-interstitial nephritis with cortical microcysts: variant of nephronophthisis or new disease entity? AB - Over a 15-year period we observed seven children (four girls, three boys) who presented within the first months of life with severe renal failure and acidosis, associated with hypertension in five patients and polyuria in four. In addition, one patient had a severe cholestatic liver disease. In two families, a similarly affected sibling had died previously. Four patients were referred with the clinical diagnosis of polycystic kidney disease because of moderate enlargement of kidneys, but renal imaging (intravenous pyelography and ultrasonography) did not confirm this diagnosis. A renal biopsy, performed in all patients, showed similar features characterized by a diffuse chronic tubulo-interstitial nephritis (TIN) and particularly by the presence of microcystic dilatation of proximal tubules and Bowman's space. Liver pathology was normal in two patients, including one with hepatomegaly. However, in the patient with cholestasis there was inflammatory portal fibrosis with mild duct proliferation. Progression of the renal disease was extremely rapid and all patients reached end-stage renal failure (ESRF) before the age of 2 years (11-22 months). Two children had successful renal transplants. Although this chronic TIN shares some features with nephronophthisis, we suggest that it represents a distinct entity both on clinical and morphological grounds. The specific clinical features of this disease are its early onset and rapid progression to ESRF. Pathologically, it differs from nephronophthisis by the absence of medullary cysts and thickened tubular basement membranes and by the presence of cortical microcysts. PMID- 2702089 TI - Rate of deterioration of renal function in juvenile nephronophthisis. AB - The rate of deterioration of renal function was determined in 29 patients with juvenile nephronophthisis presenting before the age of 18.5 years. The analysis was based on 618 serial determinations of serum creatinine (SCR). By application of a new statistical method the time elapsing between different successive SCR levels was calculated. A more or less homogeneous increase of SCR was noted starting from the time when a SCR of 4 mg/dl was reached. The median time elapsing between an SCR of 2 and 4 mg/dl was 32 months, between 4 and 6 mg/dl 10 months and between 6 and 8 mg/dl 5 months. The median age at the start of renal replacement therapy or death due to uraemia, evaluated by survival analysis, was similar in both sexes. PMID- 2702090 TI - Continent urinary diversion and bladder augmentation in children: the Mainz pouch procedure. AB - The formation of a bowel reservoir of large capacity at low pressure by using small and large bowel (ileocaecal segment) has proved reliable for achieving continent urinary diversion (n = 80), for bladder augmentation (n = 42) as well as for total bladder replacement (n = 24). Encouraged by the results we obtained in our adult patients, we have used this technique during the last 3.5 years in 29 children. Indications for urinary diversions in children have been: neurogenic bladder with diplegia (n = 8), bladder exstrophy (n = 2), traumatic loss of the bladder (n = 1), urogenital sinus (n = 1) and rhabdomyosarcoma of the prostate or bladder (n = 2). Bladder augmentation was indicated in 6 children with iatrogenic bladder loss, in 5 children with neurogenic bladder without diplegia and in 4 boys with incontinent epispadias or exstrophy. In children with bladder exstrophy or incontinent epispadias, continence was achieved using a modified Young-Dees technique with formation of a long intra-abdominal muscular tube made out of the bladder plate or the low-capacity bladder. The capacity of the urinary reservoir was guaranteed by bladder augmentation or bladder replacement with an ileocaecal pouch. During a mean follow-up period of 26 months (bladder augmentation) and 21 months (continent diversion) there was only one postoperative complication (intussusception ileus) which required operative revision. Two children had to undergo reoperation because of nipple problems. Follow-up, with monitoring of biochemical and metabolic parameters, is necessary to show whether this technique will provide a long-term successful solution for these problems. PMID- 2702091 TI - Measurement of erythropoietin in anephric children. A report of the Southwest Pediatric Nephrology Study Group. AB - Serum erythropoietin (Ep) levels were measured using a highly sensitive radioimmunoassay in 69 children undergoing chronic dialysis; 31 were anephric, whereas 38 were non-nephrectomized (nephric). Twenty-nine normal children were studied as controls. Serum Ep levels in the anephric group were much higher than anticipated (mean 19.7 +/- 1.8 mU/ml), albeit significantly lower than those measured in normal children (mean 26.2 +/- 2.4 mU/ml, P less than 0.05), or in nephric children on dialysis (33.0 +/- 2.9 mU/ml, P less than 0.001). Anephric children on peritoneal dialysis (PD) had significantly (P less than 0.05) higher serum levels of Ep (22.7 +/- 2.4 mU/ml, n = 19) than anephric children on hemodialysis (HD) (15.1 +/- 2.3 mU/ml, n = 12). There was no significant difference between Ep levels in anephric patients dialyzed for less than or equal to 1 year (19.6 +/- 2.0 mU/ml, n = 20) compared with anephric patients dialyzed for more than 1 year (20.0 +/- 3.9 mU/ml, n = 11). Although serum Ep levels showed a tendency to increase with time after nephrectomy, the mean values for less than 3 months (14.7 +/- 1.9), 3 months-12 months (21.0 +/- 2.7), and greater than 12 months (21.6 +/- 6.0) were not significantly different from each other. This demonstration of relatively normal levels of serum Ep in anephric children suggests that extrarenal sites of Ep production are able to exert a significant response to severe anemia in patients who are devoid of renal parenchyma. PMID- 2702092 TI - Fatal fungal peritonitis in an adolescent on continuous ambulatory peritoneal dialysis: association with deferoxamine. AB - An unusual case of Rhizopus microsporus (mucormycosis) fungal infection in a teenage boy on continuous ambulatory peritoneal dialysis is presented. Premortem cultures were negative and the patient developed a rapidly disseminated fatal infection. The patient was being treated with deferoxamine (DFO) for iron and aluminum overload. An argument is made for a probable association between DFO and this fatal fungal infection in patients with end-stage renal disease. PMID- 2702093 TI - Enhanced clearance of vancomycin by hemodialysis in a child. AB - Clearance of vancomycin by hemodialysis has previously been reported to be negligible. We describe a child undergoing chronic hemodialysis using a hollow fiber dialyzer with cellulose acetate membrane. When the patient was treated with intravenous vancomycin for staphylococcal bacteremia, the serum vancomycin half life was found to decrease by more than 90% during each course of hemodialysis. We conclude that, contrary to prevailing opinion, vancomycin can be rapidly cleared by hemodialysis in the small pediatric patient, and that the dosage should be adjusted accordingly. PMID- 2702094 TI - Parental attitudes toward organ transplantation. AB - We investigated parental attitudes toward organ donation by surveying the parents of 106 children attending a general pediatric, cystic fibrosis, hematology or nephrology clinic using a printed questionnaire. Only 64% of parents knew that cessation of brain function is the definition of death. Most people (73%) obtained information about organ transplantation from the mass media and significantly fewer (37%) from medical personnel (P less than 0.05). Blacks were less likely than whites to express a desire to be living-related and/or cadaveric donors (P less than 0.05). PMID- 2702095 TI - Unilateral hydrothorax in small children on chronic continuous peritoneal dialysis. AB - Three small children whose weights were under 15 kg and who were on continuous ambulatory peritoneal dialysis or continuous cycling peritoneal dialysis developed massive unilateral hydrothorax. The occurrence of hydrothorax was late, 3-22 months after the initiation of dialysis. Two of the three fluid collections were left-sided. Each episode was preceded by retention of dialysate. After drainage of the hydrothorax a modified peritoneal dialysis regimen was successful in sustaining patients for a few weeks until further therapy for end-stage renal disease could be pursued. PMID- 2702096 TI - Renal dysfunction in recurrent urinary tract infections in childhood. AB - One hundred children aged 1.5-19.5 years, with recurrent urinary tract infections, at least one of which was febrile (pyelonephritis, PN), were investigated by means of inulin and para-aminohippurate (PAH) clearance tests for the evaluation of glomerular filtration rate (GFR), effective renal plasma flow, and concentrating and diluting capacities. Renal function data were collated with the clinical history and radiological findings. GFR and PAH clearance were found to be reduced compared with controls. Patients whose first PN was diagnosed before the age of 3--particularly those with a history of three or more PN infections--showed the lowest values for GFR and PAH clearance. Furthermore, parenchymally reduced kidneys were found most frequently in this group of patients. Concentrating capacity was decreased in some patients, but a low concentrating capacity did not reveal patients with reduced GFRs. Diluting capacity evaluated as minimal urine osmolality was normal, but was reduced when evaluated as free water clearance in some patients with reduced values for GFR. PMID- 2702098 TI - Asymptomatic haematuria and proteinuria: renal pathology and clinical outcome in 54 children. AB - In a mass screening programme, 54 children with haematuria and proteinuria were detected and evaluated by clinical findings and renal histology. IgA glomerulonephritis (GN) occurred in 29 patients, diffuse mesangial proliferative GN (DPGN) in 16, membranous GN (MGN) in 4, membranoproliferative GN (MPGN) in 3, and focal segmental glomerular sclerosis (FSGS) was seen in 2. Of the 35 children with proteinuria less than or equal to 1 g/m2 per day, 21 with IgA GN and 14 with DPGN had only mild to moderate glomerular changes. None of these children had developed renal impairment after a mean period of 6.5 years (range 5-10 years). On the other hand, 8 children with IgA GN, 2 with DPGN, 4 with MGN, 3 with MPGN, and 2 with FSGS had proteinuria that exceeded 1 g/m2 per day. The biopsy specimens from these children showed moderate to severe glomerular changes, and 7 of these children had hypertension or renal impairment during the period of evaluation. This study suggests that a poor outcome correlates with the level of proteinuria and the severity of renal pathology in children with haematuria and proteinuria. PMID- 2702097 TI - Intra- and extrarenal factors of oedema formation in the nephrotic syndrome. AB - The role of intra- and extrarenal factors in oedema formation in children with nephrotic syndrome is reviewed. Oedema reflects an abnormal accumulation of fluid within the interstitial tissue. At the capillary level oedema develops when increased lymph flow is no longer effective for the removal of interstitial fluid and the maintenance of intravascular volume. Alterations of intrarenal haemodynamics and tubular sodium reabsorption contribute to sodium retention. Recent studies suggest that during oedema formation reduced effective circulatory volume triggers changes in various hormonal systems, such as renin-angiotensin aldosterone, noradrenaline, dopamine, vasopressin, prostaglandins and natriuretic factors, which contribute to sodium and water retention. It appears that the release of atrial natriuretic peptide following central volume expansion is responsible for the increased urine flow and natriuresis after intravenous administration of albumin. PMID- 2702099 TI - Long-term follow-up of patients with persistent/recurrent, isolated haematuria: a Hungarian multicentre study. AB - A retrospective multicentre study of 341 children with persistent/recurrent, isolated haematuria is described. The haematuria was isolated for at least 6 months at the beginning of observation. The duration of follow-up was 2-5 years in 201, 5-10 years in 119, 10-15 years in 19, and over 15 years in 2 cases. Of these patients 47.8% became symptom-free. In 18.4% the haematuria remained isolated; in 13.8% it was combined with proteinuria over 250 mg/day more than 2 years later. The occurrence of associated proteinuria increased progressively with time. It was 8.6% between the 3rd and 5th years, and 37.0% after the 5th year. Renal biopsy was performed because of the symptoms of glomerular disease in 47 cases at an average time of 12 months following the appearance of proteinuria. Proteinuria appeared after a 2-5, 5-10, 10-15 and more than 15 years follow-up period in 16, 23, 6, and 2 patients respectively; 14 of them had Alport's nephropathy. The percentage of more serious azotaemia was 1.7 (creatinine clearance: 10-50 ml/min per 1.73 m2) and 0.3 (creatinine clearance: less than 10 ml/min per 1.73 m2). Mortality was 0.58%. Most of the patients who developed severe azotaemia had persistent microscopic haematuria at the beginning. The prevalence of hypertension was only 1.2%. The time of its appearance was above 5 years in 2 and below 5 years in 2 cases. All these patients had chronic glomerulonephritis. The haematuria was associated with hypercalciuria in 19.9%. In 14.3% of the overall group of patients urolithiasis developed 2-15 years after onset. All of these had hypercalciuria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702100 TI - Asymptomatic hematuria--a cause for concern? PMID- 2702101 TI - A histopathological study on the prognosis of childhood IgA nephropathy and glomerular basement membrane lesions. AB - Seventy-three patients with IgA nephropathy (IgAGN), under the age of 15 years at the time of the discovery of the disease, were investigated with respect to glomerular basement membrane (GBM) lesions. Irregular attenuation or widening of GBM, especially on the epithelial side, was observed in 28 cases (38%). These two changes are referred to as lysis of GBM and were considered to be the primary and specific changes among the GBM lesions in IgAGN. GBM thickening with layering of lamina densa was found in 37 of 73 cases (51%), but this change has been observed in other types of glomerular diseases. GBM lesions similar to those seen in IgAGN were also observed in Henoch-Schonlein purpura nephritis (HSPN) and poststreptococcal acute glomerulonephritis (PSAGN). Lysis of GBM was observed only in IgAGN, HSPN and PSAGN. Subepithelial and intramembranous deposits appeared to have an important role in the development of these GBM lesions. The presence of GBM lesions was correlated with a high incidence of cellular crescents but not with other clinical or light microscopic findings. The presence of these GBM lesions in IgAGN does not have a significant effect on the prognosis, at least in childhood. The affected GBM seemed to recover without leaving any significant residual damage in most cases. In the long-term prognosis of the disease non-immunological factors, such as ageing or hypertension, seem to be important. PMID- 2702102 TI - Treatment of severe IgA nephropathy in children. AB - We treated ten children with severe IgA nephropathy (IgAN) [proteinuria greater than 1 g/day, hypertension, renal insufficiency, segmental sclerosis, crescent formation and/or glomerular basement membrane (GBM) deposition of IgA] with prednisone and azathioprine for 1 year. Following the year of therapy, seven of the ten children underwent a repeat kidney biopsy. All biopsies were scored for activity (percentage of glomeruli demonstrating crescent formation, degree of mesangial proliferation and interstitial infiltrate; maximum score = 9) and chronicity (percentage of glomeruli demonstrating fibrous crescents, segmental sclerosis, global sclerosis, and degree of tubular atrophy and interstitial fibrosis; maximum score = 12). After 1 year of therapy, the protein excretion of all the children decreased significantly (P less than 0.01) from 4,052 +/- 3,190 mg/day to 1,692 +/- 1,634 mg/day. The activity score decreased significantly (P less than 0.01) from 4.35 +/- 0.94 prior to therapy to 2.28 +/- 0.75 after therapy while the chronicity score was unchanged (5.42 +/- 1.7 vs 5.85 +/- 2.0). The percentage of glomeruli demonstrating cellular crescents decreased (P less than 0.05) from 21.2 +/- 21.7% prior to therapy to 0.94 +/- 2.4% after therapy. Mesangial deposition of IgA persisted but GBM deposition of IgA was less prominent after therapy. During the follow-up period (mean 2.6 years, range 9 months-7.5 years), one child required brief retreatment for biopsy-confirmed recurrence of active disease, two children have developed renal insufficiency due to progressive scarring in the absence of inflammation, while the remaining seven are stable. We suggest that treatment with prednisone and azathioprine may be beneficial in children with severe IgAN and that a controlled clinical trial is warranted. PMID- 2702103 TI - In vitro B-lymphocyte switch disturbance from IgM into IgG in IgM mesangial nephropathy. AB - In vitro immunoglobulin (Ig) synthesis using a co-culture technique after activation of lymphocytes with pokeweed mitogen, T-cell subsets and interleukin-2 (IL-2) production was studied in 10 children who suffered from IgM mesangial nephropathy (IgMN), 10 children who suffered from minimal change nephrotic syndrome (MCNS) with hypercellularity and 6 children who suffered from MCNS with normal cellularity during the acute nephrotic phase. Reduced in vitro IgG production was found in the presence of OKT8 cells from all groups of patients. However, in vitro IgM production was increased only in OKT8 cells from IgMN and MCNS patients with hypercellularity. In vitro Tac expression on the OKT8 cells, IL-2 production, T-cell subsets including Leu2a+15+ (suppressor T-cells), Leu2a+DR+ (activated suppressor T-cells) and Leu3a+8+ (suppressor T-cell inducer) were all increased in IgMN and MCNS patients with hypercellularity. There was a significant correlation between in vitro IgM production by co-culture technique and IL-2 production. These results strongly suggest the hyperfunction of isotype specific suppressor T-cells which may affect the switch of IgM B-cells to IgG B cells in IgMN and MCNS patients with hypercellularity and may be used to explain in part the clinical findings of lower serum IgG and increased IgM in those patients. PMID- 2702104 TI - Renal tubular differentiation in mouse and mouse metanephric culture. I. Ultrastructural studies. AB - We studied the morphologic features of renal tubular differentiation in transfilter metanephric culture. Differentiation of portions of the S-shaped loop into proximal convoluted tubule was detected shortly after 72 h of culture by the appearance of microvilli, coated membrane invaginations, and an apical vacuolar microtubular network. These features developed synchronously, and the microvilli became progressively more numerous and more compact to form a brush border. Computer-assisted morphometric analysis showed only minor differences between proximal tubular cells from 18-day embryos and tubular cells from 7-day cultures of blastema taken from 11-day embryos. Segments of tubule corresponding to distal convoluted tubules were lined with relatively simple cells that contained few differentiating characteristics. Morphometric modeling of the tubular cells indicated a simple shape consistent with an inherent transport function. PMID- 2702105 TI - Glomerular adaptation in uninephrectomized young rats. AB - To study the glomerular adaptation during compensatory renal growth starting in infancy, we assessed afferent effective ultrafiltration pressure (PUF), glomerular filtration area and hydraulic conductivity in rats uninephrectomized (Nx) or sham-operated (S) at 5 days of age. Rats were fed a normal protein diet and studied at 20 and 60 days of age. Single nephron glomerular filtration rate was significantly higher in Nx than in S rats both at 20 days of age (mean +/- SEM: 15.0 +/- 1.5 vs 7.4 +/- 0.7 nl/min) and 60 days of age (80.7 +/- 4.6 vs 43.5 +/- 3.2 nl/min). Afferent effective PUF, estimated by the stop-flow method, was significantly higher in Nx than in S rats both at 20 days (22.5 +/- 0.8 vs 18.3 +/- 0.4 mmHg) and 60 days (28.3 +/- 1.0 vs 23.2 +/- 1.1 mmHg). The filtering area per glomerulus, calculated as the area of the glomerular basement membrane facing both the endothelial and the epithelial cells, but not the mesangial cells, was not different in Nx and in S rats at 20 days (3.0 +/- 0.3 vs 2.8 +/- 0.1 10(4) microns 2), but it was significantly greater in Nx than in S rats at 60 days (23.3 +/- 3.7 vs 9.9 +/- 0.9 10(4) microns 2). The hydraulic conductivity determined in isolated glomeruli was similar in Nx and in S rats at 20 days of age (1.40 +/- 0.11 vs 1.69 +/- 0.23 microliters/min.mmHg.cm2) but was significantly decreased in 60-day-old Nx rats, compared with S rats of the same age (1.52 +/- 0.11 vs 2.35 +/- 0.17 microliters/min.mmHg.cm2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702106 TI - Beckwith-Wiedemann syndrome and its association with type III polycystic kidney disease. AB - Two cases from our institution and another from the literature in which Beckwith Wiedemann syndrome (BWS) and type III polycystic kidney disease (PKD) occurring simultaneously are discussed. The importance of recognizing the subtle signs of BWS is stressed, because of the increased risk of malignancies, as well as the need for continued evaluation of patients with BWS for the development and complications of PKD. PMID- 2702107 TI - Why is it difficult to achieve ultrafiltration in neonates who are undergoing peritoneal dialysis? PMID- 2702108 TI - Potentiated nephrotoxicity of cisplatin when combined with amikacin comparing young and adult rats. AB - We compared the nephrotoxic interaction between cisplatin (CP) and amikacin (AM) in young and adult rats, using different dosage combinations. Following a single i.v. dose of CP, AM was administered s.c. for 14 days. The dose of CP was chosen to cause a 20%-50% fall in the glomerular filtration rate (GFR), while a dose of AM was chosen that had only a minimal effect on GFR. In adult rats, a decrease in GFR to 60% of the control value after CP alone was seriously aggravated by a non toxic AM course given during 2 weeks after CP. In this combination, the GFR per 100 g body weight was reduced to 30% of control at week 2, which rose to 40% of control at week 15. In young rats, a non-toxic AM course did not aggravate the CP induced impairment in GFR. However, when the dose of AM was increased to cause a 20% reduction in the GFR, the nephrotoxicity was potentiated. When measured at week 2, the GFR per 100 g body weight was 40% of control after the combined treatment compared with 80% of control after CP alone. As in adult rats, there was only a partial recovery of the GFR. In conclusion, in both adult and young rats, a course of AM following a single injection of CP potentiated CP-induced nephrotoxicity. PMID- 2702109 TI - Cyclosporine induces abnormal facial bone growth in children: a preliminary study. AB - Using cephalometric radiography, facial bony structure of a group of pediatric renal transplant recipients immunosuppressed with cyclosporine (CsA) and prednisone was studied and compared with a control group of children. A pattern of abnormal facial growth was demonstrated on cephalometry in eight of nine transplant recipients receiving CsA. The abnormalities included shortening of posterior facial height and increased anterior facial height with a deep mandibular plane angle. There was also an absolute shortening in the mandibular body and mandibular retrognathia. These findings may be consistent with inhibition of mandibular condylar growth inhibiting the anteroinferior growth of the mandible. Similar changes were present in two children with end-stage renal disease and none of the remaining nine control patients (P less than 0.01, chi squared analysis). The affected area appears to be the lower third of the face. The role of CsA in affecting facial bony growth in children needs to be evaluated further. PMID- 2702110 TI - Relapse of nephrotic syndrome, progressive renal failure and return to chronic dialysis therapy after a renal transplant. PMID- 2702111 TI - Growth in young children with chronic renal failure. AB - Statural growth and its relation to growth potential, renal function, blood urea nitrogen (BUN), mineral metabolism hormones and dietary intake were studied in 17 prepubertal children (aged 1.6-9.3 years) on conservative treatment for chronic renal failure due to tubulo-interstitial nephropathy. Statural growth (height SDS) was related to the degree of renal failure, was more retarded than ossification, and was independent of the chronological age of the patients. We observed that the lower the glomerular filtration rate (GFR), the lower was the growth potential (increased bone age/statural age ratio). Growth velocity may be normal regardless of statural and bone maturation delay and the degree of renal insufficiency. Impaired growth rate correlated with parathyroid hormone levels, caloric intake and increased blood urea nitrogen during the year of observation. These data show that comprehensive monitoring and suitable treatment must be performed in order to prevent growth retardation at any GFR level. PMID- 2702112 TI - The immune status of uraemic children/adolescents with chronic renal failure and renal replacement therapy. AB - In adults with chronic renal failure (CRF) and/or renal replacement therapy (RRT) various immunological abnormalities have been described, but few data are available for the paediatric age group. We performed basic in vitro immunological studies in 26 patients 10 months-19 years of age with advanced renal failure, 11 with CRF (creatinine clearance 16.8 +/- 5.2 ml/min per 1.73 m2), 15 on RRT with haemodialysis (HD; n = 9) and continuous ambulatory peritoneal dialysis (CAPD; n = 6) as well as in 16 healthy controls. None had clinical evidence of deranged immune function. No significant differences were found in the percentages of B- and T-cells, T-cell subsets CD3, CD4, CD8 and mitogenic responses to phytohaemagglutinin and concanavalin A (Con A) between RRT patients (HD = CAPD) and control children. Most parameters in CRF patients were also normal, although they had a low percentage of B-cells (12.1 +/- 4.1; RRT: 19.7 +/- 6.5; controls: 18.5 +/- 7.1; P less than 0.01), relatively low levels of serum immunoglobulin G (948.4 +/- 209.4 mg/dl; HD: 1374.7 +/- 235.2 mg/dl; P less than 0.01; CAPD: 966.3 +/- 430.2 mg/dl, NS) and a high normal response to Con A (34.3 +/- 13.6 cpm x 10( 3); RRT: 24.5 +/- 11.3 cpm x 10(-3); controls: 23.4 +/- 9.9 cpm x 10(-3), P less than 0.01). All these values were, however, well within the normal accepted range. These data indicate that children/adolescents with CRF and/or RRT have no significant basic in vitro immunological defects. This study did not test the functional immune status of the young uraemic patients. PMID- 2702113 TI - Zinc and copper balance in children on continuous ambulatory peritoneal dialysis. AB - We monitored serum zinc and copper levels for 4 months in six patients treated with continuous ambulatory peritoneal dialysis (CAPD). Zinc and copper fluxes were studied during a single dialysis exchange and over a 3-day period. Routine oral trace element supplements were then discontinued for 2 months. Serum zinc levels declined but serum copper levels remained unchanged. One month after oral supplements had been restarted, serum zinc levels returned to normal and serum copper levels rose above initial values. Zinc and copper concentrations in dialysis exchange indicated that the patients absorbed zinc and lost copper in significant amounts. The patients had poor dietary intakes of both minerals. These data suggest that patients treated with CAPD benefit from oral zinc supplementation. PMID- 2702114 TI - Nifedipine, verapamil and cyclosporin A pharmacokinetics in children. AB - We report two paediatric renal transplant patients in whom interaction with the calcium channel blocking agent verapamil resulted in reduced cyclosporin A (CyA) elimination. Prior therapy with another calcium channel blocking agent, nifedipine, did not affect CyA pharmacokinetics. We speculate that verapamil reduced CyA elimination in children via an effect upon the microsomal oxidase system that is independent of calcium channel activity. PMID- 2702115 TI - Urolithiasis in children: current medical management. AB - The mechanism of stone formation in the urinary tract is reviewed. Diet, urinary tract infection and metabolic disorders account for the different epidemiological patterns of stone formation. The diagnosis and management of renal tract calculi are discussed. Calcium stones are associated with hypercalciuria, urine acidification defects, the use of furosemide in premature babies, hypercalcaemia, hyperoxaluria, hyperuricosuria, an alkaline urine and hypocitraturia. Uric acid stones occur in acid urine, from increased purine synthesis with lympho- or myeloproliferative disorders or from several inborn errors of purine metabolism which can also cause xanthine or dihydroxyadenine stones. Cystinuria, inherited as an autosomal recessive disorder is best treated with a low sodium diet, a fluid intake exceeding 40 ml/kg per day maintaining urine pH between 7.5 and 8 and, if necessary, with oral penicillamine. Oxalate stones occur in relation to diet, bowel disease and primary inherited defects in oxalate metabolism. Urinary tract infection causing struvite and carbonate apatite formation is the commonest cause of stones in Europe. PMID- 2702116 TI - Factors governing urinary tract stone disease. AB - Urinary stone formation depends on the degree of saturation of the urine with respect to potential stone-forming substances. Urine contains a range of electrolytes which ionise to different and variable degrees and which interact with one another in ways which influence their solubilities. These ionisations are themselves influenced by the pH of the urine which is another variable factor. Urinary organic molecules, which may or may not ionise and which may bear surface charges, also influence the solubility of the low molecular weight stone constituents. Some other substances in the urine, such as glycosaminoglycans, can modify the ability of inorganic micro-crystals to aggregate and form stones. Environmental factors, other urinary tract pathology and genetic influences all predispose to urolithiasis, but many cases lack either an identifiable specific cause or the presence of recognisable risk factors. In the risk factor model of calcium stone formation there are pre-renal risk factors which lead to urinary risk factors and hence to the chemical risk factors of supersaturation and decreased ability to inhibit crystallisation. There are, in addition to these general factors which may act synergistically to produce urinary stones, several specific single enzyme defects which alter the urinary composition in such a way as to produce stones of a highly characteristic composition. PMID- 2702117 TI - Do circulating factors play a role in the pathogenesis of minimal change nephrotic syndrome? AB - This review examines the studies which have been undertaken to test the hypothesis that minimal change nephrotic syndrome of childhood (MCNS) is a primary immune disorder and that there is altered T-cell function which results in release of a circulating factor. This factor alters glomerular permeability, perhaps by modifying charge sites in the glomerular capillary bed, and results in selective proteinuria. The abnormalities in immune function observed in MCNS are summarized, as are the studies of circulating factors which have been identified. Although some agents have been shown to alter capillary permeability, the unequivocal demonstration of such a factor causing selective proteinuria in vivo, either directly or indirectly, is lacking. The question is raised whether intrarenal release or activation of mediators of altered permeability, rather than the systemic release of such factors, may be important in the pathogenesis of MCNS. PMID- 2702119 TI - Clinical quiz. Branchio-oto-renal syndrome. PMID- 2702120 TI - Position paper on current status and future needs of pediatric nephrology in the United States: training and research. Writing Committee of the American Society of Pediatric Nephrology. PMID- 2702118 TI - The treatment of lupus nephritis. AB - The literature on the treatment of lupus nephritis is scattered, much of it in rheumatological rather than nephrological journals. Whatever our ignorance of the nature and genesis of lupus nephritis, under empirical treatment the prognosis, especially for severe forms, has improved dramatically during the past 20 years. For severe lupus nephritis, the evidence that the addition of cytotoxic agents to corticosteroids improves outcome is now secure, and discussion centres mainly on which drug to use and by what route. Intravenous methylprednisolone is at least as effective as high-dose tapering oral therapy for initial treatment, and carries fewer side-effects. The role of plasma exchange in lupus remains undefined: it may have a role in the treatment of cerebral manifestations or otherwise resistant patients, but controlled trials have failed to show benefit. Future developments will probably centre around the use of specific monoclonal antibodies which target specific groups and subgroups of cells, "humanised" by the splicing of human Fc piece to rodent (fab)2, perhaps bearing toxins. To use these agents to best advantage, however, we will have to understand better than we do today the nature of the cellular defects in the immune response which underlie the lupus syndrome. PMID- 2702121 TI - Developmental histories in amphibian myogenesis. PMID- 2702122 TI - Origins of the neurovascular bundle: interactions between developing nerves and blood vessels in embryonic chick skin. AB - Growth cones of nerves and endothelial cells of blood vessels are closely analogous in their migratory behavior, and they are both set a similar task during the early development of a limb. Both must invade the mesenchyme to form ramifying networks of large nerves and vessels. Both systems must densely pervade certain regions of the developing limb, such as muscle rudiments, and both form dense cutaneous plexuses at precisely the same depth beneath the epidermis. Moreover, adult tissues show many examples of neurovascular bundles in which nerves and blood vessels run closely parallel and branch in a correlated fashion, suggesting some interdependence during development. We have examined the interrelationship between developing nerves and blood vessels in chick wing skin because it allows a particularly convenient two-dimensional analysis of the two systems which can be revealed simultaneously in the same preparation by injection of Indian ink combined with silver-staining. We show that nerves do not use blood vessels as pathways along which to crawl, but that there are two other ways in which neurovascular associations arise: in some situations nerves and blood vessels follow the same route because they are responding independently to the same mesenchymal cues; and in some situations nerves induce blood vessels to remodel around them. PMID- 2702123 TI - Immunohistochemical analysis of the segregation process of the quail germ cell lineage. AB - An antiserum against quail 7 day gonadal germ cells was found to react specifically with gonadal germ cells of both sexes. Transverse sections from a range of early quail developmental stages were submitted to the antibody PAP reaction. Blastodiscs from the earliest uterine stages (II to X E.G. & K) reacted very strongly, while the overall reaction gradually decreased in older blastoderms. At stage XIII both epiblast and hypoblast were weakly stained, but some large, PGC-like cells stained intensively. During gastrulation (PS formation) the reaction of the epiblast disappears quicker than that of the hypoblast. The newly formed mesoderm and entoderm do not react at all and the reaction gradually becomes limited mainly to the PGCs and somewhat to the primary hypoblast which is moving into the germinal crescent. The widely spread reaction at the early stages is thus gradually being restricted to the PGCs. PMID- 2702124 TI - Infant feeding. The physiological basis. AB - A mother's nutritional status during pregnancy has important implications for both her own health and her ability to produce and breast-feed a healthy infant. Knowledge about adequate maternal nutrition during pregnancy is incomplete, however, and there is still considerable debate about the level of extra energy needed by a pregnant woman. A woman's usual nutritional requirements increase during pregnancy to meet her needs and those of the growing fetus. Additional energy is needed because of increased basal metabolism, the greater cost of physical activity, and the normal accumulation of fat as the energy reserve. The protein, vitamin and mineral requirements of the mother also increase during pregnancy, but the precise amounts for the last two are still a matter for discussion. A woman's weight increments during pregnancy vary between privileged and underprivileged communities. In addition to calcium, phosphorus and iron, a mother provides considerable amounts of protein and fat for fetal growth. Placental metabolism and placental blood flow, which are interrelated, are the most critical factors for fetal development.The nutritional requirements of healthy newborns vary widely according to their weight, gestational age, rate of growth, as well as environmental factors. However, recommendations for some components may be derived from the average composition of early human milk and the amounts consumed by healthy, mature newborns who are following a normal postpartum clinical course. The water requirements of infants are related to their caloric consumption, activity, rate of growth, and the ambient temperature. A postnatal weight loss of 5-8% of body weight is usual during the first few days of life in mature newborn infants; in contrast, infants who experienced intrauterine malnutrition lose little or no weight at all.The dynamic process of mother-newborn interaction from the first hours of life is intimately related to successful early breast-feeding. If this process is delayed, however, it may take longer and may be more difficult to achieve. Close mother-infant contact immediately after birth also helps infants to adapt to their new unsterile environment. Because drugs can interfere with bonding and breast-feeding, such substances should be given only when necessary and their effects should be evaluated. In general, young infants, especially newborns, have very irregular feeding intervals. It is advisable for numerous reasons to feed them whenever they indicate a need. PMID- 2702125 TI - Clearance of aluminium desferrioxamine by haemodialysis using a polysulfone high flux membrane. PMID- 2702126 TI - Effect of calcium channel blockers on granulocyte activation during hemodialysis. PMID- 2702127 TI - Membrane transfer, membrane adsorption and possible membrane-induced generation of beta-2-microglobulin. PMID- 2702128 TI - Beta-2-microglobulin and dialysis-related amyloidosis. Recent developments. PMID- 2702129 TI - Fate of beta-2-microglobulin during dialysis on polysulfone and AN69 membranes. PMID- 2702130 TI - Kinetics of beta-2-microglobulin in hemodialysis. PMID- 2702131 TI - Beta-2-microglobulin handling in dialysis. PMID- 2702132 TI - How to interpret intratreatment changes in plasma beta-2-microglobulin concentrations. PMID- 2702133 TI - Influence of variation of ultrafiltration rate on cardiovascular stability during dialysis. PMID- 2702134 TI - Clinical application of the sodium modelling computation with CMS 08. PMID- 2702135 TI - Computer-supported risk analysis of haemodialysis patients in combination with possible therapies by the CMS 08. PMID- 2702136 TI - Effects of ultrafiltration on body fluid volumes and transcapillary colloid osmotic gradient in hemodialysis patients. PMID- 2702137 TI - Variation of ultrafiltration and dialysate sodium. Beneficial effects on vascular stability in diabetic dialysis patients. PMID- 2702138 TI - Optimizing dialysis by variation of ultrafiltration rate and sodium concentration controlled by continuous measurement of circulating blood volume. PMID- 2702139 TI - Evidence of fluid shifts during dialysis sessions with sodium and ultrafiltration profiles. A blood density study. PMID- 2702140 TI - Thrombogenicity of dialyzer membranes as assessed by residual blood volume and surface morphology at different heparin dosages. PMID- 2702141 TI - Clinical implementation of sodium modeling. A reappraisal. PMID- 2702142 TI - Principles of fluid dynamics and circulatory control in end-stage renal failure. PMID- 2702143 TI - Clinical multicenter study of Hemoflow F6 in comparison with different standard dialyzers. PMID- 2702144 TI - The CMS 08 modulated dialysis. Optimization of dialysis treatment. PMID- 2702145 TI - Hydraulic properties and flow-dynamic characteristics of the new low flux polysulfone F6 membrane. PMID- 2702146 TI - Biocompatibility profile of the polysulfone 400 membrane. PMID- 2702147 TI - Induction of interleukin-1 and tumor necrosis factor during in vitro hemodialysis with different membranes. PMID- 2702148 TI - Lymphocyte DNA synthesis and surface antigen expression in chronic dialysis: comparative effects of cuprophan and polysulfone membranes. PMID- 2702149 TI - In vitro studies of endotoxin transfer across cellulosic and noncellulosic dialysis membranes. I. Radiolabeled endotoxin. PMID- 2702150 TI - In vitro studies of endotoxin transfer across cellulosic and noncellulosic dialysis membranes. II. Interleukin-1 production. PMID- 2702151 TI - Hemodiafiltration with on-line production of bicarbonate infusate. A new standard for high-efficiency, low-cost dialysis in elderly and uncompliant patients. PMID- 2702152 TI - [Introduction to the problem of compliance]. AB - The following article attempts to elucidate the basic knowledge and essential statement of the problem of compliance research--based on an exemplary literature review. Characteristics of the scope of dental care are introduced into the discussion. The following is being pointed out: 1. Non-Compliance constitutes one of the major practical problems in medicine; 2. Compliance resp. Non-Compliance can only be understood appropriately from the wider structure of the doctor patient-relationship; 3. Non-Compliance often occurs even in the case of serious diseases; and 4. Several concrete measures can be formulated which comprise an improvement of Compliance. PMID- 2702153 TI - [Influence of compliance in early infancy]. PMID- 2702154 TI - [Compliance and non-compliance in youth and adults]. PMID- 2702155 TI - [Missing upper incisors as cardinal symptom in Rieger's syndrome]. PMID- 2702156 TI - [Zonarc panoramic X-rays of the human TMJ in different stages of development]. AB - 21 human skulls in various stages of development were evaluated with the radiological equipment "Zonarc". The following projections were used: DENT program (OPG), JLA (special) program (TMJ-S program), JSA program (TMJ-PA program). The positioning of the skulls as well as the correct adjustment of the equipment have been described on the basis of this investigation. The quality of reproduction of the skeletal tissue is discussed. PMID- 2702157 TI - [Uptake and release of fluoride in enamel surface after fluoridation]. AB - After one single application of a sodium monofluorophosphate or sodium fluoride solution (1%) in an in vitro study, the incorporation of fluoride into enamel platelets was determined. Compared with sodium fluoride the increase in the fluoride concentration following the application of sodium monofluorophosphate was significantly lower, whereas the loss of fluoride after four weeks of rinsing with an artificial saliva solution was markedly reduced. The duration of fluoride incorporation may be one of the factors governing the clinical equivalence of both substances. To determine the amount of enamel in which the fluoride content was measured, the elements calcium and phosphor were determined with the aid of nuclear emission spectrometry and compared with photometric phosphate measurements. All three methods produced identical results. PMID- 2702158 TI - [Insertion of collagen matrix into open bony defects]. AB - The use of collagen as a bone substitute was examined in a clinical study involving 70 patients. In a standardized operation impacted mandibular third molars were removed simultaneously. Collagen fleece was implanted in one osseous defect while the other defect was packed with iodoform gauze. Postoperative pain, swelling and complications were analyzed. There were significant differences between the two methods. The use of collagen fleece to obturate bony defects following surgical removal of impacked molars appeared to be of no advantage. On the contrary, there was a considerably higher rate of postoperative bleeding and complications. This could probably be related to the poor stability of the implanted material. PMID- 2702159 TI - [Structural studies of veneered palladium alloys with a focus on the ceramometal interface]. AB - Samples of palladium-silver and palladium-copper alloys with ceramic veneers were examined under incident light and scanning electron microscopes in terms of their metallographic properties. Both materials showed a fine grain structure. The palladium-silver alloy had inhomogeneous crystallites. The palladium-copper alloy showed several heterogeneous phases. Wavelength dispersive x-ray analysis was used to record concentration profiles and element distribution patterns. An accumulation of nonprecious components and oxygen was observed in the immediate ceramometal interface. Adjacent to this a largely homogeneous zone was visible which is probably due to the diffusion of nonprecious elements during the different stages of baking. The results lead to conclusions concerning the final finishing after application of the ceramic veneer. PMID- 2702160 TI - [Effects of different periodontal treatment strategies on patient cooperation]. AB - Two groups of patients with moderate, slowly progressing periodontitis received individually tailored periodontal pretreatment. The experimental group (20 patients) was treated by three dental school assistants according to a plan of behavioral therapy. The control group (30 patients) was treated by students according to the usual procedure of motivation and instruction. Results were documented clinically and by x-rays. The results demonstrate that with both procedures oral hygiene and periodontal status can be improved during periodontal pretreatment. However, after six months the behavioral approach was clearly superior to the traditional methods. PMID- 2702161 TI - [Dentist-patient communication under time constraints]. AB - In the present clinical trial dentists were asked to talk to patients about the subject of "Prevention". A patient-dentist conversation was to be conducted in two different time frames. In the first group the dentist took as much time as seemed necessary for communicating with the patient. In the second group the restricting condition was that approximately an average number of patients had appointments under office conditions. The results demonstrate that under controlled conditions dentists show a communicative behavior which will focus the patients attention on compliant oral hygiene. However, under the pressure of limited time, this behavior will no longer be sufficient to achieve optimum patient compliance through such a talk alone. PMID- 2702162 TI - [Self-assessment, cooperation, and control in the motivation phase of periodontal patients]. PMID- 2702163 TI - [Awareness of oral health in 45 to 54-year old Berlin subjects and correlation with clinical periodontal findings]. AB - 143 subjects 45-54 years old were interviewed by questionnaire about their oral hygiene behaviour, their knowledge about periodontal diseases and their opinion concerning prophylaxis and therapy of periodontitis. The CPITN and the loss of attachment was measured at each tooth by clinical examination. Then the clinical data were examined for possible correlation to socioeconomic factors, gender or behaviour and knowledge of the subjects. Women showed statistically significant better clinical data than men, but no correlation to CPITN classes was found in analyzing education, profession or income. Also clinical data could not be found influenced by the frequency of toothbrushing and frequency of seeing a dentist or by the patients knowledge. However, increasing knowledge about their disease significantly increased the subjects willingness to undergo a long-term treatment. The subjects examined were interested in oral health, but their clinical data indicated that motivation or knowledge was not converted sufficiently into practice. PMID- 2702164 TI - [Studies of patient motivation during systematic periodontal treatment]. AB - Motivated patients are essential for successful periodontal therapy. The intention of this investigation was to determine the success of motivational attempts. 100 patients were examined and separated into two groups according to sex and age. As a result there was no significant difference between gender groups as well as age groups concerning the motivation. PMID- 2702165 TI - [Toxic impurities in chlorhexidine digluconate]. AB - Three preparations of chlorhexidine-digluconate were analysed for contamination with a newly developed high-pressure liquid chromatographic method. Of special interest was p-chloroaniline, a toxic as well as a carcinogenic compound. We found concentrations from 1.7 to 8.5 mmol p-chloroaniline per mol chlorhexidine digluconate, i.e. five-fold differences in the different products. Besides p chloroaniline many other contaminating substances were found, amongst others p chlorophenyl-isocyanate and p-chlorophenyl-carbodiimide. The least contamination was found in a branded article, and the highest degree of contamination in a "no name"-product. During a storage period of half a year in dark glass bottles in a solution of 0.2% under various light and temperature values the p-chloroaniline concentrations increased linearly with the period of storage, with the exception of storage in the dark at 5 degrees C. A constant temperature of 35 degrees C in the dark caused a greater increase than storing at 20-25 degrees C in the dark or the light or in direct sunlight. Therefore under similar conditions it is mostly warmth which causes an increase in toxic compounds. PMID- 2702166 TI - [Changes in the enamel surface after calculus removal]. AB - A clinical trial examined the effect of calculus removal on the enamel surface using a Gracey curette 5/6, an ultrasound unit, and three air scalers with five different tips, in terms of the rate of surface lesions and the extent and depth of the defects. A total of 140 teeth were copied to assess and measure the surface lesions. The hand-held instrument did not damage the tooth surface. For calculus removal with automatic instruments surface lesions were observed to be a function of the type of equipment and the tip configuration used, with sharp edged instruments causing the more severe destruction. Therefore automatic calculus removal instruments should not be used for routine tooth cleaning. They should be reserved for first-time removal of old, hard, and very tough calculus. PMID- 2702167 TI - [A case of prepuberty periodontitis--a classification based on laboratory results]. AB - The rare entity of periodontitis in a 4 1/2-year old child and subsequent changes over a 4-year follow-up period will be presented. Various examinations (among other immunological tests, biochemical differentiation of dermal fibroblasts, and ultrastructural skin biopsies) were made to identify whether this was a case of genuine prepuberty periodontitis or of periodontitis secondary to a general disease. On the basis of the results the case was diagnosed as Ehlers-Danlos Disease Type VIII, although at the same time signs of impaired granulocyte function were observed. PMID- 2702168 TI - [Reduction of A. actinomycetemcomitans in the subgingival microflora of adult advanced periodontitis]. AB - In 15 adult patients with severely advanced periodontal disease unrelated to localized juvenile periodontitis high numbers of A. actinomycetemcomitans (A. a.) were identified in samples of subgingival plaque (median log CFU 5.13). In order to correlate clinical conditions with bacteriological findings, in every patient 2 deep periodontal pockets were treated with a 3-phase regimen of minocycline administration, mechanical, and surgical periodontal therapy. A. a. was eliminated by minocycline alone in 2 cases. Minocycline in combination with subgingival scaling resulted in 6 patients in A. a. negative samples. Following termination of minocycline therapy, frequently increasing numbers of A. a. were observed. Patients showed significant gain in clinical attachment or reduction of probing pocket depth during different phases of therapy, but only if A. a. was suppressed close to or below the lower limit of detection (5 CFU/ml). Considerable problems with elimination of A.a. may be connected with frequently observed recurrent periodontal disease in these patients. PMID- 2702169 TI - [Effect of fluoride iontophoresis in dentin hypersensitivity of periodontally treated patients]. AB - Independent of chosen stimulus, age or differences in selected groups of teeth, a reduction in pain intensity of about 50% can be attained following initial treatment with fluoride iontophoresis. The second treatment after 4 weeks leads to a nearly complete reduction in dentin-hypersensitivity. Subsequent to a third application of fluoride iontophoresis only minimal hypersensitivity is detectable. Precipitation of calcium-fluoride and blockage of dentinal tubules should be discussed. A decrease in hypersensitivity is likewise observed in the control group. The results of the final clinical examination show that slightly greater sensitivity remains. Electroanalgetic effects are probably responsible for the reduction of dentinal pain. Treatment of hypersensitivity is dependent upon such factors as age and oral hygiene. Supervised therapy for refractive dentinal pain appears to have greater success when fluoride iontophoresis is used. PMID- 2702170 TI - [Microvitreous surgery combined with scleral encircling for the treatment of complex retinal detachments]. AB - 50 cases (50 eyes) of various complex retinal detachments (RD) were treated with a combination of vitrectomy, membrane peeling, intraocular air tamponade and scleral encircling. RD with opaque media, RD with proliferative vitroretinopathy, traction RD due to trauma or other factors, RD with posterior breaks, and giant tears were included. During the follow-up periods of 3-12 months, 27 cases (54%) obtained anatomic reattachment, 23 failed (46%). Of the successful case, 24 eyes achieved improvement, 2 eyes remained unchanged, and one eye became worse in their vision. The surgery complications were: retinal haemorrhage, choroidal haemorrhage, iatrogenic tears, and the development of cataract. PMID- 2702171 TI - [Preoperative electroretinogram for predicting postoperative visual function of vitrectomy]. AB - Vitrectomy was performed on 17 patients [19 eyes] who had dense vitreal opacity and precluding inspection of the ocular fundus. The preoperative visual acuity was light perception to 0.1, the postoperative visual acuity was 0.03 to 0.9. The preoperative electroretinogram [ERG] was tested on all patients. The correlation of the amplitudes of the ERG b-wave to the postoperative visual acuities were statistically analysed. The results showed that there was positive correlation of the amplitude of the preoperative scotopic bright ERG b-wave to postoperative visual acuity [r = 0.7709, p less than 0.01], and positive correlation of the amplitude of the preoperative photopic ERG b-wave to the visual acuity [r = 0.8086, p less than 0.01]. It suggests that the bigger amplitude of the preoperative ERG b-wave was, the better postoperative visual acuity was improved. Thus, the preoperative ERG could predict the outcome of vitrectomy in various ocular diseases with vitreal opacities and very low visual acuity. PMID- 2702172 TI - [Manifestations of fluorescein angiography in choroidal melanoma]. AB - This paper reported on the manifestations of fundus fluorescein angiography in 21 patients with choroidal melanoma. According to the findings of fluorescein angiography, we suggest that this disease can be classified into 3 types: type I shows hyperfluorescent mottles (12 cases); type II shows hyperfluorescent spots and patches, (4 cases); type III shows a dark area in the tumor body, (5 cases). The angiographic characteristics of the three types of melanoma and their histopathologic changes are discussed. The differential diagnosis of the three types of melanoma from metastatic choroidal carcinoma, senile macular degeneration with subretinal hemorrhage and choroidal hemangiomas is discussed. For the first time choroid melanoma has been classified into 3 types according to fluorescein angiography. It may contribute to the early diagnosis of this disease. PMID- 2702173 TI - [Iris nodules, ocular findings and blood grouping in neurofibromatosis]. AB - Through the analyses of 22 cases of neurofibromatosis (NF) patient ranging from 3 months to 63 yrs. old. We found that 4 cases had bilateral hearing loss and 2 of them were excluded from acoustic neuroma. The ocular appearance showed lid neurofibroma in 12 cases, orbital bone abnormalities in 4 cases, iris nodules in 20 cases (90%), congenital glaucoma (4 eyes) in 3 cases which showed abnormal gonioscopy in 3 eyes, lens opacity in 2 cases, mild and moderate myopia in 8 eyes, and high myopia in 7 eyes, occupying 16% of the total. 11 cases belong to 5 pedigrees showing autosomal dominant inheritance. The ABO and MN blood grouping of the NF cases and families in the pedigree showed that NF was more related to ABO than MN blood group. The ocular appearance, especially the shape and number of iris nodules in relation to age and diagnosis is discussed. The significance of 1 case of retinitis pigmentosa, 7 cases of high myopia in relation with NF should be further studied. PMID- 2702174 TI - [The diagnosis of intracranial A.V. malformation with orbital involvement by B scan, colour Doppler and CT scan]. AB - 20 patients with intracranial A.V. malformation with orbital involvement were examined by B-Scan (Real- time ophthascanB). colour doppler (Acason 128) and CT scan. These patients were confirmed in clinically and other examination. Ultrasonography Showed dilated superior ophthalmic vein and its pulsating which are Synchroniged with the heart beating; the echo-free cavity changed in shape upon compression with the probe and some thickened extraocular muscles. The flowing counter pulsating and volume of blood stream were showed clearly in colour doppler. CT scan showed dilated superior ophthalmic vein, thickened extraocular muscles and dilate shadow of cavernous sinus. If strengthen scan to be done, the malformation of cerebrum artery and vein can be showed clearly. These examination are of value in diagnosis. The rate of ultrasound and CT scan for the differential-diagnosis was discussed. PMID- 2702175 TI - [Study of aging macular degeneration]. AB - Aging macular degeneration (AMD) is an important ocular disease causing blind. The study of epidemiology, pathogenetic factors and visual function of AMD show that it has become a disease worth noticing in aged. Although most AMD cases were of the dry type and the patients had rather good visual acuity, various determination of visual function showed different degrees of impairment. Controlling light exposure and improving trace element metabolism may be helpful for early prevention and treatment of AMD. It will also be an important factor in the prevention of blindness in Asian nations. PMID- 2702176 TI - [Argon laser trabeculoplasty for open angle glaucoma--a four year follow-up]. AB - 79 patients (105 eyes) with uncontrolled open angle glaucoma underwent argon laser trabeculoplasty (ALT). The average pressure drop was 10.7 mmHg in 58 eyes at one year, 10.1 mmHg in 35 eyes at two years, 9.9 mm Hg in 48 eyes at three years and 10.2 mmHg in 24 eyes at four years. Teh mean success rate was 78%, failures occurred in the first six months in 21 of 23 eyes, the remaining eyes failed at three years, 18 eyes (17%) required filtering surgery. Average medication scores varied little from year 1 through year 4, 45 eyes (42.9%) were being treated with few medications after ALT. The results of ALT depend on the severity of glaucoma: the eyes with advanced disc damage (C/D greater than 0.9, visual field less than 20 degrees) had 59% rate of filtering surgery, while the eyes with C/D 0.6-0.8, visual field greater than 20 degrees at ALT had a filtering surgery rate of 3%. PMID- 2702177 TI - [Treatment of congenital cataract with McIntyre co-axial I.A. cannula]. AB - Thirty seven eyes with congenital cataract in with there a lot of transparent cortex were treated with McIntyre co-axial cannula. Primary posterior capsuloctomy after removing the cortex was performed on patients aged less 3 years; for patients over 3 years, their posterior capsule remained intact. After the operation, all cases got transparent pupillary space more than 5 mm in diameter. The visual acuities improved in 32 eyes and remained unchanged in 5 eyes. This procedure not only received satisfactory results, but also avoided side effects caused by capsuloctomy and reduced the possibility of general anesthesia accident and operation fee. PMID- 2702178 TI - [Early ocular hypertension after cataract extraction]. AB - The intraocular pressure (IOP) course during the first postoperative month was measured with Goldmann applanation tonometry in 93 eyes. The patients include 30 eyes of intracapsular cataract extraction (ICCE), 32 eyes of extracapsular cataract extraction (ECCE) and 31 eyes of ECCE combined with posterior chamber intraocular lens (PC-IOL) implantation. The preoperative average IOP was 13.30 +/ 3.24 mmHg in 93 eyes. The first day after cataract extraction was 25.33 +/- 8.18 mmHg and 59 eyes (63.44%) had an IOP higher than 23 mmHg. On the second day it was 16.03 +/- 7.54 mmHg. On the third day it was 14.69 +/- 5.45 mmHg. On the seventh day it was 13.32 +/- 3.44 mmHg and only 2 eyes (2.14%) IOP was higher than 23 mmHg. The first postoperative month average IOP was 12.93 +/- 1.31 mmHg and it was above 23 mmHg in only one eye. When compared with preoperation a significant increase in IOP was found postoperatively. But on the seventh day and after the first month there was no significant difference (P greater than 0.05). The IOP rise among ICCE group, ECCE group and PC-IOL group did not differ significantly. PMID- 2702179 TI - [Preliminary report of 10 cases of anterior segment eyeball reconstruction]. AB - We performed anterior segment reconstruction by total penetrating Keratoplasty with scleral rim in 10 patients who had infectious ulceration with total corneal necrosis and perforation and prolapse of intraocular contents of the severely damaged 10 eyes, 9 were salvaged and retained a semi-transparent corneal graft with improvement in vision for 6 months or longer. It suggested that, for eyes with severe corneal damage that would otherwise be enucleated, anterior segment reconstruction by corneoscleral transplantation is of value. PMID- 2702180 TI - [Infections in the early postoperative period following keratoplasty--a report of seven cases]. AB - Keratoplasty was performed on 3482 eyes from 1965 to 1986 in our hospital. Five eyes (0.14%) were infected in the early postoperative period. Two eyes had endophthalmitis. These seven eyes were operated on again and with local and systemic antibiotics treated as well. Followed up for 36 days to 7 years, six eyes remained safe (5 eyes transparent and 1 eye semi-transparent.) The visual acuity reached 0.3 in two eyes, 0.2 in one eye and finger counting to 0.1 in three eyes. The seventh eye was enucleated because of serious infection. Several factors of infection in the early postoperative period following keratoplasty, causative organisms, the relations between the types of operation in the early postoperative period following keratoplasty were also discussed. PMID- 2702181 TI - [Rubinstein-Taybi syndrome--a report of three cases]. AB - The main features of Rubinstein-Taybi syndrome include special facial appearance, broad thumbs, great toes and mental retardation. This syndrome presents many organogenetic and systemic deformities and various congenital ocular abnormalities, such as epicanthus, antimogoloid palpebral fissures, highly arched eyebrows, long eyelashes, obstruction of nasolacrimal ducts, strabismus and iris coloboma. In this paper we report three children with Rubinstein-Taybi syndrome with the above systemic and ocular clinical findings, and think that the lacrimal abnormality should not be overlooked in this syndrome. We brief discuss the genetics of this syndrome and suggest that the search for minimal chromosomal defects by high resolution technique might be useful for etiologic and genetic research. PMID- 2702182 TI - [Eye symptoms due to ginseng poisoning]. AB - Ginseng has been used as a tonic for mind and body. A large number of pharmacological studies on ginseng have been done and the variety of effects were shown. In this paper 2 cases of ginseng poisoning has been reported the effects on both eyes were mydriasis and disturbance in accommodation, and the systemic symptoms included dizziness and semiconsciousness, which may be associated with hyperexitability of the sympathetic nerves (adrenergic nerves) due to overdose ginseng. PMID- 2702183 TI - [Analysis of hemorrheological manifestation and serum lipids in patients with diabetes mellitus]. AB - A careful fundus examination was carried out in 65 patients with diabetes mellitus, who were divided into two groups according to the changes of fundus showing or not showing diabetic retinopathy. The hemorrheological manifestation, the serum lipids and the course of disease in the two groups were observed and compared respectively. The result showed that abnormal hemorrheological rate in the group with diabetic retinopathy was much higher than that in the group without diabetic retinopathy, with the content of serum triglyceride in the former group being obviously higher than that in the latter group, and no statistical significance were shown in the course of disease between the two groups. In the light of the principle of hemorheology, further study was done on the mechanism of the angiopathy and microangiopathy which was caused by diabetes. It could help us to analyze the relationship between the diabetic retinopathy and the hemorrheological change. We suggest that it is important that dynamic observation be carried out of hemorrheological manifestation for the clinical prevention and treatment of microcirculatory disease. PMID- 2702184 TI - [In tribute to senior Polish obstetrics and gynecology professor Dr. Ireneusz Roszkowski on his 80th birthday]. PMID- 2702185 TI - [Conversation with Professor Ireneusz Roszkowski. Interview by J. Kuczynska Sicinska]. PMID- 2702186 TI - [Carbohydrate metabolism during cholestasis in pregnancy]. AB - Blood glucose levels were measured in fasting state and 2 hours after breakfast, together with glucose tolerance tests (after a load of 100 g of glucose) and 24 hour glycaemia profile in pregnant women with intrahepatic cholestasis of pregnancy in the third trimester of pregnancy. In all these tests abnormalities were found indicating a considerable impairment of carbohydrate metabolism during this complication of pregnancy. The changes manifested themselves as increased blood glucose level 2 hours after breakfast, increased glucose level in 24-hour glucose profile, and raised blood glucose levels in glucose tolerance tests in all studied time intervals besides the first and last determinations. PMID- 2702187 TI - [Various biochemical parameters of renal tubular function in patients with type I diabetes in the third trimester of pregnancy]. AB - The studied group comprised 47 women in the 3rd trimester of pregnancy (29-40 weeks), including 17 with type I diabetes (study group) and 30 healthy women (control group). In the study group in one case diabetes was diagnosed during pregnancy and treated with diet only, in the remaining 16 pregnant women the mean diabetes duration was 6.2 years and the mean daily insulin dose was 70 u. According to White's classification one patient was in class A, 10 in class B and 6 in class C. In all cases renal function was normal, with normal blood values of creatinine, urea, electrolytes, uric acid, protein and acid-base equilibrium. Endogenous creatinine clearance was also normal. The studied biochemical parameters of renal tubular function included: 1) deamination of amino acids- with measurement of ammonium ion (NH4+) excretion with urine, 2) carbonic acid metabolism--with determination of urinary excretion of hydrogen ions (H+), 3) urinary excretion of sodium (Na+) and potassium (K+) ions. Besides that 24-hour urine was always measured. The studied women were similarly hydrated (standard diet, fluid balance control). The results were subjected to statistical analysis. In women with type I diabetes the volume of 24-hour urine was increased, although it fell within the normal range, urinary excretion of Na+ and K+ was raised. No change was found in amino-acid deamination an carbonic acid metabolism since the excretion of NH4+ and H+ was normal. PMID- 2702188 TI - [Various biochemical functions of the renal tubules and glomeruli in women during normal pregnancy and the puerperium]. AB - The study was carried out in 194 healthy women, including 50 non-pregnant, 31 pregnant in the 1st trimester, 32 in the 2nd and 30 in the 3rd trimester, and 51 in the 3rd day of puerperium. Their age was 19-43 years, they gave no history of renal disease nor urinary tract disease. The biochemical tests evaluating the function of renal tubules and glomeruli were done in 24-hour urine: 1) 24-hour urine volume, 2) NH4+, 3) H+, 4) K+ and 5) Na+ ions. Endogenous creatinine clearance was determined as well in all cases. The results were subjected to statistical analysis. Increased tumular metabolism of carbonic acid begins in the 16th week of pregnancy, increases further till the end of pregnancy and is still high on the 3rd day of puerperium. Amino acid metabolism increase in the tubules was noted only in the 3rd trimester of pregnancy, and it was normal again on the 3rd day of the puerperium. K+ and Na+ excretion was raised in the 3rd trimester, and on the 3rd day postpartum potassium excretion was still high while that of sodium was normal. Endogenous creatinine clearance rose in the 2nd and 3rd trimesters and failed to return to the value before pregnancy on the 3rd day postpartum. The observed changes in the biochemical functions of renal tubules and glomeruli in physiological pregnancy may be responsible for the typical changes of blood acid-base equilibrium in pregnancy (compensated metabolic acidosis with respiratory alkalosis). PMID- 2702189 TI - [Placental lactogen and estrogens in the amniotic fluid in normal pregnancy and in pregnancy complicated by hypertension in relation to the state of the newborn]. AB - The study was carried out in 45 samples of amniotic fluid taken by amniocentesis from 21 hypertensive mothers (study group) and 24 healthy mothers (control group). In these samples the concentrations were determined of total oestrogens and human placental lactogen. In the evaluation of the state of the newborns the following was considered: 1) length and body weight, 2) status in the 1st minute of life (Apgar score). The results were subjected to statistical analysis. In hypertensive mothers during pregnancy HPL and total oestrogen concentrations were decreased. In the study group reduction of body weight and length was found. The general condition of the newborns in the 1st minute was similar in both groups. PMID- 2702190 TI - [Respiratory distress in newborns born to hypertensive mothers and acid-base equilibrium and the ion composition of the amniotic fluid]. AB - Twenty-five samples of amniotic fluid obtained by amniocentesis from 25 pregnant women with hypertension in the 35 to 40 weeks of pregnancy were studied. The following biochemical determinations were done in the samples: acid-base equilibrium (pH, pO2, pCO2, base deficit, standard HCO3- and total CO2), concentrations of potassium and sodium ions, total and ionised calcium and inorganic phosphorus. The results were analysed depending on the presence of the respiratory distress syndrome in the newborn, and were subjected to statistical analysis. It was found that determination of acid-base equilibrium and concentrations of K+, Na+, total and ionised Ca++ and inorganic phosphorus in the amniotic fluid of hypertensive women are probably without prognostic significance with respect to the development of the respiratory distress syndrome in newborns. PMID- 2702191 TI - [Respiratory distress in newborns born to hypertensive mothers and protein, lipid and renal maturity indices and enzymatic activity in the amniotic fluid]. AB - Twenty-five samples obtained by amniocentesis were studied in 25 pregnant women between 35 and 40 weeks of pregnancy with hypertension. The following biochemical investigations were done in the samples: total protein, beta-lipoproteins, cholesterol, uric acid, urea, creatinine, AlAT and AspAT, total alkaline phosphatase and its thermostable isoenzyme, ceruloplasmin and alpha-amylase. The results were analysed in relation to the development of the respiratory distress syndrome in the newborn and were subjected to statistical analysis. In the amniotic fluid of hypertensive mothers in whose children the respiratory distress syndrome developed, reduction was found in the concentrations of beta lipoproteins and cholesterol. This may have a prognostic significance in the prediction of respiratory distress in early neonatal period. PMID- 2702192 TI - [Hypothyroidism in pregnant women]. AB - Ten pregnant women with hypothyroidism and 10 newborns born to these women were studied. In 3 pregnant women the infantile and juvenile type of hypothyroidism were diagnosed. In 6 women hypothyroidism resulted from partial or total thyroidectomy (for toxic goitre or papillary carcinoma), and in one it was a result of Hashimoto's thyroiditis. In all studied women the serum levels were determined of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3). The pregnant patients were treated with thyroid hormones such as L-thyroxine or thyroidin. All newborns of these women were evaluated clinically and the levels of TSH, T4 and T3 were determined in them. PMID- 2702193 TI - [Clinical condition of the newborns and the type of labor and pregnancy complications in cases of meconium in the amniotic fluid]. AB - The studied material comprised 36 newborns and their mothers, among them 12 newborns had meconium in the amniotic fluid (study group) and 24 newborns with clear amniotic fluid served as controls. The fluids were studied biochemically. In both compared groups the analysed factors were: 1) week of labour, 2) body weight and length, 3) clinical condition of the newborn by the Apgar score, 4) type of labour, 5) type of pregnancy complications in mothers. The results were subjected to statistical analysis. It was found that meconium presence in the amniotic fluid correlated with the presence of clinical symptoms suggesting intrauterine asphyxia of the fetus, and the number of caesarean sections was greater in this group. A correlation was noted between the presence of meconium in the amniotic fluid and worse clinical condition of the newborn. PMID- 2702194 TI - [Congenital toxoplasmosis--in prospective studies]. AB - In the action of prevention of congenital toxoplasmosis prospective studies were carried out of women at reproductive age for detection of antibodies to Toxoplasma gondii. Women seronegative before pregnancy were subjected during pregnancy to three tests for the presence of these antibodies in the 1st, 2nd and 3rd trimester. After development of seroconversion in pregnancy further observation was conducted which made possible the diagnosis of active primary infection in pregnancy in 12 cases. Prophylactic treatment of the mothers was administered and the newborns were observed for the consequences of intrauterine infection. PMID- 2702195 TI - [Detection of Chlamydia trachomatis infection of the cervical canal in women with infertility and cervical erosion]. AB - Using the immunoenzymatic test "Pharmacia Chlamydia EIA" the incidence of Chlamydia trachomatis infection of the cervical canal was studied in 141 women from groups of higher risk for this infection. C. trachomatic was found in 5% of women with infertility and 6.2% of women with non-treated cervical erosion. PMID- 2702196 TI - [Prenatal diagnosis of chromosomal aberrations in the second trimester of pregnancy--analysis of problems and diagnostic difficulties]. AB - Laboratory problems and diagnostic difficulties are analysed in 1135 prenatal cytogenetic examinations of amniotic fluid cells in the Genetics Laboratory of the Mother and Child Institute. The effectiveness and the reliability of the method for the purposes of prenatal diagnosis of chromosomal aberrations were evaluated. They were comparable to those reported from other similar centres in the world. PMID- 2702197 TI - [Risk of reproduction disorders in carriers of mutual chromosomal translocations, and methods for detection of translocation carriers]. AB - It is believed that the method of detection of chromosomal translocation carrier state may be a prognostic factor for the risk of giving birth to an ill child with unbalanced karyotype. For verification of this view 30 families were studied which had balanced mutual translocations identified by means of GTG banding technique in the Genetics Laboratory of the Child's Health Centre. In each family the risk was estimated of the development of an undifferentiated karyotype in live born offspring and fetuses in the 2nd trimester of pregnancy using a method evolved by Stengel--Rutkowski et al. (1988). In the group of families identified by examination of a child with abnormalities the individual risk of development of an undifferentiated karyotype in a newborn was from 0.45% to 19.78% and in a fetus it was 4.5% to 46%. In the group of families identified by spontaneous abortion the risk in the newborns was from 0 to 7% and in the fetuses in 2nd trimester it was 0 to 35%, while in the families undergoing cytogenetic examinations for indications other than reproduction disturbances the risk of an unbalanced karyotype in the newborns was from 0 to 23%, and in the fetuses from 0 to 34%. Since in each group of families high-risk translocations were found, the used methods of preliminary estimation of the risk based on the used ways of family identification are open to reservations. PMID- 2702198 TI - [Nutrition of pregnant women in rural and urban areas]. AB - The purpose of the study was to gain information on the present state of nutrition of pregnant women in rural areas and towns, and on the level of their knowledge of adequate nutrition. The study covered 300 women in villages and 258 in towns. The selection of women was done randomly, the method of the study was interviewing of the women. The questions concerned consumption of milk, cheese, meat and its products, eggs, vegetables and fruit during the whole pregnancy, and separately the data on potato consumption were obtained. The women were questioned also about the read publications on rational nutrition of pregnant women. The answers were obtained from mothers aged 18-42 years in labour rooms, clinics for children or in homes. The answers were noted during interviews by experienced interviewers. It was found that 26.6% of pregnant women in towns and 16.2% in villages were not consuming daily milk or cheese, while 6.2% of these women in towns and 4.3% in villages consumed no milk at all. Only 41.1% of these women in towns and 19% in villages took meat and processed pork everyday. Most frequently the women consumed meat and processed pork 4 times weekly (39.6% in towns and 60.3% in villages). Eggs were consumed daily by only 13% of women in towns and villages, and they were eaten most frequently 4 times weekly (30.2% in towns and 45.7% in villages). In a week meat, processed pork and eggs were eaten 5 to 7 times by only 43.8% of pregnant women in towns and 21.3% in villages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702199 TI - [Invasive cervical carcinoma coexistent with pregnancy]. AB - Results are presented of treatment of 28 cases of invasive cervical carcinoma coexistent with pregnancy. The degree of progression, according to FIGO, was as follows: grade I degree--9 cases, grade II degrees--7 cases, grade III degrees- 11 cases. The treatment included, depending on the degree of progression, operation and radiotherapy, both brachytherapy and teletherapy. Eight patients (28.6%) survived 5 years. The best results of the treatment were obtained in patients with low progression grade in early pregnancy. No patient with carcinoma diagnosed in puerperium survived 5 years. PMID- 2702200 TI - [Widely available cytological examinations and detectability of cervical dysplasia and carcinoma]. AB - The system of cervical carcinoma prophylaxis introduced in 1974 in the Province of Szczecin based on obligatory obtaining of cytological smears at least one in a year from each woman coming for gynaecological examination and obligatory presentation of the result of this examination by each woman going for sanatorium treatment was analysed. In the years 1974-1986 the number of cytological examinations was systematically increasing, reached recently over 100 thousand, and covered about 30% of the female population aged over 19 years. With increasing number of cytological examinations there was a rise in the detectability of dysplasia and a tendency was noted also recently for reduced incidence of cervical carcinoma. The indices of morbidity and mortality were unchanged. PMID- 2702201 TI - [Clinical aspects of intraperitoneal chemotherapy in patients with ovarian carcinoma]. AB - Ten women with primary ovarian carcinoma in clinical progression grade III degree according to FIGO received intraperitoneal chemotherapy. They all had surgical treatment and 9 of them received after operation intravenous cytostatics PAC or PC. Cisplatin 100-220 mg/m2 was given intraperitoneally through a Tenckhoff catheter for long-term dialysis. Before beginning of intraperitoneal chemotherapy in 6 cases the malignant lesions were under 2 cm in diameter, and in 4 cases the size of these lesions was exceeding 2 cm with far advanced disease. In patients with malignant lesions under 2 cm CR was obtained in 4 cases, SD in 1 case and PR in 1 case. In the group with malignant lesions exceeding 2 cm the results of intraperitoneal treatment were: SD in 2 cases and PD in 2 cases. Intraperitoneal chemotherapy is an effective method in ovarian carcinoma when intravenous chemotherapy is ineffective. This is another method which provides a chance of prolongation of the life of the patients. PMID- 2702202 TI - [Results of a 2-year study of multiple drug induction chemotherapy in patients with advanced ovarian carcinoma FIGO grade III]. AB - The results of induction chemotherapy were analysed in cases of advanced ovarian carcinoma grade III (FIGO) during second-look operation. In 108 cases after the first operation with varying degree of radical removal of the tumour chemotherapy was given by the PAC schedule (cisplatin, adriablastin, cyclophosphamide) achieving in 90 cases 9 treatment courses. The results were evaluated using WHO clinical criteria. The best therapeutic results were noted in patients after radical operations or with aggressive cytoreduction of tumour mass. The clinical assessment of chemotherapy was corrected during the second-look operation which led to reduction of the percent of cured cases. PMID- 2702203 TI - [Effect of diabetes mellitus on static changes in female genitalia]. AB - In 1410 women treated for diabetes examinations were done for detection of the correlation between changes in the statics of genitals and diabetes. In view of a rather scant literature on this problem which suggested the possibility of this correlation it was tried to study this problem in a large material. Diabetes is regarded as a public health problem in view of its prevalence and possible complications, and in this connection the interest of the gynaecologists in this association is rising. Diabetic women were compared with 920 non-diabetic women matched for body weight, age and obstetric history. The obtained results confirmed the supposition that diabetic women had much more frequently, in 40%, changes in genital statics than non-diabetic women--only 24%. Conclusions are drawn from this finding. PMID- 2702205 TI - Major K.N.Rao oration. Health for all by 2000 AD. PMID- 2702204 TI - [Evaluation of testicular biopsy as an aspect of Chlamydia trachomatis infection (introductory report)]. AB - The purpose of the study was demonstration of the presence of Chlamydia trachomatis in biopsy testicular specimens. The indication to testicular biopsy was azoospermia or cryptozoospermia. The studied group comprised 12 patients in whose semen C. trachomatis was found. For the identification of the organism culture in chick embryo was used. In 2 preparations C. trachomatis was demonstrated in testicular biopsy. PMID- 2702206 TI - Professor A.L.Saha memorial lecture. Four decades of epidemiology and health care. PMID- 2702208 TI - Abstracts of the papers presented at 33rd annual conference of IPHA. PMID- 2702207 TI - Dr. P.C.Sen memorial award paper. A study of knowledge, attitude and practice regarding primary health care and development of a participatory communication process. PMID- 2702209 TI - Presidential address of Indian Public Health Association. PMID- 2702210 TI - Dr. B.C. Dasgupta memorial oration. Air pollution-new challenge to community health. PMID- 2702211 TI - Acute bronchospasm during epidural anesthesia in asthmatic patients. PMID- 2702212 TI - The Revised Asthma Problem Behavior Checklist. AB - The Asthma Problem Behavior Checklist (APBC) has proved to be an accurate and invaluable instrument for pinpointing potential behavioral problems in children with the disorder. This article presents the Revised Asthma Problem Behavior Checklist (RAPBC). The value of the RAPBC is that: (a) it has proven reliability when tested with asthmatic adults; (b) the change from a dichotomous yes/no format, used in the APBC, to a 5-point Likert-type answer format adds greater sensitivity to the instrument; and (c) data gathered with the RAPBC compare favorably to information gathered in two previous studies with the APBC. Considering the reliability and validity of the RAPBC, it should prove useful in both clinical and research settings. PMID- 2702213 TI - Strides made in asthma research. PMID- 2702214 TI - Living with asthma: Part II. Beyond CARIH. AB - This article focuses on the evolution and assessment of additional self management programs and strategies following the original development and evaluation of Living with Asthma. In particular, it describes the basis and philosophy underlying a self-management program for adults with asthma. In doing so, it introduces strategies that can be used by adults to process and evaluate the information they gather, and to make decisions as to what steps to take to predict and prevent asthma attacks. These strategies rely upon techniques ranging from the use of decision-making trees to the calculation of conditional probabilities to enhance the patients' knowledge that an attack is apt to occur within a prescribed period. It is hoped that further refinement of these procedures will not only provide greater control over asthma, but may help reverse the recent trend of increased mortality due to the disorder. PMID- 2702215 TI - Hypogammaglobulinemia and asthma: do any patients with asthma have deficiency of antibody? PMID- 2702216 TI - A reinterpretation of psychologically induced airways changes. AB - Psychologically induced airways changes in asthmatic individuals may be a function of variation in general activation level, not variation in asthma severity. The evidence for this hypothesis derives from work showing that healthy individuals exhibit psychologically induced airways changes similar to those exhibited by asthmatics. Individuals from both normal and healthy populations display increases in bronchomotor tone in response to stress and decreases in bronchomotor tone in response to relaxing stimulation. Although these responses are not limited to asthmatics, they are not irrelevant to asthma. Knowledge of specific relationships between airways changes and psychological factors is helpful in the management of asthma. PMID- 2702217 TI - Allergic bronchopulmonary aspergillosis with coexistent aspergilloma: a long-term followup. AB - Two patients with allergic bronchopulmonary aspergillosis (ABPA) who developed aspergillomas, a rare combination, are presented. Hypertropic osteoarthropathy was a unique feature in one patient. Treatment with prednisolone resulted in striking improvement in both patients. Followup of over 30 months in Patient 1 and 18 months in Patient 2 did not show any dissemination of disease. PMID- 2702218 TI - The effect of swimming in asthmatic children--participants in a swimming program in the city of Baltimore. AB - Forty-five asthmatic children were enrolled in a swimming program in Baltimore. After participating in a 2-month swimming session, the children showed significant improvement in all clinical variables including symptoms, hospitalizations, emergency room visits, and school absenteeism compared with their previous medical history or to those of age-matched controls. These health benefits continued to be observed even 12 months after the session had been completed. The implications of these findings and the potential usefulness of adding sports programs as adjunct therapy in the comprehensive care of asthma in children are discussed. PMID- 2702219 TI - Behavior problems in children requiring inpatient rehabilitation treatment for asthma. AB - Forty-eight asthmatic children (age 6-16 years), inpatients at the Hugh McMillan Medical Centre, were rated by their parents on their behavior using Achenbach's Child Behaviour Checklist. Completed checklists were used to determine normalized T scores for behavior syndromes, and these were compared against norms for clinically referred and nonreferred children. Behavior problems were elevated compared with nonreferred children for both boys and girls, with boys scoring at a clinical level. While many behavior problems were recognized, somatic complaints was a prominent syndrome, particularly for those in the 6-11-year age group. PMID- 2702220 TI - A protocol for the emergency treatment of acute asthma in adults. PMID- 2702221 TI - Mothers of Asthmatics, Inc. provides a support system for parents of children with asthma. PMID- 2702222 TI - The elderly patient with asthma. PMID- 2702223 TI - Asthma in the elderly. PMID- 2702224 TI - Patient characteristics relevant to effective self-management: scales for assessing attitudes of adults toward asthma. AB - The Asthma Opinion Survey, a 33-item Likert-type instrument, was designed to measure attitudes relevant to self-management in adult outpatients. Items fall into eleven clusters; General Vulnerability, Specific Vulnerability, Attitudes Toward Patient Knowledge, Recognition of Airway Obstruction, Accessibility of Health Care, Panic-Fear, Belief in Treatment Efficacy, Staff-Patient Relationships, Sense of Control, Personal Impact, and Social Impact. Factor analysis of the clusters yielded three factors Vulnerability, Perceived Quality of Care, and Recognition and Control. The items, clusters, and factors all had adequate to good score spreads and internal consistencies. Asthma opinions covaried significantly with demographic characteristics, asthma severity, and intensity of health care utilization, and correlated with the Asthma Symptoms Checklist, an instrument developed at the National Jewish Hospital-National Asthma Center, in ways supporting construct validity. These results suggest the Asthma Opinion Survey is achieving its intended purpose. PMID- 2702225 TI - Management of systemic steroid therapy for asthma: an art form not likely to be replaced by computer decision making. PMID- 2702226 TI - The use of corticosteroids in childhood asthma. PMID- 2702227 TI - Demographic and psychosocial characteristics of asthmatic children in a Canadian rehabilitation setting. AB - This study investigated the demographic and psychosocial characteristics of patients attending a residential treatment program for children with asthma. Measures of background information and standardized psychosocial variables were administered to 54 inpatients over an 18-month period. Typically, our patients presented with moderate to severe chronic asthma, mostly diagnosed before 3 years of age and often associated with atopic dermatitis. The families exhibited normal levels of emotional bonding and flexibility in response to stress. Psychosocially, most children were experiencing behavioral and school-related problems, with 6-11-year-old boys exhibiting global social competency problems as well. Girls exhibited lower self-esteem. Locus of control was within the normal range for all age groups. Half the children had not previously attended an asthma education program and two-thirds of the family members either smoked and/or had a pet. The treatment implications of these characteristics of our asthma population were considered. PMID- 2702228 TI - Response localization of the pharmacological agents histamine and salbutamol along the respiratory system by forced oscillations in asthmatic subjects. AB - The bronchodilating effect of 1 mg and 0.4 mg salbutamol on the impedance of the respiratory system was studied in 25 asthmatic subjects after histamine-induced bronchoconstriction. Histamine caused an increase of respiratory resistance (Rrs) at lower frequencies and a frequency dependence of Rrs. Respiratory reactance (Xrs) decreased at all frequencies after histamine challenge. These changes can be explained by peripheral airway obstruction. Impedance measurements performed 5 min after inhalation of 1 mg and 0.4 mg salbutamol showed a decrease of Rrs values at lower frequencies, a disappearance of the frequency dependence of Rrs, and a significant increase of Xrs values. No significant differences in absolute changes of Rrs and Xrs are observed between the salbutamol regimens. These changes after inhalation of salbutamol can be explained by supposing a predominant action on the peripheral airways. PMID- 2702229 TI - Assessing the use of metered dose inhalers by adults with asthma. AB - The development and analysis of an instrument to evaluate the use of metered dose inhalers by patients in the University of Alabama at Birmingham (UAB) Asthma Program is presented. A total of 238 adult asthma patients demonstrated use of the metered dose inhaler for this analysis. Patient skill in using the inhaler was recorded using the instrument, Inhaler-Use Checklist, developed at UAB. The study found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers. PMID- 2702230 TI - Predisposing factors to death after recovery from a life-threatening asthmatic attack. AB - The outcome of 49 asthmatics (20 men and 29 women) who had suffered a severe exacerbation of asthma requiring mechanical ventilation was investigated in a follow-up study ranging from 23 weeks to 10 years. Over this time, there were 6 fatalities, all female chronic asthmatics requiring treatment with bronchodilators, beclomethasone, and short courses of oral steroids. Three died at home as a consequence of a sudden attack. Another patient developed a cardiorespiratory arrest immediately after having received a sedative. In the remaining two cases, death occurred within hours or days of progressive deterioration. Four of the six women had required psychiatric treatment for an anxiety-depression syndrome. These findings support previous studies suggesting that psychological disturbances may be predisposing factors to death in bronchial asthma. PMID- 2702231 TI - Bronchoconstrictive properties and potentiating effect on bronchial responsiveness of inhaled thromboxane A2 analogue (STA2) in guinea pigs. AB - Effect of subthreshold concentration of inhaled STA2, a thromboxane A2 (TXA2) analogue, on bronchial responsiveness to histamine was investigated in anesthetized and artificially ventilated guinea pigs. Percent increase in pressure of the airway opening (Pao) by aerosol histamine (50, 100 micrograms/ml) was significantly potentiated by subthreshold dose of aerosol STA2 (0.10 micrograms/ml) which was determined by dose-response curve of % increase in Pao by inhaled STA2 (0.033, 0.10, 0.33, 1.0 micrograms/ml). These results demonstrated that thromboxane A2 could contribute to bronchial hyperresponsiveness which is one of the major clinical features of bronchial asthma. PMID- 2702232 TI - Analysis of the individual allergens of Russian thistle pollen by an enzyme linked immunoblotting technique. AB - Russian thistle pollen extract was analyzed by immunoblots of isoelectric focused and SDS-PAGE gels. Twenty distinct protein bands were recognized by human IgE- and IgG-specific antibodies in the immunoblot from the SDS-PAGE gel. Molecular weights of these allergens ranged from 12.2 kD to 85 kD. Seventeen bands were detected on isoelectric focusing immunoblots with pI from 3.95 to 7.70. Allergic subjects had differing individual patterns of protein band recognition. Immunoblot techniques provide detailed evaluations of the response of allergy subjects to components of crude natural allergens. PMID- 2702233 TI - A practical approach to gastroesophageal reflux and asthma. PMID- 2702234 TI - Gastroesophageal reflux and diseases of the respiratory tract: a review. AB - Gastroesophageal reflux is an important cause of chronic respiratory disorders. In at least two common pulmonary conditions, chronic bronchitis and asthma, there may be a ying-yang association between the pulmonary disease and gastroesophageal reflux. Gastroesophageal-provoked disease needs to be evaluated in patients with chronic respiratory disease whose condition is progressing in spite of adequate medical therapy; whose history strongly supports this concept; and whose laboratory tests suggest a causal relationship. Recognition and treatment of gastroesophageal reflux, either medical or surgical, can benefit respiratory problems of many patients. PMID- 2702235 TI - Physical activity of asthmatic and nonasthmatic children. AB - Questionnaires examining behaviors and attitudes related to physical activity and asthma were administered to 408 urban schoolchildren aged 11-13 years. Asthmatics (16% of the sample) were more frequently active and were more anxious prior to exercise than nonasthmatics, but did not differ significantly from nonasthmatics in enjoyment of exercise or in physical self-concept. The motives for performing exercise or sport were similar in the two groups, although the asthmatics perceived less pressure to be active from parents or school than the nonasthmatics. It is concluded that asthmatic children have favorable behaviors and attitudes in relation to exercise and sport. PMID- 2702236 TI - Comparison between epinephrine and terbutaline injections in the acute management of asthma. AB - A randomized clinical trial comparing subcutaneous epinephrine and terbutaline injections was conducted in asthmatic children at The Methodist Hospital, Brooklyn, New York. Clinical evaluation using the Asthma Scoring System was done at baseline and serially, every 15 minutes, following injection of either drug. Reversal of wheezing, and changes in respiratory and heart rates were assessed using strict a priori criteria. The patients' differential response to both drugs was assessed by a crossover study when the same patients came subsequently for another episode of wheezing. Our results show terbutaline to be more efficacious at a dose comparable to epinephrine dose. PMID- 2702237 TI - Differentiation in dose-response curves of airway responsiveness to inhaled methacholine between asthmatics and nonasthmatics. AB - We compared the discriminative capacity of the parameters obtained from dose response curves of airway resistance (Raw) to inhaled methacholine (i.e., threshold dose, slope, and maximal increase in Raw) to differentiate asthmatics from nonasthmatics. Of the three parameters, maximal increase in Raw most accurately differentiated asthmatics from nonasthmatics (% correctness was 86% in asthmatics). Furthermore, an index consisting of both threshold dose and slope more clearly differentiated asthmatics from nonasthmatics (% correctness was 94% in asthmatics) than either threshold dose or slope alone (% correctness was 68% and 54% in asthmatics, respectively). We conclude, that of the three parameters, the maximal increase in Raw or an index consisting of both threshold dose and slope is the most discriminative index in asthmatics. PMID- 2702238 TI - The new gestalt: asthma as a chronic inflammatory disease. PMID- 2702239 TI - Inflammatory cells in bronchial asthma. AB - A diagrammatic representation of the interactions between mediators of hypersensitivity and leukocytes in early, late-phase, and ongoing asthma is shown in Figure 1. Early phase or immediate reactions are largely the result of bronchoconstriction consequent to the release of mediators such as histamine, PGD2, LTC4/D4, and PAF. The principal mediator cell (MC) is the mast cell (although other IgE receptor-bearing cells such as the macrophage, eosinophil, and platelet might also be involved in this immediate response). The stimulus for mediator cell activation may be either immunologic (IgE-dependent) or nonimmunologic (i.e., changes in osmolarity as a result of the respiratory water loss associated with exercise-induced asthma). Late-phase reactions appear to be a consequence of infiltration with neutrophils (N), eosinophils (E), and macrophages (M phi). These cells are recruited and activated either by mast cell associated chemotactic factors [such as LTB4, PAF, the eosinophil chemotactic factor of anaphylaxis (ECF-A), or high-molecular weight neutrophil chemotactic activity (NCA (HMW))] and/or "lymphokines" derived from T-helper cells (TH) which have been stimulated by antigen processed by the antigen-processing cells (APC). These mononuclear cell interactions are under the control of regulatory T cells [T suppressor (TS) cells] and it is speculated that the availability of these subsets may determine the magnitude of the late-phase response. Lymphokines and monokines which selectively activate neutrophils, eosinophils, and monocytes include LIF, EAF, and IFN-gamma, respectively. Macrophage-derived tumor necrosis factor (TNF) also amplifies the inflammatory response by its capacity to enhance eosinophil cytotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702240 TI - IgG4 antibodies and their role in asthmatic patients. PMID- 2702241 TI - Recent trends in asthma mortality, morbidity, and management in New Zealand. AB - Trends in mortality and hospital admission rates, prevalence, and drug sales, relating to asthma in New Zealand since 1960 were examined. Two epidemics of asthma death among people in the age range of 15-64 years occurred during this period with peak mortality rates more than four times pre-epidemic rates. Death from asthma was nevertheless rare compared with hospital admissions which have increased 20-fold in children and three- to fivefold in adults between 1960 and 1985. Asthma drug sales have also risen dramatically, particularly in the late 1970s when it is likely that a major change in the drug management of asthma occurred. Changes in asthma prevalence and severity may account in part for the increasing hospital admissions rates. However, the lack of any clear relationship between hospital admissions and death rates and the abrupt time course of the mortality epidemics suggest that changes in the management rather than in the disease itself may be responsible for the increased number of asthma deaths. PMID- 2702242 TI - Wet nebulizer versus spacer and metered dose inhaler via tidal breathing. PMID- 2702243 TI - Changes in bronchial reactivity in asthmatic children after treatment with beclomethasone alone or in association with salbutamol. AB - Airway inflammation is consistently present in patients with severe asthma. The combination of inhaled steroids and bronchodilators may be useful both for treating symptoms and improving the underlying inflammatory condition. We have compared the effect of beclomethasone dipropionate (BDP) combined with salbutamol (S), BDP alone, and placebo, on the severity of bronchial responsiveness in 30 children with allergic asthma during the period of specific allergen exposure. In children treated with BDP alone, PC20-FEV1 methacholine was 0.66 +/- 0.54 at the beginning and 1.91 +/- 2.11 at the end of the study period (p greater than 0.05). In children treated with BDP + S PC20, methacholine was 1.21 +/- 1.43 at the beginning and 4.22 +/- 3.88 at the end of the study (p less than 0.05). The group of children treated with placebo had a PC20-FEV1 methacholine of 0.79 +/- 0.61 at the beginning of the study and 0.80 +/- 0.46 at the end of the study. The results of the present study show that maintenance treatment with inhaled beclomethasone combined with salbutamol may lead to greater improvement in bronchial hyperreactivity than treatment with inhaled beclomethasone dipropionate alone. PMID- 2702244 TI - Chronic pancreatitis--etiology, diagnosis, and enzyme replacement therapy. Proceedings of a symposium held in conjunction with the third meeting of the International Association of Pancreatology. Verona, Italy, September 1-3, 1988. PMID- 2702245 TI - Etiologic aspects of chronic pancreatitis. Review of current theories and experimental evidence. AB - The recent increase in incidence of chronic pancreatitis is difficult to explain. Alcohol consumption, although the prime precipitating factor, is not the only factor involved in the etiology. Differences in risk, presentation, and mortality in various areas of the world warrant investigation of the basic pathophysiologic mechanisms that are operative, and studies to determine if they are identical in all cases of chronic inflammatory diseases of the pancreas. Satisfactory animal models for human chronic pancreatitis have not yet been produced and it is still not known if the basic mechanism(s) leading to chronic pancreatitis are identical in all cases. The only theory concerning the etiopathogenesis of chronic pancreatitis that seems to have therapeutic merit involves the aberrant effects of mixed function oxidases, cytochrome P-450 induction, free radicals of oxygen, lipid peroxidation, and so on. PMID- 2702246 TI - The assessment of chronic pancreatitis. AB - The stimulated pancreatic polypeptide (PP) response was compared to standard tests of pancreatic function in patients with proven chronic pancreatitis and control subjects. Although the median values of the PP test in patients were statistically significantly different from those of controls, much variability was seen in both groups. The PP response seems to correlate with pancreatic exocrine function and shows good agreement with the results of other tests of exocrine pancreatic function while avoiding many of the difficulties inherent in performing other tests. Although more studies are needed, the PP response provides a valuable test of pancreatic function. PMID- 2702247 TI - Management of chronic pancreatitis. Focus on enzyme replacement therapy. AB - The goals of treatment with pancreatic extracts in patients with chronic relapsing pancreatitis are twofold: pain relief and control of maldigestion caused by exocrine pancreatic insufficiency. Experience with the use of pancreatic enzymes for analgesic purposes suggests that the less severe the pain, the greater the analgesic effect of these enzymes. However, the number of trials, as well as the number of patients treated, is fairly small and more studies in larger patient populations are needed. The use of pancreatic enzymes for maldigestion owing to exocrine pancreatic insufficiency which is secondary to chronic pancreatitis, pancreatectomy, cystic fibrosis, or GI bypass surgery incurs several problems. These problems are primarily caused by gastric inactivation of the enzymes, low enzyme activity of many commercial preparations and/or poor patient compliance. Treatment with conventional enzyme products (powdered extracts, enteric-coated tablets or capsules) has been disappointing. At best, results were inconsistent, showing a high degree of individual variation. The introduction of enzyme preparations in the form of pH-sensitive enteric-coated microspheres in hard gelatin capsules represents a significant advance. These microspheres are superior to conventional enzyme preparations in improving the symptoms of pancreatic insufficiency, particularly steatorrhea, where low doses of microspheres are as effective as large doses of conventional enzyme preparations. Steatorrhea, however, is rarely completely resolved. In cases refractory to therapy, treatment with the combination of pH-sensitive enteric-coated microspheres and H2-antagonists or prostaglandins has met with some success. PMID- 2702248 TI - Development of pancreatic enzyme microsphere technology and US findings with Pancrease in the treatment of chronic pancreatitis. AB - Enzyme replacement therapy is a vital aspect of the management of patients with chronic pancreatic insufficiency. However, pharmaceutical technology in the manufacture of enzyme products has advanced significantly only in the last decade. In the late 1970s, Johnson & Johnson scientists developed novel pH sensitive enteric-coated microspheres of pancrelipase (Pancrease) that could be encapsulated for convenient administration. The increased efficiency of the formulation allowed lower daily doses than had been required with conventional enzyme products. In vitro studies indicate that the microspheres disintegrate at a pH appropriate for patients with cystic fibrosis and chronic pancreatitis. Clinical studies of Pancrease in chronic pancreatitis demonstrate a significant improvement in fecal fat excretion, fat utilization, stool weight, and stool frequency, as well as significant weight gain and improved quality of life of patients. Pancrease represents a major advance in the clinical management of chronic pancreatic insufficiency. PMID- 2702249 TI - Pancreatic enzyme replacement therapy in post-pancreatectomy patients. AB - The occurrence of malnutrition and maldigestion was studied in nine patients who underwent pancreatoduodenectomy and sclerosis of the residual pancreatic stump with neoprene. The operation causes a complete loss of exocrine pancreatic function, but spares islet cell function. Upon discharge from the hospital, patients received pancreatin powder as a dietary enzyme supplement (18,000 lipase U/meal). Patients were again hospitalized 2 y after surgery for evaluation of nutritional status and digestive function (hospital checkup). Nutritional status was evaluated by measuring serum albumin, total iron binding capacity, and total lymphocytes. Digestive function was assessed by the D-xylose tolerance test and determination of fecal fat excretion. Patients were then discharged with pancrelipase enteric-coated microspheres (ECM) as a dietary enzyme supplement (16,050 lipase U/meal). Malnutrition, defined as the occurrence of at least two abnormal nutritional parameters, was observed in three patients at the time of the hospital checkup. Upon reevaluation of nutritional status after 6 mo on pancrelipase ECM, all patients were well nourished. The mean body weight, which had been 52.8 Kg immediately after surgery, increased to 54.9 Kg at the time of the hospital checkup (p less than 0.01) and to 58.0 Kg after six months of pancrelipase ECM therapy (p less than 0.05). At the hospital checkup, the D xylose test was normal in all patients and steatorrhea had decreased from a mean of 32.8 g/d without enzyme supplementation to 16.7 g/d with pancrelipase therapy (16,050 lipase U/meal). The complete loss of exocrine pancreatic function following surgery was well tolerated. In fact, when patients were on pancrelipase therapy, much of the original body weight was recovered and the biochemical indices of malnutrition were normalized. PMID- 2702250 TI - Alipase versus nonenteric-coated enzymes in pancreatic insufficiency. A french multicenter crossover comparative study. AB - Pancreatic enzymes (PE) are prepared as pH-sensitive enteric coated microspheres [Pancrease, Alipase in France (P)], to prevent gastric inactivation of orally administered enzymes. The efficacy and tolerability of P were compared to those of Eurobiol (E) (PE lacking enteric coating) in patients with exocrine pancreatic insufficiency (PI) via an open crossover study conducted at 16 centers in France. Pancreatic insufficiency was diagnosed in patients with signs of chronic pancreatitis who showed steatorrhea (fecal fat excretion greater than 8.0 g/24 h). The dosage of P was 9 capsules/d and that of E, 3 vials/d. Stools were collected for 3 consecutive days at each of the following periods: after 10 d without any PE, and after 21 d of P and E administration. Results were analyzed statistically by the method of Hills and Armitage. Chronic pancreatitis was alcohol-induced in 33 of 35 patients (94%) who entered the study. The group that received P before E (n = 20) was comparable to the group that received E before P (n = 15) in patient and disease characteristics. Eight of 35 patients failed to complete the study for the following reasons: adverse reactions 2 cases, lost to followup 4 cases, dropped out of study 2 cases. The degree of steatorrhea was similar after P and E. However, symptomatic improvement was noted far more frequently with P than with E. Moreover, patients preferred P to E because of drug taste (p less than 10(-4] and ease of drug administration (p less than 10( 3). Drug safety was comparable in the two groups of patients. PMID- 2702251 TI - Theory and practice in the individualization of oral pancreatic enzyme administration for chronic pancreatitis. AB - Pancreatic enzyme therapy may be beneficial to all patients with chronic pancreatitis, even those in whom the condition is very mild. The goal of enzyme therapy should be to restore normal gastrointestinal physiology as completely as possible. Monitoring of body weight is recommended as the main measure of treatment efficacy. Most pancreatic enzyme preparations presently employed are porcine in origin and must meet certain standards of quality for human consumption. The amount of active lipase in the duodenum determines the quantity of enzymes to be given. An appropriate diet is also important for relieving symptoms of pancreatic insufficiency and improving nutritional status. Although administration of large amounts of proteases has provided pain relief in some patients, the rationale for using enzymes to relieve pain in chronic pancreatitis has not been generally accepted. Gastric acid plays a role in malabsorption, since administered enzymes may be destroyed by gastric acid. Also, acidic conditions in the duodenum decrease the efficacy of pancreatic enzymes administered with meals. Histamine-H2-receptor antagonists may decrease gastric acidity but there are certain drawbacks to long-term use of these agents. The use of enteric-coated microspheres overcomes many of the problems associated with enzyme destruction. Patients with chronic pancreatitis display considerable individual variation in their treatment requirements. Therapy must be tailored to meet the need for adequate disease control as well as for social and emotional acceptability by the patient. The attending physician and the patient share the responsibility for maintaining appropriate therapy. PMID- 2702252 TI - [Abstracts of papers presented at the 31st annual meeting of Japan Society of Smooth Muscle Research. Yamagata, 21-22 July 1989]. PMID- 2702253 TI - [Action potentials of the intramural ureter in the dog]. PMID- 2702254 TI - [Influence of age and sex on the reaction of isolated rat bladder to autonomic agents]. PMID- 2702255 TI - [Pharmacologic effects of baclofen on functions of the lower urinary tract]. PMID- 2702256 TI - [Effect of tiropramide on the urination reflex]. PMID- 2702257 TI - [Changes in gap junctions in smooth muscle and endometrium of the pregnant rat uterus]. PMID- 2702258 TI - [Influence of various steroid hormones on prostaglandin E2 metabolism in the smooth muscles of the human uterus--special reference to isolation and activity of 15 hydroxy prostaglandin dehydrogenase and 9 keto reductase]. PMID- 2702259 TI - [Steroid block of uterine smooth muscle and regulation of phosphoinoside-specific phospholipase C]. PMID- 2702260 TI - [Evaluation of uterine contractions in the clinical study of obstetrics]. PMID- 2702261 TI - [Effect of verapamil on contraction of the vas deferens in guinea pigs]. PMID- 2702262 TI - [Role of calcium ions in the mechanism of acetylcholine-induced contraction of the bile ducts in guinea pigs]. PMID- 2702263 TI - [Regulation of bile secretion from the gallbladder by stimulation of the hypothalamus in dogs]. PMID- 2702264 TI - [Role of the junction of the duodenum and common hepatic duct in bile secretion]. PMID- 2702265 TI - [Experimental study of the relation of vagotomy and the function of papillary muscles]. PMID- 2702266 TI - [Dynamics of bile secretion under stressful conditions]. PMID- 2702267 TI - [Effects of gastrectomy and vagotomy on the motility of the gallbladder and Oddi's sphincter]. PMID- 2702268 TI - [Gallbladder contraction after gastrectomy and CCK]. PMID- 2702269 TI - Effect of vanadate on resting membrane potential, action potential and twitch contraction in guinea-pig ureter. PMID- 2702270 TI - [Changes in tension of the pregnant rat uterus in high K+ solution and low Na+ solution]. PMID- 2702271 TI - [Miosis due to photic stimulation without retinal reflex]. PMID- 2702272 TI - [Measurement of the electrical activity of tracheal smooth muscle]. PMID- 2702273 TI - [Abnormal esophageal motility in patients with non-cardiac chest pain]. PMID- 2702274 TI - [Gastric acidity and gastric emptying]. PMID- 2702275 TI - [Gastroduodenal motor disturbances during digestion in patients with abdominal discomfort]. PMID- 2702276 TI - [Effect of HSR-803 on gastrointestinal motility]. PMID- 2702277 TI - [Effect of serotonin on gastrointestinal motility in conscious dogs]. PMID- 2702278 TI - [Basic study of the migrating complex during digestion in conscious dogs by the SG method]. PMID- 2702279 TI - [Retrograde excitation of the vagus sensory nerve fiber without regulatory function of small intestinal motility in dogs]. PMID- 2702280 TI - [Electromyographic study of small intestinal motility after jejunotomy]. PMID- 2702281 TI - [Physiopathology of small intestinal motility disturbances]. PMID- 2702282 TI - [Classification of the colonic motor complex by the SG method and estimation of pacemaker sites in dogs]. PMID- 2702283 TI - [Effect of muscarine on ileal cholinergic nerve activity and endogenous prostaglandins]. PMID- 2702284 TI - [Effect of calcitonin-gene related peptide on non-adrenergic supressive potentials of small-intestinal smooth muscle]. PMID- 2702285 TI - [Inhibitory effect of capsaicin on ileal contraction induced by stimulation of the muscle nerve]. PMID- 2702286 TI - [Functional polarity of 5-HT neurons in the intramuscular plexus of the guinea pig ileum]. PMID- 2702287 TI - [Changes of sympathetic and parasympathetic nerves in the rectum of the rat in the pull-through operation]. PMID- 2702288 TI - [Bile secretion induced by chemical stimulation of the mouth and larynx and stimulation of the upper laryngeal afferent nerves]. PMID- 2702289 TI - [Influence of bile influx to the duodenum on gastrointestinal motility in fasting dogs]. PMID- 2702290 TI - [Relation of fasting, gallbladder motility, gastro-duodenal motility, blood motilin and CCK levels in the human]. PMID- 2702291 TI - [Gallbladder motility after thoracic esophageal excision]. PMID- 2702292 TI - [Gallbladder motility after gastrectomy]. PMID- 2702293 TI - [Gallbladder contractility after gastrectomy]. PMID- 2702294 TI - [Influence of tension on the intra-urethral pressure curve]. PMID- 2702295 TI - [Effect of trospium chloride on lower urinary tract function]. PMID- 2702296 TI - [Role of K-channel and suppression of caecal smooth-muscle contraction in the guinea-pig during carbachol induced short-term desensitization]. PMID- 2702297 TI - [Inhibitory role of intracellular Ca in uterine smooth muscle contraction in an external Ca-free medium]. PMID- 2702298 TI - Postpartum depression: a clinical view. AB - Recent studies identify a much higher incidence of postpartum depression than had previously been acknowledged and show that a mother's depression may have a highly deleterious effect on the early development of her infant. Although a variety of theories exist concerning the etiology of postpartum depression, many writers now accept a transactional model of causality. This article suggests that for many women early depriving or abusive experiences are necessary but not sufficient conditions to explain the development of severe postpartum depression. Four different types of postpartum depression are presented with widely differing prognoses and needs for treatment. It is suggested that a wide range of treatment modalities may be needed with the more serious depressions and that such services are lacking in most communities. PMID- 2702299 TI - Decision rules for infant feeding: the influence of maternal expertise, regulating functions, and feeding method. AB - Decision rules used by mothers to determine actions for tasks and events of infant feeding were described and factors contributing to their use (mothers' functions in regulating the feeding, maternal experience, and feeding method) were explored. A telephone interview surveyed 122 mothers of healthy term infants 14-60 days old. Both Decision Rules and Regulating Function (Maternal-, Infant-, or Mutual-Regulation) varied by feeding task or event examined. Decision Rules and Regulating Functions were associated only for burping during a feeding. Maternal experience (primiparity, multiparity) was not associated with either Decision Rule or Regulating Functions. For several feeding tasks or events, Decision Rule was more likely to be predicted by Regulating Function when feeding method (breast, bottle) was controlled. A mother's agenda for the feeding may be an important component of her internal working model of infant feeding and a factor in making decisions for action. PMID- 2702300 TI - Anxiety levels, health behaviors, and support systems of pregnant women. AB - The purpose of this correlational descriptive study was to assess health behaviors, anxiety levels, and social support of pregnant women, ages 20 to 40, who were without complications and were patients of four private obstetrical practices in a large metropolitan city. Although sampling was a nonprobability approach, various socioeconomic, racial, and religious groups were represented. The three instruments used to test the hypotheses included the State-Trait Anxiety Inventory (STAI), the Personal Resource Questionnaire (PRQ) and a detailed Health Behavior Demographic Questionnaire. Results of the data indicated no significant differences between pregnant smokers' and pregnant nonsmokers' STAI or PRQ scores. Significant positive correlations were revealed between the following variables: Trait anxiety with increased age of pregnancy (r = .77, p = .008); trait anxiety with high educational level (r = .72, p = .001); trait anxiety with state anxiety (r = .64, p = .001); trait anxiety with years married (r = .68, p = .018); trait anxiety with numbers of children (r = .82, p = .005); trait anxiety with high occupation level (r = .68, p = .001), increased age with PRQ support (r = -.88, p = .001); caucasian women examined breast more frequently (r = .47, p = .005); pregnant women who were smokers also were more likely to drink (r = .66, p = .03). Significant negative correlations were: Increased state anxiety with decreased social support (r = -.28, p = .05); higher trait anxiety with lower PRQ (r = -.59, p = .001), and more drinks of alcohol per day with decreased social support (r = .88, p = .04). The study indicated that the subjects who continue to smoke while pregnant were highly educated. All had at least two years of college with 45% having completed graduate school. All were working in managerial or professional jobs. This has implications for nursing interventions focused on enhancing health coping strategies at the workplace and specific health promotion activities designed to reduce job-related stress during pregnancy. PMID- 2702301 TI - Comparison of breastfeeding attitudes and practices: low-income adolescents and adult women. AB - Breastfeeding attitudes and practices of two independent samples of low-income adolescents were compared to a third sample of low-income, adult women. Low income status was based on subject eligibility for the Special Supplemental Food Program for Women, Infants, and Children (WIC). Breastfeeding attitudes were significantly related to setting, race, and age. Other factors, such as previous exposure to breastfeeding, also influenced breastfeeding attitudes. Breastfeeding rates were 16.7% and 32.4% for the two teen samples, and 35.4% for the sample of adult women. Choice of infant feeding method post delivery was significantly related to intention regarding feeding method during pregnancy. Implications of these findings for health care professionals are discussed. PMID- 2702302 TI - Thiol involvement in the inhibition of DNA repair by metals in mammalian cells. AB - We have previously demonstrated that a number of metal salts have the capacity to inhibit the DNA repair process in human cells. In order to determine a role for non-protein thiols (TNPT) in this inhibition, we investigated repair of X-ray damage in metal-treated HeLa cells under normal conditions and conditions in which cellular thiols had been depleted by treatment with buthionine sulfoximine (BSO) and diethyl maleate (DEM). The combination reduced cellular TNPT by 92%, and cells so depleted became sensitized to X-ray-induced killing and exhibited retarded sealing of X-ray-induced DNA single-strand breaks. Thiol depletion also sensitized cells to the cytotoxicity of certain but not all metals tested. The sensitivity to copper was increased over 6000-fold, and significant enhancement of killing was also seen in cells treated with arsenic, lead, and mercury. Smaller effects were observed with cadmium and nickel, and sensitivity to manganese, magnesium, cobalt or zinc was not substantially altered. Enhanced sensitivity to X-ray killing was found in cells treated with nickel, cadmium, zinc, arsenic, and copper under conditions in which thiols were not limiting. In thiol-depleted cells, sensitivity was not further increased in the case of nickel and arsenic but at least additively affected for copper, mercury and zinc. X-Ray induced single-strand break repair was retarded by treatment of cells with mercury, nickel, zinc, arsenic, and copper in thiol-normal cells. In thiol depleted cells, repair inhibition by zinc, arsenic, and copper was nearly complete, while little additional effect on repair was seen following mercury and nickel treatment. An examination of the effects of brief metal treatment on cellular TNPT revealed that copper strongly decreased thiol levels whereas the other metals tested either had no effect on TNPT or reduced TNPT levels to no less than 48% under the conditions employed. No simple relationship appears to exist relating loss of cellular thiols and sensitivity of repair in the series of metals tested. Clear, although indirect, evidence exists, however, that sensitivity to X-rays is mediated through thiols and that the interaction of metals and thiols in the cell may be an important factor in modulating the response to irradiation. PMID- 2702303 TI - Effects of nickel sulfate, lead sulfate, and sodium arsenite alone and with UV light on sister chromatid exchanges in cultured human lymphocytes. AB - Sister chromatid exchanges (SCE) have been examined in human lymphocytes following in vitro treatments with metal salts, nickel sulfate, lead sulfate and sodium arsenite. All of the metal salts produced significant increases in the SCE frequencies over the levels for untreated lymphocytes. The SCE frequencies were also examined for metal treatments combined with ultraviolet light (200 ergs/mm2). For the lead treatments combined with the UV dose selected, an additive SCE response was observed compared to the SCE responses for UV or metal alone. The nickel and arsenite treatments combined with UV produced a less than additive SCE response for most concentrations tested. These results suggest that nickel or arsenite present in complex mixtures may reduce the SCE response to other compounds in the mixture normally capable of producing a much stronger SCE response and therefore lead to an underestimate of the effects of chemical exposure. PMID- 2702304 TI - Studies of induction of metallothionein in JAr (human choriocarcinoma) cells by cis and trans isomers of diamminedichloroplatinum (II) and their hydrolyzed species. AB - The inducibility of metallothionein by cis- and trans diamminedichloroplatinum(II) and their hydrolyzed products was studied in the JAr (a human choriocarcinoma) cell line. The metallothionein present in the cytosolic fraction of these cells was measured after a 12- or 24-h exposure to a fresh metal solution or a solution that had been allowed to hydrolyze. These results demonstrate that hydrolysis of the cis isomer produces a species that is able to give a 374% increase in the cytosolic level of metallothionein after a 24-h exposure to 40 microM of the metal. Fresh cisplatin, on the other hand, gives a maximal increase of 118% under the same conditions. Transplatin and its hydrolyzed species did not induce metallothionein. These results may indicate that hydrolysis of cisplatin performs an important role in the metabolism and possibly the toxicity of this widely used agent for cancer chemotherapy. PMID- 2702306 TI - Therapeutics in inflammatory bowel disease. A symposium. Veldhoven, The Netherlands, 24 February 1989. Proceedings. PMID- 2702305 TI - Hypomethylation of ras oncogenes in chemically induced and spontaneous B6C3F1 mouse liver tumors. AB - The male hybrid B6C3F1 mouse exhibits a 30% spontaneous hepatoma incidence, and both males and females of this strain are sensitive to chemical induction of liver tumors. The Ha-ras, Ki-ras, and myc oncogenes have been implicated in a variety of solid tumors. Specifically, Ha- and, less frequently Ki-ras have been reported to be activated in B6C3F1 mouse liver tumors, and such activated oncogenes frequently contain a particular point mutation. In light of indications that the transforming capacity of some oncogenes is directly related to the level of the gene product, we hypothesized that transcriptional control of Ha-ras, Ki ras, and myc is compromised in B6C3F1 mouse liver tumors. A positive correlation has been established between gene expression and hypomethylation. Therefore, the methylation states of these genes were examined in spontaneous liver tumors and in tumors induced by two diverse hepatocarcinogens: phenobarbital and chloroform. Ha-ras was found to be hypomethylated in all tumors examined, whereas Ki-ras was sometimes hypomethylated; such hypomethylation might play a role in the promotion stage of carcinogenesis. The methylation state of myc was unaltered, although this gene appeared to be amplified in tumors. These results suggest that a component of the mechanism by which these oncogenes are activated in B6C3F1 mouse liver tumors involves loss of stringent control of expression, via hypomethylation of the ras oncogenes and, possibly, amplification of myc. These results support the assertion that tumors induced by different classes of carcinogens or arising spontaneously share common biochemical pathways of oncogene activation during tumorigenesis. PMID- 2702307 TI - 5-ASA enema therapy. AB - 5-Aminosalicylic acid (5-ASA) enema therapy has been a direct extension of our understanding of the pharmacology and metabolism of sulfasalazine. Clinical studies have documented the efficacy and safety of topical 5-ASA therapy in distal ulcerative colitis. Future clinical experience should clarify the role of topical 5-ASA in a variety of inflammatory bowel disease syndromes. PMID- 2702308 TI - Acute treatment of inflammatory bowel disease, prednisolone: dosage and duration. PMID- 2702309 TI - Topical corticosteroids in inflammatory bowel disease. PMID- 2702310 TI - 5-Aminosalicylic acid derivatives. Clinical and pharmaceutical evaluation. AB - Several new 5-aminosalicylic acid (5-ASA) derivatives have been introduced for the treatment of chronic inflammatory bowel disease (CIBD). In azo-bond preparations, 5-ASA is linked to an inert carrier (Balsalazide) or to another 5 ASA molecule (Dipentum). The pharmacokinetic profile is similar to salazosulphapyridine (SASP) and the preparations are as effective as SASP in treatment of ulcerative colitis (UC) and with fewer side effects. In controlled release preparations (Asacol, Pentasa, Salofalk), 5-ASA is coated with compounds resistant to low pH, but which deliver 5-ASA to the intestines at various rates at higher pH values. The drugs are as effective as SASP in maintenance of remission and in the treatment of mild to moderate flare ups in UC. A larger systemic absorption is found for the three preparations compared to SASP. The controlled release preparations seem promising in the treatment of Crohn's disease, but further studies are needed. The controlled release preparations should be the drugs of choice in patients with UC allergic to or intolerant of SASP and to males who wish to have children. PMID- 2702311 TI - Emergency surgery for inflammatory bowel disease. PMID- 2702312 TI - Hepatobiliary abnormalities in inflammatory bowel disease. AB - Hepatobiliary abnormalities are among the most frequent extraintestinal manifestations of inflammatory bowel disease. Hepatic amyloidosis and granulomas may be found in patients with Crohn's ileitis. Clinical problems are generally absent. This also applies to fatty infiltration of the liver. The prevalence of gallstones is increased in patients with extensive ileitis. Primary sclerosing cholangitis occurs in about 5% of patients with ulcerative and Crohn's colitis. Serious complications such as bacterial cholangitis and bile duct carcinoma may develop. Because of increased awareness of primary sclerosing cholangitis complicating inflammatory bowel disease and widespread availability of endoscopic cholangiography, asymptomatic patients are now often detected Although controversial, the prognosis of these patients may be better than previously thought. Therefore, endoscopic cholangiography should probably be deferred until symptoms develop in order to avoid the risk of procedure-related cholangitis. Although a liver biopsy is not as diagnostic as cholangiography, it may have prognostic relevance. Recent preliminary results of immunosuppressive and anti fibrogenic therapies and treatment with urodeoxycholic acid for primary sclerosing cholangitis are promising, but should be confirmed in prospective controlled trials. PMID- 2702313 TI - Treatment of perianal pathology in inflammatory bowel disease. PMID- 2702314 TI - Pouchitis (pouch ileitis). AB - Construction of a continent ileostomy or ileo-anal reservoir after (procto)colectomy has provided many patients suffering from inflammatory bowel disease-in particular ulcerative colitis or polyposis coli--with a major improvement in their social wellbeing. However, complications are rather frequent and pouchitis is one of the most important chronic ones, to be defined as the combination of bothersome clinical symptoms (abdominal pain, bloating, increased faecal output, sometimes fever) with evident endoscopic abnormalities of the reservoir ileal mucosa (oedema, reddened mucosa, minor flat up to large irregular ulcerations). The contribution of pouch biopsies is limited, because chronic inflammation is always demonstrable and evidence of acute inflammation is only rarely present. Although backwash ileitis does not promote the occurrence of pouchitis, the immunological mechanism might be highly comparable. Cultures of faecal content for specific pathogens is necessary; bacterial anaerobic or aerobic overgrowth appears to be of no major significance in the development of pouchitis. Nevertheless, a short-term course with metronidazole is nearly always effective, although recurrences are far from rare. In this situation a course of corticosteroid enemas or even maintenance therapy (2-3 wk) should be advised. Experience with mesalazine compounds is limited and should be expanded. PMID- 2702315 TI - Fertility and pregnancy in inflammatory bowel disease. AB - Fertility in women is normal in ulcerative colitis but impaired in Crohn's disease. In men fertility can be decreased during treatment with sulphasalazine and after proctectomy. In the case of drug-induced (SASP) infertility, withdrawal of the drug or substitution by one of the new 5-ASA drugs will normalize the fertility. Pregnancy has no adverse effect on the course of UC or CD and there is no place for a therapeutic abortion. Moreover, therapeutic abortion does not influence the activity of the disease. In general, the outcome of pregnancy in women with IBD is good, particularly when the disease is inactive at the time of conception. When at the start of pregnancy the disease is active, the risk of spontaneous abortion or premature delivery is increased and the patient has a considerable chance of having symptoms throughout pregnancy despite medical treatment. Therefore the patient should be advised to plan pregnancy when the disease is in remission. Medical treatment of pregnant patients should be the same as in non-pregnant patients with active disease with the exception of the drugs azathioprine, 6-MP and metronidazole. The majority of the patients will respond to medical treatment and surgical intervention is rarely necessary. However, when there is an indication for surgery, there should be no delay, despite the risk to the fetus. PMID- 2702316 TI - [Benign paroxysmal vertigo in children]. AB - Based on our examination of 176 patients, we first selected, according to the general standards of diagnosing benign paroxysmal vertigo of childhood (children aged up to ten years, paroxysmal vertigo, ataxia) a group of 78 patients. Using multidisciplinary approach we have thus performed in these children the following examinations: an exhaustive anamnesis, laboratory examinations, clinical ORL (ENT), ophthalmological, neuropediatric examinations, x-ray of the cranium and the temporal bone, audiometric, vestibulogenic and EEG examinations. In the following stage we have, on the basis of the obtained data, selected 22 patients who met the restrictive standards for the diagnosis of a benign paroxysmal vertigo of childhood (typical clinical picture, isolated vestibular symptomatology, exclusion of the etiological factors, benign course of the disease). In our material the age range was between the second and the sixth year. After the sixth year of age we have not had any case of benign paroxysmal vertigo. We have not arrived at any significant fact which would indicate an etiological factor. There is no significant difference in the frequency of the disease between the two sexes, but we may assert that small girls slightly prevail. Normal psychomotoric development, normal intellectual faculties, absence of risk factors (only a twin had lower birth weight), absence of neurological abnormalities, regular EEG findings, pathological findings of the vestibular excitability together with absence of cochlear symptomatology, and evident clinical symptoms obviously indicate the right diagnosis. The evolution of the disease is exceptionally favorable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702317 TI - [Clinical characteristics of progressive supranuclear paralysis (the Steele Richardson-Olszewski syndrome)]. AB - We analyzed the clinical features and therapeutic response of 6 patients with progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome). The mean duration from the onset to establishing the diagnosis was 2.7 years, with the initial false diagnosis of Parkinson's disease in 4 patients. The most common symptoms at the moment of diagnosing were unsteady gait, speech difficulties, forgetfulness and rigidity, in addition to impairment of vertical gaze. In all the patients therapeutical response was inadequate. Clinical criteria for differential diagnosis of progressive supranuclear palsy are discussed. PMID- 2702318 TI - The oculomotor nuclear complex in humans. Microanatomy and clinical significance. AB - The oculomotor nuclear complex was examined in 12 serially sectioned midbrains. The complex comprised the somatic portion (formed by the multipolar motor neurons), and the parasympathetic portion (formed by the oval or fusiform preganglionic cells) on each side of the midbrain's raphe. The somatic portion consisted of the lateral somatic cell column and the caudal central nucleus. The somatic column measured from 0.2 x 0.1 mm to 3.4 x 1.4 mm (mean = 2.4 x 1.2 mm) in transverse sections. It was divided into the principal, intrafascicular and extrafascicular parts. The principal part was subdivided into the dorsal, intermediate and ventral portions. Neurons within the column were multipolar, with pale nucleus, prominent Nissl bodies, and 1-7 processes. The number of motor neurons in the entire column ranged from 1 to 209 per section. The diameter of neurons was 40 x 26 microns on the average. The authors also revealed the isolated multipolar neurons in the periaqueductal gray, the interstitial nucleus of Cajal, the Edinger-Westphal nucleus, and the fibre bundles of the oculomotor nerve. These cells most likely represent the displaced motor neurons of the oculomotor nerve. The caudal central nucleus was 0.8 x 0.6 mm in size, and it contained 12-58 neurons. These multipolar neurons measured 35 x 22 microns in size. The parasympathetic Edinger-Westphal nucleus usually consisted of the rostral, ventral and dorsal parts, which contained from 8 to 283 neurons per section. The longest rostrocaudal diameter of this nucleus measured 7.1 mm. The oval or fusiform neurons contained bands of the congregated Nissl bodies. The neurons measured 34 x 17 microns in size. The authors discussed the clinical significance of the obtained anatomical data, i.e. the neurologic signs following complete or partial lesions of the oculomotor nuclear complex. PMID- 2702319 TI - [Report on changes in some elements of respiration during exacerbation of schizophrenic psychosis]. AB - Disturbances of respiration occurring in the exacerbation of schizophrenic psychosis with predominant anxiety were examined in a group of 30 schizophrenic patients. In the experimental group were included patients before the application of therapy with derivants of phenotiazinic group, and in the control group the patients who were given this therapy in the period of 25 days. The psychotic intensity was determined by Rogina's Grading Scale of Psychotic Behavior, and the severity of anxiety by psychological techniques (Rorschach's Psychodiagnostic Test and Spilberg's Inquiry for Anxiety), as well as by polygraphic technique of respiration recording. This investigation has shown that the use of polygraphic neurophysiological methods in the investigation of anxiety in schizophrenia is justified. The conclusion was that hyperventilation is a consequence of anxiety. The shortening of inspiratory phase of the respiration cycle and the prolongation of expiration, particularly occurring in the phase of spontaneous fluctuation of psychogalvanic reflex were registered, what is an indication of anxiety. PMID- 2702320 TI - ["One and a half syndrome", a lesser known neuro-ophthalmologic sign of a pontine lesion]. PMID- 2702321 TI - Ataxic hemiparesis with one and half syndrome. AB - We report a case in whom clinical entity of ataxic hemiparesis (AH) is associated with one and half syndrome. The later finding favours a lesion in the dorsal pons while a lesion in the ventral pons will cause AH. Computerised axial tomography (CT) showed a pontine infarction over right side. The patient recovered within two weeks of onset in spite of diffuse (ventral and dorsal) pontine involvement. PMID- 2702322 TI - [The role of thrombocytes in the development of ischemic cerebrovascular insult]. AB - Cerebrovascular diseases appear in 10 to 15% in the general mortality of population, so that they are in the third place on the list of death causes, after cardiovascular and malignant diseases. Having in mind particular importance of hemorrheological complex in the development and course of cerebrovascular accident, in the present work we investigated adhesion, aggregation and number of thrombocytes. Parallel to the evaluation of the above mentioned hemorrheological indicators, we investigated the degree of motor deficit and the severity of of consciousness disturbances. All the indicators were determined first within 24 hours after the onset of the disease, then after 72 hours, and finally during the 9th day of the disease. The same procedure was done in the control group and all the indicators were determined during the first day, the third day and the ninth day of investigation. The group of patients consisted of 20 men and 20 women. In the control group were included 20 men and 20 women. On the basis of our investigation of hemorrheological indicators, we came to the conclusion that the adhesion of thrombocytes is of particular importance in the diagnostics and further following of the course of the cerebrovascular accident. The aggregation of thrombocytes has only a relative value in the investigation of the course of the ischemic cerebrovascular accident, while the number of thrombocytes has not significance for the onset and course of the ischemic cerebrovascular disorder. PMID- 2702323 TI - Neurology present and future. PMID- 2702324 TI - Multiple sclerosis in Istria, Yugoslavia. AB - An epidemiological research of multiple sclerosis (MS) in Istria, Yugoslavia, was made in the period of 1980-1981. After examining all the sources of health care information, 125 potential MS patients were found in the investigated area. According to the diagnostic criteria by Schumacher et al., 47 affected were recognized and accepted as clinically definite MS patients. The MS prevalence rate in Istria on March 31st, 1981 amounted to 25.0/10(5) inhabitants (CI: 19.9 38.9). Such rates classify Istria in the middle between the medium and high risk zones for the disease in Europe and in the world. The onset age of MS in Istria was about 30 years, the female/male sex ratio was 2.13. The average duration of MS in Istria up to the prevalence day was 16.5 years. The average annual incidence rate was 1.5/10(5) inhabitants. PMID- 2702325 TI - Muscle pain in neuromuscular disorders and primary fibromyalgia. AB - Muscle fiber degeneration and regeneration, inflammation in the intramuscular connective tissue and hypoxia in resting muscle are not necessarily associated with pain. However, when sustained or dynamic muscle contractions are performed in an ischaemic muscle, severe pain develops. In the chronic muscle pain syndrome called fibromyalgia (or fibrositis) the most likely cause of the pain is a combination of muscle tension and muscle hypoxia. This conclusion is supported by the finding of a pathological distribution of tissue oxygen pressure in painful muscles and a subjective feeling of muscle tension and muscle stiffness in the majority of patients. A decrease of high energy phosphates is found in biopsies from painful muscle. The most characteristic morphological finding is the so called ragged red fiber, a finding that can be seen in mitochondrial disorders. The morphological and chemical findings are possibly a consequence of a long standing hypoxia. The possibility that sympathetic nerve activity is important for the development of chronic muscle pain is discussed. PMID- 2702326 TI - [The present surgical status in the diagnosis and treatment of acute traumatic intracranial hemorrhage]. AB - The development of acute traumatic intracranial bleedings after severe head injuries is a dramatic manifestation. A great part in the timely discovery and successful treatment is equally played by the surgeon and by the radiologist, who make an inseparable diagnostic and therapeutic team. Therefore, they have an equal share in the glory of success and disappointment of failure. PMID- 2702327 TI - [The terminal latency quotient in patients with compressive syndromes]. AB - In our investigation 119 patients suffering from carpal tunnel syndrome, and 45 suffering from cubital tunnel syndrome have been analyzed. The above mentioned syndromes belong to compressive mononeuropathies and are the result of the narrowing of the anatomical channel, through which the nerve passes, causing direct or indirect pressure on the nerve and difficulties in the flow of particles and nerve impulses towards the periphery. The aim of our work was to study the influence of the compressive lesion, primarily on the distal motor and sensory latencies. To achieve a better precision, the distal motor latency is expressed as a quotient of terminal latency. It is obtained by dividing the distance between the stimulation and the recording point in centimeters with the latency of response expressed in miliseconds. Sensory latencies are obtained by orthodromic stimulation of the finger and the detection of the neural potential at the wrist. According to our results, the proximal pathological process, besides causing the localized slowing down of conduction velocity, affects the conduction velocity of the distal sensory fibers in a higher degree than of the distal motor fibers. In any case the distal motor latencies are in a higher percentage prolonged by the distal lesion, such as carpal channel syndrome, in comparison with the proximal lesion (cubital tunnel syndrome). The less pronounced prolongation of the distal latencies, especially of sensory ones, must not be proclaimed as a consequence of a local compression without additional plurisegmental analysis. PMID- 2702328 TI - Motor coordination maturity in healthy 7-10 years old children. AB - Finger-nose test and the test of diadochokinesis were performed in order to estimate motor coordination maturity in healthy children aged 7-10 years. Occurrence of immature motor coordination was recorded significantly more often in sever-year-old children (present in 44%) than in the other age groups (present in 20-27%). In some children it was present only on the side of nondominant hand, and in the rest of them bilaterally. Positive correlation between the level of ability to perform the applied tasks and specific relations between different types of lateralization are discussed. PMID- 2702329 TI - Transcranial electrical and magnetic motor cortex stimulation: studies in intact man. AB - The new method of transcranial electrical and magnetic brain stimulation was tested in 41 normal subjects. Stimulation on the scalp excites corticospinal neurones in the motor cortex while stimulation over the spine excites spinal nerve roots. The difference between EMG response latencies after both stimulations represents conduction in the central motor pathways and is called central motor latency (CML). The aim of out experiments was to investigate certain methodological aspects of the technique in order to standardize the procedure. Recordings were done from slightly contracted abductor digiti minimi and tibialis anterior muscles after electrical stimulation on the scalp and from the relaxed and contracted abductor digiti minimi and biceps brachii muscles after magnetic brain stimulation. Stimulation over the spine (C7/T1 interspace in case of upper limb muscles stimulation and T12/L1 interspace in case of tibialis anterior stimulation) was always electrical. Using a rather weak non-commercial magnetic stimulator we were not able to activate lower limb muscles, neither we succeeded to evoke responses from the relaxed arm muscles in all subjects. Electrical scalp stimulation proved successful in all cases. Muscle response after cortical stimulation in contracting muscles and shorter latencies and provided more accurate estimate of conduction time in the central motor pathways than responses in the relaxed muscles. Latencies should be measured from several superimposed responses and not from averaged ones. The intensity of stimulation over the neck did not affect CML. We nevertheless suggest that the strongest stimulus intensities should not be used in order to avoid CML overestimation. PMID- 2702330 TI - Duplex scanner versus conventional arteriography for carotid artery disease evaluation. AB - In order to evaluate extracranial circulation, Duplex scanning and conventional angiography were performed. The group of 41 patients (mean age 53.8 +/- 11.8, 71% male) were examined. Results were analyzed for extracranial disease presence such as presence of vessel stenosis (mild, moderate, severe), occlusion and presence of plaques. Data from Duplex scanning and carotid arteriography were correlated within the patients in the term of sensitivity and specificity of the methods used. The sensitivity of Duplex scanning for disease presence was 93% and specificity was 83%. For the presence of stenosis, sensitivity was 79% and specificity was 62%. For mild and moderate stenosis (less than 50% of lumen narrowing) sensitivity was 63%, whereas for severe, high-grade stenosis (greater than 50%) and occlusion the sensitivity was 100%. For the plaque presence the sensitivity was 52% and specificity was 73%. A good accordance of plaque findings with both methods was found only in 24% of patients. By Duplex scanner the plaques were discovered in 92% of patients while by arteriography they were found only in 32%. Duplex scanning and conventional arteriography are both accurate methods for determination of the reduction in diameter of carotid arteries (especially in stenosis greater than 50%), whereas Duplex scanning is more accurate for plaque detection and plaque characterisation. PMID- 2702331 TI - Some uses of visual evoked potentials in the diagnostics of neurological disorders in developmental period. AB - The diagnostic value of visual evoked potentials (VEP) was assessed in a sample of 146 patients aged from 4 months to 18 years with a variety of visual disorders, and in 81 healthy controls. The methods of stimulation consisted of 1) a series of pattern reversals (PR) in 105 fully cooperative patients aged 6-18 years, or 2) a series of diffuse flashes in 41 infants, small children and mentally retarded subjects. The ranges of normal VEP parameters were defined by comparison of the subjects' groups with healthy controls of the same age and sex, who were recently tested by the same methods developed in our laboratory. The incidence of various VEP abnormalities was related to clinical findings and other investigations carried out with the scope to establish the localization and/or the disease etiology. The greatest localizing validity of VEP was found in patients with unilateral visual disorders, while the highest frequency of the most different types of VEP abnormalities was found in subjects with multiple sclerosis. Although nonspecific for any etiology, VEP abnormalities represent a sensitive screening method aimed to discover and to follow-up possible progression of visual dysfunction in children and adolescents. Since VEP, particularly of PR type, allow monitoring of subtle influences on the neuronal cortical functions, its full diagnostic value in the developmental neurology should be determined by further studies. PMID- 2702332 TI - [Disorders of psychological function in neurological diseases and in work capability]. AB - There are many different psychiatric disorders connected with neurological diseases, such as the disorders of intellectual and cognitive functions, personality changes, neurotic and psychotic behaviour. It is important for a neurologist to recognize these disorders, because they may be of great importance in evaluating work and professional capability, especially in intellectual professions. Neurologists inclined to objectivization of neurological deficit may overlook these disorders. In making an expertise it is essential to differentiate between the reversible (transitory symptoms, clouding of consciousness) and the irreversible disorders (personality changes, intellectual impairment--dementia). Also it should be kept in mind that psychopathological features of organic psychosyndromes are characterized by common psychopathological syndromes and that they represent non-specific types of reaction. Apart from diagnosing a particular psychological disorders, when making an expertise one should also describe the disorders of various psychological functions and their impact on work and professional capability and social behaviour. The author stresses the necessity of stating diagnostic criteria for the evaluation of the psychological deficit level in neurological diseases. Basic education in neurology should be accompanied by the continuous gathering of information in neuropsychology and organic psychiatry. PMID- 2702333 TI - [Brain stem auditory evoked potentials in patients with cerebrovascular diseases]. AB - Brainstem auditory evoked responses (BAERs) were recorded in 30 patients with brainstem lesions. The aim of the study was to find the correlation between an abnormal BAER and the adequate level of a brainstem lesion. The correlation noted between an abnormal BAER and level of a brainstem lesion (medulla, pons, midbrain) was not statistically significant (p = 0.073 Kruskal-Wallis H-test). This could be explained partly by the fact that a brainstem generators for the BAERs are complex and the various components of the BAERs may actually depend on multiple generators. In patients with unilateral lesions the most prominent abnormality was noted in BAERs generated by stimulating the ear ipsilateral to the lesion, except for wave V. The present study supports the concept that ipsilateral pathway (uncrossed fibres) and crossing fibres contribute to its generation. PMID- 2702334 TI - Alexia with agraphia. AB - The authors presented a case of relatively pure syndrome of alexia with agraphia in a patient speaking Serbo-Croatian language. Reading disturbances showed some characteristics of a deep dyslexia. Besides severely impaired reading and writing abilities, some components of Gerstamnn's syndrome were also present. Infarction in the posterior half of the left supramarginal and in the anterior half of the left angular gyrus was accurately located by the graphic reconstruction of CT scans. PMID- 2702335 TI - Lesch-Nyhan syndrome: the differential diagnosis and actual aspects. AB - The paper presents a case of a nine-year-old boy with Lesch-Nyhan syndrome whose disease was characterized by: a) clinical presentation (psychomotor retardation, involuntary movements, self-mutilatory behavior) b) biochemical features (increased levels of uric acid in serum and urine, index uric acid/creatinine) c) typical diagnostic ommision that lasted up to the terminal stage of the disease In order to provide the possibility of better diagnosis (which includes possibilities of genetic consulting, antenatal diagnosis and treatment of the disorder which is extremely unpleasant both to the patient and to his family) the most common diagnostic errors are discussed. Since the biochemical deficit is the only one which produces the occurrence of Lesch-Nyhan syndrome, the disease is commonly used as a model for investigations of the biochemical basis of human behavior. PMID- 2702336 TI - [Molecular pathology of insulin-dependent diabetes mellitus (type I)]. AB - Since sufficiently long time the average life expectancy in IDDM did not change. Only new data concerning the causes and pathogenesis of the disease may improve such set-back. The most promising field of creating the better insight into etiology of IDDM are molecular pathological studies. This review attempts to summarize the state of art in this area choosing the problems of clinical relevance. Many of them are controversial, disturbing the immunogenetic hypothesis of IDDM etiology, majority positively support this idea. 6 topics are critically discussed in respective sub-chapters: 1) genetic control of autoimmunization processes as pertinent to beta cells; 2) genesis, actions and clinical significance of various types of autoantibodies against autoantigens; 3) character of beta cell antigens; 4) suggested mechanism of beta cell destruction; 5) new idea of prediabetic state and 6) lessons from immunosuppressive therapeutical trials. Author brings the story of etiological mechanisms of IDDM up to date pointing that more direct and specific information is needed to be applicable in practice. PMID- 2702337 TI - [Effects of beta-selective blockade on levels of glucagon in blood plasma during insulin-induced hypoglycemia]. AB - The effects of beta-selective blockade with metoprolol on the glucagon blood plasma level during insulin-induced hypoglycemia were studied in 20 control dogs, and 20 alloxan diabetic dogs. The results indicate that the sensitivity to exogenous insulin is increased in alloxan diabetes glucose counterregulatory mechanisms are impaired. After insulin administration glucagon concentration increased much more and quicker in the control group than in diabetic dogs. Beta blockade with metoprolol increased glucagon secretion in both groups. PMID- 2702338 TI - [Glucose tolerance disorders in individuals chronically exposed to carbon disulfide (CS2)]. AB - An incidence of glucose tolerance disorders was investigated in the group of 47 employees of the viscose fibres of the mean duration of exposition exceeding 20 years. Control group included 31 employees uniform in the age and body weight. Carbohydrate metabolism was tested with the oral load with 100 g of glucose and intravenous glucose administration according to Conrad. Glucose tolerance disorders were noted in 11 employees (23.4%) chronically exposed to CS2 in the concentrations slightly exceeding acceptable levels whereas glucose intolerance was noted in 2 individuals (6.5%) of the control group. The difference was statistically significant. No difference in the glucose absorbability index was noted. Exposition time to the studied CS2 concentrations did not affect the incidence of the glucose tolerance disorders. PMID- 2702339 TI - [Effect of vitamin E on the function of blood platelets in patients with diabetes mellitus]. AB - An effect of vitamin E on blood platelets functioning was studied in 39 patients with diabetes mellitus type 1. Control group included 20 healthy blood donors. Vitamin E in a daily dose of 1000 mg produced statistically significant decrease in platelets aggregation, number of circulating platelet aggregates and release of the platelet factory 4 in diabetics after 7 days of treatment. No adverse reactions were seen in any patient treated with vitamin E. The obtained results indicate that vitamin E inhibits increased platelets activity in the patients with diabetes mellitus type 1 and does not exert toxic reactions during the treatment. PMID- 2702340 TI - [Usefulness of the Visidex II (Ames) strip test for monitoring insulin therapy at home]. AB - Blood glucose was determined with o-toluidine and Visidex II (Ames) in 234 adult diabetics. The highest conformity of the results in both techniques was achieved in the range of blood glucose concentrations 70-110 mg%. The authors are convinced that Visidex II may be valuable in monitoring of normoglycaemia during intensive therapy with insulin, eg. during pregnancy. In other ranges of blood glucose concentrations, the results of determinations with Visidex II are significantly higher than that of simultaneously carried out determinations with o-toluidine method. Therefore, a decision on taking an additional insulin injection should be very careful in case of hyperglycaemia determined with strip test Visidex II. PMID- 2702341 TI - [Clinical examination of diabetic patients treated with monocomponent insulin manufactured by MP Polfa]. AB - An effect of replacing conventional forms of insulin by the monocomponent insulin manufactured by "Polfa" was studied in the group of 22 diabetics. The patients were followed up for 12 months. An effect of monocomponent insulin on daily requirement of insulin, levels of anti-insulin, monocomponent and pancreatic peptide antibodies, compensation of diabetes mellitus, and lipodystrophy were investigated. New insulin preparation decreased anti-insulin and pancreatic peptide antibodies level and markedly diminished lipodystrophy. However, daily insulin requirement, degree of diabetes mellitus compensation, and anti proinsulin antibodies level remained unchanged. PMID- 2702342 TI - [Significance of insulin resistance to the pathogenesis of diabetes mellitus type II]. PMID- 2702343 TI - [Principles and perspectives of immunomodulation in the treatment of diabetes mellitus type I]. PMID- 2702344 TI - [Pathogenesis of hyperglycemia in diabetes mellitus type II (insulin independent)]. AB - The most important causes of hyperglycaemia in the course of diabetes mellitus type 2 are discussed. Those include: insulin secretion disorders, resistance to the insulin and overproduction of glucose in the liver. Affected secretory function of B cells in the pancreatic islets results, first of all, from the primary genetic error and secondary regulatory disorders, chiefly hyperglycaemia. Resistance to the insulin caused by decreased insulin activity in the muscle tissue and adipose tissue includes so-called receptor and postreceptor defects. Mechanism of these disorders is partially explained. Overproduction of glucose in the liver is probably secondary to the above metabolic disturbances and decides on the basic hyperglycaemia. Pathogenetic aspects of the insulin independent diabetes mellitus therapy with particular reference to the role of sulfonylurea derivatives are also discussed. PMID- 2702345 TI - Vascular bundles and wickerworks in childhood brain tumors. AB - We reviewed 114 childhood brain tumors and brain sections from 30 children with no nervous system lesions to determine the incidence of vascular bundles (VB) and vascular wickerworks (VW). VB consist of a group of small blood vessels running parallel to each other. VW denote spiralling or twisting of two or more small blood vessels around one another, resembling vines. By light microscopy, VB cannot be differentiated from VW; both appear as a group of small blood vessels oriented in the same direction. VB and VW have been described in normal and abnormal brains at all ages, in association with aging, in neovascularization following necrosis, and in brain tumors. They occur rarely in normal brains, but are a common histological feature of cerebellar pilocytic astrocytomas in contrast to diencephalic pilocytic astrocytomas, anaplastic astrocytomas of cerebrum and cerebellum, and meningiomas. PMID- 2702346 TI - Cerebrospinal fluid shunt infections. Report of 41 cases and a critical review of the literature. AB - All shunt procedures performed at our institution from July 1982 to December 1987 were analyzed for factors possibly related to shunt infection. There were 41 infections detected in 31 patients for an overall rate of 6.9%. Only intraventricular hemorrhage (IVH) as an etiology of the hydrocephalus and internalization of an external ventricular drain (EVD) were found to correlate with septic risk. An extensive review of all the English language literature concerning shunt infections over the last 15 years was undertaken. Little consensus could be found among the 35 publications in regard to factors predisposing to shunt sepsis. Even the issue of antibiotic prophylaxis remains clouded as all papers examined exhibited methodologic flaws. PMID- 2702347 TI - Intrauterine depressed skull fracture. A report of two cases. AB - Two cases of intrauterine depressed fracture are presented. In each case, the mother had no history of abdominal trauma during pregnancy, the children were delivered normally without the use of forceps, but a round depression was present in the left frontal bone at time of delivery. CT scans demonstrated a depressed fracture of the left frontal bone and stagnation of cerebrospinal fluid around the fracture. Elevation of the depression was therefore made through a small incision along the rear edge of the frontal bone using a periosteal elevator. A review of intrauterine depressed skull fracture is made and the concept, mechanism, surgical indications and operative methods of this rare fracture are discussed. PMID- 2702348 TI - Candida albicans shunt infection. AB - Seven cases of successfully treated Candida albicans cerebrospinal fluid shunt infections are reported. Treatment consisted of shunt removal and intravenous Amphotericin B in all cases and intraventricular Amphotericin B in 4 cases. Serious underlying medical illness, recent antibiotic therapy, indwelling intravascular and/or Foley catheters, coincident candidiasis and low birth weight prematurity are major risk factors for candida shunt infection. Candida shunt infection appears to occur by either contamination at the time of shunt placement or by hematogenous dissemination. PMID- 2702349 TI - Delayed cerebrospinal-fluid shunt infection in children. AB - Twelve patients with shunt infection occurring more than 6 months following shunt implantation or revision were identified and their charts reviewed. These cases were accumulated over a 9-year period, and delays from shunt surgery to detection were as long as 11 years. For 5 patients, no antecedent infection or surgery could be identified as a presumptive cause of the shunt infection. Propionibacterium species and Staphylococcus epidermidis species were the most common organisms identified. The risk of late onset of infection at this institution is less than 1% per year. PMID- 2702350 TI - Intracranial lymphoblastic sarcoma mimicking a primary brain tumor. AB - A lymphoblastic sarcoma mimicked a medulloblastoma in a 15-year old girl with a history of acute lymphoblastic leukemia diagnosed at age of 2 years. There was no evidence of leukemic infiltration in the brain during the 13-year latency period after the original diagnosis. She had received both prophylactic intrathecal methotrexate and central nervous system irradiation. This case emphasizes the need to consider leukemia as the cause of a 'brain tumor' in any patient that has a prior history of leukemia, regardless of the tumor manifestations or the remission duration of the leukemia. PMID- 2702351 TI - 2nd annual International Symposium on Pediatric Neuro-Oncology. Philadelphia, Pa, May 24-26, 1990. Abstracts. PMID- 2702352 TI - [The role of cellular immunity in the pathogenesis of glomerulonephritis]. AB - In this article, experimental data and clinical observations suggesting the role of cell-mediated immunity in pathogenesis of primary glomerulonephritis have been presented. Serum anti-GBM antibodies have been observed in glomerulopathies mediated by anti-glomerular basement membrane antibodies with the presence of immunoglobulins in glomeruli and in their eluates. The lymphocytes from patients with glomerular disease show cell-mediated immune reactivity against GBM antigens. Cell-mediated immune mechanisms with involvement of mononuclear cells and polymorphonuclear leukocytes may participate in the pathogenesis of various forms of glomerulonephritis and contribute to prompt deterioration of renal function. PMID- 2702353 TI - [Alpha 1-antitrypsin polymorphism]. AB - Discovery, nomenclature and some genetical and molecular aspect of alpha 1 antitrypsin polymorphism are discussed. Particular attention has been paid to the deficiency variants and their role in human pathology. PMID- 2702354 TI - [Fast-acting plasminogen activator inhibitor in the plasma]. AB - This study contains a survey of papers published in the last few years on the specific inhibitor of plasminogen activation (PA-inhibitor, or antiactivator) discovered in plasma in 1983. Molecular weight of the PA-inhibitor is ranging from 40,000 to 50,000; the antiactivator is present in very small concentration in plasma. Most probably it originates from the endothelial cells. The antiactivator inhibits both tissue plasminogen activator and urokinase, forming complexes in molar ratio 1:1 with them. Possibly, it is the main plasmic inhibitor of plasminogen activators. Its increased content in plasma of patients with tendency to develop thromboembolic disease points to a relationship between lowered fibrinolytic activity and increased concentration of the PA-inhibitor in blood. PMID- 2702355 TI - [Etiopathogenesis of Hodgkin's disease in the light of current studies]. AB - Several problems concerning the etiology and pathogenesis of malignant granulomatosis have been presented with particular attention paid to immune disturbances in the course of this disease. Some modern theories of the origin of Reed-Sternberg neoplastic cells have been also discussed. PMID- 2702356 TI - [Progress in biology and therapy of acute lymphoblastic leukemia]. AB - In the paper recent advances in the etiology and pathogenesis of acute lymphoblastic leukaemia are reviewed. Role of enzymes and cytogenetic abnormalities, oncogenes and gene rearrangements in the biology of this leukaemia is presented. Progress in chemotherapy, immunotherapy and bone marrow transplantation is also discussed. PMID- 2702357 TI - [Proteoglycans: their structure and function in the connective tissue]. PMID- 2702358 TI - Myelosarcomatosis of the skin preceding leukemic generalization of acute myelomonocytic leukemia. AB - A case report of a patient with myelosarcomatosis of the skin six months preceding leukemic generalization of acute myelomonocytic leukemia is presented. To the best of our knowledge this is the first case of a myelosarcoma with generalized skin involvement diagnosed before development of an overt myeloproliferative disease. PMID- 2702359 TI - Results of argon laser treatment of port-wine stains: a method of assessment. AB - In this review of over 100 cases of argon laser treated port-wine stains, four parameters, including lesion colour, skin texture, make-up habits and scarring, are assessed and changes allocated appropriate numbers. The sum of these numbers is used to classify results as Excellent, Good, Fair or Poor, and these were found to correlate well with the level of patient satisfaction. PMID- 2702360 TI - The lower posterolateral thigh flap. AB - The vascular basis of a new distally based flap in the distal third of the posterolateral thigh has been studied in 30 cadaver limbs. This flap is supplied mainly by direct cutaneous branches of the popliteal artery and of the lateral superior genicular artery. Its use as a distally based fasciocutaneous flap for defects of the knee is illustrated and its potential as a free flap is discussed. A classification of various flaps from the posterolateral region of the thigh is also proposed. In the light of the anatomical studies, the cutaneous blood supply of the distal posterolateral region and other regions of the thigh is reviewed. PMID- 2702361 TI - Popliteo-posterior thigh fasciocutaneous island flap for closure around the knee. AB - A popliteo-posterior thigh fasciocutaneous island flap to repair skin defects around the knee is presented and discussed. Included is a description of the procedure, a comparison with alternative procedures, and an evaluation of the advantages of the new method. PMID- 2702362 TI - Microvascular surgery as an adjunct to craniomaxillofacial reconstruction. AB - Fifteen patients (8 female and 7 male) age 4 to 57 years underwent microsurgical free tissue transfers as a component of a craniomaxillofacial reconstruction. In 12 patients the free flap was performed simultaneously with the bony procedure and in three it was a secondary procedure. The patients included two craniosynostosis, four craniofacial tumours, five hemicraniofacial microsomias, one facial and skull base arteriovenous malformation, one orbitofacial neurofibromatosis and two hemifacial atrophies with extensive facial skeletal involvement. The rectus abdominis free flap was used in 9 patients, the latissimus dorsi in two, the omentum in three, and the first web-space in one. The choice of tissue varied according to the size of the defect and its location. The rectus abdominis musculofasciocutaneous flap was the most frequent source of tissue for contour restoration, and the omentum was used to fill intracranial spaces. One flap failed intraoperatively in a patient with hemifacial microsomia and inadequate and abnormal recipient vessels. One patient had an injury to the temporal branch of the facial nerve, with spontaneous recovery. In 13 patients the free tissue transfer was for soft tissue fill with cover of facial bone or skull base; secondary procedures were frequently required in these patients. In two patients with intracranial free flaps, no further procedures were necessary. In selected cases the association of microvascular techniques with craniomaxillofacial surgery can facilitate reconstruction and improve results. PMID- 2702363 TI - A composite flap for early treatment of hemifacial microsomia. AB - A composite flap based on the thoracodorsal pedicle is described for use in the early surgical treatment of children with hemifacial microsomia, having absence or gross hypoplasia of the upper vertical ramus of the mandible and associated soft tissue hypoplasia in the cheek. The flap offers some fascinating possibilities in restoration of function and growth which have yet to be explored. PMID- 2702364 TI - The trapezoid release for scar contractures: early experience. AB - A description is given of the technique of trapezoid release of scar contractures. Some clinical applications are presented and the results in 18 patients with a total of 37 flaps and maximum follow-up of 6 years are reported. A brief discussion of this method's advantages over existing techniques is presented. PMID- 2702365 TI - Pterygium colli: surgical treatment. AB - The authors report three cases of pterygium colli. Two of them presented as part of Turner's syndrome and were treated following a personal technique. The third, which was probably due to jugular lymphatic obstruction, was treated according to the butterfly excision technique of Shearin. PMID- 2702366 TI - A policy in the management of urethral fistula. AB - Our experience with repair of urethral fistula in 33 patients over a 5-year period is reviewed. The ages ranged from 2 to 12 years with an average of 8 years. Meatal advancement and glanuloplasty (MAGPI) were performed in five patients; there was no recurrence. A layered repair was used in 26 patients; of these, 12 recurred. Twelve patients needed a second operation and, of these, one had urethral dilatation with spontaneous cure of the fistula and the remaining 11 had a layered repair with a recurrence in five. Five patients had a third repair with further recurrence in three. Suprapubic urinary division was used in 13 cases with a failure rate of 77% (10 cases), while transurethral drainage was used in 31 cases with a failure rate of 35% (11 cases). Three of the cases with a MAGPI procedure had no urinary division. It is concluded that the MAGPI principle should be used in the repair of coronal and some subcoronal urethral fistulae as it carries a good healing rate with a short hospital stay. Transurethral bladder drainage should be used more frequently. PMID- 2702367 TI - A comparison of the speech results after early and delayed hard palate closure; a preliminary report. AB - An "early surgery" and a "delayed surgery" group of cleft palate cases' speech has been recorded and judged in two ways. Initially four different listener groups gave their "impressions" of the speech samples followed by the two speech therapist groups assessing specific aspects of speech. For analytical purposes the delayed surgery group was divided into "repaired" and "unrepaired" hard palate groups. The general conclusion was that delaying hard palate surgery may be responsible for the persistence of noticeable abnormal speech patterns until after hard palate repair. However, despite their higher frequency in the "delayed unrepaired" group, errors of tongue placement and airstream direction were common to all groups. The relative influence of maturation, surgery and speech therapy on speech progress has not been considered. It is suggested that a final review of oro-facial growth and speech as each subject reaches 17 years old would give more definitive results. Then the subjects might discuss the relative importance of facial appearance and speech results. PMID- 2702368 TI - Cephalic venous flap: a series of 8 cases and a preliminary report on the use of 99mTc labelled RBCs to study the saphenous venous flap in dogs. AB - From December 1985 to December 1987 a total of eight fasciocutaneous island flaps with only a proximal venous pedicle were performed. Seven of these eight survived completely. The standard flap design and operative technique are given. The results are presented in a tabulated form. One case is presented with illustrations. A preliminary report on the appearance of 99mTc tagged RBCs and Evans blue in a proximal venous saphenous island flap in the dog is included. Comments on the survival of these flaps and the solitary case where the flap necrosed completely are added. PMID- 2702369 TI - Morphological and morphometric changes in revascularised bowel grafts reconstructing the cervical oesophagus. AB - Revascularised grafts of jejunum and colon have been used to reconstruct the cervical oesophagus in dogs. The grafts were examined at 2 months to assess their morphological and morphometric behaviour in their new position in the oesophagus. The colonic grafts appeared to adapt completely, while the jejunal ones manifest persisting mucosal changes attributable to their new environment. PMID- 2702370 TI - Experimental implantation of adipose tissue fragments. AB - The healing of small adipose tissue implants was evaluated in experimental studies on rats. Adipose tissue of approximately 0.5 ml volume was obtained by resection of parauterine fat pads. The tissue was divided into fragments that were 1-3 mm in size and implanted under the dorsal skin. The implantation of adipose tissue in fragments offered no biological advantage and the healing process terminated in extensive necrosis of fat cells. The results are analysed and considered in relation to the implantation of adipose tissue fragments obtained by liposuction. PMID- 2702371 TI - Immediate return of nerve function following microsurgical repair. AB - The conduction of motor nerve impulses across the suture line of microsurgically repaired peripheral nerves has previously been demonstrated. The present study was undertaken to test the hypothesis that such conducted impulses would produce physiological responses in the limb distally. Studies of nerve conduction, muscle motor unit activity and paw tremor were carried out before and after division and repair of the sciatic nerves of nine New Zealand white rabbits. The results indicated that immediately after nerve repair stimulation of the proximal nerve can result in physiological neuromuscular responses distally. PMID- 2702372 TI - An experimental model for ear reconstruction with moulded perichondrial flaps: a preliminary report. AB - Attempts to create a pinna by moulding cartilage fragments have been reported previously by Peer. The regenerative capabilities of perichondrium are well known. Combining these concepts, we succeeded in creating a cartilage pinna by implanting perichondrial flaps between the leaves of a methylmethacrylate mould. Ten rabbits were divided into two groups, the first using vascularised perichondrial flaps and the other using free perichondrium into which an arterial and venous pedicle was implanted. Both of these preparations were placed in the moulds in a subcutaneous pocket. Six weeks later, these constructions were harvested and histological examination conducted. Active cartilage growth was noted in both groups. The construction was completed by coverage with a split thickness skin graft. Clinically, this new procedure may provide a means of pinna reconstruction with a thin flexible cartilage framework, with excellent relief. PMID- 2702373 TI - An interesting case of aglossia-adactyly syndrome. AB - A case of aglossia-adactyly syndrome with a sagittal band between the floor of the mouth and the palate is reported. The literature concerning this case is briefly reviewed. This case is being presented for its extreme rarity. PMID- 2702374 TI - Wide excision of perineal Hailey-Hailey disease with healing by secondary intention. AB - In this paper we advocate secondary healing for closure of large perineal wounds following full thickness skin excision for the treatment of Hailey-Hailey disease. PMID- 2702375 TI - An indigenous, inexpensive operating microscope. AB - A method of assembling an inexpensive operating microscope from resources indigenous to a developing country is described. PMID- 2702376 TI - Audit and action. PMID- 2702377 TI - A new high-definition microfocal X-ray unit. AB - A new microfocal unit is described with an operating range up to 170 kVp (limited to 125 kVp for medical use), 0-1 mA and a maximum output of 75-80 W. The unit comprises a lanthanum hexaboride (LaB6) cathode, a single electromagnetic lens and a stationary oil-cooled multifaced tungsten target. The estimated source size ranges from 6 to 20 microns between 14 and 77 W. The tube's output is x 3 to x 3.5 greater than that of a conventional X-ray unit. The use of fast rare-earth film-screen systems permits exposures of most views of the patient within 1 s. The spatial resolution within these film-screen systems is 40-30 microns diameter at magnifications of x 5-10. The tube is fixed so as to project a horizontal beam and the patient table is designed to position the patient close to the source (20 30 cm) with the film placed at a focus-film distance of 1-3 m. Stereopair macroradiographs permit greater accuracy in the identification and location of radiographic features. The large magnification and resolution of macroradiographs allow direct and accurate measurement of radiographic features. PMID- 2702378 TI - Paediatric brachytherapy. I. The role of brachytherapy in the multidisciplinary therapy of localized cancers. AB - Paediatric brachytherapy is rarely practised but has definite benefit in certain situations. Case reports illustrate the role of current brachytherapy strategies both as radical and salvage procedures and in the multidisciplinary management of childhood cancers. PMID- 2702379 TI - Radiation dose to neonates on a Special Care Baby Unit. AB - Neonates on a Special Care Baby Unit often require radiography to monitor the progress of their treatment and as a result can have a large number of radiographs taken during their stay in hospital. The skin entrance dose was estimated from a knowledge of the technique factors, X-ray tube output and backscatter factors. Normalized organ dose data were employed to estimate the radiation dose to a number of critical organs. A number of methods of reducing the radiation dose to neonates were investigated. Initially, this involved changing the radiographic technique factors and introducing a lead rubber adjustable collimator, placed on top of the incubator, in addition to the light beam diaphragms on the X-ray tube. It was deduced from the results of calculations that these modifications to the radiographic examination technique had reduced the average entrance dose per radiograph from 92 mu Gy to 58 mu Gy, a reduction of 37%. Later, a rare-earth film-screen combination was introduced to replace the existing fast calcium tungstate screens. This enabled the average entrance dose per radiograph to be reduced to 39 mu Gy, a further reduction of 33%. The mean radiation dose to a neonate is mainly determined by the number of radiographs taken and this is dependent on the clinical symptoms. PMID- 2702380 TI - A comparison of two different T-grain films in rare-earth screens with a standard film-screen combination for intravenous pyelography and bone examinations. AB - T-grain film is claimed to give significantly improved image quality, allowing the use of faster screens without loss of quality and thus reducing radiation dose. We tested this claim for two systems. In each case comparison was made with our usual screen-film combination, Agfa Curix RP1 film with Kodak Xomatic Regular screens (a nominally 200 speed system). The systems tested were Kodak TMatG in Kodak Lanex Medium screens (300 speed) and Agfa STG in Kodak Lanex Regular screens (400 speed). The Agfa STG-Lanex Regular system performed less well than the standard system for intravenous pyelograms (IVPs), bones and soft-tissue detail. Its speed advantage was not apparent below 70 kV. The Kodak TMatG-Lanex Medium system was better than the standard system for IVPs but not as good for bones. It gave virtually no speed advantage below 90 kV. Kodak T-grain film in a medium-speed, rare-earth screen was found to be better than the standard system for IVPs. Agfa T-grain film in a fast rare-earth screen was unsatisfactory for IVPs. Neither combination was as good as the standard system for bones. PMID- 2702381 TI - Radiobiological assessment of permanent implants using tumour repopulation factors in the linear-quadratic model. AB - By combining existing linear-quadratic equations relating to decaying-source therapy with an assumed tumour repopulation factor, it has been possible to devise a method for the radiobiological assessment of permanent implants. For calculation purposes there is a time after which an implant can no longer be considered effective in sterilizing tumour cells. This "effective" treatment time for a permanent implant can be approximately defined in terms of the radionuclide decay constant, the potential doubling time, the initial dose-rate and the value of alpha in the tumour alpha/beta ratio. The analytical technique has been applied to a specific intercomparison of commonly encountered implants using 125I and 198Au, and suggests that, even in the most favourable cases, the former radionuclide offers few radiobiological advantages. Although not specifically discussed here, the method can also be applied to the assessment of various forms of biologically targeted radiotherapy. PMID- 2702382 TI - Contribution of computed tomography in the aetiology and prognosis of cerebral palsy in children. AB - Retrospective analysis of computed tomographic (CT) examinations in 76 children with cerebral palsy without any severe intellectual handicap has revealed abnormalities in 63% of these children; abnormalities were present in 88% of former pre-term infants. This study highlights the significant pathogenic role of periventricular leucomalacia in cerebral palsy, since in 45% of the cases of this series this diagnosis had been reached as a result of a characteristic CT appearance associated with a history of premature birth and very specific clinical deficits. The CT abnormalities, mostly posterior and generally bilateral and symmetrical, affect the contours of the lateral ventricles, which become straight and angular, and often involve ventriculomegaly (85%). Localized juxtaventricular hypodensities were only found in a few cases (6%). The cognitive and intellectual sequelae in these children were more severe than in those children whose CT examination was normal, and were also more pronounced when the longitudinal fissure of the cerebrum was enlarged. PMID- 2702383 TI - Radiological appearances of colonic ring staple anastomoses. AB - The radiographic appearances of colonic staple ring anastomoses are presented. Staple ring disruption on plain abdominal radiographs in the early post-operative period suggests dehiscence of the bowel anastomosis and is an indication for urgent water-soluble contrast medium enema to confirm the diagnosis. Rectal stenosis can develop as a late complication of staple anastomosis and may be detected on barium enema. PMID- 2702384 TI - Value of bone scanning and computed tomography in fibrodysplasia ossificans progressiva. PMID- 2702385 TI - Giant central disc prolapse: a pitfall in computed tomographic diagnosis. PMID- 2702386 TI - Submarine escape training, lung cysts and tension pneumothorax. PMID- 2702387 TI - Effects of inhibition of intercellular communication on repair of damage induced by ionizing radiation. PMID- 2702388 TI - Precipitation of radiation injury in kidney epithelium reveals a low fractionation sensitivity (alpha/beta = 12.5 Gy). PMID- 2702389 TI - Autoradiographic imaging of pion stopping distribution utilizing scanning laser stimulated luminescence. PMID- 2702390 TI - Primary orbital lymphoma: staging by computed tomographic scanning. PMID- 2702391 TI - Demonstration of vertebral body end plate veins by magnetic resonance imaging. PMID- 2702392 TI - New developments in the field of acute myocardial infarction imaging. PMID- 2702393 TI - Incorporating the time factor into the linear-quadratic model. PMID- 2702394 TI - Intrarenal duplication. AB - We report the anomaly of intrarenal duplication seen during the course of investigation of urinary tract infection in 6 children. The anomaly and its embryological basis are described. PMID- 2702395 TI - Unexplained spontaneous regression and alpha-interferon as treatment for metastatic renal carcinoma. AB - A series of 73 patients with measurable metastatic disease referred to a tertiary referral centre for consideration for an experimental treatment protocol were entered into a surveillance protocol in order to establish the incidence of spontaneous regression. Initially, patients were taken off the study if metastases showed greater than 25% increase in products of bidimensional measurement but with increasing confidence patients went into therapy protocols only following the development of symptomatic progression. We observed 3 complete and 2 partial unexplained spontaneous regressions and a further 4 patients had prolonged stable disease for more than 12 months. A group of 21 patients on progression subsequently received treatment with alpha-interferon (Wellferon) as part of a multicentre study which included an additional 61 cases; 12 responded (3 surveillance relapse patients and 9 others). Patients with lung metastases only had the highest response rate (10/17 compared with 5 unexplained responses seen in 38 such patients on surveillance). These results confirm that alpha interferon is active against metastatic renal carcinoma and that the responses are not totally explicable by spontaneous regression. PMID- 2702396 TI - Leiomyosarcoma of the kidney. Immunohistological and ultrastructural findings with special emphasis on the growth fraction. AB - This report deals with a case of renal smooth muscle tumour. Considering the low mitotic rate, this neoplasm would have been classified as leiomyoma. However, it displayed a relatively large growth fraction by immunostaining with the monoclonal antibody Ki-67. This led us to the diagnosis "leiomyosarcoma", which is in line with the unfavourable clinical course. We suggest that assessment of the growth fraction with Ki-67 seems to be more objective than the conventional criteria for determining the malignant potential of smooth muscle tumours. PMID- 2702397 TI - Transitional cell carcinoma of the renal pelvis and ureter. AB - In a retrospective study of 185 patients with transitional cell carcinoma of the renal pelvis and ureter, of whom 127 were treated by total nephroureterectomy and 58 by conservative resection, the survival of those with superficial well differentiated tumours was greater than 90% in each group. When urothelium was left behind after conservative resection, there was a 22% rate of recurrence on the same side but this almost only occurred when the original tumour had been multifocal. Post-operative radiotherapy did not improve survival. PMID- 2702398 TI - Pelviureteric obstruction in children treated by retrograde ureteroplasty. AB - Pelviureteric obstruction was treated by dilatation with a Fogarty balloon catheter in 2 children. The catheter was introduced through the cystoscope without any percutaneous procedure, ureteric stents or drainage. Follow-up for 18 months indicated improved drainage and renal function. The merits and demerits of this technique are discussed. PMID- 2702399 TI - Radionuclide imaging of ureteric peristalsis. AB - Dynamic renal scintigraphy is a successful and minimally invasive technique for evaluating renal function. An extension to the basic technique involving fast frame acquisition and a modified analysis is described which enables ureteric function to be examined. Ureteric peristalsis was assessed in 32 patients using this technique. The results from 5 representative studies are described in detail. Normally functioning ureters exhibit peristaltic contractions at a frequency of up to 3/min. Hyperperistalsis that exceeds 4 contractions/min is associated with obstruction. Peristaltic behaviour in 9 patients examined before and after ESWL was not altered. PMID- 2702400 TI - The accuracy of measurement of residual urine in women by urethral catheterisation. AB - Two potential sources of error in the measurement of residual urine volumes in women were quantified. These were (i) whether a diuresis is operating at the time of measurement, and (ii) the time between voiding and residual urine volume collection. A regime is suggested for the accurate measurement of residual urine in women by urethral catheterisation. PMID- 2702401 TI - Are urodynamics necessary in female patients presenting with stress incontinence? AB - A urological and urodynamic database was used in a prospective study of female patients whose initial symptom was stress incontinence alone. The urodynamic diagnoses in 89 such patients were analysed against any additional symptoms. Fifty-four patients complained of stress incontinence without other symptoms and none of these had detrusor instability. One patient from a group of 25 who had frequency with stress incontinence had low bladder compliance but the others had normal urodynamic studies. Of the 10 patients with urgency in addition to stress incontinence, 5 had unstable bladders. A detailed urological history must be taken in all patients who are assessed for stress incontinence. Urodynamics are unnecessary in patients with stress incontinence alone but should be considered in those with additional urgency. PMID- 2702402 TI - Modified Stamey procedure for bladder neck suspension. AB - A review of 76 patients who underwent endoscopic bladder neck suspension (EBNS) for stress incontinence is presented. Pre-operative video-urodynamic studies in 71 patients demonstrated stable stress incontinence in 61 (86%). There was a history of previous pelvic surgery in 52 patients (68%). Surgery was performed by trainee urologists in 35 cases (46%). The overall complication rate was 46%, of which 17% were per-operative and did not influence the outcome of surgery. Infection occurred in 16% and necessitated removal of the suture buffers in 9%. Follow-up ranged from 7 to 30 months (mean 18.3). Complete resolution of stress incontinence or a marked improvement in symptoms was seen in 86% of cases. Patients with no history of previous pelvic surgery were all either cured or improved by the procedure. Of the 52 patients who had undergone previous pelvic surgery, 42 (80%) were either cured or improved. All of the 10 failures were in this group. There was no difference between complication or success rates achieved by consultants or urologists in training. It was concluded that EBNS is the treatment of choice in patients with primary stress incontinence and it is an effective procedure in patients who have undergone previous unsuccessful surgery for stress incontinence. PMID- 2702403 TI - Stamey needle suspension for stress urinary incontinence. A prospective study of 40 patients. AB - A series of 40 consecutive patients with proven stress urinary incontinence underwent Stamey endoscopic bladder neck suspension. There were 5 cases of detrusor instability and the results were poor in this group. Excluding these patients, 77% were cured and 12% reported significant improvement. There were 4 unpredictable failures; all but 1 occurred within 3 months of surgery and the fourth before 6 months. There were no late failures up to the mean follow-up period of 21 months (range 9-33 months; 35 cases greater than 12 months); 3 of the failures had the same procedure repeated but it was again unsuccessful. The Stamey procedure is quick, entails minimum high dependency nursing and has a short hospital stay (mean 7 days). As assessed in the medium term, it represents a useful addition to the surgical procedures available for the relief of stress urinary incontinence. PMID- 2702404 TI - Metabolic complications of cystoplasty. AB - A series of 48 patients with intestinal segments incorporated into the urinary tract underwent assessment of acid-base and electrolyte balance. All patients had abnormal blood gas analyses, usually a metabolic acidosis with respiratory compensation; 33% had hyperchloraemia. Radioisotope studies using sodium, potassium and bromine showed that all were absorbed and that absorption was unaffected by renal function. The results suggest that all such patients, but particularly women and children, may be at risk of the secondary effects of chronic acidosis, especially skeletal demineralisation, unless some compensatory mechanism is working to offset the effects of the acidosis. PMID- 2702405 TI - Blood group antigen expression in frozen sections of presenting bladder cancer: 3 year prospective follow-up of prognostic value. AB - Blood group antigen (BGA) expression was studied on frozen sections from the initial, presenting, transitional cell bladder cancers of 73 patients. Clinical follow-up was prospective and, after 3 years, 59 patients were available for assessment. Of 32 tumours that retained substantial BGA (BGA+ and BGA +/- ), 11 progressed. Of 27 tumours with less than 5% or undetectable BGA expression (BGA ), 14 did not progress. Of 24 pTa tumours, 17 had substantial BGA expression and 7 were BGA-; 5 patients progressed, 4 substantially BGA positive and 1 BGA-, all to category pT1; 15 tumours were category pT1, 7 substantially BGA positive and 8 BGA-; 7 patients progressed, 1 substantially BGA positive and 6 BGA-, all of whom died from bladder cancer; 20 were pT2 or deeper, 8 substantially BGA positive and 12 BGA-; 12 patients progressed, 6 substantially BGA positive and 6 BGA-, all of whom died from bladder cancer. Despite improved understanding of the biochemistry and techniques of detection of BGA, these results preclude the use of BGA determination as a guide to prognosis in individual transitional cell carcinoma, whether used alone or in combination with pT category. PMID- 2702406 TI - Retrospective study of radiotherapy in early carcinoma of the prostate. AB - During the years 1978 to 1983 there was a 10-fold increase in the number of patients with T1-T4 NX M0 carcinoma of the prostate referred to the Christie Hospital for radical radiotherapy. A retrospective survey of 170 patients treated during this period showed an overall age-corrected 5-year survival rate of 49%. The survival of patients in whom referral for radiotherapy had been delayed was 37% compared with 56% for those given immediate treatment. Patients with poorly differentiated tumours had a significantly reduced survival compared with those with well differentiated tumours. The overall complication rate from radiotherapy was 4% and this low rate is attributed to the small volume used uniformly for treatment. PMID- 2702407 TI - Balanitis. AB - The clinical features of 100 cases of balanitis are described. The condition affects no more than 4% of boys, is commonest during pre-school years (but rare prior to toilet training) and is usually associated with a prepuce which is partly or completely non-retractable. It does not cause phimosis and no single pathogen is involved. Most boys suffer a single episode and circumcision is indicated only for those with recurrent, troublesome attacks. PMID- 2702408 TI - Retrograde ejaculation: successful treatment with artificial insemination. AB - Between 1977 and 1987, 14 couples in whom the male partner had retrograde ejaculation were treated with artificial insemination using the husband's sperm (AIH). There were 6 pregnancies in 4 couples, giving a cumulative probability of pregnancy at 12 months of 72%. The success rate depended on a number of factors, including semen quality, methods of sperm extraction from the urine, timing of ovulation and other complicating fertility factors. PMID- 2702409 TI - Proteinuria--what value is the dipstick? AB - The value of the urinary dipstick in the assessment of proteinuria was investigated in a study correlating laboratory measurements of protein and albumin against the dipstick protein in the same samples of urine; 94 patients (100 admissions) were studied at the Royal Air Force Renal Unit, each patient collecting two 24-h urine samples. Along with each 24-h sample, 10-ml aliquots of urine were obtained at 3 designated times during the day for both ward dipstick testing and laboratory assay; + or more on the dipstick correlated with abnormal proteinuria (greater than or equal to 150 mg/24 h) in 88% of cases, whilst trace values straddled the level of significant proteinuria. Further differentiation of trace was possible by repeat testing during the day. The subsequent presence of a dipstick negative during that day correlated with normality in all but 5% of cases. In order to ensure detection of renal disease presenting as isolated orthostatic proteinuria, assay of the mid-morning sample is recommended. PMID- 2702410 TI - Which urine sample for detection of proteinuria? AB - The standard practice of screening for proteinuria in the concentrated early morning urine was examined. Protein concentration and dipstick readings were determined in early morning and daytime urines of 56 normal subjects and 110 patients with proteinuria attending a renal clinic. In normal subjects the protein concentration was similar in both urine samples and dipsticks gave the same frequency of false positive results, usually only trace positive. The protein concentration was higher in the daytime urine in 76% of patients. Dipstick readings were similar in 64.5% but higher in the daytime urine in 31% and in the early morning urine in only 4.5%. It is recommended that daytime urine should be screened for proteinuria in patients presenting in out-patient clinics. PMID- 2702411 TI - Scrotal carcinoma following prolonged use of crude coal tar ointment. PMID- 2702412 TI - Retrovesical echinococcal cyst. PMID- 2702413 TI - Autoimmune thrombocytopenia in renal carcinoma. PMID- 2702415 TI - Bilateral testicular atrophy following blunt trauma. PMID- 2702414 TI - Testicular and epididymal histology in a fetus with Klinefelter's syndrome at 22 weeks' gestation. PMID- 2702416 TI - Autotransplantation of the vermiform appendix following ureteroscopic damage to the right ureter. PMID- 2702417 TI - Duplication of the upper and lower urinary tract. PMID- 2702418 TI - Haematuria due to mucocele of the appendix. PMID- 2702419 TI - Elevation of the vagina during colposuspension: the use of a Deaver retractor. PMID- 2702421 TI - Ureterolithotripsy: report of 1000 cases. AB - A series of 1000 patients with calculi of the ureter at various levels were treated by ureteroscopy and lithotripsy over a period of 27 months. The overall success rate was 88.8%. Stones in the upper third of the ureter were removed in 15 of 39 patients. Calculi in the middle third were successfully removed in 52 of 102 patients. A success rate of 95.5% was achieved for calculi of the lower ureter. Per-operative complications included 10 ureteric perforations, 4 of which were treated surgically and 6 conservatively. Urography, performed in 520 patients 3 months post-operatively, showed 12 ureteric strictures; 9 of these were treated by insertion of a self-retaining pig-tail catheter and 3 required an operation. Ureterolithotripsy appears to be the method of choice in the management of ureteric calculi. PMID- 2702420 TI - Anterior transperitoneal approach to the upper urinary tract with one-stage bilateral procedure. AB - A total of 109 unilateral and 4 bilateral upper urinary tract conditions were treated surgically from 1975 to 1985 by the anterior transverse transperitoneal approach; 26 of these were malignant conditions and 87 were benign. The approach gives good access to the kidney, its pedicle and the upper ureter. There is no increased risk of peritonitis or paralytic ileus due to urinary leak. One-stage bilateral surgical procedures were performed in 4 cases. There was no added risk to the patients. It allows both kidneys to recover simultaneously and provides the opportunity of examining the other intra-abdominal organs. PMID- 2702422 TI - Physical growth velocity during conservative treatment and following subsequent surgical treatment for primary vesicoureteric reflux. AB - Physical growth was studied in 6 males and 16 females during 1 year of antimicrobial prophylaxis and during the 2 years following subsequent surgical treatment for severe primary vesicoureteric reflux. Surgery was performed between the ages of 2 and 8 because of either repeated breakthrough infection or persistence of grade III or IV reflux. Height and weight velocities were calculated as yearly rates and then converted into interquartile ratios (IQRs). Neither the mean centile height nor weight attained varied significantly between that at entry, after 1 year of medical treatment and at 2 years after surgery. However, the mean IQR for height velocity (+/- sem) rose significantly from -0.61 (+/- 0.45) during antimicrobial prophylaxis to 0.54 (+/- 0.25) following surgery. Similarly, the mean IQR for weight velocity rose significantly from -0.63 (+/- 0.50) during medical treatment to 0.47 (+/- 0.24) following surgery. These results suggest that surgical treatment is preferable to continued medical treatment in patients with severe primary vesicoureteric reflux who fail to respond to a trial of antimicrobial prophylaxis. PMID- 2702424 TI - Scanning electron microscopic findings in interstitial cystitis. AB - Scanning electron microscopy (SEM) was performed on transurethral resection biopsies from 13 patients with classic interstitial cystitis. Biopsies from 9 patients with stress incontinence served as controls. The SEM appearance of the bladder surface in interstitial cystitis varied considerably, exhibiting small round and large polygonal cells. The proportion of cells displaying round uniform and pleomorphic microvilli was high and sometimes dominated the area examined. SEM characteristics earlier assigned to bladder tumours were detected in patients with interstitial cystitis and, at a lower frequency, also in control patients. The mucin layer covering the urothelial cells seemed reduced in interstitial cystitis compared with control specimens. Surface characteristics specific for interstitial cystitis were, however, not detected by SEM. PMID- 2702423 TI - Intravesical Evans Bacille Calmette-Guerin in the treatment of carcinoma in situ. AB - We report our experience in the treatment of carcinoma in situ of the urinary bladder using Evans strain Bacille Calmette-Guerin (BCG). The mean period of follow-up was 30 months; 18 patients received intravesical therapy and 16 of these were evaluable. They received 8 weekly instillations of 60 mg Evans strain BCG in 50 ml of saline. No intradermal BCG was given. The response rate was 93.75% at 3 months; this declined to 57% at 2 years. The complications of therapy were frequent but mild. Seven patients failed to complete the course. These results were comparable to those obtained with other strains of Bacille Calmette Guerin. PMID- 2702425 TI - Development of the invaginated sleeve technique for continent cystostomies in dogs. AB - Two studies were undertaken in dogs to evaluate oblique tunnels through bladder walls lined by urothelium for use in continent cystostomies. In the first study, the tracts were lined completely by urothelium by 10 weeks, but tract calibre reduced considerably after stent removal and periluminal fibrosis was a prominent feature. In the second study a tubularised partial-thickness pedicle graft was invaginated through an oblique tunnel in the bladder wall, with the graft extending extravesically and then being wrapped in omentum. This technique provided complete urothelial covering by 2 weeks with much less periluminal fibrosis. In the 3 dogs catheterised daily up to 120 days, this technique afforded continence with generous tracts for catheterisation. PMID- 2702426 TI - Bonney's blue cystitis: a warning. AB - The instillation of diluted Bonney's blue into the bladder during gynaecological operations has been quite common practice over the last 50 years. Bonney's blue is composed of a 1:1 mixture of brilliant green and crystal violet dissolved in ethanol (90%) or industrial methylated spirit. Before insertion into the bladder this solution must be diluted with water to a 0.5% solution. Failure to do this will result in a severe inflammatory reaction within the bladder. The degree of resultant damage depends upon the duration of exposure. Persistent pain is a feature of this condition, although the other symptoms (frequency and urgency) may settle in time. Two cases of chemical cystitis resulting from the use of undiluted Bonney's blue are described to illustrate the possible consequences. Both patients were awarded 6-figure sums as compensation. PMID- 2702427 TI - The effects of cromakalim on the detrusor muscle of human and pig urinary bladder. AB - The effects of cromakalim, a potassium channel activating drug, have been studied on isolated detrusor muscle strips from normal Landrace boar, normal and unstable mini-pig and unstable human bladder. Cromakalim abolished spontaneous activity in all strips but did not abolish the ability of the detrusor muscle from any of the specimens studied to respond to carbachol, increased extracellular K+ or transmural nerve stimulation. Intravenous infusion of cromakalim in the urethral obstructed mini-pig caused the characteristic unstable contractions associated with bladder outflow obstruction to be abolished, leaving the animal able to void. Experiments with potassium isotopes and the sucrose gap technique demonstrated that cromakalim increased the potassium permeability and hyperpolarised the cell membrane, consistent with its reported actions on other smooth muscles. These results suggest that drugs such as cromakalim, which act by reducing membrane excitability without inhibiting responses to existing innervation, may have a clinical application in the treatment of instability which is secondary to bladder outflow obstruction. PMID- 2702428 TI - Is grade or stage of primary importance in determining the outcome after radical prostatectomy for disease clinically confined to the prostate? AB - A series of 145 patients with T1-2NOMO prostatic carcinoma underwent radical prostatectomy. Specimens were analysed by Gleason sum and categorised according to whether the disease was organ-confined, specimen-confined or margin-positive. The failure of treatment was indicated by elevation of acid phosphatase, by the appearance of biopsy proven local disease or distant nodal disease, or by parenchymal or nodal disease by any imaging modality. Analysis of the data demonstrated that the outcome of surgical intervention was related to the anatomical extent of disease. The Gleason sum was related to the extent of disease and predicted the probability of disease outside the organ of origin. PMID- 2702429 TI - Salivary testosterone in prostatic carcinoma. AB - Testosterone concentrations in saliva were measured in 13 patients with prostatic carcinoma after surgical or medical (diethylstilboestrol or Estracyt) orchiectomy. The salivary testosterone values in these patients were significantly lower than in normal males but not significantly different from those in normal females. The salivary testosterone concentrations were measured for 6 consecutive months and did not vary significantly from month to month. The results suggest that the measurement of salivary testosterone concentrations could be useful in evaluating the androgenic function of patients with prostatic carcinoma after medical or surgical orchiectomy. PMID- 2702430 TI - The cost of bilateral orchiectomy as a treatment for prostatic carcinoma. AB - Advanced prostatic carcinoma may be treated by a variety of methods of hormonal manipulation which affect the production of the male hormones. This can be achieved by surgical means, usually bilateral orchiectomy, or medically, by a number of drugs. One advantage of surgical over medical castration is that it is a once-only procedure. Another factor, which could be considered a major advantage, is the low cost of the surgical procedure. This report outlines the costs involved in treating prostatic carcinoma by surgical castration and compares them with the costs of some forms of medical treatment. PMID- 2702431 TI - Circannual rhythmicity in the occurrence of idiopathic priapism in north-western India. AB - A group of 26 patients who were operated upon for idiopathic priapism between 1972 and 1986 were classified according to the date on which they attended hospital. During the same 15-year period 150 patients with penile cancer were treated and they served as controls. The data were analysed for circannual rhythmicity (365.25 days = 360 degrees and 0 degrees = 22 December. This revealed a significant circannual rhythmicity in the occurrence of idiopathic priapism, with the acrophase located on 2 August. There was a significantly higher incidence of idiopathic priapism between April and September. PMID- 2702432 TI - Long-term follow-up of the MAGPI operation for distal hypospadias. AB - Following the introduction of the MAGPI procedure, this operation has become established in the management of distal hypospadias. In our unit 45 boys have been treated in this way and the long-term results have been assessed in 28. The cosmetic result of surgery and the direction of the urinary stream were satisfactory in 27 patients. In all but 2 cases there was partial ventral regression of the urinary meatus when compared with the immediate post-operative appearances. In the long term, it is our experience that the MAGPI operation does not maintain a terminal position for the external urinary meatus, but the functional and cosmetic results are satisfactory. PMID- 2702433 TI - Squamous cell carcinoma of the bladder presenting as vitiligo. PMID- 2702434 TI - Epidermoid cyst of the testis. PMID- 2702435 TI - Appendicovesical fistula presenting as urethral stricture. PMID- 2702436 TI - Chylothorax due to metastatic prostatic carcinoma. PMID- 2702437 TI - A timely cystoscopy. PMID- 2702438 TI - Disappearance of staghorn calculi following withdrawal of treatment with acetazolamide. PMID- 2702439 TI - Lymphatic cyst of the penis. PMID- 2702440 TI - Lithotripsy--a new treatment for the impacted Dormia basket. PMID- 2702441 TI - Re: Bulbocavernosus reflex latency in the investigation of diabetic impotence. PMID- 2702442 TI - Anastomotic leakage: an avoidable complication of Lewis-Tanner oesophagectomy. AB - Data were collected prospectively from 159 patients undergoing Lewis-Tanner oesophagectomy for carcinoma of the lower two-thirds of the oesophagus and analysed with regard to anastomotic leakage. The 30-day mortality rate was 3.8 per cent and none of these deaths was due to anastomotic leakage. In hospital, mortality was 7.5 per cent. Six patients (3.8 per cent) had evidence of a leak. In four patients this was from the suture line, but in the remaining two it was due to patches of gangrene in the fundus of the transposed stomach and was separate from the anastomosis. Two patients died with an unhealed leak. Anastomotic leaks were minor in three instances and healed with conservative treatment but the fourth required exploration. Gangrene of the oesophageal substitute resulted in gross leakage with mediastinitis and required exploration in both cases. An apparent predisposing cause was evident in five of the six cases with leakage and some of these might have been avoidable. Transthoracic oesophagectomy can be performed with acceptably low mortality and leak rates and may therefore be considered as the treatment of choice for most patients with oesophageal cancer. PMID- 2702443 TI - Gastroplasty for morbid obesity: technique, complications and results in 60 cases. AB - A series of 60 gastroplasty operations based on Mason's vertical banded procedure are described. Details of technique, modifications, complications and results are discussed. Operative treatment results in a reduction to within 40 per cent of ideal weight in 80 per cent of patients between 12 and 18 months after surgery. The constricting band should not be greater than 5 cm; if it is most procedures will fail after 18 months. Pouch size should be measured and made no greater than 20 ml. The importance of nutritional counselling is emphasized. The surgical treatment should form part of a multidisciplinary approach with careful selection and long-term follow-up. PMID- 2702444 TI - Cardia carcinoma considered as a distinct clinical entity. AB - From 1 January 1969 until 31 December 1985, gastric resections were performed in 937 patients with carcinoma of the stomach and 422 patients with carcinoma of the cardia. During this period, the general frequency of cardia carcinoma increased continuously from 6.6 per cent (1969-71) to 37.5 per cent (1984-85) and a corresponding decrease of carcinomas in other sites was observed. Early carcinomas (pT1) of the oesophageal margin (n = 10, 2.4 per cent) were diagnosed less often than early carcinomas in other sites (n = 177, 18.9 per cent). Whereas 51.4 per cent of all resected carcinomas of the stomach showed no lymph node metastases (pN0), only 14.1 per cent of cardia carcinomas belonged to this category. With respect to operative treatment, Lauren's classification which defines the required margin of clearance according to diffuse type (frequency in cardia carcinoma 43 per cent, in other stomach sites 51 per cent), is of great significance. We believe that extensive oesophageal resection is necessary for patients with such difficult tumours. The pattern of metastasis in cardia carcinoma is similar to that of cancer in other stomach sites, the preferred area is the regional lymph nodes on the lesser curve (83 per cent). Histological classification and metastasis pattern show that cardia carcinoma is a type of carcinoma of the stomach which must be treated according to the criteria of stomach cancer surgery. PMID- 2702445 TI - Somatostatin analogue SMS 201-995 (octreotide) as a possible solution to the dumping syndrome after gastrectomy or vagotomy. AB - The dumping syndrome, which may follow partial gastrectomy or truncal vagotomy and drainage, may be refractory to treatment. The aim of this study was to determine the effect of the somatostatin analogue, SMS 201-995 (octreotide), on dumping provoked by hypertonic glucose. Ten patients with symptoms and signs of dumping were studied. After a dumping provocation test with placebo, all patients developed severe symptoms: seven patients had early dumping, two had both early and late dumping and one had late dumping alone. With either 50 or 100 micrograms SMS 201-995, the symptoms of early dumping were much reduced in all patients, and those of late dumping were completely abolished. The packed cell volume, pulse and systolic blood pressure changes of early dumping were significantly reduced by SMS 201-995 and the fall in blood glucose in patients with late dumping was abolished. SMS 201-995 may be a useful treatment for early and late dumping. PMID- 2702446 TI - Delayed return of gastric emptying after gastroenterostomy. AB - A retrospective study of patients having gastroenterostomies was undertaken to identify predictive factors for the development of postoperative delayed return of gastric emptying (DRGE). A total of 322 consecutive patients underwent 324 gastroenterostomies; 35 experienced delayed return of gastric emptying. Regression analysis demonstrated preoperative obstruction to be the most significant factor (P less than 0.001). Vagotomy was not an independent variable. Age, sex, size of stoma, anastomotic technique, albumin and experience of the operator were not significant factors. Gastroenterostomy in the presence of 'gastric atony' was likely to produce DRGE. In all, 86 per cent of cases resolved spontaneously. Only one case of DRGE was found to have a mechanical cause. Most patients were supported by parenteral nutrition but, with a knowledge of the identified risk factors, more thought could be given to establishing a route for jejunal feeding at the time of surgery. PMID- 2702447 TI - Intussusception presenting as ileal reservoir ischaemia following restorative proctocolectomy. PMID- 2702448 TI - Isotopic studies during surgical convalescence. AB - We have performed paired isotopic studies in four patients undergoing resection of early colorectal cancer and four having removal of parathyroid adenomas. Kinetic measurements of protein and glucose metabolism were made before resection and at home 10 weeks after surgery. During convalescence there were major changes in both groups in glucose metabolism and the hormonal milieu despite no alterations in protein kinetics or metabolic rate. In particular, the rate of glucose production doubled from (mean +/- s.e.m.) 14.8 +/- 1.3 to 28.1 +/- 2.5 mumol kg-1 min-1 (P less than 0.01), the percentage of available glucose undergoing oxidation decreased from 35.5 +/- 3.9 to 21.5 +/- 2.9 per cent (P less than 0.05) and the percentage of glucose undergoing recycling to lactate increased from 20.1 +/- 10.0 to 52.9 +/- 2.3 per cent (P less than 0.05). During convalescence the basal plasma insulin concentration was significantly higher (P less than 0.05) and there was a proportionately smaller response to glucose infusion. The convalescent state was also associated with an elevation in serum cortisol from 291 +/- 54 to 496 +/- 75 nmol litre-1 (P less than 0.05). The values for resting energy expenditure were not significantly different from the predicted energy expenditure in either the preoperative or the convalescent groups. We conclude that (a) there is a marked increase in both glucose production and glucose recycling to lactate in convalescence from clean uncomplicated surgery, and this is associated with a decrease in the percentage of glucose uptake oxidised; (b) a relative hyperinsulinaemia is seen in convalescent patients and is associated with decreased responsiveness to a glucose load; (c) the plasma cortisol level is significantly elevated after 10 weeks of convalescence; and (d) convalescent patients do not have elevated rates of protein catabolism or energy expenditure. PMID- 2702449 TI - Free-flap reconstruction of heel pad after femorotibial bypass salvage graft. PMID- 2702450 TI - Treatment of a postoperative cholecystocutaneous fistula by an endoscopic stent. PMID- 2702451 TI - Reticuloendothelial failure in chronic intra-abdominal sepsis: the role of opsonic fibronectin. AB - Severe sepsis leads to depression of the reticuloendothelial (RE) system with delayed bloodstream clearance of particulate matter and bacteria. Fibronectin may be an important opsonin of the RE system and low fibronectin levels often accompany severe sepsis in man. We have investigated the effect of prolonged intra-abdominal sepsis on plasma fibronectin concentrations and RE function. Serial plasma fibronectin concentrations were determined in rabbits for 2 weeks after either the induction of sepsis (appendix abscess) (n = 6) or laparotomy only (n = 6). RE function was measured at 2 weeks by determining the clearance kinetics and organ distribution of low dose technetium tin colloid (TTC). There was an early transient depression in plasma fibronectin values followed by elevated concentrations at 48-72 h which were more marked in the sepsis group. There was a delay in the blood clearance with reduced hepatic and increased bone uptake of TTC. We conclude that depletion of opsonic fibronectin is unlikely to be an important factor contributing to the impairment of RE function associated with intra-abdominal sepsis and that RE depression in septic animals is due to intrinsic Kupffer cell dysfunction. PMID- 2702452 TI - Appendicitis complicating meconium ileus equivalent. PMID- 2702453 TI - Anergy in patients with biliary lithiasis. AB - A prospective study was carried out in 428 subjects (212 controls and 216 patients) to evaluate the delayed cell-mediated immune response preoperatively in patients with biliary lithiasis. The delayed hypersensitivity response was assessed by a Multitest and subjects were classified as immunocompetent, relatively anergic or anergic. Significant differences were found between control subjects and patients with cholelithiasis compared with those with acute cholecystitis (P less than 0.01), non-icteric choledocholithiasis (P less than 0.01) and choledocholithiasis with jaundice (P less than 0.05). There were also differences between patients with icteric and non-icteric choledocholithiasis (P less than 0.02). Seven possible causative factors for anergy were evaluated: a haemoglobin concentration of less than or equal to 12 g/l and a haematocrit of less than or equal to 35 per cent were related to the appearance of anergy and relative anergy in patients with acute cholecystitis. Bilirubin levels greater than or equal to 34 mumol/l were found in 60 per cent of patients with choledocholithiasis and relative anergy and in 80 per cent of those who were anergic (P less than 0.001). These results show a high incidence of failure of the cell-mediated immune response in patients with acute cholecystitis (71 per cent) and icteric choledocholithiasis (82 per cent). In the latter, jaundice appears to be associated with this failure. A close correlation between relatively anergic and anergic state and the development of postoperative septic complications was found. PMID- 2702454 TI - Pylorus-preserving pancreatectomy: functional results. AB - The pylorus-preserving technique is reported as improving the functional results of pancreatectomy but it is complicated in the early postoperative period by delayed recovery of gastric function in a proportion of patients. We have examined early and late gastrointestinal function in a prospective study of 16 patients having this procedure. The late results appear better than reported results for conventional Whipple resection and the delay in early recovery does not appear to have any late sequelae, provided that it does not require gastric bypass for relief. PMID- 2702455 TI - Characterization of breast cancer subgroups in an African population. AB - A detailed prospective study of 58 consecutive breast cancer patients and contemporaneous controls, using age, duration of tumour and presence or absence of poor prognostic signs as clinical parameters, clearly showed that the patients fell into three distinct groups. Group A accounted for 30 per cent of cancers and consisted of young women (21-45 years) with advanced cancers, a short history (3 months or less) and poor prognostic signs; these patients had fast-growing tumours. Group B, to which nearly 60 per cent of patients belonged, was made up of menopausal women (46-50 years) with advanced disease, a history of from 3 months to 1 year and poor prognostic signs; their tumour growth rate was intermediate. Group C made up slightly more than 10 per cent of cases and consisted of postmenopausal women (50 years and above) who gave a long history (1 year or more), and had resectable tumours without poor prognostic signs. Thus, although advanced breast cancer in tropical Africa is due to late presentation in the majority of cases, a small but significant proportion of women have advanced disease in spite of early presentation, attributable to fast tumour growth rate. PMID- 2702456 TI - Follow-up after treatment of primary breast cancer. AB - This study evaluates the usefulness of routine follow-up of breast cancer patients. In all, 416 patients who were treated with curative intent for breast cancer were followed according to a fixed follow-up schedule for a minimum of 2.5 years and a maximum of 13.5 years (mean about 5 years). During the 4533 routine out-patient visits, 4116 chest radiographs, 3889 pelvic radiographs and about 17,000 laboratory tests were carried out routinely. In the follow-up period, 148 patients were found to have distant recurrence of whom 34 (23 per cent) had asymptomatic metastases and 114 symptomatic metastases. Of the 8005 routinely performed radiographs, 24 (0.3 per cent) revealed asymptomatic metastases, and the 17,000 laboratory tests led to the discovery of six asymptomatic bone and four asymptomatic liver recurrences. Screening for metastases did not result in a reduction of the lead time to the diagnosis of asymptomatic metastases; the disease-free interval was equal in both symptomatic and asymptomatic patients. Of the 46 locoregional recurrences 42 were found by physical examination during a routine follow-up visit and 37 had not been noticed by the patient. Seventeen second primary breast cancers were diagnosed, six of which were in stage I (less than 2 cm). Mammography was not a part of the routine follow-up scheme. It is concluded that routine follow-up of breast cancer patients by history and physical examination is sufficient to detect local recurrence and a second primary tumour as well as giving the opportunity to track signs and symptoms of distant recurrence at an early stage. Performing annual or biannual mammography is advisable, but the use of other costly routine investigations in the follow-up is not justifiable, as no therapeutic advantages can be expected. PMID- 2702457 TI - Attitudes of operating theatre staff to inoculation-risk cases. AB - In a 12-month period, 177 patients at risk of infection with human immunodeficiency virus (HIV) or hepatitis B were operated on. Sixty-nine had HIV antibodies. The procedures used to identify these patients and minimize the risk of infection of hospital staff in the operating department are described. All staff working in the operating department were surveyed to determine their caseload, feelings of anxiety, and the incidence of high-risk exposure to infection. Anxiety was not related to workload, but was more common in those who had high-risk exposure. All members of staff who sustained a needlestick injury were tested for HIV antibodies at intervals after injury; 33 also volunteered to be tested in a screening session 3 months after the study period. None had HIV antibodies, suggesting that the risk of acquiring HIV infection in the operating department is low. PMID- 2702458 TI - Surgical anatomy of the human spleen. AB - Post-splenectomy sequelae are now well recognized, and conservative splenic surgery is widely advocated. However, controversies exist regarding splenic surgical anatomy. We studied 127 human spleens using anatomical dissection and a sequential injection method involving both radiology and corrosion casting, with the primary aim of examining segmental splenic anatomy and blood supply. The existence of well-defined splenic segments was confirmed and these ranged in number from 3 to 7 with a mean of 4.3. Each segment had its own arterial supply and venous drainage. The segments were separated from each other by avascular planes. Subsegments with independent blood supply were also identified. The splenic artery was found to divide into two branches; in all cases these further divided into segmental arteries supplying the central segments of the spleen. The polar segments were supplied by segmental vessels of highly variable origin and size. This study aims to highlight the importance of identifying these segmental vessels at operation when splenic conservation is considered. PMID- 2702459 TI - Intraperitoneal rupture of amoebic liver abscess. AB - A retrospective analysis of 23 cases of amoebic liver abscess with intraperitoneal rupture is presented. Group I consisted of 16 patients with clinical features of generalized peritonitis. Eight of these patients were treated surgically, and four died. Group II consisted of seven patients with features of localized peritonitis and all were treated conservatively. In all cases the diagnosis of liver abscess was established by liver scan or ultrasound examination; peritonitis was established either at operation or, in the conservatively managed group, by aspiration of pus from the peritoneal cavity. Amoebiasis was diagnosed by serology. Eight group I and all group II patients were managed conservatively by aspiration of the liver abscess, antibiotics and amoebicides. There were no deaths in this group. It is suggested that, if the diagnosis can be made early, conservative treatment offers the best chance of cure for patients of amoebic liver abscess with intraperitoneal rupture. PMID- 2702460 TI - Need for surgical wound dressing. AB - The need for dressings on clean and clean contaminated surgical wounds was investigated. A total of 1202 patients with 1202 clean or clean contaminated surgical wounds were randomized into two groups: 633 wounds were covered by dressings up until the time of suture removal, and 569 wounds were treated without dressings after the first postoperative day. In the group characterized by long dressing time, the rate of postoperative wound infections was 4.9 per cent. The rate was 4.7 per cent in the group represented by short dressing time. Using short dressing time not only reduces the number of nursing hours but also limits the need for costly dressing material. In addition, both wound observation and patients' personal hygiene are made easier. PMID- 2702461 TI - Surgical glove perforation. PMID- 2702462 TI - Pulsatile varicose veins associated with tricuspid regurgitation. PMID- 2702463 TI - Temporal parameters of low energy laser irradiation for optimal delay of post traumatic degeneration of rat optic nerve. AB - Compression injury of a central nerve results in its degeneration with irreversible loss of function due to the inability of the mammalian central nervous system (CNS) to regenerate. In contrast, the CNS of lower vertebrates has a high capacity to regenerate. Recently, low energy laser irradiation was shown to attenuate degeneration in injured CNS nerves. The optic nerves of rats were subjected to moderate crush, calibrated so that some electrophysiological activity was preserved. The nerves were then subjected to low energy laser irradiation (10.5 mW, 2 min daily) for various periods. The electrical activity of the nerves, distal to the site of injury, was determined by measuring the compound action potential at the termination of the experiment. Two weeks of irradiation begun immediately after injury and continued daily thereafter, resulted in a compound action potential which was significantly higher (mean +/- S.E.M. 1856 +/- 535 microV) than that of non-irradiated injured nerves (351 +/- 120 microV). The effect was temporary and subsided within a week. This two-week irradiation was slightly more effective than a treatment lasting one week (1406 +/- 225 microV) and was significantly more effective than 4 days of irradiation (960 +/- 133 microV). The number of treatments is therefore important. The time at which the treatment commences relative to the injury is also critical. Irradiation initiated two hours after the crush was about half as effective as immediate irradiation (810 +/- 42 microV). No apparent effect was evident when the laser was applied for the first time 5 h, or longer, after the crush.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702464 TI - Interspecific variations of cerebral endothelial cholinesterases in rodents and carnivores. AB - The cholinesterase equipment of cerebral microvessels was studied in some rodents and carnivores using the Koelle-Friedenwald histochemical method with 3 artificial substrates and specific inhibitors for butyrylcholinesterase or acetylcholinesterase. Our observations reveal a great heterogeneity in cholinesterase types and their distribution in each of the different species studied. Only in the rat, butyrylcholinesterase appears to be a marker for the microvessels provided with a blood-brain barrier. PMID- 2702465 TI - Hemicholinium-3 selectively alters the rhythmically bursting activity of septo hippocampal neurons in the rat. AB - The medial septal area contains neurons which project to the hippocampal formation. A sizeable proportion of these septo-hippocampal neurons (SHNs) are cholinergic. About 40% of them also display a characteristic discharge pattern in rhythmic bursts. We hypothesized that SHNs with a rhythmically bursting activity (RBA) are the cholinergic ones. To test this hypothesis we studied the effects of acetylcholine synthesis blockade by hemicholinium-3 (HC-3) on the properties of the SHNs. HC-3 (16, 32 or 64 micrograms total dose) or saline were injected in the lateral ventricles of adult male Sprague-Dawley rats anesthetized with urethane. Extracellular recordings from SHNs in the medial septal area were obtained within hours after HC-3 injections (n = 24 animals). SHNs were identified by their antidromic response following electrical stimulation of the fimbria-fornix. The pharmacological properties of SHNs were studied in some animals using microiontophoretic applications from multibarreled electrodes filled with various neurotransmitters. The hippocampal rhythmic slow activity (RSA or theta) was abolished even after the lowest dose of HC-3 tested (16 micrograms). No significant change in SHNs conduction velocity or spontaneous activity was observed at any dose of HC-3. The percentage of SHNs with RBA was unchanged. In contrast the mean frequency of the RBA was decreased by HC-3 in a dose-dependent fashion. The mean frequency was lowest within the first 3 h after injection. Although the mean spontaneous activity was unchanged SHNs tended to have more spikes per burst. The effects of various neurotransmitters on SHNs were qualitatively unchanged after HC-3 injection. These results suggest that acetylcholine synthesis blockade by HC-3 leads not only to the disappearance of the hippocampal RSA in urethane-anesthetized animals, but also to a decrease in the frequency of the rhythmically bursting activity of the SHNs. Since the 4-Hz hippocampal theta is atropine-sensitive, the results provide indirect evidence that the SHNs with rhythmically bursting activity are the cholinergic SHNs. PMID- 2702466 TI - Steroid hormone effects on picrotoxin-induced seizures in female and male rats. AB - Picrotoxin (1 mg/kg, i.p.), evoked a single generalized seizure in 75% of ovariectomized rats. Pretreatment of matched pairs with silastic implants containing 100% estradiol had an anticonvulsant effect; it protected all rats against such seizures. Implants containing 10% estradiol in cholesterol were less effective in protecting against picrotoxin-induced seizures. With 2 mg/kg picrotoxin, 85% of the seizure-affected ovariectomized controls had multiple seizures. The incidence of seizures and the ratio of single to multiple seizures induced by the higher dose of picrotoxin were unaffected by estradiol silastic implants, intraperitoneal injections of progesterone (0.5 mg, 4-5 h before convulsant) or the combination of both hormones. At the 2 mg/kg dose, 8/8 intact males had no seizures while all paired ovariectomized females had seizures. By contrast, the incidence of seizures in pairs of gonadectomized males and females did not differ. Testosterone treatment improved the ratio of single to multiple seizures in males but not in females. Males had statistically fewer multiple seizures than did females after testosterone treatment. The distribution of latencies to a single seizure is statistically different from the distribution of latencies to the first of multiple seizures irrespective of dose, sex and hormone treatment. This suggests that the population of rats responding with a single seizure at the higher dose of picrotoxin have a higher threshold for acquiring multiple seizures and that testosterone predisposes males but not females to this population. PMID- 2702467 TI - A role for nerve growth factor in collateral reinnervation from sensory nerves in the guinea pig. AB - We have investigated whether chronic nerve growth factor (NGF) depletion affects the development of a transmedian collateral reinnervation. The extent of transmedian innervation of the skin supplied by the left inferior alveolar nerve (IAN) was determined either immediately, 2 days or 7-9 weeks after sectioning and preventing regeneration of the contralateral IAN and in another group of animals left to recover for 7-9 weeks but also autoimmunised against NGF. Transmedian innervation was measured by recording the area from which a jaw-opening reflex could be evoked and by recording activity in the left IAN during mechanical and electrical stimulation of the skin. Nerve recording during electrical stimulation revealed extensive transmedian collateral reinnervation 7-9 weeks after denervation but this was prevented by NGF autoimmunisation. No change in transmedian innervation could be detected in any of the groups by nerve recording during mechanical stimulation and reflex responses revealed changes in the anaesthetic area which could not be attributed to collateral reinnervation. These results suggest that NGF plays an important role in collateral reinnervation from high-threshold sensory nerves. PMID- 2702468 TI - Neuropeptide Y-like immunoreactivity in neurons of the solitary tract nuclei: vesicular localization and synaptic input from GABAergic terminals. AB - The ultrastructural localization of neuropeptide Y-like immunoreactivity (NPY-LI) was examined in the medial nuclei of the solitary tracts (mNTS) of adult rat brain. Peroxidase-antiperoxidase (PAP) reaction product was localized extensively to the central lumen of large (100-150 nm), dense-core vesicles. The labeled vesicles were seen in axon terminals of untreated, control animals and in perikarya and dendrites of rats receiving intraventricular injections of colchicine 24 h prior to sacrifice. The labeled terminals were of two types. The first type contained numerous small, clear vesicles that were rimmed with peroxidase product and 1-6 large, dense-core vesicles that were labeled throughout their central lumen. The second type contained a more homogeneous population of labeled large, dense-core vesicles. Axon terminals showing NPY-LI formed either asymmetric synapses with unlabeled dendrites or were without recognized junctions. Within labeled terminals, as well as within perikarya and dendrites, the majority of the dense-core vesicles were located near non-synaptic portions of the plasmalemma that were heavily ensheathed with glial processes. Only a few unlabeled terminals penetrated the glial investments to form synaptic contacts on soma or dendrites containing NPY-LI. These synaptic contacts were of both symmetric and asymmetric types. Combined immunoperoxidase labeling for glutamic acid decarboxylase and immunogold labeling for NPY further established that at least some of the terminals forming symmetric junctions on the NPY immunoreactive dendrites were GABAergic. These results provide ultrastructural evidence that in the mNTS, NPY-LI is localized principally to large dense vesicles within neurons whose output is partially regulated by GABA. The preferential distribution of the labeled vesicles along non-synaptic, glial invested portions of the plasmalemma suggests that neuronal NPY may modulate the activity of nearby astrocytes. Additionally, the localization of NPY-LI in terminals containing a mixed population of synaptic vesicles and forming asymmetric axodendritic junctions suggests that NPY and/or coexisting transmitter may also exert certain known hypotensive effects by excitation of local intrinsic or projection neurons in this brain region. PMID- 2702469 TI - Purkinje cell axon collateral distributions reflect the chemical compartmentation of the rat cerebellar cortex. AB - Monoclonal antibody mabQ113 has been used to study the distribution of Purkinje cell axon collaterals in the rat cerebellar cortex. MabQ113 recognizes a polypeptide antigen, zebrin I, that is confined to a subset of Purkinje cells. Antigenic Purkinje cells are arranged in parasagittal compartments running throughout the cortex. No other cerebellar cells are immunoreactive. Immunoreactive axon collaterals are confined principally to the infraganglionic plexus with only a few extending into the molecular layer. Three probable target cells for the axon collaterals have been identified: Golgi cells, Lugaro cells, and other Purkinje cells. About 90% of immunoreactive axon collaterals in the anterior lobe are located beneath the mabQ113+ Purkinje cell compartment in which they originate but some do invade the neighboring mabQ113- territory. In the anterior lobe vermis, the distribution of invading mabQ113+ collaterals is not symmetrical, such that the probability of an invading collateral from the P2+ compartment is greater at the medial boundary into P1- than at the lateral into P2-. The distribution of immunoreactive collaterals is consistent with their playing a role in synchronizing the firing of Purkinje cells within the same compartment. PMID- 2702470 TI - The cholinergic neurotoxin ethylcholine mustard aziridinium (AF64A) induces an increase in MAO-B activity in the rat brain. AB - Recently it was reported that there is an increase in monoamine oxidase B (MAO-B) activity in post-mortem brains of patients with Alzheimer's disease. It was postulated that this increase in MAO-B activity was due to gliosis associated with neuronal degeneration. The aim of the present investigation was to evaluate the effect on MAO of neuronal degeneration primarily affecting the cholinergic system. The specific cholinergic toxin AF64A (3 and 4.5 nmol) was injected bilaterally into the cerebral ventricles of rats. We then estimated MAO-A, MAO-B, dopamine (DA) uptake rates and choline acetyltransferase (ChAT) activities in hippocampus, striatum and cortex, 1, 2.5 and 4.5 weeks after the injection. Marked long-lasting reduction in ChAT activities appeared only in hippocampus, consistent with previous reports. The MAO-A activity was unchanged as were DA uptake rates. Neither was there any change in MAO-B activity found 1 week after the injection. However, a significant increase in MAO-B activity appeared after 2.5 weeks and persisted after 4.5 weeks in all 3 brain regions investigated. This result is likely to reflect progressive gliosis after cholinergic neuronal degeneration. Previous results have shown an increased MAO-B activity with age and a further accelerated increase in Alzheimer's disease. Experimentally, hemitransection and injection of kainic acid have been shown to cause a similar increase. The present results show that changes in MAO-B activity also reflect degenerative processes in brain mainly affecting the cholinergic system. PMID- 2702471 TI - Sex steroids modulate motor-correlated increases in cerebellar discharge. AB - Adult female rats implanted with a microelectrode drive unit were trained to walk on a computer-controlled treadmill apparatus (10 s on every 20 s for 2 h) during recording of single Purkinje neurons in the paravermal area of the anterior cerebellum. Vigorous increases in the firing rate of individual units were found to be correlated with movement of specific limbs in particular stages of the step cycle during treadmill locomotion. Both spontaneous and motor-evoked discharge of individual Purkinje neurons were monitored before and after s.c. injection of either 17 beta estradiol (E2, 100 ng/kg) or progesterone (P, 50 micrograms). The percent increase in firing rate during locomotion versus rest was determined as a measure of the evoked:spontaneous discharge ratio. Drug-induced changes in this ratio indicate differential effects on the individual parameters, rather than simple excitatory or inhibitory effects. For all neurons tested, E2 augmented the movement-evoked discharge over pre-E2 control levels. The onset for this effect occurred at 15 min post-steroid, with a peak response noted at 30-35 min post steroid. By 60-90 min, a partial recovery of the evoked:spontaneous ratio was noted, although absolute increases in both parameters were still observed, indicating long-term effects on neuronal activity. These effects were independent of the stage of the estrous cycle. In contrast, P decreased absolute firing rates of Purkinje cells during stationary and locomotor phases. However, the evoked:spontaneous ratio was decreased to an even greater degree. The latency for this effect was 9-12 min, with recovery to control levels of response seen at 30 min post-steroid. This response was typical of cells tested on estrus and diestrus 1. Cells tested on proestrus or diestrus 2, when E2 levels are increasing, were not modulated by P using the above paradigm. PMID- 2702473 TI - Progesterone effects upon dopamine release from the corpus striatum of female rats. I. Evidence for interneuronal control. AB - In the present experiment, we examined whether progesterone modifies dopamine (DA) release from superfused corpus striatal (CS) tissue fragments of ovariectomized estrogen-primed rats as result of a direct interaction with dopaminergic nerve terminals or through interneurons within the CS. In Expt. I, an in vitro pulsatile infusion of progesterone (2 ng/ml) directly into superfusion chambers containing CS fragments resulted in a statistically significant increase in DA release (P less than 0.008). No such stimulation was obtained following a continuous progesterone infusion or during control superfusions receiving no progesterone. In an effort to examine a direct action of progesterone on DA terminals in Expt. II, tetrodotoxin (TTX, 1 microM) was added to the Superfusion medium to block the activity of interneurons within the CS. TTX completely abolished the effect of pulsatile progesterone on DA release. These results indicate that the stimulatory action of progesterone on in vitro DA release from CS fragments is apparently exerted through activation of interneurons which discriminately respond to a specific (pulsatile) mode of progesterone infusion. PMID- 2702472 TI - Acetylcholine synthesis and secretion by LA-N-2 human neuroblastoma cells. AB - We have investigated the rates of acetylcholine (ACh) synthesis and release in LA N-2 cells in order to characterize them as a potential model of cholinergic neurons. When grown in a serum-containing medium the cells extend few neurites. In the absence of serum most cells develop processes. ACh content of the cells (determined by a radioenzymatic assay) varies with extracellular choline concentration in a saturable fashion, reaching a maximum of approximately 25 nmol/mg protein. Radiolabeled choline is taken up by the cell and converted to ACh or phosphocholine, as determined by purification from cell extracts by HPLC, in a saturable manner which is described by a single rectangular hyperbola. Hemicholinium-3 (100 microM) inhibits this uptake. The cells release ACh spontaneously and this release is enhanced upon depolarization with potassium or veratridine (the latter effect is blocked by tetrodotoxin). The data demonstrate that LA-N-2 cells exhibit some properties similar to cholinergic neurons and may therefore be useful for studies of ACh synthesis and release. PMID- 2702474 TI - Down-regulation of norepinephrine sensitivity after induction of long-term neuronal plasticity (kindling) in the rat dentate gyrus. AB - Actions of norepinephrine (NE) in the dentate gyrus were examined before and after kindling-induced epilepsy, neuronal plasticity produced by daily high frequency stimulation. NE, acting on beta 1-receptors, depolarized granule cells, increased input resistance, firing and influx of Ca2+ in response to repetitive stimulation, and elicited long-lasting potentiation of synaptic potentials. In addition, NE acting via alpha 1-receptors, attenuated Ca2+-dependent regenerative potentials. After kindling-induced plasticity, there were marked reductions in all these effects of NE on granule cells, changes likely to influence kindling induced seizures, protecting against further enhancement of excitability once plasticity is in place. PMID- 2702475 TI - Effect of noxious tail pinch on the discharge rate of mesocortical and mesolimbic dopamine neurons: selective activation of the mesocortical system. AB - The effects of noxious tail pinch on the activity of mesocortical and mesolimbic dopamine (DA) neurons located in the ventromedial mesencephalic tegmentum were analyzed in ketamine-anesthetized rats. The great majority of mesocortical DA neurons responded to tail pinch, either by an excitation (65%), or by an inhibition (25%). In contrast, most DA neurons projecting either to the nucleus accumbens or the septum remained unaffected. These results demonstrate that noxious tail pinch selectively influences the firing rate of mesocortical DA neurons. PMID- 2702476 TI - Topographic study of the feline trigeminal ganglion via the horseradish peroxidase tracer method. AB - The somatotopic organization of the trigeminal ganglion was investigated in felines using the horseradish peroxidase (HRP) tracer method. Results were as follows. The cell bodies which send axons to the ophthalmic, maxillary and manidibular nerves were located in the anteromedial, middle and posterolateral portions of the ipsilateral trigeminal ganglion, respectively. Overlap was found, especially in the maxillary and mandibular areas. PMID- 2702477 TI - Effects of preoptic area lesions on muramyl dipeptide-induced sleep and fever. AB - Lesions of the preoptic area of rabbits caused hyperthermia, although they did not alter sleep-coupled changes in brain temperature, and reduced slow-wave sleep, rapid eye movement sleep, and amplitudes of electroencephalographic slow waves during slow wave sleep. The direction and magnitude of the muramyl dipeptide-induced responses were similar before and after the lesions, although the baseline values upon which the changes were superimposed had shifted. PMID- 2702478 TI - Lack of effect of hyperprolactinemia on serotonin turnover in ovariectomized and ovariectomized estrogen-treated rats. AB - Hyperprolactinemia suppresses luteinizing hormone (LH) and prolactin (PRL) secretion under a variety of experimental conditions. The secretion of both of these hormones is regulated at the hypothalamic level by several neurotransmitters, including serotonin (5-HT). Therefore, we examined the effect of hyperprolactinemia on 5-HT neuronal activity in key hypothalamic areas that are rich in 5-HT terminals and which are known to regulate the release of LH and PRL. Young cycling virgin rats were ovariectomized (day 0). From days 11-16, animals were injected with ovine prolactin (oPRL, 4 mg/kg, s.c.) or vehicle every 8 h. On day 14, one-half of the oPRL- and vehicle-treated rats were implanted with 20-mm long Silastic capsules containing estradiol (180 micrograms/ml). On day 16, animals were killed at 08.00, 12.00 or 18.00 h or treated with pargyline (75 mg/kg) and killed 10 min later. Trunk blood was collected and serum was radioimmunoassayed for LH and endogenous rat PRL (rPRL). Brains were removed, frozen, sectioned and the medial preoptic, suprachiasmatic, and arcuate nuclei, median eminence and globus pallidus were microdissected. Serotonin was measured using high pressure liquid chromatographic methodology. We were unable to detect any feedback effect of hyperprolactinemia on 5-HT turnover in any brain area of ovariectomized or ovariectomized estradiol-treated rats at any time of day that we examined. Several potential reasons for the absence of an effect of hyperprolactinemia on serotonergic function are discussed. PMID- 2702479 TI - Opioid-neuroleptic interaction in brainstem self-stimulation. AB - Injection of morphine into the ventral tegmental area (but not dorsal to it) induced a dose-dependent decrease in the frequency threshold for midline metencephalic brain stimulation reward. Facilitating doses of ventral tegmental morphine also reversed, in 4 of 6 animals, the threshold-increasing effects of pimozide (0.35 mg/kg, i.p.). This reversal was itself reversed by naloxone (2 mg/kg, i.p.), suggesting a direct action of morphine at ventral tegmental opiate receptors. These data fit with electrophysiological evidence that ventral tegmental morphine stimulates or disinhibits dopamine impulse flow, which would result in increased synaptic dopamine concentrations and decreased synaptic pimozide effectiveness. In the remaining two animals, the combined neuroleptic opiate treatment resulted in a complete cessation of responding that was not reversed by a 5-fold increase in stimulation frequency. This finding suggested a complete inactivation of the reward mechanism, which might be expected from the interaction of high doses of two drugs that are each known to be capable of producing depolarization inactivation of dopaminergic neurons. These data confirm that brainstem self-stimulation, like medial forebrain bundle self-stimulation, depends critically on the function of the mesocorticolimbic dopamine system. PMID- 2702480 TI - Behavioral evidence for midbrain dopamine depolarization inactivation. AB - High (2.5-5 micrograms) doses of ventral tegmental morphine, which normally facilitate brain stimulation reward, were found to cause a complete cessation of bar pressing for brainstem stimulation in animals pretreated with systemic pimozide (0.175-0.35 mg/kg). It was hypothesized that the behavioral failure was due to depolarization inactivation of the dopamine system. Electrophysiological evidence indicates that sufficient doses of morphine or neuroleptics can each cause inactivation by themselves. The behavior was reinstated by ventral tegmental muscimol, which normally suppresses both the behavior and dopamine cell firing but which reinstates dopamine cell firing in depolarization-inactivated cells. This behavioral reinstatement appears to confirm the hypothesis that depolarization inactivation of the dopamine system caused the behavioral failure, and appears to establish depolarization inactivation as a phenomenon of behavioral, and thus potential clinical, importance. PMID- 2702481 TI - The development of neurogenic plasma extravasation in the rat dura mater does not depend upon the degranulation of mast cells. AB - Mast cells were visualized in stretch preparations of the rat dura mater and were found mostly in relation to small and large blood vessels. The overall number of dural mast cells was unaffected by electrical trigeminal or chemical deafferentation. As in other tissues, mast cell degranulation increased at sites of local injury (electrode penetration) or after systemic treatment with compound 48/80. However, mast cells did not degranulate following electrical trigeminal stimulation, or after injection of drugs (capsaicin or substance P) which promote plasma extravasation in the dura. Furthermore, pretreatment with a mast cell stabilizer (sodium dicromoglycate) or with large doses of H1 and H2 histamine receptor blockers (mepyramine and cimetidine), did not block electrically- or chemically-induced neurogenic plasma extravasation (NPE). Daily pretreatment with 48/80 however completely attenuated or abolished NPE. Taken together these data suggest that as assessed by the extrusion of metachromatic granules, mast cells are not essential to the development of neurogenic inflammation within the rat dura mater. However, these findings cannot exclude the possibility that mast cells may amplify or modulate this process. PMID- 2702482 TI - Identification of serotonergic and sympathetic neurons in medullary raphe nuclei. AB - The purpose of the present study was to identify midline medullary serotonin (5 HT) neurons and to determine if these neurons were distinct from previously identified sympathoinhibitory and sympathoexcitatory neurons. Identification of medullary 5-HT neurons was based on electrophysiological and pharmacological similarities to dorsal raphe 5-HT neurons. Sympathoinhibitory and sympathoexcitatory neurons were characterized by an irregular discharge pattern which was temporally related to inferior cardiac sympathetic nerve discharge (SND) and to the cardiac cycle. Sympathoinhibitory neurons increased their discharge rate and the discharge of sympathoexcitatory neurons decreased during baroreceptor reflex activation. A third type of neuron fired in an extremely regular fashion (as judged by interspike interval analysis), fired at a rate of 1.1 spikes/s and had spike durations of approximately 2 ms. The discharges of regularly firing neurons were not temporally related to SND and were not affected during baroreceptor reflex activation. Regularly firing neurons and sympathoinhibitory neurons could be antidromically activated by electrical stimulation of the intermediolateral cell column of the spinal cord. Axonal conduction velocity of sympathoinhibitory neurons (2.4 m/s) was significantly greater than that for regularly firing neurons (1.3 m/s). Regularly firing neurons were completely inhibited by low doses of the 5-HT1A agonist 8-hydroxy dipropylamino-tetralin (8-OH-DPAT) (i.e. 2 micrograms/kg, i.v.) while much higher doses of the drug failed to affect the discharges of sympathoinhibitory and sympathoexcitatory neurons. Microiontophoretic application of 5-HT and 8-OH-DPAT profoundly depressed the firing of regularly discharging neurons. Based on the striking similarities between regularly firing medullary neurons and dorsal raphe 5-HT neurons it is concluded that the regularly firing neurons were 5-HT containing neurons. Furthermore, these medullary 5-HT neurons are distinct from sympathoinhibitory and sympathoexcitatory neurons. PMID- 2702483 TI - Timing and distribution of flash-evoked activity in the lateral geniculate nucleus of the alert monkey. AB - Simultaneous recording of activity from multiple cortical laminae in alert monkeys, using multichannel electrodes, has been used to identify the intracranial generators of surface-recorded, visually evoked potentials (VEP) to stroboscopic flash. Beyond their clinical implications, these results offer an unique view of the timing and sequence of cortical visual processing in the alert monkey, including the somewhat surprising findings of an extremely short-latency response in lamina IVA, a contra- over ipsilateral latency advantage throughout lamina IV, and the lack of a consistent flash-evoked response in the major cortical recipient of the magnocellular system, lamina IVCa. The present study used similar techniques to examine flash-evoked activity in LGN and in optic tract, both to elucidate the role of the subcortical pathways in establishing this pattern, and to provide a parallel, detailed view of the timing of visual activity in LGN and optic tract in the alert monkey. Flash-evoked responses are robust in both parvo- and magnocellular laminae, but these responses differ along several dimensions: (1) parvocellular multiunit activity (MUA) is 1/4 to 1/2 the amplitude of magnocellular MUA; (2) oscillatory activity is higher in frequency and shorter in duration in parvo- than in magnocellular responses; (3) inhibitory processes appear less prominent and diverse in parvo- than in magnocellular activity; (4) mean onset latencies of MUA are longer in parvo- than in magnocellular laminae, but there is extensive overlap in these distributions. Latencies encountered in ipsilateral lamina 3, and at laminar borders dorsal to 3, group more clearly with those of the magnocellular laminae than with those of the other parvocellular laminae. As a result, in the parvocellular division as a whole, the average latency to ipsilateral stimulation is shorter than that to contralateral stimulation. The optic tract exhibits a dorsal-to-ventral progression of onset latency and oscillation frequency consistent with a dorsal/ventral segregation of the inputs to parvo- and magnocellular layers. Comparison of optic tract and LGN data reveals that while many LGN response characteristics are initiated in the retina, significant modification of retinal output occurs at LGN. The techniques used here permit a particularly sensitive and reliable assessment of the timing and distribution of visual responses in the optic tract and LGN of alert monkeys. Our data support the view that in the alert monkey, the surface-VEP to passive, binocular flash primarily reflects activation of parvocellular thalamorecipient laminae of Area 17.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2702484 TI - Increased vulnerability of the mildly traumatized rat brain to cerebral ischemia: the use of controlled secondary ischemia as a research tool to identify common or different mechanisms contributing to mechanical and ischemic brain injury. AB - Fasted Wistar rats were subjected to either a mild mechanical injury, 6 min of transient forebrain ischemia, or a mild mechanical injury followed 1 h later by 6 min of forebrain ischemia. EEG and evoked potentials were assessed intermittently and morphological analyses were performed after 7 days postinjury survival. In all groups complete qualitative recovery of electrical activity and general behavior was observed with 7-day survival. However, rats subjected to combined concussion and ischemia displayed EEG spike activity and a delayed return of EEG and evoked potentials during acute recovery not evident in other groups. No overt neuronal cell loss was seen in trauma alone and was minimal or absent in ischemia alone. However, extensive bilateral CA1 and subicular pyramidal cell loss was found in the septal and mid-dorsal hippocampi in the combined trauma and ischemia group. In contrast, no overt axonal injury was found in any group. We conclude that even mild mechanical injury can potentiate selective ischemic hippocampal neuronal necrosis in the absence of overt axonal injury. This potentiation also occurs in conjunction with more generalized electrophysiological disturbances such as EEG evidence of postischemic neuronal hyperactivity suggesting that mild concussion may also decrease the threshold for post-ischemic neuronal excitation. These results suggest the potential of this model for examining common or different injury mechanisms in mechanical and ischemic brain injury. PMID- 2702485 TI - Adaptation of cultured mammalian neurons to a hypotonic environment with age related response. AB - The response of neurons to osmolal concentration changes has not been well documented compared to erythrocytes, urinary bladder and epithelial cells. The effects of a hypotonic solution on morphology and electrophysiological functions in cultured dissociated neurons can be precisely studied. From the analysis of video pictures from Nomarski optics, diameters of the cells were seen to increase and then recover to the initial values after the application of a hypotonic solution. The rate of increase of cell size in fetal neurons was 4-5 times faster than in mature neurons. This age-related transient response was accompanied by a change of resting potential and membrane resistance. This transient depolarization and decrease of the resistance corresponded to morphological changes. However, the amplitude of an action potential scarcely changed during the cell membrane expansion. It is plausible that increased membrane tension caused by the membrane expansion might facilitate the opening of the channel. The cell membrane expansion might also increase ionic permeability through the membrane. This may reduce a swollen cell volume to the initial one by diluting their intracellular solute concentration. After this adaptation the cultured neurons were able to survive for a long time and extend processes in the hypotonic environment. PMID- 2702486 TI - Ultrastructural features of NPY-containing neurons in the rat striatum. AB - In the present study, we examined the ultrastructure of striatal neurons containing neuropeptide Y (NPY) which were labeled by an immunohistochemical method using peroxidase-conjugated F(ab) fragments in the rat. Each of the 26 neurons identified had a deeply indented oval nucleus. The cytoplasm, which was mainly concentrated at the emergence of the dendrites, contained an abundant Golgi apparatus and a well-developed granular endoplasmic reticulum. Dendrites were poorly branched and rarely exhibited varicosities or dendritic spines. NPY immunoreactive (Ir) axons were small in diameter and unmyelinated. These features corresponded to a subpopulation of striatal neurons classified as aspiny type IV in previous Golgi studies. Axon terminals forming symmetrical synapses were numerous on the NPY-Ir perikarya and proximal dendrites. On distal NPY-Ir dendrites, synaptic contacts were mainly of the asymmetrical type, suggesting that NPY neurons are contacted by at least 2 categories of afferent fibers. Several NPY-Ir axonal processes and boutons were found to form symmetrical synapses with dendrites, dendritic spines and perikarya belonging to spiny type neurons. These data were consistent with the view that NPY may act as a neurotransmitter of striatal interneurons. Moreover, the frequent observation of NPY axonal processes in the close vicinity of striatal vessels suggested that NPY might also play a role in the control of cerebral vasomotricity. Thirty hours after intranigral injection of 6-hydroxydopamine to induce a degeneration of nigrostriatal dopamine terminals, some characteristic degenerative boutons were observed in close apposition to NPY-Ir cell bodies, suggesting that NPY neurons are under a direct nigrostriatal dopaminergic influence. PMID- 2702487 TI - Changes in glomus cell membrane properties in response to stimulants and depressants of carotid nerve discharge. AB - Intracellular recordings were made from glomus cells in the excised, intact or sliced (150-200 microns) carotid body. Carotid nerve discharge was also recorded from intact preparations. Slices were prepared for visual (Nomarski) control of microelectrode impalement. Resting potential (Em), input resistance (Ro) and voltage noise (Erms) were measured in control conditions and in response to several stimulants (interruption of flow, hypoxic and histotoxic [NaCN]anoxia, hypercapnia, asphyxia and acidity) and depressants (alkalinity, cooling) of the carotid nerve sensory discharge. Different glomus cells responded differently to the same stimulus but significant trends were found. The more common responses to zero flow and anoxia (hypoxic and histotoxic) were depolarization (64%) and decreases in Erms (63%) and Ro (71%). When extracellular pH was varied from 8.5 to 5.0, the preponderant responses were cell depolarization, and increases in noise and input resistance as pH decreased. Consequently, cell depolarization induced by zero flow and anoxia tended to be accompanied by reduced Ro, whereas that induced by acidity generally showed increased Ro. Changes in voltage noise usually followed variations in Ro. When nerve discharge frequency was plotted against delta Em or delta Erms there were positive correlations during acid stimulation. However, these correlations were complex (parabolic) during flow interruption and anoxia: an increase in discharge occurred in response to cell depolarization and to hyperpolarization. These results suggest that hypoxia and hypercapnic or acidic stimuli act on glomus cells by different mechanisms. This finding is consistent with evidence obtained by recording carotid nerve discharges in intact animals. PMID- 2702488 TI - The adenosine agonist N6-R-phenylisopropyladenosine (R-PIA) stimulates feeding in rats. AB - Administration of adenosine and agonists of the adenosine receptors to rats results in hypoactivity, hypothermia, muscle relaxation and antinociception. In the present study, we found that the adenosine ligand, N6-R phenylisopropyladenosine (R-PIA), increased food intake in rats at a time in the day when rats normally eat very little food or none at all. Feeding was not reliably stimulated upon the first exposure to R-PIA, but was clearly increased following repeated administration of this agonist. Other adenosine agonists, namely 2-chloradenosine and 5'N-ethylcarboxamide adenosine, failed to alter feeding after a single injection or after repeated exposure. The adenosine antagonist, caffeine, did not block R-PIA's effect on food intake, whereas the opioid antagonist, naloxone, blocked R-PIA-induced eating. These data suggest that R-PIA stimulates feeding independent of the A1 or A2 adenosine receptors. PMID- 2702489 TI - Effect of a superoxide dismutase derivative on cold-induced brain edema. AB - Although the involvement of reactive oxygen species has been suggested in the pathogenesis of brain edema, direct evidence supporting this concept is lacking. To elucidate a critical role of oxygen radicals, effect of a superoxide dismutase (SOD) derivative that circulated bound to albumin with a half-life of 6 h on the occurrence of cold-induced brain edema was studied in the rat. When animals were challenged with brain injury by applying a liquid-nitrogen-cold probe to one side of the cerebral hemisphere over the bony skull for 20 s, the vascular permeability of the underlying tissue increased significantly and unilateral brain edema occurred as determined by the accumulation of intravenously injected Evan's blue and the increase in brain weight. Intravenous administration of the SOD derivative markedly suppressed the increase in vascular permeability and the occurrence of brain edema, particularly at their early stages. These and other results suggest that superoxide anion and/or its metabolite(s) might play a critical role in the pathogenesis of traumatic brain injury. PMID- 2702490 TI - Effects of concurrent manipulations of cholinergic and noradrenergic function on learning and retention in mice. AB - Interactions between the neuromodulators acetylcholine and norepinephrine (NE) have been reported in both developmental neural plasticity and learning and memory. In a test of the generality of this phenomenon, we assessed the amnestic effects of the muscarinic antagonist scopolamine in normal and NE-depleted mice. Pretraining administration of scopolamine impaired 24-h retention of inhibitory (passive) avoidance training (at doses of 0.1, 0.3 and 1.0 mg/kg) and the acquisition of place-training in a water maze (at a dose of 1.0 mg/kg). NE depletion resulting from systemic administration of DSP-4 did not affect performance on these tasks and did not significantly alter the effects of scopolamine. NE depletion did, however, impair the retention of place learning when mice were retested 16 days after initial training; and this impairment in the retest was additive with one observed in mice originally trained under scopolamine. Normal acquisition but rapid forgetting has also been reported in aged rodents, who display deterioration of the noradrenergic system. Thus, observation of a similar pattern of performance consequent to experimental NE depletion suggests a role for noradrenergic dysfunction in age-related memory decline. PMID- 2702491 TI - Pyrethroids and enhanced inhibition in the hippocampus of the rat. AB - The pyrethroid insecticides have been divided into two classes on the basis of their biochemical actions and behavioral indices of toxicity. Both types of pyrethroids have effects on sodium conductance, and Type II pyrethroids have been reported to antagonize gamma-aminobutyric acid (GABA) by interacting with the t butyl-bicyclophosphorothionate (TBPS)/picrotoxinin binding site. The dentate gyrus of the hippocampus is equipped with GABAergic recurrent inhibitory circuits. The present experiment was designed to demonstrate dissociation in the biochemistry of pyrethroids by activating the perforant path with pairs of stimulus pulses and monitoring the recurrent inhibition in this circuit. Antagonism of GABA leads to a reduction in inhibition, measured as an increase in the size of the population spike in response to the second pulse of the pair. The GABAergic properties of the pyrethroids were assessed by examining paired pulse inhibition before and after oral treatment with 20 mg/kg of cismethrin (Type I), 20 mg/kg of fenvalerate, or 10 mg/kg of deltamethrin (Type IIs). Input/output (I/O) functions revealed a reduction in excitatory postsynaptic potential (EPSP) following cismethrin and deltamethrin. Population spike height was unaffected. Fenvalerate had no effect on I/O functions. In contrast to the prediction of reduced inhibition following treatment with Type II pyrethroids, deltamethrin and fenvalerate increased inhibition up to 500 and 150 ms interpulse intervals, respectively. Cismethrin was without effect on paired pulse inhibition. These findings fail to provide evidence of GABA antagonistic properties of Type II pyrethroids and may be best explained by a differential effect of these three pyrethroids on sodium channel kinetics. PMID- 2702493 TI - Non-synaptic release from dense-cored vesicles occurs at all terminal types in crayfish neuropile. AB - In the crayfish neuropile, dense-cored vesicles (DCV) have been found in chemical terminals, mixed in with round or pleomorphic agranular synaptic vesicles, as well as in electrical terminals and neurohemal endings. DCV release their content at unspecialized non-synaptic sites. The simultaneous exocytosis of DCV and synaptic vesicles seems to be the rule in chemical terminals. DCV in specific terminals suggest non-synaptic communication. In chemical and electrical terminals, the content of DCV could have a neuromodulatory function. PMID- 2702492 TI - Quantitative autoradiography of M2 muscarinic receptors in the rat brain identified by using a selective radioligand [3H]AF-DX 116. AB - Muscarinic receptors of the M2 type have been studied in the rat brain using quantitative autoradiography with the selective ligand, [3H]AF-DX 116. High specific binding of [3H]AF-DX 116 was found in areas such as laminae IV and V of the parietal cerebral cortex, thalamus and hypothalamus and dentate gyrus. Intermediate [3H]AF-DX 116 binding was found in the frontal cortex, hippocampus, caudate-putamen, nucleus accumbens, and claustrum as well as in certain brainstem nuclei such as the nucleus of the solitary tract and the dorsal motor nuclei of the vagus. In contrast, the accessory olfactory nucleus, globus pallidus and cerebellum contained very low concentrations of M2 receptors. The present study demonstrates a unique regional distribution of M2 receptors in the rat brain. PMID- 2702494 TI - Single unit response of suprachiasmatic neurons to arginine vasopressin (AVP) is mediated by a V1-like receptor in the hamster. AB - A large population of local circuit neurons within the suprachiasmatic nucleus (SCN) exhibit immunopositive staining for arginine-vasopressin (AVP). AVP has been reported to be released from SCN neurons in a circadian pattern that peaks during the subjective day. Using an in vitro hypothalamic slice preparation, the present study investigated how SCN neurons respond to AVP over the circadian cycle and whether the response to AVP is mediated by V1- or V2-like AVP receptors. Exposure of the slice to AVP 10(-8) M produced excitatory responses in 51% of the 74 SCN neurons examined. A statistically significant day-night difference in the percentage of SCN units responding to AVP was observed (chi 2 = 15.62; P less than 0.01). During the dark phase 73% were excited by AVP, while during the light phase only 24% had excitatory responses. The threshold concentration of AVP ranged from 10(-9) to 10(-10) M and 10(-7) to 10(-8) M during the dark and light phase, respectively. In a second experiment the effects of selective V1 and V2 agonists and antagonists were determined. A V1, but not a V2 receptor antagonist was found to block the effects of AVP on single unit activity. Similarly, a V1 but not a V2 receptor agonist mimicked the effects of AVP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702495 TI - Retinal projection to mammalian telencephalon. AB - Retinal projections were studied in species from 8 orders of mammals using anterograde tracing techniques. The olfactory tubercle of basal telencephalon receives a projection from the retina in all animals. In all species the course of labelled fibers is similar and the terminal distribution of label along the internal border of the granular cell layer is restricted to the mediocaudal region of the tubercle. These shared characteristics suggest that this pathway is a typical mammalian feature, possibly providing for convergence of visual and chemosensory information in telencephalon. PMID- 2702496 TI - Electrophysiological evidence for a tonic activity of the spinal cord intrinsic opioid systems in a chronic pain model. AB - The aim of this electrophysiological investigation was to evaluate the activity of the spinal endogenous opioid systems in a chronic pain model, the arthritic rat. The activity of nociceptive non-specific dorsal horn neurons (n = 23) were recorded in 23 spinal unanesthetized decerebrated rats. Naloxone (1 mg/kg i.v.) induced a highly significant increase in the spontaneous firing rate of these neurons. This observation is in favor of a tonic activity of spinal opioid endogenous systems in such a disease. In addition, the same dose of naloxone facilitates the transmission of noxious messages at the spinal level as revealed by the large enhancement of the responses of these neurons to C-fiber stimulation. These results are in good agreement with behavioral data showing that such a relatively high dose of naloxone induced well-reproducible hyperalgesia and with some biochemical observations showing an increase of levels and biosynthesis of endogenous opioids in the spinal cord of the arthritic rat. PMID- 2702497 TI - The connectivity underlying the orientation selectivity in the infragranular layers of monkey striate cortex. AB - The striate cortex of the monkey was studied with an array of 30 closely spaced microelectrodes. Responses to oriented light bars were recorded simultaneously, and interneuronal connectivity was inferred from spike train correlations of pairs of neurones. Between cells with parallel preferred orientations, interactions were strong at short ranges but negative or only weakly positive at separations of 0.3-0.4 mm. At these distances, the stronger correlations were observed between orthogonally oriented cells. The finding does not explain the generation of orientation selectivity, but it is in agreement with a cooperative principle explaining the spatially regular arrangement of oriented cells. PMID- 2702498 TI - Clinico-radiologic-pathologic conference: a patient with interstitial and airspace disease. PMID- 2702499 TI - Calcification in bronchopulmonary sequestration. AB - We report an unusual complication in a patient with intralobar bronchopulmonary sequestration. Chest tomography, computed tomography, and specimen radiography showed a mass containing numerous round calcifications in the posterior basal segment of the left lower lobe. Pathologic examination disclosed an Exophiala fungus infection and broncholiths within bronchiectatic cavities in the sequestered segment. PMID- 2702500 TI - Transcardiac passage of thrombus--ultrasonographic visualization. AB - A patient is described in whom a right atrial thrombus was seen, by two dimensional echocardiography, in the act of embolizing into the pulmonary circulation. PMID- 2702501 TI - Carcinoma of the fallopian tube presenting as renal failure: case report. AB - We describe a patient with carcinoma of a fallopian tube initially presenting with oliguric renal failure. Urinary tract symptoms are uncommon as a result of this rare tumor, and renal failure due to bilateral ureteral obstruction by nodal metastases has not been reported previously as a complication. PMID- 2702502 TI - Neuropathic arthropathy associated with chronic inflammatory demyelinating polyradiculoneuropathy. AB - We report a patient who developed acute neuropathic arthropathy secondary to chronic inflammatory demyelinating polyradiculoneuropathy. The association between these two conditions has not been previously reported. Their relationship is important to understand, as many other forms of inflammatory polyradiculoneuropathy share a similar pathology and are therefore susceptible to a similar complication. PMID- 2702503 TI - Enterolithiasis as a cause of intestinal obstruction. AB - Enteroliths are an uncommon cause of intestinal obstruction. We report two patients in whom this occurred. Conditions causing stasis predispose formation of enteroliths, which may be either radiopaque or radiolucent. They have a characteristic appearance on plain radiographs and on contrast examinations. Early recognition is helpful in preventing complications. PMID- 2702504 TI - Skeletal lymphoma. AB - The records of forty-two patients with lymphoma of bone [.11 with Hodgkin disease (HD), 31 with non-Hodgkin lymphoma (NHL)] were retrospectively reviewed to correlate histologic type with sites of osseous involvement, radiographic patterns of bone destruction, and prognosis. The vertebral column was the most frequent site of axial involvement and the femur was the commonest site overall. In HD, the most frequent radiographic pattern was vertebral sclerosis, while periosteal reaction was noted in two focal femoral lesions and hypertrophic pulmonary osteoarthropathy in one patient. In NHL, permeative destruction predominated, while unusual layered periosteal reaction and eccentric cortical destruction were each seen in two patients. Radiographic patterns of bone involvement alone cannot be used to predict histologic type or prognosis. Staging remains the most important prognostic indicator. For skeletal lymphoma, instead of the traditional Ann Arbor Staging System, we prefer the more specific Mayo Staging System which relates the temporal appearance of osseous disease to nodal or soft-tissue disease or both. PMID- 2702505 TI - Computed tomographic features of primary brain lymphoma. AB - Head computed tomographic (CT) examinations of 14 patients with primary brain lymphoma were reviewed to assess the CT features of the presenting and subsequent lesions. Presenting lesions were single in 62% and multiple in 38%. Lesions tended to be iso- or hyperdense and homogeneously enhancing. They were commonly located in the deep hemispheric regions, corpus callosum, and posterior fossa. Despite these characteristic patterns, the diagnosis of lymphoma was initially considered in just three patients. Follow-up CT showed good initial response to radiotherapy in 10 patients although mortality was high and posttherapy changes were frequent. Consideration of primary brain lymphoma by radiologists is important, as needle biopsy and radiotherapy may be preferred to a surgical resection. PMID- 2702506 TI - [Distention arthrography in the treatment of adhesive capsulitis of the shoulder]. AB - Adhesive capsulitis of the shoulder is an idiopathic condition characterized clinically by pain and limitation of movement. The characteristic arthrographic features are those of limited capacity of the joint, pain during injection, and retracted recesses. Progressive distension of the capsule with 1% lidocaine and 40 mg of triamcinolone acetonide (Kenalog) is a recommended form of treatment for this condition. Twenty-five patients treated by this method were reviewed retrospectively. Eleven (44%) were completely relieved of their symptoms, 6 (24%) had a 50% improvement, and 8 (32%) had no relief. Patients with idiopathic adhesive capsulitis responded more favorably to the treatment than those with a traumatic etiology. The duration of symptoms had no correlation with the results of therapy. There were no complications from the treatment. PMID- 2702507 TI - Some factors which influence the evaluation of a dual photon measurement of lumbar spine bone mineral mass. AB - The accuracy of a commercial dual photon densitometer was found to be within 3.0% of true values when measured using a cadaver spine. The precision, the ratio of standard deviation to mean derived from repeated measurements of a tissue equivalent phantom spine, was 1.6%. Patient size and the age of the radioisotope source had no discernable effect upon bone mineral mass measurements. The intervention of the technologist during data analysis can influence the determination of bone mineral mass in approximately 40% of measurements. When a lumbar spine phantom was measured on six different densitometers manufactured by three different companies, within-manufacturer variations of between 4% and 7% were found. Bone mineral densities differed by up to 30% between manufacturers. Values of lumbar spine mineral mass were measured for 206 apparently normal women. The resultant normal range was similar to others documented by the manufacturer. The differences between these studies and a published study of 892 normal women can best be explained on the basis of intermanufacturer differences. PMID- 2702508 TI - Calcification of axillary lymph nodes following BCG vaccination. AB - Axillary lymph node calcification was found in 18 children following BCG vaccination. Five of these also had symptomatic adenitis. The calcifications involved one to four nodes and appeared as discrete, oval densities. They disappeared over the course of several months in three patients. No axillary lymph node calcification was seen on chest radiographs of 60 other children who had had BCG vaccination in the neonatal period. PMID- 2702509 TI - Low-dose fibrinolytic therapy for recent lower extremity thromboembolism. AB - Low-dose catheter-directed fibrinolytic therapy (LDCF) using streptokinase (35) and urokinase (7) was performed on 42 separate occasions in 36 patients for recent lower extremity thromboembolic occlusion. Twenty-seven grafts and 15 native arteries were treated. Causes of occlusion were known in 32 instances: native artery proximal or distal occlusive disease or both (18 vessels); bypass graft stenosis (6); aneurysm (2); embolus (4); and postangiography thrombosis (2). Twenty-nine infusions were technically successful, and patients were clinically improved by 26 of the treatments. Twelve patients had unsuccessful infusions and six underwent subsequent amputation. In all patients, infusions longer than 12 hours resulted in prolonged thrombin times and lowered plasma fibrinogen concentrations; one infusion was discontinued due to a low fibrinogen concentration. Complications occurred on 17 occasions and included hemorrhage (6), distal embolization (3), compartment syndrome (1), retrograde thrombosis during infusion (5), hypotension (1), and systemic fibrinogenolysis (1). The cumulative success rate was 44% +/- 9% at 24 months. Late rethrombosis (five instances) was more common in patients who had inflow or outflow structural lesions not corrected following successful fibrinolysis. LDCF is a useful alternative to other methods of treatment for recent onset lower extremity thromboembolic occlusion. Structural vascular lesions uncovered by successful infusion should be corrected immediately after infusion to ensure long-term patency. PMID- 2702510 TI - Effect of maternal avoidance of eggs, cow's milk and fish during lactation upon allergic manifestations in infants. AB - Atopic/allergic manifestations and skin-prick tests (SPT) to egg white, cow's milk (CM) and fish were evaluated during the first 18 months of life in two matched groups of infants with a family history of atopy/allergy. In one group (n = 65) the mothers had a diet free from eggs, CM and fish during the first 3 months postpartum, whereas the mothers in the other group (n = 50) consumed an ordinary diet. The diet of the infants was similar in both groups, i.e. CM was not supplied until 6 months of age, and eggs and fish not until 9 months of age. The incidence of atopic dermatitis was significantly lower in the maternal diet group during the first 6 months postpartum (10.8 and 28%, respectively) but not after that age. Other atopic/allergic manifestations did not differ and the number of positive SPT to egg white, CM or fish at 9 months of age was similar in both groups. PMID- 2702511 TI - Nasal hyperreactivity to newspapers. AB - Nasal hyperreactivity occurs quite frequently while reading newspapers. This study consisted of 15 patients with vasomotor rhinitis with such problems and six asymptomatic volunteers. All subjects were exposed to printing ink and paper dust from newspapers. The effect was registered by nasal symptom score and rhinomanometry. Patients with vasomotor rhinitis reacted upon exposure to paper dust but not to printing ink. This exposure had no effect on the control group. The results indicate that paper dust is the causative agent in hyperreactivity to newspapers. PMID- 2702512 TI - Inhaled lignocaine does not alter bronchial hyperresponsiveness to hyperventilation of dry cold air in asthmatic subjects. AB - It has been hypothesized that bronchoconstriction due to exercise and hyperventilation is caused by the stimulation of irritant receptors in the upper airways. However, controversial results have been reported on the effect of lignocaine, which can inhibit the stimulation of these receptors. The aim of this study was to investigate the effect of inhaled lignocaine on bronchial responsiveness to hyperventilation of cold dry air in asthmatic subjects. Eight adult asthmatic subjects in a clinical steady state came on four different days (two placebo and two active days in random order) with a maximum interval of 3 weeks. After assessment of forced expiratory flow rates, inhalation of either phosphate-buffered saline (placebo) or lignocaine solution (40 mg) was carried out in a single-blind fashion. The technician was not aware which medication was being inhaled, but the asthmatic subject knew which drug it was by the sensation in his or her throat. Forced expiratory flow rates were reassessed 15 min after the nebulization; then, the subjects were asked to inhale cold dry air (-20 degrees C) in progressively increasing levels of ventilation (7.5, 15, 30 and 60 l/min and maximum voluntary ventilation). PD20 was interpolated from the dose response curve, relating the dose of cold air on a non-cumulative logarithmic scale on the abscissa and the percentage change in FEV1 on the ordinate. There were no significant changes in FEV1 and PD20 after inhalation of lignocaine as compared to the placebo. We conclude that inhaled lignocaine does not significantly alter bronchial hyperresponsiveness to hyperventilation of cold air in asthmatic subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702513 TI - The clinical efficacy of budesonide in hay fever treatment is dependent on topical nasal application. AB - During the last decade topical glucocorticoids have been established as the first hand choice for the treatment of allergic rhinitis. Although they are clinically effective, their precise mode of action has not been sufficiently clarified. In order to evaluate whether the clinical effect is dependent on the topical administration a randomized, double-blind, double-dummy study was performed. Ninety-eight patients with allergic rhinitis due to birch pollen were recruited at two centres in southern Sweden. The patients received one of the following three treatment alternatives: 200 micrograms of nasally applied budesonide twice daily, 250 micrograms of budesonide given orally twice daily or a placebo. The selection of the doses was based on previous pharmacokinetic studies giving almost equal plasma levels of the nasally and orally administered budesonide. To evaluate the possible clinical efficacy of the treatment, the patients kept a diary in order to register symptoms according to a 0-4 scale. After a run-in week with no treatment the patients entered the treatment period which lasted for 3 weeks. A total of 96 patients completed the study. The symptom data showed that topically applied budesonide was clinically effective with a pronounced reduction in all the nasal symptoms registered and compared with placebo treatment there was a statistically significant difference in favour of the budesonide treatment (P less than 0.001). The nasal symptoms of the patients receiving oral budesonide did not differ from those receiving placebo. Intranasally administered budesonide proved to be significantly more effective than orally applied budesonide (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702514 TI - IgE-mediated allergic reactions to fruit gums and investigation of cross reactivity between gelatine and modified gelatine-containing products. AB - A 32-year-old female reacted with a contact urticaria syndrome after eating 'gummy bears' (fruit gums). The reaction began in the oral mucosa and led to treatment on an inpatient basis. RAST measurements with allergen discs produced with gelatine and gelatine-containing products (among them 'gummy bears') demonstrated the presence of IgE antibodies in the serum of this patient. Proteins with molecular weights in the range of 40-120 kD were identified as the allergens in gelatine by using Western blot analysis. RAST inhibition showed cross-reactivity between gelatine, gelatine-containing products and the modified gelatine used in some plasma substitutes. Allergic reactions towards coloured fruit candies and 'gummy bears' may result from an IgE-mediated hypersensitivity towards gelatine. The long-known anaphylactoid reactions towards gelatine containing plasma substitutes may, at least in part, be of an allergic nature. PMID- 2702515 TI - Diet-related eczema. PMID- 2702516 TI - Clinical diagnosis in food allergy. PMID- 2702517 TI - International ethics: a survey of technology, economics, and decisions. PMID- 2702518 TI - Needlestick injuries and the risk of HIV infections. PMID- 2702519 TI - Returning to school: should you consider it now? PMID- 2702520 TI - Recruiting family physicians to underserviced areas. PMID- 2702521 TI - Licensure: competence to do what? PMID- 2702522 TI - Public health approach to infectious disease imported by plane. PMID- 2702523 TI - Hyperactivity in children. PMID- 2702524 TI - Chronic fatigue syndrome [correction]. PMID- 2702526 TI - HSOs: Ontario's answer to HMOs? [correction]. PMID- 2702525 TI - Glass is detectable on plain radiographs. PMID- 2702527 TI - Bedside monitoring of the blood glucose level: the high cost of reliable results. PMID- 2702529 TI - Fatal accident with weight-lifting equipment: implications for safety standards. PMID- 2702528 TI - Practice patterns of family physicians with 2-year residency v. 1-year internship training: do both roads lead to Rome? AB - Are there differences in patterns of practice between actively practising physicians who have been certified after a 2-year family practice residency and matched physicians without certification who have completed the standard 1-year internship? With the use of billing files prepared by the British Columbia Medical Association a group of 65 family practice certificants in active practice in British Columbia was compared with a control group of 130 internship trainees matched by year and school of graduation, category of billing (i.e., solo or group) and region. A wide range of practice features was assessed for the fiscal years 1984-85, 1985-86 and 1986-87. No differences were detected between the groups in 1986-87 for the following practice variables: number of patients (1888 and 1842 respectively), number of personal services billed for (7265 and 7173), number of personal services per patient (3.9), amount of funding for personal services ($140,192 and $140,100) and amount per patient for personal services ($77 and $79). Age-adjusted costs for male and female patients were similar in the two groups. Of six services thought to be influenced by type of training, only maternity care generated a significantly higher number of billings in the study group (341 v. 249). These results suggest that there is no demonstrable effect of training on patterns of practice. However, the question of the effect of training on quality of care and whether the 2-year residency may have a longer effect on practice patterns should be the focus of future research. PMID- 2702530 TI - Recent concepts on the pathogenesis of atherosclerosis. PMID- 2702531 TI - CFPC, OMA programs help family doctors cope with AIDS. PMID- 2702532 TI - Health care in Japan: challenged by an aging population. PMID- 2702533 TI - Health care funding in Ontario: where's the "crisis"? PMID- 2702534 TI - Health care system needs wiser spending, not more dollars: Lalonde. PMID- 2702535 TI - A house call to the big house. PMID- 2702536 TI - Dutch doctors visit CMA for lesson on Canadian health care system. PMID- 2702537 TI - CMA leadership conference: MDs must recognize that resources are limited. PMID- 2702538 TI - Reported illness after a CGE closure. AB - In March 1984, a Canadian General Electric factory in Toronto closed its doors. The result was unemployment for approximately 400 individuals. After the closure, three surveys were carried out, among other things, to assess the health of former employees and their spouses over a 27 month period. Overall, in the period following the closure, those affected by the shutdown reported far greater ill health when adjustments had been made for age, sex, education, and employment status than the Ontario population as determined by the Canada Health Survey. While stress can be linked to illness in four basic ways, the most likely explanation for this observation is that former employees and their spouses, as a result of the stress attributed to the closure, engaged in 'illness behaviour'. PMID- 2702539 TI - An evaluation of sources of information on health and travel. AB - I surveyed by telephone 108 potential sources of information on health and travel. I posed as a traveler, and evaluated the information and referrals elicited by comparison to current standards set out by the World Health Organization (WHO) and the U.S. Public Health Service. Only 7.4% potential sources gave correct information, 30.6% gave incorrect information, and 62% gave no information. 74.1% of those surveyed gave correct referrals, 22.2% gave incorrect referrals, and 3.7% gave no referrals. PMID- 2702540 TI - Weight control in the workplace: a needs assessment for men. AB - This investigation was designed to assess the needs and interests of overweight men in a worksite weight control program. Employees of 2 high-tech companies were surveyed; 373 men and 238 women responded. 56% of respondents were interested in a worksite program. 44% of male respondents had a Body Mass Index (BMI) of 25 or greater and of those, 75% indicated an interest in participating. Among women, 21% had a BMI of 25 or greater and 92% were interested in the program. Also 68% of women who were not overweight would participate in a weight control program. There was a strong preference for a self-help teaching format over group activities, and particular interest in an evaluation of their present food habits, behaviour modification techniques for weight control and the health consequences of overweight. These findings give clear direction for the development of an effective worksite intervention. PMID- 2702541 TI - [3-wheeled and 4-wheeled all-terrain vehicles: unstable and dangerous vehicles]. AB - We present the results of a questionnaire completed by 526 victims of accidents involving three- and four-wheeled all-terrain vehicles. All victims were treated at the emergency departments of 10 regional hospitals in Quebec. In 70% of cases, the vehicles overturned. Two thirds of victims were injured in accidents without collision, typically involving overturns on level ground or hills. We suggest accident reconstruction research as a means of identifying engineering solutions as one element in an injury control approach. PMID- 2702542 TI - The association between self-assessed health status and individual health practices. AB - We report the association between single health practices and self-assessed health status. Data were collected by telephone survey applied to all adults in a sample of households in metropolitan St. John's; questionnaires were completed for 3,300 subjects. Five health practices--smoking, exercise, sleep, weight and drinking--as defined by previous studies were compared with self-assessed health status--good or poor--using logistic regression; linear and quadratic functions were fitted, plots were prepared and the direction and strength of the associations studied using odds and odds ratios. For sleep, smoking, weight and exercise, our results confirm the definitions used in previous studies. Current non-drinkers in our sample do not report good health as frequently as moderate drinkers. Breakfast--which was analyzed by conventional cross-tabulation--showed no association with health status. PMID- 2702543 TI - Pharyngitis 1987: a survey of physicians' attitudes and practices in southern Alberta. AB - A questionnaire survey concerning Streptococcal pharyngitis was completed by 85 southern Alberta family physicians. The data revealed a significant trend to overtreat pharyngitis with antibiotics because of the unreliability of clinical diagnosis and the lack of diagnostic manoeuvres with suitable ability to influence management. These data and a further questionnaire survey directed to the appreciation of other bacterial pharyngitides, demonstrate the importance of laboratory reports in biasing treatment, and further suggest that significant overtreatment of non-Streptococcal pharyngitis also occurs. PMID- 2702544 TI - Appraisal of the epidemiology of fetal alcohol syndrome among Canadian native peoples. AB - Three recent studies suggest that Fetal Alcohol Syndrome (FAS) is more prevalent among Canadian Native children than non-Native children. The evidence does not appear to be conclusive. However, the Canadian research that is reviewed is important in defining areas which require further investigation. Efforts at research and intervention should be directed towards defining and modifying personal and social risk factors. Our review of current research on FAS and Native peoples suggests that it is important to consider pragmatic questions which can best contribute to the goal of preventing possible alcohol effects on the fetus. PMID- 2702545 TI - Trends in adolescent alcohol consumption in Halifax, Nova Scotia--1970-1986. AB - The drinking behaviours of 1,128 students from grades 7 to 12 in Halifax, Nova Scotia were surveyed and the results were compared to surveys done on similar samples of adolescents in 1970, 1976 and 1983. The survey instruments were self administered, anonymous questionnaires administered in class groups. In the 1986 survey, while no differences (p greater than .05) in the frequency of drinking episodes exists between males and females, the former group were found to be drinking more heavily. Since 1983, the percentage of drinkers has declined significantly (p less than .05) among both sexes. The percentage of frequent drinkers (once a week or more) and heavy drinking (6+ drinks per sitting, more than once per week) has not changed significantly (p greater than .05) in either sex. PMID- 2702546 TI - Historical employment records as data bases for occupational disease research--a case study. AB - Historical employment records in the B.C. coastal lumber industry were examined for adequacy for record linkage to the national Mortality Data Base. Employer, union, pension, and health and welfare plan records existed with varying amounts of personal information. The recommended list of identifiers for linkage is extensive. To evaluate the likelihood of successful linkage with the limited identifiers available in the case study, we compared our findings with the INCO United Steelworkers mortality study carried out by McMaster University. Their evaluation of automated record linkage using limited identifiers compared to intensive direct follow-up of a sample of 1000 indicated a satisfactory rate of follow-up. This suggests that the historical records found in the case study would provide an adequate basis for research using record linkage. PMID- 2702548 TI - [Systematic bias in measuring of the utilization of ambulatory medical services]. AB - The results of utilization studies on ambulatory medical care are usually disappointing. Since these studies have used the regression linear model with cross-sectional data, they have rarely considered the utilization of medical services as a dynamic process unfolding over a certain period of time. The utilization of medical services was observed during three consecutive two-week periods with the help of a sample, drawn from the files of the RAMQ, of 41,811 individuals living in Laval and in the Metropolitan region of Quebec. Transition rates towards user or non-user status between each period are predicted, rather than volumes of utilization. Results show that the variables which predict the volume of utilization are not those which predict the transition towards non-user status, though volume of utilization arises from the cumulation over time periods of the using status. Differences appear between the utilization processes of persons aged 65 and over and other adults. Consequently, studies on the utilization of medical services should no longer use multiple linear regression. Thus, the conclusions which these studies draw about the impact of policies of accessibility to health care are also biased. PMID- 2702547 TI - Comparison of individual follow-up and computerized record linkage using the Canadian Mortality Data Base. AB - We compared two methods of ascertaining mortality in a historical prospective mortality study. Computerized Record Linkage (CRL) with the centralized historical Canadian Mortality Data Base (CMDB) was carried out on 2469 men and an attempt was also made to trace the subjects by individual follow-up (IFU). All but 88 were traced and 60 were reported to be dead. CRL was able to locate the deaths of three men who had been untraced by IFU. Contradictory information on vital status was obtained on 5 subjects--in 4 of them, the discrepancy was resolved in favour of CRL. Overall, CRL using the CMDB performed very well. We also consider factors that affect the relative costs of the two methods, which should be balanced against the accuracy of information obtained. PMID- 2702549 TI - Use of the hospital postpartum period for population-based research. AB - A survey method was developed to conduct population-based research on behaviour in pregnancy by contacting women during the postpartum period in hospital. 85.8% of the eligible women completed the questionnaire in hospital, and follow-up measures increased the response rate to the full questionnaire to 90.8%. A shorter version of the questionnaire was completed by another 3.7% of the women for an overall response rate of 94.5%. The test-retest reliability of the questionnaire was high. This method was very acceptable to women. Non-response was due mainly to women who were missed or to lost questionnaires rather than refusal. It is important to have a high response rate on similar surveys since responders did differ from non-responders on important characteristics. This method should prove useful to other health care planners. PMID- 2702550 TI - Increasing response rates in community health surveys administered by telephone. AB - This paper reports the effects of two methods used to increase response rates in a community health survey administered by telephone. Converting refusals resulted in an increase of 3.7% in the final response rate, while the investigation and identification of indeterminate telephone numbers increased the response rate by an additional 6.1%. Together, these methods resulted in an increase of 9.8%, from an initial response rate of 70.1% to a final lower-bound response rate of 79.9%. The use of these methods helped to reduce non-response bias at a minimal cost. PMID- 2702551 TI - Acute rheumatic fever--no epidemic in Ontario. PMID- 2702552 TI - A neglected disease: tuberculosis. PMID- 2702553 TI - Environmental risk analysis: a case study. AB - Traditional risk analysis which has evolved to fit the requirements of regulatory agencies, is often too time-consuming and cumbersome for specific environmental decision making activities in public health. For instance, the discovery of an old chemical landfill operation may require highly focussed risk information to help make a decision to abandon, decontaminate, or develop the site. This paper presents an alternate approach to risk analysis which is more efficient than traditional methods in assessing the human health risks associated with specific development plans. The method is illustrated with an example of a building site in British Columbia. PMID- 2702554 TI - Some thoughts on nursing. PMID- 2702555 TI - The clinical specialist-staff nurse research team: a model for clinical research. AB - Increasing sophistication in nursing research has created a demand for preliminary work before the completion of a design for a major research project. This report presents a method which meets this need and provides research experience to nurses working on the clinical units. The role of the doctorally prepared clinical nurse specialist (CNS) in promoting collaborative research is presented. For the staff nurse the purpose of this collaboration was to facilitate an introduction of nursing research during the completion of her BSN. A secondary purpose was to provide the doctorally prepared CNS with preliminary data on the effects of nursing care on preterm infants with bronchopulmonary dysplasia. Through collaborative effort, a research protocol was developed and implemented with four preterm infants. The successful completion of this project provided the CNS with preliminary data and the staff nurse with a better understanding of the complexities as well as the rewards of clinical nursing research. PMID- 2702556 TI - Moving clients toward wellness: behavioral change. AB - Assisting clients to incorporate behavior change into their life-style presents a challenge to the clinical nurse specialist. Lack of adherence to prescribed regimens and educational interventions constitutes a primary reason for the occurrence and complications of illness, leading to inadequate control of the disease process and increased health care costs. This paper describes behavior modification techniques that can be used in conjunction with an educational program to initiate and maintain healthier behaviors among clients who demonstrate physical and emotional readiness for learning. The author also discusses how social support as a maintenance technique helps clients embarking on behavior change programs. Maintenance of a behavior change through utilizing a family systems focus not only facilitates an individual's coping with illness but also promotes family coping and adaptation. PMID- 2702557 TI - Networking: a strategy for strengthening the role of the clinical nurse specialist. AB - Networking has become a powerful means of creating change. Potentially for the clinical nurse specialist (CNS), networking can provide mutual sharing of information and resources for the purpose of improving patient care and facilitate the exchange of information in situations where there is more information than one can possibly absorb. CNSs must network with one another and with other colleagues in practice, management, and/or education. PMID- 2702558 TI - Clinical nurse specialist role development: quantifying actual practice over three years. AB - A task force of five clinical nurse specialists (CNSs) developed a data collection instrument to document CNS weekly work activities in 30-minute segments. This CNS group collected data for 2-week periods quarterly from June 1984 to May 1987. These data showed that: (1) greater than 50% of work time was allocated to clinical practice and consultation; (2) the proportion of time spent on activities in each role component varied with the number of years of experience in the CNS role; and (3) variations in amount of time spent in role categories were evident among practice specialties. The project demonstrated that it is possible to document CNS practice conveniently. The project has also enhanced the professional development of the CNS group and has set the stage for implementing peer review. PMID- 2702559 TI - Issues in liability insurance and the nursing consultant. AB - Since the number of lawsuits involving consultants has increased in recent years, it is important for clinical nurse specialists to be aware of the causes for these lawsuits and to protect themselves from the possibility of litigation. Maintaining open communication with clients, using an evaluation tool as a means for ensuring quality, drawing up a legal contract, and carrying adequate liability insurance are four important ways to protect oneself from the possibility of legal action. PMID- 2702560 TI - CNSs' support for condom advertising for the prevention of AIDS. PMID- 2702561 TI - AIDS: what are nurses' concerns? AB - The purpose of this research was to study nurses' knowledge about and attitudes toward caring for patients with acquired immunodeficiency syndrome (AIDS) and the relationship of these factors with demographic and professional characteristics. Data were gathered by questionnaires mailed to a random sample of Registered Nurses in Erie County, NY. Results indicated that many of the nurses surveyed are fearful of contracting AIDS and do not have confidence in their ability to meet the intense physical and psychological needs of patients with this illness. Further, the data suggest that caring for individuals with AIDS may be complicated by the fact that a large proportion of these patients are homosexuals who are terminally ill. The findings lead to the conclusion that targeted intervention strategies are necessary to prepare nurses to met the emerging needs of the escalating AIDS epidemic and to help assure that quality of care will be maximized. PMID- 2702562 TI - Control of breast cancer through mass screening: from research to action. PMID- 2702563 TI - Hereditary cancers disclose a class of cancer genes. PMID- 2702564 TI - Local recurrence after breast-conserving surgery and radiotherapy. Frequency, time course, and prognosis. AB - Mammary recurrences were studied in 1593 patients with Stage I and II breast cancer treated by macroscopically complete tumor excision followed by megavoltage radiotherapy, including a boost to the tumor bed (mean dose, 78 Gy). The actuarial freedom from mammary recurrence was 93% at 5, 86% at 10, 82% at 15, and 80% at 20 years. Seventy-nine percent of the recurrences were in the vicinity of the tumor bed, but with increasing time interval, an increasing percentage of recurrences was located elsewhere in the breast. A majority of recurrences after 10 years could be considered new tumors. Only ten of 181 patients with recurrence had prior or concomitant distant metastases, and 159 of 171 isolated mammary recurrences (93%) were operable. Uncorrected overall survival after operable recurrence was 69% at 5 and 57% at 10 years. Prognosis after late recurrence (after 5 years) was favorable (84% 5-year survival). Operable early recurrences retained a favorable prognosis if smaller than 2 cm and confined to the breast (74% 5-year survival). Disease-free interval and histologic grade also appeared to be important prognostic factors after early recurrence. Survival after recurrence did not depend upon the type of salvage operation. Locoregional control was 88% at 5 years after salvage mastectomy and 64% after breast conserving salvage procedures. The role of adjuvant systemic therapy at time of local recurrence requires additional study. This experience illustrates the important differences between mammary failure and chest wall recurrence after mastectomy, in particular the protracted time course and more favorable prognosis associated with the former. PMID- 2702565 TI - Chemotherapy in the management of intraocular lymphoma. AB - Six patients with intraocular (vitreous) lymphomas were treated with high-dose intravenous cytosine arabinoside (Ara-C). Four patients were previously untreated, one patient had previously received ocular and central nervous system radiation therapy and relapsed, and one patient had previously received chemotherapy for systemic lymphoma. Five responses were observed: one complete and four partial. High-dose Ara-C is active in intraocular (vitreous) lymphoma, but complete response is uncommon. Adjunctive use of Ara-C in combination with ocular irradiation may be a useful form of therapy in this uncommon lymphoma. PMID- 2702566 TI - Four-day continuous infusion of cisplatin and 5-fluorouracil in head and neck cancer. AB - A combination of cisplatin and 5-fluorouracil, both administered 4 days continuously as infusion, was assessed in advanced head and neck cancer. Of the 37 patients studied, there were 15 complete and 17 partial responses (40.5% and 45.9%, respectively). Survival is 79.1% at 22 months. None of the patients in complete response has relapsed. In general toxic effects were moderate. Given as initial treatment, the regimen is effective and of considerable use in this type of patient. PMID- 2702567 TI - DNA aneuploidy assessment of the effectiveness of hyperthermo-chemo-radiotherapy for esophageal carcinoma. AB - The relationship between DNA ploidy and effects of preoperative hyperthermo-chemo radiotherapy were investigated in 118 patients who underwent esophageal resection and reconstruction for carcinoma of the esophagus, including 56 treated with hyperthermo-chemo-radiotherapy (HCR therapy) and 62 treated with chemo radiotherapy (CR therapy). DNA ploidy patterns were grouped into low and high ploidies, according to the degree of dispersion and the peak value on the DNA histogram. In the low ploidy group, there were no significant differences in the prognosis and histologic effects between the HCR and CR therapies. In the high ploidy group, however, the difference in survival curves was statistically significant, the 3-year survival rates of patients given HCR therapy and CR therapy being 26.7% and 10.7%, respectively (P less than 0.05). The HCR therapy increased the rate of "markedly effective" in the resected tissue compared with findings in cases of CR therapy. These findings show the positive effects of the HCR therapy for carcinoma of the esophagus, especially for patients with an aneuploid profile and a poor prognosis. PMID- 2702568 TI - Biopsy results of new calcifications in the postirradiated breast. AB - A breast biopsy was performed in 19 patients for the finding of new mammographic calcifications without an associated palpable or mammographic mass after breast conserving surgery and definitive irradiation for early stage breast cancer. The interval postradiotherapy was 9 to 96 months with a median of 34 months. Eleven of the biopsy specimens (58%) were positive for recurrent breast cancer and eight (42%) were negative. The pathologic results from the positive biopsy specimens showed four with invasive ductal carcinoma, two with microinvasive ductal carcinoma, four with intraductal carcinoma, and one with lobular carcinoma in situ (LCIS). Treatment consisted of mastectomy in eight patients, mastectomy plus chemotherapy in one patient, and biopsy for the patient with LCIS. One patient refused a recommended mastectomy. All 11 patients with recurrent carcinoma are alive with no evidence of disease after salvage therapy, although follow-up is short (median, 14 months; range, 0-48 months). Calcifications which developed in a quadrant different from the initial tumor tended to be malignant with four of five having a positive biopsy result. Microcalcifications were not commonly associated with the initial tumor with only five of 19 having microcalcifications. These results show that the development of new calcifications in the postirradiated breast is associated with a positive biopsy rate of 58% and that the tumors which are found tend to be early and potentially salvageable. The positive biopsy rate of 58% in the postirradiated breast is in marked contrast to the lower positive biopsy rate for microcalcifications in the nonirradiated breast as reported in the literature. PMID- 2702569 TI - Subacute brain atrophy after radiation therapy for malignant brain tumor. AB - Brain atrophy with mental and neurologic deterioration developing a few months after radiation therapy in patients without residual or recurrent brain tumors has been recognized. Two illustrative case reports of this pathologic entity are presented. Six autopsy cases with this entity including the two cases were reviewed neurologically, radiographically, and histopathologically. All patients presented progressive disturbances of mental status and consciousness, akinesia, and tremor-like involuntary movement. Computerized tomography (CT) demonstrated marked enlargement of the ventricles, moderate widening of the cortical sulci, and a moderately attenuated CT number for the white matter in all six patients. Four of the six patients had CSF drainage (ventriculoperitoneal shunt or continuous lumbar drainage), however, none of them improved. Histologic examination demonstrated swelling and loss of the myelin sheath in the white matter in all patients, and reactive astrocytosis in three of the six patients. Neither prominent neuronal loss in the cerebral cortex or basal ganglia, nor axonal loss in the white matter was generally identified. The blood vessels of the cerebral cortex and white matter were normal. Ependymal layer and the surrounding brain tissue were normal in all patients. These findings suggested that this pathologic condition results from demyelination secondary to direct neurotoxic effect of irradiation. The authors' previous report was reviewed and the differential diagnoses, the risk factors for this pathologic entity, and the indication for radiation therapy in aged patients with a malignant brain tumor are discussed. PMID- 2702570 TI - Association of increased lytic effector cell function with high estrogen receptor levels in tumor-bearing patients with breast cancer. AB - Tumor-bearing patients with breast cancer were assayed for their natural killer (NK) cell activity and for the function of activated cytotoxic T-cells, as assessed by lectin-dependent cellular cytotoxicity (LDCC). Tumor-bearing patients with breast cancer had a significant increase in NK activity and in LDCC, as compared with healthy control individuals. Although the enhanced NK cell activity and LDCC were closely associated with high levels (greater than 31 fmol/mg) of estrogen receptor (ER) content in the primary tumor, no other clinical or histologic correlation between the increase in either parameter of cytotoxic effector cell function could be found. Thus, ER levels greater than 31 fmol/mg might be associated with increased cytotoxic effector cell function in tumor bearing patients with breast cancer. PMID- 2702571 TI - Immunosuppressive effects of recombinant interferon-alpha during long-term treatment of cancer patients. AB - Interferons (IFN) are known to modulate immune responses in an either stimulatory or inhibitory manner. Most of the knowledge about immunomodulatory activities of IFN comes from investigations of IFN effects on cells in vitro. This study examines the influence which long-term treatment with recombinant interferon alpha 2 exerts on immune functions in cancer patients. Serial in vitro immune function studies of peripheral blood mononuclear cells were done to determine parameters of B-cell and T-cell functions as well as natural killer (NK)-cell activity. The authors detected profound suppression of in vitro immunoglobulin synthesis and lymphocyte proliferation as well as depression of NK-cell activity during IFN treatment. All suppressed immune functions normalized on discontinuation of IFN therapy. The authors conclude from these observations that, apart from their beneficial effects, IFN produce substantial immunosuppression. PMID- 2702572 TI - A case of bronchogenic cyst with high production of antigen CA 19-9. AB - A 35-year-old man was hospitalized with complaints of retrosternal pain and high fever. A chest radiograph showed a large round mass in the mediastinum. Of the several tumor markers in the serum tested, only CA 19-9 was elevated. Thoracotomy revealed a cystic mass with purulent hemorrhagic materials. Histologically the cyst was lined by bronchial epithelium with no evidence of malignancy. The high level of CA 19-9 in the cystic fluid, and positive immunohistochemical staining of the bronchial glands in the cyst wall for CA 19-9 indicated that the elevated serum level of CA 19-9 originated from the bronchogenic cyst after its infection. PMID- 2702573 TI - A rational postoperative follow-up with carcinoembryonic antigen, tissue polypeptide antigen, and urinary hydroxyproline in breast cancer patients. AB - Breast cancer patients (n = 224) aged 28 to 81 were postoperatively followed up with serial determinations of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and urinary hydroxyproline (OHP). The clinical usefulness of these tumor markers to diagnose and monitor distant metastases was compared with that of the imaging techniques commonly used to monitor breast cancer patients (bone scanning [BS], liver echography [LE], chest radiograph, and skeletal radiograph). So far, 23 patients withdrew from the study, and distant metastases occurred in 33 patients. In 91% of the metastatic patients, constant elevation or progressive increase in serum CEA and/or TPA levels were the first pathologic findings of the relapse. Of the remaining 168 nonrelapsed patients, 122 were followed up longer than 24 months (43 +/- 17 months; mean +/- SD). In these 122 patients the false positive results of CEA, TPA, and OHP were 0.8%, 2.4%, and 0%, respectively, when used simultaneously with clinical examination and the common laboratory examinations. BS and LE are the only imaging techniques that showed such a high sensitivity to be suitable in the postoperative follow-up of breast cancer patients. Nevertheless, because BS has a low specificity and is not harmless, it should be performed at longer intervals than tumor markers. Eventually, in the relapsed patients, TPA and OHP well reflected the response to treatment better than CEA and prevented useless radiologic examinations. PMID- 2702574 TI - Dedifferentiated peripheral chondrosarcomas. A report of seven cases. AB - Peripheral dedifferentiated chondrosarcoma (CS) is an exceedingly rare variant of the highly malignant entity of dedifferentiated chondrosarcoma. Only five such cases have previously been reported. Seven cases are analyzed and evaluated for the presentation and natural history of this highly malignant lesion when it arises in a tumor that was previously an osteochondroma. Both peripheral and central dedifferentiated chondrosarcomas are high-grade malignant lesions and require wide or radical surgical margins for adequate treatment. Despite adequate resection, survival is poor; five of the seven cases presented herein died of metastatic spread of their disease. These cases of the peripheral variant of dedifferentiated chondrosarcoma occurred in patients who were younger than patients with central dedifferentiated chondrosarcomas and may be present with longer duration of symptoms because they occur in previously long-standing benign osteochondromas. As such, they may be easily overlooked clinically and radiographically. Therefore, careful histologic analysis of all cartilage lesions arising on the surface of bone is essential to prevent overlooking foci of high grade sarcomatous dedifferentiation. PMID- 2702575 TI - Influence of cigarette smoking on the presentation and course of chronic myelogenous leukemia. AB - It is known that cigarette smoking induces leukocytosis and increased genetic instability in normal individuals. Therefore, a retrospective review was conducted of 173 patients with chronic myelogenous leukemia to detect a possible influence of cigarette smoking on initial characteristics at the time of presentation and on the course of this disease. Thirty-nine patients (23%) were smoking 5 cigarettes/d or more at time of diagnosis. Cigarette smoking was significantly related to male sex (P = 0.0005) and younger age at diagnosis (P = 0.02) and smokers tended to have lower leukocyte counts (P = 0.07) than nonsmokers. Cigarette smoking was significantly associated with early blast crisis (P less than 0.0001) and short survival (P less than 0.0001). Other characteristics associated with a poor prognosis included hepatomegaly, anemia, and a high percentage of peripheral blast cells at time of diagnosis. When studied in a multivariate analysis, cigarette smoking remained the strongest prognostic factor for both occurrence of blast crisis (P = 0.0003) and overall survival (P = 0.0001). Other poor prognosis factors found in the multivariate analysis included a high percentage of blasts in the peripheral blood at time of diagnosis and high platelet count. It is possible that cigarette smoke may act as a promoter or cocarcinogen in the transformation of chronic myelogenous leukemia. PMID- 2702576 TI - The significance of an isolated central nervous system relapse, occurring as first relapse in children with acute lymphoblastic leukemia. AB - In a retrospective study, which comprised the whole Dutch childhood population of approximately 3 million children, the authors assessed the influence of an isolated meningeal relapse, occurring as first relapse, together with some patient and treatment characteristics on prognosis in 142 children with acute lymphoblastic leukemia (ALL). Until their first relapse, patients were initially treated according to standard protocols, whereas the treatment for relapse was heterogeneous. Concerning the probability of achieving a second complete remission (CR) it appears that the duration of the first CR is the single most important prognostic factor. The duration of the first CR is also the most important factor with regard to the duration of the second CR, upon which also age and sex have a significant influence. Concerning the survival from the time of central nervous system (CNS) relapse, again the duration of the first CR appears to be the most important prognostic factor, followed by age and the institution of systemic reinduction treatment. Other factors, such as initial leukocyte count, attainment of first CR within 48 days, type of reinduction treatment, and the cerebral spinal fluid (CSF) blast count at the time of relapse, have a less important, but nevertheless significant influence on survival. The median survival from the time of CNS relapse is 25 months, the 5 year survival is 25%, whereas the ultimate survival will be less than 20%. From 90 patients who developed second or subsequent relapses, 75% experienced a bone marrow relapse during the follow-up period. From this study the authors conclude that CNS relapse in children with ALL carries a grave prognosis, which requires the institution of intensive retreatment programs. PMID- 2702577 TI - Has the incidence of primary gastric lymphoma increased? AB - Various reports from the surgical and gastroenterologic literature have stated that the incidence of primary gastric lymphoma has increased. Other reports have claimed that this is a relative increase or represents referral center bias. The current study was designed to determine if the incidence of primary gastric lymphoma has increased in the community hospital setting. A total of 147 cases of gastric neoplasms were reviewed over a 10-year study period. The cases were divided into two 5-year periods, i.e., 1978-82 and 1983-87. There were two new cases (2.8%) of primary gastric lymphoma in the period 1978-82 and 11 new cases (19%) in the period 1983-87. The difference in proportion of primary gastric lymphoma between these two time periods was statistically significant (P = 0.01 by chi-square analysis). This increased incidence of primary gastric lymphoma is difficult to explain, but it must be recognized by surgeons and endoscopists. PMID- 2702578 TI - Transcatheter arterial embolization therapy in cases of recurrent and advanced gynecologic cancer. AB - Transcatheter internal iliac arterial embolization therapy (TAE) using Gelfoam particles was performed in 24 patients with recurrent gynecologic cancer and ten patients with advanced gynecologic cancer who had previously undergone radiotherapy. The tumor showed complete response (CR) to the therapy in six patients, partial response (PR) in 12, minor response (MR) in three, and no changes (NC) in 13 patients, with the response rate (CR + PR) of 52.9% (18 of 34). No serious or prolonged side effects were encountered except for vesicovaginal fistula in three patients and renal failure in one. The median duration of survival was 299 days, and the 1-year cumulative survival rate was 32.5%. The factors that were associated with favorable outcome after TAE were good general condition, no distant metastases, tumors less than 5 cm in diameter, and responses to the therapy of PR or better. Thus, TAE appears useful for the treatment of recurrent and advanced gynecologic malignancies. PMID- 2702579 TI - Chemotherapeutic treatment of the diencephalic syndrome. A case report. AB - Tumors of the hypothalamus present with a variety of clinical syndromes. Such syndromes appear to be both age and histology dependent. The diencephalic syndrome, an entity classically seen in infancy, presents as failure to thrive. In essentially all cases the pathologic substrate is a tumor with a predominance of gliomas. The traditional approach to treatment of the diencephalic syndrome has been surgery both for decompression and pathologic diagnosis followed by irradiation. Because of the tumor location, surgery is often confined to biopsy rather than radical extirpation. Furthermore, in infancy focal brain irradiation is not without significant morbidity. Within this context, we would like to present a case discussion regarding a 27-month-old boy with a hypothalamic midbrain protoplasmic glioma treated with primary chemotherapy after surgical biopsy and pathologic documentation. The schedule of drugs utilized was based on the hypothesis of biochemical modulation of nitrosourea chemotherapy. Successful response to therapy was documented by sequential computed tomography (CT) studies and serial neurologic examinations beginning at age 5 months and every 2 months thereafter. The response of a single patient with the diencephalic syndrome treated primarily with chemotherapy makes extrapolation premature. Rather, the authors suggest chemotherapy as an alternative to focal brain irradiation. Such therapy could be utilized either in the event of recurrent tumor or as late consolidation after primary treatment with chemotherapy. The latter approach would allow a patient to have radiation therapy deferred until a later age at which time morbidity attending brain irradiation may be minimized. PMID- 2702581 TI - Flow cytometry DNA ploidy analysis and catecholamine secretion profiles in neuroblastoma. AB - Previous studies have shown that catecholamine secretion patterns have been imperfect predictors of clinical behavior of neuroblastomas. Recently, studies of nuclear DNA content in neuroblastoma have shown that an aneuploid DNA content predicts favorable clinical behavior. To determine if a correlation exists between these tumor biologic indicators, the authors analyzed both in a series of 39 patients with neuroblastoma. Flow cytometric DNA analysis performed on paraffin blocks determined that 23 patients had tumors with aneuploid DNA content (aneuploid tumors) and 16 patients showed no demonstrable anomalies of tumor DNA content (nonaneuploid tumors). Comparison of catecholamine levels in urine and tumor homogenates with DNA content data indicate that nonaneuploid neuroblastomas include a significant number (P less than 0.02) of biochemically primitive tumors which secrete high levels of 3,4 dihydroxyphenylalanine (DOPA), dopamine and homovanillic acid (HVA). This suggests a dopamine-norepinephrine pathway block, which supports previous reports of deficiency of dopamine beta-hydroxylase activity in some neuroblastomas. The study shows that in contrast to aneuploid tumors, nonaneuploid neuroblastomas secrete higher levels of early pathway catecholamine metabolites and are more likely to present in higher (unfavorable) clinical stages of disease. PMID- 2702580 TI - Inhibition of radiogenic mammary carcinoma in rats by estriol or tamoxifen. AB - Mammary carcinomas have been induced by 3.5 Gy whole-body gamma radiation administered at age 40 to 50 days to virgin female Sprague-Dawley rats. In 142 irradiated controls carcinoma incidence averaged 7.8% in survivors observed less than 300 days and 38.3% of those surviving longer (P less than 0.001 by t test). Mammary cancer promotion was inhibited by two methods: estriol (E3) 638 micrograms/month (2.2 microns/mo) subcutaneously for natural life span begun 2 weeks after exposure reduced cancer incidence from 76% in controls to 48% after 331 to 449 mean days observation until neoplasia was palpable (P less than 0.02 by chi-square analysis). Uterine weights were similar in control and treated groups, and were 15% to 18% greater than uteri of nonirradiated controls from other simultaneous experiments. Six monthly 638-micrograms doses of 17 alpha ethinyl estriol (EE3) reduced tumors from 88% in controls to 64% (P less than 0.05 by chi-square analysis) and delayed cancer onset (P less than 0.01-0.04 by life table analysis). Ethinyl estradiol (EE2) after 6 months' treatment similarly delayed mammary tumor development reducing incidence to 75% (NS), with a six-fold increase in nonmammary epithelial malignant tumors. Estriol administration begun between 3 days before to 5 days after radiation did not alter mammary cancer incidence in six experiments. Monthly implantation of 2.5 mg tamoxifen (4.44 microns/mo) started 2 weeks after radiation reduced mammary cancer incidence from 83% to 14% after 307 to 314 days' observation (P less than 0.001 by chi-square analysis). Treated rats had atrophic ovaries and uteri consistent with blockade of endogenous estradiol activity. Short-term parenteral E3 or EE3 therapy using 10 to 30 micrograms/kg/day (35-100 microns/kg/day) rapidly differentiated virgin rat mammary glands without impairment of subsequent estrus cycles and offers an alternative to castration or life-long antiestrogen therapy for reduction of risk of radiogenic mammary carcinoma. PMID- 2702582 TI - Greater tendency for submucosal invasion in fundic area gastric carcinomas than those arising in the pyloric area. AB - Variation in tendency of gastric carcinomas for submucosal invasion according to the site of origin in the stomach was investigated. A total of 230 and 790 gastric carcinomas located in the fundic and pyloric areas, respectively, were used to determine rates of invasion (IR) beyond the lamina muscularis mucosae relative to the size and histologic type of lesion. The IR values increased with carcinoma size in both areas. However, carcinomas in the fundic area demonstrated significantly higher IR rates (P less than 0.003) in every size class and for both poorly and well-differentiated lesions. Moreover, whereas small (less than 10 mm) invasive carcinomas were remarkably frequent in the fundic area, large (greater than 81 mm) noninvasive (mucosal) carcinomas were almost exclusively limited to the pyloric area. Thus gastric carcinomas in the fundic area were clearly shown to have a greater tendency to become invasive than those in the pyloric area. This may be related to differences in local anatomical and physiologic conditions. PMID- 2702583 TI - Prognostic significance of DNA content with special reference to age in gastric cancer. AB - The authors studied 93 patients who had undergone curative resection for advanced gastric cancer to assess the prognostic significance of DNA ploidy in relation to patient age. The cancers were classified as low and high-ploidy carcinomas and the patients were grouped by age (22-44 years, 45-64 years, 65-79 years). The incidence of high ploidy cancers increased with age. The 5-year survival rate increased with patient age in the low ploidy group whereas it decreased with patient age in the high ploidy group. There was a statistically significant difference (P less than 0.05) in the 5-year survival between our oldest patients with low (100%) and high ploidy (25.7%) gastric cancer. High ploidy cancers manifested a higher incidence of vessel invasion and lymph node metastasis. Our findings indicate that analysis of the DNA distribution pattern in gastric carcinoma is of prognostic value especially in older patients. PMID- 2702584 TI - Villoglandular papillary adenocarcinoma of the uterine cervix. A clinicopathologic analysis of 13 cases. AB - The clinical and pathologic features of 13 cervical papillary adenocarcinomas of villoglandular type were reviewed. They occurred in patients 23 to 54 years of age, with ten patients younger than 40 years of age. Microscopic examination revealed surface papillae that ranged from tall and thin to short and broad and contained central fibrous cores typically containing numerous inflammatory cells. The papillae were usually lined by stratified epithelial cells with slight to moderate nuclear atypicality and mitotic activity and no more than a minor degree of cellular budding. The deeper portions of the tumors were composed of branching tubular glands separated by a fibrous or fibromatous stroma and were more or less sharply demarcated from the adjacent cervical stroma. A hysterectomy was performed in 12 cases and only a cone biopsy in one case. The cone biopsy specimen and four of the hysterectomy specimens contained no residual carcinoma. In six uteri adenocarcinoma was confined to the inner third of the cervical wall whereas in two there was deep invasion. Follow-up of 2 to 14 years' duration including more than 5 years in ten cases has revealed no evidence of recurrent tumor. The excellent prognosis of the patients in this small series and the young age of many of them suggest that this tumor may be managed by a procedure less radical than a hysterectomy provided the tumor is superficial, has been completely excised, does not exhibit vascular space invasion, and close follow-up examination is possible. PMID- 2702585 TI - Ethanol fixation of bladder irrigation specimens for flow cytometric analysis. A multiinstitutional study from the bladder cancer flow cytometry network. AB - Ethanol preservation of voided and catheterized urine has long been the standard for urinary cytologic study. In this report ethanol preservation of bladder irrigation specimens was evaluated for flow cytometric analysis in a multiinstitutional study requiring specimen transport. Specimens from ten patients obtained at one center were preserved for varying periods of time in 50% ethanol, then distributed by express mail to four other participating centers, up to 3000 miles distant. On receipt, from 1 to 3 weeks after collection, the samples were processed and examined by flow cytometric study using propidium iodide as the fluorochrome. Forty-six of the 50 (92%) analyzed specimens gave satisfactory histograms. In 41 of the 46 adequate samples (89%), an aneuploid peak in the alcohol preserved (propidium iodide stained) specimen correlated well with the fresh (acridine orange stained) specimen. However, there was variable loss of DNA stainability with a broadening of the coefficient of variation in some alcohol-preserved specimens and an increase in cellular debris so that measurements of DNA index and percent hyperdiploid cells were considered unreliable. The authors conclude that ethanol preservation of bladder irrigation specimens for short periods of time may be a feasible alternative when flow cytometric analysis cannot be carried out on fresh specimens, but that this is not optimal fixation for specimens that must be transported and further studies of other fixatives are recommended. PMID- 2702586 TI - Objective histopathologic grading of cutaneous malignant melanomas by stereologic estimation of nuclear volume. Prediction of survival and disease-free period. AB - Modern stereologic techniques enable unbiased and shape-independent estimation of the three-dimensional nuclear volume (Vv). This study investigates the prognostic impact of Vv in 47 patients with malignant melanomas (10 years of follow-up) and compares Vv to traditional prognostic parameters and two-dimensional morphometric estimates. The averaged Vv was 226 microns3 and 457 microns3 in Stage I and II melanomas, respectively. The Vv was significantly increased in the case of ulceration, nodular melanoma, and Clark's level greater than III. The Vv showed only poor correlation to two-dimensional morphometric estimates. Cox regression analysis indicated Vv to possess excellent prognostic information, only rivaled by tumor ulceration, the latter being a 100% predictor of metastatic spread. Histologic type, Clark's level of invasion, tumor thickness (according to Breslow), and patient sex were without independent prognostic significance, which may be due to attributes of the small data base. It is concluded that Vv may be a powerful prognostic indicator in cutaneous melanomas, suitable for objective malignancy grading. The clinical and prognostic value of nuclear Vv needs further investigation in a larger and contemporary series of patients with malignant melanomas. PMID- 2702587 TI - Individual risk of abdominal disease in patients with stages I and II supradiaphragmatic Hodgkin's disease. A rule index based on 341 laparotomized patients. AB - A multivariate analysis of the prognostic factors for clinical Stages I and II supradiaphragmatic Hodgkin's disease was carried out with a logistic regression model in 341 patients. The proportion of patients with positive staging laparotomy was greater in males, in individuals with several sites involved, mixed cellularity (MC) or lymphocyte depletion (LD) histologic types, systemic symptoms, or in patients with lower cervical involvement and higher erythrocyte sedimentation rate (ESR), serum copper, and LDH levels. Histology, presence of systemic symptoms (fever and sweats), and number of involved nodal regions were independent predictors of positive laparotomy. Mediastinal involvement is correlated to a significantly lower risk of positive laparotomy. Based on these observations, the individual risk for each patient of occult abdominal disease has been defined. PMID- 2702588 TI - Physical examination. Its role as a single screening modality in the Canadian National Breast Screening Study. AB - Although often recommended as an important component in screening for breast cancer, physical examination of the breasts (PE) by medical professionals has not been well evaluated. The Canadian National Breast Screening Study (NBSS) permits estimation of sensitivity, specificity, and positive predictive value (PPV) of PE alone as performed by screen-examiners because 50% of the 89,835 NBSS participants did not receive mammography. There were 19,965 women aged from 50 to 59 years who were eligible to receive four or five annual PEs from 77 nurse examiners, in 12 screen centers outside Quebec province and 58 physician examiners in three screen centers in Quebec. The gold standard was histologically proven breast cancer. When a test was positive the participant was referred to the study surgeon for review. For screens one to five, sensitivity was 83, 71, 57, 83, and 77; specificity was 88, 94, 96, 96, and 96; and PPV was 3, 3, 4, 3, and 4, respectively. For 25,620 women aged 40 to 49 years who were eligible to receive only one PE, sensitivity was 71, specificity 84, and PPV 1.5. Using a binomial regression model, X2 for heterogeneity suggested there was no difference between nurse and physician examiners (P = 0.6879). Similar estimates made for the surgeons who performed 8914 reviews showed that sensitivity and PPV were higher than for the screen examiners and specificity was lower. These results support the conclusion that physical examination of the breasts by trained nurses is a useful component in screening for breast cancer. PMID- 2702589 TI - Primary anterior mediastinal malignant teratoma. A case report with long-term survival. AB - Primary anterior mediastinal malignant teratoma is an uncommon tumor. A 17-year old girl presented with an advanced tumor extending parasternally. Therapy consisted of intraarterial iododeoxyuridine and irradiation followed by surgical resection after failing multidrug therapy. The patient is without evidence of disease 23 years after therapy. PMID- 2702590 TI - Patterns of occult bleeding in asymptomatic colorectal cancer. AB - The assumption that asymptomatic colorectal cancers bleed provides the rationale for widespread stool screening. The authors studied 12 patients with unoperated colorectal cancer but without colorectal symptoms and six healthy volunteers as laboratory controls. All stools were collected for 2 weeks and analyzed by the HemoQuant and Hemoccult tests. In controls, the mean HemoQuant value was 0.7 mg hemoglobin (Hb)/g stool (range, 0.1-1.8) and all stools were Hemoccult-negative. In cancer patients, the mean HemoQuant was 3.3 mg Hb/g (range, 0.3-13.2); stools were within the normal HemoQuant range (less than 2 mg Hb/g) in 38% and negative by Hemoccult in 70%. The mean cancer detection rate testing a single stool per patient was 57% for HemoQuant and 25% for Hemoccult (P less than 0.001). The detection rate rose testing multiple stools and was maximal with five stools at 83% for HemoQuant compared to 31% for Hemoccult (P less than 0.001). The authors conclude that fecal blood levels are commonly normal with asymptomatic colorectal cancer. Although higher with HemoQuant than Hemoccult, cancer detection rates by fecal blood testing appear to be lower than previously reported. PMID- 2702591 TI - Preoperative prediction of outcome in patients with rectal and rectosigmoid cancer. AB - This study evaluated the possibility of dividing patients with primary rectal carcinoma into prognostic groups before surgery based on preoperative serum levels of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and an antigen defined by the monoclonal antibody C-50 (CA-50), as well as on some easily available clinical characteristics providing prognostic information. The evaluation was made both for patients who were "potentially curable" by surgery and, among those, for patients who were "potentially cured." Using the Cox regression model, the serum levels of the three tumor markers, together with the knowledge of whether or not the tumor was polypoid were combined to make up the set of variables that best predicted patient outcome. These variables and their associated regression coefficients were used to classify the patients according to prognosis. The cancer-specific mortality rate for the 24% of potentially curable patients with the best prognosis was 15%; for the 26% of potentially curable patients with the worst prognosis, the cancer-specific mortality rate was 57%. For potentially cured patients among those who were potentially curable, the cancer-specific mortality rates for patients with the best and worst prognoses were 14% and 47%, respectively. The information provided by these preoperatively available variables together was comparable with that given by Dukes' staging system, but the latter system was more informative. On the other hand, some of the preoperative variables provided information not provided by Dukes' staging system. PMID- 2702592 TI - Colon cancer, physical activity, and occupational exposures. A case-control study. AB - A case-control study on colon cancer was conducted encompassing 329 cases and 658 controls. Occupations and various exposures were assessed by questionnaires. A decreased risk was found in persons with physically active occupations. This effect was most pronounced in colon descendens and sigmoideum with an odds ratio (OR) of 0.49 whereas no reduced risk was found for right-sided colon cancer. Regarding specific jobs, reduced ORs were found for agricultural, forestry, and saw mill workers and increased OR for railway employees. High-grade exposure to asbestos or to organic solvents gave a two-fold increased risk. Regarding exposure to trichloroethylene in general, a slightly increased risk was found whereas such exposure among dry cleaners gave a seven-fold increase of the risk. PMID- 2702593 TI - Operative treatment in stage I endometrial carcinoma with deep myometrial invasion and/or grade 3 tumor surgically limited to the corpus uteri. No recurrence with only primary surgery. AB - A prospective study was conducted to determine the effectiveness of primary surgical treatment without postoperative irradiation for patients with Stage I endometrial carcinoma possessing poor prognostic factors of deep myometrial invasion and/or histologic Grade 3 tumor, in whom no evidence of cancer spread was detected outside the corpus uteri at the time of staging laparotomy. All 18 patients who had only surgical treatment and cancer limited to the corpus uteri showed no evidence of disease in follow-up of 5 to 13 years. Only 26.7% (four of 15) patients with cancer spread beyond the corpus were disease-free. From these preliminary results, it is concluded that in patients with Stage I endometrial cancer who had no extracorporal spread upon adequate surgical staging, even with poor prognostic factors of deep myometrial invasion and/or Grade 3 tumor, postoperative radiation might not be necessary. PMID- 2702594 TI - Fine-needle core and aspiration biopsy. A new method for diagnosis of prostatic carcinoma. AB - Fine-needle aspiration of the prostate has failed to gain widespread acceptance among pathologists more familiar with histologic sections. The authors aspirated 27 freshly excised radical prostatectomy specimens with needles of varying caliber and type and found a 22-gauge Turner needle (Cook Incorporated, Bloomington, IN) which obtained large tissue fragments suitable for cell block preparation as well as high quality cytologic specimens. Thirty men with prostate nodules each had 14-gauge transperineal core biopsy and fine-needle aspiration. In 20 cases, cytologic smears and cell blocks and core biopsies agreed on a diagnosis: 12 benign and eight carcinoma. Of seven cases that were atypical by cytologic smears, five were benign on cell block and core; one was benign on cell block and carcinoma on core; and one was carcinoma on cell block and core. Three cases with scant specimens and diagnoses of carcinoma by cytologic smears were benign on cell blocks and cores: one contained seminal vesicle on review; one had repeat benign biopsies; and one had three microscopic foci of low-grade carcinoma in his radical prostatectomy specimen. This fine-needle aspiration technique provides histologic sections which are especially useful to those gaining experience with cytologic specimens of the prostate. Cases with discordant diagnoses on cell block and cytologic preparations warrant further evaluation. PMID- 2702595 TI - Treatment of nonmelanoma skin cancer at a large Australian center. AB - One thousand one hundred fifty-four cases of nonmelanoma skin cancer (NMSC) referred to the Consultative Skin Clinic at Peter MacCallum Cancer Institute (PMCI) (Melbourne, Australia) in 1980 were reviewed. The median age was 68 years, and the male to female ratio was 1.5:1. Final diagnosis was basal cell carcinoma (BCC) in 901 patients (78%), squamous cell carcinoma (SCC) in 242 patients (21%), and basosquamous carcinoma in 11 patients (1%). Seven hundred twelve (62%) were biopsy proven. Comparison of clinical and histologic diagnoses showed that BCC were correctly diagnosed clinically in 85% of cases but only 53% of SCC were correctly diagnosed. The distribution of sites was as follows: head and neck 871 (75%), limbs 131 (11%), trunk 50 (4%), and multiple sites 102 (9%). One thousand eighty-nine (94%) had primary lesions and 65 (6%) had recurrent lesions. The lesions were treated with surgery in 55% of cases, superficial radiotherapy in 39%, other types of radiotherapy in 3%, cryotherapy in 1%, and 5-fluorouracil in 0.2%. Recurrent lesions, lesions on the eyelids, ears or nose, and T4 lesions were significantly associated with increased failure rates. Superficial radiotherapy was associated with a 2.3-fold increase in failure rate compared to surgery when other prognostic factors were taken into account (P = 0.01, 95% confidence interval = 1.2-4.3). Nonsuperficial radiotherapy was associated with an 11.5-fold increase in failure rate compared to surgery (P less than 0.0001, 95% confidence interval = 4.9-27.1), but several of these cases were treated for palliative purposes only. The results of, and indications for treatment with surgery or radiotherapy at PMCI are discussed. PMID- 2702596 TI - Approaches to fast MR imaging. AB - Fast MR scanning may be accomplished through a number of strategies as discussed below. Each technique accomplishes improvements in scan time at the expense of signal and noise, spatial resolution, contrast resolution or other imaging artifacts. The scanning strategies discussed are in a variety of stages of clinical implementation, although several are already in wide spread use. All the existing techniques offer improvements in scan time, but they are still far from the theoretical limits imposed by the physics of MR scanning and further reduction in MR scanning time maybe expected in the future. PMID- 2702597 TI - Computed tomographic detection of a swallowed denture. AB - A 89-year-old, nursing home female presented with a two-week history of drooling and a hard palpable mass in the region of the larynx. Initial fiberoptic laryngoscopy revealed a hard pinkish-white mass which was felt to represent a tumor. Computed tomography demonstrated swallowed, impacted, complete, mandibular denture. Radiologists should be aware of this problem, particularly in the elderly demented patient. PMID- 2702598 TI - CT appearance of primary pleural lymphoma. AB - We report a case of primary pleural lymphoma. The CT appearance was of hemorrhagic pleural effusion with thickened membranes. The CT evaluation of pleural disease is discussed. PMID- 2702599 TI - Pleural metastasis of malignant thymoma. A pitfall in the CT-diagnosis of pleural mesothelioma. AB - We report two cases with metastatic thymomas mimicking the CT feature of pleural mesothelioma. PMID- 2702600 TI - Adrenal cortical carcinoma with hepatic metastasis: preoperative radiological evaluation. AB - Preoperative evaluation of a patient with adrenal carcinoma and hepatic metastases was performed by arteriography, computed tomography (CT) and computed tomographic arteriography (CTA). Early and complete demonstration of tumor involvement by these imaging modalities allowed an accurate assessment of tumor extension and subsequent aggressive surgical removal of the primary as well as the metastasis in the liver. PMID- 2702601 TI - CT of emphysematous gastritis. AB - Emphysematous gastritis is a serious, often fatal condition. It is the result of destruction of the mucosal membrane with subsequent bacterial invasion of the stomach. We have encountered two cases at CT. Recognition is important since early intervention may be lifesaving. PMID- 2702602 TI - CT and myelogram findings of os odontoideum. AB - We reviewed the findings of CT and myelogram of cases of os odontoideum. The diagnosis was confirmed by conventional tomogram in all these cases. Four cases were further confirmed by trans-oral decompression. Cartilage was found between the os odontoideum and the odontoid process during operation in these 4 cases. Four of them had no history of trauma and 2 of them had an associated anomaly; one was Down's syndrome, and the other was barrel chest and congenital dislocation of hips. CT findings of os odontoideum in these cases were a constriction and/or a gap of bony structure between the os odontoideum and the odontoid process. Myelograms showed spinal stenosis as a result of atlanto-axial dislocation, or anterior extradural compression from overgrown cartilage and posteriorly dislocated tip of shortened odontoid process. PMID- 2702603 TI - Subcortical lobar hematomas: clinico-computed tomographic correlations. AB - Eighteen patients with subcortical lobar hematomas were reviewed. Arterial hypertension was the leading cause and three had arteriovenous malformation and were treated surgically. More than half of cases had hematomas of either the temporooccipital or occipital lobes. Common neurologic findings were headaches, vomiting, alertness, dysarthria, hemiparesis and hemianopsia. All patients survived and had better resolution of neurological deficits, suggesting that surgical intervention is not necessary. PMID- 2702604 TI - Subdural mass lesion secondary to sarcoid granuloma MR and CT findings and differential diagnosis. AB - A patient with surgical and neuropathologically confirmed subdural sarcoid granuloma was evaluated using angiography, contrast-enhanced CT and MR. MR images were obtained on a superconducting magnet with T1, intermediate and multi-echo T2 weighted sequences. Review of the 2 prior cases of subdural sarcoid granuloma from the literature evaluated with MR confirm the variable nature of signal intensities of the lesion. MR was most useful in anatomically evaluating the lesion and planning neurosurgical intervention but both CT and MR alone, in this case, did not definitely obviate the other differential diagnosis including meningioma en-plaque, lymphoma, or metastasis. PMID- 2702605 TI - Primary cerebral lymphoma in acquired immunodeficiency syndrome (AIDS)--CT manifestations. AB - Primary lymphoma of the brain in AIDS is being observed with increased frequency; five pathologically proven cases are presented. Although the CT patterns may correlate well with patterns previously described in lymphoma, occasionally an irregular ring-like lesion may occur which is difficult to distinguish from toxoplasmosis or other inflammatory processes without appropriate pathological material. PMID- 2702606 TI - Capillary growth in the mesentery of normal young rats. Intravital video and electron microscope analyses. AB - Capillary sprouting was studied by a combination of intravital video recording and subsequent electron microscopy in the mesentery of young female rats without previous experimental manipulation. Selected segments of the mesenteric microvascular bed with capillary sprouts were carefully surveyed and mapped at a monitor magnification of 255 times and submitted to detailed in vivo analysis concerning flow pattern and cells at 2000 times magnification. The mesentery was preserved for light and electron microscopy by a superfusion of glutaraldehyde while observed and recorded on video, confirming earlier investigations that this type of fixation does preserve exceptionally well vascular topography and diameters of the mesenteric microvascular bed. Capillary sprouts originated as endothelial spurs from arteriolar-venular arcades and continued to grow in size through a bipolar rearrangement of endothelial cells, forming a solid sprout tip which progressively lengthened by alternately rapid and slow growth phases. The extended leading tip of the migrating endothelial cells displayed microspikes and pseudopodia denuded of basal lamina. The cytoplasm of the leading tip contained an array of microtubules, 75 A filaments and many small vesicles. In similarity with the situation in nerve growth cones, all these organelles probably participate in cytoplasmic streaming and cell migration. The sprout lumen arose between endothelial cells of the solid sprout. Mesenteric connective tissue fibroblasts approached and settled down on the sprouts, being converted to pericytes as the fibroblasts became enveloped by a basal lamina. The pericytes reinforced the wall of the delicate and fragile capillary sprouts, and trapped plasma, platelets and red blood cells which had leaked out temporarily, in the process assuming an umbrella shape. The arteriolar feeder of the arcades was surrounded by cells which were classified as intermediate between pericytes and true smooth muscle cells. Sprouts that presumably were on the verge of merging with other capillaries were analyzed for indications of how anastomoses are formed. PMID- 2702607 TI - Cytochemical and ultrastructural characteristics of the stallion epididymis (Equus caballus). AB - The epididymis of stallion castrated during the breeding and non breeding seasons were subdivided into six regions and their ultrastructural and cytochemical characteristics were studied in order to provide a better understanding of the structure-function relationship of this androgen target organ. Even when the stallion has been postulated to be a seasonal breeder, our results do not show significant ultrastructural or cytochemical differences in both seasons. The pseudostratified epithelium is composed mainly of principal and basal cells and intraepithelial lymphocytes. The principal cells show morphological features of protein or glycoprotein secretion, especially in the caput epididymidis. Although PAS, CFH and AB positive substances were found throughout the epididymis, the reactivity was maximal in the caput region. This positive reaction can be ascribed to acidic glycoproteins. In stallion tissues, 4.0 acetylated sialic acid occurs in relatively high amount and is possible that the acid glycoprotein observed in our material have also this characteristic. The principal cells of the distal caput and corpus epididymides also display morphological hallmarks of absorptive and anabolic activity. These results are consistent with the histological reactions that demonstrate that the enzymes involved in active transport showed the strongest reaction in the corpus region. The acid phosphatase reaction was also strongest in these segments. In the cauda region, where the spermatozoa are stored ready for ejaculation, morphological signs of metabolic activity were also observed, but less notorious than in the more proximal segments. Resorption of non ejaculated spermatozoa was also observed in this region. It is difficult to evaluate the functional meaning of the spermatophagy in the epididymis because the images of sperm phagocytosed by epithelial cells were seen only in one or two cases. The chemical composition of the epididymal fluids changes along the length of this organ, concomitantly with the sperm maturation process, and it is possible to assume that some of these changes are a result of the secretory and absorptive activities of the principal cells. PMID- 2702608 TI - Dermal alterations in patients with Wilson's disease treated with D penicillamine. AB - Wilson's disease is characterized by accumulation of copper and D-penicillamine favors its elimination. However, penicillamine binds to precursors of intermolecular crosslinks both in collagen and elastin, and could lead to alterations of these two fibrous proteins. In the present report skin biopsies from patients with Wilson's disease, treated with 900 mg/day of D-penicillamine, for 5, 9, 58 and 60 months, were studied by electron microscopy and compared with findings obtained from skin biopsies of age-matched normal subjects. Clinically, the elasticity and consistency of the skin of Wilson's patients was not modified by D-penicillamine treatment. The ultrastructural organization of collagen fibrils appeared normal in the adults treated with D-penicillamine for 5-9 months. In a 15-year-old girl, treated for 48 months, a high number of collagen fibrils were swollen and unreeved. Elastin fibers were altered in all patients. The alterations were mostly pronounced in the reticular dermis, were proportional to the time of treatment, and consisted of polymorphous aggregates of elastin connected to apparently normal elastin fibers. A stereological analysis, on EM pictures from the patient treated for 60 months, and from an age-matched control, showed a significant decrease in the percentage of collagen and of the mean area occupied by each collagen bundle in the reticular dermis of the patient compared to control; on the contrary, the number of elastin fibers per unit area increased significantly, and the mean area of each elastin fiber decreased. The volume density of elastin was similar to control. The results indicate that prolonged administration of penicillamine to humans induces alterations in the deposition of dermal collagen and elastin. PMID- 2702609 TI - Amsacrine-induced cytoplasmic rods. AB - Amsacrine induces cytoplasmic rods in cultured epithelial cells derived from adult rat liver hepatocytes (ARL6T). Rods become visible two hours after treatment of cells with 10 microM amsacrine. At 24 h, multiple rods are present in nearly every cell. Ultrastructural examination of treated cells reveals structures 5-10 microns in length and 0.2 to 0.3 micron in width. These rods are not found in untreated ARL6T cells. This consistently-induced morphologic finding represents a newly described drug effect. The mechanism of formation of these rods and their role in amsacrine cytotoxicity is at present unknown. PMID- 2702610 TI - Modified endoplasmic reticulum in taste bud cells of the Japanese monkey. AB - Type III cells (receptor cells) in taste buds of vallate papillae in the Japanese monkey often have one or more cytoplasmic bodies composed of modified smooth endoplasmic reticulum in the form of concentric smooth-surfaced cisternae, up to 18 in number. The most peripheral cisternae may be in continuity with rough endoplasmic reticulum (RER). Type II cells have dilated RER cisternae that often contain crystalline plates with an axial periodicity that ranges from 17 to 27 nm. These observations show that both type III and type II cells of the Japanese monkey possess the cytoplasmic machinery to carry out several secretory functions. PMID- 2702611 TI - Centriolar length variability in testicular cells from side-necked turtles. AB - Silver nitrate staining of surface spread testicular material from side-necked turtles revealed centrioles associated with the nuclei of Sertoli cells, spermatogonia, primary spermatocytes, and spermatids. Sertoli cells possessed minute centrioles comparable to those described in somatic tissues of other organisms. The other three cell types contained greatly enlarged centrioles, with those of the primary spermatocytes and spermatids exhibiting maximum lengths of 4 5 microns. During spermatogenesis, the centriolar pair apparently replicated only at prophase I, as the developing spermatids each possessed only one centriole. PMID- 2702612 TI - The influence of bromocriptine on the ultrastructure of cultured T47D (human breast cancer) cells. AB - Following a previous ultrastructural study of untreated T47D human breast cancer cells, we studied the influence of bromocriptine on the same cell line with the electron microscope. Our results suggest that bromocriptine exerts a direct effect on the morphology of T47D cells, which after treatment were better preserved. Some morphological evidence was noted hinting that colchicine and bromocriptine may have some similar properties. It is possible that the T47D cell line is biologically responsive to bromocriptine and therefore it is a potentially useful model for studies on the mechanism of action of bromocriptine on the morphological level in human breast cancer. PMID- 2702613 TI - Attachment to and phagocytosis of mineral by alveolar bone osteoclasts. AB - The mechanisms by which the osteoclast attaches to and resorbs bone are not fully understood. Morphologic techniques have primarily been used to examine these mechanisms, but many studies have been based on decalcified material. In this study, the attachment of the osteoclast to alveolar bone and its relationship to the mineral component during the active resorption associated with tooth eruption in the rat was examined using transmission electron microscopy and techniques designed to minimize demineralization effects during processing. Large conglomerates of bone mineral were found within both the ruffled border and the vacuoles adjacent to this area. These deposits were clearly more extensive than the isolated mineral fragments described in other sites by previous investigators. Examination of demineralized sections showed that collagen was largely absent within the ruffled border, and not present within vacuoles. These observations suggest that phagocytosis of bone mineral may supplement its extracellular dissolution in situations associated with rapid bone turnover, such as tooth eruption. Two types of clear zone attachment to mineral were also observed, permitting further speculation on the mechanism by which osteoclasts attach to and move along the bone surface. PMID- 2702614 TI - Viruses and annulate lamellae in Friend erythroleukemia cells. AB - Virus formation in a clone of murine undifferentiated Friend erythroleukemia cells was examined by electron microscopy. Budding C-type particles were present at the cell surface. The principal site of intracisternal particle production was in elements of rough-surfaced endoplasmic reticulum disposed about the periphery of stacks of annulate lamellae. Serial sections demonstrated that these virus laden cisternae were in direct continuity with the annulate lamellae. In addition, intracisternal particles occurred in membranous honeycomb structures present in the cytoplasm of many cells. Viral elaboration also was associated with stacks of cisternae of endoplasmic reticulum that were devoid of ribosomes, but that were coated with an extensive and continuous layer of dense material. In some instances, the outer nuclear membrane was coated with the same dense substance. It appears that in Friend erythroleukemia cells, a very substantial portion of their cytomembranes is devoted to synthesis of intracisternal particles. PMID- 2702615 TI - Trisomy 13 in a case of myelodysplastic syndrome. AB - The clinical and cytogenetic findings of a patient with refractory anemia with excess of blasts are presented. Trisomy 13 was present as the sole numerical aberration in all analyzed bone marrow metaphases; this finding has not been reported previously in myelodysblastic syndrome. PMID- 2702616 TI - A uterine leiomyoma showing both t(12;14) and del(7) abnormalities. AB - The involvement of chromosomes 12 and 14 in uterine leiomyomas has been well established. However, in a recent report of only a del(7)(q22.1q31.32) or (q11.2q22.3) in two cases of typical uterine leiomyoma, Boghosian et al. hypothesized that this could represent a cytogenetic subgroup of uterine leiomyomas. We report a case of uterine leiomyoma with both the t(12;14) and del(7) in all the cells examined and discuss the implications of this in terms of critical chromosomal rearrangements underlying the route to benign cellular proliferation. PMID- 2702617 TI - A t(3;5) in blastic phase of a Philadelphia chromosome-negative chronic myeloid leukemia. AB - Serial cytogenetic analyses from the bone marrow of a patient with blastic phase of a Philadelphia chromosome-negative chronic myeloid leukemia revealed a t(3;5)(p21;q31). The literature on translocations involving chromosome 3 and the long arm of chromosome 5 is reviewed. The importance of breakpoints in band 5q31 is discussed. PMID- 2702618 TI - T-cell receptor gene rearrangement and its expression in human myeloid leukemia cell lines. AB - ML cell lines (ML-1, -2, and -3) were derived from the cells of a patient with acute myelocytic leukemia preceded by a T-cell malignant lymphoma. A deletion of chromosome 11 (11q-) was common to the affected cells in both neoplastic phases. We report here that the three ML cell lines have DNA rearrangements of the T-cell receptor (TcR)-beta and gamma-chain genes in addition to immunoglobulin heavy chain gene rearrangement, though they do not have TcR gene messages. The findings presented here indicate that ML cell lines could be used as models for the elucidation of the bilineal nature of hematopoietic neoplastic cells, though they have a biphenotypic (myelomonocytic/T-cell) marker expression. PMID- 2702619 TI - Cytogenetic studies of Hodgkin's disease. Analysis of involved lymph nodes from 12 patients. AB - Cytogenetic studies were performed on 12 involved lymph nodes from Hodgkin's disease patients utilizing conditioned medium from 12-O-tetradecanoylphorbol-13 acetate-staphylococcus enterotoxin A induced mononuclear cells. The majority of cells analyzed had a normal karyotype. An unusually high rate of nonclonal karyotypic abnormalities was noted in most cultures. Clonal abnormalities involving chromosomes 3 and 21 were noted in two patients. Cytogenetic analysis of cultures stimulated with conditioned medium or specific growth factors may lead to a better understanding of the genetic mechanisms involved in Hodgkin's disease. PMID- 2702620 TI - Chromosome abnormalities in a pancreatic adenocarcinoma. AB - Short-term cultures initiated from a pancreatic adenocarcinoma were cytogenetically investigated. The composite karyotype was 74 76,XX,+X,+2,+3,+del(3)(p21),+5,+5,+der(7) t(1;7)(q21;p22),+der(7),del(8)(p21),+del(8)(p21),+der(8)t(8;?)(q24; +),+9,+9,+10,+10,+11,+11,+12,+13,+14,+der(14)t(14; +)(p11;?),+der(16)t(15;16)(q11;p13),+der(16),+der(17)t(17;?) (p11;?),+der(17),+18,+20,+20,-21,-21,+22,+22,+1-3mar. A comparison with the few previously cytogenetically characterized cases of this tumor type reveals no consistent abnormalities. PMID- 2702621 TI - Cytogenetic observations in a human gastric leiomyosarcoma. AB - The chromosomes of a human gastric leiomyosarcoma were studied in preparations from short-term cultures. The tumor had a triploid-near-triploid modal population characterized by extensive numerical and structural changes. Of these deviations, del(1)(p12-13), monosomy 14, and underrepresentation of chromosomes 18 and 22 were abnormalities in common with two of the three previously studied leiomyosarcomas of the small bowel. PMID- 2702622 TI - Chromosome 17p loss in carcinoma of the cervix uteri. AB - Markers derived from chromosome 17 were present in 13 (42%) of 31 carcinomas of the cervix uteri. Altogether, 14 such markers were present, ten of which were 17p+ chromosomes with a small amount of additional material, probably of variable origin, while three were i(17q)s. The significance of the chromosome 17 aberrations in cervical carcinoma may lie in the loss of recessive genes on 17p. PMID- 2702623 TI - Basosquamous papilloma. A benign epithelial skin tumor with multiple cytogenetic clones. AB - Cytogenetic analysis of short-term cultures from a basosquamous papilloma revealed the following mosaic karyotype: 46,XX,t(2;5)(q31;q31),t(8;15)(p21;q21)/46,XX,t(7;17)(p13;p13)/47,XX, t(3;20)(q12;p13),+7/46,XX,t(1:12)(p12;q13). The finding of four abnormal, cytogenetically unrelated clones suggests a multicellular origin of this benign skin tumor. None of the structural rearrangements encountered have previously been associated with neoplasia. PMID- 2702624 TI - Chromosome analyses of human mammary epithelial cells at stages of chemical induced transformation progression to immortality. AB - Benzo(a)pyrene induced extended life (EL) (i.e., a longer than normal proliferative lifespan before senescence) of human breast cells in culture. From many EL cell cultures immortalized cells emerged only once in each of two separate experiments. The original EL cells were mostly normal diploid with only a small percentage of tetraploid cells. The two immortalized cell lines, however, were near diploid, each containing a set of chromosomal aberrations that were present in all the cells analyzed, confirming the clonal origin of both cell lines. For cell line 184A1 the aberrations consisted of deficiencies only, whereas a combination of deficiencies and duplications characterized the 184B5 line. None of the individual aberrations of each set were shared by both cell lines. Both sets of aberrations have remained stable for over 150 population doublings, while some of the other chromosomes showed breakage and reunions. These data are discussed in regard to types of mutations in the sequence of changes from primary to immortalized cells, and it is concluded that the sets of aberrations most likely originated as multiple events in a single cell. PMID- 2702625 TI - Cytogenetic and clinical studies in acute promyelocytic leukemia (M3) and cytologic M3 variant (M3V). AB - Cytogenetic specimens were obtained from bone marrow 24-hour cultured cells in 22 patients with acute promyelocytic leukemia, including six with microgranular variant. A t(15;17) was identified in 10-100% of metaphase cells from 13 patients. We have found no correlation between complete remission percentage and karyotype. Our data suggest that each laboratory, as far as M3 and M3V are concerned, must study its own culture time as it relates to numerous parameters involving tumoral cell kinetics. PMID- 2702626 TI - Translocation t(1;11)(q21;q23), a new subgroup within M4 acute nonlymphocytic leukemia. AB - A case of acute myelomonocytic leukemia (M4) with a t(1;11)(q21;q23) as the sole chromosome anomaly is presented. The results, taken with those of previously published cases, point to the possibility of a subgroup within M4. PMID- 2702627 TI - Instability of integrated hepatitis B virus DNA with inverted repeat structure in a transgenic mouse. AB - We established four cell lines, from the liver cells of a transgenic mouse, constructed with hepatitis B virus DNA that had an inverted repeat structure. The integrated DNA patterns of the four established cell lines were different from one another and from the original pattern. These data show that the instability of integrated hepatitis B virus DNA would also occur in somatic cells during replication, apart from meiosis, which was previously reported. PMID- 2702628 TI - A case of inv(5) in non-Hodgkin's lymphoma. PMID- 2702629 TI - Involvement of 6p in benign lipomas. A new cytogenetic entity? PMID- 2702630 TI - Clonal chromosome aberrations in normal kidney tissue from patients with renal cell carcinoma. PMID- 2702631 TI - Sister chromatid exchange and betel quid chewing. PMID- 2702632 TI - An unusual t(9;12)(p13;q24) in childhood acute lymphocytic leukemia. PMID- 2702633 TI - The role of O6-alkylguanine DNA alkyltransferase in limiting nitrosourea-induced sister chromatid exchanges in proliferating human lymphocytes. AB - Although induction of sister chromatid exchanges (SCEs) following nitrosourea exposure may be greater during cell proliferation, the increase could be offset by the action of the DNA repair protein O6-alkylguanine DNA alkyltransferase (alkyltransferase). To evaluate these factors in resting and proliferating (phytohemagglutinin stimulated) human lymphocytes, we studied the effect of changes in alkyltransferase activity on 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU)-induced SCEs. Phytohemagglutinin stimulation resulted in induction of alkyltransferase activity (5.9 +/- 0.3 units, resting, versus 9.2 +/- 0.2 units, proliferating). In both resting and proliferating lymphocytes the alkyltransferase activity was inactivated by 85-88% after an 18-h exposure to 0.5 mM of the modified base O6methylguanine (O6mGua). However, 48 h after removal of O6mGua, proliferating lymphocytes recovered alkyltransferase activity while resting cells did not. In the absence of O6mGua, both resting and proliferating lymphocytes were equally sensitive to BCNU-induced SCEs. Following inactivation of the alkyltransferase by O6mGua, BCNU-induced SCEs were markedly increased, but the increase was much greater in resting than proliferating cells, 4-fold vs. 2.6 fold at each dose of BCNU (P less than 0.001). The factors providing partial protection against BCNU-induced SCEs in proliferating lymphocytes appear to include the proliferation-dependent increase in alkyltransferase activity and the ability of proliferating lymphocytes to rapidly recover alkyltransferase activity after its inactivation. Thus, the alkyltransferase appears to provide an important mechanism of resistance to SCE induction in human lymphocytes. PMID- 2702634 TI - Preclinical antitumor activity of an alpha-picoline derivative, penclomedine (NSC 338720), on human and murine tumors. AB - Penclomedine, a synthetic alpha-picoline derivative, was identified as a potential antitumor agent in the P388 leukemia prescreen of the National Cancer Institute. Upon further evaluation in the National Cancer Institute in vivo tumor panel, the compound demonstrated good activity against two breast tumors. A single i.p. dose or five daily doses caused partial regressions of advanced-stage s.c. implanted mouse CD8F1 mammary adenocarcinomas. Also, penclomedine administered i.p. on Days 1,5, and 9 caused regression of the human MX-1 mammary carcinoma implanted under the renal capsule of athymic mice. In contrast, penclomedine demonstrated only marginal to moderate activity against the i.p. implanted L1210 leukemia and M5076 sarcoma and was inactive in three additional non-breast tumor models (i.p. B16 melanoma, i.v. Lewis lung carcinoma, and s.c. colon adenocarcinoma 38). Penclomedine administered p.o. and i.p. was equally effective against the subrenal capsule MX-1. Doses given p.o. every fourth day caused complete regression of 39 of 40 advanced-stage s.c. implanted MX-1 tumors but were much less effective against human H82 small cell lung carcinomas (13 of 80 complete regressions). Penclomedine p.o. also inhibited growth of the human MCF-7 and mouse 16/C breast adenocarcinomas. Further studies to support the development of penclomedine to clinical trial are in progress. PMID- 2702635 TI - Formation of cigarette smoke-induced DNA adducts in the rat lung and nasal mucosa. AB - The formation of DNA adducts in the nasal, lung, and liver tissues of rats exposed daily to fresh smoke from a University of Kentucky reference cigarette (2R1) for up to 40 weeks was examined. The amount of smoke total particulate matter (TPM) inhaled and the blood carboxyhemoglobin (COHb) values averaged 5-5.5 mg smoke TPM/day/rat and 5.5%, respectively. The pulmonary AHH activity measured at the termination of each experiment showed an average increase of about two- to threefold in the smoke-exposed groups. These observations suggested that animals effectively inhaled both gaseous and particulate phase constituents of cigarette smoke. DNAs from nasal, lung, and liver tissue were extracted and analyzed by an improved 32P-postlabeling procedure. The results showed that the mainstream cigarette smoke induced a spectrum of at least four new DNA adducts in the nasal mucosa of the exposed rats and the magnitude of these adducts increased with the duration of exposure. In the lung tissue, the smoke exposure induced an accumulation of one DNA adduct, which upon cessation of exposure for 19 weeks was reduced by about 75%. Smoke-related adducts were not detected in the liver, a nontarget tissue. Selective chromatography and butanol extractability suggested that the nasal and lung DNA adducts are aromatic and/or hydrophobic in nature and that the smoke-related lung DNA-adduct may contain polar group(s). These data demonstrate the DNA-damaging potential of long term fresh cigarette smoke exposure and suggest the ability of the tissue to partially recover from such damage following cessation of the exposure. PMID- 2702636 TI - Transformation-induced changes in transferrin and iron metabolism in myogenic cells. AB - The uptake of transferrin and iron by cultured myogenic cells transformed with a temperature-sensitive strain of the Rous sarcoma virus (tsLA24) was compared with that of normal developing myogenic cells which were proliferating at the same rate as the transformed cells. The mechanism of transferrin and iron uptake was the same in the transformed cells as in normal myogenic cells and involved receptor-mediated endocytosis of transferrin. However, there were differences in transferrin receptor numbers and receptor function. The number of receptors in transformed cells was more than twice as great as in the normal cells largely due to increased surface receptor numbers. Despite this, the rate of iron uptake increased by only 20% in the transformed cells due to less efficient cycling of the transferrin receptors and less efficient release of iron from transferrin to intracellular sites. Some internalized iron was released from the transformed cells still bound to transferrin. A fast and a slow rate of transferrin exocytosis were identified in transformed cells, as in normal cells, indicating that there were at least two intracellular pathways for transferrin. The fast pathway predominated in the transformed cells, compared with an equal importance of the two pathways in the normal cells. PMID- 2702637 TI - Heat sensitivity, thermotolerance, and profile of heat shock protein synthesis of human myelogenous leukemias. AB - In anticipation of using single or fractionated hyperthermia treatment in ex vivo purging of leukemic bone marrow in the clinic, we have compared the hyperthermic sensitivity, kinetics of thermotolerance, and heat-shock protein synthesis in three human myelogenous leukemic cell lines. In terms of heat sensitivity, the chronic myelogenous leukemic cell line K562 was found to be the most resistant. The Dos of the 43, 44, and 45 degrees C heat survival curves were 22, 13, and 6 min, respectively. HL-60 and KG-1, both acute myelogenous leukemic lines, however, were found to be several fold more sensitive to the cytotoxic effects of heat. The Dos of the 43, 44, and 45 degrees C heat survival curves for HL-60 were 7.6, 5.6, and 2 min and for KG-1 were 5.7, 4.5, and 1.7 min, respectively. All cell lines developed thermotolerance. However, K562 developed more tolerance which lasted for longer times. For K562 cells at priming heat doses of 45 degrees C/10 min, 42 degrees C/2 h, or 41 degrees C/2 h thermotolerance was maximum at 4 to 6 h and began to decay at 24 h. HL-60 and KG-1 cells showed some thermotolerance at the priming doses of 45 degrees C/5 min or 42 degrees C/30 min and had fully decayed by 24 h. K562 cells synthesized Mr 70,000 heat shock protein for over 24 h following the 45 degrees C/10 min heat shock, while HL-60 and KG-1 synthesized Mr 70,000 heat shock protein for 2-4 h for the same amount of cell kill. These studies suggest that most human leukemias may be extremely sensitive to the cytotoxic effects of heat, and in vitro purging of leukemias from bone marrow specimens by heat needs to be further studied both by in vitro and in vivo model systems. PMID- 2702638 TI - Expression of a folate binding protein in L1210 cells grown in low folate medium. AB - We have isolated variants of L1210 cells (L1210B) expressing, in addition to the "classical" high affinity/low capacity system for reduced folate uptake, high levels of a membrane-associated folate binding protein. This folate binding protein was expressed in L1210 cells grown at low physiological folate levels (less than 0.5 nM), but down-regulated after transfer in standard high folate (2 microM) medium. The binding capacity of L1210B cells for [3H]folic acid and [3H] methotrexate was identical (5-11 pmol/10(6) cells) but affinities were different. The affinities relative to folic acid were 0.5 for 5-methyltetrahydrofolate, 0.25 for 5-formyltetrahydrofolate, 0.08 for 10-ethyl-10-deazaaminopterin, and 0.05 for methotrexate, respectively. L1210B cells exposed to low extracellular concentrations of [3H]folic acid (25 nM) accumulated 15 pmol [3H]folic acid/10(7) cells over a 5-h period. [3H]Folic acid accumulation by wild-type L1210 cells could not be demonstrated under these conditions. The folate binding protein in L1210B cells could be specifically and covalently labeled at 4 degrees C with a N hydroxysuccinimide ester of [3H]-methotrexate or [3H]folic acid. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of detergent-solubilized membrane proteins showed a major labeled band with Mr 42,000-44,000. PMID- 2702639 TI - Interaction of CC-1065 and its analogues with mouse DNA and chromatin. AB - CC-1065 is a potent antitumor antibiotic which is cytotoxic to P388 and L1210 leukemia cells in vitro and in vivo. CC-1065 covalently binds to calf thymus DNA preferentially to adenine-thymine regions at N3 of adenine. Here, we compare CC 1065 interaction with P388-derived chromatin, DNA, and histones as measured by electronic absorption and circular dichroism. Two CC-1065 analogues (U-71,184 and its enantiomer, U-71,185) which show different biological activities from CC-1065 were also studied. The shape and temporal behavior of the induced circular dichroism curves generated by CC-1065 or its analogues bound to chromatin were similar to CC-1065 plus DNA. This suggested that CC-1065 and its analogues bind to the minor groove of chromatin DNA in a manner similar to calf thymus DNA. However, the binding of CC-1065 and its analogues to DNA induced a more intense circular dichroism band than binding to chromatin. The order of interaction for both chromatin and DNA was CC-1065 greater than U-71,184 greater than U-71,185. In contrast to the essentially irreversible binding to DNA after 24-h incubation, binding to chromatin was primarily a reversible interaction, the degree of reversibility being U-71,185 greater than U-71,184 = CC-1065. CC-1065 binds weakly and nonspecifically to histones. PMID- 2702640 TI - Regulation of transferrin receptor in myeloid and monocytic differentiation of HL 60 leukemia cells. AB - Modulation of surface transferrin receptor activity has been associated with leukemia cell differentiation and proliferation. To examine the mechanisms involved in regulating this event, receptor protein and mRNA levels were measured in HL-60 promyelocytic leukemia cells induced to differentiate along the myelocytic and monocytic pathways. Transferrin receptor down-regulation which occurs during granulocytic differentiation by dimethyl sulfoxide, retinoic acid, or aclacinomycin A appears to be kinetically compatible with reduced biosynthesis resulting from reductions in the level of steady-state mRNA. In contrast, genetic modulation does not appear to mediate the initial receptor down-regulation seen during 12-O-tetradecanoylphorbol-13-acetate-induced monocytic differentiation. However, a reduction in levels of receptor message appears to contribute to the maintenance of diminished transferrin receptor activity in these 12-O tetradecanoylphorbol-13-acetate-treated cells. A common feature of myelocytic and monocytic differentiating cells is the complete inhibition of cellular proliferation observed within 10 to 16 h following a four-fold reduction in surface transferrin receptor. We conclude that the early decline in transferrin receptor levels precludes its regulation as a consequence of the decrease in proliferation, but rather implicates its role in the programmed cessation of growth which is requisite for the terminal differentiation of these cells. PMID- 2702641 TI - Presence of a growth-stimulating factor in serum following primary tumor removal in mice. AB - The effect of removal of a primary tumor on the kinetics of cells in a metastasis was evaluated using six different tumors (C3H, MXTa, MXTb, MC54, CD8, and 3LL) which varied relative to their origin, histology, and the strain of mice in which they were carried. There was an increase in the labeling index (LI) of distant tumor focus ("metastasis") associated with the removal of each of the tumor types and unrelated to operative and anesthetic trauma. Information presented supports the presence of a serum growth factor as being responsible for the phenomenon. Serum obtained from mice following removal of a tumor, when transferred to a recipient with the same type of tumor as in the donor, resulted in an increase in the LI of the tumor. Multiple injections of serum failed to add to the increase but did prolong its presence, suggesting that there is a finite population of cells, most likely in the G1-G0 phase, which are capable of responding to the stimulating factor. The transfer of serum obtained following removal of a tumor type different from that in recipients resulted in findings which indicate that tumors producing a stimulating growth factor are those capable of responding to it. Serum obtained from animals with unremoved tumors or less than 18 h after removal failed to substantially augment the LI of tumors in recipients. It is postulated that the growth factor released by a tumor is in an inactive form which becomes activated over time. Observations indicate that medium conditioned by the growth of C3H tumor contains a growth-stimulating factor which is capable of increasing the LI of a C3H tumor in a recipient in a fashion similar to that obtained following tumor removal. That finding indicates the capability of the tumor to elaborate growth-stimulating material which may be similar to that found in serum. The findings presented refute the premise that removal of a primary tumor is a local phenomenon with no other biological consequences. They indicate that, following primary tumor removal, metastatic behavior may be affected by an interplay of growth factor(s) which can influence the outcome of a host to its tumor. PMID- 2702642 TI - Minimal antiproliferative effect of recombinant mullerian inhibiting substance on gynecological tumor cell lines and tumor explants. AB - Mullerian Inhibiting Substance (MIS) is a testicular hormone that promotes involution of the Mullerian duct during embryogenesis. The Mullerian duct gives rise to adult female reproductive ducts including the fallopian tubes, uterus, and upper vagina. Thus, testicular MIS ensures the regression of female sex organ primordia. Partially purified bovine MIS was reported to inhibit proliferation of tumor cells derived from human gynecological cancers. These observations suggest that MIS might be an effective anticancer agent for some human tumors. Recombinant human MIS (rHu-MIS) has recently become available. To assess the antiproliferative activity of rHu-MIS, we examined its effects on 11 ovarian, six endometrial, and two nongynecological human tumor cell lines. rHu-MIS had no effect on proliferation of these cell lines in five independent assays. Forty three primary human tumor explants were also examined in human tumor colony forming assays, gel-supported primary culture assays, and subrenal capsule assays. rHu-MIS significantly inhibited the growth of five of these tumors including four ovarian and one small cell lung cancer explant. The four ovarian cancer responses include three of 13 (23%) explants tested in human tumor colony forming assays and one of eight (12.5%) explants tested in gel-supported primary culture assays. We conclude that rHu-MIS may have antiproliferative activity against some human ovarian cancers. PMID- 2702643 TI - Effect of fatty acids on formation, distribution, storage, and release of benzo(a)pyrene phenols and glucuronides in the isolated perfused rat liver. AB - The hydroxylation of benzo(a)pyrene and conjugation, storage, and release of benzo(a)pyrene phenols and glucuronides by the perfused rat liver were studied in the presence and absence of acute addition of physiological concentrations of common dietary fatty acids. The actions of fatty acids on the oxidation and conjugation of benzo(a)pyrene in the intact liver were compared with their actions on microsomes isolated from rat liver. Rats were treated with beta naphthoflavone to stimulate polycyclic aromatic hydrocarbon metabolism. Long chain fatty acyl CoA compounds (palmitoyl CoA, oleoyl CoA, linolenoyl CoA; 50 microM) inhibited hydroxylation of benzo(a)pyrene by isolated microsomes by about 45%; however, long-chain fatty acids did not affect overall rates of hydroxylation of benzo(a)pyrene by the perfused liver at concentrations ranging up to 300 microM. The medium-chain acyl CoA compound, octanoyl CoA, also did not affect benzo(a)pyrene hydroxylation in microsomes or liver. Although fatty acids did not alter rates of hydroxylation, the ratio of free benzo(a)pyrene phenols to glucuronides (F/G ratio) increased about 60% (P less than 0.05) in livers perfused with long-chain fatty acids (palmitate, oleate, linolenate). Inhibition of glucuronidation was not observed with the medium-chain fatty acid, octanoate. Benzo(a)pyrene phenols and glucuronides accumulated linearly in the liver at rates of approximately 40 nmol/g/h. A second action of both long- and medium chain length fatty acids was to increase rates of release of benzopyrene phenols into the perfusate by 50 to 80%. Fatty acids did not effect release of benzo(a)pyrene phenols and glucuronides into bile. Taken together, these data support the hypothesis that fatty acids displace carcinogenic metabolites of benzo(a)pyrene from binding sites in the liver which enter the circulation and travel to target tissues. PMID- 2702644 TI - A mouse analogue of the human carcinoembryonic antigen. AB - Functional human carcinoembryonic antigen (CEA)-like genes have been shown to be present in the mouse. Southern analyses of murine DNA using both human and murine CEA complementary DNA probes have revealed the presence of multiple CEA-like genes, while analyses of RNA from different mouse tissues showed CEA-like transcripts in adult colon and liver. Furthermore, a CEA-like protein, immunoprecipitable with a rabbit polyclonal serum raised against human CEA, has been detected in adult murine colon tissue. Several murine CEA complementary DNA clones have been isolated from a murine colon complementary DNA library, and characterization of one such clone demonstrates that both the N-terminal and the internal domains have been conserved between the two species. The existence of a murine counterpart of CEA strengthens the case for an essential function for this human tumor marker and provides an experimentally amenable system for elucidation of its biological properties. PMID- 2702645 TI - Role of DNA breakage in cytotoxicity of doxorubicin, 9-deoxydoxorubicin, and 4 demethyl-6-deoxydoxorubicin in murine leukemia P388 cells. AB - Formation and persistence of DNA single- and double-strand breaks stimulated by doxorubicin, 9-deoxydoxorubicin, or 4-demethyl-6-deoxydoxorubicin in murine leukemia P388 cells were compared in relation to drug DNA affinity, cellular pharmacokinetics, and cytotoxicity. Although cellular uptake and retention and DNA affinity of the anthracycline derivatives were similar to those of the parent drug, cytotoxic potency was quite different, 9-deoxydoxorubicin being much less cytotoxic than doxorubicin, and 4-demethyl-6-deoxydoxorubicin the most effective agent. After 1-h exposure of cells to cytotoxic drug levels, the extent of DNA strand breaks produced by 4-demethyl-6-deoxydoxorubicin was greater than that produced by doxorubicin, whereas 9-deoxydoxorubicin induced very few DNA breaks. As for the parent drug, proteolytic treatment of cell lysates on the filter was needed to detect DNA cleavage produced by the analogues. A linear increase of DNA breaks was observed for 2 h following 4-demethyl-6-deoxydoxorubicin or doxorubicin addition; by contrast, DNA break levels reached a plateau after 45 min of exposure to 9-deoxydoxorubicin. DNA lesions produced by the derivatives persisted, and doxorubicin-induced DNA breaks even increased after drug removal, indicating an absence of DNA break resealing under our conditions. These observations indicate that modifications of the chromophore moiety of the anthracycline may enhance both drug cytotoxicity and specificity of drug-target interactions, and thus provide further strong evidence that the anthracycline effect on DNA integrity is a critical aspect of the mechanism of drug action. PMID- 2702646 TI - Detection of exocyclic guanine adducts in hydrolysates of hepatic DNA of rats treated with N-nitrosopyrrolidine and in calf thymus DNA reacted with alpha acetoxy-N-nitrosopyrrolidine. AB - This report describes the isolation and characterization of DNA adducts formed in vitro from alpha-acetoxy-N-nitrosopyrrolidine and in rats treated with the hepatocarcinogen N-nitrosopyrrolidine. Esterase-catalyzed hydrolysis of alpha acetoxy-N-nitrosopyrrolidine in the presence of calf thymus DNA, followed by neutral thermal hydrolysis of the DNA, resulted in formation of three previously unknown Adducts 1-3. They were isolated and characterized by their UV, mass, and proton magnetic resonance spectra as the exocyclic 7,8-guanine adducts 2-amino 6,7,8,9-tetrahydro-9-hydroxypyrido[2,1-f]purine-4(3H)-one (Adduct 1), and cis- and trans-2-amino-7,8-dihydro-8-hydroxy-6-methyl-3H-pyrrolo[2,1-f] purine-4(6H) one (Adducts 2 and 3). Adduct 1 was formed by addition of 4-oxobutyl diazohydroxide, or a related carbonium ion, to the 7 and 8 positions of guanine. Adducts 2 and 3 resulted from Michael addition of 2-butenal to the 7 and 8 positions of guanine. Esterase-catalyzed hydrolysis of alpha-acetoxy-N nitrosopyrrolidine in the presence of DNA also produced the exocyclic 1,N2 propanodeoxyguanosine Adducts 4a and 4b which we have previously described. Neutral thermal hydrolysates of hepatic DNA isolated from rats treated with N nitrosopyrrolidine contained a fluorescent adduct, as previously reported (E.J. Hunt and R.C. Shank, Biochem. Biophys. Res. Commun., 104: 1343, 1982). This fluorescent adduct was shown to be identical to Adduct 1. Adducts 2, 3, 4a, and 4b were not detected in hepatic DNA hydrolysates from these animals. The results of this study provide the first example of a structurally characterized DNA adduct formed in vivo from a cyclic nitrosamine and support the alpha hydroxylation hypothesis of cyclic nitrosamine metabolic activation. PMID- 2702647 TI - Effect of glucocorticoid replacement on tumor growth after adrenalectomy in mice. AB - We studied the effects of glucocorticoid replacement on tumor growth after adrenalectomy of Meth A sarcoma in mice. Tumor growth was inhibited in the adrenalectomized mice when a minimum dose of corticosterone, 0.3 mg/day, was given for replacement, and higher doses led to an even greater inhibition. Corticosterone had no effect on tumor growth in the irradiated mice. Sinecomitant immunity in the case of growth of the retransplanted excised tumor was compromised in the adrenalectomized mice. In vivo neutralization and immunosuppressive activities were absent in the spleen cells of the adrenalectomized mice. It would thus appear that adrenalectomy suppresses tumor growth by mechanisms other than glucocorticoid ablation. For optimum tumor control, glucocorticoid replacement after adrenalectomy should be in excess of the minimum daily requirements. PMID- 2702649 TI - Antitumor effect of a new multienzyme inhibitor of polyamine synthetic pathway, methylglyoxal-bis(cyclopentylamidinohydrazone), against human and mouse leukemia cells. AB - Methylglyoxal-bis(cyclopentylamidinohydrazone) (MGBCP) has been synthesized as a multienzyme inhibitor for the polyamine-synthesizing pathway. This drug inhibited S-adenosylmethionine decarboxylase (EC 4.1.1.50), spermine synthase and spermidine synthase activities, competitively with S-adenosylmethionine, spermidine, and putrescine, respectively. MGBCP inhibited the growth of human leukemia Molt 4B and K 562 cells at 10 to 100 microM concentrations. Spermidine and spermine levels were markedly depressed in these MGBCP-treated leukemic cells, and the synthesis of protein, but not of DNA or RNA, was significantly diminished. In in vivo experiments, MGBCP depleted spermidine and spermine in the P388 leukemic ascites cells, and prolonged the survival time of mice bearing P388 leukemia. The S-adenosylmethionine decarboxylase-stabilizing effect of MGBCP in mouse liver, Molt 4B and K 562 cells was much less than that of the parent inhibitor methylglyoxal-bis(guanylhydrazone). Induction of ornithine decarboxylase activity by MGBCP in the cultured leukemic cells was also much less than that by methylglyoxal-bis(guanylhydrazone). PMID- 2702648 TI - Comparative study on metabolic formation of N-arylformamides and N-arylacetamides from carcinogenic arylamines in mammalian species. AB - The metabolism of carcinogenic arylamines was examined focusing on their N acylation in mammalian species. When 4-aminobiphenyl, 2-aminonaphthalene, 2 aminofluorene, or 1-aminopyrene was given orally to rabbits, the corresponding N arylformamides were isolated from the urine together with the corresponding N arylacetamides. Identification of these N-arylformamides and N-arylacetamides was performed unequivocally by comparing their mass and UV spectra, and thin-layer chromatographic behaviors with those of authentic samples. Such metabolic conversion of the arylamines to the N-arylformamides and N-arylacetamides was also observed in guinea pigs and rats. In addition, carcinogenic nitro compounds such as 4-nitrobiphenyl and 2-nitronaphthalene, which are metabolically reducible to the arylamines, were metabolized to the corresponding N-arylformamides and N arylacetamides in rabbits. On the other hand, quantitative experiments showed that only minor amounts of the N-arylformamides and N-arylacetamides were excreted in the urine or feces of rats and rabbits given the arylamines. This seems to be due to almost complete further metabolism of these N-acyl derivatives in vivo. Liver cytosols from several mammalian species exhibited a significant N formylating activity toward the arylamines in the presence of N-formyl-L kynurenine and N-acetylating activity in the presence of acetyl-CoA. In rabbits, the N-formylating activity was clearly higher than the N-acetylating activity, while the reverse was the case in guinea pigs and hamsters. The experiments with rat liver preparations showed that the liver cytosolic N-formylating and N acetylating activities are due to formamidase and arylamine acetyltransferase, respectively. Furthermore, enzymatic transfer of the formyl group from one arylamine to another was demonstrated. PMID- 2702650 TI - Immunohistochemical expression of CA 125 in endometrial adenocarcinoma: correlation of antigen expression with metastatic potential. AB - Immunohistochemical localization of CA 125 using murine monoclonal antibody OC 125 was performed on fresh frozen tissue from 44 endometrial adenocarcinomas and 26 benign endometria. Immunohistochemical evaluation incorporated both intensity and distribution of staining (CA 125 HSCORE). Thirty-seven cancers (84%) and 23 benign endometria (88%) expressed immunohistochemically detectable CA 125. Staining was confined to epithelial cells and was present both on the cell membrane and in the cytoplasm. Among the 44 endometrial cancers, CA 125 HSCORE did not correlate with histological grade, depth of myometrial invasion or estrogen/progesterone receptor levels. Following surgical staging, 13 patients (30%) were found to have extrauterine metastatic disease. The median CA 125 HSCORE of patients with metastatic disease (2.25) was significantly higher than that of patients with disease confined to the uterus (0.6) (P less than 0.001). In addition, high CA 125 HSCORE also correlated with the presence of lymph node metastasis (P less than 0.001). The results of this study suggest that high CA 125 expression by endometrial adenocarcinomas is associated with increased metastatic potential. PMID- 2702651 TI - Expression of growth factor and epidermal growth factor receptor encoded transcripts in human gastric tissues. AB - Expression of mRNA-encoding transforming growth factors alpha and beta (TGF alpha and beta), epidermal growth factor receptor (EGFR), and platelet-derived growth factors (PDGF) A and B chains was examined in 63 human gastric biopsies. Despite considerable individual variation, transcript levels were generally higher in 16 paired gastric tumors compared with surrounding epithelium. Marked increases were observed for the TGFs and c-sis, whereas EGFR mRNA was poorly expressed; there was no correlation with pathological staging of the cancers. In the nonneoplastic tissues, 14 had normal histology and 27 displayed superficial (SG) or atrophic gastritis (AG). Transcript levels greater than or equal to + were similar between these categories for all the growth factors, but were about 50% higher for EGFR in the tissues with gastritis. Concurrent expression of TGF alpha and EGFR (greater than or equal to + level) was more frequent in the paired tumors (38%) than in adjacent nonmalignant tissue (6%) and was seen in only one of 14 (7%) normal samples, in three of 19 (16%) of those with AG, and none of eight of those displaying SG. High levels of TGF beta and PDGFA mRNA were expressed in gastric ulcers, with little or no TGF alpha and EGFR transcripts; in contrast both TGFs and EGFR message were found in normal oesophagus. Stomach tissues are thus capable of synthesizing a variety of growth factors. These may be associated with nonneoplastic hyperplasia and/or malignant proliferation. Coexpression of TGF alpha/EGFR supports the possibility of an autocrine loop sustaining tumor growth which is different from the mechanisms responsible for normal cellular proliferation. PMID- 2702652 TI - Partial purification of a growth factor synthesized by a rat hepatoma cell line established in serum-free medium. AB - A rat hepatoma cell line was established from primary culture using RPMI 1640 without supplements. Hepatomas were induced in rats by 0.06% 3'-methyl-4 dimethylaminoazobenzene. An established cell line, FF101, has been maintained as a monolayer for longer than 34 months and subcultured for 42 passages. The population-doubling time was 78 h. The modal chromosome number was 66. FF101 was transplantable, and morphological examination of the transplanted tumors revealed a mixed type of hepatocellular and cholangiocellular carcinoma. FF101 retained the ability to express tyrosine aminotransferase and glucose-6-phosphatase. Also, FF101 synthesized alpha-fetoprotein. FF101-conditioned medium stimulated DNA synthesis and proliferation of several cell lines such as AH66, K562, and BALB/c3T3. The growth-promoting activity of FF101-conditioned medium was abolished by protease, dithiothreitol, acidic treatment, and heating. Gel filtration of conditioned medium on Sephacryl S-200 disclosed the growth promoting activity at the molecular size of approximately 60,000 Da, and the isoelectric point (pI) was between 5.5 and 6.5. These results suggest that FF101 synthesizes a novel growth factor which has little specificity in both species and organs. PMID- 2702653 TI - Early metabolic response to tumor necrosis factor in mouse sarcoma: a phosphorus 31 nuclear magnetic resonance study. AB - To investigate the effects of recombinant human tumor necrosis factor alpha (rHuTNF-alpha) on high-energy phosphate metabolism of cancer cells, 31P nuclear magnetic resonance (NMR) studies were performed on a murine methylcholanthrene induced sarcoma. Injection of 15 micrograms of rHuTNF-alpha caused progressive depletion of ATP and phosphocreatine within 90 min, together with an increase in inorganic phosphate. Metabolic changes were correlated with the early histological appearance of thrombosis and hemorrhage. A spatially localized NMR technique demonstrated that these changes were specific for the tumor. Acute ischemia of the tumor produced similar metabolic changes; thus the metabolic effects of rHuTNF-alpha could be due to either a primary action on tumor biochemistry or a secondary action produced by ischemia. These findings indicate that rHuTNF-alpha has a very rapid onset of action, which can be detected by 31P NMR. Furthermore, the results suggest that 31P NMR spectroscopy will be extremely useful for detecting early biochemical changes produced by rHuTNF-alpha or other treatments in animal and human cancers. PMID- 2702654 TI - Cadherin cell-adhesion molecules in human epithelial tissues and carcinomas. AB - Two distinct calcium-sensitive cell-cell adhesion molecules were identified in human epithelial tissues and carcinomas using two monoclonal antibodies raised against vulvar epidermoid carcinoma A-431 and human mammary carcinoma MCF-7 and selected on the basis of their activities to disrupt cell-cell adhesion. In immunoblot analysis, these antibodies, designated NCC-CAD-299 and HECD-1, detected main bands of Mr 118,000 and 124,000, respectively. Purified tryptic fragments of the antigen recognized by NCC-CAD-299 showed cross-reactivity with a rabbit antiserum against mouse P-cadherin, indicating that this molecule was the human homologue of P-cadherin. On the other hand, the antigen recognized by HECD 1 showed essentially the same tissue distribution pattern as E-cadherin in the mouse, suggesting that this molecule is the human homologue of E-cadherin. Availability of these monoclonal antibodies to human P- and E-cadherin allowed us to examine their distributions in human tissues immunohistochemically. Both antigens were detected in epithelial tissues, but they showed distributions that were distinct from each other. The antigen recognized by HECD-1 was expressed in almost all epithelial tissues, while distribution of the other one recognized by NCC-CAD-299 was restricted to the basal or lower layers of stratified epithelia in which both antigens were coexpressed. Moreover, immunohistochemical examination of 44 lung carcinomas showed that both molecules were coexpressed in all of them, and suggested that expression of P-cadherin was closely related to the differentiation of carcinoma cells. PMID- 2702655 TI - Multistep nature of X-ray-induced neoplastic transformation in golden hamster embryo cells: expression of transformed phenotypes and stepwise changes in karyotypes. AB - We have examined the expression of transformed phenotypes and genetic changes associated with the expression of each transformed phenotype after X-ray irradiation. Unirradiated cells grown at a constant growth rate until 8 passages (population doubling number, 15) exhibited little morphological change and ceased to divide thereafter. X-irradiated cells escaped from senescence and showed morphological alteration and anchorage independence after a population doubling number of 20. The acquisition of tumorigenicity in nude mice was observed much later (35 population doublings after irradiation). From cytogenetic analysis, all anchorage-independent clones were consistently found to have trisomy of chromosome 7. Furthermore, cells derived from tumors contained three copies of chromosome 9q in addition to the trisomy of chromosome 7. We have not detected any augmented expression of v-Ha-ras- and v-myc-related oncogenes with RNA dot blot analysis and could not find activation of any type of oncogenes by NIH3T3 transfection experiments. Our studies demonstrated that X-ray-induced neoplastic transformation is a multistep phenomenon and that the numerical change of specific chromosomes may play an important role in the expression of each transformed phenotype. The results suggest that different endogenous oncogenes, other than the ras gene family and myc oncogene, could be responsible for the progressive nature of neoplastic transformation. PMID- 2702656 TI - Isolation of purified plasma membranes from cultured cells and hepatomas by two phase partition and preparative free-flow electrophoresis. AB - This report describes and documents the isolation of plasma membranes from hepatomas and tissue culture cells by aqueous two-phase partition. The method used previously for normal liver was effective, rapid, and reproducible. Preparations from both cells and hepatomas were more than 90% plasma membrane derived based on electron microscope morphometry and assays of marker enzyme activities. Relative enrichments over starting homogenates were near theoretical as determined by electron microscope morphometry of starting cells and tissues. Recoveries were about 10% or greater. Briefly, the membranes to be separated were mixed with a combination of two different polymers that themselves separated into two phases. For tissue culture cells and hepatomas, a mixture of 6.6% (w/w) dextran and 6.6% (w/w) polyethylene glycol containing 0.25 M sucrose and 5 mM potassium phosphate (pH 7.2) was used. A potassium-stimulated, ouabain-inhibited, p-nitrophenylphosphatase was employed as a plasma membrane marker to monitor yield and recovery. In combination with free-flow electrophoresis, the preparations of plasma membranes from cultured cells were resolved further into fractions enriched in vesicles of right side-out or inside-out orientations. Unlike centrifugation methods, the same type of two-phase separations provided useful plasma membrane fractions when applied to different types of cultured cells as well as to solid tumors and normal tissues. The lower phase membranes, after two-phase partition, provided a plasma membrane-depleted source of membranes other than plasma membrane for use as reference fractions. The procedures should find wide application to problems of cancer research where facile and decisive separations of surface and internal membranes may be required. PMID- 2702657 TI - Effect of organized screening on incidence and mortality of cervical cancer in Denmark. AB - Pap smears were used only on a limited scale in Denmark until the late 1960s. Since then smears have been taken both in organized screening programs and outside the programs by general practitioners, private gynecologists, and hospital wards. The present smear-taking activity is equivalent to an average of one smear every second year per woman. As the responsibility for health care rests with the counties in Denmark, differences are found between the counties both concerning organization of screening programs, and concerning the overall level of the smear-taking activity. An analysis using multiplicative Poisson models on county-based incidence and mortality data for women aged 30-59 years in 1963-1982 showed a statistically significant effect of organized screening in reducing both the incidence (RR = 0.67; 95% CI, 0.61-0.73), and the mortality (RR = 0.68; 95% CI, 0.59-0.78) of cervical cancer from 5 years after introduction of an organized screening program. The level of overall smear-taking activity was found to be of limited importance when organized screening was taken into account. PMID- 2702658 TI - Breast fluid cholesterol and cholesterol beta-epoxide concentrations in women with benign breast disease. AB - Because cholesterol 5,6-epoxides have been reported to be mutagenic, carcinogenic, and cytotoxic, we investigated the relationship of these substances in breast fluid to histopathologically defined breast disease. We measured cholesterol and its oxidation product, 5 beta,6 beta-epoxide, in breast fluids from 68 women with biopsied benign breast disease (BBD) and 135 women with no history of breast disease (controls). Each biopsy was classified according to the most severe epithelial change: (a) nonproliferative epithelia; (b) hyperplasia without atypia; or (c) hyperplasia with atypia. Similar to our previous findings in control women, breast fluid cholesterol and beta-epoxide concentrations in women with BBD were associated with factors of interest in relation to breast cancer: concentrations increased with age and were higher in white than nonwhite women and in women who were past or current smokers; concentrations were lower in women who had given birth or breastfed within 2 yr. Increased breast fluid cholesterol and beta-epoxide concentrations were significantly associated with proliferative BBD (hyperplasia with or without atypia) compared to controls. After adjustment for covariates, the odds ratio for proliferative BBD associated with detectable versus nondetectable beta-epoxide concentrations was 8.5 (95% confidence intervals, 1.1, 68.8). Our findings suggest that the histological progression from normal epithelium to hyperplasia without atypia to atypical hyperplasia is associated with progressively increasing concentrations of both cholesterol and cholesterol beta-epoxide. PMID- 2702659 TI - Distribution of 4-hydroxy-N-desmethyltamoxifen and other tamoxifen metabolites in human biological fluids during tamoxifen treatment. AB - Several metabolites of tamoxifen, including 4-hydroxy-N-desmethyltamoxifen (metabolite BX), 4-hydroxytamoxifen (metabolite B), N-desmethyltamoxifen (metabolite X), the primary alcohol (metabolite Y), and N-desdimethyltamoxifen (metabolite Z) were identified and their concentrations determined in fluids and feces from patients receiving chronic tamoxifen treatment. The biological samples investigated were serum, pleural, pericardial and peritoneal effusions, cerebrospinal fluid, saliva, bile, feces, and urine. In serum, tamoxifen itself, and the metabolites X and Z were the prevailing species, but significant amounts of the metabolites Y, B, and BX were also detected. About 3 h after drug intake tamoxifen as well as Y, B, BX, X, and Z showed a peak in serum. This may be explained by efficient metabolism of the metabolite precursor before being distributed to peripheral compartments. Upon drug withdrawal all metabolites showed first-order elimination curves which paralleled that of tamoxifen suggesting that their rate of elimination exceeded that of tamoxifen and that the serum levels are production rate limited. The protein binding of tamoxifen and its major serum metabolites (Y, X, Z) was determined and found to be higher than 98%. Albumin was the predominant carrier for tamoxifen in human plasma. The concentrations of tamoxifen and its metabolites in pleural, pericardial, and peritoneal effusions equalled those detected in serum, corresponding to an effusion/serum ratio between 0.2 and 1. Only trace amounts of tamoxifen and metabolite X were detected in cerebrospinal fluid (CSF/serum ratio less than 0.02). In saliva, concentrations of tamoxifen and X exceeded the amounts of free drug in serum, suggesting active transport or trapping of these compounds in the salivary gland. Bile and urine were rich in the hydroxylated, conjugated metabolites (Y, B, and BX), whereas in feces unconjugated metabolite B and tamoxifen were the predominating species. PMID- 2702660 TI - The need for a search for a proximal pathogenic principle of human AIDS. AB - Some of the unexplained aspects of HIV/AIDS epidemiology, virology, and pathology (6, 13) may thus be due to a lack of knowledge of the basic virology of the virus complex and its pathological interaction with cells of the host. There may be no need to call upon anomalous immune responses, vicious transactivating activities, or new virological or biological principles if we can first do the basic virology of the disease-inducing viruses. While we do not want to propose that working out the virology will by necessity be easy on all counts, it may lead us all to more equitable immunological, pathological, and cell biological approaches to this formidable problem. A fine beginning has been made by Fisher et al. (10), Saag et al. (11), and others. To retrovirologists the problems appear not to be insurmountable. PMID- 2702661 TI - Glucocorticoid receptors: evolution, structure, function and abnormalities. Proceedings of a symposium. Osaka, Japan, July 14 & 15, 1988. PMID- 2702662 TI - Demonstration of the intracellular localization and up-regulation of glucocorticoid receptor by in situ hybridization and immunocytochemistry. AB - Glucocorticoid response in target cells closely correlates with glucocorticoid receptor (GR) level. We have compared the localization of GR (by immunocytochemistry) and GR mRNA levels (by in situ hybridization) in steroid sensitive and steroid-resistant subclones derived from the human CEM lymphoid cell line. In addition, GR was localized in lymphoid cells from patients with various hematological malignancies. In the absence of preincubation with the steroid, GR was localized at the light and electron microscopic level predominantly in the cytoplasm and to a weaker extent in the nucleus. In the presence of steroid, the GR was shown to translocate to the nucleus in the steroid-sensitive but not in the steroid-resistant cell lines. Furthermore, GR and GR mRNA levels were increased following glucocorticoid treatment of the sensitive cell line but not the resistant one. These data support a role for receptor regulation and translocation in the overall mechanism of glucocorticoid hormone action. PMID- 2702663 TI - Interaction of histones in glucocorticoid receptor binding to DNA in vitro. AB - We recently demonstrated that [1,2,4-3H]triamcinolone acetonide-receptor complexes purified 3000-fold from rat livers bound strongly to histone-agarose. The binding was not electrostatic, because it was not affected by ionic strength. In this in vitro study, we examined the effects of histones on the binding of glucocorticoid-receptor complexes to DNA-cellulose. The binding of the purified [1,2,4-3H]triamcinolone acetonide-receptor complexes to calf thymus DNA-cellulose was increased markedly in a dose-dependent manner by low concentrations of a whole histone mixture (H2A, H2B, H3, H4, and H1 from calf thymus), but this high level of binding decreased at higher concentrations of the histone mixture. The binding of receptor complexes to DNA-cellulose was enhanced greatly by histones H4 and H3 and slightly by histone H2A, was not affected by histone H2B, and was inhibited by histone H1. Similar stimulatory and inhibitory effects of these histones were seen when the DNA-cellulose was preincubated with the various histones and then washed to remove free histones before measurement of binding of the receptor complex. These results suggest that histones are involved in the mechanism of action of glucocorticoid hormones. PMID- 2702664 TI - Use of high-resolution two-dimensional gel electrophoresis and affinity labeling to probe glucocorticoid receptor structure and function. AB - The possible role of posttranslational modification in glucocorticoid receptor regulation was investigated. Glucocorticoid receptor (GR), prepared from the human B-cell line IM-9 and affinity labeled with [3H]-dexamethasone 21-mesylate, was examined by a combination of one-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis and high-resolution two-dimensional gel electrophoresis. Two-dimensional electrophoresis of immunopurified [3H]dexamethasone 21-mesylate-labeled GR revealed the presence of two isoelectric species (apparent pI approximately to 5.7, and 6.0-6.5). Both forms were present in preparations of unactivated receptor. After GR activation, the pI of neither isoform was altered, indicating that activation does not involve covalent charge modification of the steroid-binding protein. However, only the pI 6.0-6.5 isoform bound to DNA, suggesting that covalent charge modification of the GR can alter its ability to bind to DNA. Two-dimensional electrophoresis of tryptic and chymotryptic fragments showed that the charge heterogeneity responsible for the two GR isoforms is located in a Mr 26,500 tryptic fragment derived from the steroid-binding domain of the protein. In addition, analysis of [3H]dexamethasone 21-mesylate-labeled tryptic fragments suggests that the Mr 26,500 fragment corresponds to residues 499-743 of the human GR. These results demonstrate that posttranslational modification of the steroid-binding domain may regulate the ability of the protein to bind to DNA. PMID- 2702665 TI - Interactions of the phenylpyrazolo steroid cortivazol with glucocorticoid receptors in steroid-sensitive and -resistant human leukemic cells. AB - The interactions of glucocorticoids with their receptors somehow determine the cellular responses seen. The high potency glucocorticoid cortivazol differs from the usual glucocorticoids in two ways, structurally and in binding to receptors. Cortivazol contains a phenylpyrazol fused at carbon atoms 2 and 3 to the A ring of the cyclophenathrene, replacing the supposedly essential 3-keto,4,5-double bond pattern of glucocorticoids. Cortivazol binds to the glucocorticoid receptor in the cytosol from CEM C7 cells (a human acute lymphoblastic leukemia line) in a fashion consistent with interaction with at least two sites. Standard glucocorticoids show only one-site binding. In mutant leukemia cells derived from CEM C7, resistant to kill by 10(-6) M dexamethasone and deficient in standard glucocorticoid binding sites, cortivazol still finds a binding site and kills the cells. In wild-type leukemia cells, the binding sites of cortivazol, those with both higher (Kd approximately 5 x 10(-10) M) and lower (Kd approximately 1 x 10( 8] affinity appear to be on forms of the glucocorticoid receptor itself, and not on two different classes of molecules. PMID- 2702666 TI - Glucocorticoid inhibition of gene expression and proliferation of murine lymphoid cells in vitro. AB - Glucocorticoids inhibit the proliferation of murine T-lymphoma P1798 cells. P1798 cells do not die in the presence of dexamethasone, and the process of inhibition of proliferation is completely reversible. As cells cease to divide, expression of a number of genes is inhibited. Among these are genes the expression of which is regulated in some manner that is linked to cell proliferation. We have undertaken to study the mechanism whereby glucocorticoids inhibit the expression of genes in P1798 cells. Three model systems will be reviewed. In all cases, these appear to be examples of secondary regulation. Glucocorticoid-mediated inhibition of transcription of the DNA encoding ribosomal RNA (rDNA) has been investigated in some detail. The data indicate that dexamethasone causes a decrease in the amount or activity of an RNA polymerase I transcription initiation factor. This factor exhibits a short biological half-life and the data are consistent with the hypothesis that glucocorticoids regulate the synthesis of this transcription factor. The gene encoding thymidine kinase appears to be regulated in a similar fashion. On this basis, we propose that glucocorticoids may have the general property of regulating the synthesis of certain transcription factors. Glucocorticoids also regulate the translation of a certain class of mRNAs, including those that encode ribosomal proteins. These are characterized by a low efficiency of translation in untreated cells. Upon exposure to dexamethasone, the translation of these mRNAs is disproportionately inhibited. We speculate that translation of the mRNAs encoding certain transcription factors may be regulated in a similar fashion. Specifically, we propose that transcription of certain proliferation-related genes may be dependent upon factors of short biological half-life. These are encoded by mRNAs that are poorly translated under optimal growth conditions. Any slight perturbation in translation efficiency, as caused by glucocorticoids, results in a disproportionate inhibition of synthesis of these hypothetical transcription factors. Transcription of a class of proliferation-related genes ceases as a result. PMID- 2702667 TI - Chimeric receptors used to probe the DNA-binding domain of the estrogen and glucocorticoid receptors. AB - Steroid hormone receptors activate specific gene transcription by binding as hormone-receptor complexes to short DNA enhancer-like elements termed hormone response elements. The DNA-binding domain (termed region C) is a highly conserved 66-amino acid region that contains two subregions (CI and CII) analogous to the "zinc fingers" of transcription factor IIIA. Using chimeric estrogen receptors, we show that this region, and in particular the NH2-terminal zinc finger, defines the target gene specificity of the receptor. We suggest that receptor recognition of the hormone response element is analogous to that of the helix-turn-helix DNA binding motif in that the receptor binds to DNA as a dimer with the first zinc finger lying in the major groove recognizing one-half of the palindromic hormone response element and protein-DNA interaction is stabilized through nonspecific DNA binding and dimer interactions contributed by the second zinc finger. PMID- 2702668 TI - Mutational analysis of the mouse glucocorticoid receptor. AB - We have cloned the mouse glucocorticoid receptor (GR) from both wild-type and glucocorticoid-resistant variants of the mouse lymphoma cell lines WEHI-7 and S49. Mapping of the mutations present in the variant receptors, together with deletion analysis of wild-type receptor, reveals that the receptor has three clearly defined domains. The COOH-terminal domain contains the hormone-binding site. Within this domain is a small region which is important for the suppression of receptor activity in the absence of hormone. The large NH2-terminal domain is essential for full receptor activity and contains within it a highly acidic region that potentiates receptor activity. The presence of this acidic region reduces nonspecific DNA binding and may therefore be crucial in the discrimination between specific and nonspecific DNA-binding sites by the receptor. A small centrally located domain contains all the information necessary to bind specifically to DNA and to activate transcription. Although this region is absolutely conserved in the GR of different species, many mutations introduced in vitro give rise to functional receptor. In addition, part of this region in the GR can be substituted for by the corresponding sequence in the estrogen receptor to give a GR with the DNA-binding and transcriptional specificity of an estrogen receptor. Lastly, we have succeeded in obtaining stable high-level expression of wild-type and mutant GR in transfected Chinese hamster ovary cells. PMID- 2702669 TI - Identification of two regions of the human glucocorticoid receptor hormone binding domain that block activation. AB - The steroid-binding domain of the human glucocorticoid receptor has a dominant, negative influence over the activity of the remainder of the molecule. We have determined sequences within this domain that are responsible for this inhibition by creating truncations and internal deletions which remove part or all of the ligand-binding domain. Two apparently unrelated sequences within this region are shown to block the ability to stimulate transcription when fused to the carboxyl terminus of a functional, hormone-independent receptor derivative. These results support the possibility of two distinct protein-binding sites within the steroid binding domain. PMID- 2702670 TI - Regulation of glucocorticoid receptor protein and mRNA levels. AB - The level of steroid receptors in target cells affects the responsiveness of the cell to the hormone. In mouse AtT-20 cells, it has been shown that chronic glucocorticoid treatment causes a down-regulation of glucocorticoid receptor (GR) levels (F. Svec and M. Rudis, J. Biol. Chem., 256:5984-5987, 1981). The current study shows that chronic hormone treatment reduces the amount of GR mRNA to about 50% of that in untreated cells. A combined treatment of the cells with an inhibitor of RNA transcription and the glucocorticoid hormone causes a more rapid decrease in steady-state GR mRNA levels than either agent alone. This suggests that glucocorticoids regulate the expression of the GR gene posttranscriptionally, perhaps via destabilization of the GR mRNA. An additional transcriptional regulation by the steroid hormone is not ruled out by this observation. It was also found that heat shocking a variety of cell types at 42 degrees C not only causes an induction of heat shock proteins but also results in a dramatic decrease in the level of glucocorticoid-binding activity. GR labeled with a covalent ligand (dexamethasone 21-mesylate) was also reduced by heat shock, implying that heat shock caused an increased degradation in the GR protein itself. Finally, in vitro studies show that the GR is degraded in an ATP- and tRNA-dependent fashion in rabbit reticulocyte lysate. It therefore seems likely that the GR is degraded by the ubiquitin-dependent proteolytic pathway. Because ubiquitin is itself a heat shock protein, this may be the reason that the GR is rapidly degraded in heat-shocked cells. These studies point to possible mechanisms whereby the responsiveness of the cell to steroid hormones is altered by the regulation of the steroid receptor protein and mRNA levels. PMID- 2702671 TI - Intracranial arteriovenous malformations in infancy and adolescence. AB - Fifteen children and adolescents with intracranial arteriovenous malformations are reviewed and their data analyzed; their ages varied between 1 day and 15 years and there was a slight predominance of males (9 male and 6 female patients). In this series, the arteriovenous malformations appeared clinically as cerebral hemorrhage in 9 cases, epilepsy in 3, mental retardation with epilepsy in 1, subarachnoid hemorrhage in 1, and cardiac insufficiency at birth in the other. The diagnostic procedures used were computerized transmission tomography (CTT) of the cerebrum in 14 cases, cerebral panarteriography in 15, and EEG in 4 cases. Treatment took the form of surgery, radiation therapy, or medication. The last was administered to patients with epilepsy, either as a complement to other modes of treatment or as the only treatment. In all, 4 cases died, 2 for reasons to do with their operations, 1 from a lesion of the brain stem in a hematoma of the cerebellum that had not been surgically treated, and the other from an intraventricular hemorrhage 4 months after surgery. In the last patient, necropsy revealed remnants of the arteriovenous malformation. The overall mortality was thus 26% and the surgical mortality, 12.6%. Of the 11 surviving patients only 3 received anticonvulsant drugs; each of them had a good I.Q. and good marks at school, as did the other 8 survivors. PMID- 2702672 TI - Brain abscesses in children--a cooperative study of 83 cases. AB - This study reviews our experience in 83 cases of brain abscesses in children diagnosed at seven teaching hospitals during the 10-year period from June 1978 to July 1987. The average age of the patients was 7 years, with 12% of them less than 1 year old. The male-to-female ratio was 1.7:1. Of the brain abscesses, 90.4% were detected by CT brain scan. A total of 50.6% patients had congenital heart disease, and 20.4% patients had sepsis and/or meningitis. Only 6% cases had ear, nose, and throat infection. Sixty-eight (81.9%) patients received a combination of antibiotics and surgical treatment. The cerebral abscesses were totally excised in 26 cases, aspirated and partially excised in 6, and aspirated in 32. Sixty patients had pus cultures from the cerebral abscesses. Organisms were isolated in 29 (49.2%) of them. Streptococcus was by far the most common organism. The overall outcome was: 49 (59%) alive; 16 (19.3%) dead; 18 (21.7%) lost to follow-up. Among the 16 mortalities, the causes of death were due to failure to treat the diseases causing the brain abscesses. We had a better outcome in patients whose cerebral abscesses were totally excised or whose abscesses were aspirated, and in patients who were older than 1 year of age. PMID- 2702673 TI - Cervical spinal deformity following craniotomy and upper cervical laminectomy for posterior fossa tumors in children. AB - Spinal deformity is not usually regarded as a potential complication of posterior fossa tumor resection. After cervical subluxation had been recognized in 2 children following removal of posterior fossa tumors, a review was carried out to determine the incidence of this complication. Of the 72 children who had undergone resection of a posterior fossa tumor, 4 patients, including the original 2, developed a cervical spinal deformity. Factors that predisposed to this complication included laminectomy of C2 or lower, local wound complications and possibly post-operative neck weakness. It is important to be aware that cervical subluxation can occur after resection of posterior fossa tumors, when laminectomy extending below C1 has been performed. Patients at risk should be followed closely. PMID- 2702674 TI - Undifferentiated gliomas of the brain stem. AB - Undifferentiated gliomas of the brain stem were confirmed surgically in two young children. The patients were treated by aggressive irradiation of the entire neuraxis, similar to that administered for medulloblastoma. Therapy resulted in a good prognosis and there was no tumor recurrence. PMID- 2702675 TI - Treatment of glioma with intratumoral instillation of autologous lymphocytes. AB - Autologous lymphocytes were instilled into the tumor in a girl 15 years of age who had presented with a recurrent left frontoparietal astrocytoma 1.5 years after surgery, radiation, and chemotherapy. She had remissions for 5 weeks, 5 months, and 20 months after the first, second, and third instillations, respectively. The usefulness of intratumoral instillation of autologous lymphocytes [or preferably lymphokine activated killer (LAK) cells with interleukin-2 is demonstrated in such recurrent astrocytomas. PMID- 2702676 TI - Meningioma of the third ventricle. AB - A case of meningioma of the third ventricle is described. The tumor was completely removed using a transcallosal approach. PMID- 2702677 TI - Subependymal giant-cell astrocytoma associated with tuberous sclerosis. Do subependymal nodules grow? AB - A case of a 10 year-old-boy with subependymal giant-cell astrocytoma associated with tuberous sclerosis is reported. Sequential CT scan showed the growth of subependymal nodules to intraventricular neoplasm, which consequently obstructed the CSF pathway. The surgical indications for this lesion and the role of CT in following up subependymal nodules of tuberous sclerosis are discussed. PMID- 2702678 TI - Keyhole craniectomy for correction of sagittal synostosis. AB - A modification of the technique combining sagittal strip, circular occipital and biparietal wedge craniectomies (Albright's procedure) for the treatment of sagittal synostosis, with prominent occipital bossing, is described. "Keyhole," as opposed to wedge, parietal craniectomies allow improvement in the shape of the skull, beginning intraoperatively, while eliminating the outbending of the parietal bone that occurs at the apex of a wedge craniectomy. PMID- 2702679 TI - Retention of immunogenicity after X-irradiation of mouse colon tumor cells expressing the transfected influenza virus hemagglutinin gene. AB - We have previously demonstrated that murine colon tumor cells transfected with the gene coding for the hemagglutination antigen (HA) of influenza virus acquire an inherent immunogenicity, fail to grow in syngeneic mice, and demonstrate an ability to cross-protect against a challenge with parental nontransfected cells. In the present study the immunogenic potential of HA-transfected cells correlated with cell-surface HA expression, as measured both by a fluorescence-activated cell sorter and by radio-labeled antibody binding. HA-transfected immunogenic cells had a median lethal dose (LD50) that was 10,000-fold greater than that of nontransfected cells. Most importantly this study demonstrated that HA transfected cells retained their immunogenicity after X-irradiation with 12,000 rad. This characteristic makes their potential usefulness in treating human neoplasia more plausible. PMID- 2702680 TI - The significance of conversion of skin reactivity to efficacy of bacillus Calmette-Guerin (BCG) vaccinations given immediately after radical surgery in stage II melanoma patients. AB - A group of 668 stage II melanoma patients was entered into a randomized prospective study aimed at evaluating the efficacy of adjuvant BCG, 5 (dimethyltriazeno)imidazole-4-carboxamide (DTIC), or a combination of the two, given immediately after radical lymph node dissection. Of these, 176 patients received BCG and 164 BCG plus DTIC. These 340 patients had histologically proven metastatic nodes and 156 had a negative skin reactivity to BCG at the beginning of treatment. The distribution of known prognostic factors (sex, age, number of positive nodes, extracapsular invasion) was balanced in the groups of patients either with initially negative or with positive skin reactivity. All patients who were initially non-reactive to BCG developed skin reactivity after 6.7 +/- 9 BCG vaccinations. Disease-free and overall survival of patients receiving BCG or BCG + DTIC with an initially negative skin reactivity to BCG was significantly (P = 7 x 10(-3) better than that observed in patients with an initial positive skin reactivity. This finding was still evident after adjustment for other known prognostic criteria (P = 0.02). It seems likely that the initial BCG skin reactivity as such marks the prognosis; however, some therapeutic effect of BCG treatment in patients having initially no skin reactivity to BCG, can not be ruled out. PMID- 2702682 TI - Community in crisis: DCNA launches campaign to save public health. PMID- 2702681 TI - Helping the AIDS patient to cope: telling family members the news. PMID- 2702683 TI - Continuing education follow-up report. PMID- 2702684 TI - He has a disease. PMID- 2702685 TI - Getting a handle on stress. PMID- 2702686 TI - Microinjection of antibodies to a 62 kd mitotic apparatus protein arrests mitosis in dividing sea urchin embryos. AB - Previously, we described a 62 kd protein that is a component of the isolated sea urchin mitotic apparatus. This protein is a substrate for an endogenous, calcium/calmodulin-dependent protein kinase also associated with the mitotic apparatus. Phosphorylation of the 62 kd protein directly correlates with the depolymerization of microtubules in isolated mitotic apparatuses. Here we report a test of the function of the 62 kd protein in vivo. Double labeling studies using a monoclonal antibody to tubulin and an affinity purified antibody specific for the 62 kd protein reveal that the 62 kd protein co-localizes with mitotic apparatus microtubules. When affinity purified antibodies to the 62 kd protein were microinjected into dividing sea urchin embryos, mitosis was blocked in a stage-specific manner. The results are discussed with respect to the role of the 62 kd protein in the metaphase-anaphase transition. PMID- 2702687 TI - Cell-autonomous and inductive signals can determine the sex of the germ line of drosophila by regulating the gene Sxl. AB - To investigate the mechanism of sex determination in the germ line, we analyzed the fate of XY germ cells in ovaries, and the fate of XX germ cells in testes. In ovaries, germ cells developed according to their X:A ratio, i.e., XX cells underwent oogenesis, XY cells formed spermatocytes. In testes, however, XY and XX germ cells entered the spermatogenic pathway. Thus, to determine their sex, the germ cells of Drosophila have cell-autonomous genetic information, and XX cells respond to inductive signals of the soma. Results obtained with amorphic and constitutive mutations of Sxl show that both the genetic and the somatic signals act through Sxl to achieve sex determination in germ cells. PMID- 2702689 TI - A hierarchy of regulatory genes controls a larva-to-adult developmental switch in C. elegans. AB - The heterochronic genes lin-4, lin-14, lin-28, and lin-29 control the timing of specific postembryonic developmental events in C. elegans. The experiments described here examine how these four genes interact to control a particular stage-specific event of the lateral hypodermal cell lineages. This event, termed the "larva-to-adult switch" (L/A switch), involves several coordinate changes in the behavior of hypodermal cells at the fourth molt: cessation of cell division, formation of adult (instead of larval) cuticle, cell fusion, and cessation of the molting cycle. The phenotypes of multiply mutant strains suggest a model wherein the L/A switch is controlled by the stage-specific activity of a regulatory hierarchy: At early stages of wild-type development, lin-14 and lin-28 inhibit lin-29 and thus prevent switching. Later, lin-4 inhibits lin-14 and lin-28, allowing activation of lin-29, which in turn triggers the switch in the L4 stage. lin-29 may activate the L/A switch by regulating genes that control cell division, differentiation, and stage-specific gene expression in hypodermal cells. PMID- 2702688 TI - Genetic control of cell division patterns in the Drosophila embryo. AB - In Drosophila embryogenesis, mitotic control undergoes a significant transition during the 14th interphase. Mitoses before interphase 14 run on maternal products, and occur in metasynchronous waves. Mitoses after interphase 14 require zygotic transcription, and occur asyncronously in an intricate, highly ordered spatio-temporal pattern. Mutations at the string (stg) locus cause cell-cycle arrest during this transition, in G2 of interphase 14, yet do not arrest other aspects of development. This phenotype suggests that stg is required specifically for initiating mitosis. We describe the cloning of stg, and show that its predicted amino acid sequence is homologous to that of cdc25, a regular of mitotic initiation in the yeast S. pombe. In addition, we show that zygotic expression of stg mRNA occurs in a dynamic series of spatial patterns which anticipate the patterns of the zygotically driven cell divisions. Therefore we suggest that regulated expression of stg mRNA controls the timing and location of these embryonic cell divisions. PMID- 2702690 TI - Existence of slow-cycling limbal epithelial basal cells that can be preferentially stimulated to proliferate: implications on epithelial stem cells. AB - Despite the obvious importance of epithelial stem cells in tissue homeostasis and tumorigenesis, little is known about their specific location or biological characteristics. Using 3H-thymidine labeling, we have identified a subpopulation of corneal epithelial basal cells, located in the peripheral cornea in a region called limbus, that are normally slow cycling, but can be stimulated to proliferate in response to wounding and to a tumor promotor, TPA. No such cells can be detected in the central corneal epithelium, suggesting that corneal epithelial stem cells are located in the limbus. A comparison of various types of epithelial stem cells revealed a common set of features, including their preferred location, pigment protection, and growth properties, which presumably play a crucial role in epithelial stem cell function. PMID- 2702691 TI - Carcinoembryonic antigen, a human tumor marker, functions as an intercellular adhesion molecule. AB - Carcinoembryonic antigen (CEA) is a member of a family of cell surface glycoproteins that are produced in excess in essentially all human colon carcinomas and in a high proportion of carcinomas at many other sites. The function of this widely used tumor marker and its relevance to malignant transformation is therefore of considerable interest. We demonstrate here that CEA mediates Ca2+-independent, homotypic aggregation of cultured human colon adenocarcinoma cells (LS-180) and rodent cells transfected with functional CEA cDNA. Furthermore, CEA can effect the homotypic sorting of cells in heterogeneous populations of aggregating cells. CEA can thus be considered a new addition to the family of intercellular adhesion molecules. We also show that, whereas CEA is localized mainly to epithelial cell membranes facing the lumen in normal adult intestine, it is found on adjacent cell membranes in both embryonic intestine and colonic tumors. A model for the role of CEA in the tissue architecture of adult, embryonic, and aberrant tumor intestinal epithelium is presented. PMID- 2702692 TI - Reverse self-splicing of the tetrahymena group I intron: implication for the directionality of splicing and for intron transposition. AB - Using short oligoribonucleotides as ligated exon substrates, we show that splicing of the Tetrahymena rRNA group I intron is fully reversible in vitro. Incubation of ligated exon RNA with linear intron produces a molecule in which the splice site sequences of the precursor are reformed. Reversal of self splicing is favored by high RNA concentration, high magnesium and temperature, and the absence of guanosine. 5' exon sequences that can pair with the internal guide sequence of the intron are required, whereas 3' exon sequences are not essential. Integration of the intron into ligated exon substrates that have the ability to form stem-loop structures is reduced at least one order of magnitude over short, unstructured substrates. We propose that the formation of these structures helps drive splicing in the forward direction. We also show that the Tetrahymena intron can integrate into a beta-globin transcript. This has implications for transposition of group I introns. PMID- 2702693 TI - Role of the fourth complement component (C4) in the regulation of contact sensitivity. II. Qualitative differences between C4 molecules from high- and low C4 mouse strains. AB - Lymph node cells collected from CBA/J mice 4 days after painting with picryl chloride induce contact sensitivity in naive recipient mice by virtue of hapten IgM immuno complexes. The immunizing capacity of these cells ("4-day" cells) is abolished after incubation of the cells with a C4-deficient guinea pig serum reconstituted with plasma or purified C4 from mice with high C4 levels (C4h), but not with plasma or purified C4 from mice with low C4 levels (C41). The inhibition of the immunizing capacity of 4-day cells is due to the activation of the early components of the classical complement pathway which is likely to result in the solubilization of membrane-bound immunocomplexes. However, the same amounts of CBA/J and BALB/c C4 have a different effect in inhibiting the induction of contact sensitivity by 4-day cells. In fact, by dose-response experiments, we have found that the amount of C41 able to inhibit the induction of contact sensitivity is about threefold higher than that of C4h. Analysis of the covalent binding ability of C4h and C41 reveals that C4h is able to bind to the surface of 4-day cells more efficiently than C41 and this probably accounts for the difference of the two C4 molecules in inhibiting the immunizing capacity of 4-day cells. Results are discussed in terms of different reactivities of C4h and C41 with the surface of 4-day cells. PMID- 2702694 TI - Analysis of mechanisms by which NK cells acquire increased cytotoxicity against class I MHC-eliminated targets. AB - Acid treatment, where cells are exposed to 0.2 M citric acid buffer at pH 3 for 2 min, was described in a previous paper to be a method which specifically eliminates class I MHC antigens from the membrane of viable cells. We applied this method to characterize functional roles of class I MHC antigens on the target cells in NK cell cytotoxicity. When NK target cells, U937, Molt-4, and Raji, were subjected to acid treatment, the treated cells lost their surface class I MHC antigens and became more sensitive to NK cell killing. On the other hand, the susceptibility of K562 cells which initially lacked class I MHC antigens did not significantly change after such treatment. We then examined the mechanism which enables NK cells to become more cytotoxic against class I MHC antigen-eliminated target cells. Single cell binding assay and cold target inhibition assay demonstrated that class I MHC antigen-eliminated target cells did not acquire high binding affinity to NK cells. However, the interaction between NK cells and class I MHC antigen-eliminated targets resulted in a greater increase in production of NKCF-like factor than did the interaction between NK cells and untreated targets. Class I MHC antigen-eliminated targets did not acquire high killer susceptibility to NKCF-like factor. The present study utilizing the acid treatment method confirmed that surface class I MHC antigens on the targets are important immunoregulatory molecules not only for cytotoxic T lymphocytes but also for NK cells and elucidated some of the underlying mechanisms. PMID- 2702695 TI - Antiproliferative mechanism of anti-class II monoclonal antibodies. AB - The function of Class II molecules in proliferation was explored by treating human cell lines with three distinct anti-DR monoclonal antibodies (MABs). Dose dependent, specific inhibition of eight DR+ cell lines of different origin and lineage was found. Inhibition was durable (i.e., cells did not become resistant to the anti-DR MABs despite prolonged treatment) yet reversible. The mechanism of inhibition was not due to differentiation or killing but was cytostatic. Inhibition was temporally associated with decreases in nuclear size and irregularity and appeared to be due to a non-phase-specific cell cycle arrest. PMID- 2702696 TI - Cyclophosphamide potentiates the antitumor activity of v-p97NY. AB - Previous work has demonstrated that a recombinant live vaccinia virus-based tumor vaccine, v-p97NY, induces an immune response in mice which can lead to the rejection of transfected lines of mouse melanoma cells expressing the human melanoma antigen p97 (S.-L. Hu et al., J. Virol. 62, 176, 1988; C. D. Estin et al., Proc. Natl. Acad. Sci. USA 85, 1052, 1988). We now show that the ability of v-p97NY to induce delayed-type hypersensitivity to p97 improved if the vaccinated mice were given cyclophosphamide (Cy) on the day of vaccination. Likewise, treatment of vaccinated mice with Cy increased the antitumor activity of vaccination so that tumor colony formation in the lungs was inhibited even when v p9NY plus Cy was not given until 7 days after intravenous injection of tumor cells. PMID- 2702697 TI - Surface phenotype of rat bone marrow-derived mononuclear phagocytes. AB - Utilizing a panel of currently available monoclonal antibodies, the surface phenotype of a pure population of resting rat bone marrow-derived mononuclear phagocytes (BMM phi) was analyzed by means of flow cytometry. The present work provides an extensive list of surface markers expressed by BMM phi and also outlines advantages and limitations of flow cytometric analysis of this cell type. The results show that the majority of surface markers considered to be expressed selectively by T lymphocytes, such as Thy-1, CD2 and CD5 antigens, leukosialin (W3/13), or an alloantigen of peripheral T cells, are not expressed by BMM phi. On the other hand, the CD8 antigen and the leukocyte common antigen recognized by MRC OX-33, considered to represent specific markers of cytotoxic T cells and/or peripheral B cells, are expressed on a variable, often considerable proportion of BMM phi. Monoclonal antibodies W3/25, MRC OX-35, and MRC OX-38, directed against epitopes on the CD4 molecule, labeled a variable proportion of BMM phi. Among the 39 monoclonal antibodies examined, none appeared to recognize an epitope which is expressed selectively by mononuclear phagocytes. PMID- 2702698 TI - Influenza serosurvey for 1988-1989 season. PMID- 2702699 TI - Human immunodeficiency virus antibody testing in Canada. Recommendations of the National Advisory Committee on AIDS. PMID- 2702700 TI - Confidentiality in relation to HIV seropositivity. Report of the Federal/Provincial/Territorial Advisory Committee on AIDS. PMID- 2702702 TI - Effects of a preoperative teaching booklet on patients. PMID- 2702701 TI - AIDS surveillance--worldwide. PMID- 2702703 TI - Kinetic study of the interaction of glutathione with four antitumor disulfides: possible mechanism for cellular glutathione depletion. AB - The reactions between the cellular tripeptide, glutathione (GSH) and four disulfide derivatives of 6-mercaptopurine (6-MP) and 6-thioguanine (6-TG) (compounds 1-4) were studied kinetically. The decyl and phenyl derivatives of 6 MP and 6-TG were reacted with GSH in phosphate buffer (pH 7.4 or 6.0) at 25.0 degrees C and were monitored spectrophotometrically by observing the release of 6 MP and 6-TG. Second order kinetics were observed, with rate constants of 142, 564, 4174 and 429 M-1 s-1 being measured for compounds 1-4, respectively. When the reactions were carried out in the presence of GSH-S-transferase the rates were enhanced 1.3-5.4 times those observed in the absence of enzyme. Products of the reactions were isolated by chromatography and tentatively identified by TLC or fast atom bombardment mass spectrometry. It was observed that GSH reacted with each disulfide in a 1:1 manner, forming a mixed disulfide between GSH and decanethiol or thiophenol while releasing 6-MP or 6-TG. It was concluded that the reported depletion of GSH from EMT6 cells after exposure to these disulfides could be due to their reaction with GSH, and the formation of the mixed disulfides. PMID- 2702704 TI - Electrochemistry of cyclic alpha-imino carboxylates and their metal complexes: correlation with physiological activity. AB - Cyclic voltammetry data were obtained for delta 1-pyrroline-2-carboxylate, delta 3-thiazoline-4-carboxylate, delta 2-thiazoline-2-carboxylate and their complexes with Cu(II), Fe(III), and Fe(II). The free ligands were reduced at about -0.35 V and were oxidized in the range of 0.42-0.52 V. Complexing the imine carboxylates with metal ions produces reduction and oxidation in the ranges of 0.05-0.37 V and 0.52-0.74 V, respectively. Prior reports show that these ligands take part in various biological functions. We propose that electron transfer may be involved in some aspects of the physiological activity. The captodative effect can be applied. PMID- 2702705 TI - Influence of vitamin A status and DDT on vitamin A-dependent protein mannosylation in rat liver. AB - Male Wistar rats of different vitamin A status (total depletion to moderate deficiency) were administered DDT (5 mg/kg/day) or vehicule (corn oil) i.p. daily for 14 days. Vitamin A-dependent protein mannosylation was measured either by in vivo incorporation of [3H]mannose into liver glycoprotein or by in vitro assay of incorporation of [14C]mannose into mannosylretinyl phosphate. Vitamin A deficiency resulted in a significantly impaired in vivo incorporation of mannose in liver glycoprotein but had no effect on the in vitro transport of mannose via retinyl phosphate. Although DDT induced an increase synthesis of liver proteins in smooth endoplasmic reticulum and caused a diminution of the hepatic vitamin A content, it did not affect vitamin A-dependent protein mannosylation. PMID- 2702706 TI - Methyl linoleate ozonide as a substrate for rat glutathione S-transferases: reaction pathway and isoenzyme selectivity. AB - The 9,10-mono-ozonide of methyl linoleate was shown to be a substrate for rat hepatic cytosolic, rat lung cytosolic and rat hepatic microsomal glutathione S transferases (GST). The activities of lung cytosol and liver microsomes with methyl linoleate ozonide (MLO) were found to be high relative to the activity demonstrated by liver cytosol, as compared with their respective activities towards 1-chloro-2,4-dinitrobenzene (CDNB). Only a slight catalytic activity towards the ozonide was noticed for rat lung microsomes. Isoenzyme 2-2 exhibited the highest specific activity (208 nmol/min/mg) when isoenzymes 1-1, 1-2, 2-2, 3 3, 3-4, 4-4 and 7-7 were compared. This isoenzyme accounts for approx. 25% of cytosolic GST protein in rat lung, while in rat liver it represents approx. 9%. This may partly explain the high activity towards the ozonide noticed for rat lung cytosol. No stable conjugates were formed as products of the reaction of MLO with glutathione; although two glutathione-conjugates were noticed on TLC, they were only formed as intermediate compounds. Coupling of an aldehyde dehydrogenase assay or a glutathione reductase assay to the GST-catalyzed conjugation, demonstrated that oxidized glutathione and aldehydes are formed as the major products in the reaction. To further confirm the formation of aldehydes, the products of the GST-catalyzed reaction were incubated with 2,4 dinitrophenylhydrazine, which resulted in hydrazone formation. In conclusion, the activity of the GST towards the ozonide of methyl linoleate is similar to their peroxidase activity with lipid hydroperoxides as substrates. PMID- 2702707 TI - Cytotoxicity of zinc in vitro. AB - The effect of zinc ions on B16 mouse melanoma lines, HeLa cells and I-221 epithelial cells was investigated in vitro in order to ascertain whether sensitivity to Zn2+ is a general feature of cells in vitro and in an attempt to elucidate the mechanism(s) of zinc cytotoxicity. The proliferation of B16, HeLa and I-221 cell lines was inhibited by 1.25 x 10(-4), 1.50 x 10(-4) and 1.50 x 10( 4) mol/l Zn2+, respectively. The free radical scavengers, methimazole and ethanol, did not suppress the toxicity of Zn2+, neither did superoxide dismutase or catalase. The addition of the chelating agent EDTA reduced the zinc cytotoxicity. It was possible to suppress the cytotoxicity of zinc by increasing the concentration of either Fe2+ or Ca2+ but not Mg2+, which suggests that a prerequisite for the toxic action of zinc is entry into cells using channels that are shared with iron or calcium. This view was supported by experiments in which transferrin intensified the cytotoxic action of zinc in serum-free medium. Another agent facilitating zinc transport, prostaglandin E2, inhibited the proliferation of the B16 melanoma cell line. There were no conspicuous differences in zinc toxicity to pigmented and unpigmented cells. The toxic effect of zinc in the cell systems studied exceeded that of iron, copper, manganese and cobalt in the same concentration range. In vitro, Zn2+ should be regarded as a dangerous cation. PMID- 2702708 TI - When not to conduct nursing research. PMID- 2702709 TI - Effect of porous and dense hydroxyapatite implantation on periodontal tissue regeneration in monkeys. AB - Two different kinds of hydroxyapatite (HA) granules (size: 400-630 microns), 1) porous HA fabricated by the H2O2 bubbling method and 2) dense HA, were placed into the experimentally created, 3-wall, wide periodontal defects in two monkeys to evaluate whether the different structures of hydroxyapatite influence the periodontal response after implantation. Defects without HA implantation served as controls. The HA implant groups showed excellent biocompatibility. Both the porous HA and the dense HA showed a greater amount of "connective tissue attachment or adhesion" than the control group. The amount of the increase by the porous HA group was statistically significant when compared with the control group. However, the three groups showed a similar amount of new cementum formation. These results indicate that the improvement of tissue regeneration by hydroxyapatite implantation was probably due to the prevention of the epithelial downgrowth rather than to the acceleration of the coronal proliferation of the periodontal ligament cells. In the porous HA group, ingrowth of fibrous and osseous tissue in the HA and indefinite tissue-apatite interface were observed. These findings suggest that the porous HA granules formed a firmer attachment to the surrounding periodontal tissue. PMID- 2702710 TI - Effect of diet and route of administration on the DNA binding of aflatoxin B1 in the rat. AB - The effects of dietary Brussels sprouts and indole-3-carbinol (I3C) on xenobiotic metabolizing enzyme activities and hepatic aflatoxin B1 (AFB1)-DNA binding were determined in rats. Animals were dosed intraperitoneally (i.p.) or intragastrically (i.g.) with [3H]AFB1 and killed 2 (i.p.) or 3 (i.g.) h later. Brussels sprouts caused a significant (P less than 0.01) 50-60% decrease in hepatic AFB1-DNA binding, and increased hepatic and intestinal glutathione S transferase (GST) activities. Hepatic mono-oxygenase (AHH and ECD) activities were not altered in sprouts-fed rats, but greater than 2-fold increases in intestinal AHH and ECD activities were found. Although I3C increased intestinal AHH and ECD activities similarly to Brussels sprouts, I3C did not significantly decrease AFB1 binding, nor did it increase hepatic or intestinal GST activity. Route of administration did not alter the percentage inhibition of binding in comparison to control rats in either treatment group, suggesting that the small intestine may not play a significant role in the metabolism of AFB1. In a second experiment, rats were dosed either i.p. or i.g. with [3H]AFB1 and killed 2, 6, 12, 24 or 48 h later. Hepatic AFB1-DNA binding and tissue radioactivity levels were determined. Brussels sprouts once again significantly (P less than 0.001) decreased hepatic AFB1-DNA binding. Route of administration of the carcinogen did not affect DNA binding over time in sprouts-fed animals, confirming our previous results. PMID- 2702711 TI - Transformation of diploid human fibroblasts by transfection of N-ras-oncogenes. AB - To determine if diploid human fibroblasts can be transformed by the N-ras oncogene found in human tumors, early passage cell lines were transfected with an N-ras oncogene from human leukemia cell line 8402 cloned into a high expression plasmid (pSV N-ras), with the N-ras oncogene from human fibrosarcoma cell line HT1080 cloned into pNR-MG1, or with pSV2neo as a control. Each plasmid carries the neo gene coding for Geneticin resistance, but in pSV N-ras, the endogenous promoter of the N-ras gene has been eliminated, and the gene has been inserted between the viral long-terminal repeat (LTR) and the neo gene so that transcription initiated from the LTR must transcribe the N-ras gene before transcribing neo. In pNR-MG1, transcription of the N-ras gene is driven from its endogenous promoter, and the neo gene is transcribed from an SV40 viral promoter, as in pSV2neo. When the transfectants were selected for Geneticin resistance, 70% of the colonies formed with pSV N-ras consisted of morphologically altered cells. Less than 5% of the drug resistant colonies formed with pNR-MG1 had cells with altered morphology, and the change in morphology was much less distinct than with pSV N-ras. No colonies of morphologically-transformed cells were found with pSVneo. If the transfected populations were not selected in Geneticin, but were simply allowed to grow to confluence, very distinct foci composed of morphologically-altered cells could be seen against a contact-inhibited monolayer with pSV N-ras. Foci formed by the pNR-MG1 population were subtle and much less distinct. No foci were found with pSV2neo. Representative colonies and foci of morphologically-transformed cells were isolated. Those from pNR-MG1 transfection reverted to a normal morphology after 5-10 population doublings. Most of those from pSV N-ras transfection either reverted or senesced after 5-10 population doublings. However, progeny of two colonies expressed stable morphological transformation throughout a normal life span equal to that of age-matched pSV2neo controls. Both of these stably transformed cell strains exhibited anchorage independence and formed distinct foci. Immunoprecipitation analysis showed that these cells produced much larger amounts of N-ras protein than did pSV2neo transfected control cells. However, these two cell strains did not exhibit an infinite life span in culture and were unable to form tumors in athymic mice. PMID- 2702712 TI - Supplemental administration of 1 alpha-hydroxyvitamin D3 inhibits promotion by intrarectal instillation of lithocholic acid in N-methyl-N-nitrosourea-induced colonic tumorigenesis in rats. AB - The effect of 1 alpha-hydroxyvitamin D3 [1 alpha(OH)D3] on promotion by intrarectal instillation of lithocholic acid (LC) in N-methyl-N-nitrosourea (MNU) induced colonic tumorigenesis was studied in a rodent model. Ninety-two female F344 rats received intrarectal injection of 2.5 mg of MNU twice in one week followed by 1 mg of LC or its vehicle alone three times weekly for 48 weeks. Those which received LC were given a concomitant intragastric administration of 0.04 micrograms of 1 alpha(OH)D3 or its vehicle alone three times weekly. In the group receiving MNU alone (n = 30) five rats bore colonic tumors; in the MNU + LC group (n = 32) 15 and in the MNU + LC + 1 alpha(OH)D3 group (n = 30) six rats bore colonic tumors (MNU + LC versus MNU + LC + 1 alpha(OH)D3 group, P less than 0.05). These results indicated that promotion of MNU-induced colonic tumorigenesis by LC was suppressed by supplemental administration of 1 alpha(OH)D3. PMID- 2702713 TI - Interactions of rutaecarpine alkaloids with specific binding sites for 2,3,7,8 tetrachlorodibenzo-p-dioxin in rat liver. AB - Rutaecarpine alkaloids have the capacity to inhibit specific 2,3,7,8-[1,6 3H]tetrachlorodibenzo-p-dioxin (TCDD) binding in rat liver cytosol, as analysed by electrofocusing in polyacrylamide gel. The IC50 value for binding of 7,8 dehydrorutaecarpine was estimated to approximately 7 nM indicating a high affinity interaction, whereas rutaecarpine appeared less active (IC50 approximately 110 nM). These findings are of interest in view of the fact that analogues to these compounds may be formed following UV-irradiation of tryptophan and that such photo-products have been suggested to constitute (the) endogenous ligand(s) for the TCDD receptor. As further support of this notion, the rutaecarpine alkaloids investigated could be fitted into a rectangle of 6.8 x 13.7 A, a characteristic common for most high affinity ligands of the TCDD receptor hitherto studied. In view of their structural similarity to dehydrorutaecarpine and the agreement of their mol. wt with that of the photoproduct with the highest affinity for the TCDD receptor, we suggest deaza analogues of dehydrorutaecarpine to represent possible candidates for the endogenous TCDD receptor ligand. PMID- 2702714 TI - Molecular interaction of different chromium species with nucleotides and nucleic acids. AB - The interaction of chromium(III) and chromium(VI) with the phosphate groups of di and triphosphate nucleotides were examined by 31P-NMR spectroscopy. Chemical shifts of the phosphate groups, indicating the formation of Cr-nucleotide complexes, could only be detected with Cr(III). When Cr(III) was generated from Cr(VI) by reduction with an excess of glutathione, nearly the same chemical shifts could be observed. This indicates that glutathione is not capable of trapping Cr(VI) by reduction with subsequent formation of stable Cr-GSH complexes, thus preventing the binding of chromium to important target molecules as DNA or nucleotides. Using radioactively-labelled chromium no 51Cr(VI) bound to any nucleic acid, whereas 51Cr(III) bound in increasing order to poly(A).poly(U), calf thymus DNA and poly(G).poly(C). Furthermore, the melting temperature of nucleic acids increased in the same order only in the presence of Cr(III). Possible genotoxic consequences in vivo of the presented data in vitro concerning the binding of Cr(III) to sensitive molecular targets are discussed in detail. PMID- 2702715 TI - Transport of DNA-adducting metabolites in mouse serum following benzo[a]pyrene administration. AB - Metabolic activation of benzo[a]pyrene (BaP) by cellular enzymes is required for DNA adduct formation. In vivo DNA adducts might also arise from BaP metabolites supplied via the systemic circulation, rather than from in situ activation. We determined whether electrophilic metabolites could be detected in mouse serum 4 h after BaP dosing (i.p.) by trapping metabolites with salmon sperm DNA (ssDNA), followed by 32P-postlabeling analysis for DNA adducts. In vitro studies demonstrated that mouse serum sequesters BaP-7,8-diol-9,10-epoxide (BPDE) and protects it from hydrolysis. BPDE was rapidly transferred from serum to ssDNA or splenocytes, with adduct levels in ssDNA 4- to 7-fold greater than in splenocytes. After BaP administration, mouse serum produced two adduct spots when incubated with ssDNA. The major adduct (spot 3) co-chromatographed with a BPDE adduct standard, while the minor adduct (spot 2) was unrelated to BPDE. A BPDE standard curve in control serum was developed to quantitate BPDE levels in dosed serum. These levels ranged from 13.1 to 19.1 nM. Tissue DNA contained three adduct spots: spots 2 and 3 appeared identical to the respective adducts arising from dosed serum. BPDE-DNA adducts in tissues were highest in liver, lung and spleen, with kidney and stomach levels significantly lower. Levels of adduct 2 did not correlate with levels of adduct 3, especially in spleen where the adduct 2/adduct 3 ratio was very low. In vitro studies in which splenocytes were presented with both adducting metabolites suggested that splenocytes preferentially form adduct 3. These results indicate that two of the three BaP electrophilic metabolites responsible for cellular DNA damage are present in mouse serum. The levels of BPDE in serum may be sufficient to account for a substantial portion of the tissue load of BPDE-DNA adducts. PMID- 2702716 TI - The relationship between O6-alkylguanine alkyltransferase activity and sensitivity to alkylation-induced sister chromatid exchanges in human lymphoblastoid cell lines. AB - We investigated the relationship between the ability to repair the O6 alkylguanine lesions and sister chromatid exchange (SCE) induction. Six human lymphoblastoid cell lines, with O6-alkylguanine alkyltransferase (AGT) activities ranging from 0 to 13.2 fmol/micrograms DNA, were tested for their sensitivity to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-, methyl methanesulfonate (MMS)- and 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU)-induced SCEs. L33, a long established lymphoblastoid cell line with no AGT activity, was sensitive to all three alkylating agents. In the other more recently established Epstein-Barr virus transformed cell lines, no correlation between AGT activity (ranging from 2.4 to 13.2 fmol/micrograms DNA) and sensitivity to MMS or MNNG was noted. In fact, of these five cell lines, the cell line with the highest AGT activity, line 852A, was the most sensitive to MNNG-induced SCEs. While cell lines differed in overall alkylation by MNNG, no relationship between overall akylation and sensitivity to MNNG-induced SCE formation was noted. In contrast to the results with the monofunctional alkylating agents, there was a correlation between AGT activity and BCNU-sensitivity to SCE induction. Cell lines with low AGT activities were more sensitive to the bifunctional alkylating agent than cells with higher activities. Therefore, while DNA interstrand cross-links produced by BCNU exposure probably underlie SCE induction by this agent, the lesions and processes that lead to SCE induction after exposure to monofunctional alkylating agents remain unclear. PMID- 2702717 TI - DNA repair synthesis in individuals with and without a family history of cancer. AB - The influence of family history on DNA repair synthesis, unscheduled DNA synthesis (UDS), was assessed in volunteers with or without a family history of cancer. UDS, following treatment of mononuclear leukocytes with N-acetoxy-2 acetylaminofluorene, was measured as the incorporation of [3H]thymidine into DNA in the presence of hydroxyurea. The positive family history group (n = 71) had an average of 2.4 first-degree relatives with cancer, defined as any major cancer, excluding skin cancer: 31 participants reported that cancer occurred in both their parents. The "no family history' comparison group (n = 29) had no family history of cancer through the second degree. There was a significant reduction in UDS in cells from individuals with family history, compared to those with no family history (P greater than 0.002). This relationship was not explained by factors known to influence UDS, such as age, smoking or hypertension. We conclude that reduced UDS in mononuclear leukocytes is associated with a family history of any major cancer, and is not confined to a history of cancer of any single organ site. This conclusion is further supported by the observation that individuals (n = 13) with parents who had an earlier onset of cancer (less than 60 years) also had a significantly lower DNA repair synthesis than those (n = 18) whose parents had later diagnosis of cancer (greater than 60 years). PMID- 2702718 TI - 2-Aminofluorene-DNA adduct formation in acetylator congenic mouse lines. AB - The effect of the acetylator polymorphism on hepatic 2-aminofluorene-DNA adduct formation in mice was studied using two recent developments from our laboratory. Acetylator congenic mouse lines differing from their parental inbred lines in N acetyltransferase activity were used to separate the effect of the N acetyltransferase polymorphism from effects of differences in other genetically polymorphic enzymes. DNA adduct formation was used as an indicator of arylamine induced DNA damage. Adduct formation was measured by HPLC analysis of 32P postlabeled nucleotides from hepatic DNA of treated animals. At a high dose (60 mg/kg) of 2-aminofluorene for a 3 h exposure, rapid acetylator mice (C57BL/6J) accumulated twice the adducts of slow acetylators (A/J). In acetylator congenic mice this difference increased so that rapid acetylators with the slow background (A.B6-Natr) had 5- to 7-times the DNA damage of the slow acetylator congenic with the rapid background (B6.A-Nats). It was also found that within each mouse line examined, females had higher levels of adduct formation than males. Acetylator congenic mouse lines were useful in distinguishing the effect of acetylator genes from the total genetic background. Similarly, congenics were useful in demonstrating the contribution that enzymes other than N-acetyltransferase make to differences in adduct formation in inbred mouse lines. PMID- 2702719 TI - Sequential analysis of quinoline-induced hepatic hemangioendothelioma development in rats. AB - The effect of duration of quinoline treatment on the induction of hepatic hemangioendotheliomas was examined. Groups of male Wistar rats were given 0.25% quinoline in the diet for 4, 8, 12, 16 or 20 weeks and sequentially killed at these time points. Hemangioendotheliomas were only induced in the livers of rats given quinoline for more than 12 weeks and the incidences of small foci of dysplastic endothelial cells and tumors at week 20 did not differ between the 12 , 16- and 20-week-treated groups. Quantitative analysis of the liver sections at week 20 revealed increased relative area occupied by sinusoidal space even after only 4-week exposures. Parenchymal hyperplastic nodules were observed only in one rat each of the 16- and 20-week-treated groups. The present study indicates that dysplastic endothelial foci may develop into hemangioendotheliomas irrespective of whether the carcinogenic stimulus is continued. PMID- 2702720 TI - The role of specific DNA adducts in the induction of micronuclei by N-hydroxy-2 acetylaminofluorene in rat liver in vivo. AB - N-Hydroxy-2-acetylaminofluorene (N-OH-AAF) was administered i.p. to male Wistar rats 17 h after partial hepatectomy. Hepatocytes were analyzed for the presence of micronuclei 7 h, 1, 2, 3 and 4 days after injection. N-OH-AAF treatment resulted in a high frequency of micronucleated hepatocytes at days 3 and 4 (19.5% and 19.6% respectively). The frequency of micronucleated hepatocytes was not increased above control values when hepatocytes were isolated as early as 7 h, 1 or 2 days after injection. Pretreatment with the sulfotransferase inhibitor pentachlorophenol (PCP) 45 min before injection of N-OH-AAF almost completely prevented the formation of micronuclei by N-OH-AAF. Parallel biochemical studies indicated that inhibition of sulfation of N-OH-AAF by PCP pretreatment prevented the formation of the N-acetylated DNA adducts N-deoxyguanosin-8-yl-AAF and 3 deoxyguanosin-N2-yl-AAF by approximately 85%. Total adduct formation to DNA was, however, not lowered because of an increase in the formation of the deacetylated adduct, N-deoxyguanosin-8-yl-AAF. The lower frequency of micronucleated hepatocytes observed in the group pretreated with PCP, did not result from less proliferative activity in this group as compared to the group treated with N-OH AAF alone. Therefore, the decrease in the formation of micronuclei indicates that PCP prevents the clastogenic damage caused by N-OH-AAF. It is concluded that the clastogenicity of N-OH-AAF in rat liver is related to the formation of N acetylated DNA adducts (i.e. N-deoxyguanosin-8-yl-AAF and/or 3-deoxyguanosin-N2 yl-AAF) and is not related to the formation of the deacetylated DNA adduct N deoxyguanosin-8-yl-AF. PMID- 2702721 TI - UVC-induced expression of a tumor-associated antigen in human cell hybrids (HeLa X skin fibroblasts): repair of potentially lethal and potentially transforming damage. AB - The UVC-induced expression of a cell surface protein which correlates with the induction of tumorigenicity has been observed in human cell hybrids (HeLa X skin fibroblasts). A dose - response curve for the induction of this marker of neoplastic transformation has been obtained. Studies of the repair of potentially lethal and potentially transforming damage indicate a slow repair process which results in enhanced survival and decreased neoplastic transformation over the period 6-24 h post-treatment. The kinetics of this repair process are consistent with previously published work on the kinetics of removal of thymine dimers from UVC-irradiated human skin fibroblasts. During the first few hours post irradiation (0-6 h) there are fluctuations in transformation frequency while survival remains essentially constant. It is during this period that 6-4 photoproducts are removed from UV-irradiated DNA. It is possible that repair of these lesions may lead to an increase in transformation frequency and have no impact in terms of survival. PMID- 2702722 TI - Metabolism of aromatic amines: relationships of N-acetylation, O-acetylation, N,O acetyltransfer and deacetylation in human liver and urinary bladder. AB - N-Acetoxyarylamines are reactive metabolites that are implicated in the initiation of the carcinogenic process by some N-substituted aryl compounds. The objective of this study was to explore the relationship between the production of these reactive species and N-acetylation (NAT), a reaction previously demonstrated to be polymorphic in the human. Human liver and urinary bladder mucosa samples were frozen within 4-8 h post mortem. These tissues were assayed for the (i) O-acetylation (OAT) of N-hydroxy-3,2'-dimethyl-4-aminobiphenyl (N-OH DMABP) by acetyl CoA, (ii) intramolecular N,O-acetyltransfer (AHAT) of N-hydroxy 2-acetylaminofluorene (N-OH-AAF), (iii) NAT of 2-aminofluorene (2-AF) and p aminobenzoic acid (PABA) by acetyl CoA and (iv) deacetylation of N-OH-AAF. Cytosolic AHAT and OAT showed partial inhibition by paraoxon. The ratio of paraoxon insensitive AHAT to OAT to NAT of PABA to NAT of 2-AF appears to be 1:2:11:22 using freshly made cytosols from frozen livers. Freezing of the cytosol resulted in extensive loss of activities. All four of these cytosolic enzyme activities exhibited a similar polymorphic response. Microsomal deacetylation showed a monomorphic response. Similar to the liver, urinary bladder epithelial cells also catalyzed the same reactions. However, the OAT and AHAT activities were detected mainly in microsomes. These data suggest that phenotypically rapid acetylators have a greater biochemical potential for the metabolic activation of aromatic amines by pathways that involve O-acetylation. PMID- 2702723 TI - Chromatographic detection of 7-methyladenine in urine of rats administered N methylnitrosourea: a potential marker for monitoring exposure to methylating carcinogens. AB - Relatively simple and rapid analytical procedures involving two sequential HPLC separations were developed for the isolation of methylated purines in the urine of rats administered radiolabeled methylating carcinogens. Following a dose of [3H]N-methyl-N-nitrosourea (MNU), 7-methyl-adenine (m7Gua) was detected by chromatography as a urinary methylpurine in addition to the expected 7 methylguanine (m7Gua) and 3-methyladenine (m3Ade). When methyl-labeled methionine was given to rats concurrently with MNU, urinary m7Gua was labeled, but no radioactivity was recovered in either of the two methyladenine fractions. The profile of urinary methylated purines following a dose of dimethyl sulfate to the rat was similar. Small amounts of 1-methyladenine (m1Ade) and 3-methylguanine (m3Gua) were also detected in the urine. The excretion of m7Ade derived from the methyl group of the carcinogen rather than from the normal precursor for methylation, implies that this adduct, like m3Ade, may serve as an indicator in urine for exposure to methylating carcinogens. PMID- 2702724 TI - Detection and measurement of MeIQx in human urine after ingestion of a cooked meat meal. AB - A gas chromatographic-mass spectrometric assay has been developed for the measurement of 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) in urine. The method employs capillary column gas chromatography, electron capture negative ion chemical ionization mass spectrometry, a stable isotope-labelled analogue of MeIQx as internal standard and has a limit of detection of 5 pg MeIQx/ml urine. Six subjects consumed a fried beef meal and urine was collected before and after this event. While no MeIQx could be detected in urine collections made prior to meat consumption, the 12-h urine collections of all six subjects made after the meal contained the amine. When the amounts of MeIQx measured in the urine collections were compared to the quantities of amine ingested in the fried beef, it was found that 1.8-4.9% of the oral dose was excreted unchanged in urine. Metabolic studies in animals lead us to believe that MeIQx in the diet is efficiently absorbed and extensively biotransformed. PMID- 2702725 TI - A metabolite of butylated hydroxytoluene with potent tumor-promoting activity in mouse lung. AB - Chronically administered butylated hydroxytoluene (BHT) can enhance the formation of carcinogen-induced lung tumors in mice, and biotransformation of BHT is required for this activity. In the present study, oxidative metabolism of BHT by liver microsomes and lung tumor promotion by BHT in three inbred mouse strains, NGP/N, A/J and MA/MyJ, were compared. The strain order shown is the order of increasing susceptibility of these mice to BHT tumor promotion which correlates with their increasing ability to produce a particular metabolite, BHT-BuOH, by hydroxylation of BHT at one of the tert-butyl groups. Chronic BHT administration, according to the treatment regimen for promotion, selectively induced the BHT oxidization pathway leading to BHT-BuOH. The results suggest that formation of BHT-BuOH leads to the tumor promoting effects of BHT. This hypothesis was tested directly by chronic administration of BHT, BHT-BuOH, and two other metabolites, 2,6-di-tert-butyl-4-hydroxymethyl phenol and 2,6-di-tert-butyl-1,4-benzoquinone to MA/MyJ mice following a single injection of urethane. The only metabolite that enhanced lung tumor formation was BHT-BuOH, and it was effective at one-fourth the effective dose of BHT. Thus both indirect and direct evidence implicates BHT BuOH formation as an important step in the chain of events leading to promotion of lung tumors. PMID- 2702726 TI - Intracellular calcium alterations in response to increased external calcium in normal and neoplastic keratinocytes. AB - Normal keratinocytes proliferate when cultured in medium with 0.02-0.10 mM calcium and terminally differentiate when medium calcium is increased to greater than 0.1 mM. In contrast, neoplastic keratinocyte cell lines maintain the potential for continued cell renewal and survive when external calcium is increased. In order to determine whether elevation of extracellular calcium produced changes in intracellular free calcium (Cai) levels, Cai was measured in individual living keratinocytes by use of the fluorescent calcium probe fura-2. Most normal keratinocytes responded to increased extracellular calcium by a gradual 2- to 3-fold increase in Cai lasting for at least 28 min. A subpopulation displayed a sharp peak of Cai at 2 min. In contrast, the Cai level in neoplastic cells in either low or high calcium medium was 2- to 3-fold higher than that in normal cells, and all cells in the population showed a transient 4- to 9-fold elevation of Cai 2 min after external calcium was increased. Thus normal and neoplastic keratinocytes differ in the level of Cai under low calcium conditions and in their response to elevated external calcium. The regulation of Cai in keratinocytes may be important in determining their potential for terminal differentiation. PMID- 2702727 TI - The prevention of nitrosomethylurea-induced mammary tumors by d-limonene and orange oil. AB - The monocyclic monoterpenoid d-limonene and its source, orange oil, were found to prevent rat mammary carcinomas induced by the direct-acting carcinogen nitrosomethylurea. This chemopreventive effect was limited to the promotion/progression stage in this carcinogenesis model. PMID- 2702728 TI - Preparation of microgram quantities of BaP-DNA adducts using isolated rat hepatocytes in vitro. AB - The analysis of carcinogen-DNA adducts generally requires the preparation (by chemical or biological means) of DNA adduct standards, in amounts sufficient for chemical characterization. We have established conditions for the in vitro biological preparation of microgram quantities of DNA adducts derived from benzo[a]pyrene (BaP), fluoranthene and 7,12-dimethylbenzanthracene, using isolated rat hepatocytes. The metabolic activation of 180 microM BaP by isolated rat hepatocytes in a calf-thymus-DNA (CT-DNA)-supplemented medium resulted in the formation of 2.9 micrograms of BaP adducted to 56.7 mg of DNA. The average level of binding in this experiment was 148 +/- 8 pmol BaP bound/1 mg DNA, which compares favorably to the 10-30 pmol BAP/1 mg DNA which is typical of mouse skin adducts in vivo. In another experiment, BaP-DNA adduct formation in calf-thymus DNA added to hepatocyte incubations was further increased to 327 +/- 27 pmol/mg DNA, by physical shearing of the DNA prior to the incubation. The HPLC profile of the BaP adducts produced using hepatocytes plus CT-DNA is virtually indistinguishable from that produced by tumor-initiating doses of BaP applied to mouse skin in vivo, and the major DNA adduct formed by the hepatocytes co-elutes with the (+)-anti-diol-epoxide adduct of deoxyguanosine. Similar experiments using fluoranthene and 7,12-dimethylbenzanthracene also resulted in substantial DNA adduct formation; however, incubations using dibenz[a,h]anthracene did not. These results indicate that isolated rat hepatocytes in vitro can be useful for the preparation of DNA adducts of a number of polycyclic aromatic hydrocarbons, in quantities sufficient for chemical characterization. PMID- 2702729 TI - Epidermal cell proliferation and modulation of the protective potency of dexamethasone against phorbol ester-induced ornithine decarboxylase activity. AB - Treating mouse skin with dexamethasone (DXME, 1 mumol) after a single TPA (3.25 nmol) application, inhibited both the dermal inflammatory reaction and the induction of epidermal ornithine decarboxylase (ODC) activity. At the hyperplastic stage, DXME was active against inflammation, though inhibited weakly the induction of ODC. In DXME-protected skin, the hyperplastic stage was delayed; unexpectedly, before that stage, 12-O-tetradecanoyl-phorbol-13-acetate (TPA) induced strongly ODC activity in the epidermal cell layer. Provided that the proliferation process was induced, epidermal cells were increasingly sensitive toward TPA action; they may have been less dependent on inflammatory factors which may modulate the induction of ODC. PMID- 2702730 TI - Effect of superoxide dismutase on myocardial infarct size in the canine heart after 6 hours of regional ischemia and reperfusion: a demonstration of myocardial salvage. AB - Available data demonstrate that oxygen free radicals and derived reactive species of oxygen are produced during myocardial ischemia as well as upon reperfusion of the ischemic tissue. The present study was designed to determine if polyethylene glycol-conjugated superoxide dismutase (PEG-SOD), with its extended plasma half life in excess of 30 hours in contrast to the native form of the enzyme (Native SOD), could provide protection to the ischemic myocardium subjected to a 6-hour regional ischemia followed by reperfusion for 24 hours. We hypothesized that myocardial injury due to an ischemic interval is a dynamic process involving the sustained production of cytotoxic oxygen radicals that may continue beyond the ischemic interval. The ability to demonstrate a protective effect of the free radical scavenger enzyme superoxide dismutase would require the continued presence of the antioxidant during the ischemic interval and especially during reperfusion. To test this hypothesis, 22 anesthetized, open-chest dogs underwent 6 hours of circumflex coronary artery occlusion followed by reperfusion for 24 hours. Rapid administration of either Native-SOD (1,000 U/kg), PEG-SOD (1,000 U/kg), PEG-albumin (PEG-ALB), or 0.9% sodium chloride solution for injection (saline) was administered via the left atrium 15 minutes before occlusion of the vessel. A continuous infusion of an additional 1,000 U/kg of the respective enzyme interventions or an equivalent volume of PEG-ALB or saline was given during the 6-hour coronary artery occlusion and terminated 15 minutes after reperfusion. The animals were euthanized 24 hours after reperfusion, and the myocardial region at risk and the infarct region were quantitated by the tetrazolium method. The area of myocardium at risk of infarction, expressed as a percent of the left ventricle, did not differ among the groups: Native-SOD (n = 8), 46.2 +/- 1.8%; PEG-SOD (n = 6), 45.7 +/- 2.1%; PEG-ALB, 38.4 +/- 2.3% (n = 4); and saline 46.0 +/- 2.1% (n = 4). Hemodynamic parameters, the calculated rate pressure-product, as well as regional myocardial blood flow (radiolabeled microsphere method) in the endocardial, midmyocardial, and epicardial segments of the risk and the nonrisk regions were comparable for all groups. Mean infarct size, determined 24 hours after reperfusion, in the group treated with PEG-SOD was 47.1 +/- 2.9% of the area at risk (n = 6), significantly smaller than that observed in each of the other treatment groups: Native-SOD, 63.5 +/- 2.2% (n = 8); PEG-ALB, 64.6 +/- 2.4% (n = 4); saline, 70.8 +/- 2.2% (n = 4).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2702731 TI - Differential control of adrenal and renal sympathetic nerve activity during hemorrhagic hypotension in rats. AB - The reflex mechanisms that produce the neurocirculatory adjustments to hemorrhagic hypotension are incompletely understood. The goal of this study was to determine if hemorrhagic hypotension in rats produces differential effects on sympathetic outflow to the adrenal gland and kidney and if the two sympathetic nerve responses are governed by different reflex mechanisms. We performed simultaneous multifiber recordings of adrenal and renal sympathetic nerve activity (SNA) during 8 minutes of sustained hemorrhagic hypotension to a mean arterial pressure of 50 mm Hg in chloralose-anesthetized Sprague-Dawley rats with a) baroreceptors intact, b) cervical vagotomy, c) sinoaortic baroreceptor denervation, and d) combined vagotomy plus sinoaortic denervation. During hemorrhagic hypotension in rats with intact baroreceptors, renal SNA decreased by 31 +/- 10% (mean +/- SEM, p less than 0.05 vs. control) and heart rate decreased from 384 +/- 13 to 365 +/- 16 beats per minute (p less than 0.05), but adrenal SNA increased by 69 +/- 10% over control (p less than 0.05). The decreases in renal SNA and heart rate were reversed by cervical vagotomy but not by atropine, which indicates vagal afferent mediation. In contrast, the increases in adrenal SNA during hemorrhage were not affected by vagotomy alone or by sinoaortic denervation alone but were markedly attenuated by combined sinoaortic denervation and vagotomy, which indicates redundancy in the baroreflex control of adrenal SNA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702732 TI - High-salt diet elevates baroreceptor pressure thresholds in normal and Dahl rats. AB - Dahl Salt Sensitive (DS) rats rapidly develop high blood pressure when exposed to a high-salt diet. Recent studies suggest that DS rats have poorly functioning baroreceptor afferents and baroreflexes even when salt intake is restricted. This study examines baroreceptor pressure- and mechano-transduction in DS, Dahl Resistant (DR), and Sprague-Dawley (SD) rats during low- and high-salt conditions. Single unit, regularly discharging baroreceptors were studied using an in vitro aortic arch-aortic nerve preparation. Pressure thresholds and suprathreshold pressure sensitivities were determined from responses to slow ramps of pressure. Pressure-diameter relations measured in each rat were used to transform pressure threshold and pressure sensitivity values to their mechanical equivalents in terms of aortic wall strain. A total of 407 unit baroreceptors were studied from 49 rats. Tail systolic blood pressures were significantly higher only in DS during high salt. Pressure threshold was similar for all groups on low salt. Exposure to a high-salt diet increased the mean pressure threshold for all three groups. Pressure threshold for high-salt diet was highest in DS and lowest in DR. Pressure sensitivities were lowest in DS and highest in DR on low salt. High salt had no significant effect on pressure sensitivity. The differences in threshold apparent when expressed in terms of pressure were eliminated by conversion to their mechanical equivalents (strain threshold and strain sensitivity). The results suggest that baroreceptors in the two Dahl rat strains represent two extremes from normal baroreceptor function. DS tend to be less pressure responsive than normal (SD), and DR tend to be somewhat more responsive to pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702733 TI - Circulatory assistance by intrathoracic pressure variations: optimization and mechanisms studied by a mathematical model in relation to experimental data. AB - The hemodynamic effects of phasic variations in intrathoracic pressure (ITP) timed to the cardiac cycle were predicted by a mathematical model and were compared with data from canine experimental studies. The model was used to predict the hemodynamic effects of changing the onset of the ITP rise relative to the start of cardiac systole, as well as the hemodynamic effects of changes in the duration and amplitude of the ITP rise. The predictions of the model were compared with hemodynamic data from seven anesthetized dogs. Cardiac function was depressed with large doses of verapamil and propranolol, and the hearts were atrioventricular sequentially paced at a rate of 72 beats/min. Phasic ITP variations were generated by a perithoracic vest and were electronically timed to the cardiac cycle. The model predicted, and the experimental data confirmed, that phasic intrathoracic pressure variations generated by vest inflation, timed to the cardiac cycle, can augment both peak and mean aortic flow. The following predictions of the model were also confirmed by the experimental data: 1) Maximum flow augmentation occurs when the onset of the ITP rise is simultaneous with the onset of left ventricular isovolumic contraction, and the ITP rise has a duration of 400 msec. 2) The magnitude of the flow augmentation is a function of the amplitude of the ITP rise. The experimental data showed that there was little further flow augmentation when the ITP rise was greater than 30-40 mm Hg. 3) The magnitude of flow augmentation was inversely proportional to the peak left ventricular elastance (Emax). The best fit between the measured and predicted flow augmentations was obtained for an assumed Emax of 0.5 mm Hg/ml, while Emax measurements in three dogs, using a volume conductance catheter and transient vena caval occlusion, yielded values of 0.4-1.6 mm Hg/ml. Thus, both the mathematical model and canine experiments showed that relatively low-amplitude ITP variations, rising synchronously with the onset of cardiac systole and having an optimal duration, assist the failing heart by augmentation of aortic flow. The degree of cardiac assistance decreases if the ITP variations do not rise synchronously with the onset of systole, or if their duration is not optimal. Thus, properly applied ITP variations may be used as an efficient, noninvasive method to temporarily assist the failing heart. PMID- 2702734 TI - Regional left ventricular epicardial deformation in the passive dog heart. AB - Epicardial wall motion was measured on the left ventricular free wall in six isolated potassium-arrested dog hearts using a biplane video technique. Significant regional variations in epicardial deformations were recorded during static ventricular filling. Epicardial stretches varied linearly with cavity volume, sometimes exceeding 20% at physiological left ventricular end-diastolic pressures. The maximum component of epicardial stretch and the derived wall thinning increased substantially from the base to the apex on both the anterior and the posterior free walls of the left ventricle. In five hearts, the direction of greatest epicardial stretch at moderate and high filling pressures coincided closely with the local epicardial fiber direction, suggesting that the left handed epicardial fiber helices stretch preferentially during passive filling to maximize end-diastolic fiber lengths. Epicardial rotation was always counterclockwise, consistent with a reduction in the pitch of the fiber helix during filling. These results suggest that, on the epicardial surface, the passive myocardium is anisotropic with respect to the local fiber direction. We suggest that the resulting torsional shear acts to minimize transmural gradients of fiber stretch. PMID- 2702735 TI - Longitudinal propagation of contraction in the isolated conduit coronary arteries of humans and pigs. AB - We examined the longitudinal propagation of contraction in isolated human and pig coronary arteries. Epicardial coronary arteries of about 2 cm were cut open longitudinally, and the tension development of circular muscles was measured simultaneously at three sites (both cut ends and the midportion of the segment). Cyclic tension changes arising at one site of human coronary artery propagated smoothly to the other sites, and the whole length of segment worked as a single unit. Contraction induced by locally applied prostaglandin F2 alpha or histamine also propagated in four of seven preparations. The remaining three human and all seven pig coronary arteries showed propagation of such drug-induced contraction after treatment with 10 mM tetraethylammonium (TEA). In pig coronary arteries treated with TEA, electrical stimulation evoked a reproducible local contraction and its propagation. Propagation velocity was 9.0 +/- 0.7 at 0.8 mM calcium concentration and increased to 11.1 +/- 0.9 and 13.1 +/- 1.4 mm/sec as calcium concentration rose to 1.8 mM and 7.2 mM, respectively. Local contraction did not propagate at calcium concentrations of 0.2 mM or less. The calcium antagonist diltiazem decreased the propagation velocity dose dependently and blocked propagation of contraction at 0.3 microM without significant effects on the magnitude of local contraction. We conclude that smooth propagation of contraction develops in epicardial coronary arteries of humans and pigs and that the propagation may depend on calcium influx. PMID- 2702736 TI - Time-invariant oxygen cost of mechanical energy in dog left ventricle: consistency and inconsistency of time-varying elastance model with myocardial energetics. AB - We studied whether the oxygen cost of mechanical energy is time-invariant in the excised, cross-circulated canine heart. The total mechanical energy generated by ventricular contraction can be quantified by the total pressure-volume area (PVA) according to the time-varying elastance model. In this model, mechanical energy generated until a specified time (t) during systole can be quantified by the partial pressure-volume area, PVA(t). PVA(t) was obtained by quickly releasing ventricular volume at a varied time during isovolumic contraction. The quick release aborted further development of mechanical energy. We found that PVA(t) at a constant end-diastolic volume linearly correlated with myocardial oxygen consumption (VO2). This indicates that the oxygen cost of mechanical energy is time-invariant. However, we also found that the slope of the VO2-PVA(t) relation decreased with increasing quick-release speed. This indicates a decrease in VO2 by the quick release despite the same PVA(t). The time-invariant oxygen cost of mechanical energy is consistent with the time-varying elastance model of the ventricle, but the decreased VO2 with increasing quick-release speed despite the same PVA(t) is not. PMID- 2702738 TI - Estradiol-17 beta determined in plasma by gas chromatography-mass spectrometry with selected ion monitoring of mixed silyl ether-perfluoroacyl ester derivatives and use of various stable-isotope-labeled internal standards. AB - A highly specific method is described for measuring estradiol-17 beta (E2) in plasma by gas chromatography-mass spectrometry (GC-MS) associated with stable isotope dilution. A mixed derivative, E2-3-trimethylsilyl ether-17 heptafluorobutyrate (E2-3-TMS-17-HFB), was found to have excellent analytical properties. The specificity of the derivatization procedure exploits a unique feature of estrogens: the selective exchange of a phenolic perfluoroacyl ester for a trialkylsilyl ether. No significant differences in E2 concentration could be ascribed to the use of 2H- or 13C-labeled analogs, thus ruling out interferences from possible isotope exchange commonly attributed to deuterated compounds. Precision is closely similar to that for methods in which the more common E2-3, 17-bis(trimethylsilyl) ether and E2-3, 17-bis(heptafluorobutyrate) derivatives are used. Sensitivity and specificity of the mixed 3-TMS-17-HFB derivative allow adequate determinations of E2, even in plasma from males, in 2 mL samples. Interlaboratory mean concentrations of E2 obtained by routine immunoassays were consistently higher than the target values estimated by GC-MS, particularly at concentrations less than 100 pmol/L. PMID- 2702737 TI - Pressure-dependent contraction of rat juxtamedullary afferent arterioles. AB - Pressure-diameter relations were studied in rat afferent arterioles using an isolated, juxtamedullary nephron preparation perfused with a saline solution containing 5% albumin. Angiotensin I (10 microM), angiotensin II (0.1 microM), and norepinephrine (10 microM) increased perfusion pressure, and norepinephrine, but not angiotensin I or II, contracted afferent arterioles, indicating that the vessels are reactive. The control diameter of the afferent arterioles that exhibited pressure-dependent contraction (n = 58) averaged 30.8 +/- 1.1 micron at perfusion pressure of 80 mm Hg. When pressure was increased from 80 to 120 and then to 180 mm Hg, the diameter of these arterioles decreased by 16.4 +/- 2.1%. Glomerular capillary pressure was well autoregulated and averaged 45.2 +/- 2.2, 50.2 +/- 2.4, and 53.0 +/- 3.0 mm Hg, respectively, at perfusion pressures of 80, 120, and 180 mm Hg. Administration of vasodilators or a Ca2+-free solution eliminated the contractile response to pressure elevations; rather, the diameter of these vessels increased significantly by 17.5 +/- 5.1% and 32.0 +/- 9.4%, respectively, when pressure was increased from 80 to 180 mm Hg. Blocking tubuloglomerular feedback mechanism, with furosemide or by removal of the renal papilla (which interrupts the delivery of fluid to the macula densa), eliminated the pressure-dependent contraction of the afferent arterioles. Instead the diameter of these vessels increased by 27.0 +/- 7.8% and 36.0 +/- 5.6%, respectively, when the pressure was increased from 80 to 120 and then to 180 mm Hg. These results demonstrate that juxtamedullary nephrons perfused in vitro autoregulate glomerular capillary pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702739 TI - Atomic absorption spectrometric determination of selenium in human blood components. AB - We separated blood from five healthy blood donors into plasma, erythrocytes, platelets, and leukocytes; counted the number of cells in each fraction; and determined the selenium content of each component by hydride generation atomic absorption spectrometry. The mean (+/- SD) selenium concentrations and amounts measured were as follows: whole blood 102.3 +/- 16.1 micrograms/L, plasma 76.9 +/ 10.6 micrograms/L, erythrocytes 13.7 +/- 2.8 ag per cell, platelets 4.8 +/- 1.1 ag per cell, and leukocytes 99 +/- 26 ag per cell. PMID- 2702740 TI - Sensitive, direct colorimetric assay for copper in serum. AB - We have developed a sensitive procedure for determination of serum copper by use of the color reagent 4-(3,5-dibromo-2-pyridylazo)-N-ethyl-N-sulfopropylaniline. After mixing serum sample and reagent, and incubating at 37 degrees C for 5 min, we measure the absorbance of the resulting chelate complex at 580 nm (molar absorptivity, 80,000 L.mol-1.cm-1). Results of the method varied linearly with copper concentration to at least 5 mg/L; the lower limit of detection was 0.1 mg/L. Within-run CVs were 1.6% and 3.3% for copper concentrations of 1.03 and 0.72 mg/L, respectively (n = 10 each). Between-run CV was 2.8% at 1.22 mg/L (n = 14). Results of the proposed method (y) correlated well with those determined by standard atomic absorption spectrophotometric techniques (x): y = 0.99x - 0.02 mg/L; Syx = 0.08; r = 0.977; n = 56. Iron, zinc, cadmium, cobalt, and lead do not interfere. PMID- 2702741 TI - Measurement of estrone-3-glucuronide in urine by rapid, homogeneous time-resolved fluoroimmunoassay. AB - We describe a liquid-phase nonseparation time-resolved fluorescence immunoassay for measuring estrone-3-glucuronide in undiluted urine. The sensitivity, specificity, and accuracy are similar to those for a conventional separation fluoroimmunoassay or radioimmunoassay, but the speed, convenience, precision, reliability, and clinical utility of the new method are more advantageous. The labeled antigen, a fluorescent europium chelate covalently linked to estrone-3 glucuronide, is incubated for 10 min with a limited concentration of polyclonal or monoclonal antibodies to estrone-3-glucuronyl-6-bovine serum albumin and 10 microL of standard or sample (undiluted urine) in microtiter wells. The fluorescence emanating from the antibody-free label, which is proportional to the concentration of estrone-3-glucuronide in the standard or sample, is then measured in a time-resolved fluorometer. The method is useful for monitoring ovarian function in women. PMID- 2702742 TI - Biological variation of urinary N-acetyl-beta-D-glucosaminidase: practical and clinical implications. AB - The analytical, within-subject, and between-subject components of variation of N acetyl-beta-D-glucosaminidase (NAG) were estimated from duplicate assays of 10 timed first morning and 10 untimed urine specimens collected from each of 15 ostensibly healthy individuals. Results were expressed in terms of activity, NAG/creatinine ratio, and excretion rate. Current analytical methods can achieve desirable performance standards. NAG has little individuality, and conventional population-based reference intervals are therefore useful. In view of the practicability and relatively low within-subject variation, for routine clinical purposes we prefer assay of NAG in first morning urine, expressing the results in terms of activity. Using the results of assays of different specimens, we found that the correlation between urinary albumin and NAG varied considerably, owing to the large intrinsic variability of both analytes; this might explain previous conflicting results. PMID- 2702743 TI - Liquid-chromatographic assay for free and transthyretin-bound retinol-binding protein in serum from normal humans. AB - We quantified vitamin A-transporting retinol-binding protein (RBP) in serum or plasma by size-exclusion "high-performance" liquid chromatography, using a TSK 2000 column and fluorescent detection of the bound retinol. Serum or plasma samples filtered through a 0.20-microns (pore size) Millex filter were applied directly to the column. The pH 7.0 mobile phase contained sodium phosphate, disodium EDTA, and mercaptoethanol. Two peaks with RBP immunological activity were eluted: the smaller peak containing at least 86% of the vitamin A, which was identified as transthyretin-bound RBP; the larger peak containing a small amount (less than 14%) of a highly fluorescent vitamin A-containing protein, identified as free RBP. Both free and transthyretin-bound RBP can be quantified by this method. PMID- 2702745 TI - A system for toxicological screening by capillary gas chromatography with use of a drug retention index based on nitrogen-containing reference compounds. AB - Capillary gas chromatography with nitrogen-specific detection allows rapid screening of numerous drugs of toxicological interest. However, for accurate identification of individual peaks, the system must be well calibrated, e.g., through the use of retention indices (RI). To overcome problems associated with the use of RI's based on homologous series determined with nitrogen-specific detectors, we have developed an RI reference system based on molecular masses and retention times of nitrogen-containing compounds. The standards chosen are easily available in highly purified form and can be detected by the unmodified nitrogen specific detector. By using temperature programming, we can obtain a linear relationship between the molecular masses of standards and their retention times. Used in conjunction with microcomputer data handling, this screening system is rugged and reliable, operating 22 h per day. In the past two years, we have screened greater than 3000 samples (blood, serum, urine, gastric lavage) without major problems. PMID- 2702744 TI - Quantitative analysis for organic acids in biological samples: batch isolation followed by gas chromatographic-mass spectrometric analysis. AB - This new method for qualitative and quantitative determination of organic acids, aldehydes, and ketones in biological samples is effective for use with urine, plasma, and amniotic fluid, and it requires no deproteinization. Isolation by batch-wise liquid partition chromatography on silicic acid follows formation of the O-(2,3,4,5,6-pentafluorobenzyl)oximes of oxoacids, aldehydes, and ketones. The total organic acid content of the sample provides a rapid screening test for metabolic abnormality. A wide-bore, bonded-phase capillary column was used for quantitative gas chromatographic-mass spectrometric analysis, followed by automated identification and quantification. Analytical recoveries were quantitative for a wide variety of metabolites. Gas-chromatographic retention indices, discriminating ions, and control ranges in amniotic fluid, plasma, and urine of adult subjects were determined for 61 biologically important compounds. PMID- 2702746 TI - Characterization of amniotic fluid lamellar bodies by resistive-pulse counting: relationship to measures of fetal lung maturity. AB - Resistive-pulse counting studies of amniotic fluid lamellar bodies are presented and demonstrate a strong concordance with the predictions of accepted measures of fetal lung maturity. Uncentrifuged as well as centrifuged specimens could be evaluated, because cells and debris are rejected electronically. The technique is not affected by bilirubin or debris of lysed whole blood, and only mildly by meconium. Lamellar body number density and mean lamellar body volume were determined for 161 uncentrifuged and 241 centrifuged specimens. Number density maturity criteria (40,000/microL and 26,000/microL, respectively) were shown to be highly concordant with established measures of fetal lung maturity; mean lamellar body volume did not extend this concordance. Since electronic cell counters are generally available 24 h per day and the approach requires neither centrifugation nor subjective interpretation and is rapid and inexpensive, it is proposed that determining lamellar body number density by resistive-pulse counting may be a useful initial screen for the assessment of fetal lung maturity. PMID- 2702747 TI - Allowable limit of error in clinical chemistry quality control. AB - Taking the National Clinical Chemistry Quality Control of China National Center for Clinical Laboratory as an example, I present this study of some problems with using the allowable error limit in present-day clinical chemistry quality control, and propose a new allowable error limit for use in external quality control in clinical chemistry. PMID- 2702748 TI - Three methods compared for estimating the fraction of testosterone and estradiol not bound to sex-hormone-binding globulin. AB - Here we propose and validate, both theoretically and experimentally, a new technique for measuring the percentage of non-sex-hormone-binding globulin (SHBG) bound to testosterone and estradiol. In this method, SHBG is saturated with 1 mumol of 5 alpha-dihydrotestosterone per liter and the non-protein-bound fraction is subsequently measured in treated and untreated samples by centrifugal ultrafiltration dialysis (CUFD). We compared this technique with two previously published methods for measuring the percentage of albumin-bound steroid--ammonium sulfate precipitation and heat denaturation of SHBG followed by CUFD--and also with previously published computer predictions. The ammonium sulfate precipitation gave results closest to the computer-predicted percentage of albumin-bound testosterone and estradiol. Of the two techniques involving CUFD, the 5 alpha-dihydrotestosterone saturation method was the more reproducible. Results by both CUFD methods were higher than the computer-based predictions for albumin-bound steroid in pregnancy serum, in part perhaps because the CUFD measurements represent the non-SHBG-bound fraction rather than that which is albumin-bound alone. PMID- 2702749 TI - Significance of low serum urea nitrogen concentrations. AB - The prevalence of low serum urea nitrogen concentrations (less than 50 mg/L) in our patient population was 1.2% (151 per 12,380 determinations), representing 95 individual cases. Of these, 81 of the patients' charts were located, reviewed, and classified into two groups, those with and those without hepatobiliary disease. Hepatobiliary disease was found in 36% of the 81 patients; 90% of these showed evidence of alcohol abuse, as did 19% of those without hepatobiliary disease. The remaining patients without hepatobiliary disease had various clinical conditions: psychiatric disorders (14.8%), overhydration (12.3%), endocrine disorders (7.4%), cardiovascular diseases (4.9%), prednisone administration (3.7%), and special diets (2.5%). Thus, in our patient population the most frequent cause of low serum urea nitrogen concentrations was alcohol abuse, found in about half of the cases. PMID- 2702750 TI - Serum creatine kinase isoenzyme BB is a poor index to the size of various brain lesions. AB - We divided patients with brain lesions into three groups: (a) patients with primary or metastatic brain cancer, (b) brain infarctions, and (c) brain contusion(s). We analyzed each patient's sera for creatine kinase isoenzyme BB (CK-BB), using a monoclonal antibody kit (Impres-BB; International Immunoassay Laboratories). Computerized axial tomography (CAT) scans were performed on each patient. The size of the various lesions was measured from the CAT scan and recorded in milliliters. Total CK, CK-BB, and their ratios were compared with the volume of damaged brain tissue. We found no correlation between any of the variables and the various brain lesions. We attribute this lack of correlation to an intact blood-brain barrier, the rapid elimination or inactivation of CK-BB, or some combination of these factors. PMID- 2702751 TI - Hypomagnesemia and low alkaline phosphatase activity in patients' serum after cardiac surgery. AB - Significant decreases in magnesium (Mg) concentration and alkaline phosphatase (ALP, EC 3.1.3.1) activity in serum were seen in patients after cardiac surgery with cardiopulmonary bypass (Group 1), as compared with non-cardiac-surgery patients after general anesthesia (Group 2) or only spinal anesthesia (Group 3). Mean changes for Mg and ALP by the first postoperative day, compared with pre operative baseline values, were as follows: Group 1: Mg -7.5 mg/L (-38.3%), ALP 46U/L (-48.4%); Group 2: Mg -3.3 mg/L (-17.4%), ALP -17 U/L (-16.5%); and Group 3: Mg -1.9 mg/L (-10.0%), ALP -15 U/L (-14.0%). The decreases in Mg and ALP observed in post-cardiac-surgery patients appear to be a consequence of the cardiac surgery and the cardiopulmonary bypass pump. Measurement of Mg and ALP in a subgroup of 10 cardiac-surgery patients for 10 days postoperatively showed initial decreases, with gradual recovery to near-normal values by the 10th day. That the changes in Mg and ALP seen postoperatively were not attributable to hemodilution alone was confirmed by measuring total-protein concentrations before and after operation. ALP requires Mg ion in vitro for optimal activity, but addition of Mg in the appropriate amounts to sera with low ALP activity did not restore ALP activity. The low ALP activity seen in post-cardiac surgery patients in vivo may perhaps be related to factors other than Mg that were removed by the cardiopulmonary bypass pump. PMID- 2702752 TI - Proton nuclear magnetic resonance studies of plasma to determine metabolic status of patients with adult respiratory distress syndrome. AB - Adult respiratory distress syndrome (ARDS) is a non-cardiogenic pulmonary edema of various etiologies. Here we report the first application of proton nuclear magnetic resonance (NMR) for the detection of abnormal metabolites in plasma from patients with ARDS. By comparing plasma obtained from the systemic artery with that obtained from the pulmonary artery, we could study the metabolic status of the lung in patients with ARDS. Although their concentrations may vary, the peaks for acetate, acetoacetate, beta-hydroxybutyrate, phenylalanine, and other unidentified compounds in water-suppressed NMR of these patients' plasma were higher than in the normal controls. The proton NMR resonance at a chemical shift of about 7.4 ppm (relative to sodium tetradeutero-3-trimethyl-silylpropionate), presumably caused by phenylalanine and its related metabolites produced by a disordered amino acid metabolism, is detected in greater than 65% of the samples from ARDS patients. We discuss the detection of abnormal metabolites in terms of possible deranged metabolism of carbohydrates, lipids, or amino acids in this syndrome. PMID- 2702753 TI - Serum phylloquinone concentrations in a normal population of children as compared with the reference interval in adults. PMID- 2702754 TI - Confusion of apolipoprotein E phenotyping by serum amyloid A. PMID- 2702755 TI - Glyoxal: an artefact from metronidazole and glyoxylic acid in urinary organic acid analysis. PMID- 2702756 TI - Pyroglutamic acidemia in an adult patient. AB - Pyroglutamic acidemia, a rare metabolic disorder, usually appears in infancy. It is characterized by retardation, ataxia, hemolytic anemia, and chronic acidosis and is caused by a marked deficiency of glutathione synthetase (EC 6.3.2.3) activity. This disease is inherited as an autosomal recessive trait, but the clinical condition is also detected in heterozygotes. We report an unusual case of high-anion-gap metabolic acidosis in a 52-year-old woman who was admitted with neurological complaints and breathing problems but without the characteristic clinical features of congenital glutathione synthetase deficiency. The etiology of the acidosis could not be attributed to ketoacidosis, lactic acidosis, or ingestion of methanol, salicylate, or ethylene glycol. Analysis of the patient's plasma and urine for organic acids revealed the presence of high concentrations of pyroglutamate (5-oxoproline), which remained high throughout her hospitalization. PMID- 2702757 TI - Hereditary complete deficiency of lactate dehydrogenase H-subunit. AB - We report the second known case of a patient, a 45-year-old Japanese woman, with hereditary complete deficiency of lactate dehydrogenase (LDH; EC 1.1.1.27) H subunit. Total LDH activity in her serum was abnormally low (35 U/L, normal reference interval 195-360). LDH activity in her erythrocytes was also low, but all the other glycolytic enzyme activities in her erythrocytes were within normal limits. Electrophoresis of her serum, erythrocytes, lymphocytes, thrombocytes, and saliva showed only one band, the LDH M4 isoenzyme. LDH activities in her saliva and lymphocytes exceeded the reference interval. Her erythrocytes contained fructose 1,6-diphosphate 26 mumol/L (normal range 4-13), dihydroxyacetone phosphate 75 mumol/L (normal range 8-22), glyceraldehyde 3 phosphate 57 mumol/L (normal range 4-14), and pyruvate 45 mumol/L (normal range 31-63). The family study of three generations showed that this deficiency was inherited in an autosomal recessive mode. PMID- 2702759 TI - Differential determination of HDL-subfractions in clinical laboratories. PMID- 2702758 TI - A regulatory model for clinical laboratories: an empirical evaluation. AB - Clinical laboratories in the United States are subject to various regulatory and accreditation programs, which mandate a broad range of requirements regarding personnel, quality-control systems, and analytical proficiency standards. Reported here, for a cross-section of U.S. laboratories, is the degree of compliance with these regulatory requirements, some other laboratory characteristics, and their relation to analytical proficiency. The results suggest that those laboratory characteristics that predict highest proficiency test performance differ for each laboratory specialty. Regression models are presented that explain from 12% to 35% of the variation in analytical performance and suggest that factors outside of those specified in the regulatory model and other characteristics measured in this research are important. Indeed, the current regulatory approach may not ensure highest performance. Also discussed are the current status, limitations, and prospects for change of the clinical laboratory regulatory system. PMID- 2702760 TI - Alkaline phosphatase of possible renal origin identified in plasma after colchicine overdose. PMID- 2702761 TI - Phytanic acid, pristanic acid, and very-long-chain fatty acid methyl esters measured simultaneously by capillary gas chromatography. PMID- 2702762 TI - Serum zinc in homosexual men. PMID- 2702763 TI - Diagnosis of acute myocardial infarction when skeletal muscle damage is present: a caveat regarding use of creatine kinase isoenzymes. PMID- 2702764 TI - Usefulness of the lecithin/sphingomyelin ratio and uselessness of phosphatidylglycerol determinations in tracheal aspirates of preterm infants. PMID- 2702765 TI - Effect of albumin on results for the free-thyroxin index as estimated by the total T4/T3 uptake ratio. PMID- 2702766 TI - Reproducibility of creatine kinase isoenzyme electrophoresis. PMID- 2702767 TI - Moderate iodine deficiency, a possible explanation for the inverse relationship between cord serum thyrotropin and birth weight in a normal Kenyan population. PMID- 2702768 TI - (acyl)carnitine distribution between plasma, erythrocytes, and leukocytes in human blood. PMID- 2702769 TI - Relative potency of commercial calibrators for fructosamine, and their effect on measurements of fructosamine in serum. PMID- 2702770 TI - Generation of monoclonal anti-dermatan sulphate antibodies cross-reacting to calf thymus DNA. AB - Monoclonal anti-dermatan sulphate antibodies were produced with hybridization after immunizing BALB/c mice with dermatan sulphate (DS). These antibodies were tested for cross-reactivity to double-stranded DNA (dsDNA) and heat-denatured DNA (ssDNA). Five clones had binding activity to DS, dsDNA and ssDNA in enzyme-linked immunosorbent assay, but no clones binding to DS alone were produced. Two (2H8 and 3C4) of the five clones were selected for analysis. Their binding activity to DS, ssDNA and dsDNA were inhibited by DS, dsDNA and ssDNA. DNase I treatment abolished the binding activity to dsDNA and ssDNA, completely, but had no effect on the binding activity to DS. On the other hand, chondroitinase ABC treatment of the solid-phased DS augmented the binding to DS. The inhibition assay using digested fractions suggested that the epitope recognized by 2H8 and 3C4 clones could not be in delta Di-4S or delta Di-diSB but in the linkage regions of DS. PMID- 2702771 TI - Cyclosporin A enhances elimination of intracellular L. major parasites by murine macrophages. AB - In this study we analyzed the influence of cyclosporin A (CyA) on the process of phagocytosis of L. major promastigotes and amastigotes by inflammatory peritoneal macrophages (MP) from BALB/c mice. Our data clearly demonstrate that CyA profoundly enhanced the degradation by peritoneal MP of both intracellular L. major promastigotes and amastigotes. This effect was T cell-independent and specifically associated with CyA, since the similarly structured cyclosporin F (CyF) was ineffective. CyA did not alter the replication and infectivity of extracellular parasites. From these results we conclude that the inhibition of intracellular parasite replication in the presence of CyA substantially contributes to the previously described suppressive effect of CyA on the development of L. major-induced lesions in BALB/c mice. PMID- 2702772 TI - Clinical significance of anti-RNP and anti-Sm autoantibodies as determined by immunoblotting and immunoprecipitation in sera from patients with connective tissue diseases. AB - Antibodies to Sm and RNP antigens have been detected by immunoblotting and immunoprecipitation of small nuclear ribonucleoproteins in 168 sera from patients with connective tissue diseases previously characterized by immunodiffusion. Anti RNP and anti-Sm antibodies immunoprecipitated U1 and U1-U6 snRNA respectively. By immunoblotting anti-Sm reacted with B-B' and D polypeptides and we have distinguished two types of anti-RNP sera: 1) 'full spectrum' anti-RNP sera reacted with the 68 kD, A, C and B-B' polypeptides; 2) 'partially reactive' anti RNP sera reacted with various combinations of these polypeptides but not the four of them. A strong specificity of anti-Sm antibodies for systemic lupus erythematosus (SLE) was found with all three methods but immunoblotting was more sensitive and detected anti-Sm in 76% of SLE sera. Sera containing a high titer of 'full spectrum' anti-RNP without anti-Sm activity were only detected in mixed connective tissue disease (MCTD) whereas anti-68 kD antibodies alone seemed to be less specific. This strong association between 'full spectrum' anti-RNP antibodies and MCTD supports the hypothesis that MCTD is a distinct clinical entity associated with a specific serologic marker. PMID- 2702773 TI - Demonstration of anti-idiotypic antibodies directed against IgM rheumatoid factor in the serum of rheumatoid arthritis patients. AB - We have identified the presence of anti-idiotypic activity against IgMRF in the sera of RA patients. Only patients seropositive for IgMRF had significant levels of anti-idiotypic activity, while seronegative patients and normal volunteers did not. When this anti-idiotypic activity was affinity-purified from a single RA patient, two separate binding activities were identified. IgG antibodies were pepsin-digested to F(ab')2 fragments before affinity-purification to remove the Fc portion capable of binding to IgMRF. Anti-idiotypic F(ab')2 fragments of IgG were eluted from an IgMRF-Sepharose 4B column. These F(ab')2 bound preferentially to IgMRF bearing an idiotype recognized by the anti-idiotypic murine monoclonal 17.109. A second anti-idiotypic F(ab')2 was affinity purified using rabbit anti human Fc antibody bound to Sepharose 4B. These eluted antibodies behaved as the internal image of IgG, binding five out of seven IgMRF's tested. The binding of both anti-idiotypic F(ab')2 was inhibited with human IgG. The presence of both IgMRF and anti-idiotypic antibodies directed against it in the sera of RA patients suggests that anti-idiotypic antibodies alone are not capable of inhibiting the production of rheumatoid factor. PMID- 2702774 TI - Serum IgG subclasses and IgM imbalances in adult IgA mesangial glomerulonephritis and idiopathic Henoch-Schoenlein purpura. AB - Serum IgG subclass levels were investigated in 27 IgA GN and HSP patients and 19 healthy paired controls using a panel of monoclonal antibodies. IgG1 and IgG2 were statistically lower than in the controls in both the non-nephrotic and nephrotic patients, and 80% of the non-nephrotic patients exhibited a partial deficiency for either IgG1, IgG2 or IgG3. Urinary losses of IgG only accounted for decreased levels of IgG4. Fifty-four percent of these patients exhibited decreased IgM levels. This IgG-IgM imbalance may increase the susceptibility of these patients to viral and bacterial infections of the upper respiratory tract and trigger the renal disease. These findings raise the hypothesis that this IgG IgM imbalance might be involved in the etiopathogenesis of these diseases. PMID- 2702775 TI - Enhanced IgG1 and IgG3 responses to pneumococcal polysaccharides in isolated IgA deficiency. AB - Serum IgG subclass-specific antibody concentrations to pneumococcal polysaccharides (PnPs) 1 and 14 were measured in 13 adult patients with isolated IgA deficiency and nine healthy adults immediately before and 4 weeks following immunization with polyvalent pneumococcal vaccine. Samples were analysed by enzyme immunoassay using pooled human serum as a reference preparation. A significant rise in median post-immunization antibody concentrations to PnPs14 was seen for all IgG subclasses, for IgA-deficient patients and for controls. For PnPs1, post-immunization IgG2 and IgG4 antibody concentrations rose significantly in the patient group, and IgG4 antibody concentrations rose significantly in the controls. The median IgG1 and IgG3 antibody concentrations to PnPs1 were significantly higher pre- and post-immunization in IgA-deficient individuals in comparison with controls, as were post-immunization IgG3 antibody concentrations to PnPs14. This enhancement of IgG1 and IgG3 antibody responses to pneumococcal polysaccharide antigens in IgA-deficient patients suggests an alteration in regulation of the normal switching processes in the generation of subclass and isotype diversity or could possibly be due to alteration in the affinity of subclass specific antibody. PMID- 2702776 TI - Anti-thyroid peroxidase antibody activity in sera of patients with systemic lupus erythematosus. AB - Although patients with SLE have autoantibodies to thyroid peroxidase (TPO), IgG from sera of SLE patients does not inhibit TPO activities, in contrast with IgG from sera of patients with thyroid disorders. This finding suggests that the specificities of anti-TPO autoantibodies in SLE are different from those in cases of thyroid disorders. These autoantibodies to TPO should be considered when searching for associations between SLE and autoimmune thyroid disorders. PMID- 2702777 TI - Immunity to Salmonella typhi: considerations relevant to measurement of cellular immunity in typhoid-endemic regions. AB - Experiments were performed in Baltimore, Maryland and in Santiago, Chile, to determine the level of Salmonella typhi antigen-driven in vitro lymphocyte replication response which signifies specific acquired immunity to this bacterium and to determine the best method of data analysis and form of data presentation. Lymphocyte replication was measured as incorporation of 3H-thymidine into desoxyribonucleic acid. Data (ct/min/culture) were analyzed in raw form and following log transformation, by non-parametric and parametric statistical procedures. A preference was developed for log-transformed data and discriminant analysis. Discriminant analysis of log-transformed data revealed 3H-thymidine incorporation rates greater than 3,433 for particulate S. typhi, Ty2 antigen stimulated cultures signified acquired immunity at a sensitivity and specificity of 82.7; for soluble S. typhi O polysaccharide antigen-stimulated cultures, ct/min/culture values of greater than 1,237 signified immunity (sensitivity and specificity 70.5%). PMID- 2702778 TI - Nuclear phosphotyrosyl-protein with DNA-binding ability in peripheral blood mononuclear cells from systemic lupus erythematosus patients. AB - This study examined the phosphorylation of cytoplasmic and nuclear proteins in peripheral blood mononuclear cells (PBMC) of systemic lupus erythematosus (SLE) patients. The cytoplasmic and nuclear protein kinase activity in PBMC from SLE patients was at least five-fold higher than that of normal healthy subjects. PBMC of SLE patients produced different nuclear endogenous substrates on phosphorylation and also displayed distinct protein kinase activity. Nuclear phosphoproteins, with human PBMC DNA-binding ability, of 38 kD and 70 kD were detected from both SLE patients and normal healthy subjects, while the 40 kD phosphoprotein, with tyrosine as the main phosphorylation residue, was found only in SLE patients. Other nuclear phosphoproteins, and most of the detected cytoplasmic phosphoproteins, were present in higher levels in both normal PBMC with mitogen stimulation, such as PHA, and SLE PBMC. The expression level of the 40 kD nuclear phosphotyrosyl-protein showed a positive correlation with the clinical disease activity of SLE. These results suggest that PBMC from SLE patients had distinct tyrosine protein kinase (TPK) activity and/or a different endogenous substrate of nuclear DNA-binding proteins in tyrosine phosphorylation. The possible significance of tyrosine phosphorylation in PBMC of SLE patients in the pathogenesis, and its clinical meaning, are discussed. PMID- 2702779 TI - A new antigen recognized by anti-liver-kidney-microsome antibody (LKMA). AB - Sera from 23 children with autoimmune chronic active hepatitis and positive for anti-liver-kidney-microsome antibody (LKMA), as defined by immunofluorescence, were analysed by Western blot (WB) and two-dimensional gel electrophoresis using rat liver microsomes as antigen, and by WB and dot-blot analysis with rat liver microsomal subfractions. Western blot analysis showed three patterns of reactivity: 13 sera recognized a 50 kD polypeptide, six sera a 66 kD polypeptide and four sera both of them. Two-dimensional gel electrophoresis, WB, and dot-blot analysis showed the 66 kD antigen to have a pI of 5.4 and to be located in the smooth domain of the endoplasmic reticulum. Western blot analysis using monospecific antisera against human IgG subclasses showed the LKMA directed against the 66 kD antigen to be mainly of the IgG1 subclass. These results indicate that LKMA associated with a subgroup of autoimmune hepatitis of children react with at least two different microsomal antigens in rat liver: (1) the 50 kD polypeptide, recently shown to be a cytochrome P-450 of the IID subfamily, and (2) a new antigen of 66 kD, the location of which suggests it may also be part of the mono-oxygenase complex. PMID- 2702780 TI - Immunosuppression by seminal prostaglandins. AB - In this paper we report studies undertaken to determine the contribution of seminal prostaglandins to some of the known immunosuppressive properties of human seminal plasma. Initial studies revealed that fractions of seminal plasma enriched in E series prostaglandins, obtained by reverse phase chromatography, had a pronounced inhibitory effect on the PHA-induced proliferation of peripheral blood lymphocytes and on the NK-cell-mediated lysis of K562 target cells. Additional investigations revealed that similar inhibitory effects could be achieved with purified PGE2 (10(-6) to 10(-9) M) and 19-OH PGE1 (10(-6) to 10(-7) M), both of which are present in uniquely high concentrations in human seminal plasma. In contrast, 19-OH PGF1 which is found in lower concentrations in semen was slightly stimulatory in proliferative assays and had no effect on NK-cell mediated cytotoxicity. Removal of the seminal prostaglandins by absorption chromatography resulted in a dramatic decrease in immune suppressive activity. Further studies with fractions obtained by ion-exchange HPLC of desalted seminal plasma indicated that prostaglandins complexed with seminal proteins, and these too were immunosuppressive. The possible relevance of these results to sexually transmitted disease is discussed. PMID- 2702781 TI - Polymorphonuclear neutrophils function in splenectomized patients. AB - Some essential functions of polymorphonuclear neutrophils (PMN) were evaluated in 30 patients splenectomized because of rupture of the spleen. These cells revealed normal random migration, adherence, unstimulated O2- and H2O2 production. Phagocytosis of viable staphylococci was higher than in controls, whereas chemotaxis, bactericidal capacity, aggregation and stimulated O2- and H2O2 production were significantly impaired. PMN from splenectomized patients manifested also the decreased intracellular myeloperoxidase activity. The percentage of cells with receptor for Fc IgG in peripheral blood was markedly decreased. Plasma of these patients induced increased adherence of autologous as well as control neutrophils. The possible mechanisms leading to the observed events are discussed. PMID- 2702782 TI - A case of hereditary combined deficiency of complement components C6 and C7 in man. AB - Immunological investigation of a patient presenting with candidiasis and toxoplasmosis revealed a combined deficiency of C6 and C7. Deficiency of C6 was total, but small amounts (less than 1 microgram/ml) of apparently normal C7 were present in the serum. All family members (three sibs and both parents) were heterozygous for the combined deficiency. This is only the second reported case of combined homozygous deficiency of the closely linked and immunochemically similar proteins C6 and C7, and only the third kindred in which this defect has been demonstrated. PMID- 2702783 TI - The effect of cyclosporin A in delaying maturation of the small intestine during weaning in the rat. AB - As maturation of the small intestine has similar features to an immunologically mediated reaction, we studied the effect of the immunosuppressive agent, cyclosporin A (CyA), on the development of the small intestine during weaning in the DA x PVG rat. Intestinal development was measured by villus area, crypt length, crypt cell production rate (CCPR), and disaccharidase activity. Rat pups received either cyclosporin A (7.5 mg/kg daily subcutaneously) or polyethoxylated castor oil (Cremophor, drug vehicle) subcutaneously from 12 days of age. Cremophor- and CyA-treated litters were killed at 18, 20, 22, 24, and 26 days of age. CyA-treated animals had retarded weight gain, lower mesenteric lymph node and spleen weights, fewer intraepithelial lymphocytes, and reduced systemic secretion of rat mucosal mast cell protease II. CyA treatment retarded any increase in villus area, crypt length and CCPR until day 26 of age. Lactase activity was retained longer, and sucrase and maltase induction was delayed. We conclude that CyA retarded normal development of the small intestine, but some maturation still occurred at the end of weaning. PMID- 2702784 TI - Evaluation of phagolysosome fusion in acridine orange stained macrophages infected with Histoplasma capsulatum. AB - A phagosome-lysosome (PL) fusion was performed in vitro using peritoneal cells from normal BALB/c mice and the J774.2 macrophage cell line infected with the yeast phase of the fungus Histoplasma capsulatum at ratios of 5 x 10(5), 5 x 10(6) or 1 x 10(7) yeasts per 1 x 10(6) macrophages, and phagocytosis was allowed to proceed for 5, 30 and 60 min. Macrophage lysosomes were pre-labelled with acridine orange and the cells were challenged with the parasite. Fusion was evaluated by fluorescence microscopy and the number of macrophages with stained yeast cells was scored. The phagolysosome fusion frequency (PLFF) was calculated by subtracting the specific fusions of infected macrophages from the non-specific fusions of uninfected macrophages and normalizing the total number of bound yeasts. The PLFF was determined using different doses and strains of H. capsulatum. Results showed that PLFF in infected macrophages depends on the infection dose. Inhibition of PL fusion was detected mainly at a high infection ratio (1 x 10(7) yeasts/1 x 10(6) macrophages), and PL fusion varied with phagocytosis time. No significant differences were observed in the fusions when different Histoplasma strains were used. Results with J774.2 cells were similar to peritoneal cells, indicating that both methodology and fusion calculations employed were useful, in spite of the heterogeneity of macrophage populations used. PMID- 2702785 TI - Pretranslational control of the levels of glyoxysomal protein gene expression by the embryonic axis in maize. AB - Previous studies showed that the expression of catalase-2 (CAT-2) and other glyoxysomal proteins is independently controlled in the scutella of intact maize seedlings. In this study, removal of the embryonic axis prior to seed imbibition dramatically decreased the amounts of all but two of the 19 immunologically detectable glyoxysomal proteins in the scutellum, including CAT-2. The temporal expression profile of CAT-2 was also altered. Removal of the axis after seeds were fully imbibed (24 hr) had little effect on the subsequent pattern of expression of CAT-2. The effect of axis removal was specific for glyoxysomal enzymes and caused relatively little change in the population of stainable scutellar proteins. In vitro translation studies and nucleic acid hybridization with a gene-specific cloned probe (for Cat2) revealed that the mRNA levels for glyoxysomal proteins were sharply lowered by axis removal. This study provides evidence that a signal may be released from the embryonic axis during imbibition, leading to the expression of a set of glyoxysomal enzymes by enhancing either the transcription of their genes or transcript stability. PMID- 2702787 TI - Listening carefully. Improving communication about behavior and development. Recognizing parental concerns. AB - A simple checklist was developed for completion by parents prior to their regular meetings with their pediatricians for health supervision. Its efficacy in improving communication between pediatricians and parents about behavioral and developmental concerns was evaluated. Without the checklist, 30 percent of parents' concerns were discussed. More items overall, and more items that were concerns of the parent, were discussed with the use of the checklist than without it (p less than 0.05). An intermediate but statistically significant effect was observed even when the pediatrician did not see the completed checklist (43% of concerns were discussed); this effect was increased when he did (53% of concerns discussed). There were marked differences among pediatricians in the number of concerns that were discussed both with and without use of the checklist. Items regarding patterns of family life and child care, death or illness, siblings, and other stresses of modern families were frequently indicated as concerns on the checklist but were less frequently discussed. The data demonstrate the effectiveness of a simple and efficient method to improve communication about childrens' behavior and development between their parents and their pediatricians. PMID- 2702786 TI - Set of proteins shows abnormal posttranslational modification in embryos homozygous for dominant T-mutations. AB - T and Tc are dominant mutations in the mouse that affect neuroaxial development when heterozygous and cause embryonic death when homozygous. Embryos were analyzed individually by two-dimensional gel electrophoresis at 9 1/2 days gestation, 1 day before homozygotes die in utero. A comparison of the protein patterns of mutant homozygotes with those of their littermates revealed a set of proteins (T-proteins) that showed isoelectric point (pl) polymorphism. All the T proteins were more basic in mutant homozygotes. These polymorphisms could be detected, although they were less pronounced, in embryos as young as 7 1/2-day presomite stages, when it is impossible to distinguish homozygous mutants grossly. Interestingly, the same proteins show a pl shift from basic to acidic in wild-type embryos during development from 7 1/2 to 9 1/2 days. Thus, it appears that in T and Tc mutants a developmentally specific posttranslational acidic modification of these proteins is disturbed. The likely cause of the abnormality is a defect in some mechanism for phosphorylation, since the T-proteins of wild type embryos were shifted to higher pls by phosphatase treatment. This disturbance appears to be localized to axial structures (neural tube, somites, and surrounding mesenchyme) since only these structures, and not the rest of the mutant homozygous embryos, contain abnormally basic T-proteins. PMID- 2702788 TI - Language barriers in pediatric care. AB - Language differences between pediatrician and parents can create a barrier in the doctor-patient relationship. Use of a translator to overcome that barrier introduces other potential problems such as a diminished sense of privacy, inadequate data collection, and misinterpretation of medical or family history due to translator distortions. Physicians should carefully choose the translator, avoiding persons who are linguistically incompetent, culturally insensitive, and medically unsophisticated. Physicians also should avoid assuming that parents who "speak English" are fluent. A determination of their language preference and their degree of English proficiency may lead the pediatrician to use a translator even with partially fluent families. PMID- 2702789 TI - Superior vena cava syndrome in infants. AB - Superior vena cava syndrome is uncommon in infants. With the increased use of central venous catheters, however, there has been an increased incidence of central venous occlusion. We report a case of superior vena cava syndrome occurring on two separate occasions in a premature infant with an indwelling central line. We discuss current concepts of prevention and management. PMID- 2702790 TI - Effective eye shielding during phototherapy. PMID- 2702791 TI - Padding the curriculum vitae: impairing the utility and integrity of the biomedical literature. PMID- 2702792 TI - Pharmacokinetics and pharmacodynamics of long-term continuous-infusion doxorubicin. AB - Steady-state plasma levels of doxorubicin and doxorubicinol were analyzed in 32 patients with advanced cancer, each of whom was given doxorubicin by long-term continuous infusion at progressively increasing infusion rates. Patients received doxorubicin for 2 to 50 weeks at rates of 0.2 to 6.1 mg/m2/day. Dose-limiting stomatitis and leukopenia were observed. The mean maximum steady-state doxorubicin concentration was 6.04 ng/ml at a mean maximum infusion rate of 3.92 mg/m2/day. Clearance mechanisms did not appear to be saturated at the durations or infusion rates used in this study. The maximum steady-state doxorubicin level and the ln (initial WBC) were significant correlates of the ln (nadir WBC) (p = 0.002 and 0.02, respectively). A model was constructed according to these two parameters that significantly describes ln (nadir WBC) (p = 0.001). Neither age, infusion rate, nor doxorubicinol level correlated with nadir WBC. Stomatitis did not correlate with any of these parameters. The demonstration of this pharmacodynamic relationship highlights the potential importance of pharmacologic data collection in ongoing attempts to predict the clinical effects of anticancer drugs. PMID- 2702793 TI - Pharmacokinetic and electroencephalographic study of intravenous diazepam, midazolam, and placebo. AB - Eleven healthy volunteers received a single intravenous dose of diazepam (0.15 mg/kg), midazolam (0.1 mg/kg), and placebo by 1-minute infusion in a double blind, three-way crossover study. Plasma concentrations were measured during 24 hours after dosage, and the electroencephalographic (EEG) power spectrum was simultaneously computed by fast-Fourier transform to determine the percentage of total EEG amplitude occurring in the 13 to 30 Hz range. Both diazepam and midazolam had large volumes of distribution (1.2 and 2.3 L/kg, respectively), but diazepam's half-life was considerably longer (33 versus 2.8 hours) and its metabolic clearance lower (0.5 versus 11.0 ml/min kg) than those of midazolam. EEG changes were maximal at the end of the diazepam infusion and 5 to 10 minutes after midazolam infusion. Percent 13 to 30 Hz activity remained significantly above baseline until 5 hours for diazepam but only until 2 hours for midazolam. For both drugs, EEG effects were indistinguishable from baseline by 6 to 8 hours, suggesting that distribution contributes importantly to terminating pharmacodynamic action. The relationship of EEG change to plasma drug concentration indicated an apparent EC50 value of 269 ng/ml for diazepam as opposed to 35 ng/ml for midazolam. However, Emax values were similar for both drugs (+19.4% and +21.3%, respectively). PMID- 2702794 TI - Pharmacokinetics of ornidazole in patients with acute viral hepatitis, alcoholic cirrhosis, and extrahepatic cholestasis. AB - Pharmacokinetics of ornidazole, a nitroimidazole derivative, was investigated after intravenous injection in 3 groups of 10 patients with different hepatic diseases: hepatitis, noncholestatic cirrhosis and extrahepatic cholestasis. Plasma concentrations of ornidazole and its two major hydroxylated metabolites, M1 [alpha-(chloromethyl)-2-hydroxymethyl-5-nitroimidazole-1-ethanol] and M4 [3-(2 methyl-5-nitroimidazole 1-yl)-1,2-propane diol] were measured by HPLC assay. As a consequence of a decreased clearance (26% to 48%), the half-life and MRT are increased in all patients by 19% to 38% when compared with healthy volunteers. No clear difference could be established between the different groups. The volume of distribution remains the same in all patients and controls except those suffering from cancer. As previously shown in patients with severe liver cirrhosis, both metabolites accumulate in plasma as a result of decreased elimination; formation is no longer the rate-limiting step of their kinetics. This metabolite accumulation is in part due to decreased biliary excretion and to hepatocellular failure. PMID- 2702795 TI - Racial differences in drug response: isoproterenol effects on heart rate following intravenous metoprolol. AB - Healthy young black men and white men received single intravenous doses of metoprolol (0.07 mg/kg) or participated in an isoproterenol sensitivity study before and after metoprolol (0.07 mg/kg followed by 50 micrograms/min) in a randomized, crossed-over fashion. Noncompartmental pharmacokinetic parameters were calculated. The dose of isoproterenol versus change in heart rate response curves were constructed, and comparisons of dose ratio, ED50, Emax, and Ka, with the apparent association constant for metoprolol binding to beta 1-receptors, were made. There were no pharmacokinetic differences observed between the groups. The predicted Emax for the black group was 52.7 +/- 8.7 beats/min at a metoprolol concentration of 29.8 +/- 6.1 ng/ml, which was higher (p less than 0.05) than that in the white group, i.e., 43.7 +/- 7.3 beats/min at a concentration of 27.6 +/- 9.1 ng/ml. There were no differences in dose ratio, ED50, or Ka. The racial differences in beta 1-receptor responses to exogenous isoproterenol following metoprolol can simply be explained by an increase in beta 1-receptor activity in the black subjects, assuming homogeneity in cardiac beta 2-receptor responses. PMID- 2702796 TI - Acute effects of lidocaine on repolarization and conduction in patients with coronary artery disease. AB - Right ventricular repolarization and refractoriness were studied during continuous infusion of lidocaine in patients with coronary artery disease. Compared with baseline the duration of monophasic action potential was shortened (p less than 0.01) at constant and premature stimulation. Early premature action potentials were less shortened (p less than 0.05). Therefore the difference between the longest and shortest action potential duration elicited 2 to 150 msec after refractoriness decreased during lidocaine infusion (p less than 0.01). The right ventricular effective refractory period was shortened similarly to the action potential duration. Lidocaine did not change the conduction of constant paced beats, whereas the more rapid conduction of the midrange premature beats was inhibited (p less than 0.01). The inhibition of premature conduction 50 to 150 msec from the right ventricular effective refractory period may be attributed to the effect of lidocaine on the rate-dependent recovery from inactivation. The effect on the restitution curve indicates that lidocaine may influence the dispersion of premature action potentials in human beings. PMID- 2702797 TI - Absorption of minoxidil after topical application: effect of frequency and site of application. AB - The effect of application site and frequency on the systemic absorption of topical minoxidil was studied in 52 normal men. Subjects received 1 ml 3% minoxidil solution applied four, six, or eight times daily to the scalp or two, four, six, or eight times daily to the chest for 14 days. Serum and urine were collected and analyzed for minoxidil. No systemic minoxidil accumulation occurred from increasing application frequency to the scalp. Trends in the chest data suggest that absorption may have been lower with the twice-daily regimen. Absorption through the scalp and chest were similar for the lower-frequency regimens; however, trends in the eight-times-a-day regimens suggest that absorption may have been somewhat greater from application to the scalp. Systemic minoxidil accumulation resulting from frequent application is unlikely. The initial dose probably saturates the skin for a period of time longer than the dosing intervals examined. PMID- 2702798 TI - The pharmacokinetics of the enantiomers of atenolol. AB - A number of studies have demonstrated that lipophilic beta-adrenoceptor blocking agents, eliminated almost exclusively by hepatic metabolism, are stereoselectively metabolized in human beings. Previous studies in our laboratory have demonstrated that pindolol, a beta-adrenoceptor blocking agent of intermediate lipophilicity that is eliminated by both hepatic metabolism and renal excretion, is eliminated stereoselectively in the kidney. In the present study we examined the pharmacokinetics of the enantiomers of atenolol, a hydrophilic cardioselective beta-adrenoceptor blocking agent that is eliminated almost exclusively by the kidney. A single 100 mg oral dose of racemic atenolol was administered to six healthy adult men. Concentrations of d- and l-atenolol in plasma and urine were measured by a stereospecific HPLC analytic procedure. In each subject the peak concentration of d-atenolol was greater than the peak concentration of l-atenolol (mean +/- SD of 420 +/- 81 ng/ml vs 366 +/- 61 ng/ml; p less than 0.05). The peak concentration of both enantiomers was reached at the same time in each subject (between 2 and 3 hours). The renal clearances of d- and l-atenolol were not significantly different (109.7 +/- 33.5 ml/min vs 112.5 +/- 36.7 ml/min), probably because the major route of renal elimination is glomerular filtration. The half-lives of d- and l-atenolol were not significantly different (mean +/- SD of 4.6 +/- 1.1 hours vs 5.2 +/- 0.9 hours). However, both the AUC and the amount excreted unchanged in the urine in 24 hours Ae [0-24]) were significantly greater for d-atenolol than for l-atenolol (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702799 TI - Elucidation of the nifedipine-quinidine interaction. AB - Four case reports have been published that document a clinically significant drug interaction between nifedipine and quinidine in patients with left ventricular dysfunction. To define the population at risk and the mechanisms involved in manifestations of this interaction, 12 patients currently treated with quinidine for either ventricular or supraventricular arrhythmias were stratified into two groups based on left ventricular ejection fraction (EF) measurements (group A greater than 35%; group B less than 35%). The interaction was conducted through two phases: oral quinidine (Q) and oral quinidine plus nifedipine (N + Q). Pharmacokinetic modeling of total body clearance (CL) and AUC were assessed for each phase. One patient (group A, 70% EF) exhibited the interaction with a 41% decrease in steady-state serum quinidine concentrations. The patient's AUC and CL were 48.2 micrograms/ml.hr (Q) versus 28.6 micrograms/ml.hr (N + Q) and 94.4 ml/min (Q) versus 159.1 ml/min (N + Q), respectively. There was no difference in AUC or CL between the Q and N + Q phases or between groups A and B for the entire population. The N + Q interaction is not hemodynamically mediated. Clinical consideration of the possibility of this low-frequency interaction should be noted. PMID- 2702800 TI - A phase I-II trial of 4'-deoxydoxorubicin (esorubicin) in refractory or relapsed acute leukemia. AB - In a phase I-II study, 21 patients with relapsed or refractory acute leukemia were treated with 4'-deoxydoxorubicin (esorubicin), the 4'-deoxy derivative of doxorubicin. Four of 14 evaluable patients with acute nonlymphocytic leukemia (ANLL) in relapse or refractory to other anthracyclines achieved partial response (28.5%). Pharmacokinetics were similar to those of the parent compound, doxorubicin. Esorubicin has activity in ANLL and has pharmacologic properties comparable to those of other anthracyclines. Dose-limiting toxicity occurs in the form of mucositis, which may limit its use in combination with other antileukemic drugs. PMID- 2702801 TI - Influence of debrisoquin phenotype on the inducibility of propranolol metabolism. AB - The effects of rifampin (600 mg) once daily for 22 days on the total and fractional metabolic clearances of propranolol were determined in a group of six genetically extensive (EM) and six poor metabolizers (PM) of debrisoquin. The impaired ability of PMs to metabolize propranolol to the ring-oxidized metabolite 4-hydroxypropranolol was confirmed. The total oral clearance of propranolol increased about fourfold in both phenotypes from 219.2 +/- 52.8 to 976.7 L/hr in the EMs and from 75.0 +/- 12.6 to 289.8 +/- 78.2 L/hr in the PMs. The extent of induction of glucuronidation was similar in the two groups. 4-Hydroxylation was induced in both phenotypes but the increase was fifteenfold greater in EMs than in PMs. This would imply that the cytochrome P-450 determined by the debrisoquin allele or some coinherited 4-hydroxylase(s) was induced to a greater extent in EMs than PMs. PMID- 2702802 TI - The effect of probenecid on the renal elimination of cimetidine. AB - It is generally assumed that the systems involved in the transport of organic cations and organic anions in the renal proximal tubule are substrate selective (i.e., organic anions do not inhibit organic cation transport and vice versa). However, recent data obtained in vitro have suggested that the organic anion probenecid inhibits the renal transport of the organic cation cimetidine. We addressed the question of whether this interaction is biologically relevant in human beings. The study involved a two-treatment, randomized crossover design. Six healthy male subjects were given an intravenous infusion of 300 mg cimetidine alone as one treatment and, as the other treatment, received multiple oral doses of probenecid before receiving the cimetidine infusion. The renal clearance of cimetidine and inulin was determined in each period. There were no significant differences between treatments in cimetidine plasma concentrations, apparent volume of distribution, systemic clearance, half-life, amount of drug excreted unchanged in the urine, or nonrenal clearance. Probenecid significantly decreased the renal clearance of cimetidine by decreasing both the filtration clearance and the net secretory clearance. These effects were most evident in the first 1/2 to 1 hour after cimetidine administration, when probenecid levels in plasma and renal tissue would have been the highest. Because there was no effect of probenecid on cimetidine plasma concentrations, this interaction is not clinically relevant to the therapeutic use of these two compounds. However, the study demonstrates that renal interactions between organic cations and organic anions can occur in human beings. The mechanism of this interaction and the implications to other drug combinations are being explored. PMID- 2702804 TI - A perspective on the debate over scientific misconduct. PMID- 2702803 TI - Let us now go forward. PMID- 2702805 TI - IOM report of a study on the responsible conduct of research in the health sciences. PMID- 2702806 TI - Harvard guidelines for investigators in scientific research. PMID- 2702807 TI - Statement presenting the AFCR's views to the Institute of Medicine Committee on Policies for Allocating Health Sciences Research Funds. PMID- 2702808 TI - Computer graphics tools for radiation treatment planning. AB - The objective of radiation therapy treatment is to eradicate a cancerous tumor while keeping the damage to nearby healthy organs to a minimum. A variety of tools employing computer graphics exist to aid in the planning and verification of treatments. Three-dimensional (3D) image information available from sources such as computerized tomography (CT) scanners is used to define the sizes, shapes, and spatial locations of the tumor and normal structures in the form of transverse contours. These object definitions are displayed in 3D perspective to enable the determination of the best possible directions from which to aim radiation beams at the tumor. The beams may be shaped to match the outline of the tumor, and their intensities may be modified using compensating devices. The results of calculations done to predict the distribution of radiation dose throughout the body due to a given set-up of beams can be displayed to the user in many ways. Dose may be shown in the form of isodose contours overlaid on transverse CT images, or on reconstructed image planes of arbitrary orientation in space. There are also a number of methods of 3D display; dose can be shown on the surface of objects, or in the form of isodose surfaces relative to anatomical structures. Computer-generated beam film images may be used to verify patient set up and tumor coverage. PMID- 2702809 TI - Classifications of subjects with the language PROLOG. AB - The logical language PROLOG is used for the definition and characterization of groups of subjects. The groups are firstly defined by sets of variables with comparable scales. Secondly, the single members of the groups are characterized by logically structured combinations of variables which do not necessarily have comparable scales. The performance of the characterizations is estimated by determining the rates sensitivity and specificity. The new classification method is applied in a follow-up study including the assessment of the activity of 76 healthy subjects during two controlled experiments. The classification with PROLOG is then compared with the methods of logistic regression and with discriminant analysis. The comparisons demonstrate that, under similar conditions, the results of a classification with PROLOG parallel the results of statistically based classification procedures. In addition, PROLOG permits characterizations of single subjects based on variables from different scientific disciplines. PMID- 2702810 TI - A drug-to-drug interaction package. AB - This paper describes an electronic database for handling the interactions between active principles administered to various patients. The computer used is a personal computer with adequate mass memory, software, and data obtained from pharmacological sources. The main features of this work are: 'all-patient' orientation, a special sentence-coding system, suitability for most existing catalogues of drug interactions, drug-keyed and cause-and-effect-keyed accesses, menu-driven interaction between the user (a physician) and the system, implementation on a personal computer (as available in most hospital departments) and activation from other programs. PMID- 2702811 TI - A program running under MS-DOS for the analysis of epidemiologic stratified or matched data. AB - Breslow and Day's method for computing the conditional likelihood of the logistic model in case of stratified samples requires, at each iteration the generation, for each stratum, of all the permutations of nc elements drawn from a total of nc + nt elements, where nc and nt are respectively the numbers of the cases and of the controls. This procedure rapidly proves costly in time as nc and nt increase, and also when nc and nt differ from one stratum to the next. The use of this technique on microcomputers is therefore limited. Presented here is an algorithm written in FORTRAN, based on a binary representation of the possible permutations, which readily permits the implementation of Breslow and Day's model on a microcomputer. PMID- 2702812 TI - Extension of Fisher's exact test to 2-by-k contingency tables: a computer program in BASIC. AB - A randomisation method of analysis for 2 X k contingency table data has been developed. This method, which is based on the fundamental principle of Fisher's exact probability test, gives a more accurate evaluation of the significance probability than does the chi-square test, especially when the sample size is small. A listing from the computer program in BASIC to carry out the 'exact probability test' for analysis of 2 X k contingency table data is available from the authors. PMID- 2702813 TI - Computer program for statistical Mann-Whitney U nonparametric analysis of neuronal spike activity. AB - A program for neuronal activity analysis is described. The applied computational techniques are standard in the field of digital processing, but the program is particular in its field of application and mode of data selection. The program, written in Turbo Pascal for the IBM-PC and compatibles, statistically compares (Mann-Whitney U-test) two sets of graphically selected data, and establishes whether there are significant differences between them. Although the program was developed for spike frequency analysis, it can easily be adapted to perform statistical analysis of other kinds of data. PMID- 2702814 TI - dNA: a simple dBASE program for medical studies. AB - The dNA program is an entirely self-contained package consisting of dBASE programs and files, that can be used by an analyst with some dBASE experience to integrate multiple dBASE files into a simple, coherent system. Only minimal training is required for a naive user to operate the resulting system. The source file for creating a system also serves as the system documentation. Consistency and validity checks can be built in, and system modifications are quite simple. PMID- 2702815 TI - GENPRO: automatic generation of Prolog clause files for knowledge-based systems in the biomedical sciences. AB - With the increasing interest in using knowledge-based approaches for protein structure prediction and modelling, there is a requirement for general techniques to convert molecular biological data into structures that can be interpreted by artificial intelligence programming languages (e.g. Prolog). We describe here an interactive program that generates files in Prolog clausal form from the most commonly distributed protein structural data collections. The program is flexible and enables a variety of clause structures to be defined by the user through a general schema definition system. Our method can be extended to include other types of molecular biological database or those containing non-structural information, thus providing a uniform framework for handling the increasing volume of data available to knowledge-based systems in biomedicine. PMID- 2702816 TI - Automatic shape quantification of freely suspended red blood cells by isodensity contour tracing and tangent counting. AB - In several blood diseases, the resting red blood cells show deviations from the normal discoidal shape. This is of great diagnostic importance. Similar shape changes occur if cells are subjected to various physical and chemical treatments. An automatic on-line method is introduced which can quantify the mean shape of such cells, freely suspended and unaltered by the method. With the cells inside a special flow chamber, pictures are taken in the form of optical sections using a CCD camera. The image processing includes digitization, cumulation of regions of interest (ROI), contour determination by two-dimensional histogram and isodensity contour tracing, chain coding and tangent counting. The method determines the mean of the absolute number of tangents per section Ts, a quantitative unique shape factor, which allows quantification of pathological red blood cell shapes and follow-up shape changes in experiments, and makes different experiments quantitatively comparable. PMID- 2702817 TI - Querying medical databases in an environment offering logical data independence. AB - Medical information systems are becoming popular. Furthermore, their use is expected to be expanded in future. In order to easily extract information from the underlying databases, easy to use man-machine interfaces are required. This paper concerns the doctor interface of the ARPIA medical information system based on a relational database management system. The whole system is currently used inside the Outpatient Pediatric Clinic of the Catholic University of Rome, Italy. The interface provides logical data independence towards the underlying relational database. The paper contains some background about this kind of interfaces, and also, it sketches the software architecture of the implemented prototype. PMID- 2702818 TI - SIMREP: a program simulating differential DNA replication. AB - During endoreplication, different organisms in different taxa carry out DNA syntheses without nuclear division. The result of such endocycles is either a polyploid nucleus or a polytene architecture of the chromosomes. Since not all sequences of the genome may be reduplicated simultaneously and to the same extent, endocycles provide an opportunity for primary cell differentiation at the DNA level as a result of DNA amplification or underreplication. We have designed a numerical model which simulates differential endoreplications. The program SIMREP is written in TURBO PASCAL 4.0 and can be executed on a PC/XT/AT with MS DOS greater than or equal to 2.0. It uses diploid DNA contents derived from meiotic or mitotic nuclei together with data on amounts of DNA present after a given number of endocycles. SIMREP can be applied to genomes containing arbitrary numbers of chromosomes (maximum N = 24) to model details of their replication behaviour. It is also useful in analysing differential replication of single genes. The application of SIMREP is illustrated with two examples. (1) Female and male specific types of underreplication were found in the chironomid midge Prodiamesa olivacea. The heterosomes which appear homomorphic in metaphases were identified by their differential polytenization. (2) The Y chromosome of Drosophila nasutoides was assessed to ascertain whether its replication is regulated in parallel with, or independently from the large chromosome pair 4. PMID- 2702819 TI - A BASIC program for the estimation of Michaelis-Menten parameters by the direct linear plot. AB - The use of manual graphical methods for the estimation of Michaelis-Menten kinetic parameters as recommended by Eisenthal and Cornish-Bowden (Biochem. J. 139 (1974) 715-720) was found to be impractical for large (n greater than 5) sample numbers. A BASIC program providing the rank ordered coordinates of intersections, which correspond to estimates of Km and Vmax in the direct linear plot method, is described. PMID- 2702821 TI - Wound care--toilet cleaner for wound care? PMID- 2702820 TI - Automated data acquisition and analysis in muscle physiology research. AB - Research in muscle physiology has progressed in both the volume and complexity of data examined. Dependence on manual methods to analyze and condense this amount of information can present a narrow bottleneck to the efficient completion of a study, and can compromise the reliability of the results. We designed a general purpose computerized system for data acquisition in experiments in our cardiovascular physiology laboratory. In addition, we developed a software program specifically for the analysis of data from studies of isolated, isometrically contracting myocardium. This system has reduced the time for analysis of such data by approximately 50-fold over that of manual techniques, and has contributed significantly to our confidence in the measured results. PMID- 2702822 TI - Child abuse and neglect. PMID- 2702823 TI - Community nurse profile: planning the family. PMID- 2702825 TI - Catheter care at home. PMID- 2702824 TI - Whither Griffiths? PMID- 2702826 TI - The Connecticut State Joint Practice Committee. PMID- 2702827 TI - Family practice. PMID- 2702828 TI - Informed consent and common sense. PMID- 2702829 TI - Reflections on medicine. Too much science? PMID- 2702831 TI - 'Life after...'. PMID- 2702830 TI - Winter reading: the past and future of health law. PMID- 2702832 TI - Effect of aerobic training on left ventricular diastolic filling. AB - The effects of aerobic training on left ventricular diastolic filling were determined and related to the effects on maximal oxygen uptake, left ventricular systolic function, and left ventricular mass. Nine untrained healthy males with a mean age of 32 years underwent a ten-week program of bicycle training. Echocardiographic left ventricular mass, maximal oxygen uptake, radionuclide derived left ventricular ejection fraction, and average left ventricular filling rate were obtained before and after training. Training resulted in significant increases in maximal oxygen uptake (from 30 +/- 6 (mean +/- S.D.) to 40 +/- 7 ml/kg/min, p less than 0.001) and average left ventricular filling rate (from 2.04 +/- 0.36 to 2.22 +/- 0.31 end-diastolic volumes/sec, p less than 0.05), but no changes in heart rate, systolic blood pressure, left ventricular ejection fraction, or left ventricular mass. These data indicate that short-term high intensity aerobic training enhances average left ventricular diastolic filling independent of any change in left ventricular geometry, systolic function, heart rate, or blood pressure. PMID- 2702834 TI - The future of family practice. Implications of the changing environment of medicine. AMA Council on Long Range Planning and Development. PMID- 2702833 TI - Mobile mammography: the first six-months experience at Mount Sinai Hospital. AB - Mount Sinai Hospital's Mobile Mammography Program, BreastCheck, is designed to screen large numbers of women for breast cancer in the greater Hartford area. Despite the American Cancer Society recommendations for screening mammography, many physicians still are not complying with these guidelines. This report details our first six-months experience. Two thousand two hundred thirty women were screened, 38 women had biopsies, and 14 cancers were detected. The overall rate of breast cancer detection is 6.3/1,000 which compares favorably with the rates from the National Breast Cancer Demonstration Detection Project (BCDDP) of 4.6/1,000. PMID- 2702835 TI - Optimal two-stage designs for phase II clinical trials. AB - The primary objective of a phase II clinical trial of a new drug or regimen is to determine whether it has sufficient biological activity against the disease under study to warrant more extensive development. Such trials are often conducted in a multi-institution setting where designs of more than two stages are difficult to manage. This paper presents two-stage designs that are optimal in the sense that the expected sample size is minimized if the regimen has low activity subject to constraints upon the size of the type 1 and type 2 errors. Two-stage designs which minimize the maximum sample size are also determined. Optimum and "minimax" designs for a range of design parameters are tabulated. These designs can also be used for pilot studies of new regimens where toxicity is the endpoint of interest. PMID- 2702836 TI - Methodology and overt and hidden bias in reports of 196 double-blind trials of nonsteroidal antiinflammatory drugs in rheumatoid arthritis. AB - Important design aspects were decreasingly reported in NSAID trials over the years, whereas the quality of statistical analysis improved. In half of the trials, the effect variables in the methods and results sections were not the same, and the interpretation of the erythrocyte sedimentation rate in the reports seemed to depend on whether a significant difference was found. Statistically significant results appeared in 93 reports (47%). In 73 trials they favored only the new drug, and in 8 only the active control. All 39 trials with a significant difference in side effects favored the new drug. Choice of dose, multiple comparisons, wrong calculation, subgroup and within-groups analyses, wrong sampling units (in 63% of trials for effect variables, in 23% for side effects), change in measurement scale before analysis, baseline difference, and selective reporting of significant results were some of the verified or possible causes for the large proportion of results that favored the new drug. Doubtful or invalid statements were found in 76% of the conclusions or abstracts. Bias consistently favored the new drug in 81 trials, and the control in only one trial. It is not obvious how a reliable meta-analysis could be done in these trials. PMID- 2702837 TI - Monitoring versus interim analysis of clinical trials: a perspective from the pharmaceutical industry. AB - The definitions of "interim analysis" and "monitoring" of clinical trials are often ambiguous in the current literature. The resulting confusion can lead to erroneous conclusions and misguided decisions, especially when activities that are operational or observational are evaluated in a probabilistic sense as inferential. The authors seek to define "interim analysis" and "monitoring" in a mutually exclusive fashion. These definitions will then provide the opportunity to review and categorize existing clinical trial practices and procedures. This will clarify such issues as "when to look" and "when to pay a price" (e.g., test size and power) and characterize such issues in the context of pharmaceutical industry drug development. PMID- 2702838 TI - Use of restricted significance tests in clinical trials: beyond the one- versus two-tailed controversy. AB - Whether to use "one-tailed" or "two-tailed" tests for clinical trials is examined in the more general context of restricted tests, developed by J. Neyman. This is complimented by a discussion of theoretical work of Savage and Bahadur. It is concluded that all tests of statistical significance have to be "restricted" in some sense and that failure to recognize the restrictions implied by "standard" methods of analysis can have a negative effect on the ability to detect treatment effects of new drugs in phase II and early phase III clinical trials. PMID- 2702839 TI - The role of a placebo-treated control group in combination drug trials. AB - In order to satisfy regulatory requirements for fixed-dose combination drug products, clinical trials must demonstrate that each component contributes to the claimed effect of the combination. Thus, the comparisons of primary interest are usually of the combination versus combination minus one component, and do not involve placebo. However, a placebo-treated group can be useful for interpreting the primary comparisons and for clarifying the nature of effects in the presence of interactions. These points are illustrated by examples from various drug classes. Statistical analysis of combination drug trials, particularly the appropriateness of factorial analysis, is also discussed. PMID- 2702841 TI - Left ventricular function during sepsis. AB - The prevalence and prognostic significance of left ventricular involvement in septic patients without shock was investigated. Systolic time intervals (STI) and preejection period/left ventricular ejection time ratio (PEP/LVET) were used to assess left ventricular function. Forty-nine patients, 22 of whom ultimately died, were studied. The group as a whole showed abnormal PEP/LVET ratio (0.40 +/- 0.02) that differed significantly (p less than .01) from reported normal values (0.345 +/- 0.002), demonstrating widespread left ventricular dysfunction in this population. In order to establish the prognostic significance of left ventricular impairment, the population was divided into two groups according to the PEP/LVET ratio. Group 1 (PEP/LVET less than or equal to 0.42) showed a mortality rate of 10/33 (30%), while group 2 (PEP/LVET greater than 0.42) had a significantly greater mortality (12/16 [75%], p less than .001). The test that has a sensitivity of 55%, a specificity of 85%, and a positive predictive value of 75% identifies a subset of septic patients with severe impairment of left ventricular function and high risk of dying. PMID- 2702840 TI - Trendelenburg position and passive leg raising do not significantly improve cardiopulmonary performance in the anesthetized patient with coronary artery disease. AB - The effects of the Trendelenburg (TREND) position and passive straight leg raising (PLR) on cardiopulmonary performance in 18 anesthetized patients undergoing myocardial revascularization were studied with a two-dimensional transesophageal echocardiography probe and a thermodilution right ventricular ejection fraction (RVEF) pulmonary artery catheter. The TREND position (at 20 degrees) and PLR (at 60 degrees) were studied in relation to the level-supine position in random order. At 3 min, the TREND caused significant (p less than .05) decreases in heart rate (62 +/- 9 to 58 +/- 10 [SD] beat/min) and RVEF (0.48 +/- 0.11 to 0.44 +/- 0.10), and significant increases in mean arterial pressure (77 +/- 11 to 82 +/- 11 mm Hg), mean pulmonary artery pressure (16 +/- 4.3 to 19 +/- 5.5 mm Hg), wedge pressure (11 +/- 4 to 13 +/- 4 mm Hg), cardiac index (CI) (2.36 +/- 0.79 to 2.52 +/- 0.93 L/min.m2), right ventricular end-systolic volume index (44 +/- 21 to 58 +/- 21 ml/m2), right ventricular end-diastolic volume index (83 +/- 24 to 102 +/- 22 ml/m2), and shunt fraction (0.16 +/- 0.06 to 0.19 +/- 0.06). CVP and left ventricular areas did not change significantly. PLR had similar effects as the TREND position, except CI did not change significantly. Thus, the TREND and PLR resulted in minor hemodynamic improvement with right ventricular dilation, decreased RVEF, and impaired oxygenation in the anesthetized cardiac surgical patient. PMID- 2702842 TI - Effects of propranolol on resting metabolic rate after severe head injury. AB - Postabsorptive resting metabolic rate (RMR), measured by indirect calorimetry, and the effect of iv propranolol administration were studied in 12 nonseptic patients with severe head injury by means of indirect calorimetry. Before propranolol RMR was moderately increased (126 +/- 10.4% of predicted values) whereas urinary excretion of catecholamines was markedly elevated (p less than .01 vs. normal values). RMR was significantly correlated with both resting heart rate (HR) (r = .72, p less than .01) and 24-h urinary N excretion (r = .85, p less than .001). The administration of iv propranolol (0.1 mg/kg) produced a rapid decrease in HR (-10 +/- 4%, p less than .001) and in RMR (-6.1 +/- 2.3%, p less than .001). Further administration of propranolol produced no additional reduction in either HR or RMR. We conclude that severely head-injured patients are moderately hypermetabolic in resting and postabsorptive conditions, and that acute iv propranolol administration induces a reduction of about one quarter of the resting hypermetabolism. PMID- 2702843 TI - Prostaglandin E1 infusion fails to prevent hyperoxic lung injury in adult rabbits. AB - Arachidonic acid (AA) metabolites may be important mediators in the hyperoxic lung injury process. We have previously demonstrated, in an adult model of hyperoxic lung injury, that bronchoalveolar lavage (BAL) fluid levels of AA metabolites of the cyclooxygenase pathway increase before evidence of overt injury. Nonselective inhibition with indomethacin or dexamethasone failed to ameliorate the injury process, possibly because production of prostaglandin I2 (PGI2) was suppressed. In this study, we attempted to ameliorate hyperoxic lung injury using an infusion of prostaglandin E1 (PGE1), since PGE1 has some of the potentially protective effects of PGI2. Thirty-two adult rabbits were exposed to greater than 95% oxygen; eight served as controls and 24 received PGE1 infusion (five, nine, and ten received 0.1, 0.06, and 0.03 micrograms/kg.min, respectively). At the end of the 65-h exposure period, BAL of the left lung was performed; the right was saved for light microscopy. PGE1 infusion at the 0.06 and 0.03-micrograms/kg.min doses resulted in significantly fewer polymorphonuclear leukocytes (PMN) in BAL fluid (p less than .05). However, PGE1 infusion did not significantly ameliorate the lung injury process. In summary, although PGE1 infusion inhibited the influx of PMN into the lung, treatment did not result in any significant amelioration of the hyperoxic lung injury process. PMID- 2702844 TI - Determination of extracellular fluid volume using impedance measurements. AB - Currently, accurate determination of body fluid compartments depends on the sodium bromide method (NaBr), an invasive measurement requiring venipuncture with infusion of a foreign substance. Impedance (Z) measurements may provide a practical noninvasive alternative for estimating fluid compartments in sick, premature neonates. To validate the impedance method, we compared it with the NaBr technique in nine anesthetized rabbits. Electrodes were placed for impedance measurement. Vascular catheters were inserted into the femoral artery and vein. Baseline impedance data were collected at 1.0 kHz and blood samples were drawn for NaBr standard assay. Using conventional assay techniques for determination of extracellular fluid volume (ECFV), we correlated NaBr data with impedance measurements. A linear relationship between ECFV by NaBr assay and the previously developed impedance equation rho L2/Z1.0 was established using regression analysis. A correlation value of r = .95 was obtained. These data suggest the potential for impedance to estimate ECFV. PMID- 2702845 TI - High-frequency oscillation for persistent fetal circulation after repair of congenital diaphragmatic hernia. AB - A female neonate who had been diagnosed as having congenital diaphragmatic hernia by ultrasonography was delivered by cesarean section. After the hernia was repaired, she developed hypoxemia and hypercapnia, probably due to persistent fetal circulation (PFC). Neither conventional mechanical ventilation (CMV) nor manual ventilation improved the respiratory status. High-frequency oscillation (HFO) successfully improved pulmonary gas exchange, but we failed to wean the patient from HFO by using intermittent HFO. The patient was again placed on CMV for weaning and was extubated on the 12th ICU day. We conclude that HFO can be an alternative respiratory modality in patients with respiratory failure due to PFC after the repair of congenital diaphragmatic hernia. PMID- 2702846 TI - Hemodynamics in subarachnoid hemorrhage. PMID- 2702847 TI - Ranitidine--bolus or infusion prophylaxis for stress ulcer. PMID- 2702848 TI - Intravenous fentanyl for the treatment of status asthmaticus. PMID- 2702849 TI - Metformin efficacy and tolerance in obese non-insulin dependent diabetics: a comparison of two dosage schedules. AB - A comparative open study of metformin unit doses of 500 mg and 850 mg was carried out in 64 obese, non-insulin dependent diabetics on 1.5 to 3 g metformin daily. Glycaemic response, blood lactate, plasma metformin concentrations and tolerance for metformin were assessed. On changing from a 500 mg unit dose to an equivalent total dose of metformin using the 850 mg preparation, there were no significant changes in the random blood glucose, glycated haemoglobin, or blood lactate concentrations. Metformin plasma concentrations remained unchanged except for patients transferred from 1.5 to 2.0 g daily to 850 mg twice daily; in these patients plasma concentrations increased from 1.83 +/- 0.87 to 2.50 +/- 0.89 micrograms/l (p less than 0.01). Seven patients (3 asymptomatic and 4 with background symptoms) became intolerant of the 850 mg regimen and required to return to the 500 mg dose regimen. After exclusion of patients intolerant of the 850 mg dose regimen (11%), the remaining patients noted no significant change in symptoms and 28% of all patients transferred to the 850 mg dose unit indicated an overall preference for this regimen. PMID- 2702850 TI - Plasma nitrendipine concentrations in elderly normotensive volunteers after single and multiple dosing. AB - An acute and chronic dosing pharmacokinetic study of the calcium antagonist nitrendipine was carried out in 8 normotensive volunteers (mean age 80.1 +/- 3.4 years) to investigate if drug accumulation occurred in the elderly. Subjects received 10 mg nitrendipine once daily by mouth for 8 days. Plasma nitrendipine concentrations before administration and at 0.5, 1, 2, 4, 6 and 8 hours after dosing were measured after the first and last dose. Comparison of the pharmacokinetic data from Days 1 and 8 failed to show any evidence of nitrendipine accumulation in these elderly subjects. PMID- 2702851 TI - Therapeutic effects of bezafibrate and gemfibrozil in hyperlipoproteinaemia type IIa and IIb. AB - Fifty-nine patients with hyperlipoproteinaemia Type IIa and IIb who had failed to respond to 1-month's dietary therapy were treated over a 4-month period with either bezafibrate (600 mg/day) or gemfibrozil (1200 mg/day) in addition to their diet. Fasting serum lipid (cholesterol, HDL-cholesterol and triglycerides) and blood glucose levels were measured on entry and at monthly intervals, and routine laboratory investigations were carried out before and after treatment to monitor hepatic, renal and haematic tolerance. The results showed that whilst both drugs produced significant reductions from baseline in total cholesterol, LDL cholesterol and triglyceride levels from Day 30 onwards, the reductions were more marked in the bezafibrate group. There was a trend for HDL-cholesterol levels to increase. Fasting blood glucose levels decreased significantly in the bezafibrate group and to a greater extent than in patients on gemfibrozil. Only 1 patient on bezafibrate did not tolerate bezafibrate whereas 13 patients on gemfibrozil reported side-effects, mainly gastro-intestinal, and 4 had to withdraw from the study during the first or second month. PMID- 2702852 TI - John, Jack, and recertification. PMID- 2702853 TI - Iodides and bromides. PMID- 2702854 TI - A spitting image. AB - Three cases of injection of human saliva are presented, all of which occurred among incarcerated men. Although no previous cases have been described, we believe that this entity is not uncommon in the prison population. PMID- 2702855 TI - Metastatic carcinoma of the cervix in a patient with dermatomyositis. AB - A case of dermatomyositis occurring in a patient with metastatic carcinoma is reported. The epidemiology, incidence, and work-up of this disorder are discussed. PMID- 2702856 TI - Botryomycosis caused by Moraxella nonliquefaciens. AB - Botryomycosis is a bacterial infection characterized by the presence of grains of organisms in the tissue. Although Staphylococcus aureus is the most common causative agent, other bacteria have been reported to cause botryomycosis. Several factors have been hypothesized to be important in the pathogenesis of botryomycosis, including foreign bodies, quantity and virulence of organisms, and host immunity. The resulting infection tends to be resistant to antibiotic therapy. We report a case of botryomycosis of the hand caused by Moraxella nonliquefaciens, an organism of low virulence not previously associated with botryomycosis, and discuss the factors that may have led to this infection. This infection was successfully treated by excision and grafting. PMID- 2702857 TI - Nevus lipomatosus cutaneus superficialis of the scalp. AB - A 12-year-old boy with nevus lipomatosus cutaneus superficialis of the scalp is described. Asymptomatic plaques made up of varying sized aggregates of elastic soft papules were observed on the occipital region. Histologic examination of a biopsy specimen revealed ectopic fat tissue in the dermis. Two types of nevus lipomatosus cutaneus superficialis can be differentiated clinically. The classic types, with multiple lesions in a zonal distribution, occur most often on the lumbar region, buttocks, and thigh. The other types, which involve a solitary papule or nodule, have no favored location. This is the first report of multiple lesions in a zonal distribution occurring characteristically on the scalp. PMID- 2702858 TI - Evaluation of alopecia: a new algorithm. AB - The clinical evaluation of alopecia is becoming less precise as more histopathologic correlations become available. According to the classic approach, the clinician should initially differentiate between scarring and nonscarring alopecia. Because several case reports in the past ten years have demonstrated that the definition of "scarring alopecia" is ambiguous, the use of the traditional schema--scarring versus nonscarring--may well be outmoded. Therefore, we propose a new algorithm for the evaluation of alopecia that emphasizes the importance of both clinical and histologic findings. PMID- 2702859 TI - Perioral psoriasis. AB - Two cases of perioral psoriasis are described. A brief review of various dermatologic conditions that should be included in the differential diagnosis is included. PMID- 2702860 TI - Tuberoeruptive xanthomas: unusual presentation of type V hyperlipoproteinemia. AB - We report a case of pedal tuberoeruptive xanthomatosis associated with ethanol induced type Vhyperlipoproteinemia that was controlled with diet, withdrawal from ethanol use, and the fibric acid derivative gemfibrozil. PMID- 2702861 TI - Deficits in visual recognition in low birth weight infant pigtailed monkeys (Macaca nemestrina). AB - 15 low birth weight and 15 normal birth weight pigtailed monkey infants were administered an adaptation of a standardized test of visual recognition memory, originally developed for human infants. Animals were given a series of problems in which 2 identical black-and-white patterns were presented for a familiarization period. The previously exposed pattern was then paired with a novel one, and looking time to each pattern was recorded. The normal birth weight animals directed a significant amount of their visual attention to the novel stimuli, thus demonstrating recognition abilities. As a group, the performance of the low birth weight infants remained at chance. These findings have important implications for an animal model to examine factors contributing to poor cognitive outcome in low birth weight human infants. PMID- 2702862 TI - Type of day-care and preschool intellectual development in disadvantaged children. AB - Levels and patterns of intellectual development of 3 groups of socioeconomically disadvantaged children were compared. The groups consisted of (1) children who were randomly assigned to receive extensive university-based intervention group day-care, (2) children whose parents placed them in community day-care centers for varying amounts of time, or (3) children whose parents chose little to no center-based day-care for their children. Two repeated-measures analyses of variance were performed to identify possible day-care effects on IQ level and on patterns of infant and preschool cognitive development. The results suggest that quality community day-care, as well as intervention day-care, may positively change both the level and pattern of preschool intellectual development of socioeconomically disadvantaged children. PMID- 2702863 TI - Learned helplessness, test anxiety, and academic achievement: a longitudinal analysis. AB - The stability of individual differences in test anxiety and learned helplessness over a 2-year period and their relation to concurrent and future school achievement were examined. Several issues regarding the assessment of learned helplessness are also addressed. 82 children were administered measures of test anxiety and helplessness in the third grade and again in the fifth grade. Teachers also provided reports of learned helpless and mastery-oriented behaviors at these 2 grade levels. It was found that: (a) both self-report and teacher report measures of helplessness were stable over the 2-year period; (b) helplessness in the third grade was related to achievement test scores in the fifth grade; and (c) teacher reports may be a viable means of identifying helplessness. These findings are discussed in terms of cognitive developmental changes in children's understanding of effort and ability, and their implications for the assessment of learned helplessness are outlined. PMID- 2702864 TI - Self development and self-conscious emotions. AB - In each of 2 studies, the mirror-rouge technique was used to differentiate children into those who showed self-recognition and those who did not. In Study 1, 27 children (aged 9-24 months) were observed in 2 experimental situations thought to differentially elicit fear and embarrassment behaviors. In Study 2, 44 children (aged 22 months) were seen in the situations of Study 1 and 3 additional contexts thought to elicit embarrassment behavior. The results of both studies indicate that embarrassment but not wariness was related to self-recognition. PMID- 2702865 TI - The effects of parental psychopathology and maltreatment on child behavior: a test of the diathesis-stress model. AB - Past research on risk factors in child development has tended to focus on 1 risk factor rather than examining the effects of multiple factors simultaneously. The present research examines the main and interactive effects of parental psychopathology (schizophrenia, psychiatric control, and normal control) and maltreatment on child behavior. Child aggression, delinquency, and social withdrawal were assessed at 2 times so that the effects of risk factors on behavioral change could also be examined. The results indicate significant relations between the risk factors and child behavior. Most notably, parental psychiatric status and maltreatment interacted significantly, such that offspring of schizophrenic parents from maltreating families showed increases in externalized behavior problems over time. These results support a diathesis stress model of psychopathology. PMID- 2702866 TI - A longitudinal study of moral reasoning. AB - Several issues concerning Gilligan's model of moral orientations and Kohlberg's models of moral stages and moral orientations were examined in a longitudinal study with 233 subjects (from 78 families) who ranged in age from 5 to 63 years. They participated in 2 identical interviews separated by a 2-year interval. In each interview, they discussed hypothetical dilemmas and a personally generated real-life dilemma, which were scored for both moral stage and moral orientation (both Gilligan's and Kohlberg's typologies). Results revealed few violations of the stage sequence over the longitudinal interval, supporting Kohlberg's moral stage model. Sex differences were almost completely absent for both Gilligan's and Kohlberg's moral orientations, although there were clear developmental trends. Hypothetical and real-life dilemmas elicited different moral orientations, especially in terms of Kohlberg's typology. The interrelations between the 2 models of moral orientations were generally weak, indicating that they are not synonymous. PMID- 2702867 TI - How children choose among serial recall strategies. AB - A theoretical and methodological approach originally developed to investigate preschoolers' arithmetic strategies was extended to the study of 5-8-year-olds' serial recall strategies. Immediately retrospective verbal reports, together with observation of overt behavior, indicated a number of parallels between strategy choices in the 2 areas. In serial recall, as in arithmetic, most children used multiple approaches. Even among the youngest children, the majority sometimes used the most effective strategy, repeated rehearsal. Changes in strategy choices were adaptive in the sense of children rehearsing more often when not rehearsing on the previous trial had led to incorrect recall. Developmental changes occurred in how often children rehearsed, in how accurately they executed each strategy, and in the type of rehearsal that they used most frequently. Only small changes were apparent, however, in whether the 5-8-year-olds rehearsed at all. PMID- 2702868 TI - Young children's ability to differentiate appearance-reality and level 2 perspectives in the tactile modality. AB - A key acquisition in the child's developing knowledge of the mind is the subjective-objective distinction, which includes a clear understanding that things may appear to be other than the way they really are (appearance-reality distinction) and may present different appearances to self and others (Level 2 perspective-taking). Previous studies using tasks involving visual appearances have found that most children do not show such understanding until 4 or 5 years of age. However, a conceptual analysis of tactile as compared to visual and other perceptual experiences suggested the hypothesis that this understanding might appear earlier if the appearances the child must identify are tactile rather than visual. This hypothesis was supported by the results of 3 studies. In Studies 1 and 2, 3-year-old subjects could correctly indicate, for example, that an ice cube they were feeling with a heavily gloved finger did not feel cold to that finger (tactile appearance for the self), did feel cold to the experimenter's ungloved or thinly gloved finger (tactile appearance for another person), and was a cold ice cube, really and truly (reality). In contrast, and consistent with previous research findings, they were much poorer at distinguishing between real and visually apparent object identity, number, and color. Similarly, in Study 3 they tended to perform better on tactile appearance-reality tasks involving the properties of number, wetness, and intactness than on visual appearance-reality tasks that involved these same properties. PMID- 2702869 TI - What makes a vibble a vibble? A developmental study of category generalization. AB - Young children appear to know when a novel label for a novel object is a common noun. The present study was concerned with the properties of a named object that children assume to be true of other members of the category that is specified by such a noun. Preschoolers, second graders, and college students were shown drawings of objects and given nonsense labels for those objects. They then viewed other objects that varied from the labeled ones along 4 particular attributes and were asked to decide if those other objects should also receive the same label. Preschoolers focused mostly on single attributes in making category decisions, and their choices of attributes were evenly distributed among the 4 types. Older individuals primarily exhibited multiple attribute rules. The results are discussed in terms of developmental differences in the modes of processing that are used and in the types of knowledge that are brought to bear on the word learning situation. PMID- 2702870 TI - Young children's responses to "when" questions: issues of directionality. AB - On the basis of the bulk of the available literature, it appears that in talking or reasoning about temporal sequences, preschoolers lack bidirectional flexibility and are limited to forward order, antecedent toward consequent movement. 3-, 4-, and 5-year-olds and adults responded to when-questions designed to permit assessment of directional preferences. All questions referred to the second sentence of 3-sentence stories, so that before-type (antecedent to consequent) and after-type (consequent to antecedent) responses were possible for all questions. Children showed a strong preference for giving after-responses. Contrary to claims made in previous literature, preschoolers are quite capable of reasoning from consequences to antecedents when provided with a context, such as responding to when-questions, for which such movement is appropriate. Children's apparent lack of bidirectional reasoning on problems involving temporal sequence may reflect preferred directionality based on conventions associated with particular tasks rather than a lack of flexibility in temporal reasoning per se. PMID- 2702871 TI - Associations of timing of puberty, spatial ability, and lateralization in adult women. AB - The purpose of this study was to determine whether timing of puberty is related to spatial ability in adult women, and whether, if so, the relation could be attributed to timing-related differences in hemispheric specialization and/or timing-related differences in personality and spatial activity. 53 female undergraduates were given 2 tests of spatial ability, tests of both right hemispheric and left-hemispheric specialization using tachistoscopic procedures, several tests assessing masculinity and femininity, and a questionnaire on spatial activity. They were also asked to recall their age at menarche. Later age at menarche was associated with greater right-hemispheric advantage on the dot location task but not with higher spatial ability. Spatial ability in this sample was in fact correlated with greater left-hemispheric advantage on the dot location task, as well as with more balanced hemispheric specialization on the syllable task. It is suggested that variability in findings regarding cognitive correlates of timing of puberty may be related to variability in strategies for approaching tasks. The implications of these data for efforts to explain sex related differences in spatial ability are discussed. PMID- 2702872 TI - Economic hardship, parenting, and distress in adolescence. AB - The relation between family economic hardship and adolescent distress among secondary school students in a small Midwestern community was investigated. According to prior results, family hardship has both direct and indirect effects on adolescent distress. The indirect effects come about through stress-induced changes in parental nurturance and parental discipline. The findings of this study showed that hardship effects varied according to type of distress. For females as well as males, economic hardship had both direct and indirect effects on a depression-loneliness distress factor. The indirect effects occurred through less parental nurturance and more inconsistent discipline. No direct effect of economic hardship was found for either males or females on a distress factor composed of delinquency and drug use items. For both females and males, however, an indirect effect of family economic hardship on the delinquency-drug use factor was found with inconsistent parental discipline as the mediating variable. PMID- 2702873 TI - Biological and social contributions to negative affect in young adolescent girls. AB - This study is a preliminary attempt to investigate whether internal or external pubertal changes and whether social or biological factors are more likely to be associated with negative affect. About 100 white girls aged 10-14 years were given a physical examination, had blood drawn, and filled out the Youth Behavior Profile and a life-events checklist. Negative affect increased during the most rapid rises in hormone levels; however, hormones accounted for only 4% of the variance in negative affect. Pubertal status and timing were not associated with negative affect. In contrast, social factors accounted for more variance than hormonal pubertal factors alone (8%-18%), as did the interaction of negative life events and pubertal factors (9%-15%). Results are discussed in terms of what hormonal activation effects are most likely to be found, the meaning of such effects for subsequent behavior, and the interaction of biological and social events. PMID- 2702874 TI - Correspondence between mothers' self-reported and observed child-rearing practices. AB - The correspondence between self-reported child-rearing attitudes and practices and actual child management was examined among 68 mothers of young children. Data on mothers' verbal and physical control techniques along with children's responses (cooperation vs. resistance) were obtained during 90 min of spontaneous interaction in a naturalistic setting. Self-report data (the Block Q-Sort) were obtained 1-2 weeks later. The Block Q-Sort factors were combined to represent authoritarian and authoritative patterns of attitudes. The authoritarian pattern was positively associated with the use of direct commands, physical enforcements, reprimands, and prohibitive interventions, and negatively associated with the use of suggestions. The authoritative pattern was positively related to the use of suggestions and positive incentives, and negatively related to the use of physical enforcements, prohibitive interventions, and direct commands. Mothers' enjoyment of the parental role and their negative affect toward the child, as expressed in the Block Q-Sort, were more a result of the child's cooperation/resistance during the interaction than predictors of maternal control strategies. PMID- 2702875 TI - Proximate regulation by mothers: a demonstration of how differing styles affect young children's behavior. AB - An earlier observational study of mothers and toddlers in the supermarket revealed differential success of 2 styles of maternal behavior. A proactive style of preempting opportunities for misbehavior, in contrast to a reactive style of responding only after misbehavior occurred, was correlated with a lower incidence of undesirable child acts. Here, the 2 styles were studied in the laboratory to explore their function further. In an analog of the supermarket situation, mothers behaved proactively and reactively in trials in which the task was to prevent their 2- or 3-year-old children from playing with desirable toys. Children responded to proactive behavior by engaging in acceptable behaviors longer and by violating fewer rules. The 2-year-old children were less able to comply with the rules. The data illustrate the role parents play in promoting and supporting the development of compliance and self-regulation in children. PMID- 2702876 TI - Social interactions and play patterns of parents and toddlers with feminine, masculine, and neutral toys. AB - Children as young as 18 months display sex-stereotyped toy choices. The present study was designed to determine whether parents encourage involvement with sex stereotyped toys or avoidance of cross-sex-stereotyped toys and to determine whether masculine and feminine toys lead to different patterns of parent-child interaction, regardless of gender. 40 parent-toddler dyads were videotaped while playing with 6 different sets of sex-stereotyped toys. Equal numbers of boys and girls were observed with mothers and fathers. The children showed greater involvement when playing with same-sex-typed toys than with cross-sex toys even when statistically controlling for parents' behaviors. Parents' verbal behaviors, involvement, and proximity to the child differed across toy groups, regardless of the parent's or child's gender. Parents' initial nonverbal responses to the toys, however, were more positive when the toys were stereotyped for the child's and parent's gender than when they were not. PMID- 2702877 TI - Infant-mother face-to-face interaction: age and gender differences in coordination and the occurrence of miscoordination. AB - To evaluate the extent to which infants and mothers are able to coordinate their behavior, the interactions of 54 mother-infant pairs--18 each at 3, 6, and 9 months of age--were videotaped. Coordination was evaluated with 2 measures: (1) matching--the extent to which mother and infant engage in the same behavior at the same time; and (2) synchrony--the extent to which mother and infant change their behavior with respect to one another. Mother-infant pairs increase their degree of coordination with infant age, but the proportion of time they are coordinated is small. Mother-son pairs spend more time in coordinated states than mother-daughter pairs. The results suggest that interactions be characterized in terms of their movement from coordinated to miscoordinated states rather than only in terms of their degree of coordination. The gender differences are discussed in terms of their importance for the developmental differences in females and males. PMID- 2702878 TI - Mother- and father-preterm infant relationship in the hospital preterm nursery. AB - The relationships of Israeli mothers and fathers with their 38 preterm infants during hospitalization were traced in a short-term longitudinal study. Parent infant interactions were observed and self-reports of parental feelings and perceptions were assessed twice: at the beginning and end of the nursery period. Mothers engaged in more caregiving, talking, and holding during initial contacts, but the disparity in maternal and paternal interactions decreased with time. Except for caregiving, in which mothers still surpassed fathers, fathers equaled mothers in all other activities at the time of the infants' discharge from the hospital. Fathers consistently surpassed mothers in playing and stimulating. Mothers perceived their infants to be more difficult than did fathers but reported enjoying them more. With time, parents were less disappointed and concerned over the infants' well-being but perceived them as more difficult. The data also demonstrated an association between infant behavioral states, parental feelings and perceptions, and parental behavior. PMID- 2702879 TI - Recurrent autonomous esophageal peristalsis in patients with chest discomfort. AB - Routine esophageal manometry revealed a novel pattern of esophageal motility, recurrent autonomous peristalsis, in five patients evaluated for chest discomfort and heartburn. In the absence of swallowing, esophageal peristalsis occurred at frequencies of 4-8 peristaltic sequences per minute for periods of 2-8 min. The recurrent peristaltic sequences developed spontaneously during manometry and were associated with the onset of vague chest discomfort in four patients; one patient reported no symptoms during recurrent peristalsis. Duration and propagation velocity of the recurrent peristaltic contractions differed significantly from primary peristalsis in four patients. Recurrent autonomous esophageal peristalsis is an unusual motor pattern that may be associated with vague chest discomfort. The circuit(s) mediating recurrent autonomous peristalsis are unknown. PMID- 2702880 TI - Modulation of esophageal contractions by distension in vitro. AB - Stimulation of the intrinsic nerves of the esophageal body leads to a twitch of the circular muscle after the end of the stimulation (the esophageal off response), and the twitch spreads in the distal direction because of a latency gradient in the onset of the off-response between the proximal and the distal esophagus. We investigated the possibility that local input can modulate the basic off-response through intrinsic mechanisms and make it resemble more closely the sequential ring contractions that move boluses in the esophagus of intact animals (esophageal peristalsis). The esophagus up to the aortic arch and down to the gastroesophageal junction was removed from opossums and suspended in an organ bath containing 2 liters of Krebs solution at 36 degrees C. The mechanical activity of the esophagus was recorded by force transducers on the serosal surface of the esophagus 2, 4, and 6 cm above the LES. The intramural nerves of the proximal esophagus were stimulated by electrical pulses with and without distension of the esophagus by inflation of a luminal balloon. Balloon distension increased the latency of the off-response in the distal esophagus, thereby reducing the velocity at which the circular muscle contraction spread through the esophagus. In addition, balloon distension increased the amplitude and the duration of the esophageal circular muscle contraction (both off- and on responses), and decreased the amplitude of the longitudinal muscle contraction (duration response) and LES response (relaxation response). Similar changes in the esophageal contraction responses were produced by radial stretch of an open preparation of the esophagus from which the mucosa had been removed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702881 TI - Orocecal transit delay in obese patients. AB - Orocecal transit time was assessed with lactulose hydrogen breath test in 12 obese patients during intravenous infusion of placebo or naloxone 40 micrograms/kg/hr given in randomized order and in double-blind conditions. Transit time was also evaluated in 22 healthy controls. Orocecal transit was significantly (P less than 0.01) longer in the obese patients, during placebo treatment (median 130, range 100-200 min) than in the healthy controls (median 75, range 40-170 min). Compared with placebo, transit time in the obese subjects was delayed (P less than 0.05) during naloxone treatment (median 150, range 100 230 min). PMID- 2702882 TI - Sham feeding. Cephalic-vagal influences on gastric myoelectric activity. AB - The effects of sham feeding on gastric motility of human subjects have not previously been studied. The amplitude of 3-cpm electrogastrogram (EGG) waves increases after the ingestion of food. We hypothesized that sham feeding would stimulate a similar, but briefer gastric myoelectric response. Healthy human subjects chewed and expectorated a hot dog on a roll and later ate a second hot dog. EGGs were continuously recorded before, during, and after sham feeding and eating. The results of experiment I (N = 27) showed that the hand-scored amplitude of the 3-cpm waves increased significantly (P less than 0.01) during sham feeding. Two minutes after sham feeding, the mean amplitude of 3-cpm EGG waves returned to baseline level. The increase in EGG amplitude during eating was also significant (P less than 0.01), and remained increased for approximately 30 min after ingestion. The procedure used in experiment II (N = 20) was similar to experiment I, but EGGs were computer analyzed and power, ie, spectral intensities, at 3 cpm were obtained. The increase in power at 3 cpm during sham feeding and during eating was significant (P less than 0.05 and P less than 0.02, respectively). Similar to experiment I, the duration of increase in power at 3 cpm was brief during sham feeding compared to the postprandial increase. Four vagotomized subjects failed to show an increase in power at 3 cpm in response to sham feeding. We conclude: (1) The cephalic-vagal stimulation of sham feeding increases briefly the amplitude and power of 3-cpm gastric myoelectric activity in healthy subjects but not vagotomized patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702883 TI - Caloric content of a meal affects duration but not contractile pattern of duodenal motility in man. AB - The variability of the fasted duodenal contractile pattern and the patterns of contraction during the fed phase was examined in normal volunteers. Prolonged recordings from the duodenum and proximal jejunum were achieved using a series of transducers mounted on a 2.3-mm catheter. A total of 58 interMMC intervals and the response to 18 meals was examined. There was marked inter- and intrasubject variability in the fasted state, even within one study. The phase II pattern was examined in detail and propagated single peaks, propagated clusters, and repeated propagated clusters are described. Single peaks could be propagated as rapidly as 16 cm/sec. Single peaks were propagated more rapidly than propagated multiple peaks. During phase III, duodenal contractions occurred at 11.3 +/- 0.09/min and jejunal contractions at 10.73 +/- 0.15/min. The rate of progression of the onset of phase III was 0.145 +/- 0.015 cm/sec. The effect of the caloric content of the meal was examined by determining the effect of 150-kcal, 300-kcal, and 600-kcal meals on the fed pattern. Increasing caloric content increased the duration of the fed pattern but had no effect on the total or normalized motility index or on the change in motility index over time during the fed pattern. The types of contractions seen during the fed pattern are described. Propagated clusters over at least 16 cm are common during the fed phase in normals, with 10% of all contractions seen during the fed phase being propagated over 28 cm. No difference in the patterns of contractions or their propagation was seen with the different caloric contents of the meals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702884 TI - Increased dopamine receptor binding in duodenal mucosa of duodenal ulcer patients. AB - High-affinity and saturable membrane-bound dopamine binding sites have been characterized in rat and human gastrointestinal tissues. Although their role in experimental ulcerogenesis has been suggested, dopamine receptor activity in peptic ulcer disease has not been investigated. Radioligand binding studies were performed with mucosal tissue homogenates obtained from the antrum and duodenum of six male healthy volunteers and six male duodenal ulcer patients. The binding assay was performed in triplicate with a crude membrane fraction using [3H]dopamine as a ligand at a final concentration of 1 nM at 22 degrees C in the dark. Nonspecific binding (which usually comprised about 30% of total binding) was determined in the presence of a 100-fold excess of unlabeled dopamine. A significant (P less than 0.05) increase of [3H]dopamine binding was found in duodenal mucosa of duodenal ulcer patients. [3H]Dopamine binding in stomach (antrum) of normal and duodenal ulcer patients did not differ significantly. These findings provide preliminary evidence for a role of dopamine receptors in duodenal ulcer and suggest that biochemical abnormalities of gut dopamine function may be operative in the pathogenesis of peptic ulcer disease. PMID- 2702885 TI - Effect of dopamine on electrical activity of isolated stomach muscle in cats. AB - The effect of dopamine on electrical activity (gastric slow wave) of the stomach was studied in isolated stomach muscle strips of 145 cats. The gastric slow wave was recorded by four monopolar electrodes (Ag-AgCl) in Krebs-Ringer solution (pH 7.4, temperature 36 +/- 0.5 degrees C) bubbled with 5% CO2 in O2. Dopamine induced concentration-dependent alterations in frequency and propagation of slow waves. Development of irregular propagation was significantly suppressed by domperidone pretreatment. The variation of dopamine-induced slow-wave frequency was significantly inhibited by domperidone and phentolamine but not by propranolol, hexamethonium, and tetrodotoxin. The study indicates that a dopamine receptor exists in the stomach and plays a role in the genesis of gastric electrical abnormality. PMID- 2702886 TI - Xylose transport in the human jejunum. AB - D-Xylose transport in the human jejunum was studied in vivo using a standard intestinal perfusion technique, and also in vitro in human jejunal brush border membrane vesicles. Initial D-xylose concentrations were linearly related to D xylose absorption rates, a finding consistent with passive diffusion. Perfusion of D-xylose with varying D-glucose concentrations were aimed at examining D xylose-D-glucose jejunal cotransport. D-Xylose absorption rates from a 30 mM D xylose perfusate did not change significantly when 10, 30, or 60 mM glucose were added (-3.0 +/- 0.62 vs -3.34 +/- 0.71, -3.82 +/- 0.81, and -4.56 +/- 0.72 mM/30 cm/hr, respectively; minus indicates net absorption) suggesting an absence of a cotransport system. In brush border membrane vesicles, xylose uptake was partially inhibited by D-glucose and phlorizin. These data suggest that jejunal D xylose absorption, at concentrations used clinically, is by passive diffusion, which process completely overrides a minor D-glucose cotransport component. The D xylose tolerance test, therefore, reflects jejunal mucosal surface area and mucosal permeability to D-xylose and not nutrient carbohydrate absorption. PMID- 2702887 TI - Ascorbic acid absorption in Crohn's disease. Studies using L-[carboxyl 14C]ascorbic acid. AB - Total body pool and intestinal absorption of ascorbic acid were studied in 12 patients undergoing operation for Crohn's disease (six with fistulae and six without) and in six control patients undergoing operation for reasons other than Crohn's disease. L-[carboxyl-14C]Ascorbic acid, 0.19-0.40 megabecquerels (MBq), was given orally. After a period of equilibration, the labeled ascorbic acid was flushed out of the patient's body tissues using large doses of unlabeled ascorbic acid. Intestinal absorption of ascorbic acid, assessed from the total cumulative urinary 14C recovery, was found to be similar in patients with fistulizing Crohn's disease (73.9 +/- 8.45%), those without fistulas (72.8 +/- 11.53%), and in controls (80.3 +/- 8.11%). Total body pools of ascorbic acid, calculated using the plasma 14C decay curves, were similar in patients with Crohn's disease with fistulas (17.1 +/- 5.91 mg/kg), patients without fistulas (9.6 +/- 3.58 mg/kg), and in controls (13.3 +/- 4.28 mg/kg). The results indicate that ascorbic acid absorption is normal in patients with both fistulizing and nonfistulizing Crohn's disease. The results suggest that routine supplements of vitamin C are not necessary unless oral ascorbic acid intake is low. PMID- 2702888 TI - Effect of somatostatin analog (SMS 201-995) on in vivo intestinal fluid transport in rats. A limited systemic effect. AB - Somatostatin analog, SMS 201-995, effectively inhibits the release of hormones from gastrointestinal endocrine tumors and reduces hormonally mediated diarrheas. Its clinical efficacy in nonhormonally mediated diarrhea is limited, despite a potent antisecretory and proabsorptive effect in vitro. The effect of serosal addition of SMS 201-995 on in vitro short-circuit current responses in rat intestine is dependent upon chloride and more marked in colon and ileum than jejunum. In contrast, in vivo loop studies demonstrated that systemic administration of SMS 201-995 for five consecutive days produced a paradoxical decrease in basal colonic fluid absorption with no effect in jejunum or ileum. Furthermore, systemically administered SMS 201-995 did not alter cholera toxin stimulated intestinal secretion. We conclude that despite a previously identified intestinal antisecretory and proabsorptive effect of SMS 201-995 in vitro, this effect is not seen in vivo and may explain the limited use of SMS 201-995 as an antidiarrhoeal agent in nonhormonally mediated diarrhoea. PMID- 2702889 TI - 5-Aminosalicylic acid concentration in mucosal interstitium of cat small and large intestine. AB - Uncertainty regarding the concentration of 5-ASA within the mucosal interstitium has been a major limitation of defining the protective mechanisms of 5-ASA in intestinal inflammation. Therefore, we measured the concentration of 5-ASA in intestinal lymph and venous plasma during luminal perfusion of the cat small and large intestine with 10 mM 5-ASA. Blood and lymph flows were measured in each segment. 5-ASA and N-acetyl-5-ASA were extracted from plasma and lymph and quantified using fluorescence spectroscopy. Luminal perfusion of the terminal ileum with 5-ASA resulted in the following concentration profile: intestinal venous plasma (143 +/- 30 micrograms/ml) much greater than lymph (43 +/- 17 micrograms/ml) = systemic arterial plasma (40 +/- 11 micrograms/ml). In the colon the local venous plasma concentration of 5-ASA was 20 +/- 6 micrograms/ml compared to 2.0 +/- 1.0 micrograms/ml in systemic arterial plasma. N-Acetyl-5-ASA was found to comprise less than 5% of the total metabolite concentration in both ileum and colon. We also found that 58% of luminal 5-ASA was absorbed per minute in the terminal ileum, whereas only 3%/min was absorbed from the colon. The results of this study suggest that: (1) the mucosal interstitial concentration of 5-ASA in the terminal ileum and colon are approximately 100 micrograms/ml (654 microM) and 20 micrograms/ml (164 microM), respectively; and (2) the rate of 5 ASA absorption in the terminal ileum is approximately seven times greater than that in the colon. PMID- 2702890 TI - Glycoproteins and glycolipids of rat small intestinal microvillus and basolateral membranes. AB - Glycoprotein and glycolipid constituents were examined in purified microvillus and basolateral membranes isolated from rat small intestinal epithelial cells. SDS-polyacrylamide gel electrophoresis showed that the molecular weights of most of the major proteins from microvillus membranes were over 100 kD, whereas the majority of those from basolateral membranes tended to have lower molecular weights. Glycoprotein profiles were also examined using three labeling methods, and in each case marked differences were observed between microvillus and basolateral membranes. In both membranes, lectins with a specificity toward N linked sugar chains bound to the majority of the glycoproteins, in contrast to those lectins which preferentially bind to O-linked sugar chains. Glycolipids were labeled in vivo and isolated from both membrane fractions. Some differences were observed in the fucolipids and neutral glycolipids suggesting a more complex pattern in microvillus membranes. These results indicate that there are differences in the glycoprotein and glycolipid compositions of microvillus and basolateral membranes that may reflect the functional polarity of intestinal epithelial cells. PMID- 2702891 TI - Stimulation of specific Aeromonas antibody secretion in rat intestine by gamma aminobutyric acid. AB - This study was undertaken to assess a possible role for gamma-aminobutyric acid (GABA) in the regulation of intestinal secretion of IgA and IgG antibodies. Rats were immunized with culture supernatant of Aeromonas hydrophila isolate SSU. This culture supernatant contains a number of toxins that may be considered virulence factors. After 24 days of immunization, rats were anesthetized and a 10-cm intestinal segment was intubated and ligated at both ends in situ. The intestinal loop was perfused with phosphate-buffered saline (PBS). The effluents were collected for measurement of IgA and IgG by the ELISA. When compared with the effect of intravenous administration of normal saline in the control group, intravenous injection of GABA (30 mg/kg) resulted in a significant increase of IgA and IgG secretion in the experimental group. These stimulatory effects of GABA on secretion of IgA and IgG were abolished by bicuculline, a GABA-receptor antagonist, and by atropine, indicating that the GABA-stimulated secretion of IgA and IgG was mediated via the GABA receptors and cholinergic muscarinic receptors. These results suggest that GABA may participate in the nervous regulation of intestinal secretion of IgA and IgG antibodies in the rat. PMID- 2702892 TI - Amyloidosis mimics achalasia's effect on lower esophageal sphincter. AB - Esophageal involvement in systemic amyloidosis is common. Manometric studies have been few in number and have revealed a variety of findings compatible with deposition of amyloid in myopathic as well as neuropathic patterns. This report describes a patient with primary amyloid whose esophageal dysfunction was limited to the lower esophageal sphincter, with both a hypertensive sphincter and impaired relaxation after swallows. Pharmacologic testing confirmed a mild abnormality of the inhibitory pathway to the LES with an intact excitatory pathway and sphincter muscle. This case suggests that amyloidosis, like idiopathic achalasia and carcinoma of the lower esophagus, can produce dysphagia by selective impairment of the inhibitory neural pathway to the lower esophageal sphincter. PMID- 2702893 TI - Effects of replacing saturated fat with complex carbohydrate in diets of subjects with NIDDM. AB - This study examined the safety of an isocaloric high-complex carbohydrate low saturated fat diet (HICARB) in obese patients with non-insulin-dependent diabetes mellitus (NIDDM). Although hypocaloric diets should be recommended to these patients, many find compliance with this diet difficult; therefore, the safety of an isocaloric increase in dietary carbohydrate needs assessment. Lipoprotein cholesterol and triglyceride (TG, mg/dl) concentrations in isocaloric high-fat and HICARB diets were compared in 7 NIDDM subjects (fat 32 +/- 3%, fasting glucose 190 +/- 38 mg/dl) and 6 nondiabetic subjects (fat 33 +/- 5%). They ate a high-fat diet (43% carbohydrate; 42% fat, polyunsaturated to saturated 0.3; fiber 9 g/1000 kcal; cholesterol 550 mg/day) for 7-10 days. Control subjects (3 NIDDM, 3 nondiabetic) continued this diet for 5 wk. The 13 subjects changed to a HICARB diet (65% carbohydrate; 21% fat, polyunsaturated to saturated 1.2; fiber 18 g/1000 kcal; cholesterol 550 mg/day) for 5 wk. NIDDM subjects on the HICARB diet had decreased low-density lipoprotein cholesterol (LDL-chol) concentrations (107 vs. 82, P less than .001), but their high-density lipoprotein cholesterol (HDL chol) concentrations, glucose, and body weight were unchanged. Changes in total plasma TG concentrations in NIDDM subjects were heterogeneous. Concentrations were either unchanged or had decreased in 5 and increased in 2 NIDDM subjects. Nondiabetic subjects on the HICARB diet had decreased LDL-chol (111 vs. 81, P less than .01) and unchanged HDL-chol and plasma TG concentrations).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702894 TI - Development of diabetes attitude scale for health-care professionals. AB - This article describes the development of a diabetes attitude scale (DAS) that was designed to measure the attitudes of health-care professionals (HCPs). The DAS was developed through the efforts of a national panel of diabetes experts. The panel developed a 60-item scale that was pilot tested and reduced to a 50 item scale. The 50-item scale was then mailed to a national sample of HCPs with an interest in diabetes. The surveys were returned by 633 nurses, 322 dietitians, 116 physicians, and 67 others totaling 1138 returns (a return rate of 54%). The returned surveys were analyzed, and a 31-item DAS composed of 8 subscales resulted. Evidence for the reliability and validity of the 31-item DAS along with the instrument itself are included in this study. PMID- 2702895 TI - Effects of socioeconomic status on hyperglycemia and retinopathy levels in Mexican Americans with NIDDM. AB - Mexican Americans have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites. Moreover, Mexican-American diabetic people have more severe hyperglycemia and diabetic retinopathy than non Hispanic White diabetic people. Mexican Americans are predominantly of low socioeconomic status (SES), and low-SES Mexican Americans have a higher prevalence of NIDDM than higher-SES Mexican Americans. Therefore, we hypothesized that among diabetic people, low SES would be associated with more severe hyperglycemia and retinopathy. Three hundred forty-three Mexican Americans and 79 non-Hispanic Whites with NIDDM were identified from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Hyperglycemia was assessed as the sum of the fasting, 1-h, and 2-h plasma glucose concentrations during a standard oral glucose tolerance test. Retinopathy was assessed by 7 standard stereoretinal photographs. SES was assessed with three indicators: Duncan's socioeconomic index, education, and income. Contrary to expectations, low SES was not associated with greater levels of hyperglycemia or grades of retinopathy. PMID- 2702896 TI - Insulin autoimmune syndrome associated with benign monoclonal gammopathy. Evidence for monoclonal insulin autoantibodies. AB - A 64-yr-old man with benign monoclonal gammopathy developed recurrent episodes of severe hypoglycemia but lacked evidence of insulinoma or exogenous insulin administration. The patient's plasma was found to contain anti-insulin antibodies and large amounts of extractable insulin (1110 microU/ml), which was identified as human insulin by high-performance liquid chromatography (HPLC). The anti insulin antibodies consisted solely of IgG and lambda-light chains. Scatchard analysis of these antibodies revealed an almost straight-line relationship, with markedly low affinity and high capacity. An immune complex made of 125I-labeled insulin and the patient's antibodies emerged in a molecular-sieve HPLC as almost a single peak, suggesting a homogeneous antibody population. In addition, the patient's M protein was separately shown to be the IgG and lambda-light-chain type. We suggest that the insulin autoantibodies responsible for the spontaneous hypoglycemia in this patient are monoclonal and of M protein origin. PMID- 2702897 TI - Nutrition education and social learning interventions for type II diabetes. AB - Two diabetes education programs were compared to a control condition. Seventy eighty type II (non-insulin-dependent) diabetic outpatients were randomly assigned to nutrition education, nutrition education plus social learning intervention, or wait-list control conditions. Both interventions involved five weekly meetings that focused on reducing calorie intake, increasing dietary fiber, and decreasing fat consumption. The social learning condition also included individualized goal setting and feedback and training in problem-solving and relapse prevention. Within-group analyses and between-group comparisons generally revealed greater improvement in targeted goals (e.g., calorie intake, fat reduction) among intervention conditions than the control condition. There were few differences in more distal measures of outcome such as weight or glycosylated hemoglobin. The social learning component did not improve outcome more than the nutrition education program. Possible reasons for the observed findings and the advantages and limitations of focused time-limited diabetes education efforts are discussed. PMID- 2702898 TI - Carriage of Staphylococcus aureus and inflamed infusion sites with insulin-pump therapy. AB - The most common complication of continuous subcutaneous insulin infusion (CSII) is inflammation at the infusion site. To determine possible risk factors to these infections, we studied several factors in the management of CSII and compared the pyogenic skin inflammation rate, the carriage rate of Staphylococcus aureus, and the HbA1 level among 50 CSII-treated diabetic patients, 50 diabetic patients on insulin injections, 48 diabetic patients on oral medication, and 40 healthy volunteers. There was no increased carriage rate of S. aureus among CSII-treated patients (42%) as compared with the other groups. An unexpected inverse relationship existed between HbA1 level and carriage rate in the CSII-treated group (HbA1 5-8%, n = 16, 69%; HbA1 8-10% n = 15, 40%; HbA1 greater than 10, n = 19, 21% P = .02). Pyogenic skin inflammations were reported by 24 (48%) CSII treated patients, of which 18 had infected infusion sites, 6 (12%) insulin injecting patients, 2 (4%) patients on oral medication, and 3 (8%) healthy volunteers (P less than .01). The occurrence of inflamed infusion sites was not associated with carriage of S. aureus, the indwelling time of the needle, or the insulin dosage per day. There was an association, however, with the type of insulin preparation classified according to the added preservative: m-cresol containing insulin (n = 24, 54%); methyl p-hydroxybenzoate-containing insulin (n = 26, 19%, P = .02). We concluded that the carriage of S. aureus is not increased among diabetic patients on CSII treatment and is not a risk factor in the occurrence of inflammation at the infusion site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702899 TI - Augmentation of atrial contribution to left ventricular filling in IDDM subjects as assessed by Doppler echocardiography. AB - Left ventricular diastolic function was assessed by pulsed Doppler echocardiography in 21 subjects (mean age 48 yr) with insulin-dependent diabetes mellitus (IDDM) and without evidence of ischemic heart disease and in 21 healthy control subjects of similar age and sex distribution. The peak mitral valve flow velocities during the early rapid filling phase (E) and during late atrial filling (A) were measured, and the ratio of these peak flow velocities (E:A) was calculated. E was similar in both groups, but A was higher (P less than .01) in the diabetic group. Thus, E:A was lower (1.19 +/- 0.24 vs. 1.65 +/- 0.67; P less than .01) in the diabetic subjects than in the control subjects. On subgroup analysis, 6 patients with cardiac autonomic neuropathy had lower E:A than the patients with no such disorder (0.99 +/- 0.15 vs. 1.29 +/- 0.25; P less than .05). E:A was not related to the duration of diabetes, presence of retinopathy, HbA1, or blood glucose levels. In conclusion, the atrial contribution to left ventricular filling seems to be augmented in diabetic subjects. This finding indirectly supports the view that left ventricular compliance is already reduced in asymptomatic diabetic subjects. PMID- 2702900 TI - Diet low in saturated fat and cholesterol for diabetes. PMID- 2702901 TI - Magnesium administration reduces platelet hyperaggregability in NIDDM. PMID- 2702902 TI - Stability of reacted chemistrip bG. PMID- 2702903 TI - Adrenomedullary hypofunction and diabetic neuropathy. PMID- 2702904 TI - Autonomic neuropathy in pregnancy. PMID- 2702905 TI - Xylitol. PMID- 2702906 TI - Longitudinal relationship of asymptomatic hypoglycemia to cognitive function in IDDM. AB - Early-onset insulin-dependent diabetes mellitus (IDDM) is linked to subsequent learning deficits. To investigate the relationship of learning deficits to metabolic control, 23 children with IDDM (age at testing 71 +/- 21 mo, age at diagnosis 35 +/- 15 mo) diagnosed before 5 yr of age were followed for periods of 6-78 mo. Mean glycosylated hemoglobin (HbA1), episodes of severe hypoglycemia, and frequency of self-monitoring blood glucose (SMBG) measurements less than 2.8 mM (50 mg/dl, asymptomatic hypoglycemia) were recorded every 3 mo. Six subjects entered the study 12.3 +/- 6.7 mo after diagnosis, and only severe hypoglycemia was present before entry. For the remaining 17 subjects, HbA1 and severe and asymptomatic hypoglycemia were present from the time of diagnosis of diabetes. Mean HbA1 level was 10.1 +/- 1.0%, and mean severe hypoglycemic episodes per patient was 2.9, but the frequency was highly skewed; one patient had 37 episodes, and 14 had none. The mean percentage of SMBG readings less than 2.8 mM was 2.4 +/- 2.1. On the revised Stanford-Binet Intelligence Scale there was no correlation between any subscale and severe hypoglycemia. However, the relative frequency of asymptomatic hypoglycemia correlated with scores on the abstract/visual reasoning scale (r = -.39, P = .037). This relationship was primarily accounted for by the relationship of asymptomatic hypoglycemia to performance on the copying subscale (r = -.42, P = .022). Children with frequent asymptomatic hypoglycemic episodes had lower mean copying scores and abstract reasoning scores than those with infrequent episodes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702907 TI - Taste impairment and related factors in type I diabetes mellitus. AB - To study taste in type I (insulin-dependent) diabetes mellitus, 57 consecutive diabetic outpatients (mean +/- SE duration of diabetes 11.4 +/- 0.4 yr) and 38 control subjects were screened for taste disorders with electrogustometry and chemical gustometry. Both groups were comparable for all subject characteristics except body mass index, which was higher in the diabetic group (P less than .05). A taste impairment was found in the diabetic group relative to the control group with electrogustometry (mean threshold 184.3 +/- 15.8 vs. 58.7 +/- 9.2 microA; P less than .001) and chemical gustometry (mean score 13.2 +/- 0.7 vs. 17.1 +/- 0.8; P less than .001). Hypogeusia was found among 73% of the diabetic patients versus 16% of the control subjects (P less than .001). The four primary tastes were involved in taste impairment. With multivariate analysis, taste disorders were related to diabetic status and tobacco and alcohol consumption. In the diabetic group, taste impairment was significantly associated with complications and duration of disease. With multivariate analysis, peripheral neuropathy had the strongest association with taste disorders. These results suggest that taste is impaired during the course of type I diabetes mellitus and that taste impairment could be a complication of the disease. A mechanism of the neuropathic type could be involved. PMID- 2702908 TI - Reliability of self-monitoring of blood glucose by CSII-treated patients with type I diabetes. AB - The reliability of patient-generated data from self-monitoring of blood glucose (SMBG) was studied in 14 patients with type I (insulin-dependent) diabetes mellitus treated by continuous subcutaneous insulin infusion (CSII) (7 women, 7 men). The reflectance meters (Glucometer I, Ames, Elkhart, IN) used by the patients were replaced for a period of 21 days by memory-reflectance meters; patients were unaware of the memory capacity of the new meters and were instructed to continue their practice of recording the meter readings in their logbook. This study compares the data recorded in the memory-reflectance meters with those reported in the logbook. The number of SMBG measurements was different in 11 patients (differences ranging from 2 to 66). Mean glycemia was similar (8.23 +/- 0.36 mM in logbook vs. 8.49 +/- 0.48 mM in memory-reflectance meters), but both the M value and mean amplitude of glycemic excursions (MAGE) index were lower when calculated from logbook data (38 +/- 5 vs. 48 +/- 7 mM, P less than .05 and 6.91 +/- 0.43 vs. 7.72 +/- 0.52 mM, respectively; P less than .05). Overreporting (addition of phantom values in logbook) and underreporting (omission of SMBG measurements from logbook) indexes were 19 +/- 7 and 12 +/- 3%, respectively. Precision (percent of identical values in logbook and in memory reflectance meters at the corresponding time) was 77 +/- 6.8%. The number of SMBG measurements recorded in the memory-reflectance meter was negatively correlated with glycosylated hemoglobin [HbA1c; (r = -.85, P less than .001)], whereas overreporting was positively correlated with HbA1c (r = .76, P less than .01). PMID- 2702909 TI - NIDDM and prevalence of nasal Staphylococcus aureus colonization. San Luis Valley Diabetes Study. AB - Previous studies of hospitalized and ambulatory patients have found a higher prevalence of Staphylococcus aureus nasal colonization in diabetic than nondiabetic subjects. We examined this association in a geographically based study among 551 residents of the San Luis Valley of Colorado and found no statistically significant increase in the relative risk of nasal S. aureus colonization in 188 non-insulin-dependent diabetic (NIDDM) versus 363 nondiabetic subjects (relative risk 1.3, 95% confidence limits 0.9-1.8). Adjustment for confounding by age, sex, ethnicity, county of residence, and frequency of hospitalizations or physician visits in the previous year did not affect the results. Among the diabetic subjects, S. aureus colonization was not associated with type of treatment for diabetes, level of glucose control, clinical duration of diabetes, or frequency of hospitalizations or physician visits in the previous year. In this population-based study, diabetes mellitus did not increase S. aureus nasal colonization, suggesting that factors other than diabetes mellitus may have caused the higher colonization rate found in previous clinic-based studies. PMID- 2702910 TI - Changes in cortical functioning with acute hypoglycemia and hyperglycemia in type I diabetes. AB - In this study, 18 type I (insulin-dependent) diabetic subjects aged 22-35 yr (mean age 29.3) and within 10 yr of diagnosis (mean 7.7) performed a battery of cognitive and psychomotor tasks under conditions of hypoglycemia (50 mg/dl), normoglycemia (100 mg/dl), and hyperglycemia (300 mg/dl). Blood glucose levels during testing were precisely maintained at the preselected level via a Biostator insulin/glucose-infusion system. The order of glycemic level was counterbalanced across subjects in a single-blinded design. Performance on tasks requiring visual tracking, visuomotor speed, concentration, and planning ability (pursuit rotor and trails B) were significantly impaired under conditions of hypoglycemia compared with normoglycemic levels. Visual reaction time was not significantly impaired under conditions of hypoglycemia or hyperglycemia. PMID- 2702911 TI - Renal papillary necrosis in patients with IDDM. AB - Although diabetes mellitus is reported in 29% of patients with renal papillary necrosis (RPN), the frequency of RPN among patients with insulin-dependent diabetes mellitus (IDDM) has from autopsy studies been estimated to be only 4.4%. In vivo data on the prevalence of RPN in patients with IDDM have been lacking. We therefore studied the prevalence of RPN in 76 patients with long-standing IDDM and in 34 age-matched control subjects by intravenous urography. None of the control subjects showed radiographic signs of papillary necrosis. RPN was observed in 18 patients (23.7%); 15 were women (83.3%). Age and duration of diabetes was not different between patients with and without papillary necrosis, and there was no significant difference between the two groups regarding the prevalence of microangiopathic complications, i.e., proliferative retinopathy and diabetic nephropathy. Microscopic hematuria was three times more frequent in patients with than without RPN (44 vs. 16%; P less than .02). In addition, pyuria was reported in 40% of patients with papillary necrosis, and 61% of them gave a positive history of urinary tract infection compared to 16% (P less than 05) and 32% (P less than .02), respectively, in patients without papillary necrosis. It is concluded that RPN is a more frequent complication of long-standing IDDM than appreciated from autopsy studies, and being female and having a history of urinary tract infection are associated with an increased risk of RPN. PMID- 2702912 TI - Symptomatic hypoglycemia in NIDDM patients treated with oral hypoglycemic agents. AB - We assessed the prevalence of hypoglycemic symptoms in patients (aged 40-65 yr) treated with oral hypoglycemic agents (OHAs) attending routine diabetes clinics at our hospital. Symptoms were experienced during the previous 6 mo in 41 of 203 (20.2%) patients treated with sulfonylureas but in none of the 16 patients treated with metformin alone. Hypoglycemic symptoms were experienced at least monthly in 5.9% and less frequently in 14.3% of patients. The prevalence of symptoms decreased with increasing duration of sulfonylurea administration (P less than .01). Mean glycosylated hemoglobin and postprandial plasma glucose were significantly lower in patients reporting hypoglycemic symptoms than in those without symptoms (P less than .001). The prevalence of hypoglycemic symptoms was significantly higher in patients treated with glyburide than in patients treated with gliclazide (P less than .01) or chlorpropamide (P less than .05). The prevalence of symptoms was higher in patients taking medications in addition to OHAs (P less than .01). Ten (24%) of the patients who experienced hypoglycemic symptoms were taking drugs that may potentiate sulfonylureas. PMID- 2702913 TI - Case-control study of IDDM. AB - Insulin-dependent diabetes mellitus (IDDM) may be caused by a combination of genetic predisposition and environmental insults. However, there are few solid leads concerning human diabetogenic environmental agents. A case-control study was carried out to investigate the possible relationships between IDDM and various biological, chemical, and psychological factors. All 161 cases of IDDM among children aged 0-17 yr occurring in Montreal from 1983 to 1986 were included. The parent of each newly diagnosed diabetic subject was asked to provide the names of two of the child's friends or neighbors who would be age and sex matched to serve as controls. For those unable to do so, matched controls were selected from a hospital emergency room. Parents of cases and controls were interviewed concerning many factors. There was little or no difference between cases and controls with regard to parental smoking habits, exposure to pets, and consumption of meat products high in nitrosamines. In univariate analyses, there was some indication of elevated risk for children who had not been breast-fed, who attended day care or nursery before age 5 yr, who lived in a crowded household at age 3 yr, or who had a history of asthma or eczema, although in multivariate analyses the only variables that had any effect were crowding and day-care attendance. In univariate and multivariate analyses, there was high risk of IDDM among children who had experienced selected stressful life events during the 12 mo preceding onset of IDDM or who had exhibited symptoms of social or psychological dysfunction during that time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702914 TI - Fundus polaroid screening for diabetic retinopathy. Is one print per patient enough? AB - The CR3-45 NM Canon nonmydriatic fundus camera detects relevant diabetic retinopathy with high sensitivity. To determine whether examination of one eye per patient would suffice for screening purposes, 473 pairs of standard 45 degree fundus Polaroid prints obtained with the Canon camera were assessed from 167 patients with and 306 without diabetic retinopathy. On the basis of considering only one eye per patient, absence of retinopathy would have been diagnosed in 336 patients, with 9% of the diagnoses false negative. One hundred thirty-seven of the 167 patients with retinopathy in at least one eye would have been diagnosed correctly by considering one eye per patient (sensitivity 82%, specificity 100%). Thus, a standard 45 degree fundus Polaroid print from one eye per patient may suffice for screening purposes if the picture is free from diabetic abnormalities. Otherwise, both eyes should be examined immediately, and the patient should be referred to an expert ophthalmologist who specializes in diabetic retinopathy for confirmation of the diagnosis and staging of diabetic retinopathy status. PMID- 2702915 TI - Visual evoked potentials in diabetic patients. AB - Visual evoked potentials (VEPs) were assessed in 50 adult type I (insulin dependent) and 19 type II (noninsulin-dependent) diabetes mellitus patients and in 54 controls. P100 wave latency was significantly longer in diabetic patients (P less than .001). Twenty-eight percent of diabetic patients had P100 wave latencies above the normal range. There was no correlation between P100 latency and type or duration of diabetes mellitus, quality of metabolic control, or presence of degenerative complications. The significance of VEP abnormalities in diabetes mellitus remains speculative. PMID- 2702916 TI - Drivers with diabetes. Innocent until proven guilty. PMID- 2702917 TI - Clarification of error-grid analysis. PMID- 2702918 TI - Study of the effect of metformin on platelet aggregation in insulin-dependent diabetics. AB - The role of metformin on platelet aggregation was studied in subjects affected by relatively well controlled type 1 diabetes. 1700 mg of metformin were added to their usual daily treatment; nothing else was changed. Patients were trained to monitor their own glycaemia and presence of degenerative retinopathy was proved. Before the administration of metformin and on day 21, the platelet induced by 1.25, 2.5 and 5 mumol of ADP and by collagen was studied. Fibrinogen, cholesterol, triglycerides, glycosylated haemoglobin and mean blood glucose levels did not show any significant modification after treatment but the maximum aggregation induced by ADP was significantly decreased; the inhibition of aggregation was particularly sensitive for low doses of ADP. No significant correlation was found between the variations in metabolism data and the reduction of the amplitude of platelet aggregation. Metformin, added to the usual treatment undergone by a diabetic treated with insulin, seems to affect platelet aggregation independently of other metabolic factors. PMID- 2702919 TI - Failure to achieve tight control of plasma cholesterol and apolipoprotein B with intraperitoneal insulin infusion in type 1 diabetes. AB - The best route of insulin administration by infusion pumps remains a subject of controversy. For that reason plasma lipids and apolipoproteins were compared in three groups of nine patients who had been treated for several months or years with conventional treatment (group I), continuous subcutaneous insulin infusion (CSII, group II) or continuous intraperitoneal insulin infusion (CPII, group III). Plasma cholesterol and apolipoprotein B remained increased on CPII compared with CSII even when similar satisfactory or even tight diabetic control was achieved with both techniques. This study suggests that cholesterol and perhaps apolipoprotein B biosynthesis by the liver is increased in patients treated with CPII compared to those treated with CSII. PMID- 2702920 TI - The effect of repeated withdrawal episodes on subsequent withdrawal severity in ethanol-treated rats. AB - Male rats were given ethanol via an intragastric catheter (8.0-11.0 g/kg per day) for either 8 weeks daily or for four 2-week periods with a 2-week period of no drug treatment intervening between each period of ethanol administration (binge). Older rats were administered ethanol for 2 weeks, to assess the effects of age on ethanol withdrawal as age can alter an animal's sensitivity to ethanol. The presence of physical dependence during withdrawal was assessed on an open field test. Rats that experienced repeated episodes of withdrawal (binge) showed more severe withdrawal signs in successive withdrawal episodes. Older animals showed more severe signs of withdrawal than younger animals after 2 weeks of ethanol treatment. The results of this study lend support to the hypothesis that the experience of withdrawal from ethanol can alter an animal's subsequent response to the drug. Aging appeared to contribute to this effect, but further work is needed to delineate its role. PMID- 2702921 TI - A multicentre study to introduce naltrexone for opiate dependence in Spain. AB - A multicentre prospective study was performed in eight centres in Spain in order to assess the usefulness of naltrexone in the treatment of opiate dependents and abusers (113 dependents and 37 abusers) non-selected in terms of social class or professional skill. The fundamental criterion for evaluation of clinical outcome was the retention rate. At 6 months this parameter was 40%, i.e. higher than any previously reported for non-selected patients. The adverse effects were mild and did not lead to therapeutic failures. Non-pharmacological factors may have contributed to the good clinical results obtained. PMID- 2702922 TI - Screening for major depression among alcoholics: an application of receiver operating characteristic analysis. AB - When comparing several screening tests designed to detect the same disease, methodological problems arise in determining which is most accurate. We have previously demonstrated that receiver operating characteristic (ROC) methodology can provide a set of statistical procedures which allow for objective comparisons of screening tests. In this report, ROC methodology is brought to a different substantive area: the detection of clinical depression among treated alcoholics. In a sample of hospitalized alcoholics, we compared the accuracies of several commonly used screening tests for depressive disorders, as well as comparing each of these with a screening test for anxiety disorders. No test offered a statistically significant advantage over any other, and all did poorly in detecting clinically diagnosed major depression. The performance of the screening tests was worst when the non-depressed comparison group included subjects with remitted disorder, but was still poor when the comparison group did not include such potentially 'noisy' subjects. Factors contributing to the difficulty of screening for clinical depression are discussed, as well as suggestions for improvements in future screening efforts. PMID- 2702923 TI - Nicotine mydriasis. AB - In mice, nicotine produces dose-dependent mydriasis following interperitoneal or intracerebroventicular administration but not after local application through the conjunctival sac. Since mydriasis is not prevented by cervical sympathectomy, it is likely to be due to central inhibition of the parasympathetic tone. Repeated administration of nicotine over 8 h progressively diminished and finally obliterated the response to a test dose of nicotine. This acute tolerance was maintained for 24 h. Tolerance was also produced by daily administration of nicotine and lasted up to 12 days after withdrawal. The easily measurable examination of the pupillary responses provide a convenient method for the investigation of mechanisms underlying tolerance to nicotine. PMID- 2702924 TI - Assessment of the abuse potential of acetorphan, an enkephalinase inhibitor. AB - The discriminative stimulus properties, reinforcing effects and physical dependence potential of acetorphan, a parenterally-active enkephalinase (E.C. 3.4.21.11) inhibitor, were assessed in the present studies. Rats trained to discriminate 2 mg/kg morphine from saline did not generalize to acetorphan at any dose tested (5-50 mg/kg). Acetorphan also had minimal reinforcing effects in rhesus monkeys. When acetorphan was substituted for cocaine, one dose (300 micrograms/kg per inj.) maintained responding somewhat above the range of vehicle values in only two of the four monkeys tested. In physical dependence studies, acetorphan also failed to produce opioid-like effects. In morphine-dependent monkeys and rats, acetorphan failed to suppress withdrawal. Additionally, there were no overt withdrawal signs observed following the termination of chronic acetorphan infusion in the rat. Together, these results indicate that acetorphan appears to have minimal abuse potential. PMID- 2702925 TI - Drugs of abuse found in fatally injured drivers in Los Angeles County. AB - Blood or urine specimens from nearly 600 fatally injured drivers in two Los Angeles County studies were analyzed for the presence of alcohol and other drugs of abuse, including PCP, cocaine, opiates and marijuana. The results of the preliminary study indicate that 65 out of 102 fatally injured drivers had used alcohol and/or another drug of abuse - 34 had used alcohol only, 12 had used one or more other drug(s) of abuse, and 19 had used alcohol in combination with another drug of abuse. The results of the larger follow-up study, begun a year later, indicate a continued high level of both alcohol use (41.5%) and marijuana use (19%) with moderate cocaine usage (8%) and low levels (less than 2%) of barbiturate and PCP usage. PMID- 2702926 TI - Patterns of marihuana smoking among Brazilian students. AB - Changes in frequency of marihuana smoking over time were investigated by interviewing forty-seven Brazilian students from Sao Paulo between 18 and 24 years old, of both sexes. From their report, it was concluded that the course of smoking frequency follows two predominant patterns. In one of them, the 'Stable Pattern', subjects report increasing consumption up to a peak frequency where they remain for a relatively long and stable period of time. In the other one, the 'Descending Pattern', subjects report a gradual increase up to a peak, followed by a clear decline in rate of use. Two other patterns were also detected in a small number of subjects. The diversity of patterns identified stresses the difficulty in predicting the course of marihuana smoking frequency by young people. The relationship between marihuana smoking and the use of other drugs was also investigated. The only drugs that were reported to be regularly consumed by the majority of subjects were alcohol and tobacco, while 90% of the subjects reported having tried at least one other illegal drug. PMID- 2702927 TI - Chronic ingestion of ethanol increases stimulation-induced voluntary activity in the rat. AB - Acute exposure of an animal to ethanol has a biphasic effect on activity; at low doses incurring stimulation of locomotor activity whilst at higher doses eliciting a depression in activity level. The present study reports the effect of short-term (10 days) exposure to ethanol on running wheel activity in female Wistar rats. Ethanol treatment (3 g/100 ml in drinking water) increased significantly the rate of accumulation of total distance run but not the daily rate of running when compared to control animals. This increase was attributable to an increased rate of running stimulated by daily feeding and handling by the experimenter. PMID- 2702928 TI - A feeding regime for the study of the interaction of ethanol and aging. AB - A suitable model for the study of the interaction of the aging process and prolonged treatment with ethanol is described. Animals were given 15% ethanol in the drinking water for up to 25 months. There was little disruption in the growth of the animals. Ethanol treatment resulted in a number of neurological and morphological changes some of which persisted throughout the treatment period. Both young and old animals displayed metabolic tolerance by the criteria of resistance to ethanol-induced hypothermia and increased metabolism of [14C]ethanol. The regime used has proved useful in the study of the interaction of ethanol and aging in the rat. PMID- 2702929 TI - Antigenical alterations of hepatocyte membrane in rats after long-term administration of ethanol and carbon tetrachloride. AB - The presence of IgG over the hepatocyte's surfaces in ethanol- and/or carbon tetrachloride-pretreated rats was demonstrated as a very thin lineal fluorescent deposition around the membrane. The percentage of parenchymal IgG-positive liver cells ranged between 15 and 100% in all animals of treated groups. This suggests that ethanol may induce hepatic injury mediated by IgG autoantibodies which may be a response to an antigenical determinant present in hepatocytes altered by ethanol and/or carbon tetrachloride treatment. PMID- 2702930 TI - Psychoactive substance use and related behaviours of 135 regular illicit drug users in Scotland. AB - Using a 'snowballing' technique, prospective data have been collected from 135 regular drug using individuals in two Scottish towns, Edinburgh, and Ayr. Data from the first wave would suggest that poly drug use is common, with a major reliance on licit, prescribed substances. Amongst both intravenous and non intravenous drug users, awareness and concern about HIV/AIDS would not appear to have produced significant changes in sexual behaviour. Furthermore, responses from intravenous users indicate that there has been no large scale adoption of safer injection techniques. PMID- 2702932 TI - [Factitious diarrhea in the differential diagnosis of chronic diarrhea. Observations on 7 patients]. AB - Over the last seven years self-inflicted diarrhoea was diagnosed in seven patients with chronic diarrhoea which was deliberately induced by the secret intake of laxatives. Six of the patients were female, four of them in paramedical occupations. All also had loss of weight and hypokalaemia between 2.1 and 2.9 mmol/l. All had accepted extensive and interventional procedures during a mean of five hospital admissions, with minimal pathological findings and no aetiological diagnosis. They had undergone numerous therapeutic measures, in one instance even several operations and parenteral feedings. Making the correct diagnosis was decisively impeded and delayed by the patients' seeming cooperativeness. In four patients the diagnosis was finally made by demonstrating laxatives in the urine, in two others by finding hidden tablets in the room, in one by demonstrating melanosis of the colon. A factitious cause of chronic diarrhoea should be excluded if no other cause can be established. PMID- 2702931 TI - [Hypophosphatemic osteomalacia in adults]. AB - Hypophosphataemic osteomalacia occurred in a 38-year-old woman. The leading clinical symptom was severe bone pain. X-ray studies demonstrated fractures of the iliac crest and pubic and ischiadic bone, as well as Looser's zones and demineralization of the skeleton. Computerized densitometry of the bone revealed a 31% reduction of hydroxyapatite. Histological evaluation showed nearly absence of osteoclasts and extensive demineralisation of the bone. Hypophosphataemia (0.48 mmol/l), increased urinary phosphate clearance (36 ml/min), reduced renal tubular reabsorption for phosphate (73%) and increased alkaline phosphatase (355 U/l) were present. Parathyroid hormone and 1,25-dihydroxyvitamin D were normal. No inborn errors, disturbances of the calcium metabolism or paraneoplastic signs could be detected. Defective renal tubular reabsorption of phosphate is likely to be the underlying cause of the disease. Phosphate supplementation and intermittent vitamin D administration remains the therapy of choice. PMID- 2702933 TI - [Clinical-scientific autopsy in Federal Republic of Germany. Medical, legal, ethical and practical considerations]. PMID- 2702934 TI - [Does selenium reduce the cancer risk in man?]. PMID- 2702935 TI - [Juxtapapillary gangliocytic paraganglioma of the duodenum]. AB - A juxtapapillary duodenal polyp (measuring 1.5 x 1.0 x 1.2 cm) was removed endoscopically in a 57-year-old man who had had recurrent intestinal bleedings. Histological examination revealed a typical duodenal gangliocytic paraganglioma with carcinoid and paraganglioma-like components, as well as neuroid portions with ganglion cells. Various neuroendocrine markers (neuron-specific enolase, chromogranin, protein-gene product 9.5) were demonstrated immunohistochemically. Tests for pancreatic polypeptide, substance P, enkephalin, cholecystokinin, glucagon and S-100 proteins, were all positive. PMID- 2702936 TI - Paediatric drug dosing. Bodyweight versus surface area. PMID- 2702937 TI - [Which antibiotics for pneumonia treatment?]. PMID- 2702938 TI - [Pregnancy screening and premature infants]. PMID- 2702939 TI - [Juvenile neuronal ceroid lipofuscinosis]. PMID- 2702940 TI - [Protective use of seat belts in jejunal injury]. PMID- 2702941 TI - [Plastic bronchitis in a child]. PMID- 2702942 TI - [Multifocal neurological signs and pulmonary sarcoidosis]. PMID- 2702943 TI - [Routine iron supplementation during pregnancy is ill-considered]. PMID- 2702944 TI - [To put it another way]. PMID- 2702945 TI - [What does the P/S ratio mean?]. PMID- 2702946 TI - [Chronic idiopathic intestinal pseudo-obstruction]. PMID- 2702947 TI - [Routine iron supplementation and pregnancy outcome: insufficient reasons for recommendation]. PMID- 2702949 TI - [The autumn conference and its election result]. PMID- 2702948 TI - [Littlepox or smallpox?]. PMID- 2702950 TI - Posture and spontaneous motility in fullterm infants. AB - Posture and spontaneous motor patterns during the first days of life were studied in ten healthy fullterm infants by direct observation and videorecording. The aim of the study was to provide a description of motor and postural characteristics of normal newborns. The infants were recorded for 1 h on their first and fourth day of life, when unstimulated in an incubator. Incidence and duration of the different body postures and motor patterns were scored during the replay of the videorecordings. The preference for the fully flexed posture of arms and legs described in the literature could not be confirmed. There was a large intra- and inter-individual variability in the postural repertoire. No particular posture, characteristic for each behavioural state, existed. Similar postures rarely occurred in the same infant on the first and fourth day. Extended postures more often occurred on the fourth day. Spontaneous motility consisted of several distinct movement patterns, the occurrence of which in states 1 and 2 was computed for day 1 and day 4. Motor patterns were differently related to the states. No differences were noted in the motor activity between the first and fourth days. Large inter-individual differences, but an intra-individual consistency, were found in the rates of specific motor patterns: infants who showed a low or high rate of particular movements on day 1 maintained the same characteristic on day 4. There was no overall low or high motor activity. PMID- 2702951 TI - Reflections on the withdrawal of treatment from newborn infants. AB - The paper reviews the principal arguments that have been used to justify or otherwise the withdrawal of treatment for severely damaged neonates. The present confused legal situation is outlined and also the various considerations that have been put forward as relevant to the process of making decisions. It is argued that these decisions are not technical but are moral and social ones taken in the light of professional and technical expertise. Therefore parents should be involved in them as they have to live with the consequences of what is decided. The legal system does not seem very helpful in resolving present difficulties. At best, it forms a framework within which we can evolve appropriate decision-making procedures. PMID- 2702952 TI - Behavioral characteristics and early temperament of premature infants with intracranial hemorrhage. AB - Behavioral characteristics of 12 full-term and 44 premature infants with and without intracranial hemorrhage (ICH) were studied. Cranial ultrasonography prospectively documented Grade I-II ICH in 14, Grade III-IV in 19 and no ICH in 11 premature infants. Examination at corrected age of 40 +/- 2 weeks using the Neonatal Behavioral Assessment Scale showed that infants in the ICH groups had lower levels of arousal and more abnormal reflexes than full-terms. Infants with ICH III-IV displayed less optimal motor responses than full-term infants and diminished orientation responses, especially to visual stimuli. Thus, lower level of arousal, immature motoric processes, and poor visual orientation differentiated premature with ICH from full-term infants, although premature infants without these sequelae, did not differ significantly from full-term infants. The above may represent early manifestations of visual-perceptual and motor problems noted in the follow-up of ICH infants. Further, neonatal behavior was found to affect parent ratings of infant temperament (via the Bates Infant Characteristics Questionnaire) at 3 months corrected age, and the relationships between neonatal behavior and parental ratings differed depending upon the infant's gestational age and severity of hemorrhage. We conclude that neonatal behaviors are less optimal in premature infants, and least optimal in premature infants with severe intracranial hemorrhage when compared to fullterm infants. PMID- 2702953 TI - Clofazimine in pregnancy. PMID- 2702954 TI - Radial sensory innervation to index and middle fingers: electrophysiologic considerations. AB - Antidromic radial and median compound sensory nerve action potentials (CSNAPs) were recorded from the index and middle fingers in 20 subjects. No appreciable radial sensory response can be seen at the middle finger. Seventy-five percent of subjects had radial CSNAPs at the index finger, seen to a variable extent along the finger, with 40% having a response limited only to the base of the first phalanx. Radial CSNAP amplitude was small compared to median CSNAP (ratio = 0.16). Because of the small size and wide variability among individuals, radial CSNAPs from index and middle fingers seem to have limited direct clinical utility. Contamination of median CSNAPs by radial CSNAPs is negligible or absent (when there is unavoidable spread of the stimulus to the radial nerve), if median sensory responses are recorded from the distal half of the index or middle finger. PMID- 2702955 TI - Automatic recognition of random artifacts in recordings of slow brain potentials: a bias-free method. AB - A method for computerized recognition of random artifacts in recordings of slow brain potentials is presented. It is based on systematic comparison of the shape of single trial EEG segments with all other trials obtained in the same experiment. This is possible because, in contrast to short-latency event related potentials, a plateau of EEG negativity during complex tasks can often be detected in single trails. After linear trend removal and subtraction of EOG artifacts, similarity of pairs of single trials is established by point-to-point linear regression analysis, the total score of a trial being defined as the mean correlation coefficient (R) resulting from comparison to all other trials. Selection is then performed by setting a critical value for R, admitting for averaging only trials with a mean correlation coefficient above the critical value. An example is given in which the method is applied to recordings of slow brain potentials during a manual tracking task. PMID- 2702956 TI - Different changing patterns of soleus potentials due to repetitive stimulation in young and old rats. AB - Time courses of changes in medial gastrocnemius (MG) and soleus (SOL) muscle potentials induced by repetitive stimulation at 5 Hz were studied using Wistar strain rats. Particular interest was focussed on the changing pattern of SOL potentials in old rats as compared with that in young ones. Contrary changing patterns of SOL potentials were found in young and old rats. SOL potentials were rapidly reduced to respective plateau levels in old rats while they were gradually potentiated in young ones when 5 Hz stimulation was given for 10 min. Moreover, the pattern obtained from middle aged rats fell between those of the two age-groups. PMID- 2702957 TI - Neurophysiological evaluation of the muscular hypotrophy after immobilization. AB - Muscular hypotrophy due to arm or leg immobilization (MH) in absence of neuromuscular pathologies was tested by EMG spectral analysis, in order to identify a possible neurophysiological method able to analyze this kind of particular clinical picture. Two different groups of patients were tested. In group 1 the patients were suffering from vastus medialis muscle MH due to meniscus surgery, in group 2 the patients were suffering from biceps brachii muscle MH after humerus fracture. A significant difference between normal and pathological muscles was found and the methods may be useful in the neurophysiological evaluation of MH. PMID- 2702958 TI - Effect of filter setting on the electromyographic parameters of muscles contracting to fatigue. AB - The effects of various filter settings on the electrophysiological behavior of the development of muscular fatigue were studied. Eleven healthy volunteers were examined during isometric contraction of biceps brachii and rectus femoris against a constant load until fatigue occurred. The electrical activity was taped and computer processing was carried out at the basic setting of 15-5000 cycles and at low (15-200 Hz) and high (200-5000 Hz) frequence filter. The results support the hypothesis that in the low range of frequencies there is a high density of large slow motor units, while in the high range of frequencies there are numerous small fast motor units. PMID- 2702959 TI - Effect of anti-epileptic drug monotherapy and polypharmacy on visual and auditory evoked potentials. AB - Previous reports have suggested that some anticonvulsants may prolong somatosensory and auditory evoked potential latencies. We compared pattern reversal visual and brainstem auditory evoked potentials in normal controls, patients on monotherapy, and patients taking polypharmacy. Visual evoked potential amplitudes were less in seizure patients, and P1 latencies were longer in epileptics on polypharmacy than controls. Absolute latencies of brainstem auditory evoked potentials were longer in polypharmacy patients than in controls or monotherapy patients. I-III, III-V, and I-V interpeak latencies were greater in polypharmacy patients than in those on monotherapy or controls. These findings suggest that anticonvulsants may affect conduction along visual and auditory pathways, and that antiepileptic drug polypharmacy and monotherapy may differ in their effects. PMID- 2702960 TI - Comparative study of evoked potentials in multiple sclerosis and neuro-Behcet's syndrome. AB - We studied somatosensory evoked potentials (SEPs) and brainstem auditory evoked potentials (BAEPs) in Japanese patients with multiple sclerosis (MS) and those with neuro-Behcet's disease (NB). Abnormal cortical P37 of posterior tibial nerve SEPs or cervical N13 of median nerve SEPs were more frequently found in the MS patients than in the NB patients. On the other hand, prolongation of the central conduction time of median nerve SEPs or abnormal BAEPs were more common in NB than in MS. The present data showed that lesions were mainly present in the spinal cord in MS and in the brainstem in NB. SEPs and BAEPs were considered of great value for detecting the involvement of the central nervous system in MS and NB and distinguishing between these diseases. PMID- 2702961 TI - Sciatic nerve compression: diagnostic value of electromyography and computerized tomography. AB - A 54 year old man on long term anticoagulation (warfarin) treatment for prosthetic heart valve, developed sciatic nerve compression and femoral nerve dysfunction due to hematoma and edema in the gluteal muscles. Computerized tomography of the pelvis and electrodiagnostic studies helped in localizing and understanding the pathophysiology of the clinical signs and symptoms. PMID- 2702962 TI - Bleeding after thrombolysis in acute myocardial infarction. AB - 232 consecutive patients with acute myocardial infarction were treated either with 2 x 10(6) IU urokinase as an intravenous bolus injection, or 250,000 IU streptokinase intracoronary, or 60 mg recombinant tissue-type plasminogen activator (rt-PA) over 90 min. All patients enrolled had chest pain for more than 30 min and less than 3 h before admission and a typical electrocardiogram. Contra indications to thrombolytic treatment were absent. All bleeding complications occurring within 24 h after admission were assumed to be due to thrombolytic therapy. Bleeding complications occurred in 14 patients (6.5%). Only seven patients received a blood transfusion (3%). No correlation was evident between previous hypertension, diabetes mellitus, smoking, sex, age, fibrinogen level before and 24 h after thrombolytic therapy and bleeding complications. The risk of bleeding was not significantly different between the different thrombolytic regimens despite marked differences in the fall of the fibrinogen level. The decrease of fibrinogen following thrombolytic therapy did not influence the patency rate of the infarct vessel. Thrombolytic therapy in acute myocardial infarction is a safe treatment even among patients advanced in years and with medically controlled hypertension and diabetes mellitus, irrespective of the kind of thrombolytic treatment. PMID- 2702963 TI - Relative prognostic value of clinical, biochemical, echocardiographic and haemodynamic variables in predicting in-hospital and one-year cardiac mortality after acute myocardial infarction. AB - This study examined the relative value of clinical, biochemical, echocardiographic and haemodynamic variables, obtained early after acute myocardial infarction in predicting in-hospital and one-year cardiac mortality in 66 consecutive patients. Clinical examination and cross-section echocardiography were obtained in all 66 patients. An echocardiographic score index was calculated by grading wall motion from 0 to 5 in each of 16 left ventricular segments. Right sided cardiac catheterization was performed soon after admission in 51 patients. Cardiac enzymes were measured every fourth hour in all patients and peak levels were identified in 55. During the follow-up of one year, 14 patients died of cardiac causes, seven of them during hospital stay; three patients died of a non cardiac cause and were excluded from analysis. The echocardiographic score index was the best predictor of cardiac death and survival (chi 2 = 35), followed by Killip class on admission (chi 2 = 22), stroke volume index (chi 2 = 17) and a biochemical risk index (chi 2 = 11). Stepwise logistic discriminant analysis performed in the patients in whom all variables were obtained resulted in three independent prognostic variables: the echocardiographic score index, systemic vascular resistance at the time of catheterization and the development of infarct expansion. High- and low-risk patients are well identified by echocardiography in the acute phase of myocardial infarction. PMID- 2702964 TI - Electrophysiologic and haemodynamic correlates in supraventricular tachycardia. AB - In 16 subjects with paroxysmal supraventricular tachycardia (SVT) we sought a relationship between haemodynamic changes associated with artificially induced arrhythmias and the electrophysiological properties of the related atrioventricular (AV) nodal reentry circuit. In 10 patients (group 1) induced SVT was typical (long AH) and caused a significant fall in cardiac output (-1.720 ml min-1) and arterial systolic pressure (-18 mmHg). In six subjects (group 2), induced SVT was atypical (long HA) and did not significantly alter the output of the heart and systolic pressure, despite the elicitation of similar tachycardia. The opposite AV nodal reciprocation pattern which resulted in a substantial increase in AH/HH in group 1 and in a slight rise of the same variable in group 2, may explain these haemodynamic differences. In fact, atrial and ventricular systoles occurred simultaneously and impeded the ventricular filling in the former group, while a regular subsequence of contraction was maintained in the latter group. In group 2, systolic arterial pressure and cardiac output fell to the same level as in group 1 when right atrial pacing, at a similar rate of SVT, determined an increase of AH/HH similar to that observed during typical tachycardia. Thus, the haemodynamic response to SVT differs significantly between the two types of reciprocating tachycardia, particularly as regards cardiac output and blood pressure, and is mainly influenced by the temporal relationship between atrial and ventricular systole, independent of the rate of contraction. The different conduction velocities of the reciprocating circuit limbs and their interrelation seem to be major determinants of the haemodynamic pattern of SVT. PMID- 2702965 TI - Digitoxin in patients with hepatorenal insufficiency after repeated oral administration. AB - Following chronic oral administration of digitoxin 0.1 mg day-1 the pharmacokinetics of this glycoside were studied in seven patients with hepatorenal insufficiency and were compared with those of seven healthy volunteers. Liver cirrhosis of the patients was confirmed by liver biopsy. Mean creatinine clearance of the healthy subjects was 129.7 +/- 3.3 ml min-1 (mean +/- SEM), that of the patients was 25.6 +/- 20.4 ml min-1. Mean antipyrine clearance (parameter of oxidative liver function) was 49.7 +/- 6.0 ml min-1 in the volunteers and 22.0 +/- 2.9 ml min-1 in the patients. Plasma protein binding of digitoxin (PPB) was 95.0 +/- 1.1% in the patients and 96.7 +/- 0.6% in the healthy subjects (n.s.). Total body clearance of digitoxin (Cltot) was 0.0728 +/- 0.0120 ml min-1 kg-1 in the patients and 0.0615 +/- 0.0027 ml min-1 kg-1 in normals (n.s.]. Mean steady state plasma levels (Css) of the patients were 18.3 +/- 4.7 ng ml-1 and 15.8 +/- 1.3 ng ml-1 in the normals (n.s.). Our data obtained from chronic oral administration do not indicate a reduced total body clearance of digitoxin in patients with hepatorenal insufficiency. PMID- 2702966 TI - Angina pectoris-like pain provoked by i.v. bolus of adenosine: relationship to coronary sinus blood flow, heart rate and blood pressure in healthy volunteers. AB - After finding the maximum tolerated i.v. bolus dose of adenosine, three fractions of this dose were given randomly to five volunteers in a double-blind manner. Pain, estimated by a 10-graded category-ratio scale, ECG and coronary sinus blood flow (CSBF), measured by thermodilution and intra-arterial blood pressure, were continuously recorded. At the highest tolerated dose (10.3 +/- 2.3 mg), the ECG showed short lasting (less than 5 s) AV-block but no ischaemic signs. Following the maximum dose, pain started 15 +/- 2 s after injection, reached a maximum (median 6 of 10 grades) after 25 +/- 4 s and disappeared after 62 +/- 7 s. Basal CSBF was 84 +/- 14 ml/min-1, and increased to 297 +/- 48 ml/min. The rise in CSBF started 2.4 +/- 0.8 s before pain appeared (P less than 0.05), but reached its peak 18 +/- 2 s after maximum pain (P less than 0.005). Although maximum coronary vasodilation was induced at the lowest dose of adenosine given--1/3 of the maximum dose--chest pain increased in a dose-dependent manner. When AV-block did not occur, diastolic pressure did not change from baseline, while systolic blood pressure increased by 5 +/- 2% (ANOVA, P less than 0.0001) and heart rate increased by 40 +/- 7% (ANOVA, P less than 0.0001). Following AV-block, except for a decrease of short duration in heart rate and systolic and diastolic blood pressures, the responses were similar. In conclusion, the vasodilator adenosine given as an i.v. bolus to human volunteers who were awake increased heart rate and systolic blood pressure with unchanged diastolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2702967 TI - The relationship of symptoms to performance in paced patients with breathlessness. AB - Eighteen adult patients presenting with breathlessness associated with bradycardia, and whose breathlessness was diminished or abolished by permanent pacing, were studied at least one month after this procedure in order to examine the relationship between symptoms and exercise performance. All were pacing dependent at rest and were studied over successive two-weekly periods at set rates of 50, 70 and 90 beats min-1 in a double-blind, balanced and randomized trial. The degree of breathlessness was closely related to exercise capacity judged by 6-min walk testing, effort scores and weekly pedometer distance. Overall results were worse at 50 beats min-1 than the two faster rates. For a given individual, changing of ventricular rate caused parallel alterations in symptoms and performance. The 6-min walking test was a useful guide to disability in these patients, tightly linked to the symptoms of effort and breathlessness, and may be of clinical value in assessing mild heart failure. The pedometer readings were influenced more by the patients' walking habits than by fitness. PMID- 2702968 TI - Increased exercise tolerance and reduced electrocardiographic ischaemia 3 and 12 hours after oral felodipine in effort angina. AB - The antianginal properties and the duration of action of two doses of felodipine, a dihydropyridine calcium antagonist with a vascular:myocardial potency ratio approximating 100:1, were investigated in 15 patients suffering from disabling effort angina pectoris with reproducible exercise tolerance. Felodipine (5 mg, 10 mg) and placebo were administered once in the morning on three different days, with a 24 h interval between them, according to a double-blind 3 x 3 latin square design, 5 times replicated. Symptom-limited cycloergometric exercise tests were performed 3 and 12 h after administration. Duration of exercise to ST segment depression of 1 mm and to peak exercise was increased (all P less than 0.01) by both doses of felodipine in comparison with placebo. Twelve hours after administration, the 10-mg dose induced a significant improvement in the exercise time and a smaller ST segment depression (all P less than 0.01) in comparison with the 5-mg dose. The relationship between ST segment depression and the pressure-rate product during exercise was favourably influenced by the 10-mg dose at 3 and 12 h after intake, and by the 5-mg dose only at 3 h after intake. These findings suggest an increase in coronary blood flow induced by felodipine. Apart from mild headache there were no other unwanted effects. In conclusion, felodipine improves exercise tolerance and reduces electrocardiographic ischaemia for up to 12 h after single oral administration in patients with effort angina. Increasing the dose from 5 mg to 10 mg produces a more prolonged effect, with increased exercise tolerance 12 h after intake. PMID- 2702969 TI - Magnetocardiographic studies of ventricular repolarization in old inferior myocardial infarction. AB - Isomagnetic maps of 50 normal subjects (control group) and 23 patients with old inferior myocardial infarction (IMI group) were recorded in order to analyse T wave abnormalities in inferior myocardial infarction. The T wave of the magnetocardiogram (MCG) in the control group showed negative deflections in the left upper portion and positive deflections in the right lower portion, thus resulting in a T vector directed leftward and inferiorly. The T wave of the IMI group was flat or positive in the left upper portion and flat or negative in the right lower portion, suggesting a T vector directed superiorly. In addition, opposing dipoles were observed in 36.4% of the IMI group; i.e. one directed superiorly, presumably due to inferior myocardial ischaemia, and the other directed inferiorly due to normal repolarization. Localized T vector abnormalities could be detected by the MCG in some cases, in which coronary T waves of the standard electrocardiogram had returned to normal. Furthermore, multiple dipoles were more frequently observed in the isomagnetic map than in the isopotential map (5 vs. 15; P less than 0.01). These results suggest that the MCG is helpful in diagnosing myocardial ischaemia when this is not detectable on the electrocardiogram. PMID- 2702970 TI - Improved control of atrial fibrillation with combined pindolol and digoxin therapy. AB - This study has compared the effect on heart rate control of the addition of pindolol 15 mg bd or verapamil 40 mg tds to maintenance digoxin therapy in 12 patients with chronic atrial fibrillation. The study was performed in a randomized cross-over fashion. Treatment effects were assessed by 24-h ambulatory electrocardiography and symptomatic improvement by symptom scores. The results show that the combination of pindolol and digoxin provides better control of atrial fibrillation. With an attenuation of daytime tachycardia, prevention of nocturnal bradycardia and reduction in the length of nocturnal pauses in rhythm. Overall heart rate variability was significantly less with digoxin and pindolol (523 beats min-1 h-1) than with digoxin and verapamil (745 beats min-1 h-1). We conclude that, in the dosages employed, combined digoxin and pindolol therapy is superior to either digoxin and verapamil in combination or digoxin alone for the treatment of atrial fibrillation. PMID- 2702971 TI - Diagnosis of coronary aneurysms in siblings: treatment with a new surgical procedure. AB - We report the cases of two brothers who simultaneously developed myocardial infarction, and in whom we found coronary artery aneurysms at echocardiography. In one case a new surgical procedure was performed. The aneurysm was bypassed by an aorto-coronary vein graft and the coronary ostium of the related coronary artery was closed. Thus, perfusion of the dependent vessels of the aneurysm was maintained, and the risk of distal embolism was prevented. The aetiologies of coronary artery aneurysms are discussed. In our patients the aneurysms were probably congenital, but we cannot exclude the possibility of previously undiagnosed Kawasaki's disease. PMID- 2702972 TI - Identification of Patients at Low Risk of Dying After Acute Myocardial Infarction, By Simple Clinical and Submaximal Exercise Test Criteria. PMID- 2702973 TI - Survival of a Patient With an Infected Right Atrial Myxoma Following Surgery. PMID- 2702974 TI - Long term bone marrow culture in metastatic neuroblastoma. AB - We have developed a long term marrow culture assay for the study of advanced bone marrow metastatic neuroblastoma. In this in vitro system the hemopoietic growth (GM-CFU) is not affected by the presence of tumor cells. The neuroblastoma cells grow and differentiate partially when in contact with the stromal layer, arresting the culture. We present culture and histological data suggesting that the solid tumors interact specifically with the stromal layer of marrow origin. PMID- 2702975 TI - Pharmacokinetics of weekly low dose doxorubicin. AB - Weekly low dose doxorubicin (WLD-dox) is an interesting alternative to the classical 3 week schedule because of its reduced cardiotoxicity, the major dose related side-effect. This study characterized the pharmacokinetic behaviour of WLD-dox with particular attention to the effect of treatment duration on the variability of individual pharmacokinetic parameters. Twenty-eight patients with advanced breast cancer were treated by WLD-dox (12 mg/m2 week). Individual pharmacokinetic analyses were performed at the first injection and every month thereafter; residual drug levels were measured every week before injection. Dox and its main metabolite doxol were measured by HPLC and fluorescence. Pharmacokinetic data were available for 51 cycles. The mean concentration-time profile for 25 patients with normal liver function tests fitted well with a two compartment model: COext (nM) = 2905 +/- 1834; t 1/2 alpha = 0.08 +/- 0.03 h; t 1/2 beta = 10.4 +/- 3.6 h; clearance (1/h) = 55.4 +/- 24.8; Vd (1) = 809 +/- 434. The findings concur with those for classical 3-week dox schedule (45 mg/m2) analysed in six patients as controls. Exceptions were the initial extrapolated concentration and area under curves which were reduced for WLD-dox according to the dose. Dox and/or doxol overexposure was patent in all three patients with elevated pre-treatment serum bilirubin. During treatment, up to 48 WLD-dox administrations, no significant trends were noted for 10 patients in the evolution of initial extrapolated concentration, terminal half-life, total body clearance or the proportion of doxol formed. Residual drug levels were controlled up to 40 WLD-dox administrations (135 samples); in half the cases they comprised between 1 and 20 nM without particular sign of increasing along the treatment course. In this case WLD-dox can be assimilated to a continuous exposure to low drug levels with intermittent pulses thus representing an original pharmacological profile for dox. PMID- 2702976 TI - Spinal cord compression in myelomatosis: response to chemotherapy alone. AB - Current management of spinal cord compression due to multiple myeloma usually involves irradiation with or without decompressive surgery. We report five patients (three of whom were severely affected) with a neurological deficit due to spinal cord compression by multiple myeloma, who regained ambulation and sphincter control with melphalan and prednisone alone. The dramatic response in these cases, as well as other evidence presented, suggests that systemic treatment may have a major role in the management of spinal cord compression by sensitive malignant tumours. PMID- 2702977 TI - Bone marrow infiltration in hairy cell leukemia after interferon therapy detected by magnetic resonance imaging. AB - Magnetic resonance imaging (MRI) can detect bone marrow infiltration by neoplastic cells in many hematological malignancies. We studied 10 patients affected by hairy cell leukemia (HCL) and treated with interferon (IFN) with both MRI and bone marrow biopsy. T1-weighted MR scans of femurs and pelvis proved to be effective to score hairy cell infiltration, while less information was obtained from the study of the lumbar vertebral column. A good correlation (less than 10% difference) was noted between biopsy and MRI in over 90% of cases. MR scans showed, in general, a higher grade of infiltration. MR scan, however, can be useful for monitoring the course of HCL and the response to the treatment. Moreover, MRI evaluating a large amount of tissue, can detect a nodular type of infiltration which can be missed in biopsy specimens. PMID- 2702978 TI - Preparation of low density lipoprotein-9-methoxy-ellipticin complex and its cytotoxic effect against L1210 and P 388 leukemic cells in vitro. AB - Previous studies have suggested that low density lipoprotein (LDL) may be used as a drug targeting carrier for chemotherapeutic agents to neoplastic cells. In this study the cytotoxic agent 9-methoxy-ellipticin (MeOE) was incorporated into dimirystoyl phosphatidylcholine, cholesteryl oleate stabilized microemulsion and the latter fused with human LDL. Both agarose electrophoresis migration and the electron microscopic shape of the drug-LDL complexes were similar to those of native LDL. The in vitro cytotoxic tests on L1210 and P388 leukemic cells demonstrated that the complex was able to kill cells and was more effective than the free drug. This cytotoxic activity of the drug-LDL complex depends on the LDL high affinity receptor: the native LDL reduces the killing power. In contrast, methylated LDL, which does not bind to the LDL receptor, has no effect on it. On the other hand, heparin, which prevents binding on the cell surface receptors, partially reduced the cytotoxic activity of the drug-lipoprotein complex. These results suggest that it is possible to incorporate lipophilic cytotoxic drugs into LDL, using a technique of fusion with the microemulsion which contains the drug. This technique allows us to obtain a drug-LDL complex which is able to kill cells via the LDL receptor pathway. PMID- 2702980 TI - Effectiveness of routine and spontaneous follow-up visits for breast cancer. AB - The effectiveness of routine (initiated by the health services) and spontaneous (initiated by the patient) follow-up visits were compared based on a 5 year follow-up of all (551) breast cancer patients residing in one of the Finnish central hospital districts and diagnosed in 1977-1980. There were altogether 8248 visits, i.e. 4.6 per follow-up woman year, of which 2.7 visits were based on the recommended follow-up schedule. Recurrence (252) was detected in 14.7% of spontaneous visits which was five times more often than at the regular visit. False positive clinical diagnosis (63) was three times more frequent for spontaneous than for regular visits. The follow-up system should probably not be based solely on detecting of recurrences of the disease only but aspects related to the patient's quality of life may be decisive. PMID- 2702979 TI - Survival with breast cancer: the importance of estrogen receptor quantity. AB - The survival of 1184 British Columbian women whose primary breast cancers were diagnosed and assayed for estrogen receptor (ER) between 1975 and 1981 was studied. Median follow-up was 60 months. ER concentrations yielded greater prognostic information than simple positive and negative categories. When ER data were divided into four strata: less than or equal to 1, 2-9, 10-159 and greater than or equal to 160 fmol/mg cytosol protein, the association of higher ER with prolonged survival was highly significant (P less than 0.0001) and independent of TNM stage, nodal status and menopausal status. ER less than or equal to 1 and ER = 2-9 groups were distinct with respect to overall disease-specific survival. Patient age did not predict survival when controlled for ER. Prolonged recurrence free survival was associated with higher ER (P = 0.0001) for at least 5 years after diagnosis. This significant trend persisted after adjustments for nodal status, TNM stage, menopausal status and the type of systemic adjuvant therapy. PMID- 2702981 TI - Comparison of the effects of flavone acetic acid, fostriecin, homoharringtonine and tumour necrosis factor alpha on colon 38 tumours in mice. AB - Advanced subcutaneous Colon 38 tumours in mice were used for the assessment of activity of a number of anticancer drugs. Activity was measured by histological examination of tumours 24 h after a single dose of the drug and in some cases by tumour growth delay. Agents thought to exert their cytotoxic effect by damaging DNA, including Adriamycin, amsacrine and its analogue CI-921, cyclophosphamide, 5 fluorouracil and methotrexate produced no gross histological changes after 24 h, even though some delayed the growth of subcutaneous tumours. In contrast, flavone acetic acid, fostriecin and homoharringtonine caused extensive necrosis of tumours after 24 h, and each delayed the growth of advanced subcutaneous tumours by at least 10 days when administered as a single dose. The histological effects of flavone acetic acid and fostriecin were indistinguishable from those of recombinant human tumour necrosis factor alpha. It is proposed that histological assay of advanced tumours may provide a useful adjunct to existing methods in screening for antitumour agents with novel mechanisms of action. PMID- 2702982 TI - Selectivity of N-[2-(dimethylamino)ethyl]acridine-4-carboxamide towards Lewis lung carcinoma and human tumour cell lines in vitro. AB - N-[2-(Dimethylamino)ethyl]acridine-4-carboxamide (AC; NSC 601316) is a chemically novel antitumour agent which is thought to interact with DNA topoisomerase II and which has DNA binding properties which are distinct from other acridine derivatives such as amsacrine and its disubstituted analogue CI-921. AC is one of the most active agents, experimental or clinical, against the Lewis lung carcinoma in mice. AC is the first acridine derivative in our hands to show higher activity against cultured Lewis lung cells than against leukaemia lines. AC is more active against two human leukaemia cell lines (U-937 and Jurkat) than against a melanoma line (MM-96) and is inactive against the HT-29 human colon line. With all cell lines tested, cytotoxicity was higher at AC concentrations of 3-6 microM than at 15-20 microM. AC at a concentration of 20 microM inhibited the cytotoxicity of amsacrine and CI-921, but not that of another topoisomerase directed drug doxorubicin. A Lewis lung line which had been cultured for a long period was less sensitive than a line freshly isolated from mice, but sensitivity of the cultured line recovered after it was multiply passaged in vivo. Long-term cultures may therefore be less appropriate than short-term cultures for predicting effectiveness of AC in vivo. PMID- 2702983 TI - Carrier mediated action of platinum complexes on estrogen receptor positive tumors. AB - Three 1,2-diaminoethane-dichloro-platinum(II) complexes linked to 5-hydroxy-2-(4 hydroxyphenyl)-3-methylindole by spacer groups of varying length were evaluated for cytostatic activity in estrogen receptor (ER) positive and negative tumor cells. In vitro, only the growth of ER positive MCF-7 mammary tumor cells was inhibited whereas hormone independent MDA-MB 231 cells did not respond. In vivo, a strong inhibitory effect was only observed in ER positive MXT mammary tumors of the mouse. The complex with a hexyl group as spacer reduced the tumor weight by 89% after 6 weeks of treatment. The R 3327 Dunning prostatic tumor of the rat, which also contains ER was inhibited, too. Generally, the effect in ER negative tumors was weak. These findings can be rationalized by the high binding affinities of the complexes for ER. By the mouse uterine weight test it was shown that the endocrine activity of the complexes is very low. Therefore, a mode of action different from that exerted by estrogens or antiestrogens has to be assumed. PMID- 2702984 TI - Prognostic value of DNA ploidy and S-phase fraction in relation to estrogen receptor content and clinicopathological variables in primary breast cancer. AB - Tumors from 472 women with primary breast cancer were analyzed by flow cytometry. Divided into four categories, DNA ploidy showed significant association with disease recurrence and mortality. When allowance was made for its correlation with nodal status and estrogen receptor (ER) content, DNA ploidy did not add prognostic information. S-phase fraction was estimated in 290 DNA histograms. In contrast, it was significantly related to recurrence and mortality when controlling for nodal status, tumor size and ER content. When the follow-up was divided into two periods DNA ploidy and S-phase fraction showed association with disease recurrence in the first period only (less than 2.5 years), while the association with mortality was valid for both periods. Light scatter was measured in 234 samples. A low light scatter variability for the stemline nuclei was related to a high recurrence rate during the early follow-up period. In conclusion, DNA flow cytometry adds prognostic information concerning breast cancer patients. PMID- 2702985 TI - Etoposide (VP-16) uptake by tumour spheroids and activity in the presence of Brij 30, formulation additives and sodium salicylate. AB - A number of additives typically used in the formulation of poorly soluble drugs can be shown to influence drug transport across various physiological barriers. Multicellular spheroids from a human neuroblastoma cell line (NB1-G) were used to investigate the effect of etoposide in solution, as its commercial formulation, Vepesid, in the presence of a nonionic surfactant, Brij 30, and a hydrotropic agent, sodium salicylate. Enhanced growth delay, apparently related to increased drug uptake, was observed both with the Vepesid and the sodium salicylate formulations. Brij 30, however, showed no enhancement of growth delay or drug uptake at a concentration at which it was not in itself cytotoxic. Significant morphological changes in the spheroid were observed at higher concentrations of additives, particularly with Brij 30, emphasizing the fact that many formulation additives cannot be used with impunity in tissue culture systems. The enhanced uptake of drug into tumour cells and potential synergy between additive and drug is worthy of further investigation. PMID- 2702986 TI - Relation between estrogen receptor concentration and clinical and histological factors: their relative prognostic importance after radical mastectomy for primary breast cancer. AB - After modified radical mastectomy, 490 primary breast cancer patients were followed for a median of 75 months. Bloom grade was measured in 340 patients and ER status in 341. Follow-up of these patients has yielded the following results: (a) The value of traditional indices has been reaffirmed. (Cox's multivariate analysis identified, in order of decreasing importance, the number of invaded lymph nodes, the initial tumor size and the histological grade. Other variables were found to be of lesser importance and were correlated with the three main indices.) (b) The value of ER status disappeared after more than 3 years of follow-up. (c) ER positive patients fared better after recurrence. This was interpreted as being a consequence of their responsiveness to hormonal treatment. PMID- 2702987 TI - The familial dysplastic nevus syndrome. Natural history and the impact of screening on prognosis. A study of nine families in the Netherlands. AB - Since 1982, nine families with the dysplastic nevus syndrome have been identified in the Leiden area (The Netherlands). A total of 50 primary melanomas were diagnosed in 38 persons. Nineteen of these melanomas had been diagnosed before the start of the screening programme (category I), 11 were detected at the initial examination of the families (category II), and 20 were found during the course of follow-up (category III). To assess the effect of screening, we compared these categories with respect to the developmental stage of the melanomas. One of the 19 melanomas in category I, two of the 11 in category II and seven of the 20 in category III were melanoma in situ. The average thickness of the invasive melanomas in categories I, II and III was 1.75, 0.80 and 0.54 mm respectively. Sixteen of the 19 melanomas in category I (84%) were Clark III or IV, whereas 15 of the 20 melanomas in category III (75%) were Clark I or II. From these findings it may be concluded that screening can lead to the detection of melanomas at an earlier stage, which in turn can permit curative treatment and improvement of both prognosis and life expectancy. The need for supervision based on central registration of affected families to guarantee the continuity of screening is discussed. PMID- 2702988 TI - Factors affecting relapse in node-negative breast cancer. A multivariate analysis including the labeling index. AB - Between 1975 and 1982, 167 patients with carcinoma of the breast without axillary lymph node metastases were studied. The thymidine labeling index (LI), representing the percentage of cells in the DNA synthesis phase, was measured in all these patients. High LI values were more frequently encountered in young patients (P = 0.05), in low estrogen receptor (ER) tumor content (P = 0.007) and in high grade tumors (P = 0.0002). The overall 8-year relapse-free survival (RFS) was 68%. Univariate analysis demonstrated that RFS was influenced by histological grading (P = 0.03), ER (P = 0.03), PR (P = 0.02) and LI (P = 0.01). Multivariate analysis using the Cox regression model selected the LI as the single significant prognostic factor with regard to RFS (P = 0.037). These results emphasize the important role of cell proliferation kinetics in defining node-negative breast cancer patients with a high risk of relapse. PMID- 2702989 TI - Low dose aminoglutethimide without hydrocortisone for the treatment of advanced postmenopausal breast cancer. AB - One hundred and one postmenopausal patients with advanced breast cancer were enrolled in a randomized phase II clinical trial to investigate the clinical and hormonal response to aminoglutethimide administered at daily doses of 2 x 125 mg, 3 x 125 mg or 2 x 250 mg, with no addition of hydrocortisone. Among 71 evaluable patients 25% showed objective tumor response (three complete, 15 partial), at all three dose levels and irrespective of the major tumor site. Previous treatment with Tamoxifen had been successful in 75%. Out of the 18 responding patients 10 had estrogen receptor positive, four had estrogen receptor negative tumors; the receptor status was unknown in four other patients. Progression-free interval was more than 700 days in 50% of the responders. Drowsiness caused early drug withdrawal in one patient. Side-effects were very mild, comparing favorably with standard therapy of 250 mg aminoglutethimide q.i.d. plus hydrocortisone. Plasma estrogen levels were reduced by all doses to the same 50% or less as in patients on standard treatment. In nine out of 27 patients a further decrease of estrone levels could be monitored with clinically improved results in five. Plasma cortisol and mineralocorticoids remained normal throughout more than 6 months. The original role of hydrocortisone administration to suppress a reflex rise of ATH in 'medical adrenalectomy' with standard dose aminoglutethimide is no longer tenable. Further phase III comparative clinical results pending, low dose aminoglutethimide as an aromatase inhibitor may at present be considered as an appropriate second-line endocrine treatment with low toxicity and expense. PMID- 2702990 TI - Phase I study of intratumoral application of recombinant human tumor necrosis factor. PMID- 2702991 TI - A phase II study of 4-epi-adriamycin in advanced urothelial transitional cell cancer. EORTC-GU Group protocol 30867. PMID- 2702992 TI - A phase II study of mitozolomide in metastatic transitional cell carcinoma of the bladder. PMID- 2702993 TI - Sympathetic nervous system derived trophic factor augments growth of human neuroblastoma in vitro. PMID- 2702994 TI - Does screening for cervical cancer affect incidence and mortality trends? The Belgian experience. AB - Age-specific mortality and morbidity for cervical cancer from 1956 to 1985 in Belgium show a slight decline for women aged 35-54, and a constant rate for other age groups. Population screening as done in Belgium between 1965 and 1980 failed to have any impact on these trends, which could be due to poor organization of screening or changing risk factors for cervical cancer in the population. PMID- 2702995 TI - Alterations in serum levels, anti-tumor activity and toxicity of methotrexate in rats after a short period of nutritional depletion. AB - The alterations in serum levels, anti-tumor activity and host toxicity of methotrexate (MTX) were tested in tumor bearing rats following a period of dietary manipulation. A protein deprived (PD) diet or a diet containing a normal protein content (NP) was administered for 5 days and MTX injected intra peritoneally (i.p.) at the end of the 5 day period. The MTX serum levels were significantly elevated in rats which received the PD diet, as compared to NP dietary rats. This elevation correlated with an enhanced tumor response to MTX administration. In addition, bone marrow toxicity and intestinal tract toxicity, measured with flow cytometry (FCM) of the bone marrow and morphometry of the jejunal mucosa respectively was increased in rats receiving the PD diet. These results indicate that the serum clearance of MTX is delayed in animals suffering from malnutrition, leading to both enhanced tumor response and increased host toxicity. PMID- 2702996 TI - Phase II trial of idarubicin (4-demethoxydaunorubicin) in advanced breast cancer. The Clinical Screening Group of the European Organization for Research and Treatment of Cancer. AB - A phase II trial of idarubicin (IDR-4 demethoxydaunorubicin) was carried out in patients with advanced breast cancer. A dose of 45 mg/m2 was given orally once every 3 weeks. A total of 66 eligible patients were entered into the trial, 56 of whom were evaluable for response (65 were evaluable for toxicity at least). Therapeutic activity was demonstrated with an overall objective response rate of 21% (95% CI: 11-32%). When used as a first-line treatment, the response rate was 33% (95% CI: 9-57%) but this dropped to 17% when the treatment was administered after chemotherapy. Nausea-vomiting was the most frequent and severe non hematological toxicity observed (WHO grade 3-4: 29%). Loss of hair was noticed in 48% of the patients but only 4% suffered from complete alopecia. Moderate myelotoxicity was reported but no cardiac dysfunction was noticed. IDR could be very advantageous as compared to other anthracyclines, due to its simplicity of administration associated with the lack of risk of extravasation or chemical phlebitis and also the possibility of it being able to reduce cardiotoxicity. Even if the equiefficacy of IDR and DXR has not, as yet, been clearly demonstrated, IDR should be chosen with preference to DXR when administration is not suitable. PMID- 2702997 TI - Mechanisms of resistance to cis-diamminedichloroplatinum (II) in a rat ovarian carcinoma cell line. AB - A cis-diamminedichloroplatinum (II) (cisplatin)-resistant subline (Cis-Ptr) demonstrated 20-fold greater resistance to the cytotoxic effects of cisplatin, compared with the parental cloned rat ovarian carcinoma cell line (ROT 68/C1). The uptake of cisplatin into the Cis-Ptr cells was identical to that into the ROT68/C1 cells in vitro and in vivo. Glutathione activity in a cytoplasmic extract was 1.4-fold and 1.8-fold greater in the Cis-Ptr cells than in the ROT68/C1 cells in vitro and in vivo, respectively. There was no difference between the ROT68/C1 and Cis-PTr cells in 195m cisplatin binding per micrograms DNA. DNA repair of cisplatin DNA damage was increased in the Cis-PTr cells but not in the ROT68/C1 cells. These results suggest that the mechanisms of resistance to cisplatin in rat ovarian carcinoma cells involve increased activity of the DNA repair system and increased cytosolic binding to thiols may also be involved. PMID- 2702998 TI - Primary non-Hodgkin's lymphoma of the stomach: changing aspects and therapeutic choices. AB - Eighty-five consecutive patients, seen between 1970 and 1987, with primary gastric non-Hodgkin's lymphoma were studied to evaluate diagnostic findings and treatment results. At endoscopy three main patterns were recognized: ulceration (n = 21), diffuse infiltration (n = 16) and a polypoid mass (n = 26). Recently, the new technique of endoscopic ultrasonography was used to measure depth of infiltration and regional lymph nodes. Preoperative diagnosis altered the indication of surgery. Since 1978 surgical staging was performed in only 29% of the patients compared to 90% in the earlier period. In the later period stage II was more systematically treated with a combination of chemotherapy and radiotherapy. Over the whole period patients in stage I (n = 52) had a 5 year disease-free survival of 63%. In stage II 38% had a 5 year disease-free survival. Complications were one perforation and one haemorrhage after radiotherapy and two cases of haemorrhage after radiotherapy combined with chemotherapy. Intraabdominal recurrences were found in two cases. Recognition of endoscopic features may lead to early detection and ultimately improved survival. PMID- 2702999 TI - Survival after second-look laparotomy in advanced ovarian epithelial cancer. Study of 86 patients. AB - Second-look laparotomy (SLL) was performed after chemotherapy in 86 patients with advanced epithelial ovarian cancer. Seventy-one patients received cisplatin-based regimens. Median follow-up was 66 months. Negative SLL was found in 32 patients who had a 5-year survival rate of 48.3% after SLO. Microscopic residual disease was present in seven patients whose 5-year survival rate was 35.7%. Maximum residual tumor of 2 cm or less was found in 13 patients with a 5-year survival rate of 30%. Residual tumor larger than 2 cm after secondary cytoreduction was present in 20 patients; their 3-year survival rate was 19.7%. Fourteen patients with bulky residual disease who did not have cytoreduction were all dead within 17 months. Patients with initial residual tumor at first laparotomy less than 2 cm had a nearly significant advantage in survival rate over patients with residual disease greater than 2 cm and stage IV (P = 0.07). Non-responders to initial chemotherapy had a survival rate similar to that of partial responders. These findings justify discontinuation of conventional systemic chemotherapy for patients showing residual disease after SLL and secondary tumor removal in case of residual tumor at SLL. Therapeutic trials are needed in advanced ovarian cancer testing initial aggressive surgery or early debulking to avoid bulky residual disease, and consolidation therapy in patients who achieved complete pathological response or minimal residual disease. PMID- 2703000 TI - The expression of milk fat globule antigens within human mammary tumours: relationship to steroid hormone receptors and response to endocrine treatment. AB - The value of steroid hormone receptors for the management of advanced carcinoma of the breast is often limited by the lack of availability of fresh tissue. Differentiation antigens may be estimated on paraffin-embedded fixed material by immunostaining, and the aim of this study was to determine whether staining with the monoclonal antibody raised to human milk fat globule (HMFG-1) could replace receptor measurements. The indirect immunoperoxidase technique was used to stain formalin-fixed paraffin-embedded tumour samples from 168 patients. All received tamoxifen or ovarian ablation as first-line systemic therapy, and all were evaluable for response (UICC criteria). One hundred and sixty-seven had oestrogen (ER) and progesterone receptors (PR) estimated. HMFG-1 staining was assessed as the percentage of tumour cells stained, and by the site of stain. The proportion of cells stained was highly correlated with both ER (P less than 0.0001) and PR (P less than 0.0001) and with response. When greater than or equal to 30% cells stained, 53 of 69 (77%) responded; when 20-29% stained 10 of 19 (53%) responded, when 10-19% stained seven of 19 (37%) responded, and when less than or equal to 9% cells stained 16 of 61 (26%) responded (P less than 0.0001). The median survival of patients with tumours that stained greater than or equal to 30% cells was 36 months, and with no cells stained, 11 months (P less than 0.0001). ROC (receiver operator characteristic) curves found that the optimum threshold for sensitivity and specificity of response prediction was greater than or equal to 20% cells stained. Cox's multiple regression analysis of 42 variables indicated that PR was the most important predictor of survival (P less than 0.000001), but that after PR the percentage of cells stained with HMFG-1 was the most important (P less than 0.0001). We conclude that immunostaining for HMFG-1 gives similar information to receptor status, and has the advantage that fixed archival tissue may be used. PMID- 2703001 TI - Factors predicting the response of patients with advanced breast cancer to endocrine (Megace) therapy. AB - We have treated 238 patients with advanced breast cancer with megestrol acetate (Megace, Bristol-Myers): 221 were assessable for response at 6 months by UICC criteria. Thirty-six (16%) patients responded, 54 (25%) were static and 131 (59%) progressed. Survival from the time of starting Megace calculated by log-rank analysis showed no significant difference in survival between patients showing response and static disease at 6 months. Patients with progression of disease within 6 months survived significantly shorter than patients who showed response or static disease at 6 months. Categorizing response at 6 months appeared to identify patients who had static disease of worthwhile duration. ER status of the primary tumour correlated significantly with survival from the time of commencing Megace. However, when Megace was used as a second-line hormone therapy the assessment of response or static disease on prior hormone therapy was a better predictor of the effect of Megace than ER status of the primary tumour. PMID- 2703002 TI - Hyperthermia enhances the in vitro activity of 1-hexylcarbamoyl-5-fluorouracil compared to that of 5-fluorouracil. AB - The synergic effects on HeLa cells between 1-hexylcarbamoyl-5-fluorouracil (HCFU), a lipophilic masked compound of 5-fluorouracil (5-FU), and hyperthermia were investigated, with the following results: (1) After the cells had been exposed to the drug at 77 microM for 1, 2 or 3 days, with or without heat (43 degrees C) for 2 h, treatment with HCFU and heat inhibited cell growth by 9.2% on day 3, compared to control cells, HCFU alone, heat alone or the combined treatment with 5-FU plus heat. (2) The cells were exposed to the drugs at 77 microM or heat (43 degrees C) for 15-45 min and the colonies counted on day 14. Combined treatment with HCFU plus heat inhibited the clonogenicity of HeLa cells to 22.4% of findings in the control cells and as compared to findings with other treatments. The combination of 5-FU, n-hexylamine and heat had much the same effect as the combined effect of the treatment of HCFU plus heat. (3) Intracellular levels of the drugs did not increase with hyperthermic treatment. Our findings suggest that it is the hexylcarbamoyl structure of HCFU that relates to the synergic effect between HCFU and hyperthermia. This combination is expected to have positive effects for treating patients with malignancy. PMID- 2703003 TI - The association between anatomic site and survival in malignant melanoma. An analysis of 12,353 cases from the Swedish Cancer Registry. AB - The relationship between site and survival in cutaneous malignant melanoma was investigated by a follow-up of 12,353 Swedish patients diagnosed in 1960-1982. In males, the poorest prognosis was found for tumors located on the scalp-neck region (5-year relative survival rate, RS51%), followed by the lower extremity (RS66%) and trunk (RS68%). Among females, the poorest prognosis was noted for tumors located on the external ear (5-year RS 71%), trunk (RS 78%) and scalp-neck (RS 78%). The prognosis varied considerably between the sites of the head-neck region--for eyelid and facial lesions the prognosis was good, but for external ear and scalp-neck tumors it was poor. Multivariate analysis taking into account age and year of diagnosis showed the highest relative hazards (RH) for female lesions of the trunk (1.40) and male scalp-neck tumors (1.65), with the upper extremity used as reference (RH = 1.00). Except for lesions of the trunk, no significant differences in RH were found between the various sites after 4 years of observation. PMID- 2703004 TI - The paracrine stimulation of MCF-7 cells by MDA-MB-231 cells: possible role in antiestrogen failure. AB - The influence of paracrine factors secreted by the hormone independent breast cancer cell line MDA-MB-231 on the growth of the hormone dependent breast cancer cell line MCF-7 was examined in the absence of estradiol and in the presence of inhibitory concentrations of antiestrogens. MDA-MB-231 cells were grown on transwell membranes and co-cultured with MCF-7 cells (50,000) plated in 6-well tissue culture dishes. Growth was maximally increased (80%) when MCF-7 cells were grown in the presence of 150,000 or more MDA-MB-231 cells for 4 days. The non steroidal antiestrogens tamoxifen (10(-10) to 10(-6) M) and 4-hydroxytamoxifen (10(-11) to 10(-7) M), the steroidal antiestrogens ICI 164384 (10(-10) to 10(-6) M) and Ru39411 (10(-11) to 10(-7) M) all inhibited estradiol (10(-11) M) stimulated MCF-7 cell growth in a dose related manner when cultured for 4 days. However, the paracrine stimulation of MCF-7 cells produced by co-culture with 250,000 MDA-MB-231 cells was not inhibited by any of these antiestrogens. These data suggest that in heterogeneous tumors, paracrine factors from hormone independent cells may reverse the growth inhibitory action that antiestrogens have on estrogen-dependent breast cancer cell growth. PMID- 2703005 TI - Clinical and pharmacokinetic study of 96-h infusions of doxorubicin in advanced cancer patients. AB - A phase I and a pharmacokinetic study of 96-h infusions of doxorubicin were performed in order to evaluate the maximum tolerated dose with this schedule of administration. Seventeen patients suffering from a digestive carcinoma were included in the study and a total of 71 courses of treatment were performed. The starting dose was 15 mg/m2/day and was increased in 2.5 mg/m2/day increments. The main toxicities observed were neutropenia and mucositis, which became limiting from 22.5 mg/m2/day (90 mg/m2 over a 96-h period); this dose was therefore defined as the maximal tolerated dose. No objective response to treatment was observed. For further studies, the recommended dose should not exceed 20 mg/m2/day. A plasma plateau concentration of doxorubicin was reached within 24 h. Despite a constant infusion rate, the plasma concentration of doxorubicin showed transient variations in several patients. However, an average plasma concentration could be evaluated for 33 courses of treatment, and this was linearly related to the dose. Doxorubicinol was the only detected metabolite of doxorubicin and its plasma concentration progressively increased throughout infusion. A detailed pharmacokinetic study was performed in 13 courses of treatment. The mean plasma clearance of doxorubicin was 25.2 l/h/m2 and the mean terminal half-lives of doxorubicin and doxorubicinol were respectively 43.6 and 66.2 h. Urinary excretion of doxorubicin plus metabolite was regular from the 24th to the 96th hour of infusion; however, the proportion of doxorubicinol progressively increased in urine. The protracted half-life of this metabolite probably explains its accumulation during infusion. PMID- 2703006 TI - Adjuvant chemoimmunotherapy with LMF + BCG in node-negative and node-positive breast cancer patients: 10 year results. AB - A total of 254 patients with stages T1-3a/N0-1/M0 operable breast cancer were randomized to either surgery alone or surgery plus adjuvant chemoimmunotherapy (LMF + BCG). Ten-year results are presented for RFS (relapse-free survival) and OAS (overall survival) in the whole patient population as well as in the most important menopausal and nodal subgroups. LMF + BCG significantly increased RFS in the whole patient population as well as in node-positive women. The earlier impressive RFS and OAS gains for node-negative patients were fading after 5 and 8 years respectively, leaving marginal trends in favour of the LMF + BCG treated women. Node-positive patients treated with LMF + BCG continue to demonstrate a marginal gain in RFS up to 10 years. This gain is nearly exclusively expressed in postmenopausal node-positive women, an observation which can be made in the node negative patient group as well. Despite the still continuing increase in RFS,' no OAS benefit was observed for node-positive women with LMF + BCG at any time of the study. Dose still remains a critical factor in cancer therapy. However, at 10 years of follow-up, a full dose of LMF (greater than or equal to 90%) during the six cycles no longer affects OAS favourably. There was no indication of any adverse long-term toxicity of LMF + BCG in our study after a median follow-up of 10 years, especially no increase of second tumours. In the node-negative patient population, the presence or absence of intramammary lymphatic infiltration seems to be a significant prognostic factor within this nodal subgroup. PMID- 2703007 TI - Detection of tumours with nuclear magnetic resonance spectroscopy of plasma. AB - A systematic investigation of cancer detection by water-suppressed nuclear magnetic resonance (NMR) of plasma is reported. With additional suppression of lactate, a statistically significant difference between the linewidths of the methylene group signal of patients with untreated cancer (average linewidth 26.9 +/- 3.9 Hz) and normal controls (average linewidth 31.1 +/- 4.9 Hz) has been found. However, overlap was found between these two groups. It is shown that recognition of malignancy could be improved by consideration of the different relations of the linewidths on the content of serum triglycerides and the observation of a shoulder at the high field side of the methylene signal. Preliminary investigations on lipid fractions separated by ultracentrifugation (UC) indicate a connection of the appearance of the high field shoulder and the HDL lipoprotein. PMID- 2703009 TI - Phase II study of high-dose 4'-epidoxorubicin in the treatment of advanced gastrointestinal cancer. PMID- 2703008 TI - ChlVPP chemotherapy in advanced Hodgkin's disease. AB - Between March 1978 and January 1987 54 patients with advanced Hodgkin's disease (HD) or relapse following radiotherapy (RT) for Hodgkin's disease have been treated with combination chemotherapy consisting of chlorambucil, vinblastine, procarbazine and prednisolone (ChlVPP). A subgroup of five patients with bulky mediastinal disease received mantle RT in addition to ChlVPP chemotherapy. Forty two patients (77.8%) entered complete remission with 33 (61.0%) remaining in unmaintained remission and 44 (81.5%) alive at a median follow up of 51 months (range: 22-103). The treatment was generally well tolerated with minimal toxicity. ChlVPP is effective first-line treatment for Hodgkin's disease with results which may be comparable to those achieved for MOPP but with significantly less toxicity. PMID- 2703010 TI - Autonomic neuropathy following treatment with flavone acetic acid. PMID- 2703011 TI - Postsecondary transition needs and employment patterns of individuals with mild disabilities. AB - Descriptive data on the initial employment patterns of mildly disabled individuals who participated in a postsecondary, time-limited transition program are presented. Results were interpreted to indicate that the participants (a) obtained entry-level positions with varying employee benefits; (b) benefited from periodic yet ongoing support to maintain employment; and (c) requested continued but minimal support to negotiate job changes in the work world. Further research is indicated concerning longitudinal employment needs of individuals with disabilities. PMID- 2703012 TI - Career education needs of students with exceptionalities: one state's case. AB - A survey of 1,826 special education teachers and administrators from North Carolina was conducted to determine (a) the extent to which career education skills are actually being taught to children and youth with handicaps, and (b) the extent to which they need to be taught. Findings include: (a) teachers tended to perceive their schools' programs in career education at a higher level than did the administrators, yet teachers felt a greater need for additional instructional emphasis than did the administrators; (b) females' perceptions of their personal impact on students remain far behind those of males; and (c) neither inservice workshops nor college courses were the predominant way in which teachers acquired knowledge about career education. PMID- 2703013 TI - Students' time on learning tasks in special education. AB - The purpose of this study was to measure, through naturalistic observation procedures, the use of time among handicapped students in four special education alternatives--regular class, resource room, special class, and special school. The sample included 230 elementary age students enrolled in 58 classes in 16 schools. ANOVA comparisons revealed that the least restrictive alternatives, particularly the resource room, made more in-class learning time available. Discussion includes recommendations for increasing learning time. PMID- 2703014 TI - Students' preferences for service delivery: pull-out, in-class, or integrated models. AB - This study assessed students' preferences about where and by whom they receive instruction for learning difficulties. Subjects were 686 special, remedial, and regular education students in grades 2, 4, and 5, from classrooms that used a pull-out, in-class, or integrated model for specialized instruction. Results of student interviews indicated that children's preferences for in-class and pull out services were affected by the service delivery model used in their classroom and their grade level. The majority of children preferred to receive additional help from their classroom teacher rather than from a specialist. PMID- 2703015 TI - Collaborative skill instruction for promoting positive interactions between mentally handicapped and nonhandicapped children. AB - Structuring cooperative learning activities has been shown to be an effective technique for integrating handicapped and nonhandicapped students. Previous research in this area has focused on the relative effects of cooperative versus competitive and individualistic learning situations upon peer relations and academic achievement. Few investigations have examined the various elements within the cooperative learning model that appear to promote positive peer interactions among handicapped and nonhandicapped students. The present study evaluated the influence of collaborative skill instruction versus no collaborative skill instruction on the social interaction behaviors of moderately/severely handicapped and nonhandicapped students participating in group science activities. These data reveal that students receiving collaborative skill instruction interacted more positively with one another than those who did not receive the instruction. PMID- 2703016 TI - Teachers' perceptions of problem behavior in general and special education. AB - The study investigated the behavioral ratings of regular classroom and special education teachers and sought to examine the degree to which these educators agreed or disagreed in their perceptions of the problem behavior and adaptive functioning of a group of 31 adolescents who had recently been identified as seriously emotionally disturbed. Results are discussed in relation to the literature on teacher tolerance of problem behavior and the effects of classroom setting upon teacher judgments. PMID- 2703017 TI - Mitogenic lectins bind to the antigen receptor on human lymphocytes. AB - The specificity of interactions between mitogenic and non-mitogenic lectins and disulfide-linked cell surface receptors on human lymphocytes was explored. Lysates (Nonidet-P40) of surface-radioiodinated tonsil lymphocytes and T lymphoblastoid cells (HPB-ALL) were absorbed with lectin-agarose derivatives (or bovine serum albumin, BSA-agarose) or immunoprecipitated with appropriate monoclonal antibodies (mAb). Lectin eluates and solubilized immunoprecipitates were analyzed by two-dimensional (nonreduced/reduced) sodium dodecyl sulfate polyacrylamide gel electrophoresis. Radiolabeled polypeptides were visualized by autoradiography. Among the various lectin-binding polypeptides, two disulfide linked heterodimers (II and III) and two apparent homodimers (I and IV) are bound by pea lectin, concanavalin A and lentil lectin on tonsil lymphocytes; II, III and IV are bound both leukoagglutinating (L)- and erythroagglutinating (E) phytohemagglutinins from Phaseolus vulgaris (PHA). Pokeweed mitogen recognizes only II and III. These molecules are weakly bound by peanut agglutinin, soybean agglutinin, Ulex europaeus agglutinin-I, Dolichos biflorus agglutinin, Vicia villosa agglutinin and Sophora japonica agglutinin, but are not bound by Helix pomatia agglutinin or BSA-agarose. Heterodimer II (82-88 kDa), comprised of 50-55 kDa and 40-43-kDa subunits, probably represents the alpha/beta T cell antigen receptor (TcR alpha/beta). Heterodimer III (64-72 kDa), comprised of 41-kDa and 37-kDa subunits, may represent TcR gamma. The homodimers, I (120-130 kDa) and IV (55-61 kDa), comprised of 55-60-kDa and 30-kDa polypeptides, respectively, have apparently not been previously described. Evidence that H1-2D4, a mAb directed against the antigen receptor on HPB-ALL cells, and E-PHA interact with a common molecule includes: (a) immunoprecipitation of TcR with H1-2D4 from the glycopeptide fraction specifically eluted from insolubilized lectin with N acetylgalactosamine; and (b) adsorption of TcR from a solubilized H1-2D4 immunoprecipitate by E-PHA-agarose. Recognition of CD3 by E-PHA is indicated by immunoprecipitation of CD3 protein by UCHT1 from the glycopeptide fraction specifically eluted from E-PHA. The results are consistent with the view that mitogenic lectins interact with certain disulfide-linked molecules on human lymphocytes, including the TcR alpha/beta and perhaps TcR gamma; while some nonmitogenic lectins also recognize these receptors, the interaction is of low affinity. PMID- 2703018 TI - Serotyping studies of Campylobacter from naturally colonized chickens. AB - Campylobacter jejuni/coli strains from 164 chickens were serotyped by the methods previously described by Penner et al. and Lior et al. The chickens were sampled during breeding from hatching to the age of 42 weeks. The birds were housed, in two separate groups, under different environmental conditions, (for comparison of the effect of hygienic precautions on the transmission of the bacteria during breeding). In the group where the hygienic conditions could be controlled to a greater extent, the chickens became colonized later in the breeding chain and with only one single campylobacter strain. Once campylobacter appeared in the group housed at the breeding farm, the birds were colonized with heterogenous antigenic strains. All birds in this group were colonized with more than one strain. By identifying campylobacter strains from chickens during breeding, it was shown that the hygienic conditions are very important for the production of chickens free from campylobacter, or for minimizing the number of colonizing strains. PMID- 2703019 TI - Sink flora in a long-stay hospital is determined by the patients' oral and rectal flora. AB - Sinks in a new long-stay hospital (LSH) were cultured weekly during 4 consecutive months to evaluate the microbial profile before and after occupancy of the hospital. From the elderly patients admitted to the patient care rooms oral and rectal specimens were collected to examine the contribution of the patients' flora to the sink contamination. Isolates were typed biochemically, serologically and by susceptibility pattern. Before occupancy Gram-negative bacilli were not isolated. Once the elderly patients, who were highly colonized on admission, occupied their rooms identical strains gradually contaminated the sinks. Escherichia coli, Klebsiella, Pseudomonas and Acinetobacter species were the major correlating strains. The mean concentration of the correlating isolates was higher in throat and intestines compared to the mean concentration of the non correlating strains. These strains seem to have a greater chance to be shed and then transferred via the hands of personnel to sinks. This report shows that the major route of environmental contamination is from patient carriers to sinks, and not the reverse way. PMID- 2703020 TI - Comparison of different vaccines and induced immune response against Campylobacter jejuni colonization in the infant mouse. AB - The degree of protection conferred by vaccinated dams on infant mice against colonization by Campylobacter jejuni depended on the bacterial strain, preparation, and route of administration of the vaccine. In some instances of homologous protection, serum bactericidal titres correlated well with protection. However, boiled C. jejuni vaccine, which was non-protective, also elicited a strong bactericidal antibody response. Conversely, bactericidal activity could not be demonstrated against strains capable of cross-protection. There was a good correlation between high campylobacter-specific IgG response and bactericidal activity. PMID- 2703021 TI - Recovery of Campylobacter from human faeces stored at 4 degrees C. AB - Six hundred and thirteen fresh diarrhoeal faeces were inoculated on Skirrow blood agar (SK), on Preston blood free agar (PBF), and in Campy-thioglycolate broth (CT). After 24 h of storage at 4 degrees C, specimens were again inoculated on SK and PBF, and in Campylobacter enrichment broth (CEB). CT tubes were placed overnight at 4 degrees C. Plates and CEB tubes were incubated at 43 degrees C in microaerophilic conditions. A total of 68 specimens was positive for campylobacter on direct plating. Sixty-four of them were also recovered after subculturing from CT, and only 51 from CEB. Delayed inoculation of plates after storage of samples at 4 degrees C yielded 57 isolates. The storage of faeces at 4 degrees C for 24 h significantly reduces the number of campylobacter isolates. When samples are not plated immediately we recommend inoculating a CT tube maintained at 4 degrees C overnight as a holding medium. PMID- 2703022 TI - The seroepidemiology of Chlamydiae in Finland over the period 1971 to 1987. AB - The seroepidemiology of chlamydial infections in the Finnish population was studied by analysing the prevalence of chlamydial complement fixing (CF) antibodies in patients sera sent for virus serological screening tests over 17 years from 1971 to 1987. The total number of sera studied was over 160,000. In the early 1970s, the prevalence of chlamydial CF antibodies (CF titres greater than or equal to 8) was low (less than 2%), but later the proportion of seropositive cases rose, and in 1976, 18% of sera contained antibodies. In 1984, the seropositivity rate was over 31%. The prevalence of high chlamydial CF titres (titres greater than or equal to 64) also showed annual variation. In general, under 1% of sera contained chlamydial CF antibodies in high titre, but in 1979 and 1984, distinct peaks occurred when 1.3% and 1.4% of sera, respectively, had titres greater than or equal to 64. The age-related antibody positivity rate showed a decline during early infancy, an increase in childhood and adolescence, and a stable level in adulthood when approximately 20% of the sera contained antibodies. The chlamydial antigen used in this survey was genus-specific, i.e. it detects antibodies against all chlamydial species. Epidemiological data support the hypothesis that infections due to a novel chlamydial species, TWAR chlamydia, are the most likely explanation for the relatively frequent occurrence of chlamydial CF antibodies and for the variation in CF antibody prevalence. PMID- 2703023 TI - Evaluation of enzyme immunoassays in the diagnosis of camel (Camelus dromedarius) trypanosomiasis: a preliminary investigation. AB - Three enzyme immunoassays were used for the serodiagnosis of Trypanosoma evansi in camels in the Sudan in order to evaluate their ability to discriminate between infected and non-infected animals. Two assays were used for the detection of trypanosomal antibodies, one using specific anti-camel IgG conjugate and another using a non-specific Protein A conjugate. The third assay detected the presence of trypanosomal antigens using anti-T. evansi antibodies in a double antibody sandwich assay. Inspection of the frequency distribution of assay results suggested that the ELISA for circulating trypanosomal antibodies using specific antisera and the ELISA for circulating antigens can distinguish between non infected camels and infected camels exhibiting patent infections or not. The ELISA using Protein A conjugate to bind non-specifically to camel immunoglobulin did not appear to discriminate between infected and non-infected animals. PMID- 2703024 TI - Bacterial contamination of stored water and stored food: a potential source of diarrhoeal disease in West Africa. AB - The food and water hygiene in two Liberian communities was studied in a house-to house diarrhoea survey. The level of contamination with enterobacteria of drinking water stored in the households was significantly higher than at the water sources. Food hygiene standards were low, particularly in the urban slum where storage of cooked food for long periods led to bacterial multiplication at high levels. Infant foods were particularly heavily contaminated. It is concluded that when water supply programmes are planned, the presence of other risk factors for water-related diseases should be investigated. To ensure maximum health benefits, water projects should as a rule be accompanied by other interventions. PMID- 2703025 TI - Characterization of Palyam serogroup orbiviruses isolated in South Africa and serologic evidence for their widespread distribution in the country. AB - The finding that there had been multiple isolations of Palyam serogroup orbiviruses from aborted cattle fetuses in neighbouring Zimbabwe, suggested that there was a need to investigate the possible occurrence of the viruses in South Africa. Unidentified viruses isolated in South Africa, which had been in storage, were examined. Four viruses which had been isolated from Culicoides midges collected at various sites in the years from 1969 to 1977, were identified as three strains of Gweru virus and one of the Nyabira virus (Palyam group serotypes originally described from Zimbabwe). A fifth virus, isolated in 1967 from the blood of a cow with mild fever, was found to be a distinct new member of the Vellore antigenic complex of the Palyam serogroup and was named Apies River virus. Sera from 476 cattle, 150 sheep, 24 goats and 78 humans from 10 farms were tested for neutralizing antibodies to the above three serotypes of virus plus Abadina and Marondera serotypes. Only 1 of 100 cattle sera from two farms in the southern coastal area had antibody, but elsewhere there was a high prevalence of antibody with 254 (53%) of all cattle exhibiting activity for one or more of the five serotypes of virus tested. Only 6 (4%) sheep, 3 (12.5%) goats and 11 (14%) humans had antibody. PMID- 2703026 TI - Natural or vaccine-induced antibody as a predictor of immunity in the face of natural challenge with influenza viruses. AB - A study of influenza in residential schools provided the opportunity to assess the significance of antibody as a predictor of immunity. Five hundred and fifty six pupils from 8 schools were included in the investigations, and the outcome for these children in 27 naturally occurring outbreaks of influenza was analysed. The outbreaks comprised 5 caused by strains of influenza A H3N2, 10 caused by strains of influenza A H1N1, and 12 caused by strains of influenza B. On 8 occasions a second outbreak of the same serotype occurred in a school. There was a general correlation between the presence of antibody to the outbreak strain and protection from infection. For each of the three influenza virus serotypes the infection rate in those with no detectable antibody was approximately 80%. Those with past experience of the virus but no antibody to the outbreak strain experienced lower infection rates (62% overall) but the infection rates were lowest in those with intermediate and high level antibody to the challenge strain (18% overall). Vaccine was used by three of the schools. The effect of antibody derived from recent experience, either natural or vaccine-induced, on subsequent challenge with a drifted strain i.e. one showing antigenic drift away from the previous strain, was compared. Intermediate or high level antibody to the challenge strain in those who had experienced a recent natural infection was associated with a low infection rate (9%). A similar level of antibody produced in response to vaccination was associated with a significantly higher infection rate (23%: P less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703027 TI - HIV infection in England and Wales: a changing pattern. AB - Of 32,983 specimens from 307 sources in England and Wales tested in the Virus Reference Laboratory for anti-HIV between 1984 and 1987, 6491 (20%) were positive. Ninety-five per cent of the positive subjects were male and 44% of them were from three London genito-urinary medicine clinics. In 1987 the numbers of newly diagnosed HIV infections decreased in homosexual men and haemophiliacs and increased in injecting drug abusers; 148/1199 (12%) of all the positive findings in 1987 were in females. Between 1984 and 1987 the proportion of anti-HIV positive individuals who were asymptomatic fell by nearly 10% and the proportion with AIDS/ARC rose by nearly 10%. Of the requests leading to positive results 1280 (20%) were recognized as duplicates of previous positive results, while for 34% of the requests no clinical information was provided. These deficiencies in the data compromise HIV surveillance based on diagnostic testing, and supplementary bias-free data are needed. PMID- 2703028 TI - Eimeria vermiformis and E. mitis: inhibition of development in vivo by cyclosporin A. AB - Treatment of the host (Mus musculus, Gallus domesticus) with cyclosporin A during infection with Eimeria vermiformis or E. mitis resulted in a reduction in the numbers of oocysts passed in the feces and/or a delay in patency. The general immunosuppressive effects of the treatment were confirmed in chickens by monitoring their antibody responses to human erythrocytes and lymphoproliferative responses to phytohemagglutinin. Nevertheless, mice and chickens treated with cyclosporin A during a primary infection with E. vermiformis or E. mitis, respectively, were immune to subsequent challenge with these organisms. Thus, cyclosporin A did not interfere with priming. The antiparasite effect of the drug did not allow an evaluation of its effect on established immunity to the coccidia when it was administered at the time of challenge. In an exceptional treated chicken, however, delayed patency of the challenge infection was followed by the production of a number of oocysts similar to that found in unprimed animals. This suggests that the mechanisms of immunity to challenge may be susceptible to disruption by cyclosporin A. PMID- 2703029 TI - Schistosoma mansoni: effect of infection on reproduction and gonadal growth in Biomphalaria glabrata. AB - Sexually mature Biomphalaria glabrata were exposed to 12 miracidia of Schistosoma mansoni, and egg production of snails was monitored over a period of 5 weeks. During the study period, exposed snails grew at approximately the same rate as unexposed controls. Castration, as measured by a reduction in the mean number of eggs laid per snail occurred between 14 and 21 days postexposure (PE). The reduction in fecundity in infected snails coincided with the migration and establishment of daughter sporocysts in the digestive gland and gonad. Enumeration of individual oocytes in longitudinal sections of the ovotestis revealed that uninfected snails contained significantly more oocytes per section than infected snails at 27, 31, and 40 days PE. In addition, the mean area of gonadal sections of control snails increased over the 40-day experimental period, whereas there was no such increase in gonadal area of infected snails. These data suggest that there is an inhibition in gonadal growth in infected snails. When oocyte data were expressed in terms of mean gonadal area, the mean number of oocytes per mm2 of gonad of uninfected and infected snails did not differ significantly over the study period, except at Day 14 PE, when infected snails contained a significantly greater number of oocytes per mm2 of gonad than did uninfected controls. It is hypothesized that daughter sporocysts of S. mansoni are primarily responsible for the inhibition of host reproductive activity, and may be mediating their effects through mechanisms involved in the regulation of gonadal growth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703030 TI - Trichostrongylus colubriformis: epithelial cell migration in the proximal and distal small intestine of infected rabbits. AB - In Trichostrongylus colubriformis-infected rabbits, epithelial cell migration rates and cell transit times along the villi were compared by radioautography on histological slides to normal values from noninfected small intestine. Regions of gut with high (upper jejunum) and low (ileum) burdens of worms were both examined. In the control rabbits, the estimated values for the cell migration rates in the proximal and distal parts of gut were respectively 5.8 and 2.8 microns/hr. Seventy-two hours after the thymidine injection, the labeled epithelial cells were near the tip of the villi in the jejunum whereas only 60% of the villous length was labeled in the ileum. In the infected rabbits, the presence of T. colubriformis was associated with a two-fold increase of the cell velocity, in the main site of infection. Although less prominent than in the proximal region, a significant acceleration in the cell migration was also noticed in the ileum. The cell transit time was markedly reduced in the parasitized jejunum, but no variation of this parameter was found in the distal part of gut. These changes in the dynamics of epithelial cells in both regions of the gut appeared to underlie the morphological and enzymological changes of the parasitized mucosa. They particularly contribute to create an adaptive region in the small intestine beyond the main site of infection. PMID- 2703031 TI - A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior. AB - In August 1987, a letter, informational pamphlet and order coupon for free mail order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention. PMID- 2703032 TI - Strategies for evaluating adolescent pregnancy programs. PMID- 2703033 TI - A measured response: Koop on abortion. PMID- 2703035 TI - Cornucopia of AIDS products. PMID- 2703034 TI - Many teens misinformed on AIDS. PMID- 2703036 TI - Importance of being anonymous. PMID- 2703037 TI - Fetal research under fire: the influence of abortion politics. AB - Since 1973, fetal research has repeatedly been used as a weapon in the war against abortion, miring important research in seemingly endless controversy. Government funding of fetal research has been suspended several times: A 1974 moratorium was lifted in 1975 after regulations concerning such research were promulgated; in 1985, a moratorium was placed on some federally funded fetal research; and in 1988, the assistant secretary for health halted all federally funded research on fetal tissue transplantation while an outside advisory panel examined related ethical, legal and scientific issues. The panel deemed such research acceptable, while also recommending that safeguards be established to separate abortion from transplantation research and to prevent profiteering from or encouragement of abortion. Although the report was forwarded to the assistant secretary in January, the moratorium has not yet been lifted by the new administration. PMID- 2703038 TI - Pathogenesis of secondary hypertrophic osteoarthropathy: a hypothesis. AB - Wide ranges both in the location and the pathological state of the primary disease associated with hypertrophic osteoarthropathy (HO) have been noted. The combined distribution of the glossopharyngeal and vagus nerves appears to coincide with the range of locations of the primary disease associated with HO. These two nerves are believed to contribute to the innervation of the blood vessels in this same area. This hypothesis states that: i) some of this innervation is part of a blood volume control system; and ii) by an inappropriate stimulation of this system, as a result of blood-flow in an anomalous vascular rearrangement lying close to the primary disease associated with HO, a cerebral salt centre is stimulated to retain extra-cellular sodium. A secondary atrial natriuretic peptide over-secretion ensues and a "near steady-state" is established, with the presence of excess fluid and dilated vessels in all four limbs. Thus, the pathogenesis of HO and the distribution of an extra-renal volume control system are reciprocal facets of the same question. PMID- 2703039 TI - Airway mucus. AB - Airway surface liquid (ASL), a mixture of periciliary fluid and submucosal gland secretions, was collected from the ferret isolated trachea in vitro. The trachea was closed, without possibility of evaporation. The collected ASL was hyperosmolar (310-350 mosmol.kg-1) compared with Krebs-Henseleit solution (280 mosmol.kg-1). Compared with surrounding Krebs-Henseleit solution, the ASL had higher sodium and chloride contents, and considerably higher potassium and calcium contents. The ASL was acid (pH about 7.00) compared with Krebs-Henseleit solution (pH 7.40). Applying methacholine and salbutamol to the preparation significantly changed most of the electrolyte concentrations, and reduced pH. The pH was not significantly changed by bubbling the surrounding buffer with 0-20% CO2, with corresponding buffer changes in pH of 6.95-8.05. Adding labelled albumin to the external buffer resulted in lumenal concentrations that, in the presence of salbutamol, were higher than outside. This and other evidence suggested that albumin could be actively secreted into the lumen, a process enhanced by salbutamol. Thus ASL is hyperosmolar, of different electrolyte composition from interstitial fluid, and of low pH which is homeostatically regulated. The epithelium can actively secrete albumin into the lumen. PMID- 2703040 TI - Protection against pulmonary O2 toxicity by N-acetylcysteine. AB - N-acetylcysteine (NAC) is a known antioxidant. We therefore investigated NAC as an agent protective against O2 toxicity in the lung. Twelve dogs were anaesthetized with sodium pentobarbital and ventilated with 100% O2 for 54 h. Five were given diluent and 7 intravenous NAC (loading dose prior to 100% O2 ventilation of 150 mg.kg-1 and maintenance dose of 20 mg.kg-1.h-1). Every 6 h, physiological evaluation of the pulmonary circulation, mechanical properties, and gas exchange was performed. Post-mortem evaluation consisted of gross examination and weighing followed by light and electron microscopy. By both functional and structural criteria, NAC protected against the effects of 100% O2. The NAC group developed significantly less increase in pulmonary vascular resistance, arterial carbon dioxide tension (PaCO2) and lung wet weight, while dynamic compliance was greater. NAC also delayed the development of abnormal ventilation-perfusion relationships and was associated with reduced pulmonary white cell accumulation, with less evidence of alveolar and interstitial oedema. NAC may well be worthy of evaluation as a therapeutic agent in human diseases characterized by oxidant damage. PMID- 2703041 TI - Aspirin-intolerance as a precipitating factor of life-threatening attacks of asthma requiring mechanical ventilation. AB - The records of 92 asthmatics who underwent mechanical ventilation were reviewed. In seven patients (8%) the severe attack was precipitated by a non-steroidal anti inflammatory drug (NSAID); one of these patients died. Five of the cases had a history of asthmatic attacks provoked by NSAIDs; whilst in two the severe attack requiring mechanical ventilation was the first manifestation of NSAID intolerance. In two patients the NSAID had been prescribed by their physicians. Another aspirin-intolerant patient, a general practitioner, self-administered a NSAID. The sudden attack in another patient was precipitated by a preparation which contains aspirin and is usually recommended for indigestion. In the fatal case the attack was provoked by a capsule containing aspirin, which had been given by a herbalist. Unlike other reports, we found that NSAID-intolerance is a frequent provoking factor in severe acute asthma requiring mechanical ventilation. Inadequate investigation of precipitating factors in asthmatics with severe sudden attacks is a possible reason why this phenomenon is underreported. PMID- 2703042 TI - Pneumonia due to Legionella pneumophila and pneumococcal pneumonia: similarities and differences on presentation. AB - We compared clinical, radiological and laboratory data from 32 cases of community acquired pneumonia due to Legionella pneumophila, with 37 cases of pneumococcal pneumonia (PP). This study revealed few clinical differences between the two types of pneumonia: in our experience Legionnaire's disease presents like a "typical" bacterial pneumonia. Given the difficulty of making a diagnosis on clinical data alone, we propose early aetiological diagnostic measures and recommend that the choice of initial treatment be based not only on the features at the time of presentation, but also on a consideration of the epidemiology of different types of pneumonia in a given area. PMID- 2703043 TI - V/Q and alveolar gas exchange in pulmonary sarcoidosis. AB - Eleven patients with pulmonary sarcoidosis of type II or III were investigated with regard to regional distribution of ventilation and perfusion (V/Q), alveolar gas exchange and diffusion limit at rest and during exercise. Lung volumes were 50-65% of normal values. Flow-volume curves indicated obstructive changes. The transfer factor was 75% (range 16-120%) of predicted. Perfusion scintigraphy showed marked defects in 7 out of 11 patients. Radiospirometry showed matching ventilation and perfusion defects and washout of xenon was prolonged. There was a venous admixture at rest of 9%. Arterial oxygen tension (Pao2) averaged 9.7 kPa. V/Q analyses indicated the presence of a small shunt (1%), regions with low V/Q in 4 out of 11 patients, regions with high V/Q in 5 out of 11 patients and increased wasted ventilation. At rest measured Pao2 was lower (0.6 kPa) than predicted from the V/Q distribution. During mild supine exercise causing significant dyspnoea, pulmonary vascular resistance rose to abnormal values, 5.2 mmHg.l.-1 min-1.m2 BSA. The venous admixture decreased to 5.4%. The shunt was unchanged, as was the perfusion of regions with low V/Q. The regions with abnormally high V/Q disappeared. Measured Pao2 decreased to 9.1 kPa, while calculated Pao2 remained unchanged. Thus the P(A-a)o2 at rest (4.2 kPa) was 70% caused by shunt and V/Q mismatch. During exercise alveolar-arterial pressure difference for oxygen measured P(A-a)o2 rose further to 5.1 kPa, while calculated P(A-a)o2 remained unchanged and was only 50% caused by shunt and V/Q disturbances. The difference between calculated and measured Pao2 indicated significant diffusion limitation both at rest and during mild exercise. PMID- 2703044 TI - Questionnaire of the European Community for Coal and Steel (ECSC) on respiratory symptoms. 1987--updating of the 1962 and 1967 questionnaires for studying chronic bronchitis and emphysema. PMID- 2703045 TI - Pulmonary fat embolism presenting as chronic respiratory failure. AB - A patient is presented with progressive respiratory failure, caused by pulmonary fat embolism as proved by an open lung biopsy. Four and a half yrs earlier, she underwent a right hip operation. We surmise that a loosening hip prosthesis caused the marrow embolisation. PMID- 2703046 TI - Continuous intravenous therapy with theophylline in patients with brittle bronchial asthma. PMID- 2703047 TI - Violence and the systemic view: the problem of power. AB - Violence is a strikingly lineal concept that is difficult to address from a systemic perspective. Bateson's epistemological disqualification of the concept of power is often understood to imply a corresponding systemic disqualification of the concept of violence. This position is examined in light of recent feminist criticism. It is argued that (a) violence and power belong essentially to the domain of human experience and (b) human experience cannot be invalidated by theory. Accordingly, it is suggested that the (appropriate) invalidation of power and violence in the domain of systemic explanation should probably be understood both as a deliberate choice that necessarily follows from adopting a systemic perspective, and as a fundamental limitation of that perspective. In neither case, however, should the systemic view be considered to be a valid disqualification of the human experience of violence and power. PMID- 2703048 TI - The Barrett-Lennard Relationship Inventory (BLRI): current and potential uses with family systems. AB - The search for and measurement of important relationship qualities have always been of interest to family therapists. Within a Rogerian perspective, empathy, regard, and congruence are believed to be among the most important indicators of the quality of human relationships. These variables, or conceptually similar ones, are also important in several current models of family functioning. Barrett Lennard (1,2) developed an instrument, the Barrett-Lennard Relationship Inventory (BLRI), to measure empathy, regard, and congruence. Although the major use of the BLRI has been in psychotherapy outcome research (13), several studies have shown that it is a sensitive indicator of marital satisfaction and of changes occurring in marital-improvement programs. The present study is a factor analysis of the BLRI based on data from 345 women who rated levels of empathy, regard, and congruence in their relationship with their husbands. The results robustly confirm the three-factor structure of the BLRI in what is believed to be the first factor analysis in the context of a family member rating a relationship within the family. The replication of the BLRI's structure in a new relationship context suggests that the dimensions tapped by the BLRI may have some generality and warrant further exploration in a family-systems context. Several advantages of the BLRI over other currently available instruments are discussed, as are potential uses of the BLRI in systems research beyond the marital unit. PMID- 2703049 TI - Reflections on the circulation of concepts between a biology of cognition and systemic family therapy. AB - This article is a critical examination of the possible relevance of a specific approach to cognitive science for systemic family therapy. I provide a way of comparing the conceptual backgrounds for both these fields and, on that basis, propose some conclusions that underline the difficulty of the task. PMID- 2703050 TI - Some aspects of loneliness in families. AB - Although awareness of the harmful effects of loneliness has increased in recent years, lonely persons continue to be viewed as family outsiders or nonfamily. Beginning with the general-systems concept of loneliness as having a healthy, adaptive function in families, this article explores the family context of different degrees of loneliness. It assumes that prolonged loneliness (in addition to its meaning for the individual system) is a manifestation of certain kinds of family processes. Five such processes involved in the prolonging of loneliness are suggested: unresolved grief, pathological certainty, synchronicity, family expansion, and parental abdication. PMID- 2703051 TI - Outcomes of systemic/strategic team consultation: I. Overview and one-month results. AB - This is the first in a series of reports on an experimental, small-sample study of systemic/strategic team consultations. This report describes a "Milan informed" method of team consultation for resolving therapy impasses. It then focuses on the initial one-month outcomes from the larger 3-year project. Eleven therapists were asked to select two ongoing cases matched for difficulty. While all cases continued in regular therapy, one of each therapist's cases was also selected at random to participate in a systemic/strategic, five-part team consultation. Analyses of one-month follow-up data showed that clients who participated in the team consultation were more likely to achieve their main and overall treatment goals than clients who received only regular therapy (p's less than .05, eta2 as a measure of effect size ranging from 32% to 41%). The strong findings of this initial study encourage more widespread use of team consultations as a context for treatment, training, and research. PMID- 2703052 TI - Putting the illness in its place: discussion groups for families with chronic medical illnesses. AB - A new psychosocial intervention for families and patients experiencing the chronic phase of a disabling medical illness is described. The intervention, a short-term, highly structured, psychoeducationally oriented, multiple-family discussion group (MFDG), was developed within the context of a clinical research program and has been successfully applied to a heterogeneous range of disabling medical illnesses. This report includes a detailed description of the treatment model, the format and content of group meetings, and initial clinical impressions regarding MFDG efficacy. PMID- 2703053 TI - Gender differences in marital communication patterns. AB - This study examined conflict-resolution interactions of couples, and related marital satisfaction to sequential and nonsequential communication patterns. Couples' satisfaction with marriage has been differentiated on the basis of the degree of coercive versus affiliative communication between partners. Results of this study indicate that this pattern differs, however, for individuals within couples on the basis of gender. Females and males were found to demonstrate different styles of response to dissatisfaction in marriage; men assume a coercive stance toward their partners while women take an affiliative position. Drawing on systemic and gender-difference theoretical perspectives, these patterns are interpreted as attempts by individuals with different world views to resolve conflict. A view is discussed whereby systems and gender differences can be integrated into a unified conceptual formulation upon which to base future development in research and therapeutic interventions. PMID- 2703054 TI - The incidence and significance of serum hCG and CEA in patients with gastrointestinal malignant tumors. AB - Beta-human chorionic gonadotropin (hCG) is normally produced and secreted by trophoblastic cells in pregnancy, by tumors arising from those cells and by a wide variety of tumors of nonendocrine origin. Gonadotropin is produced and secreted by various tissues (stomach, pancreas, ovary, etc.) and the incidence of ectopic secretion varies between 0 and 43%. Our report is an attempt to evaluate the incidence of high plasma beta hCG levels in 101 patients with gastrointestinal malignant tumors. The results revealed negative beta hCG in the control samples, while in the studied patients 41 were positive for beta hCG (44.4%). Three samples from oesophagus squamous cell carcinoma were positive. Twenty-five out of 69 with colorectal carcinoma had raised serum beta hCG (36.8%). Gastric carcinoma showed positive beta hCG in 52% of the patients. Among all the patients high beta hCG levels were far more common in those with positive lymphnodes (P less than 0.05). The beta hCG levels decreased with colorectal carcinoma tumor size and with smaller tumors there was the probability of increasing positive serum measurements (P less than 0.05). The patients with adenocarcinoma of the stomach showed good statistical correlation between stages of the disease at the operation time to beta hCG levels. In our opinion this serological assay will become one of the markers to be added to our armamentarium in the evaluation of patients with gastrointestinal malignant tumors. PMID- 2703055 TI - Familial breast cancer and the association with colonic carcinoma. AB - A relationship between breast and colonic cancer has been suggested so we looked at the incidence of colonic carcinoma in the relatives of familial and sporadic breast cancer patients. We found that there is an increased incidence of colonic cancer in the relatives of familial breast cancer patients as compared with the relatives of sporadic breast cancer patients. This risk was higher in men than women (P less than or equal to 0.05). The relatives of familial breast cancer patients are a high risk group for developing colonic carcinoma, and would benefit from colonic screening. PMID- 2703056 TI - Cancer incidence after cholecystectomy--a cohort study with 30 years follow-up. AB - Cholecystectomy has been connected with an increase in colorectal, breast and reproductive system cancers. On 472 patients, 398 women and 74 men, cholecystectomized during the years 1951 to 1955, cancer incidence was investigated. Our results show an elevated risk of breast cancer in the female group (P = 0.016), but no significant increased risk in colorectal or gynaecologic cancer. The risk for breast cancer increased with time after operation. In our small group of men an elevated SMR was noted for colon cancer without reaching statistical significance. Possible aetiological factors for the association between cholecystectomy and breast cancer are discussed. PMID- 2703057 TI - Nuclear DNA measurements in follicular thyroid adenomas. AB - The nuclear DNA content was measured retrospectively in histologically confirmed follicular adenomas in 20 patients, and prospectively in 25 patients. In the retrospective group two of the adenomas, and in the prospective group three of the adenomas were classified as atypical due to high cellularity and nuclear atypia, but with no sign of micro-invasive growth. In the group of patients studied retrospectively, the two patients with atypical adenoma had an aneuploid DNA pattern. One of these died 11 years after diagnosis with generalized disease. The other patient in this group with an aneuploid atypical adenoma is alive, as are all the remaining 18 patients with diploid adenomas. In the prospective group there were five aneuploid tumours. The atypical adenomas were aneuploid in two cases and polyploid in one case. No patient in the prospective group has shown any evidence of recurrence so far. Although DNA measurements are of value in distinguishing between low and high malignant potential in invasive tumors, the prognostic information if no invasion is found is uncertain. The importance of examining an adequate number of tissue blocks from the capsular region is emphasized. PMID- 2703058 TI - Patients' and doctors' delay in the diagnosis and treatment of cutaneous melanoma. AB - Factors involved in patients' and doctors' delay in the diagnosis and treatment of primary or metastatic cutaneous melanoma were studied in an inquiry of 284 patients in 12 hospitals. The most important patients' delay factors were: unawareness of the danger of the earliest and to a lesser extent the late signs and symptoms in the evolution of melanoma. Age and socio-economic status were of negligible importance in this respect. When the primary melanoma was easily visible, patients noticed the first signs of the developing melanoma significantly earlier than when the primary was not visible; nevertheless visibility had no impact on tumor thickness. This again shows that the early signs were not experienced as signs that required a visit to a doctor. Patients who showed their melanoma as a secondary complaint while they visited the doctor for another condition, had a more favorable tumor thickness than those who only came for their melanoma. The most important factors in doctors' delay were lack of suspicion (often due to amelanosis), and the performance of an incisional or punch biopsy and treatment without histopathology. Melanomas discovered by chance during a physical examination while the patient was totally unaware of the lesion had a most favorable tumor thickness. These observations indicate that a better education of the general public and of the medical profession is warranted, in order to improve the prognosis of cutaneous melanoma. PMID- 2703059 TI - Pleomorphic rhabdomyosarcoma of the urinary bladder in association with recurrent urinary-tract infection. AB - An unusual case of pleomorphic rhabdomyosarcoma is presented which arose in the urinary bladder of an adult male in association with recurrent urinary-tract infection and bladder outflow obstruction, secondary to a chronic post-traumatic urethral stricture. PMID- 2703060 TI - Eighteen-year survival of unresected leiomyoblastoma of the stomach with liver and lymph node metastases. AB - A case of gastric leiomyoblastoma with liver and lymph node metastases occurring in a 31-year-old man, who has been alive with the tumor but without symptoms for more than 18 years after only an exploratory laparotomy without resection, is reported. On laparotomy, the liver metastasis and paragastric and para-aortic lymphadenopathies made it impossible to resect the stomach with the tumor. A diagnosis of malignant leiomyoblastoma was confirmed by incision of the liver and paragastric lymph nodes. Postoperative chemotherapy with mitomycin C and cyclophosphamide was performed for 6 months. As demonstrated by roentgenography, echography and computed tomography, the size of the tumor has remained almost identical for an 18-year period. Histologically, the low mitotic rate of the tumor in this case is considered primarily responsible for the long survival of the patient. A review of the records has revealed that our patient is the longest survivor to have unresectable gastric leiomyoblastoma with liver and lymph nodes metastases. PMID- 2703061 TI - Plasmacytoma of the stomach. AB - A case of plasmacytoma of the stomach is described. The clinical presentation, diagnostic pitfalls and the treatment of this rare entity are discussed. PMID- 2703062 TI - Cystadenocarcinoma of the pancreas 9 years after a pancreatic cyst operation: report of a case. AB - A patient case with cystadenocarcinoma of the pancreas in a middle-aged woman is described. Nine years prior to the pancreatic malignancy she underwent cystogastrostomy due to a pancreatic cyst presumed to be of non-neoplastic nature. The malignancy occurred at the site of the previous cystogastrostomy and was radically resected. Five years later the patient was well without signs of recurrence. The possibilities of incorrect primary diagnosis or development of a rare pancreatic malignancy in a previous cystogastrostomy are discussed. PMID- 2703063 TI - Post-irradiation angiosarcoma of the greater omentum. AB - A case of angiosarcoma of the greater omentum is reported. This angiosarcoma developed 8 years after irradiation for cervical carcinoma and presented with an intra-abdominal hemorrhage. We describe her clinical course, treatment and follow up. Although several other locations of irradiation-induced sarcomas have been published, this is the first report in literature of a postirradiation angiosarcoma in the greater omentum. PMID- 2703064 TI - Bleeding in fungating breast cancer. PMID- 2703065 TI - Breast microcalcifications. PMID- 2703066 TI - Multivariate analysis of prognostic factors for curative resectable rectal cancer. AB - Several reports have shown that prognostic factors of rectal cancer are pathological parameters such as lymph node metastases, tumour infiltration, perineural and venous infiltration, and clinical parameters such as tumour level, mobility of the tumour and number of quadrants involved. From 1979 to 1983, 208 patients were treated curatively for rectal cancer in Montpellier Cancer Institute. A multivariate analysis was done to evaluate prognostic factors of our population. Prognosis was influenced by lymph node metastases, preoperative radiotherapy, tumour infiltration and histological type. The role of preoperative radiotherapy in local control and in survival appeared highly significant. Our results confirm the importance of external beam irradiation in local recurrence and in survival as shown randomly in the EORTC prospective trial. The growing trend in sphincter-saving surgery should be associated with preoperative radiotherapy. PMID- 2703067 TI - [The role of paramedical workers in detecting malignant neoplasms]. PMID- 2703068 TI - [The value of x-ray study of the bones of the cranial vault and sella turcica in disorders of the menstrual cycle]. PMID- 2703069 TI - [Nonspecific aortoarteritis]. PMID- 2703070 TI - [Prevention of precancerous diseases of the oral cavity and vermilion border]. PMID- 2703071 TI - [Scabies]. PMID- 2703072 TI - [Stress and its sequelae]. PMID- 2703073 TI - [Acute abdomen in obstetrics and gynecology]. PMID- 2703074 TI - [Dispensary care of women with habitual abortion during the gynecological consultation]. PMID- 2703075 TI - [Inhalation drug abuse]. PMID- 2703076 TI - [Use of medicinal plant preparations in chronic noncholelithic cholecystitis]. PMID- 2703077 TI - [Coronary artery-dilating agents]. PMID- 2703078 TI - [Propaganda for contraception in preventing artificial abortions]. PMID- 2703079 TI - [Vaginal hypothermia in the combined treatment and prevention of suppurative septic diseases in obstetrics]. PMID- 2703080 TI - [Mother and child staying together in the maternity home]. PMID- 2703081 TI - Chemical dependency affects all. PMID- 2703082 TI - Honesty is the best remedy. PMID- 2703083 TI - The intervention project for nurses: nurses assisting nurses. PMID- 2703084 TI - Chemical dependency & its correlates--recovery through awareness and action. PMID- 2703085 TI - Codependency--what is it? PMID- 2703086 TI - How to identify and deal with the impaired nurse. PMID- 2703087 TI - Bay Area districts give facts on the RCT issue to their peers and the public. PMID- 2703088 TI - Proud to care. PMID- 2703089 TI - Secretary's Commission on Nursing Final Report. PMID- 2703090 TI - Lead poisoning in Wilmington, Delaware, 1974-1984. AB - This paper demonstrates the efficacy of screening for lead poisoning by determining FEP for a rapid, accurate identification of children at risk and in need of treatment. Early detection and prompt treatment significantly reduces morbidity and mortality. With improvements in childrens' environments, screening procedures and treatment regimes, lead poisoning should eventually become obsolete. PMID- 2703091 TI - A preliminary report: a patient/sibling comparison of IQ following treatment for lead poisoning. PMID- 2703092 TI - Polymyositis/dermatomyositis: a case presentation and review. PMID- 2703093 TI - The incorporation of the Medical Society of Delaware. PMID- 2703094 TI - Reflections on a bicentennial. PMID- 2703095 TI - What physicians can do regarding decisions about life support. PMID- 2703096 TI - Antitrust laws and the medical profession. PMID- 2703097 TI - Free markets and the medical profession. PMID- 2703098 TI - A prospective study of the active management of labor in women of high parity. AB - High parity has been suggested as contra-indication for the use of oxytocin stimulation in labor. The aim of our study was to prospectively evaluate a protocol of oxytocin administration in 130 consecutive low-risk patients having their sixth or subsequent delivery. Induction of labor failed only in 5 cases. No adverse effect on maternal and perinatal outcome was found. We conclude that with the introduction of electronic fetal monitoring and direct recording of uterine activity, oxytocin can be safely used for low-risk grand multiparae. PMID- 2703099 TI - Plasma and erythrocyte zinc concentrations in pre-eclampsia. AB - Plasma and erythrocyte zinc concentrations were measured in 28 Chinese pre eclamptic women and 28 controls matched for parity, race and gestation. There were no differences in either the plasma or erythrocyte zinc concentrations between pre-eclamptic and control groups, although the mean birth weight (p less than 0.001) and period of gestation (p less than 0.001) at delivery in the control group were significantly higher. In the pre-eclamptic patients, those delivering before 37 weeks or those who gave birth to low birth weight (less than 2500 g), babies had a significantly higher plasma urate concentration (p less than 0.02) compared to the pre-eclamptic patients with better fetal outcome. However, the plasma and erythrocyte zinc concentrations between these subgroups were not significantly different. Our results suggest that zinc deficiency is unlikely to play a significant role in pre-eclampsia in our patients, and that measurement of plasma and erythrocyte zinc concentrations is of doubtful clinical value in the management of pre-eclampsia. PMID- 2703100 TI - True rupture of the caesarean section scar (a 15 year review, 1972-1987). AB - In a 15 year period (1972-1987) a total of 2434 parturients with one or more previous Caesarean sections were delivered at University College Hospital, Galway. There were 1084 (44.5%) patients booked for elective repeat Caesarean delivery, because they had two or more prior sections (maximum number = 10) or a recurrent indication for section other than the prior section. Trial of labour was undertaken in 1350 (55.5%) patients, and 81.26% achieved a vaginal delivery. Regional analgesia was employed in 25.5% and oxytocin in 31.9%. There were 6 (0.44%) or 1:225, true scar ruptures, resulting in 1 stillbirth and 2 neonatal deaths with no maternal death. There were 4 (0.37%), or 1:271, uterine ruptures in patients booked for elective repeat section: a classical scar rupture before labour, with a fresh stillbirth; placenta praevia percreta with bladder involvement in two patients (both resulting in maternal death), and a patient with placenta praevia accreta. PMID- 2703101 TI - Reproductive outcome in women who lost their husbands in the course of pregnancy. AB - The loss of a husband in the course of pregnancy represents a serious life event that is accompanied by important psychosocial stress. We compared the length of pregnancy and the weight of the newborns in women who were widowed in the course of their pregnancy with control groups of married and unmarried women of the same parity and delivering in the same institute. The group of widowed parturients consisted of 40 women. The control group of married women included 38 cases, and the control group of unmarried women consisted of 33 cases. The results were statistically evaluated by means of variance analysis and sequential pair t-test. The average length of pregnancy was in the widowed women 279.46 +/- 8.54 days, in married women 277.13 +/- 10.9 days and in unmarried women 273.91 +/- 16.17 days. The differences are not statistically significant. The average weight of the newborn was 3327.0 +/- 484.98 g in the widowed women, 3347.11 +/- 404.76 g in married women and 3068.18 +/- 543.79 g in unmarried women. The weights of the newborns of widowed and married women are not different, but both are significantly higher than in the unmarried women (p less than 0.05). The results do not confirm the influence of psychosocial stress due to life events occurring in the course of pregnancy upon the length of the pregnancy and the weight of the newborn. PMID- 2703102 TI - Development of the perifollicular capillary network. Autoradiographic and morphometric studies in the rabbit ovary. AB - The published data give a report on systematic examinations on the development of the perifollicular capillary network in the theca interna in rabbit ovaries. The follicle size and the number of capillaries were investigated by means of morphometric methods. The extent of proliferation of granulosa and endothelial cells was studied autoradiographically by determining the labelling index (LI). The results show that the perifollicular capillary network is initiated only when the stratum granulosum has developed into a multilayered cell population. After that the number of capillaries increases linearly with increasing follicle size, independently of the oestrus cycle. During follicle growth at different times in the oestrus cycle the decrease and increase in the LI of granulosa cells is followed by a corresponding decrease and increase in the LI of endothelial cells several hours later. It should be noted, however, that the proliferation of endothelial cells in follicles with a diameter of 900 microns continues, although the decreasing LI of granulosa cells already indicates a reduced follicle growth. The number of labelled endothelial cells in atretic follicles decreases only after a decrease in proliferation of granulosa cells. In conclusion, it can be noted that the follicle growth and function is not influenced by variations in the number of capillaries in the theca interna. The curve of LI of granulosa and endothelial cells suggests that the granulosa cells have a certain regulatory function with respect to the growth of the capillary network in the theca interna. PMID- 2703103 TI - Ovarian function in the non-mosaic Turner syndrome; a case report. AB - A 19-year-old girl, with the 45,XO non-mosaic Turner syndrome, presented having spontaneous regular menstrual activity. Hormonal analysis showed normal ovulatory cycles; histology of the ovaries demonstrated primary follicles. Nevertheless, the karyotype of the ovary and of the peripheral lymphocytes was pure 45,XO. Comment on ovarian function in the 45,XO karyotype is given. PMID- 2703104 TI - Lupus-like syndrome in a mother and newborn following administration of hydralazine; a case report. AB - A very-low-birth-weight infant died from pericardial effusion and cardiac tamponade confirmed by the post-mortem findings. The mother suffered from lupus like syndrome consequent to hydralazine treatment for pregnancy-induced hypertension. The possible relationship between mother-infant pathology and hydralazine administration is discussed. PMID- 2703105 TI - EPA, environmental release, and the regulatory process. PMID- 2703106 TI - Studies of 5'-deiodinase activity in rats differing in hepatic lipogenic activity. AB - Studies of the relationship of hepatic 5'-deiodinase activity to hepatic lipogenic capacity were conducted. Rats of the Zucker, BHE, and Sprague-Dawley strains were used. BHE and Sprague-Dawley rats were starved and refed a 65% glucose diet, whereas lean and obese Zucker rats were fed a stock diet; the rats were thus different in hepatic lipogenic capacity. After hepatic 5'-deiodinase activity was determined, we found that rats genetically predisposed to increased hepatic lipogenesis had less deiodinase activity than rats without this genetic feature. The role of the interaction between the thyroid hormones and glucocorticoid in the activity of hepatic deiodinase was also studied. Adrenalectomized (ADX) or intact BHE and Sprague-Dawley rats were injected with saline, thyroxine, or triiodothyronine and either saline or glucocorticoid. The normal Sprague-Dawley rats made predictable adjustments to their deiodinase activity when their hormonal status was manipulated, whereas the BHE rats responded as though these manipulations were corrections rather than additions or deletions. PMID- 2703107 TI - Moderate caloric restriction delays cataract formation in the Emory mouse. AB - Eye lens senile cataract is a major cause of blindness, affecting the elderly in particular. The etiology of the disorder has been elusive, and attempts to delay the onset of senile cataracts have been unsuccessful. The need for more information is underscored by epidemiologists who estimate that the ability to delay cataract formation in humans by only 10 years would eliminate the need for 50% of the cataract extractions performed annually in the United States. The Emory mouse provides the best model for human senile cataracts. Feeding Emory mice a diet that was restricted in calories by approximately 21% delayed the onset of cataracts. This is the first study that demonstrates in vivo the delay of senile-type cataracts. In these animals, aging and cataracts are associated with diverse changes in the proportion of various proteins (particularly 21, 22, 31-34 kDa) and with transformation of proteins from a soluble to an insoluble state. In advanced cataracts, there is a loss of total protein. Within a cataract grade, there is no difference between restricted and nonrestricted animals in relative proportion of specific lens proteins or in amounts of total or soluble proteins. The transition from a clear to cataractous lens appears when the soluble-to-total protein ratio falls below about 0.58. The exclusive use of gamma crystallin as an indicator of lens viability is questioned. To the extent that cataract formation is due to lens protein oxidation and/or an inability to proteolytically remove damaged protein, it would appear that caloric restriction results in enhanced protection against lens oxidative stress or in prolonged proteolytic function. PMID- 2703108 TI - Pacing a career and setting priorities. PMID- 2703109 TI - A costly misdiagnosis. PMID- 2703110 TI - District 13 nurses involved in coalition to meet the health care needs of homeless. PMID- 2703111 TI - Gerontological nurses--moving right along. PMID- 2703112 TI - Gastrointestinal cell plasma membrane wounding and resealing in vivo. AB - Previous studies in vitro have shown that various mechanical methods used to wound plasma membranes allow normally impermeant, water-soluble markers, such as fluorescein dextran or horseradish peroxidase, to enter the cytosol. Subsequent membrane resealing traps these nontoxic fluorescent or electron microscopic markers within living, surviving wounded cells. The present report is the first, to our knowledge, to use this strategy to study cell membrane wounding and resealing in the intact animal. We show that gut cells wounded in vivo by mechanical forces are capable of resealing disruptions of their plasma membranes. More importantly, we show that wounding of cell membranes, followed by resealing, occurs not only in mechanically injured gut but also in normal, experimentally undisturbed gut. A variety of cell types were wounded and resealed membrane wounds in the mechanically injured stomach: surface mucous, endothelial, fibroblastic, parietal, and chief cells. Mucous cells successful at resealing membrane wounds apparently became active participants in the motile events of stomach repair. In undisturbed gut, cell membrane wounding and resealing was most frequently observed in the colon, but was also observed in the esophagus, stomach, duodenum, and ileum. Surface epithelial cells in undisturbed gut were retained for greater than 48 h after surviving membrane wounds. Two important roles are suggested for membrane resealing in gut: (a) preservation of motile cells nearest epithelial discontinuities requiring repair after injury, and (b) maintenance of epithelial integrity in normally functioning gut. Our finding of cell wounding in undisturbed gut may explain, in part, why rapid, continual cell turnover is characteristic of gut epithelia. We propose that membrane disruption, or wounding, is a normal and common occurrence in vivo, and that a biologically significant function of the plasma membrane is to reseal such wounds. The occurrence of in vivo cell membrane wounding and resealing suggests an unrecognized route for molecular traffic into and out of cytoplasm. PMID- 2703113 TI - Barrett's esophagus: development of dysplasia and adenocarcinoma. AB - Barrett's esophagus is considered to be a premalignant condition, and long-term surveillance seems mandatory with a careful search for dysplasia and carcinoma by means of multiple and repeated sets of biopsies. Reliable nonhistologic markers indicative of dysplasia or developing carcinoma are not yet available. To investigate development of dysplasia and carcinoma a prospective follow-up study was performed on 50 patients with Barrett's esophagus, without carcinoma at entrance to the study, for a period of 1.5-14 yr (mean, 5.2 yr). Barrett's epithelium was classified as fundic type, junctional or cardia type, or specialized columnar type. When classification in one of these three types was not possible because of lack of the characteristic features of the epithelia, the epithelium was classified as intermediate type. At entrance to the study, low grade dysplasia was found in 6 patients, high-grade in 1 patient. During follow up, dysplasia increased in frequency as well as in severity and was found almost exclusively in the specialized columnar- and intermediate-type epithelium. At the end of the observation period dysplasia had been found in 13 patients, in 10 scored as low-grade and in 3 as high-grade, and adenocarcinoma had developed in another 5 patients. This prospective study shows an incidence of carcinoma in Barrett's esophagus of 1 in 52 patient-years, a 125-fold increase compared with the general Dutch population. A sequence of worsening of dysplasia with development of carcinoma was observed in specialized columnar and intermediate type epithelium. The results of this study support the need for a long-term clinical, endoscopic, and histologic follow-up program in patients with Barrett's esophagus. PMID- 2703114 TI - Association between postprandial changes in colonic intraluminal pressure and transit. AB - The aim of this study was to correlate the movement of colonic luminal contents with the changes in intraluminal pressure. Studies were performed in 9 healthy volunteers. Intraluminal pressure was measured with perfused catheter ports in the transverse, splenic flexure, descending, and sigmoid colon. Movement of the luminal contents was measured by following the movement of technetium 99m ethylenetriamine-pentaacetic acid that was instilled as a bolus in the splenic flexure. During fasting there was very little change in pressure or in the movement of intraluminal contents. After eating a 1000-kcal meal, the tracer moved from the splenic flexure into the transverse colon and the sigmoid colon. Nonpropagating colonic motor activity increased in all colonic segments immediately after eating the meal (p less than 0.05). The increase in motility was significantly greater in the descending colon than in the transverse and sigmoid colon (p less than 0.05). In one-half of the subjects propagating contractions occurred postprandially. The movement of the intraluminal tracer occurred during both types of motility. The nonpropagating contractions were associated with a gradual movement of the luminal contents. The direction of the movement of the contents was determined by the differences in pressure in the different segments of the colon. The propagating contractions were associated with a rapid movement of intraluminal contents. These studies suggest that (a) colonic motility and transit are quiescent during fasting and (b) the transverse colon acts as a mixing and storage area, as retrograde transit into the transverse colon is the characteristic postprandial pattern. PMID- 2703115 TI - Natural history of duodenal lesions in Japanese patients with familial adenomatosis coli (Gardner's syndrome). AB - The natural history of duodenal lesions was studied in 20 patients with familial adenomatosis coli/Gardner's syndrome. These patients were followed for an average of 7.1 yr (range 1 yr, 7 mo to 12 yr, 2 mo) and repeatedly examined by hypotonic duodenography, duodenofiberscopy, and biopsy. Tubular adenomas of the duodenum (less than 8 mm in diameter) were present in 18 (90%). During the follow-up period, there was a slight increase or decrease in the number of duodenal adenomas in 4 patients but no distinct change in 13. In the remaining patient (aged 49 yr), a polypoid lesion (17 mm in diameter) of the duodenal bulb, which had been overlooked at the initial examination, became an advanced cancer (50 x 30 mm in size) during 22 mo. Tubular adenomatous tissue of the duodenal papilla was detected in 11 patients (55%). Follow-up study of the lesions revealed no change in endoscopic and histologic findings in all but 1 patient, in whom there was a slight enlargement of the duodenal papilla, as seen at endoscopy. These findings suggest to us that in patients with this disease, duodenal adenomas do not require prophylactic surgery. However, careful repeated follow-up examinations with endoscopic biopsy should be performed, with endoscopic removal of larger polyps when possible. PMID- 2703116 TI - Radioimmunolocation of hepatic and pulmonary metastasis of human colon adenocarcinoma. AB - We have established a large library of monoclonal antibodies against a human hepatoma cell line called FOCUS. One such monoclonal antibody (SF-25) detects a 125-kilodalton cell surface antigen found on FOCUS cells. As both the liver and the colon are of endodermal origin, we examined the possibility of expression in colon adenocarcinomas. This antigen was found in all 23 colon adenocarcinoma tissues surgically obtained but was absent in the adjacent normal mucosal counterpart as determined by a direct radioimmunohistologic technique. In the present study, we have established a model for human metastatic colon adenocarcinoma using the LS 180 cell line. Athymic mice were further immunosuppressed by intravenous injection of anti-NK cell antibodies (antiasialo GM1). After 24 h, mice were injected with LS 180 cells either via the tail vein or into the spleen followed by splenectomy. Macroscopic pulmonary and lymphatic metastasis developed within 2-3 wk after injection of cells and 9 of 10 mice died with advanced metastatic disease 2-3 wk later. In addition, macroscopic hepatic metastases were evident in 4 of 5 mice 3-4 wk after intrasplenic injection. Both hepatic as well as pulmonary and lymphatic tumor spread was localized by nuclear imaging with 125I-SF-25. Furthermore, micrometastases were detected by autoradiography 5-10 days later. Monoclonal antibody SF-25 is a potential candidate for tumor localization and the experimental metastatic colon cancer animal model may be useful for treatment evaluation of monoclonal antibody SF-25 either alone or in combination with other monoclonal antibodies when conjugated to radionucleotides and chemotherapeutic agents. PMID- 2703117 TI - Effect of pancreatic juice and trypsin on oleic acid-stimulated pancreatic secretion and plasma secretin in dogs. AB - We have investigated a negative feedback mechanism in the intestinal phase of pancreatic exocrine secretion in dogs with gastric cannulas and Thomas duodenal cannulas in whom pancreatic juice was collected by cannulation of the main pancreatic duct. Intraduodenal infusion of oleic acid emulsion in a dose of 18 mmol/h resulted in a significant increase in pancreatic secretion of water, bicarbonate, and protein, which was accompanied by increased plasma concentrations of both secretin and cholecystokinin. Infusion of pancreatic juice or bovine trypsin into the duodenum significantly inhibited the oleic acid stimulated pancreatic secretion. This inhibition coincided with a significant decrease in plasma secretin level, whereas plasma cholecystokinin concentration was not affected by either pancreatic juice or trypsin. Neither pancreatic secretion nor plasma secretin concentration was affected by intraduodenal administration of NaHCO3 solution. The trypsin-induced suppression of pancreatic secretion was prevented by intravenous administration of secretin in a dose that achieved a plasma secretin level comparable to that during the oleic acid administration. This study indicates that a negative feedback mechanism is operative in the intestinal phase of pancreatic exocrine secretion in dogs, and endogenous secretin plays a significant role in the mechanism. PMID- 2703118 TI - Cholangitis due to Blastomyces dermatitidis. AB - A 70-yr-old woman presented with nonspecific complaints and had findings of a cholestatic liver enzyme pattern and a dilated left intrahepatic ductal system by radiographic imaging. Endoscopic retrograde cholangiopancreatography revealed multiple irregular flat stones and a fixed filling defect of the left hepatic duct. At the time of surgery a stonelike lesion of this ductal orifice was found along with a miliary pattern of infection of the left liver lobe. Histologic and microbiologic studies confirmed an infection by Blastomyces dermatitidis. Therapy with amphotericin B resulted in eradication of this infection. Despite their rarity, fungal infections of the biliary tree need to be considered in the differential diagnosis of biliary tract disease in the elderly and immunocompromised patient. PMID- 2703119 TI - Necrolytic migratory erythema with elevated plasma enteroglucagon in celiac disease. AB - Necrolytic migratory erythema is the distinctive skin rash of the glucagonoma syndrome. Its presence is virtually pathognomonic of a glucagon-producing pancreatic islet cell neoplasm. Results of a study of a patient with hyperglucagonemia and necrolytic migratory erythema complicating untreated celiac disease are reported. Whereas pancreatic glucagon was only mildly elevated, there was marked elevation of enteroglucagon. Immunofluorescence staining demonstrated numerous (19.6 cells per square millimeter of mucosa) enteroglucagon-positive small intestinal crypt cells. Treatment with gluten-free diet not only resulted in resolution of malabsorption and improvement in small intestinal histology but was paralleled by disappearance of necrolytic migratory erythema, normalization of plasma glucagon levels, and marked reduction in the number of enteroglucagon producing crypt cells (0.2/mm2 mucosa). The findings demonstrate that necrolytic migratory erythema is not an exclusively paraneoplastic phenomenon and that it can occur in association with excess production of enteroglucagon by the intestinal mucosa. PMID- 2703120 TI - Benign recurrent intrahepatic cholestasis: treatment with S-adenosylmethionine. AB - S-Adenosylmethionine (800 mg i.v. per day) was used to treat two brothers and a brother and sister from each of two kindreds with benign recurrent intrahepatic cholestasis. Symptoms, routine tests of liver function, concentrations of total bile acids, and the oral clearances of [11,12-2H]chenodeoxycholic acid and [24 13C]cholic acid were determined before and after treatment with S adenosylmethionine. S-Adenosylmethionine did not ameliorate symptoms or biochemical parameters of cholestasis but reduced bile acid clearances in 3 of 4 subjects. Transaminase levels in both subjects of one kindred rose during treatment. These limited, preliminary observations suggest that S adenosylmethionine may be ineffective in the therapy of benign recurrent intrahepatic cholestasis and may be hepatotoxic in some patients. PMID- 2703121 TI - Diagnosis of primary sclerosing cholangitis in a blood donor with elevated serum alanine aminotransferase. AB - At routine blood donation, a 37-yr-old man with an elevated serum alanine aminotransferase was found to have primary sclerosing cholangitis. The majority of asymptomatic blood donors with elevated aminotransferase levels are presumed to have fatty liver or chronic non-A, non-B hepatitis. However, a substantial number of blood donors with elevated aminotransferase levels will have other hepatobiliary diseases, including primary sclerosing cholangitis. The implementation of aminotransferase screening of blood donors should result in earlier diagnosis, better understanding of natural history, and occasionally, earlier treatment of a number of hepatobiliary diseases. PMID- 2703122 TI - Epithelial cells develop membrane wounds--and recover! PMID- 2703123 TI - Ethanol, liver fibrosis, and the control of proteoglycan biosynthesis. PMID- 2703124 TI - Choice of liver biopsy needle. PMID- 2703125 TI - [Menarche, menstrual cycle and fertility in diabetic patients]. AB - From observations of female type I diabetics, we collected data on menarche, menstrual cycle and fertility. 337 women answered our questionnaire which had been published in journals for diabetic patients. The data were correlated with age, diabetes duration, and the onset of diabetes. The mean age at menarche was inversely correlated with the age of the patients; in diabetics it was 0.8-2 years higher than in the population in which diabetes developed after menarche. As compared to a population of non-diabetics we observed an increase in mean age at menarche of 0.4-1.3 years. The increase was most pronounced if diabetes developed between the age of 3-8 years. The prevalence of primary amenorrhoea in diabetics was 3.6%, in the controls and in diabetics with late onset 1.5%. Irregularities of the menstrual cycle were observed more often in diabetics than in the controls. The prevalences of oligomenorrhoea and secondary amenorrhoea were 14 and 7% in the group of patients with diabetes onset before menarche. In the group with late onset of diabetes the prevalence of secondary amenorrhoea was 12%. Irregularities of the menstrual cycle were found more frequently at the time of diabetes onset, although 76% of the patients had not remarked any change in the frequency of menstrual bleedings. With increasing diabetes duration, the frequency of bleedings normalized. 70.5% of the patients aged 35 or more had spontaneous conceptions, 2.1% were sterile. Both values are not significantly different from the data of the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703126 TI - [Assessment of edema in pregnancy]. AB - The clinical evaluation of oedemata during pregnancy is more or less subjective and not reproducible. There is no common factor to the relevance of its presence. The aim of this investigation was to check systematically the frequency and degree of generalised Oedemata and their clinical relevance. 184 pregnant women were examined for their finger circumference between the 16th and 36th week of gestation. According to the change in the circumference, three significantly different groups of oedemata were found. The group with strongly marked oedemata showed increased hypertensive complications and the highest rate of growth retarded children. This objective and simple method of measuring the finger circumference, is suggested for antenatal care. PMID- 2703127 TI - [Indications for cesarean section in the delivery of the 2d twin after vaginal birth of the 1st twin]. AB - Cesarean section for delivery of twin B after vaginal delivery of twin A is a rare and extraordinary event in obstetrics. From 1.1.82-31.12.86, from a total number of 9357 deliveries, 133 pairs of twins (1.4%) were born. In 3 cases (2.2%) twin B was delivered by cesarean section after vaginal delivery of twin A. Taking into account 51 published cases in the recent literature, the indications for cesarean delivery of the second twin were demonstrated and compared. In the main, emergency situations presenting more than one obstetrical complication were responsible for this uncommon practice. Regarding the results presented, cesarean section of the second twin after vaginal delivery of the first-born seems to be a proven procedure to deliver the second twin faster and more safely than by hazardous vaginal manipulations, especially in obstetrical emergency situations. PMID- 2703128 TI - [Exposure to radioactivity in the perinatal period following the reactor accident in Chernobyl]. AB - After the Chernobyl nuclear accident on 26 April 1986 Europe experienced increased radioactive radiation by contamination of the atmospheric aerosol and the soil. Foods emanating radioactive radiation were ingested by the population to an increased extent via the food chain. This proportion of radioactive radiation accounted for about 80% of the total irradiation exposure and prompted us to examine mother's milk, amniotic fluid and placenta of newborn in respect of their concentrations of radionuclides I-131, Cs-134 and Cs-137. Due to the short half-life of I-131 an increased concentration of this substance was seen only during the first eight weeks after the nuclear accident. On the other hand, however, there was a clear increase in Cs-134 and Cs-137 from this time onward, the highest concentration of these two nuclides being measured only after one year after the accident. Despite the enhanced exposure to radioactivity of mother's milk and amniotic fluid, the guideline values laid down by Federal German legislation were not exceeded. PMID- 2703129 TI - [Genital chlamydia infections and extrauterine pregnancy]. AB - Serum samples of 217 patients with ectopic pregnancy (e.p.) and of 152 women with intrauterine pregnancy (i.u.p.) were examined for their antibody content to chlamydia trachomatis by means of the indirect immunofluorescence technique. In 81% of the sera of patients with e.p., antibody could be detected, while patients with i.u.p. revealed antibody in 39%. Titres greater than or equal to 1:128 were found in 49% (e.p.) and in only 11% (i.u.p.) respectively; so they possess a high diagnostic value. These results show significant differences in the behaviour of antibodies in both groups of patients and are illustrated in 2 charts. Anamnestic data showed 54% of the patients with e.p. (i.e. adnexitis 23%, gonorrhea 12.3%, previous e.p. 18.4%); the mean age was 29 years. Affected tubes may lose their physiological function, possibly resulting in an ectopic pregnancy. The level of antibody in the serum remains stabile for many years, this enables a retrospective diagnosis of chlamydial infections. An early diagnosis and treatment, including the partners, represent the best way for prevention of complications. PMID- 2703130 TI - [Extrauterine pregnancies following "abortion" in cases with no indication of intrauterine pregnancy]. AB - 287 women underwent surgery for ectopic pregnancy from January 1, 1979 to December 31, 1985. Prior to laparotomy, seven patients (2.4%) had applied for an induced abortion elsewhere in the absence of evidence of an intact intrauterine pregnancy. During these interventions, histological examination of the scraping was only in two cases. Despite histological findings, should one patient was not advised to present for inpatient clarification. The other patient had to be hospitalized at our clinic before a histological finding was available. During operation in 5 patients, we found tubal rupture with resultant hemoperitoneum of 1500 ml to 3000 ml. Tubal abortion occurred in the remaining two cases. These observations substantiate the absolute necessity to undertake routine histological examinations of the material obtained at abortion in every case. PMID- 2703131 TI - [Early manifestation of severe gestosis (pre-eclampsia) in fetal triploidy- diagnosis and obstetrical management]. AB - A case is reported of early-onset pre-eclampsia combined with severe malformations including holoprosencephaly and hydrocephaly caused by triploidy. By ultrasonic diagnosis, maternal risks caused by either prolonged pregnancy because of immaturity or inappropriate obstetrical management, i.e. by caesarean section, could be avoided. Ventriculocentesis of the macrocephalic fetus was performed and abortion induced. PMID- 2703132 TI - [Difficulties in interpreting the cardiotocogram in atrioventricular arrhythmia of the fetal heart]. AB - During a routine screening examination of a pregnancy during the 28th gestational week, a pericardial effusion and ascites were recognized in the fetus. Ultrasound B- and M-mode evaluation (echocardiography) revealed an atrio-ventricular block grade III with commencing cardiac insufficiency. Cardiac monitoring (CTG) by ultrasound (HP 8040A Fetal Monitor) documented primarily the fetal atrial activity when the logic switch was turned off, but after it was turned on there was no continuous recording. When fetal heart action was recorded by abdominal electrocardiogram (AFEKG) the cardiotocography showed simultaneously a ventricular frequency of 50/min. and a maternal frequency of 70-80/min. This case confirms that the registration of fetal heart action without real-time imaging is only of limited value in cases of cardiac-conduction anomalies. It is important that during ultrasound screening examination, the cardiac heart action is carefully evaluated. PMID- 2703133 TI - [Disseminated peritoneal leiomyomatosis. A rare disease picture]. AB - After taking oral contraceptive hormones continuously for 17 years, a 44 year old patient developed enlarging uterine leiomyomas and multiple small to tiny subperitoneal nodules throughout the pelvic peritoneum. Histologically and immunohistochemically, the nodules proved to be leiomyomas. Similar nodules were induced in young female guinea pigs by injecting them with estradiol twice weekly. The first nodules appeared after four months. Approximately 50 cases of Leiomyomatosis peritonealis disseminata (LPD) have been reported to date in the world literature. Of these, 23 patients were pregnant. Seventeen had taken oral contraceptives continuously for many years (from 8-17). The developing leiomyomatous nodules probably arise from the Mullerian epithelium, which is distributed throughout the subperitoneal mesenchyme. By appropriate individual predisposition and excessive hormonal stimulation, the Mullerian derivatives proliferate along lines of myofibrous differentiation. Since the oral contraceptives all contained in addition to estradiol the synthetic gestagen norethindrone (or lynestrenol) and since these same hormones led to identical tumor nodules in animal experiments, it seems to suggest, that the stimulation of the Mullerian epithelium results from a specific combination of hormones. A similar combination of hormones may develop endogenously during a hormonally disturbed pregnancy. To prove these assumptions, larger case and interdisciplinary studies are needed. It is of clinical importance to realize, that the dormant Mullerian epithelium may be stimulated by excessive hormones to proliferate and that the proliferations produced, such as the benign nodular tumors of LPD, must be differentiated from nodular metastases of malignant tumors. PMID- 2703134 TI - [Plexiform tumor of the uterus]. AB - Uterine plexiform tumors are morphologically distinctive lesions. Usually they are incidental microscopic findings in hysterectomy specimens that have been removed for other reasons. The rarity and the complex histomorphology of the small intramyometrial tumors may cause confusion in the diagnosis. In the reported case immunohistochemistry was performed. The results point to the disputed histogenesis that plexiform tumors are of smooth muscle origin. All plexiform tumors reported in the literature showed a benign clinical course; also in cases with intravascular extension as in intravascular leiomyomatosis. PMID- 2703135 TI - [Proliferation index, axillary lymph node status, hormone receptors and age as prognostic factors in primary breast cancer]. AB - A total of 233 primary carcinomas of the breast (n = 68 nodal negative and n = 165 nodal positive) of 77 woman patients of less than 50 years of age and pf 156 women patients of 50 years of age or older were examined for the prognostic significance of a proliferation index (in vitro chemoresistance assay). The prognostic significance of the proliferation index (high vs low proliferation) is compared with other prognostic factors that have already been in clinical use (age, axillary lymph node status, oestrogen and progesterone receptor status). The total median observation period was 4.8 years (3-9.1 years). Determination of the proliferation index proved to be the most important prognostic factor both for premenopausal and postmenopausal, nodal negative and nodal positive primary tumours when assessing the total survival time and the time that remains free from recurrences. A simultaneous assessment of low proliferation index and positive hormone receptor as a so-called low-risk situation shows in comparison to a high-risk situation (high proliferation index, negative receptor status) the most pronounced differences. For premenopausal women (younger than 50 years of age) the hormone receptor status has no prognostic significance as far as our group of patients is concerned, whereas for women of 50 years of age or older the receptor status is of great prognostic relevance. Besides the lymph node status, the proliferation index shows in a Cox regression model the greatest prognostic importance for the further course of a primary carcinoma of the breast.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703137 TI - [The hormone profile in serum and cervix secretions in the course of a menstrual cycle]. AB - Serum and cervico-vaginal secretion were examined for LH, E2, progesterone and relaxin content throughout a cycle. Estimations were carried out using radioimmunoassays. LH, E2 and progesterone were found in markedly lower concentrations in cervical-vaginal secretion than in serum. Relaxin was detected only in cervical-vaginal secretion with the exception of one serum sample. PMID- 2703136 TI - [Initial experiences with a monoclonal antibody to the progesterone receptor complex]. AB - Today, the immuncytochemical demonstration of estrogen receptors can be regarded as established. Recently, a monoclonal antibody (mab) against the progesterone receptor-complex became commercially available. The antibody Mi 60-10, developed by Milgrom and co-workers, is murine and principally directed against the progesterone receptor of the rabbit, but it also attacks an "epitop" of the human receptor. The Western-Blot analysis shows the antibody having several specific bands against T-47-D cells in the region of 110,000 dalton. To estimate the practical performance of this antibody, 73 primary breastcarcinomas were incubated with both the ER-ICA-Kit and the new "mab". The PAP method was used for visualisation. In a frozen section the mab Mi 60-10 proved as successful as the ER-ICA-Kit. However, in contrast to the ER-ICA-Kit, the mab Mi 60-10 is also successful in locating the receptor, also in formalin-fixed samples embedded in paraffin. This is also the case with blocks, which were stored for several years. In aspirated cytological samples the immunocytochemical demonstration of progesterone was just as successful as that of estrogen and comparable with results on the histological section. A satisfactory validity can be obtained today through the development of highly specific monoclonal antibodies against the progesterone receptor complex, with the complete receptor diagnosis of mammary carcinoma both immunocytochemically in frozen sections and additionally, of progesterone receptors in paraffin wax sections. The only current problems involve the exact quantification of the immunocytochemical results. It is predictable today, that the DCC-method, when compared to the immunocytochemical receptor analysis, will reduce in significance. PMID- 2703138 TI - Alimentary tract and pancreas. Stimulation of mucosal prostaglandin synthesis in human stomach and duodenum by antacid treatment. AB - The effect of a low dose antacid treatment on mucosal prostaglandin metabolism was studied in 15 healthy volunteers. A daily dose of 46 mmol (= 138 mval) Al(OH)3 and 42 mmol (= 84 mval) Mg(OH)2 with a titrated in vitro neutralising capacity of 272 mval of H+ was given for three weeks. Total prostaglandin formation and the prostaglandin profile as well as the degradation of PGE2 were assayed by incubating homogenates of endoscopic biopsies from antral and duodenal mucosa with the precursor (14C)arachidonic acid. Total prostaglandin synthesis in antrum (623 (110) pmol/mg protein) and duodenum (432 (72) pmol/mg) was stimulated after three weeks administration of low dose antacids by 176% (p less than 0.05) and 154% (p less than 0.05), respectively. An untreated control group exhibited no significant changes. In contrast, the prostaglandin profile showed only a small increase of the prostacyclin metabolite 6-keto PGF1a (p less than 0.05) at the expense PGD2. PGE2 catabolism was unaffected. This enhanced activity of mucosal prostaglandin cyclooxygenase might represent one possible mechanism of action of a low dose antacid treatment. PMID- 2703139 TI - Gastric emptying in marathon runners. AB - Radionuclide gastric emptying studies using 99m-Tc human serum albumin egg omelette have been carried out in 10 long distance runners at rest and during a 90 minute run at sustained speed. Resting values are compared with controls comprising 10 sedentary subjects. Runners show a significantly accelerated basal gastric emptying (runners t 1/2 = 67.7 (5.9) min; sedentaries t 1/2 = 85.3 (4.5) min, p less than 0.001). The exercise had no significant effect on gastric emptying in these trained subjects (exercise t 1/2 = 66.8 (5.9) min, p = NS), suggesting adaptation to exercise. PMID- 2703140 TI - Statistical analysis of the lactulose/breath hydrogen test in the measurement of orocaecal transit: its variability and predictive value in assessing drug action. AB - The variability in the orocaecal transit time as measured by the lactulose/breath hydrogen method has been studied for three conditions: lactulose given with a meal, subjects sitting; lactulose given with a meal, subjects semirecumbent; lactulose given in aqueous solution, subjects semirecumbent. Thirty three healthy subjects attended on up to 12 occasions. It was found that administration of the lactulose with a meal significantly reduced the variability (p less than 0.05) and that adoption of the semirecumbent position further reduced variability. A power analysis was used to predict the number of subjects who would be required to show a given percentage change in orocaecal transit time at specified probabilities and powers. A graph and a table for use in the prediction of subject numbers at a probability of 5% and for powers of 50-99% is presented. A dose response curve for metoclopramide using the lactulose/breath hydrogen method is given for doses of 10, 15, and 20 mg. PMID- 2703141 TI - Chemiluminescence of ischaemic and reperfused intestine in vivo. AB - Low level chemiluminescence of exposed rat intestine was measured during occlusive ischaemia and reperfusion. Spontaneous emission of in vivo rat intestine (10 +/- 1 cps/cm2) decreased almost to zero in animals subjected to ischaemia and when the period of ischaemia lasted only two minutes, chemiluminescence increased beyond control levels (39%, three minutes after reperfusion) at intestine deligation. This overshoot did not occur when rats were pretreated with allopurinol (40 + 100 mg/kg bw). The ratio of xanthine dehydrogenase to xanthine oxidase activities was 3.46 in preischaemic intestine samples. The same ratio was changed to 0.35 in samples subjected to two minutes of ischaemia. As chemiluminescence appears to reflect the steady state level of singlet oxygen, which in turn derives from the steady state level of peroxy radicals, these results agree with the view that oxygen radicals derived from the xanthine oxidase reaction are involved in the cellular damage produced after ischaemia and reoxygenation in the intestine. PMID- 2703142 TI - Unexpected dilatation of the common bile duct after methyl tertiary butyl ether (MTBE) in rabbits. Possible implications to findings in man. AB - Methyl tertiary butyl ether (MTBE) rapidly dissolves cholesterol gall stones in vitro and in vivo. To further characterise tolerability and safety of this aliphatic ether, either MTBE (1 ml/kg body wt daily for two days) or an equal amount of saline was infused into the common bile duct (CBD) of eight cholecystectomised rabbits. Transient vomiting, dyspnoea and somnolence developed during MTBE instillation. Post-treatment values of serum transaminases and alkaline phosphatase were significantly higher in MTBE than in saline treated animals. Cholangiography one week after the last intraductal infusion showed a five-fold increase of CBD size in MTBE v control rabbits. At autopsy histological signs of chemical cholangitis and mild duodenitis were noted in MTBE treated animals. Prompted by these findings, we performed a cholangiography in two patients who had received intraductal MTBE (about 0.2 ml/kg body wt daily for one or two days) one year before: an abnormal dilatation of the CBD was present, which might represent a specific, hitherto undescribed permanent sequela of MTBE administration. PMID- 2703143 TI - Plasma concentrations of cholecystokinin, CCK-8, and CCK-33, 39 in rats, determined by a method based on enzyme digestion of gastrin before HPLC and RIA detection of CCK. AB - A new specific method for determination of cholecystokinin, CCK-8, and CCK-33, 39 in rat plasma is described. Plasma CCK radioimmunoassay (RIA) is difficult, because of cross-reactivity with gastrin. In the rat, problems because of difficulties in separating gastrin from CCK by high performance liquid chromatography (HPLC) exist. These were solved by enzyme digestion of gastrin before HPLC separation of molecular variants of CCK from gastrin fragments. Cholecystokinin immunoreactive forms in the HPLC fractions were determined by an antibody, which recognises the carboxyl terminus of CCK and gastrin. Fasting concentrations of small (CCK-8) and large (CCK-33, 39) molecular forms of CCK averaged 1.9 (0.3) pM and were raised to 13.4 (3.8) pM in rats fed ad libitum. Cholecystokinin in lactating rats rose two-fold after suckling, compared with 2.8 fold in response to feeding. The basal ratio between CCK-8 and CCK-33, 39 was approximately 1:1, but increased in favour of CCK-8 after feeding and in response to suckling. Gastrin like immunoreactivity measured in unextracted plasma was found to rise after feeding, but was unchanged in response to suckling. PMID- 2703144 TI - Pressure of intraoesophageal varices assessed by fine needle puncture: its relation to endoscopic signs and severity of liver disease in patients with cirrhosis. AB - In 40 patients with cirrhosis and oesophageal varices transmural variceal pressure was assessed endoscopically by fine needle puncture and related to endoscopic signs as well as to the severity of liver disease. Transmural pressure was significantly (p less than 0.01) higher in the presence of a red colour sign (26.7 (7.8) cm H2O) than in its absence (19.1 (6.6) cm H2O). Transmural pressure, however, was not significantly related to diameter or number of varices (diameter greater than 5 mm: 23.7 (8.4), diameter less than or equal to 5 mm: 22.2 (7.9) cm H2O; number greater than 3: 23.2 (8.0), number less than or equal to 3: 22.2 (7.8) cm H2O). The Child status (Child A: 23.9 (8.0), Child B/C: 21.3 (8.1) cm H2O) and individual Child-Pugh parameters including ascites (ascites present: 23.2 (8.3) cm H2O ascites absent: 22.8 (8.1) cm H2O) were not significantly related to transmural variceal pressure. We conclude that the endoscopic visibility of a red colour sign on the varices is associated with a high transmural oesophageal variceal pressure. Our results favour the hypothesis that variceal pressure may be of major importance for the development of the red colour sign. PMID- 2703145 TI - Laryngospasm and reflex central apnoea caused by aspiration of refluxed gastric content in adults. AB - Two patients with attacks of choking caused by aspiration of gastric contents in the laryngotracheal tube are presented. One had such severe attacks of respiratory arrest, that tracheostomy was done. The common symptoms of gastro oesophageal reflux such as pirosis, acid regurgitation, or retrosternal burning were absent in both patients and upper gut radiological and endoscopic examinations were negative. Histology of the oesophageal mucosa showed a deep chronic eosophagitis, and the 24-hour pH-monitoring of the upper oesophagus showed frequent gastro-oesophageal refluxes. Manometry showed hypotonic lower oesophageal sphincter with marked alterations of peristalsis. In the patient with tracheostomy a 24 pH monitoring of the hypolaryngeal zone showed decreased pH at the time of choking attacks. In the other patient further investigations showed that amyotrophic lateral sclerosis was the cause of the oesophageal motility disorder. An intense antireflux treatment abolished the respiratory attacks in both patients. PMID- 2703146 TI - Calcium: taking mom's advice. PMID- 2703147 TI - Focusing on caregivers. PMID- 2703148 TI - How elders adjust. PMID- 2703149 TI - Teaching patients to use a new hip. PMID- 2703150 TI - Life as a bell-shaped curve. PMID- 2703151 TI - Rx: take caution with drugs for elders. PMID- 2703152 TI - Wheelchair karate. PMID- 2703153 TI - ADNs as managers? PMID- 2703154 TI - For want of a nail. PMID- 2703155 TI - The wheel of care. PMID- 2703156 TI - Just being neighborly. PMID- 2703157 TI - Calcium: should we supplement? PMID- 2703158 TI - Secondary cytoreductive surgery in epithelial ovarian cancer: nonresponders to first-line therapy. AB - Thirty-three patients with progressive or stable epithelial ovarian cancer who underwent secondary tumor-reductive surgery at the University of Texas M. D. Anderson Cancer Center were retrospectively studied. All patients had primary cytoreductive surgery followed by chemotherapy. Lack of response to chemotherapy was clinically documented preoperatively. The tumors of 55% of the patients were secondarily cytoreduced to a greatest diameter of less than 2 cm. Sixty-six percent of the patients required bowel resection. Operative morbidity occurred in 24% of patients, mostly in those with bowel resection. Overall, median survival after secondary surgery was 9.4 months. For patients with residual tumor less than 1 cm, median survival after secondary surgery was 19.5 months, compared with 8.3 months for patients with residual tumor of 1 cm or more (P less than 0.004). Patients with an interval between primary cytoreductive effort and secondary surgery of less than 12 months survived a median of 7.3 months, compared with an 18.3-month median survival for patients with an interval of 12 months or more (P less than 0.004). The present study provided no evidence that secondary surgery is of significant benefit in most patients who have progressive disease during chemotherapeutic treatment of epithelial ovarian cancer. PMID- 2703159 TI - Primary invasive ovarian adenocarcinoma with brain and placental metastases: a case report. AB - A case of primary ovarian adenocarcinoma during pregnancy with both placental and central nervous system metastases is reported. PMID- 2703160 TI - A case report of three synchronous stage I malignant neoplasms. AB - A patient with three synchronous, Stage I neoplasms of the ovary, kidney, and lung, who underwent resection of all lesions at the same operative procedure, is presented. The incidence of multiple primary malignancies and the prognosis for Stage I cancers of the ovary, kidney, and lung are reviewed. PMID- 2703161 TI - Glassy cell carcinoma of the endometrium responsive to megestrol acetate. AB - A case of glassy cell carcinoma of the endometrium with pulmonary metastasis was responsive to treatment with a progestational agent. We believe this to be the first reported case of glassy cell carcinoma of the endometrium responsive to this form of therapy. PMID- 2703162 TI - Endodermal sinus tumor of the ovary. PMID- 2703163 TI - Epithelial ovarian cancer. PMID- 2703164 TI - Determinants of increased risk for recurrence in patients undergoing radical hysterectomy for stage IB and IIA carcinoma of the cervix. AB - From 1939 to 1977, 431 patients underwent radical hysterectomy as primary therapy for Stage IB or IIA carcinoma of the cervix at Memorial Sloan-Kettering Cancer Center. Only 11 patients were lost to follow-up at intervals of from 1 to 94 months. Assessment of gross and histologic extent of disease was correlated with the prevalence of nodal metastases and survival. Increasing tumor size, depth of invasion, and histologic grade were covariable and predictive of both lymph node metastases and recurrence. After stratifying for nodal metastases, adenocarcinoma cell type, the size of the primary tumor, depth of invasion into the cervix, and histologic grade were associated with decreased survival. For the 85 patients with documented recurrence of their carcinoma, the time to recurrence varied inversely with primary tumor size. Of 56 patients with documented recurrence and negative nodes at the time of their initial therapy, 10 patients (18%) were ultimately salvaged. None of the 29 patients with recurrent carcinoma and positive nodes at the time of their initial lymphadenectomy was successfully treated. Analysis of prognostic factors identifies a group of patients at high risk for recurrence and decreased survival for whom prospective trials of adjunctive treatment should be considered. PMID- 2703165 TI - Cytoplasmic steroid receptors in tumoral and "normal" endometrial samples from symmetrical uterine zones. AB - Cytosol progesterone (PgR) and estradiol (E2R) receptors were quantified simultaneously in "normal" and tumoral endometrium samples, located symmetrically on the longitudinal axis of the uterine cavity. With this experimental model two different groups of patients were detected. In the first group (7 of 10 women), the endometrial carcinoma had a greater cytosolic concentration of PgR than the corresponding "normal" endometrium, both kinds of tissue being affected by the same circulating hormonal "environment," peculiar to each patient. The opposite occurs in the other group (3 of 10 women), since the "normal" endometrium was found to be "richer" in receptors than the tumoral endometrium. It is suggested that this difference in the capacity of the tumor for synthesizing PgR and even E2R as compared to the "normal" endometrium may be a marker which improves selection of patients who will be more likely to respond favorably to endocrine therapy. PMID- 2703166 TI - Long-term access to the peritoneal cavity in ovarian cancer patients. AB - One hundred thirty-six totally implanted peritoneal catheter systems were placed in 130 patients. No complications occurred at catheter placement. A total of 629 courses of intraperitoneal therapy were administered. The average catheter has remained in place for 4.5 months (range 1-19 months). Seven catheters (5.1%) were removed for infection. An additional 7 catheters were removed because of blockage, for a total removal rate due to complications of 10.2%. Catheters were not used for drainage of the peritoneal cavity. The totally implanted peritoneal catheter system provides a reliable means for long-term access to the peritoneal cavity in patients with ovarian cancer. PMID- 2703167 TI - Increase of cervical adenocarcinoma: a report of 520 cases of cervical carcinoma including 112 tumors with glandular elements. AB - A total of 520 new cases of cervical carcinoma were treated at the Department of Obstetrics and Gynecology, Helsinki University Central Hospital, in 1976 through 1980. Of these carcinomas, 95 (18.3%) were pure adenocarcinomas and 17 (3.3%) represented adenosquamous tumors. The mean age was 58.9 years (range 23-88 years). The age distribution was similar in patients with and without malignant glandular elements and the peak incidence was in the age group 60-69 years. In patients with adenocarcinoma, stage I was overrepresented (62.1%) whereas epidermoid carcinomas were more evenly distributed among various stages. The overall 5-year survival rate was 63.1%, with the corresponding corrected rate being 69.1%. The survival rate for patients with adenocarcinoma did not differ significantly from that for patients with squamous cell tumor. It is concluded that in our population the increasing frequency of cervical adenocarcinoma has not influenced the favorable results of the 5-year study. This disease, however, deserves more attention since its etiology, pathogenesis, and biology are still largely unresolved. PMID- 2703168 TI - Magnetic resonance imaging in cervical cancer: a basis for objective classification. AB - Conventional clinical staging of cervical cancer is subjective because it is based on palpatory findings and inadequate because it cannot assess the single most important prognostic factor--tumor size. To determine the exactitude of in vivo MRI measurements of tumor volume, 22 patients with invasive cervical cancer were studied before surgery. The volumes obtained by MRI correlated well (r = 0.983) with those obtained by histomorphometric analysis of the surgical specimens, but only weakly with clinical stage. MRI may provide a basis for precise classification of cervical cancer and for objective comparison of surgery and radiotherapy. PMID- 2703169 TI - Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group Study. AB - Forty-nine evaluable patients with advanced or recurrent endometrial carcinoma who were no longer controllable with surgery, radiotherapy, and hormonal therapy and who had not received prior chemotherapy were treated with cisplatin 50 mg/m2 intravenously every 3 weeks. Two complete responses (4%) and eight partial responses (16%) were observed among the 49 patients. Twenty-two (45%) exhibited stable disease for at least 2 months, while 17 patients (35%) progressed less than 2 months after initiating chemotherapy. Adverse effects included mild leukopenia (31%), nausea and vomiting (72%), and mild azotemia (51%). Only 2 patients experienced life-threatening toxicity; one related to renal failure and the other to sepsis and shock. Cisplatin thus has definite activity when given at the dose and schedule tested to patients with endometrial carcinoma who have not received prior chemotherapy. PMID- 2703170 TI - Assessment of pretreatment laparotomy in patients with cervical carcinoma prior to radiotherapy. AB - One hundred fifty-five patients with cervical cancer not amenable to radical surgery underwent selective, paraaortic lymphadenectomy and exploratory laparotomy prior to the initiation of radiotherapy. Fifty-one patients underwent transperitoneal lymphadenectomy; the remainder had the procedure performed using the extraperitoneal approach. Twenty-six patients (17%) were found to have metastatic disease to the paraaortic lymph nodes. The incidence of paraaortic metastases increased with advancing clinical stage. Twenty-four of the 26 patients were treated with extended-field radiotherapy which did not exceed 5100 cGy to the paraaortic region. Twenty-three percent of the patients with positive paraaortic nodes had documented intraperitoneal tumor. Two- and five-year actuarial survival rates for patients with paraaortic metastases were 35 and 27%, respectively. Approximately 4.6% of patients undergoing a selective paraaortic lymphadenectomy derived therapeutic benefit from the information supplied by the procedure. Using a Cox model, tumor histology, status of the paraaortic lymph nodes, tumor size, and presence of intraperitoneal disease were statistically significant prognostic factors in patient survival. Tumor size and presence of intraperitoneal disease were major predictors of patient survival. PMID- 2703171 TI - Importance of steroid receptors and aromatase activity in the prognosis of ovarian cancer: high tumor progesterone receptor levels correlate with longer survival. AB - The presence of steroid receptors (82 tumors) and aromatase activity (39 tumors) in ovarian carcinomas was correlated with patient survival. No statistically significant correlation was found between the presence or absence of estrogen receptors (ER, 56.1%), progesterone receptors (PR, 57.3%), androgen receptors (AR, 91.5%), or aromatase activity (33.3%) and survival. However, high levels of PR were associated with better survival (P less than 0.05). Furthermore, there was a tendency for patients with advanced disease and PR-positive tumors to have better survival than those with advanced disease and PR-negative tumors (P = 0.13). Patients with tumors that did not contain any of the receptors and those in which ER and AR were absent, or in which PR and AR were absent, had poor survival. It is concluded that receptor status, especially of PR, may be of prognostic importance and that status of receptors and aromatase activity may become useful in selecting ovarian cancer patients for endocrine therapy. PMID- 2703172 TI - Immunocytochemical assays in human endometrial carcinomas: a multiparametric computerized analysis and comparison with nonmalignant changes. AB - Immunocytochemical assay (ICAs) were performed on frozen sections from human endometrial samples (n = 89) including normal endometrium, decidua, hyperplasia with and without atypia, and carcinomas. Monoclonal antiestrogen receptor (ER), anti-laminin (Lam), anti-type IV collagen (Coll IV), and anti-Ki67 were applied with avidin-biotin-peroxidase complex or peroxidase-antiperoxidase complex. The results of the ICAs were evaluated through a computerized system of image analysis referred to as SAMBA. It was shown that this system provided for an accurate reliable and reproducible analysis of ICAs in tissue sections. It is concluded that this multiparametric and standardized method of analysis of ICAs can further be applied in correlations with clinical and biochemical data. PMID- 2703173 TI - Vaginal adenocarcinoma developing in residual pelvic endometriosis: a clinical dilemma. AB - The clinical history of a patient with pelvic adenocarcinoma arising in residual endometriosis is reported. Detailed literature review fails to outline an optimal treatment strategy; however, thoughts concerning staging and treatment are presented. PMID- 2703174 TI - Intracavitary irradiation of endometrial carcinoma stage I by a high dose-rate afterloading technique. AB - Intracavitary irradiation was administered to 366 patients with endometrial carcinoma stage I by a high dose-rate afterloading method using 60Co sources (bulb technique). In 275 cases hysterectomy and bilateral salpingo-oophorectomy were performed 6 weeks later and in 91 cases dilation and curettage was used to verify tumor eradication. In 58% of the hysterectomy specimens no residual carcinoma was detected at the histopathologic evaluation. In the group treated with radiotherapy alone 74% showed no carcinoma remnants in the curettings 3 months after therapy. The effect of the fractionation dose was evaluated in relation to the outcome of the histopathologic examination. The proportion of specimens with no residual carcinoma increased from 27% for the 5 Gy per fraction group to 78% for the 10 Gy per fraction group. Recurrences were recorded in 13% in the hysterectomy group and in 29% in the group treated with radiotherapy alone. The 5-year corrected survival rate for the combination-treated group was 88% and for the group treated with radiotherapy alone 72%. If the dose per fraction is specified in the range of 5 to 8 Gy the high dose-rate afterloading technique seems safe with a tumor control rate and a frequency of radiation reactions comparable to the manual radium method. PMID- 2703175 TI - Preoperative CT study of lymph nodes in cervical cancer--its correlation with histological findings. AB - A study was conducted to retrospectively evaluate the accuracy of abdominopelvic computed tomography (CT) in the diagnosis of paraaortic and pelvic lymph node metastases from carcinoma of the uterine cervix. Seventy patients with a diagnosis of invasive carcinoma of the cervix had preoperative CT of abdomen and pelvis and subsequently underwent a radical hysterectomy with pelvic lymph node dissection and paraaortic lymph node biopsy or an exploratory laparotomy with paraaortic lymph node biopsy. Five of six patients with metastatic paraaortic lymph nodes larger than 15 mm in diameter on the histologic slides were diagnosed by CT scan to have enlarged nodes. CT diagnosis was true-positive in five of seven patients with paraaortic lymph node metastases (71.4%). Two patients with false-positive paraaortic lymph nodes had clusters of small lymph nodes less than 10 mm in diameter on the histologic slides. In contrast, only a small number of the metastatic pelvic nodes were diagnosed by CT as enlarged nodes. CT diagnosis was true-positive in 5 of 11 sites with pelvic lymph node metastases (45.5%). PMID- 2703176 TI - Mammographic localization and biopsy: the experience of a gynecologic oncology group. AB - From 1976 through 1986, two hundred eighty or 9% of all breast biopsies performed by a private gynecologic oncology group were for mammographically suspicious but occult breast lesions. Sixteen percent were found to be malignant. There has been improvement in mammographic techniques, and localization procedures have evolved to the current use of hooked-wire needles, which allow for the excision of smaller amounts of tissue and use of outpatient surgery facilities. Recently, the cancers encountered have been more often carcinoma in situ rather than invasive lesions. With the current increase in mammographic screening, there needs to be a continuing evolution in diagnostic modalities. PMID- 2703177 TI - Hemorheological parameters in patients with gynecologic malignancies. AB - Thromboembolic events account for a significant number of complications during surgical and chemotherapeutic treatment for gynecologic malignancies. Besides changes in the hemostatic system, changes in hemorheological parameters facilitate initiation and promotion of thrombotic disease. We used a rheoaggregometer to determine erythrocyte aggregation and a capillary viscosimeter to evaluate plasma viscosity in patients with gynecologic malignancies at the time of primary diagnosis and during follow-up and compared the results to those for a normal control group. We found a significant elevation in plasma viscosity and erythrocyte aggregation as well as in fibrinogen and globulin concentrations in cancer patients. The extent of this rise was related to the tumor volume. Treatment with cisplatin, doxorubicin, and cyclophosphamide resulted in a further rise in erythrocyte aggregation which is attributed to a direct effect on the erythrocyte membrane. Thus, additional factors contributing to the risk of thrombosis in these patients were defined. Additional administration of rheologically active agents might improve the results of thrombosis prophylaxis. PMID- 2703178 TI - Pelvic radiation therapy for gynecologic malignancy in geriatric patients. AB - Thirty-one patients, aged 75 years or older, who received pelvic radiation therapy as part of primary treatment for a gynecologic malignancy, were reviewed. Ten patients (32%) failed to complete their treatment and 4 patients (13%) died of treatment-related complications. The treatment-related complications were independent of increasing age, but did correlate closely with the patients' pretreatment ECOG performance status. Ten patients with performance levels of 2 or higher had a mortality rate of 30%, while 70% failed to complete treatment. Treatment fractions of greater than 220 cGy per day also resulted in unacceptably high complication rates. Alternative treatment formats should be considered in geriatric patients with poor initial performance levels. PMID- 2703179 TI - Pulmonary metastasis from carcinoma of the uterine cervix. AB - Of 817 patients with carcinoma of the uterine cervix that were treated and followed-up, 50 (6.1%) developed pulmonary metastases. The incidence of pulmonary metastasis was 3.2% in stage I, 5.0% in stage II, 9.4% in stage III, and 20.9% in stage IV disease. The incidence of pulmonary metastasis in patients with adenocarcinoma and undifferentiated carcinoma was higher. Of the patients in whom lung metastases were detected, 41.7% had no symptoms; 96% was diagnosed within 2 years from the initiation of treatment. All patients had abnormal shadows in chest X rays. We recommend that chest X rays be obtained every 2 months within the 8 months after treatment and every 6 months thereafter. Eighty-one percent of the patients had local recurrence or other distant metastatic lesions. The main treatment for these patients was chemotherapy, and CAP was effective for the patients with adenocarcinoma. Surgical resection of the pulmonary lesion may be an effective treatment for the patients who have no lesions in other sites. PMID- 2703180 TI - Use of CA 125 to monitor patients with ovarian epithelial carcinomas. AB - The CA 125 radioimmunoassay has been increasingly used to monitor the course of patients with ovarian epithelial carcinomas. The purpose of this report is to describe our experience in the use of this assay and to better define its clinical utility. Fifty-one patients had serum CA 125 follow-up during primary chemotherapy. All 51 patients demonstrated either a normal CA 125 level at the completion of chemotherapy or a substantial fall in CA 125 values with treatment. In 48 of 51 patients, the drop in CA 125 levels was temporally related to the clinical regression or remission of tumor. Forty of these patients underwent second-look laparotomy; 23 patients (58%) had residual disease. A total of 45 patients had serum CA 125 determinations at the time of second-look laparotomy. Eight patients with microscopic disease and 11 of 18 patients with gross residual disease had a "negative" (less than 35 U/ml) CA 125 level. The predictive value of an elevated CA 125 level was 1.00. However, the predictive value of a negative value was only 0.50. Hence, a negative CA 125 level cannot be a substitute for a second-look laparotomy. Only 7 of 18 patients (39%) with gross residual disease at second-look surgery had an elevated CA 125 level. Patients with an elevated CA 125 and gross residual tumor at the second-look laparotomy uniformly demonstrated large, bulky disease. Furthermore, the survival of patients with gross residual disease at second-look laparotomy correlated with the preoperative CA 125 value. Serum CA 125 determinations also show promise in the follow-up of patients with a negative second-look laparotomy. The serum CA 125 level from patients with a "negative" second-look laparotomy can become elevated months before recurrent disease is appreciated. PMID- 2703181 TI - Predictive value of cone margins and post-cone endocervical curettage with residual disease in subsequent hysterectomy. AB - In 51 of 106 patients (48%) residual disease was identified in hysterectomy specimens performed following cervical conization. Invasive squamous cell carcinoma was found in one patient in spite of clear cone margins. Thirty-nine of sixty-three patients (62%) with cervical intraepithelial neoplasia (CIN) involving the inner (endocervical) margin of the cone biopsy had residual disease. When both the inner margin and post-cone endocervical curettage (ECC) were involved, residual disease was present in 24 of 30 (80%) hysterectomy specimens. When the inner margins of the cone were involved with CIN-III and the post-cone ECC was negative, 36% of hysterectomy specimens contained residual disease compared to 88% when post-cone ECC was positive. These findings indicate that post-cone endocervical curettage has significant predictive value with respect to the presence or absence of residual disease in patients with CIN involving the inner margins of the cervical cone. PMID- 2703182 TI - Value of serum 125Ca levels: does the result preclude second look? AB - Forty-five women with known histories of ovarian cancer underwent reoperative surgery. Thirty-seven patients underwent routine second-look laparotomy and eight patients were reexplored with clinical evidence of disease with the intent of re resection. Preoperative CA 125 levels were obtained. Evaluation as to the predictive value of the CA 125 level and operative findings show a positive predictive value of 100% and a negative predictive value of 54%. Twenty of the forty-five patients had gross disease present on reoperation. Twenty patients were found to have persistent disease at reoperation. Twenty-five percent of patients with CA 125 levels less than or equal to 35 U/ml and 37% of these with CA 125 levels greater than 35 U/ml were resectable to no gross disease at the completion of the reoperation. CA 125 levels greater than or less than 35 U/ml were not predictive of the potential for re-resectability of the tumor. PMID- 2703183 TI - Management of patients with gynecologic cancer by serum sialic acid determination. AB - With an enzymatic technique, serum sialic acid (SA) levels were determined in patients with gynecologic tumors. Since the SA level for healthy females was 57.4 +/- 7.3 mg/dl, we set the upper normal limit of this parameter at 72 mg/dl. The SA level became larger in ascending order of uterine myoma, benign ovarian tumor, cervical cancer, corpus cancer, and ovarian cancer. The SA level proved to be significantly higher in cancer patients showing poor prognosis than in those having good prognosis irrespective of the category of therapy and it reflected well the clinical course of cancer patients. In patients who receive a combination therapy and need to be followed up for a long term, complete follow up is sometimes impossible with tumor-derived markers alone. Even in such cases, the sialic acid level will work as a useful follow-up marker because it is nonspecific to histologic types of cancer. PMID- 2703184 TI - Obstructive ureteropathy following radiation therapy for carcinoma of the cervix. AB - Between January 1959 and December 1986, 10 of 328 patients (3%) treated with curative intent using primary radiation therapy for carcinoma of the cervix developed obstructive ureteropathy due to fibrosis. The mean age of the patients with obstructive ureteropathy was 45 years and the median time to obstruction was 26 months. The obstruction was unilateral in 8 cases and involved the parametrial portion of the ureter in at least 5 cases. No predisposing risk factor was found to be associated with the development of obstructive ureteropathy. After corrective surgery, renal function remained normal in 8 patients, and resolution of the hydronephrosis occurred in 4 patients. PMID- 2703185 TI - Management of lymphocysts after radical gynecologic surgery. AB - Pelvic lymphocysts developed in 3 of 124 patients undergoing radical surgery for cervical cancer. All were managed by percutaneous aspiration under local anesthesia in an outpatient setting. Sclerosis was required in one patient. This management plan is superior to laparotomy in being less morbid and equally effective. PMID- 2703186 TI - Bilateral paraaortic lymphadenectomy in the presence of double inferior vena cava. AB - Three cases of stage IB cervical carcinoma with preoperative diagnosis of double inferior vena cava by CT scan are presented. Its importance during paraaortic lymphadenectomy and the relevant embryology of the inferior vena cava and its major anomalies are discussed. PMID- 2703187 TI - Synchronous carcinomas of endometrium and ovary. AB - Five cases of synchronous carcinomas of uterine endometrium and ovary are reported. All uterine cancers were typical endometrial adenocarcinomas. Among the ovarian cancers, four were serous papillary cystadenocarcinomas and one was an endometrioid carcinoma. There is much controversy with respect to staging and management of such cases since these tumors may represent either two synchronously occurring primaries or a single primary with metastases. It is suggested that when each tumor is confined within the limits of its tissue of origin the tumors may be considered as two separate primaries and surgery may be less aggressive. When there is evidence that at least one tumor is spreading to adjacent tissues and organs the question of two separate primaries or one metastatic tumor becomes academic only and aggressive surgical treatment with adjuvant chemotherapy is indicated. PMID- 2703188 TI - Effect of sodium saccharin and calcium saccharin on urinary parameters in rats fed Prolab 3200 or AIN-76 diet. AB - The effects of the salt form of saccharin and of diet on urinary ion levels have been studied in rats. Sodium saccharin (NaS) or calcium saccharin (CaS) was fed at a level of 5% in either Agway Prolab 3200 diet or AIN-76 diet to male, 5-wk old F344 rats for 10 wk. The AIN-76 diet contained considerably less calcium, sodium and potassium than the Prolab 3200 diet, and smaller amounts of these ions were eliminated over 24 hr in the urine of rats fed the AIN-76 diet. Although food consumption was less in the groups fed AIN-76, total urinary saccharinate ion excretion with either saccharin salt was comparable with, or even higher than, that excreted by rats fed either salt in the Prolab 3200 diet. Rats fed Prolab 3200 eliminated approximately equal amounts of saccharinate ion in the faeces and urine. Rats fed AIN-76 eliminated about 10-20 times as much saccharin in the urine as in the faeces. Total saccharin excretion (faecal and urinary) was not influenced by the salt form. Water intake and urine volume were lower in rats fed control AIN-76 diet in comparison with those fed Prolab 3200, and were increased above the control level in groups fed saccharin in the AIN-76 diet. Urine electrolyte levels and osmolality were lower in the groups fed AIN-76. In general, NaS administration in either diet resulted in increased urinary sodium compared with controls, and the pH was at, or above, the level of control rats. CaS resulted in increased urinary calcium and decreased pH. There were marked diurnal variations in the urinary excretion of the various electrolytes, pH, and urine volume over a 24-hr period in all rats. This diurnal variation was more pronounced in the rats fed the Prolab 3200 diet. These results indicate that NaS and CaS have marked effects on the excretion of urinary electrolytes, and that these effects are influenced by diet. PMID- 2703189 TI - Chronic toxicity/carcinogenicity study of trans-anethole in rats. AB - A chronic feeding study was carried out in rats with trans-anethole. The test substance was administered in the diet to groups (n = 26-78) of 312 male and 312 female Sprague-Dawley rats at concentrations of 0, 0.25, 0.5 and 1% for 117-121 wk. The average intakes of trans-anethole varied from 105-550 mg/kg body weight/day. No apparent treatment-related reactions were noted. The only effect was a transient retardation of body-weight gain. No excess mortality was caused by the treatment. No abnormalities related to treatment were seen on necropsy except for reduced adiposity in the highest dose groups. Haematological assessments did not reveal any changes related to treatment. Histological examination revealed certain non-neoplastic and neoplastic lesions common in older rats. The incidence of some hepatic lesions was significantly higher in some treated groups than in controls: altered cell foci (females of the 1% group), nodular hyperplasia (males of the 0.5% group and males and females of the 1% groups), benign tumours (females of the 1% group) and malignant tumours (females of the 1% group). The results are compared with those of previous investigations. The authors of this study stress that the low incidence of hepatocarcinomas is restricted to a single species and sex and to the highest dose tested. This pattern of species, sex and dose dependency strongly suggests that metabolic and pharmacokinetic studies will be helpful in interpreting the significance of the rat tumours with regard to the safe consumption of trans anethole by man. The changes observed in this chronic feeding study are not thought to be of genetic origin and consequently trans-anethole does not constitute a significant carcinogenic risk to man. Further studies are in progress to substantiate this conclusion. PMID- 2703190 TI - N-nitrosodimethylamine in German beer. AB - A total of 514 beer samples (called 'first samples'), produced in Baden Wurttemberg, FRG, between October and December 1987, were analysed for their N nitrosodimethylamine (NDMA) content. In 302 of the samples NDMA was not detected (less than 0.2 microgram/kg), 191 contained indeterminable traces of NDMA (0.2 less than 0.5 microgram/kg) and 21 samples showed NDMA contents of 0.5 microgram/kg to 1.7 micrograms/kg. The technical threshold value of 0.5 microgram/kg was exceeded by 14 samples. No significant differences in the NDMA content were observed between the different beer types, but beers with a higher malt extract content (strong beer) showed slightly increased average NDMA content. Top fermented pale ale produced from wheat malt showed, as expected, the lowest average NDMA content. For those samples containing greater than 0.5 microgram/kg NDMA an additional sample of the same beer type, but produced some months later (called the 'second sample'), was analysed. The highest content of NDMA found in the second samples was 3.2 micrograms/kg. The average NDMA content of the 514 first samples was 0.16 micrograms/kg and the average daily intake was calculated as 0.1 microgram for men and 0.03 microgram for women. Individual daily intake of NDMA, depending on the amount of beer consumed and the beer type, may reach up to 10 micrograms/person/day. PMID- 2703191 TI - Formation of aliphatic amine precursors of N-nitrosodimethylamine after oral administration of choline and choline analogues in the rat. AB - Trimethylamine and dimethylamine are important precursors of N nitrosodimethylamine, which is a potent carcinogen in a wide variety of animal species. Choline, a component of the normal human diet, is metabolized by bacteria within the intestine to form trimethylamine and dimethylamine. However, animals on a choline-free diet continue to excrete some trimethylamine and dimethylamine, suggesting that other dietary precursors of these methylamines might exist. To determine whether C-N bond cleavage by the intestinal bacteria is specific to the choline molecule, we measured monomethylamine, dimethylamine, trimethylamine and trimethylamine oxide excretion in rat urine after the administration of compounds that shared structural features with choline. Water, choline, dimethylaminoethanol, diethylaminoethanol, phosphocholine, betaine, carnitine, beta-methylcholine or dimethylaminoethyl chloride were administered by orogastric intubation, and the urine was collected for 24 hr. Administration of choline (15 mmol/kg body weight) resulted in increased urinary excretion of dimethylamine, trimethylamine and trimethylamine oxide (increases of approximately twofold, 500-fold and 50-fold, respectively). Of the administered choline, 12% was converted to trimethylamine or trimethylamine oxide and excreted in the urine within 24 hr. Phosphocholine administration resulted in similar increases in dimethylamine, trimethylamine and trimethylamine oxide excretion by rats. Modification of the ethyl-backbone or quaternary amine end of the choline molecule resulted in marked suppression of methylamine formation. Though administration of some analogues of choline (methylcholine, betaine and carnitine) resulted in the formation of small amounts of trimethylamine or trimethylamine oxide, and the administration of others (dimethylaminoethanol and dimethylaminoethyl chloride) resulted in the formation of some dimethylamine, the amounts formed were minimal compared with the amounts of trimethylamine and trimethylamine oxide formed after choline administration. Thus, of the many components of foods, only choline and its esters are likely to be significant substrates for trimethylamine and dimethylamine formation. How then can we explain the persistence of trimethylamine and dimethylamine excretion observed in choline-deficient rats? We suggest that endogenous (non-bacterial) synthesis of trimethylamine and dimethylamine occurs within some tissue of the rat. PMID- 2703192 TI - Evaluation of jojoba oil as a low-energy fat. 1. A 4-week feeding study in rats. AB - The nutritional properties of jojoba oil (JO) were examined in a 4-wk feeding study of rats fed a diet with JO at dose levels of 2.2, 4.5 and 9%, supplemented with a conventional fat up to 18%. General health, survival and food intake were not adversely affected. Body-weight gains showed a dose-related decline, which amounted to 20% of the body weight in the high-dose group of both sexes. Clinical chemistry revealed significantly increased levels of various enzymes that were indicative of cell damage. Haematology showed a dose-related increase in white blood cells. On necropsy an apparent distension of the small intestine was found. Histopathological evaluation revealed marked intestinal changes characterized by massive vacuolization and lipid deposition in the enterocytes, accompanied by distension of the villi and an increased cell turnover of small intestinal cells. Faeces production and faeces lipid content were increased with increasing JO levels. The recovery of JO in the faeces also increased in a dose-related manner and was found to be correlated with the intestinal histopathological changes. The significant adverse clinical and histopathological effects observed in this study imply that JO cannot be considered as a promising alternative dietary fat with a low digestibility. PMID- 2703193 TI - Evaluation of jojoba oil as a low-energy fat. 2. Intestinal transit time, stomach emptying and digestibility in short-term feeding studies in rats. AB - The influence of jojoba oil (JO) incorporation in the diet on stomach emptying and intestinal transit time, and the digestion and absorption of JO were investigated in short-term feeding studies in rats. The animals were fed purified diets containing 18% (w/w) fat, of which half consisted of a mixture of lard and sunflower seed oil (SF) supplemented with an equivalent amount of JO. The control animals were fed a mixture of lard and SF (18%). No treatment-related differences were observed in the rate of stomach emptying or the intestinal transit time. Comparative lipid analysis of lymph, intestinal content, intestinal mucosa and faeces indicated that most of the ingested JO was degraded and absorbed. Part of the JO was present as wax ester in the lymph. Hydrolysis of JO was much slower than that of triacylglycerols and continued in the alimentary tract beyond the small intestine due to bacterial processes. JO did not influence the absorption of the conventional fat. PMID- 2703194 TI - The caffeine contents of non-alcoholic beverages. AB - The caffeine content of a number of non-alcoholic beverages was determined using HPLC. It was found that Diet Coke had a greater caffeine content than Coke (4.15 compared with 3.13 mg/fl oz), Tab is virtually caffeine free, and Lucozade, sold as a tonic, contains more caffeine than any of the other carbonated beverages tested (5.17 mg/fl oz). The pure instant coffee tested contained much more caffeine than the coffee/chicory mixtures (12.61 compared with 3.18 mg/fl oz). The caffeine content of Ceylon tea blends increases with the time the tea is allowed to draw (from about 8 mg/fl oz after 1 min to about 12 mg/fl oz after 20 min). Tea that has been allowed to draw for 20 min has a caffeine content similar to that of pure coffee. PMID- 2703195 TI - Professional qualifications. PMID- 2703196 TI - Homicide in Alabama: an analysis of urban, suburban and rural murders in the Deep South. AB - Eleven hundred forty-four (1144) homicides occurring in Alabama, U.S.A. during a 2-year period are presented and analyzed according to the demographic parameters of the victims, location in urban, suburban, or rural community, type of homicide based on a medical examiner's classification, presence of drugs, weapon employed and other factors. Urban dwellers, Blacks and males are found to be at high risk. Alcohol is much more prevalent than other drugs in homicide victims. Although the handgun is the weapon most commonly used throughout the state, in the rural regions the longgun is used almost as often. The difficulty of making valid comparisons with other homicide studies is discussed and the establishment of a uniform classification of homicides urged. PMID- 2703197 TI - Postmortem stability of some markers of intra-vital wounds. AB - We have studied the diagnostic value of several markers of the intra-vital nature of wounds - cathepsin D (EC 3.4.23.5) and ions (Ca, Mg, Cu, Zn and Fe) - after the influence of putrefaction. For this purpose, we have inflicted vital wounds to six pigs, which were killed 20 min later. Ten minutes after death, wounds were excised with 5-6 cm of skin around the incision and maintained at three different temperatures (4, 18 and 28.5 +/- 13.4 degrees C). After varying periods of postmortem interval from 0 to 48 h, aliquots of each wound were taken and analyzed with atomic absorption spectrophotometry for ions and with UV spectrophotometry for cathepsin D. Our results demonstrate that ions conserve their diagnostic ability to differentiate vital from postmortem wounds after the influence of putrefaction. Nevertheless, cathepsin D does not show this ability in these experimental conditions. PMID- 2703198 TI - Death due to dextropropoxyphene: Copenhagen experiences. AB - A review of 323 fatal poisonings with dextropropoxyphene is presented. The falling tendency of the poisoning in question and the National Board of Health's attention towards it are discussed. PMID- 2703199 TI - Fatigue in multiple-car fatal accidents. AB - In a re-examination of 334 fatal multiple car accidents, without any reasonable explanation besides possible intoxication, 205 drivers were found responsible for the accident. Twenty-one of these accidents happened between midnight and 0600 h and 11 of the drivers were found to be intoxicated with a blood/alcohol content (BAC) of more than 0.080%. The remaining 184 accidents took place during the rest of the day and 55 drivers were intoxicated. By comparing this apparent over representation of intoxicated drivers in night-time accidents with that of a control group of no less than 15,923 drivers, it was possible to convert this over-representation into an under-representation. This decline in accidents while under influence seems to indicate another human accident factor specific to night time traffic. It is concluded that fatigue is an overlooked but most obvious cause of otherwise unexplainable accidents in the night-time traffic. PMID- 2703201 TI - [AIDS in East Germany. Unnecessary anxiety]. PMID- 2703200 TI - Injuries due to deliberate violence in areas of Denmark. I. The extent of violence. AB - As part of a transcultural investigation of violent behavior in Denmark and South America an analysis was made during a one year period of the incidents involving deliberate violence as registered at 3 Danish emergency wards, and at the Institute of Forensic Medicine in Copenhagen. In the three emergency wards a total of 1316 victims of deliberate violence were observed corresponding to a rate of about 3.3/1000 per year in a provincial/rural district, the catchment region of Holbaek County Hospital, 5.5/1000 per year in a mainly middle income area of the metropolis Copenhagen, the catchment region of Frederiksberg Hospital, and 7.6/1000 per year in a mainly low income area of Copenhagen, the catchment region of the Rigshospital. The highest risk, 28/1000 per year, was found for young men between 15 and 19 years of age living in the low income area of Copenhagen. The risk was low for people greater than or equal to 60 years of age in all three areas investigated, ranging from 0 (men) to 1.3/1000 per year (women). Skilled and unskilled workers were greatly over represented as victims of violence, considering their share of the background population. Seventy percent of the victims were men. At least 44% of the men and 32% of the women were alcohol intoxicated when arriving in the emergency ward. The incidents took place in restaurants or in the vicinity of restaurants for 30% of the male and 11% of female victims respectively, while 45% of the women had been subject to deliberate violence at home. The rate of fatal cases of deliberate violence in the Eastern part of Denmark, the catchment area for the Institute of Forensic Medicine in Copenhagen, was found to be 0.02/1000 per year. The risk of becoming a victim of deliberate violence has not increased during the last 4 years comparing with similar investigations from other parts of Denmark. However, the rate of homicide seems to have increased, and so has the severity of the injuries caused by deliberate violence. The pattern of deliberate violence appears to be associated with socio-economic and cultural factors, and to be closely linked with alcohol intoxication. PMID- 2703202 TI - [AIDS: social dimension should not be ignored]. PMID- 2703203 TI - [Capsular ligament lesions of the knee joint. Conservative and surgical treatment]. AB - On the basis of our experience with more than 600 reconstructed capsular ligament injuries of the knee joint, we conclude that conservative functional treatment should be preserved for patients with capsular ligament lesions with no loss of stability. On an individual basis, it must be decided whether, in the event of a more or less large degree of instability presenting, conservative mobilising treatment (patients older than 45 years), or surgical reconstructive treatment should be provided. Surgical procedures aim at achieving anatomical reconstruction, which is only approximately possible with secondary reconstruction in the presence of chronic instability. For the reconstruction of the anterior cruciate ligament, the use of the semitendinosus tendon for reinforcement with possible reattachment of the cruciate ligament can be recommended. Otherwise, the free patellar ligament transplant, as far as possible with additional synovialisation--which permits better revitalisation of the ligament--should be employed. PMID- 2703204 TI - [The value of knee joint orthoses in performance sports]. AB - Commercial limited-motion braces are now being propagated both for prophylaxis and treatment of traumatic knee instabilities. This article presents a general classification of braces used in sports medicine and discusses their effectiveness and indication criteria. PMID- 2703205 TI - [Gastrointestinal diseases: patients ask the expert]. PMID- 2703206 TI - [AIDS: trend for early treatment. Diagnostic progress--model project for children -antiviral therapy]. PMID- 2703207 TI - ["A new quality of compliance." Dr. med. Jan Oudhof, Gouda, on the concept of Holland work with heart groups]. PMID- 2703208 TI - [Arterial oxygen saturation--a new principle in intensive care monitoring? Many patients are hypoxic in the postoperative period--a simple assessment procedure in clinical use]. PMID- 2703209 TI - HHS boosts funds for outcomes research. PMID- 2703210 TI - How one hospital survived 115 years of deficit. PMID- 2703211 TI - Tapping into patient bill aids quality efforts. PMID- 2703212 TI - Researchers respond to hospitals' plastic needs. PMID- 2703213 TI - Move afoot to make computers talk to each other. PMID- 2703214 TI - Employee hotline: CEOs act to solve labor shortages. PMID- 2703215 TI - Bucks for behavior: hospitals get innovative. PMID- 2703216 TI - JCAHO confidentiality undergoes public scrutiny. PMID- 2703217 TI - Rockford merger: all in favor, say nay. PMID- 2703218 TI - Managed mental health moves inpatients out. PMID- 2703219 TI - Popularity, but not profit, marks FP specialty. PMID- 2703220 TI - Marketers and CFOs: bridging relationship gaps. PMID- 2703221 TI - Dependent health care: employers' highest bill. PMID- 2703222 TI - Premiums in the '80s: a roller-coaster climb. PMID- 2703223 TI - Personal questions plague women on way to top. PMID- 2703224 TI - Central nervous system lymphomatoid granulomatosis in AIDS? PMID- 2703225 TI - Application of molecular biology to forensic pathology. PMID- 2703226 TI - Splenic marginal zone lymphocytes and related cells in the lymph node: a morphologic and immunohistochemical study. AB - The marginal zone of the spleen contains a well-defined population of lymphocytes with an unknown function. The question is whether this cell population is unique to the spleen or is it also present in the lymph node. These cells have medium sized nuclei and a moderate amount of cytoplasm. Immunohistochemistry and enzyme histochemistry revealed a marker pattern by which these cells could be distinguished from the lymphocytes of the mantle zone of the spleen: IgD-, CD23-, KiB3-, and alkaline phosphatase+. In the lymph node, the outer side of the follicular mantle contains a subpopulation of B lymphocytes with a similar morphology and the same marker pattern. This subpopulation differs from the marginal zone cells in the spleen in that it does not form a distinct zone. These cells are especially prominent in lymph nodes with fatty atrophy. Their relationship to other subpopulations of B lymphocytes and to malignant lymphomas is evaluated but remains questionable. PMID- 2703227 TI - Lymphomatoid granulomatosis and malignant lymphoma of the central nervous system in the acquired immunodeficiency syndrome. AB - While primary and secondary malignant lymphomas have been well-documented in the CNS of patients with the acquired immunodeficiency syndrome (AIDS), only one case of lymphomatoid granulomatosis (LG) involving the CNS has been reported. We present three AIDS patients with multiple grossly evident foci of necrosis in the cerebral hemispheres which, on histologic evaluation, were seen to contain angiocentric mixed chronic inflammatory infiltrates with atypical mononuclear cells, luminal thrombosis, and infarction, which is typical of LG. LG was also identified in sections of the lung in one case. Lymphoma was found in other regions of the brain in two cases, suggesting the evolution of LG into cerebral lymphoma. In addition, widespread perivascular multinucleate syncytial giant cells, associated with human immunodeficiency virus (HIV) infection of the CNS, were identified in all patients. The features of LG, its relationship to lymphoma, and the possible etiologic role of an immunodeficiency state or the HIV virus in the pathogenesis of LG are discussed. PMID- 2703228 TI - Typical, dysplastic, congenital, and Spitz nevi: a comparative immunohistochemical study. AB - Nevus cell components have been observed in up to 40% of melanomas, but little is known of the pathobiology of these components in relation to their malignant potential. We studied 44 nevi of the typical, dysplastic, congenital, and Spitz types with a battery of monoclonal and polyclonal antibodies that react on formalin-fixed, paraffin-embedded tissues (HMB.45, S-100 protein, RAP-5, epithelial membrane antigen [EMA], and neuron-specific enolase [NSE]) by avidin biotin immunohistochemical methods. EMA and RAP-5 (which detects the ras oncogene associated P21 protein) were negative in all cases. Melanoma-specific HMB.45 was strongly reactive with the epidermal component and had a weak to negative reaction with the dermal component in the typical nevi. However, the reaction seen with HMB.45 in the junctional component of dysplastic nevi, congenital nevi, and some Spitz nevi was heterogeneous. One Spitz nevi showed HMB.45 staining in a pattern near to that of melanoma. In contrast to HMB.45, S-100 protein labeled nevomelanocytes, regardless of whether they were within the epidermis or dermis, although, in half of the dysplastic nevi, the reaction was heterogeneous, with some atypical cells failing to stain. But, with cytologically atypical junctional component (dysplastic-appearing), congenital nevi also stained heterogeneously for S-100 protein compared with the dermal component. NSE stained the central component of some Spitz nevi more intensely than the lateral component. Junctional nevomelanocytic subsets of some congenital nevi revealed HMB.45 and S 100 reactivity similar to dysplastic nevi. PMID- 2703229 TI - Shrinking pleuritis with lobar atelectasis, a morphologic variant of "round atelectasis". AB - Round atelectasis (shrinking pleuritis) is typically a localized process characterized by focal pleural scarring and subjacent peripheral atelectasis. We report three patients, studied at autopsy, with an unusual variant of round atelectasis, termed shrinking pleuritis with lobar atelectasis, which is characterized by lobar atelectasis, visceral pleural fibrosis involving multiple lobes, interlobar fibrous cords, pleural effusion, and nonspecific, persistent infiltrates on chest radiogram. The possible causes of shrinking pleuritis with lobar atelectasis in our patients were multiple and included environmental dust exposure, infection, uremia, and recurrent pleural effusions. Our findings support both the folding (pleural effusion) and fibrosing (pleural injury) theories of pathogenesis of round atelectasis and emphasize the spectrum of morphologic variability in this condition. PMID- 2703230 TI - Intracranial trigeminal nerve rhabdomyoma/choristoma in a child: a case report and discussion of possible histogenesis. AB - Rhabdomyomas are rare tumors that usually arise within the heart, orocervical, or vulvovaginal regions. The cardiac tumors have a characteristic immature morphology, occur often in association with tuberous sclerosis, and are regarded as hamartomas rather than true neoplasms. The histogenesis of the extracardiac tumors and their true neoplastic nature are matters of controversy. We report the first case of a rhabdomyoma located inside the cranium. The intimate association with the mandibular division of the trigeminal nerve, the normal embryogenesis of the craniofacial muscles, and animal homograft and xenograft experiments provide a framework for considering this tumor, and possibly other rhabdomyomas, as a choristoma/hamartoma rather than a true neoplasm. PMID- 2703231 TI - Two cases of obstructive jaundice secondary to hamartomatous cystic changes in the bile ducts. PMID- 2703232 TI - Genotyping of mitochondrial aldehyde dehydrogenase in blood samples using allele specific oligonucleotides: comparison with phenotyping in hair roots. AB - Deficiency of mitochondrial aldehyde dehydrogenase (ALDH I) is an inborn error of metabolism that is responsible for acute alcohol sensitivity (flushing response) observed only in Orientals of Mongoloid origin. Our previous studies using electrophoretic enzyme detection have shown that this deficiency is prevalent among Japanese, Chinese, and other Orientals. We report here the genotyping of ALDH I locus in blood samples of 218 South Korean individuals by means of hybridization analysis with allele-specific oligonucleotide probes and enzymatically amplified human genomic DNA. The results of genotyping are compared with the phenotype analysis in hair roots of the same individuals. Among 62 apparently deficient phenotypes, 58 heterozygote and 4 homozygote deficient genotypes were observed. PMID- 2703233 TI - Myotonic dystrophy is closely linked to the gene for muscle-type creatine kinase (CKMM). AB - We have studied genetic linkage between the gene for creatine kinase muscle type (CKMM) and the gene for myotonic dystrophy (DM). In a panel of 65 myotonic dystrophy families from Canada and the Netherlands, a maximum lod score (Zmax) of 22.8 at a recombination frequency (theta) of 0.03 was obtained. Tight linkage was also demonstrated for CKMM and the gene for apolipoprotein C2 (ApoC2). This establishes CKMM as a useful marker for myotonic dystrophy. PMID- 2703234 TI - Fragile sites and statistics. AB - A simple and reliable statistical method is proposed to distinguish real fragile sites from the casual accumulation of aberrations that can occur as a consequence of random distribution. It is based on a study of the expected random distribution, assumed to be equal to a Poisson distribution, with the expected value of events per band as the mean. PMID- 2703235 TI - A severe autosomal recessive acromesomelic dysplasia, the Hunter-Thompson type, and comparison with the Grebe type. AB - Two siblings with a short-limb dwarfing condition which we call acromesomelic dysplasia, Hunter-Thompson type are reported. Abnormalities are limited to the limbs and limb joints in this severe form of dwarfism. The middle and distal segments of the limbs are most affected. The lower limbs are more affected than the upper. We are aware of one previously published case of this entity reported by A. G. W. Hunter and M. W. Thompson in 1976. Dislocations of the elbows and ankles were present in all three patients and dislocations of the hips and knees in two. One of the siblings who did not have hip and knee dislocations clinically resembled Grebe chondrodysplasia, another severe acromesomelic dwarfing condition. However, radiological analysis suggests that while acromesomelic dysplasia, Hunter-Thompson type and Grebe chondrodysplasia are related, they are not identical. Grebe chondrodysplasia has been established as an autosomal recessive trait. It appears probable that the entity we describe has the same mode of genetic transmission. PMID- 2703236 TI - Investigations of chorionic villi after chorionic villus sampling (CVS). Correlation of morphological with clinical and laboratory data. AB - This report documents the first 262 cases of chorionic villus sampling (CVS) performed in parallel with cytogenetic and morphological investigations. Histomorphological examination of these CVS specimens gave suitable results in about 96% (251 cases). Of the latter, 201 samples (80.1%) exhibited villi and 176 (70.1%), maternal tissue. Viability and maturation of the chorionic villi were determined light microscopically even in cases with few villus trees. Smooth avascular villi with poorly defined margins observed under an inverted microscope, less than 10 mitoses after short-term incubation, and reduced growth of cell cultures were significantly correlated with sampling at the chorion laeve by means of histomorphologic criteria. Villi from cases exhibiting cytogenetically proved chromosomal abnormalities were characterized by molar degeneration or stromal fibrosis, or both, in 4 out of 9 cases, including 3 mosaics. In early abortions (within 3 weeks after CVS), an unexpectedly high rate of pathohistological changes within maternal tissue was evident. These results need further confirmation by investigation of a greater number of samples with immunohistochemical and morphometric methods. PMID- 2703237 TI - Localization of human c-mos to chromosome band 8q11 in leukemic cells with the t(8;21) (q22;q22). AB - Chromosome in situ hybridization studies locate c-mos to chromosome band 8q11 in leukemic cells carrying the t(8;21) (q22;q22). This amends the previous assignment of c-mos to chromosome band 8q22 and conforms with its recent assignment to 8q11 in normal cells and in a cell line with a structurally abnormal chromosome 8. C-mos lies proximally to, and distant from, the breakpoint at 8q22 in the t(8;21) and is unlikely to have a role in the onset of acute myeloid leukemia characterized by this translocation. PMID- 2703238 TI - Detection of single-copy genes by nonisotopic in situ hybridization on human chromosomes. AB - A technique of in situ hybridization on metaphase chromosomes with biotinylated DNA probes is described. This technique was used to localize unique DNA sequences on chromosomes and allowed a localization of two probes 1.8 and 1.3 kb long. The hybridization signal appears like two, twin, spots on the two sister chromatids, allowing a clear distinction from the background. Moreover a chromosomal localization is possible by counting a relatively small number of mitoses compared with the technique using 3H-labeled DNA probes. PMID- 2703239 TI - Molecular genetic diagnosis of sickle cell disease using dried blood specimens on blotters used for newborn screening. AB - The protein-based technologies used to screen newborns for sickle cell disease require confirmation with a liquid blood specimen. We have developed a strategy for rapid and specific genotypic diagnosis using DNA extracted from a dried blood spot on the filter paper blotter used to screen newborns. DNA could be microextracted from a specimen as small as a 1/8 inch diameter punched disc representing the dried equivalent of approximately 3 microliters of whole blood. We utilized the DNA from a 1/4 inch diameter specimen (12 microliters equivalent) for polymerase chain reaction amplification of the beta-globin region spanning the sickle cell mutation with detection by allele-specific oligonucleotide probes. Molecular confirmation of genotype from the original blotter would reduce the personnel costs associated with obtaining follow-up liquid blood specimens and would provide information to the family in a more timely and less equivocal manner. PMID- 2703240 TI - Cytogenetic analysis of in vitro fertilization (IVF) failures. AB - Cytogenetic studies were carried out on 150 oocytes obtained in a human in vitro fertilization (IVF) program. Although all cells lacked signs of fertilization at light microscopy, 46 (30.7%) appeared to show cytological evidence of fertilization. At least one-third of these cells (with development arrested before first cleavage) had chromosomal aberrations. An aneuploidy rate of 35% was found in unfertilized oocytes. The results of this study explain some of the fertilization failures and of the failures of postfertilization development. PMID- 2703241 TI - Mutation analysis of beta-thalassemia genes in a German family reveals a rare transversion in the first intron. AB - Thalassemia major is a rare disorder in the German population. We describe here the characterization of the beta-globin genes of a German patient homozygous for beta-thalassemia. Gene cloning and sequencing revealed a G to T transversion at the intron 1 donor site of the beta-globin gene on both chromosomes. PMID- 2703242 TI - Induction of the fragile X on BrdU-substituted chromosomes with direct visualization of sister chromatid exchanges on banded chromosomes. AB - After incorporation of BrdU for one or more replication cycles, the fragile site at Xq27 [fra(X)] was induced by a late pulse with excess thymidine (dT), resulting in the simultaneous visualization of G bands and differentially stained sister chromatids. The degree of BrdU substitution (uni- vs bifilarly substituted DNA) did not affect the expression of hte fra(X). Without addition of dT, expression was the same in M1, M2, and M3 cells. With the addition of dT, expression was reduced in M1 cells and increased in M2 and M3 cells. One way to explain this fact would be an increased repair of the fragile site in M1 cells by illegitimate G:BrdU pairing under dCTP-deficient conditions. A preferential depletion of M3 cells, and to a lesser extent also M2 cells, could suggest a synergistic toxic effect of BrdU substitution and dCTP depletion. With this technique, sister chromatid exchanges (SCEs) could be directly localized at band level, facilitating a more detailed study of SCEs at the Xq27 fragile site. PMID- 2703243 TI - Regional localization and molecular characterization of a DNA sequence on the long arm of chromosome 22. AB - A human genomic DNA fragment, p22hom13 (D22S16), was isolated from a chromosome 22-specific library. After elimination of repetitive sequences, a single copy BamHI-EcoRI fragment was subcloned into pTZ18. By using mouse/human somatic cell hybrids and in situ hybridization, the new DNA probe was mapped to chromosome 22q13-qter. Its application in the analysis of the distal part of chromosome 22 and its diagnostic use in translocations are discussed. PMID- 2703244 TI - Segregation frequency in microcephaly. AB - A total of 118 cases of microcephaly were clinically evaluated under two main groups: primary microcephaly (61 cases) and secondary microcephaly (57 cases). Secondary cases were generally characterized by convulsions, spasticity, and other congenital anomalies. Estimates of segregation frequency obtained separately in primary and secondary cases indicated that the primary consanguineous cases were most probably due to a single recessive gene. The segregation frequency was substantially less in other types, indicating much lower genetic risks in these cases. PMID- 2703245 TI - Medical/surgical floors--a special challenge. PMID- 2703246 TI - A day at ANA. PMID- 2703247 TI - Responding to the AIDS epidemic. PMID- 2703249 TI - Making tough decisions in HIV care. PMID- 2703248 TI - AIDS: its impact on nursing education and practice. PMID- 2703250 TI - Teaching safer sex: a nursing intervention in the AIDS epidemic. PMID- 2703252 TI - Spiritual care: the forgotten need. PMID- 2703251 TI - Practicing safer sex. PMID- 2703253 TI - The gift of life. PMID- 2703254 TI - Subpopulations of lymphocytes in the mammary gland of sheep. AB - The subpopulations of lymphocytes in the pregnant and non-pregnant mammary glands of the sheep were delineated by a panel of monoclonal antibodies. The most striking feature observed was that in the mammary gland of both pregnant and non pregnant sheep the great majority of the lymphocytes in the ductal and alveolar epithelium were agranulated CD8+ CD5- cells. A small subpopulation of granulated lymphocytes in the epithelium expressed the CD45R antigen but not the major histocompatibility complex (MHC) class II molecules. Other subpopulations, especially B lymphocytes, were present in much lower concentrations and were located mainly in the periductal and intralobular connective tissues. Patches of lymphocytes clustering around venules were observed and the majority of them were shown to be CD5+ CD4+, while some were CD5+ CD8+ but none were CD45R+ (B cell). It is suggested that selective traffic of T cells occurs at these sites. PMID- 2703255 TI - The immunological consequences of feeding cholera toxin. I. Feeding cholera toxin suppresses the induction of systemic delayed-type hypersensitivity but not humoral immunity. AB - Immunization of adult BALB/c mice with 1 microgram cholera toxin (CT) in complete Freund's adjuvant (CFA) induced both humoral (IgG and IgA) and cell-mediated (DTH) immunity. Although an immunopurified, formalinized, cholera toxoid (TD) in CFA was inferior to the native holotoxin at inducing antitoxin antibodies, both cholera-derived antigens were equally immunogenic for specific DTH. When mice were fed either 1 microgram CT or 5 microgram TD 1 week before immunization, the induction of DTH was inhibited but the development of specific antibody was the same as in sham-fed controls. A feed of 10 micrograms CT not only suppressed the induction of DTH but also enhanced the IgG antitoxin responses measured 1 week after immunization. A dose of TD (50 micrograms), with a similar cholera toxin B subunit content, also induced oral tolerance for DTH but had no effect on the subsequent development of humoral immunity. The smallest doses of CT or TD fed (0.1 microgram and 0.5 microgram, respectively) failed to affect the development of either limb of the systemic immune response. These results suggest that oral tolerance for DTH is not consequent upon the metabolic actions of CT but that stimulation of systemic antibodies after enteric administration may be. Pretreating mice with cyclophosphamide (Cy) (100 mg/kg) before feeding CT abrogated the induction of oral tolerance for DTH but had no effect on humoral immunity, suggesting that suppressor T cells may be responsible for the induction of oral tolerance in these animals. PMID- 2703256 TI - A study on type II collagen-induced arthritis in allogeneic bone marrow chimaeras. AB - In the present investigation, the incidence, day of onset and severity of type II collagen (IIC)-induced polyarthritis (CA) in allogeneic bone marrow chimaeras were compared. These chimaeras were prepared by using reciprocal combinations between DBA/1J (H-2q, Igh-1c, Hc1), which are highly susceptible to CA, and SWR/J (H-2q, Igh-1c, Hc0), which are CA resistant, strains of mice. The four kinds of chimaeras, [SWR----DBA/1], [DBA/1----DBA/1], [DBA/1----SWR] and [SWR----SWR], were shown to be full chimaeras. [SWR----DBA/1] and [DBA/1----DBA/1] chimaeras showed serum C5 antigens and most of these mice developed CA, even though severity of CA in [SWR----DBA/1] chimaeras was less than that in [DBA/1----DBA/1] syngeneic chimaeras. By contrast, [DBA/1----SWR] and [SWR----SWR] chimaeras completely lacked serum C5 and did not develop CA at all. However, most of these chimaeras produced considerable total IgG and IgG2a antibodies to IIC in the sera after immunization with the antigens, although differences in the serum levels of IgG2a antibodies were seen between [SWR----DBA/1] and [DBA/1----SWR] allogeneic chimaeras. The present results demonstrate directly a crucial role of complement cascade in the induction and development of CA and reveal that lymphoid cells of SWR mice potentially have the ability to develop CA. Differences in severity of the CA observed in some of these chimaeras, however, could not be readily explained by differences in C5 concentrations alone. PMID- 2703258 TI - The role of macrophages in the immunoadjuvant action of liposomes: effects of elimination of splenic macrophages on the immune response against intravenously injected liposome-associated albumin antigen. AB - The primary antibody response to intravenously administered and liposome associated human serum albumin (HSA) was studied in mice under conditions where no response could be detected against the non-liposome-associated form of the antigen. The positive response against the antigen, entrapped in and/or exposed on the surfaces of liposomes, thus resulted from the adjuvant action of the liposomes. In mice intravenously injected with dichloromethylene diphosphonate (C12MDP) also entrapped in liposomes, all red pulp macrophages, marginal metallophilic macrophages and marginal zone macrophages had disappeared from the spleen 2 days after administration. Twenty-two days after such a treatment red pulp macrophages and marginal metallophilic macrophages had reappeared, but marginal zone macrophages were still absent. In mice injected with liposome associated HSA at 2 days after treatment with the C12MDP liposomes, anti-HSA responses were severely depressed, but administration of the liposome-associated antigen 22 days after C12MDP liposomes elicited a normal response. These results point to a role of splenic macrophages in the processing of liposome-associated antigens, but marginal zone macrophages, which are located close to the open ends of the white pulp capillaries and thus are the first macrophages to meet the antigens arriving in the marginal zone are not required. PMID- 2703257 TI - Presence of tumour necrosis factor or a related factor in human basophil/mast cells. AB - The observation that mast cell products and cachectin/tumour necrosis factor (TNF) mediate similar responses suggested an investigation of cultured human basophil/mast cells for production of TNF. Using in situ hybridization and the avidin biotin-complex (ABC) immunoperoxidase method, we have demonstrated the presence of TNF mRNA in the cytoplasm and TNF protein in the granules of individual human basophil/mast cells. The production of TNF by these cells could explain many of their reported functions. PMID- 2703259 TI - An unexpectedly labile mitochondrially encoded protein is required for Mta expression. AB - Maternally transmitted antigen (Mta) is a mouse major histocompatibility antigen recognized by cytotoxic T lymphocytes. A role for mitochondria in expression of this class I-like cell surface antigen has been previously established. We now show that a labile product of mitochondrial protein synthesis is required for Mta expression. Reexpression of Mta determinants after enzymatic removal occurred within 24 h, and the regeneration process was sensitive to chloramphenicol (CAP), a selective inhibitor of mitochondrial protein synthesis. Additionally, target cells treated with CAP for as little as 18 h showed diminished expression of Mta. The estimated half-life for Mtf products ranged from 6 to 15 h, less than the half-lives of known mitochondrial translation products. This suggests that the Mtf product is not generated by the normal turnover of stable mitochondrial respiratory proteins. Instead, these results indicate the existence of either labile unknown mitochondrially encoded peptides or a rapid turnover pathway for known mitochondrial products. PMID- 2703260 TI - Transfected H-2Kb gene as a cause of embryonal carcinoma cell rejection in vivo. PMID- 2703261 TI - Endodontics and litigation: an American perspective. AB - Dentists can reduce the risk of legal entanglements following endodontic treatment. Dentists should not fail to meet the standard of care required at one or more of the several stages in endodontic treatment: at diagnosis, in record keeping, by accidentally treating the wrong tooth, by not using rubber dam, by breaking endodontic instruments in the root canal, by using inappropriate endodontic implants, by creating root perforations, by failing to give adequate instructions for home care and by not providing emergency care. Recognition of problems likely to rise to litigation and the methods to be used in their avoidance are emphasized. PMID- 2703262 TI - The electronic journal for dentistry. AB - Electronic publishing is expanding very rapidly and will soon substitute in part for the traditional role of paper and printing in accessing information and in its library storage. This change is occurring now for medicine and engineering. For dentistry the compact disc (CD-ROM) would have advantages over tape or on line computer systems; one or two discs a year could hold all current dental journal and textbook literature. The setting of standards is the key to the successful introduction of this technology through production and playback systems. Indexing, retrieval and hardware are considered as well as copyright problems. The profession has the chance to guide the introduction of this publishing system in preference to it being fragmented between multiple publishers and thereby becoming costly. A proposal is offered which includes the nexus of traditional printing with this new publishing form through a forum for considering standards and goals for agreement on principles. PMID- 2703263 TI - Computerized target marketing in dentistry: a personal view. AB - As anxiety over dental treatment diminishes and the mode of its provision changes, the recipient will exercise much greater judgement in choosing both provider and treatment modality. Similarly, the dentist will seek a segment of the community whose needs can be met and with whom there will be personal affinity. Segmented target marketing aims to match the professional and personal attributes of the dentist with a compatible population group. The computer is an essential tool in the process. A computer-based approach to market segmentation is presented. PMID- 2703264 TI - Reaching out to the community: the activities of the FDI-WHO Joint Working Group 10 on Periodontal Health Services. AB - Improving access to oral health care by reaching out to the community is demonstrated in the projects of the Joint FDI-WHO Working Group 10 on Periodontal Health Services. Members and associates of this Group conduct health services research in field projects in twelve countries around the world. An overview of important issues is presented on behalf of this Group. The first step in reaching out to the community is to increase awareness about oral health and oral diseases among the public in general and the individual as the potential patient. However, it has been demonstrated, and this must be remembered, that increasing awareness within the profession, on for instance preventive periodontics, is sometimes even more important. In some countries with government-controlled health services the prime targets for increasing awareness are health service administrators and political decision makers. Reaching out to the community requires the concerted efforts of the dental (and medical) profession, community leaders and health administrators. Evaluation of the impact is most important. There are, of course, numerous potential benefits for society and the individual. There are also examples of benefits for governments, health professionals professional organizations. PMID- 2703265 TI - Premedication in dentistry. Federation Dentaire Internationale Technical Report No. 32. PMID- 2703266 TI - Forty years of research--its impact on dental practice. AB - With the multiple use of fluorides the philosophical basis of dental practice shifted from the restoration of the dentition to the prevention of the initiation of dental disease. In the United States, the profound impact on caries in children, with 50 per cent of the 5-17 year olds caries-free, has changed the relative distribution of the various dental services and the pattern of dental care. The child orientation has been superceded by greater attention to the restorative and other needs of the middle-aged and geriatric population. The research-generated insights into the role of plaque in the periodontal diseases and the wide-scale efforts to improve oral hygiene via plaque control have resulted in a marked reduction in gingivitis and manageable levels of periodontis in the employed population below the age of 65. More advanced disease can be treated more effectively because of new diagnostic procedures and new technologies as well as the use of anti-bacterial and anti-inflammatory agents. Major research advances in oral biology, oral medicine and oral diagnosis have extended both the depth and breadth of preventive dental practice. The scope of preventive dentistry now goes well beyond caries and periodontal disease to include: (1) injury, oro-facial defects, malocclusion and temporomandibular joint dysfunction; (2) oral mucosal lesions; (3) systemic diseases with oral manifestations and (4) hazards associated with dental practice. Dentistry is now being practised with an ordered set of priorities. PMID- 2703267 TI - A case-control study of multiple myeloma nested in the American Cancer Society prospective study. AB - Among the subjects enrolled in the American Cancer Society Cancer Prevention Study II, a large nation-wide prospective study, 282 died from multiple myeloma (MM) during the first 4 years of follow-up. These were divided into incident cases who were initially free from disease and prevalent cases who reported MM or related symptoms at the time of enrollment. For each case, 4 controls matched for age, sex, ethnic group and residence were randomly selected. Previous history of diabetes [odds ratio (OR) = 2.0] and employment as farmer (OR = 2.7) were the risk factors consistently suggested by the results of the analysis. The risk associated with farming showed a linear trend with duration of exposure. Pesticide or herbicide exposure was not a risk factor per se but, when combined with farming, it increased the OR to 4.3. Low education, occupational exposure to dyes, and employment in a bank, on the railroad or as a maid were also suggested risk factors, but either they were not statistically significant or they were based on small numbers of exposed subjects. No association between MM and asbestos exposure was observed. PMID- 2703268 TI - Altered restriction pattern of the putative DNA binding domain of estrogen receptor or related genes in primary human meningiomas. AB - We analyzed by restriction mapping the genomic organization of the estrogen receptor gene in several primary human brain tumors in order to investigate the possible relationships between the development of these tumors and gonadal steroid hormones. In 5 out of 23 meningiomas the Eco RI restriction of genomic DNAs revealed 6 invariant normal fragments of 6.5, 4.8, 3.8, 3.1, 2.7 and 1.7 kb, plus 2 additional variant fragments of either 8.6 or 2.5 kb. More detailed analysis showed that these variant bands hybridized with a probe specific for the middle region of the estrogen receptor cDNA, coding for the DNA-binding domain of the receptor. This abnormal restriction pattern was found only in these meningiomas and not in other brain tumors or DNAs obtained from peripheral blood lymphocytes. PMID- 2703269 TI - The influence of parity and exogenous female hormones on the risk of colorectal cancer. AB - Evidence that female sex hormones may play a role in the subsequent development of colorectal cancer has accumulated from time trends in colorectal cancer rates and from epidemiologic studies. Using data available from the Cross Cancer Institute Northern Alberta Cancer Program, the relationship of parity, exogenous hormones and colorectal cancer was evaluated. Five hundred and twenty-eight colon cancer and 192 rectal cancer cases were identified and 349 nonendocrine cancers were selected as controls. All subjects were diagnosed and interviewed between 1969 and 1973. Protective associations between previous pregnancies and colorectal cancer were found in women over age 50 at diagnosis (OR = 0.5, 95% CI = 0.3-0.9) and in women who never used exogenous hormones (OR = 0.3, 95% CI = 0.2 0.7). Results from this study provide additional support for earlier suggestions that parity may have a protective effect against the development of colorectal cancer, similar to the effects reported in the case of breast, endometrial and ovarian tumors. PMID- 2703270 TI - Milk drinking, other beverage habits, and lung cancer risk. AB - The reported beverage habits of 569 lung cancer patients and 569 control patients admitted to Roswell Park Memorial Institute (RPMI) were studied, 355 male cases and 214 female cases being matched to controls within strata of age and residence. Smoking history and an index of vitamin A from vegetables had significant, dose-response associations with risk. Animal fat intake as measured by an index of animal fats from meats showed elevated risks which were not significant. Three vegetables rich in vitamin A and 3 meats contributing to the animal fat index were, individually, associated with lung cancer risk. Frequency of consumption of milk, coffee, tea, soft drinks and alcoholic beverages was studied in multiple logistic regression analyses which controlled for smoking history, intake of vitamin A from vegetables and education level. Subjects reporting consumption of whole milk 3 or more times daily had a 2-fold increase in lung cancer risk compared to those who reported never drinking whole milk (RR = 2.14). The same frequency of intake of reduced-fat milk was associated with a significant protective effect (RR = .54). Significant risk variations were observed for other beverages but, with the exception of frequencies of reported diet cola and decaffeinated coffee intake, dose-response patterns were not evident. PMID- 2703271 TI - Alcohol consumption and risk of benign proliferative epithelial disorders of the breast in women. AB - Many studies have shown a positive association between alcohol consumption and risk of breast cancer. Benign proliferative epithelial disorders (BPED) of the breast are conditions which, although not proven precursors of breast cancer, are strongly associated with increased risk of this disease. The association between alcohol consumption and risk of BPED was examined in a case-control study conducted in Adelaide, South Australia. The study involved 383 cases with biopsy confirmed BPED, 192 controls whose biopsy did not show epithelial proliferation, and 383 unbiopsied community controls individually matched (I:I) to cases on age and area of residence. When cases were compared with community controls, the unadjusted relative risk of BPED for drinkers versus non-drinkers was 0.9 (95% CI 0.6-1.3), and the corresponding relative risk derived from comparing cases with biopsy controls was 1.0 (95% CI 0.6-1.4); these estimates were not altered after adjustment for potential confounding. Variation in risk of BPED across levels defined in terms of daily total alcohol intake, and in terms of daily alcohol intake from individual beverages, was mostly insubstantial and not dose dependent. Also, there was little variation in risk with age at first drink, or by current drinking status, and risk of BPED in association with alcohol consumption did not increase with severity of cytologic atypia. Despite the absence of an association in this study, further investigation is warranted, since it may provide opportunities for the prevention of BPED and of breast cancer. PMID- 2703272 TI - Multifactorial analysis of parameters influencing chemosensitivity of human cancer xenografts in nude mice. AB - The results of single-agent chemotherapy, with 11 anticancer agents, of 15 human gastro-intestinal and breast cancer lines xenografted into nude mice indicate inherent individuality of chemosensitivity spectrum of each tumor. The following 9 parameters have been measured as factors possibly relevant to chemosensitivity of tumor tissue or tumor-bearing mice: grade of histological differentiation, vascularity, percentage of necrosis, VDT, 3H-thymidine LI, human LDH activity in the cancer tissue, tissue/serum LDH ratio, TdR Pase activity, and serum CEA. These parameters exhibited presumably constant values for each tumor line. Chemosensitivity, i.e., inhibition of tumor growth by a given drug, was used as the dependent variable, and values of the 9 parameters in each cancer as the explanatory variables. Multiple regression analyses with stepwise deletion were performed for each of the 11 drugs. The equations for 8 drugs exhibited coefficients of determination of over 70%, and in particular those for M-83 (a derivative of mitomycin C), nimustine hydrochloride and doxorubicin exceeded 80% by equations with 3-4 parameters. Consequently, the estimated value for each line of effectiveness derived from the equations for these 8 drugs showed remarkable coincidences with the actual values for the inhibition rates of the corresponding drugs. PMID- 2703273 TI - Establishment and characterization of a human neuroblastoma cell line. AB - A continuous human cell line RN-GA was established from a stage-III primary neuroblastoma prior to therapy. Light and electron microscopic analysis of the biopsy showed morphological features typical of neuroectodermal origin. Relative cellular DNA content and N-myc oncogene copy number were also analyzed in the biopsy tissue: the tumor cells presented a near-diploid genome with N-myc amplification. The derived tumor cell line expressed distinctive ultrastructural, cytogenetic and immunological markers of neuroblastoma. Moreover, cells from the culture could be serially transplanted into splenectomized-irradiated nude mice, where they formed a progressively growing solid tumor. Surprisingly, the cells in culture did not show any N-myc amplification, while they retained a near-diploid DNA content. We propose that several techniques (electron microscopy, oncogene analysis, flow cytometry, cytogenetics, tissue culture, cell antigen immunodetection) should be used to establish a firm diagnosis and a correct clinical grading of this tumor. The establishment of this continuous cell line should be valuable as an experimental in vitro system for further studies of neuroblastoma biology and morphology. PMID- 2703274 TI - The in vitro growth response of primary human colorectal and gastric cancer cells to gastrin. AB - A series of 31 colorectal and 13 gastric primary human tumours were screened for their growth response to human gastrin-17 in vitro, as assessed by 75Se-seleno methionine incorporation. Fifty-five percent of colorectal and 69% of gastric tumours showed a significant trophic response to the hormone. The responses were achieved at physiological gastrin concentrations (post-prandial circulating gastrin levels) in 35% of colorectal and 55% of gastric tumours. Lymphocytes from tumour-associated lymph nodes showed no response to the hormone and "normal" mucosal cells (obtained from the resection margin of the surgical specimen) showed lower mean levels of 75Se-seleno-methionine uptake (colorectal: 110%; gastric: 119%, expressed as a percentage of the control) when compared to tumours (colorectal: 151%; gastric: 147%). The small number of well differentiated and/or Dukes' stage A colorectal tumours examined were gastrin-responsive, but all the responsive gastric tumours were poorly differentiated. With respect to ploidy, 89% of diploid and 67% of aneuploid colorectal tumours responded trophically to gastrin. Patients with colorectal or gastric tumours may benefit from treatment with gastrin antagonists. PMID- 2703275 TI - Differential expression of cell adhesion molecules in variants of K1735 melanoma cells differing in metastatic capacity. AB - We have investigated the expression of 2 neural-cell adhesion molecules, NCAM and LI, in K1735-C116 and -MI melanoma cells which differ qualitatively in their metastatic potential, i.e., MI cells are metastatic whereas C116 cells are not. We have found that NCAM in C116 cells are expressed as 2 quantitatively major glycosylated polypeptides with Mr of 145,000 and 120,000 and a minor 190,000 Mr polypeptide, whereas MI cells expressed NCAM as 3 glycosylated polypeptides with MR of 200,000, 140,000 and 120,000. The amount of NCAM in MI cells constituted only 60% of the amount observed in C116 cells. In C116 cells, the 145,000 and 120,000 Mr NCAM polypeptides were sulphated whereas NCAM did not appear to be sulphated in MI cells. No phosphorylation of NCAM in the 2 cell lines was observed. LI was expressed as a phosphorylated glycoprotein with Mr of 210,000 in MI cells whereas no LI expression was observed in C116 cells. LI was not sulphated in MI cells. PMID- 2703276 TI - Immunocytochemical detection of the onco-developmental protein oncomodulin in pre neoplastic and neoplastic hepatocellular lesions during hepatocarcinogenesis in rats. AB - Oncomodulin is a calcium-binding protein, detectable in extra-embryonic human and rat placental cells and in a wide variety of tumors, but not in any normal embryonic or adult rodent or human tissues. It is also absent from proliferatively active fetal or regenerating adult rat liver. The presence of this oncodevelopmental marker was investigated in pre-neoplastic and neoplastic liver lesions during hepatocarcinogenesis induced in rats by DENA treatment, using an antibody raised against purified oncomodulin. Positive immunostaining was observed in foci of altered hepatocytes, in neoplastic nodules and in HC, but not in the histologically normal surrounding liver parenchyma. The proportion of oncomodulin-positive foci gradually rose from 20-25% at 2-3 months after DENA treatment, to about 88% at 6 months and later. The proportion of positive neoplastic nodules increased from 50% at 5 months to about 73% (range 36-100) at 9 months and later; 88% of the HC found 10 to 20 months after DENA treatment were also positive. That early neoplastic nodules are oncomodulin-positive in a proportion (50%) similar to that of foci after the same duration of treatment is consistent with a lineage relationship between them but makes it unlikely that oncomodulin expression conditions the focus-nodule transition. The role, if any, of oncomodulin in malignant progression remains to be elucidated. It seems out of the question that it is a simple correlate of proliferative activity. PMID- 2703277 TI - Evaluation of the carcinogenicity of different preparations of areca nut in mice. AB - Areca nut has been used as a masticatory since antiquity and it is estimated that more than 10% of the world population chews it in a variety of forms. We have evaluated the carcinogenicity of different preparations of areca nut: ripe unprocessed-sundried nut (R-UP-SD), ripe-processed-sundried nut (R-P-SD), unripe processed-sundried nut (UR-P-SD), ripe-unprocessed-sundried-water-soaked nut (R UP-SD-WS) and ripe-unprocessed-undried-water-soaked nut (R-UP-UD-WS) in mice following diet-feeding or oral feeding for 12 months. Only unprocessed areca nuts (R-UP-SD, R-UP-SD-WS and R-UP-UD-WS), at high doses, displayed a very weak carcinogenicity. PMID- 2703278 TI - Effect of cyclophosphamide and levan treatment on bone marrow and peripheral blood cells in B16-F10 melanoma-bearing mice. AB - Immunotherapeutic agents have often been found to provoke opposite effects on tumor growth--inhibitory or stimulatory--depending on dose, timing or route of administration. The reason for these opposite effects is not yet known. Levan (polyfructose), an immunomodulatory polysaccharide, has been found to exert opposite effects on the growth of the F10 variant of B16 melanoma. Low doses inhibit and high doses enhance the growth of this tumor. Cyclophosphamide (CY) augments the inhibitory effect of the polysaccharide. In order to elucidate the mechanism of these opposite effects, we tried to determine the changes induced by levan at inhibitory and stimulatory doses, alone or in conjunction with CY, on the lymphatic and hematopoietic systems of B16-F10 melanoma-bearing mice. In a previous study we reported the effect of these treatments on the morphology of spleen and lymph nodes (Leibovici, Kopel, Siegal & Gal-Mor (1986). Int. J. Immunopharmac., 8, 391). In the present study, we examined the effect of the treatments on bone marrow and peripheral blood composition. The growth of the tumor itself, as well as the various treatments, induced very marked changes in both bone marrow and blood. Tumor inoculation produced a sharp leukopenia and anemia followed by a restoration of both white and red blood cells. In the bone marrow, the tumor caused a gradual decrease in lymphocyte number. CY accentuated the severe leukopenia caused by the tumor. Lymphocyte depletion was prolonged, while restoration of granulocytes was achieved by day 7. A similar pattern of changes was observed in the bone marrow. With levan, opposite effects were observed in blood and bone marrow with the two doses in relation to the number of the cells of the lymphoid and myeloid lines: while 0.1 mg (tumor inhibitory) doses caused a more active restoration of lymphocytes as compared to 10 mg (tumor stimulatory) doses, an opposite effect was seen on the myeloid series--the high dose induced a more pronounced granulocytosis than the low dose. In the combined treatment, the low levan dose accelerated lymphocyte restoration in bone marrow compared to CY, while the high dose delayed the recovery of these cells. The results of the present study in conjunction with our previous study may explain the basis of the intriguing tumor inhibitory-stimulatory effects of some immunomodulators. Moderate increases in myeloid cell series appear to favor tumor inhibition and high increases favor tumor stimulation. In addition, the results of this study suggest that a regulatory relation might exist between the proliferation of the lymphoid and myeloid cell series. PMID- 2703279 TI - Inhibition of natural killer cell-mediated cytotoxicity by ML-9, a selective inhibitor of myosin light chain kinase. AB - To investigate the role of microfilaments in natural killer (NK) cell-mediated cytotoxicity, general microfilament inhibitors, cytochalasins B,D and dihydrocytochalasin B, and a selective inhibitor of myosin light chain kinase (MLCK) which regulates microfilament contraction, i.e. 1-(5-chloronaphthalene-1 sulfonyl)-1H-hexahydro-1,4-diazepine hydrochloride (ML-9) were examined in an NK assay system. ML-9 inhibited NK cell activity in a dose-dependent manner without affecting target cell binding, whereas cytochalasins suppressed the binding. The dextran suspension method revealed that ML-9 inhibits the programming for the lysis stage of the lytic process. In the single cell assay, the addition of ML-9 after target cell binding had occurred inhibited the lysis of bound target cells, whereas the addition of cytochalasins in a similar manner did not affect it. Thus, these results suggest the possibility that microfilament contraction is involved in the lytic mechanism of NK cell-mediated cytolysis. However, the mechanism whereby cytochalasins inhibit target cell binding remains unclear. PMID- 2703280 TI - Comparison of arterial and venous blood lactate kinetics after short exercise. AB - Seventeen healthy male volunteers participated in this study designed to compare arterial with both arterialized venous and venous lactate kinetics after short exercise. Blood samples drawn before, during, and after bicycle exercise were analyzed continuously for lactate. A mathematical function incorporating two exponential terms was fitted to the arterial, arterialized venous, and venous lactate recovery curves, and the parameters of the mathematical function were compared using a linear regression. All parameters measured on or fitted to the arterialized venous curves correlated well with the respective arterial data (correlation coefficient R = 0.82 to 0.99, P less than 0.001). Among the parameters obtained from the fit to the venous curves, only those describing lactate removal correlated closely with the arterial results. It is concluded that for lactate kinetic studies during recovery following short-term muscular exercise, the information obtained from arterialized venous blood is comparable to arterial blood, whereas the use of venous blood, from the sampling site in this study, appears suitable for determining only the parameters for lactate disappearance. These conclusions are illustrated by the comparison between arterial, arterialized venous, and venous parameters as a function of the work rate of the previously performed exercise. PMID- 2703281 TI - Effect of active warming-up on thermoregulatory, circulatory, and metabolic responses to incremental exercise in endurance-trained athletes. AB - The influence of 10 min warming-up at 40% VO2 max on thermal, circulatory, and metabolic responses to an incremental exercise to exhaustion as well as on the anaerobic threshold at the blood lactate level of 4 mmol.l-1 (AT) and the individual anaerobic threshold (IAT) was investigated in eight cross-country skiers. During exercise preceded by warming-up, the mean skin temperature (T sk) and external auditory canal temperature (Tac) did not change significantly in contrast to exercise without warming-up, producing a rise in both T sk and Tac (by approx. 1.2 degrees C and 1.1 degrees C, respectively). Warming-up did not alter the course of the rectal temperature changes during exercise. With warming up skin humidity rose immediately after the beginning of exercise, whereas the onset of sweating without warming-up appeared much later at higher work intensities. Warming-up did not change the circulatory and ventilatory responses to incremental exercise and the oxygen uptake (VO2) either at submaximal or maximal work loads. With warming-up a significant increase was found in the threshold work load both at the AT and the IAT. The data demonstrated that warming-up has an advantageous effect on the efficiency of thermoregulation in endurance-trained athletes producing an early sweating response to the incremental exercise that results in attenuation of hyperthermia. An increase in the anaerobic threshold during incremental exercise preceded by warming-up may indicate an enhancement of the endurance capacity subsequent to warming-up. PMID- 2703282 TI - Effects of reduced training on submaximal and maximal running responses. AB - The purpose of this investigation was to examine the effects of a reduction in training volume (RT) (8 km/day, 5 days/wk, for 10 days) in five highly trained collegiate distance runners. The subjects were tested midseason (MS) (110 km/wk), after a 10-day taper (80 km/wk) and subsequent championship meet (post championship, PC), and post RT. PC data represent the runners at their peak performance capacity. Maximal oxygen consumption, maximal heart rate (HR), and time to exhaustion during the max tests, as measured at PC and RT, were not altered. Other parameters were measured for all conditions. No changes were observed in body weight and percent body fat (p greater than 0.05). Submaximal treadmill runs (TR) at 265 and 298 m/min revealed no alterations in VO2 submax, ratings of perceived exertion (RPE), HR and 2-min post-run lactate levels (p greater than 0.05). The HR during a 6-min track run (265 m/min) significantly increased (p less than 0.001) by 10 bts/min with RT vs MS and PC, which may be a result of mechanical or psychological changes. After RT, 1-min recovery HR (HRr) for the track run and 1- and 2-min post-TR were significantly elevated by 16, 12, and 12 bts/min, respectively. It is not apparent what role HRr serves as an indicator of fitness level and performance capability during reduced training. These results suggest that the reduced training program used did not sufficiently diminish nor improve aerobic capacity in highly trained distance runners. PMID- 2703283 TI - Development of valid pulmonary function equations for trained athletes. AB - The validity of commonly recommended pulmonary function prediction equations (Bulletin Europeen de Physiopathologie Respiratoire, Clinical Respiratory Physiology) was tested with two samples (n1 = 156; n2 = 218) of well-trained athletes. Pulmonary function measures (FVC, TLC, RV, FEF25%-75%, FEV1.0, PEF, RV/TCL ratio, FEV1.0/FVC ratio) were typically very reliable but inaccurately predicted with recommended equations based upon anthropometric characteristics. Newly developed "unisex" regression equations were developed with "dummy" coding of gender (i.e., 0 = female; 1 = male), age, height, weight, and various interactions. The new equations were validated with a subsample of group one, cross-validated with the remaining portion of group one, and then cross-validated again with the 218 subjects from sample two. The newly created pulmonary function prediction equations are more valid for well-trained athletes than the equations in use for the general population. PMID- 2703284 TI - Exercise performance following intense, short-term ventilatory work. AB - Evidence exists to indicate that prolonged ventilatory work fatigues respiratory muscles and may limit exercise tolerance. However, the effects of short-duration, high-intensity ventilatory work on subsequent exercise remains in question. We tested the hypothesis that intense short-term volitional hyperpnea would result in respiratory muscle fatigue and would therefore hinder subsequent exercise tolerance. Pulmonary function was determined in ten healthy, male subjects before and after two constant load exercise tests to exhaustion on a cycle ergometer. Test 1 was a preliminary test to determine VO2max, peak exercise VE, and peak exercise power output. Test 2 was a constant load (85% peak power output) exercise test to exhaustion. Test 3 was identical to test 2 but was preceded by 10 min of volitional, isocapnic hyperpnea (85% of peak exercise V.E) at a controlled frequency and tidal volume. Pulmonary function measures (FVC, FEV1, FEV1/FVC, and peak flow) were not significantly (P less than 0.05) altered by the volitional hyperpnea. Ventilation and gas exchange variables (VO2, VE, f, end tidal PO2 and PCO2, VE/VO2, VE/VCO2, %SaO2) during exercise and time to exhaustion were not significantly (P less than 0.05) different between treatments. These experiments failed to show any effect of short-term ventilatory work on pulmonary function or subsequent exercise performance. PMID- 2703285 TI - An approach to noninvasive fiber type determination by NMR. AB - In vivo 31P NMR spectroscopy was used to determine the ratios of creatine phosphate (PCr) to adenosine triphosphate (ATP) and inorganic phosphate (Pi) in leg and arm muscles of four sprinters, one marathon runner, and two sedentary subjects. Both ratios were definitely higher in the sprinters indicating that, since muscle ATP and Pi concentrations are constant, the PCr muscle content of these athletes is higher than usual. Sprinters are known to have higher percentages of fast-twitch fibers, which are richer in PCr than slow-twitch fibers. It is concluded that measurements of muscle ATP, PCr, and Pi through in vivo NMR spectroscopy could be used to determine muscle fiber composition. PMID- 2703286 TI - Results of the surgical treatment of the medial tibial syndrome in athletes. AB - The medial tibial syndrome (chronic compartment syndrome) is the most common specific overuse injury among athletes in Finland, and it is especially a problem in endurance sports, long-distance running, and jogging. Conservative treatment is usually successful, but if it fails, fasciotomy of the deep posterior compartment is observed to be beneficial. In the years 1975-1984, we performed fasciotomy in 34 patients, of whom 14 had a bilateral operation. Thirty-one patients were active in sports, 22 were long-distance runners and joggers. The operations of 15 patients (22 legs) were performed under local anesthesia as an outpatient procedure. The follow-up results in general were good. In 21 patients (78%) of those 27 who could be followed up, the final result was excellent or good, in 4 (15%) fair, and only in 2 (7%) poor. Fasciotomy is a simple operation and can be performed as an outpatient procedure under local anesthesia. For bilateral symptoms, we recommend two different procedures with a time interval of about 2 weeks to avoid the postoperative hematoma and difficulties in mobilization often seen, when operated simultaneously. PMID- 2703287 TI - Physical fitness level in patients with anxiety and depressive disorders. AB - Physical work capacity (PWC) and pulmonary function were measured shortly after admission in 90 inpatients with anxiety and depressive disorders. PWC was dramatically reduced while pulmonary function was slightly increased compared with predicted normal values. This indicates that the low fitness levels were caused by physical inactivity, and it is a strong argument for integrating physical fitness training into psychiatric treatment programs. Values obtained by direct measurement and indirect calculations of PWC were highly correlated (R = 0.67). The mean differences between the two tests were 21% on an individual level and 5% on a group level. PMID- 2703288 TI - Relationship of sex hormone binding globulin to overall adiposity and body fat distribution in a biethnic population. AB - Previous data have indicated that decreased sex hormone binding globulin (SHBG) is associated with increased overall and upper body adiposity and higher levels of glucose, insulin and triglyceride (TG) and decreased levels of high-density lipoprotein (HDL) cholesterol. Since Mexican Americans have greater overall and upper body adiposity, higher rates of non-insulin-dependent diabetes mellitus, higher TG and lower HDL levels than non-Hispanic whites, we postulated that they would also have lower levels of SHBG. We measured total testosterone and total estradiol using a commercial radioimmunoassy and SHBG using a dextran-coated charcoal technique in premenopausal women (61 Mexican American and 39 non Hispanic white) as part of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular risk factors. There were no significant ethnic differences in total testosterone or total estradiol. SHBG, however, was lower in Mexican American (0.285 micrograms/dl) than in non-Hispanic white women (0.429 micrograms/dl) (P = 0.009). After adjustment for body mass index (BMI), ratio of waist-to-hip circumference (WHR) and ratio of subscapular-to-triceps skinfolds (centrality index), SHBG remained lower in Mexican Americans (0.307 micrograms/dl) than in non-Hispanic whites (0.396 micrograms/dl), although this difference was no longer statistically significant (P = 0.083). BMI, WHR and centrality index were all negatively associated with SHBG (P less than 0.01). The lower levels of SHBG in premenopausal Mexican American women compared to non Hispanic white women may reflect greater in-vivo androgenicity and may be related to a variety of metabolic abnormalities seen in this ethnic group. PMID- 2703289 TI - Exercise end-expiratory lung volumes in lean and moderately obese women. AB - End-expiratory lung volumes (EELV) and expiratory flow rates were determined in 10 moderately obese (mean, 35 percent fat) and 10 relatively lean women (22 percent fat) at rest and during exercise on a treadmill at 55 and 85 percent of VO2max. Expiratory reserve volume (ERV) as a percentage of forced vital capacity (FVC) was used as an index of EELV. Differences in body weight, body fatness, and VO2max were significant (P less than 0.05). The resting EELV in the obese women was less than (P less than 0.01) that in the leaner women (32 vs 37 percent). During exercise at the two intensities, the EELV remained near the resting value in the obese women (approximately 30 percent). In contrast, the leaner women experienced an initial decrease in EELV during exercise at 55 percent of VO2max (i.e., from 37 to 32 percent) (P less than 0.01); thereafter, the EELV changed no further during exercise at 85 percent of VO2max. There were no significant differences in relative expiratory flow rates at rest or during exercise between the obese and lean women. In conclusion, moderately obese women fail to decrease their EELV during exercise in contrast to leaner women who do. A non-linear respiratory system pressure-volume curve, plus increased resistance as maximal flow is approached may combine to determine a lower limit of EELV during exercise. PMID- 2703290 TI - The relationship between subsets of anthropometric upper versus lower body measurements and coronary heart disease risk in middle-aged men. The Paris Prospective Study. I. AB - The importance of body fat distribution as one determinant of various metabolic disorders associated with obesity is now recognized and some epidemiological evidence exists that it might be related to the onset of coronary heart disease (CHD) in men and women. The Paris Prospective Study data permitted exploration of the relationship between three subsets of anthropometric upper versus lower body measurements (waist-thigh circumferences, subumbilical-thigh skinfolds, bideltoid bitrochanter diameters) and CHD risk in a middle-aged male population. The analysis successively disclosed the simple measurement ratio for both girth and diameters and the subumbilical2: thigh skinfold ratio as the best predictors of CHD outcome. The girth and skinfold but not the diameter ratios were positively correlated with body mass index and usual CHD risk factors except smoking. The relationship of upper versus lower fat localization (girth and skinfold ratios) with CHD incidence confirmed previous results obtained in this population but its magnitude is low in comparison with usual CHD risk factors. The association of the diameter ratio as an index of upper body frame with CHD occurrence remains to be confirmed by further studies. PMID- 2703291 TI - Effect of triiodothyronine on glucose utilization in diaphragm of obese (ob/ob) mice. AB - Genetically obese-hyperglycemic (ob/ob) mice are hypothyroid, hyperinsulinemic, and insulin resistant. Because muscle plays an important role in glucose homeostasis, the role of triiodothyronine (T3) in regulation of insulin-sensitive glucose utilization by muscles of obese mice was examined. Four doses of T3, 5.0, 12.5, 25.0, and 50.0 micrograms/100 g body weight were injected, i.p., into obese and nonobese mice daily from 3 weeks until 6 weeks of age. Food consumption and body weight were decreased at lower doses of T3 and increased at higher doses of T3 in both obese and nonobese mice. By 6 weeks of age all doses of T3 treatment increased oxygen consumption in both genotypes. At 6 weeks of age, the diaphragms from the saline-injected nonobese mice had greater in-vitro insulin-stimulated glucose utilization than muscles from the saline-injected obese mice. Both anaerobic and aerobic glucose oxidation were increased by T3 treatment, but the obese had greater increases than those observed in muscles from nonobese mice. Muscles from obese mice increased insulin-stimulated glucose utilization by T3 treatment to that of the nonobese level, whereas there was no change in insulin stimulated glucose utilization of nonobese mice. Muscle glycogen synthesis in obese and nonobese mice was decreased with very high T3 doses. A higher dose of T3 was required to increase glucose utilization in the obese muscles than in the nonobese muscles. The results suggest that a functional hypothyroidism or T3 resistance may be an early part of this particular obesity syndrome. PMID- 2703292 TI - Evidence for the existence of small eaters and large eaters of similar fat-free mass and activity level. AB - The objective of this study was to identify individuals of the same age, sex, activity level and fat-free mass who differed in their level of energy intake (EI). Estimates of energy intake and physical activity level were derived from three-day food and activity records from 430 individuals 17-54 years of age. Body composition was measured by underwater weighing and body fat and fat-free mass were obtained. Subjects were grouped into four categories based on age and sex (females aged 17-34 and 35-54 years and males aged 17-34 and 35-54 years). Subjects were identified as small eaters (SE) or large eaters (LE) according to kJ of EI per kg body weight, SE being from the lower quartile and LE from the upper quartile of their distributions. The results showed that, on average, LE consumed almost twice as many kJ per kg body weight as SE (about 200 versus 100). In addition middle-aged male and female SE were significantly (P less than 0.001) heavier than middle-aged male and female LE respectively. The mean body weight for the male SE was 82 +/- 12 kg (mean +/- s.d.) against 69 +/- 9 kg for the LE, while it was 66 +/- 10 kg against 52 +/- 5 kg for the female SE and LE. The male and female SE also had a significantly higher percentage body fat in both age groups. In general, there was no difference in fat-free mass and activity level between the SE and LE. It is concluded that there exist groups of individuals who have a considerable difference in their EI and adiposity even though they have similar levels of activity and fat-free mass. PMID- 2703293 TI - Body composition in subjects with surgically obtained stable body weight normalization. AB - The body composition of lean control subjects was compared with that of subjects following biliopancreatic diversion for morbid obesity, when their excess weight had been stabilized at under 40 per cent of the ideal body weight value for over two years. Lean body mass, body cell mass and fat were indirectly calculated from total body water and total body sodium, measured by isotope dilution technique. The body composition in the two groups of subjects was essentially normal, as was indicated by the percentage values of the body composition parameters and by the linear correlations between body weight and the lean body compartments size. PMID- 2703294 TI - The relationship between social status and body mass index in the Minnesota Heart Health Program. AB - This study investigated relationships between social variables and body mass index (BMI) in 2465 men and 2792 women aged 25 to 74 in six upper midwestern communities. After controlling for age and cigarette smoking status, BMI was significantly related to education, income, occupation, and marital status in both men and women. SES variables tended to be inversely related to BMI, with a steeper gradient for women than for men. A curvilinear trend was noted, however, in that social status tended to be lower at both ends of weight distribution than in the middle. The relationship between marital status and BMI was also found to be curvilinear. Highest rates of marriage were in the middle portion of the weight distribution for both sexes. PMID- 2703295 TI - Pharmacokinetic characteristics of the obese overfed rat. AB - The present study was undertaken to examine the appropriateness of the obese overfed rat and the obese Zucker rat as animal models for evaluating drug disposition changes in human obesity. It was found that 11 of 12 characteristics that control or influence drug clearance and volume of drug distribution in obese humans were qualitatively reproduced in the obese overfed rat. In contrast, existing literature shows that the obese Zucker rat resembles the obese human in only five of 12 characteristics, with meaningful discrepancies in fat-free mass, creatinine clearance, and thyroid function. Perhaps of greatest significance were changes in hepatic cytochrome P-450, which increased in proportion to total body mass in the obese overfed rat but remain unchanged in the Zucker rat. Although P 450 status in human obesity is unknown, the overfed rat model provides an opportunity for examining increased oxidative drug elimination that appears as an established feature of human obesity. In conclusion, the obese overfed rat appears to be superior to the obese Zucker rat as an animal model for evaluating the pharmacological consequences of human obesity, particularly those in which reproducing drug pharmacokinetics is an important consideration. PMID- 2703296 TI - The dynamics of weight loss after gastric partition for gross obesity. AB - Energy intake and expenditure have been assessed in patients before gastric partition for gross obesity, 3 months after operation when they were still losing weight and at 12 months when weight loss was complete and stable. Food intake was drastically reduced after surgery and the energy deficit so produced was sufficient to account completely for the weight loss, even when allowance was made for an adaptive reduction in energy expenditure. In a majority of patients, the eventual reduction in expenditure parallels the regression of metabolic rate against body mass index for a population of stable obese patients. However, the reduction in resting metabolic rate was maximal soon after the operation, when weight loss was far from complete. Weight loss stabilized at about 6 months, not due to a further reduction in energy expenditure but because energy intake recovered until the patient was again in energy balance. PMID- 2703297 TI - Dissatisfaction with weight and figure in obese girls: discontent but not depression. AB - This study examined psychological functioning and satisfaction with weight and figure in a total of 393 obese and nonobese adolescent girls from lower-middle to middle-class families. No significant differences were observed between the two groups on measures of trait anxiety or depression, and all subjects scored well within normal limits. Obese girls did, however, report significantly greater dissatisfaction with their weight and figure than did nonobese girls. Many nonobese girls also expressed dissatisfaction with their weight, supporting the view that women's dissatisfaction with weight is a 'normative discontent'. Nearly 70 percent of the total sample had attempted to lose weight in the past year. The results of this study indicate that obese girls in the general population are dissatisfied with their weight but are not significantly anxious or depressed, as had been suggested by studies of overweight adolescents in clinical settings. PMID- 2703298 TI - Cellular glycoproteins correlating with pulmonary-colonizing potential in B16 melanoma. AB - Sublines of B16 melanoma with different pulmonary colonizing potential were examined for the relationship between cellular glycoproteins and the pulmonary colonizing potential using sodium dodecylsulfate polyacrylamide gel electrophoresis, and lectin-binding assay in nitrocellulose sheets after Western blotting. There were glycoproteins corresponding to 33,000 and 32,000, whose carbohydrate components, N-acetylgalactosamine and fucose, were positively correlated with the pulmonary colonizing potential. The protein amount of these glycoproteins was very small and showed no correlations. As regards the cell morphology and growth characteristics, there was no correlation between these parameters and the pulmonary colonizing potential. PMID- 2703299 TI - Selection of highly malignant tumour cells using reconstituted basement membrane matrix. AB - A new technique was developed to coat Nuclepore filters with basement membrane matrix components. Using the EHS tumour as a source, a proteoglycan and laminin containing fraction was extracted with guanidine and collagen type IV was solubilized in a second fraction by limited digestion with pepsin. When the two fractions are combined and guanidine removed by dialysis, a gel is rapidly formed. A flat-bed dialysis apparatus was devised, allowing gels to form on filters that are soaked in the mixture, thus coating them with components of the basement membrane. Such filters were used for selection of B16 melanoma cells penetrating the gels. 10 clones were isolated after three selection passages, and assayed for spontaneous metastasis in C57Bl/6 mice after intracutaneous injection. The metastasis rates were strongly increased to the lungs and to inguinal and axillary lymph nodes. Less accessible sites such as mediastinal and maxillary lymph nodes were reached only by selected cells. There was no particular preference for the haematogenous or lymphatic routes, indicating that the ability to traverse the basement membrane leads to a general increase of metastasis. The described method provides a valuable tool for isolating those subpopulations able to traverse basement membranes and to assess this capacity in new tumour samples. PMID- 2703300 TI - Depression of nonadaptive immunity after surgical stress: influence on metastatic spread. AB - The question of increased tumor cell dissemination after surgical stress was addressed in the model system of the spontaneously metastasizing rat adenocarcinoma BSp73ASML, wherein amputation of the hind leg 7 days after intrafootpad implantation of tumor cells cured the animals, while surgical stress by laparotomy 2 days prior to amputation resulted in lung metastases in 80% of rats. A detailed in vitro analysis of natural killer (NK) and macrophage (Mo) activity in different lymphatic compartments revealed the following impacts of surgery: splenic NK cells displayed unaltered activity. Yet, there was a considerable decrease in the number of lymphoid cells during the first 4 days after surgery, being followed by an overshooting repopulation. In the peripheral blood, activity levels of NK cells dropped significantly during the first 24 h after surgery; later on, NK cells appeared activated with an over 2-fold increase in lytic units (LU), 4 days after surgery, NK activity had returned towards normal levels. Most dramatic changes were observed in the peritoneal cavity, being directly involved in the surgical intervention. Six hours after surgery the peritoneal cavity was nearly depleted of NK cells and Mo, the few remaining cells being highly activated. Within 2 days the peritoneal cavity was repopulated with a 3-4 fold excess of lymphoid cells and Mo, but the repopulating cells were extremely low in lytic activity. It is concluded that depression of nonadaptive immunity after surgical stress is mainly due to traffic and repopulation with immature cells, i.e. there was no indication of suppressor cell activity. This was confirmed by a combined treatment consisting in a systemic application of Corynebacterium parvum 2 days before surgery and a local application of C. parvum after surgery, which counter-balanced the stress-induced depression of NK and Mo activity. Accelerated and increased metastatic spread could be prevented concomitantly. PMID- 2703301 TI - Oxygen distribution and consumption in the cat retina at increased intraocular pressure. AB - Oxygen microelectrodes were used to study the distribution of oxygen in the retina of dark adapted anesthetized cats during short term elevation of intraocular pressure (IOP) that reduced the perfusion pressure (PP = mean femoral arterial pressure - IOP) to as low as 40 mm Hg. The oxygen tension (PO2) in the inner half of the retina was affected very little over this range. Choroidal PO2, however, decreased substantially, about 0.5 mm Hg per mm Hg perfusion pressure, in the area centralis and superior retina (15-20 degrees superior to the area centralis). This decreased the oxygen available to that part of the outer retina supplied by the choroidal circulation. Oxygen consumption was estimated by fitting profiles of PO2 as a function of distance to a diffusion model. This analysis showed that photoreceptor oxygen consumption decreased significantly at perfusion pressures less than 70 mm Hg in the area centralis. Changes in consumption were also observed in the superior retina, but were not significant. Oxygenation of a region just nasal to the optic disc was also studied, but neither the choroidal PO2 nor oxygen consumption in this area was affected over the range of PP studied. These results provide direct evidence that moderately increased IOP leads to a decrease in choroidal PO2 and sufficient hypoxia in the distal retina to cause a reduction in photoreceptor oxygen consumption. This presumably slows the photoreceptor Na+/K+ pump and leads to the ERG changes reported previously (Yancey and Linsenmeier, Invest Ophthalmol Vis Sci 29:700, 1988). PMID- 2703302 TI - Effects of hyperoxia on the oxygen distribution in the intact cat retina. AB - Double-barreled oxygen microelectrodes were used to measure the distribution of oxygen within the dark adapted cat retina during systemic hyperoxia (100% O2 inspired). Oxygen tension (PO2) decreased monotonically from the choroid to the vitreous humor in most cases, showing that a greater portion of the retina was supplied by the choroid during hyperoxia than during normoxia. In the proximal half of the retina the PO2 increased during hyperoxia by an average of about 40 mm Hg, while the increase in the distal retina was larger. At the choroid the average increase in PO2 was about 150 mm Hg. Analysis of the oxygen profiles showed that photoreceptor oxygen consumption was unchanged during hyperoxia. Retinal PO2 increased rapidly at the beginning of hyperoxia, and often partially recovered from its peak value during hyperoxia, even in the distal retina, suggesting that the choroidal circulation may have some limited autoregulatory capacity. As in normoxia, retinal illumination led to an increase in PO2 in the distal retina, due to a decrease in oxygen consumption. The light-evoked increase in PO2 was larger during hyperoxia, but the underlying change in oxygen consumption was probably the same as in normoxia. PMID- 2703303 TI - Light adaptation of the electroretinogram. Diminished in retinitis pigmentosa. AB - The cone electroretinogram has been examined at different levels of ganzfeld adaptation in normals and subjects with retinitis pigmentosa (RP). As light adaptation increases, the amplitude and time course (measured as b-wave implicit time) of the cone ERG decrease in both normal and RP subjects. The same level of light adaptation, however, decreases the amplitude and the implicit time more in normal than in RP subjects. The ineffectiveness of light for adapting the ERG of RP subjects is most easily explained by assuming that RP cones absorb less light than normal cones. By comparing these parameters between normal and RP subjects at different levels of light adaptation, it is possible to estimate this ineffectiveness of cone absorption in RP subjects. The results imply that RP cones can transduce and adapt but fail to absorb light as effectively as normal cones. The quantitative relationship between cone b-wave implicit time and retinal illumination provides a unique method for examining cone function as well for standardizing ganzfeld backgrounds in ERG laboratories. PMID- 2703304 TI - Growth in amplitude of the human cone electroretinogram with light adaptation. AB - The human cone electroretinogram gradually increases in amplitude an average of 75% (range 23 to 157%) during light adaptation, over a period of approximately 20 min. This increase involves both the a- and b-wave components of this response, and both waves follow a similar time course, implying that the photoreceptors themselves are responsible for the effect. The phenomenon occurs with suprathreshold, but not with threshold, levels of stimulation, and the stronger the test light, the greater the effect. An increase in the intensity of the adapting light shortens the time course of the ERG response, measured as b-wave implicit time, but this occurs almost immediately, and the implicit time then remains constant during the slow increase in response amplitude. The stronger the background adapting light, the smaller is the ERG amplitude, but the percentage growth (or rate of recovery) is unchanged. This slow increase in amplitude is thought to reflect the redepolarization of the cones, after their initial hyperpolarization to an adapting field. It does not reflect the d.c. potential of the eye (the EOG). It is essential to control this phenomenon in any studies of the human cone ERG, in order to minimize variability. PMID- 2703305 TI - Temporal sequence of changes to the gray squirrel retina after near-UV exposure. AB - Monocularly aphakic gray squirrels (Sciurus carolinensis) were exposed for 10 min to monochromatic near-ultraviolet radiation (lambda = 366 nm, radiant exposure = 4.3 J/cm2) to determine if their yellow pigmented lens protected retinal tissue from photochemical damage. Eyes were examined from 1 to 30 days after exposure to determine the temporal sequence of retinal damage and the extent of recovery from such exposures. Light microscopy of exposed aphakic retinas revealed irreversible lesions to the photoreceptors. Swelling of inner segments, accumulation of heavy pigment deposits in the PE, presence of macrophages in the subretinal space, and pyknosis of photoreceptor nuclei were observed in the exposed region of the aphakic eye. Eyes exposed to ultraviolet radiation with their lenses intact were devoid of significant retinal lesions. This study represents a model system for studying the potential damaging effects of near-UV radiation to the aphakic eyes of humans. PMID- 2703306 TI - Feasibility of blood flow measurement by externally controlled dye delivery. AB - We are developing a new method of delivering substances locally and repeatedly in the retinal vasculature under external control. This delivery system is based on encapsulating the substance in heat-sensitive lipsomes, which are injected intravenously and lysed by a heat pulse delivered by a laser. The feasibility of using this system with dyes and creating a sharp dye front was tested in vitro and in vivo. The results indicate that the background fluorescence of intact liposomes is minimal but in contrast a dramatic increase in fluorescence is achieved where the dye is released. In vivo tests indicated that only the selected vascular branch fluoresced. Moreover, a sharp dye front could be obtained repeatedly and preserved over significant distances. The presence of a sharp dye front allowed measurements, in vitro, of blood velocity which correlated well (r = 0.985, P less than 0.001) with the average blood velocity values calculated from the known flow rate. PMID- 2703307 TI - Investigation of the source of the blue field entoptic phenomenon. AB - The cellular source of the blue field entoptic phenomenon was investigated in two microvascular preparations using video-microscopy with lighting conditions similar to those under which the entoptic phenomenon is visualized within the human eye. In the wing of the hibernating bat, microvascular flow was simultaneously videotaped under transmission illumination at 430 nm and under unfiltered illumination. In the rat cremaster alternating observations were made using transmission illumination at 430 nm and epi-illumination fluorescence microscopy with leukocytes rendered fluorescent by intravenous Quinacrine. In both preparations, low magnification video-microscopy using 430 nm illumination produced a field of particles, which were brighter than the background, flowing within a network of dark vessels. The appearance of the particles and their movement simulated the blue field entoptic particle motion. Under higher magnification, the particles appeared brighter than the plasma gaps between red blood cells and were demonstrated to be leukocytes by morphology, by specific staining and by typical behavioral movement. The particles were observed in terminal arteriols capillaries, and post-capillary venules where they were not obscured by red blood cells. The results of this study of two microvascular preparations strongly suggest that in the human eye the blue field entoptic phenomenon is produced by leukocytes flowing within the macular retinal microvasculature. PMID- 2703308 TI - Reliable measurements from fundus photographs in the presence of focusing errors. AB - When measuring the width of the blood column and the superimposed central light reflex of retinal vessels from fundus photographs, we find that the measurements are affected by focusing error, unless certain steps are taken to reduce its effect. Thus, we recommend using a scanning microdensitometer to extract the density profile of the blood column from the negative, and convert the density profile to an intensity profile by means of the characteristic curve of the film. In this paper we model the imaging process on a computer, and find that the half value width of the intensity profile is relatively insensitive to focus error. However, the maximum intensity of the central light reflex is still sensitive to focus error. Both these results are in agreement with experimental studies. PMID- 2703309 TI - Paracellular permeability of corneal and conjunctival epithelia. AB - The paracellular permeability of normal rabbit cornea and conjunctiva was studied in vivo and in vitro. After intravenous administration, horseradish peroxidase was found to percolate to the intercellular space of conjunctival epithelia and was restricted by the tight junctions of the superficial epithelium. Only minimal tracer was present in the limbus and cornea. The difference between corneal and conjunctival paracellular pathways was further compared in vitro by tissue perfusion studies using various tracers from subepithelial space to apical surface. The intact full-thickness cornea was permeable to mannitol (MW 182) but not to inulin or dextran. The conjunctiva was permeable to mannitol, inulin and FITC-dextran (MW 20,000). The quantitative permeability to 3H-mannitol (X10(-8) cm/sec) of adult rabbit cornea was 0.12 +/- 0.02, which is about 55-fold and 50 fold lower than that of conjunctiva (6.78 +/- 0.21) and peritoneum (6.12 +/- 0.63), respectively. Removal of the corneal epithelium increased the permeability 40-fold; however, removal of the endothelium had little effect on the solute permeation. When both corneal epithelium and endothelium were debrided, the bare stroma became edematous and the permeability increased 70-fold. The permeability of 1-week-old rabbit cornea was 1.32 +/- 0.18, which decreased to 0.46 +/- 0.06 in 2-week-old rabbits, and became similar to the adult level at 4 weeks of age. When Tenon's capsule was included in the perfusion, the conjunctival permeability decreased 2.5-fold. With the apposition of bare corneal stroma to the conjunctiva and Tenon's capsule, the permeability decreased further (4-fold).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703310 TI - Characterization of bicarbonate-dependent potassium uptake in cultured corneal endothelial cells. AB - Bovine corneal endothelial (BCE) cells in culture demonstrated 86Rb+ uptake which was mostly ouabain-sensitive with some (15 to 50%) ouabain-insensitive uptake that was dependent on the presence of bicarbonate in the incubation medium. Bovine smooth muscle (SM) cells demonstrated ouabain-sensitive 86Rb+ uptake but the ouabain-insensitive 86Rb+ uptake was not bicarbonate-dependent. Although omission of bicarbonate from the incubation buffer resulted in some reduction in the pH, this change was not responsible for the reduction in the ouabain insensitive 86Rb+ uptake. Furthermore, the removal of bicarbonate decreased the 86Rb+ influx but not its efflux. This ouabain-insensitive and bicarbonate dependent 86Rb+ influx in BCE cells proceeded at a linear rate for at least 60 min and increased as a function of bicarbonate concentration such that almost maximal uptake was observed at a concentration of about 10 to 15 mM. Saturation of the bicarbonate-dependent 86Rb+ pump in BCE cells occurred at a concentration of 2 mM Rb+ in the incubation buffer, similar to the previously observed value for the Na+, K+-ATPase. Competition experiments with both unlabeled Rb+ and K+ demonstrated that likewise in the Na+, K+-ATPase the 86Rb+ influx represented physiological influx of K+. Furthermore, the energy requirements of the bicarbonate-dependent 86Rb+ uptake were similar to those of the 86Rb+ uptake via the Na+, K+-ATPase. The results described in this work demonstrated a novel bicarbonate-dependent K+ pump in addition to the Na+, K+-ATPase pump.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703311 TI - Generation of oxidants in the near-UV photooxidation of human lens alpha crystallin. AB - In this study we report on the generation of superoxide anion (O2-) and hydrogen peroxide in the near-UV irradiation of human lens alpha-crystallin by monochromatic light at 300 nm. Photolysis of human lens alpha-crystallin at 300 nm, at irradiances similar to those encountered in sunlight causes an alteration of protein tertiary structure, a loss of tryptophan fluorescence and increase of nontryptophan fluorescence. The nontryptophan fluorescence is likely to be due to the photooxidation of tryptophan to N-formylkynurenine (N-FK or related species), which is a good photodynamic sensitizer, has significant absorption at 300 nm, and can thus react via its triplet state with O2 to generate 1O2 or with reducing substrates (amino acids of the protein) to generate free radicals. The latter, in the presence of O2 can lead to the generation of O2- and H2O2. These species have been directly assayed in this study in photolyzed solutions of fetal, young and old human lens alpha-crystallin. The addition of superoxide dismutase (SOD) to the protein solution prior to photolysis increased the amount of H2O2 generated by 3- to 4-fold. This observation not only provides definitive evidence for the photogeneration of O2-, but also indicates that only a fraction of this species is transformed into H2O2 in the absence of SOD. Significant amounts of O2- and H2O2 were formed by 340 nm irradiation of old human lens alpha-crystallin, in which the basal level of N-FK is high. The role of 1O2 in these photoreactions has been studied by investigating the quenching effect of azide and the enhancing effects of D2O on the rate of loss of tryptophan fluorescence yield and the effect of azide on the rate of H2O2 generation. PMID- 2703312 TI - In vitro inhibition of lens epithelial cell growth by continuous wave Nd:YAG laser. AB - Bovine lens epithelial cells were suspended in MEM medium and subjected to continuous wave, low power, pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation. The temperature of each suspension was maintained at 36 degrees C. Laser applications ranged from 1 to 10 watts and from 100 to 2000 seconds, but the total dose to each of the epithelial cell suspension was 2000 J. Six to thirty-nine percent of the cells were dead immediately after irradiation. Surviving cells, cultured for 15 days, showed decreased attachment and failed to grow. These preliminary results suggest that the Nd:YAG laser may be used during cataract surgery to prevent subsequent lens epithelial cell proliferation and the resulting vision reduction and glare. PMID- 2703313 TI - Breakdown of the blood--aqueous barrier in the rabbit eye by infrared radiation. AB - Breakdown of the blood-aqueous barrier was produced by infrared radiation (IR) at a heat flux from 24 to 44 J/cm2 in pigmented, but not in albino rabbits. Blood aqueous barrier breakdown was inhibited by indomethacin and ketamine/xylazine anesthesia mixtures, but not by [D-Trp2,D-Pro7,9]-substance P. The degree of blood-aqueous barrier breakdown could be controlled by IR flux. Two models for accurate determination of the heat flux are presented. PMID- 2703314 TI - Calcium-dependent phosphorylation of proteins in rabbit ciliary processes. AB - Calcium-dependent phosphorylation of endogenous substrate proteins in albino rabbit ciliary processes was studied by SDS-polyacrylamide gel electrophoresis and autoradiography. In the soluble fraction, a modest augmentation of phosphorylation was observed by Ca2+ alone and together with the additional activators, calmodulin (CAM) or phorbol myristate acetate (PMA). However, there was a greater enhancement of protein phosphorylation by Ca2+ and activators in the particulate fraction. The degree of Ca2+-CAM-dependent protein phosphorylation was greater than that of Ca2+-PMA-dependent phosphorylation. Endogenous substrate proteins for Ca2+-CAM-dependent protein kinases had apparent molecular sizes of 205,170,150,130,77,58,40,32 and 18 kDa. Phosphorylation of the 58 kDa protein band was strongest. This protein was identified as vimentin on the basis of its behavior with Triton-X100 treatment, and by Western blotting using anti-vimentin antibody. Endogenous substrates of protein kinase C (Ca2+-PMA dependent) were located at 87 kDa and possibly in the 56 and 54 kDa protein bands. A 50 kDa protein was found to be phosphorylated in the presence of Ca2+ alone, and was not affected by the presence of other activators (CAM or PMA). A Ca2+-dependent dephosphorylation of a 43 kDa protein was observed, and some proteins rapidly phosphorylated by Ca2+-CAM kinase were also relatively quickly dephosphorylated at incubation times greater than 1 min. PMID- 2703315 TI - Two-dimensional gel electrophoresis of calf aqueous humor, serum, and filter bound proteins. AB - Recent studies have demonstrated that bovine and primate aqueous humor (AH) obstruct flow when perfused through artificial membranes with pore sizes similar to those found in the aqueous outflow pathway. Proteinaceous AH components were implicated in this phenomenon, which is not observed with serum diluted to comparable protein concentrations. In this study, we used two-dimensional gel electrophoresis to characterize the protein composition of calf AH and to identify those proteins binding to the filters and presumably causing this obstruction. Comparison of AH and serum under denaturing conditions showed quantitative and qualitative differences in their protein content. Among the most important: AH was seen to possess two protein subunit trains (approximately 28 kD and approximately 48 kD) not found in serum and two trains (approximately 28 kD and approximately 80 kD) with additionally charged components not found in serum. Serum, on the other hand, possesses one train (approximately 80-90 kD) not found in AH as well as a slightly greater relative amount of high-molecular weight protein subunits. The finding that hydrophobic filters retain more protein components than do hydrophilic filters suggests that the type and amount of protein adhering to them is determined largely by hydrophobic interactions. Whether such interactions occur in the outflow system, and if so, how they may relate to aqueous drainage remains to be determined. PMID- 2703316 TI - Further studies on the flow of aqueous humor through microporous filters. AB - It has recently been shown that aqueous humor is able to obstruct flow through Nuclepore polycarbonate filters having flow dimensions similar to those found in the juxtacanalicular tissue (JCT). We undertook studies designed to identify the component(s) of aqueous humor responsible for this obstruction and to determine the mechanism of blockage. We conclude that aqueous humor contains two components (one of which is specific to aqueous) which, when simultaneously present, hydrophobically bind to microporous filters and lead to filter blockage. Some implications for aqueous humor flow through the JCT are briefly discussed. PMID- 2703317 TI - Buffering in human tears: pH responses to acid and base challenge. AB - The buffering capacity of tears collected from six young, healthy subjects was assessed using a microtitration technique. Each subject provided, on six separate occasions, about 100 microliter of tears, collected in small amounts and with minimal mechanical stimulation over several hours. The pH of the total stirred pool of tears from each subject was determined at the outset. This pool of tears was then divided into two equal volume aliquots, the pH of each being determined following each titration step of one of them with acid, and of the other with base. In all, 28 titration steps across the acid-base spectrum were completed for each patient pool collected. A total of 1044 tear pH measurements were made, all being done in a closed, temperature stabilized (36 degrees C) microelectrode chamber having an accuracy of within 0.04 pH units. For a comparative reference, an identical titration procedure was used on degassed, demineralized distilled water (348 pH determinations). Buffering capacity was found to show considerable intersubject variations, but in all cases the effect was more pronounced and more uniform following acid titration. Local zones of enhanced buffering across the pH spectrum could be identified, presumably reflecting the multiple buffering components (bicarbonate, protein and others) present in tear fluid. PMID- 2703318 TI - Magnitude and velocity of proximal vergence. AB - Until recently proximal vergence was considered to play only a minor role in the eye alignment changes that occur when looking between distant and near targets. We measured the magnitude and velocity of proximal vergence using infrared limbal sensing to record vergence responses between two untextured luminous horizontal rods which lacked disparity and accommodative cues. The magnitude of proximal vergence responses averaged 3.9 degrees for convergence and 3.8 degrees for divergence, about 70% of the total vergence "demand." Peak velocities for proximal convergence and divergence averaged 69 and 53 deg/sec, substantially faster than the velocities of comparably sized disparity or accommodative vergence responses. Its rapid velocity makes proximal vergence well suited to initiate the eye alignment changes between distant and near targets. PMID- 2703319 TI - Dark-rearing interference with emmetropization in the rhesus monkey. AB - Dark rearing has been shown to protect against the development of lid-suture myopia in monkeys and tree shrews. Dark-reared monkeys and cats, with or without lid suture, are significantly hyperopic in comparison to light-reared controls. The time course of refractive change during dark rearing has only been systematically investigated in chicks, with hyperopia increasing from 14 to 42 days after hatching. Longitudinal refractions of dark-reared monkeys have not been reported previously. Five infant rhesus monkeys were dark reared with their mothers from the first day of life until 58 to 161 days of age. Cycloplegic retinoscopies were performed at 2-week intervals and were compared with cross sectional data from 18 normal monkeys at ages 1 to 81 days. The normal monkeys typically had hyperopic refractions from +4 to +8 diopters at birth with an average refraction of +2.8 diopters between 30 and 81 days of age, compared with an average refraction of +5.3 diopters between 30 and 81 days of age for the monkeys raised in darkness (difference significant at P less than 0.05). Three of the dark-reared animals retained an average of 7.0 diopters of hyperopia. Darkness thus slowed or interrupted the normal loss of hyperopia in three of the five experimental subjects, and may be useful for creating model hyperopic animals on the order of +5 to +8 diopters. PMID- 2703320 TI - Metabolic changes in the cornea of vitamin A-deficient rats. AB - We have investigated alterations of the metabolic state in vitamin A-deficient (A ) corneas using phosphorus-31 (31P) nuclear magnetic resonance (NMR) spectroscopy. Comparing to the control, A- corneas showed a prominent rise of phosphocreatine (PCr) as well as a total loss of glycerophosphorylcholine (GPC). Further, ATP levels were lower, and sugar phosphates (SP) and inorganic phosphate (Pi) were higher than those of the control. The accumulation of PCr and Pi, and decrease of ATP indicate that the activity of creatine kinase may be altered in vitamin A deficiency. These results suggest that vitamin A may have a role in creatine kinase activation and/or induction and that its deficiency causes a decline of energy metabolism in corneal epithelium. Moreover, disappearance of GPC implies an impaired cellular membrane metabolism. When retinyl acetate was supplied to A-rats for 5 weeks, the 31P profiles of vitamin A-repleted rat corneas recovered to normal. PMID- 2703321 TI - A circadian rhythm of aqueous flow underlies the circadian rhythm of IOP in NZW rabbits. AB - There is a daily rhythm of aqueous flow in New Zealand White rabbits entrained to 12 hr light:12 hr dark. The phase of the rhythm of flow is determined by the phase of the light:dark cycle, and the rhythm persists in constant dark. Therefore, in New Zealand White rabbits the rhythm of aqueous flow, like the rhythm of intraocular pressure, is circadian. The range of the circadian rhythm of flow suggests it plays a major role in producing the circadian rhythm of intraocular pressure. This animal model provides a powerful tool for studying endogenous mechanisms which regulate aqueous humor formation and intraocular pressure. PMID- 2703322 TI - Health care--towards a policy. PMID- 2703323 TI - Reflex sympathetic dystrophy syndrome following minor trauma. AB - The reflex sympathetic dystrophy syndrome (RSDS) is an excessive or exaggerated response of an extremity to injury, manifested by burning pain, vasomotor disturbances, delayed functional recovery and trophic changes. The most common precipitating event is trauma. Early initiation of treatment improves therapeutic success. We describe three patients with RSDS, and discuss the prevalence, diagnosis and treatment of this condition. Physicians in primary care, traumatology and occupational medicine clinics should be aware of the clinical characteristics of this infrequent complication of limb trauma in order to avoid unnecessary diagnostic procedures and delay in treatment. PMID- 2703324 TI - Risk factors for recurrence of symptomatic urinary tract infection in young women. PMID- 2703325 TI - Tuberculosis in a family practice, 1984-86. PMID- 2703326 TI - Primary striated muscle lymphoma presenting in an amputation stump. PMID- 2703327 TI - Muscle glycogen phosphorylase deficiency. PMID- 2703328 TI - McArdle disease in a Druze family. AB - McArdle disease is reported in three generations of a consanguineous Druze family. The diagnosis was established on the basis of a failure of a rise in lactate in the ischemic forearm exercise test, glycogen accumulation in muscle fibers and the lack of myophosphorylase by histochemical and biochemical studies. The inheritance pattern is compatible with an autosomal recessive mode. Examination of family members revealed a marked variability in the clinical findings and functional status. This is the first reported case of the disorder in this ethnic group. PMID- 2703329 TI - Hyponatremia in internal medicine ward patients: causes, treatment and prognosis. AB - A prospective study among unselected patients hospitalized in an internal medicine ward showed that 46 patients, 6.9% of total admissions, had serum concentrations of sodium less than 132 mEq/l. In 28.3% of hyponatremic patients (n = 13), the cause was the syndrome of inappropriate antidiuretic hormone secretion; 21.7% of the cases (n = 10) developed hyponatremia during hospitalization, mainly because of hypotonic solution administration. The mortality rate among the hyponatremic patients was high (30.4%) and was not influenced by treatment of hyponatremia. In our opinion, the high mortality reflects the severity of the underlying diseases, although 82.5% of the patients were asymptomatic or had mild neurological signs. There was no significant correlation between the degree of hyponatremia and neurological signs, or mortality. PMID- 2703330 TI - Infant mortality in the Western Galilee, 1964-86. AB - The infant mortality rate (IMR) in the Jewish and Arab populations in the Western Galilee was studied during the 2-year period 1985-86, and compared with those of previous surveys conducted since 1964-65. The IMR declined steadily during the two decades, from 33.6 to 8.5/1,000 in the Jewish population and from 49.2 to 18.2/1,000 in the Arab population. The decline was noted in both neonatal and postneonatal periods. Analysis of the causes of death showed that enteric and respiratory infections ranked high in the first and second surveys (1964-65 and 1970) and decreased to a low level in both population groups in recent years, but were still relatively high among Arab infants living in villages. The decrease in the IMR seems to be the result of an improvement in the general living conditions of the population and the efficiency of the health services. PMID- 2703331 TI - Effectiveness of vitamin E and colchicine in amelioration of paraquat lung injuries using an experimental model. AB - The major cause of death in paraquat poisoning is a rapidly progressive respiratory failure due to an oxidative insult to the alveolar epithelium with subsequent fulminant obliterating fibrosis. The present study evaluates the effectiveness of vitamin E in combination with colchicine in ameliorating paraquat lung injuries in rats. Vitamin E is a biologic antioxidant interfering with lipid peroxidation, and colchicine reduces collagen synthesis which is significantly augmented in pulmonary fibrosis. Eight normal rats were given a single i.p. dose of paraquat at 15 mg/kg. The treated group included eight animals that received, in addition to i.p. paraquat (15 mg/kg), daily doses of vitamin E (100 mg/kg i.p.) and colchicine (0.1 mg/kg i.p.). All the rats in the paraquat group died within 42 to 96 h, six of them within 60 h, following severe respiratory failure. The treated rats developed a somewhat milder form of respiratory insufficiency, six of them dying within 48 to 72 h. Less severe intra alveolar hemorrhages were observed in this group. Two rats survived, and these had only mild emphysema on autopsy at 21 days. Our preliminary results suggest that the combination of vitamin E with colchicine may be effective in ameliorating lung injuries caused by paraquat, and warrant further studies. PMID- 2703332 TI - Colchicine treatment of abdominal pains in porphyric patients. AB - Four hepatic porphyria patients were treated with colchicine for abdominal pains. Colchicine administration during prodromal abdominal symptoms prevented the development of these abdominal crises. When colchicine was given after initiation of the crisis the duration and magnitude of the abdominal pains decreased. PMID- 2703333 TI - Co-operation means power and influence in the political arena--the Nebraska experience. PMID- 2703334 TI - NCLEX: keeping pace with practice. PMID- 2703335 TI - Medical ethics in the Soviet Union. PMID- 2703336 TI - The artificial heart juggernaut. PMID- 2703337 TI - Preterm labor and prenatal harm. PMID- 2703338 TI - Webster and the politics of abortion. PMID- 2703339 TI - Contested terrain. Beastly questions. PMID- 2703340 TI - Required request revisited. PMID- 2703341 TI - An audit of wart treatment in a Scottish dermatology department. AB - We measured a dermatology department's workload from wart treatment in terms of time and numbers, and we studied the use made of routine treatments according to the site of the warts and the age of the patient. Twenty-one per cent of new referrals were for warts and 19% of clinic time was used for wart treatment, 9% of clinic time was for plantar warts alone and 29.5% of new patients failed to attend. Overall cryotherapy was the commonest treatment, particularly for warts on the hands and face, 73.2% of patients treated for hand warts defaulted from follow-up and 11.3% were referred back for further treatment. The implications of the results are discussed and we argue that hospital budget holders should fund community-based wart treatment facilities. PMID- 2703342 TI - Rehabilitation status--dysfunction and treatment outcome in a psychiatric day hospital. AB - Two groups of patients representing the common objectives of Day Hospitals, namely steady progress and maintenance in the community, were studied. The Morningside Rehabilitation Scale was used to measure dependency, inactivity, isolation and the effects of current symptoms on the patient's life-style. Small but significant changes including in some cases crucial changes which involve working capacity were observed. There is discussion on the value of standardised measurement and the expression of results in terms of levels of functioning. The effect on multi-professional communication and on the possibilities of comparison and planning of services is discussed. PMID- 2703343 TI - Evaluation of redesignation of acute medical wards to geriatric rehabilitation/assessment. AB - This paper examines the results of the change of use of 44 out of a complement of 128 general medical beds to geriatric rehabilitation/assessment beds in a general hospital. The method is based on bed utilisation statistics and the results demonstrate that the reduced complement of medical beds functions more efficiently with no reduction in the number of discharges despite a reduction of 34% in available beds. PMID- 2703344 TI - The Chief Scientist reports ... review of computer mapping of health data. PMID- 2703345 TI - Patient access to general practice medical records. PMID- 2703346 TI - Timing of ovulation for artificial insemination. AB - Two studies involving eighty women having treatment with artificial insemination by donor (AID) have demonstrated that the use of a urinary semi-quantitative assay for luteinising hormone (LH) gives pregnancy rates comparable to those obtained using plasma LH for the timing of insemination. The advantage of self test assay is evident in a scattered region such as Grampian. PMID- 2703347 TI - Development of a new self-help guide--Freedom From Smoking for you and your family. AB - This article describes the development of a new smoking cessation and maintenance guide aimed at a broad spectrum of cigarette smokers. To accomplish this task the authors reviewed the research literature and conducted a series of iterative pretests with representatives of the target populations using qualitative and quantitative methods. A process is described for developing health education materials which includes the selection of the target audience, organization and presentation of content, and pretesting of the material. The utility of this user oriented strategy and step-by-step pretesting is discussed. PMID- 2703348 TI - Pretest and treatment effects in an elementary school-based alcohol misuse prevention program. AB - Forty-nine schools (N = 5,680 fifth and sixth grade students) were assigned to pretest/treatment, pretest/no treatment, no pretest/treatment, and no pretest/no treatment conditions in the context of an alcohol misuse prevention study. At the first posttest, five months after the pretest and two months after the intervention, the effects of the pretest and of the intervention were examined. The analyses showed that failure to correct for the design effect due to clustering within schools resulted in the overestimation of the significance of treatment and pretest effects. After correction for the design effect, a significant treatment effect in the hypothesized direction was found with respect to students' awareness of the content of the curriculum. As hypothesized, significant treatment effects on the alcohol use and misuse measures had not yet developed but are expected to occur at subsequent posttest occasions. Significant pretest effects were found for indices measuring trouble with peers resulting from students' alcohol use, students' internal health locus of control, and their perceptions of adults as a locus of control for their health. Two of the three pretest effects were in the direction that would be hypothesized if the pretest were providing the same impetus as the intervention. Implications of these findings for school-based substance abuse prevention programs are discussed. PMID- 2703349 TI - A hospital-based infant safety seat program for low-income families: assessment of population needs and provider practices. AB - Evaluation of a hospital-based car safety seat education and loan program for low income families included hospital interviews with new mothers (N = 94), a survey of pediatricians (N = 28), and a task analysis of the program coordinator's time. Mothers who entered the hospital with safety seats were more likely than those without safety seats to (1) be White or Mexican-American than Black; (2) not be dependent on public transportation; (3) have an older child who always rides in a car seat; and (4) wear seat belts themselves. Mothers with seats did not differ from mothers without seats in knowledge or beliefs about the importance of, or intent to use, car seats. Of mothers without seats, 86.3% were aware of the hospital's car seat rental program, but only 12 of 51 rented a seat from the program. 61% of pediatricians surveyed believed that mothers' lack knowledge and skills to acquire and use car seats regularly, but only 31% always included education about the importance of using car seats and only 21% always referred mothers without seats to the rental program. Car seat loan programs addressing low-income populations should place greater emphasis on education of medical providers to provide education and referrals, encourage organizational policy that requires a safe first ride home and address issues of social support and perceived norms and ease of acquisition. PMID- 2703350 TI - Measuring and tracking education program implementation: the Minnesota Heart Health Program experience. AB - In an overall framework uniting program planning and evaluation, process evaluation can assist community-based health promotion programs in establishing participation objectives, monitoring their achievement and the quality of interventions used, and translating these into useful information for managing and developing programs. This research reports on efforts by the Minnesota Heart Health Program to develop a system that permitted tracking educational program contacts, its implementation, and its use to make management decisions about program activities. The system was developed as part of a planning and evaluation framework with specific criteria for developing and tracking educational programs drawn from the social-learning literature. Overall, the system helped to make participation objectives more concrete, aided decision making about allocation of personnel and material resources, and encouraged the development of innovative programs. PMID- 2703351 TI - No pain, no gain: a Puritan legacy. PMID- 2703352 TI - Correlates of adolescents' use of smokeless tobacco. AB - Data are presented on the prevalence and correlates of smokeless tobacco use among a group of 568 adolescents from five public schools located in western New York State. Two of the five schools were located in rural communities, two were located in suburbs of Buffalo, and one school was located in the city of Buffalo. Nineteen percent of males reported current use of smokeless tobacco. There was very little regular use among girls, although 18% reported having tried it. Sharp regional differences in the use of smokeless tobacco were observed with the highest percentage of users among students from rural communities. Experimentation with cigarette smoking was associated with use of smokeless tobacco, however, few regular users of smokeless tobacco were current smokers. As is the case with cigarette smoking, social influences, especially those of peers and family members, were important factors associated with use of smokeless tobacco. Study findings suggest that programs that attempt to prepare students to cope with social pressures for using and stress the immediate negative consequences of use (i.e., stained teeth, bad breath) are more likely to be successful in discouraging adolescents from using smokeless tobacco than programs that only educate about the detrimental health effects of chewing and/or dipping tobacco. PMID- 2703353 TI - Sleep problems in pre-school children. AB - Records were kept by one health visitor on the progress of nine children with sleeping difficulties. All the children were from socially disadvantaged families. The results reveal that the individual constructional treatment programmes which were applied by the health visitor were effective within a brief period and were not costly. Implications for health visiting practice are discussed and further issues about behavioural treatment and service delivery raised. PMID- 2703354 TI - The pharmacist and the health visitor. AB - The officers and staff of the Royal Pharmaceutical Society meet with members of other organisations to discuss common areas of interest and to look at ways of achieving co-operation in the community. To this end, articles about our various roles appear in each others' professional journals. For example, an article on health visiting by Roma Iskander of the HVA was published in the RPS journal. PMID- 2703355 TI - Help--toddler at large! AB - Following an initiative by the staff at the child development centre at Maelor Hospital in Wrexham, a group of mothers with toddlers set up, manage and run self help discussion groups covering aspects of family life with toddlers. PMID- 2703356 TI - Playmates--a group childminding scheme. PMID- 2703357 TI - Practical application of Portage. AB - The Portage model and its benefits to families are outlined. The application of the model to two four year old children with behavioural difficulties is presented in case studies. In the first, a mother successfully coped with her daughter's behaviour problems and their relationship was much improved. In the second, a boy's feeding problems were resolved and the attitudes of the child and his mother to his diet benefitted. The advantages of using a structured behavioural programme to develop parents' skills are highlighted. PMID- 2703358 TI - Modularity in health visitor education. AB - This examination of curriculum innovation in health visitor education suggests proposals requiring an appreciation of changing health visiting practice, Project 2000 and developments in higher and further education. PMID- 2703359 TI - Teenage smoking and health education. AB - Whilst recent OPCS surveys in 1984 and 1986 have revealed that the proportion of smokers in secondary schools is decreasing, smoking continues to remain at alarming levels. Therefore, it is of importance to identify why, when, where and what adolescents smoke in order to produce appropriate packages of health education material. Numerous studies have sought to highlight factors and features of importance. Youthscan data provides an analysis of 16-17 year-olds which will supplement information already available. PMID- 2703360 TI - Healthy eating starts at school. AB - The healthy eating programme targeted at children attending Montagu Primary School is described. The project was placed first in the professional category of the 1987 Domestos Health Education Awards. PMID- 2703361 TI - Tackling headlice. AB - A description of the life cycle, appearance and daily habits of the headlouse is followed by guidance on eradication. The psychological effects of infestation on both child and parent are considered as a background to the relevant health education programmes. PMID- 2703362 TI - High frequencies of a rearrangement (+ATA; -T) at -530 to the beta-globin gene in different populations indicate the absence of a correlation with a silent beta thalassemia determinant. AB - DNA samples from numerous subjects of different racial and ethnic backgrounds, with or without various hemoglobinopathies (classical beta-thalassemia; silent beta-thalassemia, Hb E, sickle cell anemia), were studied for a rearrangement (+ATA; -T) at nucleotide -530 in the 5' flanking region of the beta-globin gene using amplified DNA and 32P-labeled synthetic oligonucleotide probes. The data show that this unusual sequence is a common feature among East-Asians and Blacks (particularly SS patients), and is not associated with mild thalassemic features typical for the silent form of beta-thalassemia, as has been suggested (5). PMID- 2703363 TI - Hb Hope, beta 136(H14)Gly----Asp, in a diabetic Japanese female and its functional characterization. AB - A beta-variant hemoglobin, first misjudged as a marked elevation of Hb A1, was found in a 68-year-old Japanese female with diabetes mellitus. This hemoglobin was isolated by Bio-Rex 70 chromatography combined with chromatofocusing, and was found to be Hb Hope, beta 136(H14)Gly----Asp, by classical and high performance liquid chromatographic peptide mapping techniques. Intrinsic oxygen affinity of this hemoglobin was approximately one-third as compared with that of Hb A0. This property was still observed in the constituent beta subunits isolated. Effects of such allosteric effectors as H+ (at a fixed concentration of Cl-), anion (Cl-), 2,3-diphosphoglycerate and carbon dioxide were more or less depressed. Among others, a marked reduction in the carbamate effect should be noted in a structural interpretation of the functional modifications. Subunit cooperativity, on the contrary, was not different from that in Hb A0 (n = 2.8-2.9). Explanation of these altered functions were attempted on the basis of the altered structure. The reduced stability of Hb Hope is also described. PMID- 2703364 TI - Identification of Hb J-Sardegna [alpha 50(CE8)His----Asp] by HPLC and its incidence in northern Sardinia. AB - As many as 7,717 babies born consecutively and 3,412 blood donors of Sardinian ancestry have been examined for the detection of the Hb J-Sardegna variant [alpha 50(CE8)His----Asp]; all subjects were from Northern Sardinia. Hemolysates were analyzed by isoelectricfocusing and the identification of the variant was made by reversed phase high performance liquid chromatography of the tryptic peptides. A total of 28 carriers (1:397) of Hb J-Sardegna were identified. The incidence of 0.25% makes this hemoglobin one of the most common alpha-globin structural mutants in humans. The distribution of the anomaly appears to be nonhomogeneous in the island. The quantity of the variant ranged from 19 to 36%; this wide range probably reflects the co-inheritance of an alpha-thalassemia anomaly. PMID- 2703365 TI - A search for anomalies in the zeta, alpha, beta, and gamma globin gene arrangements in normal black, Italian, Turkish, and Spanish newborns. AB - Globin gene mapping analyses of DNA from numerous Black babies, and from newborns from Sardinia, Sicily, Turkey, and Spain have identified the following: A high incidence of alpha-thalassemia-2 heterozygotes among Black babies with less than 1% Hb Bart's at birth and a high incidence of alpha-thalassemia-2 among Sardinians, but not among Sicilian, Turkish, and Spanish babies. A relatively high incidence of zeta-thalassemia was present among Black babies only, while triplicated zeta was seen in four of the five populations. Two Black babies were each found to have a different theta 1 deletion; two Sardinian babies had a newly discovered approximately 2.5 kb deletion between zeta and psi zeta; four babies had the rare Bgl II polymorphism between psi zeta and psi alpha; and one Black baby lacked the Eco RI site 3' to zeta. Quantitation of the zeta chain by reversed phase high performance liquid chromatography showed that two-thirds of the babies with four alpha genes (alpha alpha/alpha alpha) had levels between 0.1 and 1.0%, while nearly 90% of the babies with -alpha/alpha alpha had similar levels (averaging 0.2% for alpha alpha/alpha alpha; 0.35% for -alpha/alpha alpha; 0.75% for -alpha/-alpha). Additional data indicated that the occurrence and level of zeta are related to the level of beta, i.e. the gestational age. The presence of a zeta triplication did not affect the level of zeta in cord blood. The extensive search for gamma-globin gene anomalies resulted in the discovery of a chromosome with five gamma genes. gamma-Thalassemia was rare in all populations, while the -G gamma-G gamma- gene arrangement was mainly observed among Black babies; this arrangement is primarily responsible for high G gamma levels in cord blood samples. The strong correlation between the presence or absence of a C----T mutation at position -158 (measured in Xmn I digests) and the level of G gamma was confirmed for adult blood samples. A search for possible anomalies in the delta-beta- region through gene mapping with Eco RV gave negative results except for the discovery of a polymorphic site 5' to delta in one of the 371 Black babies tested. PMID- 2703366 TI - Hb G-Coushatta or alpha 2 beta 222(B4)Glu----Ala in a Turkish male. PMID- 2703367 TI - Hb J-Lome or alpha 2 beta 259(E3)Lys----Asn in a Vietnamese family. PMID- 2703368 TI - Hb N-Baltimore or beta 95(Fg2)Lys----Glu in Portugal. PMID- 2703369 TI - Further examples of Hb Takamatsu in Japan. PMID- 2703371 TI - [The "normal" pneumatization of the temporal bone]. AB - Radiographs of the mastoids and the petrous pyramids of ear-healthy adults were investigated to ascertain the normal appearance of the temporal bone pneumatisation. The radiographs included those of patients with skull trauma, provided that these subjects had had no signs or symptoms of middle ear disease or hearing loss before the trauma. The extent of pneumatisation of the mastoid and petrous pyramid ranged from small cell groups around the mastoid antrum to extensive cell formations in the squamous temporal bone, in the apex of the petrous pyramid and in the retrosinus area. The planimetric measurements did not correspond to a normal distribution. It was also striking that ears could be found among these healthy individuals with irregular, asymmetric or indistinct pneumatisation, probably as a residual of sub-clinical middle ear disorders during the development of the cell system. After eliminating these irregular findings the ears with exclusively regular, symmetric and clear cell pictures also did not follow a normal distribution. Rather, they resulted in a typical curve with a steep ascent rising from a functionally-necessary minimum of about 4 cm2 to mean values of 8-12 cm2, and then a wide distribution reaching a value of 26 cm2. All these can be taken as genetically-determined "normal variants". The irregular cell-formations were seen mainly in the smaller pneumatised mastoids, so that it can be concluded that exogenous influences have at some time disturbed the pneumatisation process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703370 TI - Hemoglobin Shenyang found among Uygurs in P.R. China. PMID- 2703372 TI - [Simultaneous determination of oxygen partial pressure in the scala tympani, electrocochleography and blood pressure values in the guinea pig]. AB - Nineteen guinea pigs were exposed to impulse noise from gunfire (G3 of the Federal German Army, 156 dB peak SPL), 6+6 shots or 12+6 shots, with a 3-s pulse interval. For simultaneous measurements of pO2, cochlea microphonics (CM) and compound action potentials of the auditory nerve (CAP), we used the thin 0.5 microns microcoaxial needle electrode described by Baumgaertl and Luebbers, which was placed through the roundwindow membrane into the scala tympani to a depth of 1000 microns. After exposure to the first 6 or 12 gunshots, the pO2 increased by about 20% of the original values in 12 guinea pigs (63%). In the following 30 min of recovery time the pO2 decreased, stabilized or showed a further decline. There were only 3 animals with a pO2 loss of 70% of the original values. Most animals showed a decline of 25% at the end of the recovery period. In all animals after 6 additional shots, the pO2 only decreased by another 5% of the original values. Amplitudes of CM and CAP were reduced by about 40% of the original values after 6 or 12 shots and by another 20%-24% (CM) and 5%-15% (CAP) after 6 additional shots. The intra-arterial blood pressure in the common carotid artery remained constant. The results are discussed with respect to the well-known morphological damage, subsequent ion imbalance and hypoxia within the cortilymph after exposure to gunfire. These changes are reflected in the loss of CMs and CAPs. PMID- 2703373 TI - [Abnormalities of the bulbus venae jugularis: a cause for pulse synchronous tinnitus?]. AB - Tinnitus synchronous with the pulse is usually caused by vascular processes. The best-known sources are vascular temporal bone tumours and arteriovenous malformations. Vascular tinnitus due to anomalies of the venous system is an entity of its own and may be associated with anomalies of the jugular foramen. The present investigation shows that a high jugular bulb facilitates the occurrence of pulsatile tinnitus, albeit not necessarily leading to a bruit. Imaging methods are necessary not only in the assessment of the jugular bulb but also in the diagnosis of intracranial hypertension, which can present by a typical venous tinnitus. PMID- 2703374 TI - [DNA impulse cytophotometry measurements in head and neck tumors. Initial results of a correlation with clinical stage, therapeutic response and pattern of recurrence]. AB - The DNA index and proliferation rate (percentage of S-phase cells) of 52 head and neck tumours were analysed by flow cytometry. Thirty-one (60%) of these tumours were aneuploid, 21 (40%) diploid. The distribution of aneuploid tumours was nearly equal in all T-stages. In contrast, the number of aneuploid tumours increased with higher N-stages. Locoregional recurrences developed more often (69%) in aneuploid tumours than in diploid tumours (54%). Furthermore, recurrence presented earlier (median 5 months) than in the latter (median 11 months). Regional recurrences were mainly observed in aneuploid tumours, local recurrences in diploid tumours. PMID- 2703375 TI - [Assessment of kidney function before cisplatin administration: the need for 24 hour urine collection]. AB - Creatinine clearance as a measure of the glomerular filtration rate is calculated from the serum creatinine, urine creatinine concentration and the 24-h urine volume (MCC). Cockroft and Gault as well as Davila and Gardener have shown that estimation of the creatinine clearance (ECC) from the serum creatinine, age, sex, and weight of the patient is at least as accurate as measurement of creatinine clearance (MCC). ECC is not influenced by inaccurate collections of urine or incorrect analyses of urine creatinine. 125 MCC was investigated in 51 patients receiving cisplatin. If ECC is less than or equal to 80, then MCC should eliminate inaccurate urine collections. If the value of ECC exceeds 80, it is not necessary to measure MCC. PMID- 2703376 TI - [Equipment for CO2 laser surgery]. AB - The laryngoscope designed by Kleinsasser is the most suitable for CO2 laser surgery of the larynx. This laryngoscope has been modified by two aspiration tubes mounted on the outside and opening only a short distance above the distal end of the endoscope. The expansion laryngoscope designed by Weerda is very suitable for the hypopharynx. We have shortened this endoscope by 5 cm for work in the oropharynx. The double-cupped forceps designed for microlaryngoscopy was modified by the addition of aspiration tubes. Several instruments have been developed to protect the soft tissues of the larynx from aberrant laser radiation. Their shaft has been fitted with aspiration canals to improve the extraction of smoke. PMID- 2703377 TI - The reaction between nitracrine and glutathione: implications for hypoxic cell radiosensitization and cytotoxicity. AB - Nitracrine (NC) is an electron affinic DNA intercalating agent and a potent hypoxia-selective cytotoxin and radiosensitizer in cell culture. Although NC is too cytotoxic and too rapidly metabolized to provide hypoxic cell radiosensitization in tumors, it is of mechanistic interest as an example of a DNA affinic radiosensitizer. We have observed a rapid chemical reaction between NC and reduced glutathione (GSH), which suggests that the observed potent in vitro cytotoxicity and radiosensitization might be dependent on thiol depletion by the large extracellular reservoir of drug. However, no GSH depletion was observed under conditions providing radiosensitization or rapid cell killing, and prior depletion of GSH by buthionine sulphoximine had no effect on cytotoxicity or formation of macromolecular adducts. Further, the intracellular reaction of NC with GSH is slower than predicted on the basis of the measured second order rate constant and the total intracellular concentrations of both species. The results are consistent with a role for DNA binding in protecting NC from reaction with GSH, and in improving the efficiency with which reduced electrophilic metabolites react with DNA in preference to GSH. PMID- 2703378 TI - Radiosensitizer-DNA interactions in relation to intracellular uptake. AB - We have studied the intracellular uptake of a number of neutral, acidic, and basic radiosensitizers. For neutral sensitizers, we observed a correlation between the measured intracellular concentration and sensitization, but for bases, a large change in average intracellular concentration results in only a small change in sensitization. In addition, by modifying the intralysosomal pH, we have altered the measured average intracellular concentration of the weak base pimonidazole by a factor of two, although this had no detectable effect upon sensitization. Using spin filtration of solutions of sensitizers with naked calf thymus DNA or chromatin we have assessed the affinity of DNA for sensitizers with different prototropic and lipophilic properties. We have also shown that this anomalous behavior of the basic sensitizers could be partly explained on the basis of intracellular localization adjacent to the DNA due to ionic interactions. Thus, intracellular localization needs to be considered when interpreting average intracellular uptake data. PMID- 2703379 TI - 1-Methyl-2-nitrosoimidazole: cytotoxic and glutathione depleting capabilities. AB - We tested 1-methyl-2-nitrosoimidazole (INO), the two electron reduction product of 1-methyl-2-nitroimidazole (INO2) for its in vitro cytotoxicity and glutathione (GSH) depleting capabilities. The half life of INO was shown to be dependent on cell concentration above 10(5) cells/ml, decreasing with increasing cell concentration up to 2 X 10(6) cells/ml. For a 10-fold decrease in cell concentration, from 10(6) to 10(5) cells/ml, the toxicity curve shifted 10-fold towards lower concentrations. At 10(6) cells/ml, INO depleted GSH, in the range of concentrations where toxicity was observed, down to a plateau of 15% of the control level at a concentration of 100 microM INO. Oxidized glutathione (GSSG) levels were not elevated significantly above control cultures at this concentration. INO2, 1000 microM, did not deplete GSH under similar exposure conditions while 2-hydroxylamino-1-methylimidazole (INHOH) depleted GSH minimally at this same concentration. The nitroso intermediate may play a central role in the toxicity and GSH depleting capabilities of 2-nitroimidazoles in mammalian cells. PMID- 2703380 TI - Combined radiation-protective and radiation-sensitizing agents. IV: Measurement of intracellular protector concentrations. AB - Radiosensitization of hypoxic V79 Chinese hamster cells by 0.5 mM misonidazole at approximately 0-4 degrees C is substantially enhanced by pretreating the cells overnight with 0.1 mM buthionine sulfoximine, which lowers the cellular glutathione content to 5% of control values (from 4 mM to approximately 0.2 mM). The enhanced sensitization is reversed by concentrations of exogenous cysteine that are much lower (0.02 mM) than the original glutathione content. Reduced Co enzyme A affords reversal of the enhancing effect at concentrations of about 1 mM. Sodium ascorbate gives no protection at all even at concentrations of 2 mM. The intracellular concentration of the reducing agents was measured using a spin through oil technique. There was no diffusion of Co-A (MW greater than 750) or ascorbate (excluded by charge) into the cells. In contrast, cysteine was rapidly concentrated by factors of 4-10, even at the low temperatures used. Extracellular ascorbate's inability to radioprotect argues against electron transfer across the cell membrane as a mechanism for radioprotection. This mechanism could have explained the ability of exogenous thiols to radioprotect in former studies using glutathione, and in the present studies using Co-A. The potential of cysteine to be concentrated by cells poses a problem in the interpretation of "exogenous protection" by non-diffusing thiols, since trace contamination by cysteine could lead to the actual protection observed. Cysteine could also be formed by exchange reactions of exogenous thiols with the disulfide of cysteine, present in all media formulations. PMID- 2703381 TI - KIH-802: 2-nitroimidazole-1-acetohydroxamate as a hypoxic cell radiosensitizer. AB - We have identified potassium 2-nitroimidazole-1-acetohydroxamate (KIH-802) as a hypoxic cell radiosensitizer potentially superior to Miso. The water-soluble acetohydroxamates of 2-nitroimidazole (KIH-802; free acid 801) and 4 nitroimidazole (KIH-852) were designed, synthesized, and evaluated by in vitro and in vivo screening against EMT6 cells. Enhancement ratios of KIH-802 and 801 were 1.92 and 1.68, respectively, compared with 1.58 for MISO all at 1 mM. These acetohydroxamates are also expected to be more effective in vitro than SR-2508 based on our previous experiments. In vivo ERs of KIH-802, 801, and 852 were 1.75, 1.50, and 1.35, respectively, compared with 1.57 for MISO all at the same dose of 200 mg/kg. The data clearly show that the addition of an acetohydroxamic acid moiety to the 2-nitroimidazole skeleton can enhance radiosensitizing ability. PMID- 2703382 TI - Importance of tumor affinity of nitroazoles in hypoxic radiosensitization. AB - In vitro and in vivo sensitizing activities of a variety of nitroazole derivatives including misonidazole (MISO), SR-2508, and RSU-1069 were correlated by the aid of pharmacokinetic measurements of the drug uptake in animal solid tumors. The sensitizer enhancement ratio in vivo (SERvivo) on solid tumors increased linearly with the square root of administrated dose (Ds). The specific activity (A) in vivo of nitroazoles was evaluated from the square-root empirical relationship, SERvivo = 1.00 + A D1/2S. The intratumor concentration of nitroazoles at a given time t after administration was in proportion to the DS, in which the proportional constant was defined as the tumor-affinity factor FT,t. The absolute molar activity alpha M defined by A(M/FT,t)1/2, where M is the molecular weight of nitroazoles, showed a linear relationship with the SER in vitro (SERvitro) at 1 mM of sensitizers. The sensitizer dose required to achieve an SERvivo of 1.5 (DS,1.5) decreased and thus the overall sensitizing efficiency on animal solid tumors increased as the FT,t became greater. PMID- 2703383 TI - NLP-1: a DNA intercalating hypoxic cell radiosensitizer and cytotoxin. AB - The 2-nitroimidazole linked phenanthridine, NLP-1 (5-[3-(2-nitro-1-imidazoyl) propyl]-phenanthridinium bromide), was synthesized with the rationale of targeting the nitroimidazole to DNA via the phenanthridine ring. The drug is soluble in aqueous solution (greater than 25 mM) and stable at room temperature. It binds to DNA with a binding constant 1/30 that of ethidium bromide. At a concentration of 0.5 mM, NLP-1 is 8 times more toxic to hypoxic than aerobic cells at 37 degrees C. This concentration is 40 times less than the concentration of misonidazole, a non-intercalating 2-nitroimidazole, required for the same degree of hypoxic cell toxicity. The toxicity of NLP-1 is reduced at least 10 fold at 0 degrees C. Its ability to radiosensitize hypoxic cells is similar to misonidazole at 0 degrees C. Thus the putative targeting of the 2-nitroimidazole, NLP-1, to DNA, via its phenanthridine group, enhances its hypoxic toxicity, but not its radiosensitizing ability under the present test conditions. NLP-1 represents a lead compound for intercalating 2-nitroimidazoles with selective toxicity for hypoxic cells. PMID- 2703384 TI - Characteristics of fluorinated nitroazoles as hypoxic cell radiosensitizers. AB - Types of 2-nitroimidazoles and 3-nitro-1,2,4-triazoles bearing one or two fluorine atoms on their side chains were synthesized to evaluate their physicochemical properties, radiosensitizing effects, and toxicity. The reduction potential of the compounds containing one fluorine was similar to that of misonidazole (MISO), whereas that of the difluorinated compounds was slightly higher. Both mono- and difluorinated compounds had an in vitro sensitizing activity comparable to or slightly higher than that of MISO. The fluorinated 3 nitrotriazoles were almost as efficient as the 2-nitroimidazoles with the same substituent. In vivo, some of the compounds were up to twice more efficient than MISO, whereas others were as efficient as MISO. Toxicity in terms of LD50/7 in mice was quite variable depending on the side-chain structure; the amide derivatives were less toxic than MISO, whereas the alcohol and ether derivatives were more toxic. In view of the radiosensitizing effect and toxicity in vivo, at least one compound, KU-2285 (a 2-nitroimidazole with an N1-substituent of: CH2CF2CONHCH2CH2OH) has been found to be as useful a hypoxic cell sensitizer as SR-2508. PMID- 2703385 TI - Potentiation of radiation-induced cell kill by synthetic metalloporphyrins. AB - The effects of the combination of several meso-substituted, water soluble metalloporphyrins with ionizing radiation on hypoxic and oxic monolayers of Chinese hamster fibroblast (V79N) cells were studied. The metalloporphyrins tested included a series of cationic metalloporphyrins complexed with Co(III), Zn(II), Fe(III), Cu(II), Pd(II) or Mn(III) and a series of anionic porphyrins chelated with Co(III), Fe(III), Cu(II), Rh(III), Mn(III) or Sn(IV). Both cationic and anionic free porphyrins were also tested. Cationic ligands were tetrakis(4N methylpyridyl)porphine [TMPyP], tetrakis(4N-trimethylamino phenyl)porphine [TMAP], tetrakis(4N-butylpyridyl)porphine [TBPyP] and tetrakis(3N methylpyridyl)porphine [3TMPyP]. Anionic ligands tested were tetrakis(4-sulfonato phenyl)porphine [TPPS], tetrakis(biphenyl)porphine sulfonate [TBPS] and tetrakis(4-carboxyphenyl)porphine [TCPP]. SER calculated from survival curves and SFR from one radiation dose were used to assess the relative effectiveness of this class as non-cytotoxic hypoxic and oxic cell-kill potentiators. Comparisons were made at 100 microM, which was essentially non-toxic (greater than 70% survival) for all porphyrins tested except for Co[TMPyP] (approximately 50% survival after 1 hour at 37 degrees C under oxic conditions). The greatest effects on radiation-induced cell kill were achieved with Co[TPPS] and Co[TMPyP] with SER values of 2.3 and 2.4 respectively. Porphyrin analogs with no coordinated metal were found to be less active than the same compound with metal. The overall charge on the molecule did not systematically relate to the biological activity of the compounds tested. PMID- 2703386 TI - High efficiency of ferricenium salts as radiosensitizers of V79 cells in vitro and the KHT tumor in vivo. AB - Ferricenium salts (Fc+X-) can act as radiosensitizers of hypoxic cells in vitro and of KHT tumor cells in vivo. Sensitization is manifest by a removal of the shoulder of the hypoxic radiation survival curve in vitro. This results in a dose modification factor (DMF) of 2.0 when measured at a surviving fraction of 0.1, for 10 mumol dm-3 FcPF6. In comparison, little sensitization is seen in air. The toxicity of these metal complexes, but not their radiosensitizing ability, can be decreased by including protein (Bovine serum albumin) in the medium. This may be related to the fact that the ferricenium complexes react readily with nucleophiles to generate OH radicals. Ferricenium trichloracetate, when given at a dose of 200 mg/kg to mice with the KHT tumor gives an enhancement ratio of 1.3. PMID- 2703387 TI - Positive clinical experience with misonidazole in brachytherapy and external radiotherapy. AB - We performed a clinical evaluation of Misonidazole (MISO) radiosensitization in brachytherapy and two schedules of hypofractionated external radiotherapy in 3 non randomized studies. MISO (1 g/m2/d) was administered to patients with ENT tumors treated by brachytherapy, two applications of 35 Gy each with an interval of 1 month. For 46 patients with tumor responses less than 50% (in the largest dimension) at time of second application, 21 received MISO and 25 did not. For these poorly radiosensitive tumors, the addition of MISO significantly increased the rate of complete remission from 9/25 (36%) in controls to 14/21 (67%) (p less than 0.05). We studied MISO with radiation hypofractionation for conservative breast cancer with 4 fractions over 17 days (5 Gy on days 1, 3 and 6.5 Gy on days 15 and 17). Brachytherapy alone was delivered three weeks later. MISO (1 g/m2/d) was given to 38 patients with 87 acting as controls. Radiosensitization was measured by mean tumor diameter at brachytherapy, which showed a residual mass of 33% in the group without MISO and only 17% in the group with MISO (p less than 0.05). We also studied MISO with radiation hypofractionation for large ENT tumors with 14 fractions over 45 days, 2 sessions with a 4 hour interval per day for totals of 6 Gy on days 1 and 3; 8 Gy on days 15, 17, 29, 31; and 6 Gy on day 45. MISO (1 g/m2/d) was given to 49 patients with 21 acting as controls. MISO increased the rate of complete remission from 7/21 (33%) in controls to 32/49 (65%) (p less than 0.02). PMID- 2703388 TI - The uptake of the radiosensitizing compound Ro 03-8799 (Pimonidazole) in human tumors. AB - The nitroimidazole, Ro 03-8799, has proved unique among the drugs tested as chemical hypoxic cell radiosensitizers because of the preferential concentration which has been observed in tumors. Our accumulation of experience has allowed new analyses to be performed upon 127 samples from 39 patients; 47 samples of normal tissue were also obtained from 26 of these patients. Tissue sampling was performed usually between 20 and 30 minutes after initiation of infusion of Ro 03 8799. By expressing results as tumor: plasma ratios, difficulties in comparison because of differing doses and body sizes, together with a variation in the actual time of sampling, have been avoided. A small portion of each specimen which was analyzed for drug concentration was also examined histologically to give an impression of the percentage of the specimen occupied by tumor cells. Analyses have shown that the average tumor concentration is approximately twice that of normal tissues which have been sampled and four times that in plasma. In 38 breast tumor samples, the concentration of drug varied directly as the proportion occupied by tumor cells. The highest tumor: plasma ratios were seen in samples taken from some samples of malignant melanoma. These findings confirm that a greater potency can be expected for this drug as a radiosensitizer because of its ability to enter tumor cells in high concentration. In drug development programs for chemical sensitizing and cytotoxic agents, drugs which show this phenomenon should be explored. PMID- 2703389 TI - Normobaric oxygen as a sensitizer of hypoxic tumor cells. AB - A series of experiments have been performed to determine the relative radiosensitivities of a mouse mammary tumor (CA NT) irradiated in 100% normobaric oxygen or in air, using clinically relevant dose-fractionation schedules. The results demonstrate that normobaric oxygen is a potent radiosensitizer, its effect being more marked with smaller size fractions. Enhancement ratios (ER) of 1.23 to 1.45 were obtained. By contrast, no significant benefit was seen with single doses (ER = 1.05 +/- 0.14). The degree of radiosensitization with oxygen, in these fractionated regimens, is greater than that reported for the chemical radiosensitizer, misonidazole. It therefore seems appropriate to re-examine the clinical potential of normobaric oxygen and to consider how the conditions of normobaric radiotherapy achieved in the laboratory can be translated to man. PMID- 2703390 TI - Pharmacokinetics of Ro 03-8799 in mice bearing melanosarcoma: comparison with tumors without melanin. AB - The pharmacokinetics of Ro 03-8799 has been studied in melanic and non-melanic tumor bearing mice after iv administration of 150 mg/kg. The peak concentration in B16 melanosarcoma tumor reached 152 micrograms/g, that is 7.6-fold higher than the plasma concentration at the same time. This concentration is 3-times greater than that obtained in the tumor of mice bearing non melanic sarcoma (DB16) or Lewis lung carcinoma (3LL). The exposure of B16 tumor (AUC) is respectively 15 times and 11-times higher than the 3LL and the DB16 ones. These experimental data confirm that this 2-nitro-imidazol compound has an important affinity for melanin and suggest that it might be used as a radiosensitizer for the treatment of malignant melanoma. PMID- 2703391 TI - Toxicity of RSU-1069 for KHT cells treated in vivo or in vitro: evidence for a diffusible toxic product. AB - RSU-1069 is a highly effective hypoxic cell cytotoxin in KHT sarcomas treated in vivo. However, relative to the hypoxic cells, the oxic cells in the tumor appear more sensitive to the drug than would have been predicted on the basis of results with CHO (AA8-4) cells treated in vitro with the drug under oxic and hypoxic conditions. To examine possible reasons for this difference, suspensions of KHT cells were prepared from tumors growing in vivo, and treated with RSU-1069 in vitro under oxic or hypoxic conditions. The sensitivity of the KHT cells was similar to that of AA8-4 cells, regardless of whether the cells were obtained from untreated tumors or from tumors given 15 Gy in vivo just prior to the preparation of the cell suspension. We observed, however, that the sensitivity of both AA8-4 cells and KHT cells to drug treatment under hypoxic conditions increased with the density of the cells in the treated suspension. This result suggests the possibility that a diffusible toxic product may be released from cells. Such a product could contribute to the toxicity of the drug for oxic cells in tumors in situ. PMID- 2703392 TI - The chemosensitizing and cytotoxic effects of RSU 1164 and RSU 1165 in a murine tumor model. AB - RSU 1069, the lead compound in a series of nitroimidazoles containing an alkylating aziridine function, has been shown to be a potent radiosensitizer and chemopotentiator both in vitro and in vivo. However, this agent also demonstrates significant in situ toxicity. Recently it has been shown that less toxic analogues of RSU 1069 can be produced by the introduction of alkyl substituents to moderate the reactivity of the aziridine function. The present investigations were undertaken to evaluate the in vivo cytotoxicity and chemosensitizing efficacy of two such analogues, RSU 1164 and RSU 1165. All experiments were performed with KHT sarcomas grown intra-muscularly. In the cytotoxicity studies, a range of sensitizer doses was utilized whereas in the chemopotentiation investigations a fixed sensitizer exposure was combined simultaneously with a range of doses of the nitrosourea CCNU. In both studies, tumor cell survival was determined 22-24 hr after treatment using a soft agar clonogenic assay. Normal tissue toxicity in the chemopotentiation studies was assessed by bone marrow CFU S assay. Both analogues were found to be significantly less cytotoxic to KHT sarcoma cells than RSU 1169 (a factor of 4-6 in dose at 50% cell survival). Combining a 1.0 to 2.0 mmol/kg dose of RSU 1164 or RSU 1165 with a range of doses of CCNU increased tumor cell killing by a factor of 1.5-1.6 but did not enhance bone marrow stem cell toxicity. The addition of either sensitizer to CCNU treatment therefore led to a significant therapeutic benefit. PMID- 2703393 TI - Combined effects of X rays, Ro 03-8799, and hyperthermia on growth, necrosis, and cell proliferation in a mouse tumor. AB - A mouse adenocarcinoma was treated with 20 Gy X rays, hyperthermia (30 minutes at 43 degrees C), Ro-03-8799, or a combination of two or three of these agents. Combined treatments increase growth delay in the tumor and this was greatest with the combination of all three modalities. Extensive amounts of necrosis were observed after the combined treatments. This effect was most pronounced after treatment modalities including hyperthermia. On the other hand, the radiation induced micronucleus formation was more enhanced by the sensitizer than by hyperthermia. After X irradiation and combined treatments with X rays a G2-block was observed in DNA-histograms. Tetraploid cells appeared in large amounts that started DNA synthesis followed by necrosis. From these tumors it was impossible to obtain regular DNA-histograms. Tumor regression is a combined result of reduced cell renewal, increased cytogenetic damage, and development of necrosis. PMID- 2703394 TI - Chemical modifiers of cancer treatment. Part I. Paris, France, 21-25 March 1988. Proceedings of the 6th international congress. PMID- 2703395 TI - Potential impact of improvements in radiation therapy on quality of life and survival. AB - The NCI goal for the U.S. is to reduce the cancer mortality rate to one-half by the year 2000. Part of this improvement will be due to use of state of art treatment on a population wide basis and in addition, major improvements in efficacy of treatment. More effective radiation therapy will result in fewer local failures, increased survival, reduced treatment associated morbidity, and less frequent complications of treatment. The latter two aspects are very important to quality of life. If radiation combined with other modalities (e.g., sensitizers) were to become of greatly enhanced efficacy, then the number of patients requiring cystectomy, abdominal perineal resection, pneumonectomy, amputation, etc., would come down. The beneficial consequence would be fewer patients subjected to permanent ileostomy, colostomy, etc. The increase in survival if local failure were eliminated was estimated to be the decrease in local failure less the same loss in the new local controls due to DM as obtained in the local control patients after conventional treatment. For all sites, patients experience higher survival rates if they do not have local failure. For those sites where loss due to metastasis is not high, more effective local therapy would result in numerically impressive gains in survival. PMID- 2703396 TI - Drug development for cancer: implications for chemical modifiers. PMID- 2703397 TI - 31P NMR spectroscopy and HbO2 cryospectrophotometry in prediction of tumor radioresistance caused by hypoxia. AB - The aim of this study was to search for possible relationships between the fraction of radiobiologically hypoxic cells in tumors and their 31P NMR spectral parameters and intracapillary HbO2 saturations. Four different tumor lines, two murine sarcomas (KHT, RIF-1) and two human ovarian carcinoma xenografts (MLS, OWI), were used. When tumor volume increased from about 200 mm3 to about 2000 mm3, hypoxic fraction increased from 12 to 23% for the KHT line, from 0.9 to 1.7% for the RIF-1 line, and from 9 to 28% for the MLS line. The OWI line showed similar hypoxic fractions at 200 (17%) and 2000 mm3 (15%). Tumor bioenergetic status decreased, that is, the inorganic phosphate (Pi) resonance increased and the phosphocreatine (PCr) and nucleoside triphosphate beta (NTP beta) resonances decreased, with increasing tumor volume for the KHT, RIF-1, and MLS lines, whereas the OWI line did not show any changes in the 31P NMR spectral parameters during tumor growth. Similarly, tumor HbO2 saturation status, that is, the fraction of vessels with HbO2 saturation above 30%, decreased with increasing tumor volume for the KHT, RIF-1, and MLS lines, but remained unchanged during tumor growth for the OWI line. Although the data indicated a relationship between hypoxic fraction and tumor bioenergetic status as well as tumor HbO2 saturation status within a specific line during tumor growth, there was no correlation between hypoxic fraction and tumor bioenergetic status or tumor HbO2 saturation status across the four tumor lines. This may have occurred because cell survival time under hypoxic stress as well as fraction of non-clonogenic, but metabolically active hypoxic cells differed among the tumor lines. This indicates that 31P NMR spectroscopy and HbO2 cryospectrophotometry data have to be supplemented with other data to be useful in prediction of tumor radioresistance caused by hypoxia. PMID- 2703398 TI - Demonstration of tumor-selective retention of fluorinated nitroimidazole probes by 19F magnetic resonance spectroscopy in vivo. AB - We have evaluated two fluorinated misonidazole analogues, Ro 07-0741 and CCI 103F, as potential probes for the non-invasive identification of hypoxic tumor cells by 19F magnetic resonance spectroscopy (MRS) in vivo. The equipment used was a 1.9 T Oxford Research Systems TMR-32 spectrometer, fitted with a 15 mm diameter surface coil. Signal was readily detectable, with similar intensity from EMT6 tumor, liver, and brain at early times (1-2 hr) after i.v. injection in BALB/c mice, indicative of an initial uniform biodistribution of parent probes. At later times (5-10 hr) there was a progressive reduction in signal intensity from brain and liver, but tumor levels remained constant or declined more slowly. This is illustrated by tumor/brain ratios at 6-7 hr of 2.9 (Ro 07-0741) and 4.2 (CCI-103F). In 4/5 mice analyzed at 20-24 hr after Ro 07-0741, and 1/2 following CCI-103F, tumor signal remained detectable. This occurred in the absence of parent probe as measured by HPLC, suggesting the involvement of a product of nitroreductive bioactivation. Studies with KHT and RIF-1 tumors in C3H/He mice showed a similar trend but retention in RIF-1 was less dramatic, and this was consistent with the known hypoxic fractions and comparative in vivo nitroreductase activities. These promising results support the continuing development of 19F nitroimidazole probes for non-invasive identification of hypoxic cells in vivo. PMID- 2703399 TI - The use of fluorescent probes to identify regions of transient perfusion in murine tumors. AB - Sequential intravenous injection of two fluorescent stains, Hoechst 33342 and DiOC7(3), can be used to quantify transient perfusion in experimental tumors. Regions of unmatched staining, indicative of intermittent perfusion, occur when vessels open or close in the 20 minute interval between administration of the dyes. In the murine SCCVII carcinoma, 8.9 +/- 2.4% (SD) of vessels in 0.5 g subcutaneous tumors had labelling of adjacent cells with only one stain, suggesting complete vessel closure lasting at least 5 minutes. Regions of intermittent perfusion were not homogeneously distributed throughout the tumor and larger tumors exhibited more mismatch than smaller tumors. Transient perfusion was observed in both subcutaneous and intramuscular tumor implants and was not significantly affected by restraint of the animal or by ketamine/diazepam anesthesia. PMID- 2703400 TI - A probe for intracellular concentrations of drugs: delayed fluorescence from acridine orange. AB - The aim of this work is to develop fluorescent probes that will indicate effective concentrations of therapeutic agents, or endogenous protectors, at important cellular sites. Acridine orange associates with nucleic acids and emits a 'delayed' fluorescence signal. This signal is quenched by oxidants such as oxygen, nitroaryl radiosensitizers, adriamycin and mitomycin-c, and reductants such as thiols, ascorbate and other radioprotectors. The quenching of the acridine orange delayed fluorescence reflects the effective concentration of these therapeutically-important oxidants and reductants near DNA. The relative concentration of basic radiosensitizers such as pimonidazole (Ro 03-8799) near the DNA is greater than that of misonidazole. Thiols quench the delayed fluorescence signal according to the degree of ionization of the thiol function; this may model the reactivity of thiols with guanine radical sites in DNA. Ascorbate and aminopyrine do not quench the delayed fluorescence from cells stained with acridine orange as these compounds are taken up by cells very inefficiently. PMID- 2703401 TI - A comparison of colorimetric and clonogenic assays for hypoxic-specific toxins with hamster and human cells. AB - The hypoxic cytotoxicities of misonidazole and pimonidazole (Ro 03-8799) towards the human tumor cell lines HT-1080 and LoVo have been compared with those seen with Chinese hamster V79-379A cells. Survival was assayed using two colorimetric assays, either a tetrazolium salt (MTT) or methylene blue, and by conventional colony scoring. The drugs were more cytotoxic towards HT-1080 and LoVo cells than V79 cells. The times taken for 10 mmol dm-3 misonidazole to reduce survival to 0.1 surviving fraction (SF) using colony formation as the end point were 2.6 hr for HT-1080, 2.4 hr for LoVo, and 3.5 hr for V79; using the MTT assay these times were 3.5 hr, 2.1 hr, and 2.9 hr, respectively. The times for 2 mmol dm-3 pimonidazole to reduce survival to 0.1 SF using colony formation as the end point were 2.0 hr for HT-1080, 1.7 hr for LoVo, and 3.7 hr for V79; using the MTT assay these times were 2.5 hr, 1.4 hr, and 2.5 hr, respectively. PMID- 2703402 TI - Comparison of 3H-misonidazole binding between CHO and 9L cells using the sandwich system. AB - 3H-misonidazole binding of 9L cells was compared with that of CHO cells using an in vitro tumor analog, the sandwich system. In sandwiches there is a gradient of microenvironments, with cells adjacent to the necrotic center subjected to low concentrations of oxygen and glucose and to high concentrations of metabolites. Mixed sandwiches, having 9L and CHO cells interspersed, were used along with sandwiches of each individual cell line. MISO binding was assessed in situ, using autoradiography. Grains per cell were counted and detailed statistics were obtained on the variation in MISO binding among cells located in the same microenvironment. In all cases binding in the regions near the necrotic center was more than 50 times the binding found at the sandwich edge and found in control monolayers, indicating radiobiological hypoxia near the necrotic center. 9L cells began to significantly increase binding of MISO metabolites at a somewhat higher oxygen concentration than did CHO cells. At all oxygen tensions, average per cell binding of the 9L cells was 3 times or more that of the CHO cells, a factor greater than can be explained by the ratio of cell volumes alone. Statistical analyses of the variation in binding among cells in a given microenvironment give some evidence that in the mixed CHO/9L sandwiches there are interactions between the cells of the two different lines which affect the growth patterns of the cells. No preferred binding of misonidazole in the nucleus or cytoplasm was noted within the cells. PMID- 2703403 TI - Autoradiographic study of tritium-labeled misonidazole in the mouse. AB - The localization of tritiated misonidazole metabolites in a number of normal tissues in the mouse is reported from autoradiography. The labeled misonidazole was injected at 750 or 75 mg/kg body weight (Rel. Sp. Act. 74 and 740 MBq/mg respectively). The grain count ratio, parenchyma:stroma, for selected tissues was: liver (centrilobular zone) 13; meibomian gland (acini) 68, (duct) 116; esophagus (keratinized layer) 61; enamel organ 17. It is concluded that there are a number of tissues which will accumulate MISO metabolites although they may not all be hypoxic. PMID- 2703404 TI - Pre- and post-irradiation radiosensitization by SR 4233. AB - SR 4233 (3-amino-1,2,4-benzotriazine 1,4-dioxide) is a bioreductive agent which exhibits highly selective killing of hypoxic cells in a variety of mammalian cell lines in vitro and in murine tumors in vivo. The selective toxicity of the drug results from its one-electron reduction under hypoxic conditions to form a free radical intermediate capable of damaging DNA, through the formation of strand breaks. Using the neutral filter elution assay, SR 4233 was found to be more efficient at producing DNA double strand breaks in Chinese hamster ovary (CHO) cells than an equitoxic dose of gamma-rays. Drug and radiation sequencing experiments were also performed, with both cell survival and DNA strand break rejoining used as endpoints. As a result of these studies, we now describe two additional properties of SR 4233: (a) radiosensitization of aerobic cells in culture produced by hypoxic incubation with drug either before or after irradiation, and (b) the inhibition of subsequent rejoining of radiation-induced DNA double strand breaks after hypoxic pretreatment with drug. The magnitude of the radiosensitization produced did not vary for drug treatments which, when given alone, reduced cell survival over a range from 30% to 2%. The extent of DNA repair inhibition increased with increasing severity of the SR 4233 pretreatment, but was quite small for non-lethal drug exposures. PMID- 2703405 TI - Structure-activity relationships for benzotriazine di-N-oxides. AB - SR 4233 (3-amino-1,2,4-benzotriazine 1,4-dioxide) is a bioreductive agent that selectively kills and radiosensitizes hypoxic mammalian cells in vitro and murine tumors in vivo. In an attempt to better understand the mechanism of action of the drug, and to determine whether a superior analog may exist, 15 benzotriazine-di-N oxide analogs of SR 4233 have been evaluated to date for the following properties: hypoxic and aerobic toxicity toward CHO cells in vitro, drug-induced stimulation of oxygen consumption by incubation with respiration-inhibited cells, and acute LD50 evaluated in BALB/c mice. We noted several correlations between these biological properties of the drugs and some of their physicochemical characteristics. Both the hypoxic cytotoxicity and stimulation of oxygen consumption by respiration-inhibited cells were positively correlated with E1/2, the polarographic half-wave reduction potential, and a measure of electron affinity. The air-to-nitrogen differential cytotoxicity reached a maximum (corresponding to SR 4233) and then declined with increasing E1/2. The acute LD50 of each analog in mice decreased with increasing E1/2. One new compound, SR 4482, was found to be more toxic to hypoxic cells in vitro, but less toxic to mice, than SR 4233. It is similar in structure to SR 4233, but lacks any substituent in the 3-position of the triazine ring. This promising drug may represent a member of a new subseries of 1,2,4-benzotriazines with different structure-activity relationships. PMID- 2703406 TI - Molecular enzymology of the reductive bioactivation of hypoxic cell cytotoxins. AB - The hypoxic cell cytotoxins SR 4233, benznidazole (Benzo), and CB 1954 were readily reduced by anaerobic mouse liver microsomes in vitro to their respective amino or single N-oxide derivatives. The reactions were inhibited in air and required reduced cofactors, particularly NADPH. The rates of reductive bioactivation were markedly different for each drug, with SR 4233 much greater than CB 1954 greater than Benzo. Using purified cytochrome P-450 reductase (P-450 reductase) and an inhibitory antibody to this enzyme, we demonstrated that P-450 reductase was involved in the reductive bioactivation of all 3 compounds. It had a minor role in SR 4233 reduction, but a more important involvement in CB 1954 metabolism to its 4-amino metabolite. Using carbon monoxide, a specific inhibitor of cytochrome P-450 (P-450), we demonstrated that P-450 was involved in both SR 4233 and Benzo reduction. P-450 had a major role both in SR 4233 conversion to SR 4317 and in the latter steps of Benzo amine formation. Purified xanthine oxidase was shown to reduce SR 4233 and Benzo in vitro, but cytosolic aldehyde oxidase activity was only detectable with Benzo as substrate. Characterizing the relative participation of the various reductases in tumor versus normal tissues may allow a more rational selection and application of hypoxic cell cytotoxins in cancer therapy. PMID- 2703407 TI - [Presentation of midwives' activities in public service in Orebro county]. PMID- 2703408 TI - [Description of the way in which an accredited Danish midwife becomes a certified Swedish midwife]. PMID- 2703409 TI - [The medical birth record--evaluation of contents and proposal for improvement]. PMID- 2703410 TI - [Selection out of education for midwives]. PMID- 2703411 TI - [Midwife--a key person in the survival of mothers and neonates]. PMID- 2703412 TI - [Fistula Hospital--hope, a chance, a fresh start]. PMID- 2703413 TI - [Observations on internationalization]. PMID- 2703414 TI - [Sunday child, sunshine child: "Janne Erico"]. PMID- 2703415 TI - Animals in research. PMID- 2703416 TI - Fox in the henhouse; editor in doghouse. PMID- 2703417 TI - The Pew report--required reading. PMID- 2703418 TI - Overview of the Pew report. PMID- 2703419 TI - Are imported food animal products safe? PMID- 2703420 TI - Disappearing food animal drugs. PMID- 2703421 TI - Biotechnology and the veterinarian--some legal considerations. PMID- 2703422 TI - Effects of the Chernobyl accident on animal husbandry and production, from a Swedish perspective. AB - About 20% of the Swedish land area was considerably contaminated by radionuclides released by the nuclear accident at Chernobyl, Ukraine, in April 1986. However, less than 10% of the arable land was contaminated. The heavy contamination was closely correlated with the amount of rain received during the first days of May 1986. Immediate restrictions on grazing limited the early uptake of contaminants in animal products. Changes in management of animals, especially sheep, goats, and reindeer in the contaminated areas have effectively reduced the transfer of radionuclides to human beings. One important factor was the possibility of obtaining uncontaminated feeds from unaffected parts of the country. The direct costs during the first 2 years after the accident were approximately +10 million for analyses and +90 million for compensation to farmers for condemned products (milk, mutton, and reindeer meat) and reimbursement for purchase of uncontaminated feeds from other parts of the country. PMID- 2703423 TI - Oxytetracycline pharmacokinetics, tissue depletion, and toxicity after administration of a long-acting preparation at double the label dosage. AB - Oxytetracycline (OTC) concentration in plasma and tissues, plasma pharmacokinetics, depletion from tissue, and toxicity were studied in 30 healthy calves after IM administration of a long-acting OTC preparation (40 mg/kg of body weight) at double the label dosage (20 mg/kg). Plasma OTC concentration increased rapidly after drug administration, and by 2 hours, mean (+/- SD) values were 7.4 +/- 2.6 micrograms/ml, Peak plasma OTC concentration was 9.6 +/- 2.6 micrograms/ml, and the time to peak plasma concentration was 7.6 +/- 4.0 hours. Plasma OTC concentration decreased slowly for 168 hours (elimination phase) after drug administration, and the elimination half-life was 23.9 hours. Plasma OTC concentration exceeded 3.8 micrograms/ml at 48 hours after drug administration. From 168 to 240 hours after drug administration, plasma OTC concentration decreased at a slower rate than that seen during the elimination phase. This slower phase was termed the depletion phase, and the depletion half-life was 280.7 hours. Tissue OTC concentration was highest in kidneys and liver. Lung OTC concentration exceeded 4.4 micrograms/g of tissue and 2.0 micrograms/g of tissue at 12 and 48 hours after drug administration, respectively. The drug persisted the longest in kidneys and liver. At 42 days after drug administration, 0.1 micrograms of OTC/g of kidney was detected. At 49 days after drug administration, all OTC tissue concentrations were below the detectable limit. Reactions and toxicosis after drug administration were limited to an anaphylaxis-like reaction (n = 1) and injection site swellings (n = 2). PMID- 2703424 TI - Factors affecting the accuracy of the live animal swab test for detecting urine oxytetracycline and predicting oxytetracycline residues in calves. AB - The live animal swab test (LAST) was compared with quantitative oxytetracycline (OTC) assay of urine samples and tissue specimens to determine the accuracy of the LAST in detecting OTC in bovine urine and predicting violative residues in tissues. When urine OTC concentration was greater than 4.3 micrograms/ml, the LAST result was 100% accurate. When urine OTC concentration was less than 4.3 micrograms/ml, the LAST result was 60% accurate; 20% of the LAST results were false-positive, and 20% were false-negative. Urine osmolarity was highest (P less than 0.05) in samples with false-positive results and lowest (P less than 0.05) in samples with false-negative results. A similar trend was observed for urine pH, but was not statistically significant. Urine samples with false-positive results apparently had osmolarity and pH conditions that inhibited growth of Bacillus subtilis when OTC was lacking. False-negative results probably were obtained because urine osmolarity and pH conditions were favorable for the growth of bacteria even in the presence of OTC or because OTC concentration was below the limit of detection by the LAST. The LAST was inconsistent in detecting urine OTC in small concentrations and correspondingly failed to accurately predict OTC residues in tissues. PMID- 2703425 TI - Hound's-tongue (Cynoglossum officinale) poisoning in a calf. AB - Cynoglossum officinale was believed to be responsible for the death of one calf and possibly 5 other calves in a group of 9 calves being fed chopped hay contaminated by this plant. The plant, commonly known as hound's tongue, contains pyrrolizidine alkaloids and has been determined to be toxic to horses fed contaminated hay, but was fed to cattle at the same time with no effect. PMID- 2703426 TI - Surgical management of urovagina and associated infertility in a cow. AB - Severe urovagina, secondary to a calving injury, was diagnosed as the cause of necrotizing endometritis and infertility in a Holstein cow. Urethral extension surgery resulted in resolution of the urovagina and endometrial recovery. Temporary paresis of the bladder was a postsurgical complication. The cow conceived promptly after insemination, but suffered similar injuries subsequently during calving. PMID- 2703427 TI - Blindness and sexual dimorphism associated with vitamin A deficiency in feedlot cattle. AB - Clinical, ophthalmoscopic, and histopathologic findings of vitamin A deficiency in a group of 535 feedlot cattle are described. Liver vitamin A content and results of histologic examination of ocular and osseous (optic canal) tissue confirmed the diagnosis. Blindness was the only clinical sign observed. Even though the steers and heifers in this feedlot were approximately the same age and were fed the same ration for an equal period, none of the heifers had overt clinical signs of hypovitaminosis A. Production of vitamin A by the bovine corpus luteum may account for the sexual dimorphism observed in vitamin A-deficient cattle. PMID- 2703428 TI - Aflatoxicosis in cattle pastured in a field of sweet corn. AB - Aflatoxicosis was diagnosed in a small herd of cattle having access to moldy, unharvested sweet corn. Necropsy of 1 cow that died revealed anasarca and a pale tan liver. In this cow, microscopic examination revealed edema of all soft tissues and liver lesions consistent with aflatoxicosis. Samples of corn taken from the field contained 2,365 ng of aflatoxin/g of corn. Weather conditions were conducive to the formation of aflatoxins by Aspergillus flavus and A parasiticus. PMID- 2703429 TI - Bilateral eyelid swelling attributable to lymphosarcoma in a horse. AB - Bilateral swelling of upper and lower eyelids was caused by lymphocytic infiltration in an 8-year-old Thoroughbred mare. The condition worsened with pregnancy and became associated with subcutaneous dissemination of lymphosarcoma at distant sites. PMID- 2703430 TI - Small intestinal strangulation caused by Meckel's diverticulum in a horse. AB - Necropsy of a 12-year-old Quarter Horse mare revealed a blind-end segment of intestine originating from the antimesenteric border of the ileum. The blind-end segment had looped around and strangulated the ileum and 3.5 m of the jejunum. PMID- 2703431 TI - Congenital malignant melanoma in two foals. AB - Two cases of congenital malignant melanomas in horses are described in this report. In each case, wide surgical excision of the mass was performed; no recurrence or metastasis was detected after a minimum of 15 months' follow-up. Melanomas are among the most common neoplasms of horses, but they typically develop in gray horses greater than 6 years old. PMID- 2703432 TI - Breeding soundness of beef bulls after circumcision: 33 cases (1980-1986). AB - Case records of 33 beef bulls that had preputial prolapses and underwent circumcisions were reviewed. Data retrieved included age, breed, duration of preoperative medical treatment, complications of surgery, length of time from surgery to first breeding, ability of bull to copulate, duration of active breeding, and complications resulting in breeding unsoundness. The mean age of all bulls was 3.5 years (1 to 7 years). Breeds represented included Santa Gertrudis (n = 13), Beefmaster (n = 8), Brangus (n = 7), Brahman (n = 4), and Angus (n = 1). The mean duration of medical treatment before surgery for all bulls was 16.4 days (2 to 38 days). There was no statistically significant difference between the mean duration of medical treatment before surgery between bulls that became breeding sound (16 days), compared with those that were breeding unsound (19 days). However, bulls requiring more than 14 days of medical treatment before surgery were approximately 3 times (relative risk, 2.8) more likely to develop postoperative complications than those bulls requiring 14 days of treatment or less. Eleven bulls (33%) developed one or more postoperative complications. The complications resolved in 4 bulls, but 7 were never able to breed. Of these 7 bulls, 4 had problems directly related to the circumcision, 2 had extensive fibrosis of the prepuce already present at surgery, and 1 was discharged from the hospital with no apparent complications but was never able to breed. Twenty-five of the 33 bulls (76%) were breeding sound for 1 or more years after surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703433 TI - Use of embryo transfer to induce twinning in beef cattle: embryo survival rate, gestation length, birth weight and weaning weight of calves. AB - Experiments were conducted in 1985 and 1986 at the Eastern Ohio Resource Development Center, Belle Valley, to examine the feasibility of using embryo transfer to induce twinning and to examine the influence of twinning on traits of the cow and calf. Embryos were collected from a total of 14 superovulated Angus donors on two dates each in 1985 and 1986 and were transferred to Angus recipients. A total of 124 embryos were transferred to 79 recipients, with 43 (34.7%) calves born alive. Seven of 45 (15.6%) recipients implanted with two embryos produced twins. In no case did both halves of the 15 embryos that were split to produce identical twins and implanted in the same recipient survive to birth. Proportion of calves born alive did not differ among transfer codes 3 (nonsplit embryos from two different donors implanted in separate uterine horns of the same recipient), 6 (nonsplit embryos from one embryo flush implanted in separate uterine horns of the same recipient) and 7 (nonsplit embryos from two different donors implanted in the same uterine horn of one recipient). Surgical transfers tended to result in a higher proportion of embryos surviving to birth (.43 vs .21; P = .16) and a higher twinning rate (.29 vs .04; P = .36) than did nonsurgical transfers. Age of recipient did not influence embryo survival (P = .98) or twinning rate (P = .99). Gestation length was 5 d shorter (P less than .01) for twin calves than for singles. Singles were 9 kg heavier (P less than .01) at birth and 32 kg heavier (P less than .01) at weaning than twins. However, cows raising twins produced 108 kg (51%) more total weaning weight than did cows raising singles. PMID- 2703434 TI - Factors affecting in-transit shrink and liver abscesses in fed steers. AB - Live weight loss (shrink) and liver conditions (abscesses) were determined on 3,570 crossbred steers of predominantly British breeding over a 5-yr period. Starting in November 1979, steers were placed on feed at bimonthly intervals and provided one of three housing treatments: no shelter, access to overhead shelter or confinement. All steers were implanted with Synovex during the first 3 yr and Compudose the last 2 yr and fed a diet consisting of high-moisture corn grain, which provided 85% of the energy, and corn silage, along with a protein, vitamin and mineral supplement. Cattle were processed into beef after a feeding period of approximately 160 d. Year affected shrink (P less than .001), and month on feed and housing type tended to alter shrink. Cattle marketed during summer and fall and those outside without overhead shelter tended to shrink more. Year, month on feed and housing type affected liver condition (P less than .01). Cattle started on feed in November and January and cattle housed in confinement or outside without overhead shelter had higher incidences of liver abscesses and slower average daily gains (P less than .01). Daily gains for steers with normal and abnormal livers were not different (P greater than .19) for any month started on feed or housing treatment. These results indicate that under the conditions of this study a 2 or 3% weight loss should be expected during the marketing of finished steers and a 16% incidence of liver abscesses should be anticipated, with some modification of the latter due to time of year and housing. The presence of liver abscesses at the time of processing steers into beef did not reduce feedlot performance. PMID- 2703435 TI - Raw mung beans as a protein source for bred gilts. AB - A study involving 546 crossbred gilts from six seasons was conducted to evaluate raw mung beans as a partial replacement for soybean meal in diets for gilts during gestation. Gilts were randomly allotted to either a control sorghum grain soybean meal diet or a diet in which a portion of the soybean meal was replaced with mung beans. In the first three seasons, gilts were fed diets in which the protein supplement was totally soybean meal or 89% mung beans (high level) and 11% soybean meal. In the last three seasons the level of mung beans in the supplemental protein was reduced to 61% mung beans with 39% soybean meal (moderate level). Feeding the high level of mung beans decreased (P less than .05) weight gain during gestation and reduced (P less than .05) weight loss during lactation compared with gilts fed the control diet or the moderate level of mung beans. Little difference was noted in litter size at birth, but litter size at 21 d for gilts fed moderate levels of mung beans was less (P less than .05) than for gilts fed the control diet or the high level of mung beans. Little difference was noted in survival rate to 21 or 42 d or individual and litter weights at birth and 21 d. Pig and litter weights at 42 d, however were reduced in gilts fed the high level of mung beans (P less than .05 and P less than .10, respectively) compared with the control diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703436 TI - Effect of fasting and transportation on various physiological parameters and meat quality of slaughter hogs. AB - Forty-nine slaughter hogs were transported and fasted or fasted with no transport for 0 (no transport), 24, 48 and 72 h. Blood samples were taken before treatments were imposed and again prior to slaughter. Soft tissues of the ham were chemically analyzed and loin samples were evaluated by a sensory panel. Fasting and transportation decreased plasma triiodothyronine and hematocrit and increased plasma osmolality. Preslaughter treatment did not affect juiciness or desirability of cooked chops or percentage of fat in the ham soft tissues. These data suggest that although fasting and transporting of slaughter hogs may disrupt homeostasis of pigs, such physiological changes do not negatively affect meat quality. PMID- 2703437 TI - Interrelationships among water quality, climate and diet on feedlot performance of steer calves. AB - Four experiments involving 16 pens of 8 to 10 crossbred steer calves each were conducted at Yuma, Arizona. Initial and final weights were approximately 170 and 275 kg, respectively. The experimental design was a 2 x 2 x 4 factorial replicated over 2 yr with main effects for season (summer, winter), diet (H = ground alfalfa hay, H + G = 50% ground alfalfa, 47.5% dry-rolled wheat and 2.5% molasses) and water source (N = normal, S = saline) during two consecutive 56-d periods in each experiment (N-N, N-S, S-N, S-S). Normal water contained approximately 1,300 ppm, and saline water contained approximately 6,000 ppm, total dissolved salts. Steers on the H + G diet gained 32% faster (P less than .01) and consumed 4% less (P less than .01) feed than those on the H diet. Gain and feed intake during winter were greater than during summer (20% and 7%, respectively, P less than .01). Gain and feed intake were reduced approximately 9% (P less than .01) on S water combinations compared with N-N water. Depression in gain and feed intake due to heat stress (summer season) or S water ingestion was greater on the H diet (diet x water source and diet x season interactions, P less than .02). Although season x water source interactions were not significant, saline water ingestion tended to be more detrimental during periods of heat stress (summer). Apparent adaptation to saline water occurred on the H + G diet, but not on the H diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703438 TI - Glycerolipid biosynthesis in porcine adipose tissue in vitro: effect of adiposity and depot site. AB - To compare genetic differences in glycerolipid biosynthesis, rates were determined in s.c. adipose tissue of lean and obese pigs at 28, 60 and 110 d of age. To compare depot-specific differences, glycerolipid biosynthetic rates were determined in outer s.c., middle s.c., perirenal and omental adipose tissues obtained from 105-kg contemporary pigs. Rates were determined with a 700 x g infranatant fraction of an adipose tissue homogenate by measuring glycerophosphate incorporation into total lipids (mostly phosphatidic acid) during 4 min. This assay represents entrance of substrates into the glycerolipid synthesis pathway or glycerophosphate acyltransferase (GPAT) activity. Rates measured for 60 min represent maximal synthesis of glycerolipid (more triacylglycerol than phosphatidic acid) or lipid synthesis capacity (LSC). Adipocyte diameter and volume were greater for adipose tissue of obese than of lean pigs both at 60 and 110 d. When expressed per cell, activity of GPAT and LSC were similar for lean and obese pigs at 28 d. At 60 d and 110 d, LSC was greater for obese than for lean pigs; GPAT activity was greater at 60 but not at 110 d in obese than in lean pigs. Expressed on a cell basis, GPAT activity was highest in omental and outer s.c., intermediate in perirenal and lowest in middle s.c. adipose tissue depots. Lipid synthesis capacity was highest in perirenal and lowest in outer and middle s.c. depots. Our results indicate that the LSC assay was more closely related to the accretion of fat in vivo than to GPAT activity. PMID- 2703439 TI - Effects of dietary salt level during gestation and lactation on reproductive performance of sows: a cooperative study. AB - Two experiments involving 1,020 litters were conducted at eight research stations to determine the effects of dietary NaCl (salt) concentration during gestation and lactation on reproductive performance of sows. Primiparous and multiparous sows were fed fortified corn- or grain sorghum-soybean meal diets at 1.82 kg/d during gestation. During the winter months (December, January, February) the feeding level was increased to 2.27 kg/d. Sows had ad libitum access to diets during lactation. Dietary concentrations of added salt were .50 and .25% in Exp. 1 and .25 and .125% in Exp. 2. When more feed was fed during gestation, the salt concentrations were reduced to .40, .20, .20 and .10%, respectively, in order to maintain a constant daily intake of Na and Cl during gestation. Gestation weight gain and lactation (21-d) weight loss of the sows were not affected by dietary salt level in either experiment. In Exp. 1, lowering the salt concentration did not influence the number of pigs farrowed, but it resulted in a .05 kg/pig reduction (P less than .01) in average birth weight. Average 21-d pig weights also tended (P less than .19) to be lower in the low-salt group. There was a decrease in litter size from the first to the second farrowing for sows fed low salt, but not for sows fed the higher salt concentration. In Exp. 2, reducing the salt content from .25 to .125% did not alter reproductive performance. The overall ratio of males to females at birth in the population of greater than 10(4) pigs was 52.3:47.7. Lower salt intakes tended to reduce the percentage of males born in both experiments, although the differences were not significant (P greater than .3). The results indicate that reducing the salt concentration in sows diets from .50 to .25 or .125% reduces birth weight in newborn pigs. When continued for more than one reproductive cycle, feeding less than .5% salt appears to reduce litter size at birth and weaning. PMID- 2703440 TI - Energy uptake and utilization by limit- and ad libitum-fed growing horses. AB - Eighteen weanling horses were assigned to two treatments: limited or ad libitum feed intake. Growth and feed utilization were evaluated over a 78-wk period. Ad libitum-fed horses gained 24% more (P less than .05) weight than limit-fed horses. Total BW was distributed into 57% fore and 43% hind weight and did not differ between groups regardless of dietary treatment or age. Net gain and ADG in wither height of ad libitum-fed horses exceeded (P less than .05) that of limit fed horses over 78 wk. Ad libitum-fed horses consumed 19, 44 and 34% more digestible energy (DE) than indicated in 1978 NRC tables from 6 to 12 mo, 12 to 18 mo and 18 to 24 mo of age, respectively. Total DE intakes were positively correlated to weight and therefore were confounded by age. Weight-scaled DE intake of ad libitum-fed weanling horses increased .2% for each 1 C degree decrease in barn temperature below 0 degree C. Maintenance energy requirements were estimated at 37.8 and 35.6 kcal DE/kg BW for limit- and ad libitum-fed horses, respectively. Grams of gain per megacalorie of DE consumed above maintenance ranged from 83 to 24 g/Mcal and were only 22 to 75% of values derived from 1978 NRC tables. Energy guidelines given by NRC were considered suitable for growth based on normalcy of musculoskeletal growth. However, the ADG by our horses, which were fed high-forage diets, were lower than those predicted by 1978 NRC. PMID- 2703441 TI - Nutrient utilization by limit- and ad libitum-fed growing horses. AB - Eighteen Quarter Horse and Paint weanling colts were assigned to two treatments, either limit or ad libitum feeding. Nutrient digestibilities of diets were evaluated between 6 and 12 mo, 12 and 18 mo and 18 and 24 mo of age. From 6 to 12 mo, energy digestibility (64 to 68%) was unaffected by feed intake level. Ad libitum-fed horses had energy digestibilities 9 to 10% greater (P less than .05) than limit-fed horses between 12 and 24 mo of age, but adjustment for DM intake removed these differences. Limit-fed, mature ponies used dietary energy similarly to growing horses from 6 to 18 mo of age, but they used digested dietary energy more efficiently (P less than .05) than young horses at 24 mo of age. Ad libitum fed horses digested more (P less than .05) dietary protein than limit-fed horses between 12 and 24 mo of age, but adjustment for DM intake removed these differences. True digestibilities of dietary Ca were estimated at 71 to 42% among periods, whereas true digestibilities of dietary P ranged from 52 to 6%. Sufficient P was absorbed by all horses between 6 and 18 of age, but by 24 mo of age horses were in negative P balance despite an apparently adequate P intake. Using regression analyses, daily endogenous fecal Ca and P were predicted to be 36 and 18 mg/kg body weight, respectively. PMID- 2703442 TI - Effects of intramuscular injections of folic acid during lactation on folates in serum and milk and performance of sows and piglets. AB - In order to determine the effect of folic acid on serum and milk folates in lactating sows as well as on serum folates and growth rate of the piglets, sows (n = 25) received either saline or 15 mg folic acid i.m. each week from d 2 after parturition to weaning, 26 d later. Blood samples were drawn from all sows at 110 d of gestation and every week during lactation. Milk samples were taken at d 7 and 21 of lactation. Piglets were weighed and blood samples were collected weekly during lactation. Serum folates of sows increased during lactation. The rate of increase was more pronounced (P less than .0002) after folic acid injections. Milk folates concentrations decreased (P less than .0007) from d 7 to 21 of lactation but were higher (P less than .0001) in treated sows (11.8 +/- .7 ng/ml) than in control sows (7.9 +/- .4 ng/ml). Serum folates of piglets in control litters increased from 55.0 +/- 2.2 ng/ml at 2 d of age to a peak value of 86.3 +/- 3.1 ng/ml 2 wk later, and then gradually decreased. In piglets from treated dams, the time response curve was similar to that of the controls, but values were about 15% higher (P less than .01). The growth rate of piglets until 8 wk of age was not changed (P greater than .47) by folic acid injection of sows. More studies are needed to evaluate the practical importance of changes in folates status in establishing the folic acid requirements of lactating sows. PMID- 2703443 TI - The evaluation of the mobile nylon bag technique for determining the apparent protein digestibility in a wide variety of feedstuffs for pigs. AB - Studies were conducted with four (50 to 70 kg) barrows to evaluate the mobile nylon bag technique (MNBT) for determining the apparent protein digestibility (AD) in a variety of feedstuffs. One-gram samples of each feedstuff, ground through a 1.0-mm mesh screen, were enclosed in nylon bags (25 X 40 mm; 48 microns mesh). Following predigestion (.01 N HCl; 4,000 Folin Intestinal Pepsin Units/liter), four bags of each sample were inserted into each pig via a duodenal T-cannula. The indigested contents were pooled within pig and feedstuff prior to crude protein analysis. The AD of each feedstuff was determined previously with four barrows according to the conventional method (CM), based on a 5-d total collection of feces following a 14-d adaptation period. The following results, AD (%), were obtained with the MNBT (n = 4) and CM (n = 4), respectively. Barley, 70.1 vs 81.2 (P less than .05); corn, 72.3 vs 82.1 (P less than .05); wheat, 79.6 vs 86.4 (P less than .05); corn gluten feed, 73.9 vs 70.9; rice bran, 57.3 vs 57.4; wheat middlings, 70.8 vs 79.4 (P less than .05); soybean meal, 89.9 vs 93.0; a mixture of soybean meal and hulls, 86.9 vs 88.8; coconut expeller, 65.0 vs 69.8; fababeans, 79.5 vs 78.5; peas, 87.6 vs 88.1; meat meal, 83.2 vs 84.0; complete diet (4.3% crude fiber), 76.3 vs 83.6 (P less than .05); and complete diet (13.6% crude fiber), 56.5 vs 55.0.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703444 TI - Apparent digestibility of nitrogen and amino acids in protein feedstuffs by growing pigs. AB - Eight digestion trials were conducted with pigs fitted with ileal T-cannulas to determine the apparent digestibilities of N and amino acids in common protein feedstuffs. Trial-to-trial variation was minimal as determined by the variation in digestibilities for soybean meal, which was evaluated in each trial. Apparent digestibilities varied widely; ileal N digestibility ranged from 88 to 63%, and ileal lysine digestibility ranged from 93 to 40%. In general, ring-dried blood meal, corn gluten meal, Menhaden fish meal, poultry-by-product meal and extruded whole soybeans were the most digestible, followed by canola meal, sunflower meal, peanut meal and meat and bone meal. Cottonseed meal and feather meal were the least digestible. Mean values for each feedstuff agree well with published data. Variation in digestibilities among samples of the same feedstuff was greater for the meat and bone meals. Regression of ileal essential amino acid digestibilities on ileal and fecal N digestibility indicated that amino acid digestibilities can be predicted more precisely from ileal N digestibility than from fecal N digestibility. However, neither ileal nor fecal N digestibility could be used with a high degree of certainty to predict ileal amino acid digestibilities. PMID- 2703445 TI - Folic acid supplementation to diets of gestating-lactating swine over multiple parities. AB - Crossbred gilts (n = 59) were utilized in a three-parity study to evaluate the effects of dietary additions of folic acid for reproducing swine and to ascertain if responses were dependent on the presence of a sulfonamide in the diet. The four dietary treatments were 1) control, a 14% crude protein corn-soybean meal diet with 110 ppm tylosin, 2) diet 1 plus 110 ppm sulfamethazine, 3) diet 1 plus 1 ppm folic acid and 4) diet 2 plus 1 ppm folic acid. Gilts were allotted to dietary treatment based on age, weight and ancestry within 15 d postbreeding and remained on the assigned dietary treatment continuously. Folic acid supplementation of the diet improved (P less than .05) total (11.17 vs 10.23) and live pigs born (10.79 vs 9.86) per litter; however, when litters were weaned at 28 d, the folic acid advantage was not significant (P greater than .20, 9.34 vs 9.03). No dietary effects (P greater than .10) were observed for pig birth weight or weaning weight. Number of breedings required per female farrowed tended (P less than .12) to be less for females fed folic acid-supplemented diets (1.07 vs 1.16). These results demonstrate improved sow performance through an increase in pigs born and possibly an improved conception rate when folic acid is supplemented to cornsoybean meal diets. PMID- 2703446 TI - Duodenal nutrient flow and digestibility in Holstein steers fed formaldehyde- and formic acid-treated alfalfa or orchardgrass silage at two intakes. AB - Formaldehyde- and formic acid-treated alfalfa or orchardgrass silage were fed at 65 and 90 g DM/kg BW.75.d) to growing Holstein steers (209 +/- SE = 35 kg) fitted with permanent ruminal and duodenal cannulas in a 4 x 4 latin square. Alfalfa had higher (P less than .01) concentrations of cell solubles, total N and rumen soluble N than did orchardgrass. Digestible energy (Mcal/d), total N and soluble N intake (g/d) were higher (P less than .05) for steers fed alfalfa than for those fed orchardgrass. Total duodenal OM, DM, NDF, N and non-NH3-N flows were greater (P less than .001) for steers fed alfalfa than for those fed orchardgrass and were greater (P less than .001) at high vs low intake. Duodenal bacterial N flow (g/d) was greater (P less than .001) for steers fed alfalfa than for those fed orchardgrass, and bacterial N synthesis (g/kg DM truly digested in the rumen) was 58 and 32, respectively (P less than .001). Ruminal concentrations of NH3-N (P less than .001) and VFA (P less than .05) were greater for steers fed alfalfa than for those fed orchardgrass. Total tract DM, energy and N digestibilities were higher (P less than .05) for steers fed alfalfa vs orchardgrass, whereas total tract NDF digestibility was lower (P less than .01). Tissue N retention tended to be greater (P less than .1) for steers fed alfalfa than for those fed orchardgrass. Regression analysis indicated that duodenal non-NH3-N flow was related to intake of metabolizable energy and soluble N (R2 = .939). Improved performance and higher efficiency of use of ME for tissue gain by steers fed alfalfa rather than orchardgrass is related to lower ruminal acetate:propionate, higher microbial efficiency and greater duodenal DM and N flows. PMID- 2703447 TI - Influence of phospholipids on ruminal fermentation in vitro and on nutrient digestion and serum lipids in sheep. AB - Phospholipid supplements were incubated in vitro or fed to sheep to determine how they affected ruminal fermentation, nutrient digestion and serum lipid concentration. In vitro, deoiled soybean lecithin added to hay increased (P less than .05) total VFA concentration but had no effect on fiber digestion in four of five trials. Purified phospholipid (synthetic phosphatidylethanolamine), however, had little effect on in vitro hay fermentation when tested at four levels (0, 10, 20 or 30 mg) in three separate trials. Deoiled soybean lecithin disappeared in vitro at two rates, 12.9 and .66%/h for the fast- and slow-degrading fractions, respectively. Compared with 2.4% corn oil supplements, 5.2% soybean lecithin added to sheep diets (56% concentrate) reduced (P less than .05) energy, fiber and nitrogen digestibilities. Crude lecithin reduced (P less than .05) energy digestibility more than deoiled lecithin. Both types of lecithin increased (P less than .05) serum nonesterified fatty acid concentrations but had no effect on serum glucose, cholesterol or triglyceride concentrations compared with the corn oil diet. In summary, phospholipids had different effects on ruminal fermentation, depending on their source. None had a beneficial effect on fiber digestion. Phospholipids are degraded in the rumen and inhibit digestion in a manner similar to that of the commercial fats and oils. PMID- 2703448 TI - Effects of ingestive mastication on particle dimensions and weight distribution of coastal bermudagrass hay fed to steers at four levels. AB - Coastal bermudagrass (Cynodon dactylon [L.] Pers.) hay was fed in the long form to four ruminally cannulated steers to evaluate the effects of intake level on the physical reduction of feed particles during ingestive mastication. The experimental design was a 4 x 4 latin square with 18-d periods. Treatments based on previous intakes were set at 50, 70, 90 and 110% of feed consumed per animal and fed at 12-h intervals. Boli of ingested, masticated hay were collected at the cardia and separated by wet-sieving into fragments retained on sieves of .0027 to 4.0 mm (mesh aperture). In addition, particles retained on the 4.0-mm and 2.0-mm sieves were scanned by image analysis. Ingestive mastication resulted in a linear decrease (P less than .05) in the proportion of boli particles retained on the top (4.0-mm) sieve and linear increases on the 2.0- (P less than .02), 1.0- (P less than .06) and .25-mm (P less than .06) sieves with increasing level of intake. Sixteen to 21% of the ingested hay particles passed through a 1.0-mm sieve. Mean particle size, as determined by sieving data, decreased linearly (P less than .05) as feeding level increased. Image analysis showed no differences in length (L) or width (W) of particles retained on the 4.0- and 2.0-mm sieves as feeding level increased, but L/W decreased linearly (P less than .05) on both sieves. The frequency of jaw movements following feeding was very similar across feeding levels and averaged 71.3 chews/min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703449 TI - Lysocellin effects on growth performance, ruminal fermentation, nutrient digestibility and nitrogen metabolism in steers fed forage diets. AB - Studies were conducted to determine the effects of lysocellin on growth performance and metabolism of steers fed forage-based diets. Treatments in all experiments consisted of 1) control, 2) 100 mg lysocellin/d, 3) 200 mg lysocellin/d and 4) 200 mg monensin/d. In each of two 90-d performance studies, 24 Hereford steers were individually fed greenchop (fungus-free tall fescue and Coastal and Tifton-44 bermudagrass) ad libitum and .91 kg/d of a corn-trace mineral salt supplement. In Exp. 1, tall fescue was fed from d 1 to 45 and bermudagrass from d 46 to 90. Bermudagrass was offered during d 1 to 45 and tall fescue during d 46 to 90 in Exp. 2. Lysocellin improved gain (Exp. 1, P less than .01) and feed conversion (Exp. 1 and 2 combined, P less than .05), decreased total VFA concentrations (P less than .05), increased molar proportions of propionate, isobutyrate and isovalerate (P less than .01), decreased molar proportions of acetate and butyrate (P less than .01) and lowered acetate:propionate (P less than .01). Two metabolism studies involving a total of 16 Hereford steers were conducted. Steers were fed tall fescue greenchop and .91 kg/d supplement for a 34-d adjustment period followed by a 5-d total collection period. Lysocellin increased N digestibility (P less than .01) and N retention (P less than .06) but did not (P greater than .05) affect DM, NDF or ADF digestibility. Data indicate that lysocellin results in major alterations in ruminal fermentation and can increase growth performance and N retention in steers fed forage-based diets. PMID- 2703450 TI - Selenium effects on glutathione peroxidase and the immune response of stressed calves challenged with Pasteurella hemolytica. AB - The present study was conducted to determine whether a marginal Se deficiency affects health, blood characteristics and the immune response of calves subjected to stresses associated with weaning, shipping (332 km) and Pasteurella hemolytica inoculation. Treatments were 1) -Se, 2) -Se/P. hemolytica, 3) +Se (.1 mg Se/kg feed) and 4) +Se/P. hemolytica. Previous Se intake was controlled; dams of -Se calves were fed diets marginally deficient in Se (.03 to .05 mg/kg), whereas dams of +Se calves received a s.c. injection of 30 mg Se (as sodium selenite) every 60 d. Calves were inoculated with P. hemolytica intratracheally on d 3 following weaning and transport. Inoculation with P. hemolytica increased (P less than .05) body temperatures, platelet counts, serum IgM concentrations and serum antibody titers and decreased serum albumin concentrations at 4 to 7 d postinoculation. Weight gains for the 21-d study were not affected by Se status, although whole blood and plasma glutathione peroxidase (GSH-Px) were higher (P less than .05) for +Se calves. Plasma GSH-Px increased (P less than .01) in calves showing signs of morbidity. Increases in plasma GSH-Px were correlated positively with body temperature. Serum IgM concentrations were higher (P less than .05) in +Se calves on d 17, but Se-supplemented calves had lower (P less than .05) anti-P. hemolytica titers on d 17 than -Se calves. Selenium status did not affect body temperatures, plasma creatine phosphokinase or serum IgG and albumin concentrations. These results indicate that Se status can affect IgM concentrations following stress. PMID- 2703451 TI - Growth response to escape protein and forage intake by growing cattle grazing cornstalks. AB - Two trials were conducted to study the protein requirements of growing cattle grazing cornstalks. Diet composition and forage intake were determined at different periods during the grazing season. Residue intake and dietary CP content decreased (P less than .05) .079 kg and .044 percentage units per day of grazing, respectively. In vitro DM disappearance of the roughage fraction of the diet remained high early in the grazing period when husk availability was high, then declined in a curvilinear pattern. Calves required time to learn to find and consume the residual grain. During 54 d of grazing in Trial 1, calves supplemented with 409 g CP gained .105 kg/d more than those supplemented with 213 g CP. Maximal daily gain (.308 kg) in Trial 2 was obtained with 163 g/d of ruminal escape protein. Growing cattle grazing cornstalks responded to protein supplementation at levels above current National Research Council recommendations for 250-kg calves gaining .3 kg/d. PMID- 2703452 TI - A simulation model of forage yield, quality and intake and growth of growing cattle grazing cornstalks. AB - A simulation model was developed to predict corn crop residue yield and quality and intake and performance of growing cattle grazing cornstalks. The model is wholly deterministic and integrates the effects of weather, residue supply and animal components. Low temperatures increase animal energy requirements, whereas snow cover decreases residue available. Residual grain and leaf are calculated from grain yield. Residue quantity and quality are reduced daily by environmental losses and animal consumption. Daily performance is predicted based on the nutrients obtained from residue and supplemental feed. Under unlimited roughage supply, leaf, husk and grain are primary diet components. Grain consumption decreases as the supply diminishes and forage quality decreases with time. Intake is calculated based on digestibility and fecal output = .0365 W.75. Forage availability affects intake in a curvilinear fashion. Energy gain is predicted by NRC equations and protein gain from metabolizable protein supply. The model underestimated intake of calves measured with chromic oxide and in vitro DM disappearance. Simulated daily gain (y, kg) of calves grazing at several stocking rates was related to observed daily gain (x, kg) by the equation y = .012 + .853 x (R2 = .71, Sy.x = .077). The model overestimated response to protein supplementation. Severe cold weather was predicted to reduce gains or cause weight loss due to increased energy requirements for maintenance. The model can be used as an aid in both research planning and cattle management. PMID- 2703453 TI - Diet composition and daily gain of growing cattle grazing dryland and irrigated cornstalks at several stocking rates. AB - Diet composition and the relationships between daily gain of calves grazing cornstalks and certain characteristics of the available residue and diets selected by esophageally fistulated cattle were studied in two trials during November and December of 1984 (Trial 1) and of 1986 (Trial 2). Eight adult steers and four esophageally fistulated calves were used in Trials 1 and 2, respectively, to collect extrusa samples from dryland and irrigated fields grazed at several stocking rates. Steers grazing irrigated cornstalks selected a diet with more (P less than .05) starch and less (P less than .05) CP than those grazing dryland fields. As grazing continued, extrusa starch content decreased (P less than .05). In vitro DM disappearance (IVDMD) of both diet and the roughage fraction of the diet decreased (P less than .05) with days of grazing; this decrease was greater (P less than .05) at higher stocking rates. Calves grazing dryland fields gained faster (P less than .05) than calves grazing irrigated fields. With a low level of protein supplementation (213 g CP/d, Trial 1), daily gain was positively correlated with CP of both diet (extrusa) or available leaf plus husk but not with grain available per animal or with extrusa IVDMD, suggesting that protein was first limiting. With a higher level of protein supplementation (458 g CP/d, Trial 2), daily gain was correlated positively with residue available per animal and IVDMD of extrusa at the end of the grazing season. The energy value of feed consumed by cattle grazing cornstalks decreases with time, and complex interactions between protein needs and energy intake may occur. PMID- 2703454 TI - Yield and quality components of corn crop residues and utilization of these residues by grazing cattle. AB - Three grazing trials were conducted to evaluate yield, relative plant part composition, quality and utilization (disappearance) of corn crop residues by growing cattle in both dryland and irrigated cornstalk fields. More (P less than .05) total residue was available from irrigated than from dryland cornstalks, but dryland cornstalks had a higher (P less than .05) proportion of leaf plus husk. In Trial 1, 18% of the residue disappeared in 53 d in irrigated fields grazed at 2.47 calves/ha, whereas 32 and 47% disappeared in dryland fields grazed at 1.54 and 2.47 calves/ha, respectively. Leaf plus husk accounted for 69% (Trial 1) and 65 to 72% (Trial 2) of the utilized residue. Utilization rate increased (P less than .05) with stocking rate. All plant parts and leaf plus husk from dryland cornstalks had more CP (P less than .05) and less NDF (P less than .05) than did these plant parts from irrigated fields. In vitro DM disappearance (IVDMD) was decreased (P less than .05) by grazing; this decrease was greater (P less than .05) at higher stocking rates. Husk IVDMD, CP and NDF from 13 corn hybrids differed (P less than .05). PMID- 2703455 TI - Why should the physician use your services? PMID- 2703457 TI - Practical image stability tests of Polaroid PolaBlue slide material. PMID- 2703456 TI - Team building. PMID- 2703458 TI - Use of radiography in soil insect research. PMID- 2703459 TI - Purification and characterization of ATP:citrate lyase from Hydrogenobacter thermophilus TK-6. AB - ATP:citrate lyase [ATP citrate (pro-3S)-lyase; EC 4.1.3.8] was purified and characterized from the cells of Hydrogenobacter thermophilus, an aerobic, thermophilic, hydrogen-oxidizing bacterium which fixes carbon dioxide by a reductive carboxylic acid cycle. The enzyme was quite stable, even in the absence of sulfhydryl reagents. Optimum pH for reaction was 6.7 to 6.9, and optimum temperature was around 80 degrees C. The molecular weight of native enzyme was estimated to be 260,000 by gel filtration analysis, and that of a subunit was estimated to be 43,000 by sodium dodecyl sulfate-polyacrylamide gel analysis. Km values for reaction components were as follows: citrate, 6.25 mM; ATP, 650 microM; coenzyme A, 40.8 microM; and Mg2+, 8 mM. The enzyme showed citrate synthase activity in the presence of Mg2+, but the reaction rate was very low (less than 1/200 of the lyase activity). PMID- 2703460 TI - Correlation between depression of catabolite control of xylose metabolism and a defect in the phosphoenolpyruvate:mannose phosphotransferase system in Pediococcus halophilus. AB - Pediococcus halophilus X-160 which lacks catabolite control by glucose was isolated from nature (soy moromi mash). Wild-type strains, in xylose-glucose medium, utilized glucose preferentially over xylose and showed diauxic growth. With wild-type strain I-13, xylose isomerase activity was not induced until glucose was consumed from the medium. Strain X-160, however, utilized xylose concurrently with glucose and did not show diauxic growth. In this strain, xylose isomerase was induced even in the presence of glucose. Glucose transport activity in intact cells of strain X-160 was less than 10% of that assayed in strain I-13. Determinations of glycolytic enzymes did not show any difference responsible for the unique behavior of strain X-160, but the rate of glucose-6-phosphate formation with phosphoenolpyruvate (PEP) as a phosphoryl donor in permeabilized cells was less than 10% of that observed in the wild type. Starved P. halophilus I-13 cells contained the glycolytic intermediates 3-phosphoglycerate, 2 phosphoglycerate, and PEP (PEP pool). These were consumed concomitantly with glucose or 2-deoxyglucose uptake but were not consumed with xylose uptake. The glucose transport system in P. halophilus was identified as a PEP:mannose phosphotransferase system on the basis of the substrate specificity of PEP pool starved cells. It is concluded that, in P. halophilus, this system is functional as a main glucose transport system and that defects in this system may be responsible for the depression of glucose-mediated catabolite control. PMID- 2703461 TI - Mobilization of the relaxable Staphylococcus aureus plasmid pC221 by the conjugative plasmid pGO1 involves three pC221 loci. AB - The Staphylococcus aureus plasmid pC221, a 4.6-kilobase multicopy chloramphenicol resistance plasmid that forms plasmid-protein relaxation complexes, was mobilized for transfer by the conjugative plasmid pGO1. Two open reading frames on the pC221 genome, now designated mobA and mobB, as well as a cis-acting locus, the putative oriT, were shown to be in involved in pC221 mobilization. The mobA (but not mobB) and oriT loci were required for pC221 relaxation, and relaxation was necessary but not sufficient for pC221 mobilization by pGO1. oriT was cloned onto a pE194 derivative and complemented in trans for both relaxation and mobilization. Mobilization of relaxable plasmids in S. aureus appears to be analogous to mobilization by donation observed in gram-negative bacteria. PMID- 2703462 TI - Sexual reproduction as a response to H2O2 damage in Schizosaccharomyces pombe. AB - Although sexual reproduction is widespread, its adaptive advantage over asexual reproduction is unclear. One major advantage of sex may be its promotion of recombinational repair of DNA damage during meiosis. This idea predicts that treatment of the asexual form of a facultatively sexual-asexual eucaryote with a DNA-damaging agent may cause it to enter the sexual cycle more frequently. Endogenous hydrogen peroxide is a major natural source of DNA damage. Thus, we treated vegetative cells of Schizosaccharomyces pombe with hydrogen peroxide to test if sexual reproduction increases. Among untreated stationary-phase S. pombe populations the sexual spores produced by meiosis represented about 1% of the total cells. However, treatment of late-exponential-phase vegetative cells with hydrogen peroxide increased the percentage of meiotic spores in the stationary phase by 4- to 18-fold. Oxidative damage therefore induces sexual reproduction in a facultatively sexual organism, a result expected by the hypothesis that sex promotes DNA repair. PMID- 2703463 TI - Identification of a gene linked to Rhizobium meliloti ntrA whose product is homologous to a family to ATP-binding proteins. AB - The ntrA gene of Rhizobium meliloti has recently been identified and shown to be required for a diverse set of metabolic functions (C. W. Ronson, B. T. Nixon, L. M. Albright, and F. M. Ausubel, J. Bacteriol. 169:2424-2431, 1987). As a result of sequencing the ntrA gene and its flanking regions from R. meliloti, we identified an open reading frame directly upstream of ntrA, ORF1, whose predicted product is homologous to a superfamily of ATP-binding proteins involved in transport, cell division, nodulation, and DNA repair. The homology of ORF1 to this superfamily and its proximity to ntrA led us to investigate its role in symbiosis by mutagenesis and expression studies. We were unable to isolate an insertion mutation in ORF1, suggesting that ORF1 may code for an essential function. We identified the start of transcription for the ntrA gene in vegetative cells and bacteroids and showed that ORF1 and ntrA are transcriptionally unlinked. ORF1 appears to be in an operon with one or more upstream genes. PMID- 2703464 TI - Structure of the cutinase gene and detection of promoter activity in the 5' flanking region by fungal transformation. AB - The cutinase gene from Fusarium solani f. sp. pisi (Nectria hematococa) was cloned and sequenced. Sau3A fragments of genomic DNA from the fungus were cloned in a lambda Charon 35 vector. When restriction fragments generated from the inserts were screened with 5' and 3' probes from cutinase cDNA, a 5.5-kilobase SstI fragment hybridized with both probes, suggesting the presence of the entire cutinase gene. A 2,818-base pair segment was sequenced, revealing a 690 nucleotide open reading frame that was identical to that found in the cutinase cDNA with a single 51-base pair intron. Transformation vectors were constructed containing a promoterless gene for hygromycin resistance, which was translationally fused to flanking sequences of the cutinase gene. When protoplasts and mycelia were transformed with these vectors, hygromycin-resistant transformants were obtained. Successful transformation was assessed by Southern blot analysis by using radiolabeled probes for the hygromycin resistance gene and the putative promoter. The results of Southern blot analysis indicated that the plasmid had integrated into the Fusarium genome and that the antibiotic resistance was a manifestation of the promoter activity of the cutinase flanking sequences. Transformation of Colletotrichum capsici with the same construct confirmed the promoter activity of the flanking region and the integration of the foreign DNA. Transformation and deletion analysis showed that promoter activity resided within the 360 nucleotides immediately 5' to the cutinase initiation codon. PMID- 2703465 TI - Evidence that the transcription activator encoded by the Pseudomonas putida nahR gene is evolutionarily related to the transcription activators encoded by the Rhizobium nodD genes. AB - The nahR gene of the 83-kilobase naphthalene degradation plasmid NAH7 of Pseudomonas putida encodes a 34-kilodalton polypeptide which binds to the nah and sal promoters to activate transcription of the degradation genes in response to the inducer salicylate. The DNA sequence of the nahR gene was determined, and a derived amino acid sequence of the NahR protein was obtained. A computer search for homologous proteins showed that within the first 124 amino-terminal residues, NahR has approximately 35% identity with the transcriptional activator proteins encoded by the nodD genes of Rhizobium species. Allowing for ultraconservative amino acid substitutions, greater than 47% overall similarity was found between NahR and NodD, while 32% similarity was found between NahR and another transcription activator, LysR of Escherichia coli. The region of greatest similarity among all three proteins contained a probable helix-turn-helix DNA binding motif as suggested by homology with the proposed consensus sequence for Cro-like DNA-binding domains. The high level of amino acid identity between NahR and NodD, in conjunction with the observations that nahR and nodD are 45% homologous in DNA sequence, are divergently transcribed from homologous promoters near the structural genes they control, and have similar DNA-binding sites, strongly suggests that these two genes evolved from a common ancestor. PMID- 2703466 TI - Identification and nucleotide sequence of the Leptospira biflexa serovar patoc trpE and trpG genes. AB - Leptospira biflexa is a representative of an evolutionarily distinct group of eubacteria. In order to better understand the genetic organization and gene regulatory mechanisms of this species, we have chosen to study the genes required for tryptophan biosynthesis in this bacterium. The nucleotide sequence of the region of the L. biflexa serovar patoc chromosome encoding the trpE and trpG genes has been determined. Four open reading frames (ORFs) were identified in this region, but only three ORFs were translated into proteins when the cloned genes were introduced into Escherichia coli. Analysis of the predicted amino acid sequences of the proteins encoded by the ORFs allowed us to identify the trpE and trpG genes of L. biflexa. Enzyme assays confirmed the identity of these two ORFs. Anthranilate synthase from L. biflexa was found to be subject to feedback inhibition by tryptophan. Codon usage analysis showed that there was a bias in L. biflexa towards the use of codons rich in A and T, as would be expected from its G + C content of 37%. Comparison of the amino acid sequences of the trpE gene product and the trpG gene product with corresponding gene products from other bacteria showed regions of highly conserved sequence. PMID- 2703467 TI - Cell-associated pullulanase from Bacteroides thetaiotaomicron: cloning, characterization, and insertional mutagenesis to determine role in pullulan utilization. AB - We have cloned a pullulanase gene from Bacteroides thetaiotaomicron. The pullulanase expressed from this clone in Escherichia coli was cell associated and soluble and had a molecular mass of 72 kilodaltons by gel filtration. Maxicell analysis of proteins coded by the cloned insert showed that a 71.6- to 73.2 kilodalton doublet was associated with pullulanase activity. Thus, the pullulanase is probably a monomer. The cloned pullulanase produced maltotriose as an end product of pullulan digestion. In B. thetaiotaomicron the pullulanase activity was cell associated. Approximately 80% of the activity was soluble, and 16 to 18% was membrane associated. The molecular mass of the soluble pullulanase was 77 kilodaltons by gel filtration. To determine whether the cloned pullulanase gene was essential for pullulan utilization, we used directed insertional mutagenesis to inactivate the B. thetaiotaomicron pullulanase gene. The pullulanase specific activity of the mutant was approximately 45% of that of wild type B. thetaiotaomicron. However, the pullulanase-negative insertional mutant 95 1 was still able to grow on pullulan at a rate similar to that of wild-type B. thetaiotaomicron. Thus, there must be a second pullulanase in B. thetaiotaomicron. PMID- 2703468 TI - Biosynthesis of the two halobacterial light sensors P480 and sensory rhodopsin and variation in gain of their signal transduction chains. AB - The two retinal-containing photoreceptors of halobacteria, P480 and sensory rhodopsin, are formed constitutively and inducibly, respectively. Both photoreceptors are synthesized as apoproteins in cells with nicotine-inhibited retinal synthesis and are reconstituted as chromoproteins by the addition of all trans retinal to cell membrane preparations. The decrease in photoreceptor mediated photophobic response at the stationary growth phase of cells is not due to photoreceptor degradation but due to a deficiency of the signal transduction chain in the cell. PMID- 2703469 TI - Comparison of killing of gram-negative and gram-positive bacteria by pure singlet oxygen. AB - Gram-negative and gram-positive bacteria were found to display different sensitivities to pure singlet oxygen generated outside of cells. Killing curves for Salmonella typhimurium and Escherichia coli strains were indicative of multihit killing, whereas curves for Sarcina lutea, Staphylococcus aureus, Streptococcus lactis, and Streptococcus faecalis exhibited single-hit kinetics. The S. typhimurium deep rough strain TA1975, which lacks nearly all of the cell wall lipopolysaccharide coat and manifests concomitant enhancement of penetration by some exogenous substances, responded to singlet oxygen with initially faster inactivation than did the S. typhimurium wild-type strain, although the maximum rates of killing appeared to be quite similar. The structure of the cell wall thus plays an important role in susceptibility to singlet oxygen. The outer membrane-lipopolysaccharide portion of the gram-negative cell wall initially protects the bacteria from extracellular singlet oxygen, although it may also serve as a source for secondary reaction products which accentuate the rates of cell killing. S. typhimurium and E. coli strains lacking the cellular antioxidant, glutathione, showed no difference from strains containing glutathione in response to the toxic effects of singlet oxygen. Strains of Sarcina lutea and Staphylococcus aureus that contained carotenoids, however, were far more resistant to singlet oxygen lethality than were both carotenoidless mutants of the same species and other gram-positive species lacking high levels of protective carotenoids. PMID- 2703471 TI - Major outer membrane proteins unique to reproductive cells of Hyphomonas jannaschiana. AB - Separation on the basis of molecular weight resolved three proteins specific to the swarmer cell of Hyphomonas jannaschiana. In the reproductive cell, 4 major proteins were identified as cytoplasmic and 10 were identified as envelope. Of these envelope proteins, one was common to both the inner and outer membranes, four were common to the inner membrane, and five were common to the outer membrane. Four of these outer membrane proteins were specific to the reproductive cell, and two of these proteins, with apparent molecular weights of 116,000 and 29,000, constituted 19% of the total cell protein and 54% of the outer membrane protein. PMID- 2703470 TI - Nucleotide sequence analysis and expression of the minimum REPI replication region and incompatibility determinants of pColV-K30. AB - We sequenced the minimum REPI replication region and the incompatibility determinants of pColV-K30. The minimum replication region contains an open reading frame which corresponds to a 35-kilodalton (kDa) protein. Sodium dodecyl sulfate-polyacrylamide gel electrophoretic analysis with maxicells transformed with a number of deletion derivatives demonstrated that this replication region encodes a 39-kDa protein and also established the direction of transcription of the RepI protein gene. The 39-kDa polypeptide was identified as the trans-acting factor essential for replication of REPI-containing plasmids. A translated region of the nucleotide sequence of the RepI protein gene showed homology with the helix-turn-helix binding domains of a number of DNA-binding proteins and also with other plasmid replication proteins. Further nucleotide analysis of the REPI region revealed the presence of direct and inverted repeat sequences in the incE, incF, and ori regions. The REPI ori also contained a perfect DnaA-binding site in addition to a high frequency of occurrence of the DNA adenine methylation (dam) site 5'GATC3'. PMID- 2703472 TI - Isolation of a Legionella pneumophila restriction mutant with increased ability to act as a recipient in heterospecific matings. AB - The ability of Legionella pneumophila to act as a recipient of IncP and IncQ plasmids in matings with Escherichia coli varies widely from strain to strain. We found that the low efficiency of mating of the Philadelphia-1 strain is due to a type II restriction-modification system, and we isolated and characterized a Philadelphia-1 mutant that lacks the restriction enzyme activity. PMID- 2703473 TI - Onset of penicillin-induced bacteriolysis in staphylococci is cell cycle dependent. AB - Synchronously growing staphylococci were treated with "lytic" concentrations of penicillin at different stages of their division cycle. Coulter Counter measurements and light microscopy were used to determine the onset of bacteriolysis. Independent of the stage of the division cycle at which penicillin was added, (i) the cells were always able to perform the next cell division; (ii) the following division, however, did not take place; and (iii) instead, at this time, when the onset of the subsequent cell separation was observed in control cultures, lysis of the penicillin-treated cells occurred. These results support a recent model (P. Giesbrecht, H. Labischinski, and J. Wecke, Arch. Microbiol. 141:315-324, 1985) explaining penicillin-induced bacteriolysis of staphylococci as the result of a special morphogenetic mistake during cross wall formation. PMID- 2703474 TI - A cloned regulatory gene of Streptomyces lividans can suppress the pigment deficiency phenotype of different developmental mutants. AB - We report here the cloning of a Streptomyces lividans gene that when introduced on a multicopy plasmid vector reversed the pigment deficiency phenotype of several distinct mutants blocked in development, pigment production, or both. Although this gene was shown by restriction enzyme analysis to be similar to a previously cloned afsB-complementing gene of Streptomyces coelicolor, we show that it does not correspond to the S. coelicolor chromosomal locus designated afsB. Thus, the cloned locus, which we propose to rename afsR, appears to complement the AfsB- phenotype by pleiotropic regulatory effects. PMID- 2703475 TI - Translation of glucocorticoid receptor mRNA in vitro yields a nonactivated protein. AB - The glucocorticoid receptor is present in cytosol prepared from cell extracts of nonhormone-treated cells as a large nonactivated (i.e. non-DNA binding) 9 S heteromeric complex which contains the Mr approximately 90,000 heat shock protein, hsp90. hsp90 is expressed under physiological conditions in mammalian cells and is also present in reticulocyte lysate, as assessed by Western immunoblotting using specific anti-hsp90 antibodies. We have translated glucocorticoid receptor mRNA in reticulocyte lysates. The receptor synthesized under cell-free conditions also interacts with hsp90 both in the presence and absence of ligand, as determined by sucrose gradient centrifugation. The in vitro synthesized glucocorticoid receptor does not bind to DNA-cellulose but can be converted to a DNA binding form following labeling with dexamethasone and heat treatment. Thus, the glucocorticoid receptor is synthesized in a nonactivated form under cell-free conditions. These data indicate that the 9 S glucocorticoid receptor complex found in cytosol does not represent an artifact due to cell homogenization and supports the existence in vivo of the glucocorticoid receptor hsp90 complex. PMID- 2703476 TI - A protein-protein interaction is essential for stable complex formation on a 5 S RNA gene. AB - Stable complex formation on a Xenopus somatic 5 S RNA gene requires protein protein interactions between the non-DNA binding domain of transcription factor (TF) IIIA and activities in a TFIIIC fraction. No significant changes in the structure of the TFIIIA.DNA complex can be detected as a consequence of stabilization, indicating that protein confirmation is the primary determinant of stability. PMID- 2703477 TI - Isolation and amino-terminal sequence of a novel cellular growth inhibitor (inhibitory diffusible factor 45) secreted by 3T3 fibroblasts. AB - A growth inhibitory protein named inhibitory diffusible factor 45 (IDF45) has been purified to homogeneity from medium conditioned by dense cultures of mouse 3T3 cells. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of fast protein liquid chromatography-purified bioactive material showed a single band corresponding to a protein of 45 kDa. The molecule is a monomer. The pI of the molecule, as determined by isoelectric focusing, is about 6.5. The amino-terminal sequence of the protein was established as Ser-Ala-Gly-Ala-Val-Gly-Ala-Gly-Pro Val-Val-Arg. The protein inhibits DNA synthesis in chicken embryo fibroblasts in a dose-dependent manner (ED50: 40 ng/ml, approximately 1 nM). The chemical properties of IDF45, i.e. molecular weight and amino-terminal sequence, clearly distinguish it from other known growth inhibitory proteins. PMID- 2703478 TI - X-ray absorption spectroscopic study of the active copper sites in dopamine beta hydroxylase. AB - X-ray absorption spectroscopy has been used to investigate the local environment of the copper sites in bovine dopamine beta-hydroylase, the enzyme that catalyzes the conversion of dopamine to norepinephrine in the adrenal medulla and noradrenergic nerve cells. The marked similarity of the x-ray absorption edge features of the oxidized and ascorbate-reduced forms of the enzyme with those of the corresponding Cu(imidazole)4 complexes suggests that the ligation in both cases is very similar. Furthermore, this similarity is found for the extended x ray absorption fine structure data, and analysis shows only nitrogen (or oxygen) ligation for both enzyme forms. Thus, four nitrogen atoms provide the best fit to the data at an average distance of 1.97 +/- 0.02 A for the oxidized enzyme and four nitrogen atoms at 2.05 +/- 0.02 A for the ascorbate-reduced form. The present data analysis also indicates that there is little change in the average copper ligand environment upon reduction of the enzyme-bound copper from Cu(II) to the Cu(I). The data for the oxidized form of the enzyme are in agreement with previous spin-echo EPR experiments that show three to four imidazole nitrogen ligands for each copper (McCracken, J., Desai, P. R., Papadopoulos, N. J., Villafranca, J. J., and Peisach, J. (1988) Biochemistry 27, 4133-4137). In addition, the data do not indicate the presence of any heavy atom (sulfur or chlorine) ligation to the ascorbate-reduced form of the enzyme as reported by Scott et al. (Scott, R. A., Sullivan, R. J., DeWolf, W. E., Jr., Dolle, R. E., and Kruse, L. I. (1988) Biochemistry 27, 5411-5417). PMID- 2703479 TI - Import and processing of precursor to mitochondrial aspartate aminotransferase. Structure-function relationships of the presequence. AB - The precursor protein of pig mitochondrial aspartate aminotransferase (pre mAspAT) contains a 29-residue presequence (Joh, T., Nomiyama, H., Maeda, S., Shimada, K., and Morino, Y. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 1-5). Pre mAspAT produced in an in vitro transcription and translation system was avidly imported into pig and rat liver mitochondria to be processed to the mature form of the enzyme. The pre-mAspAT was also processed to the mature form upon incubation with mitochondrial extracts. We synthesized precursor proteins with alterations within the presequence and compared quantitatively the effects of these mutations on the rates of both import and processing. Single and multiple substitutions of four basic residues with neutral amino acids at positions 5, 8, 18, and 28 showed that each residue contributes differentially to import and processing. Substitutions of His5 and Arg8 with glycines abolished the import activity but did not appreciably affect the rate of processing. Substitution of Arg28 with leucine at the position adjacent to the cleavage site seriously impaired the processing without appreciably affecting the rate of import. Analysis of deletions revealed that the amino-terminal region from position 2 to 8 was essential for both the import and processing. Thus the positive charges in the amino-terminal region are critical for import while the amino-terminal peptide segment and the cleavage site region appear to be requisite for recognition by a processing protease. PMID- 2703480 TI - Inhibition of protein kinase C by staurosporine promotes elevated accumulations of inositol trisphosphates and tetrakisphosphate in human platelets exposed to thrombin. AB - We have examined regulation by protein kinase C (Ca2+/phospholipid-dependent enzyme) of thrombin-induced inositol polyphosphate accumulation in human platelets. When platelets are exposed to thrombin for 10 s, the protein kinase C inhibitor staurosporine causes inositol phosphate elevations over control values of 2.7-fold (inositol 1,4,5-trisphosphate (Ins(1,4,5)P3], 1.9-fold (inositol 1,3,4,5-tetrakisphosphate (Ins(1,3,4,5)P4], and 1.2-fold (inositol 1,3,4 trisphosphate). In the same period, phosphatidic acid and diacylglycerol are unaffected. The myosin light chain kinase inhibitor ML-7 has no effect on inositol phosphate accumulations. Staurosporine does not inhibit Ins(1,4,5)P3 3 kinase and 5-phosphomonoesterase activities in saponin-permeabilized platelets incubated with exogenous Ins(1,4,5)P3 unless the platelets have been exposed to thrombin and protein kinase C is consequently activated. The protein kinase C agonist beta-phorbol 12,13-dibutyrate increases the Vmax of the 3-kinase 1.8 fold, with little effect on Km. Our results provide strong evidence for a role for protein kinase C in regulating inositol phosphate levels in thrombin activated platelets. We propose that endogenously activated protein kinase C removes Ins(1,4,5)P3 by stimulating both 5-phosphomonoesterase and Ins(1,4,5)P3 3 kinase. Initial activation of phospholipase C does not appear to be affected by such protein kinase C. Inhibition of protein kinase C by staurosporine decreases 5-phosphomonoesterase activity. The resulting elevated Ins(1,4,5)P3, as substrate for Ins(1,4,5)P3 3-kinase, promotes production of Ins(1,3,4,5)P4, which also may accumulate through decreased 5-phosphomonoesterase activity and elevated Ca2+ levels. These factors apparently counteract the inhibitory effect on 3-kinase, yielding a net increase in Ins(1,3,4,5)P4. PMID- 2703481 TI - Alterations in the glycosylation of secreted thyrotropin during ontogenesis. Analysis of sialylated and sulfated oligosaccharides. AB - We have examined the carbohydrate structure of thyrotropin (TSH) secreted in vitro by pituitaries from prenatal, perinatal, and mature rats using concanavalin A (ConA)-agarose chromatography and anion-exchange high performance liquid chromatography (HPLC). [3H]Glucosamine-labeled TSH was immuno-precipitated and treated with either Pronase to generate glycopeptides or a mixture of endo-beta-N acetyl-glucosaminidase F and peptide:N-glycosidase F to release oligosaccharides. The percentage of secreted TSH glycopeptides not bound to ConA was greater in mature animals (47 +/- 3%) than in either prenatal (29 +/- 3%) or perinatal animals (29 +/- 6%), suggesting more multiantennary oligosaccharides in the older animals. These structural changes were characterized further by performing anion exchange HPLC on released oligosaccharides. Secreted TSH from prenatal rats predominantly contained oligosaccharides with 1 and 2 negative charges, while TSH from mature rats contained these structures as well as 15% with 3 negative charges. In addition, the ratio of sialylated to sulfated oligosaccharides was greater in mature compared to prenatal animals for species with 1 negative charge (1.9-fold) as well as for species with 2 negative charges (4.3-fold). We also correlated the structural alterations noted by ConA analysis with anion-exchange HPLC. Oligosaccharides that bound to ConA and were eluted with alpha methylglucoside, when analyzed by anion-exchange HPLC, consisted of species with 1 and 2 negative charges, whereas oligosaccharides that were unbound to ConA were predominantly species with three negative charges. Together, these data suggest that with maturation of the hypothalamic-pituitary-thyroid axis secreted TSH contains more negatively charged multiantennary oligosaccharides with increased sialylation and decreased sulfation. PMID- 2703482 TI - Structural characterization of nitrimyoglobin. AB - Nitrimyoglobin was formed in greater than 94% yield by a simple reaction between excess nitrite and horse heart metmyoglobin at pH 5.5. This dark green pigment was shown by 1H NMR spectroscopy to be a single, pure product with a well defined tertiary structure that is highly similar to the starting myoglobin. Electronic spin states parallel those of myoglobin, although the relaxation times differ. Ligand binding reactions of nitrimyoglobin parallel those of normal myoglobin, but lead to a unique series of UV-visible spectra. In the ferrous state, nitrimyoglobin reversibly binds O2 with half-saturation of sites at an O2 partial pressure of 10.4 +/- 1.4 mm Hg. 1H NMR data indicate that the altered heme of nitrimyoglobin has not undergone reaction at any meso proton position, nor has it been partially saturated to the level of a chlorin. 15N NMR spectra indicate that only a single nitrogen was added to the protein as a nitro group. Extraction of the modified heme from nitrimyoglobin and spectroscopic characterization of the nitriheme by infrared spectroscopy and of the free base porphyrin methyl ester derived from nitriheme by 1H NMR indicate that the modification is regiospecific. The heme in nitrimyoglobin is 3-(trans-2-nitrovinyl)-2,7,12,18-tetramethyl-8 vinylporphyrin-13,1 7-dipropionic acid. In the Fisher nomenclature scheme, the 2 vinyl substituent is the site of modification and has been converted to a nitrovinyl group by substitution of a proton by -NO2. PMID- 2703483 TI - Identification of the active-site arginine in rat neutral endopeptidase 24.11 (enkephalinase) as arginine 102 and analysis of a glutamine 102 mutant. AB - Neutral endopeptidase 24.11 contains an active-site arginine residue involved in binding the free carboxylate of substrate peptides and inhibitors. This arginine reacts rapidly with [14C]phenylglyoxal, and its reaction is selectively blocked by the presence of either the substrate Met5-enkephalin, the competitive inhibitor phenylalanylalanine, or the transition state analog phosphoramidon. The phenylglyoxal-modified peptide was isolated by a procedure involving limited digestion by trypsin, separation of the tryptic peptides by high pressure liquid chromatography (HPLC), further digestion of the modified peptide by pepsin, and a final purification by HPLC. By this procedure arginine 102 was identified as the active-site arginine. Verification of this finding came from the use of site directed mutagenesis in which this arginine was replaced by glutamine. Both the mutant and wild-type enzyme reacted equally well with an amide containing substrate, glutaryl-Ala-Ala-Phe-4-methoxy-2-naphthylamide. However, reaction of the mutant enzyme with a substrate containing a free COOH-terminal carboxylate, 5 dimethylaminonaphthalene-1-sulfonyl-D-Ala-Gly-(NO2)Phe-Gly, was barely detectable with the mutant enzyme. Similarly the mutant enzyme showed a loss of selectivity in inhibition by D-Ala2-Met5-enkephalin compared to the corresponding amide but exhibited no difference in the maximal velocity for hydrolysis of D-Ala2-Met5 enkephalin and its amide. PMID- 2703484 TI - Succinimide formation from aspartyl and asparaginyl peptides as a model for the spontaneous degradation of proteins. AB - Nonenzymatic intramolecular reactions can result in the deamidation, isomerization, and racemization of protein and peptide asparaginyl and aspartyl residues via succinimide intermediates. To understand the sequence dependence of these reactions, we measured the rate of succinimide formation in a series of synthetic peptides at pH 7.4. These peptides (Val-Tyr-Pro-X-Y-Ala) contained an internal aspartyl, asparaginyl, aspartyl beta-methyl ester, or aspartyl alpha methyl ester residue (X) followed by a glycyl, seryl, or alanyl residue (Y). The rates of succinimide formation of the asparaginyl peptides were found to be 13.1 35.6 times faster than those of the aspartyl peptides. The rates of succinimide formation for the glycyl peptides were 6.5-17.6 times faster than those of the alanyl peptides, while the rates for the seryl peptides were 1.6-4.5 times faster than those of the alanyl peptides. The overall 232-fold range in these reaction rates for aspartyl and asparaginyl residues suggests that sequence can be an important determinant in their stability in flexible peptides. In proteins, there may be a much larger range in the rates of succinimide formation because specific conformations may greatly enhance or inhibit this reaction. PMID- 2703485 TI - Mutation in hinge region of lactose repressor protein alters physical and functional properties. AB - A mutant of the Escherichia coli lactose repressor (BG124) in which serine at position 77 is replaced by leucine has been examined by physical methods. Consistent with the phenotypic character of this i-d mutant, BG124 protein did not bind lactose operator specifically, but did bind to DNA nonspecifically. Titration with inducer monitoring tryptophan fluorescence changes yielded a biphasic saturation curve, and Scatchard and Hill plots of the fluorescence and equilibrium dialysis data demonstrated heterogeneity of inducer binding sites. Although ultraviolet difference spectra and potassium iodide quenching of fluorescence indicated that BG124 repressor has structural distinctions from wild type protein, circular dichroism spectra and acrylamide quenching of fluorescence for the two proteins were quite similar. A significantly greater increase of 1 anilino-8-naphthalenesulfonate fluorescence was observed in the presence of mutant versus wild-type repressor. Unlike wild-type behavior, changes in both 1 anilino-8-naphthalenesulfonate fluorescence intensity and maximum emission wavelength in response to inducer were found for the BG124 protein. These results are consistent with conformational alterations in the interface between NH2 terminal and core domains of this mutant repressor. The single amino acid alteration in the hinge between the core and NH2 terminus yields conformational effects which influence physical and functional properties associated with both domains. PMID- 2703486 TI - Inhibition of cholesterol synthesis and cell growth by 24(R,S),25-iminolanosterol and triparanol in cultured rat hepatoma cells. AB - 24(R,S),25-Iminolanosterol (IL) and triparanol added to cultures of rat hepatoma cells, H4-II-C3 (H4), interrupt the conversion of lanosterol to cholesterol and, depending on their concentrations, cause the accumulation in the cells of intermediates in the lanosterol to cholesterol conversion. At 45 microM, both substances cause the accumulation of 5 alpha-cholesta-8(9),24-dien-3 beta-ol (zymosterol), and at the low concentration of 4.5 microM, they cause the accumulation of cholesta-5.24-dien-3 beta-ol (desmosterol). The effect of intermediate concentrations of 9 or 22.5 microM of either substance is to cause the accumulation in the cells of three sterols: cholesta-5,7,24-trien-3 beta-ol, zymosterol, and desmosterol. The synthesis of these intermediary sterols, not found normally in H4 cells, is particularly pronounced in cultures kept in lipid depleted media that contain the inhibitors and proceeds by the use of endogenous substrates at the expense of cholesterol. The synthesis of cholesterol from [14C]acetate or [2-14C]mevalonate is completely blocked by either inhibitor even at 4.5 microM. IL or triparanol inhibits the growth of H4 cells. Cells seeded into either full growth or lipid-depleted medium containing 22.5 microM IL will not grow unless the media are supplemented with low density lipoproteins (60 micrograms/ml). Supplementation of the media with 4.6 mM mevalonate does not counteract the inhibitory effect of IL on cell growth. PMID- 2703487 TI - Possible involvement of the 90-kDa heat shock protein in the regulation of protein synthesis. AB - The heme-sensitive eukaryotic initiation factor (eIF)-2 alpha kinase regulates translational activity in reticulocytes by phosphorylation of the smallest subunit of eukaryotic peptide initiation factor 2, eIF-2. Highly purified preparations of the kinase contain an abundant 90-kDa polypeptide which appears to modulate the activity of the enzyme. The physical properties and structural characteristics of the reticulocyte 90-kDa peptide are similar to those of the 90 kDa heat shock protein (hsp 90) from HeLa and other mammalian cells. The reticulocyte and HeLa cell proteins are shown to be immunologically cross reactive. A direct comparison of the two proteins by one-dimensional peptide mapping of large peptides generated by limited proteolysis and by reversed-phase high performance liquid chromatography analysis of tryptic peptides indicates that they represent the same protein species. Like the 90-kDa reticulocyte protein, HeLa cell hsp 90 causes increased eIF-2 alpha phosphorylation by the heme-sensitive kinase and is a potent inhibitor of protein synthesis in the reticulocyte lysate system. A potential mechanism for the latter inhibition is inferred. These results implicate hsp 90 in the regulation of protein synthesis via its interaction with and perhaps regulation of the heme-sensitive kinase and phosphorylation of eIF-2 alpha. PMID- 2703488 TI - The effect of the protein matrix on glycoprotein processing by oviduct Golgi enzymes. AB - Using the avidin-biotinyl glycan system reported previously (Shao, M.-C., and Wold, F. (1987) J. Biol. Chem. 267, 2968-2972), we have compared the processing efficiency of oviduct enzymes acting on different glycan-(biotinyl)Asn and glycan (6-biotinamidohexanoyl)Asn derivatives when they are free and bound to avidin. The glycans were selected to permit exploration of the individual processing steps, and the two different groups of derivatives were used to assess both the close (biotinyl) and more distal (biotinamidohexanoyl) display of the glycan relative to the avidin surface. The direct comparison of the free and avidin bound glycans demonstrated that mannosidase I is strongly inhibited by avidin in both the close and distal complexes, whereas GlcNAc transferase I and mannosidase II are strongly inhibited only in the close complex. GlcNAc transferases III, IV, and V, which could only be assessed individually by indirect means using different substrates, did not appear to be affected in any major way by the protein matrix; the data suggest that transferase III is inhibited only to a minor extent in the close complex. Gal transferase activity showed a minor effect of the avidin matrix for both complexes in the hybrid processing pathways. The most significant consequence of the avidin effect on Gal transferase was the apparent abolishment of the incorporation of a 2nd Gal residue in the two avidin complexes. This survey of the protein matrix effects on glycan processing by oviduct enzymes appears to provide reasonable clues to the origin of the very different glycan structures observed in oviduct-processed glycoproteins. Thus, ovalbumin and avidin itself, containing a mixture of oligomannose and hybrid glycans at their single glycosylation sites, may well present they glycans to the processing enzymes in a display very similar to that of the avidin close complex observed here. The inhibition of mannosidase I and GlcNAc transferase I lead to preservation of oligomannose structures, whereas the strong inhibition of mannosidase II favors the incorporation of the bisecting GlcNAc by GlcNAc transferase III to yield hybrid structures as the most processed products. Ovomucoid, which contains multiantennary complex structures at all glycosylation sites, may on the other hand display its glycans, unencumbered by the protein surface, in conformations similar to either the free glycans or the distal complexes observed in this work. PMID- 2703489 TI - Beta 3: a new member of nicotinic acetylcholine receptor gene family is expressed in brain. AB - Screening of a rat brain cDNA library with a radiolabeled probe made from an alpha 3 cDNA (Boulter, J., Evans, K., Goldman, D., Martin, G., Treco, D., Heinemanns, S., and Patrick, J. (1986) Nature 319, 368-374) resulted in the isolation of a clone whose sequence encodes a protein, beta 3, which is homologous (40-55% amino acid sequence identity) to previously described neuronal nicotinic acetylcholine receptor subunits. The encoded protein has structural features found in other nicotinic acetylcholine receptor (nAChR) subunits. Two cysteine residues that correspond to cysteins 128 and 142 of the Torpedo nAChR alpha subunit are present in beta 3. Absent from beta 3 are 2 adjacent cysteine residues that correspond to cysteines 192 and 193 of the Torpedo subunit. In situ hybridization histochemistry, performed using probes derived from beta 3 cDNAs, demonstrated that the beta 3 gene is expressed in the brain. Thus, beta 3 is the fifth member of the nAChR gene family that is expressed in the brain. The pattern of beta 3 gene expression partially overlaps with that of the neuronal nAChR subunit genes alpha 3, alpha 4, or beta 2. These results lead us to propose that the beta 3 gene encodes a neuronal nAChR subunit. PMID- 2703490 TI - The complete primary structure for the alpha 1-chain of mouse collagen IV. Differential evolution of collagen IV domains. AB - We report here the complete nucleotide and amino acid sequences for the alpha 1 chain of mouse collagen IV which is 1669 amino acids in length, including a putative 27-residue signal peptide. In comparison with the amino acid sequence for the alpha 2-chain (Saus, J., Quinones, S., MacKrell, A. J., Blumberg, B., Muthkumaran, G., Pihlajaniemi, J., and Kurkinen, M. (1989) J. Biol. Chem. 264, 6318-6324), the two chains of collagen IV are 43% identical. Most of the interruptions of the Gly-X-Y repeat are homologously placed but strikingly show no sequence similarity between the two chains. Availability of the amino acid sequences for human collagen IV allows a detailed comparison of the primary structure of collagen IV and reveals evolutionarily conserved domains of the protein. Between the two species, the alpha 1 (IV) chains are 90.6% and the alpha 2 (IV) chains are 83.5% identical in sequence. We discuss these data with respect to differential evolution between and within the collagen IV chain types. PMID- 2703491 TI - The complete primary structure of mouse alpha 2(IV) collagen. Alignment with mouse alpha 1(IV) collagen. AB - We have determined the nucleotide and amino acid sequences of mouse alpha 2(IV) collagen which is 1707 amino acids long. The primary structure includes a putative 28-residue signal peptide and contains three distinct domains: 1) the 7 S domain (residues 29-171), which contains 5 cysteine and 8 lysine residues, is involved in the cross-linking and assembly of four collagen IV molecules; 2) the triple-helical domain (residues 172-1480), which has 24 sequence interruptions in the Gly-X-Y repeat up to 24 residues in length; and 3) the NC1 domain (residues 1481-1707), which is involved in the end-to-end assembly of collagen IV and is the most highly conserved domain of the protein. Alignment of the primary structure of the alpha 2(IV) chain with that of the alpha 1(IV) chain reported in the accompanying paper (Muthukumaran, G., Blumberg, B., and Kurkinen, M. (1989) J. Biol. Chem. 264, 6310-6317) suggests that a heterotrimeric collagen IV molecule contains 26 imperfections in the triple-helical domain. The proposed alignment is consistent with the physical data on the length and flexibility of collagen IV. PMID- 2703492 TI - The regulation of platelet-activating factor production in endothelial cells. The role of calcium and protein kinase C. AB - Endothelial cells (EC) synthesize platelet-activating factor (PAF) when stimulated with agonists that bind to cell-surface receptors. We examined events that link receptor binding to synthesis of PAF by EC. Bovine EC stimulated with agonists that interact with specific cell-surface receptors accumulated PAF only in the presence of extracellular calcium. Hormonal stimulation of EC resulted in Ca2+ entry characteristic of that seen with receptor-operated calcium channels; Indo-1 measurements demonstrated that this inward flux of Ca2+ caused prolonged elevated levels of intracellular Ca2+. EC were exposed to melittin or theta toxin from Clostridium perfringens (pore-forming peptides that increase the permeability of the plasma membrane for small molecules) resulting in an inward flux of Ca2+ and accumulation of PAF. Ca2+ appears to be regulatory for PAF production at the level of phospholipase A2-mediated production of the PAF precursor 1-O-alkyl-2-lyso-sn-glycero-3-phosphocholine, as Ca2+ was required for the stimulated hydrolysis of 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine. PAF accumulation in EC is also regulated by protein kinase C. Pretreatment of EC with phorbol esters that activate protein kinase C or with dioctanoylglycerol, followed by stimulation, resulted in a 2-fold increase in stimulated PAF production. The regulatory effect of protein kinase C also appears to be at a phospholipase A2-mediated hydrolysis of 1-O-alkyl-2-acyl-sn-glycero-3 phosphocholine. PMID- 2703494 TI - Acylation of proteins by myristic acid in isolated mitochondria. AB - Isolated and highly purified mitochondria from rat liver were incubated with [1 14C]myristate, solubilized in boiling sodium dodecyl sulfate, and analyzed by polyacrylamide gel electrophoresis and autoradiography. Six to eight protein bands were found to be radioactively labeled. If the mitochondria were heated for 5 min at 95 degrees C prior to incubation with this fatty acid, no labeling was observed. By preexposing the mitochondria to unlabeled fatty acids of varying chain lengths, the extent of labeling by [1-14C]myristate was reduced in a chain length-dependent manner, exhibiting maximal inhibition at lauric acid. Reversibility of the labeling was demonstrated by chasing the incorporated radioactivity with unlabeled fatty acids of varying chain length, resulting in a maximal displacement of the tracer again by lauric acid. Fractionation of the labeled mitochondria into mitochondrial matrix and inner mitochondrial membrane components before or after labeling showed that the modified proteins are located inside the inner mitochondrial membrane. In both cases, the pattern of labeling was different from the one observed with intact mitochondria. The labeled bands in the gel were sensitive to alkaline methanol or hydroxylamine treatment. The radioactivity recovered after this treatment co-migrated with myristic acid on thin layer chromatography plates. The chain length specificity and the rapid reversibility of the observed acylation argue for a new type of reaction, different from the acylation observed in whole cells. The possible involvement of the acylated proteins in the regulation of oxidative phosphorylation is discussed. PMID- 2703493 TI - Transcriptional activation of the heme oxygenase gene by heme and cadmium in mouse hepatoma cells. AB - Treatment of mouse hepatoma (Hepa) cells with heme or cadmium chloride in serum free medium causes a rapid increase in the steady-state level of heme oxygenase (HO) messenger RNA. This increase is both dose- and time-dependent. Maximum accumulation of HO mRNA is observed 3 h after addition of either agent. Treatment of Hepa cells with heme or CdCl2 also stimulates the transcription of the HO gene, as judged by in vitro nuclear transcription run-on assays. The maximum rate of HO gene transcription occurs 2 h after treatment with either agent. Comparison of the relative increase in the rate of HO gene transcription with the relative increase in the level of HO mRNA demonstrates that transcriptional activation is the primary mechanism by which heme and cadmium produce the accumulation of HO mRNA in Hepa cells. Cadmium may also influence other processes involved in the expression of HO, since the time course of mRNA accumulation diverges from that of gene transcription. However, neither heme nor cadmium alters the rate of HO mRNA degradation. Cobalt chloride and heat shock, which are potent inducers of HO mRNA in rat liver and rat C6 glioma cells, respectively, have only a small effect on the level of HO mRNA in mouse hepatoma cells. PMID- 2703495 TI - Alkylation of cysteine 41, but not cysteine 200, decreases the ADP ribosyltransferase activity of the S1 subunit of pertussis toxin. AB - Sulfhydryl-alkylating reagents are known to inactivate the NAD glycohydrolase and ADP-ribosyltransferase activities of the S1 subunit of pertussis toxin, a protein which contains two cysteines at positions 41 and 200. It has been proposed that NAD can retard alkylation of one of the two cysteines of this protein (Kaslow, H.R., and Lesikar, D.D. (1987) Biochemistry 26, 4397-4402). We now report that NAD retards the ability of these alkylating reagents to inactivate the S1 subunit. In order to determine which cysteine is protected by NAD, we used site directed mutagenesis to construct analogs of the toxin with serines at positions 41 and/or 200. Sulfhydryl-alkylating reagents reduced the ADP-ribosyltransferase activity of the analog with a single cysteine at position 41; NAD retarded this inactivation. In contrast, sulfhydryl-alkylating reagents did not inactivate analogs with serine at position 41. An analog with alanine at position 41 possessed substantial ADP-ribosyltransferase activity. We conclude that alkylation of cysteine 41, and not cysteine 200, inactivates the S1 subunit of pertussis toxin, but that the sulfhydryl group of cysteine 41 is not essential for the ADP-ribosyltransferase activity of the toxin. These results suggest that the region near cysteine 41 contributes to features of the S1 subunit important for ADP-ribosyltransferase activity. Using site-directed mutagenesis, we found that changing aspartate 34 to asparagine, arginine 39 to lysine, and glutamine 42 to glutamate had little effect on ADP-ribosyltransferase activity. However, substituting an asparagine for the histidine at position 35 markedly decreased, but did not eliminate, ADP-ribosyltransferase activity. Chou-Fasman analysis predicted no significant modifications in secondary structure of the S1 peptide with the change of histidine 35 to asparagine. Thus, histidine 35 may interact with a substrate of the S1 subunit without being essential for catalysis. PMID- 2703496 TI - Isolation and characterization of proteins cross-linked to DNA by the antitumor agent methylene dimethanesulfonate and its hydrolytic product formaldehyde. AB - This study attempted to characterize proteins cross-linked to DNA of Yoshida lymphosarcoma cells treated with methylene dimethanesulfonate (MDMS) and its hydrolytic products formaldehyde (HCHO) and methanesulfonic acid (MSA). MDMS and HCHO treatments produced a similar extent and type of DNA-protein cross-linking in Yoshida lymphosarcoma cells. All five major histones (H1, H2a, H2b, H3, and H4) were among the nuclear proteins cross-linked to DNA. Certain discrete differences were also apparent in these studies. MDMS cross-linked proteins of 29 and 48 kDa to DNA that were not observed following HCHO treatment alone, and HCHO cross-linked a 26-kDa protein to DNA that was not observed following MDMS treatment. Because semicarbazide prevented all MDMS-induced DNA-protein cross linking, HCHO must be the component responsible for this lesion. The 26-kDa protein has been identified as an H4-H2b dimer. The formation of this dimer is particularly sensitive to MSA release on hydrolysis of MDMS because, in the presence of MSA, HCHO preferentially cross-linked an H2a-H2b dimer and a 48-kDa non-histone protein to DNA. Differences in DNA-protein cross-linking between these two agents are therefore proposed to arise from discrete changes in chromatin structure induced directly by MSA release. PMID- 2703497 TI - Calcium-activated DNA fragmentation in rat liver nuclei. AB - Incubation of isolated rat liver nuclei with ATP, NAD+, and submicromolar Ca2+ concentrations resulted in extensive DNA hydrolysis. Half-maximal activity occurred with 200 nM Ca2+, and saturation of the process was observed with 1 microM Ca2+. ATP stimulated a calmodulin-dependent nuclear Ca2+ uptake system which apparently mediated endonuclease activation. Ca2+-activated DNA fragmentation was inhibited by the inhibitor of poly(ADP-ribose) synthetase, 3 aminobenzamide, and was associated with poly(ADP-ribosyl)ation of nuclear protein. The characteristics of this endonuclease activity indicate that it may be responsible for the Ca2+-dependent fragmentation of DNA involved in programmed cell death (apoptosis) and in certain forms of chemically induced cell killing. PMID- 2703498 TI - Selective inactivation of the exonuclease activity of bacteriophage T7 DNA polymerase by in vitro mutagenesis. AB - The 3' to 5' exonuclease activity of bacteriophage T7 DNA polymerase (gene 5 protein) can be inactivated selectively by reactive oxygen species. Differences in the enzymatic properties between the two forms are exploited to show by a chemical screen that modification of a histidine residue reduces selectively the exonuclease activity. In vitro mutagenesis of the histidine at residue 123, and of the neighboring residues, results in varying reduction of the exonuclease activity, including mutant enzymes that have no detectable exonuclease activity; as a consequence their polymerase activity is increased up to 9-fold. T7 phage containing the mutant genes have a greatly reduced burst size and demonstrate up to a 14-fold increase in the spontaneous mutation rate. PMID- 2703499 TI - Hydrophobic binding of the ectodomain of influenza hemagglutinin to membranes occurs through the "fusion peptide". AB - Toward elucidating molecular details of virus-induced membrane fusion, we have studied the low pH-triggered interaction of the bromelain-solubilized ectodomain of influenza hemagglutinin with liposomes. Polypeptide segments which insert into the apolar phase of the lipid bilayer were first labeled specifically using either of the two membrane-restricted carbene-generating reagents, 3 (trifluoromethyl)-3-([125I]iodophenyl)diazirine and 1-palmitoyl-2-[11-[4-[3 (trifluoromethyl)diazirinyl]phenyl] undecanoyl]-sn-glycero-3-phosphorylcholine, and were then identified on the basis of cyanogen bromide and 2-(2 nitrophenylsulfenyl)-3-methyl-3'-bromoindolenine-skatole fragment analysis and Edman degradations. Here, we demonstrate that the hydrophobic interaction is mediated solely by the so-called "fusion peptide" which corresponds to the NH2 terminal segment of the BHA2 subunit of nature influenza hemagglutinin. Predominant sites of labeling within that segment were Phe-3, Ile-6, Phe-9, Trp 14, Met-17, and Trp-21. The average 3-4 residue spacing between consecutive labeled amino acid side chains suggests a helical structure of that segment with an amphiphilic character. PMID- 2703500 TI - The structure and characterization of type I P-450(15) alpha gene as major steroid 15 alpha-hydroxylase and its comparison with type II P-450(15) alpha gene. AB - The structures of genes 15 alpha OH-1 and 15 alpha OH-2, within the mouse steroid 15 alpha-hydroxylase (P-450(15) alpha) family were determined. Genes 15 alpha OH 1 and -2 encoded mouse Type I and II P-450(15) alpha, respectively (Squires, E.J., and Negishi, M. (1988) J. Biol. Chem. 263, 4166-4171). The two genes, which spanned approximately 8 kilobase pairs of total length, showed nearly identical structures and were divided into nine exons at the same positions. A high nucleotide sequence homology (greater than 96%) indicated that 15 alpha OH-1 and 2 were duplicated within 5 million years. The two major transcription start sites were located at 14 and 24 base pairs (bp) upstream from the initiation Met in both genes. No tissue-specific difference in 15 alpha OH-1 and -2 transcriptional start sites was found in mouse liver and kidney. Both 15 alpha OH-1 and -2 had TATA and CAAT boxes at 30 and 100 bp, respectively, upstream from their major transcription start sites. A glucocorticoid regulatory element was present at 336 bp upstream from the start site in both genes. In addition to these motifs, 15 alpha OH-2 had an SV40 enhancer core sequence immediately downstream from its CAAT box. There were only 11 substitutions between Type I and II P-450(15) alpha in their 494-amino acid residues. Type I cDNA-transfected cell homogenates had testosterone 15 alpha-hydroxylase activity at approximately 9 pmol/min/mg protein. Type I also catalyzed progesterone and androstenedione 15 alpha hydroxylase activities. Type II, on the other hand, exhibited little activity toward these steroids. The results indicated that Type I was the major steroid 15 alpha-hydroxylase. The differential 15 alpha OH-1 expression, therefore, determined the sexual dimorphism of the tissue-specific 15 alpha-hydroxylase activity in mice. PMID- 2703501 TI - Molecular cloning of human intestinal mucin cDNAs. Sequence analysis and evidence for genetic polymorphism. AB - A human small intestine lambda gt11 cDNA library was screened using antisera prepared against the deglycosylated protein backbone of human colon cancer xenograft mucin. Three cDNAs were isolated from this screening, designated SMUC 40-42. These cDNAs were all found to contain tandem repeats of 69 nucleotides which encoded a threonine- and proline-rich protein consensus sequence of PTTTPITTTTTVTPTPTPTGTQT. RNA blots probed with one of these cDNAs, SMUC 41, exhibited large, polydisperse hybridization bands at approximately 7,600 bases. Band intensities were strongest when human small intestine, colon, and colon cancer poly(A)+ RNA was used. In vitro translation of poly(A)+ RNA from human small intestine, colon, and colon cancer cells produced a 162,000-dalton peptide that was immunoprecipitated with antibodies to deglycosylated mucin. SMUC 41 was also used to probe DNA blots, which indicated the presence of restriction fragment length polymorphisms in the intestinal mucin gene. These findings may be important in assessing the abnormal mucins found associated with several human diseases. PMID- 2703502 TI - Detection and characterization of degradative intermediates of avian apo very low density lipoprotein II mRNA present in estrogen-treated birds and following destabilization by hormone withdrawal. AB - The apo very low density lipoprotein II (apoVLDLII) gene is dormant in embryos, chicks, and roosters but can be activated by estrogen. ApoVLDLII mRNA is relatively stable in estrogen-treated birds. However, its stability decreases 4-5 fold following withdrawal of hormone. We have characterized degradative intermediates of apoVLDLII mRNA detected in liver total RNA from estrogen-treated birds and searched for alterations in the pattern of intermediates that occur upon hormone-withdrawal. Primer extension and S1 nuclease analyses have demonstrated that these intermediates consist of fragments of the molecule with intact 5' ends but which lack various 3' regions. Estrogen withdrawal results in a decrease in the steady state levels of several of these intermediates and the detection of two new species. The end points of the major fragments present in RNA from both estrogen-treated and withdrawn birds all map in, or within four nucleotides of, the tetranucleotide, GAUG. The two fragments detected only in RNA from withdrawn birds have 3' ends that immediately precede the sequence, CAGU. Based on secondary structures predicted by a global folding program, the end points also appear to be preferentially located in, or at the base of, internal "bulge-loops". PMID- 2703503 TI - In physiological salt conditions the core proteins of the nucleosomes in large chromatin fragments denature at 73 degrees C and the DNA unstacks at 85 degrees C. AB - Previous studies of chromatin melting had been done at low salt concentrations to maintain optically clear solutions permitting observation of hyperchromic effects that accompany the unstacking of bases in DNA. Scanning calorimetry does not require clear solutions and so allowed more nearly physiological levels of salt to be used in the present work. HeLa chromatin went through two major structural transitions of 73 and 85 degrees C in 150 mM NaCl, 1 mM MgCl2, 1 mM CaCl2. Proteinase K treatment eliminated the 73 degrees C transition without affecting the other one. DNase I digestion eliminated the 85 degrees C transition and shifted the other from 73 to 58 degrees C. Supported by previous reports that salt concentrations like these would largely eliminate the effect of histones on the Tm of DNA, the present observations indicate that the collapse of the core histone complex occurs at 73-76 degrees C (transition II) and the nucleosomal DNA unstacks at 85-87 degrees C (transition III). They also show that the thermal stability of the histone octamer is enhanced by the DNA folded around it in the nucleosome; although the histone core raises the Tm of the DNA in low salt, in physiological salt conditions it is the DNA that stabilizes the protein complex. PMID- 2703504 TI - Phosphotryptic peptide analysis of human progesterone receptor. New phosphorylated sites formed in nuclei after hormone treatment. AB - Human progesterone receptors (PR) exist as two independent naturally occurring steroid-binding forms of approximately 120 kDa (B-receptors) and 94 kDa (A receptors). Both are phosphorylated in hormone-untreated T47Dco breast cancer cells. Hormone treatment leads to receptor transformation and an increased phosphorylation state: the 32P-labeling intensity is 3-5 times higher after progestin treatment and 8-10 times higher after RU 486 treatment. Only serine residues are phosphorylated. To determine whether there are unique phosphorylation sites in transformed nuclear PR, we analyzed the phosphopeptides of untransformed and transformed A- and B-receptors by tryptic cleavage and reverse-phase high pressure liquid chromatography. Untransformed A- and B receptors share at least five common phosphopeptides, and a sixth is unique to B. Following transformation by either R5020 or RU 486, A-receptors generate at least six and B-receptors seven phosphopeptides. Compared with untransformed PR, there are at least two different phosphopeptides in transformed nuclear PR. Cyanogen bromide cleavage of transformed nuclear A-receptors, which lack the proximal 165 amino-terminal residues of the 933 amino acid B-receptors, produces two large fragments of approximately 43 and 19 kDa. These fragments contain all of the 32P label and comprise amino acids 165-595. Cleavage of transformed B-receptors also produces peptides of 43 and 19 kDa plus an additional 36-kDa fragment corresponding to residues 1-165. No 32P-labeled low molecular mass peptides are detected. Thus, all the hormone-dependent phosphoserine residues produced in nuclei are located in the first 595 amino acids of human PR, representing the amino terminus and 28 residues of the DNA-binding domain. PMID- 2703506 TI - At least do no harm. PMID- 2703505 TI - Amino acid sequence analysis of two mouse calbindin-D9k isoforms by tandem mass spectrometry. Protein modification by internal insertion of a single amino acid. AB - Two forms of calbindin-D9k have sometimes been observed within a single tissue. Sequencing of these proteins has been complicated by the presence of blocked amino termini. Tandem mass spectrometry is a powerful tool for comparing related proteins, and its use does not depend upon an unblocked amino terminus. In the present studies, calbindin-D9k was purified from the intestines of mice (270 animals per purification) by use of gel permeation chromatography and two preparative electrophoresis steps in the presence and absence of EDTA. The purified protein appeared to be homogeneous following electrophoresis under nondenaturing conditions, but two components were identified by sodium dodecyl sulfate-gel electrophoresis and immunoblotting. Two forms of the protein were isolated by reverse-phase high performance liquid chromatography. In each of three preparations, the average ratio of the major:minor isoforms was 2:1. The major form contained 77 amino acids and lacked the amino-terminal serine found in 78-amino acid calbindins from rat and pig. The amino acid sequence was identical with the deduced sequence reported for rat intestinal calbindin-D9k in 73 of 77 positions. In the minor form, a glutamine was found in a location between Lys-43 and Ala-44 of the major form and between the two calcium binding sites of the protein. The minor form was otherwise identical with the major form, including the presence of a blocked amino terminus. The inserted glutamine was located at the site of an intron in the rat calbindin gene, suggesting the possibility that alternative splicing produced the two forms of calbindin-D9k. The functional significance of an inserted amino acid between the two calcium binding sites remains to be explored. PMID- 2703507 TI - Salvage of the limb in the treatment of malignant pelvic tumors. AB - From 1970 through 1985, at the Mayo Clinic, sixty patients had operative treatment, with salvage of the limb, for a primary malignant tumor of the pelvis. Chondrosarcoma, osteosarcoma, and fibrosarcoma were common diagnoses. There were twenty-three iliosacral, twenty-five acetabular, and twelve ischiopubic lesions. Most of the resections were done with a wide margin and disruption of femorosacral continuity. Reconstruction included ten iliosacral, fourteen iliofemoral, and three ischiofemoral arthrodeses, and approximately 50 per cent of the procedures resulted in fusion. The average length of follow-up exceeded five years. Seventeen per cent of the patients, primarily those in whom an iliosacral lesion extended into the sacrum or along the spinal column, had a local recurrence. Twenty-one patients (37 per cent) had metastasis. The best functional results were seen after resections in which femorosacral continuity was maintained or reconstructed. If satisfactory margins can be achieved by the excision of a pelvic tumor, salvage of the limb is justified from both an oncological and a functional standpoint. PMID- 2703508 TI - Non-constrained total shoulder replacement in patients who have rheumatoid arthritis and class-IV function. AB - The results of twenty-four non-constrained total shoulder replacements that were done in twenty patients who had treatment of rheumatoid arthritis were retrospectively reviewed to determine how those results were affected by the severity of the disease. All of the patients had Class-IV functional capacity, and 92 per cent had Stage-III or IV rheumatoid progression. Nine (38 per cent) of the shoulders had a tear of the rotator cuff. The mean length of clinical follow up was 4.5 years (range, two to ten years). Preoperatively, all of the patients had disabling pain and limited function. Postoperatively, twenty-two (92 per cent) of the patients had no appreciable pain, and eighteen (75 per cent) had no significant functional limitation (p less than 0.001). Active elevation improved by 88 per cent, and external and internal rotation also improved significantly. Motion, relief of pain, and functional improvement were not significantly greater in the patients who had an intact rotator cuff. Radiolucent lines developed around ten (42 per cent) of the glenoid prostheses, but only two of the prostheses were surrounded by a complete line and were thought to be loose. No revisions were done. We believe that a non-constrained total shoulder replacement affords excellent relief of pain, satisfactorily improves range of motion, and improves function in patients who have severe rheumatoid involvement of the shoulder. However, because motion and function are severely restricted preoperatively, the end-results are not comparable with those that have been reported for patients who have less severe rheumatoid disease. PMID- 2703509 TI - Clinical presentation of complete tears of the rotator cuff. AB - To determine whether the presence and extent of a tear of the rotator cuff could be predicted on the basis of a patient's history, physical examination, and radiographic findings, detailed data from the histories and physical examinations of 103 patients who were known to have a tear of the rotator cuff were correlated with the radiographic and operative findings on these patients. An age-matched control group of fifty-one patients who had similar symptoms, but whose arthrograms showed normal results, was used to establish a baseline incidence of ten specific radiographic findings in the shoulder. Two discrete groups of patients who had a tear of the rotator cuff were identified. Twenty-eight patients (27 per cent) had a tear of a single tendon; the histories and the physical and radiographic findings in this group were consistent with a symptomatic local mechanical-impingement process in the shoulder. Sixty (80 per cent) of the seventy-five patients in the other group had a history of acute trauma to a shoulder. The patients in this second group were older and were non athletic, and had not previously had symptoms that were severe enough to need treatment. These patients were subsequently found to have a complete tear of more than one of the tendons of the rotator cuff. Multiple radiographic findings in the shoulder and other coexisting orthopaedic conditions also were more common in these patients. In this group, we believe that acute trauma in a shoulder that had chronic degenerative changes, rather than localized mechanical impingement, caused the tendons to rupture. PMID- 2703510 TI - An approach to the repair of avulsion of the glenohumeral ligaments in the management of traumatic anterior glenohumeral instability. AB - Between 1976 and 1985, we repaired avulsion of the glenohumeral ligaments in sixty-three shoulders (sixty-one patients) that had traumatic anterior glenohumeral instability. We describe the indications for operation, the operative technique, and the findings at the time of operation. We located thirty seven patients (thirty-nine shoulders) for clinical follow-up (average, 5.49 years). One patient had recurrent anterior dislocation four years postoperatively, but no patient needed reoperation. The average range of motion was 171 degrees of forward elevation and 84 degrees of external rotation in abduction. According to the criteria of Rowe et al., 97 per cent of the results were good or excellent. PMID- 2703511 TI - Total elbow arthroplasty for complete ankylosis of the elbow. AB - Sixteen patients who received nineteen semiconstrained total elbow replacements for complete ankylosis of the elbow were followed for an average of five and three-quarters years (range, two to twelve years). The average preoperative elbow score was 23 points and the average postoperative score was 84 points. Postoperatively, the average flexion was 115 degrees; extension, 35 degrees; and pronation and supination, 95 degrees. There were fifteen excellent or good results. There was one failure due to a deep infection, but after removal of the prosthesis a satisfactory fascial arthroplasty was achieved in this elbow. Function was improved in all patients, and all patients had relief of the preoperative pain. For the arthroplasty to succeed, the patient must have a good understanding of the procedure and must be willing and able to comply with the postoperative rehabilitation program. The use of a semiconstrained, often custom fit, implant is necessary. The Bryan-Morrey posteromedial approach to the elbow is recommended for the procedure, since this approach allows early institution of range-of-motion exercises. PMID- 2703512 TI - Reconstruction of malunited fractures of the lateral malleolus. AB - The cases of twenty-six patients who had a reconstructive surgical procedure for treatment of a malunion of a displaced fracture of the fibula were evaluated. In these patients, who had pain, swelling of the ankle, and stiffness at an average of six years after the injury, the malunions were classified radiographically as either occult (eighteen patients) or overt (eight patients). An occult malunion was one in which the talus remained in its normal position, but the lateral malleolus showed residual displacement, characterized by external rotation and shortening. In an overt malunion, there were similar changes in the lateral malleolus, but the talus was displaced. All of the patients were treated by osteotomy of the lateral malleolus to correct the external rotation and shortening, to reduce the lateral subluxation of the anterior aspect of the tibiofibular joint, and to restore the stability of the talus. At an average follow-up of seven years (range, six months to eleven years), twenty of the twenty-six patients were able to resume the preinjury level of activity; three had improvement in the ability to walk and in the level of functional activity, although they still had intermittent pain; and three had not benefited from the procedure. PMID- 2703513 TI - Randomized trials in orthopaedics: why, how, and when? AB - There is increasing recognition that major new medical therapies should be rigorously evaluated before they are put into general clinical use. Randomized controlled trials provide the most unbiased assessment of the risks and benefits of such therapies. In this article, the most important aspects of the design and execution of a randomized clinical trial in orthopaedics are discussed. These include the reasons for and mechanisms of randomization, appropriate selection of patients and therapy, reasons for the blinding of therapy, types of measures of outcome that can be used, aspects of sample-size calculation and analysis of data, and ethics of randomized controlled trials. PMID- 2703514 TI - The validity of survivorship analysis in total joint arthroplasty. AB - The use of survivorship analysis requires an assumption that patients who are lost to follow-up are no more or less likely to be at risk of failure of an operation or a procedure than are patients who are still being followed. This is a major assumption in long-term orthopaedic studies, in which a high percentage of patients are usually lost to follow-up. We compared the survivorship curve for the first 100 Tharies replacements done at our institution (which were completed by September 1977), using data that were collected in the standard way up to 1985, through a letter requesting a follow-up visit, with the curve for the same patients that was based on almost complete follow-up data that were gathered by telephone from 1985 on. The similarity of the two curves suggested that the assumptions that are necessary for the validity of survivorship analysis are reasonable, even in the orthopaedic setting, in which many patients are lost to follow-up. The usefulness of the survivorship curve for prediction was also evaluated by comparing the curve based on the first forty-six of the 100 Tharies replacements (before 1977) with the curve based on the last fifty-four such operations (from January 1977 to September 1977). The results of these two comparisons suggest that survivorship analysis is a valid technique to use in the long-term evaluation of patients who have had a joint replacement. PMID- 2703515 TI - Management of neuromuscular spinal deformities with Luque segmental instrumentation. AB - Forty-six patients who had a neuromuscular spinal deformity were treated with arthrodesis and Luque segmental spinal instrumentation and were followed for an average of three years. Twenty-two patients had cerebral palsy and twenty-four had another neuromuscular disease. In thirty-nine patients, the arthrodesis was extended to the sacrum. Eleven patients who had severe scoliosis as well as pelvic obliquity and decompensation of the torso had a combined anterior and posterior arthrodesis; the other thirty-five patients had a one-stage posterior procedure. Preoperatively, the average scoliosis was 74 degrees; this was corrected to 39 degrees at follow-up. Final corrections were similar for scoliosis and were better for pelvic obliquity and decompensation of the torso in patients who had combined anterior and posterior arthrodesis. The results for scoliosis and pelvic obliquity in patients who had a spastic deformity were similar to the results in patients who had a flaccid deformity. Correction of decompensation of the torso was better in patients who had a spastic deformity. Postoperatively, a brace was used in half of the patients in each group; this did not appear to affect the amount of correction in either group, although the result may have been influenced by the selection process. The rate of complications was 48 per cent. Pseudarthrosis occurred in three patients (6.5 per cent). There were no major neurological deficits related to the correction or to the use of sublaminar wires. Three patients died, one in the immediate postoperative period and the other two at eighteen months and four years after the original procedure, due to causes unrelated to the operation. PMID- 2703516 TI - Use of the anterior branch of the medial antebrachial cutaneous nerve as a graft for the repair of defects of the digital nerve. AB - Using the anterior branch of the medial antebrachial cutaneous nerve, grafting was performed on twenty-one digital nerves. The goal of the procedure was to repair a traumatic defect of greater than one centimeter in the digital nerves of fourteen patients. The patients were followed for twenty-four to eighty-nine months (average, fifty-seven months). All but one nerve graft restored the ability to distinguish between sharp and dull stimuli, and all but three restored two-point discrimination of between five and fifteen millimeters (average, nine millimeters). No painful neuromas developed at the donor site. PMID- 2703517 TI - Gait analysis of patients who have Paget disease. AB - Eighteen patients who had Paget disease were evaluated in our gait-analysis laboratory. The results were compared with those of ten healthy age-matched control subjects in order to quantitate the biomechanical changes and to describe the specific patterns of walking that occur secondary to bowing of a lower extremity. Kinetic and kinematic data were acquired using infrared video cameras and force platforms; electromyographic data were obtained using surface electrodes. Velocity and cadence were decreased and stride time and double-limb support time were increased in the patients who had Paget disease compared with the control subjects. Frequently, the knee of the limb that was affected by Paget disease was flexed during stance and flexed less during swing. When the involved knee was in varus angulation it also had an increased adduction moment, which may be related to the bowing deformity. Although the patterns of ground-reaction force were similar in the patients and the control subjects, the magnitudes of forces were reduced in the patients. Phasic muscle activity was similar in the two groups. PMID- 2703518 TI - Spinal arthrodesis for severe spondylolisthesis in children and adolescents. A long-term follow-up study. AB - The long-term results of spinal arthrodesis were evaluated in fourteen children and adolescents who had severe spondylolisthesis. Twelve patients had an in situ posterior arthrodesis and the other two had, in addition, open reduction. The two patients who had open reduction lost correction when the rods were removed. At long-term follow-up, which averaged 11.9 years, all patients had a solid fusion and their activities were unrestricted. Two patients were dissatisfied with the cosmetic result. No intraoperative or postoperative complications occurred in association with the in situ arthrodeses that were performed alone. Posterior in situ arthrodesis proved to be an effective, reliable, and safe treatment for severe spondylolisthesis. PMID- 2703519 TI - Long-term follow-up after fractures of the tibial and fibular shafts. AB - Thirty-seven patients who sustained a closed or a Grade-I open tibial and fibular fracture were evaluated an average of twenty-nine years after injury. All of the patients had had uncomplicated treatment with a plaster cast. Clinically, 78 per cent of the ankles were rated good or excellent, and 92 per cent of the knees were rated excellent. Radiographic assessment for osteoarthritic changes revealed a good or excellent result for 76 per cent of the ankles and an excellent result for 92 per cent of the knees. The clinical and radiographic outcomes were unaffected by the amounts of anterior or posterior and of varus or valgus angulation, as well as by the level of the fracture. The length of immobilization, which did not exceed one year, also did not affect the outcomes. PMID- 2703520 TI - Countercurrent centrifugal elutriation. High-resolution method for the separation of growth-plate chondrocytes. AB - Countercurrent centrifugal elutriation was used to separate, on the basis of size, isolated growth-plate chondrocytes in chicks. The mean cellular volume, activity of alkaline phosphatase, and synthesis of type-X collagen increased progressively in each of seven successive fractions. Slices of tissues that contained either proliferating or hypertrophic chondrocytes were also removed by manual dissection from the superficial and deep regions of the growth plate. These cells demonstrated differences in size and biochemistry that were similar to those observed in chondrocytes that were separated by elutriation. These differences included increased synthesis of proteoglycan and collagen in the larger chondrocytes. Radiolabeled hypertrophic chondrocytes were mixed with unlabeled resting and proliferating chondrocytes, and then were separated by elutriation. The radioactivity was recovered in fractions that contained the largest cells, confirming that differences in the sizes of the cells can be used to effect a zonal separation by centrifugal elutriation. PMID- 2703521 TI - Soft-tissue tumors and tumor-like lesions of the foot. An analysis of eighty three cases. AB - The cases of eighty-three patients who had a soft-tissue tumor or tumor-like lesion in the foot or ankle were retrospectively analyzed to determine the relative frequency of the lesions and which factors, if any, could be used to identify them preoperatively. Seventy-two (87 per cent) of the lesions were benign, with ganglion cysts and plantar fibromatoses being the most common, and eleven (13 per cent) were malignant tumors, five (45 per cent) of which were synovial sarcomas. The age of the patient and the location of the lesion were the two most important factors that characterized the malignant tumors. For eight patients (12 per cent), radiographs were helpful in identifying the nature of the lesion. The sex of the patient, a history of trauma, the duration of the symptoms, the size of the lesion, and the presence of pain or of neurological symptoms were not useful in discriminating a benign lesion from a malignant tumor. PMID- 2703522 TI - False-negative lumbar discograms. Correlation of discographic and histological findings in postmortem and surgical specimens. PMID- 2703523 TI - Osteochondritis dissecans of the dome of the talus. Computed tomography scanning in the diagnosis and follow-up. PMID- 2703524 TI - Current concepts review. Operative treatment of congenital idiopathic club foot. PMID- 2703525 TI - Lack of suppression by gangliosides of humoral or cellular immunity in vivo. AB - Gangliosides inhibit the proliferative responses of murine and human lymphocytes in vitro, and it has been suggested that they are immunosuppressive in vivo, although no in vivo studies have been performed. In view of the use of gangliosides to treat patients with a variety of neurological disorders, experiments were undertaken to evaluate the possible immunomodulatory effects of gangliosides in vivo. BALB/c mice were injected 5 days a week with buffer, mixed brain gangliosides, or GM1 ganglioside at dosage levels of 30 mg/kg, 60 mg/kg or 90 mg/kg. After 30 days of treatment, the mice were immunized with keyhole limpet hemocyanin or pneumococcal type III polysaccharide and the ganglioside treatment was continued. No differences between treated and control groups were noted in either the magnitude or duration of the antibody response. No differences between groups were noted in the proliferative responses of splenic mononuclear cells to concanavalin A or allogeneic antigens after 9-10 weeks of treatment, nor in the generation of cytotoxic effector cells after 90 days of treatment. Thus, despite the well-documented immunosuppressive effects of gangliosides in vitro, no evidence for a suppressive effect on humoral or cellular immunity in vivo was obtained in these studies. PMID- 2703526 TI - Effect of tumor necrosis factor (TNF) on lipid metabolism in the diabetic rat. Evidence that inhibition of adipose tissue lipoprotein lipase activity is not required for TNF-induced hyperlipidemia. AB - Tumor necrosis factor (TNF) administration produces an increase in plasma triglycerides that may be due to inhibition of adipose lipoprotein lipase activity and/or a stimulation of hepatic lipogenesis. We now report that TNF administration to insulinopenic diabetic rats increases serum triglycerides (2 h, 2.4-fold; 17 h, 4.3-fold). Adipose tissue lipoprotein lipase activity was markedly decreased in diabetic animals compared with controls and was not further inhibited by TNF. Incorporation of tritiated water into fatty acids in the liver was increased 45% 1-2 h after TNF and 87% at 16-17 h. These results indicate that the TNF-induced increase in circulating lipid levels can occur in the absence of a TNF-induced inhibition of adipose tissue lipoprotein lipase activity. Moreover, the clearance from the circulation of triglycerides in chylomicrons was similar in control and TNF-treated animals; these results provide further evidence that the removal of triglyceride-rich lipoproteins is not altered in the TNF-treated animals. Our data suggest that the TNF-induced stimulation of hepatic lipid synthesis may play an important role in the increase in serum triglycerides. In addition, TNF administration to diabetic animals leads to an elevation in serum glucose levels (73% at 17 h) without a change in serum insulin levels. Thus, TNF stimulation of hepatic lipogenesis is independent of changes in insulin. PMID- 2703527 TI - Disruption of the subendothelial basement membrane during neutrophil diapedesis in an in vitro construct of a blood vessel wall. AB - To examine the course of physiologic interactions between extravasating neutrophils and the subendothelial basement membrane, a model of the venular vessel wall was constructed by culturing human umbilical vein endothelial cells on a collagen matrix. After 21 d in culture, the endothelial cell monolayer displayed in vivo-like intercellular borders and junctions, deposited a single layered, continuous basement membrane that was impenetrable to colloidal particles, and supported neutrophil extravasation in a physiologic manner. Using this model, we demonstrate that neutrophil transmigration in a plasma milieu was associated with a significant disruption of the retentive properties of the basement membrane in the absence of discernable morphologic changes. The loss of basement membrane integrity associated with neutrophil diapedesis was not dependent on neutrophil elastase or cathepsin G and was resistant to inhibitors directed against neutrophil collagenase, gelatinase, and heparanase. Despite the fact that this loss in matrix integrity could not be prevented, basement membrane defects were only transiently expressed before they were repaired by the overlying endothelium via a mechanism that required active protein and RNA synthesis. These data indicate that neutrophil extravasation and reversible basement membrane disruption are coordinated events that occur as a consequence of vessel wall transmigration. PMID- 2703528 TI - Lymphocyte proliferative responses to human immunodeficiency virus antigens in vitro. AB - All HIV seronegative (HIV Ab-) and most HIV seropositive (HIV Ab+) individuals' lymphocytes failed to proliferate in primary cultures in response to purified HIV or to recombinant envelope and core antigens of HIV, even in the presence of recombinant interleukin 2 (rIL-2). Most HIV Ab- and HIV Ab+ individuals' lymphocytes, however, could proliferate or be induced by rIL-2 to proliferate in response to lysates of Escherichia coli or Saccharomyces cerevisiae. These findings indicate selective defects in lymphocyte proliferative responses to HIV antigens before the development of AIDS in which lymphocytes are unable to proliferate in response to any antigens. These defects in cell-mediated immune responses to HIV antigens are likely to play an important role in the pathobiology of HIV infections. Although intact HIV or glycosylated gp120 envelope protein of HIV are involved in these defects, a non-glycosylated recombinant form of the HIV gp120 envelope (ENV2-3) and p25 core proteins did not inhibit antigen- or mitogen-driven lymphocyte proliferation. PMID- 2703529 TI - Downregulation of the male-specific hepatic microsomal steroid 16 alpha hydroxylase, cytochrome P-450UT-A, in rats with portal bypass. Relevance to estradiol accumulation and impaired drug metabolism in hepatic cirrhosis. AB - Elevated serum estradiol concentrations and specific changes in the biliary excretion of some androstenedione metabolites have been reported in male rats with portal bypass produced by portal vein ligation (PVL). In this study, the hypothesis that male-specific forms of cytochrome P-450 are altered after PVL was tested by measuring microsomal steroid hydroxylase activities. Consistent with earlier findings in the intact animal, androstenedione 16 alpha-hydroxylase activity was reduced after PVL to 44% of control (P less than 0.05). Other pathways of androstenedione hydroxylation, and total estrogen formation (after androstenedione aromatization) were unchanged. Although total estrogen formation was not different, a sevenfold greater proportion of estradiol was produced in PVL rat microsomes. Additional experiments revealed that PVL selectively reduced the rate of microsomal estradiol 16 alpha-hydroxylation (to 56% of control, P less than 0.02). Levels of cytochrome P-450UT-A, the microsomal steroid 16 alpha hydroxylase, were lower after PVL (56% of control, P less than 0.05), so that the present observations are consistent with the earlier suggestion that portal bypass is associated with the selective downregulation of this enzyme. Since downregulation of cytochrome P-450UT-A also occurs in experimental hepatic cirrhosis, portal hypertension may well contribute significantly to altered drug metabolism in liver disease. Impaired hepatic elimination of androstenedione by hydroxylation may indirectly enhance extrahepatic aromatization of the androgen. The decreased activity of hepatic estradiol 16 alpha-hydroxylation after PVL would enhance the accumulation of estradiol, the biologically more potent estrogen. PMID- 2703530 TI - Neuropeptide-Y. A peptide found in human coronary arteries constricts primarily small coronary arteries to produce myocardial ischemia in dogs. AB - Neuropeptide-Y (NPY), a brain peptide, is located in the walls of human coronary arteries. This study assessed the effects of NPY on the coronary circulation in 40 chloralose-anesthetized, open-chest dogs. Intracoronary NPY (42 nmol over 5.2 min) caused a 39% reduction in coronary blood flow without changing heart rate or aortic pressure. To determine whether this vasoconstriction could produce ischemia, intramyocardial pH was measured in seven dogs (group I) and decreased from 7.45 +/- 0.06 to 7.37 +/- 0.06 pH units after NPY in the subendocardium (P less than 0.0002), and from 7.45 +/- 0.06 to 7.40 +/- 0.05 pH units (P less than 0.04) in the subepicardium of the infused zone. Left ventricular ejection fraction (LVEF), measured by radionuclide angiography, decreased from 0.52 +/- 0.08 to 0.42 +/- 0.12 U (n = 5, P less than 0.01) during NPY. NPY-induced vasoconstriction was also associated with ST-T wave changes on the electrocardiogram (ECG) in eight of nine other animals (group V). In another group of six dogs (group IV), the change in small vessel resistance accounted for 94% of the increase in total resistance, so that the primary vasoconstrictor effect of NPY was exerted on small coronary arteries. Thus, NPY, a peptide found in human coronary arteries, caused constriction of primarily small coronary arteries that was severe enough to produce myocardial ischemia as determined by ECG ST-T wave changes, and decreases in intramyocardial pH and LVEF in dogs. PMID- 2703531 TI - Rat lung Cu,Zn superoxide dismutase. Isolation and sequence of a full-length cDNA and studies of enzyme induction. AB - The synthesis of Cu,Zn SOD by rat lung increases spontaneously in the fetus in late gestation and during exposure of neonatal and adult rats to greater than 95% O2. To explore the regulation of these increases, we measured rat lung Cu,Zn SOD synthesis and activity. We also cloned and sequenced a rat lung Cu,Zn SOD cDNA that was used to measure Cu,Zn SOD mRNA concentration. We found that (a) under normal gestational and postgestational conditions the synthesis of this enzyme was regulated pretranslationally; (b) the increased synthesis that occurs under hyperoxia (greater than 95% O2), was pretranslationally mediated in otherwise unmanipulated neonatal rats but translationally controlled in hyperoxic adult rats; and (c) in lungs of rats made tolerant to greater than 95% O2 by allowing 24 h rest in air after an initial 48 h in greater than 95% O2, the increased Cu,Zn SOD synthesis that occurred during the second period of hyperoxia was regulated pretranslationally. We conclude Cu,Zn SOD gene expression in the lung is developmentally regulated under normal conditions and in response to an oxidant challenge. Tolerance, whether endogenous or induced, appears to require the accumulation of increased amounts of Cu,Zn SOD mRNA. PMID- 2703532 TI - Effects of chronic ethanol feeding on rat hepatocytic glutathione. Relationship of cytosolic glutathione to efflux and mitochondrial sequestration. AB - Chronic ethanol feeding to rats increases the sinusoidal component of hepatic glutathione (GSH) efflux, despite a lower steady-state GSH pool size. In the present studies, no increase of biliary GSH efflux in vivo was found in chronic ethanol-fed cells. Studies were performed on ethanol-fed and pair-fed cells to identify the kinetic parameters of cellular GSH concentration-dependent efflux. The relationship between cytosolic GSH and the rate of efflux was modeled by the Hill equation, revealing a similar Vmax, 0.22 +/- 0.013 vs. 0.20 +/- 0.014 nmol/min per 10(6) cells for ethanol-fed and pair-fed cells, respectively, whereas the Km was significantly decreased (25.3 +/- 2.3 vs. 33.5 +/- 1.4 nmol/10(6) cells) in ethanol-fed cells. The difference in Km was larger when the data were corrected for the increased water content in ethanol-fed cells. We found a direct correlation between mitochondria and cytosolic GSH, revealing that mitochondria from ethanol-fed cells have less GSH at all cytosolic GSH values. The rate of resynthesis in depleted ethanol-fed cells in the presence of methionine and serine was similar to control cells and gamma-glutamylcysteine synthetase remained unaffected by chronic ethanol. However, the reaccumulation of mitochondrial GSH as the cytosolic pool increased was impaired in the ethanol cells. The earliest time change in GSH regulation was a 50% decrease in the mitochondrial GSH at 2 wk. PMID- 2703533 TI - Changes in the metabolic clearance of vasopressin and in plasma vasopressinase throughout human pregnancy. AB - Metabolic clearance rates (MCR) of arginine vasopressin (AVP) were measured serially in five women starting before conception, during gestational weeks 7-8 (early), 22-24 (middle), and 36-38 (late pregnancy), and again 10-12 wk postpartum. Hormonal disposal rates were determined after water loading to suppress endogenous AVP release using a constant infusion method designed to achieve three different steady-state concentrations of plasma AVP (PAVP) on each test occasion. Dose schedules were altered in mid- and late pregnancy to obtain comparable AVP levels at each stage of the protocol. Prehydration decreased plasma osmolality sufficiently to suppress AVP release, as circulating AVP neurophysin measured serially in three of the women was undetectable. The MCR of AVP was similar before conception (0.75 +/- 0.31, 0.79 +/- 0.34, and 0.76 +/- 0.28 liters/min at PAVP of 2.6 +/- 1.9, 4.7 +/- 2.4, and 8.3 +/- 3.9 pg/ml), in early pregnancy (0.89 +/- 0.34, 0.97 +/- 0.04, and 0.95 +/- 0.40 liters/min at PAVP of 2.2 +/- 2.1, 3.9 +/- 3.2, and 7.9 +/- 3.4 pg/ml), and postpartum (0.70 +/ 0.21, 0.69 +/- 0.24, and 0.75 +/- 0.20 liters/min at PAVP 3.5 +/- 1.8, 5.1 +/- 3.7, and 9.1 +/- 4.2 pg/ml). Values at mid-pregnancy (2.8 +/- 1.3, 3.0 +/- 1.2, and 2.7 +/- 1.2 liters/min at PAVP 2.3 +/- 2.2, 4.0 +/- 3.6, and 7.7 +/- 3.9 pg/ml) and late pregnancy (3.2 +/- 1.4, 3.3 +/- 1.4, and 2.9 +/- 1.2 liters/min at PAVP 1.9 +/- 2.0, 3.8 +/- 2.6, and 7.4 +/- 4.1 pg/ml) increased 3-4-fold (all P less than 0.01). Plasma vasopressinase, undetectable at 7-8 gestational wk, increased markedly by mid- and slightly more by late gestation. Finally, relationships between PAVP and urine osmolality were similar before, during, and after pregnancy. We conclude that marked increments in the MCR of AVP occur between gestational weeks 7 and 8 and mid-pregnancy, which parallel the period of greatest rise in both trophoblastic mass and plasma vasopressinase. There was no evidence of a renal resistance to AVP during gestation. PMID- 2703534 TI - Hepatic adenosine triphosphate-dependent Ca2+ transport is mediated by distinct carriers on rat basolateral and canalicular membranes. AB - To characterize and localize hepatic plasma membrane ATP-dependent Ca2+ transport and Na+/Ca2+ exchange, studies were performed using highly purified rat basolateral and canalicular membrane vesicles. ATP-dependent Ca2+ transport activity was present in vesicles from both domains, insensitive to azide, oligomycin, oxalate, calmodulin, and calmidazolium, and virtually abolished at pH 6.8. However, basolateral and canalicular transport differed significantly. While basolateral transport was markedly stimulated by 1 mM Mg2+, canalicular transport was Mg2+ independent. Basolateral transport was similar at pH 7.4 and 8.0 but canalicular activity was stimulated fourfold at pH 8.0. Both Ca2+ Km [1.4 +/- 0.1 (SE).10(-8) vs. 4.8 +/- 0.7.10(-8) M] and Vmax (3.6 +/- 0.1 vs. 9.0 +/- 0.6 nmol mg-1 protein min-1) were lower in basolateral than in canalicular vesicles. Basolateral transport was somewhat more nucleotide specific (for ATP) and sensitive to vanadate (IC50 130 vs. 500 microM, respectively) than was canalicular transport. Na+/Ca2+ exchange activity was not detected in membranes from either domain. These studies suggest that hepatic ATP-dependent Ca2+ transport is mediated by domain-specific carriers on the basolateral and canalicular membranes. PMID- 2703535 TI - Parathyroid hormone suppression by intravenous 1,25-dihydroxyvitamin D. A role for increased sensitivity to calcium. AB - Numerous in vitro studies in experimental animals have demonstrated a direct suppressive effect of 1,25-dihydroxyvitamin D (1,25(OH)2D) on parathyroid hormone (PTH) synthesis. We therefore sought to determine whether such an effect could be demonstrated in uremic patients undergoing maneuvers designed to avoid changes in serum calcium concentrations. In addition, the response of the parathyroid gland in patients undergoing hypercalcemic suppression (protocol I) and hypocalcemic stimulation (protocol II) before and after 2 wk of intravenous 1,25(OH)2D was evaluated. In those enlisted in protocol I, PTH values fell from 375 +/- 66 to 294 +/- 50 pg (P less than 0.01) after 1,25(OH)2D administration. During hypercalcemic suppression, the "set point" (PTH max + PTH min/2) for PTH suppression by calcium fell from 5.24 +/- 0.14 to 5.06 +/- 0.15 mg/dl (P less than 0.05) with 1,25(OH)2D. A similar decline in PTH levels after giving intravenous 1,25(OH)2D was noted in protocol II patients. During hypocalcemic stimulation, the parathyroid response was attenuated by 1,25(OH)2D. We conclude that intravenous 1,25(OH)2D directly suppresses PTH secretion in uremic patients. This suppression, in part, appears to be due to increased sensitivity of the gland to ambient calcium levels. PMID- 2703536 TI - Lipolytic surface remnants of triglyceride-rich lipoproteins are cytotoxic to macrophages but not in the presence of high density lipoprotein. A possible mechanism of atherogenesis? AB - Hypertriglyceridemic (HTG) serum, lipolyzed in vitro by purified bovine milk lipoprotein lipase, was found to be cytotoxic to cultured macrophages. Surviving macrophages contained numerous lipid inclusions similar to those found in foam cells. Individual lipoprotein fractions isolated from the lipolyzed HTG serum, including HDL, were also cytotoxic. Lipolysis of isolated lipoprotein fractions (either HTG or normal) allowed localization of cytotoxicity to postlipolysis remnant VLDL and chylomicron particles. The presence of a critical concentration of HDL in either the lipolysis mixture or the culture dishes inhibited the cytotoxicity. Below this critical concentration HDL itself became cytotoxic, producing lipid inclusions in surviving macrophages. The lipid fraction of the cytotoxic remnants contained the cytotoxic factor(s); neither FFA nor lysolecithin alone could account for this cytotoxicity. Postprandial lipemic sera from subjects with a brisk chylomicron response, when lipolyzed in vitro, were cytotoxic to cultured macrophages; neither fasted sera from these subjects, nor postprandial sera from normolipidemic subjects with a normal chylomicron response, were cytotoxic. Postheparin (in vivo lipolyzed) serum and its isolated lipoprotein fractions obtained 30 min after heparin injection in subjects with HTG were shown to be cytotoxic to macrophages; by 60 min most of the cytotoxicity had disappeared. The postprandial and postheparin observations support an in vivo significance for remnant-associated cytotoxicity. We hypothesize that cytotoxic remnants of lipolyzed VLDL and chylomicrons may be one of the major atherogenic lipoproteins. Further, we suggest that inhibition of the cytotoxicity of these remnants may be one important way that HDL prevents atherosclerosis. PMID- 2703537 TI - Growth factor expression in aorta of normotensive and hypertensive rats. AB - Hypertension causes biochemical and morphological changes in the vessel wall by unknown mechanisms. Locally produced substances may have a role in mediating these vascular changes. We have studied the expression of platelet-derived growth factor (PDGF) B chain and PDGF A chain, insulin-like growth factor (IGF)-I and IGF-II, endothelial cell growth factor (ECGF), basic fibroblast growth factor (bFGF), and transforming growth factor-beta (TGF-beta) in aortic tissue from normotensive rats and rats made hypertensive by deoxycorticosterone (DOC)/salt treatment. Using Northern blotting, we found that genes for each of these growth factors were transcriptionally active in the aorta of both normotensive and hypertensive rats. TGF-beta aortic mRNA levels increased up to threefold as a result of DOC/salt hypertension. In contrast, no major changes in the expression of either PDGF chain, IGF-I or II, ECGF, or bFGF were detectable. The results indicate that at least seven genes coding for growth factors that were shown previously to influence growth and function of vascular cells in vitro, are expressed in rat aorta in vivo. These findings support the hypothesis that synthesis and release of growth factors in the arterial wall are involved in autocrine and/or paracrine regulatory mechanisms. In addition, the increased expression of TGF-beta in vivo may have a role in mediating the aortic changes induced by hypertension. PMID- 2703538 TI - Evidence for both a regulatory mutation and a structural mutation in a family with maple syrup urine disease. AB - Maple syrup urine disease (MSUD) results from a deficiency of branched chain alpha-ketoacid dehydrogenase (BCKDH). We have studied the etiology of MSUD by determining the enzyme activity, protein, and mRNA levels of BCKDH in fibroblasts from a classic MSUD patient and his parents. By enzymatic amplification of the patient's mRNA followed by cloning and DNA sequencing, we have identified a T to A transversion that alters a tyrosine to an asparagine at residue 394 of the E1 alpha subunit. Amplification of both mRNA and genomic DNA, in combination with allele-specific oligonucleotide hybridization, demonstrated that the father was heterozygous for this mutant allele. The mother was homozygous for the allele encoding the normal Tyr394, but expressed only about half of the normal level of mRNA and protein. The patient was genetically heterozygous for this altered allele, although only the abnormal allele was expressed as mRNA. We conclude that the patient was a compound heterozygote, inheriting an allele encoding an abnormal E1 alpha from the father, and an allele from the mother containing a cis acting defect in regulation which abolished the expression of one of the E1 alpha alleles. Our results revealed for the first time that a case of MSUD was caused by structural and regulatory mutations involving the E1 alpha subunit. PMID- 2703539 TI - Bulky extramedullary plasmacytomata: rare mode of relapse in myelomatosis. AB - In two cases of myelomatosis relapse was accompanied by the development of bulky extramedullary plasma cell tumours, which created serious management problems. In both cases the histology was of a poorly differentiated plasmacytoid tumour with frequent mitoses. In one case paraprotein had completely disappeared from the serum and urine after six months' treatment with melphalan alone but did not correlate with improved survival. It is concluded that extramedullary spread of myelomatosis in the form of bulky tumour deposits is a rare and ominous mode of tumour progression or relapse. Rises in serum and urinary paraprotein concentrations are not the inevitable signs of relapse. PMID- 2703540 TI - Clinical importance of squamous metaplasia in invasive transitional cell carcinoma of the bladder. AB - One hundred cases of transitional cell carcinoma of the bladder were studied to determine whether squamous metaplasia and other histological features within the bladder can be of value in predicting outcome of treatment with radiotherapy. Sixty cases showed the changes of squamous metaplasia, and of this group 46 (78%) failed to respond to radiotherapy. A significant response rate of 90% was seen in the 40 tumours without squamous metaplasia. It is concluded that transitional cell carcinomas of the bladder showing squamous metaplasia are mainly resistant to radiotherapy and alternative treatment methods should be sought. PMID- 2703541 TI - Clinical importance of DNA content in rectal cancer measured by flow cytometry. AB - The DNA content of 369 rectal cancers was measured by flow cytometry. One hundred and four (28%) were diploid, 252 (68%) 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 present at an early stage. DNA content, however, 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 III 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 addition of ploidy, routine adoption of flow cytometry in the assessment of rectal cancer cannot be recommended. PMID- 2703542 TI - Reproducibility of flow cytometric assessment of follicular tumours of the thyroid. AB - The reproducibility of the DNA index of paraffin wax sections from 44 follicular tumours of the thyroid (18 follicular adenomas and 26 follicular carcinomas), which had been assessed by flow cytometry was analysed in two laboratories, using consecutive sections of the same specimens and two different commercially available flow cytometers. Two slightly different cell preparation and staining techniques were used in the two laboratories. Using strictly defined criteria the histograms were classified blind as diploid, peritetraploid, aneuploid, or inadequate and insufficient by two independent investigators. Both the concordance between the two different flow cytometers and the agreement of duplicate assessments within the same flow cytometers were assessed. The mean coefficient of variation of the G0/G1 peak of the diploid tumours in the PARTEC flow cytometer was 5.5 (range 2.3-9.8) and in the FACS flow cytometer 5.2 (range 3.7-8.3); this difference was not significant. There was concordance of classification between the two laboratories in 35 of 36 cases. In 25 cases (18 diploid, seven aneuploid) the intralaboratory variation showed a 100% concordance in histogram classification. It is concluded that flow cytometer DNA index assessment of follicular tumours of the thyroid is reproducible and can be used to evaluate the discriminating and prognostic value of this feature. PMID- 2703544 TI - Jejunal enteropathy associated with human immunodeficiency virus infection: quantitative histology. AB - Jejunal biopsy specimens from 20 human immunodeficiency virus (HIV) positive male homosexual patients were analysed and compared with those of a control group to determine whether the abnormalities were caused by the virus or by opportunistic infection. The degree of villous atrophy was estimated with a Weibel eyepiece graticule, and this correlated strongly with the degree of crypt hyperplasia, which was assessed by deriving the mean number of enterocytes in the crypts. The density of villous intraepithelial lymphocytes fell largely within the normal range, either when expressed in relation to the number of villous enterocytes or in relation to the length of muscularis mucosae. Villous enterocytes showed mild non-specific abnormalities. Pathogens were sought in biopsy sections and in faeces. Crypt hyperplastic villous atrophy occurred at all clinical stages of HIV disease and in the absence of detectable enteropathogens. An analogy was drawn between HIV enteropathy and the small bowel changes seen in experimental graft versus-host disease. It is suggested that the pathogenesis of villous atrophy is similar in the two states, the damage to the jejunal mucosa in HIV enteropathy being inflicted by an immune reaction mounted in the lamina propria against cells infected with HIV. PMID- 2703543 TI - Morphometric analysis of suprabasal cells in oral white lesions. AB - Surgical specimens from the cheek mucosa of 73 patients with white lesions were studied to determine various morphometric parameters that would help differentiate between the various types of oral mucosal white lesions that carry a risk of malignant change. Four cell types were represented: traumatic keratosis, leucoplakia, candidal leucoplakia and lichen planus, in addition to a control group of normal mucosa. The shape and size of the epithelial cells in two cell compartments, parabasal and spinous, were investigated by an interactive image analysis system (IBAS-1). The results showed an increase in the cell size in the parabasal cell compartment of all the white lesions compared with the normal mucosa. In the spinous cell compartment there was an increase in the cell size in lichen planus and traumatic keratosis; leucoplakia and candidal leucoplakia showed a slight decrease in cell size compared with the normal mucosa. Attempts to discriminate between the four groups of white lesions showed that these parameters can provide a high level of separation between lichen planus and the three other groups, but not between leucoplakia, candidal leucoplakia, and traumatic keratosis. PMID- 2703545 TI - Patterns of antigenaemia and antibody response in patients infected with human immunodeficiency virus (HIV) according to clinical state. AB - Five hundred and fifty six subjects, known to be homosexuals or intravenous drug abusers and seropositive for HIV antibody, were selected on the basis of their clinical state--symptom free, lymphadenopathy syndrome (LAS), AIDS related complex (ARC), and AIDS. The presence of antigenaemia and the humoral response to viral polypeptides was investigated. The prevalence of patients positive for p31 antibody was significantly increased in those with AIDS and detectable antigenaemia. PMID- 2703546 TI - Correlations between serum proteins modified by acetaldehyde and biochemical variables in heavy drinkers. AB - A strong and highly significant correlation was observed between serum aspartate transaminase (AST) activity and an index of the cytotoxic activity associated with serum proteins modified by acetaldehyde in a group of 24 heavy drinkers. A weaker but significant correlation (R = 0.564, p = 0.008) was found between total serum creatine kinase activity and this index of serum cytotoxicity. As it is likely that the concentration of circulating modified protein was largely determined by the quantity of free acetaldehyde generated in the liver and that the AST activity was mainly derived from damaged hepatocytes, the data indicate a correlation between hepatic acetaldehyde generation and hepatocyte damage. This correlation may indicate either that increased quantities of acetaldehyde are released by damaged hepatocytes or that acetaldehyde is hepatotoxic in vivo. As only the creatine kinase isoenzyme present in skeletal muscle (CK-MM) was demonstrable in the serum in all but one of our patients, the data also suggest that circulating modified serum proteins may be toxic towards skeletal muscle cells. PMID- 2703547 TI - New enzyme immunoassay for detecting total, type I, and type II intrinsic factor antibodies. AB - A method for the detection of total, type I, and type II intrinsic factor antibodies was devised. The technique comprises a two-site solid phase enzyme linked immunosorbent assay (ELISA), with human intrinsic factor conjugated with horseradish peroxidase as label and attached to polystyrene tubes as solid phase. One conjugation provides sufficient material to assay more than 10,000 patient samples. The label proved stable during the course of this evaluation and was still in use more than 12 months after preparation. When applied to 45 serum samples from cases of pernicious anaemia, intrinsic factor antibodies were shown in 30 (67%). Simplicity, high capacity, low cost and label stability, combined with relatively high clinical sensitivity make the method suitable for cost effective screening of large numbers of samples. Simple modifications to the basic assay reagents permitted type I and type II intrinsic factor antibodies to be differentiated. PMID- 2703548 TI - Evaluation of sealed vacuum extraction method (Seditainer) for measurement of erythrocyte sedimentation rate. AB - A sealed vacuum extraction method (Seditainer) for determining the erythrocyte sedimentation rate (ESR) was compared with the standard Westergren ESR technique. The Seditainer method was particularly easy to use, showed acceptable precision, reduced the biohazard risk to laboratory staff and, on storage of sealed blood specimens for 24 hours at 4 degrees C, gave ESR values that had decreased by a mean of only 1.9% (95% CI + 0.2 to -4.0%). Seditainer tubes are shorter (100 mm) than Westergren tubes (200 mm) and this reduced test sensitivity at ESR values above 55 mm/first hour. After application of the manufacturer's correction formula to adjust for tube length there was improved correlation (n = 150, r = 0.936, p less than 0.001), but still considerable scatter, between the Seditainer and Westergren results. Seditainer ESR values above 55 mm/first hour should therefore be regarded as semiquantitative. This vacuum extraction method offers a simple and safe technique for measuring the ESR and specimens can be stored overnight at 4 degrees C. PMID- 2703549 TI - Retroperitoneal myxoid liposarcoma presenting with hypercalcaemia. PMID- 2703550 TI - Peliosis thymomis: association with tuberculosis. PMID- 2703551 TI - Performance indicators. PMID- 2703552 TI - Cholinergic innervation of the monkey amygdala: an immunohistochemical analysis with antisera to choline acetyltransferase. AB - The organization of the cholinergic innervation of the macaque monkey amygdaloid complex was investigated by means of immunohistochemical techniques and either a polyclonal antiserum or a monoclonal antibody directed against the specific synthetic enzyme choline acetyltransferase (ChAT). Adjacent series of sections were processed histochemically for the demonstration of the degradative enzyme acetylcholinesterase (AChE) or for cell bodies with thionin. The density of ChAT immunoreactivity differed substantially among the various nuclei and cortical regions of the amygdala. In general, the distribution of ChAT immunoreactivity paralleled the pattern of AChE staining. One notable exception was the presence of AChE containing cell bodies in addition to AChE positive fibers within nearly all of the nuclear and cortical regions. In contrast, ChAT immunoreactivity was associated only with fibers and terminals. The highest density of ChAT immunoreactive fibers and terminals was consistently observed in the magnocellular subdivision of the basal nucleus. Staining was substantially less dense in the more ventrally situated parvicellular subdivision. Medially, in the adjacent accessory basal nucleus, immunoreactive fibers and terminals were densest in the magnocellular and superficial subdivisions and least prominent in the parvicellular subdivision. Of the deep nuclei, the lateral nucleus generally obtained the least ChAT immunoreactive terminals and processes. Only its more densely cellular ventrolateral portion contained appreciable fiber and terminal staining. One of the more distinctive patterns of ChAT immunoreactivity was seen in the nucleus of the lateral olfactory tract. Here, ChAT positive fibers formed pericellular basket plexuses around unstained cell bodies. This unique pattern of staining was used to delineate the boundaries of the nucleus and indicated that it is present for much of the rostrocaudal extent of the amygdala. Another region of conspicuous staining on the medial surface of the amygdala was the sulcal portion of the periamygdaloid cortex. This region, associated with the sulcus semiannularis and bordering the entorhinal cortex, consistently contained dense immunoreactivity. The central nucleus also presented a somewhat idiosyncratic pattern of ChAT staining. The lateral subdivision had a diffuse distribution of immunoreactivity in which focal patches of more densely stained terminals and occasional fine fibers were embedded. In contrast, the medial subdivision contained a larger number of thicker, stained fibers without diffuse background labeling.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2703553 TI - Distribution of dopamine immunoreactivity in the brain of the mormyrid teleost Gnathonemus petersii. AB - The distribution of dopamine-containing cell bodies and fibers was studied with aid of specific antibodies against dopamine in the highly developed brain of the weakly electric fish Gnathonemus petersii. In the telencephalon, dopamine containing cell bodies were observed in a small area, i.e., area ventralis pars dorsalis and supracommissuralis. In the diencephalon, moderate numbers of dispersed dopamine-immunoreactive cells were present in the preoptic region, while large numbers of dopamine-containing neurons occurred in the hypothalamic paraventricular organ and neighbouring regions. The paraventricular organ, located around small (anterior, intermediate, and posterior) recesses contained many dopamine-immunoreactive cerebrospinal fluid-(CSF)-contacting neurons. Dopamine-containing cells were also observed in a magnocellular hypothalamic cell group, in the nucleus of the lateral recess, and in the nucleus posterior tuberis. In the mesencephalon only a few dopamine-containing cells were observed in a dorsal tegmental (possibly pretectal) area, whereas in ventral mesencephalic regions dopamine-containing cells were lacking. More caudally, dopamine containing cells were observed in the presumed locus coeruleus, in the caudal region of the reticular formation, and in the presumed area postrema. Dopamine immunoreactive fiber density was very high in the medioventral hypothalamus and in the preoptic region, where a dense subependymal plexus was observed along the preoptic recess. Such a plexus was also present in the caudal rhombencephalon, where it probably arises from the area postrema. Moderate numbers of dopamine immunoreactive fibers were present in medioventral parts of the brain along its total rostrocaudal extent as well as in several subnuclei of the torus semicircularis, in the tectum mesencephali, and in the medial part of the dorsal telencephalic area. Other parts of the dorsal telencephalic area, as well as the large cerebellum and the electrosensory lateral line lobe of Gnathonemus, did not contain detectable amounts of dopamine. In spite of the high differentiation of the brain of Gnathonemus, the distribution of catecholamines as visualized with dopamine immunohistochemistry appears to be basically similar to that described in other teleostean and actinopterygian fishes on the basis of formaldehyde induced fluorescence or tyrosine hydroxylase immunohistochemistry.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2703554 TI - Cholinergic somata and terminals in the rat substantia nigra: an immunocytochemical study with optical and electron microscopic techniques. AB - The topographical distribution, histochemical characteristics, and anatomical relationships of the cellular elements containing choline acetyltransferase (ChAT) immunoreactivity, demonstrated with specific monoclonal antibodies to ChAT following the unlabelled antibody peroxidase-antiperoxidase (PAP) procedure at the optical and electron microscopic levels, were investigated in the rat substantia nigra (SN). Scarce, large (20-30 microns in maximum soma extent) cholinergic cell bodies and processes were found within the boundaries of the SN, in the borders of the pars compacta and pars reticulata, principally at caudal levels. Occasionally, cholinergic neurons were also found at intermediate levels of the SN, in the borders of the pars reticulata and pars lateralis. Cytologically, these large cells resembled ChAT-positive neurons localized in other areas of the central nervous system (CNS) of the rat--for example, the pontomesencephalotegmental (PMT) cholinergic complex (Ch5-Ch6) and the nucleus basalis of Meynert (nbM) (Ch4). Histochemically, ChAT-positive cells in the SN were characterized by their ability to utilize the reduced cofactor nicotinamide adenine dinucleotide phosphate (NADPH). Identified ChAT-positive neurons in the light microscope were subsequently studied in the electron microscope. All cholinergic neurons in the SN share essentially the same ultrastructural characteristics. The copious cytoplasm was rich in organelles with large lipofuscin granules. The synaptic input onto cell bodies and their dendrites was studied in serial sections. Synaptic contacts onto the perikarya and proximal dendrites were sparse and of asymmetric type. Both symmetric and asymmetric synaptic specializations onto ChAT-positive distal dendrites were detected. Asymmetric synaptic contacts onto cell bodies and dendrites were often defined by the presence of subjunctional dense bodies associated with the postsynaptic membrane. The pattern of the synaptic input to these cells differs strikingly from that onto unlabelled neighboring neurons. The perikarya and dendrites of the latter were characteristically covered with synaptic boutons. Scarce immunoreactive terminals in asymmetric synaptic contact with unlabelled dendritic profiles were also detected in portions of SN compacta with no ChAT-positive cells. Extranigrally located ChAT-positive cells of the PMT cholinergic complex were also examined in the electron microscope for comparison purposes. These cells exhibited, on the basis of their morphology and synaptic input pattern, very similar characteristics to those shown by SN cholinergic neurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2703555 TI - Cortical connections of areas 17 (V-I) and 18 (V-II) of squirrels. AB - Connections of visual cortex in squirrels were investigated by placing WGA-HRP injections, and in some cases fluorescent dyes, into area 17 (V-I) or area 18 (V II). Results were related to architectonic fields determined in brain sections cut parallel to the surface of manually flattened cortex and to limited microelectrode mapping data. Injections in area 17 provided evidence for 1) a patchy pattern of horizontal intrinsic connections extending 1-2 mm from the injection site; 2) uneven, widely distributed connections with area 18 (V-II) and adjoining occipital-temporal (OT) cortex; and 3) callosal connections of large portions of area 17 with the 17/18 border zone. While restricted locations in area 17 had uneven interconnections over several mm of area 18, more rostral locations in area 17 related to more rostral locations in area 18, demonstrating a topographic tendency. Injections in area 18 revealed 1) zones of discontinuous connections with area 17 that followed a topographic pattern, 2) patches of intrinsic connections that spread over distances of up to 6-8 mm from the injection site; 3) two zones of uneven connections with OT cortex suggesting the locations of at least two visual areas, OTr and OTc; 4) connections with limbic cortex rostromedial to areas 17 and 18; 5) sparse connections with regions of temporal cortex lateral to OT; and 6) uneven callosal connections with area 18 and OT cortex. The widespread and unevenly distributed intrinsic callosal interconnection patterns of areas 17 and 18 contrast with the restricted excitatory receptive fields of neurons and the retinotopic patterns of representation in these fields. Although physiological evidence is presently lacking, the patchy connections suggest that areas 17 and 18 in squirrels are modularly organized. PMID- 2703556 TI - Regeneration of axons from the adult rat optic nerve: influence of fetal brain grafts, laminin, and artificial basement membrane. AB - After transection of the optic nerve of adult rats, most of the axons in the proximal stump die and the surviving ones are unable to regenerate into the distal optic nerve. Since the fetal brain has an inherent capacity to regenerate axons, we investigated whether fetal (E16) target regions of optic axons (thalamus and tectum) transplanted to the completely transected optic nerve of adult rats would promote axon regeneration. In control operated rats, axon growth beyond the site of transection was restricted to a few fibers that grew irregularly within the connective tissue scar. By contrast, in grafted animals directed outgrowth of optic axons toward the transplant started at 6 days postoperation (p.o.) and reached its maximum 15 days p.o. and later, when numerous single optic fibers and small axon fascicles had grown toward and into the graft, where they formed arborizations and terminal varicosities. Regenerating optic axons were further advanced than GFAP-positive strands of astroglia that emanated from the proximal optic nerve stump. Laminin immunoreactivity appeared at 6 days p.o. in the zone of reactive astroglia in the terminal part of the optic nerve stump. Later it showed a distribution complementary to the pattern of GFAP immunoreactivity, which it seemd to circumscribe. There was no unequivocal codistribution of laminin immunoreactivity with regenerating axons. In further experiments, target regions from different ontogenetic stages (E14 to neonate and adult) and nontarget regions (E16, cerebral cortex or spinal cord) were grafted to the optic nerve stump. With the exception of the adult grafts, all transplants had effects on axon regeneration comparable to those of E16 target regions. In order to test the effects of extracellular matrix molecules on axon regeneration, a basement membrane gel reconstituted from individual components of the Engelbreth-Holm-Sarcoma (EHS) sarcoma was implanted between proximal and distal optic nerve stumps. No axons were induced to regenerate by this matrix. Likewise, laminin adsorbed to nitrocellulose paper and implanted at the lesion site did not stimulate axon growth from the proximal optic nerve stump. These results indicate that fetal brain is able to induce and direct regrowth of axons from the optic nerve toward the graft across a substrate that is not composed of astroglia or basement membrane components like laminin. The directed growth of axons in the absence of a preformed substrate implies a chemotactic growth response along a concentration gradient mediated by neurotropic molecules released from the graft. PMID- 2703557 TI - Fetal brain grafts rescue adult retinal ganglion cells from axotomy-induced cell death. AB - After intraorbital transection of the optic nerve of adult rats, 90% of the retinal ganglion cells die within 30 days. Since fetal brain extracts and cocultured fetal target regions support the survival of retinal ganglion cells in vitro (Nurcombe and Bennett: Exp. Brain Res. 44: 249-258, '81; McCaffery et al.: Exp. Brain Res. 48: 377-386, '82; Armson and Bennett: Neurosci. Lett. 38: 181 186, '83) we investigated whether cell death in the adult retina could be prevented by transplanting fetal (E16) thalamus and tectum to the proximal stump of the optic nerve of adult rats that was completely transected 2-3 mm behind the optic disc. Unoperated eyes contained 119,973 (+/- 939, SEM) retinal ganglion cells, estimated from axon counts of the intact optic nerve. Of these, 11,601 (+/ 1,857) remained in control operated eyes at 30 days postoperation while in the eyes of grafted rats, 35,086 (+/- 2,278) retinal ganglion cells were counted. Thus, 23,485 (= 22% of those normally dying after transection of the optic nerve) ganglion cells were rescued by the fetal grafts from cell death normally following axotomy. These results indicate that fetal target regions of retinal ganglion cells contain and/or produce neurotrophic molecules that promote the survival of adult axotomized retinal ganglion cells. PMID- 2703558 TI - Increased secretion of insulin-like growth factor I into milk of cows treated with recombinantly derived bovine growth hormone. AB - Six lactating, non-pregnant Jersey cows were given subcutaneous injections of recombinantly derived bovine growth hormone for 7 d. Milk yield was increased by 4.5 kg/d on d 7, compared with the average yield of 10.7 +/- 0.4 kg/d (mean +/- s.e.m.) for the 7 d preceding treatment. Concentrations of insulin-like growth factor I (IGF-I) in the milk increased from 0.44 +/- 0.04 nmol/l (mean +/- s.e.m.) during the 7 d preceding treatment to 1.6 +/- 0.2 nmol/l on d 7 of treatment. Taking the increase in milk yield into account the total increase in the secretion of IGF-I into milk of one udder half was 6-fold. Plasma concentrations of total IGF-I rose from 15.5 +/- 1.3 nmol/l (mean +/- s.e.m.) on the day preceding treatment to 56.9 +/- 3.6 nmol/l (mean +/- s.e.m.) on d 7 of treatment. Mammary plasma flow increased from 1.6 +/- 0.09 to 2.2 +/- 0.06 l/min.udder half over the same time. Estimates of the amount of IGF-I that reached the mammary gland gave values of 24 and 116 nmol/min.udder half before and during treatment respectively. IGF-I in milk of treated cows was associated predominantly with proteins ranging from 40,000 to 150,000 mol.wt, but a significant proportion (19%) of the total IGF-I was present in the free unbound form. IGF-I crosslinking studies revealed the presence in milk of one specifically labelled band at 31,000 mol.wt. PMID- 2703559 TI - Cardiovascular responses and mammary substrate uptake in Jersey cows treated with pituitary-derived growth hormone during late lactation. AB - Pituitary-derived bovine growth hormone (bGH) was administered to Jersey cows during late lactation for 7 d. Milk yield increased significantly during treatment and by a maximum of 49.6% on d 7. The magnitude of the increase was similar to that of mammary plasma flow (47.8 +/- 18.3%) over the same period. By 15-21 d after treatment, both variables had returned to pretreatment values. With respect to milk composition, bGH had negligible effect on lactose and fat concentrations but there were significant decreases in protein, sodium and chloride. Arterial plasma concentrations of bGH increased substantially during treatment, but the associated rise in insulin was not statistically significant. Haematocrit decreased significantly, the lowest value being recorded 3 d after bGH treatment ceased. Mammary respiratory quotient fell progressively after the start of bGH treatment and reached the lowest recorded value 3 d after treatment ceased (62.2 +/- 7.3% of pretreatment value). Glucose and acetate uptake by the mammary gland increased significantly during treatment, increase in glucose uptake being due both to a greater arterio-venous difference and to mammary plasma flow. There was strong evidence that the acute response in increased milk yield was associated with multiple effects in terms of mammary plasma flow and metabolism, as well as haematocrit changes indicative of increased plasma volume. PMID- 2703560 TI - Lack of correlation between milk glucose concentrations and rates of milk production in the rat. AB - Concentrations of lactose, alpha-lactalbumin (alpha-la), glucose and glucose-6 phosphate were measured in milk obtained from rats under conditions where the rates of milk production varied from 0 to 2.6 g/h. In the milk from rats fed a low protein diet where milk production was 0.9 g/h, the concentration of alpha-la was 1.5 mg/ml, being significantly lower than that in the milk of control rats at 2.9 mg/ml and where the rate of milk production was 2.6 g/h. No differences were detected in the glucose concentrations. When rats were fed restricted amounts of the control diet and where milk production varied from 0 to 1.7 g/h during the course of the day, no differences in the concentrations of either alpha-la or glucose were detected. These results suggest that considerable caution must be used in interpreting the significance of milk glucose in the rat. PMID- 2703561 TI - Effect of hydraulic milking on milking performance, teat condition and lipolysis. AB - The term 'hydraulic milking' describes a new milking concept in which liner movement is restricted and the liner is flooded with milk beneath the teat. This condition, achieved with a multi-valve claw without air admission to the cluster, reduced milking time by 26% and increased milk flow rate by 20%. Four experiments describe the discovery of hydraulic milking and investigate its potential using equal or different levels of vacuum in the milkline and pulseline. Benefits from hydraulic milking include decreased lipolysis (less than or equal to 36%) and milk foam (75%), improved teat condition and a high degree of protection against machine-induced infections. Evidence of increased milk yield is inconclusive. Cluster removal is impeded by hydraulic milking and the multi-valve cluster requires modification to facilitate the process. Pulsation characteristics and vacuum levels developed for conventional milking appear adequate for hydraulic milking. Unorthodox vacuum conditions may be needed, however, to exploit fully this novel milking concept. PMID- 2703562 TI - Effect of a shielded liner on new mastitis infection. AB - Results from a field trial involving 23 Norwegian dairy herds support the theory that deflector shields inserted into the teatcup liner can reduce the risk of intramammary infection. However, the effectiveness of this measure is questionable in cows already infected and in problem herds. PMID- 2703563 TI - Metabolic adaptations in goat mammary tissue during long-term incomplete milking. AB - Lactating goats were milked incompletely in one gland and normally in the other gland twice daily for 24 weeks. Yields of the incompletely milked glands were adjusted so that a calculated 100 ml milk remained in the gland at the end of milking. On average this residual volume was greater by 7.6% of the total milk volume than that left after normal milking and was 25.9% greater than the capacity of the alveoli. After 24 weeks, the weekly milk yield of the incompletely milked gland was 23.8% lower than that of the other gland (P less than 0.001) when expressed in relation to cell number. The metabolic capacity of secretory cells in the two glands was measured in serial tissue biopsies. Two weeks of incomplete milking had no effect on enzyme activities or metabolic fluxes in the incompletely milked gland, but after 24 weeks the activities of several key enzymes were significantly lower in this gland. This was associated with a reduced rate of synthesis of total protein and casein in explants freshly prepared from the tissue. The rate of lactose synthesis also tended to be lower in explants from the incompletely milked gland. Secretory cell number in the two glands was similar at the end of incomplete milking. The data indicate that incomplete milking over a long period caused partial secretory cellular involution via a local chemical feedback mechanism in the gland. PMID- 2703564 TI - Analysis of colostral proteins in calf serum by enzyme-linked immunosorbent assay. AB - Enzyme-linked immunosorbent assay method was improved to monitor the concentrations of colostral proteins in the range of 10 to 10(3) ng/ml in calf serum. Colostral proteins were purified from fat-free colostrum, and antibodies against them were prepared from the rabbit anti-colostrum protein sera. Concentration of each protein was determined by enzyme-linked immunosorbent assay without interference by calf serum proteins in a mixture of colostrum and precolostral calf serum. Changes in the colostral protein concentrations in the sera of five postcolostral calves were monitored by enzyme-linked immunosorbent assay. After feeding colostrum to the neonatal calf, serum IgG concentration increased rapidly within 16 h to 8.1 to 36.8 mg/ml and gradually declined until 3 d to the steady levels, 4.7 to 23.6 mg/ml. The concentrations of casein and P2 (colostral small proteins, which were eluted at the second peak in Sephadex G-100 gel filtration) also increased more rapidly within 16 h to 9.6 to 264.0 micrograms/ml and 31.5 to 1600 micrograms/ml, respectively, and steeply decreased to near the detection limit on 3 d after feeding. These results indicate that enzyme-linked immunosorbent assay is useful to measure and monitor the absorbed colostral proteins and also to survey calves receiving and not receiving colostrum. PMID- 2703565 TI - Regulation of bovine adipose tissue metabolism during lactation. 5. Relationships of lipid synthesis and lipolysis with energy intake and utilization. AB - The effects of energy utilization during lactation on adipose tissue metabolism were determined in 51 first lactation Holstein heifers producing between 5950 and 10,246 kg milk in 305 d. Net energy intake ranged from 18.3 to 40.6 Mcal/d during 28 to 140 d of lactation. Milk yield ranged from 13.5 to 47.4 kg/d and fat percent from 1.49 to 4.60 during 28 to 140 d, providing a range of 8.2 to 32.6 Mcal/d milk energy secretion. Calculated energy balance ranged from -16.4 to 11.5 Mcal/d. Weight change ranged from -70 to 143 kg during that 112-d period. Subcutaneous adipose tissue was biopsied nine times from 30 d prepartum to 15 d after lactation ceased. Adipose lipid synthesis measured prepartum was negatively related to subsequent milk energy secretion. Net energy intake, body weight, and body weight change were related positively to adipose lipid synthesis rates from 28 to 56 d, but those rates were related negatively to milk energy secretion. Lipolysis was positively related to milk energy secretion and body weight and negatively related to NE intake. At d 60 of lactation, adipose tissue lipid synthesis rates were a function of body weight, weight gain, and net energy intake. However, catecholamine-stimulated lipolysis rates were a function of body weight and milk energy secretion. After 140 d, lipid synthesis and lipolysis were elevated and more closely related to the previous peak rather than to concomitant milk energy secretion. These relationships demonstrate the effects of dietary energy content and genetic selection for milk production on adipose tissue metabolism. PMID- 2703566 TI - Antiketogenic effects of monensin in early lactation. AB - Holstein cows, second lactation or later, were gradually introduced to monensin containing concentrate 1 wk prepartum and fed complete diets containing 15 and 30 g monensin/ton of DM for 3 wk postpartum. The addition of 30 g monensin/ton of feed decreased the incidence of subclinical ketosis from 6 out of 12 to 1 out of 12. The concentration of beta-hydroxybutyrate in blood from cows in the high monensin group was decreased during the 3-wk postpartum experimental period. Acetate: propionate ratios decreased from 2.32 in the control group to 1.44 in the high monensin group. Feed intake in the low monensin group was less than in the control group, but there were no significant differences in body weight changes or milk production. Monensin, when added to the diet, lowered milk fat in one of the monensin fed groups (low) but not in the other. Milk protein and lactose concentrations were not changed by the addition of monensin to the diet. No other adverse treatment effects were observed. Two cows from each group were culled for causes unrelated to treatment; the remainder completed the normal 305 d lactation and were rebred without problems. PMID- 2703567 TI - Estimating salivary flow and ruminal water balance of intake, diet, feeding pattern, and slaframine. AB - Three experiments with ruminally fistulated cattle fed 12 times daily were conducted to study the role of saliva secretion in ruminal water balance when intake, diet, and feeding pattern were altered. Water balance data were determined from continuously infused Co-EDTA and pulse-dosed Cr-EDTA with saliva flow estimated by difference between water intake and ruminal outflow. Any net transruminal water flux would be included in the estimate of salivary flow. When the concentration of bluestem hay in the diet was increased from 50 to 90%, ruminal fluid volume, saliva secretion, water intake, dilution rate, and total ruminal outflow increased. At equal intake, the higher forage diet increased ruminal liquid volume, outflow, and saliva secretion but had no effect on dilution rate. Intake, but not forage concentration, affected ruminal pH when 50 and 90% hay diets were fed. Increasing feeding frequency of forage in a 65% bluestem hay diet from 4 to 12 times daily (the grain portion was fed 12 times daily) increased dilution and ruminal outflow; however, the latter was only significant with data from Cr-EDTA. Ruminal volatile fatty acids were not altered by feeding frequency of forage. Nycterohemeral patterns were seen in water intake, ruminal dilution rate, outflow, and salivary flow in both studies. Slaframine increased saliva flow by 29% and was accompanied by increased ruminal liquid volume, dilution rate, and outflow. PMID- 2703568 TI - Effect of reactivity rate and particle size of magnesium oxide on magnesium availability, acid-base balance, mineral metabolism, and milking performance of dairy cows. AB - Four ruminally fistulated Holstein cows were arranged in a 4 x 4 Latin-square design. Treatments consisted of a control diet and three diets containing 4% MgO (DM basis) with increasing reactivity rates (A, B, C). Diets contained corn silage and concentrate at a 40:60 ratio (DM) and were fed at 95% of ad libitum intake. Total acid-consuming capacity and solubility of MgO in vitro paralleled particle size and agreed with the solubilities in the rumen. Milk fat percentage, but not milk yield, was increased by all three MgO diets. Ruminal pH was elevated by the MgO diets across all 8 h postfeeding. MgO, reactivity A diet tended to increase ruminal acetate, total VFA production, milk yield, milk fat yield, and milk fat percentage. Effect of time postfeeding on acetate and propionate production was significant; 2 to 6 h postfeeding was the period most responsive to the diets. No significant influence on blood acid-base balance was observed. On the basis of urinary excretion of Mg, MgO sources with smaller particles are more available to cattle. Both Ca and Cl metabolism appeared to be affected by reactivity rate of MgO. PMID- 2703569 TI - Nutrient digestion in the large intestine as influenced by forage to concentrate ratio and forage physical form. AB - Digestion in the large intestine was investigated in four growing steers fitted with duodenal and ileal cannulas. Diets assigned within a 4 x 4 Latin square were: 20% long alfalfa hay and 80% grain; 15% pelleted alfalfa, 5% hay, and 80% grain; 80% hay and 20% grain; and 60% pellets, 20% hay, and 20% grain. Intake of DM was not affected by diet. Organic matter digestion in the large intestine averaged 9, 3, 1, and -4% of total tract digestion for the 20% hay, 20% pellet, 80% hay, and 80% pellet diets, respectively, with significant increases due to high grain diets and long hay. Digestion of CP in the large intestine as a percentage of total tract digestion was unaffected by diet but averaged 3, -1, .3, and -6% for the respective diets. Percentage of total tract starch digestion occurring in the large intestine increased with grain feeding and averaged 6, 3, 1, and 1%, respectively. Digestion of ADF and NDF in the large intestine as a percentage of total tract was unaffected by diet; however, the respective means were 16 and 15, 7 and 7, 5 and 15, and 1 and 1%. In a second trail the same animals were fed a more typical dairy cow diet consisting of 50% grain, 25% corn silage, and 25% long alfalfa hay for a single 18-d period. Digestion in the large intestine accounted for 2.1, .2, 3.6, and 6.4% of total tract digestion of organic matter, starch, ADF, and NDF, respectively; however, feed intake was not as great as in the first trail. Although conditions of these studies differed from those commonly experienced by lactating cows, the underlying principals should apply. The large intestine would be expected to make an even greater contribution to total tract digestion in lactating cows consuming proportionally more DM. PMID- 2703570 TI - Production of volatile fatty acids in the rumen and cecum-colon of steers as affected by forage:concentrate and forage physical form. AB - Contribution of cecal and ruminal VFA to metabolizable energy was investigated in steers with cannulas in both the rumen and cecum. Animals were fed ad libitum so that data would be applicable to the lactating dairy cow. Diets assigned within a 4 x 4 Latin square were: 20% long alfalfa hay and 80% concentrate; 15% pelleted alfalfa, 5% hay and 80% concentrate; 80% hay and 20% concentrate; 60% pellets, 20% hay and 20% concentrate. Intake of DM was unaffected by diet. Cecal fluid pH, osmolality, and concentrations of valerate and isovalerate were unaffected by diet. Concentrations of total VFA, acetate, propionate, butyrate, and lactate in the cecum increased with proportion of grain in the diet. The high grain diets depressed cecal ammonia concentration and acetate to propionate ratio. Acetate production in the cecum was higher with the high grain diets whereas that in the rumen was lower. Production of propionate and butyrate in both the cecum and rumen was unaffected by diet. Cecal VFA provided 8.6% of metabolizable energy intake, on average. Contribution of ruminal VFA to total metabolizable energy was affected by diet, accounting for 72, 51, 74, and 52% of metabolizable energy from the 20% hay, 20% pelleted alfalfa, 80% hay, and 80% pelleted alfalfa, respectively. Cecal VFA were an important source of energy for ad libitum-fed steers; this contribution would undoubtedly increase with increasing feed intake. PMID- 2703571 TI - Effects of calcium carbonate on ruminal fermentation, nutrient digestibility, and cow performance. AB - Sixteen Holstein cows were used in a 4 x 4 Latin square design (four replicates) to investigate the effect of feeding calcium carbonate on feed intake, ruminal fermentation, apparent total tract nutrient digestibility, milk yield, and milk composition. Supplementation of calcium carbonate to diets that contained 60% concentrate and 40% corn silage (DM basis) decreased DM intake and milk production and was not effective in altering ruminal fluid pH, ruminal fluid dilution rate or outflow, molar proportions of ruminal fluid VFA, or synthesis of milk fat and milk protein by dairy cows. Calcium carbonate supplementation to the diet tended to improve efficiency of feed utilization (4% FCM/DM intake). The exact site of action of calcium carbonate, if any, is not known. However, these data suggest that calcium carbonate exerts little or no buffering effect in the rumen when the pH is 6 or above regardless of its reactivity rate in strong acid or its mean particle size. This lack of effect is probably because of its low solubility in ruminal fluid at pH above 5.5. PMID- 2703572 TI - Effect of chemical drying agents on alfalfa hay and milk production response when fed to dairy cows in early lactation. AB - Third-cutting alfalfa hay cut at bud stage was treated with a drying agent consisting of potassium carbonate, sodium carbonate, and citric acid at the rate of 280.6 L/ha (1 kg/37.47 L water) to alternate swaths 4.27-m wide. Hay samples were taken at cutting and at 4-h intervals during daylight until baling was initiated. Twenty lactating Holstein cows were randomly assigned to untreated and treated alfalfa hay treatments in a switch-back design. Individual feed intakes and milk yields were recorded daily. Milk composition was analyzed once weekly. Drying rates were: .40 and .48% moisture/h for control and Na2-K2CO3-citrate treatments, respectively. There was no significant difference between treatments in feed composition parameters nor in vitro DM digestibility parameters. Cows fed the hay treated with Na2-K2CO3-citrate had a higher mean daily milk yield, adjusted for feed intake, compared with cows fed untreated hay (33.0 versus 32.5 kg/d). There were no significant differences in milk composition between treatments. PMID- 2703573 TI - Short-term and long-term effects of early nutritional deprivation on adipose tissue growth and metabolism in calves. AB - Two groups of 10 Friesian calves received, respectively, 819 and 1380 g of milk replacer daily between birth and 95 d of age. After weaning, both groups were pair-fed until slaughter at 533 d of age. Body composition, cellularity, and lipogenic activity of kidney and omental fat were determined at 95 and 533 d of age. Milk intake restriction produced a 40% reduction of growth rate and a 68% decrease in lipid deposition between birth and 95 d of age. This was accompanied by a reduced adipose cell hypertrophy without any effect on adipose cell number. Acetate incorporation in isolated cells, glucose 6-phosphate dehydrogenase, NADP malate dehydrogenase, and lipoprotein lipase activities were lower in restricted animals. Glucose incorporation in isolated fat cells was very slight in both groups. Acetate incorporation and lipogenic enzyme activities were more than 10 times higher in 533-d-old animals that have larger adipocytes than in younger calves. Moreover, kidney fat presented a higher rate of de novo fatty acid synthesis than omental fat. The reverse order was observed for lipoprotein lipase activity. Early postnatal nutrition had no significant effect on lipid deposition between 95 and 533 d of age. There were no significant differences in body composition, adipose tissue cellularity, or metabolism at slaughter. PMID- 2703574 TI - Early postpartum reproductive profiles in Holstein cows with retained placenta and uterine discharges. AB - Sixty Holstein cows were allocated to three groups. Twenty cows had retained placenta. The remaining cows were examined on d 14 postpartum and those with purulent discharges (n = 22) were assigned to one group and the remaining (n = 18) to a control group. Within each group, cows were given randomly either gonadotropin-releasing hormone (i.m., 200 micrograms) or saline on d 15 postpartum to evaluate the effect on changes in ovarian structures and plasma progesterone through 50 d postpartum and fertility. Corpora lutea were found in control cows by d 21, cows with uterine discharge by d 28, and cows with retained placenta by d 27. Maximum progesterone production during the first luteal phase was higher in control cows than in cows with purulent discharge or retained placenta (4.66 ng/ml compared with 3.23 and 3.34 ng/ml, respectively). Duration of the first corpus luteum was affected by clinical condition. Only 6.2% of cows with retained placenta had corpora lutea of normal duration (12 to 16 d), whereas 43.8 and 50.0% of cows with uterine discharge and control cows had normal postpartum luteal phases. Measures of fertility were not affected by gonadotropin releasing hormone. Control cows had less days to conception (97) and fewer services per conception (1.6) than cows with retained placenta (134 and 2.5, respectively). Clinical group affected reproduction more than gonadotropin releasing hormone did, possibly by altering ovarian function. PMID- 2703575 TI - Effect of segregation on prevention of intramammary infections by Staphylococcus aureus. AB - Effectiveness of segregating cows with Staphylococcus aureus intramammary infections was studied over 1 yr. Nine herds were split into control (n = 5) or segregated (n = 4) groups. Cows with S. aureus intramammary infections were milked last in segregated herds. Monthly milk samples were collected aseptically for microbiologic analysis. Mean incidences of S. aureus intramammary infections were 3.7 and 4.3 cases/100 cow-mo in segregated and control herds. The mean prevalence of S. aureus intramammary infections decreased in both segregated and control herds during the study. Mean percentages of cows with S. aureus intramammary infections at the beginning and end of the study were 33.7 and 21.5 in segregated herds and 25.3 and 15.0 in control herds. Cows in all herds with S. aureus intramammary infections were preferentially culled. There were no significant differences in incidence and prevalence of S. aureus intramammary infections between groups, suggesting that S. aureus intramammary infections can be controlled without segregation. PMID- 2703576 TI - Effects of passive immunity on subsequent production in dairy heifers. AB - Dairy Herd Improvement data from a large, commercial dairy farm were used to evaluate the relationships of first lactation milk and fat yield and age at first calving on passively acquired immunity in Holstein heifers. Total serum Ig concentration was measured 24 to 48 h postpartum (mean = 25.5 mg/ml, SD = 19.2) on calves allowed to suckle their dams freely through 24 h postpartum. No additional colostrum was supplied and no attempt was made to ensure adequate colostrum intake. Calves were raised in Tucson, AZ until 6 mo of age, then transferred to Idaho to complete the growing phase and to be bred. Heifers were returned to Tucson during their 7th or 8th mo of gestation. Serum Ig concentration, measured shortly after birth, was an important source of variation for mature equivalent milk (b = 8.5 kg/Ig unit) and mature equivalent fat (b = .24 kg/Ig unit) production in the first lactation but did not affect age at first calving. It is impossible to ascertain from these data whether Ig concentration at birth was directly or indirectly related to production; regardless, supplying an adequate amount and concentration of colostrum at the appropriate time to dairy heifers may enhance their future productivity. PMID- 2703577 TI - Enzyme-linked immunosorbent assays of bovine lactoferrin and a 39-kilodalton protein found in mammary secretions during involution. AB - Enzyme-linked immunosorbent assays were developed for two proteins found in mammary secretions during the non-lactating period: lactoferrin and a 39-kdal protein. Minimum detectable concentrations were .12 ng/ml for lactoferrin and .0037 ng/ml for the 39-kdal protein. Standard curves were linear in the ranges of .4 to 100 ng/ml for lactoferrin and 2.4 to 30 ng/ml for the 39-kdal protein. The immunoassays were used to measure concentrations of the proteins in mammary secretions during involution. From the last day of milking to d 30 of involution, mean concentrations of lactoferrin and the 39-kdal protein increased from .82 +/- .35 to 78.5 +/- 12.43 mg/ml and from 11.8 +/- 3.8 to 84.4 +/- 21.1 micrograms/ml, respectively. The immunoassays described will be valuable for further studies on the synthesis and secretion of these proteins during mammary involution. PMID- 2703578 TI - Infection control in dental school radiology. AB - U.S. and Canadian dental schools were surveyed concerning infection control practices in dental radiology. The majority of respondents reported surface disinfection of intraoral projection operatories (55 percent) and panoramic operatories (61 percent) before or after each patient. The most frequently used surface disinfectant was iodophor. Most schools routinely disinfected the x-ray cone (89 percent) and tubehead (87 percent) of intraoral x-ray machines; however, many did not disinfect the control panel (44 percent) or the exposure button (27 percent). Although 100 percent of respondents reported student use of disposable latex gloves when exposing intraoral radiographs, 27 percent did not use gloves when processing radiographs. Fifty-six percent did not routinely disinfect countertops in the darkroom. PMID- 2703579 TI - A theory of motor performance and its applications to preclinical dental skill acquisition. AB - This article reviews one theory of motor performance that was derived from a large body of research findings. The validity of any theory depends on the extent to which it can generate testable hypotheses. Based on a number of applied investigations in the preclinical setting, several predictions developed from this theory have been supported. These, as well as other, potential applications are discussed and a model of preclinical instruction derived from the theory is presented. PMID- 2703580 TI - Personality variables as predictors of performance for first-year dental students. AB - This study attempted to determine if students with certain personality preferences outperform others over the course of the initial dental school year. The Myers-Briggs Type Indicator (MBTI) was used to assess the relationship between personality preferences and academic performance. One hundred and ninety nine dental students in four successive first-year classes, 1983-86, participated. Pearson correlation coefficients were used to relate academic performance (first-semester, second-semester, and first-year GPAs) to personality preferences (EI, SN, TF, JP) and academic predictors (entering GPA and DAT scores). For personality preferences, all correlation coefficients were low and nonsignificant. In comparison, entering GPA and DAT (academic) scores were significantly correlated with first-semester, second-semester, and first-year GPAs. DAT (perceptual ability) scores showed a significant correlation with first semester GPAs only. PMID- 2703581 TI - Do grades influence students' evaluations of clinical courses? PMID- 2703582 TI - Changes in generic and degree completion dental hygiene student characteristics. PMID- 2703583 TI - The ex-dental clinic patient: what can we learn? PMID- 2703584 TI - Adapting a matrix organizational structure to the College of Dentistry at the University of Kentucky. PMID- 2703585 TI - Curriculum guidelines for Dental Nutrition. American Association of Dental Schools. Section on Biochemistry and Nutrition. PMID- 2703586 TI - Return to the fast lane: a personal story. PMID- 2703587 TI - The implementation of a quality assurance study and program to reduce the incidence of hospital-acquired pressure ulcers. PMID- 2703588 TI - The physiologic responses of the trauma patient. PMID- 2703589 TI - Stoma rehabilitation in Japan: in the past and at present. PMID- 2703590 TI - Alternative settings for practice: extended care facilities. PMID- 2703591 TI - Urinary pouching for selected incontinent males. PMID- 2703592 TI - The antireflux pouch: is it effective, is it functional? PMID- 2703593 TI - A new way to anchor central venous catheters. PMID- 2703594 TI - When your ostomy patient is an adolescent. PMID- 2703595 TI - Issues in evaluation: evaluating assessments of elderly people using a combination of methods. AB - In evaluating a health service, individuals will give differing accounts of its performance, according to their experiences of the service, and the evaluative perspective they adopt. The value of a service may also change through time, and according to the particular part of the service studied. Traditional health care evaluations have generally not accounted for this variability because of the approaches used. Studies evaluating screening or assessment programmes for the elderly have focused on programme effectiveness and efficiency, using relatively inflexible quantitative methods. Evaluative approaches must reflect the complexity of health service provision, and methods must vary to suit the particular research objective. Under these circumstances, this paper presents the case for the use of multiple triangulation in evaluative research, where differing methods and perspectives are combined in one study. Emphasis is placed on the applications and benefits of subjectivist approaches in evaluation. An example of combined methods is provided in the form of an evaluation of the Newcastle Care Plan for the Elderly. PMID- 2703596 TI - Health assessment of the elderly at home: the case for shared learning. AB - This paper reports findings from a collaborative research project (Buckley & Runciman 1985) which examined, using video studies and questionnaires, the scope and content of health assessment of old people at home and the views and feelings of different groups of health professionals towards visiting old people at home. The study sample included student and experienced health care workers and a number of elderly people; seven professional groups were represented. A prompt list summarizing key content of health assessment was devised and tested in field studies in two primary health care teams. Views and feelings about visiting old people are presented under four headings: priorities and preferences; skills and training; work organization and the team; and the feelings and rights of the elderly themselves. Educational recommendations from the study are made and the case for shared learning in relation to health care of old people is presented. PMID- 2703597 TI - Prompted voiding therapy for urinary incontinence in aged female nursing home residents. AB - A study of 85 incontinent female nursing home residents explored the effects of two nursing interventions (prompted voiding and socialization) on incontinence. Findings indicate that a controlled prompted voiding programme is useful in decreasing incontinent episodes. Positive effects of prompted voiding were noted over a 5-week experimental period. It is suggested that nursing homes incorporate prompted voiding into their care. Nursing homes adopting this protocol should be encouraged to keep data that will contribute further to knowledge in this area. Recommendations for additional research are made. PMID- 2703598 TI - Intracranial pressure monitoring: a study of nursing practice. AB - Differences exist within neurological centres with regard to the care of the patient with an ICP monitoring device in place. A survey carried out to identify these differences shows that head injury remains the most common diagnosis associated with ICP monitoring and intraventricular catheters the most popular method, although the use of catheter tip pressure transducers appeared to be on the increase. Some centres used more than one method. The type of machinery used to process the data varied enormously. Written guidelines or standards existed in only a few centres and none of these fully covered every aspect of care as quoted in the literature. Many units appeared to rely on in-service or one to one teaching situations with new or learner staff being supervised initially. Some centres restricted the type of nurse who was permitted to care for these patients. Unfortunately, the restrictions were not clearly identified. Calibration of equipment was not considered a nursing procedure but some respondents felt that it should be. PMID- 2703599 TI - Integrating nursing theory, practice and research through collaborative research. AB - The advancement of professional nursing requires integration of theory, practice and research. One realistic mechanism to achieve this integration is collaborative nursing research. A collaborative experience between clinical nurse specialists and faculty researchers is described and evaluated. The collaborative research project focused on contraceptive nursing care and self-care conceptualized within Orem's theory. A major finding was that while job titles and settings of the participants differed markedly, role components were not disparate; rather, they were compatible and complementary. The collaborative project strengthened both the theory base for a primary care nursing practice and the practice base for faculty research and theory development efforts. PMID- 2703600 TI - Preparing teachers for the performance and evaluation of gaming-simulation in experiential learning climates. AB - Gaming-simulation exercises have become an established teaching strategy for nursing education. This paper suggests that nurse educators must now attempt to evaluate their effect on learning. Problems of evaluation are discussed and alternative approaches critically considered. The dominant 'classical' approach is rejected in favour of 'illuminative' evaluation and the approach of 'new paradigm research'. Nurse teachers are encouraged to apply the principles of therapeutic community practice and 'gestalt awareness' to the learning environment to enhance gains from experiential approaches. Finally the need to prepare teachers is examined. It is suggested that personal and interpersonal sensitivity, plus the ability to meaningfully facilitate groupwork are necessary prerequisites for effective gaming-simulation and its qualitative evaluation. PMID- 2703601 TI - Teaching microcomputing to student nurses: an evaluation. AB - This paper describes an introductory computer course designed for student nurses facing a career in nursing in which computers will play a major part. Questionnaires were given before and after the course. The purpose of the questionnaires were (a) initially to gain information about the students' previous computing experience, motivation and expectations of the course, and (b) to enable an evaluation to be undertaken. The course content, structure and results of the questionnaires are presented; modifications made to the course following the evaluation are mentioned and finally some of the issues which need to be considered when developing a computer course for nurses are raised. PMID- 2703602 TI - Conceptualizing for transcultural health visiting: the concept of transcultural reciprocity. AB - Concepts fundamental to health visiting need to be identified, clarified and developed as an on-going activity, one in which all health visitors can, and should, be involved. The concept of 'transcultural reciprocity' is presented as intrinsic to the practice of transcultural health visiting. PMID- 2703603 TI - Vaccine-preventable diseases on college campuses: the emergence of mumps. AB - Because of the adverse health impact of vaccine-preventable diseases, particularly measles and rubella, on college campuses, the American College Health Association (ACHA) Committee on Immunization and the House of Delegates issued position statements in 1983 and 1984 stating that colleges and universities should institute prematriculation immunity requirements. Since then, many colleges have implemented requirements and some states have passed comprehensive college laws requiring proof of immunity at the time of matriculation. No college rubella outbreaks have been reported to the Centers for Disease Control (CDC) since 1985. Measles outbreaks, however, have continued to be reported. In 1986-1987, 315 college measles cases were reported from 15 states, comprising over 3% of the total cases reported to CDC. Thirty-six percent of college measles cases could have been prevented through full implementation of prematriculation immunity requirements. Outbreaks of mumps were reported among students attending 16 colleges and universities in 3 states where active surveillance was undertaken during the 1986-1987 academic year. These mumps outbreaks, the first reported in colleges since vaccine licensure in 1967, were responsible for considerable health impact and disruption of activities. The outbreaks paralleled the increase in mumps reported nationally, which was largely a result of illness among unvaccinated adolescents and young adults not previously exposed to mumps. A lack of routine mumps vaccination in the past has allowed accumulation of susceptible unvaccinated persons in middle schools, high schools, and colleges. Outbreaks are likely to occur in those colleges that draw students who attended primary and secondary school in states without comprehensive laws requiring mumps vaccination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703605 TI - Bulimia: determining prevalence and examining intervention. PMID- 2703604 TI - Modeling and guided practice as components within a comprehensive testicular self examination cancer education program. AB - This study sought to assess the effects of modeling and guided practice as components within a comprehensive testicular self-examination education program for college-aged men. We studied three treatment groups (N = 161) at two Arkansas universities. The variables investigated were knowledge of testicular cancer, attitudes toward testicular cancer, and frequency of self-reported testicular self-examination. A summary of the major findings revealed a significant difference in knowledge of testicular cancer and attitudes toward testicular cancer and a significant difference in frequency of testicular self-examination for all treatment groups. Modeling and guided practice yielded no significant differences in knowledge of testicular cancer or frequency of self-reported testicular self-examination but some significant attitudinal differences. Results indicated that subjects were not knowledgeable about testicular cancer and that most (91.7%) were not practicing testicular self-examination. Three months after participation in one of three education programs, 78.9% of the subjects indicated they had performed testicular self-examination. Modeling and guided practice as components of one education approach used appear to be an essential strategy to increase the practice of regular testicular self-examination. PMID- 2703606 TI - Rubella immunity in college-aged women. PMID- 2703607 TI - Mental health first appointment no-shows. PMID- 2703608 TI - Causal relation between the pressure gradient and left ventricular ejection time in hypertrophic cardiomyopathy. AB - This study was designed to evaluate the relation between severity of obstruction to left ventricular outflow and left ventricular ejection time in hypertrophic obstructive cardiomyopathy. With dual catheters across the left ventricular outflow tract, the pressure gradient and corresponding left ventricular ejection time were measured in 10 patients as the pressure gradient was pharmacologically provoked or abolished, or both. The patients were studied during constant atrial pacing to avoid the potential errors introduced with heart rate correction equations. The pressure gradient was pharmacologically provoked or reduced over a range of greater than or equal to 62 mm Hg per patient. In each patient the left ventricular ejection time varied directly with the pressure gradient (mean r = 0.97, range 0.92 to 1.00). The change in magnitude of the pressure gradient varied directly with the corresponding change in the measured ejection time (mean r = 0.98, range 0.97 to 1.00). When the data from all 10 patients were pooled with use of Weissler's heart rate correction equation, the relation between the corrected left ventricular ejection time and the pressure gradient was still significant and linear (r = 0.86), but less so than in individual patients. This difference was the result of marked interpatient variability in the slope of this linear relation reflecting interpatient differences in other important factors, such as underlying myocardial contractility and stroke volume, that influence left ventricular ejection time. This study demonstrates a clear, direct and highly significant relation between the magnitude of the pressure gradient and the left ventricular ejection time in hypertrophic obstructive cardiomyopathy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703609 TI - Left ventricular ejection dynamics and outflow obstruction in hypertrophic cardiomyopathy. PMID- 2703610 TI - Long-term outcome of patients with hypertrophic cardiomyopathy successfully resuscitated after cardiac arrest. AB - This study describes the long-term outcome of 33 patients with hypertrophic cardiomyopathy who experienced a cardiac arrest but were successfully resuscitated. Cardiac arrest occurred at ages 9 to 62 years (mean 32); five patients survived multiple (two or three) arrests. A variety of treatments were administered; 18 patients with left ventricular outflow tract obstruction underwent ventricular septal myotomy-myectomy or mitral valve replacement and also received drug therapy; 15 patients received medical therapy alone. To date, 22 (67%) of the 33 patients have survived after the initial cardiac arrest for periods of 17 months to 22 years (mean 7 years); 12 patients have survived for greater than or equal to 5 and 6 for greater than or equal to 10 years. Of the 22 survivors, 16 have remained asymptomatic or only mildly symptomatic over the period of follow-up; 6 others have become severely symptomatic with heart failure, including 3 with evidence of left ventricular wall thinning and cavity enlargement. Eight patients ultimately died of natural cardiac causes (suddenly or of progressive heart failure) 7 months to 8.4 years (mean 4 years) after their initial cardiac arrest. Actuarial patient survival was 97 +/- 3%, 74 +/- 9% and 61 +/- 11% after 1, 5 and 10 years, respectively. Event-free rate (defined as actuarial survival without recurrent cardiac arrest of death) was 83 +/- 7%, 65 +/- 9% and 53 +/- 11%, respectively. For this group of patients with hypertrophic cardiomyopathy who were treated in a nonsystematic fashion with a variety of therapeutic strategies, the long-term outcome after surviving a cardiac arrest was variable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703611 TI - High prevalence of myocardial monoclonal antimyosin antibody uptake in patients with chronic idiopathic dilated cardiomyopathy. AB - Monoclonal antimyosin antibody studies were undertaken to assess the presence of myocardial uptake in patients with chronic idiopathic dilated cardiomyopathy. Three groups were studied: 17 patients with chronic (greater than 12 months) idiopathic dilated cardiomyopathy, 12 patients with a large, poorly contracting left ventricle not due to dilated cardiomyopathy (control patients) and 8 normal individuals. The patients in the cardiomyopathy and control groups showed a similar degree of clinical and functional impairment. Imaging was undertaken 48 h after antimyosin injection. The heart/lung ratio of antimyosin uptake was used to assess the results. The mean ratio in the cardiomyopathy group was 1.83 +/- 0.36 (range 1.40 to 2.80), a value significantly higher than that obtained in the control patients without cardiomyopathy (mean 1.46 +/- 0.04, range 1.38 to 1.50) or normal subjects (mean 1.46 +/- 0.13, range 1.31 to 1.6) (p less than 0.01). No difference in the ratio was noted between the normal subjects and control patients. Abnormal antimyosin uptake was seen in 12 (70%) of the 17 patients with cardiomyopathy and in only 1 (8%) of the 12 control patients. Positive monoclonal antimyosin antibody studies are highly prevalent in chronic idiopathic dilated cardiomyopathy. PMID- 2703612 TI - Noninvasive evaluation of global left ventricular function with use of cine nuclear magnetic resonance. AB - Previous reports have validated the accuracy of nuclear magnetic resonance (NMR) imaging for quantitating ventricular volumes and myocardial mass. In this study, a new rapid NMR imaging method, cine NMR imaging, was used to compare left ventricular volumes determined from the transverse plane and short-axis plane in healthy volunteers and patients with dilated cardiomyopathy. With use of the short-axis plane, left ventricular mass at end-systole and end-diastole were determined and left ventricular systolic wall thickening at three different levels was assessed. For validation in the current study, cine NMR imaging and two-dimensional echocardiographic measurements of left ventricular volumes were correlated. Left ventricular volumes of the normal volunteers (end-systolic volume = 34 +/- 3.8 ml, end-diastolic volume = 90.4 +/- 7.2 ml) and patients with cardiomyopathy (end-systolic volume = 173 +/- 28.3 ml, end-diastolic volume = 219.5 +/- 29.6 ml) obtained in the transverse plane were nearly identical to those obtained in the short-axis plane (normal volunteers, end-systolic volume = 30.3 +/- 3.5 ml, end-diastolic volume = 84.7 +/- 7.0 ml and patients with cardiomyopathy, end-systolic volume = 179.1 +/- 27.8 ml, end-diastolic volume = 227 +/- 30.9 ml) and correlated highly (r = 0.91) with volumes obtained by two dimensional echocardiography. Assessment of left ventricular mass over a broad range using cine NMR imaging in a short-axis plane was identical at end-systole (normal volunteers, 117 +/- 10 g; patients with cardiomyopathy, 202 +/- 20 g) and end-diastole (normal volunteers, 115 +/- 10 g; patients with cardiomyopathy, 194 +/- 21 g).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703613 TI - Relation between myocardial thallium-201 kinetics during exercise and quantitative coronary angiography in patients with one vessel coronary artery disease. AB - This study examined the relation between the kinetics of thallium-201 and coronary stenosis in 30 patients with one vessel coronary artery disease; 25 patients had no visible collateral vessels. The myocardial thallium concentration in the postexercise images and percent washout were determined in the distribution of the diseased vessel and a normal vessel, and each was expressed as a ratio. Coronary stenosis was assessed as minimal diameter stenosis, minimal area stenosis and percent diameter stenosis. The correlations between the myocardial concentration ratio or washout ratio and the descriptors of coronary stenosis improved when the patients with collateral vessels were excluded. There were significant correlations between the myocardial thallium concentration ratio and minimal diameter stenosis (r = 0.73, p less than 0.001), minimal area stenosis (r = 0.72, p less than 0.001) and, to a lesser degree, percent diameter stenosis (r = -0.51, p less than 0.01). Similarly, there were significant correlations between washout ratio and minimal diameter stenosis (r = 0.50, p less than 0.01) and minimal area stenosis (r = 0.45, p less than 0.02) but not percent diameter stenosis (r = 0.37, p = 0.06). Thus, variation in thallium kinetics in relation to the severity of coronary stenosis can be demonstrated with conventional imaging in patients with one vessel disease. The myocardial thallium concentration and washout are physiologic expressions of the severity of perfusion deficit and are dependent on collateral flow. The myocardial thallium concentration ratio and washout ratio correlate better with minimal diameter and area stenosis than with percent diameter stenosis. PMID- 2703614 TI - Reliability of the Doppler pressure half-time method for assessing effects of percutaneous mitral balloon valvuloplasty. AB - The mitral valve areas determined by Doppler pressure half-time and by cardiac catheterization with use of the Gorlin formula were compared in 18 adult patients who underwent percutaneous mitral balloon valvuloplasty. Doppler measurements and catheterization were performed simultaneously before, immediately after and 24 to 48 h after valvuloplasty. A high correlation between Doppler- and catheterization derived mitral valve areas was found before mitral valvuloplasty (r = 0.81, Y = 0.88X + 0.1, SEE = 0.11 cm2) and 24 to 48 h after valvuloplasty (r = 0.84, Y = 0.70X + 0.67, SEE = 0.20 cm2). In contrast, the correlation immediately after valvuloplasty was only moderate (r = 0.72, Y = 0.43X + 1.1, SEE = 0.49 cm2). The Doppler-derived mitral valve area (2.41 +/- 0.61 cm2) immediately after valvuloplasty was significantly larger than the catheterization-derived area (2.08 +/- 0.39 cm2, p less than 0.05). In conclusion, the Doppler echocardiographic measurement performed with the pressure half-time method may lead to significant error immediately after mitral balloon valvuloplasty, but clinically accurate measurement can be obtained 24 to 48 h after valvuloplasty. PMID- 2703615 TI - Two-dimensional and Doppler echocardiographic assessment of neonatal arterial repair for transposition of the great arteries. AB - The arterial switch procedure has become an accepted reparative technique for transposition of the great arteries with or without ventricular septal defect. In this study the accuracy of prospective noninvasive imaging in detecting arterial tract obstruction and the prevalence and severity of arterial valvular regurgitation (as assessed by Doppler ultrasound) were evaluated in survivors of arterial repair. All 53 study patients underwent two-dimensional echocardiographic examination 2 days to 20 months (median 7 months) postoperatively; 43 patients also had pulsed and continuous wave Doppler studies. The accuracy of the noninvasive evaluation of arterial tract obstruction was determined by comparison of Doppler maximal instantaneous gradients with peak to peak gradients at nonsimultaneous catheterization in 26 patients. Twenty-one (81%) of the 26 patients underwent catheterization and successful pulsed and continuous wave Doppler examination of the right heart; 17 (81%) of these 21 had a maximal pressure gradient within 20 mm Hg of the peak to peak gradient obtained at catheterization. Echocardiographic identification of the stenotic site was correct in all eight of the patients in this group requiring reoperation. Twenty three (88%) of the 26 patients who underwent catheterization had successful Doppler interrogation of the aortic tract; 22 (96%) of these 23 had a maximal instantaneous gradient within 20 mm Hg of the peak to peak catheterization gradient. Fourteen (32%) of 43 patients had mild or moderate pulmonary regurgitation by Doppler study. Three (7%) of the 43 had mild aortic regurgitation. PMID- 2703616 TI - Long-term outcome with the automatic implantable cardioverter-defibrillator. AB - The automatic implantable cardioverter-defibrillator was implanted in 270 patients because of life-threatening arrhythmias over a 7 year period. There was a history of sustained ventricular tachycardia or fibrillation, or both, in 96% of these patients, 80% had one or more prior cardiac arrests and 78% had coronary artery disease as their underlying diagnosis. The average ejection fraction was 34%, and 96% of these patients had had an average of 3.4 antiarrhythmic drug failures per patient before defibrillator implantation. There were four perioperative deaths and eight patients had generator infection or generator erosion, or both, during the perioperative period or during long-term follow-up. Concomitant antiarrhythmic drug therapy was given to 69% of patients. Shocks from the device were given to 58% of patients. and 20% received "problematic" shocks. The device was removed from 16 patients during long-term follow-up for a variety of reasons. There were 7 sudden cardiac deaths and 30 nonsudden cardiac deaths, 18 of which were secondary to congestive heart failure. The actuarial incidence of sudden death, total cardiac death and total mortality from all causes was 1%, 7% and 8%, respectively, at 1 year, and 4%, 24% and 26% at 5 years. The automatic implantable cardioverter-defibrillator nearly eliminates sudden death over a long term follow-up period in a high risk group of patients. It has an acceptable rate of complications or problems, or both, and most late deaths in these patients are nonsudden and of cardiovascular origin. PMID- 2703617 TI - A prospective, randomized evaluation of effect of ventricular fibrillation duration on defibrillation thresholds in humans. AB - The effect of ventricular fibrillation duration in humans on defibrillation efficacy as it pertains to the time of intervention of an automatic implantable defibrillator is unknown. If a difference in defibrillation efficacy exists in the early period after ventricular fibrillation onset, it may affect algorithms used by antiarrhythmic devices for arrhythmia detection and therapy. Therefore, a prospective, randomized evaluation was performed of the effect of ventricular fibrillation durations of 10 s and 20 s on defibrillation thresholds in 10 survivors of sudden cardiac arrest undergoing implantation of an automatic cardioverter defibrillator. The initial duration of ventricular fibrillation was chosen randomly. Subsequently, each patient served as his or her own control for the alternate duration of ventricular fibrillation to that chosen initially. The mean leading edge defibrillation threshold voltage was 411 +/- 114 V when ventricular fibrillation persisted for 10 s and 419 +/- 125 V when it persisted for 20 s (p = 0.73). The mean defibrillation threshold current was 11.4 +/- 2.8 A when ventricular fibrillation persisted for 10 s and 11.4 +/- 3.2 A when it persisted for 20 s (p = 0.97). The delivered energy defibrillation threshold was 11.5 +/- 5.9 J when ventricular fibrillation persisted for 10 s and 12.0 +/- 6.9 J when it persisted for 20 s (p = 0.67). These findings show that the defibrillation threshold does not change between 10 and 20 s of ventricular fibrillation in out-of-hospital survivors of cardiac arrest at the time of surgical implantation of an automatic defibrillator. The data may have influence on the programming of defibrillator detection algorithms. PMID- 2703618 TI - Surgical ablative therapy for life-threatening ventricular tachyarrhythmias: an evolutionary process. PMID- 2703620 TI - Another measurement of cardiac output: is it truly needed? PMID- 2703619 TI - Instantaneous and continuous cardiac output obtained with a Doppler pulmonary artery catheter. AB - A newly developed, flow-directed, Doppler pulmonary artery catheter, capable of measuring instantaneous and continuous cardiac output, was evaluated in both an in vitro pump model and an animal model. Quantitative flow was calculated with use of the instantaneous, space-average velocity (obtained from the velocity profile) and the instantaneous area (obtained from the vessel diameter) and compared with electromagnetic flow. Additionally, simultaneous thermodilution flow measurements were obtained. Doppler catheter-determined flow was highly predictive of electromagnetic flow in both continuous and pulsatile pump models (r2 = 0.98, slope or m = 1.04, SEE = 0.44; and r2 = 0.97, m = 1.04 and SEE = 0.33, respectively). Thermodilution was less predictive and appeared to underestimate electromagnetic flow in both the continuous and the pulsatile model (r2 = 0.99, m = 0.91, SEE = 0.20 and r2 = 0.95, m = 0.84 and SEE = 0.34, respectively). In the animal model, Doppler catheter-determined cardiac output appeared to modestly underestimate electromagnetic flow (r2 = 0.80, m = 0.87, SEE = 0.61). However, Doppler determinations of flow remained more accurate than did simultaneous thermodilution measurements (r2 = 0.73, m = 0.79, SEE = 0.72). Accurate, continuous and instantaneous cardiac output measurements appear possible with use of a flow-directed, Doppler pulmonary artery catheter. This catheter system also provides instantaneous diameter measurements and mapping of instantaneous velocity profiles within the main pulmonary artery and may lead to more accurate Doppler-derived assessment of cardiac output in humans. PMID- 2703621 TI - Chordal geometry determines the shape and extent of systolic anterior mitral motion: in vitro studies. AB - In patients with hypertrophic cardiomyopathy, the mitral valve moves anteriorly and assumes a unique shape, with mitral-septal contact centrally and preserved valve orifice area laterally. This shape is not clearly predicted by the Venturi mechanism, which stresses flow above the valve as opposed to changes intrinsic to the valve. On the other hand, it has been suggested that displacement of the papillary muscles anteriorly and toward one another, as observed in this disease, can promote anterior mitral valve motion and produce this unusual shape. The purpose of this in vitro study was to test the hypotheses that anterior motion of a membrane in a flow field can be generated by altering the distribution or effectiveness of chordal tension tethering the membrane, and that the shape achieved by this membrane depends on the geometry of chordal tension. Accordingly, a horizontal leaflet mounted in a flow chamber was attached by chords at its distal end to a series of upstream screws. Chordal tension could be varied by turning the screws or redirected by shifting the screws anteriorly. Anterior leaflet motion having the same unusual configuration seen in patients was reproduced by decreasing central chordal restraint while tension on the leaflet edges was maintained. Directing chordal tension anteriorly caused greater degrees of anterior motion at earlier stages in the release of chordal restraint; increased flow rate had a similar but less marked effect. These studies suggest that primary geometric alterations in the papillary-mitral apparatus can play an important role in determining the presence and geometry of systolic anterior mitral motion. The nature of these alterations suggests a role for anterior and inward papillary muscle displacement in promoting such motion. The geometric factors embodied in this model can explain many observed features of this motion not adequately explained by the Venturi effect, such as early systolic onset and the importance of a distal residual leaflet. Finally, flow visualization studies emphasize the importance in this process of drag forces caused by interposing the leaflet into the flow stream, and of geometric factors that enhance such forces. PMID- 2703622 TI - Applied kinesiology--what does the term mean? PMID- 2703623 TI - Very-low-calorie diets and exercise training: effect on lean tissue. PMID- 2703624 TI - Risk taking isn't risky like it used to be. PMID- 2703625 TI - Productivity of the clinical dietitian: measurement by a regression model. AB - Productivity of 283 clinical dietitians employed in 40-bed to 1,200-bed medical centers and community and general hospitals nationwide was measured from a survey. Stepwise multiple linear regression statistical analyses were used to analyze data. Five measures of productivity were developed; hours in non-patient care divided by total hours worked and the activity level in activities nonproductive in relation to the job description activities produced the better models for measuring productivity of the clinical dietitian. Activity levels measured in the study showed high-level task activities (consuming a large amount of work time) were conducting individual diet instructions, conducting nutrition assessments, reviewing and recording in medical records, and supervising support personnel. Taking anthropometric measurements, participating in medical rounds, attending professional conferences, and purchasing and dispensing specialized products were found to be low-level task activities (consuming little work time). The average amount of time spent on the job per week was 42.7 hours with a mean of 20.4 hours spent in direct patient care, 13.6 hours in indirect patient care, and 7.3 hours in nonpatient care. PMID- 2703626 TI - Energy need for weight maintenance in human beings: effect of body size and composition. AB - We estimated energy requirement by determining the amount of food needed to maintain body weight in a controlled environment. In a study of 28 adolescents and adults of widely varying weight and body fat content, we found that the energy required for weight maintenance was directly proportional to body weight (r = 0.92). The increased energy requirement of the obese is due in part to their larger lean weight and in part to their greater burden of body fat; together these account for 87% of the variance. For these subjects, who were engaged in light physical activity, the ratio of total energy to basal metabolic rate was 1.52 +/- 0.16 (SD). PMID- 2703627 TI - Determinants of attitude toward death by students enrolled in coordinated undergraduate dietetic programs. AB - Data on personal exposure, clinical experience, and educational preparation for dealing with death and dying were collected from 599 student dietitians from 43 coordinated undergraduate dietetic programs. Attitude toward death score was derived from a 15-item modified version of Coolbeth and Sullivan's Death Attitude Questionnaire. Mean score were analyzed using analysis of variance. Scores for all groups (means ranged from 56.8 to 59.9) denoted a positive attitude. No significant differences attributable to the effects of clinical experience (mean = 56.8) or to the interaction of factors were evident. Statistically significant (p less than .05) differences in attitude as a result of personal exposure (mean = 58.1) and educational preparation (mean = 57.8) were noted. Overall, findings of this study suggest that dietetic programs should seek to incorporate death education in curriculums to prepare students to provide emotional support to dying patients and grieving families. PMID- 2703628 TI - Use of a consultant to assist a dietetic association in its media and public relations efforts. AB - During 1987, the Philadelphia Dietetic Association (PDA) enlisted the aid of a public relations consultant to increase media contacts and thereby accomplish a threefold goal of (a) establishing the dietetic association and its registered dietitian members as the local nutrition experts; (b) distributing reliable, current nutrition information; and (c) marketing the PDA's DIAL-A-DIETITIAN service. Through the advice of the consultant, a media tipsheet, published monthly, was created. This publication, the Nutrition Informationist, effectively increased media contacts from two in 1986 to 19 in 1987 and resulted in a total of 8 hours of air time. Weight reduction, fad diets, and sports nutrition proved to be the most popular topics. Public service announcements (PSAs) concerning the DIAL-A-DIETITIAN program were developed by the consultant to assist the public in gaining access to local registered dietitians. Calls to that service increased 75% (from an average of 47.5 to 83.0 calls) the month following the distribution of PSAs to radio stations. The positive outcome of this collaborative effort shows that public relations consultants can be a useful resource for local dietetic associations, aiding them in their efforts to reach the media and the public and to improve their image. PMID- 2703629 TI - Development of a productivity index to increase accountability of ambulatory nutrition services. AB - The development of a system to assess the productivity of ambulatory nutrition services presented many challenges, including variations in provider settings and in the record-keeping techniques of ambulatory nutrition personnel. A model to measure the productivity of ambulatory nutrition specialists at a large urban teaching hospital was devised and was defined by the following equation: Patient/time productivity index = [(extended visits X 2) + (brief visits X 1) + (weigh-ins X 0.5) + (telephone consults X 0.25) + (group class census X 0.25)] divided by number of hours worked. Information obtained from this productivity measurement has been used to evaluate and improve patient scheduling and the organization of functions in various ambulatory nutrition settings. A productivity award based on the productivity index and distributed monthly has provided an incentive for all ambulatory nutrition specialists to streamline operations and maximize efficiency. The patient/time productivity index has been incorporated into performance reviews of ambulatory nutrition specialists as an objective measure of compliance with expectations. When used in conjunction with quality assurance techniques such as chart audits and patient satisfaction questionnaires, the patient/time productivity index can be a useful tool for management to maximize the quality and efficiency of ambulatory nutrition services. PMID- 2703630 TI - A multifactorial weight control program in a corporate setting. AB - Behavior modification, nutrition education, and exercise were the chief characteristics of an 8-week weight management program implemented in a corporate setting. Emphasis was placed on participants identifying needs and making their own behavior changes. Results indicated that this was a favorable approach. Male participants averaged a weight decrease of 12.4 lb (5.5 kg) and a decrease of 1.4% total body fat per person over an 8-week period. Female participants averaged a weight loss of 4.1 lb (1.9 kg) and a 3.9% decrease in total body fat per person. A survey completed by participants at the end of the 8-week period showed that they found behavior modification, nutrition education, and exercise all to be beneficial components of the weight management program and believed that the self-directed changes would be easy to continue. Regular aerobic exercise, recording food intake, and counting calories were rated by the participants as the three behavior practices most frequently used to aid in weight loss. PMID- 2703631 TI - Core, secondary, and peripheral foods in the diets of Hispanic, Navajo, and Jemez Indian children. AB - Our results show the importance of a number of regional foods and suggest some differences in the dietary patterns of three ethnic groups in the same region. Dietitians and nutritionists should be aware of the rich ethnic diversity of dietary patterns and use this knowledge in nutrition counseling, program planning, and nutrition education. PMID- 2703632 TI - Social marketing of nutrition education to cardiac patients in acute care. PMID- 2703633 TI - Nutrition education at the work site: a team approach. PMID- 2703634 TI - Targeting messages to supplement users. PMID- 2703635 TI - Following up on a commercial weight loss program: do the pounds stay off after your picture has been in the newspaper? PMID- 2703636 TI - Efficacy of graduate education in dietetics: influence of role delineation. PMID- 2703637 TI - Protein malnutrition in elderly Navajo patients. AB - In an examination of Navajo elderly inpatients and outpatients, high rates of protein undernutrition (despite normal caloric stores) were found to be prevalent. The protein malnutrition was present in each of several measures used, covering structural as well as visceral protein. It was more common in males, inpatients, and the aged elderly, but excess rates of undernutrition were found in all groups examined. These rates were higher than those in any comparable group reported to date. With multiple regression analysis, length of stay in the hospital is shown to be related to this undernutrition among inpatients studied. PMID- 2703638 TI - Effectiveness of influenza vaccine when given during an outbreak of influenza A/H3N2 in a nursing home. AB - An explosive outbreak of influenza A/H3N2 began in a nursing home in the Denver area early in November, 1987. Residents had not been vaccinated at that time. Vaccine was administered on November 11th. Two weeks after the vaccine was given, the attack rate differed between the vaccinated and unvaccinated individuals. There were 40 cases of influenza among the 98 elderly residents, 12 cases of pneumonia, and seven deaths. Vaccine efficacy two weeks after it was given was estimated to be 65.4% in preventing clinical illness. There were no cases of pneumonia and no deaths among people who were vaccinated more than two weeks before. The virus was identified as influenza A by complement fixation tests with convalescent sera from 16 individuals who had been ill. Many also had hemagglutination inhibition titers for A/Colorado/1/87, which were as high as titers for A/Leningrad/87. A/Colorado/1/87 closely resembled A/Sichuan/87. PMID- 2703639 TI - Treatment of osteoporosis. The psychological impact of a medical education program on older patients. AB - Participants in a therapeutic program for osteoporosis were studied to determine if program participation improved psychological outcomes. The 4-day program included intensive education about the disease and its prognosis, physical therapy education, nutritional counseling, and medical evaluation and treatment. All therapeutic patients enrolled in the program over a one-year period (N = 38) were interviewed individually pre- and post-participation. Knowledge of osteoporosis, level of social support, coping styles, and perceptions of the impact of pain and chronicity were assessed. Patients reported improved future outlook despite continued concern about pain and chronicity. Mention of depression was reduced, and knowledge of osteoporosis increased significantly. In addition, there were meaningful changes in patients' understanding of disease management. These included knowing when to make specific changes and avoid harmful actions. The findings suggest that an educational program can have a positive impact on patients' coping. Educational efforts may be an important component in the management of chronic disease. PMID- 2703640 TI - The value of Holter monitoring in evaluating the elderly patient who falls. AB - Ambulatory cardiac (Holter) monitoring is often recommended in the routine evaluation of patients who fall; however, the prevalence of arrhythmias in old people is high, and the usefulness of such monitoring is unproven. As part of a large study of institutionalized elderly fallers, we compared Holter findings of fallers (N = 51) with a group of nonfallers (N = 27) having similar medical and demographic characteristics. Prevalence of ventricular arrhythmias was 82% in each group, and all patients had supraventricular arrhythmias. The mean number of ventricular and supraventricular couplets and runs did not differ between groups. There was no difference in severity of arrhythmias between fallers and nonfallers; in fact, fallers had slightly fewer Lown 4B arrhythmias than nonfallers (10% vs 18%, NS). Prevalence of heart disease was 78% in both groups and was associated with increased ventricular ectopy in the form of runs and couplets (P less than .05). No symptoms were reported during the Holter monitoring. We conclude that Holter monitoring should not be a routine part of the work-up of the patient who falls. PMID- 2703641 TI - Cutaneous-delayed hypersensitivity in nursing home and geriatric clinic patients. Implications for the tuberculin test. AB - Cutaneous-delayed hypersensitivity was studied by one and two-step Mantoux-type skin tests to four standard antigens in 33 elderly nursing home residents, 34 geriatric clinic patients, and 20 healthy young adult controls. Demographic and anthropometric data were collected to determine the effects of nutrition and other variables on cutaneous-delayed hypersensitivity. Anergy (a lack of response greater than 5 mm of induration when read at 48 hours) to any of the four antigens occurred in 34% of nursing home residents, 17% of geriatric clinic patients, and none of the healthy young adults. Mean and maximal responses were less in the nursing home residents than the clinic patients or controls, even if anergic individuals were excluded from analysis, suggesting both a qualitative and quantitative decline in cell-mediated immune function in this elderly population. Repeat testing with each antigen for which there was a negative initial response revealed a "booster" affect of 7 to 19% and occurred as commonly in the healthy young adults as in the nursing home residents or geriatric clinic patients. The mumps antigen elicited strong responses in the healthy young adults, but weak reactions in the nursing home residents. An unexpectedly high prevalence of positive tuberculin (PPD) responses occurred in the nursing home residents, suggesting recent exposure. Analysis of anthropometric and demographic characteristics show that neither nutritional status nor age alone can account for differences in cutaneous-delayed hypersensitivity observed between populations. Cutaneous-delayed hypersensitivity may vary widely between elderly populations and have important practical implications for the tuberculin test. PMID- 2703642 TI - Effect of timing and number of baseline blood pressure determinations on postural blood pressure response. AB - We hypothesized that the blood pressure response to standing may depend on the method of establishing baseline blood pressure. Three hundred elderly subjects previously completed a postural blood pressure protocol with three supine baseline blood pressure readings obtained two minutes apart prior to standing. Comparison of the readings showed a significant drop between the first and the second (P less than .001) but not between the second and third supine systolic blood pressures. The difference between the first supine systolic blood pressure and the one minute standing blood pressure was significantly greater than that between the third supine systolic blood pressure and the one minute standing blood pressure (P less than .001). A second group was prospectively studied to determine whether the change in blood pressure after standing was greater if only a single baseline reading was taken rather than multiple readings, and whether the decline in blood pressure over three readings was related to duration supine or to the number of blood pressures taken. This group also demonstrated a decline in systolic blood pressure with three serial readings. We conclude that supine blood pressure declines significantly between the first and second readings taken two minutes apart and is secondary to the repetition of readings and not the duration supine. However, this change in supine blood pressure does not significantly alter the blood pressure response to standing. Thus, it appears that a single baseline supine blood pressure measurement is adequate for determining the postural blood pressure response, and that pooling of multiple baseline readings may not be appropriate. PMID- 2703643 TI - Abrupt recognition of age-related physical changes in appearance following cataract surgery. A case report. PMID- 2703644 TI - Respiratory depression requiring ventilatory support following 0.5 mg of triazolam. PMID- 2703645 TI - Are Alzheimer patients healthier than others? PMID- 2703646 TI - More on the toxicity of iodinated glycerol. PMID- 2703647 TI - CPR in the nursing home: a delusion? PMID- 2703648 TI - Facilitating transfer to a nursing home. PMID- 2703649 TI - Is the hearing-impairment/dementia relationship impaired? PMID- 2703650 TI - Functional assessment in the office. PMID- 2703651 TI - Portable tonometers: a clinical comparison of applanation and indentation devices. AB - Optometric services to outpatient clinics, nursing homes and hospitals require portable equipment for ocular assessment. Of the various tonometric methods available, Goldmann applanation tonometry remains the standard. We present a clinical comparison of the hand-held version of Goldmann's instrument (Perkins tonometer) and the less expensive Schiotz tonometer. In a clinical comparison, we measured the intraocular pressure (IOP) of 51 inpatient and outpatient veterans (100 eyes) during routine examination. In each case the Perkins applanation tonometer was used first. This measurement was followed by IOP measurements using the Schiotz indentation tonometer with the 7.5 g and 5.5 g plunger loads. Plunger loads were alternated so that each was used, initially, 50% of the time. Good correlations, ranging from +.85 to +.68, were achieved between the applanation and indentation modes. Compact portability, lower cost and comparable reliability make the Schiotz tonometer a viable option for IOP screening. PMID- 2703652 TI - Clinical comparison of the TruVision Omni and four progressive addition lenses. AB - The TruVision Omni is a progressive addition lens (PAL) using a bipolar design and the Dirichlet principle to minimize optical aberrations. The design was evaluated by having each patient elect to keep one lens type after masked paired comparison of the TruVision Omni with one of four other PAL types: VIP, Varilux, New Super NoLine, and Gradal HS. The Omni was chosen most frequently in each case: 16 to 8, 17 to 6, 18 to 6, and 15 to 3, respectively. Thirty-seven percent reported that no adaptation was required with the Omni compared to 20% for the paired PAL. In terms of specific performances, Omni tended to rank highest for intermediate distance functions and freedom from distortion, average for distance functions, and slightly above average for near function. The data support the merit of Omni's design strategy. PMID- 2703653 TI - Effects of ocular functioning and time upon reading proficiency. AB - We hypothesize that children with fusional and/or accommodative abnormalities will tend to tire more readily when reading than will children with normal vision and that, consequently, they will show a greater decrement in reading proficiency over time on a task requiring reading. Forty-five subjects who passed the New York State Optometric Association Vision Screening Battery and 32 who failed were given a "maze" reading test developed for the study. The abnormal vision group made significantly more errors than did the normal vision group on the reading test. The abnormal vision group also made progressively more errors than did the normal vision group at the end of each segment of the reading test. The differences, however, were not statistically significant. While the correlations between speed and accuracy reversed over time, the abnormal vision group began and ended at the most extreme levels, having undergone a significantly more radical shift in this regard. PMID- 2703654 TI - Bagolini lenses vs. PFL filters in the diagnosis of correspondence. AB - This study introduces a new product, the PFL-7501 filter (prism linear filter), as a test for correspondence. Thirty consecutive strabismic subjects were asked to verbally describe, then draw, the images seen from a small light source through the Bagolini #4 striated lenses and the PFL-7501 filters. A 97% concordance was found between the two materials. The bright, multicolored streaks seen through the PFL filters were easier for all subjects to see and describe than the images seen through the Bagolini striated lenses. PMID- 2703655 TI - Tax reform legislation and the formation of optometric group practices. AB - Tax reform legislation through 1987 was analyzed for its impact on whether a partnership form of group practice or a professional corporation form is more advantageous from a federal tax standpoint. The effect of new tax legislation on pension plan contributions and on the deductibility of fringe benefits is delineated and discussed. Several miscellaneous changes in the law affecting group practice modes are discussed. Even though the individual income tax rates are now slightly lower than the corporate income tax rates, there is still life left in the professional corporation form of group practice if the Subchapter S election is made. PMID- 2703656 TI - The educated clinician. PMID- 2703657 TI - Tumors metastatic to the eye. PMID- 2703658 TI - Hydrogen peroxide systems. PMID- 2703659 TI - Vision therapy and primary care. PMID- 2703660 TI - British optometry. PMID- 2703661 TI - Analysis of a community vision screening program. AB - For 3 consecutive years a community vision screening program has been conducted on-site at the Walker Eye Clinic of the Indiana University (IU) School of Optometry. A group of 490 screened patients, including 86 who returned for comprehensive evaluation, was retrospectively studied for a variety of characteristics. It was determined that the typical participant was likely to be an adult female who learned of the screening program through the written media. She was likely to have had a previous vision examination but it probably took place 3 or more years earlier. She usually failed the vision screening for reasons of reduced visual acuity, a problem with binocularity or asthenopia. If she returned to the Walker Eye Clinic for a comprehensive examination, she was likely to do so within 5 months and would be found to have been accurately identified as being in need of vision care. The organization and implementation of this vision screening program are described, and its value as an educational tool for students of optometry and its technician program is discussed. PMID- 2703662 TI - Evaluating the optometric literature: the educated clinician. AB - The purpose of this article is to present a framework for reader evaluation of optometric literature. The elements of a research article are outlined. Suggestions are presented that clinicians can use to develop competence in evaluating research literature. Also presented is an annotated bibliography of research references. Better patient care and increased professional growth will result when clinicians evaluate and make use of the research literature. PMID- 2703663 TI - Surgical management of spastic thumb-in-palm deformity in adults with brain injury. AB - Spastic thumb-in-palm deformity was surgically treated in 27 adults with brain injury. Procedures included muscle lengthening, recession, or release, arthrodesis of the thumb interphalangeal joint, or Z-plasty of the thumb web space. At mean follow-up of 39 months, 23 of 27 had a satisfactory correction. Unsatisfactory results included two with inadequate correction and two with over correction. Surgical treatment of this entity requires careful preoperative planning, addressing predominantly those spastic muscles responsible for the deformity. PMID- 2703664 TI - Ulnar neuropathy at the elbow: results of medial epicondylectomy. AB - Retrospective analysis of 48 medial epicondylectomy procedures in 46 patients demonstrated that symptomatic and objective improvement was usual. Most patients experienced improvement of symptoms (98%) and moving two-point discrimination (87%), and many demonstrated improved motor strength (54%). By use of the McGowan scheme for grading ulnar neuropathy, 92% of the patients with grade I neuropathy had a return to normal function. Subdividing patients with grade II neuropathy into grade IIA and IIB on the basis of the extent of motor compromise was useful in predicting postoperative outcome. Forty-five percent of the patients with grade IIA neuropathy had a return to normal ulnar nerve function and only 11% (one patient) in the IIB group had a full recovery. In the group with grade III neuropathy, one patient had improvement to grade II level and the other five remained grade III. No patient in this study demonstrated deterioration of his McGown grade. Medial epicondylectomy is a safe and predictable procedure for the treatment of symptomatic cubital tunnel syndrome. PMID- 2703665 TI - Provocative testing in the diagnosis of dynamic carpal tunnel syndrome. AB - This study measures the effects of provocative testing on a series of patients with latent symptoms of carpal tunnel syndrome. Forty patients were studied for change in hand volume and loss of sensibility after stress. Thirty-four patients demonstrated significant measurable increase in hand volume after a 7-minute stress test. In 17 of 34 patients impaired sensibility associated with swelling developed and they were considered to have dynamic carpal tunnel syndrome. Surgical treatment was effective in correcting symptoms and sensory defects in these 17 individuals despite postoperative hand swelling that continued after the operation when the hand was subjected to stress. PMID- 2703666 TI - Transection of radial digital nerve of the thumb during trigger release. AB - Iatrogenic laceration of the radial digital nerve of the thumb during trigger release occurred in four patients. Histologic cross sections through the thumb in cadaveric specimens at the level of the metacarpophalangeal crease showed the radial digital nerve to be 2.19 mm beneath the dermis and 1.15 mm directly anterior to the radial sesamoid bone. In this position the nerve is vulnerable to transection when it is trapped between the sesamoid and the knife blade. PMID- 2703667 TI - Boxer's knuckle--dorsal capsular rupture of the metacarpophalangeal joint of a finger. AB - An injury to the dorsal aspect of the metacarpophalangeal joint of a finger usually damages the sagittal fibers of the extensor tendon mechanism. Rupture of the underlying joint capsule, a far more serious injury, has received scant attention in the medical literature. The problem is often unrecognized because the extensor tendon may remain in its normal midline position. Eight dorsal capsular ruptures are described in six patients who had closed direct trauma to either the knuckle of their index or long fingers. Most of the injuries occurred in professional boxers. PMID- 2703668 TI - Stress fracture of the finger in a bowler. AB - A 28-year-old semiprofessional bowler was seen initially with pain in the right ring finger that was aggravated by bowling and relieved by rest. He had localized tenderness of the middle phalanx; x-ray films revealed a stress fracture. The fracture healed with restriction of activity and he was able to gradually resume bowling. Although rare, stress fracture should be considered in the differential diagnosis of finger pain in a patient with a history of overuse. PMID- 2703669 TI - Comparison of eleven external fixators for treatment of unstable wrist fractures. AB - We compared 11 external fixators for treatment of wrist fractures on the basis of rigidity, weight, cost, design characteristics, and provision for allowing wrist motion, and found important differences between them such as rigidity varying as much as 11 times. The Roger Anderson, Hanson Baylor Mini Hoffman, Rectangular Mini Hoffman, and Ace Colles external fixators are lightweight and have low rigidity. The C-series Hoffman unilateral frame and the A.O. have intermediate rigidity. The newly developed methylmethacrylate fixator, the regular Hoffman, the C-series Hoffman bilateral frame, and the Clyburn are more rigid. Although both the Clyburn and the Orthofix allow wrist flexion and extension, the Clyburn is lightweight and the Orthofix has the highest rigidity. These factors are analyzed and reported in a format that will guide the surgeon in the selection of an appropriate fixator for his patient with an unstable wrist fracture. PMID- 2703670 TI - Interposition of extensor digitorum tendon in distal radius fracture mimicking a compartment syndrome. AB - A 14-year-old boy sustained a dorsally displaced Salter-Harris Type II fracture of the distal radius. A single attempt at closed reduction failed. After this closed reduction, the patient was unable to passively or actively extend or flex his fingers. He had increasing pain and compartment pressures were abnormally elevated. Dorsal fasciotomy was done, and during the open reduction, entrapment of the dorsal extensor retinaculum and extensor digitorium communis within the fracture was found. After removal of these structures, fracture reduction was easily accomplished and his fingers had a full range of motion. Postoperative recovery was uneventful. PMID- 2703671 TI - An anatomic and mechanical study of the interosseous membrane of the forearm: pathomechanics of proximal migration of the radius. AB - The interosseous membrane of the forearm of 12 fresh cadaver specimens was studied anatomically and mechanically to better understand its role in stabilization of the radius after radial head excision. A central band of ligamentous tissue, approximately twice the thickness of the membrane on either side was identified in all specimens. Mechanical studies determined the relative contribution to longitudinal stiffness of the forearm. The central band was responsible for 71% of the longitudinal stiffness of the interosseous membrane after radial head excision. The contribution of the triangular fibrocartilage complex was 8%. Silicone radial head implants were much less stiff than the intact interosseous membrane. Injury to the central band of the interosseous membrane may be crucial to the development of proximal migration of the radius after radial head excision. PMID- 2703672 TI - Variations of the flexor digitorum superficialis of the small finger. AB - Normal functional variations of the flexor digitorum superficialis were clinically determined by use of the standard and modified superficialis flexion tests in 50 normal subjects. Forty hands of 20 cadavers were dissected to correlate the anatomic variations with the clinical findings. A flexor digitorum superficialis-independent pattern was found 58% of the time. A flexor digitorum superficialis-common pattern was found 21% of the time. A flexor digitorum superficialis-absent pattern was found 21% of the time. The right and left hands were asymmetric 26% of the time. All cadaver hands had a flexor digitorum superficialis tendon present in the palm and finger. The variability in flexor digitorum superficialis function may be explained by interconnections between the flexor digitorum superficialis of the small finger and either the flexor digitorum superficialis of the ring finger or the flexor digitorum profundus of the small finger. PMID- 2703673 TI - Surgical anatomy of the medial antebrachial cutaneous nerve. AB - In standard anatomy textbooks the course and distribution of the medial antebrachial cutaneous nerve and its branches are glossed over in a vague fashion as if they are of little importance. There are, however, clinical circumstances in which a knowledge of the anatomy of this nerve is invaluable. Sacrifice of the posterior branch in a medial approach to the elbow or cubital tunnel surgery can lead to annoying numbness over the olecranon and a symptomatic neuroma. The medial antebrachial cutaneous nerve is also frequently used in nerve grafting, especially in brachial plexus reconstruction, in which it is beneficial to know the available length and size of donor nerve. Fifty fresh cadaveric arms were dissected to define the course, distribution, size, and branches of the nerve. PMID- 2703674 TI - Radiographic definition of the dorsal and palmar edges of the distal radius. AB - The dorsal and palmar edges of the distal radius, as well as the concavity of the articular surface were labeled with wire and radiographs taken from neutral to 30 degrees of added dorsal tilt. The dorsal edge was identified as the structure that protrudes distally in neutral. The palmar edge was found to overlap with the sclerotic subchondral bone of the radius in neutral. With increasing dorsal tilt the profile of the palmar edge appeared as it protruded distal to the sclerotic subchondral line of the radius. The profile of the palmar edge could be distinguished from that of the dorsal edge on the anteroposterior view. The wire, which was placed midway between the dorsal and palmar edges and the concavity of the articular surface corresponded to the prominent sclerotic subchondral bone line of the distal radius. This did not change in position with increasing dorsal tilt. This clarification of the radiologic anatomy is helpful in extending the use of the anteroposterior radiograph for the interpretation of fractures and malunions of the distal radius. PMID- 2703675 TI - Stability of the transverse carpal arch: an experimental study. AB - The mechanical characteristics of the transverse carpal arch were studied using fresh-frozen human cadaveric wrists. Tensile properties of the ligaments involved in this structure were also analyzed. The flexor retinaculum did not prove to be a major factor in the maintenance of the carpal arch since its division only reduced the global transverse carpal arch stiffness an average of 7.5%. On the contrary, the transverse intercarpal ligaments connecting the bones of the distal carpal row were shown to have an essential role in providing stability to the carpal tunnel. PMID- 2703676 TI - The effects of simulated unstable scaphoid fractures on carpal motion. AB - The kinematics of five fresh frozen wrist specimens were studied before and after a simulated scaphoid waist fracture. To determine the change in wrist motion and fracture site characteristics associated with an unstable wrist, the relative motion of each carpal bone was determined from the movement of implanted carpal markers on biplanar radiographs obtained in neutral and the four extreme wrist positions. The kinematics of the wrist in our specimens before the osteotomy were similar to previous studies. After the osteotomy, the proximal and distal segments of the scaphoid moved independently. The distal scaphoid assumed a relatively flexed stance and displayed increased motion. The proximal scaphoid fragment and lunate assumed a relatively extended stance and displayed less motion after the osteotomy. These kinematic abnormalities produced significant interfragmentary motion that would be expected to complicate normal fracture healing. The spontaneous collapse of the two scaphoid fragments produced a dorsal angulation or "humpback" deformity that simulated the clinical situation of displaced scaphoid nonunions. The scaphoid serves an important role maintaining normal alignment of the carpal bones and producing normal wrist motion. PMID- 2703677 TI - Bilateral congenital hypoplasia of the carpal scaphoid bone. AB - A case of bilateral congenital scaphoid hypoplasia, with wasting of the thenar muscles and absence of certain muscles of the forearm is presented. The patient had additional congenital disorders of the vertebrae, skull and elbow. PMID- 2703678 TI - Kienbock's disease in a patient with Crohn's enteritis treated with corticosteroids. AB - In a patient with Crohn's enteritis treated with oral corticosteroids simultaneous Kienbock's disease and femoral head osteonecrosis developed 2 years after the administration of corticosteroids. The patient had no history of trauma or any other risk factor known to be associated with Kienbock's disease. This case suggests that corticosteroid administration may be an additional factor in the multifactorial causes of Kienbock's disease. PMID- 2703679 TI - Ulnar impingement syndrome after Darrach procedure: treatment by advancement lengthening osteotomy of the ulna. AB - The Darrach procedure was the standard treatment for painful disorders of the radioulnar joint for several decades. However, recent articles have described unsatisfactory results after this procedure including dorso-palmar instability of the ulna, clicking upon rotation of the forearm, ulnar translocation of the carpus, and a painful ulnar impingement syndrome. Management of these problems following an ulnar shortening procedure requires restoration of ulnar length to provide stability to the triangular fibrocartilage complex and ulnar sling mechanism. Also, recurrent impingement must be prevented. A technique of ulnar lengthening by advancement step osteotomy in conjunction with a "matched" resection of the advanced ulna is presented. Three case reports illustrate its use. PMID- 2703680 TI - Intravenous pyogenic granuloma of the hand. AB - Intravenous pyogenic granuloma is a recently described counterpart of cutaneous pyogenic granuloma. We report the second known case of this entity in the orthopedic and hand surgery literature and describe the characteristic clinical and histologic findings associated with this rare benign tumor. PMID- 2703681 TI - Longitudinal incision for trigger finger release. PMID- 2703682 TI - Fracture of hamate hook. PMID- 2703683 TI - Threshold, enzymatic, and pathologic changes associated with prolonged transcutaneous pacing in a chronic heart block model. AB - Previous studies have shown that 30 minutes of transcutaneous cardiac pacing (TCP) can induce mild, clinically insignificant myocardial damage. Longer use of TCP may cause more severe cardiac damage which might result in an increase in the capture threshold for subsequent transvenous cardiac pacing (TVP). To assess this possibility, we examined changes induced by TCP in a canine chronic heart block model. Heart block was induced in conditioned dogs (n = 8) by His bundle ablation. Seven to 10 days after induction of heart block, six animals were paced. Cardiac enzymes were drawn before pacing and at 4, 24, 48, and 72 hours after pacing. Although there was a significant rise in CK at 4 and 24 hours (P less than 0.05), there was no detectable rise in the MB fraction in any of the paced animals. There was no elevation of LDH after pacing, although three animals did develop an LDH1/LDH2 isoenzyme flip indicative of myocardial damage. Animals were sacrificed 72 hours after pacing and their hearts were examined for gross and microscopic changes. The hearts of the paced animals revealed subendocardial, subepicardial, and perivascular areas of basophilic degeneration involving less than 1% of the myocardium in four of six animals. No evidence of such damage was seen in two heart-blocked control animals not undergoing pacing. TVP and TCP capture thresholds assessed before and after a 60-minute TCP pacing period showed no significant change. Hence, use of TCP for a 60-minute period prior to TVP appears to be a safe emergency pacing technique. PMID- 2703684 TI - Acute pulmonary toxicity to nitrofurantoin. AB - Nitrofurantoin is a widely prescribed antibiotic used for the treatment of urinary tract infections. In some patients it can produce an acute pulmonary reaction ranging from mild dyspnea to noncardiogenic pulmonary edema. Symptoms include fever, dyspnea, chills, cough, and chest pain. Physical examination generally reveals an acutely ill, extremely apprehensive patient in varying degrees of respiratory distress. Fever is usually present and there is an increase in heart rate and respiratory rate. Cyanosis, rales, and a maculopapular rash are common findings. Laboratory studies typically demonstrate a leukocytosis with eosinophilia, varying degrees of hypoxia and hypocapnia, and a mild to moderate elevation of the erythrocyte sedimentation rate. The chest x-ray study may be normal but more often demonstrates bilateral lower lobe interstitial infiltrates frequently accompanied by pleural effusions. Treatment in the majority of cases requires only stopping the drug, but steroids, bronchodilators, or antihistamines may be used in selected cases. Once the diagnosis is made and the drug withdrawn, prognosis for full recovery is excellent. PMID- 2703685 TI - The inguinal hernia: not always straightforward, not always a hernia. AB - Swelling in the groin may represent much more than an inguinal hernia and an inguinal hernia may be much more complicated than it seems upon superficial consideration. Intraperitoneal or retroperitoneal hemorrhage as well as many other congenital, inflammatory, infectious, or neoplastic processes occurring either locally or at distance from the groin may present in the groin, simulating a hernia, or within an inguinal hernia sac itself. Delayed and spontaneous rupture of the spleen are not rare occurrences. The case discussed, an episode of delayed rupture of the spleen presenting as blood within an inguinal hernia sac, serves to emphasize that following a complete clinical evaluation many entities other than simple inguinal hernia must be considered if a thorough differential diagnosis of a groin mass is to be developed. PMID- 2703686 TI - Congenital giant hairy nevus: implications for treatment. AB - Congenital giant hairy nevi represent a special group of melanocytic lesions which generally cover large areas of the body surface. Giant hairy nevi assume special significance because of their predisposition to malignant transformation. Adequate treatment of this lesion involves complete surgical excision as early in the child's life as possible. PMID- 2703687 TI - A simple treatment of post-lumbar-puncture headache. AB - We report a case of post-lumbar-puncture headache successfully treated with intravenous caffeine sodium benzoate. The patient presented to the emergency department with a severe headache three days after a myelogram of the lumbar region. Caffeine sodium benzoate (500 mg) in 1 liter of fluid (D5LR) intravenously over one and a half hours was administered. The patient reported complete resolution of symptoms and no recurrence of headache. Caffeine sodium benzoate is a simple treatment of post-lumbar-puncture headaches. It should be considered as a safe alternative to an epidural blood patch for the treatment of post-lumbar-puncture headaches. PMID- 2703688 TI - Heterotopic pregnancy. AB - A 35-year-old woman presented to the emergency department with abdominal pain 36 hours after a therapeutic abortion. A positive pregnancy test was thought to be related to the recently terminated intrauterine gestation. The patient was admitted for observation. When monitoring revealed intraabdominal hemorrhage, exploratory surgery was performed and a ruptured tubal pregnancy discovered. The patient recovered uneventfully. The incidence, predisposing factors, and diagnosis of simultaneous intrauterine and extrauterine pregnancy are discussed. PMID- 2703689 TI - Hypotension, myocardial infarction, and coagulopathy following gila monster bite. AB - We report a 23-year-old man who developed life threatening hypotension, myocardial infarction, coagulopathy, and renal failure following the bite of a Gila monster (Heloderma suspectum). These are previously unreported complications in humans. The patient recovered after fluid resuscitation and treatment with pressor agents. PMID- 2703690 TI - Wolff-Parkinson-White syndrome: illustrative case and brief review. AB - The Wolff-Parkinson-White syndrome (WPWS) is a pre-excitation syndrome manifested on the 12-lead ECG by a short PR interval (less than .12 sec), a prolonged QRS interval (greater than .10 sec), and an initial slurring of the QRS complex called a delta wave. The anatomical etiology is the presence of accessory atrioventricular conduction fibers called the Kent bundle. Patients with the WPWS may present to the emergency department with a wide spectrum of symptoms, ranging from mild palpitations, to unstable tachydysrhythmias and sudden cardiac death. WPWS should be suspected in any patient presenting with a tachydysrhythmia with a rate exceeding 200/minute. Cardioversion is indicated in the unstable patient. It is impossible to predict the effect of any particular drug without prior electrophysiologic studies in a patient with WPWS. Procainamide is the safest drug for the stable WPWS patient with a tachydysrhythmia, including wide-complex and irregular rhythms. Verapamil is a useful drug in narrow-complex, regular rhythms, although complications have been reported. Atrial fibrillation may be difficult to diagnose in a very rapid tachycardia, and the use of verapamil in WPWS with atrial fibrillation is contraindicated. Electrophysiologic studies are indicated in the WPWS patient to maximize prophylactic therapy. An illustrative case as well as pathophysiology and management of WPWS are discussed. PMID- 2703691 TI - Is aeromedical transport of patients during acute myocardial infarction safe? AB - The emergence of coronary artery thrombolysis and angioplasty have raised new questions about the transfer of patients with acute myocardial infarction (AMI). Since these modalities are generally limited in their availability, and since the success of thrombolysis is strongly time-dependent, the interfacility transfer of patients during AMI has become more common. Study of a relatively small number of patients indicates that aeromedical helicopter transport can be conducted in a safe manner, and that the outcome of management is of benefit to the patients. Reperfusion events, however, must be anticipated during transport of patients in whom thrombolysis is initiated preflight. Furthermore, initiation of thrombolytic therapy may be problematic if begun in patients with events mimicking AMI, particularly aortic dissection or Prinzmetal's angina. PMID- 2703692 TI - External jugular venous access to the central circulation. PMID- 2703693 TI - In response to Dr. Pointer. PMID- 2703694 TI - Concerning ski equipment. PMID- 2703695 TI - Electron microscopic autoradiographic localization of prolactin mRNA in rat pituitary. AB - Recent immunoelectron microscopic studies have shown that immunoreactive prolactin (PRL) in rat pituitary can be detected not only in typical PRL cells, characterized by large secretory granules, but also in another type of cell, which contains small secretory granules. To determine whether or not these two cell types are involved in PRL biosynthesis, we developed a procedure to investigate PRL gene expression by using in situ hybridization at the ultrastructural level. Rat pituitary was fixed and vibratome sections were incubated with a PRL [35S]-cDNA probe and subsequently flat-embedded in Araldite. Semi-thin and ultra-thin sections were processed for autoradiography. The results indicate that only the two PRL cell types were labeled. When immunolabeling for PRL was applied to ultra-thin sections, only immunopositive cells were seen to contain silver grains. In these cells the silver grains were associated with the rough endoplasmic reticulum and nucleus. When a growth hormone (GH) [35S]-cDNA probe was used as a control, only GH-secreting cells were labeled. This study confirms that the two PRL cell types are involved in biosynthesis of PRL. Moreover, this simple in situ hybridization technique provides a new approach to accurately localize mRNA in complex tissue and to investigate the subcellular distribution of mRNA under differing experimental conditions. PMID- 2703696 TI - Electron spectroscopic imaging for high-resolution immunocytochemistry: use of boronated protein A. AB - In the present study we adapted electron spectroscopic imaging (ESI) for high resolution immunocytochemistry. To accomplish this, we applied boronated protein A (B-pA) for indirect detection of specific antigenic sites using pre-embedding and post-embedding protocols. Isolated acinar cells were exposed to wheat germ agglutinin (WGA) and anti-WGA, followed by B-pA, to reveal WGA binding sites at the level of the plasma membrane. The cells were then embedded in Epon and unstained ultra-thin sections were examined by electron microscopy using the ESI mode. For post-embedding, ultra-thin sections of glutaraldehyde-fixed, Lowicryl embedded pancreatic tissue were exposed to specific antibodies (anti-insulin or anti-amylase), followed by B-pA. The unstained sections were examined using the ESI mode. In both cases, boron was detected with high resolution either at the level of the plasma membrane of acinar cells, demonstrating WGA binding sites, or over secretory granules in pancreatic insulin-secreting cells or acinar cells, demonstrating insulin and amylase, respectively. These findings were compared to those obtained with the protein A-gold technique, and have demonstrated the analogy of both types of labeling. In addition, several control experiments assessed this novel approach. They have demonstrated the specificity of labeling and the high reactivity of B-pA, as well as its antibody-binding properties. Finally, electron energy loss spectral analysis confirmed the presence of boron in the tissue sections at sites where immunolabeling was detected. These results demonstrate that ESI is an appropriate approach for cytochemistry. Since the technique is based on detection of elements, spatial resolution is considered to be in the magnitude of 0.5 nm, which represents a major improvement in resolution over actual electron microscopic cytochemical techniques. PMID- 2703697 TI - Micro-PIGE determination of fluorine distribution in developing hamster tooth germs. AB - A micro-PIGE (Proton-Induced gamma-ray Emission) technique based on the delayed 5/2+----1/2+ nuclear transition of fluorine (E gamma = 197 keV, t1/2 = 87 ns) emitted after 19F(p,p', gamma)19F reaction was used to detect and study the distribution of fluorine in the developing enamel organ during pre-eruptive stages, i.e., the transitional to early maturation stages of enamel formation in neonatal hamsters administered a single IP dose of sodium fluoride (20 mg NaF/kg body weight). The aforementioned nuclear reaction is unique for fluorine, and therefore detection of gamma-rays emanating from this reaction in a biological specimen implies a positive identification of fluorine at that particular site. Calcium and phosphorus X-rays were also recorded and used as parameters for assessment of the relationship between the degree of mineralization and fluoride incorporation into the enamel organ. The highest fluorine concentration in the enamel organ was recorded in the dentin near the dentin-enamel junction (DEJ). In the enamel, the highest concentration of fluorine was found to be associated with the more mature areas of the enamel near the DEJ, but gradually decreased in the direction of the enamel surface. Fluorine was not detected in the control germs. These results suggest that administration of fluoride in high doses during the pre-eruptive stages of enamel formation leads to incorporation of the ion into the forming dentin and enamel mineral, and that the enamel matrix does not seem to bind fluoride avidly. PMID- 2703698 TI - Histochemical demonstration of neurotoxic esterase. AB - We developed a histochemical method for localizing neurotoxic esterase (NTE), defined as the phenylvalerate (PV)-hydrolyzing esterase that is resistant to 40 microM paraoxon (A) but inactivated by paraoxon plus 50 microM mipafox (B). NTE is considered to be the target enzyme in the production of organophosphorus ester induced delayed neurotoxicity (OPIDN). Cryostat sections were incubated in a medium containing alpha-naphthyl valerate and 6-benzamido-4-methoxy-m-toluidine diazonium chloride (fast violet B) after treatment with the above-mentioned inhibitors, leading to formation of an aqueous insoluble precipitate at sites of enzymatic activity. NTE activity was estimated as staining detectable in A but not in B. In the central nervous system (CNS) of chicken, NTE appeared to be present primarily in the somata of most neurons, but at sites indistinguishable from those of the other inhibitor-resistant and -sensitive alpha-naphthyl valerate-hydrolyzing esterases. It could not be distinguished in the CNS of cat, probably because it constitutes less than 3% of the total PV-hydrolyzing activity in the CNS of that species. PMID- 2703699 TI - Localization and cytophotometric analysis of cathepsin B activity in unfixed and undecalcified cryostat sections of whole rat knee joints. AB - Cathepsin B activity is demonstrated histochemically with a post-coupling method using Z-Arg-Arg-4-methoxy-2-naphthylamide as substrate and Fast Blue BB as coupling reagent in unfixed and undecalcified cryostat sections of whole rat knee joints. Sections were attached to transparent tape to keep the integrity of the tissue intact, such attachment being essential for precise precipitation of the final reaction product at sites of enzyme activity. Also essential was inclusion of polyvinyl alcohol in the enzyme incubation medium. High cathepsin B activity was found in osteoclasts, chondrocytes, fibroblasts, synovial cells, and bone marrow cells in knee joints after induction of arthritis. The final reaction product was precipitated as fine cytoplasmic granules probably corresponding to lysosomes. The reaction was specific because addition to the incubation medium of selective inhibitors of cathepsin B-like activity completely blocked the activity. The amount of final reaction product in synovium and in bone marrow cells was analyzed cytophotometrically. Specific formation of final reaction product was linear with incubation time up to 60 min at 37 degrees C and with section thickness up to 12 microns. Variation of the substrate concentration in the incubation medium revealed a KM value of 1.86 +/- 0.36 mM in synovial cells and 2.48 +/- 0.51 mM in bone marrow cells and Vmax values (expressed as mean integrated absorbance) of 1.18 +/- 0.10 in synovial cells and 1.02 +/- 0.11 in bone marrow cells. Both KM and Vmax values were significantly different in synovial cells and bone marrow cells (p less than 0.01) which could be owing to the presence of different isoenzymes in these tissues. We conclude that the described post-coupling method is sufficient to yield precise localization and that the method is valid for quantitative purposes. PMID- 2703700 TI - Localization of prolactin-like immunoreactivity in grafted human sweat glands. AB - Using a double-antibody immunoperoxidase technique, we demonstrated human prolactin-like material in some cells of the secretory coil and in luminal duct cells of sweat glands of human skin which had been carried as grafts on mice for 32-35 weeks. It therefore seems likely that a population of cells in the secretory coil synthesizes prolactin and can be considered as diffuse peripheral endocrine cells. The prolactin may function locally to regulate sweat electrolyte concentration. PMID- 2703701 TI - Histochemical characterization of neuronal NADPH-diaphorase. AB - We examined the properties of neuronal NADPH-diaphorase in sections of rat striatum, using histochemical procedures. NADPH-diaphorase histochemistry stained discrete populations of central neurons and provided a Golgi-like image of the neurons exhibiting this activity. The NADPH-diaphorase reaction appeared to be enzyme catalyzed, since it was abolished by pre-treatment with proteases, heat, and acid or alkaline denaturation. Under anaerobic conditions, any tetrazolium salt with a redox potential more positive than NADPH could be reduced by the enzyme. NADPH-diaphorase activity was sensitive to inhibition by sulfhydryl reagents but was unaffected by metal chelators, superoxide dismutase, and catalase. Therefore, the enzyme is unlikely to be a metalloenzyme or to reduce tetrazoliums by producing superoxide anions or hydrogen peroxide. Various analogues of beta-NADPH could be used by the enzyme; however, beta-NADH, which can be used by DT-diaphorase, was ineffective. The enzyme was also resistant to dicumarol, an inhibitor of DT-diaphorase activity. Electron microscopy indicated that the NADPH-diaphorase reaction resulted in staining of various membranous organelles. We conclude that neuronal NADPH-diaphorase is a membrane-bound enzyme distinct from DT-diaphorase and other known enzymes with diaphorase activity. The histochemical characteristics presented here should now enable meaningful biochemical studies of neuronal NADPH-diaphorase to be undertaken. PMID- 2703702 TI - Immunogold labeling of luciferase in the luminous bacterium Vibrio harveyi after fast-freeze fixation and different freeze-substitution and embedding procedures. AB - We studied the ultrastructural localization of luciferase on sections of the bioluminescent bacterium Vibrio harveyi by indirect immunogold staining, using a polyclonal antiluciferase antibody and the usual control tests, after chemical fixation or fast-freeze fixation (FFF) followed by different freeze-substitution (FS) procedures and embedding in either Epon or LR White. After liquid fixation with glutaraldehyde and paraformaldehyde and LR White embedding, labeling occurred over the cytoplasm but not over the condensed nucleoid. Epon embedding almost abolished it. FFF-FS considerably improved the morphological preservation and revealed cytoplasmic "patches" with a complex ultrastructure in Epon sections. The preservation was always less good in LR White. The patches were densely labeled, even in Epon sections, after FS in acetone. However, labeling intensity was 3.7 times greater in LR White than in Epon. With both resins, labeling diminished similarly when fixative agents were present in the FS medium. The localization of luciferase in the cytoplasm and particularly in the patches is discussed. PMID- 2703703 TI - A monoclonal antibody to rat liver arylsulfatase C and its application in immunohistochemistry. AB - We purified arylsulfatase C from rat liver microsomes and prepared a monoclonal antibody (P42C2) to the purified enzyme. By SDS-PAGE and immunoblotting analysis using P42C2, the molecular weight of the purified enzyme and of the enzyme in liver and kidney microsomes were estimated at 62,000 daltons. P42C2 caused little inhibition of arylsulfatase C activity, and was bound only slightly to liver microsomes. Localization of arylsulfatase C was studied at the light and electron microscopic level by the indirect immunoperoxidase method using P42C2. In rat liver, arylsulfatase C was detected mainly in the hepatocytes, and less frequently in endothelial cells, Kupffer's cells, and Ito's cells. In rat kidney, strong staining was observed in the straight portions of the proximal tubules. The podocytes, interstitial cells, endothelial cells, and epithelial cells of Henle's thin limbs were stained faintly. By electron microscopy, arylsulfatase C was found localized on the membranes of the endoplasmic reticulum and nuclear envelopes in these cells. These immunohistochemical findings agree with the localization demonstrated by an enzyme-histochemical method which we had previously developed. PMID- 2703704 TI - Immunocytochemical localization of cathepsins B, H, L, and T4 in follicular cells of rat thyroid gland. AB - To localize cathepsins B, H, and L in follicular cells of rat thyroid gland, we applied immunocytochemistry to the thyroid tissue using their respective monospecific antibodies. On serial semi-thin sections, cathepsins B, H, and L were localized in granules of various sizes located throughout the cytoplasm, whereas T4 was detected in larger granules located in the apical and supranuclear regions. By electron microscopy, cathepsins B, H, and L were localized in large less-dense granules (so-called colloid droplets) and in dense bodies of various sizes, whereas T4 was localized more intensely in large less-dense granules than in smaller dense bodies. By double immunostaining using an immunogold method, cathepsins H and B or L were co-localized in the same cytoplasmic granules. Moreover, immunoblotting demonstrated that proteins similar to cathepsins B, H, and L in the liver are present in the thyroid gland. These results suggest that cathepsins B, H, and L participate not only in degradation of thyroglobulin but in maturation of thyroid hormones, although it remains unknown whether all of them participate in the maturation process. PMID- 2703705 TI - Simultaneous in situ detection of beta-interferon mRNA and DNA in the same cell. AB - We report a quantitative method that combines in situ mRNA hybridization with microfluorometric analysis of DNA content to detect gene expression in single cells of a heteroploid cell population. The model was a human fibrosarcoma HT1080 cell line which consisted of diploid and tetraploid cells that were induced with polyI:polyC for production of beta-interferon. The level of beta-interferon mRNA detected by in situ hybridization was found to be two to three times higher in tetraploid compared to diploid HT1080 cells, and correlated with beta-interferon activity in that a subclone of tetraploid HT1080 cells secreted two- to fivefold more beta-interferon than a subclone of diploid HT1080 cells. Interestingly, beta interferon-related transcripts were detected during S-phase in uninduced tetraploid HT1080 cells. In addition, beta-interferon induced by polyI:polyC was expressed in all phases of the cell cycle as demonstrated with a human diploid fibroblast, HF926. The unique features offered by the combination of microfluorometry and in situ hybridization provide a valuable tool to investigate specific gene expression related to ploidy or cell-cycle stage in the same individual cell of an unsynchronized population. Since the method allows direct observation of morphology, one can be assured that all quantitative measurements were made on whole cells with intact nuclei. PMID- 2703706 TI - Immunohistochemical localization of metallothionein in developing rat tissues. AB - Metallothionein (MT) is a cysteine-rich, low molecular weight protein inducible by heavy metal ions and various endogenous factors. Using an indirect immunofluorescent technique, we studied the localization of MT in developing rat tissues (kidney, small intestine, and liver). In kidney of the neonate and fetus, MT was found in both the cytoplasm and the nucleus of renal tubular epithelia. Localization of MT changed with shift of zonation in the renal cortex during development. Metallothionein was found mainly in the inner zone of the cortex but not in tubules of the neogenic zone on Day 4. Until Day 18, tubular cells containing MT were observed in a part of the cortex adjacent to the medulla, followed by a significant decrease in immunostaining by Day 27. In small intestine of the neonate, MT was localized predominantly in Paneth and goblet cells which play secretory roles. The number of goblet cells with strong immunostaining for MT was maximal on Day 27. In liver of 20-day fetuses and of 4 day-old neonates, both the cytoplasm and the nucleus of hepatocytes exhibited strong immunofluorescence. The intensity of MT staining diminished with development, and by 18-27 days after birth no immunofluorescence was observed in the nucleus. We further studied a possible association of MT with development by localizing MT in livers obtained from partially hepatectomized and laparotomized rats. Hepatectomy led to the appearance of MT not only in the nucleus and cytoplasm of hepatocytes but also in sinusoids and bile canaliculi. After laparotomy, MT immunofluorescence was observed only in the cytoplasm. The present results suggest a possible involvement of MT in cell proliferation and differentiation, as well as in transport and secretion of this metal-binding protein. PMID- 2703707 TI - Differential effects of methylmercuric chloride and mercuric chloride on the histochemistry of rat thyroid peroxidase and the thyroid peroxidase activity of isolated pig thyroid cells. AB - This study was designed to characterize the interaction of CH3HgCl or HgCl2 with thyroid peroxidase (TPO). Two types of experiments were performed. First, the thyroids from rats that were given 5.6 mg/kg/day of either CH3HgCl or HgCl2 for 2 weeks by intubation were subjected to histochemical treatment and then to electron microscopy. TPO activities in all cell compartments were inhibited by HgCl2 but not by CH3HgCl. Morphological observation showed that taller epithelia were induced by HgCl2, whereas flattened epithelia forming large follicles were induced by CH3HgCl. The serum thyrotropin level was substantially lowered by CH3HgCl but was unchanged by HgCl2. Second, the guaiacol oxidation by TPO in isolated and ruptured pig thyroid cells was spectrophotometrically monitored in the presence of either CH3HgCl or HgCl2. The TPO was not inhibited by CH3HgCl but was inhibited by HgCl2. These results indicated that CH3HgCl induced a hypothyroid state without affecting TPO, whereas HgCl2 inhibited TPO and induced a hypertropic state owing to compensation for loss of enzyme activity, and that the lack of inhibitory activity of CH3HgCl was not due to the inability to penetrate the cells. Therefore, there appeared to be a differential interaction of organic and inorganic forms of mercurials with the thyroid. PMID- 2703708 TI - Lectins for electron microscopic distinction of eosinophils from other blood cells. AB - Colloidal gold-labeled soybean agglutinin (SBA), Helix pomatia agglutinin (HPA), Dolichos biflorus agglutinin (DBA), and Griffonia simplicifolia lectin (GS-1) were used for electron microscopic observation of blood cells. Colloidal gold labeled SBA, HPA, and DBA showed marked deposition on eosinophil granules at all stages of maturation. Gold particles were not deposited on basophils, neutrophils, monocytes, lymphocytes, or other blood cells. Only a few colloidal gold-labeled GS-1 were deposited on eosinophil granules. Eosinophil granules are rich in N-acetyl-D-galactosamine compounds, and the colloidal gold-labeled SBA, HPA, and DBA are useful for electron microscopic detection of eosinophil granules. PMID- 2703709 TI - Extracellular matrix of lymphoid tissues in the chick. AB - We describe the immunohistochemical distribution of components of the extracellular matrix of the chick lymphoid system. In the thymus, basement membranes of epithelial cells bordering the lobules were intensely stained by laminin antibodies; fibronectin antibodies labeled the capsule and the septal matrix, and similar reactivity was seen with tropoelastin and gp 115 antibodies. No positivity was detected with any of the antibodies within the cortical parenchymal cells. Laminin was not detected in the medullary parenchyma, whereas fibronectin was present as coarse fibers. Tropoelastin and gp 115 appeared as a finer and more diffuse meshwork. In the bursa, laminin antibodies outlined the epithelial cells separating the cortex from the medulla. Fibronectin, tropoelastin, and gp 115 antibody stained the interfollicular septa and the cortical matrix, although to a different extent. Laminin was also detected in association with the interfollicular epithelium (IFE) basement membrane, whereas no staining was found underneath the follicle-associated epithelium (FAE). FAE cells not only lack a proper basement membrane but are also not separated from medullary lymphocytes by any of the other extracellular matrix components were investigated. Consequently, medullary lymphocytes are not sequestered, and can come easily into contact with antigens present in the intestinal lumen. All four antibodies stained the spleen capsule and spleen blood vessels, tropoelastin and gp 115 antibodies giving the strongest reactivity. A fine trabecular staining pattern was detected with gp 115 antibodies in the white pulp. PMID- 2703710 TI - Inhibition of acute passive transfer experimental autoimmune myasthenia gravis with Fab antibody to complement C6. AB - The role of the lytic complement C5b-9 membrane attack complex (MAC) in acute passive transfer experimental autoimmune myasthenia gravis (EAMG) produced in rats was investigated by in vivo inhibition of MAC formation with anti-C6 Fab. Anti-C6 Fab totally inhibited in vitro serum hemolytic activity, but did not consume or inhibit early complement pathways. Injection of rats with 0.12 mg/ml anti-C6 Fab reduced serum C6 to 8% and inhibited the muscle weakness, electrophysiologic abnormalities and loss of acetylcholine receptor (AChR) associated with acute EAMG. This level of C6 inhibition reduced the total serum complement hemolytic activity to 29% of normal but did not reduce the serum levels of complement components C3, C5, or C7. Treatment of rats with lower amounts of anti-C6 Fab (0.08 mg/ml) also inhibited clinical and electrophysiologic signs of EAMG, however, the lower amount of anti-C6 did not prevent the loss of muscle AChR. Both the higher and the lower amount of anti-C6 Fab inhibited the accumulation of macrophages at muscle motor end-plates. The inhibition by anti-C6 indicates that muscle weakness and electrophysiologic abnormalities associated with EAMG are dependent on the complement MAC, and that muscle weakness results from tissue injury in addition to loss of muscle membrane and AChR. PMID- 2703711 TI - CDw17: a neutrophil glycolipid antigen regulated by activation. AB - The plasma membrane and intracellular granules of human polymorphonuclear neutrophils (PMN) contain large amounts of the glycolipid, lactosylceramide (LacCer; Gal beta 1----4Glc beta 1----1Cer). Despite its abundance, novel subcellular distribution, and lineage-restricted expression, nothing of PMN LacCer function is known. We examined the relationship between LacCer and PMN activation by assessing binding of anti-LacCer mAb (T5A7; anti-CDw17) to PMN during and after cell stimulation. CDw17 expression markedly decreased after treatment with PMA, dioctanoylglycerol, calcium ionophore, FMLP (with or without cytochalasin B or added Ca2+), TNF-alpha, or lymphotoxin. Depending on the stimulus, CDw17 declined to levels ranging from 70% (TNF, lymphotoxin) to less than 5% (phorbol ester, dioctanoylglycerol) of levels detected on untreated PMN. Loss of CDw17 from PMA-treated PMN followed dose- and temperature-dependent kinetics, with loss being detected after PMA treatment for 1 min. Membrane internalization explained PMA-induced loss of CDw17, as cell-associated 125I-anti CDw17 became inaccessible to fluorescent anti-Ig after PMA treatment. CDw17 on PMN cytoplasts or retinoic acid-induced HL-60 cells was only slightly affected by stimulation, suggesting that down-regulation of the epitope is associated with granule exocytosis rather than superoxide production. Results with PMN from a patient with chronic granulomatous disease confirmed that normal superoxide production is not required for CDw17 loss induced by PMA or FMLP treatment. The data collectively demonstrate that reduced levels of cell-surface CDw17 are associated with granule exocytosis after PMN activation. PMID- 2703712 TI - Dissociation between murine spleen cell mitogenic activity of enterotoxin contaminants and anti-tumor activity of staphylococcal protein A. AB - Soluble staphylococcal protein A (SpA) in the form of high m.w. complexes with IgG has been shown to significantly inhibit the growth of Meth A fibrosarcomas in BALB/c mice. Although SpA reportedly is a potent T cell mitogen that can induce immune cell proliferation and production of humoral factors with anti-tumor activity, it has been suggested that mitogenic enterotoxin contaminants might be responsible for these effects. The purpose of the present study was to investigate the nature of SpA-induced cell proliferation and the relationship between mitogenicity and the anti-tumor effect that we observed in our mouse model. SpA stimulated the proliferation of a mixed population of splenic B and T cells from BALB/c mice, but activity did not require the presence of IgG in the culture medium. Furthermore, mitogenic activity could be inhibited completely by anti-SEA plus anti-SEB, but was unaffected by anti-SpA. HPLC-purified SpA was inactive while the mitogenic factor(s) had the same retention time as authentic enterotoxin and its activity was inhibited by anti-SEA and anti-SEB, but not by anti-SpA. Enterotoxin-free rSpA produced in Escherichia coli had the same IgG binding capacity as the staphylococcal product but was not mitogenic. These data indicate that SEA and SEB completely account for mitogenicity in SpA preparations. In contrast, we found that optimal concentrations of rSpA as well as crude and HPLC purified staphylococcal SpA were equally effective in inhibiting the growth of established Meth A fibrosarcomas demonstrating that SpA is responsible for antitumor activity without any apparent role for enterotoxins. PMID- 2703713 TI - Preoperative and intraoperative considerations in adolescent idiopathic scoliosis. PMID- 2703714 TI - Intra-articular inflammatory diseases of the shoulder. AB - Intra-articular disease processes of the shoulder are uncommon. Of all the processes, adhesive capsulitis is by far the most prevalent. Stage 1 of adhesive capsulitis mimics the impingement syndrome and must be ruled out by arthroscopy before decompression is performed. Other rare conditions of the shoulder joint, such as pigmented villonodular synovitis and synovial chondromatosis, can be treated with the same surgical techniques. PMID- 2703715 TI - Impingement problems in the athlete. AB - In summary, there is a delicate balance between the mobility and the stability of the shoulder joint. The young athlete involved in overhand sports is at risk for injury, and must be clinically evaluated and treated differently from the rest of the population. Shoulder impingement and instability are a continuum of abnormalities, beginning with instability and progressing to subluxation, impingement, and, finally, rotator cuff tear. Thus, it is crucial to deal with the core of the problem, (that is, the instability) before dealing with the impingement. A kinesiologic repair is desirable. If that fails, or if there is anatomic damage, an anatomic repair is done. The anterior capsular labral reconstruction is a surgical procedure designed with biomechanical and kinesiologic principles in mind. A rehabilitation program is initiated immediately after surgery. The rehabilitation program is just as important as the surgery. PMID- 2703716 TI - Posterior instability of the shoulder. AB - Posterior instability is a rare entity in which subluxation is much more common than dislocation. This problem should be assessed and treated by someone particularly interested in shoulder problems. Reconstruction produces fairly high recurrence and complication rates. Accurate preoperative patient selection and improved surgical procedures and techniques are required to maximize success. PMID- 2703717 TI - Principles of in situ fixation in chronic slipped capital femoral epiphysis. PMID- 2703718 TI - Legg-Calve-Perthes disease: diagnostic and prognostic techniques. PMID- 2703719 TI - Assessment and prediction in leg-length discrepancy. AB - Successful treatment of patients with leg-length discrepancy requires rigorous assessment of the patient, usually over a period of time. This assessment involves not only the lengths of the legs, but all the factors that contribute to the asymmetry because they are all important in the selection of a treatment goal. Good results can be obtained with any of the three methods of prediction. Selection of a particular method must be based on convenience, accuracy, and user familiarity. PMID- 2703720 TI - Congenital hip dislocation: techniques for primary open reduction including femoral shortening. AB - Combining primary open reduction, femoral shortening, capsulorrhaphy, and acetabuloplasty in a single operation allows predictable treatment of congenital dislocation of the hip in older children without the time and expense of preliminary traction. In addition to the bony abnormalities of congenital hip dislocation, the complex pathologic anatomy of the hypertrophied capsule and associated soft tissues must be recognized and corrected. Failure to treat all components of this condition often leads to reduction that is apparently satisfactory in the intraoperative and early postoperative periods but is followed by hip subluxation or redislocation with weightbearing. Correcting all components of the congenital hip dislocation deformity in a single operation provides the best opportunity for early return of normal hip mechanics and function in the older child. PMID- 2703721 TI - Clinical research database system for orthopaedic surgery. PMID- 2703722 TI - Office management of athletic injuries of the hand and wrist. AB - Most common hand injuries occurring in athletics can be simply treated and the athlete returned to participation at an early date. Delayed or inadequate treatment may result in an unacceptable outcome, including permanent deformity. The injured athlete must be carefully examined, treated, and monitored until fully rehabilitated. PMID- 2703723 TI - Specific rehabilitation programs for the throwing athlete. PMID- 2703724 TI - UVB irradiation induces melanocyte increase in both exposed and shielded human skin. AB - This study demonstrates for the first time in humans that UV light induces an increase of the melanocyte population in exposed skin as well as in shielded areas. Because an increased mitotic activity could promote tumor development, UV exposure might play a role in melanoma development not only in exposed but also in covered skin. In addition, it was found that subjects who initially had a small melanocyte population showed a larger increase in both exposed and covered skin compared to those with a high initial density. Individuals with a low density might therefore constitute a risk group for the development of malignant melanoma. These findings support the view that infrequent periods of intensive UV irradiation might be more harmful than regular exposure. PMID- 2703725 TI - Perturbation of experimental ultraviolet light-induced erythema by passive transfer of serum from subacute cutaneous lupus erythematosus patients. AB - Several lines of investigation have implicated anti-Ro/SS-A antibody in the pathogenesis of photosensitive forms of cutaneous lupus erythematosus such as neonatal lupus erythematosus and subacute cutaneous lupus erythematosus. To further explore this possibility, we have developed a quantitative, experimental system for examining the effect of passively transferring anti-Ro/SS-A antibody containing and antibody-deficient subacute cutaneous lupus erythematosus patient sera on one aspect of cutaneous photoreactivity, UV-induced erythema. Laser Doppler velocimetry was used to quantitate the microvascular flow rates in normal control, disease control (rheumatoid arthritis, discoid lupus erythematosus), and subacute cutaneous lupus erythematosus serum-injected guinea pig skin test sites before and after combined ultraviolet B and A radiation from a solar simulator. Results, expressed as change in milli-electron voltage (perturbed milli-electron volts after irradiation minus baseline milli-electron volts before irradiation), revealed that subacute cutaneous lupus erythematosus serum injections consistently resulted in greater UV-induced microvascular flow rates than those elicited by normal or disease control serum injections. Anti-Ro/SS-A containing subacute cutaneous lupus erythematosus sera produced the greatest flow rates observed in this study. Earlier studies have suggested that the pathogenesis of lupus photosensitivity is very likely multifactorial. Our current data suggest that anti-Ro/SS-A autoantibody or other closely related humoral elements should also be considered among the factors which might contribute to this clinical phenomenon. PMID- 2703726 TI - Deposition of the membrane attack complex of complement in pemphigus vulgaris and pemphigus foliaceus skin. AB - The present study was performed to determine whether complement activation in pemphigus vulgaris (PV) and pemphigus foliaceus (PF) results in the assembly of the terminal complement sequence or membrane attack complex (MAC) in skin lesions. Biopsy specimens of skin lesions from five patients with PV and three patients with PF contained C5, C7, C9, and the MAC related neoantigen (C5b-9 neoantigen) in intercellular substance areas (ICS), as well as IgG and the early complement components Clq, C4, and C3. The presence of these late complement components and the C5b-9 neoantigens in ICS sites of the skin lesions is indicative of complement activation by the pemphigus antibody, with subsequent assembly of the MAC. The binding of IgG and early complement components to ICS was observed in both non-lesional (normal appearing) skin and in skin lesions. However, no MAC could be detected in the normal appearing skin of our pemphigus patients. It was also noted that the MAC could be generated in vitro on cryostat sectioned normal human skin by pemphigus antibody in the presence of complement. Results of these studies suggest that complement activation may be related to membrane damage of epidermal cells in both PV and PF. PMID- 2703728 TI - Cardiovascular disease in psoriasis. PMID- 2703727 TI - Modification of sunburn cell production in 8-MOP sensitized mouse epidermis: a method of assessing UVA sunscreen efficacy. AB - The UVA(320-400 nm) photoprotection of four commercially available sunscreens with different sun protection factors was evaluated in 8-methoxypsoralen (8-MOP) treated mouse epidermis with the number of sunburn cells (SBCs) as the end-point. SBC production in 8-MOP sensitized mouse epidermis with and without application of sunscreens is dose-related. The difference between the slopes of the dose response curves of the control group and the four sunscreens was highly significant (p less than 0.001). It appears that the SBC production was modified both by the dose of the UVA irradiation administered and by the UVA photoprotection of the four sunscreens. It could be concluded that the number of SBCs in 8-MOP sensitized mouse epidermis is a useful parameter to quantify the degree of UVA photoprotection of sunscreens. PMID- 2703729 TI - Zidovudine therapy of asymptomatic HIV1-infected patients and combined zidovudine acyclovir therapy of HIV1-infected patients with oral hairy leukoplakia. PMID- 2703730 TI - Identification of secretory immunoglobulin A in human sweat and sweat glands. PMID- 2703731 TI - The Scientific Citation Index and The Journal of Investigative Dermatology. PMID- 2703732 TI - Are we really ready to alleviate pain? PMID- 2703733 TI - Cultural and educational influences on pain of childbirth. AB - This study investigated the effects of sociocultural family of origin and educational level on the verbal ratings of pain and pain behavior during childbirth for 83 women. Coping style and extroversion were also measured. It was found that all women rated the pain of childbirth as high. Overall, women from a Middle-Eastern compared with a Western background gave higher ratings of pain and showed more pain behavior. This was found especially for Middle-Eastern women of a low educational background. Overall, low compared with high educational level resulted in higher ratings of pain and more pain behavior. No differences were obtained as a function of extroversion. Middle-Eastern and Western women did not differ in coping style. However, women who had higher monitoring scores rated the pain as less even through no differences were obtained for pain behavior. Sociocultural group of origin as well as other relevant reference groups, such as educational level, are important in determining pain perception and behavior. Combining this information with coping style could lead to an instructional intervention for preparing women for childbirth. PMID- 2703734 TI - Availability of sustained-release morphine. PMID- 2703735 TI - Use of methylphenidate as an adjuvant to narcotic analgesics in patients with advanced cancer. PMID- 2703736 TI - An open label trial of the possible analgesic effects of dipyridamole. AB - There is experimental evidence that adenosine and the adenosinergic agent dipyridamole may inhibit the activity of nociceptive neurons. Dipyridamole was given to 15 patients with chronic pain in an open uncontrolled investigation. Eleven patients tolerated the drug well and seven of these patients obtained subjective benefit. The results are held to justify further investigation under controlled blind conditions. A possible ceiling effect of dipyridamole was noted. PMID- 2703737 TI - The use of methotrimeprazine (Levoprome) in a patient sensitive to opioids and possible bowel shutdown. PMID- 2703738 TI - Ratings of cancer chemotherapy toxicity by oncologists, nurses, and pharmacists. AB - In order to examine the perceived toxicity of commonly used drug regimens for cancer chemotherapy, eight oncologists, twelve nurses, and five pharmacists rated the toxicity of 30 different drug combinations. Although the correlations revealed a high degree of agreement, the oncologists' ratings and the nurses' ratings differed systematically at the lower- and the higher-toxicity levels. This was most readily described by a "regression effect," wherein oncologists' ratings appear to regress toward the mean relative to the nurses' ratings. The perception of both toxicity and the importance of side effects such as nausea and vomiting may be substantially different between physicians and nurses, and hence, has important implications for how patients communicate these to the various health care professionals. PMID- 2703739 TI - Investigations into the haemolytic effects of dapsone therapy in leprosy patients. AB - Investigations into the haemolytic effects of dapsone therapy were carried out in forty four leprosy patients admitted to the Sacred Heart Leprosy Centre, Kumbakonam. They received weight based dapsone dosages varying from 1.3-3.3 mg/kg body weight. Blood levels and urinary Dapsone/creatinine ratio were assessed at 1 day, 7 days and 30 days of Dapsone treatment. At the same points of time, haematological observations were also carried out. Serum bilirubin as well as blood mathaemoglobin were also examined. The findings showed a reduction in Hb levels at 30 days observation in a good proportion of cases on 100 mg. In one case (child) weighing 15 kg and receiving 50 mg dapsone increased mathaemoglobin was observed. It is suggested that dapsone dosage be regulated to body weight and preferably not to exceed 1.5 mg/kg body weight. PMID- 2703740 TI - A report on six cases of histoid variety of lepromatous leprosy in children. AB - Six cases of histoid variety of lepromatous leprosy among children below 12 years of age were detected in over 3 years period. Bacteriological index was high (3 to 5+). None of the patients had received any anti-leprosy treatment. It is a public health problem because of infectious nature of the disease, therefore early detection and management of this entity among children is important. PMID- 2703741 TI - Destruction of ala nasi and loss of columella in borderline tuberculoid leprosy- a case report. PMID- 2703742 TI - Scalp lesions in borderline leprosy. PMID- 2703743 TI - A study of incidence of Australia antigen and derangements in liver function tests in leprosy. AB - The present study was conducted in 50 patients of various subtypes of leprosy (Lepromatous, Tuberculoid, Borderline borderline) and 25 healthy control, for detection of Australia antigen and various liver function tests (serum protein, cholesterol, alkaline phosphates, SGOT, SGPT, bilirubin and liver biopsy) to see incidence of Australia Antigen and derangement in liver function. It was concluded that incidence of Australia antigen in study and control group was zero. Total serum protein and serum globulin was increased in lepromatous leprosy. A/G ratio was reversed in 34.3% and 50% in lepromatous and tuberculoid leprosy respectively. Granulomatous hepatitis was seen in 66.66% and 50% cases of lepromatous and tuberculoid leprosy respectively. No relationships was established between hepatic lesion, Australia antigen and liver function test. PMID- 2703744 TI - Vitiligo following type II lepra reaction. AB - A middle-aged male with lepromatous leprosy developed bouts of skin lesions of depigmented macules and patches of vitiligo, just following attacks of type II lepra reaction each time. In view of the present concept of autoimmunity playing a role in the pathogenesis of vitiligo as well as lepra reaction, their association in our patient appears to be more than fortuious. The depigmented macules persisted even after regression of skin lesions of leprosy following chemotherapy. The vitiligo macules responded partially to topical and systemic psoralen therapy. PMID- 2703745 TI - Morphometric study of stratum corneum in leprosy. AB - Abnormalities in Stratum Corneum (SC) in leprosy lesions have been demonstrated as evidenced by poor hydration power of SC and increased SC turn-over. In continuation of the same study morphometric studies of the SC in leprosy was undertaken as per measurement of the Thickening of the SC, Mean epidermal thickness and Basal layer: Granular layer cell ratio (B : G ratio) of the H.E. stained tissues. Further, on freshly frozen tissues the SC cell-layers were also counted. The findings suggest increased proliferative activity of the epidermis which may lead to formation of defective SC in leprosy. PMID- 2703746 TI - Bacteriology of infected hands and feet in leprosy patients. AB - 70 cases of infected hands and feet admitted to ALERT Hospital during 1986/1987 (3/10/86-5/5/87) were studied for the infecting organisms and the sensitivity of these organisms to available antibiotics. Single organisms were isolated in 56 cases (95%), two organisms were isolated in 3 cases (5%), no organisms were isolated in 11 cases (15.7%). Proteus was the commonest organism. Most effective drug was Ampicillin. Three organisms isolated in 7 cases proved resistant to all drugs tested. The study shows that commonly available drugs are effective in the great majority of secondary infections in leprosy patients. PMID- 2703747 TI - A study of clinico histopathological correlation of leprosy in children. PMID- 2703749 TI - [Proceedings of the 62nd meeting of the Japanese Orthopedic Association. 11-13 April 1989, Tokyo. Abstracts]. PMID- 2703748 TI - Dermatoglyphics in leprosy: (III) Creases of palm. AB - Palmar configurations of triradii and creases of 100 leprosy patients [50 lepromatous (BL/LL) and 50 tuberculoid (BT/LL)] were compared with those of 100 normal persons selected from families of these patients. The patterns of position of triradii were similar in controls and leprosy patients as such. But, the patterns in the two types of leprosy patients were different. As for palmar creases patterns, there was significant difference between those of controls and patients, double radial base crease occurring more often in patients. However, the differences between the two types of patients were not statistically significant. PMID- 2703750 TI - [86th meeting of the Japanese Society of Internal Medicine. 1-3 April 1989, Kyoto. Abstracts]. PMID- 2703751 TI - A case report of a Hymenolepis diminuta infection in a child in St James Parish, Jamaica. AB - Hymenolepsis diminuta is a tapeworm which is an intestinal parasite of rats and mice. Rarely, through accidental ingestion of an infected arthropod, man can become the definitive host. This report documents, for the first time, that such infections occur in Jamaica, West Indies. The life cycle of the parasite and its treatment are also discussed. PMID- 2703752 TI - The future of medical care for the medically indigent in Louisiana and its relationship to medical education. AB - The Charity Hospital system of care for the medically indigent in Louisiana has been underfunded both for operation and for capital for a number of years. As a consequence, care is declining in quality and medical education suffers. This article examines the problems, issues, and possible courses of action. Considered are operating authority and governance, organization and finance of care, and the likely impact on medical education; it does not reach conclusions or make recommendations. Rather, its purpose is to stimulate rational discussion about these important matters. PMID- 2703753 TI - ECG of the month. Aberrant behavior. Sustained bigeminal rhythm. PMID- 2703754 TI - Pulmonary O2 toxicity: validation of the "60%" rule in cultured human lung endothelium. PMID- 2703755 TI - Granulopoiesis in the preterm infant: adequate progenitors, but still neutropenic. PMID- 2703756 TI - Cystic fibrosis and allergic bronchopulmonary aspergillosis. PMID- 2703757 TI - Gestational age-dependent changes in circulating hematopoietic stem cells in newborn infants. AB - In the fetus, hematopoietic stem cells originate in the yolk sac and are believed to be transferred to all other hematopoietic organs via the circulation. In humans, the time course of this transfer has not been systematically evaluated in viable premature infants. We examined the cord blood of 13 preterm (25 to 36 weeks of gestation) and 10 term (38 to 42 weeks of gestation) infants for pluripotent (mixed colony-forming unit-granulocyte, erythrocyte, macrophage, megakaryocyte), erythroid (burst-forming unit-erythroid, colony-forming unit erythroid) and myeloid (colony-forming unit-granulocyte, macrophage) stem cells. A gestational age-dependent decrease in all lineages of circulating hematopoietic stem cells was noted (p less than 0.001). By 34 weeks of gestation, preterm infant cord blood had a similar concentration of circulating stem cells compared with that of term infants. This gestational age-dependent decrease in hematopoietic stem cells of all lineages supports the hypothesis of a blood-borne transfer of hematopoiesis that appears largely complete by 34 weeks of gestation. Infants born after less than 32 weeks of gestation have high levels of circulating hematopoietic stem cells that may reflect the active transfer of hematopoiesis from liver to bone marrow. PMID- 2703758 TI - Effect of hepatic failure toxins on regenerative enzymes in the liver after injury with galactosamine in the rat. AB - Hepatic thymidine kinase (TK) and ornithine decarboxylase (ODC) activities were used to quantify the regenerative response to injury with galactosamine. After massive damage with 1000 mg/kg galactosamine, TK activity (DNA synthesis) peaked between 62 and 120 hours. This peak of activity was depressed as much as 91% by six subcoma doses of dimethyl disulfide (DMDS) given between 24 hours and 64 hours after galactosamine administration. Similar doses of octanoic acid (OA) had no effect, and doses of NH4Cl had no effect except at 120 hours. The first peak of ODC activity (initiation of cell growth) at 45 hours was depressed about 60% by six subcoma doses of NH4Cl or DMDS injected between 27 hours and 42 hours. OA again had no effect. After 400 mg/kg galactosamine, a narrow but high peak of TK activity occurred at 62 hours. This peak of activity was depressed more than 50% by six subcoma doses of NH4Cl, OA, or DMDS given between 24 hours and 54 hours. The first peak of ODC activity at 36 hours was similarly reduced by more than 50% by similar doses of each of the toxins given between 24 hours and 34 hours. The overt neurologic effects of the toxins were dissipated within 1 hour of each injection. The depressive effect of NH4Cl and OA on TK and ODC activities during regeneration after massive centrolobular injury with acetaminophen was more consistently present and more extensive than that seen after injury with galactosamine. PMID- 2703759 TI - Red cell deformability and lipid composition in two forms of acanthocytosis: enrichment of acanthocytic populations by density gradient centrifugation. AB - Whole cell deformability and lipid determinations were performed on red cells from two patients who had acanthocytes in the peripheral blood (10% and 20% to 30%) and normal serum lipoprotein levels. One patient had typical chorea acanthocytosis and the other had no clinical abnormalities associated with acanthocytosis. Red cells from the patient with chorea-acanthocytosis showed reduced deformability, as measured by a visco-diffractometric method (ektacytometry), which could be explained by the presence of increased numbers of dehydrated cells containing high concentrations of hemoglobin. The total cell population showed a modest increase in potassium efflux, which may be responsible for reduced cation content and dehydration in a subpopulation of cells. When the patients' red cells were separated into different density populations by centrifugation on density gradients, the cells of classic acanthocyte morphology were concentrated in the high-density layers. This was true for both patients, although the subject with acanthocytes and no clinical disorder had a normal red cell density distribution. Lipid analysis of both types of acanthocytes showed an increase in the relative proportion of sphingomyelin with respect to the glycerophospholipids. Total cholesterol and phospholipid levels were reduced in the chorea-acanthocytosis red cells, but the other acanthocytes did not differ significantly in total lipid content from normal control samples. Thus, the one common abnormal feature in these two forms of acanthocytosis is the increase in the proportion of red cell sphingomyelin. Because this is a very stable, immobile component of the membrane, we suggest that its relative enrichment could result from a defect in the transport and maintenance of glycerophospholipids. Further study of the dynamics of glycerophospholipid organization in acanthocytes may be useful in increasing our understanding of the genesis of abnormal, acanthocytic morphology. PMID- 2703761 TI - Polyethylene glycol 900 permeability of rat intestinal and colonic segments in vivo and brush border membrane vesicles in vitro. AB - Increased intestinal absorption of medium-sized aqueous probes has been found in patients with a variety of disorders. We studied the physiologic control mechanisms, intestinal regions, and effects of lumenal factors on the intestinal absorption of polyethylene glycol (PEG) 900 in the rat in vivo and in rabbit brush border membrane vesicles (BBMVs). The kinetics of PEG 900 intestinal absorption were compatible with simple passive diffusion. Because transport across BBMVs was minimal, we concluded that transport of PEG 900 is mostly through the paracellular tight junctions. Absorption was highest in the midcolon (104.3 +/- 9.5 mumol/100 mg protein per hour vs 9.1 +/- 1.2 mumol/100 mg protein per hour in the jejunum). Absorption was decreased by higher lumenal osmolarity (greater than 400 mOsm/L) after the additions of 2.5 to 5.0 mmol/L chenodeoxycholate or 2.5 mmol/L lysolecithin, or at higher lumenal flow rates (greater than 1 ml/minute), higher lumenal pressure (7.5 cm H2O),or higher lumenal pH (8.0). Lipid solubility of PEG 900 was less than 0.00079%. Under all experimental conditions, PEG net absorption followed changes in water transport. When water transport changed from absorption to secretion, PEG absorption decreased. When water absorption increased, PEG 900 absorption increased in parallel. We conclude that PEG 900 is absorbed by passive diffusion that is modulated by solvent drag and is maximal in the midcolon. Transport directly across cell membranes is mimimal, but overall PEG 900 permeability is closely linked to water absorption by solvent drag and takes place primarily through the paracellular junctions. We propose that these features and mechanisms of PEG 900 transport make PEG 900 a suitable probe molecule for studying intestinal permeability changes. PMID- 2703762 TI - Acute renal failure and fluid retention and kidney damage in copper-deficient rats fed a high-NaCl diet. AB - The effect of an interaction between Cu status and dietary NaCl level on kidney structure, water balance, and the plasma renin-angiotensin-aldosterone system (RAAS) was examined in 64 male Sprague-Dawley rats (178 gm) fed a copper supplemented diet (CuS) (10 micrograms Cu per gram) or a copper-deficient diet (CuD) (less than 0.7 micrograms Cu per gram), with (CuSNa, CuDNa) or without 3% NaCl for 42 days. NaCl did not affect growth, fluid retention, or kidney ultrastructure in Cu-supplemented rats. Cu deficiency decreased growth rate and kidney Cu, increased plasma cholesterol concentration, and suppressed plasma RAAS. NaCl increased the magnitude of these changes in Cu-deficient rats. The mortality rate was higher in CuDNa (8/16) than in Cu-deficient (2/16) rats. An acute renal failure syndrome characterized by tissue edema, pleural effusion, and ascites occurred in rats fed CuDNa. Bioelectric impedence analysis indicated that body water content was similar in rats fed CuS, CuSNa, and CuD but was higher in edematous and nonedematous rats fed CuDNa. Transmission electron microscopy indicated that glomeruli from Cu-deficient rats were poorly perfused and often occluded by expanded mesangium and contained numerous lysozome-like bodies. Fusion of podocyte foot processes, derangement of glomerular basement membrane, and hypertrophy and lipid accumulation by glomerular capillary endothelium were present in tissue from rats fed CuDNa. These results indicate that Cu deficiency reduces NaCl tolerance in rats. Ultrastructural changes in kidney tissue and the suppression of RAAS in rats fed CuDNa suggest that the edema and ascites result from acute renal failure and not from increased fluid and electrolyte reabsorption. PMID- 2703760 TI - Histidine-rich glycoprotein is elevated in mild liver cirrhosis and decreased in moderate and severe liver cirrhosis. AB - Histidine-rich glycoprotein (HRG) reduces by complex formation with plasminogen the amount of "free" plasminogen in circulation and is therefore considered an inhibitor of fibrinolysis. We studied the levels of both HRG and plasminogen in patients with different degrees of liver cirrhosis to assess the role of HRG in enhanced fibrinolysis in these patients. In mild (Child A) cirrhosis, HRG levels unexpectedly were significantly increased. The total plasminogen level and the calculated amount of free plasminogen were decreased. In moderate (Child B) cirrhosis, both HRG levels and total plasminogen levels were reduced, resulting in a normal amount of free plasminogen in circulation. In severe (Child C) cirrhosis, HRG level, total plasminogen level, and free plasminogen level were all decreased. Because the HRG level is increased in Child A liver cirrhosis, we suggest that other mechanisms, other than simply a decreased synthetic capacity of the liver, contribute to the changes in HRG levels in patients with liver disease. Because of the reduction of free plasminogen levels in severe liver cirrhosis, we propose that the decrease in HRG levels in liver cirrhosis plays no role in enhanced fibrinolysis in these patients. The increase in the HRG level in Child A liver cirrhosis may be of importance in future studies on familial thrombosis associated with elevated levels of HRG, where mild liver dysfunction should at least be excluded. PMID- 2703763 TI - Swimming in chlorinated water and its effect on Eustachian tube function. AB - Middle-ear effusion in children is considered to be the result of multiple factors. Swimming in chlorinated water has been incriminated as one such possible aetiological factor. To test the hypothesis that the chemical disinfectant in the swimming pool is probably responsible for the Eustachian tube dysfunction, 30 children between the ages of four and eight years were selected at random from the community health department computer records and were randomly allocated into two groups. Eustachian tube function was assessed by standard tympanometry both immediately prior to swimming (control) and 30 to 45 minutes following swimming in Group 1 and approximately 14 hours following swimming in Group 2. The results of the study showed no significant change (p greater than 0.05) between pre- and post-swimming tympanometry. It is therefore concluded that swimming on the surface of chlorinated water does not compromise the Eustachian tube function in children with healthy middle ears. PMID- 2703764 TI - Occasional stapes surgery--a Norwegian experience. AB - The past history of, and current trend in, stapes surgery are reviewed, and experience from a personal series of 128 procedures over an 18 year period is presented. Results are frequently poorer than many surgeons and their patients anticipate, and more stringent pre-operative case selection and centralisation of surgical activity would appear desirable. Amplification has become a more acceptable management alternative for some patient categories. PMID- 2703765 TI - Persisting nystagmus following vestibular nerve section for Meniere's disease. AB - Unilateral vestibular nerve section (VNS) creates a state of acute dysequilibrium which resolves by a process of central compensation. This disturbance resolves quickly and central compensation is complete generally within a month with resolution of symptoms and signs. The course of central compensation following VNS will be similar to that seen after labyrinthectomy because the detachment of hemi-labyrinthine input that is achieved by both will be identical. Six patients are presented who have undergone VNS at least 2.7 years ago (Average 3.5 years); all of them have persisting spontaneous peripheral type horizontal jerk nystagmus, present with optic fixation in five. This is obvious clinically and was confirmed in each case by agreement of three independent observers and has been recorded by electronystagmography (ENG). They are free from marked vestibular symptoms. The explanations of mechanisms involved in central compensation are discussed with respect to this previously unrecorded clinical observation. PMID- 2703766 TI - Out-patient examination of the upper airway: a survey of current practice in the UK. AB - Questionnaires have been sent to all ENT Consultants practising in the UK in an attempt to establish current practice with regard to out-patient examination of the upper aerodigestive tract. Seventy-eight per cent of these were returned completed. The results indicate that mirror examination remains the most widely used method, though the fibreoptic rhinolaryngoscope and/or the Hopkins rod telescope are now used by many specialists. Mirrors are most frequently warmed by a spirit lamp, despite the fact that 125 respondents reported having had a fire in their departments. Other methods of warming mirrors are discussed. PMID- 2703767 TI - Nasal endoscopy in chronic maxillary sinusitis. AB - The role of the anterior ethmoids in the pathogenesis of chronic maxillary sinusitis is still a subject of controversy. Although the symptoms of maxillary sinusitis may be clinically dominant, many previous studies have showed that the origin of this disease was, in most cases, located within the anterior ethmoid region. This study included 100 Egyptian patients, suffering from chronic maxillary sinusitis (confirmed by maxillary sinoscopy), who were subjected to 'systematic nasal endoscopy'. It was found that all cases of chronic maxillary sinusitis were associated with anatomical variations and/or pathological abnormalities of 'the ostiomeatal area'. It is recommended, therefore, that during the diagnosis and treatment of chronic maxillary sinusitis, attention should be given to the region of the middle meatus and anterior ethmoid complex (or 'ostiomeatal area') for any anatomical variations and/or pathological abnormalities in order to avoid recurrence of maxillary sinusitis. This is the basis of the procedure of functional endoscopic sinus surgery. PMID- 2703768 TI - Use of a Braunula for maxillary sinus irrigation. AB - Puncture and lavage of the maxillary sinuses is a common procedure in ENT practice. Repeated irrigations are required in chronic sinusitis refractory to treatment. In our department we use a No. 14 gauge Braunula for such cases. Over 100 patients have been treated over the past two years with no significant complications. This device is inexpensive, sterile, safe and easy to use and we recommend its use for patients with chronic maxillary sinusitis requiring repeated irrigations. PMID- 2703769 TI - Ethmoidal mucocoeles in children. AB - Children presenting with ethmoidal mucocoeles are rare. Five children are presented with such findings, and the diagnosis, treatment and possible aetiology discussed. C.T. scanning was found to be the investigation of choice, while plain sinus X-rays correlated poorly with the presence of disease. Exenteration through an external approach was found to be satisfactory. In two cases drainage obstruction due to congenital abnormality was thought to be the underlying cause, while in four cases there was a strong history of atopy, indicating allergy as a possible reason for mucocoele formation. PMID- 2703770 TI - Cephalometric analysis in patients with obstructive sleep apnoea syndrome. I. Skeletal morphology. AB - Facial skeletal morphology was studied by cephalometric analysis in 25 patients with obstructive sleep apnoea syndrome (OSAS) and ten controls. The hyoid bone was more inferiorly positioned in patients (at the level of cervical vertebrae C4 C6) than in controls (C3-C4 level). The height and length of the nasal cavity was normal, while the length of the bony nasopharynx was moderately reduced. The mandibular plane inclination was slightly larger in patients as was the anterior face height. Mandibular retrognathia was demonstrated in six patients (24 per cent), but the angles of maxillary and mandibular prognathism was within normal limits when the group was considered as a unity. Cephalometric analysis is highly recommended as a diagnostic aid in OSAS patients, especially when surgical intervention is considered. PMID- 2703771 TI - Cephalometric analysis in patients with obstructive sleep apnoea syndrome: II. Soft tissue morphology. AB - Oropharyngeal soft tissue profiles were studied by cephalometric analysis in 25 patients with obstructive sleep apnoea syndrome (OSAS) and 10 controls. The length of the soft palate was significantly higher in patients (48.0 +/- 4.3 mm. (mean +/- SD) than in controls (35.3 +/- 4.6 mm.) (p less than 0.001), as was the distance of close contact between the tongue and the soft palate (23 +/- 12 mm. and 10 +/- 8 mm., respectively) (p less than 0.01). The area of the soft palate, measured in the sagittal plane, was 4.85 +/- 0.80 cm.2 and 2.88 +/- 0.62 in the patient and the control group, occupying 39 +/- 8 per cent and 21 +/- 5 per cent of the pharyngeal area (p less than 0.001). The lower outline of the tongue, represented by the line between vallecula (V) and the hyoid bone (AH) was more inferiorly positioned in patients, apparently giving the tongue a more upright position with more of the tongue tissue at the hypopharyngeal level than found in normals. The pharyngeal airway space had significantly reduced anteroposterior dimensions both at the nasopharyngeal and velopharyngeal level (P less than 0.001) as well as the hypopharyngeal level (p less than 0.05). Cephalometric analysis is highly recommended as a valuable tool in the presurgical evaluation of OSAS patients. PMID- 2703772 TI - Role of masseter crossover flap in oropharyngeal reconstruction. AB - Oropharyngeal reconstruction especially after surgery for medially located lesions of moderate dimensions presents a challenge. The risk of using well vascularized, but insensitive tissues close to the airway has led to the development of several measures to overcome the difficulties involved. The transposition of masseter muscle which has been put forward in recent years provides successfully primary closure with preservation of function. PMID- 2703773 TI - Repair of post-laryngectomy pharyngeal fistulae. AB - Post-laryngectomy pharyngeal fistulization is an unpleasant occurrence. Presented herein is the author's approach to this problem, along with two cases in which closure was effected by sternocleidomastoid (SCM) myoplasty. SCM myocutaneous flaps have previously been considered for pharyngocutaneous fistulae and then disregarded due to the doubtful nature of the blood supply to the skin. The SCM myoplasty obviates this problem as it relies on muscle rather than skin. SCM myoplasty has been used as a bolster in pharyngeal reconstruction after the pharynx has been closed by pharyngeal mucosal advancement or rotation. The author has extended this idea utilizing the raw muscle of the SCM to directly reconstruct the defect in fistulae deemed too large for primary closure. Anatomical, oncological and technical considerations are discussed, as well as the author's protocol for post-laryngectomy pharyngocutaneous fistulae. PMID- 2703774 TI - Head and neck surgery in the elderly: a maturing problem. AB - The number of elderly patients requiring oncologic head and neck surgery is increasing as this proportion of the population continues to grow. To establish the specific problems and relative risks, 100 patients, 70 years of age and over have been examined to determine post-operative mortality and morbidity. Results do not show these to be significantly increased in the elderly and support an aggressive approach to head and neck cancer management in these patients. PMID- 2703775 TI - Perforated telescoping double catheter for uncontaminated endobronchial sampling- a new technique. PMID- 2703776 TI - Complications of mediastinoscopy. AB - From 1968 to 1987, mediastinoscopy was performed on 2021 consecutive patients. The procedure was carried out in 35.7 per cent on patients with a pulmonary infiltrate and in 28.8 per cent with bronchogenic carcinoma. Mediastinoscopy was positive in 54 per cent of the cases. The total number of complications was 2.3 per cent (47/2021). There were four cases with major haemorrhage, three tracheal ruptures and three wound infections. Recurrent nerve paralysis was verified in three patients and pericardial rupture in two patients. The total of major complications was 0.5 per cent (10/2021). There was no deaths in this series. In the authors' opinion, mediastinoscopy can be regarded as an effective and safe procedure in the hands of an experienced surgeon. PMID- 2703777 TI - Superficial malignant schwannoma on the face: a case for early radical surgery. AB - A case of superficial epithelioid schwannoma is presented. The lesion arose as a skin papule in the infra-orbital region and recurring repeatedly over a five-year period, caused significant local morbidity without metastasis. Radical surgery was delayed in the hope of preserving binocular vision. The similarity of this tumour with a rare variant of malignant melanoma, the neurotropic melanoma, is discussed. PMID- 2703778 TI - Septic arthritis of the temporomandibular joint complicating otitis externa. AB - Septic arthritis of the temporomandibular joint is an uncommon condition. As a complication of otitis externa it is extremely rare. Two cases are reported and the aetiology, diagnosis and management discussed. PMID- 2703779 TI - Rare case of obscure haemorrhage in the upper digestive tract (epiglottis). AB - An exceptional case of obscure bleeding in the upper digestive tract caused by an arteriovenous haemangioma of the epiglottis is presented. The clinical details and surgical findings are described. PMID- 2703780 TI - Idiopathic fibrosis of the upper aero-digestive tract. AB - Idiopathic fibrosis of different areas of the body such as retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Reidel's thyroiditis and pseudo-tumour of the orbit are well recognised entities that manifest individually or in combination. A case of idiopathic fibrosis of the upper aerodigestive tract is presented, which caused dense fibrosis of the floor of mouth, tongue, pharynx and larynx leading to aphonia and severe dysphagia. A permanent tracheostomy was performed and regular bouginage is necessary. This is the first such case reported in the literature. PMID- 2703781 TI - Fractured tracheostomy tube in the tracheobronchial tree. AB - A fractured tracheostomy tube is a rare complication; cases have been reported in the past, usually associated with prolonged usage in patients with chronic airway obstruction. We present here a fracture occurring in a new tube, and also describe a method for retrieving the tube from the tracheobronchial tree. PMID- 2703782 TI - View from inside radiology in focus. 'Air in the neck'. PMID- 2703783 TI - "Much to do about nothing": a clarification of issues on the regular education initiative. PMID- 2703784 TI - Acquisition and generalization of social skills in elementary-aged children with learning disabilities. AB - The generalization of specific social skills to new environments/situations by elementary-aged students with learning disabilities was the primary focus of this study. During the spring semester of 1985, training in the learning disabilities resource room, including a discussion and verbal rehearsal of appropriate skill use and positive consequences of using the specific social skill appropriately, was initiated. Once the subject became proficient in the skill of interest, attempts to establish the skill outside the resource room were initiated (training sufficient exemplars). Reinforcement in the form of systematic attention was delivered in the new environments by teachers and parents. During the fall semester of 1985 each of the subjects was again observed with respect to the behaviors of interest. All subjects manifested generalization of the social skills to the new environments. PMID- 2703785 TI - Cognitive deficits in reading disability and attention deficit disorder. AB - This paper presents data from three studies (a cross-sectional study of school referred children, a test-retest study of subtypes of reading disabilities, and a study of a large, random sample of first graders) that focus on specifying the cognitive deficits associated with reading difficulties and separating them from those associated with attentional deficits. The cognitive deficits associated with difficulty in reading were consistent across samples, developmental levels, definitions, and subtypes of reading disabilities. With IQ, age, and sex controlled for, poor readers were significantly impaired on measures of naming and phonological awareness. The effects of attentional deficits were more variable and complex but were clearly separate from the reading disability effects. PMID- 2703786 TI - Symptom expression in hyperactive children: an analysis of observations. AB - Hyperactivity is typically diagnosed when children display overactivity, inappropriate inattention, and impulsivity during the school day when involved in tasks that require sustained and voluntary attention. However, distinguishing children with hyperactivity from children with other learning and behavior disorders is often difficult because of an overlap in symptom expression. Some studies have failed to find any factors associated only with the hyperactive syndrome. The present study compared the behavior of students diagnosed as hyperactive or having attention deficit disorder to students diagnosed as having learning disabilities. Symptoms associated with overactivity, inattention, and impulsivity of 19 hyperactive and 17 nonhyperactive (learning disordered) students were observed and counted using a direct diagnostic procedure following a momentary time sampling technique. Analyses revealed that differences between the groups were often qualitative rather than quantitative, and only a few symptoms distinguished one diagnosis from the other. Hyperactive students demonstrated more talking, unsystematic search, and motor impersistence than nonhyperactive students. Nonhyperactive students demonstrated more upper extremity movement and displayed more inattention when engaged in visual tasks than hyperactive students. The findings questioned the use of general categories of behavior such as overactivity to discriminate hyperactive from nonhyperactive students. Implications for diagnosis and the need for continued studies are reviewed. PMID- 2703787 TI - Academic competence and social adjustment of boys with learning disabilities and boys with behavior disorders. AB - The aim of the present study was to compare academic competence and social adjustment of students with learning disabilities and two groups of students with behavior disorders. The sample consisted of 31 boys with learning disabilities and 52 boys with behavior disorders divided into two subgroups: (a) boys displaying hyperactive behavior (BDH) and (b) boys not demonstrating such behavior (BDNH). Significant differences were found among the three groups using the Classroom Behavior Inventory, and three measures contributed to the significant difference: Hostility versus Consideration, Extroversion versus Introversion, and Independence versus Dependence. The results highlighted teachers' needs for differential approach in their interventional planning. PMID- 2703788 TI - Learning problems, anger, perceived control, and misbehavior. AB - Fifty-four students diagnosed as having learning disabilities (LD) and 73 students in regular education were administered the School Anger Inventory and the Perceived Control at School Scale. Teachers and parents rated student deportment and motivation. Predictably, those in the LD sample indicated higher school anger levels and were rated as exhibiting more negative behavior, less positive behavior, and lower motivation for on-task performance. The samples did not differ in their ratings of perceived control, which was moderate, and were given comparable positive teacher ratings for recall of relevant and interesting material. Significant correlations between school anger and behavior were found only in the LD sample, and there was no significant overall relationship between school anger, behavior, and perceived control within either sample. Overall, however, students who reported both a high level of anger and high perceived control were found to exhibit more negative behavior than those with high anger and low perceived control. PMID- 2703789 TI - Prevalence of communication disorders in students with learning disabilities. AB - The prevalence of communication disorders in a population of 242 children with learning disabilities between 8 and 12 years of age enrolled in a school system in Alabama was studied. The prevalence of articulation, language, voice, fluency, and hearing disorders was determined through an individual assessment program. A speech, language, or hearing problem was exhibited by 96.2% (233) of the 242 children studied. Language deficits were found in 90.5%, articulation deficits in 23.5%, voice disorders in 12%, and fluency disorders in 1.2% of the students with learning disabilities. Puretone hearing deficits were observed in 7.4% and middle ear function deficits were observed in 15.7% of the students. Only 6% of the children were receiving the services of a speech-language pathologist. PMID- 2703790 TI - Perceived importance of occupations by adolescents with and without learning disabilities. AB - A study of the perceived importance of 23 occupations by 65 adolescents with learning disabilities and 85 adolescents without learning disabilities revealed that occupations were ranked similarly by the two groups (Rho = .76). Analysis of the groups' rank order indicated diversity of students' perceptions about the importance of various occupations. PMID- 2703791 TI - Manifest anxiety in children with learning disabilities. AB - Manifest anxiety scores of students receiving part-time services for learning disabilities, students receiving full-time services for learning disabilities, and a matched group of nonexceptional peers were compared. A significant difference was found between the part-time group and the nonexceptional group in Total Anxiety and Worry-Oversensitivity. PMID- 2703792 TI - Adult support and the exploratory behavior of children with learning disabilities. AB - Low- and moderate-exploratory children with learning disabilities engaged in exploratory behavior independently and with an adult who communicated support in one of two nonintrusive ways. Consistent with a developmental motivation perspective, low- and moderate-exploratory children showed higher levels of exploration under both kinds of supportive conditions. PMID- 2703793 TI - Verbal/visual processing for males disabled in print acquisition. AB - Fourteen males disabled in print acquisition were studied over time to determine their patterns of verbal and spatial processing. Comparing results of WISC-R and WAIS scales using a Bonferroni correction for t-values, it was found that the Similarities subtest scores significantly increased while the Vocabulary subtest scores and Acquired Knowledge category significantly decreased. Hemispheric specialization was suggested as a possible cause for differences in verbal and nonverbal processing. PMID- 2703794 TI - Confocal scanning fluorescence microscopy: a new method for phagocytosis research. AB - An important new method for phagocytosis research, confocal scanning fluorescence light microscopy (CSFM), is demonstrated using fluorescent microspheres ingested by murine macrophages. CSFM, in combination with Nomarski differential interference contrast microscopy (DIC), can resolve microspheres inside cells from microspheres attached to the surface of cells. Further, combined CSFM and DIC images can quantitate phagocytosis by individual cells aggregated together. No other method offers these capabilities. A comparison of CSFM and conventional epifluorescence light microscopy (EFM) images shows that CSFM produces significantly higher-resolution images of microspheres than EFM, primarily because CSFM excludes the out-of-focus light artifacts of EFM. PMID- 2703795 TI - Formalin-fixed macrophages bind tumor targets similarly to viable macrophages. AB - Macrophages (MPs) fixed with 1% formalin in PBS bound targets similarly to viable MPs. Like binding between viable MPs and tumor cells, the process was temperature and calcium dependent. Fixed MPs discriminated targets similarly to viable MPs. Targets not bound by viable MPs were not bound by fixed MPs. The lectin Bandeiraea simplicifolia (ASI-B4) was able to enhance MP binding to tumor cells regardless of whether MPs were fixed or viable. However, it did not appear that ASI-B4-like molecules were involved in the direct recognition of F5b tumor cells by MPs. Target cells could not be fixed in 1% formalin for binding to occur. These data suggest that the receptor on the MP for tumor cell binding is functional in the absence of active physiological processes. In contrast, tumor cell processes that are dependent upon target cell viability are required for binding. PMID- 2703796 TI - Fish oils in clinical medicine. PMID- 2703797 TI - Risk factors for cardiovascular disease in 16-19-year-old teenagers. AB - In a representative sample of Danish school children (124 boys and 169 girls), 16 19 years of age, blood pressure, blood lipids, body fat content, maximal aerobic power, alcohol consumption and smoking habits were studied. No systematic variation was noticed within this age in the risk factor profile. The mean values for blood pressure (BP) (systolic/diastolic) were 125/73 mmHg for the boys and 117/71 mmHg for the girls. As much as 14% of the boys and 5% of the girls had either a systolic BP above 140 mmHg or a diastolic BP above 90 mmHg. Total serum cholesterol averaged 4.13 mmol l-1 for the boys and 4.53 mmol l-1 for the girls, which is also high compared with adolescents from other countries. The ratios for high density lipoprotein cholesterol to total serum cholesterol were normal and in the range of 0.25-0.28 for both sexes. Other factors associated with coronary heart disease in adults, such as body fat content, serum triglycerides, physical activity, as well as smoking and alcohol habits were similar to that reported for teenagers in other countries. No correlation was found between aerobic power (ml min-1.kg-1) and the risk factors measured. PMID- 2703798 TI - The relationship between casual and ambulatory blood pressure in essential hypertension: the influence of work, duration of hypertension and antihypertensive treatment. AB - Casual blood pressure (BP) and ambulatory BP (mean 24-h BP) were determined in 23 untreated patients with essential hypertension and in 11 normotensive healthy control subjects. Mean 24-h BP was significantly lower than casual BP in patients with essential hypertension, but not in control subjects. This was demonstrated in the patients who did not work during the ambulatory BP monitoring and in the patients with newly recognized hypertension, whereas no differences were revealed either in the patients who went to work or had a known duration of hypertension longer than 6 months. The size of the difference between casual BP and mean 24-h BP was unaffected by antihypertensive therapy with metoprolol and also individually reproducible. An accordance between casual and ambulatory BP measurements in evaluation of the efficacy of antihypertensive treatment was found in 75% of the patients. Casual BP and mean 24-h BP were weakly correlated both before and during antihypertensive treatment. It is concluded that the higher casual BP than ambulatory BP in essential hypertension may be a specific characteristic of the disease. Both work and known duration of hypertension longer than 6 months eliminate the difference between casual ambulatory BP in essential hypertension. Ambulatory BP monitoring seems to be superior to casual BP measurements in the evaluation of antihypertensive treatment. PMID- 2703799 TI - Tick-borne viral encephalitis in Finland. The clinical features of Kumlinge disease during 1959-1987. AB - During 1959-1987, 126 patients in Aland Islands and main Finland had serologically verified infections with the virus of tick-borne encephalitis (Kumlinge disease). The most useful test for specific virological diagnosis was haemagglutination inhibition-IgM (HI-IgM). Most cases were from Aland Islands and nearby south-western main Finland. Two of the infections were imported. There were three laboratory infections and two transfusion infections. The disease occurred mainly from July to September. Detailed hospital records of 108 of the patients could be obtained. Ninety-five per cent of the patients had headaches, 82% had lymphocytosis of the cerebrospinal fluid, and 81% had high fever. Forty four per cent had a confirmed biphasic course of disease. Seventeen per cent were severely ill. There were no deaths. The sequels were psychic irritability and fatigue for up to 1 year. There were eight cases of paresis, two of which became permanent. PMID- 2703800 TI - Dental infections in association with cerebral infarction in young and middle aged men. AB - The association between dental infections and cerebral infarction was investigated in a case-control study involving 40 patients with ischaemic cerebral infarction under the age of 50, and 40 randomly selected community controls matched for sex and age. Poor oral health, as assessed by two indices measuring the severity of infections of teeth and periodontium, or by the presence of subgingival calculus or the presence of suppuration in the gingival pockets, were more common in male patients than in male controls, but no difference was observed in females. If severe dental infections were combined with other probable bacterial infections there were altogether 16 patients (40%) but only two controls (5%) who had suffered from a probable bacterial infection within 1 month or at the time of the stroke or when examined as a control (P less than 0.01). Our results suggest an association between bacterial infection and ischaemic cerebrovascular disease in patients under 50 years of age. Severe chronic dental infection seems to be an important type of infection associated with cerebral infarction in males. PMID- 2703801 TI - Familial hypocalciuric hypercalcaemia: a study of four kindreds. AB - Four kindreds with hereditary hypercalcaemia have been investigated. Thirty-seven of 72 subjects examined had hypercalcaemia with an autosomal dominant pattern of inheritance. Hypercalcaemic patients had total serum calcium of 2.91 +/- 0.12 mmol l-1. Serum parathyroid hormone (PTH) was normal while daily urinary calcium excretion was subnormal (below 2.5 mmol) in 45%. Comparison with an age-matched group of patients with primary hyperparathyroidism gave a small overlap regarding serum human PTH, urinary calcium and the ratio between calcium clearance and creatinine clearance. Family screening therefore is of diagnostic importance. Twelve subjects had been subjected to parathyroid surgery before the correct diagnosis was settled, none of the cases had an adenoma. Three patients became normocalcaemic and the others had persistent hypercalcaemia. One male non-abuser had seven episodes of acute pancreatitis before surgery and none after. The findings in all four kindreds are compatible with familial hypocalciuric hypercalcaemia (FHH). This hereditary disorder of unknown aetiology, therefore, also exists in Scandinavia. It is of importance to consider FHH in the differential diagnosis of hypercalcaemia, since this disorder usually has a benign prognosis if untreated. PMID- 2703803 TI - Giant cell arteritis: loss of vision during corticosteroid therapy. AB - The case of a patient suffering from giant cell arteritis, with loss of vision after about 60 d of steroid treatment, is reported. No other clinical or biochemical signs of active disease were observed. The aetiology of the vascular occlusion is discussed briefly. PMID- 2703802 TI - Vitamin D, parathyroid hormone, and bone mineral content of lumbar spine and femur in primary biliary cirrhosis. AB - In order to elucidate the pathogenesis and degree of osteopoenia in primary biliary cirrhosis (PBC) we conducted a cross-sectional study of 47 non-selected female patients with biopsy-proven PBC. Bone mineral content (BMC) of the lumbar spine, femoral neck and femoral shaft was determined using dual photon absorptiometry. Compared to healthy females of corresponding decades the PBC patients exhibited significantly decreased mean BMC-values in lumbar spine (88%, P less than 0.05) and femoral neck (92%, P less than 0.05) but not in femoral shaft (96%, NS). Bone mineral content was not significantly associated with duration of liver disease, impairment of liver function (serum concentrations of albumin, clotting factors II + VII + X, bilirubin, alkaline phosphatase galactose elimination capacity or histology), variables reflecting calcium homeostasis (serum concentrations of ionized calcium, parathyroid hormone, vitamin D binding protein, 25-hydroxy vitamin D3 and 1,25-dihydroxy vitamin D3) or previous treatment with glucocorticosteroids. In view of our negative findings we suggest that future studies in this field should focus on physical activity and female sex hormones as determinants for the prevention of osteopoenia in females with primary biliary cirrhosis. PMID- 2703804 TI - HbA1 self-recording in the management of diabetes mellitus. PMID- 2703805 TI - Judgments of quantity and conservation of quantity: the area of a rectangle. AB - This study examines the relationships between perceptive judgment of quantity and conservation judgment of quantity with regard to the concept of area. Twenty children who passed an area conservation task (mean age = 8) and 20 children who failed it (mean age = 6, 7) were administered an area judgment task. This task was a replication of Anderson and Cuneo's study (1978, Journal of Experimental Psychology: General, 107, 335-378). The conserving children generally appeared to apply an additive rule (the height and width rule) observed by Anderson and Cuneo in 5 year olds. The nonconserving children in contrast generally presented patterns suggesting centration on one of the two dimensions. The implications for Anderson's and Piaget's conceptions of conservation development are discussed. PMID- 2703806 TI - Expectancies and memory for spatiotemporal events in 5-month-old infants. AB - Five-month-old infants were trained to fixate four event locations, and recall was assessed following training in three experiments. Memory for four events was demonstrated in the first two studies, and memory for these events was also found to be robust following a 6- to 7-day delay. Infants demonstrated that they can anticipate upcoming events during training: they increased anticipatory behaviors during latter training trials, and they appeared to form expectancies of future events during periods of both stimulus onset and stimulus offset. Results are interpreted as consistent with a script representational view of memory for spatiotemporal events. PMID- 2703807 TI - Time and again: effects of repetition and retention interval on 2 year olds' event recall. AB - How and what very young children remember is a central question for understanding the course of memory development. In this research, we examined the effects of two factors on 2-year-old children's ability to recall novel events: repetition of the experience and time since experience. Twenty 24-month-old and twenty 28 month-old children participated in unusual laboratory play events. Half of the children returned after a 2-week delay and again after a 3-month delay (repeated experience condition); the remaining children returned only after 3 months (single experience condition). Memory was assessed by asking children to reenact the events. Recall was generally accurate, and there were no significant effects of age. All children recalled more information about the activities associated with the event than about the objects. Surprisingly, children in the repeated experience condition recalled as much about the events at the 3-month retention interval as at the 2-week retention interval. Further, children in this condition recalled more information at the 3-month retention interval than children in the single experience condition, suggesting that reexperiencing an event may guard against long-term forgetting. PMID- 2703808 TI - Generalization after intradimensional discrimination training in 2-year-old children. AB - Two-year-old children received intradimensional discrimination training at initially distant points on a circle-ellipse continuum. This training often did not produce stimulus control by circle-ellipse differences smaller than the original training values. The lack of control did not reflect capacity limitations, however. Good control was established when the children were given further training at nearer points on the continuum. The data confirm results of earlier research on stimulus generalization, extending them to a developing human subject population. PMID- 2703809 TI - Fever of unknown origin for six years: Munchausen syndrome by proxy. PMID- 2703810 TI - Disinfection of endoscopes. PMID- 2703811 TI - Toward the resolution of generalist-specialist boundary issues. PMID- 2703812 TI - Hyperhidrosis: a management dilemma. AB - Hyperhidrosis is excessive sweating in response to psychological stress and emotional stimuli. The sweat is usually limited to the palms, soles, and axillae, and is greatly accentuated by mental stimuli rather than temperature and exercise. The severity is such that for many, sweating has become socially and emotionally devastating and may predispose to other cutaneous diseases. More than 60 research papers on eccrine glands and sweating have been published since 1978. Little progress, however, has been made on the control of hyperhidrosis, and the process remains a treatment dilemma among both family physicians and dermatologists. The many treatment modalities documented in the literature have been for the most part unsuccessful or unacceptable. This report describes the use of phenoxybenzamine, an alpha-adrenergic antagonist, for control of excessive sweating in two patients. After a trial of topical medication, phenoxybenzamine is useful for the reduction of sweating to an acceptable level. PMID- 2703813 TI - The interpretation of office radiographs by family physicians. AB - This study prospectively compared the interpretations of family practice residents and faculty with those of radiologists on 532 office radiographs using a uniform protocol. A total of 136 family practice residents (44 first-year, 40 second-year, 52 third-year) and 42 full-time and part-time faculty participated in the study along with 30 radiologists. The mix of radiographs evaluated was as follows: 44 percent chest, 20 percent lower extremity, 6 percent head, 4 percent lumbosacral spine, 3 percent cervical-thoracic spine, and 3 percent abdomen pelvis. Interpretation concordance rates between family physicians and radiologists, by level of training, were as follows: first-year residents 83.0 percent, second-year residents 84.4 percent, third-year residents 86.0 percent, and faculty 88.6 percent. Concordance after the resident and faculty preceptor discussed the film and provided a collaborative interpretation was 92.1 percent. This finding compares with previously reported error rates of 10 to 40 percent between experienced radiologists. Only 10.3 percent of the discordant readings (0.8 percent of all radiographs) contained significant discordancies that may have affected patient management or outcome. Had the family physicians been given the option to refer an x-ray film to the radiologist, all x-ray films containing significant discordancies would have been referred. PMID- 2703814 TI - Family practice obstetrics in Michigan. Factors affecting physician participation. AB - The purpose of this study was to describe the characteristics of family physicians in Michigan who practice obstetrics and to identify important factors relating to a decision to discontinue obstetric practice. Questionnaires were mailed to all members of the Michigan Academy of Family Physicians (MAFP) who were listed as currently practicing obstetrics. Two hundred ninety-one questionnaires from the 357 mailed questionnaires were returned for a response rate of 81.5 percent. Two hundred thirty-five of the 291 respondents (80.8 percent) were practicing obstetrics in 1986. Twenty-two of the 235 physicians (9.4 percent) planned on discontinuing obstetric practice by early 1987. Reasons for discontinuing obstetrics included malpractice liability risk and cost and interference with lifestyle. Physicians who had recently discontinued or were planning to discontinue obstetric practice were significantly less likely than physicians practicing obstetrics to have a residency program affiliation (33 percent vs 58 percent). While malpractice concerns were found to be an important factor in deciding to discontinue the practice of obstetrics, practice arrangements and educational affiliations were other important factors that may be more amenable to change through educational or administrative interventions. PMID- 2703815 TI - Interdepartmental training in flexible sigmoidoscopy for family medicine residents. PMID- 2703816 TI - Hyperglycemia with non-insulin-dependent diabetes following intraarticular steroid injection. PMID- 2703817 TI - New family practice residency programs in Nicaragua and Costa Rica. PMID- 2703818 TI - Electro-olfactogram and multiunit olfactory receptor responses to binary and trinary mixtures of amino acids in the channel catfish, Ictalurus punctatus. AB - In vivo electrophysiological recordings from populations of olfactory receptor neurons in the channel catfish, Ictalurus punctatus, clearly showed that responses to binary and trinary mixtures of amino acids were predictable with knowledge obtained from previous cross-adaptation studies of the relative independence of the respective binding sites of the component stimuli. All component stimuli, from which equal aliquots were drawn to form the mixtures, were adjusted in concentration to provide for approximately equal response magnitudes. The magnitude of the response to a mixture whose component amino acids showed significant cross-reactivity was equivalent to the response to any single component used to form that mixture. A mixture whose component amino acids showed minimal cross-adaptation produced a significantly larger relative response than a mixture whose components exhibited considerable cross-reactivity. This larger response approached the sum of the responses to the individual component amino acids tested at the resulting concentrations in the mixture, even though olfactory receptor dose-response functions for amino acids in this species are characterized by extreme sensory compression (i.e., successive concentration increments produce progressively smaller physiological responses). Thus, the present study indicates that the response to sensory stimulation of olfactory receptor sites is more enhanced by the activation of different receptor site types than by stimulus interaction at a single site type. PMID- 2703819 TI - Na- and Cl-dependent glycine transport in human red blood cells and ghosts. A study of the binding of substrates to the outward-facing carrier. AB - Na- and Cl-dependent glycine transport was investigated in human red blood cells. The effects of the carrier substrates (Na, Cl, and glycine) on the glycine transport kinetics were studied with the goal of learning more about the mechanism of transport. The K1/2-gly was 100 microM and the Vmax-gly was 109 mumol/kg Hb.h. When cis Na was lowered (50 mM) the K1/2-gly increased and the Vmax-gly decreased, which was consistent with a preferred order of rapid equilibrium loading of glycine before Na. Na-dependent glycine influx as a function of Na concentration was sigmoidal, and direct measurement of glycine and Na uptake indicated a stoichiometry of 2 Na:1 glycine transported. The sigmoidal response of glycine influx to Na concentration was best fit by a model with ordered binding of Na, the first Na with a high K1/2 (greater than 250 mM), and the second Na with a low K1/2 (less than 10.3 mM). In the presence of low Cl (cis and trans 5 mM), the K1/2-gly increased and the Vmax-gly increased. The Cl dependence displayed Michaelis-Menten kinetics with a K1/2-Cl of 9.5 mM. At low Cl (5 mM Cl balanced with NO3), the glycine influx as a function of Na showed the same stoichiometry and Vmax-Na but a decreased affinity of the carrier for Na. These data suggested that Cl binds to the carrier before Na. Experiments comparing influx and efflux rates of transport using red blood cell ghosts indicated a functional asymmetry of the transporter. Under the same gradient conditions, Na- and Cl-dependent glycine transport functioned in both directions across the membrane but rates of efflux were 50% greater than rates of influx. In addition, the presence of trans substrates modified influx and efflux differently. Trans glycine largely inhibited glycine efflux in the absence or presence of trans Na; trans Na largely inhibited glycine influx and this inhibition was partially reversed when trans glycine was also present. A model for the binding of these substrates to the outward-facing carrier is presented. PMID- 2703820 TI - Receptor Ca current and Ca-gated K current in tonic electroreceptors of the marine catfish Plotosus. AB - The tonic electroreceptors of the marine catfish Plotosus consist of a cluster of ampullae of sensory epithelia, each of which is an isolated receptor unit that is attached to the distant skin with only a long duct. The single-cell layered sensory epithelium has pear-shaped receptor cells interspersed with thin processes of supporting cells. The apical border of the receptor cells is joined to the supporting cells with junctional complexes. Single ampullae were excised and electrically isolated by an air gap. Receptor responses were recorded as epithelial current under voltage clamp, and postsynaptic potentials (PSP) were recorded externally from the afferent nerve in the presence of tetrodotoxin. The ampulla showed a DC potential of -19.2 +/- 6.5 mV (mean +/- SD, n = 18), and an input resistance of 697 +/- 263 K omega (n = 21). Positive voltage steps evoked inward currents with two peaks and a positive dip, associated with PSPs. The apical membrane proved to be inactive. The inward current was ascribed to Ca current, and the positive dip to Ca-gated transient K current, bot in the basal membrane of receptor cells. The Ca channels proved to have ionic selectivity in the order of Sr2+ greater than Ca2+ greater than Ba2+, and presumably they also passed outward current nonselectively. Double-pulse experiments further revealed a current-dependent inactivation for a part of the Ca current. PMID- 2703823 TI - Outward current in single smooth muscle cells of the guinea pig taenia coli. AB - In single myocytes of the guinea pig taenia coli, dispersed by enzymatic digestion, the late outward current is carried by K+. It has both a Ca2+ activated component and a voltage-dependent component which is resistant to external Co2+. The reversal potential is -84 mV, and the channel(s) for it are highly selective to K+. At 33 degrees C, the activation follows n2 kinetics, with a voltage-dependent time constant of 10.6 ms at 0 mV, which shortens to 1.7 ms at +70 mV. Deactivation follows a single-exponential time course, with a voltage dependent time constant of 11 ms at -50 mV, which lengthens to 33 ms at -20 mV. During a 4.5-s maintained depolarization, IK inactivates, most of it into two exponential components, but there is a small noninactivating residue. It is surmised that during an action potential under physiological conditions, there is sufficient IK to cause repolarization. PMID- 2703821 TI - Influence of temperature on the calcium sensitivity of the myofilaments of skinned ventricular muscle from the rabbit. AB - The steady-state myofilament Ca sensitivity was determined in skinned cardiac trabeculae from the rabbit right ventricle (diameter, 0.13-0.34 mm) at 36, 29, 22, 15, 8, and 1 degree C. Muscles were stimulated to 0.5 Hz and stretched to a length at which maximum twitch tension was generated. The preparation was then skinned with 1% vol/vol Triton X-100 in a relaxing medium (10 mM EGTA, pCa 9.0). Each preparation was exposed to a series of Ca-containing solutions (pCa 6.3-4.0) at two of the six temperatures studied (temperature was regulated to +/- 0.1 degree C). The pCa values (mean +/- SD, n = 6) corresponding to half maximal tension at 36, 29, 22, 15, 8, and 1 degree C were 5.47 +/- 0.07, 5.49 +/- 0.07, 5.34 +/- 0.05, 5.26 +/- 0.09, 4.93 +/- 0.06, and 4.73 +/- 0.04, respectively. Mean (+/- SD) maximum tension (Cmax) developed by the preparation as a percentage of that at 22 degrees C was 118 +/- 10, 108 +/- 5, 74 +/- 6, 57 +/- 7, and 29 +/- 5% at 36, 29, 15, 8, and 1 degree C, respectively. As cooling led to a shift of Ca sensitivity towards higher [Ca2+] and a reduction of Cmax, the Ca sensitivity curves over this range of temperatures do not cross over as has been described for canine Purkinje fibers (Fabiato 1985). Since tension is decreased by cooling at all levels of [Ca2+] it is unlikely that changes in myofilament Ca sensitivity play a role in the large hypothermic inotropy seen in rabbit ventricular muscle. The increase in sensitivity of the myofilaments to Ca on warming from 1 to 29 degrees C might be related to the increase in force seen on rewarming from a rapid cooling contracture in intact rabbit ventricular muscle. PMID- 2703822 TI - Evidence for electrogenic Na+/Ca2+ exchange in Limulus ventral photoreceptors. AB - The Ca2+ indicator photoprotein, aequorin, was used to estimate and monitor intracellular Ca2+ levels in Limulus ventral photoreceptors during procedures designed to affect Na+/Ca2+ exchange. Dark levels of [Ca2+]i were estimated at 0.66 +/- 0.09 microM. Removal of extracellular Na+ caused [Ca2+]i to rise transiently from an estimated 0.5-0.6 microM in a typical cell to approximately 21 microM; [Ca2+]i approached a plateau level in 0-Na+ saline of approximately 5.5 microM; restoration of normal [Na+]o lowered [Ca2+]i to baseline with a time course of 1 log10 unit per 9 s. The apparent rate of Nao+-dependent [Ca2+]i decline decreased with decreasing [Ca2+]i. Reintroduction of Ca2+ to 0-Na+, 0 Ca2+ saline in a typical cell caused a transient rise in [Ca2+]i from an estimated 0.36 microM (or lower) to approximately 16.5 microM. This was followed by a decline in [Ca2+]i approaching a plateau of approximately 5 microM; subsequent removal of Cao2+ caused [Ca2+]i to decline slowly (1 log unit in approximately 110 s). Intracellular injection of Na+ in the absence of extracellular Na+ caused a transient rise in [Ca2+]i in the presence of normal [Ca2+]o; in 0-Ca2+ saline, however, no such rise in [Ca2+]i was detected. Under constant voltage clamp (-80 mV) inward currents were measured after the addition of Nao+ to 0-Na+ 0-Ca2+ saline and outward currents were measured after the addition of Cao2+ to 0-Na+ 0-Ca2+ saline. The results suggest the presence of an electrogenic Na+/Ca2+ exchange process in the plasma membrane of Limulus ventral photoreceptors that can operate in forward (Nao+-dependent Ca2+ extrusion) or reverse (Nai+-dependent Ca2+ influx) directions. PMID- 2703824 TI - Psychopathology and social functioning in women with Turner syndrome. AB - Turner syndrome (TUS) in women is associated with sex chromosome abnormalities, ovarian dysgenesis with estrogen deficiency, and short stature. The goal of this study was to assess the long-term effects of these sex chromosome and hormonal anomalies on psychopathology and social functioning. We report interview and questionnaire data concerning lifetime history of mental disorders and current psychiatric symptoms. Also reported are data from questionnaires and interviews evaluating social functioning as measured by education, occupation, personal resources, and sexual behavior. Twenty-three TUS women were studied and compared with 23 closely matched women with constitutional short stature (CSS) and with 10 normal sisters of the TUS women. TUS women reported generally less mental disorder and comparable rates of psychiatric symptoms. On the other hand, they had lower overall functioning on a measure of global psychological health and had more impairment in social functioning as measured by achievement of adult milestones. We conclude that TUS women display less mental illness by positive symptom-oriented criteria but also less mental health when day-to-day functioning is considered. Our data suggest that differences in TUS women cannot be explained solely by short stature and may be related to other psychosocial, genetic, endocrine, or CNS effects of the syndrome. PMID- 2703825 TI - Anxiety disorders among Mexican Americans and non-Hispanic whites in Los Angeles. AB - This report from the Los Angeles site of the NIMH Epidemiologic Catchment Area study reveals significant ethnic and national origin differences in lifetime prevalence rates for three out of six specific, DSM-III-defined anxiety disorders. In the case of simple phobia, United States-born Mexican Americans report higher rates than native non-Hispanic whites or immigrant Mexican Americans, the latter two groups having similar rates. Mexican Americans born in the United States had higher rates of agoraphobia than immigrant Mexican Americans, and non-Hispanic whites reported higher lifetime rates of generalized anxiety disorder compared with both immigrant and native Mexican Americans. Neither ethnic nor national origin differences in lifetime prevalence rates were found for panic disorder, social phobia, and obsessive-compulsive disorder. Selective migration is postulated as a potential factor influencing prevalence differences between native and immigrant Mexican Americans. PMID- 2703826 TI - Depression, pain, and hemispheric activation. AB - The present study attempts to delineate the role of hemispheric activation in depression and pain. It was hypothesized that the right hemisphere is specialized to become activated by and to process negative affective stimuli, and that this specialization may play a role in the co-occurrence of depression and pain. The relationship between depression, experimental pain, and cerebral laterality was investigated in 16 depressed and 16 nondepressed, right-handed, female students. Cerebral laterality was measured via tasks assessing visual and auditory biases, and pain was assessed via a cold pressor task. The proposition that the right hemisphere mediates the co-occurrence of pain and depression was not supported, but specific findings did suggest that the right hemisphere may play a unique role in pain perception. Data from the visual task indicated that prior exposure to pain results in increased right hemisphere activation as indicated by a left visual field bias. Pain perception was a complex function of mood, preceding tasks, and the hand tested, and it was suggested that exposure to a typical right hemisphere task increased the left side lateralization of pain in nondepressed subjects. Implications of these findings are discussed for coexisting problems of pain and depression and for the lateralization of pain in disorders judged to involve a significant psychogenic component. PMID- 2703827 TI - Computed tomography findings in delirium. AB - Computerized tomography of the head was carried out on 69 elderly patients who met the DSM-III criteria for delirium and 31 neurological controls in order to evaluate the focal changes and generalized brain atrophy associated with delirium. Neither the difference between the mean ages nor the sex distribution in these groups was statistically significant. The delirious patients differed from the controls significantly in ventricular dilatation and cortical atrophy, and there was a statistically significant correlation between the width of the sylvian fissure and Mini-Mental State Examination score. Focal changes were also statistically more common in the delirious patients, and these changes tended to concentrate in the high-order association areas of the right hemisphere. Results suggest a marked predisposing role for the structural brain diseases (primary degenerative and multi-infarct type dementias, parkinsonism) in the development of delirium in elderly patients. PMID- 2703828 TI - Obsessive-compulsive disorder in mentally retarded patients. AB - Of 283 mildly to profoundly retarded patients, 10 (3.5%) presented with compulsive behavior that significantly interfered with their daily functioning. Compulsions occurred in the context of obvious cerebral dysfunction and in the absence of anxiety or "ego-dystonic" qualities. The interrater reliability of the differential diagnosis between compulsions, stereotypies, and other repetitive behaviors was good (kappa = .82). A severity rating scale for the compulsive behavior yielded total scores with good interrater reliability (intraclass correlation coefficient = .82). Single items that described observable behaviors had good reliability, while inner resistance and subjective distress were not reliably assessed and contributed little to the total score. The authors suggest that the DSM-III-R diagnosis of obsessive-compulsive disorder be considered in mentally retarded patients, despite the absence of recognizable ego dystonic characteristics. Emphasis should be on the behavioral, externally observable components of the disorder, rather than on inner conflicts and anxiety. Such a diagnostic approach may also benefit nonretarded compulsive patients. PMID- 2703829 TI - Correlates of memory in Parkinson's disease. AB - There is much controversy concerning the incidence and nature of dementia, particularly memory impairment, in the parkinsonian patient. Specifically, a question arises with respect to the relationship of numerous personal, neurological, medication, and disability variables to this memory impairment. We administered a recently developed standardized test of recent memory functions to 53 idiopathic parkinsonian patients undergoing Sinemet treatment. Memory scores were correlated with age, sex, education, marital status, length of illness, age at onset of illness, dosage and time on medication, functional status, and the major symptoms of parkinsonism. Of all factors assessed, only increased bradykinesia correlated consistently and pervasively with impaired memory. Some possible explanations are offered. PMID- 2703830 TI - Posttraumatic adjustment of Australian firefighters. PMID- 2703831 TI - Behavior of [185W]thiotungstates injected into sheep and the influence of copper: their fate and the effect of the compounds upon plasma copper. AB - [185W]trithio- and tetrathiotungstates (0.5 mg W) were injected intravenously into sheep. The compounds circulated in plasma bound reversibly to plasma proteins, particularly to albumin. After the first few minutes, levels declined exponentially with a T 1/2 of 12-14 hr. The initial movement of [185W]trithiotungstate from the plasma compartment was delayed transiently by the immediate injection of copper (2-6 mg); the longer-term metabolism was unaffected. The final fate of the compounds appeared to be hydrolysis and excretion in urine as [185W]tungstate. 185W from [185W]trithiotungstate appeared more rapidly than from [185W]tetrathiotungstate, but in both the rate was unaffected by copper injections. Since the appearance in urine did not correspond to the disappearance from plasma, it was suggested that the hydrolysis occurred in extravascular tissues and that the liver might be the site. A control experiment showed that [185W]tungstate in plasma was very rapidly cleared (and appeared in urine). At higher W levels (25-50 mg W per sheep per day), systematic copper metabolism was perturbed since plasma copper levels rose. The experiments demonstrated that in sheep the behavior and the effects of thiotungstates and thiomolybdates are sufficiently similar for 185W to be used as a more convenient alternative to 99Mo for longer-term studies on the interaction of the compounds with copper metabolism in animals. PMID- 2703832 TI - Thallium (I) interactions in biological fluids: a potentiometric investigation of thallium(I) complex equilibria with some sulphur-containing amino acids. AB - Formation constants for thallium(I) complexes of L-cysteine (CysH2), DL penicillamine (PenH2), N-acetyl-L-cysteine (AcyH2), and N-acetyl-DL-penicillamine (ApeH2) in aqueous solution have been determined in 150 mmol dm-3 NaCl medium at 37 degrees C by potentiometric titrations using a glass electrode. Glycine has been used as a model for simple amino acids. The experimental data may be explained by the formation of the complexes T1(Cys)-, T1(Cys)H, T1(Pen)-, T1(Pen)H, T1(Acy)-, and T1(Ape)- with log formation constants 3.26, 11.28, 3.60, 12.05, 2.27, and 2.45, respectively. Analysis of the results obtained and comparison of thallium(I) complexing ability with that of dimethyl-thallium(III) seem to indicate that thallium(I) toxicity does not directly stem from its interference with the metabolism of sulphur-containing compounds. PMID- 2703833 TI - Doctors' versus patients' evaluation of results after neurosurgery. AB - A comparison between doctors' and patients' judgements of results after treatment for various neurosurgical conditions has been made. Ninety consecutive patients (41 women and 49 men) treated for trauma, vascular diseases, tumours, pain, and malformations were included in the study. The physicians responsible for the treatment and the patients rated the result of the therapeutic efforts (operative or nonoperative) independently from each other on a five grade scale at the time for discharge. A follow-up study was also made 8-24 months after the treatment. Three different groups of paired observations were distinguished: (1) "identical opinion", (2) "pessimistic opinion" (physician's score lower than patient's) and (3) "optimistic opinion" (physician's score higher than patient's). At the time of discharge identical opinion about the result of treatment was present in 83% (75 cases) whereas 9% (8 cases) and 8% (7 cases) were referred to the groups of pessimistic and optimistic opinions respectively. In the follow up series the corresponding values were 57%, 12%, and 31%. The increase of non-identical judgements in the follow-up study was found almost exclusively in the group of patients treated for painful conditions. Also the spread of judgements was largest in the group of painful conditions. Otherwise there was no correlation between the actual result of treatment and diagnosis, sex or age. PMID- 2703834 TI - What happens in the leucotomised brain? A postmortem morphological study of brains from schizophrenic patients. AB - Volume measurements were carried out on 19 brains from leucotomised schizophrenic patients and 20 age- and sex-matched controls using a stereological method. The volume of the total fixed brain, hemispheres, cortex, white matter, and central grey matter were all significantly reduced compared with controls. White matter and central grey structures were significantly reduced compared with a group of non-leucotomised schizophrenic brains. No difference was found in the size of the lesions in patients who improved compared with the patients who remained unchanged and the outcome was unrelated to lesional asymmetry. Morphometric measurements were correlated to a number of clinical parameters. PMID- 2703835 TI - Clinical presentations of vascular malformations of the brain stem: comparison of angiographically positive and negative types. AB - Clinical and radiographic features of 63 patients with a vascular malformation of the brain stem are described. On radiological grounds they were divided into two groups: one with angiographically visible lesions (AVAVMs), the other with lesions not seen angiographically, that is, occult (AOVMs). In the first group the initial clinical manifestation was due to haemorrhage in 20 of the 33 cases and consisted of a progressive neurological deficit in 12. In the second group 29 of the 30 initially presented with a brain stem haemorrhage. The latter was often characterised by development of symptoms over two days or more (16 cases), absence of headache (48 cases) and tendency to recurrence (20 cases). Clinical diagnosis was difficult in many cases especially in the AOVM group. Several of the patients were misdiagnosed as having multiple sclerosis. Clinical data in conjunction with magnetic resonance imaging were helpful in determining the nature of these lesions. PMID- 2703836 TI - Magnetic resonance imaging in patients with progressive myelopathy following spinal surgery. AB - Thirty one patients with insidious progressive myelopathy 2 to 8 years following surgery of the cervical spine were subjected to magnetic resonance imaging (MRI). In 15 patients operated on for vascular malformations or intramedullary tumours, syringomyelia and cystic lesions of the spinal cord were shown. Seven of these patients also showed a combination of a recurrent tumour and spinal atrophy. Out of 16 patients who had surgery for herniated disc or spinal stenosis of the cervical spine, four had syringomyelia and 12 had spinal cord atrophy. There was no syringomyelia in the 12 patients submitted to MRI prior to surgery. PMID- 2703837 TI - Plasma serotonin in patients with chronic tension headaches. AB - Previous reports have suggested that platelet level of serotonin in chronic tension headache (CTH) is lower than in normal control subjects, and that there is continuous activation of platelets both in migraine and in CTH. In this study we compared platelet serotonin concentration in 95 patients with CTH, 166 patients with migraine and 35 normal control subjects. Mean platelet serotonin (ng/10(9) platelets) was 310 for the CTH group, 384 during migraine headache, 474 for normal control subjects and 514 in headache-free migrainous patients. There was significant statistical difference of values between CTH patients and those of normal control subjects as well as headache-free migrainous patients, but not of those of migrainous patients during headache. It is suggested that CTH is a low serotonin syndrome, representing one end of the spectrum of idiopathic headache, the other end being represented by migraine. PMID- 2703838 TI - Does cognitive impairment in Parkinson's disease result from non-dopaminergic lesions? AB - In order to investigate the neuronal basis of cognitive disorders in Parkinson's disease, the neuropsychological performance of 120 patients with idiopathic Parkinson's disease was analysed in relation to motor symptoms as a function of their response to levodopa. Cognitive impairment was poorly correlated with akinesia and rigidity, symptoms which respond well to levodopa treatment, and was not correlated at all with that part of the patients' motor score that could be improved by the drug. In contrast, strong correlations were found between all neuropsychological test scores and axial symptoms such as gait disorder and dysarthria, which respond little if at all to levodopa treatment. The neuropsychological test scores were also strongly correlated with the motor score of patients estimated when clinical improvement was maximal under levodopa treatment. This score is assumed to represent residual non-dopaminergic motor dysfunctions. The correlations suggest that much of the cognitive impairment in Parkinson's disease results from the dysfunction of non-dopaminergic neuronal systems. PMID- 2703839 TI - Subarachnoid haemorrhage of unknown cause: a long term follow-up. AB - Three hundred and sixteen patients who suffered a subarachnoid haemorrhage of unknown cause were followed up by questionnaire after 2 to 23 years, the average interval being 10 years. Two hundred and fifty one (79.5%) are known to be alive, 49 (15.5%) had died, and 16 (5%) patients were untraceable. The cumulative survival for the whole group after 22 years was 69%, the expected survival being 89%. The certified cause of death of 30 patients was from diseases of the circulatory system, mainly myocardial infarction and cerebrovascular disease, the expected number being 21.8. The results of this survey show a reduced life expectancy for both males and females and suggest that a more guarded view should be taken than is presently the case about the long term prognosis of these patients. PMID- 2703840 TI - Functional prognosis in stroke: use of somatosensory evoked potentials. AB - Median nerve somatosensory evoked potentials (SEPs) were performed on 35 patients with acute stroke and correlated with functional outcome as measured by placement, length of stay and an activities of daily living index (Barthel Index). There was a statistically significant correlation of both SEP and sensory examination at the 0.05 level to eventual functional outcome. SEPs were better than age, sex and side of CVA in predicting functional outcome as measured by these scores. SEPs and sensory examination are interrelated but SEPs offer the advantages of objectivity, the ability to quantify results and the use in unconscious or dysphasic patients. PMID- 2703841 TI - Humoral immune response in patients with cerebral parenchymal cysticercosis treated with praziquantel. AB - The humoral immune response to treatment with praziquantel (PZQ) was studied in eight patients with parenchymal cerebral cysticercosis (CC). In the serum and in the cerebrospinal fluid (CSF) before, during and after the administration of the drug, the following were quantitated (a) levels of specific anticysticercous antibodies measured in optical densities by the ELISA method; (b) levels of IgG, IgM, IgA and IgE; (c) levels of complement fraction C3, C4; (d) presence of immune complexes; (e) total number of white blood cells in the CSF. It was found that after treatment with PZQ, the level of specific anticysticercous antibodies and the level of IgG rose significantly in the CSF but not in the blood. The levels of the fractions of the complement and the immunoglobulins IgM, IgA and IgE did not change significantly either in the serum or in the CSF. The blood brain barrier was found ruptured in three patients before therapy and in five patients after the therapy as measured by the albumin index. Nevertheless, the IgG index showed that there was local production of IgG in five patients before treatment and in seven after the end of it. The relative specific antibody index was greater than 1.0 in five patients before therapy and in seven after therapy. This data strongly supports the idea that the specific antibodies are produced intrathecally and are not derived from the serum pool through a ruptured blood brain barrier. It was concluded that patients with parenchymal CC have an elevation of specific anticysticercous probably due to a combination of a ruptured blood-brain barrier and intrathecal synthesis. The relatively small rupture of the blood-brain barrier and the high IgG and relative specific antibody index suggest that intrathecal synthesis is the most important mechanism. The humoral immune response may be of importance not only in the elimination of the parasite but also in the genesis of the illness. PMID- 2703842 TI - Absence of central functional cholinergic deficits in myasthenia gravis. AB - Sporadic reports have suggested central involvement in myasthenia gravis, a disorder in which there is an antibody-mediated loss of peripheral nicotinic acetylcholine receptors. Five patients with symptomatic myasthenia gravis performed an auditory vigilance test of ability to direct and sustain attention, presumed to reflect central cholinergic function. No deficits were found, either in comparison with the same subject's performance when muscle strength had improved after plasma exchange, or compared with that of healthy controls. The results thus failed to substantiate reports of functionally significant central cholinergic deficits in myasthenia gravis. PMID- 2703843 TI - Dyssynergia cerebellaris myoclonica (Ramsay Hunt syndrome): a condition unrelated to mitochondrial encephalomyopathies. AB - Thirteen patients with dyssynergia cerebellaris myoclonica (Ramsay Hunt syndrome) had full clinical and neurophysiological study as well as muscle biopsy. The patients had action myoclonus, generalised epileptic seizures, and mild cerebellar syndrome. The disease was inherited in an autosomal recessive pattern in five patients, and occurred as isolated cases in the remaining eight patients. The age at onset of symptoms ranged from 6 to 15 years (mean, 10.4 years). The EEG and polygraphic findings included normal background activity in most patients, spontaneous fast generalised spike-and-wave discharges, photosensitivity, no activation during slow sleep, and vertex and rolandic spikes in REM sleep. Results of muscle biopsy, performed an average of 14 years after onset of the disease, were normal and showed no mitochondrial abnormalities. These findings suggest that Ramsay Hunt syndrome is a condition with distinctive clinical and neurophysiological features and unrelated to mitochondrial encephalomyopathies. PMID- 2703844 TI - An unusual familial muscle disorder. AB - Autosomal dominant inheritance of an unusual muscle disease is reported in a family. The pathological appearance, of regularly arranged markedly atrophic muscle fibres without other evidence of disturbed innervation, are similar in each case. However, the onset of the disease, its distribution and its progression has varied within the family. PMID- 2703845 TI - Diffuse cerebrospinal gliomatosis presenting as motor neuron disease for two years. AB - A patient with symptoms and signs of motor neuron disease for 2 years finally developed sensory disturbances and increased intracranial pressure. MRI and CT showed enlargement of the right side of the cerebellum, the brainstem and parts of the cerebral hemisphere with focal hyperperfusion demonstrated by SPECT. Necropsy revealed a diffuse cerebrospinal gliomatosis with loss of spinal motor neurons in tumour infiltration of the anterior horns. This type of spinal cord involvement is considered responsible for the unusual clinical presentation of the neoplasm. PMID- 2703846 TI - Massive osteolysis of the skull and its therapeutic implications: a case report. AB - A case of massive osteolysis of the skull and its histology is described. Removal of the bone defect with a margin of normal bone and covering of the defect by cranioplasty is advised and may arrest the disease. PMID- 2703847 TI - Stabilisation of a severe case of P.O.E.M.S. syndrome after tamoxifen administration. PMID- 2703848 TI - Unilateral essential tremor after wrist immobilization: a case report. PMID- 2703849 TI - Superior sagittal sinus thrombosis in Wegener's granulomatosis. PMID- 2703850 TI - Extrapyramidal and depressive side reactions with flunarizine and cinarizine. PMID- 2703851 TI - Therapeutic efficacy of a novel transdermal delivery system for (+)-PHNO in parkinsonian squirrel monkeys. PMID- 2703852 TI - Herpes simplex type II encephalitis with complete Kluver-Bucy syndrome in a non immunocompromised adult. PMID- 2703853 TI - An implant clamp for atlanto-axial fusion. PMID- 2703854 TI - The frequency, characteristics and prognosis of epileptic seizures at the onset of stroke. PMID- 2703855 TI - Volumetric sampling strategies for heterogeneous brainstem nuclei. AB - Many brainstem nuclei are heterogeneous structures in which neuronal and glial populations are unevenly distributed, and focal normal or pathologic deviations in cell density, so-called "features," are found. Examples of features include subnuclei, focal neuronal loss, and focal gliosis. We present a statistical test that justifies an investigator's claim that a feature is present in a nucleus at a selected level of confidence after completion of a cell counting experiment. The computer program developed for the test also indicates the most probable location of the feature within the nucleus, and its most probable density and length, and potentially allows one to make comparisons of feature characteristics among cases. We also present quantitative guidelines for the selection of a sampling periodicity in a heterogeneous nucleus before a cell counting experiment. Sampling periodicity is based upon analysis of computer-generated simulations of the nucleus with features of different sizes; for each feature the probability of Type I (false positives) and Type II (false negatives) errors are examined against one another. Type II error rate is dependent upon feature length and density, acceptable Type I error rate, and sampling periodicity. Feature detection is important for devising sampling strategies in brainstem nuclei. PMID- 2703856 TI - Phenobarbital lacks promoting activity for neurogenic tumors in F344 rats transplacentally exposed to ethylnitrosourea. AB - A chronic rodent study in F344 rats was conducted to investigate the promoting ability of phenobarbital (PB) on neurogenic tumors initiated by transplacental administration of ethylnitrosourea (ENU). Pregnant F344 rats were given a single intravenous dose of 3.5 mg ENU/kg or vehicle on the twentieth day of gestation. A total of 192 male offspring were divided into four groups: ENU-PB, ENU-control, PB-control, and control-control. Rats in ENU-PB and PB-control groups received 0.05% PB in their drinking water from four to 78 weeks of age. Nervous system tumors were induced only in animals exposed to ENU. The difference in the incidence of neuroectodermal tumors in rats that were ENU initiated only (13/37; 35%) compared to the incidence in rats that were initiated and given PB (13/57; 23%) was not statistically significant (p greater than 0.05). ENU-control and ENU PB treatment groups exhibited no differences in tumor multiplicity or tumor latency. These results demonstrate that PB lacks promoting activity for neurogenic tumors in F344 male rats transplacentally exposed to ENU. PMID- 2703858 TI - Caring for sick people--a total approach to care. PMID- 2703859 TI - Ethical guidelines and principles of practice for Catholic nursing and midwifery personnel. PMID- 2703857 TI - Structural and chemical alterations in the cerebral maldevelopment of fetal cerebro-hepato-renal (Zellweger) syndrome. AB - The cerebra of four abortuses (estimated gestational age 14-22 weeks), diagnosed as cerebro-hepato-renal (Zellweger) syndrome in utero, were examined morphologically with light microscopic, immunocytochemical and ultrastructural techniques and biochemically with gas liquid chromatographic assays for cholesterol ester fatty acids and plasmalogens. Centrosylvian architectonic abnormalities consisting, in part, of thin cortical plates and broad subcortical heterotopic zones were found in all abortuses. Astrocytes, neuroblasts, immature neurons and radial glia contained abnormal pleomorphic cytosomes, presumably of variable lipid composition. The same areas exhibited increases in cholesterol ester very long chain fatty acids and decreased plasmalogens. A pathogenetic hypothesis, proposing that regional tissue constraints act in concert with a peroxisomal-derived biochemical abnormality to impede centrosylvian neuronal migration, is discussed. PMID- 2703860 TI - Nursing advances in the care of cardiac surgical patients. PMID- 2703861 TI - Pharmacologic management of black hypertensive patients. PMID- 2703862 TI - Circadian rhythm and the timing of digoxin administration. PMID- 2703863 TI - Using epicardial pacing electrodes. AB - Epicardial pacing electrodes are a widely used tool for the diagnosis and treatment of cardiac dysrhythmias in cardiac surgical patients. This article describes the use of epicardial pacing wires, differentiation of unipolar and bipolar electrograms, and atrial electrogram interpretation. Diagnosis and treatment of dysrhythmias with atrial pacing is described, as is trouble shooting. A case study and nursing diagnoses are used to illustrate the clinical applicability of epicardial pacing electrodes. PMID- 2703864 TI - Designing a competency-based orientation program for the care of cardiac surgical patients. AB - Orienting nurses to care for the cardiac surgical patient may require 7 to 14 days with a preceptor. Use of a competency-based orientation (CBO) program such as the one described in this article can minimize orientation time to three to five days while assuring competent practice. CBO uses a variety of learning methods and individualized instruction, focusing on the ability to perform a task or behavior correctly rather than on the ability to demonstrate knowledge. This article describes the basic components of a CBO program. Personal experience with development of such a program for the care of cardiac surgical patients in the immediate postoperative period is described. Advantages and limitations of CBO are described, as are suggestions for future research. PMID- 2703865 TI - Recognizing cardiac tamponade. AB - Cardiac tamponade is a commonly misdiagnosed, life-threatening condition that causes impaired ventricular filling as a result of increased pericardial pressure. Nurses are in an ideal position to recognize the early, often subtle signs of Decreased Cardiac Output and Altered Tissue Perfusion resulting from cardiac tamponade. Care plans for these and other nursing diagnoses of Alteration in Comfort and Anxiety are given in this article. Hemodynamic alterations, etiology, clinical presentation, and interventions are discussed. PMID- 2703866 TI - Managing postoperative mediastinitis. AB - Mediastinitis is a serious complication following cardiac surgery that requires early diagnosis and expert care. This article describes normal and impaired wound healing. Risk factors in the development of sternal wound infections are also discussed. Diagnosis, surgical management, and nursing management of mediastinitis are described, with emphasis on the nursing diagnoses Potential for Infection, Ineffective Coping, and Potential Alteration in Home Health Management. PMID- 2703867 TI - Sternal wound management: a case study. Nursing grand rounds. AB - The complication of mediastinitis has important implications for nurses. This article describes the case of a man who developed a sternal wound infection following coronary artery bypass surgery. Nursing care is discussed and is summarized in care plans for the diagnoses Ineffective Breathing Pattern, Impaired Skin Integrity, and Ineffective Coping. Expert nursing care resulted in hospital discharge approximately two months after admission. PMID- 2703868 TI - Extracorporeal blood pumping during heart-lung bypass. AB - This article describes three different types of extracorporeal blood pumps and the physiology of blood flow and analyzes the circulatory changes introduced by the pumping during heart-lung bypass. Associated clinical problems are briefly discussed. PMID- 2703869 TI - Hippocampal place cells: stereotypy and plasticity. AB - Hippocampal complex spike cells were recorded during exploration for water delivered to cups located in various regions of an elevated platform. Place fields were recorded with a video monitoring system that recorded movements as the animal explored each of the 5 cup locations where water was delivered on the platform. Plasticity of place cell firing as a function of selective water delivery to specific cup locations on the platform was also examined. Several characteristics of place cell firing were studied that indicated a high degree of control by factors such as relative direction of movement and trajectory through the field. Time-shift analyses indicated cell firing was most representative of the place field at the time of spike occurrence. It was demonstrated that place fields possess borders in which firing was increased or decreased upon entering or leaving a particular region of the platform. The most important finding from this investigation was the pronounced degree of plasticity exhibited by place cells. Selective delivery of water to a single location on the platform was sufficient in most of the cases tested to shift the location of the field to the location where water was available. These findings suggest hippocampal place cell firing, although highly influenced by spatial and directional features of the environment, can readily change under conditions in which significant stimuli are added or removed from those locations. PMID- 2703870 TI - Gaze-dependent visual neurons in area V3A of monkey prestriate cortex. AB - Extracellular recordings from single neurons of the prestriate area V3A were carried out in awake, behaving monkeys, to test the influence of the direction of gaze on cellular activity. The responsiveness to visual stimulation of about half of the studied neurons (88/187) was influenced by the animal's direction of gaze: physically identical visual stimuli delivered to identical retinotopic positions (on the receptive field) evoked different responses, depending upon the direction of gaze. Control experiments discount the possibility that the observed phenomenon was due to changes in visual background or in depth, depending on the direction in which the animal was looking. The gaze effect modulated cell excitability with different strengths for different gaze directions. The majority of these neurons were more responsive when the animal looked contralaterally with respect to the hemisphere they were recorded from. Gaze-dependent neurons seem to be segregated in restricted cortical regions, within area V3A, without mixing with non-gaze-dependent cells of the same cortical area. The most reliable differences between V3A gaze-dependent neurons and the same type of cells previously described in area 7a (Andersen and Mountcastle, 1983) concern the small receptive field size, the laterality of gaze effect, and the lack of straight-ahead facilitated or inhibited neurons in area V3A. Since the present results show that V3A gaze-dependent neurons combine information about the position of the eye in the orbit with that of a restricted retinal locus (their receptive field), we suggest that they might directly encode spatial locations of the animal's field of view in a head frame of reference. These cells might be involved in the construction of an internal map of the visual environment in which the topographical position of the objects reflects their objective position in space instead of reflecting the retinotopic position of their images. Such an objective map of the visual world might allow the stability of visual perception despite eye movement. PMID- 2703871 TI - Cortical areas involved in horizontal OKN in cats: metabolic activity. AB - Cerebral cortex improves optokinetic responses to high target velocities, but the specific cortical areas involved are unknown. Using the 14C-deoxyglucose technique, we compared local rates of cerebral glucose utilization in cats viewing a moving optokinetic nystagmus (OKN) drum (experimental group) with those in cats viewing a stationary OKN drum (control group). In the experimental group, glucose utilization was increased in areas 17 and 18 and in 4 areas in suprasylvian cortex (21a, 21b, PMLS, and VLS). There were no changes in glucose utilization in areas 7, 19, 20a, 20b, ALLS, AMLS, DLS, PLLS, the posterior suprasylvian area, and the splenial visual area. The increases in glucose utilization in areas 17 and 18 were most significant in the granular layers (inner III and IV). In areas 21a, 21b, PMLS, and VLS, the increases in glucose utilization extended from layers II through V. There was also a regional distribution of the increase in glucose utilization within each of these areas in the experimental animals. The increase in glucose utilization did not include the rostral portion of PMLS or the borders between areas PMLS and 21a, and VLS and 21b. In addition, there was a smaller increase in glucose utilization at the borders between areas 17 and 18 than in other portions of these 2 areas. The results indicate that areas 17, 18, 21a, 21b, PMLS, and VLS may be involved in the cortical modulation of horizontal OKN. The laminar distribution of label within the cortical areas corresponds with the distribution of projections from the dorsal lateral geniculate nucleus to areas 17 and 18, and from areas 17 and 18 to PMLS. The regional distribution of the metabolic activity within areas 17, 18, and PMLS coincides with that portion of cortex expected to be excited by either the spatial frequency of the stimulus or the retinalslip velocity (drum velocity minus slow phase eye velocity) occurring during the eye movements. PMID- 2703872 TI - Cortical areas involved in OKN and VOR in cats: cortical lesions. AB - Eye movements evoked by optokinetic and vestibular stimulation were measured by scleral search coil before and up to 8 weeks after unilateral cortical lesions in 11 cats. During both monocular and binocular viewing conditions, several deficits in the velocity-storage component of optokinetic nystagmus (OKN) were found. At low target velocities, the final steady-state slow-phase eye velocity and the peak value of optokinetic afternystagmus (OKAN) were reduced for slow phases towards the side of the lesion. At high target velocities OKN and OKAN were no longer elicited. The time constant of OKAN was also reduced for slow phases towards the side of the lesion. These deficits in OKN and OKAN were quantitatively similar in cats with large cortical (LC) lesions involving all known visual areas and in cats with suprasylvian (SS) lesions involving areas 21a, 21b, PMLS, and VLS. Ablation of areas 17 and 18 alone had no effect, but when combined with section of the corpus callosum (17/18+CC) resulted in a qualitatively similar but less severe deficit as the LC and SS lesions. By 3 weeks postoperatively, OKN recovered to near preoperative values in cats with SS lesions. Vestibular adaptive capabilities were impaired during the duration of the study in cats with LC, SS, and 17/18+CC lesions. Cats with these lesions could not normally increase VOR gain for slow phases directed ipsilateral to the lesion, and following vestibular adaptation most of these cats developed persistent asymmetries in VOR gain and VOR time constants. These results can be better conceptualized using a mathematical model of the vestibulo-ocular and optokinetic system adapted from Robinson (1977). This model contains a single positive-feedback velocity storage loop common to the VOR and OKN systems and a retinal-slip velocity nonlinearity. Our results suggest that SS cortex improves the retinal-slip nonlinearity feeding into the velocity-storage system by extending its range and increasing its gain. The SS cortex depends in part upon areas 17 and 18 either directly, or indirectly via the corpus callosum, for processing of high retinal-slip velocities. Cerebral cortex is also involved in increasing the gain of the velocity-storage loop during vestibular adaptation for ipsilaterally directed slow phases. PMID- 2703873 TI - Developmental expression of reactivity to monoclonal antibodies generated against olfactory epithelia. AB - The developmental expression of immunocytochemical reactivity to 3 monoclonal antibodies (Mabs Neu 4, Neu 5, and Neu 9) that were generated against adult rat olfactory epithelium was examined in olfactory tissues of embryonic rats. Tissues examined included the nasal olfactory epithelium, nerve, and olfactory bulb, as well as vomeronasal epithelium and nerve. Reactivity patterns of these Mabs in adult rats have been described previously (Hempstead and Morgan, 1985a). All 3 Mabs show reactivity on the cell surfaces of neurons, axons, and dendrites of the olfactory epithelium proper. Neu 5 alone shows reactivity on the dendritic knobs, site of transduction of the olfactory stimuli. These reactivities appear early, suggesting developmentally significant roles for the antigens to these Mabs. For Neu 5 and Neu 9 initial reactivity occurs on outgrowing olfactory axons at E13. Dendritic and perikaryal reactivities begin appearing at E14. For Neu 4 initial reactivity occurs simultaneously on olfactory neuronal perikarya, axons, and dendrites at E14. Reactivity also occurs on cells that migrate from the olfactory epithelium and are associated with the olfactory nerves. Within the developing olfactory bulb, Neu 5 behaves as a general cell-surface marker. Neu 4 and Neu 9, however, show enhanced reactivity in the glomerular layer after the onset of synaptogenesis. Reactivity is also seen in the nasal respiratory epithelium and in the vomeronasal epithelia and nerve. Neu 5 and several antibodies to rat neural cell adhesion molecules (N-CAMs) show similar, although not identical, immunohistochemical staining patterns. They also react with the same bands in Western blots of brain membrane preparations. Western blots of Neu 5-reactive material also show developmental and spatial correlations of apparent molecular weight distributions expected of N-CAM-like components as well. PMID- 2703874 TI - Two cell types in rat substantia nigra zona compacta distinguished by membrane properties and the actions of dopamine and opioids. AB - Intracellular recordings were made from 475 rat substantia nigra zona compacta neurons in vitro. The region from which recordings were made was rich in catecholamine fluorescence. Two groups of neuron, termed principal neurons (95% of the total) and secondary neurons (5% of the total) were clearly distinguishable according to one or more of the following 4 electrophysiological properties. Secondary neurons (23 cells) (1) fired spontaneous action potentials at frequencies greater than 10 Hz, or were quiescent (30%); (2) had action potentials less than 1 msec in duration; (3) did not show time-dependent inward rectification with step hyperpolarization; and (4) had slope conductances of about 4 nS (between -75 and -90 mV). In contrast, principal neurons (1) fired spontaneous action potentials in the range 1-8 Hz, or were quiescent (33%); (2) had action potentials greater than 1 msec in duration; (3) showed pronounced time dependent inward rectification; and (4) had steady-state membrane slope conductances of around 22 nS (between -75 and -90 mV). Secondary cells were not affected by dopamine but were hyperpolarized by baclofen, GABA, and the mu opioid receptor agonist Tyr-D-Ala-Gly-MePhe-Gly-ol (DAGO). On the other hand, dopamine and baclofen inhibited firing and/or hyperpolarized all principal cells tested, but mu or delta opioid receptor agonists had no effect. The properties of these 2 cell types broadly correspond with those described by electrophysiological studies in vivo, in which case the majority, or principal, cells are believed to be dopaminergic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703875 TI - Visual cortex development in the ferret. I. Genesis and migration of visual cortical neurons. AB - The production of ferret visual cortical neurons was studied using 3H-thymidine autoradiography. The genesis of cortical neurons begins on or slightly before embryonic day 20 (E20) of the 41 d gestational period, continues postnatally until 2 weeks after birth (P14), and follows an inside-out radial gradient with neurons for the deeper cortical layers being generated before those for the superficial layers. Layer I neurons are generated both early (E20-E30) and late (P1-P14) in the period of cortical neurogenesis and, thus, provide at least a partial exception to the inside-out gradient of cortical neurogenesis. Tangential gradients of cortical neurogenesis extend across areas 17 and 18 in both the anterior-to-posterior and lateral-to-medial directions. Neither of these gradients bears a meaningful relationship to the cortical representation of the visual field. Most infragranular and granular layer neurons are generated prenatally, while most supragranular layer neurons are produced postnatally. Neurons destined for a given layer are produced over a period of several days, and the neurons generated on any given day contribute to the formation of 2 or more cortical layers. In general, prenatally generated neurons complete their migration in 1 week or less, while most postnatally generated neurons require approximately 2 weeks to complete their migration. PMID- 2703876 TI - Long-term expansion and sensitization of mechanosensory receptive fields in Aplysia support an activity-dependent model of whole-cell sensory plasticity. AB - Long-term changes in peripheral receptive field properties of mechanosensory/nociceptive neurons were investigated 1-3 weeks after noxious stimulation. Noxious stimuli consisted of a deep penetrating cut through the middle of the tail, strong electric shock applied to the tail surface, or a combination of deep and superficial tail stimulation. Action potentials evoked in the tail were monitored with intracellular electrodes in central somata of tail sensory neurons. Three long-term changes in receptive field properties were produced in the region of noxious stimulation: (1) mechanosensory thresholds decreased, (2) receptive field areas increased, and (3) the percentage of cells showing receptive field extension across the tail midline increased. Sizes and shapes of individual receptive fields did not vary during extensive testing of tails perfused with artificial seawater or during testing in cobalt solutions that block synaptic transmission. This stability of receptive field geometry, coupled with the observation that increased peripheral excitability in these cells does not increase receptive field size, suggests that long-term receptive field alterations involve growth of peripheral sensory processes. A model is proposed in which the signaling strength of the entire sensory cell increases in response to trauma of its receptive field. In this model long-term enhancement of central and peripheral sensory responsiveness is selectively triggered by activity dependent extrinsic modulation of the centrally located soma, which accelerates synthesis of growth-associated proteins used in collateral and regenerative sprouting of traumatized peripheral processes. PMID- 2703877 TI - Perceived roughness of a grating: correlation with responses of mechanoreceptive afferents innervating the monkey's fingerpad. AB - Human subjects scaled gratings of alternating grooves and ridges for perceived roughness. Roughness increased with an increase in groove width and decreased with an increase in ridge width, but the effect of groove width was much greater than the effect of ridge width. In corresponding neurophysiological experiments, the gratings were moved sinusoidally across the receptive fields of single mechano-receptive afferents innervating the fingerpads of anesthetized monkeys. The measure of response used was the mean cyclic discharge rate (averaged over one cycle of the sinusoid). Slowly adapting afferents (SAs), rapidly adapting afferents (RAs), and Pacinian afferents (PCs) all showed a marked increase in response when groove width increased. An increase in ridge width had no consistent effect on the responses of SAs or RAs but resulted in a small decrease in the response of PCs. The response to a smooth surface differed significantly from the responses to the finer gratings only for the RAs. An alternative measure of response (the number of impulses elicited by each spatial cycle of the grating) increased with an increase in ridge width for all 3 fiber types. Thus, the large effect of groove width on perceived roughness can be accounted for by the mean cyclic discharge rate in the active afferent fibers. The smaller effect of ridge width can be accounted for by the number of impulses per spatial cycle of the grating. PMID- 2703878 TI - Axonal transport and localization of B-50/GAP-43-like immunoreactivity in regenerating sciatic and facial nerves of the rat. AB - Neurons that can regenerate their axons following axotomy increase their synthesis and axonal transport of a growth-associated protein, called GAP-43, which has been shown to be identical to the synaptic phosphoprotein B-50. The function of B-50/GAP-43 to the process of regeneration is unknown. We used a polyclonal, affinity-purified antibody against B-50 to study the axonal transport and localization of B-50/GAP-43-like immunoreactivity (B50LI) in the regenerating sciatic and facial nerves of adult rats. Quantitative data were obtained by densitometry of the B-50 band in immunoblots of nerve segments, which had been run on SDS-polyacrylamide gels. In the regenerating sciatic nerve, anterograde accumulation at a collection ligature was 3.0 times higher than retrograde accumulation. The mobile fraction of B50LI was only 0.28 of total B50LI and traveled with a mean anterograde velocity of 5.3 mm/hr. B50LI distribution in the newly regenerated portion of the nerve revealed maximal B50LI levels midway between the position of the crush and the fastest-growing axons. Immunocytochemistry of this portion of the nerve demonstrated B50LI to be associated with regenerating axons but also to a large extent with extra-axonal structures outlining the Schwann cell bands of Bungner. This zone of B50LI positive Schwann cell bands was found to extend more distally in nerves in which regeneration had processed longer, e.g., up to 5 mm distal to the crush after 3 d and 8 mm after 4 d. Further distal to this zone, many fine regenerating axonal profiles could be detected with B-50 antibody, but were neurofilament negative. These findings raise the possibility of an extra-axonal function of B-50/GAP-43, as this protein might be secreted from regenerating axons and might play a role in axon-Schwann cell interactions during axonal maturation. PMID- 2703879 TI - Postnatal development of the spatial contrast sensitivity of X- and Y-cells in the kitten retinogeniculate pathway. AB - The sensitivity to spatial contrast patterns of single retinal ganglion cell axons and neurons in the A-layers of the dorsal lateral geniculate nucleus (LGNd) was measured in 4 1/2- and 6 1/2-week-old kittens and adult cats. Drifting sinusoidal grating stimuli were presented at 6-12 spatial frequencies to obtain spatial contrast sensitivity functions (SCSFs). The SCSFs were normalized for the postnatal growth of the kitten eye and were interpreted using a difference of Gaussians model of the receptive field (RF). The average optimal spatial frequency, spatial frequency bandwidth, and the proportion of cells that were selective for spatial frequency did not differ significantly between the kittens and adults for ganglion cells belonging to the cluster 1 (X-) or cluster 2 (Y-) functional types. The spatial resolution of kitten ganglion cells was also adultlike, except for that of Y-ganglion cells with peripheral RFs, which was significantly higher than in the adult. The spatial resolution of X-LGNd neurons with peripheral RFs was significantly poorer at 4 1/2 weeks than in the older animals. The proportion of X-LGNd neurons that were selective for spatial frequency increased between 4 1/2 and 6 1/2 weeks postnatally, but the spatial frequency bandwidth of selective cells did not change. The increased proportion of spatially selective LGNd neurons is probably due to the maturation of intrageniculate inhibitory circuits. Developmental changes in spatial resolution were interpreted as resulting from an increase (Y-retinal ganglion cells) or decrease (X-LGNd neurons) in RF center size. A model of retinogeniculate development is presented that attributes postnatal expansion of Y-retinal ganglion cell RF centers to increased functional convergence from more distal retinal neurons and reduction in LGNdX-cell RF center size to decreased convergence from X-retinal ganglion cells. PMID- 2703880 TI - A pheromone-degrading aldehyde oxidase in the antennae of the moth Manduca sexta. AB - Antennae of the tobacco hornworm moths Manduca sexta contain an aldehyde oxidase (AOX) that oxidizes aldehydes to carboxylic acids. The enzyme, which is distinguishable from aldehyde-oxidizing activities in other tissues, is secreted into the receptor lymph that bathes the primary olfactory dendrites. First detectable about 3 d before eclosion, AOX levels increase through the first day after eclosion. This parallels the development of the antennal responsiveness to bombykal (a male attractant aldehydic pheromone produced by female M. sexta) and trans-2-hexenal (an aldehyde commonly found in leaves). The AOX is about 60% more abundant in antennae of males than in antennae of females. The antennal AOX is a dimer with Mr of 295 kDa and is capable of oxidizing a variety of aldehydes. Of all aldehydes examined, the pheromone bombykal was the best substrate with an apparent Km of 5 microM, whereas the next best substrate, benzaldehyde, had an apparent Km of 255 microM. Using kinetic parameters estimated in vitro and the assumption of first-order kinetics, the half-life of bombykal in sensilla was estimated to be about 0.6 msec. The affinity of the antennal AOX for bombykal, its location in the receptor lymph, and its pattern of developmental expression all suggest that it plays a role in modulating the sensitivity of adult M. sexta to aldehyde odors and, in particular, the sensitivity of males to the pheromone bombykal. PMID- 2703881 TI - The medullary pacemaker nucleus is unnecessary for electroreceptor tuning plasticity in Sternopygus. AB - Tuberous electroreceptors of the weakly electric fish Sternopygus macrurus are closely tuned to the frequency of electric organ discharge (EOD), which is determined by a medullary pacemaker nucleus (PMN). Previous studies have demonstrated that androgens lower the frequency of PMN discharge and concomitantly lower the best frequencies (BFs) of electroreceptors. In order to determine if the PMN serves as an internal reference for the hormone-mediated returning of electroreceptors, the PMN was lesioned and the change in mean BF was measured for dihydrotestosterone (DHT)-implanted or control animals. DHT implanted fish showed the characteristic lowering of mean electroreceptor BF by approximately 25%, a significant change compared with controls (p less than 0.01, Mann-Whitney). This result indicates that the PMN is not necessary for the hormone-mediated shift of electroreceptor tuning. In a related study, the contribution of the PMN to the genesis of tuning in regenerating electroreceptors was examined by removing a patch of cheek skin from PMN-lesioned fish. Regenerating electroreceptors became sharply tuned to the previous EOD frequency by 6 weeks in the same fashion as regenerating receptors in intact fish. In addition, intact receptors from PMN-lesioned fish remained tuned for up to 160 d. Together, these results demonstrate that the pacemaker nucleus is unnecessary for the maintenance, development, or hormone-mediated shift of receptor tuning. PMID- 2703882 TI - Local circuits and ocular dominance columns in monkey striate cortex. AB - The relationships between ocular dominance columns and intrinsic cortical circuitry were examined in brain slices prepared from the striate cortex of macaques. Ocular dominance columns in layer 4C beta were visualized in vitro following anterograde transport of rhodamine injected into the lateral geniculate nucleus in vivo. The axonal and dendritic arborizations of individual layer 4C beta cells were revealed by intracellular fluorescent dye injections. Both qualitative observations and quantitative analysis showed that the dendrites of cells close to borders remained preferentially, although not absolutely, in the "home" column (the column containing the cell body). Thus, the segregated pattern of afferent input appears to have considerable influence on the pattern of dendritic arbors. Similarly, while axon collaterals within layer 4C beta could cross into the adjacent column, their limited lateral spread produced arbors that remained primarily within the home column. The terminal arbors of collaterals that travelled from layer 4C beta to layer 3 had a larger lateral spread, and the termination pattern appeared to be independent of column borders. Thus, our observations indicate that, while the course of many layer 4C beta dendrites appears to be guided by columnar boundaries as defined by geniculate afferents, there exist morphological substrates for intercolumnar interactions even between 4C beta cells. Intercolumnar interactions are seen more commonly in layer 3, however, where larger, denser axon arbors originating from 4C beta cells can freely cross ocular dominance column boundaries. PMID- 2703883 TI - Normal numbers of retinotectal synapses during the activity-sensitive period of optic regeneration in goldfish: HRP-EM evidence implicating synapse rearrangement and collateral elimination during map refinement. AB - Optic and nonoptic fibers and synapses were counted in the primary optic innervation layer (S-SO-SFGS) in anteromedial tectum in normal goldfish and in fish 30, 60, and 240 d after the optic nerve was crushed. A newly developed "cold fill" HRP-labeling protocol was used to label optic afferents for electron microscopy, and counts were then made on EM photomontages of columns through the HRP-labeled S-SO-SFGS. Normal numbers of retinotectal synapses were present at 30 d regeneration, at a time when activity-dependent refinement of the optic projection is incomplete. Normal numbers were also found at 60 and 240 d, when refinement is largely completed. In contrast to this constancy in optic synapse numbers, there was nearly 10 times the normal number of optic fibers in the SFGS at 30 d, and these were reduced by 50% at 60 d, remaining over 4 times normal at 240 d. These findings imply extensive rearrangement of optic synapses during map refinement. They also indicate that synapse rearrangement is associated with the elimination of optic collaterals. PMID- 2703884 TI - Impulse blockade by intraocular tetrodotoxin during optic regeneration in goldfish: HRP-EM evidence that the formation of normal numbers of optic synapses and the elimination of exuberant optic fibers is activity independent. AB - Optic fibers and synapses labeled with HRP were counted in the primary optic innervation layer of tectum after continuously blocking visual impulse activity with TTX during regeneration. Normal numbers of optic and nonoptic fibers and synapses were found at both 30 and 60 d, and key ultrastructural features of optic afferents such as fiber fasciculation, myelination, terminal clustering, synaptogenesis onto different classes of postsynaptic targets and general morphology were not notably affected by impulse blockade. These findings indicate that during regeneration the normal proliferation and elimination of optic fibers and the formation of normal numbers of optic synapses are not regulated by activity and are consistent with a pattern formation role for impulse activity rather than a trophic one. PMID- 2703885 TI - Early differentiation of retinal ganglion cells: an axonal protein expressed by premigratory and migrating retinal ganglion cells. AB - A monoclonal antibody, RA4, was developed that recognizes retinal ganglion cell axons in the mature retina. Between embryonic days 3 and 9, the RA4 antigen was associated with cell bodies in certain regions of the retina in addition to the ganglion cell axons. The RA4-positive cells were of 3 types: an apolar cell adjacent to the ventricular surface, a bipolar cell that spanned the thickness of the retina, and a monopolar cell in the ganglion cell layer. Evidence suggests that these cells are premigratory and migrating retinal ganglion cells. The expression of the RA4 antigen is the earliest indicator of ganglion cell differentiation yet reported. The existence of RA4-positive apolar cells along the outer surface of the retina suggests that the ganglion cell phenotype is expressed as soon as the cell becomes postmitotic. Approximately 20% of the migrating ganglion cells were in pairs. The paired cells most likely arose from the terminal division of a germinal cell. One possibility suggested by these data is that a ganglion cell-specific germinal cell arises from a pluripotent germinal cell. Immunoblots and other analyses revealed the RA4 antigen to be a 140 kDa cytoplasmic protein in the retina. RA4 also recognized many long tract axons in the brain. In the brain, the RA4 epitope was observed on proteins with at least 7 different molecular weights. Evidence suggests that different cell types may express the RA4 antigen with slightly different molecular weights. PMID- 2703886 TI - Nonlinear summation of M- and L-cone inputs to phasic retinal ganglion cells of the macaque. AB - We have studied the responses of ganglion cells in the macaque retina to stimuli that alternate in color. With most color combinations, the phasic retinal ganglion cells, which sum input from M- and L-cones in both center and surround, showed a response with twice the alternation frequency at equal luminance. This frequency doubling was directly related to the degree to which the M- and L-cones were stimulated out-of-phase with one another, and thus varied with the wavelength combinations used. It was absent with wavelength combinations that lay along tritanopic confusion lines, when at equal luminance the M- and L-cones are not modulated. Such a frequency-doubled response is evidence for a nonlinearity at or before M- and L-cone summation. The effect became much smaller or was abolished when the receptive field center alone was stimulated, indicating that its mechanism lies in the surround or in a center-surround interaction. Also, it was much more marked at high luminance levels, being almost absent at retinal illuminances below 100 td. Its origin is not clear, but it seems to derive more from the L- than the M-cone. The results imply that phasic cells, through this nonlinearity, could respond to the red-green equal luminance borders used in some psychophysical experiments. PMID- 2703887 TI - Positive feedback by autoexcitatory neuropeptides in neuroendocrine bag cells of Aplysia. AB - Neurohormones are often secreted in large amounts from neuroendocrine cells during episodes of synchronous, repetitive spike activity. We report evidence that this pattern of activity in the neuroendocrine bag cells of Aplysia involves positive feedback by autoexcitatory transmitters. Intracellular stimulation of individual bag cells caused slow depolarizing afterpotentials and synchronous afterdischarges in the entire population of bag cells. Application of the bathing medium collected during bag cell activity mimicked these responses. Application of alpha-, beta-, or gamma-bag cell peptides (BCPs), 3 structurally related neuropeptides released from bag cells, also mimicked these responses. These autoexcitatory BCPs fulfill most of the strict criteria necessary for classification as neurotransmitters in this system. This is the first biological activity reported for beta- and gamma-BCPs and brings to 4 the number of bag cell neuropeptides derived from the egg-laying hormone/BCP precursor that are putative cotransmitters. Positive feedback by autoexcitatory transmission may provide a general mechanism for the generation of episodic activity in neuroendocrine systems. PMID- 2703888 TI - Rapid induction of the major embryonic alpha-tubulin mRNA, T alpha 1, during nerve regeneration in adult rats. AB - The mRNAs for 2 isotypes of alpha-tubulin, termed T alpha 1 and T26, are differentially regulated in the developing rat nervous system. T alpha 1 alpha tubulin mRNA is expressed at high levels when neurons extend processes whereas T26 mRNA is expressed constitutively (Miller et al., 1987b). We have examined the expression of these 2 alpha-tubulin mRNAs in regenerating facial and sciatic motor neurons of the rat using Northern blot and in situ hybridization analyses. T alpha 1 alpha-tubulin mRNA is rapidly induced in axotomized motor neurons of the facial nerve: increased levels of mRNA are detectable 4 hr after a lesion is made 1.5 cm distal to the neuronal cell bodies. T alpha 1 mRNA levels are highest from 3-7 d postcrush and decline slowly to control levels following functional reinnervation of facial muscles. In contrast, T26 mRNA levels remain constant throughout the regeneration process. Total alpha-tubulin mRNA levels do not change until 1 d postaxotomy; otherwise the changes in expression are similar to T alpha 1 mRNA, although the relative increase is not as great. Enhanced T alpha 1 alpha-tubulin mRNA expression also occurs in motor neurons of crushed or tied sciatic nerve. Ligature or crush of the sciatic nerve leads to approximately the same peak in the expression of T alpha 1 mRNA at 7-15 d postaxotomy. Following the facial nerve transection, under conditions in which reinnervation is prevented, T alpha 1 alpha-tubulin mRNA levels remain elevated significantly longer than when the nerve is crushed. Taken together, the data indicate that T alpha 1 alpha-tubulin mRNA is rapidly induced following neuronal axotomy, remains elevated during the period of axonal regrowth, and is subsequently down-regulated at the approximate time of target contact. These results are reminiscent of changes in T alpha 1 mRNA that occur during neuronal development. This growth associated pattern of T alpha 1 gene expression can be modified by inhibiting appropriate regeneration of the damaged nerve. PMID- 2703889 TI - Recognizing and rewarding excellence: a program for marketing the image of your nursing department. PMID- 2703890 TI - The International Nurse Exchange Program. PMID- 2703891 TI - Empowering nurses. PMID- 2703892 TI - Participative staff retention program. PMID- 2703893 TI - Manager impact on retention of hospital staff: Part 2. AB - This is the second article in a two-part series based on a study of the impact of middle managers on retention of 71 hospital professionals. Research design, methods, and descriptive results were presented in Part 1 (March 1989). In Part 2, the impact of managers' motivation to manage, power, influence, and leadership style on retention is detailed. Recommendations for improving retention include interventions to increase employee job satisfaction and intent to stay, and to improve managers' performance and leadership. PMID- 2703894 TI - Customer relations training: long term impact on staff's behavior. PMID- 2703895 TI - An evaluation of nurse recruitment methods. AB - Hospital administrators are using a variety of recruitment strategies to attract sufficient numbers of nurses to staff their institutions. The authors describe one recruitment project that used several different methods to hire 76 nurses. The evaluation of the project compares the different recruiting methods by number of hires and cost per nurse hired. PMID- 2703896 TI - Developing Do Not Resuscitate policies. AB - It is clear that nurse administrators must take a leadership role in developing a DNR policy. The establishment of written DNR policies are necessary, not only to meet Joint Commission Standards, but also to improve communication, reduce ethical dilemmas, legally clarify patient status, and maintain consistent quality of care. Although a DNR policy cannot address and anticipate all problems, the interdisciplinary process used to develop DNR policies can provide the health care team with a base on which to build the policies, guidelines, and support mechanisms needed to deal with future ethical issues. PMID- 2703897 TI - Medicine speaks again. PMID- 2703898 TI - Responding to patients: the unit hostess. AB - As acuity levels increase and nurses are busier with the increased intensity of their patients' procedures and treatments, what happens to the basic amenities so important to patients? The author discusses one institution's approach to satisfying basic patient needs while still continuing to provide complex nursing care. PMID- 2703899 TI - Targeting recruitment efforts for increased retention. AB - Recruitment efforts can be targeted towards Registered Nurses demonstrating specific sociometric, education, and practice variables. The authors describe the significant differences found in the comparative analysis within three sets of variables among two groups of hospital-employed Registered Nurses who reside in the suburbs of Chicago. These data can direct nursing administrators in strategic recruitment and retention marketing plans. PMID- 2703900 TI - Joint ventures in health care. AB - To remain competitive, many not-for-profit hospitals have turned to joint ventures with for-profit and other not-for-profit entities. The authors examine the organizational structures that are used most often to form joint ventures (contractual agreements, subsidiary corporations, partnerships, and not-for profit title-holding corporations), as well as the advantages and disadvantages associated with each form. Nurse executives must be aware of the opportunities that joint ventures provide their institutions. These arrangements can help improve and expand services and profitability. PMID- 2703901 TI - Managerial boredom. PMID- 2703902 TI - AIDS education and training centers. PMID- 2703903 TI - Supporting the middle manager. PMID- 2703904 TI - Advanced concepts in networking: the Nursing Research Network of Boston revisited. PMID- 2703905 TI - From LPN to RN. PMID- 2703906 TI - Innovations in nurse-midwifery education. PMID- 2703907 TI - Nurse-midwives speak out on research. Results of the 1987-88 needs assessment survey, Part 2. AB - Part 1 of this 2 part article appeared in the preceding (January/February) issue of this journal. Results from the 1987-88 ACNM Needs Assessment Survey pertaining to research are presented. As with other topics addressed in Part 1 of the Needs Assessment Survey, subgroup analysis was conducted to determine if certain groups of CNMs had differing views and perceived needs regarding research. Survey responses were categorized to include: 1) CNM attitudes about research, 2) importance of ACNM research related services and activities, 3) use of a uniform data collection instrument, 4) CNM access to research resources, and 5) views on funding for ACNM research activities. Discussion of the implications of the results as they relate to development of the goals and objectives of the newly formed ACNM Division of Research is included. PMID- 2703908 TI - Criterion-referenced competency assessment and the national certification examination in nurse-midwifery. AB - The paper presents an overview of the recent change from norm-referenced to criterion-referenced score interpretation for the ACNM certification examination for entry level practice in nurse-midwifery. The advantages of criterion referenced interpretation are presented. A successful adaptation of the Nedelsky method for the calculation of the minimum pass index, based on the identification of acceptable error, is discussed. Implications for the nurse-midwifery profession and for the national certification examination in nurse-midwifery are considered. PMID- 2703909 TI - Interpreting the electronic fetal monitor. Strategies for management. AB - Electronic fetal monitoring offers the practitioner involved in the intrapartum care of women a mechanism to validate the fetus' physiologic adaptation to the labor and delivery experience. Utilizing a predetermined framework for constant assessment of fetal well-being will assist the clinician in the bedside management of these patients. This pathway of reassurance for fetal evaluation is an effective tool in the intrapartum observations of the fetus. If the fetus can demonstrate his physiologic well-being, labor may continue. However, if there are no signs of reassurance, immediate delivery of the fetus should be considered. PMID- 2703910 TI - Early postpartum rooming-in and maternal attachment behaviors in a group of medically indigent primiparas. AB - Introduction of rooming-in at the study site provided an opportunity to examine the impact of rooming-in on maternal attachment behaviors. Maternal attachment scores for 80 mothers who received rooming-in were compared to 72 mothers who delivered before rooming-in and 35 mothers who requested but did not receive rooming-in. All subjects were medically indigent primiparas with no intrapartum or postpartum complications and term healthy infants. The groups were not significantly different in maternal age, race, or ethnicity. Maternal attachment behaviors were recorded during an infant feeding. Rooming-in mothers had significantly higher maternal attachment scores than both control groups. Rooming in had an independent effect on maternal attachment after the effects of maternal age, episiotomy or lacerations, epidural anesthesia, infant contact at delivery, and time of feeding observation had been accounted for. Of these prior factors, only maternal age had a significant impact on rooming-in. These results suggest that rooming-in helps primiparas to form early attachments to their babies, and that the impact of rooming-in cannot be explained by the mother's motivation for rooming-in. It is important to provide close contact with the infant during the early postpartum, especially for adolescents who may be at higher than average risk of mothering inadequacies. PMID- 2703911 TI - Amniotic fluid embolism. A case report. AB - Amniotic fluid embolism is a rare, yet catastrophic event. In the United States it occurs in 1 per 20,000 to 30,000 births. With an 86% maternal mortality rate, amniotic fluid embolism is responsible for 10-15% of all maternal deaths. This article presents a case study of a CNM's experience with a maternal and fetal death resulting from an amniotic fluid embolism. Pathogenesis and appropriate management are also presented. PMID- 2703912 TI - Closing of the nurse-midwifery service at Boston City Hospital: another perspective. AB - This paper is a response to an article previously published in JNM's Issues and Opinions column. It provides another perspective regarding the recent troubles of Boston City Hospital's nurse-midwifery service. PMID- 2703913 TI - Closing of the Nurse-Midwifery Service at Boston City Hospital: What Were the Issues Involved? PMID- 2703914 TI - Dietary protein enhanced mammary ornithine decarboxylase activity and tumorigenesis in rats. AB - Sprague-Dawley rats (F-1) were fed a normal protein (19% casein, NP) or high protein (33% casein, HP) isoenergetic diet containing 15% corn oil prior to conception. Female pups (F-2) were also fed the maternal diet after weaning. At 7 wk of age, before saline or N-nitrosomethylurea (NMU) treatment, ornithine decarboxylase (ODC, EC 4.1.1.17) activity in mammary epithelium and liver tissue was significantly higher in the HP group than in the NP group. Eight weeks after saline treatment ODC activity in mammary tissue decreased in both groups, but remained significantly higher in the HP group. NMU treatment caused a sixfold increase in ODC activity in the mammary tissue in the HP group and a significantly lower response in the NP group. Liver ODC activity had a minimal response to NMU treatment. Changing from the HP to the NP diet 4 wk after NMU treatment reduced mammary ODC induction response but not tumor burden; changing from the NP diet to HP diet produced no change in ODC activity or tumor burden. Mammary tumor burden was positively related to dietary protein and mammary epithelium ODC activity prior to and following NMU treatment. PMID- 2703915 TI - The distribution of [14C]-2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and its effect on the vitamin A content in parenchymal and stellate cells of rat liver. AB - Isolated liver cells from male Sprague-Dawley rats given a single dose of [14C] 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD; 10 micrograms, 0.9 microCi/kg body wt in corn oil, p.o.) or vehicle only were separated into parenchymal and nonparenchymal cell fractions 4 h, and 1, 4, 7, 25, 50, and 147 d after treatment. Vitamin A content and TCDD-derived radioactivity were estimated in the parenchymal cells and in the stellate cells, which were identified and quantified in these fractions. Similar levels of vitamin A (0.3 +/- 0.4 nmol per million cells or 0.5 +/- 0.7 mumol per liver; values are mean +/- SD for 56 rats) were found in parenchymal cells from both control and TCDD-treated rats. However, while the vitamin A content of stellate cells increased from 14 to 46 nmol per million cells (i.e., from 1.7 to 7.7 mumol per liver) in control rats over the course of the study, stellate cells from TCDD-exposed rats showed no increase in vitamin A level until at least 25 d after exposure and remained at a level about 30% below the controls thereafter. TCDD-derived radioactivity resided mainly in the parenchymal cell compartment, although stellate cells contained more radioactivity per cell. Most of the radioactivity in parenchymal cells was eliminated with a half-life of 13 d, whereas the remainder persisted with an elimination half-life of 70 d. The elimination half-life in stellate cells was estimated to be 52 d. Thus, TCDD inhibited storage of vitamin A in stellate cells until 60-90% of the TCDD-derived radioactivity had been eliminated from the liver. PMID- 2703917 TI - Inhibition of murine melanoma growth by sodium ascorbate. AB - Ascorbic acid has been reported to play a role in treatment and prevention of cancer. This study was carried out to determine the effect of ascorbate on growth of normal LLCMK cells and transformed BL6 cells in cell culture and on the growth of BL6 melanomas in vivo. Ascorbic acid levels were also measured to determine the effect of tumor growth and supplementary ascorbate on cellular ascorbic acid levels. Ascorbate addition at levels of up to 200 micrograms/ml was found to inhibit the in vitro growth of BL6 cells but not of LLCMK cells. Ascorbic acid levels in both cell types were very similar. The presence of tumors was found to reduce liver ascorbic acid levels in mice. Supplementary dietary ascorbate increased liver and tumor ascorbic acid levels and also reduced the growth of BL6 melanomas transplanted in C57 mice. Ascorbate thus appears to play a role in suppression of BL6 melanoma growth. PMID- 2703916 TI - The effect of dietary fatty acid composition on liver retinyl ester (vitamin A ester) composition in the rat. AB - The dependence of liver retinyl ester (vitamin A ester) composition on dietary fatty acid composition was studied in rats. Weanling male Sprague-Dawley rats were fed purified test diets containing 8% of one of 10 test triglycerides (either tributyrin, tricaproin, tricaprylin, tricaprin, trilaurin, trimyristin, tripalmitin, tristearin, triolein, trilinolein) or corn oil (a mixed triglyceride) for 23 d after an initial 1-wk stabilization period. Essential fatty acids were provided by safflower oil (8 g/kg diet). Total liver fatty acid composition showed the expected responses to dietary fatty acid intake; short chain and medium-chain fatty acids were readily elongated to palmitate and stearate, and palmitate and stearate were readily desaturated. Consumption of oleate or linoleate (as their triglycerides) markedly enriched their concentrations in liver lipids. The proportions of palmitate were generally greater in liver retinyl esters than in total liver fatty acids, and the proportions of oleate were less. However, retinyl ester composition was significantly affected by dietary triglyceride, particularly by diets providing long-chain fatty acids. Total liver vitamin A levels were depressed in the group fed trilinolein. PMID- 2703918 TI - Studies of iron:zinc interactions in adult rats and the effect of iron fortification of two commercial infant weaning products on iron and zinc status of weanling rats. AB - The effect of iron on zinc absorption in the rat, and vice versa, was investigated from single starch:sucrose test meals (containing 65Zn or 59Fe) by whole body counting. Zinc had no effect on iron absorption, but iron reduced zinc absorption when the total ionic species in the meal (iron plus zinc) reached 1.36 mg. Below this level, high iron:zinc molar ratios (10:1) had no effect on zinc absorption, presumably because the transport mechanism for zinc had not reached full capacity. Previous iron intake had no effect on zinc absorption. The relevance of these findings to infant foods was explored by feeding rats exclusively a vegetable or cereal weaning product, with or without additional iron, for 12 d and measuring zinc and iron status. The added iron raised body iron stores and caused a small reduction in zinc status in animals fed the oat, but not the vegetable, diet as measured by plasma and femur zinc concentrations. Since the threshold level of 1.36 mg ionic species would be exceeded when the animal ate 3-4 g of the iron-fortified weaning food at any one time, it appears that the iron:zinc interactive effect was absent in the vegetable and less potent in the oat formulation than in a carbohydrate test meal. Alternatively, it may be the case that the animals had responded over time to reduced zinc availability by increasing whole body zinc retention.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703919 TI - Effect of dietary methyl group deficiency on one-carbon metabolism in rats. AB - Amino acid-defined diets deficient in methyl groups have been shown to result in a very high incidence of hepatocellular carcinoma. It has been suggested that this is a result of decreased levels of S-adenosylmethionine and the undermethylation of DNA. Accordingly, the enzyme glycine N-methyltransferase (GNMT, EC 2.1.1.20) may play a major role in maintaining the levels of S adenosylmethionine in liver in response to changes in dietary methionine. The effect of methyl-deficient, amino acid-defined diets on GNMT activity and S adenosylmethionine levels in rat liver was therefore investigated. When rats were fed a defined amino acid diet containing no choline in which homocysteine was substituted for the methionine of the control diet at an equimolar level, there was a rapid and marked decrease in growth rate in spite of the fact that the rats consumed 85% of the food eaten by control rats fed a nutritionally adequate, defined amino acid diet. The GNMT activity in livers of methyl-deficient rats decreased rapidly, but there was no difference in amount of GNMT protein as measured immunologically. In methyl-deficient rats, the levels of S adenosylmethionine were maintained but the levels of S-adenosylhomocysteine were rapidly elevated compared to control values. These changes are consistent with the postulated role of GNMT in regulating methyl group metabolism. PMID- 2703920 TI - DNA strand break accumulation, thymidylate synthesis and NAD levels in lymphocytes from methyl donor-deficient rats. AB - Although tumor development with methyl donor-deficient diets has been well established, the biochemical and molecular mechanisms which predispose to tumor development are not yet understood. In the present study, DNA damage and nucleotide metabolism associated with DNA synthesis and repair were evaluated in splenic lymphocytes from rats fed a basal diet low in methionine and lacking in choline and folate or a supplemented control diet for a period of 3 wk. The accumulation of DNA strand breaks, as assessed by DNA unwinding in alkali, was found to be significantly elevated in lymphocytes from rats fed the methyl donor deficient diet and was associated with an increase in mitogen-stimulated incorporation of [3H]-thymidine via the salvage pathway for thymidylate synthesis. In addition, a significant decrease in the DNA repair-associated pyridine nucleotide, NAD, was observed in lymphocytes from the deficient group and was associated with a decrease in total spleen cell numbers. These results suggest that alterations in nucleotide metabolism and DNA damage are induced when methyl donor pools are stressed by dietary deficiency. PMID- 2703921 TI - Dietary beta-carotene absorption and metabolism in ferrets and rats. AB - The ability of the ferret (Mustela putorius furo) to absorb dietary beta-carotene was studied to determine its appropriateness as a laboratory animal model for studies on beta-carotene metabolism. At baseline, the mean serum beta-carotene level in ferrets was 0.6 micrograms/dl and no beta-carotene was present in liver or adipose tissue. After the ferrets were fed 4 or 20 mg of beta-carotene/kg body wt daily for 2 wk, serum levels were 15.3 and 41.5 micrograms/dl, liver values were 0.9 and 4.1 micrograms/g and adipose tissue values were 0.1 and 0.2 microgram/g of beta-carotene, respectively. Thus, like humans, ferrets are able to absorb dietary beta-carotene intact. Further, these animals can store quantifiable amounts of dietary beta-carotene in their liver and, to a lesser extent, in adipose tissue. In contrast, serum beta-carotene levels in rats fed the two levels of beta-carotene were very low (0.5 to 0.6 microgram/dl) and no beta-carotene was found in liver or adipose tissue. Thus, the ferret is a more appropriate animal model for studying the intestinal absorption of beta-carotene and its storage and metabolism in body tissues. PMID- 2703922 TI - The future direction of nutrition research: science, public health, public policy. PMID- 2703923 TI - The future direction of nutrition research: five issues confronting nutrition research. PMID- 2703924 TI - Intramedullary bone repair and ingrowth into porous coated implants in the adult chicken: a histologic study and biochemical analysis of collagens. AB - A new model was developed to study the histologic and biochemical events during intramedullary bone repair and ingrowth into porous coated implants. Adult chickens were used because of the availability of specific antibody probes. Repair in the metaphysis and diaphysis were compared. Entering through a medial arthrotomy, the distal tibiotarsus was reamed and either implanted with a double ended porous coated rod or allowed to heal without implantation of a rod. Specimens analyzed histologically at 7, 14, 21, and 70 days postoperatively revealed direct formation of bone by osteoblasts with no evidence of a cartilaginous phase. At 70 days bony ingrowth was observed deep within the porous surface. Analysis of collagens with sodium dodecyl sulfate polyacrylamide gel electrophoresis demonstrated that the synthesis of type I collagen predominated. Biosynthetic data coupled with quantitative immunologic analyses using antibodies to type II and type X collagen showed that neither of these two collagen types, which are characteristic of cartilage undergoing endochondral ossification, were produced during intramedullary bone repair. These results establish that the adult chicken is capable of bony ingrowth into porous coated implants and that this process is through direct bone deposition by osteoblasts without a cartilaginous intermediate. PMID- 2703925 TI - Centrifugal characterization of proteoglycans from various depth layers and weight-bearing areas of normal and abnormal human articular cartilage. AB - Ultracentrifugal polydispersity differential [g(S)] distributions were determined for the proteoglycans of various postmortem human articular cartilage samples extracted from six lateral patellar grooves in nondissociative conditions after mild collagenase digestion of the tissue. The samples consisted of 53 slices (250 microns thick), from normal, mildly fibrillated, and extensively ulcerated knee joints. When statistically analyzed in various subgroupings, the obtained average sedimentation coefficients and polydispersity profiles supported the following conclusions: (a) loss of proteoglycan aggregation and sedimentability is confirmed to be a primary sign of cartilage matrix degradation; (b) higher S values for proteoglycans of the high weight (HW)-bearing areas and lower values for those of the low weight (LW)-bearing areas were a typical finding in normal cartilage samples; (c) inversion of this pattern was indicative of matrix degradation, suggesting that the HW regions are more affected than the LW-bearing areas; (d) the average S value distribution across cartilage thickness tended to resemble the corresponding proteoglycan content versus distance from articular surface; and (e) the deepest cartilage layer had, in most cases, the smallest amount of aggregates while the highest average sedimentability was observed at the middle zone of the normal samples. In the discussion, a role of proteoglycan aggregation for providing a means to "pack" more proteoglycans within the collagen meshwork and to control the generation of osmotic pressure gradients is suggested. PMID- 2703926 TI - Biochemical changes in articular cartilage after joint immobilization by casting or external fixation. AB - Knees of mature dogs were immobilized for 6 weeks by long-leg casts allowing 8 degrees-15 degrees of motion, a model studied by others, or with external fixators, a new, more severe model that kept the joints rigid. Some animals were allowed to recover for 1 week after the immobilization period. Articular cartilage was examined histologically and biochemically. After 6 weeks of immobilization, water increased 7% in both casted and fixator-immobilized joints compared with normal knee cartilage, while hexuronic acid was 23 and 28% lower, respectively. The limited motion permitted by the casts resulted in a smaller depression of proteoglycan synthesis and less proteoglycan loss during immobilization than occurred in the rigid external fixator group. The protective effect of limited motion was shown clearly during the recovery period: as measured by hexuronic acid content, cartilage from the casted joints had almost recovered within 1 week, whereas the external fixator group experienced little or no recovery during the week after treatment. In contrast to previous studies by others with casted joints, both newly synthesized [35S]sulfate-labeled and accumulated unlabeled proteoglycans from both casted and fixator-immobilized cartilages were able to form complexes with exogenous hyaluronic acid to the same extent as those from control cartilage. Thus, in immobilized cartilage, failure of the newly synthesized proteoglycan to bind to hyaluronate is not a mechanism of accelerated proteoglycan loss. The accelerated proteoglycan turnover appears to be caused by a combination of decreased synthesis and increased proteolysis of the secreted proteoglycans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703927 TI - Cryopreserved articular chondrocytes grow in culture, maintain cartilage phenotype, and synthesize matrix components. AB - For osteochondral allograft transplantation to be successful, chondrocytes must survive preservation and retain their capacity to produce normal matrix components: proteoglycans and Type II collagen. Clinical success with osteochondral allograft transplantation has created an increased demand for supplies of suitable cartilage-bearing grafts. This demand has stimulated attempts to find successful methods for low temperature storage of cartilage for "banking" and heightened interest in cartilage cryobiology. In order to achieve the maximum viability of cryopreserved articular cartilage, previous comprehensive studies have focused on rates and temperatures of freezing, cryoprotective agents, and methods and influences of thawing. This study presents evidence that cryopreserved articular chondrocytes maintain their ability to grow in tissue culture following thawing and to produce normal matrix components. Chondrocytes isolated from Japanese white rabbits were divided into groups of fresh controls and experimental cryopreserved cells. Cells were incubated in dimethylsulfoxide, frozen at a rate of -1 degrees C/min, stored at -79 degrees C, rapidly thawed, and plated for culture. Growth rates were comparable in all groups. In all groups, typical chondroid characteristics were maintained throughout 14 days of culture. Typical cartilage phenotypic characteristics included maintenance of polygonal and rhomboidal cells, cell aggregation, proteoglycan production, and Type II collagen synthesis. This investigation strongly indicates that articular chondrocyte cryopreservation yields viable, functional cells and although these results cannot be directly extrapolated to intact adult articular cartilage, they do give further support for low temperature banking of cartilage-bearing allografts for transplantation. PMID- 2703928 TI - Partial restoration of immobilization-induced softening of canine articular cartilage after remobilization of the knee (stifle) joint. AB - The restoration of the biomechanical properties of articular cartilage was studied after 15 weeks of remobilization of the knee joint in beagles previously immobilized with a cast for 11 weeks. The shear moduli were determined with an indentation creep test immediately after load application and at equilibrium at six predefined test points of femoral, tibial, and patellar cartilages. Permeability of the cartilage was estimated from the creep measurements. The values were compared with nontreated, age-matched (55 weeks) controls and with cartilage collected immediately after immobilization. Remobilization reduced the high creep rates created by immobilization and shifted the depressed equilibrium shear moduli towards those of the controls. However, in the femoral condylar cartilage, the equilibrium shear modulus remained at lower level (p less than 0.05) and permeability at higher level (p less than 0.05) as compared with the controls. We conclude that articular cartilage, showing signs of atrophy after long-term immobilization, was capable of restoring its biomechanical properties during remobilization. This repair was not, however, completed in all parts of the knee joint by the end of the observation period. PMID- 2703929 TI - Neuropathology with spinal instrumentation. AB - Neurohistologic examination of the spinal cord and cauda equina were compared for 28 beagles undergoing anterior and posterior spinal destabilization procedures- Group I (n = 7), destabilized operative controls; Group II (n = 7), posterolateral bone grafting; Group III (n = 7), Harrington distraction instrumentation and posterolateral fusion; and Group IV (n = 7), Luque rectangular instrumentation and posterolateral fusion. All dogs had appeared neurologically intact upon repeated examinations prior to death. Neurohistological abnormalities (Wallerian degeneration of the dorsal columns, corticospinal tracts, and nerve roots, focal cystic degeneration, and intraspinal central cavitation) occurred in only 1 of the 14 animals (7%) in Groups I and II (noninstrumented) and in 9 of the 14 animals (64%) in Groups III and IV (instrumented). This result is statistically significant (p less than 0.001). Transient sensory disturbances and radicular paresthesias have been described in clinical reports of spinal instrumentation. It is probable that subclinical neurologic injuries, such as intraspinal and nerve root infarction in posterior neural tissue, can occur with the use of sublaminar hooks or wires. The chondrodystrophic beagle spinal model in this study should be considered a "worst case situation," and the clinical incidence of neurohistologic changes is expected to be lower. PMID- 2703930 TI - The effect of external fixation stiffness on early healing of transverse osteotomies. AB - The effect of bending stiffness of external fixators on the early healing of transverse tibial osteotomies was studied in a canine model to determine whether there is a particular range of fixation stiffness where healing is poor. Five unilateral fixators with different stiffnesses were developed and employed along with a dynamic compression plate to fix experimental osteotomies of dog tibias and the contralateral intact tibias served as controls. The six experimental fixation devices were: plate (P), stainless steel sidebar fixator (SS), stiff aluminum sidebar fixator (SA), intermediate aluminum sidebar fixator (IA), flexible aluminum sidebar fixator (FA), and Delrin sidebar fixator (D). Compared with human tibial fixation methods, the fixators ranged from a rigidity greater than a plate on a human tibia to a flexibility similar to a plaster cast on a human lower leg. Sixty-four adult male mongrel dogs (29 +/- 3 kg) underwent surgery and 52 completed the 9-week study, leaving 7 to 10 dogs in each experimental group (P = 8, SS = 7, SA = 9, IA = 9, FA = 10, D = 9). After the 9 week survival period the experimental tibias were radiographed and callus area was digitized. Both the experimental and control tibias were then tested to failure in four-point bending, and failure moment, stiffness, and energy to failure were determined. Of the 52 osteotomies, only four developed nonunions: 3 of 10 in the FA group and 1 of 7 in the SS group. Using analysis of variance, no statistical differences were detected in failure force, stiffness, or energy to failure as a function of fixator groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703931 TI - Role of mechanical loading in the progressive ossification of a fracture callus. AB - The progressive ossification pattern in a fracture callus was predicted based on a theory that relates the local stimulus for ossification to the tissue mechanical loading history. Two-dimensional finite element analyses of a fracture callus were considered at three different stages of ossification. The sites of callus ossification represented in the initial model were predicted by previous analyses relating mechanical stress and vascularity to the differentiation of mesenchymal tissue in the early callus. The zones of further ossification, bone bridging, and bone consolidation predicted in the present study were found to be similar to the ossification patterns that have been documented by other researchers. The approach used to predict fracture healing is identical to that of previous studies predicting joint morphogenesis, with the exception that fracture healing requires continuous, attached skeletal elements, whereas joint morphogenesis requires discontinuous, articulating skeletal elements. PMID- 2703932 TI - Recovery of the dog quadriceps after 10 weeks of immobilization followed by 4 weeks of remobilization. AB - Skeletal muscle fiber areas were measured in three heads of the dog quadriceps after 10 weeks of immobilization followed by 4 weeks of remobilization. Two-way analysis of variance demonstrated a significant decrease in both type 1 (p less than 0.005) and type 2 (p less than 0.001) fiber area. However, there was no significant difference among the three heads of the quadriceps (p less than 0.2). Although muscle fiber areas had not returned to control levels following remobilization, the area fraction of perimysial and epimysial connective tissue was not significantly different from control values (p greater than 0.15). These data suggest that although the degree of muscle atrophy following 10 weeks of immobilization is severe and muscle specific, following 4 weeks of remobilization, muscles uniformly recover to about 70% of control values. PMID- 2703933 TI - Laser Doppler flowmetry for bone blood flow measurements: helium-neon laser light attenuation and depth of perfusion assessment. AB - Laser Doppler flowmetry (LDF) has been successfully used in clinical and experimental settings to evaluate bone perfusion but unanswered questions regarding its capabilities and limitations still remain. This study was undertaken to determine absorption of He-Ne laser light (632.8 nm) and maximum depth for flow assessment (threshold thickness) under optimal conditions in bone. Light transmittance in bovine bone samples of femora and tibia was measured after each step of grinding and depth of penetration calculated. The threshold thickness was obtained by placing the same samples in a flow chamber where a solution of 2% latex circulated beneath; flow was detected by a laser Doppler probe resting on top of the sample. The results showed a significantly higher depth of penetration for trabecular than for cortical bone. A regression analysis showed a high correlation between the inorganic fraction of the bone and the depth of penetration. The maximum depth at which the laser Doppler probe can evaluate flow in bone conditions was found to be 2.9 +/- 0.2 mm in cortical bone, 3.5 +/- 0.3 mm in bone covered by 1 mm cartilage and 3.5 +/- 0.2 mm in trabecular bone. The study showed the limitations of LDF in bone and their correlations to various bone properties. PMID- 2703934 TI - Circulatory and mechanical response of skin to loading. AB - We investigated the tolerance of skin to mechanical loading over the tibia and over the tibialis anterior muscle in 12 normal volunteers. Surface load, subcutaneous tissue pressure, skin deformation under load, and transcutaneous partial pressure of oxygen (TcPO2) were simultaneously monitored. The skin over bone showed a significantly stiffer load deformation relationship than the skin over muscle (p less than 0.001). The displacement required to reduce TcPO2 to 0 over bone, 1.1 +/- 0.3 mm (mean +/- standard deviation), was significantly less than that required over tibialis anterior muscle, 5.4 +/- 1.1 mm (p less than 0.001). The applied pressure required to reduce TcPO2 to 0 was significantly greater for skin over muscle (71 +/- 16 mm Hg) than for skin over bone (42 +/- 8 mm Hg) (p less than 0.001). However, the subcutaneous pressure required to reduce TcPO2 to 0 was not significantly different for skin over muscle (36 +/- 11 mm Hg) than for skin over bone (28 +/- 10 mm Hg) (p greater than 0.05). Our results indicate that skin over muscle tolerates greater locally applied loads and deformations because the pressure is lower within the tissue than when similar loads and deformation are applied to skin over bone. Cutaneous perfusion, as indicated by TcPO2, seems to be linked more closely to the subcutaneous tissue pressure than to the surface load or deformations. These results provide some data for predicting mechanical and physiologic response to locally applied loads such as those that may be encountered in prosthetic wear. PMID- 2703935 TI - Energy absorptive properties of human trabecular bone specimens during axial compression. AB - Human trabecular bone specimens (n = 121) from the proximal tibial epiphysis of nine macroscopically normal cadaver knees were tested nondestructively to a fixed strain (0.6%) for analysis of unloading energy and hysteresis energy followed by a destructive test for analysis of work to failure. All energy properties showed interindividual variation (p less than 0.005). There was a strong positive correlation between unloading energy and both stress (r = 0.95) and stiffness (r = 0.89) determined at 0.6% strain. A less strong, but statistically significant, correlation was found between hysteresis energy and stress (r = 0.82) and stiffness (r = 0.76) at 0.6% strain. There was a negative correlation between the loss tangent and stiffness at 0.6% strain (r = -0.40, p less than 0.001). Work to failure correlated positively with modulus of elasticity (r = 0.75), ultimate stress (r = 0.92), and ultimate strain (r = 0.51). There was a positive mutual correlation between all energy properties (p less than 0.001). PMID- 2703936 TI - The effect of grip strength on radial bone in postmenopausal women. AB - This communication explores the correlation in 255 postmenopausal women of grip strength to bone tissue density (BTD) and cross-sectional area (CSArea) of the radius. While grip strength correlated cross-sectionally with the baseline measures of both BTD and CSArea, grip strength affected differentially the changes that transpired in the two bone parameters over the 3 years of the study. Thus, the increases in the CSArea of the radius were significantly enhanced by higher grip strength, while BTD losses were not. Since the power of muscle contraction is a factor in the mechanical loading of a bone, it is argued that the differential effects of grip strength on the two bone parameters of the radius suggest that moderate loading can effect favorable changes in the geometry of the bone, without necessarily affecting changes in BTD. PMID- 2703937 TI - Pressures in the distal radioulnar joint: effect of surgical procedures used for Kienbock's disease. AB - Radial shortening and ulnar lengthening are two accepted surgical methods for treating Kienbock's disease. The effect of these procedures on the pressure within the distal radioulnar joint between the ulnar head and the sigmoid notch of the radius was experimentally evaluated in six fresh cadaver forearms. Radical shortening and ulnar lengthening led to increased pressure at the distal radioulnar articulation and caused shifting of the location of the center of pressure distally within the sigmoid notch. Radial displacement of the distal radial fragment at the time of radial shortening, however, decreased the peak pressures. Based on these experimental data, ulnar lengthening and radial shortening can be expected to alter the normal biomechanics of the distal radioulnar joint. PMID- 2703938 TI - New technique for producing uniform partial lacerations of tendons. AB - Previous experimental studies of partial flexor tendon lacerations have used tendons cut by hand with magnification and a scalpel. When we biomechanically tested chicken flexor tendons lacerated by hand through 75% of their cross sectional area, the tensile strength of the residual tendons varied substantially among specimens from different chickens as well as between digit matched pairs of tendons from the same animal. A device was designed that uses standard scalpel blades to create a uniform tendon laceration by leaving a constant area of tendon intact regardless of original tendon size or shape. With the instrument we have called the "tenotome," a second group of chicken flexor tendons were lacerated through 75% of their cross-sectional area. Biomechanical testing of the tendons cut with the tenotome showed significantly less variation when compared with the tendons cut by hand. Use of the tenotome permits the establishment of a more uniform model for partial flexor tendon injuries, and potentially decreases the number of specimens needed to demonstrate statistical significance. PMID- 2703939 TI - Experimental method for the measurement of the elastic modulus of trabecular bone tissue. AB - A procedure has been developed to measure the elastic modulus of small, irregularly shaped specimens without significantly disturbing the specimen's internal or surface structure. This procedure was developed to measure the average elastic modulus of isolated trabeculae from human cancellous bone tissue. The procedure combines direct testing of a cantilever beam-type specimen, along with finite element modeling of the specimen and the testing conditions. Initial estimates for the bone tissue material properties are input into the finite element model; differences between the calculated finite element displacement and the experimentally observed displacement allows the actual material modulus to be determined. Machined aluminum and cortical bone specimens were used to test the accuracy and repeatability of the procedure. Manipulations of the finite element models were performed to examine the effect that mesh construction errors might have on the accuracy of the results. None of the parameters examined resulted in changes in the measured finite element displacements of greater than 8%. In tests on six trabecular bone specimens, an average elastic modulus of 7.8 GPa was calculated. Even taking into account the possible sources of error, this value remains significantly less than the accepted value for cortical bone. PMID- 2703940 TI - Some mutations affecting neural or muscular tissues alter the physiological components of the electroretinogram in Drosophila. AB - Mutants displaying generalized behavioral defects and one mutant having an enzyme deficiency were examined for electroretinogram (ERG) defects. Mutations in nine genes were examined that cause ERG defects. Two, parats4 and slrpD, cause reversibly temperature dependent loss of the off-transients in the ERG. stnC and Tyr-2 cause loss of the on and off-transients. The transient defect in Tyr-2 mapped close to a site shown to affect tyrosinase activity in this strain. Mutations bas, rex and sesD delay recovery from the prolonged depolarization afterpotential. The visual defects of mutations elavjl and nbAEE171 are not complemented by lethal mutations, which, presumably, affect other tissues. PMID- 2703941 TI - Deficiency of the corpus callosum: incomplete penetrance and substrain differentiation in BALB/c mice. AB - In a foundation population of BALB/c mice used to establish a colony at Waterloo in 1977, about 11% of adults showed either total absence or gross deficiency of the corpus callosum. Comparisons between parents and offspring, between progenies of different males, and between 13 separate lines established by full-sib inbreeding showed that variation in the adult corpus callosum reflected a genuine incomplete penetrance in a genetically uniform population. However, after seven generations of inbreeding, a spontaneous change occurred in one line (BALB/cWah 1), resulting in more than 50% of adults with deficient corpus callosum, among which about 20% have complete absence of callosal axons traversing the hemispheres. PMID- 2703942 TI - Effects of mild hyperthyroidism on levels of amino acids in the developing Lurcher cerebellum. AB - This study examines the question of whether intrinsically defective mutant Lurcher Purkinje cells, which degenerate during postnatal weeks two to five, followed by later loss of granule cells are competent to respond to neonatal hyperthyroidism, which is known to cause premature differentiation of Purkinje cells and an acceleration of the peak of proliferation in granule cells in normal rodent cerebellum. Both total amounts and concentrations (per mg wet weight) of Tau, Glu, Asp and GABA were assayed as markers of cell function in Lurcher and wild-type mice made very mildly hyperthyroid by feeding nursing dams high thyroxine food. Tau, which is present in relatively high concentrations in Purkinje cells, was affected by hyperthyroid treatment in the Lurcher in a manner that is most consistent with an acceleration of the degenerative process in Purkinje cells. The acidic amino acids Glu and Asp show later changes and response to hormone which seem to be a reaction to the Purkinje cell pattern, probably in the granule cells. We conclude that the Lurcher cerebellum is particularly sensitive to thyroid hormone, and that it responds to low levels of hyperthyroidism in a distinct way. PMID- 2703943 TI - Genetic selection for novelty-induced rearing behavior in mice produces changes in hippocampal mossy fiber distributions. AB - Previous investigations in mice revealed the existence of a set of genes that influence variations in hippocampal anatomy as well as variations in behavioral responses to novelty. In particular, a positive genetic correlation was found between the size of the intra- and infrapyramidal mossy fiber (iip-MF) projection and rearing frequency in an open-field. On the basis of these findings, we hypothesized that genetic selection for rearing would entail correlated changes in hippocampal morphology. This was tested in the inbred selection lines SRH (selection for rearing: high) and SRL (selection for rearing: low). As expected, the SRH mice appeared to possess iip-MF terminal fields that were larger than those of the SRL mice. Because the behavioral difference between the two lines is most probably caused by a single genetic unit, these animals represent valuable material for molecular-genetic investigations into the mechanisms that control behavioral and neuroanatomical variation. PMID- 2703944 TI - A pedigree primer. AB - Pedigree-taking skills can promote an understanding of how genetic information relates to a comprehensive family health assessment. The format of the pedigree is used to structure and organize data gathered in the assessment process. The pedigree can assist the nurse and genetics specialist to identify possible patterns of inheritance. This article outlines for the staff nurse the pertinent areas that need to be explored during the assessment process. It discusses common terms and symbols used in the pedigree. Information gathered from the health assessment of an adolescent with Usher's syndrome is used for an example of how the pedigree is constructed. PMID- 2703945 TI - Preschool temperament of very-low-birth-weight infants. AB - This longitudinal study examined the toddler and preschool behavioral characteristics of children who were born with very low birth weights (VLBW; less than or equal to 1,500 grams). The subjects were 40 VLBW children (average birth weight, 1,203 grams) who at birth were appropriate for gestational age and free from congenital anomalies. Data were gathered during home visits when the children were 12, 24, 36 and 48 months and were analyzed using Pearson product moment correlation and z tests. Arrhythmicity, low adaptability, and low persistence during the toddler and preschool years characterized the behavioral styles of VLBW children. The temperament dimensions of rhythmicity, adaptability, intensity, mood, and threshold were related to the quality of the child's environment. Clinicians need to be alert to the impact of temperament on the interpersonal milieu of VLBW children and their families. PMID- 2703946 TI - Siblings' responses in illness situations. PMID- 2703947 TI - Teenage suicide. PMID- 2703948 TI - Glucose meters. PMID- 2703949 TI - Multiple prescriptions for Schedule II drugs. PMID- 2703950 TI - Emergency planning for technology-assisted children. AB - Development of emergency systems is essential to ensure a safe home environment for technology-assisted children. Defined as combinations of circumstances or the resulting states that call for immediate action, assistance, or relief, emergencies may arise related to health, equipment, or environmental situations. Based on the philosophy that emergency services should be planned in advance of emergencies for technology-supported individuals, systems for each area of planning are outlined. PMID- 2703951 TI - Predicting parental anticonvulsant medication compliance using the theory of reasoned action. AB - One approach to better understanding compliance behavior is the use of the theory of reasoned action. In this article, the theory of reasoned action is used to predict the compliance behavior of 29 parents of children with epilespy. In support of the theory, behavioral intention was found to significantly predict (p less than 0.01) parental medicine-giving behavior. Contrary to the results predicted by the theory, parents' attitudes toward giving the medication correlated with a significant amount of variance in medicine-giving behavior beyond that accounted for by behavioral intention. PMID- 2703953 TI - Public health and the law: HIV antibody status and employment discrimination. PMID- 2703952 TI - Reestablishing health: factors influencing the child's recovery in pediatric intensive care. AB - This article presents a conceptual framework that examines five factors affecting the rate of recovery and return to health for critically ill children in pediatric intensive care. Stress, coping, development, social support, and immunocompetence are analyzed from a biopsychosocial perspective to gain a clearer understanding of how these variables interrelate to affect the child's ability to recover. The conceptual framework will assist the nurse in recognizing which children are at greatest risk for setbacks and delays in recovery. PMID- 2703954 TI - Envelope structure model of human immunodeficiency virus type 1. AB - The envelope structure of human immunodeficiency virus type 1 (HIV-1) was examined using a computer image processor combined with an image rotation averaging system. Our results indicate that the envelope of the HIV-1 particle is constructed of a T-7 laevo icosahedral surface net, and the knobs are distributed in the positions of pentamer-hexamer clustering, the total number being 72, which correspond to the results obtained by Gelderblom et al. and Ozel et al. PMID- 2703955 TI - Evidence that prior immune dysfunction predisposes to human immunodeficiency virus infection in homosexual men. AB - To investigate the role of host susceptibility to HIV-1 infection, we studied subsequent seroconversion in 161 individuals, initially seronegative to HIV-1, who underwent skin testing for cutaneous anergy at an index visit within a prospective study of homosexual men. There were 23 seroconversions in these men by 45 months following the skin testing, yielding a crude rate of seroconversion of 14.3%. While results of purified protein derivative (PPD), Candida, and Trichophyton skin tests were not associated with subsequent course, anergy to dinitrochlorobenzene (DNCB) was predictive of subsequent seroconversion. Kaplan Meier estimates for the risk of seroconversion during 45 months of follow-up in those men initially anergic and reactive to DNCB were 28.9 and 11.1%, respectively, yielding a relative risk of 2.6 (p = 0.006). The estimated relative risk was stable with adjustment by Cox regression for annual number of male sexual partners and frequency of receptive anal intercourse, and was not sensitive to various changes in the definition of seroconversion time and of eligibility criteria. These data suggest that an impaired host immune status may be associated with an increased risk of HIV-1 infection that is independent of risk of exposure to the virus, supporting earlier speculations that HIV-1 may itself be opportunistic. The notion of varying host susceptibility to infection, at least with regard to sexual transmission in homosexual men, may help to explain the frequent observation of individuals who have been repeatedly exposed to the virus and yet have remained uninfected. PMID- 2703956 TI - HIV serology in artificially inseminated lesbians. AB - The purpose of this investigation was to examine the risks of HIV transmission from artificial insemination in a sample of lesbians residing in California and inseminated between 1979 and 1987. This population was selected because lesbians are considered to be at low risk for HIV infection, and have traditionally used semen from men engaging in high-risk behaviors, namely, homosexual men. Each of the 98 participants had blood drawn for the HIV antibody test (ELISA) and completed a questionnaire inquiring about her sexual, health, and reproductive history, including detailed information about her inseminations (e.g., vaginal vs. uterine, fresh vs. frozen semen, sexual orientation, and antibody status of donor). One-half of the women had homosexual or bisexual donors, many of whom resided in the San Francisco Bay area; most of these inseminations were with fresh semen. The women reported a marked decline in the use of homosexual donors after 1982 and a corresponding increase in the use of donations from sperm banks and health practitioners. Based on the women's reports, as many as 11 women may have received semen from an infected donor. However, none of the 98 women tested seropositive. We attribute our negative findings to the change to low-risk donors in the years when HIV became more prevalent in the population, and to the potentially lower rates of infectivity with artificial insemination than with heterosexual intercourse. Nevertheless, we recommend that women continue to follow the CDC guidelines for screening donors prior to artificial insemination. PMID- 2703957 TI - Comparison of AIDS and HIV antibody surveillance data in Colorado. AB - We compared cumulative surveillance data for AIDS (May 1982-December 1986) and persons with positive HIV antibody tests (July 1985-December 1986) to examine the adequacy of each surveillance system in directing public health disease control activities. Neither AIDS nor HIV antibody surveillance data alone described the total extent of HIV infection. The geographic distribution of persons with positive HIV antibody tests was more widespread than the distribution of AIDS cases for all demographic and transmission categories. Ideally, preventive efforts should be based on a comprehensive surveillance system that indicates all persons who are infectious with HIV. PMID- 2703958 TI - Vinyl versus latex gloves as barriers to transmission of viruses in the health care setting. AB - One type of vinyl and seven types of latex gloves without visual defects were tested with respect to their barrier function against high concentrations of three viruses of varying size: herpes simplex virus type 1 (HSV-1, 180 nm), human immunodeficiency virus type 1 (HIV-1, 100 nm), and echovirus type 9 (Echo 9, 25 nm). Viral suspensions of HSV-1 (10(8) TCD50/ml), HIV-1 (10(5) TCD50/ml), and echovirus type 9 (10(7.5)TCD 50/ml) were placed in an inverted glove finger immersed in media and maintained for 3 h at room temperature with sampling performed from outside the glove at 10 min, 30 min, 1 h, 2 h, and 3 h. No cytopathic effect (CPE) was identified after inoculation onto Vero cells or RhMK cells for HSV-1 and Echo 9, respectively, and reverse transcriptase activity was not detected in Hut 78 cells after inoculation of HIV-1 during any of the time intervals. Stretching of a glove finger for 18 h with repetition of the procedure with Echo 9 revealed no CPE. We conclude that under these experimental conditions, intact gloves act as effective barriers to the transmission of viral particles, including HIV in the health care setting. PMID- 2703959 TI - Prenatal diagnosis of HIV infection: two attempts using fetal blood sampling. AB - Blood samples were studied, prior to medical terminations of pregnancy, in two second trimester fetuses with HIV-positive mothers. Fetal blood was obtained from the umbilical vein under ultrasound guidance. No evidence of infection was found in either fetus. In particular, lymphocyte subpopulations were at normal levels and cultures yielded no reverse transcriptase activity. Postmortem findings were normal. Reliable means for prenatal diagnosis of HIV infection, with a minimal risk of false-negative results, have yet to be developed. However, further studies using fetal blood sampling should be useful for the management of HIV positive pregnancies. PMID- 2703960 TI - Perinatal HIV infection: longitudinal study of 22 children (clinical and biological follow-up) PMID- 2703961 TI - Relationship between self-administration of amphetamine and monoamine receptors in brain: comparison with cocaine. AB - Amphetamine and cocaine, commonly abused psychostimulants, often produce similar physiologic and behavioral effects in both animals and humans. We have shown previously that the reinforcing effects of cocaine can be correlated with drug binding to the mazindol and GBR 12935 binding sites on the dopamine transporter. In an attempt to identify the receptors associated with the reinforcing properties of amphetamine and related phenylethylamines, we have compared the potencies of these compounds in studies of drug reinforced behavior with their binding potencies at monoaminergic uptake sites and neurotransmitter receptor sites. The results of these experiments indicate that d-amphetamine exhibits a pharmacologically relevant micromolar affinity for dopamine, norepinephrine and serotonin uptake sites as well as for alpha-2 adrenergic receptor sites. Analysis of the data indicates that the reinforcing effects of phenylethylamines were not positively correlated with inhibition of ligand binding to any of the monoamine sites tested. However, the self-administration of amphetamine and related compounds may be inversely related to the inhibition of [3H]paroxetine binding to the serotonin transporter, suggesting that serotonin uptake inhibition opposes the reinforcing effects of amphetamine. This effect is not related to direct effects of drug binding at 5-HT2 receptor sites. Finally, amphetamine binding to alpha-2 adrenergic receptors suggests that these receptors could play a role in mediating the releasing or uptake inhibiting properties of the drug, and perhaps a role in some of its psychotomimetic effects. PMID- 2703962 TI - Role of renal nerves in excretory responses to exogenous and endogenous opioid peptides. AB - The present study was designed to investigate opioid peptide-mediated changes in renal function in conscious Sprague-Dawley rats after administration of the native opioid agonist methionine enkephalin (ME), its synthetic analog D-Ala2 methionine enkephalinamide (DALA) and the opioid antagonist naloxone. Intravenous infusion of DALA (25 micrograms/kg/min) and ME (75 micrograms/kg/min) produced no changes in mean arterial pressure, heart rate, glomerular filtration rate or effective renal plasma flow in rats with intact or bilaterally denervated kidneys. In contrast, i.v. infusion of these opioid agonists produced differing effects on the renal excretion of water and sodium; DALA produced an increase in urinary flow rate and sodium excretion and ME produced a decrease in these parameters. Changes in renal sympathetic nerve activity were not involved in producing these effects as supported by measurements of renal sympathetic nerve activity and the finding that prior bilateral renal denervation did not alter the renal responses to either agonist. The renal excretory responses to both DALA and ME infusion were prevented by pretreatment with the opioid receptor antagonist naloxone, thus suggesting an opioid receptor-mediated effect of both agonists. Intravenous bolus injections of naloxone alone produced a dose-dependent diuresis and natriuresis without producing changes in systemic or renal hemodynamics or renal sympathetic nerve activity. These studies, therefore, provide evidence that the administration of opioid receptor agonists and antagonists produce changes in the renal excretion of water and sodium via an action on renal tubular reabsorptive mechanisms which are independent of changes in systemic or renal hemodynamics or renal sympathetic nerve activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703963 TI - Biliary excretion of acetaminophen-glutathione as an index of toxic activation of acetaminophen: effect of chemicals that alter acetaminophen hepatotoxicity. AB - Acetaminophen (AA) is converted, presumably by cytochrome P-450, to an electrophile which is conjugated with glutathione (GS). AA-GS is excreted into bile, therefore the biliary excretion rate of AA-GS may reflect the rate of activation of AA in vivo. In order to test this hypothesis, the effect of agents capable of altering the activation of AA including cytochrome P-450 inducers and inhibitors, cobaltous chloride which decreases the amount of P-450, prostaglandin synthetase inhibitors (indomethacin and naproxen), antioxidants (butylated hydroxyanisole, alpha-tocopherol, ascorbic acid and ascorbic acid palmitate) and other chemicals known to decrease AA hepatotoxicity (dimethylsulfoxide and cysteamine), on the biliary excretion of AA-GS was studied in hamsters, the species most sensitive to AA-induced hepatotoxicity. The biliary excretion of AA GS increased linearly up to 1 mmol/kg of AA i.v., but at higher dosages exhibited saturation kinetics. Dosages above 0.5 mmol/kg lowered hepatic GS concentration. Of the cytochrome P-450 inducers, 3-methylcholanthrene and 2,3,7,8 tetrachlorodibenzo-p-dioxin, increased the biliary excretion of AA-GS (2.9- and 3.2-fold, respectively) whereas ethanol and isoniazid did not affect it, and pregnenolone-16 alpha-carbonitrile tended to decrease it (43%). Phenobarbital tended to increase the biliary excretion of AA-GS, but not in a statistically significant manner. Several cytochrome P-450 inhibitors [metyrapone, 8 methoxypsoralen, 2-(4,6-dichloro-biphenyloxy) ethylamine, alpha-naphthoflavone and cimetidine] decreased the biliary excretion of AA-GS, although SKF 525-A and piperonyl butoxide did not. Cobaltous chloride decreased dramatically the biliary excretion of AA-GS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703964 TI - Irreversible and quaternary muscarinic antagonists discriminate multiple muscarinic receptor binding sites in rat brain. AB - The maximal number of binding sites (Bmax) of [3H]quinuclidinyl benzilate (QNB) binding was greater than the Bmax of N-[3H]methylscopolamine (NMS) binding to homogenates of rat brain. The competition of NMS for [3H]QNB demonstrated that NMS discriminates multiple muscarinic binding sites. Similarly, pirenzepine competition of [3H]QNB binding also revealed multiple muscarinic binding sites. Pirenzepine competition for [3H]NMS also was shallow and demonstrated the presence of binding sites with similar affinities to those labeled by [3H]QNB. These data were consistent with the presence of at least three populations of muscarinic binding sites with similar affinities for [3H]QNB: the M1 and M2 binding sites having high and low affinity for pirenzepine, respectively, but which cannot be discriminated by [3H]NMS, and a third site with high affinity for [3H]QNB which has low affinity for NMS. The classical muscarinic antagonists, atropine and scopolamine, also appear to have slightly different affinities for the putative M1 and M2 binding sites. The use of the irreversible antagonists, N ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ) and propylbenzilylcholine mustard (PBCM), were used to elucidate the distinct properties of these multiple muscarinic binding sites. Both PBCM and EEDQ irreversibly decreased the Bmax of [3H]QNB and [3H]NMS binding in cortex. PBCM did not appear to discriminate putative M1 and M2 binding sites but selectively alkylated the high affinity NMS and QNB binding sites. In contrast, EEDQ modified the low affinity NMS binding sites such that they still bound [3H]QNB but their affinity for other muscarinic antagonists was reduced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703965 TI - Inhibition of renal vasoconstriction induced by intrarenal hypertonic saline by the nonxanthine adenosine antagonist CGS 15943A. AB - The hypothesis that intrarenal infusions of hypertonic saline induce endogenous release of adenosine to result in renal vasoconstriction has been investigated in salt-deplete dogs using the nonxanthine adenosine receptor antagonist, CGS 15943A. Intrarenal artery infusions of CGS 15943A induced dose-dependent reductions in the renal vasoconstrictor response to bolus doses of adenosine into the renal artery, without altering base-line blood pressure or renal blood flow. Infusion rates of 10 micrograms/min induced an approximate 50% reduction in response, whereas 100 micrograms/min produced a substantially greater response. There was no inhibition of the renal vasoconstrictor response to angiotensin II and norepinephrine by CGS 15943A at a rate of 100 micrograms/min. Changes in RBF after intrarenal infusion of hypertonic saline were compared between further series of salt-deplete dogs receiving intrarenal artery infusions of either vehicle or CGS 15943A (100 micrograms/min). An initial infusion of hypertonic saline to both groups of dogs induced renal vasodilation followed by vasoconstriction. In dogs subsequently infused with CGS 15943A (100 micrograms/min), the initial renal vasodilation response was similar, but there was an abolition of the later vasoconstrictor response. In contrast, the renal blood flow response to hypertonic saline was unchanged in the vehicle-infused dogs. We conclude that CGS 15943A can selectively block the renal blood flow response to exogenous adenosine without altering baseline renal vascular tone and that the ability of CGS 15943A to abolish the renal vasoconstrictor response to intrarenal hypertonic saline is consistent with the hypothesis that endogenous release of adenosine is involved in mediating the reduction in renal blood flow. PMID- 2703966 TI - Role of bile acid conjugation in hepatic transport of dihydroxy bile acids. AB - The effect of conjugation and side chain length on dihydroxy bile acid unidirectional hepatic uptake and efflux was studied using the isolated perfused rat liver which was perfused prograde or retrograde in single pass fashion. Deoxycholic acid (DC) and its C23 (nor) derivative nor-DC, as well as the synthetically prepared taurine conjugate of DC, were administered at a constant dose of 1 mumol/min/kg (body weight), upon which a bolus tracer dose of labeled bile acid was superimposed. Analysis of radioactivity recovery in perfusate indicated that unidirectional uptake of all three bile acids was equally rapid, but that only nor-DC showed considerable and continuing efflux into the perfusate; this involved mostly the unchanged acid. Nor-DC was not amidated but was metabolized to mostly ester glucuronides and hydroxylated derivatives; the biotransformation products did not reflux and were secreted into bile; similarly, DC was amidated with taurine; its taurine conjugate did not efflux and was secreted into bile. When nor-DC-taurine was infused, it did not efflux and was secreted rapidly into bile. When the liver was perfused retrograde fashion to increase concentrations of bile acids pericentral cells, only nor-DC showed efflux, which again involved only the unchanged acid. All bile acids were partly 7 alpha-hydroxylated, the magnitude being greater during retrograde perfusion presumably because slower cellular transport exposed bile acid to hydroxylation enzymes for a longer period. It is concluded that bile acid conjugation, whether by esterification with CoA formation adn subsequent amidation or by esterification with glucuronate, restricts the movement of lipophilic dihydroxy bile acids to the hepatocyte and canalicular lumen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703967 TI - Evaluation of the abuse potential of methocarbamol. AB - The subjective and behavioral effects of p.o. administered methocarbamol, lorazepam and placebo were studied in a nonresidential group of adult male volunteers with histories of recreational substance abuse including sedative/hypnotics. In the first phase of the investigation, a dose run-up of methocarbamol (up to 12 g) was conducted in six subjects to determine appropriate doses. In the second phase, a randomized block cross-over study using 14 subjects was conducted. The following drug conditions were tested in the cross-over phase: placebo, lorazepam 1, 2 and 4 mg, and methocarbamol 2.25, 4.5 and 9 g. Drug conditions were tested under double-blind conditions. Psychomotor and cognitive performance measures and subject- and observer-rated behavioral responses were measured daily before dosing and for 5.5 hr after drug administration. The results showed that both lorazepam and methocarbamol produced statistically significant dose-related increases in subjects' ratings of drug effect and liking, although only lorazepam increased morphine-benzedrine group (MGB) scale scores. Methocarbamol also increased ratings on measures indicating the emergence of dysphoric and other side effects at high doses. Both drugs impaired psychomotor and cognitive performance, with lorazepam generally producing greater effects than methocarbamol. The results indicate that methocarbamol, at doses well above those used therapeutically, has some potential to be abused by persons with histories of sedative/hypnotic abuse; however, this potential for abuse is probably decreased by the accompanying side effects at high doses and is probably less than that of lorazepam. PMID- 2703968 TI - Interaction between nonsteroidal anti-inflammatory drugs and loop diuretics: modulation by sodium balance. AB - Nonsteroidal anti-inflammatory drugs have been shown to decrease the natriuretic response to loop diuretics in many but not all studies. Recently, indomethacin was shown not to affect the natriuretic response to the new loop diuretic torasemide in healthy volunteers. Inasmuch as sodium balance has been reported to modify the effect of indomethacin on furosemide-induced natriuresis in dogs, we investigated the effect of indomethacin, under two sodium balances (50 and 150 mEq/day), on the natriuretic response to two doses of torasemide in six healthy volunteers. Under the low sodium diet, indomethacin reduced the natriuretic response to torasemide like that to furosemide. In contrast, on the normal sodium diet, indomethacin failed to affect the natriuretic response to torasemide. Indomethacin reduced base-line and diuretic-induced increase in plasma renin activity, plasma angiotensin II levels and urinary excretion of prostaglandin 6 keto F1 alpha to a similar extent under the two sodium diets. Our data show that indomethacin reduces the natriuretic response to torasemide in humans. Dietary sodium restriction is a significant determinant of the interaction between nonsteroidal anti-inflammatory drugs and loop diuretics in healthy volunteers, presumably because it allows loop diuretics to provoke an increase in renal blood flow which participates in their natriuretic action and is blocked by nonsteroidal anti-inflammatory drugs. PMID- 2703969 TI - Dose dependency of furosemide-induced sodium excretion. AB - Intravenous furosemide doses ranging from 5 to 120 mg were given to healthy young volunteers with and without individualized active rehydration with a sodium chloride solution. Sodium excretion rates and fractional sodium excretions (FENa) percentages were correlated significantly with dose and with urinary excretion rates of furosemide. The ED50 was below 5 mg and no additional natriuretic effect was seen above 40 mg. The efficiency (FENa percentage per microgram of furosemide excreted per minute during a certain clearance period) was dependent on hydration and on time. For the period 15 to 30 min a significant linear relationship between furosemide dose and the reciprocal of the efficiency indicated a higher efficiency for lower doses and a theoretical maximal value of FENa of 0.4% per micrograms of furosemide excreted per minute. A relative value for a dose dependent efficiency reduction was calculated for each dose. The ED50 for dose dependent efficiency reduction was about 12 mg i.v. Simultaneous measurements of lithium clearance indicated a proximal site of action for furosemide which was saturated at furosemide excretion rates above 50 micrograms/minute. For the major, distal, site of action no maximal value was demonstrated. It is concluded that a wanted balance between a strong natriuretic effect and weak sodium retaining mechanism not necessarily is achieved by a high dose and that information concerning that problem must be obtained from studies in relevant patient groups. PMID- 2703970 TI - Effect of anti-inflammatory analgesic drugs on the regulation of cytosolic pH by anion antiport. AB - Four nonsteroidal anti-inflammatory analgesic drugs acetylsalicylic acid (aspirin), salicylic acid, indomethacin and piroxicam were tested for their action on chloride/bicarbonate exchange by anion antiport and on the regulation of cytosolic pH (pHi) in Vero cells. The Na+-independent Cl-/HCO3- exchange regulates pHi back to normal after alkalinization and is therefore in a state of high activity at alkaline pHi, whereas it is in a state of low activity when pHi is below neutrality. Preincubation with the drugs at low pH strongly increased the activity of the Na+-independent Cl-/HCO3- exchange, whereas at high pH the antiport was inhibited. The Na+-dependent Cl-/HCO3- exchange, which is most active at low pHi and normalize pHi after acidification, was inhibited after preincubation with the drugs. In cells that had been incubated with the drugs, pHi was 0.1 to 0.4 pH units lower than in cells that had been incubated in the absence of drugs. The prostaglandins E2, F2 and I2 had little effect on anion antiport, and did not counteract the effects of the anti-inflammatory drugs on Cl /HCO3- exchange, indicating that these actions of the drugs are not due to the inhibition of prostaglandin synthesis. The relevance of our findings to the clinical effects of these drugs is discussed. PMID- 2703971 TI - In vitro effect of naftidrofuryl oxalate on cerebral mitochondria impaired by microsphere-induced embolism in rats. AB - The present study was designed to determine whether naftidrofuryl oxalate (Naftidrofuryl) may exert a beneficial effect on the cerebral mitochondria after microsphere-induced embolism assessed under in vitro conditions. For this purpose, 600 microspheres (48 microns in diameter) were injected into the right carotid canal of rats, which induced an irreversible embolism in the right cerebrum. Three days after the operation, the cerebral mitochondria were isolated and their oxidative phosphorylation ability and succinate dehydrogenase activity were determined. Two types of mitochondria were obtained after cerebral embolism: one was mitochondria which revealed a marked decline in the oxidative phosphorylation activity when measured in the presence of glutamate or succinate as a substrate (severely injured mitochondria), and the other, those which revealed a decrease in the activity in the presence of succinate and an appreciable increase in the activity in the presence of glutamate (mildly injured mitochondria). Naftidrofuryl at the concentration of 3 microM elicited slight but significant restoration of the oxidative phosphorylation ability of the mildly injured mitochondria isolated from rats after the cerebral embolism, but not of the severely injured mitochondria. The succinate dehydrogenase activity of the brain mitochondria isolated from rats 3 days after the cerebral embolism was significantly decreased. Exposure of these mitochondria to 0.1 to 1 microM Naftidrofuryl significantly restored the succinate dehydrogenase activity. The results suggest that Naftidrofuryl is capable of exerting a beneficial effect in vitro on the brain mitochondria activity impaired by the cerebral embolism, particularly on the activity of mildly injured mitochondria. PMID- 2703972 TI - Blood oxygen tension-related change of theophylline clearance in experimental hypoxemia. AB - The effects of arterial blood oxygen tension on the pharmacokinetics of theophylline were investigated using an experimental acute hypoxemia model in rats. Conscious rats were exposed to hypoxic gas composed of 8% O2-92% N2. After blood gas tensions and blood pH were stabilized, rats received 5 mg/kg i.v. theophylline, and urine and blood samples were collected. The steady-state volume of distribution, unbound free fraction and hematocrit were unaffected by hypoxemia. Total body clearance was significantly changed (P less than .01) from 0.156 +/- 0.020 l/kg/hr in control to 0.0556 +/- 0.0067 l/kg/hr in hypoxemic rats due to the reduction of both hepatic and renal clearances. In another constant rate i.v. infusion study, the plateau plasma concentration of theophylline was elevated steeply as soon as animals had inspired hypoxic gas, and the elevated concentrations went down after returning to room air. The present results suggested that the variation of arterial oxygen tension is one possible mechanism for a rapid and large intraindividual variability in theophylline clearance in acutely ill patients with chronic obstructive pulmonary disease. PMID- 2703973 TI - Mechanism of increased hepatotoxicity of acetaminophen by the simultaneous administration of caffeine in the rat. AB - The simultaneous administration of caffeine has been shown to potentiate acetaminophen-induced hepatotoxicity. In the present study, the mechanisms of this effect were studied. Male Sprague-Dawley rats, fasted for 18 hr, were given acetaminophen (0.5 g/kg) and/or caffeine (0.1 g/kg) i.p. Two hours later, the depletion of hepatic reduced glutathione (GSH) induced by acetaminophen was more pronounced by the concomitant administration of caffeine, although the effect of caffeine alone on the hepatic GSH content was minimal at this dose. Covalent binding of a reactive metabolite of acetaminophen to hepatic proteins was increased by caffeine although the free acetaminophen content in the liver was not affected. In isolated rat hepatocytes prepared from normal animals, caffeine enhanced acetaminophen-induced GSH depletion and potentiated covalent binding of the reactive metabolite to cellular proteins. The extracellular release of GSH + oxidized glutathione was decreased by acetaminophen, and this decrease was potentiated further by the addition of caffeine. In the cells, the production of acetaminophen-GSH conjugate also was increased in the presence of caffeine, whereas that of glucuronide conjugate was decreased. In microsomes, NADPH dependent production of acetaminophen-GSH conjugate was increased in the presence of caffeine. Thus, caffeine appears to potentiate acetaminophen-induced hepatotoxicity mainly by enhancing the production of a reactive metabolite of acetaminophen by mixed function oxidases. To what extend caffeine-induced GSH depletion plays a role is to be clarified. PMID- 2703974 TI - Cellular mechanisms underlying the increase in cytosolic free calcium concentration induced by methylmercury in cerebrocortical synaptosomes from guinea pig. AB - Neurotoxic mechanisms of methylmercury (Met-Hg) on presynaptic nerve terminals were studied using the synaptosomes from the cerebral cortex of guinea pig as a model. Cytosolic free calcium [Ca++)c was determined using intrasynaptically trapped fluorescence indicator, fura-2; the plasma membrane potential (delta Up) by measuring the diffusion potential of 86Rb+ and the mitochondrial membrane potential was monitored using the safranine method. Synaptosomal respiration, glycolysis and concentrations of ATP and ADP in the presence and absence of Met Hg also were quantified. Met-Hg increased synaptosomal [Ca++]c by two distinctive mechanisms. Moderate elevation of [Ca++]c by 127 nM was observed at 30 microM Met Hg, at which concentration synaptosomal respiration was inhibited completely, leading to partial depolarization of mitochondria. A 3-fold activation of anaerobic glycolysis upon inhibition of respiration was insufficient to sustain terminal energy levels. The delta Up did not depolarize significantly from the resting potential of--67 mV. Thus, the rise in [Ca++]c was due to the energy failure of the synaptosomes, which has been caused by Met-Hg. With 100 microM Met Hg, [Ca++]c increased extensively by 882 nM. Upon addition of 100 microM Met-Hg the delta Up depolarized instantly dropping 36 mV within 1 min. Synaptosomes were severely energy-deprived, because anaerobic glycolysis was inhibited by 90% from the aerobic level and mitochondrial membrane potential dropped below the limit that could be detected by the safranine method. The proportion of fura-2 signal quenching by Mn++ also increased, indicating that the plasma membrane had become leaky. Thus, at high concentrations of Met-Hg, the rise in [Ca++]c was ascribed to increased ionic permeability of the plasma membrane. The contribution of presynaptic energy failure by Met-Hg is discussed as a possible biochemical mechanism underlying the neurotoxicity of organic mercury. PMID- 2703975 TI - Pharmacokinetics, brain distribution and pharmaco-electrocorticographic profile of zolpidem, a new hypnotic, in the rat. AB - Zolpidem [N,N-6-trimethyl-2-(4-methylphenyl)imidazo[1,2-a]pyridine-3- acetamide] administered as the hemitartrate salt has proven to be an effective hypnotic agent in animals and humans. This study describes the pharmacokinetic behavior of zolpidem in plasma and brain of rat after i.v. and p.o. administration of 2.63 mg.kg-1 of [14C]zolpidem (dose expressed as the base). Autoradiography was used to examine the regional distribution of the compound and the metabolic profile of zolpidem in the plasma and brain was also investigated. The pharmacokinetic data were related to electrocorticogram power spectral analysis. After i.v. administration, the disappearance of zolpidem from plasma fitted a biexponential model with a rapid phase of 0.2 to 0.3 hr and a slower phase of 1.3 to 1.5 hr. After p.o. dosing, peak plasma concentrations where already attained at 15 min (first sampling time). Independent of the route of administration, the concentrations of zolpidem in the brain at shorter times were 30 to 50% those of the plasma values. Furthermore, up to 1 hr, zolpidem accounted for 80 to 90% of brain radioactivity. The rate of disappearance from brain paralleled that from plasma. Autoradiographic studies confirmed the rapid absorption and elimination of zolpidem as well as the relatively homogenous distribution throughout the brain. Electrocorticogram analysis in immobilized rats after i.v. administration of zolpidem showed a rapid onset and a short-acting sedative effect compatible with the kinetic profile of the parent compound. Metabolites of zolpidem displayed a poor penetration into the brain and no significant hypnotic activity. At the dose of zolpidem used, no alteration of the sleep pattern was observed. PMID- 2703976 TI - Hepatotoxicity of menadione predominates in oxygen-rich zones of the liver lobule. AB - This study was designed to investigate the mechanism of zone-specific hepatotoxicity due to menadione. Infusion of menadione (64-1000 microM) into perfused livers from fasted rats caused a concentration-dependent increase in O2 uptake. During perfusion in the anterograde direction, menadione (1 mM) increased O2 uptake from 115 +/- 11 to 142 +/- 10 mumol/g/hr within 30 min, followed by a decrease to 92 +/- 11 mumol/g/hr over the next 30 min. Trypan blue was taken up by 90% of cells in periportal regions reflecting irreversible cell death, whereas cells in pericentral areas were not damaged. When the hepatic O2 gradient was reversed by perfusing in the retrograde direction, menadione increased O2 uptake initially from 114 +/- 11 to 132 +/- 14 mumol/g/hr, followed by a decline to 51 +/- 12 mumol/g/hr, qualitatively similar to data obtained from perfusions in the natural, anterograde direction. During perfusions in the retrograde direction, however, 95% of cells in pericentral regions were stained with trypan blue whereas those in periportal areas were spared. O2 uptake in specific zones of the liver lobule was then measured with miniature O2 electrodes. When menadione was infused during anterograde perfusions, O2 uptake increased in O2-rich periportal areas from 128 +/- 6 to 156 +/- 12 mumol/g/hr, but was not altered in pericentral regions. Conversely, during perfusions in the retrograde direction, menadione did not affect O2 uptake in periportal areas, but stimulated uptake in O2-rich pericentral regions from 120 +/- 4 to 150 +/- 14 mumol/g/hr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703977 TI - Pemedolac: a novel and long-acting non-narcotic analgesic. AB - Pemedolac [cis-1-ethyl-1,3,4,9-tetrahydro-4-(phenylmethyl)-pyrano [3,4-b]indole-1 acetic acid; AY-30,715] exhibited potent analgesic effects against chemically induced pain in rats and mice and against inflammatory pain in rats. In each of the animal models used the analgesic potency of pemedolac was defined by an ED50 of 2.0 mg/kg p.o. or less. Significant analgesic activity was detected in rats at 16 hr after administration of 1 mg/kg p.o. (paw pressure test) and at 10 hr after administration of 10 mg/kg p.o. to mice (p-phenylbenzoquinone writhing). Inasmuch as pemedolac was inactive in the hot plate and tail-flick tests; and its analgesic activity was not antagonized by naloxone (1 mg/kg s.c.), and tolerance did not develop upon multiple administration; this drug does not exert its analgesic effects through an opiate mechanism. Pemedolac differed from standard nonsteroidal anti-inflammatory drugs (NSAIDs) in that the doses which produced analgesia were much lower than those required for either anti-inflammatory or gastric irritant effects. In acute anti-inflammatory tests, pemedolac exhibited only weak activity as evidenced by an ED50 approximately 100 mg/kg p.o. in the carrageenan paw edema procedure. This demonstrates for pemedolac a separation of at least 50-fold between the acute analgesic and anti-inflammatory activities, which was greater than that observed with reference NSAIDs. The compound also had a low ulcerogenic liability with an acute UD50 = 107 mg/kg p.o. and a subacute UD50 estimated to be 140 mg/kg/day p.o. In contrast, the reference NSAIDS (piroxicam, indomethacin, naproxen and ibuprofen) exhibited similar dose-response relationships for the analgesic, anti-inflammatory and gastric irritant effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703978 TI - Differential effects of acute ethanol on urinary excretion of folate derivatives in the rat. AB - The ethanol-induced increase in the urinary excretion of folate has been determined to be both a time- and dose-dependent phenomenon and it has been speculated that this loss may enhance the development of folate deficiency. However, ethanol has only a minor effect on the renal clearance of exogenously administered [3H]folic acid [3H]PteGlu) in relation to that of inulin. To clarify this variable effect of ethanol, male Sprague-Dawley rats were given four consecutive hourly doses of ethanol at 1 g/kg and placed in metabolic chambers for collection of urine. At 5 hr, [3H]PteGlu was administered and urine samples were collected for 1 hr. At 6 hr, rats were sacrificed with collection of plasma, liver and kidney samples. A significant increase in the urinary excretion of endogenous folates occurred in ethanol-treated rats at both the 4-5- and 5- to 6 hr time periods, but no significant increase in 3H-labeled derivatives was noted in ethanol-treated rats. Subsequent high pressure liquid chromatographic analysis of urine extracts showed that the predominant 3H-labeled PteGlu metabolites were [3H]-5-formimino-H4PteGlu and the formyl-tetrahydrofolates, whereas the major endogenous form was 5-CH3-H4PteGlu. Ethanol administration increased significantly the excretion of the methyl derivative, with minor effects on the other folate forms. These results suggest that there is a selective effect of ethanol on the urinary excretion of specific folate derivatives. Also, inasmuch as no 5-formimino-H4-PteGlu was detected in the plasma, the rodent kidney appears to have the capacity for uptake and metabolism of filtered PteGlu. PMID- 2703979 TI - Effects of phenytoin and phenobarbital on schedule-controlled responding and seizure activity in the amygdala-kindled rat. AB - The purpose of the present study was to examine whether doses of phenytoin and phenobarbital that blocked kindled seizures in rats also disrupted operant behavior. Subjects initially were exposed to a kindling procedure in which repeated electrical stimulation of the amygdala evoked generalized seizures. After kindling, they were trained under a multiple fixed-ratio 30 interresponse time-greater than 10-sec schedule of food delivery. Once each day, 6 days per week, 30-min exposures to this schedule were followed immediately by amygdaloid stimulation which occurred at no other time. Response rate, reinforcement rate and duration of forelimb clonus were recorded. When response rates were stable, 5 rats were tested with phenytoin (25, 50, 75 and 100 mg/kg) and 5 others were tested with phenobarbital (10, 25 and 40 mg/kg). Results indicated that doses of phenytoin that controlled kindled seizures also affected operant behavior. For this drug, the ED50 for forelimb clonus was 62 mg/kg. For response rate under the fixed-ratio and interresponse-time components, it was 48 and 58.2 mg/kg, respectively. Dose-response curves for the behavioral and antiseizure effects of phenobarbital were similar. However, for this drug the ED50 for forelimb clonus (18.9 mg/kg) was significantly lower than for response rate under the fixed ratio component (37.4 mg/kg). PMID- 2703980 TI - Prostaglandin F-2 alpha receptors in corpora lutea of pregnant rats and relationship with induction of 20 alpha-hydroxysteroid dehydrogenase. AB - Luteal receptors for PGF-2 alpha in the pregnant rat were characterized. No changes in the Kd were found during pregnancy, whereas capacity increased to a maximum on Day 19, decreasing thereafter. The decrease in binding sites seen from Days 20 to 22 may be due to down regulation of the receptor by its ligand, since it was prevented by inhibition of PG synthesis by indomethacin treatment. Likewise, in-vivo treatment with PGF-2 alpha reduced the apparent number of PG binding sites. PG receptor concentration seems to be modulated by oestrogens since an increment was found on Day 19, associated with the known increase in plasma oestradiol concentrations, and since receptor concentration on Day 16 was significantly increased by oestradiol benzoate. The uterus also had a negative influence on the appearance of the PG receptor, since hysterectomy on Day 16 increased the number of binding sites on Day 18. However, receptor concentration and 20 alpha-hydroxysteroid dehydrogenase induction by hysterectomy was not affected by indomethacin, indicating that these events are probably not related to prostaglandin withdrawal. However, treatment with hCG, which diminishes enzyme induction by hysterectomy, did not produce changes in receptor concentration. The present results suggest that PGF-2 alpha, acting through a specific receptor site, is the physiological luteolytic signal. The consequence of its receptor binding seems to be the blockade of a gonadotrophic stimulus, which in turn determines (1) the decrease in progesterone synthesis and (2) the induction of 20 alpha-hydroxysteroid dehydrogenase. PMID- 2703981 TI - Delayed development in Fischer's pygmy fruit bat, Haplonycteris fischeri, in the Philippines. AB - A long delay in post-implantation embryonic development was detected in Fischer's pygmy fruit bats (palaeotropical fruit bats of the suborder Megachiroptera), the first time such a delay has been demonstrated outside the bat suborder Microchiroptera. Samples of bats were obtained from the Philippines over 5 years, and reproductive tracts were preserved and examined using standard histological techniques. Most parous female pygmy bats were impregnated in June, within a few weeks of parturition, and the embryos underwent superficial implantation at the anterior end of the uterus contralateral to the previously gravid uterus. Shortly thereafter, the rate of embryonic growth slowed tremendously for up to 8 months. During the period of delay, the mean length of the embryoblast increased only from 280 microns to 520 microns. In March of the following year, the developmental rate increased, and the embryos completed development in the next 3 months. The 8-month delay gives these bats a gestation period of 11.5 months, the longest known in bats. Most nulliparous females become pregnant at an age of 3-5 months, and their embryos entered a similar delay that terminated in March or April, after 2-6 months of delay. Males showed signs of fertility throughout the entire year, but testis volume was highest during May, June and July, at about the time when most females become receptive. PMID- 2703982 TI - Superovulation and early embryo development in the adult mouse after prenatal exposure to diethylstilboestrol. AB - Pregnant mice were injected subcutaneously with diethylstilboestrol (DES: 10 micrograms/kg body weight in 0.1 ml corn oil) or corn oil alone on Day 15 or 16 of gestation (Day 1 = day of copulatory plug) and allowed to give birth. Female progeny from control and DES-exposed animals were superovulated with exogenous gonadotrophins at 6-8 weeks of age. In-vivo results indicated that the total number of ovulated ova, 2-cell embryos and blastocysts were significantly increased in DES-exposed progeny but that there was a decline in developmental potential from the ovulated ova stage to the blastocyst stage in these animals. However, there was no significant difference in the in-vitro development of 2 cell embryos to the blastocyst stage between control and DES-exposed animals. These results indicate that the ovaries of mice exposed in utero to DES are capable of responding to exogenous gonadotrophins and that second generation progeny have the potential for normal development to the early postblastocyst stage of embryogenesis. The in-vivo decline in developmental potential may be attributable to reproductive tract abnormalities rather than ova/embryo defects. PMID- 2703983 TI - Interovarian relationship in the secretion of progesterone during the luteal phase of the capuchin monkey (Cebus apella). AB - In basal conditions, progesterone concentrations were similar in the ovarian veins of the ovary +CL (3211 +/- 526 ng/ml) and the ovary -CL (3165 +/- 554 ng/ml), but after blocking the blood flow between the ovary +CL and the uterus, the progesterone values in the vein draining the ovary -CL decreased to 1218 +/- 394 ng/ml (P less than 0.01). When [3H]progesterone was injected in the ovary +CL, the radioactivity appeared earlier and more concentrated in the vein draining the ovary -CL (30 sec, 0.53% of injected dose) than in the femoral vein (150 sec, 0.08% of injected dose). Removal of the ovary +CL was followed by a brief maintenance of peripheral progesterone within luteal-phase levels. The in vitro progesterone production by a suspension of cells isolated from the corpus luteum was 47.5 +/- 12.8 ng/ml/2 h, whereas luteal-like cells isolated from the ovary -CL secreted 14.3 +/- 6.0 ng/ml/2 h (P less than 0.01) into the medium. We therefore suggest that the symmetrical and high secretion rate of progesterone by the ovaries of the capuchin monkey indicates a between-ovary communication system, and that the luteal-like tissue of the ovary -CL can produce relatively large amounts of progesterone. PMID- 2703984 TI - Failure of melatonin to influence endogenous opioid effects on LH secretion in the anoestrous ewe. AB - In May mature seasonally anoestrous ewes were implanted with melatonin which advanced the onset of cycles by about 1 month. The LH response to an opioid antagonist, WIN-3, was determined 5, 15, 25 and 60 days after melatonin implantation, by intravenous administration of WIN-3 (12.5 mg/dose) 4 times at 15 min intervals during both the 1st and the 5th hour of an 8-h treatment period. There was no effect of WIN-3 at 5, 15 and 25 days after melatonin implantation. At 60 days LH concentration and pulse frequency were significantly increased (P less than 0.05 and less than 0.01 respectively) in response to WIN-3 treatment, but only in those animals which had begun reproductive cycles, an effect known to be mediated by the presence of progesterone. We were therefore unable to find evidence to support the hypothesis that the influence of melatonin in advancing the breeding season may be via an opioidergic pathway. PMID- 2703985 TI - Regulation of adenylate cyclase activity and stimulation response in relation to endometrial receptivity in the rabbit. AB - Adenylate cyclase activity was measured in broken cell preparations of whole endometrial tissue from rabbits on Days 0, 1, 6.5, 9 and 15 of pseudopregnancy and in endometrial epithelial and stromal cells on Days 1 and 6.5 to assess the specific response of individual cell types. In dispersed cells, adenylate cyclase activity was higher (P less than 0.01) in stromal than in epithelial cells and reduced on Day 6.5 compared to Day 1 in both cell types. The response of adenylate cyclase to isoproterenol appeared more important relative to the PGE-2 response in epithelial than in stromal cells and strongly reduced in the former on Day 6.5. In endometrium, the overall adenylate cyclase activity was increased significantly on Day 1 of pseudopregnancy compared to Day 0 (oestrus), only 18 h after injection of hCG. On the following days, the activity decreased progressively on Days 6.5 and 9 and exhibited a recovery on Day 15. Adenylate cyclase response to isoproterenol (% over GTP) was comparable on Days 0, 1 and 6.5, abolished on Day 9 and recovered on Day 15. Maximal response to PGE-2 (% over GTP) was observed on Day 6.5, at the time of implantation, maintained on Day 9 and reduced on Day 15 towards the low levels measured in oestrus and Day 1 of pseudopregnancy. Our results demonstrate a dramatic alteration of adenylate cyclase activity in rabbit endometrium during pseudopregnancy. It suggests a possible involvement of catecholamines and prostaglandin E-2 in the regulation of endometrial receptivity through a cAMP-mediated process. PMID- 2703986 TI - Correlation between the release of ovine trophoblast protein-1 by the conceptus and the production of polypeptides by the maternal endometrium of ewes. AB - We studied the biosynthesis of two proteins, p70 (Mr 70,000; pI 4.0) and p15 (Mr 15,000; pI 5.7), by endometrial tissues from ewes between Days 12 and 24 of pregnancy and between Days 12 and 16 of the oestrous cycle to determine whether production of the two was correlated with the period of biosynthesis of ovine trophoblast protein-1 (oTP-1) by the conceptus. We also compared the protein synthetic activities of endometrium from gravid and non-gravid horns of pregnant ewes at Days 14, 16 and 18 in which the conceptus had been confined to one uterine horn. Proteins p70 and p15 were produced maximally between Days 14 and 20 of pregnancy, but synthesis by endometrial cultures from cyclic ewes was low or absent. Furthermore, synthesis of Protein p70 in particular was much greater by the gravid than non-gravid horn of unilaterally pregnant ewes. We conclude that synthesis of Proteins p70 and p15 by the uterus of sheep coincides with the time of oTP-1 production by the conceptus. PMID- 2703987 TI - Light exposure of oocytes and pregnancy rates after their transfer in the rabbit. AB - Groups of unfertilized and pronuclear stage rabbit oocytes were exposed to fluorescent light of 3250 lx for 20-30 min at 37 degrees C. In 6 experiments with fertilization achieved in vivo, 54% of the zygotes exposed as secondary oocytes and 67% of light-protected controls had implanted and developed normally 16 days after transfer to the contralateral oviducts of synchronized recipients. When pronuclear oocytes were exposed similarly in 8 experiments, 63% had established a normal pregnancy at 16 days after transfer compared to 65% of the controls. In 5 of these pregnancies which were allowed to proceed to term, all the young born appeared normal. Though similar in size, it is not clear whether the rabbit oocyte constitutes a suitable model for the human oocyte in regard to the effects of visible light. However, the level of exposure used here is 200-300 times that experienced during normal in-vitro manipulation of human eggs. The absence of significant effects should allay concerns that light is a negative factor in the normal procedure of in-vitro fertilization in man. PMID- 2703988 TI - Cellular composition of the cyclic corpus luteum of the cow. AB - The cellular composition of CL from 6 cows on approximately Day 12 of the oestrous cycle, after synchronization with cloprostenol, was studied by ultrastructural morphometry. Point-count measurements of volume density (mean +/- s.d.) showed that large luteal cells occupied 40.2 +/- 7.0% of the luteal tissue, and small luteal cells 27.7 +/- 6.3%. Of the total of 393.4 +/- 52.0 x 10(3) cells per mm3 of luteal tissue, large luteal cells made up only 3.5% and small luteal cells 26.7%, a ratio of 1:7.6. Endothelial cells/pericytes, at 52.3%, were the most numerous cell type. The mean volume per large luteal cell was 29.6 +/- 6.3 x 10(3) microns 3, while that of small luteal cells was 2.7 +/- 0.4 x 10(3) microns 3. In spherical form, these volumes would represent mean diameters of 38.4 microns and 17.2 microns respectively, and are consistent with published measurements on dispersed luteal cells. However, the values for cell numbers are much higher than published values based on luteal tissue dispersion, suggesting that dispersion may result in substantial and possibly selective losses of luteal cells. PMID- 2703989 TI - Increase in digyny explains polyploidy after in-vitro fertilization of frozen thawed mouse oocytes. AB - Fewer frozen-thawed mouse oocytes cleaved to the 2-cell stage compared to fresh control oocytes fertilized in vitro (46% vs 79%). The reduced rate of 2-cell formation was only partly explained by a decreased rate of fertilization (63% vs 85%). However, subsequent development to expanded blastocysts was not different (75% vs 78%). An increased frequency of second polar body retention by fertilized frozen-thawed oocytes compared with controls (11.8% vs 1.3%) was shown to be largely responsible for the higher incidence of polyploidy (16.3% vs 3.7%). The frequency of polyspermic fertilization was not different in the two groups (3.9% vs 2.3%). PMID- 2703990 TI - Development of progesterone dependency in the appearance of the nocturnal prolactin surge in immature rats. AB - Basal concentrations of plasma prolactin in immature, Wistar-Imamichi strain rats at 25, 28 and 31 days of age were 5-12 ng/ml and no prolactin surges were observed in intact immature rats. Plasma progesterone values ranged from 5 to 9 ng/ml, while plasma oestradiol concentrations increased from 11 to 27 pg/ml between 25 and 31 days of age. When oestradiol was administered to ovariectomized 25- or 28-day-old rats by s.c. insertion of an implant, plasma prolactin concentrations at 05:00 and 12:00 h were similarly elevated 3 days after the operation. Oestradiol did not induce a nocturnal prolactin surge. The progesterone implants in ovariectomized rats at 28 days of age or on the first day of oestrus increased plasma prolactin values at 05:00 h. The magnitude of the progesterone-induced prolactin surge was greater when progesterone was given closer to the time of the first ovulation (about 34 days old). Pretreatment with oestradiol amplified the progesterone-induced prolactin surge. Mechanisms causing nocturnal prolactin surges are more sensitive to, and respond over a longer time period, to progesterone in pubertal rats than in adult animals. The results suggest that progesterone initiates the nocturnal surge of prolactin release and that oestradiol can amplify the effects of progesterone. PMID- 2703991 TI - Relationship of intratesticular testosterone content of stallions to age, spermatogenesis, Sertoli cell distribution and germ cell-Sertoli cell ratios. AB - Testes were obtained from 47 1-20-year-old stallions during the natural breeding season. Total testicular testosterone and testosterone/g testis increased with age (P less than 0.005), and total testicular testosterone was associated with larger testis size (P less than 0.05). Neither testosterone per gram nor per paired testes were related to total Sertoli cell number (P greater than 0.05), but greater testosterone per paired testes was associated with fewer Sertoli cells per unit of seminiferous tubule length (P less than 0.005) or basement membrane area (P less than 0.02) and with a higher number of germ cells supported per Sertoli cell (P less than 0.05). Although values for testosterone per gram and per paired testes were unrelated (P greater than 0.10) to sperm production/g testis or to the yield of spermatids/spermatogonium, testosterone per paired testes was positively related to sperm production per paired testes (P less than 0.05). It is concluded that intratesticular testosterone increases with age, is related in a positive manner to quantitative rates of sperm production, and can account for some of the differences in sperm production among individual stallions within a single breeding season. PMID- 2703992 TI - Ultrastructural and histochemical investigations of Call-Exner bodies in rabbit Graafian follicles. AB - In a histological survey of 19 mammalian species, Call-Exner bodies of conventional size and appearance were found in only 5, namely, human, rhesus monkey, rabbit, guinea-pig and sheep. Rabbit ovaries were used for characterizing these bodies using quantitative histochemistry, lectin binding and electron microscopy. Call-Exner bodies were topographically distinct lacunae of the extracellular space probably containing hyaluronic acid with proteoglycan complexes. The staining characteristics of the antrum and Call-Exner bodies were generally similar. However, in contrast to the antrum, the smaller lacunae contained suspended filaments with a distinctive peripheral membrane upon which a rosette of granulosa cells was resting. The membrane and narrow intercellular clefts probably prevent much exchange of large glycosaminoglycan complexes with the antrum. The origin and significance of Call-Exner bodies require further study, but it is clear that they are associated with secretion rather than with necrosis as sometimes suggested. PMID- 2703993 TI - Effect of temperature on the fluidity of boar sperm membranes. AB - Fluidity was used to assess changes in molecular organization of boar spermatozoa plasma membranes from (1) the head and (2) the rest of the sperm body and acrosome as a consequence of temperature. The initial fluidity of the head membranes at 25 degrees C was less than that of the sperm body membranes (P less than 0.05). When held at 25 degrees C, the fluidity of the head membranes decreased for 105 +/- 8 min and then stabilized for the remainder of the 160-min incubation. Calcium (10 mM) caused a significantly greater decrease in fluidity. The fluidity of the sperm body membranes increased slightly over time in the absence of Ca2+, but decreased significantly with Ca2+. Cooling from 25 to 5 degrees C and subsequent heating to 40 degrees C (0.4 degrees C/min) caused marked alterations in the fluidity of each membrane. Cooling the head membranes prevented the fluidity increase seen at 25 degrees C, while reheating caused a dramatic decrease in fluidity. Fluidity of the head membranes was now unaffected by Ca2+. Lipid phase transitions, indicated by sharp break points in data curves, were detected at the onset of reheating (7 +/- 3 C) and at 23 +/- 4 degrees C during reheating. Fluidity of the sperm body membranes decreased slightly and in a linear fashion with Ca2+. Without Ca2+, the sperm body membranes showed an additional lipid phase shift at 31 +/- 5 degrees C, which led to a rapid fall in fluidity. These results suggest that the fluidity, and therefore the molecular structure, of sperm head and body membranes differ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703994 TI - Effect of in-vitro heat stress on prostaglandin and protein secretion by endometrium from pregnant and cyclic gilts at day 14 after oestrus. AB - Endometrium from cyclic (N = 4) and pregnant (N = 4) gilts at Day 14 after oestrus was placed into three bilateral perifusion devices which allow separate perifusion of luminal and myometrial sides. Perifused endometrium was subjected to 39 or 42 degrees C. Incorporation of [3H]leucine into secreted and tissue proteins by endometrial explants following incubation at 39 or 42 degrees C was examined using trichloroacetic acid (TCA) precipitation and one-dimensional SDS polyacrylamide gel electrophoresis. Secretion of PGF was greater from the myometrial side for cyclic gilts (endocrine orientation), but greater from the luminal side for pregnant gilts (exocrine orientation). Regardless of reproductive status or endometrial side, heat stress induced a rapid increase (P less than 0.01) in PGF secretion rates. However, PGF secretion in response to heat stress was greater (P less than 0.01) from the myometrial side and greater (P less than 0.01) for pregnant gilts. PGF secretion rates increased by 63% and 42% from the luminal side, and 40% and 156% from the myometrial side in response to heat stress for cyclic and pregnant gilts, respectively (status x treatment x side interaction; P less than 0.01). Heat stress did not alter incorporation of [3H]leucine into secreted proteins regardless of reproductive status, while incorporation into tissue proteins was decreased (P less than 0.05) by heat stress for pregnant gilts, but not altered for cyclic gilts. Heat stress, in vitro, redirects PGF secretion for endometria of pregnant gilts from an exocrine to an endocrine orientation where it would be available to effect luteolysis and compromise the establishment of pregnancy. PMID- 2703995 TI - Architecture of the dorsal and ventral lobes of the prostate of the Syrian hamster, Mesocricetus auratus, after regrowth from short day-induced regression. AB - The structures of the dorsal and ventral lobes of the prostate of 4 groups of Syrian hamsters were studied by a stereological approach. Groups studied were young hamsters (kept in long-day photoperiods for 4 weeks) in their first breeding season, older hamsters (kept in short-day photoperiods for 24 weeks so that their prostates had regressed and regrown) in their second breeding season, and two groups of older hamsters in an extended first breeding season (either because they were kept in long days for 24 weeks or because they were pinealectomized before being put into short-day photoperiods for 24 weeks). There were very few differences between groups, but generally dorsal prostates of older hamsters in their second breeding season closely resembled those of young hamsters in their first breeding season. More differences were noted between either of these two groups and older hamsters in an extended first breeding season than between these two groups. The differences noted generally involved increases in the amount of smooth muscle in the walls of secretory tubules in the dorsal prostates of hamsters in an extended first breeding season. This may be associated with the fact that these glands had not regressed and regrown. Ventral prostates were very similar in all 4 groups, which may reflect the fact that they normally regress very little in short days. PMID- 2703996 TI - Season determines timing of first ovulation in rhesus monkeys (Macaca mulatta) housed outdoors. AB - In order to determine the relative importance of age and season on the occurrence of first ovulation in rhesus monkeys, the timing of puberty in spring-born females (Group S, N = 13) was compared to that of fall (N = 3) and winter-born (N = 5) females (Group W). All females were housed outdoors and were studied from 12 months of age through first ovulation. Menarche occurred at a similar age but significantly earlier in the year for Group W (31.2 +/- 0.7 months; 25 August +/- 19.5 days) than for Group S females (31.2 +/- 0.7 months; 14 November +/- 17.1 days). First ovulation, as assessed from twice weekly serum progesterone determinations, occurred exclusively in the fall or winter in a bimodal age distribution for all females. For Group W females, 6/8 ovulated during the 3rd year at 35.8 +/- 0.7 months while 2/8 ovulated during the 4th year at 45.3 +/- 0.1 months. In contrast, only 3/13 Group S females ovulated during the 3rd year and at a significantly younger age of 31.4 +/- 0.4 months compared to Group W. The remaining Group S females (10/13) ovulated the following autumn at 43.2 +/- 0.2 months, significantly younger than the later ovulating Group W females. In addition to this pattern of first ovulation, serum concentrations of prolactin varied seasonally, rather than with age, in both groups of females with higher levels in the summer and low levels in the winter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2703997 TI - Relaxation-induced contraction of smooth muscle surrounding hamster ovarian follicles. AB - Changes in intrafollicular pressure and follicular diameter resulting from injecting or withdrawing fluid from the antrum were measured in preovulatory follicles and used as an assay for changes in tension in the follicular wall by applying the Laplace relationship for thin-walled spheres. Passive length-tension curves were constructed from pressure-volume measurements to establish baseline wall stiffness. Any subsequent change in pressure could then be compared to the length-tension curves to evaluate whether it arose from active tension development or from passive stretch. When intact follicles (1-2h before ovulation) were subjected to release of passive stretch, they exhibited a contractile response that lasted 15 sec-2 min and was characterized by cyclic increases and decreases in tension, with a period of 1 cycle every 2-3 sec. The probability of activating a response in the tissue was most strongly correlated with the rate of release of passive stretch. Intrafollicular pressures generated during active contractile responses sometimes reached 80 mmHg (10.64 mPa), corresponding to a wall tension of 5332 dynes/cm (5.332 N/m) (for a 1 mm follicle) and were clearly well above the passive length-tension curves. Passive stretching of the follicular wall during a contractile response to 5 hydroxytryptamine stimulation resulted in large reductions in active wall tension for the duration of the stretch. These results are consistent with a stretch activated inhibition of contractile events. PMID- 2703998 TI - Effect of heparin on the expression of calmodulin-binding proteins in bull spermatozoa. AB - A 125I-labelled calmodulin gel overlay procedure in the presence and the absence of Ca2+ was used to evaluate bull spermatozoa calmodulin-binding proteins. Frozen spermatozoa were thawed, washed and incubated for 6 h before being processed for SDS polyacrylamide gel electrophoresis and the 125I-labelled calmodulin gel overlay procedure. In non-incubated spermatozoa, up to 14 binding proteins were detected. Some exhibited greater calmodulin binding in the presence of Ca2+ while others exhibited greater binding when Ca2+ was absent. When heparin (2 micrograms/ml) was present in the incubation medium, a decrease in the calmodulin binding to the proteins of Mr 28,000 and 30,000 was detected in the presence of Ca2+ and EGTA. This effect of heparin was time- and dose-dependent and was increased by the presence of the acrosin inhibitor benzamidine. Sperm capacitation could thus be related to a decrease in the binding of calmodulin to these proteins. PMID- 2703999 TI - Role of platelet-activating factor (PAF) in the initiation of the decidual reaction in the rat. AB - Injection of PAF into the left uterine horn induced a dose-dependent decidua-like reaction in the pseudopregnant rat. This reaction was maximal when PAF was injected at Day 5 of pseudopregnancy and was blocked by the specific PAF antagonist, BN 52021. BN 52021 did not interfere with the decidual reaction induced by prostaglandin E-2 or insertion of a cotton thread in the uterine horn. In contrast, a decidua-like reaction was not evoked by the inactive lyso-PAF, demonstrating the specificity of the action of PAF. The decidua-like reaction induced by PAF involves the generation of cyclooxygenase metabolites of arachidonic acid since it was inhibited by indomethacin. The histological alterations induced by PAF were similar to those observed after embryo implantation, strengthening the postulate for a role of the autacoid in the early stages of pregnancy. PMID- 2704000 TI - Androgen-dependent messenger RNA(s) related to secretory proteins in the mouse epididymis. AB - Total RNA from mouse epididymides was translated in a cell-free system derived from rabbit reticulocyte lysate. The androgen dependence of a highly represented mRNA(s) was detected. This mRNA(s) encoded for a band of Mr 26,000 visualized by denaturing gel electrophoresis (SDS-PAGE). No other mouse sexual tissues (testis, vas deferens and seminal vesicle), liver, kidney or striated muscle presented such a band. Furthermore, this mRNA(s) was restricted to the caput epididymidis. Two-dimensional gel electrophoresis (2D-PAGE) showed that this band of Mr 26,000 was composed of 6 basic polypeptides. This translated protein may correspond to a newly synthesized secretory protein of Mr 24,000. The concentration of translatable mRNA(s) encoding for the band of Mr 26,000 dropped to 31% of the normal level at 3 days after castration and to 7%, 20 days later. Administration of testosterone to 30-day-castrated mice partly reversed these changes: 32% of the control value was reached after 10 days of treatment. Accumulation of this mRNA(s) was also just detectable (7% of the mature level) at 10 days of age. The high levels attained by 20 days of age (60% of the control value) suggest that the greatest increase of accumulation for this mRNA(s) occurs during the prepubertal period. PMID- 2704001 TI - Histopathology of Chlamydia trachomatis salpingitis after primary and repeated reinfections in the monkey subcutaneous pocket model. AB - Monkeys with subcutaneously autotransplanted salpingeal fimbrial tissues were subjected to primary and repeated infections with Chlamydia trachomatis. The inflammatory response after primary inoculation was characterized by infiltration with polymorphonuclear leucocytes in the acute phase and mononuclear cells in the chronic phase. However, the inflammatory response after repeated infections was dominated by a mononuclear cell infiltration with a conspicuous absence of the initial phase of polymorphonuclear leucocyte infiltration. The remarkable findings of repeated infections were plasma cell infiltration, lymphoid follicle formation, and increased fibroblast activity resulting in extensive fibrosis. These findings are similar to those described for monkeys inoculated directly into the oviducts with C. trachomatis and support our original hypothesis that, after chlamydial infection, the tissue damage is provoked by immune-mediated mechanisms. PMID- 2704002 TI - Seasonal pattern of LH and testosterone secretion in adult male fallow deer, Dama dama. AB - At monthly intervals during the year blood samples were collected every 20 min for 12 h from 4 entire and 2 prepubertally castrated adult fallow deer bucks. In the entire bucks there were seasonal changes in mean concentrations and pulse frequencies of plasma LH. Mean concentrations in late summer and autumn were 3-6 times higher than during other seasons. LH pulse frequency was low (0-1 pulses/12 h) during most of the year and increased only during the 2-month period (January and February) that marked the transition from the non-breeding season to the autumn rut. During this period there was a close temporal relationship between pulses of LH and testosterone. However, during the rutting period (March and April) episodic secretion of testosterone, manifest as surges in plasma concentrations of 4-6 h duration, was not associated with any detectable pulses in LH although mean plasma concentrations of LH remained elevated. During the rut, the surges of plasma testosterone occurred at similar times of the day. Plasma profiles in May indicated very low concentrations of LH and testosterone secretion in the immediate post-rut period. Castrated bucks exhibited highly seasonal patterns of LH secretion, with mean plasma LH concentrations and LH pulse frequency being lowest in November (early summer) and highest in February and March (late summer-early autumn). Mean concentrations and pulse frequency of LH in castrated bucks were higher than for entire bucks at all times of the year. PMID- 2704003 TI - Seasonal variation in serum testosterone, testicular measurements and semen characteristics in the collared peccary (Tayassu tajacu). AB - Blood samples and testicular measurements were obtained from 4-8 captive adult collared peccaries monthly for 18 months and from wild adult males during summer (N = 16) and winter (N = 22) seasons. Serum concentrations of testosterone were determined by radioimmunoassay. Semen samples were collected monthly by electroejaculation from captive males for 1 year. Serum testosterone concentrations and testicular measurements varied in a low-amplitude circannual pattern, with maximum mean testosterone concentrations in fall and winter (1150 1400 pg/ml) and minimum values in summer (500-700 pg/ml). Circannual rhythms appeared to be related to dominance. Serum testosterone levels in wild males generally were lower than in captive males, although this difference was not significant (P greater than 0.05). Semen characteristics did not exhibit a circannual rhythm. These results suggest that the male peccary remains reproductively fertile throughout the year, yet may undergo a facultative summer quiescence influenced by ambient temperature and social factors. PMID- 2704004 TI - Co-culture of early cattle embryos to the blastocyst stage with oviducal tissue or in conditioned medium. AB - In Exp. 1, 5-8-cell embryos from superovulated cattle were co-cultured with oviducal tissue suspended in Ham's F10 + 10% fetal calf serum (F10FCS) or in F10FCS alone. After 4 days, the proportion of embryos developing into compact morulae or blastocysts was greater (P less than 0.005) in co-culture (38/82; 46%) than in F10FCS (1/27; 4%). In Exp. 2, a solution of collagenase, trypsin, DNAse and EDTA was used to disperse oviducal tissue, which was then cultured in TCM199 + 10% fetal calf serum (M199FCS) to obtain monolayers. Embryos (1-8 cells) were then co-cultured with monolayers or in M199FCS alone. The proportion of embryos developing into compact morulae and blastocysts after 4-5 days was higher (P less than 0.005) in co-culture (15/34; 43%) than in M199FCS (1/37; 3%); mean numbers of cells/embryo were also higher (P less than 0.001) (27.70; range 2-82 in co culture; 8.83; range 2-18 in M199FCS). In Exp. 3, embryos obtained from in-vitro maturation and fertilization were used to compare development between co-culture and medium conditioned by oviducal tissue. Initial cleavage rate (no. embryos greater than 1 cell/total) was 76% (611/807) and did not differ among treatments. After 5 days, the proportion cleaving to greater than 16 cells was higher (P less than 0.005) in co-culture (71/203; 35%) and conditioned medium (48/205; 23%) compared to M199FCS (14/203; 7%). Similarly, the proportion developing into compact morulae and blastocysts was greater (P less than 0.005) in co-culture (44/203; 22%) and conditioned medium (46/205; 22%) than in M199FCS (7/203; 3%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704005 TI - Hyperandrogenism in infertility. AB - Hyperandrogenism, whether of ovarian or adrenal etiology, can be associated with impairment of folliculogenesis, resulting in anovulation. Various therapeutic modalities can be utilized to reestablish ovulation, including correction of the underlying pathophysiology, the use of fertility-promoting drugs and surgery. PMID- 2704006 TI - Laparotomy in infertility patients with endometriosis. Use of the CO2 laser. AB - Sixty-eight women underwent laparotomy for endometriosis associated with infertility. They were not candidates for laser laparoscopy by our criteria, or they had failed to conceive after previous therapy. The cumulative pregnancy rate was 70% at 48 months. Patients who failed to conceive after previous laparotomy and those who failed to conceive after previous medical therapy experienced 44% and 28% term pregnancy rates, respectively, after laparotomy using the CO2 laser. Thus, for women who have failed to conceive after major surgical procedures, repeat surgery may offer a greater chance of conception than do multiple cycles of in vitro fertilization/embryo transfer. PMID- 2704007 TI - Epidemiology of endometriosis-associated infertility. AB - To explain the great discrepancy between the prevalence estimates for endometriosis in the literature, a series of operations was studied from a combined patient population derived from a 21-physician collaborative. The reported discrepancy appears to have to do more with operative indications and technique than with an actual increase in the prevalence of endometriosis over time. The least-biased estimate for the overall prevalence of endometriosis in reproductive-age women is about 10% on the basis of a study of women operated on for symptoms other than those associated with endometriosis. Accepted criteria for causality applied to the endometriosis literature failed to demonstrate an association between endometriosis and infertility. PMID- 2704008 TI - Fetal bradycardia during antepartum testing. Further observations. AB - One hundred twenty-one cases of antepartum fetal bradycardia, occurring at 36 weeks' gestation or greater, were prospectively managed by active intervention and delivery. There were no fetal deaths. Intrapartum complications were similar at all gestational ages, regardless of whether the bradycardia was associated with a reactive or nonreactive nonstress test. Only the incidence of low five minute Apgar scores was significantly higher in the nonreactive group. The incidence of cord compression patterns (variable decelerations) in labor was higher than that of uteroplacental insufficiency patterns (late decelerations). Intervention with delivery in the presence of fetal bradycardia should be considered in all cases with evidence of fetal lung maturity. PMID- 2704009 TI - Successful transplantation of a free fimbrial graft to the peritoneum. AB - Loss of fertility due to prior segmental resection of the fallopian tube (for ectopic pregnancy or sterilization) can be treated with a free fimbrial graft, especially when the fimbrial segment is contralateral to the proximal tube that is needed for the anastomosis. To evaluate the structure and function of the fimbria after free grafting, the fimbria was cut from the tube and sewn without a blood supply to the peritoneum in 14 rabbits. After convalescence, scanning electron microscopy showed fewer secondary mucosal folds in the grafted fimbria than in the normal fimbria. The ciliated and secretory cells in the graft were identical to those of normal cells. The transport rate of surrogate ova across the grafted fimbrial mucosa was consistent with that across the normal fimbrial mucosa, demonstrating that near-normal structure and function are preserved after a free graft of the fimbria. PMID- 2704010 TI - Immature teratoma of the fallopian tube. A case report. AB - An immature cystic teratoma of the left fallopian tube was found incidentally in a 30-year-old, multiparous woman requesting tubal ligation. Only one case of immature tubal teratoma was reported on previously. PMID- 2704011 TI - Racial distribution of aneurysms in Zimbabwe. AB - The distribution of aneurysms amongst African and Caucasian patients in two hospitals in Zimbabwe was surveyed in a retrospective study. Aneurysms were more common amongst the Caucasian patients and abdominal aortic aneurysms predominated (85%). Amongst the African patients there was a high incidence of thoracic aortic aneurysms (42%). Possible roles of atherosclerosis and syphilis in explaining these results are discussed. PMID- 2704012 TI - Severe herpes zoster infection in the United Kingdom: experience in a regional infectious disease unit. AB - Seventy-three cases of severe herpes zoster infection admitted to a regional infectious disease unit over a 3-year period were reviewed. Complications were common. Elderly patients were in the majority (55%), were hospitalized for longer and accounted for 78% of all complications. Acyclovir therapy was used in 44 cases with a reduction in both the duration of hospital stay and complication rate. PMID- 2704013 TI - Raising the profile of epidemiological research: discussion paper. PMID- 2704014 TI - The role of registers in epidemiology: discussion paper. PMID- 2704015 TI - Focal dermal hypoplasia syndrome in the neonate. PMID- 2704016 TI - Death from eczema herpeticum in a child with severe eczema, mental retardation and cataracts. PMID- 2704017 TI - Late presentation of a traumatic abdominal hernia associated with constipation. PMID- 2704018 TI - Cryptococcal infection of the lumbar spine. PMID- 2704019 TI - Unacceptable variation in the core diameters of some AO type cancellous screws. PMID- 2704020 TI - Fish oils--their significance to human health. PMID- 2704021 TI - Enterolith ileus. PMID- 2704022 TI - Benzofurans as mechanism-based inhibitors of dopamine beta-hydroxylase. PMID- 2704023 TI - Hybrid cholecystokinin (CCK) antagonists: new implications in the design and modification of CCK antagonists. PMID- 2704024 TI - Analogues of cisplatin derived from diaminodideoxytetritols. Synthesis and activity against the ADJ/PC6 plasmacytoma in mice. AB - Four new analogues of the anticancer drug cisplatin have been prepared that contain a diaminodideoxytetritol derivative as the amine ligand moiety, and their activities have been measured against the ADJ/PC6 plasmacytoma in mice. Two of these compounds, the enantiomers of cis-dichloro(1,4-diamino-1,4-dideoxy-2,3-O isopropylidenethreitol) -platinum(II) , show a higher TI value than cisplatin when administered by intraperitoneal injection and, importantly, show significant antitumour activity when administered orally. PMID- 2704025 TI - Potential antitumor agents. 58. Synthesis and structure-activity relationships of substituted xanthenone-4-acetic acids active against the colon 38 tumor in vivo. AB - In a search for compounds related to flavoneacetic acid with activity against solid tumors, a series of methyl-, methoxy-, chloro-, nitro-, and hydroxy substituted xanthenone-4-acetic acids have been synthesized and evaluated against subcutaneously implanted colon adenocarcinoma 38 in vivo, using a short-term histology assay as a primary screening system. A major goal of this work was to identify compounds with similar profiles of activity to that of flavoneacetic acid but of higher potency. The level of activity of the compounds appeared to depend more on the nature of the substituent than its positioning, in the order Cl greater than Me, OMe greater than NO2, OH. However, the potency of the compounds was related much more to the position rather than the nature of the substitution, with 5-substituted compounds being clearly the most dose potent. 5 Methylxanthenone-4-acetic acid has a similar level of activity to that of flavoneacetic acid in the test systems employed but is more than 7-fold as dose potent. PMID- 2704026 TI - 2'-Fluorinated isonucleosides. 1. Synthesis and biological activity of some methyl 2'-deoxy-2'-fluoro-2'-pyrimidinyl-D-arabinopyranosides. AB - New reactions of methyl 2,2-difluoro glycosides are described that were utilized for synthesis of some novel nucleoside derivatives. Thus, treatment of methyl 2 deoxy-2,2-difluoro-3,4-O-isopropylidene-alpha (beta)-D-erythro-pyranoside (2) with anhydrous HCl resulted in selective displacement of one fluorine atom with chlorine to give a 2-deoxy-2-chloro-2-fluoro glycoside 3. Reaction of 3 with silylated uracil in the presence of SnCl4 provided a 2-deoxy-2-fluoro-2-uracil substituted glycoside 4. 2-Fluoro-2-deoxy glycosides substituted with other pyrimidines at C-2 were prepared similarly by the reaction of acylated 2,2 difluoro or 2-fluoro-2-bromo derivatives (5 and 6, respectively) with silylated pyrimidines. The resulting 2'-fluorinated isonucleosides were evaluated for their antitumor and antiviral activities. Compounds 7a,b, 8a,b, and 10a,b demonstrated 50% tumor cell growth inhibition in vitro (IC50) at 10(-4)-10(-5) M. At similar concentrations no antiviral activity was observed in vitro. Therapeutic activity was obtained with 7a,b and 8a,b in DBA/2 mice with L1210 leukemia. Administration of 7a,b at 500 mg/kg, ip daily, for 5 consecutive days, resulted in a 55% increase in life span (% ILS) while administration of 8a,b in the same manner at 200 mg/kg caused a 29% ILS. Treatment with 7a,b to mice with drug-resistant L1210 sublines (5-FU and araC) resulted in 22 and 57% increases in life span, respectively. Lewis lung carcinoma and M5076 sarcoma in mice also responded to the administration of 7a,b with reductions in tumor growth for both tumors and significant increases in life span in mice with Lewis lung carcinoma. Although the mechanism of action of 7a,b is not known, it has been found to be a relatively fast-acting, cell-cycle nonspecific cytotoxic agent that decreases [3H]deoxyuridine incorporation, blocks L1210 cells at the G2 phase of the cell cycle, and is not reversed by exogenous thymidine. These 2'-fluorinated isonucleosides have demonstrated biological activity and may have potential as antitumor drugs. PMID- 2704027 TI - Hydroxyacetophenone-derived antagonists of the peptidoleukotrienes. AB - Considerations of the possible similarities between leukotriene D4 and its prototypical antagonist, FPL 55712, led to the development of a new series of leukotriene antagonists incorporating a hydroxyacetophenone group (e.g., the toluic acids 16 and 18). Although considerable attention has focused on FPL 55712 derived analogues, only limited investigations into alternatives for the standard 4-acetyl-3-hydroxy-2-propylphenoxy moiety have been reported. Therefore, an extensive study of modifications to the hydroxyacetophenone portion of toluic acid 18 was undertaken. Although no viable alternative to the 3-hydroxy moiety was discovered, replacements for the 2-propyl group (34, 37) and the 4-acetyl functionality (56, 59) yielded potent antagonists. A number of compounds exhibited longer duration of action in vivo than FPL 55712. PMID- 2704028 TI - Retinobenzoic acids. 2. Structure-activity relationships of chalcone-4-carboxylic acids and flavone-4'-carboxylic acids. AB - The structure-activity relationships of (E)-chalcone-4-carboxylic acids, which are retinoidal benzoic acids represented by R-Ph-X-Ph-COOH (4, X = -COCH = CH-), are discussed on the basis of differentiation-inducing activity on human promyelocytic leukemia cells HL-60. The activity was increased by the substitution of a bulky alkyl group(s) (R), and among such compounds, (E)-4-[3 (3,5-di-tert-butylphenyl)-3-oxo-1-propenyl]benzoic acid (Ch55) and (E)-4-[3-oxo-3 (5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)-1 -propenyl]benzoic acid (Ch80) are several times more active than retinoic acid. Though the stable conformer of chalcone derivatives is linear (s-cis form), the conformationally restricted analogue 4-(6,7,8,9-tetrahydro-6,6,9,9-tetramethyl-4H-4-oxonaphtho[2,3 b]py ran-2-yl)benzoic acid (Fv80) is more active than Ch80. While the effect of introduction of an oxygen atom varied, 4-[1-hydroxy-3-oxo-3-(5,6,7,8-tetrahydro-3 hydroxy-5,5,8,8-tetramethyl-2 - naphthalenyl)-1-propenyl]benzoic acid (Re80), regarded as a derivative of Ch80 with two additional hydroxyl groups, has very strong activity. PMID- 2704029 TI - Synthesis of some novel potent and selective catechol O-methyltransferase inhibitors. AB - A series of disubstituted catechol derivatives was synthesized and tested as potential COMT inhibitors. The most active compounds were more than 1000 times more potent (IC50 = 3-6 nM) in vitro than the known COMT inhibitor, 3',4' dihydroxy-2-methylpropiophenone (U 0521, IC50 = 6000 nM). The new compounds were also highly selective COMT inhibitors with no activity against other essential enzymes involved in the synthesis and metabolism of catecholamines. PMID- 2704030 TI - Quinazoline antifolates inhibiting thymidylate synthase: 2-desamino derivatives with enhanced solubility and potency. AB - The poor solubility of the thymidylate synthase (TS) inhibiting antifolate 10 propargyl-5,8-dideazafolic acid has posed problems for its clinical use and is probably responsible for its renal toxicity. The insolubility is caused by the 2 amino-3,4-dihydro-4-oxopyrimidine moiety of the drug which stabilizes the solid state by intermolecular hydrogen bonding. In examining this moiety we have removed the 2-amino group and now report on 2-desamino-10-propargyl-5,8 dideazafolic acid (8e) and four analogues with H, Me, Et, and allyl at N10. 3,4 Dihydro-4-oxo-6-methylquinazoline was solubilized by alkylating the lactam nitrogen with chloromethyl pivalate. Reaction with N-bromosuccinimide gave the corresponding 6-bromomethyl compound, which was coupled with diethyl N-(4 aminobenzoyl)-L-glutamate or the appropriate N-substituted derivative thereof. The quinazoline N3 nitrogen and carboxyl groups in the product were simultaneously deprotected by cold alkali in the final step to give the desired five antifolates. These were tested against L1210 TS and it was found that removal of the 2-amino group caused a slight (3-9-fold) loss of TS inhibition. 8e was only 8-fold a lesser TS inhibitor than the parent drug. Inhibition of rat liver dihydrofolate reductase was reduced by over 1 order of magnitude for three compounds tested. All five analogues were more cytotoxic to L1210 cells in culture than their 2-amino counterparts; 8e was 8.5-fold more active with an ID50 of 0.4 microM. This remarkable result probably owes to increased cellular penetration. 8e was 5-fold more soluble than 1 at pH 5.0 and greater than 340 fold more soluble at pH 7.4. PMID- 2704031 TI - Comparison of the biological effects of selected 5,8-dideazafolate analogues with their 2-desamino counterparts. AB - Three new 5,8-dideaza analogues of folic acid devoid of an amino group at position 2 have been prepared by using synthetic routes patterned after earlier methodologies. They were 2-desamino-5,8-dideazaisofolic acid, 2b, 2-desamino-10 thia-5,8-dideazafolic acid, 2c, and 2-desamino-10-oxa-5,8-dideazafolic acid, 2d. These compounds were found to be 4-6-fold more cytoxic toward L1210 leukemia cells than their 2-NH2 counterparts and to be poor inhibitors of mammalian thymidylate synthase. However, they were only 1.5-3-fold less inhibitory toward dihydrofolate reductase than the analogous compounds containing a 2-NH2 group. The known thymidylate synthase inhibitors 2-desamino-10-propargyl-5,8 dideazafolic acid and 10-propargyl-5,8-dideazafolic acid were included in this study for purposes of comparison. PMID- 2704032 TI - Conformationally restricted analogues of the muscarinic agent N-methyl-N-(1 methyl-4-pyrrolidino-2-butynyl)acetamide. AB - Conformationally restricted analogues of the selective partial muscarinic agonist N-methyl-N-(1-methyl-4-pyrrolidino-2-butynyl)acetamide (BM 5; 2) were synthesized. The compounds were tested for muscarinic and antimuscarinic activity in the isolated guinea pig ileum and in intact mice. They were found to be moderately potent muscarinic antagonists or weak partial agonists. The new compounds were less potent than 2 in inhibiting (-)-[3H]-N-methylscopolamine binding in the rate cerebral cortex. Thus, structural modifications of 2 in which part of the amide moiety has been connected with the methyl group in the butynyl chain to form a five-membered ring decrease affinity and in most cases abolish efficacy. PMID- 2704034 TI - Topographic probes of angiotensin and receptor: potent angiotensin II agonist containing diphenylalanine and long-acting antagonists containing biphenylalanine and 2-indan amino acid in position 8. AB - A series of phenylalanine-mimicking amino acids with increasing conformational restraint were prepared and incorporated into angiotensin II, in order to develop topographic probes of angiotensin useful for probing receptor boundaries by molecular graphics analysis and for conformational analysis of the ligand by NMR. In binding studies, all analogues displayed high affinity for rat uterus (Ki of 0.74-6.08 nM) and brain (0.46-1.82 nM) receptors. In smooth muscle (rat uterus) contraction assay, the diphenylalanine-containing [Sar1,Dip8]AII and [Sar1,D Dip8]AII were potent agonists with respectively 284% and 48% activity of [Asn1]AII. In contrast, the biphenylalanine-containing [Sar1,Bip8]AII, [Sar1,D Bip8]AII, and the 2-indan amino acid containing [Sar1,2-Ind8]AII were potent inhibitors, approximately 9, 2, and 1.4 times more effective than a standard antagonist, [Sar1,Leu8]AII. Their respective pA10 values in rat uterus assay were 8.87, 8.70, and 8.82. By comparison, the pA10 value for [Sar1,Leu8]AII was 8.35. In rats, a single dose of 10 micrograms of [Sar1,2-Ind8]AII or [Sar1,Bip8]AII produced prolonged blockade of the pressor response toward angiotensin II for over 90 min. The very different pharmacological profiles of these rigid aromatic analogues suggest that the angiotensin receptor activation site consists of a relatively wide and elongated pocket with a narrow opening. PMID- 2704033 TI - [(1H-imidazol-1-yl)methyl]- and [(3-pyridinyl)methyl]pyrroles as thromboxane synthetase inhibitors. AB - Several [(1H-imidazol-1-yl)methyl]- and [(3-pyridinyl)methyl] pyrroles were prepared and evaluated in vitro as thromboxane synthetase inhibitors in human platelet aggregation studies. A number of structures, e.g. 10b,f,g,i (respective IC50 values: 1 microM, 50 nM, 42 nM, 44 nM) showed superior in vitro inhibition of TXA2 synthetase when compared to the standard dazoxiben (1). However, it was found that in vitro potency did not translate into nor correlate with in vivo activity when these compounds were evaluated in mice in a collagen-epinephrine induced pulmonary thromboembolism model. (E)-1-Methyl-2-[(1H-imidazol-1 yl)methyl]-5-(2-carboxyprop-1-enyl) pyrrole (10b) was found to offer protection against collagen-epinephrine-induced mortality in mice, thereby demonstrating that oral administration is an effective route for absorption of this drug. Additional evidence for the oral effectiveness of 10b in lowering serum TXB2 levels was obtained by performing ex vivo radioimmunoassay experiments with rats. A 13-week study of 10b in rats with reduced renal mass was conducted in order to evaluate the role of TXA2 production in hypertension and renal dysfunction. Although serum and urinary TXB2 levels in rats were found to be lowered during this study by 10b, the levels of urinary protein excretion remained comparable to that of the control group. PMID- 2704035 TI - New sensitizers for photodynamic therapy: controlled synthesis of purpurins and their effect on normal tissue. AB - Purpurins are a class of porphyrin derivative that have been shown to have good in vivo cytotoxicity to N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) induced rat bladder tumors (AY-27) implanted into Fisher 344 rats. The synthesis of purpurins from etioporphyrin I and coproporphyrin I proceeds in high yield and with a high degree of regioselectivity. Product formation can be rationalized in terms of relief of steric strain about the periphery of the purpurin macrocycle. The effect of therapeutic light doses using the rat footpad model suggests that, at therapeutic sensitizer doses, normal tissue damage is within acceptable limits, particularly for metalated purpurins. PMID- 2704036 TI - Adherence of staphylococci to intravascular catheters. AB - Adherence of seven strains of Staphylococcus epidermidis and three strains of S. aureus to three types of intravascular catheters was assessed by ATP bioluminescence, by culture after ultrasonication and by scanning electronmicroscopy. The catheter materials studied were silicone elastomer, thermoplastic polyurethane and polyurethane coated with Hydromer, a coating which absorbs water and provides a hydrophilic sheath around the catheter. The adherence assays were performed in phosphate-buffered saline on a rotary shaker at 37 degrees C, with the catheters precoated with serum and uncoated, and the results were correlated with bacterial hydrophobicity. There was wide strain-to strain variation in bacterial adherence; S. aureus and slime-producing S. epidermidis strains adhered better than did non-slime-producing strains. Overall, there was less bacterial adherence to Hydromer-coated catheters than to polyurethane and silicone catheters but it was unrelated to bacterial hydrophobicity. Serum coating of catheters resulted in marked reduction of bacterial adherence. PMID- 2704037 TI - Two-dimensional 1H nuclear magnetic resonance studies on the gene V-encoded single-stranded DNA-binding protein of the filamentous bacteriophage IKe. I. Structure elucidation of the DNA-binding wing. AB - Two-dimensional nuclear magnetic resonance techniques were used to obtain residue and sequence-specific assignments in the 1H spectrum of the single-stranded DNA binding protein encoded by gene V of the filamentous phage IKe (IKe GVP). The residue-specific assignments are based on the analysis of J-correlated spectra, i.e. correlated spectroscopy and homonuclear-Hartmann-Hahn total correlated spectroscopy. Complete assignments of side-chain spin systems, e.g. long side chains, were, to a major part, derived from two-dimensional spectra obtained by means of the latter technique. Sequence-specific residue assignments were obtained for the two neighbouring residues V41 and Y42, and the amino acid sequence segment encompassing residues S17 through I29. The structure of this segment, a beta-loop, was deduced from the interresidue nuclear Overhauser effect pattern. Residues S17 through V19 and P26 through I29 form an anti-parallel beta ladder segment, whereas residues Q21 to K25 constitute the loop region. The beta loop is expected to project into the solution and is intimately involved in binding to single-stranded DNA; it is therefore designated the "DNA-binding wing". By analogy with the structure of the DNA-binding wing deduced from IKe GVP, a similar structure is proposed for the corresponding domain of the gene V protein encoded by the filamentous phage Ff for which, from X-ray diffraction studies, a three-dimensional structure has been deduced. Essential differences appear to exist between the DNA-binding domain in the X-ray structure and that proposed in this paper. Possible reasons for these differences are discussed. PMID- 2704038 TI - Two-dimensional 1H nuclear magnetic resonance studies on the gene V-encoded single-stranded DNA-binding protein of the filamentous bacteriophage IKe. II. Characterization of the DNA-binding wing with the aid of spin-labelled oligonucleotides. AB - The DNA-binding domain of the single-stranded DNA-binding protein IKe GVP was studied by means of 1H nuclear magnetic resonance, through use of oligonucleotides of two and three adenyl residues in length, that were spin labelled at their 3' and/or 5' termini. These spin-labelled ligands were found to cause line broadening of specific protein resonances when bound to the protein, although they were present in small quantities, i.e. of the order of 0.04 molar equivalent and less. The line broadening of protein resonances was made manifest by means of difference one and two-dimensional spectroscopy. Difference one dimensional experiments revealed line broadening of the same protein resonances upon binding of either 3' or 5' spin-labelled oligonucleotides. Evidence in favour of the existence of a fixed 5' to 3' orientation in the binding of oligonucleotides to the protein surface was therefore not obtained from the spin labelled oligonucleotide binding studies. Residue-specific assignments of broadened resonances could not, or could only sparsely, be derived from the difference one-dimensional spectra, because of the tremendous overlap in the aliphatic region of the spectrum. In contrast, such assignments were easily obtained from the difference two-dimensional spectra, which were recorded by means of both total correlated spectroscopy and nuclear Overhauser effect spectroscopy. Difference signals were detected for 15 spin systems; ten out of these were assigned to the residues I29, Y27, S20, G18, R16, T28, K22, Q21, V19 and S17 in the amino acid sequence of IKe GVP; the other five spin systems could be assigned to a phenylalanyl residue, an arginyl or lysyl residue, an aspartic acid or asparagyl residue, a glycyl residue and a glutamic acid or glutamyl residue. From the evaluation of the relative difference signals, it was concluded that the direct surroundings of the spin-label group of the labelled oligonucleotide in the bound state is composed of the first five residues in the former group of residues and the five residues in the latter group.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2704039 TI - Structure and refinement of the oxidized P21 form of uteroglobin at 1.64 A resolution. AB - One of the monoclinic P21 forms of uteroglobin, a progesterone-binding protein secreted by the rabbit uterus, was crystallized and subjected to X-ray diffraction analysis at 1.64 A resolution. The analysis was refined to an R factor of 0.19 and the 1096 non-hydrogen atomic positions are known to an accuracy of about 0.18 A. The average isotropic temperature factor B was 10.4 A2. Uteroglobin is a dimer of two independent polypeptide chains of 70 residues linked by two disulfide bridges and related by a pseudo binary axis. Each monomer is folded into four alpha-helices. An oblong hydrophobic pocket is observed inside the dimer, and the possibility that it represents a progesterone-binding site is discussed. The present model includes 165 possible sites for water molecules, of which six are located in the hydrophobic pocket. Polar groups are involved in hydrogen bonding (intramolecular, intermolecular or with water molecules). PMID- 2704040 TI - Crystallization of p68 on lipid monolayers and as three-dimensional single crystals. AB - Two-dimensional crystals of p68, a Ca2+ -binding protein that has homology with members of the lipocortin/calpactin family, were obtained by interaction with a phospholipid monolayer. By measuring surface pressure at constant surface area, p68 was found to interact in a Ca2+ -dependent manner specifically with phosphatidylethanolamine, less so with phosphatidylserine and not at all with phosphatidylcholine. With dimyristoyl-phosphatidylethanolamine, two-dimensional crystalline arrays were formed. Image analysis of electron micrographs of these crystals, which diffracted to about 50 A, revealed p3 symmetry with a unit cell of about 178 A by 178 A; the protein densities showed a two-domain structure giving a cylindrical molecule of about 100 A by 35 A diameter packed as trimers. Three-dimensional microcrystals obtained without lipid or Ca2+ were suitable for electron microscopy and gave a tetragonal unit cell of about 256 A by 68 A. The implications of these observations on the structure and lipid specificity of p68 binding are discussed. PMID- 2704041 TI - N-terminal amino acid sequences of three functionally different troponin T isoforms from rabbit fast skeletal muscle. AB - The different isoforms of fast skeletal muscle troponin T (TnT) are generated by alternative splicing of several 5' exons in the fast TnT gene. In rabbit skeletal muscle this process results in three major fast TnT species, TnT1f, TnT2f and TnT3f, that differ in a region of 30 to 40 amino acid residues near the N terminus. Differential expression of these three isoforms modulates the activation of the thin filament by calcium. To establish a basis for further structure-function studies, we have sequenced the N-terminal region of these proteins. TnT2f is the fast TnT sequenced by Pearlstone et al. The larger species TnT1f contains six additional amino acid residues identical in sequence and position to those encoded by exon 4 in the rat fast skeletal muscle TnT gene. TnT3f also contains that sequence but lacks 17 amino acid residues spanning the region encoded by exons 6 and 7 of the rat gene. These three TnTs appear to be generated by discrete alternative splicing pathways, each differing by a single event. Comparison of these TnT sequences with those from chicken fast skeletal muscle and bovine heart shows that the splicing pattern resulting in the excision of exon 4 is evolutionarily conserved and leads to a more calcium-sensitive thin filament. PMID- 2704042 TI - Control of gene expression in the P2-related temperate coliphage 186. VI. Sequence analysis of the early lytic region. AB - We have completed the sequence of the 186 early lytic region and established that this region encodes the four genes CP75, CP76, CP77 and CP78, with CP79 the first gene of the next region. Functions have been assigned to the four early genes. PMID- 2704043 TI - DNA replication studies with coliphage 186. II. Depression of host replication by a 186 gene. AB - Using pre-labelling rather than pulse-labelling studies to determine rates of replication, we have shown that coliphage 186 infection is accompanied by a depression in host DNA replication. We have isolated mutants of the phage gene involved and mapped them in the early region of the phage genome. Sequencing the mutants ultimately led us to the identification of the gene that we have named the dhr gene. PMID- 2704044 TI - Keeping an eye on the environment. PMID- 2704045 TI - Fluorescein angiography. Part 1: Technique and normal study. AB - 1. Fluorescein angiography is a relatively noninvasive diagnostic test which provides the ophthalmic practitioner with anatomic and physiologic information about the ocular structures. 2. Once the dye solution is injected, the photographer observes the fundus through the camera until it appears in the retinal vessels. Photographs are then taken in a rapid sequence. 3. The retinal arteries fill rapidly and evenly within two seconds following the initial choroidal flush. The dye circulates through the whole arterial tree in the body, and in the late stage angiogram recirculation can be seen in the retinal blood vessels. PMID- 2704046 TI - Calculating combined prism for spectacle prescriptions. AB - 1. Combined prisms are required when correction incorporates vertical and horizontal strengths in one lens. 2. Calculations of the resultant prism power requires diagramming the vertical and horizontal vectors and drawing the resultant diagonal vector. The power is either derived from the Pythagorean Theorem or measured on graph paper. 3. The resultant prism base direction or axis designation is calculated from an equation or measured directly off the diagram with a protractor. PMID- 2704047 TI - Mixing contact lens solutions. PMID- 2704048 TI - Paul Larson, COMT, president, Association of Technical Personnel in Ophthalmology. Interview by Norma Garber. PMID- 2704049 TI - Metalloproteinases and malignant conversion: does correlation imply causality? PMID- 2704050 TI - Trends in survival from malignant melanoma: remarkable improvement in 23 years. AB - Trends in incidence of and mortality and survival from malignant melanoma in Sweden for 1960 through 1982 were analyzed. Incidence rates increased annually by 5.4% for females and by 5.8% for males, whereas mortality rates increased annually by 2.7% for females and 3.3% for males. For females, the 5-year relative survival (RS) rates increased by approximately 15 percentage points before 1970. In contrast, males before 1970 had a successive improvement in RS rates of 4.6 8.2 percentage points for each 5-year period of diagnosis. Multivariate analyses revealed that during the study period the malignant melanoma-specific hazard decreased by 71% [95% confidence interval (CI) = 59%-79%] for females and by 64% (95% CI = 54%-73%) for males during the first 5 years of follow-up. PMID- 2704051 TI - Hydralazine-induced tumor hypoxia: a potential target for cancer chemotherapy. AB - Currently available cancer chemotherapeutic agents have been designed to exploit subtle differences in proliferation and biochemistry that are known to exist between host and malignant cells. However, chemotherapeutic agents may also be used to exploit physiological differences between cancer and normal tissue. The present study was conducted to determine whether the reduction in blood flow to the tumor (and thus oxygen delivery) induced by the vasodilator hydralazine would increase the cytotoxicity of drugs known to be more toxic in regions of reduced oxygenation. Results obtained with three murine tumor models clearly demonstrate that hydralazine potentiates the tumor cytotoxicity of such agents to a greater extent than it does their systemic toxicity. This study indicates a potential strategy for increasing the efficacy of certain cancer chemotherapeutic agents in solid tumors. PMID- 2704052 TI - Cure of experimental human malignant mesothelioma in athymic mice by diphtheria toxin. AB - A single ip or iv dose of 1-3 micrograms of diphtheria toxin consistently cured athymic mice of an advanced stage experimental human malignant mesothelioma. All cancer cells were killed within 18 hours and the profuse ip ascites plus large solid tumor masses associated with this model of neoplastic disease were subsequently eliminated. Treated mice appeared normal in 3 days and lived for greater than 300 days with no signs of recurrence, while control animals did not survive greater than 32 days. The complete tumoricidal effect implies that toxin readily reached, entered, and preferentially killed each human cancer cell. This outcome exemplifies the true therapeutic potential of highly selective, site directed toxins, and offers a frame of reference for judging the performance of current as well as prospective toxin-based agents. PMID- 2704053 TI - Generation of metastatic variants in populations of mutator and amplificator mutants. AB - Genetic instability has been hypothesized by P. C. Nowell and other investigators to be an important aspect of tumor progression that leads to the generation of metastatic variants. In this study we examined the rate of generation of metastatic variants in mutant cell lines having increased rates of spontaneous mutation and gene amplification. Parallel clonal populations of the spontaneous mutation rate mutant thy-49 and the gene amplification mutants YMP1 and YMP7 and their respective wild types were generated and grown to a critical population size. The number of metastatic variants in each clonal population was then determined following iv injection into nude mice. Lung tumors were scored 3-4 weeks after injection of cells, and the mean number per clonal population was determined. Analysis of the means with the Luria-Delbruck fluctuation test showed no significant differences in the rate of generation of metastatic variants produced in the genetically unstable lines compared to their normal counterparts. This study suggests that increased spontaneous mutation and gene amplification rates in mammalian cells are not sufficient on their own to increase the rate of generation of metastatic variants. PMID- 2704054 TI - ELISA detection of fentanyl in horse urine and plasma. AB - The prototype of a commercial ELISA test kit designed for fentanyl determination in human urine has been evaluated for screening fentanyl in horse urine and plasma. The measurement of fentanyl after intravenous (2 mg) and intramuscular (0.25 mg) administration in undiluted plasma was not reproducible while accurate quantification of fentanyl in urine greatly depends on the composition of the horse urine. The ELISA assay, however, is simple and could be successfully used for quantitative measurements in diluted urine and for rapid qualitative screening for fentanyl in large numbers of urine samples. PMID- 2704055 TI - Disposition kinetics of 2-pyridine aldoxime methochloride in Bubalus bubalis. PMID- 2704056 TI - Pharmacokinetics and metabolism of sulphadimidine in kids at 12 and 18 weeks of age. AB - The pharmacokinetics and metabolism of sulphadimidine (SDM) following intravenous administration of 100 mg/kg were studied in seven dwarf preruminant kids at 12 weeks of age, and again at the ruminant stage, when the animals were 18 weeks old. The persistence of SDM in 18-week-old kids was prolonged in comparison to the 12-week-old animals: a lower total body clearance and a prolonged elimination of SDM were obtained in the older animals. The renal clearance values of SDM and its metabolites were the same at both ages. The decrease of SDM clearance is related to the significant reduction in SDM hydroxylation at the older age. The reduced oxidative hepatic metabolism may result from the sexual maturation of the kids. PMID- 2704057 TI - The concentration of penicillin in bovine conjunctival sac fluid as it pertains to the treatment of Moraxella bovis infection. (I) Subconjunctival injection. AB - Single dose, subconjunctival injections of procaine penicillin using either skin or conjunctival routes of administration were evaluated in order to compare the duration of antibacterial concentrations at the site of Moraxella bovis infection. Samples of conjunctival sac fluid (CF) were collected using blunted capillary tubes and were periodically assayed for penicillin by an agar-well diffusion technique. Linear regression lines were constructed for concentration of penicillin-time profiles. Similarity of the regression slopes for each treatment enabled the construction of three common lines by the method of co variance analysis in order to represent each treatment. Treatments were thereafter compared by the slopes of the common regression lines. A subconjunctival injection of procaine penicillin at a dose of 6 X 10(5) iu in 2 ml, administered either through the skin or through the conjunctiva, produced a peak penicillin concentration in the CF of approximately 8 iu/ml for either route and a duration of therapeutic concentration (DTC) of 67.6 +/- 4.9 and 40 +/- 2.7 h respectively. A dose of 3 X 10(5) iu in 1 ml, administered through the conjunctiva, produced a similar peak but the DTC was reduced to 35 +/- 4.2 h. The results of this study support field practices, as adequate penicillin concentrations were maintained by both techniques investigated. PMID- 2704058 TI - The concentration of penicillin in bovine conjunctival sac fluid as it pertains to the treatment of Moraxella bovis infection. (II) Topical application. AB - Sodium benzyl penicillin, procaine penicillin and benethamine penicillin were applied into the bovine conjunctival sac as an aqueous solution or in ointment form in order to study the concentration-time profiles. The series of treatments was repeated in five animals in a random sequence. Penicillin concentration in conjunctival sac fluid (CF) was determined using the agar-well-diffusion assay technique. The data obtained were transformed to linear regression slopes. Similarity of the slopes within treatments (in five different eyes) enabled the construction of four common lines by co-variance analysis to represent each treatment. The regression coefficients of the four common lines were then compared to study the difference between treatments. Topical application of 5,000 iu sodium benzylpenicillin in aqueous solution at a concentration isotonic with 0.9% saline, produced a duration of therapeutic concentration (DTC) in CF of 12.6 +/- 1.5 h. When the same salt or other less water-soluble ones were formulated at the same concentration in an ointment base, the DTC was significantly prolonged. For all treatments, peak concentrations in CF were recorded at the first sampling and ranged between 7 iu/ml and 14 iu/ml. Sodium benzylpenicillin or procaine penicillin, both in the ointment base, produced DTCs of 38.8 +/- 2.1 h and 37 +/- 4.0 h, respectively, while the ointment formulation of benethamine penicillin produced a DTC of 56 +/- 4.5 h. The prolonged duration observed in the eye ointments can be partly accounted for by the viscous nature of the base. Other differences may be dependent on relative water solubility of each penicillin product and complexity of the surface mucosae of the eye. PMID- 2704059 TI - Concentrations of sulphadimidine, oxytetracycline and penicillin G in serum, synovial fluid and tissue cage fluid after parenteral administration to calves. AB - Drug concentrations in serum, synovial fluid and tissue cage fluid (TCF) in calves were measured after single i.m. doses of oxytetracycline hydrochloride (OTC), procaine penicillin G (PPG) and potassium penicillin G (KPG) and single i.v. doses of sulphadimidine (SDM) and OTC. For all drugs, concentration-time curves in serum and synovial fluid were not identical but they had similar profiles, with peak levels occurring at about the same time. Concurrent concentrations were lower in synovial fluid than in serum. For each drug, elimination half-lives from synovial fluid and from serum were similar, except for penicillin G after KPG administration which had a significantly longer half life from synovial fluid than from serum (P less than 0.05). Of the two penicillin G preparations, PPG gave a significantly higher synovial fluid:serum area under curve (AUC) ratio than did KPG; 0.76 +/- 0.10 and 0.54 +/- 0.12, respectively (P less than 0.05). For OTC, the synovial fluid:serum AUC-ratio was 0.33 +/- 0.12 after i.m. and 0.34 +/- 0.08 after i.v. administration. Drug concentration-time curves of TCF had different profiles compared with serum, with relatively low and delayed peak levels and slow elimination from TCF. TCF:serum AUC-ratios did not differ significantly for i.m. and i.v. administration of OTC; 0.10 +/- 0.10 and 0.19 +/- 0.03 respectively (P greater than 0.05). Potassium penicillin G (KPG), however, gave a significantly higher TCF:serum AUC-ratio than PPG; 0.55 +/- 0.21 and 0.19 +/- 0.07, respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704060 TI - Pharmacokinetics and bioavailability of ronidazole from a prolonged release tablet in the homing pigeon (Columba livia). AB - The pharmacokinetics of ronidazole and the bioavailability of a prolonged release tablet were studied in the homing pigeon. After intravenous administration of 5 mg ronidazole, the drug plasma concentration profile fitted a one-compartment open model. The mean half-life of the drug was 11 h and the volume of distribution was 0.86 l/kg. Total body clearance was 0.056 l/h/kg. A sustained release matrix tablet exhibited prolonged drug release in vitro. After oral administration of the matrix tablet to pigeons drug absorption was nearly complete. When given on an empty stomach, the tablet failed as a prolonged release system. Administration to previously fed pigeons resulted in an increase in tmax and a decrease in Cpmax. PMID- 2704061 TI - Toxocara vitulorum: treatment based on the duration of the infectivity of buffalo cows (Bubalus bubalis) for their calves. AB - Treatment of buffalo calves (Bubalus bubalis) at different times after birth demonstrated that transmission of Toxocara vitulorum from the cow to the calf via milk occurs in all calves during the first 2 days after birth, decreases to 53% by 6 days, 10% by 8-9 days and 2% from Day 10 onwards. This may be because the larvae are no longer in the milk or because the calf has become resistant to the establishment of a new infection. The result also emphasizes the importance of mammary transmission of the parasite. Against immature parasites the efficacy of pyrantel and levamisole was 97%; febantel was 100% on one farm, only 35% on another; piperazine 42% and thiabendazole 35%. Santonin was ineffective in four calves. Against mature parasites the efficacy of pyrantel was 100%; febantel was 100% on one farm, only 35% on another; oral levamisole 83%; cutaneous levamisole 73%; oxfendazole 89%; and piperazine 57%. Nevertheless, piperazine reduced the infection to levels which were probably not pathogenic. In general, the efficacy against mature parasites was similar to that against immature parasites. Treatment of 10-16-day-old calves with an anthelmintic, which is effective against immature parasites, is recommended. This procedure greatly reduces contamination of the environment and also precludes the pathogenic effect of a large number of immature or mature parasites. PMID- 2704062 TI - Pharmacokinetics, metabolism and renal clearance of sulphatroxazole in calves and cows. AB - The pharmacokinetic analysis of plasma concentration--time curves after a single i.v. dose of 20 mg/kg sulphatroxazole (STZ) to calves and cows revealed a small distribution volume of STZ (mean VD(area) = 0.22-0.26 l/kg) and an age dependent elimination (mean t1/2 6.6-18.8 h). In calves and cows, STZ was extensively metabolized into the N4-acetyl and 5-hydroxy derivatives. In the plasma of calves, the N4-acetyl metabolite (N4-STZ) was present in greater amounts than the hydroxy metabolite (5-OH-STZ), while in cows' plasma concentration of these two metabolites were similar. In the milk of dairy cows STZ concentrations paralleled those of the metabolites and were approximately 21 times lower than corresponding plasma concentrations. The mean plasma protein binding of STZ and its metabolites ranged from 36.4 to 82.5% of total concentration. The N4-STZ derivative was excreted by tubular secretion; the 5-OH-STZ and the parent compound, mainly by glomerular filtration. In calves the majority of STZ administered was excreted as N4-STZ (40-52%), while in cows the parent drug dominated the urinary excretion (36%). PMID- 2704063 TI - Regulation of bronchomotor tone in conscious calves. AB - The purpose of this study was to investigate the effects of some alpha and beta sympathomimetic and sympatholytic drugs on respiratory impedance in healthy conscious calves. Ten Friesian calves were investigated in this study. The forced oscillation technique was used to measure the resistance (Rrs) and the reactance (Xrs) of the respiratory system at frequencies ranging from 4 to 26 Hz. Isoprenaline (1 microgram/kg i.v.), propranolol (3 micrograms/kg i.v.), noradrenaline (2 micrograms/kg i.v.), xylazine (20 micrograms/kg i.v.) and yohimbine (0.25 mg/kg i.v.) were were administered. Isoprenaline induced a significant decrease of Rrs. An increase of Rrs after administration of propranolol was observed but without any change of the frequency dependence of Rrs. A small increase in the resonant frequency was also recorded. A decrease of Rrs was recorded after yohimbine injection. Noradrenaline and xylazine administration increased the resistances and the resonant frequency and induced a negative frequency dependence of Rrs. These results suggest that (1) the major effects of beta adrenergic drugs are on the central airways, (2) the alpha adrenergic system may play a role on the regulation of bronchomotor tone in calves, (3) the effects of alpha adrenergic drugs are on both central and peripheral airways and (4) the forced oscillation technique allows the differentiation of calibre changes occurring in small and large airways. PMID- 2704064 TI - Single-dose pharmacokinetics of detomidine in the horse and cow. AB - The pharmacokinetics of detomidine, a novel analgesic sedative, was studied in the major target species after high (80 micrograms/kg) i.v. and i.m. doses. In addition, drug residues in some organs were determined. Concentrations were measured using a sensitive, detomidine-specific radio-immunoassay method. Rapid absorption following i.m. dosing occurred. Absorption half-lives were 0.15 h (horse) and 0.08 h (cattle). The mean peak concentration in the horse (51.3 ng/ml) was achieved in 0.5 h and in the cow (65.8 ng/ml) in 0.26 h. The areas under the concentration curve after i.m. dosing were 66% (horse) and 85% (cow) of the corresponding i.v. values. Distribution was rapid with half-lives of 0.15 h (horse, i.v.) and 0.24 h (cow, i.v.). The apparent volume of distribution was higher after the i.m. dosing (horse 1.56 l/kg, cow 1.89 l/kg) than after i.v. dosing (horse 0.74 l/kg, cow 0.73 l/kg). Elimination half-lives were 1.19 h (horse) and 1.32 h (cow) for the i.v. dose and 1.78 h (horse) and 2.56 h (cow) for the i.m. dose. Total clearances ranged from 6.7 (horse, i.v.) to 12.3 (cow, i.m.) ml/min/kg. Renal clearances were less than 1% of the total clearances showing negligible excretion of the drug in urine and suggesting elimination by metabolism. A cross-reacting metabolite in urine corresponded to less than 1.5% of the detomidine dose's immunoreactivity. High-dose detomidine increased urine flow significantly. Excretion of detomidine in milk in cattle was extremely low. No detectable amounts were present 23 h after dosing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704065 TI - Characterization of a soft-tissue infection model in the horse and its response to intravenous cephapirin administration. AB - A soft-tissue infection model was created in eight horses by infecting subcutaneous tissue chambers with Streptococcus zooepidemicus organisms. Responses of the horses to the infections were determined by monitoring changes in the complete blood count and body temperature and by following changes in the cytology and protein content of the tissue chambers. Systemic reactions to the infections included a mild neutrophilia, mild pyrexia and mild anemia. There was a marked influx of neutrophils and protein into the chambers after they were seeded with bacteria and chamber neutrophil viability decreased markedly at the height of the infection. Subsequent to establishing tissue chamber infections four of the horses were treated with intravenous cephapirin t.d. at a dosage of 20 mg/kg for 5 days. Quantitative culturing of tissue chamber fluid was performed to analyze the efficacy of cephapirin therapy. Cephapirin therapy was accompanied by decreases in the systemic neutrophilia, pyrexia, anemia, and chamber bacterial counts. However, cephapirin did not eliminate the infection in any of the chambers. Chamber neutrophil viability was markedly increased during the cephapirin therapy period. PMID- 2704066 TI - Probenecid effect on cefuroxime pharmacokinetics in calves. AB - Cefuroxime pharmacokinetics were studied in unweaned calves. The antibiotic was administered at 10 mg/kg to six calves i.v., to 12 calves i.m. and to ten of the previous 12 calves i.m. at 10 mg/kg together with probenecid at 40 mg/kg. Intramuscular doses of cefuroxime alone at 20 mg/kg were given to seven calves; to five of these calves cefuroxime was also given together with probenecid at 40 mg/kg and at 80 mg/kg. The serum concentration-time data were analyzed using statistical moment theory (SMT). The elimination half-life (t1/2) was 69.2 min (harmonic mean) after i.v. and 64.8 min and 64.9 min following i.m. administration of the lower and higher dose, respectively. Co-administration of probenecid did not affect the t1/2. The mean residence time (MRT) was 80.9 +/- 23.5 min (mean +/- SD) after i.v. and 117.8 +/- 9.3 min and 117.7 +/- 5.4 min after i.m. administration of cefuroxime at 10 and 20 mg/kg, respectively. The MRTi.m. following administration of cefuroxime at 10 mg/kg together with probenecid at 40 mg/kg was 140.0 +/- 8.8 min. The MRTi.m. values were 132.8 +/- 2.3 min and 150.8 +/- 5.1 min after cefuroxime was given at 20 mg/kg together with probenecid at 40 mg/kg or 80 mg/kg, respectively. The total body clearance (ClT) was 3.56 +/- 1.11 ml/min/kg and the volume of distribution at steady state (Vd(ss] 0.270 +/- 0.051 l/kg. The MIC90 values of cefuroxime were 16 micrograms/ml for E. coli and Salmonella isolates, 0.5 microgram/ml for Pasteurella multocida and 2.0 micrograms/ml for P. haemolytica. PMID- 2704067 TI - Effect of tiamulin on antipyrine kinetics in chickens. PMID- 2704068 TI - Bioavailability and pharmacokinetics of sulfamethazine in the pony. PMID- 2704069 TI - Molecular analysis of the function of direct repeats and a polypurine tract for plus-strand DNA priming in woodchuck hepatitis virus. AB - The replication of the hepadnavirus DNA genome is initiated by reverse transcription of pregenome RNA into minus-strand DNA followed by plus-strand DNA synthesis. The priming of plus-strand DNA requires the transfer of an RNA primer from pregenome RNA to the primer-binding site on minus-strand DNA. Annealing of the primer to the primer-binding site is facilitated by short direct repeats, DR1 and DR2. To investigate the mechanism of plus-strand primer formation, we have introduced specific mutations into DR1 and DR2 and measured the effect of these mutants on initiation of plus-strand DNA synthesis. To facilitate such an analysis, we have constructed a vector for the efficient expression of woodchuck hepatitis virus in cultured cells. Our results suggest that the 3' end of the RNA primer is determined prior to its transfer to the primer-binding site and that the determination of the 3' end of the primer does not depend on a specific sequence motif at the cleavage site. In addition, we have identified an alternative initiation site for plus-strand DNA synthesis at a purine-rich sequence between DR1 and DR2. Initiation at this site occurs by a mechanism that is independent of the direct repeats and does not require the transfer of an RNA primer to the primer-binding site. PMID- 2704070 TI - Novel use of polymerase chain reaction to amplify cellular DNA adjacent to an integrated provirus. AB - We describe a modification of the polymerase chain reaction technique which allows amplification of cellular DNA adjacent to an integrated provirus given sequence information for the provirus only. The modified technique should be generally useful for studies of insertional mutagenesis and other situations in which one wishes to isolate DNA adjacent to a region of known sequence. PMID- 2704071 TI - Detection of virus-specific RNA-dependent RNA polymerase activity in extracts from cells infected with lymphocytic choriomeningitis virus: in vitro synthesis of full-length viral RNA species. AB - We have developed an in vitro assay for the lymphocytic choriomeningitis virus (LCMV) RNA-dependent RNA polymerase with ribonucleoprotein complexes extracted from acutely infected tissue culture cells. The RNA products synthesized in vitro corresponded in size to the full-length genomic L and S RNAs and subgenomic NP and GP mRNAs normally produced in vivo during acute LCMV infection. In a temporal analysis spanning the first 72 h of acute infection, the in vitro polymerase activity of ribonucleoprotein complexes was maximal at 16 h and declined significantly at later times. In contrast, the intracellular levels of the viral L protein (the putative polymerase protein) appeared to be maximal at 48 to 72 h postinfection. Our results suggest that the accumulation of L protein correlates with reduced viral replication and transcription at later times in acute infection and may be involved in the transition from acute to persistent LCMV infection. PMID- 2704072 TI - Regulation of human immunodeficiency virus env expression by the rev gene product. AB - A single simian virus 40 late replacement vector which expresses both the rev and envelope (env) genes of human immunodeficiency virus was used to examine the mechanism underlying the dependence of env gene expression on the rev protein. When rev was deleted from the vector, no envelope protein expression could be detected in transfected cells, and the levels of cytoplasmic env mRNA were dramatically reduced. In contrast to this, the levels of env RNA in total cellular RNA preparations were similar with or without rev coexpression, and analysis of nuclear RNA showed that the levels of nuclear env RNA were increased in the absence of rev. These results suggest that rev functions to regulate nuclear export of env mRNA. It was possible to restore env expression from the vector lacking rev by supplying rev in trans, provided that a cis-acting sequence was also present. This sequence was mapped to a 854-base-pair region within the env open reading frame, and it was shown that the sequence could be moved but that it worked only in its original orientation. PMID- 2704073 TI - The proteolytic cleavage of PE2 to envelope glycoprotein E2 is not strictly required for the maturation of Sindbis virus. AB - The ionophore monensin has been shown previously to block the maturation of Sindbis virus as well as prevent the cleavage of pE2 to E2 when applied to cells in high concentration. We found that a moderate dose of monensin reduced virus titer and inhibited the cleavage of pE2 to E2. Under these conditions, pE2 appeared on the cell surface in a form susceptible to lactoperoxidase-mediated iodination. This pE2 was incorporated into virions, replacing E2. PE2-containing virions had a normal PFU-to-particle ratio, cosedimented with normal virus, and retained a normal morphology when negatively stained preparations were examined by electron microscopy. We conclude that the cleavage of pE2 to form E2 is not an absolute prerequisite for virus maturation. Recently, Russell et al. have reached a similar conclusion (D. L. Russell, J. M. Dalrymple, and R. E. Johnston, J. Virol. 63:1619-1629, 1989). PMID- 2704074 TI - Intramolecular homologous recombination in cells infected with temperature sensitive mutants of vaccinia virus. AB - I have used a plasmid containing two copies of the Saccharmyces cerevisiae his3 gene to study intramolecular homologous recombination in vaccina virus-infected cells. Recombination of the plasmid was monitored by restriction enzyme digestion and Southern blot hybridization in cells infected with representatives from each of 32 complementation groups of temperature-sensitive mutants ts42 and ts17 did not replicate nor detectably recombine the input plasmid. All except one of the mutants that synthesized normal amounts of viral DNA and protein replicated and recombined the plasmid in a manner indistinguishable from wild-type virus. The remaining mutant, ts13, only poorly replicated and recombined the input plasmid. Thus, the processes of replication and recombination could not be separated by using this battery of mutants. Viral mutants defective in late protein synthesis were unable to resolve the vaccinia virus concatemer junction in plasmids but carried out intramolecular homologous recombination with plasmids as efficiently as did wild-type virus at the conditionally lethal temperature. This result distinguishes homologous recombination, which requires early gene products, from resolution of concatemer junctions, which requires additional late gene products. PMID- 2704075 TI - Mutational analysis of polyomavirus small-T-antigen functions in productive infection and in transformation. AB - The function of polyomavirus small T antigen in productive infection and in transformation was studied. Transfection of permissive mouse cells with mixtures of mutants that express only one type of T antigen showed that small T antigen increased large-T-antigen-dependent viral DNA synthesis approximately 10-fold. Under the same conditions, small T antigen was also essential for the formation of infectious virus particles. To analyze these activities of small T antigen, mutants producing protein with single amino acid replacements were constructed. Two mutants, bc1073 and bc1075, were characterized. Although both mutations led to the substitution of amino acid residues of more than one T antigen, the phenotype of both mutants was associated with alterations of the small T antigen. Both mutant proteins had lost their activity in the maturation of infectious virus particles. The bc1075 but not the bc1073 small T antigen had also lost its ability to stimulate viral DNA synthesis in mouse 3T6 cells. Finally, both mutants retained a third activity of small T antigen: to confer on rat cells also expressing middle T antigen the ability to grow efficiently in semisolid medium. The phenotypes of the mutants in these three assays suggest that small T antigen has at least three separate functions. PMID- 2704076 TI - Variability and evolution of the plant RNA virus pepper mild mottle virus. AB - The RNA genomes of 26 isolates of pepper mild mottle virus were compared by their RNase T1 fingerprints. Twenty-three isolates came from epidemic outbreaks in greenhouse-grown peppers in Almeria (southeastern Spain) from 1983 to 1987; three other isolates, from 1980, came from Sicily (Italy) and Zaragoza (central Spain). The 26 fingerprints can be classified into 10 different types; nucleotide substitution rates show them to be very similar. Cluster and cladistic analyses group types corresponding to the Almeria isolates separate from those of 1980. Intraannual and interannual nucleotide differences were estimated. An evolutionary model for pepper mild mottle virus built on these data indicates a highly stable population, maintaining its diversity through time, with a main prevailing haplotype from which closely related variants arise that do not replace it. This high stability could be due to strong functional constraints on variation, as suggested by the high proportion of invariant versus polymorphic sites in fingerprints. PMID- 2704077 TI - Lymphotropic papovavirus early region is specifically regulated transgenic mice and efficiently induces neoplasia. AB - Transgenic mice have been generated which carry the early region of lymphotropic papovavirus (LPV). Eight of eleven founder animals died before 3 months of age after developing one or both of two distinct proliferative disorders. Of the three surviving animals, two are known to have rearranged or partial copies of the LPV genes. The majority of the founder animals (six) developed debilitating choroid plexus tumors by 26 to 42 days. Although this is the same tumor type induced by the simian virus 40 T-antigen gene, those induced by LPV appeared at a much younger age. The LPV early region was expressed in the brain tumors of these mice, as well as in the thymus and spleen. Expression in the latter two tissues reflects the cell-type specificity of the LPV enhancer demonstrated in cultured cells (i.e., lymphoid cells). Two founder animals (LP41 and LP50) gave rise to lines of mice that routinely develop lymphoproliferative disorders. LP50 and its LPV-positive offspring developed aggressive lymphomas and choroid plexus tumors. The transgenic offspring of LP41 also developed lymphomas. High levels of LPV RNA were expressed in the lymphomas of these mice as well as in the spleens and thymuses. The origin of the lymphomas from B- and T-cell lineages suggests that the LPV early genes are expressed in and can transform both of these cell types in vivo. PMID- 2704078 TI - Two blocks in Moloney murine leukemia virus expression in undifferentiated F9 embryonal carcinoma cells as determined by transient expression assays. AB - Transient expression assays were used to investigate the restriction of Moloney murine leukemia virus (MoMuLV) expression in undifferentiated mouse F9 embryonal carcinoma (EC) cells. We previously reported that the MoMuLV long terminal repeat (LTR) is inactive in undifferentiated F9EC cells due to inactivity of the tandemly repeated MoMuLV transcriptional enhancers. Others suggested that the inactivity was due to the presence of negative regulatory elements that interact with the MoMuLV tandem repeats. Two heterologous enhancer sequences that are active in undifferentiated F9 EC cells were inserted into the MoMuLV LTR: the B enhancers from the F101 variant of polyomavirus and a cellular enhancer sequence isolated from EC cells that we previously identified. The chimeric LTRs were then fused to the bacterial chloramphenicol acetyltransferase gene and tested for expression by transfection into F9 EC or NIH 3T3 cells. Insertion of these enhancers either upstream or downstream of the MoMuLV tandem repeats resulted in transcriptionally active LTRs in undifferentiated EC cells, which did not support the existence of negative regulatory elements interacting with the tandem repeats. In our previous MoMuLV enhancer deletion constructs, the GC-rich sequences downstream from the tandem repeats were also deleted, which might have contributed to the inactivity in EC cells. However, restoration of the GC-rich sequences did not yield an active LTR. The experiments also suggested that the EC cellular enhancer was preferentially active in undifferentiated EC cells and inactive in NIH 3T3 cells. The possibility of negative regulatory sequences in the vicinity of the MoMuLV primer-binding site was tested by inserting MoMuLV sequences from +30 to +419 base pairs into the LTR-chloramphenicol acetyltransferase gene constructs downstream of the transcriptional start site. Transient expression assays confirmed that these sequences reduced expression from functional LTRs in undifferentiated F9 EC cells but reduced expression significantly less in NIH 3T3 cells. Moreover, equivalent sequences from myeloproliferative sarcoma virus did not exhibit this effect. These results supported restriction of MoMuLV expression in undifferentiated F9 EC cells at two levels, inactivity of the MoMuLV enhancers and interaction of negative regulatory factors in the vicinity of the primer-binding site. PMID- 2704079 TI - Cell-to-cell transmission of human immunodeficiency virus type 1 in the presence of azidothymidine and neutralizing antibody. AB - Very few peripheral blood lymphocytes of seropositive individuals are presumably actively infected with human immunodeficiency virus type 1 (HIV-1). During coculture of lymphocytes of a seropositive individual with mitogen-stimulated normal peripheral blood lymphocytes, the number of infected cells becomes amplified such that detectable HIV-1 is produced. We report here that in addition to transmission by extracellular virus, cell-to-cell transmission is responsible for spreading HIV-1 infection from infected to uninfected cells. Azidothymidine and virus-neutralizing antibody had no effect on cell-to-cell transmission of HIV 1. Monoclonal antibodies to the CD4 receptor, but not to the CD3 receptor, prevented cell-to-cell transmission, which suggests that CD4 receptor-mediated cell fusion is involved in cell-to-cell transmission. Spread of infection in a cell-to-cell manner may be important in development of drug therapies for HIV-1 infection. PMID- 2704081 TI - Proposed new death certificate is only as good a data source as physician who fills it out. PMID- 2704082 TI - States modify certificate to meet specific needs. PMID- 2704080 TI - The Mlvi-1 locus involved in the induction of rat T-cell lymphomas and the pvt 1/Mis-1 locus are identical. AB - Mlvi-1 defines a locus of proviral integration in rat thymomas induced by Moloney murine leukemia virus. pvt-1/Mis-1 represents an independently identified locus which becomes rearranged either by chromosomal translocation in murine plasmacytomas or by provirus insertion in retrovirus-induced murine and rat thymic lymphomas. Although it had been claimed that pvt-1/Mis-1 and Mlvi-1 represent two different loci, we present here evidence showing that they are identical. This finding demonstrates the need for rigorous characterization of any newly identified common regions of integration in retrovirus-induced neoplasms. PMID- 2704083 TI - What's been added to 1989 certificate? Well... PMID- 2704084 TI - Hearings focus on cancer prevention among poor. PMID- 2704085 TI - Leads from the MMWR. Acquired immunodeficiency syndrome associated with intravenous-drug use--United States, 1988. PMID- 2704086 TI - Estimates of gestational age. PMID- 2704087 TI - Attention disorder in children: is the literature purged? Was it ever tainted? PMID- 2704088 TI - Assessing hospital-associated deaths. PMID- 2704089 TI - Divorce among physicians. Comparisons with other occupational groups. AB - This study had two goals--to evaluate critically the literature regarding the quality and stability of physicians' marriages and to present national data regarding the divorce-proneness of physicians in comparison with other occupational groups. The conclusions from the literature review were that (a) there is no sound evidence that physicians have lower marital quality than other groups, and (b) methodological weaknesses in past research leave open the question of whether physicians are more prone or less prone to divorce than other groups. The conclusion from new analyses of 1970 and 1980 US census data was that both male and female physicians have a lower tendency to divorce than other occupational groups, including other groups of professionals. PMID- 2704090 TI - The psychology of postponement in the medical marriage. AB - Many physicians' marriages are characterized by a strategy of postponement. The demands of medical training, the rigors of establishing a practice, and the expectations of colleagues are often used as excuses to avoid emotional intimacy in the marital relationship. Attention to the needs of the marriage is regularly postponed until some indefinite point in the future, resulting in considerable covert marital discord. The psychology of postponement ultimately proves to be a psychology of avoidance, growing directly out of the compulsive personality traits of most physicians and their preference for work over family life. Preventive measures are suggested to address the physician's tendency to avoid issues of marital intimacy. PMID- 2704091 TI - Marriage: if it lasts, does that mean it's good? PMID- 2704092 TI - A piece of my mind. A small price to pay. PMID- 2704093 TI - Visual loss following intranasal corticosteroid injection. PMID- 2704094 TI - Should we legalize drugs? Society should take the risk. PMID- 2704095 TI - Should we legalize drugs? PMID- 2704096 TI - Alcoholism. Recognizing the diagnosis. PMID- 2704097 TI - Neurosurgeons assess who's, what's, when's, where's, how's of brain grafts. PMID- 2704098 TI - Proliferating 'self-help' groups offer wide range of support, seek physician rapport. PMID- 2704099 TI - Copolymer, undergoing trials, could improve fibrinolytics' effectiveness. PMID- 2704100 TI - Leads from the MMWR. Chronic disease reports: mortality trends--United States, 1979-1986. PMID- 2704101 TI - Leads from the MMWR. Hospital discharge rates for cerebrovascular disease--United States, 1970-1986. PMID- 2704102 TI - Leads from the MMWR. School policies and programs on smoking and health--United States, 1988. PMID- 2704103 TI - The efficacy of generic primidone. PMID- 2704104 TI - A case report on California's Proposition 65. PMID- 2704105 TI - Counseling and antibody testing to prevent HIV infection. PMID- 2704106 TI - Renaming AIDS: 'retroviral immunodeficiency'? PMID- 2704107 TI - Reduced sexual activity in HIV-infected homosexual men. PMID- 2704108 TI - High-altitude flights and risk of cardiac disease. PMID- 2704109 TI - The role of data audits in detecting scientific misconduct. Results of the FDA program. AB - To evaluate the extent of the problem of scientific misconduct in investigational drug trials, we reviewed data from 1955 routine audits conducted by the US Food and Drug Administration (FDA) from June 1977 to April 1988. Serious deficiencies were detected in 12% of audits prior to October 1985, but in only 7% since that date. At the same time, there was no evidence of a decline over time in the rate of detection of many categories of deficiencies, and some investigators were able to continue to participate in drug trials after flagrant violations of recognized norms of research. The data auditing program should be continued, but additional measures are needed to regulate misconduct. These must be tailored to the variety of causes of misconduct, ranging from negligence to fraud. Possible additional approaches could include certifying the competence of potential investigators; peer-reviewed, competitive application for the opportunity to conduct FDA authorized clinical trials; limiting an investigator's level of participation in clinical trials; penalizing manufacturers who fail to detect their investigators' misconduct; and permitting the FDA to suspend investigators prior to a hearing. Measures taken should maximize public utility at the least economic cost to society and should be evaluated thoroughly. PMID- 2704110 TI - Measles and measles immunity in children infected with human immunodeficiency virus. AB - The development of measles vaccination recommendations for immunodeficient children infected with human immunodeficiency virus requires assessment of disease risk and the risks and benefits of vaccination. Measles in 4 such children resulted in 3 severe pneumonias and 1 death despite previous immunization in 2. Antibody to measles as determined by enzyme-linked immunosorbent assay was present in 3 (12.5%) of 24 children studied retrospectively and developed in only 2 (25%) of 8 children immunized and followed up prospectively. The sera of 9 of 24 children had antibody when tested by sensitive hemagglutination inhibition. Measles developed in 2 of 6 children who had negative enzyme-linked immunosorbent assay results and positive hemagglutination inhibition results. No adverse consequences of measles immunization were detected. Although the immunogenicity of measles vaccine in children infected with human immunodeficiency virus was low and vaccine failure occurred, the apparent safety provides the rationale for immunization in the face of a potentially fatal disease. Since neither documented immunization nor low level antibody guaranteed immunity to measles, we recommend passive postexposure immunoglobulin prophylaxis for all children infected with human immunodeficiency virus. PMID- 2704111 TI - New epidemiologic evidence confirming that bias does not explain the aspirin/Reye's syndrome association. AB - To determine the validity of the aspirin/Reye's syndrome association, we developed an epidemiologic investigation to assess the effects of five potential sources of bias. A case-control study incorporated procedures to avoid temporal precedence and susceptibility bias. These included classifying cases as having monophasic or biphasic patterns of illness and matching for severity of symptoms at zero-time. To evaluate the effect of a potential recall bias, an "alternate condition" control group was enrolled. A medical record review study was conducted to assess the potential for diagnostic bias, and a blanket surveillance of all hospitals in a region was conducted to evaluate reporting bias. Twenty four case subjects and 48 matched controls were enrolled. Eight-eight percent of case subjects and only 17% of controls had received aspirin prior to the onset of Reye's syndrome (matched odds ratio, 35; 95% confidence interval, 4.2 to 288). Further analyses demonstrated that the association could not be attributed to the five potential sources of bias. PMID- 2704112 TI - Testosterone replacement with transdermal therapeutic systems. Physiological serum testosterone and elevated dihydrotestosterone levels. AB - Testosterone was administered transdermally to hypogonadal men under three protocols. In the first protocol, it was shown that peak levels of testosterone were achieved three to eight hours after scrotal application of a transdermal therapeutic system containing 5, 10, or 15 mg of testosterone, and values at 22 hours were greater than 60% of peak values. In the second protocol, patients were treated with 10-mg systems for four weeks followed by 15-mg systems for eight weeks. Serum samples were obtained three to five hours after application of the transdermal therapeutic system. Testosterone increased from a pretreatment level (mean +/- SE) of 1.5 +/- 0.4 nmol/L to 15.2 +/- 3.4 nmol/L at four weeks, 18.6 +/ 3.3 nmol/L at eight weeks, and 17.3 +/- 2.8 nmol/L at 12 weeks. The serum testosterone/dihydrotestosterone (DHT) ratio fell from 4.53 to 2.47 at four weeks and was similar at eight and 12 weeks, reflecting a greater rise in DHT with this route of treatment (normal testosterone/DHT ratio, 9/1 to 12/1). Eight patients were treated with the 15-mg systems for an additional year. Seven of the eight were compliant and maintained serum testosterone levels (at six time points from two to 12 months [mean +/- SE] ) ranging from 11.5 +/- 1.2 to 44.9 +/- 2.4 nmol/L. It was possible to achieve physiological serum levels of testosterone by transdermal administration of testosterone in two thirds of our hypogonadal men. PMID- 2704113 TI - Hospital violence reduction among high-risk patients. AB - We describe the success of one general hospital in reducing violent behavior among a group of repetitively disruptive patients. Following a pilot phase during which violent incidents at the medical center were characterized by location, type, and person responsible, a group of patients at high risk for repeated violence was identified (N = 48). Data were gathered for 1 year before and after the institution of a program designed to reduce violence, primarily in ambulatory care areas, among this group. Outcome assessment included comparison of the number of violent incidents and the number of visits to the medical center during the 12 months before and after the program was started. The number of incidents declined by 91.6%, and visits to the medical center for any reason decreased by 42.2%. The ratio of violent incidents to visits after the program was begun was less than one sixth the rate before the program. Components of the program are described, including staff resistance and management strategies. PMID- 2704114 TI - Editors and auditors. PMID- 2704115 TI - Proactive violence reduction: successful quality assurance. PMID- 2704116 TI - A piece of my mind. A small town hero. PMID- 2704117 TI - An American pathologist's view of medicine on the island of Grenada. PMID- 2704118 TI - [Research on the development of common basic technologies for cancer research]. AB - 1. The research into the development of common basic technologies for cancer research was carried out by national institutes, universities and private research facilities through the use of the Special Coordination Funds for Promoting Science and Technology. 2. The research included both basic cancer researches and applied technologies for clinical oncology. 3. The research proved successful fruits as follows; Development of technologies for the gene transduction and the gene expression Development of searching methods of oncogenes Development of technologies for the extract and the refinement of tumor specific proteins Production of the DNA sequencer, the ultramicroanalyser of amino acids, the automatic monoclonal antibody producing cell sorter. PMID- 2704119 TI - [Comprehensive 10-year strategy for cancer control]. AB - Since 1981, cancer has been No. 1 cause of death in Japan. A "Comprehensive 10 Year Strategy for Cancer Control" is a national project that was strongly promoted by the former Prime Minister Mr. Yasuhiro Nakasone in 1983. The program comprises project research studies and functions supporting them. These include the education and utilization of young researchers (research resident), international cooperation and research resources (cell and gene) bank. The aim of studies is clarification of the mechanism of human carcinogenesis within 10 years and the results will be applied to prevention, diagnosis and therapy of cancers. PMID- 2704120 TI - [Epidemiology and cancer control under the health services for the aged]. AB - Six years have passed since the beginning of health services for the aged in 1983. The second 5-year program of health services for the aged has just started. Health education, health consultation, and health examination for cancer prevention are now in the stage for evaluation. It is difficult, however, to get agreement on the effectiveness. I would recommend a sampling method for a comprehensive evaluation. Exploration of other methods will be developed by epidemiologists, and that will contribute to the planning by the government in cancer control for the next 5-year program. The content of health education has been of single pattern. It should be different to educate what should be done by inhabitants or individuals depending on their way of life, local specificity and other factors. So it is necessary to explore the method to serve effective health education considering these differences. The informations necessary for such planning could be easily obtained from the health center or other public institutes, so that health professionals can apply these effective methods for health education. PMID- 2704121 TI - [Health center and epidemiological research of cancer]. AB - There are 851 Health Centers in Japan. The staffs of Health Centers are doctors, dentists, public health nurses and other co-medical staffs. The total number of Health Center staffs is about 35,000. The main functions of Health Centers for community health are prevention of various diseases, health education and survey for environmental problems and Cancer prevention. Especially, Surveillance System of tuberculosis and communicable diseases was taken effect in Jan. 1987. Sometimes, Epidemiological Research of Cancer may be carried out by using the network of Health Centers. But this research system is not yet authorized by national level. The problem on the new functions of Health Centers in the future is discussed now by the special committee on Health Center in which the relationship between Epidemiological Research of Cancer and the function of Health Center will be one of the main theme. PMID- 2704122 TI - [New strategy for cancer control]. AB - Japan has experienced a remarkable change in cancer mortality in the recent decades. Mass-screening programs are main strategy for preventing cancer deaths, but the cost-benefits are not satisfactory. Importance of primary prevention becomes greater. Budgets for cancer research and prevention by the Japanese government were compared with those of U.S.A., and necessity to grow epidemiologists in this field is proposed. PMID- 2704123 TI - [An alternative theory and practice on preventive medicine with special emphasis on total cancer studies]. AB - In order to solve our common problems on preventive medicine as well as health promotion, we have developed "General Network (GN) Approach" based on our general hypothesis "GN Concept" which should be deeply rooted among ourselves. The present paper is the application of the above approach into cancer control measures with special emphasis on the introduction of an alternative theory and methodology on preventive medicine. The main thrust of the paper is the schematic presentation on the function (theory) and structure (methodology) of preventive medicine by means of GN Model, including the methodologic illustration on (paradigm change) on the subject. It should be mentioned that GN Approach is applied for the common problem solvings on cancer prevention, epidemiology, etiology, and control systems by means of the realization of "Two-in-One" Concept. This in turn means that GN Approach should be one of pragmatic candidates for the general problem solvings. PMID- 2704124 TI - [Primary cancer prevention by life style modification]. AB - A large scale cohort Study, 1966-88 in Japan, for 265, 118 adults revealed daily cigarette smoking as the most important risk factor for cancer of all sites and major sites. The risk was observed to go up further when daily alcohol drinking and daily meat consumption are added to daily smoking, while addition of daily consumption of green-yellow vegetables was found to lower down the risk. Smoking cessation and nutrition improvement as represented by daily consumption of green yellow vegetables, therefore, must be the most practical and promising strategies for cancer prevention. PMID- 2704125 TI - [The development of health risk appraisal for Japanese as a new health educational tool]. AB - Health risk appraisal (HRA) is a new health educational tool widely-used in the United States, which informs clients about how their health habits and lifestyles affect their probability of dying from potentially preventable causes and helps to motivate them to reduce their personal health risks. It personalizes mortality statistics and epidemiologic data by combining these data with a person's risk factors. We have got started the development of HRA for Japanese with reference to a new version of HRA named "Healthier People" revised by the Carter Center of Emory University and the Centers for Disease Control in the United States. PMID- 2704126 TI - [Methodological consideration on evaluation of lung cancer screening program: one step process and two-step process]. AB - A reasonable method to evaluate lung cancer screening program is to measure the reduction in death rate from lung cancer among those randomly allocated to screening program (one-step process). Alternative method is two-step process; step 1 is to measure what proportion of lung cancer patients, can be detected through screening and how early the screening can detected lung cancer patients, and step 2 is to delineate effectiveness of therapy following early detection. Advantages and disadvantages of the two processes were described in view of statistical power and sample size. In addition, a workplace-based screening program using chest X-ray files was mentioned as an example of step 1 of two-step process. The example also included economical consideration of the screening. PMID- 2704127 TI - [The role of epidemiologic research of the natural history of cancer for evaluating cancer screening programs--a prospective study of colorectal polyps on the occurrence of colorectal cancer]. AB - In order to elucidate the natural history of colorectal polyps and to examine the effectiveness of endoscopic polypectomy in reducing the incidence of colorectal cancer, we conducted a retrospective cohort study of all patients who had undergone endoscopic examination at the Center for Adult Diseases, Osaka in 1970 82. The study subjects consist of 653 non-polyp cases and 431 colorectal polyp cases including 222 cases treated by endoscopic polypectomy. These were followed up until the end of 1985 by the method of a record linkage with the Osaka Cancer Registry's file. The colorectal polyp group and the endoscopic polypectomy group experienced 4.4 and 2.9 times, respectively, as much incidence of colorectal cancer as the non-polyp group. The magnitude of the prevented fraction by the use of endoscopic polypectomy was estimated at 31.3%. A large-scale and long-term study is necessary to elucidate the original study purpose. PMID- 2704128 TI - [How can we make mass-screening of stomach cancer more efficient using epidemiological results?]. AB - From an observation of personnel we expect epidemiological studies make mass screening of stomach cancer more efficient and suppose they should be done as to following aspects: (1) To decide the most efficient interval of mass-screening, investigating the frequency distribution of "Saving Duration" on many stomach cancers that is the duration when a stomach cancer is both detectably by screening and curable. (2) To decide who should undergo stomach examination quantifying cancer-risks of individuals with the use of epidemiological results. (3) To make epidemiological studies more sensitive and useful, classifying stomach cancers by microscopic pathological type, macroscopic one or "Saving Duration". (4) To settle a statistical standard of epidemiological results which is demanded for them to be useful in mass-screening. PMID- 2704129 TI - [Epidemiologic follow-up study of cancer and borderline lesions of uterine cervix]. AB - Follow-up results of 329 cases, who were recommended for colposcopy and biopsy after uterine cervical cytologic tests among 38,610 screenees in Shiga Prefecture 1986, were studied. 41 cases (12.8%), including 26 CIS cases, were diagnosed as cervical cancer. 102 cases (30.7%) belonged to dysplasia and other lesions, such as erosion and chronic cervicitis, were 155 cases (47.1%). Only 8 screenees (2.4%) were lost in follow-up. Close follow up for borderline cases may be enough if dysplastic lesions do not progress for over 3 years. PMID- 2704130 TI - [An epidemiological approach to increase mass screening efficiency, by finding high-risk group of esophageal cancer]. AB - An improvement of mass screening efficiency for esophageal cancer was studied by a simple form of questionnaire on the basis of case-control study in Saitama prefecture. This questionnaire consisted of several questions on risk-associating factors and the answers were scored such that the exposure to plural factors was quantified. The high-scored group is then regarded to be at high risk and to be examined for the cancer. The selection of factors for questionnaire was made by estimating the efficiency of screening. The expected detection rates were high with the range from 0.16 to 0.27% for males and 0.04 to 0.09% for females, contrasting to the rates of 0.05 and 0.01% without pre-screening by the questionnaire. PMID- 2704131 TI - [A long-term follow-up study of the histologically confirmed chronic liver diseases in the Juntedo University Hospital]. AB - In order to calculate the survival rate and elucidate the risk factors of liver cancer, 1,034 patients of the chronic liver diseases were followed up for 7.1 years of average. All patients were confirmed histologically from 1973 to 1982 in Juntendo University Hospital as liver cirrhosis (367), liver fibrosis (27), and chronic hepatitis (640). Until the end of 1986, 244 cases were died including 52 cases of liver cancer. The 10 years survival rate by Kaplan-Meier's method ranged from 39.85 for male liver cirrhosis to 80.64 for male chronic hepatitis. The results of proportional hazard model for male liver cirrhosis revealed that drinking alcohol affected negatively to the death from liver cancer, and that cigarette smoking and no history of operation due to portal hypertension affected slightly to it and that HBs antigen, history of blood transfusion and history of acute hepatitis almost have no relation to it. PMID- 2704132 TI - [A new approach to hospital-based cancer epidemiology]. AB - In order to clarify risk modifiers which affect cancer progression, as well as general risk factors, a hospital-based epidemiological study on a large scale is planned. For the first step of this study, a method of systematic data collection from all new patients who visit the Aichi Cancer Center Hospital is designed. Through such a hospital-based study, epidemiologists can play the important role in the development of both a basic study on cancer risks and an applied study on cancer prevention in cooperation with physicians and basic scientists. In the process of an advancing hospital-based epidemiological study, the important information will be built-up for the comprehensive measurement of cancer prevention for future. PMID- 2704133 TI - [Japan children's cancer registry and strategy for children's cancer epidemiology]. AB - A registry of 19,853 children with various types of cancer has been made during 1969-1984 in Japan. The advantages and methods of database control in setting up the strategy for prevention of children's cancer were described. Several procedures of statistical analysis were treated, along with the discussion of data search mode, medical record linkage technique, recent trends in medical care facilities, and study of high-risk conditions for cancer. PMID- 2704134 TI - [Evaluation of adult health program conducted by local municipalities]. AB - A method for evaluation of adult health programs conducted by local municipalities (city, town and village) is elaborated. The evaluation is made from the three view points, which are the amount, the quality and the effects of the program. Although the limitation of the method, which uses information obtained from usual activity and is not enough to demonstrate the effects of the program, it is to be worthwhile for improvement of their programs. PMID- 2704135 TI - [Malignant tumors of the ethmoid sinuses--treatment and prognosis]. AB - From 1981 to 1987, 15 cases of malignant tumors of the ethmoid sinuses were treated by radiotherapy, either with or without chemotherapy. Pathologically, these cases consisted of 7 squamous cells ca., 2 transitional cells ca., 3 anaplastic ca., 1 adenoid cystic ca., 1 malignant teratoma, and 1 rhabdomyosarcoma. The three-year survival in all cases 37%. Of eight patients determined to be in stages I and II, 4 patients had a localized relapse locally within 10 months after treatment and a distant metastases developed at a later time in 4 patients, whereas in 7 patients in stage III and IV, a distant metastases developed in 5 patients immediately after radiotherapy. PMID- 2704136 TI - [Radiotherapy of squamous cell carcinomas of the tongue--a statistical review]. AB - The cases of 36 patients referred for radiotherapy of the tongue after an excisional biopsy or after an inadequate excision of the tongue cancer have been reviewed. In 32 patients treated by radiotherapy, the actuarial survival rate at five years was 86%, and the local rate control, was 82%. The local control rate for those treated by interstitial radiotherapy (Int. RT) was successful in 12 out of 13 cases, and the rates for those treated by external radiotherapy (Ext. RT) followed by Int. RT, or by the intraoral cone technique with electron beams (Elec.), or by Ext. RT, or by Elec. followed by Int. RT, or by no additional therapy were 7 out of 9, 4 out of 5, 2 out of 4, 1 out of 1, and 2 out of 4, respectively. For such cases of cancer, subsequent interstitial radiotherapy is advisable to maintain local control. PMID- 2704137 TI - [Histopathological study of juvenile thyroid carcinoma]. AB - We have examined 12 cases of juvenile thyroid carcinoma histopathologically. The characteristics uncovered of juvenile thyroid carcinoma have been summarized below. 1) The predominant histological type was a papillary carcinoma with abundant follicular components. Which was inclined to show trabecular and solid pattern. 2) The growth pattern was highly infiltrative, showing a frequent extrathyroidal extension, a wide intrathyroid spread, and a severe involvement of the lymph nodes. 3) Many psammoma bodies were observed frequently. 4) Remarkable lymphocytic infiltration was seen in the thyroid around the tumor, and in one case it resembled chronic thyroiditis. In addition, a case of a multicentric papillary carcinoma showed unusual histological features. PMID- 2704138 TI - [An evaluation of scalene lymph node metastasis in patients with gynecologic malignancies]. AB - From 1981, through 1985, 90 patients with primary or recurrent gynecologic malignancies underwent a scalene lymph nodes (SLN) biopsy. Pelvic lymph nodes (PN) and paraaortic lymph nodes (PAN) also were examined for metastasis with CT, lymphography, and palpation or were biopsied after a laparotomy. Twenty-three of these 90 patients (25.6%) were found to have positive SLN. In 5 of these 23 (21.7%), their SLN had not been palpable on physical examination. All signs of PN, PAN and SLN were examined in 42 patients. Twenty-one of these 42 (50%) had positive PN, 14 (66.7%) had positive PAN, and 4 (28.6%) had positive SLN. Seven patients with negative PAN had no SLN metastasis. Of twenty-one patients with negative PN, 2 had positive PAN and none had an SLN metastasis. Thus, it has been concluded that an evaluation of SLN is important for the management of a gynecologic malignancy in patients with positive PAN. PMID- 2704139 TI - [Radiotherapy of a pure seminoma of the testis]. AB - Twenty-six cases of a pure seminoma of the testis that had been treated by postoperative radiotherapy have been reviewed. The overall 5-year survival rate was found to be 92.3%. Further, no severe adverse effects, including sterility, was found. Prophylactic mediastinal radiation is considered to be unnecessary, because supradiaphragmatic lymph node metastasis was seen in only 1 patient, who has remained disease-free 4.5 year after the treatment of a recurrence. Extranodal metastasis was seen 5 cases, 2 of these cases showing bone metastasis that was successfully treated, thereby achieving complete remission. A seminoma is considered to be one of the most curable malignant diseases, however, long term follow up is a necessity since stage 1 seminoma has been found to show a generalized dissemination after a 16-year, disease-free interval. PMID- 2704140 TI - [A giant cell glioblastoma--a case report]. AB - Discussed is an 8-year-old girl with a history of convulsive seizures. A sharply demarcated tumor, measuring 3 X 4 cm, was located in the right frontal lobe. The mass grey and cystic in the center, and microscopic specimen demonstrated bizarre, irregular, giant cell with a long vesicular nuclei and spindle-shaped cell. A perivascular pseudo-rosette formation also was seen, and silver impregnation revealed reticulin network and extracellular collagen fibers. The pathological entity of an intracranial giant celled glioblastoma remains controversial. This entity is considered a giant celled glioblastoma by some and a monstrocellular sarcoma by others. In this that the authors experienced, a CT scan showed a ring that formed a high density area and low density in the center at the right frontal lobe. Also reviewed and discussed are the historical aspects of a giant celled glioblastoma and radiologic problems that have been encountered. PMID- 2704142 TI - [75th meeting of the Japanese Society of Gastroenterology. 27-29 March 1989, Yokohama. Abstracts]. PMID- 2704143 TI - [29th meeting of the Japan Society of Chest Diseases. 5-7 April 1989, Kyoto. Abstracts]. PMID- 2704141 TI - [An undifferentiated carcinoma of the stomach--a report of 2 cases]. AB - Two cases of an undifferentiated carcinoma of the stomach have been investigated by conventional histologic, immunohistochemical, and ultrastructural methods. The patients were a 73-year-old man and 65-year-old man. A postoperative histological examination of the resected stomach of each patient disclosed large areas of an undifferentiated carcinoma which were relatively well demarcated from areas of the adenocarcinoma. In the undifferentiated carcinomatous areas, the reticulin fiber stain was epithelial in pattern, and mucin staining proved negative. Similarly both Grimelius and Fontana-Masson staining also negative. In like manner immunostains using cytokeratin , vimentin , IgG, IgA, s-100 protein, and NSE were all negative, and an electron microscopic study showed no neurosecretory granules or mucin secretory granules. Based on these findings, the diagnosis of either a malignant lymphoma or small cell anaplastic carcinoma could be excluded, and thus an undifferentiated carcinoma was the determination. PMID- 2704145 TI - Some things remain the same (wonderful attributes of nurses). PMID- 2704144 TI - [64th meeting of the Japanese Society for Tuberculosis. 27-28 April 1989, Osaka. Abstracts]. PMID- 2704146 TI - From there to retirement: personal view of a journey. PMID- 2704147 TI - [Surgical treatment of ununited fractures and pseudarthroses of the femoral diaphysis]. AB - The article analyses experience in the treatment of 125 patients with ununited fractures and pseudarthrosis of the humeral diaphysis by osteosynthesis with massive compressing metal plates. The possibility of creating the necessary reserve of mechanical stability at the expense of the massive plates and strained fixation allows immobilization in a plaster cast to be avoided in most cases and early motor rehabilitation of the patients to be undertaken. The results were positive in 96.8% of cases, which makes it possible to consider the method to be sufficiently effective in the management of fractures of the humeral diaphysis and their sequelae. PMID- 2704148 TI - [Arrest of parenchymal hemorrhage in surgery of the liver]. PMID- 2704149 TI - [Correction of microcirculation disorders and rheologic properties of the blood in patients with dynamic intestinal obstruction]. PMID- 2704150 TI - [Concurrent pancreatic pseudocysts in the thoracic and abdominal cavities]. PMID- 2704151 TI - [Posttraumatic cholecystitis]. PMID- 2704152 TI - [Treatment of multiple pyogenic abscesses of the liver by drainage under computed tomography control]. PMID- 2704153 TI - [Treatment of diaphyseal fractures of the humerus and the leg bones]. AB - In the period from 1983 to May, 1988 229 patients were treated at the 2nd traumatological department of the Podolsk Central Regional Hospital for fractures of the diaphyses of the humerus and leg bones. The method of shortened plaster casts and early function was used among other methods in the treatment of 48 patients. The method requires strict indications with due consideration for the degree of instability, shortens the time of hospital stay by 8-10 days and the period of general incapacity by 15-18 days, and allows the patient's residual working capacity to be put into action early. PMID- 2704154 TI - [Acute acalculous cholecystitis as a surgical problem]. AB - Experience in operative treatment of 228 patients for acute acalculous cholecystitis is analysed. This disease differs from acute calculous cholecystitis essentially in the main clinical and morphological signs. Four types of acute acalculous cholecystitis were distinguished according to origin: vascular, enzymatic, enzymatic-vascular, and obturative. The clinical forms are shown: primary vascular, emphysematous, posttraumatic, gallbladder torsion, enzymatic, obturative. It is pointed out that acute acalculous cholecystitis is characterized by rapid destruction of the cystic wall and frequent and severe involvement of the liver and bile ducts, in view of which the tactics of early operations is justified in this pathological condition. PMID- 2704155 TI - [Surgical tactics in acute cholecystitis]. AB - More active surgical tactics is recommended in acute cholecystitis, which consists in a tendency to solve the question of an emergency operative intervention in the first 24 hours after admittance to the clinic and the performance of postponed operations on the 3rd-5th day. This leads to increase of surgical activity, decrease of the frequency of complicated forms of acute cholecystitis and total and postoperative mortality and postoperative complications, and a shorter period of hospital stay. PMID- 2704156 TI - [Predicting surgical risk in acute cholecystitis]. AB - From mathematical treatment of the results of operative treatment of 163 patients with acute cholecystitis on a computer with the use of program complexes on the basis of the mathematical theory of image recognition the authors obtained a decisive rule which allowed calculation of the prognostic index reflecting the severity of the patient's condition and the prognosis of the surgical treatment according to the initial values of total protein, leucocytosis, AlAT, and the patient's age. Besides, the efficacy of the preoperative management can be judged from the dynamics of changes of the index. Development of the tactics of treatment of patients with acute cholecystitis on the basis of the prognostic index improved the results of operative treatment considerably. PMID- 2704157 TI - [Clinico-anatomical characteristics of various forms of chronic calculous cholecystitis]. AB - The authors conducted clinical and anatomical study of 207 gallbladders removed for chronic calculous cholecystitis. In 29% of cases the structural changes in the gallbladder had the character of hyperplastic and hypertrophic processes with the formation of polyps and moderate sclerosis of the wall. In 40% of cases the process showed a tendency towards sclerosis and atrophy from the very beginning. In 31% of cases the morphological changes in the gallbladder hardly differed from the controls. Comparison of the morphological changes in the gallbladder with the clinical findings made it possible to distinguish three forms of the course of chronic cholecystitis: hyperplastic, hypoplastic, and normoplastic. The authors substantiate the choice of the operative method in elderly patients according to the morphological features of this disease. PMID- 2704158 TI - [Principles of treating blood coagulation disorders in patients with obstructive jaundice]. AB - Activation of blood anticoagulative potential, fibrinolysis in particular, facilitates the development of hemorrhagic complications of obstructive jaundice. Increase of blood platelet adhesion and fibrinogen concentration and reduction of fibrinolysis are evidence of the risk of occurrence of thrombotic complications in the postoperative period. Changes in the findings of laboratory tests for blood coagulation precede the appearance of clinical signs of complications as a rule. The use of protease inhibitors in hemorrhages is an essential supplement to the scope of measures of hemostatic therapy and increases its efficacy significantly. This method was used for treating 28 patients with hemorrhagic complications of jaundice among 96 patients suffering from hemocoagulation disorders caused by prolonged obstruction of the bile tract. PMID- 2704159 TI - [Acute peptic lesions of the gastroduodenal mucosa in patients with obstructive jaundice]. AB - Complex study of the gastric acid-producing activity, the condition of the gastroduodenal mucosa, and the serum gastrin concentration in 80 patients with obstructive jaundice showed that the appearance of acute erosive-ulcerative injuries of the mucosa of the gastroduodenal zone depended on the increase of activity of the peptic factor of the gastric medium. Peptic complications occurred in 27.1% of patients with initial normo and hyperacidity and a high level of blood gastrin. The absence of bile in the duodenum (obstructive jaundice, by-pass biliodigestive anastomoses) stimulated the peptic factor. This is evidently linked with secretin deficiency (absence of the effect of bile on the secretin producing S-cells) leading to weakened inhibiting effect of secretin on the serum gastrin content, which results in hypergastrinemia and hyperacidity. PMID- 2704160 TI - [Transduodenal sphincteroplasty]. AB - Transduodenal sphincteroplasty was carried out in 237 (24%) of 1002 patients subjected to planned and emergency primary operations for benign lesions of the bile tracts and in 50 (58%) of 86 patients who were operated on for a second time. On the whole, 287 operations for sphincteroplasty accounted for 63% of operations on the hepaticocholedochus. The indications for transduodenal sphincteroplasty (TDSP), its techniques, specific complications, and mortality are discussed on the basis of retrospective analysis of the clinical material. Nineteen patients (6.6%) died after the operation, 11 of them due to a severe initial condition and unspecific postoperative complications. Specific complications were registered in 22 patients and were the cause of death in 8 of them. The author suggests an improved TDSP method which reduces the risk of the occurrence of technical errors and postoperative complications. It is concluded that TDSP is expedient and necessary in choledocholithiasis and stenosis of Oddi's sphincter. PMID- 2704161 TI - [Surgical tactics in injury of the bending surface of the forearm]. PMID- 2704162 TI - [External biliary fistulae following surgery of the bile ducts]. AB - Twenty-nine patients with external biliary fistulae were under observation. In 22 cases the formation and functioning of the fistula was caused by obstruction of the flow of bile into the intestine. The abdominal cavity was drained in the acute stage, and then, after the formation of the fistula was concluded and the general condition normalized, its source was removed. In addition to liquidation of the fistula for removal of the cause of biliary hypertension, choledochoenteroanastomosis was established in 4 patients and various manipulations on the papilla were performed in 16 patients. PMID- 2704163 TI - [Endoscopic removal of calculi from the gallbladder in acute cholecystitis]. AB - The authors discuss the results of endoscopic removal of concrements from the gallbladder of 18 patients with acute cholecystitis through a gallbladder fistula established by operation or after drainage with a wide catheter during laparoscopy. Endoscopic manipulators were used for removal of the concrements, small stones were removed by forced washing off, large concrements were crushed by means of the "Urat-I" device. The concrements were removed in all cases. Recurrent attacks of acute cholecystitis were not registered for a period of one year. The method of fistulocholecystoscopy is described. Therapeutic fistulocholecystoscopy makes it possible to abandon the performance of the traditional operative interventions in patients suffering from severe concomitant diseases. PMID- 2704164 TI - [Intra-arterial therapy in the combination therapy of acute pancreatitis]. AB - The article discusses the results of endovascular therapy (ET) in 92 patients with various forms of acute pancreatitis. ET was conducted without operative treatment, in preparation for operation, and in the postoperative period. Ten patients were subjected to direct hypothermia by intraarterial infusion of cooled solutions. Bi-arterial catheterization of the aortic branches was performed for higher efficacy of the management of acute pancreatitis and prevention of its complications. The inclusion of ET in the complex of therapeutic measures for acute pancreatitis led to a fall of pancreonecrosis lethality from 54% to 25%. PMID- 2704165 TI - [Early diagnosis of acute pancreatitis]. AB - The article discusses clinical experience of the Sklifosovsky Emergency Ambulance Service Institute in establishing early diagnosis of acute pancreatitis in the last decade. Over 3,000 patients were examined; they were admitted to the Institute for acute pancreatitis the diagnosis of which was made according to the program of complex diagnosis at the stage of the admission department and during the first three days of the hospital stage. The decisive role in establishing the diagnosis is attached to the clinical manifestations, medical history, amylasuria, and obligatory radiological and ultrasonographic examination (USE). The characteristic radiological and ultrasonic signs of various forms of acute pancreatitis are described. Radiological pleuro-pulmonary signs were found in 15.1% of patients with the edematous and in 42% of those with destructive pancreatitis. Specific indirect signs during radiography of the abdominal organs were registered in almost 80% of cases of acute pancreatitis. Informativeness of USE in acute pancreatitis was 95.4%, and it also made it possible to identify the clinico-morphological form of the disease. It is emphasized that USE must be undertaken in the first hours of the patient's admittance to the clinic. The suggested complex program of early diagnosis may be used in essence in all emergency ambulance service hospitals. PMID- 2704166 TI - [Non-clostridial anaerobes in the etiopathogenesis of perivesical cholangiogenic abscesses of the liver]. AB - The authors had under observation 318 patients who were subjected to operation and suffered from various inflammatory diseases of the bile tract; perivesical and cholangiogenic abscesses of the liver were found in 33 of them. Bacteriological tests of the contents of the abscesses demonstrated most frequently the presence of Bacteroides fragilis as a monoculture in cholangiogenic abscesses and associations of anaerobic and aerobic bacteria in perivesical abscesses. Early operation with obligatory consideration for the anaerobic component of the microflora is recommended. PMID- 2704167 TI - [Diagnosis and treatment of liver injuries and their sequelae]. AB - The authors studied 222 cases of closed and open injuries to the liver and, in addition, had 5 patients who were treated for sequelae of injury (hemobilia, abscesses, biliary fistula of the liver). The diagnosis of open injuries to the liver is established without great difficulties; laparocentesis and laparoscopy are indicated in closed injury. The volume of the operation is determined by the character of the damage: closure of the hepatic wound proves sufficient in most patients; surgical debridement is necessary in deep extensive wounds; resection of the liver is resorted to in disturbed blood supply. The high postoperative mortality rate is due to the fact that 71.8% of patients had concurrent injuries of the liver, other abdominal organs, organs of other cavities, central nervous system, and the locomotor apparatus. PMID- 2704168 TI - [The effect on the liver of a semiconductor IR laser with a constant magnetic field]. AB - Comparative appraisal of the effect of repeated percutaneous action of semiconductor IR-laser, magnetic field, and a combination of these two factors on the liver showed metabolic changes to be sharply manifest in the first 10 days after exposure to the different variants of action. After 20 irradiation sessions the metabolic changes were less manifest and became stabilized in subsequent irradiation of the animals, which may probably be attributed to certain adaptation of the hepatic tissue to the prolonged effect of the factor. The distinguishing feature of the magnetic-laser effect was an increase of the main substrates of energy metabolism (glucose and lipids) and a stable malonic dialdehyde content with a predominant tendency towards neutralization of free radical reactions. All this justifies the experimental substantiation of the necessity of using a semiconductor IR-laser with a constant magnetic field for correcting metabolic disorders associated with hepatic insufficiency. PMID- 2704169 TI - [Contraindications to splenectomy in primary total extrahepatic portal hypertension]. AB - The authors studied changes of hepatic circulation, hepatoportal hemodynamics, and homeostasis of peripheral and portal venous blood in response to removal of the spleen in primary total extrahepatic portal hypertension. The findings of rheohepatography, isotope hepatography, and ultrasonic flow measurement provided proof that splenectomy does not lead to intensification of the flow of arterial blood to the liver. Study of the portal pressure level did not demonstrate any significant hypotensive effect of splenectomy. Considerable changes occur after removal of the spleen, which creates real preconditions for the development of portal system thrombosis. All the above-said provides the basis for reducing considerably the range of indications for splenectomy and recommending it only in cases with marked clinical manifestations of hypersplenism hemolysis and increased tendency to bleeding. PMID- 2704170 TI - [Immunoreactivity in cholelithiasis and its correction in the prevention of postoperative complications]. PMID- 2704171 TI - [Lavsan ligatures as the cause of choledocholithiasis following resection of the stomach]. PMID- 2704172 TI - [Cryodestruction of the pancreas by abdominal approach in acute destructive pancreatitis]. PMID- 2704173 TI - [Diagnosis and differential diagnosis of heart tumors in infancy and childhood]. AB - The clinical features of 10 children, in whom the diagnosis of a cardiac tumor has been made, are reviewed. There were nonspecific systolic murmurs in 9 patients, depression of the S-T segment in the ECG of 7 children, and premature extrasystoles or supraventricular tachycardia in 4 children. X-ray always showed mild to moderate enlargement of the heart, but an abnormal contour could be detected only in 2 of the patients. While findings of cardiac catheterization were unspecific, the diagnosis could be made angiographically in 8 cases. Invasive studies, however, are now only indicated, if a proper diagnosis cannot be made by means of echocardiography. The diagnosis should be suspected in children with a nonspecific murmur, cardiomegaly and ECG-changes. Usually the diagnosis of a cardiac tumor is an indication for operation. PMID- 2704174 TI - [A rare combination: persistent ductus arteriosus and pulmonary stenoses. Is there a correlation with rubella embryopathy?]. AB - The combination of patent ductus arteriosus, valvular pulmonary stenosis and/or peripheral pulmonary stenosis is very rare. We examined 23 children with this entity. In 9 children there were findings suggestive of rubella syndrome. 17 of the 23 children were born predominantly between October and March. Most of them showed low birth weights. Regarding the cardiac involvement there was no difference between the children with signs of rubella syndrome and those without noncardiac manifestations. In many children the symptoms of the patent ductus are leading. On evaluation of the noninvasive diagnostic procedures the ECG showed often a right ventricular hypertrophy and the x-ray of the chest showed in most cases a cardiac enlargement. In all patients a heart catheterization was necessary to establish the diagnosis. The review of the literature and the interpretation of our findings seems to suggest that the combination of a patent ductus arteriosus with pulmonary stenosis is a typical manifestation of rubella infection in the heart. PMID- 2704175 TI - [Coronary aneurysm in Kawasaki syndrome: incidence and prognosis]. AB - Out of 10 pediatric patients with coronary aneurysms after Kawasaki-syndrome 9 were reinvestigated 1 to 9 years after their initial illness. Out of 21 aneurysms of all types and sizes 2 showed early and 1 late, silent thrombosis leading to myocardial infarction. 8 aneurysms regressed spontaneously and another 8 became smaller. The tendency to regress or to decrease in diameter war greatest in the group of patients with a low Asai-Score and initially small aneurysms. Myocardial infarction was only seen in the group of giant aneurysms (over 8 mm of diameter). A simple prophylaxis with anti-platelet agents does not seem to be adequate especially in over-sized aneurysms. Those should be prevented now by gamma globulin therapy. If they occur, however, thrombosis should be prevented by the use of anticoagulants. PMID- 2704176 TI - [Anthracycline transport in sensitive and resistant leukemia cells]. AB - The in-vitro uptake of four anthracyclines into leukemic cells was investigated. The accumulation was found to be dependent on the extracellular anthracycline concentration in a linear fashion. The steady state intracellular drug level was reached very quickly and was found to be correlated to the extracellular pH-value in the range between 6.4 and 7.4. Intracellular anthracycline accumulation was restricted in a leukemic subline (F 4-6 R), which was found to be 86 times more resistant to doxorubicin compared with its wild tpye (F 4-6). The importance of the initial uptake phase of anthracyclines into leukemic cells raises the question whether long-term "cardioprotective" anthracycline application schedules will retain the same antileukemic effect as conventional bolus injection. PMID- 2704177 TI - [Sex behavior in puberty]. AB - The increasing number of Aids cases raises questions as to the risks to which young people are exposed. The present study attempts to illustrate the psychological development of sexuality during puberty. Taking development psychological and depth-psychological aspects into account, the author attempts to throw light on the development of the ego and the instinctual and defensive behavior of young people. These intrapsychic constellations and social norms have a major influence on young people's sexual behavior. PMID- 2704178 TI - [Ewing's sarcoma of the rib]. AB - In addition to eosinophilic granuloma, chondroma, osteochondroma, aneurysmatic bone cyst, and osteomyelitis, the differential diagnosis of primary costal tumors in children must also include Ewing's sarcoma. Radiologic diagnostic problems in localizing the tumor, in differential diagnosis, and the importance of imaging procedures are discussed with reference to a 16-year-old female patient. PMID- 2704179 TI - [Unilateral lung aplasia--on the danger of diagnostic-therapeutic erroneous assessment. A case report]. AB - A 6 month old infant with recurrent respiratory infections showed a strange chest x-ray film. After axial CT of the chest and bronchoscopy the diagnosis of aplasia of the right lung was established. The case report illustrates the high risk of malpractise in patients suspected of hypogenetic lung syndrome. PMID- 2704180 TI - Ethical issues in research and publication. AB - Ethical considerations inherent in the process of research and publication represent one issue of particular concern to professionals. Members of a profession usually are guided by a code of ethics that specifies standards for practice. However, rarely do professional preparation programs sufficiently prepare students to deal with the concerns associated with research and professional publication. The authors address three specific areas of concern for health educators: the student-professor relationship, joint authorship, and ethics in publishing. Potential problems are discussed, and implications for the profession are cited. PMID- 2704181 TI - Instrument validity and reliability in three health education journals, 1980 1987. AB - Investigators examined how often validity and reliability measures were reported for research articles in three health education journals: Health Education, Health Education Quarterly, and the Journal of School Health. Articles published from 1980 to 1987 were considered in the analysis. Of the 611 articles published by Health Education during the period used for analysis, 128 (21%) met the criteria of a research article. Reliability was reported for 22 (17%) articles, and validity was reported for 78 (61%) articles. Health Education Quarterly published 212 articles; 74 (35%) were research articles. Reliability was reported for 16 (21%) articles and validity was reported for 40 (54%) articles. The Journal of School Health published 778 articles, of which 243 (31%) were research articles. Reliability was reported for 62 (25%), and validity was reported for 164 (67%) of the research articles. A chi-square test found a significant difference among the number of research articles published by the journals. Chi square tests also found significant differences among the journals in the proportion of research articles that reported reliability information and the proportion that reported validity. A significant trend was noted for Health Education Quarterly and the Journal of School Health; the proportion of research articles that reported validity and reliability increased over time for both publications. PMID- 2704182 TI - Toward some principles of school nursing. AB - An examination of the school nursing role based on four principles covering provision of health care, the nurse as a source of knowledge, the school as a health promoting community, and a team approach which acknowledges parents as partners is presented. PMID- 2704183 TI - Attitudes, knowledge, and beliefs as predictors of exercise intent and behavior in schoolchildren. AB - Physical education programs represent an important gateway for encouraging young people to develop life-long exercise habits. In this study of middle school students (N = 603), attitudes toward physical education, knowledge about the benefits of exercise, and beliefs about one's abilities were assessed to determine their influence on exercise intent and current exercise behavior. As predicted, perceived benefits of exercise, current exercise behavior, attitudes toward physical education, self-esteem, and gender contributed significantly and independently to exercise intent (total variance explained = 37%). Exercise intent, outside sports activities, perceived benefits of exercise, gender, and attitudes toward physical education contributed significantly and independently to current exercise behavior (total variance explained = 27%). Programs that make attending physical education a pleasant experience and that explain specific benefits of exercise can influence exercise intent and can enhance students' sense of self-esteem, both of which may increase future exercise behavior. PMID- 2704184 TI - Do warning labels on alcoholic beverages deter alcohol abuse? PMID- 2704185 TI - Fine-grained auditory discrimination in normal children and children with language-learning problems. AB - Two large groups of children--one progressing normally in school and the other exhibiting language-learning problems--were tested on a set of fine-grained auditory discrimination tasks that required responding to small acoustic differences. Discriminant analysis procedures, using only results for the auditory tasks, correctly classified nearly 80% of the 6- and 7-year-olds and nearly 65% of the 8- to 11-year-olds according to their school placements. Percentages of correct classifications increased to 87% and 75% when measures of receptive vocabulary (PPVT-R), receptive language (the Token Test for Children), and the Digit Span, Coding, and Block Design subtests of the WISC-R were also included in the discriminant functions. Results suggested that fine-grained auditory discrimination makes a major contribution to language learning, particularly in the early elementary school years. PMID- 2704186 TI - Early speech production of children with cleft palate. AB - Word-initial target phonemes and the production of those phonemes were examined in normal children and children with cleft palate during the period when the children were acquiring their first 50 words. As a group, the children with cleft palate tended to target more words with word-initial nasals, approximants, and vowels ([ +sonorant] phonemes) and fewer words with word-initial stops, fricatives, and affricates ([-sonorant] phonemes). Normal children tended to target more words with initial consonants articulated in the center of the oral tract ([+coronal]) and the children with cleft palate targeted more words with initial phonemes articulated at the periphery of the oral tract ([-coronal]). The same patterns also were observed in production, but individual children with cleft palate did not always follow this pattern. Although the accuracy of the productions of individual children appeared to be related to word choice, factors such as hearing sensitivity, structural adequacy, and the timing of surgical repair also might have affected speech production accuracy. PMID- 2704187 TI - The emergence of phonetic segments: evidence from the spectral structure of fricative-vowel syllables spoken by children and adults. AB - A variety of evidence, including the speech errors of normal and aphasic speakers, and the metalinguistic skills of literate individuals, demonstrates that speech has an underlying phonemic organization. However, we know little about how this organization develops in the child. The purpose of the present study was to test the hypothesis that phoneme-sized phonetic segments emerge as functional units of perceptuomotor control from the child's gradual reorganization of the gestures forming its early words or syllables. We investigated the acoustic structure of syllables produced by young children and adults. Fricative-vowel syllables spoken by 40 subjects (eight adults and eight children at each of the ages 3, 4, 5, and 7 years) were analyzed acoustically to determine how well different syllables-initial fricatives were contrasted and how strongly they were affected by vocalic context. Results indicated two independent developmental trends: The extent to which speakers differentiated between /integral of/ and /s/ increased with age, while the extent to which they coarticulated each fricative with its following vowel decreased. The results support the hypothesis that children initially organize their speech gestures over a domain at least the size of the syllable and only gradually differentiate the syllable into patterns of gestures more closely aligned with its perceived segmental components. PMID- 2704188 TI - Frequency discrimination ability and stop-consonant identification in normally hearing and hearing-impaired subjects. AB - Identification of place of articulation in the synthesized syllables /bi/, /di/, and /gi/ was examined in three groups of listeners: (a) normal hearers, (b) subjects with high-frequency sensorineural hearing loss, and (c) normally hearing subjects listening in noise. Stimuli with an appropriate second formant (F2) transition (moving-F2 stimuli) were compared with stimuli in which F2 was constant (straight-F2 stimuli) to examine the importance of the F2 transition in stop-consonant perception. For straight-F2 stimuli, burst spectrum and F2 frequency were appropriate for the syllable involved. Syllable duration also was a variable, with formant durations of 10, 19, 28, and 44 ms employed. All subjects' identification performance improved as stimulus duration increased. The groups were equivalent in terms of their identification of /di/ and /gi/ syllables, whereas the hearing-impaired and noise-masked normal listeners showed impaired performance for /bi/, particularly for the straight-F2 version. No difference in performance among groups was seen for /di/ and /gi/ stimuli for moving-F2 and straight-F2 versions. Second-formant frequency discrimination measures suggested that subjects' discrimination abilities were not acute enough to take advantage of the formant transition in the /di/ and /gi/ stimuli. PMID- 2704189 TI - Effects of age on comprehension of complex sentences in adulthood. AB - This study was designed to determine effects of aging on comprehension of complex sentences. In particular, we were interested in whether normal aging modifies a subsystem of comprehension (i.e., syntactic or semantic) or places unusual demand on working memory related to the distance between constituents that must be integrated. Five age-defined groups of healthy adults were asked questions about thematic roles of nouns in sentences with center-embedded or right-branching subordinate clauses. Results indicated that comprehension accuracy declines after age 60. Although aging did not affect the semantic component, it did affect the syntactic component when evaluated with sentences representing implausible events. There appeared to be an effect of distance between constituents in the 70s decade that was not related solely to embedding of a subordinate clause. Instead of affecting a single component of the language system, normal aging may have an impact on interactions between components. PMID- 2704190 TI - Effects of transition length on the perception of stop consonants by children and adults. AB - The purpose of this investigation was to determine whether children with normal linguistic skills demonstrate increasing developmental changes in their perception of place of articulation for stop consonants with short- and long duration formant transitions. Three experimental paradigms were used with children and adults: discrimination, labeling, and selective adaptation. Two sets of synthetic CV syllables, varying along a seven-step, bilabial-to-alveolar dimension, were used as stimuli. These two synthetic continua differed in the length of the second and third formant transitions. Results showed that children's discrimination abilities gradually approximated those of adults, but did not reach adult levels even at 10 years of age. Differences were not observed in the labeling task. Further, results of the selective adaptation task indicated that only the adult subjects showed a significant boundary shift for any adapting stimuli. The absence of selective adaptation in children was interpreted as a possible reflection of their poorer auditory abilities. Thus, the pattern of speech perception development for children for place of articulation is a complex one with a strong auditory developmental component. PMID- 2704191 TI - Laryngeal configuration and constriction during two types of whispering. AB - Laryngeal functioning during the production of whispered speech is not well understood. The efficacy of whispering as a means of voice rest is a common clinical concern that is unresolved. This investigation examined vocal-fold configuration, glottal size, and airway constriction by supraglottal structures during whispering. Ten normally speaking adults produced consonant-vowel syllables with three different vowels while whispering in low-effort and high effort manners. The larynx was visualized through fiberoptic endonasolaryngoscopy, and the views were recorded on videotape. Analysis and descriptions of the data revealed that low-effort and high-effort whispering were differentiated to a small extent by vocal-fold adjustments and to a somewhat larger degree by supraglottal constriction. However, for each dependent variable, individual subject differences tended to be considerably larger than any systematic effects due to whisper type or vowel. PMID- 2704192 TI - Effects of decision variables on stimulus dominance in dichotic listening. AB - Stimulus dominance occurs when one member of a dichotic pair is identified more accurately than the other member. The contribution that attentional factors, listener biases, and other nonsensory variables make to stimulus dominance was assessed by comparison of scores obtained in a conventional two-ear monitoring task with scores obtained in a yes/no target-monitoring task. The target monitoring paradigm is an application of signal detection theory to dichotic listening that allows calculation of d', a measure of perceptual sensitivity. Patterns of dominance for the two paradigms were very similar, which indicates that nonsensory factors had little influence in determining those patterns. PMID- 2704193 TI - Input stimuli for obtaining frequency responses of automatic gain control hearing aids. AB - Developing a family of frequency response curves for AGC types of hearing instruments using swept pure tones at varying input levels often produces erroneous results. This problem is caused by exceeding the threshold for activating the AGC circuit at some frequencies but not at other frequencies during the pure-tone sweep, thereby producing a different frequency response from that which would be obtained with a complex input signal such as speech-shaped noise. This measurement artifact may be minimized by ensuring that the threshold for activating the AGC circuit is either always exceeded or never exceeded during the development of a frequency response curve. Three input signals are compared for developing a family of frequency responses for an AGC hearing aid: (1) swept pure tone, (2) swept pure tone with bias tone added, and (3) shaped broad-band noise. The shaped broad-band noise appears to be the input signal of choice. PMID- 2704194 TI - Using simultaneous photodetection and nasometry to monitor velopharyngeal behavior during speech. AB - The purposes of this investigation were (a) to study the temporal relationships among velopharyngeal closing and opening maneuvers monitored by phototransduction and the onset and offset of Nasometer output signals and (b) to determine the extent to which photodetector output maxima are correlated with output peaks from the Nasometer when both are used simultaneously to monitor nasal productions among normal speakers. Simultaneous Nasometer and photodetector data were collected from 6 normal adult subjects as they produced 6 repetitions of 10 sentences. A major finding of this study was that over 96% of the 540 nasal utterances studied produced Nasometer and photodetector signal maxima that were within 30 ms of one another. The results of this study also suggest that simultaneous nasometry and photodetection may provide useful information concerning the temporal relationships among various velopharyngeal movements and the onset and offset of speech as indicated by output signals from the Nasometer. The potential use of this procedure with clinical patients is discussed. PMID- 2704195 TI - Rhyme generation by deaf adults. AB - Congenitally deaf college students were asked to generate rhymes to 50 target words. Results of the investigation indicate that it is possible for deaf individuals to develop the sensitivity to the phonologic structure of the words necessary for rhyming: Approximately half of the responses generated correct rhymes. Of these correct rhymes, the majority were orthographically similar to their target (c.g., BLUE-glue and TIE-lie), although 30% were orthographically dissimilar to their targets (e.g., BLUE-through and TIE-sky), indicating an ability to generate rhymes independent of orthographic structure. Errors were analyzed in an attempt to determine the basis on which the subjects generated rhymes. Evidence of both orthographic and speech-related strategies were obtained. PMID- 2704196 TI - Technical considerations in computation of spectral harmonics-to-noise ratios for sustained vowels. AB - This paper explores technical issues affecting computed measures of the relative level of noise in the frequency spectrum of a vowel. This type of measure has been proposed for quantification of hoarseness in pathological speakers. An analysis of synthesized vowels was used to test the influence of vowel type, fundamental frequency, perturbation type, perturbation level and quantization. The algorithms were shown to be highly sensitive to errors in pitch-period demarcation, and a dependency on jitter perturbations, fundamental frequency, and vowel type was demonstrated. Relationships between algorithm performance and methods of spectrum estimation were discussed, and approaches for reducing the dependencies were proposed. Finally, a method for achieving a significant reduction in computation time was described. PMID- 2704197 TI - A response to Gierut, Elbert, and Dinnsen (1987), "A Functional Analysis of Phonological Knowledge and Generalization Learning in Misarticulating Children". PMID- 2704198 TI - Evaluation of the Siemens Minifonator vibrotactile aid. AB - The Siemens Hearing Instruments Minifonator, a single-channel, wrist-worn vibrotactile aid, was evaluated in a laboratory setting with hearing-impaired adults. Eight subjects, with hearing loss greater than 70 dB in the better ear, were administered a test battery including sound-field detection, speech awareness threshold, environmental sound identification, syllable rhythm and stress categorization, and sentence identification subtests. Performance on each subtest was compared for hearing-aided and tactile-aided conditions. Mean performance levels for the two conditions were comparable for all but one subtest. However, closer inspection revealed that the data for the hearing-aided condition were bimodal: some subjects proved to be good hearing aid users and other performed at chance levels with their hearing aids. Performance in the tactile-aided conditions did not show such variability and mean levels fell between the hearing-aided levels for "good" and "poor" hearing aid users. The effects of training with the device were assessed for two normal-hearing subjects, who were trained in 1-hour daily sessions over a several week period on the environmental sounds and syllable rhythm and stress subtests. Results indicated substantial improvements in performance over the course of training. The implications of these results for long-term use of the device are discussed. PMID- 2704199 TI - Dimensional thinking in language impaired children. AB - This study investigated the dimensional knowledge evidenced by language impaired (LI) preschoolers. Ten LI and 10 language normal (LN) children, aged 3:6 to 5:9, were asked to solve verbal and nonverbal problems requiring color and size judgments. There were no group differences on the verbal task, but the LI children performed less well than the LN children on the nonverbal task. Much of this difference stemmed from their difficulty with size items. The ordinal nature of the size dimension implies greater cognitive processing demands than are inherent in nominal dimensions such as color. Given the known processing limitations of language impaired children, this complexity apparently can lead to erroneous judgment even when requisite knowledge is present. It may also contribute to delays in the initial construction of dimensional knowledge. PMID- 2704200 TI - An analysis of velopharyngeal timing in normal adult speakers using a microcomputer based photodetector system. AB - Using a microcomputer interface and dedicated software, a photodetector was employed to collect data on the timing of velopharnygeal movements during the production of speech by 10 normally speaking adult subjects. The duration of velopharnygeal closing gestures varied consistently across productions of /m/, /n/ and /n/ in both normal and fast speech. Velopharyngeal opening movements also appeared to be affected by the nasal consonant that was produced. These phenomena are explained in terms of biomechanical constraints known to act upon the velopharyngeal mechanism. PMID- 2704201 TI - The relation between vowel recognition and measures of frequency resolution. AB - The purpose of this study was to employ measures of frequency resolution obtained from individual subjects to predict each subject's vowel recognition performance. Input filter patterns at six test frequencies were obtained from normal-hearing and hearing-impaired subjects. These patterns were used to correlate frequency resolution with vowel recognition in those same subjects. Vowels were presented at levels at which the entire spectrum was fully audible to each subject. Using each subject's measured filter characteristics (and interpolated values for intermediate frequencies), an "internal spectrum" of each vowel was calculated by determining the outputs of all filter channels for the vowel as the input signal. It was speculated that the more similar two internal spectra for a subject were, the more often they would be confused in the vowel recognition task. This expectation received some support when the measure of similarity was a point-by point Euclidean distance between the two internal spectra. Stronger support was obtained when the measure of similarity was based upon Klatt's (1982) "weighted slope metric" that emphasizes similarities of spectral peak locations. The present study demonstrates a relation between impairments of frequency resolution and vowel recognition. The described filter-bank model of vowel recognition suggests that measures of frequency resolution along with the acoustic spectra of vowel stimuli may be useful in predicting the recognition of vowels by individuals. PMID- 2704202 TI - Idiom interpretation in isolation versus context: a developmental study with adolescents. AB - Idiom interpretation under two different presentation modes, Isolation and Context, was examined developmentally in 475 adolescents ages 14 through 17. Results demonstrated that accuracy was greater for idioms in Context than idioms in Isolation, and that accuracy for both presentation modes slowly improved during the target age range. However, even the oldest subjects had not yet mastered the task in either mode. Qualitative analysis indicated that No Response, Literal, and Unrelated error types were produced most often by the youngest subjects but tended to decrease as subject age increased. In general, more No Response, Literal, Related, and Unrelated error types were produced for idioms in Isolation than in Context, but more Restatement errors were produced for idioms in Context. It was also found that idiom interpretation was significantly correlated to specific measures of literacy in 16-year-olds. PMID- 2704203 TI - The oral syntactic proficiency of learning disabled students: a spontaneous story sampling analysis. AB - A comprehensive analysis of syntactic complexity was performed on spontaneously generated oral stories obtained from 93 learning disabled (LD) and normally achieving (NA) students, 14 to 16 each at 8:0-9:11 (years:months), 10:0-11:11, and 12:0-13:11 age levels. Syntactic complexity was measured using a structural constituent analysis and a T-unit analysis. In direct contrast to the extant LD literature, the results revealed almost identical rates of correct usage and extremely similar patterns of usage between the LD and NA subjects on all measures. Post-hoc analyses indicated that three syntactic structures were used by a significantly greater percentage of NA subjects than LD students. The significance of these findings is discussed with respect to: (a) previous and current characterizations of syntactic abilities of LD students; and (b) the importance of differentiating between statistical and clinical significance for the meaningful interpretation of research data. PMID- 2704204 TI - Direct magnitude estimation and equal appearing interval scaling of vowel roughness. AB - Direct magnitude estimation (DME) and equal-appearing interval (EAI) ratings of the perceived roughness of isolated sustained vowel samples (/a/ and /i/) were obtained. The linear and curvilinear relationship between the resulting EAI and DME ratings was then examined. That relationship was found to be more strongly curvilinear than linear, a characteristic of a prothetic continuum. The amount of variance accounted for by a curvilinear model of the relationship, however, was minimally more than that accounted for by a linear model. The findings thus suggest that the roughness continuum manifests no more than "a little" protheticness, if any. It does not seem clear from this initial study that there is greater validity associated with roughness ratings obtained by the DME than the EAI method. Rather, the findings suggest that a small degree of such advantage may exist, but it may be too small to be of practical consequence in many instances. PMID- 2704205 TI - Comparison of two single-channel vibrotactile aids for the hearing-impaired. AB - Two commercially available single-channel vibrotactile aids, designed to transmit information about acoustic stimuli to persons who cannot perceive such stimuli through conventional amplification, were compared in a number of tasks with the same subjects. Both devices employed a vibratory transducer worn on the wrist. One device represented characteristics of the envelope of the waveform by using it to modulate the amplitude of a 250-Hz carrier vibration (an amplitude modulated, or AM, signal). The other device presented and amplitude-modulated a broad-band signal whose spectral characteristics preserved information about the signal. Subjects performed several tasks. On some tasks (sound detection, environmental sound identification, syllable rhythm and stress categorization) information about the envelope of the stimulus was expected to be sufficient for good performance. On others (speech sound recognition) additional information about the spectral fine structure of the signal spectrum was anticipated to be required for good performance. Results indicated that the subjects performed comparably with both devices on all tasks, suggesting that they did not make use of the spectral information available in the more complex signal. PMID- 2704206 TI - Prosodic and segmental aspects of speech perception with the House/3M single channel implant. AB - Four adult users of the House/3M single-channel cochlear implant were tested for their ability to label question and statement intonation contours (by auditory means alone) and to identify a set of 12 intervocalic consonants (with and without lipreading). Nineteen of 20 scores obtained on the question/statement task were significantly better than chance. Simplifying the stimulating waveform so as to signal fundamental frequency alone sometimes led to an improvement in performance. In consonant identification, lipreading alone scores were always far inferior to those obtained by lipreading with the implant. Phonetic feature analyses showed that the major effect of using the implant was to increase the transmission of voicing information, although improvements in the appropriate labelling of manner distinctions were also found. Place of articulation was poorly identified from the auditory signal alone. These results are best explained by supposing that subjects can use the relatively gross temporal information found in the stimulating waveforms (periodicity, randomness and silence) in a linguistic fashion. Amplitude envelope cues are of significant, but secondary, importance. By providing information that is relatively invisible, the House/3M device can thus serve as an important aid to lipreading, even though it relies primarily on the temporal structure of the stimulating waveform. All implant systems, including multi-channel ones, might benefit from the appropriate exploitation of such temporal features. PMID- 2704207 TI - Automated analysis of prerecorded evoked electromyographic activity from rat muscle. AB - An automated microprocessor-based data acquisition and analysis system has been developed specifically to quantify electromyographic (EMG) activity induced by the convulsant agent catechol in the anaesthetized rat. The stimulus and EMG response are recorded on magnetic tape. On playback, the stimulus triggers a digital oscilloscope and, via interface circuitry, a BBC B microcomputer. The myoelectric activity is digitized by the oscilloscope before being transferred under computer control via a RS232 link to the microcomputer. This system overcomes the problems of dealing with signals of variable latency and allows quantification of latency, amplitude, area and frequency of occurrence of specific components within the signal. The captured data can be used to generate either signal or superimposed high resolution graphic reproductions of the original waveforms. Although this system has been designed for a specific application, it could easily be modified to allow analysis of any complex waveform. PMID- 2704208 TI - Coefficient of static friction at pig femoral osteotomies: the role of anatomic reduction and compression on the value of the coefficient. AB - The coefficient of static friction for pig femora following an osteotomy has been determined in vitro. It was found that the coefficient had a value of 0.46 +/- 0.05, and that this was independent of the reduction force applied to the osteotomy site, provided there was good anatomical reduction. When the osteotomy was not anatomically reduced, the coefficient of friction varied in a linear manner with the applied reduction force. PMID- 2704209 TI - Instrumented implants in orthopaedics. AB - This brief paper discusses the need for instrumentation in orthopaedic implants, and examines areas for further research and development. It is suggested that the future of this technology may have major clinical applications. PMID- 2704210 TI - Flexible device for vertebral body replacement. AB - A novel vertebral prosthesis is presented. The prosthesis was developed for surgical procedures requiring the resection of a complete vertebral body and the adjacent intervertebral discs, the design objective being to develop a flexible implant that would be robust enough to withstand the in vivo stress environment of the human spine. In theory, a flexible implant should preserve a more normal range of motion and apply less stress to surrounding tissue than a rigid implant. A prototype implant was constructed so as to combine a rigid stainless steel structure with flexible silicon rubber elements in order to form an implant with static and dynamic mechanical characteristics similar to those of the anterior spinal column. Implant flexibility characteristics were determined from ex vivo stress-strain behaviour during bending and compressive creep testing. Results from the bending tests indicated good agreement for the lateral and sagittal bending characteristics in comparison with in vitro bending tests of human lumbar motion segments. Comparison of the implant compressive creep response with similar in vitro tests on human lumbar intervertebral discs also demonstrated similarities in the time-dependent mechanical parameters. PMID- 2704211 TI - Measurement of fracture movement in patients treated with unilateral external skeletal fixation. AB - Axial movement occurring at the fracture site has been determined in a group of healing tibial fractures treated by external skeletal fixation. Fracture movement was determined via a strain gauge transducer which was attached to the column of the external fixator and measured the deflection of the bone screw adjacent to the fracture site and the active loading or weight bearing given by the patient to the fractured limb was monitored using a force platform. The results for 27 subjects show that, with a rigid unilateral fixator, the axial movement occurring at the fracture site was initially small (mean = 0.28 mm at 5 weeks post fracture). This movement increases to reach a mean maximum value of 0.43 mm at 11 weeks post-fracture and then decreases, despite increased weight bearing, as fracture healing progresses. In the early stages of healing, the movement can be increased slightly if the fixator is fitted with a module which permits additional fracture site movement, although the resultant increase in movement is only a small proportion of the potential available with this module. PMID- 2704212 TI - Proximal femoral surface strain gauge analysis of a new epiphyseal prosthesis. AB - This paper describes a new type of proximal femoral, replacement arthroplasty and its preliminary, pre-clinical, evaluation. The prosthesis was designed as a replacement for the femoral capital epiphysis. It comprises a thin, metal, articular shell and an underlying 'epiphyseal' replacement which is modulus matched to adjacent proximal femoral bone. Surface strain gauge analysis of the proximal femur under conditions simulating static single leg stance demonstrated that the new prosthesis maintains an essentially normal femoral strain distribution. It is hoped that selective load transmissions across the prosthesis bone interface should result in less post-implantation proximal bone resorption. PMID- 2704213 TI - Design and performance of a high speed driver circuit for PIN diode switches used in microwave hyperthermia. AB - In many cancer treatment facilities where hyperthermia treatments are performed, there is a need to split a single channel microwave source into multiple, individually controllable channels. In the application reported here, microwave power is alternately switched between active and passive elements for each channel. The active element is either a microwave antenna inside a catheter in tumour tissue or a planar spiral applicator placed superficially, the total power to each channel being pulse width modulated from 1 to 99% of a 1 s duty cycle. The system is computer controlled and is capable of dividing and controlling power to 12 channels. PIN diode switch assemblies control the flow of power in each channel but they must be switched within a few microseconds to avoid failure at the high power levels used in the clinic. A high speed circuit was fabricated and tested to drive each PIN diode switch; the PIN diode switches are turned on in 1.5 microseconds and off in 3.0 microseconds, which meets the specifications for hot switching. The increase in speed over the former driver system is a factor of 5.1 for the on cycle and 1.5 x 10(5) for the off cycle and the maximum power tested in each channel was 80 W for 1 h at random duty cycles between 1 and 99%. The circuit was also tested with 40 W of power at duty cycles of 1, 50 and 99% for 1 h each; no failures or performance decrements were observed. The 12 channel circuit driver has been used for six months of clinical treatments without failure. PMID- 2704214 TI - Neurosurgical stimulation, impedance monitoring and data acquisition system. AB - We describe the design of a programmable neurosurgical stimulator with impedance monitoring facilities. The computer is used both to control a stimulator and for the storage of various parameters employed in the process. The stimulator is designed to minimize tissue damage by injecting net zero charge; its output is a current, independent of load resistance. By measuring electrode voltage, the load impedance can be calculated. Software is provided in order to log patient data, and trajectory details with reference to coordinates calculated from other imaging systems such as CAT scanners. PMID- 2704215 TI - Topographical brain electrical activity mapping on an IBM-compatible personal computer. AB - A new system for computing brain electrical activity maps on a standard IBM compatible computer has been developed. The EEG is recorded using a CED1401 intelligent laboratory interface and stored in the computer; colour coded maps are generated using software developed in Turbo PASCAL and displayed on the EGA graphics screen. An acceptable computation time of 1.2 s for a 64 x 64 map displayed as a 128 x 128 pixel image has been achieved by incorporating assembly language routines and a maths coprocessor. The system may be readily upgraded as improved hardware becomes available and further software can be added. In addition to triggering auditory, visual and somatosensory stimulators, it provides the potential for the generation of complex stimuli for cognitive experiments by means of mass RAM and digital-to-analogue converters. PMID- 2704216 TI - Method for studying muscle properties under orderly stimulated motor units with tripolar nerve cuff electrode. AB - An electrical nerve stimulation technique, using single tripolar electrode, was shown to be capable of recruiting motor units according to their size, while allowing simultaneous but independent control of firing rate in the active units. Test paradigms consisting of established fundamental physiological concepts of soleus-gastrocnemius architecture, firing rate behaviour of motor units of different sizes, and their susceptibility to fatigue were employed to validate the technique and demonstrate its utility as a basic and applied research tool. PMID- 2704217 TI - Measurement of human cervical compliance. AB - A critical evaluation of the various methods for the measurement of the compliance of the human cervix uteri was made. The resistance of this tissue to a dilating force was measured by a previously constructed strain gauge instrument equipped with exchangeable Pratt cervical dilators. The dilating resistance offered by the cervical canal was recorded on a polygraph at a constant paper speed. Control experiments in which the dilating instrument was allowed to meet artificial cellulose tissue showed that the peak value recorded was of importance for estimating cellulose tissue resistance. Measurements of the area under the curve were shown to be of minor importance in this system. Using this technique in clinical applications, it was also shown that peak resistance provides the most accurate measurement of human cervical resistance. PMID- 2704218 TI - Simple fibre optic spectrophotometric cell for pH determination. AB - A simple, inexpensive fibre optic spectrophotometric cell has been developed for clinical use. The system may employ one of two indicator reagents for the measurement: phenol red and BDH universal indicator. The spectrophotometer uses two ultrabright LED sources and a PIN diode photodetector. The fibre is of the plastic type with a core diameter of 1.0 mm. Two alternative analytical methods are available: electronic or computer processing. In the case of phenol red the measuring range using computer processing is between 6.0 and 8.0 pH units, with an accuracy of 0.015 pH units. The range for electronic circuit processing is from 6.8 to 8.0 pH units with an accuracy of 0.02 pH units. Using a BDH universal indicator, the range for computer processing is between 5.5 and 8.5 pH units with an accuracy of 0.05 pH units, while with electronic processing the range is between 6.0 and 8.0 pH units with an accuracy of 0.03 pH units. A description of the optoelectronics, an analysis of the indicator reagents and the calibration procedure are presented here, together with some example results. PMID- 2704219 TI - Electrochemical engineering approach to the irrigation of tooth canals under the influence of a vibrating file. AB - Doubt exists concerning the irrigation of secondary tooth canals when the vibration of a file introduced into the main root canal is superimposed on flow through irrigation of the main canal. Depending on the type of commercial equipment used, the vibrations of the file are sonic or ultrasonic. We use the methodology of an electrochemical engineering approach in a study of the intensity of the irrigation of the secondary canals under the influence of sonic and ultrasonic vibrations of a file located at various heights in the main canal. The tooth canals are simulated by small electrochemical cells containing electrodes located at the end of cavities simulating the secondary canals. An electrochemical method is used to measure the mass transfer coefficients at these electrodes, a classical method in electrochemical engineering laboratories. The values of the mass transfer coefficients are representative of the importance of the irrigation of the electrodes. Thus they give a quantitative idea of the vibrations on the irrigation of secondary tooth canals. The work demonstrates the usefulness of the electrochemical engineering approach in contributing to the solution of a biomedical problem. PMID- 2704220 TI - Quantification of heart sounds interference with lung sounds. AB - An index to quantify the contamination of lung sounds by heart sounds is described. Using the index, the efficacy of high pass filtering and adaptive filtering methods for the reduction of heart sounds is evaluated. PMID- 2704221 TI - Capacitance sensing drop counter. AB - A simple and inexpensive capacitive sensor which fits around any normal drip chamber has been devised. When it is made part of a suitable AC bridge circuit, the small changes in capacitance caused by the presence of a drop between the sensor plates can be reliably detected. The sensor is insensitive to its position on the drip chamber or to tilt of the chamber and unlike optical drop sensors, it is insensitive to ambient lighting. PMID- 2704222 TI - Potential of lumbodorsal fascia forces to generate back extension moments during squat lifts. PMID- 2704223 TI - Circumferential and longitudinal viscoelasticity of human iliac arterial segments in vitro. PMID- 2704224 TI - Frequency domain analysis of contrast echocardiographic images. AB - Sequences of echocontrastographic images of the dog's myocardium are analysed in the frequency domain for the identification of underperfused areas. Owing to the fact that echo images are contaminated by noise and artifacts, we have applied filtering techniques based on Fourier's methods in sequences of raw frames recorded during perfusion with a contrast agent. Thus we have been able to assess correctly the spatial and temporal distribution of the contrast, i.e. the agent kinetics which parallel the distribution of coronary blood flow, in terms of the time necessary for the flow gradient to reach its maximum value, and to describe such a distribution by a functional image obtained by means of an original procedure. PMID- 2704225 TI - Oral calcium promotes pigment gallstone formation. AB - Dietary calcium supplementation has been recommended for prevention of osteoporosis and has become a standard component of most "health food" diets. Biliary calcium has been recognized to play a central role in the formation of pigment gallstones. We have recently demonstrated that 5 days of oral calcium supplementation significantly increases biliary calcium in the prairie dog (K. D. Lillemoe, T. H. Magnuson, G. E. Peoples, et al., Gastroenterology 94: A563, 1988). We hypothesized, therefore, that long-term oral calcium supplementation would promote pigment gallstone formation. Sixteen adult male prairie dogs were maintained on a standard nonlithogenic diet. Eight animals received calcium supplementation (2.5 x control levels) in their water, while the remaining eight animals served as controls. After 8 weeks, cholecystectomy was performed, and the common bile duct was cannulated. Bile was examined microscopically and analyzed for ionized calcium, bilirubin, glycoprotein, and biliary lipids. The cholesterol saturation index (CSI) was calculated. Pigment stones and calcium bilirubinate sludge were present in all animals receiving calcium supplementation. Only one control animal had evidence of pigment stones (P less than 0.001). Biochemical analysis of gallbladder bile demonstrated a significant increase in total bilirubin and bilirubin monoglucuronide (P less than 0.01) as well as bile glycoprotein content (P less than 0.05) after oral calcium supplementation. Gallbladder bile ionized calcium was also increased although not significantly. These data suggest that oral calcium supplementation promotes gallbladder sludge and pigment gallstone formation in the prairie dog. This observation raises concern that oral calcium supplementation, especially in the older female population, may enhance gallstone formation. PMID- 2704226 TI - Burn injury alters intestinal glutamine transport. AB - Several studies have established that intestinal glutamine (GLN) metabolism is altered during catabolic states. It remains unclear whether these alterations are due to a defect in metabolism or in transport of the amino acid. The present study examines the kinetics of GLN transport across basolateral membrane vesicles (BLMV) of enterocytes obtained from control rats and rats subjected to 20% full thickness scald burn, 48 hr previously. BLMV were prepared from freshly isolated enterocytes using differential centrifugation with separation on a Percoll density gradient. BLMV were enriched (10- to 12-fold) with Na+-K+-ATPase while markers for brush border membranes were impoverished. Previous studies from our laboratory indicated that, in this preparation, GLN transport is into an osmotically sensitive space, dependent on GLN concentration, linear up to 30 sec, and both temperature and Na+ dependent. Our results indicate that in thermal injury, initial rates of GLN uptake were depressed (y = 3.67 + 0.435X for burned rats vs y = 18.7 + 0.907X for controls, P less than 0.01). Kinetic analysis of GLN uptake showed a marked decrease in transport Vmax (81.8 +/- 15 nmole/mg protein/15 sec for burned rats vs 185 +/- 17 nmole/mg protein/15 sec for controls, P less than 0.001). Transport Km also decreased from 0.25 +/- 0.004 mM for controls to 0.08 +/- 0.03 mM glutamine for burned rats (P less than 0.001). Kinetic studies performed at GLN levels greater than 0.6 mM showed that GLN uptake proceeded by a nonsaturable process in both the control and burned rats. No significant alteration in this nonsaturable component was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704227 TI - Gastrointestinal transit after proctocolectomy with ileal pouch-anal anastomosis or ileostomy. AB - Proctocolectomy with ileal pouch-anal anastomosis increases the frequency of stooling, perhaps due in part to the loss of an ileocecal or colonic braking effect on gastrointestinal transit. To assess whether colectomy with ileal pouch anal anastomosis (IPAA) or with ileostomy accelerates gastrointestinal transit, we studied 16 IPAA patients (mean +/- SEM stool frequency, 8 +/- 1 stools/day), 5 patients after colectomy and Brooke ileostomy, and 8 healthy, unoperated controls (1 +/- 1 stools/day). Gastric emptying of liquids and small bowel transit of chyme were measured concurrently with a dual isotope technique. Gastric emptying was similar among all groups. In contrast, postprandial small bowel transit of the head of a duodenal marker was slowed, not accelerated, in IPAA patients (178 +/- 26 min) compared to Brooke subjects (80 +/- 32 min, P less than 0.05) and controls (75 +/- 15 min, P less than 0.01). Maximal filling of both the ileal pouch (341 +/- 19 min) and the ileostomy bag (348 +/- 12 min) occurred later than filling of the colon in controls (243 +/- 32 min, P less than 0.01). Overall stool frequency did not correlate with small bowel transit in the ileoanal patients, but the two ileoanal subjects with greatest stool frequency (11 and 18 stools/day) had the earliest arrival of marker at the pouch. In conclusion, removal of the colon markedly slowed small bowel transit in most patients, although it did not alter gastric emptying of liquids. Creation of an ileal pouch and ileoanal anastomosis further slowed transit of the head of the meal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704228 TI - The influence of intestinal resection on the growth of intestinal neomucosa. AB - Intestinal resection stimulates proliferative activity in the intestinal remnant. The aim of this study was to determine the influence of intestinal resection on the growth of intestinal neomucosa. Forty-eight New Zealand white rabbits had 2 x 5-cm ileal defects patched with adjacent cecal serosal surface. Group I (n = 24) served as controls. Group II (n = 24) underwent simultaneous 50% enterectomy. Neomucosal coverage was significantly greater in Group II at 1 week (36 +/- 11% vs 67 +/- 9%, P less than 0.05) and 2 weeks (94 +/- 2% vs 99 +/- 1%, P less than 0.05), but was similar at 3 and 4 weeks. There was significantly more neomucosa at 1 week in the animals that underwent resection (134 +/- 55 mm2 vs 199 +/- 54 mm2, P less than 0.05). Degree of patch contraction, glucose uptake, and disaccharidase activities were similar in each group. Ornithine decarboxylase activity and crypt cell production rate were significantly greater at 1 week in the animals that underwent resection. Intestinal resection results in an early increase in neomucosal growth and increased proliferative activity. Since contraction of the patches occurs to a similar extent in both groups, the total amount of neomucosa was not increased. Thus, performing patching at the time of resection is not necessary for optimal growth. PMID- 2704229 TI - Propranolol stimulates the crosslinking of matrix components in skin from the aneurysm-prone blotchy mouse. AB - Propranolol prevents or delays the formation of aortic aneurysms in both the lathyritic turkey and the Blotchy mouse models. This finding in the turkey is reported to be a direct effect on crosslinking of aortic collagen and elastin, independent of effects on pulse and blood pressure. The present work was performed to evaluate this hypothesis in the mouse model by studying the effect of propranolol on the insolubility of matrix proteins of skin, which would isolate the phenomenon from direct hemodynamic effects. Eight 6- to 8-week-old Blotchy mice were fed a diet containing 0.10% (w/w) propranolol for 12 weeks, and six Blotchy controls ate regular chow. At sacrifice the skins were extracted with 8 M urea, and the soluble and insoluble fractions were analyzed for hydroxyproline to determine the collagen contents. The elastin was estimated by subtracting the collagen from the insoluble fraction. There was a 147% increase in insoluble elastin with propranolol and a lesser increase of 54% in insoluble collagen. These results suggest that propranolol has a direct effect on crosslinking of matrix components. PMID- 2704230 TI - Mechanism of endothelial cell shape change in oxidant injury. AB - Changes in endothelial cell morphology induced by neutrophil-generated hydrogen peroxide (H2O2) may account for the capillary leak of the adult respiratory distress syndrome (ARDS). The relationship of H2O2 effects on the concentration of intracellular Ca2+ [( Ca2+]i) and ATP to changes in microfilaments and microtubules, important determinants of cell shape, was examined. Bovine pulmonary artery endothelial cells were injured over a 2-hr time course with a range of H2O2 doses (0-20 mM). The higher concentrations of H2O2 consistently produced contraction and rounding of greater than 50-75% of cells by 1-2 hr. The range of 1-20 mM H2O2 produced rapid, significant reductions in endothelial ATP levels over the time course of injury. Although there were significant increases in mean endothelial [Ca2+]i in response to 5, 10, and 20 mM H2O2, 1 mM H2O2 did not affect the [Ca2+]i. Fluorescence microscopy revealed that microfilament disruption occurred as ATP levels fell and preceded depolymerization of microtubules which developed after [Ca2+]i approached 1 X 10(-6) M. H2O2 at 1 mM injury caused microfilament disruption but did not depolymerize microtubules. Microfilament disruption occurred without oxidant exposure, when ATP levels were reduced by glucose depletion and mitochondrial inhibition with oligomycin (650 nM). If a Ca2+ ionophore, ionomycin (5 microM), was then added, [Ca2+]i rose to greater than 1 X 10(-6) M, microtubules fragmented and depolymerized, and cell contraction and rounding very similar to that induced by H2O2 occurred. These results suggest that endothelial cell dysfunction and capillary leak in ARDS may be due to H2O2-mediated changes in cellular ATP and [Ca2+]i. PMID- 2704231 TI - Relationship between cellular accumulation of rhodamine 123 (R123) and cytotoxicity in B16 melanoma cells. AB - Rhodamine 123 (R123) is a mitochondria-specific prototype anticancer agent because its target is the energy-producing mechanism of the cell. The goal of this study was to investigate the relationship between intracellular R123 accumulation and cytotoxicity in a R123-sensitive cell line (RS) and a R123 resistant subline (RR) that we developed. Cytotoxicity after exposure to R123 (0 60 micrograms/ml) was assessed using the clonogenic assay. Intracellular R123 was extracted with acid-alcohol and measured by fluorimetry. The rate of R123 accumulation over 1 hr was significantly higher (P less than 0.0001) for RS cells (4.65 +/- 0.39 micrograms/min/10(6) cells) than for RR cells (1.29 +/- 0.24 micrograms/min/10(6) cells). R123 accumulation in RS cells was strongly correlated (r = 0.80; P less than 0.0001) with cytotoxicity. Treatment of RR cells with verapamil (100 microM) reversed R123 resistance. The resulting dose survival curve was identical to the dose-response curve of RS cells treated with R123 alone. Cellular content of R123 in RR cells treated with verapamil increased to a level similar to that of RS cells and correlated with cytotoxicity. These data suggest that cytotoxicity of R123 in B16 cells results from increased cellular accumulation of R123. PMID- 2704232 TI - The mature and immature heart: response to normothermic ischemia. AB - Low cardiac output after heart surgery occurs more frequently in infants than in adults. This study was designed to determine whether this finding could be explained by a greater susceptibility of the immature heart to ischemia. An isolated working heart model was used to compare myocardial recovery in sets of hearts from six immature (2 weeks, 500 g) and six mature (20 weeks, 2 kg) rabbits after 10, 20, and 30 min of ischemia at 37 degrees C. Mean aortic pressure (MAP), aortic flow (AF), heart rate (HR), left atrial pressure (LAP), and ATP and glycogen levels were measured before and after ischemia. Hemodynamic results are expressed as the percentage recovery of preischemic values. ATP and glycogen are reported as micrograms per gram dry weight. After each period of ischemia, the immature hearts had superior recovery of AF (95 +/- 7.0, 72 +/- 8.8, 70 +/- 7.5 vs 58 +/- 7.1, 34 +/- 15.5, 13 +/- 9.1, P less than 0.05). After 10 min of ischemia, recovery of MAP was not different (97 +/- 1.5 vs 100 +/- 3.5), but after 20 and 30 min of ischemia, the immature hearts had better recovery of MAP (108 +/- 10.8, 98 +/- 5.4 vs 64 +/- 10.8, 48 +/- 6.0, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704233 TI - Pretransplant hyperthermia promotes permanent survival of murine thyroid allografts. AB - Hyperthermic treatment of skin has been shown to abolish stimulation of allogeneic lymphocytes in a mixed skin-lymphocyte reaction. These experiments test the hypothesis that hyperthermic pretreatment of endocrine tissue can promote its permanent survival in allogeneic recipients. Murine thyroid tissues were treated at 37, 43, or 45 degrees C for 0.5-4.0 hr and transplanted to the left renal capsule of recipient mice. Graft survival was determined after 100 days by the ratio of counts between the left and right kidneys 24 hr after administration of 0.5 microCi 125I. Balb/c recipients of C57BL/6 thyroids treated at 43 degrees C for 2 or 4 hr had viable grafts in 4/7 (P = 0.032) and 4/5 (P = 0.015) cases, respectively, compared to controls (0/10). C57BL/6 recipients of Balb/c thyroid treated at 43 degrees C for 4 hr had viable grafts in 6/10 cases (P = 0.009) compared to control (0/10). Treatment at 45 degrees C was lethal, evidenced by failure of all isografts. Pretransplant treatment at 43 degrees C promotes permanent thyroid allograft survival without immunosuppression. PMID- 2704234 TI - Adenosine triphosphate (ATP) treatment of hypoxic pulmonary hypertension (HPH): comparison of dose dependence in pulmonary and renal circulations. AB - In this study we investigated the relationship between pulmonary and renal responses to a low dose infusion of adenosine triphosphate-magnesium chloride (ATP-MgCl2) in a newborn piglet model of hypoxic pulmonary hypertension (HPH). Three- to five-day-old piglets were cannulated for the measurement of pulmonary and systemic arterial pressure, pulmonary and renal artery flow, and urine output. The animals were then made hypoxic by ventilation with a mixture containing 10% oxygen, 4% CO2, and balance nitrogen. Serial infusions of ATP MgCl2 at 0.01, 0.025, 0.05, 0.1, 0.5, and 1.0 mg/kg/min were compared to preinfusion hypoxia baselines. Hypoxia alone produced a significant elevation in pulmonary artery pressure (73%) and a reduction in pO2. All dose rates of ATP MgCl2 greater than or equal to 0.05 mg/kg/min produced a significant decrease in mean pulmonary artery pressure. However, as baseline mean pulmonary artery pressure increased there was an increased sensitivity to ATP-induced vasodilation. Pulmonary artery flow did not change during ATP infusion, thus, the change in pulmonary vascular resistance accounted for the decrease in pulmonary artery pressure. In contrast to the response of the pulmonary vasculature, systemic pressure was significantly decreased only during the 1.0 mg/kg/min infusion. Renal blood flow decreased by 46% during hypoxia and decreased further only during the highest dose rate of ATP infused (i.e., 1.0 mg/kg/min). Creatinine clearance (Ccr) and fractional reabsorption of Na (FreNa) also fell during hypoxia, but were not further altered during all but the highest dose of ATP infused.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704235 TI - Independent release of peptide YY (PYY) into the circulation and ileal lumen of the awake dog. AB - Peptide YY (PYY) is a recently discovered polypeptide found in the endocrine cells of the distal small intestine, colon, and rectum. This study was designed to evaluate the postprandial release of PYY into the peripheral blood and the ileal lumen in response to different ingested nutrients. Six adult conditioned mongrel dogs had 25-cm distal ileal Thiry-Vella segments surgically constructed. After a 2-week postoperative recovery period the animals were fed meals consisting of protein (2 g/kg), fat (5 g/kg), or glucose (1.5 g/kg). Circulating and ileal intraluminal PYY concentrations were measured by a sensitive radioimmunoassay developed in our laboratory. Significant increases in circulating PYY levels were seen only after the fat meal in dogs. Ileal intraluminal PYY concentrations were significantly greater than those concentrations seen in the peripheral blood. A significant rise in ileal intraluminal PYY was seen only after the glucose meal without concomitant changes in circulating PYY. These findings document independent release mechanisms of PYY into the circulation and ileal lumen of the awake dog. We believe that the release of PYY into the canine circulation and into the ileal lumen after feeding may be dependent on the type of nutrient ingested and may serve to regulate the diverse physiologic roles of PYY in the gastrointestinal tract. PMID- 2704236 TI - Elongation factor 2 as the major substrate for Ca2+/calmodulin-dependent protein kinase in rat adrenal glomerulosa cells. AB - We have previously shown the existence of the major substrate protein of Mr 100,000 (substrate 100 K protein) for Ca2+/calmodulin (CaM)-dependent protein kinase in rat adrenal glomerulosa cells. In the present study, the identity of the substrate 100 K protein to elongation factor 2 (EF-2) was investigated. In a 105,000 g-supernatant fraction (cytosol), the protein of Mr 100,000 with the pI (isoelectric point) value of 6.7 was phosphorylated in the presence of calcium and CaM. The optical densities of this phosphorylated band were greatly enhanced in the presence of the EF-2 purified from pig liver (1 microgram) [20-23-fold, n = 5] when compared with those in the absence of the component. In the presence of the purified EF-2, the phosphorylation of Mr 100,000 was detected only in the presence of calcium alone or calcium plus CaM. This phosphorylation in the presence of calcium alone was completely inhibited in the presence of the CaM antagonist pimozide (500 microM), showing the existence of endogenous CaM in the cytosol. In the same fraction, the ADP-ribosylated protein of Mr 100,000 was detected in the presence of diphtheria toxin (fragment A) and (adenylate-32P) NAD, indicating the presence of EF-2 in the cytosol from rat adrenal glomerulosa cells. These results suggest that the substrate 100 K protein may be identical to EF-2 in rat adrenal glomerulosa cells. PMID- 2704237 TI - Prostate. III--A structural feature characteristic of the rat prostate 5 alpha reductase active site. AB - To aid in the design of new inhibitors of steroidal 5 alpha-reductase for treatment of prostate cancer, we have studied the topography of the 5 alpha reductase active site (5 alpha-R) and of the related androgen (RA) and progesterone (RP) receptors in the region complementary to C.6 of progesterone. To this end we have determined the total structures of 17 alpha-acetoxy-6 methylene-4-pregnene-3,20-dione (VII; R = H) and of 17 beta-hydroxy-6,6-ethylene 4-androsten-3-one (VIa) by X-ray crystal structure analysis and, using these data, have developed Newman projections of the 6 alpha-Me, 6 beta-Me, 6-methylene and 6,6-ethylene derivatives of progesterone. From them we have developed a Newman projection of a composite model formed from steroids (V), (VI), (VIIIa) and (VIIIb). This is shown in Fig. 4 and illustrates the relative conformations of these substituents around C.6. From there we proceeded to receptor-binding studies. Our results led to the conclusion that androgen receptor, (RA), takes up preferred but different conformations when bound to testosterone (T) and to 17 beta-hydroxy-5 alpha-androstan-3-one (5 alpha-dihydrotestosterone, DHT), respectively, and that the resulting steroid-receptor complexes bind preferentially to different chromatin acceptor sites. We have therefore used the convention RT and RDHT in place of RA as appropriate. Working on the assumption that binding affinities reflect spatial contours, we have developed comparative silhouettes for the 5 alpha-R, RP and RDHT protein binding sites complementary to C.6 of the steroidal ligand. These data show that the 5 alpha-reductase active site is characterized by a hydrophobic pocket which specifically accommodates a 6 methylenic moiety and partially accommodates a 6 beta-methyl group. RDHT, in contrast, shows much less specificity and largely accommodates all the above substituents. Progesterone receptor differs in failing to accommodate 6,6 ethylene and 6 beta-methyl, with minimal accommodation of 6-methylene. It possesses a hydrophobic pocket skewed towards the alpha-face of the steroid, thereby allowing optimal binding of the 6 alpha-methyl substituent to the receptor. 6-Methylene-4-pregnene-3,20-dione (V) fails to bind significantly to androgen and progesterone receptors thereby supporting the postulate that its antiprostatic activity stems primarily from 5 alpha-reductase inhibition. PMID- 2704238 TI - Cobalt-protoporphyrin, a synthetic heme analogue, feminizes hepatic androgen metabolism in the rat. AB - A single injection of cobalt-protoporphyrin (50 mumol/kg) produced marked changes in the metabolism of 14C-labeled testosterone and 4-androstenedione by male rat liver microsomes and this effect was maintained for at least 3 weeks. The rate of 3 beta- and 5 alpha-reduction was increased to levels observed in untreated adult female animals and cobalt-protoporphyrin altered the metabolic profile of testosterone towards that observed after infusion of growth hormone whereas hypophysectomy produced a more general inhibition of androgen metabolism. The reduction of testosterone or 4-androstenedione by liver microsomes was also increased when cobalt-protoporphyrin (10-30 microM) was added in vitro but a higher concentration (100 microM) led to inhibition of androgen metabolism. The identity of the main androgen metabolites was established by TLC, HPLC and mass spectrometry and the role of 5 alpha-reductase was demonstrated using a specific inhibitor of this enzyme. The possible sites of action of cobalt-protoporphyrin are discussed in relation to its in vivo effects on serum testosterone and LH concentrations. PMID- 2704239 TI - In vitro effects of cytosolic inhibitor and opiates on the binding of [3H]oestradiol to nuclear type II binding sites of rat uterus and hypothalamus. AB - The effect of cytosolic ultrafiltrates prepared from intact rat uteri, brain hemispheres and hypothalami and of some opiate analogues on oestradiol binding to nuclear type II sites in rat uterus and hypothalamus was studied. Opiate binding in nuclear fraction of rat uteri was also evaluated. Both uterine and hypothalamic low affinity nuclear oestradiol binding was inhibited by filtrate from uteri, while only hypothalamic nuclear binding was decreased in presence of hypothalamic filtrate. Filtrate from brain was ineffective on nuclear oestradiol binding of the studied tissues. Concentration dependent inhibition of uterine nuclear oestradiol binding could be demonstrated by some opiate analogues in vitro. Specific low affinity nuclear binding of opiate antagonist naloxone and agonist dihydromorphine was observed in rat uteri which could be inhibited by uterine filtrate and oestradiol but not by hypothalamic filtrate or other steroids. Present findings support the probable intracellular interplay of opiates and oestradiol action and suggest that cytosolic inhibitor factor might be involved. PMID- 2704240 TI - Plasma testosterone levels and ovarian testosterone content in adult mice treated with diethylstilbestrol neonatally. AB - Neonatal female NMRI mice (n = 16) were treated with 5 micrograms diethylstilbestrol (DES) per day, for the first 5 days after birth and killed postpubertally. Control females (n = 52) were injected with vehicle only and killed in different stages of the estrous cycle. The plasma testosterone level was significantly lower in DES females than in control females in any of the estrous phases. Ovariectomy (n = 5), adrenalectomy (n = 5) or a combination of both ablations (n = 3) did not affect the plasma testosterone in DES treated females while it was significantly reduced in control females (ovariectomy n = 5; adrenalectomy n = 9); most effective was the combination ovariectomy adrenalectomy (n = 7). Ovarian homogenates from DES treated females (n = 10) had a significantly lower testosterone content than homogenates from control females in any phase of the estrous cycle (6-10 females per phase), which held true on both a per ovary basis and when related to ovarian weight. After a 2 h incubation in vitro, the testosterone levels had increased significantly in DES homogenates (n = 6) and to a lower extent in homogenates from control females in estrus (n = 9). No similar effect was found in homogenates from diestrus (n = 10) or proestrus (n = 9) females. The results are discussed in relation to the special ovarian morphology of adult but neonatally DES treated females and also with respect to endocrine control mechanisms. PMID- 2704241 TI - Microbial transformation of steroids--II. Transformations of progesterone, testosterone and androstenedione by Phycomyces blakesleeanus. AB - Phycomyces blakesleeanus transformed progesterone, testosterone and androstenedione into mixtures of products. Five monohydroxylated metabolites were obtained in reasonable yields from the progesterone transformation. Only 7 alpha- and 15 beta-hydroxyprogesterone have been reported previously from this organism. We find that it gives these two metabolites and also 6 beta-, 14 alpha- and 15 alpha-hydroxyprogesterone as major products. Five compounds were also purified from testosterone transformation mixtures. Two of these were monohydroxylated, two were ring A dehydrogenation products, and two were oxidised at C-17. The products were identified as 6 beta-hydroxytestosterone, 7 alpha hydroxytestosterone, androsta-1,4-diene-3,17-dione (1-dehydroandrostenedione), 17 beta-hydroxyandrosta-1,4-diene-3-one (1-dehydrotestosterone) and androstenedione. All five metabolites were produced in reasonable yields, although hydroxylation was the minor transformation in this case. Only two significant products were formed from androstenedione. Both were reduced at C-17; one was also monohydroxylated. They were testosterone and 14 alpha-hydroxytestosterone. The testosterone and androstenedione transformation products have not been reported previously for this organism. We also report for the first time the preparation of P. blakesleeanus cell-free extracts which transformed progesterone reasonably efficiently and faithfully in vitro, although the proportions of each product varied from one extract to another. PMID- 2704242 TI - Effect of neonatal estrogenization on testosterone metabolism in the prostate and in the epididymis of the rat. AB - The present experiments were performed in order to analyze whether the administration of estrogens (single injection of 500 micrograms of estradiol benzoate s.c.) to neonatal male rats might modify the weight of the ventral prostate and the epididymis as well as the metabolism of testosterone in these two organs. The metabolism of testosterone was evaluated in vitro using 14C radiolabelled testosterone as the substrate. The metabolites dihydrotestosterone (DHT), 5 alpha-androstane-3 alpha, 17 beta-diol (3 alpha-diol), 5 alpha androstane-3 beta,17 beta-diol (3 beta-diol), androstenedione, 5 alpha-androstane 3,17-dione (5-A-dione) and 3 alpha-hydroxy-5 alpha-androstane-17-one (androsterone) were quantified. After neonatal estrogen administration animals were killed on days 22 and 90 of age. The following changes were observed: (1) the body weight, the weight of the testes and of the ventral prostate were lower than in controls on both day 22 and 90; (2) the weight of the epididymides was higher than in controls on day 22 and lower on day 90; (3) in the ventral prostate the in vitro formation of DHT was lower and that of the diols was higher than in control tissue on day 22 of age; (4) the in vitro formation of alpha reduced metabolites of the 17-keto series (5 alpha-A-dione + androsterone) was higher in ventral prostate of treated animals than in that of controls on day 22; (5) in treated animals, no formation of DHT in the caput epididymis was observed at day 22. On the contrary, at the same age the formation of androstenedione was higher than in controls; on day 90 of age the formation of DHT, androstenedione and the 5 alpha-reduced metabolites of the 17-keto series was identical in caput epididymis of the treated animals and of the controls, while the formation of the diols was higher in the treated than in the controls. The data indicate that neonatal estrogenization may induce important changes in testosterone metabolism in the prostates and in the epididymides of the rat. PMID- 2704243 TI - Rapid and specific RIA of serum estrone sulfate with selective solid phase extraction. AB - The methods commonly used to evaluate conjugated steroids require hydrolysis and chromatographic purification. To avoid these steps, a simple method involving selective solid phase extraction and RIA using a highly specific antiserum for estrone sulfate (E1S) has been evolved. A Bond-Elut C2 cartridge was used for solid phase extraction of estrone (E1) and E1S; recoveries were 80 and 90% respectively. The intra- and inter assay precision of the assay at 3 serum levels, were 6.5, 10.4 and 4.4 and 12.7, 13.9 and 7.4% respectively. Accuracy, tested by linearity and recovery tests, was acceptable. A good correlation exists between a conventional enzymatic method and the proposed method. The latter is less time consuming and more reliable, thus providing a rapid assay to evaluate E1 and E1S in the same serum sample. PMID- 2704244 TI - Effects of steroid anaesthesia on some liver function tests in goats. AB - The effect of Saffan, a steroid anaesthetic, on the liver function of goats has been studied. Forty healthy animals were divided into 4 equal groups. The first 2 groups were given 2 and 4 mg Saffan/kg b. wt respectively. A mixture of Saffan (1 mg) and Xylazine (0.1 mg)/kg b. wt was given to the third group and Xylazine alone to the fourth group (0.1 mg/kg b. wt). Serum samples from all groups were analysed for glucose, total protein, total and direct bilirubin and the level of activity of transaminases. Administration of Saffan evoked more hyperglycemia than a mixture with Xylazine, or Xylazine alone. The hyperglycemic effect of both doses of Saffan (2 and 4 mg) was equivocal beyond 2 h. The effect then differed and glucose was increased 4-fold by 2 mg and 3-fold by 4 mg Saffan. Serum total protein, conjugated and total bilirubin, and GPT and GOT were not changed in the four experimental groups. This was good evidence of a normally functioning liver during the course of steroid anaesthesia administration in goats. PMID- 2704245 TI - Tail immersion test for the evaluation of a nociceptive reaction in mice. Methodological considerations. AB - The effect of two commonly used methods to immobilize the animals, viz. tube restrainer and wrapping in a diaper (chux) on the tail flick latency in immersion test, was evaluated in mice using a stimulus temperature of 50 degrees C. The animals were immobilized either in the tube or chux briefly (25-30 sec) during the tail flick measurements. The basal tail flick latency was 2.8 +/- 0.2 in the tube restrained and 5.5 +/- 0.3 sec in chux restrained groups (p less than 0.001). The analgesic effect of morphine (1, 3, 4, 7, and 10 mg/kg) was significantly higher in the chux-restrained animals as indicated by the dose ratio of 2.16 for the 50% analgesic response in the chux versus tube restrained mice. The tail flick latency, 15 min after naloxone injection (1 and 3 mg/kg), expressed as % of predrug latency was significantly reduced in the chux- but not the tube-restrained group. The hyperalgesic effect of naloxone could not be detected in chux-restrained animals, when the water temperature was increased to 55 degrees C. The results demonstrate that the restraining procedure will influence the analgesic effects of test drugs in tail immersion test. Furthermore, the stimulus temperature appears to be an important variant that could influence the results in this test. The present results demonstrate the hyperalgesic effect of naloxone after systemic administration in the tail immersion test and supports the concept that tail flick response is tonically inhibited by endogenous opioid systems. PMID- 2704246 TI - Screening of positive inotropic agents in isolated cardiac preparations from different sources. AB - The present study was designed to elucidate whether or not the positive inotropic effects of isoprenaline, milrinone, and DPI 201-106 in myocardial tissue from various sources reveal reliable results for the failing human heart. Therefore, in vitro positive inotropic responses were studied in human papillary muscle strips from patients with moderate heart failure (NNYHA II-III), human atrial trabeculae (HAT), isolated papillary muscles from Wistar-Kyoto rats (WK), and from spontaneously hypertensive rats (SHR). Results were compared with the effects of the compounds in papillary muscle strips from patients with severe heart failure (NYHA IV). In NYHA IV, positive inotropic responses were smaller for isoprenaline and milrinone than in NYHA II-III. The response to DPI 201-106 was more pronounced. In HAT, the effects of isoprenaline and milrinone were greater than in NYHA IV. The positive inotropic effect of DPI 201-106 was similar. In SHR, only the positive inotropic effect of isoprenaline was smaller than in WK. The effects of DPI 201-106 and milrinone did not differ. These data show that inotropic responses in NYHA II-III, HAT, WK, and SHR differ from the severely failing myocardium. It is concluded that new positive inotropic agents should be screened in human myocardial tissue from patients with heart failure, as experimental results from other sources may be irrelevant in this respect. PMID- 2704247 TI - Assessment of erectogenic drugs by numeric plethysmography. AB - A method of assessment of the erection in man, using numeric penile plethysmography, is presented. The data concerning the sensor, the electronic circuit, and the computer interfacing with an IBM PC are described. As a validation of this method, apomorphine (0.009 mg/kg) was tested in a double blind, placebo-controlled study, carried out in healthy volunteers. Apomorphine induced an erection starting, as a mean, at the fourth minute postinjection. The treatment increased the penis volume without any other stimulation (p = 0.0008) and potentiated the physiologic response induced by visual erotic stimulation (p = 0.0012). The limits of plethysmography are discussed in reference to rigidimetry. PMID- 2704248 TI - Novel and versatile superfusion system. Its use in the evaluation of some spasmogenic and spasmolytic agents using guinea-pig isolated tracheal smooth muscle. AB - We have developed a novel, eight-chamber superfusion system that is suitable for a variety of applications involving the study of both contraction and relaxation of smooth muscle preparations, and the effect of agents that interfere with these actions. The system allows electrical stimulation of preparations, and thus neuronally mediated responses and agents that interfere with neurotransmission may also be studied. To demonstrate some of the applications of the system, we have evaluated both spasmogenic and spasmolytic agents on the guinea-pig isolated tracheal strip preparation. The potency and the times for onset and offset of action of the spasmogens, acetylcholine, histamine, and prostaglandin F2 alpha, and the spasmolytics, isoprenaline, clenbuterol, salbutamol, papaverine, N ethylcarboxamide adenosine, theophylline, and verapamil, have been investigated. The spasmolytic agents have been tested against both prostaglandin F2 alpha induced tone and electrically induced contractile responses of the guinea-pig trachea. This superfusion system has several advantages over previously described superfusion or immersion techniques. It is compact and allows simultaneous study of up to eight preparations. It is suitable for a wide range of tissues, and the use of this system avoids the necessity of repeatedly washing drugs from organ baths. However, one of the most important applications of the system is its use in the study of rates of onset and offset of drug action. We believe, therefore, that this system represents an important alternative to the classical organ bath for in vitro pharmacological experimentation. PMID- 2704249 TI - Rapid screening of experimental cardiac drugs using atria and a microcomputer. AB - The authors investigated the use of a programmable digitizer, multiplexer, and laboratory microcomputer as a rapid and accurate means of evaluating potential inotropic or antiarrhythmic drugs using mammalian atrial preparations. PMID- 2704250 TI - MSNA position on AIDS. PMID- 2704251 TI - Cross cultural experience in Jamaica. PMID- 2704252 TI - Silo-filler's disease. AB - Between 1955 and 1987, 17 patients were examined at the Mayo Clinic shortly after exposure to silo gas. All exposures had occurred in conventional top-unloading silos. Acute lung injury occurred in 11 patients, 1 of whom died; early diffuse alveolar damage with hyaline membranes and hemorrhagic pulmonary edema and acute edema of the airways were found at autopsy. In one patient, hypoxemia and transient obstruction of the airways developed, but no pulmonary infiltrates were noted. One patient had symptoms for 5 weeks and diffuse confluent pulmonary infiltrates; many years later, chronic obstructive pulmonary disease developed (he had, however, been a heavy smoker before exposure). Bronchiolitis obliterans was not observed in the other patients, probably because of less severe exposure or early corticosteroid therapy. Prophylactic corticosteroid therapy is advised for workers who have been exposed to silo gas. The management of patients with established acute lung injury is reviewed. Previously unreported patterns of exposure to silo gas in conventional silos are described, and recommendations for avoiding exposure are suggested. PMID- 2704253 TI - Cerebral tuberous sclerosis: postmortem magnetic resonance imaging and pathologic anatomy. AB - We conducted postmortem magnetic resonance imaging (MRI) studies of five brains from patients with a clinical and pathologic diagnosis of tuberous sclerosis. Areas of prolonged T1 and T2 relaxation could easily be identified within the white matter subjacent to the cortical tubers despite formalin fixation and storage. The signal changes were identical to those reported in living patients with the disease. The detection of cortical tubers by MRI in two patients who were 34 and 35 years of age, respectively, at the time of death suggests that the signal changes on MRI are less affected by aging than are the low-attenuation changes on computed tomography, which are rarely identified in patients older than 27 years of age. Once the changes caused by fixation of tissues are considered, postmortem MRI is a viable investigative tool in studying tuberous sclerosis and other diseases, and it seems to correlate well with the MRI findings in living patients, as well as the gross and histopathologic changes seen at autopsy. PMID- 2704254 TI - Cardiac tamponade: characteristic Doppler observations. AB - Abnormal respiratory variation in diastolic filling has been reported in patients with cardiac tamponade. To determine the characteristic diastolic filling abnormalities in this disorder, we recorded left ventricular isovolumic relaxation time and transvalvular and hepatic venous flow velocities by pulsed wave Doppler echocardiography in 28 patients with pericardial effusion (16 with and 12 without cardiac tamponade) and 20 normal control subjects. The phase of respiration was recorded simultaneously with all profiles. In 13 of the 16 patients with cardiac tamponade, Doppler examination was repeated after pericardiocentesis. In patients with cardiac tamponade, respiratory variations in transvalvular flow velocities and isovolumic relaxation time were substantially increased in comparison with values in normal subjects, patients without tamponade, and those who had undergone pericardiocentesis. An exaggerated expiratory decrease in diastolic forward flow and increase in reverse flow in the hepatic vein also were characteristic of patients with cardiac tamponade. Thus, Doppler echocardiography is an additional noninvasive means of detecting hemodynamic compromise in patients with pericardial effusion. PMID- 2704255 TI - Tetanus: an uncommon cause of dysphagia. AB - A 53-year-old woman was examined at our medical center because of progressive dysphagia of 14 days' duration and a severe inability to open her mouth and swallow saliva. A barium esophagogram showed no obstruction, but pooling of barium in the hypopharynx suggested a neuromuscular disorder. The clinical diagnosis of tetanus was confirmed by electromyography. With appropriate therapy, the patient recovered during a period of 6 weeks. This case illustrates both an uncommon cause of dysphagia and an uncommon initial manifestation of tetanus. PMID- 2704256 TI - Silo-filler's disease: a new perspective. PMID- 2704257 TI - Tuberous sclerosis--another success for magnetic resonance imaging. PMID- 2704258 TI - The use of female spouse proxies in common symptom reporting. AB - To determine the quality of proxy health reports by telephone the 1984 Wisconsin Health Status Survey employed a repeated-measure design in an interview covering 22 recently occurring health and psychologic complaints. Comparisons on individuals in households containing two or more adults revealed a relatively weak correspondence between the respondent and proxy reports. While a previous analysis of these data found that certain characteristics thought to underlie reporting differences are not useful in explaining proxy underreporting, the current analysis focuses on spousal pairs and achieves greater success by applying somewhat more sophisticated methods. The authors examined the nature, persistence, and number of health complaints as factors in reporting bias. They find evidence that female proxies vary by symptom in their ability to report common complaints and also observed that proxy underreporting diminishes somewhat as the persistence of symptoms increases. Using multiplicative models, the authors show that the gross misclassification of complaints is concentrated in the respondent-proxy pairs with the shortest exposure to the symptom. Finally, an examination of the disagreements on all 22 health complaints simultaneously revealed that neither mutual misallocation by respondents and proxies nor a diminished health status of the individual reported on are important influences on reporting behavior. PMID- 2704259 TI - The General Health Questionnaire by interview. Performance in relation to recent use of health services. AB - The General Health Questionnaire (GHQ) is a widely used method of assessing psychiatric distress in clinical settings and in the community. The authors administered a 20-item interview version of the GHQ and a battery of survey items on use of ambulatory health care services to 3,389 respondents in eastern Baltimore as part of the Epidemiologic Catchment Area survey. In addition, a subsample of these respondents (n = 810) was examined by research psychiatrists who provided a reference mental disorder diagnosis for comparison with GHQ results. Psychiatrists determined that 102 respondents had American Psychiatric Association's Diagnostic and Statistical Manual, third edition, (DSM-III) disorders suitable for detection by the GHQ. These respondents were categorized by the health service use they reported over the previous 6 months. A comparison indicated that 82% of the diagnosed cases with recent specialty care also had elevated GHQ scores. Among cases with recent general medical care, 52% had elevated GHQ scores. Among diagnosed cases reporting no recent ambulatory health care, only 38% had elevated GHQ scores. Receiver operating characteristic analysis demonstrated a similar trend. Cases of depression were separated into less severe cases (adjustment disorder with depressed mood) and more severe cases (major depression). There were relatively more cases of severe depression than cases of mild depression in those respondents reporting recent health service use compared with those respondents reporting no recent service use. This may account for the higher sensitivity of the GHQ in detecting psychiatric disorders for those persons utilizing health services compared with individuals using no health services.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704260 TI - A severity classification system for AIDS hospitalizations. AB - The authors describe a new model for classifying hospitalized patients with acquired immunodeficiency syndrome (AIDS) according to their severity of illness. In the first phase of the project, a clinical model indicating the relative severity of AIDS complications was formulated, based on the clinical literature and expert opinion. In the second phase, the model was tested empirically using data on in-patient mortality of over 6,000 adult AIDS hospitalizations in New York State during 1985. The ordering of AIDS-related complications in the clinical model was revised to reflect a continuum of increasing likelihood of death in the hospital. The final classification system for AIDS hospitalizations has 20 substages, grouped into three stages, with in-patient mortality rates increasing from 6% to 60%. The system is automated and can be applied to different AIDS populations to analyze resource use and outcomes of hospital care. PMID- 2704261 TI - Medical problems in pregnancy. PMID- 2704262 TI - The legal liability of the medical consultant in pregnancy. AB - The potential for professional liability that accompanies complications associated with obstetric care can be minimized by an understanding of the roles and responsibilities of both the consultant and the obstetrician. Critical to this is a fundamental knowledge of the medical malpractice action from a legal perspective. This article discusses several issues involved in professional liability as it relates to the obstetrician/gynecologist. PMID- 2704263 TI - [Stress and bad personnel policy made nurses to quit their jobs]. PMID- 2704264 TI - [The 1988 Olympic Games--a turning-point in the doping problem?]. PMID- 2704265 TI - [Adrenal cortex hyperplasia in newborn infants. Promising results after screening]. PMID- 2704266 TI - [Why doesn't the number of patients with hepatitis B diminish in western Skane?]. PMID- 2704267 TI - [Prevention of sexually transmitted diseases. More resources for clinics serving adolescents]. PMID- 2704268 TI - [Prevention of cardiovascular diseases: let words be action--carry out activities for non-pharmacologic treatment]. PMID- 2704269 TI - [Medical ethics questions: When is an organism a person?]. PMID- 2704270 TI - [The quality of indoor air and its significance for health. Ventilation systems and smoking are the most hazardous]. PMID- 2704271 TI - [Injuries after rocket seat ejections in the Swedish Air Force 1967-1987]. PMID- 2704272 TI - [A Mitochondrial mutation defect is identified in Leber's hereditary optic neuropathy]. PMID- 2704273 TI - [Medical language. Technicians have what physicians lack...TNC (Technical Nomenclature Center)--in the role of both gene surgeon and midwife when new technical terms are created]. PMID- 2704274 TI - [Acute withdrawal symptoms in alcoholism]. PMID- 2704275 TI - [Suspected atypical, mycobacterium infection in a child with a neck nodule]. PMID- 2704276 TI - [Ethylene glycol poisoning--a review]. PMID- 2704277 TI - [A lack of ethylene glycol in the blood doesn't exclude severe poisoning]. PMID- 2704278 TI - [Treatment of various stages of ethylene glycol poisoning]. PMID- 2704279 TI - [Consensus conference in Norway: clinical mammography is a valuable diagnostic method, but for early recognition mass screening is recommended]. PMID- 2704280 TI - [Pleural mesothelioma--problems in diagnosis and clinical course in 25 patients]. AB - Patients with benign pleurafibromas should undergo surgery as suspect thoracic tumors have the potential to become malignant. In benign cases diagnosis can easily be made during the operation. In such a case the prognosis is good and it is seldom necessary to undergo repeated surgery due to recurrence. In the case of malignant pleuramesothelioma the preoperative diagnosis with an exact staging of the tumor is very important to determine an adequate therapeutic regimen. X-ray, CT-scanning, tapping of the pleura fluid and biopsy of the pleura are together insufficient to diagnose a pleuramesothelioma correctly. Since it is not always possible to diagnose a malignant pleuramesothelioma even at thoracoscopy, one should not hesitate to perform an open lung biopsy in order to obtain enough material under adequate vision. PMID- 2704282 TI - [What should surgeons know about Campylobacter pylori?]. PMID- 2704281 TI - [Effect of the transfusion of blood and hemoderivatives on the prognosis of colorectal cancer]. AB - In recent years in the literature several investigators described a negative effect of perioperative transfusion of blood and hemoderivatives on the prognosis of malignant tumors. Concerning the patients with colorectal carcinoma operated between 1979 and 1983 at Erlangen University Hospital these results could be proven. We observed a significantly worse 5-year survival rate for patients who received perioperative blood transfusion. However, multivariant analysis in Cox regression model revealed other factors like tumor stage and localisation responsible for the poorer prognosis. Therefore blood transfusion seems not to have any influence on the prognosis itself. Furthermore we observed a significantly poorer prognosis concerning patients who perioperatively received fresh frozen plasma (FFP). Surprisingly multivariant analysis showed that FFP substitution in contrast to blood transfusion has an own prognostic influence. This difference in prognosis cannot be explained by selection criteria. The mechanism of the negative influence of FFP on the prognosis of colorectal carcinoma remains unclear and is investigated currently in prospective studies. PMID- 2704283 TI - [Breast saving treatment in the primary therapy of breast cancer]. PMID- 2704284 TI - [Breast saving therapy in the small breast cancer]. AB - According to the satisfying results reported by Fisher, Veronesi and other authors who used a breast-conserving operation modality in the treatment of breast cancer since 1980 109 patients with a carcinoma up to 2.5 cm underwent this kind of operation at the surgical department of the Hanusch-Hospital, Vienna. Although the median follow-up-time (29 months) is too short for conclusive statements, results of recurrence and survival compared to 162 cases of modified radical mastectomy were satisfying. Therefore--following certain indications--breast conserving operation is offered to our patients as a possible method. PMID- 2704285 TI - [Problems of tracheotomy in locally invasive anaplastic thyroid cancer]. AB - Between 1955-1985 515 patients with carcinoma of the thyroid have been operated. Among 170 cases with a local infiltration 69 tracheostomies were performed in 55% for lesions of both laryngeal nerves or intratracheal bleeding (absolute indication), in 45% as a prophylactic intraoperative procedure to avoid later death from asphyxiation (relative indication). In a retrospective study clinical results were analysed with special reference to the question whether patients profit by the tracheostomy. Follow-up examinations showed that tracheostomy did not influence the outcome of patients with a differentiated thyroid carcinoma while there was a remarkable difference in survival of patients with anaplastic tumors where those with a tracheostomy had a worse survival. In this group postoperative external radiotherapy often could not be administered or was delayed due to local complications of the tracheostoma. PMID- 2704286 TI - [Effect of time of operation and clinic organization on postoperative complications]. AB - During a 1-year period 1082 general surgical interventions were prospectively documented and their complication rates evaluated by a score system. Factors responsible for the complication rates and possibly depending on hospital organization should be analysed. The complication rates were influenced by the selection of the weekday, the length of operation time and the extent of discrepancy between planned and required operation time. Furthermore, the complication rates paralleled the extent of utilization of the operation theatre during a workday. The complication rates were not affected by the beginning of operation and the operation month as well as the monthly utilization of the operation theatres. Whether the weather did influence the complication rates could not be decided: higher complication rates were found in the summer as compared to the winter period, but the complication score was independent of the level of the outside temperature and humidity. PMID- 2704288 TI - [Splenectomy in idiopathic thrombocytopenic purpura]. AB - In the period between 1978 to 1987 16 female and 11 male patients with a median age of 35 years (range: 14 years to 85 years) underwent splenectomy for ITP. There was no lethality in the postoperative period. 77.8% of all patients are in a complete remission, only 22.2% showed a recurrence and need further conservative therapy. PMID- 2704287 TI - [The portacaval anastomosis in the liver cirrhosis model in the rat--significance of special preoperative preparation for decreasing surgical fatalities]. AB - Following portocaval anastomosis a high lethality (87%) can be observed in a standardized micronodular liver cirrhosis model. By a special preoperative regimen this lethality can be reduced to 10%. PMID- 2704289 TI - Defibrotide decreases cholesterol amount in hypercholesterolemic rabbit aorta, with no modification of plasma or lipoprotein cholesterol. AB - Defibrotide, (D) an antithrombotic agent, when administered i.v. to cholesterol fed rabbits decreased cholesterol in the aorta without changing total plasma cholesterol, triglyceride or phospholipid, nor the cholesterol, triglyceride, phospholipid and protein of plasma lipoproteins. Platelet aggregation was decreased in rabbits treated with D. There were fewer vascular lesions in the hearts and kidneys of animals treated with D than in animals fed cholesterol and treated with placebo. These data suggest that the antithrombotic activity of D and its ability to reduce platelet sensitivity could help to reduce the amount of cholesterol in the cardiovascular system in atherosclerosis-prone situations. PMID- 2704290 TI - Effect of glucagon-(1-21)-peptide on secretin-stimulated pancreatic exocrine secretion in anesthetized dogs. AB - The effects of glucagon-(1-21)-peptide on pancreatic exocrine secretion and plasma glucose levels were studied and compared with those of native glucagon in anesthetized dogs. Intravenous bolus administration of 1 nmol or 10 nmol/kg of glucagon-(1-21)-peptide evoked a significant inhibition of secretin-stimulated pancreatic juice secretion and protein output in a dose-dependent manner, as equimolar doses of glucagon did. Native glucagon induced an immediate and transient increase in pancreatic juice volume, which was followed by a significant inhibition. However, glucagon-(1-21)-peptide showed only the inhibitory action. Glucagon-(1-21)-peptide had no effect on plasma glucose levels even when a dose of 10 nmol/kg was given. The results suggest that the N-terminal amino-acid residues of glucagon play an important role in the inhibition of pancreatic exocrine secretion. PMID- 2704291 TI - Pineal involvement in the diurnal rhythm of nociception in the rat. AB - Male Wistar rats under cyclic lighting conditions (LD 12:12) were tested for tail flick latencies. A day-night rhythm of pain sensitivity was clearly demonstrated; response latencies were longest 2 hrs. before 'lights on' (-2 hrs.) and shortest 4 hours into the light phase (+4 hrs.). Hot plate data conformed to the tail flick results and supported the notion that the light-dark cycle cues were responsible for the observed diurnal rhythm of analgesia. The possible involvement of the pineal was studied on rats under LD 12:12 schedules, using two paradigms: (1) Functional pinealectomy by light induced suppression and (2) Surgical pinealectomy. The difference between hot plate response latencies measured at '-2 hrs.' and '+4 hrs.', was reduced when the analgesia tests were preceded by either functional pinealectomy or surgical removal of the pineal gland. The data indicates that the pineal gland is involved in modulation of the baseline diurnal rhythm of analgesia in the rat. PMID- 2704292 TI - Examination stress, platelet peripheral benzodiazepine binding sites, and plasma hormone levels. AB - The maximal binding capacity (Bmax) and the equilibrium dissociation constant (KD) values for [3H]PK 11195 binding to peripheral benzodiazepine binding sites were measured in the platelets of subjects immediately after examination stress and 10 days later, as well as in unstressed controls. Increased (52%; p less than 0.05) Bmax, but unaltered KD, values were observed immediately after the stress as compared to the controls. Ten days after the stress, a slight decrease (15%) in the number of peripheral benzodiazepine binding sites was observed, but their values remained higher (29%) in comparison to unstressed controls. Levels of plasma stress hormones (cortisol, growth hormone, and prolactin) did not differ in the stressed subjects from those of the controls. PMID- 2704294 TI - In vivo specific binding of [3H]1-nicotine in the mouse brain. AB - [3H] 1-Nicotine was used as a receptor ligand in the intact mouse. It was injected i.v., and radioactivity in brain regions was assayed. Nonspecific binding was estimated by pretreatment with unlabelled 1-nicotine. Radioactivity entered the brain rapidly, was heterogeneously distributed, and declined after 5 min. Estimated specific binding was highest in the medial and posterior cortex, midbrain, thalamus/hypothalamus and medulla/pons; intermediate in the cerebellum, caudate/putamen, frontal and frontoparietal cortex; and lowest in the hippocampus and olfactory bulb. Autoradiography showed similar patterns. Coinjection of unlabelled 1-nicotine reduced specific binding so that it approached estimated nonspecific binding. Nicotinic agonists reduced radioactivity in the thalamus/hypothalamus, but nicotinic antagonists were less active. Non-nicotinic drugs did not reduce brain radioactivity. The results suggest that radiolabelled nicotine may be used for in vivo receptor studies despite problems in estimating nonspecific binding. PMID- 2704293 TI - Tonic activity of submucosal neurons influences basal ion transport. AB - The influence of tonically active submucosal neurons on basal ion transport was studied using sheets of guinea pig ileum set up in flux chambers. Tetrodotoxin evoked an immediate and sustained decrease in short-circuit current that was sustained for 60 minutes compared with control tissues in which basal currents gradually decreased over time. Time-dependent changes in basal short-circuit currents in tissues treated with atropine were not significantly different from control tissues. The decrease in short-circuit current after tetrodotoxin resulted from a greater increase in net chloride absorption than sodium absorption. Changes in net sodium and chloride transport were due to an increase in the mucosal-to-serosal fluxes of these ions. The results suggest that tonic activity of submucosal neurons limits the absorptive capacity of the guinea pig ileum. PMID- 2704295 TI - Identity of acyl-CoA oxidase with glutaryl-CoA oxidase. AB - Rats fed on clofibrate- and DEHP-containing diets showed virtually proportional increases in hepatic acyl-CoA oxidase and glutaryl-CoA oxidase activities. The solubilization profiles of the two activities from the light mitochondrial fraction of the liver homogenate of DEHP-treated rats were the same, and the glutaryl-CoA oxidase/acyl-CoA oxidase activity ratio remained constant through the purification. The final preparation obtained was a single protein based on the result of polyacrylamide gel electrophoresis. The evidence indicates that the two activities are associated with the same protein. PMID- 2704296 TI - She cares for the ones no one cares about. Interview by Carol Stocker. PMID- 2704297 TI - A strategy for analysing multiple risk factors with application to cervical pain syndrome. AB - When studying the possible effects of several factors in a given disease, two major problems arise: (1) confounding, and (2) multiplicity of tests. Frequently, in order to cope with the problem of confounding factors, models with multiple explanatory variables are used. However, the correlation structure of the variables may be such that the corresponding tests have low power: in its extreme form this situation is coined by the term "multicollinearity". As the problem of multiplicity is still relevant in these models, the interpretation of results is, in most cases, very hazardous. We propose a strategy--based on a tree structure of the variables--which provides a guide to the interpretation and controls the risk of erroneously rejecting null hypotheses. The strategy was applied to a study of cervical pain syndrome involving 990 subjects and 17 variables. Age, sex, head trauma, posture at work and psychological status were all found to be important risk factors. PMID- 2704298 TI - Risk rate neglect in decisions involving invasive diagnostic procedures. AB - To investigate whether the risk of life-threatening complications influence the decisions involving invasive diagnostic procedures, a study was conducted that focused on the use of coronary angiography and endomyocardial biopsy with risk rates of either 1% or 2%. The participants included 38 physicians from two university-affiliated hospitals. Of their 76 pairs of decisions, 53% were of the "risk-avoidance" type and 26% were of the "risk-taking" type. Only 13% of decisions were of the "risk-conscious" type. The practical implication of these biases can be substantial in real-life decisions regarding events with low probability, but high-consequence risks. PMID- 2704299 TI - Recall of injury events by thirteen year olds. AB - The level of under-reporting of injury events which resulted in medical treatment was determined for a group of 631 thirteen-year olds. Two-year recall data was compared with the medical records of an accident and emergency department. Thirty nine percent of all visits to the accident and emergency department were not recalled. Recall was shown to be related to the number of injury events, time elapsed since an injury event, type and severity of injury but not to whether the victim was hospitalized. Logistic regression analysis suggested that the recall of injury events depended on the type of injury sustained, time elapsed since the injury event, the number of injury events, and an interaction effect between the time and the number of injuries. PMID- 2704300 TI - Validating the knowledge base of a therapy planning system. AB - Validation of expert system knowledge bases has proved to be difficult. This paper presents a description of a system called ScriptGen that generates test data for validating the knowledge base of the ONCOCIN cancer therapy planning system. Because of the size and complexity of the ONCOCIN knowledge base, we require tools for automated validation. ScriptGen, which applies techniques developed in testing both traditional software and expert systems, uses a parallel model of the ONCOCIN knowledge base and its own inference engine to generate test cases. We derived the limits of the system from a study that seeded errors into an existing knowledge base. PMID- 2704302 TI - Significant victories won on a number of key issues. PMID- 2704301 TI - A knowledge-based system for data analysis and interpretation. AB - Traditionally, statistical packages are employed to derive or infer facts about a Universe of Discourse through data analysis and interpretation. It is analysis that serves to transform data into information. Statistical packages provide the users with relatively easy-to-use and powerful mechanics of data analysis, but up to now they do not provide much help with the design and strategies of the analysis. As such, there is a risk of misuse of these packages by statistically inexperienced users. We propose the use of knowledge-based interfaces to support this category of users in statistical evaluations. This paper discusses our experiences from the implementation of a knowledge-based system called MAXITAB. It provides guidance in the processes of data analysis and interpretation and has been programmed as an interface to the statistical package MINITAB. PMID- 2704303 TI - A record number of bills passed in 1987-88. PMID- 2704304 TI - Governor Blanchard asks for help in lowering state's health costs. PMID- 2704305 TI - MDPAC: a potent force in Michigan. PMID- 2704306 TI - Maternal death as a result of anesthesia--the Michigan experience. PMID- 2704307 TI - Island conference promotes healthy living. PMID- 2704308 TI - MSMS endorses medical equipment leasing firm. PMID- 2704309 TI - AIDS story disturbing. PMID- 2704310 TI - Risk management revisited. PMID- 2704311 TI - Research with cognitively impaired older adults: issues of informed consent. PMID- 2704312 TI - Who is holding the baby? AB - A survey of neonatal units has been undertaken to establish how many maternity units have to separate mothers from their well, low birthweight babies or low dependency special care babies. The study also looked at some differences in the hospitals practising transitional care, or shared care with mother, and a group of maternity wards looking after babies down to 1.8 kg on normal maternity wards. PMID- 2704313 TI - Phenylketonuria. PMID- 2704314 TI - Parental understanding and attitudes towards neonatal biochemical screening. PMID- 2704315 TI - Maternal PKU pre-conception treatment--the need for free prescriptions. PMID- 2704316 TI - Pain in the neonate. PMID- 2704317 TI - Team midwifery for everyone--building on the "Know your midwife" scheme. PMID- 2704318 TI - Setting up the "team approach". PMID- 2704319 TI - The team approach to midwifery care. PMID- 2704320 TI - Practical guidance for midwives facing ethical or moral dilemmas. PMID- 2704321 TI - Pregnancy home visiting study. PMID- 2704322 TI - Managing midwifery. PMID- 2704323 TI - Midwifery--crisis within a profession. PMID- 2704324 TI - Think before you link. PMID- 2704325 TI - Prophets without honour--the burn-out of midwifery visionaries. PMID- 2704326 TI - [Dental caries]. PMID- 2704327 TI - [Prevention of dental caries. An interview with Dr. Lutz Netuschil, Tubingen]. PMID- 2704328 TI - [Hormone substitution in menopause]. PMID- 2704329 TI - [Estrogen/progesterone substitution in and following menopause. Position of the German Society of Endocrinology]. PMID- 2704330 TI - Malignancy in the neonate. AB - From January 1962 to July 1988, 34 infants less than 29 days of age who had cancer were seen at St. Jude Children's Research Hospital (SJCRH). The malignancies in this group consisted of 19 neuroblastomas, 6 leukemias, 3 retinoblastomas, 2 Wilms' tumors, 2 melanomas, and 2 teratomas. Twenty-three patients (68%) are alive and free of disease 2 months to 24 years after diagnosis. We reviewed the presentation and initial symptoms, pathology reports, patient population, associated anomalies, potential genetic influences, and possible perinatal factors. The most common initial symptom was an enlarging abdomen or abdominal mass. Pathological findings were occasionally difficult to interpret; five additional infants who were referred to us did not have malignancies. There was no increased incidence of associated anomalies or perinatal insults. The only genetic factor was retinoblastoma in one parent of each infant diagnosed as having retinoblastoma. The possible etiology of neonatal tumors is discussed. PMID- 2704331 TI - Soft tissue sarcomas in infants younger than 1 year of age: a report of the German Soft Tissue Sarcoma Study Group (CWS-81). AB - Of 357 patients with soft tissue sarcomas (STSs) who were registered between 1981 and 1986 in the CWS-81 study, 21 (5.8%) were younger than 1 year of age. Six cases were probably of congenital origin since they were diagnosed in the 1st month of life. There was no difference in clinical grouping (staging and primary site) between infants and older patients. The major histological subsets comprised 12 patients with embryonal rhabdomyosarcoma (57% vs. 44% in older patients) and five patients with fibrosarcoma (23% vs. 2% in older patients). Of 21 patients, 17 received chemotherapy. The response rate (tumor reduction more than 1/3) to exclusive cytostatics therapy within 7-9 weeks, of ten evaluable patients, was 100% (vs. 86% in older patients). Eight of the responders achieved complete remission after 16 weeks of therapy and are in continuous complete remission (CCR). Most patients received 20-50% of the recommended chemotherapy dose for older children, which was calculated using body surface area. No fatal or life-threatening complications were observed. The event-free survival rate for children younger than 1 year of age with rhabdomyosarcoma was 70% vs. 47% in older children (no significant difference). Now, 2-5 years after therapy all five fibrosarcoma patients are alive and free of disease. Our data indicate that children under 1 year of age with rhabdomyosarcoma have a slightly better prognosis than older children, when therapy modalities are adapted to age. PMID- 2704332 TI - Similar chromosomal patterns and lack of N-myc gene amplification in localized and IV-S stage neuroblastomas in infants. AB - Chromosome analysis was performed on 33 neuroblastomas in infants. Near triploid chromosome abnormalities (range, 60 to 77) were found in 29 patients with localized and IV-S stage neuroblastoma, and hyperdiploidy (range, 50 to 56) in 3 patients with localized neuroblastoma. No marker chromosome 1, homogeneously staining region (HSR), or double minutes (DMS) was observed in these patients, all of which have been previously reported in advanced neuroblastomas. N-myc gene amplification was not detected in any of these patients. All the patients were completely free of disease 4-45 months after diagnosis. Only one patient with stage IV neuroblastoma had a marker chromosome 1 (mode 46) and N-myc gene amplification and relapsed. Five patients with IV-S neuroblastoma lacking N-myc gene amplification had near triploid chromosomal abnormalities similar to those seen in localized neuroblastoma in infants. We consider that, cytogenetically, localized and IV-S neuroblastoma may be within the same disease category and different from advanced neuroblastoma. PMID- 2704333 TI - Selection of a management strategy for pediatric brainstem tumors. AB - Brainstem tumors arise in portions of the rhombencephalon and mesencephalon. Some authorities include diencephalic tumors in this group. We have reviewed our clinical experience of 69 children (less than 21 years of age) with brainstem tumors evaluated and treated at Duke University Medical Center (DUMC) from 1960 to 1986. There were 19 patients with group 1 tumors (thalamus, third ventricle region, or midbrain) and 50 with group II tumors (pons, medulla oblongata). The common presenting signs and symptoms were ataxia, headache, motor loss, and cranial nerve palsies. The most commonly employed diagnostic imaging studies were air examinations and CT. Preradiotherapy confirmation of malignancy was obtained in five group I patients (astrocytoma, 4; germinoma, 1) and 8 group II patients (astrocytoma, 3; anaplastic astrocytoma, 2; glioblastoma multiforme, 3). All patients received radiotherapy. The 5-year survival rate for the entire population was 40%. The survival rate for group I patients was significantly better than that observed for group II patients. In the 50 group II patients neither patient sex nor age nor presence of cranial nerve palsies nor pretreatment CT scan findings nor field size influenced survival. A long duration of symptoms positively influenced survival. The vast majority of tumor recurrences were within the radiation field. Half of the patients had either stable or improved Karnofsky status 6 months following completion of irradiation. The management strategy for childhood brainstem tumors is discussed. PMID- 2704334 TI - Pulmonary function in childhood leukaemia survivors. AB - Little is known of pulmonary function in survivors of acute lymphoblastic leukaemia (A.L.L.); this is despite the fact that some drugs used, most notably methotrexate, have well-recorded pulmonary toxicity, and the most common infections during therapy in most series are of upper and lower respiratory tract. As part of a survey of all cancer survivors attending the Royal Hospital for Sick Children in Edinburgh, 38 leukaemic patients, who had completed treatment 3 months to 14 years 6 months (median 6 years and 8 months) prior to survey were assessed with regards to their respiratory status. Each patient completed a questionnaire and had spirometry and lung volumes measured; 30 patients additionally had transfer factor for carbon monoxide (TCO) measured. There were 21 children, 11 adults, and 6 patients in the age range between child and adult. Of the 26 adults and children studied with complete data available, 17 (65%) had one or more low values for vital capacity (VC), total lung capacity (TLC), residual volume, or TCO. Mean VC, TLC and TCO were significantly lower than the mean of the predicted values (P less than .001). Gas transfer per unit lung volume (KCO) was normal in all cases. Few patients had symptoms of respiratory disease. There was an increased incidence of low TCO in patients diagnosed under 8 years of age. Impairment of lung growth could be a contributing factor to the observed abnormalities in pulmonary function. Impairment of pulmonary function in survivors of A.L.L. may be of significance for them in later life. PMID- 2704335 TI - Very late recurrence of childhood acute lymphoblastic leukemia treated with chemoimmunotherapy: a report of three cases occurring 19, 11, and 9 years after discontinuation of chemotherapy. AB - Current therapeutic modalities for childhood acute lymphoblastic leukemia (ALL) are associated with a high cure rate, and recurrences more than 4 years after therapy cessation are very unusual. We report three cases of exceptionally late recurrences of childhood ALL after cessation of chemotherapy (CT) given for respective periods of 8, 7, and 24 months. CT was followed by maintenance immunotherapy (IMT) with Bacillus Calmette-Guerin (BCG) and allogeneic leukemic lymphoblasts pretreated with formaldehyde or irradiated in vitro. Leukemic recurrences were observed 19, 11, and 9 years after cessation of CT and appeared morphologically similar to the original blasts. A second complete remission was easily achieved in all three patients, but two went on to repeated relapse (one has died following the fourth recurrence). We speculate that some residual leukemic cells, remaining after the inadequate, short-term CT, were responsible for these unusual evolutions, and we question a possible delaying role of IMT in prolonging remission. Other possible etiologies are discussed. PMID- 2704336 TI - Mitoxantrone and high-dose ara-C in refractory malignancies: a phase I trial. AB - On the basis of in vitro studies demonstrating marked synergy between mitoxantrone and high-dose cytosine arabinoside (ara-C) (HiDAC) against L5178Y murine leukemia and clinical studies showing usefulness of the combination in patients with refractory acute myeloid leukemia, a phase I study was initiated to find tolerable doses for use in patients with refractory solid tumors. Initial dose levels were mitoxantrone 2 mg/m2 infused over 30 minutes, followed by high dose ara-C 750 mg/m2 infused over 3 hours repeated once at 24 hours (total dose 4 mg/m2 mitoxantrone and 1,500 mg/m2 HiDAC per 2-day course), with planned subsequent escalation of mitoxantrone. Moderate-to-severe myelosuppression, however, required sequential dose reduction of both agents. Nonhematologic toxicity was restricted to manageable nausea and vomiting in one-half the patients and a single episode of transient delirium of uncertain etiology. No responses were observed in 23 heavily pretreated patients with a wide variety of malignancies. On the basis of this study, doses of 187-375 mg/m2 ara-C given every 24 hours for two doses following mitoxantrone 1 mg/m2 every 24 hours for two doses would be tolerated by most patients with subsequent dose escalation in some as allowed by myelosuppression. PMID- 2704337 TI - Mediastinal germ cell tumor in a young woman. AB - Primary mediastinal germ cell malignancies are uncommon neoplasms, usually presenting in young men. We review a case of a primary mediastinal seminoma occurring in a 23-year-old woman. The differential diagnosis, work-up and therapy for these lesions is discussed with emphasis on the role of magnetic resonance imaging in the evaluation of anterior mediastinal masses. PMID- 2704338 TI - Case report of successful use of VP-16 in nasopharyngeal carcinoma. AB - We report the use of VP-16 as a single agent for the treatment of nasopharyngeal carcinoma. Our patient, a 16-year-old Black Haitian male, had complete clinical and radiographic response to VP-16. The remission continued for 14 months. The patient experienced minimal toxicity. We believe that the good response, excellent compliance, and minimal toxicity experienced by our patient should encourage more trials of VP-16 as upfront therapy for patients with nasopharyngeal carcinoma. PMID- 2704339 TI - Nasopharyngeal Hodgkin's disease with intracranial extension in a child. AB - Childhood Hodgkin's Disease rarely involves the nasopharynx or the brain. This is a report of a 12-year-old boy who presented with a 3-month history of headache, diplopia, dizziness, and early morning vomiting. Computerized axial tomography (CT) scan revealed a nasopharyngeal mass with intracranial extension through the skull base. Biopsy of the nasopharyngeal mass and an upper cervical lymph node was consistent with Hodgkin's disease of mixed cellularity. This, to the author's knowledge, is the first report of a child having the combination of nasopharyngeal and intracranial involvement in Hodgkin's disease. PMID- 2704340 TI - Treatment of acute nonlymphocytic leukemia in the elderly with intermediate high dose cytosine arabinoside. AB - Effective treatment of the elderly patients (greater than or equal to 65 years) with acute nonlymphocytic leukemia (ANLL) remains elusive and controversial. In the present study, single-agent Cytosine Arabinoside (ARA-C) was administered at an intermediate dose level (500 mg/m2 intravenously [I.V.] 1-hour infusion q12 hours for 12 doses) to 30 newly diagnosed and previously untreated patients. Complete remission was achieved in seven patients after the initial cycle of treatment, in two patients after retreatment, and in one patient after delayed recovery of his peripheral count over a 6-month period. The toxicity of this schedule was primarily hematologic, and the response rate was in keeping with that reported by other groups using aggressive multiagent regimens. PMID- 2704341 TI - Treating childhood acute lymphoblastic leukaemia (ALL): summary of ten years' experience in Italy. ALL Steering Committee of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP). AB - Between 1976 and 1986, 2,093 children with ALL were enrolled in three consecutive generations of trials conducted by the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP). A 50% event-free survival at 5 years was achieved overall in this population, approximately accounting for more than 50% of the entire childhood ALL population in Italy. Participation in the group protocols increased from the original seven founding centers to the current 37 institutions. Results in the standard population (non-T immunophenotype, non-FAB L3, and less than 50,000 white blood cells (WBC/ml) were considerably better with more recent, more aggressive protocols. The two major results in this population (N = 540) were a relatively low incidence (8% at 5 years) of central nervous system (CNS) relapse in the "good"-risk population (less than 10,000 WBC, ages 3-6 years, and FAB L1), without the use of cranial irradiation, and a projected 4-year disease-free interval for bone-marrow relapse of 80% in the "average"-risk group, where a three-drug reinduction program was adopted after consolidation. Overall, the event-free survival of the most recent generation (protocol 82, median follow-up time of 38 months) is 66% at 4 years (95% confidence limits [CL] 61-71). Based on these 10 years of experience, the general strategy of the group for the 90s is outlined and discussed. PMID- 2704343 TI - Brain damage and plasticity (Part II). Proceedings from an international symposium. Kotor, Yugoslavia, June 2-5, 1988. PMID- 2704342 TI - Ovarian function following chemotherapy for childhood brain tumours. AB - Pubertal development, basal gonadotrophin, and oestradiol levels were assessed in 21 girls who had received neuroaxis irradiation for a brain tumour followed by adjuvant chemotherapy with carmustine (BCNU) or lomustine (CCNU) and procarbazine. Thirteen received chemotherapy before the age of 11 years. Ten remained prepubertal at their last assessment, nine of whom showed biochemical evidence of primary ovarian failure. The remaining three were pubertal or adult, and although basal follicle-stimulating hormone (FSH) and luteinising hormone (LH) levels were normal, all had shown abnormalities of gonadotrophin secretion previously. Eight girls received chemotherapy after 11 years of age. Only three girls exhibited an elevated basal FSH level or exaggerated FSH response to GnRH. Elevated basal FSH values had been noted previously in two of the other five girls. All girls entered or progressed through puberty spontaneously. Seven experienced menarche at an appropriate age. However in four, gonadotrophin levels, which had been elevated, were now within the normal range. In two, menses had continued throughout with normal midfollicular oestradiol levels, whilst the other two developed secondary amenorrhoea associated with radiation-induced gonadotrophin deficiency. The majority of girls showed evidence of primary ovarian dysfunction. This did not prejudice pubertal development or the timing of menarche. Ovarian function may return to normal in the years after treatment, indicating a potential for fertility. PMID- 2704344 TI - Brain plasticity after corpus callosum transection in the newborn rat. AB - The importance of afferent fibers in the final shaping of the central nervous system has been well established in several papers. In order to study how much one can influence cortical development by changing afferent input to the cortex cerebri, we transected corpus callosum in rats at 2 or 3 postnatal days. Equal numbers of lesioned and control animals were transcardially perfused with mixed aldehydes at postnatal day 6 (P-6) or P-14. Brain tissue was processed for Golgi impregnation, Nissl stain, and quantitative electron microscopic analysis. Morphometric image analysis (MOP 3) of the primary sensory area did not show significant differences with respect to cortical depth and total and apical dendritic length. The cross-sectional area and maximal diameter of neuronal cell bodies were smaller in P-14-lesioned animals. Ultrastructural analysis of the cortex revealed that synaptic density was not reduced in lesioned animals. In conclusion, early in development, rat brain can compensate for major changes in the commissural afferent system. PMID- 2704345 TI - Growth-associated protein 43 is down-regulated in cultured astrocytes. AB - Growth-associated protein 43 (GAP-43: other designations--pp46, F1, B-50, p-57) is an abundant, neural, membrane-associated protein involved in synaptic plasticity and regeneration. We recently reported that GAP-43 is present in plasma membranes of cultured rat astrocytes. In the present study the level of astrocytic GAP-43 was assessed by indirect immunofluorescence labeling of cells with a specific anti-GAP-43 serum and immunoblotting of plasma membrane proteins. The results indicate that all astrocytes from 1-day-old cortex contained GAP-43 and those differentiated in culture did not. Furthermore, GAP-43 decreased dramatically during 3 weeks in culture. These results are consistent with the developmental down-regulation of GAP-43 in vivo. PMID- 2704346 TI - Ablation of the area postrema and emesis. AB - The emetic action of dopamine, norepinephrine, epinephrine, nicotine, dimethylphenyl-piperazinium (DMPP), and 4-m-chlorophenylcarbamoyloxy-2 butynyltrimethylammonium (McN-A-343) injected intracerebroventricularly (i.c.v.) to the unanesthetized cat was investigated and compared. ED50 values (mg) were as follows: nicotine, 0.011; epinephrine, 0.047; norepinephrine, 0.57; DMPP, 0.9; dopamine, 1.66; and McN-A-343, 4.42. The most potent was nicotine, whereas the least active McN-A-343. On the other hand, DMPP produced the longest emetic response, about 30 min, while McN-A-343-induced emesis lasted up to 1 min. The ablation of the area postrema abolished the emetic response to i.c.v. dopamine, norepinephrine, epinephrine, nicotine, and DMPP. However, the emetic response to i.c.v. McN-A-343 was significantly reduced in cats with an ablated area postrema. Taken together, the results obtained show that the area postrema is almost always involved in the central regulation of emesis and that the area postrema represents, in most cats, a common site of confluence of different inputs subserving the emesis. PMID- 2704347 TI - The area postrema and the hypertensive effect of angiotensin. AB - The intracerebroventricular administration of angiotensin II in pentobarbital anesthetized cats produced dose-dependent increases in the arterial blood pressure without significant changes in the heart rate. The ablation of the area postrema significantly reduced, but did not abolish, the pressor effect of angiotensin injected into the cerebral ventricles. It follows, then, that the central pressor effect of angiotensin is dependent on the integrity of the area postrema and that this central site, at least in part, contributes to the pressor action of endogenous angiotensin. PMID- 2704348 TI - Crisis in the country: retention of nurses in rural hospitals. PMID- 2704349 TI - Recruiting steps up in schools. PMID- 2704350 TI - The nursing shortage: personal perspectives. PMID- 2704351 TI - Survey reveals nursing shortage in state: is there a nursing shortage in Mississippi? PMID- 2704352 TI - The nursing shortage: is there an answer? PMID- 2704353 TI - Caffeine citrate in the NICU. AB - Administering caffeine citrate is a safe, noninvasive way to treat premature infants with persistent apnea. This drug decreases the frequency of apneic episodes, thus reducing the need for mechanical ventilation. It is given once a day, either orally or intravenously. Ideally, caffeine citrate can treat apnea of prematurity and prevent insults to the premature infant's neurological status. PMID- 2704354 TI - Drug protocols. PMID- 2704355 TI - Ethics in theory and practice. The principled way. PMID- 2704356 TI - The AMA: gambling with nursing's future. PMID- 2704357 TI - Pharmacokinetic considerations in neonatal drug therapy. AB - The application of pharmacokinetics has contributed to improved drug treatment regimens for the neonatal population. Significant advances in neonatal drug therapy occurred once it became possible to measure serum concentrations for medications with a narrow therapeutic range or low margin of safety. The nurse who understands the neonate's pharmacokinetic profile will not only be aware of the therapeutic effects and signs of toxicity of a given drug; she will also be able to actively plan the preferred route of administration with the physician and pharmacist and accurately time medication administration and scheduled blood sampling. PMID- 2704358 TI - Professionalism: the plight of the American nurse. PMID- 2704359 TI - [Clinical features of traumatic diaphragmatic injuries with or without herniated visceral organs]. AB - The difficulty of diagnosis and selection of operative approach in traumatic diaphragmatic injuries (T. D.I.) have been debated for a long time. The reason why these problems remain unsolved is possibly due to the inaccuracy in the definition of T.D.I. We propose to classify the T.D.I. into two categories; diaphragmatic rupture without herniated visceral organs (D.R.) and diaphragmatic hernia with herniated visceral organs (D.H.). Clinical features in these two groups (D.R. in 9 cases and D.H. in 11 cases) were compared and discussed as follows: 1) Intrathoracic injuries were associated in all cases of both groups, but intraabdominal injury was found in 90.9% of D.H., whereas 33.3% of D.R. 2) Diagnostic findings in chest X-ray were not observed in D.R., but frequently observed in D.H. 3) All cases of D.R. were operated through a single approach (transabdominal or transthoracic), but additional approach was necessary in 78% of D.H. It is considered that T. D.I. should be classify into D.R. and D.H. because T.D.I. with or without herniated visceral organs exhibit definitely different clinical features. PMID- 2704360 TI - [Experimental study of superior vena caval's reconstruction with ringed E-PTFE grafts]. AB - For evaluating whether 2 types of expanded polytetrafluoroethylene, ringed E-PTFE graft can be utilized for venous reconstruction, especially, for superior vena caval reconstruction or not, the ringed E-PTFE grafts which had 10-15 micron fibril length and 30 micron fibril length were implanted between the innominate vein and the right atrium of the 20 dogs. The grafts were removed for histological and scanning electromicroscopic evaluation at intervals varying from one to twelve postoperative months. Overall patency rate was 62% and severe stenosis at the site of anastomosis was seen in 2 grafts. More than half of the graft showed mild to moderate intimal hyperplasia at the anastomotic sites and the early stage of thrombosis at the middle of the grafts. Mesenchymal cell infiltration was occurred in 46% of the grafts. PMID- 2704361 TI - [Studies on the relationship between desmosomes and the mode of infiltration and metastasis of esophageal cancer]. AB - To define highly metastatic esophageal cancers morphologically, desmosomes were evaluated numerically and morphologically under electron microscope. Twenty-six esophageal cancers were analyzed. The prognosis of patients was also analysed with reference to the findings of desmosomes. The number of desmosomes per cell perimeter was significantly reduced in cancer cells (8.9 +/- 3.4/cell), as compared with normal esophageal epithelia (21.0 +/- 2.6/cell), especially in epidermoid carcinoma invading as thin irregular cords of cells or with metastasis to lymph nodes (7.8 +/- 3.1/cell) and distant organs (4.8 +/- 4.3). A positive correlation was found between desmosomes and prognosis. These results suggested that the number of desmosomes was a good parameter for malignancy of esophageal cancer. PMID- 2704362 TI - [A case report of sacral chordoma]. AB - Sacrococcygeal chordoma is one of the retrorectal tumors. Relative rarity and anatomical location of this may lead to difficulty in diagnosis and surgical treatment. We report a case of sacrococcygeal chordoma successfully treated by high sacral resection by a posterior approach, in which the co-operative efforts of gastroenterological surgeons and an orthopedic surgeon were employed. A 64 year-old man with a long term continued vague anal pain was referred to our hospital. Digital rectal examination revealed an elastic hard mass presacrally. Plain sagittal radiograph, CT, barium enema showed a retrorectal mass and sacral destruction. Diagnosis was confirmed histologically by the specimen taken by open biopsy. Surgical resection was carried out in prone position with the buttocks elevated. The skin incision was upward arched transverse. The lower sacral vertebrae, including S3, were removed en block with the tumor. Bilateral S3 sacral nerve roots were preserved. Postoperative disturbances of the urination and defecation were not seen. High dose radiation therapy, 80 Gray, was done after surgery. Radiation ulcer of the skin was treated by free skin graft, but radiation proctocolitis was not seen. Now he is free from the disease. PMID- 2704363 TI - [Factors influencing depression of natural killer activity and its prevention in esophageal cancer patients]. AB - Factors influencing the depression of natural killer (NK) activity and its prevention were studied in 57 esophageal cancer patients. NK activity off peripheral blood mononuclear cells was measured by a 51Cr-release assay against K 562 target cells. NK activity in esophageal cancer patients was significantly lower than that in healthy individuals and tended to be lower compared with those in stomach and colon cancer patients. The depression of NK activity was significantly correlated with the reduction of serum albumin level, creatinine height index of nutritional assessment. The activity was also suppressed in proportion to the size of cancer and its staging. Both preoperative radiation and surgery markedly depressed NK activity. Postoperative depression recovered to the Preoperative level 4 weeks after operation. These results indicated that malnutrition, cancer bearing and therapeutic stress were associated with the depression of NK activity. As the preventive measures against such depression of NK activity, avoidance of preoperative radiation and better selection for two stage operation enhanced recovery of the depressed NK activity. Furthermore, the preoperative administration of OK-432, as n immuno-activator, could be effective to minimize a decrease of NK activity related to radiation and surgery, and to accelerate its recovery to the level before treatment. PMID- 2704364 TI - [Experimental study on artificial esophagus created by a latissimus dorsi muscle flap with grafted jejunal mucosa]. AB - An experimental study on artificial esophagus was performed in 38 mongrel dogs. Artificial esophagus was created by using a latissimus dorsi muscle, woven dacron vascular prosthesis and jejunal mucosa. A prepared latissimus dorsi muscle flap was cylindrically rolled, and jejunal mucosa with a woven dacron vascular prosthesis as a stent was inserted into this muscle canal. Although, all of these mucosal grafts fell down to necrosis with severe bacterial infections. The main cause of this failure was poor blood supply to the grafted mucosa via the muscle flap. For this reason, artificial granulation tissue with newly developed abundant vessels was made on the muscle surface by means of an insertion of the woven dacron vascular prosthesis into the muscle canal. Two weeks later, inner surface of the muscle canal had good granulations with a rich blood flow. And then the free jejunal mucosa of 10cm in length was grafted into this canal. Consequently, all grafted mucosa were well survived and had normal mucosal structures in the whole transplanted length. Based on these results, a latissimus dorsi muscle flap with the mucosal graft is possible to use as an artificial esophagus. PMID- 2704365 TI - [Dopamine infusion test as a gastric secretion test]. AB - The secretion of gastric acid in the peptic ulcer patients were examined by the dopamine infusion test (DIT). Production of gastric acid was investigated when the patients were treated by 30-minute dopamine infusion of 2 micrograms/kg/min. According to the difference of production of gastric acid, 132 patients were categorized into three groups: 59 Cata-responders, 28 Ana-responders and 45 Non responders. Cata-responders were the patients whose production was less than 0.2mEq/30 min, Ana-responders, greater than 0.2mEq/30 min and Non-responder less than or equal to 0.2mEq/30 min. Cata- and Ana-responders showed higher gastric acid secretion preoperatively, and higher gastric acid reduction rate after selective proximal vagotomy (SPV) than Non-responder. Cata-responder showed decreased acid output preoperatively and unchanged after SPV with DIT. Ana responder showed increased acid output preoperatively and decreased after SPV with DIT. Non-responder showed unchanged acid output preoperatively and decreased after SPV. Cata-responder may be depending more on vagus-mediated factor and parietal cell mass. Ana-responder may be depending more on vagus-mediated factor, parietal cell mass and dopaminergic factor. Non-responder may be depending more on gastrin cell mass and less cholinergic influence. From these findings dopamine receptor may exist in the stomach, and DIT seems to be useful in studying pathogenesis of the peptic ulcer and determining treatment for patients with peptic ulcer. PMID- 2704366 TI - [Promoting effect of bile acids on gastric carcinogenesis induced by MNNG in rats]. AB - The promoting effect of bile acids on the development of gastric carcinoma was examined in rats treated with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). At the first experiment, two hundred and fifteen male Wistar rats were divided into 5 groups; after oral administration MNNG (120 micrograms/ml) for 24 weeks, group 1 received tap water, group 2 administered of chenodeoxycholic acid (CDCA) solution, group 3 had deoxycholic acid (DCA) solution for the next 12 weeks. Group 4 received CDCA solution and group 5 received DCA solution for 36 weeks without MNNG. At the second experiment, fifty one rats were divided into 3 groups; for the first 12 weeks, group 1 received tap water, group 2 CDCA and group 3 DCA. These 3 groups received MNNG for the next 24 weeks followed by tap water for 12 weeks. The incidence of gastric adenocarcinoma in MNNG-treated rats was significantly higher in group 3 (63.6%) as compared with that in group 1 (36.7%) in the first experiment. No carcinoma lesions was found in groups 4 and 5. In the second experiment, no significant changes was observed among 3 groups. Undifferentiated adenocarcinomas were identified in groups 2 and 3, especially treated with MNNG plus bile acids. The result suggested a promoting effect of bile acids, especially DCA, in stomach carcinogenesis. PMID- 2704367 TI - [Surgical treatment in pulmonary metastases of colorectal cancer]. AB - From 1962 to 1987, 72 patients with primary colorectal cancer underwent surgical treatment for pulmonary metastases. The overall cumulative 5 year survival rate was 41.3%. But the cumulative 1 year survival rate of patients with incomplete resection was 20.0%. Reduction surgery should not be employed. Twenty-nine of 66 patients with complete resection have recurred. The most of first manifested recurrences were in the lung and within 18 months after thoracotomy. This tendency was remarkable in patients with multiple pulmonary metastases and all recurrences of them were within 18 months and 80% were multiple in bilateral lung. Almost all multiple pulmonary metastases seemed to be only one manifestation of generalized metastatic disease. So indication of surgical treatment for them should be cautious. Type of pulmonary resection had no influence on post-thoracotomy survival rate. But in patients with partial resection, 7 recurrences at surgical margin and one recurrence on regional lymph nodes were doubted. Four metastatic lesions less than 3cm in maximum diameter had metastases to the regional lymph nodes. To resect more curatively, lobectomy and systemic lymphadenectomy should be recommended as the standard operation for pulmonary metastases of colorectal cancer. PMID- 2704368 TI - [Liver resection by water jet]. AB - Major problem in resecting liver parenchyma is how to control the bleeding. Recently, resection of the liver by water jet has been reported. So, experimental and clinical studies were performed to investigate the usefulness of the water jet equipment. Ten pigs weighing around 17kg were used. The optimal pressure to resect the porcine liver was 7 to 15kg/cm2. By 4 weeks the cut surface was covered with fibrous capsule. Portal angiography showed no abnormality in the resected area. The water jet was also used in 30 human operations. The optimal pressure was 12 to 18kg/cm2 for non cirrhotic liver and 15 to 20kg/cm2 for cirrhotic liver. The surface immediately after jet cutting was more smooth than that of CUSA and histologically there was slight bleeding and necrosis. The volume of blood loss during dissection was not different between water jet group and CUSA group. No significant changes were found in the laboratory data. These results suggest that water jet is as useful as CUSA for cutting the liver parenchyma. PMID- 2704369 TI - Aminopyridines enhance opening of calcium-activated potassium channels in GH3 anterior pituitary cells. AB - The effects of aminopyridine analogs on Ca2+-activated K+ channels in GH3 clonal anterior pituitary cells were studied using whole-cell voltage-clamp and single channel recording techniques. Step depolarization from a holding potential of -50 mV activated a noninactivating, tetraethylammonium- and Cd2+-sensitive outward current. Tail current analysis indicated that this sustained outward current is carried predominantly by K+ ions. Extracellular perfusion with 4-aminopyridine and 3,4-diaminopyridine (0.05-5 mM) caused a dose-dependent enhancement of the outward current by up to 100 and 170%, respectively. This effect typically occurred with prolonged depolarizations of greater than 1-2 sec. Patch-clamp recordings in the cell-attached configuration demonstrated that 4-aminopyridine (2 mM) promotes the activity of a large-conductance (150-175 pS; 50-135 mM external K+), tetraethylammonium-sensitive, Ca2+-activated K+ channel; the drug had no effect on these channels in excised patches. These results indicate that aminopyridines enhance the opening of Ca2+-activated K+ channels in GH3 cells. Several lines of evidence suggest that this effect may occur indirectly, possibly as a result of an increase in the effective intracellular free Ca2+ level. PMID- 2704370 TI - Antagonist binding properties of five cloned muscarinic receptors expressed in CHO-K1 cells. AB - A family of five cholinergic muscarinic receptor genes (m1, m2, m3, m4, and m5) has recently been identified and cloned. In order to investigate the pharmacological properties of the individual muscarinic receptors, we have transfected each of these genes into Chinese hamster ovary cells (CHO-K1) and have established stable cell lines expressing each receptor. In the present study we have examined the antagonist binding properties of each muscarinic receptor. Antagonists were chosen that had previously been proposed to be selective for muscarinic receptor subtypes and included pirenzepine, AF-DX 116, methoctramine, dicyclomine, hexohydrodifenidol, hexahydrosiladifenidol, hexocyclium, and silahexocyclium. m1, m2, and m3 receptors express binding properties similar to those expected of high affinity pirenzepine-type receptors of cerebral cortex ("M1"), low affinity pirenzepine-type receptors of atria ("M2 cardiac type"), and the intermediate affinity pirenzepine-type receptors found in exocrine glands ("M2 glandular type"), respectively. The M1/M2 schema cannot readily accommodate the binding properties of the m4 and m5 receptors. Pirenzepine, methoctramine, and hexahydrosiladifenidol were the most selective agents for the m1, m2, and m3 receptors, respectively. None of the antagonists used in this study were uniquely selective for either the m4 or m5 receptors. The diverse binding profiles of individual cloned receptors and the widespread distribution of m1-m4 mRNAs indicate that radioligand binding studies performed on primary tissues may actually be assessing the composite properties of a heterogeneous mixture of muscarinic receptor subtypes. PMID- 2704371 TI - The existence of stable enantiomers of telenzepine and their stereoselective interaction with muscarinic receptor subtypes. AB - [3H]Telenzepine has been shown to bind with high affinity (3 x 10(9) M-1) to a subpopulation of muscarinic binding sites in rat cerebral cortex, which have a high affinity for pirenzepine. The binding kinetics were very slow at 30 degrees. Only 50% of the [3H] telenzepine was found to be capable of binding to the receptors with high affinity. This suggested the presence of optical isomers of telenzepine. These were partially resolved on the picomole scale by using cortical muscarinic receptors to selectively bind the active isomer. It was then possible to measure the temperature and time dependence of the racemization of the inactive to the active enantiomer. The energy barrier for the inversion was 35 kcal/mol, and racemization was very slow even at 90 degrees. The affinity and selectivity of the unlabeled enantiomers for the different muscarinic receptor subtypes present on membranes from rat cerebral cortex, heart, and lacrimal gland was measured. The selectivity of active (+)-isomer was considerably greater than that of the (-)-isomer. As a consequence, the stereoselectivity of the enantiomers varied from 500 (M1 receptors in cerebral cortex) to 75 (cardiac receptors). PMID- 2704372 TI - Interactions between glycolysis and mixed function oxidation: studies with 7 ethoxycoumarin in perfused livers from beta-naphthoflavone-treated rats. AB - Interaction between glycolysis and mitochondrial oxidations to supply reducing equivalents at high rates for mixed function oxidation was evaluated in the perfused liver after treatment of rats with beta-naphthoflavone. Livers from fasted beta-naphthoflavone-treated rats were employed because rates of 7 ethoxycoumarin O-deethylation were constant (16 mumol/g/hr) for at least 1 hr of perfusion. Preinfusion with KCN, an inhibitor of oxidative phosphorylation, caused the rate of 7-ethoxycoumarin O-deethylation to decline by 60% over 30 min of perfusion. The decline in rates of mixed function oxidation in the intact liver was not due to a direct effect of KCN on cytochrome P-450, inasmuch as cyanide did not diminish rates of 7-ethoxycoumarin O-deethylation by isolated microsomes. Cyanide rapidly decreased hepatic oxygen uptake by 70% and increased rates of glycolysis (lactate plus pyruvate production) from less than 10 to over 60 mumol/g/hr. Rates of glycolysis and mixed function oxidation subsequently declined in parallel during infusion of KCN. Infusion of ethanol (20 mM), a known inhibitor of glycolysis, decreased the stimulation of glycolysis caused by KCN to 20 mumol/g/hr and lowered maximal rates of 7-hydroxycoumarin production to about 6 mumol/g/hr. Both mixed function oxidation and glycolysis also declined in parallel over 30 min of perfusion in the presence of ethanol and KCN. When cyanide infusion was terminated, rates of oxygen uptake returned rapidly to basal values; however, rates of mixed function oxidation remained low. In contrast, infusion of ethanol in the absence of cyanide had no effect on rates of mixed function oxidation. Infusion of glucose (30 mM) or pyruvate (1 mM) after KCN restored maximal rates of mixed function oxidation in parallel with increases in rates of glycolysis. In contrast to results obtained in livers from fasted rats, cyanide and ethanol had little effect on 7-ethoxycoumarin O-deethylation in livers from fed rats. Taken together, these results argue strongly that rates of mixed function oxidation in the intact livers of fasted rats are sustained by reducing equivalents derived from mitochondrial oxidations. Glycolysis can supply substrates needed for the transport of reducing equivalents from the mitochondria into the cytosol for mixed function oxidation. Because glycogen reserves are minimal in the fasted state, rates of glycolysis and mixed function oxidation declined in parallel during the infusion of cyanide, because reducing equivalents derived from mitochondria are not available. PMID- 2704373 TI - The immunochemistry of sandwich ELISAs--III. The stoichiometry and efficacy of the protein-avidin-biotin capture (PABC) system. AB - The protein-avidin-biotin capture (PABC) system was developed to decrease the adsorption-induced loss of antigen capture capacity (AgCC) of capture antibodies (CAb) used in sandwich ELISAs. This system involves immobilization of biotinylated CAbs through linkage by streptavidin (SA) to biotinylated carrier proteins adsorbed on polystyrene. Studies reported here describe the stoichiometry of the system and the influence of biotinylation of different carrier proteins and CAbs on the reaction stoichiometry and the AgCC of CAbs. Because of the widespread use of sandwich ELISAs to measure the concn of multivalent protein antigens, the AgCCs of monoclonal and polyclonal CAbs to pig IgG in the PABC system were compared with the AgCCs of these Abs immobilized on the plastic by direct adsorption. Optimal assay conditions for the carrier were obtained when 1 microgram/ml of the biotinylated protein was added to the polystyrene solid phase. An increasing degree of biotin substitution in three carrier proteins was paralleled by an increasing AgCC until a constant maximum was reached. Under conditions of maximal AgCC, 120 ng of the carrier rabbit gamma globulin (RGG; i.e. RGG25biot) was bound to polystyrene, which in turn yielded the maximum amount (i.e. 100 ng) of bound streptavidin (SA; Bdngmax) when 20 micrograms/ml of SA was added. Under conditions giving the Bdngmax for SA, CAb12biot yielded a higher Bdngmax than did CAb25biot or CAb2biot. When the AgCC of equal amounts of differentially biotinylated CAbs were compared, the following order of AgCC was observed: CAb12biot greater than CAb12biot greater than CAb25biot. Hence, while the maximal amount of CAb is immobilized on SA when CAb12biot is used, optimal AgCC is achieved with CAb2biot. The carrier:SA:CAb2biot ratio was 1:2:1 while that for carrier:SA:CAb12biot was 1:2:2. The same ratio was obtained using IgG2biot from four different species. Monoclonal antibodies to swine IgG showed a 5-6-fold increase in Bd%max when immobilized as CAbs using the PABC system versus when adsorbed on polystyrene. Plots of these data suggest that the differences result from a loss of functional affinity. On the contrary, no significant differences in Bd%max and hence functional affinity were observed when a polyclonal antibody to pig IgG was compared using the two assay configurations. Furthermore, when the globulin fraction of the anti-pig polyclonal was adsorbed on plastic, it behaved nearly as well as its affinity-purified counterpart immobilized by the PABC system. The PABC system appears to offer significant advantages for sandwich ELISAs utilizing monoclonal antibodies as the CAb, and may offer some advantages in other s PMID- 2704374 TI - Estimation of the avidity of antibodies in polyclonal antisera against Streptococcus pneumoniae type 3 by inhibition ELISA. AB - The reliability of the determination of antibody avidity in polyclonal sera by indirect sandwich ELISA was studied. Binding of IgM and IgG (sub)classes in unpurified serum to Streptococcus pneumoniae type 3 capsular polysaccharide, which was coated onto ELISA plates, was inhibited with different inhibitors. The inhibitor concn at which 50% inhibition of antibody binding to the ELISA coat was achieved, was used as a measure for antibody avidity. As this 50% inhibition value is dependent upon the dilution of the serum and thus upon the initial amount of free antibody, it is necessary to define (a narrow range of) final ELISA absorbance values to which the dilutions of non-inhibited sera have to be adjusted. The shapes of the serum dilution curves have a good correlation with the numerical 50% inhibition values of the antibody avidity. The inhibition ELISA is suitable to compare the avidity values of the different antibody isotypes, but two remarks should be made: (1) antibody heterogeneity should be considered to influence the results and prevent the accurate measurement of absolute numerical avidity values. Because in the ELISA system merely antibody "activity" is measured, comparison of the efficacy of vaccines by means of the 50% inhibition (avidity) value of various antibody (sub)classes can still be performed in a reliable way; (2) results of the determination of the 50% inhibition values of the different antibody (sub)classes showed them to be dependent on the molecular ratio between antibody (sub)class levels. More aspects of the determination should be taken into account, like shapes of simple dilution curves, influences of various inhibitor concns in the diluent and whole (extended) inhibition curves. PMID- 2704375 TI - Binding of human IgA1 and IgA1 fragments to jacalin. AB - Interaction of jacalin, an N-terminal galactose specific lectin, with human IgA1 and IgA1 fragments was investigated. IgA1 and all galactose containing fragments bound to jacalin-Sepharose, including Fab fragments containing only the galNac linked to serine-224 and Fc fragments containing four gal-galNac sequences. These data indicate that both the galNac and gal-galNac sequences can interact with jacalin. Jacalin precipitated IgA1 and the fragments F(abc)2, F(ab')2 and Fc in agar gel and from solutions. It also precipitated Fab' fragments in agar gel. Jacalin did not precipitate Fab fragments significantly. This suggests that, except for the single binding site on the Fab fragments containing the galNac linked to serine-224, jacalin itself also has a limited number of sites to interact with N-terminal galactose residues. ELISA studies revealed that intact IgA1 had a lower jacalin binding capacity than F(abc)2 fragments which lack CH3 domains, than F(ab')2 which lack the CH2 and CH3 domains, and than Fc fragments containing four gal-galNac sequences. This led to the conclusion that part of the galNac or gal-galNac sequences in intact IgA1 molecules are inaccessible to interaction with jacalin. Cleaving the C-terminal domains off may have induced a reorientation of the hinge region structure, including the orientation of the carbohydrate units. PMID- 2704376 TI - Recombination between VH pseudogenes. AB - The peculiar pattern of nucleotide differences between germline VH genes V104A/VAR104 and 122B could be the result of an exchange of genetic information through gene conversion. A palindromic sequence in one of the genes seems to have been the target site for the break that initiated recombination. PMID- 2704377 TI - Comparison of the 40 kDa hematopoietic cell antigens bound by monoclonal antibodies IV.3, 41H.16 and KB61. AB - A study is presented which compares the properties of antigens with relative mol. mass of about 40,000, detected by three different monoclonal antibodies: IV.3, 41H.16 and KB61. Antibody IV.3 has been shown (in work by other investigators) to detect the Fc receptor for IgG. It recognizes this molecule on neutrophils, macrophages and platelets. Antibody 41H.16 precipitates a molecule of mol. wt of approximately 40,000, which is present on B cells, neutrophils and macrophages. The antigens precipitated by IV.3 and 41H.16 have been compared by isoelectric focusing, sequential antibody-mediated affinity chromatography and trypsin hydrolysis. The results indicate that these two antibodies bind different molecules of similar relative mol. mass. A third antibody, KB61, has been reported, which also reacts with a 40,000 mol. wt molecule and has a distribution of cellular reactivity which is similar to 41H.16. Sequential preclearing experiments have shown that these molecules recognize the same antigen. PMID- 2704378 TI - SCE induction by CCNU and pregnancy. PMID- 2704379 TI - Mutagenicity of sodium saccharin to human cells in vitro. PMID- 2704380 TI - Comments on the proposed use of Salmonella and structural alerts for the prediction of rodent carcinogens. PMID- 2704381 TI - Reference to unpublished data in review articles--response to Ashby's comments. PMID- 2704382 TI - In vivo and in vitro genotoxic evaluation of indorenate. AB - 5-Methoxytryptamine, beta-methylcarboxylate hydrochloride (indorenate) is a new antihypertensive serotonin derivative. We evaluated its genotoxic activity using the mouse bone marrow and cytogenetic test and the human lymphocyte culture cytogenetic assay. As endpoints we measured chromosomal aberrations, sister chromatid exchanges and cellular proliferation kinetics. Our results agree in both systems showing that indorenate is a non-genotoxic agent in these assays. PMID- 2704383 TI - Triethylene melamine-induced sister-chromatid exchange in murine lymphocytes exposed in vivo. AB - The induction of sister-chromatid exchange (SCE) by triethylene melamine (TEM), a known animal carcinogen, was investigated in an in vivo exposure/in vitro culture murine lymphocyte assay. Dose-related increases in SCE were observed in B6D2F1 mice following a single i.p. injection of 0.5, 1 or 2 mg/kg TEM. SCE frequencies remained elevated over baseline levels at 24 h post exposure. It is hoped that studies of this nature can determine whether the in vivo/in vitro murine lymphocyte SCE assay is useful for predicting the carcinogenic potential of an agent. PMID- 2704385 TI - Chromosome aberrations in spermatogonia and sperm abnormalities in Curacron treated mice. AB - Curacron is an organophosphorus pesticide widely used in cotton fields. In order to assay its mutagenic potential in mammalian germ cells chromosomal aberrations in spermatogonial cells and sperm abnormalities were examined in mice after Curacron treatment. For studying chromosomal aberrations mice were treated both acutely (single treatment) and subacutely (for 5 consecutive days) with 3 dose levels of Curacron, 12, 36 and 72 mg/kg. Curacron was found to produce a significant increase in structural chromosomal aberrations after acute and subacute treatments. This increase was dose-dependent. A dose-dependent inhibition in mitotic activity in spermatogonia was also found. For studying sperm abnormalities mice were treated for 5 consecutive days with 20, 40 and 60 mg/kg. Morphological sperm abnormalities increased significantly after treatment with Curacron. The increase was dose-dependent. An inhibition of 40.2% in sperm count and of 74.5% in sperm motility occurred after treatment with 60 mg/kg Curacron. These results show that Curacron has a damaging effect on spermatogonial cells as well as on sperm morphology. PMID- 2704384 TI - Assessment of unscheduled DNA synthesis in a cultured line of renal epithelial cells exposed to cysteine S-conjugates of haloalkenes and haloalkanes. AB - The ability of S-(1,2-dichlorovinyl)-L-cysteine (DCVC), S-(1,2,2-trichlorovinyl) L-cysteine (TCVC), S-(1,2,3,4,4-pentachlorobutadienyl)-L-cysteine (PCBC), S-(2 chloro-1,1,2-trifluoroethyl)-L-cysteine (CTFEC) and S-(2-chloroethyl)-L-cysteine (CEC) to induce DNA repair was investigated in LLC-PK1, a cultured line of porcine kidney tubular epithelial cells. DNA repair due to exposure of the cells to the S-conjugates was determined as unscheduled DNA synthesis (UDS) after inhibition of replicative DNA synthesis in confluent LLC-PK1 monolayers. DCVC, TCVC and PCBC induced dose-dependent UDS in LLC-PK1 at concentrations which did not impair the viability of the cells compared to untreated controls; higher concentrations were cytotoxic, resulting in lactate dehydrogenase leakage into the medium. Cell death was also induced by CTFEC, which failed to exert genotoxicity. CEC induced the highest response among these cysteine conjugates without impairing cell viability. Inhibition of cysteine conjugate beta-lyase with aminooxyacetic acid abolished the effects of DCVC, TCVC, PCBC and CTFEC but did not influence the genotoxicity of CEC. PMID- 2704386 TI - Direct third party reimbursement for nurses. PMID- 2704387 TI - Elevated phosphoglycerate kinase mRNA but not protein in monomorphic Trypanosoma brucei: implications for stage-regulation and post-transcriptional control. AB - Phosphoglycerate kinase (PGK) is present in high levels in the glycosomes of bloodstream stage Trypanosoma brucei, but is virtually absent in procyclic stage glycosomes. Glycosomes isolated from slender and stumpy stage bloodforms show similar levels of PGK, although levels are slightly lower in stumpy forms. Lower levels of glycosomal PGK transcripts are observed in stumpy form RNA, paralleling the decrease in glycosomal PGK activity. Monomorphic strains and pleiomorphic strains show similar glycosomal PGK activity, but monomorphic strains have much higher levels of the glycosomal PGK transcript. In three separate cases, predominantly monomorphic strains derived from highly pleiomorphic strains showed increased levels of glycosomal PGK (gPGK) mRNA. gPGK synthesis rates in monomorphic and pleiomorphic strains were similar, and no significant differences in turnover were observed. These data suggest the possibility of translational control of gPGK protein levels in trypanosome bloodforms. The data also indicate that the metabolism of gPGK mRNA in highly passaged laboratory strains is altered, and counsel caution when attributing differences in transcript levels to stage-specific regulation. PMID- 2704388 TI - Onchocerca volvulus heat shock protein 70 is a major immunogen in amicrofilaremic individuals from a filariasis-endemic area. AB - Infestation with organisms causing lymphatic filariasis (i.e. Wuchereria bancrofti and Brugia malayi) results in a variety of clinical presentations. It is possible that some of the variation is due to differences in host response to parasite. To determine whether individuals who live in an endemic area but differ in their clinical manifestations respond to different filarial antigens, we screened Onchocerca volvulus expression libraries with sera from a number of individuals belonging to different clinical groups. The results of the study demonstrate that there are indeed differences in the recognition of three cloned filarial antigens and that this differential recognition is related to clinical symptomatology. The most striking finding is that an Onchocerca volvulus protein homologous to the 70 kDa Xenopus laevis heat shock protein is primarily recognized by individuals who are amicrofilaremic. Further analysis is required to determine whether these antigens play any role in the pathogenesis of filarial infection or have any potential value in protective immunity. PMID- 2704390 TI - Faure Hospital at the National Accelerator Centre. PMID- 2704389 TI - Purification and characterization of the adenine phosphoribosyltransferase and hypoxanthine-guanine phosphoribosyltransferase activities from Leishmania donovani. AB - The adenine phosphoribosyltransferase (APRTase) and hypoxanthine-guanine phosphoribosyltransferase (HGPRTase) activities from promastigotes of Leishmania donovani have been purified to homogeneity using ammonium sulfate precipitation, DEAE-cellulose exclusion, and either AMP-agarose (APRTase) or GTP-agarose (HGPRTase) affinity chromatography. The specific activities of the affinity purified APRTase and HGPRTase fractions were 326-fold and 1341-fold greater than those in the 40-80% ammonium sulfate precipitate, respectively. The purified APRTase migrated as a single band on sodium dodecyl sulfate (SDS) polyacrylamide gels with a size of 29 kDa, while HGPRTase was also determined to be homogeneous by SDS gel electrophoresis with a size of 24 kDa. In addition, a mutant cell line, APPB2, partially deficient in APRTase activity, still contained quantities of purifiable APRTase protein, while a clonal secondary derivative of the APPB2 cell line that is completely deficient in APRTase activity, APPB2-640A3, failed to express purifiable APRTase protein. The homogeneous enzymes possessed apparent Km values for their nucleobase substrates between 2.0 and 5.0 microM, and both enzymes were inhibited by their immediate or ultimate reaction endproducts, APRTase by AMP and PPi and HGPRTase by GMP, GTP, and PPi. The generation of homogeneous preparations of APRTase and HGPRTase protein will serve as a prerequisite for the generation of immunological and molecular biological probes to analyze the leishmanial phosphoribosyltransferases. PMID- 2704391 TI - Wounds caused by weapons of war. Part I. PMID- 2704392 TI - How valuable are vitamins? PMID- 2704393 TI - Midwives' inservice training in newborn-care in the Cape. PMID- 2704394 TI - [Hospital romances: bicycles and flowers]. PMID- 2704396 TI - AIDS education forges ahead. PMID- 2704395 TI - Planning an academic nursing school in the north of Israel. PMID- 2704397 TI - [Nursing as a mission]. AB - When nursing is viewed as a mission (calling) five facets ought to be built in the nurse's approach: a philosophical-, a personal-, a interpersonal-, a scientific-, and a professional facet. When attention is given to all five these facets it is just as a diamond that is polished to shine. These facets are in reality interwoven and are only differentiated to be discussed. PMID- 2704398 TI - Counselling teenage males about sex. Part 4. PMID- 2704399 TI - Single-use drapes. PMID- 2704400 TI - Ethical, legal issues for nurses: further perspectives. PMID- 2704401 TI - Continuous assessment strategy for post-basic courses. PMID- 2704402 TI - Choice or habit?: a surgical glove study. PMID- 2704403 TI - Lasers in surgery. PMID- 2704405 TI - Course evaluation meetings. An alternative strategy. PMID- 2704404 TI - Cataract extraction with lens implant. PMID- 2704406 TI - But is it nursing? PMID- 2704407 TI - Does anyone fancy a sandwich? PMID- 2704408 TI - Staff development in the operating theatre. PMID- 2704409 TI - Occupational hazards of bone cement: the realities. PMID- 2704410 TI - An evaluation of three systems for the extraction of methylmethacrylate vapour in orthopaedic operating theatres. PMID- 2704411 TI - Law and the nurse. PMID- 2704412 TI - The curate's egg: a review of the "White" and "Working" Papers on the NHS. PMID- 2704413 TI - Inquiry into Pasteur deaths. PMID- 2704414 TI - Soviets readmitted to WPA. PMID- 2704415 TI - Blood products. All suspect in India. PMID- 2704416 TI - Drosophila back to front. PMID- 2704417 TI - Clue to seal epizootic? PMID- 2704418 TI - Posterior segmentation of the Drosophila embryo in the absence of a maternal posterior organizer gene. AB - Maternal hunchback activity suppresses the genetic pathway for abdomen formation in the Drosophila embryo. The active component of the posterior group of maternal genes, nanos, acts as a specific repressor of hunchback in the posterior region. Absence of both repressors results in normal embryos, indicating that posterior segmentation may not directly require maternal determinants. PMID- 2704419 TI - The Drosophila posterior-group gene nanos functions by repressing hunchback activity. AB - The development of the body plan in the Drosophila embryo depends on the activity of maternal determinants localized at the anterior and posterior of the egg. These activities define both the polarity of the anterior-posterior (AP) axis and the spatial domains of expression of the zygotic gap genes, which in turn control the subsequent steps in segmentation. The nature and mode of action of one anterior determinant, the bicoid(bcd) gene product, has recently been defined, but the posterior determinants are less well characterized. At least seven maternally acting genes are required for posterior development. Mutations in these maternal posterior-group genes result in embryos lacking all abdominal segments. Cytoplasmic transplantation studies indicate that the maternally encoded product of the nanos(nos) gene may act as an abdominal determinant, whereas the other maternal posterior-group genes appear to be required for the appropriate localization and stabilization of this signal. Here we show that the lack of the nos gene product can be compensated for by eliminating the maternal activity of the gap gene hunchback (hb). Embryos lacking both of these maternally derived gene products are viable and can survive as fertile adults. These results suggest that the nos gene product functions by repressing the activity of the maternal hb products in the posterior of the egg. PMID- 2704420 TI - Sound localization in the barking treefrog. PMID- 2704421 TI - Effects of moving textured background on neuronal responses in the toad's optic tectum. PMID- 2704422 TI - Circulating immune complexes in acute leukemia. AB - Circulating immune complexes (CIC) were measured at the time of diagnosis in 81 patients with acute leukemia or blast crisis of chronic myeloid leukemia using precipitation by 3.75% polyethyleneglycol. Elevated CIC levels did not adversely influence complete remission duration and survival, patients with normal CIC levels exhibited mostly shorter remission and survival than those with elevated or borderline levels. No significant correlation was observed between CIC levels and Hb, WBC, CBC, platelet count, age, serum bilirubin, total protein, fibrinogen, AST and ALT levels, presence of hepatosplenomegaly and/or lymphadenopathy, HbSAg positivity, complete remission duration and survival. The lack of correlation may be caused by altered immune response in leukemic patients, but the obtained results may also be affected by the nonspecific nature of the method used for the detection. Simultaneous detection of CIC levels by multiple tests and evaluation not only of the number but also of the composition and size of CIC may decrease the incidence of false results. Nevertheless, only the establishment of antigen-specific assays may resolve the controversies in the detection of CIC and thus contribute to a more precise assessment of the role of CIC in prognosis of cancer, as well as to the verification of reliability of using CIC as a tumor marker. PMID- 2704423 TI - Enhanced take of spontaneous murine tumors in mice treated with inhibitors of macrophage and/or NK cell function. AB - Both macrophages and NK cells have been suggested to play a role in recognizing and eliminating early, in situ neoplasms. Therefore we studied the effect of inhibitors of macrophage and/or NK cell function on the take of transplantable spontaneous murine tumors in syngeneic mice. The treatment of animals with trypan blue, a selective inhibitor of macrophage function, decreased considerably the period of latency of BSP3 adenocarcinoma; however, it did not increase the take of SP4, SP82 and SP84 adenocarcinomas. The treatment of recipients with neutral red, a selective inhibitor of NK cell function, enhanced the take of SP4 adenocarcinoma. The treatment of mice with agents depressing both macrophage and NK cell function (silica or carrageenan) decreased the both macrophage and NK cell function (silica or carrageenan) decreased the period of latency and/or increased the take of SP4, SP82 and SP84 adenocarcinomas. Carrageenan or a combined treatment with both trypan blue and neutral red also enhanced the take of BaF1, a benzo(a)pyrene-induced fibrosarcoma. We concluded that both macrophages and NK cells may function as effector cells of an antitumoral surveillance system. PMID- 2704424 TI - Cathepsin B in human breast tumor tissue and cancer cells. AB - The cysteine proteinase cathepsin B (EC 3.4.22.1) has been proposed to play an important role in the proteolytic mechanism of the ability of breast cancer cells to invade into and through normal tissues during metastasis. In this study, activity of cathepsin B was measured with a fluorometric microtiter plate assay in human breast tumors as well as in mammary gland dysplasias and in four human breast cancer cell lines (BT-20, MDA-MB-231, PMC42 and T47D). It was found that primary breast carcinomas and cystosarcomas phyllodes contain significantly higher levels of cathepsin B activity than mammary dysplasias; the activity of cathepsin B in cystosarcomas phyllodes was comparable with that in breast carcinomas. The enzyme from breast carcinoma tissue exhibited properties of a mature form of cathepsin B. All investigated breast cancer cell lines display positive cytochemical staining for cathepsin B activity with granular pattern of distribution of the final reaction product. Biochemically, the breast cancer cell lines differed significantly from each other in the level of cathepsin B activity decreasing in the following order: T47D, PMC42, MDA-MB-231 and BT-20. PMID- 2704425 TI - Cytogenetic analysis of metastatic effusions from breast tumors. AB - Chromosome analysis was performed on direct and in vitro cultures of 30 effusions from breast carcinoma. Although in 14 samples normal diploid stem-lines were found, chromosome abnormalities were present in stem- or side-lines of all cases. Recurrent numerical deviations were only verified as gains of Nos. 6 and 7. Rearrangements were seen involving almost all chromosome pairs (except No. 18 and gonosomes), however, Nos. 1, 3, 6 and 11 were those most frequently related to the genesis of markers. Double minutes (DMs) were found in seven samples, and there was a homogeneously staining region (HSR) in one. PMID- 2704426 TI - Inhibitor of normal granulopoiesis produced by cells of MDS patients. AB - Low-density blood cells from patients with refractory anemia with excess of blasts (RAEB) and RAEB in transformation (RAEB-T) release a high molecular weight inhibitory substance that reduces the entry of normal progenitor cells of granulocytes and macrophages (CFU-GM) into the S-phase. Out of 20 patients with refractory anemia (RA and RAS) only 3 were positive. One patient with CMML was negative. Serial examination of 3 patients (two RA and one CMML) revealed that the production of the inhibitory activity preceded the development of the disease into RAEB, RAEB-T, or AML. With one exception, the inhibitory activity in positive cases was neutralized by antiserum against human placental ferritin. PMID- 2704427 TI - Primary screening and inhibition of macromolecular biosynthesis by benfluron metabolites in vitro. AB - Cytotoxicity and mechanisms of action of 2 metabolites of benfluron (BF), namely 7-dihydrobenfluron (DBF) and benfluron N-oxide (NOBF) were tested. Cytotoxicity in the primary biochemical screening was measured by the inhibition of 14C adenine and 14C-valine incorporation into the TCA-insoluble fraction of Ehrlich ascites carcinoma (EAC) cells under defined in vitro conditions. Both metabolites were found to have cytotoxic effects, with NOBF being more active than DBF. Further we investigated the kinetics of incorporation not only of adenine and valine, but also of 14C-thymidine and 14C-uridine both into Ehrlich carcinoma cells and into P388 leukemia cells. PMID- 2704428 TI - Survey: new management structures. PMID- 2704429 TI - Playing God. PMID- 2704430 TI - Nursing crisis issues. PMID- 2704431 TI - Quality of care and quality of caring. PMID- 2704432 TI - For-profit smoking-cessation programs and their clients. PMID- 2704433 TI - The importance of documentation in peer review. PMID- 2704434 TI - Your prescription--an instrument of your license. PMID- 2704435 TI - Of feelings and manners. AB - Patients and physicians may be at odds these days because of physicians' bad manners, which lead to patients' hurt feelings. I use cases to demonstrate that sick people, no matter how intelligent or powerful, feel helpless and awed, and are extremely sensitive to lapses in physicians' manners. Good manners can help by being an automatic brake. Good manners are society's safeguard against the incoherent jumble of human feelings to which we are all subject. Translating such feelings into something more presentable, is what manners are about. PMID- 2704436 TI - Videoteleconferencing: solving mobility and recruitment problems. AB - Many nurses and nursing students live far from the closest campus or health care agency that can provide basic or continuing education. Videoteleconferencing is one way to bridge this distance. As videoteleconferencing technologies become available and cost effective, nurse educators must be knowledgeable about their use. The authors explain telecommunications technologies of videoteleconferencing, identify advantages and disadvantages, and discuss planning, implementation, and evaluation for offering a program by videoteleconference. PMID- 2704437 TI - How do you document student nurse performance in the clinical setting? PMID- 2704438 TI - Educators urged to stress-inoculate students. PMID- 2704439 TI - Strategies for recruiting nursing students. AB - When the authors' baccalaureate nursing school was experiencing a decline in enrollment and faculty positions were being threatened, a structured recruitment plan was developed, implemented, and evaluated. This plan increased prospective applicants' access to reliable information about not only the school of nursing but also the profession of nursing. The components of the plan included publicity, prospective applicant contacts, and alumni involvement. The increased number of new entering freshmen with a major in nursing and faculty retention demonstrated the plan's effectiveness. PMID- 2704440 TI - Responding to student writing. AB - Sunday evening. You can't put off any longer the chore of correcting the stack of student papers. Picking up the first one, you scan it. It isn't good. The paper is full of sentence fragments and typographical errors. You decide that this is going to be a long evening. Scenes like this, hours spent correcting students' papers, only to discover that the students barely look at the comments, may lead faculty to avoid assigning writing. Fortunately, there are effective ways to respond to student writing without tying oneself down to hours of tedious correcting. These techniques can help nursing faculty enjoy reading and responding to students' papers, as well as help students to improve their writing skills. PMID- 2704441 TI - Legacies, reminiscence, and ego-integrity. PMID- 2704442 TI - Posology: the battle against dosage calculation errors. AB - The authors explored math and dosage calculation deficiencies in a sample of 223 baccalaureate, associate, and diploma programs representing the geographic United States. The dissemination of results serves to inform nurse educators of the potential for graduating math deficient student nurses and to recommend measures for resolution of the identified problem. PMID- 2704443 TI - Defining doctoral education. PMID- 2704444 TI - Promoting creativity: the use of student projects. AB - Can creativity be developed in our nursing students? The authors describe their experience in using creativity projects in a nursing course and the impact the experience had on students and patient care. PMID- 2704445 TI - The impaired nursing student. AB - Nursing students are at risk for abusing chemical substances during the nursing education experience. To assist faculty and administrators address this issue, characteristics of the chemically dependent nursing student are described. The authors also discuss teaching strategies and preventive approaches that might impact on the student's current or potential substance abuse. PMID- 2704446 TI - Reframing manuscript rejection. PMID- 2704447 TI - Students select course content. PMID- 2704448 TI - The right to fail? PMID- 2704449 TI - Changes in self-concept during baccalaureate nursing education. PMID- 2704450 TI - Two approaches to clinical evaluation. AB - The authors describe two methods of clinical evaluation which, when combined, give faculty a more objective evaluation of clinical performance. One method examines student performance throughout the semester; the other evaluates the student during an actual performance examination. This combination of methods gives the instructor an opportunity to observe the students' clinical performance from two different perspectives and to assign the grade for the student's performance in the practicum setting. PMID- 2704451 TI - Changes in postprandial plasma lipids and lipoproteins in humans. PMID- 2704452 TI - Estrogen receptors in bone. PMID- 2704453 TI - Coronary heart disease without risk factors. PMID- 2704454 TI - Amino acid transport and cellular glutathione. PMID- 2704455 TI - Guar gum and hypoglycemia in the rat. PMID- 2704456 TI - Energy intake in cystic fibrosis. PMID- 2704457 TI - Optimal mineral intakes by very-low-birth-weight infants. PMID- 2704458 TI - Osteoporosis followed by primary hyperparathyroidism. PMID- 2704459 TI - Arguments about the atherogenic potential of foods. PMID- 2704460 TI - Computers in cardiology. PMID- 2704461 TI - Pituitary apoplexy. AB - Pituitary apoplexy, a rare neurological emergency resulting from pituitary haemorrhage or infarction, should be considered a possibility in patients presenting with headache. Six cases are reported. The patients, four females and two males, ranged in age from 18 to 53 years. In only two had pituitary pathology previously been recognised. Headache occurred in all patients, visual field defects in four, ocular paresis in two, and subsequent hypopituitarism in five. The headache type suggested intracranial catastrophe in only one patient. A possible precipitant was noted for three of the episodes, including, in one patient, salmonella gastroenteritis. Cortisol deficiency during the acute event was common. Semi-urgent surgery was performed in two patients. In two others, prompt resolution of symptoms occurred following administration of dexamethasone. PMID- 2704462 TI - Otitis media and hearing loss in the children of the Ruatoki valley: a continuing public health problem. AB - A longitudinal survey of ear disease using repeated otomicroscopy has demonstrated cases of persistent middle ear effusion, cholesteatoma and perforation in a group of 275 Maori children. The hearing of 194 of the children was assessed, and 25% of them were found to have a hearing loss. It is concluded a public health problem exists with these children. Improved detection and treatment of ear disease and hearing loss in this population is recommended. PMID- 2704463 TI - CanTeen: the New Zealand teenage cancer patients society--a new direction in psychosocial oncology? PMID- 2704465 TI - Emergency and disaster medicine. PMID- 2704464 TI - Strategies for reducing the drug bill. PMID- 2704466 TI - National Cancer Registry. PMID- 2704468 TI - Life after Cartwright. PMID- 2704467 TI - Treatment of herpes zoster. PMID- 2704469 TI - A standard for ethical committees. PMID- 2704470 TI - Paraparesis due to extruded thoracic disc for 25 years. PMID- 2704471 TI - Who minds the minders? PMID- 2704472 TI - Blow hole syndrome. PMID- 2704473 TI - Asthma costs. PMID- 2704474 TI - The scientific method. PMID- 2704475 TI - AIDS statistics. PMID- 2704477 TI - Cervical cytology in general practice. PMID- 2704476 TI - Delayed reaction: an update on the implementation of the Cartwright report. PMID- 2704478 TI - Eketahuna Health Centre: a recipe for success. PMID- 2704479 TI - Managing an obese and immobile patient. PMID- 2704480 TI - Specialised care at the Christchurch spinal unit. PMID- 2704481 TI - Lessons in primary health care. Can we learn from Jumna? PMID- 2704483 TI - Striking results. PMID- 2704482 TI - NZNA restructuring explained. PMID- 2704484 TI - Trial rosters and tribulations. PMID- 2704485 TI - Racism: looking beyond guilt. PMID- 2704486 TI - Justice for all? PMID- 2704487 TI - Seeking a fair go. PMID- 2704488 TI - A question of ethics: an update on the implementation of the Cartwright report. PMID- 2704489 TI - Spinal injuries: first aid and acute nursing. PMID- 2704490 TI - Superannuation: a glimpse into the future. PMID- 2704491 TI - Legal and surgical considerations in evaluating candidates for implant procedures. PMID- 2704492 TI - The inspiring promise of dental implantology. PMID- 2704493 TI - Multiple gestation complicated by the death of one fetus. AB - The antepartum death of a fetus in a multiple gestation can be associated with mortality or major morbidity in the survivor. To evaluate the risk after death of one fetus, all cases of multiple gestation complicated by a fetal death were evaluated. There were 17 multiple gestations in which one fetus died, with 19 surviving infants. The incidence of fetal death in multiple gestation was 2.6%. There was one case of major morbidity in a monochorionic gestation. PMID- 2704494 TI - Second-breech presentation in twins--a possible adaptive measure to promote fetal growth. AB - Two hundred eighty-three longitudinally lying twin pairs were evaluated for the possible etiology of breech presentation in twins. Breech-breech pairs were delivered at a significantly earlier gestational age (P less than .02), because of significantly more deliveries (P less than .04) between 30-32 weeks, compared with vertex-second twins. Nevertheless, breech-breech pairs attained similar or larger birth weights when compared with other combinations. Discordant-second twins were found five times more frequently in breech-second pairs when twin A was in the vertex presentation. It is possible that breech-breech pairs reach a critical utero-fetal proportion earlier, resulting in earlier labor. Alternatively, twins may arrange in second-breech presentations as an adaptive measure to promote growth. We recommend special care for persistent breech-breech presentations diagnosed at the beginning of the third trimester. PMID- 2704495 TI - Meconium aspiration syndrome without evidence of fetal distress in early labor before elective cesarean delivery. AB - Seventy-seven cases of meconium aspiration were documented among 14,527 deliveries. Four cases occurred in early labor and with normal fetal heart tracings. Three cases followed repeat cesarean sections at term, and one followed an elective cesarean section for a primigravid breech presentation. Aggressive airway management was used in every case, and included intrapartum pharyngeal suctioning with a DeLee catheter and intubation of the trachea with suctioning under direct vision. These cases suggest that meconium aspiration may occur before the onset of active labor and without evidence of fetal distress. PMID- 2704496 TI - Substance abuse in pregnant women: recent experience at the Perinatal Center for Chemical Dependence of Northwestern Memorial Hospital. AB - Drug abuse during pregnancy is associated with adverse perinatal outcome. Patterns of abuse have changed in recent years with the increasing popularity of cocaine. We compared pregnancy outcome data from 137 women receiving prenatal care in the Perinatal Center for Chemical Dependence of Northwestern Memorial Hospital with those of matched controls. Among drug-using women, the mean gestational age at delivery and mean birth weight were significantly lower than those of controls. In addition, study pregnancies were more frequently complicated by the need for antenatal hospitalization, preterm delivery, low birth weight (less than 2500 g), and abruptio placentae. PMID- 2704497 TI - Use of ampicillin and corticosteroids in premature rupture of membranes: a randomized study. AB - A randomized study was conducted to investigate the effects of antenatal corticosteroids and ampicillin in the management of preterm pregnancies under 34 weeks complicated by premature rupture of membranes. Patients with documented lecithin/sphingomyelin (L/S) ratios of less than 2.0 and a singleton gestation were eligible to participate in the study. One hundred sixty-five patients qualified and were randomized, using sealed envelopes, to four study groups. All patients were followed expectantly. Group I (41 patients) received neither ampicillin nor corticosteroids. Group II (43 patients) received 24 mg of antenatal betamethasone. Group III (37 patients) received 2 g of intravenous ampicillin every 6 hours, with discontinuation of antibiotic therapy if cultures were negative for pathogenic bacteria. Group IV (44 patients) received both corticosteroids and ampicillin as described for groups II and III, respectively. Compared with patients not receiving corticosteroids, those administered antenatal corticosteroids experienced a reduction in the incidences of respiratory distress syndrome (53 versus 26%), bronchopulmonary dysplasia (23 versus 9%), severe grades of intracranial hemorrhage (15 versus 3%), and patent ductus arteriosus (18 versus 6%), with no difference in the incidence of maternal or neonatal infection. Compared with patients not receiving antenatal antibiotics, the group of patients treated with ampicillin on admission had a lower incidence of clinical chorioamnionitis (4 versus 26%) and neonatal sepsis (5 versus 10%). This reduction in infectious morbidity by antenatal ampicillin was restricted to those patients (28.4% of the study population) colonized with group B streptococci.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704498 TI - Precision of reflectance meters in screening for gestational diabetes. AB - The use of reflectance meters to screen for gestational diabetes has been advocated because of convenience and apparent accuracy. The present study addresses the possibility that imprecision of reflectance meters may affect the reliability of the blood sugar values obtained with their use. We tested four reflectance meters (Glucometer, Glucometer II, Glucoscan 3000, and Accuchek II) on 84 gravidas undergoing 1-hour, 50-g glucose screening, and calculated average coefficients of variation (9.6 +/- 10.9, 8.2 +/- 4.7, 6.8 +/- 4.5, and 7.4 +/- 4.4%, respectively). One-way analysis of variance testing indicated no significant difference between these values (P = .11). However, comparison with the coefficients of variation from standard laboratory technology (YSI Model 23A Glucose Analyzer) applied to simultaneously obtained venous samples (2.3 +/- 1.5, 1.5 +/- 0.6, 1.9 +/- 1.0, and 1.0 +/- 0.5%) revealed that the meters all had coefficients of variation significantly higher (P less than .0001). Use of reflectance meters would have resulted in 45.2% (38 of 84) of the subjects undergoing 3-hour oral glucose tolerance tests. Use of standard laboratory values would have indicated these tests in only 16% (14 of 84). The inconvenience and increased cost of these oral glucose tolerance tests suggest that meters may not be appropriate for screening. PMID- 2704499 TI - Factors associated with rectal injury in spontaneous deliveries. AB - Rectal injury during childbirth is a complication with potentially debilitating long-term consequences. Several factors have been suggested as influencing the risk of rectal injury. Among these are parity, infant birth weight, and various procedures performed by the birth attendant, including episiotomy. Whether episiotomies protect against or provoke laceration of the rectal sphincter and rectal mucosa is particularly controversial. Logistic analysis was used in an observational study of 2706 spontaneous cephalic deliveries to determine the risk of rectal injury for each of six explanatory factors, simultaneously controlling for the other factors. The adjusted risk for rectal injury was significantly increased for midline episiotomy (8.9 versus no episiotomy), nulliparity (3.3 versus parous), delivery by a physician (2.4 versus midwife), fetal macrosomia (2.4 versus normal weight), and delivery in a delivery room (2.0 versus labor bed). Compared with the risk for whites, significantly increased risk was found for Hispanic (1.9), Filipino (3.7), and Chinese (2.9) women. The practice of prophylactic midline episiotomy is questioned, and suggestions are offered for the design of experimental studies to resolve the questions raised. PMID- 2704500 TI - Antenatal steroid therapy and 5-year outcome of extremely low birth weight infants. AB - Over a 63-month period beginning January 1, 1977, 258 infants with birth weights of 500-999 g were born alive at one tertiary perinatal center; 170 were offered full intensive care. The mothers of 67 (39.4%) of these 170 infants had been given betamethasone antenatally to accelerate fetal lung maturation. Of the 67 infants exposed to steroids antenatally, 46 (68.7%) survived their primary hospitalization, compared with 43 (41.7%) of the 103 infants who had not been exposed to steroids. This difference is highly significant (chi 2 = 10.7; P less than .005) but is biased because infants in the steroid group had a better prognosis. After adjustment for discrepancies in birth weight and gestational age and other confounding obstetric variables, survival in the steroid group remained substantially higher (relative odds of survival 1.85, 95% confidence intervals 1.16-2.86; P = .006). The improvements in survival were not at the expense of increased rates of chronic ill health or impairments of growth neurodevelopment up to at least 5 years of age. For extremely immature and extremely low birth weight infants, steroids are rarely contraindicated on fetal grounds. PMID- 2704501 TI - Paired Papanicolaou smears in the evaluation of atypical squamous cells. AB - Between February 1985 and April 1988, 360 women were seen at Tripler Army Medical Center's cervical clinic as part of a prospective study to assess the value of paired Papanicolaou smears in the follow-up of atypical squamous cells in a cervical cytologic smear. The evaluation consisted of paired repeat Papanicolaou smears and colposcopy. Colposcopically directed biopsies and/or endocervical curettage were performed in 86% of the subjects. The results of the paired Papanicolaou smears were negative/negative in 202 patients (56%). Cervical intraepithelial neoplasia was diagnosed histopathologically in 16% of all patients and in 10% of those with negative/negative repeat smears. We conclude that the presence of atypical squamous cells in a Papanicolaou smear should be considered abnormal and that colposcopy and colposcopically directed biopsies should be performed for these patients. PMID- 2704502 TI - The significance of a negative Papanicolaou smear with hyperkeratosis or parakeratosis. AB - The significance of a cytologic diagnosis of hyperkeratosis or parakeratosis on a Papanicolaou smear reported as negative is unknown. We conducted a review of 170 women without uterine descensus who presented to Tripler Army Medical Center cervical clinic with a negative Papanicolaou smear but with hyperkeratosis or parakeratosis noted on the slide. All patients underwent colposcopy, and 64% had either cervical punch biopsy or endocervical curettage. Six women (3.5%) had cervical intraepithelial neoplasia documented histopathologically. We conclude that the cellular findings of hyperkeratosis or parakeratosis on a Papanicolaou smear are not associated with an increased histologic or colposcopic detection of cervical intraepithelial neoplasia. PMID- 2704503 TI - Metabolic effects of continuous estradiol-progestin therapy in postmenopausal women. AB - Sixty postmenopausal women with climacteric complaints were randomly allocated to four treatment groups. Without interruption, each patient was given one tablet daily containing 2 mg 17 beta-estradiol along with either norethisterone acetate 1 mg and 0.5 mg or megestrol acetate 5 mg and 2.5 mg. Blood samples were obtained before treatment and then after 1, 4, and 12 months of treatment. Serum was analyzed for cholesterol and triglycerides in serum and for cholesterol in the ultracentrifugally separated lipoprotein fractions of very low-density lipoproteins, low-density lipoproteins, and high-density lipoproteins. Significant reductions of serum cholesterol were found in all treatment groups except for that given 2.5 mg megestrol acetate. After 1 and 4 months of treatment, low-density lipoprotein cholesterol decreased 7-22%, whereas high density lipoprotein cholesterol was reduced by 2-16% in the four groups. No significant differences could be demonstrated among the groups in low-density lipoprotein cholesterol or high-density lipoprotein cholesterol during treatment, as assessed by analysis of variance. Thus, cholesterol metabolism was equally influenced by both progestin types. Accordingly, the clinical efficacy and acceptance would decide the preparation to be advocated for women in need of hormone replacement therapy. PMID- 2704504 TI - A prospective one-year study of estrogen and progestin in postmenopausal women: effects on clinical symptoms and lipoprotein lipids. AB - Ninety-five healthy women who had been amenorrheic for at least 6 months were randomly assigned to one of four cyclic, sequential hormone regimens for 1 year. Groups A and C received 0.625 or 1.25 mg conjugated equine estrogen (Premarin), respectively, from days 1-25 and 5 mg medroxyprogesterone acetate (Provera) from days 15-25. Groups B and D were given 0.625 or 1.25 mg conjugated equine estrogen, respectively, from days 1-25 and placebo from days 15-25. Plasma estrone levels were physiologic after the lower dose of conjugated equine estrogen and supraphysiologic after ingestion of the higher dose. All four treatment regimens successfully controlled hot flushes, but patients who received 1.25 mg conjugated equine estrogen with or without medroxyprogesterone acetate had a higher energy level and a more enhanced sense of well-being (P less than .05). The four treatments all had favorable effects on lipid metabolism, albeit in a dose-related manner: After 1 year of treatment, high-density lipoprotein levels increased 4.3, 13.7, 13.4, and 19% in groups A, B, C, and D, respectively, compared with pre-treatment values. The high-density lipoprotein/low-density lipoprotein ratios, an antiatherogenic index, increased by 7.3, 13.6, 24, and 43% in groups A, B, C, and D, respectively. The findings of this study on the relative effects of different doses of oral estrogen and progestin, administered sequentially, on clinical symptoms and lipid metabolism provide guidelines for the treatment of postmenopausal women. PMID- 2704505 TI - Serum CA 125 antigen levels and disease severity in patients with endometriosis. AB - We wished to test whether there was a relationship between CA 125 levels and the severity of endometriosis that would allow CA 125 to be used to monitor disease progression. CA 125 levels were measured in 52 women with laparoscopically staged endometriosis and in eight women with normal pelvic findings at laparoscopy. There was a positive correlation (r = 0.63; P less than .0001) between disease severity and CA 125 levels. CA 125 was also elevated, compared with women with a normal pelvis, in patients with mild and moderate disease. There was no relationship between CA 125 levels and the day of the menstrual cycle. These results suggest that after malignancy has been excluded, CA 125 levels may offer a useful method of monitoring disease progress. PMID- 2704506 TI - Endometrial cancer: histologic correlates of immunohistochemical localization of progesterone receptor and estrogen receptor. AB - Progesterone and estrogen receptor localization, using monoclonal anti-receptor antibodies JZB39 and H222, was studied in 105 endometrial adenocarcinomas. Immunohistochemical evaluation incorporated both intensity and distribution of staining. Both anti-progesterone receptor and anti-estrogen receptor localized in the nucleus of target cells. Significant levels of progesterone receptor and estrogen receptor were seen localized in stromal and myometrial elements that diverged from the malignant epithelial component. Analyses of endometrial adenocarcinomas with anti-progesterone receptor and anti-estrogen receptor antibodies correlated with histologic differentiation. The ability to define divergent receptor populations in stromal and myometrial elements versus malignant epithelial elements indicates that immunohistochemical assay of progesterone and estrogen receptor provides information complementary to that from conventional quantitative ligand binding assays. PMID- 2704507 TI - Normal-sized ovary carcinoma syndrome. AB - A clinical situation occasionally presents in which diffuse metastatic disease of the peritoneal cavity is noted, but the ovaries are of normal size, with or without a fine granularity on their external surface. We term this clinical phenomenon the "normal-sized ovary carcinoma syndrome." In an effort to study this dilemma, the clinical records and pathology slides were reviewed for 11 cases identified from 1976-1987. Four diagnostic groups were identified: mesothelioma (four patients), "extragonadal mullerian" tumors (two patients), metastatic tumors of unknown origin (four patients), and ovarian carcinoma (one patient). The survival for each of the first three groups is usually less than 1 year. Improved survival for mesotheliomas may be achieved with a combination of radiotherapy, an adriamycin-based chemotherapy regimen, and debulking surgery. A successful treatment strategy for serous surface papillary carcinoma has not been identified. Patients with metastatic tumors of unknown origin should either be treated with 5-fluorouracil or should not be treated at all. In order to discern the site of origin, satisfactory perioperative radiologic assessment, fastidious surgical exploration, and adequate communication between the surgeon and the pathologist are necessary. PMID- 2704508 TI - Re-treatment of patients with recurrent epithelial ovarian cancer with cisplatin based chemotherapy. AB - Nineteen patients with recurrent epithelial ovarian cancer who had responded to initial cisplatin-based combination chemotherapy were re-treated with cisplatin based therapy. The median disease-free interval, as measured from the last cycle of primary chemotherapy to the diagnosis of relapse, was 26.3 months (range 5-81 months). Eighteen of the 19 patients had measurable disease at the time of relapse. Nine patients had a clinical complete response to the cisplatin-based re treatment, and nine patients had a partial response (surgically documented in one case). The overall response rate to secondary cisplatin-based chemotherapy was therefore 100% in patients with measurable disease. Toxicity of re-treatment was acceptable. The median progression-free survival, as measured from the diagnosis of relapse to the time of disease progression, was 10.6 months (range 4-24 months). The median survival from diagnosis of relapse was 19.3 months (range 5 39 months). At the time of analysis, three patients were alive without evidence of disease, four were alive with tumor, and 12 were dead of cancer. These data suggest that re-induction with cisplatin-based chemotherapy should be considered for patients who develop recurrent disease after favorable responses to primary cisplatin-based chemotherapy. PMID- 2704509 TI - The application of a computer data base system to the generation of hospital discharge summaries. AB - The task of maintaining accurate and timely records of resident experiences, as well as section and departmental statistical data, may be readily accomplished with many commercially available computer data base packages. The application of this type of technology to the generation of "narrative" discharge summaries represents an extension of these applications and an incentive for house officer compliance. A system of data gathering and reporting, combined with the generation of discharge summaries, letters to referring physicians, and billing work sheets, has been in use in the Department of Obstetrics and Gynecology at The Medical College of Georgia for 2 years. A group of 103 patients discharged during the month of October 1985 served as controls for a comparable prospective group of 104 patients discharged beginning October 1, 1987. Analysis shows an average (+/- SEM) of 3.8 +/- 0.6 days from discharge to printed discharge summary from the computer system. Before implementation of the system (1985), the average was 20.9 +/- 4.5 days. This difference was statistically significant at P = .001. Although it may be difficult to quantitate improvement in quality of the data obtained for residency and departmental purposes, this reduction in delinquent charts alone may be sufficient to recommend the application of computer technology to this problem. PMID- 2704510 TI - Ticarcillin/clavulanic acid versus clindamycin and gentamicin in the treatment of post-cesarean endometritis following antibiotic prophylaxis. AB - One hundred fifty-two women who received cefazolin prophylaxis and subsequently developed postpartum endometritis were randomized to treatment with either ticarcillin/clavulanic acid (75) or clindamycin-gentamicin (77). Bacteria isolated from the endometrium were predominantly facultative anaerobic bacteria. The ratio of facultative anaerobes to obligate anaerobes was 3:1. Nineteen percent of the women were bacteremic, with mycoplasma the organism most frequently isolated from venous blood specimens. Cure rates were similar for both groups: ticarcillin/clavulanic acid 85% and clindamycin-gentamicin 81%. The advantages of ticarcillin/clavulanic acid are an increased spectrum of activity against beta-lactamase-producing bacteria, less toxicity, and lower cost. PMID- 2704511 TI - A beltless tocodynamometer--a preliminary report. AB - The clinical usefulness of a newly developed beltless external tocodynamometer system was evaluated in a group of 56 patients in active, early, premature, or false labor. The uterine activity records so obtained were compared with those made in the same patients using the tocodynamometer with belt (49 patients) and the intrauterine pressure catheter (seven patients). The records were classified as "usable" if the baseline was above zero and the peak of the recorded contraction was at least 15 mmHg above the baseline. Both systems were studied under similar clinical conditions. Overall, of the 7434 minutes of recordings in 49 patients using the beltless system, 7008 minutes (94%) were usable. In contrast, only 2515 out of 5667 minutes (45%) of recordings made with the belted system were usable (P less than .001). Seven additional patients were monitored simultaneously with the beltless tocodynamometer and the intrauterine pressure catheter systems. Of the 1367 minutes' total monitoring time, the recovery rates of usable data for the beltless and intrauterine pressure catheter systems were 85 and 87%, respectively (P = not significant). These preliminary results indicate that the beltless system is a convenient, simple-to-use external tocodynamometric system that assesses uterine activity more efficiently than the belted system. PMID- 2704512 TI - A randomized trial of intrapartum versus immediate postpartum treatment of women with intra-amniotic infection. PMID- 2704513 TI - Comparison of copolymer staple versus chromic suture during hysterectomy: gross, histologic, and microbiologic findings. PMID- 2704514 TI - Coccidiodal meningitis and pregnancy: a case report. AB - A woman with coccidiodal meningitis had two successive pregnancies and was treated with intrathecal amphotericin B. The outcome was successful. PMID- 2704515 TI - Fibromuscular dysplasia of the carotid arteries complicating pregnancy. AB - Fibromuscular dysplasia is an arteriopathy of unknown etiology that affects the intermediate-size branches of the aorta. Partial occlusion of these arteries may result in neurologic symptoms when carotid arteries are affected, and impaired liver or kidney function when their blood supply is compromised. Pregnancy and delivery in women who are diagnosed as having fibromuscular dysplasia may be associated with disease-related complications such as ischemic attacks. We report the course of a pregnancy and delivery in a patient with carotid artery fibromuscular dysplasia and suggest steps for general obstetric management and contraception in patients suffering from fibromuscular dysplasia. PMID- 2704516 TI - Eosinophilic fasciitis during pregnancy. AB - The first reported case of eosinophilic fasciitis developing in pregnancy is discussed, and the obstetric management is reported. Eosinophilic fasciitis is a rare disease characterized by pain, swelling, and tenderness over the extremities, followed by induration of the skin. Laboratory findings include peripheral eosinophilia, hypergammaglobulinemia, an elevated erythrocyte sedimentation rate, distinctive histopathologic changes, and scleroderma-like skin induration without rheumatoid serologic markers. Diagnosis is made by biopsy of the deep fascia of the affected area. The deep fascia will be infiltrated with plasma cells, lymphocytes, and eosinophils. Prednisone is the therapy of choice. Carpal tunnel syndrome and rare serious hematologic abnormalities have been associated with eosinophilic fasciitis. PMID- 2704517 TI - Squamous carcinoma of the cervix complicating pregnancy: recurrence in episiotomy after vaginal delivery. AB - A patient developed recurrence of squamous carcinoma of the cervix in the episiotomy scar after vaginal delivery through the involved cervix. At the time of her radical hysterectomy, all margins and nodes were free of tumor, suggesting implantation at delivery as the etiology of the recurrence. Review of the literature revealed three other cases of episiotomy recurrence. All cases were either clinically unsuspected or had negative Papanicolaou tests during pregnancy. Careful surveillance and early therapy appear to give a more favorable prognosis for this unusual type of recurrence. PMID- 2704518 TI - Pregnancy following conservative surgery and adjunctive chemotherapy for stage III immature teratoma of the ovary. AB - A 24-year-old woman with stage III grade 3 immature teratoma of the ovary was treated with a unilateral salpingo-oophorectomy and nine courses of vincristine, actinomycin D, and cyclophosphamide combination chemotherapy. She had a negative second-look exploration; 30 months after initial surgery she became pregnant, and subsequently delivered a normal child at term. This is the first report of a successful pregnancy following conservative surgery and chemotherapy for advanced stage immature teratoma. PMID- 2704519 TI - Epidural analgesia in the management of symptomatic symphysis pubis diastasis. AB - The pain of symphysis pubis diastasis during and after pregnancy can be disabling. This report describes for the first time the successful use of epidural analgesia in relieving the pain of this disorder. Our patient had been confined to bed or chair for 10 weeks. The epidural analgesia described allowed her to mobilize immediately and remain normally active for the remainder of her pregnancy. Early consultation with an anesthesiologist in severe cases of symphysis pubis diastasis is encouraged. PMID- 2704520 TI - Anti-Co3 and severe hemolytic disease of the newborn. AB - Irregular antibodies have been described to cause hemolytic disease of the newborn of varying severity. A case of anti-Colton 3 causing moderate to severe hemolysis in the newborn in two pregnancies is described. Only two cases of hemolytic disease of the newborn have been previously described; these resulted in mild hemolysis. The management of the condition is reviewed in the light of the current management of hemolytic disease of the newborn. PMID- 2704521 TI - The fingerprint, a false-positive fern test. AB - Microscope slides were prepared to confirm the presence of ferning from a 32-week gestation with possible premature rupture of the membranes. Although no amniotic fluid was seen in the vagina, an atypical ferning pattern was produced and was again reproducible with fingerprints on the glass slide. Guidelines to recognize and avoid this source of error are outlined. PMID- 2704522 TI - Cavernous lymphangioma of the vulva. AB - Lymphangiomas are rare benign proliferations of the lymphatic system. Three types are generally acknowledged: circumscriptum (or capillary), cavernous, and cystic. The management of these lesions depends on type, size, and anatomical location. We present a case of cavernous lymphangioma of the right labium majus in a young woman with no history of radiation therapy or other pathology, which was treated by wide resection. PMID- 2704523 TI - Incisional hernia of the vaginal apex following vaginal hysterectomy in a premenopausal, sexually inactive woman. AB - A woman experienced a small-bowel herniation through a rupture in the vaginal fascia at the apex of a well-supported vagina, leaving the small bowel covered only by a transparent mucosal membrane. This condition developed after a vaginal hysterectomy, with prophylactic plication of the uterosacral ligaments to obliterate the cul-de-sac, had been performed for uterine prolapse, which in turn developed subsequent to a high retropubic urethral suspension. This woman was premenopausal and sexually inactive, and had no other risk factors for failure of the vaginal apical scar. At the time of surgical repair, it appeared that the vaginal incision had failed because the apex was placed on tension between the anterior vaginal wall's attachment to the iliopectineal line and the opposing posterior traction of the uterosacral plication on the posterior vagina. This phenomenon seemed to be a consequence of the original alteration of the vaginal axis by the urethral suspension combined with subsequent enterocele prophylaxis. PMID- 2704524 TI - Vaginal myxoma presenting as acute urinary retention. AB - Vaginal myxoma is an extremely rare tumor. We report a case in which the initial complaint was acute urinary retention. The tumor had grown quite rapidly over a 4 month period. It was resected easily and did not recur over the next 5 years. PMID- 2704526 TI - Treating chemical splash. PMID- 2704525 TI - Access to medical reports. PMID- 2704527 TI - RSI hits the newsroom. PMID- 2704528 TI - RSI. The sufferer's story. PMID- 2704529 TI - How to recognise RSI. PMID- 2704530 TI - Going underground. PMID- 2704531 TI - Facing up to criticism. PMID- 2704532 TI - Against her will: a case in informed consent. PMID- 2704533 TI - Nursing: the decade ahead. PMID- 2704534 TI - Relative canalicular tear flow as assessed by dacryoscintigraphy. AB - Studies evaluating the relative importance of the upper and lower canaliculi in tear drainage have been many and varied, and at times the application of the data to clinical situations is difficult. In order to evaluate the relative tear flow in the upper and lower canaliculi and to quantitatively evaluate the different tear flow rates by a physiologic method, we have studied 11 patients using partial canalicular obstructions and dacryoscintigraphy. The authors found no statistical difference in tear flow between the upper and lower canalicular systems. This information has clinical application when deciding whether to repair an isolated canalicular injury. PMID- 2704535 TI - Bipolaris hawaiiensis-caused phaeohyphomycotic orbitopathy. A devastating fungal sinusitis in an apparently immunocompetent host. AB - The authors present a case report of a devastating bilateral optic neuropathy and orbitopathy initiated by a contiguous fungal sinusitis, in an apparently immunocompetent young man. The causative organism, Bipolaris hawaiiensis, and other species classified in the genus Bipolaris, are being recognized with increased frequency as causes of several ophthalmic and systemic disorders in both immunocompromised and normal hosts. A literature review demonstrates the variety of clinical presentations with emphasis on those cases which may present to the ophthalmologist. PMID- 2704536 TI - Primary liposarcoma of the orbit. Problems in the diagnosis and management of five cases. AB - The clinicopathologic features and the results of diagnostic studies were reviewed in five patients with primary orbital liposarcoma. The major clinical complaints were diplopia and proptosis; visual function was typically well maintained. In three cases, computed tomographic (CT) scans displayed lesions with a central fat density rimmed by a variably radiodense pseudocapsule, leading to the erroneous clinical impression that the lesions were cystic in character. Ultrasonography ruled out a truly cystic tumor by demonstrating internal acoustic interfaces. Magnetic resonance imaging (MRI) in one case showed hyperintense signals in T-1-weighted images, suggesting the presence of fat within the lesional tissue. In the other two cases, CT scans showed reticulated densities accentuating the septa of the orbital fat in the absence of clear-cut circumscription. A potentially useful feature pointing to a neoplasm was bowing of an involved extraocular muscle, which is usually straightened and splinted in either Graves' disease or inflammatory pseudotumor. Histopathologically, two lesions were well-differentiated liposarcomas and three were myxoid liposarcomas, all featuring univacuolar signet ring lipoblasts. Scattered bizarre hyperchromatic mesenchymal cells without prominent lipidization were present in the lesions. None of the patients has experienced regional or distant metastases with follow-ups from onset of 1 to 7 years (mean, 5.2 years); three required orbital exenteration after local recurrence; and two who refused exenteration received only orbital radiotherapy. PMID- 2704537 TI - Macular abnormalities in papilledema from pseudotumor cerebri. AB - Three young women with papilledema secondary to pseudotumor cerebri evolved mottled macular pigmentation with preservation of normal visual acuity. Choroidal folds or macular star figures were observed. These macular changes could represent the sequelae of either macular edema or a mechanical disruption of the retinal pigment epithelium. The mechanism of choroidal folds in papilledema remains uncertain. PMID- 2704538 TI - Visual outcome after surgical removal of craniopharyngiomas. AB - Thirty patients with craniopharyngiomas were examined preoperatively and immediately postoperatively to determine their level of visual impairment and the extent of visual recovery. Twenty-two patients also were examined during extended follow-up. Twelve of these patients were younger than 18 years of age and 18 were older than 18 years of age at the time of diagnosis. Visual acuity was reduced in 42% of eyes preoperatively. One week postoperatively, visual acuity was reduced in only 23% of eyes. Color vision was a more sensitive indicator of afferent system damage, being abnormal at presentation in 71% of patients. Visual field defects were typically bitemporal hemianopsias, but 20% of patients with evidence of optic neuropathy had no definite visual field deficit preoperatively. Postoperatively, 48% of patients had normal visual fields. There was no long-term improvement in visual acuity or field performance for patients with deficits present after the first postoperative month during an average 2.8 years of follow up. PMID- 2704539 TI - Bilateral idiopathic inflammation of the optic nerve sheaths. Light and electron microscopic findings. AB - Idiopathic perioptic neuritis is a term used to describe noninfectious inflammatory disorders of the optic nerve sheaths, the causes of which are unknown. In the following report, a 68-year-old woman with bilateral visual loss was found to have chronic inflammation with necrobiotic granulomas of her optic nerve sheaths. The patient, who had no systemic condition known to be associated with necrobiotic granuloma, lost vision from infarction of the optic nerve parenchyma and from compression due to thickened meninges. Although there are similarities between the inflammatory reaction in this case to the necrobiotic dermatoses, the pathogenesis of this condition remains obscure. PMID- 2704540 TI - Isolated metastasis to optic nerve from medulloblastoma. AB - Isolated involvement of the optic nerve with metastatic tumor is uncommon. A 19 year-old man had a midline cerebellar medulloblastoma; a gross total removal was performed. He received postoperative radiation therapy to the whole brain, posterior fossa, and craniospinal axis. A progressive optic neuropathy developed 28 months later with radiologic evidence of an enlarged optic nerve. There was no evidence of metastatic disease elsewhere. An optic nerve biopsy showed metastatic medulloblastoma. An intramedullary metastasis developed 48 months after the primary diagnosis, and the patient died 5 months later. PMID- 2704541 TI - The effect of panretinal photocoagulation on optic nerve cupping. AB - Panretinal photocoagulation (PRP) can produce damage to all layers of the retina, including the nerve fiber layer. The hypothesis that these changes in the nerve fiber layer may alter the contour of the optic disc and change the cup-to-disc (C/D) ratio was tested. In a masked retrospective study, the authors evaluated the stereoscopic disc photographs of 100 patients with proliferative diabetic retinopathy (PDR) before and 1 year after undergoing PRP. The fellow untreated eyes were used as controls. Neither argon nor xenon PRP produced a significant change in the C/D ratio. PMID- 2704542 TI - Optic nerve involvement in retinoblastoma. AB - This retrospective review of 814 retinoblastoma patients discloses 240 cases of tumor extension into the optic nerve. Optic nerve involvement was classified according to the degree of invasion; grade I is superficial invasion of the optic nerve head only, grade II is involvement up to and including the lamina cribrosa, grade III is involvement beyond the lamina cribrosa, and grade IV is involvement up to and including the surgical margin. The incidence of optic nerve involvement was 29.5% (240/814). The mortality rate of patients with optic nerve involvement with grade I was 10%; grade II, 29%; grade III, 42%; and grade IV, 78%. Actuarial life-table analysis shows an increased mortality rate with increasing grade of optic nerve involvement. Multivariate statistical analysis shows that the grade of optic nerve involvement and the age at diagnosis of optic nerve involvement are the factors most significantly associated with survival. PMID- 2704543 TI - Open-label crossover study of vitamin A ointment as a treatment for keratoconjunctivitis sicca. AB - The authors evaluated the efficacy of all-trans retinoic acid (vitamin A) ointment as a treatment for keratoconjunctivitis sicca (KCS) in a group of 11 patients selected on the basis of clinical history, slit-lamp examination results, rose Bengal staining, and tear film osmolarity. In this open-label crossover study, vitamin A ointment was no more effective than placebo in increasing tear secretion, as indicated by Schirmer test with proparacaine or tear film osmolarity, or in decreasing ocular surface disease, as indicated by rose Bengal staining. Seven patients stated some preference for the placebo ointment, two patients for the vitamin A ointment, and two patients had no preference. PMID- 2704544 TI - Morphologic evaluation of Descemet's membrane and corneal endothelium in diabetes mellitus. AB - Diabetes mellitus is characterized by abnormally thickened basement membranes throughout the body and the eye. In addition, abnormal corneal endothelial cell morphology has been found in eyes of diabetics. The authors examined Descemet's membrane (the basement of the corneal endothelium) and the endothelial cells in 19 diabetic corneas and 19 age-matched nondiabetic normal corneas in a masked fashion by transmission electron microscopy and specular microscopy. No statistically significant quantitative or qualitative differences were found between the two groups. PMID- 2704545 TI - Increased retinal vascular tortuosity in gestational diabetes mellitus. AB - The authors report the first study which demonstrates that women with gestational diabetes mellitus (GDM) have increased tortuosity of their retinal vessels. Women with GDM underwent fundus photography and were compared with a normal control group (NC) and a pregnant nondiabetic control group (PC). Five ophthalmologists evaluated the unlabeled photographs, resulting in a combined mean prevalence of tortuosity of 21.6% NC, 24.7% PC, and 60.3% GDM. Statistical analysis showed that the GDM group was significantly different from both the NC and PC groups. Tortuosity was unrelated to acute elevation in blood glucose and was still present at 5 months postpartum. PMID- 2704546 TI - Acute macular neuroretinopathy. AB - Acute macular neuroretinopathy is a rare, unilateral, or bilateral condition of abrupt onset causing parafoveal scotomata and occasionally reduced visual acuity. The features are described in five new cases, and the evolution of the lesions described over a period of 9 months to 9 years. One patient was studied by fine matrix perimetry, which indicated a generalized elevation of thresholds at the macula early in the disorder, together with parafoveal scotomata. The thresholds improved over several months, and the scotomata became less dense. In another case, the scotomata were still present at 9 years, although at this time they were less dense. The condition appears to mainly affect young women, and in this group there is a high incidence of a recent immunologic disturbance suggesting an immune-based etiology. PMID- 2704547 TI - Oculoplastic surgery. PMID- 2704548 TI - [Ergometry-induced silent ischemia--clinical and angiographic features]. AB - This study was planned to clarify the clinical and angiographic attributes of patients with exercise induced silent myocardial ischaemia. The study sample consisted of 102 patients who had ischaemic exercise electrograms (greater than = 1 mm ST segment depression) and significant angiographic stenosis (greater than = 50% diameter stenosis), in at least one of the major coronary arteries. In 61 patients (60%) painful ischaemia was observed during exercise (group A) while in 41 patients (40%) only SD depression (silent ischaemia) occurred (group B). The groups were similar with respect to age, sex, history of diabetes and all angiographic parameters including the Gensini coronary score. A history of prior myocardial infarctions was observed more frequently (p less than 0.01) in patients with silent ischaemia (group B). Prior myocardial infarction may be a factor causing silent myocardial ischaemia. PMID- 2704549 TI - [Pregnancy in acute lymphoid leukemia]. AB - Authors followed up 5 girls, aged 7 to 13 years suffered of acute lymphoid leukemia, who got into complete remission due to induction therapy with multiple cytostatic agents and who became pregnant after the maintenance treatment lasting two and a half years. Of 8 pregnancies of the 5 women 4 pregnancies were terminated by spontaneous deliveries with mature newborns, and 4 ones were interrupted in gestational weeks 7 to 14. Except for one patient who died one year after the termination of pregnancy the other remained in complete remission during and after the pregnancy, and at present their survival times range between 12.5 and 15 years. Among the newborns one had dysplasia coxae congenita of mild grade. Progenies developed healthily in the course of follow-up ranging between 1.5 and 6 years. PMID- 2704550 TI - [Hypertrophic osteopathy in alcoholic males]. AB - Hypertrophic osteopathy was observed in 5 alcohol addict men. Periosteal newbone formation on the femur, tibia, fibula, radius and ulna appeared symmetrical. The short tubular and flat bones of hands and feet did not suffer impairment. Liver biopsy confirmed in each case portal cirrhosis. Hypertrophic osteopathy is a late complication of alcohol disease. Its development may be due to individual predisposition influenced by nutritional, hormonal, genetic, pancreatohepatic and biomechanical factors. PMID- 2704551 TI - [1988 Nobel laureates in medicine]. PMID- 2704552 TI - [Computerized tomography determination of bone mineral content in quantitative diagnosis of osteoporosis]. AB - Quantitative determination of bone mineral content has become important for the early diagnosis of osteoporosis prior to radiological evidence of vertebral deformities. Quantitative CT (QCT, computer tomometry), whether the single-energy (SE-QCT) or the dual-energy (DE-QCT) technique is used, yields volume-related values that can be used for accurate and reproducible assessment of spongious and cortical vertebral bone mineral. QCT seems to be superior to photon absorptiometry for early detection and follow-up of osteoporosis. PMID- 2704553 TI - [The 3-dimensional surface reconstruction from computerized tomography sections]. AB - Three-dimensional (3D) images can easily be reconstructed from computed tomography (CT) data. Three-dimensional reconstruction of osseous surfaces facilitates the analysis and detection of post-traumatic dislocations, tumorous changes or disturbances in the mechanics of joints. PMID- 2704554 TI - [The value of nuclear magnetic resonance tomography in staging of bone and soft tissue sarcomas]. AB - The prognosis of survival in bone and soft-tissue sarcomas is definitely correlated with compartmental tumor extension at the time of surgery and with the surgical margins achieved by resection. Preoperative planning and selection of an adequate surgical treatment procedure require a maximum of information on the tumor size, compartmental extension, proximity to the physis, skin layers, and the vessels and nerves. This information is indispensable and can only be obtained by a combination of several diagnostic investigations, MRI being of utmost importance. Whereas CT is superior in illustrating the bone structure, MRI outclasses CT in outlining the intraosseous tumor extension and the extraosseous tumor components. The latter aspects are especially important in planning and performing tumor resection. With the combined use of gradient echo sequences and Gadolinium DTPA with MRI, appreciation of the tumor margin and response to polychemotherapy may be possible in the future. PMID- 2704555 TI - [Magnetic resonance tomography studies with contrast media in post-discotomy syndrome]. AB - The syndrome encompassing failed back-surgery is a relatively uniform combination of complaints caused by a variety of pathological changes in the lumbar spine, alone or in various combinations. The MRI's capability of detecting these factors is described. MRI can detect recurrent disc herniations and separate them from intradural and/or extradural scar formation. With further experience, MRI might also be able to assess instability of the lumbar spine motion segments. MRI is not very helpful in detecting neural lesions or facette syndromes. For this kind of pathology, advances in diagnosis will depend on the further improvement of neuro- and electrophysiological tests. The same applies to the diagnosis of cases of spinal stenosis. The size of the spinal canal can be measured by MRI as well as by other modalities. These results just point out the risk of disease - not the disease itself. PMID- 2704556 TI - [Magnetic resonance tomography of the locomotor system with rapid image sequences]. AB - Rapid imaging of the musculoskeletal system with gradient-echosequences exhibits important advantages. Scanning time is reduced to 1/50 up to 1/100. Depending on TR, TE and flip-angle T1 or T2*-weighted image contrast can be achieved with comparable information to spin-echo images. Gradient-echo techniques combined with 3D-data acquisition is especially advantageous. Within a few minutes imaging of the whole interesting volume with thin contiguous slices is possible as well as secondary reconstruction of any plane. Applications of 2D- and 3D-gradient echo-sequences for imaging pathological conditions of the spine, pelvis, upper and lower extremities, with special regard of the knee joint, will be demonstrated. PMID- 2704557 TI - Characterization of the translocation between chromosomes X and 18 in human synovial sarcomas. AB - Recent studies have identified a specific chromosomal translocation, t(X;18)(p11.2;q11.2), in a high proportion of human synovial sarcomas. As a first step towards characterizing the X;18 translocation we have established a synovial sarcoma cell line. Fusion of this cell line to mouse RAG cells gave rise to somatic cell hybrids that contain the derivative (X) marker chromosome in the absence of other genetic material from chromosomes 18 and X. Southern analysis of DNA from these somatic cell hybrids demonstrated that the human X chromosome markers DXS94, DXS14, DXZ1 and DXS62 were retained. In contrast DXS7, GAPDP1, ARAF1, DXS146 were not consistently present in the hybrids indicating that these markers were on the region of the X chromosome replaced by part of the long arm of chromosome 18 during the generation of the X;18 translocation. The predicted position of the translocation relative to X chromosome markers is DXS7-DXS146-X; 18-DXS14-DXZ1-DXS94. PMID- 2704558 TI - Otology--current concepts and technology. PMID- 2704559 TI - Developments in hearing aid fitting and delivery. A decade of revolution. AB - The socioeconomic changes and technological advances that have occurred in the field of hearing aid dispensing are chronicled. The various instruments available to aid the hearing-impaired person, including digital electronics and programmable hearing aids, are described. The qualifications required of those who deliver hearing aids are also discussed. PMID- 2704560 TI - Stability of tympanoplasty in children. AB - The results of tympanoplasty performed for noncholesteatomatous chronic otitis in children aged 2 to 14 years are described. The authors report that the stability of hearing was excellent; they found hearing to be equally good in young children and in older children. Tympanic membrane perforation can be closed at any age. There is no age limit below which perforation should not be closed. PMID- 2704561 TI - Lasers in otology. AB - The author describes the use of lasers in over 2500 tympanomastoid surgical procedures. The advantages of using laser energy in microsurgery, which include fewer complications and the possibility of outpatient treatment, are presented. PMID- 2704562 TI - Techniques of tympanomastoidectomy. AB - The authors describe the various techniques of tympanomastoidectomy that can be used to eradicate chronic disease processes. The techniques are either open or closed operations; the factors in determining the choice of technique for specific conditions are presented. PMID- 2704563 TI - The flexible/intact-bridge tympanomastoidectomy technique. AB - A combination of otologic techniques has been presented in the step-wise surgical rationale that we call the flexible approach. The sequence of steps involved in the flexible approach allows the surgeon to adjust his or her surgery to the individual patient's needs. Very often, in patients with chronic otitis media, a middle ear reconstructive procedure (ossiculoplasty including lateralization of the malleus, removal of pathological tissue, insertion of an implant of silicone rubber sheets, and use of ventilation tubes with or without tympanic grafts) will obviate mastoidectomy. When a mastoidectomy is indicated, the IBM is a suitable procedure that encompasses the advantages of both closed and open mastoidectomy techniques. PMID- 2704564 TI - Patterns of covert speech behavior and phonetic coding. AB - In previous research a discriminative relationship has been established between patterns of covert speech behavior and the phonemic system when processing continuous linguistic material. The goal of the present research was to be more analytic and pinpoint covert neuromuscular speech patterns when one processes specific instances of phonemes. Electromyographic (EMG) recording indicated that the lips are significantly active when visually processing the letter "P"(an instance of bilabial material), but not when processing the letter "T" or a nonlinguistic control (C) stimulus. Similarly, the tongue is significantly active when processing the letter "T" (an instance of lingual-alveolar material), but not when processing the letters "P" or "C". It is concluded that the speech musculature covertly responds systematically as a function of class of phoneme being processed. These results accord with our model that semantic processing ("understanding") occurs when the speech (and other) musculature interacts with linguistic regions of the brain. In the interactions phonetic coding is generated and transmitted through neuromuscular circuits that have cybernetic characteristics. PMID- 2704565 TI - Frequency analysis of electromyographically measured covert speech behavior. AB - Eleven subjects were asked to silently read slides of the letters "P" and "T," and to view meaningless control slides similarly as they were presented visually. One-eighth-second electromyographic excerpts were sampled from the baseline and response periods. The data were then transformed into the frequency domain for inferential analyses. The mean power spectral frequencies for the response period were significantly lower than those for the base-line in the overall analysis. There were, however, no significant changes from baseline as a function of kind of stimulus (T, P, or Control) or muscle activated (lips or tongue). It was concluded that there was a generalized responding, not unique to the processing of the specific stimuli studied. Frequency analysis of EMG measures of covert behavior holds some promise of yielding unique information not available through traditional analysis procedures, but more sensitive methods than those used here would be required to demonstrate this. PMID- 2704566 TI - Assessment and management of the child with asthma. AB - The physical challenges of asthma present problems for children and their parents. Nurses can minimize the physical difficulties experienced by asthmatic children and enhance their emotional growth and self confidence by teaching and support. PMID- 2704567 TI - Temperament: a variable in children's pain management. AB - Young children undergoing similar surgical procedures vary greatly in their need for analgesics. The influence of temperament on pain management differences in hospitalized 3- to 7-year-old children was examined. Variation in the number of analgesic medications administered was attributed to the impact of the child's individual behavioral style. A child's temperament should be considered when pain management is planned. PMID- 2704568 TI - Primary amenorrhea. AB - Primary amenorrhea, or the absence of menarche, signals physical abnormality in 70% of afflicted girls. Nurses working with adolescents may prevent more serious problems through early identification and intervention. PMID- 2704569 TI - Stressful life events and accidents at school. AB - High school is a time of stress for most adolescents. School nurses need to be aware of the high levels of stress and the potential relationship stress has to accidental injury in order to plan better preventive care along with teachers, counselors, and coaches. PMID- 2704570 TI - New legislative efforts to improve child health and decrease infant mortality. Interview by Veronica Feeg. AB - Senator Bill Bradley (D-NJ) recently introduced the Infant Mortality and Children's Health Act of 1989, a bill that requires states to provide Medicaid coverage to pregnant women and infants living below 185% of the federal poverty level. In this article, Senator Bradley answers questions for Pediatric Nursing readers about this new federal legislative initiative. PMID- 2704571 TI - Pediatric management problems (AIDS serodiagnosis). PMID- 2704572 TI - Anti-staphylococcal penicillins. PMID- 2704573 TI - A need to market nursing's 'usefulness' as a profession. AB - The growing nursing shortage has pointed to the need for health care professionals and nurses in particular to understand general marketing principles. For nurses to be valued as competent and important health care professionals, they must continually market their 'usefulness' and work cooperatively with other professionals. PMID- 2704574 TI - Pediatric/neonatal graduate nurse internship: a collaborative effort. AB - An internship was developed as a single unit program to prepare graduate nurses to function competently and confidently in the Pediatric Intensive Care Unit (PICU). An analysis of resources, common goals, and philosophies subsequently led to the development of a collaborative internship program between the Pediatric and Neonatal Intensive Care Units. This innovative approach enhanced the internship program and met the mutual goals of each nursing unit. PMID- 2704575 TI - Certification in pediatric nursing. PMID- 2704576 TI - Pain reduction during neonatal circumcision. AB - PURPOSE: To determine the effect of two comfort interventions during unanesthesized circumcision on neonatal pain. METHODOLOGY: Fifty-eight neonates were randomly assigned to one of three intervention groups. Eighteen control infants received routine care, 15 infants had music played, and 15 infants had a tape of intrauterine sounds played. During circumcision, monitors measured cardiac rate, rhythm, blood pressure, and transcutaneous oxygen. Pain was measured by analysis of videotaped facial expressions using Izard's Maximally Discriminative Facial Movement Coding System (1983). RESULTS: Mean heart rate was above normal limits during all steps of the circumcision for the control group and during some of the steps for the other two groups. Facial expressions analyzed showed all three groups had pain much more than any other emotion during the procedure. CONCLUSIONS: The two interventions were unable to offset the effects of circumcision pain. PMID- 2704577 TI - Airway pressures during crying in healthy infants. AB - Maximal inspiratory and expiratory airway pressures (PI max and PE max) were measured in 100 healthy infants (51 males, 49 females; age range, 0.06-3.76 years) by occluding the airway with a suitable face mask during a crying effort. Mean values +/- SD for PI max and PE max were 118 +/- 21 cm H2O and 125 +/- 35 cm H2O, respectively. Maximal inspiratory pressure was independent of age, sex, and anthropometrics, while maximal expiratory pressure showed a low but statistically significant positive correlation with body weight (P less than 0.001). PMID- 2704578 TI - Resting oxygen consumption and ventilation in cystic fibrosis. AB - Resting oxygen consumption (VO2) and minute ventilation (VE) were measured on nine control subjects and 13 patients with cystic fibrosis (CF). In patients with CF, VO2 was 20% higher (P less than 0.01) when expressed per m2 and 47% higher (P less than 0.001) when expressed per kg body weight, and VE was 58% higher when expressed per m2 and 94% higher when expressed per kg body weight (P less than 0.001) than in control subjects. Repeated measures of VO2 and VE were highly reproducible over 2 hours (within-subject coefficients of variation: in controls, VO2 = 5.5%, VE = 7.4%; in CF, VO2 = 3.1%, VE = 5.1%). Since the increases in VE were greater than those in VO2, the ventilatory equivalent (VE/VO2) was 32% higher in CF than in controls. We conclude that size-corrected total energy expenditures and VE at rest are higher in patients with CF than in control subjects. Ventilation appears mechanically inefficient but necessary to keep arterial PCO2 from rising and oxygen saturation from falling at rest. Our results are consistent with observations that these patients have an abnormally large physiological dead space (Featherby et al.: Ann Rev Respir Dis 1969; 102:737). PMID- 2704579 TI - Passive total respiratory system compliance and gas exchange in newborns with hyaline membrane disease. AB - Passive total respiratory system compliance (CRS) and gas exchange measurements were performed in nine newborns during the course of hyaline membrane disease. None of the subjects presented bronchopulmonary dysplasia at follow-up investigations. Gestational age ranged from 29 to 37 weeks. CRS was measured by the multiple occlusion technique. Gas exchange parameters were the fraction of inspired oxygen concentration (FIO2) and the arterial/alveolar ratio for oxygen (a/AO2 ratio). In each subject four tests were performed: test 1 during the first day of life; test 2 during the second day of life; test 3 between the fourth and the seventh days of life; test 4 after extubation. CRS/BW (CRS normalized for body weight) was not statistically different at tests 1-3, but it significantly increased (P less than 0.001) between tests 3 and 4. FIO2 and a/AO2 ratio presented no statistical difference at tests 1-2 but several significant differences were noted thereafter: FIO2 decreased significantly (P less than 0.001) when results from tests 2 and 3 were tabulated. The a/AO2 ratio increased significantly between tests 2 and 3 (P less than 0.001), and a further significant increase (P less than 0.01) was also noted when results obtained during tests 3 and 4 were compared. A significant relationship existed during the evolution of the disease between CRS/BW and gas exchange parameters (FIO2 and a/AO2 ratio) (P less than 0.01), but gas exchange improved earlier than lung mechanics. PMID- 2704580 TI - Predicting arterial oxygen tension from maximum expiratory flow volume curves in cystic fibrosis. AB - Measurements of arterial oxygen tension (PaO2) while breathing room air, and maximum expiratory flow volume curves were performed in 34 patients with cystic fibrosis (age range 7-27 years, 24 males and 10 females). Logistic regression was performed using forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEFR), and forced expiratory flow at 75% of expired vital capacity (FEF75) to model an equation for predicting when PaO2 would be less than 55 mmHg (severe hypoxemia). Equations were modelled using one, two, three, or all four of the variables. For the univariate logistic regression, each of the four variables was a significant (P less than 0.001) predictor for severe hypoxemia. FVC was the best predictor with an R2 = 0.56, sensitivity of 100% (false negative rate = 0%), and a specificity of 88.5% (false positive rate = 27%). The model predicted that patients with an FVC less than 35% of the predicted normal were at risk of having PaO2 less than or equal to 55 mmHg. Adding FEV1, FEF75, or PEFR in various combinations to FVC made the model equation more complicated but did not add significantly to the ability to predict severe hypoxemia. PMID- 2704581 TI - Short-term variability of pulmonary function tests in infants with bronchopulmonary dysplasia. AB - We determined the short-term variability of pulmonary function in infants recovering from bronchopulmonary dysplasia. Sixteen infants with birth weight of 1,231 +/- 929 grams (mean +/- SD) and gestational age of 29 +/- 4 weeks were studied twice at 17 +/- 8 weeks postnatally at intervals of 4 to 8 days during a period of clinical stability. The infants were still on supplemental oxygen but were off diuretics and bronchodilators. We used a modification of the rapid thoracic compression method to measure forced expiratory flow (Vmax FRC) and the time constant (tau) of expiratory flow at functional residual capacity. Thoracic gas volume (TGV), mean and total airway resistance (RawM and RawT), and mean and total specific airway conductance (SGawM and SGawT) were measured in a whole body pressure plethysmograph. An esophageal balloon was used to measure dynamic pulmonary compliance (Cdyn). Variabilities were defined as the standard deviation of percent changes between the first and second tests. They were 30% for VmaxFRC, 23% for tau, 12% for TGV, 20% for RawM, 35% for RawT, 25% for SGawM, 72% for SGawT, and 23% for Cdyn. All these tests are useful in assessing pulmonary function of infants with BPD; however, their variability must be taken into account when interpreting short-term changes. PMID- 2704582 TI - Immunoreactive trypsinogen screening for cystic fibrosis: characterization of infants with a false-positive screening test. AB - Blood immunoreactive trypsinogen (IRT) is elevated in newborns with cystic fibrosis (CF) and has been used as a neonatal screening test. However, not only is the benefit of early diagnosis unknown, but also the sensitivity, specificity, and time related decline of IRT values have yet to be comprehensively evaluated. This report describes the characteristics of infants with a false-positive IRT in our experience with CF screening of 87,000 infants. The IRT value was elevated in 92 newborns; 13 had a confirmed diagnosis of CF by quantitative pilocarpine iontophoresis sweat testing, and 79 infants did not have CF and were therefore classified as false positives by IRT screening. In order to test the hypothesis that perinatal stress factors are associated with high neonatal IRT values, we evaluated Apgar scores at 1 and 5 minutes. We found that the scores of false positive infants were significantly lower (P = 0.0004 and P = 0.0102 at 1 and 5 minutes, respectively), compared with infants in the general population. While perinatal asphyxia as reflected by low Apgar scores is an associated factor accounting for an elevated IRT value, the majority of non-CF newborns with an elevated IRT have normal Apgar scores. PMID- 2704583 TI - Changes in pulmonary mechanics following caffeine administration in infants with bronchopulmonary dysplasia. AB - The effects of caffeine upon pulmonary mechanics were measured in 16 infants with bronchopulmonary dysplasia (BPD). Pulmonary function tests were performed immediately prior to and 1 hour following a dose of 10 mg/kg of caffeine. A 37% increase in minute ventilation (mean +/- SEM; 436.6 +/- 26.3 to 580.8 +/- 30.7 ml/min/kg) was seen with caffeine administration (P less than 0.001), primarily from a 42% increase in tidal volume (6.2 +/- 0.4 to 8.5 +/- 0.4 ml/kg) (P less than 0.001). Total lung resistance decreased by 20% (134.6 + 24.2 to 105.3 +/- 20.1 cmH2O/L/sec) (P = 0.01), and total pulmonary compliance improved by 47% (0.642 +/- 0.104 to 0.908 +/- 0.190 ml/cmH2O/kg) (P less than 0.01). In five matched control infants with BPD, no effects of placebo upon pulmonary mechanics were detected. Since caffeine has a wide therapeutic index with few side effects, it may be an effective adjunct in the treatment of infants with BPD. PMID- 2704584 TI - Acute effects of oxygen, nifedipine, and diltiazem in patients with cystic fibrosis and mild pulmonary hypertension. AB - The acute effects of oxygen, nifedipine, and diltiazem were studied in eight patients with cystic fibrosis and mild pulmonary hypertension, to assess the possibility of relieving the latter before the occurrence of irreversible vascular changes. Oxygen decreased pulmonary pressure (-23%) and resistance ( 21%), while increasing systemic resistance (+23%). Nifedipine increased cardiac index (+30%), at the expense of augmented right ventricular work (+42%), resulting in a decreased calculated pulmonary resistance (-23%); pulmonary artery pressure remained unchanged, however. Nifedipine decreased arterial Po2 (-10%), suggesting ventilation-perfusion mismatch. Four of the eight patients responded to diltiazem. Their pulmonary pressure (-35%) and resistance (-43%) decreased, while systemic vascular tone remained unchanged. Oxygen in three patients, and diltiazem in two, returned pulmonary pressures and resistances to normal values. Early reversal of pulmonary hypertension is possible, and intervention is desirable before the establishment of chronic hypoxia, cor pulmonale, or right ventricular failure. Our data does not support the use of nifedipine in pulmonary hypertension, but shows that oxygen, and in some cases diltiazem, act as effective and selective pulmonary vasodilators. PMID- 2704585 TI - Evaluation of the flow-volume loop as an intra-operative monitor of respiratory mechanics in infants. AB - Airway pressure is currently the primary indicator of respiratory mechanics used by the anesthetist in the operating room. This quantity can signal that the mechanical properties of the respiratory system have changed. However, there is a need for more sophisticated monitors of mechanics, capable of indicating the nature of the change. We have investigated the use of the tidal flow-volume loop in differentiating between an obstruction of the endotracheal tube and changes in the distribution of regional ventilation, using a computer model. Endotracheal obstruction caused the descending limb of flow-volume loop to become convex to the volume axis, whereas ventilation inhomogeneity caused the curve to become concave to the volume axis. In contrast, examination of peak airway pressure did not allow differentiation between the two conditions. We conclude that, while the peak airway pressure is useful in signaling a change in a patient's condition, the combination of airway pressure and the flow-volume loop serves as a more comprehensive monitor of respiratory mechanics. PMID- 2704586 TI - Development of intestinal host defense: an increased sensitivity in the adenylate cyclase response to cholera toxin in suckling rats. AB - To determine if developmental variations existed in the second messenger system that mediates cholera toxin (CT) action, the adenylate cyclase (AC) response was studied in 2-wk-old suckling and 6-wk-old weaned rats. AC was assayed in the proximal small intestine 4 h after intraduodenal administration of various doses of CT. Dose-effect analysis showed a 9-fold increase in the sensitivity of the CT activated cyclase response in suckling rats when measured by the ED50, expressed as microgram CT/g body wt (0.03 for 2 wk, 0.27 for 6 wk). When the CT dose was expressed as microgram/animal, suckling rats were 50 times more sensitive than 6 wk-old rats. In addition, the CT-induced fluid secretion was closely correlated with the elevated cyclase activities (correlation coefficient: 0.83 for 2 wk, 0.93 for 6 wk). Furthermore, more fluid seemed to be secreted/unit wt of gut in the sucklings, even when the same level of enzyme activity was compared. A maximum of 3- to 4-fold rise in AC activation occurred at 0.5 microgram CT/g body wt, but both the basal and the maximal stimulated levels of AC were not developmentally different. This study demonstrates an in vivo increase in AC responsiveness to CT that may be in part responsible for the increased incidence of toxigenic diarrhea in neonates. PMID- 2704587 TI - Effect of acute umbilical cord compression on hepatic carbohydrate metabolism in the fetal lamb. AB - Although the liver plays a central role in glucose homeostasis in the adult, its importance in fetal glucose homeostasis during acute reductions of substrate delivery is unknown. To examine this, we studied eight fetal lambs at 121 +/- 2 d gestation. We placed catheters in the descending aorta, inferior vena cava umbilical vein and the left (n = 6) or right (n = 2) hepatic vein, and a balloon occluder around the umbilical cord. At least 4 d after surgery, before and during umbilical cord compression, we measured blood oxygen saturation, glucose, lactate, and Hb concentrations, and blood flows using the radiolabeled microsphere technique. Gluconeogenesis was assessed by infusion of [U14C]lactate. Reducing umbilical flow by 50-60% from a control value of 181 +/- 20 mL/min/kg (mean +/- SD) caused a dramatic decrease in hepatic blood flow from 332 +/- 99 to 94 +/- 77 mL/min/100 g (p less than 0.05). Oxygen delivery to the fetus fell by 50% and that to the liver by 73%. However, hepatic O2 consumption was maintained by increased extraction. Glucose delivery to the liver fell from 67 +/- 24 to 20 +/- 13 mg/min/100 g (p less than 0.001), but lactate delivery did not change. In spite of the maintenance of lactate delivery, net hepatic lactate uptake fell significantly from 3.3 +/- 1.7 to 1.4 +/- 0.9 mg/min/100 g (p less than 0.05). This could account, in part, for the increase of blood lactate concentration from 16 +/- 4 to 27 +/- 7 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704588 TI - The effect of saccharolactone on rat intestinal absorption of bilirubin in the presence of human breast milk. AB - Beta-glucuronidase hydrolyzes glucuronic acid from bilirubin glucuronides. The unconjugated bilirubin that results is more readily absorbed from the intestine. Human breast milk has significant beta-glucuronidase activity, and it has been suggested that the milk may play an etiologic role in the hyperbilirubinemia commonly seen in breast-fed infants. To test whether breast-milk can facilitate intestinal bilirubin absorption, pairs of rats were fitted with bile duct and duodenal catheters. One rat of each pair received an intraduodenal infusion of rat bile plus breast-milk; the other rat received a similar amount of bile and milk plus the beta-glucuronidase inhibitor saccharolactone. Rats receiving saccharolactone excreted significantly less bilirubin in their bile, suggesting that inhibition of beta-glucuronidase decreased intestinal absorption of bilirubin. These findings were not seen in similar experiments when saline was substituted for human breast-milk. PMID- 2704589 TI - Initiation of fetal rat lung phospholipid and surfactant-associated protein A mRNA synthesis. AB - To determine whether the initiation of fetal lung surfactant phospholipid production and the activation of the gene for the 35-kD surfactant-associated protein are dependent on circulating corticosteroids, we cultured dexamethasone responsive explants of 15- to 17-d fetal rat lung in medium with 1% FCS (controls), charcoal-stripped 1% FCS, or a variety of glucocorticoid antagonists. The steroid antagonist RU 486 almost completely abolished specific cytoplasmic and nuclear dexamethasone binding in the explants but had no glucocorticoid agonist activity. There was a significant increase in disaturated phosphatidylcholine synthesis during 7 d in culture in control explants (78%) and in those cultured with Charcoal-stripped serum (83%), RU 486 (82%), or the other glucocorticoid antagonists--clotrimazole, cortexelone, and 11-ketoprogesterone. Specific mRNA for surfactant-associated protein A was not detectable in preculture 17-d lung tissue, but accumulated to the same extent in cultures with or without RU 486 in the medium. These findings support the view that expression of the genes responsible for the synthesis of the various components of surfactant is not induced by glucocorticoids, but by signals contained within the lung tissue itself. The role of circulating hormones is later acceleration and modulation of surfactant production. PMID- 2704590 TI - Ligating the ductus arteriosus before birth causes persistent pulmonary hypertension in the newborn lamb. AB - We determined whether closing the ductus arteriosus of the fetal lamb several d before birth would cause persistent pulmonary hypertension after birth. Six experimental fetuses who had their ductus arteriosus ligated 3-17 d before delivery, three control fetuses who had sham ligation of the ductus arteriosus 14 d before delivery, and six control fetuses who had no prenatal surgery were delivered by cesarean section between 138 and 144 d of gestation. Each was instrumented to measure pulmonary and systemic arterial pressures and pulmonary blood flow. Each newborn lamb was ventilated with room air during the first 45 min after birth and then with decreasing amounts of inspired oxygen from 100 to 9%. Pulmonary arterial pressure decreased significantly when ventilation was begun in the control lambs but not in the lambs who had their ductus arteriosus ligated before delivery. Throughout the experiment, pulmonary arterial pressure and total pulmonary resistance were significantly higher, and pulmonary blood flow was significantly lower in the lambs who had their ductus arteriosus ligated before delivery. In two of them, pulmonary arterial pressure was greater than or equal to systemic arterial pressure, even during ventilation with 100% oxygen. This animal preparation provides a method of investigating persistent pulmonary hypertension in the newborn lamb and may provide insight into an etiology of the syndrome of persistent pulmonary hypertension of the newborn. PMID- 2704591 TI - Ligating the ductus arteriosus before birth remodels the pulmonary vasculature of the lamb. AB - The clinical syndrome of persistent pulmonary hypertension of the newborn includes a developmentally abnormal pulmonary microvasculature which contains excessive amounts of muscle and which cannot adapt to air breathing in the perinatal period. Surgical ligation of the ductus arteriosus of the fetal lamb has produced a physiologic model of pulmonary hypertension of the newborn. The aim of the present investigation is to determine whether surgical ligation of the ductus arteriosus in fetal sheep produces anatomic changes in the pulmonary blood vessels. The pulmonary vasculature of seven neonatal lambs that underwent surgical ligation of the ductus arteriosus from 6 to 17 d before birth was compared to that of five control lambs with a patent ductus arteriosus without fetal surgery and three control lambs with a patent ductus arteriosus that underwent sham surgery. Quantitative microscopic analysis of the barium gelatin filled peripheral pulmonary vascular bed revealed an increase in the proportion of partially and fully muscularized pulmonary arteries at the level of the terminal bronchiole and within the acinus (p less than 0.0001). This finding demonstrates that medial muscle develops in areas of the distal pulmonary vascular bed where it is normally absent. Periadventitial fibrosis surrounding intraacinar pulmonary arteries was also present. No change in the number of small intraacinar arteries was detected. This structural remodeling of the peripheral pulmonary vascular bed was initiated in utero by ductus arteriosus occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704592 TI - Periodic breathing cycle duration in preterm infants. AB - Periodic breathing cycle duration (PCD), the time interval from the beginning of one respiratory pause to the beginning of the next pause within an episode of periodic breathing (PB), was measured by examination of 24-h impedance pneumograms in 51 preterm infants. Calculations of the SD of PCD within a given PB episode (approximately 3 s) and comparison of PCD values between two PB episodes in each infant (r = 0.68) revealed considerable variability in PCD. This variability was not related to the number of cycles in the PB episode or to the amount of PB in the recording. Contrary to the decrease in PCD from 15.0 s at 1 wk to 12.4 s at 12 wk in term infants reported previously, PCD did not vary as a function of postconceptional, gestational, or postnatal age in our preterm population. PCD has limited value as an indicator of chemoreceptor maturation in the preterm infant, and most likely reflects transient adjustments in respiratory system control. PMID- 2704593 TI - The cardiopulmonary effects of calcium infusion in infants with persistent pulmonary hypertension of the newborn. AB - Low blood ionized calcium levels have been reported previously in association with alkalosis in infants undergoing hyperventilation for persistent pulmonary hypertension. We investigated the effect of acute calcium infusions on the cardiopulmonary status of 10 hypocalcemic, hyperventilated infants with persistent pulmonary hypertension. Acid-base status, arterial partial pressure of oxygen, vital signs, and echocardiographically determined right and left systolic time interval ratios and left ventricular shortening fractions were obtained before and after rapid infusions of calcium gluconate or saline. At 5 and 15 min after calcium infusion, but not after saline infusion, there were significant decreases in both right and left ventricular systolic time interval ratios, and an increase in transcutaneous PO2 and PaO2 that coincided with peak levels of ionized calcium. These findings provide evidence that high levels of ionized calcium in newborns with persistent pulmonary hypertension transiently improve myocardial performance and oxygenation. PMID- 2704594 TI - Effects of digoxin on diaphragmatic contractility in the piglet. AB - Minute ventilation, arterial blood gases and pH, cardiac output, and transdiaphragmatic force generation were measured in eight anesthetized, tracheostomized piglets before and after administration of 40 micrograms/kg body wt of digoxin. No changes were noted in cardiac output, heart rate, tidal vol, respiratory rate, or minute ventilation. Blood pressure decreased from baseline to 60 min postinfusion. No change was noted in the force frequency curves at 30 and 60 min postinfusion. Serum digoxin levels averaged 10.4 ng/mL at 30 min and 5.6 ng/mL at 60 min. In seven control animals, no changes were noted in any ventilatory or hemodynamic parameter from baseline to 60 min. In contrast to the reported effects of digoxin on the diaphragm of adult humans and animals, digoxin did not augment diaphragmatic contractility in normal infant swine. PMID- 2704595 TI - Evaluation of a new method for the prevention of neonatal anemia. AB - Blood sampling for diagnostic purposes is a major cause of neonatal anemia. We propose a new method of blood sampling which preserves the infant's erythrocytes. Upon drawing of 1.5-ml blood samples, the syringe is centrifuged and erythrocytes are injected back into the circulation. Using rabbits as an experimental model, we documented the efficiency of this method in decreasing the need for foreign blood transfusion. Results of a variety of laboratory tests performed with plasma obtained with the new method were identical to those achieved with whole blood. Subsequent testing did not show increased risk of contamination or bleeding phenomena secondary to heparin load. Red blood cells obtained by centrifugation were morphologically normal. This new method may be effective in reducing the need for foreign blood transfusions in neonates. PMID- 2704596 TI - The effects of hypoxemia on myocardial blood flow during exercise. AB - We evaluated the adequacy of regional and transmural blood flow during exercise and rapid pacing after 1 wk of hypoxemia. Seven mature mongrel dogs were made hypoxemic (mean O2 saturation = 72.4%) by anastomosis of left pulmonary artery to left atrial appendage. Catheters were placed in the left atrium, right atrium, pulmonary artery, and aorta. Atrial and ventricular pacing wires were placed. An aortic flow probe was placed to measure cardiac output. Ten nonshunted dogs, similarly instrumented, served as controls. Recovery time was approximately 1 wk. Cardiac output, mean aortic pressure, and oxygen saturation were measured at rest, with ventricular pacing, atrial pacing, and with treadmill exercise. Ventricular and atrial pace and exercise were at a heart rate of 200. Right ventricular free wall, left ventricular free wall, and septal blood flow were measured with radionuclide-labeled microspheres. Cardiac output, left atrial blood pressure, and aortic blood pressure were similar between the two groups of dogs in all testing states. Myocardial blood flow was significantly higher in the right and left ventricular free wall in the hypoxemic animals during resting and exercise testing states. Myocardial oxygen delivery was similar between the two groups of animals. Pacing resulted in an increase in myocardial blood flow in the control animals but not the hypoxemic animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704597 TI - Effect of hypoxia on ventilatory control during exercise in children and adults. AB - Little is known about maturation of peripheral chemoreceptor tone (PCT) during growth. We recently demonstrated that the increase in PCT was 49% greater during hypoxic (15% O2) exercise in children compared to adults. As the PCT is a major determinant of ventilatory (VE) response at the onset of exercise (measured by the time constant tau), we hypothesized that hypoxia would affect tau VE (and tau VCO2) to a greater extent in children. Nine healthy children (6-10 y old) and nine healthy adults (18-40 y old) performed multiple transitions from rest to constant work rate on the cycle ergometer. Studies were done breathing 21% O2 and 15% O2. Hypoxic breathing quickened the VE responses in all of the adults and children, but the magnitude of the hypoxic effect did not differ between the two groups (in children, tau VE was 50.9 +/- 9.9 s during 21% O2 breathing and 32.6 +/- 6.9 s during hypoxia; in adults, tau VE was 69.4 +/- 17.6 s, which fell to 50.9 +/- 18.4 s during hypoxia). The hypothesized greater ventilatory response to hypoxia in children compared to adults during exercise was not observed. During 21% O2 breathing, the data demonstrated that children stored relatively less CO2 (by 49%) than did adults in the transition between rest and exercise, possibly explaining the faster ventilatory kinetics. We speculate that there must be additional respiratory control differences between adults and children such that for a given increase in PCT-induced by hypoxia, the VE response at the onset of exercise is less in children than in adults. PMID- 2704598 TI - Changes in ovine hepatic circulation and oxygen consumption at birth. AB - The umbilical vein provides the majority of hepatic blood flow during fetal life. After birth, liver blood flow is derived from the hepatic artery and portal vein, but ductus venosus patency can alter portal venous blood flow to the liver. To characterize changes in hepatic blood flow and oxygen metabolism in the immediate perinatal period, we studied liver and ductus venosus blood flow in seven fetal sheep before and after birth using the radionuclide-labeled microsphere method. Hepatic blood flow fell from 423 +/- 117 (mean +/- SD) mL/min/100 g liver in the fetus to 144 +/- 73 by 2 h after delivery. Although portal venous blood flow increased progressively from 2 to 10 h (137 +/- 48 to 305 +/- 140 mL/min/100 g), because of increasing ductus venosus shunt flow, total hepatic blood flow did not change. Hepatic arterial flow was 46 +/- 24 mL/min/100 g at 2 h, providing 35% of total hepatic blood flow, and did not change over the next 8 h. Hepatic oxygen delivery fell after birth from 58 +/- 25 mL/min/100 g liver in the fetus to 21 +/ 11 at 2 h and then remained constant. Hepatic oxygen consumption was 7.3 +/- 2.6 mL/min/100 g liver in the fetus and ranged from 3.2 +/- 1.5 to 4.1 +/- 1.8 mL/min/100 g liver during the 10 h after birth. Loss of the umbilical-placental circulation at birth substantially reduces hepatic blood flow. Hepatic arterial flow does not increase to compensate for decreases in total hepatic blood flow. The persistent ductus venosus shunt compromises portal venous supply to the liver.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704599 TI - A mathematical procedure for estimating the spatial relationships between lung function, somatic growth, and maturation. AB - A mathematical procedure is described for examining growth velocity rates of lung function (FEV1) in relationship to somatic growth and maturation. This procedure uses a polynomial smoothing spline model to yield a fitted curve through the data and to estimate the process first derivatives (i.e. growth velocity curves). We demonstrate this technique using data from children and adolescents enrolled in the Tucson Epidemiological Study of Airway Obstructive Diseases. The study group consisted of 772 healthy normal subjects, aged 3 to 25 y. The results for the normal subjects (male and female) indicate that the growth velocity peak (GVP) of somatic growth leads the GVP of functional growth (FEV1) by approximately 7 and 11 mo for females and male subjects, respectively, and that the GVP of maturation lags behind that of functional growth (FEV1) by approximately 1 y (male and female subjects). In addition, the normal subjects' growth velocity curves for FVC and FEV1/FVC were examined. The FEV1/FVC ratio was consistently high, and its growth velocity was not significantly different than 0 over the age range studied. This suggests that in normal children, the GVP seen in FEV1 is primarily due to a GVP in vital capacity or lung vol, rather than to a direct effect on expiratory flow rates alone. From this study we concluded that the polynomial smoothing spline procedure can adequately model the inherently noisy pulmonary function data and additionally yield an accurate estimate of the process first derivative. PMID- 2704600 TI - Effects of undernutrition on infection with Vibrio cholerae O1 and on response to oral cholera vaccine. AB - The association between undernutrition and the risk of colonization and disease with Vibrio cholerae O1, concentrations of salivary IgA and the serologic response to infection and to orally administered cholera B subunit were examined prospectively in a family study in Bangladesh. Children ages 1 to 8 years who were family contacts of patients hospitalized with culture-confirmed cholera were visited within 24 hours of the hospitalization and daily for 10 days, queried for the presence of diarrhea and cultured for V. cholerae O1. On Day 1 each child was weighed and saliva was collected to measure total IgA. On Days 1 and 21 blood was taken to assess vibriocidal and antitoxin titers, and on Days 1 and 2 B subunit or placebo was given orally as part of a trial to look for a toxin-blocking effect. Of 412 children enrolled in the study 35% (143) became infected with V. cholerae O1 and 49% (70) of these developed diarrhea. Undernutrition, defined in a child as weight less than 70% of the Harvard reference weight-for-age, was not associated with colonization, disease or the duration or severity of cholera. Moreover well-nourished children did not differ from undernourished children in their concentrations of salivary total IgA, initial serum antitoxin or vibriocidal antibodies or in their serologic response to colonization, disease or B subunit. The immune system in its response to cholera appears to be quite resistant to nutritional insults. The good antitoxin response to B subunit among undernourished children is of particular importance in considering the use of future oral cholera vaccines in areas where such undernutrition is common. PMID- 2704601 TI - Rubella in Panama: still a problem. AB - In 1986 there were 3795 cases of acquired rubella reported in the Republic of Panama (177/100,000 population) of which 1550 were from the Metropolitan Region (261/100,000 population). Fifty-four neonates (218/100,000 of those born alive), born predominantly in two medical centers within the capital, were identified with compatible or confirmed congenital rubella manifesting as cardiopathies and neurologic defects in 68.5%; low birth weight in 61%; ocular defects in 48%; muscular tone alterations and psychomotor retardation in 35 and 33%, respectively; and hearing loss and purpura in 29.6%. It is estimated that the annual direct cost of care for these 54 patients would be close to $123,730, and this confirms the high cost of continuing care compared with the use of a safe, economical and efficient vaccine. PMID- 2704602 TI - Possible role of tonsillectomy and adenoidectomy in children with recurrent fever and tonsillopharyngitis. PMID- 2704603 TI - Systemic bacterial infections in children with fever greater than 41 degrees C. PMID- 2704604 TI - Tularemia transmitted by a squirrel bite. PMID- 2704605 TI - Toxic shock syndrome associated with osteomyelitis in premenarcheal girl. PMID- 2704606 TI - Immunization of children who have received fractional doses of diphtheria-tetanus toxoids-pertussis vaccine. PMID- 2704607 TI - Neurobrucellosis in children. AB - Reports on nervous system involvement in brucellosis are rare in children. We report nine children with neurobrucellosis. The clinical presentation included meningitis in six patients, one with encephalitis, one with meningoencephalitis and one with meningomyeloencephalitis. The blood from all patients showed elevation in Brucella microagglutination test titers (greater than or equal to 1:640) and in Brucella-specific enzyme-linked immunosorbent assay for IgM (greater than or equal to 1:800), IgG (greater than or equal to 1:800) and IgA (greater than or equal to 1:800) antibodies. Brucella melitensis was recovered from the blood in five patients and from the cerebrospinal fluid in three patients. The cerebrospinal fluid showed lymphocytic pleocytosis in eight patients with elevated protein in three, decreased glucose in four and a Brucella microagglutination test titer of greater than or equal to 1:80 in all. Treatment with a combination of oral tetracyclines with intramuscular streptomycin was successful in five patients, rifampin with streptomycin in two, tetracycline with rifampin in one and tetracycline, rifampin and streptomycin in one. No relapses, mortality or sequelae occurred in our patients. PMID- 2704608 TI - Outcome of treatment of candidemia in children whose central catheters were removed or retained. AB - In this study we reviewed the outcomes of all pediatric patients at Duke University Medical Center between 1978 and 1987 who were treated with amphotericin B and in whom Candida sp. fungemia occurred in the presence of a venous or arterial central catheter. Twenty-one episodes were evaluated for efficacy of either of 2 interventions. In 13 patients the catheter was removed and amphotericin B therapy was begun (Group 1), and in 8 patients, the catheter was retained and amphotericin B therapy was begun (Group 2). Persistent candidemia beyond onset of intervention occurred in 2 of the 13 patients in Group 1 and in 6 of the 8 patients in Group 2 (P = 0.018). In Group 1, 2 of the 13 patients subsequently developed new complications of candidiasis, and no patient died of causes related to candidiasis. In Group 2, 3 of the 8 patients had resolution of persistent candidemia only after catheter removal, 3 developed new complications of candidiasis after initiation of amphotericin B and 2 died with systemic candidal infection. Only one of the catheters initially retained was maintained successfully beyond the second week of amphotericin B therapy. We conclude that adverse outcomes (persistent fungemia, morbidity and mortality) are associated with attempts to maintain central catheters in the presence of candidemia. PMID- 2704609 TI - Implications of stress on nurse retention. PMID- 2704610 TI - Latest developments: the AMA registered care technologist. PMID- 2704611 TI - COAR--the new core of ANA. PMID- 2704612 TI - Nurses change lives: to be honored on May 6. PMID- 2704613 TI - School nurses surveyed on smoking policies. PMID- 2704614 TI - Criteria for the evaluation of baccalaureate and higher degree programs in nursing. PMID- 2704615 TI - Nurse faculty: socioeconomic trends 1988. PMID- 2704617 TI - Non-radioactive chemical sequencing of biotin labelled DNA. AB - Methods for the nonradioactive chemical sequencing of DNA are described. A biotin marker molecule, attached chemically to an oligonucleotide primer or enzymatically in an endfilling reaction of restriction enzyme sites, is stable during the base-specific chemical modification and strand scission reactions. Following fragment separation by direct blotting electrophoresis, the membrane bound sequence pattern can be visualized by a streptavidin-bridged enzymatic color reaction. The biotin labeling is also applicable for DNA sequencing by random degradation of phosphothioates, thus showing to be a universal label for nonradioactive DNA sequencing. PMID- 2704618 TI - Nucleotide sequence and genomic organization of bird minisatellites. AB - Two minisatellite loci from a Eurasian songbird, the willow warbler (Phylloscopus trochilus) were isolated, sequenced and used as probes to detect more than 20 related hypervariable loci. In addition, a sequence flanking one of the minisatellite loci was isolated, and used to study a VNTR locus. The bird minisatellites have a repeat unit of either 12 (AGGGAAGGGCTC) or 17 bp (GGGGACAGGGGACACCC), repeated in tandem 40-100 times per locus, and shows partial similarity to the sequence motifs of human minisatellites. These sequences are among the most variable minisatellites known, with the incidence per gamete of new length alleles estimated from family studies of warblers to about 5.6% per locus. The bird minisatellite alleles show mendelian inheritance and segregation analysis indicates that they are derived from families of sequences with members on several autosomal linkage groups. Some of the warbler core sequences cross hybridize to hypervariable loci in other species of birds, mammals and fishes. PMID- 2704619 TI - Extraordinary stable structure of short single-stranded DNA fragments containing a specific base sequence: d(GCGAAAGC). AB - Short single-stranded DNA fragments carrying a GCGAAAGC sequence were found to move unexpectedly faster than other fragments of the same length in electrophoresis on a polyacrylamide gel containing a denaturing agent. The fragments were noted to have a stable structure even in 7M urea solution, but the stability cannot be explained simply on the basis of base pair formation alone. Physical characterization of the GCGAAAGC fragment indicated that it takes a hairpin-like structure in spite of the short chain length with only two G-C base pairs, comprised of GCG and AAAGC subsegments, each possessing a helical configuration independent of the others. Some biological implications of this unusual structure are discussed. PMID- 2704620 TI - The synthesis of 2-pyrimidinone nucleosides and their incorporation into oligodeoxynucleotides. AB - The synthesis of 1-(beta-D-2'-deoxyribosyl)-2-pyrimidinone (dK) and its 5-methyl derivative (d5) from 2'-deoxycytidine or 2'-deoxythymidine, respectively, via silver oxide oxidation of 4-hydrazinopyrimidines is described. The necessary hydrazine substituted pyrimidine nucleosides have been prepared by transamination of a protected cytidine derivative or by addition/elimination reactions to an O4 sulfonated thymidine derivative. Oxidation of the 4-hydrazino pyrimidines was complicated by a competing hydrolytic reaction which generated 2'-deoxyuridine or 2'-deoxythymidine. However, in the presence of an organic base such as triethylamine, oxidation became the predominant reaction. After suitable protection and formation of the 3'-phosphoramidite derivatives, these modified nucleosides were incorporated into seven self-complementary oligodeoxynucleotides by chemical synthesis using phosphite triester methodology. Oligodeoxynucleotides were prepared such that dA-dT and dG-dC base pairs were substituted by dA-d5 or dG-dK base pairs, respectively. Both circular dichroism spectra and thermal denaturation studies were used to characterize the modified oligodeoxynucleotides. PMID- 2704622 TI - The nucleotide sequence of Atlantic salmon growth hormone cDNA. PMID- 2704621 TI - The effects of transcription on the nucleosome structure of four Dictyostelium genes. AB - Micrococcal nuclease digestion of Dictyostelium discoideum nuclei from various developmental stages was used to investigate transcription-related changes in the chromatin structure of the coding region of four genes. Gene activity was determined by Northern blotting and nuclear run on experiments. During strong transcription of the developmentally regulated cysteine proteinase I gene, a smear superimposed on a nucleosomal ladder was observed, indicating perturbation of nucleosomal structure was occurring. However, two other developmentally regulated genes, discoidin I and pSC253, showed only slight nucleosome disruption during high levels of transcription. The chromatin structure of a fourth gene (pCZ22) was disrupted throughout development, even at those stages where transcription was greatly reduced. We suggest that although nucleosome structure can be transiently perturbed by the passage of the transcription complex in vivo, the degree of perturbation and the speed with which nucleosomes reassemble is also influenced by the DNA sequence. PMID- 2704623 TI - Sequence of a 21 kd zein gene from maize containing an in-frame stop codon. PMID- 2704624 TI - Nucleotide sequence of rat liver glutamate dehydrogenase cDNA. PMID- 2704626 TI - Nucleotide sequence of the 5'-flanking region of the murine ornithine decarboxylase gene. PMID- 2704625 TI - Nucleotide sequence of rat liver glutamate dehydrogenase cDNA. PMID- 2704627 TI - Isolation and nucleotide sequence of the cDNA encoding human ventricular myosin light chain 2. PMID- 2704628 TI - Nucleotide sequence of the plasmid stimulating portion of Xrep. PMID- 2704629 TI - The signal intensity on Southern blots developed by nonisotopic methods is linear with time and quantity of DNA. PMID- 2704630 TI - Setback for nursing. PMID- 2704632 TI - I'm all right, Ken. PMID- 2704631 TI - Tipping the balance. PMID- 2704633 TI - Making sense of resource management. PMID- 2704634 TI - Resource management. Freeman's choice. PMID- 2704616 TI - The 5' splice site: phylogenetic evolution and variable geometry of association with U1RNA. AB - The 5' splice site sequences of 3294 introns from various organisms (1-672) were analyzed in order to determine the rules governing evolution of this sequence, which may shed light on the mechanism of cleavage at the exon-intron junction. The data indicate that, currently, in all organisms, a common sequence 1GUAAG6U and its derivatives are used as well as an additional sequence and its derivatives, which differ in metazoa (G/1GUgAG6U), lower eucaryotes (1GUAxG6U) and higher plants (AG/1GU3A). They all partly resemble the prototype sequence AG/1GUAAG6U whose 8 contigous nucleotides are complementary to the nucleotides 4 11 of U1RNA, which are perfectly conserved in the course of phylogenetic evolution. Detailed examination of the data shows that U1RNA can recognize different parts of 5' splice sites. As a rule, either prototype nucleotides at position -2 and -1 or at positions 4, 5 or 6 or at positions 3-4 are dispensable provided that the stability of the U1RNA-5' splice site hybrid is conserved. On the basis of frequency of sequences, the optimal size of the hybridizable region is 5-7 nucleotides. Thus, the cleavage at the exon-intron junction seems to imply, first, that the 5' splice site is recognized by U1RNA according to a "variable geometry" program; second, that the precise cleavage site is determined by the conserved sequence of U1RNA since it occurs exactly opposite to the junction between nucleotides C9 and C10 of U1RNA. The variable geometry of the U1RNA-5' splice site association provides flexibility to the system and allows diversification in the course of phylogenetic evolution. PMID- 2704635 TI - Resource management. Fighting together. PMID- 2704636 TI - Forty years in the wilderness. PMID- 2704637 TI - Should midwives wear uniform? PMID- 2704639 TI - Fit for nursing at St Andrew's. PMID- 2704638 TI - A heartwarming scheme. PMID- 2704640 TI - Unwanted and unwell. PMID- 2704641 TI - NHS Review. Pawns in the game? PMID- 2704642 TI - Two roles--one job. PMID- 2704643 TI - AIDS: how much do you know? PMID- 2704644 TI - Life crises. Haunted by memories. PMID- 2704645 TI - A bereaved child. PMID- 2704646 TI - Death with dignity: funerals abroad. PMID- 2704647 TI - NHS or PLC? PMID- 2704648 TI - Anatomic correction for transposition of the great arteries: first follow-up (38 patients). AB - Between April 1983 and October 1985, 38 consecutive patients with transposition of the great arteries (TGA) underwent anatomic correction. Ages ranged from 1 day to 284 weeks (mean 26.2 weeks). Simple TGA was present in 17 patients, 17 had an associated ventricular septal defect, and the remaining four had a Taussig-Bing anomaly. Hospital mortality was 2 of 38, with 1 late death. Follow-up time varied from 6 to 35 months. Postoperative cardiac catheterization was performed in 34 of the 36 early survivors. Right ventricular outflow tract obstruction with a systolic gradient greater than 20 mmHg was found in four. A residual left-to right shunt was found in nine; Qp/Qs exceeded 2.0 in only one. In four, the pulmonary-to-systemic resistance ratio calculated was greater than 0.3. All 35 survivors are in excellent condition. Only one patient has slight aortic insufficiency. Most pre- and postoperative electrocardiographic abnormalities disappeared in due course. Echocardiography revealed normal left ventricular dimensions and fractional shortening. The aortic root diameter showed in almost all a value above the 95th percentile of normal. Postoperatively, the aortic root has grown parallel to, but above, the 95th percentile and as yet has shown no tendency to normalization. PMID- 2704650 TI - Radionuclide evaluation of right ventricular wall motion after surgery in tetralogy of Fallot. AB - Regional wall motion patterns in tetralogy of Fallot and its postoperative modifications by electrical and hemodynamic factors were assessed by Fourier analysis of gated radionuclide angiograms in 24 studies performed in children after surgical correction of tetralogy of Fallot. The range of right ventricular (RV) phase angles (standard deviation of the peak [SDP] of RV) as well as the difference between RV and LV (delta MPh) were used as indices of the synchronicity of wall motion and were correlated with RV apical electrical activation time determined by endocardial electrical mapping. Postoperative studies were divided into two groups according to apical activation: (a) those involving right bundle branch block (RBBB) (nine patients), and (b) those involving distal RBBB (15 patients). delta MPh was longer in proximal than in distal RBBB. Best discrimination between the two groups was obtained with SDP of RV (proximal = 24 degrees +/- 3 degrees, and distal = 17 degrees +/- 2 degrees; p less than 0.0001). These results showed that the range of ventricular phases measured by the SD of the phase distribution of the right ventricle is a good index for distinguishing between proximal and distal RBBB after cardiac surgery. PMID- 2704649 TI - Comparison of types of pulmonary stenosis with the state of the ventricular septum in complete transposition of the great arteries. AB - The pulmonary valve and left ventricular outflow tract of 214 hearts with d transposition of the great arteries (d-TGA) were visually inspected (126 of 214 with intact ventricular septum and 88 of 214 with ventricular septal defect [VSD]). Pulmonary stenosis (PS), either valvular, subvalvular, or in combination, was present in 26 cases and was found to be more common in the presence of a VSD (20.5%) than intact ventricular septum (6.3%). PS occurred more commonly in the presence of a supracristal VSD than an infracristal VSD (70%, 7 of 10 vs 15%, 10 of 66). Further, infracristal or supracristal VSDs were associated with different types of pulmonary obstruction. In seven of ten cases with infracristal VSD and PS, the stenosis was caused by an anomaly of an atrioventricular valve. In six of seven cases with supracristal VSD and PS, the latter was caused by membranous encirclement of the left ventricular outflow tract. PMID- 2704651 TI - Open heart surgery in the first 24 hours of life. AB - The results of open heart surgery in infants have steadily improved. The performance of corrective surgery very early in life has thereby been encouraged. We report four patients who underwent successful surgical correction within 24 h of birth. Two patients with total anomalous pulmonary venous drainage and one patient with pulmonary atresia and intact septum were corrected with the aid of profound hypothermia by the combined surface and bypass cooling technique. Cardiopulmonary bypass alone was used for the fourth patient with aortic stenosis. The usual surgical techniques can be applied successfully to infants even within 24 h of life. PMID- 2704652 TI - Hereditary atrioventricular conduction defect in a child. AB - Hereditary atrioventricular conduction defect is an uncommon cause of acquired complete heart block in children. We report a father and son, both of whom presented with seizures as the initial manifestation of acquired complete heart block and required permanent pacemaker implantation. A review of the variations of this entity and the histopathological findings of previously reported cases is presented. Family members of patients with acquired heart block of uncertain etiology should be examined for the presence of conduction abnormalities that may progress to complete heart block. PMID- 2704653 TI - Acute angular origin of left coronary artery from aorta: an unusual cause of left ventricular failure in infancy. AB - An unusual congenital anomaly of the left coronary artery, consisting of ostial stenosis caused by an acute angular origin of the vessel from the aorta in an infant, is presented. This anomaly resulted in progressive myocardial fibrosis and development of left ventricular congestive heart failure. The clinical state mimicked anomalous origin of the left coronary artery from the pulmonary artery. PMID- 2704654 TI - Noninvasive diagnosis of congenital left coronary artery to right ventricle fistula by nuclear magnetic resonance imaging. AB - In two children with left coronary artery to right ventricle fistula, nuclear magnetic resonance imaging provided high-quality images of the course of the dilated coronary artery and its termination in the right ventricular apex. The advantages of this noninvasive multiplanar imaging technique for visualization of coronary fistulae and dilated coronary arteries are described. This report represents the first description of coronary artery fistula by nuclear magnetic resonance imaging. PMID- 2704655 TI - Aortic root dilatation associated with partial trisomy 7(q31.2----qter). AB - Aortic root dilatation and mitral valve prolapse are cardiac findings sometimes seen in disorders of connective tissue, most often in the Marfan syndrome. This report describes an infant with these cardiac anomalies and a specific chromosomal abnormality, partial trisomy of chromosome 7 associated with partial monosomy of chromosome 22. This association may have significance with respect to the etiology of cardiac disease in connective tissue disorders such as Marfan syndrome. PMID- 2704656 TI - Cerebral perfusion during major cardiac surgery in children. PMID- 2704657 TI - Hemodynamic effects of sodium nitroprusside in infants and children with large ventricular septal defect. PMID- 2704658 TI - Dilated cardiomyopathy complicating a case of epidermolysis bullosa dystrophica. AB - A child with epidermolysis bullosa dystrophica, recessive type (EBDR) developed significant anemia at 9 years of age and was treated with long-term transfusion therapy. At age 17 he had symptoms of congestive heart failure secondary to dilated cardiomyopathy. Treatment with digoxin and vasodilators for the past year has failed to improve his cardiomyopathy significantly. Chronic iron overload and secondary hemosiderosis may have contributed to his problems, and we propose that chelation therapy be used in any child receiving long-term transfusion therapy. PMID- 2704659 TI - Ichthyosis, deafness, and Hirschsprung's disease. AB - An infant with congenital ichthyosis and deafness developed Hirschsprung's disease. No evidence of keratitis was present. No previous cases of ichthyosis have been associated with aganglionic megacolon. Although no corneal changes were observed, we believe that the clinical features of ichthyosis and deafness suggest the diagnosis of KID (keratitis, ichthyosis, deafness) syndrome. Whether corneal changes would have occurred is unknown, since the infant died of malnutrition and infectious complications. PMID- 2704660 TI - Congenital self-healing reticulohistiocytosis: report of a patient with a strikingly large tumor mass. AB - A newborn male Thai infant had numerous brownish red nodules of various sizes scattered over both palms and soles, left thigh, abdomen, chin, and left upper eyelid. An extremely large tumor mass was present on the right sole. Many lesions showed spontaneous ulceration. No extracutaneous involvement was found. All lesions involuted spontaneously within two to three months, some with scar formation. Histology showed large numbers of mononucleated and multinucleated histiocytic cell infiltrations, 10% of which contained Birbeck's granules. Areas of necrosis and calcification were also seen in the largest tumor. No recurrence was observed after follow-up for three years. PMID- 2704661 TI - Survey of cutaneous lesions in Indian newborns. AB - A total of 900 consecutive newborns delivered at the Nehru Hospital, Chandigarh, India, over a period of 7 months were examined for presence of skin lesions within 48 hours of birth. Commonly observed skin lesions were Epstein pearls (88.7%), mongolian spots (62.2%), milia (34.9%), sebaceous hyperplasia (31.8%), salmon patches (28.4%), and erythema toxicum neonatorum (20.6%). These figures are comparable with earlier reports. Impetigo neonatorum occurred in 11.3% of infants, and was frequent in our hot and humid climate from May to August. Traumatic skin lesions were most often present in babies who had forceps deliveries. Three hundred ten (34%) babies were available for follow-up up to six weeks. Additional skin lesions observed were omphalitis (16 babies), oral thrush (9) and postinflammatory hypomelanosis (8). Three infants had atopic dermatitis, two each had seborrheic dermatitis, diaper dermatitis, pityriasis versicolor, and nevus achromicus. One each had vitiligo, ichthyosis vulgaris, urticaria, and strawberry hemangioma. These observations highlight the importance of repeat examination for the appearance of skin lesions during the neonatal period. PMID- 2704662 TI - Syphilis. PMID- 2704663 TI - Inability to produce white dermographism in the early stage of infantile eczema. AB - White dermographism constitutes an abnormal vascular reaction characteristically demonstrable in atopic dermatitis; however, there is no information about it in the infantile phase of atopic dermatitis. Therefore we examined 73 infants younger than 3 years of age with eczematous dermatitis for the demonstrability of white dermographism after mechanical stroking of the lesional skin. None of the 40 healthy control infants showed white dermographism on their normal skin. In contrast, an age-dependent increase was demonstrated in patients with infantile eczema, from 11% in those 1 to 2 months of age to 85% in those older than 7 months. There was no correlation between the demonstrability of white dermographism in early infancy and the prognosis of infantile eczema. Based on our study of various types of dermatitis experimentally induced in adult volunteers, we think that, in addition to the immaturity of infantile skin, the presence of acute dermatitic changes may be related to inability to demonstrate white dermographism in the early phase of infantile eczema. PMID- 2704664 TI - Fetal hydantoin syndrome? PMID- 2704665 TI - School failure. AB - Numerous factors may contribute to a child's failure to learn. Certain causes of school failure, such as specific learning disabilities, mental retardation, sensory impairment, and chronic illness may be regarded as intrinsic characteristics of the child. Other causes, such as family dysfunction, social problems, and ineffective schooling, are characteristics of the child's environment. Still other influences on school performance, such as temperamental dysfunction, attention deficits, and emotional illness, may be viewed as the consequence of the interaction between the child and his or her environment. The reasons for a child's school failure must not be considered in isolation but rather within the context of social and environmental circumstances. Evaluation must consider the myriad of reasons for a child's school failure and attempt to identify "clusters" of adverse influences on school performance. Detailed information must be sought from the student, parents, and school system through the history and physical examination. Questionnaires are useful in data gathering. Ancillary methods of assessment that may be of value include neurodevelopmental screening and laboratory studies. Further investigations and referrals, particularly psychoeducational evaluation, are of major importance. Traditional roles of the pediatrician in school failure include the treatment of underlying medical conditions, counseling, the coordination of further investigations and referrals, and the facilitation of communication with community services and resources. Participation with other disciplines in the development of a child's educational plan is feasible and useful. PMID- 2704666 TI - Relative bioavailability of manganese in a manganese-methionine complex for broiler chicks. AB - The relative bioavailability of Mn from reagent grade Mn monoxide and feed grade Mn-methionine was compared with that from reagent grade Mn sulfate using 288 one day-old male Cobb chicks. The basal corn-soybean meal diet (93 ppm Mn dry matter basis) was supplemented with 0, 700, 1,400, and 2,100 ppm Mn as Mn sulfate monohydrate, Mn oxide, or Mn-methionine. Additional diets contained 700, 1,400, and 2,100 ppm Mn as sulfate or oxide in combination with .16, .32, or .48% added DL-methionine, respectively, to equalize methionine concentrations in Mn methionine-containing diets. Diets were fed ad libitum for 3 wk. Tibia and kidney Mn concentrations increased linearly (P less than .001) as dietary Mn increased. Addition of methionine to diets containing sulfate and oxide did not influence (P greater than .10) tissue Mn concentrations. Based on slope ratios from multiple linear regression of bone and kidney Mn concentrations on added dietary Mn from various sources, the respective relative bioavailability values were 96 and 86% from Mn oxide and 108 and 132% from Mn-methionine compared with 100% from Mn sulfate. Except for the first, all values were significantly different from 100%. Thus, Mn from Mn oxide is significantly less available and Mn from Mn-methionine is significantly more available than that from Mn sulfate monohydrate. PMID- 2704667 TI - Influence on performance of three to six-week-old broilers of varying dietary protein contents with supplementation of essential amino acid requirements. AB - Effects were evaluated of feeding diets differing in CP content but formulated to be adequate in essential amino acids (EAA) on performance and certain plasma metabolites of female broilers from 21 to 42 days of age. In Experiment 1, isocaloric diets containing either 22.6, 18.2, 15.7, 14.2, or 12.3% CP were used. Experiment 2 was similar to Experiment 1 but included three additional diets, which consisted of the three lowest CP diets supplemented with L-glutamic acid (GLU) to increase formulated CP levels to 18%. Protein efficiency ratio and abdominal fat deposition (AFD) decreased linearly as CP increased in both experiments. Increasing CP increased plasma thyroxine in Experiment 1 but not in Experiment 2. Plasma triiodothyronine and triglycerides were not significantly influenced by treatment. A positive curvilinear relationship existed between CP level and body weight gain in both experiments. The calculated CP requirement for growth 95% of maximum ranged from 16.0 +/- 1.8 (Experiment 1) to 17.5 +/- 1.8% (Experiment 2). Feed efficiency (FE) increased in a curvilinear manner as CP increased in Experiment 1, and the calculated CP requirement for FE 95% of maximum was 18.9 +/- 2.5%. In Experiment 2, however, improvements in FE were obtained with each increase in CP. The calculated requirement levels of CP for optimal growth were low compared to conventionally fed levels. However, obtaining optimal growth consistently with the former levels appeared unlikely because of the magnitude of associated standard errors. The CP level required for optimal FE was clearly higher than that for optimal growth. PMID- 2704668 TI - Precision of bioassays for apparent and true metabolizable energy adjusted to zero nitrogen balance. AB - Formulae are presented for calculating the variance of estimates of AMEn and TMEn obtained from several commonly used bioassay protocols. Formulae are also developed for calculating the variance of the difference between bioavailable energy (BE) estimates of two materials tested in the same bioassay. Methods are described for determining the allocation of experimental units among dietary treatments that minimizes the variance of AMEn or TMEn estimates in bioassays based upon a completely randomized allocation of the dietary treatments to the experimental units. In many situations, the precision of the assay can be considerably improved by assigning more experimental units to the control diet than to the test diets. For completely randomized designs, the precision of AMEn estimates from the basal diet substitution assay is always greater than that from the reference material substitution assay. For randomized block designs, the relationship depends upon the level of substitution and the ratio of the among to within-block variance components. However, the precision of the difference between the estimates of AMEn for two materials is the same in the basal diet and reference material substitution assays for both completely randomized and randomized block designs. PMID- 2704669 TI - Immunoglobulin concentrations in serum and tissues of vitamin A-deficient broiler chicks after Newcastle disease virus vaccination. AB - The effect of all-trans retinol and retinoic acid (RA) on the local and systemic immune system of broiler chicks was examined. Chicks fed diets supplemented with .2 micrograms retinol/g of diet had significantly greater serum immunoglobulin IgG, IgM, and IgA concentrations 5 wk after primary vaccination with live B1 strain of Newcastle disease virus (NDV) than did chicks fed 2 micrograms retinol/g of diet. Eight days after a second vaccination with an inactivated La Sota strain of NDV, serum, intestinal, and tracheal IgG and IgM concentrations were higher in chicks fed a diet without retinol or retinoic acid (RA) than in chicks fed either 2 micrograms of retinol or RA/g of diet, respectively. Despite an increase in serum immunoglobulin concentration, serum antibody titer in response to the second NDV vaccination was significantly lower in chicks fed a vitamin A-deficient diet than in chicks fed adequate retinol and RA-supplemented diets. Eight days after revaccination, IgA concentrations in bile were also significantly lower in vitamin A-deficient chicks than in controls. Serum IgG, IgM, IgA, biliary IgA, and antibody responses were greater in chicks fed diets supplemented with 2 micrograms of RA/g of diet than in chicks fed an equivalent amount of vitamin A in the form of retinol. PMID- 2704670 TI - Lack of effect of dietary factors on nicarbazin toxicity in broiler chicks. AB - Effects of dietary fat, protein, and methionine levels and the type of dietary grain in nicarbazin-containing diets on the growth response of broiler chicks were evaluated in five experiments in a factorial design. Nicarbazin at levels ranging from 100 to 200 mg/kg significantly (P less than .05) depressed weight gain and feed efficiency. Feed intake was significantly reduced only when nicarbazin was used at levels of 150 and 200 mg/kg. The latter concentration also significantly decreased water intake and water:feed ratio. Nicarbazin, at a level of 150 mg/kg, did not affect dietary metabolizable energy content or the retention of nitrogen and dry matter. A higher level of soybean oil (3.5 vs. .5 or 1.0%) did not counteract the growth-depressing effects of 100, 150, and 200 mg nicarbazin/kg. The growth-depressing effect of the highest dose also was not affected by increasing the protein level from 18.2 to 20.4%. Neither type of dietary grains (corn vs. sorghum) nor supplemental methionine level affected the toxicity of 125 mg nicarbazin/kg. Water intake and water:feed ratio were significantly increased due to elevation of dietary protein and fat levels. It was concluded that the severity of the growth-depressing effect of nicarbazin on chicks was not dependent on the levels of dietary unsaturated fat, protein, and methionine. PMID- 2704671 TI - Omega-3 fatty acid levels and general performance of commercial broilers fed practical levels of redfish meal. AB - A total of 1,200 day-old Arbor Acre broiler chickens was randomly assigned to 12 pens (50 males and 50 females/pen) and divided into three blocks of four pens each. Each of four different diets was fed ad libitum to one pen of birds within each block to determine the effect of feeding practical levels of redfish meal (RFM) on performance and omega-3 fatty acid content of edible meat and skin lipids of broiler chickens. The four diets included (control) 0%, 4.0%, 8.0%, and 12.0% RFM. Feeding diets containing RFM had no effect on overall mortality or feed efficiency but resulted in decreased incidence of sudden death syndrome and lower body weight (P less than .01) and feed consumption (P less than .05). Additions of RFM to the diets resulted in a substantial dietary enrichment of omega-3 fatty acids (especially eicosapentaenoic acid, EPA or 20:5n-3, and docosahexaenoic acid, DHA or 22:6n-3). Analyses (wt/wt%) revealed that breast meat (less skin) was lower (P less than .001) in lipid and triglyceride but higher in free cholesterol (P less than .001) and phospholipid (P less than .001) than thigh meat (less skin). Dietary treatment had no effect on carcass lipid content or composition. Breast meat lipid contained more (P less than .001) omega 3 fatty acids (especially EPA and DHA), more docosapentaenoic acid, (DPA or 22:5n 3) and more total omega-3 polyunsaturated acids (n-3 PUFA) than thigh meat lipids. Feeding additional RFM resulted in an increased (P less than .001) accumulation of EPA, DPA, DHA, and total n-3 PUFA primarily at the expense of two omega-6 fatty acids, linoleic (18:2n-6) and arachidonic acid (20:4n-6). It can be calculated from the data presented that the consumption of 100 g of chicken that has been fed 12.0% RFM would contribute approximately 197 mg of omega-3 fatty acids (EPA + DPA + DHA) in contrast with the 138 mg of omega-3 fatty acids which would be realized from the consumption of 100 g of white fish such as cod. PMID- 2704672 TI - Sulfur amino acid requirement of broiler chickens from 3 to 6 weeks of age. AB - Two experiments were conducted to determine if the TSAA level suggested by the National Research Council (NRC) in 1984 was adequate for optimum performance of 3 to 6-wk-old broilers, and to assess the effect of added copper on the TSAA requirement. A 2 x 3 x 2 factorial arrangement involving two copper (0 and 240 ppm) and three TSAA levels (.72, .78 and .84%) and two sexes was used in each experiment. Copper sulfate (CuSO4.5H2O) and DL-methionine were the dietary supplements to pelleted diets. There were four groups of 20 males or 20 females in each experiment, housed in floor pens. Methionine supplementation significantly improved body weight gain and feed efficiency in males but not in females. A significant copper x methionine interaction was observed, with methionine supplementation improving feed efficiency more in the presence of copper than in its absence. Abdominal fat per unit of body weight was significantly reduced by both methionine and copper in females but not in males. In a second experiment, methionine significantly improved body weight gain in males fed no added copper and significantly reduced abdominal fat per unit of body weight. Methionine supplementation improved body weight gain in males more in the absence than in the presence of copper (significant TSAA x copper interaction). Methionine supplementation had no significant effects on performance of females in the second experiment, but copper supplementation significantly improved feed efficiency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704673 TI - Effect of thyroidectomy of immature male chickens on circulating thyroid hormones and on response to thyroid-stimulating hormone and chronic cold exposure. AB - Previous studies in the author's laboratory established that thyroidectomized (Tx) immature male chickens had significant levels of circulating thyroid hormones, and it was proposed that extrathyroidal tissue might be present. Three experiments were conducted to further investigate this possibility. In all experiments, thyroid glands were removed surgically at 3 wk of age. In the first experiment, birds were kept until 20 wk of age. It was found that only triidothyronine levels were reduced significantly in the Tx birds. In the second experiment, Tx as well as sham-operated control groups received a single iv injection of bovine thyroid-stimulating hormone (TSH) to determine if extrathyroidal tissue in Tx birds would respond to exogenous TSH. It was found that circulating thyroxine (T4) concentrations in sham-operated control birds, but not Tx birds, were increased following TSH injection. In the third experiment, Tx and sham-operated birds were exposed chronically to cold (7 C), and only circulating T4 was found to be elevated in both groups. It was concluded that extrathyroidal tissue in Tx birds does not respond to TSH. PMID- 2704674 TI - Daily changes in plasma prolactin, corticosterone, and luteinizing hormone in the unrestrained, ovariectomized turkey hen. AB - Plasma concentrations of prolactin (PRL), corticosterone (B), and luteinizing hormone (LH) were determined in hourly samples collected over a 24-h period from unrestrained, long-term ovariectomized (OVX) turkey hens maintained in cages in an isolation room on a 14 h light: 10 h dark photoperiod. Mean plasma concentrations of all three hormones were found to vary significantly with the time of sampling. Mean plasma PRL levels reached a peak (6.50 +/- 1.70 ng/mL, means +/- SEM) during the latter half of the photophase, declined to a nadir (5.22 +/- 1.20 ng/mL) prior to the onset of darkness, and then rose gradually during the scotophase to reach another peak (8.96 +/- 1.80 ng/mL) 1 h prior to lights on. Mean plasma LH levels rose significantly (P less than .001) from a nadir of 4.11 + .29 ng/mL prior to lights out to a peak of 4.74 + .34 ng/mL during the dark period. No evidence of random fluctuations in LH levels was observed in any individual, suggesting that episodic LH release may not occur in OVX turkey hens. Individual patterns of B secretion varied substantially so that, although significant increases and decreases in mean plasma B levels were observed, no clearly defined peaks in mean plasma B levels were identified. Individual secretory profiles revealed that peaks in PRL secretion often coincided with peaks in B secretion, but B peaks were usually more numerous. It is concluded that PRL and LH are secreted in a daily rhythm in the OVX turkey hen, with the highest levels of both hormones occurring during the scotophase. PMID- 2704675 TI - Age influence on digestive transit time of particulate and soluble markers in broiler chickens. AB - The gastrointestinal transit-time of two markers, Cr-mordanted bran, a solid marker, and Cr-EDTA, a soluble marker, have been studied in chickens (Gallus gallus) at 1, 2, and 3 wk of age. Mean retention time of the particular marker decreased as chicks grew. The excretion of Cr-EDTA took longer as birds grew; this soluble marker was retained in the ceca of the fowl. It was postulated that the ceca are not fully functional until total resorption of the yolk sac content occurs. PMID- 2704676 TI - Influence of monensin and salinomycin on the performance of broiler chicks. AB - Because monensin and salinomycin are widely used to control coccidiosis, two experiments were conducted to compare the performance of broiler chicks when these compounds were added to the diet. Five levels of each coccidiostat were fed. Increasing the levels of coccidiostat resulted in a decrease in body weight and feed intake. Monensin gave a greater depression at the level suggested by the manufacturer for prevention of coccidiosis (121 ppm) than did salinomycin (66 ppm). The interaction of experiment x treatment was significant and was a result of the greater performance depression at the lower levels (manufacturers' recommended levels) of coccidiostat administered in the first experiment than in the second. This research points out the necessity of the accurate use of the coccidiostats. PMID- 2704677 TI - Cross resistance to the ionophorous polyether anticoccidial drugs in Eimeria tenella isolates from Czechoslovakia. AB - Two field isolates of Eimeria tenella were isolated on farms where continuous outbreaks of coccidiosis in broilers had occurred over several years. The isolates were repeatedly tested for their sensitivity to ionophorous polyether drugs in floor pen trials lasting 7 wk. Hybro cockerels were inoculated with 25 x 10(3) oocysts/chicken at the age of 23 to 24 days. Total mortality, mortality caused by coccidia, live weights, feed conversion ratios, number of oocysts in litter, and titers of circulating antibodies against E. tenella were followed. Tested isolates were not controlled by the monovalent polyether drugs monensin, narasin, and salinomycin, but maduramicin, which is a monovalent monoglycoside polyether, and the bivalent polyether lasalocid controlled them effectively. This study indicates that coccidia that lose their sensitivity to a monovalent polyether drug lose the sensitivity to other monovalent polyethers, also, but might yet be effectively controlled by drugs from other classes of polyether antibiotics. This supports the hypothesis that there are differences in the mechanisms of anticoccidial activity of different classes of polyether antibiotics. PMID- 2704678 TI - Monocyte function in chickens with hereditary muscular dystrophy. AB - Monocyte functions of Storrs strain muscular dystrophic (MD) chickens and Storrs control strain were compared. After short-term in vitro culture of monocytes, cells taken from Storrs MD chickens had a significantly lower incidence of cells capable of phagocytizing sheep red blood cells than did cells cultured from the control strain. In contrast, no difference was found in the ability of MD vs. control strain blood mononuclear cells to undergo in vitro chemotaxis in response to a bacterial culture supernatant. The study also revealed a distinct peripheral blood leukocyte profile of young MD chickens: elevated percentages and absolute numbers of granulocytes. The total leukocyte count in MD chickens was not significantly different from that of normal chickens. These findings extend previous observations concerning altered reticuloendothelial system function in MD strain chickens. PMID- 2704679 TI - Influence of sodium pentobarbital on pH, sarcomere length, and muscle tenderness of broiler Pectoralis major muscle. AB - Six trials were conducted to determine the effect of sodium pentobarbital (SP) anesthesia on broiler muscle pH, sarcomere length, and Allo-Kramer shear values. Birds were divided into six groups, three of which were anesthetized with SP prior to slaughter. Birds from both the anesthetized and nonanesthetized groups were subjected to one of three processing treatments: 1) muscles hot boned as soon as possible after death and immediately analyzed (HB/0); 2) muscles hot boned and aged 24 h in ice/water slush (HB/24); and 3) muscles left on carcass (conventional process) and aged 24 h in ice/water slush (CP/24) before deboning. The SP/HB/0 group was found to have significantly higher (P less than .05) pH values and longer sarcomere lengths than those of the other five treatment groups. No significant differences were observed for pH among the four 24-h aged groups. Sarcomere lengths were found to be shortest in the SP/HB/24 and HB/24 groups followed by SP/CP/24, HB/0, and CP/24 groups. The CP/24 and SP/CP/24 groups had the lowest shear values, with the HB/0, HB/24, and SP/HB/24 groups exhibiting three-fold higher shear values. These results indicate that SP can delay the effects of ante-mortem stress on early rigor processes; however, no such effects were apparent following 24-h aging. PMID- 2704680 TI - Effects of electrical stimulation on the post-mortem biochemical changes and texture of broiler pectoralis muscle. AB - A study was conducted to determine the influence of electrical stimulation (50,200, or 350 V ac) on biochemical and textural changes in broiler breast muscle. Sixty-four broilers were stunned (50 V ac) prior to kill, and all but a control group were pulse stimulated during bleeding. After processing, carcasses were held in 10-C water for 1 h, then in 2-C ice/water slush for 1 h prior to muscle removal at 2 h post-mortem (PM). Bagged samples were held at 2 C for 24 h, then cooked. The pH, R value (ratio of adenine nucleotides to inosine nucleotides), cook yield, fluids and solids lost (F&S), and objective texture were measured. In addition, 16 broilers processed in the same manner were used in producing a profile of sarcoplasmic protein/enzyme changes in the breast muscle by cation exchange fast protein-liquid chromatography at 10 min, 2, and 24 h PM. The R values and soluble protein were also determined. Stimulation at 200 and 350 V accelerated the onset of rigor noted by lower pH values at 10 min and 1 h PM, and higher R values at 2 h PM. Muscle stimulated at 350 V exhibited the lowest cook yield and highest percentage of F&S lost, suggesting both the loss of functional properties and muscle integrity due to this treatment. All control and stimulated samples exhibited shear values in excess of what would be considered tender. Hardness and chewiness values increased as stimulation voltage levels increased. Only one of the seven principal chromatographic peaks decreased in response to increased electrical stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704681 TI - Indirect calorimetry evaluation of dietary protein and animal fat effects on energy utilization of laying hens. AB - A multichamber indirect calorimeter was constructed and used to measure energy utilization of laying hens. Four basic diets were formulated by a least cost linear program for use in this study. The first diet was formulated to meet the 1984 National Research Council (NRC) recommendations and contained by analysis 14.5% protein, .58% TSAA, and .68% lysine (designated NRC). The second diet (NRCAA) was formulated to the same amino acid specifications without a protein restriction and contained 12.9% protein, .57% TSAA, and .69% lysine. Another pair of diets was formulated with higher protein (HP) and amino acid restrictions. The HP diet contained 16% protein, .67% TSAA, and .85% lysine; whereas the HPAA diet had 14% protein, .68% TSAA, and .86% lysine. Four additional diets were formulated with the inclusion of 3% animal fat, using the same protein and amino acid restrictions as were used to formulate the first four diets. Animal fat supplementation significantly (P less than .05) improved energy balance (retention) of birds fed all formulations compared with the diets without added fat. Formulation of a diet based on amino acid restrictions significantly increased net energetic efficiency of birds fed amino acid levels higher than those recommended by the NRC (79.2 for HPAA vs. 62.1% for HP), but did not significantly affect net efficiency of birds fed the lower amino acid levels (NRC and NRCAA). PMID- 2704682 TI - Effects of dietary protein and added fat on turkeys varying in strain, sex, and age. 1. Live characteristics. AB - An experiment was conducted to determine the effects of dietary protein and added fat on body weight, feed consumption, and feed efficiency of male and female Nicholas Large White (N), Jaindl Large White (JL), and Jaindl Medium White (JM) turkeys at various ages. At 8 wk of age, 162 males and 288 females from each strain were divided equally into six pens of males and six pens of females per strain. Each of 6 pelleted diets containing standard or high protein and 0, 5, or 10% added fat was fed to one pen of each sex and strain of turkeys. At 20 wk of age, N, JL, and JM males weighed 14.77, 11.56, and 9.00 kg, respectively, and females weighed 8.97, 7.49, and 5.75 kg, respectively. At 28 wk of age, N, JL, and JM males weighed 18.32, 15.10, and 11.65 kg, respectively, and females weighed 10.35, 9.12, and 7.04 kg, respectively. The feeding of diets containing 10% rather than 0% added fat from 8 to 20 wk of age decreased feed consumption 11.1 and 13.1% and increased feed efficiency 16.3 and 16.4% in males and females, respectively. Feeding high protein diets significantly increased body weight gains. The apparent smaller increase than previously experienced in feed efficiency from dietary added fat may be associated with the use of pelleted feed in this experiment. PMID- 2704683 TI - Effects of dietary protein and added fat on turkeys varying in strain, sex, and age. 2. Carcass characteristics. AB - The effects of dietary protein and added fat on carcass characteristics were determined at various ages for female and male turkeys and from three strains: Nicholas Large White (N), Jaindl Large White (JL), and Jaindl Medium White (JM). A total of 1,350 turkeys was divided into 36 pens and fed diets containing 0, 5, or 10% added fat and standard or high protein levels from 8 wk of age to time of processing. One-fourth of the females and one-third of the males from each pen were processed at 16, 20, 24, or 28 wk and at 20, 24, or 28 wk, respectively. Breast meat weight, expressed as a percentage of carcass weight, was greater for JM and JL turkeys than for N turkeys (34.6, 33.9, and 31.7%, respectively), increased with age (31.9, 34.1, and 34.2% at 20, 24, and 28 wk of age, respectively), was greater for females than for males (34.2 and 32.6%, respectively), decreased with added fat (33.7, 33.4, and 33.1% for 0, 5, and 10% fat, respectively) and increased with a 3% addition of dietary protein (33.2 and 33.6%, respectively). PMID- 2704684 TI - Effect of Salmonella gallinarum infection on zinc metabolism in chicks. AB - The effect of Salmonella gallinarum infection in chicks on serum, liver, and kidney zinc concentrations was studied. Within 48 h after intraperitoneal administration of the organism, serum zinc declined to approximately one-half the control value. In one experiment, the serum zinc concentration remained low for the 12 days of the experiment, whereas in a second experiment, the concentration gradually increased after 6 days postinoculation but never returned to the control value. Feeding as much as 500 ppm supplemental zinc did not prevent the infection-induced decline in the serum zinc concentration. The infection resulted in a sequestering of zinc in the liver; the kidney remained relatively unresponsive in this system. Fractionation of liver homogenates by gel filtration column chromatography revealed that the zinc in the livers of the infected animals eluted in a volume characteristic of metallothionein, whereas that of control animals was associated with high molecular weight proteins. Increasing the zinc content of the serum by repeated subcutaneous injections of zinc had no effect on mortality from this infection. Restricting feed consumption of uninfected chicks to that of infected animals did mimic the influence of infection of serum zinc and hepatic metallothionein concentrations. PMID- 2704685 TI - Utilization of dietary diammonium citrate by germ-free chicks. AB - This study was conducted to clarify the effect of the gut microflora on the utilization of dietary diammonium citrate in the chick. Germ-free and conventional Single Comb White Leghorn chicks were given a basal diet, which contained adequate amounts of all essential amino acids but none of the nonessential amino acids as nitrogen sources, or a diammonium citrate supplemented diet. Irrespective of presence or absence of the gut microflora, values for body weight gain, feed efficiency, and protein and energy utilization were improved by supplementing the basal diet with diammonium citrate. This suggests that the gut microflora are not required for the chick to utilize diammonium citrate. PMID- 2704686 TI - Genetic effects on embryonic growth in domestic turkeys. AB - Embryo growth rates for two strain crosses of domestic turkeys were compared. Female parents of both crosses came from the same flock of Nicholas parent stock hens. The strain providing sires for Cross L was approximately twice the adult size of the strain providing sires for Cross S. Egg weight was correlated with late embryo weight (starting by 20 days of incubation), poult weight at hatch, and carcass weight (i.e., yolk sac removed) at hatch. When analyses of covariance were done to remove the effects of egg weight, no significant cross differences were found between embryo weights at 8, 12, 16, 20, and 24 days of incubation, poult weight at hatch, and carcass weight. No significant sex differences were found between poult weights or carcass weights at hatch. PMID- 2704687 TI - Effect of dietary phosphorus levels on performance of turkey breeder hens. AB - One hundred 30-wk-old medium weight white Orlopp turkey breeder hens were equally divided into four treatment groups according to the level of available P in the diet (.15, .30, .50, and .70%, respectively). The P provided in the basal diet (.15% available, .35% total) was from cereal grains and soybean meal. No supplemental phosphate was added. During the 20-wk experiment, there were no differences in number of days required to come into lay and in subsequent egg production. Specific gravity, egg weight, number of shell pores, and body weight were similar under all treatments. The P levels of birds fed the four diets were 4.82, 4.93, 4.93, and 4.94 mg/100 mL, respectively, in serum and in femur were 15.8, 16.1, 16.8, and 16.4%, respectively. The P levels were slightly lower in birds fed the diet without added P. Excreta P levels (1.93, 2.49, 2.81, and 3.10%, respectively, in birds fed the four diets) were significantly (P less than .05) higher with each successive increase in dietary P. Hens fed diets containing .50 or .70% available P retained (46.9 and 54.8%, respectively) significantly more P than those fed diets containing .15 or .30% available P (28.1 and 33.8%, respectively). Fertility (76, 93, 90, and 89%, respectively) was significantly lower (P less than .05) from feeding the diet without added P. Hatchability rates of fertile eggs were similar for all treatments. PMID- 2704688 TI - Production performance of laying hens fed L-tryptophan. AB - The purpose of this study was to determine whether supplementing L-tryptophan to a nutritionally complete diet would influence egg production rate and egg shell quality in laying hens. One hundred and twenty layers (Rhode Island Red x White Leghorn) were randomly allocated into three groups. Birds were fed a basal diet or diets supplemented with L-tryptophan at 250 or 500 mg/kg for 405 days from 25 wk of age. Hen day egg production and daily egg output were proportionately higher with higher levels of supplemental dietary L-tryptophan; the differences were significant (P less than .05) for layers fed the 500 mg tryptophan/kg diet. The improvement in egg production by dietary L-tryptophan was greatest during the latter part of the laying period. These findings suggest that supplemental L tryptophan improves the egg production rate in laying hens. PMID- 2704689 TI - Estimation of apparent protein digestibility using uric acid-corrected nitrogen values in poultry excreta. AB - Apparent protein digestibility values were calculated using three methods based on nitrogen digestibility, corrected and uncorrected for uric acid and amino acid digestibility. Amino acid digestibility, as determined by the summation of individual amino acid values, excluding methionine and cystine (81.2%), closely approximated protein digestibility values derived from nitrogen corrected for uric acid (81.4%). Uncorrected nitrogen values gave misleading results (38.4%). Apparent protein digestibility values, when corrected for uric acid, appear to provide a simple and reliable method for estimating protein digestibility. PMID- 2704690 TI - Genetic assessment of the behavior of White Leghorn type pullets in an open field. AB - Open field tests were carried out using 17-wk-old pullets derived from two commercial White Leghorn type stocks of males bred to White Leghorn type females from a stock kept at the University of Guelph. Behavioural differences both between and within stocks were investigated, and the heritabilities of the behavioral variables were calculated. The offspring of male parental Stock 1 took longer to manifest pecking behavior than those of male parental Stock 2, and also made less use of the areas of the open field farthest from the starting point. Male parental Stock 1 showed significant variability due to sires for sitting and standing behavior, whereas for male parental Stock 2, variability existed for neck extension and the number of behavioral states manifested. Significant variability due to dams was apparent for several behavioral variables. Heritability estimates ranged from zero to quite high, with those corresponding to the significant sire effects being the highest. The results suggest that the offspring of male parental Stock 2 were the more responsive to social stimuli and were possibly more investigative. Significant sire and dam effects indicate that there are differences in the way individual chickens respond to novel environments, and that these responses may be modifiable through selection. PMID- 2704691 TI - Restricted feeding in early and late-feathering chickens. 1. Growth and physiological responses. AB - Broiler-breeder females from a parent stock segregating for early and late feathering were fed ad libitum (AL, feed was always available), ad libitum restricted (ALR, feed restricted daily to control body weight), skip-one-day and skip-two-days (SOD and STD, given two or three times ALR allowance on Day 1 and not fed on the next 1 or 2 days, respectively). At 160 days of age, pullets on SOD and STD were changed to ALR feeding, and daily feed allowances were increased to 135 g by Day 180 and 138 g by Day 250. Responses of early and late-feathering females were similar for traits measured. Generally, body weights of AL chickens increased to 4,600 g at 130 days of age and then reached a plateau. Body weights of feed-restricted groups were less than half of that of AL chickens by 160 days of age. Controlled release from feed restriction enabled chickens to reach a weight of approximately 3,200 g by Day 210. Daily feed consumption for AL chickens increased to about 220 g by 140 days of age and then decreased to approximately 150 g by Day 250; it eventually decreased to approximately 120 g by Day 350, where it reached a plateau. Mortality, plasma glucose levels, and surface and cloacal temperatures were lower for females whose feed was restricted than for those fed AL. Plasma protein levels were greater for STD than for AL, ALR, and SOD groups whereas plasma lipids were higher for AL and SOD than for ALR and STD groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704692 TI - Restricted feeding in early and late-feathering chickens. 2. Reproductive responses. AB - Reproductive traits of females from a broiler-breeder parent stock segregating for early and late feathering were measured under four feeding regimens. Feeding regimens consisted of ad libitum (AL, feed was always available), ad libitum restricted (ALR, feed restricted daily to control body weight), and skip-one-day and skip-two-days (SOD and STD, given two or three times ALR allowance on Day 1 and not fed on the next 1 or 2 days, respectively). At 160 days of age, pullets on SOD and STD were changed to ALR feeding, and daily feed allowances were increased to 135 g by Day 180 and 138 g by Day 250. Early and late feathering chickens responded similarly, except that hen-day ovulation rates, relative egg shell weights, and incidences of extracalcified and compressed eggs were greater for the former than the later. For most traits measured, differences among restricted feeding regimens were minor, but considerable differences were noted between them and the AL regimen. Females fed AL reached sexual maturity approximately 60 days earlier than those whose feed intake was restricted. Also, body weights at onset of lay were about 1,200 g greater for AL than for feed restricted females. Percentages of hen-day ovulation, normal egg production, and duration of fertility were lower, whereas incidence of defective eggs was higher for AL than for feed-restricted chickens. PMID- 2704693 TI - Restricted feeding in early and late-feathering chickens. 3. Organ size and carcass composition. AB - Carcass composition traits and weights and lengths of organs relative to body weight were measured in females from a broiler-breeder parent stock segregating for early and late-feathering alleles maintained under four feeding regimens. Feeding regimens consisted of ad libitum (AL), ad libitum restricted (ALR, feed restricted daily), and skip-one-day and skip-two-days (SOD and STD, given two or three times ALR allowance on Day 1 and not fed on the next 1 or 2 days, respectively). At 160 days of age, pullets on SOD and STD were changed to ALR feeding; daily feed allowances were increased to 135 g by day 180 and to 138 g on day 250. Organ growth and carcass composition were generally similar for early and late-feathering genotypes. Restricted feeding increased relative weights and lengths of segments of the gastrointestinal tract (GIT) and pancreas and reduced relative weights of the abdominal fat depot (AFD) and lipid contents of the liver, AFD, and total carcass. Relative weights of legs, breast, feathers, heart, and liver and carcass protein composition were not affected by feeding regimen. Relative oviduct and ovary weights were not affected, but number of rapidly developing follicles was higher for AL than restricted-fed hens. Relationships of most organs to total body weight changed little after sexual maturity. Relative weights and lengths of GIT decreased whereas breast, legs, and AFD increased. Feed-restricted chickens adapted to fasts by retaining GIT contents longer. Feeding regimen x age interactions were significant for esophagus, proventriculus, gizzard, shank, breast, legs, feathers, and AFD weights; esophagus, duodenum, jejunum, ileum, and shank lengths; and lipid contents of AFD and liver. PMID- 2704694 TI - Effects on turkey mortality and body weight of type of beak trimming, age at trimming, and injection of poults with vitamin and electrolytes solution at hatching. AB - This study was designed to determine the influence of: 1) age at and type of beak trimming (BT), and 2) injection of poults at hatch with 2 mL of a commercial mineral and vitamin solution versus noninjection of poults on the viability and growth rate of turkeys to market age. Mortality from 0 to 20 wk of age and BW at 8, 16, and 20 wk of age were recorded. At hatch, poults were BT 1.0 mm (Experiment 1) or 1.5 mm (Experiment 2) anterior to the nostril using an electric arc beak trimmer. In a second treatment (Experiments 1 and 2), one-third to one half of the beak was removed at 11 days of age with a hot blade beak trimmer. In Experiment 1, offspring from three large-bodied crosses were used whereas in Experiment 2 birds were from a single large-bodied cross. The BT at 1.0 mm anterior to the nostril with an electronic beak trimmer (Experiment 1) increased mortality and decreased BW at 8, 16, and 20 wk of age relative to BT at 11 days of age with the hot blade beak trimmer. The BT at 1.5 mm (Experiment 2) at hatching did not affect mortality and reduced BW only at 8 wk of age relative to BT at 11 days of age. The use of an injectable commercial vitamin-mineral solution did not influence mortality in either experiment and significantly increased BW only at 8 wk of age in Experiment 2. The interactions of strain cross with either age of BT or injection vs. noninjection of poults were NS in Experiment 1. PMID- 2704695 TI - Effect of nicarbazin and narasin-nicarbazin combinations on broiler pigmentation. AB - An experiment was conducted with young battery-reared chickens to evaluate the effects of graded levels of nicarbazin (0, 40, 80, 120, and 160 ppm) on plasma pigmentation in the presence and absence of coccidial infection. A second experiment was also performed to determine whether nicarbazin (50 ppm) and the narasin nicarbazin combination anticoccidial (50 ppm each) affected pigmentation values in coccidia-infected and healthy chicks. Pigmentation values were expressed as micrograms beta-carotenoid equivalents per milliliter of plasma (beta-CE). Results of these studies indicated that nicarbazin improved beta-CE in both parasitized and coccidia-free chicks, but the magnitude of improvement was greater in coccidia-infected animals. Linear responses to nicarbazin additions were observed in both groups. The second experiment revealed that the effects produced in healthy chicks receiving the narasin nicarbazin combination were equivalent to those which received nicarbazin alone, indicating that the nicarbazin response in beta-CE is manifested with the combination anticoccidial as well. PMID- 2704696 TI - Eimeria acervulina and Eimeria tenella in 15.B-congenic White Leghorns. AB - Six Ea-B-congenic lines of chickens were used to study the role of the B histocompatibility complex in susceptibility and immunity to Eimeria tenella and E. acervulina. The B haplotypes were 2, 2, 5, 12, 13, or 19. Parental line 15I5 with the B15 haplotype (15I5-15) and a commercial White Leghorn (CWL) line were also used. The B-congenic lines were generally less susceptible to E. tenella than the CWL line based on weight gain, cecal lesion score, plasma pigment, and packed cell volume. Within the congenic lines, the 15I5-15 line was more resistant to E. tenella than the 15.6-2 and 15.7-2 lines. Using a level of infection of E. acervulina resulting in moderate disease, the 15.7-2 line was more susceptible than all other lines based on weight gain, and the 15.6-2 and 15.7-2 lines had greater intestinal lesion scores than the 15.15I-5 or 15I5-15 lines. The CWL line was most susceptible based on lesion score. Thus 15I5-15 chickens were more resistant to primary infection by several criteria than the 15.7-2 or 15.6-2 chickens infected with either coccidial species. A single immunization with 100 oocysts of E. tenella produced less immunity in the congenic lines than in the CWL, whereas four immunizations resulted in immunity in all lines except 15.15I-5. Immunization with E. acervulina produced good immunity to a challenge infection in all lines. These results suggest that the B complex has a detectable influence on resistance and susceptibility to avian coccidiosis, but it may play only a minor role in the development of immunity to a challenge infection. PMID- 2704697 TI - Early post-mortem metabolism and muscle shortening in the Pectoralis major muscle of broiler chickens. AB - Three experiments were conducted to examine the effects of sodium pentobarbital (SP), iodoacetate (IO), tubocurarine (TC), and surgical denervation (DN) on early rigor development in broiler breast muscle. In Experiment 1, birds were either anesthetized or not with SP before receiving an injection of IO or TC or maintained as noninjected controls. Experiment 2 was identical except that a treatment of denervation of the breast muscle was added. Experiment 3 was conducted to contrast birds at 1 day (DN1) and 3 days (DN3) denervation prior to slaughter to nonoperated controls. Measurements of muscle lactate, ATP, R value (ratio of inosine to adenine nucleotides), pH, sarcomere lengths, and shear were used to evaluate treatment effects. Results for Experiment 1 showed no significant differences among treatment and control groups for ATP and lactate contents, R values, or sarcomere lengths; however, significantly lower pH and higher shear values were observed for control birds. In Experiment 2, no significant differences were observed among the treatment groups for ATP, R values, or sarcomere lengths. However, lactate and shear values were significantly lower, and pH higher, for the DN and SP treated birds. Experiment 3 resulted in lower lactate and higher pH values for the DN3 treatment in comparison with both DN1 and control groups. Results of these studies indicate that the use of SP and DN can be used to alter the early profiles of rigor development. PMID- 2704698 TI - Renal function in freshwater and chronically saline-stressed male and female Pekin ducks. AB - Hematocrit (Hct) and plasma ionic and osmotic concentrations were measured in Pekin Ducks, Anas platyrhynchos, drinking freshwater (FW), during rapid acclimation to sea water (RA), and after 6 mo exposure to 180-mM NaCl (SW). Glomerular filtration rate (GFR) and extracellular fluid volume (ECFV) were measured in FW and SW ducks. Estimated renal plasma flow (ERPF) was measured in SW ducks. During RA, Hct and plasma concentration increased significantly (P less than .05) when drinking water sodium concentration ([Na]dw) was 300 mM; body mass decreased (P less than .01) when [Na]dw was 375 mM. The Hct and plasma ionic or osmotic concentrations of FW and SW ducks were the same, except that female SW ducks had lower (P less than .05) plasma chloride concentrations than FW female ducks. Relative to body mass, the FW female duck ECFV (26.88%) was larger (P less than .01) than that of the male (17.50%). The ECFV was not affected by SW in either sex. Mean (+/- SE) GFR determined using inulin and polyethylene glycol (PEG) in the same five FW ducks, were the same, 4.4 +/- .7 and 4.7 +/- .6 mL(min.kg)-1, respectively. In female FW ducks, the GFR (PEG) was 5.00 +/- .30 mL(min.kg)-1, significantly (P less than .001) greater than that of the male, which was 3.07 +/- .21 mL(min.kg)-1. Female and male SW duck GFR were 3.96 +/- .57 and 2.60 +/- .37 mL(min.kg)-1, respectively, but the decrease in GFR was significant (P less than .05) only for females. The GFR were the same, relative to kidney mass, in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704699 TI - Characterization of electrolytes and protein content in isthmic and uterine flushings from hens laying shell-less versus hard-shell eggs. AB - In Experiment 1, hens laying hard-shell (HS) eggs were sacrificed at each of eight stages of egg formation including oviposition (0 h) and 1, 4, 8, 12, 16, 20, and 24 h after oviposition. In Experiment 2, hens laying either shell-less (SL) or HS eggs were sacrificed at four stages of egg formation (oviposition, 4, 8, and 20 h after oviposition). The isthmus and uterus were flushed with 6 and 10 mL of cold .85% NaCl, respectively, and electrolyte contents were determined. Total flushing contents of calcium, potassium, and magnesium were higher (P less than or equal to .01) in uterine than in isthmic flushings (Experiment 1). In every case, an interaction (P less than or equal to .01) between time of collection and organ (isthmus and uterus) was found, indicating that patterns of change in flushing content of each electrolyte differed in the two organs over time in birds laying HS eggs. In Experiment 2, total recoverable calcium, magnesium, potassium, and total protein were higher in uterine than isthmic flushings (P less than .01). Interactions between time of collection (0, 4, 8, and 20 h) and treatment group (SL or HS) were observed for all electrolytes measured in uterine flushings. Results suggest that calcium, required for shell calcification, does not appear in the isthmic or uterine lumen or both at an appropriate time in SL hens. Thus, production of SL eggs may be related to mechanisms regulating patterns of change or ratios of electrolytes (calcium, magnesium, potassium) or both in the isthmus or uterus of the laying hen. PMID- 2704700 TI - Physiological responses of heat-stressed broilers fed nicarbazin. AB - Two experiments were conducted to determine physiological responses in heat stressed broilers fed a control diet or one containing 125 ppm Nicarbazin. Male birds were surgically implanted with a carotid catheter and fitted with a chest movement transducer and rectal probe. In Experiment 1, birds were exposed to an abrupt change from thermoneutral (22.5 C, 70% relative humidity [RH]) to heat stress (37 C and 40 to 50% RH) conditions within 10 min and maintained in this environment for 120 min. In Experiment 2, birds were exposed to a gradual change from thermoneutral to heat stress (38 C, 68% RH) conditions over 4 h and maintained in this environment for an additional 1 h. Heart rate (HR), respiration rate (RR), and body temperature (Tb) were monitored throughout each experiment, and arterial samples were obtained for determination of acid-base balance and lactate. Birds fed Nicarbazin had higher (P less than .05) Tb and lower (P less than .05) blood PCO2 and bicarbonate during heat stress than controls in both experiments. Thermal polypnea was observed in both experiments, but, although there were no treatment differences in Experiment 1, RR was lower (P less than .05) in the last hour of heat stress for Nicarbazin-fed birds in Experiment 2. In the second experiment, birds fed Nicarbazin exhibited higher (P less than .05) HR and blood lactate during heat stress than control-fed birds. The results of this study indicate that Nicarbazin, by an as yet unidentified mechanism, increases Tb in heat-stressed birds, which results in greater deviations in blood acid-base balance, blood lactate, and HR than in control-fed birds. PMID- 2704701 TI - Effect of iodine-treated water on the performance of broiler chickens reared under various stocking densities. AB - A total of 544 day-old sexed broiler chicks were used to investigate the effects of 2 ppm iodine-treated water on body weight and feed efficiency when the chicks were reared at 900, 720, 540, and 360-cm2 stocking densities. Chicks were fed a corn-soybean meal diet calculated to contain 3,212 kcal ME/kg and 21.58% CP. Iodine added to the drinking water at the rate of 2 ppm improved growth significantly after 4 wk of age. Feed efficiency was not significantly affected by the addition of iodine to the drinking water. Maximum effects on growth were obtained when the broilers were housed at stocking densities of 720 and 540 cm2/bird. A stocking density of 360 cm2 appeared to provide a crowding stress severe enough to negate the beneficial effects of adding iodine to the drinking water. PMID- 2704702 TI - Should the American Nurses' Association (ANA) have the sole responsibility for establishing the standards of practice? Part IV. PMID- 2704703 TI - [What type of curriculum in phthisiology should there be for medical students?]. AB - Reconstruction in public health requires further improvement of medical personnel training by using more perfect curricula and methods of teaching. Different curricula on phthisiology are discussed in regard to disease pathomorphism and organization of personnel activity. It is advisable that the main attention should be paid to mastering differential diagnosis by medical students during their individual work. PMID- 2704704 TI - [Ways of increasing the quality of the advanced training of therapists in phthisiology]. AB - One hundred and thirty three therapists registered as students of the courses for advanced medical training were questionnaired anonymously on lung pathology and particularly on phthisiology. The analysis of the questionnaires revealed that their knowledge of the problems of prophylaxis, early detection and differential diagnosis of tuberculosis was not sufficient. The shortcomings were taken into consideration in the lectures and practical lessons on phthisiology. The emphasis was given to the problems which proved to be the most difficult for the therapeutists. PMID- 2704705 TI - [Immunologic characteristics of children with varying sensitivity to tuberculin having recovered from pneumonia]. AB - The state of cellular immunity and intensity of cell tuberculin reactions were studied in tuberculin negative and tuberculin positive children recovering from pneumonia. It was shown that the state of cellular immunity in the tuberculin negative children who had had pneumonia was different and depended on the skin mark after administration of BCG vaccine. The most marked changes in T-immunity were observed in the children without the inoculation mark. The changes referred to relatively lower counts of T-lymphocytes and their inhibited functional activity. In the tuberculin sensitive children there was marked tuberculin sensitization of the immunocompetent cells independent of the presence of the postvaccinal mark which indicated increased specific reactivity in them. PMID- 2704706 TI - [Genetic aspects of chronic lung diseases (early diagnosis and prevention)]. AB - According to the data of the Institute of Pulmonology of the USSR Ministry of Public Health about 20 per cent of the patients in the specialized pulmonological department had hereditary diseases of the lungs. The most frequent were pulmonary mucoviscidosis in adults, obstructive pulmonary affections with deficiency of alpha 1-inhibitor of proteases and Zivert Kartagener syndrome. Schemes for diagnosis of such diseases and dispensarization of the patients and probant families are described. Early diagnosis and medicogenetic consultations in the probant families are important for prophylaxis of development of severe forms of hereditary diseases of the lungs. PMID- 2704707 TI - [Pathomorphosis of coniotuberculosis]. AB - Changes in the epidemiology, morphology and clinical picture of active anthracotic tuberculosis within the last 20 years referred to an increase in the average age of the patients and the length of service under dust conditions. Among the patients with anthracotic tuberculosis the number of drufters increased while the number of coal cutters and breakage face workers decreased. There was observed a rise in the proportion of infiltrative tuberculosis and tuberculomas of the lungs with a simultaneous decrease in the proportion of fibrocavernous tuberculosis. At present the process of active anthracotic tuberculosis is more favourable. The percentage of extended forms of anthracotic tuberculosis decreased. PMID- 2704708 TI - [Ways of increasing the effectiveness of tuberculosis control]. AB - Ways for improving quality of tuberculosis control at the present stage are discussed. The necessity for estimating the quality of the activities of medical institutions by the final results with respect to all the parameters is grounded. Such results should be the level of tuberculosis incidence, susceptibility to tuberculosis, death rate due to tuberculosis, temporary and stable invalidity. PMID- 2704709 TI - [Cavernotomy in patients with solitary lung]. AB - Patients with a resected lung because of pulmonary tuberculosis and a cavernous process in the single lung were subjected to open surgical treatment on that lung. The authors consider the operation as sparing for patients with low functional respiration reserve. PMID- 2704710 TI - [Surgical interventions in diffuse pulmonary tuberculosis in undisciplined patients]. AB - The experience with surgical treatment of 134 patients with extended destructive tuberculosis of the lungs was studied. Among them 79 patients were subjected to lung resection in combination with thoracoplasty, 14 patients were subjected to thoracoplasty and 41 patients were subjected to various forms of cavernoplasty. It was shown that corrective thoracoplasty carried out simultaneously with lung resection lowered the risk of tuberculosis aggravation. PMID- 2704711 TI - [Direct endolymphatic administration of antitubercular drugs in patients with inflammatory diseases of the urogenital organs]. AB - Direct endolymphatic administration of broad-spectrum antibiotics was used in treatment of approximately 21 patients with complicated urogenital tuberculosis. The duration of the endolymphatic therapy ranged from 3 to 13 days. In the patients treated with endolymphatic administration of the antibiotics the effects were favourable. The use of the procedure were shown expedient because marked lesions in the urinary tracts, frequent chronic renal failure and the microbial flora resistance to the drugs lowered the efficacy of the treatment with the routine administration of the drugs. The drugs used i.e. klaforan and gentamicin were approved by the USSR Pharmacological Committee. The drugs were administered with dosator NDL-3 in original modification which provided continuous polycollector endolymphatic antibiotic therapy with simultaneous lavage of the lymphatic channel. It was shown expedient to use endolymphatic administration of antibiotics in treatment of complicated urogenital tuberculosis alone or in combination with the preoperative procedures. PMID- 2704712 TI - [Modified subcutaneous tuberculin test in the diagnosis of tuberculosis of the male genital organs]. AB - Efficiency of the clinical use of a new procedure for estimating the host focal response to subcutaneous administration of 50 TU of OT was studied in 121 patients. The procedure is based on measuring conductivity in the zones of lowered resistance on the scrotum skin and over the prostate at the background of a provocative tuberculin test performed with apparatus Elektronika-Elita-4M. The procedure provided positive effects in 85 per cent of the patients with tuberculosis of the external genitalia and in 50 per cent of the patients with specific inflammation of the prostate. PMID- 2704713 TI - [Changes in intraorganic hemomicrocirculation in renal tuberculosis in the light of experimental morphofunctional studies]. AB - As a result of long-term (from 1969) and extended (800 rabbits) experimental studies using an original complex of specific methods including intravital microscopy with video recording, new evidence on regulation of intrarenal circulation and its impairment in nephrotuberculosis was obtained. The role of the Trueta shunts in this was shown to be insignificant. Of importance was periglomerular shunting. It was concluded that extended microcirculatory disorders in the region of the intact renal parenchima defining development of renal insufficiency were possibly of tuberculosis allergic origin. Measures for their prevention and treatment are proposed. PMID- 2704714 TI - [Integration of phthisiology and pulmonology in rural areas]. PMID- 2704715 TI - [Association of tuberculosis and cancer of the kidney]. PMID- 2704716 TI - [Resonance stimulation of regional ventilation of the lungs by sound vibration in the prevention of acute respiratory insufficiency]. PMID- 2704717 TI - [A case of disseminated (hematogenic) tuberculosis predominantly affecting the liver and spleen]. PMID- 2704718 TI - [Multiple tuberculomas of the brain in a patient with tuberculous meningitis]. PMID- 2704719 TI - [Tuberculoma of the brain in a 14-month-old child]. PMID- 2704720 TI - [The role of socio-psychological factors in the causative interrelations of alcoholism and tuberculosis]. AB - The role of social and psychological factors in casual relationship between alcoholism and tuberculosis was studied in regard to alcoholic patients with tuberculosis. The results confirmed the suggestion that the role of these factors in relation between alcoholism and tuberculosis was of exceptional importance. PMID- 2704721 TI - Transformation of oocysts from several coccidian species by heat treatment. AB - The transformation of sporocysts in oocysts of Eimeria caviae, E. intestinalis, E. nieschulzi, E. separata, E. tenella, Isospora canis, I. heydorni, and Toxoplasma gondii by heat treatment was examined. Fresh unsporulated oocysts from these species were heated at 50 degrees or 55 degrees C for less than 5 min and cultivated at 25 degrees C for 1 week. No transformation of sporocysts was observed in the sporulated oocysts following heating at 55 degrees C, but sporulated oocysts of Tyzzeria and Caryospora types were found in some I. canis and I. heydorni oocysts after heating at 50 degrees C followed by cultivation. A few sporulated oocysts of the Isospora type were observed in E. intestinalis oocysts after cultivation. All transformed sporulated oocysts contained eight sporozoites. In contrast, the number of sporocysts varied from two to 0. These results indicate that sporocyst formation in oocysts was affected by heat treatment. The relationship between the total numbers of sporozoites and sporocysts in the transformed oocysts was consistent with that of the "Octozoic" group classified by Hoare. PMID- 2704722 TI - Spermatogenesis and the fine structure of the mature spermatozoon in the free proglottis of Trilocularia acanthiaevulgaris (Cestoda, Tetraphyllidea). AB - Spermatogenesis and the structure of the mature spermatozoon of Trilocularia acanthiaevulgaris have been studied by light microscopic histochemistry and transmission and scanning electron microscopy. The primary spermatogonia occupy the periphery of the testis and undergo four mitotic divisions; incomplete cytokinesis results in two secondary, four tertiary and eight quaternary spermatogonia and sixteen primary spermatocytes. The quaternary spermatogonia and successive stages develop in a plasmodial rosette with their nuclei at the periphery and connected to the cytophore by cytoplasmic bridges. The primary spermatocytes undergo two meiotic divisions, resulting in 64 spermatids that develop into spermatozoa. Intranuclear synaptonemal complexes in primary spermatocytes confirm the first meiotic division. The onset of spermiogenesis is marked by an elongation of the spermatid nucleus and the appearance of "arching membrane-bound clefts" (after Rosario 1964) that delimit the differentiation zone. The latter contains a pair of axonemes with their associated basal bodies and rootlets and, as it extends, the nucleus migrates into it. At first, the axonemes grow at right angles to the extension, but during development they rotate through 90 degrees and come to fuse with the cytoplasmic extension. The mature spermatozoon has a broad head region, a middle piece and a narrow tail region. It consists of a highly coiled nucleus, paired axonemes of the 9 + 1 pattern typical of platyhelminths, one of which extends the full length of the tail and the other ends part-way along the tail, particles of beta-glycogen and peripheral microtubules. A crested body spirals around the outside of the sperm body in the tail region. T. acanthiaevulgaris is placed in context within the phylogenetic schemes for cestodes based on sperm ultrastructure. PMID- 2704723 TI - Development of the tegument of Echinococcus granulosus (Cestoda) protoscoleces during cystic differentiation in vivo. AB - During the first 4 days following infection, early tegumentary changes are confined to the protoscolex soma of Echinococcus granulosus, the thick glycocalyx being lost and the blunt elevations, flattened. The Golgi complexes within the tegumentary cytons produce T2 vesicles that increase in number in the tegument from days 4 to 12, whereas T1 vesicles decline. Spineless, truncated microtriches develop at the somal surface, and the laminated layer starts to form around the developing cyst from days 20-40 onwards. T2 vesicles do not appear to be involved in its formation and decline in number. Two additional vesicle types participate in the production of the laminated layer: T4 vesicles contribute to the carbohydrate matrix, and 'G' vesicles form granular accumulations. Cystic differentiation is completed after 2-3 months, when the spined microtriches and rostellar hooks of the scolex are shed into the laminated layer and replaced by truncated microtriches. These ultrastructural changes are discussed with respect to parasite survival. PMID- 2704724 TI - Observations on the lipids of Oochoristica agamae (Cestoda). AB - An investigation of the lipids of Oochoristica agamae, an anoplocephalid cestode of the Agama lizard, was undertaken. Total lipids of the parasite accounted for 8.4% of the fresh weight; neutral lipids comprised 82.98% of the total, glycolipids, 5.01%, and phospholipids, 12.03%. The major lipid classes in O. agamae include triglycerides, cholesterol, phosphatidyl choline, and phosphatidyl ethanolamine. The 16- and 18-carbon fatty acids were predominant in the parasite. Hexadecenoic acid, usually found at low concentrations in the lipids of helminth parasites, was the most abundant of the 16-carbon fatty acids of O. agamae (notably in the neutral lipid fraction). Although octadecatrienoic acid occurred only in trace amounts in the intestinal contents of the host, significant amounts of this fatty acid were detected in the parasite. A lack of 20-carbon fatty acids was determined in the lipids of the host's intestinal contents and the neutral lipid fraction of the parasite. O. agamae is suspected to be capable of modifying fatty acids obtained from dietary sources by chain elongation. PMID- 2704725 TI - Polyamine metabolism in Setaria cervi, the bovine filarial worm. AB - Spermine and spermidine were found to be the principal polyamines in the bovine filarial parasite Setaria cervi, whereas putrescine was observed in very low amounts. Studies conducted on the enzymes of polyamine biosynthesis revealed low activity for S-adenosyl-methionine decarboxylase, questionable and negligible activities for the decarboxylation of ornithine and arginine, and appreciable activity for ornithine aminotransferase. Uptake studies with radiolabeled putrescine, spermidine and spermine showed that these amines are rapidly taken up from the medium by an active uptake process. The uptake was temperature-sensitive and abolished at 0-4 degrees C. The questionable presence of biosynthetic enzymes such as ornithine and arginine decarboxylase and, on the other hand, an effective uptake mechanism indicate that the parasite may depend on the host for its polyamine requirement, thereby indicating a possible target for chemotherapy. PMID- 2704726 TI - Ultrastructural localization of antigenic substances in Trichinella spiralis. AB - The in situ localization of antigenic substances in Trichinella spiralis muscle larvae was demonstrated at the subcellular level. Larvae recovered from mouse muscle were fixed with half-strength Karnovsky fixative, dehydrated with alcohol, and embedded in LR White resin. Ultrathin sections were incubated with sera from infected Wistar rats and, subsequently, protein A-gold complex. The specificity of the immunostaining was confirmed by a control experiment. Positively immunostaining structures included the stichocyte granules, body cuticle, hindgut cuticle, hypodermis, hemolymph, glycogen aggregates, esophagus-occupying substance (EOS), midgut-occupying substance (MOS), brush border, cytoplasmic granules in the cord, intestinal gland cell granules, and discrete areas in the genital primordial cell. However, the esophageal cuticle, nucleus, nucleolus, mitochondria, rough endoplasmic reticulum, and muscle fibers were negative by immunostaining. PMID- 2704727 TI - Repetitive detection by immunoblotting of an integumental 25-kDa antigen in Ixodes ricinus and a corresponding 20-kDa antigen in Rhipicephalus appendiculatus with sera of pluriinfested mice and rabbits. AB - Mice were pluriinfested with nymphs and rabbits, with adult Ixodes ricinus. As determined by immunoblotting, greater than 50% of sera from these animals reacted against a tick antigen with a molecular weight of 25 kDa, which was detected in total extracts of partially fed I. ricinus females and in tick integumental extract. It was also found in engorged nymphs but was absent from larvae. Sera of I. ricinus-infested rabbits and mice or of rabbits infested with Rhipicephalus appendiculatus adults reacted with a 20-kDa antigen in total extracts of partially fed R. appendiculatus females and the integument of this species. PMID- 2704729 TI - Evidence for the development of human hydatid daughter cysts from protoscoleces. PMID- 2704728 TI - The effect of cyclosporine A on murine trichinellosis. PMID- 2704730 TI - The pill electrode. New technology as an adjunct to nursing assessment of patient arrhythmias. AB - The value of esophageal electrocardiography (ECG) in differential diagnosis of complex arrhythmias has been well known for the past half century. However, until recently, the technique was not widely used primarily because of the patient discomfort associated with esophageal placement of nasogastric tubes containing the ECG electrodes. With the advent of the pill electrode and development of appropriate recording methodology, interest in and use of esophageal electrocardiography has increased dramatically. In this article, the authors review the historic development of the pill electrode, recording technique, and current case studies in which the technique of pill electrode esophageal ECG monitoring facilitated differential diagnosis of complex arrhythmias. PMID- 2704731 TI - Transcutaneous pacing. AB - Transcutaneous pacing is a safe and effective treatment for use in a variety of emergent and nonemergent situations. Large anterior and posterior skin electrodes transmit electrical current through the thorax in an attempt to stimulate myocardial contraction. Advantages include its safe and effective use, timeliness and ease of initiation, and economical value. Revisions of the former models allow for improved comfort for the patient; however, many patients continue to find the sensation unacceptable. In the critical care environment, transcutaneous pacing has several implications for nursing. PMID- 2704732 TI - Permanent visual display exhibits. A supplementary instructional technique in critical care education. AB - The discipline of critical care is being challenged to provide ongoing education to the various groups of critical care health providers. Traditional modalities of instruction may not suffice as unique circumstances exist in the practice and daily delivery of patient care. These unique circumstances include a never-ending introduction of new devices, tubes, and catheters into practice. In addition, the intensive care setting features a wide variability of work experience, a high turnover rate of personnel, variable cognitive approaches to understanding technical devices, and a stressful workplace. In their surgical intensive care unit, the authors have developed a set of permanent visual display exhibits. These exhibits were designed to specifically address the above problems and serve as a supplementary mode of education for our diverse medical, nursing, and technical staff. The exhibits may provide an example for other intensive care units and educators. PMID- 2704733 TI - An erythroid-specific, developmental-stage-independent enhancer far upstream of the human "beta-like globin" genes. AB - We have identified an erythroid-specific enhancer element far upstream of the human "beta-like globin" genes, at 10.2-11.0 kilobases 5' of the embryonic epsilon-globin gene, and thus at 53-54 kilobases 5' of the adult beta-globin gene. It is capable of enhancing the expression of a cis-linked test gene by up to 300-fold. This enhancer element is apparently developmental-stage-independent, as it is functional at the embryonic and the adult developmental stages in erythroid cells that are expressing the respective beta-like globin genes. The enhancer and globin promoter sequences work in synergy and are capable of conferring on a cis-linked gene the high transcriptional efficiency (enhancer function), erythroid specificity (enhancer and promoter functions), and developmental-stage specificity (promoter function) that are characteristic of the in vivo transcription of the beta-like globin genes in erythroid cells. PMID- 2704734 TI - Complete amino acid sequence of rat brain hexokinase, deduced from the cloned cDNA, and proposed structure of a mammalian hexokinase. AB - The complete amino acid sequence for the type I isozyme of hexokinase from rat brain has been deduced from the nucleotide sequence of cloned cDNA. The nucleotide sequence of 91 bases in the 5' untranslated region as well as that of the entire 3' untranslated region preceding the poly(A) sequence have also been determined. The N- and C-terminal halves of brain hexokinase show extensive sequence similarity to each other and to yeast hexokinase. These results provide direct support for the proposal that the mammalian hexokinases of approximately 100 kDa have evolved by a process of duplication and fusion of a gene encoding an ancestral hexokinase similar to the yeast enzyme of approximately 50 kDa. Taking this similarity in sequence to indicate basic similarity in structure between the N- and C-terminal regions of brain hexokinase and the yeast enzyme, a proposed structure for the mammalian hexokinase has been developed by fusing two molecules of yeast hexokinase, whose structure has previously been determined by x-ray crystallographic studies. Various features of the model are shown to be consistent with experimental observations bearing on the structure of the brain enzyme. PMID- 2704735 TI - Expression of the U1 RNA gene repeat during early sea urchin development: evidence for a switch in U1 RNA genes during development. AB - The majority of the genes for U1 RNA are organized in tandemly repeated units in the sea urchin. To assess the level of expression of these genes in the sea urchin Lytechinus variegatus, we measured the transcription of sequences 3' to the gene. The tandemly repeated U1 genes are expressed in morula and continue to be expressed at high rates until 2 hr after hatching, at which time the rate of expression of all the U1 genes and the tandemly repeated U1 genes declines sharply. By the gastrula stage the synthesis of total U1 RNA has declined by a factor of 8. The major tandemly repeated genes are inactive by this time, although other U1 genes remain active. The sequence of U1 RNA synthesized late in embryonic development differs from the sequence of U1 RNA encoded by the tandemly repeated set of U1 RNA genes, indicating that there must be other U1 RNA genes that are active late in embryonic development. PMID- 2704736 TI - Molecular cloning and analysis of cDNA encoding a plant tryptophan decarboxylase: comparison with animal dopa decarboxylases. AB - The sequence of a cDNA clone that includes the complete coding region of tryptophan decarboxylase (EC 4.1.1.28, formerly EC 4.1.1.27) from periwinkle (Catharanthus roseus) is reported. The cDNA clone (1747 base pairs) was isolated by antibody screening of a cDNA expression library produced from poly(A)+ RNA found in developing seedlings of C. roseus. The clone hybridized to a 1.8 kilobase mRNA from developing seedlings and from young leaves of mature plants. The identity of the clone was confirmed when extracts of transformed Escherichia coli expressed a protein containing tryptophan decarboxylase enzyme activity. The tryptophan decarboxylase cDNA clone encodes a protein of 500 amino acids with a calculated molecular mass of 56,142 Da. The amino acid sequence shows a high degree of similarity with the aromatic L-amino acid decarboxylase (dopa decarboxylase) and the alpha-methyldopa-hypersensitive protein of Drosophila melanogaster. The tryptophan decarboxylase sequence also showed significant similarity to feline glutamate decarboxylase and mouse ornithine decarboxylase, suggesting a possible evolutionary link between these amino acid decarboxylases. PMID- 2704737 TI - A simple high-resolution procedure to study DNA methylation and in vivo DNA protein interactions on a single-copy gene level in higher eukaryotes. AB - We describe a method that permits the study of the state of cytosine methylation and of in vivo protein-DNA interactions in higher eukaryotes. This powerful technique is applicable to any gene of interest at the single-copy level. To study DNA methylation, the total uncloned genomic DNA, digested with a restriction endonuclease is subjected to a cytosine-specific hydrazine reaction and chemical cleavage. The DNA fragments of interest are linearly amplified with Taq polymerase and a sequence-specific radioactivity labeled synthetic primer. Following amplification, the DNA fragments are separated on a sequencing gel that is directly autoradiographed. To study protein-DNA interactions in vivo, we use a similar method, except that the DNA of interest is isolated from cells treated either with dimethyl sulfate or UV light. The resolution power of this technique is demonstrated by two examples, which have been studied previously by the conventional methods of genomic sequencing and "footprinting." PMID- 2704738 TI - Trypanothione is the primary target for arsenical drugs against African trypanosomes. AB - The trypanosomatid metabolite N1,N8-bis-(glutathionyl)spermidine (trypanothione) has been demonstrated to form a stable adduct with the aromatic arsenical drug melarsen oxide [p-(4,6-diamino-s-triazinyl-2-yl)aminophenyl arsenoxide]. The stability constant of the melarsen-trypanothione adduct (Mel T) has been determined to be 1.05 x 10(7) M-1. When bloodstream Trypanosoma brucei are incubated with either melarsen oxide or the 2,3-dimercaptopropanol adduct of melarsen oxide (melarsoprol), Mel T is the only arsenical derivative detectable in acid-soluble extracts of the cells. Trypanothione may therefore be regarded as a primary target for aromatic arsenical derivatives against African trypanosomes. The selective toxic action of these compounds might arise through sequestration of intracellular trypanothione in the form of Mel T, or Mel T itself may be toxic within the cell. The latter possibility is illustrated by the finding that Mel T is an inhibitor of trypanothione reductase from T. brucei (Ki = 9.0 microM)--an enzyme that is central to the regulation of the thiol/disulfide redox balance in the parasite and absent from the host. PMID- 2704739 TI - Structural basis for DNA bending. AB - We report proton NMR studies on DNA oligonucleotides that contain A tracts of lengths known to produce various degrees of bending. Spectra of duplexes in the series 5'-(GGCAnCGG).(CCGTnGCC) (n = 3, 4, 5, 7, 9) reveal substantial structural changes within the An.Tn tract as its length is increased. Chemical-shift comparisons show that A tracts with fewer than about seven members do not contain regions of uniform [or poly(dA).poly(dT)-like] structure. Long An tracts (n greater than or equal to 7) appear to consist of an internal segment of homopolymeric conformation flanked by regions of transitional structure that occupy about four A.T pairs on the 5' side and two A.T pairs perhaps the directly adjacent G.C pair on the 3' side. In shorter duplexes (n less than 7), these two transitional regions overlap and an apparent mutual incompatibility causes length dependent changes that are most pronounced near the 3' end. Throughout the series, there is a striking monotonic relationship between the location of an A.T pair in the A tract and the relative position of its ThyH3 resonance. The direction of the chemical-shift dispersion is opposite to that expected from consideration of ring-current effects alone; this discrepancy suggests a gradual decrease in ThyH3...N1Ade hydrogen-bond length as one moves from the 5' to the 3' end of the A tract and from short to long A tracts. Nuclear Overhauser effect measurements reveal that the interproton distances AdeH2...H1'Ade and AdeH2...H1'Thy vary along each A tract, except in the central regions of the longer ones where they are fairly constant and in good agreement with the poly(dA).poly(dT) structure proposed by Lipanov, A.A. & Chuprina, V. P. [(1987) Nucleic Acids Res. 15, 5833-5844]. This model features a substantial negative base-pair tilt, which has been suggested previously as the source of A-tract bending. In contrast, the nuclear Overhauser effect distances are inconsistent with at least one known crystallographic A-tract structure [DiGabriele, A. D., Sanderson, M. R. & Steitz, T. A. (1989) Proc. Natl. Acad. Sci. USA 86, 1816 1820], which lacks appreciable base-pair tilt. PMID- 2704740 TI - A double-stranded RNA unwinding activity introduces structural alterations by means of adenosine to inosine conversions in mammalian cells and Xenopus eggs. AB - Amphibian eggs and embryos as well as mammalian cells have been reported to contain an activity that unwinds double-stranded RNA. We have now found that adenosine residues have been modified in the RNA products of this unwinding activity. Although the modified RNA remains double-stranded, the modification causes the RNA to be susceptible to single-strand-specific RNase and to migrate as a retarded smear on a native polyacrylamide electrophoresis gel. The modification is specific for double-stranded RNA. At least 40% of the adenosine residues can be modified in vitro in a given random sequence RNA molecule. By using standard two-dimensional TLC and HPLC analyses, the modified base has been identified as inosine. Mismatched base-pairing between inosine and uridine appears to be responsible for the observed characteristics of the unwound RNA. The biological significance of this modifying activity and also of the modified double-stranded RNA is discussed. PMID- 2704741 TI - Medium-chain fatty acid binding to albumin and transfer to phospholipid bilayers. AB - Temperature-dependent (5-42 degrees C) 13C NMR spectra of albumin complexes with 90% isotopically substituted [1-13C]decanoic acids (3 mol of fatty acid per mol of albumin) showed a single peak at greater than 30 degrees C but three peaks at lower temperatures. The chemical-shift differences result from different ionic and/or hydrogen-bonding interactions between amino acid side chains and the fatty acid carboxyl carbon. Rapid exchange of fatty acid among binding sites obscures these sites at temperatures greater than 30 degrees C. Rate constants for exchange at 33 degrees C were 350 sec-1 for octanoate and 20 sec-1 for decanoate, corresponding to lifetimes in a binding site of 2.8 msec (octanoate) and 50 msec (decanoate). Temperature-dependent data for octanoate showed an activation energy of 2 kcal/mol for exchange. Spectra of albumin complexes with the 12-carbon saturated fatty acid, lauric acid, had several narrow laurate carboxyl peaks at 35 degrees C, indicating longer lifetimes (tau much greater than 66 msec) in the different binding sites. Fatty acid exchange between albumin and model membranes (phosphatidylcholine bilayers) occurred on a time scale comparable to that for exchange among albumin binding sites, following the order octanoate greater than decanoate greater than laurate. The equilibrium distribution of fatty acid between lipid bilayers and protein was measured directly from NMR spectra. Decreasing pH (8.0 to 5.5) increased the relative affinity of fatty acid for the lipid bilayer. The results predict that the relative affinity of octanoic acid for albumin and membranes will be similar to that of long-chain fatty acids (e.g., oleic acid), but the rate of equilibration will be approximately 10(4) faster for octanoic acid. PMID- 2704742 TI - Monte Carlo simulation of equilibrium globular protein folding: alpha-helical bundles with long loops. AB - To help elucidate the general rules of globular protein folding, computer simulations of the conformational transition in model proteins having the left handed, four-helix bundle motif in which the helices are joined by one or two long loops, as in apoferritin and somatotropin, respectively, have been undertaken. In the context of simple tetrahedral lattice protein models, these unique native helix bundle motifs can be obtained by a set of interactions similar to those found in previous simulations of the folding of four-member alpha-helical bundles with tight bends and beta-barrel proteins including the Greek key motif. The essential features sufficient to produce the four-helix bundle motif with long loops are as follows: (i) a general pattern of hydrophobic and hydrophilic type residues which differentiate the interior from the exterior of the molecule; (ii) the existence of hydrophilic regions in the amino acid sequence that, on the basis of short-range interactions, are indifferent to loop formation but that interact favorably with all the exterior residues of the helix bundle. Thus, these simulations indicate that, to reproduce all varieties of the left-handed four-helix bundle motif, site-specific interactions are not required. PMID- 2704743 TI - Phagocytosis of aggregated lipoprotein by macrophages: low density lipoprotein receptor-dependent foam-cell formation. AB - Low density lipoprotein (LDL) modified by incubation with phospholipase C (PLC LDL) aggregates in solution and is rapidly taken up and degraded by human and mouse macrophages, producing foam cells in vitro. Human, mouse, and rabbit macrophages degraded 125I-labeled PLC-LDL (125I-PLC-LDL) more rapidly than native 125I-labeled LDL (125I-LDL), while nonphagocytic cells such as human fibroblasts and bovine aortic endothelial cells degraded 125I-PLC-LDL more slowly than 125I LDL. This suggested the mechanism for internalization of PLC-LDL was phagocytosis. When examined by electron microscopy, mouse peritoneal macrophages appeared to be phagocytosing PLC-LDL. The uptake and degradation of 125I-PLC-LDL by human macrophages was inhibited greater than 80% by the monoclonal antibody C7 (IgG2b) produced by hybridoma C7, which blocks the ligand binding domain of the LDL receptor. Similarly, methylation of 125I-LDL (125I-MeLDL) prior to treatment with phospholipase C decreased its subsequent uptake and degradation by human macrophages by greater than 90%. The uptake and degradation of phospholipase C modified 125I-MeLDL by macrophages could be restored by incubation of the methylated lipoprotein with apoprotein E, a ligand recognized by the LDL receptor. These results indicate that macrophages internalize PLC-LDL by LDL receptor-dependent phagocytosis. PMID- 2704744 TI - UACUAAC is the preferred branch site for mammalian mRNA splicing. AB - The conserved branch-site sequence UAC-UAAC is known to form base pairs with the complementary sequence GUAGUA in U2 small nuclear RNA (snRNA) during mRNA splicing in the yeast Saccharomyces cerevisiae. Although the GUAGUA element is conserved in mammalian U2 snRNA, mammalian branch sites conform only weakly to a YURAC consensus and can even be deleted without obvious effects on the efficiency of splicing in vivo. To understand why the GUAGUA element of U2 is conserved in evolution but the branch site is not, we have devised two different competitive assays for branch-site selection using the first intron of the human beta-globin gene. We find that a sequence resembling UACUAAC is the most efficient branch site for mammalian mRNA splicing both in vivo and in vitro. Our results suggest that in mammals U2 snRNA can form base pairs with the branch site and the interaction between U2 and the branch site can be augmented or replaced by an interaction between the spliceosome and some other element of the intron or exons, perhaps the conserved polypyrimidine tract located immediately upstream from the 3' splice site. PMID- 2704745 TI - Allele-specific enzymatic amplification of beta-globin genomic DNA for diagnosis of sickle cell anemia. AB - A rapid nonradioactive approach to the diagnosis of sickle cell anemia is described based on an allele-specific polymerase chain reaction (ASPCR). This method allows direct detection of the normal or the sickle cell beta-globin allele in genomic DNA without additional steps of probe hybridization, ligation, or restriction enzyme cleavage. Two allele-specific oligonucleotide primers, one specific for the sickle cell allele and one specific for the normal allele, together with another primer complementary to both alleles were used in the polymerase chain reaction with genomic DNA templates. The allele-specific primers differed from each other in their terminal 3' nucleotide. Under the proper annealing temperature and polymerase chain reaction conditions, these primers only directed amplification on their complementary allele. In a single blind study of DNA samples from 12 individuals, this method correctly and unambiguously allowed for the determination of the genotypes with no false negatives or positives. If ASPCR is able to discriminate all allelic variation (both transition and transversion mutations), this method has the potential to be a powerful approach for genetic disease diagnosis, carrier screening, HLA typing, human gene mapping, forensics, and paternity testing. PMID- 2704746 TI - Variant translocation of the bcl-2 gene to immunoglobulin lambda light chain gene in chronic lymphocytic leukemia. AB - The bcl-2 gene has been identified as a gene directly involved in the consistent chromosome translocation t(14;18), which is found in approximately 90% of human follicular lymphoma cases, and is a prime candidate for the oncogene playing a crucial role in follicular lymphomagenesis. In this paper, we describe a case of chronic lymphocytic leukemia showing the juxtaposition of the bcl-2 gene on chromosome 18 to immunoglobulin lambda light chain (Ig lambda) gene on chromosome 22 in a head-to-head configuration. Sequencing analysis of the joining site of the bcl-2 gene and Ig lambda gene has shown that the breakpoint is within the 5' flanking region of the bcl-2 gene and about 2.2 kilobases 5' to the joining segment of Ig lambda locus in a germ-line configuration. The extranucleotide, commonly appearing at the joining site of the t(14;18) translocation involving the IgH locus, is absent from the joining site of bcl-2 and Ig lambda. The lack of extranucleotide suggests that the juxtaposition of the bcl-2 and Ig lambda genes occurred during physiological rearrangement of the Ig lambda gene since it has been shown that the rearrangement of the Ig lambda locus is not accompanied by extranucleotides. PMID- 2704747 TI - Mutation and selection in bacterial populations: alternatives to the hypothesis of directed mutation. AB - Bacterial populations have served as model systems for studying evolutionary processes ever since the classic experiments of Luria and Delbruck, which demonstrated the occurrence of mutations prior to selection for the traits they conferred. However, several authors have recently presented experiments suggesting that bacteria may have mechanisms for directing which mutations occur, such that the rate of adaptive mutations is enhanced. Before the hypothesis of directed mutation is accepted, it is imperative to consider alternative hypotheses that might account for the same observations. To this end, we expand upon existing mathematical theory of the dynamics of mutation and selection in clonal populations for two cases of particular interest. The first case concerns selection against mutants before plating; this selection occurs as the result of differences in growth rate between mutants and nonmutants. We demonstrate that this selection model gives rise to distributions of mutants, obtained by plating from sister cultures, that are very similar to those expected when some mutations are induced by the selective environment. The second case concerns the sequential incorporation of two mutations as the result of selection for an intermediate genotype after plating. We demonstrate that this two-step mutation model also yields distributions that are similar to those expected when some mutations are induced by the selective environment. These two cases therefore provide alternatives to the hypothesis of directed mutation. We suggest experiments that might be used to examine our alternative hypotheses. We also contrast the hypothesis of directed mutation with the notion of inheritance of acquired characteristics. PMID- 2704748 TI - Gastrin releases a blood calcium-lowering peptide from the acid-producing part of the rat stomach. AB - Gastrin-17 induces hypocalcemia in the rat without stimulating calcitonin release. The gastrin-induced hypocalcemia persisted after thyroparathyroidectomy or parathyroidectomy. In contrast, gastrectomy or extirpation of the acid producing part of the stomach prevented the hypocalcemic effect, suggesting the involvement of the proximal stomach in the gastrin-evoked lowering of blood calcium. The drop in blood calcium upon injection of gastrin-17 did not reflect a loss of calcium via the gastric juice or via the urine. Extracts of the acid producing mucosa of the rat stomach had a hypocalcemic effect. The extracts were purified by gel chromatography and reversed-phase high-performance liquid chromatography. Digestion with leucine aminopeptidase destroyed the hypocalcemic activity, while trypsin had no effect, suggesting a peptide (or peptides) with an unprotected NH2 terminus and without basic amino acid residues (or with protected basic amino acids). Both gastrin-17 and the mucosal extract stimulated the uptake of 45Ca into bone (radius and sternum). Gastrin-17 was without effect in rats that had undergone gastrectomy, while the mucosal extract was equally effective in gastrectomized and unoperated rats. We suggest that the effects of gastrin-17 on blood calcium and on calcium transfer into bone are indirect and that gastrin 17 stimulates the release of a peptide hormone, tentatively named gastrocalcin, from the acid-producing mucosa of the stomach. Gastrocalcin stimulates the uptake of 45Ca into bone, thereby causing hypocalcemia. PMID- 2704749 TI - Localization of tissue factor in the normal vessel wall and in the atherosclerotic plaque. AB - Tissue factor (TF)-producing cells were identified in normal human vessels and atherosclerotic plaques by in situ hybridization and immunohistochemistry using a specific riboprobe for TF mRNA and a polyclonal antibody directed against human TF protein. TF mRNA and protein were absent from endothelial cells lining normal internal mammary artery and saphenous vein samples. In normal vessels TF was found to be synthesized in scattered cells present in the tunica media as well as fibroblast-like adventitial cells surrounding vessels. Atherosclerotic plaques contained many cells synthesizing TF mRNA and protein. Macrophages present as foam cells and monocytes adjacent to the cholesterol clefts contained TF mRNA and protein, as did mesenchymal-appearing intimal cells. Significant TF protein staining was found deposited in the extracellular matrix surrounding mRNA positive cells adjacent to the cholesterol clefts and within the necrotic cores. These results suggest that deposition of TF protein in the matrix of the necrotic core of the atherosclerotic plaque may contribute to the hyperthrombotic state of human atherosclerotic vessels. PMID- 2704750 TI - GLQ223: an inhibitor of human immunodeficiency virus replication in acutely and chronically infected cells of lymphocyte and mononuclear phagocyte lineage. AB - GLQ223 is a highly purified, formulated preparation of trichosanthin, a 26-kDa plant-derived ribosome-inactivating protein with potent inhibitory activity against human immunodeficiency virus (HIV) in vitro. The compound produced concentration-dependent inhibition of HIV replication in acutely infected cultures of T-lymphoblastoid cells (VB cell line). Treatment with GLQ223 selectively reduced levels of detectable viral proteins compared to total cellular protein synthesis and produced a selective decrease in levels of viral RNA relative to total cellular RNA in acutely infected cells. Substantial inhibition of viral replication was observed at concentrations of GLQ223 that showed little inhibition of parallel uninfected cultures. Selective anti-HIV activity was also observed in cultures of primary monocyte/macrophages chronically infected with HIV in vitro. When freshly drawn blood samples from HIV infected patients were treated with a single 3-hr exposure to GLQ223. HIV replication was blocked for at least 5 days in subsequently cultured monocyte/macrophages, without further treatment. The anti-HIV activity of GLQ223 in both acutely and chronically infected cells and its activity in cells of both lymphoid and mononuclear phagocytic lineage make it an interesting candidate as a potential therapeutic agent in HIV infection and AIDS. PMID- 2704751 TI - In vitro duplication and in vivo cure of mast-cell deficiency of Sl/Sld mutant mice by cloned 3T3 fibroblasts. AB - Sl/Sld mutant mice are profoundly deficient in tissue mast cells as a result of a defect in the microenvironment promoting the development of these cells. To facilitate the analysis of the Sl mutation, we attempted to establish an in vitro system in which the in vivo defect of Sl/Sld mice could be reproduced. 3T3 cell lines were established from 17-day-old embryos of Sl/Sld and congenic +/+ genotypes and were cocultured with mast cells obtained in vitro from the bone marrow of +/+ mice. All eight 3T3 cell lines derived from +/+ of T-cell-derived growth factors. By contrast, none of eight 3T3 cell lines from Sl/Sld embryos supported mast cells under similar conditions. The defect in Sl/Sld 3T3 cells was further characterized as a failure to induce the G1-to-S transition in synchronized mast cells upon contact, suggesting that the Sl gene product is indispensable for this activity. When 3T3 cells of +/+ genotype, grown on pieces of cellulose acetate membrane, were transplanted into the peritoneal cavity of Sl/Sld mice, mast cells appeared locally in the transplanted 3T3 cell layers. These results suggested an essential role of fibroblasts in vivo as the tissue microenvironment promoting the development of mast cells and that they are defective in Sl/Sld mice. The present coculture system duplicated mast-cell deficiency of Sl/Sld mice in vitro and should prove useful for analysis of the Sl gene product. PMID- 2704752 TI - Relationship of insulin-like growth factor II gene expression in muscle to synaptogenesis. AB - A striking correlation between insulin-like growth factor II (IGF-II) gene expression and turnover of neuromuscular synapses was observed. The IGF-II gene was expressed at a high level in fetal rat hind limb muscles prior to the developmental formation of synapses and increased while polyneuronal innervation accumulated. Thereafter, there was a selective down-regulation of IGF-II mRNAs that was exactly coincident with the postnatal time course for elimination of superfluous synapses. The hypothesis that innervation might provide a signal suppressing IGF-II gene expression was tested. Upon transection of the sciatic nerve, there was up-regulation of IGF-II mRNA content in muscle. This up regulation was selective and correlated with the capacity of denervated muscle to accept reinnervation. These results suggest that the IGF-II gene may play a role in the development and turnover of synapses. PMID- 2704753 TI - Purification and sequencing of neuropeptides contained in neuron R15 of Aplysia californica. AB - R15 is a large identified neuron present in the abdominal ganglion of the mollusc Aplysia. Previous studies have indicated that this neuron may play a role in water balance and possibly renovascular functions. A peptidic factor contained in the neuron R15 has been shown to increase the water content of Aplysia. To determine the structure of the peptides contained in R15, we purified the extracts of 820 R15 cells by means of two steps of reverse-phase HPLC. The purification yielded a number of peptides, only one of which, R15 alpha 1, resulted in water uptake when injected into animals. Determination of the amino acid content and sequence analysis of the R15 alpha 1 peptide demonstrated that this peptide contains 38 residues, including two cysteines. The peptide failed to react with iodoacetate, indicating that the two cysteines are connected by a disulfide bridge. To confirm the assigned structure, the peptide was synthesized with a disulfide bridge. The chromatographic properties and bioactivity of the synthetic material were identical to those of the native peptide. Several other R15 peptides were inactive in the bioassay for water uptake. The sequence of one of these peptides (R15 beta) was determined, and it was established that the peptide contains 28 residues. Amino acid analysis of three other peaks was performed. One of these peaks contained a peptide (R15 beta f) whose amino acid composition suggests that it is a fragment of the R15 beta peptide. The other two peaks contained peptides with identical amino acid compositions, suggesting that they are variants of a single peptide (R15 gamma). The amino acid sequences of all the peptides identified in neuron R15 correspond to stretches of a polyprotein encoded by a recently sequenced R15 cDNA. PMID- 2704754 TI - Differential expression of acetylcholine receptor mRNA in nuclei of cultured muscle cells. AB - Muscle cells in vitro and in vivo are multinucleated and express acetylcholine receptors (AcChoRs). On innervated cells, the AcChoRs form clusters which lie under the nerve terminals. However, noninnervated cells in culture also express clusters of AcChoR. Both in vivo and in vitro the AcChoR clusters appear to be associated with clusters of nuclei. We have used in situ hybridization to determine whether all the nuclei in cultured chicken embryo myotubes are equally active in expressing the AcChoR alpha subunit message. Cells were hybridized with 35S-labeled probes that contained either both an exon and an intron region or only exon sequences. Control cultures were hybridized with a labeled actin DNA probe or poly(U). The hybrids were detected by emulsion autoradiography; simultaneously, the nuclei were visualized with bisbenzamide. Cells hybridized with the intron/exon probe showed a striking preferential silver grain localization in and around some of the myotube nuclei, whereas those hybridized with the exon probe gave a rather homogeneous grain distribution in the cytoplasm. These results show that myotube nuclei possess differential activation capacities for the expression of AcChoR alpha subunit mRNA and that this difference is due to differential rates of transcription. PMID- 2704756 TI - A question of ethics. PMID- 2704755 TI - Monitoring cytosolic free magnesium in cultured chicken heart cells by use of the fluorescent indicator Furaptra. AB - Cytosolic free magnesium concentration [Mg2+]i and its regulation were studied in cultured embryonic chicken heart cells by use of the fluorescent indicator 2-[2 (5-carboxy)oxazole]-5-hydroxy-6-aminobenzofuran-N,N,O-triacet ic acid (Furaptra). The intracellular location of Furaptra was confirmed by its complete release from cells upon addition of saponin. The basal [Mg2+]i, which averaged 0.48 +/- 0.03 mM (n = 31), increased 3-fold on perfusion with sodium-free solution. This increase could not simply be attributed to intracellular sodium-extracellular magnesium exchange because a similar increase in [Mg2+]i occurred with magnesium free, sodium-free perfusion. Furthermore, the increase in [Mg2+]i was largely attenuated when calcium was removed from the sodium-free perfusate. Thus, a substantial part of the increase in [Mg2+]i that occurs upon sodium-free perfusion is dependent on an increase in cytosolic free calcium (intracellular sodium-extracellular calcium exchange). The data suggest that [Mg2+]i is altered by calcium, most likely due to a competition for intracellular binding sites. PMID- 2704757 TI - Nursing care of adults having craniofacial surgery. PMID- 2704758 TI - Preoperative reasons for aesthetic surgery in men. PMID- 2704759 TI - Marketing to help keep the patients you already have. PMID- 2704760 TI - Blepharoplasty. PMID- 2704761 TI - Ethics--a dilemma unto itself. PMID- 2704763 TI - Prevention in practice. PMID- 2704762 TI - Managing malignant melanoma. PMID- 2704764 TI - Screening, diagnosis, and treatment of hypercholesterolemia. AB - All adults should be screened for high blood cholesterol. Those found to be high should undergo a diagnostic process to confirm and classify their disorder. Diet is recommended for all and drug therapy should be considered for those who do not meet treatment goals on diet. PMID- 2704765 TI - [Expert assessment of competence to make a will following the death of the testator]. AB - The paper expounds the legal basis in the DDR for preparing a retrospective assessment of a deceased person's capacity to make a will, and examines the special features and the conclusions of 26 expert psychiatric opinions. A commentary is supplied on the characteristics of the situation. PMID- 2704766 TI - [Psychogeriatric management and sectorized psychiatry]. AB - Together with a general assessment of gerontopsychiatric care in the Federal Republic of Germany, the paper presents a model in hospitalised gerontopsychiatric treatment that has been tested at Hanover College of Medical Studies (Medizinische Hochschule Hanover). Results presented cover a wide range of divergent disorders, and appear to justify the employment of the model elsewhere. PMID- 2704767 TI - [Changes in thyroid function in primary degenerative dementia processes]. AB - To overcome diagnostic uncertainties in early phases of Alzheimer's disease (pre senile dementia), the analysis of T-3 and T-4 concentration can be usefully employed. Arising out of the localisation neuropathological findings in Alzheimer type dementia, it could be that hormonal findings perform a useful function as indicators of a change in neurotransmitter activity in this disease. PMID- 2704768 TI - [Risk and value of conventional myelography with reference to the radiation burden of the patient]. AB - To estimate the effective equivalent dosage with reference to the area under examination and the foils employed, fifty patients underwent conventional diagnostic myelography, after which, by means of thermoluminescence surface dosimetry, the mean organ dosage was ascertained from the radiation field size, using a computer program ORDOS. Effective equivalent dosage can be used to determine the inherent risk of radiation injury involved. The risk-benefit ratios obtained would suggest that conventional myelography, prospectively in the form of digital myelography, and spinal computer tomography are not opposing but complementary approaches to spinal diagnosis. Spinal magnetic resonance (MR) merits discussion not from the aspect of exposure to radiation but that of availability. PMID- 2704769 TI - [The diagnostic significance of auditory evoked brain stem potentials in multiple sclerosis]. AB - 30 patients suffering from multiple sclerosis were examined by BERA among other audiological tests. In 47% we stated significant pathological BERA-latencies, in 53% pathological interpeak-intervals. The most patients have symptoms of brainstem, but 3 cases spinal symptoms. There are no constant correlations to subjective hearing threshold measurements. According to literature BERA, especially the measurement of interpeak-intervals, increases diagnostic security of the diagnosis multiple sclerosis. PMID- 2704770 TI - [Changes in psychophysical parameters in relation to computer screen control work sites]. AB - Exceptionally high demands on the psychonervous system of those engaged in certain regulatory capacities at the fluorescent screen are the order of the day. In such work, reliability of performance depends on the state of activation of the ions. Findings from the simultaneous measurement of critical fusion frequency and heartbeat frequency can be used to map out the state of activation of the ions. Optimum performance may be maintained at work for a period of up to five hours. After five hours under especially exacting working conditions, flicker frequency and heartbeat frequency were found to go into opposing phases. PMID- 2704771 TI - The future of psychoanalysis. PMID- 2704772 TI - Technique and countertransference in Freud's analysis of the Rat Man. AB - Freud's records of his treatment of the Rat Man constitute a unique document in the history of psychoanalysis. Through the years different analysts have used these records to support different theories about analytic technique. Certain non interpretive interventions of Freud's have especially aroused their interest, and many reasons have been put forward to "explain" Freud's behavior. One reason never yet advanced and documented is that a countertransference tension may have been involved in one of these instances. This is surprising, since countertransference is a necessary part of every analysis. Evidence is presented that Freud's behavior may indeed have been under the sway of countertransference. Some recently discovered details concerning his early life are discussed as constituting a plausible background for ths countertransference enactment. PMID- 2704773 TI - The psychoanalytic process and the development of insight in child analysis: a case study. AB - This paper describes a segment of the analysis of an aggressive latency-age child. The data demonstrate the relationship between the establishment of a psychoanalytic process (the analysis of transference, defense, and resistance), the development and nature of insight in the child, and the resulting therapeutic change. Examination of the process shows that the therapeutic gains were a result of insights acquired by the child, particularly his awareness of painful affects that had been warded off. This case is compared with Bornstein's treatment of a phobic child who manifested severely "out-of-control" behavior. PMID- 2704774 TI - Transitional phenomena, projective identification, and the essential ambiguity of the psychoanalytic situation. AB - Ambiguity, which is an intrinsic and essential aspect of the psychoanalytic situation, is related to the concepts of transitional phenomena and projective identification. The analyst's feelings of uncertainty that accompany this ambiguity are contrasted with a "pathological certainty." The consequences of the loss of ambiguity and the role of the analyst's countertransference in this process are described. PMID- 2704775 TI - [The significance of psychology in medicine]. AB - It is shown in a retrospective review how the specific political climate twenty years ago helped to establish psychosomatics, psychotherapy and medical psychology as disciplines in their own right. The "reform-minded" trend gave psychotherapy recognition as a treatment method to be acknowledged as cost refundable under the Federal German health insurance system. Furthermore, it prompted the Federal German government to start an inquiry into the present situation of psychiatry and psychosomatic medicine, whereas research workers at the base developed models of psychosocial working teams and of a renewal of sociopsychiatry. Meanwhile the political "turnabout" in the Federal Republic from a socioliberal to a predominantly conservative line has produced a conservative countercurrent: the medical institutions undergo reinstatement of ancient hierarchies, jobs in the psychosocial sphere are being dramatically axed, psychosomatics is being streamlined as an adapted auxiliary discipline ruled with an iron hand by a dramatically expanding clinical pathology or laboratory medicine and by a concept of "health" that is purely functional. Basing on the case history of a woman suffering from psychogenic sterility the author critically discusses the gap-clearly noticeable although frequently denied-now dividing the individual disciplines and schools of psychological medicine, separating in each case a preferably conformistic branch from a critically engaged one. PMID- 2704776 TI - [On the way to a pre-oedipal society]. AB - A quarter of a century after the publication of A. Mitscherlichs "Society without father" we have to state that his diagnosis should be extended and specified based upon a critical look at the moral theory of A. MacIntyre and the feminist anthropology of E. Badinter the thesis is developed that the decay of patriarchal social structures is connected with a regression towards a pre-oedipal society. PMID- 2704777 TI - [The finite nature of human life and its significance in the perception of neurotic patients]. AB - This article is a presentation of the manifold fears that beset humans in respect of dying and death-based on case reports-as are frequently encountered in patients suffering from anxiety neuroses, phobias and obsessional neuroses, hypochondria and depersonalisation syndromes. The links between these individual fears with the personality structure of the affected person are discussed. This also raises the question to what extent these fears become manifest because of a slackening of the defence mechanisms. It appears to be a characteristic sign of the times that collective worries about the finite nature of human life focus entirely on dying, whereas the problems and questions regarding death itself are not subject to any discussion. PMID- 2704778 TI - [Ethics in psychotherapy]. AB - After introducing the terms "morality" and "ethics" as defined by Patzig, the discussion focuses on applying to the practicing of psychotherapy the guidelines for ethics in medicine formulated by Beauchamp and Childress, i.e. respect of the autonomy of the patient, the doctor's duty to prevent injury, the obligation to give assistance and the principle of fairness. In particular, it is pointed out that to hale respect for the autonomy of the patient, a thorough and patient inquiry concerning diagnosis, indication and therapy is necessary in order for the patient to develop intrinsic motivation based on insight into his condition and evaluation of the prognosis. In connection with the discussion of the nil nocere, reference is made to the therapist's duty to take a patient's various limits of tolerance into account. Emphasis is also placed on the psychotherapist's duty to "service" his own psychic apparatus with the help of continued education and in-service training, supervision and self-analysis. Applied to psychotherapy, the obligation to give assistance means encouraging the patient to go in the direction of greater autonomy which means the reduction of helplessness. In psychotherapy, problems of distributing resources fairly may be manifested in unjustifiably long waiting lists or in the form of patient selection carried out in a way that is not justifiable on medical grounds but based rather on a tendency to eliminate certain groups of disorders by using contra-indications that are basically rationalizations of countertransference reactions and which are not in keeping with the professional and personal identity of therapists. PMID- 2704779 TI - [The psychosocial position of internal medicine patients following admission to the hospital--an empirical study]. AB - 56 patients with an average age of 55 years have been interviewed about their psychosocial situation at the 3rd till 5th day of treatment in a medical department of a hospital. They were more disturbed by their illness than by the medical therapy, although some were even stressed hardly by routine investigations like taking blood or sonographies. The hospital atmosphere was also found to be a source of disturbances (tying away from home, immobilisation). Especially patients older than 60 years, patients who were ill for the first time and those, who were not sufficiently informed had difficulties in adaptation. Female patients had more problems than male patients to cope with the changes. In further studies the different distressing factors and the strategies of coping of the ill should be investigated more exactly during the whole stay in hospital, to develop specific offers to help the patients. PMID- 2704781 TI - ANA to act on shortage commission's recommendations. PMID- 2704780 TI - [The development and status of inpatient psychotherapy in The Netherlands]. AB - Based on experiences of world war two the "Militair Neurose Hospitaal" was founded. It became an outstanding training place for young psychiatrists due to its psychoanalytic, groupdynamic and milieutherapeutic concepts. It also became a model for numerous neuroses hospitals to be fonded. In this paper the further development of therapy and research in this domaine is described. Finally a restructuring of clinical units is presented, differentiating the hospital in social psychiatric units on the one hand and real psychotherapeutic wards on the other hand. PMID- 2704782 TI - A Markov formulation of the repair-misrepair model of cell survival. AB - Tobias' repair-misrepair (RMR) model of cell survival is formulated as a Markov process, a sequence of discrete repair steps occurring at random times, and the probability of a sequence of viable repairs is calculated. The Markov formulation describes the time evolution of the probability distribution for the number of lesions in a cell. The probability of cell survival is calculated from the distribution of the initial number of lesions and the probabilities of the repair events. The production of lesions is formulated in accordance with the principles of microdosimetry, and the distribution of the initial number of lesions is obtained as an approximation for high and low linear energy transfer cases. The Markov formulation of the RMR model uses the same biological hypotheses as the original version with two statistical approximations deleted. These approximations are the neglect of the effect of statistical fluctuations in calculating the average rate of repair of lesions and the assumption that the final number of unrepaired and lethally misrepaired lesions has a Poisson distribution. The quantitative effect of these approximations is calculated, and a basis is provided for an alternative approach to calculating survival probabilities. PMID- 2704783 TI - Cell cycle traverse in NHIK-3025 carcinoma of the uterine cervix after low-dose rate irradiation. AB - Theoretically, fractionation schemes could be tailored to the individual pattern of radiation-induced synchronization of cells in the radiosensitive G2 phase, leading to more effective radiotherapy. Using a human cervical carcinoma xenografted to nude mice, the effects of low-dose-rate irradiation on the cell cycle distribution were studied. Flow cytometric analysis demonstrated that cells accumulated in G2 + M phase 35 h after a total dose of 10 Gy of 137Cs irradiation. This accumulation time corresponded closely to the cell cycle time (Tc) (31 h) of this tumor, as determined by autoradiography. Further experiments are planned to determine the potential of fractionation schemes adjusted to the Tc-related accumulation in G2 in improving the effectiveness of radiotherapy. PMID- 2704784 TI - Response of a brachytherapy model using 125I in a murine tumor system. AB - The effects of low-dose-rate irradiation (brachytherapy) were investigated in vivo using a murine mammary adenocarcinoma (MTG-B) growing in the flank of C3H mice. For local tumor irradiations, a noninvasive cap was devised to cover the tumor and house three 125I seeds (average apparent activity 5.2 mCi each) located at 120 degree intervals around the circumference of the hemispherical cap (13 mm i.d.). Mice were secured during treatment in a tube allowing limited mobility while restricting access to the seeds. Tumors were exposed to a series of dose rates ranging from 14-40 cGy/h, and the total dose over the treatment interval (48 or 72 h) ranged from 830 to 2378 cGy. A total of nine experiments were conducted using the caps over a 10-week interval. In each experiment three groups (irradiated tumors, sham controls, and untreated controls) were analyzed, each containing 8-15 mice (N = 34, untreated control; N = 46, sham control; N = 91, brachytherapy irradiation). The brachytherapy results are compared to the effects of external beam irradiation in the same tumor system. A linear relationship was observed between the total radiation dose and doubling volume growth delay (GDDV) or treatment volume growth delay (GDTV) for the brachytherapy and external beam irradiation. The slopes of the dose-response curves are steeper for the acute dose (517 cGy/min) external beam irradiation (0.0072 day/cGy, GDDV; 0.00695 day/cGy, GDTV) than for the brachytherapy (0.0050 day/cGy, GDDV; 0.0057 day/cGy, GDTV) using both GDTV and GDDV end points. Comparison of the tumor volume regrowth slopes indicates that the tumor bed effect is larger for external beam irradiation than for brachytherapy, suggesting that the tumor bed effect may be dose-rate dependent. PMID- 2704785 TI - Effect of pretreatment with cysteamine on gamma-radiation-induced sister chromatid exchanges in mouse bone marrow cells in vivo. AB - The effect of pretreatment with cysteamine on gamma-radiation-induced sister chromatid exchanges (SCEs) and on the mitotic index and average generation time was determined. Groups of mice were treated in one of the following regimens: (1) irradiated, (2) treated with cysteamine and irradiated, (3) treated with cysteamine only, or (4) left untreated. Intraperitoneal administration of cysteamine preceding gamma-radiation exposure protected against SCE induction. However, radioprotection was not reflected by change in the mitotic index or in the average generation time. The results suggest that, under the experimental conditions of this study, the SCEs are caused by free radicals produced by gamma radiation, but not the additional damage indices measured. PMID- 2704786 TI - Life shortening in mice exposed to fission neutrons and gamma rays. VIII. Exposures to continuous gamma radiation. AB - Data are presented on the mean aftersurvival of male B6CF1 mice exposed for 22 h per day, 5 days per week, to 60Co gamma radiation at dose rates of 1.36 to 12.64 x 10(-3) cGy/min for 23 weeks or 1.36 to 6.32 x 10(-3) cGy/min for 59 weeks. For deaths from all causes, linear dose-response curves were obtained with slopes (days of life lost/cGy) of 0.158 +/- 0.016 and 0.077 +/- 0.002 for 23- and 59 week exposures, respectively. These values were not significantly altered when the analysis was restricted to those mice dying with tumors (92% of the total) or to those presumably dying from tumors (82% of the total). Analysis of mortality rates showed that about 90% of the radiation-specific excess mortality was tumor related. The 59-week exposure series induced only a small increase in the number of days of life lost/cGy/weekly fraction over that induced by 23 weeks of irradiation, 4.53 +/- 0.15 compared to 3.64 +/- 0.36 days lost/cGy/weekly fraction. This lower than expected value for 59 weeks of exposure may signal the approach to the final linear, additive, injury term postulated from earlier studies at this laboratory with low-dose-rate, daily, duration-of-life 60Co gamma irradiation. PMID- 2704787 TI - The radiosensitivity of kidney colony-forming cells: a short-term assay in situ in the mouse. AB - A short-term colony assay for renal tubule epithelium has been developed. Uranyl nitrate (UN) is a heavy metal nephrotoxin that induces acute tubule necrosis followed by a large compensatory increase in the rate of cell proliferation in the nephron. UN was used to precipitate latent damage following renal irradiation. Using a subcapsular colony count at 14 days after unilateral irradiation, a single-dose cell survival curve was obtained with a D0 of 4.2 +/- 0.3 Gy. High-dose irradiation of an exteriorized kidney resulted in a survival curve which was biphasic, with a plateau in survival between 18 and 40 Gy. Subtraction of this plateau level from all the survival data gave D0 values of 2.5 +/- 0.2 Gy (data analyzed between 7.5 and 16 Gy) or 2.0 +/- 0.2 Gy (over range 12-16 Gy). The D0 value obtained at 20 months after bilateral (or unilateral) kidney irradiation, without the use of UN, was 2.9 +/- 1.1 Gy (over range 10-14 Gy). PMID- 2704788 TI - Cell death (apoptosis) in mouse intestine after continuous irradiation with gamma rays and with beta rays from tritiated water. AB - Apoptosis is a pattern of cell death involving nuclear pycnosis, cytoplasmic condensation, and karyorrhexis. Apoptosis induced by continuous irradiation with gamma rays (externally given by a 137Cs source) or with beta rays (from tritiated water injected ip) was quantified in the crypts of two portions of mouse bowel, the small intestine and descending colon. The time-course change in the incidence of apoptosis after each type of radiation could be explained on the basis of the innate circadian rhythm of the cells susceptible to apoptotic death and of the excretion of tritiated water (HTO) from the body. For 6-h continuous gamma irradiation at various dose rates (0.6-480 mGy/h) and for 6 h after injection of HTO of various radioactivities (0.15-150 GBq per kg body wt), the relationships between dose and incidence of apoptosis were obtained. Survival curves were then constructed from the curves for dose vs incidence of apoptosis. For the calculation of the absorbed dose from HTO, the water content both of the mouse body and of the cells was assumed to be 70%. One megabecquerel of HTO per mouse (i.e., 40 MBq/kg body wt) gave a dose rate of 0.131 mGy/h. The mean lethal doses (D0) were calculated for gamma rays and HTO, and relative biological effectiveness values of HTO relative to gamma rays were obtained. The D0 values for continuous irradiation with gamma rays were 210 mGy for small intestine and 380 mGy for descending colon, and the respective values for HTO were 130 and 280 mGy, indicating the high radiosensitivity of target cells for apoptotic death. The relative biological effectiveness of HTO relative to 137Cs gamma rays for cell killing in both the small intestine and the descending colon in the mouse was 1.4-2.1. PMID- 2704789 TI - A general approach to chord length distributions applied to a hemisphere. AB - General formulas for chord and related joint density distributions of convex volumes are derived and applied to the hemisphere. The resulting single integral for the joint chord length and beam angle distribution is evaluated analytically. The chord length distribution is obtained by the same methods by evaluating a double integral. Both results are presented graphically, and accurate agreement with norm and average chord length is exhibited. The chord distribution agrees with previous work. While not new, the general approach used here appears to be of more extensive applicability than current methods, potentially applying to all chord and related distributions of all convex volumes. PMID- 2704790 TI - Measurements of neutron energy using a recoil-proton telescope and a high pressure ionization chamber. AB - Two very different techniques for measuring the energy of neutrons in the energy range 0.1-10 MeV are presented and compared. A recoil-proton spectrometer is used to determine the energy spectra of neutrons produced by the d(4)-Be and p(4)-Be reactions down to the low-energy threshold of 0.7 MeV. The same radiation fields are also measured with a recently developed method using a high-pressure ionization chamber that can be used to determine the mean energy of the neutrons in a mixed neutron-gamma radiation field provided the gamma-ray absorbed dose fraction is determined independently. An intercomparison of the two methods shows that the high-pressure ionization chamber compares well and supplements the established recoil-proton spectrometer technique. The almost isotropic response of the chamber has enabled measurements to be made of the variation of mean neutron energy with depth in water for the two radiation fields. PMID- 2704791 TI - Thermalization of subexcitation electrons in solid water. AB - We present the results of our Monte Carlo simulations of the slowing down and thermalization of subexcitation (E less than 7.4 eV) electrons in solid water. The scattering cross sections used in the simulations were obtained in another study from the analysis of electron-impact experiments performed on thin ice films deposited on a metal substrate at 14 K. The procedure by which these cross sections were determined is tested with our simulation code and is shown to be satisfactory. We find an average electron thermalization distance of approximately 13 nm, which is larger than what is usually assumed (2-7 nm) in models describing the diffusion-controlled track reactions which occur after 10( 12) s in irradiated liquid water. As for our calculated average thermalization time, it is of the order of 10(-13) s, in good agreement with experimental observations. To show the progression of the thermalization process, we give the distributions of slowing-down distances and times obtained for different stages of this process. The possibility that the subexcitation electrons undergo a dissociative attachment to water molecules is considered and its consequences on the initial yield of various chemical species are discussed. In particular, this dissociative attachment could provide a new explanation for the origin of the unscavengeable initial yield of molecular hydrogen. PMID- 2704792 TI - LET spectra of cosmic-ray nuclei for near earth orbits. AB - Measurements of cosmic-ray LET spectra were part of the radiobiological space research programs during the Spacelab 1 (SL-1) and the D1 missions. We analyzed CR-39 plastic nuclear track detectors of the Advanced Biostack experiment of SL-1 and of the Dosimetric Mapping and Carausius morosus experiments in the BIORACK on D1. The particle tracks in the CR-39 were detected and measured by an automatic scanning and measuring system. An in-flight calibration was derived from track measurements of minimum ionizing oxygen and iron nuclei and of stopping nuclei as a function of the residual range. LET spectra measured at different locations in the space shuttle are presented and discussed for both missions. A model describing the effects of the geomagnetic field of the earth on charged cosmic ray particles and the shielding by matter is used to calculate LET spectra for the two missions and for typical space station orbits at low inclinations. A comparison of measured LET spectra and LET spectra calculated for different flight parameters shows that besides geomagnetic shielding the shielding by matter is most important in comparison to solar modulation and to variation of particle flux with flight altitude. Model calculations must be improved and must consider more detailed sectored shielding by matter and the influence of trapped radiation. The last item is of importance in the case of low-inclination orbits. PMID- 2704793 TI - Radiobiology of ultrasoft X rays. II. Cultured C3H mouse cells (10T1/2). AB - In the first paper of this series (Radiat. Res. 110, 396-412 (1987], using V79 cells, we reported that the relative biological effectiveness (RBE) of ultrasoft X rays was found to increase with decreasing energy, and the oxygen enhancement ratio (OER) was found to decrease with decreasing energy. In this report, we present RBE and OER results for 10T1/2 cells that are known to grow uniformly flat and are considerably thinner than V79 cells. Thus the variation in dose across the cell nucleus is considerably reduced. The OER results agree well with our earlier V79 results. However, the RBE values for 10T1/2 cells compared to V79 cells are systematically less for all soft X rays and especially for 0.28 keV carbon-K (1.3 compared to 3.4 for V79 cells). Some plausible explanations are presented to reconcile the apparent discrepancy between V79 and 10T1/2 results. PMID- 2704794 TI - Accelerated heavy particles and the lens. III. Cataract enhancement by dose fractionation. AB - For a number of biological end points it has been shown that, in contrast to low linear energy transfer (LET) radiation, dose fractionation of high-LET radiation does not result in a reduction in overall effectiveness. Studies were conducted to determine the effect of fractionating the exposures to heavy ion doses on the development of cataracts. Rat eyes were exposed to single doses of 1, 5, and 25 cGy of 570 MeV/amu40Ar ions and to 2, 4, and 10 Gy of 250 kVp X rays. These were compared to unirradiated controls and eyes which were exposed to the same total dose delivered in four fractions over 12 h. While in all cases fractionation of the exposure to X rays produced significant reduction in cataractogenic potential, fractionating doses of 40Ar ions caused a dose- and stage-dependent enhancement in the development of cataracts. PMID- 2704795 TI - On research, training, politico-economics, and radiology. PMID- 2704796 TI - MR imaging of the uterus. PMID- 2704797 TI - Short TI inversion-recovery imaging of the liver: pulse-sequence optimization and comparison with spin-echo imaging. AB - Magnitude-reconstructed short inversion-time (TI) inversion-recovery (IR) sequences have the advantage of reducing the signal of fat while providing additive T1 and T2 contrast. A double-echo short TI IR sequence was implemented to offer different degrees of T1- and T2-dependent image contrast. In 50 consecutive patients with proved liver tumors (30 metastases, 13 hemangiomas, seven other primary liver tumors), images obtained with a double-echo IR sequence at a repetition time (TR) of 1,500 msec, echo time (TE) of 30 and 60 msec, and TI of 80 msec (TR/TE/TI = 1,500/30, 60/80) were compared with those obtained with spin-echo (SE) sequences at a TR of 275 msec and a TE of 14 msec (TR/TE = 275/14) and 2,350/60, 120, 180. Metastases-liver contrast-to-noise ratios were highest at SE 275/14, followed by IR 1,500/30/80 and SE 2,350/180. IR 1,500/30/80 and SE 275/14 sequences consistently showed higher sensitivity for the detection of metastases than T2-weighted SE sequences. Differential diagnosis of benign and malignant lesions was more reliable with T2-weighted SE sequences than T2 weighted short TI IR sequences. PMID- 2704798 TI - Intrahepatic periportal abnormal intensity on MR images: an indication of various hepatobiliary diseases. AB - The frequency and degree of intrahepatic periportal abnormal intensity (PAI) on magnetic resonance images in patients with or without various hepatobiliary and pancreatic diseases were analyzed. In 63 patients without hepatobiliary disease, except for a small metastatic liver tumor or cavernous hemangioma, no definite PAI was seen. Definite PAI was seen in all patients with obstructive jaundice, cholangitis, and cholangiocellular carcinoma. It was also clearly seen in all four cases of malignant lymphadenopathy in the hepatoduodenal ligament, in one of two cases of acute hepatitis, and in four of 47 cases of liver cirrhosis. However, in patients with bile duct dilatation or with gallstone or pancreatic disease without obstructive jaundice or cholangitis, no definite PAI was seen. Histologic studies of the liver performed in 23 patients with definite PAI showed edema, ductular proliferation, dilatation of lymph vessels, and inflammatory cell infiltration in portal tracts. It is concluded that definite intrahepatic PAI is a useful sign that indicates the presence of biliary or diffuse hepatic disease. PMID- 2704799 TI - Chronic pancreatitis: reassessment with current CT. AB - A retrospective analysis was performed of contrast material-enhanced current generation computed tomographic (CT) examinations in 56 patients with documented chronic pancreatitis. Dilatation of the main pancreatic duct was seen in 68% of cases, parenchymal atrophy in 54%, pancreatic calcifications in 50%, fluid collections in 30%, focal pancreatic enlargement in 30%, biliary ductal dilatation in 29%, and alterations in peripancreatic fat or fascia in 16%. The relatively small proportion of examinations in which no abnormalities were observed, 7%, differs from that in early reports, as does the absence of generalized pancreatic enlargement. Pancreatic ductal dilatation and parenchymal atrophy were notably more prevalent than reported previously. Nine of the 17 patients with focal pancreatic enlargement had calculi within the mass, which suggested benign disease; of the eight other patients, two of whom had coexistent carcinoma, this finding was absent and the masses were considered indeterminate at CT. PMID- 2704800 TI - Equivocal mammographic findings: evaluation with spot compression. AB - Seventy-five spot compression views of equivocally suspicious lesions detected at routine mammographic examination of 72 women were reviewed in this retrospective study. Sixty-five of the 75 lesions appeared less suspicious on spot compression views, two did not change, and eight appeared more suspicious. Biopsy findings confirmed that the eight more suspicious lesions were cancer. The adjunctive use of spot compression helped characterize equivocal findings seen on routine mammographic views and improved the accuracy of mammographic interpretation. PMID- 2704801 TI - Thoracic outlet syndrome: evaluation with CT. AB - Diagnosis of the thoracic outlet syndrome is often difficult, particularly in patients without osseous abnormalities on plain radiographs. The radiographic and computed tomographic (CT) findings were reviewed from 27 patients with thoracic outlet syndrome and 21 normal subjects. The plain radiographs and CT scans were assessed by two independent observers without awareness of the clinical history. Fifteen patients with thoracic outlet syndrome had osseous abnormalities (anomalous cervical ribs; abnormally long, drooping C-7 transverse processes) identifiable on plain radiographs. CT did not provide further diagnostic information in the patients with abnormal radiographs. Eight of 12 patients (66%) with normal plain radiographs had abnormal findings on CT scans, consisting of impingement of the C-7 transverse process on the scalene triangle or anteromedial aspect of the middle scalene muscle. Only two of 21 control patients (9.5%) displayed this CT abnormality (P less than .01). CT may be useful in patients with symptoms suggestive of thoracic outlet syndrome and no osseous abnormalities on plain radiographs. PMID- 2704802 TI - Aging of the diaphragm: a CT study. AB - To determine the normal morphologic evolution of the diaphragm with aging and to correlate age-related changes with other indicators of physical condition--such as skeletal muscle status, obesity, presence of pulmonary emphysema, and presence of esophageal hiatus hernia--a systematic morphometric and morphologic evaluation of computed tomographic studies of 120 patients from the 3d to 8th decades of life was undertaken. Diaphragm muscle thickness did not change significantly with increasing age. Diaphragmatic defects and pseudotumors, nonexistent in the 3d and 4th decades, increased in number and severity to affect 56% of the patients in the 7th and 8th decades. Neither the status of the skeletal muscle nor the presence of obesity correlated with age or with the presence of diaphragmatic defects. Eighty-four percent of the patients with emphysematous changes demonstrated diaphragmatic defects; thus, a strong association with emphysema was observed. If emphysematous patients are excluded, defects were more common in women. The esophageal hiatus width was found to increase with age. PMID- 2704803 TI - Pulmonary vasculature: high-resolution MR imaging. Work in progress. AB - High-resolution magnetic resonance (MR) imaging of the lung has the potential to depict not only small pulmonary vascular structures but also pulmonary blood flow. Five healthy volunteers were examined to assess the effects of (a) the use of two 5-inch surface coils located on the anterior and posterior chest walls, with a 24-cm field of view and a matrix of 256 X 256; (b) spin-echo acquisition with electrocardiographic (ECG) gating during systole or diastole; and (c) gradient recalled acquisition in a steady state (GRASS) with breath holding. These techniques yielded images showing small peripheral pulmonary vascular structures. Most subsegmental vessels and sixth- and seventh-order branches could be traced, especially near the coils. GRASS images obtained with dual surface coils and breath holding depicted fifth- and sixth-order branches. Preliminary results indicated that small pulmonary vessels can be imaged with MR with a combination of high-resolution techniques and ECG gating in diastole. The sensitivity and reproducibility of these techniques in demonstrating pulmonary vasculature warrant further investigation. PMID- 2704804 TI - Pulmonary edema localized in the right upper lobe accompanying mitral regurgitation. AB - Focal patterns of pulmonary edema are confusing and often mistaken for the more common causes of focal lung disease, pneumonia, infarction, or aspiration. The authors report four cases of right upper lobe edema secondary to mitral regurgitation. The pathogenesis believed to be responsible for this condition is the vector of blood flow from the left ventricle to left atrium, which may be targeted at the right superior pulmonary vein, locally accentuating the forces for edema formation in the right upper lobe. Pulmonary edema accompanying mitral regurgitation should be suspected whenever right upper lobe consolidation develops in a patient with known or suspected mitral valve disease. The presence of interstitial edema in the remainder of the lungs can help in the differentiation of this condition from pneumonia and other disorders. PMID- 2704805 TI - Hickman nodule: a mimic of metastatic disease. AB - A characteristic small subcutaneous soft-tissue mass can be seen on the computed tomographic scans of patients after removal of Hickman catheters. The mass is indistinguishable from subcutaneous metastatic deposits seen with a variety of malignant tumors. This potentially confusing finding can be differentiated from true metastatic disease by the characteristic location of the subcutaneous nodule in the second or third anterior intercostal space, along the midclavicular line, and by the absence of other subcutaneous masses. PMID- 2704806 TI - Brucellar and tuberculous spondylitis: comparative imaging features. AB - Radiographs, scintigrams, computed tomographic scans, and magnetic resonance (MR) images of 17 patients with brucellar spondylitis and 15 with tuberculous spondylitis were analyzed to identify distinguishing features. Characteristic findings of brucellar spondylitis included predilection for the lower lumbar spine (68% of lesions), bone destruction limited to the end plates, disk collapse (16 of 19 disks), and granulation tissue or localized soft-tissue edema (17 of 19 sites). MR imaging showed diffuse increased signal in vertebrae and disks on long repetition time (TR)/echo time (TE) images in four patients and focal increased signal with normal disks in one. Epidural extension was best seen on short TR/TE images in four. Tuberculous spondylitis was characterized by predilection for the midthoracic spine (73%), vertebral destruction with gibbus deformity (60%), disk collapse, and paraspinal abscesses (14 of 15). On MR images signal intensity of affected vertebrae was similar to but more severe than findings in patients with brucellar spondylitis. Scintigraphy was the least helpful in differentiating the two infections. Lesions of tuberculous spondylitis affecting the lower lumbar spine were difficult to differentiate from those of brucellar spondylitis. PMID- 2704807 TI - Life-threatening intraperitoneal bleeding: demonstration with CT. AB - The authors report a case in which computed tomography (CT) demonstrated life threatening peritoneal hemorrhage from severe trauma. CT scans through the upper abdomen showed focal collection of extravasated contrast material; scans through the lower abdomen revealed a large hemoperitoneum with highest attenuation values near the site of contrast material extravasation. Upon recognition of this sign, the trauma radiologist can speed the patient to appropriate emergency surgery. PMID- 2704808 TI - Percutaneous drainage of chest abscesses in children. AB - Seven patients ranging in age from 3 to 18 years underwent percutaneous drainage of eight intrathoracic abscesses. Five of the abscesses were mediastinal or paramediastinal and resulted from esophageal perforation or esophageal anastomotic leakage. The abscesses resolved in each case, with a mean catheter drainage time of 28 days and no need for surgical intervention. Three of the abscesses were intrapulmonary, and each lay adjacent to a pleural surface. All three lung abscesses resolved within 19-24 days, without thoracotomy or wedge resection. PMID- 2704809 TI - Intratemporal vascular tumors: detection with CT and MR imaging. AB - The diagnostic contributions of computed tomography (CT) and magnetic resonance (MR) imaging were compared in 12 patients with benign intratemporal vascular tumors (hemangioma or vascular malformation). The tumors included six in the internal acoustic canal and six in the geniculate ganglion region. Clinical and histologic correlations were made. Two of the six patients with tumors in the internal acoustic canal underwent CT, and both required gas cisternography to show the tumor. Five patients in that group underwent MR imaging, and all five studies showed the tumor. All six patients with geniculate ganglion tumors underwent CT. Results in one study were questionable, and five showed the tumor. Five patients in this group underwent MR imaging, but the MR findings were positive in only two cases. MR imaging should therefore be performed before CT in the evaluation of facial nerve dysfunction, as it demonstrated all tumors in the internal acoustic canal and some in the geniculate ganglion region. If MR findings are negative, CT should then be performed to rule out a possible geniculate ganglion lesion. PMID- 2704810 TI - Nonacute subdural hematoma: fundamental interpretation of MR images based on biochemical and in vitro MR analysis. AB - Few reports have described the nature of the appearance of nonacute subdural hematoma on magnetic resonance (MR) images. The authors analyzed MR images in 39 cases of nonacute subdural hematoma and subdural effusion by measuring in vitro proton relaxation times and the biochemical variables of hematoma fluids. T1 became proportionally shorter than T2 with an increase in hematocrit but the direct cause of the variation in T1 and T2 was the amount of methemoglobin. The free iron content, not the bound iron content, was another main cause for shortened T1 and T2. Paradoxical findings in the correlation between the total protein or albumin concentration and relaxation times were noted. It is possible that as the protein level in the supernatant increased, more free iron was bound to the protein, decreasing the influence of the free iron on the relaxation times. PMID- 2704811 TI - Cerebral cysticercosis: documentation of natural history with CT. AB - The purpose of this study was to describe the natural history of untreated cysticercosis as monitored by cranial computed tomography (CT) and correlate it when possible with the pathologic stage of the disease noted at surgery. Serial CT was performed in 113 patients; two to four scans were obtained in each patient. Correlation with surgical specimens and clinical presentation is given. In the early, acute stage, focal nonenhancing areas of edema progress to homogeneously enhancing lesions. In the chronic phase, beginning a few months after infestation, nonenhancing cysts are seen, which later demonstrate ring enhancement. Lesions may then completely resolve or may resolve only to appear later as punctate calcifications. This radiologic progression suggests the need to reevaluate current concepts in therapy and diagnosis of this disorder. Studies on therapeutic efficacy should be based on both the improvement of clinical symptoms and evidence of lesion regression at CT. PMID- 2704812 TI - Posterior fossa hemangioblastomas: MR imaging. AB - The magnetic resonance (MR) imaging findings of 18 surgically proved posterior fossa hemangioblastomas (15 patients) were retrospectively analyzed and correlated with computed tomographic (ten patients) and angiographic (eight patients) findings. Thirteen tumors were located in the cerebellar hemisphere, three in the vermis, and two in the medulla with associated syrinxes. Three patients had von Hippel-Lindau disease, two of whom had multiple cerebellar hemangioblastomas. Seven hemangioblastomas appeared as solid tumors, six as solid masses with central cysts, and five as cysts with mural nodules. Abnormal tumor vessels, with characteristic signal void, were demonstrated in 13 tumors. Associated hemorrhage was present in four tumors. Although angiography is usually required for the diagnosis and preoperative assessment of this tumor, MR imaging demonstration of a posterior fossa mass with abnormal vessels should suggest the diagnosis of hemangioblastoma. Moreover, the combination of a peripheral posterior fossa cyst with a mural nodule supplied by enlarged vessels may be pathognomonic. PMID- 2704813 TI - Synergy of chymopapain and diatrizoate studied in an experimental model. AB - The effect of diatrizoate on the chronic toxicity of chymopapain in the epidural space was studied. Chymopapain was injected epidurally into four monkeys; chymopapain plus diatrizoate meglumine, into four. In 3 months, neither group developed significantly more arachnoiditis than a control group of animals that had received epidural injections of physiologic saline. No synergistic effect of chymopapain and diatrizoate on the meninges was detected. PMID- 2704814 TI - Laser-induced thermal occlusion of berry aneurysms: initial experimental results. AB - An intravascular laser-catheter technique was used to occlude 12 experimental berry aneurysms, ranging in size from 4 X 3 mm to 8 X 6 mm (length X width), while the patency of adjacent arteries was preserved. A small steel cap on the end of an optical fiber was fluoroscopically positioned within the aneurysm. The cap was rapidly heated by the optical transmission of laser energy. This produced a thermal tissue reaction within the aneurysm, resulting in its occlusion. After treatment, the steel cap was detached atraumatically from the fiber and left as a permanent implant within the occluded aneurysm. This method has an advantage over the use of a bare-ended intravascular optical fiber because the steel cap provides a uniform distribution of thermal energy, thereby reducing the risk of unexpected perforation during treatment. The radiologic and histologic results of using this laser-catheter system were evaluated 1-21 weeks after treatment. PMID- 2704815 TI - CT-guided biopsy: prospective analysis of 1,000 procedures. AB - The authors prospectively analyzed 1,000 biopsies guided with computed tomography (CT) and performed in 955 patients over a 30-month period. All patients were followed up from 3 months to 2 years. The biopsies were performed in an average of 22 minutes (range, 3-85 minutes) by 26 different radiologists; five radiologists performed 547 of the procedures. Of the 1,000 biopsies, 722 were performed in areas in the liver, retroperitoneum, pancreas, pelvis, and adrenal glands. Of 69 errors in diagnosis, 67 were falsely negative and two were falsely positive; 747 true-positive and 184 true-negative diagnoses were made. CT directed biopsy for accurate diagnosis was 91.8% sensitive and 98.9% specific, with a positive predictive value of 99.7% and a negative predictive value of 73.3%. Of 11 patients with complications, seven had hematomas, three had pneumothorax, and one had hematuria. No deaths occurred, and only one patient required surgery. PMID- 2704816 TI - Postoperative abscesses with enteric communication: percutaneous treatment. AB - Patients with abscesses that have enteric communication in the absence of underlying inflammatory bowel disease require modification of the usual percutaneous treatment techniques. An ongoing source of output (gastrointestinal secretions) is a complicating factor in treatment. The results of percutaneous treatment of 17 abscesses with enteric communication in 16 patients without a history of inflammatory bowel disease were reviewed. The long-term cure rate was 71%. Pancreatic involvement in abscess-bowel communication diminished the cure rate to 50% (two of four) and lengthened the duration of drainage required. The results suggest that percutaneous treatment of abscesses with enteric communication is a viable alternative to surgical intervention. Minimal morbidity and no mortality were directly attributable to percutaneous therapy in this series. When the pancreas is involved in the establishment or persistence of the abscess-bowel communication, or when the underlying bowel is diseased, the rate of success decreases. PMID- 2704817 TI - Informed consent for intravascular administration of contrast material: how much is enough? AB - To determine the usefulness of informed consent prior to the intravascular administration of contrast material, the authors evaluated four equal groups of patients with different degrees of counseling concerning risks and risk factors. Group 1 was given no information. Group 2 was informed of the common risks in a written statement. Group 3 was informed of all known risks in a written statement. Group 4 was informed of all known risks by means of physician counseling. The average times it took for the technologist (groups 1-3) or the physician (group 4) to counsel the patient and obtain informed consent were 1.7, 6.2, 13.6, and 11.4 minutes, respectively. Counseling by physicians would require approximately 7% of their professional time in a busy radiology department. On a postprocedure test, the patients in groups 1-4 scored on average 38.4%, 68.2%, 63.2%, and 69.8%, respectively. There was no statistical difference in the performance of groups 2-4 on the postprocedure test. If informed consent is to be obtained prior to intravascular administration of contrast material, use of a straightforward written consent form detailing the common risks and risk factors appears to be the best method. PMID- 2704818 TI - Variable-flip-angle spin-echo MR imaging of the pelvis: more versatile T2 weighted images. AB - Dependence on T1 contrast can be reduced by changing the excitation flip angle. The authors compared T2-weighted spin-echo images (with 30 degrees and 90 degrees flip angles) of the male and female pelvis in 22 individuals. In six women imaged with a 1,000/80 sequence (repetition time msec/echo time msec), signal difference to-noise ratios (SD/Ns) were higher with a 30 degree flip angle than with a 90 degree angle for urine/fat (mean, 15.2 vs -6.2; P less than .05) and endometrium/myometrium (13.8 vs 9.0, P less than .05). In eight additional examinations, a 1,000/80 sequence with a 30 degree flip angle and two signal averages had less motion artifact (1.2 vs 2.7, P less than .01) than a 2,000/80 sequence with a 90 degree angle and one signal average (4.5 minutes each); SD/Ns were similar. In a third series of experiments, contiguous sections without cross talk, obtained by interleaving two 1,000/100, 30 degrees-flip-angle acquisitions, had better contrast than contiguous sections obtained at 2,400/100 with a 90 degree flip angle (10 minutes each), with SD/Ns of urine/fat of 28.5 versus 16.1 (P less than .01) and SD/Ns of endometrium/myometrium of 15.5 versus 7.8 (P less than .05). Reducing the flip angle can improve examination time, contrast, or motion artifact suppression or eliminate cross talk in T2-weighted spin-echo MR imaging of the pelvis. PMID- 2704819 TI - Enlarged uterus: differentiation between adenomyosis and leiomyoma with MR imaging. AB - The potential of magnetic resonance (MR) imaging in differentiation of adenomyosis from leiomyoma was evaluated in 93 patients who had a palpable enlarged uterus that was suspect for leiomyoma or adenomyosis. In all cases, MR images were correlated with surgical/pathologic findings. Pathologic findings showed that 71 enlarged uteri were due to leiomyoma, including one leiomyosarcoma, and 16 were due to adenomyosis. The other six patients were shown to have an enlarged uterus attributable to simultaneous involvement of both lesions. On T2-weighted images, adenomyosis appeared as an ill-defined, relatively homogeneous low-signal-intensity area embedded with sparse high intensity spots. In contrast, leiomyomas were well-circumscribed masses with a spectrum of signal intensity. The cause of uterine enlargement was correctly diagnosed with MR images in 92 of the 93 cases. It is concluded that MR imaging is highly accurate in helping to distinguish between adenomyosis and leiomyoma in cases of enlarged uterus. PMID- 2704820 TI - Ureteropelvic junction obstruction: treatment with percutaneous endopyelotomy. AB - The authors review their experience with percutaneous endopyelotomy in the treatment of ureteropelvic junction obstruction. Twenty-four patients with symptoms of ureteropelvic junction obstruction underwent excretory urography, which revealed nonspecific narrowing in several cases. Angiography was performed in 14 patients suspected of having a vessel crossing at the junction, but such a vessel was found in only four, who subsequently underwent dismembered pyeloplasty. One patient was treated with decompression, but later required endopyelotomy. Nineteen patients underwent percutaneous endopyelotomy; in 11 of them, dilation with a balloon catheter was required to ensure complete disruption of the stenosis. After 6-36 months follow-up, 17 of the 19 patients were asymptomatic with no obstruction and two were asymptomatic with mild obstruction. PMID- 2704821 TI - Chemical shift imaging with paramagnetic contrast material enhancement for improved lesion depiction. AB - The depiction of contrast material-enhanced lesions with magnetic resonance imaging can be improved by using chemical shift imaging (CSI) for lipid suppression in combination with gadolinium diethylenetriaminepentaacetic acid (DTPA) enhancement. Gd-DTPA enhancement was combined with the hybrid technique for lipid suppression, which provides water-only images without increasing imaging time or postprocessing. Lesions with high signal intensity due to paramagnetic relaxation enhancement are easily distinguished from low-intensity lipid, which would otherwise dominate T1-weighted images. Preliminary studies were performed to compare Gd-DTPA-CSI images with conventional postcontrast T1 weighted images. In patients examined for orbital, pituitary, and musculoskeletal abnormalities, the Gd-DTPA-CSI technique enabled improved detection and finer anatomic staging of lesions. In theory, a similar result can be achieved by using any chemical shift-selective method that results in true lipid suppression together with paramagnetic contrast agents that generate high signal intensity. This general approach should be applicable to clinical studies in other tissues or organ systems dominated by lipid, including the pelvis, mediastinum, and breast. PMID- 2704822 TI - MR fluoroscopy: initial clinical studies. AB - Magnetic resonance (MR) fluoroscopy is a method for high-speed MR image acquisition with the goals of short acquisition time per image (500 msec or less), high image rate (10 images or more per second), and high-speed image reconstruction (150 msec or less from data acquisition to image display). The authors present their results with the first two goals in volunteers. MR fluoroscopic image data were acquired with a limited flip angle pulse sequence with reduced repetition times (TRs) and fewer phase encodings used per image. The sequence was applied continuously, and images were formed by updating one set of data with data from the most recently taken measurements. Sample head images were generated with TR/echo times as small as 11/5.5 msec and 48 phase encodings for a total acquisition time of about 500 msec. Images were acquired while the volunteer flexed his head. Artifacts from the motion became less evident on images as progressively shorter acquisition times were used. PMID- 2704823 TI - Quantification of blood flow with dynamic MR imaging and presaturation bolus tracking. AB - A technique is described for rapid imaging of blood flow and dynamic measurement of its velocity. The method is a combination of bolus tracking and low-flip-angle gradient-echo cine angiography. This method provides precise determination of velocity with high temporal resolution in a single measurement. Unlike what occurs in phase imaging techniques, flow is displayed directly, eliminating potential errors that result from non-flow-related sources of phase shifts. Manipulation of raw data sets is avoided. Results obtained from a flow phantom, healthy volunteers, and a patient with an aortic aneurysm demonstrate the capability of the technique to track flow at low and high velocities and to differentiate flowing blood from thrombus. Because of its conceptual simplicity, rapidity, and lack of susceptibility to extraneous phase shifts, this technique may prove ideal for in vivo flow measurement and evaluation of flow patterns. PMID- 2704824 TI - Effect of intravenous fructose on the P-31 MR spectrum of the liver: dose response in healthy volunteers. AB - Dynamic phosphorus-31 magnetic resonance (MR) spectroscopy of the liver after intravenous administration of fructose has been suggested as a test of liver function. To establish dose-response curves of the phosphorus metabolites in the normal human liver, each of four healthy volunteers was given two to four different fructose doses on separate days: 62.5, 125, 250, 375, or 500 mg per kilogram of body weight. P-31 MR spectra of the liver were acquired with a 2-T whole-body magnetic, both before and after fructose administration, at 2.5-minute intervals over at least 30 minutes. The fructose load caused a significant, linearly dose-dependent accumulation of phosphomonoesters (r = .72, P less than .01) and a decrease in inorganic phosphate (r = .78, P less than .005) and adenosine triphosphate (r = .73, P less than .01). On the basis of these experiments, dynamic P-31 MR spectroscopy seems promising in the assessment of liver function. PMID- 2704825 TI - Artifacts on lung CT scans: removal with Fourier filtration. AB - A preliminary study was done of Fourier analysis of high-resolution computed tomographic (CT) images of normal pulmonary parenchyma. A two-dimensional fast Fourier transform was applied to 20 regions of interest (64 x 64 pixels) obtained from CT images of six lungs. A qualitative analysis of the spectra and the application of filters in the frequency domain allowed the characterization and removal of reconstruction artifacts. Selective application of a low-pass filter removed these parasitic frequencies and clearly enhanced the quality of the image. PMID- 2704826 TI - Sagittal tomography in the supine patient. AB - The authors have developed a multidirectional tomographic unit to obtain sagittal images with the patient in the supine or prone position. The apparatus is particularly useful for examination of the vertebral column and sella turcica. It can be employed in circular (0 degrees -40 degrees) and spiral (10 degrees -32 degrees) motions. The apparatus provides correct and easy positioning of subjects with easy maintenance of posture. It reduces the distortional effects of respiration and thereby markedly improves reproducibility. PMID- 2704827 TI - Gd-DTPA as a contrast agent in CT. AB - An evaluation was done of the effect of gadolinium diethylenetriaminepentaacetic acid (DTPA) on computed tomographic (CT) studies performed after magnetic resonance (MR) imaging. CT scans of two solutions of Gd-DTPA demonstrated substantial attenuation. In two patients who underwent CT after Gd-DTPA-enhanced MR imaging, the high attenuation of concentrated Gd-DTPA was seen in the urinary bladder and renal collecting system. However, in the concentration presently used in MR imaging, Gd-DTPA results in only minor enhancement of renal cortex. PMID- 2704828 TI - Danger or opportunity ahead? PMID- 2704829 TI - Epidural lipomatosis. PMID- 2704830 TI - Embolization hazard of hydrophilic guide wires. PMID- 2704831 TI - Longitudinal stress fractures of the tibia: diagnosis with CT. PMID- 2704832 TI - Fibrocystic "disease". PMID- 2704833 TI - C-section delayed: accusations fly. PMID- 2704834 TI - Nurse-expert's testimony held admissible. Case in point: Wickliffe v. Sunrise Hosp., Inc. (766 P. 2d 1322--NV (1988)). PMID- 2704835 TI - Live birth question: wrongful death action. Case in point: Wheeler v. Yettie Kersting Mem. Hosp. (761 S.W. 2d 785--TX (1988)). PMID- 2704836 TI - Research and the acute care setting. PMID- 2704837 TI - Family stress and family strengths: a comparison of single- and two-parent families with handicapped children. AB - Using the Typology Model of Adjustment and Adaptation, a family stress model, the differences in family stressors, resources, family types, parental coping patterns, and child health indices were examined in 27 single-parent families and 27 two-parent families who had a child with cerebral palsy. The two groups of families were matched on the severity of the child's handicap and the age and gender of the parent. There was no significant difference between the two groups of families on the accumulation of stressors and demands, resource strains, family types, family cohesion, family resources of esteem/communication, mastery/health, extended family social support, and the child health indices of overall physical health status and health improvement. Single-parent families were significantly lower on financial well-being and the mother's coping related to maintaining family integration, cooperation, and optimism about the situation. Single-parent families also were higher on family adaptability than two-parent families, reflecting an ability to be more flexible in family rules, power structure, and role relationships. PMID- 2704838 TI - Employed mothers' concerns about separation from the first- and second-born child. AB - The effect of birth order on mothers' anxiety about separation from their infants was examined. Forty employed mothers were assessed in 1982 when their firstborns were 7 months old and again when their second-borns were 7 months old. Assessment included two measures: an Interview-Based Rating Scale (IBRS) and the Maternal Separation Anxiety Scale (MSAS). Findings revealed that mothers felt less guilt and anxiety about separation from their second-borns than they had from their first-borns at a similar age. They were more positive about the effects of separation on the child; however, their concerns about employment-related separation did not change. PMID- 2704839 TI - Interfacing bioinstruments with computers for data collection in nursing research. AB - Nurse researchers gain many advantages over manual collection and recording of data when they interface bioinstruments with computer technology for data collection. This article describes both the advantages and disadvantages of such technology, and uses examples from a study evaluating the effects of parent touch on preterm infants to illustrate strategies to overcome potential disadvantages. PMID- 2704840 TI - An explanatory model of recovery from disaster loss. AB - The development and testing of an explanatory model of recovery from disaster loss are described. The sample consisted of 155 persons at Time1-1981, 101 persons at Time2-1983, and represented five magnitudes of disaster loss: bereaved of disaster victims presumed dead; bereaved of disaster victims confirmed dead; persons whose permanent homes were destroyed; persons whose recreational property was destroyed; and a no disaster-loss comparison group. Data tested in the model were collected 1 and 3 years following the volcanic eruption of Mt. St. Helens in 1980 on eight variables: magnitude of loss, mass media coverage, negative rating of change, change in income, self-efficacy, social support, satisfaction with financial settlement, and mental distress. Path analysis was selected to estimate the magnitude of hypothesized direct and indirect linkages between variables presumed as causes of variables treated as effects. Results showed an improvement of goodness of fit by testing the model with the 1981 data, respecifying the model, and testing it again with the 1983 data. The greatest explanatory effects on mental distress 3 years postdisaster were mental distress reported 1 year postdisaster and negative ratings of change associated with disaster loss. PMID- 2704841 TI - Artful design: writing the proposal for research in the naturalist paradigm. AB - The preparation of the research proposal for a study that involves an emergent research design compels the investigator to negotiate the paradox of planning what should not be planned in advance. This paper is a guide to writing the proposal for research in the naturalist paradigm, and includes illustrative sections of a proposal recently funded by the National Center for Nursing Research. PMID- 2704842 TI - Ego defensiveness and its relationship to attitudes of registered nurses toward older people. AB - This study was designed to simultaneously examine the relationship between select independent variables and attitudes of registered nurses toward older people. Emphasis was placed on exploring the relationship between ego defensiveness and attitudes. Data analysis was based on the responses of 255 registered nurses. The following variables were found to be significantly related to attitudes: ego defensiveness, age, highest level of education, position, close personal relationship with an older person and perception of a relationship with an older person. The findings serve as a cautionary signal that attitudes of registered nurses toward older people may not be as positive as recent literature has indicated. PMID- 2704843 TI - Health perceptions and lifestyles of the elderly. AB - Adoption of a healthy lifestyle can slow physical decline and improve well being of the elderly. The purpose of this study was to examine the relationship of six aspects of a healthy lifestyle (nutrition, exercise, stress management, self actualization, health responsibility, and interpersonal support) with selected demographic variables, perceived health status, and health locus of control in the well elderly. The sample consisted of 297 volunteers. Person product-moment correlations and stepwise multiple regression procedures revealed that perceived health status and health locus of control were significant predictors of healthy lifestyles. Demographic variables, posited as modifying factors, were found to be associated with perceived health and locus of control but were not predictive of lifestyle practices. PMID- 2704844 TI - [The correlation of serum parathyroid hormones among patients with dementia of vascular type, hemodialysis, and bone-joint disorders]. AB - PTH levels were analysed in sera of patients receiving maintenance hemodialysis, with the vascular type of dementia and orthopedic patients with bone-joint disorders, using PTH assay kits. There were significant interrelationship among all kinds of PTH levels in the hemodialysis patients, but not in patients with the vascular type of dementia and the bone-joint disorders. Renal functions might be responsible for fragmentation of PTH in blood stream. These results suggested that the measurement of PTH levels is needed to examine various kinds of amino sequence of PTH levels in keeping normal function of kidney. PMID- 2704845 TI - [Introduction to genetic engineering experiments. XIV. Gene expression of cloned genes in mammalian cells]. PMID- 2704846 TI - [Double tracer whole body autoradiography using a short-lived positron emitter and a long-lived beta emitter]. AB - We investigated glucose and amino acid metabolism in tumors and other organs using whole body autoradiography with a short-lived positron emitter and a long lived beta emitter. The radioactive compounds used were 2-deoxy-2-[18F]-fluoro-D glucose (18F-FDG) with a half life of 109.8 min and L-[methyl-14C]-methionine (14C-MET) with a half life of 5,730 years. A Donryu rat weighing about 150 g was subcutaneously inoculated at the back with experimental tumors of AH109A and AH272. 74 MBq (2 mCi) of 18F-FDG and 740 kBq (20 microCi) of 14C-MET was administered and after 30 min, the rat was sacrificed. Whole body frozen sections were obtained using autocryotome. For the 18F-FDG autoradiogram, the frozen sections were exposed to an X-ray film for 6 h. After seven days, these frozen sections were again exposed to 14C-MET for a week. Cross-contamination was minimized by adjusting the exposure time, the interval of exposures and the administered dose. The accumulation of the tracers was represented as the optical density ratio of the tissue of interest to the muscle. The tumor ratios were 12.5 for 18F-FDG and 8.6 for 14C-MET showing the highest accumulation in the whole body autoradiogram. In contrast the inflammatory tissue ratios were 1.27 for 18F FDG and 0.77 for 14C-MET showing very low amino acid metabolism. With the present double tracer whole body autoradiogram, 18F-FDG accumulation was seen in the brain and the heart but not to the liver as against 14C-MET accumulation which was seen to the liver but not to the brain and the heart. PMID- 2704847 TI - [The incidence of postural headache in in- and outpatients following lumbar myelography (needles of different gauges and headache)]. AB - The incidence is reported of postural headache and other types of headache arisen after myelography in a pilot sample of 540 patients, divided into 3 groups. The myelographic study was performed on the first two groups using 20 and 22 gauge needles, and with 25 gauge needles on the third group. 140 patients in the third group were treated on an outpatient basis, and 25 of them underwent myelo-CT. Myelography was performed on all the patients in the second and third group in erect position. In the authors' opinion, the erect position and the use of a fine needle determined a considerable reduction in post-myelographic side effects, i.e. postural headache. PMID- 2704848 TI - [Early diagnosis of cerebral infarct. Hyperdensity of the middle cerebral artery as the first CT sign of an ischemic lesion]. AB - An early CT sign of cerebral infarction in the sylvian area is described: the normal density value of the middle homolateral cerebral artery is increased, because of thrombotic or embolic deposits inside. PMID- 2704849 TI - [High-resolution computed tomography in injuries to the cervical spine]. AB - Correct orthopedic therapy for traumas of the cervical rachis requires perfect knowledge of the spatial balance of the fracture focus. The authors believe Computed Tomography (CT) to be the most suitable, and often indispensable, method for this purpose. Twenty-four patients were examined for traumatic pathology of the cervical rachis. In 7 cases with clinically minor traumas, the negative outcome of the traditional exam was considered reliable and sufficient for therapeutic purposes. The extant 17 patients were examined also by means of CT, either to better determine the characteristics of skeletal lesions already ascertained with traditional techniques or to assess the presence of clinically suspected osteo-articular lesions, even with negative conventional X-rays. For 9 of these patients orthopedic treatment was considered sufficient, whereas 8 patients underwent surgery and were subsequently examined with CT, which allowed correct evaluation of postoperative pictures even in the presence of metal prostheses. In 10 cases CT demonstrated the presence of lesions which had not been diagnosed with traditional X-ray techniques. PMID- 2704850 TI - [Torsional defects of the lower limb: an evaluation of the reliability of the results obtained by CT]. AB - The torsional angle was calculated goniometrically of 9 femurs and 2 tibio peroneal groups, and then compared to the values obtained from CT scans of the corresponding bones. The results show how the methods adopted up to now have been inaccurate and have yielded only gross definitions of the axis of the femoral neck. As far as this feature is concerned, an error of +/- 6.5 degrees can be estimated, with limits of confidence of 95%, after applying a more accurate system of measurement to the images and considering statistical interferences. After pointing out the advantages of this method, we suggest that the test performed in vivo be systematically proposed to all those patients in whom a more accurate diagnosis would lead to a different medical/surgical therapy considering that: 1) the inevitable error such a measurement bears can be contained between acceptable limits; 2) the radiation dose sufficient to distinguish the bone from the other surrounding tissues is much reduced with respect to the dosage necessary to perform a common CT of the inferior limbs. It comprises one topogram and four tomograms, with a total dose to the patient of approximately 10-20 mGy. PMID- 2704851 TI - [Radiologic examination in assessing the response to chemoradiotherapy of esophageal spinocellular carcinoma]. AB - Squamous cell carcinoma represents more than 90% of esophageal cancers; its prognosis is still extremely severe. A treatment consisting in the combined use of preoperative chemotherapy and radiotherapy is now in course of experimentation at Istituto Nazionale Tumori, Milan. Over a period of 28 months (July 1985 to October 1987), 21 patients with 22 lesions (stage III) underwent a double contrast study of the esophagus, both before and after therapy. The radiological evaluation of the lesions after treatment was compared with the pathological diagnosis. Radiological diagnosis has been confirmed in 86.3% of cases (19/22 lesions) as far as mucosal detailing was concerned. On the contrary, radiological evaluation has proven unreliable as far as submucosal layers were concerned. No radiological false positives have been observed. PMID- 2704852 TI - [The radiologic picture of total colonic aganglionosis]. AB - The radiological findings pathognomonic of Hirschsprung's disease have been known for quite a long time. However, in addition to those diseases characterized by rectum or rectum-sigmoid aganglionosis (as in the classic form of Hirschsprung's disease), in pediatric pathology of surgical interest severe affections exist characterized by aganglionosis extending from the rectum to the entire colon, and exceptionally as far as the small bowel (ultra-long Hirschsprung's disease). The authors report on the results they obtained in radiological studies of 6 cases of total colonic aganglionosis by means of the current radiological procedures, i.e. plain abdominal films and barium enema. As for total colonic aganglionosis, no diagnostic radiological parameters have been assessed yet. The authors compare their results with those taken from international literature: microcolon with reflux into mega-ileum (2 out of 6 cases) appears to be the most suggestive X-ray finding for total colonic aganglionosis. Finally, the role is discussed of radiological studies in the diagnostic approach to total colonic aganglionosis. The authors conclude that, even though radiological investigations are indispensable, they are often not conclusive. Therefore, an accurate evaluation of the proximal extension of aganglionosis can be made only at surgery. PMID- 2704853 TI - [Postoperative radiologic follow-up of rectocolonic anastomoses. The visualization of fistulous passages after evacuation]. AB - The early postoperative study of colo-rectal anastomoses is a common diagnostic procedure with symptomatic patients which is extended to asymptomatic patients by some authors. Eighty-eight anastomotic fistulas were early diagnosed after intervention in 316 patients who underwent a water-soluble contrast enema. Four out of these fistulas (4.5%) could not be demonstrated at complete filling on X ray, but were only opacified on radiographs taken after the spontaneous evacuation of contrast medium. The increase in endoluminal pressure due to the evacuation and the lack of balloon catheter probably play a role in allowing these fistulas to be visualized. PMID- 2704854 TI - [Varicocele: the effects of sclerotherapy on hemodynamics and spermatogenesis]. AB - Between January 1984 and July 1988, percutaneous retrograde sclerotherapy of varicocele was successfully performed on 267 patients. A 5% solution of sodium morrhuate and benzylic alcohol (Varicocid) was administered through a coaxial balloon catheter inserted into the spermatic vein. Nine of the patients had relapses after surgery. Long-term follow up was available for 248 patients. Three of them had incomplete relapses after sclerotherapy. In terms of spermatologic improvement, sclerotherapy appeared to be effective in the treatment of varicoceles. In our experience, sclerotherapy is a safe and effective procedure to be preferred to surgery in the management of varicocele. PMID- 2704855 TI - [The use of 3-dimensional CT reconstruction in childhood. Technics and dosimetry]. AB - A new computer method has been developed that allows the reprocessing of standard CT scans to produce 3D surface images. We employed the 3D reconstruction program developed by Hitachi Medical System using an Ansaldo A-TOM XR 1200 scanner. The process requires only standard CT scanner hardware, and reconstruction time is comparable to that of sagittal and coronal reconstructions. The applications of this technique and methodology to pediatric patients are discussed. In order to assess the relationship between image quality and radiation dose, we performed many CT scans with different protocols. A skull was employed for phantom, and plunged into a physiological solution, which helped us to determine the radiation exposure dose from every single CT scan. The measurements were taken with film and thermoluminescent crystal dosimeters (TLD). The results confirm that low-dose techniques allow a significant reduction in the total exposure. The authors discuss the clinical indications and the eventual applications of these techniques. PMID- 2704856 TI - [Software for record reporting and filing with the personal computer]. AB - During the past four years the authors have been gaining experience in reporting radiological examinations by personal computer. Today they describe the project of a new software which allows the reporting and filing of roentgenograms. This program was realized by a radiologist, using a well known data base management system: dBASE III. The program was shaped to fit the radiologist's needs: it helps to report, and allows to file, radiological data, with the diagnostic codes used by the American College of Radiology. In this paper the authors describe the data base structure and indicate the software functions which make its use possible. Thus, this paper is not aimed at advertising a new reporting program, but at demonstrating how the radiologist can himself manage some aspects of his work with the help of a personal computer. PMID- 2704857 TI - [Osteomesopyknosis]. PMID- 2704858 TI - [Eosinophilic granuloma located in the sternum]. PMID- 2704859 TI - [Tracheopatia osteoplastica. Report of a case examined by CT]. PMID- 2704860 TI - [Neonatal pericardial effusion]. PMID- 2704861 TI - Making a difference. PMID- 2704862 TI - The business of nursing: do you suffer from jackpotophilia? PMID- 2704863 TI - Have you heard about Ontario's nursing shortage?. Interview by Carol Thomas. PMID- 2704864 TI - Patient advocacy a new role for nurses. PMID- 2704865 TI - The short shrift of shiftwork. PMID- 2704866 TI - [Prevalence of hepatitis B markers in the personnel of psychiatric hospitals]. AB - The current rules and regulations in Spain state that those working in closed institutions, helping mentally disturbed patients, are considered personnel at risk for acquiring hepatitis B virus infection, without drawing distintions between professions and fields of work. The immunological state against HBV has been studied in a representative population group of workers of the Cadiz Provincial Psychiatric Hospital (82.90%). Our results show that the percentage of chronic carriers (3.15%) and those with other positive biological markers (30.07%) is greater than that found in the General hospitals of our country. Thus, the inclusion of this population group in preventive programs as well as vaccination programs against hepatitis B virus infection is totally justified. PMID- 2704867 TI - [Clinical evaluation of pirozadil, administered continuously over four and a half years, in patients with hyperlipoproteinemia type IIa]. AB - With the goal to evaluate the long term efficacy and tolerance of pirozadil, 20 patients with hypercholesterolemia (type II a hyperlipoproteinemia) received this drug for 4.5 years. Lipidic parameters and the appearance of subjective manifestations related to the drug were periodically controlled. The triglyceride concentration (34%), total cholesterol (24%) and LDL-cholesterol (47%) decreased after 6 months of treatment with 1.5 to 2 g/day of pirozadil. These changes were more manifest during the second semester of therapy and did not show important oscolations in subsequent controls. Adverse effects, indicating the withdrawal of the drug were not encountered. Three patients had minor and transient epigastralgias. Taken as a whole, these results reinforce the usefulness of pirozadil in treating patients with hypercholesterolemias. PMID- 2704868 TI - [Cysticercosis in Spain. Epidemiologic data]. AB - In our country, cysticercosis is an endemic zoonosis due to the infestation of the larva (cysticercus) of the helminth, Tenia Solium. We Have analyzed the epidemiological data of 52 patients studied at the "Doce Octubre" hospital. The areas at risk are those western rural communities of the peninsula. Although the disease has not yet been erradicated, the lowest number of cases reported was in the 70's due to the greater health, sanitary and social development of these areas. Computorized tomography has helped to identify late manifestations of the disease. PMID- 2704869 TI - [Endobronchial hamartoma. Report of 3 new cases]. PMID- 2704870 TI - [Treatment with nifedipine retard: increasing doses as a therapeutic method]. PMID- 2704871 TI - [The electrocardiogram in Steinert's disease]. PMID- 2704872 TI - [Clinical trials in everyday medical practice]. PMID- 2704873 TI - [Granuloma of the bone marrow]. PMID- 2704874 TI - [Severe secondary metabolic alkalosis caused by intravenous administration of calcium gluconate]. PMID- 2704875 TI - [Tinea versicolor and Cushing's disease]. PMID- 2704876 TI - [Palatal tumor as the first manifestation of gastric cancer]. PMID- 2704877 TI - [Reversible isolated paralysis of the hypoglossal nerve preceded by the common cold]. PMID- 2704878 TI - Intraruminal controlled release of cyromazine for the prevention of Lucilia cuprina myiasis in sheep. AB - The efficacy of cyromazine, continuously released from intraruminal capsules at dose rates from 0.5 to 2 mg kg-1 d-1, was evaluated against implants of eggs and first instar larvae of Lucilia cuprina on Merino sheep. Estimates from the non linear relationship between the success of implants and plasma concentrations showed that 95 per cent protection of sheep could be achieved at a mean release rate of 1.39 mg kg-1 d-1 cyromazine which gave rise to a mean plasma concentration of 0.26 mg litre-1. Present formulations allowed protection for about 90 days in a 40 kg sheep. The 'square wave' type of release profile provided negligible suboptimal dosing thus limiting the potential for selection of resistance. Systemic application of cyromazine provides control of covert and overt strike among sheep and could be used in ecologically based strategies for the control of L. cuprina populations. PMID- 2704879 TI - Effect of different methods of maintenance on the pathogenicity and infectivity of Babesia bigemina for the vector Boophilus microplus. AB - Observations were made on the effects of five different methods of laboratory maintenance on the infectivity and virulence of Babesia bigemina for the tick Boophilus microplus. The original isolate was highly infective and virulent, causing premature death of engorged female ticks and reduced egg production. Maintenance of the strain by syringe passage in unsplenectomised calves at six to 10 week intervals reduced both its infectivity and virulence for ticks. When slow passages were preceded by a series of rapid passages in splenectomised calves, the changes to the strain were less pronounced. The other three procedures, rapid syringe passage in splenectomised calves and tick passage in either splenectomised or intact calves, had no statistically significant effect on the characteristics measured. PMID- 2704880 TI - Lymphocyte blastogenesis and cellular cytotoxicity in a congenital infection of bovine fetuses related to epizootic bovine abortion. AB - The disease referred to as epizootic bovine abortion (EBA) was experimentally induced in bovine fetuses. Dark-field microscopy was used to detect congenital infection with an unclassified spirochaete-like organism. Some of the fetuses collected at abattoirs were also found to be naturally infected with a morphologically similar microorganism. Blood counts and organ weights were correlated with the presence of the microorganism. Lymphocyte blastogenesis increased, the result of in vivo stimulation among the infected fetuses. Phytomitogens (phytohaemagglutinin, concanavalin A and lipopolysaccharide) also stimulated greater responses in infected fetuses when compared to results in normal fetuses. Cellular cytotoxicity was examined by the single cell assay and results indicated that there were fewer cytotoxic lymphocytes among the diseased fetuses. The infected abattoir-collected specimens were obtained from clinically normal adult cattle, and the immunological changes in these fetuses were closely characterised with those of the EBA diseased fetuses. These naturally infected fetuses showed signs of a mild infectious disease. PMID- 2704881 TI - Surface antigens on equine sarcoid cells and normal dermal fibroblasts as assessed by xenogeneic antisera. AB - To characterise the expression of surface antigens on equine sarcoid cells compared to normal equine fibroblasts, immune sera were produced in rabbits against transformed cells of a virus-containing sarcoid cell line (Mc-1) and normal dermal fibroblasts, respectively. The specificities of the sera were analysed by antibody-dependent cellular cytotoxicity against 51Cr-labelled target cells using human lymphocytes as effector cells. Anti-Mc-1 antiserum induced strong cytotoxicity against transformed cells of two sarcoid cell lines (Mc-1 and Bay Mc-1), whereas the cytotoxicity against transformed cells of equine testis, or against cells grown in short term or primary cultures derived either from sarcoids or normal dermis was low or absent. In contrast, anti-normal dermal fibroblasts antiserum did not induce antibody-dependent cellular cytotoxicity against Mc-1 or Bay Mc-1 but reacted strongly against both normal fibroblasts and primary cultured cells derived from sarcoids. The apparent specificity of the anti-Mc-1-induced cytotoxicity was confirmed by absorption of the anti-serum with either normal dermal fibroblasts and equine testis cells or Mc-1 cells. Immunoprecipitation of 125I-surface labelled Mc-1 cells by absorbed anti-serum and analysis by SDS-PAGE and autoradiography revealed that anti-Mc-1 antibodies reacted with at least four surface components with a wide range of molecular weights. Immunofluorescence with rabbit anti-human beta 2mu serum indicated that Mc-1 cells in contrast to equine lymphocytes and fibroblasts did not express class 1 major histocompatibility complex antigens.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2704882 TI - Effect of age on absorption and immune responses to weaning or introduction of novel dietary antigens in pigs. AB - Pigs weaned at three weeks old absorb food protein antigens from the intestine. The amount of antigen absorbed declines over the next three weeks, and this decline is associated with an increasing level of serum antibody to the fed proteins. There was no difference in the rate of immune elimination of intravenously injected antigen in fed and unfed controls. The reduction of serum antigen is thus likely to reflect reduced absorption, possibly mediated by locally produced antibody. Pigs weaned at 10 weeks old also absorbed antigens and produced an antibody response when introduced to soya; and after three weeks of feeding soya the absorption of antigen was substantially reduced. This latter exclusion was specific for soya as a second novel protein (ovalbumin) was absorbed when introduced to the diet at this time. At six months, pigs no longer absorbed soya proteins when they were introduced to the diet. Furthermore, pigs of this age had serum 'antibody' to soya and other proteins such as keyhole limpet haemocyanin to which they had never been exposed. PMID- 2704883 TI - Kinetics of IgA plasma cells in the intestine of NIH mice infected with Trichinella spiralis. AB - In uninfected mice, the percentage of IgA-containing cells labelled one day after a single injection of tritiated thymidine [( 3H] d Thd) was constant in the upper, middle and lower small intestine. In uninfected mice receiving an additional injection on the two preceding days there was about a threefold increase after the three injections indicating accumulation of labelled cells during the three day period. Five days after infection with Trichinella spiralis, the percentage of IgA cells labelled after a single injection of (3H)d Thd was increased at each site indicating increased division and, or, localisation of IgA cell precursors in the intestine. The numbers of cells labelled after three injections were reduced at this time, with no evidence of accumulation of further cells labelled from the two additional injections on previous days. By nine, 13 and 18 days after infection the numbers of IgA cells labelled after both single and triple injections were each increased, indicating increased division and, or, localisation of IgA precursors in the intestine with accumulation of labelled cells over the three day period resembling that in uninfected mice. PMID- 2704884 TI - Carrageenan-induced acute inflammatory response in chicks. AB - Carrageenan from two commercial sources was used in varying concentrations to evoke an acute inflammatory response in the foot pad of chickens. Oedema formation and increased vascular permeability were less severe using this experimental model than with turpentine-induced injury. Inflammation was monophasic, of short duration and apparently mediated by histamine and serotonin as their respective antagonists diminished the response. Prostaglandins seemed to play only a minor role as indomethacin blocked only the later phase of oedema. Bothrops jararaca venom did not potentiate the inflammatory response, implying that bradykinin was not a significant mediator. PMID- 2704885 TI - In vitro evaluation of various quinolone antibacterial agents against veterinary mycoplasmas and porcine respiratory bacterial pathogens. AB - The in vitro activities of 12 quinolones and four antibiotics were determined against 15 veterinary mycoplasmal species and four species of bacteria commonly involved in respiratory infections in pigs. The newer quinolones were markedly more active in vitro against a wide range of mycoplasmas than nalidixic acid and the earlier quinolones. Against Mycoplasma hyopneumoniae ciprofloxacin was the most active quinolone with a geometric mean minimal inhibitory concentration (MIC) against 16 strains of 0.01 microgram ml-1 compared with 0.04 microgram ml-1 for tiamulin, 0.06 microgram ml-1 for tylosin, 0.17 microgram ml-1 for oxytetracycline and 0.23 microgram ml-1 for gentamicin. M hyosynoviae was less sensitive to the quinolones with mean MICs of 0.6 microgram ml-1 for ofloxacin and 0.7 microgram ml-1 for ciprofloxacin compared with 0.034 microgram ml-1, or less, for tiamulin. Norfloxacin and its 6-chloro analogue were both mycoplasmacidal in vitro at five or 10 times their MICs against M hyopneumoniae UCD4. Tiamulin was mycoplasmastatic. The quinolones were also active against porcine Bordetella bronchiseptica and Pasteurella multocida strains and Haemophilus species. Ciprofloxacin was the most active quinolone with mean MICs of 0.58 microgram ml-1 against B bronchiseptica (nine strains), 0.026 microgram ml-1 against P multocida (five strains) and 0.01 microgram ml-1, or less, against Haemophilus pleuropneumoniae (nine strains) and H parasuis (two strains) compared with mean MICs of from 0.5 microgram ml-1 to 64 micrograms ml-1, or more, for the antibiotics. This combination of excellent mycoplasmacidal activity against M hyopneumoniae and good antibacterial activity, suggests that the quinolones have great potential for treating respiratory infections in pigs, including enzootic pneumonia. PMID- 2704886 TI - Isotypic antibody responses in cattle infected with Haemophilus somnus. AB - Bovine antibody responses to Haemophilus somnus were compared on the basis of clinical and bacteriological findings. Serum IgG1 and IgM antibody titres were significantly increased in clinically normal cattle that were bacteriologically positive for H somnus from the nasal or vaginal mucosae compared with clinically normal, negative cows. IgG2 titres did not differ significantly between these two groups. However, IgG2 antibody was significantly higher in animals with H somnus disease (pneumonia or abortion) than in clinically normal cattle (whether bacteriologically positive or negative), while IgG1 and IgM titres did not differ between diseased and bacteriologically positive, clinically normal cattle. These antibody trends were duplicated in experimental H somnus abortion or pneumonia, with the greatest response occurring within the IgG2 subclass. Cattle vaccinated systemically with killed whole H somnus produced a predominant IgG2 response with minimal IgG1 and IgM responses. These results demonstrate that IgG2 antibody is consistently elevated in H somnus disease, and suggest that this response may be useful in discriminating diseased from asymptomatic cattle. PMID- 2704887 TI - Pathophysiological and parasitological studies on Ostertagia ostertagi infections in calves. AB - Friesian calves given a low level infection of the abomasal parasite Ostertagia ostertagi over a six week period displayed a mild diarrhoea with high faecal egg counts and elevated plasma pepsinogen values. At necropsy on day 23 abomasal lesions characteristic of ostertagiasis were widespread. At 42 and 84 days oedema and congestion were also prominent. Total worm burdens on days 23 and 42 were similar but a marked decrease had occurred by day 84. Feed digestibility and nitrogen economy were not markedly affected but radioisotopic measurements demonstrated an increase in albumin disappearance and catabolic rates, and plasma faecal clearance during the course of the infection. Prior administration of a morantel sustained release bolus to a group of similarly infected calves reduced the total worm burdens to less than 50 per cent of those recorded in the infected calves on days 23 and 42 and this fell to 3 per cent on day 84. Abomasal damage and the adverse pathophysiological changes associated with infection were prevented in this group. PMID- 2704888 TI - Increased indices of lipid peroxidation in stress-susceptible pigs and effects of vitamin E. AB - When stress-susceptible and stress-resistant pigs consumed diets containing 10 iu vitamin E kg-1, the stress-susceptible pigs had damaged cell membranes. This was indicated by increased plasma activities of creatine kinase and pyruvate kinase. Plasma concentrations of thiobarbituric acid reactive substances and conjugated dienes were also increased suggesting that the membrane damage was caused by free radicals. Susceptibility to free radicals was further demonstrated by an increased tendency for erythrocytes and tissue homogenates from stress susceptible pigs to peroxidise when incubated with hydrogen peroxide and iron, respectively. Supplementation of the diets with approximately 20 times normal requirements of vitamin E decreased plasma creatine kinase and pyruvate kinase activities, and inhibited the formation of the indices of peroxidation in vivo and in vitro. It is concluded that the stress-susceptible pig has an abnormality in its antioxidant defence mechanisms. However, this abnormality was not due to a deficiency in selenium-dependent glutathione peroxidase, since activities were significantly increased in the longissimus dorsi of stress-susceptible pigs. Although the nature of the antioxidant defect is unclear, it is suggested that stress-susceptible pigs are under a sustained oxidant stress and that a decreased ability to accommodate even a normal free radical load may contribute to the rapid development of the fatal stress response. PMID- 2704889 TI - Liver function of dairy cows in late pregnancy and early lactation. AB - The possibility that alterations in liver function may occur during late pregnancy as well as after calving has been investigated in healthy dairy cows and the results compared with those from non-pregnant non-lactating cows. There were significant alterations in plasma total bilirubin, glucose, total ketone body and urea concentrations, in bromsulphthalein clearance and in plasma aspartate aminotransferase and creatine kinase activities in periparturient cows compared with non-pregnant non-lactating cows. Of these, only the alterations in glucose, ketone bodies and urea concentrations and bromsulphthalein half-time and retention were markedly different before calving. The degree of fatty infiltration of the liver was significant two weeks before as well as two weeks after calving which differed from previous reports. It seems likely that the changes in the liver in dairy cows are functional and reversible and related to the metabolic demands of late pregnancy and early lactation. The results suggest that such changes in the liver occur well before calving. PMID- 2704890 TI - Development of immunity to incoming radiolabelled larvae in lambs continuously infected with Ostertagia circumcincta. AB - Infective larvae of Ostertagia circumcincta were radiolabelled with 75selenium by a method which did not affect their viability. Three groups of five-month-old lambs were infected daily with 1000 unlabelled infective larvae for four, eight and 12 weeks, respectively. After each period one of these groups and a group of worm-free controls were challenged with three consecutive daily doses of 1000 radiolabelled third stage larvae. The lambs were killed 13 days after the first dose of challenge larvae and their worm burdens examined. The first indication of immunity was retardation of developing worms observed at four weeks. Resistance to the establishment of incoming worms developed between four and eight weeks and a brief period of population turnover probably took place at this time. Simultaneously a greater inhibition of worm development occurred resulting in an increase in the number of parasites recovered as early fourth stage larvae. By 12 weeks the animals were almost completely immune to incoming worms. The development of resistance to incoming worms correlated with a rise in serum antibody titre and an increase in the number of intraepithelial globule leucocytes in the gastric mucosa. PMID- 2704891 TI - Clearance of bromosulphthalein by the liver of sheep. AB - The application of a serial sampling technique for assessing bromosulphthalein (BSP) clearance by the liver of sheep is described. After a single intravenous injection BSP was almost completely cleared by the liver into the bile. Clearance by the liver was in two phases which allowed the calculation of the proportionality transfer constants a (from plasma to liver), h (from liver to bile) and b (from liver back to plasma). The ratio of a:h was approximately 4:1 in sheep. The proportionality transfer constants had the advantage over fractional clearance and retention tests of relating the test more precisely to the condition of the liver at the cellular level. The single injection method was simple, non-invasive and repeatable and suitable for conscious animals. PMID- 2704892 TI - Pharmacokinetics of three formulations of diphenylhydantoin in the dog. AB - The pharmacokinetics of the sodium salt of diphenylhydantoin was studied in three healthy dogs, using three formulations, a capsule, a tablet and a suspension. The results were essentially the same for all three formulations. The serum half life after intravenous injection ranged from 3.1 to 3.6 hours before and 1.3 to 1.6 hours after a two-week period of oral treatment. The bioavailability of the formulations varied from 43 to 54 per cent. Serum levels likely to be required for canine therapy could not be maintained with any of the formulations used in this experiment. PMID- 2704893 TI - Alterations in acid-base status and blood gas dynamics during progressive hyperkalaemia in neonatal calves. AB - Alterations in acid-base status and blood-gas dynamics were studied during induced progressive hyperkalaemia in neonatal calves. The hyperkalaemia was associated initially with respiratory alkalosis in arterial blood when plasma K+ was increased to 6.08 +/- 1.02 mmol litre-1. The rise of plasma K+ above 6.08 +/- 1.02 mmol litre-1 led to the development of metabolic acidosis in arterial and venous blood. There was partial respiratory compensation. Plasma K+ concentrations at or above 11.03 +/- 0.34 mmol litre-1 were associated with a decrease in arterial oxygen tension and arterial oxygen saturation. The oxygen extraction ratio was increased during hyperkalaemia. PMID- 2704894 TI - Effect of omeprazole treatment on feed intake and blood gastrin and pepsinogen levels in the calf. AB - Previous work has shown blood gastrin levels to be elevated and appetite depressed in ostertagia-infected calves. A possible relationship between raised blood gastrin values and feed intake was investigated in worm-free animals using the human gastric acid secretion inhibitor, omeprazole. An initial dose-titration experiment established that administration of the drug by intravenous injection at 1.95 mg kg-1 (four times the recommended human dose rate) resulted in a marked (5.2-fold) increase in blood gastrin levels in the calf. Daily administration of omeprazole by intravenous injection at 2 mg kg-1 for four days in a subsequent experiment resulted in a significant depression in feed intake (up to 40.4 per cent) which was accompanied by a significant rise in blood gastrin levels (peak 940 pg ml-1; 6.5-fold increase over control values). It is suggested that such a rise in hormone levels would reduce reticuloruminal and abomasal motility, slow down the passage of ingesta and, in turn, lead to a reduction in appetite. PMID- 2704895 TI - Failure to induce neoplasia in nude mice by injection of disrupted cells from continuous cell lines. AB - Nude mice were injected subcutaneously with disrupted cells from three continuous cell lines (HeLa, NCTC clone 2472 and Morris hepatoma). No tumours were observed at either the inoculation site or in other organs taken at 35 or 90 days after injection. Live cells from one line (HeLa) produced tumours at the inoculation site after eight to 12 days. PMID- 2704896 TI - A comparison of statistical methods for combining event rates from clinical trials. AB - We compare two statistical methods for combining event rates from several studies. Both methods treat each study as a separate stratum. The Peto-modified Mantel-Haenszel (Peto) method estimates a combined odds ratio assuming homogeneity across strata and provides a test for heterogeneity. The DerSimonian and Laird modified Cochran method (D&L) produces a weighted average of rate differences, where the weights allow for among-study variability. We analyse 22 meta-analyses from ten reports by both methods. The pooled estimates are divided by their standard errors to produce a Z-statistic. A t-test comparing Z statistics from all 22 studies suggests that the D&L method tends to be more conservative [d(Peto - D&L) = 0.29, t = 2.53, p = 0.02]. For a subset of 14 non heterogeneous studies, the difference is smaller and non-significant (d = 0.09, t = 0.72, p = 0.49). The results from the methods correlate well (r = 0.66 for all 22 studies, r = 0.95 for 14 non-heterogeneous studies). Thus, the presence of heterogeneity influences our conclusion. We discuss the statistical and scientific implications of these findings. PMID- 2704897 TI - Required duration and power determinations for historically controlled studies of survival times. AB - This paper provides power formulae for historically controlled studies with survival time endpoints, and considers two designs. The first design involves no further follow-up of control group subjects; the second design involves collection of additional information on control group subjects who had not failed at the time of design of the prospective portion of the study. The power functions differ from those for concurrently controlled studies, since, under the first design, the control group data are constant for purposes of power calculations, while under the second design, some of the control group data are constant while the remainder are random. I contrast the required duration of these studies with the required duration for comparable concurrently controlled studies under a wide range of conditions. PMID- 2704898 TI - Factorial designs in clinical trials: the effects of non-compliance and subadditivity. AB - Factorial designs in clinical trials allow for the study of several medical treatments simultaneously. This paper distinguishes among different types of settings in which factorial designs are useful. For the experiment that involves investigation of several new or untested therapies, we introduce a model that incorporates rates of non-compliance to therapy as well as various degrees of subadditivity of treatment effects. We compare the operating characteristics of the factorial under this model with those of competing designs and show that a modest negative interaction can considerably diminish the power to detect treatment effects in the factorial even in cases that have little power to detect this interaction. We urge, therefore, that designers of clinical trials with factorial layouts posit realistic estimates of interactions among treatments in order to assure adequate power to detect beneficial effects of treatment. PMID- 2704899 TI - Issues in analysing the effects of occupational exposure to low levels of radiation. AB - A major objective of studying populations exposed to low levels of radiation is provision of direct assessment of the adequacy of estimates of health risks obtained by extrapolation of data on populations exposed at high levels. Meeting this objective requires the use of statistical methods that fully utilize available exposure measurements, and that consider the extensive body of prior knowledge regarding radiation-induced health effects. This paper describes various methods of analysis and illustrates the methods with data on workers at the Hanford Site. Special problems are discussed, with attention to comparability of estimates and confidence limits with those obtained from extrapolation. PMID- 2704900 TI - Application of a two-stage random effects model to longitudinal pulmonary function data from sarcoidosis patients. AB - We applied a two-stage random effects model to pulmonary function data from 31 sarcoidosis patients to illustrate its usefulness in analysing unbalanced longitudinal data. For the first stage, repeated measurements of percentage of predicted forced vital capacity (FVC%) from an individual were modelled as a function of time since initial clinical assessment. At the second stage, parameters of this function were modelled as a function of certain patient characteristics. We used three methods for estimating the model parameters: maximum likelihood; empirical Bayes; and a two-step least-squares procedure. Similar results were obtained from each, but we recommend the empirical Bayes, since it provides unbiased estimates of variance components. Results indicated that deterioration in FVC% is associated with a higher initial FVC% value and large numbers of both total cells and eosinophils in bronchoalveolar lavage at the initial assessment. Improvement is associated with higher values of pulmonary Gallium uptake at initial assessment and race. Blacks are more likely to improve than whites. PMID- 2704901 TI - Estimation of parameters and missing values under a regression model with non normally distributed and non-randomly incomplete data. AB - We carried out a simulation study to compare the performance of three algorithms (complete cases, ALLVALUE, and expectation maximization, EM) in estimating regression parameters and missing values for situations that have varying amounts of missing data, distributions (normal, mixture of normals and lognormal), patterns of incomplete data (random, related and censored), and degrees of correlational structure among the dependent and independent variables. We found that the EM and complete cases algorithms performed equally well regardless of the correlational structure, when the percentage of incomplete data was only 5 per cent. When this percentage increased to 25 per cent, the EM algorithm was generally best for estimation, but the complete cases algorithm was safe and conservative. This finding may be attributed to the study design, which required that the slopes be the same in the population of all cases, and in the population of complete cases. In addition, the one-step imputing method (ALLVALUE) was competitive only for situations with weak correlational structure and/or little missing data. In that situation the bias caused with use of all available information was less than that caused with use of only complete cases. On the other hand, for imputation, the EM algorithm performed optimally, even in situations of censored or log-normally distributed data. PMID- 2704902 TI - Variance estimation for medical decision analysis. AB - We have derived the variance of an expected utility for a probability tree in medical decision analysis based on a Taylor series approximation of the expected utility as a function of the probability and utility values used in the decision tree. The resulting variance estimate is an algebraic expression of the variances associated with the probability and utility estimates used. We also derive expressions for the case where the input parameter estimates are not independent. We discuss the choice of input parameters and their variance estimates and give an example that compares two protocols for the treatment of chlamydial infection. PMID- 2704903 TI - [The deleterious effects of vesicant war gases]. PMID- 2704904 TI - [Multi-organ procurement: an essential link in the chain of interdependence]. PMID- 2704905 TI - [The physiology of the breast and hormones]. PMID- 2704906 TI - [Functional disorders of the diaphragm in the sequelae of abdominal surgery]. PMID- 2704907 TI - [The value of sleep EEG in depressive states]. PMID- 2704909 TI - [The orbit (1). The eyeball, the eye fundus]. PMID- 2704908 TI - [Anatomo-clinical conference. Apropos of a subacute dementia syndrome with cutaneous lesions responding to corticoids in a 71-year-old woman]. PMID- 2704911 TI - [Eyelid injuries]. PMID- 2704910 TI - [Recovery room (1)]. PMID- 2704912 TI - [Injuries of the excreting lacrimal ducts]. PMID- 2704913 TI - [Orbital contusions]. PMID- 2704914 TI - [Injuries and contusions of the eyeball. Long term outcome]. PMID- 2704915 TI - [Let us pay attention to our eyes]. PMID- 2704917 TI - [Listening to patients with AIDS]. PMID- 2704916 TI - [What one should know about AIDS]. PMID- 2704918 TI - [Small eye injuries]. PMID- 2704919 TI - [Eye burns]. PMID- 2704920 TI - [Grief and health in older persons]. PMID- 2704921 TI - [The HIV patient in the surgical emergency unit]. AB - At the emergency station of the Surgical Department of the University Hospital in Zurich, 90% of the group with high risk of infection with the human immunodeficiency virus are intravenous drug abusers and 10% are promiscuous homosexuals. When compared with the group of i.v. drug addicts, the group of homosexual patients is small, as homosexual behaviour is not recognised and drug consumption and surgical emergency cases occur more often with i.v. drug addicts than with homosexuals. Surgical illnesses of i.v. drug abusers are directly connected with drug addiction (needle abscesses, injuries by accident or violence). Homosexual patients have no characteristic surgical problems outside of anal difficulties. I.v. drug abusers are running a very high risk of viral infections: 75% have antibodies against the human immunodeficiency virus. 77% have antibodies against the hepatitis-B virus and 50% have antibodies against the hepatitis-A virus. At the surgical emergency station of the University Hospital in Zurich, the problem of i.v. drug consumption patients with risk of viral infection is permanently increasing. The surgical emergency station can be considered as an ideal place for the prevention from HIV-infection and for taking care of i.v. drug abusers. PMID- 2704922 TI - [The difficult neurotic patient from the psychiatrist's viewpoint]. AB - Neurotic applicants for an infirmity-pension belong to the group of problem patients for attending general practitioners and specialists alike. The doctor patient relationship is often disturbed. The source of the article emanates from problematic relationships. It is described how the psychiatrist deals with the difficulties in the expertise situation, where he attempts to gain insight into the personality structure. Furthermore, psychodynamics of a frequent personality structure of neurotic invalids are described. Finally, reference to literature is introduced and discussed. PMID- 2704923 TI - [Adynamia, finger paresthesias]. AB - A 40-year-old woman was admitted for investigation of weakness and angina pectoris. She had generalised weakness of muscles, cold intolerance and a reduced physical performance. A previous neurological examination had already revealed a carpal-tunnel syndrome of the right hand. This syndrome, combined with a rough, cool skin and a periorbital edema, lead to the assumption of hypothyroidism. The diagnosis was confirmed by a combination of very high concentrations of TSH and decreased concentrations of the thyroid hormones. Replacement therapy by oral administration of L-thyroxin resulted in a gradual improvement of the patient's state. PMID- 2704924 TI - [A case from practice (133). Female patient: J. L., born 1957, secretary]. PMID- 2704925 TI - Polymicrobial fungemia: microbiology, clinical features, and significance. AB - In a retrospective study covering a period of 13 1/2 years, polymicrobial fungemia was documented in 22 (3.4%) of 645 patients with fungemia. These infections were hospital acquired and occurred in patients with significant underlying diseases. In terms of the clinical setting and features, predisposing factors, fungal species responsible, management, and mortality rate (59%), polymicrobial fungemia appears similar to the more common "monomicrobial" fungemia. With increasing numbers of patients at risk and improved laboratory detection of fungemia, clinicians will probably encounter increasing numbers of these polymicrobial bloodstream infections. PMID- 2704926 TI - Economic benefits of an effective infection control program: case study and proposal. AB - An economic model of the 981 nosocomial infections that occurred in 1985 at the University of Virginia Medical Center was developed. It was determined that $2,401,709 in excess charges and $2,111,753 in excess variable costs were saved in 1985 as a result of having an effective infection control program in place. If a nominal per diem patient fee ($5) were billed to each patient or third-party carrier for preventive services rendered by the infection control team and channeled to infection control for the 196,141 patient-days in 1985, income of $980,705 would have been generated, leaving net income of $812,979 after the deduction of infection control operating costs. In addition, patients, third party payers, and the hospital would have still saved $1,421,004 in excess charges, or $1,131,048 in excess variable costs, in prevented infections. Infection control programs are extremely cost effective, and if preventive care is to be encouraged, financial incentives for value received for infection control services are needed. PMID- 2704927 TI - Needles that kill: modeling human immunodeficiency virus transmission via shared drug injection equipment in shooting galleries. AB - Case notification data from the U.S. Centers for Disease Control imply that AIDS has spread rapidly among intravenous drug users in the northeastern United States. These data determine a doubling time for AIDS cases of 5-6 months for this population early in the epidemic. A new mathematical model of transmission of human immunodeficiency virus (HIV) via shared drug injection equipment in "shooting galleries" is developed to understand the rapid spread of HIV and AIDS among drug users. The model depends on quantities such as rates of sharing injection equipment, the ratio of addicts to injection equipment in the population, the infectivity of HIV transmitted by shared injection equipment, the likelihood that infectious equipment is "flushed" by the blood of an uninfected user, and the duration of needle-sharing activity by HIV-infected addicts. The model is extended to incorporate the impact of cleansing or bleaching of injection equipment. Also, the model is reformulated to account for the inactivation of HIV infectiousness over time. The models demonstrate that policies such as the distribution of cleansing solutions and/or injection equipment among drug addicts could slow or stop the intravenous transmission of HIV in shooting galleries. PMID- 2704928 TI - Cutaneoarticular mucormycosis due to Cunninghamella bertholletiae in a patient with AIDS. AB - A case of mucormycosis in an AIDS patient is reported. The infection was located in the skin and knee joint after open trauma of the left thigh. Cunninghamella bertholletiae was isolated. The prognosis of this infection is ominous in patients with AIDS because of their precarious immunologic status. PMID- 2704929 TI - Streptococcus pneumoniae endocarditis presenting as an epidural abscess. AB - Streptococcus pneumoniae is an important pathogen in many serious infections, such as pneumonia, sinusitis, and meningitis. It uncommonly causes infective endocarditis and only rarely produces spinal epidural abscesses. This report describes a patient who had pneumococcal infection presenting as an acute epidural abscess and who was subsequently found to have endocarditis. S. pneumoniae was cultured from both blood and abscess material. A high level of clinical suspicion of endocarditis is important in all cases of bacteremic pneumococcal illness; patients with such an illness and back pain may harbor potentially catastrophic epidural abscesses. PMID- 2704930 TI - Chronic hip pain and limp in a 3-year-old girl. PMID- 2704931 TI - Does vaccination with bacille Calmette-Guerin protect against AIDS? AB - In the United States a majority of patients with AIDS are infected with bacteria of the Mycobacterium avium complex (MAC), while in Sweden only approximately 10% of AIDS patients are so infected. It is proposed that general vaccination with bacille Calmette-Guerin (BCG) in Sweden may have induced protection not only against tuberculosis but also against infections with MAC, accounting for the lower incidence of MAC infection in Swedish patients with AIDS. The current AIDS pandemic may indicate a need for reevaluation of national BCG vaccination policies. PMID- 2704932 TI - Monocytes in HIV infection. PMID- 2704933 TI - [The public and private in health]. PMID- 2704934 TI - [How the midwive employs her time]. PMID- 2704935 TI - [The Hickman catheter. Its maintenance and care]. PMID- 2704936 TI - [How to prevent drug-food interactions?]. PMID- 2704937 TI - [Occlusive dressing of patients with vascular ulcers of the lower extremities. The nursing care]. PMID- 2704939 TI - [Continuous ambulatory peritoneal dialysis. 3. A cycling machine for peritoneal dialysis]. PMID- 2704938 TI - [Health education of the hypertensive patient and his family]. PMID- 2704941 TI - [The public-private debate on health]. PMID- 2704940 TI - [Continuing education. 34. Field: public health. Topic: the epidemiology and control of pulmonary tuberculosis]. PMID- 2704942 TI - Meeting tops RNAO's initiatives on nursing shortage. PMID- 2704943 TI - Forum reviews province's need for French-speaking health care workers. PMID- 2704944 TI - [New prospects in the treatment of vertigo]. AB - Vertigo results from sensory conflicts that are usually intralabyrinthine or between two labyrinths. Symptomatic treatments rests on the reduction of these conflicts by vestibuloplegic drugs. However, this treatment should not last for more than 48 or 72 hours since in established vestibular lesions central compensation demands that the centres be informed. The use of sedative drugs in vertigo, therefore, should be reduced, and vestibular rehabilitation is recommended in most cases. Only Meniere's disease escapes this rule, being a self limited process. PMID- 2704945 TI - [Obstructive dyspnea of oropharyngeal origin]. AB - Obstructive dyspnoea of oropharyngeal origin is a recently recognized entity with numerous clinical forms depending on age, severity and symptoms. The authors insist on the two facets of this pathology that are most frequently seen and therefore of special interest to practitioners: the oropharyngeal obstructive syndrome due to enlarged tonsils in children, and the pharyngeal obstruction responsible for snoring and for the sleep apnoea syndrome in adults. In children, tonsillectomy is necessary to avoid complications which are sometimes severe. The various clinical features of snoring and sleep apnoea syndrome in adults, as well as their exploration and treatment, are described. PMID- 2704946 TI - [ORL manifestations of gastroesophageal reflux]. AB - In the E.N.T. area, gastro-oesophageal reflux (GOR) is manifested as atypical pharyngitis or laryngitis. E.N.T. examination is frequently negative. The diagnosis rests on demonstration of the reflux which is clinically obvious in most cases. It must be confirmed by exploratory methods, the main one being oesophageal pH measurement. Fibroscopy is useful to exclude an associated oesophagitis. GOR is very frequent in children and indeed unavoidable during the first weeks of life. It may produce inflammatory E.N.T. symptoms, but also obstructive apnoea and nocturnal cough. Management essentially consists of hygienic and dietetic measures. It is highly effective as regards both GOR and its atypical E.N.T. manifestations. PMID- 2704947 TI - [Treatment of intractable pain in ORL cancer]. AB - Numerous effective treatments are available to relieve the intractable pain of terminal E.N.T. cancers when aetiological therapies are no longer of any use. These treatments must be prescribed as a progressive therapeutic scale ranging from analgesics, and notably morphine which remains the basic drug, to the classical or stereotactic surgical operations. To these must now be added other routes of administration of morphine (e.g. intraventricularly) which in some cases give unexpected results. PMID- 2704948 TI - [Cholesteatoma of the ear]. AB - Cholesteatoma of the ear is characterized by the presence of a keratinizing squamous epithelium in the cavities of the middle ear. The epithelium invades the ear either by direct migration or by retraction of the eardrum. Owing to is potentials for migration, desquamation, bone erosion and infection, it is for most of the complications of chronic otitis and fully justifies the adjective "dangerous" applied to chronic cholesteatomatous otitis. The clinical diagnosis rests on microscope otoscopy. Audiometry informs on the degree of hearing loss and on the state of the contralateral ear. Standard radiography and computerized tomography of the petrous bone evaluate the extent of the lesion. Treatment is purely surgical: it consists of excision of the entire epithelium that has entered the middle ear and, secondarily, conservation or improvement of hearing. Whatever the surgical technique used, the frequency of recurrences calls for long term follow-up. PMID- 2704949 TI - [Acoustic oto-emissions: the ear emits sounds]. AB - Otoacoustic emissions are sounds emitted by the inner ear. Their genesis requires the outer hair cells of the organ of Corti to be intact. Analysis of these sounds provides a fine evaluation of cochlear function. Evoked otoacoustic emissions (in response to a sound) are constant in subjects with normal hearing, whereas they always have pathological characteristics in patients with endocochlear conduction or perceptive deafness. When the acoustic nerve or the central nervous system are affected, otoacoustic emissions are normal for as long as the pathological process has no repercussions on the inner ear. This new functional exploratory method is of particular interest, being simple, non-invasive, rapid and objective. One of its main uses in adults is early detection of a lesion of the organ of Corti by e.g. ototoxic drugs or acoustic trauma. In children, it might become a test for objective detection of deafness, being easier to perform than evoked potentials of the brain stem. PMID- 2704950 TI - [Management of the parents of a patient with intestinal cancer]. PMID- 2704951 TI - [Drugs acting on feeding behavior]. AB - The pharmacology of food intake has made considerable progress due to recent developments in neurobiology and to advances in the final analysis of eating behaviour. In this way, the pharmacology of food intake has risen to the rank of a more global pharmacology of eating behaviour. It is now possible to evaluate the points of impact of catecholaminergic, serotoninergic and opioid agents in terms of central or peripheral mode of action and also in terms of behavioral sequence. Some serotoninergic and opioid agents currently under development are opening new therapeutic vistas. PMID- 2704952 TI - [Post-puberty anorexia nervosa]. AB - Post-puberty anorexia nervosa requires a thorough clinical study to facilitate its diagnosis and its early treatment. Longitudinal studies have demonstrated that good results usually depend on the speed of medical intervention (preferably with admission to hospital) and to the duration of treatment. The fact that certain cases result in death is too often due to excessive intensive care. Infusions must be avoided at all costs and should be replaced by forcible feeding if absolutely necessary. Finally, a better approach to, and a better understanding of adolescents should contribute to the prevention of anorexia nervosa. PMID- 2704953 TI - [Bulimic behaviors]. AB - Bulimic behaviours are becoming increasingly frequent, notably among adolescents and young adults. They present under several clinical forms the most frequent of which (but also the most often missed) is compulsive maintenance of normal weight, which proceeds by attacks with vomiting. This is a potentially invalidating behaviour with serious somatic, affective and social repercussions, which requires a protracted, difficult treatment with uncertain results. PMID- 2704954 TI - [Eating disorders and obesity]. AB - In most cases, obesity does not stem from a specific psychologic disturbance. Some obese people overeat, as do their family or their socio-professional peers, and this cannot be considered a pathologic behaviour. Many obese patients increase their energy intake when frustrated, anxious, or tired, like many normal individuals who enjoy a better weight regulation. But when obesity increases suddenly and/or severely in these circumstances, and in gross obesity, abnormal feeding behaviour is usually responsible: prandial or, more often extraprandial overeating (nibbling, gorging, binge eating, night eating, excess alcohol, carbohydrate craving). Serotoninergic mechanisms of the latter have focused wide interest. Conflicting situations and/or anxiety are usually a factor in child obesity. Deppreciated self-image and feelings of culpability, partly secondary to obesity itself and dietary failures often contribute to feeding disturbances, sometimes surreptitious, carrying a risk of vicious circle. But weight reduction itself, while improving self image, carries a risk of unmasking depressive tendencies, especially when too quick. Hence the importance of careful and comprehensive management. PMID- 2704955 TI - [Kluver-Bucy syndrome in man: study of behavioral eating disorders]. AB - Patients with Kluver-Bucy syndrome have severe behavioral disturbances of food intake associated with complex neuropsychological features. The complex mechanisms of these troubles are discussed on the basis of pathological and psychological data, and the supposed models of regulation of food intake. PMID- 2704956 TI - [Is estro-progestative supplementation after menopause a youth drug?]. PMID- 2704957 TI - [Budd-Chiari syndrome]. PMID- 2704958 TI - [Early diagnosis of Alzheimer's disease]. AB - An early diagnosis of Alzheimer's disease is nowadays required for a better assistance of the patient and his family, and also to carry out therapeutic trials at that stage. This early diagnosis rests on a systematic study of disorders of memory and behaviour in an elderly subject, on the demonstration of a deficient cognition and on the use of accurate diagnostic criteria. PMID- 2704960 TI - [Differential diagnosis of Alzheimer's disease]. AB - The differential diagnosis of Alzheimer's disease is a problem that arises in different circumstances. At an advanced stage of the disease the symptoms are so typical that the clinical diagnosis can be made immediately. Complementary examinations (i.e. essentially computerized tomography) are performed to exclude other causes of amnesia and dementia, notably curable dementias. The diagnosis may be more difficult at the early stage of the disease in patients with only slight disorders of memory or certain types of depression. The same applies to cases with unusual presentation, focal symptoms, episodes of confusion, or delirium and hallucinations. PMID- 2704959 TI - [Clinical aspects and course of Alzheimer's disease]. AB - The diagnosis of Alzheimer's disease must be considered in all subjects over 40 years of age whose mental functions have insidiously become altered and are progressively getting worse. The initial phase of the disease, which precedes dementia, is characterized by disorders of memory often associated with changes in personality and behaviour and with subtle disorders of speech, reasoning and abstraction ability and visuo-constructive capabilities. The results of neurological and paraclinical examinations are normal. This phase lasts from two to four years and may be diagnosed as "possible Alzheimer's disease". When the disease is established the patient has lost his autonomy and can only be kept at home with the help of his relatives. Dementia gradually becomes worse, with a combination of memory disturbance, aphasia-apraxia-agnosia syndrome, impaired intellectual faculties and disorders of behaviour. Computerized tomography shows evidence of cerebral atrophy. This phase lasts from three to six years and may be called "probable Alzheimer's disease". The terminal phase of the disease includes somatic lesions, and all mental functions are profoundly altered. Death occurs seven to ten years after the first symptoms. Histopathological data are necessary to make a diagnosis of "confirmed Alzheimer's disease", since there is no clinical, morphological, electrophysiological or radiological sign that is pathognomonic of that disease. PMID- 2704961 TI - [Alzheimer's disease: from morphology to pathogenic hypotheses]. AB - Main changes of Alzheimer's disease (neuronal degeneration and death, neurofibrillary tangles, senile plaques, granulo-vacuolar degenerations) are described. Recent hypotheses concerning their causes, origin and development and their relationship with the mental changes are given. PMID- 2704962 TI - [Neuropsychological evaluation]. AB - The neuropsychological evaluation of Alzheimer's disease relies on a functional analysis of the various mental or cognitive activities (memory, speech, etc.). It demands the use of standardized and usually quantifiable methods such as mental tests, standard test batteries and behaviour scales. The objective of evaluation is threefolds: (1) to provide an early or difficult diagnosis (elderly or depressed patients); (2) to establish a qualitative and quantitative typology of demential state, and (3) to assess the effects of drugs on behaviour in therapeutic trials. PMID- 2704963 TI - [Practical management of Alzheimer's disease]. AB - In patients with confirmed Alzheimer's disease--a condition for which no active treatment is available--the practitioner's first duty is to abstain from prescribing useless of harmful drugs that would make the situation worse. There is a long list of such potential nuisances. The most badly tolerated drugs unquestionably are anticholinergics, but one must also beware of tricyclic antidepressants, neuroleptics (sometimes unavoidable, however) and also, to a lesser extent, benzodiazepines, beta-blockers and so forth. Yet medical support is far from being ruled out. The benefits of placebos and drugs of undemonstrated value are not negligible, but above all it is mandatory to help the relative understand the truly pathological nature of almost unbearable behaviours. It is also very useful to advise the family on the life organization at home in order to perdure, on the legal safeguards, on whether or not the patient should be institutionalized, and similar topics. Inside institutions, keeping a sensible attitude between relentless therapy and euthanasia is the best way to ensure that the dignity of the demented patient will be preserved. PMID- 2704964 TI - [Practical considerations on the legal and social assistance of patients with Alzheimer's disease]. AB - The mental incapacity of patients with Alzheimer's disease may be such that they need legal protection. The consequences and mode of implementation of placing the patient under protection of the Court, under simple or extended guardianship and under tutelage are described. These measures, and others left to individual initiatives, are costly. The various possible financial contributions provided by the Health Insurance or Social Assistance are reviewed. Finally, the patient may require hospitalization, either temporarily, to relieve his family, or for a long time. The financial consequences of prolonged hospitalization, which in the end is very expensive, ought to be well known. PMID- 2704965 TI - [The aging of joints and osteo-arthrosis]. AB - Although the frequency and severity of osteo-arthrosis regularly increase after the age of 50 years, individual's age does not seem to be a causal factor of this disorder. Indeed, osteoarthrosis does not affect all age individuals and not all joints are involved at the time. Various etiological factors (traumatisms, joint malformations and preexisting disorders, overuse of joints, etc.) are usually identified. Joint lesions in osteo-arthrosis are not those characteristic of senile involution, but rather represent proliferative reparative processes. Therefore, old age may act as one of the risk factors, which favors a development of osteo-arthrosis if others, more specific, etiological factors are present. PMID- 2704966 TI - [Experimental models of osteo-arthrosis]. AB - A number of experimental models that variably simulate human osteo-arthritis with respect to pathology, biochemistry, and pathogenesis are already available. They are reasonably consistent in reproducibility, and the exact time of induction of joint derangement leading to degenerative change can be accurately identified. The availability of such models has led to an increased understanding of pathology, biochemical changes, pathogenesis and therapeutic assessment of osteoarthritis. PMID- 2704967 TI - [Early diagnosis of osteo-arthrosis of the hips and knees]. AB - The early diagnosis of osteo-arthritis of the hip and knee rests on the following findings: mechanical pain in the joint and/or intra-articular effusion of the mechanical type (i.e. less than 1000 cells/mm3, with less than fifty per cent polymorphonuclears); or narrowing (no matter how small) of the articular space; or normal radiography with stage two osteo-arthritic lesions in an otherwise normal arthroscopy; or normal X-ray films and normal bone scintigraphy in a subject over 50 years of age. PMID- 2704968 TI - [Congestive outbreaks of osteo-arthrosis]. AB - Osteo-arthritis is often interspersed with congestive episodes due to inflammation of the synovial membranes, the vascular component of which is more important than the cellular component. This explains why the clinical signs of inflammation are moderate and characterized mainly by a mechanical-type formula. The mechanism of these episodes involves several factors, and osteo-cartilaginous fragments, microcrystals and perhaps immune complexes have been blamed for their occurrence. The influence of inflammation on cartilage degradation has been proved experimentally, and this is supported by some clinical findings. Treatment consists of non-steroidal anti-inflammatory agents, intra-articular corticosteroid injections and relief of articular overload. PMID- 2704969 TI - [Methods of evaluating chondroprotective treatment]. AB - A chondroprotective therapy is a basic treatment of osteo-arthritis aimed at stopping pathological processes involved in articular cartilage degradation. Assessing the clinical benefit of such treatment is difficult, as it is related to individual characteristics (primary or secondary osteo-arthritis, anatomical location and/or evolutive stage), to the duration of treatment and to the efficacy criteria utilized. Whether this assessment can be made in a single patient or requires studies of patient populations is debated. PMID- 2704971 TI - [Three-dimensional x-ray computed tomography in maxillo-facial pathology]. PMID- 2704970 TI - [Sleep in patients with chronic bronchitis]. PMID- 2704972 TI - [Management of medical computing at hospitals: why, how?]. PMID- 2704973 TI - [The finger, the eye and the balloon catheter, or experiences in mitral commissurotomy]. PMID- 2704974 TI - Frequent sugar intake--then and now: interpretation of the main results. AB - The Vipeholm Study is a unique diet-caries interventional study that has earned its place as a citation classic. One of the findings, that quantity of sugar consumed at meals in a non-sticky form had little influence on caries rate, has often been misinterpreted, as it is based on an institutional population under supervised dietary control. The other main finding, that sugary foods consumed in a sticky form at high frequency between meals are highly cariogenic, is generally accepted. Although the Vipeholm Study has been criticized on ethical grounds, relatively fewer teeth were extracted for caries than are currently extracted in an adult population. The results of two modern studies in Northumberland, UK, and Michigan, USA, on the relationship between dietary habits and caries increments in children have been compared with the Vipeholm findings. Currently the correlations between dietary habits and caries increments are low because of the low caries increments and relatively small differences in dietary patterns in non interventional conditions. High frequency of snacking is uncommon and use of topical fluoride agents (dentifrices, rinses) is widespread. However, for the caries-susceptible person, between-meal consumption of sugary foods is still a risk factor. PMID- 2704975 TI - Sugar substitutes--one consequence of the Vipeholm Study? AB - One of the main conclusions from the Vipeholm Study is that consumption of sticky sugar-containing between meal products can be associated with high caries activity. Another important result from this study is that there is a great variation in the caries development between different individuals, for example among those who consume 24 toffees a day. Thus, the answer to the question that was raised in the title of this paper: "Sugar substitutes - one consequence of the Vipeholm Study?" is "Yes" for those products that are consumed frequently and "Yes" for those individuals who have a high risk for dental caries, but "No" for those products that are not consumed frequently and "No" for those individuals who do not have a high risk for dental caries. There are many substitutes available on the market today, both non caloric and caloric, which have a low or even no cariogenic potential. Even if some of these products have economic, technologic and toxicologic shortcomings, sugar substitution is an important part of the caries prevention. PMID- 2704976 TI - Fluorescence from dentin and cementum in human mandibular second premolars and its relation to age. AB - Investigations were carried out to study the fluorescent properties of human dentin and cementum and their relation to age. One hundred mandibular second premolars were ground according to the "half tooth" technique. The intensity of the red fluorescence was measured during illumination of dentin and cementum with a green light. The results were analyzed with the use of the SPSS. The intensity of the fluorescent light recorded from cementum was stronger than that recorded from dentin. A paired t-test showed no statistically significant left/right difference in fluorescence. Pearson's correlation coefficient indicated a strong relationship between age and fluorescence from dentin (r = 0.73) and from cementum (r = 0.77). The sex of the individual had no significant influence on the fluorescence. Teeth removed from decreased individuals emitted fluorescence with a slightly stronger intensity than did teeth extracted from living patients. Regression analysis indicated a linear relationship between age and the fluorescence from either dentin or cementum. There was a strong correlation between the intensity of the fluorescence and color estimates from the same teeth and the partial correlation coefficient was still statistically significant when controlling for the effect of age. PMID- 2704977 TI - Subgingival microflora, dental and periodontal conditions in patients with hereditary fructose intolerance. AB - Hereditary fructose intolerance (HFI) is a rare autosomally recessive disease which leads to severe hypoglycemia. The fructose-free diet of these patients apparently influences dental health. Half of the patients are free of caries, but there are no reports on their periodontal condition nor on the composition of their subgingival microflora. Therefore 18 patient with HFI were examined for the following parameters: radiographic bone loss, caries rate, gingival bleeding, occurrence of calculus, pocket depths, salivary flow rate, buffer capacity and pH from paraffin wax-stimulated saliva. Salivary S. mutans and lactobacilli were also enumerated. Specific antibody titers from whole saliva and serum to Actinobacillus actinomycetemcomitans gamma 4, Bacteroides gingivalis, and Capnocytophaga ochracea were determined with ELISA. Finally the subgingival plaque was analyzed by culture. Altogether 196 anaerobic or microaerophilic isolates representing 29 different species were obtained from the HFI patients and 164 isolates of 26 species from the controls. The frequency of Actinomyces odontolyticus, Veillonella parvula, and Wolinella recta in the HFI patients was significantly high The DMF-induces were lower in the study group than in the controls and so was the occurrence of S. mutans and lactobacilli in the saliva. Of the periodontal parameters examined, the only difference found was an increased incidence of gingival bleeding and calculus formation in the HFI patients. The results suggest that in the HFI patients the common gingival bleeding is associated with the more frequent occurrence of Actinomyces odontolyticus, Veillonella parvula, and Wolinella recta. PMID- 2704978 TI - Salivary immunoglobulins, lysozyme, pH, and microbial counts in children receiving anti-neoplastic therapy. AB - Salivary immunoglobulins, lysozyme, pH, and microbial counts were determined in 55 children with cancer diseases (37 cured subjects and 18 acute ones) and 103 healthy subjects. 5-10 ml unstimulated whole saliva was collected and pH, immunoglobulins and lysozyme were measured. Chairside dip-slide cultivations were used for microbiologic cultures. Reduced salivary pH and an increased amount of lysozyme were found in the saliva of those children who had been cured of their cancer diseases, but ongoing cancer disease or the treatment provided for it reduced pH and increased the amounts of lysozyme, lactobacillus, Streptococcus mutans and some immunoglobulins. These findings suggest that children with childhood cancer may be more susceptible to dental diseases than healthy ones. PMID- 2704979 TI - Potentiation of fibroblast DNA synthesis by a phenytoin-induced mononuclear cell derived factor in vitro. AB - Human mononuclear cells purified by Lymphoprep flotation were incubated with phenytoin (PHT) (20 micrograms/ml) or its metabolite p-HPPH (2 micrograms/ml) in the presence of Concanavalin A (10 micrograms/ml) in vitro. The results indicate that phenytoin and its metabolite p-HPPH induce the release of a mononuclear cell factor(s) that activates quiescent human gingival fibroblast to synthesize DNA. PMID- 2704980 TI - Why was the Vipeholm Study done and why have this symposium? PMID- 2704981 TI - Subjective disease experience in Sjogren's syndrome. A computerized discrimination analysis. AB - A study was made of the ability of a computerized discrimination analysis to distinguish between primary or secondary Sjogren's syndrome on the one hand and, on the other, various rheumatic diseases which may be, but in this study were not, complicated by Sjogren's syndrome. The analysis was based on a questionnaire including 76 two- or three-scale items. Among these 76 questions, five with a maximum potential for distinguishing between various subgroups were selected and obviously represent the questions for the physician to ask when taking the patient's history. As shown by classification matrix tables, computerized analysis of questionnaires might represent a useful way to assess the prevalence of clinical cases of Sjogren's syndrome and to aid health care administrators in assessing the extent of the Sjogren's syndrome problem. In contrast, manual analysis of patients' graded answers did not provide any simple or practicable method for the diagnostic work-up of cases. Therefore it seems that subjective symptoms should not be included in the diagnostic criteria for Sjogren's syndrome, which in clinical work should be based on objective evidence alone. PMID- 2704982 TI - Fibromyalgia features in patients with primary Sjogren's syndrome. Evidence of a relationship with psychological depression. AB - The prevalence of musculoskeletal complaints suggestive of the fibromyalgia syndrome (FS) was evaluated in 30 patients with primary Sjogren's syndrome (1 degree SS) and in two control groups of patients with osteoarthritis (OA) and diabetes mellitus (DM). In addition, the presence of depressive state was investigated in patients and controls using the Hamilton rating scale and an Italian self-evaluating test. Fibromyalgia features were found in 14 1 degree SS patients (47%), in 21 OA (70%) and in 10 DM (33%) controls. 1 degree SS patients showed the highest prevalence (47%) of moderate-severe depression with respect to OA (20%) and DM (7%) groups (p less than 0.01). Furthermore, while FS features correlated closely with both tests for depression in 1 degree SS (p less than 0.001), this correspondence was absent or much less significant in the other disease groups. Finally, neither psychopathological features nor FS complaints appeared to be related to the other clinical and serological findings of 1 degree SS. PMID- 2704983 TI - Standing balance in rheumatoid arthritis. A comparative study with healthy subjects. AB - Standing balance was studied with use of a force platform (AMTI) in 67 subjects with classical/definite rheumatoid arthritis (RA) and 152 healthy subjects, 67 of whom formed a group matched for sex and age. Compared with healthy subjects, RA subjects showed significantly (p less than 0.01) greater postural sway, reflected by increased area and length of sway path, differences being greatest in those tests representing a relatively high level of difficulty, involving standing on one leg, looking straight ahead. PMID- 2704984 TI - Methimazole-induced arthritis. PMID- 2704985 TI - Debrisoquine hydroxylation phenotype in SLE patients. PMID- 2704986 TI - Pheochromocytoma and ischemic enterocolitis. AB - In the nine year period, 1978-1987, two patients with pheochromocytoma presented to Sacred Heart Hospital, Yankton, South Dakota. Both cases were complicated pre operatively by ischemic enterocolitis--a rarely reported, usually fatal complication of pheochromocytoma. It is thought that catecholamine-induced vasoconstriction of the mesenteric vessels resulted in the wide-spread hemorrhagic necrosis of the gut. Both patients survived not only the initial ischemic mesenteric insult, but also excision of the tumor. PMID- 2704987 TI - Needlesticks and HIV infection. PMID- 2704988 TI - Body mass index in practice. PMID- 2704989 TI - "Computers in medicine"--a course for students at the USD School of Medicine. AB - The University of South Dakota School of Medicine offers an elective course for senior medical students in the use of computer technology for patient care. The philosophy of the course, its current composition, and changes to the course in the future are described. By organizing topic information using computer tools for text, outline, data item, math, and image processing, students learn formats for information storage in the computer. In the near future, students will have the opportunity to make a hypothesis and test it with decision support tools that are present in an integrated hospital database. PMID- 2704990 TI - Central synaptic inputs to identified leech neurons determined by peripheral targets. AB - Developing Retzius (Rz) neurons in different segments of the central nervous system of the medicinal leech have different peripheral targets: Rz cells in standard segments innervate the body wall, whereas Rz cells in the reproductive segments innervate reproductive tissue. Early removal of reproductive tissue primordia causes reproductive Rz cells to develop morphologically like their standard segmental homologs, suggesting that Rz cells depend on peripheral targets for signals that determine their central and peripheral morphology. Furthermore, after removal of reproductive tissue, reproductive Rz cells also receive synaptic inputs normally appropriate for standard Rz cells. These results suggest that the functional identity of these neurons is specified by the target they contact during embryogenesis. PMID- 2704991 TI - Odor-induced membrane currents in vertebrate-olfactory receptor neurons. AB - In olfactory receptor neurons, odor molecules cause a depolarization that leads to action potential generation. Underlying the depolarization is an ionic current that is the earliest electrical event in the transduction process. In two preparations, olfactory receptor neurons were voltage-clamped and stimulated with odors and this generator current was measured. In addition, a method was developed to estimate the time course and absolute concentration of odorants delivered to the receptor sites. With this method, olfactory neurons were found to have relatively high stimulus thresholds, steep dose-response relations, long latencies, and an apparent requirement for cooperativity at one or more steps in the pathway from odorant binding to activation of the generator current. PMID- 2704992 TI - Enhanced activity and altered specificity of phospholipase A2 by deletion of a surface loop. AB - Protein engineering and x-ray crystallography have been used to study the role of a surface loop that is present in pancreatic phospholipases but is absent in snake venom phospholipases. Removal of residues 62 to 66 from porcine pancreatic phospholipase A2 does not change the binding constant for micelles significantly, but it improves catalytic activity up to 16 times on micellar (zwitterionic) lecithin substrates. In contrast, the decrease in activity on negatively charged substrates is greater than fourfold. A crystallographic study of the mutant enzyme shows that the region of the deletion has a well-defined structure that differs from the structure of the wild-type enzyme. No structural changes in the active site of the enzyme were detected. PMID- 2704993 TI - Fund-raising and NIH. PMID- 2704994 TI - How cancer cells spread in the body. PMID- 2704995 TI - The cycle of violence. AB - Despite widespread belief that violence begets violence, methodological problems substantially restrict knowledge of the long-term consequences of childhood victimization. Empirical evidence for this cycle of violence has been examined. Findings from a cohort study show that being abused or neglected as a child increases one's risk for delinquency, adult criminal behavior, and violent criminal behavior. However, the majority of abused and neglected children do not become delinquent, criminal, or violent. Caveats in interpreting these findings and their implications are discussed in this article. PMID- 2704996 TI - Regulation of calcium concentration in voltage-clamped smooth muscle cells. AB - The regulation of intracellular calcium concentration in single smooth muscle cells was investigated by simultaneously monitoring electrical events at the surface membrane and calcium concentration in the cytosol. Cytosolic calcium concentration rose rapidly during an action potential or during a voltage-clamp pulse that elicited calcium current; a train of voltage-clamp pulses caused further increases in the calcium concentration up to a limit of approximately 1 microM. The decline of the calcium concentration back to resting levels occurred at rates that varied with the calcium concentration in an apparently saturable manner. Moreover, the rate of decline at any given calcium concentration was enhanced after a higher, more prolonged increase of calcium. The process responsible for this enhancement persisted for many seconds after the calcium concentration returned to resting levels. Thus, the magnitude and duration of a calcium transient appear to regulate the subsequent calcium removal. PMID- 2704998 TI - Entry into practice issues: findings and conclusions. PMID- 2704997 TI - Inescapable versus escapable shock modulates long-term potentiation in the rat hippocampus. AB - A group of rats was trained to escape low-intensity shock in a shuttle-box test, while another group of yoked controls could not escape but was exposed to the same amount and regime of shock. After 1 week of training, long-term potentiation (LTP) was measured in vitro in hippocampal slices. Exposure to uncontrollable shock massively impaired LTP relative to exposure to the same amount and regime of controllable shock. These results provide evidence that controllability modulates plasticity at the cellular-neuronal level. PMID- 2704999 TI - Current developments and future direction with ifosfamide. Proceedings of a satellite symposium of the European Society of Medical Oncology. October 31, 1988, Lugano, Switzerland. PMID- 2705000 TI - A bladder behavior clinic for post prostatectomy patients. PMID- 2705001 TI - Radiation exposure reduction during lithotripsy. PMID- 2705002 TI - Interstitial cystitis: a challenge to urology. PMID- 2705003 TI - Assessing leakage from around the urethral catheter. PMID- 2705004 TI - Introduction of information during the initial medical visit: consequences for patient follow-through with physician recommendations for medication. AB - While negotiation of treatment decisions in the medical visit has long been recognized as an important interviewing skill, limited work has been done to investigate how doctors and patients negotiate what information is relevant in understanding the patient's problem. In this research we tested how the introduction of information reflecting both the patient's and physician's perspective is related to the patient's adherence to physician recommendations for medication. Introduction of information was defined as bi-directional if patients independently offered information or behavior as frequently as they provided the information or exhibited behavior that physicians requested. Thirty random samples of audiotaped dialogue were used to construct estimates of introduction of information during the history, examination, and consultation phases of initial ambulatory care visits of 45 older male patients. The data demonstrate that bi-directional introduction of information during the examination segment explains more than half of the variance in patient adherence to physician recommendations for new medication. These findings support the idea that physician willingness to allow patients to contribute input may contribute to the partnership's arrival at treatment decisions that have meaning for both. PMID- 2705005 TI - Treatment patterns for schizophrenia in psychiatric hospitals. AB - This paper analyzes the patterns of clinical treatments prescribed to patients diagnosed with schizophrenia who were admitted to state and county mental hospitals, private for-profit psychiatric hospitals, and private nonprofit psychiatric hospitals in July 1980. Treatment patterns were specified by examining the distribution of treatment types provided to patients over a 3-month period through standard tabular arrays and matrix analysis that holds constant the number of treatment types received by the patients. Data for this study are based on nationwide patient sample surveys and facility enumerations conducted in 1980 by the Survey and Reports Branch, National Institute of Mental Health. Clear differences and similarities emerged among the three types of hospitals in terms of the number and type of treatments provided to patients with schizophrenia. In general, patients with schizophrenia admitted to private psychiatric hospitals received a more comprehensive care regimen (generally inclusive of individual therapy) than similarly diagnosed patients admitted to state and county mental hospitals; private nonprofit psychiatric hospitals had marginally discernible treatment patterns from private for-profit psychiatric hospitals, especially with respect to assignment of group and self-care skill training. PMID- 2705006 TI - Communication in the hospital setting: a survey of medical and everyday language use amongst patients, nurses and doctors. AB - Forty physicians, 40 student nurses, and 40 hospital patients were surveyed regarding their usage and evaluations of medical and everyday language use in the hospital setting. Medical language (ML) and everyday language (EL) were operationalized as distinct speech registers that doctors, nurses and patients can use in their encounters with each other. A complex interaction of speaker characteristics (bilingualism in ML and EL) motivational factors (accommodation theory), situational language norms in favor of communicative effectiveness, as well as status and power differentials that exist between health professionals and patients were hypothesized to influence language switching strategies in the health setting. While doctors reported using mostly ML with health professionals, they did report converging to the EL of their patients. However, patients and student nurses did not perceive doctors converging to the EL of their patient. Student nurses reported using an equal mixture of ML/EL with each other, while converging to the ML of the doctor and converging to the EL of their patients. The 'communication broker' role of the nurse was corroborated by perceptions of nurses' language use from all groups. Patients reported using mostly EL with each other while attempting to converge to the ML of the health professional. Nurses perceived these attempts to converge by the patients, but doctors did not report a change in the patients' register as a function of conversants. Regarding the evaluation of language use strategies, all groups felt that it was more appropriate for health professionals to converge to the EL of patients than to maintain ML. In conversations with health professionals, patient use of EL was seen as more appropriate than ML.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705007 TI - Geographic differences in the use of Veterans Administration hospitals. AB - This study contrasts the determinants of community hospital utilization with Veterans Administration (VA) hospital utilization using traditional planning variables. The comparisons had some expected and some unanticipated findings. Regional differences in non-VA hospital admissions and bed days are fairly well explained by measures of medical need, provider supply, community alternatives, and sociodemographic characteristics (other than those used as proxies for case mix). However, regional variations in the VA are explained less well by the same classes of variables and the unexplained differences between the two systems do not correspond geographically. This suggests that the two systems have different reasons for regional variation. Further, contrary to expectation, when other predictors are held constant, excess bed capacity in the area does not correlate with lower VA utilization. The study is important as the VA comes under increasing pressure to contain costs. It may well be that the rational planning model attributed to the public sector is less likely to overcome maldistribution than the private sector 'invisible hand'. Policy analysts need to give more attention to the political, bureaucratic determinants of resource allocation before changing eligibility criteria or merging the two systems. PMID- 2705008 TI - Breast-feeding and health professionals: a study in hospitals in Indonesia. AB - This paper presents findings on knowledge, attitudes, and practices regarding breast-feeding management in the modern health sector in Indonesia. The methodology applied was a survey which was carried out in teaching hospitals in major cities throughout Indonesia. The results showed that although the perinatal health care providers' attitudes toward breast-feeding were very positive, there were many areas in which knowledge was incomplete and in which wide variation existed or incorrect advice given to breast-feeding mothers. The content of advice on breast-feeding was not always sound. Many thought that a wide range of illnesses were a contraindication to breast-feeding, nearly one in five thought that breast-feeding should follow a fixed schedule rather than the baby's needs, and only 54% thought that breast-feeding should be initiated immediately after delivery. Most of the providers did not seem to have the knowledge to cope with the common problem of insufficient breast-milk supply syndrome. Similarly, although support for the concept of rooming-in was strong, about one-third of respondents did not think the mother and infant should be together for the full 24 hr implied by true rooming-in. Fears about the possibility of increased risk of infection with rooming-in were expressed These and other misconceptions about rooming-in imply that a consistent, well-designed training program needs to be carried out in the modern health sector which will provide the necessary information to health care providers about this important aspect of early infant care. PMID- 2705009 TI - Sensitization to illness and the risk of death: an explanation for Sri Lanka's approach to good health for all. AB - Recent research has shown clearly that levels of mortality are not determined solely by income levels and the provision of modern health services. There appears to be an important sociocultural component so that the same density of health services produces lower mortality in one country than in another. Sri Lanka has achieved an expectation of life at birth of 68 years with an annual per capita income of U.S. $330 and no greater provision of health services than most countries at that income level. This paper records the investigation of how such success has been attained. A collaborative program of the University of Colombo and the Australian National University, beginning in 1985, employed both demographic and anthropological methods to study almost 11,000 persons in seven localities of southwestern Sri Lanka. It was found that the major geographical mortality differentials are no longer urban-rural but between the richer and poor areas of Colombo. The low mortality was found to be based on a great sensitivity to illness and the risk of dying. This is ancient in origin but has been heightened by a nineteenth century religious reform movement and twentieth century mass education. It has been further increased by universal death registration, the carrying out of post-mortems wherever necessary with the informing of the police if the death was unnecessary, and by the erection of a system for examining the circumstances of sudden death. This sensitivity was not sufficient to produce low death rates in conjunction with traditional medicine but only with modern medicine. Traditional medicine is still widely practiced, and exorcism is a major cause of expenditure in many families. Nevertheless, the key findings were two. First, where modern medicine can save a life, the sick person nowadays is nearly always exposed to it while there is still sufficient time for a cure. Modern medicine is now usually obtained at a shorter distance and more cheaply than traditional medicine. Second, and of central importance, is the continuing evaluation of sickness from its first appearance and the quick resort to new treatments if the present treatment does not appear to be efficacious. Because of an apprehension of an unnecessary death occurring during their treatment, healers frequently refer cases, from traditional to modern medicine and from general practitioner to hospital. Nevertheless, most changes of treatment are decided by the sick themselves and their relatives so that unsuccessful treatment is changed on average every 5 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705010 TI - Fijac: fright and illness in highland Yemen. AB - Sudden fright, 'fijac', has played an important role in the traditional explanatory models of illness experiences in highland Yemen. Fijac is quite similar to other examples of the fright illness taxon in that it is a folk illness category that is attributed to a wide variety of underlying conditions. It is argued that given the extremely labile symptomatology, fijac, like other examples of the fright illness taxon, does not constitute a culture-bound psychiatric syndrome. Based on analysis of case studies and preliminary survey data, fijac appears to be much more common among folk etiologies offered by Yemeni women than men. It is suggested that this social profile might be explained by changes in the distribution of medical knowledge in Yemen. With the rapid rate of social change and the increased exposure to cosmopolitan medicine resulting from internal development of cosmopolitan health care and international labor migration, men have supplemented their traditional explanatory models with alternatives drawn from cosmopolitan medicine. Succumbing to illness as a result of fright is contradictory to the male ideal of the courageous tribesman; alternative explanatory models that do not challenge this ideal self predominate. By contrast, the Yemeni value system defines women and children as vulnerable and weak; therefore, being subject to the impact of fright is consistent with youth and the cultural definition of the female self. PMID- 2705011 TI - Longitudinal study of appraisal at Three Mile Island: implications for life event research. AB - This study tests a path model which indicates the occurrence of appraisal following the accident at Three Mile Island (TMI). The model posits a causal relationship between trust in TMI-related authorities, perceived danger, perceived harm to health, and psychological distress. The implications of the findings for life event research are discussed in terms of the etiological significance of meaning, event consequences, and control. PMID- 2705012 TI - Shame among unemployed men. AB - Explicit criteria for rating feelings of shame were applied in a group of 80 unemployed men. Shame was prominent in 15% of the sample and milder features were present in a further 10%. It was strongly associated with the presence of minor affective disorder and with some, but not all, of the vulnerability factors associated with the latter. Possible explanations for these associations are discussed. PMID- 2705013 TI - Suicide and increased availability of handguns in the United States. AB - During the 25 years between 1959 and 1984, the suicide rate in the United States increased from 10.5/100,000 to 12.4/100,000. The increase was confined to those suicides using a firearm, which had reached 58.5% of the total by the end of the period. At the same time, there was a marked increase in the household ownership of handguns (but not of shotguns and rifles). The present study investigates whether the increase in suicide might be due to the increase in the ownership of handguns. Regression analyses showed a strong relationship between handgun ownership and the rate of gun suicides, but not between handgun ownership and the overall rate of suicide. These results support the hypothesis that the rise in handguns has led to an increase in gun suicides, but, they do not permit a choice between two further competing hypotheses: (i) that more people are now committing suicide because there are more handguns available or, (ii) that people who would otherwise have killed themselves in some different way are now using guns. Because of the potential implications for prevention, further study of these issues is needed. PMID- 2705014 TI - A new approach to community health. AB - This article deals with the local health care among the Shipibo-Conibo in eastern Peru. A project called AMETRA--application of traditional medicine--is functioning in the area. The aim of AMETRA is to give courses and stimulate co operation between traditional medical practice and Western medicine. The solutions to the health problems are seen in direct relation to the socio economic structure and to the environmental prerequisites. The aim and purposes of AMETRA are described and analysed. It is proposed that the two medical systems should co-operate in such a manner that their complementary nature is emphasized and fully utilized. PMID- 2705015 TI - Patient involvement in decision-making in surgical and orthopaedic practice: the Project Perioperative Risk. AB - As part of the Project Perioperative Risk (PROPER), which is a clinical and epidemiological study of surgical complications, patient involvement in the decision to operate was evaluated by means of a questionnaire. The sample of 666 patients, on the waiting list for an operation, received a questionnaire on a broad range of issues concerning their involvement in the decision-making process one week before the operation. The results show that 41% regarded the decision to have an operation as a joint patient-doctor decision, in 29% of the cases the doctor advocated an operation and in 8% the patient asked to be operated. A clear majority, 73% felt involved in the decision-making as much as they wished. Two groups--women and immigrants from non-European countries--were least satisfied with their involvement and they also found the decision more difficult to make. In the discussion, it is argued that the comparatively high degree of patient satisfaction with involvement in the decision-making process cannot be taken as evidence of a high level of influence in an absolute sense. In a normative perspective--and considering the fact that the increased responsibility of the health sector is aimed at involving patients in decision-making in health matters -patient satisfaction can just as well be understood as resulting from low expectations with respect to one's own influence. The results also indicate that patient's information needs when facing surgery relate to three issues; possible complications, precise nature of the operation as such, and nature and consequences of anaesthetic procedures. PMID- 2705016 TI - Predictors of foetal and neonatal mortality in Curacao, Netherlands Antilles. A multivariate analysis. AB - In Curacao a systematic and comprehensive investigation of numerous factors, potentially associated with an increased risk of foetal and neonatal mortality, was carried out in a 2-year period (1984-85). The inquiry was restricted to singleton births. Data on 205 women who experienced pregnancy loss were compared with those on 913 women who did not sustain foetal or neonatal loss. Data comprised information on maternal characteristics, clinical course of pregnancy and delivery, and neonatal characteristics. Of 130 factors measured, 14 were entered into a multivariate analysis. From the analysis 5 risk factors emerged as significant predictors of mortality: gestational age, birth weight, sex, foetal presentation and congenital anomalies. Factors such as social class, marital status, maternal age and parity were not associated with an increased risk of foetal and neonatal mortality in Curacao. PMID- 2705017 TI - The politics of immunization in public health. AB - The role of socio-political and psychological factors in the decision to immunize is explored using data collected in a county health department in the United States. Decisions regarding the administration of post-exposure immunizations for hepatitis A and rabies are described, and a tendency toward unnecessary use noted. At times these interventions function more to reduce the anxiety of a patient or clinician than they do to prevent an infection. These findings may have implications for analyses of clinical decision making that involve other types of interventions. PMID- 2705018 TI - Punctuality, pain and time-orientation among Sicilian-Canadians. AB - Southern Italians, including immigrants residing in North America, are often labeled as having a present time-orientation. This notion, in turn, has been used as an explanation for diverse phenomena commonly attributed to southern Italians- such as 'arriving late for appointments'; 'seeking immediate relief from the sensation of pain'; and, generally displaying 'a high degree of emotion and expression in their illness behavior'. Labeling an entire group of people as having a particular time-orientation, however, may generate stereotypes that affect negatively the type of medical treatment patients receive. In this paper, I challenge the unsubstantiated notion that southern Italians are present time oriented. The data I have collected among Sicilian-Canadians indicates that there are alternative explanations for the phenomena people commonly attribute to southern Italians. I will support my contention by examining: (1) Sicilian Canadian conceptions of punctuality; and, (2) the communicative dimension of the pain experience. PMID- 2705019 TI - The impact of prospectively set hospital budgets on psychiatric admissions. AB - This article examines the impact of prospectively set hospital budgets on rates of admission of psychiatric patients in New York state, U.S.A. The analysis takes advantage of a natural experiment which took place in the early 1980s, whereby a geographic region adopted a prospective hospital budget reimbursement scheme that differed from the prospective per diem reimbursement scheme used in the rest of the state. The results indicate a strong decrease in psychiatric admissions attributable to the experimental payment method. PMID- 2705020 TI - Intolerance of ambiguity in students entering medical school. AB - Intolerance of ambiguity is the perception of ambiguous situations as a threat. Medical students with differing levels of intolerance of ambiguity may select medical specialties based upon the amount of ambiguity existing in the practice of each specialty. A cross-sectional survey at one state university administered Budner's Intolerance of Ambiguity Scale to all entering first-year medical students for four consecutive years (N = 609) to investigate patterns of intolerance of ambiguity in relationship with demographic variables and initial medical specialty preference. The medical students in this study were more intolerant of ambiguity than those first studied by Budner in 1962. Students entering in 1985 were slightly more intolerant of ambiguity than students in 1988. Students age 23 and older were less intolerant of ambiguity than students 18-22 years old. Men and students with natural/physical science undergraduate majors were more intolerant of ambiguity than their counterparts. However, medical specialty preference was not related to intolerance of ambiguity. Intolerance of ambiguity may be a personality trait or a learned characteristic, and needs further investigation. PMID- 2705021 TI - The practice of traditional Korean medicine in Washington, D.C. AB - Therapeutic relationships between Korean immigrants and their hanui, traditional Korean professional physicians, and the role adaptation of these physicians in the United States are discussed. The professional practices of four hanui who work in the Washington, D.C., area are examined through case studies. Research methods included semi-structured interviews, participant observation, key informant interviews, and examination of documentary materials. In hanbang, the traditional Korean medical care system, illness is related to a disturbed state of ki, the cosmological vital energy. Symptoms are often interpreted in terms of a psychosocial base. Pathophysiology is usually illustrated in functional and holistic terms. Treatment modalities include acupuncture, herbal medicines, moxabustion, and cupping. Improvement is evaluated by the quality of pulse, the disappearance of symptoms, restoration of the appetite and of a healthy look and voice, and the return of the ability to function in everyday life. The therapeutic relationship between hanui and their clients is genuine, spontaneous, and harmonious. Clients actively enter into the clinical process by negotiating with hanui about treatment decisions. Hanui practicing in the United States modify their practices to meet their immigrant clients' expectations in relation to the impact of Western biomedicine. They may use some biomedical diagnostic techniques, offer traditional medicines in tablet form, and explain symptoms and treatment with reference to some biomedical terms. Koreans use both hanbang and Western biomedical treatments. However, clients who receive both types of therapy may experience conflicts because of the lack of cooperation between hanui and biomedical physicians. PMID- 2705022 TI - The Nottingham Health Profile. PMID- 2705024 TI - [Preparation of simple parenteral injections. Fundamental criteria]. PMID- 2705023 TI - [Antitussive agents]. PMID- 2705025 TI - [Treatments in AIDS]. PMID- 2705027 TI - [Nursing care and AIDS]. PMID- 2705026 TI - [Nutrition and acquired immunodeficiency syndrome]. PMID- 2705028 TI - [Recapitulation of the hygiene measures applicable against the AIDS virus]. PMID- 2705029 TI - [Occupational risk to the nurse and precautions to follow]. PMID- 2705030 TI - [AIDS and psychological suffering]. PMID- 2705031 TI - [Psychological concerns in AIDS]. PMID- 2705032 TI - [Education of a person carrying the HIV virus]. PMID- 2705033 TI - [Testimony of nurses. Nursing personnel facing AIDS]. PMID- 2705034 TI - [The day hospital]. PMID- 2705036 TI - [The role of societies in a disease like AIDS]. PMID- 2705035 TI - [M. B., a patient with AIDS]. PMID- 2705037 TI - [Juridical aspects of HIV infection]. PMID- 2705038 TI - [Diagnostic and epidemiologic methods in AIDS]. PMID- 2705039 TI - [Bronchial fibroscopy with alveolar lavage]. PMID- 2705040 TI - [Preparation of the materials for pleural puncture and lavage]. PMID- 2705041 TI - [Pneumococcal pneumonia]. PMID- 2705043 TI - [Respiratory infections]. PMID- 2705042 TI - [A superinfection of chronic obstructive broncho-pneumopathy. First hospitalization]. PMID- 2705044 TI - [Superinfection of chronic obstructive broncho-pneumopathy. Second hospitalization]. PMID- 2705045 TI - [Superinfection of obstructive chronic broncho-pneumopathy. The 3rd hospitalization]. PMID- 2705046 TI - [Pulmonary tuberculosis]. PMID- 2705048 TI - [Special legislation for the nursing personnel of the public function of hospitals]. PMID- 2705047 TI - [Purulent pleurisy]. PMID- 2705049 TI - [Minor reforms in nursing education]. PMID- 2705050 TI - [The nursing movement (1). Facts and perspectives]. PMID- 2705051 TI - [Reflections on the nursing movement]. PMID- 2705052 TI - [The attainments of the 1. Forum on Communication in Hospitals]. PMID- 2705053 TI - [Persistent digestive troubles...]. PMID- 2705054 TI - [Mutual aid between nurse and physician in the response to emergencies]. PMID- 2705055 TI - [Psychiatric emergency intervention in the home]. PMID- 2705056 TI - [From social emergencies to psychiatric emergencies]. PMID- 2705057 TI - [Prescription of psychotropic agents during a psychiatric emergency]. PMID- 2705058 TI - [An experience with the nursing record in a psychiatric department]. PMID- 2705059 TI - [Psychiatric emergencies. For diversification of responses]. PMID- 2705060 TI - [From the special service to the unit for difficult patients. A second breath]. PMID- 2705062 TI - [Illusions ... disillusions ... results from a nursing record]. PMID- 2705061 TI - [Reorganizing timetables. Experiences in a psychiatric service]. PMID- 2705063 TI - [From crisis to emergency]. PMID- 2705064 TI - [Approach to violence]. PMID- 2705065 TI - What hath God wrought! PMID- 2705066 TI - Lack of recognition of internal medicine as a specialty: a factor in medical student career choice? AB - Interest among medical students in a career in internal medicine has recently declined. We propose that lack of recognition of general internal medicine as a specialty may be one factor in students' decisions to enter other fields. A survey of 300 first-year and second-year medical students at the Medical College of Georgia showed that 84% of the respondents plan to specialize, yet only 49% recognized general internal medicine as a specialty. Significantly higher percentages of students correctly classified six other specialties. Only family practice was less likely than internal medicine to be recognized as a specialty. Earlier recognition of general internal medicine as a specialty among students who want to specialize might result in an increased number of students entering internal medicine residency programs. PMID- 2705067 TI - Changes in the internal medicine internship from 1967 to 1987: explanations for decreasing interest in the discipline? AB - We compared the schedules and responsibilities of medical interns at an urban university hospital in 1967 with those in 1987. We analyzed admissions, length of stay, diagnostic problems, demographic data on interns, changes in diagnostic and therapeutic options, and number and type of consultations. The intern in 1987 spent less time in the hospital but had more admissions, more interruptions, more clerical responsibilities, and more therapeutic and diagnostic options, and was more dependent on senior colleagues with special expertise. For these reasons the intern in 1987 had less time with individual patients and less autonomy than his 1967 counterpart. Recognition and modification of the negative aspects of medicine interns' experience will increase the attractiveness of internal medicine residencies. PMID- 2705068 TI - AIDS and student attitudes. AB - When recently polled, one half of 4,100 physicians believed they had the right not to treat patients with the acquired immunodeficiency syndrome (AIDS), and 15% said they would actually refuse to care for them. To assure medical care for the 365,000 AIDS patients projected for the US by 1992, it is imperative to know whether there is something unique about AIDS patients that produces aversion among physicians. We hypothesized that the desire to avoid AIDS patients derived from three fears: fear of contagion, homophobia, and a desire to avoid dying patients. To identify the extent to which these three fears affect the attitudes that students hold toward AIDS patients, we conducted three studies. In our first study, we discovered that students' views about a patient with a terminal illness are the same whether the illness is leukemia or AIDS. In the second study, we found that the patient's sexual preference was not the major reason students would avoid an AIDS patients. In a third study, we confirmed that fear of contagion is the principal cause of students' desire to avoid an AIDS patient. In the course of these studies, we found important differences between the attitudes of male and female students. Female students scored lower on the homophobic scale than male students, and they had less antipathy toward AIDS patients. Helping health care professionals understand their fears toward patients with AIDS will in the long run improve medical care. Since the origins of these fears are for the most part well hidden in our unconscious, dissemination of facts alone will not do the job. Interventions are needed to help health care professionals acknowledge and overcome their negative feelings about AIDS. PMID- 2705069 TI - Ticarcillin-clavulanate therapy for infections with ticarcillin-resistant microorganisms. AB - In a prospective study, 46 episodes of serious infection with ticarcillin resistant microorganisms were treated with the combination ticarcillin disodium and clavulanate potassium (Timentin). Clinical cure was achieved in 35 of the 46 episodes (76%), and microbiologic eradication was achieved in 30 (65%). We found no development of resistance to ticarcillin-clavulanate and observed no serious side effects. PMID- 2705070 TI - Relationship between menarcheal age and adult height. AB - Many factors contribute to the attainment of adult height, including genetic and environmental variables. To assess the relationship between menarcheal age and adult height, measured adult height and recalled menarcheal age were compared by regression analysis in 425 women. The overall regression equation, Height = 158.14 + .4321 (Age) - .1667 (Age - 13)2, was significant (P less than .003), as was the coefficient for the quadratic term (P not equal to .014). After exclusion of those in whom menarche occurred after age 16, the overall linear regression equation for the remaining 416 patients, Height = 153.95 + .7353 (Age), was still significant (P not equal to .001), but the coefficient for the quadratic term was not. These data suggest that menarcheal age significantly correlates with adult height as an independent variable. PMID- 2705071 TI - Cholecystectomy. AB - We retrospectively reviewed 360 consecutive cholecystectomies done by the four surgeons in our private group practice. No patient had dehiscence of the wound or evisceration. One patient had a seroma, which was opened in the office, but the fluid contained no white blood cells or bacteria on smear, and the culture was negative. No deaths occurred during the hospitalization or within 30 days after the operation. Routine perioperative antibiotics were used, and most wounds were drained with closed suction drainage. Routine intraoperative cholangiography was also done. On the basis of the favorable morbidity and mortality in this large group of patients and a review of the literature, we recommend the routine use of antibiotics and cholecystectomy for most patients with gallstones. PMID- 2705072 TI - Cardiac complications of aneurysm repair. AB - To assess the early morbidity and mortality from coronary artery disease (CAD), we reviewed the charts of 49 patients who had elective resection of infrarenal abdominal aortic aneurysms between September 1978 and February 1986 at the VA and LSU medical centers in Shreveport. On the basis of history, physical examination, and resting electrocardiogram, patients were divided into two groups--those with clinical evidence of coronary artery disease (group 1, n = 21) and those without clinical evidence of coronary artery disease (group 2, n = 28). End points measured were perioperative (30-day) myocardial infarction (MI) rate and death. A definite MI was diagnosed when an abnormally elevated CPK-MB was accompanied by a new electrocardiographic abnormality or a reversal of the normal LDH isoenzyme pattern. A possible MI was diagnosed when an elevated CPK-MB was the only abnormality. In group 1, one definite (4.5%) and two possible (9.5%) MIs occurred. In group 2, there were no definite or possible MIs. All cardiac events were discovered by measurements of cardiac enzymes, since none of the patients had cardiac symptoms. This retrospective study reveals a low incidence of clinically significant cardiac events after resection of abdominal aortic aneurysms, even in patients with clinical evidence of coronary artery disease. Prophylactic coronary artery bypass surgery does not appear to be necessary for most patients needing repair of an abdominal aortic aneurysm. PMID- 2705073 TI - Forensic autopsy in the elderly. AB - We analyzed deaths in a geriatric population investigated by the Mobile County (Alabama) Coroner's Office during the three years of 1983 through 1985 inclusively. These subjects died both within and outside hospitals and thus provide broad representation of all types of deaths in the elderly. Of the total number of deaths investigated by the Coroner's Office, 924 of the deceased (39%) were 65 years old or older; they represent 15% of the deaths occurring in Mobile County in this age group. Of these 924 deaths, 209 (23%) were studied by autopsy; this number is 36% of the total autopsies done on subjects aged 65 or more in Mobile County during this three-year period and 89% of autopsies done after death from trauma (ie, homicide, suicide, accident, or undetermined). The potential value of medicolegal investigative data with regard to mortality statistics and the elderly is emphasized. PMID- 2705074 TI - STRETCH: a rehabilitative program for patients with breast cancer. AB - Participants in an exercise-based rehabilitative program for women with breast cancer were evaluated for physical disability. Of 114 women who were evaluated initially, there was almost universal evidence of restriction of range of motion or abnormal posture. Of the 47 women who were available for evaluation after completion of the eight-week program, 42 showed increases in one or more movements with no concomitant decreases. Five patients had a decrease in a single measurement. Of 96 participants evaluated for psychosocial benefits, two thirds reported positive psychologic effects. PMID- 2705075 TI - Oriental medicine today. PMID- 2705076 TI - The day I ran without my watch. PMID- 2705077 TI - Acute upper airway obstruction in rheumatoid arthritis of the cricoarytenoid joints. AB - We have reported two cases of acute, life-threatening upper airway obstruction due to previously unrecognized rheumatoid arthritis of the cricoarytenoid joints with severe acute and chronic deformities of the larynx. Attempted endotracheal intubation with the rigid laryngoscope failed in each case, resulting in the need for emergency tracheostomy. We recommend the use of the fiberoptic bronchoscope for elective or emergency endotracheal intubations in patients with severe rheumatoid arthritis involving the cervical spine and the larynx. PMID- 2705078 TI - Ibuprofen-induced meningitis in an elderly patient with systemic lupus erythematosus. AB - The use of ibuprofen by patients with systemic lupus erythematosus poses a major threat of aseptic meningitis. Although previously reported cases have all been in young adults, our case of ibuprofen-induced meningitis occurred in a 73-year-old woman. This report greatly expands the age population that may suffer meningitis from this analgesic, now available over the counter, and emphasizes the importance of recognizing this causative relationship in patients with headache. PMID- 2705079 TI - Para-adrenal teratoma: CT presentation. AB - In the case we have reported, computerized tomography detected a mass in the right adrenal area and characterized it as a typical cystic teratoma in a para adrenal location. PMID- 2705080 TI - More on swearing by Apollo the physician. PMID- 2705081 TI - Addicting drug danger. PMID- 2705082 TI - [The bronchial ventilation mechanism. Differential diagnosis in childhood]. PMID- 2705083 TI - [Typical cases of an inflammatory aortic aneurysm demonstrated by computed tomography]. PMID- 2705084 TI - [Results of radiotherapy of hypernephroma metastases]. PMID- 2705085 TI - A study of Supplemental Security Income awardees. AB - Since its enactment in 1974, the Supplemental Security Income (SSI) program has had a stable caseload of about 4 million recipients. Hidden by this unchanging total is the fact that nearly 9 million persons were served by the program from 1974 to 1986. This study explores some SSI program dynamics by following a group of SSI awardees for a period of 4 years from the initial receipt of award in 1981. Many of these awardees had previous contact with the program either through a previous award or a denial. About 60 percent of the awardees were eligible at the end of the 4-year period. Most persons who became ineligible did so within the first 6 months after the award. PMID- 2705086 TI - [Injectable hormonal progestational contraceptive agents]. PMID- 2705087 TI - [The discussion before voluntary interruption of pregnancy]. PMID- 2705088 TI - ["Counseling" and induced abortion]. PMID- 2705089 TI - [RU 486 and interruption of pregnancy]. PMID- 2705090 TI - [Complications of induced abortions]. PMID- 2705092 TI - [Voluntary interruption of pregnancy]. PMID- 2705091 TI - [Psychosociology of the demand for abortion]. PMID- 2705093 TI - [Nutritional hygiene for 8-to-10-year-old children at breakfast]. PMID- 2705094 TI - [The law concerning voluntary abortion]. PMID- 2705095 TI - [Technic of interruption of pregnancy up to 12 weeks of amenorrhea]. PMID- 2705096 TI - Strategy for lymphadenectomy of gastric cancer. AB - To determine the extent of lymphadenectomy necessary to cure early gastric cancer, the relationship between the frequency of nodal involvements and the extent of the primary invasion was examined in 274 patients with primary cancer of the stomach. We also evaluated the relationship between the number of metastatic lymph nodes, the pattern of metastases to the nodes, and the histologic type of the primary tumor. In early gastric cancer, lymph node metastasis was more frequent in protruded-type cancer with invasion into the submucosa more than 3 cm in diameter and located in the lower third of the stomach, but was limited to the group 1 lymph nodes, which were defined as being anatomically located nearest to the cancer. In cancer invading into the muscularis propria, metastasis to the group 2 or 3 lymph nodes, which were defined as being anatomically located farther from the cancer than group 1, was found. The number of lymph nodes involved and extent of cancer metastasis in these lymph nodes metastasis, differentiated early gastric cancer had more lymph node involvement and wider extent of metastases than undifferentiated cancers. The cancer cells sometimes replaced most of the node and invaded the perinodal fatty tissue, even in early gastric cancer. In addition, it is occasionally difficult to distinguish macroscopically early gastric cancer with submucosal invasion from cancer invaded into the muscle layer. In conclusion, group 1 and 2 lymph nodes, including perinodal fatty tissue, should be removed completely, even in early gastric cancer, except for carcinoma in situ, particularly when the cancer is of the differentiated type. PMID- 2705097 TI - The effects of hypoproteinemia and volume expansion on lung and soft tissue transvascular fluid filtration. AB - Resuscitation from major trauma or replacement of major operative blood loss frequently results in varying levels of protein depletion and alterations in plasma volume. To assess the importance of these factors on pulmonary and soft tissue transvascular fluid filtration, we compared the effects of hypoproteinemia and plasma volume expansion on the rate of lung and soft tissue transvascular fluid filtration in unanesthetized adult sheep. Ten animals were surgically prepared with chronic lung and soft tissue lymph fistulas. Lung (QL) and soft tissue (Qs) lymph flow rates were used to determine changes in transvascular fluid filtration. Initially, lactated Ringer's solution (LR) was infused to elevate pulmonary arterial wedge pressure of normoproteinemic animals (Norm/LR) 5 mm Hg for 2 1/2 hours. After a plasmapheresis-induced protein depletion of 30% to 35%, similar volume expansions with LR (Hypo/LR) and fresh frozen plasma (Hypo/Plas) were performed. Plasma, lung lymph, and soft tissue lymph oncotic pressures were determined, and transvascular oncotic gradients were calculated. Plasma volume expansion during Hypo/Plas conditions limited (p less than or equal to 0.05, 3 hours after infusion) Qs elevations compared with Hypo/LR expansion. However, there appeared to be no significant advantage with fresh frozen plasma over LR infusion in limiting QL. During fresh frozen plasma infusion, a distinct 10- to 12-hour lag in protein transport into the interstitium was observed in the soft tissue but not the lung microcirculation. The resultant differences in fluid filtration properties were in part the result of significant widening of the oncotic gradient in soft tissue. Plasma protein infusion appeared not to be beneficial over LR in limiting lung transvascular fluid filtration during hypoproteinemic states but significantly decreased soft tissue transvascular fluid flux. PMID- 2705098 TI - Operative strategies in patients with symptomatic internal carotid artery occlusion. AB - A 15-year experience with 98 patients who underwent extracranial artery reconstruction for symptomatic internal carotid artery occlusion is reviewed. Thromboendarterectomy of the occluded carotid artery resulted in unacceptably high mortality and morbidity rates, and long-term patency of the internal carotid artery was rarely achieved. Carotid endarterectomy on the side opposite the occlusion proved to be successful in relieving nonlateralizing symptoms of cerebral ischemia, whereas results were less encouraging in patients with focal symptoms in the hemisphere ipsilateral to the occlusion. External carotid artery reconstruction on the side of the occlusion was successful in relieving focal symptoms. Surgical treatment in patients with symptomatic internal carotid artery occlusion should be planned in each patient on the basis of symptoms and anatomic pattern. PMID- 2705099 TI - Inhibition of thromboxane synthetase accentuates hemodynamic instability and burn edema in the anesthetized sheep model. AB - Thromboxane A2 production is increased early after burn. We studied the effect of inhibiting thromboxane synthetase, using dazmegrel, on postburn hemodynamic stability and edema formation, the latter monitored by burn tissue lymph flow. Dazmegrel (3.4 mg/kg) was given to six anesthetized sheep, and a 40% of total body-surface third-degree burn was produced. Lactated Ringer's solution was infused at a rate to restore filling pressures during a 12-hour study period. Data were compared to burn alone (n = 8), anesthesia alone (n = 6), and dazmegrel alone (n = 5) groups. The latter two groups showed no physiologic changes. Dazmegrel pretreatment prevented increased thromboxane A2, measured as thromboxane B2, but resulted in a significant increase in plasma prostacyclin, measured as 6-keto-PGF1 alpha. In addition, a marked vasodilatation and decrease in systemic vascular resistance were noted, as well as a 30% increase in fluid requirements and an increase in lymph flow compared with burn alone. The increase in prostacyclin more than likely accentuated the burn-induced permeability change. Of interest was that oxygen consumption was better maintained with dazmegrel postburn, even with the relative hypovolemia, indicating that postburn vasoconstriction impairs adequate O2 delivery to tissues and that thromboxane synthetase inhibition attenuates this process. PMID- 2705101 TI - Comments on the article by Fackler et al. PMID- 2705102 TI - [Torture--does it concern us?]. PMID- 2705100 TI - "Angiography" by magnetic resonance imaging: detailed vascular anatomy without ionizing radiation or contrast media. AB - Using software to transform magnetic resonance imaging (MRI) tomographic data into three-dimensional projections, we have produced "angiograms" of the abdominal aorta in 18 patients with occlusive (15) and aneurysmal (3) disease. This information may be displayed to demonstrate flow, cross-sectional diameter, or aortic surface anatomy. To test the accuracy of the MRI studies, we compared them at selected points with the transected aorta and with routine aortograms. Relative cross-sectional diameter estimated by MRI was within 15% of measured aortic diameter in 14 of the 18 vessels and enabled correct detection of thrombus in 16. We conclude that MRI may accurately image the diseased abdominal aortic wall. In addition, an angiographic display format may aid in the interpretation of these studies. Although MRI is not likely to replace aortography, it could be used adjunctively to define aortic wall thickness and the presence of thrombus. PMID- 2705103 TI - [Nursing in France. Nurses move away from the patient]. PMID- 2705104 TI - [Nursing care of children. Communication with children in the hospital]. PMID- 2705105 TI - [Ethics: Christian values in nursing]. PMID- 2705106 TI - [Eiksmarka home for the aged. The elderly are also in need of nurses' competence]. PMID- 2705107 TI - [Guidance. Field of practice everybody's responsibility]. PMID- 2705108 TI - [Making more efficient--the most important thing is to want it]. PMID- 2705109 TI - [Organization--shared responsibility under joint leadership]. PMID- 2705110 TI - [Miriam Bergholz. From Ulleval Hospital to the torture chamber in Chile]. PMID- 2705111 TI - [Human rights. Torture concerns nurses in Norway]. PMID- 2705112 TI - [Midwifery services. Home childbirth meets massive resistance]. PMID- 2705113 TI - [Acetylsalicylic acid-aspirin-against heart and vascular diseases. A new use of an old and wellknown preparation]. PMID- 2705114 TI - [Lapps in Norway. The health system should respect the Lapp patient. Interview by Kjell Arne Bakke]. PMID- 2705115 TI - [Can principal agreements become more comprehensible?. Interview by Kjell Arne Bakke]. PMID- 2705116 TI - [Comprehensive new concept in a small community]. PMID- 2705117 TI - [Women's jobs--do they survive equality policies?. Interview by Kjell Arne Bakke]. PMID- 2705118 TI - [Nursing practice. High time to reassess practical competencies?]. PMID- 2705119 TI - [Preventive health activities. District nurses in Lorenskog invest in a new undertaking]. PMID- 2705120 TI - [Report from Argentina. Adoptive mothers can also breastfeed!]. PMID- 2705121 TI - [Do we have a professional attitude concerning hand hygiene?]. PMID- 2705122 TI - [Incontinence--experiences from the Center for Incontinence]. PMID- 2705123 TI - [District nurses--new function with the introduction of ADP]. PMID- 2705124 TI - [Trial project in Aust-Agder--school students will procure Maurasen nurses]. PMID- 2705125 TI - [Cancer treatment. Can music alleviate the side effects of cytostatic agents?]. PMID- 2705126 TI - [Midwives' organizations: much to serve in team work. Interview by Kjell Arne Bakke]. PMID- 2705127 TI - [Ethics--dry dust of old values. Interview by Bjorn Arild Ostby]. PMID- 2705128 TI - [Quality of life. Competently treated but in need of care]. PMID- 2705129 TI - [Nursing home--waiting room or internment camp?]. PMID- 2705130 TI - [Hospital services. Sectorization in Oslo from the nurses' viewpoint]. PMID- 2705131 TI - [International activities. Welfare activities and our new countrymen]. PMID- 2705132 TI - [HIV infection and AIDS in 1988. The epidemiological situation in Norway]. PMID- 2705133 TI - [Premature infants with HIV-positive mothers]. PMID- 2705134 TI - [Hernes Committee--with science and support]. PMID- 2705135 TI - [Diabetes mellitus--status after a 20-year illness]. PMID- 2705136 TI - [A critical look at the open nursing care plan]. PMID- 2705137 TI - [Responsibility and safety. Responsible behavior with the administration of drugs, injections and intravenous treatment]. PMID- 2705138 TI - [Legal conduct between physicians and nurses]. PMID- 2705139 TI - [Health for All. WHO's guidelines for nursing services]. PMID- 2705140 TI - [Nursing language. "Writing sins"--a book about nursing language]. PMID- 2705141 TI - [Responsibility and safety. Quality assurance in the hospital]. PMID- 2705142 TI - [Parttime studies: pioneering study program at Ulleval's nursing college]. PMID- 2705143 TI - [Rehabilitation in Columbia. Orthopedic Foundation CIREC in a tailwind]. PMID- 2705145 TI - Effective writing: a key to advancement. PMID- 2705144 TI - RCT update: N.C. medical society's position on nursing. PMID- 2705146 TI - Ethnic differences in prevalence of asthma symptoms and bronchial hyperresponsiveness in New Zealand schoolchildren. AB - Maoris and Pacific Islanders in New Zealand have a higher asthma mortality and hospital admission rates than Europeans. To determine whether difference in asthma prevalence is the major factor underlying these differences in mortality, 2053 Auckland children aged 7-10 years (European 1084, Maori 509, Pacific Islander 460) were randomly sampled from school classes in the Auckland Urban Area, and studied by questionnaire (completed by parents) and histamine inhalation challenge to assess the provocative dose of histamine causing a 20% fall in FEV1 (PD20). Maoris had the highest prevalence rates of respiratory symptoms, and Europeans had rates similar to Pacific Islanders. For "any current wheeze" for example, the prevalence in Maoris was 22.2% compared with 16.1% and 16.3% in the Europeans and Pacific Islanders. The prevalence of diagnosed asthma was similar in the three groups. When bronchial hyperresponsiveness (defined as a PD20 less than or equal to 7.8 mumol histamine) was considered, Europeans had the highest rates (20%), followed by Maoris (13%), and then Pacific Islanders (8.7%). These differences were not accounted for by differences in socioeconomic status, rates of smoking in the home, age, gender, or height. It is concluded that differences in asthma prevalence do not satisfactorily explain the mortality and admission rate differences, although the higher symptom prevalence in the Maoris could be relevant to the higher mortality rate. Maori and Pacific Island children with symptoms of asthma were less likely to be taking prophylactic medication than European children. It is proposed that differences in management are important factors relevant to the increased mortality and morbidity from asthma in Polynesians. PMID- 2705147 TI - Six years' experience with perthoracic core needle biopsy in pulmonary lesions. AB - Six years' experience of percutaneous core needle biopsy using the Hausser needle in 502 patients, aged 20-89 years, is reported. A biopsy was carried out when sputum and bronchoscopic methods had failed to establish a definitive histological diagnosis. Over 60% of the lesions were peripheral and about 40% were 2-4 cm in diameter. A correct diagnosis was made by this means in 312 of the 339 patients shown eventually to have a malignant lesion (92%) and in 130 of 146 patients with a benign lesion (89%). A definitive diagnosis was never established in 17 patients. Complications arose in 15% of cases. Pneumothorax occurred in 43 patients (7%), of whom 12 required a chest drain. Further complications included a small haemoptysis (less than 30 ml) in 27 patients (5%), haemothorax necessitating a chest drain in three patients, and an intrapulmonary haematoma in five patients. There were no fatal or permanent complications. Percutaneous core needle biopsy is a valuable procedure with a high diagnostic accuracy in these patients and a low rate of complications. PMID- 2705148 TI - Results of resection for bronchogenic carcinoma in patients over the age of 80. AB - Thirty three patients aged over 80 years underwent resection for bronchogenic carcinoma. The operations performed were: lobectomy (21), segmentectomy (4), wedge resection (2), pneumonectomy (3), carinal resection (1). In two patients no resection was feasible. Three patients died within two months of surgery. The cumulative five year survival rate was 55%, 79% for patients with stage I carcinoma and 31% for stage III. It is considered that resection has an acceptable outcome in patients over 80 years. PMID- 2705149 TI - Surgical treatment of hydatid cysts of the lung: report on 1055 patients. AB - Of 1055 patients treated surgically for pulmonary hydatid disease, most (950) had isolated lung cysts, the other 105 having both liver and lung cysts. The chest radiograph was most valuable in diagnosis; the Casoni and Weinberg tests and blood eosinophil counts were found to be diagnostically unreliable. One thousand and seventy seven primary operations were performed. Cystotomy and capitonnage were carried out in 906 patients, 40 of whom also had decortication of the pleura. Other procedures included cystotomy with wedge resection of locally damaged lung (29 patients) and cyst removal with capitonnage by Ugon's method (33) or the Perez-Fontana procedure (8) and with costal resection for osteomyelitis in two cases. More radical surgery was carried out in 99 patients for longstanding infection or severe lung destruction. Postoperative complications occurred in 37 patients (3.5%) and the 30 day mortality rate was 1.7%. It is concluded that a lung conserving surgical operation is the treatment of choice for most patients with pulmonary hydatid disease. In patients with coexisting liver cysts the thoracic transpleural approach allowed the lung and liver cysts to be removed at the same session. PMID- 2705150 TI - A self management plan in the treatment of adult asthma. AB - To determine whether routine assessment of peak expiratory flow (PEF) in association with a self management plan based on inhaled corticosteroid use is effective in the management of chronic asthma, 36 consecutive adult patients with asthma attending an outpatient chest clinic were admitted to an open prospective study. Patients were treated with inhaled salbutamol and beclomethasone dipropionate in an attempt to achieve normal lung function. Each patient had a "potential normal value," which was either the predicted normal or the maximum PEF value achieved by the patient, whichever was the higher. Patients measured PEF at home and if it fell by more than 30% from the potential normal value the dose of beclomethasone was doubled until PEF returned to the potential normal value, then continued at 20 mg/day for the same number of days. If PEF fell to below 150-200 l/min patients were asked to obtain emergency medical assistance. In the 30 patients who completed the trial the six months before and the six months after intervention with the self management plan were compared. There was a substantial improvement in both subjective and objective measurements of asthma severity, with a significant reduction in nights woken, days lost from work, and requirement for oral corticosteroids and a significant increase in baseline lung function. Routine measurement of PEF in association with a self management plan appears to be effective in reducing symptoms of asthma and improving lung function. PMID- 2705151 TI - Lung function after coronary artery surgery using the internal mammary artery and the saphenous vein. AB - Lung volumes and arterial blood gas tensions in patients undergoing coronary artery surgery were compared in 77 patients given an internal mammary artery graft (group 1) and 33 patients given a saphenous vein graft only (group 2). Patients in both groups developed a severe restrictive ventilatory defect after surgery, more pronounced in those receiving an internal mammary artery graft. Mean (SEM) vital capacity in groups 1 and 2 was reduced to 36% (1.2%) and 45% (2.0%) of preoperative values on the second postoperative day (1.56 and 1.85 1 respectively), with some recovery by day 4 to 56% (1.2%) and 63% (2.1%) of preoperative values. The mean (SEM) arterial oxygen tension was 7.34 (0.13) kPa for group 1 and 7.46 (0.20) kPa for group 2 on day 2, rising to 8.39 (0.13) and 9.01 (0.23) kPa on day 4. Analgesic requirements were greater in the group receiving an internal mammary artery graft. Possible explanations for the differences between the effects of the two grafts include the higher frequency of pleurotomy, the placing of pleural drains, and additional surgical trauma when internal mammary artery grafts are used. PMID- 2705152 TI - Pulmonary manifestations of tuberous sclerosis in first degree relatives. AB - In a family with tuberous sclerosis affecting four generations a mother and daughter had the rare pulmonary manifestations of the disease. Pathologically the pulmonary disease may be the same as pulmonary lymphangioleiomyomatosis. PMID- 2705153 TI - Occupational asthma due to soft corrosive soldering fluxes containing zinc chloride and ammonium chloride. AB - Two cases of occupational asthma due to soft corrosive soldering fluxes used in metal jointing are described in which the diagnosis was based on work related deterioration in daily peak expiratory flow rate and positive responses in bronchial provocation tests. Both fluxes contained ammonium chloride and zinc chloride. Occupational asthma provoked by these agents has not previously been reported. PMID- 2705154 TI - Bronchial casts associated with hilar lymphatic and pulmonary lymphoid abnormalities. AB - A patient who has expectorated bronchial casts for 23 years is reported. The casts contained mucus, fibrin, and lymphocytes, and the resected middle lobe showed dilated lymphatics with thickened walls at the hilum and lymphoid aggregates in the terminal bronchioles. PMID- 2705155 TI - Q fever pneumonia presenting as an eosinophilic pleural effusion. PMID- 2705156 TI - Malignant change in a benign pulmonary hamartoma. AB - Sarcomatous transformation in a longstanding, clinically silent hamartoma is reported. Malignant change occurred shortly after resection, suggesting that surgical manipulation may have played a part. PMID- 2705157 TI - Severe methaemoglobinaemia after flexible fibreoptic bronchoscopy. AB - A patient with the acquired immunodeficiency syndrome (AIDS) developed severe cyanosis after bronchoscopy (oxygen saturation 34%) from methaemoglobinaemia. This was thought to be due to enhanced absorption of local anaesthetic from the nasopharynx or trachea as a result of candidiasis. The patient responded dramatically to intravenous methylene blue. PMID- 2705158 TI - Mitral prosthetic valve regurgitation due to stent fracture of a porcine bioprosthesis. AB - Mitral prosthetic valve regurgitation due to stent fracture with consequent cusp prolapse occurred in two patients with a Wessex porcine bioprosthesis. PMID- 2705159 TI - Prolonged hypoxaemia following inhalation of hydrogen chloride vapour. AB - A patient is described who developed prolonged hypoxaemia and subsequent asthma after a single exposure to a high concentration of hydrogen chloride vapour (and a small amount of phosphorus trichloride). PMID- 2705160 TI - Predicted values: how should we use them? PMID- 2705161 TI - [Balint-inspired general practice groups]. PMID- 2705162 TI - [Compulsory treatment of patients with anorexia?]. PMID- 2705163 TI - [A snow avalanche in Vassdalen. Medical experiences]. AB - Of 31 soldiers caught by an avalanche in Northern Norway, one was not buried, 13 were partly buried and 17 were completely buried by the mass of snow. Only one of the completely buried soldiers survived. On admission to hospital after being buried by snow for three hours he had moderate hypothermia. The cause of death in the other 16 was most probably general compression of the body with acute respiratory and circulatory failure. Five of the 13 partly buried had physical traumas. None of the nine attempts at resuscitation succeeded. Self-rescue and rescue by friends were most important to the soldiers who survived. We discuss aspects of the organized rescue operation. PMID- 2705164 TI - [From contact to contract. Psychiatric supervision of groups of general practitioners]. AB - For the last 2 1/2 years, supervision groups for general practitioners have been run at Telemark sentralsjukehus. Initially the instructors emphasised flexibility, utility and servicemindedness. By means of group process thinking and emphasis on distinct contracts the meetings eventually developed into consultation groups. Parallel with the group process we have experienced more informal contact and new forms of collaboration with the individual general practitioners which may indicate an increased interest among them for psychiatry. PMID- 2705165 TI - [Psychosis and involuntary admission of patients with anorexia nervosa. A questionnaire study among 123 Norwegian psychiatrists]. AB - According to Norwegian law, one of the conditions of involuntary admission is that the patient must be psychotic at time of admission. The therapeutic benefits of involuntary admission of anorectic patients in a life-threatening phase of the illness have been discussed for quite some time, as well as whether the conditions for such admission may be fulfilled by this kind of patient. The authors have conducted a nationwide survey among the 57 psychiatrists in private practice and the 66 chief psychiatrists at adult psychiatric institutions in Norway, asking them to answer a questionnaire on these issues. The findings may point to a need for more specific guidelines on how to handle such patients, and for further analyses on the meaning and fruitfulness of the concept of psychosis in general, and related to anorexia nervosa in particular. PMID- 2705166 TI - [The skin and aging. Spontaneous and drug-induced repair of radiation-induced dermal injuries]. AB - For the last 2 1/2 years, supervision groups for general practitioners have been run at Telemark sentralsjukehus. Initially the instructors emphasised flexibility, utility and servicemindedness. By means of group process thinking and emphasis on distinct contracts the meetings eventually developed into consultation groups. Parallel with the group process we have experienced more informal contact and new forms of collaboration with the individual general practitioners which may indicate an increased interest among them for psychiatry. PMID- 2705167 TI - [Familial antithrombin deficiency]. AB - When known causes of a disposition to thrombosis are discovered (e.g. antithrombin, protein C or protein S deficiency) it is important to investigate family members and inform individuals who are deficient in the factor in question. Knowledge about the cause of the thrombophilia will stimulate prophylactic efforts, and may be very important for diagnosis and treatment of the patient. A recently discovered new family with antithrombin deficiency is presented. PMID- 2705168 TI - [Caustic injuries of the esophagus]. AB - Several different agents can cause lesions of the esophagus if they are ingested. An esophagoscopy is necessary for proper evaluation of the damage. Our experience over the last 12 years substantiates that lye and strong alkalis are the most dangerous substances to swallow. The decision to do an esophagoscopy should be based on certain criteria listed in the paper. PMID- 2705169 TI - [Nervous system damage caused by H2S poisoning without unconsciousness]. AB - Acute H2S (hydrogen sulfide) poisoning can cause permanent damage to the nervous system. We describe two patients with such damage. Both reported nausea, feeling unwell and irritation of the eyes during work, and have developed persistent memory problems and neurasthenic symptoms. Neither of them had been unconscious. The first patient was exposed during one and a half hours welding of a sewage pump. The second patient worked for three weeks in a laboratory where hydrogen sulfide leaked from faulty equipment. The cases demonstrate the need for thorough work and symptom anamnesis together with neuropsychological testing in order to achieve a correct diagnosis of encephalopathy caused by hydrogen sulfide exposure. PMID- 2705171 TI - [Norwegian nomenclature in immunology]. AB - Immunology represents one of the medical disciplines that has witnessed the fastest growth in new knowledge in recent decades. In the international journals the new concepts are introduced using English terminology. Norwegian immunologists are almost exclusively exposed to English immunological literature, and are therefore prone to adopt English rules of syntax when translating this literature into Norwegian. Two years ago a nomenclature-committee was established, with the mandate to ensure improved translations and, where relevant, to point out rules of syntax. The article presents the results from the work of this committee. PMID- 2705170 TI - [Drug therapy of hypercholesterolemia. Treatment of hypercholesterolemia in adults--a Norwegian therapeutic program 1988]. AB - There are indications that treatment of hypercholesterolemia by means of drugs reduce risk of atherosclerosis in patients with increased concentrations of atherogenic lipoproteins. Such therapy should be initiated only after satisfactory exclusion of secondary causes of hyperlipoproteinemia, and should be regarded as an adjunct to appropriate dietary therapy. Drug therapy should be strongly considered in patients with total cholesterol above 8-9 mmol/l on diet therapy only. Drug therapy should be considered at even lower concentrations of cholesterol when coronary heart disease is present and in familial forms of hyperlipidemia when increased risk of atherosclerosis has been documented. In patients with increased plasma concentrations of total cholesterol the drugs of choice are agents which enhance the rate of LDL catabolism (resins) or reduce the rate of LDL synthesis (nicotinic acid). Fibrates should be used when triglycerides and cholesterol are both increased. HMG CoA reductase inhibitors offer considerable promise in the therapy of patients with primary hypercholesterolemia. Probucol may be used in combination with other drugs, particularly when xanthomas are present in patients with familial hypercholesterolemia. PMID- 2705172 TI - [Radiculography in the polyclinic]. PMID- 2705173 TI - [Treatment of phobias and compulsive disorders]. PMID- 2705174 TI - [Significance of the operative technic in surgical treatment of primary inguinal hernia. A prospective study of recurrence frequency when 2 different methods were used]. AB - 204 male patients aged 16 years and older who had been operated for acquired inguinal hernia at Sarpsborg Sykehus during the period 1975-81 were reexamined by means of a personal follow-up examination. Before the operation the patients were randomized into two different groups. One group was operated using Bassini's technique and the other using Hindmarsh's technique. This prospective clinical study revealed far fewer recurrences after the Hindmarsh operation. The recurrence rate of all inguinal herniae treated by the Hindmarsh operation was 7.4%, as against 18.7% in cases treated by the Bassini operation. Our study shows that the operative procedure chosen for treatment of acquired inguinal hernia is a variable affecting the rate of recurrence. PMID- 2705175 TI - [Ambulatory radiculography (lumbar myelography) with iohexol]. AB - Iohexol lumbar myelography was performed in 133 consecutive patients remitted to a private radiological institute on an outpatient basis. Adverse reactions were recorded during the first week after myelography. The data were collected through a questionnaire returned by the patients. The results showed that half (48%) of all patients had no side effects. Some more than one third (41%) of all patients had only mild or moderate side effects from the ambulatory myelography. Of all patients 11% experienced headache or other bothersome symptoms for more than three days following myelography. In this material there was no difference in side effects between women and men. About half of the patients was punctured with a 22 gauge spinal needle and the others with a 25 gauge needle. There was no significant difference in side effects related to needle size. Iohexol lumbar myelography can safely be performed without hospitalization of the patient. PMID- 2705177 TI - [Exposure therapy of phobic and compulsive disorders]. AB - Several methods have been used to treat anxiety disorder. In phobic conditions and in obsessive compulsive disorders, exposure therapy is most effective. In exposure therapy, the relevant evoking stimuli are presented repeatedly to the patient. This method does not suit all patients, however. For favourable results, certain exclusion criteria must be observed. In addition, the treatment procedure must be followed systematically. PMID- 2705176 TI - [Experiences with ambulatory radiculography]. AB - 54 outpatients who were referred with the clinical diagnosis lumbar disk herniation, underwent lumbar myelography with iohexol. After the examination the patient returned to the ward where he was observed for about 2 hours while resting in a chair. He was then allowed to leave the hospital with the recommendation to avoid hard physical exercise for the next 24 hours. No serious complications occurred. Severe headache was reported by 20% of the patients and 22% experienced transient minor discomfort. It is concluded that lumbar iohexol myelography can be performed safely on ambulatory patients. PMID- 2705178 TI - [Alcohol and head injuries]. AB - 42 patients with epidural haematoma were operated upon in the surgical department of the regional hospital, Tromso, in the years 1967-1985. Clinical evaluation showed that 17 of these patients (40.5%) were intoxicated by alcohol at the time of trauma. 14 of the intoxicated (82.4%) but only 7 (28%) of the sober patients, had been injured either in the evening or at night. 13 in the intoxicated group (76.5%) and 10 in the sober group (40%) were hurt by falling or as a result of violence. 15 of the sober group (60%) and 4 intoxicated patients (23.5%) arrived less than 4 hours after the accident. We found a significant difference between the two groups as regards the time lag between accident and arrival at Tromso hospital. PMID- 2705179 TI - [Cyclophosphamide-induced pneumonitis]. AB - Cyclophosphamide is an alkylating agent with a wide spectrum of activity against malignant tumours. Because of its pronounced immunosuppressive effect it is also frequently used in organ transplantations and in the treatment of certain autoimmune diseases. The drug has toxic side effects, however, some of which are ascribed to specific metabolites. This report describes a patient who developed cyclophosphamide associated cystitis and pneumonitis while being treated for Wegener's granulomatosis. Early recognition of the condition and discontinuation of therapy is essential for a favourable outcome. PMID- 2705180 TI - [Danger in tipping of anesthetic vaporizers]. AB - Tipping or agitating a loaded anaesthetic vaporizer may lead to subsequent delivery of an uncontrolled, potentially lethal concentration of anaesthetic vapour to the patient. Cardiovascular collapse may ensue. Prompt recognition of the situation and correct handling is essential to prevent a fatal outcome. The practice of swapping vaporizers equipped with quick-change mounting systems has revived this hazard. Recommendations are outlined for handling vaporizers. PMID- 2705181 TI - [Breast feeding. Effects of smoking and education]. AB - A study of 885 women who had given birth in Oslo, Norway in 1985 disclosed that 80% were still breastfeeding three months after delivery. Forty percent of the mothers smoked cigarettes daily. Only 7% had stopped smoking because of pregnancy or lactation. High social class and educational level was positively correlated to prolonged breastfeeding. Smoking was negatively correlated to breastfeeding when the infant was three and four months old. While 93% of non-smokers with an education of 17 or more years still breastfed four months after delivery, this was true of only 6% of heavy smokers with an education of nine years or less. Also within each social group and educational level the prevalence of breastfeeding was lower among the smokers, with a dose/response effect of the number of cigarettes smoked. More smokers than non-smokers stopped breastfeeding because they had "too little milk". Forty percent of infants breastfed by smokers suffered from colic or excessive crying, as compared with 26% of the children of non-smokers. PMID- 2705182 TI - [Information technology in health care. A new industrial policy program]. AB - Health care is chosen as one of the major target sectors under a national industrial policy program for information technology. The program offers direct support to industrial information technology projects. The part of the program related to health care is executed partly by the Ministry of Health and Social Affairs, partly through a new program under the Royal Norwegian Council for Scientific and Industrial Research. This program is called IT in health care and runs 1989-92. During this five-year period the health care program has a total budget of approximately NOK 85 million for research and development. The funds are used for projects with a distinct industrial objective, and emphasis is placed on cooperation between health care services, research and industry. PMID- 2705183 TI - [Training of surgical specialists in England. A report and personal reflections]. AB - The article gives an account of postgraduate training in surgery. It describes the hierarchy in hospitals, the teaching and the examination system. It also describes use of a formal medical audit and the different working hours. It further presents the pros and cons of evaluation based on exams alone, and on operation lists alone. PMID- 2705184 TI - [Englishmen under stress]. PMID- 2705185 TI - [The presence of nortestosterone in edible parts from non-castrated male pigs]. AB - Nortestosterone is a major growth-promoting agent in Europe which is often used illegally in various species of meat animal. Recent studies showed that this compound was also present in the urine of young male pigs (boars) to which nortestosterone had not been administered. To determine to which extent nortestosterone may also be present in liver and muscle tissues, samples of the urine, bile, liver and muscle of twenty five boars were analysed. The mean and highest concentrations, detected respectively in muscle were 1.1 and 13 micrograms/kg and were 23 and 200 micrograms/kg in liver. The corresponding concentrations in urine were 55 and 132 micrograms/l and 88 and 212 micrograms/l in bile. PMID- 2705187 TI - [What is the role of the farm environment in edema in swine?]. PMID- 2705186 TI - [A case of selenium poisoning in weaned piglets; the persistent one wins]. AB - A case of selenium poisoning involving eighty approximately nine-week-old piglets is reported. Feed and water were supplied with a dry feed hopper with nipple in the through. Clinical symptoms appeared within ten days after the feed-intake. The symptoms consisted in loss of condition (emaciation), drawn-in thin bellies, long hair, loss of appetite, hard, dark faeces, cerebral symptoms and mortality. Autopsy was performed on a total number of four piglets, in which severe hepatic degeneration was detected. When pig prestarter (creep feed) was substituted for piglet-raising feed (weaner-diet), the condition was gradually restored to normal within a few days. PMID- 2705188 TI - [An immunofilter catches anabolic steroids. An improved method for the monitoring of hormone residues]. PMID- 2705189 TI - Organizations set goals. PMID- 2705190 TI - Structuring and implementing productivity programs. PMID- 2705191 TI - Developing and using standards for work performance. PMID- 2705192 TI - Staffing approaches to productivity programs. PMID- 2705193 TI - Special issues in productivity programs. PMID- 2705194 TI - Patient acuity systems and productivity. PMID- 2705195 TI - What is the proper experimental unit for long-term rodent studies? An examination of the NTP benzyl acetate study. AB - The National Toxicology Program (NTP) rat bioassay on benzyl acetate shows an apparent increase in acinar-cell adenomas of the pancreas in male rats [1]. The statistical significance of the apparent trend is examined using the animal, cage, or rack/shelf location as the statistical independent experimental (sampling) unit. Experimental, statistical, and empirical considerations indicate that, in this experiment, if there is a proper experimental unit, it is the shelf of animals on a rack rather than the individual animal or cage of animals. Using the shelf as the experimental unit, the apparent increase in acinar-cell adenomas is not statistically significant. There is strong evidence for pancreatic tumor rates to differ among shelves which implies that toxicologists should consider cage randomization. PMID- 2705196 TI - Assessment of thrombogenic potential of liposomes. AB - The effects of liposomes with positive, neutral and negative surface charges on platelets and the plasmatic coagulation system were investigated in several in vitro and in vivo models. Negatively charged liposomes stimulated the plasmatic contact activating system as demonstrated by significant acceleration of whole blood clotting time measured in containers with nonwettable (siliconized) surface. The same liposomes induced reversible aggregates of human platelets in vitro and circulating reversible platelet aggregates after intravenous infusion in guinea pigs. Liposomes with positive and neutral surface charges had no effect on plasmatic coagulation and platelets. The biological mechanisms and the toxicological relevance of these findings are discussed. PMID- 2705197 TI - Thiosulphate and hydroxocobalamin prophylaxis in progressive cyanide poisoning in guinea-pigs. AB - The duration of action of the cyanide antidotes sodium thiosulphate and hydroxocobalamin was investigated in guinea-pigs after prophylactic administration before a long-term infusion of NaCN. The parameter for the diminution of the antidote action was the point of time at which the concentration of HCN in the exhaled air of the animals exceeded 100 nmol/kg per min. The time taken to reach this threshold level in the control animals was 12 min. While the threshold level could be extended only to 35 min with hydroxocobalamin (300 mg/kg i.v.) the protective action of sodium thiosulphate (100, 500 and 1000 mg/kg i.v.) persisted dose dependently for about 1, 2 and 4 h, respectively. Additionally we found a plasma half-life of sodium thiosulphate in guinea-pigs of 26 min. This value corresponds approximately to the plasma half life of sodium thiosulphate in humans given in the literature. Because of the large injection volume necessary, sodium thiosulphate is not suitable for prophylactic use in man. PMID- 2705198 TI - Health signficiance and early detection of nephrotoxicity. Proceedings of the joint CEC/IPCS Workshop. Commission of the European Communities/International Programme on Chemical Safety. Luxembourg, 26-29 April 1988. PMID- 2705199 TI - Contribution of toxic nephropathies to end-stage renal failure in Europe: a report from the EDTA-ERA registry. AB - In countries which reported to the registry of the European Dialysis and Transplant Association (EDTA)-European Renal Association, 2.4% of 147 092 treated patients were recognized as having analgesic nephropathy (AN) as the cause of end stage renal failure (ESRF) on 31 December 1986. A small number of patients had other specific drug nephropathies, but these do not yet make an important contribution to ESRF treatment programmes. It is possible that more patients have ESRF due to AN, and evidence from studies of age distribution, the demography of urothelial malignancies, a special study of diagnostic criteria, data on sales of analgesics, and a study of regional areas of high incidence lend some support to that view. Changes in prescription and self-medication practices over the last 20 years have almost eradicated analgesic nephropathy from the U.K. and Sweden, two countries in which there was previously a high frequency of ESRF due to AN. In other countries where action has been taken more recently, cases are still reported fairly frequently, and this seems likely to continue for several years to come. PMID- 2705200 TI - Epidemiological application of early markers of nephrotoxicity. AB - This paper is a review of epidemiological studies in which sensitive markers of nephrotoxicity have been used to detect the early effects of chemicals on the kidney. Most of the studies are cross-sectional, and their objective was either to identify potentially nephrotoxic chemicals (organic solvents, heavy metals) in the working or general environment or to establish dose-response/effect relationships from which safe exposure levels can be defined (e.g., for cadmium and mercury vapour). A few longitudinal studies were conducted to determine the persistence of renal disturbances and to get information on their predictive value (e.g., microproteinuria in cadmium workers). Nephrotoxicity tests, which have proved to be the most useful in these epidemiological studies, rely on the determination of specific urinary proteins which, according to their size, reflect the functional integrity of the proximal tubule (e.g., retinol-binding protein or beta 2-microglobulin) or the glomerulus (e.g., albumin, immunoglobulin G). An increased urinary excretion of the lysosomal enzyme N-acetyl-beta-D glucosaminidase has been reported in several studies (e.g., in lead-exposed workers), but the pathological significance of this finding remains to be clarified, particularly when it is not associated with changes in the urinary excretion of specific proteins. Further work is needed to assess the usefulness of tests introduced more recently such as the assay of renal antigens in urine and the use of red-blood-cell membrane negative charges as an index of the glomerular polyanion. With the exception of microproteinuria observed in chronic cadmium poisoning, no epidemiological data are available on the prognostic value of subclinical renal effects caused by nephrotoxic chemicals. PMID- 2705201 TI - [What is independence?]. PMID- 2705202 TI - [Employees without pension arrangements]. AB - Old age pensions in modern western industrial countries rest on three pillars: public, collective and individual-private arrangements. The flat-rate public system and the collective systems, domain of industrial relations, prevail in Holland. Since the early seventies the public old age pension (AOW) has been raised to the net minimum wage level. In the meantime the importance of the collective systems has been increasing. The pension levels of these systems are, however, not prescribed by law. In order to measure the present state of the collective systems the Dutch Chamber of Pensions has started a research project to investigate how many workers lack such an arrangement and why they lack it. The results of the project have recently been reported: in 1985 18% (650,000) of the workers (25-65 years) lacked an arrangement. The vast majority of them (87%) was found in the sector of services, especially the commercial services. A second research project has been started to find out the quality of the existing pension arrangements. The results of the two projects together are meant to answer the question whether or not some sort of collective pensions must be enforced by law. The improvement of collective pension schemes, however, should not lead automatically to decreasing public schemes. For most people the public pension system is the most important source of income. PMID- 2705204 TI - [The patient with a long-term indwelling catheter]. AB - A working-group of the Scientific Council of the CBO has drawn up a report on infection control of patients with longterm indwelling catheterization of the urinary bladder. In the first place, restricted use of catheters and shortening of their indwelling use are intended. Furthermore preventive and diagnostic measures and treatment are recommended in case of urinary tract infection and blocking catheters. PMID- 2705203 TI - [Temporary lumbar external drainage in normal pressure hydrocephalus]. AB - In a prospective study twenty-two patients diagnosed as suffering from idiopathic normal pressure hydrocephalus, were investigated using temporary external lumbar drainage. Five patients had to be excluded from the study because of complications of external lumbar or definite ventricular shunting. External drainage correctly predicted the outcome of shunting in all of the remaining seventeen patients. This technique appears to be a safe and valuable tool for predicting the outcome of definitive shunting procedures. PMID- 2705205 TI - Unlock the mystery of lupus. PMID- 2705206 TI - Your nursing power to resolve conflict in the professional setting. PMID- 2705207 TI - A guide to topic selection in publishing. PMID- 2705208 TI - Subcellular fractionation of tissue culture cells. AB - Subcellular fractionation has two major steps, (1) the homogenization of the cells and (2) the subsequent separation of the organelles. The homogenization step is discussed with reference to the problems encountered using tissue culture cells. Promising techniques for the isolation of specific compartments are illustrated using the isolation of the endosomal compartment as the example. PMID- 2705209 TI - Effect of platelet-activating factor antagonist on cyclosporine nephrotoxicity. Glomerular hemodynamics evaluation. AB - In order to evaluate the effect of platelet-activating factor (PAF) antagonist BN 52021 (5 mg/kg i.v.) on cyclosporine (50 mg/kg i.v.) nephrotoxicity, euvolemic Munich-Wistar rats were submitted to micropuncture studies. BN 52021 alone did not change the total (1.08 +/- 0.07 vs. 1.04 +/- 0.06 ml/min) or single nephron (SN) (29.1 +/- 50 vs. 31.3 +/- 4.0 nl/min) and glomerular filtration rate. The CsA administration caused a decline on GFR (0.47 +/- 0.07 vs. 0.96 +/- 0.04 ml/min, P less than 0.05) and on SNGFR (14.0 +/- 3.5 vs. 27.9 +/- 3.4 ml/min, P less than 0.05). An increase in afferent (RA) and efferent (RE) arteriolar resistances, 180% and 360%, respectively, that caused a decrease on glomerular plasma flow rate (QA) from 100.99 +/- 17.09 to 44.37 +/- 13.37 nl/min (P less than 0.05) was observed. Moreover, the glomerular ultrafiltration coefficient (Kf) declined by 70% (0.096 +/- 0.003 to 0.031 +/- 0.10 ml/sec mmHg, P less than 0.05). The previous BN 52021 administration on rats treated with CsA blunted its effects on superficial nephrons. The SNGFR (22.3 +/- 3.0 vs. 28.0 +/- 25 nl/min), QA (72.2 +/- 5.9 vs. 91.7 +/- 12.1 nl/min) and KF (0.038 +/- 0.009 vs. 0.048 +/- 0.005 nl/s mmHg) remained unaltered. By contrast, the total renal function was not prevented by BN 52021 treatment: GFR 0.45 +/- 0.12 vs. 0.94 +/- 0.05 ml/min (P less than 0.05). Thus, this study suggests that PAF may participate in CsA nephrotoxicity. Furthermore, the protective effect of BN 52021 on superficial nephrons may indicate that BN 52021 is a drug that can minimize the impairment of renal function induced by CsA. PMID- 2705210 TI - Comparison of specific radioimmunoassays for cyclosporine. AB - This study compares two recently introduced radioimmunoassay kits involving specific monoclonal antibodies to cyclosporine. One kit (Sandimmun) involved 3H labeled CsA (3H-CsA) as tracer and the other (CY-CLO-Trac-SP) involved a 125I labeled conjugated derivative of CsA. The kits were nearly equivalent in method performance characteristics. They produced superimposed standard curves and equivalent values to transplanted patient samples. Concentrations of CsA determined by either kit were apparently equivalent to values measured by high performance liquid chromatography, suggesting that the specific monoclonal antibodies used with the kits detect in trough blood mainly native CsA. The 125I labeled CsA, when compared with the 3H-CsA alternative, increased the sensitivity and precision, decreased the turnaround time, and provided a technically efficient and conveniently capable method of replacing HPLC for measuring native CsA. PMID- 2705211 TI - Dissociation between the immunosuppressive activity of cyclosporine derivatives and their effects on intracellular calcium signaling in mesangial cells. PMID- 2705212 TI - Norfloxacin and cyclosporine--a safe combination. PMID- 2705213 TI - Absorption of monoclonal antibodies under different administration forms. PMID- 2705214 TI - Effect of 15-deoxyspergualin on the survival of thyroid allografts in mice. PMID- 2705215 TI - Epithelial cell cultures and determination of surface antigens (class-II-antigens in mice). PMID- 2705216 TI - Monoclonal antibodies recognizing shared molecules on endothelial cells and leukocytes. PMID- 2705217 TI - The inhibition of cell mediated cytotoxicity by 16,16 dimethyl PGE2. PMID- 2705218 TI - Comparison of immune responses in mice after transfusions from single or multiple H-2 donors. PMID- 2705219 TI - Expression of immune cell surface markers in vivo and immune competence in mice by dietary nucleotides. PMID- 2705220 TI - Differential sensitivity of human leukocyte subpopulations to ultraviolet light. PMID- 2705221 TI - Comparison of the effect of cyclosporine, verapamil, and trifluoperazine on calcium-induced membrane permeability of mitochondria. PMID- 2705222 TI - Lymphokine-activated killer (LAK) cells are identical to the uterine granulated metrial gland (GMG) cells. PMID- 2705223 TI - Thymus allografts fail to improve lymphopenia or prevent autoimmune diabetes in the BB rat. PMID- 2705224 TI - Regulation of class I antigens responsible for prolonged graft survival after organ culture. PMID- 2705225 TI - Suppression of the DTH response in miniature swine by pretreatment with ultraviolet light-irradiated blood lymphocytes. PMID- 2705226 TI - Expression of adhesion molecules by human renal tubular cells in culture and binding of activated lymphocytes. PMID- 2705227 TI - Preformed natural antibodies (PNAB) and possibilities of modulation of hyperacute xenogeneic rejection (HXAR). PMID- 2705228 TI - Anti-Wra antibody following recurrent abortion or term pregnancy. PMID- 2705229 TI - Class I MHC antigens on rat placental trophoblast and yolk sac fetal membrane. PMID- 2705230 TI - DNA sequence analysis of a class I clone from a rat cDNA placental library. PMID- 2705231 TI - A unique placental antigen controlled by an MHC-linked locus, RT11. PMID- 2705232 TI - Characterization of the pregnancy-associated rat MHC class I antigen Pa by mating studies and by peptide mapping. PMID- 2705233 TI - Molecular analysis of MHC-linked genes affecting growth and development. PMID- 2705234 TI - Infertility treated with donor specific lymphocytes in recurrent idiopathic spontaneous abortion. PMID- 2705235 TI - IgG on normal human placenta is bound both to antigen and Fc receptors. PMID- 2705236 TI - The expression of an "alloantigen"-like molecule is a general phenomenon in AKR leukaemias. PMID- 2705237 TI - Increased tumour growth after blood transfusion. PMID- 2705238 TI - Effect of blood transfusions and surgery on metastatic growth and immune parameters in a rat model. PMID- 2705239 TI - The role of HLA matching and blood transfusions in the cyclosporine era. Collaborative Transplant Study. PMID- 2705240 TI - The use of retroviral vectors to study cell transformation and malignancy. PMID- 2705241 TI - HLA-B SNA antigen: a BW6-associated B locus antigen belonging to the B5 CREG. PMID- 2705242 TI - In vivo microscopy of recirculation and allograft rejection in the rabbit ear chamber. PMID- 2705243 TI - Failure of splenectomy to affect the antibody rebound after plasma exchange in the rat. PMID- 2705244 TI - Effects of cholestasis on cyclosporine metabolism in the pig. PMID- 2705245 TI - Fc-receptors regulate secretion of tumor necrosis factor by human monocytes. PMID- 2705246 TI - Drug-drug interaction between cyclosporine and agents affecting calcium-dependent lymphocyte proliferation. PMID- 2705247 TI - Specificity of the nuclear effect of cyclosporine on the immune cells. PMID- 2705248 TI - The reversal of cyclosporin A-mediated suppression of allogeneic induced monocyte procoagulant activity by H2 antagonists in-vitro. PMID- 2705249 TI - Cyclosporin A plus fish oil: accentuate the positive, eliminate the negative. PMID- 2705250 TI - Cyclosporin A binding to calmodulin. PMID- 2705251 TI - Cyclosporin A and G inhibition of cytokine production. PMID- 2705252 TI - Receptor-mediated cellular uptake of cyclosporine. PMID- 2705253 TI - Failure of cyclosporine A to affect generation of large granular lymphocytes (OX 8+, OX-19-) and natural killer cell activity following systemic cyclophosphamide administration and immunization in the rat. PMID- 2705254 TI - Fully automated high-performance liquid chromatographic determination using pretreatment polymer column and column-switching for fast, daily, routine bedside monitoring of cyclosporine in whole blood. PMID- 2705255 TI - Acute effects of intravenous cyclosporine on renal function in healthy humans. PMID- 2705256 TI - Effect of cyclosporine administration on vascular reactivity in the rabbit. PMID- 2705257 TI - Cyclosporin inhibition of glucose transport in cell culture. PMID- 2705258 TI - Effects of cyclosporine on oxidative phosphorylation and adenylate energy charge of regenerating rat liver. PMID- 2705259 TI - The effect of cyclosporine on the glucose tolerance of normal monkeys. PMID- 2705260 TI - Cyclosporine: its harmful effects on testicular function and male fertility. PMID- 2705261 TI - The relative effects of aztreonam versus gentamicin on nephrotoxicity induced by warm ischemia in the presence and absence of cyclosporine. PMID- 2705262 TI - The role for reactive oxygen species in cyclosporin A induced nephrotoxicity in rats. PMID- 2705263 TI - Cyclosporin A nephrotoxicity in streptozotocin-diabetic rats. PMID- 2705264 TI - The effects of cyclosporine on human platelet aggregation and thromboxane release. PMID- 2705265 TI - Experimental cyclosporin hypertension: characterization of the rat model. PMID- 2705266 TI - Differential effects of azathioprine (Aza), cyclosporine A (CsA) and dexamethasone (Dexa) on lymphokine mediated inflammation (LMI) in rejecting allografts. PMID- 2705267 TI - Proceedings of the twelfth international congress of the Transplantation Society. August 14-19, 1988, Sydney, Australia. Book III. PMID- 2705268 TI - Electrocardiographic and histopathologic changes developing during experimental brain death in the baboon. PMID- 2705269 TI - Experimental tracheal allotransplantration using omentopexy. PMID- 2705270 TI - Effect of ex vivo allograft irradiation combined with cyclosporine therapy in a pig intestinal transplant model. PMID- 2705271 TI - Lymphocyte migration patterns in small bowel transplants. PMID- 2705272 TI - Immune response of rat small bowel lymphocytes. PMID- 2705273 TI - Early microvascular changes in small intestinal allografts. PMID- 2705274 TI - The small bowel pouch: technical and physiologic aspects of a new model of small intestinal grafting. PMID- 2705275 TI - The effect on the cornea of alpha cyclodextrin vehicle for cyclosporin eye drops. AB - We tested four different combinations of alpha-CD and CYA: 0.075% and 80 mg/mL alpha-CD, 0.025% CYA and 40 mg/mL alpha-CD, 0.009% CYA and 20 mg/mL alpha-CD, and 0.003% CYA and 10 mg/mL alpha-CD. We found that 0.025% CYA (alpha-CD[40 mg/mL]) resulted in the least corneal toxicity and penetrated in the cornea 5 to 10 times more than did lipophilic vehicle with CYA. PMID- 2705276 TI - Fundamental investigation of neural transplantation for Parkinson's disease in mice. PMID- 2705277 TI - Preliminary report of peripheral nerve allografting in primates immunosuppressed with cyclosporin A. PMID- 2705278 TI - Experimental study of urinary vesical transplantation. PMID- 2705279 TI - Experimental analysis of the effects of cyclosporine on the induction and growth of epithelial tumors. PMID- 2705280 TI - [Information dissemination by specialty periodicals]. PMID- 2705281 TI - [Hyperthermia in cancer research. Historical development, current status of research, future perspectives and differentiation from alternative medical procedures]. AB - Already at the beginning of the 19th century first clinical trials with systemically induced fever were performed on malignant tumors. An intensified research in thermobiology in the sixties of this century gave the rationale for using this modality for cancer treatment. Clinical use of hyperthermia in combination with radiation or chemotherapy begun in the mid of the seventies when a better technique for selective heating of the tumor was used. In the technical development the problem of heating deep-seated tumors was mainly solved. Temperature measurements of the tumor and surrounding tissues are performed with specialized thermometry systems using thin implanted catheters to measure inside the body. 1986 a pilot study was initiated at the Medical Clinic III of the Klinikum Grosshadern to study the effects of regional hyperthermia combined with systemic chemotherapy. This study is aimed on feasibility, toxicity, and tumor response. PMID- 2705282 TI - [Physician responsibility for patient education in relation to unconventional methods of treatment]. AB - The fact is to go on record that, the greater the danger involved in the application of an unconventional method and the less familiar this method, the greater the physician's obligation to inform the patient of its nature and gravity. This obligation increases or decreases in indirect proportion to the amount of relevant information available in classical medicine on the method. It further increases with degree of certainty in current medical knowledge. It is however only possible for the patient to exercise his right of self-determination if he is also familiar with the physicians's obligation to inform. PMID- 2705283 TI - [Experiences with medical expert committees--procedures in physician malpractice claims]. AB - For the relaxation of the physician-patient relationship from 1975 on Settlement Institutions and Expert Commissions were established at all General Medical Councils of the Federal Republic of Germany. The first Settlement Institution was founded on April 24th, 1975 in Bavaria, the first Expert Commission on December 12th, 1975 in North-Rhine. These institutions without example met all requirements and have stand the test. Quality standards are ensured by cooperation of lawyers. The 7288 reproaches of malpractice during the 12,5 years at the Expert Commission North Rhine are analyzed. Out of these 7288 reproaches 1126 cases of malpractice were assessed. PMID- 2705284 TI - Interference in the establishment of tsetse-transmitted Trypanosoma congolense, T. brucei or T. vivax superinfections in goats already infected with T. congolense or T. vivax. AB - An interference phenomenon that delays superinfection with a trypanosome species different from that used for the initial infection has been found to occur in goats. Following tsetse transmission of Trypanosoma brucei to goats already infected with T. congolense, there was a delay in chancre development, as well as in the appearance of T. brucei and anti-T. brucei antibodies in the blood when compared to previously uninfected goats. However, there was no delay in the establishment of a tsetse-transmitted superinfection with T. vivax in goats already infected with either T. congolense or in animals already infected with a different serodeme of T. vivax. PMID- 2705285 TI - Spleen hydatidosis in sheep from north Jordan. AB - A total of 380 ewes of different age groups were inspected for spleen hydatidosis during the summer of 1985. Of these, 7.6% had cysts in the spleen. There was an increase in the prevalence of the disease with increasing age of the animal, reaching 11.8% in greater than or equal to 8-year-old ewes. Out of all the animals with spleen hydatidosis, 61.5% were found to have fertile cysts and, when classified, 46.7% were found to be fertile with a mean total number of protoscolices of 13.4 x 10(3) per cyst. The majority of the protoscolices were found to be viable (74%). Spleen hydatidosis which is mainly solitary seems to be secondary to the involvement of the liver or the liver and lung simultaneously. The importance of these aspects of spleen hydatidosis are discussed. PMID- 2705286 TI - Comparison of dot enzyme-linked immunosorbent assay (Dot-ELISA), passive haemagglutination test (PHT) and thin layer immunoassay (TIA) in the diagnosis of natural or experimental Fasciola hepatica infections in sheep. AB - The dot enzyme-linked immunosorbent assay (Dot-ELISA) was compared with the passive haemagglutination test (PHT) and thin layer immunoassay (TIA) for the detection of antibodies against Fasciola hepatica in naturally and experimentally infected sheep. The infected animals gave titres from 1:25,000 to 1:204,000, while control animals gave titres of from 1:100 to 1:800. The titres of the infected sheep obtained by Dot-ELISA were 1000-2000 times higher than the ones obtained using TIA or PHT. Due to its high sensitivity, this technique could be very useful for the diagnosis of ovine fascioliasis. PMID- 2705287 TI - The effect of levamisole and albendazole on some enzymes of Ascaridia galli and Heterakis gallinae. AB - Ascaridia galli and Heterakis gallinae obtained from the common fowl Gallus gallus were exposed to 10(-2)-10(-5)M levamisole and albendazole; both compounds caused death of the parasites in vitro. The effect of the drugs was investigated on homogenates of the treated worms. Albendazole, at 10(-2)M, inhibited oxaloacetate reduction by 67 and 53% and malate oxidation by 21 and 17% in A. galli and H. gallinae, respectively, whereas 10(-4)M levamisole completely inhibited malate dehydrogenase activity in both directions in the two parasites. Lactate dehydrogenase was not affected significantly by either anthelmintic. Aldolase activity was diminished by 57 and 32% in A. galli and H. gallinae, respectively, with 10(-4)M levamisole. Levamisole at 10(-4)M also inhibited the activity of acid and alkaline phosphomonoesterase and cholinesterase. Albendazole had no significant effect on these enzymes in either parasite. Malate dehydrogenase and cholinesterase activity of the host tissue (intestine and caecum) was also reduced significantly with 10(-2) and 10(-3)M levamisole. These studies indicated a multiple mode of action of levamisole and albendazole. PMID- 2705288 TI - Reliability and reproducibility of the larval paralysis test as an in vitro method for the detection of anthelmintic resistance of nematodes against levamisole and morantel tartrate. AB - In order to study the reliability of the larval paralysis test as an in vitro assay for the detection of resistance of nematodes to levamisole and morantel tartrate, the influence of different parameters was evaluated using resistant and susceptible Ostertagia ostertagi strains. The operator, the sample (10% of the larvae present in the suspension), the incubation time (24, 48 or 72 h), the incubation temperature (20 or 25 degrees C) and the observation period of the larvae (5 or 15 s) had no statistically significant influence on the test results. Statistical differences were obtained only when L3 larvae of different ages (1 or 2 months) were used. Reversibility of the paralysis did not occur when concentrations of levamisole of less than or equal to 200 micrograms ml-1 or morantel tartrate of less than 2000 micrograms ml-1 were used. The reproducibility of the test was fairly good, with a mean standard deviation of 21.3% for the LC50 values. Morantel resistance in a strain of O. ostertagi was not confirmed as such by the larval paralysis test. The resistance factor was less than or equal to 1, in spite of an efficacy of morantel of 77.4% as shown in vivo. PMID- 2705289 TI - Feeding of the chewing louse Damalinia ovis (Schrank) (Phthiraptera:Trichodectidae) on sheep. AB - The possibility that Damalinia ovis ingests intact epidermis could explain economically important irritation behaviour by infested sheep. To test this, feeding lice were observed on sheep by hand lens and macrophotography and on light and scanning electron microscope preparations. Aspects of feeding behaviour were described, particularly an epidermal ingestion posture. Louse ingesta were examined in paraffin and frozen sections. Lipid-covered stratum corneum squames were identified in crop, midgut, rectum and faeces. Nucleated keratinocytes from inner epidermal strata were not seen, neither were wool fibres. Vertical frozen sheep skin sections, with feeding lice cryofixed by liquid nitrogen, showed mandibles engaged in the outer stratum corneum of the epidermis. The epidermal origin of some ingesta was confirmed by confirming lice over sheep whose skin was stained with Oil Red O, whose colour was seen in crop, midgut, rectum and faeces of harvested lice. Lipase was found in louse midgut. It was concluded that sebaceous secretions may form an important component of the D. ovis diet. The relative contribution from loose scurf or from stratum corneum squames was not determined. Mechanical stimuli by feeding lice did not seem to be the source of host irritation. The role of sensitising agents in louse brei filtrates was investigated with inconclusive results. Intradermal injections of louse faeces did not elicit a demonstrable response. PMID- 2705290 TI - A mouse lethal dose assay for detection and titration of Cowdria ruminantium (Kwanyanga strain) in goats and ticks. AB - A mouse lethal dose assay was used to detect a mouse pathogenic strain (Kwanyanga) of Cowdria ruminantium, the etiological agent of heartwater in goats and ticks. The titer of the rickettsial organisms in goat blood was directly related to the febrile response of the goat and the rickettsia were undetectable after the fever subsided. The maximum rickettsial titer in goat blood was 10(3) mouse LD50 ml-1. Cowdria-infected goat blood was shown to retain infectivity when held on ice for up to 2 h, but when held at room temperature infectivity declined by greater than 50% in 2 h. The mouse assay detected Cowdria in feeding female Amblyomma variegatum only on the eighth day of feeding and in feeding males on the second and eleventh days of feeding. Cowdria was shown to persist in the hemolymph of the soft tick Ornithodoros coriaceus for a period of at least 2 years. PMID- 2705291 TI - Differentiation of the vaccine F-strain from other strains of Mycoplasma gallisepticum by restriction endonuclease analysis. AB - The electrophoretic patterns of the nucleic acids (DNA) of Mycoplasma gallisepticum strains digested with the restriction enzymes Bam HI, Eco RI and Hind III were useful for differentiating the vaccine F-strain from other strains of M. gallisepticum. The procedure was more sensitive than the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) technique. The vaccine F strain, represented by cultures designated F-K810 and F-F2F10 was clearly differentiated from other strains of M. gallisepticum. This procedure may be useful in field studies to determine if the vaccine strain will replace wild-type M. gallisepticum in commercial layers. PMID- 2705292 TI - The effect of anti-inflammatory agents on the clinical expression of bovine ephemeral fever. AB - The effect of two anti-inflammatory drugs on the development and persistence of clinical signs in cattle experimentally infected with bovine ephemeral fever (BEF) virus was investigated by their administration, either before or after the commencement of fever. A total of 16 cattle was given phenylbutazone sodium (PBZ). The drug prevented fever and other clinical signs in six cattle when given daily during the incubation period, and at 8-h intervals for 5 days when clinical disease might be expected. When treatment with PBZ was deferred until 2-4 h after the commencement of fever, the rectal temperature returned to normal within 4 h in four of six cattle and the development of other clinical signs was suppressed. Clinical signs of ephemeral fever occurred in four untreated cattle infected at the same time. Viraemia, the development of neutralizing antibodies (at 8-11 days), resistance to subsequent challenge with BEF virus, neutrophilia, lymphopenia and a rise in plasma fibrinogen occurred in all BEF-infected animals whether treated or untreated, despite different clinical appearances. The mean peak of plasma fibrinogen in the untreated cattle was 6.9 g l-1; 3.2 g l-1 when treated 2-4 h after fever developed and 3.8 g l-1 when treated from 18-h post infection. BEF virus was isolated from leucocytes of each of the cattle, but the frequency of isolation was lower in the treated group. The results indicate that treatment with PBZ blocked the host response which produces the clinical signs and did not have an anti-viral effect. In a similar experiment, a long-acting anti-inflammatory drug, flunixin meglumine, failed to prevent BEF or to modify the clinical signs once they had developed, except for the rectal temperature which returned to normal within 2-4 h of the administration of the drug. The efficacy of this drug was not improved by increasing the dosage to two or three times the recommended level. PMID- 2705293 TI - Spontaneously active suppressive cells in canine peripheral blood. AB - The phenomenon of the unusually high spontaneous suppressive activity of cells in peripheral blood of dogs was analysed. The m/c (mitomycin C)-treated population of peripheral blood leucocytes (PBL) contained cells able to reduce the responsiveness of autologous cells by 48 +/- 15% (P less than 0.01) and their activity was not indomethacin dependent. Thoracic duct lymphocytes (TDL) did not reduce the response of PBL to PHA, neither did cell crowding. The supernatants from 24-h cultures of m/c-treated PBL did not affect the response to PHA, and parallelly precultured cells inhibited the proliferation of PBL to a lesser degree (24 +/- 9%) than the fresh cells (50 +/- 16%, P less than 0.05). Addition of m/c-treated polymorphonuclear cells at PMN to PBL ratios of 1:4 and 1:1 progressively inhibited PBL reactivity to PHA, from 29.5 +/- 3.5% to 68.5 +/- 9%, respectively, and the supernatants from 24-h cultures of PMN reduced the proliferation by 48 +/- 2.8%. The neutrophil-derived inhibitory factor(s) was non cytotoxic and reduced the formation of blasts to 61.5 +/- 3.5% of the control values. These results indicate that dog PBL from Lymphoprep gradient contain a population of non-recirculating, short-lived, spontaneously suppressive cells, mainly PMN, which modulate T cell reactivity in vitro, suggesting that neutrophils may be able to exert a regulatory effect in vivo. PMID- 2705294 TI - Genetic control of immunity to Eimeria tenella. Interaction of MHC genes and non MHC linked genes influences levels of disease susceptibility in chickens. AB - The relative importance of MHC genes and background genes in the genetic control of disease susceptibility and the development of protective immunity to E. tenella infection was investigated in eight different strains of 15I5-B congenic and four inbred chicken strains. RPRL 15I5-B congenic chickens that share a common genetic background but express different B haplotypes demonstrated wide variations in disease susceptibility and the development of acquired resistance to E. tenella infection. Infection of chickens sharing a common B haplotype but expressing different genetic backgrounds showed quite contrasting levels of susceptibility to secondary E. tenella infection. In all chicken strains examined, infected chickens developed high levels of serum and biliary anti coccidial antibodies regardless of their B haplotypes. Furthermore, no correlation between antibody levels and the phenotypically expressed levels of disease resistance was demonstrated. These findings lend support to the view that interaction of MHC genes and non-MHC genes influences the outcome of host response to E. tenella infection. PMID- 2705295 TI - In vivo effects of a thymosin alpha 1-containing colostral whey product on neutrophils and lymphocytes from lactating cows without and with experimentally induced Staphylococcus aureus mastitis. AB - Two separate experiments evaluated ID-1 (a commercial bovine whey product containing 5200 pg of thymosin alpha 1/ml) as an immunotherapeutic agent in lactating cows. In the first experiment, cows without mastitis were evaluated for blood leukogram, milk production, total and differential milk cell counts, lymphocyte (Lc) blastogenesis, and neutrophil (PMN) functions (random and directed migration under agarose, chemiluminescence, ingestion of bacteria, iodination, cytochrome C reduction, antibody-independent neutrophil-mediated cytotoxicity, and antibody-dependent cell-mediated cytotoxicity) before and after ID-1 therapy. ID-1 treatment resulted in a significant treatment group by time period interaction for the relative proportion of mononuclear cells (MNC) in milk (P less than 0.009) and for PMN random migration (P less than 0.01). Based on these interactions, ID-1 treatment appeared to slightly increase the proportion of small MNC in milk and to increase random migration from pretreatment levels by 73% more than increases observed in controls. No significant effect of ID-1 treatment on milk production, total milk somatic cell counts, Lc blastogenesis, or other PMN functions was observed. In cows with experimental Staphylococcus aureus intramammary infections, ID-1 treatment resulted in a significant decline in blood leukocyte count (P less than 0.001) and blood PMN count (P less than 0.02), and maintained PMN random migration (P less than 0.01) while controls declined and abrogated a depression in the ability of Lc to respond to mitogens (P less than 0.05) that developed in controls as a result of S. aureus mastitis. Injection of ID-1 into cows had no adverse effect on their overall health or level of milk production, but did cause subtle and potentially favorable changes in several in vitro immune parameters. In spite of these subtle changes which might indicate increased resistance to mastitis, cows actually developed a more severe S. aureus intramammary infection based on a 9% increase in log 10 bacterial shedding in milk. PMID- 2705296 TI - Complete nucleotide sequence of the cucumber necrosis virus genome. AB - The complete nucleotide sequence of the cucumber necrosis virus (CNV) genome has been determined. The genome is 4701 nucleotides in length and contains five long open reading frames (ORF). ORF1 begins at the first AUG codon at the 5' terminus and terminates at an amber codon. The predicted molecular weight of the polyprotein encoded by ORF1 is 33 kilodaltons (kDa). Readthrough of the ORF1 amber codon would yield a protein with a molecular weight of 92 kDa. Comparison of the amino acid sequence of the 92-kDa protein with the putative replicases of carnation mottle virus (CarMV) and barley yellow dwarf virus (BYDV) shows extensive sequence similarity. This suggests that the CNV 92-kDa protein is the viral replicase and, furthermore, suggests a close evolutionary relationship between CNV, CarMV, and BYDV, members of the Tombus-, Carmo-, and Luteovirus groups, respectively. Immediately following the 92-kDa protein is ORF3 which can encode a 40-kDa protein. It is identified as the coat protein based on its similarity in amino acid composition to the previously determined CNV coat protein sequence (J. H. Tremaine, 1972, Virology 48, 582-590) and on its amino acid sequence similarity with the tomato bushy stunt virus coat protein. Two nested ORFs (ORF4 and -5), in different frames, follow the coat protein gene. Although it is not known if both ORFs are expressed, they would encode proteins with predicted molecular weights of 21 and 20 kDa, respectively. PMID- 2705297 TI - Newcastle disease virus evolution. I. Multiple lineages defined by sequence variability of the hemagglutinin-neuraminidase gene. AB - We compared the hemagglutinin-neuraminidase gene sequence among 13 strains of Newcastle disease virus (NDV) isolated over the last 50 years. Although overall homology was remarkably high, the sequence variability demonstrated the existence of at least three distinct lineages, which must have co-circulated for considerable periods. The sequence variability also appears to reflect some accumulation of mutations over time. Strictly correlating with the lineages, the translation products could be classified into three size classes. One class lacked the interchain disulfide bond, and another represented unusual precursor protein of biologically inactive form. The lineages correlated to some extent with virulence and place of isolation of the strains. However, antigenic variations, which were neither cumulative nor progressive, did not correlate with the lineages. These analyses showing multiple lineages were greatly facilitated by a precise calculation of synonymous substitutions, which had been largely free from selective pressures and had occurred frequently and evenly throughout the coding region. PMID- 2705298 TI - Newcastle disease virus evolution. II. Lack of gene recombination in generating virulent and avirulent strains. AB - Sequence analysis and comparison of the fusion glycoprotein genes of 11 Newcastle disease virus (NDV) isolates indicated a high degree of functional and structural constraint exerted on the change of the glycoprotein. However, synonymous nucleotide substitutions occurred frequently throughout the coding region. Facilitated by an analysis of synonymous difference (Ks) in pairwise strain comparison, we defined the branching orders of the strains and identified three distinct evolutionary lineages correlating with the virulence as expressed by mean death time (MDT) for chick embryo. The typically virulent strains with MDT of about 50 hr were associated with one lineage, while the typically nonvirulent strains with MDT of infinity were of another lineage. The third lineage consisted of both virulent and avirulent strains whose MDTs lay on a continuum from 50 to 120 hr. Synonymous substitutions were found to occur with almost the same rates in the adjacent hemagglutinin-neuraminidase and membrane protein genes as in the fusion protein gene, and the branching orders based upon the Ks for these genes were essentially identical to those derived from the fusion protein gene. Therefore, no gene exchange by recombination seems to have occurred to generate the strains of distinct lineages. Rather, the different strains appear to have evolved through various degrees of accumulation of point mutations. Besides these evolutionary features, the present study strongly supports the importance of the previously identified signals for gene expression and for the proteolytic activation of the gene product. PMID- 2705299 TI - Evolution of the hemagglutinin of equine H3 influenza viruses. PMID- 2705300 TI - Expression of the 16K cistron of tobacco rattle virus in protoplasts. AB - An antiserum was raised against a synthetic peptide corresponding to the 18 C terminal amino acids of a putative 16K protein encoded by the 3'-terminal open reading frame of tobacco rattle virus (TRV) RNA-1. This antiserum was used to demonstrate expression of the 16K cistron in vivo. TRV-infected tobacco protoplasts accumulated similar amounts of 16K protein and viral coat protein but in tobacco plants only the coat protein was detectable. Time course experiments revealed that in protoplasts the accumulation of 16K protein lagged somewhat behind that of coat protein. The 16K protein was incorporated in a high-molecular weight cellular component that was resistant to treatment with nonionic detergents. PMID- 2705301 TI - The S RNA segment of Sandfly Fever Sicilian virus: evidence for an ambisense genome. AB - The complete nucleotide sequence of the S RNA segment of Sandfly Fever Sicilian (SFS) virus (Phlebovirus, Bunyaviridae) was determined from overlapping cDNA clones and by primer extension. The RNA is 1746 nucleotides in length and has two large open reading frames (ORF), one of which (24.8 kDa) is viral-complementary in sense, and the other (30.4 kDa) is in the viral sense. This ambisense genome arrangement has been seen in another member of the Phlebovirus genus, Punta Toro (PT) virus (T. Ihara, H. Akashi, and D. H. L. Bishop, 1984, Virology 136, 293 306), but not in representatives of either the Bunyavirus or Hantavirus genera of the Bunyaviridae. Comparison of the predicted amino acid sequences for SFS virus with the recognized products of PT S RNA (T. Ihara, Y. Matsuura, and D. H. L. Bishop, 1985, Virology 147, 317-325; H. A. Overton, T. Ihara, and D. H. L. Bishop, 1987, Virology 157, 338-350) indicated that the 24.8-kDa ORF encodes the nucleoprotein (N) of SFS virus, and the 30.4-kDa ORF codes for a nonstructural protein (NSs). Subgenomic messenger RNAs, from which these two proteins are presumably translated, were detected in virus-infected cells. PMID- 2705302 TI - Analyses of the terminal sequences of West Nile virus structural proteins and of the in vitro translation of these proteins allow the proposal of a complete scheme of the proteolytic cleavages involved in their synthesis. AB - The proteolytic processes involved in the synthesis of the structural proteins of the West Nile (WN) flavivirus were analyzed: The carboxy-terminal sequences of the structural proteins were determined and the proteins translated in vitro in the presence of membranes from a mRNA coding for the structural polyprotein were analyzed. The results obtained indicate that the following proteolytic activities are involved in the synthesis and assembly of WN virus structural proteins: The growing peptide chain which contains the sequences of the structural proteins in the order C-pre-M-E is cleaved at three places by cellular signalase(s). This cleavage generates the primary amino acid sequence of the mature structural proteins pre-M and E (and the amino-terminus of the ensuing nonstructural protein NS 1). The amino-terminal part of the polyprotein containing the amino acid residues 1 to 123 is released as a molecule which migrates slightly slower than the mature viral core protein and which presumably is associated to the RER membranes via its carboxy-terminal sequence. This protein is called the anchored C virus particles the anchored C protein is converted into mature C protein by removal of the carboxy-terminal hydrophobic segment containing the amino acid residues 106 to 123. Presumably a virus-coded protease which can cleave the polyprotein after two basic amino acid residues is responsible for this cleavage. The cell-associated WN virus particles are constructed from the proteins C, pre M, and E which contain the amino residues 1-105, 124-290, and 291-787 of the polyprotein, respectively. Cleavage of the pre-M protein between amino acid residues 215 and 216, presumably by a cellular enzyme located in the Golgi vesicles, and loss of the amino-terminal fragment of this protein are associated with the release of virus from the cells. PMID- 2705303 TI - The primary structure of the lymphocytic choriomeningitis virus L gene encodes a putative RNA polymerase. AB - The complete RNA sequence of the L protein gene of lymphocytic choriomeningitis virus (LCMV) is presented. It is the first L protein sequence to be obtained for the Arenaviridae, a family of single-stranded RNA viruses which includes Lassa fever virus, and the Tacaribe complex viruses such as Pichinde and the Argentine and Bolivian hemorrhagic fever viruses. It is the largest open reading frame on the L RNA spanning 6633 nucleotides and coding for a 2210 amino acid protein with a calculated molecular weight of 254,529. Antipeptide sera identify a gene product encoded on the L RNA: it has a mass of approximately 200,000 Da and is found in virions and ribonucleoprotein complexes from infected cells (M. Singh, F. Fuller-Pace, M. J. Buchmeier, and P. J. Southern, 1987, Virology, 161, 448 456). Mutations mapped to the L gene affect plaque morphology (Kirk et al., 1980), the lethality of a virulent LCMV strain on guinea pigs (Y. Riviere, R. Ahmed, P. J. Southern, M. J. Buchmeier, and M. B. A. Oldstone, 1985, J. Virol., 55, 704-709), and the ability of a variant strain of LCMV to suppress the cytotoxic T-cell response and initiate persistent infection (M. Salvato, E. Shimomaye, P. Southern, and M. B. A. Oldstone, 1988, Virology, 164, 517-522; Ahmed et al., 1988). All of these phenotypes indicate that the viral genes on the L strand are critical elements controlling virus replication and the pattern of LCMV infection. The L gene sequence encodes a viral polymerase although this protein bears little resemblance to the published sequences of other RNA virus polymerases. Therefore the LCMV polymerase likely represents a distinct category of viral transcriptase. PMID- 2705304 TI - Distinct lineages of influenza virus H4 hemagglutinin genes in different regions of the world. AB - To understand the determinants of influenza virus evolution, phylogenetic relationships were determined for nine hemagglutinin (HA) genes of the H4 subtype. These genes belong to a set of viruses isolated from several avian and mammalian species from various geographic locations around the world between 1956 and 1985. We found that the HA gene of the H4 subtype is 1738 nucleotides in length and is predicted to encode a polypeptide of 564 amino acids. The connecting peptide, which is removed from the precursor polypeptide by peptidases to yield the mature HA1 and HA2 polypeptides, contains only one basic amino acid. This type of connecting peptide is a feature of all avian avirulent HAs. On the basis of pairwise nucleotide sequence homology comparisons the genes can be segregated into two groups: influenza virus genes isolated in North America and those isolated from other parts of the world. A high degree of homology exists between pairs of genes from viruses of similar geographic origin. The nucleotide sequences within a group differ by 1.5 to 10.6%; in contrast, between groups the differences range from 15.8 to 19.4%. An evolutionary tree for the nine sequences suggests that North American isolates have diverged extensively from those circulating in other parts of the world. Geographic barriers which determine flyway outlay may prevent the gene pools from extensive mixing. The lack of correlation between date of isolation and evolutionary distance suggests that different H4 HA genes cocirculate in a fashion similar to avian H3 HA genes (H. Kida et al., 1987, Virology 159, 109-119) and influenza C genes (D. Buonagurio et al., 1985, Virology 146, 221-232) implying the absence of selective pressure by antibody that would give a significant advantage to antigenic variants. In contrast to avian influenza virus genes, human influenza virus genes evolve rapidly under the selective pressure of antibody. PMID- 2705305 TI - The pattern of accumulation of cauliflower mosaic virus-specific products in infected turnips. AB - The concentrations of cauliflower mosaic virus (CaMV) DNA and protein products in the developing leaves of a host, turnip, have been measured and the results have been correlated with symptom production. Virus-specific products were limited to the symptomatic leaves. CaMV DNA was detected in the youngest foliar tissues showing full systemic symptoms and continued to accumulate as the leaf expanded, indicating that virus multiplication was not restricted to meristematic tissues of the host plant and that virus concentration was not a primary determinant for symptom production. Using specific antisera for Western blot analysis, the distribution of CaMV-specific proteins (P1-P6) in a range of subcellular fractions of infected tissue was determined. The protein products (P2-P6) of genes II-VI were all detected in fractions enriched for virus inclusion bodies, although P5 was present only at low levels. A high-speed pellet fraction enriched for virus replication complexes revealed P5 in higher concentrations, and also contained P4 and small amounts of P6 in proportions which indicated that replication complexes had been released from inclusion bodies. In the different leaves of the host, P2, 3, 4, 5, and 6 all increased in concentration in parallel with viral DNA, although there appeared to be a bias toward protein rather than DNA synthesis in the very young leaves. P1 showed a different pattern of accumulation; it was most concentrated in the very young and the oldest infected tissues, and showed a different spectrum of products between leaves. The experiments described provide a more complete picture of the relationship between CaMV multiplication and expression, and leaf development, and an increased understanding of how the disease syndrome is established. PMID- 2705306 TI - The oncogenicity of avian adenoviruses. IV. Confirmatory evidence for recombination between viral and cellular DNA sequences and repetition of the recombinant in cells of a tumor line. AB - On the basis of hybridization analyses with viral DNA fragments as probes, we previously concluded that, in DNAs of many fowl adenovirus type 1-induced rodent tumors, units consisting of viral DNA segments flanked on both sides by cellular DNA segments are repeated more than 100 times per diploid genome of cell. Molecular cloning of virus-cellular junction fragments and analyses of their sequence arrangement in the present study confirmed that the previous conclusion was basically correct. PMID- 2705307 TI - Identification of mutations in the M RNA of a candidate vaccine strain of Rift Valley fever virus. AB - The M RNA species of a candidate vaccine strain of Rift Valley fever virus (RVFV ZH-548M12), derived by consecutive high level mutagenesis using 5-fluorouracil (H. Caplen, C. J. Peters, and D. H. L. Bishop, J. Gen. Virol., 66, 2271-2277, 1985), has been cloned and the cDNA sequenced. The data have been compared to those obtained for the parent virus strain RVFV ZH-548 as well as the previously published data for RVFV ZH-501 (M. S. Collett, A. F. Purchio, K. Keegan, S. Frazier, W. Hays, D. K. Anderson, M. D. Parker, C. Schmaljohn, J. Schmidt, and J. M. Dalrymple, Virology, 144, 228-245, 1985). Some eight nucleotide and three amino acid differences were identified between the M RNAs of ZH-501 and ZH-548. Between the M RNAs of ZH-548 and that of the M12 mutant there were 12 nucleotide and 7 amino acid changes. Unique to the mutant virus is a new AUG codon upstream of that which initiates the open reading frame of the RVFV M gene product (the viral glycoprotein precursor). The significance of this and other differences in the mutant RNA with regard to the derivation and potential attenuation of the candidate vaccine is discussed. PMID- 2705308 TI - Are the PR1 proteins of tobacco involved in genetically engineered resistance to TMV? AB - Transgenic tobacco plants constitutively expressing the coat protein (CP) of tobacco mosaic virus (TMV) exhibit enhanced resistance ot TMV (P. Powell Abel, R. S. Nelson, B. De, N. Hoffman, S. G. Rogers, R. T. Fraley, and R. N. Beachy, Science, 232, 738-743, 1986; R. S. Nelson, P. Powell Abel, and R. N. Beachy, Virology 158, 128-132, 1987). To determine if this enhanced resistance might be mediated through the PR1 family of pathogenesis-related (PR) proteins, their synthesis was examined. In transgenic plants derived from NN genotypic tobacco, a high proportion (approximately 80%) of those producing CP also expressed the PR1 genes at low levels. However, this correlation between TMV CP and PR1 gene expression was not observed in similarly transformed nn genotypic tobacco plants. Therefore, it appears unlikely that PR1 proteins play a critical role in genetically engineered resistance in transgenic plants producing TMV CP. PMID- 2705309 TI - trans-activation of viral enhancers including long terminal repeat of the human immunodeficiency virus by the hepatitis B virus X protein. AB - Human hepatitis B virus contains an open reading frame designated X. We have investigated the trans-activating function of the hepatitis B virus X gene in regulating transcriptional control elements. In the HBV genome the major target for X trans-activation is the enhancer element. Further, the X protein stimulates several other viral promoters/enhancers including the long terminal repeats (LTR) of human retroviruses. One of the viral sequences studied in detail is the human immunodeficiency viral (HIV) LTR which is trans-activated by the X protein. Using mutational analysis of the HIV LTR, we show that the NF-kappa B sequences contained within the U3 region are involved in this stimulatory activity. Nuclear run-on analyses support the notion that X-mediated trans-activation occurs at the level of transcription. PMID- 2705310 TI - Low pH-dependent Sindbis virus-induced fusion of BHK cells: differences between strains correlate with amino acid changes in the E1 glycoprotein. AB - Expression of alphavirus glycoproteins on the surface of infected cells leads to cell fusion after exposure to acidic pH. Two strains of Sindbis virus, AR339 (SV) and neuroadapted Sindbis virus (NSV), which differ in virulence for weanling mice, were found to differ in pH-dependent fusion. BHK-21 cells infected with SV fused maximally after shifting to pH 5.4, whereas cells infected with NSV required a lower pH, pH 4.8, for maximal fusion. No difference was noted in the optimal pH for agglutination of goose erythrocytes (5.75 for both viruses). To determine the molecular basis for the difference in fusion a series of recombinant viruses was constructed using a cDNA clone of Sindbis virus from which infectious RNA can be transcribed in vitro. Cells infected with a recombinant virus that had the SV E1 and NSV E2 genes had a fusion response curve as a function of pH like SV, while cells infected with recombinant virus with the NSV E1 and SV E2 genes fused like NSV. The E1 glycoproteins of SV and NSV differ at two positions: Val-72 in SV is Ala in NSV (a change near the putative fusion site), and Gly-313 in SV is Asp in NSV. Recombinant viruses which had Val-72 (SV) and Asp-313 (NSV) or Ala-72 (NSV) and Gly-313 (SV) had a lowered pH of fusion like NSV suggesting that both positions participate in determining some aspect of the conformational change in the E1-E2 heterodimer associated with pH-dependent fusion. PMID- 2705311 TI - [Growth kinetics of breast cancer]. AB - The rate of breast tumors growth was studied in 71 cases on the basis of tumor measurements taken from successive mammograms. Tumor doubling time (DT) varied 2.9-440 days and averaged 94.1 days (less than 35 days in 18.3; 36-75 days--35.2; 76-110 days--15.1, and 110 days and more--in 30.9% of tumors). Mean age proved shorter in patients with DT of less than 35 days (49.5 +/- 3.1 years) as compared to cases of DT of more than 110 days (55.4 +/- 2.7 years). DT in reproductive patients (77.3 +/- 10.2 days) was significantly lower than in menopausal ones (125.3 +/- 16.6 days) (p less than 0.05). Mean duration of exponential tumor growth till clinical signs development proved 8.35 years with a range of variation from 1.75 to 18.4 years. Terms of tumor development was found to match (+/- 2 years) a number of conditions involving changes in hormonal profile as established on the basis of case history. PMID- 2705312 TI - [Deficiency of the triiodothyronine pool in patients with stomach cancer]. AB - Thyroid status was evaluated in 265 patients with gastric pathology. The degree of tissue triiodothyronine (T3) deficiency was assessed versus stage and histologic pattern of tumor. Also, it was measured before and after surgery. No correlation was found in gastric cancer patients between T3 concentration, degree of blood--T3 level decrease and tissue T3 deficiency, on the one hand, and stage and histologic pattern of tumor, radical surgery and postoperative treatment, on the other. Said T3 parameters differed significantly in cases of chronic gastritis, gastric ulcer and polyps. PMID- 2705313 TI - [Survival of stomach cancer patients (based on data from the All-Union Center for the Study of Treatment Effectiveness in Patients with Malignant Tumors)]. AB - The dynamics of survival in gastric cancer patients treated at Soviet hospitals within 1974-1980 is discussed. Total five-year survival in those admitted to hospitals was 11% and relative one--13%; with regards to those discharged from hospitals, these indexes were 12 and 14%, respectively. Radical surgery alone (stages I-II) and in combination with radiotherapy (stage III) proved the most effective. Longer survival was registered in those patients with stage IV tumors who had undergone surgery followed by chemotherapy. On the whole, the effectiveness of treatment of gastric cancer patients admitted to Soviet hospitals was shown to be identical or even higher than in developed European countries and USA. PMID- 2705314 TI - [Dosimetric planning in the radiation therapy of patients with cancer of the corpus uteri]. AB - The paper deals with application of computerized procedures for dose planning in intracavitary irradiation of endometrial carcinoma from the Agat-B source. Computer calculations of dosage measured at some basic points of reference as well as dose distribution in different schedules of multipositional irradiation of carcinoma are presented. Lateral position of single-source applicators and central position of a 4-5 source applicator proved to offer most advantage. Radiobiologic aspects of planning radiation treatment for endometrial carcinoma versus dose rate in application of three-position technique of intracavitary irradiation are discussed. PMID- 2705315 TI - [Cisplatin (platidiam) and the prospects for using complex platinum compounds in the clinical chemotherapy of malignant tumors]. AB - The paper discusses the results of combination chemotherapy of 652 patients using platinum derivatives. The treatment proved effective in patients with metastatic tumors (79.7%), ovarian cancer (71.2%) and breast carcinoma (71.2%). Longer survival was obtained in cases of complete regression of ovarian tumor and in effectively treated patients with breast cancer. Response was registered in 30.8% of cases of osteogenic sarcoma. Application of cisplatin in chemoradiation treatment for inoperable bladder cancer resulted in regression of tumor in 57.4%. Literature data on some newly developed platinum derivatives undergoing phase-I and -II clinical trials outside the USSR are discussed. PMID- 2705316 TI - [The role of thrombocyte aggregation function in the mechanism of the antimetastatic action of an extract of Baikal skullcap]. AB - The advancement of Pliss' lymphosarcoma in rats was shown to be associated with disorders of platelet-mediated hemostasis presenting with either lowered or increased aggregation activity of platelets. In the latter case, a direct correlation was observed between functional activity of thrombocytes, on the one hand, and degree of tumor advancement and its metastatic activity, on the other. Extract of Scutellaria baicalensis Georgi was shown to produce a normalizing effect on platelet-mediated hemostasis whatever the pattern of alteration which points to the adaptogenic activity of the drug. This activity is thought to be responsible for the drug's antitumor and, particularly, metastasis-preventing effect. PMID- 2705317 TI - [The induction of stomach cancer in monkeys with N-methyl-N'-nitro-N nitrosoguanidine]. AB - Gastric tumors were detected in 2 out of 9 apes following MNNG treatment with a total dose of 800-848 mg/kg (40 mg/kg, thrice a month, 49-50 weeks, via gastric probe). The characteristics, course, symptoms and histologic patterns of the tumors proved comparable with similar neoplasms in humans. PMID- 2705318 TI - [The immediate results of the surgical treatment of lung cancer in patients over 70 years of age]. AB - The study was concerned with analysis of the data on 342 patients with lung cancer aged more than 70 years, 170 of whom had undergone surgery (peripheral cancer--117, central--53). Considering the poor functional status of the patients and their low compensatory potential, mostly organ-saving procedures (80.4%) (lobe-, bilobectomy, segmentectomy or wedge pneumonectomy) were used. Postoperative, largely bronchopulmonary and cardiovascular, complications developed in 37.6%. Postoperative lethality rate was 14.7%: after partial resection of the lung--13.5%, pneumonectomy--29.6%. PMID- 2705319 TI - [Multiple primary malignant tumors in esophageal cancer]. PMID- 2705321 TI - Fairness. PMID- 2705320 TI - Doctor bashing. PMID- 2705322 TI - Fatter than ever. PMID- 2705323 TI - The virus in our midst. AB - AIDS and HIV-seropositivity have shown increasing prevalence in the Mountain State. Charleston Area Medical Center (CAMC), being the state's largest tertiary health center, has attracted a number of seropositive patients. This sample, though small by comparison to the experience of other tertiary centers, constitutes the largest single cluster of patients so studied in a single West Virginia hospital to date. This study documents both sociological and economic issues associated with the AIDS population. A clear profile of the typical AIDS patient in West Virginia emerges: 1) gay male; 2) native son; 3) unemployed; 4) Medicaid-dependent; 5) clinically well advanced; 6) infected out of state; 7) under age 30; 8) tertiary care dependent; and 9) homeless. The paper closes with a discussion of the possible growth of the AIDS population in West Virginia in the years ahead. Strategies are set forth to serve as guidelines for managing effectively the AIDS population's needs in both the clinical settings and in society at large. PMID- 2705324 TI - Caveney Health Care Voucher System. PMID- 2705325 TI - [Comparison of the accuracy and precision of 7 reflectometers in self-control of blood glucose]. AB - 7 types of reflectance meters (Hypocount GA and MXB, Glucometer II and M, Petita B and B II, Reflolux II) were tested for accuracy and for within-run precision. To test the accuracy blood sugar was measured in 30 venous blood samples in the blood glucose ranges from 30 to 70, 71 to 180 and 181 to 300 mg/dl resp. on 4 instruments of each meter-type and by the hexokinase method as a reference method. With Hypocount MXB and Glucometer II great differences between correlation coefficients within the 4 instruments occurred. In the low blood glucose range all meters correlated best with the hexokinase method whereas poorer results were obtained in the low and the high glucose range. As regards the mean percental deviation, Reflolux II correlated closely with the reference method in the blood glucose range from 30 to 70 mg/dl, Hypocount MXB in the range from 71 to 180 mg/dl and Petita B in the range from 181-300 mg/dl. The greatest differences were found with both types of Hypocount- and Petita-meters in low blood sugar levels. With none of the tested meters a linear correlation with the hexokinase method was observed over the whole blood glucose range. Coefficients of variation for within-run precision ranged from 1.9% (Reflolux II) to 8.1% (Hypocount GA) depending on blood glucose concentration. PMID- 2705326 TI - [The effect of iodized mineral substance mixtures for cattle and swine on iodine requirements and struma prevention]. AB - In the southern districts of the GDR the calculated iodine uptake of adults was 80 micrograms/day before the iodine supplementation of the mixtures of mineral substances and the packet kitchen salt. The iodine supplementation of the mixtures of mineral substances for cattle and pig tripled the iodine content of the milk or increased it fivefold in the county of Erfurt and doubled the proportion of iodine of the meat, the inner parts and the sausage produced from them. In a daily consumption of 0.31 of milk and 250 g of meat and sausage a surplus supply of 35 micrograms of iodine for adults was calculated in the southern counties of the GDR. The 35 micrograms of iodine for the future necessary for covering the demand of iodine are certainly delivered by the iodized kitchen salt. PMID- 2705327 TI - [Development and status of intensive care medicine in internal medicine at the Karl Marx University in Leipzig]. AB - Issuing from the accomplishments of Kohler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Kohler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine. PMID- 2705328 TI - [Clinical, biochemical and anthropometric studies and determination of biological age in relation to body mass in a longitudinal study]. AB - On 46 adipose persons (25 males and 21 females) and 53 test persons with normal weight (35 males and 18 females) at the age of 25-40 years since 1976 clinical, biochemical and anthropometric investigations as well as the determination of the biological age have annually been performed. Several of the parameters established (e.g. cholesterol, triglycerides, fasting blood sugar, blood pressure among others) in the course of 9 years within the well-known normal regions draw towards the adequate valid limit value to the pathological entity. The results of the study distinctly show the central role of obesity for the development of risk factors. Despite the partly only with a certain tendency recognizable behaviour of single parameters after 9 years from our point of view the longitudinal method represents itself as a very well suitable method for establishing dynamic processes and risk factors of age. PMID- 2705329 TI - [Computer-assisted perioperative blood glucose control in metabolically stable diabetic patients and diabetic patients with coronary disease--a contribution to computer-assisted optimal therapy of diabetes]. AB - Issuing from the metabolic changes under perioperative conditions the problems and the significance of a subtile perioperative management of the metabolism in diabetics with labile metabolism and coronary disease are described. The device technical components and the function of a computer-assisted regulation and advisory system (Glucon) for the support of the perioperative management of blood glucose and for the parenteral glucose supply in diabetics during large operative interventions. When the system was applied for several days under submaximal metabolization of glucose nearly normoglycaemia conditions could be achieved. The system is proposed as alternative to the conventional perioperative blood glucose management for diabetics with labile metabolism and coronary diseases in large operations. PMID- 2705330 TI - Localisation of the temperature-sensitive defect in the nucleoprotein of an influenza A/FPV/Rostock/34 virus. AB - The nucleotide sequences of the nucleoprotein (NP) genes of fowl plague virus (FPV) and of a temperature-sensitive (ts) mutant (ts81) derived therefrom have been determined. The ts81-NP nucleotide sequence possesses a single nucleotide substitution in comparison to the wild type. This causes an amino acid exchange at position 332 of the NP. An alanine in the wild type-NP is substituted by a threonine in ts81-NP. This substitution leads to a significant difference in the secondary structure prediction. Although this mutation is located within the karyophilic region of the NP, the accumulation of the NP in ts81-infected cells is not significantly affected at 40 degrees C. Therefore, we assume that the cooperation with one of the polymerase proteins (P) is interfered with at 40 degrees C, leading to the loss of viral vRNA or replicative cRNA synthesis. The comparison of the FPV-NP nucleotide sequence to a previously published sequence of the same strain (Tomley and Roditi, 1984) highlights ten nucleotide differences, four of them leading to amino acid substitutions. PMID- 2705331 TI - Characterization of fastidious adenovirus types 40 and 41 by DNA restriction enzyme analysis and by neutralizing monoclonal antibodies. AB - The DNA of 48 strains of adenovirus type 40 (Ad40) and of 128 strains of adenovirus type 41 (Ad41), isolated between 1971 and 1986 from various countries, was characterized by restriction enzyme analysis using nine and ten restriction endonucleases respectively. Five new DNA variants of Ad40 and 18 new DNA variants of Ad41 were detected. Most of the restriction sites which differed among the various DNA variants appeared to be distributed at random over the entire length of the viral genomes of the two serotypes. The number of restriction sites by which two DNA variants differed from each other was used as a measure of their relatedness. Several clusters of closely related DNA variants were observed for each of the two serotypes. The 35 DNA variants of Ad40 and Ad41 were used to test monoclonal antibody preparations for their range of reactivity in a neutralization assay. One monoclonal antibody (5-8), raised against Ad40 strain Dugan, showed type-specific neutralization of all 11 Ad40 DNA variants tested. Six monoclonal antibodies, raised against Ad41 strain Tak, neutralized different proportions of the variants of Ad41. Two of these preparations (1-21 and 3-19) neutralized all 24 Ad41 DNA variants, while a third (1-23) reacted with only 12 Ad41 variants. Three other monoclonal antibody preparations (3-10, 3-18, 7-14) reacted specifically with only 6 of these 12 variants. The patterns of reactivity with the monoclonal antibody preparations correlated with the presence or absence of a HindIII restriction site at 56 map units and of an EcoRI restriction site at 52 map units on the Ad41 DNA. This region of the adenovirus DNA codes for the hexon protein, which is known to contain the type-specific neutralizing antigenic determinants. PMID- 2705332 TI - Reflections of a dying patient. PMID- 2705333 TI - Delivering continuing nursing education via interactive satellite television. PMID- 2705334 TI - Addiction among nurses: identification and referral. PMID- 2705335 TI - On being President of the AARN: realizing the possibilities. PMID- 2705336 TI - CT of adrenal tumors: frequency and clinical significance of low-attenuation lesions. AB - The CT values of adrenal tumors were evaluated in 36 patients to determine the frequency and significance of negative CT values. Twenty-seven patients had adrenocortical adenomas (13 had primary aldosteronism, 12 had Cushing syndrome, and two had nonhyperfunctioning adenoma), one had adrenocortical carcinoma, and eight had pheochromocytomas. The CT values in primary aldosteronism (mean, 1.8 +/ 9.9 H) were lower than those in Cushing syndrome (27.6 +/- 12.0 H) and pheochromocytoma (35.9 +/- 9.8 H). Six adrenocortical adenomas had homogeneous, low CT attenuation, with CT values ranging from -20 to -0.4 H. Four of these had primary aldosteronism, one had Cushing syndrome, and one had nonhyperfunctioning adenoma. Our results suggest that adrenal tumors with homogeneous, slightly negative CT attenuation are likely to be adrenocortical adenomas, mainly primary aldosteronism and nonhyperfunctioning adenomas. This finding may be especially useful in diagnosing nonhyperfunctioning adenoma. PMID- 2705337 TI - Subcutaneous metastases from malignant melanoma: prevalence and findings on CT. AB - We reviewed 197 body CT studies on 53 sequential patients who had a histologic diagnosis of malignant melanoma in order to determine the CT appearance, pattern of spread, and prevalence of subcutaneous melanoma metastases. Seventeen (38%) of 45 patients with CT evidence of metastatic melanoma had subcutaneous nodules shown on CT. Five patients (11%) had subcutaneous nodules as the only indication of metastatic disease on their CT scans. All patients who developed subcutaneous metastases had primary lesions classified as Clark level IV or V. (The Clark classification is based on the depth of tumor invasion and is rated I to V.) Metastases appeared as small, discrete rounded densities in the subcutaneous fat; lesions were occasionally subtle because of their small size and peripheral location. The location of subcutaneous nodules could not be predicted consistently on the basis of the site of the primary malignancy. We conclude that subcutaneous metastases are common with melanoma in patients with Clark level IV or V lesions. These subcutaneous nodules are readily detected on CT scans if the subcutaneous tissues are carefully examined. The detection of these lesions may affect management or prognosis of patients, especially in those cases where subcutaneous nodules are the only CT evidence of metastatic disease. PMID- 2705338 TI - MR imaging of the finger: correlation with normal anatomic sections. PMID- 2705339 TI - Detection of osteomyelitis at fracture nonunion sites: comparison of two scintigraphic methods. AB - Forty-nine patients with 50 fracture nonunions 4-48 months after injury underwent technetium-99m methylene diphosphonate (99mTc-MDP) scintigraphy on day 1, combined 99mTc-MDP and indium-111 leukocyte (111In-WBC) scintigraphy on day 2, and gallium-67 (67Ga) scintigraphy on day 3. The results were compared to evaluate the relative abilities of these scintigraphic techniques to detect osteomyelitis. Nine patients had clinical evidence of infection at the time of imaging, and 40 patients (41 fractures) did not. Open-biopsy cultures were performed at all fracture sites and were positive at 21 (42%) of the 50 sites. Combined 99mTc-MDP/111In-WBC images were interpreted with the use of two criteria. A positive study by the first criterion required 111In-WBC localization in the region of the nonunion fracture. A positive study by the second criterion required 111In-WBC localization in bone at the fracture site. The first criterion yielded a sensitivity of 84%, specificity of 72%, and accuracy of 74%; the specificity improved to 97% with an accuracy of 88% when the second criterion was used. Ten (25%) of the 40 patients thought not to have osteomyelitis by clinical criteria at the time of imaging had true-positive 99mTc-MDP/111In-WBC studies by biopsy culture results. Gallium-67 studies were interpreted as nondiagnostic if localization of radioisotope at fracture sites was equal to that with 99mTc-MDP, positive if 67Ga localization was greater than that of 99mTc-MDP, and negative if it was less than that of 99mTc-MDP. Twenty-one 67Ga studies were interpreted as nondiagnostic; 11 (52%) of the 21 had culture-positive fracture sites. The accuracy of 67Ga/99mTc-MDP imaging was 39%. Combined 99mTc-MDP/111In-WBC imaging is useful in the detection of osteomyelitis at fracture nonunion sites and improves the specificity of 111In-WBC imaging by differentiating inflammation/infection in adjacent soft tissue from osteomyelitis at the fracture site. Gallium-67 with 99mTc-MDP imaging is not sufficiently reliable in this clinical setting to be useful as an indicator for osteomyelitis. PMID- 2705340 TI - Blunt renal and ureteral trauma in childhood: CT patterns of fluid collections. AB - The CT scans of 25 children with blunt renal and ureteral trauma were analyzed to determine the severity of injury, the appearance of retroperitoneal fluid collections, and whether the extent of these collections correlated with the severity of injury. CT showed renal parenchymal injuries in 23 patients and ureteral injuries in two patients. Retroperitoneal fluid was detected in 19 (76%) of 25 patients. Perirenal fluid collections were present in all 19, periureteral fluid in 12, interfascial fluid in eight, anterior pararenal fluid in four, and psoas hemorrhage in three. The presence of perirenal and periureteral fluid was not a good predictor of the extent of renal injury. Fluid collections in the interfascial or anterior pararenal spaces and psoas muscle appeared to correlate with the severity of injury. Patients with these fluid patterns usually had renal fractures, arterial injuries, or ureteral disruptions. The presence of perirenal and periureteral fluid did not correlate with the extent of renal injury, while the presence of interfascial, anterior pararenal, and psoas muscle fluid correlated somewhat with renal fractures and renal pedicle disruption. PMID- 2705341 TI - Hypermagnesemia: a cause of abnormal metaphyses in the neonate. PMID- 2705342 TI - MR imaging of brain abscesses. AB - The MR images and CT scans of 14 patients with surgically verified pyogenic cerebral abscesses were reviewed. The MR findings correlated well with those seen on CT and were believed to be sufficiently characteristic to allow early and accurate diagnosis with MR alone. These features include (1) peripheral edema producing mild hypointensity on short TR/short TE and marked hyperintensity on long TR/intermediate to long TE scans; (2) central necrosis with abscess fluid hypointense relative to white matter and hyperintense relative to CSF on short TR/short TE scans and hyperintense relative to gray matter on long TR/intermediate to long TE scans (the fluid had concentric zones of varying intensity in seven cases, a finding not previously identified in other lesions); (3) extraparenchymal spread (intraventricular or subarachnoid), which was detected more easily on MR than on CT and was manifested by increased intensity relative to normal CSF on both short TR/short TE and long TR/intermediate TE scans; and (4) visualization of the abscess capsule, which was iso- to mildly hyperintense relative to brain on short TR/short TE scans and iso- to hypointense relative to white matter on long TR/intermediate to long TE scans. On the long TR scans, the relative hypointensity of the rim allowed for visualization of the typical morphologic features of the capsule, which in turn aided in differentiation of abscesses from other lesions (as it does on CT). To investigate the cause of the capsular intensity, pathologic studies of the capsules were reviewed when available (10 cases). Fibrosis was identified in all mature abscess capsules, but the combination of the intensities seen on short TR/short TE and long TR/intermediate to long TE scans as well as the temporal changes in intensity were believed to be incompatible with fibrosis as a cause of the capsular changes. Intensity patterns were suggestive of hemorrhage, but neither acute nor chronic hemorrhage was identified on routine H and E stains, while iron stain revealed scant hemorrhage in only two of the eight patients in whom these stains were used. We believe the capsular intensity (in particular the hypointense rims on long TR scans) may reflect paramagnetic T1, and to a greater extent T2, shortening, possibly due to the presence of heterogeneously distributed free radicals that are products of the respiratory burst produced by actively phagocytosing macrophages in the capsule wall. Distinctive MR features of pyogenic abscesses should afford early and accurate diagnosis. PMID- 2705343 TI - Gd-DTPA-enhanced MR imaging of spinal tumors. AB - Forty-eight Gd-DTPA-enhanced MR examinations of the spine were performed in 40 patients referred for MR because of clinically suspected spinal tumor or for further evaluation of an expanded cord. The study group consisted of 32 patients with spinal tumors (seven ependymomas; seven astrocytomas; four hemangioblastomas; two arteriovenous malformations; two unidentified intramedullary neoplasms; four meningiomas; and single cases of metastatic breast carcinoma, cavernous hemangioma with associated hematomyelia, neurinoma, angiolipoma, drop metastasis from medulloblastoma, and epidermoid with diastematomyelia). In the remaining eight patients, other diagnoses were established: thoracic disk herniation (two patients), lumbosacral meningocele (one), syringomyelia secondary to arachnoiditis (four), and expanded cord secondary to gliotic tissue (one). All but two diagnoses were proved histologically by biopsy, surgery, or autopsy; in the two patients with arteriovenous malformations, the definitive diagnosis was made by spinal angiography. Contrast enhancement occurred in 30 of the 32 spinal tumors, and Gd DTPA-enhanced T1-weighted images proved helpful in defining and outlining intra- and extramedullary spinal neoplasms. All ependymomas and astrocytomas (including low-grade astrocytomas) enhanced. In meningiomas, an immediate and uniform contrast uptake was demonstrated. Additional advantages of Gd-DTPA MR include the differentiation of solid tumor components vs syrinx or cyst or pseudotumoral areas of cord expansion, and the differentiation of residual or recurrent tumor from scar tissue in postoperative patients. Our results suggest that IV-injected Gd-DTPA improves MR sensitivity and specificity in the evaluation of spinal lesions. PMID- 2705344 TI - Pulsed-spray pharmacomechanical thrombolysis: preliminary clinical results. AB - Pulsed-spray pharmacomechanical thrombolysis was used to treat 41 patients with 47 complete thrombotic occlusions of hemodialysis grafts (n = 29), arterial bypass grafts (n = 10), or peripheral native arteries (n = 8). The procedure involves the use of small pulses of highly concentrated urokinase, which are forcefully sprayed throughout the thrombus during systemic heparinization. Virtually complete lysis was achieved in 46 of 47 occlusions. In the 46 thrombi that lysed, mean time for completion of lysis was 63 +/- 35 min and initial partial return of flow required 26 +/- 18 min. Complications included small peripheral emboli in one treated bypass graft (which cleared promptly after further pulse-spray therapy) and bleeding in three cases (one case of hematoma in the infused field at the site of recent surgery, one case of bilateral hematomas at the femoral puncture site, and one minor delayed self-limited gastrointestinal hemorrhage). Results to date suggest that the pulsed-spray pharmacomechanical method augments the speed, consistency, safety, and cost efficacy of clinical thrombolysis. Further study is warranted. PMID- 2705345 TI - A report-coding system for integration into a digital radiology department. AB - Report-coding systems allow the radiologist to generate a typewritten radiographic report with a computer. Typically, the report is generated by selecting bar codes, speaking key words, or selecting items on a screen. MAMM REPORT is a report-coding system for mammography, developed by radiologists, that runs on a microcomputer (Amiga, Commodore Co., West Chester, PA). MAMM REPORT speaks questions to the radiologist, who responds by pressing one of two buttons on a computer mouse, thus generating the report. MAMM REPORT allows labeling of digital images and reduction of data required to store the report in computer memory (data compression). Data compression is useful for improving computer operating speed. Digital image labeling and data compression facilitate use of MAMM REPORT on a future digital radiology workstation for an all-digital radiology department. Sixty mammographic reports, reviewed by a radiologist who is not a specialist in mammography, were entered into MAMM REPORT. The mammography specialists who dictated the original reports then judged whether the reports generated by MAMM REPORT would be acceptable replacements on the basis of descriptions of findings, diagnoses, and recommendations for further study. Data compression was measured by calculating the ratio of the number of bytes for storage of the reports in original form to a standard storage form (Huffman encoding) and to the MAMM REPORT coded form. All 60 coded reports were acceptable replacements for the original reports. For computer storage, MAMM REPORT produced a compression ratio of 135 to 1 and Huffman encoding, 1.1 to 1. Huffman encoding did not compress most reports because of their brevity. The results indicate that report coding can produce data compression of radiographic reports. The standard method of text storage, Huffman encoding, is not suitable for application to mammographic reports, which tend to be brief. PMID- 2705346 TI - Comparison of 2048-line digital display formats and conventional radiographs: an ROC study. AB - Observer performance tests were conducted to compare the effects on diagnostic accuracy of digital hard copy and video display formats versus conventional radiographic film. Digital images were obtained by digitizing conventional chest radiographs to a 2048 x 2048 matrix with a laser film scanner. Three digital display formats were used: laser-printed digital film, a 2048-line video monitor without user interaction, and a 2048-line video monitor with user interaction. Thirty-one posteroanterior chest radiographs, determined by consensus of four thoracic radiologists to contain septal lines (n = 11), parenchymal nodules (n = 7), nodules and septal lines (n = 7), or neither abnormality (n = 6), were used for the study. Images were interpreted by four radiologists in four separate viewing sessions. Diagnostic accuracy was determined by receiver-operating characteristic analysis for each observer with each viewing technique. No statistical differences in diagnostic accuracy, determined by the area under the receiver-operating-characteristic curve, were found between the analog film, the digital film, and the two video digital display formats. This preliminary study suggests that 2048-line digital displays may be an acceptable alternative to the traditional lightbox viewing method for the perception of these two abnormalities commonly seen on chest radiographs. PMID- 2705347 TI - Strategies for resolving interpersonal conflicts in radiology. PMID- 2705348 TI - The staggering cost of endoscopy. PMID- 2705349 TI - Duodenal angioma: transcatheter embolotherapy. PMID- 2705350 TI - Pneumomediastinum due to a sucking wound of the knee. PMID- 2705351 TI - Acute thrombocytopenia after i.v. administration of a radiographic contrast medium. PMID- 2705352 TI - Leptospirosis of the lung: radiographic findings in 58 patients. AB - Leptospirosis is the disease produced by any of the group of spirochetes of the genus Leptospira. The main organs involved are the liver, central nervous system, kidneys, skeletal muscle, and lungs. Thirty-seven (64%) of 58 patients with leptospirosis, proved by positive serology, had pulmonary radiographic findings. Three radiographic patterns were evident: (1) 21 (57%) of the 37 patients had small nodular densities, (2) six (16%) had large confluent areas of consolidation, and (3) 10 (27%) had diffuse, ill-defined, ground-glass density. Serial radiographs showed a tendency for the nodular pattern to be followed by confluent consolidation and/or ground-glass density. Abnormalities were bilateral, nonlobar in all cases, and had a marked tendency toward peripheral predominance. Pulmonary abnormalities resolved within 15 days, except in eight patients who died because of respiratory failure (six patients) or other causes (two patients). In order to correlate pathology with the radiographic findings, Leptospira, isolated from a patient, was injected intraperitoneally into 20 guinea pigs. All lungs from the guinea pigs showed petecheal hemorrhage, which progressed to large confluent areas of hemorrhage. The typical pulmonary radiographic findings of leptospirosis are compatible with the multifocal pulmonary hemorrhage seen in the guinea pigs. PMID- 2705353 TI - Pulmonary lymphangioleiomyomatosis: high-resolution CT findings in four cases. AB - Lymphangioleiomyomatosis is a rare disease of unknown cause that affects women of reproductive age. It is characterized by progressive proliferation of smooth muscle in the lung. The patients present with progressive shortness of breath, pneumothorax, chylous effusion, and hemoptysis. Four patients with biopsy-proved lymphangioleiomyomatosis of the lung were evaluated using high-resolution CT. In all patients, the scan showed well-defined cystic air spaces, surrounded by uniformly thin walls, distributed diffusely throughout both lungs. The cystic air spaces ranged in size from a few millimeters to 5 cm. Pathologically, these cysts were predominantly bounded by normal-looking parenchymal components, with occasional patchy involvement by a smooth-muscle proliferative process. The CT appearance of lymphangioleiomyomatosis differs quite distinctly from that of other diseases that can cause cystic air spaces, such as fibrosing alveolitis, neurofibromatosis, and bronchiectasis, and less distinctly from pulmonary emphysema and eosinophilic granuloma. Our experience in these few cases suggests that the high-resolution CT findings in lymphangioleiomyomatosis are characteristic of the disease. PMID- 2705354 TI - Rounded atelectasis of the lung: MR appearance. PMID- 2705355 TI - Sedimented calcium in benign breast cysts: the full spectrum of mammographic presentations. AB - We retrospectively reviewed the mammograms of 318 patients that showed sedimented calcifications within benign breast cysts to describe the natural history and full spectrum of the mammographic appearances. Sedimented calcifications are seen in approximately 4% of symptomatic women undergoing mammography. Their recognition is important to avoid unnecessary workup, follow-up, or biopsy. Key to recognition is the difference in their radiographic features on lateral and craniocaudal views. The classic appearance is that of milk of calcium, seen as linear, curvilinear, or teacup-shaped particles on horizontal-beam lateral views and as ill-defined smudges on vertical-beam craniocaudal views. The most common presentation is multiple, bilateral, scattered and occasionally clustered calcifications within microcysts. Other presentations include milk of calcium within microcysts in a unilateral, clustered distribution; milk of calcium within macrocysts; sandlike calcifications (discrete particles rather than smudges on craniocaudal view) within cysts of various sizes; and rarely, milk of calcium within the lipid cysts of either fat necrosis or galactoceles. None of our cases has proved to be malignant. However, adjacent malignancies are a potential pitfall. We encountered eight patients with carcinoma presenting as clustered microcalcifications in a breast also containing typical sedimented calcifications. In each of these cases, the malignant calcifications could be distinguished by their mammographic appearance. The recognition of sedimented calcifications present in about 4% of symptomatic women undergoing mammography is important because these characteristic calcifications are an indication of benignity. Malignant-appearing microcalcifications found in the vicinity of sedimented calcifications can be distinguished and require biopsy. PMID- 2705356 TI - Hepatic perfusion in cavernous transformation of the portal vein: evaluation by using CT angiography. PMID- 2705357 TI - Is routine chest radiography required with biliary lithotripsy? AB - Routine pre- and postlithotripsy chest radiographs are usually obtained on patients undergoing biliary extracorporeal shock-wave lithotripsy. To evaluate the need for this procedure, we reviewed posteroanterior and lateral chest radiographs obtained before and after 107 lithotripsy sessions in 75 patients. In each case, posteroanterior and lateral chest radiographs were obtained as a routine baseline (not to detect incidental abnormalities) before the patient was scheduled for lithotripsy. Posteroanterior and lateral chest radiographs were obtained routinely after each lithotripsy session. Seventy-five patients had 107 lithotripsy sessions on a second-generation lithotripter. Sixty had gallbladder stones, five had cystic duct stones, and 10 had common duct stones. All chest radiographs were reviewed by a chest radiologist. No pulmonary or pleural changes occurred after lithotripsy. We conclude that routine pre- and postlithotripsy chest radiographs are not warranted in patients undergoing biliary lithotripsy. PMID- 2705358 TI - Primary tumors of the small intestine: CT evaluation. PMID- 2705359 TI - Diagnosis of fistulae and sinus tracts in patients with Crohn disease: value of MR imaging. AB - To investigate the potential of MR imaging in the evaluation of sinus tracts or fistulae associated with Crohn disease, 17 patients with pelvic or abdominal fistulae or sinus tracts underwent MR imaging with multislice spin-echo techniques, 500/15 and 1600/22,80 (TR/TE). The presence of fistulae and/or sinus tracts was confirmed by contrast-enhanced CT (n = 17) and/or sonography (n = 8), sinography (n = 6), or barium studies (n = 4). In all but three cases the fistulae and extramucosal inflammatory abnormalities were shown by MR. T1 weighted images provided excellent delineation of the extension of the fistulae relative to sphincters and adjacent hollow viscera and showed inflammatory changes in fat planes. T2-weighted images showed fluid collections within the fistulae, localized fluid collections in extraintestinal tissues, and inflammatory changes within muscles. The supralevator and infralevator compartments were well defined on coronal images. Thus, the perirectal spread of fistulae and sinus tracts with respect to the levator ani could be demonstrated in all cases. Our results suggest that MR imaging is useful for the demonstration and evaluation of pelvic and abdominal sinus tracts or fistulae associated with Crohn disease. PMID- 2705360 TI - Cholesterol counseling. PMID- 2705361 TI - Bronchogenic cysts. PMID- 2705362 TI - FDA studies AIDS home test kits. PMID- 2705363 TI - Bartholin's gland cancer. AB - Bartholin's gland cancer is a rare malignancy that must be considered in the differential diagnosis of a labial mass. The prognosis is generally poor due to the aggressive metastatic tendencies of this cancer. The etiology of Bartholin's gland cancer remains unknown, and no optimal plan of treatment has been established. Early detection followed by radical vulvectomy and bilateral inguinal-femoral node dissection may improve survival. PMID- 2705364 TI - Acute rheumatic fever. PMID- 2705365 TI - Alcohol: the other drug problem. PMID- 2705366 TI - Magnetic field exposure guidelines. PMID- 2705367 TI - OSHA--Final rule. Air contaminants--permissible exposure limits. (Title 29 Code of Federal Regulations Part 1910.1000). U.S. Department of Labor, Occupational Safety and Health Administration. PMID- 2705368 TI - Effect of thermal conditions on the acceptability of respiratory protective devices on humans at rest. AB - The physiological and subjective responses of six sedentary subjects wearing half facepiece respirators were observed over a wide range of room and respirator air conditions. Room air and dew-point (Ta:Tdp) temperatures were 25:11 degrees, 30:13 degrees, and 35:16 degrees C in still air. Respirator air temperatures were maintained independently of room conditions at 27 degrees, 30 degrees, 33 degrees, and 36 degrees C with relative humidity levels of 47% and 73%. Physiological measurements included local skin and dew-point temperatures. Subjective judgments of acceptability, thermal sensation, degree of discomfort, sense of skin moisture, and difficulty of breathing were recorded separately for the thermal environment in the room and inside the respirator. Respirator temperatures cooler than 33 degrees C were always comfortable and 100% acceptable; respirator air temperatures above 33 degrees C or higher humidity levels decreased respirator acceptability. Acceptability of the respirator environment decreased as lip temperature increased above 34.5 degrees C or when respirator dew-point temperature increased above 20 degrees C. Increased respirator air temperature and humidity often made breathing seem "slightly hard." The respirator conditions influenced the subjects' judgment of the acceptability of the surrounding thermal environment. PMID- 2705369 TI - A method for monitoring dermal exposure to volatile chemicals. AB - Absorptive pads of charcoal cloth were developed and tested for monitoring the deposition of volatile toxic materials on skin. The dosimeters can retain over 60% of volatile deposits such as toluene or dichloropropene droplets over an 8-hr workday. Evaporation from liquid deposits and vapor adsorption onto the dosimeters are factors which can complicate the interpretation of exposure data. Evaporation was inversely proportional to the log of the deposit size (volume), vapor pressure, and the air humidity. Vapor adsorption was proportional to the vapor concentration, exposure duration, and the log of air velocity. A procedure is offered for estimating the initial size of the liquid deposit from retained mass. The charcoal cloth dosimeter's accuracy and precision are optimal in situations involving possible dermal exposure to toxic materials with low to moderate volatility or with low vapor concentration, i.e., those where dermal exposure may be equal to or more significant than respiratory exposure. PMID- 2705370 TI - An approach to occupational health risk management for a diversified international corporation. AB - A risk management program is presented which is effective in handling occupational health risks in a diversified multinational corporation. The three step program of plant reviews involves initial assessment visits designed to determine the compliance status and degree of sophistication of the occupational health program. These assessments are followed by more formal assurance reviews which include consultation, training, and program support. Finally, formal surveillance reviews are conducted to verify compliance with respect to company and regulatory agency requirements. Each type of review requires planning and adherence to a standardized process to allow comparability of the information generated. Critical elements of this approach include senior management support, knowledge of applicable regulations, and communication of results. Reporting is done on several levels and is designed to communicate relevant information to management from line supervisors to the board of directors. Corrective action, where indicated, is planned by local managers with assistance from other groups as required. Corrective action plan implementation is tracked in conjunction with other mechanisms of occupational health and medical services to assure effective management of these risks. PMID- 2705371 TI - Magnesium--coming of age. PMID- 2705372 TI - Thiazide treatment of systemic hypertension: effects on serum magnesium and ventricular ectopic activity. AB - Clinical and investigational evidence has proved an association between thiazide induced electrolyte imbalances and ventricular arrhythmias. It is hypothesized that this increases the potential for sudden unexplained death. Elderly hypertensive patients are at particular risk because of their tendency to have significantly depressed serum magnesium levels, which decrease even further when treated with thiazide diuretics. Potassium supplementation does not effectively restore electrolyte balance unless accompanied by magnesium. Therefore, concomitant administration of potassium and magnesium supplementation appears to be an approach to reducing the risk of arrhythmias and death in thiazide-treated hypertensive patients. PMID- 2705373 TI - Effect of rapid mobilization on ejection fractions and ventricular volumes after acute myocardial infarction. AB - Despite the current practice of early mobilization and early hospital discharge after uncomplicated acute myocardial infarction (AMI), physicians are reluctant to permit normal physical and social activity for several weeks after the AMI "to allow the heart to heal." This study tested whether it was possible to identify a low risk group of patients on day 3 after AMI, and whether vigorous early mobilization from days 4 through 7 affected left ventricular function and volumes (studied by gated blood pool scan on days 4 and 14). There was 1 death in 3 months in 45 patients with uncomplicated AMI suitable for randomization to activity (group A) compared with 11 deaths in 55 patients unsuitable for rapid early mobilization (group B) (p less than 0.01). Early vigorous mobilization in 24 of the group A patients compared with sedentary care in 20 did not affect change in ejection fraction, end-diastolic volume, end systolic-volume, stroke volume, heart rate or cardiac output between days 4 and 14. A very low risk group suitable for early vigorous mobilization can be defined on day 3 after AMI; further, vigorous early mobilization does not affect left ventricular function or volumes. Early return to physical, social and occupational activity after uncomplicated AMI should result in marked reduction in direct and indirect costs of AMI. PMID- 2705374 TI - Frequency of uncomplicated angina pectoris in type A compared with type B persons (the Framingham Study). AB - The impact of type A behavior on coronary artery disease was examined in 570 men and 719 women based on 20 years of follow-up in the Framingham Study. A comparison of type A and B persons showed similar levels of systolic blood pressure, total and high density lipoprotein cholesterol and body mass index. Behavioral status also was unrelated to diabetes, cigarette smoking and alcohol intake. Despite similar cardiovascular risk profiles, type A behavior was associated with more than a 2-fold excess risk of angina pectoris, uncomplicated by other symptoms of coronary artery disease (p less than 0.05 for men and p less than 0.01 for women). Type A behavior, however, was not related to an increased risk of myocardial infarction and fatal coronary events. Among the victims of uncomplicated angina, the risk of subsequent coronary morbidity and mortality in both type A and type B men and women increased by more than 4-fold (p less than 0.001). Although the risk was reduced among type A persons, it was not statistically significant. It is concluded that uncomplicated angina pectoris occurs with greater frequency in type A persons than in those who are type B, without explanation by concomitant risk factors. In addition, the prognosis for myocardial infarction and coronary artery disease mortality in angina patients classified as type A is as serious as the prognosis for those who are type B. PMID- 2705375 TI - Prognostic value of early electrophysiologic studies for ventricular tachycardia recurrence in patients with coronary artery disease treated with amiodarone. AB - Amiodarone was used in 86 patients with ventricular tachycardia (VT) (67 patients) or ventricular fibrillation (19 patients) secondary to coronary artery disease. The mean +/- standard deviation left ventricular ejection fraction was 30 +/- 12% (range 8 to 65%). Prior trials with 4 +/- 1.2 alternate antiarrhythmic agents had been unsuccessful. Amiodarone was loaded at dosages of 1,200 to 1,800 mg/day, with maintenance dosages of 400 to 600 mg/day. Drug efficacy was evaluated by programmed stimulation at 10 to 14 days in 68 patients. In 38 patients sustained VT or ventricular fibrillation was inducible (group I), whereas 30 patients (group II) had either no inducible VT (8) or had nonsustained VT induced (22). Holter monitoring was used to assess drug efficacy in 18 patients (group III). All patients were evaluated at 3- to 6-month intervals with Holter monitors for efficacy and a standard protocol for toxicity. During a long term follow-up of 18 +/- 16 months, sudden death occurred in 5 patients and nonfatal arrhythmia recurrences were detected in 16. The actuarial probability of freedom from fatal and nonfatal arrhythmia recurrences at 24 months was 0.52 for group I, 0.97 for group II and 0.68 for group III. The mode of induction, rate change or hemodynamic tolerance of the induced ventricular tachycardia did not predict arrhythmia recurrence. Among the clinical variables analyzed, only an ejection fraction of less than or equal to 30% was identified as a significant predictor of arrhythmia recurrence. Nonsudden cardiac death occurred in 21 patients, including 19 from heart failure and 2 from myocardial infarction. Noncardiac death occurred in 7 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705376 TI - Factors determining maintenance of sinus rhythm after chronic atrial fibrillation with left atrial dilatation. AB - Successful therapy of atrial fibrillation (AF) has been reportedly influenced by a variety of factors including patient age, type of underlying heart disease, duration of arrhythmia, left ventricular function and left atrial (LA) size. To determine which of these factors are associated with maintenance of sinus rhythm after conversion, 43 patients with symptomatic chronic AF in the setting of a dilated left atrium (greater than or equal to 45 mm, range 45 to 78) were followed for at least 6 months after the return of sinus rhythm. Class IA drugs, IC drugs or amiodarone were used for therapy. Life table analysis showed sinus rhythm to be maintained in 81% for 6 months, 79% for 12 months and 60% for 24 months. Factors positively associated with success were conversion with drug therapy alone, duration of chronic AF less than or equal to 1 year, absence of mitral valve disease and LA dimension less than or equal to 60 mm (all p less than 0.05). Patient age, left ventricular function and presence of coronary disease were not associated with outcome. Thus, patients with moderate LA dilatation (45 to 60 mm) and a short duration of chronic AF can often be maintained in sinus rhythm, especially if they convert with pharmacologic intervention alone. PMID- 2705377 TI - Management strategies for surgical treatment of dysrhythmias in infants and children. AB - To elucidate the role of surgery in the management of refractory pediatric dysrhythmias, the investigators' 1987 experience with this therapy was reviewed. Sixteen patients (8 male, 8 female) had surgery. Age ranged from 3 months to 21 years (mean 7.7 years) with 2 being younger than 1 year of age. Eight patients had Wolff-Parkinson-White syndrome with supraventricular tachycardia (SVT), 6 had SVT alone and 2 had ventricular tachycardia. Patient symptoms fell into 3 distinct categories. Nine patients had frequent non-life-threatening tachycardia episodes despite aggressive medical management, 4 patients had life-threatening symptoms either related to frequent tachycardia episodes or due to side effects of drugs and 3 patients had minimal tachycardia symptoms but were judged to be at risk for sudden death. The mechanisms of the tachycardias included reentrant SVT using an accessory atrioventricular connection in 9, the permanent form of junctional reciprocating tachycardia in 2, atrioventricular node reentrant SVT in 2, atrial ectopic focus in 1 and ventricular ectopic foci in 2. Ablation techniques involved either surgical dissection or cryoablation of the arrhythmogenic substrates. There was no surgical mortality and follow-up shows 15 of 16 patients to have had no recurrence of symptomatic tachycardia without any therapy. Based on this experience, management strategies for surgical control of recalcitrant pediatric dysrhythmias are proposed. Surgery for infant dysrhythmias should be performed only for life-threatening symptoms. Beyond the first year of life, after failing 2 medications, surgical options for SVT should be considered. For patients with ventricular tachycardia, aggressive medical management with class II, IC and III agents should be attempted before surgical therapy. PMID- 2705378 TI - Results of operative therapy in the permanent form of junctional reciprocating tachycardia. AB - To assess the results of operative therapy for permanent junctional reciprocating tachycardia, a type of incessant tachycardia, the clinical and electrophysiologic data of 8 such patients referred for management of tachycardia were reviewed. The duration of incessant tachycardia was 14 +/- 10 years (range 2 to 30). The heart rate at rest during tachycardia ranged from 120 to 150 beats/min. Four of 8 patients had cardiomegaly or depressed ejection fraction (16 +/- 10%, range 5 to 27) at presentation and, of these, 2 had symptoms of congestive heart failure. Exertional dyspnea despite normal left ventricular function was noted in 1 patient, 2 had chronic palpitations and 3 were asymptomatic. Electrophysiologic data confirmed the presence of a posteroseptal pathway with atrioventricular node like properties conducting slowly in the retrograde direction only. Seven patients underwent successful surgical ablation of the accessory pathway. Hypothermic cardiopulmonary bypass was used in 2 and a closed heart technique without cardiopulmonary bypass in the other 5. Three of 4 patients with reduced left ventricular function showed an improvement in ejection fraction to 34 +/- 20% (range 16 to 63) after control of dysrhythmia. Three patients had no evidence of cardiomegaly despite equivalent periods of incessant tachycardia. Another patient with normal left ventricular function despite incessant tachycardia for over 30 years underwent spontaneous remission to sinus rhythm and did not undergo surgery. These data suggest that permanent junctional reciprocating tachycardia has a variable presentation and that congestive heart failure is not an infrequent presenting symptom. The substrate is invariably an accessory atrioventricular pathway with a long conduction time and decremental properties conducting only in the retrograde direction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705379 TI - Renovascular reconstruction: factors affecting long-term prognosis in 919 patients followed up to 31 years. AB - During the 31-year period from May 3, 1955, to May 12, 1986, renovascular reconstructions were performed on 919 patients. The mean age of the 529 men was 54 +/- 0.58 (SE) years and, of the 390 women, 48 +/- 0.7 years. Mean preoperative diastolic blood pressure was 110 +/- 0.6 mm Hg. The most common causes of renal artery stenosis were atherosclerosis in 647 patients, fibromuscular disease in 161 patients, and renal artery aneurysm in 51 patients. In the remaining 60 patients, other causes were present, including kinks and fibrous bands. The most common surgical procedures were Dacron bypass graft (780 arteries) and endarterectomy with or without a patch graft (329 arteries). Four hundred sixty nine patients had associated operations, the most common of which were abdominal aortic aneurysmectomy in 231 and aortoiliofemoral reconstruction in 141 patients. The perioperative mortality rate was 5.5% (51 of 919 overall); for renal procedures alone, it was 1.7% (8 of 450) and for combined surgical procedures, 9.2% (43 of 469). The overall graft patency rate at a follow-up of 18.8 +/- 1.9 months was 88.6% (381 of 430) and at a second follow-up of 50 +/- 4.3 months, 86.7% (111 of 128). Analysis of long-term blood pressure response and factors affecting late survival indicated that patients with preoperative diastolic pressures of greater than 100 mm Hg and renal artery stenosis of greater than 70% had the best blood pressure responses and that male sex, increasing age, bilateral renal stenosis, and associated vascular operations lowered the survival rate whereas fibromuscular disease enhanced the duration of survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705380 TI - Usefulness of Doppler echocardiography in the diagnosis of congestive heart failure. AB - One hundred fifty-one consecutive patients with a diagnosis of congestive heart failure (CHF) referred for echocardiography were prospectively evaluated to (1) define the frequency of normal left ventricular systolic function in a referral based population with CHF; (2) establish cardiac mechanisms responsible for symptomatology in these patients; and (3) assess the ability to clinically differentiate these subsets of patients based on routine history and physical examination. Of the 151 total patients, 51 (34%) had normal left ventricular systolic function (left ventricular ejection fraction greater than or equal to 55%). Primary valvular disease was present in 4 of these 51 patients (8%), and Doppler echocardiographic evidence of abnormal left ventricular filling (diastolic dysfunction) was evident in 10 (20%). In addition, no predefined resting abnormality was noted in 34 (66%) of them. Despite this finding, 51% of all patients with normal left ventricular systolic function were being treated with digoxin therapy in the absence of atrial arrhythmia. Clinical differentiation of this group of patients from those with abnormal left ventricular systolic function was difficult and may have accounted for this apparently inappropriate treatment. Thus, evaluation of left ventricular function and of causative mechanisms of CHF before initiation of long-term treatment is mandatory. PMID- 2705381 TI - Factors affecting Doppler echocardiographic valve area assessment in aortic stenosis. AB - Doppler echocardiographic assessment of the aortic valve area (AVA) using the continuity equation was performed before cardiac catheterization in 100 patients with suspected aortic stenosis. Doppler echocardiographic AVA correlated closely with AVA calculated by the Gorlin equation at catheterization (r = 0.96). However, Doppler echocardiography slightly but systematically underestimated the AVA (p less than 0.001) and did so most markedly in patients with mild stenosis (greater than 1.0 cm2). In multivariate analysis, the difference in AVA by the 2 techniques was positively associated with left ventricular (LV) stroke volume and inversely with the difference between mean catheterization and Doppler gradients, LV ejection fraction and LV outflow tract velocity. Furthermore, the AVA difference also was related to gender, being larger in women. Thus, overall Doppler echocardiography reliably assesses AVA, but the usefulness of the method is somewhat reduced by its underestimation of AVA in mild stenosis. This drawback, however, is usually overcome by taking patients' symptoms into account. Furthermore, lacking a "gold standard," this underestimation need not imply errors of the Doppler echocardiographic method alone, but also may reflect known inaccuracies of the catheterization technique. PMID- 2705382 TI - Two-dimensional and color Doppler assessment of ventricular septal defect of congenital origin. AB - Two-dimensional echocardiography and color Doppler examinations were performed in 53 patients with 58 ventricular septal defects (VSD) proven surgically or anatomically. All patients also had angiocardiograms. Two-dimensional echocardiography/color Doppler examination detected all VSDs and correctly categorized the site and extension of VSDs in 50 of 58 (86%). All 40 perimembranous VSDs were diagnosed in the left ventricular outflow tract short axis plane as an area of discontinuity adjacent to septal tricuspid valve leaflet attachment. Fourteen of 16 VSDs with inlet extension showed initial color flow signals along the septal tricuspid leaflet and along the ventricular septum. Of 23 perimembranous VSDs with outlet extension, 19 had flow signals moving directly toward the right ventricular outflow tract. One perimembranous VSD with trabecular extension showed flow signals directed anterolaterally toward the right ventricular free wall. Eleven of 13 muscular VSDs were similarly categorized correctly by color Doppler as inlet, outlet and trabecular. All 5 doubly committed VSDs were correctly diagnosed as an area of discontinuity adjacent to the pulmonary valve in the short-axis view with flow signals directly moving through VSD into right ventricular outflow and pulmonary artery. Angiography correctly detected all VSDs and correctly classified their site and extension in 45 of 58 (77.5%). It misclassified 8 of 40 perimembranous, 3 of 13 muscular and 2 of 5 doubly committed VSDs. Color Doppler compares favorably with angiocardiography in the detection and localization of VSDs. PMID- 2705383 TI - Effect of passive tilt on sympathetic and parasympathetic components of heart rate variability in normal subjects. AB - Decreased heart rate (HR) variability has been shown to be an independent predictor of poor outcome after acute myocardial infarction. Presumably, both reduced parasympathetic activity and increased sympathetic activity contribute to this observed HR variability response. To elucidate the physiologic contributions of the sympathetic and parasympathetic nervous systems to HR variability, the effect of passive head-up tilt (+70 degrees) was investigated on 4 indexes of HR variability in 17 healthy subjects. The standard deviation of the mean of 512 consecutive RR intervals, a traditional marker of HR variability and a purported index of cardiac parasympathetic neural tone, was compared with the mean difference of 512 consecutive RR intervals, with the maximal expiratory RR interval to minimal inspiratory RR interval ratio (respiratory RR ratio) and with the low- and high-frequency components of the power spectrum of 512 consecutive RR intervals. Passive tilt produced a nonsignificant decrease in the standard deviation of RR intervals. There was, however, a highly significant decrease in the mean difference of consecutive RR intervals and the high-frequency component of the RR-interval spectrum. Both the respiratory RR ratio and the low-frequency component of the RR-interval spectrum increased with tilt. It was concluded that the mean difference of consecutive RR intervals and the high-frequency component of the RR-interval spectrum are potentially superior indexes of "pure" parasympathetic neural tone and may be preferable for future use in cardiovascular studies of autonomic dysfunction. PMID- 2705384 TI - Effect of intravenous magnesium sulfate on supraventricular tachycardia. PMID- 2705385 TI - Influence of isoproterenol on the left ventricular response to right ventricular extrastimuli. PMID- 2705386 TI - Correlation of morphology of the left ventricular outflow tract with two dimensional Doppler echocardiography and magnetic resonance imaging in atrioventricular septal defect. PMID- 2705387 TI - Effects of circulating norepinephrine on platelet, leukocyte and red blood cell counts by alpha 1-adrenergic stimulation. PMID- 2705388 TI - Effect of chronic ibuprofen therapy on early healing of experimentally induced acute myocardial infarction in dogs. PMID- 2705389 TI - Familial myxomatous valvular disease. PMID- 2705390 TI - Intramural coronary vessels in partial absence of the myocardium of the right ventricle. PMID- 2705391 TI - Pet food-derived penicillin residue as a potential cause of hypersensitivity myocarditis and sudden death. PMID- 2705392 TI - Echocardiography in low pressure cardiac tamponade. PMID- 2705393 TI - A symposium: Cardiovascular disease in the elderly--etiology, prevention, diagnosis and treatment. February 26-27, 1988, Newport Beach, California. PMID- 2705394 TI - Cardiovascular disease in the elderly: current considerations. AB - Today, elderly patients account for one-third of the total United States health care costs and for one-third of all drug prescriptions. As the United States population grows older, health care costs are expected to grow proportionately unless cost reduction strategies are developed. Cardiovascular disease is ranked as the primary cause of mortality and disability in this age group. It is estimated that 80% of cardiovascular disease in the elderly arises as complications of atherosclerosis. Whereas modern technologic advances--cardiac catheterization, coronary angiography, coronary angioplasty, coronary bypass surgery, pacemaker insertion--can help to treat the effects of atherosclerosis, such advances are costly. The most effective cost reduction strategy lies in prevention of atherosclerosis and its complications. A number of studies have linked reduction of risk factors for atherosclerosis to reduction of coronary disease events. However, it is not certain that these data apply directly to the elderly; more research is necessary to develop effective preventive and management strategies. PMID- 2705395 TI - Epidemiologic considerations in cardiovascular diseases in the elderly: international comparisons and trends. AB - As developed countries experience an "aging" of their populations, concern over cardiovascular disease, an important cause of death in the elderly, has grown. Improvements in the mortality rates of ischemic heart disease have been observed over the last 10 or 15 years in many nations, including Australia, the United States, Canada and Belgium. In other countries, mortality rates have remained unchanged and in some Eastern European countries, mortality rates have increased. In most instances where mortality rates have decreased, the reduction has been observed in both genders and has occurred across a wide age grouping, even in those aged 75 years and older. Truly representative data on risk factors for cardiovascular disease in the elderly are difficult to find; a new study has commenced in Australia and may provide more information. PMID- 2705396 TI - European lipid guidelines: therapeutic recommendations. European Atherosclerosis Society. AB - The European Consensus Conference has classified persons with hyperlipidemia into 5 groups on the basis of cholesterol and triglyceride levels. Plasma cholesterol concentration alone is not sufficient for the assessment of myocardial infarction risk; other risk factors must be considered for a more sensitive prediction. Guidelines for risk assessment of coronary heart disease and treatment regimens for each of the 5 hyperlipidemia groups, as outlined in the Policy Statement on coronary heart disease of the European Atherosclerosis Society, are described. It is emphasized that therapeutic goals for patients with hyperlipidemia depend to some extent on the presence or absence of other risk factors; plasma cholesterol and low-density lipoprotein cholesterol target levels may be lower in those with associated risk factors. PMID- 2705397 TI - Primary lymphoma of bone: the use of MRI in pretreatment evaluation. AB - Primary lymphoma of bone (PLB) is an uncommon neoplasm representing only 5% of all extranodal non-Hodgkin's lymphomas. The precise role of magnetic resonance imaging (MRI) scanning is unknown. A review of the literature and a recent case treated at the University of Alabama at Birmingham in which MRI unveiled other foci of disease undetected by routine staging studies is presented. PMID- 2705398 TI - CA-125 values predictive of clinical response during second-line chemotherapy for epithelial ovarian cancer. AB - Between November 1984 and January 1987, 19 patients with epithelial ovarian cancer were monitored with CA-125 values during second-line therapy. There was a statistically significant association between clinical response to therapy and CA 125 trend when trend was defined as a greater than or equal to 26% change in CA 125 from baseline value to last value prior to demonstration of clinical response (p = 0.0002). In 8 of 11 patients (73%), increasing CA-125 values were predictive of clinical progression during second-line therapy. In six of seven patients (86%), decreasing values predicted clinical regression. Three patients began second-line therapy with baseline values less than 35 U/ml. Two of these progressed during second-line therapy while the third progressed in follow-up. Two of four complete clinical responders completed second-line therapy with values less than 35 U/ml. Both progressed in follow-up with increasing CA-125 values. In this analysis, a 26% change in CA-125 values was a useful predictor of clinical response in patients receiving second-line therapy for epithelial ovarian cancer. Patients undergoing second-line chemotherapy with values less than 35 U/ml may still benefit from CA-125 monitoring. PMID- 2705399 TI - The CDRH helix. A phase I clinical trial. AB - Seventeen patients have been given regional hyperthermia treatments using the Center for Devices and Radiologic Health (CDRH) Helix, a resonant helical coil unit. Most of these patients had large, clinically advanced tumors, whose mean volume exceeded 1000 cc. Mean maximum, minimum, and average temperatures were 40.6, 38.6, and 39.6 degrees C, respectively, for all sites combined. The pelvic heating capabilities of the CDRH Helix and the BSD-1000 annular phased array were compared, and generally were equivalent. Although the Helix could be used in a wider variety of locations, and was more comfortable and easier to use than the BSD-1000 annular phased array, neither device was particularly effective in generating clinically useful temperatures; the Helix is currently under investigation for use in regional-systemic hyperthermia in combination with antineoplastic drugs and biologic response modifiers. PMID- 2705400 TI - First-line chemotherapy with intraperitoneal cisplatin and intravenous cyclophosphamide in ovarian carcinoma. A preliminary report. AB - Between August 1982 and October 1986, the feasibility and activity of five cycles of intraperitoneal (i.p.) cisplatin (CDDP) (90 mg/m2 in 6 h dwelling) and i.v. cyclophosphamide (600 mg/m2) were studied in 24 previously untreated patients with ovarian carcinoma having small or no residual disease after cytoreductive surgery. Six patients (25%) had local complications requiring catheter removal before the end of therapy. Fifteen of the 21 patients (71%) evaluable for activity achieved or maintained a pathologic complete remission. The median disease-free survival was 29+ months (range 18-58+ months). Three patients with tumor progression (two patients previously without evidence of disease, and one patient with minimal residual disease), and three partial responders were documented by laparotomy at the end of therapy. Two patients who achieved pathologic complete response relapsed at 20 and 36 months. All treatment failures (eight cases, 38%) occurred in the peritoneal cavity. Since patients were selected for having the most favorable tumor characteristics to benefit from i.p. treatment, our findings may cast some doubt on the actual contribution of i.p. CDDP at a dose of 90 mg/m2 in the treatment of patients with ovarian carcinoma and small residual disease in the peritoneal cavity. PMID- 2705401 TI - Ten-year results of FAC adjuvant chemotherapy trial in breast cancer. AB - Two hundred twenty-two patients with stage II or III breast cancer were treated in the first adjuvant trial from M.D. Anderson Hospital. At a median follow-up of 133 months, estimated 10-year disease-free survival was 58 and 36% for stage II and III disease, respectively. Estimated 10-year survival was 62% for patients with stage II disease and 40% for those with stage III disease. The fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide (FAC) regimen was effective in improving disease and overall survival regardless of age of the patient, stage of disease, or extent of nodal involvement in comparison with the historical control patients treated with similar local therapy. The treatment was not associated with increased risk of other malignancies, and doxorubicin-related cardiotoxicity was observed in 1% of patients. Long-term follow-up of this study confirms the earlier observation that the FAC regimen is effective in reducing the risk of recurrence and prolonging the survival of high-risk patients. PMID- 2705402 TI - A phase II trial of iproplatin (CHIP) in previously treated advanced breast cancer. AB - Iproplatin (CHIP) was administered to 35 previously treated women with metastatic adenocarcinoma of the breast. The drug was given at a dose of 45 mg/m2 intravenously for 5 consecutive days and was repeated every 28 days. In this trial, there was one partial response and two patients with stable disease out of 29 evaluable patients. The median duration of response in patients with either a partial response or stable disease was 4.8 months. Myelosuppression was the major toxicity, 11 patients had severe thrombocytopenia and 3 severe neutropenia. Mild renal insufficiency, anemia, and nausea and vomiting were also noted. Iproplatin has limited activity in heavily pretreated women with advanced breast carcinoma; further studies in patients less heavily treated may show an improved response rate. PMID- 2705403 TI - Chemotherapy with cis-platin, doxorubicin, and cyclophosphamide (CAP) in patients with metastatic breast cancer. AB - Thirty-three evaluable patients with metastatic breast cancer (12 previously treated with adjuvant chemotherapy) were treated with a combination of cis platin, doxorubicin, and cyclophosphamide (CAP). cis-Platin was given intravenously, 20 mg/m2, on days 1-3, doxorubicin, 40 mg/m2 i.v., on day 1, and cyclophosphamide, 200 mg/m2 i.v., on days 1-3. Cycles were repeated every 3 weeks. A complete response (CR) was obtained in 3 patients (9%) and a partial response (PR) in 18 (54%). The highest response rate was observed in soft tissue and in liver metastases. Median response duration was 48 weeks and median survival 93 weeks. Toxicity was moderate and consisted of alopecia (100%), gastrointestinal toxicity (86%), and myelosuppression (60%). We conclude that this regimen is active in the treatment of advanced breast carcinoma, with a generally acceptable tolerance, but further evaluations in Phase III studies are required. PMID- 2705404 TI - Mitoxantrone in the treatment of advanced vulvar and vaginal carcinoma. A gynecologic oncology group study. AB - Nineteen evaluable patients with advanced carcinoma of the vulva or vagina were treated with mitoxantrone, 12 mg/m2, every 3 weeks. All patients had good performance status and measurable disease and only nine had received prior chemotherapy. No complete or partial responses were noted. The major toxicity was myelosuppression; other toxicity was mild, and no cardiac toxicity or drug deaths occurred. The median progression-free interval was 1.3 months for patients with vulvar cancer and 1.6 months for patients with vaginal cancer. Median survival was 3.2 months for patients with vulvar cancer and 2.7 months for patients with vaginal cancer. Mitoxantrone displays no activity in patients with advanced carcinoma of the vulva or vagina. PMID- 2705405 TI - A prospective, randomized controlled trial of megestrol acetate among high-risk patients with resected malignant melanoma. AB - In light of some evidence that hormonal factors may impact on malignant melanoma, we performed a randomized trial of megestrol acetate versus observation among 67 patients with high-risk resected stage I or stage II (nodal) malignant melanoma. Following stratification by relevant prognostic factors, we observed a statistical significance in survival advantage for megestrol acetate that approached 7.6 versus 2.6 years, median survival; two-sided log rank p = 0.06. Disease-free survival was also greater for patients who received this hormonal therapy (3.4 versus 1.1 years, median disease-free survival), but the difference was not statistically significant (two-sided log rank p = 0.20). The most noteworthy side effects were weight gain (median 6-month gain of 8.2 kg) and impotence. Fully recognizing the hazards of limited sample analyses and the need for confirmatory trials, our findings suggest a possible role for megestrol acetate as adjuvant therapy for selected patients with malignant melanoma. PMID- 2705406 TI - Bio-adhesio-chemo (BAC) therapy for patients with malignant pleural effusion. AB - Eighteen patients with serious pleuritis carcinomatosa with remarkable pleural effusion were treated with a new pleurodesic therapy, and all the patients treated obtained favorable results. After removing pleural effusion, fibrinogen solution was intrapleurally instilled and then, our newly devised material, G.T.XIII and an anticancer drug, Adriamycin (ADM), were administered as chemosclerosing agents in an attempt to prevent recurrence of the effusion and also to provide locoregional antineoplastic effects. Recurrence of pleural effusion was nil in all patients treated, and subjective complaints of the patients were remarkably relieved. There were 14 patients evaluable, and all the response of these patients resulted in partial response (PR) according to the World Health Organization (WHO) criteria. Improvement of performance status (PS) was observed in 61% (11/18). Eight patients could be discharged. Three patients have remained alive. Fifteen patients died after the therapy, and their median survival was 67 days. Eight patients were autopsied. The postmortem examinations confirmed that fibrous adhesion in the pleural cavity with these materials was significant, and evidence of recurrence of pleural fluid was not seen. Topical oncolytic effects of the ADM were histologically remarkable. This pleurodesis was called "Bio-adhesio-chemo (BAC) therapy." PMID- 2705407 TI - Oncologic imaging: state of the art and research priorities. PMID- 2705408 TI - Electromyography of masticatory muscles in three jaw registration positions. AB - The purpose of this study was to investigate whether anteroposterior changes in mandibular position affect masticatory muscle activity. The electromyographic (EMG) activity of masticatory muscles during full and partial (10%) clenching in three mandibular bite registration positions--retruded contact position (RCP), intercuspal position (IP), and muscular position (MP)--was studied. Three groups of subjects with different ranges of anteroposterior positioning of the condyles were evaluated (normal occlusion, Class II, Division 2 malocclusion, and dual bite malocclusion). A posterior stabilizing splint for each registration position was made. EMG data were obtained from three bilateral muscles (masseter, anterior temporal, and posterior temporal). Clenching in the RCP elicited the lowest masseter muscle activity during full clenching, and the highest anterior temporal and posterior temporal muscle activity during partial clenching. If the relationships of the masticatory muscles are analyzed through a ratio that represents the interaction between biting and positioning muscles (masseter/posterior temporal muscle ratio), the RCP as compared with other positions had the lowest ratio. The RCP required more positioning muscle activity and permitted less biting muscle activity. There was no significant difference in the muscle activity between the IP and MP registrations. Small changes in jaw position (anterior to RCP) are not critical for the masticatory apparatus provided there is good intercuspation. The results of this investigation suggest that intercuspation in RCP is not the optimal position. PMID- 2705409 TI - A cephalometric study of 32 North American black patients with anterior open bite. AB - The purpose of this research project was to investigate a group of 32 North American black patients with anterior open bite and compare them to the North American black norms established by Altemus and Drummond and to white population norms established by Steiner. In addition, values were established for black patients by use of the overbite depth indicator of Kim. The method involved the tracing of lateral cephalometric radiographs of 32 patients with anterior open bite using the analyses of Tweed, Steiner, and Kim. The resulting angles were added and the means and standard deviations calculated. On the basis of the criteria used for this study, the significant findings were as follows: (1) the maxilla was normally positioned to the cranial base; (2) the upper and lower incisors were procumbent with an acute interincisal relationship; (3) the mandibular position tended to be retrusive to the cranial base; (4) the lower facial height was greater and the mandibular plane angle (GoGn-SN) was smaller than white population standards; and (5) the overbite depth indicator of Kim was smaller for this group than for the white population studied. PMID- 2705410 TI - A multivariate approach to analyzing the relation between occlusion and craniofacial morphology. AB - This study examined the association between occlusion and craniofacial morphology using univariate and multivariate statistical methods. Data were obtained from study casts and lateral cephalometric radiographs of 164 children in the early permanent dentition. The following multiple features of occlusion were assessed: molar relation, overjet, overbite, and anterior crowding. Angular skeletal measures assessed cranial base flexure, maxillary horizontal and vertical positions, mandibular horizontal and vertical positions, horizontal and vertical maxillary-mandibular relations, and positions of the incisors. The relation between the Occlusal Index, which is a malocclusion severity index, and skeletal morphology was also investigated. Associations were examined by use of linear correlation, stepwise multiple regression, and canonical correlation analyses. Individually and in combination, occlusal features were poorly associated with individual skeletal measures (r2 less than or equal to 0.35). The strongest association occurred between a linear combination of occlusal features and a linear combination of skeletal measures (R2 = 0.66, p = 0.0001). A malocclusion severity index did not aid in the identification of craniofacial morphology. The results suggested that combinations of certain occlusal characteristics may be associated with specific skeletal types; however, a generalized statement of this concept could not be supported. PMID- 2705411 TI - The influence of cephalostatic ear rods on the positions of the head and neck during postural recordings. AB - This study examined the effect of cephalostatic ear rods on the positions of the head and neck. The method error was assessed for postural recordings of the head and neck position made with and without ear rods. A photographic angle was correlated with the postural angles on x-ray film. The material compared 33 dental students who were recorded with ear rods in and with ear rods out. Subjects were chosen randomly to repeat the postural recordings. The differences between the mean for each postural variable were subjected to comparative analysis, using Student's t test for paired samples. A significant difference (p less than or equal to 0.05) was found between the means of the inclination of the cervical spine to the true horizontal and the means of the photographic angle. The mean values for the remaining postural variables showed an insignificant but consistent pattern of axial extension of the cervical spine. Cephalostatic ear rods may alter head and neck position during postural recordings. The method error made for recording total head and neck position with ear rods was higher than without ear rods. The difference in the photographic angle was found to have a moderate positive correlation with the difference in the cervical inclination and the total head and neck position. These data suggest that lateral cephalostatics without ear rods may be used to record total head and neck position and the photographic technique may be used as a quick, inexpensive method for the clinician to determine head and neck positional changes before and after treatment. PMID- 2705412 TI - A cephalometric assessment of children with fetal alcohol syndrome. AB - Lateral cephalometric radiographs were quantitatively assessed in a series of 15 American black children with fetal alcohol syndrome (FAS). Although none was profoundly affected, FAS had been diagnosed in all the children at birth. Comparisons with age-, sex-, and race-matched controls disclosed a triad of facial profile differences: (1) frontal bossing, (2) palatal plane tipped up in the front with proclined upper incisors and a sharp nasolabial angle acquired from digit habits, and (3) above-average length of the mandibular corpus. Collectively these generate the perception of midface hypoplasia, although the midface actually is unremarkable in size and position. A high prevalence of chronic digit habits (8 of 15) is a secondary consideration in FAS, leading to localized skeletodental problems. PMID- 2705413 TI - A 3-year clinical and SEM study of surface changes of carious enamel lesions after inactivation. AB - The surface features of incipient carious lesions around bonded orthodontic brackets were assessed during a 3-year period after appliance removal. At standardized intervals color slides and silicone impressions for replication were made of two maxillary incisors on each of six adolescent patients. The labial surfaces of the teeth had demineralized white areas around the bonded brackets. The color slides were projected and studied in a darkroom. The positive surface replicas were studied by scanning electron microscopy (SEM). At the time of debonding, large accumulations of dental plaque were observed in those areas with white, demineralized surfaces. During the posttreatment or experimental period, there was a reduction in the amount of plaque. The appearance of the lesions changed from chalky-white at time of debonding to a more diffuse opacity, particularly in the peripheral parts. Under SEM the surfaces of the lesions were less irregular 3 years after debonding. At higher magnification the labial surfaces showed signs of wear. The present study confirms that removal of cariogenic challenge results in arrest of further demineralization. The gradual regression of the lesion at the clinical level is believed to be primarily a result of surface abrasion. PMID- 2705414 TI - Postsurgical maxillary movement: a comparison study of bone plate and screw versus wire osseous fixation. AB - This study was designed to examine amounts of postoperative maxillary movement in patients who received Lefort I osteotomies, comparing bone plate and screw fixation with conventional transosseous wire fixation. Cephalograms of 17 patients whose maxillae were fixated with wire osseous fixation and 13 patients whose maxillae were fixed with bone plates and screws were compared at four different time periods throughout the first postoperative year. Millimeters of movement of five maxillary assessment points were assessed in the horizontal and vertical planes of space by use of a line constructed 7 degrees to sella-nasion at nasion as the horizontal reference. Results indicate that the amount of maxillary movement was similar for the two groups during the two time periods subsequent to the surgical procedure. However, it appears that the maxillae fixated with bone plates and screws were more stable than those with wire osteosynthesis during the last postoperative period (6 months to 1 year) and during the overall postoperative time interval (2 days to 1 year). PMID- 2705415 TI - The accuracy of measuring condylion location. AB - In locating condylion (Co), clinicians have used cephalograms in maximum mandibular opening to provide a clearer image of the condyle. The purpose of this study was to evaluate the accuracy of identifying condylin on a sample of open and closed mouth cephalograms of 20 patients. Five orthodontists traced each mandibular outline and located condylion and the tip of the mandibular incisor (I). The incisor tip was assumed to be relatively interpretable and served as an internal control. The differences between the open and closed positions in the horizontal and vertical components of condylion relative to the mandibular plane or in the length Co-Gn were not statistically significant. The absolute deviation around condylion was significantly different (p = 0.007), but the average absolute deviation of condylion in the open position was only 0.5 mm less than condylion in the closed position. Statistically significant differences also occurred in the means of the vertical component of the incisor tip (p = 0.002), the length Gn-I (p = 0.006), and the absolute deviation of incisor tip (p = 0.004). These results indicate that the open mouth method does not significantly change the location of condylion. It does increase the accuracy of landmark identification, but this increased accuracy on the average is not clinically significant. PMID- 2705417 TI - "Error" or test? PMID- 2705418 TI - "The scientific basis of a new preventive odontology". PMID- 2705416 TI - Legal aspects of orthodontic practice: risk management concepts. Professional liability insurance. PMID- 2705419 TI - More on obstructive sleep apnea. PMID- 2705420 TI - In re: An American Board of Orthodontics case report. PMID- 2705421 TI - Computerized patient records--a potential risk. PMID- 2705422 TI - Genetic and environmental influences on level of habitual physical activity and exercise participation. AB - In order to quantify genetic and environmental determinants of physical activity level, 1,610 subjects from 375 families who lived in the greater Quebec city area completed a three-day activity record in 1978-1981. Level of habitual physical activity, which includes all the usual activities of life, and exercise participation, which includes activities requiring at least five times the resting oxygen consumption and more, were derived from this record. Familial correlations were computed in several pairs of biologic relatives and relatives by adoption after adjustment for the effects of age, sex, physical fitness, body mass index, and socioeconomic status, and analyzed with a model of path analysis that allows the separation of the transmissible effect between generations (t2) into genetic (h2) and cultural (b2) components of inheritance. The transmission was found to be statistically significant, but was accounted for by genetic factors for level of habitual physical activity (t2 = h2 = 29%), and by cultural factors for exercise participation (t2 = b2 = 12%). Although non-transmissible environmental factors remain the major determinants of these two physical activity indicators in this population, the results suggest that children can acquire from their parents certain customs regarding exercise behavior and that the propensity toward being spontaneously active could be partly influenced by the genotype. PMID- 2705423 TI - Acute health effects among firefighters exposed to a polyvinyl chloride (PVC) fire. AB - Firefighters are frequently being called on to fight fires that are chemical in nature. In the aftermath of a chemical fire in Plainfield, New Jersey on March 20 21, 1985, the authors conducted a retrospective cohort study which surveyed 80 firefighters exposed to burning polyvinyl chloride (PVC) as well as 15 nonexposed firefighter subjects. By means of an 81-item symptom checklist, exposed firefighters reported more frequent and severe symptoms at 5-6 weeks post incident. This was true for a total symptomatology score as well as 19 individual items. Some of the items with an elevated risk were consistent with exposure to hydrogen chloride, the main pyrolysis product of polyvinyl chloride. Other items with an elevated risk appeared to be related to smoke inhalation while others seemed psychosocial in nature. Analyses conducted within the exposed firefighter group showed that fighting the fire the first day, being a truckman, and residence within 1 mile (1.6 km) of the firehouse were significant risk factors for high total symptom scores. These risk factors may have been associated with level or duration of exposure to the toxic substances produced during the fire. PMID- 2705424 TI - Infant feeding and deaths due to diarrhea. A case-control study. AB - The association between infant feeding habits and infant mortality from diarrhea was investigated in a population-based case-control study in two urban areas in southern Brazil during 1985. Each of 170 infants who died due to diarrhea was compared with two neighborhood controls. After allowance was made for confounding variables, infants who received powdered milk or cow's milk, in addition to breast milk, were at 4.2 times (95% confidence interval (CI) 1.7-10.1) the risk of death from diarrhea compared with infants who did not receive artificial milk, while the risk for infants who did not receive any breast milk was 14.2 times higher (95% CI 5.9-34.1). Similar results were obtained when infants who died from diarrhea were compared with infants who died from diseases that were presumed to be due to noninfectious causes. Each additional daily breast feed reduced the risk of diarrhea death by 20% (95% CI 2-34%), but the increase in risk associated with each bottle feed was not significant after allowance was made for the number of breast feeds. The only other consumption variable associated with diarrhea mortality was the frequency with which tea, water, or juice were drunk with each feed (increase in risk, 42% (95% CI 4-93%]. The odds ratios associated with nonbreast milk were highest in the first two months of life. Possible biases were investigated, including the interruption of breast feeding as an early consequence of the terminal illness, but the strong protective effect of breast-feeding persisted after these adjustments. PMID- 2705425 TI - A comparison of response rate, data quality, and cost in the collection of data on sexual history and personal behaviors. Mail survey approaches and in-person interview. AB - The authors examined differences in rate of response, data quality, and cost between mail approaches and in-person interview in the collection of data on sexual history and personal behaviors. A sample of women from a midwestern United States university (n = 342) was identified from health service medical records as having been seen for a sexually transmitted disease (cases) or a contraceptive visit (controls) during the latter half of 1985. The women were randomly assigned to one of three data collection strategies. A total of 268 subjects (78%) participated. Results indicated no differences in validity by method of data collection or by case-control status but there were significant differences in completeness, cost, and response rates. In-person interviews resulted in more complete data than mail approaches, although all instruments had low proportions of missing data (0.001-0.006). Response rate differences were not found when data collection methodologies were compared (75-82%) but were found in case-control analyses. Cases were consistently less likely to participate and significantly less likely to respond by mail (p less than 0.05). The cost of the in-person interview was approximately four times that of the mail survey for the data collection. Implications of the case-control response rate difference suggest that mail methodologies, although low in cost, may introduce sampling bias in studies of sexually transmitted diseases. PMID- 2705426 TI - Estimating and correcting for confounder misclassification. AB - Confounder misclassification is as pervasive a problem in epidemiologic studies as misclassification of the primary exposure variables. Adjustment using imperfectly classified confounders has been shown to remove only part of the confounding effect of that variable, most important when studying an exposure postulated to have a modest effect in the presence of a strong confounder. The Per Cent Adjustment (amount of confounding bias removed using the misclassified measure relative to the total confounding bias present) is derived for several case-control scenarios, and is found to have a stable relation to the sensitivity and specificity of confounder classification. Figures are provided for estimation of the completely adjusted odds ratio given the results from the misclassified proxy and an estimate of the extent of misclassification. This offers a method for quantitative assessment of the impact of residual confounding that results from confounder misclassification, illustrated with studies of coffee consumption and bladder cancer in the presence of confounding by cigarette smoking. PMID- 2705427 TI - Reduced fecundability in women with prenatal exposure to cigarette smoking. AB - Animal studies have suggested that fertility may be impaired by transplacental exposures, but little is known about human prenatal exposures and subsequent adult reproduction. A possible relation between prenatal exposure to cigarette smoking and adult fecundability in women was explored, with the use of data from a prospective study of 221 North Carolina couples. These couples were recruited during 1983-1985, at the time they stopped using birth control in order to become pregnant. The relative fecundability of exposed compared with unexposed women was estimated by applying a discrete-time proportional probabilities model to the cycle-by-cycle conception rates. Women with prenatal exposure to their mother's cigarette smoking had reduced fecundability. The fecundability ratio associated with prenatal exposure to mother's smoking, adjusted for age, frequency of intercourse, current smoking status, age at menarche, and childhood exposure to cigarette smoking, was 0.5 (95% confidence interval 0.4-0.8). This association was not changed by further adjustment for other possible confounding variables, including educational level, reproductive history, body weight, and consumption of alcohol and caffeine. Thus, women whose mothers smoked while pregnant with them may be on average substantially less fecund than women whose mothers did not smoke during pregnancy. PMID- 2705428 TI - Do women with childhood exposure to cigarette smoking have increased fecundability? AB - The authors earlier conducted a retrospective study of time to pregnancy among a group of pregnant women in Minnesota, in order to investigate the relation between cigarette smoking and fecundability. Further analysis of these data shows that women who had been exposed as children to cigarette smokers had increased fertility. This finding lacks biologic plausibility. However, the authors found a similar association in a group of North Carolina women whose fecundability had been measured prospectively. Furthermore, both groups showed an apparent dose response effect. The authors briefly describe this unexpected finding so that it might be more fully explored in other studies. PMID- 2705429 TI - Re: "Mortality of lead Smelter Workers. PMID- 2705430 TI - Re: "Confounding Confounding". PMID- 2705431 TI - Re: Sample size estimation in occupational mortality studies with use of confidence interval theory. PMID- 2705432 TI - Intrauterine growth retardation and risk of sudden infant death syndrome (SIDS) AB - The purpose of this study was to assess whether intrauterine growth retardation was associated with an increased risk of sudden infant death syndrome (SIDS). A total of 148 SIDS cases were identified from the Upstate New York (exclusive of New York City) live birth cohort for 1974 (n = 132,948). Dead controls represented all other sudden deaths (n = 114). Live controls were randomly selected and matched to cases on mother's age, race, parity, and residence and infant's birth date (n = 355). Data were collected from vital certificates (response, 97%), medical records (89%), and autopsy reports (100%). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with the use of logistic regression techniques to control for confounding. With live controls, significant risks were observed for gestations less than 37 weeks (OR = 2.2, CI 1.2-4.1), birth weights less than 2,500 g (OR = 2.5, CI 1.3-5.0) and birth lengths less than or equal to 47.0 cm (OR = 3.4, CI 1.8-6.4). Birth length less than or equal to 47.0 cm was the only significant risk factor observed when dead controls were used (OR = 2.9, CI 1.3-6.8). Risk decreased with increasing gestation and birth size. Postterm infants (greater than or equal to 42 weeks) were at lowest risk (live controls OR = 0.9, CI 0.5-1.6; dead controls OR = 0.6, CI 0.3-1.1). When gestational age was controlled for, SIDS infants were found to have reductions in both weight and length; this suggests that responsible mechanisms begin early in pregnancy. PMID- 2705433 TI - Adverse pregnancy outcomes in relation to water contamination, Santa Clara County, California, 1980-1981. AB - An epidemiologic study was conducted to investigate a suspected cluster of adverse outcomes of pregnancies conceived in 1980-1981 among women who resided in a census tract in Santa Clara County, California that was thought to be exposed to drinking water from a well contaminated by an organic solvent, trichloroethane. A comparison census tract that received water from a different source was selected on the basis of demographic comparability. The cluster was confirmed; the odds ratio for spontaneous abortion was 2.3 (95% confidence interval (Cl) 1.3-4.2) after adjustment by multiple logistic regression for maternal risk factors, including maternal age, alcohol consumption, smoking, and prior fetal loss. The relative risk for congenital malformations was 3.1 (95% Cl 1.1-10.4). Because of the lack of precise information on the timing and extent of contamination, the pattern of spontaneous abortion rates throughout the study period cannot be used to either support or refute a causal inference. PMID- 2705434 TI - National trends in educational differentials in mortality. AB - The authors examined national changes in socioeconomic differentials in mortality for middle-aged and older white men and women in the United States with the use of 1960 data from the Matched Records Study and 1971-1984 data from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow up Study (NHEFS). In 1960, there was little difference in mortality by educational level among middle-aged and older men. Since 1960, death rates among men declined more rapidly for the more educated than the less educated, which resulted in substantial educational differentials in mortality in 1971-1984. In contrast, among women, death rates declined at about the same rate regardless of educational attainment, so that a strong inverse relation between education and mortality in 1960 remained about the same magnitude during 1971-1984. Trends in educational differentials for heart disease mortality are responsible for much of the change for all causes of death. Relative risk estimates based on the NHEFS indicate that after taking into account selected baseline risk factors the least educated are still at substantially elevated risk of death from heart disease, ranging from a relative risk of 1.38 for men aged 65-74 years at baseline to 2.27 for men aged 45-64 years. Reasons for the observed educational differentials and their changes over time are not easily explained and are likely to be multifactorial. PMID- 2705435 TI - The international comparability of cancer mortality data. Results of an international death certificate study. AB - In preparation for the 10th revision of the International Classification of Diseases (ICD-10), a two-part study was undertaken to assess the international comparability of the coding, by the 9th revision (ICD-9), of death certificates mentioning cancer, to see whether there had been improvement since the 8th revision (ICD-8). Part I repeated a 1978 study in which nine countries coded the same 1,234 United States death certificates mentioning cancer by ICD-9. The proportion of disagreements in coding the underlying cause of death fell about 35% between 1978 and the present study. This reduction was probably due to the new more detailed rules for coding cancer death certificates given in ICD-9. To combat the criticism of the possible bias associated with using United States death certificates only, in Part II of the study, each of seven countries submitted about 100 certificates translated into English which had posed problems in coding cancer. Discrepancies in assigning the underlying cause of death were found for 54% of these problem certificates. The major types of problems identified were coding when multiple cancer sites were mentioned on the death certificate, whether to select heart disease or cancer as the underlying cause of death, and the interpretation of the coding rules. Better rules for ICD-10 must be provided for both physicians and coders if international comparability of cancer mortality data is to be achieved. PMID- 2705436 TI - Marital correlates of blood pressure. AB - In 1982, 1,260 white spouse pairs, aged 18 years and over, were interviewed as part of the Connecticut Blood Pressure Survey. The present report is based on a systematic analysis of 1) the personal characteristics and behavior of the spouse, 2) the roles and responsibilities of the material partners, and 3) similarity between spouses on selected variables. Results indicated that a number of these marital variables were associated with either systolic or diastolic blood pressure in husbands and in wives. Some components of the marital situation were associated with lower blood pressure whereas others were associated with higher blood pressure. Effects of marriage on blood pressure were observed both for husband's and wife's blood pressures, although the effects varied by sex. Similarity in spouses' behaviors and characteristics were more frequently associated with blood pressure than the individual effects of these behaviors. Age difference, measured as husband older than wife, was associated with lower blood pressure in husband's but with higher blood pressure in wives. Spouse's educational level and occupational status were not significantly related to blood pressure. Responsibility for common household chores (e.g., cooking) was associated with higher blood pressure in wives but responsibility for the family's health care was associated with lower blood pressure in both spouses. PMID- 2705437 TI - Correlates of high density lipoprotein cholesterol in women studied by the method of co-twin control. AB - This study examines the relation between each of the following risk variables and high density lipoprotein (HDL) cholesterol: cigarette smoking, alcohol use, leisure exercise, postmenopausal estrogen use, and body mass, before and after adjustment for genetic and nongenetic variables shared by monozygous and dizygous co-twins. Subjects were 179 dizygous and 255 monozygous twin pairs from the Kaiser Permanente Twin Registry who participated in a special examination in 1978 1979 in Oakland, California. A multivariate co-twin analysis made it possible to adjust for measured covariables and also to adjust for unmeasured familial variables shared by co-twins. After adjustment for measured covariables, further adjustment for the unmeasured familial variables shared by monozygous co-twins reduced a positive association between alcohol and HDL cholesterol and eliminated a positive association between exercise and HDL cholesterol. On the other hand, adjustment for unmeasured familial variables shared by monozygous co-twins had little effect on significant associations between smoking and HDL cholesterol, postmenopausal estrogen use and HDL cholesterol, and body mass and HDL cholesterol. Although an important role for random error was not ruled out in the sample size available, findings are consistent with the following interpretations: 1) alcohol consumption and leisure exercise may have smaller effects on HDL cholesterol than predicted by studies unadjusted for familial factors because effects of these variables are confounded by familial factors; and 2) smoking, postmenopausal estrogen, and body mass have effects predicted by studies unadjusted for familial factors and may therefore be good targets for interventions to raise HDL cholesterol. PMID- 2705439 TI - Iron metabolism in normal and hemochromatotic macrophages. AB - Certain metabolic pathways of iron were studied in macrophages (cultured human monocytes) obtained from normal and hemochromatotic subjects. The relative abilities of the hydrophobic ferrous chelator 2,2' bipyridine and the hydrophilic ferric chelators desferrioxamine (DFO) and diethylenetriaminepenta-acetic acid (DTPA) to release iron from normal and hemochromatotic macrophages which had previously been loaded with diferric transferrin were tested but there were no differences between the two groups. The relative affinity of the macrophages for diferric transferrin was next studied. Although the hemochromatic macrophages had a somewhat lower affinity for diferric transferrin iron than normal macrophages (Kd 4.7 x 10(-8) M vs. 3.0 x 10(-8)M) the difference did not reach statistical significance (t = 2.01013; P less than 0.07). In a further experiment there was no evidence that apotransferrin was directly involved in the release of iron from hemochromatotic macrophages. A clue to the nature of postendocytotic trans membrane transport of iron was provided by the finding that it was inhibited by the hydrophobic ferrous chelator 2,2' bipyridine. However, the degree of inhibition was similar in both normal and hemochromatotic macrophages. In summary, none of the metabolic processes examined in the present study was abnormal in cultured human blood monocytes from hemochromatotic subjects. PMID- 2705438 TI - In vitro DNA synthesis by megaloblastic bone marrow: effect of folates and cobalamins on thymidine incorporation and de novo thymidylate synthesis. AB - The de novo pathway of thymidylate synthesis (i.e., methylation of dUMP to dTMP) is directly folate dependent and indirectly vitamin B12 (cobalamins) dependent. In deficiency of these vitamins, this pathway is impaired, and exogenous deoxyuridine (dU) fails to suppress adequately in vitro incorporation of [3H]thymidine (3H-TdR) into DNA via the salvage pathway (i.e., abnormal dU suppression). This abnormality is corrected by the addition of folate compounds (analogues) and/or vitamin B12 depending on the nature of the underlying deficiency. We studied the effects of addition of PteGlu, 5-methyl THF (5-CH3 FH4), 5-formyl-THF (5-CHO-FH4), and hydroxy-cobalamin (OH-cbl) on 3H-TdR incorporation into DNA and thymidine kinase activity (salvage pathway), and on [3H]deoxyuridine (3H-dU) incorporation and dU suppression values (de novo pathway) in cultures of normal and megaloblastic bone marrows. The results showed that 3H-TdR incorporation into DNA and the salvage enzyme, thymidine kinase, activity were greater and 3H-dU incorporation into DNA less in megaloblastic cells as compared with normal cells. The addition of folates significantly reduced 3H-TdR incorporation and thymidine kinase activity and enhanced 3H-dU incorporation in folate and vitamin B12-deficient cells except that 5-CH3-FH4 had no effect on vitamin B12-deficient cells. None of these additives had any significant effect on normal cells. This study also showed that the addition of the deficient vitamin(s) to the "control tubes" in the dU suppression test is inappropriate, as these vitamins may at least partially correct the defect in cellular DNA synthesis caused by the deficiencies of these vitamins and may mask these deficiencies in the results of the in vitro correction of the dU suppression abnormalities in mild cases of megaloblastic anemia. PMID- 2705440 TI - B-cell chronic lymphocytic leukaemia: prognostic value of the immunophenotype and the clinico-haematological features. AB - Sixty-two previously untreated patients with B-cell chronic lymphocytic leukaemia were analysed to study the prognostic value of both the immunologic phenotype and the clinicobiologic characteristics. Univariate studies showed that none of the immunological markers analysed, sheep-rosette, mouse-rosette, slg, and HLA/DR, CD20, FMC7, CD5, and CD9 antigens, had a significant influence on survival. On the other hand, several clinical and haematological characteristics were identified as being associated with survival: 1) clinical features--presence of lymphadenopathies (P less than .05) and hepatomegaly and/or splenomegaly (P less than .04); 2) haematologic parameters--presence of anaemia and/or thrombopenia (P less than .05), the absolute peripheral blood lymphocyte count (P less than .03), and the presence of hypogammaglobulinemia (P less than .08); 3) biochemical parameters--serum uric acid (P less than .03); and 4) bone marrow histopathological features--biopsy pattern (P less than .04) and the percentage of lymphocytes in bone marrow aspirate (P less than .03). Both the Rai staging and the International Workshop on CLL staging systems were effective in identifying groups of patients with significantly different prognoses (P less than .05). Multivariate regression analysis demonstrated that the combination of three clinicopathologic characteristics (bone marrow histopathologic pattern, absolute peripheral blood lymphocyte count, and the presence or not of hypogammaglobulinaemia) had the strongest predictive relationship with survival time. In summary, our findings show that the clinicobiological and anatomopathologic parameters have much more prognostic relevance than the immunological markers analysed in the present study. PMID- 2705441 TI - Subcutaneous desmopressin (DDAVP) shortens the bleeding time in uremia. AB - The intravenous infusion of 1-deamino-8-D-arginine vasopressin (DDAVP) is used as a nontransfusional form of treatment in patients with congenital and acquired bleeding disorders, including patients with uremia associated with prolonged bleeding times. Since uremic patients experience minor bleeding episodes that might be self-managed at home (particularly epistaxis, gingival bleeding, and menorrhagia), we carried out a double-blind, placebo-controlled crossover study in nine uremics to evaluate whether the prolonged bleeding times could be shortened by subcutaneous injections of DDAVP. One hour after administration, the bleeding time was significantly shortened (P less than .01) and became normal in seven of nine patients. After 4 hr, the bleeding time was still shorter than baseline (P less than .01), but in only three patients was it still normal. There was no significant bleeding time change after placebo. When the same patients were treated with the same dose of DDAVP infused intravenously, the bleeding times were not significantly different from those measured after subcutaneous administration. Hence, subcutaneous DDAVP is an alternative method for short-term shortening of the bleeding time in uremia, at least as effective as intravenous DDAVP but with the possibility of self-administration by the patients at home. PMID- 2705442 TI - Thrombocytosis as a presenting feature of acute lymphoblastic leukemia in childhood. AB - To determine the incidence of thrombocytosis at presentation in acute lymphoblastic leukemia (ALL), medical records of all children diagnosed at the Children's Hospital of Pittsburgh from 1980 to 1987 were reviewed. Out of 217 such patients, 7 (3.2%) had platelet counts greater than 400,000/mm3. All of the seven were boys compared with a male:female ration of 1.4:1 in the entire ALL population. Other than sex, no characteristics were clearly associated with thrombocytosis, including white blood cell count, hemoglobin, lymphoblast morphology, and immunologic or chromosomal markers. Apart from ALL, no inflammatory or infectious process which might have caused a thrombocytosis, was detected in any of these patients. The period of induction therapy was notable for the preservation of platelet counts greater than 20,000/mm3 in all patients. However, of the seven children with thrombocytosis, two had major induction complications: one, a cavernous sinus thrombosis; and the other, gastrointestinal bleeding with duodenal perforation. We conclude that thrombocytosis at diagnosis can be seen in children, particularly boys, with ALL. Based on small numbers, this group of patients may be at risk for major events during induction therapy. Large numbers, longer follow-up, and platelet function studies on similar patients will be of interest. PMID- 2705443 TI - Age-dependent variation in the cytosol/membrane distribution of red cell protein kinase-C. AB - An age-dependent increase in membrane association of protein kinase-c and a decrease in the cytosolic enzyme, especially in the densest fraction rich in senescent red cells was observed in Stractan-gradient-separated normal erythrocytes. PMID- 2705444 TI - Rethinking the diagnostic criteria for thrombocytopenic purpura. PMID- 2705445 TI - Naproxen thrombocytopenia. PMID- 2705446 TI - Plasma aluminum levels (unstimulated and stimulated): clinical and biochemical findings in 185 patients undergoing chronic hemodialysis for 4 to 95 months. AB - Plasma aluminum levels (unstimulated and stimulated by deferoxamine infusion), along with signs and symptoms associated with aluminum overload, were evaluated in 185 patients (97 men, 88 women; mean age, 58 +/- 8 years) who had been undergoing dialysis for 4 to 95 months and who were still receiving treatment in 1985 at a free-standing dialysis facility which has always used water purified by reverse osmosis. Monthly water aluminum levels never exceeded 15 micrograms/L; therefore, the major source of aluminum in these patients was oral phosphate binders. Unstimulated plasma aluminum levels ranged from 7 to 392 micrograms/L, averaged 81.5 +/- 56.4, and did not correlate with the duration of dialysis (r = 0.07; P greater than 0.31) or frequency of symptoms. Stimulated plasma aluminum levels increased in a linear fashion (r = 0.57; P less than 0.0001) with time on dialysis; however, there was no statistical association between the stimulated aluminum levels and a variety of nonspecific musculoskeletal or CNS symptoms, evidence of hyperparathyroidism, hematocrit, or calcium or phosphorus levels. These findings suggest that total body aluminum, as reflected in deferoxamine stimulated serum aluminum levels, increases as a function of time undergoing dialysis. PMID- 2705447 TI - Sex and the single kidney. AB - Micropuncture measurements revealed that approximately 9 to 10 months after uninephrectomy and maintenance on a high-protein diet, glomerular capillary BP was significantly higher in male than in virgin female rats. This might account for the greater susceptibility of the male to age- and ablation-induced glomerular damage reported by others, although at the time of the present studies, significant reduction in function and worsening in glomerulosclerosis in males v females was barely evident. In a second group of chronically uninephrectomized females, the effects of multiple (five) consecutive pregnancies and lactations were investigated and did not indicate any severe deleterious long term effects of pregnancy on the glomeruli in this model of underlying renal compromise. Variable responses to an acute intravenous glycine challenge which did not correlate well with the extent of glomerular damage were observed in each group, suggesting that this test may not always be informative regarding underlying glomerular disease. PMID- 2705448 TI - The time course of peritoneal transport kinetics in continuous ambulatory peritoneal dialysis patients who develop sclerosing peritonitis. AB - The time course of measurements of peritoneal solute transport in four continuous ambulatory peritoneal dialysis (CAPD) patients who developed sclerosing peritonitis is described. Loss of fluid removal capacity was found in all of them. In three, this loss was associated with an increase in peritoneal absorption of glucose from the dialysate and an increase in the transperitoneal transport rates of low-molecular-weight solutes and proteins. In the other patient a decrease in all these parameters was found. This seems to imply that the effective peritoneal surface area was increased in three patients and decreased in one. Peritoneal permeability to macromolecules remained unchanged as judged by the ratio between the clearance of IgG and albumin. Among the possible factors that contribute to the development of sclerosing peritonitis, some are likely to lead to a larger effective peritoneal surface area, like prostacyclin and the formation of new capillaries in poorly vascularized parts of the peritoneum. Others, such as extensive formation of collagen, could lead to a smaller effective surface area. Individual differences in susceptibility to these factors may lead to an increase or decrease in peritoneal solute transport rates. Follow-up measurements of peritoneal solute kinetics are necessary to identify those patients who are at risk. PMID- 2705449 TI - Accelerated removal of deferoxamine mesylate-chelated aluminum by charcoal hemoperfusion in hemodialysis patients. AB - Although deferoxamine mesylate (DFO) is effective in removing aluminum (Al) in hemodialysis patients, treatment with this drug is associated with a number of adverse effects. In order to limit the exposure of patients to DFO-Al complexes, the efficacy of colloidin-coated microencapsulated charcoal cartridges added in series to conventional dialyzers was investigated. The clearances of Al by the sorbent system were initially 116 +/- 4.7 mL/min, but decreased to 42.5 +/- 6.6 mL/min after 120 minutes of treatment. Thereafter, the Al clearances remained constant. In contrast, the Al clearances of the dialyzer were 29.5 +/- 1.8 mL/min initially and did not change during the treatment period. Both the percent and absolute decrease in Al levels after four hours of dialysis were greater with the dialyzers plus carbon cartridges than with the dialyzers alone. This resulted in an increase in the minimum net Al removal from 1,862 +/- 174 micrograms/treatment to 3,007 +/- 43 micrograms/treatment (P less than 0.05). Treatment with sorbent hemoperfusion should be considered in selected hemodialysis patients being treated with DFO for Al overload. PMID- 2705450 TI - Choice of urine sample predictive of microalbuminuria in patients with insulin dependent diabetes mellitus. AB - Twenty-four-hour, four-hour (8 to 12 am), and overnight urine collections were examined for their ability to detect microalbuminuria in 292 patients with insulin-dependent diabetes mellitus (IDDM). Albumin excretion rate (AER) was measured and also estimated from the product of the urinary albumin/creatinine ratio (A/C) and the calculated 24-hour creatinine excretion. The fractional excretion of albumin (FEA) was also determined in aliquots from each urine sample. The correlation coefficients between measured 24-hour AER and estimated AER were 0.940 and 0.956 for four-hour and overnight collections, respectively (significance of each correlation, P less than 0.001). There was no advantage in using the FEA over the A/C ratio in predicting measured AER. Urinary A/C ratios (mg/mg) between 0.03 and 0.31 in the four-hour collections were highly predictive of microalbuminuria and of measured AER in the 24-hour collections: AER24-h (microgram/min/1.73 m2) = 2.74 + 0.870 x A/C4-h (all log10 values). In a subgroup of 175 patients having all three collections validated, 34 (20%) had microalbuminuria defined as AER 20 to 200 micrograms/min/1.73 m2 in at least two of the three samples and 44 (25%) had overt nephropathy (greater than 200 micrograms/min/1.73 m2). The ability of the AER in one urine collection to predict microalbuminuria in at least one of the other two collections was assessed in these 175 patients. Compared with the overnight urine collection, the four-hour collection had greater sensitivity while affording similar specificity and positive predictive value. Based on these data, the A/C ratio from a morning urine sample following initial AM voiding would seem adequate for the detection and monitoring of microalbuminuria in patients with IDDM. PMID- 2705451 TI - Resolution of nephrotic syndrome and lack of progression of heroin-associated renal amyloidosis. AB - The case of a patient with nephrotic syndrome and renal insufficiency due to renal amyloidosis secondary to chronic subcutaneous heroin abuse who discontinued her drug habit is reported. During the 6 years following the initial renal biopsy, the patient's nephrotic syndrome remitted: urinary protein decreased from 6.8 g/d to 170 mg/d, serum albumin increased from 2.5 g/dL to 3.9 g/dL, and she was no longer edematous. Serum creatinine remained stable at 1.8 mg/dL and creatinine clearance was also unchanged at 34 mL/min. Repeat renal biopsy showed AA amyloidosis involving the glomeruli, with minimal interstitial inflammation. This appears to be the first case of clinical improvement in heroin-associated renal amyloidosis after cessation of drug injections. As in other cases of AA amyloidosis that have improved, the clinical picture does not correlate with the findings on renal biopsy. PMID- 2705452 TI - Autosomal dominant polycystic kidney disease with liver and pancreatic involvement in early childhood. AB - In a patient with autosomal dominant polycystic kidney disease, liver and kidney cysts were found by biopsy at the age of 8 months. Computed tomography at the age of 16 years confirmed the presence of liver and kidney cysts and also revealed pancreatic cysts. Such early onset of liver cysts in a patient with autosomal dominant polycystic kidney disease has not been reported previously. PMID- 2705453 TI - Twenty years of hyperfiltration without diabetic-type glomerulosclerosis. PMID- 2705454 TI - Antiglomerular basement membrane (GBM) antibody-mediated disease. PMID- 2705455 TI - The probability of detecting the origin of nondisjunction of autosomal trisomies. AB - For studying the biology of autosomal trisomies it is necessary to establish the parental origin and meiotic stage of nondisjunction by using genetic markers. Theoretical formulas are obtained for calculating the probability of establishing (1) parental origin and meiotic stage of nondisjunction by using a centromeric marker, (2) parental origin of nondisjunction by using a noncentromeric marker, and (3) meiotic stage, given parental origin of nondisjunction. These theoretical calculations demonstrate that parental origin of nondisjunction can be identified with virtual certainty by utilizing multiple genetic markers along a chromosome arm. Centromeric markers are by themselves inefficient for determining meiotic stage of the error, but the efficiency can be considerably increased if parental origin is known with certainty. Even then, multiple centromeric markers may be necessary. PMID- 2705456 TI - Analysis of liver/bone/kidney alkaline phosphatase mRNA, DNA, and enzymatic activity in cultured skin fibroblasts from 14 unrelated patients with severe hypophosphatasia. AB - Hypophosphatasia is a heritable disorder characterized by defective bone mineralization and a deficiency of liver/bone/kidney alkaline phosphatase (L/B/K ALP) activity in serum and tissues. Severe forms of the disease, which are generally lethal in infancy, are inherited in an autosomal recessive fashion. The gene defects that produce hypophosphatasia are poorly understood, but many are likely to occur at the L/B/K ALP locus. To investigate these gene defects, we analyzed L/B/K ALP DNA, RNA, and enzyme activity in cultured dermal fibroblasts from 14 patients with perinatal or infantile hypophosphatasia and from 12 normal individuals. Southern blot analyses of the L/B/K ALP genes from patients and controls revealed identical restriction patterns. Control fibroblast ALP activity correlated with the corresponding L/B/K ALP mRNA levels estimated by blot hybridization analysis and densitometry (r = .94, P less than .0001). In contrast, fibroblasts from the hypophosphatasia patients were deficient in ALP enzyme activity but expressed apparently full-sized L/B/K ALP mRNA at normal levels. Bone specimens from one of the patients were examined and found to be deficient in histochemical ALP but contained immunologic cross-reactive material detected by anti-human liver ALP antiserum. Our results demonstrate that the deficiency of ALP activity in fibroblasts from 14 patients with severe hypophosphatasia is not due to decreased steady-state levels of the corresponding mRNA. The presence of enzymatically inactive L/B/K ALP protein in one of these patients is consistent with a point mutation or small in-frame deletion in the coding region of L/B/K ALP gene. PMID- 2705457 TI - Prolidase deficiency: biochemical classification of alleles. AB - Prolidase (E.C.3.4.13.9) is a homodimeric enzyme encoded at a locus on chromosome 19. Prolidase deficiency is an autosomal recessive disorder with a highly variable clinical phenotype. We purified prolidase to homogeneity from normal human fibroblasts, raised a monospecific rabbit antiserum, and studied biosynthesis of the subunit in normal and prolidase--deficient fibroblasts. Pulse chase immunoprecipitation experiments showed that the subunit is synthesized and retained in cytosol as a 58-KDa polypeptide. Three types of mutations were identified in six prolidase-deficient cell strains; half conferred a CRM-negative phenotype, while the CRM-positive mutations were of two types, one mutation encoding an enlarged subunit (60 KDa) and the others associated with subunits of normal size. Complementation analysis indicated that these mutations map to one locus. Normal subjects and obligate heterozygotes expressing CRM-negative mutations had thermostable prolidase activity at 50 degrees C in cell extracts, whereas heterozygotes expressing CRM-positive mutations had thermolabile activity under the same condition, implying negative allelic complementation in the putative heterodimer. The occurrence of prolidase-like activity about 5% of normal in amount but with a preference for substrate different from normal, in cells homozygous (or compound) for CRM-negative mutations, identified an alternative cleavage activity not encoded at the prolidase locus. Allelic heterogeneity at the major locus and the amount of alternative peptidase activity encoded elsewhere appear to be determinants of the associated and heterogeneous clinical phenotype. PMID- 2705459 TI - Inheritance of low-density lipoprotein subclass patterns: results of complex segregation analysis. PMID- 2705458 TI - An extended long-range restriction map of the human sex-determining region on Yp, including ZFY, finds marked homology on Xp and no detectable Y sequences in an XX male. AB - We have used pulsed-field gel electrophoresis to study the short arm of the Y chromosome by using a pseudoautosomal probe (MIC2Y) and adjacent Y-specific sequences 27a and 47z (DSXY5) in XX males and XY females, in order to detect chromosomal breakpoints which may have given rise to these individuals. The preliminary published long-range restriction map was used as a basis for this study. Our data confirm the reported fragment sizes and resolve some discrepancies. In addition, the recently cloned ZFY locus, pDP1007, the putative sex-determining locus, has been used to extend this long-range restriction map on Yp. Thus far, the X and Y copy of this sequence appear to have conserved GC islands around this locus, since it is found on a 280-kb fragment in males and females by using SacII, BssHII, NarI, and NotI. Only two Y-specific sequences of 50 and 70 kb have been detected at the pulsed-field level by using SfiI and NaeI, respectively. No translocation breakpoints have been detected in any of the patients studied. One XX male, GM1889, however, does not have any of the Y specific fragments detected using conventional or pulsed-field gel electrophoresis. This is one of the few typical XX males who therefore does not have the ZFY copy of the TDF clone. Since all the other XX males hybridized to 47z, which is centromeric to ZFY, a series of DNA loci that are centromeric to 47z need to be studied in order to detect chromosomal breakpoints. PMID- 2705460 TI - Mild exercise therapy increases serum high density lipoprotein2 cholesterol levels in patients with essential hypertension. AB - In ten patients with essential hypertension who were on a prescribed regimen of supervised mild exercise, we examined serum lipids, HDL cholesterol subfractions (HDL2 and HDL3), and apolipoproteins. The findings were compared with data on age and sex-matched hypertensives not on this regimen of exercise. Blood samples were obtained from the auricle during the multistage exercise test, and changes in levels of lactate were measured. The exercise was done for 30 minutes three times weekly for 10 weeks. A significant reduction of both systolic and diastolic blood pressure was evident at 10 weeks. Serum concentrations of HDL2 cholesterol increased significantly at 10 weeks, but there were no changes in total and HDL3 cholesterol. No significant changes were observed in serum concentrations of total cholesterol, triglyceride, and apolipoproteins, (apo) A-I, apo A-II, apo B, apo C-II, apo C-III and apo E following 10 weeks of exercise therapy. In the hypertensive controls who were not on exercise therapy, blood pressure as well as all parameters related to lipoproteins remained unchanged. Thus, mild exercise lowers blood pressure and improves the lipoprotein profile. PMID- 2705461 TI - Effects of phenobarbital on hypothalamic-pituitary-thyroid axis in the rat. AB - It has been reported that phenobarbital (PB) increases the peripheral clearance of T4 and T3 and decreases serum T4 and T3 concentrations in the rat, but serum TSH remains unchanged. To explore a possible direct effect of PB on TSH secretion at the hypothalamic-pituitary level, adult male rats were given PB 100 mg/kg or vehicle IP for 10 days. No difference in their thyroid weights was observed. In the PB-treated group serum T4 was decreased (PB, 3 +/- 0.2 micrograms/dl vs. control, 3.8 +/- 0.1 micrograms/dl, mean +/- SE, p less than .002), as was serum T3 (PB, 51 +/- 6 ng/dl vs. control, 70 +/- 5 ng/dl, p less than .05), but serum TSH remained unchanged. Pituitary TSH and hypothalamic TRH contents also were unchanged. Further studies were carried out similarly in the thyroidectomized hypothyroid rat to eliminate the effect of PB on serum T4 and T3 levels. PB or vehicle were started two days after thyroidectomy. By postoperative day 12, TSH levels in the PB-treated rats were lower than in the controls (PB, 697 +/- 62 microU/ml vs. control, 891 +/- 53 microU/ml, p less than .05). Pituitary TSH and hypothalamic TRH contents again were similar in both groups. When TRH (500 ng/kg body weight, IV) was given, the increment in serum TSH at 10 minutes was significantly lower in the PB group (PB, 53 +/- 26 microU/ml vs. control, 131 +/- 18 microU/ml, p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705462 TI - Body mass as a determinant of seat belt use. AB - Prevention of death and injury from motor vehicle accidents depends in part on seat belt use. Understanding the determinants of seat belt use is important for developing strategies to increase seat belt use. The cross-sectional association between body mass index (BMI) and self-reported seat belt use was analyzed using data from 3,140 Health Risk Appraisals completed by Tennessee residents during 1986. Persons in the lowest quintile BMI (less than or equal to 21.8 kg/m2) stated they use seat belts 63% (SD = 38%) of the time compared to persons in the highest BMI quintile (greater than or equal to 29.0 kg/m2) who reported using seat belts 50% (SD = 38%) of the time. BMI remained associated with seat belt use after adjustment for age, sex, race, education, cigarette use, alcohol use, drug use, urban/rural residence, state area of residence, miles driven per year, self reported physical activity, and satisfaction with life. For a 1 kg/m2 increase in BMI, seat belt use declined -0.73% (95% CI = -1.01, -0.46), and the relative odds of not being a frequent seat belt user increased 3% (odds ratio 1.03, 95% CI = 1.01, 1.05). BMI was the third variable selected in a step-wise multiple linear regression after education and race. The BMI/seat belt association, if causal, has implications for (1) targeting of education programs to likely nonusers by traffic safety agencies; (2) targeting health promotion messages to likely nonusers by primary care providers; and (3) design of automobile seats and restraint devices. PMID- 2705463 TI - The enterococci: evidence of species-specific clinical and microbiologic heterogeneity. AB - Investigations of the clinical role of enterococci have been limited largely to enterococcal bacteremia and endocarditis and have not distinguished between the various species of enterococci. To characterize the full spectrum of enterococcal disease and to determine whether clinically important differences exist among infections and/or instances of colonization (infections/colonizations) by the various enterococcal species, cases of enterococcal infection/colonization diagnosed at the Dallas Veterans Administration Medical Center (DVAMC) in 1986 were reviewed. During this period, 220 Enterococcus faecalis, 21 Enterococcus faecium, 12 Enterococcus avium, and no Enterococcus durans isolates were identified in clinical specimens (other than stool) submitted to the DVAMC microbiology laboratory. Clinical characteristics of cases of infection/colonization by the three species of enterococci were similar and did not vary significantly when blood stream invasion occurred. Nevertheless, mortality data and therapeutic response rates suggested differences in virulence of the three enterococcal species. Enterococcal infections/colonizations (including bacteremia) frequently were polymicrobial. Although Enterobacteriaceae were the most common copathogens identified overall, Staphylococcus aureus was the most common copathogen in bloodstream infections. E. avium was more resistant than E. faecalis or E. faecium to penicillin G and ampicillin and less resistant to most other antimicrobial agents. The results of this investigation suggest that enterococci are a heterogeneous group of bacteria that should not be treated as a single entity in clinical investigations. PMID- 2705464 TI - Correlation of serum fructosamine activity in type I diabetic children. AB - The serum fructosamine assay is a new commercially available test designed to measure serum glycated protein as an index of glycemic control in diabetes. The test relies on the ability of glucose bound to protein with a ketamine linkage (fructosamine) to act as a reducing agent in alkaline solution. Serum fructosamine activity was studied in 61 Type I diabetic patients attending a 2 week American Diabetes Association sponsored diabetic camp for children. The initial fructosamine level was found to correlate well with the initial HgA1C value (r = .82, p less than .001). To assess if mean blood glucose correlated with these objective parameters, the authors performed capillary blood glucoses preprandially and at bedtime on all 61 diabetic campers during the 2-week period of observation and reassessed serum fructosamine activity and HgA1C on day 14 of camp. We found the HgA1C and fructosamine correlated well with the mean daily blood glucose obtained during the preceding week (r = .45, p less than .01 and r = .58, p less than .01) respectively. Our data suggest that the serum fructosamine is as effective as the HgA1C in correlating to mean blood glucose control in this cross-sectional study of Type I diabetic patients. PMID- 2705465 TI - Pulmonary sporotrichosis with massive hemoptysis. AB - Pulmonary sporotrichosis is an uncommon condition that may mimic tuberculosis. We present a patient who, years after antifungal therapy, presented with massive pulmonary hemorrhage. Although such life-threatening hemoptysis caused by sporotrichosis is rare, the possibility of this complication of progressive disease should influence decisions regarding medical and surgical treatment of patients with extensive cavitary involvement. PMID- 2705466 TI - Red cell fragmentation produced by renal artery stenosis. AB - Fragmentation hemolytic anemia caused by mechanical trauma of red cells has been associated with abnormalities either of the heart and aorta or of small arteries. However, disease of arteries that constitute major branches of the aorta, in particular renal artery stenosis, has not previously been shown to produce this syndrome. In this report, the authors describe a patient with severe, bilateral renal artery stenosis, who had a fragmentation hemolytic anemia that resolved after surgical correction of the arterial lesions. PMID- 2705467 TI - Loss of pubic and axillary hair following treatment with glucocorticoids. AB - A woman with prior bilateral oophorectomy developed loss of pubic and axillary hair following treatment with glucocorticoids. Serum androgens were low while cortisol and aldosterone levels were normal. This unusual presentation, which continued for at least 3 years, was most likely attributable to the prolonged selective suppression of adrenal androgens by glucocorticoids. PMID- 2705468 TI - Dress codes: are they appropriate for medical education? PMID- 2705469 TI - Juvenile polyposis: a case with early presentation and death attributable to adenocarcinoma of the pancreas. AB - A male child who first presented in the second year of life demonstrated all the recognized clinicopathological manifestations of juvenile polyposis with associated birth defects. Subsequent death at age 19 years from adenocarcinoma of the pancreas further broadens the recognized spectrum of possible sequelae in this disorder and is in keeping with current hypotheses of inherent cancer potential throughout the polyposis syndromes. PMID- 2705470 TI - Impaired spermatogenesis is not an obligate expression of receptor-defective androgen resistance. AB - We are studying a man who presented at age 21 years with severe extragenital subvirilization despite high-normal to above-normal levels of plasma testosterone for at least 5 years. At puberty, his penis, scrotum, and testes matured normally, and he did not develop gynecomastia; however, his voice, muscularity, and facial, sexual, and body hair remained immature. A 2.5-ml ejaculate yielded normal results for sperm density, morphology, and motility. Because persistent undervirilization was emotionally disabling, he has received pharmacologic doses of testosterone enanthate intramuscularly for 3.5 years. The treatment has improved his virilization and masculine self-image substantially, and his semen analysis has remained well within the normal range. The androgen receptor in his genital skin fibroblasts has a distinctively mutant phenotype: it has a low affinity (increased apparent equilibrium dissociation constant, Kd) for 5 alpha dihydrotestosterone and two synthetic androgens, mibolerone (MB) and methyltrienolone (MT), and its binding capacity (Bmax) is normal for the other two ligands, but questionably low for MT. In addition, it up-regulates its activity normally in response to prolonged incubation with androgen, and its androgen-receptor complexes are not thermolabile. Our study of this man permits two conclusions: impaired spermatogenesis is not the irreducible expression of receptor-defective androgen resistance in man; and androgen pharmacotherapy may be remedial for those in whom extragenital subvirilization is emotionally costly and subnormal spermatogenesis is not an inevitable side effect of such therapy. PMID- 2705471 TI - The genetics of Crohn disease: complex segregation analysis of a family study with 265 patients with Crohn disease and 5,387 relatives. AB - We have analysed the pedigrees of 265 probands with Crohn disease, collected from a specialty clinic at the University of Dusseldorf. Complex segregation analysis suggests the presence of a recessive gene with incomplete penetrance for susceptibility to the disease with no residual causes of family resemblance. However, a proportion of the isolated cases are probably due to phenocopies, this proportion being greatest among cases with an advanced age of onset. PMID- 2705472 TI - Interstitial deletion of chromosome 22 in a patient with the DiGeorge malformation sequence. AB - We describe a chromosome 22 deletion in a patient with the DiGeorge malformation sequence as manifested by an interrupted aortic arch, mild thymic hypoplasia, and minor craniofacial anomalies. Although others have reported DiGeorge sequence patients with deletions derived from unbalanced translocations involving the chromosome 22 long arm, the small interstitial deletion described here appears to be unusual for patients with this disorder. PMID- 2705473 TI - X-linked cutaneous amyloidosis: further clinical and pathological observations. AB - A 10-year follow-up of a family with X-linked cutaneous amyloidosis confirmed no more than streaks or spots of brown pigmentation of the skin in females but much more varied and severe manifestations in males. These included neonatal colitis, infantile diarrhea, recurrent respiratory infections, corneal dystrophy, photophobia, unruly hair with a frontal upsweep, dry skin, and mottled, muddy brown pigmentation seen first on the inner thighs and spreading diffusely to the buttocks, trunk, and arms. Amyloid was found in the pigmented skin of adults of both sexes but not in children. An autopsy of a 50-year-old man, subject to recurrent pneumonia, confirmed the presence of amyloid in the skin, but it was not found in other organs. Changes in the lungs were those of late-stage diffuse pulmonary fibrosis. The pattern of inheritance is X-linked, but the pathogenesis remains obscure. PMID- 2705474 TI - A girl with the Pitt-Rogers-Danks syndrome. AB - A severely mentally retarded girl is presented, with symptoms as described by Pitt, Rogers, and Danks (pre- and postnatal growth retardation, and unusual facies). Additional manifestations are glaucoma, pre-auricular pits, and an atrial septal defect. PMID- 2705475 TI - Rett syndrome: genetic clues based on mitochondrial changes in muscle. PMID- 2705476 TI - Effectiveness of prevention of cystic fibrosis by artificial insemination by donor can be markedly improved by DNA-analysis of sperm donors. PMID- 2705477 TI - GOMBO syndrome of growth retardation, ocular abnormalities, microcephaly, brachydactyly, and oligophrenia: a possible "new" recessively inherited MCA/MR syndrome. PMID- 2705478 TI - Chromosome findings in twins with early-onset autistic disorder. AB - In a twin study of autistic disorder, chromosome analyses were carried out in nine pairs of monozygotic (MZ) twins, two pairs of dizygotic (DZ) twins, one set of MZ triplets, one single twin from a MZ pair, and seven single twins from DZ pairs. All but one of the MZ sets were concordant for autistic disorder; all DZ pairs were discordant. Fragile X(q)(27.3) was found in one pair of MZ twins and in MZ triplets, i.e., in 9% of the population with autistic disorder. A marker chromosome of unknown origin was detected in a male twin with autistic disorder from a discordant DZ pair. PMID- 2705479 TI - New chromosome aberration: duplication of a large part of chromosome 4q and partial deletion of chromosome 1q. AB - We describe a preterm female infant with multiple anomalies who has a duplication of a large part of 4q and partial deletion of chromosome 1q. Her karyotype was interpreted to be 46,XX,-1,+der(1),t(1;4) (q44;q23 or 24)mat. She is the first patient with an unbalanced translocation involving chromosomes 4 and 1. There is a substantial amount of concordance between the phenotypic features of this patient and those described in the context of partial deletion 1q. The extensive duplication of 4q has no dominant clinical effects in the present infant. These facts support the general concept of much more deleterious effects of deletions versus duplications in human species. PMID- 2705480 TI - Dysmorphogenesis of the mandible, zygoma, and middle ear ossicles in hemifacial microsomia and mandibulofacial dysostosis. AB - A review of the anatomical changes in patients with various "first arch" syndromes shows that some anomalies (e.g., micrognathia, ear defects) generally appear together. This study tested the hypothesis that the mandible, zygomatic arch, and middle ear ossicles are a developmental field (i.e., when any of these structures is anomalous, the other two will be also). The hypothesis was tested using data from 25 patients with mandibulofacial dysostosis (MFD) and 40 patients with hemifacial microsomia (HFM). Analysis of the pooled data showed that the hypothesis of character association was generally supported. However, the medians suggested that different factors probably played a role in determining how these three anatomical structures were associated in MFD and HFM. Errors in chondrogenesis may have been primarily responsible for the HFM phenotype. Alterations in Meckel and palatoquadrate cartilages would account for the size and shape changes observed in the ossicles and mandible, while changes in cranial base cartilages may explain the changes noted in the zygomatic arch. Since all three structures were equally affected in MFD, it is problematic to use an interference with chondrogenesis as an explanation for the phenotype. We conclude that although the mandible, zygomatic arch, and middle ear ossicles appear to form a "developmental field," the association between structures varies for HFM and MFD. The relatively lesser involvement of the zygomatic arch in HFM than in MFD suggests different pathogeneses for the two diagnostic groups and maybe a useful criterion for judging animal models of HFM. PMID- 2705481 TI - Autosomal dominant hypoparathyroidism with intracranial calcification outside the basal ganglia. AB - We describe a family with autosomal dominant hypoparathyroidism. The 3 affected individuals had no detectable serum parathyroid hormone on radioimmunoassay. The propositus presented with seizures and on CT scan had bilateral basal ganglion calcification and calcification in the frontal lobes. His similarly affected mother had even more intracerebral calcification. The latter manifestation has not been described previously in autosomal dominant hypoparathyroidism. PMID- 2705482 TI - A man with isochromosome Xq Klinefelter syndrome with lack of height increase and normal androgenization. AB - We report on a patient with Klinefelter syndrome (KS) and the homogeneous aneuploidy 47,Xi(Xq)Y, or male trisomy Xq. He had many characteristics of classical KS: small testes, azoospermia, elevated FSH and LH, average intelligence, and normal androgenization, but his stature was not increased, compared with his father's and brothers'. The i(Xq), found in all cells analyzed, was late-replicating, monocentric, and also asymmetric for the RBG-banding of the two arms, indicating a different chronology of DNA synthesis in each arm. When indicated, in the seven previously reported cases, the level of plasma testosterone was always subnormal; it was normal (650 ng/100 ml) in our patient, who had normal masculinization. Thus the level of testosterone among patients with KS is not necessarily lower with an extra Xq. Furthermore, the sharp contrast in the height of KS patients with or without an i(Xq) is striking. It appears definitely possible to associate the isochromosome Xq Klinefelter syndrome with a lack of height increase. PMID- 2705483 TI - Two brothers with facial anomalies, microcephaly, hypoplastic genitalia, and a failure of psychomotor development. AB - We report on 2 brothers from a consanguineous Moslem family with prenatal onset of growth deficiency, microcephaly, hypoplastic genitalia, and convulsions from birth. Phenotypic anomalies consisted of a prominent glabella, arched eyebrows, a low upswept frontal hairline, a small pinched nose, large posteriorly rotated ears with overfolded upper helices, partial camptodactyly, and widespaced nipples. Psychomotor development was absent, and there was marked failure to thrive. Death occurred at ages 21 days and 7 months, respectively. Postmortem examination on one child showed dilated cerebral ventricles and hydronephrosis. Microcephaly was detectable by fetal ultrasound in one brother at 17 weeks of gestation. PMID- 2705484 TI - Etiologic heterogeneity in dyskeratosis congenita. AB - Most patients with dyskeratosis congenita [DC or Zinsser-Cole-Engman syndrome] are males hemizygous for an X-linked recessive mutation. However, one or more autosomal form(s) of DC may exist. We have studied a 6-year-old black girl with the characteristic triad of nail dystrophy, cutaneous and mucosal pigmentary changes, and bone marrow failure. Severe microcephaly, mental retardation, cerebellar hypoplasia, and purple discoloration of the tongue were other manifestations not usually seen in DC. Comparison of our patient's phenotype with that of 5 other sporadic and 10 familial cases of DC in females showed that the autosomal and X-linked phenotypes are not distinguishable in the absence of a suggestive pedigree pattern. Additional cases of DC need to be studied to better elucidate the apparent causal heterogeneity in this syndrome. PMID- 2705485 TI - Macrosomia and mental retardation: evidence of autosomal dominant inheritance in four generations. AB - We describe a large family with 14 persons presenting macrosomia with or without mental retardation in which dominant transmission is evident over 4 generations. A wide range of phenotypic variability was observed, some patients showing macrosomia and mental impairment, others only macrosomia. The cases will be discussed in relationship with other conditions in which the 2 signs may be present, and above all in Sotos sequence. PMID- 2705486 TI - Deletion of terminal portion of 6q: report of a case with unusual malformations. AB - We present the necropsy findings of a 21-week-gestation male fetus with deletion of the terminal portion of long arm of chromosome 6 [46,XY,del(6)(q23----qter)]. Major anomalies include intrauterine growth retardation, facial anomalies, nuchal cyst, scoliosis, bilateral diaphragmatic hernias, persistent common atrioventricular canal, absent olfactory bulbs and agenesis of corpus callosum. In aberrations of chromosome 6q, patients usually have psychomotor retardation, somatic growth failure, and facial anomalies; nuchal cyst and bilateral diaphragmatic hernias have not yet been described. PMID- 2705487 TI - Ullrich-Turner syndrome and anorexia nervosa. AB - We report on a 6-year-old girl with Ullrich-Turner syndrome and anorexia nervosa. The diagnosis was made at 6 years and she became anorectic at 14 years. She had been treated with low doses of estrogen just before the onset of anorexia. In spite of remarkable decrease in food intake, her body weight was in the normal range compared to standard weight. Rohrer indices were also normal, probably due to abnormal habitus in individuals with the syndrome. The pathogenetic relationship between this disorder and the hormone treatment in the onset of anorexia nervosa is discussed. PMID- 2705488 TI - A new Spanish family with Hb Louisville. AB - The clinical, hematological, and biochemical characteristics of a new family with heterozygous hemoglobin (Hb) Louisville are described. The family showed a decrease in both oxygen affinity and cooperativity with the normal Bohr effect. This family has the greatest number of affected members reported to date. Among the descendants, two first cousins (III-10 and III-11), both of whom are affected by the heterozygous trait of Hb Louisville, had had three abortions of undetermined causes. PMID- 2705489 TI - Mild Brachmann-de Lange syndrome: changes of phenotype with age. AB - We present a girl with mild manifestations of the Brachmann-de Lange syndrome (BDLS) with gradual change of the phenotype. Her findings support the hypothesis of variability of the phenotypic spectrum of the disorder. PMID- 2705490 TI - NBC's tinsel handmaidens. PMID- 2705491 TI - Quick HIV screening test. PMID- 2705492 TI - Lower admission criteria? PMID- 2705493 TI - To registry/agency nurses. PMID- 2705494 TI - Diabetes and bulimia. A deadly duo. PMID- 2705496 TI - A place to call home. PMID- 2705495 TI - Blood transfusions outside the hospital. American Association of Blood Banks. PMID- 2705497 TI - Translating nursing diagnosis into ICD code. PMID- 2705498 TI - Comparing the costs of i.v. drug delivery systems. PMID- 2705499 TI - A dialogue with excellence. The power of certainty. PMID- 2705500 TI - New York jobfocus. The sweetness of the Big Apple--and vicinity. PMID- 2705501 TI - How to keep floats afloat. PMID- 2705502 TI - New Jersey jobfocus. The Garden State's greener grass. PMID- 2705503 TI - Heart sounds and one-liners. PMID- 2705504 TI - Antigenicity of low molecular weight surfactant species. AB - The authors tested the antigenicity of human lung surfactant isolated from amniotic fluid. Mice and rabbits were immunized. Rabbit polyclonal antisera to these surfactant preparations were absorbed with normal human plasma proteins. Polyclonal antisera reacted with both high molecular weight (35 kd) surfactant apoprotein and to lower molecular weight species, both 18 kd and 9 kd. Mice were used to generate monoclonal antibodies to surfactant. Enzyme-linked immunosorbant assay was used to identify five monoclonal antibodies that reacted with surfactant. By Western blot analysis, all of these recognized a low molecular weight surfactant species (9 kd) that could be either SP-B or SP-C. One reacted with a 37 kd protein in the surfactant preparation, consistent with SP-A. One monoclonal antibody also recognized a higher molecular weight species (44 kd) of unknown origin. The ability of antisera and monoclonal antibodies to inhibit the functional activity of surfactant was assayed using a pulsating bubble surfactometer. Rabbit polyclonal antisera inhibited initial surface adsorption to equilibrium surface tension and increased the minimum surface tension after 1 and 5 minutes of initiation of pulsations. This inhibitory activity of the antisera was noted in divalent F(ab')2 fragments. Monovalent F(ab) fragments and control normal rabbit sera did not inhibit surfactant function in this assay. Of the anti surfactant monoclonal antibodies that reacted with surfactant by ELISA and Western blot, three inhibited its capacity to lower surface tension on the pulsating bubble apparatus. The other two monoclonal antibodies showed no functional inhibitory activity. It is concluded that both the 35 kd SP-A and the 9 kd proteins of human surfactant are highly immunogenic and partially crossreactive. Resulting antibodies could alter the ability of surfactant to perform its physiologic function, ie, to lower surface tension. PMID- 2705505 TI - S100 protein positive dendritic cells in primary biliary cirrhosis and other chronic inflammatory liver diseases. Relevance to pathogenesis? AB - A study to determine the location of dendritic cells, in chronic inflammatory liver disease was performed. S100 protein positivity and dendritic cytoplasmic morphology were used to identify dendritic cells. S100 protein positive dendritic cells (S100 + DC) were found inside the basement membrane between biliary epithelial cells of septal bile ducts of livers affected by early stage PBC, but were not present at later stages. S100 + DC also were seen in areas of piecemeal necrosis in chronic active hepatitis of various etiologies. In contrast, intra epithelial S100 + DC were not found with any consistency in sclerosing cholangitis, secondary biliary cirrhosis, extrahepatic biliary atresia, or chronic liver allograft rejection, all of which are characterized by inflammatory bile duct damage. The possible relevance of DC in the pathogenesis of PBC is discussed. PMID- 2705506 TI - Walker carcinosarcoma cells damage endothelial cells by the generation of reactive oxygen species. AB - The passage of circulating tumor cells across vessel walls is an important step in cancer metastasis and is promoted by endothelial injury. Because Walker carcinosarcoma 256 (W256) cells generate oxygen-derived free radicals after cellular activation, the authors tested the hypothesis that these cancer cells can damage endothelial monolayers by producing such reactive oxygen species. To confirm that oxygen-derived radicals can damage endothelial cells, 3H-2 deoxyglucose-labeled human endothelial cell monolayers were exposed to xanthine oxidase in the presence of 0.2 mmol/l xanthine. 3H-2-deoxyglucose release was observed after the addition of xanthine oxidase in concentrations ranging from 6.5 x 10(-3) to 52 x 10(-3) units/ml. The extent of damage correlated with xanthine oxidase-dependent chemiluminescence (r = 0.91). Chemiluminescence assays in the presence of 5 x 10(-5) M luminol confirmed activation of the W256 cells by 1 x 10(-6) M chemotactic peptide fMLP. When fMLP-activated activated W256 cells were incubated with endothelial monolayers, concentrations of 2 x 10(6) to 6 x 10(6) W256 cells/ml were found to cause a 27% increase in the specific release of 2-deoxyglucose after a 90-minute incubation. A small but significant increase in 3H-2-deoxyglucose release also was observed in the absence of fMLP. Detection of 3H-2-deoxyglucose release in the presence of activated or unactivated tumor cells was dependent on preincubating the endothelial cell monolayer with 1 mM buthionine sulfoximine, an inhibitor of glutathione synthesis. Under these conditions, the specific release of 3H-2-deoxyglucose was increased from nondetectable levels to 21%, in the presence of 6.5 x 10(-3) units of the oxidase. Cultured W256 cells promoted isotope release from endothelial cell monolayers when activated with phorbol myristate acetate. Catalase (1000 units/ml) inhibited the tumor cell-induced release of 3H-2-deoxyglucose by 84% whereas superoxide dismutase, even at concentrations of 1 mg/ml, had no effect. A requirement for cell contact was shown because addition of cell-free supernatants from fMLP activated tumor cells did not cause 3H-2-deoxyglucose release and because pretreatment of W256 cells with 1 microM cytochalasin B inhibited their ability to promote isotope release even while increasing tumor cell-generated chemiluminescence threefold. Electron microscopy revealed that fewer cytochalasin B-treated W256 cells were attached to the endothelial cell monolayer than in untreated controls. It is concluded that the W256 tumor cells can damage endothelial cells directly via a mechanism involving production of reactive oxygen species. PMID- 2705507 TI - The proinflammatory effect of intra-articular injection of soluble human and venom phospholipase A2. AB - The proinflammatory effects of intra-articular injection of purified phospholipase A2 from snake venom and rheumatoid synovial fluid were studied in rats. Purified soluble phospholipase A2 (PLA2) in concentrations ranging from 1000 to 20,000 units/ml, was injected intra-articularly. Histologic parameters examined were cell and protein content of synovial fluid, subsynovial cellular infiltration, synovial lining cell hyperplasia, bone erosion, and peri-articular soft tissue infiltration. Single intra-articular injections of PLA2 resulted in an acute inflammatory infiltrate of the subsynovium with maximal changes seen 2 to 6 hours after injection. Acute inflammatory changes were dose-dependent. Joints injected repeatedly at 24-hour intervals showed prominent synovial lining cell hyperplasia, maximal at 96 hours. Human synovial and snake venom PLA2s were equipotent at inducing both the acute and chronic articular changes. These changes were not seen in joints injected with inactivated PLA2. It is concluded that soluble PLA2 causes time- and dose-dependent acute inflammatory changes after a single intra-articular injection and synovial lining cell hyperplasia in response to repeated exposure to PLA2. The experimental proliferative synovitis in this model may correlate with features of acutely inflammed joints bathed in synovial fluids containing high levels of PLA2 in patients with rheumatoid arthritis. PMID- 2705508 TI - Analysis of healing after myocardial infarction using polarized light microscopy. AB - To better understand the healing process after permanent coronary artery occlusion in a canine model, the authors used polarized light microscopy. At 6 weeks after occlusion the scar collagen was mainly type I. Some regions of the scar contained a fiber lattice which appeared to be type III collagen. Collagen orientation was measured using a universal stage; subepicardial collagen was obliquely aligned (-14.0 +/- 3.5 degrees), midmyocardial collagen circumferentially aligned (1.4 +/- 0.4 degrees) and subendocardial collagen obliquely aligned (12.7 +/- 2.1 degrees). The molecular organization of scar collagen increased from 1 to 6 weeks after occlusion. Muscle cell disarray, similar to that in hypertrophic cardiomyopathy, was seen in the viable muscle adjacent to the scar. Such abnormal organization extended as far as 1 cm from the edge of the scar. The ability of polarized light microscopy to assess these different parameters from histologic sections demonstrates that it is a useful adjunct to other methods commonly used to study myocardial healing. PMID- 2705509 TI - Immunocytochemical study of transforming growth factor expression in benign and malignant gliomas. AB - Immunocytochemical studies using polyclonal antibodies to epidermal growth factor (EGF) and transforming growth factor (TGF) alpha and beta were performed on 20 cases of human gliomas. EGF immunoreactive material was detected in both benign and malignant glial tumors. In addition, EGF immunoreactive material was detected in normal brain. TGF-beta was detected in both benign and malignant tumors, but was not detected in normal brain. In contrast, TGF-alpha was highly conserved in its expression, occurring predominantly in malignant compared with benign or normal brain tissue (P less than 0.0001). In malignant gliomas, glioblastomas contained 76% TGF-alpha reactivity (immunoreactive product), and anaplastic types contained 85% reactivity. Benign gliomas contained only 13% TGF-alpha reactivity. These findings support the role of TGF-alpha as an oncoprotein marker in brain neoplasms. PMID- 2705510 TI - Pathogenesis of acute arthritis due to viable Chlamydia trachomatis (mouse pneumonitis agent) in C57Bl/6 mice. AB - The purpose of this investigation was to determine the natural history and pathogenesis of the acute arthritis induced by inoculation of a viable Chlamydia trachomatis biovar (mouse pneumonitis agent or MoPn) in C57Bl/6 mice. Immunologically naive (previously unsensitized) mice as well as mice immunized against Chlamydia (MoPn) by vaginal infection were employed. Both intravenous and intraarticular inoculations were employed. No arthritis developed after intravenous injections of MoPn although statistically significant antibody titers and splenic enlargement ensued. Intra-articular inoculation into knee joints produced a definite arthritis of 7 to 10 days duration marked by granulocyte and mononuclear cell infiltration of the joint and vacuolated synovial macrophages that stained heavily for chlamydial antigen by immunoperoxidase technique. Statistically significant increases in articular acute and chronic inflammation (P less than 0.02 were observed in previously sensitized, but not unsensitized, female mice at 2 but not 7 days after intra-articular chlamydial challenge. Chlamydiae were isolated from injected joints up to day 5, but not at day 10, after challenge. Chlamydial antigen disappeared rapidly from knee joints between day 10 and 15 after challenge. Electron micrographs demonstrated vacuolated synovial cells of the macrophage type, many of which contained degenerating chlamydial elementary bodies. Reticulate and intermediate bodies also were seen but were far less frequent than degenerating elementary bodies. Unaltered elementary bodies were difficult to identify beyond day 2 after articular inoculation. Thus, it appears likely that intra-articular chlamydial survival is shorter than the duration of the arthropathy. This may have important implications in attempts to identify chlamydiae in human joints in Reiter's Disease. PMID- 2705511 TI - Relationship between interphasic nucleolar organizer regions and growth rate in two neuroblastoma cell lines. AB - The relationship between the quantity of silver-stained interphasic nucleolar organizer regions (NORs) and nuclear synthetic activity, caryotype, and growth rate was studied in two established neuroblastoma cell lines (CHP 212 and HTB 10). Statistical analysis of silver-stained NORs revealed four times as many in CHP 212 cells compared with HTB 10 cells. No difference was observed in the ribosomal RNA synthesis between the two cell lines. The caryotype index was 1.2 for CHP 212 and 1.0 for HTB 10 cells. The number of chromosomes carrying NORs and the quantity of ribosomal genes was found to be the same for the two cell lines. Doubling time of CHP 212 cells was 20 hours compared with 54 hours for HTB 10 cells. In CHP 212 cells bindering of cell duplication by serum deprivation induced a progressive lowering (calculated at 48, 72, and 96 hours) of the quantity of silver-stained interphasic NORs. Recovery of duplication by new serum addition induced, after 24 hours, an increase of the quantity of silver-stained interphasic NORs up to control levels. In the light of available data, these results indicate that the quantity of interphasic NORs is strictly correlated only to the growth rate of the cell. PMID- 2705512 TI - Effects of substrate and hypoxia on smooth muscle metabolism and contraction. AB - Suprabasal heat production, oxygen consumption, and lactate production were measured, together with force, in 30-s isometric contractions of longitudinal smooth muscle from rabbit urinary bladder at 27 degrees C. Either glucose or pyruvate was provided as exogenous substrate. Under aerobic conditions with glucose as substrate, force averaged 95 mN/mm2 and heat production 121 mJ/g. Oxygen consumption (0.18 mumol/g) could account for only two-thirds of the total energy expenditure represented as heat production. The remaining one-third was accounted for by aerobic lactate production (0.36 mumol/g). When pyruvate replaced glucose as substrate, both the force developed and the total heat liberated were unchanged. Oxygen consumption, however, increased by approximately 40% (to 0.25 mumol/g) and was able to fully account for the measured heat production. The frequency of spontaneous contractions under aerobic conditions was always reduced in the presence of pyruvate. Under anaerobic conditions force was essentially unaltered, and heat production was only slightly reduced (101 mJ/g) with glucose present. Lactate production increased threefold over that under aerobic conditions. With pyruvate as substrate both force and heat production declined markedly (to less than 5% of the aerobic values). The results indicate that under aerobic conditions and with glucose as substrate, smooth muscle of rabbit urinary bladder generates about one-third of its suprabasal energy requirements through glycolysis and that glycolysis can be further accelerated under anaerobic conditions to provide sufficient energy to sustain contraction. If pyruvate replaces glucose as substrate, the metabolism shifts to being virtually all oxidative, and contraction can no longer be sustained in the absence of oxygen. PMID- 2705513 TI - Vascular myosin expression during cytokinesis, attachment, and hypertrophy. AB - Primary cultures of canine saphenous vein smooth muscle cells downregulate the expression of the two muscle myosin heavy chains (mMHC) and upregulate the expression of a nonmuscle myosin heavy chain (nmMHC) when maintained in medium containing 10% fetal calf serum (FCS). The cellular function and control of these changes in contractile protein expression are not known. The purposes of these experiments were to determine whether the expression of nmMHC was required for cytokinesis, whether cell attachment stimulated nmMHC expression, and whether during changes in total myosin production the relative amounts of the two mMHCs remained constant. Primary cultures were maintained in FCS, in a serum-free defined medium (SFM), or after 2 days in SFM switched to FCS to induce proliferation and changes in myosin expression. nmMHC expression occurred before cytokinesis if cells were placed directly in FCS, whereas it occurred after cytokinesis if growth-arrested cells were exposed to FCS. The position of the cell in the cell cycle was responsible for these differences, and the temporal correlation of cell-cycle progression and nmMHC expression indicated that expression occurred during G1. Cells that remained unattached in the presence of FCS or attached in SFM did not express nmMHC. During net production or loss of mMHC by growth in SFM or FCS, respectively, the relative amounts of the two mMHC remained constant. These results suggest that 1) the expression of nmMHC requires the combined effect of FCS and attachment, 2) it occurs in cells progressing through G1 but is not required for cytokinesis, and 3) during changes in net myosin production, the two mMHC are coregulated. PMID- 2705514 TI - Effects of muscle length and load on intracellular Ca2+ in tracheal smooth muscle. AB - Canine tracheal smooth muscle strips were loaded with the bioluminescent Ca2+ indicator aequorin, mounted in a tissue bath, and attached to an electromagnetic lever to investigate the effect of changes in muscle length and load on cytosolic free Ca2+. The intracellular Ca2+ concentration ([Ca2+]i) was inversely correlated with muscle length and active force developed during isometric contractions elicited by electrical field stimulation. In addition, quick release to either constant length or constant load at any time point during an active contraction resulted in an increase in [Ca2+]i. These observations are consistent with the possibility that the binding of Ca2+ to contractile or regulatory proteins is decreased when muscle length or active force development is decreased, resulting in the release of bound Ca2+ into the cytoplasm. However, the possibility that changes in muscle length or load affect other mechanisms that regulate [Ca2+]i cannot be excluded. PMID- 2705515 TI - Rat vs. rabbit ventricle: Ca flux and intracellular Na assessed by ion-selective microelectrodes. AB - Trans sarcolemmal Ca movements in rabbit and rat ventricular muscle were compared using extracellular double-barreled Ca-selective microelectrodes. In rabbit ventricle, steady-state twitches were associated with transient extracellular Ca (Cao) depletions, indicative of Ca uptake during the twitch. In contrast, steady state twitches in rat ventricle were associated with net cellular Ca extrusion. Rest periods in rabbit ventricle lead to a net loss of cell Ca and resumption of stimulation induces a net uptake of Ca by the cells. Conversely, in rat ventricle rest periods lead to cellular Ca gain and resumption of stimulation induces a net Ca loss from the cells. Thus stimulation is associated with net Ca gain in rabbit ventricle and net Ca loss in rat ventricle. These observations provide an explanation for some of the functional differences between rat and rabbit ventricle (e.g., negative force-frequency staircase and rest potentiation in rat vs. positive staircase and rest decay in rabbit). Resting intracellular Na activity (alpha iNa) was 12.7 +/- 0.6 mM in rat and 7.2 +/- 0.5 mM in rabbit ventricle. This alpha iNa in rat ventricle is sufficiently high that Ca entry via Na-Ca exchange is thermodynamically favored at the resting membrane potential. This may explain why rest potentiation is observed in rat ventricle. In contrast, the lower alpha iNa in rabbit ventricle would favor Ca extrusion via Na-Ca exchange at rest (and consequent rest decay). In rat ventricle, the increase of intracellular [Ca] ([Ca]i) associated with contraction, coupled with the short action potential duration, strongly favor Ca extrusion via Na-Ca exchange and explain the observed Cao accumulation observed during twitches in rat. The high plateau of the rabbit ventricular action potential tends to prevent Ca extrusion via Na-Ca exchange during the contraction and explains the Cao depletions observed in rabbit. It is concluded that the higher alpha iNa and shorter action potential duration in rat vs. rabbit ventricle can explain many of the functional differences observed in these tissues. PMID- 2705516 TI - Ultrastructure of Amphiuma distal nephron: evidence for cellular heterogeneity. AB - To obtain more information on the ultrastructure of the distal nephron of the salamander, Amphiuma, we conducted freeze-fracture electron microscopy and morphometric experiments. In the early distal tubule, the organization of the tight junction is variable, containing from one to two strands in the proximal region and four strands in distal regions. The length density of the tight junction in this segment varies from greater than 60 m/cm2 of apical membrane surface to less than 10/cm2 of apical membrane surface. These observations agree with a previous study demonstrating that the junction of this segment exhibits considerable axial heterogeneity. The junctions of the late distal tubule and collecting tubule are more complex. In the late distal tubule, the tight junction is composed of 6-8 strands, whereas the tight junction of the collecting tubule is composed of 8-12 strands. The collecting tubule contains principal cells and two types of intercalated cells: alpha and beta. The alpha-cells contain a high density of rod-shaped particles in the apical plasma membrane and in membranes of apical cytoplasmic vesicles. The beta-cells contain rod-shaped particles only in the basolateral membrane. In principal cells, we observed a novel organization of intramembranous particles within the apical plasma membrane. A model describing the relationship of the two types of intramembranous particles within the membrane is presented. This study demonstrates that the amphibian and mammalian distal nephron share many morphological characteristics including cellular and axial heterogeneity. PMID- 2705517 TI - Cl-dependent K transport in a pure population of volume-regulating human erythrocytes. AB - Swelling of human red cells activates a putative K-Cl cotransport that is not present at normal cell volume and that disappears after several hours. To determine whether regulatory volume decrease (RVD) is occurring in human erythrocytes and is responsible for the inactivation of K-Cl cotransport, the relationship between cell volume and the inactivation and reactivation of volume sensitive (VS) K-Cl cotransport was studied. VS K influx into high K cells was transient, whereas influx into low K cells (prepared with nystatin), which are unable to shrink via K efflux, remained fully activated. Likewise, VS K efflux into hypotonic medium disappeared after 100 min in a low K medium but remained activated in a high K medium that prevented cell shrinkage. Cells that had been preincubated in hypotonic medium to inactivate VS K-Cl cotransport showed no significant recovery of VS cotransport after a 6-h incubation in isotonic medium but showed full restoration of VS cotransport after treatment with nystatin in isotonic medium to reequilibrate cell water. A pure fraction of volume-regulating (VR) cells was subsequently isolated by preincubating red cells in hypotonic medium and then subjecting them to further hypotonicity to lyse all non-VR cells. The 2.5% of cells that remained consisted of 16% reticulocytes and exhibited a Cl dependent RVD in hypotonic medium. VS K-Cl cotransport was enriched 10-fold and Na-K-Cl cotransport was enriched 12-fold in these cells, whereas the enrichment of N-ethylmaleimide (NEM)-activated K-Cl cotransport was only threefold.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705518 TI - Na+ and Cl- transport across rabbit nonciliated bronchiolar epithelial (Clara) cells. AB - Radioisotopic flux measurements were performed on rabbit Clara cell epithelium cultured in serum-free hormone-supplemented medium to identify the major ion transport pathways in the cell type. Clara cells cultured in serum-free hormone supplemented medium exhibit a large short-circuit current compared with cells maintained in serum-containing medium (45 microA/cm2 vs. 15 microA/cm2). The responses to amiloride and isoproterenol, however, are similar for cells grown in the two media. A net amiloride-sensitive movement of Na+ in the mucosal (M)-to serosal (S) direction undershort- and open-circuit conditions is detected (1.48 and 0.67 mueq.h-1.cm-2, respectively). No statistically significant difference in the unidirectional fluxes of Cl- is apparent in the basal state, but a net flux of Cl- in the S-to-M direction is observed after exposure of the apical membrane to amiloride (0.93 mueq.h-1.cm-2). The partial ionic conductances for Na+ and Cl- estimated from the fluxes measured in the passive directions (JNaS----M, JClM--- S) exceed the total tissue conductance by 20%. Ussing flux ratio analyses of Cl- movements at clamped potentials between -60 and +20 mV show that Cl- movements are not strictly through passive conductive pathways at negative potentials. The movement of Cl- can be modeled by passive diffusion combined with Cl- -Cl- exchange equal to 20% of total passive fluxes of Na+ and Cl-. These observations indicate that 1) Na+ absorption is the major active ion transport pathway across cultured Clara cells, 2) active Cl- secretion is minimal in the basal state, and 3) approximately 20% of the unidirectional Cl- fluxes occur via nonconductive pathways. PMID- 2705519 TI - Erythropoietin production in exhypoxic polycythemic mice. AB - Our present study was undertaken to determine the serum erythropoietin concentration (radioimmunoassay), hematocrit, red cell mass, and body weight of mice exposed to hypoxia in a hypobaric chamber (0.42 atm, 22 h/day) for 14 days and during the 10 posthypoxic days at ambient pressure to clarify the correlation of the red cell mass and erythropoietin production during hypoxia. The mean serum erythropoietin titer was 326.23 +/- 77.04 mU/ml after 2 days, reached the highest level after 3 days (452.2 +/- 114.5 mU/ml), then gradually declined to a level of 36.5 +/- 11.4 mU/ml after 14 days of hypoxia, and was undetectable during the 10 day posthypoxic period. The hematocrit values were significantly increased from 41.09 +/- 0.50% at day 0 to 51.65 +/- 1.08% after 3 days and to 72.20 +/- 1.53% after 14 days of hypoxia. The red cell mass (calculated from initial body weight) increased from 3.24 +/- 0.1 ml/100 g at day 0 to 7.32 +/- 0.46 ml/100 g after 14 days of hypoxia and declined to 6.66 +/- 0.53 ml/100 g at the end of the 10-day posthypoxic period. The mice lost weight while they were in the hypobaric chamber and showed a significant increase in body weight during the 10-day posthypoxic period. These studies support the concept that chronic intermittent hypoxia causes an early increase, followed by a rapid decline, in erythropoietin production, which is correlated with the gradual increase in red cell mass. PMID- 2705520 TI - Food intake, body and heart composition, and heart rate in T3 plus atenolol treated rats. AB - Thyroid hormones and beta-blockers both affect energy balance and the heart. The interaction of 3,5,3'-triiodothyronine (T3) and the beta-blocker atenolol on some cardiac and energy balance parameters was therefore investigated. Stock-fed male Wistar rats (approximately 400 g) received 5 micrograms (expt 1) or 1.5 micrograms (expt 2) T3.100 g body wt-1.day-1 for 3 wk, with or without atenolol. In expt 3, rats were overfed with a "cafeteria" diet before and during the experiment and otherwise treated as in experiment 2. Compared with stock-fed (expt 1 and 2) or overfed (expt 3) controls, T3 caused an increase in food intake in experiments 1 and 2 but not in experiment 3. There was a large loss of body fat in all experiments, disproportionately greater than the body weight loss. Protein loss was significant only in experiment 1 and negligible in cafeteria rats. Heart rate and weight were increased, although heart composition remained unchanged. Atenolol, in a dose that abolished T3-induced tachycardia, did not modify any of the other T3 effects investigated, including the hypertrophy of the heart. These results indicate that T3-induced tachycardia can be abolished by concomitant treatment with a beta-blocker without altering parameters connected with energy balance, whereas protein loss caused by T3 can be attenuated by lowering the dose of T3 used and can be further blunted by dietary manipulation (cafeteria overfeeding). PMID- 2705521 TI - 1,25-Dihydroxyvitamin D3 restores fertility of vitamin D-deficient female rats. AB - Vitamin D deficiency reduces mating success and fertility in female rats, but it is not known if the reduction in reproductive performance is a direct action of vitamin D or the hypocalcemia associated with vitamin D deficiency. The effect of vitamin D deficiency with normocalcemia on fertility and reproductive capacity in female rats was investigated. Female weanling rats were maintained on vitamin D deficient or vitamin D-replete diets until maturity and mated to age-matched, normal, vitamin D-replete males. Three groups of vitamin D-deficient females were maintained on diets varying in calcium and Pi concentrations to test the effect of vitamin D deficiency with different serum calcium and Pi concentrations on reproductive performance. Vitamin D-deficient females were capable of reproduction, but successful matings by all groups of vitamin D-deficient females were markedly reduced regardless of serum calcium concentration, when compared with matings with vitamin D-replete females. Fertility was also drastically reduced in litters from all groups of vitamin D-deficient females regardless of serum calcium concentration, when compared with litters from vitamin D-replete females. Vitamin D-deficient female rats that received vitamin D or 1,25 dihydroxyvitamin D3 were capable of successfully mating and giving rise to normal, healthy litters. These results indicate that vitamin D and not hypocalcemia is directly responsible for reduced reproductive capacity and fertility in vitamin D-deficient female rats. PMID- 2705522 TI - Anti-calmodulin agents affect osmotic and angiotensin II-induced vasopressin release. AB - Calcium ions and particularly calcium influx play a crucial part in initiating the intracellular events that result in arginine vasopressin (AVP) release to both osmotic and nonosmotic stimuli. Calmodulin appears to modulate the effects of calcium on synaptic transmission and hormone release in other systems. This study tested the effects of three distinct classes of anti-calmodulin agents on the release of AVP to either a rise in osmolality of 20 mosmol/kg water or to 1 X 10(-5) angiotensin II (ANG II) in cultured hypothalamo-neurohypophysical complexes. Micromolar concentrations of R 24571, the active naphthalenesulfonamides, W 7 and W 13, and trifluoperazine (TFP) inhibited AVP release to osmotic stimulation. In contrast, W 5, a severalfold less active anti calmodulin agent, had no effect on osmotically stimulated AVP release. The active naphthalenesulfonamides, but not R 24571 or TFP, blocked release of AVP to ANG II. In contrast, neither R 24571 nor TFP inhibited AVP release to ANG II stimulation. Collectively, the data demonstrated a dissociation between inhibition of AVP release and the anti-calmodulin properties of the drugs, thereby suggesting that nonspecific actions masked the calmodulin-blocking effects of the drugs or that the inhibition occurred by some alternative mechanism(s). PMID- 2705523 TI - Nuclear thyroid hormone receptors: ontogeny and thyroid hormone effects in sheep. AB - To investigate the mechanism(s) responsible for the paucity of fetal thyroid hormone effects, thyroid hormone nuclear receptor (T3NR) binding characteristics were quantified in liver and brain of fetal and neonatal sheep. Maximal binding capacities [MBC; mean +/- SE fmol 3,5,3'-triiodothyronine (T3)/mg DNA] in liver increased from values of 68 +/- 14 at 80 days gestation to 684 +/- 152 at term. Liver T3NR MBC in newborn and adult sheep were comparable to values in term fetuses. Liver T3NR binding affinities were similar in all animals, averaging 1.68 +/- 0.05 X 10(9) M-1. Brain T3NR MBC were comparable at all fetal ages studied (410 +/- 55 fmol T3/mg DNA), increasing to 1,517 +/- 315 fmol T3/mg DNA during the 1st postnatal week and returning to comparable fetal values (368 +/- 37 fmol T3/mg DNA) in the 3rd week after birth. Brain T3NR binding affinities were comparable in all animals studied (7.5 +/- 2.1 X 10(9) M-1), and the mean value was significantly greater than mean liver T3NR affinity. T3NR binding of T3 analogues in six term fetal animals were qualitatively similar for both brain and liver and showed T3 = triiodothyroacetic acid greater than thyroxine greater than reverse T3. Like T3 binding affinity, T3NR analogue binding affinities in brain tissue were five- to sevenfold greater than those in liver. Fetal hypothyroidism induced by thyroidectomy at either 99-107 or 129-132 days of gestation was not associated with changes in brain or liver T3NR binding characteristics. The heterogenous ontogeny and binding characteristics of brain and liver T3NR is compatible with the hypothesis that different thyroid hormone receptors are expressed in these tissues. PMID- 2705524 TI - Impaired very low-density lipoprotein-triglyceride catabolism in acute and chronic fructose-fed rats. AB - Very low-density lipoprotein (VLDL)-triglyceride (TG) catabolism was compared in rats given chow and either a 10% fructose (F) or 10% glucose (G) drinking solution for both acute (A) (16 h) and chronic (C) (14 days) periods. VLDL-TG were labeled in F and G donor rats using different isotopic forms of glycerol. A mixture of the VLDLs was injected into F and G recipients and the decline in plasma TG radioactivities used as a measure of clearance. VLDL-TG from F donors was cleared more slowly than VLDL-TG from G donors. In F recipients, the half life of VLDL-TG from either F or G donors was longer than that in G fed recipients. VLDL from the AF group, had a lower apoprotein E-to-C apoprotein ratio (E/C) than VLDL from the AG group. VLDL from both F groups had a lower E/C than did that from control rats. The E/C negatively correlated with plasma VLDL TG. CF and CG VLDL had elevated CIII0 and lower CIII3 levels compared with their respective A groups and controls. The ratio of VLDL apoprotein B100, B95, and B48 did not differ between treatments. AF and AG VLDL were larger and enriched in TG compared with control or the CF and CG groups. The saturated fatty acid-to unsaturated fatty acid ratio in VLDL-TG was higher in the G groups and AF group compared with controls. The present study suggests that the E/C may be lowered as a result of F consumption, thereby contributing to the impairment in VLDL-TG removal. PMID- 2705525 TI - Identification of the intestinal Na-phosphate cotransporter. AB - Na-dependent phosphate uptake in intestinal brush-border membrane vesicles was sensitive to arginine group-specific reagents in a substrate-sensitive manner. Four different arginine group-specific reagents were tested. All four reagents irreversibly inhibited Na-dependent phosphate uptake with the concentration for 50% inhibition, K0.5, varying between 150 and 40 microM. Maximum inhibition approached 80%. Addition of substrates during exposure to these reagents resulted in protection of Na-phosphate cotransport only in the presence of Na and phosphate. Na-phosphate cotransporter labeling at or near the phosphate site was accomplished using a pretreatment step with phenylglyoxal and substrates followed by a fluorescent phenylglyoxal-labeling step. Fluorescein isothiocyanate phenylglyoxal (FITC-PG) specifically labeled a 130-kDa polypeptide on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) in a substrate sensitive manner, consistent with its effect on Na-phosphate cotransport. n Acetylimidazole (NAI) inhibited Na-phosphate cotransport in a Na+- but not K+ sensitive manner. NAI or fluorescein n-acetylimidazole (FNAI) inhibited Na dependent phosphate uptake with a K0.5 for inhibition of 38 microM. Maximum inhibition of Na-phosphate cotransport was 75%. On SDS-PAGE, FNAI labeled five polypeptide bands in a Na-sensitive manner including the 130-kDa polypeptide band labeled by FITC-PG. Of these five bands only the 130-kDa polypeptide lost substrate protectability against FITC-PG inhibition of Na-phosphate cotransport and FITC-PG labeling on prior exposure to NAI in the absence of Na+. On this basis the 130-kDa polypeptide is tentatively identified as the intestinal Na phosphate cotransporter and this polypeptide band contains both the Na substrate site and the phosphate substrate site. PMID- 2705526 TI - Permeability of the rat biliary tree to ursodeoxycholic acid. AB - The permeability of the biliary epithelium to [14C]ursodeoxycholic acid (UDCA), a hypercholeretic bile acid, was compared to that of the 14C-labeled nonhypercholeretic bile acids cholic acid (CA), taurocholic acid (TCA), and tauroursodeoxycholic acid (TUDCA) by means of anterograde intrabiliary infusions and retrograde intrabiliary injections in the anesthetized rat. Anterograde intrabiliary infusions were performed by perfusing an isolated segment of common bile duct in vivo. After anterograde intrabiliary infusions, the fraction of unrecovered UDCA (that had presumably been absorbed from the biliary lumen) was 11.03 +/- 1.03 (SE)% (n = 6) of the administered dose. It was significantly higher than that of TUDCA (1.25 +/- 0.27%; n = 5; P less than 0.01), CA (2.62 +/- 0.43%; n = 4; P less than 0.01), and TCA (2.57 +/- 0.79%; n = 6; P less than 0.01). In separate experiments, bile was collected from the common bile duct and from the left hepatic duct. UDCA recovered from the left hepatic duct was found in the conjugated form, indicating that, after absorption in the common bile duct, it had been conjugated by the hepatocyte and secreted into bile. After retrograde intrabiliary injections of UDCA and CA, the cumulative percentages of recovered radioactivity were not significantly different (84.50 +/- 2.65 and 87.33 +/- 1.80%, respectively); however, peak recovery of UDCA was significantly delayed compared with that of CA. Moreover, UDCA was recovered mostly in the conjugated form, while CA was recovered mostly in the unconjugated form. These results suggest that, in the rat, UDCA is significantly more absorbed by the biliary tree than CA, TUDCA, and TCA. They support the hypothesis that UDCA undergoes a cholehepatic circulation. PMID- 2705527 TI - Effect of chelators on copper metabolism and copper pools in mouse hepatocytes. AB - Disorders of copper storage are usually treated by chelation therapy. It is generally thought that the chelators act by mobilizing copper from the liver, hence allowing excretion in the urine. This paper has examined the effect of chelators on copper uptake and storage in mouse hepatocytes. Penicillamine, a clinically important chelator, does not block the uptake of copper or remove copper from hepatocytes. Two other copper chelators, sar and diamsar, which form very stable and kinetically inert Cu2+ complexes by encapsulating the metal ion in an organic cage, were shown to block copper accumulation by the cells and to remove up to 80% of cell-associated copper. They also removed most (approximately 80%) of the 64Cu accumulated by the cells in 30 min, but released only a small percentage (less than 20%) of that accumulated over 18 h. The results show that copper in the hepatocyte can be divided into at least two pools, an easily accessible one, and another, not removable even after long-term incubation with any of the chelators. Most of the copper normally found in the cell appeared to be associated with the former pool. PMID- 2705528 TI - Rat liver metabolism of dicarboxylic acids. AB - Recently, we demonstrated in rat liver that dicarboxylic acids containing more than five carbons can be activated by a microsomal dicarboxylyl-CoA synthetase (J. Vamecq, E. de Hoffmann, and F. Van Hoof. Biochem. J. 230: 683-693, 1985). The products of this reaction, dicarboxylyl-CoA esters, were found to be substrates for an H2O2-generating dicarboxylyl-CoA oxidase. In the present work we report that 1) the catalytic center or the essential domains of dicarboxylyl-CoA synthetase are located at the cytosolic aspect of the endoplasmic reticulum membrane; 2) dicarboxylyl-CoA oxidase is optimally active on dodecanedioyl-CoA and is a peroxisomal enzyme; 3) cyanide-insensitive dodecanedioyl-CoA oxidation (NADH production) is catalyzed by rat liver homogenates. Cell fractionation studies disclose that, similar to dodecanedioyl-CoA oxidase (H2O2 production), the cyanide-insensitive dodecanedioyl-CoA oxidizing activity also belongs to peroxisomes; 4) a dodecanedioyl-CoA oxidoreductase reaction can be assayed by the dichlorphenolindophenol procedure in rat liver homogenates, and the activity is abundant in peroxisomal, mitochondrial, and soluble fractions; 5) by contrast with monocarboxylyl-CoA esters, the dicarboxylyl-CoAs are apparently not substrates for mitochondrial fatty acid oxidation; however, the use of dicarboxylylcarnitine esters as direct substrate for mitochondria suggests the existence of an active beta-oxidation of dicarboxylates in these organelles, which is further confirmed by experiments in which mitochondria are permeabilized with digitonin; 6) the in vivo oxidation of infused dodecanedioic acid results in a rapid appearance in urine of medium-chain dicarboxylic acids, with only 30-50% of the infused dose recovered in urine. PMID- 2705529 TI - Ultrastructural analysis of VIP internalization in rat beta- and acinar cells in situ. AB - We perfused the pancreas with 125I-labeled vasoactive intestinal peptide (VIP) to follow the concomitant distribution of radioactivity in beta- and acinar cells as a function of time. This distribution was quantitated by computer-assisted analysis of high-resolution video autoradiographs. Density labeling was expressed as normalized specific activity (disintegration density per volume density). Immediately after a 4-min perfusion of 125I-VIP, labeling in beta-cells was mainly concentrated on the cell surface and peripheral tubules and vesicles. After three 30-s pulses of 125I-VIP, separated by intervals of 3.5 min of buffer perfusion, lysosome-like structures were heavily labeled. When VIP internalization was prolonged, labeling was similar to that observed with the 4 min perfusion, indicating a high VIP disposal rate in the lysosome-like structures. In acinar cells, labeling persisted on the surface and the early vacuolar system. We conclude the following: 1) an active endocytotic system, linked to the transport and sorting of a neuromediator, is present in beta-cells; and 2) the differences between the distribution of labeling in acinar and beta cells suggest that the regulation of VIP internalization is tissue specific. PMID- 2705530 TI - Length-tension relationship of striated muscle of cat external anal sphincter. AB - The active and passive length-tension curves of small strips of cat external anal sphincter (EAS) were examined in vitro. The striated muscle fibers were arranged perpendicular to the long axis of the longitudinal smooth muscle cells of the longitudinal layer of the anal canal. Histological examination indicated that the strips were comprised of striated muscle fibers oriented in the long axis of the strip. Electrical field stimulation elicited twitch and tetanus responses that were not altered by the administration of gallamine triethiodide (10(-6) to 10( 4) M), a neuromuscular blocking agent. At 37 degrees C the time from the onset of the twitch contraction to the development of peak force ranged from 30 to 37 ms, the time from peak force to one-half relaxation ranged from 20 to 25 ms. The maximum active twitch and tetanus tension (Po) averaged 0.23 and 0.90 kg/cm2, respectively. Active tension could be developed over a range of 0.6-1.4 optimum length (Lo). The passive length-tension curve showed that the muscle had significant passive tension at lengths below the Lo for tension development and a high passive tension at Lo (average of 44% of active isometric twitch tension, 12.2% of active isometric tetanus tension) and above Lo. We conclude that the passive length-tension curve for the EAS is stiffer than that of typical mammalian skeletal muscles. We suggest that this difference is related to the adaptation of the EAS to its sphincteric function as a component of a hollow organ. PMID- 2705531 TI - Effects of methylene blue on rhythmic activity and membrane potential in the canine proximal colon. AB - The hypothesis that methylene blue has a direct effect on colonic muscle cells was tested. Intracellular recordings were made from cross-sectional preparations of canine proximal colon. Cells through the circular layer were impaled and membrane potentials ranging from -81 mV at the submucosal surface to -46 mV at the myenteric border were recorded. Methylene blue (10(-5) M) depolarized cells near the submucosal border by an average of 43 mV and slow-wave activity ceased. The loss of slow-wave activity could be explained by the depolarizing effects of methylene blue rather than a specific effect of methylene blue on the pacemaker mechanism. Other experiments suggested that the depolarizing effects of methylene blue were not confined to muscle cells within the submucosal pacemaker region. Depolarization of cells was noted throughout the circular layer, but the magnitude of the depolarization decreased with distance from the submucosal border. After methylene blue, the gradient in resting potential across the circular layer was greatly reduced or abolished. The data suggest that methylene blue is not necessarily a specific probe for interstitial cells and has direct effects on smooth muscle cells in the canine proximal colon. This effect is similar to treatments that are known to block the electrogenic sodium pump. PMID- 2705532 TI - Renal actions of neuropeptide Y in the primate. AB - Neuropeptide Y (NPY) is a potent vasoconstrictor peptide contained in sympathetic nerve terminals and is co-released with norepinephrine. Previous studies in the rat have suggested that NPY influences renal sodium reabsorption and renin release. However, little is known about the physiological effects of NPY on the kidney in the human. In the present study NPY was infused intravenously and directly into the renal artery of the primate Macaca fascicularis, an experimental model of the human. Intravenous NPY infusion at doses of 20-1,000 ng.kg-1.min-1 produced dose-dependent rises in renal vascular resistance with minimal changes in arterial pressure. Urine flow and sodium excretion were changed significantly only at doses of NPY that significantly reduced renal blood flow and filtration rate. Arterial plasma renin activity and renin secretion rate were not significantly altered at any dose of NPY. Intrarenal infusion of NPY at doses of 20-400 ng.kg-1.min-1 produced potent dose-dependent renal vasoconstriction with minimal changes in arterial pressure. Under these conditions sodium excretion was significantly reduced concurrent with decreases in renal blood flow and glomerular filtration rate. However, no significant changes in arterial plasma renin activity or renin secretion rate were found at any dose of NPY. These data indicate that in the nonhuman primate NPY is a potent renal vasoconstrictor agent that has variable effects on renal excretory and secretory function, which may be secondary to its vasoconstrictor actions. PMID- 2705533 TI - Dose-dependent heterogenous actions of vasopressin in rabbit cortical collecting ducts. AB - In cortical collecting ducts (CCD), arginine vasopressin (AVP) has been proposed to autoinhibit its own hydrosmotic effect through stimulation of prostaglandin (PG) synthesis or binding to a receptor coupled to phosphatidylinositol (PI) hydrolysis, the so-called V1-receptor, with resultant elevation of intracellular Ca2+ concentration [( Ca2+]i) and activation of protein kinase C (PKC). Using isolated perfused rabbit CCD, we examined whether blocking the negative feedback by a PKC inhibitor, staurosporine (SSP), or a cyclooxygenase inhibitor, indomethacin (IND), enhances AVP-induced increase in hydraulic conductivity (Lp). The Lp induced by a pharmacological concentration (23 nM) of AVP was lower than that induced by 230 pM AVP. This blunted Lp response to 23 nM AVP was significantly restored by SSP or IND pretreatment. In contrast, both SSP and IND did not affect the Lp induced by 23 pM or 230 pM AVP. Fluorescence microscopy of isolated perfused CCD using fura-2 showed a spike-like increase in [Ca2+]i only by 23 nM but not by 23 or 230 pM AVP. We conclude that 1) AVP can increase [Ca2+]i, activate PKC, and stimulate PG synthesis in CCD with resultant autoregulation of its own hydrosmotic effect and 2) importantly, however, this negative feedback occurs only with pharmacologically high concentrations of AVP. Therefore it is unlikely that circulating AVP, via binding to receptors on CCD, autoregulates water transport through activating PG synthesis and/or PI breakdown. PMID- 2705534 TI - Independence of urea and water transport in rat inner medullary collecting duct. AB - Several published models of the renal concentration mechanism have assumed a reflection coefficient for urea in the inner medullary collecting duct (IMCD) that is less than unity, implying direct coupling between water and urea transport. In the present study, we used isolated perfused terminal IMCD segments and mathematical modeling of IMCD transport to determine the validity of this assumption. Mathematical simulations of IMCD transport, using recently published data on urea and water permeability, revealed that the method previously used to measure the reflection coefficient for urea underestimates the true value. The modeling results allowed us to design two new experimental protocols to determine the reflection coefficient for urea. In the first protocol, we measured the ability of a transepithelial urea gradient to induce a water flux, correcting for the dissipation of the urea gradient by rapid passive urea permeation. In the second protocol, we directly measured the solvent drag of urea resulting from an osmotically induced water flux. Both protocols yielded values for the urea reflection coefficient that were not significantly different from unity (0.92 +/- 0.04 and 1.07 +/- 0.05, respectively). Thus we find no evidence for direct coupling between urea and water transport in the rat terminal IMCD. PMID- 2705535 TI - The occurrence of nephrogenic diabetes insipidus in domestic fowl. AB - Nephrogenic diabetes insipidus (NDI) results from an inability of the kidney to concentrate the urine. The underlying cause of NDI is the failure of the collecting ducts to respond to antidiuretic hormone, however, the specific tubular defect is not well understood. In the present investigation an apparent case of NDI was studied in a strain of White Leghorn domestic fowl. In this strain, water intake of the males equaled 24.0% (controls 5.4%) of their body mass (BM) per day while that of the females equaled 51.4% (controls 11.7%) of their BM per day. Plasma osmolality (mosmol/kgH2O) of the NDI birds was significantly higher than that of controls (males 319 +/- 1.7 vs. 311 +/- 1.2; females 323 +/- 1.5 vs. 310 +/- 2.2). Urine osmolality of NDI birds was substantially lower than that of controls (males 90 +/- 6.2 vs. 524 +/- 4.0; females 70 +/- 4.7 vs. no value). In response to water deprivation, plasma osmolality of the NDI birds increased more markedly than that of the control animals (males 357 +/- 2.5 vs. 331 +/- 1.2; females 375 +/- 6.0 vs. 348 +/- 1.4 at 48 h of water deprivation). Basal plasma antidiuretic hormone (plasma arginine vasotocin, PAVT) levels in male NDI birds (9.9 +/- 0.7 microU/ml) and in female NDI birds (7.0 +/- 0.5 microU/ml) were nearly sixfold or nearly threefold higher, respectively, than in control birds. In response to water deprivation, PAVT of both NDI and control birds increased to similar levels, although the absolute increases in PAVT levels were substantially less in NDI birds.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705536 TI - Anion dependence of taurine transport by rat renal brush-border membrane vesicles. AB - The anionic requirements and the stoichiometric relationships of Na+-taurine cotransport into rat renal brush-border membrane vesicles (BBMV) were evaluated. External Cl- (100 mM) or Br- (100 mM) gradients supported the full overshoot of Na+-taurine symport and yielded similar high-affinity transport systems for taurine uptake. No active uptake of taurine was evident in the presence of external (100 mM) NaF, NaI, Na gluconate, or Na p-aminohippurate (PAH). Na+:taurine stoichiometry was 2.18:1 in the presence of Cl- and 1.60:1 in the presence of Br-. When the external anion gluconate was employed, Na+-dependent taurine uptake was negligible over the whole range of Na+ concentrations examined. Cl-:taurine and Br-:taurine stoichiometries in the presence of external Na+ were 0.97:1 and 0.81:1, respectively. External furosemide (1 mM) or bumetanide (1 mM) did not change taurine accumulation and kinetic parameters. The anionic transport inhibitors 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (5 x 10(-4) M), N-(4-azido-2-nitrophenyl)-2-aminoethylsulfonate (10(-3) M) and p chloromercuribenzoate (5 x 10(-4) M) significantly decreased initial rate of taurine uptake by 48, 31, and 31%, respectively. These data suggest that Na+ taurine cotransport into rat renal BBMV is Cl- or Br- dependent and probably operates by means of 2 Na+:1 Cl- or Br-:1 taurine carrier complex. Na+-taurine symport across the rat renal brush-border membrane surface is not affected by diuretics that influence NaCl cotransport but is affected by selected anionic transport inhibitors. An intact anionic binding site may be needed for this translocation process. PMID- 2705537 TI - Abnormal diurnal rhythm of plasma vasopressin and urinary output in patients with enuresis. AB - The diurnal variation of plasma vasopressin (AVP), urinary excretion rate, urinary osmolality, and serum osmolality was studied twice in 15 patients with enuresis and in 11 age, weight, and sex matched nonenuretic normal subjects. A diurnal rhythm of AVP with constant levels during the day (8 AM-10 PM) and a highly significant increase during the night (10 PM-8 AM) was found in normal subjects. In contrast, enuretics showed a significantly less pronounced nocturnal increase in AVP with significantly lower nocturnal levels than normal subjects. Normal subjects showed a diurnal rhythm in urinary excretion rate reciprocal to urinary osmolality with a low and highly concentrated nocturnal urinary output. In enuretics, however, this normal diurnal rhythm was absent. In conclusion, an abnormal diurnal rhythm of AVP seems to be an important pathophysiological factor in enuresis, explaining the abnormally high nocturnal urinary volume and the low nocturnal urinary osmolality found in these patients. PMID- 2705538 TI - Control of bicarbonate transport in collecting tubules from normal and remnant kidneys. AB - Bicarbonate transport in the rabbit cortical collecting tubule (CCT) and outer medullary collecting tubule (MCT) in vitro was studied under two types of conditions that were anticipated to alter distal tubule bicarbonate transport: 1) reduction of renal mass, and 2) acid and base loading in vivo. Bicarbonate secretion (both total and acetazolamide sensitive) and bicarbonate reabsorption (studied separately) in CCT and bicarbonate reabsorption in the MCT were not different between tubules from normal and remnant kidneys. The control or conditioning of the separate processes of bicarbonate secretion and bicarbonate reabsorption was also studied in CCT from normal and remnant kidneys. Bicarbonate secretion was not increased by base-loading animals with either normal or remnant kidneys. In contrast, bicarbonate secretion was consistently decreased by acid loading (studied in CCT from remnant kidneys). Bicarbonate reabsorption in the CCT was not altered by acid or base loads given to animals with normal kidneys. And bicarbonate reabsorption in MCT was not increased by acid loading of animals with remnant kidneys. These studies demonstrate that bicarbonate transport (and its conditioning by acid or base loads in vivo) in both CCT and MCT in vitro is not altered by reduction of renal mass in rabbits. The predominant conditioning effect of acid or base loads in vivo is for acid loads to inhibit CCT bicarbonate secretion. PMID- 2705539 TI - The role of free fatty acids in hypoxia-induced injury to renal proximal tubule cells. AB - Phospholipase activation with resulting phospholipid breakdown and lipid byproduct accumulation may play a critical role in hypoxic cell injury. To explore this role, mildly hypoxic rabbit renal proximal tubules (PT) in suspension were treated in vitro with exogenous phospholipase A2 (PLA2). This treatment produced severe tubule cell injury measured by alterations in tubule cation homeostasis, respiratory rates, and adenosine nucleotide metabolism. This injury was associated with loss of the major membrane phospholipids, phosphatidylcholine (PC) and phosphatidylethanolamine (PE), with accumulation of lipid byproducts, lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), and free fatty acids (FFA). Addition of fatty acid-free bovine serum albumin (BSA) to PTs reduced markedly FFA levels and improved significantly derangements in metabolic parameters of hypoxic PTs treated with exogenous PLA2, suggesting that FFA accumulation was a critical factor in this injury process. Effects of increasing durations of hypoxia (30, 45, and 60 min) with or without reoxygenation recovery demonstrated increased FFA levels, especially polyunsaturated FFA, which correlated better with the degree of hypoxic injury than alterations in membrane phospholipid and lysophospholipid levels. PTs undergoing hypoxia and reoxygenation recovery exposed to BSA were not protected. Although 60 min of hypoxia with 60 min reoxygenation produced accumulation of FFA to levels nearly identical to those seen in hypoxic PTs treated with exogenous PLA2 and BSA, with a similar distribution of various FFA species, hypoxia/reoxygenation produced a more severe degree of cell injury than that observed with hypoxia plus exogenous PLA and BSA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705540 TI - Reversible chloride-dependent potassium flux across the rabbit cortical collecting tubule. AB - We have demonstrated previously active Cl and K secretion by the cortical collecting tubule (CCT). The aim of these studies was to determine whether a component of Cl and K secretion is coupled. Such coupling has been observed in the rat distal nephron but K secretion in the rabbit CCT is believed to be strictly conductive. We measured the rate of K secretion in three protocols. In the first, bath bumetanide did not affect K secretion but K secretion (-JK; in pmol.mm-1.min-1) decreased from 12.7 +/- 2.2 to 8.28 +/- 1.2 when gluconate replaced bath Cl (P less than 0.01), whereas transepithelial voltage (VT) and lumen-to-bath 22Na flux (JNal----b) were unchanged. In the second, bath Cl removal stimulated significant K absorption (JK, from -0.19 +/- 0.97 to 2.03 +/- 0.57) only in the presence of a lumen-to-bath Cl gradient (Na-free perfusate). This identical maneuver had no effect on JK in the absence of luminal Cl (NaCl free perfusate). In the third, reducing luminal [Cl] from 112 to 5 mM stimulated K secretion from 13.6 +/- 3.1 to 20.1 +/- 3.2 (P less than 0.01) without affecting VT or net Na transport. We conclude the following: the CCT possesses a Cl-dependent K secretory mechanism that can be influenced by the transepithelial Cl gradient independent of VT and JNal----b. Reducing luminal [Cl] stimulates K secretion and K secretion can be reversed to K absorption by reversal of the ambient Cl gradient. These data imply a coupling between a component of K and Cl fluxes, consistent with the presence of KCl cotransport in the rabbit CCT. PMID- 2705541 TI - Effect of chronic renal failure and parathyroid hormone on phospholipid content of brain synaptosomes. AB - The effects of 21 days of chronic renal failure (CRF) with and without excess parathyroid hormone (PTH) and those of 21 days administration of intact PTH on phospholipids and cholesterol contents of rat brain synaptosomes were examined. CRF and PTH treatment were associated with a significant (P less than 0.01-0.02) reduction in the synaptosomal contents of total phospholipids, phosphatidylinositol (PI), phosphatidylserine (PS), and phosphatidylethanolamine (PE). Parathyroidectomy (PTX) prior to the induction of CRF prevented the decrements in the synaptosomal contents of total phospholipids, PI, PS, and PE. The synaptosomal contents of these phospholipids in CRF-PTX rats were not different from those in normal rats despite CRF. There were no significant changes in the cholesterol content of the synaptosomes in the various experimental groups of animals. The data show that CRF affects synaptosomal metabolism of total phospholipids, PI, PS, and PE, and these derangements are due to the state of secondary hyperparathyroidism of renal failure. The decrements in the content of PI, PS, and PE could be, at least in part, responsible for the previously reported abnormalities in the neurotransmitter functions of brain synaptosomes in CRF and could underlie some of the abnormalities in central nervous system dysfunction in uremia. PMID- 2705542 TI - Glomerular dynamics and salt balance in pregnant rats with renal hypertension. AB - These studies were aimed at investigating whether chronic hypertension in pregnancy causes changes both in salt excretion (NaE) and in glomerular hemodynamics. Metabolic and renal micropuncture studies were performed in pregnant (P) and Virgin (V) Munich-Wistar rats with normal blood pressure (N) and two-kidney Goldblatt hypertension (H). Mean NaE was higher in PN than VN (2.7 vs. 1.7 meq/day, P less than 0.01). Hypertension raised NaE both in P and V rats: in P and V rats with "benign" hypertension (blood pressure less than 180 mmHg) NaE averaged 3.2 and 2.6 meq/day, respectively (P less than 0.05); mean NaE was 5.9 and 3.8 meq/day, respectively (P less than 0.01), in P and V rats with "malignant" hypertension (blood pressure greater than or equal to 180 mmHg). Afferent arteriole resistance (Ra) averaged 1.73 and 3.50 10 dyn.s-1.cm5 in PN and VN, respectively (P less than 0.01). Hypertension raised Ra in V, but not in P rats (4.47 vs. 2.14 10 dyn.s-1.cm5, P less than 0.01). Thus glomerular plasma flow, glomerular capillary hydrostatic pressure, and single-nephron glomerular filtration rate were markedly higher in PH than VH rats: in PH rats single nephron filtration fraction was significantly lower than in VH. These results show that in PH rats a marked rise in NaE is associated with glomerular vasodilation. PMID- 2705543 TI - Extra- and intracellular metabolism of platelet-activating factor by cultured mesangial cells. AB - Metabolism of platelet-activating factor (PAF) was examined in cultured mesangial cells from human and rat glomeruli. Human mesangial cells, similar to those from rat, generated PAF after A23187. Both human and rat mesangial cells rapidly hydrolyzed [3H]PAF to lyso-[3H]PAF, and reacylated it into 1-alkyl-2-acyl glycerophosphocholine. Extra- and intracellular metabolism of PAF was then analyzed separately. The majority of [3H]PAF metabolism occurred extracellularly and generated Lyso-[3H]PAF. Intracellularly generated lyso-PAF was rapidly converted to 1-alkyl-2-acyl glycerophosphocholine. Cells prelabeled with [3H]PAF released some [3H]PAF within minutes and then rapidly converted it to lyso-PAF extracellularly. Under control conditions no acetylhydrolase activity was released from cells into the buffer. Acetylhydrolase activity could, however, be released from cell surface into buffer by limited trypsinization, supporting its location on the outer cell membrane. The acetylhydrolase activity was different from phospholipase A2, since phosphatidylcholine was not a substrate for the enzyme. In summary our results show that both rat and human mesangial cells can generate and metabolize PAF. Acetylhydrolase for PAF is present intracellularly, but also and predominantly on the outer cell surface of cells. This ectoenzymatic acetylhydrolase activity may be important in the rapid inactivation of PAF presented to cells, thus protecting cells from deleterious effects of PAF. PMID- 2705544 TI - Protein kinase inhibitor prevents pulmonary edema in response to H2O2. AB - We investigated the effect of H2O2 (92 microM) in isolated guinea pig lungs perfused with a buffered Ringer solution. Pulmonary arterial pressure (Ppa), pulmonary capillary pressure (Ppc), and change in lung weight (delta W) were recorded at 0 min and at 15, 30, and 60 min after the H2O2. The capillary filtration coefficient (Kfc) was measured at 0 and 30 min. The perfusion of H2O2 increased the Ppa, Ppc, delta W, and Kfc. The thromboxane synthetase inhibitor Dazoxiben, or the vasodilator papaverine, prevented the increases in Ppa and Ppc. The protein kinase C (PKC) inhibitor H7 [1-(5-isoquinolinesulfonyl)-2 methylpiperazine dihydrochloride] prevented the increases in Ppa, Ppc, delta W, and Kfc, whereas the inactive isoquinoline HA1004 [N-(2-guanidinoethyl)-5 isoquinolinesulfonamide hydrochloride] had little effect on the H2O2 response. H2O2 increased the number of stress fibers and disrupted the peripheral band of cultured confluent endothelial cells, changes that were prevented with pretreatment with H7. PKC may mediate the increases in vascular permeability and pulmonary edema that occur in response to H2O2. PMID- 2705545 TI - Whole body autoregulation in conscious areflexic rats during hypoxia and hyperoxia. AB - We have previously shown whole body autoregulation during normoxia in conscious areflexic rats in response to an acute increase and decrease in blood volume. In this study we used this technique to determine the effect of hypoxia and hyperoxia on whole body autoregulation. Rats with an arterial catheter for blood pressure measurement and an electromagnetic flow probe for cardiac output measurement were placed in a chamber with a controlled oxygen environment. Neurohumoral blockade was achieved with chlorisondamine (10 mg/kg), methscopolamine (0.5 mg/kg), captopril (1 mg/kg), and [d(CH2)5Tyr(Me)]arginine vasopressin (10 micrograms/kg). Hemodynamic variables were restored to normal with a constant norepinephrine infusion. Group 1 (n = 7) underwent a 6-min infusion of donor blood (0.9 ml) during hypoxia (Po2 = 52 +/- 3 mmHg) and hyperoxia (Po2 = 296 +/- 12 mmHg). Group 2 (n = 8) was subjected to a 6-min withdrawal of blood (0.9 ml) during hypoxia (72 +/- 2 mmHg) and hyperoxia Po2 = 258 +/- 8 mmHg). The slope of the pressure-flow relationship was used as an index of autoregulation so that a slope of 0 indicated complete autoregulation and a slope of 1 represented no autoregulation. The pressure-flow slopes with volume expansion were 0.54 during hypoxia and 0.15 during hyperoxia, while the slopes with volume contraction were 0.29 during hypoxia and 0.54 during hyperoxia. Thus, when arterial pressure was raised above normal, the autoregulatory capacity was greater during hyperoxia than with hypoxia. Conversely, when arterial pressure was lowered below normal, the autoregulatory capacity was greater during hypoxia than with hyperoxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705546 TI - Inhibition of platelet hemostatic plug formation by trigramin, a novel RGD peptide. AB - Trigramin, a cysteine rich, RGD (Arg-Gly-Asp)-containing peptide from Trimeresurus gramineus snake venom (Mr 7,500) has been previously reported to inhibit fibrinogen binding to ADP-activated platelets and platelet aggregation (disassociation constant 10(-8) M). The present study demonstrates that the infusion of trigramin (17-212 micrograms/100 g body wt) significantly prolonged the bleeding time of severed mesenteric arteries in hamsters (anesthetized with 65 mg/kg pentobarbital), whereas the infusion of RGDS (Arg-Gly-Asp-Ser, 0.45-1.0 mg/100 g body wt) failed to increase the bleeding time in this model. The bleeding time immediately returned to normal after cessation of trigramin infusion. The pattern of the disappearance of 125I-labeled trigramin from the circulation fit a two-compartment model with the half-life for the fast component between 0.7 and 2.0 min and with the half-life for the slow component between 31 and 105 min. It appeared that the kidney and liver are major routes of elimination of trigramin from the circulation. The ability of trigramin to prolong bleeding time, as well as its rapid disappearance from the circulation, indicates that this peptide may be a useful compound to transiently prevent the ability of platelets to form thromboemboli without impairing their long-term hemostatic function. PMID- 2705547 TI - Stenotic amplification of vasoconstriction responses. AB - Based on simple hemodynamic principles, arterial stenoses could accentuate the effects of arterial vasoconstriction by reducing intraluminal pressure. To examine this mechanism we employed an in vitro stenotic carotid artery preparation. Eight carotid arteries, obtained from anesthetized heartworm positive dogs, were isolated and perfused with a physiological salt solution under constant pressure (100 mmHg) and with a fixed distal resistance. After creating an intraluminal stenosis, proximal pressure, distal pressure, and flow were continuously recorded as norepinephrine was incrementally added to the perfusion reservoir. At each norepinephrine concentration, arterial dimensions were recorded on 35-mm film and measured by quantitative dimensional analysis. These data were approximated by a four-parameter logistic equation. The proximal diameter data were considered to represent solely the effects of arterial vasoconstriction, while the stenotic diameter data were considered to be affected both by arterial vasoconstriction and by stenotic pressures. The stenotic diameters shortened significantly more than the proximal diameter (1.2 +/- 2 vs. 0.5 +/- 0.1 mm, P less than 0.01). The shape of the stenotic diameter dose response curve was similar to the distal pressure curve and was significantly (P less than 0.05; - 3.4 +/- 0.7) steeper than the proximal diameter curve (-0.7 +/- 0.1). Furthermore, the half maximum effective doses (ED50) were significantly interrelated for distal pressure and stenotic diameter data and unrelated for proximal diameter data. In five additional experiments, to eliminate the stenotic pressure changes, the flow was maintained constant. Maintaining stenotic vasoconstriction response (0.6 +/- 2 mm). The results of the present study show exaggerated stenotic vasoconstriction caused by a stenotic pressure decrease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705548 TI - Serial study of factors influencing changes in cardiac output during human pregnancy. AB - Serial hemodynamic measurements were performed in 13 women on two occasions before conception and then at monthly intervals throughout pregnancy. Cardiac output (CO) was measured by Doppler and cross-sectional echocardiography at the aortic, pulmonary, and mitral valves. Cardiac chamber size and ventricular function were investigated by M-mode echocardiography. CO increased from a mean of 4.88 l/min before the conception to a maximum of 7.21 l/min at 32 wk, the increase being significant by 5 wk after the last menstrual period. Heart rate and left ventricular performance increased during the first trimester. Heart rate increased further during the second trimester, during which left atrial and left ventricular end-diastolic dimensions increased, suggesting an increase in venous return. Derived values of total peripheral vascular resistance fell during the first 20 wk. These changes were associated with a progressive increase in valve orifice area and left ventricular wall thickness during pregnancy. PMID- 2705549 TI - Reflex control of mesenteric vein diameter and pressure in situ in rabbits. AB - We have directly demonstrated that the mesenteric veins actively constrict and dilate in response to reflex stimuli in the in situ preparation. A segment of small intestine of 23 chloralose-anesthetized rabbits was exposed in a specially designed bath. Small vein diameter and intravenous pressure (575-1,375 microns and 6.2-11.4 mmHg at rest, respectively) of the mesentery were measured continuously at the same site with the use of videomicrometer and micropressure systems during celiac ganglion stimulation (CGS), bilateral carotid occlusion (BCO), and aortic nerve stimulation (ANS). Innervation to the mesenteric vein was evident by a frequency-dependent venoconstriction in response to CGS, which was completely abolished by local application of tetrodotoxin. Vein diameter and intravenous pressure changed from an average of 1,042 +/- 32 to 1,003 +/- 32 microns (-3.8 +/- 0.3%, P less than 0.01) and from 8.1 +/- 0.3 to 9.0 +/- 0.3 mmHg (10.6 +/- 0.8%, P less than 0.01), respectively, during BCO. During ANS, vein diameter increased from 990 +/- 32 to 1,012 +/- 31 microns (2.4 +/- 0.2%, P less than 0.01), and intravenous pressure decreased from 8.5 +/- 0.3 to 7.9 +/- 0.2 mmHg (-6.1 +/- 0.6%, P less than 0.01), respectively. Vein diameter changes of -3.8 and 2.4% corresponded to volume changes of -7.6 and 4.9%, respectively. During BCO, vein diameter decreased while intravenous pressure increased, whereas during ANS vein diameter increased while intravenous pressure decreased. These results indicate that the reflex change in vein diameter is due to an active response. PMID- 2705550 TI - Muscarinic autoreceptors do not modulate kinetics of acetylcholine release in hearts. AB - We determined the time course of the cellular mechanism that mediates the attenuation of the chronotropic response in anesthetized dogs to decreases in the time interval (interpulse interval) between pulses of vagal stimuli. We injected propranolol, cut the cervical vagi, and repetitively stimulated the cardiac segment of the right vagus nerve with one brief burst of electrical pulses during each cardiac cycle. We recorded the initial and steady-state changes in cardiac cycle length that were induced by the phasic vagal stimulation. The decrease in the interpulse interval decreased the initial and steady-state responses. The time delay between the release of acetylcholine (ACh) from the vagal nerve endings in the heart and inhibition of the release of additional ACh was less than 4 ms. Published delays between the time of ACh release and the time of the resulting change in membrane potential, in other biological systems, are 30 12,000 ms. We conclude that the time delay was too brief for muscarinic autoreceptors to have mediated the attenuation of ACh release from postganglionic vagal nerve endings in the heart in response to decreases in interpulse interval. PMID- 2705551 TI - Impedance of arterial system simulated by viscoelastic t tubes terminated in windkessels. AB - An improved asymmetric t-tube model of the arterial system is proposed. The model consists of two viscoelastic tubes of differing lengths, each terminated in a modified windkessel with inductance as well as resistance and compliance. Equations for calculating the input impedance of this model are presented. Using typical data from the literature, the model predicts a more realistic impedance modulus and phase than previous models of the circulation. Parametric analysis shows that when peripheral compliances are altered, sharp peaks in the very low frequency portions of the impedance spectra are produced, whereas alterations of either the characteristic impedances or inductances of the terminations have little effect on input impedance. Alteration of the elasticity or relative lengths of the tubes results in shifts in the positions of the maxima and minima akin to those observed experimentally. Change in the viscosity of the walls or of the blood only affects the fluctuations of the impedance spectra without affecting the positions of the maxima and minima. Thus, with this still simple model, very realistic impedance spectra are obtainable. The model provides more insight than previously proposed models into the individual influence of various parameters of the proximal and peripheral vasculature on central hemodynamics. PMID- 2705552 TI - Capillary tortuosity in rat soleus muscle is not affected by endurance training. AB - The total capillary length available for blood-tissue transfer is determined by the number and orientation of the capillaries. Therefore, whether capillary tortuosity changes with exercise training has important implications for peripheral gas exchange. To determine the effects of exercise training on capillary orientation and capillary length per volume of muscle fiber [Jv(c,f)] female rats were trained by treadmill running (30 m/min, up to 60 min/day, 5 days/wk) for 4 wk. Muscles from control and trained rats were perfusion fixed at sarcomere lengths (l) ranging from 1.59 to 2.15 microns, and morphometric techniques were used to estimate capillary orientation and Jv(c,f). Training increased (P less than 0.05) musculus soleus oxidative capacity 35% [as estimated from citrate synthase activity: 24.7 +/- 1.4 to 34.7 +/- 1.0 (SE) mumol.g-1.min 1], capillary-to-fiber ratio 30% (2.17 +/- 0.06 to 2.83 +/- 0.05), and Jv(c,f) 32% (1,886 +/- 73 to 2,496 +/- 180 mm-2). Capillary tortuosity (as determined from comparisons of transverse and longitudinal sections) was a direct function of l in control and trained rats and contributed 17-73% of capillary length above that estimated from capillary counts on transverse sections. We conclude that capillary tortuosity in m. soleus is unchanged by training. Therefore, Jv(c,f) increases as a consequence of increased capillary number. M. soleus citrate synthase activity is best correlated with Jv(c,f) and not with capillary counts on transverse sections. We hypothesize that training-induced muscle changes of capillary geometry improve O2 delivery to skeletal muscle and may therefore alter the metabolic response (e.g., lactate accumulation) to exercise after training.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705553 TI - Leukocyte effects on microcirculation in artificially perfused rat lungs. AB - Evidence indicates that leukocyte microvascular flow obstructions play an important role in no-reflow phenomena after ischemia and that leukocytes may cause significant disturbances of capillary perfusion in low flow states. In the present study, a cell-free colloid perfusion (20-60 ml.kg-1.min-1) of isolated ventilated rat lungs was interrupted by bolus injections of leukocytes in varying numbers. Leukocyte effects on flow resistance, tracer gas exchange, and micromorphology were evaluated. The vast majority of the infused leukocytes remained trapped in the lungs after repeated infusions regardless of the number of leukocytes given, although leukocyte trapping decreased at the higher flow rates. The functional and morphological analyses showed that the polymorphonuclear granulocytes had a greater tendency than the mononuclear cells to become permanently trapped in the pulmonary capillaries. The tracer gas analyses indicated that the trapped leukocytes were scattered in the alveolar capillary networks and did not cause complete exclusion of flow from the affected alveoli. This was probably due to the anatomy of the pulmonary microvasculature, with its abundancy in interconnecting pathways. PMID- 2705554 TI - Intraocular oxygen tension measured with a fiber-optic sensor in normal and diabetic dogs. AB - A new fiber-optic O2 sensor was used to measure the O2 tension in the living dog eye, and the results were compared with simultaneous O2 tension measurements with polarographic electrodes. The fiber-optic sensor and the polarographic electrodes gave similar readings of anterior chamber O2 tension and gave an identical response to elevation of inspired O2 levels. In the preretinal vitreous, the fiber-optic probe measured the O2 tension 26 +/- 5 mmHg (means +/- SD, n = 5), whereas the polarographic electrode showed 23 +/- 7 mmHg (means +/- SD, n = 5) in the contralateral eyes. Breathing 100% O2 raised the preretinal O2 tension similarly with both systems. Preretinal O2 tension was measured with the fiber optic sensor in seven alloxan diabetic dogs and was 26 +/- 7 mmHg, which is not significantly different from normal dogs. The fiber-optic sensor has some advantages over the polarographic electrodes. The fiber-optic sensor does not consume O2 and is not dependent on the diffusion characteristics of the medium or changes due to stirring or fluid currents. PMID- 2705555 TI - Vascular sensitivity and reactivity to norepinephrine in diabetes mellitus. AB - Vascular sensitivity (VS) and reactivity (VR) of hindquarters, totally isolated from rats made diabetic with 45 mg/kg of streptozotocin (STZ), were determined at 1, 2, 4, 8, and 12 wk post-STZ. Age-matched controls received saline injections and were followed for comparable periods. The hindquarters were perfused at constant flow (8-10 ml/min) with a Tyrode-perfluorocarbon (FC-43)albumin-alpha globulin solution gassed with 95% O2-5% CO2. Tissues were continuously weighed and venous pressure adjusted to maintain an isogravimetric condition. VS and VR were determined from norepinephrine (NE) dose-response curves generated by infusing stock NE (1 mg/ml) at progressively increasing rates (0.004-0.025 ml/min) into a constant tissue perfusion rate (8-10 ml/min) for sufficient time to reach a plateau (2-3 min). Delivered doses ranged from 0.4 to 2.5 micrograms/ml. VR was established as the perfusion pressure reached in response to 2.5 micrograms/ml NE (Pmax). VS was defined as the delivered NE dose that increased perfusion pressure to 50% of Pmax (ED50). VS increased slightly but significantly (P less than 0.01) by 1 wk post-STZ and remained above control throughout the 12-wk post-STZ period. VR also increased significantly (P less than 0.05) by 1 wk post-STZ and remained above control throughout the 12-wk post STZ period. PMID- 2705556 TI - Persistent right coronary flow reserve at low perfusion pressure. AB - To determine whether right coronary (RC) flow reserve persists at perfusion pressures below the apparent autoregulatory range, the RC artery of 18 anesthetized dogs was cannulated and perfused at controlled pressures. RC blood flow (RCBF) fell from 65.3 +/- 6.1 to 33.7 +/- 2.3 ml.min-1.100 g-1 as RC perfusion pressure (RCPP) was reduced from 80 to 40 mmHg. At 40 mmHg, intracoronary adenosine increased RCBF by 97.9 +/- 10.6 ml.min-1.100 g-1 (P less than 0.001). RCBF fell to 9.5 +/- 1.7 ml.min-1.100 g-1 at 20 mmHg, and RCBF did not significantly increase during adenosine, although RC vasodilation was observed in four dogs. Regional right ventricular (RV) blood flows at RCPP of 80 and 40 mmHg were measured by radioactive microsphere technique. Before adenosine infusion, RCBF was distributed uniformly across the RV free wall at normal and low perfusion pressures. During adenosine infusion, blood flow in both regions increased significantly, but the flow reserve was greater in the subendocardial region at both normal and reduced pressures. RV myocardial O2 consumption (MVo2) was decreased significantly at 40 mmHg, however, there was no evidence of ischemia at this pressure, since the RV lactate extraction ratio was normal (n = 8). Thus RV O2 demand fell when RC O2 supply was reduced, although a flow reserve was available. RV MVo2 was restored to normal when right coronary flow reserve was mobilized by adenosine infusion. For RCBF from 65 to 365 ml.min-1.100 g-1, RC venous O2 content rose and RV MVo2 was essentially constant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705557 TI - Effect of long-term tilt on mechanical and electrical properties of rat saphenous vein. AB - Femoral vein pressure in adult male Sprague-Dawley rats kept in specially designed tubelike cages rose immediately from a control value of 2.9 +/- 0.2 (SE) mmHg to a gravity-induced sustained value of 5.9 +/- 0.2 mmHg on initiation of a 2-wk 45 degrees head-up tilt period. Femoral arterial pressure was not altered by tilting. In 2 wk mean external diameter, but not total wall thickness, of in vitro distal saphenous vein segments from tilted rats was increased approximately 30% above that of segments from nontilted controls at each of four successive 5 mmHg intralumenal pressure (IP) increments applied between 0 and 20 mmHg. Consequently, in tilted rats isobaric stress was increased 38% at low and 24% at high IP, whereas incremental distensibility was decreased at mid IP. Vascular smooth muscle (VSM) in tilted rat vein, but not artery, was hyperpolarized relative to controls both in vitro at normal physiological pressures [membrane potential (Em) = -58.2 +/- 0.8 vs. -52.4 +/- 0.8 mV, respectively] and in situ during local neural blockade (Em = -61.3 +/- 2.3 vs. -53.5 +/- 0.5 mV, respectively). The conclusion is that a moderate chronic elevation of IP in a vein results in hyperpolarization of its VSM and an elevation of its total capacity due to an as yet unexplained mechanism of physiological adaptation. PMID- 2705558 TI - alpha-Tocopherol attenuates myocardial membrane-related alterations resulting from ischemia and reperfusion. AB - Myocardial ischemia and reperfusion have been shown to result in damage to the phospholipid components of cardiac myocyte cell membranes as indicated by the tissue accumulation of unesterified fatty acids (UFA). A portion of this damage and subsequent dysfunction may be a consequence of free radical-induced membrane lipid peroxidative events. alpha-Tocopherol, a lipophilic antioxidant, was used in this study as an agent by which the extent of ischemia and reperfusion injury might be decreased. Increasing rat myocardial tissue levels of alpha-tocopherol by 51% was found to attenuate lipid perturbations as determined by the accumulation of tissue UFA in an isolated heart model of global ischemia and reperfusion. Nontreated hearts made ischemic for 25 min with 30 min of reflow had a significantly increased total UFA level of 5,961 +/- 799 nmol/mg protein (P less than 0.05) compared with control perfused hearts containing 3,116 +/- 463 nmol UFA/mg protein and with alpha-tocopherol-treated ischemic and reperfused hearts containing 3,066 +/- 365 nmol UFA/mg protein. Contractile dysfunction, excessive accumulation of tissue calcium, and release of lactate dehydrogenase after ischemia and reperfusion were also reduced, demonstrating protective effects in alpha-tocopherol-treated hearts. Thus alpha-tocopherol proved effective in the attenuation of ischemia and reperfusion damage. These results suggest that reducing lipid alterations may prove beneficial in protecting against membrane damage subsequent to ischemia and reperfusion. PMID- 2705559 TI - Ventrolateral medullary lesions and fastigial cardiovascular response in beagles. AB - These studies were designed to verify that the putative vasomotor center in the rostral ventrolateral medulla (RVLM) contained the outflow paths for the fastigial nucleus (FN) sympathoexcitatory cardiovascular response. If so, then lesions placed by radiofrequency heating (75 degrees C) or application of kainic acid (40 mM) pledgets would reduce or ablate the pressor-tachycardia response after electrical stimulation of FN. Anesthetized beagles (alpha-chloralose, 115 mg/kg) were used in this study to maintain consistency in medullary brain stem anatomy. A ventral brain stem approach exposed the three chemosensitive zones of Mitchell, Schlaefke, and Loeschcke. In other species the intermediate zone and a portion of the rostral zone underlie the Hokfelt C1 cell group and the putative RVLM vasomotor center. Heart rate, arterial and left ventricular (LV) pressures, and maximal rate of pressure development (LV dp/dt) increased 14-84% above control levels in response to stimulating FN 5-10 times the stimulation threshold. The cardiovascular response was abolished in four of six dogs that received bilateral radiofrequency lesions at a depth of 1-2 mm. In five of seven dogs that received kainate surface lesions, the response was substantially reduced but not abolished. These lesions were effective only in the RVLM, above the corresponding intermediate, but not adjacent rostral or caudal chemosensitive areas. The data support the hypotheses of others that an epinphrine-containing cell group in this region is a final common pathway of sympathoexcitation. Expression of the FN cardiovascular response is primarily mediated through this vasomotor region previously identified by others in the rat, cat, rabbit, and primate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705560 TI - Rapid baroreceptor resetting is unaltered by chronic hypertension in rats. AB - This study compares rapid baroreceptor resetting in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Single-fiber baroreceptor activity and aortic diameter were measured in in vitro preparations. Baroreceptor pressure threshold (Pth) and suprathreshold pressure sensitivity were measured during periods after various levels of conditioning mean arterial pressure (cMAP). The ability of a baroreceptor to reset was expressed as the resetting ratio (delta Pth/delta cMAP). Rapid resetting was successfully characterized in 30 baroreceptors (18 SHR and 12 WKY). SHR blood pressures were higher, and aortic distensibility was lower than in WKY. SHR baroreceptors showed signs of chronic resetting, i.e., elevated Pth (105.4 vs. 88.5 mmHg, SHR and WKY, respectively) and decreased suprathreshold sensitivity (0.92 vs. 1.42 spikes.s.-1.mmHg-1, SHR and WKY, respectively), but their resetting ratios were similar to WKY (0.260 and 0.237, SHR and WKY, respectively). Characterization of rapid resetting of more than one baroreceptor from single animals reveals that the resetting ratio can vary by greater than 50% within animals. During simultaneous discharge-diameter recordings, the strain threshold was better correlated to cMAP than Pth. We conclude that the ability of baroreceptors to rapidly reset is unaltered by chronic hypertension or chronic baroreceptor resetting, and we hypothesize that rapid resetting is probably a result of an intrinsic neural property rather than vessel mechanics. PMID- 2705561 TI - Laser-Doppler assessment of brain microcirculation: effect of systemic alterations. AB - There is a need for new technical approaches whereby the cerebral microcirculation can be easily and continuously assessed. The objective of this study was to determine whether laser-Doppler (LD) flowmetry can be utilized to assess changes in cerebral cortical blood flow and to determine whether changes in blood perfusion measured by LD flowmetry correlate with simultaneously measured changes in flow measured by H2 clearance in cats or with changes in pial arteriolar diameter measured with a microscope in rabbits equipped with a closed cranial window. In the rabbit experiments a 0.84-mm-diam LD probe was inserted through a cranial window port, and in the cat experiments the probe was fixed adjacent to the H2 probe. The probe was fixed at a distance of 1-2 mm from the cortical surface, where it and its associated electronics detect changes in blood cell velocity and blood volume within a tissue volume of approximately 1 mm3. Volume and velocity are multiplied to provide a flow signal. When cerebral blood flow in cats was decreased by hyperventilation-induced hypocapnia and increased by norepinephrine-induced hypertension, the percent changes in LD flow and H2 clearance flow changed linearly (r = 0.94, slope = 0.97). When arterial PCO2 was increased from 28 to 48 mmHg in the rabbit experiments, the pial arterioles dilated 19 +/- 4% (mean +/- SE) and LD flow increased by 74 +/- 9%, LD flow changes which would be predicted by a third power relationship of diameter to flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705562 TI - Laser-Doppler assessment of brain microcirculation: effect of local alterations. AB - The objective of this study was to determine whether changes in blood perfusion measured by laser-Doppler (LD) flowmetry correlate with simultaneously measured changes in pial arteriolar diameter after local application of vasoactive agents on the brain surface. A closed cranial window was implanted in anesthetized rabbits. A 0.84-mm-diam LD probe was inserted through one window port and fixed at a distance of 1-2 mm from the cortical surface. The probe detects changes in perfusion within a tissue volume of approximately 1 mm3. The diameter of pial arterioles in the area adjacent to the LD probe was simultaneously measured with a microscope and image-splitting device. Topical application of bradykinin (80 nM to 8 microM), which stimulates the formation of dilator prostaglandins and O2 radicals, induced a dose-dependent arteriolar dilation and increase in LD flow. Topical application of 33 microM 2-chloroadenosine, a stable analogue of adenosine, induced the same degree of pial arteriolar dilation as 8 microM bradykinin but produced a much larger increase in LD flow, probably due to its greater tissue penetration and stability. At 5 min after bradykinin washout the arterioles had nearly returned to their control diameter, whereas LD flow was still increased. Similarly, there was a discrepancy between LD flow and diameter changes after washout of 2-chloroadenosine. We conclude that LD flowmetry is a useful technique for continuous assessment of cortical blood flow in response to topically applied agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705563 TI - Adaptations of carotid arteries of young and mature rabbits to reduced carotid blood flow. AB - Adaptive responses of rabbit common carotid arteries were examined after 70-80% reductions in blood flow produced by ipsilateral external carotid artery ligation. These flow reductions elicited growth inhibition of arterial wall tissue in immature rabbits. Specifically, experimental carotid arteries exhibited DNA levels significantly lower, by 35%, than contralateral control arteries 1 mo after external carotid ligation. Lower elastin contents (38%) were also observed, although collagen contents were not affected. These changes were accompanied by a relative reduction in wall mass of 30% and a 31% reduction in internal diameter. Adult rabbits exhibited decreased internal diameter (21%) after flow reduction, but no significant change in vessel mass or wall constituents was observed. Early diameter reductions were vasoconstrictor in origin, but the vessel functioned as a smaller artery rather than as a partially constricted normal vessel after 1 mo, i.e., both maximally dilated and maximally constricted diameters were reduced. A reduction in endothelial cell number was detected for the narrowed vessels. Manipulation of local flow conditions indicated that the vessels responded to changes in mean blood flow rather than the pulsatile component of flow. PMID- 2705564 TI - Mechanisms behind increased dermal imbibition pressure in acute burn edema. AB - We have measured tissue pressures in excised rat skin subjected to in vitro burn injury and investigated the mechanisms behind the increased imbibition (swelling) pressure in burned skin. Skin pieces wrapped in aluminum paper were immersed into boiling hot water for 10, 30, or 60 s. Dermal imbibition pressure was measured with micropipettes and tissue osmometry as interstitial fluid hydrostatic pressure (Pif) and/or interstitial fluid colloid osmotic pressure (COPif). COPif was also measured in interstitial fluid sampled with intradermal wicks. Control values of Pif (micropipettes) and of COPif (wick fluid) averaged -1.5 mmHg and 17.5 mmHg, respectively. An increase in imbibition pressure was seen after thermal injury. After 10 s of heat exposure, the imbibition pressure gain was mainly due to a strongly negative hydrostatic pressure (Pif mean value -33.3 mmHg). Pif became slightly positive and COPif increasingly negative after longer exposure (mean Pif 0.3 and mean COPif -133 mmHg after 60-s exposure). Collagen degradation and water solubility increased with extension of the heat exposure time. Thermal degradation of collagen seems to be the main mechanism responsible for the generation of increased imbibition pressure. PMID- 2705565 TI - Monophasic action potential recordings in response to graded hyperkalemia in dogs. AB - Recent interest in sudden cardiac death during exercise in normal healthy people has highlighted the possible role of swings of extracellular potassium in arrhythmogenesis in conditions other than ischemia. Regional differences in action potential duration and conduction may be important. We have recorded monophasic action potentials (MAPs) from the endocardium and epicardium in nine open-chest dogs during graded intravenous infusion of potassium up to a plasma level of 9 mM. The animals were anesthetized with alpha-chloralose and urethan. Continuous, online arterial potassium monitoring was employed. MAP duration showed a biphasic response with initial shortening up to 7 mM, which tended to be more obvious on the epicardium. Regional activation time was measured as the difference between the onset of depolarization of the endocardial and epicardial MAP. Regional activation time also showed a biphasic response with initial shortening and subsequent delay. The QRS width of the scalar lead II electrocardiogram also showed biphasic changes, and the T wave amplitude progressively decreased. Our results suggest that regional differences in repolarization time may develop in the nonischemic myocardium in response to increased extracellular potassium levels mainly as a result of local changes in regional activation time rather than as a result of a direct effect on action potential duration. PMID- 2705566 TI - Heart failure depresses endothelium-dependent responses in canine femoral artery. AB - Vascular responses to many physiological stresses are abnormal in heart failure. Increased peripheral resistance and a reduction in the vasodilator response to exercise and ischemia are examples of this abnormal vascular control. Such abnormal vascular control in heart failure is a result of interplay between neural, hormonal, and local vascular factors. This study was designed to test the hypothesis that a specific local mechanism, endothelium-dependent relaxation to acetylcholine (ACh), is depressed in experimental heart failure. Experiments were performed on 11 purebred beagles. Experimental heart failure was induced by rapid ventricular pacing for approximately 30 days. Femoral artery diameter was measured by sonomicrometry, and dose-response relationships to ACh, norepinephrine (NE), and nitroglycerin (NTG) were done before and after inhibition of cyclooxygenase by indomethacin. Heart failure resulted in a significant depression of ACh relaxation at all concentrations. In dogs with heart failure, indomethacin enhanced the dilation response to low concentrations of ACh. Constriction to NE and dilation to NTG were unchanged by heart failure. These data demonstrate that in the canine femoral artery endothelium-dependent dilation to ACh is depressed in experimental heart failure. Depression of endothelium-dependent vasodilation represents one local mechanism for abnormal control of the vasculature in congestive heart failure. PMID- 2705567 TI - Early in reperfusion, leukocytes alter perfused coronary capillarity and vascular resistance. AB - Myocardial no-reflow is a critical consequence of myocardial ischemia-reperfusion (I/R). Recent studies indicate that formed blood elements (e.g., leukocytes and platelets) contribute greatly to the compromise of myocardial blood flow that occurs after I/R. To assess the contributions of leukocytes and platelets to alterations in microvascular perfusion, we measured total coronary vascular resistance and perfused coronary capillary density before and after a 30-min period of no-flow ischemia in isolated rat hearts perfused with either 1) a Krebs albumin-red cell solution [K(2)RBC]; 2) diluted whole blood (DWB) with Krebs (1:1); or 3) leukocyte-free DWB (LFB). We found that hearts perfused with K(2)RBC before ischemia demonstrated a significant decrease in perfused capillarity ( 25%, P less than 0.05) after 25 min of reperfusion. Hearts perfused with LFB before ischemia exhibited a similar decrease in perfused capillarity (-33%, P less than 0.05) during reperfusion. However, in the DWB-perfused hearts, there was a 62% decrease in perfused capillarity (-62%, P less than 0.01) during reperfusion. Moreover, during reperfusion, total coronary vascular resistance was elevated significantly (+76%, P less than 0.01) in the DWB-perfused hearts but not in either the K(2)RBC or LFB groups. These results indicate that 1) platelets do not play a major role in alterations of microvascular perfusion after ischemia; 2) leukocytes are not requisite for the development of microvascular no reflow early in reperfusion but their presence further exacerbates this deleterious effect; and 3) a relationship exists between perfused capillarity and vascular resistance in the isolated rat heart after global ischemia. PMID- 2705568 TI - Semiparametric approach to pharmacokinetic-pharmacodynamic data. AB - A semiparametric model for analysis of pharmacokinetic (PK) and pharmacodynamic (PD) data arising from non-steady-state experiments is presented. The model describes time lag between drug concentration in a sampling compartment, e.g., venous blood (Cv), and drug effect (E). If drug concentration at the effect site (Ce) equilibrates with arterial blood concentration (Ca) slower than with Cv, a non-steady-state experiment yields E vs. Cv data describing a counterclockwise hysteresis loop. If Ce equilibrates with Ca faster than with Cv, clockwise hysteresis is observed. To model hysteresis, a parametric model is proposed linking (unobserved) Ca to Cv with elimination rate constant kappa ov and also linking Ca to Ce with elimination rate constant kappa oe. When kappa oe is greater than (or less than) kappa ov clockwise (or counterclockwise) hysteresis occurs. Given kappa oe and kappa ov, numerical (constrained) deconvolution is used to obtain the disposition function of the arterial compartment (Ha), and convolution is used to calculate Ce given Ha. The values of kappa oe and kappa ov are chosen to collapse the hysteresis loops to single curves representing the Ce E (steady-state) concentration-response curve. Simulations, and an application to real data, are reported. PMID- 2705569 TI - Molecular mechanisms of osmosis. AB - Osmosis across a semipermeable membrane is usually treated in terms of thermodynamics, but the equations for osmosis can also be derived from kinetic considerations. Since fewer solvent molecules bombard the semipermeable membrane from the solution side, a kinetic pressure difference (osmotic potential) is generated into pore openings. Intermolecular forces cancel each other and do not affect the osmotic potential. On the other hand, osmotic flow is dependent on intermolecular cohesive forces permitting the generation of large negative pressures in the membrane pores. Osmosis is therefore a unique property of liquids, whereas intermolecular cohesive forces do not affect diffusion. Osmotic pressure up to 180 atm can be correctly determined from the reduction in saturated vapor pressure above the solution because osmotic pressure and reduction in vapor pressure to some extent are analogous phenomena. Osmotic pressures up to 180 atm may also be correctly determined from kinetic considerations by accounting for binding between solvent and solute molecules (4 5 water molecules per solute molecule for sucrose solutions). PMID- 2705570 TI - Rumen volume, saliva flow rate, and systemic fluid homeostasis in dehydrated cattle. AB - This work was carried out to test the hypothesis that the high level of salivary secretion containing much Na+ and the volume of fluid sequestered in the foregut of ruminants play an important part in water and Na+ homeostasis. Saliva flow and composition and water and Na+ balance in the rumen have been measured in hydrated and dehydrated cows with esophageal fistulas. Reduction of voluntary feed intake in beef cattle during water deprivation was related to the stage of dehydration. Salivary secretion rate was linearly related to voluntary feed intake (r = 0.96) and inversely and linearly related to plasma osmolality (r = 0.88). The reduction in the volume of water stored in the rumen contributed to the major portion (55%) of the total water loss. Utilization of gut water attenuated the rise in blood plasma osmolality, and this may be connected with an animal's ability to continue eating despite dehydration. PMID- 2705571 TI - Role of rumen and saliva in the homeostatic response to rehydration in cattle. AB - It has been shown recently that the circulation created by the continuous secretion of voluminous amounts of saliva rich in Na+ to the large store of fluid sequestered in the rumen and its reabsorption from the gut is an integral part of water and Na+ homeostasis in cattle. The role of this system in water and Na+ restitution following acute dehydration and rapid rehydration was studied. Cattle were able to withstand dehydration of 18% of their initial mass and to replenish their water losses in one drinking. The water imbibed was first retained in the rumen and slowly released. Rapid expansion (or dilution) of their blood as a result of large influxes of hypotonic water from the rumen was prevented by a parallel increase in the secretion of hypotonic saliva. The accelerated saliva secretion refluxed back to the rumen almost half of the water absorbed. Saliva electrolyte concentration varied simultaneously with an increase or decrease in saliva flow. Na+, HCO3-, HPO3-, and pH were inversely related to saliva flow rate while Cl and K+ were positively related. It seems that visceral afferent response was involved in activation of salivary flow rate. PMID- 2705572 TI - Swallowing reflex elicited by water and taste solutions in humans. AB - We investigated whether water and taste solutions are adequate stimuli for elicitation of the swallowing reflex from the pharyngolaryngeal region in humans. Subjects were five healthy males. Small amounts of water and taste solutions were applied to the posterior tongue of the subject as he reclined on a dental chair. The latency between the onset of application of the stimuli and the occurrence of swallowing was measured. Water was a most effective stimulus for elicitation of the swallowing reflex. The stimulatory effect was altered by anions, particularly Cl-, added to the water. Gustatory factors affected the latency of swallowing. The results suggest that humans have water-sensitive receptors in the pharyngolaryngeal region and that these receptors are responsible for initiation of the swallowing reflex by water. PMID- 2705573 TI - Blood pressure responses to cyclic blood volume changes in awake and anesthetized dogs. AB - A dynamic analysis of blood pressure regulation was performed in conscious and anesthetized dogs. The mean arterial pressure (MAP) responses to 5 and 10% sinusoidal changes in total blood volume with cycle lengths of 1, 4, and 8 min were measured in anesthetized 1) control dogs, 2) carotid and vagal baroreflex (CVB)-denervated animals, and 3) spinal-ablated dogs; in addition, the MAP responses to 10% sinusoidal blood volume changes with cycle lengths ranging from 0.25 to 8 min were measured in conscious control and CVB-denervated dogs. The presence of the baroreflexes in both the conscious and anesthetized control dogs essentially eliminated MAP excursions during the cyclic volume changes. The MAP changes in both the conscious and anesthetized denervated dogs were large. However, the responses in the anesthetized denervated dogs were linear, stationary, and cycle-length insensitive with respect to the sinusoidal forcing function, whereas the responses in the conscious CVB-denervated dogs were nonlinear, nonstationary, and cycle-length dependent. These results indicate that the cardiovascular system in the anesthetized CVB-denervated and spinal-ablated dogs is passive or "hydraulic" in nature; conversely, factors other than the carotid and vagal baroreflexes appear to exist that alter the arterial pressure responses to cyclic blood volume perturbations in the conscious CVB-denervated dogs. PMID- 2705574 TI - Glomerular filtration rate in conscious unrestrained starlings under dehydration. AB - Glomerular filtration rate (GFR) was measured in conscious unrestrained starlings, Sturnis vulgaris. Alzet osmotic minipumps were inserted into the peritoneal cavity under lidocaine local anesthesia and served to infuse the GFR marker [14C]sodium ferrocyanide. GFR was measured in hydrated birds and again after a 24-h period of water deprivation. GFR in dehydrated birds was 1.15 +/- 0.09 ml.min-1.kg-1, significantly lower (P less than 0.001) than the 2.71 +/- 0.31 ml.min-1.kg-1 in fully hydrated animals. In addition, the GFR of the hydrated birds was significantly lower (P less than 0.01) than values of 4.43 +/- 0.24 ml.min-1.kg-1 measured in hydrated anesthetized birds during micropuncture studies. A 24-h period of water deprivation caused significant increases in plasma osmolality and concentration of sodium, chloride, and phosphate. The osmolality and concentrations of calcium, magnesium, and phosphate were significantly elevated in both cloacal urine supernatant and in ureteral urine of dehydrated birds. In both hydrated and dehydrated states, the concentration of magnesium, phosphate, potassium, and total osmolality were significantly higher in cloacal urine than in ureteral urine. PMID- 2705575 TI - Flow dynamics of the crocodilian heart. AB - We report for the first time the flow events corresponding to the pressure patterns in the left and right aorta (LAo and RAo) during the cardiac cycle in the caiman (Caiman crocodylus ssp). These experiments show a complex LAo flow pattern; an initial small anterograde flow in the early systole is reversed to a backflow at midsystole. At the end of systole there is again a small anterograde flow. This second flow pulse corresponds to a pressure peak ("foramen spike") in the LAo pressure trace. The observed pattern is compatible with the view that the foramen Panizzae is obstructed by the medial cusp of the RAo valve during part of the systole. LAo pressure remains normally above right ventricular pressure throughout the cardiac cycle and there is thus no contribution to LAo flow from the right ventricle. The net flow in the LAo normally equals the flow through the foramen Panizzae and is very small compared with the systemic flow in the RAo. PMID- 2705576 TI - Effects of exercise-rest cycles on energy balance in rats. AB - The present study investigated the nutritional energetics of rats exercised either intermittently or continually. Male rats were divided into three groups: a sedentary group, an intermittently trained group, and a continually trained group. Continually trained rats were exercised every day for a period of 8 wk. Over the same period, intermittently trained rats were exercised for 4 wk, each week being followed by a week of rest. Rats were trained on a rodent treadmill at a moderate intensity. Carcasses were analyzed for energy, fat, and protein contents. Brown adipose tissue (BAT) thermogenesis was assessed by measuring mitochondrial guanosine 5'-diphosphate binding. Energy intake was lower in both intermittently and continually trained rats than in sedentary animals. The weight, fat, and protein gains were, in continually trained rats, significantly lower than in sedentary animals. Similarly, intermittently trained rats had lower gains than sedentary animals, although the difference between the two groups was not as marked as the difference between sedentary and continually trained animals. Energy expenditure, which represents the difference between energy intake and energy gain, was less than sedentary controls in both intermittently and continually trained rats. The low expenditure in trained groups did not, however, relate to changes in facultative BAT thermogenesis.A low energy expenditure on components such as basal metabolic rate and obligatory diet induced thermogenesis would most likely account for the difference in expenditure between sedentary and trained rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705577 TI - Osmotic thresholds for AVP release with the use of plasma and urine AVP and free water clearance. AB - Eleven hydrated normal subjects were infused with hypertonic saline so that plasma osmolalities (POsmol) ranged from 280 to 306 mosmol/kg. Linear relationships were calculated between POsmol and plasma and urine arginine vasopressin (AVP) in the 11 individual subjects. There was an excellent linear correlation between POsmol and plasma and urine AVP, with the latter as concentration or rate of excretion. The highest correlation coefficient occurred when urine AVP was expressed as microunits of AVP per 100 milliliters of glomerular filtrate. The smallest coefficient of variation of the slopes occurred when urine AVP was expressed as microunits of AVP per minute. The osmotic thresholds obtained by abscissal intercepts from relating POsmol to urine AVP per minute or per 100 milliliters of glomerular filtrate were 285.9 and 285.5 mosmol/kg, respectively. These values did not differ from the mean osmotic threshold obtained by traditional free water clearance changes (285.8 mosmol/kg). Analysis of the relationship between plasma osmolality and plasma AVP resulted in the greatest variation in slope and osmotic threshold, with the latter being significantly lower than that obtained by free water clearance changes. The data also demonstrated a much more rapid rise of urine than of plasma AVP under the stated conditions of osmotic stimulation. PMID- 2705578 TI - Regulation of VO2 in red muscle: do current biochemical hypotheses fit in vivo data? AB - Observations used to test biochemical models of the regulation of O2 consumption (VO2) by cytosolic phosphate energy state must include a change in intracellular pH and/or a change in the adenine nucleotide or phosphate pools [Connett, R. J. Analysis of metabolic control: new insights using a scaled creatine kinase model. Am. J. Physiol. 254 (Regulatory Integrative Comp. Physiol. 23): R949-R959, 1988]. Data were collected over a wide range of energy turnover from canine muscles in situ. Intracellular PO2, glycolytic intermediates, adenine nucleotides, creatine, phosphocreatine (PCr), phosphate, and intracellular pH were determined for each muscle. PO2 was used to eliminate muscles in which VO2 could have been O2 limited (PO2 less than 0.5 Torr). This removed an important source of heterogeneity. Because adenine nucleotide and phosphate pools were constant relative to the creatine pool, discrimination among models depended solely on pH. The observed pH range from 7.2 to 5.9 did not permit separation of [PCr] from log[( ATP4-]/[ADP3 ][H2PO4-]) (phosphorylation potential) as a regulatory parameter for VO2. However, [ADP] could be eliminated as an independent regulator. Because 90% of variability in VO2 was accounted for by phosphate energetics, an independent redox component must be small when intracellular PO2 greater than 0.5 Torr. PMID- 2705579 TI - Gluconeogenesis in perfused livers from dexamethasone-treated chickens. AB - Gluconeogenesis was studied in hemoglobin-free perfused livers from chickens that had received daily injections of dexamethasone sulfate for 5 days. Dexamethasone increased to approximately 160% the level of plasma glucose and doubled the content of hepatic glycogen in fed chickens. In the isolated perfused livers from chickens starved for 48 h after the last dexamethasone injection, the rates of production of glucose from lactate decreased by approximately 30% and biphasic changes in glucose production from fructose proceeded in parallel with biphasic changes in the production of lactate and pyruvate. Quinolinate had no effect on gluconeogenesis in both groups. NH4Cl markedly inhibited the production of glucose from pyruvate-lactate mixtures in dexamethasone-treated chickens but stimulated in controls. Aminooxyacetate reversed the effects of NH4Cl in dexamethasone-treated chickens. The data presented provide evidence indicating that the reaction of mitochondrial alanine aminotransferase plays an important role in the regulation of the hepatic gluconeogenesis in dexamethasone-treated chickens. PMID- 2705580 TI - Fish muscle energy metabolism measured by in vivo 31P-NMR during anoxia and recovery. AB - By means of in vivo 31P nuclear magnetic resonance (NMR) we measured energy stores and intracellular pH at 10-min intervals in the myotome of unanesthetized carp and goldfish before, during, and after a period of anoxia (1 h for carp and 4 h for goldfish). The fish were mounted in a modified bioprobe, and their gills were irrigated with a constant flow of aerated or anoxic water. Anoxia caused a steep decline of phosphocreatine and intracellular pH in carp muscle. After the phosphocreatine stores had been exhausted by greater than 85%, [ATP] fell, whereas IMP and phosphodiesters accumulated. In goldfish muscle, initial changes followed the same pattern, but after 20 min a steady state of high-energy phosphates was reached and the development of acidosis was dampened. The resistance of goldfish to anoxia is due to metabolic suppression and a switch from lactate to ethanol and CO2 as the anaerobic end products. In both species, recovery was complete within 3 h. The fast pH recovery seems to be mainly caused by H+ and lactic acid efflux. PMID- 2705581 TI - Renal denervation alters forebrain hexokinase activity in neurogenic hypertensive rats. AB - The effect of afferent renal nerve transection (tARN) on the metabolic activity of forebrain structures the activity of which was altered after aortic depressor nerve transection (tADN) was studied using the hexokinase (HK) histochemical method in the rat. In tADN-sham (s) ARN rats, increases in HK activity were observed in the medial septum (MS), median preoptic nucleus (MnPO), subfornical organ, supraoptic nucleus, nucleus circularis (Nc), magnocellular, and dorsal and medial (mpPVH) parvocellular components of paraventricular nucleus, the anterior, lateral, and dorsomedial (DMH) hypothalamus, and in the central and medial nuclei of the amygdala. In addition, a decrease in HK activity was seen in the dorsal arcuate nucleus (dArc). Similarly, increases in HK activity were seen in sADN tARN rats in all the above structures except MS, Nc, and DMH, where no changes were observed, and dArc, where an increase in HK activity was noted. The bed nucleus of the stria terminalis, lateral preoptic nucleus (POA), and ventral (v) Arc also showed elevated HK activity. In contrast, the increased HK activity after either tADN or tARN alone was returned to levels not different from sADN sARN rats in all structures in the tADN-tARN rats, except MnPO, mpPVH, and dArc, where the level of HK activity was only attenuated, and MS, POA, and vArc, where it remained elevated. These data suggest that similar forebrain structure are associated with the hypertension after tADN and are involved in the integration of ARN information and that these sites of interaction are involved in the maintenance and the reversal of the neurogenic hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705582 TI - Body weight of rats following area postrema ablation: effect of early force feeding. AB - This study examined the effect of intragastric force-feeding of a milk diet on body weights of rats with lesions of the area postrema/caudal medial nucleus of the solitary tract (AP/cmNTS). Force-feeding was conducted over the first 10 days after the ablation. Body weight was monitored both during and after force feeding. Food intake was measured during all ad libitum feeding periods. During force-feeding, rats with AP/cmNTS lesions gained weight at the same rate as force fed sham-lesioned rats or sham-lesioned rats that voluntarily ingested an equal amount of the milk. When returned to ad libitum feeding, lesioned rats that had been force-fed were not hypophagic and did not lose weight. Body weights of such rats remained above those of lesioned rats that were not force-fed and similar to those of nonlesioned rats throughout this study. Despite their normal weights, preliminary analysis indicated that body fat of the force-fed lesioned rats may have been reduced. These findings suggest that the effects of AP/cmNTS ablation are multiple and that reduction of body weight need not be the primary effect of such lesions. PMID- 2705583 TI - Beat-to-beat regulation of left ventricular function in the intact cardiovascular system. AB - A variety of regulatory mechanisms have evolved to control the heart's pump function because the cardiovascular system must continually adapt to the changing demands that body functions place on it. This regulation takes place through many physiological systems; however, fine adjustments in cardiac pumping probably require adaptations more quickly than external control mechanisms (such as the autonomic nervous system) can compensate. Thus cardiac pumping is also regulated by mechanisms intrinsic to the heart. To better understand these intrinsic control mechanisms, we studied the beat-to-beat response of left ventricular function to continually varying changes in loading conditions produced by transiently occluding the pulmonary artery, venae cavae, and aorta. We used multiple linear regression to identify and quantify the important beat-to-beat determinants of left ventricular systolic function, quantified as stroke work. We could not adequately explain or predict beat-to-beat changes in stroke work with traditional determinants of ventricular function, preload, afterload, and heart rate, because a large systematic error remains after taking these traditional determinants of function into account. To eliminate this systematic error, we had to include some function of previous beat stroke volume and end-systolic size and pressure. This additional information significantly improved both our ability to model the observed transient changes in left ventricular stroke work and to predict additional observations that were not used to develop our model. We conclude that previous beat contraction history is an important determinant of left ventricular function and implies an important regulatory mechanism whereby the left ventricle can fine tune its function from beat to beat in response to continually changing loading conditions. PMID- 2705584 TI - Capillary and mitochondrial unit in muscles of a large lizard. AB - We asked whether capillaries and mitochondria form a structural and functional unit in the musculature of the Cuban iguana (Cyclura nubila) similar to that found in mammals. We found a significant correlation between capillary length density [Jv(c, f)] and mitochondrial volume density [Vv(mt, f)] of the musculature with a slope that revealed that on average 3.5 km of capillaries were associated with each milliliter of mitochondria (vs. approximately 11 km/ml in mammals). These capillaries had a diameter of 9 microns (vs. 4.5 microns in mammals), and the mitochondria had a surface density of the inner membranes of 25 m2/ml (vs. 30-45 m2/ml in mammals). These dimensions resulted in ratios of capillary to mitochondrial volume (0.22 ml/ml) and capillary wall to mitochondrial membrane surface area (39 cm2/m2) that were similar in Cyclura to those found in mammals (approximately 0.18 ml/ml and 35-52 cm2/m2, respectively). Also in agreement with mammalian values were the average oxidative capacity of the mitochondria derived from maximum rate of O2 consumption (VO2max) during exercise at 37 degrees C and the inner mitochondrial membrane surface area [S(im)] of the musculature [VO2max/S(im) = 0.04 vs. 0.06-0.15 ml O2.m-2.min-1 in mammals]. These common structural and functional relationships support the notion that capillaries and mitochondria represent a similar fundamental unit in muscles of both Cyclura and mammals. PMID- 2705585 TI - Age sensitivity of osmoregulation and of its neural correlates in Aplysia. AB - Osmoregulation was studied in the marine mollusc Aplysia californica in young, mature, and old adults. To monitor volume and osmoregulation, we measured body weight, hemolymph osmolality, and chloride concentration. These parameters were measured at regular intervals with animals in 90% artificial seawater (90% ASW) for up to 36 h. They showed that the rates at which Aplysia osmo- and volume regulate were significantly slowed with increased age. However, no age effect was found in osmoregulation when the hemolymph was diluted to 90% of control in animals without an external stress, i.e., by injection of distilled H2O and keeping animals in 100% ASW. Because the dilution bypassed the sensory receptors that detect external changes of osmolality, this finding suggested that the slowed osmoregulation involved age-impaired functioning of the neural pathway mediating osmoregulation. Other evidence was from mature adults whose osmoreceptive organ, the osphradium, was lesioned; they mimicked osmoregulation measured in old adults. In preparations containing a portion of the osmoregulatory pathway, the osphradium was stimulated by 90% ASW, and the responsiveness of neuron R15, which putatively regulates antidiuresis, was tested. The stimulus inhibited spiking in R15 from mature adults but not in R15 from old adults or from osphradiallesioned mature ones. In old Aplysia the refractoriness of R15 to osphradial stimulation demonstrated that the effecacy of the pathway was impaired with increased age; it helped explain the slower rate of osmoregulation. Possible changes of osmoregulatory mechanisms and behavior compensating for the age sensitivity of osmoregulation are discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705586 TI - Fluoridation then and now. PMID- 2705587 TI - Improving cause-of-death statistics. PMID- 2705588 TI - Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, NY. AB - A study was undertaken in New York State to determine the changes in dental fluorosis prevalence from 1955 to 1986 in fluoridated Newburgh and non fluoridated Kingston children. The frequency and severity of dental fluorosis among 884 7-14-year-old children were measured by two dentists utilizing Dean's Index. Data regarding residential and fluoride history were obtained from the parents of participants. Among the Newburgh residents, the prevalence of dental fluorosis (very mild to moderate) varied from a low of 5 per cent for the 9-10 year-old group to a high of 9.4 per cent for 11-12-year-olds. Except for the 13 14-year-old group, children in non-fluoridated Kingston had the lowest dental fluorosis prevalence rates. A comparison of Dean's Community Fluorosis Indices to the 1955 baseline data obtained from studies conducted after 10 years of fluoridation in Newburgh revealed no changes of consequence among Newburgh residents. However, the changes are apparent for Kingston residents, indicating the availability of fluorides in non-fluoridated areas. The increased risk for dental fluorosis for Kingston residents appears to be from the use of fluoride tablets. An analysis of dental caries data revealed that caries prevalence declined substantially in both fluoridated and non-fluoridated areas. PMID- 2705589 TI - Survey of cause-of-death query criteria used by state vital statistics programs in the US and the efficacy of the criteria used by the Oregon Vital Statistics Program. AB - A survey of the 52 vital statistics registration areas in the United States revealed that at least 23 did not fulfill the minimum cause-of-death query guidelines recommended by the National Center for Health Statistics. The Oregon Center for Health Statistics is one of only a few that query certifying physicians at a comprehensive level. During August 1986-July 1987, a total of 2,453 of 23,238 death certificates were returned to the certifiers for additional information, not including those returned in a tobacco use study. More than one half (56.1 per cent) resulted in new and more specific underlying cause-of-death data. Only 5.2 per cent of the queries were unanswered. One probable result of Oregon's program is that the state has the highest percentage of liver cirrhosis and disease deaths attributed to alcohol abuse in the United States. Nationally, 41.7 per cent of all liver disease and cirrhosis deaths in 1984 were listed as due to alcohol compared to 82.4 per cent in Oregon. The state's total liver cirrhosis and disease death rate (12.0 per 100,000 population) is only marginally higher than the United States rate (11.6). The query program also serves to locate maternal deaths that would otherwise not be reported, as well as to provide more accurate cause-of-death statistics in general. PMID- 2705590 TI - Two variants of coronary atherosclerosis in six populations. AB - Coronary arteries and aortas obtained at autopsy in six populations were examined microscopically. Two variants of atherosclerosis could be separately quantified by objective morphometry. These two variants, fibroplasia and atheronecrosis, were both found to increase with age and to correlate with each other from one autopsy to the next after age adjustment. Despite the correlation of these two variables among individuals, the measures of fibroplasia and atheronecrosis did not correlate with each other across population groupings. A positive correlation of this kind between some populations was canceled by an inverse correlation between other populations. For example, Manila was the population with the greatest intimal fibroplasia in the coronary arteries at each age, and Sao Paulo was among those with the least intimal fibroplasia. Nevertheless, Sao Paulo showed the greatest tendency toward atheronecrosis, while Manila was among the populations with the least tendency toward atheronecrosis. The possibility arises, therefore, that the subjects from Sao Paulo were exposed to a different assortment of etiologic agents than were the subjects from Manila, and that their arteries, therefore, manifested a different kind of atherosclerosis. PMID- 2705591 TI - Hypertension in Israeli adolescents: prevalence according to weight, sex and parental origin. AB - We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (greater than 140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (greater than 90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of each weight group ranged between 1.5-2.3 per cent. PMID- 2705592 TI - Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience. AB - To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results. PMID- 2705593 TI - Multiple program participation: comparison of nutrition and food assistance program benefits with food costs in Boston, Massachusetts. AB - The values of government cash and food assistance benefits are compared to estimated food costs in Boston for households whose sole source of income is Aid to Families with Dependent Children (AFDC) and who have housing in the private sector. Methods developed by the General Accounting Office (GAO) in 1978 are replicated. GAO found that the value of combined benefits can exceed the cost of the United States Department of Agriculture's Thrifty Food Plan. Key assumptions underlying GAO's methodology are challenged, and an alternate method is applied. The new results contradict GAO's conclusions and suggest that Boston food costs exceed the combined value of benefits that AFDC households may receive, although participation in multiple food assistance programs is more beneficial than receipt of benefits from single programs. The authors conclude that food stamps and AFDC benefits indexed to actual costs of living are needed to meet the food needs of low-income families in Boston. PMID- 2705594 TI - Fatal violence among spouses in the United States, 1976-85. AB - In this paper we examine patterns and trends in homicides between marriage partners in the United States for 1976 through 1985 using data from the Federal Bureau of Investigation's Supplemental Homicide Reports (FBI-SHR). We identified 16,595 spouse homicides accounting for 8.8 per cent of all homicides reported to the FBI-SHR during this 10-year period. The rate of spouse homicide for this 10 year period was 1.6 per 100,000 married persons. The risk of being killed by one's spouse was 1.3 times greater for wives than for husbands. Black husbands were at greater risk of spouse homicide victimization than Black wives or White spouses of either sex. The risk of victimization was greater for spouses in interracial than in intraracial marriages and increased as age differences between spouses increased. From 1976 through 1985, the risk of spouse homicide declined by more than 45.0 per cent for both Black husbands and wives but remained relatively stable for White husbands and wives. Demographic patterns in the risk of spouse homicide were similar to those reported for nonfatal spouse abuse suggesting that the causes of spouse homicide and nonfatal spouse abuse may be similar. PMID- 2705595 TI - A comparison of gestational age reporting methods based on physician estimate and date of last normal menses from fetal death reports. AB - Utilizing 10,587 cases from the 1980 National Center for Health Statistics Fetal Death Statistics File, we examined the comparability of two methods of determining the gestational age of a fetal death, the calculated interval from date of last normal menses (DLNM) and the physician's estimate. The physician estimated gestational age distribution exhibits even number digit preference and a distinct clustering at the 40-week value. The DLNM distribution appears more smoothly distributed but with a more pronounced post-term tail. An exact agreement between the two methods is observed in only 27.9 per cent of the cases. A 1.7 week mean difference between the methods indicates a systematic underestimation by physician reported gestational age when compared to that calculated from the DLNM, potentially biasing gestational age distributions when the physician estimate is substituted for cases with a missing DLNM. Over 8 per cent of cases 20+ weeks by DLNM are estimated as less than 20 weeks by the physician. This underestimation has important implications for the completeness of reporting of fetal deaths on vital records and the comparability of fetal death rates. Further, it may limit investigations of the completeness of reporting of less than 500 gram live births. PMID- 2705596 TI - Variations in the reporting of gestational age at induced termination of pregnancy. AB - Utilizing the 1980 Induced Abortion File maintained by the National Center for Health Statistics, we compared gestational age from date of last normal menses and the physician-based estimate of gestational age. An average .51 week difference between the two methods was observed. Beyond seven weeks gestation, the date of last normal menses value was underestimated by the physician-based estimate with a markedly greater divergence after 20 weeks. A relatively greater underestimation of the date of last normal menses interval by the physician estimate was apparent for Whites after 13 weeks. The data of last normal menses value for non-state residents was overestimated across the entire range of the date of last normal menses gestational age distribution until 21 weeks. PMID- 2705597 TI - The effect of occupational, marital and parental roles on mortality: the Alameda County Study. AB - This study investigated the impact of combining marital, parental, and occupational roles upon 18-year risk of mortality from all causes. The respondents were 3,700 participants in the Human Population Laboratory cohort ages 35-64 who completed a comprehensive health and psychosocial questionnaire in 1965 and were followed for mortality status through 1982. Employment status and type of employment were not found to predict mortality risk among women. Contrary to the multiple roles hypothesis, there was virtually no impact upon mortality of increasing numbers of children among employed women, except possibly among single working parents. The major impact of children was felt by housewives who had significantly elevated risks when a child was present in the home or when they had four or more children. Neither the number of children nor the presence of a child in the home affected mortality risk of men. Controlling for a variety of factors thought to be related to mortality in a logistic regression analysis did not change the foregoing relation. PMID- 2705598 TI - The relationship of park maintenance and accessibility to dogs to the presence of Toxocara spp. ova in the soil. AB - Three parks in St. Joseph/Benton Harbor, Michigan were examined for the presence of Toxocara spp. ova in the soil. Nineteen per cent (22/114) of the samples contained ova, and mean density (eggs/5 g soil) was 0.73. The density of two samples, collected at the base of playground equipment in one park, was greater than 2.1, which is considered sufficient for human infection. Subjective assessments of park maintenance and accessibility to dogs were not good indicators of the presence of Toxocara spp. ova. PMID- 2705599 TI - American Indian youth and drugs, 1976-87: a continuing problem. AB - Continuing surveillance of drug use among American Indian adolescents living on reservations shows them to have rates of use higher than those of their non Indian counterparts. Marijuana use is particularly high among Indian students. By the 7th grade a significant number of Indian youth have tried drugs, particularly marijuana and alcohol, and there are few significant differences by gender. Based on observed patterns of use, intervention strategies need to begin in the elementary school years and target both males and females equally. PMID- 2705600 TI - Family physicians' views of chiropractors: hostile or hospitable? AB - Family physicians in the State of Washington were surveyed about their knowledge and views about chiropractors; 79 per cent (476) responded. Sixty-six per cent indicated discomfort with what they believed chiropractors do while acknowledging their effectiveness for some patients; 25 per cent viewed chiropractors as an excellent source of care for some musculoskeletal problems and only 3 per cent dismissed chiropractors as quacks that patients should avoid; 57 per cent admitted having encouraged patients to see a chiropractor. These views are less negative than those of organized medicine. PMID- 2705601 TI - Increasing response rates in physicians' mail surveys: an experimental study. AB - It is becoming increasingly difficult to obtain high response rates in physicians' mail surveys. In 1983-84, we tested the effectiveness of two techniques among 604 Quebec physicians who had not responded to an initial letter. A handwritten thank you note at the bottom of the letter accompanying the questionnaire and a more personalized mailout package increased response rates by 40.7 per cent and 53.1 per cent, respectively, compared to control groups. PMID- 2705602 TI - How free care improved vision in the health insurance experiment. AB - We studied reasons for the improvement in the functional vision of enrollees receiving free care in the Rand Health Insurance Experiment. Among low income enrollees, 78 per cent on the free plan and 59 per cent on the cost-sharing plans had an eye examination; the proportions of those obtaining lenses were 30 per cent and 20 per cent, respectively. Visual acuity outcomes of low income vs non poor enrollees were more adversely affected by enrollment in cost-sharing plans. Free care resulted in improved vision by increasing the frequency of eye examinations and lens purchases. PMID- 2705603 TI - Reflections on curative health care in Nicaragua. AB - Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. PMID- 2705604 TI - Combating nutrition quackery: the San Bernardino County experience. PMID- 2705605 TI - Estrogen use and gallstone disease. PMID- 2705606 TI - Recent reduction in male urethritis in France. PMID- 2705607 TI - On specialization in nursing: toward a new empowerment. PMID- 2705608 TI - Anaesthesia and intensive care. PMID- 2705609 TI - Tracheal dilatation followed by stenosis in Mounier-Kuhn syndrome. A case report. AB - A patient with previously undiagnosed Mounier-Kuhn syndrome (tracheobronchomegaly) was admitted with a head injury after a fall. The trachea was intubated with an oral tracheal tube with high-volume low-pressure cuff. The intracuff pressure was within the normal safe range recommended by the manufacturer. However, the patient developed tracheal dilatation on the second day after intubation. The trachea was extubated on the 15th day, and it was noticed 48 hours later that the patient was developing a tracheal stenosis at the site of the previous dilatation. The stenosis was so severe that the patient underwent resection-anastomosis surgery of his stenotic tracheal segment 2 months after extubation. It may be preferable in patients with Mounier-Kuhn syndrome who require mechanical ventilation to intubate the trachea with an uncuffed tube and to pack the throat to decrease the chances of gas leak and inhalation. PMID- 2705610 TI - Laryngeal anaesthesia with aspiration following intubation. AB - Two patients who had undergone emergency tracheal intubation developed signs of aspiration of ingested food. Nasendoscopy demonstrated supraglottic anaesthesia which recovered from the laryngeal margins in towards the vocal cords. It is assumed that this was caused by a neuropraxia of the internal branch of the superior laryngeal nerve, presumably as a result of trauma related to intubation. PMID- 2705611 TI - Obstructive sleep apnoea. AB - A patient with obstructive sleep apnoea is described, who required admission to an intensive care unit on two separate occasions within 2 months. The first admission was after anaesthesia for operation on the upper airway. The second occurred after a relative overdose of an opioid analgesic was administered. The diagnosis, treatment and anaesthetic management of patients with this syndrome are discussed. PMID- 2705612 TI - Characteristics of the Pharmaseal continuous flushing device. AB - Pharmaseal continuous flushing devices were tested with regard to flow characteristics into simulated arterial and venous pressure systems. Two driving pressures were used and it was found that variation in driving pressure made a significant difference to the flow, while arterial or venous pressure made no significant difference. The flow devices had a wide variation although they were all of the same type. The fluid volume delivered was in the region of 100 ml in a 24-hour period. PMID- 2705613 TI - Death on the table. Some thoughts on how to handle an anaesthetic-related death. AB - This describes one way to handle the aftermath of anaesthetic catastrophe. The techniques of how to share bad news, interview relatives, complete official forms, deal with the legal process and debrief colleagues are outlined. It is hoped that this article will promote discussion on this topic and improve communication with all those affected by mishaps in the operating suite. PMID- 2705614 TI - Obstetric anaesthetic workload in a teaching unit. AB - The distribution of obstetric anaesthetic work through the day was examined. Workload audit and prediction are discussed with their relevance to service and training. PMID- 2705615 TI - Blood pressure response of neonates to tracheal intubation. PMID- 2705616 TI - Replacing analgesic nitrous oxide with a dangerous alternative. PMID- 2705617 TI - Skills in basic life support. PMID- 2705619 TI - Anxiety and informed consent. PMID- 2705618 TI - Midazolam, hypotension and neurological sequelae. PMID- 2705620 TI - Body temperature during cardiopulmonary bypass. PMID- 2705621 TI - Accidental femoral nerve block during local anaesthesia for inguinal hernia repair. PMID- 2705622 TI - Anaesthesia for emergency caesarean section using the brain laryngeal airway. PMID- 2705623 TI - A narrow escape from epidural anaesthesia? PMID- 2705624 TI - A modified coaxial system for use with a circle absorption system. PMID- 2705625 TI - A benefit of clinical trials. PMID- 2705626 TI - Subarachnoid spread or injection? PMID- 2705627 TI - Pyrexia and epidural blood patch. PMID- 2705628 TI - Kinking of a Seldinger wire. PMID- 2705629 TI - Patient-controlled analgesia: the need for caution. PMID- 2705630 TI - Pulse oximeters and finger nails. PMID- 2705631 TI - Effect of intermittent pneumatic compression on lower limb skin perfusion. AB - Transcutaneous oxygen (tcPO2) and carbon dioxide (tcPCO2) measurements were used before, during, and after intermittent pneumatic compression (IPC) to assess lower limb skin perfusion in 21 healthy adult volunteers and 23 elderly patients. The temperature of the sensors was set at 44 degrees C during calibration and maintained throughout all tests. Resting tcPO2 was significantly lower (p less than 0.01) in patients than in controls. In all subjects tcPO2 decreased and tcPCO2 increased during compression. Patients showed a highly significant increase (p less than 0.001) in tcPCO2 during and after the treatment. Results of this study indicate that the symptomatic improvement, in peripheral vascular disease and wound healing following IPC, is not due to improved skin perfusion or enhancement of oxygenation and CO2 removal. PMID- 2705632 TI - Effects of 3-glucosaminoglycan sulfate on hemorheologic parameters in hyperlipidemic peripheral vascular disease (PVD) patients: a preliminary double blind crossover study. AB - The effects of 3-glucosaminoglycan sulfate on lipids and the hemorheologic parameters were observed in a preliminary double-blind crossover study in 30 hyperlipidemic peripheral vascular disease (PVD) patients. Parenteral administration of the test drug was associated with a reduction in serum lipids, especially in triglyceride levels, and a lowering of fibrinogen, plasma viscosity, and whole blood viscosity levels. These effects justify the drug's use in the treatment of PVD, especially when associated with hypertriglyceridemia and hemorheologic disturbances. PMID- 2705634 TI - Risk factors in alcoholic cardiomyopathy. AB - Although a relationship has been suggested between abstinence from alcohol and improvement in left ventricular (LV) function, no long-term studies in large groups of patients have been done to confirm this impression or to demonstrate an effect on survival. To address these questions, the authors analyzed the outcome in 105 male patients with alcoholic cardiomyopathy and 64 control male patients with nonalcoholic dilated cardiomyopathy. Survival data were available for all patients. The correlates of survival were assessed via the Cox proportional hazards model. Variables considered were age, race, drinking pattern (current drinker versus former drinker), presence of coronary artery disease (CAD), hypertension, and diabetes, and these echo variables: left atrial (LA) size, posterior wall thickness, LV end diastolic dimension (LVDD), minimal E point septal separation, wall motion, presence of incomplete mitral leaflet closure (IMLC) or low cardiac output, and the ratio of relative wall thickness to LVDD. The two study groups were comparable with respect to all echocardiographic variables. At a mean follow-up of 17.2 months +/- 12.1 months, 42.85% of the alcoholics and 41% of the nonalcoholics had died. Nonsurvival in the alcoholic group was significantly associated with only two factors: an increased LVDD and the presence of IMLC. The drinking pattern was not significantly associated with survival. By contrast, in the nonalcoholics,the variables most closely related to survival were LVDD, low cardiac output, increasing age, and abnormal wall motion. Therefore: (1) the risk factors in alcoholic and nonalcoholic cardiomyopathy are similar although IMLC appears to be a relatively specific prognostic factor for alcoholic cardiomyopathy and (2) abstinence from alcohol does not appear to improve survival. PMID- 2705633 TI - Reducing hypertriglyceridemia in elderly patients with cerebrovascular disease stabilizes or improves cognition and cerebral perfusion. AB - Effects of lowering serum triglyceride levels were investigated among 44 elderly hypertriglyceridemic patients with risk factors for stroke, reduced cerebral perfusion, and a history compatible with symptomatic occlusive cerebrovascular disease. Patients were randomly assigned to either treatment with gemfibrozil, a lipid-lowering agent, or control conditions. Subjects in both groups were instructed to follow a diet recommended for lowering serum lipid levels, while the treatment group was additionally administered 600 mg daily of gemfibrozil. Subjects assigned to the treatment group (n = 22) showed significant reductions in serum triglyceride levels (p less than .0005). Control subjects (n = 22) did not show any significant changes in serum triglyceride levels. There were also no significant changes in total cholesterol levels in either group. Analyses of values for mean bihemispheric gray matter cerebral blood flow measured by the xenon 133 inhalation method and cognitive scores tested by the Cognitive Capacity Screening Examination indicated that gemfibrozil-treated patients maintained significantly higher levels of cerebral perfusion and cognitive performance than untreated controls did. Regression analyses for different treatment intervals indicated that both cerebral blood flow and cognition showed linear improvements that correlated directly with the duration of treatment. Lowering triglyceride levels in hyperlipidemic subjects appears to benefit cerebral perfusion and cognitive performance after four to six months. PMID- 2705635 TI - Can patients with chest pain and normal coronary arteries be discriminated from those with coronary artery disease prior to coronary angiography? AB - To determine whether the precatheterization clinical data in patients with chest pain could be used to discriminate patients with normal coronary arteries (NCA) from those with coronary artery disease, the authors compared 125 consecutive patients with less than 30% stenosis of all major coronary arteries and 125 patients with greater than 60% stenosis of one or more major coronary arteries. Clinical characteristics that occurred more frequently in patients with NCA were: nonexertional pain, pain to the left of the sternum, sharp pain, associated palpitations, absence of typical relief with sublingual nitroglycerin, pain commencing less than one week or more than ten years prior to coronary angiography, a normal electrocardiogram, and negative results from a treadmill stress test or from thallium scintigraphy. However, none of these clinical features, either singly or in combination, could be used to identify the patients with NCA with certainty. PMID- 2705636 TI - Testing crossover studies for carryover effects. AB - For the study of cardiovascular disease, for instance, hypertension and angina pectoris, properly designed crossover studies are to be preferred over parallel design studies. Many statisticians now propose that these studies should always be tested for carryover effects. In the present paper the author analyzes the crossover studies published after November, 1985, in two general and two specialist journals (New England Journal of Medicine, Lancet, Angiology, British Heart Journal). Of 73 papers only 23 (32%) consider the possibility of carryover effects. Of these latter papers 12 (16%) perform statistical tests for these effects. The results of these tests were shown in only 7 papers (10%). It is concluded that there is a discrepancy between the statistical recommendations and the data presented in the literature. PMID- 2705637 TI - Mechanical, biochemical, and structural effects of vitamin D deficiency on the chick heart. AB - The effects of vitamin D deprivation on the chick heart were investigated from three aspects: cardiac contractility (+/- dP/dT), intracellular high-energy phosphorus compounds, and structural differences. Four-week-old vitamin D deficient chicks were divided into four groups: Group A served as the normal group and received subcutaneous injections of cholecalciferol; Groups B and C were vitamin D-deficient hearts but perfused differently; Group D received daily subcutaneous injections of 5 micrograms of 1,25(OH)2D3. When the isolated spontaneously beating hearts (modified Langendorff preparation) were perfused with Krebs-Henseleit (KH) solution containing a calcium concentration of 2.5mM, the myocardial contractility of the vitamin D-deficient hearts was significantly increased when compared with group A. After the isolated heart had beaten for one hour, the myocardial contractility in the vitamin D-deficient hearts was found to decline to significantly lower values. Presacrifice administration of 1,25(OH)2D3 improved cardiac performance. Vitamin D deficiency resulted in an enhanced rate of decline of the intracellular high-energy phosphorus compounds. No differences were found in the microscopic study. These observations suggest that vitamin D has a role in cardiac function. PMID- 2705638 TI - Acute total occlusion of the left main coronary artery associated with long-term survival--a case report. AB - The occurrence of total occlusion of the left main coronary artery (LMCA) is rare. Prognosis with complete LMCA occlusion is generally considered poor and essentially depends on the rate of obstruction and the extent of collateral circulation. The authors report a case of long-term survival after complete occlusion of the left main coronary artery without prior development of collateral circulation. PMID- 2705639 TI - Myocardial infarction caused by blunt chest injury: possible mechanisms involved- case reports. AB - Two cases are reported in which blunt chest trauma caused myocardial infarction. Coronary angiography revealed apical aneurysms in both patients with normal coronary arteries in the first and total occlusion of left anterior descending artery in the other. The main possible mechanisms of myocardial infarction after blunt chest trauma are discussed. PMID- 2705640 TI - Catheter embolization from implanted venous access devices: case reports. AB - Two cases of catheter embolization from implanted venous access devices are reported and the available literature is reviewed. The catheter from an implanted venous access device migrated into the right heart after slippage of the O-ring, which attaches the catheter to the infusion port. The distal 6 cm of an infusion port catheter embolized to the right heart after spontaneous fracture of the catheter at the point where it passed between the clavicle and first rib. Both catheters were removed percutaneously without complication. Risk factors for embolization were apparent on x-ray films with evidence of O-ring slippage in 1 case an obvious kinking of the catheter in the other. Symptoms of embolization included chest discomfort, right upper quadrant pain, and nausea. In 1 case, an extra heart sound, initially thought to be an S3, disappeared when the catheter was removed. PMID- 2705641 TI - Quinapril--a new angiotensin-converting enzyme inhibitor: an overview. PMID- 2705642 TI - The role of angiotensin-converting enzyme inhibitors in the therapy of cardiovascular disease: an overview. PMID- 2705643 TI - The clinical pharmacokinetics of quinapril. AB - Quinapril (Q) and quinaprilat (QT) pharmacokinetics are dose proportional following single oral 2.5- to 80-mg Q doses. Q absorption and hydrolysis to QT is rapid with peak Q and QT concentrations occurring one and two hours postdose, respectively. Peak plasma QT concentrations were approximately fourfold higher than those of Q (923 vs 207 ng/mL following 40-mg Q). Dose-proportional QT area under the curve and dose-independent percent of dose excreted in urine as QT demonstrate that the extent of Q conversion to QT is constant over the dose range studied. Q and QT were eliminated from plasma with apparent half-lives of 0.8 and 1.9 hours and apparent plasma clearances of 1,850 and 220 mL/min, respectively, over the 2.5- to 80-mg dose range. Following oral 14C-Q, 61% and 37% of radiolabel was recovered in urine and feces, respectively. Q plus QT accounted for 46% of radioactivity circulating in plasma and 56% of that excreted in urine. Metabolism to compounds other than QT is not extensive. Two diketopiperazine metabolites of Q have been identified in plasma and urine, with approximately 6% of an administered dose excreted in urine as each of these metabolites. Peak plasma concentrations of these metabolites are similar to that of Q, and each is eliminated rapidly with a half-life of approximately one hour. Urinary excretion profiles indicate the presence of other minor metabolites. In summary, the absorption of Q and conversion to QT is rapid and dose-proportional, subsequent clearance of both Q and QT is independent of dose, and metabolism to compounds other than QT is not extensive. PMID- 2705644 TI - Preliminary hemodynamic report of the efficacy and safety of quinapril in acute and chronic treatment of patients with congestive heart failure. AB - A two-part hemodynamic trial of the efficacy and safety of quinapril hydrochloride was conducted in 26 patients with congestive heart failure (NYHA Class III or IV) who had not optimally responded to treatment with diuretics and digitalis. A total of 25 patients had evaluable data after receiving single doses (2.5, 5, or 10 mg) of quinapril. Following acute dosing, favorable hemodynamic changes began within thirty minutes to one hour and usually reached a maximum within four hours post-dose. Nineteen evaluable patients who had responded to acute therapy received an additional sixteen weeks of chronic treatment with quinapril in individualized dosage regimens. Hemodynamic responses did not differ markedly between acute and chronic therapy. Favorable hemodynamic responses were maintained or enhanced following chronic doses of 5 to 30 mg/day (given either once daily or in divided doses). The most frequent doses were 10-15 mg/day in divided doses. The mean maximum percent changes in four primary hemodynamic parameters after chronic dosing (compared with baseline) were: mean arterial blood pressure, -3.9%; pulmonary capillary wedge pressure, -39.7%; cardiac output, +31.7%; and systemic vascular resistance, -25.2%. Changes in heart rate and mean arterial blood pressure did not result in clinically significant bradycardia or hypotention. Overall, quinapril produced both acute and sustained beneficial hemodynamic effects in patients whose congestive heart failure was not clinically controlled with diuretics and digitalis. PMID- 2705645 TI - Mapping the cerebral blood vessels with high-field MRI: technical and anatomic review. AB - The technical background and quality of images obtained upon studying the cerebral circulation with high-field MRI are reviewed. Fifty studies were selected as representative of normal cerebral blood vessels to illustrate the anatomic information derived from the review. MRI appears to be a safe, easy, and reliable method of imaging the cerebral circulation noninvasively. PMID- 2705646 TI - Exercise first-pass radionuclide assessment of left and right ventricular function and valvular regurgitation in symptomatic mitral valve prolapse. AB - The changes in right ventricular (RV) and left ventricular (LV) function and in regurgitant fractions on first-pass exercise radionuclide angiography (RNA) were assessed in 29 consecutive patients with symptomatic mitral valve prolapse (MVP). The mean right ventricular ejection fraction (RVEF) was 35 +/- 8% at rest and 46 +/- 15% after exercise (p less than 0.001). The mean left ventricular ejection fraction (LVEF) was 62 +/- 11% at rest and 74 +/- 13% after exercise (p less than 0.001). Seven of 29 patients had an abnormal RV response and 6 had an abnormal LV response. Eight had abnormal wall motion after exercise. A total of 12/29 patients (41%) had one or more abnormalities. The mean left-sided regurgitant fraction before exercise was 27 +/- 17% in 21/29 patients (72%) and 31 +/- 21% after exercise (p = ns). An additional 5 patients (17%) developed left-sided regurgitation after exercise. These findings indicate that wall motion abnormalities and abnormal RVEF and LVEF responses to exercise occur in symptomatic MVP patients. In addition, 26/29 (89.6%) had left-sided regurgitation after exercise. Since the presence of a murmur did not correlate with the presence of mitral regurgitation by RNA, then symptomatic patients with MVP should have first-pass exercise RNA to assess the presence of regurgitation at rest and after exercise. Antibiotic prophylaxis is recommended in MVP patients with systolic murmurs or with regurgitation. Since patients without murmurs can have regurgitation, further study is necessary to determine the need for endocarditis prophylaxis in these patients. PMID- 2705647 TI - Effect of nifedipine on the sick sinus syndrome. AB - The effect of nifedipine (N) on sinus node (SN) function was studied in 15 patients (9 males, 6 females) sixty-two to seventy-six (mean 68.1 +/- 11) years old, with sick sinus syndrome (SSS). SSS was characterized electrophysiologically by a prolonged corrected sinus node recovery time (CSNRT greater than 535 msec) and/or prolonged sinoatrial conduction time (SACT greater than 125 msec), assessed by applying premature atrial stimulation. Ten mg N was given sublingually, and CSNRT and SACT were again evaluated sixty minutes after N administration, and again ten minutes after 1.5 mg atropine (A) was given IV. Heart rate increased significantly after N (p less than 0.005), systolic blood pressure (SBP) diminished significantly (p less than 0.005), and CSNRT and SACT shortened significantly (p less than 0.005, p less than 0.005) and became normal in 7 and 5 patients respectively. After A administration, a further significant increase of heart rate (p less than 0.005) and decrease of CSNRT (p less than 0.005) and SACT (p less than 0.005) were observed. CSNRT and SACT became normal in 8 and 7 patients respectively. SBP remained stable. PMID- 2705648 TI - Individually controlled aspirin in the long-term treatment of patients with chronic arterial diseases. AB - A simple method of measuring the biological effect of acetylsalicylic acid (ASA), based on the determination of the disaggregation rate (DR) of platelet aggregation induced by adenosine diphosphate (ADP), is described. The DR was found to correlate with the inhibition of the production of malondialdehyde (MDA) by platelets (r = 0.66, P less than 0.001). Therefore, the DR was used for laboratory monitoring of the ASA effect. The study included 63 arteriosclerotic patients--patients with ischemic heart disease (IHD), peripheral arterial disease (PAD), or cerebrovascular insufficiency (CVI) -- who were analyzed before treatment and after receiving ASA in an individually controlled dosage. Before treatment the authors found an increased level of MDA and a longer euglobulin clot lysis time in patients when compared with healthy volunteers (n = 16). Extremely different doses of ASA were required to normalize initially elevated MDA levels in patients. Normalization of the MDA level corresponds to a DR of at least 50% (in comparison with 0-13% without treatment). When judging the ASA dose individually from the 50% DR, the authors demonstrated that there were no differences in the levels of cyclooxygenase- and lipoxygenase-derived eicosanoids between healthy volunteers (n = 16) and arteriosclerotic patients receiving 100 250 mg (n = 18), 500 mg (n = 17), or 750-1500 mg ASA per day (n = 6). Thus, their results support the idea of using individually controlled ASA as the most promising way of resolving the "aspirin dilemma" and provide a simple and reproducible method of measuring the biological effect of ASA. PMID- 2705649 TI - Increased production of oxygen free radicals by polymorphonuclear leukocytes in heart failure due to aortic stenosis. AB - Oxygen free radicals have been linked to a wide variety of cellular damage in biological systems. Polymorphonuclear (PMN) leukocytes stimulation is one of the known sources for oxygen free radicals. It has been suggested that oxygen free radicals depress the excitation-contraction coupling in cardiac muscle. It is possible that a decrease in the myocardial contractility in heart failure might be due to an increased oxygen-free-radical-producing activity of PMN leukocytes. The authors studied, therefore, the release of oxygen free radicals, as measured by luminol-dependent chemiluminescence activity, from the PMN leukocytes in dogs with heart failure due to aortic stenosis. Hemodynamics and phagocytic activity of PMN leukocytes were studied in 6 control dogs and 6 dogs with aortic stenosis of six to nine months' duration. There was a significant decrease in the index of myocardial contractility and an increase in the left ventricular end-diastolic pressure in dogs with aortic stenosis, suggesting left ventricular failure in these dogs. Although there was a tendency for a decrease in the cardiac index in dogs with aortic stenosis, the decrease was not significant. Phagocytic activity of PMN leukocytes in blood was studied in control dogs and dogs with aortic stenosis. Phagocytosis was initiated by addition of opsonized zymosan and chemiluminescence was monitored by use of a luminometer. The peak chemiluminescence activity of the PMN leukocytes in blood of dogs with heart failure was about threefold greater than that in the blood from control dogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705650 TI - The natural history of unexpected Doppler mitral regurgitation. AB - It is common for patients to be diagnosed as having valvular regurgitation by Doppler echo when no such murmur has been heard by the referring clinician. To test the hypothesis that such patients have clinically unimportant heart disease, the authors evaluated the records of 213 consecutive men in whom mitral regurgitation had been found by pulsed Doppler. In 95 patients (group I) mitral regurgitation was audible, whereas in the other 118, it was not. In 97 patients with inaudible mitral regurgitation there were no structural mitral valve abnormalities by 2D echo. This group of 97 patients (group II) was defined as having unexpected Doppler mitral regurgitation. In group II patients there was a high prevalence of hypertension (50%), congestive heart failure (44%), alcohol abuse (46%), diabetes (27%), coronary artery disease (63%), and atrial fibrillation (13%). The following variables were distributed similarly in groups I and II: survival time, age, presence of congestive heart failure or coronary artery disease, left ventricular short-axis end diastolic and end systolic dimensions, E point septal separation, and the severity of dyssynergy. Atrial fibrillation was more common in group I (p = 0.017), and group I patients had a higher Quetelet's Index (weight/height squared) (p = 0.03). In group II, the factors most closely related to survival were the presence of dyssynergy, of atrial fibrillation, or of congestive heart failure. Although no group II patient had endocarditis or required mitral valve replacement, their survival was markedly decreased compared with people of similar age in the general population. The majority of cardiogenic deaths in group II patients were due to coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705651 TI - Hemodynamic benefits of atrial ventricular sequential pacing in complete heart block and left ventricular failure: case study. AB - The authors describe 2 cases of insertion of atrial ventricular (AV) sequential pacemakers and their hemodynamic benefits. PMID- 2705652 TI - Nonbacterial thrombotic endocarditis complicating mitral valve prolapse presenting as Parinaud's syndrome--a case report. AB - Nonbacterial thrombotic endocarditis is the most common form of endocarditis found at autopsy. Systemic embolization may complicate this condition in patients with mitral valve prolapse. The authors report a case of mitral valve prolapse and nonbacterial thrombotic endocarditis in which the presenting feature was Parinaud's syndrome. PMID- 2705653 TI - Phlegmasia cerulea dolens and its association with hypercoagulable states: case reports. AB - Six patients who developed phlegmasia cerulea dolens are described. All patients had associated hypercoagulable states: heparin-induced thrombocytopenia (2 patients), congenital deficiency of protein C (1 patient), and antithrombin III deficiency (3 patients). Their clinical course and management are discussed. Previous reports have failed to show a definite correlation between phlegmasia cerulea dolens and hypercoagulable states because of an unavailability of appropriate diagnostic techniques. Phlegmasia cerulea dolens is a life- and limb threatening complication. An appreciation of underlying hypercoagulable states is essential to proper management, prophylaxis, and treatment of this disorder. PMID- 2705654 TI - Chronic abdominal pain, lymphopenia, and hypogammaglobulinemia in a 9-year-old female. PMID- 2705655 TI - Facial swelling secondary to inhaled bronchodilator abuse: catecholamine-induced sialadenosis. AB - A patient with asthma presented with a history of recurrent episodes of facial swelling. The swelling occurred in the preauricular area and extended to the angle of the jaw. The patient attributed these episodes to a "food allergy" as they occurred during or immediately following meals. The only medication the patient was using was inhaled epinephrine (Primatene MistR), two puffs, ten to twenty times a day. Subsequent evaluation revealed that the patient had sarcoidosis. Differential diagnosis of the facial swelling included food-related angioedema, sarcoid parotitis, or catecholamine-induced sialadenosis, which is a rare complication associated with excessive catecholamine administration. A gallium-67 citrate scan demonstrated abnormal pulmonary and hilar uptake of the radiotracer, but not lacrimal or parotid gland uptake, strongly arguing against sarcoidosis as the cause of the facial swelling. Episodes of swelling completely abated when the patient stopped using the epinephrine inhalers. At 5 months of follow-up she has had two recurrent episodes of facial swelling, each time associated with the use of inhaled epinephrine. Thus this patient's facial swelling most likely represents catecholamine-induced sialadenosis. This adverse drug reaction, associated with excessive use of inhaled catecholamines must be kept in mind in patients who abuse inhaled beta-adrenergic agonists and report parotid swelling. PMID- 2705656 TI - The role of a documented allergic profile as a risk factor for radiographic contrast media reaction. AB - To determine the relevance of a documented allergic profile as a predisposing factor in radiographic contrast media (RCM) reaction, we investigated its incidence among 100 subjects who underwent RCM studies. Fifty of these subjects reacted to RCM (reactors) and 50 were non-reactors (controls). All 100 subjects completed an allergy questionnaire, allergy skin testing, and in vitro assay to common allergens. Sixty-eight percent of reactors and 30% of controls had a positive history of allergy/hypersensitivity (P less than .001). Fifty-six percent of reactors and 24% of controls had positive skin test (P less than .005). These data suggest that allergic individuals are at twice the risk for developing adverse RCM reaction as compared with non-atopic subjects. PMID- 2705657 TI - Basidiospore identification. AB - Basidiospores are a significant component of the airspora and have been implicated in both allergic rhinitis and asthma. Identification of these spores is hindered by the lack of available reference material. The preparation of reference slides from local specimens is necessary. Collecting procedures and a simple method for making permanent reference slides are presented. PMID- 2705658 TI - Mortality versus improvement in severe chronic asthma: physiologic and psychologic factors. AB - Improved outcome (1 to 10 years) of 140 asthmatic children retrospectively correlated with 8 of 49 variables in admission evaluation: (1) age of onset, (2) IgE, (3) night/early AM bronchospasm, (4) aggression, (5) severely disrupted family circumstances, (6) severe psychopathology, (7) psychotic signs, and (8) I.Q. Patients with fatal outcome (6% to 12%) deviated in the last three variables; most were 12.1 to 16.5 years, male, Black/Hispanic, aggressive, depressed and/or anxious. Clinical implications include high-risk identification on the basis of psychologic and physiologic variables, preventative measures, and consideration of residential treatment. PMID- 2705659 TI - Anaphylactic reactions to a cow's milk whey protein hydrolysate (Alfa-Re, Nestle) in infants with cow's milk allergy. AB - It has been shown in an animal model that cow's milk (CM) protein hydrolysates do not elicit an antibody response to CM proteins and do not induce passive cutaneous anaphylaxis. In addition, babies fed with these formulae during the first months of life do not show antibodies to betalactoglobulin (BLG). These data suggest that these hydrolysates are not antigenic, therefore they have been employed as CM substitutes for the management of infants with CM allergy (CMA). We report five exclusively breast fed infants aged 3 to 8 months (median age = 5 mo) with IgE-mediated CMA, who experienced allergic reactions when they were first fed (median age = 5 months) with a small amount of CM whey protein hydrolysate (Alfa-Re, Nestle). Family history was positive for atopy in 3/5 babies. All infants had atopic dermatitis during breastfeeding, positive skin tests, and RAST to CM proteins as well as to Alfa-Re. Total IgE levels ranged from 45 to 2,990 U/mL. These data show that Alfa-Re, a CM whey protein trypsin hydrolysate, can trigger severe allergic reactions in children with CMA and it should be employed with great caution as a CM substitute in the management of CMA. PMID- 2705660 TI - Inadequate parental understanding of asthma medications. AB - The parents of 128 children with asthma were interviewed about their knowledge of asthma medications. Simple understanding of the modes of action of these drugs was present in only 42.2% (for beta 2-agonists), 12.1% (methylxanthines), 11.7% (cromoglycate), 0% (inhaled corticosteroids), and 3.6% (oral corticosteroids) of parents. Simple understanding of when to use these drugs was present in 13.4% (beta 2-agonists), 4% (methylxanthines), 50% (cromoglycate), 47.1% (inhaled corticosteroids), and 0% (oral corticosteroids). Some understanding of the side effects was observed in 51.6% (beta 2-agonists), 40.4% (methylxanthines), 10% (cromoglycate), 5.9% (inhaled corticosteroids), and 25% (oral corticosteroids). Poor parental knowledge about the pharmacology of asthma was underlined by the inclusion of antibiotics, antihistamines, and decongestants as medications used in asthma. This study also uncovered the continuing misuse of compound methylxanthine preparations and non-selective sympathomimetics in a small percentage of patients. PMID- 2705661 TI - Effect of pollen immunotherapy on food hypersensitivity in children with birch pollinosis. AB - Of 72 children with severe rhinoconjunctivitis due to birch pollinosis, 67 (93%) reported sensitivity against nuts, apples, etc. The hayfever symptoms improved by immunotherapy but neither subcutaneous (n = 42) nor oral (n = 14) immunotherapy with birch pollen allergen preparations made the food sensitivity decrease significantly more than the placebo oral immunotherapy (n = 16). PMID- 2705662 TI - Regional distribution of deaths from asthma. AB - Data from the National Center for Health Statistics indicate rates of death from asthma at 5-34 years of age in the USA in 1980 were .166 per 100,000 general population for whites and .914 for blacks. Rates for blacks were higher in the Northeast (1.313) and North Central Region (1.179) than in the West (.905) and South (.659). The rate for whites was higher in the West (.263) than in the Northeast (.180), South (.149), or North Central Region (.108). During 1981-84 rates remained higher for blacks in the Northeast and North Central Regions than other regions and higher for whites in the West than elsewhere. Most deaths from asthma at 5-34 years of age from 1979-84 in the USA occurred at hospitals (70% of blacks, 77% of whites for the 40 states reporting this detail on death certificates). Rates of discharge from hospitals after admission for the treatment of asthma at 5-34 years of age have also been much higher for blacks than for whites from 1979-86. These rates have been highest in the Northeast and North Central Region for both blacks and whites. Accordingly, neither failure to reach a hospital nor lack of hospitalization can account for regional and racial differences in asthma mortality rates. Median household incomes have been lower for blacks than whites, and unemployment rates have been higher for blacks than whites. From 1980-84 unemployment rates for blacks were highest in the North Central Region. Economic factors may account in part for racial and regional differences in mortality from asthma. PMID- 2705663 TI - Immunotherapy with dog and cat allergen preparations in dog-sensitive and cat sensitive asthmatics. AB - Standardized dog and cat allergen preparations with defined allergen composition were used for immunotherapy (IT) in dog-sensitive and/or cat-sensitive adult patients. Seventeen patients completed 1 year of IT. Eleven patients were treated with dog allergen, five with cat allergen, and one with both dog and cat allergen. The treatment was well tolerated, with increased subjective tolerance. After 3 months of IT there was a significant decrease in conjunctival (p less than .05) and skin sensitivity (p less than .05). Specific IgE decreased significantly within 1 year as assayed by RAST and IgE-crossed radioimmunoelectrophoresis. Specific IgG increased in all patients. The results indicate that IT with potent and standardized dog and cat allergens influence the sensitivity to these allergens. PMID- 2705664 TI - Theophylline: Primary or Tertiary Drug? A Brief Review. PMID- 2705665 TI - The effect of norepinephrine versus epinephrine on myocardial hemodynamics during CPR. AB - Alpha-adrenergic agonists improve myocardial blood flow during CPR by increasing aortic diastolic pressure. Adrenergic agonists with beta-2 properties may enhance peripheral vasodilation and may prove less beneficial during CPR. The purpose of this study was to compare epinephrine (E), an alpha-1,2; beta-1,2 agonist, versus norepinephrine, an alpha-1,2; beta-1 agonist, on myocardial hemodynamics during CPR. Twenty swine were instrumented for pressure, arterial and coronary sinus oxygen content (CAO2 and CCSO2, respectively), and myocardial blood flow measurements using tracer microspheres. CAO2, CCSO2, myocardial blood flow, myocardial oxygen delivery (MDO2) and myocardial oxygen consumption (MVO2), extraction ratio, and aortic diastolic pressure were determined during normal sinus rhythm and during CPR following a ten-minute arrest. After three minutes of CPR, the animals were allocated to receive either norepinephrine 0.08 mg/kg (n = 5), norepinephrine 0.12 mg/kg (n = 5), norepinephrine 0.16 mg/kg (n = 5), or epinephrine 0.20 mg/kg (n = 5). One minute after drug administration, all hemodynamic parameters were again determined. Three and one half minutes after drug administration defibrillation was attempted. A Newman-Keuls multiple comparison procedure was used to compare differences following drug administration. During CPR, aortic diastolic pressure averaged less than 13 mm Hg, and myocardial blood flow averaged less than 6 mL/min/100 g. All doses of norepinephrine and epinephrine improved all hemodynamic parameters over those seen during CPR. The two highest doses of norepinephrine significantly improved extraction ratio compared with norepinephrine 0.08 mg/kg (P = .04).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705666 TI - Evaluation of blood-warming devices with the apparent thermal clearance. AB - Hypothermia (less than 35 C) associated with massive transfusions is a serious clinical problem. Maintenance of normal temperatures in this setting is essential and requires the use of rapid and efficient blood-warming devices. The optimal design of such units should include a low priming volume, large heat transfer area, low pressure drop, the ability to operate at high flow rates, and the capability of warming blood from 4 to 32 C, or higher, without untoward effects. We have previously formulated a theoretic model for blood warmers and described a measure of the intrinsic efficiency of these devices, the apparent thermal clearance (VT,cl). In this study, we tested four different types of commercially available blood warmers (the single-coil immersion heater; the single-channel dry wall electric heater; the multichannel countercurrent heat exchanger; and the single-channel, countercurrent heat exchanger) and determined the apparent thermal clearance values using saline and packed red blood cells. The results indicate that only the single-channel countercurrent unit is efficient enough to meet the established requirements. The apparent thermal clearance provides a useful and rigorous means for comparing and evaluating blood-warming devices. PMID- 2705667 TI - Comparative efficacy of chlorpromazine and meperidine with dimenhydrinate in migraine headache. AB - Approximately 20% of the population suffers from migraine headache, and a significant number develop "fixed" migraines, refractory to oral medications. Of this group, many become habitual narcotic users. A previously published case series using IV chlorpromazine suggested efficacy, so a randomized, double-blind, controlled trial was conducted. The study compared IV chlorpromazine against IV meperidine with dimenhydrinate. Entry criteria were emergency department patients from 18 to 60 years of age with a clinical diagnosis of common or classic migraine headache. After informed consent was obtained, an IV line with normal saline was established, and a bolus of 5 mL/kg was administered. Patients were randomized into two groups: chlorpromazine and meperidine with dimenhydrinate. The chlorpromazine group received a bolus injection of 5 mL normal saline placebo followed by 0.4 mL/kg chlorpromazine solution (0.1 mg/kg). The chlorpromazine was repeated every 15 minutes as needed up to a total of three doses. The meperidine with dimenhydrinate group received 5 mL dimenhydrinate solution (25 mg) followed by 0.04 mL/kg meperidine (0.4 mg/kg). Again, the meperidine solution was repeated in the same dosage every 15 minutes as needed up to a total of three doses. If response was inadequate 15 minutes after the third dose, the sequence was broken, and the other medication given. Blood pressure and response were assessed at 15 minute intervals for one hour. Pain was assessed by both visual and verbal analogue scales every 15 minutes. In all, 46 patients were entered in the study (24 chlorpromazine and 22 meperidine with dimenhydrinate).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705668 TI - HMOs and utilization of emergency medical services: a metropolitan survey. AB - A survey was conducted of a diverse group of health maintenance organizations (HMOs) serving a large metropolitan area regarding enrollee instructions for use of emergency medical services. Written and verbal requests for written information concerning emergency medical system instructions for enrollees were made to the 25 largest HMOs serving Chicago and surrounding suburbs. Sixteen responses, representing more than 95% of total HMO enrollees, were obtained. Options for access for prehospital care were reviewed and categorized: call 911, call toll-free telephone number, call HMO office or primary physician, go to the nearest HMO-affiliated hospital, and go to the nearest hospital. Of the 16 respondents, 15 HMOs responsible for 99% of the total HMO enrollees advised their subscribers to contact their HMO office or primary physician or to call a toll free number in the case of an emergency. No HMO advised use of the 911 access as a first response for an emergency. Only two HMO brochures, responsible for 7% of the total HMO enrollees, recommended that 911 access be used. These data suggest that HMO enrollees may not be adequately informed regarding proper use of 911 and the emergency medical services system. PMID- 2705669 TI - Substantial increase in human immunodeficiency virus (HIV-1) infection in critically ill emergency patients: 1986 and 1987 compared. AB - In a follow-up study conducted one year after a previous report, we found that 7.8% of 126 patients with critical illness or injury were infected with the human immunodeficiency virus (HIV-1) in 1987 as compared with 3.0% of 203 similar patients in 1986. In the earlier study all patients with infection (six) were confined to a narrow age range (25 to 34 years old) and were trauma presentations. However, in the follow-up study, infections were found in all age groups under 45 years of age (nine) as well as in 3.4% of patients with nontrauma presentations. Infection rates among patients between the ages of 25 and 34 presenting with penetrating trauma remained over 18% during both study periods. While emergency health care providers may have inadvertently interpreted the results of the first study as indicating that the need for infection control precautions could be restricted to young victims of trauma, the follow-up study clearly indicates that appropriate protective measures must be taken on all patients requiring resuscitative measures regardless of age or clinical presentation, particularly in emergency facilities within similar locations. PMID- 2705670 TI - Elevated Toxoplasma IgG antibody in patients tested for infectious mononucleosis in an urban emergency department. AB - There are many infectious causes of fatigue, sore throat, and fever, including mononucleosis and toxoplasmosis. Toxoplasma antibody testing is rarely performed in most emergency departments; as a result, toxoplasmosis is diagnosed infrequently. We obtained Toxoplasma IgG IFA titers on ED patients who had mononucleosis testing performed to determine the frequency of toxoplasmosis in this population. Two hundred sixty patients were included in our study. Eleven (4.2%) had a positive mononucleosis test, and 14 (5.4%) had a positive Toxoplasma titer. In the detection of toxoplasmosis, Toxoplasma IgG titers of 1:1,024 or greater have been shown to be a sensitive means of detecting infection in the first six months. Further testing with IgM titers is needed to establish a positive diagnosis when necessary. We found more patients with elevated Toxoplasma IgG titers than with positive heterophil antibody titers in an ED population tested for mononucleosis over a two-year period. We conclude that toxoplasmosis may be as common as mononucleosis in our ED and that clinicians should consider this pathogen when working up patients with appropriate symptoms. PMID- 2705671 TI - Pine oil cleaner ingestion. AB - We report the cases of 22 patients who were hospitalized for pine oil cleaner ingestion. The toxic manifestations most commonly observed were mucous membrane and gastrointestinal irritation. Ataxia, which did not occur in adults, was a frequent presenting sign of intoxication in children. Fifty-nine percent of patients who ingested only pine oil cleaner developed central nervous system depression, and three of these developed coma. Three of five children and three of 17 adults developed acute hydrocarbon pneumonitis. Unlike aspiration pneumonitis, which follows petroleum distillate ingestion, chemical pneumonitis from pine oil cleaner may occur from gastrointestinal absorption of pine oil and deposition in lung tissue. However, recovery from pneumonitis in our patients was typically rapid and complete. Only two adults developed secondary bacterial pneumonia; no patient died. Ingestion of pine oil cleaner was rarely life threatening; most patients needed only gastrointestinal decontamination and minimal supportive care. PMID- 2705672 TI - Staphylococcus intermedius: clinical presentation of a new human dog bite pathogen. AB - Staphylococcus intermedius is a Gram-positive, coagulase-positive coccus that can be distinguished from Staphylococcus aureus by routine microbiological testing. Whereas S intermedius is recognized as flora and pathogen of dogs, it has never been isolated from human infections. We hypothesized that S intermedius may cause human dog bite wound infections and that it has been previously misidentified as S aureus. Fourteen isolates from clinically infected dog bite wounds that were originally identified as S aureus were subjected to further testing; three (22%) were found to be S intermedius. The clinical and microbiological characteristics of these three S intermedius cases are described. All three patients were nonimmunocompromised persons seen within 24 hours for bites on the upper extremity. All patients developed cellulitis within one to three days. All S intermedius isolates were distinguished from S aureus by the lack of acetoin production and by the presence of beta-galactosidase activity. S intermedius was susceptible to a wide range of antibiotics; one isolate was resistant to penicillin. Two patients were treated with penicillin, one with amoxicillin clavulanate, and all were clinically cured. These are the first three reported human infections involving S intermedius. Further study is necessary to define its clinical importance as a potential human pathogen. PMID- 2705673 TI - Model curriculum in emergency medical services for emergency medicine residencies. PMID- 2705674 TI - HMOs and the use of 911. PMID- 2705675 TI - More protection from HIV exposure. PMID- 2705676 TI - Scopolamine anisocaria. PMID- 2705677 TI - Accidental intra-arterial injection of epinephrine treated with phentolamine. PMID- 2705678 TI - Theophylline therapy. PMID- 2705679 TI - Of seat belts and sternal fractures. PMID- 2705680 TI - Manual immobilization. PMID- 2705681 TI - Safety of axial traction. PMID- 2705682 TI - Nomina nuda tenemus (holding naked names) PMID- 2705683 TI - Irreversibility in hemorrhagic shock is caused by sepsis. PMID- 2705684 TI - Hirschsprung's disease in adolescents. Misadventures in diagnosis and management. AB - Three male adolescents, ages 13, 15, and 17 years, presented with complications of their Hirschsprung's disease, including acute enterocolitis with sepsis, chronic enterocolitis with anemia and leukocytosis, and severe fecal impaction. All had experienced delay in diagnosis resulting from either physician error in diagnosis or physician misinformation concerning the surgical treatment of the disease. These three patients illustrate some of the pitfalls in the diagnosis and surgical management of patients with Hirschsprung's disease. Misinformation concerning the surgical correction of this disease still exists, and these patients emphasize the necessity of continued, updated information in the diagnosis, management, and outcome of patients with Hirschsprung's disease. PMID- 2705685 TI - Management of Hirschsprung's disease in adolescents. AB - It is unusual for Hirschsprung's disease to go undiagnosed until late childhood. Adolescents presenting with Hirschsprung's disease offer unique challenges to the surgeon because of the massively dilated and hypertrophied colon that is invariably present. Five adolescents (four males and one female; ages, 11 1/2 to 16 1/4 years) with newly diagnosed Hirschsprung's disease were managed by slightly different methods between January 1981 and March 1987. Three patients had a "leveling" colostomy, followed by a Swenson procedure in two and a Duhamel procedure with a temporary diverting colostomy in one. One patient had a primary Duhamel procedure with a temporary diverting ileostomy. One patient had a primary Swenson procedure without diversion. Long-term results were uniformly excellent. Based on the experience with these patients the following principles of management emerge: 1) Avoid loop "leveling" colostomies because of their grotesque size and their tendency to retract or prolapse. 2) Rectal tube decompression can often adequately prepare a patient for a primary pull-through procedure. 3) When a diverting ostomy is required, it should be an ileostomy rather than a colostomy because its subsequent closure will not endanger the marginal artery, which if divided, could compromise the blood supply to the pulled-through colon. 4) The Swenson procedure, although difficult in adolescents, can be done with excellent long-term results. 5) Several applications of the stapling instrument are required in the Duhamel procedure to fully divide the septum between the aganglionic rectum anteriorly and the normal colon posteriorly. PMID- 2705687 TI - Isolated regional perfusion for treatment of limb melanoma in the American black. AB - Since 1957, 961 patients with invasive malignant melanoma of the limbs were treated by regional perfusion. Forty-eight patients were black, representing 5 per cent of all patients with regional melanoma treated during this period. Thirty-one of the 48 patients were men, and 17 were women. Only 21 of the 48 patients had stage I lesions (M.D. Anderson classification), of whom 63 per cent had level IV or greater invasion. The average depth of invasion was 3.70 mm. Of 21 patients with stage III disease, 15 came to diagnosis with an intact primary lesion in addition to regional disease, and the majority of lesions arose on a plantar site with level V invasion. Eighty per cent of the patients had acral lentiginous melanoma. All melanoma patients were treated by isolated regional perfusion with wide excision of the primary plus regional lymph node dissection for biopsy-proven regional disease. At 10 years, survival rates were 71 per cent for stage I patients and 12.5 per cent for those with stage III disease. When black patients having had acral melanoma on a plantar or palmar site were compared with white patients of a similar stage of disease, however, it was found that black patients had equivalent long-term survival rates. PMID- 2705686 TI - The potential value of mammographically guided fine-needle aspiration biopsy of nonpalpable breast lesions. AB - Nonpalpable breast lesions in 20 female patients were prospectively evaluated with a new technique of fine-needle aspiration biopsy (FNAB) under mammographic guidance. The patient age range was 37-82 years (mean: 60 years), and the mammographic indications for biopsy were microcalcifications (30%), mass (30%), mass with calcifications (25%), and asymmetric density (15%). Seven (35%) patients had significant risk factors for breast cancer. Prototype coaxial 19 gauge/22-gauge and 18-gauge/20-gauge needle systems (Cook, Inc., Bloomington, IN) were used for localization and biopsy. The technique involved needle localization of the target lesion with FNAB performed through the localizing needle after radiologic confirmation of position. A localizing wire then was inserted to allow each patient to proceed directly to the operating room for a standard needle localization open biopsy. Successful localization and aspiration was possible in 18 (90%) patients. Surgical excision was performed in all 20 patients and confirmed by specimen radiography in 17 (85%). A significant concordance of 94 per cent was found between the histologic results of the open biopsy specimens and the cytologic findings of aspirated specimens. These findings suggest that mammographically guided FNAB may offer a safe, reliable, and cost-effective alternative to open biopsy of nonpalpable breast lesions. Further study of this procedure is warranted to confirm its potential in this area. PMID- 2705688 TI - Does fine-needle aspiration biopsy really spare patients thyroidectomy? AB - Fine-needle aspiration (FNA) biopsy is widely used in the evaluation of nodular thyroid disease. From January 1979 to May 1983, 100 patients underwent FNA biopsy at Wake Forest University Medical Center for evaluation of nodular thyroid disease. Forty-six underwent immediate thyroidectomy based upon clinical and cytologic criteria. Fifty-three patients identified as having benign atypical or normal cells initially were managed nonoperatively. An additional patient with Hurthle cell neoplasm diagnosed by cytologic evaluation refused surgery and is included in the group treated nonsurgically. This report concentrates on the characteristics and subsequent course of these 54 patients. Emphasis was placed on whether surgery was actually avoided or merely delayed by the results of FNA biopsy. Follow-up evaluation ranged from 16 to 92 months (mean, 57 months). Fifty two (96%) patients had not been operated upon for thyroid disease during the follow-up period, and in none of the 52 had there developed new indications for surgery. The two (4%) patients who had undergone thyroidectomy proved to have benign disease. The authors conclude that with adequate clinical follow-up, FNA biopsy can accurately and appropriately guide the nonoperative management of nodular thyroid disease, and that the technique does spare patients the cost and risk of thyroidectomy, both initially and during subsequent follow-up evaluation. PMID- 2705689 TI - Thoracoabdominal approach for cure of patients with an adenocarcinoma in the upper third of the stomach. AB - In 134 patients with an adenocarcinoma in the upper third of the stomach and involving the lower esophagus, the authors retrospectively assessed the significance of a thoracoabdominal approach (TAA). Nineteen (48.7%) of 39 with TAA had major postoperative complications, while 25 (26.3%) of 95 with the abdominal approach (AA) had similar complications (P less than 0.02). The most frequent complication was anastomotic leakage. In the case of TAA, seven (18.0%) experienced this, and nine (9.5%) did so after AA. However, deaths resulting from complications were few for both TAA (five, or 12.8% and AA nine, or 9.5%). There was one (2.6%) patient with histologically positive cancer cells at the proximal stump of the resected specimen in patients with TAA, while there were seven (7.7%) such patients with AA. In the histologically curative cases without palliative factors, patients with TAA had a significantly better prognosis than did those with AA (P less than 0.05). In the histologically noncurative cases and in cases with palliative factors, the prognosis was poor for both TAA and AA patients. These results suggest that the surgeon should perform the TAA in order to obtain tumor-free margins at the proximal stump and a better prognosis in patients without palliative factors, while the surgeon need not consider doing the TAA in patients with palliative factors. PMID- 2705690 TI - The HSE National Exposure Database--(NEDB). AB - The U.K. Health and Safety Executive's (HSE) National Exposure Database (NEDB) enables the storage and selective retrieval of occupational hygiene data. These data are used to inform policy-making and standard-setting bodies, such as the Advisory Committee on Toxic Substances (ACTS), of national trends in exposure to particular substances categorized into the various industries, processes and jobs at which exposures occur. The exposure data currently held are limited to those obtained from inspections and investigations carried out by HSE specialist inspectors. Discussion is under way with industry on how the database can be extended to include validated data provided by industry so as to provide a focal point for exposure data in the U.K. The database will thereby become a valuable source of information for industry. Standardization of the way in which exposure data and qualifying information are presented will assist in fulfilling these aims. The paper describes the structure of the database, the types of information input to it and the information which can be obtained from it. Organizations wishing to establish their own exposure databases, those who may wish to contribute data, and the many who are concerned with the collection and recording of occupational hygiene data, irrespective of the methods of storage and retrieval, are encouraged to use a similar format. PMID- 2705691 TI - Effect of respiratory protective equipment on exposure to asbestos fibres during removal of asbestos insulation. AB - Asbestos concentrations were measured within powered respirators used by workers involved in the removal of asbestos-containing insulation. Fibre concentrations within the protective gear appeared to be above the Dutch threshold limit value for crocidolite (0.2 f cm-3). Possible sources of exposure were analysed and measures were taken to improve the situation. After this, the fibre concentrations in the breathing area were reduced and were below the Dutch concentration limit. PMID- 2705692 TI - Noise exposure of motorcyclists. AB - This study was designed to evaluate noise exposure of motorcyclists at work. Open and full face safety helmets were compared and the effects of helmet design and the contribution of radio intercoms investigated. Special measuring equipment is described and hearing protection discussed. Previous studies concentrated mainly on the attenuation of noise by safety helmets, and were made under conditions untypical of day-to-day motorcycling. During town driving the sample equivalent continuous noise level (s.leq) ranged from 63 to 90 dB(A), the intercom giving the highest peak levels. On the open road s.leq was up to 105 dB(A); exposure to this level for only 15 min would exceed the present recommended maximum of 90 dB(A) for an 8 h working day. PMID- 2705693 TI - Video filming and pollution measurement as a teaching aid in reducing exposure to airborne pollutants. AB - A method called PIMEX has been developed for investigation of the causes of exposure to airborne pollutants at workplaces. The method involves measurement of the subject's exposure with a personal, direct-reading instrument. The sampling signal is transmitted by telemetry to a special video mixer. A video camera is also connected to the video mixer. The camera is used for filming the subject. The video mixer's output signal is fed to a monitor which continuously shows how the subject works and how exposure varies. The method has been used for producing two films on the causes of exposure to solvent and effective measures for reducing exposure: one deals with screen printing and the other with surface treatment at wood-processing plants. The films have been shown at a large number of workplaces at discussions about workplace conditions, proving useful tools in efforts to reduce workplace risks and giving rise to concrete measures and increased interest in the workplace environment. PMID- 2705694 TI - Hygiene aspects of occupational exposure to waste anaesthetic gases in Ontario hospitals. AB - Exposure of workers to waste anaesthetic gases in the operating and recovery rooms of hospitals is an ongoing concern because a number of epidemiological and mortality studies have reported significant adverse effects. To evaluate the health risks if any, and to assist in the development of guidelines or regulations for the hospital sector in Ontario, the Health and Safety Support Services Branch of the Ontario Ministry of Labour conducted this extensive study. The results of the hygiene study show that exposure to waste anaesthetic occurs because of leaks in the anesthetic equipment. The three major sources of leaks (i.e. exhalation valves, masks and high-pressure fittings) produced concentrations above the limit of detection of nitrous oxide (1000 ppm of N2O) in a significant number of samples. Of the samples taken at leak sources those taken at the exhalation valve had the highest percentage of samples above 1000 ppm, which suggested that scavenging systems were not receiving proper service and maintenance. Only 23% of the operating rooms surveyed met the Ontario Ministry of Health Criterion of 24 air changes per hour. Dilution ventilation was less effective than scavenging in keeping down concentrations of air contaminants. The sampling data show that the anaesthetists have the highest time-weighted average exposure (median value range 56-79 ppm) of the major group of occupations surveyed and that the general surgeons' TWA is much lower (28 ppm). It was concluded that the dilution ventilation rate of 24 air changes per hour should be maintained in all operating rooms and that there should be no recirculation of exhaust air when operations are in progress. To keep down concentrations of anaesthetic gases scavenging systems should be provided in all operating rooms. In each hospital maintenance should be the responsibility of a qualified staff member who has been adequately trained in the repair and maintenance of anaesthetic delivery systems. Finally, a qualified staff member should be responsible for conducting periodic personal monitoring in operating rooms (ORs) and recovery rooms (RRs) and the sampling strategy should include individuals and the exhaust grilles. PMID- 2705695 TI - Building sickness, are symptoms related to the office lighting? AB - Office lighting has been suggested as one of the possible factors in producing 'building sickness'. Health questionnaires were completed by 106 out of 109 (97%) workers in six randomly sampled multi-occupied offices in each of two buildings, one air-conditioned and one naturally ventilated. There was a significantly higher prevalence of work-related headache and work-related lethargy in the air conditioned building than in the naturally ventilated one. There was also less daylight in the air-conditioned building and lower mean luminance and illuminance of the work positions despite there being more lights on (p less than 0.01). The workers had a greater dislike of fluorescent lighting (p less than 0.01) and overall found the lighting to be less comfortable (p less than 0.01) and glare readings were higher. The workers perceived their control of lighting as poorer (p less than 0.001) and consequently there was less agreement about it (p less than 0.001). Those with work-related headache found the lighting less comfortable (p = 0.059) and perceived more glare (p less than 0.05). This study suggests the need to maximize the use of natural light from untinted windows, to reduce the impingement of fluorescent tubes on the line of sight and to return the control of levels of lighting to each individual worker. PMID- 2705696 TI - Detection of reactive free radicals in fresh coal mine dust and their implication for pulmonary injury. AB - Freshly ground and aged anthracite and bituminous coal samples were investigated by electron spin resonance (ESR) spectroscopy to detect the presence, concentration and reactivity of free radicals. Freshly ground anthracite coal produced greater concentration of free radicals than the bituminous coal, and the radical reactivity was also greater for the anthracite. The reactivity of the newly produced free radicals in the anthracite dust correlated with the dust's toxicity. Furthermore, similar coal-based free radicals were detected in the lung tissue of autopsied coal miners, suggestive of persistent reactivity by the embedded coal dust leading to the progressive disease process. Results of the studies on the severity of coal workers' pneumoconiosis (CWP) and free radical concentration in lung tissue support this hypothesis. PMID- 2705697 TI - Exposure to shock and vibration and symptoms in workers using impact power tools. AB - In The Netherlands damage to health due to occupational exposure to shock and vibration is seldom reported. A survey was therefore made of the nature, extent and severity of exposure to shock and vibration. This paper presents the results of an epidemiological study, by questionnaire, among workers using impact power tools. Data were collected about exposure time, symptoms and the subjective workload. A prevalence rate of 17% for symptoms of white finger was found. In the logistic regression symptoms of back pain showed an increased prevalence with increasing total time exposed to vibration. This study shows that exposure to vibration due to working with impact power tools, either alone or in combination with ergonomically bad working conditions, probably contributes to these symptoms. An estimate of the population at risk showed that over 30,000 workers in The Netherlands who use impact power tools are exposed to a vibration intensity of 10-40 m s-2. This intensity exceeds the standards advocated in draft standards in the U.K. (BSI, 1987) and U.S.A. (ACGIH, 1984). The results also provide evidence that in The Netherlands exposure to hand-arm vibration damages health. It is suggested that damage to health due to occupational exposure to vibration is underestimated by the Dutch occupational health services. It was concluded that more investigation is needed to evaluate the precise nature of occupational exposure to vibration in order to provide a basis for its reduction or elimination. PMID- 2705698 TI - Hearing in chronic suppurative otitis media. AB - In individuals with chronic otitis media, mixed hearing impairments are common but it is unclear whether the raised bone conduction thresholds are a reflection of the pathologic process affecting the inner ear or a combination of the high prevalence of sensorineural hearing impairments in the population along with the artificial elevation of bone conduction thresholds associated with a conductive defect. A total of 395 ears with chronic otitis media but without cholesteatoma were studied. In them, once the artificial elevation (Carhart effect) of the bone conduction thresholds, which occurs whenever there is an abnormality of the sound conduction mechanism, had been taken into account, there was no difference in the bone conduction thresholds compared with those in 920 control ears. In addition, in 100 instances, the contralateral ear was normal and there was no difference in the bone conduction thresholds between the diseased and the normal ears. Raised bone conduction thresholds in chronic otitis media are considerably likely to reflect both the Carhart effect and the high prevalence of sensorineural impairments, rather than disease damage to the inner ear. PMID- 2705699 TI - Low frequency oscillatory ventilation through the suction channel of a pediatric bronchoscope. AB - To determine whether low frequency oscillatory ventilation (LFOV) may be safely applied through the suction channel of a pediatric fiberoptic bronchoscope, we devised a system using a combination of jet ventilation and constant air suction, both delivered with a single interface valve. The system was tested on an in vitro lung model and on rabbits. With tidal volumes of 12 mL, inadvertent increase in functional residual capacity (FRC) measured in the lung model was minimal. All rabbits experienced marked hypoventilation (PaCO2 62 +/- 2 torr) on introduction of the bronchoscope, which promptly improved with administration of LFOV (PaCO2 41 +/- 4 torr). That baseline FRC remained stable indicated that air trapping did not occur. We conclude that LFOV improves ventilation in rabbits during bronchoscopy without causing air trapping. A similar system might be applied during bronchoscopy in full-term and premature infants, thus facilitating safer and more complete visualization of their airways and preserving the possibility of obtaining samples by suction. PMID- 2705700 TI - Chemically induced esthesioneuroepithelioma: ultrastructural findings. AB - Tumors of the olfactory epithelium of rats were induced with two different nitrosamines: 2,6-dimethylnitrosomorpholine and N-nitrosopiperidine. Both carcinogens yielded identical tumors consisting of small, undifferentiated, neuroblastic cell elements without specialized cell contact. Cell processes contained microtubuli, centrioles, and neurosecretory granules. Two kinds of rosettes were encountered frequently: neuroblastic Homer Wright rosettes consisted of undifferentiated cells, surrounding a minute lumen filled with amorphous material; and Flexner rosettes showed a higher degree of maturation. Inside their central lumen, cell processes with characteristic features of olfactory sensory cells (basal bodies, cilia, centrioles, microtubuli) could be demonstrated. The stem cell of this tumor is most likely the undifferentiated light basal cell inside the olfactory epithelium, since its ultrastructural appearance and its cytoskeleton are alike. At least under neoplastic conditions, this stem cell may likewise differentiate into epithelial cells, since transition to squamous cell carcinomas has been observed. In view of their overwhelming similarity to their human counterpart, the induced tumors are most likely to represent esthesioneuroepitheliomas. PMID- 2705701 TI - Pharyngeal fistulas in postoperative hypothyroid patients. AB - Hypothyroidism is a well-recognized complication of combined treatment for head and neck cancer. We discuss four patients who developed pharyngeal fistulas after total laryngectomy and preoperative (one patient) or postoperative (three patients) radiation therapy. The fistulas were refractory to conservative and surgical repair. Once the existence of hypothyroidism was established, immediate substitution therapy resulted in rapid healing of the fistulas and marked improvement of the patients' general condition. Few clinical reports exist on postoperative hypothyroidism and wound healing complications. Experimental work shows delay and impairment of wound healing in hypothyroid animals as opposed to hyperthyroid ones, in which wound healing was accelerated. Suspicion is warranted in patients after treatment for head and neck cancer when they exhibit even minimal symptoms of hypothyroidism or develop postoperative complications refractory to conservative treatment. PMID- 2705702 TI - Auditory nerve and brain stem evoked response thresholds in infants treated with gentamicin as neonates. AB - Thirty-two infants (18 full-term and 14 premature) who had been treated with gentamicin as neonates were examined to ascertain whether this drug induced hearing loss, even of low severity. Objective thresholds to clicks were obtained using auditory nerve and brain stem evoked responses. In addition, behavioral audiometry was performed. Serum concentrations before and after gentamicin treatment were at therapeutic levels. All infants were examined at least 1 1/4 months after cessation of therapy. Normal thresholds were obtained in all ears, with the exception of two with demonstrable middle ear effusion. It appears that gentamicin in therapeutic doses and serum concentrations, in the absence of renal insufficiency, does not cause hearing loss in neonates. PMID- 2705703 TI - Flexible transbronchial needle aspiration for the diagnosis of sarcoidosis. AB - To determine the value of transbronchial needle aspiration biopsy in the diagnosis of sarcoidosis, we reviewed a 1-year experience of consecutive patients with sarcoidosis presenting with hilar and/or paratracheal adenopathy. The sensitivity of transbronchial needle aspiration biopsy in obtaining specimens of noncaseating granulomas was 90%. This yield exceeds that of most published reports of transbronchial lung biopsy and bronchial mucosal biopsy and suggests that transbronchial needle aspiration biopsy may be a valuable diagnostic tool in the evaluation of these forms of sarcoidosis. PMID- 2705704 TI - Acute effects of sulfur dioxide exposure on the middle ear mucosa. AB - A variety of atmospheric pollutants are known to depress mucociliary function in the respiratory system. Since the mucociliary function in the middle ear is similar, and the middle ear may be invaded by atmospheric pollutants, we decided to investigate the possible contribution of sulfur dioxide to middle ear effusion. Guinea pigs were exposed for 24 hours to 300 ppm of sulfur dioxide or air. Immediately after exposure, ciliary activity and epithelial structure were examined close to the tympanic orifice (proximal site) and more distal to it (distal site). In the animals exposed to sulfur dioxide, no effusion was found in the tympanic cavity. Ciliary activity was reduced only in the distal site. Electron microscopy demonstrated hypersecretion in the proximal site and severe pathologic changes in the distal site. Although the normally functioning cilia in the proximal site may prevent retention of surplus secretions in the ear, sulfur dioxide may promote middle ear effusion when combined with other detrimental factors, because it stimulates mucus secretion in the proximal site and impairs ciliary function in the distal site. PMID- 2705705 TI - Brain stem auditory evoked potentials in jaundiced Gunn rats. AB - Bilirubin encephalopathy causes potentially preventable brain damage and hearing loss. The site of auditory dysfunction is controversial, despite pathologic studies showing damage to brain stem auditory nuclei in humans and experimental animals. We studied the effects of bilirubin toxicity on the auditory system of homozygous jaundiced Gunn rats by use of brain stem auditory evoked potentials. Small but statistically significant abnormalities were found for wave latencies, interwave intervals, and amplitudes. PMID- 2705706 TI - Computed tomography of internal jugular vein thrombosis. PMID- 2705707 TI - Orbital cellulitis with abscess formation caused by sinusitis. PMID- 2705708 TI - The principles of functioning muscle transplantation: applications to the upper arm. AB - Functioning muscle can be transferred from one location to another using microneurovascular anastomoses. Reinnervation and useful muscle contraction are produced by suturing an appropriate motor nerve in the recipient area to the motor nerve of the transplanted muscle. Clinical experience and experimental investigations have led to an understanding of some of the important principles in extremity muscle transplantation. Successful deltoid and biceps reconstruction are reported. PMID- 2705709 TI - External septorhinoplasty--exposure for the difficult nose. AB - External septorhinoplasty affords direct exposure, which allows both the novice and the expert surgeon to treat the most challenging noses with a higher degree of assurance. Criticism of the external columellar scar is unwarranted. The technique is reviewed in detail, and complex cases are illustrated. PMID- 2705710 TI - The use of high-dose lidocaine in wetting solutions for lipoplasty. AB - The use of lidocaine as a local anesthetic has been limited to 7 mg/kg. The authors question whether amounts of lidocaine greater than the recommended dosage may be safely used in the patient undergoing lipoplasty of the torso and knees. Six patients were used as a sample and a wetting solution of 750 mg or 1,000 mg of a .25% lidocaine solution containing 1:400,000 epinephrine was injected into the surgical site. The ratios of milligrams of lidocaine to kilograms of body weight varied from 9.1 to 13.8. Serum lidocaine levels were measured at frequent intervals. Because of many factors, including poor vascularity of subcutaneous fat, vasoconstrictive effect of epinephrine, and aspiration of a portion of the lidocaine, blood levels of lidocaine in the patients never exceeded 1.0 microgram%. We conclude that lidocaine, 9 to 14 mg/kg, results in peak serum lidocaine levels of only 0.5 to 0.8 microgram%. PMID- 2705711 TI - Congenital sinuses of the lower lip: reappraisal of Van der Woude syndrome on the basis of nine patients. AB - Congenital sinuses on the lower lip in association with cleft lip, cleft palate, or both are rare and occur in four syndromes, namely Van der Woude syndrome, popliteal pterygium syndrome, orofacial digital syndrome, and the ankyloblepharon filiform adnatum. The most common and best studied among these--the Van der Woude syndrome--is believed to be due to an autosomally dominant gene with 80 to 100% penetrance and a variable expressivity. We present our study of 9 patients with congenital lower lip sinuses and the penetrance in their families. On the basis of our observations we conclude that this syndrome may have low penetrance among the populations studied. PMID- 2705712 TI - Cleft palate in the Beckwith-Wiedemann syndrome. AB - Patients with the Beckwith-Wiedemann syndrome have numerous anomalies, varying somewhat from case to case. The most common presentation is exomphalos, macroglossia, and somatic gigantism. Although cleft palate in association with this syndrome has been rarely reported, we have observed 6 patients with cleft palate in 10 patients who were diagnosed with the Beckwith-Wiedemann syndrome. The literature is reviewed and discussed. PMID- 2705713 TI - Successful replantation of the heel pad: a seven-year follow-up. AB - The authors present a case of successful replantation of the soft tissue of the heel. Circulation was restored by the use of a vein graft from the posterior tibial artery to an arterial branch of the subcutaneous plexus found on the medial aspect of the heel. Two small veins were anastomosed at the edge of the defect. The heel lacks sensation, but the patient has been able to return to work as a heavy laborer in a steel foundry and is walking without the use of orthotics or modified shoes seven years later. This is the first reported case of successful replantation of only the soft tissue of the heel. PMID- 2705714 TI - The use of suction curettage as adjunct to the management of lymphedema. AB - This case report describes the use of suction curettage as an adjunct to the method of skin and subcutaneous tissue excision in the treatment of primary lymphedema. Pretreatment with high-vacuum cannula suction can provide three advantages over straightforward primary excision and closure; (1) larger volumes of skin and subcutaneous tissue can be resected at a single setting; (2) tensionless closure can be obtained without skin flap undermining; and (3) procedural blood loss is minimized. PMID- 2705715 TI - Re: Artz et al: Breast reconstruction with a subcutaneous tissue expander followed with a polyurethane-covered silicone breast implant. PMID- 2705716 TI - Enterovesical fistulas in Crohn's disease. AB - A total of 19 enterovesical fistulas were recorded in a series of 799 patients with Crohn's disease (2.4%). The origin of the fistulas was: ileum (9), colon (6) and four were complex involving the small and large bowel. Only 13 patients presented with urinary symptoms: pneumaturia (9), haematuria (1) and urinary tract infection (3). Four fistulas were identified incidentally during contrast radiology, one fistula was identified during a laparotomy and one further fistula developed after a previous resection for Crohn's disease. Four patients were managed conservatively and all are asymptomatic, but it is not known whether the fistula has healed. Twelve fistulas were resected: 9 healed, 2 recurred and 1 patient died following resection for a malignant fistula complicating Crohn's disease. Early in the series three patients were managed by bypass or defunction of the fistula. In all cases the sepsis persisted resulting in mortality. Persistent symptomatic fistulas should be treated by resection of the affected segment of bowel with primary anastomosis if appropriate. The defect in the bladder should be closed over an indwelling catheter which should not be removed until there is radiological confirmation that the bladder defect has healed satisfactorily. PMID- 2705717 TI - Surgery in a geriatric population. AB - A prospective audit of 1111 general surgical procedures undertaken on 1040 elderly patients (over 64 years) revealed a mortality of 3.5% in potentially viable patients. Aged patients (over 74 years) had twice the mortality of old patients (65-74 years). Emergency surgery carried a sevenfold risk factor which is greater than is usually described. Of those patients who died (n = 56) 20 had a laparotomy for surgically incurable disease. Although the four grades of surgeon achieved similar mortality rates (range 4-5.8%), senior surgeons performed more major procedures (Consultants, 40%; SHOs, 19%). There was a low supervision rate of SHOs (37/100 overall, and 9/19 major cases). Of the 26 patients dying from medical disorders 17 had a previous history of that disorder, and only nine of these patients were admitted to our high dependency care unit. We conclude that mortality rates in the elderly could be improved by encouraging elective surgery and avoiding diagnostic laparatomy in patients with incurable surgical disease. We also suggest that no inexperienced surgeon should operate unsupervised on any elderly patient who is in ASA category 4 or 5, or who undergoes major or intermediate surgery. Further, all elderly patients in ASA category 4 or 5, or those with previous medical problems who have major emergency procedures should be managed postoperatively in a high dependency care unit. PMID- 2705718 TI - A review of the practice of fibreoptic endoscopic dilatation of oesophageal stricture. AB - Over a 5-year period 82 patients underwent 244 fibreoptic endoscopic dilatations for oesophageal stricture. A total of 55 patients had benign peptic oesophageal stricture caused by reflux oesophagitis. Two-thirds of these patients had good symptomatic relief with dilatation combined with medical treatment of reflux, whereas one-third had an unsatisfactory result. The practice of endoscopic dilatation in benign stricture proved to be safe and was cost-effective as the procedure was carried out under intravenous sedation on a day-care basis. Three patients underwent dilatation for achalasia with good results in two cases. There were 16 patients with malignant oesophageal stricture and, in this group, fibreoptic endoscopic dilatation had little role to play in relieving dysphagia and its practice was associated with a substantial morbidity and mortality. Dilatation of malignant strictures facilitated biopsy and was used prior to oesophageal intubation. The virtues of the Atkinson or Celestin tube put in with the Nottingham introducer are summarised. Eight patients developed anastomotic stricture after resection of carcinoma of the oesophagus and dilatation provided only very transient relief of dysphagia in this group. Most anastomotic strictures represented recurrent malignancy and the difficulty in gaining biopsy proof endoscopically is emphasised. We advocate the early use of a CT scan in this situation to make the diagnosis of recurrent malignancy so that, if appropriate, palliative treatment can be instituted while the patient's general condition is good enough to benefit from it. PMID- 2705719 TI - Sutures for inguinal herniorrhaphy--a comparison of monofilaments with PTFE. AB - Polybutester (Novafil, Davis & Geck) and expanded polytetrafluoroethylene PTFE (Gore-tex, W L Gore) were compared with nylon (Ethilon, Ethicon UK) for elective inguinal herniorrhaphy. PTFE had the best handling characteristics, but is expensive, and increased wound sepsis attended its use. Polybutester had significantly better handling characteristics, and is an attractive alternative to nylon for hernia repair. PMID- 2705720 TI - Unilateral digital ischaemia secondary to embolisation from subclavian atheroma. AB - Four cases of unilateral digital ischaemia in the upper limb secondary to embolisation from atheromatous plaques in the proximal subclavian artery are presented. Digital subtraction angiography or arch aortography were used to demonstrate the site of atheroma. In one case diagnostic delay resulted from failure to visualise the site of embolisation on the original aortogram and a repeat examination was necessary. Subclavian endarterectomy was undertaken in each case and irreversibly ischaemic digits were managed by local amputation in two cases. Direct surgery to remove the site of embolisation was preferred to bypass or transposition procedures. No further embolic episodes have been recorded with a follow-up of 6 months to 3 years. The important diagnostic features and options in surgical management of this syndrome are discussed. PMID- 2705721 TI - Intraoperative testing of the integrity of left-sided colorectal anastomoses: a technique of value to the surgeon in training. PMID- 2705722 TI - The anesthetic management of patients undergoing free flap reconstructive surgery following resection of head and neck neoplasms--a review of 64 patients. PMID- 2705723 TI - Posterior tibial tendon rupture--a brief report. PMID- 2705724 TI - Acute urinary retention: which catheter? PMID- 2705725 TI - The use of flexible nasoendoscopy in adults with acute epiglottitis. PMID- 2705727 TI - 168 double J (pigtail) ureteric catheter insertions: a retrospective review. PMID- 2705726 TI - Does oedema following lower limb revascularisation cause compartment syndromes? PMID- 2705728 TI - Cardiac tamponade: a review of diagnosis and anesthetic and surgical management illustrated by three case reports. PMID- 2705729 TI - Bone mass in women with hip fractures. AB - Bone mass was measured by single photon absoptiometry in 52 women with hip fractures and compared to controls of similar age. No difference in the forearm bone mineral content (BMC) was detectable between the groups. Extracapsular fractures had lower forearm BMC than intracapsular fractures, but these differences were eliminated by allowance for age. Clinical management therefore was not influenced by such measurements. PMID- 2705730 TI - Intravenous urography after acute urinary retention. AB - The results of a 12-month prospective study of 113 patients show that intravenous urography has no place in the management of men with acute urinary retention without haematuria. PMID- 2705731 TI - Experience with circulatory arrest and hypothermia to facilitate thoracic aortic surgery. AB - A total of 12 patients underwent surgical repair for thoracic aortic dissections with a technique which included cardiopulmonary bypass, profound hypothermia, high-dose thiopentone and circulatory arrest. Seven of nine early postoperative survivors made a complete recovery on clinical criteria. There were three perioperative deaths and there was one late postoperative death from chronic renal disease. There were no deaths among those operated on electively. Neuropsychological testing may help to define the consequences of circulatory arrest on higher function. PMID- 2705732 TI - Thyroidectomy for Graves' disease: is hypothyroidism inevitable? AB - The outcome of 234 patients with Graves' disease treated by subtotal thyroidectomy over a 12-year period is analysed with specific reference to hypothyroidism. Of definite hypothyroid cases, 98% occurred within 2 years. Failure to develop hypothyroidism was statistically related to large remnant size and a large goitre preoperatively. Histological review showed that any degree of lymphocytic infiltration was associated with the development of hypothyroidism (50% vs 22%). Late onset hypothyroidism occurred rarely and is not an inevitable outcome of thyroid surgery in our hands. PMID- 2705733 TI - The value of angiography in the surgical management of pancreatic disease. AB - Selective visceral angiography should help to determine the nature and extent of pancreatic lesions and their suitability for resection. Between 1980 and 1987 coeliac and superior mesenteric angiograms were obtained in 76 patients considered for pancreatic resection. Anomalous arterial anatomy was delineated in 25%. Among arterial abnormalities observed in 42 patients (55%), increased or decreased vascularity and displacement were of limited diagnostic value, but encasement correctly predicted cancer in 18 of 21 cases and irresectability in nine of these. When present (17%), invasion or occlusion of the portal or superior mesenteric vein was even more accurate, indicating cancer in 12 of 13 cases and irresectability in 11 of these. Hepatic metastases were only detected in 7 of 15 patients (47%). Overall, angiography confirmed the diagnosis in 54%, localised the lesion in 64% and correctly forecast irresectability in 58%. Misleading data were obtained in five patients. There were no complications. PMID- 2705734 TI - [Cardiac toxicity of 5-fluorouracil]. AB - A 67 year-old patient receives 5-fluorouracil for vocal chord cancer. During the perfusion, atypical angina pain occurs, accompanied with offset of ST above the baseline in standard leads and in V4 through V6. The pain subsides spontaneously in 45 minutes. These ECG alterations are followed 48 hours later by diffuse inverted T waves with lengthened QT. Cardiac ultrasonography and isotopic angiography do not show any abnormality of the left ventricular function, but myocardial tomoscintigraphy with labelled thallium show a lower hypofixation on exertion. The cardiac toxicity of 5-fluorouracil is in frequent. It is usually believed that it involves a coronary spasm, as suggested by the ECG tracing in the reported cases. The incident, which may be painful or painless, may result in a myocardial infarction or even sudden death during the perfusion. Therefore, it is advisable to discontinue the treatment as soon as an angina-type pain occurs. PMID- 2705735 TI - [Value of nuclear magnetic resonance in the detection of false aneurysm of the abdominal aorta]. AB - Among the long-term complications that jeopardize bilateral aorto-femoral prostheses, the development of a false aneurysm on the aortic suture line, is indeed one of the most severe. Its frequency, approximately 1 p. cent of cases, is probably underestimated, since its diagnosis, with usual exploration methods, is difficult. The nuclear magnetic resonance (NMR) examination is here particularly indicated and, when in doubt, must be systematically requested, especially in the presence of a false aneurysm of the femoral suture line. PMID- 2705736 TI - [Description of electrocardiographic data in children and adolescents. Apropos of more than 100,000 ECGs]. AB - The authors record the most frequent electrocardiographic anomalies in children and teenagers. The course of the frequency of ectopic rhythms and right focal blocks is studied. Variations in the duration and axis of the electrocardiographic complexes are described in terms of age and sex, and reference figures are presented. PMID- 2705737 TI - Cytogenetic studies of 19 meningiomas and their clinical significance. I. AB - Cytogenetic analysis of 19 meningiomas from 10 female and 9 male patients are reported. Chromosomal abnormalities were found in all cases with a stemline karyotype 45, XY, -22 or 45, XX, -22. Three of these had additional sidelines: (a) 44, XX, -1, -4, -6, -8, -22, +19, +del(1) (:p33----q43), +dup(1) (p24----q31) t(1;1) (pter----p33::ter): (b) 44, X, -9, -14, -22, -X, +4, +del(X) (pter--- q26), and (c) 44, XY, -19, -22, respectively. PMID- 2705738 TI - Gene amplification correlates with sister chromatid exchange in B16 murine and human melanoma and human astrocytoma cell lines. AB - The incidence of double minute chromosomes and sister chromatid exchanges has been examined in four variant lines of the B16 murine melanoma, two human melanoma and two astrocytoma cell lines. The incidence of double minutes and sister chromatid exchanges appears to be strongly associated in these cell lines. PMID- 2705739 TI - Intermediate-dose Ara-C/m-AMSA for remission induction and high-dose Ara-C/m-AMSA for intensive consolidation in relapsed and refractory adult acute myelogenous leukemia (AML). AB - Twenty nine consecutive patients (pts) with either relapsed (n = 23) or primary refractory AML (n = 6) were treated with 1 or 2 cycles of intermediate-dose (ID) ara-C (1g/m2 IV q 12 h days 1-6) and m-AMSA (120 mg/m2 IV days 5-7). Pts reaching complete remission (CR) were consolidated with 1 cycle of ara-C 3 g/m2 IV q 12 h days 1-4 and m-AMSA 120 mg/m2 IV day 5. The median duration of the preceding remission was 9.5 months, median time from last chemotherapy until relapse 3 months. 18/23 (78%) of relapsed pts achieved CR regardless of the type of prior intensive maintenance (HD-ara-C/m-AMSA/5-AZA or DNR/CD-ara-C). 3/23 (13%) pts died during hypoplasia, 2/23 (9%) pts were refractory to 2x ID-ara-C/m-AMSA. 3/23 pts died in CR during hypoplasia after intensive consolidation with HD-ara-C. Predictive factors for remission were the duration of preceding remission and the time from last chemotherapy to relapse. Three pts were transplanted in 2nd CR. 1/6 refractory pts reached CR, 2 pts remained refractory, and 3 died during hypoplasia. The median duration of disease-free survival (DFS) of relapsed pts was 3.3 months without further treatment, median survival of responding pts (18 replased pts, 1 refractory pt) was 4.6 months, the overall survival (n = 29) was 4.8 months. Pts receiving BMT were censured at the time of BMT. Seven pts experienced lung toxicity due to ara-C, four of whom died. The incidence of lung toxicity was clearly related to the extent of ara-C pretreatment during intensive maintenance. In conclusion, ID-ara-C/m-AMSA is a very effective reinduction treatment in these pts with acceptable toxicity; the impact of HD-ara-C during consolidation for DFS and survival is questionable. PMID- 2705740 TI - Cellular events during invasion by tumor cells of chick embryo skin. AB - Tumor cell invasion was studied using the 9-day chick embryo skin (CES). The invasion process was broken down into 4 sequential events: adhesion, penetration, proliferation and colonization. Tumor cells used in this study included cells from various human and canine solid tumors, tumor cell lines from human and animal origin and malignant effusions. Where samples permitted, the invasion in CES was compared with tumorigenicity in athymic nude mice and clonal growth in soft agar. The effects of 5-FU and vincristine on the component events of invasion in CES were studied at doses that inhibited 3H-thymidine labelling. The results suggest that DNA synthesis and invasion are independent properties of tumor cells with malignant potential. PMID- 2705741 TI - Angioimmunoblastic lymphadenopathy--a malignant disease due to DNA aneuploidy. AB - Angioimmunoblastic lymphadenopathy (AIL) was considered by most authors in the 1970s as a non-malignant disease. However, it is widely accepted that many AIL cases would now be categorised as T-cell lymphomas of the AIL type. DNA measurements were performed on imprint smears from lymph nodes of 10 AIL patients to obtain further evidence for the malignancy of this disease. The 5c Exceeding Events (5cEE), representing the number of cells with a DNA content greater than 5c, excluding cells with 8c, 16c or 32c (+/- 12.5%), were taken as an index for aneuploid cells. 5cEE greater than or equal to 3 was considered to be evidence for aneuploidy and thus for malignancy. According to this definition of aneuploidy, malignancy was assumed in 9 cases out of 10. No aneuploid cells (5cEE = 0) were found in four patients with lymphadenitis. PMID- 2705742 TI - In vitro studies on the invasion of blood vessel wall by choriocarcinoma cells. AB - The development of metastases represents the lethal event in the clinical course of most neoplastic diseases. The complex mechanism responsible for the spread of cancer are governed by interactions between tumour cells and the host tissues. Choriocarcinoma cells and cultured blood vessels were used to study the interaction between tumour and endothelial cells. Seeding of tumour cells onto blood vessel wall caused retraction of endothelial cells leading to the exposure of underlying tissue. Subsequently, the tumour cells penetrated the sub endothelial connective tissue and the internal elastic lamina. PMID- 2705743 TI - Continuous venous infusion of vindesine in metastatic breast cancer: experience with a subcutaneously implanted system and portable pump. AB - Fourteen patients with advanced pretreated breast cancer were treated with vindesine in continuous venous infusion (1.5 mg/sm/24 hours for 72 hours every 3 weeks). A totally implanted venous access and a portable pump were used. A total of 33 courses was administered. No objective response was observed and treatment was stopped. Drug-related toxicity consisted mainly of alopecia (64% of patients), nausea and vomiting (29%) and mucositis (29%). Catheter - related toxicity was observed in 6 patients (43%) and consisted of infection of the skin pocket in 4 patients and dislodging of the needle and catheter break in one patient. The feasibility of continuous venous infusion of vesicant drugs in outpatients is discussed. PMID- 2705744 TI - Age-related cell surface proteins of human astrocytoma cells in culture. AB - The 125I labelling patterns of the cell surface proteins of human malignant astrocytoma cells in culture have been analysed with respect to patient age. 125I incorporation into two groups of proteins of MWs 26K and 49K increased with patient age. For the 49K group (but not the 26K group), the tumours tended to segregate into two groups related to tumour grade. These findings may be relevant in the context of the reported patterns of resistance of malignant astrocytoma to chemotherapy and the use of patient age as a prognostic factor for these tumours. PMID- 2705745 TI - Density distribution and antigenic characterization of cell subpopulations isolated from cystic fluids of ovarian serous neoplasms. AB - The immunological reactivity of serous ovarian tumor cells was evaluated, taking into account their density and morphological features. Discontinuous density gradient centrifugation was applied to fractionate cell subpopulations from cystic fluids of patients with ovarian serous carcinomas, cystadenomas and benign serous cysts. For phenotypic characterization of tumor cell subpopulations the immune sera against perchloric acid extracts of ovarian serous (anti-PCA-CaOs) and mucinous (anti-PCA-CaOm) carcinomas were used. The expression of carcinoembryonic antigen (CEA) and nonspecific cross-reacting antigen (NCA) on tumor cell fractions was also checked. Some relationship between immunological reactivity, cell morphology and cell density was found; however, individual patient-to-patient variations in cellular composition and antigenic expression were also observed. The presence of ovarian serous carcinoma-associated antigen (CaOs-Ag) was related mainly to frankly malignant cells. Neither CEA nor NCA were constant and characteristic markers for serous ovarian neoplasms. These neoplasms were unreactive with anti-PCA-CaOm serum. Our results indicate the possibility of correlation between morphological features, density distribution and immunological phenotypes of ovarian tumor cell populations. PMID- 2705746 TI - Transforming growth factor alpha in human mammary carcinomas and their metastases. AB - A binding competition assay was used to measure the content of transforming growth factor alpha in human mammary carcinomas and their metastases. Thirty one percent of the primary and 50 percent of the metastases expressed the transforming growth factor alpha with values ranging between 1.6 to 278 EGF equivalent ng/mg tumour extract protein. There was no correlation between the transforming growth factor alpha content and the estrogen receptor value. PMID- 2705747 TI - Synergism of 1-beta-D-arabinofuranosylcytosine and cis-diamminedichloroplatinum in their lethal efficacies against seven established cancer cell lines of gastrointestinal origin. AB - We previously reported that the combination of cis-diamminedichloroplatinum (CDDP) and 1-beta-D-arabinofuranosylcytosine (ara-C) induced a remarkable synergistic killing effect on an established human colon carcinoma cell line, LoVo. The current study investigated whether this effect was LoVo specific or could be extended to other colon cancer cell lines as well as to cell lines of different histological origins, including an estrogen receptor-positive breast cancer cell line (MCF7), an ovarian cancer cell line (OV1225), and an esophageal cancer cell line (Hcu18). The six human colorectal cancer cell lines included in this study represent three biological groups with distinct phenotypic properties. Group 1 (well-differentiated) consisted of LoVo and SW48; group 2 (intermediately differentiated) comprised SW480 and SW620; and group 3 (undifferentiated) was represented by SW403 and SW1116. No significant synergistic cytotoxicity was noted after the breast and ovarian cancer cells were treated. However, synergistic lethal effects were observed in all of the six colon cancer cell lines as well as the esophageal cancer cell line. The synergistic effect on the gastrointestinal cancer cell lines was related to the concentration of ara-C and CDDP during treatment. Our results suggest that the cytotoxic synergism between ara-C and CDDP may be tissue-type specific and that synergism may depend on the histological origin of the cancer. PMID- 2705748 TI - Metabolic energy availability and proliferative activity in adriamycin-treated cells. AB - Metabolic energy availability and proliferative activity were studied in HeLa cells treated with Adriamycin (Adr). Conditions (ID50) that induced growth delay, without significant cell lethality, did not appreciably alter ATP content, over 72 hours after treatment. Energy-dependent membrane permeability properties, assessed with the vital dye fluorescein, were similarly unaffected. The cytostatic effect was confirmed by the incorporation rate of 3H-thymidine and 14C leucine, and by flow cytometric analysis of cell cycle progression. Early depletion in cellular ATP occurred when Adr induced an evident cytocidal effect. PMID- 2705749 TI - Adriamycin interacts with diacylglycerol to inhibit human leukemia protein kinase C. AB - Protein kinase C (PKC) from human leukemia ML-1 cells was found to be susceptible to inhibition by the antineoplastic anthracycline adriamycin (ADR). Half-maximal inhibition (IC50 value) was observed at 200 microM. However, preincubation of ADR with phosphatidylserine (PS) or PKC enzyme, prior to the enzyme assay, reduced the IC50 value from 200 microM to 52 microM or 40 microM, respectively, indicating an affinity of ADR for PS, and also a possible action site for ADR on PKC molecules. Preincubation of ADR with diacylglycerol (DAG) before the PKC assay resulted in a more pronounced effect, i.e., a more rapid decline of PKC activity with an IC50 value of 7 microM. However, the IC50 for ADR inhibition was not altered when ATP, histone or Ca++ were preincubated with ADR. Studies of the kinetic nature of the inhibition revealed that ADR inhibition assumes competitive kinetics with respect to DAG. Therefore, the mechanism by which ADR inhibits PKC activity may involve a multi-site action: a primary interaction with DAG, and a secondary lower interaction with membrane PS and PKC apoenzyme. PMID- 2705750 TI - Contribution of quantitative cytology to the cytological diagnosis of thyroid neoplasms. AB - In a previous study we determined that the fine needle aspiration (FNA) biopsy of thyroid produces 16% of false-negative cases (FNC). In order to determine the value of quantitative cytology (QC) as a tool for predicting the FNC result, thirty-seven cases, 18 of which were operated (histologically benign: 13; malignant: 3; atypical adenoma; 2) were examined for quantitative morphologic characteristics. The smears were stained by the Feulgen method and nuclear parameters of morphometry, densitometry and texture were computed by a cell image processor. The system was first taught to recognize the benign and malignant cells from 3 histologically benign and malignant lesions. Thereafter, prospective cases were submitted to decisional analysis. For 10 histologically benign cases, the benign cell rate (bcr) ranged from 65% to 99.4 (95% confidence interval). Among the patients with a cytologically benign lesion (and an unknown histological diagnosis), 2 had a bcr less than 65% and so were not to be regarded as benign. The follow-up of these patients will show whether they represent FNC and whether QC can be of predictive value in assessing the FNC. PMID- 2705751 TI - Targeting adriamycin to tumour cells by means of an affinity ligand; a model system for drug delivery. AB - Actively migrating tumour cells possess the proteolytic enzyme guanidinobenzoatase (GB) in an uninhibited form. This enzyme has been used as a target for the delivery of adriamycin to invasive tumour cells in frozen sections. An adriamycin-agmatine complex has been prepared which act as a competitive inhibitor of GB. Competition experiments have demonstrated that the adriamycin-agmatine complex competes with 9-aminoacridine for the active centre of GB associated with invasive tumour cells, located in the lymph nodes and in squamous cell carcinoma of the oral cavity. The technique described should be generally applicable to the targeting of drugs to cells. PMID- 2705752 TI - Doxorubicin resistance circumvention by verapamil in B16 melanoma cells. AB - We present data on the cellular drug pharmacokinetic alterations correlated with the circumvention of doxorubicin resistance by verapamil in a B16 melanoma cell line. An increased drug uptake, a decreased drug efflux and a different intracellular drug distribution appear to be responsible for the enhancement of doxorubicin cytotoxicity induced by treatment with verapamil in drug-resistant cells. However, doxorubicin pharmacokinetics and cytotoxicity were not affected by verapamil in doxorubicin-sensitive melanoma cells. PMID- 2705753 TI - Treatment of colorectal cancer and other malignancies with continuous infusion of 5-fluorouracil. AB - Twenty-six consecutive patients with gastrointestinal and other epithelial origin neoplasms were treated with continuous intravenous infusion of 5-Fluorouracil using a portable pump. Out of twenty-four evaluable patients, four achieved complete remission, four a partial response while in twelve patients the disease remained stable. The overall response rate was 33%. Twenty out of the 24 patients achieved significant improvement in their performance status and quality of life. The median survival was 9.5 months. The two more frequently observed toxicities were stomatitis (19.5%) and hand-foot syndrome (15.3%). Our study shows that long term continuous infusion of 5-Fluorouracil is of palliative value in patients with gastrointestinal and other neoplasma of epithelial origin. The use of portable pumps makes this a practical and cost effective outpatient form of treatment. PMID- 2705754 TI - Cytotoxicity of N4-behenoyl-1-beta-D-arabinofuranosylcytosine through gradual conversion to 1-beta-D-arabinofuranosylcytosine in HeLa cells. AB - The metabolism of 1-beta-D-arabinofuranosylcytosine (ara-C) and N4-behenoyl-1 beta-D-arabinofuranosylcytosine (BH-AC) was studied in Hela cells. After the cells were exposed to ara-C at a concentration of 20 micrograms/ml or BH-AC at 46.5 micrograms/ml for 1, 3, 6, 12 or 24 hr, the level of ara-C was determined using the radioimmunoassay method, and the level of BH-AC and 1-beta-D arabinofuranosyluracil (ara-U), using high-performance liquid chromatography. In the ara-C-treated cells, the intracellular ara-C increased to 1.26 micrograms/g cells after exposure for 6 hr, and ara-C was rapidly changed to ara-U in the cells and in the medium. In the BH-AC-treated cells, the intracellular BH-AC increased after exposure for 24 hr and BH-AC was gradually converted to ara-C in the cells: the intracellular level of ara-C was only 15% of that of BH-AC after exposure for 24 hr. BH-AC level in the medium persisted for 24 hr, at the initial concentration. Our findings show that BH-AC is stable compared to ara-C and gradually converts to ara-C. This conversion is presumably a critical step in the antineoplastic effect of BH-AC. PMID- 2705755 TI - Growth delay effect of combined interstitial hyperthermia and brachytherapy in a rat solid tumor model. AB - The rat mammary AC33 solid tumor model was used to investigate the efficacy of interstitial hyperthermia and/or brachytherapy. Subcutaneous flank tumors were heated with an interstitial microwave (915 MHz) antenna to a temperature of 43 +/ 0.5 degrees C for 45 min for two treatments, three days apart, and/or implanted with Ir-192 seeds for three days (-25 Gy tumor dose). Following treatments, tumors were measured 2 to 3 times per week. Hyperthermia alone produced a modest delay in tumor volume regrowth, while brachytherapy was substantially more effective. The combination produced a improvement in tumor regrowth delay compared to brachytherapy alone. PMID- 2705756 TI - Bactericidal and cytotoxic effect of combination of norfloxacin and 5 fluorouracil. AB - Using the agar dilution technique, we examined the in vitro antibacterial activity of 5-fluorouracil and norfloxacin alone and in association against several bacterial strains. When administered in association, the two drugs did not antagonize each other in tests carried out on strains both sensitive and resistant to penicillins, cephalosporins, aminoglycosides, tetracyclines; furthermore their respective antibacterial properties remained largely unimpaired. The cytotoxic activity and the antitumoral effect of a combination of 5-fluorouracil and norfloxacin was determined in cultured tumor cells, and in mice bearing Ehrlich ascites carcinoma. No significant interference with the cytotoxic activity and antitumoral activity of 5-fluorouracil was observed. PMID- 2705757 TI - Immunogold and immunogold/silver staining in the ultrastructural localization of target molecules identified by monoclonal antibodies. AB - A new method for demonstrating the binding and internalization of target molecules identified by two different monoclonal antibodies (MAbs) is described. This double staining technique utilizes, in a pre-embedding procedure, an immunogold/silver staining and a MAb that recognized cell surface antigens and a post-embedding technique where only immunogold is used to identify intracytoplasmic antigens. We could demonstrate that immunogold and gold followed by silver enhancement are two highly sensitive and accurate techniques. Colloidal gold particles are versatile tracers at the electron microscopic level when used at two different particle sizes (5 and 20 nm in diameter) in a double labelling method for the simultaneous identification of antigenic sites on the same section; the combined use of immunogold and gold/silver staining for the simultaneous localization of breast cancer-associated antigens on the same thin section is more accurate. These techniques have also been used to visualize the internationalization of antigen-antibody complexes by incubating MAb-gold labelled tissue sections for 30 min at 37 degrees C. We conclude that the use of both colloidal gold and gold/silver constitutes a further improvement in immunoelectron microscopy techniques and can help visualize the relative pattern of reactivity of two MAbs on the same cells. Further applications of these techniques will have an important impact on the development and use of MAbs in oncology. PMID- 2705758 TI - Inhibition by beta-carotene-rich algae Dunaliella of spontaneous mammary tumourigenesis in mice. AB - Effects of beta-carotene-rich algae Dunaliella on spontaneous mammary tumourigenesis were studied in SHN mice. In both breeder and virgin mice, mammary tumourigenesis was significantly inhibited in the experimental groups fed diets supplemented with spray dried powder of D. bardawil and oily solution of D. salina Teod. extract compared with the control. There was little difference between the experimental and the control groups in plasma prolactin level, endocrine organ weights and pattern of oestrous cycles. Moreover, mammary gland susceptibility to mammotrophic hormones was affected little by Dunaliella. These results suggest that the inhibition by Dunaliella of spontaneous mammary tumourigenesis of mice may not be through their modulation of endocrine systems. PMID- 2705759 TI - Increased ovarian tumor cell surface reacting antibodies in patients with ovarian adenocarcinoma after viral oncolysate treatment. AB - Antibodies reacting with the cell surface of ovarian tumor cell lines were detected in the sera of untreated patients with ovarian cancer using cell surface immunofluorescence and FACS analysis. Vaccination of these patients with viral oncolysates increased the antibody production against ovarian cell surface antigens. These antibodies cross-reacted with a melanoma cell line (WM-75), and a lymphoblastoid cell line (Daudi). Immunoprecipitation and SDS-PAGE analysis of 125I-iodine labelled cell surface antigens of ovarian cells revealed a response to private and common antigens expressed on the cell surface of the tumor cells. PMID- 2705760 TI - Effect of verapamil in vitro and in vivo on the accumulation of vincristine in leukemic cells from patients with low malignant lymphoma. AB - The accumulation of vincristine in leukemic cells and normal mononuclear cells and the effect of verapamil on cellular drug accumulation were studied. Leukemic cells were isolated from 10 patients with chronic lymphocytic leukemia, immunocytoma and prolymphocytic leukemia. Normal mononuclear cells were collected from 3 healthy subjects. The cells were incubated with [3H]-vincristine and cellular drug accumulation was determined. The accumulation of vincristine differed nine-fold between patients. The presence of verapamil, 6.6 microM, during the incubation, increased drug accumulation by 150-550%. The effect increased with increasing verapamil concentrations up to 12-15 microM. The increased accumulation of vincristine caused by verapamil also led to increased in vitro cytotoxicity. However, neither the cellular accumulation of vincristine nor the effect of verapamil on drug accumulation was correlated with the clinical response to vincristine-containing treatment regimens. To study the clinical effect of verapamil on leukemic cell accumulation of vincristine, 4 patients were given verapamil, 120 mg three times orally. The plasma concentrations of verapamil after 3 days of treatment were lower than those required to enhance vincristine accumulation in vitro. In addition, norverapamil could also be detected in all patients. Before and at the end of the verapamil treatment period, blood from the patients was incubated with [3H]-vincristine and the leukemic cells then isolated. Verapamil treatment had no effect on the accumulation of vincristine in leukemic cells. PMID- 2705761 TI - Effect of food restriction on the metabolism of dimethylnitrosamine (NDMA) in rats. AB - The influence of food restriction on the macromolecular interactions of the hepatocarcinogen dimethylnitrosamine (NDMA) in the livers of male Sprague Dawley rats was investigated. Two-three month old rats were food restricted (FR) (40% with respect to ad libitum fed rats) for three weeks. The liver weight, total protein, microsomal and cytoplasmic protein, cytochrome P-450 and DNA content per whole liver were all reduced significantly in food restricted rats. Five hours after a single dose of (14C) NDMA (28 mg/k.b.w., 21 microCi/rat) the levels of 7 methylguanine increased in restricted rats by 32%. Cytochrome P-450 mediated generation of HCHO from NDMA (1.8 fold) in restricted rats was greater. Binding of NDMA derived radioactivity to total hepatic proteins decreased by 46% in restricted rats. These results suggest that food restriction enhances the metabolic activation of dimethylnitrosamine in Sprague Dawley rats. PMID- 2705762 TI - Kinetics of in vivo tumor cell destruction after specific immunization. AB - The natural cytotoxic activity in vivo can be evaluated by measuring in vivo tumor cell destruction after injecting mice with 125IUdR-labeled tumor cells, measuring their total body radioactivity and calculating the % radioactivity lost. We have studied the in vivo destruction of 125IUdR-labeled L1210 leukemic cells by B10.D2 mice previously immunized 4 times with heavily irradiated L1210 leukemic cells. Mathematical analysis of our results indicates that the radiolabel loss on day 1 is similar in normal and immunized animals, but that it stays greater over the following days in immunized animals, indicating that the difference between the two groups is not the extent of the initial cell destruction but the durability of the response. There is a good correlation between the eventual survival, the % of 125IUdR lost and the number of tumor cells present in the peritoneal cavity three hours after their injection. Such a methodology provides a very early prediction of the survival of each mouse, thus identifying animals with a poor prognosis. PMID- 2705763 TI - Microbial colonization of injured cactus tissue (Stenocereus gummosus) and its relationship to the ecology of cactophilic Drosophila mojavensis. AB - Necrotic tissue of agria cactus (Stenocereus gummosus) serves as a feeding and breeding substrate for Drosophila mojavensis. This fly species is one of the four endemic Drosophila species in the Sonoran Desert. Freeze injuries were created in arms of agria cactus in Mexico to study the events of microbial colonization. Facultative anaerobic bacteria were the first microbes to be detected, and the exclusion of large arthropods by covering the injuries with netting did not affect bacterial colonization. Yeast growth lagged behind bacterial growth by 2 days, and excluding arthropods delayed the detection of yeasts by an additional 2 days. Thus, insects (such as Drosophila species) and other arthropods do play a role in the colonization of agria rots by yeasts. All injuries were attractive to D. mojavensis within 5 days, and these flies were shown to be carrying significant densities of both bacteria and yeasts. Analysis of the volatile compounds present in the developing rots over time indicated that the volatile pattern is dynamic. Ethanol and acetic acid were the two volatile substances most likely responsible for the initial attraction of the injuries for Drosophila species. PMID- 2705764 TI - Agarose soy casein digest medium for replacement of blood agar for potency determinations of live Pasteurella vaccines. AB - Blood agar, prepared with Trypticase (BBL Microbiology Systems, Cockeysville, Md.) soy agar and 5% defibrinated bovine blood, is used for testing the potency of live Pasteurella multocida and Pasteurella haemolytica vaccines, but its potential for variation makes it undesirable to use in a standard assay method. Tests done with RPMI 1640 and Trypticase soy medium indicated that the benefits obtained by adding defibrinated blood to the Trypticase soy agar medium were more likely due to neutralization of toxic components than to the presence of transferrin or iron as growth factors. Reduction of toxic components in the Trypticase soy agar medium was accomplished by replacing agar with agarose and by autoclaving glucose as a separate solution to produce the replacement medium. The replacement medium was prepared by autoclaving three separate solutions- Trypticase soy broth without glucose; glucose; and agarose--cooling to 55 degrees C, and mixing and then pouring the mixtures into petri dishes. The growth obtained with this medium as judged by determination of the number of CFU and the colony sizes of P. multocida or P. haemolytica was equal to or better than those obtained with blood agar. PMID- 2705765 TI - Development of a differential medium for bile salt hydrolase-active Lactobacillus spp. AB - An agar plate assay was developed to detect bile salt hydrolase activity in lactobacilli. On Lactobacillus-selective MRS or Rogosa SL medium supplemented with taurodeoxycholic, taurocholic, or taurochenodeoxycholic acids, bile salt hydrolysis was manifested at two intensities: (i) the formation of precipitate halos around colonies or (ii) the formation of opaque granular white colonies. Sixty-six lactobacilli were tested for bile salt hydrolase activity by both the plate assay and a sensitive radiochemical assay. No false-positive or false negative results were detected by the plate assay. Based on results of experiments with Eubacterium lentum and Bacteroides species, the plate assay was dependent on two factors: (i) the presence of bile salt hydrolytic activity and (ii) the ability of the organism to sufficiently acidify the medium to protonate free bile acids. The availability of a differential medium for determination of bile salt hydrolase activity will provide a rapid method for determining shifts in a specific functional activity of intestinal Lactobacillus species and provide a rapid screening capability for identifying bile salt hydrolase-deficient mutants. The latter application should allow bile salt hydrolase activity to be used as a marker enzyme in genetic experiments. PMID- 2705766 TI - Associated bacterial flora, growth, and toxicity of cultured benthic dinoflagellates Ostreopsis lenticularis and Gambierdiscus toxicus. AB - The growth, toxicity, and associated bacterial flora of 10 clonal cultures of the toxic benthic dinoflagellates Ostreopsis lenticularis and Gambierdiscus toxicus isolated from the coastal waters of southwest Puerto Rico have been examined. Clonal cultures of O. lenticularis grew more rapidly and at broader temperature ranges than those of G. toxicus. All five Ostreopsis clones were toxic, while only one of the five Gambierdiscus clones was poisonous. The degree of toxicity among poisonous clones was highly variable. The number of associated bacterial genera and their frequency of occurrence were quite variable among clones of both dinoflagellate genera. Bacterial isolates represented six genera (Nocardia, Pseudomonas, Vibrio, Aeromonas, Flavobacterium, and Moraxella) in addition to coryneform bacteria. Extracts of dinoflagellate-associated bacteria grown in pure culture were not toxic. Gambierdiscus clones were characterized by the frequent presence of Pseudomonas spp. (four of five clones) and the absence of coryneforms. In O. lenticularis, only one of five clones showed the presence of Pseudomonas spp., and Moraxella sp. was absent altogether. Detailed analyses of toxicity and associated microflora in a selected Ostreopsis clone, repeatedly cultivated (four times) over a period of 160 days, showed that peak cell toxicities developed in the late static and early negative culture growth phases. Peak Ostreopsis cell toxicities in the stationary phase of culture growth were correlated with significant increases in the percent total bacteria directly associated with these cells. Changes in the quantity of bacteria directly associated with microalgal cell surfaces and extracellular matrices during culture growth may be related to variability and degree of toxicity in these laboratory-cultured benthic dinoflagellates. PMID- 2705767 TI - Ruminal cellulolytic bacteria and protozoa from bison, cattle-bison hybrids, and cattle fed three alfalfa-corn diets. AB - Ruminal cellulolytic bacteria and protozoa and in vitro digestibility of alfalfa fiber fractions were compared among bison, bison hybrids, and crossbed cattle (five each) when they were fed alfalfa and corn in a ratio of 100:0, 75:25, and 50:50, respectively. The total number of viable bacteria (2.16 x 10(9) to 5.44 x 10(9)/ml of ruminal fluid) and the number of cellulolytic bacteria (3.74 x 10(7) to 10.9 x 10(7)/ml) were not different among groups of animals fed each diet. The genera of protozoa in all of the animal groups were similar; however, when either the 100:0 or 50:50 diet was used the percentage of Entodinium sp. was lower and the percentage of Diplodiniinae was higher (P less than 0.05) in bison than in bison hybrids or cattle. Bacteroides succinogenes made up the largest number of cellulolytic isolates from bison (58 and 36%, respectively, on the 100:0 and 75:25 diets), which were more numerous (P less than 0.05) than those from bison hybrids (36 and 12%) and cattle (33 and 18%). This was offset by a lower number of cellulolytic Butyrivibrio isolates. The numbers of Ruminococcus albus and R. flavefaciens isolates, in general, were similar among the bovid species, although R. flavefaciens generally made up less than 10% of the cellulolytic isolates. In vitro digestibility coefficients were greater (P less than 0.05) for the bison when the 75:25 diet was used and similar for the other two diets. The concentration of ruminal volatile fatty acids was larger (P less than 0.05) in bison than in bison hybrids and cattle when the 50:50 diet was used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705768 TI - Biodegradation of polycyclic hydrocarbons by Phanerochaete chrysosporium. AB - The ability of the white rot fungus Phanerochaete chrysosporium to degrade polycyclic aromatic hydrocarbons (PAHs) that are present in anthracene oil (a distillation product obtained from coal tar) was demonstrated. Analysis by capillary gas chromatography and high-performance liquid chromatography showed that at least 22 PAHs, including all of the most abundant PAH components present in anthracene oil, underwent 70 to 100% disappearance during 27 days of incubation with nutrient nitrogen-limited cultures of this fungus. Because phenanthrene is the most abundant PAH present in anthracene oil, this PAH was selected for further study. In experiments in which [14C]phenanthrene was incubated with cultures of P. chrysosporium containing anthracene oil for 27 days, it was shown that 7.7% of the recovered radiolabeled carbon originally present in [14C]phenanthrene was metabolized to 14CO2 and 25.2% was recovered from the aqueous fraction, while 56.1 and 11.0% were recovered from the methylene chloride and particulate fractions, respectively. High-performance liquid chromatography of the 14C-labeled material present in the methylene chloride fraction revealed that most (91.9%) of this material was composed of polar metabolites of [14C]phenanthrene. These results suggest that this microorganism may be useful for the decontamination of sites in the environment contaminated with PAHs. PMID- 2705769 TI - Biotransformation and detoxification of T-2 toxin by soil and freshwater bacteria. AB - Bacterial communities isolated from 17 of 20 samples of soils and waters with widely diverse geographical origins utilized T-2 toxin as a sole source of carbon and energy for growth. These isolates readily detoxified T-2 toxin as assessed by a Rhodotorula rubra bioassay. The major degradation pathway of T-2 toxin in the majority of isolates involved side chain cleavage of acetyl moieties to produce HT-2 toxin and T-2 triol. A minor degradation pathway of T-2 toxin that involved conversion to neosolaniol and thence to 4-deacetyl neosolaniol was also detected. Some bacterial communities had the capacity to further degrade the T-2 triol or 4 deacetyl neosolaniol to T-2 tetraol. Two communities, TS4 and KS10, degraded the trichothecene nucleus within 24 to 48 h. These bacterial communities comprised 9 distinct species each. Community KS10 contained 3 primary transformers which were able to cleave acetate from T-2 toxin but which could not assimilate the side chain products, whereas community TS4 contained 3 primary transformers which were able to grow on the cleavage products, acetate and isovalerate. A third community, AS1, was much simpler in structure and contained only two bacterial species, one of which transformed T-2 toxin to T-2 triol in monoculture. In all cases, the complete communities were more active against T-2 toxin in terms of rates of degradation than any single bacterial component. Cometabolic interactions between species is suggested as a significant factor in T-2 toxin degradation. PMID- 2705770 TI - Mycotoxin production by Fusarium oxysporum and Fusarium sporotrichioides isolated from Baccharis spp. from Brazil. AB - Fusarium oxysporum isolated from roots of and soil around Baccharis species from Brazil produced the trichothecenes T-2 toxin, HT-2 toxin, diacetoxyscirpenol, and 3'-OH T-2 (TC-1), whereas Fusarium sporotrichioides from the same source produced T-2 toxin, HT-2 toxin, acetyl T-2, neosolaniol, TC-1, 3'-OH HT-2 (TC-3), iso-T-2, T-2 triol, T-2 tetraol, and the nontrichothecenes moniliformin and fusarin C. Several unknown toxins were found but not identified. Not found were macrocyclic trichothecenes, zearalenone, wortmannin, and fusarochromanone (TDP-1). PMID- 2705771 TI - Lasalocid-catalyzed proton conductance in Streptococcus bovis as affected by extracellular potassium. AB - The effect of extracellular potassium on lasalocid-catalyzed proton conductance in Streptococcus bovis 24 was measured by using the fluorescent probe 9 aminoacridine. Increasing external potassium concentration resulted in decreased proton flux into S. bovis cells exposed to the ionophore. These results suggest that lasalocid catalyzes K+/H+ exchange diffusion in S. bovis cells. PMID- 2705772 TI - Use of nutrient response techniques to assess the effectiveness of chlorination of rapid sand filter gravel. AB - A direct viable counting method was used to rapidly assess the effectiveness of chlorination of biofilms on rapid sand filter gravel. A total of 50% of the cells were nutrient responsive after exposure to 0.5 mg of chlorine per liter, while this value was 25% after exposure to 25 mg of chlorine per liter. A large variation was seen in the numbers of nutrient-responsive cells on different rocks. More cells attached to the sandblasted side of marbles than to the smooth side, but there was no difference in eight of nine cases in the proportion of survival to chlorination between the two different sides. The effectiveness of chlorination appeared to be influenced by the species of bacterium in the biofilm. PMID- 2705773 TI - Isolation of Vibrio cholerae from aquatic birds in Colorado and Utah. AB - Vibrio cholerae was isolated from cloacal swabs and freshly voided feces collected from 20 species of aquatic birds in Colorado and Utah during 1986 and 1987. About 17% (198 of 1,131) fecal specimens collected from July 1986 through August 1987 contained the organism. Both O1 and non-O1 V. cholerae strains were isolated from the fecal specimens. Isolates from eight birds (representing five species) agglutinated in O group 1 antiserum. Supernatants of broth cultures from three isolates which typed as V. cholerae O1 serotype Ogawa gave reactions typical of cholera toxin when tested on Y-1 mouse adrenal cell cultures. Several serovars of non-O1 V. cholerae were isolated from the fecal specimens; serovar 22 was the most prevalent type. All non-O1 isolates were cytotoxic to Y-1 mouse adrenal cells. Only non-O1 V. cholerae was detected in water samples collected from the habitat of the birds. The results of this study suggest that aquatic birds serve as carriers and disseminate V. cholerae over a wide area. PMID- 2705774 TI - Bile salt micelle can sustain more cholesterol in the intermicellar aqueous phase than the maximal aqueous solubility. AB - The intermicellar aqueous phase in equilibrium with micelle plays an important role in the uptake of sterol. To test the hypothesis whether cholesterol concentration in the intermicellar aqueous phase of a micellar solution is similar to its maximal aqueous solubility, cholesterol concentration in the intermicellar aqueous phase of a bile salt-cholesterol solution and maximal aqueous cholesterol solubility were quantitatively determined by capillary gas liquid chromatography after filtration. Cholesterol concentration in the intermicellar aqueous phase increased linearly with cholesterol concentration in the micellar solution and reached 1.3 microM at its micellar solubility limit, while the maximal aqueous solubility of cholesterol was (1.2-1.4) x 10(-8) M. The intermicellar monomer concentration of taurocholate was 5.8 mM in which 26 x 10( 8) M cholesterol was solubilized. The results indicate the presence of a cholesterol concentration in the intermicellar aqueous phase that is significantly higher than its maximal aqueous solubility, which can be ascribed primarily to the presence of an intermicellar concentration of bile salt. PMID- 2705775 TI - Vanadium(IV)-stimulated hydrolysis of 2,3-diphosphoglycerate. AB - Vanadium(IV) stimulates the hydrolysis of 2,3-diphosphoglycerate at 23 degrees C. The pH optimum is 5.0. Reactions were analyzed by enzymatic and phosphate release assays. The products of 2,3-diphosphoglycerate hydrolysis are inorganic phosphate and 3-phosphoglycerate. The reaction is inhibited by high concentrations of 2,3 diphosphoglycerate and an equation has been formulated that describes the kinetic constants for this reaction at pH 7. The possible relevance of the reaction to the therapeutic lowering by vanadium(IV) of red cell 2,3-diphosphoglycerate in sickle-cell disease is discussed. PMID- 2705776 TI - Interactions involved in ovomucin gel-forming properties: a rheological biochemical approach. AB - Different kinds of interactions involved in the properties of ovomucin gel formation from hen egg white were studied by combining physical and biochemical methods. A decrease in viscosity of the ovomucin gel was observed when it was subjected to chymotrypsin or sonication treatment. The viscosity decrease correlated with a change from non-Newtonian to Newtonian properties of the ovomucin gel. By treatment of the gel with either 5 M guanidinium HCl, 6 M urea, or 5% sodium dodecyl sulfate a change from non-Newtonian to Newtonian properties was also obtained. Although high ionic strength or sialic acid liberation from the ovomucin gel by neuraminidase treatment provoked a decrease in viscosity, it was not followed by a change in non-Newtonian properties. The results obtained suggest that different noncovalent interactions might be involved in gel formation. Electrostatic interactions (partially destroyed by sialic acid removal or 2 M NaCl) and hydrophobic interactions might be responsible for protein-mucin and mucin-mucin interactions. Other bonds susceptible to chymotrypsin treatment and sonication would be involved in the interaction between mucin subunits. PMID- 2705777 TI - Multiple forms of biliverdin reductase: modification of the pattern of expression in rat liver by bromobenzene. AB - Rat liver biliverdin reductase was purified from control and bromobenzene-treated rats and was designated as C-BVR-T and B-BVR-T, respectively. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed the existence of two molecular weight variants (30,100 and 29,800) in C-BVR-T but only one form (30,100) in B-BVR-T. Western immunoblotting confirmed that both molecular weight variants were biliverdin reductase. Nondenaturing electrophoresis separated C-BVR T and B-BVR-T preparations into groups of four variants, designated as BVR ND1 to ND4. However, the C-BVR-T preparation contained three major forms (BVR ND1, ND2, and ND3) while the B-BVR-T preparation contained two major forms (BVR ND2 and ND3). In vitro treatment of biliverdin reductase preparations with either bromobenzene or dithiothreitol did not interconvert the variants of the enzyme. QAE-Sepharose anion-exchange chromatography was used to isolate the ND2 and ND3 variants for physiochemical analysis. The amino acid composition of the variants was rather similar except for their Tyr content. Also, the peptide maps were similar except for a series of moderately early chromatographic peaks. These findings implied secondary modifications to the protein rather than substantial differences in primary structure. The pH-dependent cofactor requirements for enzyme activity were examined. Both variants exhibited 2 pH optima that were cofactor dependent; maximum activity with NADPH and NADH was observed at pH 8.5 and 6.7, respectively. However, both variants exhibited a higher catalytic rate with NADH than with NADPH at their pH optima. Furthermore, BVR ND3 exhibited a higher catalytic rate than BVR ND2 with either cofactor throughout the pH range 6.5-9. PMID- 2705778 TI - Studies on the biosynthesis of avermectins. AB - To elucidate the pathway of avermectin biosynthesis, the biosynthetic relationships of avermectins A1a, A2a, B1a, B2a, and their respective monosaccharides and aglycones were studied. 14C-labeled avermectin compounds prepared from [1-14C]acetate were fed to Streptomyces avermitilis strain MA5502 and their metabolites were determined. Two furan ring-free aglycones, 6,8a-seco 6,8a-deoxy-5-keto avermectin B1a and B2a, have been isolated from the fermentation broth of a blocked mutant of S. avermitilis. Addition of the compounds and a semisynthetic compound, 5-keto avermectin B2a aglycone, to the fermentation medium of a second blocked mutant established that the two compounds are intermediates in the avermectin biosynthetic pathway immediately preceding avermectin aglycones. PMID- 2705779 TI - Reactions of phosphonate analogs of pyridoxal phosphate with apo-aspartate aminotransferase. AB - We have investigated reactions of the 5-phosphonoethyl and 5-phosphonoethenyl analogs of pyridoxal 5'-phosphate in the coenzyme site of cytosolic aspartate aminotransferase. Acid dissociation constants and equilibrium constants for hydration and for tautomerization have been evaluated for these compounds. In confirmation of previous results, both compounds are partially active. They bind to apoenzyme well and undergo conversion in the presence of glutamate to amine forms which show induced circular dichroism comparable to that of native enzyme. A normal "external" Schiff base is evidently formed with 2-methylaspartate, but the amounts of quinonoid intermediate formed with erythro-3-hydroxyaspartate are less than those formed with pyridoxal phosphate. The pKa of the imine group of the enzyme reconstituted with the phosphonoethyl analog is more than two units lower than that in the native enzyme. Binding of the dicarboxylates glutarate, 2 oxoglutarate, and succinate shifts the pKa upward. The absorption spectra of the resulting complexes indicate the existence of at least three low pH species. A shift of 2.3 to 2.9 ppm to a lower frequency was observed for the 31P NMR signal upon binding of these dicarboxylates or of 2-methylaspartate. Enzyme containing the analogs crystallizes. Polarized absorption spectra suggest that the coenzyme has an orientation similar to that of pyridoxal phosphate in the native enzyme. PMID- 2705780 TI - Possible involvement of a 95-kDa protein phosphorylation in phorbol 12-myristate 13-acetate-induced suppression of zymosan phagocytosis in guinea pig macrophages. AB - Recently, we characterized a surface antigen (Z-1) of guinea pig macrophages by monoclonal anti-Z-1 antibody. The Z-1 antigen consists of two different polypeptide chains; alpha (140 kDa) and beta (95 kDa). This antigen is closely correlated with the phagocytic activity of the cells for zymosan and presumably functions as a receptor for zymosan. In the present study, the effect of phorbol 12-myristate 13-acetate (PMA) on the function of Z-1 was examined. Incubation of ortho-[32P]phosphate-labeled macrophages with PMA greatly increased the phosphorylation of the beta subunit of Z-1 but not that of the alpha subunit. Optimal phosphorylation was observed when cells were incubated with 300 ng/ml of PMA for 60-120 min. The PMA-induced phosphorylation was markedly suppressed by treatment of the macrophages with H-7, an inhibitor of protein kinase C. A chemotactic peptide, N-formyl-Met-Leu-Phe (fMLP) also caused phosphorylation of the beta subunit. Unlike PMA, fMLP maximized the phosphorylation within 30 s. Purified Z-1 was an excellent substrate for the exogenously added protein kinase C only in the presence of both Ca2+ and phosphatidylserine. H-7 completely inhibited the in vitro phosphorylation. These data suggest that the beta subunit of Z-1 is phosphorylated by protein kinase C. The phosphorylation of Z-1 by PMA and fMLP coincided with inhibition of zymosan phagocytosis. A linear relationship was obtained between the level of phosphorylation of Z-1 and the degree of inhibition of zymosan phagocytosis induced by PMA. Thus, the results suggest that zymosan uptake is negatively regulated by protein kinase C-mediated phosphorylation of the beta subunit of Z-1. PMID- 2705781 TI - Suppression in the expression of a male-specific cytochrome P450, P450-male: difference in the effect of chemical inducers on P450-male mRNA and protein in rat livers. AB - Hypophysectomy of male adult rats caused a 70% decrease in the hepatic level of mRNA hybridized to two specific oligonucleotide probes for the sequence of coding and 3'-noncoding regions of P450(M-1) (H. Yoshioka et al., (1987) J. Biol. Chem. 262, 1706-1711), which corresponds to P450-male. Treatment of hypophysectomized male and female rats with subcutaneous injection of human growth hormone twice a day for 7 days increased the mRNA to a level similar to that of normal male rats. In contrast, the mRNA was decreased by treatment with continuous infusion. These results correlated well with those on the amounts of P450-male protein, indicating that growth hormone regulates the hepatic level of P450-male protein mainly by acting at the pretranslational step. Treatment of adult male rats with phenobarbital (PB), dexamethasone (Dex), or 3-methylcholanthrene (MC) decreased the content of P450-male protein by 68, 36, and 46%, respectively. The content of P450-male protein was also decreased to 65% in Dex-treated hypophysectomized male rats, but was not changed by treatment of hypophysectomized male rats with PB or MC, suggesting that PB and MC decrease P450-male protein through a pituitary growth hormone-mediated process. However, the level of mRNA hybridizable to the P450-male oligonucleotide probe was not decreased, but rather it increased in PB- or Dex-treated hypophysectomized male rats. A similar inconsistent change in protein and mRNA was also observed in PB-treated normal rats. These results indicate that PB and Dex have an additional effect of increasing the hepatic level of the specific mRNA of P450-male/(M-1) or a closely related form. Noncoordinate changes in the level of P450-male protein and mRNA also suggest that the hepatic level of P450-male protein is regulated by plural mechanisms: pretranslational and translational regulation in which pituitary growth hormone and/or other endocrine factors are involved. PMID- 2705782 TI - Homology of the D-galactose-specific lectins from Artocarpus integrifolia and Maclura pomifera and the role of an unusual small polypeptide subunit. AB - The Maclura pomifera agglutinin (MPA) was purified by affinity chromatography from a seed extract and its properties were compared with those of the Artocarpus integrifolia lectin, jacalin. Reverse-phase high-performance liquid chromatography showed both proteins had multiple forms of a small approximately 20-residue polypeptide chain in addition to the major 12,000 Mr subunit. The amino acid sequences of the small chains and the N-terminal sequences of the large subunits showed considerable similarity between the two proteins, approximately 60% identical residues. The homology of the proteins was confirmed by the similarity of their circular dichroism and fluorescence emission spectra. MPA showed much greater spectral changes upon binding methyl alpha-D-galactoside, suggesting it has complete activity rather than the partial activity found for jacalin. The binding of methyl alpha-D-galactoside by MPA was measured by fluorescence titration; the KA was 1.9 X 10(4) M-1 compared to 3.4 X 10(4) M-1 for jacalin. MPA also precipitated human IgA1 in the same manner as jacalin. The spectra indicate the involvement of tryptophan and tyrosine residues in the binding site of these lectins. Since a tryptophan residue is conserved in all the small subunits, they may form part of the binding site. PMID- 2705783 TI - Expression of rat liver heme oxygenase gene during development. AB - We studied the genetic expression during fetal development of heme oxygenase, the rate-limiting enzyme in the oxidation of heme to bilirubin. The transcription of the heme oxygenase gene in livers of fetal and neonatal rats (9 days before birth to 28 days after birth) was examined. Hybridization analyses of total RNA from livers of these animals using cDNA for rat heme oxygenase as the probe revealed a single mRNA species of approximately 18 S in every sample examined. The mRNA level was above the adult level throughout the course of study and reached a maximum 24 h after birth. The high level of heme oxygenase mRNA in fetuses was unaffected when Sn-protoporphyrin, a potent inhibitor of heme oxygenase, was administered to their mothers. On the other hand, the mRNA levels in the mothers treated with this heme analog were substantially increased, possibly by the same mechanism as for the induction by heme. Sn-protoporphyrin potentiates induction of heme oxygenase mRNA in cobalt chloride-pretreated rats, and also acts as a potent inhibitor of heme oxygenase enzyme activities. Our results also indicate that high heme oxygenase levels during fetal maturation are due to an increase in transcription of the gene. Thus, Sn-protoporphyrin which crosses the placenta controls fetal hyperbilirubinemia by direct enzyme inhibition. PMID- 2705784 TI - Steady-state kinetic studies of the metal ion-dependent decarboxylation of oxalacetate catalyzed by pyruvate kinase. AB - Steady-state kinetic studies with differing divalent metals ions have been carried out on the pyruvate kinase-catalyzed, divalent cation-dependent decarboxylation of oxalacetate to probe the role of the divalent metal ion in this reaction. With either Mn2+ or Co2+, initial velocity patterns show that the divalent metal ion is bound to the enzyme in a rapid equilibrium prior to the addition of oxalacetate. Further, there is no change in the initial velocity patterns or the kinetic parameters in the presence or absence of K+, indicating that K+ is not required for oxalacetate decarboxylation. Dead-end inhibition of the decarboxylation reaction by the physiological substrate phosphoenolpyruvate indicates that phosphoenolpyruvate binds only to the enzyme-metal ion complex and not to free enzyme. The pKi values for both Mn2+ and Co2+ decrease below a pK of 7.0, and increase above a pK of 8.9. Since these pK values are the same for both ions, both of the observed pK values must be attributable to enzymatic residues. The pK of 7.0 is presumably that of a ligand to the metal ion, while the pK of 8.9 is probably that of the lysine involved in enolization of pyruvate in the normal physiological reaction. However, with Co2+ as divalent cation, the V for oxalacetate decreases above a pK of 8.0, the V/K decreases above two pK values averaging 7.8, and the pKi for oxalate decreases above a single pK of 7.3. These data indicate that metal-coordinated water is displaced during the binding of substrates or inhibitors and the other pK value observed in both V and V/K pH profiles (pK of 8.3 with Co2+ and 9.2 with Mg2+) is an enzymatic residue whose deprotonation disrupts the charge distribution in the active site and decreases activity. PMID- 2705785 TI - Mitochondrial damage as a mechanism of cell injury in the killing of cultured hepatocytes by tert-butyl hydroperoxide. AB - The killing of cultured hepatocytes by tert-butyl hydroperoxide (TBHP) occurs by different mechanisms depending on the presence or absence of the antioxidant N,N' diphenylphenylenediamine (DPPD). In either situation there is evidence of mitochondrial damage. The mitochondrial inner membrane potential is lost, a result determined by the release from the cells of the lipophilic cation [3H]triphenylmethylphosphonium (TPMP+). Deenergization of the mitochondria is accompanied by a loss of ATP. Oligomycin reduced ATP stores without release of TPMP+ or without effect on the viability of the hepatocytes over the same time course that TBHP killed the majority of the cells. Monensin, a H+/Na+ ionophore, potentiated the toxicity of tert-butyl hydroperoxide in the presence or absence of DPPD. By contrast, extracellular acidosis reduced the toxicity of tert-butyl hydroperoxide in the presence or absence of DPPD. Neither monensin nor extracellular acidosis affected the metabolism of tert-butyl hydroperoxide, the release of TPMP+, or the extent of the peroxidation of cellular lipids. These data document the presence of mitochondrial damage in hepatocytes intoxicated with TBHP in both the presence and absence of DPPD. Furthermore, the potentiation by monensin is readily explained by the proposal that mitochondrial deenergization is accompanied by an intracellular acidosis. Such acidosis tends to delay the development of lethal cell injury. The protective effect of extracellular acidosis supports this interpretation. PMID- 2705786 TI - Adrenoleukodystrophy: impaired oxidation of fatty acids due to peroxisomal lignoceroyl-CoA ligase deficiency. AB - Very long chain fatty acids (lignoceric acid) are oxidized in peroxisomes and pathognomonic amounts of these fatty acids accumulate in X-adrenoleukodystrophy (X-ALD) due to a defect in their oxidation. However, in cellular homogenates from X-ALD cells, lignoceric acid is oxidized at a rate of 38% of control cells. Therefore, to identify the source of this residual activity we raised antibody to palmitoyl-CoA ligase and examined its effect on the activation and oxidation of palmitic and lignoceric acids in isolated peroxisomes from control and X-ALD fibroblasts. The normalization of peroxisomal lignoceric acid oxidation in the presence of exogenously added acyl-CoA ligases and along with the complete inhibition of activation and oxidation of palmitic and lignoceric acids in peroxisomes from X-ALD by antibody to palmitoyl-CoA ligase provides direct evidence that lignoceroyl-CoA ligase is deficient in X-ALD and demonstrates that the residual activity for the oxidation of lignoceric acid was derived from the activation of lignoceric acid by peroxisomal palmitoyl-CoA ligase. This antibody inhibited the activation and oxidation of palmitic acid but had little effect on these activities for lignoceric acid in peroxisomes from control cells. Furthermore, these data provide evidence that peroxisomal palmitoyl-CoA and lignoceroyl-CoA ligases are two different enzymes. PMID- 2705787 TI - Effect of nitrous oxide inactivation of vitamin B12-dependent methionine synthetase on the subcellular distribution of folate coenzymes in rat liver. AB - The effects of nitrous oxide inactivation of the vitamin B12-dependent enzyme, methionine synthetase (EC 2.1.1.13), on the subcellular distribution of hepatic folate coenzymes was determined. In controls, cytosolic folates were 5 methyltetrahydrofolate (45%), 5- and 10-formyltetrahydrofolate (9 and 19%, respectively), and tetrahydrofolate (27%). Exposure of rats to an atmosphere containing 80% nitrous oxide for 18 h resulted in a marked shift in this distribution pattern to 5-methyltetrahydrofolate, 84%; 5- and 10 formyltetrahydrofolate, 2.1 and 9.1%, respectively; and tetrahydrofolate, 4.7%. Activity of the cytosolic enzyme, methionine synthetase, was reduced by about 84% as compared to that of air breathing controls. In controls, mitochondrial folates were 5-methyltetrahydrofolate (7.3%), 5- and 10-formyltetrahydrofolate (11.5 and 33.1%, respectively), and tetrahydrofolate (48.1%). This distribution did not change after exposure to nitrous oxide. These results show that the effects of nitrous oxide inactivation of vitamin B12 are confined to the cytosol, at least in the short term, and suggest that there is little, if any, transport of free folates between the cytosolic and mitochondrial compartments. PMID- 2705788 TI - [DNA repair and drug resistance: enhancement of the effects of anticancer agents by DNA repair inhibitors]. AB - Recently, it has been revealed that anticancer effects are increased by the inhibition of DNA repair of cancer cells. Methylxanthine is the drug which block DNA repair. In this study we discussed the combined effects of CDDP and caffeine or pentoxifylline using human osteosarcoma cells (OST strain). When 2 mM caffeine was added before 1 hr exposure of CDDP or caffeine and CDDP was added simultaneously for 1 hr, no synergistic effect was shown. On the other hand, marked synergistic growth inhibition was observed when caffeine or pentoxifylline was added continuously after 1 hr exposure of CDDP. The addition of caffeine from 24 hr to 48 hr after 1 hr exposure of CDDP also showed synergistic effects as the doubling time of OST cells was about 30 hrs. Further more we treated three patients with advanced osteosarcomas by the combination of CDDP, ADM, and caffeine (p.o.) or that of CDDP and caffeine. A nine-year-old boy with multicentric osteosarcoma treated by the combination of CDDP, ADM, and caffeine showed partial response, and caffeine did not increase the side effects of anticancer agents. Hence the study on overcoming drug resistance by the inhibition of DNA repair will be promising. PMID- 2705789 TI - [Metallothionein as a resistance factor for antitumor drugs]. AB - Metallothionein (MT), a metal binding protein induced by bismuth and other heavy metals, has been proved to have a potential to prevent toxic side effects of several antitumor drugs. It has also been demonstrated that the induction of MT in tumor tissues diminishes the antitumor activity of the drugs as well. These facts suggest a possibility that MT may play an important role in acquiring multi drug-resistance in tumor cells. Thus, we were encouraged to examine the sensitivity of cultured cells overexpressing MT to various antitumor drugs which differ from each other in the mechanism of action. Cadmium-resistant cells (HeLa R) were obtained from HeLa S3 cells (HeLa-S) by successive cultivation in a medium containing 100 microM CdCl2. MT level in HeLa-R was 180 times higher than that of HeLa-S. Comparison of the sensitivity of these two strains to the antitumor drugs, such as, cis-diamminedichloroplatinum (cis-DDP), adriamycin (ADR), peplomycin (PEP) and melphalan (MEL), revealed that HeLa-R was significantly more resistant to these drugs than HeLa-S. Further, there was no significant discrepancy between these strains, either in the level of major radical scavenging factors other than MT or in the cellular uptake of the drugs. The experimental results described above appear to support the hypothesis that MT may act as a multi-drug-resistance factor in tumor tissues. PMID- 2705790 TI - [Expression of cell surface transformation-associated antigens TAAs on activated oncogene-transfected rat fibroblast and antitumor immunity by hosts]. AB - The key point in this study was that the cell surface antigens in the events of transformation were analyzed using the same clonal-derived nontransformed cell and various oncogenes. WKA rat fetus-derived fibroblast line, WFB, showed the strict non-transformant phenotypes. Transfection of EJras and polyoma middle T oncogenes into WFB resulted in the acquisition of tumorigenicity in vitro and in vivo. The newly expressed cell-surface antigens on some transformants were analyzed using four monoclonal antibodies (Moabs) (#109, #061, #081 and #067) that were produced after immunization of BALB/c mice with EJ-ras-transformed WFB clone, W31 and W14. #109 recognized a glycoprotein composed of a single polypeptide chain with 86 KD. This antigen was also expressed in the FJ ras transformants of Fisher rat fetus-derived 3Y1 fibroblast, FTL43 rat T lymphoma, SP56 rat gliosarcoma, and ca. 16th-day embryo. #061 could react with WFB transformants, but not with fetus. Furthermore, these two antigens are expressed on TGF-beta-stimulated WFB. However, #109 but not #061 is expressed on PDGF stimulated WFB, indicating that #109 expression does not require the transforming process. It is also indicated that these two antigens act as target structures in the Natural killer (NK) cytotoxicity assay. #081 could react with WFB transformants but not with FTL43, SP56 and 3Y1 ras transformants, suggesting a limited expression of #081 defined antigen on WFB transformants. #067 reacted with W31 but not with W14. This antigen is expressed on 5 clones out of approximately 40 highly tumorigenic WFB ras transformed clones. We also analyzed the expression dynamics of these TAAs during the morphological reversion of W31 to parental WFB using cAMP analogues such as dibutylic cAMP. The data indicated that, although W31 cells were reversed morphologically to WFB, the level of #109 antigen expression was not changed. #061 and #081 defined antigens were reduced by cAMP treatment for 4-5 days. However, it is of interest that #067-defined antigen expression was greatly enhanced during the morphological reversion of W31 to WFB by cAMP. This was also true when W31 was treated with 1% FCS for 5 days and heat shock, suggesting that this antigen is a heat shock-related protein. PMID- 2705791 TI - Penetrating eye injuries. AB - A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over four years (1 January 1982-31 December 1985) was undertaken. A total of 202 penetrating eye injuries were seen of which 68 (34%) were in children under the age of 15 years. Airgun, dart, and knife injuries accounted for 28 (41%) of the injuries. Thirty seven patients (54%) achieved a good visual result (6/12 or better) and eight (12%) had enucleations. The period of inpatient treatment ranged from two to 18 days. From the analysis of the activities at the time of the injury, many of the injuries can be considered to be preventable. PMID- 2705792 TI - Coarctation of the aorta corrected during the first month of life. AB - Forty eight children (29 boys) had surgical correction of coarctation of the aorta during the first month of life; all had patent ductus arteriosus. The 33 survivors were reviewed at a mean age of 6.6 years. Of the 19 children with no associated anomaly, none had died. The more complex the associated anomalies, the greater the mortality. Two (6%) of the survivors, both with associated anomalies, have some residual disability; one is incapable of leading an independent life. No survivor has systemic hypertension. Six (18%) of the survivors have required correction of recurrent coarctation, and one is awaiting repair. Newborn babies suspected of having coarctation should be assessed for surgical correction without delay, and medical treatment (including, if necessary, infusion of prostaglandin E2 in a dose of 0.025 micrograms/kg/minute) should be instituted in the interim. Long term follow up is important to detect systemic hypertension or recurrence of the coarctation. This occurred in seven (21%) of our survivors. PMID- 2705793 TI - Factors associated with developmental progress of full term neonates who required intensive care. AB - The development of 43 infants born at full term, who were admitted to neonatal intensive care units shortly after birth, was compared in a prospective longitudinal study with that of a group of 29 healthy newborn babies. Thirty infants required emergency operations during the neonatal period, and 13 were admitted for medical reasons. The effects of being in hospital and being separated from their mothers were also studied. At 1 year the 'sick' babies were performing significantly less well in almost all areas of development. In the group of sick infants, the mothers' mental health explained 25% of the variance in developmental outcome at 6 months. At 1 year the most important predictor was length of stay in hospital, which explained 35% of the variance. PMID- 2705794 TI - Value of selective screening for congenital adrenal hyperplasia in Hungary. AB - Measurement of the 17-hydroxyprogesterone concentration in blood spots was used to identify cases of congenital adrenal hyperplasia among patients with inappropriate virilisation, or salt wasting, or both. Between 1978 and 1986 61 were identified among 707 patients (278 neonates, 204 infants, and 225 children). The incidence of classic congenital adrenal hyperplasia was calculated for a seven year prospective trial period using the blood spot 17-hydroxyprogesterone method in selective screening. There were 38 salt losers and 14 simple virilisers in 968,303 live births, an incidence of congenital adrenal hyperplasia of 1:18,000 in the Hungarian population. Selective screening led to earlier diagnosis of congenital adrenal hyperplasia and a pronounced decrease in mortality. A central laboratory to measure the blood spot 17-hydroxyprogesterone concentrations is valuable for the investigation of patients at risk for congenital adrenal hyperplasia in countries where blood steroid assays are not readily available. PMID- 2705795 TI - Changes in trimethoprim pharmacokinetics after the newborn period. AB - The pharmacokinetics of trimethoprim administered orally or intravenously were investigated in six infants aged 1.7 months to 1.1 years. In these infants trimethoprim had a mean half life of 4.6 hours; this was comparable with the values found in young and school age children (3.8 and 5.4 hours respectively) and about a quarter of the half life in newborns. The volume of distribution (1.5 l/kg) was smaller than in newborns but larger than in young or school age children (0.9 and 1.1 l/kg respectively). The plasma clearance in these infants (3-3 ml/min/kg) was slightly larger than in newborns or in either group of older children (2.9 and 2.4 ml/min/kg respectively). Thus the most dramatic changes in trimethoprim pharmacokinetics seem to occur during the first two months of life. A reduced daily dose of trimethoprim is necessary during the first two months only. An increased daily dose, by addition of a third dose each day, is recommended from two months. PMID- 2705796 TI - Anorexia nervosa and food avoidance emotional disorder. AB - A retrospective and longitudinal study was carried out on all children and adolescents who presented to a child psychiatry service over a period of 26 years to identify the nature, course, and outcome of cases meeting criteria for anorexia nervosa (n = 27). Two groups of the same age were identified for comparison, firstly those with food avoidance and emotional disorders (n = 23), and secondly those with emotional disorders but no symptoms associated with eating (n = 22). The results confirm previous reports that early onset anorexia nervosa shows a similar nature, course, and outcome to the adult disease. Being tall at presentation seems to be associated with a poor outcome. Self starvation of early onset may result in short stature in some cases. There seem to be more boys among the group in whom the disease was of early onset than would be predicted from the sex ratio among adult patients. In addition boys with anorexia nervosa may have a better prognosis than girls. Children with food avoidance emotional disorders seem to have a worse prognosis than expected for childhood emotional disorders. They may represent a middle group between those with anorexia nervosa and those with emotional disorders but no symptoms associated with eating. PMID- 2705797 TI - Blood selenium concentrations and glutathione peroxidase activity. AB - Selenium concentrations in children and teenagers without a metabolic disorder eating normal diets (group 1), and young patients with classical phenylketonuria and milder forms of hyperphenylalaninaemia being treated with a diet low in natural protein (group 2) were investigated. There was a strong correlation between blood selenium concentration and age in children in group 1 up to 10 years of age. Blood selenium concentrations and glutathione peroxidase activities were significantly lower in the patients who were receiving diets containing reduced amounts of natural protein, and the differences were more than would be expected for age. When the concentrations of selenium in blood from groups 1 and 2 were compared with glutathione peroxidase activity, a strong association was found when blood selenium concentrations were below 1.26 mumol/l. Reduction in glutathione peroxidase activity may be harmful in the long term, and the addition of selenium to therapeutic diets is recommended. PMID- 2705798 TI - Seizures presenting as apnoea. AB - Between the ages of 3 and 6 months a baby boy presented with repeated, non specific episodes of cyanosis, apnoea, bradycardia, and abnormal movements of the limbs. The episodes were severe and required resuscitation and several admissions to hospital. Initial investigations showed only signs of oesophagitis. Despite treatment of the oesophagitis the symptoms recurred, and electroencephalography and polygraphy eventually showed evidence of minor seizures. Severe epilepsy with tonic-clonic seizures developed when he was 6 months old. PMID- 2705799 TI - Oesophageal atresia and associated anomalies. AB - Of 253 infants with oesophageal atresia treated over an eight year period, 122 (48%) had a total of 213 other anomalies. Most commonly affected were the cardiovascular (61 cases, 29%), anorectal (30 cases, 14%), and genitourinary (29 cases, 14%) systems. The VATER (or VACTERL) association was present in 10% of cases, but occurred more often in patients who had oesophageal atresia without an associated tracheo-oesophageal fistula (3/13, 23%). The level of the associated anorectal malformation was not associated with the type of oesophageal atresia. The presence and severity of other anomalies did not influence the basic approach to treatment of the oesophageal atresia--that is, primary repair whenever possible. Despite aggressive treatment, cardiac malformations were the most common cause of death. There were five infants with the CHARGE association, two with Potter's syndrome, and two with 'SCHISIS' syndrome (cleft lip and palate, omphalocoele, and hypogenitalism). PMID- 2705800 TI - Maternal insecurity and failure to thrive in Asian children. AB - Four Asian babies were investigated because they failed to thrive. In all four cases the failure to thrive was a result of the mother's social isolation and inability to communicate, and to the father's refusal to accept that there was a problem in the family. PMID- 2705801 TI - Energy and nutrient intakes in cystic fibrosis. AB - The diets of 20 children with cystic fibrosis were analysed for energy and nutrient content with simultaneous measurement of energy losses in stools. Median energy intakes were in excess of the WHO estimated daily requirements (118.2%) when expressed as MJ/kg/24 hours, the excess almost accounted for by energy losses in the stools. When expressed as MJ/24 hours, however, median energy intakes were 98.7% of that estimated for normal children of median weight for age. Compared with recently published data for normal school children the fat content of the diet was reduced (30.0%) as were intakes of iron and zinc. Children whose whole milk intakes were high had the greatest amount of fat and energy in their diets and were able to absorb energy in excess of that recommended. We conclude that many children with cystic fibrosis are still on low fat diets and whole milk is the single most useful food for the provision of extra dietary fat and energy. PMID- 2705802 TI - Growth and very low birth weight. AB - Information on the likelihood of catch up growth in poorly grown very low birthweight children is sparse. The centiles for weight, height, and head circumference were recorded at both 2 and 5 years of age for 135 very low birthweight children and 42 normal birthweight children. At both ages significantly more children of very low birth weight were under the 10th centile for weight and height. Children of birth weight under 1000 g were more often under the 10th centile for weight at 5 years compared with those of birth weight 1000-1500 g. Mean incremental weight gain between 2 and 5 years was significantly less for very low birthweight children. Mean increment in weight from 2 to 5 years was less for very low birthweight children who had been under the 10th centile for weight at 2 years; children who had been under the 10th centile for height also had lower mean height increments. The growth centiles achieved by 2 years of age were useful predictors of poor growth at 5 years, with perinatal data of marginal importance. Only six of 43 (14%) children with a weight at 5 years of age under the 10th centile were small for gestational age at birth. Very low birthweight children who had a weight or height under the 10th centile at 2 years of age usually remained in this category at 5 years with no evidence of catch up growth. PMID- 2705803 TI - Weight and age at menarche. AB - In the National Child Development Study (1958 cohort) information on their age at menarche and their weights and heights measured at 7, 11, and 16 years was available for 4427 girls. The distribution of age at menarche was not influenced by social class. Weight adjusted for height did not play an important part in the timing of sexual maturation of the girls in the study. Relative weight (weight expressed as a percentage of standard weight) at the ages of 7 and 11 years explained only 3.2%, and 4.9%, respectively of the variation in age at menarche, and changes in relative weight between these two ages accounted for 2%. Girls with early menarche were more likely to be overweight at ages 7, 11, and 16 years than those with late menarche, although early menarche was also reported by girls who were underweight or of average weight. These findings support the hypothesis that in well nourished populations the relation between menarche and body size is largely regulated by genetic factors and that nutrition is less important. PMID- 2705804 TI - Outcome of neonatal necrotising enterocolitis: results of the BAPM/CDSC surveillance study, 1981-84. AB - Neonatologists in 100 special care baby units in the United Kingdom and Ireland collaborated in a four year surveillance study of neonatal necrotising enterocolitis. The average overall annual reporting rate of necrotising enterocolitis for infants in England and Wales was 0.3/1000 live births, but ranged from 9.5/1000 live births in infants weighing less than 1000 g at birth to 0.2/1000 live births in infants weighing 2500 g or more. There were more deaths among girls, infants who weighed less than 1500 g at birth, those whose bleeding was abnormal or who had low peripheral platelet counts, infants with Gram negative bacteraemia, and very low birthweight infants who developed it during the first few days of life. In both boys and girls, and in all birthweight groups, operation was associated with increased mortality. PMID- 2705805 TI - Immunoreactive trypsin in Shwachman's syndrome. AB - We studied two infants with Shwachman's syndrome in whom the immunoreactive trypsin concentration was found to be abnormally low. Experience with several hundred assays for immunoreactive trypsin has not shown this low concentration. This finding is probably specific for pancreatic acinar deficiency at this age and strongly suggests Shwachman's syndrome. PMID- 2705806 TI - Mildly anaemic toddlers respond to iron. AB - Thirty eight children with a haemoglobin concentration of 106-110 g/l were given either oral iron (n = 17) or placebo (n = 21) for two months. The treated group achieved a significantly higher rise in haemoglobin concentration; in a quarter it was greater than 20 g/l. While those with the lower mean corpuscular volume and ferritin showed greater rises in haemoglobin these indices were of little value in predicting response in an individual child. PMID- 2705807 TI - Inner city tuberculosis and immunization policy. PMID- 2705808 TI - Ribavirin in respiratory syncytial virus infection. PMID- 2705809 TI - Lung function and bronchial responsiveness measured by forced oscillometry after bronchopulmonary dysplasia. PMID- 2705810 TI - Maternal narcotic abuse and neonatal thrombocytosis. PMID- 2705811 TI - Intracranial pressure monitoring in a group of critically ill children. PMID- 2705812 TI - Comparison of five tests used in the diagnosis of neonatal bacteraemia. PMID- 2705813 TI - Validity of forced expiratory flow volume loops in neonates. PMID- 2705814 TI - Renal failure in the newly born. PMID- 2705815 TI - Prone or supine? PMID- 2705816 TI - Surgery and the ultimate public good. PMID- 2705817 TI - Current results in repair of esophageal atresia with tracheoesophageal fistula using physiologic status as a guide to therapy. AB - Since 1966, 118 infants with esophageal atresia associated with tracheoesophageal atresia (Vogt-Gross Type C) have been operated upon with an overall survival rate of 90% at our institution. Since Haight's first survivor in 1941, argument has continued about the relative merits of immediate repair, delayed primary repair, and staged repair, and the criteria for selection of each approach. The Waterston classification served as the foundation for selection of surgical management from 1966 to 1982. Since 1982, physiologic status has been used as the sole basis for surgical management without regard to weight, gestation, or pulmonary condition. Twenty-six patients so chosen for immediate repair have all survived. Fewer have required gastrostomy, and the average hospital stay has shown significant decrease, a reflection of improved overall care of the neonate. Thirteen infants with severe cardiopulmonary compromise had some form of staged repair in this latter period with a 77% survival rate. Our experience using a refinement of Waterston's principles has led to more and earlier primary repairs with maintenance of excellent survival rates in stable infants. A staged approach is still useful for certain severely compromised infants. PMID- 2705818 TI - Preoperative endoscopic retrograde cholangiopancreatography (ERCP) in patients with pancreatic pseudocyst associated with resolving acute and chronic pancreatitis. AB - Experience with patients with pancreatic pseudocysts has led the authors to the hypothesis that preoperative evaluation of the pancreatic and bile ducts by ERCP will define those patients who may be inadequately treated by pseudocyst drainage alone without attention to associated pancreatic and biliary ductal abnormalities. In patients with certain ductal abnormalities, the pseudocyst operation was combined with a definitive operative drainage of the pancreatic duct and/or of the biliary tree where appropriate. A prospective evaluation of routine preoperative ERCP was undertaken over a 36-month period in all patients scheduled for operative treatment of pseudocyst of the pancreas. From an initial group of 44 patients with pseudocysts, three patients who had spontaneous regression of the pseudocyst were excluded. ERCP was successful in 39 of the remaining 41 patients. Among 41 operated patients, 24 were admitted with a diagnosis of pseudocyst that arose after an episode of acute pancreatitis, and 17 had chronic pancreatitis with pseudocyst. Nine patients, initially assumed to have acute pancreatitis, were recognized to have chronic pancreatitis on the basis of ERCP findings. Communication with the main pancreatic duct (MPD) was demonstrated in 18 of 41 pseudocysts, and the rate of communication was similar in patients with acute and chronic pancreatitis. Dilatation of the MPD was seen in 23 of 41 patients and was associated with chronic pancreatitis in 21. Dilatation of the common bile duct was found in 12 patients with chronic pancreatitis. The operative plan was altered by ERCP findings in 24 of 41 patients; 22 of the 24 patients had chronic pancreatitis. There were no complications of ERCP. These data suggest that ERCP should be performed in all patients with pseudocysts to establish correct diagnosis and to allow optimal choice of operation. PMID- 2705819 TI - Comparison of trauma assessment scores and their use in prediction of infection and death. AB - Current trauma assessment scores do not include an assessment of immune competence and have not been designed to predict late death from or risk of infection. We have compared the use of the Outcome Predictive Score (OPS) with other standard scales to predict clinical outcome after trauma. The OPS combines the Injury Severity Score (ISS) corrected for age (%LD50), degree of bacterial contamination, and monocyte HLA-DR antigen expression on hospital admission. The OPS was compared to the ISS, %LD50, Revised Trauma Score (RTS), Combined Trauma Score-ISS (TRISS), and Anatomical Index (AI). Sixty-one seriously ill patients were studied. Patient outcome was defined as uneventful recovery (n = 18), major infection (n = 27), and death (13 of 16 deaths resulted from infection). The assessment scores were compared for their use in prediction of these outcomes, as well as their ability to distinguish patients with good outcome from those patients who developed major infection or died, and to differentiate survival from death. Only the OPS was able to significantly segregate all five outcome groups (p less than 0.05). Although the age-adjusted ISS distinguished between survival and death (p less than 0.05), only OPS consistently distinguished between good outcome and sepsis/death (p less than 0.05), and therefore best identified the patients who developed infection. AI, RTS, and TRISS had little predictive value. PMID- 2705820 TI - Reconstruction of the pharynx after resection for cancer. A comparison of methods. AB - Repair of the pharynx after extirpation of malignancy may require the introduction of independently vascularized tissue either at the time of resection (primary reconstruction) or later for undesirable sequelae, such as fistula or stenosis. A ten-year retrospective study compares two methods of pharyngeal reconstruction, the pectoralis major musculocutaneous flap (MCF) and the jejunal free autograft. One hundred and seventeen patients undergoing laryngopharyngectomy at Emory University affiliated hospitals between 1977 and 1987 were reconstructed with either the pectoralis major musculocutaneous flap (24 patients) or with the jejunal free autograft (93 patients) Primary repair with the pectoralis MCF was attempted on 12 patients (Group I) with initial success in 5 patients (42%), fistula in 7 patients (58%), and salvage surgery necessary in 6 patients (86%). Primary reconstruction with jejunal free autograft (Group II) was performed in 70 patients with 44 initial successes (63%), 9 graft failures (13%), 5 of which were salvaged by a second jejunal free autograft. Seventeen fistulas occurred (24%). Of these, nine (53%) closed with nonoperative therapy and five (29%) required surgery. Secondary reconstruction with the pectoralis major MCF was attempted in 12 patients with initial success in 3 patients (25%), and fistula in 9 patients (75%). Of these 9 fistula patients, 3 (33%) closed with nonoperative therapy and 6 required salvage surgery, which was successful in only 2 patients. Secondary repair with jejunal free autograft was performed in 23 patients with 13 (56%) initial successes and 8 patients resolving with nonoperative therapy (89%) for a total success rate of 21/23 or 91%. The higher initial success rates and more expeditious resolution of problems demonstrates that the jejunum is the superior method of reconstruction for the pharynx. PMID- 2705821 TI - Differentiating pancreatic pseudocyst and pancreatic necrosis using computerized tomography. AB - Ten per cent of patients with acute pancreatitis will develop pancreatic complications. Differentiating pancreatic pseudocyst formation from pancreatic necrosis may be difficult based on clinical grounds. The purpose of this study was to evaluate the role of computerized tomography in differentiating these processes. A retrospective analysis was performed of 40 patients who developed pancreatic complications following an episode of acute pancreatitis and who subsequently underwent operation for drainage of their pancreatic fluid collections. All 40 patients had abdominal CT scans performed before surgery and the patients were then categorized on the basis of CT findings as having (1) a pseudocyst with a well-defined cyst wall, (2) peripancreatic fluid marked by the absence of a cyst wall, and (3) a combination of a pseudocyst as well as free peripancreatic fluid. Patients with pseudocysts had an average hospital stay of 14 +/- 2 days, a hospital morbidity rate of 16%, and a hospital mortality rate of 0%. In contrast, patients with peripancreatic fluid collections had an average hospital stay of 43 +/- 4 days (p less than 0.01) and hospital morbidity and mortality rates of 74% (p less than 0.01) and 22% (p less than 0.05), respectively. Patients with both pseudocysts and peripancreatic fluid collections behaved in a similar fashion to patients with peripancreatic fluid alone as characterized by a prolonged hospital stay and a high incidence (80%) of postoperative complications. At one year follow-up, 89% of the patients with pseudocysts were asymptomatic, whereas only 13% (p less than 0.01) of patients with peripancreatic fluid were symptom free. These data demonstrate that pseudocyst and peripancreatic fluid collections have markedly different biologic characteristics both in their short-term and long-term behavior. The results suggest that CT scanning can differentiate these processes and may help in directing the appropriate surgical therapy. PMID- 2705822 TI - Evolving management of pectus excavatum based on a single institutional experience of 664 patients. AB - Most pediatricians and family physicians believe that children with pectus excavatum require surgery only for cosmetic indications and then only in teenagers. We believe pectus excavatum should be repaired in childhood (1) to relieve structural compression of the chest and allow normal growth of the thorax; (2) to prevent pulmonary and cardiac dysfunction in teenagers and adults; and (3) to obviate the cosmetic impact that may cause a child to avoid sports and gymnastics. Preoperative CT scans now help select those children who need repair to prevent progressive deformities. Pulmonary function studies during vigorous exercise can document respiratory dysfunction in teenagers. These features are reversible if repair is completed before the pubertal growth spurt. The ideal age for repair is 4 to 6 years, which permits enough emotional maturity for a positive hospital experience and avoids later psychological effects. Repair at an earlier age has no operative advantages. Our operative technique consists of the removal of three to four overgrown costal cartilages, repositioning of the sternum with a transverse osteotomy, and internal support using the child's lowest normal ribs, avoiding any prosthetic support. To prevent recurrence in teenagers, we add a temporary bar beneath the sternum to prevent depression of the sternum from the weight of the chest-wall muscle mass. Six hundred sixty-four patients have been followed for 1 to 40 years; 95% have excellent long-term results and only 5% have mild to moderate recurrences. Our current techniques of patient selection and surgery will be presented. PMID- 2705823 TI - The role of bacteria in gallbladder and common duct stone formation. AB - Debate continues as to the role that bacteria play in gallstone pathogenesis in Western countries. We therefore, examined gallbladder and common duct stones from 67 consecutive patients undergoing cholecystectomy and/or common bile duct exploration. Bile was cultured and stone cholesterol content was measured. Stones were examined by scanning electron microscopy (SEM) for bacteria. Individual calcium salts were classified by windowless energy-dispersive x-ray microanalysis. Gallbladder stones in 65 patients were identified as cholesterol in 46 (71%), black pigment in 17 (26%), and brown pigment in 2 patients (3%). Common bile duct stones from ten patients were cholesterol in 4, black pigment in 2, and brown pigment in 4 patients. The five patients with brown pigment stones were significantly (p less than 0.05) older, more likely to be men and to present with bile duct obstruction. Bile cultures were positive in 13% of patients with cholesterol stones, in 14% of those with black pigment stones, and in all of the patients with brown pigment stones (p less than 0.001). By SEM, bacteria were observed only within the calcium bilirubinate-protein matrix of brown pigment stones (p less than 0.001). In comparison to black pigment stones, brown stones were more likely to contain calcium palmitate (p less than 0.005) and cholesterol (p less than 0.001). We conclude that black and brown pigment stones have different pathogenic mechanisms and that bacterial infection is important only in the formation of brown pigment stones. PMID- 2705824 TI - Colostomy and drainage for civilian rectal injuries: is that all? AB - One hundred consecutive patients with injuries to the extraperitoneal rectum were treated over a ten-year period at an urban trauma center. The mechanisms of injury included firearms in 82 patients, stab wounds in 3 patients, a variety of other penetrating injuries in 10 patients, and in 5 patients the injuries resulted from blunt trauma. Treatment of the rectal injury was determined by the bias of the operating surgeon, the condition of the patient, and the magnitude of the rectal injury. Proximal loop colostomies were performed in 44 patients, diverting colostomies in 51 patients, Hartmann's procedure in 4 patients, and an abdominoperineal resection in 1 patient. Extraperitoneal rectal perforations were closed in 21 patients and the rectum was irrigated free of feces in 46 patients. Transperineal, presacral drainage was used in 93 patients. Infectious complications potentially related to the management of the rectal wound occurred in 11 patients (11%) and included abdominal or pelvic abscesses (4 patients), wound infections (6 patients), rectocutaneous fistulas (3 patients), and missile tract infections (2 patients). Four patients (4%) died as a result of their injuries. Of the therapeutic options available, statistical analysis revealed that only the failure to drain the presacral space increased the likelihood of infectious complications (p = 0.03); however, as it could not be determined with certainty that the use of, or failure to use, any particular therapeutic option had an effect on the risk of death. It is concluded that colostomy and drainage are the foundations of the successful treatment of civilian injuries to the extraperitoneal rectum. The use of adjuncts such as diverting colostomies, repair of the rectal wound, and irrigation of the rectum has little effect on mortality and morbidity. PMID- 2705825 TI - Experience with the Grillo pleural wrap procedure in 18 patients with perforation of the thoracic esophagus. AB - Perforation of the thoracic esophagus may be fatal unless diagnosed promptly and treated with an effective operation. The wide mortality range in different reports reflects the importance of these two factors. This range spans from as low as 11%, if operation is within 24 hours, to greater than 50% after two to three days. The high mortality with delayed treatment is principally due to inability to surgically close the perforation. Eighteen patients (aged from 31 to 78 years) were treated four hours to 14 days after thoracic esophageal perforation (less than 24 hours: 7 patients; 24 to 72 hours: 7 patients; greater than 72 hours: 4 patients). In 14 patients the perforation was sutured, after which the suture line was buttressed with a circumferential wrap of parietal pleura, originally described by Grillo. Underlying esophageal pathology was corrected and wide mediastinal drainage was instituted. All 14 patients recovered and were discharged from the hospital after a median stay of 20 days. Two patients had minor leaks at the suture line that soon closed. Four patients had perforations too extensive to close. Of these, one was resected, the Urschel procedure was used in two, and the Abbott T-tube drainage was used in one. Three of the four patients died. It was quite significant that the pleural wrap was equally effective with both early (6 patients) and delayed perforations (8 patients). These data indicate that the pleural wrap should be used routinely. Extensive perforations that cannot be closed should probably be treated by resection and drainage, followed by esophageal reconstruction at a later time. PMID- 2705826 TI - Effect of pyruvate on regional ventricular function in normal and stunned myocardium. AB - The prolonged ventricular dysfunction following brief periods of coronary artery occlusion that does not produce irreversible damage has been termed the "stunned" myocardium. Although ventricular function returns to preischemic values by 1 to 7 days after reperfusion is established, inotropic therapy may be necessary to enhance contractility in the stunned heart. The purpose of this study was to determine the effect of pyruvate on ventricular function in normal and stunned myocardium. Eight chloralose/urethane anesthetized dogs were instrumented with ultrasonic crystals to measure systolic wall thickening in the left anterior descending artery (LAD) and left circumflex artery perfused regions of the left ventricle. Pyruvate (1 ml/min of 150 mM sodium pyruvate, pH 7.4) was infused directly into the LAD prior to and 30 minutes after a 10 minute LAD occlusion. Prior to LAD occlusion, LAD pyruvate infusion increased systolic wall thickening in the LAD-perfused region from 16.2% +/- 4.3% to 23.4% +/- 5.1% (p less than 0.05). Thirty minutes after LAD occlusion, regional wall thickening was depressed (3.3% +/- 2.6%; p less than 0.05), which is indicative of stunned myocardium. Subsequent LAD pyruvate infusion increased wall thickening in the stunned myocardium to 12.7% +/- 2.5%. The improvement of regional ventricular function was maintained only during the pyruvate infusion, as function returned to prepyruvate levels within 20 minutes after cessation of pyruvate infusion. These data indicate that pyruvate exerts a positive inotropic effect in normal and stunned myocardium. If pyruvate, a key intermediate in energy-producing pathways, exerts its inotropic effect through an enhancement of the energy state of the heart, it may have advantages over traditional inotropic agents in the treatment of postischemic contractile dysfunction. PMID- 2705829 TI - Guidelines for eye care in patients with diabetes mellitus. Results of a symposium. The Kentucky Diabetic Retinopathy Group. AB - A symposium was held in Lexington, Ky, that resulted in state-of-the-art current management recommendations or guidelines regarding eye care in patients with diabetes mellitus. These guidelines have been endorsed by the American Academy of Ophthalmology and are presented in a 10-point outline. PMID- 2705827 TI - Treatment of malignant ventricular arrhythmias with the automatic implantable cardioverter defibrillator. AB - Twenty-eight patients with malignant ventricular arrhythmias were treated with the automatic implantable cardioverter-defibrillator (AICD) in a 14-month period. Thirteen patients were resuscitated from a ventricular fibrillation (VF) episode. Fifteen patients presented with ventricular tachycardia (VT) refractory to medical therapy. The etiology was coronary artery disease in 23 of 28 patients (82%), dilated cardiomyopathy in 2 of 28 patients (7%), sarcoidosis in 2 of 28 patients, and 1 patient in 28 had lupus erythmatosis. The mean left ventricular ejection fraction was 29%. A total of 27 of 28 patients (96%) patients had inducible ventricular tachycardia using programmed stimulation. The patients considered for AICD implant failed a mean of 3.6 antiarrhythmic drugs. Rate counting and defibrillating leads were inserted through a lateral thoracotomy in 17 patients and a mediansternotomy incision in 11 patients in conjunction with another cardiac procedure in 10 patients. The generators were positioned in a subcutaneous pocket beneath the left costal margin. There were no operative deaths. The mean follow-up was 6.7 months (range 1 to 14) with no VT/VF deaths in patients with defibrillators. The study demonstrated that AICD is an effective device for prevention of sudden cardiac death. PMID- 2705828 TI - Pulmonary artery banding revisited. AB - Pulmonary artery (PA) banding to reduce pulmonary blood flow was described by Muller and Dammann in 1952. This review describes the outcome of 170 children who had PA banding at the University of Virginia Medical Center between 1955 and 1988. One hundred and one of the patients were banded between 1958 and 1970; fewer bands were placed in later years because early total correction was feasible for certain conditions. When analyzed by preoperative diagnoses, the data reveal that children with a single ventricle undergoing banding had a significantly lower 30-day mortality rate of 12% compared to other preoperative diagnoses, including atrioventricular canal, truncus arteriosus, and ventricular septal defect (VSD) at 30% (p less than 0.05). The late overall mortality for all patients was approximately 10%, an attrition rate of 1% per year. PA banding still has a role in management of patients with congenital heart disease, particularly for infants with a single ventricle. Actuarial survival at 10 years for patients with this condition is 92%. Interestingly, this indication for pulmonary banding is the same one cited in the original report. PMID- 2705830 TI - Primary hyperparathyroidism. A review of the long-term surgical and nonsurgical morbidities as a basis for a rational approach to treatment. AB - We studied long-term morbidity after parathyroid surgery for primary hyperparathyroidism in 100 patients and compared it with the long-term morbidity of medical follow-up from the literature. The surgical treatment of primary hyperparathyroidism was associated with negative results of neck explorations, persistent hypercalcemia, recurrent hypercalcemia, permanent hypoparathyroidism, or recurrent laryngeal nerve damage in 13 (19%) of 68 patients followed up for five years postoperatively. A review of medical follow-up as reported in the literature showed progression of disease in 8% to 22% of patients followed up for five to ten years. There was no convincing evidence that mild primary hyperparathyroidism resulted in progressive osteoporosis or renal failure. Furthermore, no significant improvement in hypertension, peptic ulcer disease, or renal function followed successful parathyroid surgery. Unless future studies demonstrate progressive osteoporosis or renal damage in untreated, mild primary hyperparathyroidism, medical follow-up is a reasonable alternative to surgery in the compliant patient over 50 years of age. PMID- 2705831 TI - Adrenal crisis in the setting of high-dose ketoconazole therapy. AB - We describe a patient with type I diabetes mellitus and hypothyroidism who developed frank adrenocortical insufficiency while receiving a high-dose ketoconazole therapy for keratitis caused by Acanthamoeba species. While impaired cortisol responses to corticotropin and mildly symptomatic hypoadrenalism have been described previously with ketoconazole therapy, to our knowledge, this case represents the first documented article of an actual adrenal crisis associated with this drug. Two reasons are postulated for the development of this complication in our patient: high-dose ketoconazole therapy given in divided doses during the day, and a possibly impaired central response to stress because of hypothyroidism. Our article points to the need to monitor patients treated with high-dose ketoconazole for adrenal insufficiency, particularly if associated illnesses are present that may impair an adequate stress response. PMID- 2705832 TI - Magnetic resonance imaging of the brain in bacterial endocarditis. AB - Computed tomographic scanning of the brain is useful but not always conclusive in delineating central nervous system involvement in patients with bacterial endocarditis. Two patients are described in whom computed tomographic findings were normal, but magnetic resonance imaging revealed evidence of multiple brain abnormalities. Magnetic resonance imaging appears to be more sensitive than computed tomography for detecting central nervous system involvement in patients with bacterial endocarditis and should be employed when computed tomographic findings are normal in a patient with endocarditis and neurologic deterioration. PMID- 2705833 TI - The use of follow-up chest roentgenograms among hospitalized patients. AB - Follow-up chest roentgenograms are a commonly performed test. We prospectively evaluated their diagnostic and therapeutic influence at a tertiary care teaching hospital. When a follow-up chest roentgenogram was ordered, physicians indicated their reason for ordering the test, the likelihood that the roentgenogram would show changes, and expected alterations in therapy. After the roentgenogram was obtained, physicians described the help provided by the roentgenogram and what changes in therapy were performed. Using receiver operating characteristic curves, we have shown that physicians have difficulty in predicting which roentgenograms will show important changes. Unexpected findings are frequent (25.4%) and highly valued by the physician. Fifty-seven percent of these roentgenograms had a definite or possible influence on patient treatment. Further studies are indicated to define when follow-up chest roentgenograms are likely to be of benefit. PMID- 2705834 TI - A comparison of employment rates of patients treated with continuous ambulatory peritoneal dialysis vs in-center hemodialysis (Michigan End-Stage Renal Disease Study). AB - This study examines factors associated with employment status in a stratified subsample of the Michigan End-Stage Renal Disease Study population. To reduce the variation in employment potential, the subsample consisted of nondiabetic patients aged 20 to 64 years. The patients were stratified on the basis of their treatment histories as follows: (1) treated by in-center hemodialysis only; (2) primarily treated by continuous ambulatory peritoneal dialysis; and (3) failed continuous ambulatory peritoneal dialysis, substituted by another form of dialysis. A significantly higher percentage of the patients undergoing stable continuous ambulatory peritoneal dialysis were in the labor force than were those undergoing in-center hemodialysis (27.4% vs 9.6%). Using logistic regression, even when adjusted for sex, race, age, education, marital status, primary diagnosis, and duration of end-stage renal disease, the stable continuous ambulatory peritoneal dialysis group was significantly more likely to be employed than the group undergoing either in-center hemodialysis only or the group that failed continuous ambulatory peritoneal dialysis. PMID- 2705835 TI - The role of fiberoptic bronchoscopy in evaluating the causes of pleural effusions. AB - To evaluate the diagnostic merit of fiberoptic bronchoscopy in pleural effusions, we performed fiberoptic bronchoscopy in addition to thoracocentesis and closed pleural biopsy in 140 patients who were admitted for diagnostic investigation of the causes of pleural effusions. The patients were divided into subgroups based on clinical features and roentgenographic findings of chest x-ray films. In 39 patients, the pleural effusions were due to various nonneoplastic disorders and in 95 patients it was caused by malignancy. In six patients, the causes of the pleural effusions remained undetermined. A final diagnosis was made by pleural examination in 68 patients, by fiberoptic bronchoscopy in 58 patients, and by either one or both in 100 patients. In 82 patients who had no hemoptysis, a final diagnosis was made by pleural examination in 57 cases and by fiberoptic bronchoscopy in 11 cases only. The diagnostic yield of fiberoptic bronchoscopy (47/58) was superior to that of pleural examination (11/58) in 58 patients presenting with hemoptysis. In 74 patients who had pleural effusions as the sole roentgenographic abnormality, the final entity was established by pleural examination in 45 and by fiberoptic bronchoscopy in 12. The diagnostic merit of fiberoptic bronchoscopy was significantly higher in 59 patients who had concurrent pulmonary abnormalities on their chest roentgenograms. A final diagnosis was made in 43 cases by fiberoptic bronchoscopy in comparison with 21 cases by pleural examination. For patients with unknown pleural effusions, fiberoptic bronchoscopy was more likely to yield a diagnosis than thoracocentesis with closed pleural biopsy in those who had hemoptysis or pulmonary abnormality on chest x-ray films, whereas the reverse applied when these features were absent. PMID- 2705836 TI - Yield of hypothyroidism in symptomatic primary care patients. AB - Symptoms suggestive of hypothyroidism are common in primary care practice, but the yield of this disorder from symptom-based testing has not been adequately evaluated. We attempted to determine this yield and examine the effect of various patient factors on its magnitude. The records of 982 consecutive primary care health maintenance organization patients who had a thyroid-stimulating hormone (TSH) determination for suspicion of hypothyroidism were reviewed. Forty-two (4.3%) had an increased TSH concentration on initial testing, but only 17 (1.7%) had a TSH level 5 mU/L or more above normal. Abnormal thyroid examination results and white vs black race were independently associated with a TSH concentration 5 mU/L or more above normal. Female sex and age did not significantly affect the odds of an elevated TSH concentration. The yield of hypothyroidism from symptom based testing in this setting was quite low. Although increasing age and female sex are both strong determinants of the risk of hypothyroidism in the general population, neither factor permitted risk stratification in symptom-based testing. The strong racial association noted was not anticipated and requires confirmation. PMID- 2705837 TI - Tendency to serious sequelae of infection with the human immunodeficiency virus in sibships with hemophilia. AB - Cofactors for the clinical expression of infection due to the human immunodeficiency virus (HIV) are not well understood. We asked if there was a familial tendency to the development of complications of HIV infection. We examined 35 hemophilic sibships in which at least two brothers with classic hemophilia (factor VIII deficiency) were infected with HIV. Twenty-four (34%) of the 70 patients had serious sequelae of infection, and 46 (66%) were asymptomatic or had only lymph node enlargement. Using Fisher's exact test, we found the concordance among siblings for serious sequelae of HIV infection was greater than would be expected by chance. When analysis was restricted to include only siblings known to be infected for more than two years, this concordance was still present. In the study population, birth order and mean yearly usage of factor VIII concentrate were unrelated to the outcome of HIV infection. The data indicate a familial tendency to serious complications of HIV infection. The factor(s) responsible for this familial tendency are currently under investigation. PMID- 2705838 TI - Variability of serum phenytoin concentrations in nursing home patients. AB - A marked variability in serum phenytoin concentrations was observed in an elderly nursing home resident. To determine the prevalence of this problem, 15 frail nursing home patients who were receiving phenytoin therapy were studied over a mean follow-up period of 10.6 +/- 0.89 months. The mean number of serum phenytoin level measurements during this period was 13.1 +/- 1.5. For a given individual, there was no variation in phenytoin dose or preparation administered. All the patients had a difference of more than 50% between the highest and the lowest serum phenytoin levels, and in five patients (33%), the difference exceeded 150%. The change in serum phenytoin level was temporally related to influenza vaccination in only three patients. The form of phenytoin was not a significant determinant of the variability in this patient population, nor did enteral feeding have any effect. It is recommended that nursing home patients receiving phenytoin therapy have periodic serum phenytoin measurements obtained, even in the absence of seizures or classic signs of phenytoin toxicity. PMID- 2705839 TI - Serologic evidence of Cryptosporidium infection in US volunteers before and during Peace Corps service in Africa. AB - To obtain prevalence data on Cryptosporidium infection in healthy US adults and to determine how often Cryptosporidium infection occurs after relocation to a situation of potentially great exposure, an enzyme-linked immunosorbent assay for anti-Cryptosporidium IgM or IgG was used to examine serum from 75 US Peace Corps volunteers before overseas service and after up to two years in West Africa. Of the volunteers, 32% had detectable anti-Cryptosporidium IgG initially, suggesting that infection sometime in life is common. After six weeks, one year, or two years overseas, 5% (1/19), 14% (8/56), and 13.6% (3/22), respectively, became newly IgG positive. This implies that the risk of acquiring Cryptosporidium infection and its associated diarrhea is real for travelers and temporary workers in endemic areas. Persistence of IgG and/or IgM response for 12 months or more occurred in some volunteers, although the significance is unclear. PMID- 2705840 TI - Barbiturate-related connective tissue disorders. AB - Development of Dupuytren's contractures, frozen shoulder, Ledderhose's syndrome, Peyronie's disease, fibromas, and general joint pain has been linked in retrospective studies and case reports to the use of antiepileptic drugs. We undertook a prospective survey of the incidence of connective tissue disorders in 622 patients newly treated with carbamazepine, phenobarbital, phenytoin sodium, or primidone. Ten of the 406 patients who were treated for 6 months or more developed connective tissue disorders. All affected patients were taking a barbiturate (primidone, 4 patients; phenobarbital, 6 patients). Seven of the 10 problems occurred during the first year of treatment. These data are prospective evidence of a statistically significant relationship between barbiturate use and the development of connective tissue disorders, and timing of appearance. PMID- 2705841 TI - Hyperthyroxinemia in patients receiving thyroid replacement therapy. AB - Eleven patients, with a history of hypothyroidism, who had hyperthyroxinemia and an elevated free thyroxine index but normal serum triiodothyronine concentrations on levothyroxine replacement underwent levothyroxine dose reduction at three month intervals until the free thyroxine index fell into the normal range. All were clinically euthyroid throughout. Normalization of the thyrotropin response to thyrotropin-releasing hormone occurred concomitantly, indicating correction of subtle hyperthyroidism. The mean thyroxine dose decreased from 161 micrograms/d (2.06 micrograms/kg) to 120 micrograms/d (1.51 micrograms/kg). The resting heart rate fell in eight of 11 patients (P less than .02). The left ventricular ejection fraction decreased in eight of 11 patients, although the decrease was not statistically significant. Considering the sensitivity of pituitary, cardiac, and bone tissue to even a small excess of thyroxine over time, hyperthyroxinemia associated with an elevated free thyroxine index should be corrected even in patients taking levothyroxine replacement who are clinically euthyroid and whose serum triiodothyronine concentrations are within normal limits. PMID- 2705842 TI - Multiple, large aneurysms of pulmonary arteries in Behcet's disease. Clinical remission and radiologic resolution after corticosteroid therapy. AB - We describe the case of a young European woman with Behcet's disease, hemoptysis, and multiple, large aneurysms of pulmonary arteries as confirmed by computed tomographic scan and angiography. Complete resolution of hemoptysis and radiologic signs of pulmonary artery aneurysms was observed three months after prednisone treatment, and a persisting remission was noted after ten months. We reviewed the literature on this rare complication and described the therapeutic approaches. PMID- 2705843 TI - Listeria monocytogenes osteomyelitis. AB - Listeria monocytogenes is usually an opportunistic pathogen causing either meningitis or bacteremia in adults. Focal infection outside the central nervous system occurs infrequently. We describe two cases of osteomyelitis caused by L monocytogenes. Certain characteristics of L monocytogenes may make cure difficult, particularly in a deep-seated focus such as bone, and may warrant special consideration when planning therapy. PMID- 2705844 TI - Physician recognition and treatment of hypercholesterolemia. AB - To assess physician behavior regarding hypercholesterolemia, records of patients whose serum cholesterol levels averaged 6.85 mmol/L or greater during a two-month period were reviewed. Of 111 eligible patients, physicians noted hypercholesterolemia in 62 (56%) and prescribed treatment in 34 (31%). Excluding those whose condition had been previously diagnosed and who were receiving treatment at the time of initiation of the study, only 22% of patients with high risk serum cholesterol levels received treatment. An aggressive physician education program on the definition, evaluation, and management of hypercholesterolemia is needed. PMID- 2705845 TI - Pelvic endometriosis simulating colonic malignant neoplasm. AB - Three women had endometriosis that involved the rectosigmoid colon; their clinical presentation suggested primary colonic malignant neoplasm. Intestinal obstruction, weight loss, and, in two patients, rectal bleeding with radiologic evidence of a mass lesion that involved the rectosigmoid were present at initial evaluation. All patients eventually underwent colonic resection as definitive therapy. Endometriosis of the pelvic colon may mimic primary intestinal disease, mistakenly suggesting malignant neoplasm. Such symptoms in a young woman should prompt a search for endometriosis, which is a more likely diagnosis. Adequate therapy frequently requires surgical intervention. PMID- 2705846 TI - Fever and urticaria in acute giardiasis. AB - Travelers' diarrhea afflicts some 250 million people yearly. A number of etiologic agents have been identified, including bacteria, viruses, and parasites. Giardia lamblia is one of the pathogens clearly associated with this syndrome. Typical symptoms of giardiasis that include abdominal bloating and cramps are well known, whereas urticaria has rarely been associated with this illness. An American tourist developed acute giardiasis accompanied by urticaria and high fever. No other pathogens were identified, and response to metronidazole therapy was prompt. Giardiasis should be included in the differential diagnosis of acute urticaria and fever in the traveler. PMID- 2705847 TI - Brain lesions in patients with acquired immunodeficiency syndrome. AB - Infections involving the brain have become a major complication in patients with acquired immunodeficiency syndrome. We have reviewed 48 cases of central nervous system lesions in patients with acquired immunodeficiency syndrome. and its related complex. All patients had computed tomographic scans with contrast performed; 31 of 48 were intravenous drug abusers. Computed tomographic abnormalities found included 21 patients with multiple ring-enhancing lesions, 13 with single ring-enhancing lesions, 11 with single hypodense lesions, and three with multiple hypodense lesions. Twenty-five patients had a positive serologic reaction for Toxoplasma. Sixteen patients had brain tissues examined. Of the 16 patients, six had cerebral Toxoplasma (one with concomitant Mycobacterium tuberculosis), and ten had diagnoses other than toxoplasmosis (three of whom had a positive serologic reaction for Toxoplasma). Two patients had M tuberculosis; one patient had Nocardia asteroides with Salmonella enteritidis. Of the remaining seven patients, three had encephalitis of unknown cause, two had inconclusive tissue diagnoses, one had progressive multifocal leukoencephalopathy, and one had vasculitis. In the population of intravenous drug users, brain lesions from diseases other than toxoplasmosis may be just as prevalent. Attempts to obtain a diagnosis from brain tissue is highly recommended to permit the design of effective and specific therapy for those diseases amenable to therapy. PMID- 2705848 TI - Disseminated coccidioidomycosis with peritonitis in a patient with acquired immunodeficiency syndrome. Prolonged survival associated with positive skin test reactivity to coccidioidin. AB - Coccidioidomycosis involving the lungs and the meninges occurred as the sole opportunistic infection in a patient with the acquired immunodeficiency syndrome (AIDS). Skin test reactivity to coccidioidin was present, but antibody response to coccidioidal antigens was markedly distinguished. Treatment with amphotericin B, administered intravenously for 3 1/2 months and intrathecally for 13 months, resulted in a disease-free interval of one year. Subsequently, coccidioidal peritonitis developed, which responded to treatment with amphotericin B. However, 29 months after the initial diagnosis, the patient died of complications of hepatic encephalopathy resulting from alcoholic cirrhosis. To our knowledge, this patient represents the first reported case of coccidioidal peritonitis in AIDS and involves the most prolonged survival of a patient with coccidioidomycosis and AIDS. The presence of positive skin test reactivity to coccidioidin may have been a predictor of prolonged survival in this patient. PMID- 2705849 TI - Delayed neurologic display in murine typhus. Report of two cases. AB - Two cases of murine typhus with prolonged neurologic manifestations appearing after the febrile stage of the illness are described. One patient had behavioral and memory disturbances for almost 18 months after defervescence, which terminated gradually without specific therapy. The second patient had similar manifestations over a period of weeks that rapidly resolved after tetracycline therapy. Such phenomena were not previously described in the literature, as far as we know, although similar manifestations were noted in Rocky Mountain spotted fever. PMID- 2705850 TI - Staphylococcal pericarditis. An atypical presentation. AB - Purulent pericarditis is typically an acute and often catastrophic illness. The case presented herein has unusual manifestations of pericarditis caused by Staphylococcus aureus. The clinical course was indolent and prolonged, and unlike the usual case, no primary source could be found. PMID- 2705851 TI - Intra-articular amphotericin B treatment of Sporothrix schenckii arthritis. AB - Arthritis caused by Sporothrix schenckii may not respond satisfactorily to a full course of intravenous amphotericin B therapy. Left untreated, the fungus continues to be recovered from cultures of joint fluid, and the patient typically has serious joint disability. We have shown in one patient with sporotrichosis of the knee that direct low-dose injections of amphotericin B can be performed safely, resulting in eradication of the fungus. The patient has had continued useful range of motion and weight bearing on the involved knee. PMID- 2705852 TI - The terminal cancer syndrome. PMID- 2705853 TI - Pneumonia appearing as multiple 'coin lesions'. PMID- 2705854 TI - Deep venous thrombosis and the risk of cancer. PMID- 2705855 TI - A perspective on careers in academic medicine. PMID- 2705856 TI - Cardiac tamponade from central venous line placement. PMID- 2705857 TI - Respiratory muscle dysfunction in hereditary motor and sensory neuropathy. PMID- 2705858 TI - Assessment of thyroid function during high-dosage furosemide therapy. PMID- 2705859 TI - Isolation and characterization of thymidylate synthetase mutants of Xanthomonas maltophilia. AB - Thymidylate synthetase mutants of Xanthomonas maltophilia ATCC 13270 were isolated on a solid minimal medium containing 50 mg/l thymidine and a high concentration of trimethoprim (500 mg/l). It was found that a high concentration of trimethoprim was required to prevent background growth of the wild-type strain. The isolated mutants could grow on thymidine or dTMP at a concentration of 50 mg/l while they were unable to grow on 1000 mg/l thymine or 50 mg/l deoxyuridine. Thymidylate synthetase activity was assayed in the wild-type cells and in the mutant cells but only the wild-type cells contained measurable enzyme activity. PMID- 2705860 TI - Transport of branched-chain amino acids in Corynebacterium glutamicum. AB - The transport of branched-chain amino acids was characterized in intact cells of Corynebacterium glutamicum ATCC 13032. Uptake and accumulation of these amino acids occur via a common specific carrier with slightly different affinities for each substrate (Km[Ile] = 5.4 microM, Km[Leu] = 9.0 microM, Km[Val] = 9.5 microM). The maximal uptake rates for all three substrates were very similar (0.94 - 1.30 nmol/mg dw.min). The optimum of amino acid uptake was at pH 8.5 and the activation energy was determined to be 80 kJ/mol. The transport activity showed a marked dependence on the presence of Na+ ions and on the membrane potential, but was independent of an existing proton gradient. It is concluded, that uptake of branched-chain amino acid transport proceeds via a secondary active Na+-coupled symport mechanism. PMID- 2705861 TI - Hodgkin's disease and malignant lymphoma in acquired immunodeficiency syndrome. PMID- 2705862 TI - Pathology education should occur during the clinical years of medical school. PMID- 2705863 TI - A senior elective program in anatomic pathology. AB - The faculty of the Department of Pathology at the University of Miami School of Medicine has developed a senior elective program in anatomic pathology for fourth year students. The program is designed in such a way that the fundamental concepts involved will be easily remembered and clinically useful. The teaching methods, which maximize active learning, include the students' group resolution of challenging unknown autopsy cases, participation in the performance of necropsies, individual presentation of one of their own autopsy cases to the group, and work with several interactive videodisc programs. The program has proved to be both effective and popular. It could be reproduced with relative ease in any academic department of pathology. PMID- 2705864 TI - Breast carcinoma in bronchoalveolar lavage. A cytologic and immunocytochemical study. AB - To evaluate the effectiveness of bronchoalveolar lavage in detecting pulmonary metastases of breast cancer, we examined lavage fluid from 20 patients with routine cytologic preparations and immunoperoxidase stains with monoclonal antibody B72.3. Bronchoscopy was performed for infection surveillance prior to autologous bone marrow transplantation (nine patients), or to assess abnormal chest roentgenogram (11 patients). Metastatic adenocarcinoma was identified on Papanicolaou-stained-membrane filters in seven patients (35%), corroborated by transbronchial biopsy in four patients. No patients with chest roentgenogram suggestive of metastatic cancer or transbronchial biopsy positive for metastatic cancer had a negative lavage. Monoclonal antibody B72.3 uniformly marked malignant cell aggregates and many single cells that were inapparent in routinely stained material. Because bronchoalveolar lavage may detect metastatic adenocarcinoma with sensitivity comparable to transbronchial biopsy but with less morbidity, it is useful in the evaluation of pulmonary infiltrates in patients with primary breast carcinoma. Staining with monoclonal antibody B72.3 can be readily performed on lavage specimens and may serve as an adjunct in diagnosing malignancy. PMID- 2705865 TI - Pulmonary endocrine cells in pulmonary arterial disease. AB - Pulmonary endocrine cells containing bombesin or calcitonin have been identified in human lungs by the peroxidase-antiperoxidase method. The numbers of such cells were greatly increased in patients with plexogenic pulmonary arteriopathy whether that condition was associated with primary pulmonary hypertension or with pulmonary hypertension from intracardiac shunts. The numbers of endocrine cells tended to be increased, but to a lesser extent in patients with pulmonary hypertension and medial hypertrophy of the muscular pulmonary arteries in the absence of plexogenic arteriopathy. Increased numbers of endocrine cells comprised both greater numbers of solitary cells and a pronounced clustering, often of a disorganized nature. PMID- 2705866 TI - Evidence for the failure of the Laplace law as a sole explanation for wall thickening of arteries in hypertensive and aging normotensive kidneys. AB - Nephrosclerosis, the morbid condition of the kidney that accompanies essential hypertension, is characterized by thickening of the walls of cortical arteries. According to the law of Laplace, the tension in the wall of an artery should be proportional to the product of pressure (P) times diameter (D). Thus, if wall thickness (T) is governed by wall tension, then it should be proportional to the same product: T = kPD, where k is a proportionality constant. A comparison of immersion-fixed kidneys in normotensives aged 75 to 90 years with those aged 19 to 34 years showed the magnitude of k to increase with age. The increase was 41% in vessels that were relatively close to the heart (outer diameter, 150 to 300 microns) and 30% at the more remote level (outer diameter, 80 to 140 microns). In perfusion-fixed specimens, k also increased with age, being 77% and 35% greater, respectively, for the comparison between normotensives in the two age groups. Normotensives were defined to be those with mean blood pressure less than 115 mm Hg. A similar result was found by defining normotension to be systolic pressure less than 140 mm Hg. Wall thickness was not proportional to pressure in hypertensive compared with normotensive subjects, but rather to a quadratic function that combined age and blood pressure taken together. The law of Laplace did not fully encompass the data that relate the thickening of renal arterial walls to hypertension or to aging in the absence of hypertension. The thickening with age is structurally a metaplasia that exchanges fibrotic intima in the elderly for muscular media in the young. The result was reproduced in perfusion- as well as immersion-fixed specimens and is therefore not distorted by postmortem collapse. The results favor the conclusion that arterial wall thickening in hypertensive and aging normotensive kidneys is sclerosis and not adaptive hypertrophy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705867 TI - Chondrolipoma of the breast. AB - Benign cartilage-containing mesenchymal tumors of the breast are extremely rare. We describe a patient with chondrolipoma of the breast who presented with a breast mass that was detected by routine mammography. Although the mammographic features of chondrolipoma are not specific, the histologic features are diagnostic and show a well-circumscribed mass composed of benign adipose tissue and lobules of mature cartilage. We also discuss the differential diagnosis of benign mesenchymal tumors of the breast. PMID- 2705868 TI - Melanin-producing medullary carcinoma of the thyroid gland. AB - An unusual case of medullary carcinoma of the thyroid gland with melanin production is described. In addition to typical histologic characteristics, some tumor cells show strong positive reaction for calcitonin by immunohistochemical study. Ultrastructurally dense-core granules and immature melanosomes are found in the same tumor cell. The tumor is thought to arise from a common precursor cell of neural crest origin with both C cell and melanocytic differentiation capable of producing both calcitonin and melanin. PMID- 2705869 TI - Epithelial proliferation in thymic hyperplasia. An immunohistochemical study and correlation with the developing fetal thymus. AB - Thymic hyperplasia is a B-cell lymphoid proliferation in which an epithelial component has not, to our knowledge, been previously described. We present a case of thymic hyperplasia in which numerous lymphoid follicles with germinal centers were partially surrounded by small sheets of spindle and epithelioid cells. Electron microscopy confirmed the epithelial nature of these cells. Immunostaining was performed using antibodies to keratins, S100 protein, and two B-cell markers, LN1 and MB2. The proliferated epithelium stained only for high molecular-weight keratin, whereas the lymphoid tissue stained positively for both B-cell markers. To determine the origin of the proliferated epithelium, the staining was compared with that of the developing fetal and normal adult thymus. We have shown that during fetal development, the keratin composition of thymic epithelium changes from staining predominantly with low- to high-molecular-weight keratin. The immunostaining characteristics of the epithelium in this case of thymic hyperplasia suggest an origin from adult-type epithelium. Furthermore, the association of S100-positive interdigitating reticulum cells with the proliferated epithelium suggests that it is of medullary origin. Our results indicate that epithelial proliferation can be an important component of thymic hyperplasia. PMID- 2705870 TI - Perineural and intraneural inflammatory infiltrates in the intestines of patients with systemic connective-tissue disease. AB - Intestinal biopsy specimens were examined from patients with connective-tissue diseases who had symptoms that were thought to represent early gastrointestinal involvement by the disease. Specimens from the small and large intestines contained eosinophils and mast cells, in close association with Meissner's and Auerbach's plexuses. The intimate association of mast cells and eosinophils in various stages of activation and degranulation with nerves was confirmed by electron microscopy. These cells, particularly the eosinophil with its neurotoxic potential, in close proximity to the intramural nerves may contribute to the recognized motor disorders in patients with scleroderma and similar connective tissue diseases. PMID- 2705871 TI - Hepatic calcification in proliferated bile ductules in a uremic patient. AB - Hepatic calcification in uremia is rare and, to our knowledge, only two cases have been reported in the English literature. In both previous reports, calcification was found in the damaged hepatocytes in the centrilobular to midzonal area of the hepatic lobules. The patient, a 61-year-old man, was uremic due to diabetic nephropathy. He had suffered posttransfusion hepatitis just before his death. Antemortem radiographic examination of the abdomen failed to visualize the calcification in the liver. At autopsy, microscopic examination of the liver revealed bile ductular proliferation and calcification mainly in the ductular epithelial cells. We suggest that calcification could occur preferentially in abnormally proliferated ductules when the serum calcium and serum phosphorus products are elevated. PMID- 2705872 TI - Tubular seminoma. Report of a case. AB - A 34-year-old man had a 1.5-cm-diameter solid, tan, right testicular tumor. Microscopic examination revealed a predominance of solid tubular structures containing cells with the characteristic features of seminoma cells. The neoplasm, which had a sparse lymphocytic infiltrate, was a rare tubular variant of seminoma, the architecture of which closely resembled that of a Sertoli cell tumor. PMID- 2705873 TI - Collision of malignant lymphoma and multiple early adenocarcinomas of the stomach. AB - An unusual case of coexisting malignant lymphoma and adenocarcinoma of the stomach is described. A 61-year-old man with weight loss, malaise, and tarry stool demonstrated diffuse lymphoma, large-cell type, and two early gastric carcinomas. Each of the two early carcinomas collided with malignant lymphoma, respectively. Two histologically different tumors were precisely diagnosed preoperatively in this case. Frequent endoscopy with biopsies from various sites of the lesion is important in achieving a correct diagnosis. PMID- 2705874 TI - Diffuse storage of vegetal wax hydrocarbons of dietary origin. Pathologic and chemical findings in a case. AB - A 55-year-old man died suddenly, after presenting with unstable angina and an asymptomatic micronodular pulmonary pattern. Autopsy revealed storage of a crystallized fatty substance in the lymph nodes, liver, spleen, adrenal glands, and lungs. In the latter organ, the deposition formed foreign body granulomas, accounting for the radiographic appearance. Mass spectrometry identified the fatty substance as straight-chain saturated hydrocarbons (n-alkanes) of carbon-29 and carbon-31 atoms, which are naturally present in the cuticular wax of many vegetals. The case history and the elimination as causal agent of products manipulated in the patient's work led to the conclusion that the storage was due to excessive consumption of apples, and to a lesser degree of Brussels sprouts. We present the light-microscopic findings and the principal biochemical results. Pathogenic mechanisms are described. As far as we are aware, this is the only observation of vegetal alkane storage to be described to date. PMID- 2705875 TI - Gastric xanthelasma in hyperplastic gastric polyposis. AB - Hyperplastic polyps of the stomach are uncommon, while xanthelasma of the gastric mucosa has a variable reported frequency. The frequency of both lesions appear increased in association with chronic gastritis and previous gastrointestinal anastomosis. The present article consists of a case report that documents for the first time (to our knowledge) the coexistence of these two lesions in a patient with a history of erosive gastritis. PMID- 2705876 TI - Bile duct carcinoma and biliary tract dysplasia in chronic ulcerative colitis. AB - A case of chronic ulcerative colitis with a moderately differentiated adenocarcinoma of the common hepatic duct is described. Throughout the entire biliary tree, there was extensive epithelial dysplasia associated with changes of primary sclerosing cholangitis. The development of primary sclerosing cholangitis in the biliary tract of patients with ulcerative colitis appears to precede dysplasia and may be a marker of patients at risk for developing biliary tract carcinomas. PMID- 2705877 TI - Association of viral 126 kDa protein-containing X-bodies with nuclei in mosaic diseased tobacco leaves. AB - During the development of systemic mosaic symptoms in tobacco mosaic virus (TMV) infected tobacco, the viral non-structural 126-kDa-protein was present among the chromatin-associated proteins in fractionated leaf homogenates [Van Telgen HJ et al. (1984) Virology 143: 612-616]. Using an antiserum raised against a fusion protein of beta-galactosidase and part of the 126-kDa-protein of TMV, this viral protein was detected by immunoelectron microscopy in X-bodies in infected tissue. No labelling of nuclei was apparent. However, in embedded purified nuclear preparations from systemically infected leaves amorphous structures, most likely X-bodies, were present and specifically labelled. In contrast, using antibodies against tobacco histones, only nuclei were labelled. Antibodies against viral coat protein labelled crystalline virus inclusions in the cytoplasm and did not react with nuclei. Light microscopic analysis indicated that X-bodies were almost always associated with nuclei. Thus, the presence of X-bodies in nuclear preparations appeared to result from adherence of the X-bodies to the nuclei. PMID- 2705878 TI - Long-term effect of elevated temperatures on SSPE virus expression in persistently infected rat glial cells. AB - Cultivation of measles virus (SSPE virus, Lec strain) persistently infected C6 rat glioma cells at 39 degrees C resulted in the loss of detectable expression of measles virus proteins. Temperature shift-back led to reactivation of measles virus even after maintenance of the cells at 39 degrees C for 15 days. In Northern blot analysis viral mRNA disappeared at 3 days after shift-up whereas 50 S viral genome-sized RNA was detectable until 6 days. The 50 S RNA decreased in quantity in rough correlation with dilution by cell passage at 39 degrees C. The 50 S viral RNA was found in the nucleocapsid fraction. On day 9 after shift-down of persistently infected cells, maintained at 39 degrees C for 15 days, 50 S viral RNA reappeared although mRNAs were not yet detected. Infectious center assays showed that the number of cells in the population at 39 degrees C, which contained an SSPE virus genome that could be reactivated, declined after temperature shift. Moreover, cell cloning experiments, in which single cells of cultures maintained for various lengths of time at 39 degrees C were incubated at 35 degrees C and examined by immunofluorescence, reconfirmed the above results. This indicates that the reactivation of SSPE virus described here was due to re infection of virus-antigen negative cells with progeny virus produced by a few latently infected cells in the population. The biological significance of this phenomenon in the central nervous system virus infection is discussed. PMID- 2705879 TI - Serotype specificity of monoclonal antibodies to cucumber mosaic virus. AB - Ten monoclonal antibodies (McAbs) against cucumber mosaic virus (CMV) have been raised from fusion experiments performed after immunizing mice with different CMV antigens. Their reactivities with members of the three CMV serotypes, CMV-DTL, CMV-ToRS, and CMV-Co were tested in a double antibody sandwich format of enzyme immunosorbent assay (ELISA). Several of the McAbs were specific for different members of the CMV-DTL and CMV-ToRS groups while two allowed the detection of CMV Co. By using a mixture of two McAbs, any member of the three major CMV serotypes could be detected in infected plant sap. One of the antibodies made it possible to discriminate between subunits and whole virions of CMV-D when it was used in ELISA simultaneously as coating antibody and as biotin-conjugate. McAbs were shown to be useful for quantifying the amount of CMV present in plant sap. PMID- 2705880 TI - The use of nucleic acid hybridization to detect human coronaviruses. AB - We have applied an RNA:RNA hybridization test for the detection of human coronavirus 229E. This test is undergoing further development but already allows a diagnosis of HCV 229E infection within 48 hours. PMID- 2705881 TI - Population structure of some street rabies virus strains. AB - Street rabies virus strains can contain from one to three biological (clinical) variants as it has been estimated using random-bred white mice and dogs. PMID- 2705882 TI - Enzymatic detoxification using lipophilic hollow-fiber membranes: III. Oxidation reactions of sulfides. AB - A lipophilic hollow-fiber membrane preparation that was previously described for glucuronidation and sulfation reactions was used for the enzymatic oxidation of sulfides. Endogenous and exogenous toxins in buffer solution or in serum or blood of intoxicated animals were circulated through the internal lumen of lipophilic hollow fibers. Native liver microsomes of the rabbit were circulated on the outside of the hollow fibers. Lipophilic toxins accumulate in and penetrate through the lipophilic membrane and the toxins are oxidized by the mixed function oxygenase system of liver microsomes. The oxidized products cannot rediffuse to the donor side. The endogenous toxin dimethylsulfide (DMS) was converted on the enzyme side to dimethylsulfoxide (DMSO) and small amounts of dimethylsulfone, which are hydrophilic and nontoxic substances. Other sulfide compounds, ethylmethylsulfide (EMS) and s-butylmethylsulfide (BMS), have also been converted to their oxidized forms. The enzymatic clearance of the hollow-fiber module for DMS in in vivo experiments in the rabbit was found to be 1.30 nmol/h/mg protein/cm2 hollow-fiber surface. The transmembranous enzymatic clearance of the in vitro oxidation reactions of DMS, EMS, and BMS in buffer solutions (open circuit) were measured, respectively, as 1.63, 3.45, and 5.16 nmol/h/mg protein/cm2 hollow-fiber surface. This technique allows the enzymatic oxidation of sulfur compounds with liver microsomes in vitro and in vivo without immunological hazards, and it is suited for artificial liver support. PMID- 2705883 TI - In vitro evaluation of a bioartificial pancreas under various hemodynamic conditions. AB - A bioartificial pancreas in which isolated islets of Langerhans are placed between two polyacrylonitrile membranes, blood circulating successively above the upper and below the lower membranes following a U-shaped circuit, has been developed. The two parts are connected by an outer loop consisting of a thin tubing. The length of this tubing determines the magnitude of the flow rate of blood through the device. The aim of this work was to determine experimentally the optimal configuration of the system containing isolated rat islets and a Krebs buffer circulating through the device. The amount of insulin released by the bioartificial pancreas was determined during a 20-mM square-wave glucose stimulation. First, the inlet pressure was set at 100 mm Hg, and the effect of the length of the tubing was investigated with two devices perfused simultaneously. For a short tubing (flow rate, 20 ml/min), a sharp increase in insulin release in response to glucose was observed; it increased within 4 min from 217 +/- 50 to 761 +/- 237 microU/500 islets/min (p less than 0.05), the peak value being reached at 11 +/- 2 min following the beginning of the stimulation. For a long tubing (flow rate, 3 ml/min), the increase in insulin release was more sluggish. It increased from 133 +/- 53 to 222 +/- 43 microU/500 islets/min at 4 min, the peak value being reached only at 20 +/- 3 min. These data are consistent with a more efficient diffusional transfer of insulin in the case of the high circulating flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705884 TI - Extracochlear electrical stimulation. AB - Twelve patients with sensorineural hearing loss were stimulated by a transtympanic electrode contacting the cochlear promontory. Nine of them were tested to study hearing perception associated with various features of electrical signals, using an auditory electrical stimulator. Biphasic pulse bursts and sine wave bursts were used as stimuli. Different electrical characteristics such as amplitude, width and rate for pulses and amplitude and frequency for sine waves were used to investigate hearing perception. The patients' perception threshold, comfortable level, uncomfortable level, dynamic range, just-noticeable difference in frequency or pitch discrimination, just-noticeable difference in intensity or loudness discrimination, loudness perception associated with the electrical signal energy, and sounds associated with electrical stimulation was determined. Pertinent results assisted in the development of a speech electrical stimulator that was used to test three patients for vowel, word, and consonant identification and recognition of patterns of intonation. These results in turn are being used to design a prototype of a single-channel extracochlear prosthesis. PMID- 2705885 TI - Endothelial cell seeding on different polyurethanes. AB - Six polyurethanes (PUs) were tested with respect to their cytocompatibility. Initial adhesion, initial spreading, and the proliferation of endothelial cells were investigated. All smooth PUs showed similar initial adhesion. Initial spreading was faster on rough PUs. Collagen coating resulted in faster initial adhesion but not better proliferation of endothelial cells. PMID- 2705886 TI - In vitro comparison of velocity profiles and turbulent shear distal to polyurethane trileaflet and pericardial prosthetic valves. AB - A comparative study of flow dynamics past biomer trileaflet valves and a pericardial bioprosthetic valve under steady and physiological pulsatile flow conditions in vitro is reported in this paper. The velocity profiles and the turbulent shear stresses distal to the valves were measured using laser Doppler anemometry. The authors' results showed that the velocity profiles distal to the trileaflet valves were similar to that measured distal to the pericardial valve. Higher magnitudes of absolute turbulent shear stresses were measured distal to the synthetic valves in comparison to the pericardial valves. However, when the stresses were nondimensionalized with respect to the orifice diameter at the inlet aspect, the stresses were comparable for all of the three valves. With design modifications to increase the orifice diameter at the inlet aspect of the polyurethane valves, the turbulent stresses distal to the valves can be minimized. Such in vitro studies on the flow dynamics past the polyurethane valves can provide information towards design changes to improve the performance characteristics of these valves. Polyurethane valves with flow characteristics comparable to the pericardial valves can be manufactured relatively inexpensively compared to mechanical or tissue valve prosthesis. Hence, the synthetic valves may be a viable alternative for short-term use in total artificial heart devices as a bridge to transplant. PMID- 2705887 TI - Experience with the Hemasite vascular prosthesis. AB - A 3-year experience with the no-needle vascular prosthesis Hemasite, implanted in 10 patients who underwent hemodialysis and have a long history of multiple vascular access failures, is described. During 182 months of follow-up study, 30 thromboses occurred, while nine of 10 patients did not receive any antiplatelet aggregant treatment. Hemasite was declotted 12 times with a local infusion of urokinase and 12 more times by thrombectomy. A surgical procedure was performed only in the other cases, and the rate of surgical intervention fell from 0.18 interventions per patient per month before Hemasite implantation to 0.027 after implantation. PMID- 2705888 TI - The realization of a pulsatile implantable impeller pump with low hemolysis. AB - A pulsatile implantable impeller pump with low hemolysis was developed without markedly increasing the complexity of the system compared with the nonpulsatile pump. The key to the question is to design a three-dimensional impeller with twisted vanes, compacted by an axial helical spiral and a radial logarithmic spiral so as to reduce the turbulent shear in the pump as the impeller changes its rotations per minute periodically to generate a physiologic pulsatile flow. Both mathematic computation of velocity distribution in the impeller and geometric illustration of the velocity triangle at the top of the vane have demonstrated that the peripheral velocity variation of blood cells in a twisted impeller will be less than that in an untwisted impeller. Thus, the main mechanical factor of hemolysis in the impeller pump, namely, the turbulent shear, should be reduced because it is proportional to the product of velocity variations measured in two perpendicular directions. In the in vitro experiments, the pump delivered 4 L/min mean flow at 100 mm Hg mean pressure (pulsed between 80-120 mm Hg) for more than 3 h in a circulatory model containing 700 ml of fresh citrated porcine blood. Every half hour, the free hemoglobin level in the plasma was tested, and the resulting index of hemolysis was about 0.020, slightly more than that of a nonpulsatile impeller pump developed in Shanghai. To compare hemolysis, the index of hemolysis of this pump is about 1/6 of that of the self made diaphragm pump and 1/13 of that of the Polystan Pulsatile Pump.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2705889 TI - Abstracts from the International Workshop on Implantable Glucose Sensors. September 27-30, 1988, Gohren-Lebbin, German Democratic Republic. PMID- 2705890 TI - The need for a second-generation pump oxygenator. PMID- 2705891 TI - High shear rate hemofiltration: influence of fiber dimensions and shear rates. AB - The variation of ultrafiltration flow rate (QF) at high transmembrane pressure with inlet wall shear rate (gamma w) was found to be proportional to gamma wn, with n ranging from 0.45 to 0.55, when gamma w increases up to 4,500 s-1. To test whether long filters operated at high shear rates were more efficient than shorter ones for the same inlet blood flow, we made experiments with 10- and 20 cm filters with same number of fibers (550) at various shear rates from 700 to 3,000 s-1. The filtration rates provided by the 20-cm filter were found to be 5 15% larger than those provided by two 10-cm filters arranged in parallel and 10 20% smaller than those provided by two 10-cm filters arranged in a series. The explanation lies in the rapid decay of QF with distance from the inlet due to the developing concentration boundary layer. When pulsations are imposed on the inlet blood flow, the filtration rate was seen to increase by 10-20%, and the effect of plugging was seen to decrease in small-area hemofilters. PMID- 2705892 TI - Does neuroretinitis rule out multiple sclerosis? PMID- 2705893 TI - Central pontine myelinolysis and the rate of correction of hyponatremia. PMID- 2705894 TI - Deterioration of Wilson's disease following the start of penicillamine therapy. PMID- 2705895 TI - Inflammatory arteriopathies and pure motor hemiplegia. PMID- 2705896 TI - McArdle's disease aggravates nuchal and cranial muscle contraction pains. PMID- 2705897 TI - Very mild senile dementia of the Alzheimer type. II. Psychometric test performance. AB - A brief battery of psychometric tests was used to compare 41 individuals with very mild senile dementia of the Alzheimer type (SDAT) with 83 healthy participants and 66 individuals with mild SDAT. Although canonical analysis indicated that the same psychological functions (memory, speeded psychomotor performance, and language) are involved in both very mild and mild SDAT, objective levels of performance by the very mildly affected individuals overlapped extensively with those of both healthy aged and mildly demented individuals. Consideration of premorbid individual differences in psychological functions will probably be required if psychometric test performances are to be effective in detecting SDAT in the very mild stage. PMID- 2705898 TI - Spatial disorientation in Alzheimer's disease. AB - Spatial disorientation was investigated in 28 ambulatory patients meeting the National Institute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association Work Group criteria for "probable" Alzheimer's disease. Based on caregivers' reports, 39% of subjects engaged in at least three of four behavioral measures of spatial disorientation three or more times a week; these patients did not significantly differ from other Alzheimer's disease subjects with regard to age, sex, education, or symptom duration. Using stepwise regression analysis, we found that neuropsychologic measures of memory and visuoconstructive functions, but not disease severity, attention, or language impairment, emerged as significant predictors of spatial disorientation. In the setting of impaired memory, the tendency of some patients with Alzheimer's disease to wander or to get lost may implicate particularly severe dysfunction of right hemisphere neocortical areas concerned with visuospatial processes. PMID- 2705899 TI - Brain gangliosides in dementia of the Alzheimer type. AB - Gangliosides GM1, GD1a, GD1b, and GT1b were measured in nine brain regions of five patients, clinically and neuropathologically diagnosed as having dementia of the Alzheimer type (DAT), and of three control patients. Analysis of variance revealed that mean concentrations of all gangliosides analyzed were significantly lower in DAT than in control brains. The areas affected in DAT included the nucleus basalis, and entorhinal, posterior cingulate, visual, and prefrontal cortices. A significant interaction between ganglioside type and brain area indicated unequal ganglioside concentrations. Individual gangliosides had significantly different concentrations in the hippocampal, entorhinal, posterior cingulate, visual, and prefrontal cortices. Analysis of ratios of "a"-ganglioside (GM1 and GD1a) and "b"-ganglioside (GD1b and GT1b) subtypes indicated that DAT preferentially affected "b"-gangliosides. Ganglioside concentrations in nucleus basalis did not correlate with age at disease onset, age at death, or postmortem interval. Changes in gangliosides, observed in this study, were not correlated with classic DAT neuropathology. PMID- 2705900 TI - Rippling muscle disease. AB - Six patients from two families with an autosomal dominantly inherited disease, apparently a myopathy, are described. Their major complaint was muscle stiffness, primarily in the legs. The muscles displayed an unusual sensitivity to stretch, manifested by rippling waves of muscle contraction. These rippling contractions were not accompanied by muscle fiber action potentials. Nonspecific, mild abnormalities were seen on muscle biopsy. These findings raise the possibility that there is an intracellular derangement in the muscle fiber responsible for the muscle rippling; further studies are necessary to establish the underlying pathophysiologic condition. PMID- 2705901 TI - Regional distribution of cerebral arteriovenous malformations. Interactions with sex and handedness. AB - On the basis of clinical observation and a developmental theory of cerebral laterality, Geschwind and Galaburda suggested that cerebral arteriovenous malformations (AVMs) are more common in the left hemispheres of male patients. We tested this hypothesis by examining interactions among sex, handedness, and location of lateralized, supratentorial AVMs. Data from 112 cases were analyzed by log-linear procedures. We found that (1) females had a greater proportion of left-hemisphere AVMs, whereas males showed an opposite trend; (2) there were no interactions between sex and handedness; and (3) nondextrals showed a higher proportion of AVMs located in frontal regions, regardless of the hemispheric side of the lesion. Although these findings appear to be inconsistent with the Geschwind-Galaburda hypothesis, the inconsistency may be attributable to the embryonic stage at which this developmental abnormality occurs. In addition, the unexpected findings may also reflect our use of multivariate statistical procedures, which control for interaction effects. PMID- 2705902 TI - Lacunar syndrome due to neurocysticercosis. AB - Seven patients with neurocysticercosis presented with a lacunar syndrome. Four patients had sensorimotor stroke, two had pure motor hemiparesis, and one had ataxic hemiparesis. In every patient, computed tomography or magnetic resonance imaging or both showed a lacunar infarct that was secondary to the occlusion of a terminal vessel affected by endarteritis and was most commonly associated with cysticerci in the suprasellar cistern. Diagnosis of neurocysticercosis was difficult on clinical grounds, but proper integration of data from computed tomography and cerebrospinal fluid analysis provided an accurate diagnosis in every case. Neurocysticercosis should be considered in the differential diagnosis of young adults with a lacunar syndrome who come from areas of the world where this disease is endemic. PMID- 2705903 TI - Predictive value of carotid bruit for carotid atherosclerosis. AB - To assess the predictive value of carotid bruit for moderate-to-severe carotid atherosclerosis, the results of carotid arteriograms performed on 1004 subjects were correlated with the findings of auscultation of the carotid arteries. Predictive values of carotid bruit for ipsilateral extracranial carotid atherosclerosis were 77% for localized bruits and 74% for diffuse bruits. The predictive values of extracranial carotid bruit for ipsilateral intracranial carotid atherosclerosis were 16% for localized bruits and 18% for diffuse bruits. Assessing both carotid arteries together, the predictive value of carotid bruit for moderate-to-severe atherosclerosis at any extracranial carotid site was 85%, there being no difference whether the bruits were diffuse, localized, bilateral, or unilateral. Diffuse or localized bruits, whether unilateral or bilateral, are equally predictive of moderate-to-severe atherosclerosis in the extracranial carotid artery, but both are poor predictors of intracranial carotid artery disease. PMID- 2705904 TI - A new family with Joseph disease in Japan. Homovanillic acid, magnetic resonance, and sleep apnea studies. AB - Four male patients and one female patient of a new family with Joseph disease are reported. Their disease was characterized by autosomal dominant inheritance, bulging eyes, rigidity and spasticity of the lower extremities, dystonia, and bradykinesia. Cerebrospinal fluid homovanillic acid level was markedly reduced. Levodopa improved dystonia. Magnetic resonance imaging revealed mild atrophy of the frontal lobe and the cerebellum and marked atrophy of the lenticular nucleus and the brain stem. Polysomnographic studies revealed non-rapid eye movement stage central type sleep apnea syndrome. This is the first report using magnetic resonance imaging and sleep apnea studies of Joseph disease. PMID- 2705905 TI - Interhemispheric transfer in patients with incomplete section of the corpus callosum. Anatomic verification with magnetic resonance imaging. AB - Tests of interhemispheric disconnection including visual, somesthetic, kinesthetic, auditory, and complex motor functions were performed on seven patients with chronic epilepsy who had undergone partial surgical section of the corpus callosum, verified by magnetic resonance imaging. Two patients with only one third of the splenium remaining demonstrated disconnection syndromes involving all modalities except vision, which was completely intact. Five patients had lesions involving the rostrum and the anterior two thirds to four fifths of the body of the callosum, with the splenium spared. They demonstrated little evidence of disconnection in the modalities indicated, except for left ear suppression on a dichotic listening task and partial somatosensory disruption in some cases. These results emphasize the importance of the posterior corpus callosum for interhemispheric sensory and sensorimotor transfer, although some discrepancies between current behavioral data and previous anatomic findings remain. PMID- 2705906 TI - The alien hand syndrome. Clinical and postmortem findings. AB - Two patients had automatonlike movements of their left hands and arms (alien hand syndrome) following damage to the brain. Autopsy findings in one patient demonstrated gunshot wound damage to the medial frontal white matter bilaterally, as well as the corpus callosum, right basal ganglia, internal capsule, and thalamus. The other patient had a ruptured anterior communicating aneurysm, with subsequent resection of the right frontal gyrus rectus. We postulate that this syndrome is due to the combination of a partial callosectomy and mesial frontal lesions. PMID- 2705907 TI - Relapsing bilateral brachial plexopathy during pregnancy. Report of a case. AB - We describe a case of relapsing bilateral brachial plexopathy occurring during pregnancy and the postpartum period. This condition is known to occur with a familial predilection, but it has not been previously reported on a sporadic basis. The outcome was poor and associated with several psychosocial consequences. PMID- 2705908 TI - Problems in the use of tranexamic acid by ophthalmologists. PMID- 2705909 TI - Failed retinal detachment repair after intravitreal air injection. PMID- 2705910 TI - Serotonin, vasoconstrictor of human aqueous humor. PMID- 2705911 TI - Incidental discovery of dislocated lenses by computed tomography. PMID- 2705912 TI - Fish hook removal from vitreous and retina. Case report. PMID- 2705913 TI - Problems with punctal plugs. Case report. PMID- 2705914 TI - Follicular thyroid cancer metastatic to the iris. Case report. PMID- 2705916 TI - Vessels. part one: Retina. PMID- 2705915 TI - Ocular trauma epidemiology. PMID- 2705917 TI - The topography of normal corneas. AB - Previously we have analyzed photokeratographs to determine the topography of congenital, acquired, and surgically induced deformations of corneal shape. In this article, we survey the variety of corneal shapes found in both eyes of 22 individuals with normal corneas. The degree of correlation of the distribution of corneal power around the visual axis was striking for both eyes of 18 of the 22 individuals, as was the variability of the corneal topography of different individuals. The average centrally weighted corneal power determined from the photokeratographs correlated well with the average keratometric corneal power (r = .96). By defining the topographic features characteristic of normal corneas, we will be better able to diagnose corneal shape anomalies and understand the role such anomalies play in the degradation of vision. PMID- 2705918 TI - Time trends in the incidence of hospitalized ocular trauma. AB - Ocular trauma is an important cause of blindness and visual impairment in the United States. We examined the incidence of hospitalized ocular trauma in Maryland from 1979 through 1986 using hospital discharge abstracts. The annual incidence for those with definite ocular trauma (principal diagnosis) was 13.2 per 100,000 population and for total ocular trauma (principal or secondary diagnoses), 27.3 per 100,000. There was a 25% decline in incidence of definite ocular trauma over this eight-year period; however, this was likely due to changing indications for hospitalization. The pattern of risk by age was bimodal, with peaks in the 15- to 29-year and over-70-year age categories. Males were at higher risk than females except in the oldest age groups, and nonwhites had higher rates than whites. PMID- 2705919 TI - The cup-to-disc ratio and central retinal vein occlusion. AB - Recent reports have suggested that a small optic cup may contribute to the development of certain optic disc disorders, such as anterior ischemic optic neuropathy. In a masked fashion, the cup-to-disc ratios from the fellow eyes of 55 patients with central retinal vein occlusion (CRVO) were compared with 55 controls to determine whether a similar association could be established for CRVO. Controls came from two population-based surveys, and they were matched to cases for age, race, and sex. The mean cup-to-disc ratios for the CRVO fellow eyes and controls were 0.39 and 0.40, respectively; the distribution of the sizes of the cup-to-disc ratios was nearly identical in the two groups. These results suggested that the cup-to-disc ratio is not a useful predictor of the development of CRVO. PMID- 2705920 TI - Agreement between clinicians and an image analyzer in estimating cup-to-disc ratios. AB - We studied optic disc photographs of 35 eyes to determine the level of agreement between estimates of vertical and horizontal cup-to-disc ratios (CDRs) provided by two clinicians and estimates of these ratios obtained using an image analyzer. We also evaluated the agreement of each clinician with himself and with the other clinician to provide a relative standard by which to judge agreement between the clinicians and the image analyzer. Agreement between the clinicians and the image analyzer was moderate. Differences of more than 0.2 disc diameters (DD) between the CDR estimates of clinicians and those obtained using the image analyzer were limited to discs having small (CDR of 0.4 DD or lower) or very large (CDR of 0.9 DD or higher) cups. The clinicians' agreement with themselves and with each other was substantial to near perfect. PMID- 2705921 TI - Fast and slow oscillations of the electro-oculogram in Best's macular dystrophy and retinitis pigmentosa. AB - Fast oscillations (FOs) of the electrooculogram are fluctuations in the corneo fundal or standing potential of the eye that are greatest in response to stimulation by dark and light periods of approximately 1.25 minutes each, in contrast to the slow oscillations (SOs) of the electrooculogram, which are greatest in response to dark and light periods of approximately 12.5 minutes each. The FOs and SOs were measured in 11 patients from four families with Best's macular dystrophy who were found to have marked loss of the SOs with prolonged light peaks but relatively preserved normal or near-normal FOs. A patient with autosomal recessive retinitis pigmentosa (RP) with a pericentral distribution of pigmentary changes also had preserved FOs of abnormal phase and markedly subnormal SO with normal light-peak time. Six patients with early RP (two sisters with autosomal recessive RP and four patients from three families with autosomal dominant RP) had greater attenuation of FOs than SOs. These results can be partially explained by consideration of the generators of these potentials and the known pathophysiology of the two diseases. PMID- 2705922 TI - The association of posterior capsular lens opacities with bilateral acoustic neuromas in patients with neurofibromatosis type 2. AB - This study of 47 patients from 11 families with neurofibromatosis type 2 (NF 2) confirms our previously reported association between posterior capsular cataract and NF 2. A highly significant statistical association was found between the presence of posterior capsular lens opacities and the presence of NF 2 as determined by magnetic resonance imaging or pathologic diagnosis. This association was not present for other types of lens opacities that could be the result of age-related or nonspecific changes. When considering the diagnosis of NF 2, this finding now makes it essential to use a careful dilated biomicroscopic examination of the lens to evaluate known, suspected, or at-risk individuals for this potentially early associated manifestation. PMID- 2705923 TI - Discoid lupus keratitis. AB - Two patients with long-standing discoid lupus erythematosus developed acute, unilateral, corneal stromal infiltration and edema. No evidence of infection was found, and both responded rapidly to topical corticosteroid therapy. To our knowledge, only one case of stromal keratitis associated with discoid lupus erythematosus has been published previously. We describe the first cases, to our knowledge, in which a satisfactory response to corticosteroid therapy is demonstrated. PMID- 2705924 TI - Iris melanoma with increased intraocular pressure. Differentiation of focal solitary tumors from diffuse or multiple tumors. AB - A 70-year-old man presented with an apparent focal iris ciliary body mass and increased intraocular pressure. Fine needle aspiration biopsy 180 degrees from the main lesion demonstrated uveal melanoma cells in the angle. The eye was enucleated, and multiple separate iris and ciliary body melanomas were noted. This case demonstrates the usefulness of fine needle aspiration biopsy for both diagnosis and optimum therapy in selected cases. PMID- 2705925 TI - An orbital hemangiopericytoma recurrent after 33 years. AB - A middle-aged woman developed a recurrent orbital hemangiopericytoma 33 years following its initial removal. Preoperative computed tomographic and magnetic resonance imaging scans revealed a well-circumscribed superotemporal orbital mass. A tumor that appeared grossly encapsulated was removed intact via a lateral orbitotomy. Histopathological examination showed a hemangiopericytoma with hypercellularity and a moderate number of mitotic figures. A review of the initial pathologic report confirmed the diagnosis of hemangiopericytoma with histological features similar to those of the recurrent mass. To our knowledge, this case represents the longest reported interval to recurrence of any hemangiopericytoma and demonstrates the extended follow-up needed in patients with hemangiopericytoma. PMID- 2705926 TI - Fibronectin and corneal epithelial wound healing in the vitamin A-deficient rat. AB - The time course of the appearance of fibronectin (Fn) on wounded corneal surfaces was studied in vitamin A-deficient (A-) and pair-fed control rats. At various times following a central epithelial abrasion, the tissue was harvested, and Fn was localized on frozen corneal sections by an indirect immunofluorescence technique. There was no detectable Fn in intact, nonwounded control or intact A corneas, except for Descemet's membrane. Within a half hour after abrasion, a band of Fn appeared on the denuded corneal surface of pair-fed control rats and became a continuous, prominent layer at four hours. This layer remained until 16 hours but disappeared at 24 hours when the epithelium had resurfaced over the defect. In severely A- rats, reepithelialization following central epithelial abrasion was delayed, and no Fn band was discernible at any time from one to 32 hours after injury. Light microscopy revealed a progressive increase in polymorphonuclear neutrophil infiltration with time in the underlying stroma in severely A- rats. This study indicated that in severe vitamin A deficiency, delayed epithelial migration is associated with an inflammatory cell layer and occurred in the absence of Fn. PMID- 2705927 TI - Patterns of aqueous humor outflow in glaucomatous and nonglaucomatous human eyes. A tracer study using cationized ferritin. AB - We used cationized ferritin, which binds to negatively charged membrane surfaces, as a tracer to delineate the aqueous humor outflow pathway by perfusing it into the anterior chamber of 14 normal human eyes and five with primary open angle glaucoma. In the normal human eyes, diffuse labeling with cationized ferritin was evident throughout the outflow pathway, while in the glaucomatous eyes distinctly different staining patterns were noted. A decorating pattern similar to that seen in normal eyes was observed, as well as apparent areas of underperfusion, suggestive of possible segmental changes in aqueous outflow. These findings may support the hypothesis that primary open angle glaucoma is a segmental disease of the outflow system due to possible regional increases in resistance to aqueous outflow. PMID- 2705928 TI - Transforming growth factor beta. A biologic chorioretinal glue. AB - Transforming growth factor beta (TGF-beta) stimulates fibrosis. We studied its possible role as a bioactive substance for inducing localized chorioretinal wound healing along the edge of a retinal tear. The TGF-beta was applied to induced retinal tears that were examined histopathologically. One day after surgery, neither control nor TGF-beta-treated eyes developed chorioretinal wound healing. Four days, two weeks, and two months after surgery, the control eyes still had not developed chorioretinal wound healing. In contrast, the edges of the retinal tear treated with TGF-beta were adherent to the underlying Bruch's membrane via localized fibrous tissue without apparent effects elsewhere. These results demonstrate intraocular in vivo bioactivity of TGF-beta and suggest that TGF-beta may have a potential role as an alternative means for inducing a chorioretinal adhesion in the treatment of retinal tears. PMID- 2705929 TI - Corneal ablation by nanosecond, picosecond, and femtosecond lasers at 532 and 625 nm. AB - We produced corneal excisions with nanosecond (ns)-, picosecond-, and femtosecond (fs)-pulsed lasers at visible wavelengths. The threshold energy for ablation was proportional to the square root of the pulse duration and varied from 2.5 microjoules (microJ) at 100 fs to 500 microJ at 8 ns. Excisions made with picosecond and femtosecond lasers was ultrastructurally superior to those made with nanosecond lasers and, at pulse energies near threshold, showed almost as little tissue damage as excisions made with excimer lasers at 193 nm. We conclude that ultrashort-pulsed lasers at visible and near-infrared wavelengths are a possible alternative to excimer lasers for corneal surgery and might have advantages over conventional ophthalmic neodymium-YAG lasers for some intraocular applications. PMID- 2705930 TI - Spontaneous carotid cavernous fistula presenting with acute angle closure glaucoma. PMID- 2705931 TI - Polymorphic amyloid degeneration. PMID- 2705932 TI - Tarsoconjunctival flap for upper eyelid reconstruction. AB - Reconstruction of large, full-thickness upper eyelid defects is a challenge to the ophthalmic plastic surgeon. Ideally, the defect should be reconstructed with tissues similar or identical to those that have been lost. We present a procedure similar to the Hughes tarsoconjunctival flap technique for lower eyelid reconstruction. However, our technique was used for upper eyelid reconstruction. A remnant of tarsus at least 3 mm wide must be available to be advanced inferiorly in the upper eyelid. We have performed this procedure on 13 patients over ten years (1977 to 1987) with good to excellent results. PMID- 2705933 TI - The lateral tarsal strip revisited. The enhanced tarsal strip. AB - The lateral tarsal strip procedure was originally designed for the treatment of upper and lower eyelid laxity, or lateral canthal tendon laxity or malposition. Despite the excellent results with a standard tarsal strip procedure for those eyelids with laxity and excess skin, we have encountered a number of patients with lower eyelid or canthal malpositions or both who would benefit from a tarsal strip, but who do not have lax tissues (especially skin), and may in fact have a shortage of skin. These include cases of lower lid retraction or canthal malposition following trauma, blepharoplasty, or other operations, and patients with tendency toward or having cicatricial ectropion. Any anterior lamella removal in such patients would aggravate the lid malposition and weaken the lateral canthal tissues to be sutured. We suggest a modification of the tarsal strip (developed by one of us [R.L.A.]) to treat many such patients without requiring additional anterior lamella (skin graft) or more formidable procedures. We refer to this technique as the "enhanced tarsal strip" technique, and we use this technique more frequently than the original tarsal strip procedure. PMID- 2705934 TI - Evacuation/cautery vitreous needle. AB - Since hemostasis and passive suction to remove preretinal blood are important elements to the vitrectomy surgeon, a new disposable evacuation/cautery needle has been developed to accomplish these two objectives. This instrument allows the surgeon to clear the vitreous proximate to the bleeding site and cauterize the vessels without changing instruments. PMID- 2705935 TI - Use of cross-polarized light in anterior segment photography. AB - A photographic technique improved the quality of anterior segment photography by using one polarizer in the illumination path and another polarizer that was perpendicularly oriented to the first in front of the camera film back. A significant improvement was noted by impartial masked observers who assessed standard photographs of the iris, conjunctiva, and sclera. A crosslike artifact, observed in photographs using cross-polarizers, was present and originated from corneal birefringence. The significance of the artifact and its possible diagnostic applications were determined. PMID- 2705936 TI - Do we make what we earn? Or do we earn what we make? PMID- 2705937 TI - The relationship between microbiological assays and the clinical signs of periodontal disease. AB - Ninety-five patients with periodontal disease each had subgingival plaque samples collected from four sites (one from each quadrant) in their mouths. The relative proportions of spirochaetes, motile rods and cocci were determined using dark field microscopy and the proportion of anaerobic to aerobic micro-organisms calculated after culture. In addition, clinical recordings were made. The only significant correlations observed were between probing depth or attachment loss and the proportion of cocci in the plaque (negative association), probing depth or attachment loss and sites which were suppurating or displayed a radiolucent interdental crest (positive association), and the percentage of cocci and sites with a radiolucent interdental crest (negative association). Partial correlation analysis controlling for probing depth or attachment loss showed that a significant inverse association between the percentages of cocci and the presence of a radiolucent interdental crest remained. No significant associations were observed between clinical signs such as bleeding on probing or suppuration and the microbiological assays. Overall there was a poor correlation between many of the signs thought by some to indicate periodontal disease activity. PMID- 2705938 TI - Ameloblastic fibro-odontoma. Case report. AB - Ameloblastic fibro-odontoma is a relatively rare odontogenic tumour which is composed of ameloblastic fibroma and a complex or compound odontoma. In this article, a case of a two-year-old boy with this tumour is presented. PMID- 2705939 TI - Discriminant function analysis of clinical and psychological variables in temporomandibular joint pain dysfunction. AB - Detailed clinical, psychological and illness behaviour information was obtained from 43 patients with temporomandibular joint pain dysfunction. A discriminant function analysis was performed on the multiple variables to test their effectiveness as predictors of a successful response to simple conservative therapy. The questionnaire and statistical methodology employed are described in detail. It was found that clinical, psychological, and illness behaviour factors when used alone were poor predictors (less than 60 per cent) of treatment outcome. However, grouping clinical and psychological factors resulted in over 80 per cent successful prediction. PMID- 2705940 TI - An in vitro comparison of the single cone and lateral condensation techniques using 'friction-fitted' and 'solvent dip-fitted' primary gutta-percha cones. AB - Extracted teeth, root-filled by single cone and lateral condensation techniques, using friction fitted and solvent (chloroform and eucalyptol) dip-fitted primary gutta-percha cones, were compared with respect to apical sealing as measured by length of dye penetration and frequency of no dye penetration. Overall, the single cone techniques were significantly more effective than lateral condensation techniques regarding length of dye penetration. The single cone techniques were not significantly different from the lateral condensation technique which employed chloroform dip-fitted primary gutta-percha cones regarding length of dye penetration. The single cone and lateral condensation techniques which utilized chloroform dip-fitted cones ranked first and second with respect to frequency of no dye penetration. PMID- 2705941 TI - Refractory chronic periodontitis: effect of oral tetracycline hydrochloride and root planning. AB - Refractory chronic periodontitis of 16 patients was treated by root planing and adjunctive tetracycline hydrochloride therapy. The antibiotic was taken orally one hour before root planing and continued for six days at a dosage of 250 mg six hourly. The clinical data for each patient were recorded as the number of probing depths in each of the 1-3 mm, 4-6 mm and 7-10 mm ranges. The Multivariate Analysis of Variance (MANOVA) procedure for repeated measurements was used to analyse the data. The results demonstrated that the number of sites with probing depths of 4-6 mm and 7-10 mm associated with incisors, canines, premolars and molars decreased with a corresponding increase in the number of sites in the 1-3 mm range. Incisor and canine teeth showed a better response to treatment than premolars, which responded better than molars. The cases were followed for varying periods of time from six months to two years following antibiotic therapy. The probing depth reduction achieved following root planing and tetracycline hydrochloride therapy was maintained during this review period. PMID- 2705942 TI - Premenstrual syndrome. A general practice view. AB - Up to 95 per cent of women experience some physical or psychological symptoms in the premenstrual phase of the cycle. The authors describe the syndrome and provide a practical guide to management strategies for women experiencing severe symptoms in this part of their cycle. PMID- 2705943 TI - Teaching of breast self examination. Is it practical? AB - In this study 348 patients attending outpatient clinics at Royal Hobart Hospital were interviewed, assessed in their breast self examination (BSE) technique, and taught BSE by the authors. A standard method of assessing BSE competence was devised applying the criteria outlined in a Tasmanian Cancer Committee brochure (Further reading) using a silicone breast examination teaching model. The measurable benefits of this form of teaching BSE were shown to persist for seven to 10 months in 11 women who re-attended clinics and were tested a second time after receiving instruction by the authors in the initial part of the study. PMID- 2705944 TI - Managing the breast lump. Solving the dilemma--reassurance versus investigation. AB - This article studies the dilemma faced by the general practitioner when a woman presents with a selfdetected breast lump. It emphasises the processes involved in determining whether the lump is a 'real' lump, and whether further action is warranted. In all instances an accurate clinical diagnosis is inextricably intermingled with a response to the personal needs of each woman. PMID- 2705945 TI - Medical management of epilepsy. AB - The treatment of epilepsy depends on an accurate diagnosis of the specific type of epilepsy. Where possible it is important to prescribe the minimum amount of medication for seizure control, preferably with monotherapy. The ultimate aim of treatment is to achieve maximal improvement in the quality of life for the patient. PMID- 2705946 TI - Complications of chronic glue ears. PMID- 2705948 TI - Caring for people at home. PMID- 2705947 TI - 62 year old man with erythema of his feet. PMID- 2705949 TI - Effect of electromagnetic fields. PMID- 2705950 TI - Myeloid leukaemia. PMID- 2705951 TI - Estimating the ideal peak flow rate. PMID- 2705952 TI - Soybean products. PMID- 2705953 TI - The Lachman test. PMID- 2705954 TI - Pelvic inflammatory disease. PMID- 2705955 TI - Women's health: just one question? PMID- 2705956 TI - Breastfeeding debate. PMID- 2705957 TI - Enuresis and food sensitivity. PMID- 2705958 TI - Self perceived standards of care in women's health. An illustrative case. AB - This article compares the reality of cervical cancer screening rates in general practice with doctors' self perceived standards of care. It also examines other aspects of women's health care as revealed in a random sample of New South Wales general practitioners. The implications for continuing medical education and quality assurance are discussed. PMID- 2705959 TI - Thermal profiles of blood vessels heated by a laser. AB - Thermal profiles of ectatic capillaries, modelled on those found in port wine stain birthmarks, are calculated by a method of finite differences. Yellow 578nm light is assumed to illuminate these vessels. The coagulation of endothelial cells is assumed to occur when the cells are heated to at least 70 degrees C. We model this by asking that a point 6 microns above the top of the vessel lumen attains a temperature of 70 degrees C. We constrain the parameters to prevent heating of blood above 100 degrees C, so as to avoid vapourisation. The treatment parameters of dose and illumination time are varied until they produce thermal profiles that show the model's coagulation conditions. being treated and are rather longer than the thermal relaxation time of the vessel and also much longer than the pulses of pulsed dye lasers. PMID- 2705960 TI - Reliability of the Cobb angle index derived by traditional and computer assisted methods. AB - The reliability of the traditional Cobb angle index, which at present exhibits a wide range of reported values, was determined in this study and amounted to a within subject error of +/-4.3 degrees and a between subject error of +/-4.9 degrees. An attempt to pinpoint the source of this variability by investigating the influence of choice of end vertebrae proved inconclusive. The reliability of a computer assisted Cobb angle index, developed to improve measurement accuracy, was also examined and an estimated within subject error of +/-1.5 degrees and a between subject error of +/-1.6 degrees obtained. A comparison of the traditional and computer assisted methods indicates a high correlation between the Cobb angle derived using the two methods when measuring like curves and an improved reliability obtained by the computer method. Such an improvement is worth implementing clinically but of course the availability of a computer and digitizer and a little extra time for an operator to input the X-ray coordinates may be a barrier to its general use. PMID- 2705961 TI - Ultrasound physiotherapy treatment and calibration measurements in simulated tissue. AB - The absorption, heating and relative intensities of ultrasonic beams used for physiotherapy are studied in water and in simulated tissue as a function of position in relation to the transducer head. It is found that the heating effects are significantly different from the beam profile shape. The effective area and depth of ultrasonic physiotherapy treatment is established for various situations, and tissue temperature rise curves are obtained. The results are appropriate for treatment planning. As an example, the typical volume of tissue effectively treated by ultrasound is a cylinder 6 to 8 cm in diameter and 1 cm deep. PMID- 2705962 TI - Determination of electron density, mass density and calcium fraction by mass of soft and osseous tissues by dual energy CT. AB - Techniques of CT analysis of trabecular regions are concerned with bone mineral assessment, with considerable attention being paid to the effect of unknown fat content. Information concerning mass density and electron density might provide a more complete picture but is not normally obtained. A method for the calculation of mass and electron density, as well as the fraction of calcium by mass, is described and requires only a measurement of effective beam energy on the skin in addition to the CT numbers from a dual energy scan. The method uses the six major elements, H, C, N, O, P and Ca as compartments for the analysis and can also be applied to soft tissue by using only the first four. The calculated mass fraction of Ca is found to be sensitive to fat content and difference between surface and internal energies which can lead to serious underestimates below a fraction of about 0.04. Mass and electron density results are independent of fat content and only marginally affected by energy differences. Results were obtained with simple materials confirming mass density can be calculated to the order of 3% and electron density to considerably better than 1%. PMID- 2705963 TI - Scattered radiation doses during per operative screening. AB - Measurements of scattered radiation doses during per operative screening indicate maximum mean dose rates to the eye are unlikely to exceed 56 microgray per minute for lateral projections and 14 microgray per minute for PA projections. The potential radiation doses to staff can be further reduced by the implementation of some simple protective measures. PMID- 2705964 TI - Computed organ doses for diagnostic radiology procedures. AB - The computer code for organ dose estimation developed by the Bureau of Radiological Health (BRH) has been modified to run on a personal computer (PC). Results obtained with the PC code correlate highly with results from BRH publications. Copies of the code are available on request from the author. PMID- 2705965 TI - Thoughts and thanks. PMID- 2705966 TI - Crew workload in JASDF C-1 transport flight: II. Change in urinary catecholamine excretion. AB - Serial changes in urinary catecholamine excretion were determined for 17 cockpit crews (6 captains, 6 copilots and 5 flight engineers) of JASDF C-1 aircraft during 10-hour (h) scheduled flights, in which captains and copilots performed almost the same flight tasks. The norepinephrine/epinephrine ratio (N/E) in copilots decreased significantly during the flight, whereas little decrease of the N/E was found in captains. Flight engineers showed an intermediate N/E value between captains and copilots. Hormonal responses appeared to correlate with differences in the amount of flying experience of crewmembers. Differences between captains and copilots were more significant when handling the aircraft. Results suggested that flight stresses perceived by crewmembers in the same cockpit were influenced by their flying experience and flight position which could be clearly assessed by determining relative excretions of epinephrine and norepinephrine. PMID- 2705967 TI - Effect of head or neck cooling used with a liquid-conditioned vest during simulated aircraft sorties. AB - The effectiveness of head or neck cooling in reducing head sweating and increasing subject comfort when used in conjunction with a liquid-conditioned vest during simulated sorties in the European Fighter Aircraft was investigated. Six subjects underwent three 2-h exposures at 40 degrees C wearing Aircrew Chemical Defence clothing and one of three combinations of liquid-conditioned garments. In all three exposures, a liquid-conditioned vest was worn and, in two exposures, either a head-cooling cowl or a neck-cooling collar was worn in addition to the vest. All six subjects reported increased comfort and decreased head sweating with head cooling, a result supported by the data collected. PMID- 2705968 TI - Ocular refraction with body orientation. AB - Body inversion is used experimentally to raise the intraocular pressure (IOP). Psychophysical and electrophysiological methods of assessing visual function in artificially raised IOP are generally influenced by the clarity of the retinal image. It is therefore essential to be aware of any changes in ocular refraction induced by changes in body orientation. The present study reports on the refractive changes occurring with body orientation in conditions where accommodation is freely responding, and also immobilized pharmacologically. Ocular refraction varies by less than 0.50D across all body orientations as measured by a laser optometer which provides refractive measurements independent of the perception of blur. These results indicate that pattern-dependent tests of visual function are not likely to be influenced by refractive changes on body inversion. PMID- 2705969 TI - Reticuloendothelial phagocytic activity in high-altitude acclimatized rats. AB - Experiments were undertaken with rats to determine the effects of chronic exposure to a simulated high altitude of 5,000 m on phagocytic activity of the reticuloendothelial system (RES). Phagocytic index (K) was determined by measuring the rate of blood clearance of colloidal carbon given intravenously. K value of the chronically altitude exposed rats was found to be greater than that of the sea level control animals (p less than 0.02), indicating that acclimatization to high altitude stimulated the RES phagocytosis. On analysis of the weights of the liver and spleen, the corrected phagocytic index (alpha) of the high altitude-acclimatized rats was also found to be higher than that of the sea level control animals (p less than 0.05) while the weights of the liver and spleen expressed in percent body weight were not affected by high altitude exposure. The increased number of carbon-containing Kupffer cells in the liver and the increased phagocytic indices (both K and alpha values) suggested that most of the increase in RES phagocytic activity was due to increased RES tissue activity per unit mass of tissue rather than tissue hypertrophy. PMID- 2705970 TI - Sudden inflight incapacitation in general aviation. AB - This study considered NTSB data and post-crash medical data received by the Medical Statistical Section of the Civil Aeromedical Institute (CAMI), Oklahoma City, OK from 1975-82, and other related literature to estimate the probability of incapacitation in general aviation. Data for the years studied indicate that approximately 3 accidents per 1,000 (15 per 1,000 fatal accidents) are known to result from the incapacitation of the pilot for all causes. Results suggest that the likelihood of incapacitation increases with age. The occurrence of incapacitation for obvious medical reasons is less than would be expected based on general population morbidity/mortality data; however, the need for continued vigilance in certification, and education regarding flying with known or suspected medical problems, is emphasized. PMID- 2705971 TI - Thrombophlebitis following intravenous glucose in the cold. AB - In an effort to characterize the role of carbohydrate metabolism during the hypermetabolic state associated with whole body cooling, oral (n = 6) and intravenous (iv; n = 3) glucose tolerance tests (GTT) were performed in nude subjects. Unexpectedly, 1-2 wks after the completion of their iv GTT (50% dextrose) in the cold, superficial thrombophlebitis was diagnosed in all 3 subjects. No subject developed thrombophlebitis after the oral GTT in the warm and cold, nor after the iv GTT in the warm. Since this complication was not observed in further testing with isotonic iv solutions under identical conditions in the cold as above, we conclude that the adverse reaction is the result of an interaction between whole body cooling or vasoconstriction and the hypertonicity of the dextrose solution. Environmental physiologists and medical officers should be aware of this complication. PMID- 2705972 TI - Trends in Poland in space psychology research. AB - This paper discusses the basic directions of research carried out in Poland during the years 1981-86 within the Polish Academy of Science project 06.7. The subject matter concerns: individual and situational determinants of human functioning in stress conditions; functioning of a human in extreme conditions; and load imposition through activities requiring risk-taking decisions. PMID- 2705973 TI - Experiences of rocket seat ejections in the Swedish Air Force: 1967-1987. AB - From 1967 to 1987 there were 83 successful and 9 fatal ejections with Saab rocket seats in the Swedish Air Force. Medical consequences and injury factors are reviewed. Thirty-nine survivors had nontrivial injuries; four were seriously injured. The risk for injury has been approximately 50% throughout the period. Two-thirds of the survivors resumed flying within a week, the remainder after up to 1 year, except for three pilots who terminated their flying status. PMID- 2705974 TI - Office hypertension. PMID- 2705975 TI - G-induced loss of consciousness. PMID- 2705976 TI - Olfactory discrimination of estrous condition by the male golden hamster (Mesocricetus auratus). AB - After repeated exposure to receptive and nonreceptive females, male golden hamsters were tested for olfactory preferences in a four-choice olfactometer. Males discriminated between the odor of anesthetized females in different stages of their estrous cycle when the airstreams carrying the stimulus odors were diluted. Previous failures to demonstrate such an ability were probably due to ceiling effects resulting from laboratory testing. Males preferred the odor of females on the day before receptivity (a day coincident with maximal scent marking by the female) and least preferred the odor of females on diestrus-1 (the day on which females attacked and chased males during pretesting encounters). Detection and quick response to an impending estrus would be especially important for males of a solitary and promiscuous species in which there is a first male mating advantage. PMID- 2705977 TI - Post-training memory facilitation blocks extinction but not retroactive interference. AB - Rats were trained in a step-down inhibitory avoidance task using a 0.2-mA footshock and tested 6 h later. Exposure to a session of extinction (animals placed on the box where they had been trained and left to explore it freely for 100.0 s without footshocks) or to a series of 10 tones presented in another box, in the dark, 2 h after training, hindered retention test performance. The immediate post-training ip administration of epinephrine (5.0 micrograms/kg), ACTH-(1-24) (0.2 microgram/kg), or lysine-vasopressin (10.0 micrograms/kg) facilitated retention test performance and cancelled the effect of extinction, but not the retroactive interference caused by exposure to the tones. These results support the concept that post-training facilitation induced by the hormones is due to a strengthening of the memory trace left by the avoidance task, whereas the retroactive interference caused by the tones occurs independently from that process and is more likely due to the incorporation of postevent information. PMID- 2705978 TI - Associative morphine tolerance in the rat: examinations of compensatory responding and cross-tolerance with stress-induced analgesia. AB - The results of three experiments designed to examine the processes subserving associative tolerance to morphine's analgesic effects, as assessed by the tail flick test, are reported. The experiments indicated that associative tolerance in male Holtzman rats was not subserved by conditioned compensatory responses but was cross-tolerant with an apparently nonopioid form of stress-induced analgesia (SIA). Experiment 1 showed that rats tested for morphine analgesia in a distinctive context that had been paired previously with morphine injections (5 mg/kg) were more tolerant than animals that had had this context explicitly unpaired with a series of morphine injections or animals that were drug-naive. There was no evidence of a conditioned compensatory response of hyperalgesia in animals given a saline injection in the presence of environmental stimuli that had been previously paired with morphine, even under test conditions designed to minimize the possibility of floor effects that might have obscured the detection of drug-compensatory hyperalgesia. Experiment 2 demonstrated that the footshock procedures used for stress induction produced an SIA that was not attenuated by naloxone (10 mg/kg). Experiment 3 replicated the associative tolerance phenomenon of Experiment 1 and again failed to find evidence of conditioned compensatory responses. It was found that animals exposed to footshock in the context that had been associated with morphine administration developed significantly less SIA than control animals. The relevance of these findings for associative models of drug tolerance is discussed. PMID- 2705979 TI - Male-related chemical cues promote sexual receptivity in the female musk shrew. AB - The role of conspecific chemical cues in the activation of sexual behavior was investigated in the female musk shrew (Suncus murinus). In Experiment 1, virgin female musk shrews were exposed to either clean cages or cages recently vacated by an adult male. Regardless of whether the male used for the sexual behavior test was "familiar" to the female (having spent the 24 h exposure in his vacant cage) or "unfamiliar," females exposed to male-related cues received mounts from males significantly sooner than females exposed to clean cages. In Experiment 2, females housed for 24 h in a cage soiled by an adult male allowed males to mount significantly sooner than females housed in a cage soiled by a castrated male, another female, or a clean cage. These results demonstrate that chemical cues, produced exclusively by adult males, promote sexual receptivity in female musk shrews. PMID- 2705980 TI - Does directed exploration influence locomotor activity in a holeboard test? AB - The effects of three drugs, chosen for their differential effects on directed exploration and locomotion (ethanol, caffeine, and FG 7142), were examined on the locomotor activity of mice in a holeboard apparatus containing either a solid floor or one with four holes in it. The dose-related effect of all three drugs on locomotor activity was not changed by the presence of the holes, although activity was slightly higher when a solid floor was used. The results indicated that the two measures can vary independently and that the directed exploration component (head-dipping) of the holeboard test does not significantly influence the locomotor activity component. PMID- 2705981 TI - Naloxone administration impairs autoshaped learning. AB - Effects of naloxone on acquisition of autoshaped behavior were investigated. Rats deprived to 85% of free-feeding weights were trained to touch a retractable lever; delivery of a food pellet occurred on every trial following lever retraction. The lever was retracted immediately if a touch occurred within 15 s, or automatically after 15 s. Analyses were conducted on number and latencies of touches of the extended lever, nose-pokes (touches) directed at the retracted lever during intertrial intervals (a measure less constrained by ceiling effects than extended lever touches), and unconditioned exploratory rearing activity, measured as touches of a metal strip mounted above the grid floor of the apparatus. In an initial experiment, male Sprague-Dawley rats were given saline or naloxone (2.0 mg/kg, ip) 5 min before a training session of 12 trials. Two days later they were tested, in the absence of drug, in a session of 36 (three blocks of 12) trials. Naloxone depressed training levels of lever responding, in addition to slowing acquisition rate. No effect of naloxone was observed on rearing activity. Previous work showed that injection of saline 5 min before behavioral testing increases the rate of autoshaping compared to injections 30 min before (Messing & Sparber, 1984). Thus, effects of naloxone on acquisition of lever-directed behaviors may have been confounded by behavioral depressant effects and/or by an injection effect such a short time before testing. In a second experiment naloxone (0.5 or 2.0 mg/kg) was injected after five of seven training sessions (12 trials each) to male and female rats. A 6-s delay of reinforcement was inserted between lever retraction and food delivery, slowing acquisition rates and providing the opportunity to test the effects of naloxone throughout a multiple-session task. The low dose retarded acquisition of extended lever touching in both sexes; both doses retarded acquisition of interim lever touching in males. Thus, in some circumstances, post-training naloxone administration may impair learning. The results support the notion that low doses of naloxone may have agonist activity. PMID- 2705982 TI - Facilitation of the effect testosterone on male sexual behavior in rats deprived of REM sleep. AB - The possibility of rapid eye movement sleep deprivation (REMd) altering the effect of testosterone on masculine sexual behavior was investigated. Adult castrated male Wistar rats with no sexual experience were randomly assigned to the following three groups: REMd (using the water tank technique) for 7 days, large platform control for 7 days, and undisturbed sleep control. All subjects were treated with 1 mg testosterone propionate daily for 14 days. Masculine sexual behavior was assessed 3 consecutive days prior to steroid administration and was evaluated daily during the treatment. Frequencies and latencies of mounts, intromissions, and ejaculations, as well as the postejaculatory refractory period were recorded. One hundred percent of the REMd subjects presented mounts, intromissions, and ejaculations sooner than the control group. In almost all parameters, a clear facilitation of sexual activity was observed in the REMd group. PMID- 2705983 TI - Thermoregulation and performance of heat-reinforced autoshaped keypecking in chicks. AB - Performance of autoshaped keypecking reinforced by heat was found to increase and then to decrease when chicks were exposed to training under a constant thermal load on a daily basis over the first 1-2 weeks after hatching. The decline in performance was not affected by variation in US duration (Experiment 1). No decline in performance was observed when food reinforcement was used (Experiment 2), suggesting that the effect depended on the use of thermal motivation. When thermoregulation was disrupted by pharmacological blockade using propranolol hydrochloride (10 mg/kg), keypecking was reinstated (Experiment 3). The increase in keypecking produced by propranolol was not due to a nonspecific energization of behavior inasmuch as the drug depressed autoshaped keypecking established with food reinforcement (Experiment 4). These findings support the conclusion that the decline in autoshaped keypecking reinforced by heat is due to development of the chick's thermoregulatory system. Various physical changes (e.g., feathering) and the increasing effectiveness of autonomic and behavioral thermoregulatory responses reduce the net motivational value of external heat sources, thus leading to a decline in the likelihood of approach and contact with signals for heat. PMID- 2705984 TI - Attenuation of amphetamine-stereotypy by mesostriatal dopamine depletion enhances plasma corticosterone: implications for stereotypy as a coping response. AB - The relationship between amphetamine-induced stereotyped behavior and a neuroendocrine index of arousal, plasma corticosterone (CCS), was investigated. 6 Hydroxydopamine lesions of the caudate-putamen, which produced dopamine depletions of 60%, blocked stereotypy and prolonged the elevation in corticosterone associated with d-amphetamine treatment (5 mg/kg). Similar dopamine depleting lesions of the nucleus accumbens, which attenuated the locomotor, but not the stereotypic, response to AMPH did not have this effect on CCS. This pattern of results supports the hypothesis that stereotypy has a coping function which may serve to alter arousal and further suggests important differences between the nigrostriatal and mesolimbic dopamine projections in modulating the responsiveness of the neuroendocrine system. These results have implications for understanding the function of behavioral stereotypies common to a number of psychopathological conditions, including schizophrenia and childhood autism. PMID- 2705985 TI - Epileptic tendencies in relation to behavioral responses to a novel environment in the Mongolian gerbil. AB - The severity of epileptic-like seizures in gerbils (Meriones unguiculatus), placed in an open field, is directly related to their ambulatory activity on subsequent trials. An inverse relationship, however, occurs between seizure severity and oriented, bipedal rearing behavior on subsequent trials. Principal components and multiple linear regression analyses support the hypothesis that ambulation and rearing have different underlying neuronal mechanisms. If these two activities are considered as measures of arousal and attention, respectively, then epileptic-like seizures may be caused by hyperactivity of mechanisms which induce arousal. PMID- 2705986 TI - Effect of alkaline pH on photosynthetic water oxidation and the association of extrinsic proteins with Photosystem Two. AB - Incubation of a membrane preparation enriched in Photosystem Two (PSII) at alkaline pH inhibited the water-splitting reactions in two distinct steps. Up to pH 8.5 the inhibition was reversible, whereas at higher alkalinities it was irreversible. It was shown that the reversible phase correlated with loss and rebinding of the 23 kDa extrinsic polypeptide. However, after mild alkaline treatments a partial recovery was possible without the binding of the 23 kDa polypeptide when the assay was at the optimal pH of 6.5 and in a medium containing excess Cl-. The irreversible phase was found to be closely linked with the removal of the 33 kDa extrinsic protein of PSII. Treatments with pH values above 8.5 not only caused the 33 kDa protein to be displaced from the PSII enriched membranes, but also resulted in an irreversible modification of the binding sites such that the extrinsic 33 kDa protein could not reassociate with PSII when the pH was lowered to 6.5. The results obtained with these more extreme alkaline pH treatments support the notion that the 23 kDa protein cannot bind to PSII unless the 33 kDa protein is already bound. The differential effect of pH on the removal of the 23 kDa and 33 kDa proteins contrasted with the data of Kuwabara & Murata [(1983) Plant Cell Physiol. 24, 741-747], but this discrepancy was accounted for by the use of glycerol in the incubation media. PMID- 2705987 TI - Rapid stimulation of calcium uptake into rat liver by L-tri-iodothyronine. AB - The short-term effect of L-tri-iodothyronine (T3) on hepatic Ca2+ uptake from perfusate was compared with changes induced by T3 on cellular respiration and glucose output in isolated perfused livers from fasted and fed rats. The same parameters were also studied after the addition of glucagon or vasopressin. T3 (1 microM) induced Ca2+ uptake from the perfusate into the liver within minutes, and the time course was similar to that for stimulation of respiration and gluconeogenesis in livers from fasted rats, and for the stimulation of respiration and glucose output in livers from fed rats. The effects were dose dependent in the range 1 microM-0.1 nM. Similar changes in the same parameters could be observed with glucagon and vasopressin, but with a completely different time course. Also, the influence of the T3 analogues L-thyroxine (L-T4), 3,5-di iodo-L-thyronine (L-T2) and 3,3',5-tri-iodo-D-thyronine (D-T3) on hepatic energy metabolism was examined. Whereas D-T3 had practically no effect, L-T4 and L-T2 caused changes in Ca2+ uptake, O2 consumption and gluconeogenesis in livers from fasted rats similar to those with T3. It is concluded that changes in mitochondrial and cytosolic Ca2+ concentrations are involved in the stimulation of respiration and glucose metabolism observed with T3, glucagon and vasopressin. PMID- 2705988 TI - Kinetics and mechanism of electron transfer from dithionite to microsomal cytochrome b5 and to forms of the protein associated with charged and neutral vesicles. AB - The kinetics of the dithionite reduction of calf liver microsomal cytochrome b5, both free in solution and bound to dimyristoyl phosphatidylcholine vesicles, are consistent with electron transfer between SO2- and the exposed haem edge of the protein. The vesicle membrane does not hinder the approach of SO2- to the site of electron transfer on the protein. In 0.01 M-Tris/HCl buffer, pH 8.1, ket (25 degrees C), delta H et and delta S et are estimated to be 1.44 x 10(6) M-1.s-1, 7.8 kJ.mol-1 and -92.3 J.K-1.mol-1 respectively. The cytochrome exhibits an acid dissociation, pKa 9.3 +/- 0.3, and the rate of electron transfer from dithionite to the high-pH form is about one-third of that to the neutral-pH form. The effect of ionic strength on the kinetics is consistent with a reaction between like charged species and is discussed in terms of a number of theoretical models. In systems comprising cytochrome b5 and negatively charged vesicles, the effect of increasing the charge density of mixed dimyristoyl phosphatidylcholine/dicetyl phosphate vesicles and of increasing the concentration of dicetyl phosphate vesicles is to lower the rate of electron transfer from dithionite to the haem moiety of the cytochrome. With vesicles of high charge density, however, the kinetics are complicated by vesicle-induced conformation changes of the cytochrome. PMID- 2705989 TI - Analysis of progress curves by simulations generated by numerical integration. AB - A highly flexible computer program written in FORTRAN is presented which fits computer-generated simulations to experimental progress-curve data by an iterative non-linear weighted least-squares procedure. This fitting procedure allows kinetic rate constants to be determined from the experimental progress curves. Although the numerical integration of the rate equations by a previously described method [Barshop, Wrenn & Frieden (1983) Anal. Biochem. 130, 134-145] is used here to generate predicted curves, any routine capable of the integration of a set of differential equations can be used. The fitting program described is designed to be widely applicable, easy to learn and convenient to use. The use, behaviour and power of the program is explored by using simulated test data. PMID- 2705990 TI - Analysis of progress curves for enzyme-catalysed reactions. Automatic construction of computer programs for fitting integrated rate equations. AB - The computer analysis of progress curves for enzyme-catalysed reactions involves a series of mathematical and computational tasks. The three most daunting of these are the derivation of an integrated rate equation, solving this equation so that the amount of product formed by the reaction at any time can be calculated, and incorporating this solution into a non-linear-regression computer program. This paper describes the basis of a computer program that greatly simplifies the problem. The proposed mechanism is specified in the familiar kinetic constant form, which is automatically translated into a program capable of fitting this mechanism to a series of experimental progress curves. The approach is illustrated for a reversible reaction with one substrate and one product, and tested with some data obtained for the fumarase reaction. A copy of the program has been deposited as Supplementary Publication SUP 50148 (13 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. (1989) 257, 5. PMID- 2705991 TI - Characteristics and adaptive regulation of glycine transport in cultured glial cells. AB - The transport of glycine in C6 glioma cells takes place mainly in a heterogeneous Na+-dependent manner which can be resolved into different components. A Na+- and Cl(-)-dependent component with high affinity for glycine is pH-sensitive and inhibited by sarcosine, all these characteristics corresponding to System Gly. The low-affinity component of the transport of glycine can be discriminated as two components, namely System A and System ASC. The main proportion of glycine transport through the low-affinity system is carried out by the ASC System, which appears to be constitutively expressed by the cells. The adaptive response of the low-affinity Na+-dependent transport of glycine to amino acid deprivation was identified with System A on the basis of its ion-dependency, pH-sensitivity and by inhibition analysis. The possible physiological role of the high- and low affinity components of the transport system for glycine in glial cells is discussed. PMID- 2705992 TI - Purification of chicken liver ferritin by two novel methods and structural comparison with horse spleen ferritin. AB - Ferritin was purified from chicken liver by two different methods: gel filtration on controlled-pore glass beads, and immunoaffinity chromatography employing a chicken ferritin-specific monoclonal antibody that did not cross-react with horse spleen ferritin. This antibody recognizes intact ferritin and an oligomeric 240 kDa form of the molecule after protein transfer to nitrocellulose, but not the 22 kDa chicken ferritin subunit. Chicken liver ferritin purified by these methods exhibited reduced migration on non-denaturing polyacrylamide gels compared with horse spleen ferritin. These results were consistent with the difference in calculated isoelectric points of chicken and horse ferritin subunits. By two dimensional gel electrophoresis, chicken ferritin 22 kDa subunits exhibited isoelectric points from 6.1 to 6.6 whereas horse spleen ferritin subunits exhibited isoelectric points of 5.8-6.3. The 240 kDa form of the chicken ferritin molecule had an isoelectric point of 6.6 whereas the 210 kDa form of the horse ferritin molecule had isoelectric points of 5.1 and 4.9. Intact chicken liver ferritin particles were 13.4 +/- 0.8 nm (controlled-pore glass-purified) and 12.5 +/- 0.9 nm (affinity-purified) in diameter when viewed by electron microscopy. Horse spleen ferritin consisted of slightly smaller particles with an average diameter of 11.0 +/- 0.7 nm. However, ferritin from chicken liver and horse spleen co-migrated with an apparent molecular mass of 470 kDa when analysed by Sepharose 4B gel filtration chromatography. These results indicate that, consistent with results from other published purification methods, the chicken ferritin purified by the methods reported here exhibits both structural similarities to, and differences from, horse spleen ferritin. PMID- 2705993 TI - A discoordinate increase in the cellular amount of 3-hydroxy-3-methylglutaryl-CoA reductase results in the loss of rate-limiting control over cholesterogenesis in a tumour cell-free system. AB - Cholesterol biosynthesis was characterized in cell-free post-mitochondrial supernatant systems prepared from both normal rat liver and Morris hepatoma 3924A. The rate of cholesterol synthesis per cell was 9-fold greater in the tumour system than in that from normal liver, and the tumour systems showed the loss of rate-limiting control at the hydroxymethylglutaryl-CoA reductase (HMGR) catalysed step. The apparent absence of rate-limiting control over cell-free tumour cholesterogenesis was traced primarily to a discoordinate and dramatic increase in the amount of HMGR in the tumour relative to the liver system. Preliminary evidence for an altered control of the post-lanosterol portion of the pathway was also obtained with the tumour system. PMID- 2705994 TI - Effects of oxidative stress on some physiochemical properties of caeruloplasmin. AB - We report the effects of oxidative stress generated by low-intensity u.v. irradiation (366 and 254 nm), dialysis against ascorbate and isolated stimulated neutrophils on some physicochemical properties of caeruloplasmin. Low-intensity u.v. irradiation resulted in a loss of ferroxidase activity and 610 nm absorption, changes previously reported to occur during storage and manipulation of caeruloplasmin. These alterations were found to correspond to aggregation of the protein, induction of visible fluorescence (excitation, 360 nm; emission, 454 nm), changes in c.d. spectra which were indicative of alterations in protein conformation, loss of half-cystine, tryptophan and tyrosine content and loss immunoreactivity. The changes in the far-u.v. c.d. spectrum of caeruloplasmin were more pronounced than those observed for u.v.-irradiated IgG. Similar c.d. changes and induction of fluorescence were observed following dialysis of caeruloplasmin against ascorbate or exposure to stimulated neutrophils. It is concluded that the lability of caeruloplasmin may arise from oxidative modification, in addition to the previously described susceptibility of this protein to proteolysis. PMID- 2705995 TI - Phosphorylation-dependent and -independent pathways of platelet aggregation. AB - We have used the non-specific inhibitor of protein kinases, staurosporine, to investigate the role of protein phosphorylation during aggregation, the mobilization of intracellular Ca2+ (Ca2+)i and intracellular pH (pHi) in thrombin stimulated platelets. The concentration of staurosporine chosen for these studies, 1 microM, was previously reported to inhibit protein phosphorylation completely but to have no effect on the activation of phospholipase C in thrombin stimulated human platelets [Watson, McNally, Shipman & Godfrey (1988) Biochem. J. 249, 345-350]. Aggregation induced by phorbol dibutyrate is slow (several minutes) and is inhibited completely by staurosporine. In contrast, aggregation induced by thrombin, platelet-activating factor or ionophore A23187 is rapid (occurs within 60 s), and is slowed, but not inhibited, in the presence of staurosporine. On the other hand, staurosporine causes a small potentiation of the peak [Ca2+]i signal induced by thrombin and a marked increase in the half life of decay of this signal, but has no effect on pHi. Under conditions designed to prevent an increase in [Ca2+]i (presence of Ni2+ to prevent Ca2+ entry, and depletion of the intracellular Ca2+ stores), aggregation induced by thrombin resembles that by phorbol dibutyrate and is now inhibited completely by staurosporine. Taken together, these results provide evidence for two signalling pathways for aggregation, a relatively rapid phosphorylation-independent route mediated by Ca2+ and a slower, phosphorylation-dependent, pathway mediated by protein kinase C. Since staurosporine slows aggregation induced by thrombin, it appears that under normal conditions these pathways interact synergistically. PMID- 2705996 TI - Intracellular transport of formaldehyde-treated serum albumin in liver endothelial cells after uptake via scavenger receptors. AB - Endocytosis of formaldehyde-treated serum albumin (FSA) mediated by the scavenger receptor was studied in rat liver endothelial cells. Suspended cells had about 8000 receptors/cell, whereas cultured cells had about 19,000 receptors/cell. Kd was 10(-8) M in both systems. Cell-surface scavenger receptors were found exclusively in coated pits by electron microscopy, by using ligand labelled with colloidal gold. Cell-surface-bound FSA could be released by decreasing the pH to 6.0; it was therefore possible to assess the rate of internalization of surface bound ligand. This rate was very high: t1/2 for internalization of ligand prebound at 4 degrees C was 24 s. The endocytic rate constant at 37 degrees C, Ke, measured as described by Wiley & Cunningham [(1982) J. Biol. Chem. 257, 4222 4229], was 2.44 min-1, corresponding to t1/2 = 12 s. Uptake of FSA at 37 degrees C after destruction of one cell-surface pool of receptors by Pronase was decreased to 60%. This finding is compatible with a relatively large intracellular pool of receptors. The intracellular handling of 125I-tyramine cellobiose-labelled FSA (125I-TC-FSA) was studied by subcellular fractionation in sucrose gradients, Nycodenz gradients or by differential centrifugation. The density distributions of degraded and undegraded 125I-TC-FSA after fractionation of isolated non-parenchymal cells and whole liver were similar, when studied in Nycodenz and sucrose gradients, suggesting that the subcellular distribution of the ligand was not influenced by the huge excess of non-endothelial material in a whole liver homogenate. Fractionation in sucrose gradients showed that the ligand was sequentially associated with organelles banding at 1.14, 1.17 and 1.21 g/ml. At 9-12 min after intravenous injection the ligand was in a degradative compartment, as indicated by the accumulation of acid-soluble radioactivity at 1.21 g/ml. A rapid transfer of ligand to the lysosomes was also indicated by the finding that a substantial proportion of the ligand could be degraded by incubating mitochondrial fractions prepared 12 min after intravenous injection of the ligand. The results indicate that FSA is very rapidly internalized and transferred through an endosomal compartment to the lysosomes. The endosomes are gradually converted into lysosomes between 9 and 12 min after injection of FSA. The rate-limiting step in the intracellular handling of 125I-TC-FSA is the degradation in the lysosomes. PMID- 2705997 TI - Pyruvate dehydrogenase activities during the fed-to-starved transition and on re feeding after acute or prolonged starvation. AB - We investigated the temporal relationship between hepatic glycogen depletion and cardiac and hepatic PDH (pyruvate dehydrogenase complex) activities during the acute phase of starvation. There was a striking correlation between the decline in hepatic glycogen and PDH inactivation during the first 10 h of starvation. Re feeding after 6 h starvation was associated with complete re-activation of PDH in liver and re-activation to approx. 75% of the fed value in heart, whereas in rats previously starved for 24-48 h re-activation was delayed in liver and diminished in heart. The results are discussed with reference to the fate of dietary carbohydrate after re-feeding. PMID- 2705998 TI - Alterations in the protein-synthesis, -degradation and/or -secretion rates in hepatic subcellular fractions of selenium-deficient mice. AB - Single mouse livers were subfractionated by differential centrifugation and isopycnic centrifugation on sucrose or metrizamide gradients and separated into subcellular compartments. The fractionation procedure was highly reproducible and yielded essentially similar results in different preparations of livers from selenium-adequate (Se+) and selenium-deficient (Se-) mice that were fed on a Torula-yeast-based diet containing less than 10 parts per 10(9) of selenium for at least 16 weeks. Mice of both dietary groups were injected intraperitoneally with 370 kBq of L-[U-14C]leucine, and 48 h later 1.85 MBq of L-[4,5-3H]leucine was injected intraportally. After another 1 h, the livers were removed and subjected to subcellular fractionation. Incorporation of the 3H label into proteins of the subcellular fractions was taken as a measure of relative protein synthesis rate. The ratio of the 3H to the 14C protein-bound label of the same fractions was used as an estimate of relative protein-degradation and/or secretion rate. The results showed a statistically significant 180% increase in protein-synthesis rate in the endoplasmic reticulum and a 80% increase in relative protein-degradation and/or -secretion rate in the same compartment. A significant decrease in the 3H/14C ratio, by 40 and 30% respectively, was observed in the Golgi fraction and in liver homogenate. The observed changes suggest a highly regulated hepatic response to selenium deficiency. PMID- 2705999 TI - Subcellular distribution of selenium in deficient mouse liver. AB - Selenium (Se)-deficient mice were labelled in vivo with single pulses of [75Se]selenite, and the intrahepatic distribution of the trace element was studied by subcellular fractionation. At 1 h after intraperitoneal injection of 3.3 or 10 micrograms of Se/kg body weight, 15% of the respective doses were found in the liver. Accumulation in the subcellular fractions followed the order: Golgi vesicular much greater than lysosomal greater than cytosolic = microsomal greater than mitochondrial, peroxisomal, nuclear and plasma-membrane fraction. At a dose of 3.3 micrograms/kg, more than 90% of the hepatic Se was protein-bound. When cross-contamination was accounted for, the following specific Se contents of the subcellular compartments were extrapolated: Golgi apparatus, 7.50 pmol/mg; cytosol, 0.90 pmol/mg; endoplasmic reticulum, 0.80 pmol/mg; mitochondria, 0.49 pmol/mg; nuclei, lysosomes, peroxisomes and plasma membrane, less than 0.4 pmol/mg. At 10 micrograms/kg, a roughly 2-3-fold increase in Se content of all fractions was found without major changes in the intrahepatic distribution pattern. An extraordinary rise in the cytosolic fraction was due to an apparently non-protein-bound Se pool. At 24 h after dosing, total hepatic Se had decreased to 6% of the initial dose and had become predominantly protein-bound. The 60% decrease in hepatic Se was reflected in a similar fall in the subcellular levels of the trace element. The Golgi apparatus still had the highest specific Se content, although accumulation was 5 times less than that after 1 h. The cytosolic pool accounted for 50% of the hepatic Se at both labelling times. After 1 h the Golgi apparatus was, with 19%, the second largest intrahepatic pool, followed by the endoplasmic reticulum with 16%. The high affinity and fast response of the Golgi apparatus to Se supplementation of deficient mice is interpreted in terms of a predominant function of this cell compartment in the processing and the export of Se-proteins from the liver. PMID- 2706000 TI - Characterization of translation systems in vitro from three developmental stages of Strongylocentrotus purpuratus. AB - We have developed and characterized cell-free systems active in translation from unfertilized eggs, 30-min zygotes and hatched blastulae of the sea urchin Strongylocentrotus purpuratus. The ion concentrations selected for preparation of the lysates were 150 mM-K+, 40 mM-Na+, 40 mM-Cl-, 5 x 10(-7) M free Ca2+ and 1 mM free Mg2+. It was necessary to include the ribonuclease inhibitor RNas in the preparations to obtain full activity consistently. The pH optimum was 7.2 and was extremely sharp for the three S. purpuratus lysates. The temperature optima of the three lysates were remarkably similar to those of the intact unfertilized egg and embryos. Lysates from unfertilized egg and 30-min zygotes showed a temperature optimum at 15 degrees C. The hatched blastula lysate showed a broader temperature optimum with a shift to about 20 degrees C. The optimized lysates incorporated radiolabelled amino acids into polypeptides for up to 90 min. The polypeptides synthesized ranged in Mr from 200,000 to 20,000, suggesting that the mRNA in the lysates was intact and capable of directing the synthesis of complete polypeptides. Furthermore, the three lysates were capable of initiation, as demonstrated by inhibition of initiation using the inhibitors edeine and 7 methylguanosine 5'-triphosphate (m7GTP). At 15 degrees C, the transit times for the three lysates were: unfertilized egg, 40 min; 30-min zygotes and hatched blastula lysates, 20 min. These transit times are similar to those of intact eggs and embryos, and significantly, reflect the two-fold increase in elongation rate seen following fertilization in intact embryos. Thus, these lysates display many features and characteristic responses typical of intact eggs and embryos, indicating that the lysates should be useful tools for the analysis of translation control in early embryogenesis. PMID- 2706001 TI - Study of the interaction between the antitumour protein alpha-sarcin and phospholipid vesicles. AB - alpha-Sarcin is a single polypeptide chain protein which exhibits antitumour activity by degrading the larger ribosomal RNA of tumour cells. We describe the interaction of a alpha-sarcin with lipid model systems. The protein specifically interacts with negatively-charged phospholipid vesicles, resulting in protein lipid complexes which can be isolated by ultracentrifugation in a sucrose gradient. alpha-Sarcin causes aggregation of such vesicles. The extent of this interaction progressively decreases when the molar ratio of phosphatidylcholine increases in acidic vesicles. The kinetics of the vesicle aggregation induced by the protein have been measured. This process is dependent on the ratio of alpha sarcin present in the protein-lipid system. A saturation plot is observed from phospholipid vesicles-protein titrations. The saturating protein/lipid molar ratio is 1:50. The effect produced by the antitumour protein on the lipid vesicles is dependent on neither the length nor the degree of unsaturation of the phospholipid acyl chain. However, the aggregation is dependent on temperature, being many times higher above the phase transition temperature of the corresponding phospholipid than below it. The effects of pH and ionic strength have also been considered. An increase in the ionic strength does not abolish the protein-lipid interaction. The effect of pH may be related to conformational changes of the protein. Binding experiments reveal a strong interaction between alpha-sarcin and acidic vesicles, with Kd = 0.06 microM. The peptide bonds of the protein are protected against trypsin hydrolysis upon binding to acidic vesicles. The interaction of the protein with phosphatidylglycerol vesicles does not modify the phase transition temperature of the lipid, although it decreases the amplitude of the change of fluorescence anisotropy associated to the co-operative melting of 1,6-diphenyl-1,3,5-hexatriene (DPH)-labelled vesicles. The results are interpreted in terms of the existence of both electrostatic and hydrophobic components for the interaction between phospholipid vesicles and the antitumour protein. PMID- 2706002 TI - Chylomicron-remnant uptake by freshly isolated hepatocytes. Effect of heparin and of hepatic triacylglycerol lipase. AB - Chylomicron remnants labelled biologically with [3H]cholesterol were efficiently taken up by freshly isolated hepatocytes during a 3 h incubation in Krebs bicarbonate medium. Their [3H]cholesteryl ester was hydrolysed (74% net hydrolysis), and 0.1 mM-chloroquine could partially inhibit this hydrolysis, provided that hepatocytes were first preincubated for 2 h 30 min at 37 degrees C. This hydrolysis was also measured in preincubated cells with remnants double labelled (3H and 14C) on their free cholesterol moiety; [3H]cholesterol arising from [3H]cholesteryl ester hydrolysis was recovered in the free [3H]cholesterol pool. A dose-response study showed saturation of remnant uptake at 180 micrograms of remnant protein/10(7) cells. Heparin (10 units/ml) increased remnant uptake by 63% (P less than 0.01), [3H]cholesteryl ester accumulation in the cell pellet by 110% (P less than 0.025) and hepatic lipase activity secreted in the medium by 2.4-fold (P less than 0.01) and by 3.3-fold (P less than 0.01) at the end of the preincubation and incubation periods respectively. Addition of 100 munits of semi purified hepatic lipase preparation/flask stimulated remnant uptake by 44-69%, and [3H]cholesteryl ester accumulation in the presence of chloroquine by 2.1-fold (P less than 0.025). When hepatic lipase was incubated solely with the remnants, it decreased their triacylglycerol and phospholipid contents by 24% and 26% respectively. Thus freshly isolated hepatocytes may be used to study chylomicron remnant uptake. Hepatic lipase, which seems to underly the stimulating effect of heparin, facilitates remnant uptake in vitro, and this could be mediated by at least one (or both) of its hydrolytic properties. PMID- 2706003 TI - Regulation of 5-methyltetrahydrofolate synthesis. AB - After an intraperitoneal injection of 100 mumol of methionine to rats, there is rapid oxidation of the methyl group of hepatic 5-methyltetrahydrofolate to formate and CO2. Recovery of the methylfolate level starts 2.5 h after the methionine injection, when the hepatic methionine level and the S adenosylmethionine/S-adenosylhomocysteine ratio have returned to baseline values. S-Adenosylmethionine concentration is still elevated at this time. PMID- 2706004 TI - Change in specificity of glycosidase inhibition by N-alkylation of amino sugars. AB - The synthetic amino sugar 1,4-dideoxy-1,4-imino-L-allitol (DIA) is a moderately good inhibitor of human liver alpha-D-mannosidases and a weak inhibitor of alpha L-fucosidase, N-acetyl-beta-D-hexosaminidase and beta-D-mannosidase. Methylation of the ring nitrogen of DIA markedly decreases the inhibition of all the glycosidases except N-acetyl-beta-D-hexosaminidase. N-Benzylation of DIA essentially abolishes all inhibitory activity, except towards alpha-L-fucosidase, which is more strongly inhibited than by either DIA or N-methyl-DIA. This is the first report of a change of specificity of inhibition of a glycosidase inhibitor by substitution of the ring nitrogen. PMID- 2706005 TI - The mechanism of initiation of lipid peroxidation. Evidence against a requirement for an iron(II)-iron(III) complex. AB - When Fe2+ ions are added to rat-liver microsomes, lipid peroxidation begins after a short lag period. Fe2+-dependent peroxidation in the first few minutes of the incubation can be increased by adding Fe3+, ascorbic acid or Pb2+ ions; these stimulations are not additive. By contrast, Pb2+ ions inhibit peroxidation of microsomes in the presence of Fe3+/ascorbate or Fe3+-ADP/NADPH. In liposomes made from ox-brain phospholipids, Fe2+-dependent peroxidation is stimulated slightly by Fe3+, but much more so by ascorbic acid, Al3+ or Pb2+; these stimulations are not additive. Liposomal peroxidation in the presence of Fe3+/ascorbate is inhibited by Pb2+ or Al3+. These results argue against the participation of an Fe2+-Fe3+-O2 complex, or a critical 1:1 ratio of Fe2+ to Fe3+, in the initiation of lipid peroxidation in liposomes and rat-liver microsomes. PMID- 2706006 TI - Potentiation by lithium of CMP-phosphatidate formation in carbachol-stimulated rat cerebral-cortical slices and its reversal by myo-inositol. AB - This paper describes a rapid and simple method for measuring CMP-phosphatidate (CMP-PA; CDP-diacylglycerol), providing a novel assay for inositol phospholipid metabolism. Rat cerebral-cortical slices labelled with [14C]cytidine were incubated with the muscarinic cholinergic agonist carbachol in the presence of various concentrations of LiCl; 10 mM-LiCl greatly enhanced the carbachol stimulated formation of [14C]CMP-PA over a 60 min incubation period. The potentiation by Li+ was concentration-dependent, with a maximal enhancement at 3 mM and half-maximal enhancement at 0.6 mM-LiCl. The enhancement by Li+ could be reversed by incubation with myo-inositol; a maximal effect was observed with 10 mM-inositol. A similar, though smaller, enhancement of CMP-PA concentrations in the presence of LiCl was observed in slices stimulated with noradrenaline, 5 hydroxytryptamine and K+. The results are discussed in relation to previously observed effects of Li+ on inositol phospholipid metabolism. PMID- 2706007 TI - Studies on the inhibition of mitochondrial DNA replication by 3'-azido-3' deoxythymidine and other dideoxynucleoside analogs which inhibit HIV-1 replication. PMID- 2706008 TI - Differential forskolin activation of rat heart and lung adenylate cyclase. Dependence on membrane-protein interactions. AB - We have investigated whether the greater ability of forskolin to activate adenylate cyclase (EC 4.6.1.1) from rat heart compared with rat lung is due to interactions between G-proteins and catalytic units, isoforms of catalytic units or membrane-protein interactions. Interactions between Gs and catalytic units were found to be similar in both tissues with 10 microM Gpp(NH)p increasing activity up to 5-fold. While MnCl2 increased the response of the lung enzyme to forskolin, it reduced the response of the cardiac enzyme and uncoupled Gs from the cardiac catalytic units indicating that Gs interactions potentiate the response to forskolin. After enzyme solubilisation with n-octyl-beta-D glucopyranoside, the response to forskolin was identical in heart and lung whether assayed with magnesium or manganese chloride, and not significantly different from the heart membrane enzyme. Overall, the results show that the relatively poor response of lung adenylate cyclase to forskolin is due to specific inhibitory interactions between the enzyme and lung membrane constituents. PMID- 2706009 TI - Antitumour imidazotetrazines--XVIII. Modification of the level of 5 methylcytosine in DNA by 3-substituted imidazotetrazinones. AB - The effect of 3-methyl(temozolomide) and 3-ethyl (CCRG 82019) substituted imidazotetrazinones on cytosine methylation has been studied in the human lymphoblastoid cell line GM892. There was a decrease in the 5-methylcytosine content of newly synthesized DNA in cells treated with the 3-methyl and a small increase in cells treated with the 3-ethyl analogue, which was maximal 4 days after drug treatment. There was a progressive decrease in nuclear DNA methyltransferase after treatment with temozolomide with complete inhibition at 11-12 hr after drug addition, followed by a re-establishment of enzyme levels towards control values. While the free drugs had no effect on DNA methyltransferase activity in vitro, DNA isolated from GM892 cells previously treated with temozolomide inhibited the transfer of methyl groups from S-adenosyl L-methionine to M. lysodeiktious DNA. The maximum effect was observed at 6 hr after drug addition and was proportional to the concentration of temozolomide to which the cells had previously been exposed. These results suggest that temozolomide may induce a block in cellular replication as a result of an indirect inhibition of DNA methylation and cells which escape this block progress with hypomethylated DNA. PMID- 2706010 TI - Microsomal warfarin binding and vitamin K 2,3-epoxide reductase. AB - Rat liver microsomal 4-hydroxycoumarin binding was studied by assaying specific [14C]warfarin binding. Microsomes of warfarin-sensitive rats contained about 40 pmole of specific binding sites per mg of microsomal protein. There was no difference for R- or S-[14C]warfarin. Neither was there any difference between the enantiomers of acenocoumarol and phenprocoumon to prevent the in vitro racemic [14C]warfarin binding. Pretreatment of the microsomes with dithiothreitol, the in vitro reductor for microsomal vitamin K epoxide reductase activity, reduced the warfarin binding. Vitamin K epoxide nor vitamin K affected the warfarin binding. Microsomes of the Welsh warfarin resistant genotype showed weak warfarin binding properties. The Scottish resistant variant, on the other hand, did not differ from sensitive microsomes. Warfarin binding was reduced in microsomes of rats to which S-warfarin was administered. The reduction in warfarin binding was linear with the inhibition of microsomal vitamin K epoxide reductase activity and was linear with the amount of S-warfarin present in the microsomes. The results show the microsomal 4-hydroxycoumarin binding to be related to the target enzyme vitamin K epoxide reductase. PMID- 2706011 TI - Phenylazoxycyanide damages microtubular protein more than its reference antibiotic, calvatic acid. AB - The effect of phenylazoxycyanide and calvatic acid, its reference antibiotic, on some functions of tubulin obtained from different sources has been studied. Our purpose was to establish a possible correlation between the antitumour activity of these drugs and their antimicrotubular action. Microtubules are subcellular structures involved in proliferation and maintenance of the cell shape and probably in malignant transformation; indeed most antimitotic drugs influence the stability of microtubules through the interaction with tubulin, their main protein. In this work we found phenylazoxycyanide impairs, more than calvatic acid, polymerization of purified tubulin from calf brain. It also damages, in a dose-dependent manner, colchicine-binding ability of tubulin derived from rat liver and AH-130 Yoshida ascite hepatoma cells. Compounds displaying an azoxycyano group may represent new antimicrotubular agents and their effect could be modulated by the different polarity and structural characteristic of the molecule. PMID- 2706012 TI - Metabolism of metronidazole and antipyrine in isolated rat hepatocytes. Influence of sex and enzyme induction and inhibition. AB - The metabolism of metronidazole and antipyrine was investigated in freshly isolated hepatocytes from 7 male and 6 female control Wistar rats, 8 males and 5 females pretreated with phenobarbital (PB) and 3 males pretreated with 3 methylcholanthrene (MC). Pretreatment with PB increased the intrinsic clearance (CLi = Vmax/Km) of metronidazole to its acetic acid (MAA) and hydroxy metabolite (HM) 7- and 2.8-fold in the males and 3.2- and 3.0-fold in the females, whereas MC treatment increased the values 9- and 10-fold, respectively (P less than 0.05). The CLi of metronidazole to HM and its glucuronide conjugate was higher in the control and PB treated male than in the corresponding female groups, whereas the rank order was reversed for sulphate formation (P less than 0.05). SKF 525A was a more potent inhibitor of MAA formation than of HM formation, except in the PB treated male group. Pretreatment with MC increased the inhibitory potency of alpha-naphthoflavone and antipyrine toward MAA and HM formation. In male rats PB treatment increased the CLi of antipyrine to 3-hydroxymethyl-(HMAP), nor-(NORAP) and 4-hydroxyantipyrine (OHAP) 2.5-, 2.1- and 4.5-fold, respectively (P less than 0.05). Pretreatment with MC in male and with PB in female rats had no significant effect on antipyrine metabolism. SKF 525A was a more potent inhibitor of HMAP and OHAP formation than of NORAP formation. Treatment with MC increased the inhibitory potency of alpha-naphthoflavone toward the formation of all antipyrine metabolites. Metronidazole increased the formation rate of HMAP, but inhibited the formation of NORAP and OHAP, particularly the latter. The results suggest that the formation of MAA, HM, HMAP, NORAP and OHAP from metronidazole and antipyrine is catalyzed by different cytochrome P-450 isozymes, which may be supplemented or substituted by PB or MC induced species. The involved P-450 isozymes have more or less overlapping substrate and product specificity. Metronidazole appears to be a sensitive probe for detection and identification of PB and MC type induction. PMID- 2706013 TI - Inhibition of Na+/Ca2+ exchange by amiloride acting from opposite sides of cardiac sarcolemma. AB - Amiloride inhibited the Na+Ca2+ exchange activity of cardiac sarcolemmal vesicles with similar affinities at the cis and trans sides of the membrane, estimated apparent Ki on both sides of the sarcolemma being similar. The extent of amiloride inhibition on Na+/Ca2+ exchange activity was decreased by alkaline pH only when the drug was acting from the external side of the vesicle sarcolemma, whereas when vesicles were preincubated with the drug at different pH values, amiloride appeared to act as a weak permeant base, being a more effective inhibitor at alkaline pH values. In fact, a rise in the pH of the preincubation medium may favour the entry and consequently the effect of the drug on the exchanger. The pH dependence of the inhibition of Na+/Ca2+ exchange activity by either extravesicular or intravesicular amiloride was consistent with the hypothesis that in both cases the protonated drug was the active form. Evidence is presented that the pattern of interaction of amiloride on the Na+/Ca2+ exchange system strictly depended on the sidedness of drug action. In fact, while Na+ protected against inhibition by amiloride when it was acting on the same side of the vesicle membrane as the drug, it synergically interacted with amiloride to inhibit exchange activity when it was acting on the opposite side of the sarcolemma as the drug. Furthermore, only extravesicular amiloride removed the stimulation of Na+/Ca2+ exchange activity in Ca2+-treated vesicles. PMID- 2706014 TI - Actions of orally administered organotin compounds on heme metabolism and cytochrome P-450 content and function in intestinal epithelium. AB - The gastrointestinal tract is a major route by which humans are exposed to environmental chemicals. We have examined in these studies the effects of oral administration of organotin compounds in the small intestinal epithelium, an organ which exhibits highly active drug and other chemical metabolism. A series of n-butyltin compounds was administered by gavage to male Sprague-Dawley rats (225-275 g) in single doses up to 250 mumol/kg body weight. Bis(tri-n butyltin)oxide (TBTO) produced dose- and time-dependent decreases in the content and functional activity of intestinal cytochrome P-450, together with an elevation (3-fold) in the activity of microsomal heme oxygenase. The effects of di-n-butyltin dichloride on heme oxygenase and cytochrome P-450 were pronounced in the small intestine and extended to the liver and kidneys within 21 hr after oral-exposure, whereas TBTO did not affect the liver until much later (6 days), when cytochrome P-450 content was reduced markedly (30%). Furthermore, the effects produced by tetra-n-butyltin on cytochrome P-450 at 24 hr were localized in the intestinal epithelium. These studies indicate important pharmacological effects of organotin compounds in the gut, and raise the possibility that concurrent oral ingestion of organotins with other environmental pollutants may alter the cytochrome P-450-dependent metabolism of xenobiotics and natural substrates of this monooxygenase system in the small intestine. PMID- 2706015 TI - Toxicity of uricosuric diuretics in rat hepatocyte culture. AB - Several aryloxyacetic acid diuretics have shown hepatotoxicity in humans, yet there continues to be interest in developing these compounds because of the uricosuric properties of some of them. This study was designed to test the utility of the hepatocyte monolayer culture as a model for studying these compounds. In addition, an attempt was made to define the structural components that are common to hepatotoxicity. Ticrynafen, indacrinone, ethacrynic acid and A 49816, an investigational compound, were found to be toxic in hepatocyte cultures; thus, with the exception of indacrinone, paralleling the experience in humans. The toxic compounds share a ketodichlorophenoxyacetic acid chemical structure. A-56234, an investigational uricosuric, was also found to be toxic in cultures but has not been demonstrated to be hepatotoxic in humans in limited clinical experience. It does not possess the ketodichlorophenoxyacetic acid structure proper but may be metabolized to a closely related structure. Furosemide, which does not have the ketodichlorophenoxyacetic acid structure, was not toxic in hepatocyte cultures and has not been hepatotoxic in humans. Thus, the structure common to the toxic compounds is ketodichlorophenoxyacetic acid or a closely related compound. The hepatocyte monolayer system appears to be a good model for demonstrating toxicity and, perhaps, for predicting toxicity of new compounds under development. PMID- 2706016 TI - Microsomal nicotine metabolism: a comparison of relative activities of six purified rabbit cytochrome P-450 isozymes. PMID- 2706017 TI - Phorbol ester-induced attenuation of tissue DNA synthesis: antagonism by prolactin in liver and thymus. PMID- 2706018 TI - Activation of protein kinase C by the dihydropyridine calcium channel blocker, felodipine. AB - Felodipine, a dihydropyridine Ca2+ channel blocker, appears to have intracellular sites of action in addition to its ability to attenuate voltage-dependent Ca2+ channels in smooth muscle cells. In vitro, felodipine inhibits several calmodulin dependent enzymes such as myosin light chain kinase, cyclic nucleotide phosphodiesterase and caldesmon kinase [Walsh MP, Sutherland C and Scott-Woo GC, Biochem Pharmacol 37: 1569-1580, 1988]. Such effects may partially explain the relaxant effects of felodipine and related dihydropyridines on vascular smooth muscle. We have examined the effects of felodipine on the activity of another important enzyme which has been implicated in the regulation of the contractile state of smooth muscle, protein kinase C. We chose to use a physiologically relevant substrate of protein kinase C for these studies, viz. platelet P47 protein, rather than the more commonly used lysine-rich histone which is probably not a physiologically important substrate. Protein kinase C and P47 were purified from human platelets and their important structural and functional properties were characterized. Felodipine and the p-chloro analogue of felodipine enhanced both the rate and extent of P47 phosphorylation by protein kinase C. Half-maximal activation was observed at 9.5 microM felodipine and 8.5 microM p-chloro analogue. Activation by felodipine was dependent upon the presence of phospholipid but did not require diacylglycerol. These observations suggest that the pharmacological actions of felodipine and related dihydropyridines may involve activation of protein kinase C in addition to their known effects on voltage-dependent Ca2+ channels and calmodulin-dependent enzymes. PMID- 2706019 TI - Inhibition of rat heart and liver microsomal lipid peroxidation by nifedipine. AB - Lipid peroxidation in rat heart and liver microsomes was induced by an NADPH generating system or by ascorbate in the presence of an ADP-iron complex. Microsomal lipid peroxidation, as measured by malonaldehyde formation, was inhibited by nifedipine over a wide range of concentrations (47 microM to 6 mM). Nifedipine also decreased the oxygen consumption of cardiac and hepatic microsomes in a concentration-dependent manner. These results indicate that nifedipine may perturb microsomal electron transport systems. Nifedipine may have the potential to alter the sensitivity of cardiac and hepatic membranes to peroxidative damage. PMID- 2706020 TI - Differences between induction effects of 1,4-bis[2-(3,5 dichloropyridyloxy)]benzene and phenobarbitone. AB - The inductive effects of phenobarbitone (PB) and 1,4-bis[2-(3,5 dichloropyridyloxy)]benzene (TCPOBOP) were compared in C57BL/6J mice. Induction parameters included six substrates: ethylmorphine (EM), benzphetamine (Bph), biphenyl, ethoxycoumarin (EtoC), pentoxyresorufin and dichloro-p-nitroanisole (DPNA). In order to validate this descriptive approach the comparison was extended to diazepam, rifampicin, warfarin, and pregnenolone-16 alpha carbonitrile (PCN). All inducers were clearly distinguishable from each other. Warfarin was similar to PB, rifampicin was similar to PCN. TCPOBOP differed significantly from PB in relative liver weight, cytochrome P-450 content of liver microsomes, EM-, Bph- and DPNA-demethylations, biphenyl-hydroxylations, EtoC de ethylation and absorption maximum of reduced CO-cytochrome P-450. TCPOBOP, as an inducer, was less "specific" than PB: total metabolic rates were excessively increased due to microsomal protein (1.5 times) and cytochrome P-450 (4 times) augmentation, whereas cytochrome P-450-related metabolic rates were less increased than those after PB. Thus TCPOBOP does not seem to be as similar to PB as was suggested in the first description of its inducing potency. PMID- 2706021 TI - 32P-post-labeling analysis of DNA adduct formation by antitumor drug nitracrine (Ledakrin) and other nitroacridines in different biological systems. AB - A 32P-post-labeling method has been employed to detect DNA adducts formed by derivatives of nitro-9-aminoacridine in both cellular and non-cellular systems. The treatment of HeLa S3 cells in culture or Ehrlich ascites tumor cells in vivo with nitracrine and two other antitumor 1-nitro-9-aminoacridines, denoted C-857 and C-1006, resulted in covalent binding of these compounds to cellular DNA. Each derivative studied gave rise to a distinct pattern of adduct spots and the similarity of the respective adduct profiles was noted for the both cellular models. Calf thymus DNA samples modified in vitro with nitracrine and C-857 in the presence of either rat hepatic microsomal fraction or dithiothreitol yielded chromatographic profiles resembling those obtained in the cellular systems, suggesting similarity in the DNA adduct structures. There were also neither qualitative nor quantitative differences in calf thymus DNA modification by these two 1-nitro derivatives between aerobic and anaerobic conditions, thus the reduction of a nitro group seems not to be the only determinant of covalent binding to DNA in vitro. No DNA adduct formation was detected in the cellular systems used with 2-nitro and 4-nitro isomers of nitracrine that are devoid of cytotoxic activity, which provides further evidence that both covalent binding and DNA crosslinking, but not intercalation, are responsible for cytotoxic and antitumor properties of 1-nitro-9-aminoacridines. PMID- 2706022 TI - The effect of a novel inhibitor of aldehyde dehydrogenase on viral replication. AB - The effect of AMPAL (4-amino 4-methyl 2-pentyne 1-al), an inhibitor of aldehyde dehydrogenase, on adenovirus type 5 (Ad5) replication was studied. AMPAL at 2 x 10(-4) M clearly reduced the cytopathic effect on HeLa cells but had no effect on cell growth at this concentration. Viral adsorption, penetration and protein synthesis were not affected by adding AMPAL at 2 hr post infection. When viral DNA synthesized in the presence of AMPAL was investigated, no significant inhibition was observed on either synthesis or the physicochemical properties of the neosynthesized DNA. However, there was a 4-fold increase in the amount of condensed DNA. In addition, AMPAL inhibited intracellular viral production (40%) and brought about concomitant inhibition of virus release (70%) into the medium. The absence of a quantitative relationship between the inhibition of viral DNA synthesis on one hand and that of viral production on the other may imply that the antiviral effect of AMPAL is indirectly mediated by the action of the malondialdehyde which has accumulated on some, as not yet identified, membrane constituent. PMID- 2706023 TI - Methionine synthase activities in mice following acute exposures to ethanol and nitrous oxide. AB - Acute or chronic exposure to nitrous oxide or chronic exposure to ethanol decreases the activity of the vitamin B12-dependent enzyme methionine synthase. To assess the combined effect of acute exposure to nitrous oxide and ethanol, mice were given an intraperitoneal injection of ethanol (3 g/kg) and exposed to an inspired mixture of 66% nitrous oxide and 34% oxygen for 4 hr. Methionine synthase activities in liver, kidney, and brain were measured immediately after exposure to nitrous oxide and at various times over a 4-day recovery period. Methionine synthase activities in liver and kidney returned to control levels 2-4 days following inactivation. In brain, a significant 16% decrease in methionine synthase activity remained after a 4-day recovery period. The acute administration of ethanol did not alter the magnitude of the inactivation induced by nitrous oxide nor the time course of recovery of methionine synthase activity following inactivation. Moreover, in mice that were not exposed to nitrous oxide, methionine synthase activity was not altered by the acute administration of ethanol alone or in combination with 0.4% atm isoflurane. Thus, in this animal model, an acute dose of ethanol does not alter methionine synthase activity nor does it enhance the inactivation produced by nitrous oxide. PMID- 2706024 TI - Formation of pentane versus 1-pentanol in the ferrous sulfate-initiated decomposition of 15-hydroperoxyeicosatetraenoic acid in hypoxic and hyperoxic conditions. PMID- 2706025 TI - Fluorometric assay of hepatic microsomal monooxygenases by use of 7 methoxyquinoline. PMID- 2706026 TI - DNA-anti-DNA complexes account for part of the antihistone activity found in patients with systemic lupus erythematosus. AB - We examined the effect of DNase treatment of sera with antihistone activity. In non-systemic lupus erythematosus (SLE) sera, antihistone levels remained unmodified, but a significant decrease was observed in 7 of 11 SLE sera with anti DNA antibodies. This was accompanied in some by an increase in anti-DNA levels. We therefore considered that DNA-anti-DNA complexes were being detected, as part of the antihistone activity in SLE patients, by binding of the complexes through their DNA to the histones used in the assay. This was confirmed by demonstrating that DNA-anti-DNA complexes formed in vitro, and by studies performed with monoclonal antibodies with affinity to double-stranded DNA and/or histones. PMID- 2706027 TI - Genetic studies of Ro (SS-A) and La (SS-B) autoantibodies in families with systemic lupus erythematosus and primary Sjogren's syndrome. AB - Using enzyme-linked immunosorbent assays, autoantibodies to Ro (SS-A) were detected in the sera of 21% of the first-degree relatives and 11% of the second degree relatives of anti-Ro-positive probands with systemic lupus erythematosus (SLE) or primary Sjogren's syndrome, as compared with 3% of normal control subjects (P = 0.003 and P = 0.09, respectively). In a parallel study, anti-Ro occurred in 28% of the first-degree relatives of unselected members of families of SLE patients, regardless of the proband's serologic status, compared with 6% of the relatives from normal healthy families. Antibodies to La and to Sm/nuclear RNP were infrequent. Anti-Ro occurred in 41% of the relatives considered to have a dominant, non-HLA-linked "autoimmune trait" by virtue of having any autoimmune disorder and/or serologic abnormality (antinuclear antibodies, anti-single stranded DNA, or biologic false-positive VDRL test result), as compared with only 2% of the healthy, seronegative relatives without the trait (P = 0.009). Moreover, HLA-DR2 and/or DR3 occurred in 90% of anti-Ro-positive subjects, regardless of their clinical status. These results demonstrate that the Ro autoantibody response occurs frequently in relatives of patients with SLE and is genetically mediated by both major histocompatibility complex and non-major histocompatibility complex effects. PMID- 2706028 TI - Proliferative response of peripheral blood mononuclear cells to autologous and allogeneic muscle in patients with polymyositis/dermatomyositis. AB - We examined the proliferative responses of peripheral blood mononuclear cells (PBMC) to autologous and homologous muscle homogenates in 21 patients with early, active, untreated polymyositis/dermatomyositis (PM/DM), 8 patients with chronic PM/DM, 10 patients with myopathies other than PM/DM, 7 patients with connective tissue diseases without myositis, and 12 healthy individuals. PBMC from patients with PM/DM and from control subjects were incubated with various dilutions of autologous and homologous muscle homogenates. PBMC from patients with active PM/DM underwent significant proliferation on exposure to both the autologous muscle and the homologous muscle homogenates. In contrast, PBMC from patients with chronic PM/DM, other myopathies, connective tissue diseases without myositis, and from healthy individuals did not respond to either autologous or homologous muscle. Our findings demonstrate that the PBMC of patients with PM/DM are sensitized to muscle. PMID- 2706029 TI - Aerobic fitness in patients with fibrositis. A controlled study of respiratory gas exchange and 133xenon clearance from exercising muscle. AB - Aerobic fitness was evaluated in 25 women with fibrositis, by having them exercise to volitional exhaustion on an electronically braked cycle ergometer. Compared with published standards, greater than 80% of the fibrositis patients were not physically fit, as assessed by maximal oxygen uptake. Compared with matched sedentary controls, fibrositis patients accurately perceived their level of exertion in relation to oxygen consumption and attained a similar level of lactic acidosis, as assessed by their respiratory quotient and ventilatory threshold. Exercising muscle blood flow was estimated by 133xenon clearance in a subgroup of 16 fibrositis patients and compared with that in 16 matched sedentary controls; the fibrositis patients exhibited reduced 133xenon clearance. These results indicate a need to include aerobic fitness as a matched variable in future controlled studies of fibrositis and suggest that the "detraining phenomenon" may be of relevance to the etiopathogenesis of the disease. PMID- 2706030 TI - Suppression of glycosaminoglycan synthesis by articular cartilage, but not of hyaluronic acid synthesis by synovium, after exposure to radiation. AB - We recently found that injection of 2 mCi of yttrium 90 (90Y; approximately 23,000 rads) into normal canine knees stimulated glycosaminoglycan (GAG) synthesis by femoral condylar cartilage. The present investigation was conducted to determine whether radiation affects cartilage metabolism directly. Rates of GAG synthesis and degradation in normal canine articular cartilage were studied following irradiation. Cultured synovium from the same knees was treated similarly, to determine the effects of irradiation on hyaluronic acid synthesis. Twenty-four hours after exposure to 1,000 rads, 10,000 rads, or 50,000 rads, 35S GAG synthesis by the cartilage was 93%, 69%, and 37%, respectively, of that in control, nonirradiated cartilage. The effect was not rapidly reversible: 120 hours after exposure to 50,000 rads, GAG synthesis remained at only 28% of the control level. Autoradiography showed marked suppression of 35S uptake by chondrocytes after irradiation. Cartilage GAG degradation was also increased following irradiation: 4 hours and 8 hours after exposure to 50,000 rads, the cartilage GAG concentration was only 66% and 54%, respectively, of that at time 0, while corresponding values for control, nonirradiated cartilage were 90% and 87%. In contrast to its effects on cartilage GAG metabolism, radiation at these levels had no effect on synovial hyaluronic acid synthesis. PMID- 2706031 TI - Nuclear imaging and clinical features of childhood reflex neurovascular dystrophy: comparison with adults. AB - Reflex neurovascular dystrophy (RND) is less common in children than in adults, and differences in onset, clinical course, response to treatment, and degree of disability suggest a different pathogenesis. We have assessed the usefulness of nuclear imaging in 15 children with RND who were evaluated from March 1983 to September 1985. Abnormal findings on 3-phase bone scans were observed in 14 children, with diffusely decreased bone uptake at the symptomatic site being the most common observation. This contrasts sharply with previous reports of diffusely increased uptake in most adults with RND. PMID- 2706032 TI - Effects of salicylate on chondrocytes from osteoarthritic and contralateral knees of dogs with unilateral anterior cruciate ligament transection. AB - Salicylates suppress net glycosaminoglycan synthesis in articular cartilage. The inhibitory effect is greater in osteoarthritic (OA) cartilage than in normal cartilage. Whether the isolated OA chondrocyte is inherently more susceptible to the effects of salicylate on glycosaminoglycan metabolism has not been determined. The results of this study show that, after isolation from the extracellular matrix, normal and OA chondrocytes in suspension culture are similarly susceptible to the metabolic effects of salicylate. However, chondrocytes from the contralateral knees of dogs with unilateral OA were notably resistant to the effects of salicylate. PMID- 2706033 TI - Comment on the article by Laxer et al. PMID- 2706034 TI - Articular presentation of herpes zoster eruption. PMID- 2706035 TI - Perinatal antecedents of cerebral palsy. PMID- 2706036 TI - n-3 fatty acids in clinical medicine. PMID- 2706037 TI - n-3 fatty acids in health and disease. Introduction. PMID- 2706038 TI - Dietary fish oil and ischaemic arrhythmias. AB - Ventricular fibrillation (VF), a serious arrhythmia, is an important cause of death from ischaemic heart disease. There is substantial evidence that experimental diets with a high polyunsaturated (linoleic acid) to saturated fatty acid ratio offer protection against VF. In this article the effects of large amounts of dietary fish oil (up to 30% cal) are reviewed. It is concluded that in all recently published studies marked increases in the incorporation of n-3 fatty acids in membranes was achieved. Two studies were too small, however, to demonstrate any statistically significant difference in VF. The results from a third, a long term feeding study, show a reduction in VF when compared with a highly saturated fat diet, but not when compared to a polyunsaturated fatty acid (n-6) rich diet. Using a more realistic fish oil supplement (0.4% cal) for 8 weeks, we observed a small but nonsignificant reduction in the incidence of VF during acute myocardial ischaemia in the isolated perfused rat heart. The need for further work on the effect of dose, dietary period and confounding influences of saturated fatty acids and linoleic acid are discussed. PMID- 2706039 TI - n-6 and n-3 fatty acids during early human development. AB - The food intakes of pregnant women were analysed from two contrasting socio economic areas in London. There were significant differences in mean calorie and EFA intakes. Analysis of maternal and cord blood essential fatty acids (EFAs) in relation to birth weight, placental weight and head circumference were consistent with the dietary data. To assess the EFA tissue status of the low birth weight babies, the umbilical arteries from 14 separate babies of different birth weights were studied. Surprisingly high levels of the Mead acid (20:3 n-9) were found, with the highest appearing in the artery from the baby with the lowest birth weight. This data may not necessarily imply an EFA deficiency, but at the least it probably indicates a remarkable thirst for long chain n-6 and n-3 fatty acids for fetal brain development. PMID- 2706040 TI - Dietary n-3 fatty acids and children with hyperlipidaemia. AB - A review of the literature shows that no studies on children with primary genetic lipid disorders have been published. Case reports are presented indicating that hyperlipidaemias presenting in children--both familial hypercholestrolaemia and disorders with secondary hyperlipidaemia (triglycerides) may benefit of the intake of n-3 fatty acids. PMID- 2706041 TI - Pregnancy duration and the ratio of long-chain n-3 fatty acids to arachidonic acid in erythrocytes from Faroese women. AB - Dietary long-chain n-3 fatty acids (FA) may prolong gestation by inhibiting formation of prostaglandins from arachidonic acid. FA were quantified in phosphatidylcholine (PC), phosphatidylethanolamine (PE), and total lipids (TL) of red cells sampled during pregnancy from 29 Faroese women. The ratio of long-chain n-3 FA to arachidonic acid (the (3/6) ratio) was used as the most relevant single measure of exposure. In 18 women with certain gestational age and with spontaneous onset of delivery, gestational age was significantly associated with the (3/6) ratio quantified in PC (correlation coefficient 0.50, P = 0.035), but not with the (3/6) ratio in PE (correlation coefficient 0.21, P = 0.40) or TL (correlation coefficient 0.29, P = 0.26). The association with the (3/6) ratio in PC could not be attributed to confounding by maternal age, weight, marital status or smoking. PMID- 2706042 TI - n-3 fatty acids in old age. AB - Plasma phospholipid fatty acid concentrations have been measured in 735 individuals 12-89 years old. The absolute concentrations of palmitic, stearic, oleic, linoleic, dihomo-gammalinolenic, arachidonic, eicosapentaenoic, docosapentaenoic and docosahexaenoic acids increased from the third to the fifth decade of life, thereafter remaining fairly constant into the ninth decade. Alpha linolenic acid showed no change. When expressed as g 100 g-1 fatty acids, palmitic, stearic, and linoleic acid decreased from the third to the fifth decade of life, dihomo-gammalinolenic and arachidonic acid remained unchanged, while the relative concentrations of long-chain n-3 fatty acids increased in a similar manner as when expressed in absolute concentrations. The results indicate that old age in itself has only a minor impact on the availability of n-3 fatty acids in the elderly. Factors such as living area and eating habits probably have a much more profound effect on their availability, also in old age. PMID- 2706043 TI - The effect of n-3 polyunsaturated fatty acids on lipids, haemostasis, neutrophil and monocyte chemotaxis in insulin-dependent diabetes mellitus. AB - Insulin-dependent diabetes mellitus (IDDM) is associated with an increased risk of coronary artery disease (CAD). There is some evidence that polyunsaturated fatty acids of the marine n-3 type (n-3 PUFA's) may offer protection against CAD. We have studied the effect of short-term dietary supplementation with n-3 PUFAs on lipids, haemostasis, neutrophil and monocyte chemotaxis in 10 patients with IDDM. The patients were given 4 g daily of n-3 PUFAs (fish oil) for 6 weeks and were investigated before and after the supplement. No significant effects on platelets or haemostasis were observed. High density lipoprotein (HDL) cholesterol significantly increased, and triglycerides and the ratio of total cholesterol to HDL-cholesterol significantly decreased. Monocyte chemotaxis was unaltered, while neutrophil chemotaxis significantly increased after fish oil. The finding of an improvement in neutrophil chemotaxis after supplementation with n-3 PUFAs to patients with IDDM needs to be confirmed in future studies. PMID- 2706045 TI - Arthroscopic anatomy of the shoulder. AB - Arthroscopic anatomy of the shoulder was evaluated using cadaver dissections. The anatomical areas of clinical importance were documented both photographically and with illustrations. It is hoped this anatomical study will prove to be an aid to arthroscopists during their early experiences with shoulder arthroscopy. PMID- 2706044 TI - Effects of moderate freshwater fish diet on lipid metabolism of Finnish students. AB - The effect of moderate freshwater fish intake on the lipid metabolism was studied in healthy students using a public catering system. In the first trial, male students ate an average of 3.7 fish meals per week (about 1 g of n-3 fatty acids daily) for 15 weeks. The n-3 fatty acids increased in the erythrocyte and platelet membranes at the expense of n-6 fatty acids. Serum triglyceride, apolipoprotein A1 and B levels and platelet thromboxane B2 production decreased. In the dose response study, four groups had been eating fish for 12 weeks. Similar findings were made with the highest dose as in the previous study. In addition, new measurements showed a decrease in the platelet and erythrocyte aggregability. With two lower doses (1.5 and 2.3 diet meals eaten per week), only a tendency to decreased triglyceride level and aggregability was noticed. The results obtained show that already moderate freshwater fish intake modifies, in a long-term, lipid metabolism, supporting the hypothesis of protective effect against cardiovascular diseases. PMID- 2706046 TI - Endoscopic management of carpal tunnel syndrome. AB - This article describes a subcutaneous endoscopic operative procedure for carpal tunnel syndrome and analyzes its effectiveness using electrophysiological data. Subcutaneous transverse carpal ligament release under universal subcutaneous endoscope (USE) was performed using local anesthesia without pneumotourniquet in 54 hands of 45 patients since June 1986. The mean follow-up period was 13.8 months. Sensory disturbances began to subside immediately after the operation and disappeared within 2 months in all cases. After the disappearance of sensory disturbances, we performed postoperative electrophysiological studies in 27 patients (33 hands). Postoperative electrophysiological data were significantly improved in all cases. Patients did not suffer from any serious complications such as motor branch injuries of the median nerve, hypesthesia of the palm, or injuries of the superficial palmar arch. From these results, we conclude that the transverse carpal ligament can be safely incised by this procedure. PMID- 2706047 TI - Endoscopic release of the carpal ligament: a new technique for carpal tunnel syndrome. AB - This is a preliminary report outlining an endoscopic technique to release the carpal ligament employing current arthroscopic methods. The technique has been used successfully on 62 hands in 46 patients with no known complications. In some cases, the follow-up period has been rather short. Based on our results, however, there has been rapid recovery with decreased scarring and postoperative pain and no loss of grip or pinch strength, which is sometimes seen with the conventional method of carpal ligament release. PMID- 2706048 TI - The arthroscopic treatment of unicompartmental gonarthrosis: a five-year follow up study of abrasion arthroplasty plus arthroscopic debridement and arthroscopic debridement alone. AB - A retrospective review with a mean follow-up time of 60 months was performed on 126 patients who had treatment of unicompartmental gonarthrosis with either abrasion arthroplasty plus arthroscopic debridement or arthroscopic debridement alone. Fifty-nine patients had abrasion arthroplasty and arthroscopic debridement, and 67 patients had arthroscopic debridement alone. All patient had stage II Ahlback changes roentgenographically, as well as Outerbridge stage IV changes arthroscopically in the involved compartment. All the knees were evaluated postoperatively at a minimum of 60 months, utilizing The Hospital For Special Surgery Knee Scoring System. In the group treated with abrasion arthroplasty, 51% had good to excellent results, 16% had fair results, and 33% had poor results. The conditions of ten of the patients who had poor results actually became worse subsequent to their abrasion arthroplasty. In the group that had arthroscopic debridement, 66% had good to excellent results, 13% had fair results, and 21% had poor results. The conditions of 12 of the patients who had poor results actually became worse subsequent to the arthroscopic debridement. PMID- 2706049 TI - Subacromial anatomy for the arthroscopist. AB - One of the most significant recent advances in arthroscopic surgery of the shoulder has been in the evaluation of the subacromial space and the anatomical structures within. Arthroscopic visualization of this area provides an unusual perspective of the anatomy that was not heretofore appreciated through open surgical techniques. This study was undertaken to attempt to define better the anatomy of the subacromial space as it pertains to arthroscopic surgery. Clinical arthroscopic evaluation of the subacromial space was correlated with gross anatomical dissections of 12 fresh cadaver shoulders and a review of the pertinent anatomical and surgical literature. By doing so, we have attempted to define better the boundaries of the subacromial space, the portions of the rotator cuff that are readily visualized arthroscopically, as well as those areas that are "blind" to arthroscopic evaluation. In addition, the anatomy of the coracoacromial ligament, the inferior surface of the acromion, and the acromioclavicular (AC) joint as viewed arthroscopically is presented with gross anatomical correlation. We feel that this information will help arthroscopists better understand the advantages as well as the limitation of arthroscopy of the subacromial space. PMID- 2706050 TI - Ankle arthroscopy: neurovascular and arthroscopic anatomy of standard and trans achilles tendon portal placement. AB - Ankle arthroscopy is an accepted method of evaluating ankle disorders. Accurate arthroscopic portal placement is essential because of the proximity of superficial and deep neurovascular and tendinous structures of the ankle. In order to define this anatomy as it pertains to safe portal placement, five fresh frozen cadaver ankles were dissected after standard arthroscopic portals were placed anteriorly and posteriorly. All structures were identified. The distances to these structures from the most lateral portals were recorded. Five other ankles were arthroscoped using standard portals and evaluated. In addition, a trans-achilles tendon (TAT) approach was evaluated for portal use. Ankle arthroscopy can be performed in a safe, reproducible manner when the following recommendations are followed: (a) outline tendinous structures, and remain parallel to them with the knife blade to avoid laceration of underlying structures; (b) penetrate only the skin with the knife to avoid laceration of superficial nerves in the subcutaneous tissue; (c) perform pre- and postneurovascular examination; and (d) understand that anterocentral and posteromedial portals are potentially hazardous to their respective neurovascular bundles. The TAT approach, based only on cadaver studies, appears anatomically safe and offers the potential advantage of an additional posterior portal. PMID- 2706051 TI - Arthroscopic treatment of synovial chondromatosis of the knee. AB - Between 1971 and 1987, arthroscopy was performed in 39 patients with synovial chondromatosis of the knee; 29 of these patients (32 knees) were followed an average of 3.5 years. A good result was obtained in 78% of the cases. Removal of loose bodies was the only treatment in 31 of the 32 knees. A synovectomy was performed in one case. No synovectomies were performed secondarily. Only three patients required a second arthroscopic procedure. The essential prognostic factor for a good functional result is the condition of the femorotibial cartilage. We concluded that simple arthroscopic removal of cartilaginous bodies without synovectomy is the treatment of choice for synovial chondromatosis of the knee. PMID- 2706052 TI - Lateral discoid menisci in children. AB - In children, the snapping-knee syndrome is strongly suggestive of a diagnosis of discoid menisci; alternatively, the loss of physiological hyperextension of the knee suggests a diagnosis of a torn lateral discoid meniscus. We used arthroscopic meniscectomy to treat 19 lateral discoid menisci in 16 children (average age, 10.5 years). Excellent results were achieved in 18 of 19 cases, with disappearance of the snapping with knee flexion (maximum follow-up, 3 years). PMID- 2706053 TI - Arthroscopic treatment of osteochondral lesions of the talar dome. AB - Nine osteochondral lesions of the talar dome were treated arthroscopically. Two patients (a 16-year-old boy) had two recent osteochondral fractures, anterior and superior lateral, with a free fragment detached in the joint. The lesions were treated with simple ablation of the loose body. Seven old lesions were found in four men and three women, aged 18-32 years, with an osteocartilaginous, partially loose body with necrosis of the underlying bone. The lesion was posterior medial in these seven cases. Technically, arthroscopy is usually performed using an anterior approach. However, it is sometimes necessary to place the foot in the talipes equinus position to achieve articular distraction for diagnosis and treatment of posterior lesions. Treatment consisted of removal of the loose body, with curettage of the necrotic bone. The nine patients were clinically and radiologically reviewed with a follow-up period of 10-24 months. For the two osteochondral fractures, clinical results following the removal of free loose bodies in the joint were spectacular, with complete pain relief and osseous rehabilitation almost radiologically complete after 2 years. In the seven patients with an old necrotic lesion, the result was very good or good in six cases, and poor in one case. Radiologically, osseous rehabilitation occurred progressively, but remained incomplete at 2 years. This technique provides multiple advantages: minimal morbidity, 48-h hospitalization, and rapid functional recuperation without immobilization. Our results confirm the recent data in the literature (1-4). PMID- 2706054 TI - Pigmented villonodular synovitis of the knee: results from 13 cases. AB - Arthroscopy is an indispensable tool in the diagnosis, treatment, and postoperative follow-up of pigmented villonodular synovitis (PVNS) and enables classification of PVNS into three forms: diffuse, localized, and mixed. A series of 13 cases of PVNS of the knee is presented; 12 patients underwent surgery. According to the anatomic type of PVNS found, the authors used extensive classic surgery or endoscopy. Follow-up averaged 4.2 years (range, 1-10 years). The best results were obtained in cases of localized PVNS. Overall, nine patients were totally asymptomatic at follow-up. Four patients experienced some pain when fatigued or with changes in the weather. There was no recurrence of symptoms. PMID- 2706055 TI - Knee arthroscopy after yttrium or osmic acid injection. AB - This study presents the macroscopic and histologic results of 35 knee arthroscopies performed on patients with rheumatoid arthritis, some months after an yttrium or osmic acid intraarticular injection. The procedure was most often performed after a failure of the injection or a relapse of synovitis. Arthroscopy provides an understanding of the cause of synoviorthesis failure--insufficient action of the product on the synovitis or its poor diffusion, fibri-nonecrotic deposits, or cartilaginous lesions--and may be used both diagnostically and therapeutically. PMID- 2706056 TI - Resection of the patellar ligament: a complication of arthroscopic synovectomy. AB - Knee arthroscopy has evolved over the years to a point where most orthopaedic surgeons feel comfortable with both diagnostic and operative arthroscopy. As a result of the more powerful and sophisticated instrumentation available today, the role of operative arthroscopy has far surpassed original expectations. Certain instrumentation carries with it increased risk of both intraarticular and extraarticular injury if the surgeon fails to pay attention to anatomic landmarks. In this communication, we report a previously undescribed complication of operative arthroscopy--resection of the patellar ligament. PMID- 2706057 TI - Gas-gangrene following arthroscopic surgery. AB - An arthroscopic anterior cruciate ligament repair was followed by gas-gangrene and the development of a compartment syndrome. Treatment consisted of extensive fasciotomy, debridement, and antibiotic therapy with penicillin G, cefotiam, and metronidazole. The patient was also treated with five sessions of hyperbaric oxygen in a pressure chamber for a duration of 2 h per session. This therapeutic regimen resulted in the preservation of a functionally intact extremity despite severe complication. PMID- 2706058 TI - Multiple technical difficulties in maintaining reliable oximeter readings. PMID- 2706059 TI - [Electronic noise compensation for improving speech discrimination in airplane pilots]. AB - Noise exposure measurements were performed in pilots of the Federal Navy during realistic flight situations. The ambient noise levels during regular flight service were maintained at levels nearly all the time above 90 dB. To avoid occupational hearing loss, the "Noise Injury Prevention Code" issued by the insurers would demand wearing personal ear protection, e.g. ear plugs. But such equipment in the aircraft cockpit would have precisely the opposite effect, because one of the reasons for possible damage to hearing is radio communication. To be able to understand radio traffic in spite of the noisy environment, headphone volume must be raised above the noise of the engines. The use of ear plugs can be of only limited value. Whereas pilots with normal hearing show only little impairment of speech intelligibility, those with noise-induced hearing loss show substantial impairment that varies in proportion to their hearing loss. Communication abilities may be drastically reduced which may compromise the reliability of radio traffic. Cockpit noise has its maximum intensity around 125 Hz and flight helmets and ear defenders are not very effective in low frequency ranges. Sennheiser electronic KG developed an active noise compensation circuit, which makes use of the "anti noise" principle. Here the outside noises picked up by two microphones integrated into the headset are processed electronically in such a way that they largely neutralise the original noise. It had to be made sure that the radio traffic signal was not also compensated and that the signal to noise ratio was clearly increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706060 TI - [The significance of psychological factors in the early diagnosis of laryngeal and hypopharyngeal tumors]. AB - The clinical course of malignant disease is influenced by the patient's personality and his attitude to disease and to treatment. The authors interviewed 150 patients scheduled to undergo microlaryngoscopy, indicated to identify pathologic aberrations of the larynx and pharynx. - Analysis of the data showed that fear of cancer was less common in patients found to have a carcinoma than in those with benign aberrations. Patients with cancer were more inclined to postpone medical examination and showed a significantly greater degree of denial of their symptoms. A positive family history of malignant disease was significantly more frequent in patients who had marked fear of cancer than in those who did not have such fears. Female patients fearing cancer had a significantly greater frequency of neurotic symptoms, compared to females who had no fear. For nearly a half of smokers (45%) the proposed microlaryngoscopy provided a motive to give up smoking. PMID- 2706061 TI - [The psychosocial environment of patients with neoplasms of the head and neck. A clinical study]. AB - A survey was made of 96 patients of the University ENT Clinic Gottingen suffering from malignomas in the head and neck region, to gain insight into the patients' personal assessment of discomfort during and after tumour therapy, and into their psychological and social environment. The questionnaires were developed in cooperation with a psychologist trained in oncology. The most important result of the survey was a tendency to idealisation and alexithymia in patients with head and neck tumours. The situation of the tumour patients is characterised by a feeling of lonesomeness and isolation within their social environment. It also became evident that some of the patients in the survey had a certain "health promoting potential". Our results are compared with reports published on the subject so far and suggestions are made for the incorporation of psychological support during and after tumour therapy. PMID- 2706062 TI - [Pharyngeal complications following ventral fusion operations of the cervical spine]. AB - Dysphagias that are due to cervical spine surgery are increased. A complication that has not yet been described is explained and pointed out by two case reports. Possible life threatening consequences are discussed. PMID- 2706063 TI - [Procurement of an ethmoid bone block from a cadaver for microanatomic preparation]. PMID- 2706064 TI - [How do I manage lymph drainage of the neck in malignant melanoma of the head?]. PMID- 2706065 TI - [The value of high-resolution computerized tomography in abnormalities of the middle ear]. AB - Middle ear malformations are common congenital disorders of the head and neck area. Recent advances in plastic and middle ear surgery have improved the prognosis of patients suffering from congenital hearing disorders. However, sophisticated preoperative procedures are mandatory. The development of HR-CT has improved the radiologic possibilities to evaluate middle ear disorders significantly. In the present study we examined by means of HR-CT twenty patients with congenital middle ear malformation. Our findings include different sizes of the middle ear as well as dysplastic alterations of the malleus and incus. The inner ear was normal in almost all cases. Our results indicate that preoperative HR-CT is a reliable diagnostic method to demonstrate middle ear disorders. PMID- 2706066 TI - [Brain stem evoked response audiometry study with a bone conduction receiver in atresia of the auditory canal and microtia]. AB - Conductive hearing loss may be determined from the latency delay of the brainstem auditory evoked response Jewett V, if other reasons that may prolong latency are ruled out. Therefore it is important to determine the bone conduction threshold when examining infants. Two bone vibrators have been chosen, which, with the help of "inverse filtering", provide the possibility of a good sound conduction of the click stimulus and thus a measurement near the hearing threshold. When applying bone vibrators to infants it must be borne in mind, that the sound transfer is reduced because the cranial sutures are not yet closed. The measurement of bone conduction is suitable for securing the result of high-grade combined hearing defects. In two cases of atresia of the external auditory canal and microtia brainstem evoked response audiometry is presented with evaluation of both air and bone conduction. PMID- 2706067 TI - [Experiences with the Vienna auditory prosthesis]. AB - Open set speech comprehension can be achieved by intra- and extracochlear stimulation using an analog broadband signal. There is a tendency that intracochlear provided patients achieve better scores for open set speech comprehension than extracochlear implanted patients. Four prelingually deaf children acquired awareness of tones and sounds and some of them are able to use suprasegmental cues. After reimplantation, speech comprehension scores remain stable. For three patients scores even improve. Controls of the pure-tone audiograms demonstrate that extracochlear implants do not destroy residual hearing. PMID- 2706068 TI - [Prevention of unilateral hearing loss]. AB - Unilateral hearing loss entails many problems in hearing during the entire life of the affected patients. This article is an attempt to inform about the special problems of the hearing loss in infancy and about preventive measures for the benefit of these patients. PMID- 2706069 TI - Laterality for visual-spatial processing in two language-trained chimpanzees (Pan troglodytes). AB - Most reviews of laterality in nonhuman primates indicate that hemispheric asymmetries, similar to those found in humans, are not evident. With the growing evidence for cognitive processes germane to language in apes, in addition to their phylogenetic similarity to humans, they appear to be useful candidates for studies of laterality. Laterality for visual-spatial processing in two language trained chimpanzees (Pan troglodytes) was investigated with a visual half-field paradigm. Initially, the chimpanzees were taught to manipulate a joystick that controlled the movement of a cursor on a computer monitor to a central fixation point. Subjects were then taught a visual discrimination based on the location of a short line contained within a geometric form. Testing consisted of systematic presentation rates of 15, 122, and 226 ms to the left and right visual fields. For half of the trials, subjects used their left hand to respond and, alternately, used the right hand for the remaining trials. Accuracy and reaction time were the dependent measures. One subject demonstrated significantly faster reaction times to stimuli presented to the left visual field (LVF) regardless of which hand was used to respond. The other subject demonstrated a significant LVF bias when using the left hand to respond. The results are discussed in the context of current theories on the evolution of laterality and its relation to linguistic functioning. PMID- 2706070 TI - Specificity of the cardiac response to conspecific vocalization in chimpanzees. AB - Heart rate measures were used to examine the functional response of young chimpanzees and orangutans to acoustic stimuli, including white noise and chimpanzee vocalizations (threat, stress, and alarm). The initial response of the animals to all stimuli was characterized by a prominent cardiac deceleration and an increase in heart period variability. The deceleratory responses persisted with repeated presentations of the noise, stress, and alarm stimuli. In contrast, the response of chimpanzees to the conspecific threat stimulus reverted over trials to a notable cardiac acceleration. This acceleratory response was not attributable to potential patterns of evoked somatic responses. The features of the cardiac response, together with the results of frequency-domain analyses of heart period variability, suggest that this acceleratory response was consistent with the evocation of an aversive or a defensive reaction characterized by sympathetic activation. This pattern of cardiac response appeared early in ontogeny (within 48 hr postnatally) and was not manifest in orangutans. Taken together, the results suggest the existence of specialized perceptual processing mechanisms for vocal stimuli in the chimpanzee. Further examination of these mechanisms may contribute to our understanding of central perceptual processes and the evolution of vocal communication. PMID- 2706071 TI - Cryptopsychobiology: the appearance, disappearance, and reappearance of a species typical action pattern during early development. AB - Late in gestation, intraoral infusion of lemon elicits a facial wiping response from rat fetuses. This facial wiping response is isomorphic with that of older pups and adult rats exposed to aversive oral stimulation. Most studies of the postnatal development of aversive responses have demonstrated that facial wiping does not appear in the repertoire of rat pups until the second postnatal week. In certain test situations, however, wiping can be elicited from neonatal rats. This fact suggests that the expression of facial wiping by neonates is constrained or facilitated by the environmental conditions present at the time of testing. In this report, a series of seven experiments is described that document the wiping response of rat fetuses and pups in age-typical environments, and an environmental constraint hypothesis is examined. Examination of the ontogeny of facial wiping in this manner highlights issues that should be addressed in studies of behavioral continuity between the prenatal and the postnatal periods. PMID- 2706072 TI - Methysergide-induced nipple attachment depends on suckling experience in juvenile rats. AB - These studies were designed to investigate the links between pharmacological and behavioral procedures that facilitate suckling in weanling rats by assessing the effects of methysergide on nipple attachment behavior following experiential manipulations known to either promote or attenuate suckling. In the first experiment, methysergide failed to stimulate suckling in 25-day-old rats separated from their dam on Day 20, although it facilitated suckling in rats kept with the dam until either Day 24 or Day 25. In the second experiment, methysergide did not facilitate suckling in 35-day-old rats separated on Day 25, although rats separated on Day 30 or 34 were induced to suckle. In the third experiment, rats were housed with preweanling litters until Day 35 and then separated, housed with 25-day-old litters, or housed with preweanling litters for another 10 days. Rats in a fourth group remained with their dams until Day 35 and were then separated for 10 days. When tested at Day 45, nipple attachment was facilitated by methysergide only in the three groups that had received extended suckling experience. These results demonstrate that serotonergic inhibitory mechanisms modulate nipple attachment only when suckling experience is recent or extensive. PMID- 2706073 TI - Reversal learning in pigeons: effects of selective lesions of the Wulst. AB - The effects of bilateral lesions of individual laminae of the Wulst on reversal learning performance in pigeons were evaluated. After surgery, the birds were trained to perform a simultaneous color discrimination. Once successful discrimination was achieved, the positive and negative stimuli were reversed, and the birds were again trained to criterion. Twenty such reversals were carried out. A multiple regression analysis indicated that those components of the Wulst that were critical for increasing the numbers of errors on each reversal were the laminae that receive the thalamofugal visual projections, that is, the nucleus intercalatus of the hyperstriatum accessorium and the hyperstriatum dorsale. Lesions in the other laminae of the Wulst (the hyperstriatum accessorium and the hyperstriatum intercalatus superior) had no effect on errors. There was no evidence of an increase in either perseverative errors or position habits in the birds with lesions, which suggested that the reversal deficits were not likely to be due to perseveration, attentional impairment, or inappropriate processing of spatial information. The deficit may have been produced by excessive interference between learning in a given session and learning in previous sessions. PMID- 2706074 TI - Performance of a weight-lifting task by normal and deafferented monkeys. AB - The role of topographic information from a moving limb in controlling the trajectory of the limb was explored by comparing the ability of 3 normal and 2 unilaterally deafferented monkeys to generate criterion elbow flexions when opposed by different weights. When lifting initially unknown weights, both groups of monkeys reached maximum positions that were inversely related to load. The performance of the deafferented monkeys approached that of the normal monkeys on these first lifts of initially unknown weights. The preceding load had a greater effect on the initial lifts of the deafferented monkeys than on those of the normal monkeys. When allowed to repeatedly lift the same weight, both groups obtained a high density of reinforcement, but the responses of the deafferented monkeys were more dependent on the weight. The results are consistent with the hypothesis that the mechanical properties of muscle make an important contribution to compensation. PMID- 2706075 TI - Temporal patterns of the rabbit's nictitating membrane response to compound and component stimuli under mixed CS-US intervals. AB - The acquisition of the rabbit's nictitating membrane response to a tone and light compound and to its components was examined when compound presentations were reinforced at one conditioned stimulus-unconditioned stimulus (CS-US) interval and individual component presentations were reinforced at another CS-US interval. Examination of the time course of the CRs revealed that (a) despite the mixture of CS-US intervals, conditioned response (CR) timing remained accurate, that is, CRs reached their peaks at the alternative points of US delivery; (b) the momentary magnitude of the CR to the compound was predominantly an additive function of the CR magnitude to the individual components; but (c) there was modest evidence of differentiation between the compound as a unit and the individual components. The results are discussed in terms of their implications for the study of the neural substrates of temporal and sensory integration as they modulate CR acquisition. PMID- 2706076 TI - Heart rate conditioning with pentobarbital as a conditioned stimulus and amphetamine as an unconditioned stimulus. AB - Pentobarbital was injected into rats 20 min after they were placed in an apparatus where heart rates were recorded. Amphetamine was injected after they were removed from the apparatus 29-30 min later. A Pavlovian conditioned response (CR) began after three or four such trials in the form of a failure of conditioned rats to show the same decline in heart rate obtained in controls after the pentobarbital injection. On later trials, the amphetamine was not injected until 50 min after the pentobarbital, and the CR was most obvious during the period 30-50 min after the pentobarbital injection, an effect characteristic of Pavlovian delay conditioning. The pharmacological effects of pentobarbital were necessary for conditioning because the CR was not obtained (a) when normal saline was substituted for the pentobarbital after successful conditioning or (b) when saline was used instead of pentobarbital throughout. Because of the speed and effectiveness of the conditioning, we believe the mechanism responsible for it has homeostatic regulation as its natural role. It was puzzling that environmental cues seemed to have a role in the conditioned stimulus complex, because conditioning was not apparent when the drug-drug pairings were administered in the home cage. PMID- 2706077 TI - Effects of intrahippocampal administration of colchicine on incentive contrast and on radial maze performance. AB - The behavior of rats given intradentate injections of the neurotoxin colchicine was examined in three experimental settings. In Experiment 1, colchicine-treated, artificial cerebrospinal fluid (CSF)-treated, and untreated animals did not differ in the intake of 32% and 4% sucrose solutions, nor did they differ in degree of successive negative contrast when the 32% solution was changed to 4% sucrose. In Experiment 2, the colchicine-treated and CSF-treated animals did not differ in degree of suppression in the intake of a 0.15% saccharin solution when it preceded 32% sucrose in once-daily pairings (anticipatory contrast), nor did they differ in reversal performance when saccharin-sucrose and saccharin saccharin pairings were reversed. In Experiment 3, the colchicine-treated animals were substantially impaired in radial-arm maze performance compared with CSF treated controls. These results suggest that a completely functioning hippocampus is not necessary for the memory of reward quality, the comparison of rewards, the suppression of behavior when reward is decreased, the formation of associations between two levels of reward, and the reversal of this association, as long as these processes are reflected in consummatory behavior. The data are interpreted in terms of differences between instrumental behavior and sensory memory and/or consummatory behavior--an interpretation that is not incompatible with a deficiency in working memory in the animals with lesions. PMID- 2706078 TI - Prefrontal cortex lesions differentially disrupt cocaine-reinforced conditioned place preference but not conditioned taste aversion. AB - The reinforcing efficacy of cocaine is thought to involve, at least in part, mesocortical dopaminergic (DA) neurons. Rats will self-administer cocaine applied directly into the medial prefrontal cortex but not into nucleus accumbens or the ventral tegmental area (Goeders & Smith, 1983). The present experiments were conducted to assess whether lesions of prefrontal cortex (mesocortical DA target regions) attenuate the reinforcing properties of systemically administered cocaine. Male Sprague-Dawley rats were anesthetized, and one of three subfields (medial, orbital, or precentral) of the prefrontal cortex was removed by aspiration or no brain injury was done (sham operates). In four experiments the rats were tested on conditioned place preference (CPP), conditioned taste aversion (saccharin conditioned stimulus, cocaine unconditioned stimulus), general activity in the running wheel and open field, and food-reinforced spatial alternation in the T-maze. Sham operates demonstrated a cocaine-induced place preference, rats with medial frontal lesions showed a cocaine-induced place aversion, and other operates showed neither a conditioned place preference nor an aversion. The results of this experiment suggest that lesions of the DA projection fields of the prefrontal cortex in the rat reduce the positive reinforcing properties of systemically injected cocaine. In the second experiment, all subjects showed a conditioned taste aversion of equal magnitude. This suggests that whereas the positive reinforcing properties were affected differentially by prefrontal cortex lesions, the aversive properties were not affected. In Experiment 3 there were no lesion-induced differences in activity in either the running wheel or the open field. Therefore, changes in motor activity cannot account for the CPP data. In the final experiment, the medial frontal operates were impaired relative to the precentral and sham operates on learning to alternate choices in the T-maze, but the orbital frontal operates' performance was not different from that of any other group. This suggests that a general disruption of all reinforcement mechanisms did not occur following these lesions. Instead, these results indicate that mesocortical DA projection regions are involved with mediating the reinforcing properties of cocaine and that there is a separate system mediating the aversive properties of cocaine. PMID- 2706079 TI - Chronic voluntary nicotine drinking enhances nicotine palatability in rats. AB - The response of rats to nicotine solutions was examined with the brief-exposure, taste reactivity test and a two-bottle, 24-hr preference test. In Experiment 1, naive nondeprived rats were administered intraoral infusions (0.8 ml infused during 1 min) of distilled water and 1 microgram/ml, 5 micrograms/ml, 10 micrograms/ml, 25 micrograms/ml, 50 micrograms/ml, and 100 micrograms/ml nicotine. The oral motor, taste reactivity (TR) responses of the rats were recorded during the infusion. Nicotine solutions up to a concentration of 50 micrograms/ml elicited a number of ingestive TR responses similar to that by water. Ingestive responses significantly decreased and aversive TR responses significantly increased in response to 100 micrograms/ml nicotine. On the basis of these results, two-bottle preferences for water versus 1 microgram/ml, 5 micrograms/ml, and 0 microgram/ml (water control group) nicotine were measured in three groups of naive rats. Rats initially showed an equal preference for 0 microgram/ml and 1 microgram/ml nicotine. After 16 days of exposure, however, rats developed a significant preference for 1 microgram/ml nicotine. The preference ratio for 5 micrograms/ml nicotine significantly increased during the experiment, but the preference ratio remained significantly less than that for 1 microgram/ml and 0 microgram/ml nicotine solutions. Last, TR responses elicited by intraoral infusions of 1 microgram/ml and 5 micrograms/ml nicotine were then measured in these rats having had the two-bottle experience. Rats showing a two bottle preference for the 1 microgram/ml nicotine solution displayed significantly more ingestive TR responses to 1 microgram/ml and 5 micrograms/ml nicotine than did the control rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706080 TI - Drug discrimination training during chronic drug treatment affects the development of tolerance. AB - The purpose of this experiment was to evaluate the extent to which continued drug discrimination training during chronic drug treatment affects the development of tolerance. Rats were trained to discriminate distilled water from 0.75 mg/kg amphetamine in a two-lever drug discrimination task. Two groups were then given a chronic drug regimen of 13 daily injections of either distilled water or 10 mg/kg amphetamine. Drug discrimination training was continued for half of each chronic drug group. Tolerance was apparent only in the group that was not trained during the chronic amphetamine treatment. The data support the conclusion that continued training throughout the chronic drug treatment provides the opportunity for reinforced correct responding as both nondrug- and drug-cue states are gradually shifted by the chronic drug regimen. PMID- 2706081 TI - Factors influencing cortisol and behavioral responses to maternal separation in guinea pigs. AB - Infant guinea pigs recently were found to respond to brief maternal separation with an increase in plasma cortisol levels. The present experiments were conducted to further characterize this response and compare it with the cortisol separation response previously observed in primates. In Experiment 1, separation of guinea pig pups from their mothers did not elevate the plasma cortisol levels of the pups at either 30 or 180 min when they remained alone in their home cages during the separation. Experiment 2 showed that cortisol levels of pups placed alone in a novel cage were greater at 30, 90, and 180 min than were those of pups placed in the cages together with their mothers. In contrast, the separated pups vocalized more than did pups tested with their mothers during the initial 30 min only. In Experiment 3, pups raised on inanimate surrogates responded less intensely to rearing-figure separation in terms of both cortisol and vocalizations than did mother-reared controls. Taken together, these results indicate both differences (response to home cage separation) and similarities (dissociation of cortisol and vocalization responses, effect of surrogate separation) in the separation responses of guinea pig and primate infants. The guinea pig model may provide a useful adjunct to primate studies for examining particular issues concerning physiological effects of brief separation from an attachment object. PMID- 2706082 TI - Neural systems for early independent ingestion: regional metabolic changes during ingestive responding and dehydration. AB - The ingestive behavior of young rodents, studied independently of the mother and suckling, provides a system for the developmental analysis of the neurobiology of feeding and drinking. In these experiments regional neural metabolic activity, as assessed by semiquantitative deoxyglucose (DG) autoradiography, was related to dehydration and ingestive behavior in 6-day-old rat pups. During simple ingestive responding, changes in relative DG uptake, representative of changes in neural metabolic activity, occurred primarily in hindbrain sensory and motor nuclei. Producing cellular dehydration resulted in activity changes primarily in the basal forebrain. When pups were dehydrated and allowed to ingest during the DG uptake period, activity changes were seen in both the hindbrain and forebrain areas that responded to ingestion or dehydration alone as well as in regions that were not affected by either manipulation alone. These latter changes, which result from an interaction of behavioral and physiological stimuli, call attention to areas that may subserve motivational aspects of behavior. Extracellular dehydration was found to produce fewer and different forebrain responses in neural metabolic activity. During ingestion, the only effects of extracellular dehydration that overlapped with those of cellular dehydration appeared in circumventricular hypothalamic regions and brain stem motor nuclei. Thus, there appeared to be only a limited final common pathway for these two types of dehydration-induced drinking. Taken together, these findings in infant rats depict distributed neural systems subserving ingestion and responding to state change. They provide a starting point early in ontogeny for the developmental analysis of neural substrates of ingestive systems. PMID- 2706083 TI - Electron microscopical examination of different aggregation and decomposition states of phosphorylase kinase. Identification and computer averaging of the alpha gamma delta fragment. AB - A sample of phosphorylase kinase aged by storage was subjected to chromatography on a size exclusion column. Samples from the four major peaks were analysed by electron microscopy. The first major peak consisted of oligomers of the enzyme monomers which showed no structural order. The second peak mainly consisted of dimers of phosphorylase kinase connected to each other by the outer tipes of the "wings", thus identifying a binding locus through cross-labelling. The third peak showed the already known typical forms of phosphorylase kinase ("butterflies", "chalice form"). The last peak yielded structures identical to the alpha gamma delta fragments obtained by lithium bromide cleavage of the intact enzyme. These structures correspond to the curved outer parts of the cup substructures of the chalice and butterfly forms. The result could be verified by computer averaging of the alpha gamma delta fragments. This finding confirms reports (Chan, K.-F. J. & Graves, D.J. (1984) Calcium Cell Funct. 5, 1-31) that the beta-subunits (missing in the distally situated fragment) are located in the central parts of the molecules. The good quality of the averages of the low molecular mass fragment (about 200 kDa) recommends computer averaging of electron micrographs of partial complexes as suitable method for the study of protein complexes. PMID- 2706084 TI - Carnivora: the primary structure of the Pacific Walrus (Odobenus rosmarus divergens, Pinnipedia) hemoglobin. AB - The primary structure of the alpha- and beta-chains of the hemoglobin from the Pacific Walrus (Odobenus rosmarus divergens, Pinnipedia) is presented. Sequence analysis revealed only one hemoglobin component whereas two bands were found in polyacrylamide gel electrophoresis. The globin chains were separated by high performance liquid chromatography and the sequences determined by automatic liquid- and gas-phase sequencing of the chains and their tryptic peptides. The alpha-chains show 20 and the beta-chains 12 exchanges compared to the corresponding human chains. In the alpha-chains one heme- and two alpha 1/beta 1 contacts were exchanged whereas in the beta-chains one alpha 1/beta 1-, one alpha 1/beta 2-and one heme-contact are substituted. Compared to Harbour Seal (Phoca vitulina) the Walrus hemoglobin shows 9 amino-acid replacements in the alpha chains and 5 in the beta-chains. The relation between Pinnipedia and Arctoidea is discussed. PMID- 2706085 TI - Rabbit urinary tamm-horsfall glycoprotein. Chemical composition and tentative carbohydrate structure. AB - The urinary Tamm-Horsfall protein (THP) is the major glycoprotein secreted by the mammalian kidney. We recently isolated and immortalized thick ascending limb of Henle cells from rabbit kidney, which produce Tamm-Horsfall protein in cell culture in vitro. In order to further study the yet undefined functional role and biosynthetic pathways of this protein, we first re-examined the chemical composition and the carbohydrate structure of rabbit urinary Tamm-Horsfall protein. Using precipitation with 0.58 mol/l NaCl a protein was isolated from rabbit urine which showed extensive microheterogeneity and had an average molecular mass of 95 kDa. Deglycosylation of the protein led to a loss of microheterogeneity and yielded a molecular mass of 58-60 kDa. Amino-acid analysis of the native and deglycosylated protein revealed a lower cysteine (20 mol/mol THP) and a higher histidine (20 mol/mol THP) content than described previously. Chemical analysis of the carbohydrates showed a high glucosamine (50 mol/mol THP), galactose (43 mol/mol THP), and mannose (24 mol/mol THP) content. The amount of sialic acid was 15 mol/mol THP. Using lectins to identify the structure of the carbohydrate chains it was shown that rabbit Tamm-Horsfall protein possesses complex-type oligosaccharide chains with terminal sialic acid, beta galactose, and probably alpha-fucose and chains of the mucin type. These results indicate that some of the cysteine residues in the polypeptide chain of THP can be replaced by histidine, suggesting a role of some cysteins in metal binding rather than intramolecular stabilization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706086 TI - High degree of homology between primary structure of human lysosomal acid phosphatase and human prostatic acid phosphatase. AB - Alignment of the amino-acid sequences of the human lysosomal acid phosphatase (LAP) and human prostatic acid phosphatase (PAP) yielded an extensive homology between the two mature polypeptide chains. In the overlapping part, which extends over the entire PAP sequence and the N-terminal 90% of the LAP sequence, the identity is 49.1%. The LAP has an additional C-terminal sequence, which is encoded by the last exon of the LAP gene. This sequence contains the transmembrane domain of LAP, which is lacking in the secretory PAP. All six cysteine residues as well as 20 out of 27 (LAP) and 26 (PAP) proline residues present in the overlapping part of the proteins are conserved, suggesting that they are involved in stabilization of the tertiary structure of both proteins. Only two out of 8 N-glycosylation sites in LAP and 3 in PAP are conserved, suggesting that the dense N-glycosylation of LAP is related to its function in lysosomes. PMID- 2706087 TI - Total fatty acids of hair lipids in cystic fibrosis. AB - In a preliminary study, total fatty acids of lipids removed from hair of subjects of either sex with cystic fibrosis (n = 17; average age 8.3 years) and controls (n = 24; average age 9.1 years) were analyzed by gas chromatography. In contrast to the blood lipids in cystic fibrosis which display various fatty acid changes as a depression in 18:2 and increases in 16:0, 16:1, and 18:1, such profiles did not occur with the hair lipids. With the latter, total fatty acids in cystic fibrosis showed decrements in 18:1 and in the lesser concentrations of 20:1 and members below C14 as compared to the respective control series. PMID- 2706088 TI - Lipid-coated particles--a new approach to fix membrane-bound enzymes onto carrier surfaces. AB - A new method to covalently link phosphatidylethanolamine via the headgroup at the surface of cell-size spherical polymer particles is described. Because the density of the reactive groups linked to the polymer beads is extremely high, a dense, tightly bonded lipid monolayer is formed. When a solubilized lipid is added to the suspension of monolayer-coated polymer beads, the spontaneous formation of a bilayer-like structure is observed. The upper layer of lipid can be removed by washing with detergent solution or organic solvents, ethanol or butanol, and can be replaced in a relipidation step by any other phospholipid; thus, an asymmetric lipid bilayer structure can be formed. Membrane-bound enzymes such as alanine aminopeptidase or dipeptidyl peptidase IV may be inserted with their hydrophobic anchor segments in a stable and enzymatically active form in this artificial system. Incorporation of integral membrane enzymes such as bacteriorhodopsin with membrane-spanning domains and bulky segments at both sides of the membrane succeeded only when a hydrophilic spacer of appropriate length (e.g., pentaalanine) was introduced between the carrier surface and the lipid headgroups. PMID- 2706089 TI - Modification of partial pressure of oxygen (P50) in mammalian red blood cells by incorporation of an allosteric effector of hemoglobin. AB - Internalization of inositol hexaphosphate (IHP) in mammalian red blood cells (RBC) produces a modification of the hemoglobin-oxygen affinity, leading to a rightward shift of the dissociation curve. The process of incorporation, based on an osmotic shock, has been tested on RBC of different species. Two dialysis protocols have been defined to transform RBC, the first one for small volumes in a cellulose bag and the other for larger volumes using a commercially available dialysis device. Different optimal conditions must be used for each species. Most of the cellular characteristics of the transformed RBC having encapsulated IHP are similar to those of native cells. For several species, such modified RBC could be reinfused and used for physiological studies. PMID- 2706090 TI - Erythrocyte adducin differential properties in the normotensive and hypertensive rats of the Milan strain. Characterization of spleen adducin m-RNA. AB - Previous studies have shown that erythrocytes from the Milan hypertensive strain of rats (MHS) differ from erythrocytes from the control normotensive strain (MNS). These differences are determined within the stem cells, are genetically associated with the development of hypertension, and are similar to those found between the tubular cells of the two strains. Moreover they seem to be dependent upon the presence of the membrane skeleton proteins. In this paper we describe our studies aimed at identifying some precise protein difference between the membrane skeletons of the two strains, which may cause the cellular differences described above. Milan hypertensive strain and MNS rats were immunized with ghost or membrane skeleton extracts prepared from the other or their own strains. Only MHS rats immunized with MNS ghost or membrane skeleton extracts produced an antibody against a 105 KD protein in about 95% of the animals. This protein has been identified with the recently described cytoskeletal protein adducin on the following bases: the protein binds calmodulin (CaM) and protein kinase C (PKc) in a Ca2+ dependent way. It also binds phosphatidylserine, is the substrate of exogenous PKc, and finally it is purified by high salt extraction of Triton-X100 insoluble erythrocyte cytoskeletons followed by affinity chromatography on CaM sepharose. Using this antibody the isolation from a mouse spleen library, the characterization and sequencing of a partial cDNA clone coding for this protein has been carried out. In conclusion adducin may be considered a very useful tool to test the hypothesis that the cellular differences between MHS and MNS may be caused by a difference in a membrane skeleton protein. PMID- 2706091 TI - Renal hemodynamics in patients with sustained essential hypertension and in patients with unilateral stenosis of the renal artery. AB - Systemic and renal hemodynamics including split renal function tests were studied in 41 patients with renovascular hypertension (RVH) related to unilateral stenosis of main renal artery in comparison to 36 subjects with essential hypertension (EH). The two populations were matched for age, sex, body surface area, and systemic arterial pressure. Cardiac output and total peripheral resistances were similar in both groups, with total peripheral resistances increased in comparison to normal values (P less than .001). Patients with EH had a decreased blood volume (P less than .01) with a normal cardiopulmonary blood volume. Patients with RVH had a normal blood volume with an increase in cardiopulmonary blood volume (P less than .02). The para-amino hippurate clearance (CPAH) was decreased in EH. The decrease was similar in the right (160.3 +/- 56.9 mL/min/m2) and left kidneys (158.7 +/- 45 mL/min/m2). The inulin clearance (Cin) was similar in both kidneys (35.2 +/- 12.5 v 33.6 +/- 11.6 mL/min/m2). In addition, in EH, CPAH was negatively correlated with blood pressure (P less than .01). In patients with RVH, CPAH of the "stenotic" kidney was reduced (91.5 +/- 47.8 mL/min/m2) as well as Cin (22.9 +/- 9.3 mL/min/m2). In contrast a significant increase in CPAH (194.1 +/- 63.8 mL/min/m2) and Cin (47.6 +/- 12.6 mL/min/m2) was observed in the contralateral kidney. Kidney function (CPAH and Cin) was not correlated with blood pressure in the "stenotic" kidney. The CPAH and Cin of the nonstenotic kidney were positively and significantly correlated with systemic arterial pressure (P less than .001). The Cin was positively correlated with CPAH in all kidneys in RVH or in EH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706092 TI - Effect of chloride on blood pressure and sympathetic nervous system activity in deoxycorticosterone acetate-treated rats. AB - The effect of selective chloride loading on blood pressure and sympathetic nervous system activity was studied in deoxycorticosterone acetate (DOCA)-treated rats. The rats fed a normal sodium-high chloride and fed a high sodium chloride diet had higher blood pressure and lower cardiac norepinephrine concentrations than those fed a normal sodium chloride diet. Furthermore, cardiac norepinephrine concentrations were significantly correlated with systolic blood pressure. These data suggest that selective chloride loading can raise blood pressure in DOCA treated rats due to augmented sympathetic nervous system activity. PMID- 2706093 TI - Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. AB - Several reports suggest that urinary albumin excretion may be elevated in patients with essential hypertension and that this index may be a good predictor for cardiovascular complications. The aim of this study was to compare 24-hour urinary albumin excretion in a group of normotensives, borderline, and untreated mild hypertertensives and to assess, in a subgroup of them, the possible relations between microalbuminuria and arterial blood pressure. Fifteen normotensives, 16 borderline, and 19 mild hypertensive patients were studied. Slightly but significantly higher values of microalbuminuria were observed in the mild hypertensives compared to the other two groups. In 21 borderline and mild hypertensive patients 24-hour microalbuminuria was related to casual blood pressure and noninvasive ambulatory blood pressure monitoring. A significant correlation was found between microalbuminuria and average day-time diastolic blood pressure. Our data suggest that albumin excretion is slightly increased in mild arterial essential hypertension; the direct association between microalbuminuria and arterial diastolic blood pressure during daily activities seems to confirm a pathophysiological link between transcapillary protein escape and arterial blood pressure that warrants further studies. PMID- 2706094 TI - Differentiation of angiotensin-converting enzyme (ACE) inhibitors by their selective inhibition of ACE in physiologically important target organs. AB - Seven ACE inhibitors were studied for possible differences in distribution to aorta, brain, heart, lung, and kidney after administration of single oral doses to spontaneously hypertensive rats (SHR). Doses, normalized for differences in inhibitory potency and molecular weight, were expected to deliver equivalent levels of ACE-inhibitory activity to the circulation, and this was confirmed by preliminary dose-response studies. The relative potencies of the active moieties of the seven drugs and the normalized oral doses used were: SQ 29,852 (1.0), 100 mg/kg; captopril (3.5), 30 mg/kg; enalapril (12), 20 mg/kg; fosinopril (13), 25 mg/kg; zofenopril (20), 10 mg/kg; lisinopril (24), 10 mg/kg; and ramipril (51), 5 mg/kg. In these ex vivo studies, ACE activities were determined fluorometrically in SHR sera and in uncentrifuged homogenates of the solid tissues at various times after oral dosing with the ACE inhibitors. As expected, the normalized oral doses of the seven inhibitors had equivalent effects on serum ACE. In lung, where ACE has a vascular endothelial localization, and in aorta, where ACE inhibition correlates with antihypertensive action, ramipril, lisinopril, and zofenopril were distinguished by the magnitude and duration (three to four days) of their effects. In the brain, where ACE may affect central regulation of blood pressure and participate in the degradation of certain neuropeptides, ramipril and enalapril had no effect; captopril and zofenopril had modest, short-lasting effects, and fosinopril, lisinopril, and SQ 29,852 had delayed but long-lasting inhibitory actions. In the kidney, where ACE inhibition may have positive or negative effects on renal function, ramipril and fosinopril could be distinguished by their weak actions, perhaps associated with biliary routes of excretion. In the heart, where ACE inhibitors may prevent ischemic damage to the myocardium, single oral doses of captopril, fosinopril, and particularly zofenopril produced striking and long-lasting inhibition, whereas equivalent doses of ramipril and enalapril produced barely detectable inhibition. PMID- 2706095 TI - [Automobile drivers in the "drinking and driving" conflict: behavior pattern and influence factors]. AB - The question of how to encourage "normal" drivers to modify either their alcohol consumption or the use of their cars formed the starting point of a representative survey undertaken by the Federal Highway Research Institute (Kretschmer-Baumel, Karstedt-Henke 1986). The following variables were identified as having a decisive influence on the drinking and driving conflict and its solution: Attitude to the legal BAC limit of 80 mg/100 ml, evaluation of the risk arising from drinking and driving, evaluation of excessive alcohol consumption, and sex of the driver. Attitudes of the legal norm and its intended results which are relevant to behaviour, as well as the wide-spread acceptance of a lower BAC limit of 50 mg/100 ml or 0 mg/100 ml, together form the basis for new measures. A reduction in the numbers of alcohol-related accidents seems most likely to result from a lowering of the current legal BAC limit. PMID- 2706096 TI - [The sensitivity of clinico-chemical markers of alcoholism following short-term motivated alcohol abstinence]. AB - The liver enzymes GGT, GOT and GPT, as well as MCV, of 40 alcoholics were examined. They had presented at the psychiatric department of the University for withdrawal therapy. All of them had consumed alcohol up to the time of admission. The laboratory values were obtained on admission, then at weekly intervals for a period of 5 weeks, under total alcohol abstinence. GGT (85 per cent) and MCV (95 per cent) demonstrated a high sensitivity relating to alcohol abuse. While the raised GGT values reduced gradually, the MCV values remained consistently high even after strict withholding of alcohol. The sensitivity of MCV was not impaired by the previous substitutions of vitamin B complex. At the beginning GOT and GPT were elevated in only about half the number of cases and quickly became normal. Because of the more rapid lowering of the GOT activities, compared to the GPT activities, the De Ritis quotient sank to below 1 even after only one week. To demonstrate the clinical chemical evidence of the appraisement more clearly, the MCV as well as liver enzymes, must be taken into account. In general there was a decline in the diagnostic value of the laboratory results, the longer the period of alcohol abstinence lasted. Therefore, it is recommended not to set a long term time limit for examination, to favour the motivated total abstinence periods. PMID- 2706097 TI - [The protocol for blood collection, report of medical findings and expert assessment of blood alcohol in criminal procedures]. AB - The author deals with the question when and on which conditions it is allowed to read out the record on the blood-sample, the report on medical findings and the expert-opinion and blood-alcohol in the main hearing of a law court as a documentary proof. Furthermore he explains how the revision reproof is to represented to the appeal court in case of violation. PMID- 2706098 TI - [The reliability of instruments for measuring breath alcohol]. AB - To describe the reliability of breath-alcohol testers, values are measured which characterize precision, accuracy, analytical sensitivity, drift, and hysteresis. The instruments tested were two infrared devices (Alcomat, Alcotest 7110) and one device equipped with a fuel cell (Alcolmeter EBA). Criteria of acceptability are the limits from the first preliminary draft of recommendations by the Organisation Internationale de Metrologie Legale (OIML). The results of measurements clearly show the level of reliability of modern instruments which largely attain the OIML requirements. All measurements were performed with a simulator at 34 degrees C. Therefore the definite influence of breath temperature on the alcohol concentration could be neglected. PMID- 2706099 TI - [Methanol, isopropanol, n-propanol--endogenous formation affected by alcohol?]. AB - Methanol, isopropanol and n-propanol are detected usually in blood samples during the determination of congeners. The ethanol-induces formation of methanol and isopropanol has been described formerly. Also little amount of n-propanol were detected in blood, which could not be reduced to the alcoholic beverages. PMID- 2706101 TI - The Jack R. Anderson Lecture. PMID- 2706100 TI - [Alcohol drinking experiments with men over 60 years of age]. AB - Alcohol drinking experiments (exposure: 0.68 g alcohol per kg body weight; type of drink: hard liquor and wine) was carried out in 20 men over 60 years old. The peak alcohol concentration, the course of the alcohol curve, co, r and beta 60 were compared with the results of drinking experiments with young persons published in the literature. No appreciable differences between the two age groups could be detected. PMID- 2706102 TI - Extensive variations in nasal mucosa in infants with and without recurrent acute otitis media. A scanning electron-microscopic study. AB - Biopsy specimens of the nasal mucosa from the inferior turbinate of infants aged 2 to 26 months were examined by scanning electron microscopy. The specimens were obtained from 23 clinically healthy infants and compared with those from 43 infants with recurrent acute otitis media (RAOM). Potentially pathogenic bacteria were isolated from 61% of the control subjects and 90% of those with RAOM. Infants with RAOM had about as extensive alterations as the healthy ones. A single healthy child and one with RAOM had what was interpreted as a normal nasal mucosa; all others showed reduced frequencies of ciliated cells, deformation of cilia, extensive loss of normal mucosal epithelium, and metaplasia in their nasal epithelial lining. Severely damaged area could be seen close to more normal ones. Nasal mucosa in clinically healthy infants rarely had a normal appearance, probably due to frequent infections and the fairly long time needed for the repair process. We proposed that the high frequency of damaged, incompletely healed nasal mucosa may constitute an important factor with regard to the susceptibility to further infections. PMID- 2706103 TI - Primary deficits in eustachian tube function in patients with otitis media with effusion. AB - A study was performed to detect primary and secondary deficits in eustachian tube (ET) function in children with otitis media with effusion (OME). We examined ET function in the active and convalescent stages of OME in a total of 103 children (141 ears) and compared the results with those obtained in a control group of 34 ears. There were 27 children (33 ears) with OME in the convalescent stage and 76 children (108 ears) in the group with active OME. The test of ET function included the inflation-deflation test and dye clearance test. No cases of abnormally high tubal opening pressure were found in the convalescent OME group, and only 11% of ETs in the active OME group had high pressure. Negative middle ear pressure equalizing function, which was impaired in 97.2% of ETs in the active OME group, was still found to be impaired in 93.9% of ETs in the convalescent OME group. Eustachian tube clearance was impaired in 64.0% of ears with OME in the active stage; this percentage decreased considerably to 36.0% in ears in the convalescent stage of OME. We conclude that poor ability to equalize negative pressure is a fundamental deficit of ET function in OME; impaired clearance function of ET in the active stage of OME is not considered to be a primary cause of OME; there is almost no organic obstruction or stenosis of the ET in patients with OME. PMID- 2706104 TI - Ultrastructural studies of the human round window membrane. AB - An ultrastructural study of 14 round window membranes of seven human ears disclosed three basic layers: an outer epithelium lining the middle ear, a middle core of connective tissue, and an inner epithelium bordering the inner ear. Morphological evidence suggests that these layers participate in absorption and secretion of substances to and from the inner ear. A comparison of morphological features of round window membranes suggests that the average thickness of 70 microns does not change with advancing age. However, in the elderly, the connective tissue has a looser arrangement; there is an increase in ground substance; and elastic fibers thicken. Fibroblast nuclei become larger, rounder, and less uniform and have extensions. The ultrastructure of the "false round window membranes," with epithelial cells of the same type bounding both sides, suggests that these membranes consist of juxtaposed epithelial folds of the overlying promontory. PMID- 2706105 TI - Autosomal recessive nonsyndromal profound childhood deafness in a large pedigree. Audiometric features of the affected persons and the obligate carriers. AB - Nonsyndromal autosomal recessive profound childhood deafness will affect about one in 4000 children in western Europe. A nonsyndromal autosomal recessive type of profound childhood deafness was thought to be the cause of deafness in at least eight and probably 12 children from a large family with various consanguineous matings and other family interrelations. Audiograms of all affected deaf children showed a profound childhood deafness with only a very slight variation. Audiometric examinations, such as pure-tone audiometry, high frequency audiometry, stapedial reflexes, and Bekesy audiometry, of ten obligate or presumed carriers did not show any significant findings that would allow identification of carriers of this autosomal recessive gene. Families like this one seem to be very rare. Large clinically well-studied families like this one are indispensable for gene linkage studies of nonsyndromal autosomal recessive types of profound childhood deafness. Such studies should make it possible to trace the origin of these types of childhood deafness at an early age. In consequence, carrier detection should also become available. PMID- 2706106 TI - Clinical experience with electroneurography in the pediatric patient. AB - Electroneurography (ENoG) has demonstrated utility in adults with facial nerve paralysis. We wished to evaluate the possible usefulness of this test in children. Twenty-six patients, aged 3 months through 16 years, were studied. Initial measurements were obtainable in all but two patients; they were successfully tested on a second attempt. All subsequent patient testing efforts were completed, for an overall successful test rate of 95%. Waveform amplitude and morphology were consistent with adult values, except in infants. The most clinically helpful use of this test was to objectively assess facial nerve function, once spontaneous motion was lost in acquired paralysis or if it had never been seen in congenital paralysis. Surprisingly, analysis of the "normal" side of the face proved most informative for three patients. Use of the test as an absolute predictor for return of function is not possible; however, the ENoG results add data that can be incorporated into the clinical information to make such predictions more rational. We conclude that ENoG can be performed on children, and that the measurements, within bounds of interpretation, can offer objective data not usually available in this age population. PMID- 2706107 TI - Immediate reconstruction of pharyngoesophageal defects. Preference or reference. AB - In this era of development in reconstruction, interest in searching for the most appropriate procedure for replacing the pharyngoesophageal defect is intense. The type of defect, depending on the level of invasion by the cancer, should be classified as partial pharyngeal, circumferential pharyngeal, or pharyngoesophageal. Within each class, the surgeon can have his preference for a reconstructive procedure according to available expertise and familiarity. In our series of 97 patients with pharyngoesophageal defects resulting from resection of laryngeal, hypopharyngeal, and cervical esophageal cancers, the patch-on pectoralis major myocutaneous flap, the tubed pectoralis major myocutaneous flap, and the stomach were used for the three types of defects, respectively. Mortality and morbidity, while kept at an acceptable level, appear to rise as the complexity of the procedure increases. This supports the argument that the reconstructive method should be selected with reference to the type of defect, which is in turn dependent on the site and behavior of the tumor. The reconstructive procedure is to fit the defect, and not vice versa. PMID- 2706108 TI - T staging of the laryngohypopharyngeal carcinoma. A 7-year multidisciplinary experience. AB - Sixty-six whole-organ sectioned, nonirradiated, laryngopharyngectomy specimens that were removed because of cancer during a 7-year period were uniformly examined to determine the accuracy of perioperative T staging by high-resolution computed tomography (CT) and clinical evaluation (indirect-direct laryngoscopy) by comparing this preoperative staging with the postsurgical pathologic staging. The accuracy of the clinical vs CT staging for laryngeal carcinomas was 58.8% vs 70.6%, whereas the accuracy of the staging by combination of the two modalities was 88.2%. Combined staging modalities showed the same accuracy for laryngeal and hypopharyngeal carcinomas (88.2%), whereas clinical staging accuracy for hypopharyngeal carcinomas was lower (52.9%) and CT accuracy was higher (82.4%) than that observed for laryngeal carcinomas. In the majority of the cases that were staged inaccurately, the error was one of under-estimation: in particular, tumors confined to the mucosa and early infiltration of laryngeal fat spaces were not detected by CT. PMID- 2706109 TI - Tracheal stenosis in Larsen's syndrome. AB - Larsen's syndrome is known to have an association with laryngomalacia and tracheomalacia. We report a case of Larsen's syndrome with respiratory difficulty due to a tracheal stenosis. To our knowledge, this association has not previously been reported. PMID- 2706110 TI - Heterotopic lingual brain in the newborn. AB - Heterotopic brain is a rare entity. Histologically, this lesion resembles mature brain and often contains specialized tissues similar to choroid plexus or glia. Specialized neural stains are necessary to differentiate this rare anomaly from other tumors or conditions found in the head and neck. The differential diagnosis includes squamous cell carcinoma, granular cell tumor, hemangioma, lymphangioma, thyroglossal duct cyst, dermoid cyst, hamartoma, rhabdomyosarcoma, and teratoma. We describe a newborn with heterotopic brain tissue occurring on the dorsum of the tongue. We found only one other description of this developmental aberration in the English literature. Our patient was successfully treated with carbon dioxide laser excision of the mass. There has been no evidence of complication or recurrence after one year of follow-up. PMID- 2706111 TI - Compound pharyngeal myocutaneous flap. PMID- 2706112 TI - Tracheoesophageal procedures and voice restoration. PMID- 2706113 TI - Selective approach to surgery for delayed enophthalmos. PMID- 2706114 TI - Facial nerve palsy following tympanmastoid surgery. PMID- 2706115 TI - Pathologic quiz case 2. Malignant lymphoma, diffuse, small, noncleaved cell, Burkitt's type. PMID- 2706116 TI - Pathologic quiz case 1. Oral hairy leukoplakia (HL). PMID- 2706117 TI - Design and methodological requirements for studying the role of language acquisition in cognitive/social development. PMID- 2706118 TI - Augmentative and alternative communication. PMID- 2706119 TI - Indirect aspects of communicative gains: toward fuller accounts of sequence and process. PMID- 2706120 TI - Classification of normally achieving and mildly mentally retarded students on the basis of their oddity transfer performance. AB - Forty mildly retarded, 6- through 9-year-old children selected from educable mentally retarded (EMR) classes and 40 normally achieving students of the same age were pretrained on the oddity solution and then given eight different, six trial oddity transfer problems. A higher level of transfer was associated with the older (8- and 9-year-olds) and with the normally achieving students. The students' performance on the oddity transfer trials was used to classify them into their two respective groups. High levels of classification accuracy were observed in the discriminant function analyses. On both the group comparison and the individual student classifications, all eight oddity types were sensitive to differences between the normally achieving and mildly retarded grade school students. PMID- 2706121 TI - Relation between the receptive language and mental age of persons with mental retardation. AB - The purpose of this study was to determine whether the development of receptive language lags behind nonverbal cognitive development in school age persons with mental retardation. The relation between receptive language and nonverbal MA was examined as a function of MA level and the linguistic form to be understood. Individual differences in the receptive language-MA relation were also investigated. Results indicated that the relation between receptive language and MA varied across MA levels, linguistic forms, and individuals at the same MA for listeners with mental retardation. PMID- 2706122 TI - Downward shift in IQ in persons with Duchenne muscular dystrophy compared to those with spinal muscular atrophy. AB - Patients with Duchenne progressive muscular dystrophy (DMD) and those with spinal progressive muscular atrophy (SPMA) were compared on the basis of memory and IQ. The DMD group was inferior to the SPMA group in memory tests and Full Scale IQ. The DMD group showed poorer scores, despite the fact that functional disabilities and social environments were similar for the two groups. Results thus support the current view that lower IQ is one of the primary manifestations of DMD. PMID- 2706123 TI - Similarity of IQs of siblings with Duchenne progressive muscular dystrophy. AB - The similarity of IQs of siblings with Duchenne progressive muscular dystrophy (DMD) was examined to determine whether the view that downward shift in IQ of patients with DMD is a genetically determined primary manifestation of the disease. The mean IQ difference was smaller and the IQ correlation was higher for siblings with DMD than for siblings without the disease. Moreover, these two indices were closer to those for healthy monozygotic twins reared together. These results suggest that the lowered IQ in patients with DMD has a genetic background. PMID- 2706124 TI - Alzheimer-type neuropathology and clinical symptoms of dementia in mentally retarded people without Down syndrome. AB - Postmortem morphometric analyses of Bielschowsky stained sections from brains of 70 mentally retarded people without Down syndrome, age 65 and over when they died, indicated Alzheimer-type neuropathology in 22 cases (31%) and a majority with at least presence of some Alzheimer-type lesions. Based upon information abstracted from clinical histories, however, old-age-associated dementia proved to be difficult to judge reliably. Nevertheless, for otherwise healthy individuals (n = 25), loss of motor skills, development of problem behaviors, and a 10-point drop in IQ appeared to be likely indicators of Alzheimer's disease. Prevalence estimates of Alzheimer-type neuropathology among nonretarded people and the present sample appear comparable, and projections must be made to address the special needs of this rapidly growing population of retarded people. PMID- 2706125 TI - Sibling relationships involving developmentally disabled people. AB - Forty-six sisters of moderately to profoundly developmentally disabled individuals completed questionnaires measuring qualitative aspects of their sibling relationships. In comparison to relationships with their nondisabled siblings, these relationships were described as less competitive and less intimate as well as different in nurturance, admiration, and domination patterns. Relationship scores were predicted, either independently or interactively, by sibling dependency, sibship constellation variables, the ages of subjects and their siblings, and living arrangements. Implications of these results were discussed as they pertain to various conceptualizations of sibling relationships and to future research. PMID- 2706126 TI - Acceptability of behavioral interventions for self-injurious behavior. AB - Using a case description methodology, we examined the effects of behavior problem severity, intervention type (accelerative vs. reductive), client status (child vs. adult), and type of work setting (child vs. adult unit) on staff members' acceptability ratings of six behavioral interventions used to treat self injurious behavior (SIB). Results indicated that (a) accelerative interventions were rated more acceptable than reductive treatments, (b) acceptability of treatments varied as a function of SIB severity, and (c) client status and type of work setting failed to significantly influence acceptability ratings. Findings were discussed in the context of the current controversy surrounding the use of aversive treatments. The implications of the results for the design of institutionally based behavioral intervention programs were examined. PMID- 2706127 TI - Primary meningeal melanoma. PMID- 2706128 TI - Informing patients about phase I trials--how should it be done? PMID- 2706129 TI - Long-term psychological sequelae of mastectomy and breast conserving treatment for breast cancer. AB - Psychiatric and psychosocial adaptation to two types of treatment for primary breast cancer, modified radical mastectomy and partial mastectomy with radiotherapy, was studied five years after the primary treatment. 102 consecutive patients with pT1NOMO breast cancer were invited to follow-up which was done by standardized questionnaires. Nineteen women declined the invitation and 25 others were not included for various reasons, leaving 58 to complete the interviews. 30% of the women reported accentuated mental symptoms compared to the state before treatment, with no significant difference between the two treatment groups. Psychiatric state, marital adjustment and fear of cancer recurrence were also similar in the two groups. However, breast conserving treatment seems to preserve the woman's female identity and acceptance of body configuration. We conclude that breast conservation does not in itself prevent mental sequelae after treatment for primary breast cancer. Selective psychoprophylactic programs and reorganization of the postoperative follow-up should be tried to diminish unwanted psychological reactions. PMID- 2706130 TI - A curriculum in oncology for medical students in Europe. AB - A curriculum in oncology for medical students in Europe is proposed. The proposals are presented with the unanimous approval of the deans of undergraduate medical schools and oncologists from 17 European countries who attended an EC/EORTC Workshop in Bonn in May 1988. The proposals arise as a response to the recognised deficiency of undergraduate cancer education in many medical schools and the pressing need to ensure that newly qualified doctors possess the necessary skills and knowledge to participate in cancer prevention, early diagnosis and curative and palliative management. The proposals concern both basic science and clinical practice, stressing the need for bedside teaching, instruction in the multi-disciplinary nature of cancer care and the elimination of bias towards particular disciplines. To achieve the objectives it is proposed that each medical school shall have an undergraduate teaching programme in oncology. A detailed prescription for an undergraduate curriculum is not attempted but rather a frame-work provided that should be adopted regardless of national and local differences in medical educational practice. PMID- 2706131 TI - Non-palpable invasive breast carcinomas from the Stockholm screening project. AB - Sixty-six non-palpable, invasive mammary adenocarcinomas from the Stockholm mammography screening project were studied with respect to histopathology. In 53 of these tumors estrogen receptor (ER) content was estimated and in 30 of them also the DNA distribution pattern. The tumors were predominantly of low or intermediate histological malignancy grade and ER-rich, whereas the distribution of DNA ploidy equalled that found in a non-selected tumor material. Only 2 tumors recurred during follow-up (median 51 months), indicating that non-palpable breast carcinomas represent a prognostically favourable subset in spite of a relatively high proportion of aneuploid tumors. PMID- 2706132 TI - Experiences in home care of cancer patients. A new approach in cancer nursing. AB - As a result of mutilating operative procedures, aggressive cytotoxic chemotherapy and terminal stage of the disease, tumor patients face frequent visits to the tumor center. They are often hospitalized and thereby excluded from family and home. To enable cancer therapy and supportive care on an ambulatory basis, a team consisting of two physicians, two nurses and one psychologist was settled in our department in November 1986. The purpose of this team was to transfer several oncological treatment modalities from the hospital to the homes of the patients. Apart from organizing the patients' discharge from the hospital and coordinating treatment, the main task of the team has been to follow the patient during the course of the disease and give psycological support. In our experience the possibility of home care has clearly improved the patients' quality of life. PMID- 2706133 TI - Prognostic factors in non-Hodgkin lymphoma stage I treated with radiotherapy. AB - The results of treatment in 175 consecutive patients with nonHodgkin lymphoma (NHL) clinical stage I treated between 1969 and 1984 were analysed according to different pretreatment prognostic variables. Treatment consisted of radiotherapy in 166 of the 175 patients. The estimated 5 and 10-year disease-free survival rates (DFS) were 63% and 60% and the survival rates at 5 and 10 years 82% and 76% respectively. Lymphomas arising from gut-associated lymphoid tissue, i.e. Waldeyer's ring, the thyroid and the gastrointestinal tract had a more favourable clinical course (10-year projected DFS 83%) than nodal (50%) and other extranodal lymphomas. Although the number of patients with other extranodal sites was small, sites such as testis, nasal cavity, paranasal sinus and extradural space seemed to have a high relapse rate. Unfavourable clinical courses were also observed among nodal high-grade NHL if the lymph nodes were larger than 5 cm in diameter. Chemotherapy before radiotherapy may be recommended in NHL subgroups with a high relapse rate and which today are potentially curable with chemotherapy, i.e. highgrade NHL. This study indicates that large nodal lymphomas and some extranodal sites belong to this group. PMID- 2706134 TI - The predictive value of initial cytostatic response in primary unresectable rhabdomyosarcoma in children. AB - The relation between the initial tumour regression produced by chemotherapy and the later event-free survival was studied in a prospective multicentre study on soft-tissue sarcomas in children. The event-free survival rate in patients with complete remission after seven weeks of chemotherapy was 95%; in patients with incomplete tumour reduction of greater than 2/3, 61%; and in patients with tumour reduction of less than 2/3 but greater than 1/3, 31%. Patients with partial remission at week 7, who achieved complete remission by week 16 after additional chemotherapy had an event-free survival rate of 64%. A multivariate analysis suggested that the response per unit of time was an important prognostic factor. PMID- 2706135 TI - Primary carcinoma of the fallopian tube. A retrospective study of patients reported to the Danish Cancer Registry in a five-year period. AB - Fifty-two patients with carcinoma of the fallopian tube diagnosed and treated during a 5-year period in Denmark were reviewed. The median age of the patients was 60 years. No patients had a preoperative diagnosis. History and clinical findings were similar to previously reported series. Treatment consisted of hysterectomy and bilateral salpingo-oophorectomy, often succeeded by postoperative whole pelvic irradiation. Five-year survival was 37.4%, depending on stage. In stage I+II the survival rates were similar regardless of whether postoperative radiation therapy had been given or not. Little is known about the patterns of spread. The relatively bad prognosis for stages I and II after radical surgery indicates early undetected metastases and the need for more aggressive adjunctive therapy. PMID- 2706136 TI - Chemotherapy in invasive carcinoma of the bladder. A review of phase II trials in Egypt. AB - Since 1976, a series of phase II studies with screening of various chemotherapeutic agents in invasive bladder cancer have been conducted at the National Cancer Institute, Cairo. Different drugs were screened, one by one, in groups of 20-25 patients with inoperable, metastatic, or recurrent carcinomas. Evaluation was done by clinical bimanual examination, radiography, sonography, cystoscopy, and urine cytology. In these trials bleomycin and doxorubicin were ineffective. Tenoposide, 5-fluorouracil, methotrexate, and cisplatin had minimal or moderate effect (response rates 4-16%). More pronounced effect was found for dibromodulcitol, cyclophosphamide, pentamethylmelamine, etoposide, hexamethylmelamine, ifosfamide, vindesine, vincristine, and epidoxorubicin (response rates 18-60%). Some complete responders remained in response for a period of 3-7 years. Drugs seemed to be more effective in metastatic than in local lesions. PMID- 2706138 TI - Radiostrontium-induced oncogenesis and the role of immunosuppression. I. Influence of 90Sr dose, adult thymectomy and antilymphocyteglobulin treatment on the development of neoplastic and preneoplastic lesions in the skeleton of CBA mice. AB - Ionizing irradiation by incorporated strontium-90 exerts two major effects: it induces tumours (mainly osteosarcomas and lymphoreticular tumours) and depresses the immune system. The interrelation between these functions, i.e. the significance of decreased immunological responsiveness in the oncogenic process, remains unclear. The influence of the 90Sr dose and the role of immune modulation on the tumour yield, were investigated in young adult CBA mice. The animals were exposed to different single doses of 90Sr and, in addition, some groups were subjected to long-term unspecific immune suppression by adult thymectomy (ATx) and/or prolonged antilymphocyteglobulin (ALG) treatment. The present paper (part I) reports on the effects of the treatments on bone tumour responses as reflected by incidence, multiplicity, latency time, histologic characteristics and growth behaviour. The histogenesis of osteosarcomas, as evidenced morphologically by preneoplastic and early neoplastic growth, is illustrated and discussed. The results demonstrate a positive dose-response relationship for osteosarcomas, in which the relative incidences of the various osteosarcoma subtypes were differentially affected. Thus, well-differentiated tumours were gradually replaced by less differentiated types as the dose decreased. A correlation was also observed between the incidence of osteosarcomas and that of assumed preneoplastic lesions in the same bones and sites. Immune suppression by ATx and/or ALG did not distinctly alter the neoplastic or preneoplastic responses at any dose-level of 90Sr. PMID- 2706139 TI - Interactive morphometry: the influence of magnification. AB - The influence of magnification on light microscopic morphometry was studied. Morphometry was performed on 34 hepatocytes by using a digitizer plate with micrographs of the nuclei, and with digitized image of the nuclei on a separate monitor. Intraobserver variation was smallest at objective magnifications of 40 and 100 X (CV of form factor, maximum diameter and nuclear perimeter under 1%, of nuclear area under 2%, when measured from the monitor). The results show that more reproducible measurements are possible with higher magnifications. The authors recommend objective magnifications of 40 and 100 X for morphometric measurements on nuclei. The results also suggest that morphometric grading should apply an intermediate third grade in dichotomous grading scales. PMID- 2706137 TI - The spatial distribution of parenterally administered monoclonal antibodies against CEA in a human colorectal tumour xenograft. AB - A recently developed experimental model consisting of athymic rats carrying human colonic tumours from the cell line LS 174 T in both hind legs was used. 125I labelled anti-carcinoembryonic (anti-CEA) monoclonal antibodies were injected either intra-arterially after a bolus injection of mannitol, or intra peritoneally with or without mannitol. On the fourth day the rats were killed and pieces from the tumours and various organs were measured in a well scintillation counter. Tumour pieces were then submitted to autoradiography and immunohistochemistry for examination of the antibody distribution at the cellular level. In all examined tumours injected with anti-CEA antibodies, most of the antibodies were located in the periphery close to fibrovascular septa. It appears, in addition to the specificity of the antibody for the CEA, that the tumour vascular permeability and anatomy are of utmost importance for tumour targeting in this experimental model with the particular antibody used. PMID- 2706140 TI - Secondary amyloidosis of the testis: an electron microscopic and histochemical study. AB - A histochemical and ultrastructural study of the testes, epididymides and spermatic cords from 6 adult men with amyloidosis secondary to several diseases is described. Amyloid fibrils, consisting mainly of AA protein, were deposited in the walls of blood vessels of the testis, epididymis and spermatic cord, as well as in the tunica propria of the seminiferous tubules. The seminiferous epithelium showed slight hypospermatogenesis. Many Leydig cells exhibited unstained 'bar' or 'arc'-shaped cytoplasmic areas similar to the cholesterol deposits of Leydig cells in adrenoleukodystrophy. PMID- 2706141 TI - Lectin histochemistry of colonic adenomas. AB - 34 adenomas of the colon and adjacent flat mucosa were reexamined by morphological, histochemical and immunohistochemical means. Adenomas were grouped according to the degree of epithelial cell atypia: group 1 (dysplastic adenomas) showing mild and moderate dysplasia and group 2 (cancerous adenoma) with severe dysplasia and carcinoma. Morphological and secretive changes (hyperplasia with hypersialomucin secretion), considered typical of 'transitional mucosa', were constantly found in the adjacent and stalk mucosa. A panel of six lectins were tested using PAP and ABC system methods to compare amount and cytoplasmic localization of labelling sites with the morphological changes such as hyperplasia, dysplasia and carcinoma. All the tested lectins were reactive in up to 90% of adenomas as well as in adjacent mucosa. Positivity was unrelated to the severity of dysplasia and no preferential localization of labelled sites was shown in the adenoma groups. However, cytoplasmic distribution of reactivity was quite different in hyperplastic epithelium compared to dysplastic ones. PMID- 2706142 TI - Mixed lipomas of the uterus and the broad ligament. PMID- 2706143 TI - Suppression of atherogenesis by nifedipine in the cholesterol-fed rhesus monkey. AB - Diet-induced atherosclerosis in rhesus monkeys was suppressed in the carotid arteries and thoracic aorta by the calcium antagonist nifedipine given orally for a period of 1 year at a dose of 10 mg b.i.d. The extent of atherosclerosis was determined by quantitative micromorphometric studies. No change in serum blood cholesterol or biochemical composition of the major vessels was detected, but the intimal area and thickness of the atherosclerotic plaques in the carotid arteries of the nifedipine group were markedly less than those found with the control group (p less than 0.05). However, no statistically significant differences were seen in the degree of atherosclerotic involvement of the other major arterial vessels. Although the mechanism is not clear, nifedipine may be useful in the treatment of carotid artery disease. PMID- 2706144 TI - Dentists and ethnic minority communities. AB - It is estimated that 4.5% of the UK population originates from the New Commonwealth and Pakistan (NCWP). However, the distribution is not equal. For instance, two-thirds of all young children in the inner wards of Birmingham, and one-third of those in inner London, have parents who were born in the NCWP. Uptake of dental services is reported to be low in some inner city areas. There, as elsewhere, dental care needs to be accessible, acceptable and appropriate. But how are these objectives best achieved? PMID- 2706145 TI - 'The great debate'. PMID- 2706146 TI - 'Patient safety in general anaesthesia'. PMID- 2706147 TI - 'Representation for all?'. PMID- 2706148 TI - 'Specialisation in dentistry'. PMID- 2706150 TI - 'Kawasaki syndrome'. PMID- 2706149 TI - Survey of dental health initiatives among ethnic minorities. PMID- 2706151 TI - 'The control of cross-infection in dentistry'. PMID- 2706152 TI - An extraordinarily large asymptomatic submandibular salivary calculus. PMID- 2706153 TI - Deteriorating conditions for ancillary workers. PMID- 2706154 TI - The elimination of cross-infection in dental practice--a 5-year follow-up. AB - A survey in 1983 showed that 16% of general dental practitioners in the Lothian Region wore operating gloves when treating patients; 9% wore them continually and 7% only when performing dento-alveolar surgery. Twelve per cent replied that they would not consider wearing operating gloves and 72% stated that they might consider their use. A similar survey has now been completed 5 years later, involving practitioners in the Lothian and Borders regions. This shows that 163 (97%) of the 168 practitioners who replied now wear operating gloves; 51% restrict their use to the treatment of 'potentially infectious patients' and dento-alveolar surgery; 46% wear them continually. The main objections given to wearing gloves continually were loss of tactile sensation (67%) and cost (13%). The most difficult task to perform wearing gloves was root canal therapy (56%). The majority of practitioners (84%) believed that gloves reduced the dangers of cross-infection. The methods stated to be available for instrument sterilisation in 99.5% of practices were acceptable. This paper proposes that to eliminate cross-infection and protect the dental practitioner, operating gloves should be worn when treating all patients. PMID- 2706155 TI - Significance tests. Part 2. AB - The comparison of two means obtained from either small or large samples and the comparison of two proportions is described, together with the use of logarithmic transformation of quantitative data in order to stabilise variance. PMID- 2706156 TI - Getting back to dental practice. AB - The results from the survey 'The Provision of Dental Care by Women Dentists in England and Wales in 1985' indicated that the lack of a specific retraining course was a major barrier in preventing women who have left dental practice from returning to work. The need for a course also applied to men and women who have ceased to work because of ill-health. PMID- 2706157 TI - Life as a GDP--down under. AB - At the end of 1987 a colleague and friend from New Zealand offered me the opportunity to work in a general dental practice in his beautiful country for six months. It seemed an ideal way to combine some travelling 'down under' with living and working in Auckland thus affording the chance to get to know the country and its people better. PMID- 2706158 TI - My year in vocational training: highlights and horrors. AB - I am now drawing towards the end of my year in Eastbourne as a vocational trainee on the Brighton Scheme. Eastbourne is a busy seaside resort on the south coast. Rather a lot of 'grannies' reside there; but contrary to popular belief I do not spend all day, every day making and repairing dentures! The work is varied and interesting and I am spending a happy year consolidating my knowledge and becoming more confident at practising dentistry. Here are a few of the best and worst parts of the year. PMID- 2706159 TI - The role of closed circuit television in the teaching of operative dentistry. AB - Closed circuit television has been used in the Department of Operative Dental Surgery of the University of Newcastle-upon-Tyne since 1966. The medium has played an increasingly important role in the teaching of technique courses, especially after 1978 when the large 80-place teaching laboratory of the newly built Dental School was commissioned. PMID- 2706161 TI - 'The great debate'. PMID- 2706160 TI - Future patterns of dental care--manpower implications for industrialised countries. AB - After a century of increasing dental caries levels there have been dramatic reductions in dental caries and periodontal disease in the past 15 years in most industrialised countries. PMID- 2706162 TI - 'Patients charges and the use of dental services: some evidence'. PMID- 2706163 TI - 'Keeping up-to-date with tooth notation'. PMID- 2706164 TI - 'Dentists causing harm with X-rays'. PMID- 2706165 TI - A photographically recorded assessment of enamel hypoplasia in fluoridated and non-fluoridated areas in England. AB - This study assesses the effect on enamel formation of the use of fluoride toothpaste in a fluoridated area. The prevalence of enamel hypoplasia in 251 9-10 year-old children born and raised in a fluoridated city (Birmingham) was compared with that in 319 similar children born and raised in a non-fluoridated city (Leeds). Observer bias was eliminated by the use of a new photographic technique, enabling colour slides of both groups to be assessed together in a random order. Scoring was done using both the Jackson-Al-Alousi (J-A) index, which is designed to record nonspecific hypoplasias and the Tooth Surface Index of Fluorosis (TSIF). Both were compared to the results from conventional clinical recording using the J-A index. The results showed that the photographic method was highly reproducible and more sensitive than conventional recording and showed a higher level of mild fluorosis in the fluoridated area. However, no evidence of an increase in the higher grades of fluorosis was found. It is concluded that the use of fluoride toothpaste by young children in fluoridated areas is unlikely to produce aesthetically unacceptable levels of enamel fluorosis. PMID- 2706166 TI - Management of anxiety in dental practice in the UK. AB - A postal questionnaire was sent to a random sample of dentists in the United Kingdom. The response rate was 59.9%. Anxiety was reported as a significant problem by 66% of dentists and information was gained regarding the techniques used to manage this anxiety. 'Patient management' and general anaesthesia were the techniques most commonly employed. The frequency of usage of intravenous and inhalational sedation varied according to the age of the patient. Only 55.3% of dentists in general practice had any training in a sedative technique. PMID- 2706167 TI - An approach to the treatment of malocclusion caused by bone expanding lesions. AB - A case is described in which fixed orthodontic appliances were used to correct a malocclusion complicated by the local effects of a dentigerous cyst. PMID- 2706168 TI - Significance tests. Part 3. AB - A discussion of basic parametric statistical tests of sample proportions and frequencies is concluded with a description of the chi-squared test. The treatment of distribution-free or non-parametric data is then illustrated with examples of the sign test and Wilcoxon's two-sample rank test. PMID- 2706169 TI - Vocational training. My year as a guinea pig. AB - In the twilight of the first year of the new Vocational Training Scheme I am reflecting on my metamorphosis from a naive dental student to vocational trainee and ultimately (hopefully) to competent clinician. PMID- 2706170 TI - A survey of the use of micro-computers in general dental practice in Scotland. AB - The aim of the study was to determine current and future use of micro-computers in general dental practice. A piloted questionnaire was sent to 736 general dental practitioners in Scotland, with the intention of contacting one principal from every dental practice known to the Scottish Dental Estimates Board. A total of 390 (53%) of the questionnaires were returned. If it is assumed that those dentists who did not reply have a low interest in computers then the results of the survey are not likely to lead to an overestimation of trends. Six per cent of the 736 practices that were contacted are using a micro-computer, mainly for practice management and particularly for word processing. In addition, 25% of the replies showed some interest in introducing micro-computers in the future. Thirty four per cent of current users and 19% of prospective users indicated a high degree of interest in direct data transmission between the practice and the Scottish Dental Estimates Board. PMID- 2706171 TI - A perspective of dental education in the twenty-first century. AB - With the beginning of the twenty-first century only twelve years away, it is clearly not too early for dental educators to be planning for it. If one compares the practice of dentistry and the nature of dental education in 1888 with that of 1988, and then tries to project what they will be like in the year 2088, we have a difficult task indeed. As Alvin Toffler has pointed out in his book Future Shock, we are in an ever escalating period of change. Dentistry and dental education will change much more in the next one hundred years than they have in the last one hundred years. PMID- 2706172 TI - Predicting the spread of spinal anaesthesia. PMID- 2706173 TI - Spread of spinal anaesthesia with plain 0.5% bupivacaine: influence of the vertebral interspace used for injection. AB - Three millilitre of plain 0.5% bupivacaine was injected intrathecally at two different levels in two groups of 20 patients. Injection at the L2/3 space produced a significantly higher spread of analgesia (mean T7 (SD 3.9)) than injection at L4/5 (T11(1.8)). The range of the cephalad spread of the block was less in the L4/5 group (P less than 0.001 at 60 min). The spread of anaesthesia continued beyond 30 min in both groups. In all patients anaesthesia sufficient for surgery of the knee and the foot was achieved. One patient had a final block level of T1 after injection at L2/3, accompanied by transient arterial hypotension. PMID- 2706174 TI - Lung function in the supine and lateral decubitus positions in anaesthetized infants and children. AB - We have measured dynamic lung compliance or static lung thorax compliance, functional residual capacity (FRC), and two indices of pulmonary gas mixing (pulmonary clearance delay (PCD) and single breath alveolar mixing efficiency (SBAME)) in 25 children in the supine and lateral decubitus position during nitrous oxide-halothane anaesthesia. Fifteen children (5 month-8 yr) breathed spontaneously and 10 (4 month-9 yr) underwent mechanical ventilation. Tidal volume and rate of ventilation were, respectively, 3.5-6.6 ml kg-1 and 22-46 b.p.m. in spontaneously breathing supine children, and 8.3-15 ml kg-1 and 20-30 b.p.m. in mechanically ventilated supine children, and did not differ significantly in the lateral position. There was no significant change in compliance when the child was turned to the lateral position, but FRC increased from 22 (SD7) to 25 (8) ml kg-1 (P less than 0.01) in the spontaneously breathing group and from 19 (6) to 24 (8) ml kg-1 (P less than 0.01) in the other group. In spontaneously breathing children, PCD and SBAME indicated a somewhat impaired pulmonary gas mixing (P less than 0.05) after the child had been turned to the lateral position, but no change occurred in the other group. These findings suggest that the distribution of ventilation in anaesthetized children in the lateral position is similar to that reported previously in anaesthetized adults. PMID- 2706175 TI - Influence of preoperative gastric aspiration on the volume and pH of gastric contents in obstetric patients undergoing caesarean section. AB - Aspiration of gastric contents, the most common anaesthetic cause of maternal mortality, is decreased by emptying of the stomach and the use of antacids and H2 receptor antagonists. One hundred and eighty-three mothers presenting for emergency Cesarean section were allocated to three groups. In group 1, the stomach was emptied before operation via an orogastric tube and thereafter 30 ml of sodium citrate 0.3 mol litre-1 was ingested 5-15 min before induction of general anaesthesia (our usual practice). Group 2 received only 30 ml of sodium citrate 0.3 mol litre-1. Group 3 received ranitidine 50 mg i.v. before operation, 5-15 min before induction of anaesthesia, in addition to sodium citrate. Our results show that preoperative gastric emptying with an orogastric tube followed by sodium citrate is preferred if anaesthesia should be induced 15-20 min later. However, the use of ranitidine and sodium citrate is preferred at subsequent times. Although our data show that preoperative gastric emptying decreased the mean intragastric volumes before Caesarean section, the number of patients at risk of acid aspiration was not reduced. In view of these findings and the unpleasantness of orogastric intubation, we suggest that routine preoperative gastric aspiration via an orogastric tube is not justified, although the manoeuvre should still be used following a recent meal. PMID- 2706176 TI - Effect of halothane, enflurane and isoflurane on body temperature during and after surgery. AB - The superficial and deep body temperatures of 40 healthy females undergoing total abdominal hysterectomy were measured during surgery and for 4 h afterwards. The patients were allocated randomly to one of five groups and anaesthetized to produce an end-tidal concentration of 1% halothane, 1% enflurane, 2% enflurane, 1% isoflurane or 2% isoflurane. The patients received also 70% nitrous oxide in oxygen and neuromuscular blockade. The theatre temperature was maintained at 22.0 degrees C. There were significant body temperature changes during operation in all groups. The mean (SD) decrease in core temperature over 85 min was approximately 1.1 (0.3) degrees C in the 1% halothane, 2% enflurane and 2% isoflurane groups, and 0.6 (0.4) degrees C in the 1% enflurane and 1% isoflurane groups (P less than 0.05). During the recovery period the 1% halothane, 2% enflurane and 2% isoflurane groups took 2 h to rewarm to preoperative temperatures, and the rate of rewarming during this time was similar for all groups. PMID- 2706177 TI - Serial peak expiratory flow rates in mothers during caesarean section under extradural anaesthesia. AB - Peak expiratory flow rate (PEFR) was measured in 19 mothers during elective Caesarean section under unsupplemented extradural anaesthesia. In 18 mothers, serial measurements of peak expiratory flow rate indicated adequate expiratory reserve and residual abdominal muscle power consistent with an effective cough. In one mother, with severe respiratory disease, PEFR decreased to a value indicative of inadequate cough. Data for one other mother who came for emergency Caesarean section after 4 h of an extradural infusion also indicated an inability to cough. PMID- 2706178 TI - Short term effect of nitrous oxide on methionine and S-adenosyl methionine concentrations. AB - Concentrations of methionine and S-adenosyl methionine (SAM) have been measured in various tissues of rats exposed to 50% nitrous oxide for periods up to 80 min, a time by which there is detectable interference with thymidine synthesis in bone marrow. There were no significant changes of either SAM or methionine in plasma, whole blood or brain. Hepatic SAM was unchanged, but there was a highly significant reduction in hepatic methionine, to 62% of control, after 80 min exposure to nitrous oxide. PMID- 2706179 TI - Solubility of freon-22 in blood and lung tissue. AB - Despite the frequent use of freon-22 (e.g. to measure pulmonary blood flow), there is no agreement on its solubility in water or body fluids. The values in the literature vary, often quoted without reference to measurement or identification as Ostwald or Bunsen coefficients. We used a Scholander apparatus and determined the Bunsen solubility coefficient (mlgas.(mlfluid.atmosphere)-1) at 37 degrees C as: 0.476 in water; 0.673 in human whole blood; 0.479 in human plasma; 0.662 in canine whole blood; 0.437 in canine plasma; and 1.077 in homogenized canine lung tissue. As pure freon was used, these solubilities may not be applicable if freon-22 does not obey Henry's law. In man, the Ostwald solubility coefficient is calculated as 0.76 ml/ml whole blood at BTPS. These results provide information for further studies involving freon-22, and clear the confusion which has arisen from poorly defined solubility coefficients. PMID- 2706180 TI - Pretreatment with paracetamol inhibits metabolism of enflurane in rats. AB - We studied the interaction between paracetamol (acetaminophen U.S.P.) and enflurane. Sixteen rats were assigned to four groups (n = 4) to receive: paracetamol 7.5 mg/100 g body weight; paracetamol plus 1% enflurane; 1% enflurane alone, or no treatment (controls). Animals were killed 6 h later. A second series of 16 were treated identically, but were killed after 24 h. Measurements were made of fluoride concentrations in serum, liver and urine (indicators of biotransformation of enflurane), paracetamol concentrations in urine, pathological changes in liver samples, and concentrations of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum. Pretreatment with paracetamol significantly decreased urinary fluoride at 6 and 24 h after exposure to enflurane, but decreased fluoride concentrations in serum and liver only at 6 h after exposure to enflurane. Paracetamol concentrations in urine did not change after exposure to enflurane. Exposure to paracetamol alone increased AST and ALT. At 24 h after exposure to enflurane, serum concentrations of enzymes in rats pretreated with paracetamol were similar to those of control rats. Pretreatment with paracetamol may therefore inhibit metabolism of enflurane. Although no hepatic damage was observed, the increased in AST and ALT suggested subclinical liver damage in rats given only paracetamol. PMID- 2706181 TI - Anaesthetic management for caesarean section in a patient with uncorrected truncus arteriosus. AB - We describe the successful management of a 25-yr-old primigravida with uncorrected truncus arteriosus, requiring an urgent Caesarean section for delivery of a live infant and we discuss the rationale of using the chosen drug combination and the importance of adequate monitoring in selecting an anaesthetic technique based on the pathophysiology of the congenital cardiac lesion. PMID- 2706182 TI - Comparison of pulse oximeters: effects of vasoconstriction and venous engorgement. AB - The effects of cold-induced vasoconstriction and venous occlusion on the detection of induced hypoxaemia by four pulse oximeters were examined in 10 volunteers. In three further subjects vasoconstriction was maintained until at least one instrument failed to detect the induced hypoxaemia. Time taken to detect hypoxaemia was increased for all instruments to between two and three times the instrument's own control value for both vasoconstriction and venous engorgement (P less than 0.01). There was highly significant variation in detected minimum saturation between the instruments (P less than 0.001). One instrument failed to detect the full extent of desaturation under the experimental conditions and was more likely to fail completely to detect desaturation than the other test instruments when influenced by vasoconstriction (P less than 0.05). Significant impairment in the performance of all the instruments tested occurred in the presence of normal pulse signals. The duration of detected reductions in oxygen saturation was not significantly affected. PMID- 2706183 TI - A new microprocessor-controlled anaesthetic machine. AB - This paper describes the development of a microprocessor controlled anaesthetic machine comprising an integrated anaesthetic apparatus and monitoring system. Following prolonged reliability trials in the laboratory, changes have been made to major components which were described in earlier publications. PMID- 2706184 TI - Resistance to airflow in anaesthetic breathing systems. AB - We have examined, under reproducible conditions, the resistance to airflow of complete anaesthetic breathing systems (Magill, Coaxial Lack, Parallel Lack and Bain systems) and components of these systems. All systems had resistances within the recommended ranges at all flows likely to be experienced in normal clinical practice. The Magill system had the lowest resistance under all conditions. It is concluded that comparisons should be made only between complete breathing systems. PMID- 2706185 TI - Adverse reactions to atracurium. PMID- 2706187 TI - Predicting difficult intubation. PMID- 2706186 TI - Suxamethonium and malignant hyperthermia. PMID- 2706188 TI - Pharmacokinetic evaluation in man of terbutaline given as separate enantiomers and as the racemate. AB - 1. The pharmacokinetics of the two enantiomers of terbutaline, (+)T and (-)T, and the racemate (+/-)T, have been evaluated after single intravenous and oral dosage to six healthy volunteers. 2. The mean systemic clearance, CL, was 0.19 and 0.13 l h-1 kg-1 for (+)T and (-)T, respectively. This difference was statistically significant. The mean clearance of (+/-)T was 0.20 l h-1 kg-1. Volumes of distribution were similar (1.9 l kg-1) after the three intravenous administrations. The differences in CL were reflected in values of the elimination half-life and MRT. 3. The difference in CL of the isomers could be explained by a corresponding difference in their renal clearance, CLR. Competition for stereoselective active reabsorption in the tubule might explain why (+)T seemed to enhance the CLR of (-)T when the drug was given as the racemate. 4. Oral bioavailability, calculated from plasma data, of (+)T was 7.5% and that of (-)T was 14.8%. This difference was statistically significant and was mainly due to a difference in absorption of (+)T and (-)T, but also to a difference in their subsequent first-pass metabolism. The bioavailability of (+/ )T was similar to that of (-)T. 5. (-)T appears to govern the absorption properties of the racemate, while (+)T determines its elimination behaviour. Systemic metabolism of the two enantiomers was similar and, therefore, a greater first-pass metabolism of (+)T would reflect a higher capacity of the gut wall to metabolise this isomer. PMID- 2706189 TI - Pharmacokinetics of felodipine in patients with impaired renal function. AB - 1. The pharmacokinetics of felodipine and its effects on blood pressure and heart rate were studied in eight male patients aged between 28 and 57 years with a glomerular filtration rate, GFR, between 8 and 68 ml min-1, following single i.v. and oral administration. 2. Clearance, Cmax, AUC, Vss and V, of felodipine were unaffected by the renal disease. The metabolite excretion (14C-labelled) was slower than in healthy subjects. Initial renal clearance of these metabolites correlated with individual GFR values. The total amount of the dose excreted in the urine was also decreased. PMID- 2706190 TI - Rate-controlled rectal absorption enhancement of cefoxitin by co-administration of sodium salicylate or sodium octanoate in healthy volunteers. AB - 1. The effects of sodium octanoate and sodium salicylate on the rectal absorption of cefoxitin were investigated in healthy volunteers. Drug solutions were given either as a bolus or as a zero-order infusion. 2. On rectal infusion sodium octanoate and sodium salicylate both enhanced mean cefoxitin bioavailability (+/- s.d.) from 5.0 +/- 1.2% to 9.1 +/- 1.3% and 9.2 +/- 1.5%, respectively. After rectal bolus delivery octanoate increased the mean cefoxitin bioavailability from 7 +/- 3% to 17 +/- 3%, whereas bolus salicylate did not produce a statistically significant effect. All formulations were well tolerated by the volunteers. 3. It is concluded that both octanoate and salicylate are capable of enhancing rectal cefoxitin absorption in man; rate of delivery seems to be an important factor. PMID- 2706191 TI - Effect of oral activated charcoal on quinine elimination. AB - The effect of repeated dose oral activated charcoal on quinine elimination has been studied following a therapeutic (600 mg) dose of quinine bisulphate to seven normal volunteers. Activated charcoal lowered quinine half-life from 8.23 +/- 0.57 s.d. h to 4.55 +/- 0.15 s.d. h (P less than 0.001) and increased its oral clearance by 56%. Activated charcoal may have a role in the management of quinine poisoning. PMID- 2706192 TI - Treatment of quinine overdosage with repeated oral charcoal. AB - In five symptomatic patients with acute quinine poisoning the mean admission plasma concentration was 11.1 mg l-1. After treatment with repeated oral charcoal 50 g 4 hourly, plasma quinine concentrations fell rapidly with a mean half-life of 8.1 +/- 1.1 h (s.d.) compared with more than 24 h in a previous report in similarly poisoned patients. The visual impairment which was expected in a patient with cardiotoxicity and a plasma quinine concentration of 12.6 mg l-1 did not occur, but late treatment with charcoal was of no obvious benefit in another patient who was already blind. Repeated oral charcoal has been shown to increase the rate of elimination of a therapeutic dose of quinine in healthy volunteers. It appears to be the only practical means of enhancing the removal of this drug after overdosage and should reduce the risk of potentially disastrous complications. PMID- 2706193 TI - The will in psychoanalytic theory and practice. AB - In psychoanalytic treatment insight does not necessarily lead to change, because psychoanalysis has not yet integrated into its theory and technique the full significance of two determinants: (1) the resistances arising from the patient's environment, and (2) the role played by the patient's will in his/her analysis. This paper is focused on the second determinant. Freud's elucidation of repression and other defences challenged the assumption that the will operated in an uncomplicated, straightforward manner. When, however, neurotic fears, secondary gain, or guilt underlying the inhibited or misdirected will are thoroughly analysed, patients are enabled to strive for their long-range aims, as clarified during the course of their analysis. Psychoanalytic theory has not recognized the will for two reasons. (1) Its theory is committed to determinism, which does not characterize its practice. Psychoanalysis does not predict outcome as required by philosophical determinism, but traces it backwards to find that it is meaningful, and not arbitrary or purposeless. (2) It attributes 'willing' to the ego, along with other multifarious functions, which confounds the development and operation of distinct functions, and distracts attention from the phenomenological investigation of each separate function. PMID- 2706194 TI - Object relations, Holocaust survival and family therapy. AB - The authors focus on a family therapy, construing the process of change within an object-relations theory integrated with psychodynamic thoughts about Holocaust survivors. Specifically, the authors concentrate on the mutual influence of parents and their children as figures for a two-way identification, and on the potential constructive role the offspring may have in promoting change, in this case reparative change, in the family. A clinical illustration of such a family treated by one of the authors illustrates this aspect. The disturbed intra familial relationships in the history of each parent led to the development of pathological internalized object relations. This was reinforced by traumatic life events, especially with the father who was a Holocaust survivor. Serious problems developed in marital life and in relation with the children. Couple therapy alone did not seem successful. The couple who lived in a sado-masochistic collusion for years could not change. Only after including the children in the therapy did the family's relations improve. Confrontation with some positive aspects of the family which the children represent may have been a factor in this change. The couple were able to resynthesize and integrate positive aspects of themselves as represented and reinforced by their children. It seems that reparation through the children helped modify all relations in the family. PMID- 2706195 TI - A content analysis of thoughts and emotions elicited from depressed patients during cognitive therapy. AB - A sample of 200 thoughts obtained from 50 depressed patients at the beginning of a course of cognitive therapy were analysed within the context of Beck's cognitive theory of depression. The results indicated that, of the three elements of the negative cognitive triad, negative view of self and of the world occurred more frequently than negative view of the future. Correspondingly, the principal themes referred to self-deprecation and a hostile world, with hopelessness occurring less frequently; inter- and intra-personal situations were equally represented. Anxious mood was reported as often as depressed mood with anger, directed inwards or outwards, being less frequent. Two raters were able to label the five logical errors listed by Beck reliably, although there was a certain degree of overlap; arbitrary inferences were the most frequent and personalization the least frequent. Emotions, themes and errors were not indiscriminately related; anger was predominantly associated with themes of hostile world and 'shoulds'; 'selective abstraction' was predominantly associated with depression and 'arbitrary inference' with anxiety; 'selective abstraction' was predominantly associated with 'shoulds' and 'arbitrary inference' with 'illness' themes. The conclusion was that Beck's early analysis of depressed thinking is valid cross-culturally and across time. PMID- 2706196 TI - An evaluation of personal construct therapy for the elderly. AB - Short-term personal construct therapy was implemented with a group of elderly people, and its effects on their psychological states evaluated using content analysis scales. The states of these elderly were compared with those of two groups, one of well-functioning elderly and the other a group of elderly who were matched with the psychotherapy group for age, sex and type of chronic illness. Neither control group had psychotherapy. When compared with the fully functioning group immediately after therapy, the psychotherapy group showed less anxiety and depression. When compared with the matched group on follow-up 12 weeks later, they showed less anxiety, depression and indirectly expressed anger, and more feelings of competence as well as other good feelings. PMID- 2706197 TI - Meta-analyses of the reliability of Type A behaviour measures. AB - The accuracy of assessments of Type A behaviour made using different methods is the focus of active debate. Presented here are preliminary meta-analyses regarding: (a) internal consistency, test-retest and parallel forms reliabilities of the most frequently used questionnaire (Jenkins Activity Survey); (b) inter rater and test-retest reliabilities of the most prospectively valid method (Friedman Structured Interview); and (c) correlations and percentage classification agreement between these measures. The findings generally suggest highly statistically significant yet moderate effect strengths for these various psychometric properties. PMID- 2706198 TI - The Type A behaviour pattern and self-evaluation. AB - This paper is concerned with how Type A and B subjects perceive themselves. Subjects first completed a unidimensional A type measure, then rated themselves and their ideal selves on various personality traits. As expected, Type A was associated with negative self-ratings and high actual-ideal self-discrepancy scores. However, it is argued that self-evaluation in negative terms by Type As is not necessarily synonymous with low self-esteem. Negative self-ratings may be an important factor in the aetiology and maintenance of the Type A behaviour pattern. PMID- 2706199 TI - Eating attitudes, sociodemographic factors and body shape evaluation in adolescence. AB - The Eating Attitudes Test (EAT) and another questionnaire aimed at sociodemographic and body shape information were administered to an adolescent population of 1554 students from Barcelona in the 12-19 age group. The highest scores on EAT were obtained by girls, older adolescents, overweight adolescents, adolescents practising restrictive diets, adolescents considering themselves obese and those wishing to modify their body size. The same characteristics were associated with EAT scores higher than 30 (the cut-off score, established by the authors of the questionnaire, above which the anorexic population is placed). Results are analysed in terms of sociocultural pressures on adolescents, particularly females, who are subjected to the 'culture of slenderness'. PMID- 2706200 TI - Sources of stress and dissatisfaction among nurses in four hospital environments. AB - A study was designed to examine the hypothesis that occupational stress in nurses is a function of how they perceive their work environment. Sixty-five nurses on four mixed-sex wards were interviewed using a nursing stress and work environment scale. Demographic data including age, sex and nursing status were also collected. 'Work overload' and the 'death and dying' of patients were identified as the major sources of stress for all the nurses. In general, although there was little difference between the specialized and non-specialized groups of nurses in the degree of stress experienced, the work environments were found to be dissimilar. The reported level of dissatisfaction with their work environment combined with certain demographic characteristics were found significantly to predict the degree of stress experienced. These findings have implications for the organization of the ward and for the skills taught to nurses by which stress may be managed or alleviated. PMID- 2706201 TI - The treatment of post-traumatic stress disorder. AB - This report reviews treatment studies of post-traumatic stress disorder (PTSD). Much of the literature is descriptive and concentrates on particular treatment modalities without attempting to integrate these different approaches into the wider body of knowledge about PTSD. No study has randomly assigned patients to experimental and control groups. The treatment of 56 patients with PTSD is described, highlighting issues which influence the choice of approach and focus of therapy. These issues are seldom mentioned in the PTSD literature and include the unusual difficulties involved in developing a therapeutic alliance, the role of non-specific elements and the treatment of coexistent psychiatric disorders which are frequently present. The need to consider separately the degree of disturbed attention and arousal, the nature of the traumatic preoccupation and the patient's social and occupational functioning are stressed. The lack of knowledge about the natural history of PTSD and the different effectiveness of treatments in the acute and chronic stages are other uncertainties about the treatment of PTSD. Consideration of these points has led to a series of recommendations for future studies of the treatment of PTSD. PMID- 2706202 TI - A note on early indicators of non-adherence to a cardiac rehabilitation programme. AB - Of 44 patients enrolled in a study to examine rehabilitation efficacy from myocardial infarction (MI), seven experimental subjects did not adhere to the rehabilitation programme. Serendipitous differences in early cortisol levels following admission for MI differentiated adherent from non-adherent subjects at six to 12 weeks post-MI. PMID- 2706203 TI - Cellular debris--a key to the aging macula. PMID- 2706204 TI - Scanning electron microscopic observation of Bruch's membrane with the osmium tetroxide treatment. AB - Scanning electron microscopic observation of Bruch's membrane was performed after removal of retinal pigment epithelium (RPE) with the osmium tetroxide treatment. Eight human eyes from subjects at various ages (from newborn to 77 years old) were examined in order to investigate aging changes in Bruch's membrane. The collagen fibres of the inner collagenous zone in young eyes formed a tightly interwoven membrane, and the meshes were regular and fine. In old eyes the meshes were irregular and coarse, and deposits were observed. Deposits were embedded in the collagen fibres of the inner collagenous zone, or attached to the surface on the inner-collagenous-zone side of the basement membrane of RPE. PMID- 2706205 TI - Rhodopsin-induced experimental autoimmune uveoretinitis in monkeys. AB - We present the first evidence that purified rhodopsin can induce experimental autoimmune uveoretinitis (EAU) in monkeys. Injection of a highly purified lipid free rhodopsin preparation provokes severe chorioretinitis with concomitant anterior uveitis. The onset of disease is earlier, its frequency is higher, and the inflammation is considerably more severe than in EAU induced under similar conditions by opsin. The first inflammatory cells are observed in the ciliary body and pars plana. Within a few days the inflammation extends into the anterior chamber, choroid, and retina. Retinitis predominates in the central area, while chorioretinitis is observed in the periphery, both accompanied by damage to and elimination of the photoreceptor cells. The monkeys develop high cellular and humoral immune responses against rhodopsin and opsin. The cellular response maximum just precedes the onset of EAU. This may indicate that cellular immunity has an important role in the pathogenesis of rhodopsin-induced EAU. PMID- 2706206 TI - Allopurinol use and the risk of cataract formation. AB - Several reports have suggested an association between chronic allopurinol ingestion and cortical and subcapsular cataract formation. To examine this possibility we identified 51 allopurinol users and compared their lenses with those of 76 patients who did not use allopurinol. The existence of lens opacities and the level of visual acuity were assessed by review of medical records or by prospective ophthalmic examinations; in both phases of the study the examiners were blinded as to the patient's use or non-use of allopurinol. Three different outcomes were considered: formation of any cataract, formation of a posterior subcapsular cataract, and formation of a cataract contributing to a corrected visual acuity of 20/30 or worse. The risk ratio for the formation of any cataract was 1.3 (95% confidence interval: 0.8, 2.0), the risk ratio for the formation of a posterior subcapsular cataract was 0.9 (0.3, 2.0), and the risk ratio for the formation of a cataract contributing to a loss of visual acuity was 1.3 (0.6, 2.9). None of these risk ratios was changed appreciably after controlling for age, sex, hypertension, or diabetes. Thus, after a mean of 6.9 years of allopurinol use, we found no evidence to confirm that allopurinol users were at higher risk of acquiring cataracts. PMID- 2706207 TI - Pulsed neodymium-YAG laser trabeculotomy: energy requirements and replicability. AB - Short pulsed laser trabeculotomy has been shown to reduce intraocular pressure in patients with primary open angle glaucoma. This study seeks to determine the energy levels required to produce a fistula into the canal of Schlemm for four different Q-switched neodymium-YAG lasers. The laser was fired at fixed human trabecular meshwork specimens at a range of energy settings for each laser and the characteristics and replicability of the lesions produced were analysed. Energy levels between 3 and 5 mJ were sufficient to produce fistulae into the canal of Schlemm with an approximately 50% success rate for each instrument. PMID- 2706208 TI - Efficacy of Nd-YAG laser iridotomies in acute angle closure glaucoma. AB - Between September 1984 and April 1987 a total of 150 patients underwent Nd-YAG laser iridotomy procedures at the Bristol Eye Hospital. Forty of these patients (27%) were treated for acute angle closure glaucoma (AACG), and three of them (7%) suffered recurrent AACG. Sixteen patients who had been treated for AACG have been challenged by a pharmacological provocative test introduced by Mapstone, with a total of 23 eyes being tested. A negative result was obtained in all cases. Provocative testing is recommended to help identify those at risk of recurrent AACG. PMID- 2706209 TI - Primary trabeculectomy in congenital glaucoma. AB - The reported success rates in the treatment of congenital glaucoma with goniotomy, trabeculotomy, and trabeculectomy suggest that trabeculectomy should be performed if the other procedures fail. We propose that the decision to perform primary trabeculectomy in primary and secondary congenital glaucoma reduces the effect which the many variable findings in surgical anatomy may have on the outcome of other procedures. This is a retrospective study of the results of primary trabeculectomy in 21 consecutive eyes of 15 patients with congenital glaucoma. Eighteen of 13 patients' eyes were controlled after a single trabeculectomy and remained controlled after a mean follow-up of 3.9 years (range 1.5 to 6.7 years). The role of primary trabeculectomy in congenital glaucoma merits further consideration. PMID- 2706210 TI - Rat bite injury to the eyelids in a 3-month-old child. AB - A 3-month-old child received severe rat bit injuries to the face, including subtotal loss of upper and lower lids of one eye. The presentation and management are discussed. PMID- 2706211 TI - Orbital cellulitis: review of 23 cases from Saudi Arabia. AB - We studied a total of 23 patients with orbital cellulitis and/or orbital abscess over a period of four years in Saudi Arabia. The study showed a high rate of abscess formation (12/23) and surgical intervention (17/23). Twelve out of 23 patients were 18 or more years of age. Furthermore, 12 of 23 (52%) patients had blind eyes on admission and remained blind after treatment, and one patient died of cavernous sinus thrombosis. Only 7/23 (30%) had a predisposing cause of primary sinus disease. This study of orbital cellulitis in a developing country presents a variation in disease pattern from previous reports and suggests that delay in the initiation of antibiotic therapy may lead to serious complications which may be life threatening. The course and outcome of orbital cellulitis may vary, depending on the predisposing factor, time of onset, associated systemic disease, or delay in initiation of treatment. PMID- 2706212 TI - Necrosis of choroidal melanoma: in ciliary artery involvement with temporal arteritis. AB - A choroidal melanoma was clinically suspected in one eye of an 84-year-old farmer. At the time of the first examination the patient refused the studies necessary for a certain diagnosis as well as any treatment. Later, when the eye suddenly became blind and painful, it was enucleated. Pathological study revealed necrosis of all ocular contents, but the presence of a choroidal melanoma could still be verified histologically. The ciliary artery supplying the region of the melanoma was involved with giant cell arteritis. General examination of the patient gave support to a diagnosis of temporal arteritis, and steroid treatment resulted in general improvement. PMID- 2706213 TI - Computerised intraocular lens calculation: clinical results and predictability. AB - The predictability of a theoretical, computer-assisted IOL calculation method and of the Sanders-Retzlaff-Kraff (SRK) method was evaluated from pre- and postoperative biometry in 110 cataractous patients subjected to a routine IOL calculation. With the theoretical method and the preoperative data the refraction was on the average 0.72 D (SD 0.78) more myopic than expected, an error which could be corrected for by (1) substituting the assumed postoperative chamber depth by the actual mean value and (2) adding 0.16 mm to the preoperative axial length. With the postoperative data the error was 0.05 D (SD 0.78) (p greater than 0.05). By the SRK method the refraction was 0.15 D (SD 0.71) and 0.37 D (SD 0.69) more hyperopic than expected with the pre- and the postoperative data respectively. These offset errors could be corrected for in either case by adjusting the assumed A constant in the SRK formula. With appropriate empirical corrections for offset errors the theoretical and the SRK method were similar in accuracy, that is, about 82% of the predictions within +/- 1 D, 99% within +/- 2 D, and 100% within +/- 3 D error. The variation in postoperative refraction after computerised IOL calculation was about one-third of the variation previously seen after implantation of standard power IOL. PMID- 2706214 TI - Alterations of the anterior lens capsule associated with climatic keratopathy. AB - We describe changes in the anterior lens capsules of older people in Somalia, a country which is close to the equator and with large areas of sand, often highly reflective of sunlight. The capsule changes are confined to the central pupillary area. In order of apparently increasing severity they consist of a white opalescence ('frosting'), an elevation in front of the contour of the rest of the lens to form a plateau, and a 'bag' or herniation of the lens capsule through the pupil. Plateau and bagging taken together are strongly associated with climatic keratopathy (and by inference with reflected ultraviolet exposure), weakly associated with exfoliation syndrome, inversely related to the degree of cataract, and interfere severely with vision. PMID- 2706215 TI - An inexpensive method of indirect ophthalmoscopy. AB - Attention is drawn to the possibility of performing monocular indirect ophthalmoscopy with a pen torch and a condensing lens when facilities for binocular indirect ophthalmoscopy are not available. PMID- 2706216 TI - Necrotising fasciitis of the eyelids. PMID- 2706217 TI - Optic nerve involvement in methanol poisoning. PMID- 2706218 TI - Recommended dietary amounts for the United Kingdom. PMID- 2706219 TI - The Kilkenny Health Project: food and nutrient intakes in randomly selected healthy adults. AB - 1. Sixty healthy subjects aged 35-44 years (thirty men and thirty women) were randomly selected from electoral registers to participate in a dietary survey using the 7 d weighed-intake method during June-August 1985. 2. Energy intake (MJ/d) was 12.5 for men and 8.4 for women. Fat contributed 36.0 and 39.1% of the total energy intake of men and women respectively. When this was adjusted to exclude energy derived from alcoholic beverages, the corresponding values were 38.8 and 39.7% respectively. The major sources of dietary fat (%) were spreadable fats (28), meat (23), milk (12) and biscuits and cakes (11). 3. The subjects were divided into low- and high-fat groups both on the relative intake of fat (less than 35% or greater than 40% dietary energy from fat) and on the absolute intake of fat (greater than or less than 120 g fat/d). By either criterion, high-fat consumers had lower than average intakes of low-fat, high-carbohydrate foods such as potatoes, bread, fruit and table sugar, and higher intakes of milk, butter and confectionery products. Meat intake was higher among high-fat eaters only when a high-fat diet was defined as a percentage of energy. PMID- 2706220 TI - Assessment of adipose tissue distribution by computed axial tomography in obese women: association with body density and anthropometric measurements. AB - 1. Abdominal obesity is associated with numerous metabolic complications. Deep abdominal adipose tissue is critical in the association between the level of abdominal obesity and cardiovascular risk factors. 2. Adipose tissue localization was assessed by computed axial tomography (CAT), and its association with body density and anthropometric measurements was investigated in a sample of fifty-one obese women (percentage body fat 45.9 (SD 5.6)) aged 35.7 (SD 5.5) years. The CAT scans were performed at three levels: lower chest, abdomen and mid-thigh. 3. The total adipose tissue volume computed from these three scans was highly correlated with body fat mass (r 0.94, P less than 0.001). The proportion of deep abdominal fat as measured by the ratio of deep: total adipose tissue areas at the abdominal level was not significantly correlated with body fat mass, but it was moderately associated with the ratio of waist: hip circumferences (WHR) (r 0.49, P less than 0.001). The absolute amount of deep abdominal fat was, however, significantly correlated with body fat mass (r 0.72, P less than 0.001). 4. The subscapular (r 0.38) and the abdominal (r 0.38) skinfolds were the only two skinfolds that were significantly associated with the proportion of deep abdominal fat (P less than 0.01). These skinfolds were also those which showed the highest correlation with the absolute amount of deep abdominal fat (r 0.65, P less than 0.001, for both skinfolds). 5. A three-site CAT-scan procedure can be used for the estimation of body fat mass in premenopausal obese women. 6. In these obese women, there was no significant association between total adiposity and the proportion of deep adipose tissue at the abdominal level. 7. In premenopausal obese women, the absolute amount of deep abdominal fat can be predicted from anthropometric measurements with more accuracy than the relative amount of deep abdominal fat. PMID- 2706221 TI - The effect of lactation and other factors on post-partum changes in body-weight and triceps skinfold thickness. AB - 1. Mothers were followed from 1 month post-partum up to 12 months post-partum to measure changes in their body-weight and triceps skinfold thickness. 2. Overall there was a significant weight loss in the first few months but this levelled off by 7 months. 3. The triceps skinfold increased significantly up to 5 months post partum and then decreased. 4. These changes in body-weight and skinfold were not affected by the duration of lactation, smoking or the educational achievement of the mothers, but were influenced by the initial body mass index and the desire to lose weight. PMID- 2706222 TI - The effect of exercise and improved physical fitness on basal metabolic rate. AB - 1. The suggestion that there is a sustained enhancement in metabolic rate after exercise was investigated during the course of a study in which six normal-weight volunteers (three men, three women) took part in a 9-week training programme. Baseline values were assessed in a 3-5 week control period of minimal activity before training. At the end of the study the subjects were capable of running for 1 h/d, 5 d/week. 2. Throughout the entire study the subjects were maintained on a constant diet. Measurement of energy expenditure by the doubly-labelled water (2H2(18)O) method showed that the subjects had an energy imbalance of +3% in the control and -20% at the end of the training period. The subjects were in positive (1.1 (SE 0.2) g) nitrogen balance in the second week of the control, and in negative (-0.6 (SE 0.3) g) N balance in the last week of the exercise period. 3. Over the course of the study maximum oxygen consumption (VO2max) and high-density lipoprotein-cholesterol levels increased by 30%. Heart rate at rest and when performing a standard step test fell significantly. 4. Body composition was assessed weekly by 40K counting and skinfold thickness measurements, in addition to 2H2 dilution at the beginning and end of the study. Fat-free mass was apparently gained in the early phases of the study, but there was lack of agreement between the different methods of assessing body composition. Changes in body-weight were not significant. 5. Basal metabolic rate (BMR), overnight metabolic rate (OMR) and sleeping metabolic rate (SMR) were measured on three occasions: in the control period, and the beginning and end of the training periods. Average BMR in the control period was 5.91 (SE 0.39) MJ/24 h and was not changed with activity. There were no changes in OMR (5.71 (SE 0.27) MJ/24 h in the control) nor in SMR (5.18 (SE 0.27) MJ/24 h in the control), nor in BMR, OMR or SMR when expressed per kg body-weight, or per kg fat-free mass. 6. These results do not support the suggestions that there is a sustained increase in BMR following exercise that can usefully assist in weight-loss programmes. PMID- 2706223 TI - The use of heart rate monitoring in the estimation of energy expenditure: a validation study using indirect whole-body calorimetry. AB - 1. A modified heart rate (HR) method for predicting total energy expenditure (TEE) was cross-validated against whole-body calorimetry (CAL). Minute-by-minute HR was converted to energy expenditure (EE) using individual calibration curves when HR exceeded a pre-determined 'FLEX' value designed to discriminate periods of activity. ('FLEX' HR was defined as the mean of the highest HR during rest and the lowest HR during the lightest imposed exercise.) Sedentary EE (below FLEX) was calculated as the mean EE during lying down, sitting and standing at rest. Sleeping EE was calculated as basal metabolic rate (BMR) predicted from standard equations. 2. Calibration curves of oxygen consumption v. HR for different postures at rest and during exercise were obtained for twenty healthy subjects (eleven male, nine female); mean r 0.941 (SD 0.04). The mean FLEX HR for men and women were 86 (SD 10) and 96 (SD 6) beats/min respectively. 3. Simultaneous measurements of HR and EE were made during 21 h continuous CAL, which included 4 x 30 min imposed exercise (cycling, rowing, stepping, jogging). HR exceeded FLEX for a mean of 98 (SD 41) min. Mean TEE by CAL (TEE.CAL) was 8063 (SD 1445) kJ. 4. The HR method yielded a mean non-significant underestimate in TEE (TEE.HR) of 1.2 (SD 6.2)% (range -11.4 to +10.6%). Regression of TEE.HR (Y) v. TEE.CAL (X) yielded Y = 0.868 X + 927 kJ, r 0.943, SE of the estimate 458 kJ, n 20. 5. The satisfactory predictive power and low cost of the method makes it suitable for many field and epidemiological applications. PMID- 2706224 TI - Changes in energy expenditure during the menstrual cycle. AB - 1. Eight women were studied under metabolic-ward conditions while consuming a constant diet throughout a single menstrual cycle. Basal body temperature, salivary and urinary hormone concentrations were used in monitoring the cycle and designing the study so that whole-body calorimetry for 36 h was conducted at four phases of the cycle in relation to the time of ovulation. 2. The metabolic rate during sleep showed cyclical changes, being lowest in the late follicular phase and highest in the late luteal phase. The increase amounted to 6.1 (SD 2.7)%. Energy expenditure (24 h) also increased but the change was not statistically significant (P greater than 0.05). Exercise efficiency did not change during the cycle. 3. There were no significant changes in plasma thyroxine, 3,5,3' triiodothyronine or free 3,5,3'-triiodothyronine concentrations to explain the metabolic rate changes; nor did they relate to urinary luteinizing hormone, pregnanediol-3 alpha-glucuronide or oestrone-3-glucuronide excretion rates. No link with salivary cortisol or progesterone concentrations was observed, but there was a small inverse relation between the individual increase in sleeping metabolic rate and the subjects' falling ratio of urinary oestrone-3-glucuronide: pregnanediol-3 alpha-glucuronide. PMID- 2706225 TI - Thermogenic responses to graded doses of noradrenaline in undernourished Indian male subjects. AB - 1. Seventeen male subjects with an energy intake of 10.6 (SD 1.7) MJ/d and ten male undernourished labourers with an energy intake of 8.0 (SD 1.2) MJ/d were studied. The controls were subdivided into ten underweight controls with a body mass index (weight/height2; BMI) less than 18 (17.2 (SD 0.9)) and seven normal weight controls with a BMI greater than 20 (21.3 (SD 1.6)), while the undernourished labourers had a BMI less than 18 (16.8 (SD 1.2)). 2. Comparison of thermogenic responses to increasing doses of noradrenaline showed no overall significant inter-group differences when subjected to a nested analysis of variance (ANOVA). For the initial doses of 0.05 and 0.1 micrograms noradrenaline, significantly lower responses were seen in the undernourished subjects, while the highest dose showed comparable responses in all three groups. Thermogenic responses to the initial two doses, when corrected for fat-free mass (FFM) differences, were 40% lower in the undernourished group when compared with the underweight group with similar BMI and FFM values. However, this finding was not statistically significant. 3. The basal oxygen consumption of the undernourished group, expressed per unit FFM, was significantly higher than that of the controls. PMID- 2706226 TI - Liver function in protein-energy malnutrition measured by cinnamic acid tolerance and benzoic acid tolerance: effect of carnitine supplementation. AB - 1. Rats fed on a protein-depleted diet for 8 weeks were repleted for 5 weeks on high-protein (HP), high-protein + 20 g DL-carnitine/kg (HP + C), or low-protein + 20 g DL-carnitine/kg (LP + C) diets. At 4 and 8 weeks of depletion, and 1 and 5 weeks of repletion, rats from each treatment group were given a benzoic acid tolerance test (BATT) or a cinnamic acid tolerance test (CATT) as a measure of liver function. 2. BATT and CATT measured the molar percentage of a test dose (1 mmol/kg body-weight) of benzoic acid or cinnamic acid excreted in the urine as hippuric acid within 24 h. Liver weight, liver lipid levels, and carnitine concentration in plasma and liver were also measured following liver-function testing. 3. BATT and CATT were severely impaired in protein-depleted rats, but returned rapidly to control levels following protein refeeding. Correlations of BATT and CATT with liver lipid concentration were high (r -0.49 and -0.62 respectively), and both tests show promise as clinical tests for liver function in protein-energy malnutrition. 4. Carnitine supplementation was required to return liver carnitine concentration of protein-depleted rats to control levels during repletion, but was not associated with accelerated reduction in liver fat concentration in protein-repleted rats. PMID- 2706227 TI - Protein and energy relations in the broiler chicken. Chronic or acute effects of alternating protein or intermittent feeding regimens on broiler lipid metabolism. AB - 1. Broiler chickens growing from 7 to 28 d of age were given: (1) a 210 g protein/kg control diet for the entire experimental period, (2) an intermittent feeding regimen (210 g protein/kg diet for either 1 or 2 d followed by a 1 d fast), or (3) a daily change in the dietary protein level from 120 to 300 g/kg diet. Treatment variables examined were lipogenesis and glucose production in vitro, and circulating concentrations of insulin, triiodothyronine (T3) and thyroxine (T4) to determine the effects of chronic or acute dietary treatments. 2. Giving the 300 g protein/kg diet or withholding feed for 1 d decreased (P less than 0.05) lipogenesis in vitro compared with controls. 3. Giving the 120 g protein/kg diet or refeeding with a 210 g protein/kg diet for 1 or 2 d increased (P less than 0.05) lipogenesis in vitro compared with controls. Glucose production was affected in the same manner. 4. Fasting decreased (P less than 0.05) plasma insulin and T3 and increased T4. Both refeeding and a low-protein diet increased T3. Refeeding increased and a low-protein diet decreased insulin. 5. Chronic use (7-28 d of age) of either an alternating protein or intermittent feeding regimen caused greater responses compared with acute bouts (single cycle) of either of the regimens. PMID- 2706228 TI - Influence of dietary non-protein energy intake on whole-body protein turnover in chicks. AB - 1. Three experiments were conducted to investigate the influence of dietary energy intake on whole-body protein turnover in chicks. 2. In Expt 1 a semi purified diet with various dietary metabolizable energy (ME) concentrations, 10.9, 12.6, 14.2 and 15.9 kJ/g, was fed ad lib. to young chicks. Whole-body fractional synthesis rate (FSR) was increased with each increment in dietary ME level from 12.6 to 15.9 kJ/g, and whole-body fractional degradation rate (FDR) showed a similar, though less sensitive, trend to that of FSR. 3. In Expts 2 and 3, chicks were given graded ME intakes of 84, 126, 167, 209 or 293 kJ/d with a fixed intake of dietary protein. FSR was increased when the energy intake was raised from 84 to 167 kJ/d, and above this level it was almost constant. Similar to the trend obtained with ad lib. feeding, the response of FDR to changes in dietary energy intake was less sensitive than that of FSR. 4. Total heat production was increased when dietary energy intake was increased from 84 to 167 kJ/d, and there was no further increase at 209 kJ/d. In contrast, the contribution of protein synthesis to total heat production was not affected by varying the dietary energy intake. PMID- 2706229 TI - Changes in glutathione status and 3,5,3'-triiodothyronine action in livers of rats given cysteine-deficient diets. AB - 1. For a period of 32 d young rats were given a diet containing (g/kg) 220 casein, 120 casein + 1.93 L-cysteine (Cys), or 120 casein. 2. The formation of 3,5,3'-triiodothyronine (T3)-nuclear protein complexes was reduced in rats fed on the Cys-deficient diet. 3. Scatchard analysis showed that decreased formation of T3-nuclear protein complexes was due to a decreased affinity of T3 receptors; this decrease was induced, at least in part, by a reduced glutathione content. 4. In rats fed on the Cys-deficient diet there was an expected decrease in growth but an unexpected increase in the activities of glucose-6-phosphate dehydrogenase (EC 1.1.1.49) and malate dehydrogenase (oxaloacetate-decarboxylating) (NADP+) (EC 1.1.1.40). It is suggested that this increase is related to an increased oxidized glutathione:reduced glutathione ratio. PMID- 2706230 TI - Nitrogen metabolism and urinary excretion of purines in goat kids. AB - 1. In Expt 1 three male goat kids of the Swedish Landrace breed were bottle-fed on isoenergetic liquid diets composed of goat's milk alone or substituted with 200, 400, 600 and 800 ml of a nitrogen-free liquid diet/l. The goat kids were 3 weeks old at the start of the experiment and weighed on average 5.3 (SD 0.22) kg. The experiment lasted for 45 d divided into nine 5 d periods. The goat kids were kept individually in metabolism cages, and faeces and urine were collected daily. 2. In Expt 1 there was a significant (P less than 0.001) relation between N intake and N retention, with an estimated (extrapolation) basal N excretion of 211 mg N/kg metabolic live weight (W0.75). While the creatinine excretion remained fairly constant (19.9 mg/W0.75), there was a tendency for both the allantoin and uric acid excretions to change with N intakes. Hypoxanthine showed no consistent excretion pattern, and xanthine could not be detected. 3. In Expt 2 three male goat kids of the Swedish Landrace breed were used to study the effect of level of intake on N and purine metabolism. The first experimental period (period 1) started at 2 weeks of age (5.5 kg live weight) and the second experimental period (period 2) at 9 weeks of age (9.8 kg live weight). The goat kids were bottle-fed on goat milk at intended intakes of 400, 600, 800 and 1000 kJ gross energy/kg W0.75. Each treatment was given for 7 d with adaptation for 3 d and collections for 4 d. 4. In Expt 2 there were significant (P less than 0.001) increases in both live weight and N retention when level of intake was increased. With increasing N intakes both total N and urea-N excretions increased significantly (P less than 0.05). The proportions of urea-N and ammonia-N were fairly constant within periods, and were on average respectively 0.81 and 0.059 in period 1 and 0.84 and 0.068 in period 2. There was no significant effect of treatment on the urinary excretion of allantoin, hypoxanthine, xanthine and creatinine. In period 2 uric acid excretion was significantly (P less than 0.01) affected by the treatments. 5. From the presented findings it is concluded that the endogenous urinary excretion of purine derivatives in a young growing ruminant was only marginally affected by large variations in protein supply, and also by the level of intake of milk. PMID- 2706231 TI - Nitrite and nitrate levels in ileostomy effluent: effect of dietary change. AB - 1. Nitrite and nitrate levels were measured in samples from ileostomy bags or stomal samples of thirty-one ileostomists (twenty-two ulcerative colitis, nine Crohn's disease), 14-16 h after ingestion of a conventional meal or a meal containing a high content of nitrite and nitrate. 2. Ileostomy samples were decolourized with barium chloride, sodium sulphate and charcoal. Nitrite was determined spectrophotometrically by the Griess reaction and nitrate determined as nitrite after reduction with nitrate reductase (EC 1.7.99.4) in the presence of sodium formate. The mean percentage recovery from twenty-six spiked samples was 101.9 (SE 3.5)% for nitrite and 82.9 (SE 3.3)% for nitrate. 3. Ileostomy bag samples were obtained in twenty-nine cases of which ten had measurable nitrite (median 0, range 0-20.7 nmol/g) on a conventional meal compared with twenty-three cases (median 7.2, range 0-31.1 nmol/g) on the test meal (P less than 0.01). Nitrate levels were measurable in sixteen (median 6.7, range 0-48.2 nmol/g) after a conventional meal compared with twenty-one (median 20.5, range 0-53.2 nmol/g) after the test meal (P less than 0.01). 4. Stomal fresh-catch samples were obtained in twenty-four cases: combined nitrate and nitrite was higher in eighteen, lower in four and unchanged in two subjects after the test meal (P less than 0.05). 5. The type of foodstuff ingested can significantly alter measurable levels of nitrite-nitrate in the distal ileum and is one factor determining nitrite-nitrate input into the proximal colon. PMID- 2706232 TI - Profiles of 67Cu in blood, bile, urine and faeces from 67Cu-primed lambs: effect of 99Mo-labelled tetrathiomolybdate on the metabolism of recently stored tissue 67Cu. AB - 1. The relative importance of excretory routes in the removal of recently stored 67Cu following tetrathiomolybdate (TTM) administration was studied. Lambs fed on either 5 mg Cu/kg dry matter (DM) or 35 mg Cu/kg DM, were primed intravenously (iv) with 67Cu and challenged 27 h later with 99Mo-labelled TTM given either iv or intraduodenally (id). The profiles of 67Cu and 99Mo and of Cu and Mo in blood, bile, urine and faeces were measured. 2. Level of dietary Cu and route of administration of 99Mo-TTM affected the amplitude of blood, bile and urine profiles of 67Cu and stable Cu, but not the pattern of the responses observed. 3. The present study describes for the first time increased excretion of endogenous 67Cu through gastrointestinal secretions other than the bile due to TTM administration. 4. Administration of TTM resulted in the immediate release of 67Cu from storage compartments in the body into the blood circulation. Changes in stable Cu levels in blood, bile, urine and faeces, and gut and systemic effects were evident. Biliary and urinary Cu excretion due to TTM was rapid and maximal within 24 h of injection. 5. Administration of 67Cu iv resulted in the immediate excretion of 67Cu in bile in a pulsatile, constant pattern. A similar pattern of 67Cu excretion into bile in synchrony with that of 99Mo was observed after 99Mo labelled TTM administration. 6. The similar pattern of biliary 67Cu excretion observed after injection of 67Cu and after injection of 99Mo-labelled TTM 27 h later is discussed in relation to the times required to process the Cu through different hepatic pathways for excretion in bile. PMID- 2706233 TI - Profiles of 67Cu in blood, bile, urine and faeces from 67Cu-primed lambs: effect of 99Mo-labelled tetrathiomolybdate on the metabolism of 67Cu after long-term storage. AB - 1. The effectiveness of tetrathiomolybdate (TTM) in the removal of 67Cu from the long-term storage compartment in liver was studied. Lambs receiving 5 mg Cu/kg dry matter (DM) or 35 mg Cu/kg DM were primed intravenously (iv) with 67Cu and challenged 10 d later with 99Mo-labelled TTM given either iv or intraduodenally (id). The profiles of 67Cu and 99Mo and of Cu and of Mo with time were measured in blood, bile, urine and faeces. 2. The level of dietary Cu affected the amplitude of profiles of 67Cu and Cu in blood, bile and urine after administration of 99Mo-labelled TTM. TTM administration increased liver Cu removal and this was most marked in sheep given TTM iv. The liver Cu removal from the long-term storage Cu compartment was low and was not affected by the route of administration of TTM. Endogenous Cu excretion was higher in lambs given TTM id. 3. Excretion of 67Cu in bile through the transhepatocellular pathway after TTM administration appeared absent, while the transbiliary and hepatolysosomal pathways were operative. The potential reasons for this change are discussed. 4. TTM predominantly enhances the removal of Cu from the short-term storage compartment, but effects on the long-term storage compartment may still be of significance. PMID- 2706234 TI - Relations between passage rates of rumen fluid and particulate matter and foam production in rumen contents of cattle fed on different diets ad lib. AB - 1. A group of six cattle, three of which had a non-bloating history (group A) and had been ruminally cannulated for the previous 2 years, and three with a history of being bloat-prone (group B) and which had been ruminally cannulated only 3 months before the study, were fed ad lib. on chopped lucerne (Medicago sativa) hay, lucerne pellets, or a 100 g chopped hay and 900 g rolled barley grain/kg diet over three periods of 30 d each. Flow of rumen digesta, by reference to CoEDTA and chromium-mordanted fibres, and foam production from samples of rumen contents were measured. 2. Samples of rumen contents (50 ml) from group A produced foam heights of 150 and 60 mm, 2 and 4 h after feeding respectively, compared with 240 and 150 mm for group B (P less than 0.05). 3. The fractional passage rate of the 1-2 mm particles mordanted with Cr did not differ (P greater than 0.05) between groups. 4. The fractional outflow rates (FOR) for CoEDTA 0-2 h and 2-7 h after feed was offered were 0.205 and 0.160/h for group A and 0.093 and 0.086/h for group B respectively (P less than 0.05). 5. Rumen-fluid FOR 0-2 h and 2-7 h after provision of feed were significantly (P less than 0.05) inversely correlated (r -0.74 and -0.85 respectively) with the amount of foam produced from rumen contents at these times. PMID- 2706235 TI - Particle breakdown and rumen digestion of fresh ryegrass (Lolium perenne L.) and lucerne (Medicago sativa L.) fed to cows during a restricted feeding period. AB - 1. Five rumen-fistulated cows were given freshly cut ryegrass (Lolium perenne L.) and lucerne (Medicago sativa L.), on separate occasions, to compare rates of particle breakdown and aspects of rumen fermentation. 2. Cattle were required to consume their daily allowance (offered ad lib.) in two 2 h feeding periods daily. 3. During the first 2 h feeding period, dry matter (DM) intakes of ryegrass (4.75 kg) and lucerne (4.85 kg) were similar. Eating reduced 46% of ryegrass and 61% of lucerne to a size able to pass a 2 mm sieve (P less than 0.001). Rumen DM particles retained on the 2 and 4 mm sieves had a low probability of passage out of the rumen, and accounted for only 6% of faecal DM with both feeds. 4. Ryegrass was cleared from the rumen more slowly than lucerne. During eating, rumen DM particles which could not pass the 2 mm sieve increased from 323 to 511 g/kg for ryegrass and from 201 to 389 g/kg for lucerne. The rate of particle size reduction for lucerne stem was similar to that for ryegrass. 5. When lucerne was eaten the increases in rumen volatile fatty acid (VFA) and ammonia concentrations were much greater than for ryegrass (P less than 0.001). The proportions of plant chlorophyll released during eating were similar for both feeds (0.570 and 0.607), but 2 h after eating 22.3 g had been released from lucerne (79.1%) compared with 15.0 g from ryegrass (63.8%). The flux of water from the rumen to the omasum was similar for ryegrass (10.2 litres/h) and lucerne (12.7 litres/h) during eating, but declined to 6.0 litres/h after eating with the lucerne diet. PMID- 2706236 TI - End-label fingerprintings show that an N-terminal segment of depactin participates in interaction with actin. AB - A 1:1 complex of actin and depactin, an actin-depolymerizing protein isolated from starfish oocytes [Mabuchi, I. (1983) J. Cell Biol. 97, 1612-1621], was cross linked with 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide (EDC) to introduce covalent bonds at their contact site. Locations of cross-linking sites were identified along the depactin sequence by the end-label fingerprinting, which employed site-directed antibodies against the N- and C-termini of depactin as end labels. Mappings with these end labels have revealed that the N-terminal segment of depactin (residues 1-20) contains sites in contact with the N- and C-terminal segments of actin, both of which participate in interaction with depactin [Sutoh, K., & Mabuchi, I. (1986) Biochemistry 25, 6186-6192]. PMID- 2706237 TI - Interaction of tetrahydropteroylpolyglutamates with two enzymes from mitochondria. AB - The dissociation constants of tetrahydropteroylpolyglutamates, having from one to six glutamate residues, have been determined for the two mitochondrial enzymes serine hydroxymethyltransferase and dimethylglycine dehydrogenase. The ratios of the dissociation constants for the mono- and hexaglutamate forms of the coenzyme were 200 and less than 10 for serine hydroxymethyltransferase and dimethylglycine dehydrogenase, respectively. Km and kcat values were determined for the reversible interconversion of serine and glycine as a function of the number of glutamyl residues on the coenzyme. The values in the serine to glycine direction did not significantly change with the number of glutamyl residues, but in the glycine to serine direction, there was a 9-fold increase in the kcat/Km when the longer chain polyglutamates were used as the coenzyme substrate. A sensitive and rapid method for determining the dissociation constants of proteins which bind either tetrahydropteroylpolyglutamates or their 5-methyl and 5-formyl conjugates is described. PMID- 2706238 TI - Noncovalent modulation by ATP of the acyl transfer from acyl-glyceraldehyde-3 phosphate dehydrogenase to phosphate. AB - The effect of ATP on the formation, spectral properties, and reactions of [beta (2-furyl)acryloyl]glyceraldehyde-3-phosphate dehydrogenase (FA-GPDH) has been investigated. The chromophoric FA-GPDH has the advantage of providing spectrophotometric signals of the interaction of acyl enzyme with nucleotides and dinucleotides. The results are consistent with the exclusive existence of two acyl-enzyme conformations previously inferred from the interaction of the acyl enzyme with NAD+ and NADH. ATP interaction stabilizes a conformation different from that stabilized by NAD+. The inhibitory effects of ATP on these reactions are consistent with the reported inhibitory effect of ATP on the steady-state reaction with the true substrate. The physiological significance of these results to the regulation of glycolysis, via the ligand-dependent fate of 3 phosphoglycerol-GPDH, is discussed. PMID- 2706239 TI - Inhibition of pig liver esterase by trifluoromethyl ketones: modulators of the catalytic reaction alter inhibition kinetics. AB - The kinetics of substrate hydrolysis by pig liver esterase show activation by various substrates as well as activation by organic solvents (both Vmax and Km increase) [Barker, D.L., & Jencks, W.P. (1969) Biochemistry 8, 3890]. The trifluoromethyl ketones 1,1,1-trifluoro-4-phenylbutan-2-one (TPB) and 1,1,1 trifluoro-4-(p-hydroxyphenyl)butan-2-one (OH-TPB) are slow, tight binding inhibitors of pig liver esterase with Ki values of 6.8 X 10(-9) M and 6.0 X 10( 9) M, respectively. Acetonitrile, TPB, and OH-TPB as well as the substrates pNPA and ethyl lactate caused a 15-130-fold increase in the rate of association (kon), and dissociation (koff), of the enzyme--TPB complex. The value of Ki (koff/kon) did not change. The effect cannot be attributed to half-sites reactivity since an increase in koff of OH-TPB is also observed with enzyme monomers. The results are consistent with a model proposed for the catalytic reaction (Barker & Jencks, 1969) which invokes two binding sites on each esterase subunit, a catalytic site and an effector site. Occupation of the effector site can increase koff and kon for the inhibitors TPB and OH-TPB. Not all compounds which bind at the effector site increase koff. Butanol binds at the effector site but does not effect koff of TPB. The results also indicate that an aromatic or a hydrophobic structure and a carbonyl group are required for optimal interaction with the effector site. PMID- 2706240 TI - 3 Beta-hydroxy-delta 5-steroid dehydrogenase/3-keto-delta 5-steroid isomerase from bovine adrenals: mechanism of inhibition by 3-oxo-4-aza steroids and kinetic mechanism of the dehydrogenase. AB - Several 3-oxo-4-aza steroids (1) have been identified as inhibitors of the 3 beta hydroxy-delta 5-steroid dehydrogenase/3-keto-delta 5-steroid isomerase catalyzed conversion of pregnenolone to progesterone. By kinetically decoupling the two enzyme activities isolated from bovine adrenal cortex, it has been demonstrated that inhibition by 1 occurs through interference of both activities. A preferred ordered association of substrates to the 3 beta-hydroxy-delta 5-steroid dehydrogenase in which the cofactor binds prior to steroid was determined by isotope exchange at equilibrium. With this result, the dead-end inhibition patterns of 1 with the dehydrogenase were interpreted to originate from a preferred association of inhibitor within an enzyme ternate containing NADH; this proposal is supported by data from multiple inhibition analysis indicating synergistic binding of NADH and 1. Similarly, inhibition of the 3-keto-delta 5 steroid isomerase by the 3-oxo-4-aza steroids was enhanced in the presence of the positive effector NADH. On the basis of pH profiles upon Vm, Vm/Km, and 1/Ki for both enzyme activities, inhibition is proposed to result from the structural similarity of 1 to intermediate states formed upon enzyme catalysis. PMID- 2706241 TI - Kinetic and ultraviolet spectroscopic studies of active-site mutants of delta 5-3 ketosteroid isomerase. AB - delta 5-3-Ketosteroid isomerase (EC 5.3.3.1) of Pseudomonas testosteroni promotes the highly efficient isomerization of delta 5-3-ketosteroids to delta 4-3 ketosteroids by means of a direct and stereospecific transfer of the 4 beta proton to the 6 beta-position, via an enolic intermediate. An acidic residue responsible for the protonation of the 3-carbonyl function of the steroid and a basic group concerned with the proton transfer have been implicated in the catalytic mechanism. Recent NMR studies with a nitroxide spin-labeled substrate analogue have allowed positioning of the steroid into the 2.5-A X-ray crystal structure of the enzyme [Kuliopulos, A., Westbrook, E.M., Talalay, P., & Mildvan, A.S. (1987) Biochemistry 26, 3927-3937], thereby corroborating the approximate location of the steroid binding site deduced from a difference Fourier X-ray diffraction map of the 4-(acetoxymercuri)estradiol-isomerase complex [Westbrook, E.M., Piro, O.E., & Sigler, P.B. (1984) J. Biol. Chem. 259, 9096-9103]. The steroid lies in a hydrophobic cavity near Asp-38, Tyr-14, and Tyr-55. In order to assess the role of these amino acid residues in catalysis, the gene for isomerase was cloned, sequenced, and overexpressed in Escherichia coli [Kuliopulos, A., Shortle, D., & Talalay, P. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 8893-8897], and the following mutants were prepared: Asp-38 to asparagine (D38N) and Tyr-14 and Tyr-55 to phenylalanine (Y14F and Y55F, respectively). The kcat value of the D38N mutant enzyme is 10(5.6)-fold lower than that of the wild-type enzyme, suggesting that Asp-38 functions as the base which abstracts the 4 beta-proton of the steroid in the rate-limiting step. Threefold lower Km values in all mutants indicate tighter binding of the substrate to the more hydrophobic sites. In comparison with the wild-type enzyme, the Y55F mutant shows only a 4-fold decrease in kcat while the Y14F mutant shows a 10(4.7)-fold decrease in kcat, suggesting that Tyr-14 is the general acid. The red shift of the ultraviolet absorption maximum of the competitive inhibitor 19-nortestosterone from 248 to 258-260 nm, which occurs upon binding to the wild-type enzyme [Wang, S.F., Kawahara, F.S., & Talalay, P. (1963) J. Biol. Chem. 238, 576-585], is mimicked in strong acid. This spectral shift was also observed with the D38N and Y55F mutants, but not on binding of the steroid to the Y14F mutant.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2706242 TI - Cholesterol modifies the short-range repulsive interactions between phosphatidylcholine membranes. AB - Pressure versus distance relationships have been obtained for egg phosphatidylcholine bilayers containing a range of cholesterol concentrations. Water was removed from between adjacent bilayers by the application of osmotic pressures in the range of 0.4-2600 atm (4 x 10(5)-2.6 x 10(9) dyn/cm2), and the distance between adjacent bilayers was obtained by Fourier analysis of X-ray diffraction data. For applied pressures up to about 50 atm and bilayer surface separations of 15-5 A, the incorporation of up to equimolar cholesterol has little influence on plots of pressure versus bilayer separation. However, for the higher applied pressures, cholesterol reduces the interbilayer separation distance by an amount that depends on the cholesterol concentration in the bilayer. For example, the incorporation of equimolar cholesterol reduces the distance between bilayers by as much as 6 A at an applied pressure of 2600 atm. At this applied pressure, electron density profiles show that the high-density head-group peaks from apposing bilayers have merged. This indicates that equimolar concentrations of cholesterol spread the lipid molecules apart in the plane of the bilayer enough to allow the phosphatidylcholine head groups from apposing bilayers to interpenetrate as the bilayers are squeezed together. All of these X-ray and pressure-distance data indicate that, by reducing the volume fraction of phospholipid head groups, cholesterol markedly reduces the steric repulsion between apposing bilayers but has a much smaller effect on the sum of the longer ranged repulsive hydration and fluctuation pressures. Increasing concentrations of cholesterol monotonically increase the dipole potential of egg phosphatidylcholine monolayers, from 415 mV with no cholesterol to 493 mV with equimolar cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706243 TI - Hydrogen-1 NMR evidence for three interconverting forms of staphylococcal nuclease: effects of mutations and solution conditions on their distribution. AB - It has been known for several years that 1H NMR spectra of the enzyme staphylococcal nuclease contain resonances due to conformational heterogeneity [Markley, J. L., Williams, M. N., & Jardetzky, O. (1970) Proc. Natl. Acad. Sci. U.S.A. 65, 645-651]. One source of conformational heterogeneity has been attributed recently to cis/trans isomeriation of the Lys116-Pro117 peptide bond [Evans, P. A., Dobson, C. M., Kautz, R. A., Hatfull, G., & Fox, R. O. (1987) Nature (London) 329, 266-268]. In this paper we present evidence for three interconverting folded forms of nuclease. Forms N and N' are monomeric; form N" appears at higher nuclease concentrations and probably corresponds to dimerized enzyme. Saturation transfer was used to demonstrate that exchange occurs between the denatured state and N". The effects of temperature, pH, and Ca2+ and nucleotide binding on NMR spectra of nuclease were examined. When the temperature is increased or the pH is lowered, form N' is favored relative to N. Binding of a competitive inhibitor (thymidine 3',5'-bisphosphate plus calcium ion) strongly favors one form of nuclease. 1H NMR spectra of wild-type nuclease, the single mutant nucleases L89F and H124L, and the double-mutant nuclease F76V+H124L were compared. In the unligated proteins, the equilibrium constant for the conformational equilibrium N in equilibrium with N' is approximately 0.1 in wild type nuclease and nuclease H124L; by contrast, this equilibrium constant is about 0.7 in nuclease L89F and 1.2 in nuclease F76V+H124L under similar conditions. PMID- 2706244 TI - Metal binding sites of the estradiol receptor from calf uterus and their possible role in the regulation of receptor function. AB - The existence of putative metal binding sites on the estradiol receptor (ER) molecule from calf uterus was evaluated by immobilizing various divalent metals to iminodiacetate-Sepharose. ER from both crude and highly purified preparations binds to metal-containing adsorbents complexed with Zn(II), Ni(II), Co(II), and Cu(II), but not to those complexed with Fe(II) and Cd(II). Elution of ER was obtained by chelating agents or by imidazole, thus indicating that histidine residues on the ER molecule are involved in the interaction with the metal. Analysis of affinity-labeled ER by [3H]tamoxifen aziridine after elution from a column of Zn(II)-charged iminodiacetate-Sepharose showed that ER fragments obtained by extensive trypsinization were also bound. Zn(II) and the same other metals able to bind ER, when immobilized on resins, inhibit the binding of estradiol to the receptor at micromolar concentrations. This inhibition is noncompetitive and can be reversed by EDTA. The inhibition of the hormone binding was still present after trypsin treatment of the cytosol, and it was abolished by preincubation with the hormone. Micromolar concentrations of these metals were able to block those chemical-physical changes occurring during the process of ER transformation in vitro. Furthermore, if added to pretransformed ER-hormone complex, they strongly inhibited the binding of the complex to isolated nuclei. The presence of metal binding sites that modulate the ER activity in the hormone binding domain of ER is therefore speculated. Since progesterone receptor showed the same pattern of binding and elution from metal-containing adsorbents, the presence of metal binding regulatory sites could be a property of all steroid receptors. PMID- 2706245 TI - Tryptophan fluorescence as a probe of placental ribonuclease inhibitor binding to angiogenin. AB - The binding of human placental ribonuclease inhibitor (PRI) to angiogenin, a human protein that induces neovascularization, occurs with a 1:1 stoichiometry and is accompanied by a 50% increase in tryptophan fluorescence. In contrast, the binding of PRI to bovine pancreatic RNase A or to angiogenin oxidized at its single tryptophan residue results in a quenching of fluorescence. These observations suggest that there is a change in the local environment of Trp-89 of angiogenin. Quenching experiments with acrylamide are consistent with the view that Trp-89 is exposed in the native protein and becomes less accessible upon formation of the complex with PRI. Stopped-flow kinetic measurements monitoring the fluorescence enhancement indicate a two-step mechanism for the binding of PRI to angiogenin. The first step involves rapid formation of an enzyme-inhibitor complex, EI, followed by a slower isomerization of EI to a tight enzyme-inhibitor complex, EI*: (Formula: see text). In 0.1 M NaCl at pH 6 and 25 degrees C, the values of K1 and K2 are 0.53 microM and 97 s-1, respectively. The apparent second order rate constant of association at protein concentrations much less than K1 is approximated by K2/K1 and equals 1.8 X 10(8) M-1 s-1. The corresponding value for the association of PRI with RNase A is only slightly higher, 3.4 X 10(8) M-1 s-1. The effects of pH and sodium chloride concentration on the association rate of PRI with angiogenin suggest the importance of ionizable groups and ionic interactions, respectively, in the association process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706246 TI - Tight-binding inhibition of angiogenin and ribonuclease A by placental ribonuclease inhibitor. AB - The dissociation rate constant of the angiogenin-placental ribonuclease inhibitor complex was determined by measuring the release of free angiogenin from the complex in the presence of scavenger for free placental ribonuclease inhibitor (PRI). In 0.1 M NaCl, pH 6, 25 degrees C, this value is 1.3 X 10(-7) s-1 (t1/2 congruent to 60 days). The Ki value for the binding of PRI to angiogenin, calculated from the association and dissociation rate constants, is 7.1 X 10(-16) M. The corresponding values for the interaction of RNase A with PRI, determined by similar means, are both considerably higher: the dissociation rate constant is 1.5 X 10(-5) s-1 (t1/2 = 13 h), and the Ki value is 4.4 X 10(-14) M. Thus, PRI binds about 60 times more tightly to angiogenin than to RNase A. The effect of increasing sodium chloride concentration on the binding of PRI to RNase A was explored by Henderson plots. The Ki value increases to 39 pM in 0.5 M NaCl and to 950 pM in 1 M NaCl, suggesting the importance of ionic interactions. The mode of inhibition of RNase A by PRI was determined by examining the effect of a competitive inhibitor of RNase A, cytidine 2'-phosphate, on the association rate of PRI with RNase A. Increasing concentrations of cytidine 2'-phosphate decrease the association rate in a manner consistent with a competitive mode of inhibition. PMID- 2706247 TI - Solid-state 13C NMR of the retinal chromophore in photointermediates of bacteriorhodopsin: characterization of two forms of M. AB - Solid-state 13C NMR spectra of the M photocycle intermediate of bacteriorhodopsin (bR) have been obtained from purple membrane regenerated with retinal specifically 13C labeled at positions 5, 12, 13, 14, and 15. The M intermediate was trapped at -40 degrees C and pH = 9.5-10.0 in either 100 mM NaCl [M (NaCl)] or 500 mM guanidine hydrochloride [M (Gdn-HCl)]. The 13C-12 chemical shift at 125.8 ppm in M (NaCl) and 128.1 ppm in M (Gdn-HCl) indicates that the C13 = C14 double bond has a cis configuration, while the 13C-13 chemical shift at 146.7 ppm in M (NaCl) and 145.7 ppm in M (Gdn-HCl) demonstrates that the Schiff base is unprotonated. The principal values of the chemical shift tensor of the 13C-5 resonance in both M (NaCl) and M (Gdn-HCl) are consistent with a 6-s-trans structure and a negative protein charge localized near C-5 as was observed in dark-adapted bR. The approximately 5 ppm upfield shift of the 13C-5 M resonance (approximately 140 ppm) relative to 13C-5 bR568 and bR548 (approximately 145 ppm) is attributed to an unprotonated Schiff base in the M chromophore. Of particular interest in this study were the results obtained from 13C-14 M. In M (NaCl), a dramatic upfield shift was observed for the 13C-14 resonance (115.2 ppm) relative to unprotonated Schiff base model compounds (approximately 128 ppm). In contrast, in M (Gdn-HCl) the 13C-14 resonance was observed at 125.7 ppm. The different 13C 14 chemical shifts in these two M preparations may be explained by different C = N configurations of the retinal-lysine Schiff base linkage, namely, syn in NaCl and anti in guanidine hydrochloride. PMID- 2706248 TI - The conformation of dolichol. AB - An understanding of the natural conformation of dolichol is important for the elucidation of the mechanism of protein glycosylation and dolichol's other as yet undisclosed biological functions. Since the molecular mechanics method has been shown to be well suited for the prediction of alcohol and alkene conformations, we have employed it to study the conformations of apparent least energy of dolichol-19 and smaller polymers of isoprene, namely, squalene, trans,trans farnesol, and cis,cis-farnesol. Additionally, the small-angle X-ray scattering (SAXS) method was employed to determine the validity of the apparent least energy conformer of dolichol-19 derived by the molecular mechanics method. The results indicate that the solution conformation of dolichol-19 is comprised of a central coiled region flanked by two arms. The central coiled region has two and a half turns of dimensions 9.84 x 16.55 x 51.66 A3. The arms of dimensions 3.99 x 5.89 x 17.47 A3 and 4.49 x 9.23 x 11.14 A3 are approximately diametrically opposed. Measurement of the intrinsic viscosity of dolichol in both isopentyl alcohol and oleyl alcohol showed that the natural conformation of dolichol is capable of increasing solution fluidity (i.e., lowering solution viscosity). Thus, while examination of the conformation of dolichol in a membrane-mimetic solvent by SAXS is not possible, the quantitative measure of the effect of dolichol on solution viscosity (and thus solution fluidity) is possible. The results are consistent with dolichol acting as a membrane-fluidizing agent and provide the first quantitative measure of the effect of dolichol on solution fluidity of a membrane mimetic solvent. PMID- 2706249 TI - "Post-assay" covalent labeling of phosphorothioate-containing nucleic acids with multiple fluorescent markers. AB - A simple protocol has been developed which allows the covalent introduction of multiple fluorescent markers into DNA fragments after gel electrophoresis techniques, that is, while the nucleic acid is imbedded in the polyacrylamide gel matrix. "Post-assay" fluorescent labeling in this manner employs DNA fragments containing phosphorothioate diesters, which can be easily incorporated during chemical and enzymatic synthesis procedures, and can be alkylated with the fluorescent marker monobromobimane. Labeling the internucleotidic phosphorus residue in this manner allows the introduction of a fluorescent marker for each nucleotide residue present. Roughly a linear increase in emitted fluorescence, thus detection sensitivity, is observed with an increasing number of bimane markers. With this technique, oligodeoxynucleotides and DNA fragments can be observed in the gel matrix, without sophisticated electronic detection devices in the low femtomolar (10(-15) mol) range. PMID- 2706250 TI - Melting behavior of a covalently closed, single-stranded, circular DNA. AB - We synthesized the 26-residue deoxynucleotide sequence d(TTCCT5GGAATTCCT5GGAA) which folds intramolecularly to form a dumbbell-shaped, double-hairpin structure with a gap between the 3' and the 5' ends. We used T4 polynucleotide kinase to phosphorylate the 5' end followed by T4 DNA ligase to close the 3' and 5' ends. Melting of the dumbbell structure formed by this ligated sequence produces a covalently closed, single-stranded, circular final state. We employed calorimetric and spectroscopic techniques to characterize thermodynamically the melting behavior of the ligated molecule and compared it with the corresponding melting behavior of its unligated precursor. This comparison allowed us to characterize uniquely the influence of single-stranded ring closure on intramolecular duplex melting. The data reveal that ring closure produces a thermally more stable structure which exhibits significantly altered melting thermodynamics. We rationalize these thermodynamic differences in terms of differential solvation and differential counterion association between the ligated and unligated molecules. We also note the importance of such constrained dumbbell structures as models for hairpins, cruciforms, and locally melted domains within naturally occurring DNA polymers. PMID- 2706251 TI - Kinetic studies of anthracycline-DNA interaction by fluorescence stopped flow confirm a complex association mechanism. AB - The kinetics of association and dissociation between calf thymus DNA and five anthracyclines, including doxorubicin, daunorubicin, and three synthetic analogues, were investigated with stopped flow using fluorescence detection. The sensitivity of this technique allowed us to work with submicromolar drug concentrations, thus excluding formation of aggregates, and with ratios of DNA base pairs to drug in the range 10-250, where site exclusion effects could be taken into account with a simple correction of DNA concentration and pseudo-first order conditions were nearly fulfilled. In all cases, both association and dissociation reactions required a sum of three exponential terms to be fitted. However, satisfactory interpretation of reciprocal relaxation times as functions of DNA concentration was only achieved with kinetic models comprising a total of five steps. One of the extra steps was tentatively assigned to formation of a weakly bound, probably nonintercalated species. Another step was deduced from a comparison between results of association and dissociation experiments. The five steps are arranged, for convenience, in an association mechanism with two branches, though other mechanisms cannot be definitely ruled out. Correlation of cytotoxicity data with both association and dissociation rates is not found to be significant. This suggests that other factors must be involved in modulating the different biological properties of the investigated anthracyclines. PMID- 2706252 TI - Dynamics of bases in hydrated [d(CGCGAATTCGCG)]2. AB - Solid-state 2H NMR spectroscopy has been used to investigate the dynamics of a DNA oligonucleotide with a defined sequence, [d(CGCGAATTCGCG)]2, which contains the EcoRI binding site. Quadrupole echo line shapes and spin-lattice relaxation times were obtained as a function of hydration on two different deuterated samples, both in the form of the Na salt. In one sample, the C8 protons of all purines in the self-complementary dodecamer were exchanged for deuterons. In the other sample, a specifically labeled thymidine (C6 deuterated) was synthetically incorporated at the seventh position (counting 5' to 3') in the sequence. The general trends for both samples were quite similar. At all levels of hydration, the data reveal the presence of a rapid, small-amplitude libration of the bases (tau c less than or equal to 1 ns, 6 degrees-10 degrees amplitude). At the higher hydration levels (80% relative humidity or higher), the results indicate the presence of a much slower motion (tau c approximately 10-100 microseconds), which at 80% relative humidity is of small amplitude (approximately 5 degrees) and at higher hydration levels may be of larger amplitude. There is no evidence for large-amplitude (greater than +/- 10 degrees) motion on a nanosecond or faster time scale under any hydration condition. The 2H NMR results were analyzed with a dynamical model which treats the oligonucleotide as a deformable filament and which can include collective torsional fluctuations. The slow motion observed at high hydration levels is attributed to the uniform twisting mode (of the entire helix).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706253 TI - Conformational transitions in cytidine bulge-containing deoxytridecanucleotide duplexes: extra cytidine equilibrates between looped out (low temperature) and stacked (elevated temperature) conformations in solution. AB - High-resolution homonuclear and heteronuclear two-dimensional NMR studies have been carried out on the self-complementary d(C-C-G-C-G-A-A-T-T-C-C-G-G) duplex (designated GCG 13-mer) in aqueous solution. This sequence contains an extra cytidine located between residues G3 and G4 on each strand of the duplex. The exchangeable and nonexchangeable proton resonances have been assigned from an analysis of two-dimensional nuclear Overhauser enhancement (NOESY) and correlated (COSY and relay COSY) spectra for the GCG 13-mer duplex in H2O and D2O solution. The extra cytidine at the bulge site (designated CX) results in more pronounced changes in the NOE distance connectivities for the G3-CX-G4 segment centered about the CX residue compared to the C9-C10 segment on the partner strand opposite the CX residue for the GCG 13-mer duplex at 25 degrees C. The cross-peak intensities in the short mixing time NOESY spectrum also establish that all glycosidic torsion angles including that of CX are anti in the GCG 13-mer duplex at 25 degrees C. The observed chemical shift changes for the CX base protons and the G3pCX phosphorus resonance with temperature between 0 and 40 degrees C demonstrate a temperature-dependent conformational equilibrium in the premelting transition region. The NOE and chemical shift parameters establish that the predominant conformation at low temperature (0 degree C) has the extra cytidine looped out of the helix with the flanking G3.C10 and G4.C9 base pairs stacked on each other. These results support conclusions based on earlier one-dimensional NMR studies of extra cytidine containing complementary duplexes in aqueous solution [Morden, K. M., Chu, Y. G., Martin, F. H., & Tinoco, I., Jr. (1983) Biochemistry 22, 5557-5563. Woodson, S. A., & Crothers, D. M. (1987) Biochemistry 26, 904-912]. By contrast, the chemical shift and NOE parameters demonstrate that the conformational equilibrium shifts toward a structure with a stacked extra cytidine on raising the temperature to 40 degrees C prior to the helix-coil melting transition. The most downfield shifted phosphorus resonance in the GCG 13 mer duplex has been assigned to the phosphate in the C2-G3 step, and this observation demonstrates that the perturbation in the phosphodiester backbone extends to regions removed from the (G3-CX-G4).(C9-C10) bulge site. PMID- 2706254 TI - Effect of the G.T mismatch on backbone and sugar conformations of Z-DNA and B DNA: analysis by Raman spectroscopy of crystal and solution structures of d(CGCGTG) and d(CGCGCG). AB - The Z-DNA crystal structures of d(CGCGTG) and d(CGCGCG) are compared by laser Raman spectroscopy. Raman bands originating from vibrations of the phosphodiester groups and sensitive to the DNA backbone conformation are similar for the two structures, indicating no significant perturbation to the Z-DNA backbone as a result of the incorporation of G.T mismatches. Both Z structures also exhibit Raman markers at 625 and 670 cm-1, assigned respectively to C3'-endo/syn-dG (internal) and C2'-endo/syn-dG conformers (3' terminus). Additional Raman intensity near 620 and 670 cm-1 in the spectrum of the d(CGCGTG) crystal is assigned to C4'-exo/syn-dG conformers at the mismatch sites (penultimate from the 5' terminus). A Raman band at 1680 cm-1, detected only in the d(CGCGTG) crystal, is assigned to the hydrogen-bonded dT residues and is proposed as a definitive marker of the Z-DNA wobble G.T pair. For aqueous solutions, the Raman spectra of d(CGCGTG) and d(CGCGCG) are those of B-DNA, but with significant differences between them. For example, the usual B-form marker band at 832 cm-1 in the spectrum of d(CGCGTG) is about 40% less intense than the corresponding band in the spectrum of d(CGCGCG), and the former structure exhibits a companion band at 864 cm-1 not observed for d(CGCGCG). The simplest interpretation of these results is that the conventional B-form OPO geometry occurs for only 6 of the 10 OPO groups of d(CGCGTG). The remaining four OPO groups, believed to be those at or near the mismatch site, are in an "unusual B" conformation which generates the 864 cm-1 band.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706256 TI - Effect of probucol on the physical properties of low-density lipoproteins oxidized by copper. AB - Human plasma low-density lipoproteins (LDL) were incubated with 10 microM probucol for 1 h at 37 degrees C. Probucol incorporation into the LDL was complete as judged by filtration through a 0.2-micron filter, ultracentrifugation, and gel filtration. LDL with and without probucol were incubated for up to 24 h with 5 microM Cu2+ at 37 degrees C. Copper oxidation increased the content of random structure in the LDL protein from 30% to 36% at the expense of beta-structure (which decreased from 22% to 16%) without a change in alpha-helical content as measured by circular dichroism spectroscopy. This loss of beta-structure was prevented by the presence of probucol in the LDL during the copper incubation. Probucol reduced the rate of increase of fluorescence during copper oxidation at 37 degrees C. After 6 h, the fluorescence intensity at 360-nm excitation and 430-nm emission was 30% less in probucol containing samples. Probucol had no effect on the circular dichroic spectrum of LDL and only minimal effects (less than 5%) on the fluorescence emission spectrum at wavelengths below 500 nm. Two fluorescence peaks, with emission at 420 nm and excitation at 340 and 360 nm, are resolved in three-dimensional fluorescence spectra of oxidized LDL. Probucol reduces the intensity of both peaks equally. The binding of a highly reactive heparin (HRH) fraction to LDL was measured by titration of LDL with HRH in the presence of fluoresceinamine-labeled HRH. The decrease in fluorescence anisotropy of the labeled HRH is proportional to the concentration of bound HRH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706255 TI - Enzymatic and physical characterization of diacylglycerol-phosphatidylcholine interactions in bilayers and monolayers. AB - The miscibility of 1,3-dioleoylglycerol (DOG) with 1-stearoyl-2 oleoylphosphatidylcholine (SOPC) and 1-palmitoyl-2-oleoylphosphatidylcholine (POPC) dispersed in excess buffer was characterized by physical and enzymatic methods. Thermograms for all SOPC-DOG mixtures exhibit a transition at 5.3 degrees C. Above 0.25 mole fraction of DOG, metastability is observed; after the first scan, a second peak appears at 23.4 degrees C which corresponds to the chain melting of pure DOG. This suggests that a complex or preferred packing array is formed which has a DOG mole fraction of 0.25 (XC). Bilayer morphology is maintained in the metastable state up to 0.8 mole fraction of DOG. Above 0.8, a novel, nonlamellar phase is formed. Fluorescence polarization of 1,6 diphenylhexatriene shows that, relative to SOPC alone, there is little change in the order of the acyl chains up to Xc followed by a large decrease above Xc. Similar results were obtained using POPC. Miscibility was also studied in lipid films at the argon-buffer interface. Isothermal phase diagrams for the mixtures at 15 and 24 degrees C exhibited phosphatidylcholine-DOG complex formation, a region of phosphatidylcholine and complex coexistence, and a region of complex and DOG miscibility. The mole fractions of DOG in the complex (Xc) range from 0.24 to 0.27. Porcine pancreatic phospholipase A2 and pancreatic lipase plus colipase were used as probes of the surface in both the monolayer and bilayer systems. In both systems and with both enzymes, substrate hydrolysis increased abruptly with increasing DOG.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706257 TI - Biochemical dissection of the role of the one-kilodalton carboxyl-terminal moiety of tubulin in its assembly into microtubules. AB - The 4-kDa C-terminal domain of both tubulin subunits plays a major role in the regulation of microtubule assembly [Serrano et al. (1984) Biochemistry 23, 4675]. Controlled proteolysis of tubulin with subtilisin produces the selective cleavage of this 4-kDa moiety from alpha- and beta-tubulin with a concomitant enhancement of the assembly. Here we show that gradual removal of the last six to eight amino acid residues of the C-terminal region of alpha and beta subunits by an exopeptidase, carboxypeptidase Y, produces a modified protein (C-tubulin) without relieving the modulatory effect of the C-terminal domain and the usual need of MAPs for microtubule assembly. Actually, treatment with this proteolytic enzyme did not change tubulin assembly as promoted by either MAP-2, taxol, MgCl2, dimethyl sulfoxide, or glycerol. The critical concentration for the assembly of C tubulin remained the same as that for the unmodified tubulin control. Microtubule associated proteins MAP-2 and tau incorporated into C-tubulin polymers. Clearly, pure C-tubulin did not assemble in the absence of MAPs or without addition of assembly-promoting compounds. However, proteolysis with the exopeptidase induced changes in tubulin conformation as assessed by biophysical methods and double limited proteolysis. The cleavage with subtilisin after carboxypeptidase digestion did not result in enhancement of the assembly to the levels observed after the treatment of native tubulin with subtilisin. Interestingly, Ca2+ ions affected neither C-tubulin assembly nor depolymerized microtubules assembled from C-tubulin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706258 TI - Self-association of calcium and magnesium complexes of dentin phosphophoryn. AB - Self-association of rat dentin phosphophoryn in the presence of calcium and magnesium ions was examined by chemical cross-linking and electron microscopy. Highly phosphorylated phosphophoryn (HP) binds a maximum of 1.33 calcium ions or 1.07 magnesium ions per organic phosphate residue at pH 7.4-8.0. The Ca-HP complexes are predominantly linear when the calcium content of the complex is less than about 65% of the saturation level. At higher calcium levels, the protein has a folded conformation, and transient protein-protein interactions occur. The equilibrium mixture of monomers and oligomers is predominantly monomeric unless the protein is saturated with calcium. The saturated Ca-HP complex forms discrete high molecular weight particles about 25 nm in diameter. The particles are electrically neutral and generally occur in clusters. Mg-HP complexes appear predominantly linear by electron microscopy at all concentrations of bound magnesium up to about 99% of the saturation level; however, protein-protein interaction is measurable when the magnesium content is as little as 65% of the saturation level. At saturation, Mg-HP complexes form high molecular weight particles which are negatively charged. Because of the negative charge, these particles form a stable colloidal suspension and have a rather stellate configuration. PMID- 2706259 TI - Binding of calcium and phosphate ions to dentin phosphophoryn. AB - The concomitant binding of calcium and inorganic phosphate ions by the highly phosphorylated rat dentin phosphophoryn (HP) was measured in the pH range of 7.4 8.5 by an ultrafiltration procedure. HP binds almost exclusively the triply charged PO4(3-) ion, and for each PO4(3-) ion bound, the protein binds about 1.5 additional Ca2+ ions. Therefore, the protein-mineral ion complex can be described as a protein with two different ligands, Ca2+ ions and calcium phosphate clusters having a stoichiometry of about Ca1.5PO4. Empirically the binding of calcium and phosphate can best be described as a function of a neutral ion activity product in which 2.5-10% of the phosphate is HPO4(2-). The stoichiometry of the bound clusters is similar to that of amorphous calcium phosphate, and it is clear that the protein does not sequester crystal embryos of octacalcium phosphate or hydroxyapatite. The protein-mineral ion complex is amorphous by electron diffraction analysis and does not catalyze the formation of a crystalline phase when aged in contact with its solution. About 15% of the bound phosphate is buried in protected domains, and it is stable with respect to dissociation for extended periods in phosphate-free calcium buffers. The buried mineral maintains the protein in an aggregated state even at calcium ion concentrations which are too low for the aggregation of unmineralized HP. In vivo HP should be ineffective in the nucleation of a crystalline mineral phase, if it is secreted in a mineralized aggregated state similar to casein and the bivalve phosphoprotein. PMID- 2706260 TI - Analysis of peptides for helical prediction. AB - Two terminally blocked peptides, acetylAETAAAKFLRQHMamide and acetylAETSSSRYLRQHMamide, were obtained by solid-phase synthesis, purified by reversed-phase chromatography, and characterized by fast atom bombardment mass spectrometry. Both peptides were soluble in aqueous solutions and remained monomeric over the concentration range examined. Changes in the temperature, pH, and trifluoroethanol concentration of solutions of each peptide produced changes in the far-ultraviolet circular dichroic spectrum characteristic of a two-state helix/coil transition. The limiting mean residue ellipticity of the coil and helix form of each peptide was estimated by addition of the denaturant guanidinium chloride at elevated temperature and by addition of trifluoroethanol at subzero temperatures, respectively. The midpoint for the thermal transition of the peptide SSSRY is lowered by about 30 degrees C relative to that of peptide AAAKF, in qualitative agreement from predictions based on helix probabilities of amino acid residues. The magnitude of the change observed in the midpoint of the thermal transitions suggests that the effect of single amino acid replacements on helix formation should be experimentally measurable. PMID- 2706261 TI - A molluscivorous Conus toxin: conserved frameworks in conotoxins. AB - We purified and characterized a 27 amino acid toxin from a snail-hunting Conus venom, Conus textile. This toxin causes convulsive-like activity in snails and causes subordinate lobsters to assume an exaggerated dominant posture. The sequence of this peptide is Trp-Cys-Lys-Gln-Ser-Gly-Glu-Met-Cys-Asn-Leu-Leu-Asp Gln-Asn-Cys-Cys-Asp- Gly-Tyr-Cys-Ile-Val-Leu-Val-Cys-Thr. The sequence was confirmed by determining the nucleotide sequence of a cDNA clone coding for the peptide. The conservation of Cys residues compared to the omega-conotoxins from piscivorous Conus venom suggests that toxins from different cone venoms may use only a few "Cys-motifs" as conserved structural backbones for targeting to a variety of receptors in different animals. PMID- 2706262 TI - A magnetization-transfer nuclear magnetic resonance study of the folding of staphylococcal nuclease. AB - The equilibrium between alternative folded states of a globular protein, staphylococcal nuclease, has been investigated by using 1H NMR. Magnetization transfer experiments have revealed the existence of a related structural heterogeneity of the unfolded state, and quantitative analysis of a series of these experiments has permitted the kinetics of folding and interconversion of the different states to be explored. A model based on cis/trans isomerism at the peptide bond preceding Pro-117 has been developed to account for the results. This model, recently supported by a protein-engineering experiment [Evans et al. (1987) Nature (London) 329, 266], has been used to interpret the kinetic data, providing insight into the nature of the folding processes. The predominance of the cis-proline form in the folded state is shown to derive from a large favorable enthalpy term resulting from more effective overall folding interactions. The kinetics of folding and isomerization are shown to occur on similar time scales, such that more than one pathway between two states may be significant. It has been possible, however, to compare the direct folding and unfolding rates within the cis- and trans-proline-containing populations, with results suggesting that the specific stabilization of the cis peptide bond is effective only at a late stage in the folding process. PMID- 2706263 TI - Fluorescence lifetime and solute quenching studies with the single tryptophan containing protein parvalbumin from codfish. AB - The fluorescence decay of cod parvalbumin (both its Ca2+-loaded and Ca2+-depleted forms) is found to be a nonexponential process. The decay data can be fitted either by a double-exponential decay law or by a distribution of decay times. To try to distinguish between the double-exponential and distribution fits, we have collected frequency domain and steady-state fluorescence data as a function of temperature and concentration of the quencher acrylamide. We argue that the correct decay law (i.e., double exponential or distribution) must be consistent with all the data collected as a function of temperature and quencher concentrations. We employ a global analysis procedure to simultaneously fit multiple data sets that are linked by an Arrhenius or Stern-Volmer relationship. For the Ca2+-loaded form of parvalbumin, the distribution model provides a consistent and reasonable fit for all of the frequency domain and steady-state data. The double-exponential model requires more fitting parameters, and some of these assume unreasonable values when this model is fitted to all of the data. For the Ca2+-depleted form of the protein, it is not clear whether the double exponential or distribution model is superior. For our steady-state solute quenching studies we present a novel analysis in terms of a distribution of quenching constants. PMID- 2706264 TI - Amino acid sequence of a mouse mucosal mast cell protease. AB - The amino acid sequence has been determined of a mouse mucosal mast cell protease isolated from the small intestines of mice infected with Trichinella spiralis. The active protease contains 226 residues. Those corresponding to the catalytic triad of the active site of mammalian serine proteases (His-57, Asp-102, and Ser 195 in chymotrypsin) occur in identical positions. A computer search for homology indicates 74.3% and 74.1% sequence identity of the mouse mast cell protease compared to those of rat mast cell proteases I and II (RMCP I and II), respectively. The six half-cystine residues in the mouse mast cell protease are located in the same positions as in the rat mast cell proteases, cathepsin G, and the lymphocyte proteases, suggesting that they all have identical disulfide bond arrangements. At physiological pH, the mouse and rat mucosal mast cell proteases have net charges of +3 and +4, respectively, as compared to +18 for the protease (RMCP I) from rat connective tissue mast cells. This observation is consistent with the difference in solubility between the mucosal and connective tissue mast cell proteases when the enzymes are extracted from their granules under physiological conditions. PMID- 2706265 TI - Fluorescence studies of a single tyrosine in a type II DNA binding protein. AB - We studied the fluorescence properties of a single tyrosine (Tyr94) located in the C-terminal tail of transcription factor 1 (TF1), a type II procaryotic DNA binding protein encoded by the Bacillus subtilis phage SPO1. The time-resolved fluorescence intensity of Tyr94 in free TF1 dimers decays as a single exponential, and this is consistent with a twofold symmetrical structure. The fluorescence is readily quenched by acrylamide, but it is less accessible to anionic quenchers (iodide and citrate), suggesting that the tyrosine is located on the protein surface in a negatively charged environment provided by neighboring Glu95 and Asp96 residues. TF1 dimers associate at moderate concentrations (greater than 0.02 mg/mL) as judged from concentration dependencies in the molar fluorescence intensity, the steady-state fluorescence polarization, and the bimolecular quenching constants. Nonspecific binding of TF1 to SPO1 and calf thymus (CT) DNA and various double-stranded polynucleotides quenches the Tyr94 fluorescence to varying extent. Fluorescence lifetimes of TF1 in the bound state correlate with spectral overlaps between TF1 emission and DNA absorption, demonstrating that excitation energy transfer to DNA bases contributes significantly to the observed quenching. From analysis of the observed quenching in the DNA complexes we conclude that Tyr94 is located within 10-14 A of the DNA helix axis and not in direct contact with the DNA bases. Equilibrium analyses based on fluorescence titrations show that the maximum binding density on DNA extrapolates to ca. 1 TF1 dimer/5 DNA base pairs. We find several differences in TF1 binding to SPO1 DNA, which contains hydroxymethyluracil instead of thymine, and CT DNA: (i) The tyrosine residue is less exposed to the solvent in the SPO1 DNA complex than in the CT DNA complex. (ii) D2O addition enhances the Tyr94 fluorescence when TF1 binds to SPO1 DNA but not when it binds to CT DNA. (iii) The TF1-SPO1 DNA complex is stable at higher NaC1 concentrations than is the TF1-CT DNA complex, and its formation involves the dissociation of more Na+ ions than does the TF1-CT DNA complex. On the basis of these observations and the fact that the Tyr94-containing tail of TF1 is essential for binding to SPO1 DNA, we discuss various models for the TF1-DNA complex. PMID- 2706266 TI - Conformational states of the nicotinic acetylcholine receptor from Torpedo californica induced by the binding of agonists, antagonists, and local anesthetics. Equilibrium measurements using tritium-hydrogen exchange. AB - The tritium-hydrogen exchange kinetics of Torpedo californica AChR, in native membrane vesicles at pH 7.4 and 0 degrees C, have been analyzed in the presence of agonists, partial agonists, local anesthetics, and competitive antagonists. The agonists carbamylcholine (10 microM-1 mM) and suberyldicholine (10 microM) and the partial agonists decamethonium (25 microM and 1 mM) and hexamethonium (1 mM) have no effect on the exchange kinetics, although at lower concentration carbamylcholine may slightly accelerate exchange. Nondesensitizing local anesthetics do affect the exchange behavior, dependent on concentration. Procaine at 500 microM moderately retards exchange while procaine at 10 mM and tetracaine at 5 mM slightly accelerate exchange. The competitive antagonist alpha bungarotoxin retards exchange significantly, as does d-tubocurarine although to a lesser extent. These results suggest that the resting and desensitized conformations of the AChR are very similar in overall solvent accessibility and that at lower concentrations noncompetitive blockers such as procaine may stabilize a less solvent-accessible state of the AChR. The competitive antagonists alpha-bungarotoxin and d-tubocurare also stabilize a dynamically restricted, less solvent-accessible conformation of the acetylcholine receptor, demonstrating that a large conformational change accompanies binding of these toxins. Any change in conformation which may accompany desensitization is very different from these effects. PMID- 2706268 TI - Membrane permeability to macromolecules mediated by the membrane attack complex. AB - A simple and well-defined system of purified phospholipids and human complement proteins was used to study membrane permeability to macromolecules mediated by the membrane attack complex (MAC) of complement. Large unilamellar vesicles (LUVs) of phosphatidylcholine (PC) or phosphatidylserine (PS) containing trapped macromolecules [bovine pancreatic trypsin inhibitor (BPTI), thrombin, glucose-6 phosphate dehydrogenase (G6PD), and larger molecules] were used to monitor permeability. Membrane permeability to macromolecules was measured by thrombin inhibition by an external inhibitor or by separation of released molecules by gel filtration. Membrane-bound intermediates (C5b-8 or C5b-93) were stable for hours, and macromolecular permeability occurred without fragmentation, fusion, or aggregation of the vesicles. Quantitative membrane binding by C5b-7 as well as essentially quantitative release of thrombin was obtained for PS vesicles. MAC binding to PS-LUVs approximated the theoretical Poisson distribution curve for full release of vesicle contents by one complex per vesicle. Reactions with PC LUVs occurred with some fluid-phase MAC assembly. Therefore, results from experiments with these vesicles were interpreted in a relative manner. However, the values obtained closely corroborated those obtained with PS-LUVs. At low C9/C5b-8 ratios, the size of the lesion was proportional to the C9 content of the MAC. Half-maximum release of BPTI, thrombin, and G6PD, by a single MAC per vesicle, required approximately 3,5, and 7 C9/C5b-8 (mol/mol), respectively. Larger molecules (greater than or equal to 118-A diameter) were not released from the vesicles. Release of G6PD (95.4-A diameter) required 45% of saturating C9. Therefore, it appeared that the last half of the bound C9 molecules did not increase pore size and the pore which released G6PD approached the diameter of the closed circular lesion measured (by others) in electron micrographs (approximately 100 A). The results were consistent with the formation of a stable membrane pore by a single complex per vesicle in which C9 molecules line only one side of the pore at low C9/C5b-8 ratios and maximum pore size is attained by incomplete, noncircular polymers of C9. PMID- 2706267 TI - Synthesis, photochemistry, and biological activity of a caged photolabile acetylcholine receptor ligand. AB - A biologically inert photolabile precursor of carbamoylcholine has been synthesized; it is photolyzed to carbamoylcholine, a well-characterized acetylcholine analogue, with a half-time of 40 microseconds at pH 7.0 and a quantum yield of 0.8. The compound, N-(alpha-carboxy-2 nitrobenzyl)carbamoylcholine, was synthesized from (2-nitrophenyl)glycine. The photolysis rates (of five compounds) and the biological activity (of two compounds) were determined, and both properties were found to depend on the nature of the substituents on the photolabile protecting group. Laser pulse photolysis at wavelengths between 308 and 355 nm was used to investigate the wavelength dependence, quantum yield, and rate of the photolysis reaction. Photolysis products were isolated by high-performance liquid chromatography and identified by chemical and spectroscopic analysis and by their ability to activate the nicotinic acetylcholine receptor. BC3H1 muscle cells containing those receptors and a cell-flow method were used in the biological assays. The approach described may be useful in the preparation and characterization of other photolabile precursors of neurotransmitters that contain amino groups. The importance of these rapidly photolyzed, inert precursors of neurotransmitters is in chemical kinetic investigations of the reactions involving diverse neuronal receptors; such studies have been hampered because the available techniques have an insufficient time resolution. PMID- 2706269 TI - Characterization of a partly folded protein by NMR methods: studies on the molten globule state of guinea pig alpha-lactalbumin. AB - NMR spectroscopy has been used to investigate the structure of a partially folded state of a protein, the molten globule or A-state of alpha-lactalbumin. The 1H NMR spectrum of this species differs substantially from those of both the native and fully unfolded states, reflecting the intermediate level of order. The resolution in the spectrum is limited by the widespread overlap and substantial line widths of many of the resonances. Methods have therefore been developed that exploit the well-resolved spectrum of the native protein to probe indirectly the A-state. A number of resonances of the A-state have been found to be substantially shifted from their positions in the spectrum of the unfolded state and have been identified through magnetization transfer with the native state, under conditions where the two states are interconverting. The most strongly perturbed residues in the A-state were found to be among those that form a hydrophobic core to the native structure. A number of amides were found to be highly protected from solvent exchange in the A-state. These have been identified through pH-jump experiments, which label them in the spectrum of the native protein. They were found to occur mainly in segments that are helical in the native structure. These results enable a model of the A-state to be proposed in which significant conformational freedom exists but where specific elements of native-like structure are preserved. PMID- 2706270 TI - Specific RNA binding by Q beta coat protein. AB - The interaction between the bacteriophage Q beta coat protein and its specific binding site on Q beta genomic RNA was characterized by using a nitrocellulose filter binding assay. Q beta coat protein bound to a synthetic 29-nucleotide RNA hairpin with an association constant of 400 microM-1 at 4 degrees C, 0.2 M ionic strength, pH 6.0. Complex formation had a broad pH optimum centered around pH 6.0 and was favored by both enthalpy and entropy. The salt dependence of Ka revealed that four to five ion pairs may be formed in the complex although approximately 80% of the free energy of complex formation is contributed by nonelectrostatic interactions. Truncation experiments revealed that coat protein binding required only the presence of a hairpin with an eight base pair stem and a three-base loop. Analysis of the binding properties of hairpin variants showed that the sequence of the stem was not important for coat protein recognition and only one of the three loop residues was essential. A bulged adenosine present in the coat protein binding site was not required for coat protein binding. Q beta coat protein binding specific is therefore primarily achieved by the structure and not by the sequence of the operator. PMID- 2706271 TI - A photoreactive derivative of radiolabeled GM1 ganglioside: preparation and use to establish the involvement of specific proteins in GM1 uptake by human fibroblasts in culture. AB - A new procedure was used to synthesize a derivative of ganglioside GM1 containing a photoreactive nitrophenyl azide group at the end of the fatty acyl moiety, using deAc-deAcyl-GM1 obtained by deacetylation of the sialic acid and deacylation of the ceramide portion of GM1. This deAc-deAcyl-GM1 was first acylated at the long chain base amino group with 12-aminododecanoic acid, which has the amino group protected by a fluorenyl residue, and tritium labeled at the sialic acid amino group with [3H]acetic anhydride of very high specific radioactivity. The fluorenyl group removed by ammonia treatment was substituted by a nitrophenyl azide group. Cultured human fibroblasts were exposed to mixtures of radioactive photolabeled GM1 and cold natural GM1 (1:10 by mol) for different times and then illuminated and the radioactive protein patterns studied by SDS PAGE. After 2h of exposure, the photolabeled GM1 was stably associated to the cells and underwent almost no metabolic processing, behaving exactly as the underivatized natural GM1. Under these conditions very few proteins became radioactive: one, of about 30 kDa, interacted with the ganglioside molecules inserted into the outer membrane layer; three, in the region of 46 kDa, interacted with the portion of associated ganglioside able to be released by trypsin treatment. Thus, it is evident that the ganglioside binding to fibroblasts and insertion into the outer layer of the plasma membrane involve few individual proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706272 TI - Nucleotide and deduced amino acid sequence of the hydrophobic surfactant protein SP-C from rat: expression in alveolar type II cells and homology with SP-C from other species. AB - Pulmonary surfactant lowers surface tension in the lung. Its deficiency leads to the severe physiologic abnormalities seen in the respiratory distress syndrome. The hydrophobic surfactant proteins, SP-B and SP-C, appear to be especially important in the surface-spreading characteristics of pulmonary surfactant. We report the nucleotide sequence of cDNA clones for rat SP-C and compare the deduced amino acid sequence for SP-C from several species. A highly conserved domain exists within the confines of mature human SP-C. An Eisenberg plot of this region predicts a membrane-associated helix. We also demonstrate by Northern analysis the tissue-specific expression of SP-C. A comparison of signal strength between total lung RNA and RNA derived from isolated type II cells supports the idea that most SP-C messenger RNA in total lung can be accounted for by that present in alveolar type II cells. PMID- 2706273 TI - Proton magnetic resonance spectra of adrenodoxin: features of the aromatic region. AB - This paper presents the first 1H-NMR spectra of the aromatic region of adrenodoxin, a mammalian mitochondrial 2Fe-2S non-heme iron ferredoxin. One dimensional proton NMR spectra of both reduced and oxidized adrenodoxin were recorded as a function of pH. Resonances due to two of the three histidines of adrenodoxin gave sharp signals in the one-dimensional proton NMR spectra. The pKa values of the resolved histidine resonances in the oxidized protein were 6.64 +/- 0.03 and 6.12 +/- 0.06. These values were unchanged when adrenodoxin was reduced by the addition of sodium dithionite. In addition, the oxidized protein showed a broadened histidine C-2H resonance with a pKa value of approx. 7. This resonance was not apparent in the spectra of the reduced protein. The resonances due to the single tyrosine in adrenodoxin were identified using convolution difference spectroscopy. In addition, a two-dimensional Fourier-transform double quantum filtered (proton, proton) chemical shift correlated (DQF-COSY) spectrum of oxidized adrenodoxin was obtained. The cross peaks of the resonances due to the tyrosine, the four phenylalanines, and two of the three histidines of adrenodoxin were resolved in the DQF-COSY spectrum. Reduction of the protein caused several changes in the aromatic region of the NMR spectra. The resonances assigned to the C2 proton of the histidine with a pKa of 6.6 shifted upfield approx. 0.15 ppm. In addition, when the protein was reduced one of the resonances assigned to a phenylalanine residue with a chemical shift of 7.50 ppm appeared to move downfield to 7.82 ppm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706274 TI - Amino acid sequence of alpha-chain of hemoglobin IV from trout (Salmo irideus). AB - The amino acid sequence of the alpha-chain of trout hemoglobin (Hb) IV is given, thus completing the primary structure of the hemoglobin component of trout's blood characterized by the Root effect. The trout Hb IV alpha-chain consists of 142 amino acid residues; comparison with the corresponding sequences from human and carp hemoglobins shows differences of 50.0 and 35.9%, respectively. A difference of 39.6% is found with the alpha-chain of trout Hb I, the other major hemoglobin component of trout blood, devoid of heterotropic effects. PMID- 2706275 TI - Antisera to synthetic peptides as probes of structural changes during aging of alpha-crystallin from the bovine lens. AB - Polyclonal antisera have been made to synthetic peptides of 11-15 residues that correspond to nine different regions of the alpha A crystallins. These antisera have been used in a radioimmunoassay to quantitatively probe for structural and/or covalent changes of alpha-crystallins in the nucleus versus cortex of the adult bovine lens. Antisera specific for the C-terminal and N-terminal regions of the alpha-crystallins bind more to alpha-crystallins from cortex. Antisera to three out of the seven internal sequences (residues 75-89, 87-101 and 135-149) bind better to alpha-crystallins from the bovine lens nucleus, suggesting a greater accessibility of these sequences to antisera binding. Together, these studies demonstrate that antisera against synthetic peptide sequences of alpha A crystallins are very specific probes that can detect structural and/or covalent changes in specified regions of the alpha-crystallins during the process of aging in the bovine lens. PMID- 2706276 TI - Inhibition and covalent modification of rape seed (Brassica napus) enoyl ACP reductase by phenylglyoxal. AB - The NADH-dependent enoyl-ACP reductase from oil seed rape (Brassica napus) was inactivated by treatment with phenylglyoxal, a reagent which specifically modifies arginine residues. The inhibition at various phenylglyoxal concentrations shows pseudo-first-order kinetics, with an apparent second-order rate constant of 14.2 M-1.min-1 for inactivation. The protective ability of several substrates and substrate analogues was investigated in order to ascertain if the inhibition was directed towards the active site of the enzyme. NADH and NAD+ did not protect but acyl carrier protein (ACP) and reduced coenzyme A, along with various derivatives, did protect. 9 microM ACP gave 35% protection from inactivation and 10 mM reduced coenzyme A gave 98% protection. The effectiveness of various subfragments of coenzyme A in protecting against inhibition indicates that the phosphate group is essential for preventing the binding of phenylglyoxal. The idea that phenylglyoxal is inhibiting by binding at the active site is further supported by the observation that the incorporation of 14C labelled phenylglyoxal is directly related to the loss of activity. Extrapolation of the amount of label incorporated to give total inhibition shows that 4 mol of phenylglyoxal would be incorporated per mol of enzyme. This corresponds to the modification of two arginine side-chains with equal reactiveness towards the reagent. These results are consistent with there being two arginine residues either at the active site of the enzyme or in an environment which is protected from phenylglyoxal by a conformational change induced by coenzyme A binding. PMID- 2706277 TI - Studies on the mechanism of action of the alkaline phosphatase from Dictyostelium discoideum. AB - The Dictyostelium discoideum alkaline phosphatase was investigated kinetically in an attempt to elucidate its mechanism of action. Analysis of the hydrolysis of p nitrophenyl phosphate by stopped-flow spectrophotometry revealed biphasic kinetics, suggesting a double displacement enzyme mechanism. Furthermore, Tris stimulated activity in an uncompetitive manner, a result that was consistent with this interpretation. The enzyme was inhibited reversibly by phosphate at low ionic strength, but the inhibition was irreversible at high ionic strength and the latter effect was enhanced at alkaline pH values. These results indicate that high ionic strength and alkaline pH conditions bring about a conformational change that renders the enzyme susceptible to irreversible inhibition by phosphate. PMID- 2706278 TI - Temporal pattern discrimination within the receptive field of cat retinal ganglion cells. AB - ON-center and OFF-center receptive fields of cat retinal ganglion cells can be divided into two categories: sensitive (type N) and insensitive (type L) to three statistical temporal visual stimuli with different second order statistics but identical first order statistics (Tsukada et al. 1982). The temporal pattern sensitivity of type N response is closely related to the nonlinear stage of Y cells depending on the interaction between center and surround mechanism. The temporal pattern sensitivity of type N responses has a spatial profile within the receptive field; it is highly sensitive in the center region of the receptive field and less sensitive toward the field periphery. The temporal pattern sensitivity in the center region of the receptive field to statistical properties (irregular or regular) of a surrounding flash annulus shows modulation like a switching element: when the surrounding area is stimulated by a more regular flash stimulus with normal distribution of inter-stimulus intervals the system is sensitive (switching on) to the temporal pattern, while a change to an irregular one with an exponential distribution makes it insensitive (switching off) to the temporal pattern. PMID- 2706279 TI - [Signal-flow diagrams as aids to describe hypnotic trance states: an impulse for our statement]. AB - A model is developed to show the formation of the hypnotic trance states. As experimental results are rare in this field the development of the model is mainly done by assuming possible and practicable connections. It is the beginning of cybernetic models for this domain and may encourage further work in this direction. The focal point is the separation of energy-flow from information flow. Only the latter is needed with the arrangement of signal-flow diagrams. These diagrams show that the different trance states may be explained as different information-processing systems. We don't require the physiological background as we have transformed the problem into a pure psychology-problem - On this way we find two switch-over systems: One that opens the loop between the model of outer world and the inner decision system. By this way it gives to the other system the possibility to follow word-for-word the suggestions, given by the hypnotist. PMID- 2706280 TI - Visual localization of briefly presented peripheral targets. AB - Reported here are the results from two experiments designed to investigate Mateeff and Gourevich's (1983, 1984) claim that adult observers make large constant errors when judging the direction of briefly presented peripheral targets, with respect to a continuously visible scale. Experiment 1 involved a virtually exact duplication of Mateeff and Gourevich's paradigm. Experiment 2 involved adjusting the position of a light emitting diode (LED) so as to match the direction of a LED previously flashed in the periphery. No significant constant errors were found in either experiment. PMID- 2706281 TI - A robust orthogonal algorithm for system identification and time-series analysis. AB - We describe and illustrate methods for obtaining a parsimonious sinusoidal series representation or model of biological time-series data. The methods are also used to identify nonlinear systems with unknown structure. A key aspect is a rapid search for significant terms to include in the model for the system or the time series. For example, the methods use fast and robust orthogonal searches for significant frequencies in the time-series, and differ from conventional Fourier series analysis in several important respects. In particular, the frequencies in our resulting sinusoidal series need not be commensurate, nor integral multiples of the fundamental frequency corresponding to the record length. Freed of these restrictions, the methods produce a more economical sinusoidal series representation (than a Fourier series), finding the most significant frequencies first, and automatically determine model order. The methods are also capable of higher resolution than a conventional Fourier series analysis. In addition, the methods can cope with unequally-spaced or missing data, and are applicable to time-series corrupted by noise. Finally, we compare one of our methods with a well-known technique for resolving sinusoidal signals in noise using published data for the test time-series. PMID- 2706282 TI - Parameter optimization model of learning in stepping motion. AB - In this study we combine the representation of motion by a finite number of hardwired functions with parameter optimization to model learning during a stepping motion. Representation of experimental kinematic data by a finite number of predetermined functions and undetermined coefficients was analyzed. Least squares approximation was used to represent experimental data of stepping motions over obstacles of different heights. Functional relationships between coefficients and obstacles heights were also obtained. Learning of stepping over an obstacle was then formulated as a finite dimensional optimization problem. The pattern of foot path, and joint angles trajectories obtained by this learning model, were then compared to the experimental data. The results of the data fitting analysis and of the optimization process as a model for motion learning, indicate that motion can be adequately represented by a set of hardwired functions, and a finite number of task dependent coefficients. PMID- 2706283 TI - Perceptual spatial frequency--orientation surface: psychophysics and line element theory. AB - We have investigated the discriminability of gratings which simultaneously vary in spatial frequency and orientation. Thirteen and nine reference gratings were used with two observers, and bivariate discrimination probability surfaces were determined around each grating. These data were then fitted to a general bivariate Gaussian function. The results clearly demonstrate local separability in this log frequency and orientation discrimination domain. Our results also show that the factor contributing most to the non-Euclidean nature of such frequency/orientation discrimination is orientation anisotropia, although we also find some evidence for smaller changes in the associated Riemannian line-element at different frequency ranges. These results cast doubt upon claims for a "pseudo line-element" for frequency discrimination based upon the nonlinear outputs of a fixed set of detectors. PMID- 2706284 TI - Bi-lateral reactive force patterns in postural sway activity of normal subjects. AB - Postural activity of normal subjects while standing still, as measured via the reactive foot-ground reactive forces, was investigated separately for each of the supporting legs, to provide detailed information on the individual activity of each side. Such information is not accessible if the overall reactive forces on the whole body are measured instead. Twenty-three normal adult subjects (average age 41 years) took part in the measuring tests, which were made on two collaterally installed force platforms. From the force traces obtained, the following parameters were determined: timings and amplitudes of the waveforms, separately for each foot and sequence of the force vectors on both feet and in relation to each other. Weight-bearing imbalance was defined in the vertical direction to express the difference between the average forces supported by each of the legs. Two parameters were defined by combining the force results obtained on each of the legs in the horizontal plane: sway total activity, representing the resultant of the added vector-norms in the anteroposterior and mediolateral directions, respectively; and asymmetry, representing the resultant of the subtracted above vector norms. The results indicated that, although the force traces were synchronous to each other, different vectorial force patterns were found, indicating different levels of stabilizing activities on each of the legs. This was also demonstrated by the fact that sway total activity was found considerably higher than the net reactive forces acting on the whole body during sway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706285 TI - Spacetime representation of global electrocortical activity. AB - A model for global electrocortical activity is developed by considering telencephalonic structures as mass of linked oscillators generating activity with a number of resonant modes. Equations for the signals are written in the comoving frame and then transformed into the laboratory frame. The state transition matrix is obtained in the presence of electric and magnetic fields. PMID- 2706286 TI - Planning and execution of hand movements. AB - The presented approach focuses on the attempt to specify strategies of visually organizing sequences of different hand movements and the resulting fine-control of movement close to the target, since in skilled activities our ability to sequence a number of separate movements each having different spatiotemporal characteristics is of central importance. Sequences of different moves have been analysed here. After a gross distance covering part of the move, small correction movements are performed close to the target to reduce the position error. The length of the required correction movements and the corresponding positioning time increase with target distance. In order to investigate motor control strategies two different tasks, with and without time pressure, have been designed. Time pressure forces the subjects to finish the previous move and to prepare the next move simultaneously. Absolute, constant and variable errors revealed that under time pressure the subject changes the control strategy by increasing the constant and reducting the variable error. PMID- 2706287 TI - Walking in the American cockroach: the timing of motor activity in the legs during straight walking. AB - The timing of bursts of motor activity in extensor muscles in the coxae of pairs of legs in intact freely walking American cockroaches was studied. The timing of bursts in adjacent and non-adjacent leg pairs generally reflected the common alternating tripod gait of these insects. Detailed study of the timing further revealed two previously unreported features. 1) The timing of extensor bursts in the middle legs relative to bursts in the rear legs was more variable than it was relative to those in the front legs. This difference in variability was statistically significant for the means of bursts when all insects were considered together as well as for bursts in individual insects. An apparent difference in variability of the timing of burst starts compared to burst ends for any one leg pair was not significant. 2) There was a shift in the timing of motor bursts relative to one another when an insect walked fast such that motor bursts in the middle legs tended to lag farther behind those in the front legs, and those in the rear legs tended to lag farther behind those in the middle legs compared to the timing during slow walking. This shift was apparent in both burst starts and burst ends, although more obvious in the former. It occurred in both ipsilateral and contralateral leg pairs, and in both the mean data and the data for individual insects. The implications of these characteristics of the timing data are discussed in terms of the neural organization of insect walking. PMID- 2706288 TI - System analysis of Phycomyces light-growth response in single and double night blind mutants. AB - The sum-of-sinusoids method of nonlinear system identification has been applied to the light-growth response of the Phycomyces sporangiophore. Experiments were performed on the Phycomyces tracking machine with the wild-type strain with single and double mutants affected in genes madA, madB, and madC. The sum-of sinusoids test stimuli were applied to the logarithm of the light intensity. The log-mean intensity level was 10(-1) W m-2 and the wavelength was 477 nm. The system identification results are in the form of first- and second-order frequency kernels, which are related to temporal kernels that appear in the Wiener functional series. The first-order kernels agree well with those obtained previously by the white noise method. In particular, the madA madB and madB madC double mutants show very weak responses. With the superior precision of the sum of-sinusoids methods, we have achieved sufficient resolution to measure and analyze their second-order kernels. The first- and second-order frequency kernels were interpreted by system analysis methods involving a nonlinear parametric model. In addition a nonparametric hypothesis concerning interactions of gene products was tested. Results from the interaction tests confirm the earlier conclusion that the madB and madC gene products interact. In addition, with the enhanced precision and with the extension to nonlinear analysis, we have found evidence of interaction of the madA gene product with the madB and madC gene products. Thus all three genes appear to have mutual interactions, presumably because of their close physical association in a photoreceptor complex. PMID- 2706289 TI - Perinatal epidemiology and health care organization: the case of Belgium. PMID- 2706290 TI - Perinatal geography of Belgium. AB - The use of routinely collected perinatal data allows calculation of health indicators at regional levels. It helps the health managers in making decisions and provides etiological clues for epidemiology. The information is more easily assimilated with the use of maps. In Belgium, the rates of perinatal mortality, low-birthweight and preterm births vary widely between the districts. Southern districts maintain the highest rates of low-birthweight and preterm births. Even though these two factors account for most perinatal mortality cases, within 20 years, a disproportion of perinatal mortality rates between the north and the south of the country was progressively inversed to the disadvantage of the north. Advances in perinatology of some major services of the southern part may explain a good deal of this change. Discrepancies between low-birthweight and preterm rates in some districts may be explained by biomedical characteristics of ethnic groups concentrated in these areas. PMID- 2706291 TI - Perinatal health in Belgium: an introduction. AB - The objectives of this special issue are reviewed. The principle aim is to discuss the relatively high perinatal mortality rate observed in Belgium. Belgian perinatal mortality is higher than that of Japan and very close to that of the USA, even though Belgium has fewer low-birthweight newborns and teenage pregnancies than the USA. This introduction also briefly describes the general organization of the Belgian health care system. PMID- 2706292 TI - Bile secretory apparatus in the newborn dog: relationship between structural and functional immaturities. AB - In the dog, bile secretion is not fully mature at birth and develops during postnatal life. To try to establish morphologic correlates to the physiologic deficiencies, we examined the ultrastructure of hepatic parenchyma and biliary epithelium in a newborn puppy and in 3 puppies of 1, 3, and 7 days of age. At birth, the hepatocytes contain much glycogen and fat droplets, a small smooth endoplasmic reticulum and Golgi apparatus, rare autophagic vacuoles, and numerous lysosomes. The sinusoidal microvilli are short, and submembrane vesicles are few and small. The bile canaliculus is not dilated, but few and short microvilli and no pericanalicular vesicles are seen. The biliary epithelial cells are normal in size, but the luminal surface of the bile ductule has no microvilli and numerous blebs. These morphologic features change with maturation and, by the first week of life, the fine structure of the hepatocytes, bile ductular cells, and biliary passages resemble that observed in the adult liver. These findings provide morphologic support for the concept that, in the dog, the bile secretory apparatus is immature at birth and develops during postnatal life. PMID- 2706293 TI - Frequency of cesarean deliveries in Belgium. AB - Belgium has not been spared the increase in the rates of cesarean section (CS) observed in other Western countries. In contrast with some of these countries, however, rate increases have been rather modest, both nationally and in most Belgian hospitals. Casuistic data suggest that the indications explaining the increase of CS rates in Belgium are by and large comparable to those pinpointed elsewhere. Ways to reduce rates of abdominal delivery are suggested. PMID- 2706294 TI - Effect of light on diurnal variation of blood amino acids in neonates. AB - Normal newborns show a diurnal variation of blood amino acid concentration, with lower values at 04.00 h and higher at 12.00 h. Three groups of infants, each consisting of 10 normal, full-term neonates, remained under different lighting conditions for 24 h and blood amino acids were determined at 04.00 and 12.00 h. Group A remained under continuous light, group B had the eyes covered, and group C was exposed to intermittent light, with the lights dimmed between 22.00 and 04.00 h. Group A showed a reversal of blood amino acid periodicity with a mean decrease of total amino acid concentration by 17.7% at 12.00 h (p less than 0.025). In group B there was no statistically significant difference between 04.00 and 12.00 h values. Group C showed the usual amino acid periodicity with a mean increase of total amino acid concentration by 36.1% at 12.00 h (p less than 0.005). The differences observed between groups A and C were statistically highly significant (p less than 0.0005). These data indicate that lighting conditions may affect the diurnal variation of blood amino acids and this should be considered for infants who remain under continuous light for prolonged periods in neonatal units. PMID- 2706295 TI - Properties of poly(2-hydroxyethyl acrylate) networks. AB - Hydrogels, based on poly(2-hydroxyethyl acrylate) cross-linked with 1,4 butanediol dimethacrylate, were studied in respect to their swelling and mechanical behaviour. The determination of Young's modulus at r.t. permitted the calculation of average molecular weight between cross-links. This value could, in turn, be correlated with water-swelling data to give indicative values of the interaction parameter for the system poly(2-hydroxyethyl acrylate)-water. PMID- 2706296 TI - Tissue reactions around two alloplastic ligament substitute materials: experimental study on rats with carbon fibres and polypropylene. AB - The early connective tissue reactions around two alloplastic and prosthetic materials, carbon fibre and polypropylene were examined in 30 rats. Each of the materials was implanted into three sites: under the skin, intraperitoneally and into a femoral bone tunnel. Microscopic and scanning electron microscopic findings at 1, 3, 6, 9 and 12 wk post-operatively are described. The amount of granulation tissue around the carbon fibres was more prominent in all the environments, but the connective tissue remained less mature and less organized during the whole follow-up compared to that of the polypropylene. There was no ingrowth of bone between the bundles of the artificial materials in the bony tunnels. The differences in the early cellular reactions and scar tissue maturation in the interstices of these two materials are probably due to the structural differences rather than to the surface properties of the materials. PMID- 2706297 TI - Role of corrosion in Harrington and Luque rods failure. AB - Ten in-vivo failed spinal instrumentation systems, i.e. six Harrington distraction rods with sublaminar hooks, one Harrington distraction rod with segmental wiring and three Luque rods with sublaminar wires, were fractographically analysed. In both Harrington and Luque rods corrosion fatigue was the predominant mechanism resulting in the failure. Five Harrington rods fractured at the first ratchet junction; fractures of the Luque rods were initiated by fretting of sublaminar wire with the rod surface in the presence of spinal non-union. Fretting and crevice corrosion were found to play an important role in compromising the segmental spinal instrumentation. The susceptibility of the 316 L CW austenitic stainless steel to pitting and relative resistance to crevice corrosion were measured by cyclic anodic polarization tests. The oxide inclusions have been found to play a significant role in the pitting of the alloy. PMID- 2706298 TI - Interaction between hydrogen peroxide and titanium: a possible role in the biocompatibility of titanium. AB - Hydroxyl radicals formed from hydrogen peroxide during an inflammatory response are potent agents for cellular deterioration. The behaviour of implanted material in terms of its ability to sustain or stop free radical formation may be therefore very important. In vitro studies of titanium which is known to be biocompatible and osseointegrates into human bone were carried out. In our model studies, the production of free radicals from H2O2 at Ti and TiO2 surfaces was measured by spin trapping techniques. Our findings suggest that there is no sustained hydroxyl radical production at a titanium (oxide) surface. We propose that this is due to the quenching of the Fenton reaction through both trapping and oxidation of superoxide radicals in a TiOOH adduct. PMID- 2706299 TI - Interface between bone tissue and implants of solid hydroxyapatite or hydroxyapatite-coated titanium implants. AB - Loaded prestressed implants of dense hydroxyapatite and non-loaded hydroxyapatite coated titanium implants were placed in edentulous regions of the lower jaw of dogs. After 6 month the jaw specimens were fixed and embedded in methyl methacrylate. Thin non-decalcified ground sections were made for histology. Although the hydroxyapatite showed histological differences between the coated implants and the prestressed solid ones, both had an extensive apposition of normal lamellar bone on the whole surface of the bone-buried part of the implant. The bone contact was very intimate and without any visible intermediate tissue layer. The tissue response observed forms a good biological base for the clinical application of hydroxyapatite-coated titanium implants. PMID- 2706300 TI - Reaction of Ca2+ and phosphate ester. AB - The reaction of calcium ions and organic phosphate ester monomer at varying pHs was examined. Above pH 10, poorly crystallized hydroxyapatite was formed, which had lower crystallinity than that synthesized with inorganic phosphate as a source of P under the same conditions. On the other hand, the results of X-ray diffraction, chemical analysis, infrared absorption analysis and differential thermal analysis suggested that, crystalline organic calcium phosphate ester was formed below pH 10, whilst for the synthesis with inorganic phosphate hydroxyapatite was formed at pH 7.4. PMID- 2706301 TI - Mechanical properties of hydroxyapatite-reinforced gelatin as a model system of bone. AB - The elastic Young's modulus of hydroxyapatite-reinforced gelatin as a mechanical model system of bone was measured as a function of the volume fraction of hydroxyapatite, phi h. Initially, the Young's modulus gradually increased with an increase in phi h and then increased rapidly in the vicinity of phi h approximately 0.2. The phi h dependence of the Young's modulus was analysed by means of the theory of composite materials. It was found that with the increase in phi h the initial uniform stress deformation mode of the sample changed to the uniform strain deformation mode. The non-linear character in phi h dependence of the Young's modulus of this system was considered to reproduce well the novel behaviour of the mechanical properties of bone as a function of the mineral fraction. The situation was considered to be similar to a percolation problem. A preliminary analysis revealed that the critical exponent about the viscosity of the system accorded with the theoretically expected value. The result may present the evidence that the discontinuous point in mechanical properties of bone would be originated from an interaction such as a percolation of mineral particles on a matrix protein. PMID- 2706302 TI - Tissue response to subperiosteal implantation of dense hydroxyapatite: case report. AB - Hydroxyapatite is becoming a popular implant material, yet reports on the tissue response it evokes in humans have been few in number and are based on relatively short periods of implantation. In the present case, implant material became available when it proved necessary to modify an alveolar ridge augmentation procedure carried out 18 month previously. Histology showed that whilst some parts of the implanted material were embedded only in fibrous tissue, others had become fully integrated within partly remodelled bony trabeculae. These findings confirm the status of hydroxyapatite as a biocompatible implant material and provide further evidence of its bone-bonding and osteoconductive capacities. PMID- 2706303 TI - Antibiotic-metal interactions in saline medium. AB - The commonly used surgical alloys, stainless steel, titanium and Vitallium, were exposed to normal saline solution containing antibiotics frequently used for the control and treatment of orthopaedic infections and the corrosion potential versus time behaviour was followed. It was found that only one antibiotic, oxytetracycline, exerted a significant effect on electrochemical behaviour, producing an anodic shift of 120-250 mV in the Ecorr of the three metals. The study indicated that oxytetracycline at addition levels of 0.01-1.0 mg/ml acts as an anodic corrosion inhibitor. PMID- 2706304 TI - Use of high-performance polyethylene fibres as a reinforcing phase in poly(methylmethacrylate) bone cement. AB - First results are presented concerning the elastic and ultimate mechanical behaviour of p(MMA) bone cement reinforced with as-received and surface-modified Spectra 900 polyethylene fibres. Even though the surface chemistry and reactivity of the fibres was modified, the surface oxidation and surface grafting treatments of the polyethylene fibres apparently did not significantly affect the mechanical properties of the polyethylene-reinforced p(MMA) bone cement or improve the interfacial bonding. This may be attributed to the rather unfavourable area-to volume ratio of PE fibres for such treatments, as well as to the necessarily low content of PE fibres in the bone cement which does not allow a clear differentiation between the various samples. PMID- 2706305 TI - Hydrophilic polyurethane versus autologous femoral vein as substitutes in the femoral arteries of dogs: quantification of platelets and fibrin deposits. AB - Hydrophilic, microporous polyurethane vascular prostheses displayed good mechanical characteristics and the behaviour in vitro was excellent. The in-vivo results were, however, disappointing. To obtain a better understanding of the phenomena involved in the acute and early thrombosis, we implanted the polyurethane graft in the canine left femoral artery and an autologous femoral vein in the right for 4 and 24 h. At 4 h, one polyurethane graft was totally occluded and the other two were close to complete occlusion; at 24 h, none was patent. On the other hand, all autologous veins were patent. The thrombotic matrix incorporating both platelets and fibrinogen, quantified by labelling, was anchored along the anastomotic lines. This study confirms that polyurethane occlusion is initiated by hyperplastic reaction, but does not explain why. PMID- 2706306 TI - Culture of human vascular endothelial cells on a positively charged polystyrene surface, primaria: comparison with fibronectin-coated tissue culture grade polystyrene. AB - Two culture surfaces, fibronectin-coated tissue culture grade polystyrene and a surface-modified polystyrene called Primaria (Falcon), were compared. The morphological (contact inhibition and cobblestone aspect), biological (production of von Willebrand factor and prostacyclin) and physiological (growth activity, non-thombogenicity and regeneration after mechanical injury) properties of human endothelial cells were studied. Adhesion and growth of endothelial cells at low and clonal density were identical on both substrates and the biological properties were preserved. Regeneration of injured endothelium was less easy to study on Primaria polystyrene because the extracellular matrix was damaged during the lesion process. Nevertheless, Primaria polystyrene can easily be substituted for fibronectin coating in growth experiments, especially at very low seeding density. PMID- 2706307 TI - Water absorption of methacrylate soft lining materials. AB - The water absorption of soft methacrylate prosthetic materials is very high compared with rigid methacrylates and is not at an equilibrium value even after 6 yr. This very high and prolonged uptake can be explained qualitatively in terms of the presence of water soluble impurities which form sites for the formation of water droplets. These droplets grow until the osmotic and elastic forces balance; this mechanism can be accompanied by creep or even rupture under the osmotic pressure. Desorption on the other hand, is rapid and obeys diffusion laws, giving diffusion coefficients of 5-7 X 10(-8) cm2 s-1. PMID- 2706308 TI - In vivo degradation of polymers. I. Change of mechanical properties in polyethylene pacemaker lead insulations during long-term implantation in the human body. AB - The results of mechanical testing and microscopic examination of explanted clinically-used polyethylene pacemaker lead insulations are presented. An experimental set of 98 lead insulations implanted for times ranging from 7 d to 11 yr was evaluated for changes in mechanical properties during clinical use. The results showed that the polyethylene tubing suffered a gradual structural change, due to its exposure to the physiological environment of the human body. The decline of the mechanical properties with implantation time is described by empirical formulae. Abrasive deterioration was also observed and is discussed. PMID- 2706309 TI - Direct examination of chemical kinetic laws by visual imagery. IV. Association processes between antigen- and fragmented antibody carrying fluorescent latex particles. AB - The binary association process was further examined by direct visual observation using a fluorescence microscope connected to an image-processing system and by a spectrophotometric method. In the present paper, we used human serum albumin (HSA)- and fragmented anti-HSA antibody-carrying fluorescent latex particles in order to attain higher sensitivities and exclude complexities that might be caused by dissociation of the association product. The rate constant of the binary association process was estimated to be 6.0 x 10(8) M-1 s-1 at 30 degrees C and pH 7.6. The activation parameters of the association process were evaluated. The effects of pH and viscosity of the suspension on the association process were also examined. PMID- 2706310 TI - Proton nmr relaxation study of the dynamics of anthopleurin-A in solution. AB - Spin-spin and spin-lattice 1H-nmr relaxation times of the sea anemone polypeptide anthopleurin-A were measured at frequencies of 200, 300, 400, and 500 MHz. Relaxation times were fitted iteratively by least squares regression to the isotropic tumbling model, Woessner's model for anisotropic motion, and Lipari and Szabo's "model-independent" model. Data for aromatic and aliphatic methine protons could not be fitted satisfactority using the isotropic model. Good fits were obtained, however, using the model-independent approach, indicating that high-frequency internal motions of the polypeptide backbone were significant. In addition, a range of tau c values from 2.2 to 3.2 ns was obtained for various methine protons, suggesting that overall rotational reorientation of the molecule was anisotropic. Methyl group relaxation data were fitted satisfactorily by Woessner's model. Some assessment has been made of the effect of experimental errors on the quality of fit to the data, as well as of the contribution of experimental values at certain frequencies to definition of the spectral density function. PMID- 2706311 TI - Thermodynamics of the various forms of the dodecamer d(ATTACCGGTAAT) and of its constituent hexamers from proton nmr chemical shifts and UV melting curves: three state and four-state thermodynamic models. AB - Chemical shifts of base and H1' protons of the single-stranded hexamers d(ATTACC) and d(GGTAAT), of the 1:1 mixtures of these complementary hexamers, and of the self-complementary dodecamer d(ATTACCGGTAAT) were measured at various temperatures in aqueous solution. Four different sample concentrations were used in the case of the dodecamer and of the mixture of the complementary hexamers; the individual hexamers were measured at two different DNA concentrations. Absorbance temperature profiles at five different NaCl concentrations were measured for the dodecamer in order to quantify the effect of the ionic strength on the duplex formation. Under suitable conditions of nucleotide concentration, temperature, and ionic strength, the dodecamer adopts either a B-DNA duplex or a hairpin-loop structure. Chemical shift vs temperature profiles, constructed for all samples, were used to obtain thermodynamic parameters either for the various stacking interactions in the single strands or for the duplex or the hairpin-loop formation. In the analysis of the duplex formation of the hexamers, a two-state approach appeared too simple, because systematic deviations were revealed. Therefore, a new three-state model (DUPSTAK) was developed. In order to investigate the magnitude of error arising from the use of the two-state approach in cases where the DUPSTAK model appears more appropriate, a series of test calculations was made. The magnitude of error in the enthalpy and in the entropy of duplex melting is found to depend linearly upon the actual melting temperature and not upon the individual delta Hd degrees and delta Sd degrees values. Thermodynamic analysis of the chemical shift vs temperature profiles in D2O solution (no added salt) yields an average Tmd value of 341 K (1M DNA) and delta Hd degrees of - 121 kJ.mol-1 for the dimer/random-coil transition of the hexamer duplex d(ATTACC).d(GGTAAT). For the duplex in equilibrium random-coil transition of the 12-mer d(ATTACCGGTAAT) an average Tmd value of 336 K (1M DNA) and delta Hd degrees of -372 kJ.mol-1 are found. The hairpin/random-coil transition of d(ATTACCGGTAAT) is characterized by a rather large delta Hh degrees value, -130 kJ.mol-1, and an average Tmh value of 304 K. PMID- 2706312 TI - Hydration of B-DNA: comparison between the water network around poly(dG).poly(dC) and poly(dG-dC).poly(dG-dC) on the basis of Monte Carlo computations. AB - A computational method is elaborated for studying the water environment around regular polynucleotide duplexes; it allows rigorous structural information on the hydration shell of DNA to be obtained. The crucial aspect of this Monte Carlo simulation is the use of periodical boundary conditions. The output data consists of local maxima of water density in the space near the DNA molecule and the properties of one- and two-membered water bridges as function of pairs of polar groups of DNA. In the present paper the results for poly(dG).poly(dC) and poly(dG dC).poly(dG-dC) are presented. The differences in their hydration shells are of a purely structural nature and are caused by the symmetry of the polar groups of the polymers under study, the symmetry being reflected by the hydration shell. The homopolymer duplex hydration shell mirrors the mononucleotide repeat. The water molecules contacting the polynucleotide in the minor groove are located nearly in the plane midway between the planes of successive base pairs. One water molecule per base pair forms a water bridge facing two polar groups of bases from adjacent base pairs and on different strands making a "spine"-like structure. In contrast, the major groove hydration is stabilized exclusively by two-membered water bridges; the water molecules deepest in the groove are concentrated near the plane of the corresponding base pair. The alternating polymer is characterized by a marked dyad symmetry of the hydration shell corresponding to the axis between two successive base pairs. The minor groove hydration of the dCpdG step resembles the characteristic features of the homopolymer, but the bridge between the O2 oxygens of the other base-stacking type is formed by two water molecules. The major groove hydration is characterized by high probability of one-membered water bridges and by localization of a water molecule on the dyad axis of the dGpdC step. The found structural elements are discussed as reasonable invariants of a dynamic hydration shell. PMID- 2706313 TI - Conformations of dehydrophenylalanine containing peptides: nmr studies of an acyclic hexapeptide with two delta Z-Phe residues. AB - The conformation of an acyclic dehydrophenylalanine (delta Z-Phe) containing hexapeptide, Boc-Phe-delta Z-Phe-Val-Phe-delta Z-Phe-Val-OMe, has been investigated in CDCl3 and (CD3)2SO by 270-MHz 1H-nmr. Studies of NH group solvent accessibility and observation of interresidue nuclear Overhauser effects (NOEs) suggest a significant solvent-dependent conformational variability. In CDCl3, a population of folded helical conformations is supported by the inaccessibility to solvent of the NH groups of residues 3-6 and the detection of several NiH----Ni + 1H NOEs. Evidence is also obtained for conformational heterogeneity from the detection of some Ci alpha H----Ni + 1H NOEs characteristic of extended strands. In (CD3)2SO, the peptide largely favors an extended conformation, characterized by five solvent-exposed NH groups and successive Ci alpha H----Ni + 1H NOEs for the L-residues and Ci beta H----Ni + 1H NOEs for the delta Z-Phe residues. The results suggest that delta Z-Phe residues do not provide compelling conformational constraints. PMID- 2706314 TI - Solvated helical backbones: x-ray diffraction study of Boc-Ala-Leu-Aib-Ala-Leu Aib-OMe.H2O. AB - A second example of insertion of a water molecule into the helical backbone of an apolar peptide is presented here and compared to a similar occurrence in a longer peptide with the same type of sequence of residues, i.e., Boc-Aib-(Ala-Leu-Aib)3 OMe. The backbone of the title compound assumes an approximate 3(10)-helical form with three 4----1 hydrogen bonds. In the place of a fourth 4----1 hydrogen bond, a water molecule is inserted between O(1) and N(4), and acts as a bridge by forming hydrogen bonds N(4) ... W(1) (2.95 A) and W(1) ... O(1) (2.81 A). The water molecule participates in a third hydrogen bond with a neighboring peptide molecule, W(1) ... O(4) (2.91 A). The insertion of the water molecule causes the apolar peptide to mimic an amphiphilic helix. Crystals grown from ethyl acetate/petroleum ether (reported here) or from methanol/water solution are in space group P2(1)2(1)2(1) with a = 12.024(4) A, b = 15.714(6) A, c = 21.411(7) A, Z = 4 and dcalc = 1.124 g/cm3 for C32H58N6O9.H2O. The overall agreement factor R is 6.3% for 2707 reflections observed with intensities greater than 3 sigma(F) and the resolution is 0.90 A. PMID- 2706315 TI - Physiologically based pharmacokinetic model for the renal clearance of iodopyracet and the interaction with probenecid in the dog. AB - Plasma kinetics and renal excretion of iodopyracet (3.0 g, administered i.v.) with and without concomitant administration of probenecid were studied in the beagle dog. Pharmacokinetic analysis revealed that tubular secretion is the predominant route of excretion, and that secretion is inhibited by probenecid. A physiologically based kidney model is proposed comprising all the functional characteristics of the kidney that determine the excretion of iodopyracet, i.e. renal plasma flow, urine flow, protein binding, glomerular filtration, tubular secretion, and tubular accumulation. The model enabled an accurate description and analysis of the measured plasma levels and renal excretion rates. Renal clearance of iodopyracet is characterized by supply-limited elimination at low plasma concentrations and capacity-limited elimination at high plasma levels. The interaction with probenecid could be adequately described with the model by competitive inhibition of the carrier-mediated uptake of iodopyracet into the tubular cells. Model calculations showed that in the control experiments tubular secretion was accompanied by a pronounced accumulation of iodopyracet within the cells, which was clearly diminished in the presence of probenecid. PMID- 2706316 TI - The absorption of sustained-release methylphenidate formulations compared to an immediate-release formulation. AB - A crossover study in 18 subjects evaluated the plasma concentration-time profile of two different 20 mg sustained-release (SR) methylphenidate (MPH) tablets administered before breakfast, compared to a 10 mg immediate-release (IR) tablet administered before breakfast and again 5 h later, before lunch. Plasma MPH concentrations were determined using a sensitive and precise gas chromatography mass spectrometry method, incorporating a deuterated internal standard. The mean peak MPH concentration was 6.4 ng ml-1 for the IR product versus 4.6 ng ml-1 and 4.8 ng ml-1 for the two SR formulations. Peak concentrations occurred at 3.3 h after dosing with the SR products, compared to 1.5 h after the first dose of the IR product. The extent of absorption for the three products, as determined from areas under the plasma concentration-time curves, were within 5 per cent of each other. There was no significant difference in rate or extent of absorption between the two SR formulations. PMID- 2706317 TI - Removal of sulfonamides by hemofiltration. AB - Hemofiltration is a relatively new technique for removing toxic substances from the body. Unlike hemodialysis or hemoperfusion, the driving force behind hemofiltration is ultrafiltration. There have been several studies examining the clearance of drugs by hemofiltration but to date no study has investigated in a systematic way the effects of protein binding, perfusate flow, transmembrane pressure, and the duration of treatment on drug clearance by hemofiltration. The influence of these factors on the hemofiltration clearance of three sulfonamides with differing degrees of protein binding was investigated. It was found that hemofiltration drug clearance decreased with the duration of hemofiltration and protein binding but increased with perfusate flow and transmembrane pressure. PMID- 2706318 TI - Pharmacokinetics and pharmacodynamics of physostigmine in the rat after oral administration. AB - The distribution, metabolism, and pharmacokinetics of physostigmine (Phy) and the time course of butyrylcholinesterase (BuChE) in plasma and cholinesterase (ChE) activity in brain and muscle and their relationship to Phy concentration were described after oral administration of 3H-Phy (650 micrograms kg-1) to rats. Physostigmine concentration vs time data was analyzed by nonlinear computer fitting program using one-compartment model. The absorption rate constant (ka) and elimination rate constant (ke) were found to be 0.1 +/- 0.07 min-1 and 0.036 +/- 0.024 min-1, respectively. Cpmax and tmax were 3.3 ng ml-1 and 16 min. The clearance (C1) was found to be 80.9 ml min-1kg-1. Half-life of Phy in brain, muscle, and liver were 33.4 min, 22.5, and 28 min, respectively. The bioavailability (F) was calculated to be 0.02 and the extraction ratio was found to be 0.98 indicating the 'first pass' effect. Butyrylcholinesterase activity in plasma was 76 per cent at 15 min and this activity did not change significantly up to 120 min. However, Phy concentration in plasma was very low; 2.89 ng ml-1 at 15 min and declined to 0.71 ng ml-1 at 90 min. Physostigmine concentration in brain peaked at 22 min to 2.85 +/- 1.09 ng g-1 and declined to 0.33 +/- 0.11 ng g 1 at 60 min. Cholinesterase activity in brain was 96 per cent, 82 per cent and 89 per cent at 10, 45, and 120 min, respectively. Physostigmine concentration in muscle was very low and the ChE activity in the muscle was 66.4 per cent of control at 45 min. The time course of Phy metabolism indicated that at 5 min most of the RA in the tissues was due to metabolites accounting for 94.6 per cent in plasma, 90 per cent in liver, 79.8 per cent in brain and 86.3 per cent in muscle. M1 appeared to be the major metabolite followed by eseroline. The results showed extremely low concentrations of Phy (200 times less in plasma and 350 times less in brain) after oral administration compared to our previous studies with the same dose after i.m. administration. PMID- 2706319 TI - Bioequivalency of oral suspension formulations of cefixime. AB - A study was performed in 24 healthy male subjects to establish that two suspension formulations of cefixime were bioequivalent to each other and to a reference oral solution. A single 400 mg oral dose of the drug was given in a randomized three-way crossover design as two suspensions (a research suspension (RS) used during clinical trials and a suspension intended for marketing (MS] and a reference oral solution (SOL). Each dose was separated from the other by a 3 day washout period. Mean peak serum concentrations (Cmax) were 4.67, 4.10, and 4.27 micrograms ml-1 after the MS, RS, and SOL, respectively. Although comparison (ANOVA) of the mean pharmacokinetic parameters for cefixime found significant differences (p less than 0.05) in Cmax, the time to Cmax, and area under the serum concentration time curve (AUC 0----infinity) values among the three formulations, the mean differences were less than 20 per cent. No significant differences (p greater than 0.05) were found in either the elimination half-life or renal clearance of unchanged drug. Overall, with a 98 per cent power to detect a 20 per cent difference in AUC0----infinity or urinary recovery values between the formulations tested, the results show that the MS was bioequivalent to the RS and that both suspensions were bioequivalent to the SOL. PMID- 2706320 TI - Sustained release properties of the once daily theophylline capsule BY912 as compared with Theo-24 capsules. AB - In a multiple dose cross-over experiment in 12 healthy male adults the bioavailability and sustained release characteristics of new once daily BY912 400 mg theophylline capsules (= B, Byk Gulden Research Laboratories, FRG) were studied using Theo-24 capsules (= T, Searle & Co., USA) as reference. Both products were given once daily for a period of 7 days as an 800 mg theophylline dose at 8 am, half an hour after a standardized breakfast. Theophylline concentrations in plasma were measured on days 1, 6, and 7 using high-performance liquid chromatography. Significantly better sustained release characteristics, resulting in longer plateau time (t75%, 11.6 vs 9.2 h on day 6 and 13.1 vs 8.8 h on day 7) and smaller per cent peak-trough fluctuation in the steady state (per cent PTF, 80 vs 103 per cent on day 6 and 66 vs 100 per cent on day 7), were found for B in comparison with T. The extent of absorption on both days, however, was smaller for B compared with T (relative bioavailability 84 per cent and 81 per cent, respectively). In conclusion, the absorption of theophylline from B resulted in a more extended shape of the plateau phase, indicating better sustained release characteristics. The extent of absorption, however, over the dosing intervals was more complete with T. PMID- 2706321 TI - Ocular absorption of benzydamine by the rabbit. AB - An aqueous solution of 0.15 per cent benzydamine hydrochloride, a non-steroidal anti-inflammatory drug, was applied to the rabbit eye. Following topical application to the cornea, the drug was soon detected in the aqueous fluid of the treated eye, whereas the plasma levels were negligible. The possibility that benzydamine can inhibit inflammatory processes in the eye without the risk of side-effects is discussed. PMID- 2706322 TI - Biological information processing: the use of information for the support of function. AB - In biological systems, the processing and use of information has evolved out of the need for survival in the face of an uncertain environment. As a consequence, the information-function relationship in these systems is shaped by their adaptability characteristics. In contrast, the information-function relationship in man-designed, goal-oriented organizational systems depends on the ability of the information processing system to support the achievement of the organization's goals. In this paper we use results from adaptability theory in the analysis of control-related aspects of the information-function relationship in man-designed organizational systems. In particular, we use a conceptual model of organizational control to characterize features of functional and control structures and their effect on the adaptability of these systems. The concept of implicit control and a design principle for adaptability-enhancing information systems are derived for this analysis. PMID- 2706324 TI - Toluene-associated myelofibrosis. PMID- 2706323 TI - Heterozygous protein C deficiency type I. AB - Protein C is a vitamin K-dependent plasma protein which has anticoagulatory and profibrinolytic properties as a result of inactivating coagulation factors Va and VIIIa and enhancing fibrinolysis. Heterozygous protein C deficiency is well known to be a risk factor for thromboembolic diseases. We here present a family with 16 members deficient in protein C, out of which only two persons were suffering from thromboembolic disorders. In patients suffering from heterozygous protein C deficiency thromboembolic complications in childhood are rare and are not obligatory in adults. These patients should therefore not be treated with oral anticoagulants unless thromboembolic complications have already occurred or are imminent. Coumarin anticoagulation implicates a serious risk of coumarin skin necrosis in protein C deficient patients during the initial therapeutic phase. This risk may be avoided by initiating coumarin therapy with low doses of the drug and in cases of thromboembolic complications by overlapping with heparin anticoagulation. PMID- 2706325 TI - DNA index and cell cycle analysis of primary breast cancer and synchronous axillary lymph node metastases. AB - The DNA Index (DI) and the percentage of cells in S-phase (S-phase fraction, SPF) were measured by flow cytometry in 80 primary breast carcinomas and in 80 accompanying axillary lymph node metastases. The DI in primary tumors and metastases agreed in 61 cases (76%). Cases with diploid primary tumors revealed more constancy of the DI in comparison to the metastases than the cases with aneuploid primary tumors (91% and 70% respectively). The mean values of the SPF were in close agreement in the primary tumors and in the lymph node metastases (6.1% and 6.0% respectively). Differences between the SPF of the two groups could be detected only by the consideration of case-related data pairs. In 50 cases (62%), the percentage of SPF agreed approximately in primary tumors and in the correspondent metastases. The cases with diploid primary tumors revealed more agreement of the SPF in the primary site and the metastases than did cases with aneuploid primary tumors (78% and 56% respectively). In conclusion, diploid carcinomas and their metastases revealed more constancy of the DI and the percentage of SPF than aneuploid carcinomas. These findings agree well with a better prognosis of diploid mammary carcinomas, as reported in the literature. Comparisons between the DI and the SPF in primary tumors and the corresponding metastases could be a source of valuable information on the biological behaviour and the aggressiveness of mammary carcinomas. PMID- 2706326 TI - Prognostic value of nuclear DNA content in breast cancer in relation to tumor size, nodal status, and estrogen receptor content. AB - The prognostic value of nuclear DNA distribution pattern in relation to tumor size, axillary lymph node status, and estrogen receptor (ER) content was studied in 464 patients with primary, operable mammary adenocarcinoma. The median follow up time was 3 1/2 years. Slide cytophotometric DNA analysis was performed on morphologically identified Feulgen-stained tumor cells. The tumors were classified into four subgroups according to their DNA histogram type. DNA content was significantly related to tumor size and ER level but not to nodal status. When all variables were stimultaneously introduced into Cox's proportional hazards model, tumor size, nodal status, and DNA profile remained as significant predictors of recurrence. Restricting the analysis to node-negative patients, both DNA profile and tumor size showed a significant prognostic value. DNA did not contribute significant prognostic information in node-positive patients. However, the trends in recurrence-free survival were similar to those in the node negative subgroup: patients with aneuploid tumors tended to fare worse than those with euploid carcinomas. PMID- 2706327 TI - Histopathologic and dietary prognostic factors for canine mammary carcinoma. AB - Histologic and dietary prognostic factors for survival following naturally occurring breast cancer were studied for 145 pet dogs. Information was collected from the dog's owner and veterinarian regarding medical and reproductive history, nutritional status, treatment, tumor recurrence, and length of survival. The usual intake of all dog and table foods consumed 1 year prior to diagnosis was obtained using a validated quantitative food frequency questionnaire. A histologic malignancy score was derived based on 7 histopathologic criteria. The mean age of the dogs was 10.4 +/- 2.5 years; 37% had been ovariohysterectomized prior to diagnosis. Product-limit estimates of survival indicated that 6 factors, namely body conformation 1 year prior to diagnosis (p = 0.03), histologic tumor type (p = 0.004), histologic malignancy score (p = 0.02), histologic invasion (p = 0.002), tumor recurrence (p less than 0.0001), and completeness of surgery (p = 0.01) were of prognostic significance. In addition, when dogs were characterized by the percent of total calories they derived from fat and protein, the median survival time for dogs in the low fat group (less than 39%) with protein greater than 27%, 23-27%, and less than 23% was 3 years, 1.2 years, and 6 months, respectively (p = 0.008). For dogs in the high fat group (greater than or equal to 39%), there was no difference in survival for the different intake levels of dietary protein (p = 0.84). When these data were fitted to a proportional hazards model, recurrence, histologic score, tumor type, percent of calories derived from protein, fat group, and a protein-fat group interaction term were statistically significant. Predicted 1 year survival for dogs on a low fat diet with 15%, 25%, and 35% of total calories derived from protein was 17%, 69%, and 93%, respectively. PMID- 2706328 TI - Nipple aspirate fluids in adult nonlactating women--lactose content, cationic Na+, K+, Na+/K+ ratio, and coloration. AB - The presence of lactose in nipple secretions is considered biochemical evidence of breast secretory activity, and has been reported to occur more frequently in white compared to brownish or green colored breast fluid. We studied lactose, Na+, and K+ concentrations, the Na+/K+ ratio, and the coloration of nipple aspirate fluid (NAF) from 49 nonpregnant women. A significant relationship was found between the concentrations of lactose, Na+, and K+, and age and the coloration of NAF. Lactose was present in 22/49 (44.8%) of the NAF samples and declined with age from 100% positivity in women less than or equal to 29 years to 29% in those less than or equal to 35 years. In NAF of deep yellow, brown and green colorations, only traces of lactose were found. Na+ and K+ increased with age and with darker colorations compared to white, pale yellow, or colorless NAF. Lactose was present in NAF samples from both parous and nulliparous younger women, indicating that the breasts of many nonpregnant women respond to prolactin stimulation; hence, lactose may provide a simple marker indicating active physiologic secretory activity of the breast. As reported previously, NAF of darker coloration, containing elevated levels of cholesterol, cholesterol oxidation products, and other substances, suggests retention and impaired reabsorption of these and other products of secretion. Because of the secretion and temporary retention by the breast glands of chemical substances of exogenous and endogenous origin, including mutagens and carcinogens, lactose concentration and coloration of NAF may be useful as markers of secretion and reabsorption in future physiologically based clinical and epidemiologic studies of the pathogenesis of breast disease. PMID- 2706329 TI - The Stockholm breast cancer screening trial--5-year results and stage at discovery. AB - In screening programmes it is important to assess a preliminary effectiveness of the screening method as soon as possible in order to forecast survival figures. In March 1981 a controlled single-view mammographic screening trial for breast cancer was started in the south of Stockholm. The population invited for screening mammography consisted of 40,000 women aged 40-64 years, and 20,000 women served as a well-defined control group. The main aim of the trial was to determine whether repeated mammographic screening could reduce the mortality in the study population (SP) compared to the control population (CP). The cumulative number of advanced mammary carcinomas in the screening and the control populations from the first five years of screening have shown a tendency towards more favourable stages in the screened population aged 40-64 years. A breakdown by age suggests an effect in age group 50-59 years, but not yet in age groups 40 49 and 60-64 years. When comparing the rates of stage II+ cancer, an increased number is found in the study group. As the total rate of breast cancer is higher in SP than in CP, there ought to be a concealed group of stage II+ cancers in the CP which makes the comparison biased. A new approach has been designed, where an estimation of the 'hidden' number of stage II+ cancers in CP is added to the clinically detected cases, and in this respect a comparison has shown a decrease in the cumulative number of advanced cancers in the SP in relation to the CP (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706330 TI - Investigators' and judges' opinions about civil commitment. AB - As part of our work with the Oregon Task Force on Civil Commitment, we surveyed the judges and commitment investigators involved in the state's involuntary treatment program. In Oregon the investigators recommend whether or not a commitment hearing should be held. These mental health professionals indicated that current confidentiality laws restrict their access to important information. The investigators also expressed concern about the lack of resources with which to divert clients out of the commitment system. Judges too felt that relaxing the rules of evidence would improve the quality of commitment hearings. Regarding changes in the system, investigators and judges indicated that outpatient treatment (including compliance with medications) should be required of committed patients. These professionals noted that involuntary outpatient treatment could only be enforced if the system included a mechanism for hospitalizing patients who were noncompliant. Although the investigators believed commitment criteria should be broadened so that their clients could receive treatment before becoming dangerous, judges did not generally endorse this view. We discuss the implications of these findings for new civil commitment legislation. PMID- 2706331 TI - The diagnostic and statistical manual of mental disorders in the courts. AB - The DSM is designed with the intention that it will be used in clinical and research contexts, not as a guide for the courts. Increasingly, from DSM to DSM III-R, the introductory cautionary statement in the manual has warned against its use in the judicial context. The drafters of the DSM faced a choice and might have chosen to address in some greater detail those disordered behaviors that do have legal relevance in that they arise with some degree of regularity in the courts. The following essay examines this choice and its consequences. PMID- 2706332 TI - An HIV-infected psychiatric patient: some clinicolegal dilemmas. AB - The acquired immune deficiency syndrome (AIDS) crisis has raised many clinical and forensic dilemmas for the health-care system. Psychiatrists may encounter particular problems when evaluating and treating human immunodeficiency virus (HIV) infected patients. The authors present a case of an HIV seropositive, bipolar, intravenous drug abusing patient who participates in unsafe sexual practices to illustrate clinicolegal dilemmas involving dangerousness, involuntary hospitalization, confidentiality, and Tarasoff-like duty. PMID- 2706333 TI - Influences of an interviewer's behaviors in child sexual abuse investigations. AB - The content of an investigatory interview is one of several factors which may influence the data gathered in the course of a sexual abuse investigation. This article focuses on the impact of an interviewer's behaviors upon the information presented by the alleged victim. Behavioral aspects of the interview which may influence the child's information include inappropriate interactional patterns, emotional reactions of the interviewer, and/or changes in continuity of specific behaviors. Recommendations are made to assist investigators in avoiding these interviewing pitfalls and, thereby, minimizing contamination of the child's data. PMID- 2706334 TI - Capgras syndrome and dangerousness. AB - This article discusses Capgras syndrome and its association with harmful and potentially harmful behaviors. Phenomenological and psychodynamic analysis of a series of cases will highlight danger signals that may be present in Capgras patients. PMID- 2706335 TI - Should forensic patients be informed of evaluators' opinions prior to trial? AB - There are several articles in the literature that discuss the problems which occur when persons who have been evaluated by forensic clinicians hear the results of those evaluations for the first time in court. The authors agree that the scenarios presented are problematic but suggest that in many cases the problems can be avoided by sharing the information with the person prior to presenting it in court. They present several case examples to illustrate their point. PMID- 2706336 TI - The psychiatrist's guide to right and wrong: Part II: A systematic analysis of exculpatory delusions. AB - Although delusions are prima facie evidence of psychosis, their mere presence is not a sufficient condition for exculpation on the grounds of insanity. In most cases, a determination of insanity will depend on the specific content of the delusions and whether, as a result of these delusions, the defendant was unable to know or appreciate the wrongfulness of his or her act. Delusions may be subdivided into four types, according to their content: 1) delusions of being controlled, 2) delusions of grandiosity, 3) delusions of persecution, and 4) delusions of jealousy. An analysis is undertaken of these delusional subtypes in terms of their exculpatory effect within the jurisdictions which follow each of the three respective standards of wrongfulness (i.e., the illegality standard, the subjective moral standard, and the objective moral standard). The criminal law does not recognize a transcendent constancy in the legal insanity status of psychotic individuals whose offense was the result of their delusional ideation. In most such cases, exculpation is based primarily on the specific content of their delusions and how it comports with the law of the jurisdiction specific content of their delusions and how it comports with the law of the jurisdiction in which the act was committed (the lex loci delicti commissi). PMID- 2706337 TI - Forensic psychiatry in private practice. AB - This paper presents statistical and explanatory analyses of 637 forensic psychiatry cases in a private practice setting during the past 12 years, highlighting the remarkable variety of clinical and legal issues addressed by forensic psychiatrists. Emphasis is on how and why forensic psychiatrists need to be expert diagnosticians and clinicians, and ways in which they may respond to difficult clinical and legal opinions are recommended. PMID- 2706338 TI - Silent suicide in the elderly. AB - The suicide rate in the United States rises consistently with age. Silent suicide is defined as the intention, often masked, to kill oneself by nonviolent means through self-starvation or noncompliance with essential medical treatment. Silent suicide frequently goes unrecognized because of undiagnosed depression and the interjection of the personal belief systems of health-care providers and family members. Elderly individuals committing silent suicide are often thought to be making rational end of life decisions. However, the elderly committing silent suicide must be distinguished from terminally ill patients who refuse further treatment in order not to prolong the act of dying. The clinical/legal issues surrounding silent suicide will be discussed. PMID- 2706339 TI - Toxicity of chlorine dioxide to early life stages of marine organisms. PMID- 2706340 TI - Acute toxicity of the pesticide diazinon to the freshwater snail Gillia altilis. PMID- 2706341 TI - Sensitivity of midge larvae of Chironomus tentans Fabricius (Diptera Chironomidae) to heavy metals. PMID- 2706342 TI - Drift response of stream invertebrates to aerial applications of glyphosate. PMID- 2706343 TI - Bioaccumulation of four heavy metals in two populations of grass shrimp, Palaemonetes pugio. PMID- 2706344 TI - Levels and interactions of selenium with group IIB metals in mussels from Swansea Bay, South Wales, U.K. PMID- 2706345 TI - Acute toxicity of tributyltin (TBT) to early life history stages of the hard shell clam, Mercenaria mercenaria. PMID- 2706346 TI - Effects of water hardness and salinity on the acute toxicity and uptake of fenvalerate by bluegill (Lepomis macrochirus). PMID- 2706347 TI - Effects of formulated ethyl parathion on fertilization of the sea urchin Pseudechinus magellanicus (Philippi). PMID- 2706348 TI - Cadmium kinetics in freshwater clams. Uptake of cadmium by the excised gill of Anodonta anatina. PMID- 2706349 TI - Persistence of fenthion in the aquatic environment. PMID- 2706350 TI - Effects of two diesel fuel mixtures on fecal coliform bacteria densities. PMID- 2706351 TI - Influence of continuous monoculture and insecticide treatments on the rate of chlorfenvinphos soil biodegradation in cabbage crops. PMID- 2706352 TI - Feasibility of toxaphene transport through sandy soil. PMID- 2706353 TI - Toxicity of acrylonitrile on human KB cells in culture. PMID- 2706354 TI - DDT residues in human milk samples from Delhi, India. PMID- 2706355 TI - Correlation between lead and prolactin in males exposed and unexposed to lead in Buenos Aires (Argentina) area. PMID- 2706356 TI - Effects of postnatal aluminum lactate exposure on neuromotor maturation in the rat. PMID- 2706357 TI - Distribution and excretion of thallium after oral and intraperitoneal administration of thallous malonate and thallous sulfate in hamsters. PMID- 2706358 TI - Solid phase extraction and HPLC determination of spiramycin in plasma and vitreous concentrations. AB - A method for extracting spiramycin by an octadecylsilica cartridge is described for plasma or vitreous samples. The macrolide antibiotic is then measured by reversed-phase HPLC with UV detection. The limit of detection is estimated to be 50 ng/mL. The coefficient of variation for the procedure is 6.1% and 5.2% for the range of concentrations 0.2 micrograms/mL and 10 micrograms/mL respectively. By this method, pharmacokinetic profiles were performed for five adult patients. Spiramycin could be accurately measured in the vitreous humour, allowing the determination of antibiotic at its site of action. PMID- 2706359 TI - A simplified method for the preparation of WGA-Sepharose 4B and its use in the purification of MN blood group antigens. AB - A simplified method for the preparation of wheat germ agglutinin(WGA)-Sepharose 4B by coupling highly purified WGA, prepared by improved affinity chromatography, with BrCN activated Sepharose 4B in a solution of high carbonate buffer is described. The amount of WGA linked to Sepharose 4B was 82.40% (3.07 mg WGA per ml Sepharose 4B). MN blood group antigens of human erythrocyte membranes purified with WGA-Sepharose 4B affinity chromatography showed a single band on sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS/PAGE). The yield of the antigens from 400 mL fresh blood was 32-40 mg. The WGA-Sepharose 4B column could be used several times without loss of activity. PMID- 2706360 TI - HPLC determination of cis-diamminedichloroplatinum(II) in plasma and urine with UV detection and column-switching. AB - A method for determining cis-diamminedichloroplatinum(II) (CDDP), an anticancer drug, in plasma and urine by HPLC with UV detection and column-switching has been developed. Typical conditions were as follows. An apparatus was composed of two columns, two pumps, a UV detector, a sample injector with a 100 microL loop, a switching valve, a column oven and a recorder. A Rheodyne model 7125 sample injector was used as the switching valve. A precolumn (4.6 mm ID x 25 cm) was packed with MCI GEL CK10S (a strong cation exchanger), and an analytical column (4.6 mm ID x 5 cm) was packed with MCI GEL CDR10 (a strong anion exchanger). Both columns were connected in series via the switching valve. The CDDP-containing fraction of the effluent from the precolumn was loaded to the analytical column by column-switching and the effluent from the analytical column was monitored at 210 nm. An eluent of 0.3 M sodium dihydrogen phosphate was pumped at a flow rate of 1 mL/min and the columns were maintained at 40 degrees C. CDDP was eluted at about 11 min and the identity of the peak of CDDP on the chromatogram was confirmed by its 3-dimensional chromatogram and analysis of platinum in the column effluent. Under the conditions described above, a linear relationship was obtained between peak height and concentration of CDDP up to 100 microM. Correlation efficients were 0.998 for plasma and 0.999 for urine. The detection limit was 0.1 microM for CDDP in both plasma and urine (S/N = 3,0.005 AUFS). The reproducibility was within 3% for 10 determinations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706361 TI - Conditions for quantitation of dolichyl phosphate, dolichol, ubiquinone and cholesterol by HPLC. AB - Conditions for the isolation and quantitation of dolichyl phosphate, dolichol, cholesterol, and ubiquinone by reversed phase high performance liquid chromatography were investigated. A simple and fast sample preparation procedure using prepacked mini columns was employed. The UV spectra of the fractions obtained were examined and, in the case of dolichol compounds, the maximum absorbance around 205 nm was shown to be linearly dependent on the number of double bonds present in the isoprenolog. The analytical procedure described shows a very broad range of linearity (five orders of magnitude) and detects single dolichyl phosphate isoprenologs in amounts as small as 0.1 ng. The lowest overall recovery, that for dolichyl phosphate, is 77%. Use of isoprenolog 23 and ergosterol as internal standards reduced the variation in the method to 2.5, 4.0 and 5.5% for cholesterol, dolichyl phosphate and dolichol, respectively. The method described was employed to study the lipid composition of rat organs and biological variations in these compositions. PMID- 2706362 TI - Compositional analysis of the three main gangliosides from adult human myometrium by a rapid capillary gas chromatographic method. AB - A new capillary GC method is described for the compositional analysis of the three main gangliosides isolated from adult human myometrium. The sample was subjected to methanolysis, acetylation and trimethylsilylation which allows all the constituents to be analyzed simultaneously. The predominant ganglioside was found to be GD3, with GM3 and GT1b the next most abundant. PMID- 2706363 TI - A simple method for the characterization of photoproducts from DNA applied to the cis-syn thymine dimer. AB - A method for the unambiguous characterization of DNA photoproducts has been developed. It does not require radio-labelled DNA, or specialized techniques. In the preliminary step, UV-irradiated DNA is hydrolysed to its constituent bases and photoproducts. The photoproducts are then separated from nucleic acid bases using low pressure ion-exchange chromatography on a Dowex 1 x 8 200-400, and an Amberlite CG-50-H+ column. Further separation and purification of photoproducts is carried out on the HPLC Whatman Partisil ODS2 column, using 15% MeOH. The procedure is simple, reproducible and versatile. PMID- 2706364 TI - High-performance liquid chromatography/chemiluminescence determination of biological thiols with N-[4-(6-dimethylamino-2-benzofuranyl)phenyl]maleimide. AB - The peroxyoxalate chemiluminescence detection of biological thiols combined with high-performance liquid chromatography (HPLC) is described. SH groups of the thiol compounds including glutathione (GSH), cysteine, N-acetylcysteine, cysteamine, and D-penicillamine were labelled with N-[4-(6-dimethylamino-2 benzofuranyl)phenyl]maleimide (DBPM), a specific fluorogenic reagent for SH group. The labelling reaction was carried out at 60 degrees C for 30 min and at pH 8.5 and a sample of the resulting reaction mixture was subjected to HPLC. Five kinds of labelled thiols were separated within 12 min on ODS-80 column (150 x 4.6 mm ID; 5 microns) and detected in the ranges from 500 fmol to 2 pmol/100 microL (cysteamine and N-acetylcysteine), to 3 pmol/100 microL (cysteine) and to 5 pmol/100 microL (GSH and D-penicillamine). The lower detection limits were from 7 fmol (cysteamine) to 113 fmol (GSH) per 100 microL (S/N = 2). The method was applied to the determination of thiols in a rat liver. The amounts of glutathione and cysteine were 1.23 +/- 0.15 mumol/g (n = 5) and 0.15 +/- 0.04 mumol/g (n = 5), respectively. PMID- 2706365 TI - Improved TLC systems for rapid resolution of phenyl thiohydantoin amino acids. AB - Two new solvent systems, n-hexane + propionic acid (26:5, v/v) and chloroform + acetone (29:3, v/v), for the rapid resolution and identification of an 18 component mixture of phenylthiohydantoin amino acids are reported. Using these systems certain difficult combinations of phenylthiohydantoin amino acids are resolved. Two more solvent systems, viz chloroform + acetic acid (27:3, v/v) and chloroform + methanol (30:4, v/v), are developed to resolve phenylthiodantoin derivatives of aspartic and glutamic acids. PMID- 2706366 TI - Separation of some antihistamines on impregnated TLC silica plates. AB - Different metal salts have been tried as impregnating reagents for developing TLC separation schemes for some antihistamines on silica gel 'G' plates, using a new solvent system benzene + dimethyl formamide + acetic acid (30:10:7). Spots were visualized by spraying with a solution of Dragendroff's reagent. PMID- 2706367 TI - Analysis of leukotrienes by liquid chromatography/electrochemistry after conversion to dinitrobenzoate derivatives. AB - A sensitive liquid chromatography method has been developed using electrochemistry for the determination of leukotrienes in biological fluids. Biological specimens are treated with 3,5-dinitrobenzoyl chloride in acetonitrile which undergoes rapid reaction with hydroxyl groups of non-peptidic leukotrienes in the presence of pyridine and with amino groups of peptidic leukotrienes in the presence of potassium tetraborate buffer. The resulting dinitrobenzoate derivatives of leukotrienes are highly electroactive, suitable for reduction or oxidation at moderate potentials by an electrochemical detector. In reductive mode at -0.7 V or oxidative mode at +1.15 V potentials, the lower limits of detection for leukotriene derivatives were approximately 8 +/- 3 pg and 70 +/- 16 pg respectively, with a signal-to-noise ratio of 5 to 1. This method was applied to the detection of leukotrienes in plasma, nasal and bronchial fluids of patients with asthma. PMID- 2706368 TI - Characterization of abnormal human haemoglobins by fast atom bombardment mass spectrometry. AB - A procedure using fast atom bombardment mass spectrometry for mapping the proteolytic digest of alpha-, beta- and gamma-globin chains of normal human haemoglobin was developed. It required the separation of globins prior to their analysis by mass spectrometry of their enzymatic digests. Almost all the expected peptides were identified by direct analysis of the peptide mixture. Peptide recognition along the globin chain sequences was easily made on the basis of their molecular weight and the assignments performed were confirmed submitting the whole peptide mixture to a single step of Edman degradation. The procedure was successfully applied to the structural characterization of three variant human beta-globin chains, demonstrating the general applicability of this mapping procedure in the analysis of haemoglobinopathies. PMID- 2706369 TI - Isolation, purification and structure elucidation of cyclosporin A metabolites in rabbit and man. AB - Metabolism of cyclosporin A (CsA) was studied in a model of isolated and perfused rabbit liver, and in man. After diethyl ether extraction, CsA metabolites were separated and successfully purified by a combination of two high-performance liquid chromatographic (HPLC) procedures. A normal-phase HPLC methodology was used to separate most of the metabolites, and further separation and purification were optimized with a reversed-phase HPLC method. 27 different CsA metabolites were separated, collected, and characterized by fast atom bombardment mass spectrometry. In addition to several metabolites already described (OL-1, OL-17, OL-18 and OL-21), new compounds (of original molecular weights 1236, 1222 and 1174, and numerous structural isomers of previously reported molecular weights) were isolated from rabbit and human bile. Mass spectral analysis of two of these new metabolites strongly suggests vicinal dihydrodiol (mol. wt 1236) and N demethylated vicinal dihydrodiol (mol. wt 1222) structures. These two new metabolites most probably derive from an epoxide as a preliminary intermediate. PMID- 2706370 TI - Detection of residues of chloramphenicol in crude extracts of fish and milk by tandem mass spectrometry. AB - The collision-induced dissociation mass spectrum, observed with a hybrid tandem instrument, of the ammonia chemical ionization protonated molecular ion of chloramphenicol was used for the detection of residues of the drug in biological samples. The extracted oil from fish was subjected to a rapid clean-up on a pre packed silica gel cartridge prior to non-chromatographic tandem mass spectral analysis. Fat extracted from milk was analysed directly by on-line combined high performance liquid chromatography/tandem mass spectrometry with rapid elution of chloramphenicol. Identification was on the basis of agreement of the daughter ion spectra obtained from sample extracts with that of the chloramphenicol standard. Detection was unambiguous at 0.5 mg kg-1. The sensitivity advantage normally expected with multiple reaction monitoring was not achieved owing to the effect of neutral noise phenomena. PMID- 2706371 TI - Mass spectrometric approaches to the confirmation of maduramicin alpha in chicken fat. AB - Because of the structural information it provides, mass spectrometry has gained widespread acceptance as the preferred analytical technique for drug residue confirmatory procedures. For the confirmation of the polyether ionophore antibiotic, maduramicin alpha, in chicken fat, the techniques of desorption chemical ionization (DCI), thermospray liquid chromatography/mass spectrometry (TSP LC/MS), and thermospray liquid chromatography/tandem mass spectrometry (TSP LC/MS/MS) were investigated as potential approaches. Sample clean-up was found to be totally inadequate for DCI and only marginally acceptable for TSP LC/MS. Only TSP LC/MS/MS adequately resolved the analyte from the tissue coextractives and generated satisfactorily reproducible mass spectrometric data for a confirmatory method. The techniques developed here should be applicable to other commonly used polyether ionophores. PMID- 2706372 TI - Capillary supercritical fluid chromatography/negative ion chemical ionization mass spectrometry of trichothecenes. AB - A capillary supercritical fluid chromatography/mass spectrometry interface incorporating a heated frit restrictor is described. The trichothecene mycotoxins T-2 toxin, deoxynivalenol and roridin A were used to evaluate the effect of restrictor temperature and carbon dioxide mobile phase on the negative ion chemical ionization (CI) spectra of these compounds under electron capture, proton abstraction and chloride attachment conditions. Restrictor temperatures less than 100 degrees C above the melting point of the samples retarded sample transfer into the mass spectrometer, but neither restrictor temperature nor carbon dioxide mobile phase significantly affected negative ion CI conditions. PMID- 2706373 TI - Comparison of 252Cf plasma desorption mass spectrometry and fast atom bombardment mass spectrometry in identification of simple monoglucosyl conjugates. AB - The fast atom bombardment (glycerol) and 252Cf plasma desorption mass spectra of 16 simple monoglucosyl conjugates have been compared. Plasma desorption mass spectrometry, in general, has been found to be the superior technique for characterizing these low molecular weight conjugates because of the relative absence of interfering matrix peaks. PMID- 2706374 TI - Residue characterization of triadimefon in grapes by gas chromatography and mass spectrometry/mass spectrometry. AB - A field study of the use of the new fungicide triadimefon (Bayleton) on grapes has indicated that residue levels of 0.01 ppm may be expected on the ripe fruit in spite of the 60-75 day interval from spray to harvest. Triadimefon and its primary metabolite triadimenol (Baytan) have been characterized by gas chromatography and mass spectrometry to provide identification down to a detection level of 0.001 ppm. Recovery studies on these fungicides have indicated that they are completely extracted by the single multi-residue analytical methodology presently in use for monitoring fresh produce. PMID- 2706375 TI - Identification of oestrogen metabolites in human urine by capillary gas chromatography and mass spectrometry. AB - Oestrogen metabolites from the urine of males and pregnant and non-pregnant females were enriched by a procedure involving column chromatography on adsorber resins, gels and ion exchangers, enzymatic solvolysis and extraction, thereby separating the oestrogens from most of the interfering material. After derivatization of the oestrogens as their trimethylsilyl ethers profiles were measured with a fused silica column and a flame ionization detector by gas chromatography. Using a combination of capillary gas chromatography and mass spectrometry approximately 50 oestrogen metabolites were detected in the human urine of males and females, of which 19 were unknown urine compounds. Not all could be identified definitely owing to the lack of reference material. Mass spectra of trimethylsilylated oestrogens with functional groups at position 11 (11-dehydroestradiol, 11-dehydroestrone and 11 beta-hydroxyestrone) were discussed in their common and discernible fragmentations. PMID- 2706376 TI - Solvent-sample interactions in thermospray mass spectrometry of antineoplastic nitrogen mustards. AB - Conditions are reported for the optimization of thermospray mass spectrometric analysis of antineoplastic nitrogen mustard alkylating agents. In aqueous ammonium acetate mobile phase, multiple sequential solvolytic reactions occur with these highly labile compounds, and protonated molecular ions of the reaction products are observed. However, when high proportions of acetonitrile or other organic modifier are added to the mobile phase, solvolytic reactions are much reduced and abundant protonated molecular ions are detected. One exception to these observations is phosphoramide mustard, which solvolyses under all conditions attempted. A lower limit for detection of melphalan using direct injection and summing the ion current between m/z 120 and 870 is about 150 ng. Successful thermospray liquid chromatography/mass spectrometry of these compounds should be possible using high percentages of methanol in the mobile phase or increasing the organic content by post-column solvent modification. PMID- 2706377 TI - Indole derivatization procedures for electron capture negative chemical ionization mass spectrometry: identification of 1-methyl-1,2,3,4-tetrahydro-beta carboline in rat brain and lung. AB - Procedures have been developed for the isolation of pharmacologically active indole compounds from biological samples and for the introduction of electron capturing groups, pentafluorobenzyl and trifluoroacetyl, onto the indole nitrogen atom. The resulting derivatives have good gas chromatographic properties and strong electron affinities which make them highly suitable for detection by electron capture negative chemical ionization mass spectrometry. These procedures were used to identify 1-methyl-1,2,3,4-tetrahydro-beta-carboline as a component of rat brain and lung. PMID- 2706378 TI - Analysis of platelet activating factor in human saliva by gas chromatography/mass spectrometry. AB - Platelet activating factor (PAF) bioactivity has been demonstrated in saliva from normal volunteers. We sought structural confirmation and evidence of heterogeneity in the 1-O-alkyl chain of the acetyl glyceryl ether phosphoryl choline (AGEPC) extracted from saliva by employing stable isotope dilution techniques in conjunction with gas chromatography/mass spectrometry. The method described involves removal of the polar phosphocholine moiety, accounts for acetyl group migration, and allows for acylation of the resultant free hydroxyl with pentafluorobenzoyl chloride. Thin-layer chromatography (TLC) purification is undertaken after phospholipase C cleavage and again after pentafluorobenzoyl chloride derivatization. The majority of the ion current is represented in the molecular anion, allowing measurement of 50 pg in biological fluid with a signal to-noise ratio of greater than or equal to 9. In one subject with markedly increased salivary PAF levels, we found evidence for molecular heterogeneity of AGEPC with production of not only C16:0 but also C18:0 and C18:1 in the alkyl chain. This technique, by using TLC in lieu of high-performance liquid chromatography, avoids potentially confounding trace contamination effects, produces spectra with few interfering signals and increases sample throughput. PMID- 2706379 TI - The differentiation of methyl guanosine isomers by laser ionization Fourier transform mass spectrometry. AB - Laser ionization of guanosines containing methyl substitutions in the 1-, N2-, 3' O-, O6- and 7-positions generated two characteristic negative ions: loss of hydrogen to generate [M - H]- and elimination of the sugar ring to form the nucleic base ion. The ions generated by elimination of the sugar ring provided the information necessary to determine whether the methyl group was on the nucleic base or sugar ring. Fourier transform mass spectrometry was used to isolate and collisionally dissociate selected negative ions from these nucleosides. The collisional dissociation spectra indicated daughter ions which were sufficient to differentiate all the isomers with methyl substitution of the nucleic bases. In addition, accurate mass measurement and sequential collisional dissociation experiments were employed to investigate fragmentation mechanisms. PMID- 2706380 TI - Applied biosensors. PMID- 2706381 TI - Alcohol research in Latin America: is the cup half full or half empty? PMID- 2706382 TI - Resisting temptation: a psychological analysis. AB - It is proposed that self control involves several related processes including vivid awareness of future consequences, overcoming learned helplessness and tunnel vision, developing commitment and accepting anxiety/frustration. Facing up to temptation and resisting the compulsive urge is considered to be a crucial therapeutic experience. Evidence is presented to support the view that cue exposure should therefore be a central component of treatments for compulsions and addictions. PMID- 2706383 TI - The practical business of treatment--1. A multidisciplinary and team approach. AB - This paper outlines the context in which I work, and then expresses my beliefs about treatment. The value placed on day care and multi-disciplinary teamwork is stressed. My treatment philosophy is explained and reference made to the ways we control the therapeutic setting. I argue for some of the more controversial aspects of our therapeutic activities and describe the roles of psychiatrist and psychotherapists in our work. It is hoped that these opinions which are candidly expressed will provoke a constructive debate on how we can all best help these challenging people. PMID- 2706384 TI - Mortality among alcoholics discharged from a Japanese hospital. AB - A study of mortality among alcoholics was carried out involving patients discharged from the alcoholic ward of a Hamamatsu University-affiliated hospital from 1972 to 1984 (1021 patients). The average age at death was 48.4 years. The causes of death were divided into three groups; 'diseases', 'accidents', 'suicide and homicide', accounting for 73.5%, 10.5% and 7.3% of 257 deaths, respectively. Death rates per 1000 persons for the years at risk were compared with the expected rates for the general population. Briefly, the death rates for patients were more than 10 times as large as those in the general population. Our results showed that liver cirrhosis and heart failure ranked high among the causes of death in alcoholics. Among patients who died, only 3.1% were total abstainers after discharge from hospital, which was an extremely low proportion in comparison with the average cross-total abstinence rate of 25.8% among patients after discharge. PMID- 2706385 TI - Regional cerebral blood flow changes associated with amyl nitrite inhalation. AB - Regional cerebral blood flow (CBF), mood states and somatic symptoms were measured before and after inhalation of amyl nitrite in 10 physically healthy volunteers with a prior history of using volatile nitrites for recreational purposes. CBF was measured with the same technique, under identical laboratory conditions, in an equal number of normal volunteers. During CBF measurements, blood pressure, pulse rate, respiratory rate and end-tidal levels of carbon dioxide were monitored. The amyl nitrite group and the control group were compared on CBF, rating scale scores and physiological indices via analysis of variance. Amyl nitrite inhalation was associated with significant global increases in CBF, while the control group did not show any change. Pulse rate increase was the only physiological change associated with administration of the drug. Subjects who received the drug reported significant decrease in anger, fatigue and depression and increased palpitation, breathing difficulty, dizziness and headache. Changes in the rating scale scores, physiological indices, and somatic symptoms after amyl nitrite did not correlate with regional CBF change. PMID- 2706386 TI - Drug abusers' perceptions of their parents. AB - Many clinicians in the area of drug addiction believe that emotional problems arise from particular styles of parenting. To investigate this link, 63 young male and female addicts who had sought treatment completed the Parental Bonding Instrument which tapped their perceptions of their relationship with each parent. Addicts reported early parental experiences differing from those of a control group. Drug abusers judged their parents as cold, indifferent, controlling and intrusive. In addition, these perceptions were shared by male and female addicts. These results, together with previous research suggest that these perceptions might well point to a general risk factor for the development of a broad range of psychological and psychiatric disorders. In addition, the issue of family factors in the design and implementation of drug treatment programs needs to be addressed. PMID- 2706387 TI - The Short Alcohol Dependence Data (SADD) questionnaire: norms and reliability data for male young offenders. AB - The Short Alcohol Dependence Data (SADD) questionnaire was administered to 100 male young offenders. The mean score was 8.09. Eighty subjects were available between 19 and 40 days later for retest. Of these, 44 were given the original SADD, resulting in a test-retest correlation of 0.87. The remaining 36 young offenders were given at retest a version of the SADD reworded to eradicate difficult words and ambiguous items. The test-retest reliability using the reworded SADD was 0.88 and the split-half reliability of the reworded SADD was 0.85. Thus, the SADD is shown to be reliable over time and the reworded SADD is a satisfactory alternative to the original SADD with this population. PMID- 2706388 TI - Cross-cultural study of alcohol behaviour among Singapore college students. AB - To test the hypothesis that Singapore Indian college students would experience higher rates of drinking problem behaviour than their Chinese counterparts, the Engs and Hanson questionnaire was administered to 767 Chinese and 185 Indian undergraduate students. The significant differences in drinking problems found between Indian and Chinese students were interpreted as reflected a higher level of anomie among the Indians in terms of their drinking norms. Singapore Indian students' alcohol-related problem behaviours, however, are considerably less than those found in college students from western countries. PMID- 2706389 TI - Alcohol, smoking and pregnancy: some observations on ethnic minorities in the United Kingdom. AB - This paper describes drinking and smoking patterns before and during pregnancy in 363 women from ethnic minorities living in West London. Drinking and smoking were less common and levels of consumption were lower amongst women of Afro-Caribbean, Asian or Oriental origin than amongst Europeans. However, 75% of the Afro Caribbeans, 56% of the Orientals and 47% of the Asians did drink alcohol before pregnancy. Twenty-one per cent of the Europeans, 5% of the Afro-Caribbeans, 3% of the Orientals drank more than 100 g alcohol per week (the level at which fetal harm may result). Drinking and smoking decreased in pregnancy in all ethnic groups, but 31% of Afro-Caribbeans, 29% of Orientals and 18% of Asians continued drinking. It is important to take alcohol and smoking histories from all pregnant women whatever their racial origin as part of good antenatal care. PMID- 2706390 TI - Alcohol-related admissions to a psychiatric hospital: a comparison of Asians and Europeans. AB - The prevalence of alcohol-related problems in the British Asian community is unknown. We obtained details of all patients living in Southall who had been admitted with a primary alcohol-related diagnosis to a psychiatric hospital from 1980 to 1987. We used 1981 census data to calculate overall and age-specific incidence rates for Asian and European men and woman, expressed per 10,000 subjects over the 7-year period. The overall incidence in Asian men (105.8) was markedly higher than in European men (54.3) (p less than 0.001). The overall incidence in Asian women was markedly lower than in European women (4.1 versus 18.6, p less than 0.001). Proportionately more Asian than European men were married (82% versus 34%, p less than 0.001). This pilot study suggests that alcohol-related problems severe enough to warrant inpatient treatment are unduly common in Southall Asian men, especially in married subjects. Further community based studies are needed to ascertain the prevalence of alcoholism in this and other British Asian communities. PMID- 2706391 TI - Subcellular topology of rat liver methionyl-, leucyl-, and arginyl-tRNA synthetases. AB - We have investigated the distribution of methionyl-, leucyl-, and arginyl- tRNA synthetases in primary liver fractions obtained by differential centrifugation of homogenates in isotonic sucrose: 78-93% of synthetase activities are recovered in the cytosolic fraction. Microsomes contain only 4.8%, 19.4%, and 6.4% of the methionyl-, leucyl-, and arginyl-tRNA synthetases activities, respectively. This proportion increases up to 11.3%, 26.1%, and 20.7%, respectively, when the homogenization medium is supplemented with 5 mM Mg2+ and 25 mM K+. The presence of protease inhibitors in the homogenization medium does not increase the proportion of synthetases recovered in microsomes. After subfractionation of microsomes by isopycnic centrifugation, the distributions of the 3 synthetases display a second peak overlapping that of at a density of 1.12. In addition, methionyl- and leucyl- tRNA synthetases display a second peak overlapping that of RNA. This suggests that a small proportion of these synthetases (0.7% and 5.71% of total activities, respectively) bind to the d domain of the ER. The Golgi complex, the plasma membranes, and the peroxisomes lack aminoacyl-tRNA synthetase activity. The 3 synthetases are readily detached from membranes when intact microsomes are washed with 250 mM sucrose alone or containing 5 mM PPi, or 320 mM KCl. The binding of methionyl-tRNA synthetases to microsomes was measured in vitro, at 4 degrees C, with a sample of the cytosolic fraction as a source of synthetase. Microsomes stripped of their bound polysomes display a binding capacity that is not significantly different from that of unstripped microsomes. Even in the presence of cations, the amount of synthetase bound to the membranes remained low by comparison with the cytosolic content. PMID- 2706392 TI - Actin cytoskeletal lesions in differentiated human colon carcinoma Caco-2 cells after exposure to soybean agglutinin. AB - We have investigated the effects of soybean agglutinin on the cytoskeletal element actin in differentiated Caco-2 cells. The actin cytoskeleton of the cells was visualized by fluorescence microscopy using 7-nitrobenz-2-oxa-1, 3-diazole phallacidin as a specific marker for F-actin. Compared with control Caco-2 cells no changes in the fluorescence pattern were observed after incubation with soybean agglutinin. However, using the deoxyribonuclease-I inhibition assay a dose-related response was noted in the increase of intracellular G-actin after a 2-hour incubation period with soybean agglutinin. Already after exposure for 15 min to soybean agglutinin a decrease in intracellular F-actin was demonstrable. This apparent depolymerization could be prevented by incubating the Caco-2 cells with soybean agglutinin and the appropriate monosaccharide simultaneously. The increase in the amount of G-actin appeared to be correlated with a shortening of microvilli on the Caco-2 cells. PMID- 2706393 TI - Monotonic versus oscillating microtubule assembly: a cryo-electron microscope study. AB - Depending on the free GTP concentration, microtubules can assemble following either a monotonic or an oscillatory mode. We have used cryoelectron microscopy to compare the tubulin assemblies characteristic of each polymerization pathway. We focus on the first assembly peak. At this particular time point, despite their strikingly different subsequent evolution, both systems are similar with regard to the extent of tubulin polymerization and to the microtubule length distribution. The present study shows that whilst the observed microtubule structures are the same in both systems, the oscillatory system shows quantities of closed ring-like tubulin oligomers, far in excess of those observed in the monotonic system. Furthermore, the conversion of the oscillating system to a monotonic one by GTP addition during the first oscillation is accompanied by a marked decrease in the number of rings. Based on these results we propose that the GTP dependent step which governs microtubule oscillations is the opening of inactive tubulin oligomers. PMID- 2706394 TI - Binucleate cells in the Ehrlich ascites tumor. Autoradiographic labeling. AB - An autoradiographic study was performed on binucleate and mitotic cells in the Ehrlich ascites tumor (EAT) untreated and after treatment with 5-fluorouracil (FU). The number of binucleate cells was greater in the treated tumor than in the controls. It was also observed that the number of labeled mitoses was greater in the Fu-treated tumor. Autoradiographic labeling showed that the cells that proved to be binucleate had previously passed through S-phase; thus, these cells belonged to the proliferative compartment. PMID- 2706395 TI - Mathematical analysis of molecular sequences. PMID- 2706396 TI - Probabilistic models of genome shuffling. AB - The comparison of entire genomes in evolutionary studies gives rise to alignments characterized by many intersections, or inversions in the order of two fragments in different genomes. To model this, we suggest a random migration process for fragments, and discuss its equilibrium distribution in the case of linear and circular genomes. Simulations are carried out to explore "cut-off" behavior as the process approaches equilibrium. We define a new process to take into account the indistinguishability of two fragments which are adjacent in both genomes being compared. Questions of applicability of these models are discussed. PMID- 2706397 TI - Tutorial on large deviations for the binomial distribution. AB - We present, in an easy to use form, the large deviation theory of the binomial distribution: how to approximate the probability of k or more successes in n independent trials, each with success probability p, when the specified fraction of successes, a identical to k/n, satisfies 0 less than p less than a less than 1. PMID- 2706398 TI - Weak hierarchies associated with similarity measures--an additive clustering technique. AB - A new and apparently rather useful and natural concept in cluster analysis is studied: given a similarity measure on a set of objects, a sub-set is regarded as a cluster if any two objects a, b inside this sub-set have greater similarity than any third object outside has to at least one of a, b. These clusters then form a closure system which can be described as a hypergraph without triangles. Conversely, given such a system, one may attach some weight to each cluster and then compose a similarity measure additively, by letting the similarity of a pair be the sum of weights of the clusters containing that particular pair. The original clusters can be reconstructed from the obtained similarity measure. This clustering model is thus located between the general additive clustering model of Shepard and Arabie (1979) and the standard hierarchical model. Potential applications include fitting dendrograms with few additional nonnested clusters and simultaneous representation of some families of multiple dendrograms (in particular, two-dendrogram solutions), as well as assisting the search for phylogenetic relationships by proposing a somewhat larger system of possibly relevant "family groups", from which an appropriate choice (based on additional insight or individual preferences) remains to be made. PMID- 2706399 TI - Computational experience with an algorithm for tetrangle inequality bound smoothing. AB - An important component of computer programs for determining the solution conformation of proteins and other flexible molecules from nuclear magnetic resonance data are the so-called "bound smoothing algorithms", which compute lower and upper limits on the values of all the interatomic distances from the relatively sparse set which can usually be measured experimentally. To date, the only methods efficient enough for use in large problems take account of only the triangle inequality, but an appreciable improvement in the precision of the limits is possible if the algebraic relations between the distances among each quadruple of atoms are also considered. The goal of this paper is to use a recently improved algorithm for computing these "tetrangle inequality limits" to determine just how much improvement really is possible, given the types of experimental data that are usually available. PMID- 2706400 TI - Algorithms for the optimal identification of segment neighborhoods. AB - Two algorithms for the efficient identification of segment neighborhoods are presented. A segment neighborhood is a set of contiguous residues that share common features. Two procedures are developed to efficiently find estimates for the parameters of the model that describe these features and for the residues that define the boundaries of each segment neighborhood. The algorithms can accept nearly any model of segment neighborhood, and can be applied with a broad class of best fit functions including least squares and maximum likelihood. The algorithms successively identify the most important features of the sequence. The application of one of these methods to the haemagglutinin protein of influenza virus reveals a possible mechanism for conformational change through the finding of a break in a strong heptad repeat structure. PMID- 2706401 TI - Approximate matching of regular expressions. AB - Given a sequence A and regular expression R, the approximate regular expression matching problem is to find a sequence matching R whose optimal alignment with A is the highest scoring of all such sequences. This paper develops an algorithm to solve the problem in time O(MN), where M and N are the lengths of A and R. Thus, the time requirement is asymptotically no worse than for the simpler problem of aligning two fixed sequences. Our method is superior to an earlier algorithm by Wagner and Seiferas in several ways. First, it treats real-valued costs, in addition to integer costs, with no loss of asymptotic efficiency. Second, it requires only O(N) space to deliver just the score of the best alignment. Finally, its structure permits implementation techniques that make it extremely fast in practice. We extend the method to accommodate gap penalties, as required for typical applications in molecular biology, and further refine it to search for sub-strings of A that strongly align with a sequence in R, as required for typical data base searches. We also show how to deliver an optimal alignment between A and R in only O(N + log M) space using O(MN log M) time. Finally, an O(MN(M + N) + N2log N) time algorithm is presented for alignment scoring schemes where the cost of a gap is an arbitrary increasing function of its length. PMID- 2706402 TI - The alignment of protein structures in three dimensions. AB - This article extends the use of dynamic programming algorithms in molecular sequence comparison to the alignment of the alpha-carbon (C alpha-) coordinates of two protein structures in three dimensions. The algorithm is described in detail and is applied to the comparison of alpha-lactalbumin with both hen egg white lysozyme and T4 lysozyme. In the first case, the structures are similar, while the second comparison is between two distantly related molecules. References are made to the usual sequence alignments. A variety of complementary methods are introduced to display the results. PMID- 2706405 TI - Self-assessment of hearing in rehabilitative audiology: developments in the USA. AB - Self-assessment of hearing is being used for screening, diagnostic, and rehabilitative audiology. Hearing handicap/disability measures were derived on a large number of patients who were classified based on pure tone findings into Pure Tone Groups (PTGs). A systematic relationship was found between handicap/disability as measured with Self-Assessment of Communication (SAC) and PTG. Handicap/disability ratings were also found to be systematically related to use of hearing aids. PMID- 2706403 TI - Stochastic models for heterogeneous DNA sequences. AB - The composition of naturally occurring DNA sequences is often strikingly heterogeneous. In this paper, the DNA sequence is viewed as a stochastic process with local compositional properties determined by the states of a hidden Markov chain. The model used is a discrete-state, discrete-outcome version of a general model for non-stationary time series proposed by Kitagawa (1987). A smoothing algorithm is described which can be used to reconstruct the hidden process and produce graphic displays of the compositional structure of a sequence. The problem of parameter estimation is approached using likelihood methods and an EM algorithm for approximating the maximum likelihood estimate is derived. The methods are applied to sequences from yeast mitochondrial DNA, human and mouse mitochondrial DNAs, a human X chromosomal fragment and the complete genome of bacteriophage lambda. PMID- 2706404 TI - Codon preference and primary sequence structure in protein-coding regions. AB - The stochastic complexity of a data base of 365 protein-coding regions is analysed. When the primary sequence is modeled as a spatially homogeneous Markov source, the fit to observed codon preference is very poor. The situation improves substantially when a non-homogeneous model is used. Some implications for the estimation of species phylogeny and substitution rates are discussed. PMID- 2706406 TI - Comparison of single-channel extracochlear and multichannel intracochlear electrodes in the same patient. AB - A postlingually deaf patient who had been using a single-channel extracochlear implant for 5 years was reimplanted in the same ear with a 22-channel intracochlear device after electrical failure of the internal receiver. In the subsequent follow-up period, auditory performance was investigated in a series of tests with nonspeech and speech material. Two weeks after processor fitting most test scores were equal or better with the new implant. Three months later, with only minimal training, the patient's performance in sentence, numerals and vowel tests was markedly improved. Analysis of vowel confusion matrices indicated a high percentage of F2 information perceived (53% compared with 5% with the single channel device) and somewhat less F1 information (35% compared with 4% using the single-channel device). Further improvements of speech discrimination (especially consonant recognition) are conceivable if the fine temporal resolution provided by some single-channel devices can be combined with the spectral resolution of multichannel systems. PMID- 2706407 TI - The effect of attitude on benefit obtained from hearing aids. AB - Hearing aids are obtained or provided with the primary objective of diminishing the handicapping effect of hearing impairment. The benefit obtained from amplification by an individual can be assessed in many different ways. The amount of use made of the hearing aid has the merits of reasonable accuracy, relevance and simplicity in determination. Poor use of hearing aids may be a result of many factors. Modern instruments are technically adequate to the needs of most candidates provided they are correctly fitted. The reasons for disuse and under use nowadays appear to be more related to the attitude of the potential user. To investigate this aspect of hearing aid provision, questionnaires have been sent to hearing aid candidates prior to the supply of the instrument. These questionnaires have been designed to assess such factors as failure to come to terms with the hearing loss, perceptions of stigma associated with hearing aids, lack of support or even overt hostility from close relatives, and withdrawal from social contacts. The relationships between these attitude measurements and outcome in terms of daily use of the aid 4 months later have been investigated. The findings of this study support the concept that attitude is a significant determinant of hearing aid use, and also suggest that aberrant attitudes can, in many individuals, be modified by counselling such that a better outcome can be achieved. PMID- 2706408 TI - The core and corps of audiology. PMID- 2706409 TI - High-frequency monitoring using an electrostimulation audiometer. AB - Electrostimulation audiometry can provide high-frequency bone-conduction threshold measurements. To evaluate the use of such an audiometer in monitoring hearing, the following areas were investigated. (1) The variability and repeatability of threshold measurements. (2) To see if the instrument could be used on the ward where the patient would have to wear ear plugs to attenuate background noise, the effect of occluding the ears was assessed. (3) The applicability of the instrument to the range of patients in whom monitoring would be appropriate, specifically the relationship between the patient's age and the effective upper frequency limit of the audiometer. The data showed a variability in threshold measurement that is quite comparable with that obtained with conventional audiometry but which became smaller at frequencies of 12 kHz and higher. There was no overall effect on the threshold of occluding the ears, which meant that the instrument can be used to monitor a non-isolated environment such as a ward. The effective cut-off frequency was about 9 kHz for patients aged 55 years, and so the use of an electrostimulation audiometer to monitor high frequency auditory thresholds is restricted to younger patients. PMID- 2706410 TI - Frequency-resolving ability in systemic lupus erythematosus. AB - An audiological investigation was performed of 20 patients suffering from the well characterized autoimmune disease systemic lupus erythematosus (SLE). In addition to threshold estimations, psychoacoustical tuning curves were measured to provide an indication of frequency-resolving ability. Comparison of these data with age, sex and socioeconomically matched controls did not show that the SLE group had significantly worse hearing. PMID- 2706411 TI - Problems of the hearing impaired in Poland. AB - Auditory disability was studied in a group of 140 Polish hearing aid candidates using an oral presentation of the problem questionnaire of Barcham and Stephens (1980). The overall pattern of problems reported by Polish hearing-impaired patients was similar to that found among English respondents. Some difference in the prevalence of the problems emerged which may result from the different socio economic situations in the two countries. PMID- 2706412 TI - Changing systems of amplification. AB - This paper reports on the changing systems of amplification used by hearing impaired children in the last decade (1977 to 1987). The major changes noted were in terms of ear-level v. body-worn hearing aids, monaural v. binaural hearing aids and FM-wireless v. hardwire group hearing aids (GHAs). There was an increase in the use of ear-level hearing aids, binaural hearing aids and FM-wireless hearing aids with a corresponding decrease in the use of body-worn hearing aids and hardwire GHAs. PMID- 2706413 TI - Tumour necrosis factor activity in joint fluids from rheumatoid arthritis patients. AB - Although tumour necrosis factor (TNF) was first studied as an anti-cancer agent it is now recognized as a potent mediator of inflammation and could potentially play a role in rheumatoid arthritis. In this study TNF activity has been sought in fluids from arthritic joints. TNF was assayed by a well established bioassay which depends upon cytolysis of particular tumour cell lines and which has a limit of detection of c. 25 pg/ml. Of the 92 joint fluids tested (70 rheumatoid and 22 others) only three had demonstrable TNF activity. Despite this, joint fluid cells from all 14 patients tested (12 rheumatoid and two others) had the ability to synthesize TNF on stimulation in vitro. Subsequently it was shown that joint fluids contain a macromolecule which inhibits TNF activity in cytolytic assays and which may mask low levels of TNF activity in joint fluids. PMID- 2706414 TI - Mortality of Jamaican patients with systemic lupus erythematosus. AB - A retrospective study of all patients with systemic lupus erythematosus (SLE) who died at the University Hospital of the West Indies over a 14-year period is presented. The major cause of death was infection followed by renal failure. Gram negative organisms were the major microbiological agents causing infections. Side effects of therapy were common, in particular bone marrow depression and haemorrhage related to anticoagulants. It appears that controlling severe lupus activity without increasing the risk of lifethreatening complications remains an important goal in the treatment of SLE. PMID- 2706415 TI - Podophyllum derivatives (CPH 82) compared with placebo in the treatment of rheumatoid arthritis. AB - The efficacy, tolerance, and safety of CPH 82 (semisynthetic lignan glycosides) (Conpharm AB) for patients with rheumatoid arthritis (RA) were assessed in a 12 week double-blind placebo-controlled study. Thirteen patients out of 15 in the CPH 82 group and 10 out of 15 in the placebo group completed the study. No improvement was seen in placebo treated patients. Patients treated with CPH 82 showed a statistically significant improvement in most clinical and immunological variables. Some patients treated with CPH 82 reported gastrointestinal discomfort (diarrhoea and abdominal pain). PMID- 2706416 TI - Outcome from multiple joint replacement surgery to the lower limbs. AB - All patients who had three or more major joints (hips or knees) replaced were identified from operation records at one hospital and reviewed to assess outcome. Forty-three were found to suffer from rheumatoid arthritis, four from osteoarthritis and three from psoriatic arthritis. Eight patients had died an average of 2.6 years (range 1-7 years) after their last operation and this was higher than expected, even for RA. Average follow-up in the 36 surviving RA sufferers was 1.8 years, with a minimum of 6 months since last operation. Range of joint movement, pain relief, satisfaction, mobility, disability and social outcomes were assessed and are reported. Patients were satisfied with outcome because of pain relief and functional improvement. No patient required permanent in-patient care, although they still represented a very disabled group with mean HAQ score of 2.75. PMID- 2706417 TI - Can the distribution of symptomatic and radiographic osteoarthritis within the human body be explained? PMID- 2706418 TI - Elevation of serum aluminium concentrations in patients with rheumatoid arthritis treated with drugs containing aluminium. AB - In a group of 19 rheumatoid arthritis (RA) patients with normal renal function, serum levels of aluminium (AlS) were monitored during treatment with drugs containing this metal (Al). The AlS levels during treatment were significantly higher (0.005 less than p less than 0.01) than those before treatment, i.e. 19.4 (SEM 2.3) micrograms/l and 12.3 (1.7), respectively. This increase in AlS was significantly (0.025 less than p less than 0.05) correlated with the pretreatment serum creatinine level (mean value for the whole group 80.5 (SEM 4.7) mumol/l) but showed no correlation with the predicted creatinine clearance. Although the increase in AlS during therapy with A1 containing drugs is not dramatic in RA patients with normal renal function, the rheumatologist should be aware of the risk of increased AlS concentration in RA patients, especially those with impaired renal function. PMID- 2706419 TI - Prospective long term follow-up of methotrexate therapy in rheumatoid arthritis: toxicity, efficacy and radiological progression. AB - We followed all 128 patients started on methotrexate (MTX) for rheumatoid arthritis (RA) over a 4-year period. Forty-nine were followed for over 3 years. Forty-three patients discontinued treatment, 23 because of toxicity, 15 for inefficacy and five for other reasons. Forty-seven of the 75 followed on treatment for over 2 years had hand radiographs available before and after this treatment period. None showed improvement and 15 showed marked deterioration. Patients' acceptance of this therapy was good although most were noted objectively to have persistent disease activity. We would recommend that if MTX is to be used, a more aggressive approach be adopted to reduce not only the symptoms but the signs of active disease. PMID- 2706420 TI - A serial study of anticardiolipin antibody and antimitochondrial antibody type M5 in a patient with polyarthritis and polymyositis. AB - A 22-year-old female presented with polyarthritis and subsequent polymyositis. Initially, she had moderately high levels of anticardiolipin (aCl) and antimitochondrial antibody (AMA) type M5. Following corticosteroid therapy, the anticardiolipin antibody rapidly fell to background levels but reappeared with the onset of two significant clinical events. PMID- 2706421 TI - Not an epidemiological study of scleroderma. PMID- 2706423 TI - ARA criteria for rheumatoid arthritis. PMID- 2706422 TI - ARA criteria for rheumatoid arthritis. PMID- 2706424 TI - An outbreak of acute sarcoidosis with arthropathy in Norfolk. PMID- 2706425 TI - Thymoma in a case of linear scleroderma. PMID- 2706426 TI - Cystic fibrosis and rheumatoid arthritis. PMID- 2706427 TI - Cystic fibrosis and drug-induced arthropathy. PMID- 2706428 TI - RSI--regional pain syndrome: the importance of nomenclature. PMID- 2706429 TI - The British Society for Rheumatology Senior Registrar UK Travelling Fellowship, 26-30 September 1988. PMID- 2706430 TI - Rheumatology education in the late 20th century. PMID- 2706431 TI - Serum type III procollagen peptide concentrations in systemic sclerosis and Raynaud's phenomenon: relationship to disease activity and duration. AB - Serum levels of the amino-terminal type III procollagen peptide (P-3-NP) have been used as an index of collagen synthesis. Systemic sclerosis (SS) is characterized by uncontrolled production of collagen of several types. This study aimed to explore the profile of P-3-NP in patients with SS and Raynaud's phenomenon, a common forerunner of the disease. Using a radioimmunoassay, the mean level for P-3-NP was found to be raised in SS compared with both the control (p less than 0.001) and Raynaud's groups (p less than 0.001). Analysis of serial samples from the patients with SS suggested that the P-3-NP level reflected changing clinical activity. Three groups emerged: a group with stable disease which showed a less than 20% change in P-3-NP level (mean 5.7%); a group with increasing activity which showed an increase of greater than 20% (mean 35.8%) and a group of decreasing activity which showed a decrease of greater than 20% (mean 33.6%). These data suggest that there is an increase in collagen metabolism in SS and that changes in P-3-NP levels may reflect the clinical course of the disease. PMID- 2706432 TI - The homosexual escort agency: deviance disavowal. AB - This article examines the management of deviance disavowal techniques by a commercial organization. Ball's abortion clinic ethnography (1972:158-86) paved the way for an analysis of the neutralization of disreputable encounters. This study, based on research conducted in London, England during 1981, attempts to explore how stigmatizing sexual liaisons are routinely managed by an escort agency. The article is based on interviews conducted with one homosexual escort agency owner and twenty-eight male escorts and discusses the neutralization of moral approbrium through the organization of names, space and structure. PMID- 2706433 TI - Framing of information: its influence upon decisions of doctors and patients. AB - Prospect theory postulates that decisions are influenced not only by probability and value of possible outcomes, but also by the manner in which these probabilities are presented. Variations in the presentation of the same information, in several areas of care, are considered to determine their influence upon health decisions of both doctors and patients. Three health related predicaments involving varying levels of risk are presented either in a positive or a negative frame and were given to 74 medical students who stated whether they would advise a patient or be prepared themselves to undergo one of three medical procedures. The influence of framing upon these decisions was evident both when subjects responded as patients and as doctors, but its influence was bounded by the level of risk and the type of health decision. These findings raise questions concerning how probabilistic information should be presented to both patients and doctors to counteract the effect of framing upon their decisions. PMID- 2706434 TI - Spatiotemporal contrast sensitivity and colour vision in multiple sclerosis. AB - Measures of contrast sensitivity and colour vision were taken from a group of 18 multiple sclerosis patients. Contrast sensitivity losses, measured at 5 spatial frequencies and 4 temporal frequencies, were found to be significant in 11 patients. Red/green (Rayleigh equation) and green/blue (Engelking-Trendelenburg equation) Pickford-Nicolson anomaloscope settings were abnormal in 15 patients. Correlating each of the 20 spatiotemporal losses with the colour losses revealed that in 19 conditions the red/green loss was greater than the green/blue loss. None of the green/blue losses correlated significantly with spatiotemporal losses while between 2 and 8 cycles/deg 11/12 spatiotemporal conditions showed significant correlations with red/green colour loss. These results support a locus of damage before the cortex at a stage in the visual pathway where red/green chromatic information may be encoded in pathways which also code luminance information. PMID- 2706435 TI - The ability of patients with brain damage to generate mental visual images. AB - The ability to form mental visual images was investigated in normal controls, patients with localized brain damage, and patients with Parkinson's disease. Verbal and visuospatial imagery tasks were compared with tasks in the same modality that did not demand the formation of visual images. In the verbal part, memorizing of word pairs was tested for abstract words, concrete words without imagery instruction, and concrete words with imagery instruction. In the visuospatial part, three tests required the evaluation of spatial features of imagined letters. In one of them mental rotations had to be performed in the exploration of the imagined stimulus. The visuospatial control tasks tested the ability to judge the position of perceived dots and mentally to rotate a seen mannekin. The pattern of results was determined mainly by the differential sensitivity of visuospatial and verbal tasks to right and left brain damage, respectively. Multidimensional scaling of correlations between test results did not show a close relationship between the results of verbal and visuospatial imagery tasks, but suggested that brain damage affected visuospatial imagery tasks differentially from visuospatial control tasks. Analysis of single cases showed that patients with lesions of the left temporo-occipital region failed to benefit from the imagery instruction in the memorizing of concrete words. These patients could nonetheless solve correctly the visuospatial imagery tasks. Possibly this dissociation is due to differences in the amount or the quality of information conveyed by the visual images rather than to the verbal or visuospatial mode of processing to which the images are subjected. PMID- 2706436 TI - Evidence for preserved reading in 'pure alexia'. AB - We describe 4 patients who developed pure alexia after infarctions of the left cerebral hemisphere. All subjects employed a letter-by-letter strategy (with varying degrees of success) to explicitly identify visually presented words. Although all 4 subjects explicitly denied that they could identify briefly presented words, they all performed significantly better than chance on lexical decision and forced-choice semantic categorization tasks with briefly presented words which they could not explicitly identify. Three subjects regained the ability to explicitly identify briefly presented words; these subjects were more accurate with nouns than functors and words of high as compared with low imageability. Additionally, these subjects were impaired in the processing of suffixes. These data are not accommodated by the 'disconnection' account of pure alexia but are more consistent with the hypothesis that reading in these patients is mediated by the right hemisphere. PMID- 2706437 TI - Cognitive impairment in patients with clinically isolated lesions of the type seen in multiple sclerosis. A psychometric and MRI study. AB - This study reports the performance on psychometric tests of a group of 48 patients with clinically isolated lesions of the type seen in multiple sclerosis (optic neuritis, brainstem and cord lesions). The cognitive functions studied were: 'IQ deficit', verbal and visual memory, abstracting ability, visual and auditory attention, and naming ability. The presence of brain pathology was investigated by means of magnetic resonance imaging (MRI). A group of 46 patients with rheumatic and neurological conditions not known to cause brain disease was used for comparison. Normative MRI data were obtained from a group of 40 normal volunteers. An overall 'Cognitive Ability Index' was significantly worse in patients with clinically isolated lesions when compared with physically disabled controls. IQ deficit and defective auditory attention were the more severely affected parameters. These deficits were significantly correlated with the duration of neurological symptoms and with the degree of brain pathology detected by MRI. PMID- 2706438 TI - The effects of voluntary contraction on the H reflex of human limb muscles. AB - The effects of a voluntary contraction on the H reflexes of various muscles were quantified to determine whether the reflex responses were sufficiently reproducible to be used in diagnostic studies. During a voluntary contraction, H reflexes could be recorded reliably from tibialis anterior and abductor pollicis brevis, but accurate identification of the onset of the H wave from the on-going background EMG required duplicate averages of multiple responses. During a contraction the H reflex could be obtained at lower stimulus intensities in the forearm flexor muscles than when relaxed, and a more clear separation of the H wave from the M wave was possible. The background contraction abolished the attenuation of reflex amplitude with increasing stimulus repetition rates, such that repetition rates of up to 4 Hz could be used without significant loss of reflex amplitude. There were only small and usually insignificant differences in the latency of the H reflex or its variability when elicited with the forearm muscles relaxed and when flexor carpi radialis was contracting steadily. The reflex latencies of abductor pollicis brevis, tibialis anterior and soleus were compared with F wave latencies for these muscles. The minimal F wave latencies were shorter than the H reflex latencies for abductor pollicis brevis (mean 2.2 ms) and tibialis anterior (mean 1.0 ms) but not for soleus. Comparison of the spread of F wave latencies (F max-F min) suggests that, for soleus, F waves are recorded only from the faster conducting motor units in the pool, presumably those less readily recruited in the H reflex. It was calculated that the distribution of motor conduction velocities responsible for the F waves of abductor pollicis brevis was 8.8 m.s-1. This value underestimates the likely distribution of motor conduction velocities for the thenar muscle by as much as 50%, consistent with the view that F waves rarely occur in slowly conducting motor units, the units of lowest threshold in reflex studies. It is concluded that, for many motoneuron pools, the H reflex and the F wave appear preferentially in different motoneurons, low and high threshold, respectively, and that reflex studies can provide information not available from somatosensory evoked potentials or F wave studies. PMID- 2706439 TI - Distribution and toxic effects of intravenously injected epirubicin on the central nervous system of the mouse. AB - Epirubicin (4'-epi-doxorubicin) is a new anthracycline cytostatic, which was synthesized in an effort to find an agent with an improved therapeutic effect on human malignant tumours combined with reduced myocardial toxicity. Animal experiments have previously shown that the parent drug doxorubicin, besides being a myocardial toxin, may cause nerve cell lesions both in the central and the peripheral nervous system. Intravenously (i.v.) injected doxorubicin passes into regions of the nervous system located outside the blood-brain barrier (BBB); the drug accumulates in the nucleus of neurons and causes cell degeneration. This investigation was performed to establish whether epirubicin, given as a single i.v. injection in the mouse, could enter the central nervous system (CNS) and cause neurotoxic effects. Epirubicin was found to emit a primary orange fluorescence in thin frozen sections. Detectable amounts of epirubicin could not be seen in regions protected by the BBB. The choroid plexus and all the circumventricular brain regions with the exception of the subcommissural organ showed the presence of the drug in the parenchyma and a marked accumulation in cell nuclei. Severe cellular changes were found in these regions by light and electron microscopy and the alterations were most marked in mice with the longest survival period (45 days). The animals also developed a progressive sensory polyneuropathy and appeared lethargic. Epirubicin given as a single i.v. injection in the mouse will thus spread into brain regions lacking a BBB where it produces toxic lesions in the same way as previously reported for the parent compound, doxorubicin. PMID- 2706440 TI - Lateral visually-guided saccades in progressive supranuclear palsy. AB - Lateral visually-guided saccades were studied electro-oculographically in 40 patients with progressive supranuclear palsy (PSP) in order to increase understanding of the pathophysiology of the oculomotor syndrome and the suprareticular control of saccades. In the two main paradigms used, the central fixation point was removed just before the appearance of a lateral target, the subject being told either to look at the target (gap task) or, particularly to test frontal lobe influence, in the direction opposite to the target (antisaccade task). Saccade latency distribution in the gap task was significantly more scattered in patients as compared with 40 normal control subjects, although mean latencies did not differ greatly. In particular, many patients had latencies shorter or longer than those of control subjects. In the PSP group, the percentage of errors in the antisaccade task (misdirected saccades made towards the target) was strongly correlated with latency in the gap task, high percentages of errors corresponding to short latencies. There was also a correlation between latency and the frontal dysfunction evaluated by neuropsychological tests. These correlations suggest that short latencies could result from a severe impairment of the frontal inhibitory system involved in saccade initiation. Long latencies would result from damage to diverse excitatory suprareticular pathways (such as the superior colliculus) or to circuits responsible for shifts in visual attention. Lastly, 20 patients were followed longitudinally (for 3-12 months). The initially great intersubject variability of saccade latency in the gap task significantly decreased over a period of several months. This finding could result from a secondary balance between the impairment of the frontal inhibitory system and that of the diverse excitatory pathways. PMID- 2706441 TI - CNV abnormalities following closed head injury. AB - Event-related potentials (ERPs) were recorded in a GO/NO-GO reaction time task from 20 closed head injury patients, at least 6 months postinjury, and from 20 controls. In this task the pitch of an initial tone (Sl) indicated whether or not a response was required to a second tone (S2) occurring 1.5 s later. In the control group both the early, frontal-maximum, and the later vertex-maximum, components of the contingent negative variation (CNV) were larger on GO than NO GO trials. In the patients, the early frontal CNV wave did not differentiate GO and NO-GO trials, and the late CNV showed a smaller separation between these trial types than did the late CNV of the control group. These CNV abnormalities may reflect impairments in selectively orienting to salient stimuli, and in differential response preparation. Such impairments might in turn reflect the damage to the frontal lobes and/or their connections that commonly occurs as a result of closed head injury. PMID- 2706442 TI - Spatial contrast sensitivity in unilateral cerebral ischaemic lesions involving the posterior visual pathway. AB - Contrast sensitivity function was studied in 16 patients with unilateral ischaemic lesions involving the posterior visual pathway. Sixty-two percent of the patients showed contrast sensitivity loss in at least one eye for horizontal or vertical stimulus orientation. Visual perception was distorted in a qualitatively different way according to the anteroposterior site of the lesion. Patients with occipital or occipitotemporal lesions showed high spatial frequency selective losses and patients with temporal or parietal lesions low frequency selective losses. Stimulus orientation selectivity was observed in patients with lesions of the primary visual cortex as well as in patients with lesions anterior to the striate cortex. Contrast sensitivity orientation-selective losses were demonstrated in 14 of the 17 'affected' eyes. PMID- 2706443 TI - Cytoskeletal abnormalities in motor neuron disease. An immunocytochemical study. AB - Immunocytochemistry with antibodies against cytoskeletal proteins has been used to search for molecular differences in the spinal cord from patients with motor neuron disease (MND) of amyotrophic lateral sclerosis type and normal spinal cord. Monoclonal antibodies which recognize phosphorylated neurofilament epitopes diffusely labelled a proportion of normal and MND anterior horn cells, but did not permit differentiation between normal and MND tissue. However, in some MND and control anterior horn cells, dense 'floccular' accumulations were labelled by antibodies recognizing phosphorylated neurofilament epitopes. These accumulations of phosphorylated neurofilaments suggest abnormalities of cytoskeletal regulation, but were neither a common nor a specific feature of MND. Axonal spheroids, which were as common in normal as in MND tissue, were labelled by all antineurofilament antibodies. Normal-appearing axons, but not spheroids, in MND and control tissue were identified by an antiactin antibody, indicating that actin may be absent from the cytoplasmic domain which gives rise to spheroids. In summary, we have not found specific posttranslational changes of cytoskeletal proteins in MND and, in particular, phosphorylated neurofilament epitopes are common to both MND and control anterior horn cells. PMID- 2706444 TI - Word recognition and orthographic context effects in a letter-by-letter reader. AB - The performance of letter-by-letter readers when attempting to decipher written material gives the impression that words fail to directly evoke any higher-level representation. As a consequence, spelling patterns appear to be treated perceptually as if they were a collection of random letters. We tested the hypothesis that words are no longer mapped onto orthographic descriptions by examining the ability of a letter-by-letter reader to identify letters in familiar words, pseudowords, and random strings. A clear effect of orthographic context was obtained on the accuracy of letter recognition, indicating that spelling patterns do gain access to more central components of the reading mechanism. The implications of this result for our understanding of the syndrome are discussed. PMID- 2706445 TI - Processing of visual syntax in a globally aphasic patient. AB - A globally aphasic patient was trained on a computerized visual communication system. His ability to comprehend reversible locative prepositional phrases after training was studied and compared with the performance of Broca's aphasics on a similar task. This patient's ability to generalize symbols for actions was also investigated. The results demonstrate our patient's capacity to master a formal visual syntax in the absence of natural language and illustrate how this capacity may be used successfully in a visual communication system. A problem in generalizing symbols for actions is demonstrated, suggesting that certain heuristic and cueing capabilities in the approach may be helpful. PMID- 2706446 TI - Direction of gaze and emergence of speech in the second year. AB - Orienting to the right member of a pair of identical pictures increased monotonically with age in a longitudinal sample of 14 infants seen monthly from 13 to 22 months. The magnitude of the correlation between this orientation bias and a measure of language development also rose with age reaching a peak at 20 months and then declining. It was suggested that the acceleration of vocabulary and maturational changes in the central nervous system that occur between 16 and 22 months are associated with a special excitatory state in the temporal cortex of the left hemisphere. PMID- 2706447 TI - The nature of prolonged word search. AB - Two alternative hypotheses were considered concerning the process of prolonged search for an uncommon word in response to hearing its definition. One alternative is that a conscious retrieval effort brings the target progressively closer to threshold. The second is that the retrieval process is a random neural exploration outside of conscious control. A tachistoscopic probe was devised to compare word recognition thresholds after 10 sec versus 30 sec of presumed search time. Results failed to show a difference between the two delay conditions and were interpreted as inconsistent with the first alternative but consistent with the second. PMID- 2706448 TI - Priming and semantic memory loss in Alzheimer's disease. AB - Semantic memory (SM) was investigated in six patients with probable Alzheimer's disease (AD) by on-line measurement of semantic priming in a lexical decision task, and off-line tests of comprehension. Detailed assessment was carried out on naming, name comprehension, and probes of semantic knowledge with a battery of 150 items. The patients performed normally on perceptual tests and displayed an item-specific loss of knowledge on the semantic tests. In a primed lexical decision task, greater semantic priming was found relative to age-matched normals. The priming was substantially greater for items with "degraded" representations as determined by the off-line tests. Lexical decision was also performed more slowly on these items. These unexpected results demand a reevaluation of the concepts of the lexicon and semantic memory structure and their possible alteration in dementia. PMID- 2706450 TI - The influence of speaking rate on articulatory hypokinesia in parkinsonian dysarthria. AB - This study addressed the question of whether or not speaking rate influences articulatory hypokinesia in dysarthria associated with Parkinson's disease. Analyses of parkinsonian speech samples revealed mean speaking rates consistent with normal controls. Thus, speaking rate was not abnormal overall in this group of dysarthric subjects. Kinematic analyses of labial displacement amplitude, peak instantaneous velocity, and movement time were made during repetitive syllable production spoken at two speaking rates: 3-5 syllables/sec and 5-7 syllables/sec. The results suggested that labial movements were normal at the slower of the two speaking rates. Conversely, labial movements became hypokinetic as speaking rate increased to the rate consistent with conversational speech. These findings provide a physiologic basis for the perception of hypokinetic dysarthria in Parkinson's disease and suggest that speaking rate may be an important control variable contributing to articulatory hypokinesia in Parkinson's disease. Moreover, these findings provide quantitative evidence that articulatory hypokinesia plays a dominant role in the perception of parkinsonian dysarthria. PMID- 2706449 TI - Variation in the pattern of omissions and substitutions of grammatical morphemes in the spontaneous speech of so-called agrammatic patients. AB - We describe the patterns of omissions (and substitutions) of freestanding grammatical morphemes and the patterns of substitutions of bound grammatical morphemes in 20 so-called agrammatic patients. Extreme variation was observed in the patterns of omissions and substitutions of grammatical morphemes, both in terms of the distribution of errors for different grammatical morphemes as well as in terms of the distribution of omissions versus substitutions. Results are discussed in the context of current debates concerning the possibility of a theoretically motivated distinction between the clinical categories of agrammatism and paragrammatism and, more generally, concerning the theoretical usefulness of any clinical category. The conclusion is reached that the observed heterogeneity in the production of grammatical morphemes among putatively agrammatic patients renders the clinical category of agrammatism, and by extension all other clinical categories from the classical classification scheme (e.g., Broca's aphasia, Wernicke's aphasia, and so forth) to more recent classificatory attempts (e.g., surface dyslexia, deep dysgraphia, and so forth), theoretically useless. PMID- 2706451 TI - Written spelling agraphia. AB - When a disorder of single word writing is seen in conjunction with preserved oral spelling and intact written grapheme formation ("written spelling agraphia"), the deficit may be presumed to lie somewhere between letter choice and written motor output. Two potential deficits are considered: (1) visual letter codes are not activated properly and (2) the information contained within properly activated visual letter codes fails to reach intact graphic motor patterns. Two patients with written spelling agraphia were each given a series of tests aimed at distinguishing between the two possibilities. Results suggest that the written spelling agraphia seen in these two patients arises from different underlying deficits. The results are discussed in terms of the patients' CT scan lesion sites, which were markedly different. PMID- 2706452 TI - Protein kinase C activity in the rat hippocampus after forebrain ischemia: autoradiographic analysis by [3H]phorbol 12,13-dibutyrate. AB - The influence of transient forebrain ischemia on the temporal alteration of protein kinase C (PKC) activity in the rat hippocampus was analyzed by quantitative autoradiography using [3H]phorbol 12,13-dibutyrate [( 3H]PDBu). As reported previously, the grain density was highest in the strata oriens and radiatum in the CA1 subfield. After transient forebrain ischemia (20 min), the [3H]PDBu binding in the CA1 subfield gradually increased during early recirculation, and became maximum 6-12 h after ischemia, when no microscopic damage of the CA1 pyramidal cells was obvious. Thereafter, grain density decreased and binding activity in the CA1 was lost by approximately 40% 7 days after ischemia, when CA1 pyramidal cells had become necrotic. This indicated a close association of phorbol ester binding sites with CA1 pyramidal cells. By contrast, [3H]PDBu binding sites were unchanged in the stratum radiatum in the CA3 throughout the recirculation, although the number of binding sites in the stratum oriens of the CA3 was decreased during early recirculation period. Seven days after recirculation, in the molecular layer of the dentate gyrus, where granule cells remained intact, [3H]PDBu binding activity increased by 33%, with a higher grain density in the inner region (supragranular layer). These results suggest that enhancement of PKC activity and/or translocation of the enzyme play an important role in the postischemic modulation of synaptic efficacy in the hippocampal formation and neuronal death of CA1 pyramidal cells. PMID- 2706453 TI - Studies on the sympathetic efferent nerves of brown adipose tissue of lean and obese Zucker rats. AB - Previous studies have suggested that the sympathetic tone to brown adipose tissue (BAT) is reduced in the genetically obese (fa/fa) rat. The following experiments were designed to examine with electrophysiological techniques the activity of the sympathetic nerve innervating the interscapular BAT. The spontaneous activity of the efferent nerves was reduced in the obese (fa/fa) rat compared with the lean control. The activity of the nerve showed a linear relationship with changes in core temperature in both genotypes. Electrical stimulation of the ventromedial hypothalamus resulted in similar heat increments in BAT temperature for lean and obese, but this was associated with a smaller increase in nerve firing in the obese rat. Intracerebroventricular administration of glucose enhanced the nerve activity, whereas 2-deoxy-D-glucose reduced the nerve activity in both lean and obese rats. These data suggest that the sympathetic tone is suppressed in the genetically obese rat, but the response to temperature and central glucose metabolism is intact. PMID- 2706454 TI - PNMT-containing catecholaminergic neurons are not necessarily adrenergic. AB - The intermediolateral cell column (IML) in the spinal cord is densely innervated by the phenylethanolamine-N-methyltransferase (PNMT)-containing neurons of the ventrolateral medulla (C1 cell group). The present study used a sensitive HPLC-EC assay for catecholamines to quantitate epinephrine levels in the region of the spinal cord containing the IML. In dissections of thoracic cord enriched in IML, as well as total thoracic cord, epinephrine levels were below the limit of sensitivity of the assay, indicating that epinephrine levels were less than 0.2 pg/mg tissue. In the region of the IML, epinephrine levels were less than 0.05% of the norepinephrine content. Thus, no epinephrine could be detected in the IML even though the IML contains a dense network of nerve terminals that stain immunohistochemically for PNMT and the other enzymes required for epinephrine biosynthesis. These results suggest that nerve terminals that contain all the enzymes required for epinephrine biosynthesis are not necessarily adrenergic. PMID- 2706455 TI - Cycloheximide-sensitive [35S]methionine labeling of proteins in goldfish retinal ganglion cell axons in vitro. AB - Polypeptides of retinal ganglion cell axons of the goldfish, regenerating in culture, were labeled by [35S]methionine after decentralization from the explant. Microscopic samples, composed of isolated axonal fields, were analyzed by SDS ultramicroelectrophoresis and autoradiography. Of the several proteins exhibiting cycloheximide-sensitive labeling, beta-tubulin and actin were consistently and prominently labeled, although the possibility of a labeled alpha-isoform with a lower mol. wt. could not be ruled out. PMID- 2706456 TI - Role of adenosine in cerebral hypoxic hyperemia in the unanesthetized rabbit. AB - The present study was undertaken to determine the importance of adenosine in the cerebrovascular response to hypoxia. The mass spectrometry method was used to investigate local blood flow, tissue pO2 and pCO2 in 3 cerebral structures: caudate nucleus (n = 8), thalamus (n = 5) and hippocampus (n = 5) in unanesthetized, spontaneously breathing rabbits. After having tested the reproducibility of the hypoxic response each animal was exposed twice to moderate hypoxia. I.v. theophylline (10 mg/kg) was administered between the first and second exposures to hypoxia. The principal finding is that in each cerebral region, the vasodilatation induced by hypoxia was significantly decreased by pretreatment with theophylline despite the low theophylline dose used. It is concluded that adenosine is partly responsible for the cerebral vasodilatation observed during hypoxia. Several other mechanisms possibly involved in this cerebrovascular response are discussed. PMID- 2706457 TI - Responses of single auditory cortical neurons to tone sequences. AB - The responses of single neurons in the primary and secondary auditory cortex of cat were recorded during the presentation of sequences consisting of five tones of different frequencies. Discharges to tones within these sequences usually (84%) exhibited a dependence on the 'direction' of the sequence (ascending, descending, or mixed frequencies). For sequences consisting of 5 tones of identical frequency (monotone) the response often depended on serial position, including cases in which the neuron only responded to later tones in the sequence. Comparison of responses to heterogeneous and monotone sequences showed that response dependence on serial position was a factor in response dependence on sequence direction. Auditory cortical neurons can exhibit stronger responses to a tone presented in a sequence than to the same tone presented alone. Hence, the responses to tones within sequences may not be highly predictable from the responses to isolated tones. PMID- 2706458 TI - Studies of endothelial mitochondrial density in degenerating rat optic nerve. AB - The greater mitochondrial density found in blood-brain barrier endothelium has been attributed to greater utilization of energy, for tasks such as maintaining ionic homeostasis of brain extracellular fluids. To examine whether endothelial mitochondrial density changes in parallel with neural activity, we studied capillaries in rat optic nerves rendered functionless by enucleation. We found no change in endothelial mitochondrial density compared with that in contralateral control nerves. Perhaps endothelial mitochondrial density may not change in capillaries in white matter tracts, or may not ever drop below a baseline level. PMID- 2706459 TI - Delta-sleep-inducing peptide (DSIP) stimulates the release of immunoreactive Met enkephalin from rat lower brainstem slices in vitro. AB - We studied whether delta-sleep-inducing peptide (DSIP) acted on opioid receptor directly or indirectly. DSIP did not have binding activity to any subtype of opioid receptors. DSIP at doses of 1 pM-1 nM significantly stimulated the release of immunoreactive Met-enkephalin (iME) from superfused slices of the rat lower brainstem. The DSIP-induced release of iME was calcium-dependent. These results show that DSIP acts on opioid receptor indirectly by stimulating the release of iME in producing antinociceptive effects. PMID- 2706460 TI - Avian nucleus isthmi ventralis projects to the contralateral optic tectum. AB - Injections of HRP throughout the upper tectal strata led in 4 cases to the appearance of retrogradely labeled neurons within n.isthmi ventralis, contralateral to the experimental side. An additional case proved that this projection courses through the ventral supraoptic commissure. This is the first description of a crossed isthmo-tectal projection in birds. PMID- 2706461 TI - Immunocytochemical study of angiotensin II cell bodies in the rat thalamus. AB - The distribution of angiotensin II cell bodies in the thalamus of the rat was studied by means of intratissue injections of colchicine and using an indirect immunoperoxidase technique. The densest clusters of immunoreactive perikarya were observed in the nuclei geniculatum laterale, medialis dorsalis, ventralis posterior, centralis lateralis, centralis medialis and anterior dorsalis, whereas the nuclei lateralis posterior, lateralis and geniculatum laterale dorsalis had the lowest density. In other thalamic nuclei, geniculatum mediale, lateralis anterior, paraventricularis and ventralis medialis, the density of angiotensin II cell bodies was intermediate. In all these thalamic nuclei, small, round immunoreactive cells with short processes were observed. PMID- 2706462 TI - Neurotrophic action of Alzheimer's disease brain extract is due to the loss of inhibitory factors for survival and neurite formation of cerebral cortical neurons. AB - Cell cultures of neonatal rat cerebral cortex in a serum-free medium were used to investigate whether specific neurotrophic factors are accumulated or inhibitory factors for neuronal survival and neurite formation decrease in AD brain extract. Neurotrophic activity in brain extract was quantified by using the ELISA for microtubule-associated protein 2 (MAP2). Inhibitory factors, which blocked neurotrophic activity, were present in normal brain extract. In AD brain extract, loss of the inhibitory factors resulted in a relative increase in neurotrophic activity. The inhibitory factors in normal brain extract were retained on the ultrafiltration membrane with molecular weight cutoff of 10 kDa. PMID- 2706463 TI - Noradrenergic systems in human cerebellum. AB - Thin, beaded axons, immunostained with antisera to human dopamine beta hydroxylase (DBH), were present in all layers of the anterior vermis of human cerebellum. This plexus appears similar to that described in rodents and provides information complementary to receptor autoradiographic studies that show significant noradrenergic innervation of mammalian cerebellum. Moreover, in two aged controls, we demonstrated abnormal, swollen, tortuous axons not visualized in young controls. PMID- 2706464 TI - Reciprocal regulation of tachykinin- and vasoactive intestinal peptide-gene expression in rat sensory neurones following cut and crush injury. AB - The relative abundance of preprotachykinin- (PPT), actin- and vasoactive intestinal peptide- (VIP) mRNA's was measured in L5 dorsal root ganglia of rats after resecting or crushing the sciatic nerve. PPT-mRNA levels fell to 40% of control values 3, 6 and 9 days following nerve resection. Crushing produced a lesser fall at 3 and 6 days with a partial recovery at 9 days. Following resection actin-mRNA levels transiently rose to twice control values and had returned to normal by day 9. VIP-mRNA was not detectable in control ganglia but increasing amounts of VIP-mRNA were present 3, 6 and 9 days after nerve injury. The results are discussed in terms of the control mechanisms operating. PMID- 2706465 TI - Tongue-muscle-controlling motoneurons in the Japanese toad: neural inputs from the thalamus. AB - The anuran tongue is an effector organ specialized for snapping up prey during visually guided prey-catching behavior. As a step toward elucidating the control mechanisms of the tongue movement and overall organization of visually guided behavior, properties of neural inputs from the thalamus (of which electrical stimulation elicited a behavior very similar to the visually guided predator avoidance behavior under freely behaving conditions) were investigated in paralyzed Japanese toads. Tongue-muscle-controlling motoneurons (tongue protractor motoneurons (PMNs) and tongue-retractor motoneurons (RMNs)) were identified antidromically, and synaptic inputs in response to electrical stimuli applied to various points in the thalamus (mainly the posterocentral thalamic nucleus) were examined. Hyperpolarizing potentials were evoked in both PMNs and RMNs in response to single electrical stimuli applied to the thalamus contralateral or ipsilateral to the recording side. Since these potentials reversed to depolarizing ones after injecting Cl- ions into the cell interior, these hyperpolarizing potentials were concluded to be the usual fast type of inhibitory postsynaptic potentials (IPSPs). On the other hand, depolarizing potentials which were superimposed on the underlying IPSPs were evoked when repetitive electrical stimuli were applied to the thalamus. The amplitude of these depolarizing potentials was decreased when depolarizing currents were injected intracellularly, while it was increased when hyperpolarizing currents were injected, indicating that these depolarizing potentials are excitatory postsynaptic potentials (EPSPs).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706466 TI - Postcordotomy spontaneous dysesthesias in macaques: recurrence after spinal cord transection. AB - Monkeys chronically attack the hypoalgesic hindlimb after thoracic contralateral anterolateral cordotomy or hemisection. This compulsive behavior could be induced by innocuous stimulation in the hypoalgesic region, and it also appeared to occur spontaneously. The postcordotomy spontaneous compulsive self-directed behavior was studied in 4 macaques after subsequent upper lumbar crush spinal transection. Despite the paraplegia and bilateral analgesia/anesthesia, this spontaneous abnormal behavior continued to be directed to the same hindlimb as before transection, but not to the opposite hindlimb. Hence, it is concluded that the recurring syndrome originated from the initial contralateral cordotomy. The rationale for the presumption of postcordotomy spontaneous dysesthesias is presented, and the experimental results are offered in refutation of alternative interpretive hypotheses. In conjunction with previous findings, these results lead to the argument that postcordotomy dysesthesias are caused by a neuropathological compensatory response to partial deafferentation of brain somatosensory neurons. PMID- 2706467 TI - Electromyographic activity of cat hindlimb flexors and extensors during locomotion at varying speeds and inclines. AB - Electromyographic activity (EMG) was used to determine how hindlimb muscle activation patterns are modified as speed and incline of locomotion are varied in treadmill-trained cats. EMG was recorded using chronically implanted i.m. electrodes from the soleus, medial gastrocnemius, gluteus medius, and tibialis anterior muscles of adult cats during treadmill locomotion at a range of speeds and inclines. The patterns of changes in EMG activity at varying speeds and inclines were similar in all cats. Across speeds, the integrated EMG per step decreased for the soleus but remained constant for the other muscles. The integrated EMG per step was elevated in all muscles at higher inclines. Generally, with increased speed or incline the mean EMG per step was elevated in the medial gastrocnemius, gluteus medius, and tibialis anterior, the largest increase seen in the medial gastrocnemius. Soleus mean EMG per step remained unchanged with increased speed, but showed an absolute increase at the higher inclines. The integrated EMG per minute was always highest for the soleus followed by the medial gastrocnemius, and always lowest for the tibialis anterior. At the faster speeds, the 'on-time' increased in the tibialis anterior and decreased in the other muscles. These data suggest that the number of motor units activated and/or their firing frequencies increased in the medial gastrocnemius and the gluteus medius during locomotion at faster speeds or larger inclines, while relatively little change occurred in the soleus and tibialis anterior. These data also suggest that while there is considerable modulation of the level and duration of excitation of the extensor motor pools there is relatively little modulation of the flexor motor pools to adjust for both the speed and the incline of locomotion. PMID- 2706468 TI - Serotonin innervation in adult rat neostriatum. II. Ultrastructural features: a radioautographic and immunocytochemical study. AB - High-resolution radioautography after cerebroventricular administration of tritiated serotonin (5-HT) and PAP immunocytochemistry with an antiserum against 5-HT-glutaraldehyde conjugate (kindly donated by M. Geffard) were used in parallel to investigate the intrinsic and relational fine structural features of 5-HT axon varicosities (terminals) in the neostriatum of the adult rat. The uptake-labeled varicosities were examined in single thin sections from a paraventricular sector of neostriatum, whereas their immunostained counterparts were viewed in serial thin sections from the same paraventricular sector plus a dorsal neostriatal sector. The two approaches yielded complementary results in terms of varicosity dimensions, synaptic features and appositional relationships. Serotonin axon terminals were generally small and, as measured in immunostained material, even smaller in the dorsal than in the paraventricular neostriatum. Their internal features, best viewed in radioautographs, included small pleomorphic synaptic vesicles with occasional large granular vesicles and mitochondria. Junctional 5-HT terminals from both the paraventricular and the dorsal neostriatal sectors synapsed exclusively, and with equal frequency, on dendritic spines or shafts, almost always with asymmetrical membrane differentiations. The proportion of junctional varicosities, however, was very low in serial (immunocytochemical) as well as single (radioautographic) thin sections. Only 10-13% of 5-HT varicosities from either the paraventricular or the dorsal neostriatum exhibited a synaptic junction, in contrast with a junctional incidence of at least 70% for randomly selected axonal varicosities similarly sampled in the surrounding neuropil. Serotonin axon terminals, whether or not synaptic, were closely apposed to a variety of structures comprising mostly other axon terminals, dendritic spines and branches, but rarely neuronal somata. The synaptic and appositional features of immunostained 5-HT varicosities were similar for both the dorsal and the paraventricular neostriatum. In this context, it is likely that the effects of 5-HT in the neostriatum are exerted upon a multiplicity of cellular target sites in addition to the restricted number of dendritic spines and shafts synaptically contacted by this type of monoamine terminal. PMID- 2706469 TI - Hemicholinium-3 binding sites in rat brain: a quantitative autoradiographic study. AB - Quantitative in vitro autoradiography was used to study the distribution of [3H]hemicholinium-3 ([3H]HC-3) binding sites in the rat brain. Regional concentrations of HC-3 binding sites were corrected for regional tissue quenching of tritium in a number of brain structures. Specific binding of 10 nM [3H]HC-3 was highest in the interpeduncular nucleus, followed by the caudate-putamen, olfactory tubercle, amygdala, and the medial and lateral habenulae. There was a high positive correlation between regional HC-3 binding and choline acetyltransferase activity in rat brain; however, a novel pattern of the distribution of cholinergic terminals in the subnuclei of the interpeduncular nucleus was discovered. The apparent Kd in the 1-5 nM range and the pharmacological specificity of the HC-3 binding site agreed with data for choline uptake and for the HC-3 binding site as determined in membrane preparations. HC-3 autoradiography appears to be a useful anatomical marker for cholinergic terminals. PMID- 2706470 TI - In vivo [31P]NMR studies on the influence of age on rat brain hypoxia. AB - In this paper the response of cerebral phosphate metabolism to mild hypoxia in young, medium and old rats has been studied via in-vivo [31P]nuclear magnetic resonance (NMR). It was found that the young adults (5-6 months) were more sensitive to this mild stress than either the mature adult (11-12 months) or senescent (23-24 months) rats even though the depth of hypoxia (paO2 = 45-55 mm Hg) was equal for all age groups. They displayed an earlier onset of acidosis, a greater fall in PCr and larger rise in Pi. This response is presumably an attempt to maintain adequate adenosine triphosphate (ATP) levels via anaerobic glycolysis. In contrast, mature adults and senescent adults appear to be able to maintain ATP levels by increasing mitochondrial rates. Acidosis is less severe as are drops in PCr and rises in Pi. Recovery is less complete for the young rats: Pi levels remain high while PCr and pHi levels stay low after normoxia has been reinstigated. All metabolite levels in the mature and senescent adults return to within 10% of control levels. All the data were analyzed and differences were found to be statistically significant. This study reveals that, contrary to popular belief, mature and old rats respond more favorably to reduced O2 than younger individuals. This is due to a more severe anaerobic acidosis in the latter age group. Speculations to explain this disparity are based on the fact that previous in-vitro studies involve systems that are totally or partially disconnected from the organism will not account for important feedback control present in an in-vivo system as studied here. PMID- 2706471 TI - Effects of perfusion flow rate, prostaglandin F2 alpha, phenylephrine, and serotonin on isolated, perfused brains of spontaneously hypertensive rats. AB - Effects of perfusion flow rate and three vasoconstrictors, phenylephrine, prostaglandin F2 alpha (PGF2 alpha) and serotonin, on isolated, perfused brain preparations of spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto rats (WKY) were investigated. The basal perfusion pressure of the cerebral vascular beds at a flow rate of 2.5 ml/min was 48 +/- 3 mm Hg (n = 11) in SHR and 32 +/- 2 mm Hg (n = 12) in WKY (P less than 0.005). The perfusion pressures at all flow rates tested (2.5-6.5 ml/min) in SHR were significantly greater than those in WKY. Concentration-perfusion pressure curves for the vasoconstrictors showed that the brain vascular bed was much more reactive to serotonin compared with phenylephrine and PGF2 alpha. EC50 values (-logM) for serotonin in the perfused brains of SHR and WKY were 7.0 +/- 0.06 (n = 10) and 6.5 +/- 0.06 (n = 11), respectively (P less than 0.01). There were no differences in EC50 values for phenylephrine or PGF2 alpha between SHR and WKY. Exogenous serotonin and phenylephrine caused significantly greater maximal vasoconstrictor responses in SHR compared with WKY, while the pressor response to PGF2 alpha was very weak and no significant difference between SHR and WKY preparations was observed. These results indicate that cerebral vascular beds in SHR exhibit higher cerebrovascular resistance than those in WKY. and that reactivity and sensitivity to serotonin and reactivity to phenylephrine in SHR rats are enhanced to a greater extent compared to WKY. PMID- 2706472 TI - Unusual motor unit firing behavior in older adults. AB - Motor unit firing behavior was studied in the first dorsal interosseus (FDI) and tibialis anterior (TA) muscles of 10 aged subjects during slow, isometric contractions. Previous study in younger individuals had shown that motor units are recruited and derecruited in an orderly manner whereby the early-recruited units are the last to be derecruited. However, there were several examples in the old subjects in which some high-threshold motor units were derecruited at much lower levels of force. Concurrent antagonist firing in an effort to maintain the required precision is considered a likely candidate for such prolonged motor unit activation. PMID- 2706473 TI - Carbachol depresses synaptic responses in the medial but not the lateral perforant path. AB - The effects of applications of carbachol on evoked synaptic responses recorded in the dentate gyrus of guinea pig hippocampal slices were examined. Carbachol depressed potentials recorded extracellularly in the medial perforant path terminal zone, but did not significantly alter field potentials recorded in the lateral perforant path terminal zone. Carbachol-induced depression was reversed by applications of the muscarinic antagonists, atropine or pirenzepine. It was suggested that the difference observed in carbachol-induced depression of medial versus lateral perforant path field potentials may be due to regional differences in acetylcholine receptor distribution in the molecular layer of the dentate gyrus. PMID- 2706474 TI - Stimulation of endogenous dopamine release and metabolism in amphibian retina by light- and K+-evoked depolarization. AB - The release and metabolism of dopamine (DA) in retina was assessed using an in vitro eye cup preparation of the African clawed frog. The concentration of DA in the incubation medium and of 3,4-dihydroxyphenylacetic acid (DOPAC) and DA in retinas was measured by high-performance liquid chromatography with electrochemical detection (HPLC-ED). K+-induced depolarization stimulated DA overflow from the eye cups into the incubation medium and increased tissue DOPAC levels in dark-adapted retinas. Basal and K+-stimulated DA overflow and DOPAC accumulation were Ca2+-dependent. Exposure of dark-adapted retinas to constant white light for 1 h also increased DA overflow and DOPAC levels, while 1 h of alternating 10 s periods of light and dark had no effect. The results indicate that DA release and metabolism may be stimulated as a function of light adaptation. PMID- 2706475 TI - Dextromethorphan attenuates post-ischemic hypoperfusion following incomplete global ischemia in the anesthetized rat. AB - The effects of dextromethorphan (DM) were tested in an in vivo model of incomplete global cerebral ischemia. Anesthetized rats were divided into 4 groups: Group 1 (saline); Group 2 (DM pre-treatment, 20 mg/kg i.v. bolus followed by 10 mg/kg/h DM infusion); Group 3 (DM post-treatment, 2 mg/kg i.v. bolus followed by 10 mg/kg/h DM infusion at the onset of post-ischemic hypoperfusion); and Group 4 (sham-operated, drug-treated). Groups 1-3 underwent 15 min of 4 vessel occlusion followed by 3 h of reperfusion. Administration of DM in sham operated animals (Group 4) had no effect on cerebral blood flow or electroencephalographic (EEG) activity. In contrast, when compared to the Group 1 saline controls, significant attenuation of post-ischemic hypoperfusion and EEG dysfunction was demonstrated in ischemic rats treated with DM (both pre- and post treatment), suggesting an ability of DM to improve cerebral blood flow (CBF) and brain function in cerebral ischemia. PMID- 2706476 TI - Modulation of reflex responses during fictive locomotion in the forelimb of the cat. AB - During cat forelimb fictive locomotion, short-latency reflex pathways were examined by recording nerve discharges and intracellularly from motoneurones. Stimulation of cutaneous afferents, superficial radial nerves, evoked trisynaptic excitation of the elbow flexors, biceps brachii and brachialis, and stimulation of muscle afferents, deep radial nerves, evoked oligosynaptic, i.e. monosynaptic and disynaptic excitation of the flexors. The short-latency excitatory postsynaptic potentials (EPSPs) evoked from both nerves were rhythmically modulated; they were facilitated during the flexion phase and suppressed during the extension phase. Stimulation of high threshold muscle afferents evoked EPSPs with a central delay of ca. 4.2 ms, which were depressed throughout episodes of fictive locomotion. Since the short-latency EPSPs and longer-latency EPSPs in the same motoneurone were differently influenced during fictive locomotion, the effects observed could not be explained by changes occurring at only the motoneuronal level but they probably occurred at the premotoneuronal level. In addition, short-latency cutaneous excitation of the distal muscles, innervated by the median and ulnar nerves, was little modulated during fictive locomotion. PMID- 2706477 TI - Phenothiazines reduce ischemic damage to the central nervous system. AB - We found substantial alterations in reactions catalyzed by calcium/phospholipid dependent and calcium/calmodulin-dependent protein kinases during CNS ischemia which suggested that phenothiazines, drugs capable of inhibiting these reactions, might reduce neurologic damage. To test this hypothesis, we used chlorpromazine and trifluoperazine. Both drugs reduced neurologic function deficits relative to controls in a rabbit multiple cerebral embolism model and a rabbit spinal cord ischemia model. Chlorpromazine was effective despite reduction of blood pressure, and trifluoperazine did not alter blood pressure. These findings suggest that phenothiazines may be useful for preserving neurologic function when administered shortly after the onset of CNS ischemia. PMID- 2706478 TI - Effect of anticholinergic drug on long-term potentiation in rat hippocampal slices. AB - Long-term potentiation (LTP) was studied in CA1 neurons by tetanization of the Schaffer-commissural pathway in rat hippocampal slices. A brief tetanus (200 Hz for 1 s) caused an increase in amplitude of the population spike recorded from the CA1 area (typically about 200% of control), which lasted for more than 2 h. LTP was suppressed by perfusion of the muscarinic antagonist scopolamine (10(-5) M) from 5 min before to 15 min after the tetanus. If perfusion of the drug was begun after the tetanus, there was no affect on LTP. Scopolamine perfused without tetanus did not change the amplitude of the population spike. These results suggest that cholinergic system may affect the generation mechanisms of LTP. PMID- 2706479 TI - Selective reduction of serotonin immunoreactivity in some forebrain regions of rats induced by acute methamphetamine treatment; quantitative morphometric analysis by serotonin immunocytochemistry. AB - The influence of acute methamphetamine treatment on serotonin-like immunoreactive axons was studied in the rat forebrain. Animals, sacrificed 90 min after i.p. injection of methamphetamine (16 mg/kg) or saline, were processed for immunocytochemistry using serotonin antiserum. The numerical density of immunoreactive boutons of terminals and varicosities was quantitatively analyzed by a computer-assisted image analyzer. Compared with the control, administration of methamphetamine caused varying degrees of reduction in the numerical density in several forebrain regions. A high decrement (over -90%) was found in deep layers of the cerebral cortex, striatum and thalamic paraventricular nucleus, while a less prominent reduction (about -50%) was seen in such regions as the suprachiasmatic nucleus and basolateral amygdaloid nucleus. Moreover, superficial layers of the cerebral cortex contained uncommon features of immunopositive axons which were characterized by intensely stained fibers with large varicosities. The results suggest that the rat forebrain contains at least two types of serotonin nerves, one very sensitive to methamphetamine and another relatively insensitive or resistant to it. PMID- 2706480 TI - Burst discharges of thalamic reticular neurons: an intracellular analysis in anesthetized rats. AB - In order to analyze the mechanism of burst discharges intracellular recordings were made from 27 somatosensory thalamic reticular (S-TR) neurons in urethane anesthetized rats. Burst discharges, composed of 2-7 spikes, were always superposed on a slow depolarization (SD) lasting for 40-60 ms, which appeared only when the membrane was hyperpolarized. The number of spikes superposed on an SD varied depending upon the amplitude of the SD. A single shock stimulation of the lemniscus medialis elicited a series of SDs, each without being preceded by a phasic hyperpolarizing potential. The SDs were repeated with spindle rhythms. Evidence has been provided that EPSPs contribute to the mechanism for triggering SDs. In spontaneous rhythmic SDs occurring with the rhythm of EEG spindles, steps representing EPSPs were recordable on the rising phase of each SD. It is suggested that excitatory synaptic inputs to S-TR neurons with the spindle rhythm are responsible for the rhythmic generation of SDs. Ventrobasal relay neurons are presumed as the source of the inputs. PMID- 2706481 TI - The nucleus reticularis gigantocellularis modulates the cardiopulmonary responses to central and peripheral drives related to exercise. AB - It is known that muscle afferents and the hypothalamic locomotor region (HLR) both project to the nucleus reticularis gigantocellularis (NGC) and that the NGC is capable of influencing cardiovascular and respiratory variables. Therefore, the role of NGC in the cardiovascular and respiratory response to exercise related signals was investigated in anesthetized cats. These signals were generated by stimulation of: (1) spinal ventral roots to induce hindlimb muscle contraction (MC) and (2) the HLR. Bilateral electrolytic lesion of the NGC at the pontomedullary border caused tidal volume, respiratory frequency and heart rate responses to HLR stimulation to be greater than the responses recorded prior to lesioning. Lesioning had no effect on the ventilatory or cardiovascular responses to MC but did decrease phrenic responsiveness; lesion had no effect on any resting values. In this preparation, the pontomedullary NGC acts as an inhibitory influence on tidal volume, breathing frequency and heart rate responses to the central command for exercise. In addition, NGC modulation of ventilation would appear to be selective for certain respiratory muscle groups. PMID- 2706482 TI - Distribution and time course of protein extravasation in the rat spinal cord after contusive injury. AB - We have previously characterized a graded, spinal cord contusive injury in the rat. We have now used this reproducible model to examine vascular permeability to horseradish peroxidase (HRP) after injury. The relationship between severity of injury and distribution of protein extravasation was evaluated at 3 h after injury. After mild injury, tracer was primarily confined to central gray matter and the ventral part of the dorsal columns. After moderate injury, protein extravasation was similar to that observed after mild injury, with the exception that the central hemorrhage included pericentral while matter and occasionally extended to the pial surface. After severe injury, reaction product (RP) was more densely distributed within the central cord and peripheral white matter. The axial extent of tracer at sites proximal and distal to the impact site increased with severity of injury. At 2.0 cm from the injury, no leakage of tracer was noted after mild injury. In contrast, after moderate and severe injury limited microvascular leakage of HRP was noted. Furthermore, after severe injury, in addition to local sites of microvascular leakage, intense RP was present in the dorsal columns up to at least 2.0 cm from the injury. The time course for re establishment of the blood-spinal cord barrier to protein was evaluated from 3 h to 14 days after moderate injury. At 3 h to 1 day, protein leakage was maximal and coincided with sites of extravasated blood components, although was consistently more extensive. By 7 days, despite resolution of the initial hemorrhage, there remained scattered evidence for protein extravasation at the injured site and at sites along the axis of the cord. The blood-spinal cord barrier to HRP was reestablished by 14 days after injury. PMID- 2706483 TI - Neurally mediated cardiovascular responses to stimulation of cell bodies in the hypothalamus of the rat. AB - To study the cardiovascular responses to selective activation of neuronal cell bodies in the hypothalamus, DL-homocysteate (5-50 nl of a 0.15-M solution, pH 7.4) was injected into 417 histologically verified sites in the hypothalamus of 46 urethan-anesthetized, paralyzed and artificially ventilated rats. Injections resulted in depressor responses (-5 to -32 mm Hg) in 271 sites, in pressor responses (5-47 mm Hg) in 77 sites and 69 sites were not responsive. Depressor effects had a shorter latency (85% started within 5 s) than pressor effects (42% started within 5 s). Control injections of 0.15 M NaCl into 126 of the responsive sites were ineffective. Arterial pressure (AP) responses showed a positive correlation (r = 0.61, P less than 0.001) with changes in heart rate (HR). Analysis of the anatomical distribution of responsive sites showed that in all hypothalamic subdivisions depressor responses predominated except in the paraventricular nucleus, where mainly pressor effects and tachycardia were elicited. These results demonstrate that excitation of cell bodies in most hypothalamic regions elicits neurally mediated changes in AP and HR and that the traditional functional division of the hypothalamus into a rostral depressor and a caudal pressor area is probably based on the combined excitation of fibers of passage and cell bodies. PMID- 2706484 TI - Low-concentration N-acetylaspartylglutamate suppresses the climbing fiber response of Purkinje cells in guinea pig cerebellar slices and the responses to excitatory amino acids of Xenopus laevis oocytes injected with cerebellar mRNA. AB - Whether N-acetylaspartylglutamate (NAAG) at micromolar concentrations shows a modulatory action on the synaptic transmission mediated by excitatory amino acids was investigated using Guinea pig cerebellar slices and the Xenopus laevis oocytes injected with mRNA from Guinea pig cerebellum. The climbing fiber response consisted of an excitatory postsynaptic potential (EPSP) and a plateau potential intracellularly recorded from Purkinje cell dendrite was depressed by 30 microM NAAG; the EPSP was decreased by about 21% in amplitude and the plateau potential was depressed by about 42% in duration. The depolarization induced by L aspartate, L-glutamate, N-methyl-D-aspartate and quisqualate in mRNA-injected Xenopus oocytes were non-selectively antagonized by 0.5 microM-5 microM NAAG, the mean % blockade by 5 microM NAAG being about 38%. Higher concentrations (greater than 100 microM) of NAAG alone by 33% on average by 10 microM NAAG. These results suggest the possibility that micromolar concentrations of NAAG may attenuate the synaptic transmission mediated by glutamate receptors not only by blocking postsynaptic receptors but also by facilitating the high-affinity re-uptake of transmitter amino acids. PMID- 2706485 TI - The spinal antinociceptive actions of morphine metabolites morphine-6-glucuronide and normorphine in the rat. AB - The profound and prolonged effects of morphine in patients with renal dysfunction have been associated with high plasma levels of the opiate metabolites morphine-6 glucuronide (M6G) and morphine-3-glucuronide (M3G) rather than an increased concentration of morphine. We present here electrophysiological evidence to suggest that potent spinal antinociception can be produced by both M6G and normorphine, another metabolite of morphine. Extracellular recordings of A beta- and C-fibre-evoked responses of convergent dorsal horn neurones were made in the halothane anaesthetised rat. M6G elicited dose-dependent, naloxone-reversible inhibitions of C-fibre-evoked responses which were completely suppressed (8% of control) by 2 micrograms M6G whereas A beta-fibre-evoked responses were only reduced to 57% of controls. The ED50 for the effects of M6G on C-fibre-evoked activity was calculated to be 0.53 micrograms. Systemic administration of M6G (2 mg/kg) also profoundly reduced noxious evoked neuronal activity. Intrathecal normorphine was less potent than M6G but complete selective inhibitions of C fibre-evoked response could be elicited by 25 micrograms and the ED50 was calculated to be 2.68 micrograms. No such inhibitions were observed following administration of M3G. A comparison with intrathecal morphine in the same preparation reveals that normorphine is equipotent with morphine whereas M6G is 13-fold more potent. These results therefore confirm that M6G and normorphine might be significant contributers to opiate analgesia after administration of morphine. PMID- 2706486 TI - Age-dependent changes in brain glycine concentration and strychnine-induced seizures in the rat. AB - Glycine levels and receptor binding were measured in the medulla and spinal cord of 2-month, 10-month, and 24-month-old Fischer 344 rats. The behavioral response to the administration of the glycine antagonist, strychnine, was also evaluated in 2- and 24-month-old animals to investigate the relevance of these parameters to the susceptibility to seizures. Significant reductions in glycine in both the spinal cord and medulla occurred from 2 to 24 months of age. The glycine precursors, serine and threonine, were decreased only in the spinal cord. [3H]Strychnine binding was also decreased by 38% and 34% in the medulla and spinal cord, respectively, of 24-month-old rats compared to 2-month-olds. [3H]GABA binding was similarly reduced while no age-related changes in [3H]diazepam binding in the spinal cord were detected. Comparison of 2- and 24 month-old animals after systemic injection of 1.75 mg/kg strychnine showed that senescent animals have a higher incidence of seizures and mortality compared to young animals. Decreases in glycinergic neurotransmission may lower strychnine seizure threshold in the aged animal. PMID- 2706487 TI - Experimental fluid percussion brain injury: vascular disruption and neuronal and glial alterations. AB - Because of the potential relationship between vascular disturbances and secondary tissue damage, we identified areas of brain which exhibited hemorrhage and leakage of protein during the acute stage after experimental brain injury and subsequently studied the development of pathologic changes, including cavity formation, neuronal necrosis, and gliosis within these regions. The development of pathologic changes was evaluated at 1, 6, and 24 h and 1, 2, and 4 weeks after lateral, fluid percussion (FP) brain injury of moderate severity in the rat. Vascular disruption in the acute stages, as evidenced by hemorrhage and leakage of Evans blue albumin, was most prominent 6 h postinjury and was maximal in the parieto-occipital cortex. From 1 to 24 h after injury, regions of the injured hemisphere, including the cortex and hippocampus, exhibited abnormal neurons which stained with acid fuchsin and Alizarin red, histochemical markers for injured neurons and calcium, respectively. These same regions suffered significant neuronal cell loss from 1 to 4 weeks after injury. The distribution of reactive astrocytes was also evaluated by immunocytochemical localization of glial fibrillary acidic protein (GFAP). By 2 weeks postinjury, a prominent cavity was present in the frontoparietal and occipital cortices. Although astrogliosis was most pronounced in the cortex surrounding the cavity, prominent reactive astrocytes were widely distributed throughout the injured hemisphere. This study characterized the pathological changes which occur after experimental traumatic brain injury. In particular, we propose that neuronal cell injury in the hippocampus serves as a useful 'window' to assess beneficial efficacy of pharmacological intervention in the treatment of brain injury. PMID- 2706488 TI - The retinohypothalamic tract in the cat: retinal ganglion cell morphology and pattern of projection. AB - The pattern of retinal projection to the hypothalamus and the morphological properties of the retinal ganglion cells that comprise the retinohypothalamic tract have been examined in the cat. Intraocular injections of horseradish peroxidase revealed a dense retinal projection to the ventral suprachiasmatic nucleus; however, lighter projections were seen in the dorsal suprachiasmatic nucleus, and in hypothalamic regions both dorsal and lateral to the suprachiasmatic nucleus. Intrasuprachiasmatic nucleus injections of horseradish peroxidase retrogradely labelled retinal ganglion cells that were small to medium in soma size. The labelled ganglion cells exhibited long thin dendrites that were sparsely branched. The labelled retinal ganglion cells exhibited a significant change in soma size associated with retinal eccentricity. The morphological characteristics of the ganglion cells that project to the suprachiasmatic nucleus are similar to those of gamma cells. PMID- 2706489 TI - Increase in the activity of tryptophan hydroxylase from cortex and midbrain of male Fischer 344 rats in response to acute or repeated sound stress. AB - Exposure of male Fischer 344 rats to an acute sound stress consisting of 100 dB tones of 2-s duration presented at random 60-s intervals for 2 h, increased cortical and midbrain tryptophan hydroxylase activity, measured in vitro, 50% over that from sham-stressed animals. This increase in enzyme activity was observed when animals were killed immediately, but not 1 h, after termination of the sound stress. It was non-additive with the increase in activity induced by incubation of enzyme under phosphorylating conditions and could be reversed in vitro with alkaline phosphatase. Graded increases in enzyme activity were obtained with increments of sound intensity (90-120 dB). In contrast to acute stress, chronic sound stress (110 dB) repeated over a period of 1, 2 or 6 weeks (3 sessions per week each of 2-h duration) produced a 50% increase in cortical enzyme activity that persisted 24 h after the termination of the stress and was not reversed by alkaline phosphatase. However, a further increase in enzyme activity could be produced if the chronically stressed animals were exposed to an acute 2-h stress (110 dB) immediately before being killed. This additional increase in activity was reversible in vitro by alkaline phosphatase and non additive with that produced by incubation under phosphorylating conditions. In summary, acute sound stress produced a prompt, reversible activation of tryptophan hydroxylase. Repeated exposure to sound stress induced a persistent increase in enzyme activity that was detected 24 h after the last stress. PMID- 2706490 TI - Sensitivity of ERG components from dark-adapted goldfish retinas treated with APB. AB - The electroretinogram (ERG) of the dark-adapted goldfish was examined before and after intravitreal injection of DL-2-amino-4-phosphonobutyric acid (APB). APB abolished the b-wave and decreased absolute sensitivity of the remaining waveform, which was composed of a vitreal-negative component followed by a vitreal-positive component. The sensitivity, time course and amplitude of these components differed from ERGs obtained from animals treated with sodium aspartate. Spectral sensitivity of both post-APB components closely resembled that of the normal dark-adapted b-wave. The results suggest that APB does not act selectively on any particular class of photoreceptors or photoreceptor pathways in the dark-adapted goldfish retina. PMID- 2706491 TI - Death of sensory ganglion neurons after acute withdrawal of nerve growth factor in dissociated cell cultures. AB - The time course of dependence on nerve growth factor (NGF) for survival in sensory neurons in vitro was examined with microscopic and biochemical methods. Primary dorsal root ganglion (DRG) cultures from embryonic-day-15 (E-15) and day 19 (E-19) rats were maintained with standard dissociated cell culture techniques in the absence of most non-neuronal cells. After various times in culture, neurons were acutely deprived of neurotrophic support by changing to NGF-free medium and adding NGF antiserum to eliminate any residual NGF. Neuronal cultures were examined with phase microscopy; and, their metabolic activity was measured with a protein assay at various time points after NGF deprivation. E-15 neurons grown in culture for 5 days were exquisitely sensitive to acute NGF deprivation. By 12 h after NGF deprivation, neuronal morphology was severely disrupted and the majority of neurons appeared dead. E-15 neurons grown in culture for 8 or 11 days showed progressively less dependence on NGF for survival. These older neurons did not die until 24 and 48 h, respectively, following NGF withdrawal. Neurons grown in culture for 20 days did not show any morphologic changes by phase microscopy up to 4 days after NGF deprivation. Protein incorporation progressively decreased between 12 and 48 h after NGF withdrawal in E-15 neurons grown in culture for 5, 8, or 11 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706492 TI - The twitcher mouse: accumulation of galactosylsphingosine and pathology of the central nervous system. AB - In the twitcher mouse, a murine model of globoid cell leukodystrophy (GLD), pathological changes of various parts of the central nervous system correlated well with the concentration of galactosylsphingosine (psychosine). The development of GLD lesions was more obvious in tracts with a more rapid progression of myelination. It was suggested that accumulation of galactosylsphingosine subsequent to myelin maturation caused suicidal death of myelin forming cells. PMID- 2706493 TI - Release of acetylcholinesterase from the guinea-pig substantia nigra during peripheral nerve stimulation. AB - A soluble form of acetylcholinesterase is released from the substantia nigra in both a spontaneous and drug-induced fashion. The aim of this study was to see whether this phenomenon was also sensitive to a non-pharmacological event. During electrical stimulation of the intact sciatic nerve, there was an increase in the activity of acetylcholinesterase, measured in perfusates of the guinea-pig substantia nigra in vivo. This increase was not due to spontaneous fluctuations in acetylcholinesterase release, plasma contamination, tissue damage or release of acetylcholinesterase from a non-specific site. The possible pathways mediating this phenomenon are discussed. PMID- 2706494 TI - Effect of preganglionic stimulation or chronic decentralization on neurotensin like immunoreactivity in sympathetic ganglia of the cat. AB - In pentobarbital-anesthetized cats, supramaximal stimulation (40 Hz, 2 h) of the preganglionic input to the acutely decentralized right stellate (RSG) or superior cervical (RSCG) ganglion resulted in a decrease in neurotensin (NT)-like immunoreactivity (IR), by 83% in the SG and by 46% in the SCG, as determined by radioimmunoassay. Chronic (7 days) decentralization of the ganglia resulted in a similar depletion of NT-like IR (SG: 86%; SCG: 76%). Supramaximal stimulation (40 Hz, 2 h) of the intact postganglionic outflow of either ganglion had no effect on NT-like IR. These data suggest that NT in the SG and SCG is present in preganglionic axons and is released by activation of these axons. PMID- 2706495 TI - Changes in frequency content of inspiratory neuron and nerve activities in the course of inspiration. AB - In decerebrate paralyzed cats, the spectra and coherences of inspiratory (I) nerve activities and of medullary I neuron discharges were compared between different stages of I. The correlated high-frequency oscillations (HFOs) in the activities had common time courses of frequency and strength, which were influenced by lung afferent input; whereas the time courses for the uncorrelated medium-frequency oscillations (MFOs) depended on individual activity patterns. These results indicate that HFOs are characteristic of the common I pattern generator, whereas MFOs are specific to individual activities. PMID- 2706496 TI - Respiratory rhythmicity after extensive lesions of the dorsal and ventral respiratory groups in the decerebrate cat. AB - It was previously demonstrated that extensive destruction of the regions of the dorsal (DRG) and rostral portions of the ventral respiratory groups (VRG) in the medulla does not disrupt respiratory rhythmicity in the anesthetized cat. The present experiments examined if either higher CNS structures or the caudal expiratory VRG might have been responsible for preserving rhythm in those studies. Results indicate that the DRG and VRG are not required for respiratory rhythmicity in the midcollicularly decerebrated cat. PMID- 2706497 TI - Electrophysiological analysis of the trigemino-olivo-cerebellar (crura I and II, lobulus simplex) projection in the rat. AB - In albino rats the whisker area was electrically stimulated while climbing fiber responses were surveyed in the cerebellar hemisphere on the ipsilateral side. They were identified both deep in the intercrural sulcus, and in the posterior superior fissure. Histological examination has revealed that the response areas extend longitudinally from the dorsal surface of crus II to the ventral surface of crus I in the intercrural sulcus, and from the rostral surface of crus I to the caudal surface of lobulus simplex in the posterior superior fissure. These are supposed to be transmitted through direct trigemino-olivary projections. PMID- 2706498 TI - Effect of exogenous pyruvate on acrylamide neuropathy in rats. AB - The protective effect of exogenous sodium pyruvate on the distal-proximal progression of experimental acrylamide neuropathy in rats was examined. Incorporation of 2% (w/w) sodium pyruvate powder in the diet of rats receiving subcutaneous injections of an aqueous solution of acrylamide (35 mg/kg/day, 5 days/week) retarded the onset and development of functional, morphological, and biochemical measures of acrylamide neuropathy. Pyruvate supplementation did not alter hexobarbital sleep time or zoxazolamine paralysis time, two in vivo measures of microsomal mixed-function oxidase activity, and the disposition of radioactivity in plasma or sciatic nerve following subcutaneous injection of [14C]acrylamide. Although acrylamide can interfere with energy metabolism at a variety of sites where pyruvate can rescue neurons (axons), the data of this study are consistent with our earlier hypothesis that acrylamide neuropathy may be associated with a glycolytic deficit. The exact site of pyruvate protection is unknown. Exogenous pyruvate is perhaps utilized by axons to circumvent toxin induced glycolytic inhibition and provide chemical energy for fast axonal transport. PMID- 2706499 TI - Anatomical mapping of brain stimulation reward sites in the anterior hypothalamic area: special attention to the stria medullaris. AB - The boundaries and relative fiber density of the brain stimulation reward systems of the anterior hypothalamic area were mapped at the level of the stria medullaris using a dorsal-ventral moveable electrode. Three clusters of reward sites were observed. One cluster was just medial to the stria medullaris, a second larger cluster was within the boundaries of the myelinated fibers of the stria, and a third cluster was observed just lateral to the stria in the medial forebrain bundle. These data are consistent with the view that there exist at least two anatomically distinct brain stimulation reward pathways connecting the midbrain and forebrain: one in the medial forebrain bundle and a second in the dorsal diencephalic bundle. PMID- 2706500 TI - Hemispheric asymmetry in the effects of cerebral cortical ablations on mitogen induced lymphoproliferation and plasma prolactin levels in female rats. AB - Female rats were subjected to unilateral left or right, bilateral, or sham ablation of the cerebral cortex. Eight weeks after surgery, the rats were sacrificed by decapitation and spleen cells were grown in culture for 96 h in the presence or absence of the T-cell mitogen concanavalin A or the B-cell mitogen lipopolysaccharide. Mitogenesis was determined by the addition of [3H]thymidine 24 h prior to harvesting. Both T- and B-cell mitogenesis were significantly depressed in subjects bearing cortical ablations in the right hemisphere, whereas left hemisphere ablation was without reliable effect. Prolactin in plasma collected at sacrifice was elevated in rats bearing right but not left hemisphere ablation and was significantly negatively correlated with both T- and B-cell immune responses. These results demonstrate a lateralized modulatory influence of cerebral cortex on immune function in female rats and they implicate elevated prolactin levels as a possible mediator of this effect. PMID- 2706501 TI - Identification of a GABA-activated chloride-mediated synaptic potential in rat pars intermedia. AB - Intracellular recordings from melanotrophs in acutely isolated, intact pituitaries revealed inhibitory postsynaptic potentials (IPSPs) resulting from both pituitary stalk stimulation and exogenous gamma-aminobutyric acid (GABA) application. The stalk-stimulated and GABA-evoked IPSPs displayed identical conductance increases to chloride ions. Both responses reversed in polarity at the same membrane potential and were blocked with bicuculline, a GABAA antagonist. We conclude that activation of this synapse releases GABA which acts on a classical GABAA receptor to increase conductance to chloride in the melanotroph. PMID- 2706502 TI - Fetal hypothalamic transplants promote survival and functional regeneration of axotomized adult supraoptic magnocellular neurons. AB - This study investigated the mechanisms by which fetal hypothalamic transplants promote functional recovery in neurohypophysectomized rats. Seven days after neurohypophysectomy (resulting in urine osmolalities of about 800 mOsm), young adult male Long-Evans rats received either fetal hypothalamic grafts (n = 10) or sham transplants (n = 7). Recovery from the lesioned-induced diabetes insipidus was monitored for 6 months and then the transplant sites were evaluated by immunocytochemistry. Surviving host supraoptic magnocellular neurons and neurophysin-positive grafted neurons were counted and their formation of neurohemal contacts evaluated by retrograde transport of systemically injected horseradish peroxidase (HRP). There were significantly more surviving supraoptic magnocellular neurons in neurohypophysectomized animals with median eminence placed grafts (2236 +/- 261 neurons/animal) than in animals with ectopic tissue grafts (895 +/- 142 neurons/animal) or sham implants (1052 +/- 92 neurons/animal). Almost all surviving host magnocellular neurons were labeled with retrogradely transported HRP while virtually none of the grafted neurophysin positive cells showed evidence of HRP uptake. The degree of functional recovery was directly correlated with the increased survival of host neurons. By 8 weeks post-transplantation, animals with median eminence-placed grafts had recovered from their diabetes insipidus and could concentrate their urine to within normal limits (2,120 +/- 110 mOsm). This recovery was stable for the remainder of the 6 month test period. In contrast, animals with ectopic grafts and sham transplants had permanent deficits in fluid regulation. Our results provide evidence for the long-term capacity of fetal neural tissue implants to rescue host neurons from the cell death that typically occurs in the mature central nervous system after axotomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706503 TI - Phenytoin protects against ischemia-produced neuronal cell death. AB - Brief bilateral carotid occlusion in the gerbil produces forebrain ischemia that results in almost complete neuronal destruction in the CA1 sector of the hippocampus. Treatment with phenytoin (200 mg/kg) blocked the ischemia-induced neuronal death. The average density of CA1 pyramidal neurons (cells/mm CA1) was 253.6 +/- 4.4 in the sham surgery group, 12.3 +/- 3.4 in the ischemia group, and 119.5 +/- 16.6 in the group treated with phenytoin before ischemia. Thus, phenytoin reduced ischemia-produced neuronal loss in hippocampal CA1 by 44.4% (P less than 0.001). The plasma levels of phenytoin that produced this effect ranged from 28.1 to 45.0 mg per liter, with a mean phenytoin level of 34.7 +/- 1.7 mg/l (n = 10). The results suggest that phenytoin may be a clinically useful cerebroprotective agent. PMID- 2706504 TI - Vasopressin excites neurones located in the dorsal cochlear nucleus of the guinea pig brainstem. AB - The effect of arginine vasopressin (AVP) on neurones in the dorsal cochlear nucleus (DCN) of young guinea-pigs of either sex was investigated in brainstem slices. Most impaled neurones fired in a regular manner, either spontaneously or following a depolarizing current injection. AVP, at concentrations of 10-1000 nM, excited 19/19 neurones from male and 16/19 neurones from female animals. This effect of AVP was concentration-dependent and could be mimicked by the V1 agonist [Phe2,Orn8]VT. Oxytocin was less potent than AVP and a selective V2 agonist, deamino-DAVP, was without effect. Thus, a class of DCN neurones is probably endowed with functional V1 vasopressin receptors. By making use of an antibody raised against the vasopressin-related glycopeptide, dense AVP-like immunoreactivity was found in the DCN of young animals of either sex. PMID- 2706505 TI - Neural cell adhesion molecule (N-CAM) expression during cardiac development in the rat. AB - Neural cell adhesion molecule (N-CAM) expression was examined in the rat heart using immunohistochemical and immunochemical techniques. N-CAM immunoreactivity was displayed by myocardial cells from embryonic day E12 and by cardiac nerves when first identified at day E18. Myocardial immunostaining increased up until about postnatal day 1 and then declined rapidly thereafter whereas neural immunoreactivity persisted in the adult. N-CAM cardiac isoforms also exhibited developmental changes from the main embryonic moieties (105 and 145 kDa) to the principal postnatal (125 and 155 kDa) and adult isoforms (125 kDa). Cardiac N-CAM expression is therefore subject to temporal regulation and may modulate cellular interactions in the developing heart. PMID- 2706506 TI - Fusimotor neurones can be reflexly influenced by activity in receptor afferents from the posterior cruciate ligament. AB - Recordings were made simultaneously from 2-4 primary muscle spindle afferents from triceps surae and/or posterior biceps and semitendinosus muscles in cats anaesthetized with alpha-chloralose. It was demonstrated that stretch of the posterior cruciate ligament of the ipsilateral knee could cause changes in dynamic and/or static sensitivity of these afferents to sinusoidal stretching. The changes were due to reflex actions of stretch/tension-sensitive receptors in the cruciate ligaments onto fusimotor neurones. It is concluded that the cruciate ligaments may play an important 'sensory' role and that they may participate, via reflex actions on the gamma-motor-muscle spindle system, in the regulation of muscular stiffness of the knee joint, and thereby of the knee joint stability. PMID- 2706507 TI - Magnetic resonance imaging of rat brain following kainic acid-induced lesions and fetal striatal tissue transplants. AB - Use of a small diameter (5.1 cm) radiofrequency coil provided relatively high resolution magnetic resonance (MR) images of rat heads at 0.14 Tesla. On T1 weighted images, the rat brain was clearly visible in the rat head as a region of high signal intensity. No structures were distinguished within the normal rat brain. In contrast, in the brains of rats receiving unilateral kainic acid lesions of the striatum, enlarged lateral ventricles, which are characteristic of the lesion, were clearly visible as dark areas of low signal intensity. Extrastriatal damage on the lesioned side of the brain was also evident in some of the images. Fetal striatal tissue transplants growing within the lesioned striata were also identified in the MR images. The transplanted tissue appeared as areas of high and intermediate signal intensity, similar to the host brain. MR imaging is a useful technique for monitoring excitotoxin lesions of brain and fetal striatal tissue transplants in vivo. PMID- 2706508 TI - Inputs from the nucleus of the solitary tract to subfornical organ neurons projecting to the paraventricular nucleus in the rat. AB - Extracellular single-unit activity was recorded from 26 subfornical organ (SFO) neurons antidromically identified as projecting to the hypothalamic paraventricular nucleus (PVN) in urethane-anesthetized male rats. Of these identified SFO neurons, 10 displayed an inhibitory response and 2 exhibited an excitatory response in neuronal excitability following electrical stimulation of the nucleus of the solitary tract (NTS), while the remaining neurons were unresponsive. Eight out of 10 SFO neurons that demonstrated the inhibitory response to NTS stimulation also displayed a reduction in ongoing activity in response to activation of peripheral baroreceptors, achieved by rising arterial blood pressure with an intravenous administration of the alpha-agonist metaraminol, whereas the remaining responsive neurons to NTS stimulation were ineffective. These results show that a part of SFO neurons projecting to the PVN may receive inhibitory inputs from the peripheral baroreceptors through NTS neurons. PMID- 2706509 TI - Static magnetic fields increase the power intensity of EEG of man. AB - In static magnetic fields the power values of EEG are increased. This influence is different in the two cortical hemispheres and not the same for all EEG frequencies. The increased control values following on inverted magnetic flux vector point to a - reversible - alteration of brain function induced by a static magnetic field. PMID- 2706510 TI - Effects of kainic acid lesions in rat ventral lateral geniculate nucleus upon field potentials of the superior colliculus: correlation between morphological and physiological observations. AB - Morphological and physiological effects of kainic acid (KA) lesions in rat ventral lateral geniculate nucleus (LGV) were studied 1.5 and 6 h after KA injection. Morphological changes were examined mainly by electron micrographs. At 1.5 h after KA injection dendrites were dilated and some vacuolations occurred in both dendrites and perikarya including geniculotectal relay neurons while axons were completely intact and cell organelles almost remained intact. Six h after KA injection dendrites and cell bodies were massively dilated with degeneration of cell organelles accompanied by sparse cytoplasm and deformed chromatin in the nucleus. However, almost all presynaptic axons, mainly retinogeniculate fibers, still remained intact. The electron micrographs demonstrate that destruction occurred first in dendrites, next in cell bodies and finally axons were likely to be affected. These morphological changes induced by KA are compatible with physiological effects which were assessed by the field response of the superior colliculus (SC) evoked by stimulation of the optic chiasm. During 1.5-2 h after KA injection all components of the SC response, the presynaptic and postsynaptic negative-positive waves were enhanced. The enhancement of the SC response may be correlated with morphological changes in terms of excitatory action of KA resulting in facilitation of geniculotectal transmission. Six h after KA injection postsynaptic negative-positive waves gradually declined in amplitude while the presynaptic wave returned to control level. The late suppression of postsynaptic components of the SC response may be attributable to a marked loss of geniculotectal transmission resulting from destruction of geniculotectal relay neurons by KA. PMID- 2706511 TI - Brain creatine phosphate and creatine kinase in mice fed an analogue of creatine. AB - Brain phosphocreatine (PCr) concentration and creatine kinase (CK) activity have been studied by 31P nuclear magnetic resonance (NMR) spectroscopy in mice fed an analogue of creatine, beta-guanidinopropionic acid (GPA). The phosphorylated analogue (GPAP), which almost completely replaces PCr in skeletal muscle, is a poor substrate for CK. Mice, which received GPA in food (2%) and water (0.5%) for up to 9 months beginning at 35 days of age, were normal in appearance and activity. Maximal brain GPAP concentration, reached after two weeks of feedings, was approximately equal to the concentration of PCr. The concentration of PCr decreased at least 20% relative to that of the nucleoside triphosphates. When GPA feedings were stopped, GPAP disappeared in about 20 days from skeletal muscle, but only after 40-50 days from brain. Steady-state NMR saturation transfer studies showed a markedly reduced chemical exchange rate from PCr to ATP in brains of GPA-fed mice. These results suggest a compartmentation of brain PCr. The GPA-accessible PCr compartment has a slow rate of PCr turnover compared to skeletal muscle. The slow reaction rate of the GPA-inaccessible PCr as a CK substrate is consistent with the hypothesis that this residual PCr is the same compartment which is stable in hypoxic or seizing animals. PMID- 2706512 TI - Ceruletide suppresses endogenous dopamine release via vagal afferent system, studied by in vivo intracerebral dialysis. AB - Ceruletide, a cholecystokinin-related decapeptide, has been reported to have some therapeutic effects on tardive dyskinesia and other involuntary movement disorders. In order to clarify the effects of ceruletide on dopaminergic activity in the rat striatum, we measured the release of endogenous dopamine (DA), 3,4 dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) after intraperitoneal administration of ceruletide (2, 20, 200 micrograms/kg) using in vivo intracerebral dialysis techniques. After administration of ceruletide (200 micrograms/kg), extracellular DA decreased significantly (P less than 0.05) for 0.5-3 h. The maximal reduction of extracellular DA (by 29%) was observed for 2 2.5 h. Extracellular DA was reduced (21%) by 20 but not by 2 micrograms/kg ceruletide. DOPAC and HVA did not change at any dose of ceruletide. We also demonstrated that bilateral subdiaphragmatic vagotomy blocked this inhibitory effect of ceruletide on DA release. These findings indicate that peripherally administered ceruletide suppresses endogenous DA release via the vagal afferent system. PMID- 2706513 TI - Effect of tunicamycin, an inhibitor of protein glycosylation, on the high affinity transport of acidic amino acid neurotransmitters in C6 glioma cells. AB - The effect of tunicamycin, an inhibitor of protein glycosylation, on the high affinity transport of D-aspartate was investigated in C6 astrocytoma cells. A concentration of tunicamycin (1 microgram/ml) that after 24 h exposure inhibited the rate of transport by 70% and incorporation of [3H]mannose by 82-95% had only a small effect on [14C]leucine incorporation into protein and cell growth (20% reduction). Tunicamycin decreased the Vmax for transport without affecting the Km, which suggests that inhibition of glycosylation reduces the number of competent transporters on the surface of the plasma membrane. The decrease in the velocity of uptake was attenuated when C6 cells were treated with tunicamycin in the presence of protease inhibitors, indicating that the underglycosylated carriers are subject to enhanced proteolytic degradation. Incubation in drug-free medium following treatment with 1 microgram/ml of tunicamycin for 24 h resulted in recovery of D-aspartate transport within 48 h. This recovery was prevented by the presence of cycloheximide, which indicates that synthesis of new transporters is necessary for the restoration of normal rates of D-aspartate uptake. These results support our earlier postulate that the high-affinity carriers for amino acid transmitters are transmembrane glycoproteins. PMID- 2706514 TI - Conditioned place aversion produced by microinjections of semicarbazide into the periaqueductal gray of the rat. AB - Previous studies have shown that the blockade of GABA-ergic neurotransmission in the periaqueductal gray (PAG) of the rat induce flight reactions. The present study examined whether a negative affective state was produced by such a blockade. Microinjections of semicarbazide, a GABA synthesis inhibitor, into the PAG were found to produce a conditioned place aversion. In a second experiment, it was found that the potent GABA agonist muscimol antagonized the effects of semicarbazide, without producing a conditioned place preference or aversion by itself. These results suggest that the blockade of the tonic inhibition exerted by GABAergic terminals in the PAG results in both an aversive experience and an overt flight reaction. PMID- 2706515 TI - Microvascular spasm is mediated by vasopressin fibers in the rat hippocampal slice. AB - Microvessels in the rat hippocampal slice can be used as an in vitro model for the study of cerebral vasospasm. Serum from coagulated blood causes prompt and long-lasting microvascular constriction that is neurogenic in nature. Here we show that a candidate spasmogen, thromboxane B2, has excitatory action on neural elements in the slice. However, spasmogenic serum lacks this excitatory effect. Instead, it is inhibitory for a major population of slice neurons. Thus, neurogenic microvascular spasm is produced by a subpopulation of slice neurons or projection fibers, not all neurons acting in concert. Arginine vasopressin (AVP) is contained in fibers that project to the hippocampus, and hippocampal microvessels contain pressor (V1) receptors for the peptide. AVP causes vasoconstriction in the slice, and a specific V1 antagonist for the peptide blocks the microvascular spasm induced by blood serum. The results are interpreted to mean that neurogenic microvascular spasm is mediated by locally released AVP. PMID- 2706516 TI - Electrical stimulation of the medial prefrontal cortex supports both 'pure reward' and 'reward-escape' behavior in rats. AB - In female Sprague-Dawley rats, 8 of 12 medial prefrontal cortex (MPFC) sites that yielded criterion self-stimulation behavior supported only self-stimulation, i.e. were 'pure reward' in type. The remaining 4 sites supported behavior to escape from experimenter-administered stimulation of the same parameters as well, i.e. were 'reward-escape' in type. 'Pure reward' and 'reward-escape' sites in the MPFC were distinguished by both the magnitude and temporal form of the escape response functions generated, and by the prevalence of 'pounce-back', a vigorous and repetitive barpressing during the 3-s MPFC stimulation-escape interval produced by an effective barpress. The finding that both 'pure reward' and 'reward-escape' patterns of behavior can be elicited by stimulation of the MPFC provides a basis for further assessment of similarities and differences in medial prefrontal cortical and lateral hypothalamic (LH) 'reward' systems. It is suggested that 'reward-escape' in the MPFC may be mediated by the activity of 'reward' neurons which respond to stimulus offset, rather than by a secondary aversive process as is proposed to underlie 'reward-escape' in the LH. PMID- 2706517 TI - Hedonic interactions of medial prefrontal cortex and nucleus reticularis gigantocellularis. AB - It has been shown that 'pure reward' and 'reward-escape' sites in the lateral hypothalamus (LH) of rats respectively ameliorate and exacerbate nucleus reticularis gigantocellularis (NGC) stimulation-induced aversion52. Conversely, the present studies found that 'rewarding' medial prefrontal cortex (MPFC) stimulation increased escape from NGC stimulation regardless of whether the MPFC site tested was 'pure reward' or 'reward-escape' in type. This suggested that a simple algebraic summation model of positive and negative affective processes may not adequately describe the NGC-MPFC interaction. In a subsequent study, rats were observed both to barpress less to obtain, and more to escape from, 'rewarding' MPFC stimulation during continuous NGC stimulation, supporting the hypothesis that the observed MPFC stimulation-mediated increase in NGC stimulation escape reflected an exacerbation of aversion. Finally, NGC stimulation was seen to increase barpressing to obtain 'subreward' MPFC current trains, indicating a potentiation of the reward value of such current. Results of this series of studies suggests a hedonic interaction model of NGC and MPFC characterized by reciprocal neuromodulation. The model is conceptualized as a 'neural opponent process' subserving affective 'balance' and 'feature enhancement', and its possible relevance to the putative role of the MPFC in cocaine use is discussed. PMID- 2706518 TI - Somatic and autonomic integration in the midbrain of the unanesthetized decerebrate cat: a distinctive pattern evoked by excitation of neurones in the subtentorial portion of the midbrain periaqueductal grey. AB - Microinjections of the excitant amino acid D,L-homocysteic acid (DLH) made in a restricted part of the subtentorial (P0.2-P0.9) midbrain periaqueductal grey (PAG) of the unanesthetized decerebrate cat evoked a distinctive pattern of coordinated somatic and autonomic changes which was characterized by strenuous hindlimb movement and a concomitant vasodilation in the hindlimb vascular bed. The vasodilation was not secondary to movement as it could still be evoked in the paralyzed preparation. The autonomic changes also included pupillary dilation, increases in arterial pressure and heart rate, and vasoconstriction in renal and mesenteric vascular beds. This evoked response is quite different from that elicited by DLH microinjections made in a restricted part of the pretentorial PAG of the unanesthetized cat (Carrive et al., Neurosci. Lett., 81 (1987) 273-278). This latter response is characterized by a threat display which includes strong facial and vocal changes, but no strenuous hindlimb movement, and skeletal muscle vasoconstriction. The present results together with our previous research suggest that two distinct sets of neurons located in different midbrain PAG regions mediate coordinated patterns of somatic and autonomic change characteristics of different aspects of defensive behavior. PMID- 2706519 TI - The reinnervation of the tongue and salivary glands after lingual nerve injuries in cats. AB - The recovery of fibres in the chorda tympani and lingual nerves has been investigated in cats following nerve injury by recording the receptor properties of gustatory, thermosensitive and mechanosensitive units and the return of vasomotor and secretomotor responses. The combined trunk of the chorda tympani and lingual nerves was either crushed (4 animals) or sectioned (3 animals) unilaterally and recovery allowed for 12 weeks. After nerve crush, integrated whole nerve activity recorded from the chorda tympani during stimulation of the tongue with gustatory or thermal stimuli revealed a response profile which was similar to controls. After nerve section little or no activity could be recorded. Recordings made from 52 single units in the chorda tympani after nerve crush revealed that the proportions of gustatory, thermosensitive and mechanosensitive units were similar to those of controls. The units had slower conduction velocities, responded less vigorously and to a narrower range of stimuli. Recordings made from 46 units in the chorda tympani after nerve section revealed very few gustatory or thermosensitive units, the majority were purely mechanosensitive and the decrease in conduction velocity was greater than after nerve crush. Electrical stimulation of efferent vasodilator fibres in both the chorda tympani and lingual nerves, evoked a temperature rise on the dorsal surface of the tongue. This effect was completely restored after nerve crush but was significantly smaller after nerve section. The flow rate of saliva from the submandibular salivary gland was not significantly changed by nerve crush but was significantly smaller after nerve section. There was no evidence for functional reinnervation of gustatory or secretomotor terminals by inappropriate fibre types. PMID- 2706520 TI - Putative nociceptive modulatory neurons in the dorsolateral pontomesencephalic reticular formation. AB - The present study was undertaken to confirm the dorsolateral pontomesencephalic reticular formation (an area that includes the nucleus cuneiformis (NCF) and nucleus parabrachialis (NPB)) as a sensitive site for stimulation-produced antinociception and to investigate the possibility that there are cells in this region that show a change in activity that can be correlated with the occurrence of a nocifensive reflex (the tail-flick withdrawal response from noxious heat (TF)). Such cells have been previously demonstrated in the rostral ventromedial medulla (RVM). Extracellular single unit recording studies were made at sites from which it was possible to inhibit the TF with currents of 10 microA or less. Cellular response to 3 TF trials at 5 min intervals, and spontaneous activity over a 10 min period, were monitored for each unit. Of the cells encountered, 17% displayed an increase (on-cells) and 4% a decrease (off-cells) in activity that preceded the TF. The remaining cells were unaffected by the TF (neutral cells). On- and off-cells were found throughout the region from which TF suppression was observed but were most concentrated in the areas of the NCF and NPB. The presence of on- and off-cells in the NCF/NPB region as well as the RVM suggests that the input to RVM from NCF/NPB may be important in descending nociceptive modulation. PMID- 2706521 TI - Auditory neural activity evoked by pure-tone stimulation as a function of intensity. AB - The 2-deoxyglucose (2-DG) autoradiographic technique was employed to map activation of the central auditory pathway in the mongolian gerbil during stimulation with a 3.0 kHz tone at several intensities. In most auditory nuclei, the tone produced restricted areas in which 2-DG uptake was markedly higher than that of adjacent tissue, at locations consistent with the known tonotopic organization of the structure. The size of these regions changed relatively little with increasing stimulus intensity from 25 to 65 dB SPL (re 0.0002 dyne/cm2). At higher intensities, evoked uptake spreads into locations which represent frequencies above 3.0 kHz. In the inferior colliculus, relative 2-DG uptake decreased with increasing stimulus intensity in bands on either side of the 3.0 kHz region. These bands of reduced uptake became wider with increasing stimulus intensity from 25 to 85 dB SPL. The optical densities of auditory structures were normalized by the density of non-auditory white matter to derive optical density ratios. In the cochlear nuclei, optical density ratios in the 3.0 kHz region increased monotonically with increasing stimulus intensity, to a plateau at 45 dB SPL. In higher auditory nuclei, relative 2-DG uptake increased to a peak at 45 dB SPL and then declined at higher intensities. PMID- 2706522 TI - Two types of K+ channels in excised patches of somatic membrane of the leech AP neuron. AB - The patch-clamp technique has been applied to the somatic membrane of the leech AP neurons. Ionic currents from single potassium channels were recorded in inside out configuration. Two types of channels, sharing close values of conductance in symmetrical K+, were identified as distinct, according to their properties of rectification, Ca2+ sensitivity and voltage dependence. The channels designated as VCI exhibited an outward rectification and their gating was quite independent on changes of patch potential and of [Ca2+]i. The channels designated as VCD showed a linear I-V relationship and their activity was dependent on both the membrane potential and the intracellular [Ca2+]. PMID- 2706523 TI - Brain CCK-B receptors mediate the suppression of dopamine release by cholecystokinin. AB - The sulfated octapeptide of cholecystokinin (CCK-8S) and CCK fragments were administered to mice to determine the subtype and central versus peripheral location of the CCK receptor that modulates dopamine release in the neostriatum. Dopamine release was decreased when unsulfated CCK (CCK-8U) or the butoxycarbonyl tetrapeptide of CCK (t-boc-CCK-4) was infused into the brain ventricles but not when injected subcutaneously. These CCK fragments bind to the brain-type (CCK-B) but not alimentary-type (CCK-A) receptor. Centrally or peripherally administered CCK-8S also lowered dopamine release and this action was not blocked by the selective CCK-A receptor antagonist, L 364,718. The increase in dopamine release following amphetamine administration was attenuated by central injections of t boc-CCK-4, CCK-8U, or CCK-8S, and this action of CCK-8S was not prevented by L 364,718. These data are the first to demonstrate that CCK-B receptors in brain mediate the suppression of dopamine release by cholecystokinin, especially when release is augmented. CCK-B receptor agonists should be useful for the treatment of psychiatric conditions that result from hyperactive dopamine neurons. PMID- 2706524 TI - Diazepam modulates lateral hypothalamic self-stimulation but not stimulation escape in rats. AB - Rats electrically stimulated via chronically implanted lateral hypothalamic (LH) electrodes were assessed with and without diazepam (DZ), for thresholds of stimulation-bound feeding (SBF) and for barpressing rates to administer and to escape from the same current, Six pure-reward rats, who self-stimulated but did not escape LH stimulation, exhibited SBF. Their electrode tips lay in medical forebrain bundle (MFB) and zona inserta along the entire rostral-caudal extent of the ventromedial nucleus of the hypothalamus (VMH). Six reward-escape rats, who self-stimulated and escaped from LH stimulation, did not (with one histologically deviant exception) show SBF. Reward-escape electrode tips were anterior to all the pure-reward placements. They lay in MFB rostral to the VMH up to the level of the bed nucleus of the stria terminalis (with the deviant electrode tip located on the zona inserta/ventral thalamic border). After i.p. injections of DZ, self stimulation (SS) rates increased for both groups of animals and SBF thresholds decreased. Stimulation-escape (SE) rates, however, remained unchanged by the drug. The results are consistent with the existence of dual substrates: a DZ sensitive reward system, present in both groups of animals, and a simultaneously stimulated, drug-resistant aversion system which is powerfully engaged in reward escape animals only. PMID- 2706525 TI - Immunocytochemical localization of microtubule-associated proteins 1A and 2 in the rat retina. AB - We have studied the immunocytochemical localization of microtubule-associated proteins (MAPs) in rat retinal cells. Using biochemical and immunochemical methods we have identified microtubule-associated protein 1 (MAP1) and microtubule-associated protein 2 (MAP2) as major MAPs in the rat retina. With indirect immunofluorescence microscopy, the inner plexiform layer and the ganglion cell layer were stained with both anti-MAP1A antibody and anti-MAP2 antibody. Cells at the inner margin of the inner nuclear layer were prominently stained with anti-MAP2, but not with anti-MAP1A. Thin section-immunoelectron microscopy using colloidal gold-labeled secondary antibodies revealed MAP1A and MAP2 staining in the neuronal processes of the inner plexiform layer. A filamentous network between the microtubules in the neurites was stained with both antibodies. The developmental course of expression of MAP1A and MAP2 in rat retina was studied by indirect immunofluorescence microscopy. Although MAP2 was already present at 1 day postnatal, MAP1A was not detected until 7 days postnatal. These results indicate that: (1) retinal neurons are heterogeneous in their expression of MAPs; (2) retinal ganglion cells show the same intracellular distribution of MAP1A and MAP2 as typical nerve cells such as motor neurons; and (3) MAP1A and MAP2 are differentially expressed in developing rat retina. PMID- 2706526 TI - Bilateral changes in neocortical [3H]pirenzepine and [3H]oxotremorine-M binding following unilateral lesions of the rat nucleus basalis magnocellularis: an autoradiographic study. AB - Neocortical choline acetyltransferase (ChAT) activity and muscarinic [3H]pirenzepine, [3H]oxotremorine-M, [3H]N-methylscopolamine ([3H]NMS; both high- and low-affinity agonist (carbachol) sites) and nicotinic [3H]acetylcholine binding were assessed both ipsi- and contralaterally 1 week and 13 weeks after unilateral ibotenic acid lesions of the rat nucleus basalis magnocellularis (NBM). Ipsilateral ChAT activity was reduced to 49% of control values 1 week postlesion but by 13 weeks had recovered to 80% of control values. Contralateral ChAT activity did not change significantly at either 1 week or 13 weeks postlesion. At 1 week postlesion, [3H]oxotremorine-M binding was increased by 33% and 54% in ipsilateral and contralateral neocortex, respectively. By week 13, both ipsi- and contralateral [3H]oxotremorine-M binding had returned to normal but [3H]pirenzepine binding was significantly decreased by 31% and 39% in the ipsilateral and contralateral hemispheres, respectively. The binding of [3H]NMS and [3H]acetylcholine did not differ significantly from control values at either 1 week or 13 weeks postlesion. These data suggest that none of the cholinergic binding sites studied is preferentially localized presynaptically and that there may be interhemispheric regulation of neocortical cholinergic binding sites. PMID- 2706527 TI - Gravitational representation of simultaneously recorded brainstem respiratory neuron spike trains. AB - Experiments designed to study concurrent processes in neural networks have been hampered by limitations of available analytical methods. A recently described gravitational representation of spike train data was used to evaluate groups of simultaneously monitored medullary respiratory related neurons in anesthetized, vagotomized cats. The results establish that the method can detect and define functional associations among elements of such groups after as few as 20 respiratory cycles. PMID- 2706528 TI - Selective labeling by propidium iodide injected into the lateral cerebral ventricle of the rat. AB - Injections of propidium iodide (PI) into the lateral cerebral ventricle of the rat resulted in a bilateral labeling in the septohippocampal nuclei, substantia nigra (SN), ventral tegmental area (VTA), retrorubral nuclei (rr), dorsal and median raphe nuclei, regions within and dorsal to the medial lemniscus of the caudal midbrain, and Purkinje cells in the cerebellum. No labeled neurons were seen in other areas of the brain. The data suggest that PI appears to exhibit selective labeling, and the mechanism underlying the selective labeling is discussed. Combined with Faglu histofluorescence, it was found that all PI labeled cells in SN-VTA-rr were catecholamine (CA) neurons. After a transection of the medial forebrain bundle immediately before the PI injection, an accumulation of PI was only seen in the distal segments of severed nigrostriatal CA fibers. This provides a strong evidence that PI labeling of CA cells in SN-VTA rr is due to axonal uptake and retrograde transport. PMID- 2706529 TI - Involvement of protein kinase C in the Ca2+-dependent vesicular release of GABA from central and enteric neurons of the guinea pig. AB - The involvement of protein kinase C (PKC) in the release of endogenous gamma aminobutyric acid (GABA) was studied using slices of deep cerebellar nucleus and strips of small intestine from the guinea pig. 12-O-tetradecanoylphorbol 13 acetate (TPA), but not 4 alpha-phorbol-12,13-didecanoate (4 alpha-PDD), potentiated the high K+-evoked release of GABA from both preparations in the presence of tetrodotoxin. Ouabain evoked the release of GABA from both preparations, and this release was not altered by TPA. Therefore, the activation of protein kinase C potentiates the Ca2+-dependent vesicular release of GABA from nerve terminals of the central and enteric GABAergic neurons of the guinea pig. PMID- 2706530 TI - Dorsal pallidum as a functional motor output of the corpus striatum. AB - A major function of the dopamine in the striatum is to control the activity of its efferent systems which contain primarily GABAergic neurons. Direct intracerebral injections of haloperidol into the corpus striatum impaired the performance of rats trained to depress a lever in a sensitive reaction time task. Rats were trained to depress a lever until the presentation of a visual conditioned stimulus and then to release the lever within a time limit of 500 ms to obtain a food reward. The increase in reaction time produced by dopamine blockade of the corpus striatum was mimicked by injection of a GABA agonist muscimol in nanogram quantities into the region of the dorsal pallidum, but not into the substantia nigra reticulata. Injections of a GABA agonist into the substantia nigra impaired performance by increasing the number of anticipatory responses (increased number of lever releases before the conditioned stimulus). These results suggest that the dorsal pallidum may play an important role in the response initiation associated with activation of the corpus striatum, and that the dorsal pallidum may form a significant part of parallel striatal outputs that have different functional significance. PMID- 2706531 TI - Brain muscarinic receptor subtypes are differently affected in Alzheimer's disease and Parkinson's disease. AB - The muscarinic receptor subtypes determined by displacing [3H]quinuclidinyl benzylate by carbachol showed distinct profiles in Alzheimer's disease (AD) and in Parkinson's disease (PD). A decrease in the M2-receptor count was seen in the hippocampus in AD as compared to controls, while PD patients had unaltered binding. By contrast, PD patients had increased M2-binding in the frontal and temporal cortex, whereas unchanged binding was seen in AD. In PD the total number of cortical muscarinic receptors was negatively associated with the activity of ChAT, but had a positive correlation with the degree of dementia of the patients. PMID- 2706532 TI - Direct effects of ovarian hormones on antidepressant binding sites. AB - Tricyclic antidepressants such as imipramine interact with a membrane binding site associated with the uptake of serotonin. Ovarian hormones estradiol and progesterone were found to affect the concentration and affinity of imipramine binding sites in the hypothalamus but not the cortex of female rats. In vivo and in vitro, estradiol increased the amount of imipramine binding at physiological concentrations; at high concentrations estradiol decreased imipramine binding. Ovariectomy (OVX) had no effect on imipramine binding, consonant with the biphasic dose-response relationship for estradiol. The effects of progesterone were dependent upon the concentration of estradiol. Effects of physiological concentrations of both estradiol and progesterone on imipramine binding in an isolated membrane preparation suggest that the hormones are affecting this aspect of serotonergic neuronal function by nongenomic mechanisms. PMID- 2706533 TI - Tremorogenesis by LON-954 [N-carbamoyl-2-(2,6-dichlorophenyl) acetamidine hydrochloride]: evidence for the involvement of 5-hydroxytryptamine. AB - LON-954 [N-carbamoyl-2-(2,6-dichlorophenyl) acetamidine hydrochloride], a novel tremorogen known to affect the central dopaminergic system, has been investigated in rats for tremor and 5-hydroxytryptamine (5-HT) metabolism. Five, 10 and 20 mg/kg of LON-954 IP caused a reproducible and consistent tremor with a high frequency (16 Hz) within 2 minutes and lasting 30-45 minutes. 5-HT content of the tuberculum olfactorium and basal ganglia was found to be increased significantly at a time when 5-hydroxyindoleacetic acid (5-HIAA) content showed a decrease. 5 HT and 5-HIAA of medulla oblongata showed significant changes only after 15 minutes. The alterations in the levels of the indoleamine in tuberculum olfactorium and its relationship with dosage as well as duration and intensity of LON-954 tremor indicate the involvement of the mesolimbic system in its action. A direct role of 5-HT in LON-tremor was evidenced since the drug failed to produce tremor in rats pretreated with p-chlorophenylalanine (300 mg/kg IP) for 3 days. PMID- 2706534 TI - Central effect of agents which alter sodium transport on water drinking in the rat. AB - The central effect of ouabain (OUA), ethacrynic acid (EA) and diphenylhydantoin (DPH) on water drinking was studied in rats. OUA and EA inhibit cellular Na efflux, increasing intracellular (IC) Na content, while DPH inhibits cellular Na influx lowering IC sodium content. The animals were injected into the third ventricle (3V), fourth ventricle (4V), lateral ventricle (LV), or lateral hypothalamus (LH). Ouabain (50 pg) and EA (50 ng) when injected into the 3V or LV significantly decreased the water intake induced by 24 hr water deprivation. No effect was observed after injections in other loci, thus supporting the hypothesis that sensors could be located in the circumventricular organs, in an area without the blood brain barrier. DPH (270 ng) injected into the 3V or LV significantly enhanced water intake in rats deprived of water for 14 hr, but it did not increase water intake in water-repleted rats. DPH also enhanced water intake induced by cellular-dehydration (2 M NaCl IP). These results suggest that changes in the Na content of sensor cells located on or near the walls of the 3V could be responsible for the movement of water between the cells and their medium, in agreement with the osmoreceptor hypothesis for thirst. PMID- 2706535 TI - Mapping the effects of motor cortex stimulation on single neurons in the dorsal column nuclei in the rat: direct responses and afferent modulation. AB - The major aim of this study was to define the topography of descending motor cortical influences on the dorsal column nuclei of the rat. A total of 1442 single neurons were recorded throughout the rat cuneate (Cu) or external cuneate (ECu) nuclei and classified according to their: 1) location within the nuclei, 2) receptive fields, and 3) response to standardized deep layer microstimulation in the forelimb area of the motor (MI) cortex. Excitatory neuronal responses to this MI cortical stimulation ranged in latency from 2-28 msec, with 80% of responses in the 4-12 msec range. Overall, the rostral extremity of the Cu (0.5-1.0 mm rostral to the obex), and the ECu contained the highest percentage of recorded neurons responding to the MI cortical stimulation (61%). By contrast, only 11% responded in the middle subregion of the Cu (+0.4 to -0.9 mm relative to the obex), and 28% responded in the caudal-most subregion (1.0-2.0 mm caudal to obex). A similar paradigm was used to investigate the topography of MI corticofugal modulation of afferent transmission through the Cu and ECu. The MI cortical stimulation was used as a conditioning (C) stimulus in a condition-test (C-T) paradigm in which the test (T) stimulus was standardized mechanical vibration of digit No. 4 of the contralateral forepaw. A total of 30 cells from different subregions were analyzed by measuring the averaged evoked unit responses to the T-stimuli, and plotting them as a function of C-T intervals from 0-50 msec.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706536 TI - Ascending projections of long descending propriospinal tract (LDPT) neurons. AB - Ascending projections of long descending propriospinal tract (LDPT) cells were investigated using the technique of double retrograde labeling. In rat, injection of one fluorescent dye was made into either the reticular formation or the cerebellum, and a second dye was injected into the lumbosacral enlargement (LSE). In cat, injections were made into the reticular formation and into the lumbosacral enlargement. Using fluorescence microscopy, observation of neurons in the cervical enlargement (CE) revealed single- and double-labeled cells which were either spinoreticular or spinocerebellar tract cells and/or LDPT cells. In both cat and rat, the location of double-labeled LDPT-spinoreticular cells were in the ventromedial spinal gray matter of the CE and were coextensive with single labeled LDPT and spinoreticular cells. The locations of double-labeled LDPT spinocerebellar cells in rat were in the ventromedial gray and were coextensive with single-labeled LDPT cells, but not with single-labeled spinocerebellar cells. The latter group was located in central lamina VII and medial laminae V and VI. Overall, the mean number of double-labeled cells was 40% of rat and 7% of cat LDPT cells, indicating projections to either the brainstem reticular formation or cerebellum as well as to the lumbosacral enlargement. Thus, a subpopulation of LDPT cells apparently also serves as a spinoreticular (SR) and spinocerebellar (SC) projection system. PMID- 2706537 TI - Retinoids in the bovine pineal gland. AB - Using high performance liquid chromatography, the level of retinoids was determined in the bovine pineal gland, retina, retinal pigment epithelium, cortical and subcortical brain tissues, skeletal muscle and the liver. Except the retina, the bovine pineal gland possesses levels of retinol and retinyl esters significantly higher than other brain tissues and muscle. However, unlike the retina, the bovine pineal gland does not possess a significant level of retinal, the chromophore for visual pigments in the retina. This finding suggests that the bovine pineal gland does not possess rhodopsin nor the property of phototransduction which has been fully established in the retina and pineal glands of lower vertebrates. PMID- 2706538 TI - Paraventricular nucleus projections mediating pineal melatonin and gonadal responses to photoperiod in the hamster. AB - Knife cuts were placed around the paraventricular nucleus of the hypothalamus (PVN) in order to identify the pathways mediating photoperiodism and pineal melatonin production in male golden hamsters. Cuts in the coronal plane caudal to the PVN, have no effect on photoperiodic control of the testes unless they actually damage the PVN. Bilateral parasagittal cuts at the medial border of the lateral hypothalamus block short photoperiod-induced gonadal regression. Nighttime levels of pineal melatonin are reduced by these cuts, but unaffected by caudal cuts. Projections from the lateral PVN region descending towards the spinal cord appear to be critical for the control of pineal melatonin production and the control of the testicular function by short photoperiod. PMID- 2706539 TI - Effect of septal ablation on choline acetyltransferase in the paraventricular nucleus. AB - To determine whether there is a cholinergic projection from the lateral septum to the paraventricular nucleus of the hypothalamus (PVH), a quantitative histochemical analysis of the effects of unilateral ablation (0.5 microliter of a 10 micrograms/ml solution of ibotenic acid) of the lateral septum (LSV) on the choline acetyltransferase (ChAT) activity of the PVH and surrounding perinuclear area was undertaken. Comparisons of the ChAT activity of the PVH region ipsilateral to the LSV lesion (lesioned side) with that of the PVH contralateral (nonlesioned side) to the ablated LSV showed a 20% reduction (p less than 0.05) of ChAT activity in 2 areas of the PVH on the lesioned side. When ChAT activity of LSV-ablated and intact control rats was compared, a 20% difference in activity (p less than 0.05) was noted in four areas on the nonlesioned side and a 35% difference (p less than 0.05) of ChAT activity was noted in five regions of the PVH on the lesioned side of LSV-ablated animals. Taken together these data suggest that the pathway from the LSV to the PVH contains a small, bilateral cholinergic component. However, the data also indicate that this is not the only cholinergic projection to the PVH. PMID- 2706540 TI - Occlusion of pressor responses to posterior diencephalic stimulation and muscular contraction. AB - Although neural occlusion has been suggested to occur between the central and reflex mechanisms increasing arterial pressure, evidence consistent with this phenomenon is lacking. To assess the possibility of neural occlusion we recorded, in chloralose-anesthetized cats, the pressor responses to statically contracting the hindlimb muscles and to electrically stimulating histologically confirmed sites in the posterior hypothalamus and subthalamus. We also recorded the pressor responses to topical application of capsaicin onto the intestine and to stimulation of these diencephalic sites. The pressor responses to simultaneous static contraction and diencephalic stimulation were significantly smaller than the algebraic sum of the pressor responses to contraction and diencephalic stimulation evoked separately. Likewise, the pressor responses to simultaneous capsaicin application and diencephalic stimulation were significantly smaller than the algebraic sum of the responses evoked separately. High intensity stimulation of the L7 dorsal root or the diencephalic sites evoked pressor responses similar in magnitude to the algebraic sum of the two responses evoked separately; thus, the inability of the simultaneous maneuvers to evoke pressor responses that summed algebraically was not due to the fact that they caused a maximal effect. Our findings are consistent with the hypothesis that neural occlusion occurs during stimulation of the posterior diencephalon and static muscular contraction. PMID- 2706541 TI - Digital rat brain: a computerized atlas. AB - Digital brain mapping provides the techniques required for 3 dimensional (3D) reconstruction and display. This paper describes work which extends the data published in the Paxinos and Watson (1982) atlas of the rat brain to a computerized form. The product of these experiments is a 3D digital neuroanatomic atlas. The data were transformed from 2D outlines to 3D volumes each associated with a specific neuroanatomic structure. The system which manages this transformation also provides tools to manipulate the composition, orientation and appearance of the displays interactively. PMID- 2706542 TI - Neurochemical and immunocytochemical studies of serotonin in the Hermissenda central nervous system. AB - In the preceding paper we showed that serotonin mimics the effects of associative conditioning on Type B photoreceptors of Hermissenda. Here we show that serotonin is present in the Hermissenda central nervous system, and that it is released in a calcium-dependent manner. A large number of serotonergic cell bodies are present in the cerebropleural ganglia (CPG). Cell bodies in the CPG are located in three small, symmetrical clusters. One cluster (2-3 cells) located at the anterior end of the CPG contains a large cell that projects to the buccal ganglion. A second cluster (2-3 cells) is located posterior to the first and near the midline of the nervous system. A third cluster (1-2 cells) was located slightly more posteriorly than the second. Type B photoreceptors and the S/E optic ganglion cell project to a region of the CPG neuropil which is heavily innervated by serotonin immunoreactive fine processes. Since serotonin mimicked the effects of associative conditioning on Type B cells, and is present in an appropriate region of the CPG neuropil, serotonin may mediate some effects of associative conditioning on Type B cells. Results supporting this hypothesis are presented in an accompanying paper. PMID- 2706543 TI - Serotonin involvement during in vitro conditioning of Hermissenda. AB - To determine if serotonin may be involved in associative conditioning-produced changes in the excitability and photoresponses of Type B photoreceptors, isolated nervous systems were exposed to an in vitro conditioning procedure in the presence or absence of drugs that alter normal serotonergic neurotransmission. Pairings of light and intracellular depolarization of a caudal hair cell (in vitro conditioning) produced a pairing-specific depolarization of Type B photoreceptors that was accompanied by an increase in resting input resistance. Treatment of nervous systems with pharmacological agents which disrupt 5-HT neurotransmission attenuated membrane potential and input resistance changes of Type B photoreceptors. These drugs included serotonin uptake inhibitors (imipramine, fluoxetine), a receptor antagonist (bufotenine), and a neurotoxin (5,7-dihydroxytryptamine; 5, 7-DHT). Yohimbine, an alpha 2-receptor antagonist, was without effect. These results, and those in the accompanying papers, suggest that serotonin modulates Type B photoreceptor excitability during associative conditioning. PMID- 2706544 TI - Efferent tectal cells of crucian carp: physiology and morphology. AB - Tectal cells of the crucian carp (Carassius ararssius) showing antidromic responses evoked by rhombencephalic electrical stimulation were physiologically studied and subsequently stained with Lucifer Yellow CH. The stained efferent tectal cells were fusiform, horizontal, and multipolar. The main axon of these efferent tectal cells descended along the wall of the deep tegmentum and could be traced to the motor area below the cerebellum. The axons gave off their collaterals in several brain areas: 1) descending collaterals in the torus semicircularis, dorso-lateral tegmental area and mesencephalic reticular formation and 2) an ascending collateral in the area between the hypothalamus and tegmentum. Fifty percent of the efferent cells were unresponsive to visual stimuli, but some of these cells were activated by visual or tactile stimulation in conjunction with rhombencephalic electrical stimulation. On the other hand, most of the visually active cells were On-transient and movement sensitive with habituation and some were bimodal. PMID- 2706545 TI - Correlative scanning-immunoelectromicroscopic analysis of neuropeptide localization and neuronal plasticity in the endocrine hypothalamus. AB - Thirty-two Sprague-Dawley rats were divided into four groups, eight rats per group. Animals were hypophysectomized with removal of both the pars distalis and the neural lobe of the neurohypophysis. Groups of eight rats were euthanized 1, 2, 4 and 8 weeks following hypophysectomy and prepared for routine scanning electron microscopy (SEM) and correlative immunoelectron microscopy employing antisera against arginine vasopressin (AVP). Eight normal rats served as controls. In experimental rats that survived one to eight weeks posthypophysectomy, remarkable neuroanatomical alterations were notable in the median eminence and adjacent third cerebral ventricular lumen. In contrast to normal control rats, large numbers of neurites were observed with SEM to insinuate from the lateral recess into the cerebral ventricular lumen and as early as one week following hypophysectomy they overgrew the apical surfaces of ependymal cells that constitute the lining of the cerebral ventricle. Immunoelectron microscopy revealed that a significant proportion of these neurites were magnocellular in origin in that they harbored AVP-positive neurosecretory vesicles. In addition to large numbers of invading magnocellular neurites, neuronal perikayria with apparent axosomatic synapses were observed to emerge upon the thick feltwork of invading axons, the latter of which appeared to freely terminate within the ventricular lumen. AVP-positive axon profiles were, in addition, seen to terminate upon the basal lamina of portal perivascular spaces in the zona externa of the median eminence. These data are consistent with the idea that following hypophysectomy (to include high stalk section of the neurohypophyseal system), that there is rapid, and dynamic sprouting and regrowth of AVP-positive axons into the adjacent third cerebral ventricular lumen and to the contact zone of the median eminence as well. This phenomenon may represent a compensatory physiological response to injury of the neurohypophyseal system characterized by a highly plastic neuroanatomical reorganization of magnocellular elements which appear to utilize the CSF of the third cerebral ventricle as a functional terminus for the neurocisternal secretion of AVP which ultimately enters the systemic circulation. PMID- 2706546 TI - Sleep-waking discharge of basal forebrain projection neurons in cats. AB - We have previously described a population of neurons in the magnocellular basal forebrain which have selectively elevated discharge rates during slow-wave sleep compared to waking; we postulate that these sleep-active neurons are a component of a basal forebrain sleep-promoting system. The purpose of the present experiment was to determine if sleep-active neurons contribute axons to recently described basal forebrain projection pathways. In cats prepared for chronic single unit and EEG-sleep recordings, stimulating electrodes were placed in the mesencephalic reticular formation, and the external capsule and anterior cingulate bundle, fiber bundles known to contain axons of basal forebrain projection neurons. Fifty-nine neurons were antidromically driven; differences in antidromic response latencies were related to sleep-waking discharge profiles. Of the cells with short antidromic latencies (less than 5 msec), the majority (9 of 12) had high discharge rates during waking and low rates during slow-wave sleep. Cells with long antidromic latencies had either very low discharge rates (less than 1 spike/sec) across all states, or had elevated discharge rates in slow-wave sleep. Sleep-active neurons were antidromically driven from external capsule (n = 9), anterior cingulate bundle (n = 9), or mesencephalic reticular formation (n = 5). Projection sleep-active neurons were recorded in the substantia innominata, ventral to the globus pallidus and medial to the central nucleus of the amygdala. Our study found that identified basal forebrain projection neurons in cats exhibit a variety of sleep-waking discharge patterns and conduction velocities. Sleep-active neurons were found to have slowly conducting axons, and to be a source of both ascending and descending projections. PMID- 2706547 TI - The influence of cholesterol on synaptic fluidity and dopamine uptake. AB - The present study examined how the synaptic cholesterol/phospholipid ratio influences membrane fluidity and a transmembrane process of the dopaminergic system, dopamine uptake. Fluorescence polarization of DPH was used as a measure of membrane fluidity. The cholesterol content of synaptosomal and synaptic plasma membranes was altered using a lipid transfer protein. The results of the present study demonstrate that the transmembrane process of dopamine uptake may be inhibited by an elevated synaptic cholesterol/phospholipid ratio, which correlates with increased fluorescence polarization. Specifically, a 10-30% increase in the cholesterol/phospholipid ratio resulted in an approximately 20% increase in fluorescence polarization, a 3- to 6-fold increase in Km, a 4-fold increase in Vmax, and a marked decrease in the Vmax/Km (the first order rate constant for dopamine uptake at low substrate concentrations). PMID- 2706548 TI - An autoradiographic analysis of cholinergic receptors in mouse brain. AB - Autoradiographic techniques were used to localize cholinergic receptors in the central nervous system of female DBA mice. Nicotinic receptors were identified using [3H]-L-nicotine and alpha-[125I]-bungarotoxin (BTX); [3H]-quinuclidinyl benzilate (QNB) was used to examine muscarinic receptor binding. There was little overlap between the regional distribution of binding sites for these ligands. Nicotine binding was highest in thalamic nuclei, the superior colliculus and the interpeduncular nucleus. For BTX binding, high density receptor populations were identified in the hippocampus, caudate putamen, colliculi (superior and inferior) and various nuclei in the hypothalamus and hindbrain. Muscarinic receptors were distributed more uniformly than nicotinic receptors; the colliculi, hippocampus and cerebral cortex had the highest level of QNB binding. Species differences between rats and mice in terms of cholinergic receptor binding are discussed. PMID- 2706549 TI - Peripheral pathways mediating salivary secretion after nucleus parvocellularis activation in the rat. AB - The present study demonstrates that activation of the nucleus parvocellularis in the pontine reticular formation of the rat evokes salivary hypersecretion. The secretory effect observed was found to be mediated by parasympathetic mechanisms, as transection of the preganglionic parasympathetic salivatory fibers at the level of the middle ear blocked the flow of saliva evoked by activation of the nucleus parvocellularis (Experiment 1). Furthermore, transection of these salivatory fibers was followed several days later by the development of a prandial model of drinking. These behavioral data suggest that the transection procedure employed in the present study indeed affected those parasympathetic fibers which control the secretory activity of all three pairs of major salivary glands (Experiment 2). PMID- 2706550 TI - An automated approach for conditioning and testing the hearing of gerbils. AB - A simple, inexpensive hardware and software protocol is described for conditioning and testing hearing of gerbils with minimal experimenter involvement. Behavioral thresholds correspond closely with data which employ nonautomated procedures. Partial source listings of the programs written in the 'C' programming language are provided. PMID- 2706551 TI - Assessment of symptoms in adult survivors of incest: a factor analytic study of the Responses to Childhood Incest Questionnaire. AB - Although research has established the long-term damaging effects of incest, these efforts have suffered from the lack of valid, standardized assessment instruments. The present study reports on the construction and factor validation of the Response to Childhood Incest Questionnaire (RCIQ), a self-report instrument that assesses a range of commonly reported symptoms experienced by adult survivors of incest. A clinical population of 104 adult women who had experienced childhood or adolescent incest completed the RCIQ. A factor analysis of the RCIQ items revealed seven factors which corresponded to hypothesized stress response themes experienced by survivors of traumatic events. These factors include vulnerability and isolation, fear and anxiety, anger and betrayal, reaction to the abuser, sadness and loss, and powerlessness. In addition, four factors corresponded to the diagnostic criteria for post-traumatic stress disorder: intrusive thoughts, avoidance and intrusive emotions, detachment, and emotional control and numbness. The usefulness of the RCIQ as a pre- and post-treatment measure and the need for further research is discussed. PMID- 2706552 TI - Kempe memorial lecture. Children, society, and ethics. PMID- 2706553 TI - Adult male report of childhood sexual abuse by mothers: case descriptions, motivations and long-term consequences. AB - Sexual abuse of male children by their mothers is rarely reported. However, it may not be as rare as commonly believed. Eight case histories are presented which exemplify mothers' sexual abuse of their sons to satisfy the mothers' own needs. In no case was the mother psychotic. In seven cases the mother began the seduction and sexual abuse while the son was prepubescent and continued until at least early adolescence. As adults, each of these sons experienced difficulty maintaining an intimate emotional and sexual relationship with one person, and most presented with some degree of depression. Substance abuse was present in five of eight cases. PMID- 2706554 TI - The family environment of sexual abuse: a comparison of natal and stepfather abuse. AB - Data from 17 states, drawn from the 1983 National Study on Child Neglect and Reporting, were used to compare families in which a daughter had been sexually abused by a natal father or stepfather. While broad comparisons are made in terms of age and race of victims, as well as household composition, the primary focus is on familial stress factors. Given the lower incidence of natal father abuse and the assumption that natal fathers have stronger emotional links to their children and greater commitment to the father role, we predicted that when they did engage in sexual abuse, it would be in a family environment characterized by relatively high levels of personal, social, and economic stress. This was confirmed to the extent that natal father abuser families showed significantly higher levels of drug and/or alcohol abuse, marital problems, and insufficient income than did stepfather abuser families. PMID- 2706555 TI - Factors influencing mothers' reactions to intrafamily sexual abuse. AB - A mother's question of whether to believe her child's disclosure of intrafamily child sexual abuse is complex, with many factors influencing her conclusion. Variables related to the abuse and to the family's functioning are examined to determine if particular circumstances are too threatening to mothers, resulting in their disbelief. The findings indicate that the age of the victim, nature of the abuse, presence of the mother in the home during the abuse, relationship of the victim to the offender, prior physical abuse of the child, and alcohol abuse by the offender all contribute to mother's conclusion regarding the reported abuse. The majority of mothers do believe their child, with difficult situations and other family stressors occasionally detracting from a mother's willingness to accept the report. PMID- 2706556 TI - Munchausen syndrome by proxy: a survey of professionals' knowledge. AB - This study examined professionals' knowledge of a relatively rare form of child abuse, Munchausen syndrome by proxy (MSBP). Eighty-six professionals representing hospital or other medical settings, community services programs, the state children's service agency, and various law enforcement agencies were surveyed. Results indicated that professionals employed in medical or hospital settings were three times more likely to have heard of the syndrome than those employed by community service agencies. Journal articles and colleagues were the most popular sources of information pertaining to MSBP. Respondents identified 77 possible cases of MSBP in their caseloads over the past year. Findings suggest the need for educating community professionals as well as the possibility that the incidence of MSBP has been grossly underestimated. Implications for future research and preventive efforts are discussed. PMID- 2706557 TI - Sexual abuse in Greece: management in two different settings. PMID- 2706558 TI - Abuse and neglect of children brought up in families with an alcoholic father in Bulgaria. PMID- 2706559 TI - Prediction of weight for height following intervention in three-year-old children with early histories of nonorganic failure to thrive. AB - The present study assessed the weight for height outcomes of 59 3-year-old children who had been hospitalized for nonorganic failure to thrive (NOFT) as infants (average age of 5 months) and received time-limited outreach intervention. Although the majority of children attained normal weight for height, nearly one-third demonstrated at least mild wasting. Type of outreach intervention did not affect weight for height at outcome. The predictive efficacy of a variable set which included characteristics of NOFT (age of onset and duration), velocity of weight gain subsequent to diagnosis and environmental characteristics (income and home stimulation) was tested. Shorter duration of NOFT prior to diagnosis and greater initial rate of weight gain following hospitalization predicted weight for height at 36 months. The findings underscore the need for close monitoring of physical growth and nutritional status of NOFT children following hospitalization as well as comprehensive assessment and treatment for children who continue to demonstrate nutritional deficits. Additional studies of factors which affect the prognosis of NOFT children are needed. PMID- 2706560 TI - A systems approach to child abuse: management and treatment issues. AB - In the systems approach certain patterns of family interaction are seen as fitting with physical abuse towards children in the family. If these interactions are blocked or changed using specific family therapy interventions, the risk of further abuse will be significantly reduced. Identifying typical patterns of interaction that fit with abuse is a useful first step in planning the management of physically abusing families. A full systemic formulation of the presenting problem will address numerous systems and sub-systems simultaneously, notably the family-professional system, the family within the extended family/friendship system, and the nuclear family. Interventions may have to be directed on a variety of these levels. The Marlborough Family Service has assessed and treated over 100 child-abusing families. A family day unit is used as the setting, and a multifamily group as the principle medium of treatment. Within the day unit real life stress situations are recreated around everyday issues, enabling families to find new and nonviolent solutions to the problems of daily life. In the cases seen, approximately one-third have resulted in a recommendation of permanent alternative family care for the children. In those families reunited, the re injury rate has been found to be extremely low. PMID- 2706561 TI - Inconsistent response patterns and the prediction of child maltreatment. AB - Inconsistent response patterns have been used with other measures to screen for child maltreatment. To date the inconsistency (IC) scale, a validity scale on the Child Abuse Potential (CAP) Inventory, has not been used as a screening criterion for physical child abuse. The present study examined the responses of 89 physical child abusers and 108 comparison subjects to determine if the CAP Inventory IC scale has any utility in the screening for physical child abuse. While results indicated the CAP Inventory IC scale scores were significantly higher for the physical child abuse group, a series of discriminant analyses indicated that the IC scale did not account for any meaningful variance after variance related to child abuse factors was removed. Further, the results indicated that dependence on the IC scale alone for physical child abuse screening purposes could be expected to produce excessive false positive and false negative classifications. PMID- 2706562 TI - University males' sexual interest in children: predicting potential indices of "pedophilia" in a nonforensic sample. AB - A survey was administered to 193 male undergraduate students regarding their sexual interest in children, as well as their responses to a number of questions theoretically relevant to pedophilia. In total, 21% of subjects reported sexual attraction to some small children, 9% described sexual fantasies involving children, 5% admitted to having masturbated to such fantasies, and 7% indicated some likelihood of having sex with a child if they could avoid detection and punishment. These sexual interests were associated with negative early sexual experiences, masturbation to pornography, self-reported likelihood of raping a woman, frequent sex partners, sexual conflicts, and attitudes supportive of sexual dominance over women. The data did not, however, support clinical theories regarding sexual repression or impulse-control problems among potential pedophiles. PMID- 2706563 TI - Sex abuse prevention programs: offenders' attitudes about their efficacy. AB - Little scientific basis exists for the content of school-based programs which are intended to help children protect themselves from sexual abuse. Children are taught about protecting themselves from a stereotypical old male stranger, yet perpetrators are most frequently young, known to the victim, and use a variety of methods to gain access to children. Programs generally include concepts of body ownership, acceptable touching, good vs. bad secrets, saying no, telling, and trusting one's intuition. Seventy-two prison inmates incarcerated for child sexual abuse were surveyed to evaluate their attitudes about the effectiveness of topics intended to prevent abuse. Offenders described the ideal victim and the modus operandi they used to involve children. Inmates indicated which topics in prevention programs they believed were efficacious and which topics would have little value in preventing abuse. Responses of incestuous and nonincestuous abusers were compared. Inmates indicated that parents could help prevent child abuse and that they must be involved if programs are to be effective. Information from abusers is useful and can be incorporated into programs if the potential for prevention of abuse is to be improved. PMID- 2706564 TI - Multiple systems organ failure. PMID- 2706565 TI - Multiple systems organ failure: malignant intravascular inflammation. PMID- 2706566 TI - The effect of modifying the culture medium on cell polarity in a human colon carcinoma cell line. AB - The human colonic cancer cell line HT29, when grown in DMEM, forms a morphologically unpolarized cell culture in which the cells are covered with irregular microvilli and devoid of belt zonula occludens type tight junctions. However, by modifying the culture medium and growing the cells in RPMI, a different morphology was obtained. A large number of intracellular luminae appeared and at late confluency 90-95% of cells exhibited an apical brush border after four subsequent passages. Junctional complexes and a well developed zonula occludens were revealed under the apical brush border. Immuno-electron microscopical localization of specific markers, sucrase isomaltase (SI), secretory components (SC) and beta 2 microglobulin (beta 2M) showed that SI was limited to the apical surface, whereas 2M and SC were located at the basolateral surfaces. These results indicate that modification of culture conditions affects the ability of HT29 cells to express epithelial cell polarity. PMID- 2706567 TI - Participation of hepatocytes in the production of basement membrane components in human and rat liver during the perinatal period. AB - Little is known about the role of the extracellular matrix in cellular growth, migration and differentiation in the developing liver. The distribution and origin of the main constituents of the hepatic extracellular matrix have never been studied during liver differentiation. We have investigated the extracellular and intracellular distribution of fibronectin, laminin and types I, III and IV collagen in both rat and human liver during the perinatal period by light and electron microscopy, using the indirect immunoperoxidase method. All these components were demonstrated extracellularly, located mainly in portal spaces and, to a lesser extent, surrounding central veins. In perisinusoidal spaces, variations in distribution were observed depending on the matrix protein, the age of the donor and the species. In fetal rat liver, fibronectin formed a continuous layer around hepatocyte clusters while laminin and type III procollagen were present in small amounts. Collagens and laminin were visualized more easily in newborn rat liver. Fetal and newborn human liver contained higher amounts of matrix components than their rat counterparts. Fibronectin also reacted strongly in the sinusoid, and laminin and collagens formed discontinuous deposits. The source of this extracellular matrix was demonstrated to be of mixed origin. The major finding was the presence of immunoreactive laminin in the rough endoplasmic reticulum of hepatocytes irrespective of the age or species. In addition, hepatocytes contained large amounts of fibronectin and little of type I collagen. Another basement membrane component, type IV collagen, was also found in hepatocytes from all groups except fetal rat. Perisinusoidal cells also contained various matrix components including laminin, type III procollagen and, again with the exception of fetal rat liver, type IV collagen. The greater amounts of basement membrane components in the sinusoids of developing liver than in adult tissue and the participation of immature hepatocytes in the production of laminin and to a lesser degree of type IV collagen suggest that these matrix proteins play a critical role during liver differentiation. PMID- 2706568 TI - Avian spinal cord chimeras. Further studies on the neurological syndrome affecting the chimeras after birth. AB - These experiments bring new information concerning the immunological status after birth of quail----chick spinal cord chimeras. Such birds have been produced using recipient flocks of chickens different from those in our previous experiments. The breakdown of tolerance after hatching has been recorded and found to vary with the origin of the embryos. Chickens of broiler JA 657 strain and of a white leghorn strain raised in Japan started to exhibit signs of neural graft rejection later in life than the white leghorn chickens from a French breeder used in our previous studies. As previously described, in two animals, long-term tolerance was observed only for allogeneic chick----chick neural tube grafts. In one chimera the neurological syndrome resulting from rejection was reversible, and no signs of immune attack of the grafted central nervous tissue could be detected at sacrifice. This and other observations reported in this article strongly support the contention that the host immune response to foreign neural tissues starts in peripheral nerves and ganglia where no blood-brain barrier exists rather than in the spinal cord. A humoral response of the host against non-polymorphic quail antigens present on fibroblasts was observed in all birds at the time of rejection. PMID- 2706569 TI - In vitro adhesion of mouse fetal germ cells to extracellular matrix components. AB - Mouse primordial germ cells (PGCs) isolated from the dorsal mesentery and gonadal ridges of 10.5-12.5 days post coitum (dpc) embryos showed a progressively increasing adhesiveness to laminin and fibronectin coated substrates, whereas type I collagen and various glycosaminoglycans (hyaluronic acid, heparin and chondroitin-sulphates) were poor adhesive substrates. At later stages germ cells appeared to lose their adhesiveness to fibronectin and laminin substrates; the ability to adhere to laminin decreased very rapidly in male and slowly in female germ cells. Oocytes and prospermatogonia from 15.5 dpc fetal gonads showed poor adhesiveness to all substrates tested. PGC adhesion to laminin and fibronectin substrates did not require calcium but was markedly trypsin sensitive. Antibodies against the fibronectin receptor of CHO fibroblasts and short peptides containing the Arg-Gly-Asp sequence greatly reduced PGC adhesion to fibronectin. Following adhesion to laminin or fibronectin, most PGCs did not exhibit a morphology typical of motile cells, but remained spherical. A significant proportion (about 30%) of oocytes from 13.5-14.5 dpc embryos appeared, however, able to spread and elongate following attachment to laminin. The results support the hypothesis that mouse PGCs may utilize laminin and/or fibronectin as adhesive substrates during migration and gonad colonization, but indicate that additional factors are probably required to promote PGC motility. In addition, our data provide indirect evidence that binding sites for specific components of extracellular matrix are present in PGCs, and that their expression may be developmentally regulated. PMID- 2706570 TI - The state of DNA methylation of human epsilon-globin gene in erythroid and non erythroid cells. AB - The extent of DNA methylation within the embryonic human epsilon-globin gene domain was studied in erythroid and non-erythroid cell lines. The results obtained show that the human epsilon-globin gene is totally methylated at all sites tested in tissues where it is not expressed, i.e. blood leucocytes. In the erythroid cell lines, K562 and PUTKO, both forced to embryonic differentiation by induction with haemin, the level of methylation is reduced compared with that observed in blood leucocytes. In the nonerythroid cell lines HeLa and Rajii, where the human epsilon-globin gene is not expressed, the overall level of methylation in all sites tested is lower compared with that in erythroid cell lines. PMID- 2706572 TI - The new epidemic: chronic fatigue syndrome. PMID- 2706571 TI - The comprehensive perinatal services experience. PMID- 2706573 TI - CNA takes case against RCTs to CMA meeting. PMID- 2706574 TI - Atherosclerosis, the early lesion. PMID- 2706575 TI - Pharmacologic alterations of the isovolumic index: a study of the effects of isoproterenol, propranolol and verapamil. AB - The isovolumic index has been proposed as a noninvasive index of left ventricular function which, unlike the traditional systolic time index, incorporates the period of isovolumic relaxation. The responses of the isovolumic index and the systolic time index to three cardioactive drugs (isoproterenol, propranolol and verapamil) were assessed by measurements of ejection time (ET), isovolumic contraction time (IVC) and isovolumic relaxation time (IVR) in 23 dogs instrumented with high fidelity micromanometers and ultrasonic crystals. Isoproterenol infusions resulted in improvements in both the isovolumic and systolic time indices as a result of significant shortening of ET, IVC and IVR. Propranolol infusions caused significant and parallel increases of IVC (P less than 0.01) and ET (P less than 0.05) but failed to cause prolongation of either the systolic time index, defined as (IVC/ET) or deterioration of regional function. A higher propranolol dose caused significant increases in ET, IVC (P less than 0.001) and IVR (P less than 0.05), yet neither the systolic time index or the isovolumic index (IVC + IVR/ET) were prolonged, and regional function remained normal. Verapamil infusion caused an upward, nonsignificant trend in the isovolumic index and no change in the systolic time index. Stepwise multiple linear regression analysis demonstrated a similar load dependency of both indices and a higher inverse correlation of the isovolumic index with fractional shortening. The systolic time index showed a higher dependency on peak positive dP/dt whereas only the isovolumic index showed dependency on the isovolumic relaxation time constant. When altered loading conditions are accounted for, the isovolumic index shows directional changes that reflect changes in peak positive dP/dt, the isovolumic relaxation time constant and regional shortening. PMID- 2706576 TI - Acute myocarditis presenting as asymmetric septal hypertrophy. AB - A 19-year-old male with myocarditis presented with the echocardiographic appearance of asymmetric septal hypertrophy. After six days of steroid therapy the septum and the posterior wall returned to normal thickness. This case suggests that a diagnosis of myocarditis should be considered in patients demonstrating asymmetric septal hypertrophy, particularly when there are associated left ventricular wall motion abnormalities. PMID- 2706577 TI - Failure of amiodarone to prevent ventricular fibrillation (sudden death) in hypertrophic cardiomyopathy. AB - A case of ventricular fibrillation with successful resuscitation is described in a patient with hypertrophic cardiomyopathy and a history of syncope. Patients with hypertrophic cardiomyopathy who are at risk for sudden death can be identified by electrocardiographic monitoring which demonstrates episodes of ventricular tachycardia. Therapy with amiodarone has been shown to abolish ventricular tachycardia and to reduce the incidence of sudden death. Amiodarone therapy eliminated malignant ventricular ectopic activity in this patient during 48 h of ambulatory electrocardiographic monitoring, yet the subsequent exercise stress test provoked an episode of ventricular fibrillation. PMID- 2706578 TI - Unidirectional coronary collateral blood flow in a patient with congenital anomaly of a coronary artery: an angiographic artefact. AB - A 53-year-old female underwent coronary arteriography for evaluation of chest discomfort. A congenital anomaly of a large interconnecting vessel between the right coronary and circumflex arteries was documented. Selective injection of the right coronary artery resulted in visualization of the circumflex branch of the left coronary through a large interconnecting vessel. Through careful analysis of the left ventriculogram and coronary arteriograms, it appears that retrograde filling of the circumflex artery during right coronary injection is an angiographic artefact. PMID- 2706579 TI - Long term efficacy and toxicity of amiodarone in the treatment of refractory cardiac arrhythmias. AB - Amiodarone has remarkable efficacy, but it also has a high incidence of severe side effects. Nevertheless, it is extensively used. The findings of an amiodarone treatment follow-up period of one to 72 months (mean 19 +/- 17) in 95 patients with recurrent life threatening arrhythmias resistant to other antiarrhythmic drugs are described. The mean loading dose of 800 mg/day for one week was followed by an average dose of 600 mg/day for two weeks. The long term daily dose was 400 mg in 80 patients and 200 mg in the remaining 15 patients. Amiodarone was particularly effective in suppressing complex ventricular arrhythmias. It also decreased premature ventricular beats by 83% and atrial premature beats by 41%. Supraventricular tachycardias were completely controlled and the ventricular response to atrial fibrillation was slowed. Twelve of the 95 patients (12.6%) died while taking amiodarone, two of sudden death and 10 of heart failure. Side effects were recorded in 77 (81%) patients. They were generally dose related and subsided with a decrease in dose or discontinuation of the medication. There was a correlation between the concentration of rT3 and the significance of the side effects. Thirty-nine patients stopped taking amiodarone, however, only 14 of these stopped because of toxicity: five developed pulmonary fibrosis; three had neurological toxicity; two had bradyarrhythmias; two developed hepatic dysfunction; one had hypothyroidism; and one patient suffered an aggravation of a pre-existent heart failure. It was concluded that amiodarone is a very effective treatment for supraventricular and ventricular arrhythmias. However, it does have numerous and severe side effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706580 TI - Canadian Ophthalmological Society, 52nd annual meeting. 25-28 June 1989, Calgary. Abstracts. PMID- 2706581 TI - The decision not to resuscitate. PMID- 2706582 TI - Nonionic contrast media. PMID- 2706583 TI - Canada's health care legislation: good intentions, bad laws. PMID- 2706584 TI - Crystal diaper syndrome. PMID- 2706585 TI - Anemia causing cerebral infarction in a child. PMID- 2706586 TI - Abortion: reducing demand. PMID- 2706587 TI - "Universal" moral principles. PMID- 2706588 TI - Chronic fatigue syndrome. PMID- 2706589 TI - Canadian regulation of the medical use of fetal tissue in research and therapy. PMID- 2706590 TI - Quality of care in family practice: does residency training make a difference? AB - As the proportion of physicians who enter residency training in family practice steadily increases, so does the need to evaluate the impact of their training and postgraduate education on the quality of care in their practices. We audited the practices of 120 randomly selected family physicians in Ontario, who were separated into four groups: nonmembers of the College of Family Physicians of Canada (CFPC), members of the CFPC with no certification in family medicine, certificated members without residency training in family medicine and certificated members with residency training in family medicine. The practices were assessed according to predetermined criteria for charting, procedures in periodic health examination, quality of medical care and use of indicator drugs. Generally the scores were significantly higher for CFPC members with residency training in family medicine than for those in the other groups, nonmembers having the lowest scores. Patient questionnaires indicated no difference in satisfaction with specific aspects of care between the four groups. Self-selection into residency training and CFPC membership may account for some of the results; nevertheless, the findings support the contention that residency training in family medicine should be mandatory for family physicians. PMID- 2706591 TI - Occupational death due to heat stroke: report of two cases. PMID- 2706592 TI - Primary bony involvement in Hodgkin's disease. PMID- 2706593 TI - Apnea monitors of little use in preventing SIDS, experts say. PMID- 2706594 TI - Marfan's syndrome: MDs must take great care diagnosing, treating. PMID- 2706595 TI - The CMA Leadership Conference: an American perspective. PMID- 2706596 TI - AIDS tales: "When knowledge is scant or conflicting, folklore takes over". PMID- 2706597 TI - Multicultural medicine: fad or forgotten concept? PMID- 2706598 TI - [Project OSIS (integrated health care organizations): opinions are very divided]. PMID- 2706599 TI - Nail disorders. PMID- 2706600 TI - Nail changes associated with scleroderma: a case report. AB - A case report and literature review on the association of nail changes and scleroderma was presented. The exact etiology of these nail changes seen in scleroderma and of the disease entity itself, has not yet been determined. The current treatment regimen, which is at best supportive, was discussed. Proper treatment of the nail changes depends on a good understanding of what to expect as the disease or condition progresses to its later stages. The extent and severity of the onychodystrophy can be correlated with the duration of the disease. Nonetheless, there are still questions that remain to be answered regarding the nail changes associated with scleroderma. For example, are these nail changes the result of Raynaud's phenomenon and its associated arterial insufficiency, or are they a normal sequelae of the integumentary degeneration so characteristic of scleroderma? Whatever the answer may be, it should be recognized that these changes are a source of clinical concern. Practitioners should take note of this clinical entity and record their findings so that these perplexing questions, as well as many others, may be discussed in the future. PMID- 2706601 TI - DSM-III in residency training: results of a Canadian survey. AB - The authors surveyed directors of residency training as well as residents across Canada to determine the extent to which DSM-III has been incorporated into the Canadian psychiatric residency training programs, how this has been accomplished, and the respondents' assessment of certain effects of DSM-III on residency training. This study is a replication of an earlier study done by another team in the United States. Our study indicates that, in most cases, the attitude towards DSM-III was positive: 100% of respondents described the system as useful or somewhat useful in the training settings. The most frequently selected positive features were its value as a common language, an aid in differential diagnosis, its empirical approach and specificity or clarity of the criteria. The criticisms frequently centred on the DSM-III's potential to induce a false impression of all encompassing theoretical knowledge, to be misused in a mechanistic manner as a "cookbook", and on the DSM-III's inadequacy with some patients (for example, children, neurotic disorders, and personality disorders). PMID- 2706602 TI - Utility of the Beck Depression Inventory with psychiatrically disturbed adolescent outpatients. AB - Thirty-seven consecutively assessed adolescents were evaluated at two intervals, one week apart, using the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HLDRS). Scores on the two instruments were compared to each other and to the DSM-III clinical diagnosis. High scores on the BDI were not found to be specific to symptoms of patients with a diagnosis of depressive syndrome but rather measured the degree of subjective dysphoria. The severity of dysphoria was found to be greatest in the group with personality disorders and to vary most in this group from one week to the other. Suggestions for an appropriate use of the BDI in an adolescent population are made. PMID- 2706603 TI - Development of a young man with Prader-Willi syndrome and secondary functional encopresis. AB - A case review of a twenty-two year old man suffering from Prader-Willi Syndrome, Secondary Functional Encopresis, mental retardation and aggressive behaviour is presented. Emphasis is made in assessing this man from various developmental perspectives. This includes: personality development, cognitive development, physical abilities, sexual development and family life stage. The role of a psychiatrist in treating this complex problem is established. An eclectic approach to treatment is reviewed using many therapeutic modalities found effective with the mentally handicapped. These modalities include: group therapy, play therapy, individual psychotherapy, behavioural therapy, family therapy, and use of medication. A literature review of Prader-Willi Syndrome is included. PMID- 2706604 TI - Organic affective disorder and vascular dysregulation in systemic lupus erythematosus. AB - A case is reported in which an exacerbation of systemic lupus erythematosus presented as an organic depressive disorder with psychotic features. Brain imaging using regional cerebral blood flow techniques demonstrated vascular dysregulation in the left frontal lobe of this patient. The implications for understanding the pathogenesis of psychiatric disorders in lupus are discussed. PMID- 2706605 TI - Bulimia and dissociative states: a case report. AB - The case history of a 17 year old girl, who initially presented with symptoms of bulimia and later developed dissociative states, is described. The possible relationship between bulimia and dissociative states is discussed in the context of psychometric tests and the underlying family dynamics. PMID- 2706606 TI - Anorexia nervosa in a young Chinese woman in Hong Kong. PMID- 2706607 TI - Family background and physical health of adolescents admitted to an inpatient psychiatric unit, I: Principal caregivers. AB - A retrospective chart review of 100 consecutive adolescents discharged from a provincial psychiatric hospital adolescent unit was conducted. At the time of admission, eighty-four percent no longer lived with one or both of the biological parents. The children remained with the mother more often than with the father. However, boys who had lost their principal male caregiver more often acquired a new one, compared with girls. The latter tended to remain more in a single-mother home. Thirty-four patients were no longer in the care of either parent at admission. Seventy-four had a conduct disorder. Members of this group were more likely to have lost one or both parents. Recent loss of a parent seemed to be related to a combined diagnosis of depression and conduct disorder. Parental loss was not prominent among one class of the patients with conduct disorder--those with under-socialized aggressive disorders. The latter were often still in their intact biological family of origin, and in four instances they presented serious cases of aggressive actions in the absence of any history of parental deprivation. PMID- 2706608 TI - Family background and physical health of adolescents admitted to an inpatient psychiatric unit, II: Physical health. AB - The charts of 100 adolescents admitted to a special unit of a provincial psychiatric hospital were reviewed. These patients primarily had a conduct disorder (71.6% of boys and 77.5% of girls) or an affective disorder (6.6% of boys, 15.0% of girls). There was a higher incidence of congenital disorders in the population than expected, suggesting that such disorders may predispose to psychological troubles later in life. Convulsions also occurred more often in this population. Most patients (78.3% of boys and 85.0% of girls) had one or more medical diagnoses. Several potentially serious findings (anemia, pregnancy, hepatomegaly, thyroiditis) were first noted on the admission physical examination. Patients with conduct disorder had certain health problems that are likely to be the result of the psychiatric disorder, such as liver function changes in drug and alcohol abusers and abnormal Pap smears in sexually active girls with multiple partners. If these medical conditions are not followed and treated, they have the potential for causing serious problems at a later date. These findings point out the continued need for the expertise of psychiatrists and other physicians in children's mental health facilities. PMID- 2706609 TI - A comparison of voluntary with remanded schizophrenics. AB - In this study two groups of schizophrenic patients are compared on a number of clinical and demographic variables. The first group consists of 52 consecutive admissions to a forensic assessment unit of patients with a diagnosis of schizophrenia. The second is a consecutive series of schizophrenic patients admitted to two open admission units. Significant differences were found between the two groups. Specifically the forensic patients were more often male, single and antisocial as assessed by previous convictions and more often transient or living semi-independently in sheltered accommodation. They were less compliant with treatment. The two groups did not differ with respect to clinical features such as duration of illness and number of hospitalizations. It is concluded that individual patient characteristics may contribute to an outcome of legal involvement among schizophrenics. The implications of this for service delivery and future research on criminalization are discussed. PMID- 2706610 TI - [Psychological factors in falls in elderly patients]. AB - This article recognizes the high incidence and prevalence of falls in the elderly. Psychological factors can play a definite role as part of the etiology. The fall can be a depressive signal or a cry for help from a demoralized elderly patient. The authors stress the importance of recognizing the depressive syndrome of the elderly. Psychological consequences of the falls are reviewed at three different levels. For the elderly, the consequences are frequently a fear that can lead to a sharp decrease in functional capacity. For the family, the fall can lead to the institutionalization of the elderly or a very restrictive surveillance. For the family physician, the fall is frequently perceived as an emergency that leads to immediate unwarranted admission. A rational approach, with education and guidelines, is proposed and can render this traumatic experience less dramatic at these three different levels. PMID- 2706611 TI - Short-term group therapy with depressed adolescent outpatients. AB - A selected review of the literature about short-term therapy and social skills as they may apply to depressed adolescents is presented. Two forms of group therapy are described. These are social skills and a traditional discussion group format. Some of the difficulties in establishing and evaluating a group therapy program are outlined. PMID- 2706612 TI - Art smart. PMID- 2706613 TI - The trouble with baby walkers. PMID- 2706614 TI - Multiple sclerosis and female sexuality. PMID- 2706615 TI - Female circumcision. PMID- 2706616 TI - Handle with care. PMID- 2706617 TI - [A nurse directs CSAM (AIDS Committee Montreal). An interview with Lise Lanctot, MN (adm), MAP]. AB - Lise Lanctot, who has a master's degree in nursing and a diploma from the high ranking Ecole nationale d'administration, is the executive director of the Montreal AIDS Support Committee (its French initials are CSAM). This private organization focuses on advocacy and community health, offers services to people with AIDS or AIDS-related illnesses, those who test HIV-positive, as well as their family and friends. Believing that prevention is the cornerstone in the fight against AIDS, Lanctot calls for a coordinated effort in this area, best achieved through a strong network of individuals and organizations. PMID- 2706618 TI - Keeping children safe. PMID- 2706619 TI - Up-regulation of c-myc in a transformed cell line approaching stationary phase growth in culture. AB - The present report describes a transformed cell line (AKR-MCA) in which the c-myc proto-oncogene is up-regulated by as much as 14-fold as cultures approach stationary phase growth. The untransformed counterpart AKR-2B cells did not exhibit such an increase in c-myc expression at high cell densities, nor did chemically transformed derivatives of another murine fibroblast cell line (C3H 10T1/2). N,N-Dimethylformamide and retinoic acid reduced c-myc levels in confluent AKR-MCA cells in association with a loss of transformed morphology, a reduction in saturation density, and the formation of a contact-inhibited monolayer at confluency. These findings suggest that the high levels of c-myc in confluent AKR-MCA cells may interfere with the normal signals involved in density dependent growth regulation in this cell system. The effects of N,N dimethylformamide and retinoic acid were reversible and dose-related. The half time for the early, rapid decline in c-myc mRNA was approximately 26 min in response to N,N-dimethylformamide and 38 min in response to retinoic acid, effects which preceded the alterations in morphology and saturation densities. Activation of the latent transforming growth factor-beta in serum-free medium conditioned by confluent AKR-MCA cells, followed by its addition to preconfluent AKR-MCA cells, resulted in an up-regulation of c-myc mRNA. However, addition of serum-containing conditioned medium under similar conditions did not require prior acidification to up-regulate c-myc. Thus, active transforming growth factor beta may be present in conditioned medium from confluent AKR-MCA cells grown in serum-containing medium, or autocrine factors other than TGF-beta may produce the confluency-associated up-regulation of c-myc and the altered density-dependent growth regulation in AKR-MCA cells. PMID- 2706620 TI - Sensitivity of human melanoma cells to L-dopa and DL-buthionine (S,R) sulfoximine. AB - Four of seven human melanoma cell lines were sensitive to killing by L-dopa (D37 1.0-4.7 microM) compared with fibroblasts, Hela, and three ovarian tumor cell lines (D37 12-59 microM). All seven melanoma lines, however, were sensitive to DL buthionine(S,R)sulfoximine (BSO) (D37 0.73-8.5 microM) compared with the nonmelanoma cells (D37 25-68 microM). The melanoma line most sensitive to BSO (MM418) was highly melanized, proliferated slowly and was resistant to other agents [dopa, 5-(3-methyl-1-triazeno)5-imidazole-4-carboxamide, melphalan, methotrexate, hydroxyurea, etoposide, Adriamycin]. In most cell lines, L-dopa and BSO blocked cell proliferation in all phases of the cell cycle. Cellular sensitivity to dopa or BSO did not correlate with levels of total soluble SH, glutathione (GSH), GSH reductase, GSH peroxidase or GSH transferase, or with the extent of GSH depletion induced by the drug. No GSH transferase activity could be detected in the dopa-resistant HeLa line, indicating that detoxification of quinones is not an important mechanism of resistance. Within the group of melanoma cell lines, sensitivity to dopa correlated with decreased level of gamma glutamyl transpeptidase (r = 0.81). However, the gamma-glutamyl transpeptidase inhibitor azaserine was less effective than BSO in enhancing the toxicity of dopa. It can be inferred that (a) there is no simple relationship between GSH metabolism and sensitivity to dopa or BSO in human melanoma cells, and (b) BSO may be an effective agent for melanoma. PMID- 2706621 TI - Inhibitory effects of estrogen and castration on the early stage of pancreatic carcinogenesis in Fischer rats treated with azaserine. AB - Effects of sex steroids on pancreatic carcinogenesis during the early stage were studied in azaserine-treated rats of both sexes. Fischer rats were given weekly i.p. injections of azaserine (30 mg/kg) [CAS:115-02; diazoacetate serine(ester)] at 2 and 3 weeks of age and were divided into six groups. Castration, ovariectomy, and s.c. implantations of either a 0.3-mg or a 1.0-mg 17 beta estradiol (CAS:50-28.2; estradiol) pellet were performed at 7 weeks of age. The groups were as follows: group 1, intact male; group 2, castrated; group 3, castrated plus 0.3 mg estradiol; group 4, castrated plus 1.0 mg estradiol; group 5, ovariectomized; and group 6, intact female. Rats were killed 4 months after the last injection of azaserine. Azaserine treatment induced atypical acinar cell foci and nodules (AACN) in both sexes. The acidophilic AACN are considered preneoplastic lesions. An apparent sex difference was observed; the number of acidophilic AACN was greater in male rats than in female rats. Castration caused a significant decrease in both the serum testosterone levels and the number of acidophilic AACN, which were comparable to those in ovariectomized female rats. Furthermore, when estradiol treatment was administered to the castrated male rats, a linear decrease in the number of acidophilic AACN and an elevation in the serum estradiol levels were observed and were dose dependent. There were also positive relationships between estradiol treatments and the mean pituitary and pancreas weights. These results showed that estradiol treatment and the drop in testosterone levels caused by castration were highly effective in inhibiting the development and growth of preneoplastic lesions of the pancreas of the rats treated with azaserine. This estradiol effect was dose dependent. The present study, therefore, provides evidence that estrogen may act as an inhibitor and androgen as a promoter in the early stage of pancreatic carcinogenesis in rats. PMID- 2706622 TI - Oxidative metabolism of cyclophosphamide: identification of the hepatic monooxygenase catalysts of drug activation. AB - Cytochrome P-450-catalyzed activation of cyclophosphamide to alkylating metabolites was studied in isolated rat liver microsomes and purified, reconstituted P-450 enzyme systems in order to identify the major enzymatic catalysts of drug activation in both uninduced and drug-induced liver tissue. P 450 form PB-4 (P-450 gene IIB1) activated cyclophosphamide with high efficiency [Vmax (app) = 18.2 nmol metabolite/min/nmol P-450; Km (app) = 0.16 mM] via the formation of 4-hydroxycyclophosphamide, which was quantitatively trapped as a bisulfite adduct then characterized following its conversion to cyano derivatives. Antibodies to P-450 PB-4 inhibited cyclophosphamide activation catalyzed by phenobarbital-induced adult male rat liver microsomes (specific activity, 5.4 nmol metabolite/min/mg liver microsomes) in a selective and near quantitative (greater than 80%) fashion; little or no inhibition was obtained using antibodies inhibitory towards six other rat hepatic P-450 forms. Cyclophosphamide activation catalyzed by uninduced adult male rat liver microsomes (specific activity, 0.68 nmol/min/mg), although not inhibited by anti P-450 PB-4 antibodies, was partially inhibited (approximately 60%) by antibodies to P-450 PB-1 (gene IIC6) and more completely inhibited (greater than 95%) by antibodies reactive with both P-450 PB-1 and P-450 2c (gene IIC11). Consistent with these observations, P-450 PB-1 and P-450 2c both activated cyclophosphamide at moderate rates in reconstituted systems (turnover, 1.6-2.7 nmol metabolite/min/nmol P-450), while seven other purified hepatic P-450 forms exhibited significantly lower activities (turnover less than or equal to 0.5 nmol metabolite/min/nmol P-450). Further studies revealed that the changes in liver microsomal cyclophosphamide activation rates with age and sex and in response to in vivo administration of cisplatin primarily reflect changes in the levels of P 450 forms PB-1 and 2c. These studies establish that P-450 forms PB-1, 2c, and PB 4 are the major catalysts of cyclophosphamide activation in rat hepatic tissue and that the modulation of microsomal cyclophosphamide activation with development and in response to drug exposure largely reflects alterations in the levels of these three hepatic P-450 enzymes. PMID- 2706623 TI - Stimulation by localized tumor hyperthermia of reductive bioactivation of 2 nitroimidazole benznidazole in mice. AB - We have investigated the effects of localized tumor hyperthermia (LTH; 43.5 degrees C x 30 min) on the reductive bioactivation of the 2-nitroimidazole benznidazole in C3H mouse normal tissues and KHT tumors. Mice were allocated to one of three treatment groups: (a) unrestrained controls, (b) sham tumor treatment, and (c) LTH. Concentrations of benznidazole and its amine metabolite were determined by high-performance liquid chromatography. Conscious mice were given LTH or sham treatment 2.5 h after 2.5 mmol/kg benznidazole i.p. This gave steady-state plasma benznidazole concentrations of 120-170 micrograms/ml at 2-5 h in all three groups. Plasma amine concentrations were very low at 0.1-1 micrograms/ml in all cases. Liver benznidazole concentrations were similar to plasma but amine concentrations were 30-40-fold greater at 20-40 micrograms/g in all three groups, implicating the liver as a major site of reductive metabolism. Benznidazole concentrations in tumors from unrestrained mice were comparable to those in plasma and liver, with tumor/plasma ratios of 85-113%. Tumor amine concentrations were intermediate at about 2-3 micrograms/g, indicating reductive bioactivation had occurred. Sham treatment decreased tumor benznidazole concentrations by 25-50%, particularly at later times, and amine concentrations were correspondingly increased. This may be a result of sham tumor treatment at 37 degrees C, a temperature 3-4 degrees C higher than in unrestrained controls. More importantly, LTH further decreased tumor benznidazole concentrations over sham treatment, e.g., by 59% from 114 to 47 micrograms/g (P less than 0.01) immediately after heating. Amine concentrations were correspondingly elevated, e.g., by 40% from 5.1 to 8.4 micrograms/g (P less than 0.01). These results clearly show that LTH can selectively enhance the reductive bioactivation of benznidazole in KHT tumors in mice, and support a particular role for the use of bioreductive agents with heat. PMID- 2706624 TI - Stimulatory effects of 4-hydroxytamoxifen on proliferation of human endometrial adenocarcinoma cells (Ishikawa line). AB - The effects of trans-4-hydroxytamoxifen (OHTam) on proliferation of cells of the Ishikawa human endometrial adenocarcinoma line were studied under serum-free, phenol red-free conditions and compared to those of estradiol. The addition of OHTam (1 microM) to basal medium (BM), consisting of equal parts of Dulbecco's modified Eagle's medium and Ham's F-12 with additional glutamine and 4-(2 hydroxyethyl)-1-piperazineethanesulfonic acid, resulted in significant increases in cell numbers relative to controls. These effects were even greater than those obtained with estradiol (10 nM-1 microM) or 1% charcoal-treated fetal bovine serum (ctFBS). Addition of 1% ctFBS to BM containing 1 microM OHTam further increased cell numbers whereas addition of estradiol (10 nM) did not do so. The stimulation of growth was positively correlated with OHTam concentrations in the range of 10 nM to 1 microM. Dissociation of estradiol and OHTam proliferative effects was observed in a variant of Ishikawa cells in which estradiol did not increase proliferation while OHTam had a strong stimulatory effect. The growth promoting effects of OHTam were also observed in BM containing 5% or 15% ctFBS. In contrast, in parallel experiments in which BM was replaced by minimal essential medium (Eagle's) with Earle's salts, OHTam (1 microM) did not stimulate proliferation under these conditions and acted as an antiestrogen, inhibiting the proliferative effects of estradiol. These results illustrate marked effects of medium composition on proliferation and antiestrogenic actions of OHTam. Alkaline phosphatase activity was strongly stimulated by estradiol (10 nM) but only very weakly affected by OHTam (1 microM); at these concentrations, OHTam inhibited the effect of estradiol, both in serum-free BM and in minimal essential medium plus 15% ctFBS, demonstrating dissociation in its actions on proliferation and on enzymatic activity. These findings suggest that OHTam may stimulate the proliferation of particular clones of endometrial cancer cells in human tumors. They also suggest that OHTam can exert effects not mediated by the estrogen receptor system, or form OHTam-estrogen receptor agonistic complexes unlike those resulting from estradiol-estrogen receptor interactions. Clearly, Ishikawa cells provide a useful model to investigate mechanisms of action of antiestrogens. PMID- 2706625 TI - Specific inhibitors of tyrosine-specific protein kinases: properties of 4 hydroxycinnamamide derivatives in vitro. AB - Inhibition by seven synthetic 4-hydroxycinnamamide derivatives, ST 271, ST 280, ST 458, ST 494, ST 633, ST 638, and ST 642, of tyrosine-specific protein kinases (tyrosine kinase) of oncogene or proto-oncogene products (p130gag-v-fps, p70gag actin-v-fgr, pp60v-src, pp60c-src) and epidermal growth factor (EGF) receptor kinase were investigated. ST 638 (alpha-cyano-3-ethoxy-4-hydroxy-5 phenylthiomethylcinnamamide) strongly inhibited more of the tyrosine kinases than any of the other compounds. The susceptibilities of these tyrosine kinases to ST 638 increased in the following order: EGF receptor greater than p70gag-actin-v fgr greater than pp60c-src greater than p130gag-v-fps, pp60v-src, with 50% inhibitory concentration values of 1.1, 4.2, 18, 70, and 87 microM, respectively. The phosphorylation of the tyrosine residues in particulate fractions from RR1022 cells expressing pp60v-src was inhibited by ST 638 in a dose-dependent way, while it had a negligible effect on the phosphorylations of threonine and serine residues. Kinetic analysis showed that ST 638 competitively inhibited the phosphorylation of an exogenous substrate by the EGF receptor kinase with a Ki of 2.1 microM. ST 638 noncompetitively inhibited autophosphorylation by EGF receptor kinase. These results indicate that ST 638 is a potent and specific inhibitor of tyrosine kinases in vitro, and that its inhibitory activity is caused by competing with the substrate protein for the tyrosine kinase binding site. PMID- 2706626 TI - Lack of in vitro synergy between etoposide and cis-diamminedichloroplatinum(II). AB - Claims of synergy between etoposide and cisplatin have been based upon preclinical in vivo murine P388 models or upon human clinical trials in tumors such as lung cancer. Such in vivo studies are useful in exploring therapeutic synergy, i.e., an improved therapeutic strategy. The term "synergy" in this context is sometimes, however, taken to imply greater than additive kill of tumor cells. Unfortunately, it is virtually impossible to document supra-additive tumor cell kill in vivo, since in vivo curves of therapeutic effect are not linear and drugs are therefore not additive with themselves. Therapeutic synergy may, in fact, occur when two drugs are merely additive (or even antagonistic) with regard to cytotoxicity if the drugs have nonoverlapping host toxicity. The demonstration of true supra-additive cell kill would imply an interaction of the two agents at a cellular level and would have profound implications for biochemical studies. In order to determine whether the reported therapeutic synergy of etoposide and cisplatin is due, in part, to supra-additive cell kill, we used an in vitro tetrazolium-based colorimetric assay for cytotoxicity (MTT assay) and an isobologram analysis to test combinations of the two drugs against four human small cell and four human non-small cell lung carcinoma lines. Using a rigorous test for in vitro synergy, we could not establish a greater than additive cytotoxic effect on our cell lines. It thus appears that the clinical synergy between etoposide and cisplatin is not due to a supra-additive effect at the cellular level. Our results have implications for a variety of fields in which claims of "synergy" often appear. PMID- 2706627 TI - Points of action of estrogen antagonists and a calmodulin antagonist within the MCF-7 human breast cancer cell cycle. AB - Tamoxifen and other structurally related nonsteroidal antiestrogens possess properties in addition to their estrogen antagonist activity including inhibition of both calmodulin and protein kinase C. The present studies were designed to test whether the estrogen-reversible (estrogen receptor mediated) and estrogen irreversible effects of nonsteroidal antiestrogens on cell cycle progression in vitro were mediated at the same or different points within the cell cycle and if the estrogen-irreversible effects coincided temporally with that of a calmodulin antagonist, R24571. Initial experiments investigated the effects of ICI 164384, a pure estrogen antagonist, on proliferation kinetics in asynchronous cultures of MCF-7 human breast cancer cells. At concentrations greater than 1 nM ICI 164384 significantly reduced growth rate while at greater than or equal to 50 nM, ICI 164384 completely arrested growth after the first 24 h of exposure. Concentrations up to 5 microM failed either to cause more profound effects on growth or induce cytotoxicity. Growth inhibition was associated with a decrease in the proportion of S phase cells and an accumulation of cells in G1 phase, and was completely reversed by the simultaneous addition of equimolar estradiol. In order to identify the points of action within the cell cycle of ICI 164384, and the estrogen-reversible and estrogen-irreversible components of the nonsteroidal estrogen antagonist, hydroxyclomiphene, and the calmodulin antagonist, R24571, experiments were undertaken with MCF-7 cells synchronized by mitotic selection. The mean point of action was assessed by delaying addition of the drugs for increasing time periods following mitotic selection and using DNA flow cytometry to determine the proportion of the population affected by drug administration at a specific time within G1 phase. These studies showed that sensitivity to ICI 164384 was restricted to the early part of G1 phase and that the mean time of action was 4.9 h after the beginning of G1 for this pure estrogen antagonist. The mean times of action of the estrogen-reversible (4.1 h into G1 phase) and estrogen-irreversible (4.1 h) mechanisms of action of hydroxyclomiphene, and R24571 (4.0 h), all appeared to be within a similar time frame in early to mid G1 phase. It is concluded that ICI 164384 inhibits breast cancer cell proliferation by inducing a transition delay in G1 phase and that the point of action of this pure estrogen antagonist in early G1 phase is indistinguishable temporally from that of nonsteroidal antiestrogens and calmodulin antagonists. PMID- 2706628 TI - Down-regulation of a Mr 90,000 heat shock cognate protein during granulocytic differentiation in HL-60 human leukemia cells. AB - Modulation of the synthesis of heat shock proteins in HL-60 human promyelocytic leukemia cells during differentiation was studied by metabolic labeling with [35S]methionine and Northern blot analysis. HL-60 cells were found to synthesize constitutively a high level of a Mr 90,000 protein (heat shock cognate protein, hsc90), which was very closely related to Mr 90,000 heat shock protein, hsp90, as far as molecular weight, isoelectric point, peptide maps, immunoreactivity, and encoded mRNA were concerned. Differentiation induction by dimethyl sulfoxide markedly decreased the level of the hsc90 expression, but preserved the ability to preferentially express hsp90 in response to heat stress. These results suggest distinct regulatory mechanisms of the synthesis between hsc90 and hsp90 although they are indistinguishable by conventional protein or mRNA analysis, and indicate that hsc90 has some role in cell growth and differentiation. PMID- 2706629 TI - Basis for the differential modulation of the uptake of 5-iododeoxyuridine by 5' aminothymidine among various cell types. AB - We have previously reported that 5'-aminothymidine (5'-AdThd), an antagonist of the feedback inhibition exerted by dTTP that regulates thymidine kinase, enhances the uptake and cytotoxicity of 5-iododeoxyuridine in various human bladder cancer cell lines but not in normal human urothelial cells (HU) propagated in vitro. In this work we have analyzed the factors that could potentially account for the differential effect of 5'-AdThd among various cell types: 647V (a human bladder cancer cell line); HU; SV-HU (a SV40-transformed human urothelial cell line), and C3H/10T1/2 mouse embryo fibroblasts (10T1/2) cells. 5'-AdThd enhanced the uptake of IdUrd in SV-HU cells (greater than 400%), similar to what we have observed before for 647V cells. However, in 10T1/2 and HU cells, 5'-AdThd only minimally increased the uptake of 5-iododeoxyuridine (about 160%). Thymidine kinases purified from the different sources were similarly sensitive to inhibition by dTTP or 5'-AdThd and to deinhibition of the dTTP-induced regulation of enzyme activity by 5'-AdThd. Furthermore, [3H]-5'-AdThd permeated and accumulated intracellularly in all cell types. In none of these cultures was nucleoside phosphorylase activity detected, as indicated by the inability of the cells to produce thymine or iodouracil after exposure to the appropriate nucleosides. Also, 5'-AdThd did not affect the breakdown of dTMP by crude preparations of cytosolic 5'-nucleotidase from the different cells. We found that intracellular dTTP pools in the various cell types were substantially high (15-26 microM) compared to the sensitivity of thymidine kinase to inhibition by dTTP (IC50 2-4 microM). This suggests that thymidine kinase is in a strongly inhibited state in situ. To test the sensitivity of thymidine kinase (in situ) to regulation by dTTP we investigated: (a) the effect of depleting intracellular dTTP pools with methotrexate on the uptake of thymidine (dThd); and (b) the effect of pH on the uptake of dThd and its perturbation by 5'-AdThd, since the inhibition of thymidine kinase activity by dTTP is known to be pH dependent. We found that a 47% reduction of dTTP pools by methotrexate in 10T1/2 and HU cells did not result in an increase in thymidine kinase activity, as indicated by the lack of an effect on the uptake of dThd. However, we have previously shown that, under similar conditions, 647V cells show a substantial increase in dThd uptake.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2706630 TI - Regulation of D-beta-hydroxybutyrate dehydrogenase in rat hepatoma cell lines. AB - Quantitation of D-beta-hydroxybutyrate dehydrogenase (BDH) in normal rat hepatocytes was compared with that in two rat hepatoma cell lines, H4-II-EC3 and RLT-3C. BDH activity in normal rat hepatocyte mitochondria was 321 nmol/min/mg, which was greatly reduced to 10.7 nmol/min/mg and 1.7 nmol/min/mg in H4-II-EC3 and RLT-3C cell mitochondria, respectively. The cell growth rate and L [35S]methionine incorporation rate showed that RLT-3C cells had the highest growth rate (32.4-h doubling time) and the fastest protein biosynthesis rate (2.65 x 10(5) cpm/min/10(6) cells). The H4-II-EC3 cell line grew more slowly (48.5-h doubling time) and had lower protein biosynthesis rate (1.46 x 10(5) cpm/min/10(6) cells). The protein synthesis rate in hepatocytes was 1.25 x 10(5) cpm/min/10(6) cells. These results suggest that there is a reciprocal correlation between BDH activity and cell growth and protein synthesis rates. Immunochemical quantitation of BDH showed the amount of BDH in H4-II-EC3 and RLT-3C cells was about 4.8 and 0.5% of that in normal rat hepatocytes, respectively. Quantitation of BDH by biosynthesis indicated that BDH content in H4-II-EC3 cells and RLT-3C cells was 9.3 and 4.0% of that of normal hepatocytes, respectively. Precursor BDH synthesized by in vitro translation primed with RNA of H4-II-EC3 cells or RLT-3C cells was 3.0 and 1.1% of that translated from normal rat hepatocyte RNA. These results suggest that the decrease in BDH content in hepatoma cells results from a decrease in functional BDH-mRNA. The coupling of a decrease in BDH activity with an increase in activity of succinyl-CoA: acetoacetyl-CoA transferase in hepatoma cells may play a role in generating additional energy required for the rapid growth of tumor cells. PMID- 2706631 TI - Modulation by CR-1409 (lorglumide), a cholecystokinin receptor antagonist, of trypsin inhibitor-enhanced growth of azaserine-induced putative preneoplastic lesions in rat pancreas. AB - Feeding of raw soya flour or other trypsin inhibitors such as camostate is a well established method for promoting growth of (pre)neoplastic foci induced in the exocrine pancreas of rats by azaserine. The effect of trypsin inhibitors is thought to be mediated through an increased release of cholecystokinin. Using the specific cholecystokinin receptor antagonist lorglumide (CR-1409), we performed a 16-wk study to investigate the potential of this drug in inhibiting growth of putative preneoplastic foci and to determine whether and to what extent cholecystokinin is responsible for the effect of trypsin inhibitors on pancreatic growth. After initiation with 30 mg/kg of azaserine at 19 days of age, six groups of 15 rats each received one of the following treatments: camostate, cholecystokinin-8, or gelatin control, either or not in combination with CR-1409, once daily, 3 days wk for 16 wk. Plasma cholecystokinin levels, measured 30 min after the stimulus, were similar after camostate and cholecystokinin octapeptide administration. After 16 wk the pancreata were removed, weighted, and quantitatively analyzed for the number and size of putative preneoplastic foci by light microscopy. Both camostate and cholecystokinin octapeptide stimulated pancreatic growth and development of acidophilic putative preneoplastic foci, whereas growth of basophilic putative preneoplastic foci was inhibited by camostate but stimulated by cholecystokinin. CR-1409 almost completely abolished the effect of cholecystokinin and was found to cause a significant decrease in the effects of camostate. It is concluded that (a) cholecystokinin plays a significant role in camostate-stimulated growth of acidophilic putative preneoplastic foci in rat pancreas and (b) CR-1409 inhibits growth of putative preneoplastic foci induced in rat pancreas by azaserine and hence may be of potential value for the treatment of pancreatic cancer in humans. PMID- 2706632 TI - Methylazoxyprocarbazine, the active metabolite responsible for the anticancer activity of procarbazine against L1210 leukemia. AB - Procarbazine is a 1,2-disubstituted hydrazine derivative that is used to treat human leukemias. The anticancer activity of procarbazine results from bioactivation to reactive intermediates. It is first oxidized to azoprocarbazine and further N-oxidized to a mixture of methylazoxyprocarbazine and benzylazoxyprocarbazine isomers. In this study the azoxyprocarbazine isomers were synthesized and purified. The cytotoxic effect of the metabolites on the L1210 murine leukemia cell line were then evaluated in vitro by use of a colorimetric assay using 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide. The results of this study showed that the methylazoxyprocarbazine isomer was the most cytotoxic metabolite (IC50, 0.2 mM). The benzylazoxy isomer had an insignificant cytotoxic effect, and a mixture of the two isomers was intermediate in effectiveness. This assay, however, could not be used to determine the cytotoxicity of procarbazine since the drug itself (not the live cells) reduced the dye. A soft-agar clonogenic assay demonstrated that procarbazine was cytotoxic only at higher concentrations (IC50, 1.5 mM) than methylazoxyprocarbazine (IC50, 0.15 mM). The effect of procarbazine and its metabolites on the survival of L1210 tumor-bearing mice was determined, and methylazoxyprocarbazine was again the most effective compound. These studies demonstrate that the methylazoxyprocarbazine metabolite is probably the major cytotoxic intermediate involved in the mechanism of anticancer action of procarbazine. PMID- 2706633 TI - Identification of a membrane-associated folate-binding protein in human leukemic CCRF-CEM cells with transport-related methotrexate resistance. AB - CEM/MTX cells, a subline of CCRF-CEM cells resistant to methotrexate (MTX) by virtue of impaired transport by the reduced folate/methotrexate transport system, were grown in media containing folate levels in the physiological range rather than in standard media supplemented with high folate concentrations. Over a 7 month period folic acid concentrations were gradually lowered from 2 microM to 2 nM without subsequent changes in the transport-defective phenotype. In these cells we observed the up regulation of a membrane-associated folate-binding protein with high affinities for folic acid and reduced folates, but poor affinities for the folate antagonists MTX and 10-ethyl-10-deazaaminopterin. The binding capacity for [3H]folic acid was 12.5 pmol/10(7) cells, but could be further increased to 30 pmol/10(7) cells following cell transfer to completely folate-deficient medium for 3 days, except that in the latter situation cell growth stopped. The affinities of the folate-binding protein for 5 methyltetrahydrofolate, folinic acid, and MTX were 0.33, 0.11, and 0.009, respectively, relative to that of folic acid. Growth of CEM/MTX cells was promoted by nanomolar concentrations of either folic acid (median effective concentration, 0.35 nM) or folinic acid (median effective concentration, 0.75 nM), suggesting that the folate-binding protein is not only involved in folate binding, but also in the uptake of folates. The insensitivity of CEM/MTX cells to MTX was correlated with the poor affinity of the folate-binding protein for MTX, compared to folic acid. MTX was only growth inhibitory when added at concentrations at least 30-fold exceeding those of folic acid in the culture medium. On the other hand, CEM/MTX cells grown at 2 microM or 2 nM folic acid were equally sensitive to the lipophilic antifolate trimetrexate. Despite the low affinity for MTX, the folate-binding protein could be specifically labeled by an N-hydroxysuccinimide ester of [3H]MTX and appeared to have a molecular weight of 44,000 as shown by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. These data suggest that an alternative folate uptake system, a folate-binding protein, car play an important role in transport-related methotrexate resistance. Moreover, since all these effects were observed for CEM/MTX cells grown at folate levels in the physiological range, it is conceivable that this mechanism of methotrexate resistance can also be of significance in leukemic cells in vivo. PMID- 2706634 TI - Formation and elimination of 7-hydroxymethotrexate in the rat in vivo after methotrexate administration. AB - Bile, urine, and serum concentrations of methotrexate (MTX) and 7-hydroxy methotrexate (7-OH-MTX) were monitored in rats in vivo following a short-time infusion of 10 mg/kg [3H]MTX. The experiments were performed in one group of anesthetized, bile-drained rats and in two control groups, one anesthetized and one unanesthetized, that were not bile-drained. Peak biliary levels of MTX (3.8 x 10(-3) M) and 7-OH-MTX (1.8 x 10(-4) M) appeared within 15 min after cessation of infusions. For two log ranges of serum MTX concentrations, biliary levels remained 180-fold higher. High bile 7-OH-MTX levels appeared few min after start of MTX administration, and were 720 times higher than the peak serum concentrations, indicating that the liver is a major site of 7-OH-MTX formation in the rat. 7-OH-MTX concentrations in bile declined monophasically with a half life of 29.4 min, while MTX showed a biphasic elimination with initial and second phase half-lives of 23.1 and 86.4 min, respectively. Bile was the major excretory route for MTX and 7-OH-MTX, with 50% of the dose recovered as the parent compound and 3.6% as the metabolite. There was no difference in urinary recovery of MTX in bile-drained and control animals, indicative of insignificant enterohepatic circulation of MTX. This was further corroborated by the finding of just 2.1% urinary recovery of MTX in rats who received previously collected MTX-containing bile through a duodenal catheter. Serum concentration curves were analyzed according to a three-compartment open model with an initial elimination half-life of 1.7-3.3 min, a second phase half-life of 15.4-21.0 min, and a terminal phase half-life of 119-240 min. Our finding of 7-OH-MTX formation and high biliary levels of the metabolite in the rat, can be used as basis for studies of interactions with in vivo MTX conversion to the 7-hydroxy metabolite. PMID- 2706635 TI - SC-1, a functional human monoclonal antibody against autologous stomach carcinoma cells. AB - Human monoclonal antibodies were isolated from stomach carcinoma patients by the fusion of spleen and lymph node lymphocytes with the heteromyeloma line SPM4-0. Initial screening was carried out on autologous primary tumor cell cultures in an adhesion assay in order to select surface-reactive functional antibodies. This was followed by live cell immunoperoxidase staining assays. The human monoclonal antibody SC-1 was found to selectively react with cultured cells isolated from autologous and allogeneic stomach carcinoma patients, and with cryostat sections of the primary tumors. More extensive screening revealed that the antibody showed no reactivity with a wide range of tumor tissues and normal cells. Some reactivity was present on fetal tissues. SC-1 inhibits movement of the autologous tumor cells and identifies a protein with a molecular weight of 50,000. This study demonstrates that, with the use of selective screening assays on primary tumor material, it is possible to isolate antibodies which not only result from an immune response in the patient but also interfere with intercellular processes of tumor cells. PMID- 2706636 TI - Effects of reciprocal changes of diets differing in fat content on pulmonary metastasis from the 13762 rat mammary tumor. AB - The effect of changing the amount of polyunsaturated fat in the diet of aged female Fischer 344 rats at the time of tumor implant on metastasis from the 13762 transplantable mammary tumor was studied. Three experiments were performed. (a) Retired breeders, maintained on standard commercial chows until 10 to 12 mo of age, were transferred to high fat (HF, 23% corn oil) or low fat (LF, 5% corn oil) diets for 4 wk; at tumor implant, half of each group were kept on their original diets, while half were changed to the other diet (i.e., HF----HF, HF----LF, LF--- LF, LF----HF). (b) Aged virgins, 14 to 16 mo old, were fed HF and LF diets from weaning; at tumor implant, the LF group stayed on the LF diet, while half the HF group remained on the HF diet and half were changed to LF. (c) Retired breeders were fed Purina rodent chow (5% mainly saturated fat) until tumor implant when they were placed on either the HF or LF diets. Six wk after tumor implant, all rats were necropsied, and the extent of pulmonary metastasis was determined. Data were expressed as volume of pulmonary metastases. In Experiment 1, animals maintained on a HF diet or changed to a HF diet at implant had significantly more pulmonary metastases than those animals kept on a LF or changed to a LF diet. Likewise in Experiment 2, pulmonary metastasis was less in rats which were fed a HF diet from weaning and then changed to LF at tumor implant than in the animals maintained on a HF diet both before and after tumor implant. Finally, in Experiment 3, when rats were changed from Purina rodent chow to either the HF or LF diet at tumor implant, there was no significant difference in the extent of pulmonary metastasis between the two groups; in both, the extent of metastasis was comparable to that seen in animals maintained on the LF corn oil diet. Data on metastasis were also examined in light of body weight, growth of the primary tumor, and food disappearance. These results suggest that the amount of fat consumed by aged rats after tumor implant is an important determinant of the extent of pulmonary metastasis from the 13762 mammary tumor. However, a period of prefeeding the semipurified diets appears to be required in order for the HF corn oil diet to stimulate metastasis in this system. PMID- 2706637 TI - The anticancer drug, cisplatin, increases the naturally occurring cell-mediated lysis of tumor cells. AB - It has been proposed that a component of the antitumor potential of the chemotherapeutic agent, cisplatin, resides in the host's ability to respond to cisplatin-treated tumor cells. Here we report that tumor cells that are normally resistant to lysis mediated by naturally occurring cytotoxic cells showed an increased sensitivity to lysis mediated by murine spleen cells or human peripheral blood monocytes and lymphocytes when cisplatin was added at the beginning of the lytic assay. This was shown for the lysis of both murine and human tumor cells. The pretreatment of tumor cells, but not effector cells with cisplatin caused an increase in lysis in the presence of murine spleen cells or human peripheral blood leukocytes, indicating that the effect of cisplatin is to reduce resistance to lysis by these effector cells. The lysis of tumor cells by naturally occurring cytotoxic cells was blocked by antibodies specific for tumor necrosis factor. In addition, the ability of cisplatin to increase lysis was seen with cells that are sensitive to natural cytotoxic cells, but not with cells that are sensitive to natural killer cells. These results suggest that the effector cells that mediate the lysis of these tumor cells in the presence of cisplatin are likely to be natural cytotoxic cells. The ability of cisplatin to increase the lysis of tumor cells by naturally occurring cytotoxic cells indicates that these cells may be a host defense mechanism that contributes to the anticancer potential of cisplatin. PMID- 2706638 TI - Synergic action between tumor necrosis factor and endotoxins or poly(A.U) on cultured bovine endothelial cells. AB - In order to investigate whether direct effects on tumor vasculature may contribute to induction of necrosis of solid tumors in vivo, agents and combinations with an established different capacity to induce tumor necrosis were studied for their effects on endothelial cells in vitro. Tumor necrosis serum caused a marked inhibition of [3H]thymidine incorporation by bovine umbilical cord endothelial cells after 4 h coincubation. Endotoxin was less inhibitory, whereas detoxified endotoxin and recombinant human tumor necrosis factor (rTNF) were hardly active in concentrations that can be achieved in vivo. Combinations of rTNF and (detoxified) endotoxin caused synergic inhibition. By 24 h effects of the separate agents and synergic effects of the combinations were much stronger. The nontoxic dsRNA, poly(A.U), also had inhibitory activity, and acted synergistically with rTNF. Morphologically, a combination of endotoxin and rTNF but not the separate constituents induced marked cell detachment by 24 h, an indication of cell death. Whereas both endotoxin and rTNF inhibited DNA synthesis of human endothelial cells, the agents did not act synergistically on these cells. The ability of the agents and the combinations to affect endothelial cells in culture appeared to be well in line with their capacity to induce tumor necrosis. Data suggest that direct (synergic) effects on endothelium may contribute to the induction of vascular damage in tumors by (combinations of) the agents. The fact that endothelial cell death is only induced by the combinations and not by the separate agents in vivo, may be a cause of the greater therapeutic activity of the combinations in vivo. The synergy between rTNF and the other agents indicates that the agents act by different mechanisms. PMID- 2706639 TI - A preliminary pharmacokinetic study of 111In-labeled 260F9 anti-(breast cancer) antibody in patients. AB - The pharmacokinetics of 111In-labeled 260F9, a murine monoclonal antibody directed against a breast-cancer-associated antigen, was determined in seven patients with advanced breast cancer. Six patients were administered 1 mg antibody containing 1 mCi 111In. The seventh patient was administered 20 mg unlabeled antibody followed by 1 mg 111In-labeled antibody all via a peripheral vein. Immunoprecipitation, HPLC and SDS-PAGE gels demonstrated the stability of radiolabel on the antibody. The serum clearance of the radiolabel closely fits (r2 greater than 0.95) a two-compartment model for the first six patients. The apparent volume of distribution of the radiolabel approximated to the plasma volume (31) and its mean residence time was 23.7 h. The radiolabel had an average t 1/2 beta of 22.9 +/- 12.21 h at the 1-mg dose. At the 20-mg dose one compartment elimination kinetics were observed with the radiolabel and antibody showing similar mean residence times (36-41 h) and a t 1/2 beta of 26-28 h. Whole body imaging showed that the blood-pool: liver ratio of radioactivity increased fourfold (at 48 h postinfusion) at the higher dose and the percentage of the injected dose of radioactivity in the liver decreased from 25% to 8% (24 h postinfusion). In one patient 7-14 times more radioactivity was localized in a breast tumor than in fat (normal breast). Over the first 25 h an average (cumulative) 7.5% of the total dose was excreted in urine. A study of 260F9 in CDF-1 mice demonstrated that the radiolabel remained associated with the antibody in serum. The antibody, however, cleared 60-fold slower in mice than in patients and showed an increased mean residence time of 191 h. The disparity in the pharmacokinetics of the antibody seen in the mouse and in the clinic, points to the different behavior shown by murine monoclonal antibodies in humans. This points to the need for preliminary studies of antibodies in patients for preclinical evaluations of their effectiveness as drug-targeting agents. PMID- 2706640 TI - Discontinuing therapy in childhood acute lymphoblastic leukemia treated with a chemoimmunotherapy protocol. AB - We examined the results of discontinuing therapy in Japanese children with acute lymphoblastic leukemia. Of the 209 patients in the chemoimmunotherapy study, 120 (57.4%) had all chemotherapy stopped after 3 years of complete remission, and 72 (34.4%) reached the point of discontinuing immunotherapy after 5 years of complete remission. Of the 120 children removed from chemotherapy, 14 (11.7%) have relapsed, mainly in the extramedullary sites (5: testis, 5: bone marrow, 3: central nervous system, 1: bone); relapses occurred 1-23 months after cessation of chemotherapy (median 11 months). Boys had higher post-chemotherapy relapse rate than girls (0.21 versus 0.08, P less than 0.05). None of the 72 children removed from immunotherapy have yet relapsed. Long-term remission and possibly cure can be expected in approximately one-half of newly diagnosed Japanese patients. Although the active immunotherapy had no beneficial effect on the overall outcome for leukemic children, it could be of benefit to the elimination of bone marrow relapses after cessation of chemotherapy. PMID- 2706641 TI - Role of respiratory-burst products from polymorphonuclear leukocytes in the antitumor activity of Propionibacterium acnes vaccine. AB - Tumor cells injected into Balb/c mice together with heat-killed 48-h P. acnes cells were rendered nontumorigenic as early as 12 h after injection, as determined by the inability of the tumor cells to give rise to tumors when transferred to a new host. Determination of tumor cell antigen levels by ELISA indicated that the tumour antigens had virtually disappeared by 24 h after injection of tumor cells and P. acnes. In contrast, in control animals injected with tumor cells only, there was an initial drop in tumor antigen levels at 12 h, after which the level rose steadily and tumors developed in 7-10 days. Since the cellular exudate at 12 h was almost entirely composed of polymorphonuclear leukocytes (PMN), we tested the ability of PMN, stimulated by phagocytosis of 48 h P. acnes cells, to produce substances toxic to tumor cells. Results indicated that the supernatant fluid from a phagocytosis mixture of PMN and P. acnes contained material toxic to tumor cells and also to Chinese hamster ovary cells. Tests with scavengers and inhibitors of oxygen-derived radicals suggested that the toxic material is either hydrogen peroxide (H2O2) or hydroxyl radicals (OH). Suspensions of 12-h P. acnes, P. acnes cells walls, P. freudenreichii, or latex beads were ineffective in preventing tumor growth, and induced little toxicity when phagocytosed. We conclude that in this test system 48-h P. acnes prevents tumor growth by stimulating the production of toxic oxygen metabolites during phagocytosis by PMN. PMID- 2706642 TI - Representativity of endomyocardial biopsies: a theoretical approach based on quantitative light microscopy. AB - To create a model for studying the regional variation in the histologic structure of left ventricular myocardium and the representativity of samples from endomyocardium in predicting the state of myocardium as a whole, 12 human hearts (3 normal and 9 pathological) were investigated with histoquantitative methods. Ten small endomyocardial areas representing biopsy sites (mean area on section 0.94 mm2) were delineated from each heart. The volume fractions of myocardial fibers (VVMY), interstitial space (VVINT) and connective tissue (VVCT) were determined with a point counting method on these areas. Also the mean fiber diameter was measured. The results were compared with the results from three full thickness samples (mean area 3 cm2) from each heart. The values for fiber diameter estimates were almost identical in endomyocardial samples and full thickness samples. On the other hand, VVCT was significantly higher and VVMY lower in endomyocardial samples. The coefficient of variation (10 endomyocardial areas) was 8.3% for fiber diameter, 17.8% for VVMY and 77.5% for VVCT. When estimates of the regional variation within the heart area are available, it is possible to create a model for the prediction of the number of endomyocardial biopsies needed to reach a given accuracy and probability of measurements. The representativity and clinical value of endomyocardial biopsies are discussed on the basis of this statistical approach. PMID- 2706643 TI - Left ventricular diastolic filling improvement obtained by intravenous verapamil in mild to moderate essential hypertension: a complex effect. AB - In order to try and evaluate through what prevailing mechanism verapamil (V) can induce an improvement in left ventricular (LV) diastolic early filling in mild to moderate essential hypertension, 43 properly classified essential hypertensives, aged 41-74 years (mean age 58.1 +/- 10.3), and 20 age-matched normotensives were studied. All subjects underwent both echocardiographic evaluation and 99mTc radionuclide angiocardiography in basal conditions between 8.00 a.m. and noon, after an overnight rest. In essential hypertensives gated equilibrium angiocardiography was repeated 3 and 30 min after i.v. V (0.1-mg/kg bolus, followed by 0.005 mg/kg/min for the period of radionuclide data acquisition). Simultaneously, supine arterial pressure was measured with a cuff manometer. In 36 essential hypertensives a phono-echo evaluation was obtained, both at 3 and 30 min after V, deriving a LV isovolumetric relaxation index (IRTI). Among diastolic early filling indices, we particularly considered the ratio of peak filling rate (PFR) to peak ejection rate (PER) in order to take into account the interaction of systolic performance with LV relaxation and diastolic early filling. Three minutes after V the increase in PFR (from 2.47 +/- 0.5 to 3.04 +/- 0.8 EDV/s, p less than 0.001) and the upwards tendency of PFR/PER were coupled with the enhancement in ejection fraction (from 61.1 +/- 13.3 to 63.9 +/- 13.8%, p less than 0.001) and heart rate (from 70.3 +/- 12.6 to 77.7 +/- 12.2 b/min, p less than 0.001) and with the reduction in mean arterial pressure (from 122 +/- 16 to 107 +/- 14 mm Hg, p less than 0.001), systemic arterial resistance index (from 3,234 +/- 968 to 2,432 +/- 678 dyn s cm-5 m2, p less than 0.001) and end-systolic volume index (from 32.9 +/- 17.1 to 31.5 +/- 18.3 ml/m2, p less than 0.02). On the contrary, 30 min after V, when systolic indices, heart rate, mean arterial pressure and systemic arterial resistance index had returned towards baseline values, PFR/PER showed a persistent improvement when compared with basal values (0.71 +/- 0.12 vs. 0.63 +/- 0.08, p less than 0.005). No changes were observed in LV volumes and IRTI, either at 3 or 30 min. Moreover, also the pulmonary blood volume ratio was unchanged. A weak negative correlation was found between delta % of IRTI and delta % of PFR/PER 30 min after drug administration (r = 0.58, p less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2706644 TI - Pre- and intraoperative identification of multiple accessory pathways. Experience of 19 pathways in 9 patients. AB - The pre- and intraoperative electrophysiological studies in 9 patients with two or more accessory pathways are described. The presence of multiple accessory pathways was clinically suspected in only 2 patients. During the preoperative electrophysiological study two accessory pathways were identified in 7 patients and a single pathway in 2 patients. At operation, additionally three accessory pathways were identified in 3 patients. One out of two pathways, found preoperatively, could not be confirmed in 1 patient. It is concluded that the clinical or preoperative electrophysiological evidence of only one accessory pathway should not distract one's attention from considering multiple accessory pathways in patients presenting only one type of tachycardia. PMID- 2706645 TI - Diagnosis of dual accessory pathways by ajmaline test. AB - In a patient with the Wolff-Parkinson-White syndrome, the existence of dual accessory pathways, both right-sided, was suspected during ajmaline test and confirmed during electrophysiologic study. The first accessory pathway was manifest in sinus rhythm while the second was obscured and revealed during low right atrial pacing. Ajmaline abolished conduction over the first pathway which most probably had a long refractory period allowing manifestation of the second pathway which had a very short refractory period. A longer conduction time over the second accessory pathway was suggested to explain its concealment during sinus rhythm. PMID- 2706646 TI - Cardiovascular malformations in lecanosomatopagus conjoined twins: a cardiologic curiosity. AB - Female conjoined twins were delivered after 42 weeks' gestation, but they died within a few minutes of birth. They were dicephalus, dibrachius and dipus conjoined twins with two separate spines and fusion of the trunk and the pelvis. The pericardial sac was common, and the heart was a single structure. The atrial complex was a common chamber with an attempt at division into two parts by a circular ridge of tissue; the ventricular complex was formed by three chambers which were all communicating between each other in the superior margin of their muscular interventricular septum. PMID- 2706647 TI - Cardiovascular mortality in patients with rheumatoid arthritis. AB - Patients with rheumatoid arthritis (RA), 500 men and 500 women, aged 40 years and over, together with a control population matched by age and sex were followed up with respect to cause-specific mortality over a 10-year period. The overall mortality was significantly higher in both men and women with RA than in the controls. A statistically significant increase in mortality from all cardiovascular diseases (p less than 0.001) and cardiac diseases (p = 0.004) was observed in men with RA but not in women with RA compared to corresponding controls. No difference in mortality from cerebrovascular diseases was observed between RA patients and controls. PMID- 2706648 TI - Heart failure. PMID- 2706649 TI - Neurons in primary cultures from five defined rat brain regions--cellular composition and morphological appearance. AB - Primary cultures from 15-17 days old fetal rat cerebral cortex, striatum, hippocampus, substantia nigra and brain stem were grown for ten days. Cell aggregates were formed one to two days after seeding. The cell bodies migrated peripherally from the clusters during development and networks of processes were formed. The cultures from the different brain regions contained predominantly neurons, stained by an antiserum against the neuron-specific enolase (NSE). There were differences in morphological appearance of the aggregates and also of the single neuronal cells cultivated from the various brain regions. On the bottom of the culture dishes a monolayer was formed of predominantly undifferentiated (mesenchymal-like) cells. Some cells of the monolayer stained for the astrocyte markers glial fibrillary acidic protein (GFAp) or S-100. The majority of the cells were, however, unstained to these markers. Very few endothelial cells and macrophages were observed. PMID- 2706650 TI - Electron microscopic studies on chromatin loop of rat ascites hepatoma cells. AB - Isolated nuclei from rat ascites hepatoma cells were treated with 0.09% detergent Joy and chromatin, protruded from the nucleus, was observed with an electron microscope. It was demonstrated that most, but not all of the protruded chromatin fibers had a loop structure. The protrusion of chromatin from the nucleus was 3 microns in average length. A high magnification view showed that the protruded chromatin consisted mainly of beaded nucleosomal fiber. Therefore, the chromatin loop size at the level of nucleosomal fiber was estimated to be at least 6 microns in length. PMID- 2706651 TI - Role of hexokinase in controlling the glucose metabolism flux: a study of its flux control coefficient in different tissues. AB - Flux control coefficients of hexokinase for glucose metabolism in different rat tissues have been determined, showing that the hepatocyte cytosolic hexokinase is the only one which plays an important role in the control of the glucose-input flux studied among the different tissues. Explanation of these results are given in terms of the kinetics features of hexokinase and the metabolic role of glucose in these tissues. PMID- 2706652 TI - Acetyl-cholinesterase and fluoride-resistant acid phosphatase activities in dorsal root ganglia in the rat. AB - Acetylcholinesterase and fluoride-resistant acid phosphatase activities were contrasted in alternative serial sections of rat dorsal root ganglia. The morphometric analysis demonstrated no correlation between cellular size and enzymatic activity. Differences with previous works in this area are discussed. PMID- 2706653 TI - High density lipoproteins during rat liver regeneration. AB - Compositional and maturative parameters of high density lipoproteins (HDL) have been examined during the early stages of rat liver regeneration, when lecithin:cholesterol acyltransferase (LCAT) activity, responsible for the maturation of this lipoprotein class, is markedly decreased. Both HDL subclass distribution and chemical composition are not significantly different from the control, except for a slightly lower cholesterol ester content. Few disc-shaped particles are detectable by electron microscopic observation. Cholesterol ester decrease and presence of immature particles are related, but the entity of the modification is lower than suggested by the deep decrease of LCAT activity. This seems to indicate that proper HDL maturation is assured in the regenerating liver despite low LCAT activity. PMID- 2706654 TI - Effect of a diet low in methionine-cysteine on rat liver chromatin and nuclear proteins. AB - Rats were fed a diet low in methionine-cysteine for 6 days. One group was given the control diet after 6 days of methionine-cysteine restriction. Liver nuclei were isolated and incubated with 30 units DNA-A I (EC 3.1.4.5) per mg of DNA for 20 min. at 27 degrees C. The lysed nuclei were fractionated into a 1100 x g pellet P1 and a supernatant fraction S1. Protein distribution was analyzed by SDS polyacrylamide gel electrophoresis. In the methionine-cysteine restricted group histone H1 relative to the other proteins was increased in the P2 fraction. Relative to the total content of histone H1 the subtype H1:2 was increased and H1(0) decreased. Refeeding the missing amino acids or pair-feeding of the rats gave results similar to the controls. On agarose gel electrophoresis, DNA of the P1 chromatin of the methionine-cysteine restricted rats migrated at a slower rate than that of the refed, pair-fed or control group, indicating a more compact structure of higher resistance to DNA-A I in the chromatin of the amino acid restricted rats. The results correlated with a diminished transcription activity in these animals. The alterations in the relative composition of histone H1 were the result of or the reason for the modulation in the chromatin structure observed after the restricted intake of the amino acids methionine-cysteine. PMID- 2706655 TI - Acceleration by triiodothyronine of adipose conversion of rat preadipocytes from two adipose localizations. AB - Since we have previously reported that hyperthyroidism induces adipose tissue hyperplasia in the young rat, the effect of thyroid hormones on growth and differentiation of preadipocytes from retroperitoneal (RPAT) and epididymal (EAT) adipose tissue was studied in a primary culture system which allows a precocious cell differentiation. In this culture system, preadipocytes from RPAT exhibited a greater potentially to differentiate than cells from EAT. Chronic exposure to triiodothyronine (T3) induced an acceleration of the differentiating process as shown by a transient increase of the number of differentiated cells without alteration of cell multiplication. This effect was more important in cultures of cells from RPAT than from EAT. T3 was ineffective on lipoprotein-lipase activity but induced a stimulation of the esterification pathway which was durable and could likely be related to an increased lipid turn-over. T3 induced also a stimulation of fatty acid biosynthesis, only on the first stages of morphological differentiation which suggests that this effect could be specifically in relation with the stimulation of adipose conversion. PMID- 2706656 TI - An experimental and ultrastructural study on the development of the avian choroid plexus. AB - The choroid plexus consists of the choroidal epithelium, a derivative of the neural tube, and the choroidal stroma, which originates from the embryonic head mesenchyme. This study deals with epithelio-mesenchymal interactions of these two components leading to the formation of the organ. Grafting experiments of the prospective components have been performed using the quail-chicken marker technique. Prospective choroidal epithelium of quail embryos, forced to interact with mesenchyme of the body wall of chicken embryos, gives rise to a choroid plexus showing normal morphogenesis and differentiation. The choroidal epithelium induces the differentiation of organ-typical fenestrated capillaries, which are highly permeable to intravenously injected horseradish peroxidase. The choroidal epithelium of the grafts constitutes a blood-cerebrospinal fluid barrier. On top of the choroidal epithelium, there are epiplexus cells displaying a typical ultrastructure. The experimental results show that these cells do not originate from the transplanted neural epithelium. Prospective choroidal stroma of chicken embryos does not exert a choroid plexus-inducing influence upon a quail embryo's neural epithelium isolated from parts of the brain that normally do not develop a choroid plexus. The experiments show that the choroidal epithelial cells are determined at least three days before the first organ anlage is detectable. PMID- 2706657 TI - Ultrastructural and biochemical studies of lipolysis by lipolysosomes in chick hepatocytes. AB - Lipolysosomes in chick hepatocytes were studied by biochemical and electron microscopic techniques. Their lipolysis was investigated in vitro using the floating lipid fraction isolated from chick liver homogenates. Many lipid droplets were noted to be enveloped by a unit membrane with a partially thickened electron-dense layer containing some myelin-like structures, electron-dense material or electron-lucent droplets, close to the inner leaflet of the membrane. Cytochemically, the dense layer showed acid phosphatase activity, and thus the lipid droplets were identified as lipolysosomes. The lipolysosomes isolated in a floating lipid fraction retained the characteristic dense layer and the surrounding membrane, and the fraction showed little contamination by other organelles. Free fatty acids were released in the fraction after incubation at 37 degrees C, but not at 0 degree C. The reaction was completely inhibited by HgCl2, p-chloromercuribenzoate and esterastin, a potent inhibitor of acid lipase. These results suggest an involvement of acid lipase in lipolysis of the lipolysosomes. PMID- 2706658 TI - Role of intestinal mucus in crystal biogenesis: an electron-microscopical, diffraction and X-ray microanalytical study. AB - In the posterior intestine of the sea-water eel, mucus plays an important role in biocrystallization of calcium ions. By means of transmission and scanning electron microscopy associated with X-ray microanalysis and X-ray diffraction it has been possible to determine the role of mucous fibers as nucleation sites. Biocrystallization occurs in 2 steps: (1) Calcification of mucus. As soon as mucus is excreted in the intestinal lumen, it is loaded with calcium, as shown by lanthanum affinity and X-ray microanalysis on freeze-dried tissues. (2) Genesis of crystals. Needle-shaped crystallites build up in coalescent spherites in the intestinal lumen near the microvilli. Genesis occurs as follows: (a) crystallite mineralization by nucleation in an organic matrix composed of glycoproteinaceous mucous fibers, followed by the appearance of spherites; (b) coalescence in spherites and association of spherites in rhombohedra; (c) extrusion of organic material during the final step of crystallization. PMID- 2706659 TI - Early stages of ciliogenesis in the respiratory epithelium of the nasal cavity of rabbit embryos. AB - Previous studies have shown that ciliogenesis in the epithelial cells of various species exhibits similarities as well as differences. In an attempt to establish whether this process is identical in epithelial cells of a single species, early stages of centriole formation not previously described were encountered. Ciliogenesis was investigated in the respiratory epithelium of the nasal cavity of 18 to 23-day-old rabbit embryos. The appearance of groups of deuterosomes and fibrous granules is followed by the radial formation of procentrioles around the deuterosomes and parent centrioles. The majority of the procentrioles, forming acentriolarly, occur in pairs, with their distal ends facing each other, between the deuterosomes. Subsequent growth of these procentrioles between deuterosomes in a group results in separating the deuterosomes from one another. The deuterosomes, however, still remain interconnected by means of the growing procentrioles. Accordingly, long chains and networks consisting of the above mentioned structures are formed. After the procentrioles have attained a certain length, the chains and networks split into separate deuterosome-procentriole complexes. During these earlier stages of ciliogenesis fibrous granules are present, however, their function is yet to be determined. PMID- 2706660 TI - Immunohistochemical localization of glial fibrillary acidic protein (GFAP) and vimentin in the subcommissural organ of the Mongolian gerbil (Meriones unguiculatus). AB - The chemical composition of intermediate filaments (IF's) in the ependyma of the subcommissural organ (SCO) of the Mongolian gerbil (Meriones unguiculatus) was investigated immunohistochemically in paraffin-embedded tissue. Antibodies against glial fibrillary acidic protein (GFAP), vimentin, neurofilament proteins and cytokeratins were used. Only GFAP and vimentin were detected in the non specialized diencephalic ependyma and in the ependymocytes of the SCO. Staining could be observed in apical and basal processes of the SCO-cells. The latter processes extended into the posterior commissure up to the subpial surface, thus establishing a well-developed leptomeningeal route of ependymal projections. In contrast to the homogeneous vimentin-labeling, the SCO was particularly immunoreactive for GFAP in its lateral aspects and in the supra- and precommissural parts. The coexpression of GFAP and vimentin in a subclass of SCO ependymocytes was demonstrated on differentially immunostained semithin sections. The present study confirms the glial nature of the SCO-ependyma, which has been a matter of debate recently. It appears from this investigation that the high degree of secretory activity in the SCO does not necessarily lead to the disappearance of glial IF proteins. Moreover, the SCO-cells belong to the expanding group of mature astroglia, which is characterized by coexpression of GFAP and vimentin. The morphological similarity between SCO-ependymocytes and tanycytes is underscored by their common immunoreactivity against these two IF proteins. In view of the absence of GFAP from the rat SCO, interspecific differences must be considered in the evaluation of the IF protein composition. PMID- 2706661 TI - Localization of calcium and phosphorus in early predentin-matrix components by electron spectroscopic imaging (ESI)-analysis in rat molars. AB - The subcellular distribution of the inorganic elements calcium (Ca) and phosphorus (P) was studied in the first-formed dentin matrix during initial mineralization in neonatal rat molars. This most peripheral matrix region is comprised of a proteoglycan-rich ground substance, interwoven by a collagenous network, matrix vesicles, aperiodic fibrils derived from the dental basal lamina, and apical odontoblastic cell processes. All matrix components may possibly serve as templets for mineral deposition during initial calcification of first-formed mantle dentin and predentin. By means of the very sensitive ESI-analysis we studied the subcellular localization of Ca and P and their possible association with distinct organic extracellular matrix components and odontoblasts. Ca signals were found in the ground substance, at striated collagen fibrils and plasma membranes of odontoblasts in the cuspal early matrix region, but occurred only sparsely in the ground substance of the more distal matrix region where odontoblast processes attach to aperiodic fibrils of the dental basal lamina. Ca was generally absent in matrix vesicles. In contrast, P-signals were found in matrix vesicles, at aperiodic fibrils and at the plasma membranes of odontoblasts. Ca and P co-localized at striated collagen fibrils (type I or II). These results suggest that striated collagen fibrils might serve as primary deposition sites for calcium phosphate during early biological calcification of organic extracellular macromolecules. PMID- 2706662 TI - Terminal processes of serotonin neurons in the caudal spinal cord of the molly, Poecilia latipinna, project to the leptomeninges and urophysis. AB - The caudal neurosecretory complex of poeciliids has previously been shown to be innervated by extranuclear and intrinsic serotonergic projections. In the present study, immunohistochemical techniques were used to characterize fibers originating from serotonin neurons intrinsic to the caudal spinal cord. Bipolar and multipolar neurons were oriented ventromedially, and contained numerous large granular vesicles. Three types of serotonergic fibers were distinguished based on their distribution and morphology. Intrinsic Type-A fibers branched into varicose segments near the ventrolateral surface of the spinal cord and contacted the basal lamina beneath the leptomeninges. Type-B fibers coursed longitudinally to enter the urophysis, where they diverged and terminated around fenestrated capillaries. Labelled vesicles in Type-A and Type-B terminals were the same size as those in labelled cells and in unlabelled neurosecretory terminals in the urophysis. Type-C small varicose fibers branched within the neuropil of the caudal neurosecretory complex. Serotonin may be secreted into the submeningeal cerebrospinal fluid, the urophysis, and the caudal vein by Type-A and Type-B fibers, whereas, Type-C fibers may be processes of serotonergic interneurons in the neuroendocrine nucleus. The possibility that urotensins I and II or arginine vasotocin were colocalized in the processes of the intrinsic serotonin neurons was investigated immunohistochemically. The negative results of these experiments suggest that serotonin-containing neurons may represent a neurochemically distinct subpopulation in the caudal neurosecretory complex. PMID- 2706663 TI - Appearance of lectin-binding sites during vascularization of the primordium of the central nervous system in 10 to 12-day-old mouse embryos. AB - In the present study lectin-binding sites were investigated for the lectins Ricinus communis agglutinin (RCA I), wheat germ agglutinin (WGA), soya bean agglutinin (SBA), concanavalin A (Con A), Lotus tetragonolobus-(LTA) and Limulus polyphemus agglutinin (LPA) during the initial stages of vasculogenesis of the CNS-anlage in 10 to 12-day-old NMRI mouse embryos. Specific binding sites for the lectins RCA I (sugar specificity: beta-D-galactose, N-acetylgalactosamine), WGA (sugar specificity: N-acetylglucosamine, sialic acid), and SBA (sugar specificity: N-acetylgalactosamine, beta-D-galactose) were detected in the newly formed capillaries within the neuroepithelial cell layer. In contrast, binding sites for Con A, LTA and LPA could not be observed at the start of the vascularization of the CNS-anlage. From these results, the conclusion can be drawn that glycoconjugates containing D-galactose, N-acetylgalactosamine and N acetyl-glucosamine moieties are involved in the early vasculogenesis of the embryonic CNS-anlage of the mouse. PMID- 2706664 TI - Formation of a new fibrous attachment to human dental roots. Effect of co culturing periodontal ligament-derived and allogenic cortical bone-derived cells. AB - Human periodontal ligament cells have been shown to produce a new fibrous attachment at the surface of scaled dental root discs in vitro. The purpose of this investigation was to answer the question whether cells derived from human alveolar bone would enhance this attachment. Three partially erupted third molars were extracted and collected from one female patient and used for harvesting periodontal ligament cells as well as for cutting 0.3 mm dental root discs. Cells derived from alveolar bone were obtained by enzymatic digestion of bone chips harvested after extraction of wisdom teeth from three additional patients. Experimental cultures were prepared by seeding 1.0 x 10(6) suspensions of periodontal ligament cells onto five Puropor-200 filters. The following day, root disc pairs were placed on the cell layer, leaving a gap (interdental space) of 0.1-0.3 mm. Five days later, all cultures received equal aliquots of alveolar bone cells. The cultures were terminated and processed for microscopic and morphometric evaluation after 56, 112 and 124 days. All cultures demonstrated a dense fiber-fringe attachment along most of the cementum-lined surfaces of root discs. Adjacent to other root-disc surfaces, cells were surrounded by halos of their collagenous product. Mean diameters of collagen fibrils for the 56-, 112- and the two 124-day cultures were 64.6, 48.9 and 62.6 nm, respectively. Compared to results obtained in this system with periodontal ligament cells alone (Bernstein et al. 1988), the fiber fringe in this experiment was denser, composed of collagen fibrils with a larger diameter, and maintained for longer duration in culture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706665 TI - Neural activity pattern is not necessary for the development of adult ultrastructure in katydid (Neoconocephalus robustus) singing muscles. AB - The singing muscles of the katydid Neoconocephalus robustus develop adult ultrastructure late in the last nymphal instar and during the first few days of adult life. The ultrastructural changes during early adulthood were not affected by unilateral axotomy shortly after the adult molt. Both denervated and innervated muscles developed adult proportions of mitochondria, myofibril, and sarcoplasmic reticulum and transverse tubules. PMID- 2706666 TI - Cultured fetal rat pituitaries kept in synthetic medium are able to initiate synthesis of trophic hormones. AB - An immunohistochemical study was performed to determine the capacity of early fetal pituitaries to differentiate into specific hormone-synthesizing tissue in the absence of any influence from the central nervous system. Rathke's pouches from rats were removed from their juxtadiencephalic position on day 11 and 12 of gestation and maintained for 2-7 days in a chemically defined culture medium (M 199) without antibiotics and serum supplementation. The immunocytochemical observations provided evidence for the differentiation of ACTH-, TSH-beta-, LH beta-, FSH-beta-, GH- and PRL-synthesizing cells in the isolated organ cultured from 11 to 12-day-old pituitary primordia. The appearance of specific hormone synthesizing cells in vitro displayed a delay of 1.5-2 days compared to the day of appearance in vivo, however, the sequential order of developmental events occurred as observed in vivo. The present results suggest that endocrine or neuroendocrine signals are not required for the expression of specific secretory functions of fetal pituitaries, at least at an age of 11-12 days. PMID- 2706667 TI - Immunocytochemical localization of hypocalcin in the endocrine cells of the corpuscles of Stannius in three teleost species (trout, flounder and goldfish). AB - In order to identify the cell-type responsible for the production of hypocalcin (the recently isolated hypocalcemic hormone of teleost fish), the corpuscles of Stannius (CS) of trout, flounder and goldfish, were immunocytochemically stained with antisera raised against trout hypocalcin. The secretory granules of the type 1 cells of the CS, considered to be the hypocalcin-producing cells, showed intense immunoreactivity in all species examined. However, in trout and flounder, the secretory granules produced by the type-2 cells, which have been suggested to represent a functionally different cell-type, also showed an intense immunoreactivity. In goldfish, no type-2 cells were observed. We tentatively conclude that type-1 and type-2 cells represent structurally different forms of the same functional cell-type. PMID- 2706668 TI - High resolution scanning electron-microscopic study on the three-dimensional structure of the sarcoplasmic reticulum in the slow (tonic) muscle fibers of the frog, Rana nigromaculata. AB - The three-dimensional structure of the sarcoplasmic reticulum (SR) in the slow (tonic) fibers of the rectus abdominis muscle of the Japanese meadow frog (Rana nigromaculata nigromaculata Hallowell) was examined by high resolution scanning electron microscopy, after removal of the cytoplasmic matrices by the osmium-DMSO osmium procedure. The SR forms a repetitive network throughout these fibers. At the level of the Z-line, a slender transverse tubule (T-tubule) runs transversely to the longitudinal axis of the myofibril. Small, spherical or ovoid terminal cisternae couple laterally with the T-tubule at intervals of 0.4-1.0 microns, and form a "terminal cisterna-T-tubule complex" on whose surface tiny indentations are occasionally seen. Each terminal cisterna gives rise to a few sarcotubules that run in various directions, divide frequently and form circular or oval meshes of diverse sizes in front of the A- and I-bands. The sarcotubules usually form small meshes in the middle of the A-band, but occasionally fuse and form a poorly developed H-band (fenestrated) collar. PMID- 2706669 TI - Cilia on bovine mammary epithelium: ultrastructural observations. AB - Ultrastructural examination of bovine mammary tissues revealed the presence of 9+0 or primary cilia protruding from surfaces of alveolar epithelial and myoepithelial cells. Cilia of epithelial cells protruded approximately 1200 nm into lumina of alveoli and arose from a basal body centriole, the associated centriole of the diplosome, and an accessory rootlet system. Cilia on epithelial cells were more frequently observed than cilia on myoepithelial cells. Occasional cilia made contact with macrophages in the alveolar lumen. The structures were more commonly found in tissues from nonlactating cows, and most were observed in the ventral portion of the mammary gland. PMID- 2706670 TI - Chronic paroxysmal hemicrania (CPH): nomenclature as far as the various stages are concerned. PMID- 2706671 TI - Lateralization of headache: possible role of an upper cervical trigger point. AB - An ipsilateral upper neck trigger point was found in 21 of 24 patients with unilateral headache. During the prodromic period this trigger point was detected as a tender protrusion on neck palpation. In 18 out of 24 patients it was also found during the headache-free period. On standard roentgenogram, this protrusion seemed to be a laterally developed C2 spinous process. The EMG study showed latent trapezius hypertonicity on the side of the headache, even during the headache-free period. The association of the painful protrusion and trapezius hypertonicity could create an autoreinforcing nociceptive loop, which in turn could be the cause of lateralization of the pain. PMID- 2706672 TI - Personality and memory in childhood migraine. AB - A series of neuropsychological tests were administered to a group of healthy children and another group suffering from common migraine. The tests demonstrated that children with common migraine do not have definitely abnormal personality traits even though inhibition of aggressivity and greater anxiety levels following certain environmental stimuli were seen. We also observed a decreased short- and long-term memory function in children with common migraine. PMID- 2706673 TI - Platelet catecholamines in migraine. AB - We measured platelet levels of norepinephrine (NE), epinephrine (E), and dopamine (DA) in migraine patients. Platelet NE was selectively increased in common migraine. This is attributed to platelet dense body hyposecretion. PMID- 2706674 TI - Psychologic factors in chronic headache: assessment by means of the SCL-90-R inventory. AB - A survey of the psychologic profile of 540 chronic headache cases, including migraine, tension, and mixed headache, has been carried out with the symptom check list (SCL)-90-R inventory. The results obtained were viewed in relation to sex, age, illness onset, and illness duration. Females showed a positive correlation of somatization with present age and with age at onset of illness and a negative correlation of interpersonal sensitivity, hostility, and paranoid ideation with present age and age at onset of illness. Men showed a negative correlation of obsessive-compulsive and paranoid scores with age and a positive correlation between onset of illness and somatization. Data were also analyzed by cluster analysis, which showed underpopulation with peculiar patterns of symptom profile. A prospective, long-term epidemiologic study could provide more conclusive results. PMID- 2706675 TI - Migraine and intracerebral hemorrhage. AB - Stroke is a well described complication of migraine. Recently, attention has been drawn to the development of cerebral hemorrhage in middle-aged patients with common migraine. We report a patient with classic migraine who developed an intracranial hemorrhage 36 h after the onset of a migraine attack and had a good recovery over a period of six days. Including our patient there are now five cases, all females, with this complication of migraine. It is postulated that the condition is fairly common and under reported. PMID- 2706676 TI - Horner's syndrome. Sweat gland and pupillary responsiveness in two cases with a probable 3rd neurone dysfunction. AB - Two patients with a Horner's syndrome due to a probable 3rd neurone lesion were examined with regard to the pupillometric and evaporimetric patterns. The results are compared with those found in patients with a Horner's syndrome due to a 1st or 2nd neurone lesion, previously described by our group. Concurring with observations by others, the pupil on the symptomatic side did not dilate at all when stimulated with hydroxy-amphetamine eye drops. Postganglionic dysfunction may thus be distinguished from 1st and 2nd neurone dysfunction. Supersensitivity was present on the side of the Horner's syndrome, both on pupillometry (phenylephrine stimulation) and in the medial part of the forehead at evaporimetry (pilocarpine stimulation). The lateral part of the forehead, however, did not demonstrate deficient evaporation in these postganglionic sympathetic lesions. PMID- 2706677 TI - Muscle contraction headache and migraine. Platelet activation and plasma norepinephrine during the cold pressor test. AB - For clarification of possible platelet activation in migraine and chronic muscle contraction headache (MCH) under stress, plasma platelet factor 4 (PF4), norepinephrine (NE), and free fatty acids (FFA) were investigated during the cold pressor test. Both PF4 and NE increased significantly, whereas FFA showed no remarkable changes. The increases of PF4 in MCH and migraine during this test were significantly greater than in healthy controls. The increase of PF4, however, was independent of NE increase and FFA changes. On the other hand, we observed decreased NE levels in both MCH and migraine, which might suggest peripheral sympathetic hypofunction. The platelets of MCH or migraine patients seem to be impaired, and the impairment may be caused by continuous sympathetic hypofunction. The behaviour of the above three substances in MCH was similar to that in migraine throughout the present study. PMID- 2706678 TI - Unilaterality of headache in classic migraine. AB - The localization of a headache is a matter of importance for the diagnosis. Migraine is considered to be a unilateral headache. There is, however, only limited information available on the constancy of the unilaterality: how frequently is the pain locked to one side? This aspect is of importance in the differential diagnosis vs. cervicogenic headache, where the pain persistently seems to occur on the one side. In the present study, 31 cases (26F, 5M with a mean age of 40 years; range: 17-63) with a diagnosis of classic migraine were questioned with regard to laterality of headache at the first consultation. A unilaterality as such was present in 42%; unilaterality alternated with bilaterality in 42% of the cases; unilaterality in some form was therefore found in 84% of the cases. In classic migraine, unilaterality thus seems to outweigh bilaterality. In every case of unilaterality there was a sideshift. A side-locked unilaterality thus seems to be a rare phenomenon in classic migraine. These patients were followed-up after between 3 and 9 years; they then filled in a questionnaire (response rate: 81%). The consistency between the two sets of information in the responders was good. Only one case (possibly two) showed a side-locked unilaterality at the time of the questionnaire. PMID- 2706679 TI - Variants of chronic paroxysmal hemicrania. PMID- 2706680 TI - Cluster headache: combined assessment with pupillometry and evaporimetry. PMID- 2706681 TI - Single coronary artery from the left sinus of Valsalva. AB - A patient with chronic exertional angina and electrocardiographic signs of myocardial ischemia at exercise stress test had recent onset of rest chest pain and underwent coronary arteriography. Besides severe atherosclerotic coronary disease (which was probably responsible for clinical presentation), a single coronary artery arising from the left sinus of Valsalva was discovered. This is an exceptional finding, and its in-life diagnosis may be relevant for surgical treatment. PMID- 2706682 TI - Myocardial infarction due to multiple coronary-ventricular fistulas. AB - Coronary-ventricular fistulas have been described in both right and left coronary arteries and have been implicated in causing cardiac symptoms and coronary ischemia. We present a case of three-vessel coronary-ventricular fistulas emptying into both ventricles, associated with a left-to-right shunt and a myocardial infarction. PMID- 2706683 TI - A wire technique to cross the congenitally stenotic aortic valve. AB - We describe a double-catheter "rendezvous" technique that allows the successful placement of a balloon valvotomy catheter retrogradely across a congenitally stenotic aortic valve when traditional single-catheter retrograde methods fail. An important therapeutic procedure that might otherwise be abandoned can be completed with only the additional procedure of a transseptal atrial puncture and a second arterial entry. PMID- 2706684 TI - An improved catheter design for crossing stenosed aortic valves. AB - Retrograde catheterization of the left ventricle in patients with aortic valve stenosis is commonly performed using a pigtail or coronary arterial catheter. This approach, although usually ultimately successful, may be highly tedious. To overcome the limitations of these conventional catheter shapes, we have designed a catheter specifically for crossing stenotic aortic valves. In a group of 17 patients, mean aortic valve area 0.75 cm2, the average time to cross the aortic valve was 2 minutes 45 seconds and the median time 30-40 seconds. Once the proper size catheter was selected, the average time to cross was 59 seconds. The success of this catheter is based on the operator's ability to "scan" or interrogate the surface of the valve thoroughly by manipulating the catheter and a moveable core straight tip guidewire. PMID- 2706685 TI - Stimulatory effects of protein synthesis inhibitors on the spreading rate of 3T3 cells. AB - Three protein synthesis inhibitors, puromycin, cycloheximide and anisomycin were found to increase the rate of spreading of Swiss-3T3 cells after 1 h incubation in the presence of low concentrations of serum. Data from experiments with anisomycin suggest that this effect is roughly proportional to the extent of inhibition of protein synthesis. PMID- 2706686 TI - The competence of transformed keratinocytes to differentiate is accompanied by amplification of the LDL- and EGF-receptor genes but not of the insulin receptor gene. AB - The possible relationship between cell surface receptor numbers, receptor gene expression for low density lipoprotein (LDL), insulin and epidermal growth factor (EGF), and differentiation capacity has been studied in normal and SV40 transformed (SVK14) keratinocytes, various squamous carcinoma cell (SCC) lines and A431 cells. Our recent studies demonstrated that an inverse relationship exists between LDL- and EGF-receptor binding and the ability to differentiate of both normal and transformed keratinocytes. In the present study cloned LDL- and EGF-receptor complementary DNAs were used as probes to identify both LDL and EGF receptor gene fragments on genomic DNA blots. The extent of hybridisation was found to be increased to the highest extent in A431 cells and decreased in other cells in the following order SCC-4 greater than SCC-15. In SCC-12F2, SVK14 and normal keratinocytes no increase has been observed. The increased hybridisation of LDL- and EGF-receptors in A431, SCC-4 and SCC-15 cells was found to be due to gene amplification and not to aneuploidy. In contrast to the LDL- and EGF receptor binding, no correlation has been found between insulin receptor binding and ability of cells to differentiate. Furthermore, no amplification of insulin receptor gene has been observed in any of the cells under study. PMID- 2706687 TI - Bovine colostric transforming growth factor-beta-like peptide that induces growth inhibition and changes in morphology of human osteogenic sarcoma cells (MG-63). AB - TGF-beta like peptide, termed TGF(BC-1), was partially purified from defatted and decaseinated bovine colostrum by a sequence of DEAE-Sephacel chromatography and Sephadex G-50 gel filtration in 1M acetic acid. TGF(BC-1) was distinct from well known 25K TGF-beta in chemical properties: TGF(BC-1) was sensitive to acid ethanol extraction (Roberts et al., 1980). Its apparent molecular weight ranged from 21k to 11k by gel filtration and it was composed of low MW peptides (15k, 13k, 10k and 7.3k but not 25k) as examined by SDS-PAGE under non-reducing conditions. However, TGF(BC-1) shares some biological properties with the prototype TGF-b. TGF(BC-1) remarkably suppressed growth of osteogenic sarcoma cells (MG-63), and this was intriguingly accompanied by a striking change in morphology. PMID- 2706688 TI - Effects of IGF-I, rGH, FGF, EGF and NCS on DNA-synthesis, cell proliferation and morphology of chondrocytes isolated from rat rib growth cartilage. AB - The effects of IGF-I, rGH, FGF, EGF and NCS on DNA-synthesis were analyzed in resting, proliferative and hypertrophic chondrocytes obtained by fractionation. Proliferation and morphology were studied on non-fractionated cells. The highest stimulation of DNA-synthesis was induced by NCS followed by IGF-I at all stages of chondrocyte differentiation. DNA-synthesis was also stimulated by a low concentration of FGF (1 microgram/1) in proliferative and hypertrophic chondrocytes, while FGF in a higher concentration (10 micrograms/1) had no significant mitogenic effect. Cell proliferation was stimulated by both NCS and IGF-I, whereas FGF and EGF only caused morphological changes. Our data indicate that IGF-I is the main serum growth factor regulating growth and proliferation by interacting with chondrocytes at all stages of differentiation. PMID- 2706689 TI - Exponential pattern of cell age distribution in dividing cells of plant meristems. AB - In order to determine the pattern of cell age distribution in proliferating cells of Allium cepa roots we have measured by cytophotometry two cell size parameters, protein content and surface area projection, in cells that correspond to the entire proliferating population or only to the ana-telophase subpopulation. The size values of ana-telophase cells have been employed to construct theoretical size distributions for the entire proliferating cell population of the root meristem by assuming either a uniform or an exponential cell age distribution. Statistical comparison of theoretical distributions with the experimental one rules out a uniform cell age distribution and strongly favours an exponential age distribution similar to that found in bacteria. PMID- 2706690 TI - Nuclear granules recognized by some monoclonal antibodies against intermediate filament protein locate on chromosomes during mitosis. AB - AC54 monoclonal antibody (MAb), an anti-desmin MAb, recognizes both intermediate filaments (IFs) and nuclear granules in BHK21/C13 cells. To investigate nuclear granules, similar MAbs were obtained by using desmin fraction as an antigen. Among them, DSB389 MAb recognized mainly nuclear granules in HeLa and rat liver cells. The nuclear granules in HeLa cells were aligned in arrays, sometimes connected by, or part of, a rope-like structure, and stable against treatment with 0.5% Triton X-100 and 2 M NaCl. They located on or around the chromosomes during mitosis. Essentially the same results were obtained with DSB860 and AC54 MAbs. The distribution of the granules in liver nuclei recognized by DSB389 MAb was similar to that of DNA and was different from that of the nuclear pore complexes. The biological significance of the nuclear granules is discussed. PMID- 2706691 TI - In vivo interaction of bilirubin with the cells of the immune system in mice: an ultrastructural electronmicroscopic study. AB - Morphological evidence revealed the presence of round-shaped particles after application of bilirubin. The possibility of polymerization of bilirubin-albumin complexes is discussed. PMID- 2706692 TI - Immunohistochemical localization of 'enhancing factor', a novel growth modulator, in the mouse small intestines. PMID- 2706693 TI - Local adverse reactions to adsorbed DPT vaccine--Surrey, British Columbia. PMID- 2706694 TI - 1989 Canadian Guidelines for the Diagnosis and Management of Sexually Transmitted Diseases, by Syndrome, in Children, Adolescents and Adults. PMID- 2706695 TI - [Methodological approach to the study of effectiveness of health services. II]. AB - The paper deals with theoretical problems associated with the evaluation of medical, social and economic effectiveness, and the authors mention different approaches to the evaluation of provision concerning the health of some population groups and provisions concerning the population as a whole. Attention is also focused on information problems of effectiveness. In the paper formulae and methodological aspects are given which can be used for the calculation of the economic effect of various prosions which reduce the morbidity, which help to save human lives or lead to an increased productivity of labour. In the conclusion methodological recommendations are given for the approach in investigations of the effectiveness of health care. PMID- 2706696 TI - [The present share of health services financing provided by state enterprises]. AB - At the moment none of the managing departments is concerned with investigations of financing of factory health facilities by enterprises and organizations. A pilot study revealed that hitherto valid methods of investigation of these costs, as regards investments, were not very successful and thus it is very difficult to follow up these data. As regards operational costs, considerable differences were revealed between different departments in their contribution to the costs of factory health facilities. It was revealed that during the 7th Five-year Plan all financial means spent by enterprises on health services were cca 3.2% of the expenditure for health services (i. e. the total expenditure of the state health administration and enterprises). From the fund of cultural and social needs 0.1% to 1% are spent on the health services. The paper discusses also possibilities of the further development of factory health services. PMID- 2706698 TI - Masking and biological rhythms. PMID- 2706697 TI - [Problems in drug prescribing. Structure of the prescription for individually prepared drugs]. AB - The authors give an account of the structure of different drug forms within the framework of individually prepared drugs based on an analysis of 7862 prescriptions made in 1985. They analyze the structure in relation to the territory and type of pharmacies. Ointments were most frequent by prescribed (31.6%), followed by solutions for external use. PMID- 2706699 TI - Masking and biological rhythms. PMID- 2706700 TI - Masking in plants. AB - Circadian rhythms in plants are liable to masking, i.e. alterations by environmental influencing agents. Experiments have been reported for both positive and negative masking, attributed to a Zeitgeber which may either increase or decrease the amplitude of a circadian rhythm (CR). In some instances, the CR may even be unexpressed. This inhibition, however, may be alleviated by synchronizing agents. Reports are also available for changes in the shape or pattern of an oscillation. The latter may be prevented, at least in Acetabularia in certain conditions, by a phytohormone antagonist. Masking may also be brought about by water stress, relative humidity, bacterial infection and alteration in the relative direction of the gravitational force. Finally, subjecting plants to constant conditions, particularly continuous light, alters the physiological state of the organism. PMID- 2706701 TI - Ultradian rhythms in arousal--the problem of masking. AB - Studies utilizing widely different experimental techniques provided evidence that there are spontaneous ultradian cycles in arousal during the waking state. These comprised of cyclic fluctuations between increased and decreased sleep propensity with a periodicity of about 1.5 hr. Being of relatively low amplitude, these cycles are vulnerable to masking effects by a variety of experimental conditions. Masking can be exerted by varying the tonic level of arousal, by coexisting slow ultradian components which are particularly prominent during the second half of the day, or by some specific experimental conditions. Furthermore, increased sleepiness was shown to enhance the slow ultradian components and suppress the 1.5-hr cycles in EEG indices of arousal on the one hand, and to emphasize the 1.5 hr cycles in motor activity and reaction time performance on the other hand. Much more attention should be paid to the problem of masking of ultradian cycles in arousal. Recognizing the sources and reasons for masking will advance our knowledge of the characteristics of these cycles and their function. PMID- 2706702 TI - The pragmatic approach to masking. AB - This paper advocates the use of a pragmatic approach to the problem of masking in real-life situations involving an abrupt change in the timing of sleep, i.e. shiftwork and "jet-lag" situations. Although "pure" chronobiological research has pointed to the importance of taking masking effects into account, the techniques that it has provided for doing so are extremely difficult to apply in real-life situations. The approach advocated here is based on Wever's pioneering work, and involves estimating the normative endogenous and exogenous components of the circadian rhythm in body temperature. These estimates are then used to: (a) simulate the results of shiftwork studies; and (b) to "remove" the exogenous component in "jet-lag" studies to allow analysis of the estimated endogenous component. The simulated curves obtained cross-correlated extremely highly with published night-shift temperature curves, while the "removal" of the exogenous component resulted in very similar findings to those obtained in temporal isolation studies. It is concluded that this pragmatic approach to masking may prove extremely useful in interpreting the results of field studies of shiftwork and "jet-lag". PMID- 2706703 TI - Adaptation to shift work--experimental approaches with reduced masking effects. AB - Chronobiological characteristics of night and shift work, features of the adaptive process to be expected are briefly considered in the first part of the paper. Demands for experimental routines to imitate these situations and the need for routines reducing masking effects are discussed. Experiments meeting these demands are reviewed. Practical considerations are derived. Interindividual differences of the circadian system are taken into account. PMID- 2706704 TI - Regression models for the estimation of circadian rhythms in the presence of effects due to masking. AB - The estimation of human circadian rhythms from experimental data is complicated by the presence of "masking" effects associated with the sleep-wake cycle. The observed rhythm may include a component due to masking, as well as the endogenous component linked to a circadian pacemaker. In situations where the relationship between the sleep-wake cycle and the circadian rhythm is not constant, it may be possible to obtain individual estimates of these two components, but methods commonly used for the estimation of circadian rhythms, such as the cosinor analysis, spectral analysis, average waveforms and complex demodulation, have not generally been adapted to identify the modulations that arise from masking. The estimates relate to the observed rhythms, and the amplitudes and acrophases do not necessarily refer to the endogenous rhythm. In this paper methods are discussed for the separation of circadian and masking effects using regression models that incorporate a sinusoidal circadian variation together with functions of time since sleep and time during sleep. The basic model can be extended to include a time-varying circadian rhythm and estimates are available for the amplitude and phase at a given time, together with their joint confidence intervals and tests for changes in amplitude and acrophase between any two selected times. Modifications of these procedures are discussed to allow for non sinusoidal circadian rhythms, non-additivity of the circadian and time-since sleep effects and the breakdown of the usual assumptions concerning the residual errors. This approach enables systematic masking effects associated with the sleep-wake cycle to be separated from the circadian rhythm, and it has applications to the analysis of data from experiments where the sleep-wake cycle is not synchronized with the circadian rhythm, for example after time-zone transitions or during irregular schedules of work and rest. PMID- 2706705 TI - The dim light melatonin onset as a marker for circadian phase position. AB - Masking is known to affect a variety of circadian rhythms, making it difficult to use them as reliable markers of circadian phase position. Melatonin may be unique in that it appears to be masked only by (bright) light. Sleep and activity do not appear to influence the melatonin rhythm. By measuring the onset of melatonin production, a clearly demarcated event, we can reliably assess circadian phase position, provided blood is sampled under dim light (the dim light melatonin onset, or DLMO). The DLMO has been useful in assessing the phase-shifting properties of bright light and in phase typing patients with chronobiologic disorders, such as winter depression. PMID- 2706706 TI - Interpleural block. PMID- 2706707 TI - Intrapleural analgesia for post-thoracotomy pain and blood levels of bupivacaine following intrapleural injection. AB - An epidural type catheter was placed in the pleural space under direct vision before the closure of the chest in 24 patients who underwent thoracotomy for various types of lung or aortic surgery. All patients received intrapleural injections of 20 ml of 0.5 per cent bupivacaine with or without epinephrine as initial pain therapy. Patients also received subsequent doses of a similar volume of 0.375 per cent bupivacaine with epinephrine 1:200,000 up to four times a day for a maximum duration of seven days. Good pain relief was achieved in patients who underwent lateral and posterior thoracotomies. No pain relief was achieved in patients who underwent anterior thoracotomy or in patients in whom there was excessive bleeding in the pleural space. Bupivacaine blood concentrations were measured in 11 patients following the initial dose of 20 ml of 0.5 per cent bupivacaine (with epinephrine 1:200,000 in five of the 11 patients). The mean peak plasma concentration of bupivacaine when used with epinephrine was 0.32 +/- 0.02 microgram.ml-1. The mean peak plasma concentrations of bupivacaine when used without epinephrine was 1.28 +/- 0.48 microgram.ml-1. Our present data show that intrapleural analgesia is useful in the management of postoperative pain in patients who undergo thoracotomy. Our data also show that there is a significant decrease in peak plasma concentrations of bupivacaine when epinephrine is added to the solution (P less than 0.05). PMID- 2706708 TI - Ketamine enhances phase I and phase II neuromuscular block of succinylcholine. AB - The effect of intravenous injection of ketamine 2, 5 and 10 mg.kg-1 on the neuromuscular blocking action of succinylcholine was studied on the indirectly stimulated adductor pollicis muscle twitch of monkeys anaesthetized with 0.5-1.0 per cent halothane in oxygen. Neuromuscular block was quantified by single twitches evoked at 0.1 Hz. The changing nature of neuromuscular block from Phase I to Phase II was monitored periodically by train-of-four fade. In the absence of succinylcholine, ketamine had no consistent neuromuscular effect of its own. In the presence of succinylcholine, ketamine in a dose-dependent manner potentiated both the Phase I and the Phase II neuromuscular blocking effect of succinylcholine. In Phase I, 2 mg.kg-1 of ketamine reduced the ED50 of succinylcholine from 0.46 +/- 0.07 mg.kg-1 to 0.33 +/- 0.06 mg.kg-1 (P less than 0.01), and increased its 25-75 per cent recovery index from 4.0 +/- 0.4 min to 5.3 +/- 0.1 min (P less than 0.01). In Phase II, ketamine in the same dose deepened a steady neuromuscular block maintained by succinylcholine infusion from 48 +/- 3 per cent block to 71 +/- 2 per cent block (P less than 0.01). We concluded that ketamine potentiates the Phase I and the Phase II neuromuscular blocks of succinylcholine. PMID- 2706709 TI - Decreases in arterial oxygen saturation in paediatric outpatients during transfer to the postanaesthetic recovery room. AB - Arterial oxygen saturation was measured by pulse oximetry in two groups of paediatric outpatients breathing room air during transport from the operating room to the postanaesthetic recovery room. In Group I (n = 60) readiness for transfer from OR to PARR was decided clinically. In Group II (n = 50) additional criteria of oxygen saturation (SaOe) greater than or equal to 98 per cent with end-tidal gas N2O less than or equal to 10 per cent and CO2 less than or equal to 45 mmHg were met. A higher incidence of desaturation (SaO2 less than or equal to 90 per cent) occurred in Group I (27 per cent) than in Group II (eight per cent) (P less than 0.05). More children under 2 yr desaturated in Group I (50 per cent) than Group II (17 per cent) (P greater than 0.05 less than 0.10). Twenty-two patients in each group had a recent history of upper respiratory tract infections. In these patients, desaturation was more marked in those in Group I (32 per cent) than in Group II (five per cent) (P less than 0.05). Within each group, the incidence of desaturation during transport was similar in patients with or without a recent URI. PMID- 2706710 TI - Pulmonary function after extracorporeal shock wave lithotripsy--a comparison of general and regional anaesthesia. AB - The effect of general anaesthesia on postoperative pulmonary mechanics was studied by comparing pre- and postoperative spirometry in 30 patients undergoing extracorporal shock wave lithotripsy, 15 of whom received a unilateral intercostal nerve block, the remainder a general anaesthetic. Both groups of patients had significant postoperative changes in peak expiratory flow rate, expiratory reserve volume and vital capacity; forced expiratory volume at one second was not significantly changed in either group. There were no significant differences in the pre- or postoperative mechanics between the two groups. We conclude that general anaesthestics do not play a significant role in the generation of abnormalities in postoperative spirometry. PMID- 2706711 TI - Evaluation of an animal model for teaching fibreoptic tracheal intubation. AB - Twenty-seven anaesthesia faculty, fellows and residents compared a standard intubating mannequin and an anaesthetized pig as models for teaching fibreoptic tracheal intubation. When likened to the clinical situation, the anatomic characteristics of the pig airway were rated as significantly more realistic than the airway characteristics of the mannequin with the exception of the appearance of the epiglottis. In addition, the overall score for the pig model was significantly higher than the score for the mannequin and 26 of 27 evaluators rated the anaesthetized pig as the more effective teaching model. We conclude that an anaesthetized, spontaneously breathing pig is a valid model for teaching fibreoptic endotracheal intubation. PMID- 2706712 TI - Fentanyl increases catecholamine oxidation current measured by in vivo voltammetry in the rat striatum. AB - A proposed mechanism for fentanyl-induced muscular rigidity is the effect of opioids on dopaminergic transmission in the striatum. The objective of this study was to observe the effect of fentanyl on the rat striatal catechol oxidation current (CA.OC) which reflects extracellular DOPAC (3-4,dihydroxyphenylacetic acid) concentration (a major metabolite of dopamine), as measured by in vivo voltammetry. Male Sprague-Dawley rats, anaesthetized with halothane, were stereotaxically implanted with carbon fibre electrodes in the striatum and after an initial stabilization period of an hour were given a control saline IV injection followed 30 min later by fentanyl 10 micrograms.kg-1 IV over 10 min and at 70 min by the monoamine oxidase inhibitor pargyline 70 mg.kg-1 IP. Fentanyl produced a significant (P less than 0.05 Anova) increase in CA.OC in all animals. This reached a plateau 15 min following the administration of fentanyl and was at a maximum of 148 +/- 10.2 per cent of control 35 min after the administration of fentanyl. Pargyline produced a rapid decline in CA.OC peak height which went from 143 +/- 11.6 to 39 +/- 6.8 per cent of control over 30 min. There were no significant differences between the pH, PaO2 and PaCO2 during the saline and fentanyl injection periods and there was no significant variation of blood pressure throughout the experiment. This study shows that under stable physiological conditions, fentanyl produces a significant increase in CA.OC in the rat striatum. PMID- 2706713 TI - Analysis of an anaesthetic gas scavenging system hazard. AB - The collapse of the reservoir bag in a circle circuit was observed during anaesthesia. This resulted from the incomplete closure of the pressure relief valve on the absorber whie it was connected to the scavenging system. Although the scavenging system was operating and installed according to the manufacturer's recommendations and to the CSA standard on Anaesthetic Gas Scavenging Systems (Z168.8), the patient was not protected from this hazard. Introducing an air break into the scavenging interface device will protect the patient. However, such a system would not meet the CSA standard and would make the relief valves on the scavenging interface device unnecessary. PMID- 2706714 TI - Right atrial myxoma: case report and anaesthetic considerations. AB - Primary cardiac tumours occur rarely. Myxoma is the most common of these tumours and 25 per cent of myxoma occur in the right atrium. We present a patient with a right atrial myxoma and hypoxaemia who suffered sudden hypotension upon induction of anaesthesia. PMID- 2706715 TI - Nicardipine HCl: clinical experience in patients undergoing anaesthesia for intracranial aneurysm clipping. AB - Previous studies have reported haemodynamic interactions between dihydropyridine calcium antagonists and general anaesthesia. During anaesthesia for intracranial aneurysm surgery, we prospectively compared haemodynamic values obtained from 13 patients being treated with nicardipine HCl (0.15 mg.kg-1.hr-1 IV) for cerebral vasospasm against values obtained from 11 untreated controls. Prior to induction of anaesthesia, nicardipine-treated patients had significantly elevated mean +/- SD cardiac index (5.67 +/- 1.30 vs 3.99 +/- 0.73 L.min-1.m-2) while MAP (86 +/- 10 vs 99 +/- 14 mmHg) and systemic vascular resistance (647 +/- 227 vs 1141 +/- 404 dynes.sec-1.cm-5) were reduced. Heart rate, CVP, and PACWP were similar between groups. Anaesthesia induction and tracheal intubation resulted in similar haemodynamic values between groups with the exception of CVP (10 +/- 5 vs 5 +/- 2 mmHg) and PACWP (15 +/- 5 vs 8 +/- 3 mmHg) which were elevated in the nicardipine group (P less than 0.01). Mannitol infusion and deliberate hypotension resulted in nearly identical haemodynamic responses in both groups. Nicardipine-treated patients required more intravenous fluids during the operative procedure (2.4 +/- 0.3 L vs 1.5 +/- 0.4 L, P less than 0.05) and were less likely to require isoflurane supplementation to morphine sulphate/nitrous oxide anaesthesia (P less than 0.01). In summary, our experience with nicardipine HCl revealed no major untoward effects with respect to maintenance of intraoperative haemodynamic stability despite continuous antivasospasm therapy with this vasodilator. PMID- 2706716 TI - Heparin reversal protocol. PMID- 2706717 TI - Phaeochromocytoma. PMID- 2706718 TI - Caudal mepivicaine and ventilation. PMID- 2706719 TI - Antegrade vs retrograde insertion introducer for guided intubation in needle laryngostomized patient. PMID- 2706720 TI - An alternative use for a nasotracheal tube. PMID- 2706721 TI - Obstetric anaesthesia: informed consent. PMID- 2706722 TI - Obstetric epidural analgesia in remote hospitals. PMID- 2706723 TI - Avoiding nosocomial infection in anaesthesia. PMID- 2706724 TI - Global surveillance and forecasting of AIDS. AB - The short-term forecasting of future AIDS cases has been attempted by statistical extrapolations of the observed curve of reported AIDS cases. In areas where such reporting is very incomplete or has only recently started, extrapolation is not possible and an epidemiologically-based forecasting model has been developed to estimate the annual number of AIDS cases which may have occurred and to project the annual number and distribution of AIDS cases for up to ten years. This model, which relies on the current understanding of the epidemiology and natural history of HIV infections and on the available HIV serologic survey data, is used to provide estimates and short-term projections of AIDS cases for the USA, Europe, Africa and the world. Because of the very long (mean of 8-9 years) incubation period between HIV infection and the development of AIDS, new cases over the next five years will be mostly derived from persons who became infected with HIV in or before 1987. WHO has estimated that 5-10 million persons worldwide were infected with HIV in 1987. Based on the lower estimate of 5 million, the cumulative number of AIDS cases which can be projected for the end of 1991 is over one million, and for the mid-to-late 1990s could reach 2 to 3 million. HIV/AIDS will therefore be an increasing public health problem throughout the world. Health care systems everywhere will have to be strengthened to respond to this large toll of disease and death due to AIDS. PMID- 2706725 TI - Research on improving infant feeding practices to prevent diarrhoea or reduce its severity: memorandum from a JHU/WHO meeting. AB - In developing countries the highest incidence of diarrhoea occurs among infants who are given fluids or foods to supplement or replace breast-feeding, and numerous studies have been conducted to examine the relationship between feeding practices during the weaning period and the risk of diarrhoea and malnutrition. This Memorandum summarizes current knowledge about the potential impact of improved infant feeding practices on diarrhoeal morbidity and mortality and describes experiences gained with interventions to promote improved practices. Further research activities to examine the role of improved infant feeding practices in the control of diarrhoeal diseases and to identify more effective approaches to the promotion of such practices in the context of a public health programme are also proposed. Finally, methodological issues concerning the design, implementation, and analysis of intervention studies are reviewed. PMID- 2706726 TI - The distribution and implications of BCG scars in northern Malawi. AB - Reported are data on the BCG scar status of more than 112,000 individuals who were surveyed in Karonga District, northern Malawi, between 1979 and 1984. The age and sex patterns of apparent BCG scars reflect the history of BCG vaccination activities in the district. Repeated independent examinations of large numbers of people revealed that the proportions remaining with the same observed scar status among those initially classified as being scar "positive" or scar "negative" were each approximately 90%. The repeatability of positive scar reading was lower among children and older adults than among young adults aged 15-24 years, and blind follow-up of children known to have been vaccinated as infants in child health clinics indicated that less than 60% had a detectable scar 3 years after receiving the vaccine. "Negative" repeatability increased consistently with age. The implications of these findings for estimating BCG vaccine uptake and for assessing its efficacy in case-control and cohort studies are discussed. The finding that BCG scars may be difficult to read suggests there is a danger of observer bias that could lead to distortion--in particular, to overestimates of vaccine efficacy. PMID- 2706727 TI - Malaria prophylaxis with proguanil and sulfisoxazole in children living in a malaria endemic area. AB - The effects of three separate antimalarial prophylactic regimens (proguanil, sulfisoxazole, and proguanil plus sulfisoxazole) and of vitamins in a control group were compared in a study population of 380 children living in a malaria endemic area along the Thai-Burmese border. The subjects, aged 5-16 years, were matched for age, weight, and presence of splenomegaly, then randomly assigned to one of the four groups. All medications were administered daily by the investigators and malaria smears were performed on a weekly basis. Among 99 subjects taking proguanil plus sulfisoxazole for a total of 1464 man-weeks, there was only one case of falciparum and no vivax malaria. Statistically, this regimen proved superior to each of the other groups against both Plasmodium falciparum and P. vivax. The data show that proguanil alone, as a causal or suppressive prophylatic, has poor efficacy against P. falciparum. Side-effects were infrequent and generally mild, except for two subjects whose sulfisoxazole prophylaxis was discontinued because of urticarial rash. PMID- 2706728 TI - Water availability and trachoma. AB - As part of an epidemiological survey of risk factors for trachoma in 20 villages in the United Republic of Tanzania, we investigated the relationship of village water pumps, distance to water source, and quantity of household water to the risk of inflammatory trachoma. We also evaluated whether there was an association between the cleanliness of children's faces and these water variables. No association was found between the presence of a village water supply and the prevalence of trachoma. However, the risk of trachoma in the household increased with the distance to a water source--although there was no association with the estimated daily amount of water brought into the house. Likewise, children were more likely to have unclean faces if they lived more than 30 minutes from a water source, but whether they had clean faces was not associated with the daily quantity of water brought into the household. The effect of the distance to water supply on trachoma may well reflect the value placed on water within the family, and this determines the priority for its use for hygiene purposes. The results of the study suggest that changing the access to water per se may be insufficient to alter the prevalence of trachoma without also a concomitant effort to change the perception of how water should be utilized in the home. PMID- 2706729 TI - Nutritional interventions through primary health care: impact of the ICDS projects in India. AB - In 1975 the Government of India initiated an integrated approach for the delivery of health care as well as nutrition and education services for deprived populations at the village level and in urban slums through centres, each of which was run by a local part-time female worker (anganwadi) who was paid an honorarium and had a helper. This national programme, known as the Integrated Child Development Services (ICDS), began with 33 projects but, by March 1986, had expanded to 1611 projects covering 23% of the country's population and representing about 50% of the population in the socioeconomically backward areas. The ICDS can therefore be considered to function as a primary health care programme for preschool children (under 6 years old), pregnant women, and lactating mothers. The present study investigated the impact on the nutritional status of the target population after 3-5 years and after 8 years of ICDS interventions, compared with the nutritional status of non-ICDS (control) groups. The results showed that the ICDS nutrition intervention programmes achieved better coverage of the target population and led to a significant decline in malnutrition among preschool children in the ICDS population, compared with the non-ICDS groups that received nutrition, health care and education through separate programmes. This example may lead other developing countries to introduce integrated programmes with certain modifications to suit local conditions. International agencies and national governments should strive to bring about the integration of nutritional services with primary health care and development programmes for children because of the good results in terms of child survival and child development. PMID- 2706730 TI - Method for the classification of countries according to health-related indicators. AB - A taxonomic approach using cluster analysis and principal component analysis has grouped the countries of the world in eight clusters, in an initial attempt to propose a worldwide spatial classification based on the following health-related indicators: (a) those directly related to the health status of the population; (b) those measuring the provision of health care; (c) those linked to population characteristics; and (d) those reflecting economic parameters. The cartographic representation was based on demographic maps which display the area of each country in proportion to its population size. PMID- 2706731 TI - Knowledge about condoms and their use in less developed countries during a period of rising AIDS prevalence. AB - Apart from sexual abstinence and monogamous relationships between uninfected partners, the use of condoms is currently the only effective means available for preventing sexual transmission of human immunodeficiency virus (HIV) infection. Worldwide data on people's knowledge about condoms and their use have not previously been studied in the context of prevention of HIV transmission. This paper presents survey data taken among women of reproductive age in the developing countries. The results show a wide range in the women's knowledge of condoms, which was poorest in sub-Saharan African countries, including those that are considered to have high HIV seroprevalence. Use of condoms was lowest in sub Saharan Africa and very low in some other countries with a high prevalence of HIV. PMID- 2706732 TI - The transport of pteridines in CCRF-CEM human lymphoblastic cells. AB - The transport routes used by CCRF-CEM human lymphoblastoid cells for the influx and efflux of unconjugated pteridines were analyzed using [3H]6 hydroxymethylpterin as a model compound. Influx proceeds by a mechanism that exhibits a Km of 66.7 microM and a Vmax of 0.077 nmol/min per mg cellular protein. The process is somewhat sensitive to metabolic inhibitors, particularly uncouplers of oxidative phosphorylation, and is significantly affected by the presence of other pteridines in the extracellular medium. The results suggest that pterins with either no 6-substituent (pterin) or those with methyl, hydroxyl, or formyl groups in this position, which exhibit Ki values between 25 and 77 microM, may share the same pathway for uptake. 6-Carboxypterin exhibits low affinity for the system (Ki greater than 500 microM), as do 7-substituted and 6,7-di-substituted derivatives and compounds with larger groups at the 6 position, such as neopterin and biopterin (Ki = 250-300 microM). Efflux of [3H]6 hydroxymethylpterin occurs rapidly and can proceed by at least two routes. The first, comprising approximately 50% of total efflux, is inhibited by extracellular pterins and exhibits similar properties to the uptake system in both its pattern of sensitivity to metabolic inhibitors and its specificity for pteridine structure. The route by which the remaining efflux occurs is relatively insensitive to metabolic inhibition. Adenine significantly inhibits 6 hydroxymethylpterin influx and efflux (Ki = 10.6 microM for uptake) but does not appear to share the same transport system. Similarly, methotrexate and folic acid exhibit little affinity for the unconjugated pteridine transport routes. PMID- 2706733 TI - The effect of cimetidine, phenobarbitone and buthionine sulphoximine on the disposition of N-5-dimethyl-9-[(2-methoxy-4-methyl-sulphonylamino)phenylamino]- 4 acridinecarboxamide (CI-921) in the rabbit. AB - N-5-dimethyl-9-[(2-methoxy-4-methylsulphonyl-amino)phenylamino]-4- acridinecarboxamide (CI-921) is an amsacrine analogue currently undergoing phase II clinical trials as an antitumor drug. Significant alterations in the plasma clearance (CL) of amsacrine have been demonstrated in rabbits after pretreatment with cimetidine (CT), phenobarbitone (PB) and buthionine sulphoximine (BSO). In the present study, the influence of these agents on the disposition of CI-921 was investigated in rabbits. After a short infusion of CI-921 (12.7 mumol/kg), blood (8 x 3 ml) was collected up to 12 h and the total plasma concentration of CI-921 determined by HPLC. Model-independent pharmacokinetic parameters were compared by Student's paired t-test. CT pretreatment significantly (P = 0.011) increased the AUC (mean, 21%; range, 3%-43%) and significantly (P = 0.019) decreased the CL (mean, 17%; range, 4%-30%). The induction effect of PB pretreatment was not confirmed with CI-921. No significant reduction in AUC or increase in CL was apparent. BSO pretreatment caused a small but significant (P = 0.049) increase in AUC (mean, 20.5%; range, 4%-59%) but had no effect on CL. Although more modest changes in kinetic parameters were observed with CI-921 than with amsacrine, these results suggested the involvement of the hepatic mixed-function oxidase system but not PB-inducible cytochrome P-450 isozymes in the elimination of CI 921 in the rabbit. As with amsacrine, a reduction in hepatic glutathione (GSH) concentrations in the body also appeared to have a modest effect on the disposition of CI-921. PMID- 2706734 TI - Effect of cyclosporin A on daunorubicin accumulation in multidrug-resistant P388 leukemia cells measured by real-time flow cytometry. AB - We investigated the mode of action of cyclosporin A (Cy-A) as a modifier of multidrug resistance in P388 mouse leukemia cells. A fluorescence-activated flow cytometer (FCM) was modified with a flow-through cuvette to allow continuous on line monitoring of daunorubicin uptake in vitro. The addition of Cy-A to multidrug-resistant P388/R cells at steady-state daunorubicin uptake, led to a dose-dependent increase in cellular daunorubicin accumulation, as measured by FCM and high-performance liquid chromatography (HPLC). A linear relationship was found between the daunorubicin concentration in the incubation medium and the Cy A concentration required for optimal stimulation of cellular anthracycline accumulation. The results of a cytotoxicity assay indicated that Cy-A completely restored the chemosensitivity of the P388/R cells. Intracellular Cy-A measurements in P388/S and P388/R cells showed that P388/R cells accumulated significantly less Cy-A than P388/S cells. Relatively high daunorubicin concentrations could not restore that accumulation defect. These results suggest that Cy-A promotes cellular anthracycline accumulation by competing for an outward drug-transport system that operates in multidrug-resistant cells. PMID- 2706735 TI - Phase I/II study of intraventricular and intrathecal ACNU for leptomeningeal neoplasia. AB - A total of 27 patients with leptomeningeal neoplasia were treated with the water soluble nitrosourea ACNU given intraventricularly or intrathecally in a phase I/II study. Patients were entered in the study if they showed evidence of either a positive CSF cytology or neurodiagnostic evidence of leptomeningeal disease, or both. Patients were evaluated for toxicity and efficacy; additionally, in 13 patients ACNU pharmacokinetic studies were carried out. A variety of tumor types were represented in the study group, including primary and metastatic CNS tumors. Toxicity was mild and included pain at the injection site (four patients), transient radicular symptoms at a short distance from the injection site (three patients), and nausea and vomiting (one patient). No myelotoxicity was seen. Of 21 patients who presented with positive cytology, 8 (38%) had a conversion from positive to negative cytology, with a range of response durations from 1 to 20+ months. Of the remaining six patients with negative cytology but other neurodiagnostic evidence of leptomeningeal disease, one patient showed an improvement seen on the myelogram and one underwent a brief reduction in CSF protein. ACNU elimination from the ventricular system is rapid, with a beta slope of 0.028 min-1 and a computed elimination constant, Ko of 13 min. The mean clearance was 3.8 ml/min (range, 1.0-6.2 ml/min). Peak ACNU levels varied between 108 and 620 micrograms/ml, with the AUC being 1.4-14.7 mg.min/ml. The total dose of ACNU given was between 9 and 104 mg, and the single dose range was 4-16.5 mg. We conclude that ACNU can be given safely with minimal toxicity as intra-CSF therapy, that it demonstrates efficacy in some patients with leptomeningeal disease, and that further studies are warranted to evaluate more fully alternative dosing and drug delivery approaches. PMID- 2706736 TI - A phase I study of meta-azidopyrimethamine ethanesulphonate (MZPES)--a new dihydrofolate reductase inhibitor. AB - A total of 68 patients were treated in a phase I study of meta-azidopyrimethamine ethanesulphonate (MZPES)--a novel lipophilic dihydrofolate reductase (DHFR) antagonist. The dose was increased from 5.4 mg/m2 to 460 mg/m2 given as a 1-h infusion, with 460 mg/m2, 600 mg/m2 and 800 mg/m2 given as a 24-h infusion. The dose-limiting toxicity was nausea and vomiting, which was marked at doses above 360 mg/m2 by 1-h infusion and 600 mg/m2 by 24-h infusion. Above 250 mg/m2 patients also described subjective neurological symptoms, although no objective signs were apparent. Myelosuppression was not consistent at any dose level. No objective responses were seen. In view of the lack of anti-folate activity at toxic levels, no phase II trials are currently proposed; toxicological and in vitro studies will continue. PMID- 2706737 TI - Phase I clinical trial and pharmacokinetic evaluation of 4'-0 tetrahydropyranyladriamycin (THP-adriamycin). AB - Tetrahydropyranyladriamycin (THP-adriamycin) is an anthracycline analogue currently under development in Europe and Japan. Preclinical studies suggest that it may have greater activity and less cardiac toxicity than doxorubicin. We conducted a phase I clinical and pharmacologic study of THP-adriamycin given as a weekly 15-min infusion for 3 weeks, followed by 1 week of observation. Therapy was associated with minimal acute toxicity. The dose-limiting toxicity was neutropenia, usually maximal during the 4th week after treatment; alopecia was rare. The maximum tolerated dose was 25 mg/m2; for phase II studies using this schedule, a dose of 20 mg/m2 weekly for 3 weeks is recommended. Pharmacokinetic studies revealed a triphasic elimination of the parent compound with alpha, beta, and gamma half-lives of 5.6 min, 1.4 h, and 9.3 h, respectively. THP-adriamycin was rapidly taken up by blood cell components, with concentrations in red blood cells (RBCs), lymphocytes, and polymorphonuclear cells exceeding those in plasma. In all, less than 10% of the compound was eliminated in the urine within 24 h. PMID- 2706738 TI - Topical dimethylsulfoxide may prevent tissue damage from anthracycline extravasation. AB - The optimal management of anthracycline extravasation remains unclear. Traditional topical measures to reduce local tissue damage, including corticosteroids, sodium bicarbonate, and ice applications, have not consistently demonstrated beneficial effects. This report describes our experience with four adult patients who suffered anthracycline extravasation and were treated with a regimen of ice, local glucocorticoid injection, and dimethylsulfoxide (DMSO) 55% 99% applied topically every 2-4 h after extravasation for a minimum of 3 days. In all four cases, pain and erythema resolved within 2 days; in no case did tissue necrosis or skin ulceration occur. Topical DMSO is a safe, inexpensive agent that appears to reduce the risk of anthracycline-induced tissue damage. Further studies are needed to determine the optimal dose and schedule of DMSO application and to assess its efficacy in extravasation injuries from other vesicants. PMID- 2706739 TI - Glucose-6-phosphate dehydrogenase deficiency and cancer in a Sardinian male population: a case-control study. AB - A case-control study was conducted to test the hypothesis whether the genetic condition of glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with a reduced risk of cancer. One hundred and eighty seven male cancer patients admitted to hospitals in Cagliari (Sardinia, Italy), between November 1984 and March 1986, were compared with 186 male patients with other diseases, except hemolytic anemia, admitted to the same hospitals in the same period. In contrast to previous reports, our study found no reduction of cancer risk in G6PD deficient subjects. The study had sufficient statistical power to detect a 0.5 fold decrease in the risk of cancer. The recent suggestion from other studies that tumoral cells of G6PD-deficient subjects can produce their own G6PD, seems to be consistent with this negative finding. Among those subjects presenting some level of erythrocyte G6PD activity, the average enzyme activity was significantly higher in cancer patients than in controls. This finding is consistent with previous experimental studies suggesting a positive correlation between cell proliferation and G6PD activity. PMID- 2706740 TI - Comparison of epidermal protein kinase C activity, ornithine decarboxylase induction and DNA synthesis stimulated by TPA or dioctanoylglycerol in mouse strains with differing susceptibility to TPA-induced tumor promotion. AB - The purpose of this study was to examine the activity and associated kinetic parameters of epidermal protein kinase C (PKC) following stimulation by sn-1,2 dioctanoylglycerol (DIC8) or 12-O-tetradecanoylphorbol-13-acetate (TPA) and to examine the relationship between levels of epidermal PKC activity and the induction of ornithine decarboxylase by these agents, utilizing various stocks and strains of mice. Importantly, the mouse strains and stock used in this study have known differing susceptibilities to undergo TPA-induced tumor promotion: the CD-1 stock and the DBA/2 strain (both sensitive to TPA-induced tumor promotion) and the C57BL/6 strain (resistant to TPA-induced tumor promotion). TPA-stimulated protein kinase C activity was measured in the 10(5)g supernatant fraction of epidermal homogenates using lysine-rich histone as a phosphate acceptor substrate. The maximal velocities for TPA-stimulated epidermal PKC activity in CD 1, DBA/2 and C57BL/6 were 0.28, 0.29 and 0.27 nmol PO4-histone/mg 10(5)g protein/min, respectively. TPA-stimulated epidermal PKC from CD-1, DBA/2 and C57BL/6 had similar theoretical Vmax values and the apparent concentrations of TPA yielding half-maximal stimulation of PKC were also similar. DiC8-stimulated PKC activity to a greater Vmax; however, the concentration required to yield half maximal stimulation of PKC was one thousand times greater than that of TPA. There were no strain differences in these parameters when the enzyme was stimulated with DiC8. Thus, the levels of epidermal PKC activity in CD-1, DBA/2 and C57BL/6 mice exhibit no strain differences when stimulated by TPA or DiC8 using lysine rich histone as a phosphate acceptor substrate. Since sn-1,2-diacylglycerols are known effective inducers of epidermal ornithine decarboxylase (ODC) activity, the induction of epidermal ODC was examined in each mouse strain 5 h after topical application of 2 nmol TPA, 5 nmol TPA or 2.5 mumol DiC8. After topical treatment with TPA, C57BL/6 demonstrated an unexpected 2- and 4-fold increase in ODC activity over CD-1 and DBA/2 mice. After treatment with DiC8, C57BL/6 demonstrated a 6- and 10-fold increase in ODC activity over CD-1 and DBA/2, respectively. Thus, the resistant strain (C57BL/6) demonstrated a 'hyperinducibility' of epidermal ODC activity by TPA or DiC8. The time course for the induction of epidermal ODC was examined in each strain, and at every time point measured (3-15 h), the C57BL/6 strain exhibited this 'hyperinducibility' of ODC relative to the other strains. Epidermal DNA synthesis was stimulated to a similar extent in C57BL/6 and CD-1 mice.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2706741 TI - Hepatic tumor-promoting chlorinated hydrocarbons stimulate protein kinase C activity. AB - Various chlorinated hydrocarbons, many of which are known hepatic tumor promoters, have been evaluated for their ability to stimulate protein kinase C (PKC) activity in vitro. Chlordane, kepone, toxaphene, heptachlor, 2,2-bis(4 chlorophenyl)-1,1-dichloroethane, the polychlorinated biphenyl Aroclor 1254, aldrin, 2,2-bis(4-chlorophenyl)-1,1,1-trichloroethane (DDT) and gamma hexachlorocyclohexane (lindane) were the most potent stimulators of PKC activity. Of these compounds, chlordane was the most potent organochlorine pesticide. Chlordane (100 microM) stimulated mouse brain PKC activity in the 10(5) g supernatant to a maximum velocity equal to that obtained when the enzyme was maximally stimulated with the skin-tumor-promoting phorbol ester, 12-O tetradecanoylphorbol-13-acetate (TPA). Chlordane concentrations as low as 1 microM significantly stimulated PKC activity. Chlordane-stimulated PKC activity was calcium-dependent, and in the presence of exogenous calcium, chlordane stimulated PKC activity was at least 5-fold greater than in the absence of added calcium. In contrast, the addition of calcium only minimally affected (less than 30% increase) the TPA-stimulated PKC activity. Concentrations of TPA and chlordane which maximally stimulate PKC did not produce an additive effect on PKC activity. Chlordane- and TPA- stimulated PKC activity was phospholipid-dependent and could be inhibited by quercetin, a known inhibitor of PKC activity. Chlordane in the presence of calcium also stimulated mouse epidermal and hepatic PKC as well as purified rat brain PKC. These results demonstrate that a wide variety of chlorinated hydrocarbons, which are considered hepatic tumor promoters, stimulate protein kinase C activity in vitro. PMID- 2706742 TI - Intralobular distribution of preneoplastic foci in rat liver after a single dose of N-methyl-N-nitrosourea (MNU) following partial hepatectomy. AB - ATPase-deficient foci in rat liver, considered to be clonal in origin and possible precursors of hepatocellular carcinomas, were induced by injecting male Wistar AF/Han (200-220 g) rats with N-methyl-N-nitrosourea (MNU) (25 mg/kg) 16 or 22 h after partial hepatectomy and feeding for 80 days with a diet containing phenobarbital. The animals were killed after 90 days and the intralobular distribution of the preneoplastic foci was analysed quantitatively. The locations of 48 foci in the 16-h group and 22 foci in the 22-h group were determined from serial sections and blocks of liver from five animals. The mean distance of the foci from the portal vein in the 16-h group (385 microns) was 30% less than the distance of randomly selected points (546 microns), while the mean distance of the foci in the 22-h group (450 microns) was 16% less than the random points (535 microns). The mean diameter of the foci (235 microns) was 17% greater in the 22-h group than in the 16-h group (196 microns). We suggest that the cells in early S phase which are periportally situated 16 h after partial hepatectomy and occupy an intermediary position at 22 h represent the sensitive target population for initiation. PMID- 2706743 TI - Development of a human cell line by selection and drug-metabolizing gene transfection with increased capacity to activate promutagens. AB - We have isolated a human lymphoblastoid cell line with higher levels of native cytochrome P450IA1 activity and by DNA transfection introduced human cDNAs for a putative cytochrome P450IIA2 and epoxide hydrolase (E.C. 3.3.2.3). The resultant cell line, designated MCL-1, was substantially more sensitive to the mutagenicity of dimethylnitrosamine and benzo[a]pyrene than the AHH-1 cell line and was found to have increased metabolism of benzo[a]pyrene to dihydrodiols. The increase in native cytochrome P450IA1 activity was achieved by mutation and selection based on resistance to the phototoxicity of benzo[ghi]perylene. One resistant clone, designated L3, was used for subsequent studies. Two complete cDNAs, one encoding a putative cytochrome P450IIA2 and the other a microsomal epoxide hydrolase, were isolated from a human liver cDNA library. After introduction of the cDNAs into an expression vector and transfection into AHH-1 cells, gene expression was detected at the level of enzyme activity (epoxide hydrolase) or by increased sensitivity to dimethylnitrosamine cytotoxicity/mutagenicity (putative P450IIA2). A vector containing both cDNAs was then constructed and transfected into L3 cells to produce MCL-1 cells. The potential usefulness of drug-metabolizing gene transfection and of the MCL-1 cell line, in particular, for genetic toxicity testing is discussed. PMID- 2706744 TI - Proliferation kinetics of pepsinogen altered pyloric gland cells in rats treated with N-methyl-N'-nitro-N-nitrosoguanidine. AB - The cell kinetics of pepsinogen isozyme 1 altered pyloric gland (PAPG) cells with low pepsinogen isozyme 1 (Pg 1) content were analysed using double immunohistochemical staining for bromodeoxyuridine (BrdU) incorporation and Pg 1 in male WKY/NCrj rats treated with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). After administration of 100 micrograms/ml MNNG for 10 weeks in the drinking water, carcinogenic insult was terminated and the animals killed two weeks later. BrdU was given either as a single i.p. injection (100 mg/kg b.w.) 1 h prior to death or continuously by osmotic minipump (120 micrograms/h) for 4, 7 and 10 days before killing. Immunogold-silver staining was used to detect BrdU and the avidin biotin-peroxidase complex method adopted for demonstration of Pg 1. PAPG were found only in the MNNG treated group: their frequency was 4.1 +/- 0.6 per 100 pyloric glands. Almost no normal pyloric gland cells with high Pg 1 content demonstrated incorporation after BrdU flash labelling. However, a few pyloric gland cells in PAPG were labelled. The number of labelled cells in the pyloric columns containing PAPG was larger (P less than 0.05) than in normal pyloric columns. After continuous BrdU administration, the life span of cells comprising PAPG was estimated to be approximately 6-8 days while that of normal pyloric gland cells was approximately 11-13 days. Thus, the data indicate that PAPG cells demonstrate a degree of independence from surrounding pyloric glands with regard to proliferation kinetics, suggesting that PAPG is a preneoplastic lesion involved in gastric carcinogenesis. PMID- 2706745 TI - Nuclear protein organization and the repair of radiation damage. AB - A complex network of proteins having attachment sites with DNA are known to exist in mammalian cells and have been referred to as a nuclear cage, matrix, scaffold and nucleoid. Since ionizing radiation is known to induce DNA--protein crosslinks as well as DNA single- and double-stranded breaks, an investigation of the sedimentation of the nucleoid in Chinese hamster ovary (CHO)* cells before, during and after treatments with ionizing radiation was undertaken. Using neutral sucrose gradient sedimentation, it was possible to reproducibly separate the protein and DNA components of interphase nucleoids. Under conditions of radiation damage, the DNA and protein components of the nucleoid were shifted to a coincident position in the gradients consistent with the generation of single- and double-stranded DNA scissions. During DNA damage repair, an apparent recruitment of protein to the nucleoid occurred and a rearrangement of the protein sedimentation was observed as the repair of DNA progressed. These data suggest that the protein component of the nucleoid was dynamic under conditions of DNA damage repair. PMID- 2706746 TI - Constraints upon parenting: experience of a psychologist. PMID- 2706747 TI - Thoughts from Sweden: the blind child at nursery school with sighted children. PMID- 2706748 TI - Thoughts from Canada: starting school--emotional considerations. PMID- 2706749 TI - Changes in lipopolysaccharide concentrations in hepatic portal and systemic arterial plasma during intestinal ischemia in monkeys. AB - The time course of changes in the level of plasma lipopolysaccharides (LPS) in both the hepatic portal and the systemic arterial circulations, together with changes in cardiovascular parameters, was ascertained during a 1 hr occlusion of the superior mesenteric artery (SMA) in six primates. The LPS concentrations before occlusion of the SMA in the hepatic portal and systemic arterial circulation were 0.051 +/- 0.009 and 0.065 +/- 0.011 ng/ml, respectively (NS). At the end of the occlusion period, there was no significant increase in either the hepatic portal or systemic arterial plasma LPS concentrations. Immediately on removal of the occlusion, however, the LPS concentration in the portal plasma increased and peaked at 0.431 +/- 0.124 ng/ml (P less than 0.01) within 17.5 +/- 1.71 min, whereas in the systemic arterial circulation the LPS concentration began to rise but only after a delay of approximately 10 min to peak at 0.287 +/- 0.126 ng/ml (P less than 0.05) within 32.5 +/- 4.23 min of reperfusion. The mean arterial pressure (MAP) declined during the reperfusion period from 98.6 +/- 6.89 to 65.0 +/- 9.5 mm Hg (P less than 0.05). The heart rate showed a small but not significant increase (P greater than 0.2) after about 80 min of reperfusion. These data indicate that the gut is the source of the increased plasma LPS concentration following occlusion of the SMA. PMID- 2706750 TI - Improved survival from compound 48/80-induced lethal stress and inhibition of myocardial histamine and carnosine mobilization by lodoxamide. AB - The precise roles of carnosine and histamine in the physiologic response of the cardiovascular system to stress are unknown. We have previously shown in skeletal and cardiac muscle that carnosine serves as a histidine reservoir available for subsequent histamine synthesis following trauma and sepsis. This study was designed to quantify the effect of histamine-releasing and blocking agents on the myocardial carnosine-histamine pathway as well as on survival during severe stress. Four groups of mature (9-month-old) Sprague-Dawley rats were treated with either (1) saline, (2) lodoxamide (L, mast cell degranulation inhibitor), (3) compound 48/80 (a mast cell degranulator which causes stress), or (4) L followed by 48/80, and observed until agonal or the end of 30 min. When either endpoint was reached the animals were sacrificed and their hearts were removed for tissue analyses of histidine, histamine, 3-methylhistamine, and carnosine via high pressure liquid chromatography. All five L-pretreated animals survived challenge with 48/80 while all five animals given 48/80 alone died (P less than .005). This mortality correlated well with the increase in the myocardial levels of histidine (P less than or equal to .0005), histamine (P less than or equal to .0077), and 3 methylhistamine (P less than or equal to .0004) and the decrease in carnosine (P less than or equal to .009) experienced by the animals treated with 48/80 alone in comparison to the control, L-only- and L + 48/80-treated groups. A protective effect of L was shown against the deleterious effects of 48/80 which is associated with prevention of myocardial carnosine mobilization to histidine and histamine. These data support the role of carnosine as a nontoxic myocardial histidine reservoir which is mobilized in response to stress-induced increases in histamine requirements. PMID- 2706751 TI - D-Arg-[Hyp3-D-Phe7]-bradykinin, a bradykinin antagonist, reduces mortality in a rat model of endotoxic shock. AB - The kallikrein-kinin system is activated during endotoxic shock, suggesting that bradykinin plays a role in the pathology of this disease. To test this hypothesis, a bradykinin antagonist, D-Arg-Hyp3-D-Phe7-bradykinin (NPC 567), was studied in conscious, chronically catheterized rats undergoing lipopolysaccharide (LPS)-induced endotoxic shock. LPS treatment resulted in an increase in circulating bradykinin from less than 23 pg/ml to 144 +/- 18 pg/ml at 1 hr. Intravenous administration of LPS resulted in a 38% drop in mean arterial pressure at 1 hr which was partially reversed by NPC 567. NPC 567 did not affect the moderate tachycardia observed following LPS. NPC 567 infusion at 8 nmol/kg/min dramatically reduced mortality from 100% to 50% at 24 hr (P less than 0.01). In response to LPS, blood thromboxane B2 (TXB2) rose from less than 200 pg/ml to 2,298 +/- 64 pg/ml, while 6-keto-prostaglandin-F1 alpha (6kPGF1 alpha) rose from 289 +/- 23 pg/ml to 7,927 +/- 822 pg/ml. NPC 567 reduced the rise in 6kPGF1 alpha by 42% (P less than 0.05), without affecting TXB2. In summary, NPC 567 reduced mortality in rats treated with LPS, reduced the rise in 6kPGF1 alpha and partially reversed the hypotensive effects. These results suggest that bradykinin plays a significant role in the pathology of endotoxic shock. PMID- 2706752 TI - Mechanisms involved in the effect of M6434 on experimental hemorrhagic shock: I. Effects on myocardial contractility and venous return. AB - To elucidate the mechanisms of protective effect of M6434 on experimental shock, the authors examined the effects of this compound on the survival time and hemodynamic changes in severely hemorrhagic-shocked dogs. We also examined the effects of M6434 on contractile tension of isolated canine ventricular strips and on venous return in dogs with cardiopulmonary bypass in normal and shock state. Intravenous infusion of M6434 at 10 micrograms/kg/min prolonged survival and maintained mean arterial pressure, cardiac output, and first derivative of left ventricular pressure at higher levels than those in the control group, whereas dopamine (10 micrograms/kg/min) did not significantly affect survival time and hemodynamic parameters. M6434 did not change contractile tension in electrically stimulated canine ventricular strips. M6434 (20 micrograms/kg/min) increased the venous return of dogs with cardiopulmonary bypass in both shock and normal state. Phenylephrine (20 micrograms/kg/min) slightly increased venous return in normal state, but not during shock. Dopamine had no effect at 20 micrograms/kg/min, but it increased venous return in both states at 50 micrograms/kg/min. These results suggest that M6434 may improve the hemodynamic derangement in severe hemorrhagic shock through decreasing venous blood pooling. PMID- 2706753 TI - Mechanisms involved in the effect of M6434 on experimental hemorrhagic shock: II. Effects on energy metabolism and organ blood flow. AB - Effects of M6434 on survival time and hepatic energy metabolism of hemorrhagic shocked rats were examined. Effects of the compound on rat mitochondrial respiration and regional blood flow in hemorrhagic-shocked rats were also studied to clarify the mechanisms of the antishock effects. Intravenous infusion of M6434 (3 or 10 micrograms/kg/min) prolonged the survival time of hemorrhagic-shocked rats. M6434 at 10 micrograms/kg/min significantly suppressed the decline of adenosine triphosphate contents and energy charge of the liver, shifted the blood flow distribution from skin and skeletal muscles to vital organs such as the liver and the heart, and also increased cardiac output in hemorrhagic-shocked rats. The mitochondrial respiration was unaffected by M6434 in vitro (10(-6)-10( 5) M). These data suggest that mechanisms of the beneficial effect of M6434 in hemorrhagic-shocked rats may not be based on the direct activation of energy metabolism, but rather on the redistribution of organ blood flow as well as an increase in cardiac output. PMID- 2706754 TI - Hemodynamic effects of monophosphoryl lipid A compared to endotoxin. AB - The acute hemodynamic effects of Salmonella minnesota monophosphoryl lipid A (MPL) were compared with Salmonella minnesota lipopolysaccharide (LPS) in rats. Ten animals were randomized to receive either 0.25 mg MPL/100 g or 0.25 mg LPS/100 g intravenously. Arterial pressure (MAP), thermodilution cardiac output (CO), and colloid osmotic pressure (COP) were measured prior to and 30 and 60 min after MPL or LPS administration. In LPS-treated animals, CO decreased from 356 +/ 23 to 229 +/- 24 ml/kg/min at 30 min (P less than .01). MAP decreased from 115 +/- 7 to 89 +/- 2 mm Hg (P less than .05), and COP decreased from 18.4 +/- 0.6 to 15.4 +/- 0.8 mm Hg (P less than .05) at 60 min. In MPL-treated animals, no significant changes were observed in CO, MAP, and COP at 30 and 60 min. Intravenous infusion of MPL does not produce the hemodynamic derangements or increases in capillary permeability observed with endotoxin. These observations are consistent with previous reports demonstrating the limited toxicity of this lipid A derivative. PMID- 2706755 TI - Thallium 201 uptake in kidneys and heart as an indicator of prognosis in septic shock in the rat. AB - The change in distribution of cardiac output in septic shock was examined by radionuclide imaging with thallium 201 thallous chloride (201Tl) which allows noninvasive evaluation of relative blood flow to various organs except for the brain. Pseudomonas aeruginosa (1 X 10(9)-2 X 10(10) organisms) were inoculated into the thigh of rats 18-24 hr before the study. The mean arterial pressure was measured with an intracarotid catheter. Fractional blood flow to the heart, kidneys, and liver was evaluated as organ uptake of 201Tl. Those with zero or less than 5% kidney uptake (n = 8) had a high heart uptake and all died within 3 hr even if their pressure was maintained. In contrast, 20 out of 24 rats with kidney uptake greater than 5% survived for more than 6 hr. Those results suggest that the kidney uptake, representing fractional renal blood flow, is an excellent indicator of short-term prognosis in septic shock. PMID- 2706756 TI - Cardiac dysfunction caused by factors released from endotoxin-activated macrophages. AB - This study was designed to evaluate the role of macrophages in cardiac dysfunction associated with endotoxemia or septic shock. Rat peritoneal macrophages were cultured on glass bead-carrier and placed in the perfusate stream of an isolated rat heart perfused according to the Langendorff technique. The heart was thus perfused with a Krebs solution exposed to macrophages stimulated with endotoxin. After 10-15 min of exposure, the macrophages released substance(s) that decreased left ventricular pressure (VP) 50-80% and coronary flow (CF) without significantly affecting heart rate or the ECG. In a separate study, macrophages were incubated with endotoxin and the incubate injected into the heart; a 20-30% reduction in VP and CF was observed. However, when macrophages were further stimulated with opsonized zymosan, 60-80% reductions in VP and CF were observed. Treatment with prostaglandin antagonists, leukotriene inhibitors, or trypsin did not significantly modify the activity of the material released from macrophages. Free radical scavengers (catalase and superoxide dismutase) reduced the activity of macrophage derived product by 15-20%. However, platelet-activating factor (PAF) antagonist prevented the action of macrophage mediators on the heart by approximately 58%. Heat inactivation destroyed activity released from the macrophages almost entirely. These findings may contribute to a better understanding of endotoxemia and endotoxin shock mechanisms. PMID- 2706757 TI - Subcellular calcium content in cardiomyopathic hamster hearts in vivo: an electron probe study. AB - In the Syrian cardiomyopathic hamster heart, abnormal cellular calcium regulation, resulting in cellular calcium overload, is believed to play a role in the pathogenesis of cardiac hypertrophy and failure. Alternatively, the primary abnormality may be coronary vasospasm, resulting in reperfusion-induced necrosis. According to the latter hypothesis, only those cells that suffer an ischemic insult would contain elevated calcium levels. To determine whether a generalized elevation in myocytic calcium exists in myopathic hamster hearts, we measured cellular and subcellular calcium concentrations by electron probe microanalysis in cryosections of 50-day and 96-day myopathic and control hearts, rapidly frozen in vivo. Total calcium content of ventricular homogenates from each group was also measured by atomic absorption spectrophotometry. No significant differences in subcellular calcium were found by electron probe microanalysis among 50-day and 96-day myopathics and their age-matched controls. In 50-day myopathic and control hearts, mitochondrial calcium was 0.7 +/- 0.2 and 0.9 +/- 0.2, respectively, and A-band calcium was 3.0 +/- 0.4 and 2.6 +/- 0.4 mmol calcium/kg dry wt(+/- SEM). Results from 96-day animals were similar. Localized regions of elevated calcium were found only at sites of necrotic foci: in Na+-loaded cells (mitochondria: 4.7 +/- 1.3 (SEM) mmol/kg dry wt), in dying cells (mitochondria: 72 +/- 22 (SEM) mmol/kg dry wt) or as extracellular deposits (7-10 mol/kg dry wt). Total calcium content of hearts from myopathic hamsters, as determined by atomic absorption spectrophotometry, was also 13 times (50-day) and 50 times (96 day) higher than controls. These results demonstrate that there is a marked heterogeneity in cellular calcium content in myopathic hamster hearts, but the data do not support the hypothesis of a generalized cellular calcium overload. PMID- 2706758 TI - Role of prostaglandins in proximal tubule sodium reabsorption: response to elevated renal interstitial hydrostatic pressure. AB - Previous studies have shown that the elevation of renal interstitial hydrostatic pressure by the direct expansion of renal interstitial volume increases urinary sodium excretion. The objective of the present study was to investigate whether proximal tubules respond to the elevated renal interstitial hydrostatic pressure and whether the inhibition of prostaglandin synthesis would alter the effect of elevated renal interstitial hydrostatic pressure on proximal sodium reabsorption. Expansion of renal interstitial volume by injecting 100 microliters of 2.5% albumin solution through a chronically implanted matrix increased renal interstitial hydrostatic pressure similarly in control rats (n = 8) and in indomethacin (n = 8) or meclofenamate-treated (n = 7) rats. In the absence of prostaglandin synthesis inhibition, renal interstitial volume expansion significantly increased the fractional delivery of sodium at the superficial late proximal tubules from 56.5 +/- 6.1 to 67.0 +/- 6.5% (p less than 0.01) with an accompanying increase in fractional excretion of sodium from 2.1 +/- 0.5 to 3.0 +/- 0.4% (p less than 0.01). In the presence of indomethacin or meclofenamate, renal interstitial volume expansion failed to augment the fractional delivery of sodium and the fractional excretion of sodium. In summary, these studies demonstrate that the synthesis of prostaglandins plays a role in the regulation of sodium reabsorption by the proximal tubules in response to elevated renal interstitial hydrostatic pressure. PMID- 2706759 TI - Effects of activation on distribution of Ca2+ in single arterial smooth muscle cells. Determination with fura-2 digital imaging microscopy. AB - A rise in cytosolic free Ca2+ is the immediate trigger for contraction in mammalian vascular smooth muscle. We used the fluorescent calcium indicator fura 2 and digital imaging microscopy to study the spatial distribution of intracellular Ca2+ in arterial myocytes and the changes elicited by activation with norepinephrine (NE). Viable arterial myocytes were obtained from bovine tail arteries by enzymatic digestion. In modified Krebs' solution containing 1.8 mM Ca2+, these myocytes were relaxed and spindle-shaped. The cells contracted rapidly when exposed to NE or high-K+ solution ejected from a micropipette; they relaxed slowly when the activator was washed away. NE evoked a rise in Ca2+ concentration ([Ca2+]) in the cells within 100 msec, at a time when the cells had not yet begun to contract. Maximal [Ca2+] levels were attained within 600 msec, at which time the cells were substantially contracted. Digital analysis of images of cellular fura-2 fluorescence revealed that the intracellular [Ca2+] was relatively uniformly distributed prior to activation, with an average resting level of 111 +/- 14 nM (n = 6). During NE-evoked contractions, intracellular [Ca2+] increased, and the distribution of [Ca2+] became much more heterogeneous. On recovery from activation, the cells relaxed, usually attaining less than 90% of their original resting length. In contrast to the relatively uniform Ca2+ distribution observed prior to NE activation, discrete regions of elevated [Ca2+] were observed throughout the recovered cells. The large spatial variation of [Ca2+] after cell activation implies that Ca2+ was sequestered at localized sites in the cell during relaxation. PMID- 2706760 TI - Neuropeptide Y as a putative modulator of the vagal effects on heart rate. AB - Neuropeptide Y is stored in sympathetic nerve terminals throughout the heart and has direct and indirect effects on cardiac function. Although neuropeptide Y has been shown to be released upon intense (16-30 Hz) cardiac sympathetic stimulation, we sought to determine whether effective quantities of neuropeptide Y were released from cardiac sympathetic neurons under more natural conditions. We recorded arterial pressure and cardiac cycle length in 29 anesthetized dogs. We assessed neuropeptide Y release by measuring the attenuation of vagally induced increases in cardiac cycle length (10 seconds every 2 minutes) after trains of sympathetic stimulation. We examined the effect of constant-frequency sympathetic stimulation (frequencies of 2, 5, 10, and 15 Hz, applied for train durations of 1, 3, and 5 minutes) on vagally induced chronotropic responses. We also determined the effect of varying the pattern of sympathetic stimulation. Both the magnitude and duration of the inhibition of the vagal effects on cardiac cycle length were augmented significantly by increases in the frequency or duration of sympathetic stimulation. In contrast, the inhibition of the vagally induced chronotropic responses was not significantly affected by changes in the pattern of sympathetic stimulation. We also characterized the role of adrenergic receptors. Phentolamine significantly increased the sympathetically mediated inhibition of the vagal effects on cardiac cycle length, but propranolol had no effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706761 TI - Role of LDL receptors in the in vitro uptake and degradation of LDL in the media of rabbit thoracic aorta. AB - The possible role of plasma low-density protein (LDL) receptors in the uptake and degradation of LDL in the whole arterial wall was investigated by comparison of the in vitro uptake of 125I-native LDL (nLDL) and 131I-methylated LDL (mLDL) by the media of deendothelialized rabbit thoracic aorta excised at in vivo length and pressurized to 70 mm Hg, taking the advantage that mLDL is not recognized by the LDL receptor. The distribution of the relative concentrations of nLDL (Cn) and mLDL (Cm) across the wall was obtained using a serial frozen sectioning technique. The aorta was incubated under three different conditions for varying periods of incubation in order to analyze separately the processes of binding, binding-internalization, and degradation. At 39 degrees C, in which binding internalization and degradation occurred, Cn was significantly higher than Cm at each position across the media. The mean medial Cn/Cm ratio was 1.36 +/- 0.15 (n = 5) after 1 hour of incubation, and decreased to 1.23 +/- 0.22 (n = 7) after 2 hours of incubation and to 1.13 +/- 0.11 (n = 5) after 4 hours of incubation. At 4 degrees C, in which internalization and degradation were blocked, the Cn/Cm ratio reflected the surface nLDL binding alone; the Cn/Cm ratio was 1.47 +/- 0.20 (n = 5) after 4 hours of incubation, higher than the value obtained at 39 degrees C. To investigate whether degradation of nLDL occurred after receptor binding, the interstitial LDL was washed out by an LDL-free solution after 2-hour incubation at 39 degrees C. After 30 minutes of washout, the Cn/Cm ratio decreased to 1.06 +/- 0.20 (n = 5) in the inner media and was unchanged in the outer media. After 1 hour of washout, the ratio declined to 0.57 +/- 0.18 (n = 7) in the inner part of the media and increased progressively to 1 at the media adventitia boundary. The Cn/Cm ratio, at 0.67 +/- 0.12 (n = 5), was practically constant throughout the media after 2 hours of washout. The nLDL degradation rate across the media was obtained from the comparison of nLDL and mLDL before and after the washout. A steep decreasing gradient in nLDL degradation rate was observed from the luminal to the external surface. The mean medial nLDL degradation rate value was 9.6 +/- 4.5 microliters/cm3 wet tissue/hr. We concluded that functional LDL receptors participate in the uptake and degradation of LDL in the whole aorta. PMID- 2706762 TI - Response of myocardial metabolites to graded regional ischemia: 31P NMR spectroscopy of porcine myocardium in vivo. AB - The changes in myocardial high energy phosphates and pH during regional ischemia, and their potential role in mediating functional abnormalities, is unclear. To determine the degree of regional blood flow reduction required to induce changes in high energy phosphates and pH, and to correlate these metabolic changes with alterations in blood flow, 31P nuclear magnetic resonance spectroscopy was employed in an in vivo porcine model of graded coronary stenosis. Simultaneous measurements of regional blood flow and phosphate compounds were made during various steady-state degrees of regional ischemia in which subendocardial blood flow was reduced by as much as 80%. ATP did not fall over the total range of graded ischemia, while phosphocreatine (PCr), inorganic phosphate (Pi), and pH all changed progressively after blood flow was reduced below 50% of normal. The ratio of PCr/Pi (a measure of the energy reserve of the myocardium) was strongly correlated to subendocardial blood flow (r = 0.94) and declined by 25% when blood flow was reduced by only 21% below normal. These findings indicate that PCr/Pi is a sensitive marker of ischemia and support the hypothesis that the in vivo energy status of the myocardium is closely coupled to myocardial blood flow. PMID- 2706763 TI - Cerebral and peripheral circulatory responses to intracranial hypertension in fetal sheep. AB - Fetal head compression during normal labor can increase intracranial pressure (ICP). We studied the cerebral and peripheral blood flow responses to ICP elevation in utero in chronically catheterized fetal sheep using the radiolabeled microsphere technique. ICP was elevated, stepwise, in increments of 6 +/- 1 mm Hg by infusion of artificial cerebrospinal fluid into a lateral ventricle. When ICP was raised to within 28 mm Hg of baseline mean arterial blood pressure (i.e., ICP above 22 mm Hg), arterial pressure began to increase. Above this ICP level, up to 41 mm Hg, mean cerebral perfusion pressure was maintained by equivalent increases in arterial pressure. Cerebral blood flow and O2 uptake at the highest ICP levels were not different from baseline values. Changes in peripheral organ blood flow were graded according to the level of ICP. At the highest level (ICP = 41 mm Hg), renal, gastrointestinal, and skin blood flow decreased by 68%, 69%, and 65%, respectively. Myocardial and adrenal blood flow doubled, whereas heart rate and cardiac output were unchanged. Placental blood flow increased in proportion to arterial pressure. Arterial plasma epinephrine, norepinephrine and arginine vasopressin increased by nearly two orders of magnitude. Therefore, as ICP approaches baseline mean arterial pressure, fetal lambs are capable of sustaining cerebral perfusion by initiating profound visceral vasoconstriction without curtailing placental blood flow. Since cerebral O2 uptake was maintained, there is no evidence that stimulation of the peripheral response requires pronounced cerebral ischemia. This highly developed Cushing response may be important for ensuring cerebral viability when the fetal head is compressed during parturition. PMID- 2706764 TI - Age-dependent supersensitivity to the glycogenolytic effect of K+ in the cerebral cortex of the spontaneously epileptic quaking mouse mutant. AB - K+, at concentrations reached in the extracellular space during neuronal activity (5-10 mM), promotes a time- and concentration-dependent hydrolysis of [3H]glycogen newly synthesized by mouse cerebral cortical slices. In the present study, the glycogenolytic action of K+ was examined in the neocortex of the quaking mouse, a spontaneously epileptic mutant characterized by deficient myelination of the CNS. The potency and efficacy of K+ in eliciting glycogen hydrolysis was greatly enhanced in cerebral cortical slices prepared from homozygous quaking mice (qk/qk) older than 7 weeks of age, indicating a supersensitive response to a metabolic action of the ion. A detailed ontogenic analysis showed an evolution of the supersensitive response to K+ which is reminiscent of the previously described increase in the number of alpha 2 adrenoreceptors in the brainstem of this mutant. In contrast to the altered response to K+, the glycogenolytic action of noradrenaline and vasoactive intestinal peptide reported earlier was equally expressed in qk/qk and in their unaffected littermates. PMID- 2706765 TI - Cells positive for the O4 surface antigen isolated by cell sorting are able to differentiate into astrocytes or oligodendrocytes. AB - Cells expressing the surface antigen O4 were isolated as pure populations from cultures of murine brain or cerebellum using fluorescence activated cell sorting. When these O4-positive cells were further cultured in the presence of fetal calf serum (FCS) many cells expressed both O4 and the astrocyte marker glial fibrillary acidic protein (GFAP) after 4 days of culture. Cells not exposed to FCS expressed O4, but never GFAP. GFAP-positive cells in the presence of fetal calf serum very rarely expressed the myelin associated glycoprotein (MAG) or O1, both of which are expressed on more differentiated oligodendrocytes, and never expressed O10 that is characteristic of even more mature oligodendrocytes. These results show that glial cells expressing O4, but not MAG, O1, O10 or GFAP are bipotential precursor cells able to differentiate into astrocytes or oligodendrocytes depending on the culture conditions and suggest that bipotentiality of glial precursor cells is retained up to a later developmental stage than that of the O2A progenitor cell. PMID- 2706766 TI - Postnatal expression of opioid genes in rat brain. AB - Developmentally regulated expression of opioid genes in rat brain was studied by Northern blot hybridization, using cloned rat genes as probes. Total RNA was isolated from the rat medulla oblongata, hypothalamus and striatum at 11 stages of development from birth to postnatal day 28. The steady-state levels of opioid precursor mRNAs in the above tissues were determined by hybridization to 32P labeled opioid DNA probes and densitometric scanning of the appropriate bands. Analysis of the relative steady-state concentrations of opioid mRNAs has shown that the tissue distribution and size of these mRNAs during postnatal development of the CNS are similar to the pattern described in the adult. However, up to 50 fold changes in the relative mRNA concentrations were observed. These changes are tissue-specific, characterized by a peak within the postnatal stage of development, and are followed by a build-up of mRNA levels characteristic of the adult. Moreover, comparison of the changes in mRNA levels of proenkephalin to those of prodynorphin at their main site of synthesis in the brain, namely the striatum, revealed striking similarities in pattern. The association of this phenomenon with a possible role of opioid genes in development is suggested. PMID- 2706767 TI - Behavioral analysis of the postnatal development of micturition in kittens. AB - Micturition in neonatal mammals of various species can be induced by a somatovesical reflex that is triggered by the mother licking the perineal region of the neonate. The present study was conducted to ascertain whether neonatal kittens can also urinate via a vesicovesical reflex that is elicited by bladder distension. Initial experiments consisted of isolating kittens from their mothers and observing urine release. Kittens less than 3 weeks of age did not urinate despite the presence of large volumes of urine in their bladders. Kittens older than 3 weeks of age did urinate, completely emptying their bladders. The volumes of urine that induced micturition in the older kittens were generally less than those that were ineffective in inducing micturition at younger ages. Cystometrograms in unanesthetized kittens less than 3 weeks of age revealed that distension of the bladder by saline infusion did not evoke bladder contractions. However, saline infusion in older kittens did produce bladder contractions that were accompanied by squatting and the release of urine from around the bladder cannula. Surprisingly, bladder contractions, which were typically abolished by spinal transection, were observed in kittens less than 3 weeks of age when the kittens were anesthetized with either ketamine or chloralose. This latter finding indicates that the vesicovesical reflex is present in neonatal kittens, but it is being suppressed by anesthetic-sensitive mechanisms. Thus, micturition in neonatal kittens is normally mediated entirely by the somatovesical reflex. PMID- 2706768 TI - Expression of the oxytocin and vasopressin genes in the rat hypothalamus during development: an in situ hybridization study. AB - Oxytocin (OT)- and vasopressin (VP)-mRNAs were detected in the hypothalamus, during development, by in situ hybridization with synthetic oligonucleotide probes. The presence of VP- and OT-mRNAs was first detected in the supraoptic nucleus at E16 and E17 respectively, and simultaneously at E18 in the paraventricular nucleus. VP- (but not OT-) mRNA then appeared in the suprachiasmatic nucleus at E21, and OT- (but not VP-) mRNA, in the anterior commissural nucleus at time of birth. In the different nuclei, the relative distribution of cells containing OT- or VP-mRNA was comparable, from the earliest stages on, with that observed in the adult. These data suggest that the later appearance of mature OT (E20), versus VP (E16), reported in immunocytochemical studies, may not be due to a delayed transcription. Moreover, since the presence of both OT- and VP-prohormones has been reported at E16, the results support the idea of a rapid translation of both OT- and VP-mRNAs. In no location could OT- and VP-mRNAs be detected before final cell settlement; the possible role of environmental factors in final non-proliferative differentiation is discussed. PMID- 2706769 TI - Cholinergic modulation of epileptiform activity in the developing rat neocortex. AB - The effects of carbachol on picrotoxin-induced epileptiform activity and membrane properties of neurons in the developing rat neocortex were examined in an in vitro slice preparation. Intracellular recordings were obtained in layer II-III neurons of slices prepared from rats 9-21 days of age. Epileptiform activity in 9 to 14-day-olds consisted of a sharply rising, sustained (10-30 s) membrane depolarization with superimposed action potentials. Bath application of carbachol (5-50 microM) raised the threshold for evoking epileptiform activity but, when such responses were evoked, their underlying depolarizations were increased in amplitude. Orthodromic stimulation in slices from 15- to 21-day-old animals evoked a prolonged epileptiform burst response that triggered an episode of spreading depression (SD). Carbachol reduced epileptiform responses and suppressed the occurrence of SD. It did not significantly affect the resting membrane potential or the height of the action potential but decreased the rheobase current needed to evoke an action potential and increased the input resistance. All effects of carbachol were antagonized by atropine (1 microM). These results indicate that carbachol has both pre- and postsynaptic effects in the developing neocortex and can significantly modulate neuronal excitability in the immature nervous system. PMID- 2706770 TI - Quantitative assessment of dendritic branching and spine densities of neurons of hippocampal embryonic tissue transplanted into juvenile neocortex. AB - Embryonic 18-day-old hippocampal tissue was transplanted into a fresh cavity in frontal neocortex in 18-day-old (juvenile) Wistar rats. The transplant was examined after 2-5 months. The rapid Golgi procedure was used to assess quantitatively the dendritic branching (intersections and branching orders) and spine numbers per neuronal region, and spine densities (per 20 microns segment) on the pyramidal neurons, granule neurons and other types. The results revealed that the graft neurons generally have significant deviations from those of normal native hippocampal neurons. The aberrations were present in both pyramidal and granule cells. There were also many neurons which could not be classified into the known types. The pyramidal neurons showed a significant deficiency in dendritic branching, more often in basal dendrites than in apical dendrites. Apical dendrites of the graft pyramidal neurons also developed spine densities relatively better than basal dendrites, and sometimes significantly higher than even normal neurons. The significant deficiency in spine numbers of basal dendrites was primarily due to deficiency in dendritic branching rather than to spine density. On the contrary, the granule cells developed significantly less of both dendritic branching and spine densities (hence spines per neuron) than normal hippocampal granule neurons. The unclassifiable neuronal types had generally high dendritic branching and spine densities relative to the other neurons of the graft. The study discusses the importance and necessity of making quantitative assessments of neurons to understand whether the apparently normal neurons of transplants are really normal, and how far they are deviant. So far, quantitative assessments have been seldom reported in this important area of research, hence, this study is the first of its kind to highlight it. PMID- 2706771 TI - The generation and differentiation of cholinergic neurons in rat caudate-putamen. AB - By combining [3H]thymidine autoradiography with choline acetyltransferase (ChAT) immunocytochemistry, we have determined the generation pattern of the large cholinergic neurons in the neostriatum. All of these neurons are produced between embryonic days 12 and 17 (E12-E17), with 75% of them being born between E13 and 15. Cholinergic neurons appeared to be among the earliest cells produced in the neostriatum when compared with previous generation studies of all neurons in the rat caudate-putamen. The caudal-to-rostral neurogenic gradient reported in previous investigations of all neurons was the only spatiotemporal gradient observed for cholinergic neurons. The generation peak for these cells was E13 caudally, and E15 rostrally. Additional immunocytochemical studies detected ChAT immunoreactivity within somata and primary dendrites of 1 day postnatal (1 dpn) rat neostriatum, and subsequently demonstrated a dramatic increase in the intensity of reaction product and the complexity of dendritic arborizations by 14 dpn. Large ChAT-positive neurons of the basal forebrain contained within the same specimens appeared to differentiate their cholinergic phenotype earlier than those in the neostriatum. However, recent generation studies of basal forebrain neurons combined with the present results have demonstrated that both cholinergic populations are produced simultaneously along the same neurogenic gradients. This then represents an example of cholinergic projection (basal forebrain system) and local circuit (neostriatum) neurons that share similar generation patterns but differ with respect to sequences of transmitter phenotype expression. Thus, for cholinergic forebrain neurons, a cell's position along the neurogenic gradient and its transmitter phenotype appear to be more closely associated with its birth date than its ultimate projection or rate of differentiation. PMID- 2706772 TI - Intraocular injections of tetrodotoxin reduce transiently expressed acetylcholinesterase activity in developing rat visual cortex. AB - Geniculo-recipient layers of primary visual cortex in the rat display a transient pattern of acetylcholinesterase (AChE) activity during the second postnatal week of life. Previous work has demonstrated that neonatal enucleations markedly reduce the transient AChE activity in visual cortex. The present studies were undertaken to determine the effects of reduced afferent neural activity on expression of the transient pattern of AChE activity. Rat pups received intraocular injections of tetrodotoxin (TTX) on postnatal days (PND) 3, 5, 7, 9 and 11 and were sacrificed on PND 12. Some animals were enucleated on PND 3. Brain sections were processed for AChE histochemistry and analyzed by optical densitometry. These experiments show that uniocular injections result in a markedly decreased level of AChE activity in layer IV of the medial part of cortical area 17 contralateral to the injected eye. The degree of reduction of AChE activity from repeated TTX injections was similar to the degree of reduction following enucleation on PND 3. Binocular injections of TTX result in a reduction of AChE activity in layer IV throughout cortical area 17, similar to the effects of binocular enucleation on PND 3. Experiments combining injection of horseradish peroxidase along with TTX on PND 11 demonstrate that retinal ganglion cells of TTX injected eyes are still capable of anterograde axonal transport. These data demonstrate that normal innervation and afferent activity are necessary for the transient expression of AChE activity by geniculocortical neurons. PMID- 2706773 TI - Prenatal ontogenesis of pro-opiomelanocortin in the mouse central nervous system and pituitary gland: an in situ hybridization and immunocytochemical study. AB - Pro-opiomelanocortin (POMC) mRNA detected by in situ hybridization and POMC/ACTH (adrenocorticotropin)-containing neurons detected by immunocytochemistry were first observed in the presumptive arcuate nucleus of embryonic mouse brain on gestational day 10.5 (E10.5). Immunostained fibers were also evident on E10.5 in the lateral and dorsal diencephalon. In these areas, a dense network of processes developed by E11.5 and extended into the mesencephalon. Fibers were detected in the myelencephalon at this stage and a day later (E12.5) in the spinal cord. Adult-like patterns of POMC/ACTH fibers were established in the diencephalon, mesencephalon, metencephalon and the myelencephalon between E13.5 and E15.5. POMC expressing cells in the anterior and intermediate lobes of the pituitary gland appeared on E12.5 and E14.5, respectively. The early expression of POMC and the rapid establishment of dense fiber tracts in the brain is consistent with a role for POMC-derived peptides in the development of the central nervous system. PMID- 2706774 TI - A proposed relationship between increases in the number of olfactory receptor neurons, convergence ratio and sensitivity in the developing rat. AB - In the rat neonate, as in other altricial young, olfaction, in contrast to vision and hearing, is functional at birth, being critically important in feeding, growth and other aspects of infant-mother interaction. Yet, olfactory sensitivity, i.e., the ability to detect odors at low levels, is poor in the newborn, improving dramatically in the first few postnatal weeks. To find a neural explanation for this phenomenon at the level of peripheral olfactory system, we present quantitative light microscopic data which reveal that during the suckling period of postnatal development the surface area of the olfactory receptor sheet and the total number of olfactory receptor neurons increase by about 8- and 12-fold respectively, being about 15 mm2 and 1.0 million on each nasal half of the newborn. Since the number of mitral cells, the principal relay neurons of the olfactory bulb, is already established at birth, at about 40,000 per olfactory bulb, it may be estimated that the convergence ratio of the olfactory neurons to mitral cells increases by more than 10-fold in the suckling period. We propose that the increased number of primary sensory afferent units and the higher convergence upon the central relay cells enhances the physiological capacities of the olfactory afferent pathway, increasing the opportunity for spatial summation and facilitation. The latter changes may lead to reduced olfactory thresholds and improved sensitivity with development. The relative contribution of these peripheral changes in enhancement of olfactory sensitivity during growth is discussed in the light of our knowledge on the developing olfactory system. PMID- 2706776 TI - Magnetic resonance spectroscopy in biology and medicine. AB - Magnetic resonance spectroscopy has developed from a standard tool of the chemist into a very promising modality for clinical and analytical evaluation of human pathophysiology. We present a brief outline of the method and its parameters, as well as a series of examples of its application. Anatomical imaging is also discussed. PMID- 2706775 TI - Effect of potassium depolarization on phosphate-activated glutaminase activity in primary cultures of cerebellar granule neurons and astroglial cells during development. AB - The cerebellar granule cells are believed to be glutamatergic neurons. During the normal development of granule cells grown in a chemically defined medium, the specific activity of phosphate-activated glutaminase increased from 60 at 3 days to 150 (nmol/h/mg protein) at 15 days in vitro. Treatment with 25 mM K+ for the last 2 days elevated glutaminase activity in an age-dependent manner: about 100% at 3 and 6 days, 75% at 10 days, and 40% at 15 days in vitro. The enhancement of glutaminase in granule cells was dose-dependent. The half-maximal effect was obtained at about 20 mM K+, whereas the maximum concentration, which produced about a 2.5-fold increase in 3-day-old cultures was about 40 mM K+. The voltage sensitive Na+ channel inhibitor tetrodotoxin had no effect on the depolarization induced activity in granule cells. However, the increase in glutaminase by 25 mM K+ was significantly blocked by both organic (nifedipine) and inorganic (Ni2+ and Mg2+) calcium antagonists, indicating that elevation in activity may be mediated through transmembrane Ca2+ entry into granule cells. In contrast to neurons, in cultured cerebellar astrocytes, the activity of glutaminase slightly decreased during development, and treatment with 25 mM K+ had no significant effect on this enzyme activity. The present findings, together with previous observations, would indicate that depolarization with K+, which is believed to mimic in vivo presynaptic stimulation, could be one of the mechanisms that selectively controls the development and function of neurons, when measured in terms of the activity of the enzymes involved in the synthesis of cell-specific neurotransmitters. PMID- 2706777 TI - Canines erupted through grafted alveolar cleft defects in patients with alveolar clefts: a pulp testing evaluation study. AB - An electric pulp tester (EPT) was used to evaluate the pulpal response of erupted canines in 75 patients: 16 patients with unilateral cleft palate who received autogenous bone grafts to correct their alveolar cleft defects before canine eruption; 35 patients without cleft palate whose canines erupted spontaneously, but who required orthodontic treatment for alignment; and 24 patients without clefts whose canines required surgical uncovering and orthodontic assistance for eruption. Thirty-one percent of the erupted canines in the patients with grafted unilateral clefts did not respond to EPT, whereas all canines in the contralateral noncleft side responded to EPT. There was no clinical or radiographic evidence of pulpal pathosis of the canines that had erupted through the grafted alveolar clefts. However, these teeth had a high incidence of nonresponsiveness to pulp stimulation, therefore necessitating close follow-up in case they show eventual signs of pulpal degeneration that may require endodontic intervention. PMID- 2706778 TI - Absorbed doses and energy imparted from radiographic examination of velopharyngeal function during speech. AB - Absorbed doses of radiation were measured by thermoluminescent dosimeters (TLDs) using a skull phantom during simulated cinefluorographic and videofluorographic examination of velopharyngeal function in frontal and lateral projections. Dosages to the thyroid gland, the parotid gland, the pituitary gland, and ocular lens were measured. Radiation dosage was found to be approximately 10 times less for videofluoroscopy when compared with that of cinefluoroscopy. In addition, precautionary measures were found to reduce further the exposure of radiation sensitive tissues. Head fixation and shielding resulted in dose reduction for both video- and cinefluoroscopy. Pulsing exposure for cinefluoroscopy also reduced the dosage. PMID- 2706779 TI - The fate of buccal mucosal flaps in primary palatal repair. AB - The fate of buccal mucosal flaps used in 50 cases at the time of primary palatal repair is reviewed. It was found that in 13 cases (26 percent) the pedicle of the flap interfered with the eruption of the permanent molars and had to be divided. Nasendoscopic examination was made of the palate in 16 cases in an attempt to visualize the buccal flap. It was identified in only three cases. It is suggested that if this flap is to be used, it must be designed carefully, and that regular intraoral examination of the patients is required around the time of eruption of the permanent molars. PMID- 2706780 TI - Self-concept of early primary school age children with visible or invisible defects. AB - This study compares self-concept scores on the Primary Self-Concept Inventory (PSCI) of 58 7-year-old children. The experimental groups included the three following subgroups: those with visible defects (cleft lip), mixed visible and invisible defects (cleft lip and palate), and invisible defects (cleft palate). The control consisted of first grade students with no physical defects. Significant differences between the subjects with clefts and controls were found. Children with cleft lip and palate (visible and invisible defects) demonstrated the lowest self-concept scores. These test results suggest that early primary school age children experience significant stigma. Therefore, early evaluation of psychosocial stress factors for children with clefts is suggested. School personnel can contribute to addressing self-concept concerns of children with defects. Suggestions for further research are presented. PMID- 2706781 TI - Proplast as a pharyngeal wall implant to correct velopharyngeal insufficiency. AB - Proplast I was used as posterior pharyngeal wall implant to correct velopharyngeal insufficiency (VPI) in 26 patients. Specific criteria were followed in patient selection. Follow-up ranged from 4 months to 124 months. Postoperatively, 18 patients had elimination of VPI and three patients had minimal residual VPI. Four patients lost the implants secondary to infection with residual VPI. One patient had significant residual VPI without the loss of the implant. Based on long-term follow-up, no migration of the implant was seen and there was no detectable effect on subsequent facial growth. Predictably better results were achieved with younger patients in whom smaller implants were used. Conclusions from this study indicate that Proplast I is an acceptable pharyngeal wall implant material to correct VPI when the specific criteria are met and good surgical technique is used. PMID- 2706782 TI - The use of videonasopharyngoscopy for biofeedback therapy in adults after pharyngeal flap surgery. AB - Nasopharyngoscopy with videorecording was used as a visual feedback therapy tool to establish and promote consistent closure of the velopharyngeal ports during connected speech after pharyngeal flap surgery. Of the three adults in this report, two achieved consistent closure during connected discourse and have been discharged from therapy; the third demonstrated improved velopharyngeal closure but elected not to continue therapy. These outcomes demonstrate that nasopharyngoscopy biofeedback therapy is useful in helping the motivated adult to achieve better velopharyngeal closure during connected speech after pharyngeal flap surgery or revision. This type of therapy may also prove beneficial with children. PMID- 2706783 TI - Deepithelialized mucosal-submucosal flaps to correct the "whistling lip" deformity. AB - Many methods have been described for correction of the "whistling lip" deformity, a possible sequela of bilateral cleft lip repair. A technique is described that utilizes medially based deepithelialized mucosal-submucosal flaps to augment the central tubercle and to reduce lateral lip fullness. This technique is also useful for certain mucosal contour defects that follow unilateral cleft lip repair. Indications for applying this technique and its advantages, compared with other procedures, are described. PMID- 2706784 TI - Cleft lip and palate and related disorders: issues for future research of high priority. AB - On October 14 to 17, 1987, a meeting entitled "State of the Art Conference: Multidisciplinary Management of Cleft Lip and Palate" was held in Iowa City. The major purpose of the conference was to review the available knowledge concerning management of unilateral cleft lip and palate from the perspectives of surgery, speech-language pathology, and orthodontics. The closing feature of the conference was the identification of issues for future research. Participants identified issues of high priority that were then discussed by the entire conference faculty. This paper reports the summary of that discussion and the recommendations of the Conference. PMID- 2706785 TI - Cleft lip and palate: new directions for research. AB - In this personal essay, presented as the keynote address at the inaugural meeting of the Australasian Cleft Palate Association, the author provides an overview of what many might call "the state-of-the-art." But beyond that, the author also plots direction to our efforts so our science can progress. PMID- 2706786 TI - Research revisited. PMID- 2706787 TI - A comment on Clifford's "The state of what art?". PMID- 2706788 TI - Comparison of multi-view videofluoroscopy and nasopharyngoscopy in the assessment of velopharyngeal insufficiency. AB - Ratings and drawings of multi-view videofluoroscopy and nasopharyngoscopic studies of the velopharyngeal valve in 25 subjects with velopharyngeal insufficiency (VPI) were compared. The videofluoroscopic projections assessed were lateral, base, and Towne views. The Towne view was visually compared with flexible fiber optic nasopharyngoscopic studies in the same subjects. The Towne view was found to compare well with nasopharyngoscopic examination, and lateral view alone was found to be inadequate for the description of velopharyngeal movements. PMID- 2706789 TI - The neurophysiological aspects of electrical injuries. AB - Neurologic and psychologic studies were done on 16 victims of alternate current electrical injuries. The patients were followed for a period of over 5 years. The findings point to a stereotyped generalized cerebral dysfunction, resulting in depression, divorce, unemployment as well as a high incidence of atypical seizures (atonic and myoclonic seizures). The EEG and CT studies were nondiagnostic. Evoked potentials revealed abnormalities in the upper cervical spinal cord and lower brain stem regions, raising the possibility that the epileptogenic focus was too deep to be recorded by standard surface EEG recording. The fact that the electrical injury patients have a high incidence of severe emotional disturbance and post-traumatic depression along with atypical seizures, in the face of nondiagnostic EEG and CT studies, may result in improper management of such patients. PMID- 2706790 TI - Sleep spindles in twins. AB - Sleep spindle characteristics and spindle power periodicity were studied in 4 identical and 3 fraternal twin pairs (mean age, 16 years). There were no significant genetic effects such as concordance between the identical twins and discordance between the fraternal twins for mean duration, mean amplitude and mean frequency of spindles. Spindle periodicity, which is correspondent to the sleep cycle, was visually more similar between the identical twins than between the fraternal twins. These observations suggest that the sleep cycle which is expressed by periodic appearance of spindle powers is genetically determined. On the other hand, some spindle characteristics and some physical measures had significant relationships. These relationships may suggest that some spindle characteristics are influenced by the individual development rather than by a genetic trait. PMID- 2706791 TI - Angelman's (happy puppet) syndrome: clinical, CT scan and serial electroencephalographic study. AB - Of four patients having Angelman's syndrome admitted to a state mental facility who were clinically and electroencephalographically evaluated, 2 patients had CT scan studies of the brain. The most impressive and striking features that help in the diagnosis are the mental and physical retardation, nondevelopment of speech despite adequate visual and auditory function, various types of seizures, and episodic uncontrollable laughter. The CT scans of the brain did not offer any clue as to the pathogenesis. The EEGs appeared to fall into two groups: in one an arrest of electrical maturation occurred between ages 1 and 3 and in the other a slow but progressive maturation was evident. PMID- 2706792 TI - Epileptiform discharges in presence of continuous background activity in anoxic coma. AB - The EEGs of a group of patients in anoxic coma following cardiorespiratory arrest were retrospectively studied. Twelve of 70 patients had at least one EEG recorded during the acute period which consisted of epileptiform discharges in the presence of continuous diffuse background activity. Nine of the patients died while three made a generally favorable recovery. The analysis confirms the prediction of a recent revision of EEG grades in coma that this particular pattern of activity is of uncertain prognostic significance. This is in contrast to the occurrence of epileptiform discharges during discontinuous "burst suppression" activity which generally indicates a fatal outcome. PMID- 2706793 TI - The relationship between EEG changes and cognitive functions in dementia: a study in a VA population. AB - This study explores the relationship between the results of tests of dementia and the EEG findings in 94 demented patients of different etiologies. Abnormal EEGs were found in 83% of all patients, usually diffuse slow wave abnormalities, the degree of which correlated very well with the Modified Hachinski test. Only a weak relationship was found between the EEG and the Mini-Mental Status Examination, while the Mattis and its subtests correlated better. Focal EEG abnormalities on the temporal areas were the characteristic pattern in patients with alcoholic dementia. The test scores in the 17% with normal EEGs were consistent with the above findings, in that patients with normal tracings scored well on the Modified Hachinski and Mattis tests, but not on the Mini-Mental Status Exam. PMID- 2706794 TI - Development of West syndrome in a patient with Reye syndrome: a case study. AB - We report the case of a 3 month old female with a diagnosis of Reye Syndrome, confirmed with laboratory exams. Three months after apparently recovering from the acute clinical picture, the patient developed massive spasms and psychomotor delay with an EEG tracing typical of hypsarrythmia, the classic triade which suggests West Syndrome. PMID- 2706795 TI - Maturational study of short-latency somatosensory evoked potentials after posterior tibial nerve stimulation in infants and children. AB - SSEPs produced in response to PTN stimulation were studied in 41 normal infants and children from 4 months to 16 years in age. SSEPs were recorded on the scalp with reference electrodes attached to the contralateral knee, shoulder and earlobe. Four positive SSEPs, PI, PII, PIII and PIV, named in order of appearance, and one negative SSEP, N0, were recorded as FFPs on the scalp with the cKn reference. Following these FFPs, the cortical component P1 which corresponded to P37 in adults was recorded. Preceding P1, another negative wave, N1, could be recognized solely at Cz' mainly at the onset of P1. P1 and N1 could be identified in all children with derivations with noncephalic references, although they could not be identified in 5 of 41 children with a Cz' - Fpz derivation. PI, bilobed in configuration, was considered to originate at the sacral plexus or entry to the spinal canal. PII was the least reproducible potential and was considered to originate at the dorsal root, dorsal horn or conus medullaris. PIII, PIV and N0 were considered to originate at the cervical cord, brain stem and thalamus, respectively. With the peak latencies of PI, PII, PIII, PIV, N0, N1 and P1, the RV was calculated in order to eliminate the influence of body height. The RV of the later appearing components leveled off in the older age categories. The RV of P1 reached a steady level at 3 years of age. RVs of PII and PIII appeared to level off by the age of 6 years. The RV of PIV leveled off by the age of 9 years. RVs of N0 and N1 leveled off by the age of 12 years, and that of P1 decreased until over 12 years of age. Furthermore, to eliminate the influence of naturation in the peripheral nerves, the RV was obtained from PI-PIV, PI-P1, PIV-P1 and N1-P1 interpeak latencies. The RVs of these 4 interpeak latencies all decreased until over 12 years of age. Accordingly, the maturation of afferent conduction in the central nervous system after PTN stimulation appeared to be complete after 12 years of age. PMID- 2706796 TI - The effect of intrathecal serotonergic antagonists on the pressor response to stimulation of the brainstem in the rat. AB - Previous studies from our laboratory have shown that stimulation of the brainstem in the area of the descending lateral serotonin containing neurons of the B3 group in the rostral ventrolateral medulla (RVLM), increases blood pressure and serotonin release in the spinal cord. The present experiments were designed to investigate the spinal cord serotonin receptor subtypes involved in mediating this pressor response. The area of the B3 neurons in the RVLM was electrically stimulated and the effects of intrathecally administered methysergide, an antagonist of 5HT1 and 5HT2 receptors, of ketanserin, a 5HT2 receptor antagonist or of ICS 205930 (ICS) or MDL 72222 (MDL), antagonists of 5HT3 receptors, were examined. Electrical stimulation of the area of the B3 serotonin-containing neurons in the RVLM increased mean arterial pressure. Intrathecal methysergide treatment attenuated the pressor response, but intrathecal MDL, ICS, ketanserin or saline were without effect. These results suggest that the pressor responses seen after stimulation of the area of the B3 serotonin neurons in the RVLM may be mediated through activation of spinal 5HT1 receptors. PMID- 2706797 TI - Thrombin-stimulated calcium uptake is altered in platelets from spontaneously hypertensive rats. Effect of external magnesium. AB - Thrombin-induced calcium uptake and serotonin release were measured on platelets from spontaneously hypertensive rats (SHR) and normotensive control animals (WKY). Both 45Ca uptake and serotonin release induced by thrombin are enhanced in platelets from SHR in the presence of various Ca2+ concentrations. In the presence of [Ca2+] 10(-6)M a correlation exists between thrombin-induced calcium uptake and serotonin release; platelets from SHR and WKY do not differ in this respect, which demonstrates that the anomaly observed in platelets from SHR concerns an early reaction in the stimulation-response coupling. The inhibitory effect of magnesium on thrombin-induced serotonin release, less important in platelets from SHR than in control ones, seems to pass through two phenomena: an inhibition of calcium influx occurring at high concentrations and less effective on SHR platelets and a stimulation of calcium influx, probably corresponding to intracellular calcium sequestering, observed in the presence of low magnesium concentrations and enhanced in platelets from SHR. This study therefore evidence a relationship between the increases observed in both serotonin secretion and calcium influx on thrombin-stimulated SHR platelets and suggests cellular mechanisms involved in the inhibitory action of magnesium impaired in these SHR platelets. PMID- 2706798 TI - Dexamethasone suppression in essential hypertension: effects on cortisol and blood pressure. AB - Hypothalamic-pituitary-adrenal axis (HPA) function was examined in normotensive (n = 20) and hypertensive (n = 16) men, by measurement of basal cortisol levels, diurnal variation and the response to dexamethasone suppression. Comparison between groups did not reveal any differences in basal cortisol concentrations, in their diurnal variation, or in response to dexamethasone suppression. In separate studies, treatment with dexamethasone did not alter blood pressure in normal men (n = 6) but produced a small fall in pressure in hypertensive subjects (n = 8), compatible with the notion that the HPA might contribute to blood pressure elevation in some subjects with essential hypertension. PMID- 2706799 TI - Perinatal and first year follow-up of patients with Prader-Willi syndrome: normal size of hands and feet. AB - Four patients with Prader-Willi syndrome, diagnosed in the neonatal period and followed during the first year of life, are reported. There were three males and one female. All four patients presented with hypotonia and distinct craniofacial dysmorphism. Prometaphase chromosome analysis showed interstitial deletion of 15q in all of them. The placentae and umbilical cords were examined in three of the patients and found normal. Electromyography done in the neonatal period suggested primary myopathy. Height, weight and head circumference were normal at birth in all patients. Hand and foot measurements showed normal size at birth and during the first year of life. PMID- 2706800 TI - Tuberous sclerosis and the relation with renal angiomyolipoma. A genetic study on the clinical aspects. AB - Renal angiomyolipomas were present in 23 out of a series of 38 patients with proven tuberous sclerosis (60.5%). Multiplicity and bilateral localization of combined renal angiomyolipomas were important differences between this category and the isolated, usually solitary, angiomyolipomas. One of the parents of a patient with tuberous sclerosis had small renal angiomyolipomas without signs of tuberous sclerosis. This indicates that renal angiomyolipomas might be a forme fruste of tuberous sclerosis. Two patients with suspected isolated renal angiomyolipomas proved to have tuberous sclerosis. From this study we can conclude that multiple angiomyolipomas, or a combination of a single renal hamartoma with one of the signs suggestive of tuberous sclerosis, warrant a thorough examination to exclude tuberous sclerosis. PMID- 2706802 TI - Autosomal dominant inheritance in familial angiolipomatosis. AB - A patient with familial angiolipomatosis in whom an autosomal dominant mode of inheritance could be established is described. This patient also had coincidental autosomal dominant polycystic kidney disease. PMID- 2706801 TI - Chorionic villi sampling for early prenatal diagnosis: an option for the Jewish orthodox community. AB - The Jewish religion permits abortion up to 40 days after conception. To accommodate the Jewish orthodox community, prenatal diagnosis in the eighth gestational week may be a feasible goal with clear benefits. We present our experience with chorionic villus sampling (CVS), wherein out of 144 patients requesting CVS, 125 were found to be suitable for the procedure. Excluding patients with fundal placenta and cervical or uterine myoma, chorionic sampling was successfully performed on 102 out of 106 patients (96.2%) and a chromosome result was available for 98 of those patients (96%). Fetal losses, within 14 days following procedure, were 2 out of 125 (1.6%). No complications were encountered following the procedure. The cytogenetic analysis was improved by culturing CVS fragments for 48 h, after which clearer banding patterns could be observed. One of the CVS preparations, from a 7.2/7-week-old embryo was successfully examined. Short-term (6 days) cultures were used as an additional method for chromosome analysis, to extend and confirm results obtained by the direct method. PMID- 2706803 TI - Prader-Willi syndrome and Sotos syndrome. PMID- 2706804 TI - Interstitial deletion of the long arm of chromosome 6(q22.2q23) in a boy with phenotypic features of Williams syndrome. PMID- 2706805 TI - Blood pressure, plasma and pituitary prolactin responses to bromocriptine in New Zealand genetically hypertensive and normotensive rats. AB - 1. The effects on blood pressure (BP), plasma and pituitary prolactin (PRL) of a 13 day intraperitoneal infusion of bromocriptine (BRC) delivered by osmotic minipump were investigated in genetically hypertensive rats (GHR) and their normotensive (NT) controls. 2. In the GHR, the mean BP in the BRC-treated group over the 13 day period of study was significantly lower than in the vehicle treated group. In the NT rats, the mean BP in the BRC-treated group over the 13 day period was also significantly lower than in the vehicle-treated group. 3. Mean plasma PRL concentration in the GHR and NT rats were comparable. In the GHR, the mean plasma PRL concentration taken on day 13 was significantly lower in the BRC-treated group than in the vehicle-treated group. In the NT rats, the mean plasma PRL concentration taken on day 13 in the BRC-treated group was, however, not significantly different from that in the vehicle-treated group. 4. The mean pituitary PRL content was not significantly different in the GH and NT rats. There was a greater suppression of pituitary PRL content in the BRC-treated GHR than in the BRC-treated NT rats compared with their respective vehicle-treated groups. 5. The results raise the possibility that PRL may have an indirect role in the pathogenesis of the hypertension of the GHR. PMID- 2706806 TI - Perhexilene: effects on hepatic lysosomal function in rats. AB - 1. Perhexilene, a long-acting anti-anginal drug, can induce adverse effects on the liver which may be dose-dependent. At high concentrations, perhexilene causes marked morphological changes in hepatocyte lysosomes. The current study examined the effect of 'therapeutic' doses of perhexilene on hepatic lysosomal function, particularly the biliary release of lysosomal enzymes, using an isolated perfused rat liver (IPRL) model. 2. Pharmacokinetic studies demonstrated that clearance of single doses of perhexilene by the perfused rat liver was dose-dependent and established a 'therapeutic' dose of 0.6 mg using the IPRL. A 5 day pretreatment regimen of 20 mg/kg per day was shown to produce 'therapeutic' perhexilene concentrations of 150-210 ng/ml. 3. At perhexilene concentrations equating the 'therapeutic' range in man, the major effect of perhexilene was at the biliary pole of the hepatocyte. In 5 day pretreatment dose studies, lysosomal enzyme excretion into bile was markedly increased. In single dose studies, the increase in biliary lysosomal enzyme output partially reflected an increase in bile water production which was not seen with the 5 day pretreatment regimen. Hepatic and perfusate lysosomal enzyme activities were not affected. 4. This selective effect of perhexilene on hepatocyte-to-bile lysosomal excretion may reflect intracellular lysosomal drug localization. PMID- 2706807 TI - Effect of magnesium depletion and potassium depletion and chlorothiazide on intracellular pH in the rat, studied by 31P NMR. AB - 1. Both dietary magnesium depletion and potassium depletion (confirmed by tissue analysis) were induced in rats which were then compared with rats treated with chlorothiazide (250 mg/kg diet) and rats on a control synthetic diet. 2. Brain and muscle intracellular pH was measured by using a surface coil and [31P]-NMR to measure the chemical shift of inorganic phosphate. pH was also measured in isolated perfused hearts from control and magnesium-deficient rats. Intracellular magnesium status was assessed by measuring the chemical shift of beta-ATP in brain. 3. There was no evidence for magnesium deficiency in the chlorothiazide treated rats on tissue analysis or on chemical shift of beta-ATP in brain. Both magnesium and potassium deficiency, but not chlorothiazide treatment, were associated with an extracellular alkalosis. 4. Magnesium deficiency led to an intracellular alkalosis in brain, muscle and heart. Chlorothiazide treatment led to an alkalosis in brain. Potassium deficiency was associated with a normal intracellular pH in brain and muscle. 5. Magnesium depletion and chlorothiazide treatment produce intracellular alkalosis by unknown mechanism(s). PMID- 2706808 TI - Taurine: effect on myocardial relaxation. AB - 1. The effects of taurine on cardiac inotropic state and relaxation were studied in the isolated rabbit heart using solutions containing three concentrations of calcium: 0.7, 1.8 and 3.0 mmol/l. 2. Increases in Ca2+ caused increases in inotropic indices, but had no effect on rate constant of relaxation. 3. Taurine had a positive inotropic effect at Ca2+ = 0.7 mmol/l, an equivocal effect at Ca2+ = 1.8 mmol/l and a negative inotropic effect at Ca2+ = 3.0 mmol/l. 4. Taurine had no effect on the rate constant of relaxation at any Ca2+ concentration. 5. Taurine modulates the positive inotropic effect of Ca2+ but neither taurine nor Ca2+ affect the rate constant of relaxation. PMID- 2706809 TI - Indirect clinical evidence that 1 alpha OH vitamin D3 increases the intestinal absorption of aluminum. AB - In a previous study we showed that 1 alpha OH vitamin D3 [1 alpha (OH)3] given to 16 hemodialyzed patients taking Al(OH)3 at a constant dose increased their plasma concentrations of aluminum [Demontis et al. 1986]. In order to choose between 2 possible mechanisms explaining this increase (increased intestinal absorption or decreased tissue storage of aluminum), we gave, in the present study, 1 alpha (OH)3 the same dose (6 micrograms per week) for the same period (4 weeks) to 15 stable hemodialyzed patients after their Al(OH)3 had been discontinued for 6 weeks. Under Al(OH)3 treatment they had a mean plasma aluminum (2.33 +/- 2.36 mumol/l) which was not significantly different from that of the patients in our former study (1.23 +/- 0.25 mumol/l). After Al(OH)3 discontinuation, plasma aluminum (measured by inductively coupled plasma emission spectrometry) decreased significantly as early as the 2nd week of the control period (1.39 mumol/l). The decrease was maintained at a plateau throughout the 5 weeks of the control period (1.38 mumol/l), the 4 weeks of 1 alpha OH vitamin (vit) D3 administration (1.40 mumol/l) and the 8 weeks of the post 1 alpha (OH)3 period (1.22 mumol/l). Plasma calcium and phosphate concentrations increased significantly with 1 alpha (OH)3 and decreased thereafter whereas plasma PTH concentrations decreased during 1 alpha (OH)2 D3 and increased after its discontinuation suggesting biological activity of 1 alpha (OH)3. Since 1 alpha (OH)3 increases plasma aluminum in hemodialyzed patients only when they are simultaneously taking Al(OH)3, it is suggested that this increase is explained by an increase of intestinal absorption of aluminum and not by a tissue redistribution of aluminum. PMID- 2706810 TI - Calcium-free dialyzate: development and applications. AB - A calcium-free, bicarbonate-containing concentrate was prepared for hemodialysis, which, after dilution, gave analyzed concentrations of sodium of 146 mmol/l, Cl 110 mmol/l, HCO3 of 35 mmol/l and pH of 8.3. When compared with standard bicarbonate dialysis, no important differences in blood chemistries, symptoms or signs were seen. The solution has been trouble-free in over 300 dialyses. Total amount of calcium lost uncorrected for time, dialyzer or blood flow was 40.6 +/- 1.1 mmol, n = 62. This loss was replaced by a calcium infusion into the venous line giving 40 mmol calcium over 4 h. The dialyzate calcium loss could be accurately predicted by sampling without collecting the total dialyzate volume. The uses of this concentrate for bicarbonate dialysis, citrate anticoagulation and avoidance of hypercalcemia in patients treated with oral calcium for phosphate binding is discussed. PMID- 2706811 TI - Energy expenditure in postoperative multiple organ failure with acute renal failure. AB - The provision of an adequate energy supply is of particular importance in patients sustaining long periods of multiple organ failure (MOF). Energy expenditure (EE) and hypermetabolism (measured EE expressed as percent above predicted basal metabolic rate) were investigated in 22 artificially ventilated patients with MOF during the second to fourth postoperative weeks. Eleven of these patients had severe acute renal failure (ARF) necessitating extracorporeal renal replacement therapy, whereas eleven patients had normal or only moderately impaired renal function (serum creatinine less than 200 mumol/l). The average EE in all patients was 124 +/- 17 (SD) kJ/kg x 24 h and the average hypermetabolism was 35 +/- 12%. Patients with MOF including ARF had significantly (p less than 0.01) lower EE (114 +/- 12 kJ/kg x 24 h) and hypermetabolism (28 +/- 7%) than patients with normal or only moderately impaired renal function (133 +/- 17 kJ/kg x 24 h and 42 +/- 12%, respectively). The results confirm that patients with MOF have only a moderate hypermetabolism and indicate that hypermetabolism is even less pronounced in MOF patients with ARF. The results suggest that the presence of ARF in MOF is associated with a more extensive reduction in aerobic metabolism than may be attributed to the loss of renal function. The marked interindividual variation in EE emphasizes the importance of EE monitoring as a guideline for nutritional support. PMID- 2706812 TI - Characterization of the NC1 domain of collagen type IV in glomerular basement membranes (GBM) and of antibodies to GBM in a patient with anti-GBM nephritis. AB - Anti-glomerular basement membrane (GBM) nephritis is associated with production of antibodies to the Goodpasture antigen (GPA) component of the NC1 domain of collagen type IV. We studied a patient with anti-GBM nephritis with regard to 1) reactivity of the anti-GBM antibodies in his serum, plasmapheresis fluid (PPF), and an eluate prepared from GBM of his nephrectomy specimen, and 2) electrophoretic and immunologic properties of the NC1 domain extracted by collagenase digestion from GBM of his nephrectomy specimen. Antibodies to different NC1 determinants in serum, PPF and eluate were detected by immunofluorescence of glomerular capillaries of normal kidney. In addition, the antibody in PPF, but not in the eluate, reacted strongly in a plate-binding radioimmunoassay with NC1 domain extracted from normal human GBM, and bound by Western blotting to both dimer (46 kD and 49 kD) and monomer (24 kD, 26 kD and 28 kD) components of the NC1 domain. Analysis of the NC1 domain in the patient's GBM by SDS-PAGE showed a number of abnormalities, including an absence of monomer bands. Moreover, there was diminished reactivity of the patient's NC1 domain by the radioimmunoassay and Western blotting, using his PPF and a rabbit anti-NC1 antiserum. These findings indicated that there were different types of antibodies to NC1 domain in PPF and eluate, associated with an abnormal NC1 domain in GBM. These results have allowed us to speculate on the pathogenesis of anti-GBM nephritis in this patient. PMID- 2706813 TI - Criteria for the classification of primary fibromyalgia syndrome (fibrositis): an unsolved problem. PMID- 2706814 TI - Minocycline in the treatment of patients with Reiter's syndrome. PMID- 2706815 TI - Successful removal of antiphospholipid antibodies using repeated plasma exchanges and prednisone. PMID- 2706816 TI - Proteoglycan metabolism in isolated chondrocytes from human cartilage and in short-term tissue-cultured human articular cartilage. AB - The effect of piroxicam on proteoglycan metabolism of human cartilage cells was investigated in two in vitro models. Cells or tissue samples were obtained from six different donors. Piroxicam levels used in the test systems ranged from 2 to 6 micrograms r/ml and were comparable with serum concentrations in humans after oral intake. Piroxicam increased the synthesis rates of proteoglycan in some batches of isolated and monolayer-cultured chondrocytes and in tissue-cultured articular cartilage. The fact that this increase in the synthesis of proteoglycan was restricted to some of the donors whereas isolated cells or tissue samples from other individuals remained unaffected illustrates the heterogeneity of different human donors. Depression of proteoglycan synthesis in the presence of the drug was not observed. PMID- 2706817 TI - Cartilage-derived ribonucleotide binding activity. AB - Previous investigations of ribonucleotide binding activity in the sera of patients with connective tissue diseases unexpectedly identified binding to the single stranded nucleotide polyadenylic acid (Poly [A]) in osteoarthritic patients serving as control subjects. The basis for this response and the nature of the binding factor(s) were not evaluated. Hypothesizing that such activity may originate from diseased joint tissue and that its measurement would provide a valuable parameter to assess active cartilage catabolism, the present study examined the Poly (A) binding affinity of cartilage isolates. It was shown that low buoyant density associative cesium chloride gradient fractions of guanidine extracts of cartilage could bind to Poly (A). Activity appeared to be largely masked in native proteoglycan aggregates but could be identified in low buoyant density dissociative cesium chloride gradient fractions of aggregates. Chondroitin sulfate, hyaluronic acid and native and denatured cartilage collagen had a minimal binding affinity. By nucleotide absorption, a purine ring specificity was shown for the active binding factor. Using polyacrylamide slab gel elution and Poly (A) affinity chromatography, activity was localized to a 57 KDa protein. PMID- 2706818 TI - Cineradiography identifies esophageal candidiasis in progressive systemic sclerosis. AB - Cineradiography of the esophagus showed signs of esophageal candidiasis in 11 out of 71 patients with progressive systemic sclerosis (PSS) - both in diffuse scleroderma and the CREST syndrome. Culture of esophageal brushings confirmed the presence of Candida albicans in eight of these 11 patients. Antimycotic treatment decreased the cineradiographic signs of candidiasis and the degree of dysphagia. Since impaired esophageal motility and treatment with immunosuppressive drugs may predispose to candida esophagitis, and since dysphagia will decrease after antimycotic treatment esophageal mycosis should always be sought in patients with PSS. PMID- 2706819 TI - Microvascular dynamics at the nailfold in rheumatoid arthritis. AB - Conventional and fluorescence videomicroscopy using Na-fluorescein as tracer was performed in 13 patients with rheumatoid arthritis (RA) and Waaler Rose titers less than 1: 112, 10 patients with titers greater than or equal to 1: 112 and 11 patients with osteoarthritis (OA) (control group). At the nailfold different microvascular diameters, capillary flow pattern, red blood cell velocity and transcapillary diffusion of Na-fluorescein were determined. Mean red blood cell velocity was significantly (p less than 0.02) decreased in patients with RA and high titers (0.23 +/- 0.21 0.21 mm/s) when compared to OA patients (0.59 +/- 0.20 mm/s). Abnormal flow patterns, in 2 cases even a reversal of flow direction, were only observed in RA patients and not in controls. Mean transcapillary and interstitial diffusion of Na-fluorescein was not enhanced at the nailfold in RA patients. These findings do not exclude increased microvascular permeability in synovial membranes or in RA patients with vasculitis. PMID- 2706820 TI - Preliminary criteria for primary fibromyalgia syndrome (PFS): multivariate analysis of a consecutive series of PFS, other pain patients, and normal subjects. AB - Primary fibromyalgia syndrome (PFS) is a common form of nonarticular rheumatism with chronic and generalized musculoskeletal aching and stiffness, accompanied by tender points at characteristic sites in the absence of an underlying condition. No satisfactory criteria for its diagnosis, based on appropriate controlled studies, have yet been proposed. We undertook such a study which included a consecutive series of clinically diagnosed PFS and compared them with 3 control groups--mild rheumatoid arthritis, localized fibromyalgia secondary to trauma and normal controls. Multivariate statistical analysis plus clinical judgement identified 6 historical features and 7 pairs of tender points that best discriminated PFS from the control groups. The criteria, derived from a combination of these historical features and tender points, provided greater than 90% sensitivity and specificity. In an independent and consecutive sample of 45 PFS patients, the criteria yielded a sensitivity of 89%. The present study indicates that a combination of historical features and TP's will likely provide effective PFS criteria. PMID- 2706821 TI - False-positive seroreactions for syphilis as a harbinger of disease revisited. AB - A cohort of 59 initially healthy subjects with chronic false-positive seroreactions for syphilis was followed for 3 to 19 years (mean 13 years) by data linkage to computerized population registry and to national hospital discharge registry using a unique personal identification number. One subject had moved abroad, but all others were known to be alive at the end of the follow-up period. Four subjects developed systemic lupus erythematosus and two developed rheumatoid arthritis. One subject was admitted to hospital because of protracted substernal pain, but a myocardial infarction could not be verified. This case corresponds to the expected number of cardiovascular events in the cohort. A chronic false positive seroreaction for syphilis was calculated to represent a hundred-fold risk for the development of systemic lupus, but such seroreactions did not seem to predict an excess of cardiovascular diseases. PMID- 2706822 TI - The effect of long-term corticosteroid therapy on joint mobility. AB - Long-term corticosteroid therapy has been implicated as a cause of joint hypermobility. The joint mobility of 25 patients who had been on oral corticosteroids for at least 5 years, was compared to that of 40 controls. There was no significant difference between the two groups. It was concluded that oral corticosteroids do not contribute to joint hypermobility. PMID- 2706823 TI - Bilateral recurrent laryngeal nerve palsy in systemic lupus erythematosus. AB - An unusual occurrence of bilateral recurrent laryngeal nerve palsy as an initial manifestation of systemic lupus erythematosus (SLE) is described. The patient had positive lupus anticoagulant (LAC) and high titers of anti-dsDNA antibody. She showed rapid improvement following intravenous pulse dexamethasone. PMID- 2706824 TI - Transient global amnesia and antiphospholipid antibodies. AB - The patient, a 55 year-old man, developed an episode of transient global amnesia. He was a smoker and had hypercholesterolemia. He was found to have a positive rapid plasma reagin test and high levels of anticardiolipin antibodies. Other investigations were negative. The presence in this patient of antiphospholipid antibodies suggests a vascular mechanism for transient global amnesia. PMID- 2706825 TI - Gold-induced hypersensitivity pneumonitis in a patient with rheumatoid arthritis. AB - A case of gold-induced hypersensitivity pneumonitis in a patient with rheumatoid arthritis is reported. Its differentiation from interstitial pulmonary fibrosis associated with rheumatoid arthritis is discussed and the low T4/T8 ratio in the bronchoalveolar lavage fluid of these patients is highlighted. PMID- 2706826 TI - Influence of serum inactivation on detection of anticardiolipin antibodies (ACA) by ELISA. PMID- 2706827 TI - In vivo selection of human renal cell carcinoma cells with high metastatic potential in nude mice. AB - Studies were made to determine whether the orthotopic implantation of human renal cell carcinoma cells (HRCC) into nude mice will produce distant metastases, thus allowing for the selection of variant cells with high metastatic potential. The parental SN12C line was established in culture from a surgical specimen of HRCC. The renal subcapsule (RSC) of adult nude mice was injected with SN12C cells; the mice were killed when they became moribund. Cell lines were established from either single or multiple lung HRCC metastases. The intravenous injection of many (but not all) of the metastasis-derived lines produced significantly more experimental metastases than did the parental cells. The injection of cells into the RSC demonstrated that, in general, cells derived from spontaneous metastases were more metastatic than cells of the parental line. Hence adult nude mice can be used to select HRCC cells with high metastatic potential. These HRCC variant lines offer a good model for studying the cell properties of metastatic HRCC. PMID- 2706829 TI - Hypomethylation of the human HLA-DR alpha gene in breast carcinomas and autologous metastases. AB - The methylation pattern of the human HLA-DR alpha gene was analyzed in normal breast tissues, breast primary tumors and lymphonodal metastases isolated from patients carrying breast carcinomas. In breast adenomas and also in normal tissues (including breast, muscle, brain, sperm and T- and B-lymphocytes), the HLA-DR alpha gene is hypermethylated at the CCGG and GCGC sites. In all tissues studied, the only constantly unmethylated region is located in the 5' portion of the gene, near the promoter sequence. Further, the results indicate that the HLA DR alpha gene is hypomethylated in carcinomas and in the relative metastatic lymph nodes. It is suggested that hypomethylation of the human HLA-DR alpha gene could be proposed as a molecular marker of malignant breast tumors. PMID- 2706828 TI - Modulation of human breast cancer cell adhesion by estrogens and antiestrogens. AB - In order to study the effect of estrogens and antiestrogens on the adhesive properties of human breast cancer cells, the attachment on endothelial cells (EC), on subendothelial extracellular matrix (ECM) and on ECM components (collagen I and IV, laminin, fibronectin) of estrogen-dependent (MCF-7, ZR75-1) and estrogen-independent (BT-20) breast cancer cell lines was investigated. The cells were grown under conditions of controlled exposure to estrogen [17 beta estradiol (E2)] and/or antiestrogens [tamoxifen (Tam) or 4-hydroxytamoxifen (OH Tam)]. Treatment by E2 enhanced the ability of ZR75-1 cells to adhere to the various substrates, which contrasts with the observed absence of effects with the BT-20 cells. Similarly, Tam or OH-Tam induced a reduction of the adhesion of ZR75 1 tumor cell, but not of BT-20 cells. This effect was reversed by competing concentrations of E2. The effects on MCF-7 cell adhesion were similar to those described for ZR75-1 cells, but could not be reproducibly observed. Adhesion assays carried out with ZR75-1 cells grown in the absence or presence of phenol red, a pH indicator which behaves as a weak estrogen, led to a similar pattern of cell attachment. Conditioned media harvested from E2- or Tam-treated ZR75-1 cells failed to induce any effect on adhesion of other ZR75-1 cells grown in E2 deprived medium, suggesting that secretory activities are not required for the control of cell adhesiveness. The results suggest that estrogens and antiestrogens can control the adhesive behavior of breast tumor cells through their hormone responsive structures possibly by regulating expression of cell adhesion proteins and/or their cell surface receptors. PMID- 2706830 TI - Inhibition of protein synthesis, pulmonary localization and pulmonary tumour formation by drug-treated tumour cells as a means of predicting their chemosensitivity. AB - Mouse mammary carcinoma cells were exposed in vitro to increasing concentrations of doxorubicin hydrochloride [adriamycin (ADR)] or 5-fluorouracil (5-FU). Uptake of [75Se]selenomethionine (75SeM) in a methionine-deficient medium measured the resulting inhibition of protein synthesis by the tumour cells. This was compared with the ability of the 75SeM labelled tumour cells to localize in mouse lungs and to form pulmonary tumours following intravenous (i.v.) injection into isogenic hosts. These parameters were also related to the ability of the drugs to inhibit pulmonary tumour formation in vivo when injected into mice which had received tumour cells i.v. Results from five different tumours were pooled for analysis. At the highest drug concentration (10 micrograms/ml ADR, 100 micrograms/ml 5-FU) inhibition of protein synthesis was significantly related to the in vivo action of the drugs in limiting formation of pulmonary tumors (P less than 0.02 using the rank difference coefficient). There was also a direct relationship between pulmonary localization of tumour cells following exposure to drugs, their ability to form tumour nodules (P less than 0.025) and the in vivo action of the drugs in inhibiting tumour formation (P less than 0.05). Thus inhibition of protein synthesis in vitro and pulmonary localization following i.v. injection may be of value in predicting the in vivo effect of cytotoxic drugs. PMID- 2706831 TI - The in vitro invasiveness and interactions with laminin of K-1735 melanoma cells. Evidence for different laminin-binding affinities in high and low metastatic variants. AB - The invasive and metastatic characteristics of cloned cells derived from the K 1735 murine melanoma were investigated. Cell lines which are highly metastatic in mice were found to be invasive in vitro, and to show an enhanced attachment to, spreading on and migration toward laminin. As attachment, spreading and directional migration are thought to be receptor-mediated events, the binding of laminin to these cells was studied. Biotinylated laminin was used to evaluate receptor binding by fluorescence activated cell sorting (FACS) and this method was compared with that in which the binding of radioactive laminin is measured. Both studies revealed that metastatic K-1735 cells (a) have more receptors for laminin compared with non-metastatic cells and (b) exhibit a second population of low-affinity binding sites not present on the non-metastatic cells. The differences in receptor number and type may account for the greater interaction of metastatic cells with laminin and their invasive phenotype. PMID- 2706832 TI - New, simple model of mesenteric lymph node metastases in the rat. AB - Injection of 1 x 10(6) CC531 colonic carcinoma cells into the mesenteric lymph nodes of Wag/Rij rats resulted in the growth of tumors within the lymph nodes. These were apparent after 3 days, whereas lung and liver metastases were not observed until 5 weeks after inoculation. In vivo labeling with bromodeoxyuridine (BrdU) followed by immunostaining with an anti-BrdU monoclonal antibody showed a marked difference in the proportion of labeled cells of the metastases at different times after inoculation: after 3 days, many tumor cells but also many stromal cells were labeled; after 7 and 11 days, however, far less stromal cells were positive, most labeled cells being tumor cells. PMID- 2706833 TI - Anti-AChR-negative myasthenia gravis: clinical and immunological features. AB - The clinical and immunological characteristics of myasthenia gravis (MG) patients without detectable anti-Acetylcholine Receptor (anti-AChR) antibody were studied. Sixty anti-AChR negative MG patients were compared with 287 anti-AChR positive cases. Significant differences were found with respect to the sex incidence, the disease severity and the thymic pathology, while the age at the onset of the disease, the presence of other auto-antibodies and the efficacy of medical treatments were similar in the two groups of patients. Anti-AChR-negative MG could have pathogenetic mechanisms different from the antibody-positive disease. PMID- 2706834 TI - Enhanced carcinogenesis in the proximal small intestine of the rat following rumenectomy. AB - Various techniques have been used to enhance carcinogenesis in experimental animals. This study examines the effects of the excision of the forestomach (rumen), a squamous epithelial pouch of the rat, on the incidence and distribution of intestinal neoplasms induced by 1,2-dimethylhydrazine (DMH). Thirty-four male Sprague-Dawley rats were randomly assigned to control and experimental groups. The experimental group was subjected to an excision of the rumen while the control group underwent a gastro-rumenotomy and closure. Following a two week recovery period, each animal was weighed and injected with DMH (20 mgm/kg body wt) on a weekly basis for 22 weeks. At 24 weeks, the 32 surviving rats were sacrificed and the number, location, and histology of the neoplasms in the intestinal tract of each rat were noted. Rumenectomy resulted in a statistically increased incidence of neoplasms in the proximal small bowel (mean of 1.3 +/- 0.01 neoplasms/rat) when compared with the control group (mean of 0.1 +/- 0.2 neoplasms/rat) (p less than 0.001); but did not influence the incidence, distribution, or histology of colonic neoplasms between control and experimental animals. All neoplasms of the proximal small bowel when examined histologically were classified as invasive adenocarcinomas. The colon contained adenomata and carcinoma in situ, as well as adenocarcinomas. It is therefore concluded that excision of the rumen of the rat stomach selectively promotes malignant formation in the proximal small bowel following repeated injections of DMH. PMID- 2706836 TI - ATH-3, a new gene for atherosclerosis in the mouse. AB - Mice derived from resistant A/J (A) and susceptible C57BL/6J (B) strains have been used to study the genetics of diet-induced atherosclerosis. A comparison of lesion scores between the parental strains, the F1 offspring of A x B and B x A matings and the offspring of (B x A)F1 hybrids backcrossed to either parent strain, indicates that a single major gene with alleles for resistance and susceptibility is responsible for the difference in response of A/J and C57BL/6J mice to a high fat, high cholesterol diet. By comparing the strain distribution pattern of susceptibility with known genetic markers in 30 A x B and B x A recombinant inbred (RI) strains, this gene, designated Ath-3, has been mapped close to a coat colour gene, c, on chromosome 7. Although a single gene may be primarily responsible for the difference in susceptibility to diet-induced atherosclerosis in these mice, the results of the breeding experiments indicate that its expression is probably modified by one or more additional genes. PMID- 2706835 TI - Sympatho-adrenal and cardiovascular responses during hand-grip in human hypertension. AB - Circulating norepinephrine and epinephrine levels were correlated with echocardiographic indices of cardiovascular function during isometric exercise (hand-grip at 30% of maximum force for 3 minutes) in 19 patients with mild essential hypertension and 9 normotensive subjects. At the end of the third minute of exercise, plasma norepinephrine and epinephrine, blood pressure and heart rate, increased significantly and similarly in both groups of patients. In contrast, peripheral resistance tended to increase in hypertensives but tended to decrease in normotensives. Moreover, indices of ventricular function increased in normotensives but decreased in hypertensives. At the end of the exercise, systolic and diastolic blood pressures were directly correlated with epinephrine levels in normotensives but were correlated only with norepinephrine levels in hypertensives. On the other hand, norepinephrine and epinephrine levels were inversely correlated with changes in indices of left ventricular performance in hypertensive patients only. These results demonstrate that during isometric exercise, the increase in blood pressure in normotensives is associated with a sympatho-adrenal activation of cardiac performance and contractility, while in hypertensives the increase in blood pressure results mainly from an increase in peripheral resistance associated with a reduction in cardiac performance and contractility, despite a similar sympatho-adrenal activation in both groups. These differences in the hemodynamic responses may be compatible with the hypothesis of beta-adrenoceptor desensitization or structural alterations of the cardiovascular system in hypertensive patients. PMID- 2706837 TI - Genetic conditions among Canadian Mennonites: evidence for a founder effect among the old colony (Chortitza) Mennonites. AB - Distinctive disease patterns exist among Canadian Old Colony (Chortitza) Mennonites. This religious and genetic isolate is of 16th century Dutch/German ancestry. The group originated in the Netherlands, then settled in the Vistula delta area of western Prussia for 200 years. A small number of founding families later migrated to Chortitza, the "Old Colony", in the Ukraine in the late 18th/early 19th century, where they remained a distinct genetic isolate. This group has come to Canada over the past 100 years. The more conservative Canadian Mennonites of Chortitza descent practice strict endogamy, have a large family size and live predominantly in rural public health subdistricts in the four western provinces, and in southern Ontario. The world's largest reported familial aggregations of insulin-dependent diabetes mellitus, of autoimmune diseases and of Tourette syndrome were initially ascertained in a small northern Alberta public health subdistrict. Clusterings of malformations, inborn errors of metabolism, and other conditions were also found in the subdistrict, and in group descendents living in other provinces. A founder effect, or genetic drift, accounts for the familial aggregations of autosomal recessive and dominant conditions, some diseases of multifactorial determination, and other inherited conditions in Canadian kinships descending from this ancestral group. The medical literature on genetic conditions among Canadian Mennonites is reviewed and re evaluated in the light of this information. There is biochemical, serologic, and molecular biologic evidence in favour of genetic homogeneity amongst patients with certain inherited conditions in this special population group. This genetic isolate offers potential for the study of the genetic epidemiology and molecular biology of inherited diseases. A computerized genealogic data base on about 1400 group members, as well as a cryopreserved lymphocyte/DNA bank on over 100 individuals with genetic conditions has been established in this special population group. PMID- 2706838 TI - New experiences; old genes--lessons from the Mennonites. PMID- 2706839 TI - Disseminated melanomatosis of the central nervous system and other organs: a case report. AB - This case represents an example of clinically occult, disseminated neoplastic disease with almost asymptomatic but severe involvement of the central nervous system. The only helpful diagnostic investigation appeared to be cerebrospinal fluid cytology. Extensive post mortem examination was inconclusive as to whether the widespread CNS involvement with melanoma was primary or secondary. PMID- 2706840 TI - Immunohistochemical localization of human immunodeficiency viral antigens in formalin-fixed spinal cords with AIDS myelopathy. AB - Some patients with the acquired immunodeficiency syndrome (AIDS) have long-tract degeneration in the spinal cord. Spinal-cord sections showing degeneration were immunoreactive in 13 of 17 AIDS patients using rabbit antiserum to whole disrupted human immunodeficiency virus (HIV) or a mouse monoclonal antibody to HIV core protein p24. The immunostaining was in a few macrophages, multinucleated cells, gliomesenchymal-cells nodules, glial cells and vascular endothelial cells. Eleven of the positive cases had histopathologic evidence of long-tract vacuolar alterations associated with this immunoreactivity, and the two cases without vacuolar alterations had immunoreactive multinucleated cells and gliomesenchymal cell nodules. Immunolocalization of HIV in the spinal cord correlated well with clinical signs and symptoms, although concomitant cerebral and systemic infections often obscured the significance of the spinal-cord findings in the clinical setting. HIV vasculitis could lead to myelitis and to the clinical appearance of long-tract signs and symptoms. PMID- 2706841 TI - Central hypomyelination associated with congenital hypomyelinating polyneuropathy: report of an autopsied case. AB - The central nervous system (CNS) findings associated with congenital hypomyelinating polyneuropathy (CHN) are not established due to a paucity of reported post-mortem examinations. In this report we describe the pathologic changes found in the peripheral nervous system and CNS in a 2 1/2-week-old infant with a clinical diagnosis of CHN who died of respiratory failure clinically attributed to phrenic nerve dysfunction. Macroscopic findings included striking hypoplasia of the corpus callosum and anterior commissure, cerebellum, crus cerebri, ventral pons and pyramids. Histologic and immunohistochemical findings included complete absence of myelin staining and myelin basic protein immunoreactivity (MBP-IR) in the cerebral hemispheres, cerebellum, brainstem, cranial nerves and spinal cord despite little or no detectable reduction in numbers of oligodendrocytes. A severe fibrillary astrocytosis was seen at each of these sites. A slight reduction in neurons was identified in the cerebellum and spinal cord but nowhere else in the brain. These findings raise the possibility that deficient or markedly delayed CNS myelination accompanies peripheral hypomyelination in some cases of CHN. PMID- 2706842 TI - Solitary midbrain toxoplasmosis and olivary hypertrophy in a patient with acquired immunodeficiency syndrome. AB - Toxoplasmosis, one of the most common central nervous system lesions in patients with the acquired immunodeficiency syndrome (AIDS), has not been reported as a solitary lesion in the brainstem. This report describes a patient with AIDS that presented with third cranial nerve palsy and contralateral cerebellar signs, who at autopsy had a necrotic midbrain lesion due to toxoplasma. Inferior olivary hypertrophy, due to interruption of olivary afferent fibers by the lesion, in addition to subacute encephalitis and vacuolar myelopathy were other CNS findings. PMID- 2706843 TI - Recurrent intracranial and spinal meningiomas: clinical and histological features. AB - The clinical records and histopathological features of 424 patients treated surgically for meningioma over a 20-year period were reviewed. Forty-nine patients (11.5%) required a second operation and in 8 other cases (1.8%) there was clinical evidence of recurrence but further surgery was contra-indicated. The two independent factors associated with recurrence were incomplete surgical resection at the first operation and angioblastic histology. In contrast, recurrences were uncommon in the very elderly, in spinal lesions and fibroblastic tumors. Transitional and meningocytic meningiomas were equally represented in each group, and there was no individual intracranial site where meningiomas were especially likely to recur. PMID- 2706844 TI - The anthropometric total hip femoral prosthesis. Preliminary clinical and roentgenographic findings of exact-fit cementless application. AB - Total hip arthroplasty in the young patient remains a considerable challenge. Cemented arthroplasty has an unacceptably high failure rate. Porous ingrowth designs are one alternative, but bone ingrowth is unpredictable, thigh pain is a frequent clinical finding, stress shielding is often observed, revision is more complicated, and microporous components are mechanically weaker. A new anthropometric femoral component has been designed with a goal of long-term stability through osseointegration. The prosthesis is optimized for canal fill in the distal metaphysis and proximal diaphysis. The components are manufactured in 16 sizes, with cutting broaches precisely machined to the same dimensions to provide an exact fit to the femur. The high-strength TiAl6V4 alloy stem is combined with heads of either CoCr alloy or alumina (Al2O3) for reduced polyethylene wear. The 135 degrees neck-shaft angle and modular design allow for restoration of the abductor lever arm. Because the prosthesis is not porous coated, it is also suitable for use with cement. In cemented application, the prosthesis shape provides an optimal cement mantle. Seventy-one total hip arthroplasties have been performed using the Anthropometric Total Hip (ATH) prosthesis: 31 with exact-fit cementless fixation and 40 with cement. Of those using cementless fixation, 21 have been followed for more than one year (mean, 20 months; range, 12-48 months). The early clinical findings are as good as, or superior to, other cementless designs used at the authors' institution. Stress remodeling of the proximal femur occurs early and stabilizes by one year. The observed changes appear to improve the stability of the prosthesis. Clinical and roentgenographic findings suggest the osseointegration of the ATH femoral component. PMID- 2706845 TI - A 37-year follow-up evaluation of multiple-stage femur and tibia lengthening in dyschondroplasia (enchondromatosis) with a net gain of 23.3 centimeters. AB - This case report presents the rare combination of circumstances of a child with (a) dyschondroplasia (enchondromatosis) limited to all the major epiphyseal plates of one lower extremity, (b) unusual capacity to cooperate, and (c) parents who refused permission to treat the limb by amputation but allowed the child to participate in a long-term clinical experiment. In dyschondroplasia (Ollier's disease), the long bones grow in diameter but not in length. In this condition, it was possible (by fasciotomy, osteotomy, and interposition of wedge blocks or hemicylindrical bone implants (stabilized by an intramedullary rod) to lengthen the leg 23.3 cm in ten stages, during the period between five and 14 years of age. With the additional procedure of epiphyseal arrest of the contralateral distal end of the femur at age 11, the eventual correction of discrepancy in leg length was 25.6 cm. Intraoperative and postoperative skin temperature recordings, toe plethysmography, and electromyography show that there were no deleterious changes in the circulatory or neurological functions of the extremity. PMID- 2706846 TI - Radiographic evidence of posterior lumbar interbody fusion with an emphasis on computed tomographic scanning. AB - The ideal result of a successful posterior lumbar interbody fusion is a bony arthrodesis across the disc space. Evidence for the presence of fusion has been trabeculation on plain roentgenograms, lack of motion on stress films, and osteosynthesis across the graft-host interface on tomography. However, none of the above is entirely conclusive. Computed tomographic scanning affords a better assessment of the stages of arthrodesis by examination of the remodeling processes. When a graft is totally remodeled and assumes the function of the host bone, the vertebral body in this case, then anatomic fusion or bony arthrodesis has been achieved. In autogeneic graft techniques, this occurs about nine to 12 months after surgery. Initially, there is formation of a peripheral cortical ring phenomenon and then a gradual remodeling of the centrum to cancellous bone and bone marrow. PMID- 2706847 TI - Segmental spinal instrumentation for neuromuscular spinal deformity. AB - Seventy-six consecutive surgical cases of paralytic neuromuscular spinal deformity were retrospectively analyzed. Posterior arthrodesis with segmental spinal stabilization with Luque L-rods, sometimes preceded by anterior release, was done in all cases. The infection rate of 14.5% was observed to be markedly higher in patients with myelodysplasia. Deep placement of the rods lateral to the spine and well beneath full-thickness skin is recommended to reduce the incidence of this complication. PMID- 2706848 TI - Office management of frozen shoulder syndrome. Treatment with hydraulic distension under local anesthesia. AB - Twenty patients with frozen shoulder syndrome treated by hydraulic distension of the glenohumeral joint under local anesthesia are reported. All patients were followed for six months to ten years. Subjective complaints included pain, sleep loss, and limited shoulder motion, which compromised daily activities. Objective findings included decreased intracapsular volume; decreased glenohumeral motion, particularly internal and external rotation; and exquisite pain on extremes of motion. Hydraulic distension is carried out under local anesthesia. Capsular inflammation in the anterior synovial recess with resulting tenting of the adjacent subscapularis and biceps tendons is involved in the etiology of the frozen shoulder. The advantages of this modality of treatment are that it is safe, has direct and immediate results, and is cost-effective. PMID- 2706849 TI - Total shoulder arthroplasty. AB - Seventy Neer Series II total shoulder arthroplasties were performed in 65 patients. The average age was 69 years. The average follow-up period was 40 months. Rheumatoid arthritis or osteoarthritis was the diagnosis in 34 and 29 shoulders, respectively. Rotator cuff tears were identified in 18 patients. There were no infections, neurological injuries, or vascular injuries, or vascular injuries. Two glenoid fractures and two humeral shaft fractures were sustained intraoperatively. Uniformly, excellent pain relief was obtained regardless of the disease process. The resultant average increase in range of motion (ROM) was 60 degrees of active forward elevation and 18 degree of external rotation. Radiolucent lines were present in 17 humeral components; however, none was symptomatic or had progressed in thickness. Five glenoid components demonstrated progression of radiolucency, and two required revision. Both of these were in patients with rheumatoid arthritis. Although pain relief was uniformly good among all patient groups, a statistically significant degree of improvement in ROM was found in individuals with osteoarthritis. The etiology of the disease process and the status of the rotator cuff may determine the eventual outcome in individuals treated with total shoulder arthroplasty. PMID- 2706850 TI - Congenital dislocation of the hip treated by total hip arthroplasty. AB - Thirty-two total hip arthroplasties (THAs) were performed on 26 severely incapacitated patients with congenital dislocation of the hip. The arthroplasty technique varied with the problems encountered, but the cup was always placed in the true acetabulum. In 19 cases, femoral head autografts were transplanted. The overall results were satisfactory. Roentgenologic evaluation of the bone grafts showed no nonunion or secondary displacement. Nineteen previously invalid patients now lead normal lives. Five patients are minimally incapacitated and only two were unimproved by the operation. THA with autogeneic grafts to deepen the acetabulum is recommended whenever a congenital dislocation of the hip in an adult is associated with severe pain. PMID- 2706851 TI - Cardiac isoenzyme values after total joint arthroplasty. AB - The purpose of this study was to prospectively determine what effect total joint arthroplasty had on the myocardial-associated isoenzymes of serum creatine kinase (CK-MB) and lactate dehydrogenase (LD-1:LD-2). Fifty patients treated with total joint arthroplasty of the hip or knee had isoenzyme determinations using automated spectrophotometry and agarose gel electrophoresis. Skeletal muscle injury associated with the trauma of surgery resulted in significant elevations of the absolute value of CK-MB; however, the percentage of CK-MB comprising total CK activity and LD-1:LD-2 did not rise significantly in patients who did not experience postoperative myocardial infarction. It is important to determine both serum CK-MB and LD-1:LD-2 in suspected postoperative myocardial infarction since false positive elevations of CK-MB can occur. Elevations of CK-MB exceeding 50 International Units/liter or 5% of the total CK activity combined with LD-1:LD-2 exceeding 1.0 should not be attributed to skeletal muscle injury alone following total joint arthroplasty of the hip or knee. PMID- 2706852 TI - Rotational stability of a posterior stabilized total knee arthroplasty. AB - The effect of the posterior stabilizing mechanism on rotational stability in total knee arthroplasty (TKA) was investigated in six cadaver knees using a special knee-testing device. The device evaluated varus-valgus, rotational, and anteroposterior (AP) stability in the normal knee compared to a posterior stabilized TKA with either a rotationally constrained or an unconstrained articular surface. None of the stability parameters was significantly different from normal in either configuration of the tibial surface, but the constrained surface did decrease rotational deflection compared to the rotationally unconstrained surfaces. These findings show that rotational constraint in a posterior stabilized TKA is not necessary to achieve rotational stability as long as varus-valgus stability is achieved by appropriately tensioning the collateral ligaments. PMID- 2706853 TI - Further observations on the isometricity of the anterior cruciate ligament. An anatomical study using a 6-mm diameter replacement. AB - Six anatomical specimens were used to evaluate the ligament length pattern and mean maximal ligament length change (MMLLC) of the anterior cruciate ligament (ACL) using a ligament replacement with a 6-mm diameter. Three femoral and three tibial attachment sites were selected. Nine different combinations were studied in intact knees and also in knees whose posterior capsule and arcuate ligament complex were sequentially divided, whose menisci were resected, and whose capsule and arcuate complex were repaired. The smallest ligament length change (5.6 mm) was obtained in the intact knee with the anatomic femoral and tibial attachments. Moving the femoral origin either anteriorly or to the over-the-top position significantly increased the MMLLC. Moving the tibial insertion posteriorly had a negligible effect, but changing to an anterior attachment site increased (but not significantly) the MMLLC. Even for anatomically positioned ligaments, the instability caused by sectioning the posterior capsule and arcuate ligament complex increased the MMLLC by more than 80%. Resection of both menisci did not result in a further increase in the MMLLC, but repairing the posterior capsule and arcuate complex restored the length changes to those of the intact knee. These data confirm the importance of precise anatomic placement of the femoral and tibial tunnels when performing intraarticular ACL grafts for anterolateral rotatory instability. The adverse effect of certain other associated instabilities on the ligament length change, even with correct tunnel placement, has been demonstrated and may be one explanation for the variability in the clinical results of these procedures. PMID- 2706854 TI - A mechanical assessment of applied compression and healing in knee arthrodesis. AB - The applied compression and stiffness of a knee arthrodesis treated with unilateral external fixation can be mechanically assessed. Of ten patients in whom arthrodesis bending stiffness measurements were obtained during healing, nine had a minimum bending stiffness of 5 Nm/degree and sound clinical fusion. In seven of these nine patients, a bending stiffness of at least 10 Nm/degree was obtained, suggesting that this stiffness value is a safe and reliable indicator for successful arthrodesis. Arthrodesis compression declined rapidly; daily adjustments were required to maintain a compression of 500 Newtons. A small but significant loss of length was associated with this high value of compression. On reduction of the compression to 200 Newtons, the rate of decrease of compression and the loss of length across the arthrodesis were simultaneously reduced. PMID- 2706855 TI - The cast brace and tibial plateau fractures. AB - Three hundred six tibial plateau fractures treated at the authors' institutions and in private practice were analyzed in relation to the use of a cast brace or fracture brace. One hundred forty-one of these patients had had a cast brace or fracture brace as part of their treatment program, either as the primary fracture treatment or after open reduction or traction. The aims of this study were (1) to determine if cast bracing could maintain alignment, fracture position, and range of motion and (2) to compare its results with those of other major long-term studies of similar fractures. There were 85 lateral, 24 medial, and 32 bicondylar fractures. Cast bracing was used for one to 17 weeks, with a mean of eight weeks. Ninety-nine of the 141 patients were followed for at least one year. Eighty-two of the patients maintained alignment with less than 5 degrees of deformity, and fracture position was maintained in 85% of cases, with only 15% having 4-8 mm of loss of position. Medial plateau and subcondylar fractures had an increased incidence of fracture position loss. Ninety-seven percent of patients had greater than 90 degrees of flexion, and 90% had full extension, i.e., less than 5 degrees of contracture. Pain was minimal or absent after heavy exercise in 90% of patients using cast bracing. Arthritic changes on roentgenographic analysis were absent or mild in 93.5% and moderate or severe in 6.5% of patients. Complications, including phlebitis, pulmonary emboli, wound infection, hardware slippage, and skin slough, occurred in nine patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706856 TI - Posteromedial release for idiopathic talipes equinovarus. A long-term follow-up study. AB - Eighteen children with 26 idiopathic talipes equinovarus deformities were treated by postermedial release (PR) in the interval between 1975 and 1980 and investigated retrospectively. Evaluations included physical examination, functional evaluation, roentgenographic evaluation, and evaluation of foot track tracing pattern. The average follow-up period was 8.2 years. Thirty percent had had previous tendo Achilles lengthenings and 15% had had previous lengthenings plus posterior capsulotomies. Based on Turco's criteria, the results of PR were graded 38.9% excellent, 26.9% good, 15.6% fair, and 18.6% failure. PMID- 2706857 TI - Tumoral calcinosis in two infants. AB - Tumoral calcinosis (TC) is an uncommon disease, characterized by deposits of large, calcified painless soft-tissue masses around major joints in otherwise healthy children and young adults. This condition is a rare inherited metabolic disorder of unknown etiology. Biochemical findings are normal except for its occasional association with hyperphosphatemia. The youngest occurrence reported in the literature on TC may be one case of a five-month-old boy. The authors report here on two younger infants with TC, one aged ten days and the other aged three months, who were followed for more than three years and observed to completely recover all motorskeletal functions. PMID- 2706858 TI - The effects of dexamethasone on periarticular swelling and joint stiffness following fracture in a rabbit hindlimb model. AB - An established rabbit hindlimb model was used to determine the effects of systemic steroid administration on posttraumatic limb swelling and joint stiffness. Dexamethasone acetate was administered intramuscularly to the test rabbits in one of four doses two hours following fracture as well as one and two weeks later. Dexamethasone did not produce a significant decrease in swelling but did produce a statistically significant dose-dependent decrease in ankle stiffness compared to controls. Tibia torsional strength to failure was not adversely affected. PMID- 2706859 TI - Subcellular regulation of the ionized calcium pool in isolated growth-plate chondrocytes. AB - At a low total endogenous calcium content, as in the reserve and proliferative zone chondrocyte, cells buffer their ionized calcium pool at a low steady state between 150 and 300 nM. The endoplasmic reticulum appears to be primarily effective in the regulation of the ionized calcium pool under these conditions. With calcium loading of 20 to 30 nmol Ca+2/mg protein, as in the hypertrophic zone chondrocyte, the cells buffer their ionized calcium pool at a higher steady state between 600 and 700 nM. The mitochondria appear to be primarily effective in buffering the cytosolic ionized calcium pool after calcium loading. These data suggest that in the growth plate as the chondrocyte approaches the mineralization front, there is an accumulation of intracellular calcium that results in the saturation of the capacity of the endoplasmic reticulum to buffer the ionized calcium pool at a low steady state. Under these conditions of calcium loading, there is an increase in the intracellular ionized calcium concentration and a shift toward mitochondrial buffering of this calcium pool. This study has clinical relevance because in the cartilaginous tissues of the growth plate and in fracture callus, the matrix mineralizes as a prerequisite step in the formation of bone. Intracellular calcium accumulation and calcium release appear to play a role in matrix mineralization. An understanding of how the chondrocyte regulates intracellular calcium homeostasis in states of calcium accumulation is important in the overall understanding of bone development and fracture healing. PMID- 2706860 TI - Metabolic characteristics of in vitro cultured human chondrocytes in relation to the histopathologic grade of osteoarthritis. AB - Isolated human chondrocytes derived from healthy and osteoarthritic (OA) cartilage were cultured in high density in a newly designed microculture system. The severity of OA was graded according to a modified histopathologic score originally described by Mankin et al. Chondrocytes from adult patients with OA showed 35S-sulphate and 3H-thymidine incorporation in vitro, which increased with severity of the disease through Mankin 11-12. Incorporation rapidly declined after Mankin 11-12. Both matrix synthesis and cell proliferation were strongly reduced in the severe grades of OA. Histologic examination of the newly formed cartilage was only possible if the chondrocytes were derived from less severe grades of OA. Microscopy showed healthy chondrocytes surrounded by newly synthesized matrix, which stained well with specific dyes, indicating the ability of the cells to synthesize normal matrix components. The phenotype of human articular chondrocytes, derived from different grades of OA, was maintained in a high-density culture system. The data suggest dysregulation of the cell metabolism in OA cartilage. The increased cell metabolism was directly related to the histopathologic grade of OA. PMID- 2706861 TI - Disc space infection and vertebral osteomyelitis as a complication of percutaneous lateral discectomy. PMID- 2706862 TI - Computed tomography solves problems in orthopedic radiology. AB - One of the most important developments in orthopedic diagnostic radiology in the past 50 years has been that of computed tomography. The cross-sectional display, the capacity to reformat in other planes, the extreme sensitivity to differences in X-ray beam attenuation, the ability to manipulate the contrasts of the images, and the ability to produce blurless tomographic sections of varying thicknesses while the patient, even in a heavy plaster cast, does nothing more than lie still, are some of the capabilities that have enabled computed tomography to improve the way radiology can help the orthopedic surgeon care for patients. PMID- 2706863 TI - Internal fixation of pelvic ring fractures. AB - The orthopedic care of unstable pelvic fractures requires reduction and stabilization in order to promote union in a satisfactory position and provide a satisfactory clinical result. The results of three treatment techniques, skeletal traction and/or pelvic sling, anterior frame external fixation, and internal fixation, were evaluated over a four-year period. PMID- 2706864 TI - Acetabular development in the infant's dislocated hips. AB - The course of development of acetabulae after the reduction of congenitally dislocated hips was investigated to identify factors that might predict the need for acetabuloplasty. One hundred five congenitally dislocated hips in 83 children were followed roentgenographically for an average of eight years after reduction. While the percentage of children requiring later acetabuloplasty increased somewhat with advancing age at the time of reduction, numerous acetabulae in the older groups developed satisfactorily without later surgery. The prereduction acetabular index proved a much more reliable predictor of the need for later acetabuloplasty. Sixty percent of those with an acetabular index greater than 37 degrees required later pelvic surgery, compared with 17% of those with a prereduction index less than 30 degrees. The major acetabular response occurred in the first year after reduction in children whose hips were reduced before the age of three years, whereas the maximal response in children whose hips were reduced after three years of age occurred in the second through fourth years. A further drop can be expected in all reduced hips of children between the ages of eight and 11 years. PMID- 2706865 TI - Testicular ischemia and infarction following herniorrhaphy or varicocelectomy: evaluation by radionuclide imaging. AB - The postoperative use of testicular imaging to evaluate the preservation of testicular circulation has been reported after orchiopexy, excision of a hematocele, and repair of a traumatized tunica albuginea. The authors discuss the previously unreported use of testicular imaging in patients who have undergone recent herniorrhaphy or varicocelectomy. The scan of a patient with intact testicular perfusion following herniorrhaphy is compared to the scans of two patients with absence of perfusion of a testicle five to seven days following respective herniorrhaphy and varicocelectomy surgeries. PMID- 2706866 TI - Differentiation of bone and bone marrow infarcts from osteomyelitis in sickle cell disorders. AB - To determine whether imaging techniques can differentiate osteomyelitis from bone infarction in sickle cell disorders, 39 sets of bone scans (BS) and bone marrow scans (BMS) were performed on 31 patients with sickling disorders and bone pain. In addition, three patients who had either a BS or a BMS were included. Results were analyzed according to whether scans were performed three days or less (Period 1), four to six days (Period 2), or seven or more days (Period 3) after the onset of pain. Regardless of the period, all but five BMS for 34 episodes of assumed infarction showed decreased uptake. BS findings varied depending on the time interval, with none of the ten in Period 1 showing increased uptake, but all 11 in Period 3 showing increased uptake. However, in Period 2, about half of the 13 BS showed increased uptake. All three patients with osteomyelitis in Period 3 had increased uptake on BS. The BMS done in one of these patients showed decreased uptake. Three patients with cellulitis had normal BS and BMS. One patient with septic arthritis had normal BMS, but slightly increased uptake on BS. Although typical imaging patterns are present in early and late infarction (Periods 1 and 3), the patterns for late infarction may not differ from those of advanced osteomyelitis. Therefore, imaging studies are only of value in differentiating infarction from osteomyelitis when both BS and BMS are performed soon after the appearance of symptoms. PMID- 2706867 TI - The role of bone scan and radiography in the diagnostic evaluation of suspected pedal osteomyelitis. AB - The authors reviewed the three-phase bone scans and radiographs of 24 patients with suspected pedal osteomyelitis who also had histologic confirmation of the diagnosis. Twenty patients had a pedal ulcer, cellulitis, or necrosis. Sensitivity and specificity of bone scanning were 70% and 43% respectively. Sensitivity and specificity of radiography were 70% and 50% respectively. The non invasive diagnosis of pedal osteomyelitis remains problematic due to the poor specificity of bone scans and radiographs. PMID- 2706868 TI - Splenic imaging in a patient with functional asplenia. AB - A 65-year-old woman presented with right upper extremity paralysis and left cerebrovascular accident. A routine complete blood count (CBC) demonstrated Howell-Jolly bodies on peripheral smear, and a liver-spleen scan showed absent splenic sulfur colloid uptake suggesting functional asplenia. A subsequent heat damaged red blood cell study demonstrated a normal sized spleen with preserved sequestering function, thereby excluding anatomic asplenia, vascular alterations, or congenital anomalies in the differential diagnosis of functional asplenia. This case illustrates the use of Tc-99m heat damaged red blood cells as a unique and useful diagnostic aid in identifying the presence and size of a spleen in patients with functional asplenia. It also demonstrates an apparent qualitative separation of splenic functions in processing sulfur colloid and heat damaged red blood cells. PMID- 2706869 TI - Perfusion lung scan in patients operated for transposition of the great arteries. AB - Fifty perfusion lung scans were performed with Tc-99m albumin microspheres in 42 patients, 15 days to 12 years after corrective surgery for transposition of the great arteries. The scan was entirely normal in nine of 42 patients. Absence of left lung perfusion was observed in three patients and hypoperfusion of the left lung in 19 patients. Segmentary zones of hypoperfusion was visualized in 13 patients either in the right or left lung. A moderate right to left shunt was observed in eight cases. The absence or decrease in left lung perfusion was due to pulmonary vein occlusion in four patients, left pulmonary artery stenosis in two patients, and preferential right blood flow in one patient. Right to left shunt was due to dehiscence of the atrial patch in four patients. PMID- 2706870 TI - Unusual pattern of lung uptake of technetium-99m sulfur colloid seen on the liver scan of a patient with pulmonary tuberculosis. AB - In evaluating alcoholic liver disease in a patient with pulmonary tuberculosis, a liver-spleen scan was performed that showed an unusual uptake of sulfur colloid in the lungs. There was diffuse uptake in the left lung and portions of the right lower lung with absent uptake in the right upper lobe and portions of the right lower lung corresponding to areas of pulmonary consolidation. A perfusion lung scan confirmed absent pulmonary arterial perfusion in these areas and a gallium scan demonstrated active infection there. PMID- 2706871 TI - Significance of nodal uptake on indium 111 labeled leukocyte scans. AB - A retrospective study of 132 indium 111 labeled leukocyte scans on 129 patients was undertaken to determine the incidence and significance of activity in the neck, axilla, and groin suggestive of regional lymph nodes. Possible nodal uptake was observed in 35 out of 108 (32%) adults and 11 out of 21 (52%) children. Activity was characterized as symmetric or asymmetric. Based on medical record review, positive scans were divided into two groups: with or without clinical correlation. Nodal visualization was common in children and showed a high degree of clinical correlation. In adults, asymmetric uptake in the axilla and groin was frequently associated with disease. Cervical activity, however, often remained unexplained and may represent false-positive uptake in mandibular marrow or submandibular glands. In summary, nodal uptake may represent a significant finding, reflecting known disease or may signal subclinical disease. PMID- 2706872 TI - Unusual pattern of indium-111 leukocyte distribution in a patient with widespread infection. PMID- 2706873 TI - Abnormal gallium-67 citrate imaging in tuberculosis appearing like sarcoidosis. PMID- 2706874 TI - Intra-abdominal abscess and peritonitis. PMID- 2706875 TI - Hand and forearm Tc-99m HMDP bone image findings of reflex sympathetic dystrophy similar to those of radiopharmaceutical arterial administration in the arm. PMID- 2706876 TI - Artifact on iodine-131 whole body scan due to contaminated handkerchief. PMID- 2706877 TI - The case of the pathetic pagetic patella. PMID- 2706878 TI - Demonstration of periorbital cerebrospinal fluid leak by radionuclide cisternography. PMID- 2706879 TI - Scintigraphic demonstration of restored Denver peritoneovenous shunt patency using urokinase. PMID- 2706880 TI - Influence of renal function on the pharmacokinetics and cardiovascular effects of nisoldipine after single and multiple dosing. AB - The pharmacokinetics and cardiovascular effects of the calcium entry blocker nisoldipine (10 mg twice daily) were studied in 6 patients with renal failure (creatinine clearance 23 +/- 9 ml/min) and 6 healthy control subjects after a single dose and 1 week of oral administration. No significant differences in elimination half-life, area under the concentration/time curve, peak plasma drug concentration and time to reach that peak were observed between renal patients and control subjects, and between single-dose and short term administration. The decrease in systolic blood pressure and increase in heart rate were similar in both groups, but the decrease in diastolic blood pressure was more pronounced in the patients. This can be explained by increased haemodynamic sensitivity for nisoldipine. Adverse effects were mainly restricted to the first day of administration. PMID- 2706881 TI - Giftedness. Can it be predicted in infancy? AB - A cohort of 200 children, who were followed from birth and periodically evaluated as part of a longitudinal study of child development, was used to determine the ability of the Bayley Scales of Infant Development (BSID) to predict children who would be considered intellectually gifted at 7.5 years. The cohort was predominantly white (91%), upper middle class (70% in Hollingshead class 1 or 2), and had preschool educational experiences (94%). At outcome, 36 children had WISC R verbal, performance, or full scale IQs greater than 135 and were called gifted. On average, gifted children walked 0.7 months earlier and spoke two-word sentences 2.2 months earlier than the non-gifted group. As a group, gifted children showed statistically significant, but clinically small, advantages for age of walking, age of speaking two-word sentences, BSID, and Stanford Binet IQ. Of the 36 children who later proved to be gifted, only two had BSID IQs greater than 134. Of the four children who had BSID IQs greater than 134, two maintained their superior function but 2 did not. A discriminant function analysis was used to predict giftedness for individual children based on BSID performance. The resulting classification achieved sensitivity = 0.69 and specificity = 0.39. Although groups of infants who will be gifted have higher BSID scores, the BSID cannot be endorsed as a method of identifying individual infants who will later demonstrate superior cognitive function. PMID- 2706882 TI - Recruitment of a large community of pediatricians in a collaborative research project. AB - To investigate the effects of an educational program on the compliance-enhancing behavior of pediatricians and the subsequent regimen adherence of their patients, it was necessary to enlist the participation of a large number of pediatric practitioners. The physicians had to be motivated to attend two evenings of tutorial training; to enroll their patients in the project; and to complete detailed study documents. Ultimately, 90 of the 97 pediatricians practicing in the community took part. The following factors are felt to have contributed to the widespread participation of the pediatricians: 1) the subject was interesting and of relevance to clinical practice; 2) the study was designed so as not to interfere with office routine; 3) major demands were not made on the patients; 4) due consideration was given to the value of the physicians' participation; and 5) communication between the investigators and the practitioners was facilitated by a liaison pediatrician. PMID- 2706883 TI - Measures of attention deficit. Part I: Questionnaires. AB - Despite much progress in the diagnosis and management of children with attentional problems, hyperactivity, and learning difficulties, current diagnostic techniques remain inadequate to readily distinguish a primary attentional disorder from a more complex secondary problem. Developmental and behavioral questionnaires to supplement office evaluation of hyperactivity, neuromaturation, and selected cognitive processes continue to be improved. These measures suffer from different biases, focus on different childhood characteristics and associated problems, and approach childhood interaction with the environment differently. Several are psychometrically more sound, and several provide the physician with developmental and social information that may help improve the habilitative prescription. The general pediatrician can use these questionnaires to complement his or her evaluation and follow-up of children who present with learning and behavioral problems. Prior to choosing an instrument, the clinician should review the advantages of each and choose the one most suited to his or her practice. PMID- 2706884 TI - Infection control barrier techniques. Used by physicians during routine examinations. Parental attitudes. AB - Parents of 316 children seen in the outpatient clinics of a large pediatric teaching hospital completed a questionnaire regarding their attitudes toward the use of infection control procedures by doctors during the routine examination and treatment of their children. Results revealed that the majority of parents held favorable attitudes toward the wearing of gloves and masks during patient care activities. Parents who agreed that gloves and masks should be worn also tended to believe that diseases could be spread through cross-infection, that protective wear would prevent such infection, and that their children generally would benefit from these precautions. Parents of preschool-aged children felt that such procedures might make their children more fearful. These data indicate that many parents are basically supportive of the use of infection control procedures with their children and that such techniques do not appear to be an obstacle to effective relationships between health-care professionals and their patients. PMID- 2706885 TI - Heparin lock intravenous line. Use in newborn infants. A controlled trial. AB - The heparin lock technique has been available for parenteral access in older children and adults but has not yet been described for use in newborns. We randomized 39 newborns who needed parenteral medication in the intermediate care nursery to receive a heparin lock catheter (17) or an intravenous line kept patent by continuous low infusion rate (22). There were no differences between study groups with regard to birthweight, gestational age, or distribution of diagnoses. Infants in the heparin lock group were enrolled in the study on average 1 day longer than the continuous intravenous group (p less than 0.05). Subcutaneous infiltration occurred twice as frequently with the continuous intravenous line (p = 0.0015), and the life span was significantly less than heparin lock (1.0 +/- 0.5 days versus 2.1 +/- 1.0 days, p = 0.0003). Infants with continuous intravenous lines received approximately 20 ml/kg/day greater quantity of fluid (p less than 0.0001). There was no difference between groups with regard to mean heparin activity level. None of the infants developed hemorrhagic complications, thrombophlebitis, or documented nosocomial infection. Nurses significantly favored heparin locks over continuous intravenous lines for ease of use. The heparin lock technique is a safe and reasonable alternative to a continuous low infusion intravenous line for administering parenteral medications to intermediate care newborns. PMID- 2706886 TI - [Magnetic resonance tomography imaging of Botallo's duct--a case report]. AB - In a female patient suffering from renal insufficiency in whom angiography could not be performed, it was possible to confirm the diagnosis of a ductus arteriosus (Botallo's duct) by magnetic resonance imaging. The present case report shows that it is possible to visualise this congenital heart disease by MRI. This can be of importance especially if angiography cannot be performed (as in this case) because of renal insufficiency or because of contrast medium allergy. PMID- 2706887 TI - [The value of magnetic resonance tomography using gadolinium-DTPA in the diagnosis of the post-lumbar disk surgery syndrome]. AB - Our results have shown that MR tomography - especially if gadolinium-DTPA is used as a contrast medium - is an excellent method to differentiate between the various possible causes of the post-discotomy syndrome. In particular, it is definitely possible to differentiate between a relapsed hernia of an intervertebral disc and a postoperative development of cicatricial tissue which is practically inevitable. This differentiation is of vital importance to the clinician, because a second operation should be performed only in case of a relapse, whereas cicatricial tissue is best left alone, because no matter how carefully the operation is performed with preparation of the neural structures, even more extensive cicatricial plates are bound to develop. Instability of the vertebral column in the operated disc segment, or other causes of complaints, can be identified via MR equally well if not better than by other means. Hence, the method should be the method of choice in postdiscotomy syndrome, since it facilitates the difficult choice between conservative therapy and reoperation. PMID- 2706888 TI - [Picture quality of a digital urogram using image enhancement radiography]. AB - The use of digital image radiography in urographic diagnostics yields a high percentage of images that are useful in diagnosis, even at the present state of technical development which is rapidly improving. Our own results obtained in a prospective study on 75 patients supply proof of such diagnostically useful pointers. Clear improvements in demonstrating the details when employing a 28 cm image amplifier input format in place of the additionally used 40 cm are seen only with the system of the renal calices. However, we found that the 40 cm image amplifier input format proved satisfactory in respect of assessing renal contours, kidney pelvis and ureters as far as image quality was concerned. Enhance image quality can be expected in future from the use of wedge-shaped diaphragms as well as a selective influencing of the automatic exposure (several measurement chambers, weighting factors) and the transfer of monitor screen contents to hard copy without incurring any losses during transfer. PMID- 2706889 TI - [Postoperative computed tomography control of allogeneic vascular prostheses]. AB - 33 CT-studies of 26 patients with alloplastic vascular prostheses were evaluated and compared with postoperative digital subtraction-angiography in 16 cases. 13 patients had no pathologic findings confirmed by further clinical development. In 4 cases bypass infection was diagnosed, which CT findings were perigraft gas (2/4), perigraft fluid (4/4), cm-enhancement (4/4) and fistulas (2/4). 10-21 d. post.-op. sterile hematomas were found in 3 patients. Further 3 cases had 5 weeks 2 post.-op. perigraft seromas. CT was method of first choice for diagnostic of perivascular alterations after bypass surgery. DSA was complementary to CT and should be performed to detect vascular complications. PMID- 2706890 TI - [A new multislice gradient echo sequence for magnetic resonance tomography of the liver]. AB - A multislice gradient echo sequence was developed for screening the liver and examined in studies on probands. This sequence is characterized by pronounced T1 weighting and low susceptibility to artifacts as well as a good contrast-to-noise ratio. Examination of the probands yielded suitable parameters for the repetition time, the delay echo, the excitation pulse angle and the number of data acquisitions. The optimized sequence yields, at a repetition time of 306 msec and an echo delay of 12 msec, 18 adjacent slices. With these measurement parameters an excitation pulse angle of 90 degrees was found to be adequate. Four data acquisitions (5.4 minutes measurement time) resulted in an effective reduction of motion artifacts. Compared with the T1-weighted spin echo sequences, the entire liver can be measured in half the time when using the multislice gradient echo sequence. PMID- 2706891 TI - [The inverted cockade sign. An indication in CT of an impending rupture of an abdominal aortic aneurysm]. AB - A new CT-sign as a pointer to the imminent rupture of an abdominal aortic aneurysm is described: the enhanced shell of the thrombus of the aneurysm. This sign is caused by bleeding into the thrombotic layer. PMID- 2706892 TI - Effect of continuous cimetidine infusion on steady-state theophylline concentration. PMID- 2706893 TI - Effect of erythromycin in patients receiving long-term warfarin therapy. PMID- 2706894 TI - Preliminary study of the effects of postoperative methylprednisolone therapy on lung function recovery in patients with chronic obstructive pulmonary disease. PMID- 2706895 TI - Amphotericin B concentration in cerebrospinal fluid of patients with AIDS and cryptococcal meningitis. PMID- 2706896 TI - Transient increase in plasma quinidine concentrations during ketoconazole quinidine therapy. PMID- 2706897 TI - Theophylline-thiabendazole drug interaction. PMID- 2706898 TI - Milk-alkali syndrome associated with use of chlorothiazide and calcium carbonate. PMID- 2706899 TI - Alpha thalassaemia in Zambian newborn. AB - The umbilical cord blood from 109 consecutive Zambian neonates (excluding those found to be anti-HIV positive) were analysed for haemoglobin (Hb) Bart's and for alpha thalassaemia by restriction endonuclease analysis. This showed that 52.3% had the genotype alpha alpha/alpha alpha, 38.5% had -alpha 3.7/alpha alpha, 7.3% had -alpha 3.7/-alpha 3.7 and 1.8% had alpha alpha alpha/alpha alpha. The alpha thalassaemia gene (-alpha) frequency was 0.27. There were no apparent differences in gene frequency between six major Zambian ethnic groups. Detection of Hb Bart's identified all alpha-thalassaemia homozygotes (-alpha/-alpha), but fewer than 10% of heterozygotes (-alpha/alpha alpha). alpha-thalassaemia was associated with slight but significant anaemia and microcytosis. PMID- 2706900 TI - Intravenous immunoglobulin therapy in thrombocytopenic infectious mononucleosis. AB - Severe haemorrhagic thrombocytopenia in infectious mononucleosis with positive Epstein-Barr virus (EBV) serology remains a threatening clinical problem. Although rare, fatalities have been reported. We present clinical, haematological and serological details of two patients with diffuse bleeding associated with this disease who failed conventional steroid treatment and who both responded promptly and effectively to infusions of intravenous immunoglobulin (i.v. Ig). A platelet immunofluorescence test was used to detect platelet antibodies in acute and recovery phase patient sera against autologous recovery platelets and against normal allogeneic group O platelets. In one patient, indirect immunofluorescence using recovery platelets detected an IgG platelet autoantibody with acute phase autologous serum. No platelet antibody was detected in the second patient. The data presented demonstrate that response to i.v. Ig is independent of serological detection of platelet autoantibodies. Therapy with i.v. Ig should be considered in any case of haemorrhagic thrombocytopenia associated with EBV infection shown to be refractory to steroid treatment. PMID- 2706901 TI - The use of the technicon H1 in the diagnosis of hereditary spherocytosis. AB - Blood samples from 21 patients with confirmed hereditary spherocytosis (HS) were studied using the Technicon H1 blood counter. Nine patients had had a splenectomy and 12 were unsplenectomized. In the latter, the means of MCHC and RDW as measured by the H1 were significantly higher than results obtained using the Technicon H6000. Furthermore, spherocytes were recognizable in all of the H1 histograms of red cell size and Hb concentration as distinctive hyperchromic and microcytic tails, and the HDW (Hb distribution width) was consistently elevated. In the splenectomized patients, although the mean MCHC and RDW results were significantly higher as measured by the H1, it was not possible to recognize any abnormalities in the red cell histograms, and the HDW results were normal. Two of 75 apparently normal blood donors showed very small tails of hyperchromic cells, but in neither was this sufficient to disturb the MCHC, RDW or HDW parameters, and confusion with an unsplenectomized case of HS would be very unlikely. The H1 appearances of HS are so specific that the measurement of osmotic fragility will seldom be necessary. PMID- 2706902 TI - CFU-GM inhibitors in neutropenia. AB - Peripheral blood lymphocytes from 20 patients with neutropenia not consistent with aplastic anaemia were tested for their ability to inhibit the proliferation of normal granulopoietic precursor cells (CFU-GM) in agar culture. Two patients, both with features of an autoimmune disorder, had lymphocytes which were more inhibitory than normal lymphocytes to both normal and their own CFU-GM. Two other patients had lymphocytes which were more inhibitory than normal lymphocytes to either their own CFU-GM or normal CFU-GM but not both. Eight patients had lymphocytes which were significantly less inhibitory than normal lymphocytes to either normal or their own CFU-GM, but only one showed this feature against both normal and their own CFU-GM. One patient had a highly potent plasma inhibitor of CFU-GM--this patient had received multiple transfusions and had a leucocyte antibody of a broad specificity. No clinical or haematological features were common to any of these groups of patients which reflects the heterogeneity of patients studied and stresses the importance of controls. PMID- 2706903 TI - Chronic lymphocytic leukaemia presenting with bilateral breast involvement. PMID- 2706904 TI - Polycythaemia vera with Sweet's syndrome. PMID- 2706905 TI - A study of the reliability of clinical palpation of the spleen. AB - Clinical palpation of the spleen was assessed by reference to a radionuclide scan method for measuring spleen volume in vivo from V = 9.88A - 534, where V = volume (cm3) and A = posterior scan area (cm2) (Zhang & Lewis 1987). The position of the spleen tip in relation to the costal margin correlated well with clinical palpability when the spleen was clearly enlarged, but when the spleen tip was just below the costal margin it was not always palpable. In some cases a normal sized spleen was palpable, whereas a non-palpable spleen was not always normal sized. As the scanning method gives an accurate measurement of spleen size it is especially useful in lesser degrees of enlargement when reliable information on the splenomegaly may help to elucidate a diagnosis and problems of management. PMID- 2706906 TI - UK national external quality assessment scheme (NEQAS) in blood coagulation. PMID- 2706907 TI - Protein C deficiency: spontaneous healing of necrotic rash on warfarin. PMID- 2706908 TI - A comprehensive anticoagulant management support system (AMSS) PMID- 2706909 TI - Screening for G6PD by sigma kits. PMID- 2706910 TI - Progressive multifocal leucoencephalopathy in patients with chronic lymphocytic leukaemia. PMID- 2706911 TI - Determination of the oxygen cost of level walking. AB - We have developed devices and methods for the determination of the oxygen cost of level walking. Oxygen uptake is determined with an argon dilution method. The validity of this technique is demonstrated. Walking speed is recorded and controlled by means of a speedometer cart. The reproducibility of a convenient, self-selected walking speed and of a predetermined speed was studied. Coefficients of variation were below two per cent. Corresponding values of the oxygen cost of walking at a predetermined speed were three per cent or less up to an interval between tests of six months. We conclude that the proposed methods are suited for longitudinal studies of the oxygen cost of level walking, for example in patients with walking disorders. PMID- 2706912 TI - Effects of chronic dobutamine administration on the response to acute exercise in dogs. AB - The effects of chronic dobutamine administration on haemodynamic and metabolic responses to submaximal and maximal exercise were studied in dogs. Dobutamine was infused at a rate of 40 micrograms/kg min-1, 2 h day-1, 5 days week-1 for a period of 6 weeks. Acute infusion of dobutamine for 1 h increased heart rate by 73 +/- 30 beats min-1 and cardiac output by 143 +/- 141 ml/min kg-1, reduced mean arterial blood pressure by 12 +/- 10 mmHg and arterial-venous O2 difference by 1.5 +/- 1 vol%. Maximal oxygen consumption, heart rate, stroke volume, cardiac output and arterial-venous O2 difference were unchanged after 6 weeks of treatment. Reductions in heart rate at rest and during submaximal exercise following chronic dobutamine treatment were small and significant only at the lowest exercise level studied. Mixed venous lactate concentrations measured at rest, during submaximal and maximal exercise and at 2 min of recovery were not different after dobutamine treatment. Chronic dobutamine infusion did not change the citrate synthase activity in the lateral gastrocnemius muscle. These results suggest that chronic dobutamine therapy in healthy dogs does not produce aerobic training responses. PMID- 2706913 TI - Influence of vibration on endurance of maximal isometric contraction. AB - In order to investigate how vibration affects endurance during muscular contraction, knee-joint extension efforts were performed with and without superimposed vibrations. Fourteen healthy non-smoking 20-year-old males performed maximal isometric and sustained knee-joint extension efforts (angle 90 degrees) in sitting posture three times with each leg, with or without vibration. The tests were done once with each leg in a randomly chosen order. The frequency of the vibration was 20 Hz and the acceleration 20 m/s2 RMS, applied in a horizontal sagittal direction to the ankle. The endurance was defined as the time in seconds that it took for the exerted force to decrease by 10% of the initial value. The endurance time averages 22.5 s without vibration and 15.8 s with vibration. The vibratory stress reduced endurance by 6.7 +/- 1.84 s (mean +/- SEM) (P less than 0.005). The difference in maximal force recorded initially was 34 +/- 1.9 N (P less than 0.1). Our conclusion is that vibration may decrease the endurance of maximal och sustained isometric muscular contraction. PMID- 2706914 TI - The Q-oTc and Q-Tc interval and ionized calcium in newborns. AB - Ionized calcium (CaF), Q-oTc and Q-Tc intervals were determined in 31 full-term healthy newborns, 12 infants subjected to blood exchange transfusion (ET) and 10 infants with verified clinical hypocalcaemia. There was no significant correlation between CaF values and QT intervals. The large fluctuations in CaF during ET did not correspond to any similar change in Q-oTc or Q-Tc intervals. The Q-oTc interval was slightly longer in the hypocalcaemic and the blood exchanged groups compared to controls. The Q-Tc interval was somewhat longer in the ET group. The differences in mean values for QT intervals were fairly small and the ranges wide. ECG findings lack practical implications in diagnosing and following neonatal hypocalcaemia and we therefore recommend the measurement of CaF as a guideline. PMID- 2706915 TI - Diagnostic value of longterm ambulatory ECG in patients with syncope, dizziness or palpitations. AB - The diagnostic value of longterm ambulatory ECG recording (LTER) was determined in 63 patients referred for investigation of syncope, in 32 with dizziness and in 89 with palpitations. Among patients referred for syncope, dizziness or palpitations 8, 13 and 54%, respectively, had typical symptoms during the recording with concomitant arrhythmia explaining the symptom, and 6, 50 and 11% had a typical symptom without concomitant arrhythmia. In 12 and 3% of the patients referred for syncope or dizziness, respectively, arrhythmia was observed and probably explained their previous complaint, but no symptoms occurred during LTER. LTER was found to be of diagnostic value in 24% of the patients with syncope, in 66% of those with dizziness and in 65% of those with palpitations. In the latter two groups the presence of symptoms the week before the start of these recordings predicted the occurrence of symptoms during LTER. Only occasionally was there a higher yield of typical symptoms beyond 48 h of recording. PMID- 2706916 TI - Effect of oral administration of nifedipine on neuropeptide Y- and noradrenaline induced vasoconstriction in the human forearm. AB - Neuropeptide Y (NPY) has recently been shown be co-released with noradrenaline (NA) from sympathetic nerves and to cause arterial vasoconstriction in experimental animals and man. The effect of a single oral dose (10 mg capsule) of nifedipine on NPY- and NA-induced reductions of forearm blood flow (FBF) was studied in seven healthy volunteers. Intra-arterial infusions of NPY and NA into the brachial artery before nifedipine caused dose-dependent reductions in FBF with threshold doses of 0.2 and 0.03 nmol x min-1, respectively. The response to NPY was slower in onset and more long lasting than that to NA. Forty-five min after administration of nifedipine, FBF and heart rate had increased significantly (by 49% and seven beats x min-1, respectively, P less than 0.001), while no significant change was observed in systemic blood pressure. The NPY induced decrease in FBF was slightly but significantly attenuated after compared to before nifedipine (19 +/- 6 vs. 28 +/- 5% at 1.0 nmol NPY x min-1; P less than 0.01). The response to NA was, however, not significantly altered by nifedipine. In conclusion, the NPY-induced reduction in FBF in man was only slightly prevented and the NA response not significantly affected by oral nifedipine administration in a clinically used dose. This suggests that this calcium antagonist, in the present dosage, does not, to any major extent, inhibit the vasoconstrictor effect of NPY or NA in man in vivo. PMID- 2706918 TI - Metabolic functions of the lungs. PMID- 2706917 TI - Continuous and stepwise cystometry through suprapubic catheters--effect of infusion pattern and infusion rate on the cystometrogram of the normal human bladder. AB - Continuous cystometry at two filling rates (50 and 100 ml min-1) and stepwise cystometry (successive rapid volume infusions followed by bladder wall relaxation) were performed in 12 healthy subjects. Suprapubic catheters were used for infusion and recording of perivesical and intravesical pressures. The continuous cystometrograms obtained at filling rates of 50 and 100 ml min-1, respectively, did not differ with respect to desire to void, transmural pressure increase or bladder capacity. Stepwise cystometry allowed the bladders to be filled to a slightly larger volume than during continuous cystometry, but with comparatively lower transmural pressures only at very large distension of the bladder. There was considerable inter-individual variation in transmural pressure at both continuous and stepwise cystometry. Stepwise cystometry did not appear to provide any important additional information about pressure-volume relationship in the normal human bladder than could be obtained at routine clinical cystometry. PMID- 2706919 TI - Evolution, selection and cognition: from "learning" to parameter setting in biology and in the study of language. AB - Most biologists and some cognitive scientists have independently reached the conclusion that there is no such thing as learning in the traditional "instructive" sense. This is, admittedly, a somewhat extreme thesis, but I defend it here in the light of data and theories jointly extracted from biology, especially from evolutionary theory and immunology, and from modern generative grammar. I also point out that the general demise of learning is uncontroversial in the biological sciences, while a similar consensus has not yet been reached in psychology and in linguistics at large. Since many arguments presently offered in defense of learning and in defense of "general intelligence" are often based on a distorted picture of human biological evolution, I devote some sections of this paper to a critique of "adaptationism," providing also a sketch of a better evolutionary theory (one based on "exaptation"). Moreover, since certain standard arguments presented today as "knock-down" in psychology, in linguistics and in artificial intelligence are a perfect replica of those once voiced by biologists in favor of instruction and against selection, I capitalize on these errors of the past to draw some lessons for the present and for the future. PMID- 2706920 TI - A unified theory of the meaning of some spatial relational terms. AB - This paper presents a unified account of the meaning of the spatial relational terms right, left, in front of, behind, above and below. It claims that each term has three types of meanings, basic, deictic and intrinsic, and that the definitions of each type of meaning are identical in form for all six terms. Restrictions on the use of the terms, which are different for above and below than for the rest, are explained by a general constraint on all uses of spatial relational terms, the framework vertical constraint. This constraint depends on the existence of a fourth type of meaning for above and below, one defined by the framework in which the related objects are located. It is argued that a theory centred on the framework vertical constraint is preferable to one centred on the principle of canonical orientation (Levelt, 1984). PMID- 2706921 TI - Suppressing valid inferences with conditionals. AB - Three experiments are reported which show that in certain contexts subjects reject instances of the valid modus ponens and modus tollens inference form in conditional arguments. For example, when a conditional premise, such as: If she meets her friend then she will go to a play, is accompanied by a conditional containing an additional requirement: If she has enough money then she will go to a play, subjects reject the inference from the categorical premise: She meets her friend, to the conclusion: She will go to a play. Other contexts suppress the conditional fallacies. The first experiment demonstrates the effects of context on conditional reasoning. The second experiment shows that the inference suppression disappears when the categorical premise refers to both of the antecedents, such as: She meets her friend and she has enough money. In this case, subjects make both the valid inferences and the fallacies, regardless of the contextual information. The third experiment establishes that when subjects are given general information about the duration of a situation in which a conditional inducement was uttered, such as: If you shout then I will shoot you, they reject both the valid inferences and the fallacies. The results suggest that the interpretation of premises plays an even more central role in reasoning than has previously been admitted. PMID- 2706922 TI - Reducing emotional distress associated with childhood illness. PMID- 2706923 TI - Menopausal mood disorders. PMID- 2706924 TI - Diagnosis and treatment of epilepsy in adults. PMID- 2706925 TI - Epilepsy surgery. PMID- 2706926 TI - Similarity information versus relational information: differences in the time course of retrieval. AB - Two experiments are reported that examine the time course of retrieval in a sentence matching procedure. Subjects learned lists of active and passive sentences and were tested with sentences in active or passive, correct or incorrect versions; for example, if "John hit Bill" was a studied sentence, "Bill hit John" would be an incorrect active test sentence. A response signal procedure was used so that accuracy could be measured as a function of time. The data show that sentences containing words from studied sentences are discriminable early in processing from sentences containing all new words, but discrimination of correct from incorrect versions of studied sentences occurs only later in processing (after 600-700 ms). These results demonstrate that different kinds of information are available at different points during the time course of retrieval and so suggest that modifications are required of models that provide only a unitary value for the amount of match between a test probe and information in memory. Early in processing, the growth of accuracy can be explained by a simple model that assumes independent contributions to total amount of match for each of the content words of a sentence, but this independent processing model cannot account for discrimination later in processing. Several, more general, memory models are examined with respect to their abilities to produce independent item information early in processing and relational information later in processing. PMID- 2706927 TI - Can we imagine how objects look from other viewpoints? AB - Many psychologists who study cognition believe that perception achieves object centered representations that make it possible to extract representations of how the object would appear from differing viewpoints. Others believe we can achieve representations of how an object would appear by a process of visualization or mental rotation. We report experiments in which the subject tries to imagine how three-dimensional novel wire objects would appear from positions other than the one they are in. Subjects are unable to perform this task unless they make use of strategies that circumvent the process of visualization. It is suggested that the linear increase in time required to succeed in mental rotation tasks as a function of the angular discrepancy between the figures compared is the result of increasing difficulty rather than of the time required for rotation. PMID- 2706928 TI - Mental rotation and orientation-dependence in shape recognition. PMID- 2706929 TI - Koelliker haemoglobins in developing chick embryo. AB - 1. Three Koelliker haemoglobins, HbKE, HbKA and HbKH, derived from a post translational loss of alpha-Arg-141, were isolated from red cells of chicken embryos. HbKE is typical of embryos up to 7 days of incubation, HbKA and HbKH are found in mature embryos. 2. All the precursor haemoglobins contain alpha A chains. HbKA derives from adult haemoglobin A whose globin composition is alpha A2 beta 2, HbKH from embryonic haemoglobin H with a globin composition alpha A2 beta H2 and HbKE from embryonic haemoglobin E with globin composition alpha A2 epsilon 2. 3. No Koelliker derivatives of haemoglobins with alpha-like chains other than alpha A were observed. PMID- 2706930 TI - Chemical modification and composition of tetrameric isozyme K of alkaline phosphatase from harp seal intestinal mucosa. AB - 1. The carbohydrate content of isozyme K of alkaline phosphatase (EC 3.1.3.1) from harp seal intestinal mucosa was examined. The presence of N acetylglucosamine, N-acetylgalactosamine and considerable amounts of mannose residues was shown. 2. The amino acid content of seal alkaline phosphatase was determined. A high extent of homology (85%) between bovine and seal alkaline phosphatases was demonstrated. 3. By chemical modification lysine, dicarboxylic acids, arginine and tyrosine residues of tetrameric seal alkaline phosphatase are located near or at the active site. By contrast, the modification of either thiol or imidazole groups resulted in no alterations of the enzyme activity. 4. It has been demonstrated that inorganic phosphate is an inhibitor of alkaline phosphatase and entirely prevents the enzyme inactivation with succinic anhydride. PMID- 2706931 TI - Activation and peroxisomal beta-oxidation of fatty acids and bile acid intermediates in liver from Bombina orientalis and from the rat. AB - 1. Bombina orientalis excretes mainly C27 bile acids: trihydroxycoprostanic and varanic acids. More than 90% of the trihydroxycoprostanic acid (THCA) present in the bile, was conjugated with taurine; varanic acid was present in the unconjugated form. 2. Trihydroxycoprostanoyl-CoA (THC-CoA) synthetase activity, required for the formation of the taurine conjugate, was present in the liver of Bombina orientalis. 3. Peroxisomal beta-oxidation, which catalyzes the oxidation of fatty acids as well as the conversion of C27 bile acids into C24 bile acids in rat and human liver, could be detected in liver of Bombina orientalis when palmitoyl-CoA was used as substrate, but not when trihydroxycoprostanoyl-CoA (THC CoA) was used. PMID- 2706932 TI - Amino acid uptake and incorporation not cell-specific peptides and evidence for intracellular peptide pools in Aplysia neurons R3-R14. AB - 1. Relationships between intracellular amino acid concentrations and uptake rates and their utilization in synthesis of cell-specific peptides in neurons R3-R14 in the Aplysia parietovisceral ganglion are explored. 2. The uptake rates and intracellular concentrations of most amino acids are positively correlated and inversely related to their degree of incorporation into the peptides. 3. The bulk cellular pool of arginine is probably utilized in the synthesis of R3-R14 peptides, but much of the glycine taken up appears not to be readily available for protein synthesis. 4. There are rapidly and slowly turning over pools of the peptides, and portions of the peptides stay in the cell bodies for days. PMID- 2706933 TI - Inherited persistence of immature type pyruvate kinase and hexokinase isozymes in dog erythrocytes. AB - 1. Red cell pyruvate kinase (EC 2.7.1.40) and hexokinase (EC 2.7.1.1) in high and low potassium (K) dogs were shown to exist as multiple forms which were separable by electrophoresis and ion-exchange chromatography. The R2-type pyruvate kinase, which was determined to be a young type enzyme in canine red cells, was shown to be the predominant form of pyruvate kinase in high K cells. 2. The M2-type pyruvate kinase, a prototype isozyme in erythroid cells, existed in high K dog erythrocytes as well as in high K and low K dog reticulocytes. 3. Isozyme analysis of high K red cell hexokinase also showed a profile similar to that obtained for low K reticulocytes. 4. These results seem to reflect the immaturity of high K erythrocytes, which suggest that an abnormal cell differentiation or maturation may occur at an early stage of erythroid cell proliferation in high K dogs. PMID- 2706934 TI - The haemocyanin of the whelk, Busycon contrarium (Conrad): aggregation states and subunit structure. AB - 1. The haemocyanin of the left-handed whelk Busycon contrarium (Conrad) exists largely as six or more multi-decameric aggregates characterized by sedimentation coefficients of approximately 105S, 132S, 155S, 170S, 185S and about 200-220S. 2. These aggregates represent di- to hepta- or octa-decameric assemblies of the basic haemocyanin decamer having a mol. wt of 4.3 x 10(6)-4.5 x 10(6). 3. The fully dissociated subunits in 8.0 M urea (pH 8.5) and at pH 11.1, 0.01 M EDTA have mol. wts of 4.78 x 10(5) and 4.62 x 10(5), close to one-tenth of the mol. wt of the basic decameric unit of most gastropod haemocyanins. 4. The pH dependence of the mol. wts (Mw), studied by light-scattering at the constant protein concentration of 0.010%, exhibit bell-shaped pH transition profiles with mol. wt values of about 16 x 10(6) in the presence of 0.01 M Mg2+, in the pH region from about pH 4.5-8.0; in the absence of stabilizing divalent ions the observed mol. wt is about 10 x 10(6) at pH 4.5-7.0. Below pH 4.5 and above 7.0-8.0 there is a sharp drop in mol. wt to about 4 x 10(5)-4.5 x 10(5). 5. The transition profiles observed with both the urea and salt series of probes investigated at concentration = 0.010% are found to produce aggregation at low reagent concentrations with mol. wt changes from about 9 x 10(6)-12 x 10(6)-14 x 10(6), followed by a decrease in mol. wt below 4.3 x 10(6)-4.5 x 10(6) of the haemocyanin decamers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2706935 TI - Comparative biochemical and pharmacological properties of epidermal secretions from Ariid catfish of the Arabian Gulf. AB - 1. Comparative biochemical and pharmacological studies on epidermal secretions from three species of Ariid catfish were carried out to determine whether they share common properties. 2. Protein compositions are generally similar, but show some differences in size and numbers of proteins. 3. Lipids also differ. However, seasonal and dietary changes in lipid compositions exceed the differences among species. 4. Enzymes in the secretions appear common to each fish species, though some differences are noted in relative activities. 5. Toxicity responses of rabbits to injections with secretions from each of the catfish species indicated that two were lethal, with similar lethal dose levels when injected intravenously. 6. Secretions from all three catfish induced changes in plasma enzyme levels indicative of heart and liver damage, and also induced changes in blood glucose and cholesterol levels. PMID- 2706936 TI - A galactose-specific lectin from the hemolymph of the pearl oyster, Pinctada fucata martensii. AB - 1. A lectin in the serum of Pinctada fucata martensii was purified by a combination of affinity chromatography on Sepharose 4B coupled with bovine submaxillary gland mucine, anion exchange chromatography on Mono Q and gel filtration on Superose 6. 2. The purified lectin was indicated to be homogeneous by polyacrylamide electrophoresis and rechromatography on Mono Q. 3. The purified lectin was approximately 440,000 in molecular weight and was composed of identical subunits with a molecular weight of approximately 20,000. 4. D galactose and N-acetylgalactosamine gave a 50% inhibition of agglutination of horse erythrocytes by the lectin at 0.3 and 1.2 mM, respectively. 5. The antibody obtained from rabbit immunized with the purified lectin was monospecific to the lectin judged from the hemagglutination blocking test, immunoelectrophoresis and immunoblotting. PMID- 2706937 TI - Physicochemical characterization and tissue distribution of esterases in two salamandridae species (Mertensiella luschani and Salamandra salamandra). AB - 1. Tissue- and species-specificity of the electrophoretic patterns of the multiple molecular forms of esterases were observed in the urodele amphibians Mertensiella luschani luschani, M.l. helverseni and Salamandra salamandra. All esterases--distributed into two electrophoretic mobility areas in gonads, muscles and brain and into four areas in liver, stomach and intestine--were characterized as carboxylesterases. 2. M. l. luschani and S. salamandra liver esterases were electrofocused into nine and eleven major bands with pIs ranging from 4.60 to 5.65 and from 4.40 to 6.20, respectively. 3. Two size groups of esterases were observed in liver extracts of the above three subspecies by Sephadex G-200 gel filtration. The mean values of their apparent molecular weights were 70,000 and 230,000 respectively. PMID- 2706938 TI - A basic phospholipase A from the venom of the Australian king brown snake (Pseudechis australis) showing diverse activities against membranes. AB - 1. A basic phospholipase A (MSPA) was isolated from the venom of the Australian king brown snake, Pseudechis australis. 2. MSPA had an approximate Mr of 13,000 and consisted of a single polypeptide chain of 119 amino acid residues cross linked by seven disulphide bridges. 3. MSPA exhibited direct haemolytic, anticoagulant and myotoxic activities. 4. Treatment of MSPA with p-bromophenacyl bromide modified a single histidine residue, resulting in complete loss of enzyme activity. PMID- 2706939 TI - Isolation, characterization, and expression of fatty acid binding protein in the liver of Gallus domesticus. AB - 1. Fatty acid binding protein (FABP) was isolated from chicken liver cytosol. 2. Apparent molecular weight, pI, functional activity, and hybridization of a rat hFABP cDNA probe with chicken liver mRNA suggest that chicken liver FABP is structurally related to hepatic FABP (hFABP) previously isolated and characterized in the rat. 3. Fatty acids bound to liver FABP affect the electrophoretic nature of FABP. 4. Levels of liver FABP mRNA isolated from chickens at various stages of development parallel developmental alterations in lipid metabolism, being highest in day old chicks and laying hens versus juvenile birds. PMID- 2706940 TI - A study of the biochemical characteristics of NADP+ isocitrate dehydrogenase from the liver and kidney of the Arabian camel (Camelus dromedarius). AB - 1. NADP+ isocitrate dehydrogenase was partially purified from camel liver and kidney by an FPLC. 2. The specific activity of the purified preparation from liver was 63.5 mumol/min/mg protein and from the kidney was similar, 58.7 mumol/min/mg protein. 3. The enzyme from the two sources were similar in their pH optimum (7.6), electrophoretic mobility and stability to thermal inactivation at 60 degrees C. 4. Heat inactivation was accelerated by oxidized glutathione and cystine and decreased by dithiothreitol, reduced glutathione and cysteine. 5. The molecular weight of the enzyme from both organs was estimated as 60,000 +/- 5000. 6. Divalent metal ions increased the activities of both enzymes, with maximum catalytic activity in the presence of Mn2+ ions. PMID- 2706941 TI - Lysozyme activity in animal extracts after sodium dodecyl sulfate-polyacrylamide gel electrophoresis. AB - 1. Lysozyme activity was detected after electrophoresis in sodium dodecyl sulfate polyacrylamide gels containing 0.2% (W/V) autoclaved Micrococcus lysodeikticus cells as substrate. 2. Lysozyme activity appeared as clear lysis zones after incubation of opaque gels at 37 degrees C in buffered Triton X-100. 3. As low as 0.1 pg of purified hen egg white lysozyme could be detected after 16 hr incubation at pH 6.5. 4. Bands with lytic activity from kidney and pancreas acetone powders, bird's egg whites and vitelline membranes, animal sera and human saliva corresponded to c-type (Mr 14,500), g-type (Mr 20,500) or both lysozymes as far as molecular weight is concerned. 5. Some extracts, like porcine kidney, exhibited more than two bands. 6. Bands with lytic activity migrating at the level of g-type lysozymes were detected in some kidney and pancreas extracts. PMID- 2706942 TI - Allelic expression at the sorbitol dehydrogenase and glucosephosphate isomerase loci in an interspecific hybrid ricefish. AB - 1. The expression of alleles encoding the enzymes sorbitol dehydrogenase (SDH; EC 1.1.1.14) and glucosephosphate isomerase (GPI; EC 5.3.1.9) was investigated in Oryzias melastigma, O. javanicus and in O. melastigma female x O. javanicus male hybrids by acrylamide gel electrophoresis. 2. It was not possible to investigate the expression of SDH or GPI in reciprocal hybrids as these fry failed to develop past the stage of embryonic body formation. 3. The delay in appearance of isozymes of paternal SDH subunit composition, and paternal and maternal GPI-B subunit composition is in keeping with observed effects of gene regulatory divergence where alleles of maternal origin interact more effectively with maternal cytoplasmic regulatory factors than do alleles of paternal origin. PMID- 2706943 TI - Comparative study of two arginine ester hydrolases, E-I and E-II from the venom of Crotalus ruber ruber (red rattlesnake). AB - 1. Two arginine ester hydrolases, E-I and E-II from the venom of Crotalus ruber ruber were isolated and characterized. 2. E-I and E-II have molecular weights of 32,000 and 33,000, and isoelectric points of 5.2 and 4.6, respectively. 3. E-I and E-II are active upon the glandular kallikrein substrate, but neither enzyme was shown to have plasma kallikrein substrate hydrolytic activity. 4. E-I has minimal fibrinogen-clotting activity. It was found to induce clotting by catalyzing the hydrolysis of only the A fibrinopeptide from the A alpha-chain of fibrinogen. PMID- 2706944 TI - Blood plasma catecholamine concentration of poult embryos during the transition from diffusive to convective respiration. AB - 1. Plasma catecholamines were determined in turkey embryos. 2. Decreased eggshell permeability depressed dopamine and epinephrine, but increased permeability also depressed epinephrine. 3. Norepinephrine (NE) was greatest before transition to convective respiration when hypoxia occurs. 4. NE was associated inversely with eggshell permeability. 5. Catecholamines appear to assist the embryo during hatching hypoxia. PMID- 2706945 TI - Proteins in cerebrospinal fluid and plasma of postnatal Monodelphis domestica (grey short-tailed opossum). AB - 1. The protein composition and concentrations of total protein in cerebrospinal fluid (CSF) and plasma of opossum (Monodelphis domestica) from birth until adulthood have been estimated. 2. Total protein in CSF increased from birth to a peak concentration between 5 and 10 days (500 mg/100 ml) after which it declined rapidly. 3. Total protein in plasma started at a low level at birth (below 400 mg/100 ml) and increased progressively to the adult value (8500 mg/100 ml). 4. Proteins identified in CSF and plasma were: albumin, alpha 1 antitrypsin, transferrin, alpha 2 macroglobulin, lipoproteins and immunoglobulin G. A fetal protein, probably alpha-fetoprotein, has been identified. 5. The only plasma proteins found within the brain, even in the very immature newborn of this species, appeared to have an intracellular rather than an extracellular distribution. This indicates that the blood-brain barrier is present very early in development and that there is also a CSF-brain barrier that appears to exclude CSF protein from brain extracellular space. PMID- 2706946 TI - Precise water vapor pressure value calculations. AB - Precise values for water vapor pressure in saturated systems may be computed using the Goff-Gratch equation. This equation has been adapted for convenient use on microcomputers. A Microsoft BASIC listing of the programming version of the equation is presented. This BASIC version may be easily translated into other high level programming languages and thus is suitable for use on many computer systems for routine laboratory computations. PMID- 2706947 TI - A computer program in BASIC for estimation of ED50 and LD50. AB - A BASIC computer program for calculating ED50 and LD50 values and their confidence limits by probit analysis and weighted linear regression is presented. It also includes the Chi square procedure for testing the mathematical model and allows on-screen high resolution graphic display. The portable program can easily be modified for use in different models of microcomputers. PMID- 2706948 TI - A SAS procedure for exact probability testing of difference between sample and population proportion. AB - Statistical testing of the hypothesis that the proportion of subjects in a defined population having a certain attribute (proportion of "positives" in a population, P) is equal to some specified value (P0) is frequently encountered in biomedical research. For example, a study might be carried out to statistically test whether the postoperative wound infection rate in patients having undergone an operation with a "new" surgical procedure is 20%, the same value that has been observed for the "established" surgical procedure. The significance test for this hypothesis (e.g., test H0: P = 0.20 against HA: P not equal to 0.20) is usually based on the normal theory approximation method. However, when the sample size is "small", especially if P0 is close to 0 or 1, the normal theory method can yield grossly unreliable results. In contrast, the significance test based on the exact binomial probability procedure always yields reliable results. A computer program coded in SAS is described herein to perform this exact probability test procedure. PMID- 2706949 TI - A radioimmunoassay program for Lotus 1-2-3. AB - Spreadsheet programs have become very popular as convenient ways of performing mathematical operations, as well as entering and organizing data. This paper describes how Lotus 1-2-3 can be used to calculate the results of a radioimmunoassay, a widely used technique in biomedical laboratories. PMID- 2706950 TI - Computer software for development and simulation of compartmental models of neurons. AB - A software package 'Nodus' for simulation and development of compartmental models of neurons is described. Passive or excitable membranes with voltage dependent ion conductances or synaptic conductances can be modeled. Detailed simulations of morphology and electrophysiology of neurons are possible. Neurophysiological experiments like voltage clamps and complex current injections can be simulated. Two integration methods are available: a fast hybrid method and an accurate fifth order Runge-Kutta method, with variable time steps. Nodus is implemented on Apple Macintosh microcomputers, with the standard user interface and interactive graphics. Simulations of simple test models demonstrate the accuracy and computation speed of the application. PMID- 2706951 TI - A one-compartment single-pore model for extracorporeal hemoperfusion. AB - A one-compartment single-pore model is proposed for the dynamic analysis and performance evaluation of a hemoperfusion column under operation. Experimental data obtained from binary systems containing creatinine and uric acid may be well predicted by the theoretically computed curves. This theory offers a means for the preclinical evaluation of any prototype hemoperfusion column. PMID- 2706952 TI - Hemodynamics in transposition of the great arteries with comparison to ventricular septal defect. AB - This paper uses a mathematical model of the circulations to study the hemodynamics of transposition of the great arteries (TGA) with comparison to ventricular septal defect (VSD). Computer experiments are conducted to determine the influence of the defect conductance and the pulmonary vascular conductance on the pulsatile pressures, flows, and oxygen concentrations of the circulation. In particular, the model is used to determine the waveform of the (possibly bidirectional) shunt through the ventricular and atrial septal defects. The results of the computer experiments consist of two parts. The first set of experiments is devoted to the comparison of VSD and TGA with a ventricular septal defect. The results are theoretical in the sense that most parameters have been fixed at the same levels. In each case TGA is represented by changing the connection of the chambers and reversing the compliance of the two ventricles. In the second set of experiments we attempt to simulate conditions clinically observed in a variety of cases of TGA. In each case we use clinical observations to infer parameters as the input to the model. We find that the model (with appropriate choice of parameters) generally exhibits blood pressure, blood flows and oxygen concentrations similar to the clinical observations. As a byproduct of these computer experiments we predict the effects of changing the pulmonary conductance. The comparison between TGA and VSD shows that as the defect conductance increases, the systemic oxygen concentrations decrease in VSD and increase in TGA. Even at large defect conductance, the two conditions remain distinct, however, since the mixing of the right and left ventricular blood pools is incomplete. This phenomenon of incomplete mixing sets quantitative limits on the benefits that can be achieved by surgical enlargement of the defect. A result of this study that may be useful in the management of TGA patients with a ventricular septal defect is the finding that there is a value of the pulmonary conductance that maximizes the effective flow and hence the systemic oxygen concentrations. The optimal pulmonary conductance is approximately equal to the systemic conductance when the defect is large. PMID- 2706953 TI - Complement in laboratory medicine. PMID- 2706954 TI - Measurement of complement proteins C2 and B in systemic lupus erythematosus and septic shock. AB - We developed sensitive radioassays to quantitate the homologous complement proteins C2 and B, in intact form, in sera from patients with diseases associated with hypocomplementemia. In a study of systemic lupus erythematosus (SLE) patients, we found a subset of patients (6/40) with low C2 concentrations, though overall, C2 concentration was not related to disease activity. Protein B concentration was increased in 23/40 SLE patients, apparently not due to a generalized acute phase response. Among patients with both gram-negative and gram positive septic shock, C2 and B concentrations were low in a subset of patients with pre-existing cirrhosis, suggesting hepatic hyposynthesis of these proteins may be important in their prognosis and predisposition to severe infections. PMID- 2706955 TI - Complement in laboratory medicine. Preface. PMID- 2706956 TI - Contact dermatitis in children. AB - 125 children under the age of 12 years were patch tested over a period of 7 years. 60 (48%) of the children had 1 or more positive (+ve) reactions, of which 92% (55/60) were considered relevant. The most common allergens were metals (35 + ves), fragrances (24 + ves) and rubber compounds (11 + ves). 40 of the children were also tested for contact urticaria against food additives and fragrances, of whom 20 were positive (benzoic acid 14, cinnamaldehyde 12). PMID- 2706957 TI - The influence of repeated exposure to surfactants on the human skin as determined by transepidermal water loss and visual scoring. AB - The purpose of this study was to develop a new model for the induction of chronic irritant contact dermatitis, which would reflect well the conditions of daily practice. Various weak irritant agents were tested for irritating potency on the skin and the sensitivity of transepidermal water loss (TEWL) measurements in the detection of early skin changes was also studied. 10 widely used surfactants and 1 solubilizer were applied to the skin of the forearms of healthy volunteers in aqueous solutions of 12.5 millimoles/l for 45 min twice daily for 3 weeks. The effect on the skin was evaluated daily by means of TEWL measurements and by a visual scoring system. Each solution caused an increase in TEWL value over time due to the cumulative irritating action on the epidermal barrier. This increase in TEWL was different for the various solutions, resulting in different mean TEWL values on the last day of the experiment. Thus, it was possible to rank the agents according to irritating potency. This ranking order was the same in almost every individual and remained constant during the 3 weeks. In comparison with the visual scoring system, the TEWL measurements were more sensitive in the detection of early changes in the skin. PMID- 2706958 TI - Sensitization to Kathon CG in Geneva and Switzerland. AB - Between October 1986 and June 1987 we patch tested 420 patients with Kathon CG at 100 ppm and obtained 23 positive reactions (5.5%). The other 5 Swiss university clinics joined our study between January and June 1987 and obtained sensitization rates ranging from 0.7 to 7.5%. The total mean value including Geneva was 3.6%. We did threshold patch testing in 12 patients with the following Kathon CG dilutions: 100, 50, 25, 15 and 7 ppm. We observed progressively diminishing skin reactions, especially below 25 ppm, but we still obtained slight positive reactions in 2 patients with Kathon CG at 7 ppm. Those reactions were relevant because the dermatitis disappeared when the use of Kathon-containing creams was discontinued. PMID- 2706959 TI - Intradermal testing in doubtful cases of contact allergy to metals. AB - Among 1670 consecutively patch tested patients an intradermal test with chromium, cobalt and nickel was added in 66 cases. There were three indications for intradermal testing: 1) the patch test reaction at 72 h was difficult to interpret; among 49 patients with one or more doubtful reactions a metal allergy was confirmed in 24 and rejected in 54. 2) ten patients with a negative patch test in spite of a positive history of metal allergy; among these, one was positive to cobalt, two to nickel and the other seven negative. 3) seven patients checked for a previously diagnosed allergy; a metal allergy was confirmed in four. Intradermal testing is recommended for confirmation of doubtful patch test reactions, particularly to disclose false positive reactions to metals. PMID- 2706960 TI - Local anesthetic intolerance due to metabisulfite. AB - The case of a 40-year-old woman with severe edema of the face and neck after the injection of a local dental anesthetic is presented. The reaction is attributed to the presence of sodium metabisulfite, and antioxidant, in the local anesthetic. Both the anesthetic and the sodium metabisulfite gave a delayed positive patch-test response. PMID- 2706961 TI - Delayed patch test reactions at days 7 and 9. AB - 403 consecutive patients were examined on days 2, 4, 7, and 9 following application of patch tests. Late positive reactions, i.e., those which manifested after day 4, were seen in 29 patients (7.2%). The allergens which most commonly produced late positive reactions were neomycin (7), potassium dichromate (4), and cobalt (3). Paired patch test readings on days 4 and 7 were more reliable than those on days 2 and 4. If only 1 patch test reading were performed, a single reading on day 4 would have been most useful. The reading on day 9 proved to be of limited value. Of 11 patients who were retested after an interval of more than 6 months, 7 showed earlier eliciting reactions, which may have been due to active sensitization. PMID- 2706962 TI - Contact allergy to colophony. (IV). The sensitizing potency of commercial products. An investigation of French and American modified colophony derivatives. AB - The sensitizing capacity of 15 commercial colophony products was studied experimentally in guinea pigs. The study included 8 French and 6 American colophony derivatives as well as French tall oil colophony. The results indicate that tall oil colophony is the strongest sensitizing material within the tested group and that the maleic-modified products and the zinc-calcium-resinate are moderate sensitizers. Most of the modified products show a higher sensitizing capacity than the genuine resin acids themselves. Cross-reactions between the resin acids and the derivatives are uncommon. Therefore, patch testing with high concentrations of colophony (e.g., 60%) will not help to detect patients with colophony-derivative allergy. PMID- 2706963 TI - Phytophotodermatitis from a Cachrys species. PMID- 2706964 TI - Confetti-like depigmentation from hydroquinone. PMID- 2706965 TI - Footwear dermatitis due to bisphenol A. PMID- 2706966 TI - Influence of topical cyclosporin A on patch test reactions. PMID- 2706967 TI - Contact dermatitis from Setaria viridis Beauv. (green bristle grass) in Japanese children. PMID- 2706968 TI - Mercury dermatitis. PMID- 2706969 TI - A survey of the results of patch tests with tixocortol pivalate. PMID- 2706970 TI - Measurement of transepidermal water loss. PMID- 2706971 TI - Effect of mineral oil and linoleic-acid-containing emulsions on the skin vapour loss of sodium-lauryl-sulphate-induced irritant skin reactions. AB - This study evaluates the influence of mineral oil and linoleic-acid-containing emulsions on the skin vapour loss (SVL) of detergent-induced irritant skin reactions. During a period of 2 weeks, 2 x 45 min applications of a sodium lauryl sulphate solution of low molarity were performed on the forearm of 9 volunteers. In the same period, a standard amount of each emulsion was applied on the induced irritant skin reactions, 3 times each day. The effect of the emulsions on the barrier function of the skin was evaluated by means of SVL measurements. The emulsion based on mineral greases significantly reduced SVL values during both weeks, possibly because of an occlusive effect. The emulsion with 15% of linoleic acid significantly reduced SVL values during the 1st week but not during the 2nd week. The emulsion with 38% of linoleic acid did not reduce SVL values at all. PMID- 2706972 TI - Contact lens intolerance; allergic conjunctivitis? AB - 20 patients complaining of contact lens intolerance were patch tested to a contact lens solution and a contact lens components battery. Contact urticaria testing was also carried out. 8 patients had positive delayed reactions on patch testing, 6 patients had positive contact urticaria reactions, and 9 patients had no reactions. These results are discussed and possible alternative diagnoses for the 9 undiagnosed patients are proposed. PMID- 2706973 TI - Adenocarcinoma of the cervix arising in pregnancy. PMID- 2706974 TI - Treatment of obesity in adults. AMA Council on Scientific Affairs. PMID- 2706975 TI - Consensus conference. Urinary incontinence in adults. National Institutes of Health. PMID- 2706977 TI - Relationship of syphilis to drug use and prostitution: Connecticut and Philadelphia, Pennsylvania. Centers for Disease Control. PMID- 2706976 TI - Reye's syndrome in an adult. AB - There have been over 3,500 cases of Reye's syndrome reported to the CDC since 1973. The temporal use of aspirin with a prodromal viral illness has been statistically associated with the etiology of the syndrome. Reye's syndrome presents as an acute progressive encephalopathy with varying levels of coma and normal cerebrospinal fluid (CSF). Hepatic transaminases are elevated, and the serum aspartate aminotransaminase (AST) is usually elevated three to 30 times normal. Histological changes on liver biopsy are characterized by microvesicular intrahepatocyte lipid deposition, which is rarely found in other diseases. The syndrome has rarely been reported to occur in adults over 18 years old. We report the 25th case of Reye's syndrome occurring in an adult, which initially presented as acetominophen toxicity but was shown to be Reye's syndrome on histological examination of the liver. PMID- 2706978 TI - State and local influenza immunization program activities. PMID- 2706979 TI - Hypothermia prevention. PMID- 2706980 TI - State-specific estimates of smoking-attributable mortality and years of potential life lost--United States, 1985. PMID- 2706981 TI - Rules for surviving a chief medical residency. PMID- 2706983 TI - CSMS-1988: the society's year in review. PMID- 2706982 TI - Cost-containment and medical malpractice. PMID- 2706984 TI - Reye's syndrome. PMID- 2706985 TI - Letters of reference and hospital appointments. PMID- 2706986 TI - Call to arms. PMID- 2706988 TI - The McConnell case and the "Death with Dignity Statute". PMID- 2706987 TI - Reflections on medicine. Emil von Behring and diphtheria. PMID- 2706989 TI - The relationships of SHBG with current and previous use of oral contraceptives and oestrogen replacement therapy. AB - Sex hormone binding globulin (SHBG) concentration was measured in serum samples from 2077 premenopausal and 901 naturally postmenopausal women who had no history of disease or of recent drug use likely to affect SHBG. Current users of oral contraceptives (OCs) and of oestrogen replacement therapy had higher mean SHBG values than non-current users. Both premenopausal and postmenopausal women who had previously used OCs had a lower mean SHBG concentration than never users of OCs. Previous use of oestrogen replacement therapy was not related to SHBG. PMID- 2706990 TI - Safety evaluation of a male injectable antifertility agent, styrene maleic anhydride, in rats. AB - Injection of a polymer, styrene maleic anhydride (SMA), into the lumen of the vas deferens of rats, was observed to have effective and reversible contraception. The safety evaluation of the polymer, for 90 days, was carried out in Charles Foster male rats. There have been no significant changes in any of the toxicity parameters in the test animals as compared to the control animals. Hence, it is concluded that the compound is non-toxic to rodents. PMID- 2706991 TI - Gonadal and pituitary responses to progesterone antagonist ZK 98.299 during the follicular phase of the menstrual cycle in bonnet monkeys. AB - ZK 98.299 is a potent progesterone antagonist. Its effects on folliculogenesis, bioactive LH, ovulation and menstrual cycle (m.c.) length were studied in adult bonnet monkeys. ZK 98.299 (20 mg/day) was administered s.c., once daily on days 5 to 15 of m.c., to ten animals. The pretreatment m.c. was of 26.5 days (25 to 28 days, mean with 95% confidence limits) and on treatment it was significantly (p less than 0.001) prolonged to 46.9 days (39 to 54 days). The anticipated midcycle rise in estradiol and bioactive LH levels was completely blocked in six and attenuated in three animals during the treatment period. However, the levels did not drop below the early follicular phase levels. In one animal (#90), though the cycle length was prolonged by 5 days the midcycle rise in estradiol and bioactive LH levels was observed during the treatment period and this animal had normal luteal function. Seven animals had delayed ovulation whereas, two had anovulatory treatment cycles. The rise in estradiol and bioactive LH levels, prior to ovulation in the treatment cycles, was compatible with the midcycle rise observed in the pretreatment cycles. Serum progesterone levels during the luteal phase of the treatment cycles were normal in six animals whereas, in two they were indicative of luteal insufficiency. In two animals, the treatment cycles were anovulatory. ZK 98.299 had no effect on the duration of menses. The post treatment cycles were of normal duration. This study suggests that the administration of ZK 98.299 during the follicular phase blocks estradiol and bioactive LH release and terminates the follicular phase in most of the animals. The follicular phase is reinitiated after the treatment is stopped. PMID- 2706992 TI - Achievements in gynecology. PMID- 2706993 TI - Modern biophysical criteria of fetal well-being. PMID- 2706994 TI - Human fetal blood flow and behavioural states. PMID- 2706995 TI - Computers in obstetrics and gynecology. PMID- 2706996 TI - Problems of conservation treatment for breast cancer. PMID- 2706997 TI - How do old dogs learn new tricks: teaching a technological skill to brain injured people. AB - Little is known about the way people learn technological skills. This investigation was carried out to see how 100 brain injured, 50 controls and two amnesic patients performed on a task requiring them to learn a six-step programme for an electronic memory aid. Performance was correlated with other measures of memory to determine whether the technological skill was similar to a procedural learning task, a spatial memory task, a visual task, a verbal task or an amalgam of these. All controls but only 59 percent of the patients learned the task within three trials. The two amnesic patients also failed to learn the new skill. There was a high correlation between overall performance on a standardized test of everyday memory (the Rivermead Behavioural Memory Test) but little evidence that the technological skill was similar to a procedural learning task; nor was it specifically related to visual, verbal or spatial memory. It is concluded that a combination of skills is required to learn the technological task. Implications for the concept of procedural learning are discussed. PMID- 2706998 TI - The progressive breakdown of number processing and calculation ability: a case study. AB - We examined a retired Army General with Progressive Dementia whose initial major presenting complaint was dyscalculia. Our examinations revealed an orderly dissolution of calculation ability with differing dissociations in calculation ability apparent at progressive stages of cognitive decline. For example, we found that number reading and writing errors were qualitatively different from calculation errors. Numerosity knowledge and magnitude comparisons can remain intact even when other arithmetic knowledge and calculation abilities were grossly impaired. His decline in calculation abilities was first demonstrated on more complex problems (e.g., multiplication) and only in later stages on simpler (e.g., addition) problems. The patient was aware that aspects of his performance were impaired, but he was unable to state why--a dissociation between declarative and procedural knowledge. PMID- 2706999 TI - Altitudinal neglect following traumatic brain injury: a case report. AB - We present an analysis of altitudinal neglect in a patient who following traumatic brain injury showed extinction to a visual stimulus presented in the lower field when another stimulus was simultaneously presented in the upper field. When estimating the midpoint of vertically-oriented rods presented below eye level using visual cues, tactile/kinesthetic cues or a combination of these cues, she consistently pointed higher than control subjects did. She showed less severe impairments when the rods were presented at or above eye level. When estimating the midpoint between two clicks presented above and below her head, she pointed higher than did control subjects. These deficits cannot be accounted for by sensory or motor disorders and appear to be due to a disorder in attending to stimuli in the lower half to space. PMID- 2707000 TI - Infarct of the anterior limb of the right internal capsule causing left motor neglect: case report and cerebral blood flow study. AB - A sixty-nine year old hypertensive man had left motor neglect following an infarct of the anterior limb of the right internal capsule. He also had left auditory extinction on verbal dichotic listening and a sligh constructional apraxia. Regional cerebral blood flow (CBF) was measured at rest with Xenon 133 inhalation and was found to be slightly decreased in a diffuse fashion. Motor activation of the right hand resulted in an increase of CBF in the contralateral superior rolandic area, whereas no such increase was found during motor activation of the left hand. This lack of cortical CBF increase on contralateral motor activation is interpreted as a consequence of the failure of some corticosubcortical connexions involved in motor arousal. The specifically dynamic appearance of regional CBF abnormalities, i.e. during selective activation as opposed to rest measurements, is consistent with the functional character of neglect. PMID- 2707001 TI - Hemispheric specialization for mental rotation. AB - A sample of 133 normal subjects, and one commissurotomized subject, were given a "mental-rotation" task, in which they were timed as they decided whether rotated letters, flashed in the left or right visual hemifield, were normal or backward. The normal subjects showed a significant right-hemifield advantage in reaction time, while the commissurotomized subject showed a pronounced left-hemifield advantage in both accuracy and reaction time. We argue that mental-rotation is primarily a right-hemispheric specialization, but that this was offset in the normal subjects by a stronger left-hemispheric specialization for letter identification. PMID- 2707002 TI - Shifts in hemispheric advantage during familiarization with complex visual patterns. AB - Twenty females unfamiliar with kanji were given a recognition task involving tachistoscopic presentation of kanji to the right and left visual fields. Repeated exposure to these novel stimuli resulted in significantly increased competence at the task. To analyze different approaches to the task, subjects were divided into an initial left visual field advantage and an initial right visual field advantage group. Over the course of the experiment subjects in the initial left visual field advantage group shifted from a left to a right visual field advantage, showing both a linear trend and a quadratic trend, while the initial right visual field advantage group showed only a quadratic trend. The results are consistent with observations in other novel stimuli situations which have demonstrated a shift in hemispheric advantage from right to left with increased competence and which have demonstrated individual differences in the pattern of shifting hemispheric advantage. PMID- 2707003 TI - Focused and divided attention in each half of space with disconnected hemispheres. AB - The effects of spatial location and strategy of attention on the processing of speech messages were investigated in ten right-handed subjects and four persons with complete forebrain commissurotomy and one case of right hemispherectomy. Lists of simultaneous but different words, with one of each pair spoken by a male and the other by a female, were monitored for target words. The lists were presented to the left ear, the right ear and to both ears (central) in separate conditions. Unimanual responses were made to targets in either voice (divided attention) or to only one of the voices (focused attention). The performance of the clinical subjects was generally less efficient than that of the controls. In contrast to intact subjects, they responded to more distractor and unattended items. They also showed a nonsignificant tendency for better processing of right rather than centrally-presented words. With right-sided presentation two clinical subjects, with extracallosal damage to the right cortex, were unable to divide attention and responded to only one of the voices. These results implicate an intact corpus callosum for efficient use of attention strategies as well as hemispheric differences in the control of attention. PMID- 2707004 TI - The role of individual difference in determining the nature of comprehension defects in aphasia. AB - This study was concerned with the relationship between locus of lesion and subtypes of language comprehension defect in aphasia. Previous studies had indicated that performance in sound recognition identified two subtypes of aural comprehension deficit and that performance in pantomime recognition identified two subtypes of reading comprehension defect. Defects in sound recognition and pantomime recognition were found in association with a variety of lesion loci. However, comprehension defective aphasics with normal sound recognition or pantomime recognition had lesions closely similar in location and size to those of aphasics who performed poorly on these tests. Findings suggest that whether an aphasic with a language comprehension defect is impaired in sound recognition or pantomime recognition depends, at least in part, on individually variable predisposing factors. It would appear possible that this phenomenon reflects a separate dimension of hemispheric cerebral dominance. PMID- 2707005 TI - Verb finding in aphasia. AB - Word finding for nouns and verbs was examined in a heterogeneous group of aphasics (N = 9) by comparing the ability to generate synonyms and sentences for the same set of 20 nouns and 20 verbs. Synonym Generation performance resembled that of an age-matched group of normal control subjects (n = 9): In both groups, some subjects produced comparable numbers of synonyms for nouns and verbs while other subjects produced significantly fewer synonyms for verbs. Essentially the same two patterns were displayed on Sentence Generation using the frequency of "empty" nouns (e.g., 'it', 'man') and "empty" verbs (e.g., 'is', 'do') as an index of word-finding difficulty: In both groups, some subjects produced comparable numbers of empty nouns and verbs, while other subjects produced significantly more empty verbs. However, the Sentence Generation performance of one aphasic subject stood out overall by her tendency to avoid empty verbs and produce incomplete sentences. This pattern of performance was interpreted as a breakdown in an early stage of sentence planning that may be directly related to her diagnosis of transcortical motor aphasia. PMID- 2707006 TI - Auditory agnosia with relative sparing of speech perception. AB - We report a case of auditory agnosia in which the initial clinical picture began with generalized auditory agnosia for verbal and non verbal sounds, but rapidly changed to a selective auditory agnosia confined to the perception of non verbal sounds. CT scanning and MRI did not demonstrate cortical or subcortical damage, except for bilateral ventricular enlargement. The patient was submitted to audiological investigations including physical and psychoacoustic studies. Deficits were revealed during the decay and loudness discrimination test, but no temporal auditory acuity deficit was observed. The results of these studies are discussed in relation to the clinical picture. Also the dissociation between verbal perception and non verbal perception is discussed. PMID- 2707007 TI - Hemispheric asymmetry in tactile forgetting induced by tactually-guided movement. AB - Asymmetries in tactile short-term memory related to differential specialization of the cerebral hemispheres were studied in normal human adults using the Brown Peterson distractor task. When the distractor was an auditory arithmetic task, no difference emerged between the two hands for the retention of touches to the fingers; however, when the distractor was a tactual maze task executed by the right hand, asymmetry in favor of the left hand was observed. Specifically, when the right hand performed the tactual maze, there was greater interference with tactile memory than when the left hand performed the maze, independent of which hand received the memory material. The results support a characterization of short-term memory as embracing multiple, limited storage capacities divided along the lines of processing demands, arising from different classes of material, placed on the two cerebral hemispheres. PMID- 2707008 TI - Jugular venous bulb catheterization in infants and children. AB - Cross-brain oxygen extraction may be altered by coma, hyperventilation, hypothermia, or barbiturates, and has been demonstrated in adults and more recently in children to be related to functional neurologic recovery after a variety of brain injuries. However, measurement of cross-brain oxygen extraction in children is currently not a part of routine clinical care, partly because there have been no published attempts relating the technique of jugular venous bulb (JVB) catheterization and its complication in children. We catheterized the JVB to measure cerebral venous oxygen content and calculate cross-brain oxygen extraction in 26 deeply comatose neonates and children ranging in age from a few hours to 14 yr. Bedside catheterization using the Seldinger technique was successful in 25 children, with standard venous cutdown necessary in the remaining child. All JVB catheterizations were performed with parental consent and during continuous monitoring of the intracranial (ICP) or fontanelle, as well as arterial, pressure. ICP was not significantly altered by the cannulation procedure in any of the children studied, although the cannulation occurred early in the child's course when ICP was well controlled. Inadvertent carotid artery puncture with bleeding controlled by local pressure occurred in four children, and catheter malposition was confirmed on lateral skull xray in two others. Jugular venous bulb catheters remained in place for 2 to 7 days (average 3) and malfunction or obstruction of the catheter did not occur. Organisms were grown from three of 26 catheter tips submitted for culture, with peripheral blood cultures also positive for the same organisms in two of these.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707009 TI - Tall T waves during metabolic acidosis without hyperkalemia: a prospective study. AB - The specific ECG characteristics of metabolic acidosis have not been satisfactorily defined in man. We addressed this question by prospectively studying 14 consecutive patients admitted with metabolic acidosis and without hyperkalemia. Arterial blood gas analysis and serum potassium determinations were performed during acidosis and after its correction. ECGs were recorded at the same times. Mean pHa increased from 7.11 +/- 0.05 to 7.40 +/- 0.01 (p less than .001) in response to an increase in total CO2 content from 6.8 +/- 1.4 to 21.2 +/ 0.7 mmol/L (p less than .001). Serum potassium concentration decreased only slightly after correction of the acidosis from 4.2 +/- 0.1 to 3.9 +/- 0.14 mmol/L (p less than .05). T waves were taller during acidosis than after correction (0.68 +/- 0.1 vs. 0.28 +/- 0.04 mV, p less than .001 and 0.64 +/- 0.08 vs. 0.38 +/- 0.04, p less than .005, in precordial leads V2 and V3, respectively). Moreover, the amplitude of T waves in V2 was correlated positively with the arterial concentration of H+ (r = .786, p less than .001) and negatively with the arterial total CO2 content (r = -.71, p less than .005). In addition to their augmented amplitude, T waves were peaked and symmetrical with a narrow base ("tent-shaped"). Thus, metabolic acidosis may be accompanied by an increase in the amplitude of T waves, even in the absence of hyperkalemia. PMID- 2707010 TI - Comparison of two simplified severity scores (SAPS and APACHE II) for patients with acute myocardial infarction. AB - The Simplified Acute Physiology Score (SAPS), the Acute Physiology and Chronic Health Evaluation II (APACHE II), the Acute Physiology Score (APS), and the Coronary Prognostic Index (CPI), calculated within the first 24 h of ICU admission, were compared in 76 patients with acute myocardial infarction (AMI). Sixteen (21%) patients subsequently died in the ICU. The nonsurvivors had significantly higher SAPS, APACHE II, and CPI scores than the survivors. ROC curves drawn for each severity index were in a discriminating position. There were no significant differences either between the areas under the ROC curves drawn for SAPS, APACHE II, and CPI, or between the overall accuracies of these indices. APS provided less homogeneous information. We conclude that SAPS and APACHE II, two severity indices which are easy to use, assess accurately the short-term prognosis, i.e., the ICU outcome, of patients with AMI. PMID- 2707011 TI - Interhospital comparisons of patient outcome from intensive care: importance of lead-time bias. AB - We studied 432 admissions to two Danish ICUs by using a standard severity of illness classification system to assess utilization and outcome. Substantial differences in utilization were found. The patients in Hospital 2 were younger, had better previous health records, and were admitted significantly more often for active treatment as opposed to monitoring than the patients in Hospital 1. Although their measured severity of illness was similar, patients at Hospital 2 received significantly more therapy and their mortality exceeded that of the patients at Hospital 1. The mortality rate of Hospital 2 also exceeded that predicted from a recent survey of U.S. hospitals. We found, however, that 35% of the patients at Hospital 2 had been transferred to the ICU from other ICUs. This created the possibility of an adverse selection and lead-time bias for the patients at Hospital 2. These findings indicate that although national and international comparisons of intensive care are now possible using common classification systems, this progress has created a new need for more precise measurement of potential confounding biases, such as the duration of intensive care services received before formal ICU admission. PMID- 2707012 TI - Historical controls for extracorporeal membrane oxygenation in neonates. AB - A retrospective review of all patients cared for who met Loe's criteria for extracorporeal membrane oxygenation (ECMO) was conducted covering the 3-yr period 1983 through 1985. There were five out of 3,726 admissions who met criteria for ECMO (three of 127 outborn admissions). All infants were greater than 2 kg birth weight and met criteria based on alveolar-arterial oxygen pressure difference (P[A-a]O2), barotrauma criteria, or both P(A-a)O2 and barotrauma criteria. All infants had persistent pulmonary hypertension. Two patients also had hyaline membrane disease and one also had asphyxia and meconium aspiration. All patients were treated with conventional therapy and all survived. There were no patients who met criteria for ECMO and died and there were no patients referred for ECMO during this period. Published criteria for ECMO estimate a control group mortality rate of 80% to 94%. Mortality for this series was 0%. (Ninety-five percent confidence interval for mortality in a group of five survivors is 0% to 45%.) Controlled trials of ECMO were not done initially because it was considered unethical. This series shows that historical mortality rates are no longer valid and that controlled trials must be done. PMID- 2707013 TI - Intravenous lipids in newborn lungs: thromboxane-mediated effects. AB - Lipid infusions can interfere with oxygenation and cause pulmonary hypertension. We studied the effects of iv lipid infusions on pulmonary hemodynamics and oxygen transport to investigate whether the vasoconstrictor, thromboxane (Tx), mediates resulting changes. Newborn piglets were instrumented to observe cardiopulmonary hemodynamics, blood gases, and oxygen contents. Oxygen delivery (DO2), oxygen consumption, and extraction ratios were calculated. All piglets received continuous 1-g/kg.h iv lipid infusions. After one hour, and as the lipid infusion continued, six piglets were given placebo (PL) and six others were given the Tx antagonist SQ 29548 (SQ). Pulmonary vasoconstriction occurred in both groups after one hour of lipid infusion (pulmonary artery pressure [PAP] 28 +/- 6 mm Hg in the PL piglets and to 31 +/- 13 mm Hg in the SQ piglets. After intervention, PAP remained elevated only in the PL group (32 +/- 2 vs. 23 +/- 8 mm Hg) (p less than .02). PaO2 and DO2 fell significantly with iv lipid and improved after intervention in SQ animals only (p less than .02). TxB2 increased in all animals with iv lipid (276 +/- 295 to 1481 +/- 716 in PL; 228 +/- 110 to 1402 +/- 580 in SQ), and fell with intervention in the SQ animals only (2632 +/- 1236 vs. 964 +/- 305, respectively; p less than .02). In conclusion, interference with DO2 associated with pulmonary hypertension and increased TxB2 occurred with iv lipid infusion in piglets. Tx antagonism ameliorated these changes. PMID- 2707014 TI - Comparison of epinephrine and norepinephrine in the treatment of asphyxial or fibrillatory cardiac arrest in a porcine model. AB - Many animal experiments have shown that alpha-receptor stimulation is a prerequisite for the improvement of myocardial perfusion during CPR. As there are no recent reports on the effectiveness of norepinephrine in the treatment of cardiac arrest, we investigated the effectiveness of epinephrine and norepinephrine after asphyxial or ventricular fibrillation cardiac arrest using a porcine model. After 3 min of asphyxial cardiac arrest, seven animals each received either 45 micrograms/kg epinephrine, 45 micrograms/kg norepinephrine, or placebo (controls). All drugs were given blind. All seven animals given epinephrine could be resuscitated after 174 +/- 53 sec, whereas six of seven given norepinephrine could be resuscitated after 473 +/- 116 sec. None of the seven given the placebo could be resuscitated. After 4 min of ventricular fibrillation cardiac arrest, none of the seven animals that received defibrillating countershocks at 4 min without either mechanical measures or drug therapy, and none of the seven that received CPR and countershocks but no drugs, could be resuscitated. In the group that received CPR plus 45 micrograms/kg epinephrine, defibrillation and restoration of spontaneous circulation were achieved in six of seven animals in 667 +/- 216 sec. In the group that received CPR plus 45 micrograms/kg norepinephrine, defibrillation and restoration of spontaneous circulation were achieved in all seven animals in the significantly shorter time of 86 +/- 18 sec. In this porcine model, norepinephrine appeared superior to the same dose of epinephrine in the treatment of ventricular fibrillation, with respect to resuscitation time. PMID- 2707015 TI - Differences in systemic and myocardial blood acid-base status during cardiopulmonary resuscitation. AB - Simultaneous arterial (aortic), mixed venous (pulmonary artery), and myocardial venous (great cardiac vein) blood gas and lactate concentrations were obtained in 12 dogs before and during cardiac arrest and CPR. We observed marked mixed venous and myocardial venous acidosis and increased PaCO2 but normal pHa and reduced PaCO2. Furthermore, the pH was significantly lower and the PCO2 significantly higher at the myocardial venous site compared to the mixed venous site, and marked myocardial lactate production occurred during CPR. Calculated bicarbonate and CO2 content (CCO2) did not increase during CPR from any site compared to control values and actually decreased significantly in arterial and myocardial venous samples. Changes in hydrogen ion concentration in both mixed venous and myocardial venous blood correlated with changes in lactate concentration but not total CCO2. Our results during CPR demonstrate a) a significant discrepancy between arterial and mixed venous blood gases but also a large and significant discrepancy between mixed venous and myocardial venous blood gases, b) significant anaerobic systemic and myocardial metabolism, and c) that mixed venous and myocardial venous acidosis is possibly a result of lactic acidosis. PMID- 2707016 TI - Volume monitor for mechanical ventilation in the hyperbaric chamber. AB - Treatment of critically ill patients requiring ventilatory support and hemodynamic monitoring in the hyperbaric medicine department is a frequent occurrence. We provide mechanical ventilation principally with the Penlon Oxford ventilator; however, its simple design lacks volume, rate, and disconnect monitors. Therefore, we combined the ventilator with the Ohmeda volume monitor, a pulmonary function monitor for adult and pediatric use that gives reliable, accurate measurements of tidal volume, rate, and minute ventilation. The Ohmeda unit is easily adaptable to the Penlon ventilator, and may also be used to monitor respiratory function in the spontaneously breathing patient. To our knowledge, this is the only battery-driven monitor on the market that provides rate, volume, apnea, and minute ventilation within the same unit. It should be used as an adjunct to the Penlon Oxford ventilator in the hyperbaric chamber. PMID- 2707017 TI - Preliminary evaluation of an intra-arterial blood gas system in dogs and humans. AB - The reliability and accuracy of an intra-arterial fluorescent optode system to measure continuously pHa, PaCO2, and PaO2 were evaluated in a dog model and in a group of critically ill patients. Six hundred sixty-three arterial blood gas (ABG) samples were analyzed for pHa, PaCO2, and PaO2 in the dog studies. The intra-arterial blood gas system (IBGS) indicated a steady state in 420 instances for pH, 359 instances for PaCO2, and 256 instances for PaO2. Comparison of these ABG and IBGS values by linear regression analysis revealed r = .97 for pHa, .95 for PaCO2, and .96 for PaO2. The mean +/- SD of the difference between ABG and IBGS was -0.02 +/- 0.03 for pHa, 1.05 +/- 3.8 for PaCO2, and -17 +/- 13 for PaO2. Nonsteady states were correctly identified by the IBGS in every instance. Comparisons between 79 temporally matched ABG and IBGS values, exclusive of in vivo calibration samples, in 12 critically ill patients revealed r = .97 for pHa, .96 for PaCO2, and .99 for PaO2. The difference was 0.002 +/- 0.02 for pHa, 0.44 +/- 2.97 for PaCO2, and -1.22 +/- 9.34 for PaO2. We conclude that it is possible to measure continuously pHa, PaCO2, and PaO2 with the IBGS in critically ill patients for periods from 3 to 25.5 h while maintaining the ability to monitor BP and withdraw blood samples from the arterial cannula. Agreement between the two techniques is within clinically acceptable ranges for pHa and PaCO2, whereas PaO2 measurement by the IBGS requires further refinement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707018 TI - Comparison of two methods of bacteriologic sampling of the lower respiratory tract: a study in ventilated patients with nosocomial bronchopneumonia. AB - The purpose of this prospective study was to compare the results of bacteriologic assessment of the lower respiratory tract in mechanically ventilated patients by two sampling techniques: fiberoptic protected brush biopsy or blind bronchial aspiration of secretions. Thirty-three mechanically ventilated patients with acute bronchopneumonia were studied. Paired samples were collected by both techniques 47 times. Identical results were obtained in 93% of the cases. In 28 pairs, one or several identical organisms were cultured. In 16 pairs, no bacteria were isolated; in the three remaining pairs, results were contradictory. In five patients with concomitant positive blood cultures, the same organisms were cultured from fiberoptic protected brush biopsy, blind bronchial sampling, and blood cultures. These findings support the fact that blind bronchial sampling can be recommended for bacteriologic assessment of the lower respiratory tract in mechanically ventilated patients with diffuse nosocomial bronchopneumonia. PMID- 2707019 TI - Unilateral pulmonary edema after intubation of the right mainstem bronchus. PMID- 2707020 TI - Quest for the philosopher's stone. PMID- 2707021 TI - The optode: next generation in blood gas measurement. PMID- 2707022 TI - Systemic response to sepsis. PMID- 2707023 TI - Pulmonary microthrombosis in severe adult respiratory distress syndrome. PMID- 2707024 TI - Ranitidine produces minimal hemodynamic depression. PMID- 2707025 TI - J-wire and translaryngeal guided intubation. PMID- 2707026 TI - Reversal of the pulmonary artery distal and right atrium proximal lumens on a thermodilution catheter. PMID- 2707027 TI - Studies on cryoprotectant equilibration in the intact rat liver using nuclear magnetic resonance spectroscopy: a noninvasive method to assess distribution of dimethyl sulfoxide in tissues. AB - Nuclear magnetic resonance (NMR) spectroscopy was used in the study of rat livers following flushing with a clinically used preservation solution containing either 12 or 30% (v/v) Me2SO. The extent of equilibration of Me2SO in the tissue after 10-15 min of perfusion with Me2SO and again after subsequent washout with Me2SO free medium was assessed by 1H NMR spectroscopy. 31P NMR spectroscopy was used to follow the changes in ATP, ADP, inorganic phosphate, and tissue pH. The data show that 1H NMR spectroscopy can be used as a sensitive and rapid method of assessing the equilibration and concentration of compounds such as Me2SO, since these compounds are likely to be present at concentrations greatly in excess of other constituents of the medium and will therefore give rise to strong, easily detected signals. At the same time, 31P NMR spectroscopy can be used to monitor the metabolic status of the tissue reflected in the levels of ATP, ADP, and inorganic phosphate, as well as being a noninvasive monitor of intracellular pH. The possibility of determining the tissue pH in the presence of solutes such as Me2SO is discussed. PMID- 2707028 TI - Electron microscopical studies of membrane injuries in blue fox spermatozoa subjected to the process of freezing and thawing. AB - Disintegration of blue fox sperm membranes is studied by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). In unfrozen spermatozoa studied by SEM, the plasmalemma and the acrosome appeared to be intact, except for a few cases of disruption of the former structure at the anterior part of the head. In semen frozen in 0.5-ml plastic straws by use of N2 vapor after dilution with Tris-fructose-citric acid with 8 vol % glycerol and 20 vol % egg yolk and thawed at 70 degrees C for 8 sec, the spermatozoa displayed different degrees of membrane damage. These alterations could be classified into three main categories of which the first included only minor changes in the plasmalemma, but vesiculation and disintegration of the outer part of the acrosomal membrane. In the second category (also the most frequent one) the outer part of the acrosomal membrane was extensively vesiculated, and the plasmalemma was discharged proximal to the equatorial segment. Extensive loss of plasmalemma and complete absence of the outer part of the acrosomal membrane characterized the last category of membrane damage. The functional implications of the three categories of membrane alterations are discussed. PMID- 2707029 TI - Ice recrystallization in a model system and in frozen muscle tissue. AB - Recrystallization produces modifications on ice crystal sizes during storage and transport of frozen foods, reducing the advantages obtained by quick freezing and inducing physicochemical changes which alter their quality and shorten their shelf life. This process involves the growth of the larger crystals at the expense of the smaller ones, being the interfacial energy, the driving force of the phenomenon. In the present work recrystallization was analyzed using direct microscopic observation of ice crystals in a model solution (0.28 N NaCl) and indirect observation of frozen muscle tissue. The model solution allowed visualization of the interface behavior; from the analysis of the ice crystal frequency distributions, relationships between shape and size of the grains were established. A kinetic model based on the average system curvature was proposed obtaining a satisfactory fitness of the experimental data. Values of the kinetic constants determined at different temperatures allowed the estimation of the process activation energy. In muscle tissues isothermal freeze-substitution was used to observe the holes left by the ice in frozen semitendinous beef muscle stored at -5, -10, -15, and -20 degrees C during long periods of time. A different evolution of the mean ice crystal diameter was observed with respect to the model system. In meat samples, at long storage times, a limit diameter value was reached; this situation has been proved to be independent of temperature and initial size (freezing rate); a theoretical expression based on tissue characteristic parameters was proposed for its evaluation. Activation energy for recrystallization in muscle tissue was also determined, being comparable to values for protein denaturation and quality losses. PMID- 2707030 TI - Effect of chemical modifications on freeze denaturation of lactate dehydrogenase. AB - Lactate dehydrogenase (LDH) was chemically ethyl-acetimidated (EA-), dimethyladipimidated (DMA-), carbamylated, acetylated, acetoacetylated, or succinylated in order to alter the ionic charges on the epsilon-amino group of lysine residues. Acetylation, acetoacetylation, and succinylation, which change the positive charge at the lysine side chains to a negative one, inactivated the enzymic activity, but the rest of the modifications exerted no such inactivating effects. The active modified enzymes were subjected to freeze denaturation study, using the enzymic activity as an indication of the degree of the denaturation. The active enzymes were diluted with deionized water and stored in a freezer (-23 degrees C) for 1-3 days. Enzymic activity was assayed immediately after thawing. All the modified enzymes retained their activity even after the 3-day frozen storage, while the control or native enzyme lost its activity within 1 day of storage. Furthermore, the modified LDHs freeze-stored in 0.2 M monosodium glutamate (MSG) or 0.2 M lysine-hydrochloride (Lys-HCl) retained their activity. The cryoprotective effects exerted by the modifications and by 0.2 M MSG seemed to be synergistic, whereas those exerted by the modifications and by 0.2 M Lys HCl did not. The mechanisms of cryoprotection and freeze denaturation are discussed in relationship with the cryoprotective effect exerted by already known cryoprotectants, such as sucrose or dimethyl sulfoxide. PMID- 2707032 TI - The ovarium of the hibernator (Citellus citellus L.) after spring arousal. AB - The ovaries of 20 ground squirrels (Citellus citellus L.) were studied after spring arousal, while the animals were in the stage of estrus. The membrana granulosa of the preovulatory folic was luteinized. Epithelial cords were observed in the ovarial stroma. Cells in different stages of differentiation were found in the cords. For the first time nucleoli-like bodies in the nucleus and in the interstitial cells of the ovary of the ground squirrels. Probably, these nucleoli-like bodies played a definite role in the process of membrane formation during the cell differentiation. The NADH2 reductase and 3 beta-hydroxy-delta 5 steroid dehydrogenase activity confirmed that the process of differentiation of the interstitial cells was still in an initial stage. The findings were compared with the changes that took place during the puberty period. PMID- 2707031 TI - Effect of trehalose on the phase properties of hydrated and lyophilized dipalmitoylphosphatidylcholine multilayers. AB - The structure and thermal behavior of hydrated and lyophilized dipalmitoylphosphatidylcholine (DPPC) multilayers in the presence of trehalose were investigated by differential scanning calorimetry and X-ray diffraction methods. Trehalose enters the aqueous space between hydrated bilayers and increases the interbilayer separation (from 0.36 to 1.37 nm in the different DPPC phases at 1 M trehalose). It does not affect the lipid chain packing and also the slow isothermal conversion at 4 degrees C of the metastable L beta' phase into the equilibrium crystalline Lc phase. Addition of trehalose leads to a slight upward shift (about 1 degrees C at 1 M trehalose) of the three phase transitions (sub-, pre-, and main transition) in fully hydrated DPPC while their other properties (enthalpy, excess specific heat, and transition width) remain unchanged. The effect of trehalose on the thermal behavior of DPPC multilayers freeze-dried from an initially completely hydrated state is qualitatively similar to that of water. These data support the "water replacement" hypothesis about trehalose action. It is suggested that trehalose prevents the formation of direct interbilayer hydrogen bonds in states of low hydration. PMID- 2707033 TI - The effect of pH on the viability of hypothermically stored rat hepatocytes. AB - Hepatocytes isolated from the rat liver were stored for up to 72 hr at 4 degrees C in a tissue culture medium (Liebovitz-15) at different pH values to determine how pH affects hepatocyte viability. This is a model to simulate cold storage of livers for transplantation and determine the optimal pH for maintenance of liver cell function. The cells were stored in the absence of oxygen. At the end of cold storage the percentage of the total cellular LDH released into the extracellular medium was used as a measure of hepatocyte viability. Also, lactate dehydrogenase (LDH) release was determined in hepatocytes incubated at normothermia (37 degrees C) for 90 min following 72 hr of cold storage. The results demonstrate that hepatocytes tolerate a wide range of pH values in the storage medium and that only about 10% of the total LDH was released from hepatocytes stored up to 72 hr at pH's from 5.0 to 8.0. Normothermic incubation, however, demonstrated that the pH of the storage medium affected viability. After 48 hr of storage only hepatocytes stored at pH values from 7.0 to 8.0 remained viable (LDH release similar to that of freshly incubated hepatocytes = 28 +/- 7.2%). After 72 hr of storage and 90 min of normothermic incubation, hepatocytes incubated at all pH values studied were nonviable (greater than 60% release of LDH). These results suggest that the optimal pH for storage of hepatocytes at 4 degrees C is near neutrality (7.0 to 7.4). PMID- 2707034 TI - Thickness of medial layers of arteries prior to and during hibernation. AB - The thickness of the media of the aorta and the carotid, iliac, and renal arteries was measured in hibernating and nonhibernating marmots. A positive correlation was found between body weight and the thickness of the media of carotid and iliac arteries. The relation noted apparently was not due to the mean arterial pressure prior to and during hibernation, since there was no difference in the thickness of the media between nonhibernating and hibernating females. The difference due to gender could be accounted for by the greater average body weight of males. The media of the renal arteries demonstrated no relation between their thickness and body weight. PMID- 2707035 TI - An enriched set of features of nuclear cataract identified by multidimensional scaling. AB - Development of an improved system for visual classification of cataracts requires a three-step procedure: first, to identify the full range of visible features of cataracts; second, to develop and test scales for the visual assessment of each feature; and third, to establish the epidemiological or clinical validity of each scale for cataract classification. This paper focuses on the first step, applying a powerful psychometric technique for identifying the visible features of nuclear cataracts. New visual features of nuclear cataract were identified using the psychometric procedure of multidimensional scaling (MDS). Each of 5 observers independently examined pairings of slitlamp photographs of 24 cases of pure nuclear cataract, making two different ratings of dissimilarity of each of the 276 possible pairs. The two dissimilarity ratings were, first, of nuclear color and, second, of nuclear structure. MDS analysis of the dissimilarity ratings of nuclear color revealed two major visual features underlying the judgments: one a combination of hue and saturation, and the other brightness. Analysis of the ratings of nuclear structure identified a total of nine features: one distinguishing between immature and mature cataracts, four describing features of the immature cataracts (aspect ratio, background haze, clarity of the embryonal nucleus, and clarity of the outer nuclear shell), and four describing features of the mature cataracts (opalescence, aspect ratio, color of the nucleus, and symmetry). We conclude that there are many more systematic distinctions to be made in the appearance of nuclear cataracts than are now recognized in clinical practice. PMID- 2707036 TI - The assessment of endothelial integrity by scanning electron microscopy and fluorescein diacetate staining following treatment with cryoprotective additives. AB - As part of the development of methods of corneal cryostorage for transplantation, a toxicity study was carried out on the rabbit corneal endothelium using four cryoprotective additives (CPA's) 1) dimethyl sulphoxide (Me2SO), 2) propane-1,2 diol (PG), 3) glycerol (GLY), 4) polyvinylpyrrolidone (PVP). A fifth group, based upon a CPA combination of Me2SO and PVP, was used to characterize both the assays, and the response of the endothelial layer to osmotic stress. The effect upon the cell membrane was assessed using scanning electron microscopy (SEM) and fluorescein diacetate with ethidium bromide staining (FDA/EB). Two sampling points were used, one immediately after treatment and the other following an incubation period. Calculations were performed to predict the maximum relative volume of cells during CPA exchange. Immediately following serial addition and removal of 2 or 3 mol/L (M) PG or GLY, the cells exhibited adverse morphological changes shown with SEM, and the proportion of intact cells judged by FDA/EB staining was significantly reduced when CPA equilibration was performed at 37 degrees C rather than at 20 degrees C. A 3M Me2SO concentration gave less morphological change than 3M PG or GLY, but even after treatment with 4M Me2SO more than 95% cells were judged intact by FDA/EB staining. PVP at 40% w/v showed minimal damage with both assays, and the fifth experimental group suggested that PVP may protect from injury during hypotonic stress. With all groups, the integrity of the cell layer recovered during incubation, so that for each sample the percentage of intact cells was high. However, although confluency was often restored following incubation, total cell density was usually reduced. The results indicate that serial addition and removal of 3M Me2SO is tolerated by the cornea, whereas PG or GLY cannot be used at 2 or 3M without inducing osmotic damage. There was low toxicity to PVP, and it was an effective osmotic buffer. PMID- 2707037 TI - Immunogold staining of elastin in the wall of the retinal arteries in Macaca mulatta. AB - Elastin has been demonstrated in the wall of the retinal arteries in or immediately adjacent to the optic disc of adult Macaca mulatta using the immunogold labelling technique with delta-elastin antibody. Since elastin is thought to provide elasticity to the walls of these vessels, perhaps its presence in the retinal arteries plays a role in contractility and regulation of blood flow throughout the retinal vascular system. PMID- 2707038 TI - Dopamine receptors in rabbit and rat eye: characterization and localization of DA1 and DA2 binding sites. AB - In vitro autoradiography is used to characterize and localize DA1 and DA2 receptors in rabbit and rat eyes. The bindings of 125I-SCH 23982 (DA1 antagonist) and of 125I-Iodosulpride (DA2 antagonist) to slide mounted tissue sections take place with characteristics expected of substances that recognize DA1 and DA2 receptors respectively. They are saturable, have high affinity and exhibit an appropriate pharmacology. The regional distribution of these receptors indicates that they are mainly present in retina. Precise cellular localizations are visualized in retinal structures by means of histoautoradiography: DA1 receptors are found in inner plexiform layer, outer plexiform layer and inner nuclear layer and DA2 binding sites are present in the two plexiform layers. PMID- 2707039 TI - Modification and calibration of the Bigliano-Webb Tonometer for improved accuracy of tonometry in rabbits. AB - The Bigliano-Webb Tonometer (Pneumatonograph) was calibrated for adult and young rabbit eyes using open stopcock and closed stopcock methods. The performance of an old and new instrument were compared illustrating the importance of recent calibration of the instrument for most accurate use. The fact that this tonometer is a high displacement tonometer which requires specific calibration, not only for species but for age of the animal (or size of the eye) is illustrated. A minor modification of the instrument--reducing the setting of a pressure regulator which supplies gas to the tip from its nominal 9 PSI to 2.5 PSI--is illustrated as a method of reducing the difference between intraocular pressure before tonometry and during tonometry, Pt-Po. PMID- 2707040 TI - Limbal lymphangiogenesis after corneal injury: an autoradiographic study. AB - Blood and lymphatic vessel proliferation into the cornea occurs after severe trauma. Whilst the events early in blood vessel growth are reasonably understood, little is known of the early events in lymphangiogenesis. In this study, a model for proliferating lymphatic vessels using tritiated-thymidine autoradiography and light microscopy is described. A two-hour labeling index of 0.59% occurred in the lymphatic endothelium of the normal unstimulated limbus. After thermal cautery of the peripheral cornea, labeling of the limbal lymphatic vessels increased significantly at 36 hours, rose to a maximum of 6.8% four days after injury and thereafter returned to normal levels. Blood capillaries with a background level of 0.83% showed an increase in labeling at 17 hours, with high levels occurring at 36 hours (13.6%) and again from 61 to 84 hours (12.6%). Venular cells increased labeling at 25 hours from a control level of 0.58%, with a sharp peak of activity around 36 hours (13.2%). Synthesis of DNA similarly returned to normal levels in the blood vessels after four days. The staggered onset and differing durations of significantly increased labeling suggest either that various stimuli or arrays of stimuli are involved, or each cell type responds differently to the same stimulus for proliferation. PMID- 2707041 TI - Quantitative analysis of labelled inner retinal proteins in experimental optic neuritis. AB - In order to determine if axonal transport changes in chronic experimental allergic encephalomyelitis (EAE) were due to blockade or increased discharge of fast transported proteins from the inner retina, we examined the presence of pulse labeled proteins in autoradiograms of the optic nerve head, retinal ganglion cell and nerve fiber layers of juvenile strain-13 guinea pigs with chronic EAE and normal controls. Quantitative analysis of silver grains, performed six and twenty-four hours following the intravitreal injection of tritiated leucine, showed a decrease in inner retinal radioactivity in those with EAE, whereas no difference was detected between the two groups after three days. Grain counts within the optic nerve heads of guinea pigs with EAE were reduced at all time intervals studied. These results are consistent with an increase in discharge of fast transported proteins from retinal ganglion cells into optic nerve axons and support our previous observations of increased radioactivity at the foci of optic nerve demyelination. PMID- 2707042 TI - Axonal transport reductions in acute experimental allergic encephalomyelitis: qualitative analysis of the optic nerve. AB - In order to determine if changes in axonal transport were different in adult animals with acute experimental allergic encephalomyelitis (EAE), in comparison to juvenile animals with chronic EAE, the effects of this acute demyelinating disorder on axonal transport were examined in the optic nerves of adult strain-13 guinea pigs. Utilizing autoradiographic analysis of silver grain counts, both the fast and slow components of orthograde transport were studied at intervals of thirty minutes, three hours, one day and three days after tritiated leucine injection into the vitreous cavity. In order to determine the contribution of fiber loss in acute EAE, optic nerve fiber density was analyzed from electron micrographs of normal and demyelinated nerves. Animals with acute EAE had a decrease in radioactivity at the lamina retinalis and lamina choroidalis after thirty minutes and three hours, and at the lamina scleralis and foci of demyelination after one and three days. A 16% loss of fibers did not account for as much as a 74% reduction in radioactivity with acute EAE. The global reductions in axonal transport observed in acute EAE animals may contribute to their progressive deterioration and eventual demise by lack of delivery of tubulo vesicular materials for synaptic transmission, axolemmal proteins for electrogenesis and neurofilamentary components of the cytoskeleton. Moreover, they are unlike the increase of fast axonal transport associated with recovery of physiologic function characteristic of animals with the chronic form of the disease. PMID- 2707043 TI - Lectin-ferritin binding on spontaneously diabetic and control rat retinal microvasculature. AB - We previously reported, in the spontaneously diabetic Bio-Breeding (BB) rat, an increase in horseradish peroxidase (HRP) uptake that was associated with reduction and patching of cationized ferritin (CF) binding to anionic sites on the luminal plasma membrane of the retinal capillary endothelium. To see whether alterations in the negatively charged terminal sugar residues, N-acetyl glucosamine (NAG) and sialic acid (SA), might contribute to these changes in the diabetic rat retina, we used lectin-ferritin (Fe) conjugates to study the distribution of these sugars on the retinal endothelial luminal membranes. Wheat germ agglutin (WGA, binds to NAG and SA) and Limax flavius (LFA, binds only SA) were used. Plasma membrane WGA-Fe binding was dense and uniform in control animals. Binding sites were also found in coated luminal vesicles, within some uncoated luminal vesicles and on their diaphragms. Unlabeled uncoated luminal vesicles were also seen, suggesting two populations of uncoated vesicles. In diabetic animals, the binding sites were present within the same membrane associated microdomains as in the controls. However, in the majority of outer plexiform layer (OPL) vessels in diabetic animals, WGA-Fe binding was reduced to a single, discontinuous layer of particles (p less than 0.02). In both diabetic and control vessels, WGA-Fe binding was greatly reduced by the addition of competitive sugars. A few particles remained on the plasma membrane, on the diaphragms of some vesicles, and at the edge of vesicles. LFA-Fe binding was similar to that seen with WGA-Fe in the presence of competitive sugars. These results suggest that luminal membranes of retinal capillaries are rich in NAG and contain little SA. The sparse WGA-Fe binding pattern in the diabetic OPL may reflect decreases in number or accessibility of NAG residues, since similar binding patterns are seen in both the control and diabetic animals under conditions specific for SA. Thus, alteration of terminal NAG residues may contribute to decreased luminal surface anionic sites and increased pinocytotic transport in the retinal microvasculature of spontaneously diabetic BB rats. PMID- 2707044 TI - Human fetal lens epithelial cells in culture: an in vitro model for the study of crystallin expression and lens differentiation. AB - We have cultured and passaged human fetal lens epithelial cells. Cultured cells exhibited hexagonal, cuboidal shape typical of epithelial cells. Unlike previous observations made with cultured mammalian lens epithelial cells, indirect immunofluorescence and temporal analysis of 35S-labeled proteins demonstrated undiminished levels of alpha B-crystallin in primary, secondary, and tertiary cultures. Among the alpha-crystallins only alpha B synthesis was detected. Two dimensional gel electrophoresis indicated the presence of alpha B2 and no alpha B1. beta B2-crystallin, a fiber cell specific protein hardly detectable in primary cultures, increased significantly upon passaging. Human fetal lens epithelial cell cultures, described in this report, thus present a useful in vitro model for the study of lens epithelial cell differentiation and its pathological manifestations. PMID- 2707045 TI - Fluorescence studies on the age related changes in bovine and human lens membrane structure. AB - Bovine and human lens fiber cell plasma membranes were isolated as the urea insoluble fraction for a study of age related changes. The changes in fluorescence intensity, both intrinsic (tryptophan) and extrinsic probes ANS (1 anilinonaphthalene-8-sulfonic acid) and DPH (1,6-diphenyl 1,3,5-hexatriene), as well as DPH anisotropy and lifetime were measured. The results of tryptophan fluorescence indicate that tryptophan residues in membrane proteins are in a very hydrophobic environment and do not show a change with aging. ANS reacts with surface protein in the polar-apolar interface, while DPH penetrates into the interior of membranes. Both probes show a decrease in fluorescence intensity in the old membranes. The decrease in ANS fluorescence may result from the conversion of MP26 to MP22, while the decrease of DPH fluorescence intensity may indicate a decrease in accessibility of lipid to DPH. To further delineate the change, fluorescence anisotropy and lifetime data of the lipid probe DPH were obtained. While lifetimes do not change with age, anisotropy shows a definite age dependent increase. Anisotropy is related to the degree of lipid structural order. Greater anisotropy values were found for older membrane samples, indicating an increased rigidity with age, which may be partially caused by the increased cholesterol/phospholipid (C/P) ratio as reported in the literature. PMID- 2707046 TI - An in vitro analysis of aminoglycoside corneal epithelial toxicity. AB - We evaluated the cytotoxicity of four aminoglycoside agents (neomycin, gentamicin, tobramycin, and amikacin) using an in vitro confluent rabbit corneal epithelial cell culture model. Primary corneal epithelial cell cultures were established and cells replated at 2 x 10(4) cells/2 cm2 well. After 48 hours either vehicle or an antibiotic was added at varying concentrations, each for 5, 30, or 60 minutes. 3H-thymidine was added immediately after drug removal and incorporation was measured 8 hours after drug or vehicle exposure. Comparisons of each drug to vehicle were expressed as % inhibition of control culture values. At the 5-minute exposure time tobramycin and amikacin showed no significant inhibition at any concentration, whereas neomycin and gentamicin showed significant inhibition at 6 mg/ml and 3.5 mg/ml or greater concentrations, respectively (p less than 0.05). At 30- and 60-minute exposure times all agents demonstrated significant inhibition at all tested concentrations in a non-dose dependent fashion (p less than 0.05). These in vitro data corroborate the animal and limited clinical data available for the aminoglycosides. Based on these toxicity profiles, tobramycin appears to be the topical agent of choice in the treatment of susceptible bacterial keratitis. PMID- 2707047 TI - Interaction between progesterone and mifepristone on intraocular pressure in rabbits. AB - The interaction between a topically administered progesterone, medrysone, and a steroid antagonist, mifepristone, on rabbit intraocular pressure (IOP) has been determined. Medrysone alone increased IOP significantly above parallel controls over the first three weeks; this increase was not sustained. When medrysone and mifepristone were given simultaneously the IOP increased initially, but then fell after two weeks to control levels. When mifepristone was added 14 days after medrysone, the IOP was again reduced to, or below, control levels by mifepristone. The use of mifepristone alone reduced IOP relative to controls and the further addition of medrysone at 14 days had no effect on IOP. It appears that mifepristone is an effective antagonist against progesterone effects on IOP. PMID- 2707048 TI - Ceftriaxone versus clavulanate-potentiated amoxycillin for prophylaxis against post-operative sepsis in biliary surgery: a prospective randomized study in 200 patients. AB - A prospective study was carried out in 200 consecutive patients undergoing biliary surgery to compare the prophylactic effectiveness of ceftriaxone and clavulanate-potentiated (CP-) amoxycillin. Patients were assigned in a randomized fashion to two groups and received ceftriaxone (2 g intravenously pre operatively), or CP-amoxycillin (1200 mg, to be repeated for 2 more doses in the case of patients undergoing procedures other than elective cholecystectomy). Post operative wound infection occurred in 4% of patients in each group. Administration of ceftriaxone was associated with a lower incidence of post operative pyrexia and chest infection as well as with a shorter hospital stay. PMID- 2707049 TI - Treatment of hyperlipidaemia with acipimox. AB - In an open, uncontrolled study, the hypolipidaemic effect of acipimox was evaluated in 34 patients with Types IIa, IIb, IV or V hyperlipidaemia. Doses of 250 mg twice daily or 250 mg 3-times daily were maintained over a 12-week treatment period. The reduction in total plasma cholesterol levels was small and not statistically significant; however, significant increases in high density lipoproteins were achieved. Triglyceride levels were significantly lowered in patients with Type IV hyperlipidaemia. Acipimox was well tolerated by patients and no biochemical or haematological changes were noted. Considerable resolution in tubo-eruptive xanthomata was observed in 1 patient with Type V hyperlipidaemia. PMID- 2707050 TI - Allergic contact dermatitis from an olive wood necklace. PMID- 2707051 TI - My most unforgettable case. A workmanlike job. PMID- 2707052 TI - Crustaceans: crabs, crayfish, lobsters, and shrimp. PMID- 2707053 TI - Necrobiosis lipoidica diabeticorum: platelet survival and response to platelet inhibitors. AB - Results of an open trial of platelet inhibitor treatment for necrobiosis lipoidica diabeticorum suggest the possible importance of abnormal platelet function in this disease. In ten female patients with necrobiosis lipoidica diabeticorum (six who were diabetic and four who were not) platelet survival times were measured before and after treatment with aspirin and dipyridamole. Pretreatment platelet survival time was considerably shortened in 50 percent of the diabetic and nondiabetic patients. Platelet-inhibitor treatment prolonged platelet survival time toward normal in most of these patients. The clinical response to treatment varied from healing to no noticeable effect. PMID- 2707054 TI - Widespread oral papillomatosis due to chronic buccal trauma. AB - We present a case of oral papillomatosis occurring in a 52-year-old woman. This condition is well known and is characterized by an exuberant proliferation of multiple, flat, verruca-like elevations on the oral and pharyngeal mucosa. This is apparently the first documented case of oral papillomatosis due to trauma to the oral tissue from a dental prosthesis, with subsequent inflammation. Correction of the prosthesis resulted in marked improvement. This presentation emphasizes the causes, diagnosis, pathologic basis, and treatment of this condition. PMID- 2707055 TI - Herpes zoster infection with trigeminal and facial nerve involvement. AB - In most cases, herpes zoster (shingles) infections are benign and self-limited, requiring no treatment. However, if patients are elderly or immuno-compromised, they are at increased risk of complications such as visceral dissemination, cranial and nerve palsies, ophthalmic zoster, and postherpetic neuralgia. We present a case of herpes zoster infection complicated by both motor and sensory involvement in an elderly man. PMID- 2707056 TI - A case of multiple urate deposition, without gouty attacks, in a patient with systemic lupus erythematosus. AB - We describe urate deposition on the hands and feet of a patient with systemic lupus erythematosus. The coexistence of systemic lupus erythematosus and tophaceous gout is very rare. Our patient did not experience gouty attacks and demonstrated a peculiar skin manifestation that has not been reported previously. PMID- 2707057 TI - Acute myeloid and lymphoblastic leukemia in adults. The course of the disease in 315 patients from one region, during a ten-year period. AB - In a ten-year retrospective singlecenter study of a nonselected patient population, we describe our experience with an unchanged chemotherapy regimen for 264 patients with acute myeloid leukemia (AML) and 51 patients with acute lymphoblastic leukemia (ALL). In the AML group, 85 patients could not receive specific antileukemic treatment because of uncontrollable bleeding, infection or organ failure, but 179 were fit for remission-induction therapy with cytarabine and daunorubicin, resulting in complete remission in 79 patients. During treatment, 54 patients died of resistant disease or complications. The median duration of survival of the patients in complete remission was 18-24 months (n = 79) compared with 1-2 months for patients in partial or no remission (n = 100). As maintenance chemotherapy, thioguanine, cytarabine and daunorubicin were given for one year. In the ALL group 50 of 51 patients received remission-induction therapy with vincristine, prednisone and Adriablastin, resulting in complete remission in 39 of the patients. The median duration of survival of the patients in complete remission was nine months (n = 39) compared with 2-3 months for patients not in remission (n = 12). Central nervous system prophylaxis with intraspinal methotrexate and cranial irradiation was given, followed by methotrexate and Purinetol for three years as maintenance chemotherapy. The remission rate for AML and adult ALL was 44% and 78%, respectively. The major Cause of death after first complete remission was leukemic relapse in boths groups, with a median survival time after relapse of 3-4 months for 48 AML and six months for 30 ALL patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707058 TI - Aerosolized metaproterenol in the treatment of asthmatics with severe airflow obstruction. Comparison of two delivery methods. AB - The bronchodilator response to metaproterenol delivered by metered-dose inhaler (MDI) with a spacer device (Aerochamber [A]) and by jet nebulizer was studied in 44 asthmatic patients who presented to the emergency department with acute severe (FEV1 less than 50 percent predicted) airflow obstruction. The delivery method was randomized, double-blinded and placebo controlled. The A group received one puff of metaproterenol every five minutes for a total of three puffs (1.95 mg). The jet nebulizer group received 15 mg of metaproterenol by continuous nebulization over ten minutes. Only about 2.75 mg of the original 15 mg delivered by jet nebulizer was calculated to be available for inhalation due to the inefficiencies of the delivery system. The mean percentage of improvement in FVC and FEV1 in the A group was 33.5 and 49.0 percent, respectively. The mean percentage of improvement in FVC and FEV1 in the jet nebulizer group was 22.8 and 33.0 percent, respectively. There was no significant difference in the mean percentage of improvement values between the two groups. We were unable to demonstrate a difference in bronchodilator response to metaproterenol delivered by MDI-A and jet nebulizer in emergency department asthmatics with acute severe airflow obstruction. PMID- 2707059 TI - Bronchoscopy in the diagnosis of pulmonary histoplasmosis. AB - Although histoplasmosis is the most common fungal infection of the lungs in the United States, there are no reports evaluating the efficacy of fiberoptic bronchoscopy in the diagnosis of this disease. We reviewed all cases of histoplasmosis diagnosed at our institution from 1972 to 1987. Of 469 patients, 71 underwent fiberoptic bronchoscopy and had culture/histologic proof of histoplasmosis established by fiberoptic bronchoscopy or other means. A diagnosis of pulmonary histoplasmosis could be made without thoracotomy in only 27. Among those not requiring thoracotomy, diagnosis of pulmonary histoplasmosis was confirmed by fiberoptic bronchoscopy and cultures of sputum, gastric washings, blood, bone marrow, and urine. In this subgroup, fiberoptic bronchoscopy was the only positive diagnostic method in eight of 27 patients. We conclude that fiberoptic bronchoscopy is a useful adjunct to other noninvasive measures yielding diagnostic material in most cases, except for solitary pulmonary nodule where it is rarely helpful. PMID- 2707060 TI - Transmitral flow changes during dipyridamole-induced ischemia. A Doppler echocardiographic study. AB - Myocardial ischemia results in altered left ventricular (LV) diastolic compliance, reflected by an abnormal mitral inflow pattern on Doppler echocardiography. To investigate the relationship of Doppler echocardiography and regional myocardial systolic function during dipyridamole infusion, we evaluated transmitral flow changes detected by pulsed Doppler technique during a high-dose dipyridamole echocardiography test (DET, two-dimensional echo monitoring with dipyridamole infusion, up to 0.84 mg/kg over 10 min). The DET response produced two groups: group 1 (34 patients) with negative DET, and group 2 (35 patients) with positive DET, defined as the development of a newly onset LV regional asynergy. The E/A values overlapped at baseline (1.07 +/- .32 vs .92 +/- .22; p = NS) but differed at peak changes (.92 +/- .26 vs. 75 +/- .25; p less than .01). Heart rate changes could not account for the observed Doppler changes, since the values of R-R interval were similar in the groups, both basally (.927 +/- .226 vs .867 +/- .143 s; p = NS) and at peak dipyridamole (.754 +/- .100 vs. 681 +/- .112; p = NS). Transient myocardial ischemia induced by dipyridamole administration is accompanied by changes in transmitral flow, which consist of an increase in the relative atrial contribution to LV filling, possibly owing to an acute impairment in LV relaxation. PMID- 2707061 TI - Diagnosis and characteristics of lone atrial fibrillation. AB - Thirty-two patients with LAF were studied. Nineteen (59 percent) were male subjects. Mean age was 46.8 years. They were followed up for 2 to 16 years. On admission, most patients (94 percent) were symptomatic and had palpitations, nine had nonspecific chest pain, and five had syncope or near syncope. Left atrial size measured by echocardiography was less than 40 mm in all patients. During the follow-up period, only one patient had a complication, ie, cerebral embolism. We conclude that LAF may be regarded as a relatively benign form of AF. According to our study, one of its features is left atrial size not larger than 40 mm in echocardiography. PMID- 2707062 TI - Combination of ofloxacin and amikacin in the treatment of sternotomy wound infection. AB - Mycobacterium fortuitum infection of soft tissue and wound (postoperative or otherwise) has been well reported in medical literature. In 1987, ten patients in our hospital with various cardiac diagnoses requiring open-heart surgery developed M fortuitum infection at the sternotomy site. As successful chemotherapy, in addition to surgical debridement, relies on in vitro susceptibility testing, ofloxacin and amikacin were thus assessed and found to have very satisfactory MIC. For the former: 1.25 mg/L for eight isolates, 2.5 mg/L for one isolate, and greater than 20 mg/L for one isolate were found. For the latter: 1 mg/L for six isolates, 2 mg/L for two isolates, and 4 mg/L and 8 mg/L for the remaining two isolates were found, respectively. These patients were given ofloxacin (300 mg once daily to 1,200 mg daily in divided doses) for three to six months and 500 mg amikacin daily (in two divided doses intravenously or intramuscularly) for three to eight weeks. The clinical outcome was favorable except for one patient who died of bacteremia due to M fortuitum coupled with many medical complications. Encouraged by these preliminary results, a future prospective study with ofloxacin as single agent for soft tissue, particularly postoperative sepsis due to M fortuitum, will be planned. PMID- 2707063 TI - Obstructive sleep apnea leading to increased intracranial pressure in a patient with hydrocephalus and syringomyelia. AB - Rises in intracranial pressure from normal baseline values up to 50 cm H2O occurred shortly after the onset of obstructive sleep apnea in a patient with myelomeningocele, hydrocephalus, Arnold-Chiari malformation, and syringomyelia. Tonsillar hypertrophy caused the airway obstruction during sleep, because the obstructive sleep apnea and also the periodic elevation of intracranial pressure disappeared after tonsillectomy. Only one report from Japan has previously described three patients with elevated cerebrospinal fluid pressures during obstructive sleep apnea. It is conceivable that episodic airway obstruction and concurrent intracranial hypertension may have contributed to the development of syringomyelia in our patient. PMID- 2707064 TI - Midazolam as intravenous sedative for electrocardioversion. AB - Of the various agents which have been employed for sedation in patients undergoing electrocardioversion, diazepam has had the most extensive use. However, this agent possesses several disadvantages including pain and venous complications at the site of injection and a lower incidence of amnesia. Midazolam, a benzodiazepine derivative, is being increasingly used in general and local anesthesia as well as for procedures requiring conscious sedation, eg, endoscopy. We used intravenous midazolam for conscious sedation in 12 patients undergoing a total of 17 cardioversions. All of the patients experienced amnesia for the procedure and manifested no significant adverse effects. However, serious respiratory failure may occur when intravenous midazolam is used in patients with COPD, debilitated patients, or when the drug is injected rapidly. The use of midazolam should therefore be confined to areas that are able to deal with cardiorespiratory complications. Using guidelines and precautions described here, we encountered no major complications. We conclude that midazolam offers a safe and effective alternative to other agents for conscious sedation in patients undergoing electrocardioversion. PMID- 2707065 TI - A circulating myocardial depressant substance is associated with cardiac dysfunction and peripheral hypoperfusion (lactic acidemia) in patients with septic shock. AB - Using spontaneously beating rat myocardial cells as an in vitro model of myocardial depression, recent studies demonstrated that septic shock patients' sera frequently contain a myocardial depressant substance (MDS) that is associated with a reversible decrease in left ventricular ejection fraction (LVEF). To further characterize MDS, 50 consecutive patients with possible septic shock were studied serially from shock onset until recovery or death. Thirty-four patients had criteria diagnostic of septic shock, and 16 had a nonseptic critical illness. Of the 34, 14 met strict criteria for circulating MDS, with a mean inhibition of 35 percent (range 20 percent to 62 percent). Compared with those patients not exhibiting significant MDS activity, the 14 MDS-positive patients had a lower mean minimal EF (28 percent vs 39 percent, p less than 0.01), a greater mean decrease in EF (22.1 percent vs 8.8 percent, p = 0.002), a higher pulmonary artery wedge pressure (16.8 vs 11.9 mm Hg, p less than 0.01), greater LV dilatation (162 vs 118 ml/m2, p = 0.02), and a higher circulating mean peak lactic acid (6.9 vs 2.7 mmol/L, p less than 0.01). In the 14 MDS-positive patients, the in vitro myocardial cell depression had a negative correlation with the in vivo EF (r = -060, p less than 0.05). These findings suggest that a circulating MDS is a cause of the myocardial depression frequently accompanying human septic shock. PMID- 2707066 TI - Evidence of prolonged myocardial dysfunction in heat stroke. AB - Heat stroke is a life-threatening syndrome of multi-organ dysfunction caused by elevated body temperature. It may result from failure of the thermoregulatory mechanisms or from inadequate heat dissipation and affects members of several risk groups. A number of authors reported cardiac involvement in heat stroke, but heart failure rarely has been documented. We report the cases of two heat stroke victims, one of whom developed pulmonary edema and the other, peripheral edema. In both, RVG demonstrated dilatation and diffuse hypokinesis of the right ventricle, which persisted for several weeks. We conclude that the heart may be involved in heat stroke and that heart failure is a potential complication of the syndrome that can have a prolonged subclinical course. Fluid replacement in heat stroke should be done under careful observation, which may be facilitated by noninvasive assessment of cardiac function. PMID- 2707067 TI - Mechanism of blood flow generated by precordial compression during CPR. I. Studies on closed chest precordial compression. AB - The mechanism of forward flow produced by precordial compression during CPR was investigated with the aid of echocardiographic and hemodynamic measurements in anesthetized, mechanically ventilated domestic pigs. Both mitral and tricuspid valves opened during compression diastole and closed during compression systole. Valve motion persisted throughout resuscitation in 17 of 22 animals which were hemodynamically resuscitated. There was a 25 percent reduction in left ventricular area during compression systole. Maximum pressure generated during compression systole in the aorta exceeded that of the right atrium throughout the 12-min interval of precordial compression in successfully resuscitated animals. These observations provide evidence of direct cardiac compression as the mechanism accounting for effective forward blood flow during CPR. The persistence of valve function, chamber compression, and pressure gradients during precordial compression was predictive of successful resuscitation. The absence of these factors prognosticates failure of resuscitation and explains, in part, the inconsistency of prior reports. PMID- 2707068 TI - Roentgenogram of the month. Chest mass in a paraplegic. PMID- 2707069 TI - Carotid body resection for COPD? PMID- 2707070 TI - Massive hemoptysis during catheterization of the internal jugular vein. AB - Percutaneous cannulation of the internal jugular vein is commonly performed to obtain central venous access. We report the first case of massive hemoptysis occurring during cannulation of the internal jugular vein. PMID- 2707071 TI - Left upper lobe torsion following lower lobe resection. Early recognition of a rare complication. AB - Left upper lobe torsion occurred in a woman during the first 24 hours following left lower lobectomy for bronchogenic carcinoma resection. To our knowledge, this is the first report of left upper lobe torsion. When atypical chest pain or opacification of the remaining lung develops following resectional surgery, torsion of the remaining lung must be suspected. Prompt diagnosis and treatment may prevent the morbidity and mortality associated with pulmonary infarction from torsion. PMID- 2707072 TI - Hypersensitivity pneumonitis due to mushroom (Pholiota nameko) spores. AB - Hypersensitivity pneumonitis due to the inhalation of spores from the edible mushroom Pholiota nameko was demonstrated. A 52-year-old mushroom worker noticed cough, exertional dyspnea, and high fever several hours after work in the mushroom-cultivating room. His examination revealed bilateral basilar crepitations, fine granular shadows in both lung fields of chest x-ray film, and slight decrease in diffusion capacity. Precipitin and macrophage migration inhibition factor were found against the mushroom spore extract and not other contaminants and molds. Histologic finding by transbronchial lung biopsy showed granulomatous alveolitis. Manifest increase of lymphocytes was found in his bronchoalveolar lavage fluid. Provocative inhalation test with the extract revealed similar symptoms and signs in his workplace eight hours after inhalation. It seems to be the first case of hypersensitivity pneumonitis to the Pholiota nameko mushroom spores. PMID- 2707073 TI - Fiberbronchoscopy in smear-negative miliary tuberculosis. AB - Twenty-two patients with smear-negative miliary tuberculosis underwent fiberbronchoscopy and brush smears; bronchial aspirates and transbronchial lung biopsy specimens were obtained. A definite diagnosis of tuberculosis was made in 16 (73 percent) patients. A rapid diagnosis was established in 14 of these 16 patients either from brush smears alone (three) or bronchial aspirate smear alone (one) or exclusively by histopathologic study of biopsy specimens (seven). Both brush smears and biopsy histopathology results provided the diagnosis in three patients. Bronchial aspirate culture was the only positive specimen in two patients. No serious complication resulted from the procedure. Our experience substantiates previous reports of the value and safety of fiberbronchoscopy in the rapid diagnosis of smear-negative miliary tuberculosis. PMID- 2707074 TI - Prolonged survival in pulmonary veno-occlusive disease treated with nifedipine. AB - A case of pulmonary veno-occlusive disease diagnosed by open lung biopsy is presented. The patient had a clinical and hemodynamic response to therapy with nifedipine with a significant reduction in pulmonary vascular resistance. This is the first reported case of prolonged survival in this disease resulting from vasodilator therapy with nifedipine. PMID- 2707075 TI - Aspergilloma in an open chest cavity. AB - We present the findings in a patient who underwent pneumonectomy and developed a chronic bronchopleural fistula and empyema and who developed an intrathoracic aspergilloma after open-window thoracostomy. To our knowledge, formation of an aspergilloma in an open intrathoracic cavity has not been reported previously. PMID- 2707076 TI - Pulmonary phaeohyphomycosis in a patient with hemoptysis. AB - A 79-year-old retired schoolteacher had a history of bronchiectasis. She developed recurrent hemoptysis requiring multiple blood transfusions. Exophiala dermatitidis was cultured repeatedly from bronchial lavages. To our knowledge, this is the first documented case of isolated pulmonary phaeohyphomycosis due to E dermatitidis, and it was successfully treated with amphotericin B and 5 fluocytosine. PMID- 2707077 TI - Corticosteroid-induced myopathy and the respiratory muscles. Report of two cases. AB - Two women with connective tissue disease developed a characteristic steroid induced myopathy. Reduced maximal transrespiratory pressures indicated reduced respiratory muscle strength. Gradual steroid dosage tapering resulted in prompt clinical improvement and marked increases in respiratory muscle strength, maximal inspiratory pressure increasing by 33 percent in one patient and by 70 percent in the other. This reversible steroid-induced respiratory muscle weakness may be of great significance in reconsidering long-term steroid therapy in patients with underlying lung disease. PMID- 2707078 TI - De novo circumscribed pulmonary lobar cystic lymphatic anomaly in a young boy. A possible sequela of bronchopulmonary dysplasia. AB - This report describes a massive pulmonary lymphatic cystic anomaly affecting the right lower lobe of a nine-year-old boy. A year earlier, only an ill-defined small infiltrate could be seen in the affected lobe radiologically. The pathogenesis of this highly unusual lesion is discussed, taking into consideration the possible role of three months of mechanical ventilation in the neonatal period. PMID- 2707079 TI - Endobronchial tuberculosis simulating foreign body aspiration. AB - A case of sudden onset of severe respiratory distress is reported. Appropriate clinical and roentgenologic findings suggested foreign body aspiration. The foreign body was removed by fiberoptic rigid bronchoscope. Bronchoscopic, histopathologic, and microbiologic findings revealed that the foreign body was a granulomatous mass originating from endobronchial tuberculosis. PMID- 2707080 TI - Roentgenographic underestimation of early asbestosis. PMID- 2707081 TI - Reexpansion pulmonary edema localized to a lobe. PMID- 2707082 TI - Is CT useful in the unequivocal diagnosis of hydatid cyst on a chest X-ray film? PMID- 2707083 TI - Constrictive pericarditis. PMID- 2707084 TI - Olympus BF-1T20 fiberoptic bronchoscope and a flexible 18 gauge transbronchial aspiration needle. PMID- 2707085 TI - Myocardial dysfunction in sepsis. Recent insights. PMID- 2707086 TI - The sun should never set on a parapneumonic effusion. PMID- 2707087 TI - Arterial oxygen desaturation during sleep in interstitial pulmonary disease. Correlation with chemical control of breathing during wakefulness. AB - Patients with IPD often develop oxygen desaturation during sleep. We investigated whether or not the degree of falls in SaO2 during sleep were correlated with the daytime data of pulmonary function tests, arterial blood gas tensions, or ventilatory responses to chemical stimuli. Fourteen patients with IPD who had restrictive ventilatory impairment were studied to evaluate these relationships. The magnitude of SaO2 depression from awake to REM sleep was inversely correlated with the level of baseline SaO2. Hypercapnic ventilatory response was inversely related to the amount of maximal desaturation in both REM and NREM sleep. These results indicate that patients with IPD who have insufficient ventilatory response to hypercapnia reveal larger falls in SaO2 during sleep, particularly if they have lower baseline SaO2. PMID- 2707088 TI - Surgical treatment of primary lung cancer and solitary intracranial metastasis. AB - From 1976 through 1986, 12 patients underwent 14 thoracotomies (two patients had a second thoracotomy for recurrence) and 16 craniotomies (two patients had three craniotomies for recurrence) for carcinoma of the lung and solitary intracranial metastasis. Age ranged from 40 to 65 years. Adjuvant therapy (chemotherapy and thoracic irradiation) was employed in three patients prior to thoracotomy and in four patients following thoracotomy. Whole-brain irradiation was used in four patients after craniotomy. Improvement in neurologic symptoms following craniotomy was noted in 15 of 16 instances. There were no operative mortalities. Overall survival from the time of initial diagnosis ranged from 13 to 63 months. Survival following initial craniotomy ranged from 12 to 56 months. Eight patients are currently alive and well with no disabling neurological symptoms. These results support an aggressive approach to the resection of solitary brain metastasis from bronchogenic carcinoma, both for palliation and prolongation of survival. PMID- 2707089 TI - Recurrent pulmonary embolism. A prospective study. AB - We have prospectively studied a series of 121 consecutive patients with venous thromboembolism (38 with pulmonary embolism, 83 with venous thrombosis of the lower extremities) searching for recurrences of pulmonary embolism despite adequate heparin therapy. A baseline ventilation-perfusion lung scan was obtained initially in every patient, whether the original diagnosis was pulmonary embolism or venous thrombosis. Repeat chest roentgenograms and lung scans were obtained routinely at eight days of heparin treatment. The primary trial endpoints were a finding of a clinically apparent recurrent pulmonary embolism, or laboratory evidence of subclinical pulmonary embolism. Eight items of clinical and laboratory information were recorded at admission and then correlated with the lung scan results. Recurrences were seen in seven of 38 patients with an original diagnosis of pulmonary embolism, and in five of 83 patients admitted because of venous thrombosis (p = 0.034). Recurrences were also more frequent in patients with a free-floating thrombus on venography (p = 0.014). The risk of new defects in patients with venous thrombosis and without free-floating thrombus was 3.05 percent, venous thrombosis with free-floating thrombus, 13.33 percent; patients with pulmonary embolism without free-floating thrombus, 11.42 percent; and with free-floating thrombus, 38.67 percent. Venography seems thus mandatory in patients with pulmonary embolism, as it recognizes a subgroup of patients at a high risk of recurrences. PMID- 2707090 TI - Do hemodynamic responses to the valsalva maneuver reflect myocardial dysfunction? AB - In 14 consecutive patients with varying myocardial function, evaluation of the Valsalva maneuver was performed using aortic pulse pressure decay to investigate a possible quantitative relationship between the pattern of response and the degree of myocardial dysfunction. The aortic pulse pressure response during strain correlated with resting left ventricular end-diastolic pressure and pulmonary wedge pressure but not with resting cardiac output, cardiac index and ejection fraction. Similar results were obtained when several indices characterizing the aortic pulse pressure decay during Valsalva were used together to predict resting hemodynamic data by multiple regression analysis. In conclusion, quantitative aortic pulse pressure decay during the strain phase of the Valsalva maneuver correlated only moderately with hemodynamic indices used to identify myocardial dysfunction. These results raise doubts about the use of the Valsalva maneuver for the evaluation of myocardial dysfunction. PMID- 2707091 TI - Ethnic differences in the prevalence of pulmonary airflow obstruction among grain workers. AB - World Health Organization data suggest that British males over 45 have a higher death rate from chronic bronchitis, emphysema, and asthma combined than do other Europeans. Although widely supposed that this is due to particularly unfavorable environmental factors in the British Isles, as well as a higher rate of tobacco consumption, ethnicity itself may be a significant factor in determining risk of obstructive airways disease. To test this hypothesis, we have analyzed the prevalence of airflow obstruction (100 x FEV1:FVC less than 68% and FEV1 less than 84 percent predicted) in Saskatchewan grain workers of British, German, and Eastern European ancestry using the Mantel-Haenszel odds ratio (OMH) and stepwise logistic regression. We found that the British grain workers had a significantly greater prevalence of airflow obstruction (OMH = 3.2; p less than 0.01) than the Eastern Europeans. We also found that ethnic origin made a significant contribution to the estimation of risk of airflow obstruction among grain workers independent of the effects of age and smoking. PMID- 2707092 TI - Smoking and cotton dust effects in cotton textile workers. AB - Cotton textile workers have an increased prevalence of both obstructive and restrictive lung function patterns compared with control subjects. Similar abnormal patterns may occur with respiratory diseases of other etiologies, notably those associated with cigarette smoking. The shape of the maximum expiratory flow volume (MEFV) curve has been used to characterize patterns of lung function abnormality. To better evaluate the respiratory effects of cotton dust exposure and to contrast them with those of cigarette smoking, we defined a new functional parameter (angle beta) related to the shape of the MEFV curve. We compared 477 cotton textile workers, both current smokers and never smokers, 45 years and older, with 932 similarly aged control subjects from three communities. Smokers, regardless of their occupational exposure or sex, have smaller beta values than nonsmokers. Cotton textile workers, despite a greater prevalence of abnormal lung function, have beta values that do not differ from those of persons without occupational exposure to cotton dust. We suggest that morphologic patterns of flow volume curves reflect separate effects of cotton dust exposure and smoking and may be related to different sites of airway injury. PMID- 2707093 TI - [Carotid endarterectomy. Risks and benefits of treatment]. AB - From 1980 to 1985, 210 endarterectomies of the carotid artery were performed in 187 patients (50 female, 127 male). In 55 cases there were asymptomatic filiform stenoses with concomitant high grade stenosis or occlusion of the contralateral artery. 155 stenoses of the carotid artery of mostly the highest degree were symptomatic. Patients were examined by means of the direct CW-doppler ultrasound immediately postoperatively and every six months up to six years. In 9 cases (4.3%) there was a perioperative (central) neurologic incident, which in 5 (2.3%) cases was followed by permanent neurologic deficits. Three of these incidents were caused by an early occlusion of the reconstruction. The stroke rate (including perioperative stroke rate) determined by life table analysis for the whole group after 6 years was 5.6%. The rate of TIA's was 4.5%. The rate of local recurrence (stenosis greater than 50% or occlusions) after six years was 15.3%. Except for the above mentioned early occlusions only one recurrent stenosis was symptomatic. We believe that asymptomatic, non multimorbid patients with doublesided high grade stenoses and symptomatic patients profit from an endarterectomy of the carotid artery, as long as the perioperative stroke rate and mortality do not exceed 3-4%. PMID- 2707094 TI - [Progressive papillomatosis of the intra- and extrahepatic bile ducts]. AB - The papillomatosis of the bile duct may occur at any age but more often at the age of 40 and 50 with a slight preference for men. The main symptom is an icterus often combined with right-sided epigastric pain. ERC and PTC allows the preoperative diagnosis on the basis of the typical clinical picture. The papillomatosis of the bile duct has to be considered as a disease with cancer risk. The prognosis in case of incomplete removal is unfavorable because of the continuous growth, the intrahepatic spread and the elevated degenerative tendency. Therefore a complete removal should be considered. PMID- 2707095 TI - [Operation documentation. A program for the detection and statistical documentary evaluation of surgery reports]. AB - A computer program specifically designed for surgical data retrieval was tested for longer than one year. By using the information contained in operation reports, with this program statistical analysis may be achieved. The reports are generated and printed using a personal computer running MS-DOS. Entering data does not cause any additional effort for the secretary. The selection of requested data is possible with any combination of criteria, and the resultant information is displayed on the computer terminal screen or printed on the computer printer. A combination of terms is used instead of a numeric code for data entry allowing far greater selectivity, with a reduced risk of data loss due to wrong numeric code entry. PMID- 2707096 TI - [A rare complication following vagotomy with circular myotomy of the esophagus and hemifundoplication. A case report]. PMID- 2707097 TI - [The premium curved end-to-end anastomosis instrument. Further development of mechanical anastomosis instruments]. PMID- 2707098 TI - [Surgical indications status in ileus using a simple clinical index]. AB - Based on a retrospective analysis of a group of patients with ileus disease in regard of the indication for operative intervention an "ileus index" was created which is derived from simple clinical and radiological findings and laboratory data. Prospective evaluation of this index showed its effectiveness in separating patients who had to undergo an emergency operation from those who could be operated electively after preceding diagnostic procedures or could be treated conservatively. PMID- 2707099 TI - Scaffold morphology in histone-depleted HeLa metaphase chromosomes. AB - In a study of HeLa metaphase chromosomes depleted of histones with 2M NaCl and spread with cytochrome c, two new types of images of chromosome scaffolds have been observed in the electron microscope. In the first type, scaffolds are very large and fibrous but still display the shape typical of metaphase chromosomes. The regularity and lack of distortion in these scaffolds, despite their openness and seeming fragility, support the notion that the underlying scaffold structure is an interconnected network of fibers. In the second type, fibrous regions and dense regions are juxtaposed in the same chromosome scaffold. These micrographs suggest that the dense appearance of some previously observed scaffolds may be the result of incomplete adherence to the cytochrome c monolayer, leading to collapse and aggregation during dehydration. PMID- 2707100 TI - Classification of Y chromosome polymorphisms by DNA content and C-banding. AB - A system has been developed using a microscope photometer to measure the DNA content of individual chromosomes. After correcting for the systematic and statistical errors the measured values are highly reproducible. Data are presented of measurements of human Y chromosomes from a cytogenetically normal population. When compared with the C-banding pattern from the same specimens the DNA content is found to change in discrete steps of 1.36 x 10(-14)g or 13.26 x 10(6) bp for each of the Y chromosome polymorphic types. PMID- 2707101 TI - Characterization of GATA/GACA-related sequences on proximal chromosome 17 of the mouse. AB - Autosomal loci have long been thought to have a role in sex determination of mice. We studied the localization of GATA/GACA repeats on chromosome 17 in regard to the possibility of their involvement in sex determination. We performed in situ hybridizations on chromosome 17s carrying the Hairpain tail (Thp) deletion of the T locus since this deletion has been associated with sex reversal and hermaphroditism. We did not detect a significant decrease in the amount of hybridization of GATA/GACA repeats to the Thp deletion. In addition, three Bkm positive cosmids from proximal chromosome 17 did not contain sequences deleted in Thp or TOrl and a fetal testes cDNA probe did not hybridize to the cosmid sequences. Although we confirmed the localization of Bkm-related sequences on chromosome 17, we were not able to relate GATA/GACA sequences on chromosome 17 to sex determination in mice. PMID- 2707102 TI - Further examination of the production-line hypothesis in mouse foetal oocytes. II. T(14; 15)6Ca heterozygotes. AB - Pachytene oocytes from foetal mice heterozygous for the translocation T(14; 15)6Ca were screened for evidence of a "production-line" effect on chromosome pairing. Metaphase I oocytes from adult heterozygotes were also examined to determine whether any such effect on pahytene chromosome pairing is subsequently repeated during adult reproductive life as anticipated by the production-line hypothesis. It was found that as gestation proceeded the proportion of pachytene oocytes with a translocation quadrivalent declined and that with a trivalent and univalent correspondingly increased. That is, there was evidence of variation in pairing behaviour of the translocation at different times of gestation. In contrast, the proportions of metaphase I cells with either a quadrivalent or a trivalent plus univalent did not vary between adult females of different ages. Thus if the variation observed at pachytene was the result of a production-line effect, clearly this was not reflected in the behaviour of the translocation at metaphase I. Our observations therefore do not support the production-line hypothesis for the maternal age effect on nondisjunction. PMID- 2707103 TI - Selection of cells with different chromosomal localizations of the amplified c myc gene during in vivo and in vitro growth of the breast carcinoma cell line SW 613-S. AB - The c-myc gene is amplified in the human breast carcinoma cell line SW 613-S. At early in vitro passages, the extra copies of the gene were mainly localized in double minute chromosomes (DMs), as shown by in situ hybridization with a biotinylated c-myc probe. However, cells without DMs were also present in which the c-myc genes were found integrated into any of several distinct chromosomes (mainly 7q+, 4 and 4q+, and 1). When this cell line was propagated in vitro, the level of c-myc amplification decreased because cells with DMs and a high amplification level were lost and replaced by cells without DMs and having a low amplification level. On the contrary, when early passage SW 613-S cells were grown in vivo, as subcutaneous tumours in nude mice, cells with numerous DMs and a high level of c-myc amplification were selected for. In one cell line (SW 613 Tu1) established from such a tumour, the DM-containing cells were substituted at late passages for cells with a high number of c-myc copies integrated within an abnormally banded region, at band 17q24 of a 17q+ chromosome. When only cells with integrated genes were present, this cell line was still highly tumorigenic indicating that the localization of the c-myc genes in DMs was not required for these cells to be tumorigenic in nude mice. Furthermore, cells of the secondary tumours induced by SW 613-Tu1 did not contain any DMs showing that in vivo growth did not promote the release of integrated c-myc copies into DMs. PMID- 2707104 TI - Nuclease activity in human metaphase chromosomes substituted with 5' bromodeoxyuridine. AB - Human metaphase chromosomes, substituted with 5'-bromodeoxyuridine (BrdUrd) for one, two or three rounds of replication, were briefly pretreated with ultraviolet light (UV), in the presence of 33258 Hoechst, and subsequently digested with either exonuclease III or S1 nuclease. Pretreatment alone was not sufficient to induce sister chromatid differential staining (SCD), but allowed subsequent digestion with exonuclease III or S1. Such enzymes were found to induce SCD with ethidium bromide, as unifilarly BrdUrd-substituted chromatids (TB) were more resistant than bifilarly substituted chromatids (BB). Other experiments with DNase I or the AluI and HaeIII restriction endonucleases showed that only HaeIII was capable of inducing SCD by attacking BB more than TB chromatids preincubated with UV in the presence of Hoechst. SCD with exonuclease III/S1 nuclease seems to be due to (1) UV-induced DNA debromination occurring twice in BB as opposed to TB chromatids, and (2) alteration of chromatin protein structure occurring to a different extent in differently BrdUrd-substituted chromatids. Our findings with endonucleases, on the contrary, may depend on the capacity of enzymatic cleavage to cancel the different protein alterations induced differentially by UV in TB as opposed to BB chromatids. PMID- 2707105 TI - Indirect mitotic nondisjunction in Vicia faba and Chinese hamster cells. AB - The hypothesis of indirect mitotic nondisjunction was tested in plant and mammalian cells. This hypothesis states that micronuclei derived from lagging chromosomes or chromatids are able to perform DNA synthesis and undergo mitotic condensation synchronously with main nuclei. Hence, as chromosomes, they can be moved to spindle poles together with the chromosomes of the main nuclei during mitosis. In that way chromosomes "lost" as micronuclei can be reincorporated in the main nuclei. In order to test this, both Vicia faba meristematic cells and cells of a Chinese hamster line (Cl-1) were treated with low doses of colchicine. Mitotic anomalies, micronuclei and cells with a polyploid or aneuploid karyotype were scored at different fixation times. A detailed analysis was performed on single chromosome misdistributions, as well as on micronuclei and cells with aneuploid karyotypes derived from single chromosome misdistributions. Indirect mitotic nondisjunction was shown to play a primary role in the origin of aneuploid karyotypes in Vicia faba, but not in Cl-1 cells. PMID- 2707106 TI - Development of resistance in calves to nymphs of Rhipicephalus appendiculatus (Acarina:Ixodidae) during test feeds. AB - A test of host resistance to infestation by the tick Rhipicephalus appendiculatus was repeated 5 times, at weekly intervals, on 2 initially susceptible calves. One hundred nymphs (NN) were used each time. Pairs of tick-susceptible rabbits served as controls. The engorged NN were weighed, then allowed to moult individually, and the sex of each was noted after emergence of the adult. During the course of the experiment there was a significant reduction in mean engorged weight (especially in the pre-male NN) and also in the length of the feeding period, and a downward trend in the percentage of NN which engorged. There was a significant increase in the percentage of engorged NN that moulted. Pre-male NN were significantly heavier than pre-female NN after feeding on susceptible hosts, but though mean feeding times were the same, they took 1-2 days longer to moult than pre-females at 28 degrees C. It was concluded that the test itself could induce resistance if applied to fully susceptible calves. PMID- 2707107 TI - Toxicology and metabolism of isomers of flumethrin in larvae of pyrethroid susceptible and resistant strains of the cattle tick Boophilus microplus (Acari: Ixodidae). PMID- 2707108 TI - Evaluation of the eradication program for Amblyomma variegatum (Acari:Ixodidae) on Puerto Rico. AB - A cooperative effort between the United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, the Agricultural Research Service, and the Department of Agriculture, Commonwealth Government of Puerto Rico has been successful in eradicating Amblyomma variegatum (Fabricius) from the islands of Puerto Rico and Vieques (an island municipality of Puerto Rico). Application of acaricides to livestock and dogs at 14-day intervals for an 18-month period eliminated foci of tick infestation on 188 farms in four different locations without additional aerial or ground treatment. Reasons for the success and some of the costs associated with the eradication program on Puerto Rico are presented. PMID- 2707109 TI - Distribution of some anystid mites (Acari: Anystidae) in Australia and Indonesia and their role as possible predators of the cattle tick, Boophilus microplus (Acari: Ixodidae). AB - The geographic and habitat distributions of Anystis baccarum, A. jabanica, A. salicinus, and A. sp. B Walzia australica Womersley and Chaussieria warregense in Australia and parts of Indonesia are presented. Laboratory trials showed that A. baccarum will feed upon the larvae of the cattle tick Boophilus microplus, whilst A. jabanica also showed some predatory potential. Walzia australica and C. warregense had no effect on survival of tick larvae. PMID- 2707110 TI - Development rates, fecundity and survival of developmental stages of the ticks Rhipicephalus appendiculatus, Boophilus decoloratus and B. microplus under field conditions in Zimbabwe. AB - To determine development rates, fecundity and survival of Rhipicephalus appendiculatus, Boophilus decoloratus and B. microplus, a study was carried out in long and short grass in the highveld of Zimbabwe. Engorged adult females of the three species and engorged larvae and nymphs of R. appendiculatus were buried beneath the soil in small cages in the rainy, cool and hot seasons in 1980 and 1981. Half the number of cages were examined regularly to determine development rates and half were left undisturbed to determine survival rates and the fecundity of engorged females. Development was most rapid during warm conditions and slowest during cool conditions, but high temperatures appeared to prolong the preoviposition periods of all species. The relationship between fluctuating temperatures and rate of development in the field was defined using a least squares procedure. Survival of engorged females was usually high, but was reduced by predation when they were not protected. Fecundity was reduced in long grass during the cool season and in short grass during the hot season. A higher percentage of eggs hatched in the rainy season than in the cool or dry seasons. The survival of engorged larvae and nymphs was usually high in all seasons. Engorged nymphs were the hardiest stage and eggs the most suceptible stage to adverse microclimatic conditions. PMID- 2707111 TI - Fine structure of the developing oocytes in adult Argas (Persicargas) arboreus (Ixodoidea: Argasidae). AB - The structure of the developing oocytes in the ovary of unfed and fed female Argas (Persicargas) arboreus is described as seen by scanning (SEM) and transmission (TEM) electron microscopy. The unfed female ovary contains small oocytes protruding onto the surface and its epithelium consists of interstitial cells, oogonia and young oocytes. Feeding initiates oocyte growth through the previtellogenic and vitellogenic phases of development. These phases can be observed by SEM in the same ovary. The surface of isolated, growing oocytes is covered by microvilli which closely contact the basal lamina investing the ovarian epithelium and contains a shallow, circular area with cytoplasmic projections and a deep pit, or micropyle, at the epithelium side. In more advanced oocytes the shell is deposited between microvilli and later completely covers the surface. Transmission EM of growing oocytes in the previtellogenic phase reveals nuclear and nucleolar activity in the emission of dense granules passing into the cytoplasm and the formation of surface microvilli. The cell cytoplasm is rich in free ribosomes and polysomes and contains several dictyosomes associated with dense vesicles and mitochondria which undergo morphogenic changes as growth proceeds. Membrane-limited multivesiculate bodies, probably originating from modified mitochondria, dictyosomes and ribosomal aggregates, are also observed. Rough endoplasmic reticulum is in the form of annulate lamellae. During vitellogenesis, proteinaceous yolk bodies are formed by both endogenous and exogenous sources. The former is involved in the formation of multivesicular bodies which become primary yolk bodies, whereas the latter process involves internalization from the haemolymph through micropinocytosis in pits, vesicles and reservoirs. These fuse with the primary yolk bodies forming large yolk spheres. Glycogen and lipid inclusions are found in the cytoplasm between the yolk spheres. PMID- 2707112 TI - Effect of blood meal and mating on the genital tract ultrastructure in the female camel tick Hyalomma (Hyalomma) dromedarii (Ixodoidea: Ixodidae). AB - The genital tract ultrastructure in the female Hyalomma (Hyalomma) dromedarii is described during feeding and mating and up to oviposition. The vagina, consisting of vestibular (VV) and cervical (CV) regions, is formed of an epithelium lined internally with a folded cuticular layer and surrounded externally by muscle layers. These facilitate the passage of endospermatophores containing sperm into the receptaculum seminis (RS), and ova to the exterior. A pair of tubular accessory glands (AG) opening at the junction of VV and CV consist of an epithelial layer of undifferentiated cells. As feeding progresses, these cells synthesise their granular secretion which lubricates the egg surface during its passage through VV. The RS, opening anteriorly into the CV, consists of cuboidal cells lined with a thin cuticular layer. These cells become rich in glycogen and lipid vacuoles, possibly acting as a source of energy for various cell activities including granule synthesis and exocytosis. The granules discharge their contents into intercellular spaces distributed throughout the RS wall and communicate with the main lumen via narrow channels. The cell secretion may dissolve the endospermatophore wall to release sperm, while their lysosome-like structures may function in the breakdown of endospermatophoric material taken up by pinocytosis. The connecting tube (CT) opens into the CV anterodorsally and leads into the common oviduct (COV) posteriorly. It consists of an epithelium lined by a closely adhering cuticular layer, giving the tube lumen the appearance of an undulate labyrinth with a complicated configuration. No secretory activity in the CT has been observed before, during, or after feeding. The paired, non-cuticular oviducts, extending from the ovary and fusing anteriorly to form COV, consist of an epithelium poor in cell organelles. At the final stages of feeding the cell cytoplasm contains large, phagosomal vacuoles penetrated by sperms, in addition to micropinocytotic vesicles which serve to break down the seminal fluid and other materials. The basal membrane is infolded giving characteristic features, which increase dramatically during oviposition, of epithelia involved in ion and water transport. The oviducal secretion may function as a tanning agent to harden the egg-shell and may also act as a lubricant for egg passage. PMID- 2707113 TI - Importance of cardiovascular autonomic dysfunction in IDDM subjects with diabetic nephropathy. AB - Diabetic nephropathy (DNP) is associated with increased cardiovascular mortality. This may be contributed to by associated cardiovascular autonomic dysfunction (CAD). The aim of this study was to investigate the prevalence of CAD in patients with insulin-dependent diabetes mellitus (IDDM) at different stages of DNP. We studied patients with incipient DNP (group 1, n = 10), overt DNP (group 2, n = 20), renal insufficiency (group 3, n = 27), and end-stage renal failure (group 4, n = 12) and compared them with 30 IDDM patients without clinical signs of DNP (group 5) and with 17 nondiabetic controls (group 6). All groups were matched for age and diabetic groups were matched for duration of diabetes. Assessments of CAD included beat-to-beat variation during forced respiration, heart-rate response to standing, heart-rate response to Valsalva maneuver, basal heart rate, and blood pressure response to standing. Clinical evaluation included assessment of the history and an examination for peripheral polyneuropathy. We found mean impairment of heart-rate variation during respiration, in response to Valsalva maneuver, and in heart-rate response to standing in all diabetic groups compared with nondiabetic controls (P less than .01). Heart-rate responses differed significantly between patients with renal insufficiency (groups 3 and 4) and with other patient groups (group 5; P less than .01). CAD was shown to be more prevalent in patients with DNP, more so as DNP progresses. To some extent, it is already present in the early stages of DNP. CAD may be a contributory factor for increased cardiovascular mortality in patients with DNP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707114 TI - Measuring diabetic neuropathy. Assessment and comparison of clinical examination and quantitative sensory testing. AB - The need for a standardized and valid means of assessing diabetic neuropathy has been increasingly recognized. To identify potential components of such an assessment, interobserver variation (neurologist and internist) of a standard neurologic examination and the comparability of this examination with vibratory and thermal sensitivity testing was studied. The study population comprised the first 100 participants in a neuropathy substudy of 25- to 34-yr-old subjects with insulin-dependent diabetes mellitus taking part in a cohort follow-up study. Symptoms of dysesthesias, paresthesias, and burning, aching, or stabbing pain revealed good interobserver agreement. Signs of neuropathy, more prevalent in the great toe than index finger, showed poor interobserver agreement for vibration, but fair interobserver agreement for touch and pinprick. Mean quantitative sensory thresholds differed significantly by clinical category of abnormal vibratory and pinprick sensations. Threshold testing showed twice the prevalence of abnormality compared with clinical examination. It is concluded that components of the clinical examination can be identified that, along with quantitative sensory-threshold testing, may provide a satisfactory core assessment for use both in epidemiologic studies and incorporation into more in depth protocols required for clinical research and practice. The clinical relevance of the greater prevalence of abnormalities on threshold testing will be established by long-term follow-up. PMID- 2707116 TI - Diabetes in American Indians of Washington, Oregon, and Idaho. AB - The prevalence of diabetes among 29,000 American Indians living on or near 10 reservations in the Pacific Northwest was established from clinical data sources. The age- and sex-adjusted prevalence rate in 1987 was three times higher [95% confidence interval (CI) 2.8-3.1] than the comparable United States rate in 1980. The age-adjusted prevalence for women was 1.3 times that for men (95% CI 1.2 1.4). The prevalence varied by culture area. Reservation communities whose principal tribe came from the Great Basin culture area had 3.6 times more diabetes than found in the U.S. as a whole. Reservation communities whose principal tribe was from the Plateau culture had 3.0 times more diabetes than found in the U.S., and those from the Northwest Coast culture had 1.9 times more diabetes than found in the U.S. The reasons for these variations are unknown and warrant investigation. PMID- 2707115 TI - Elevated plasma glucose and lowered triglyceride levels from omega-3 fatty acid supplementation in type II diabetes. AB - We studied the effect of omega-3 fatty acids (omega 3FA) on glucose homeostasis and lipoprotein levels in eight type II (non-insulin-dependent)-diabetic subjects ingesting 8 g/day omega 3FA for 8 wk as marine-lipid concentrate capsules. After omega 3FA supplementation, fasting plasma glucose levels increased 22% (P = .005) and meal-stimulated glucose increased 35% (P = .036). The percentage of glucose elevation correlated with percentage ideal body weight (r = .73, P = .04). No significant changes were seen in fasting or meal-stimulated plasma insulin, glucose disposal, or insulin-to-glucagon ratios. Very-low-density lipoprotein cholesterol and triglyceride (TG) levels showed consistent reductions of 56% (P less than .001) and 42% (P less than .001), respectively, after omega 3FA supplementation. Total cholesterol levels decreased 7% (P less than .05) without alteration in low- or high-density lipoprotein cholesterol. Thus, omega 3FA supplementation at a dose of 8 g/day significantly improves plasma TG levels but increases fasting and meal-stimulated glucose concentrations in the type II diabetic patient not treated with insulin or sulfonylurea agents. Marine-lipid concentrate capsules supplying large amounts of omega 3FAs should be used cautiously in the type II diabetic patient. PMID- 2707117 TI - Hyperglycemic effect of sucrose ingestion in IDDM patients controlled by artificial pancreas. AB - The hyperglycemic effect of 28 g sucrose, taken during a mixed meal, was studied in six insulin-dependent diabetes mellitus (IDDM) patients controlled by artificial pancreas. On 2 consecutive days the patients were given, in random order, two Italian meals containing macaroni, bread, meat, vegetables, fruit, olive oil, and an eggnog made with sucrose (meal A) or saccharin (meal B). The two meals were isocaloric and contained equal amounts of carbohydrates. The feedback control on blood glucose continued for 180 min after the meals. Plasma glucose levels and insulin infusion rates delivered by the artificial pancreas after the two test meals did not show any significant differences regarding basal and peak values, peak times, and areas under the curves. A modest amount of sucrose, taken during a mixed meal, does not produce a hyperglycemic effect higher than an equal amount of complex carbohydrates in IDDM patients controlled by artificial pancreas. The same may be expected in well-controlled IDDM patients in conventional therapy because a correlation exists between insulin requirement for conventional therapy and insulin delivered during glucose-controlled insulin infusion. PMID- 2707118 TI - Accuracy of nurses in performing capillary blood glucose monitoring. AB - The accuracy and outcome of capillary blood glucose (CBG) monitoring as routinely performed by nursing staff were assessed. The sample consisted of 160 readings conducted by 93 nursing staff members in four hospitals; 19% of the readings deviated from simultaneous laboratory results by greater than 20%, and deviations resulted in altered responses to standing orders in 26 patients (17%). There was no statistically significant difference between the total variation attributed within and between nurses, possibly indicating that all nurses should be given the same intensity of follow-up training rather than targeting those who perform incorrectly on sample tests. Nurses in the one hospital that required certification before CBG monitoring had significantly less deviation from the laboratory standard than the other three hospitals. Although these data do not provide direct evidence that the certification program increased accuracy, this seems a logical conclusion. More study is needed to determine the most cost effective type of training and follow-up. PMID- 2707119 TI - Ultrasonic measurement of forearm subcutaneous adipose tissue thickness suitable for monitoring of subcutaneous glucose concentration? PMID- 2707120 TI - DNA sequence of the Pasteurella haemolytica leukotoxin gene cluster. AB - Bovine serum was used to identify a recombinant phage clone carrying the Pasteurella haemolytica leukotoxin gene. This fragment produced the 102-kD leukotoxin and several smaller P. haemolytica-specific protein antigens in Escherichia coli. An additional contiguous fragment, containing sequences upstream from the leukotoxin gene. Using these clones, we determined the nucleotide sequence of a 7745-bp region that included four open reading frames: an upstream gene, lktC; the leukotoxin gene, lktA; and two downstream genes, lktB, and lktD. The predicted molecular weights of the proteins encoded by these genes were 19.9, 102, 79.6, and 54.7 kD, respectively. These genes and their predicted proteins were similar in organization and in sequence to the corresponding elements of the gene cluster that encodes an E. coli alpha hemolysin and its activation and secretion functions. Expression of the leukotoxin was enhanced in E. coli, by fusing the gene to the lac promoter. Under these conditions the leukotoxin was not secreted into the medium, as it is in P. haemolytica. However, in the presence of the alpha-hemolysin genes, the leukotoxin was secreted into the medium, demonstrating functional complementation by the hemolysin secretory system. PMID- 2707121 TI - Hepatic expression of rat P450 mRNA assessed by in situ hybridization to oligomer probes. AB - Cell-specific chemical toxicities may be influenced by P450-catalyzed biotransformation reactions. We have undertaken an analysis of P450 expression in isolated rat liver sections to assess better the cellular distribution of P450 gene products. Discriminatory 18-mer oligodeoxynucleotides directed to the phenobarbital (PB) inducible P450s, P450IIB1 (P450b) and P450IIB2 (P450e), were employed as probes for in situ hybridization experiments. With these techniques we demonstrate that P450b and P450e mRNAs are each expressed in the hepatic lobule with similar spatial distribution. In animals pretreated with PB, only cells within the immediate periportal region were refractory to induction. Based on autoradiographic grain densities, responsive hepatocytes accumulated P450b mRNA at levels exceeding that for P450e. We employed in situ hybridization methodology in combination with Northern blot analyses to compare the expression of these mRNAs in two rat strains, Sprague-Dawley and Marshall 520/N (the latter being deficient in the synthesis of P450e isozyme; Rampersaud and Walz, 1987). These strains provided valuable comparative models, demonstrating the specificity and sensitivity of the oligomer probes. The continued development of in situ hybridization methodologies, especially when used in conjunction with synthetic oligomer probes, will permit a detailed analysis of P450 expression in different tissues, under a variety of chemical exposures, and may be a valuable adjuvant to the prediction of target organ toxicities. PMID- 2707122 TI - Identification and developmental expression of a novel embryonic myosin heavy chain gene in chicken. AB - The developmental expression of an embryonic chicken myosin heavy-chain (MHC) gene homologous to the genomic clone pCM4.1 was examined by S1 analysis. Transcripts homologous to pCM4.1 are first detected at day 12 in ovo, and are maximally expressed between days 15-17 in ovo. No pCM4.1 transcripts are detected at earlier stages of embryogenesis or at high levels in posthatch stages. This unique pattern of expression has led to the proposal that pCM4.1 represents a previously uncharacterized MHC gene, which is confined in its expression to late embryogenesis. Genomic hybridization data, in addition to a comparison between the DNA and amino acid sequences of pCM4.1 and other characterized chicken MHC 3' end clones, provide further evidence for this proposal. We also present observations made during the sequence analysis of pCM4.1 that may be relevant to our understanding of the 3'-end processing of homologous primary transcripts, and of the mechanism controlling developmental MHC isoform transitions. PMID- 2707123 TI - An efficiently transcribed human tRNA(Val) gene variant produces a stable pre tRNA: repair of the processing defect by in vitro mutations. AB - A tRNA(CACVal) gene variant, pHtV4, was cloned from human placenta genomic DNA. This gene differs from a closely related, functional tRNA(CACVal) gene by four base exchanges: T residues in place of C25, C62, and C66 create G:U pairs, and an A instead of G65 creates an A:C mismatch in the corresponding RNA transcript. The tRNA(Val) gene variant in pHtV4 is efficiently transcribed in HeLa cell nuclear extracts; however, the resulting pre-tRNA is processing-deficient, i.e., neither its 5'- nor its 3'-flanking sequences are removed to generate mature tRNA. Reversion of all four point mutations in pHtV4 by oligonucleotide-directed mutagenesis yielded a functional tRNA(CACVal) gene within the flanks of pHtV4, the pre-tRNA of which was processed to mature tRNA. Construction of a chimeric tRNA(Val) gene and site-directed mutagenesis of the tRNA(Val) gene in pHtV4, respectively, followed by transcription and processing studies showed that each of the four mutations contributes to the processing defect of the pHtV4-derived pre-tRNA. Moreover, this revealed that G:U pairs, which are common in all tRNAs, can impair pre-tRNA processing and therefore do not occur in certain positions in eukaryotic tRNAs. PMID- 2707124 TI - [Epidemiology and therapy of Campylobacter pylori infection]. AB - The prevalence of Campylobacter pylori in gastric mucosa was investigated prospectively (by histology, cytology, bacterial culture and urease rapid-test) in 302 patients of a routine gastroenterological endoscopy programme. According to the histopathological findings the following prevalence of C. pylori was established: 3 of 35 normals (9%); 116 of 167 with antral gastritis (69%), 28 of 40 with gastric ulcers (70%); 26 of 33 with duodenal ulcers (79%); 5 of 27 with other conditions (19%). The activity degree of the gastritis correlated closely with the presence of C. pylori. In a prospective open trial 110 patients with antral gastritis or gastroduodenal ulcer were treated according to the following schedule: (a) bismuth subsalicylate, 1800 mg/d for four weeks (35 patients); (b) amoxycillin 2250 mg/d for two weeks (6); (c) ranitidine 300 mg/d for four weeks (26); (d) bismuth plus amoxycillin (20); (e) bismuth plus ranitidine (23). Immediately after the end of treatment and four weeks later the elimination rates were: (a) bismuth 51% (18) and 23% (8), respectively; (b) amoxycillin 50% (3) and 17% (1); (c) ranitidine 0% (0); (d) bismuth plus amoxycillin 60% (12) and 25% (5); (e) bismuth plus ranitidine 43% (10) and 17% (4). These data indicate that treatment with bismuth plus amoxycillin will achieve a negative bacterial result in about half the patients. But frequently as early as four weeks later C. pylori can again be demonstrated, so that the long-term elimination rate is only 15-30%. PMID- 2707125 TI - [The duty to inform of the seller of a medical practice. The judgement of the Federal Republic's Court of Justice of 13 July 1988]. PMID- 2707126 TI - [Sepsis due to Propionibacterium acnes?]. PMID- 2707127 TI - [Neuroleptic malignant syndrome]. PMID- 2707128 TI - [Fatal shock following metamizole]. PMID- 2707129 TI - [Carcinoid tumor of the liver]. AB - Multiple primary hepatic carcinoid tumours of the liver was a chance finding at autopsy of an 81-year-old woman. There had been no signs of this or any other paraneoplastic syndrome in life. The tumour had a characteristic solid-alveolar structure (type A of Soga) with only a few atypical cells. Neuron-specific enolase and chromogranin were demonstrated immunohistologically in almost all tumour cells, but S-100 protein, human choriogonadotropin and serotonin in only a few. Peptides and alpha-fetoprotein, however, could not be demonstrated in the tumours. Electronmicroscopy revealed secretory granules of variable size and density in the cytoplasm of the tumour cells. PMID- 2707130 TI - [Ulcero-mutilating acro-osteopathy in hereditary neuropathies. Differential diagnosis and pathogenesis]. AB - Two patients, aged 51 and 70 years, had indolent ulcerations at the sole of the foot with destructive osteolysis in the bones of the feet, lesions characteristic of mutilating ulcerative acro-osteopathy. Patient 1, who had pes cavus, developed ulcerations on the balls of the feet along the second metatarsal bones, and patient 2 with pes equinovarus developed ulcers in the area of the calcaneus. Sock-like hypesthesia/hypalgesia from the toes to the ankles was present in both patients, and electrophysiological tests confirmed the presence of axonal sensory motor neuropathy. Diabetes mellitus and alcohol abuse was excluded in both patient. Clinical findings, history and neurological disturbances in both patients identified the disease as hereditary sensory neuropathy (type I). PMID- 2707131 TI - [Calculation of salary of affiliated hospital physicians]. PMID- 2707132 TI - [Ventricular fibrillation and electric defibrillation]. PMID- 2707133 TI - [Implantable catheter systems. Experience with 205 patients]. AB - In a five-year period (1983-1988) catheters were implanted in 205 patients (118 venous, 31 peritoneal, 29 arterial, 25 epidural and 2 pleural), using the same system (Port-a-Cath). Total implant duration was 88,345 patient days (242 patient years). On average there was one catheter complication per 2000 patients days. The only catheter-system infections occurred with peritoneal catheters. This relatively low complication rate was probably due to the use of only one system, a uniform implantation technique practised by only three surgeons, and strict postoperative supervision by the oncology nursing team. PMID- 2707134 TI - [Replacement of aluminum-containing phosphate binders by calcium and magnesium carbonates in long-term hemodialysis]. AB - Aluminium-containing phosphate binders were replaced by a calcium and magnesium carbonate-containing antacid in 20 patients on long-term haemodialysis, over a three-month period in all of them, for 12 months in ten. After two months the serum aluminium level fell (mean +/- SD) from 3.0 +/- 1.6 to 1.4 +/- 0.5 mumol/l (P less than 0.001). After three months the serum phosphate level had fallen from 1.8 +/- 0.4 to 1.5 +/- 0.4 mumol/l (P less than 0.05), while during the same period parathormone (PTH-NH2) fell from 1.4 +/- 1.4 to 0.8 +/- 0.7 ng/ml (P less than 0.05). Serum total calcium concentration rose after two months from 2.2 +/- 0.2 to 2.4 +/- 0.2 mmol/l (P less than 0.001). In a third of patients the uraemic acidosis was corrected, standard bicarbonate rising from 18 +/- 2 to 21 +/- 3 mmol/l (P less than 0.05). Serum pH, potassium, sodium, magnesium and alkaline phosphatase did not change significantly. Hypercalcaemia was an expected disadvantage: repeated symptom-free episodes of hypercalcaemia occurred in six of 20 patients during the first three months and in a further two up to 12 months. These episodes were successfully controlled by a reduction of CaCO3/MgCO3 dosage and readministration of Al(OH)3. Extraosseous calcifications were not observed. PMID- 2707135 TI - [Familial Mediterranean fever in a German family]. AB - A 14-year-old German boy had the characteristic signs and symptoms of familial mediterranean fever with recurrent attacks of fever which ran a uniform course and were self-limiting. Laparoscopy revealed sterile peritonitis and marked humoral inflammatory signs. Each acute phase was confined to three days, alternating with symptom-free intervals which lasted for as long as several months. The boy's father and three other members of the paternal family have had similar disease symptoms. Even in patients who are not members of a predisposed ethnic group familial mediterranean fever should be included in the differential diagnosis as a rare cause of recurrent episodes of fever of unknown aetiology. PMID- 2707136 TI - [Therapy of subarachnoid hemorrhage]. PMID- 2707137 TI - [Renoparenchymal hypertension]. PMID- 2707138 TI - Risk factors in geriatric drug prescribing. A practical guide to avoiding problems. AB - Although the use of medication has helped to cure and control disease, it has also led to serious iatrogenic illness. Toxicity is most common and severe in the elderly. Confusion, falls, depression, sedation, deterioration of function, and urinary incontinence and retention are frequently the manifestation of that toxicity. Normal ageing places older patients at risk because of changes in metabolism, distribution, and excretion of drugs, and sensitivity to drug effects is often greater in the elderly. Disease and the interactions of other drugs can increase the incidence and severity of side effects. Certain drugs should be avoided in the elderly. Those that are long acting and require hepatic metabolism, those with strong anticholinergic properties, and those that are highly sedating tend to cause the most problems. In every case, physicians must weigh the potential benefit of prescribing against the potential risk. PMID- 2707139 TI - Variability in electromyographic surface recordings of the human masseter muscle. AB - Serial registrations of integrated unilateral surface masseter EMG were performed in eight healthy subjects in the rest position, during controlled gentle biting and during maximal clenching at five different sessions in order to analyse the variability. The recording conditions were standardised. The EMG activity for the group did not differ significantly between the sessions at any level but individual variations were great in the rest position both within and between days. Good consistency was found at controlled force levels. Temporally stable measurements of masseter activity which permit quantitative comparisons thus seem possible. PMID- 2707140 TI - The impact of paired motor unit discharges on tremor. AB - We studied paired discharges (PDs) of single motor units (MUs) of the first dorsal interosseus muscle in parkinsonian and essential tremor. The number of PDs increased with increasing tremor strength and the duration of their intervals shortened. The amplitudes of the single tremor beats showed a significant negative correlation to the duration of the intervals of the preceding PDs. It is concluded that PDs play an important role as tremor amplifiers. The basic mechanism is probably the more than linear summation of two twitch contractions with short interval which is known from animal experiments. PMID- 2707141 TI - Electromyographic study of the trapezius (pars superior) and serratus anterior (pars inferior) muscles in free movements of the shoulder. AB - The trapezius (pars superior) and serratus anterior (pars inferior) muscles were analyzed in 25 adult volunteers from both sexes with a 2-channel TECA TE4 electromyograph with single coaxial needle electrodes. It was observed that in elevation and lowering of the shoulders, the trapezius shows preponderant activity. During retraction, both muscles are inactive, and during protraction, only the serratus anterior is inactive. PMID- 2707142 TI - Trigemino-cervical reflex in pathology of the brain stem and of the first cervical cord segments. AB - The trigemino-cervical reflex (CR) sensitivity and specificity in the assessment of cervico-bulbar lesions was evaluated in eleven selected subjects (4 multiple sclerosis, 3 tumoural processes and 4 cervical cord spondilogenetic myelopathies). Results were compared with those obtained from others neurophysiological investigations (EMG and blink-reflex) and with neuroimaging findings. Significant abnormal responses of CR were found in all patients varying from absent responses, to delayed or reduced amplitude patterns. These data stress the utility of CR in the check of cervico-bulbar lesions, where it can be considered complementary to other electrophysiological tests. PMID- 2707143 TI - Motoneurone recurrent inhibition is enhanced by L-acetylcarnitine in humans. AB - Renshaw cells, which mediate the recurrent inhibition of spinal a-motoneurones, are activated by acetylcholine, both through motoneurone collaterals and the reticulo-spinal system. Since it is known that L-acetylcarnitine (L-AC) has central cholinergic effects, we tested in ten normal subjects and three spastic patients the ability of L-AC to induce changes in excitability of the Renshaw cells. These were activated by a conditioning monosynaptic reflex of the soleus muscle, evoked by electrical stimulation of the tibial nerve, and the resulting recurrent inhibition of the motoneurones was assessed by a subsequent monosynaptic reflex (H'). Recurrent inhibition was tested prior to, during and after an intravenous administration of a solution containing 2000 mg of L-AC. L AC administration proved to be able to induce in all subjects a decrease in the H'-reflex. This effect ensued approximately 30 min after onset of L-AC administration, reached the peak after 40 min and vanished in about one hour. The extent of the decrease in H' varied among subjects, being on the average 22% of the control values. A relationship was found between duration of L-AC administration and time for reaching the maximal effect. These results show that L-AC is able to decrease a-motoneurone excitability by increasing Renshaw cell activity, both in normal and spastic subjects. PMID- 2707144 TI - Digital filtering of EMG-signals. AB - Even under field conditions the registration of EMG-signals is often interfered with artifacts. For quantitative signal processing it is necessary to eliminate artifacts and noise from the EMG raw data. We show a simple and efficient way with the help of a recursive digital first order Butterworth filter. This filter type has a great slope steepness and requires minimal calculations. The algorithm is derived and easily programmable. PMID- 2707145 TI - Effect of N-REM sleep on the cortical SEPs in early life. AB - Cortical and cervical somatosensory evoked potentials (SEPs) were studied by the averaging method in twenty healthy children, aged 20 days to 3 years. The stimulus was applied to the median nerve at the wrist and SEPs were recorded by electrodes placed on to the contralateral parietal scalp region as well as over the skin at the C6-7 vertebral region. The reference electrode was placed at the Fz. All subjects were studied during the awake state as well as during the N-REM sleep. The results indicate that N-REM sleep influenced the latency and the duration of SEPs, especially in children aged less than one year. This finding probably reflects a variable rate of maturation of the somatosensory pathway. The state of wakefulness must therefore be taken into account when assessing the pathological relevance of SEP recording in young children. PMID- 2707146 TI - Modified impulse diminishes discomfort of transcranial electrical stimulation of the motor cortex. AB - Transcranial electrical stimulation of the motor cortex has been developed in 1980 for electrophysiological assessment of the descending pathways. However, the widespread use of this procedure is limited by its painfulness due to simultaneous excitation of the sensory receptors and muscles of the scalp, especially if higher stimulus strengths are necessary in patients with motor deficits to evoke electromyographic responses. The present invention concerns a device which allows modification of the impulse delivered by a commercially available motor stimulator. By interruption on the exponentially decreasing impulse, "cutting" it after a freely selectable time by a low resistant short circuit on the patient's side, discomfort due to excitation of the sensory receptors and muscles of the scalp can be diminished with identical electromyographic responses regarded amplitudes and latencies of the potentials, thus making electrical stimulation less painful. Considering the applied charges we found a marked reduction of charge per phase using the modified impulse as compared to the original one with the difference increasing linearily depended on the preselected voltage. PMID- 2707147 TI - Electrophysiologic evaluation of Emery-Dreifuss muscular dystrophy. A single fiber and quantitative EMG study. AB - A 16-year-old boy, the only affected member of the family, noticed early onset contracture of the elbows, and developed slowly progressive humeroperoneal weakness and atrophy, and bilateral equinus. The severe restriction of the forward flexion of the neck and thoracolumbar spine, resembled a rigid spine syndrome. An electrocardiogram showed atrioventricular conduction abnormalities. Muscle biopsy was consistent with mild myopathy. The overall conventional findings of a detailed electromyographic study in the limbs and erector trunci muscles, as well as the results of conduction velocity, automatic analysis of the voluntary pattern and single fiber electromyography studies were consistent with myopathy, although some atypical findings were found. The controversy about neurogenic and myopathic features in Emery-Dreifuss disease is discussed. The unspecific value of the flexion limitation of the spine, and the uncertain nosological position of the rigid spine syndrome are also commented. PMID- 2707148 TI - Retinoic acid selectively stimulates growth hormone secretion and messenger ribonucleic acid levels in rat pituitary cells. AB - Hydrocortisone (HCT) is known to stimulate rat GH gene expression. As the retinoic acid receptor cDNA bears a 15% homology to the hydrocortisone receptor cDNA, the effects of retinoic acid were tested in GH3 rat pituitary cells. Retinoic acid selectively stimulated GH secretion after 24 h. Maximal induction of basal GH secretion (220% of controls) was achieved with 1 microM retinoic acid after 72 h. HCT (50 nM) alone stimulated GH secretion 3.5-fold during 72-h incubation, and retinoic acid (1 microM) with HCT caused a further 7-fold increase in GH secretion. The stimulating effects of retinoic acid on GH were observed when cells were incubated in defined serum-free medium, 4% fetal calf serum, or Dulbecco's Modified Eagle's Medium containing HCT. Northern gel hybridization showed that steady state levels of GH mRNA transcripts in these cells were also selectively induced by retinoic acid. PRL secretion and mRNA levels, however, were not appreciably altered by retinoic acid. The results show that retinoic acid selectively stimulates basal and HCT-induced GH secretion and mRNA levels in these cells in a dose- and time-dependent manner. This selective action of retinoic acid appears to occur independently of the presence of serum in the culture medium. PMID- 2707149 TI - Trenbolone alters the responsiveness of skeletal muscle satellite cells to fibroblast growth factor and insulin-like growth factor I. AB - The potential role of satellite cells in mediating the effect of trenbolone [17 beta-hydroxyestra-4,9-11-trien-3-one (TBOH)] on skeletal muscle hypertrophy was examined. Young female Sprague-Dawley rats received TBOH injections daily for 2 weeks; growth, body composition, and the composition of selected muscles were assessed. Treated rats grew more rapidly and deposited less body lipid and more protein. The semimembranosus muscle from treated rats was larger and had approximately 60% more DNA per muscle than muscles from control rats. The addition of trenbolone directly to the medium of cultured satellite cells did not stimulate cell proliferation, nor did it augment the stimulatory response of these cells to fibroblast growth factor (FGF) or insulin-like growth factor I (IGF-I). In contrast, satellite cells cultured from TBOH-treated rats exhibited greater proliferative responses to FGF and IGF-I than satellite cells from control rats. In addition, serum from TBOH-treated rats stimulated greater cell proliferation in satellite cell cultures than serum from control rats. These experiments suggest that one possible mechanism responsible for the ability of TBOH to stimulate skeletal muscle hypertrophy may be through enhanced proliferation and differentiation of satellite cells as a result of the increased sensitivity of these cells to IGF-I and FGF. PMID- 2707150 TI - Regulation of renal 25-hydroxyvitamin D-1-hydroxylase activity in the mouse after uninephrectomy. AB - Although renal hypertrophy occurs rapidly after uninephrectomy, restoring the majority of renal excretory function, it remains unknown whether similar compensatory mechanisms maintain 1,25-dihydroxyvitamin D production (and calcium homeostasis). To address this issue we compared plasma calcitriol levels and renal 25-hydroxyvitamin D (25OHD)-1-alpha-hydroxylase activity (in remnant kidneys) of mice at various times after uninephrectomy to similar observations obtained in sham-operated age- and sex-matched controls. At all times postoperatively, the uninephrectomized mice sustained plasma 1,25 dihydroxyvitamin D levels no different from those of shams. Maintenance of calcitriol production occurred secondary to a significant increment of renal 25OHD-1 alpha-hydroxylase activity (per mg DNA) 1-3 days after surgery when renal mass/function remained markedly depressed. In contrast, 10 and 21 days postoperatively, when hypertrophy was complete, enhanced enzyme function was no longer apparent. Throughout this period a significant inverse linear correlation existed between renal 25OHD-1 alpha-hydroxylase and the renal mass as well as glomerular filtration rate and renal blood flow. The variance in enzyme activity resulted in maintenance of a stable renal 25OHD-1 alpha-hydroxylase (per animal or total kidney mass) at all times investigated postuninephrectomy. Such compensatory regulation of vitamin D metabolism after unilateral kidney extirpation may be an important factor contributing to the low morbidity/mortality in the renal donor. PMID- 2707151 TI - Effects of progesterone on pulsatile luteinizing hormone (LH) secretion and LH subunit messenger ribonucleic acid during lactation in the rat. AB - In ovarian-intact lactating rats, removal of the suckling stimulus leads to restoration of pituitary LH beta mRNA levels and pulsatile LH secretion after 72 h, which correlates with a sharp decrease in plasma progesterone concentrations to basal levels. In contrast, in ovariectomized lactating rats, the increase in pituitary LH function is observed by 24 h after pup removal. To determine if progesterone secretion from the ovary participates in the delayed recovery of LH secretion, we treated lactating rats with the progesterone antagonist RU 486 and determined the effects on the time course of recovery of pulsatile LH secretion and LH subunit mRNA after pup removal and on pituitary responsiveness to GnRH. In ovarian-intact lactating rats treated with RU 486, pulsatile LH secretion was observed in about 40% of the rats within 24 h after pup removal (LH interpulse interval, 43.7 +/- 8.3 min) and in about 90% of the rats within 48 h after pup removal (LH interpulse interval, 46.1 +/- 3.6 min). The mean plasma LH level in the RU 486-treated rats was 10.1 +/- 2.2 ng/ml 24 h after removal of pups (control, less than 5 ng/ml) and had increased to 35.1 +/- 6.4 ng/ml 48 h after pup removal (control, 9.1 +/- 2.5 ng/ml). However, RU 486 treatment had no significant effect on LH mRNA subunit levels. To determine whether progesterone acts at the pituitary to block GnRH stimulation of LH secretion, we tested the effects of RU 486 on LH secretion in response to 2- and 5-ng pulses of GnRH. Pituitary responsiveness was tested 24 h after pup removal. We found that both doses of GnRH were effective in stimulating pulsatile LH secretion, and treatment with RU 486 had no significant effect on this response. We conclude from these studies that progesterone secretion from the ovary contributes to the inhibition of LH secretion that occurs after pup removal, since antagonizing progesterone's action resulted in an earlier restoration of pulsatile LH secretion. The increase in LH secretion occurred in the absence of any significant changes in responsiveness of the pituitary to GnRH stimulation or in LH subunit mRNA levels. Therefore, the primary site of action of progesterone would appear to be at the hypothalamus to suppress pulsatile GnRH secretion. PMID- 2707152 TI - The ontogeny of melatonin secretion in the lamb. AB - In the female lamb, early postnatal photoperiod treatments do not alter the timing of puberty as do treatments at later ages. In the male lamb, early photoperiod treatments also fail to influence reproductive development. This prompted the hypothesis that the very young lamb may be unable to transduce changes in daylength into appropriate endocrine cues for puberty. The hypothesis was evaluated by determining the ontogeny of pineal melatonin secretory patterns in both female (n = 4-6) and male (n = 4) lambs under natural photoperiods. Serum melatonin concentrations were determined by a modified RIA in samples collected hourly for 24 or 48 h. Clustering analysis was used to define elevated and nonelevated periods of melatonin secretion. Elevated secretion was evident at night in six of eight lambs by 1 week of age and in all lambs by 3 weeks of age. In nearly all cases, the elevated nighttime levels accurately and consistently reflected the duration of the dark period. The mean amplitude of the elevated nighttime melatonin secretion was low in very young lambs and increased with age. No difference between females and males was observed in either the amplitude or duration of the nocturnal melatonin rise. Our results do not support the hypothesis that the failure of early photoperiod treatments to influence reproductive development is due to an inability of the young lamb to transduce photoperiod patterns into an endocrine signal. Rather, they suggest that some other aspect of reproductive neuroendocrine function is restrictive at these ages. PMID- 2707153 TI - Nuclear progesterone-binding protein in the guinea pig adrenal cortex: distinction from the classical progesterone receptor. AB - Nuclei purified from the guinea pig adrenal cortex contain a specific progesterone-binding activity which, based on enzyme degradation studies, appears to be proteinaceous. Saturation analysis revealed a Kd of about 15 nM and a binding capacity of about 33 pmol/mg DNA. The activity of the nuclear binding protein was specific essentially for progestational steroids; the two most potent progesterone competitors were 5 alpha-pregnane-3,20-dione and medroxyprogesterone (17 alpha-hydroxy-6 alpha-methylprogesterone), while 17 beta-estradiol, testosterone, cortisol, and other related steroids were poor competitors. The adrenocortical nuclear progesterone-binding protein was present to an equal extent in both male and female guinea pigs. The adrenocortical nuclear progesterone-binding protein differed from the classical progesterone receptor in that 1) the affinity of the adrenocortical binding protein for progesterone is an order of magnitude lower; 2) the potent synthetic progestin R5020 binds less tightly to the adrenocortical progesterone-binding protein; 3) the adrenocortical progesterone-binding protein is not modulated by estrogenic activity; 4) the adrenocortical progesterone-binding protein is more stable at 37 C; 5) the adrenocortical nuclear progesterone-binding protein is not salt extractable; and 6) Western blot analysis has revealed that an antiprogesterone receptor monoclonal antibody, which recognizes the guinea pig uterine classical nuclear progesterone receptor, does not recognize the adrenocortical nuclear progesterone binding protein. Thus, the guinea pig adrenocortical nucleus contains a type of progesterone-binding protein that appears to be clearly different from the classical progesterone receptor. PMID- 2707154 TI - A study of hepatic low Km iodothyronine 5'-monodeiodinase. AB - To document the presence of a low Km rT3 and T4-5'-monodeiodinase (5'MDL; Km in nanomolar concentrations) in the liver and to study its characteristics in comparison with the high Km 5'MD (5'MDH; Km in micromolar concentrations), we incubated rat liver microsomal protein (20 micrograms for rT3 substrate and 200 micrograms for T4 substrate) with 125I-labeled rT3 or T4 and dithiothreitol (DTT; up to 20 mM) for 5 min (for rT3) or 30-120 min (for T4) and determined the amount of 125I liberated during incubation. Pilot studies had shown that the activity of rT3 5'MDH is markedly (greater than or equal to 85%) inhibited in the presence of 2 M NaCl, while the rT3 5'MDL is essentially unaffected, and both low and high Km T4 5'MD are minimally (approximately 20%) inhibited. The representative kinetics of various substrates studied were: Km, 13 nM for rT3 5'MDL, 640 for rT3 5'MDH, 26 for T4 5'MDL, and 3620 for T4 5'MDH; maximum velocity, 0.28 nmol/h.mg protein for rT3 5'MDL, 46 for rT3 5'MDH, 0.002 for T4 5'MDL, and 0.46 for T4 5'MDH. Propylthiouracil and iopanoate inhibited all enzymic activities studied. The relative Ki values (micromolar concentrations) for propylthiouracil were: 7.1 for rT3 5'MDL, 1.5 for rT3 5'MDH, 24 for T4 5'MDL, and 40 for T4 5'MDH; those for iopanoate were 0.4 for rT3 5'MDL, 18 for rT3 5'MDH, 7.0 for T4 5'MDL, and 4.0 for T4 5'MDH. DTT was a potent stimulator of enzyme activities studied; its dose (millimolar concentrations) that caused a 50% maximal stimulation was 0.04 for rT3 5'MDL, 1.0 for rT3 5'MDH, 0.025 for T4 5'MDL, and 0.035 for T4 5'MDH. T4 inhibited rT3 5'-monodeiodination and vice versa. The Ki of T4 was 1.3 microM for rT3 5'MDL and 2.0 for rT3 5'MDH, while that of rT3 was 0.4 for T4 5'MDL and 0.6 for T4 5'MDH. We examined the activity of the hepatic 5'MDL (rT3, 0.5 nM; DTT, 0.06 nM; 2 M NaCl) and 5'MDH (rT3, 0.5 microM; DTT, 20 mM; no NaCl) in groups (six animals per group) of rats that were saline treated (control), thyroidectomized, or hyperthyroid (given T3, 20 micrograms/day for 5 days). The relative values for 5'MDL were (mean +/- SD) 17 +/- 3.0, 4.0 +/- 2.0 (P less than 0.01), and 24 +/- 2.0 (P less than 0.01) pmol/h.mg protein, respectively, whereas those for 5'MDH were 13 +/- 4.0, 3.0 +/- 1.6 (P less than 0.01), and 25 +/- 1.0 (P less than 0.01) nmol/h.mg protein, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2707155 TI - Alterations in adipogenic and mitogenic activity of porcine serum in response to hypophysectomy. AB - The importance of the pituitary in postnatal regulation of peripheral preadipocyte proliferation and differentiation was examined by hormone supplementation of hypophysectomized pig serum in primary cultures of preadipocyte and stromal-vascular cells derived from rat inguinal adipose tissue. Hypophysectomized pig serum promoted at least 25% less preadipocyte proliferation, less differentiation of sn-glycerol-3-phosphate dehydrogenase activity, and less histochemical differentiation than serum from intact pigs. Porcine GH supplementation of hypophysectomized serum-stimulated [3H]thymidine incorporation by preadipocytes and stromal cells and also histochemical differentiation of preadipocytes, but not enzymatic differentiation. Insulin-like growth factor I (IGF-I) stimulated [3H]thymidine incorporation by preadipocytes and stromal cells. Enzyme differentiation by developing cells was stimulated by IGF-I. Hydrocortisone supplementation of hypophysectomized serum inhibited [3H]thymidine incorporation and stimulated enzymatic differentiation. Thyroid hormones (T3 and T4) stimulated [3H]thymidine incorporation by preadipocytes in a dose-responsive manner when supplemented to hypophysectomized serum. Thyroid hormones stimulated differentiation of enzyme activity at the lowest concentrations examined. The mitogenic effects of GH, IGF-I, and T4 were not specific to the preadipocyte population, since the stromal-vascular cells responded in a similar manner. However, hypophysectomy resulted in a specific reduction in preadipocyte proliferation while stimulating multiplication of stromal-vascular cells. These results suggest that these hormones are nonspecific mitogens in adipose tissue, while unidentified factors of pituitary origin may be important for the specific regulation of proliferation of preadipocytes. Additionally, hypophysectomy appears to remove mitogenic inhibitors that are specific for the stromal-vascular cells. PMID- 2707156 TI - The effect of altered thyroid status on pituitary hormone messenger ribonucleic acid concentrations in the rat. AB - To study the effects of altered thyroid status on pretranslational control of pituitary hormones, adult male rats were given propylthiouracil for 6 weeks and underwent the following studies. 1) Rats were injected with T3 at 10 micrograms/100 g BW daily for 10 days. 2) Rats were given T3 injections at 0, 0.01, 0.1, 1.0, or 10 micrograms/100 g BW for 10 days. 3) Rats were killed 0, 1, 6, or 24 h after a single injection of T3 at 10 micrograms/100 g BW or after 5 or 10 days of daily T3 injections. Pituitary mRNA concentrations of TSH beta, alpha subunit, PRL, GH, POMC, FSH beta, and LH beta were determined for individual animals. Marked increases in TSH beta and alpha-subunit mRNAs occurred after PTU treatment, and these changes were reversed by 1.0 microgram/100 g BW T3 and within 24 h of a single T3 injection of 10 micrograms/100 g BW. Further increases in the dose or time course of T3 administration led to a relatively greater suppression of TSH beta mRNA levels than alpha-subunit mRNA levels. In contrast, GH and PRL mRNA levels were low in hypothyroid animals, and both rose toward control levels with 0.1 microgram/100 g BW T3 and by 24 h after a single T3 dose. Induction of hyperthyroidism did not further increase GH mRNA levels above control, but increased PRL mRNA levels 2-fold over control. No changes were seen in FSH beta, LH beta, or POMC mRNA levels with any treatment. Thus, studies of altered thyroid status in the rat reveal dose-response and time-course variability in the pretranslational control of TSH beta, alpha-subunit, GH, and PRL by thyroid hormone. PMID- 2707157 TI - The binding characteristics and biological effects in FRTL5 cells of placental protein-12, an insulin-like growth factor-binding protein purified from human amniotic fluid. AB - We have studied the binding of recombinant human insulin-like growth factor I (hIGF-I), and hIGF-II, and rat IGF-II [rIGF-II (multiplication-stimulating activity)] to the human amniotic fluid IGF-binding protein placental protein-12 (PP12). PP12 displayed a 5- to 10-fold higher affinity for IGF-I compared to hIGF II or rIGF-II. These differences in binding affinity were confirmed by both saturation binding analysis and competitive binding analysis using 125I-labeled IGF-I, hIGF-II, and rIGF-II and each of the unlabeled ligands. PP12 produced dose dependent inhibition of IGF-I-stimulated [3H]thymidine incorporation in the rat thyroid follicular cell line FRTL5. Inhibition of IGF-I-stimulated thymidine incorporation paralleled the ability of PP12 to inhibit IGF-I binding to the surface of FRTL5. At a high concentration, PP12 also inhibited TSH-stimulated DNA synthesis but did not inhibit the binding of 125I-labeled TSH to FRTL5. Insulin did not inhibit the binding of 125I-labeled IGFs to PP12, and PP12 did not inhibit the ability of insulin to stimulate DNA synthesis. These data suggest that the ability of PP12 to inhibit TSH-stimulated DNA synthesis is through the inactivation of IGF produced endogenously by FRTL5. Low concentrations of PP12 produced a statistically significant enhancement of TSH-stimulated DNA synthesis; the mechanism by which this occurs remains unclear. PMID- 2707158 TI - Tumor necrosis factor stimulates hepatic lipid synthesis and secretion. AB - Previous studies have shown that tumor necrosis factor (TNF) administration acutely increases serum triglyceride levels and stimulates hepatic de novo fatty acid synthesis. We now demonstrate that 60-90 min after TNF administration the incorporation of glycerol into triglycerides in the liver is increased 57% in chow-fed rats. Additionally, the quantity of labeled lipid in serum is increased 96% in the TNF-treated animals. TNF also acutely increases hepatic lipid synthesis and the quantity of labeled lipids in serum in rats fed a high sucrose diet. Moreover, using the Triton WR-1339 method, from 1-2 h after TNF administration there is a 52% increase in total hepatic triglyceride secretion. In contrast, in animals fasted before TNF administration, the characteristic increase in serum triglyceride levels is not observed, and neither the incorporation of glycerol into hepatic lipids nor the quantity of labeled lipids in the circulation are increased. By 17 h after TNF administration the incorporation of glycerol into hepatic lipid and the quantity of labeled lipid in the serum are no longer increased. These results indicate that in addition to TNF acutely stimulating de novo fatty acid synthesis, TNF also acutely stimulates hepatic triglyceride synthesis. The increase in hepatic triglyceride synthesis leads to increased secretion of lipids into the circulation. These observations provide strong support for our hypothesis that a TNF-induced stimulation of hepatic lipid synthesis and secretion contributes to the TNF-induced hyperlipidemia. PMID- 2707159 TI - Serum thyrotropin concentrations are more highly correlated with serum triiodothyronine concentrations than with serum thyroxine concentrations in thyroid hormone-infused thyroidectomized rats. AB - To assess the relative role of circulating T4 and T3 in the regulation of serum TSH, we have measured serum T4, T3, and TSH concentrations in normal and thyroidectomized rats, some of which were chronically infused with T3 or T4. Serum T3, T4, and TSH concentrations were measured 7 and 14 days after surgery. Some groups of infused rats were mildly hypothyroid, as judged by elevated serum TSH concentrations. At both 7 and 14 days, there was a significant inverse correlation between serum T3 and serum TSH concentrations (day 7, r = 0.65, P less than 0.01; day 14, r = 0.71, P less than 0.01). The coefficients for the inverse correlations between serum T4 and TSH concentrations were 0.37 on day 7 (P less than 0.05) and 0.37 (P less than 0.05) on day 14. Linear regression analysis was performed using TSH as the dependent variable for outcome and serum T3 and T4 concentrations as the independent predictor variables. This analysis revealed that after controlling for T3, TSH and T4 were no longer significantly correlated (P = 0.14). The correlation between T3 and TSH remained highly significant. These results suggest that in the euthyroid and mildly hypothyroid rat, serum T3 has a greater inhibitory effect on TSH secretion than does serum T4. PMID- 2707160 TI - Carrier-mediated [125I]-T3 uptake by mouse thymocytes. AB - Thyroid hormone entry into the thymocyte, a thyroid hormone target, was investigated by incubating the cells with tracer amounts of [125I]L-T3. At 37 C T3 uptake was linear with time up to 2 min, and then approached a plateau. The specific T3 uptake, obtained by subtracting the uptake in the presence of excess unlabeled T3, represented 48 +/- 6% of the total at equilibrium. Unlabeled L-T4, D-T3, and triiodothyroacetic acid were less effective than L-T3 in reducing [125I]T3 uptake. Kinetic studies on the initial rate of T3 uptake indicated, for the saturable process, a maximum velocity of approximately 1 pmol/10(6) cells.min and a Km of approximately 0.8 nM. Lowering incubation temperature to 4 C resulted in a two thirds reduction of the total T3 uptake. Washout experiments indicated a different hormone release, being more rapid for cells incubated at 4 C than at 37 C; at 30 min 70% of labeled T3 was released when incubation was carried out at 4 C compared to only 35% after incubation at 37 C, indicating the major intracellular location of the hormone at the latter temperature. An energy requirement of T3 uptake in thymocytes was shown by sensitivity to oligomycin; the effect was dose dependent, showing a maximal decrease in specific uptake of 85%. The involvement of cation movement in the entry process of T3 was indicated by the sensitivity to ouabain. These results indicate the existence of a stereospecific, energy-dependent, saturable process for T3 entry in thymocytes. PMID- 2707161 TI - A cytochrome P450 immunochemically related to P450c,d (P450I) localized to the smooth microsomes and inner zone of the guinea pig adrenal. AB - In addition to their capacity for steroid synthesis, guinea pig adrenal microsomes have a well documented ability to metabolize foreign compounds. The capacity for metabolism of foreign compounds is localized to the smooth endoplasmic reticulum-filled cells of the inner zone. However, it has not been clear whether they possess cytochrome P450(s) specific for this function, distinct from the two known steroid hydroxylases, P450(21) and P450(17)alpha. Multiple prominent protein bands in the mol wt range of known cytochrome P450s are seen on sodium dodecyl sulfate gels of guinea pig adrenal microsomes. Most are more intense in smooth microsomes, where the concentration of cytochrome P450 is highest. However, one band (52K) appears unique to the smooth microsomes. This band is also characteristic of microsomes obtained from the inner zone. This protein and two others (54K and 50K) are concentrated in the membrane pellet after carbonate treatment of the microsomes, indicating that they are integral membrane proteins. All three decrease in intensity after treatment of the animals with spironolactone, a compound known to cause depletion of adrenal cytochrome P450s. On Western blots of microsomal proteins the 54K and 50K proteins react with antibodies specific for P450(17) alpha and P450(21), respectively. The 52K protein, characteristic of the smooth microsomes and inner zone, does not react with anti-P450(21) or anti-P450(17) alpha, but does react with polyclonal antibody raised against microsomal cytochrome P450s induced by methylcholanthrene in rat liver (P450c,d). These results suggest that there is at least one additional cytochrome P450 in adrenal microsomes which is immunochemically distinct from P450(21) and P450(17) alpha. Its localization to the smooth microsomes and inner zone microsomes correlates with the high activity for ethylmorphine metabolism detected in these fractions. This suggests that this cytochrome P450, which is immunochemically related to members of the P450I subfamily, may be associated with the ability of guinea pig adrenal microsomes to metabolize foreign compounds. PMID- 2707162 TI - Characterization and applications of monoclonal antibodies to the prolactin receptor. AB - Monoclonal antibodies (mAbs) were produced in BALB/c mice immunized with partially purified PRL receptors from rat liver. Two mAbs (T1 and T6) were able to completely inhibit [125I]ovine PRL ([125I]oPRL) binding to solubilized rat liver PRL receptors, while two other mAbs (U5 and U6) showed only a small effect on PRL binding, but were able to precipitate hormone-receptor complexes. Scatchard analysis of [125I]oPRL binding to rat liver microsomes in the presence of mAbs resulted in a decrease in the number of sites without changing the affinity of PRL binding by T1 and T6, whereas U5 and U6 altered neither parameter. [125I]mAb binding to rat liver microsomes was performed in the presence of various concentrations of unlabeled mAbs or oPRL to examine the interaction between mAbs. Competition of binding to the receptor was observed, respectively, between T1 and T6, U5 and U6, and U5 and E21 (a mAb to the rat liver PRL receptor previously produced). Both [125I]T1 and [125I]T6 binding were inhibited by oPRL, although not completely (80% inhibition at the higher concentrations). When [125I]T1 binding was analyzed by Scatchard analysis, two classes of binding sites to rat liver microsomes were found, of which only the number of higher affinity sites was affected by the presence of oPRL in incubation. Similar results were observed for [125I]T6 binding. [125I]mAb binding to microsomes from other tissues and species was examined. All five mAbs were able to bind to microsomes from rat tissues (liver, ovary, adrenal, prostate, and Nb2 lymphoma cells), similar to the level of [125I]oPRL binding in these tissues. The binding characteristics of [125I]T6 or [125I]U5 were essentially identical in all rat tissues examined. Although T1, U6, and E21 showed strong species specificity, there was significant binding of T6 to rabbit liver and mammary gland and of U5 to rabbit and pig mammary gland and mouse liver Competition curves of [125I]U5 binding were parallel for rat, rabbit, and mouse tissues, while [125I]T6 binding was able to distinguish PRL receptors in rabbit mammary gland from those in rat tissues. The use of 125I-labeled mAb in immunoblot analysis of the PRL receptor resulted in a marked increase in sensitivity. All mAbs detected microsomal PRL receptors in rat liver with mol wt of 84,000, 42,000 and 40,000. As little as 4 fmol receptors can be identified using this approach. Microsomal PRL receptors from rat ovary, prostate, and Nb2 cells and purified receptors from pig and rabbit mammary gland were subjected to immunoblot analysis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2707163 TI - Growth responses in a mutant dwarf rat to human growth hormone and recombinant human insulin-like growth factor I. AB - A new mutant GH-deficient dwarf rat has been used to study the effects of iv infusions of human GH (hGH) and recombinant human insulin-like growth factor I (hIGF-I). This animal has only about 5% of normal pituitary GH content, low circulating GH levels, and no regular GH surges. The defect seems to be specific for GH. Infusions of hIGF-I at 180 micrograms/day for 9 days elevated serum IGF-I concentrations significantly over those in the saline-infused controls (713 +/- 20 ng/ml vs. 395 +/- 31 ng/ml); hGH infusions did not raise IGF-I levels significantly (435 +/- 20 ng/ml). Gel filtration of serum samples showed that the high-dose hIGF-I infusions increased free IGF concentrations, without apparently altering the pattern of IGF-I binding whereas hGH infusions increased the amount of high mol wt IGF-I binding protein. Neither IGF-I nor hGH infusions affected the small amounts of rat GH present in the dwarf rat pituitary glands. Continuous iv infusions of hGH (200 mU/day for 9 days) stimulated body wt gain (2.1 +/- 0.2 g/day) and bone growth (96 +/- 9 microns/day) significantly compared to saline infused dwarf rats (1.2 +/- 0.3 g/day and 43 +/- 3 microns/day). Infusions of hIGF-I at 180 micrograms/day produced a body wt gain (2.1 +/- 0.5 g/day) similar to that seen in the hGH-infused group but a significantly smaller stimulation of bone growth (63 +/- 3 microns/day). Infusion of a 5-fold lower dose of hIGF-I (36 micrograms/day for 9 days) had no effect on body wt or bone growth. Food intake was unaffected by either hGH or hIGF-I infusions. The pattern of tissue growth was affected differentially by hGH and IGF-I infusions that produced the same overall body wt gain. hGH induced a relatively proportional growth in most of the organs studied, whereas hIGF-I infusion at 180 micrograms/day stimulated a disproportionately greater growth of the kidney, adrenals, and spleen. In some of the animals, tissues were extracted for RIA of IGF-I; the amounts of IGF-I in the liver were similar in control, hGH, or IGF-I-infused animals, whereas kidney and adrenals from IGF-I infused animals contained larger amounts of immunoreactive IGF-I than did those tissues from hGH-treated rats. Thus, both hGH and hIGF-I can promote growth in the mutant dwarf rat, but they differ both quantitatively and qualitatively in their pattern of actions. PMID- 2707164 TI - Plasma membrane cholesterol: removal and insertion into the membrane and utilization as substrate for steroidogenesis. AB - The plasma membrane cholesterol content of MA-10 Leydig tumor cells is depleted by trophic hormone stimulation and repleted by incubating the cells with low density lipoprotein. The present studies used subcellular fractionation to investigate the membranes involved in steroid hormone synthesis. The results showed that the plasma membrane was the major source of cholesterol substrate and that the cholesterol content changed independently of any mass changes in membrane protein or phospholipid. Membrane phospholipid composition also did not change as membrane cholesterol content decreased or increased, a finding inconsistent with the proposal that phospholipid composition dictates the amount of cholesterol contained in a membrane. The mitochondria of the MA-10 cells were cholesterol rich, containing more cholesterol per unit protein or phospholipid than the plasma membrane. This cholesterol was presumably in the outer mitochondrial membrane, since virtually all of the cholesterol of intact mitochondria was accessible to cholesterol oxidase. Although there was a high concentration of mitochondrial cholesterol, this cholesterol was largely inert as a substrate for steroidogenesis, and plasma membrane cholesterol was incorporated into steroid hormones without ever equilibrating with the mitochondrial cholesterol pool. PMID- 2707165 TI - Thyroid hormone antibodies and Hashimoto's thyroiditis in mongrel dogs. AB - Abnormally elevated serum T3 concentrations measured by RIA were observed in 19 clinically euthyroid or hypothyroid mongrel dogs. The serum T4 concentrations in these sera were low, normal, or high. Measurement of the intensity of thyroid hormone binding to serum proteins was determined by equilibrium dialysis. A marked decrease in the percent free T3 was observed in these abnormal sera. Polyacrylamide gel electrophoresis, pH 7.4, of normal dog serum enriched with tracer 125I-labeled thyroid hormones demonstrated binding of [125I]T4 to transthyretin, thyroid hormone-binding globulin, and albumin and of [125I]T3 primarily to thyroid hormone-binding globulin. In all abnormal sera, polyacrylamide gel electrophoresis demonstrated strikingly higher binding of T3 to immunoglobulin (Ig). Eleven of 16 abnormal sera had minimal to moderate binding of T4 to Ig. The percent free T4 was lower only in dogs whose sera demonstrated markedly increased binding of T4 to Ig. All abnormal sera tested had positive antithyroglobulin antibodies, consistent with the diagnosis of autoimmune lymphocytic thyroiditis. As in humans, antibodies to thyroid hormones in dogs are more common in the presence of Hashimoto's thyroiditis and should be considered when elevated serum thyroid hormone concentrations are observed in the absence of clinical thyrotoxicosis. When an antibody to only one thyroid hormone is present, a marked discrepancy in the serum concentrations of T3 and T4 will be observed. PMID- 2707166 TI - In vivo biological validation and biophysical modeling of the sensitivity and positive accuracy of endocrine peak detection. I. The LH pulse signal. AB - The false positive (type I) and false negative (type II) errors inherent in computerized peak detection algorithms can have a major impact on the valid interpretation of physiological experiments. To objectively define the nature and extent of statistical errors associated with the identification of episodic gonadotropin (LH) peaks, we have employed two complementary approaches. First, using a general biophysical model for simulating episodic LH secretion, we have estimated optimal pulse analysis parameters that yield maximal sensitivity (probability of finding any given peak) and positive accuracy (probability that any identified peak is a true pulse) in synthetic LH series approximating those observed spontaneously in vivo. Secondly, we have estimated optimal peak detection parameters in an in vivo primate animal model, in which electrophysiological correlates of spontaneous LH pulses were documented independently by continuous electrophysiological monitoring of medial basal hypothalamus multiunit activity. These combined approaches indicate that LH time series can be analyzed for episodic LH pulsatility by an appropriately constrained, objective computerized algorithm with minimal false negative and false positive errors, i.e. with resultant high sensitivity and positive accuracy. Moreover, optimal pulse analysis parameters exhibited similar sensitivity and positive accuracy rates in both the biophysical simulations and the animal model. Thus, we suggest that the combined use of an algebraically explicit biophysical simulation model and an in vivo animal paradigm may serve to clarify the nature and extent of false negative and false positive errors in the detection of other hormone peaks as well as the gonadotropin LH. PMID- 2707167 TI - Female gene expression in the seminal vesicle of mice after prenatal exposure to diethylstilbestrol. AB - Previous studies from our laboratory on the feminization of the male mouse reproductive tract after prenatal exposure to diethylstilbestrol (DES) showed that the mRNA for the major estrogen-inducible uterine secretory protein, lactoferrin (LF), was constitutively expressed in the seminal vesicle of male mice exposed prenatally to DES, but not in the seminal vesicle of control mice. After castration, treatment with 17 beta-estradiol (20 micrograms/kg.day) for 3 days induced the LF mRNA in the seminal vesicle of both control and prenatally DES-exposed mice; however, the levels in DES-treated tissues were approximately 6 fold higher than those in control tissue. This report describes the presence of LF in seminal vesicle tissues and secretions of prenatally DES-exposed mice, as determined by immunohistochemistry and Western blot analysis. Further, these data are correlated with immunolocalization of the estrogen receptor in the seminal vesicle tissue. We conclude that the seminal vesicle of prenatally DES-exposed male mice has acquired two key characteristics of female tissues, namely LF production/regulation and estrogen receptor localization/distribution similar to that in uterine tissues. PMID- 2707168 TI - Roles of plasma clearance and corticosteroid-binding globulin in the developmental increase in circulating corticosterone in infant rats. AB - The aim of this study was to determine the role of plasma clearance in the developmental increase in plasma corticosterone concentration in the infant rat. Previous studies indicated that the corticosterone rise may be mediated entirely by a decrease in the MCR. The rationale of the current study was that if this is true, then corticosterone from an exogenous source (at a constant dose) should also produce a developmental increase in circulating levels of the hormone. Therefore, infant rats, aged 12, 16, and 21 days (i.e. near the beginning, middle, and end of the endogenous corticosterone developmental rise), were adrenalectomized and provided with a constant dose of corticosterone via sc pellets. There was a significant age-related increase in plasma corticosterone in pellet-treated pups which closely paralleled that seen in sham-operated littermates. This indicates that the decrease in plasma clearance is sufficient to account entirely for the normal developmental rise in plasma corticosterone. The declining MCR for corticosterone with increasing age is due primarily to a decrease in the apparent volume of distribution (Vd), which, in turn, may result from the concurrent increase in plasma corticosteroid-binding globulin (CBG). To investigate this possibility, the Vd of dexamethasone, a synthetic glucocorticoid that does not bind to CBG, was determined and compared with that of corticosterone. While the Vd of corticosterone declined significantly with age, there was no consistent change in the Vd of dexamethasone. Taken together, these data indicate that the decrease in clearance of corticosterone from plasma with increasing age is sufficient to account for the normal developmental rise of corticosterone. Moreover, increased binding of corticosterone to CBG appears to be responsible for decreases in Vd and clearance. PMID- 2707169 TI - The glucocorticoid hormone dexamethasone reverses the growth hormone-releasing properties of the cholinomimetic carbachol. AB - We recently reported that dexamethasone (DEX) enhances acetylcholine (ACh) release from pituitary cell aggregates. In the present study, the effect of DEX on the GH-releasing properties of the cholinergic agonist carbachol (CCh) was investigated. Perifusion of hemipituitaries from 14-day-old rats with CCh stimulated basal GH release. CCh also increased basal GH release from organ cultured pituitaries and from pituitary cells cultured as reaggregates, but only when the thyroid hormone T3 was supplemented to the culture medium. Pretreatment of the animals in vivo with DEX abolished the CCh-induced increase in basal GH release from hemipituitaries tested in vitro. Treatment of pituitary organ cultures and reaggregate cell cultures with DEX reversed the stimulation of basal GH release by CCh into an inhibition. CCh also inhibited isoproterenol- and GRF stimulated GH release from DEX-treated pituitary cell reaggregates. In contrast, the responsiveness of tumoral GH3 cell aggregates to CCh was not dependent on T3 or DEX during culture. The half-maximal concentration of CCh for inhibition was significantly lower than that for stimulation (1 and 10 microM, respectively). Perifusion with CCh of DEX-treated cell reaggregates consisting of a highly enriched somatotroph population (greater than 90% GH immunoreactive cells), obtained by sequential velocity and buoyant density sedimentation of dispersed cells, also inhibited basal GH release. Pretreatment of pituitary cell reaggregates cultured in DEX-supplemented medium with pertussis toxin completely abolished the inhibition by CCh. The inhibition of GH release by CCh was not affected by the Na+ conductance blocker tetrodotoxin, the Cl- channel blocker picrotoxin, or the K+ channel blocker caesium, but was abolished by the Ca2+ channel blockers cadmium and verapamil. In conclusion, CCh is capable of both stimulating and inhibiting GH release in different pituitary in vitro assay systems; the inhibition is dependent on glucocorticoids and the stimulation on the thyroid hormone T3. The mechanism of action of the inhibition seems to involve a GTP-binding protein and most probably a decrease in calcium conductance in the somatotroph. PMID- 2707170 TI - Growth stimulation of T47D human breast cancer cells by the anti-progestin RU486. AB - Our laboratory has previously reported that physiological levels of progestins stimulate growth of the human breast cancer cell line T47D. We have also determined that the antiprogestin RU486 inhibits this stimulation. Here we present the unexpected finding that RU486 alone also stimulates growth of these breast cancer cells. Thus, RU486 exhibits both antagonist and agonist-like activity, in a manner somewhat reminiscent of the antiestrogen tamoxifen. To our knowledge, this is the first report of stimulation of breast cancer growth by RU486. PMID- 2707171 TI - Perinephric abscess due to spontaneous perforation of the right hepatic duct--an ERCP diagnosis. PMID- 2707172 TI - The effect of routine endoscopy on the detection rate of T1 gastric cancer (early gastric cancer) in Birmingham. AB - The introduction of routine endoscopy facilities at the General Hospital, Birmingham has made no significant impact on the proportion of stage T1 or 'early' gastric cancers detected. Prior to this, T1 cancers comprised 2.8% of all tumors diagnosed, or 4.2% of resected cases. Following establishment of the service in 1974, 3.2% of all cases and 6.3% of those resected were stage T1 lesions. The clinical presentation reflected the high proportion of tumors associated with ulceration (67%). The accuracy rate for pre-operative diagnosis of a malignant lesion was barium meal 67%, cytology alone 73%, biopsy alone 80%, and cytology and biopsy in combination, repeated if suspicious, 100%. The crude survival rate at 5 years was 83.3% (age-adjusted 96%), and at 10 years 53.8%). PMID- 2707173 TI - Diagnostic significance of endoscopic biopsy in Crohn's disease. AB - We investigated the diagnostic value of biopsies taken from Crohn's lesions such as ulcers, aphthoid lesions, cobble-stone epithelium and "pseudopolyps". One hundred and forty-six colonoscopies performed in 141 patients with Crohn's disease (CD) were analyzed. Biopsies were taken during colonoscopy from different gross lesions. Histologic confirmation of CD by granulomas and microgranulomas was obtained in 36 cases from 146 colonoscopies (24.7%). In 80 investigations (54.8%) the histologic findings were consistent with, but not diagnostic of, CD, in 30 cases (20.5%) histology was non-diagnostic. The lesions most likely to contain granulomas were ulcers and we therefore conclude that biopsies taken from ulcer are diagnostically superior to those taken from other lesions seen in CD. PMID- 2707174 TI - New modalities for treating chronic pancreatitis. AB - Over the last few years, a new method, neither medical nor surgical, has been developed for treating often difficult-to-treat chronic pancreatitis. In the case of obstructive pancreatitis, endoscopy permits both drainage and calculus extraction. Even encrusted concrements and calcifications can be removed from the pancreatic duct with the aid of extracorporeal shockwave lithotripsy. The first aim is to relieve pain by restoring a free flow of secretion. Perhaps the use of endoscopic treatment in the early stages will break the vicious circle of chronic inflammation and ultimate gland destruction. PMID- 2707175 TI - A novel device for removal of the gastric remnant after intragastric balloon implantation for obesity. AB - A new system for endoscopic removal of a gastric prosthesis for treatment of obesity is presented. This technique permits rapid deflation of intragastric balloons as well as safe endoscopic removal of the gastric remnant. The method has been successfully employed in 26 patients, i.e. 74 events of balloon extraction. PMID- 2707176 TI - Development of a laser balloon for the treatment of gastrointestinal obstruction. AB - This work describes the initial results using a laser balloon in a canine model in an attempt to deliver the energy in a circumferential pattern. A balloon catheter, 2 cm long and 3 mm in diameter, was developed. Using a standard cw 100 watt Nd:YAG laser, a 600 micron fiber was tapered to 200 microns and passed through the proximal end of the balloon. Laparotomies were performed on mongrel dogs 14-18 kg in weight. After a gastrotomy, the gastric mucosa was exposed and rugal folds were pulled over the balloon to create a cylinder. Using power settings between 10 and 60 watts, and pulse durations between 10 and 40 seconds, radial energy was delivered and the tissue was examined for both gross and histologic effects. Circumferential zones of coagulation and necrosis were demonstrated. PMID- 2707177 TI - Endoscopic removal of a pedunculated bronchial lipoma by means of the hot snare. AB - The complete endoscopic removal by means of the hot snare of a pedunculated bronchial lipoma with a carcinoma in situ in its covering bronchial epithelium is reported. To our knowledge, the endoscopic removal of peripheral polypoid bronchial lesions has not been reported to date. The advantage of this technique lies in its ability to permit an exact histologic examination of the lesion, in contrast to laser vaporisation. PMID- 2707178 TI - Endobronchial pseudolymphoma associated with Sjogren's syndrome. Report of a case. AB - A case of pseudolymphoma occurring in a patient with Sjogren's syndrome is described. The lesion, which gave rise to intraluminal tumor masses in the airway, grew progressively, resulting in severe dyspnea. Treatment with prednisolone brought relief. The lymphoproliferative disorders, the principle clinical manifestation of which was pseudolymphoma, might have given rise to the M-component of the IgA-Ktype. PMID- 2707179 TI - Effects of the antiglucocorticoid RU 486 on the maturation of fetal rat lung surfactant. AB - The role of endogenous glucocorticoids in the control of surfactant system maturation was investigated in the fetal rat using an antiglucocorticoid molecule synthesized by Roussel-UCLAF, RU 486. The drug was administered to the mother from day 16 of gestation on. In a preliminary step, the transplacental transfer of RU 486 and its antiglucocorticoid effects on fetal target tissues were verified by evidencing RU 486-receptor complexes in fetal liver and lung, by measuring liver glycogen content, and by evaluating fetal blood corticosterone. The maturational state of fetal lungs was assessed biochemically on days 19, 20, and 21 of gestation by measuring their glycogen content, the phospholipid content of whole lung tissue and isolated surfactant fraction, and the incorporation of [methyl-3H]choline into DSPC. Morphological development was studied by analyzing electron micrographs of type II cells. The measured parameters clearly indicated a slowing of maturational processes in lungs of fetuses from RU 486-treated mothers, thereby demonstrating that endogenous glucocorticoids are actually involved in the control of lung maturation. In addition, the obtained results showed that endogenous corticosteroids specifically acted on the surfactant system of the fetal lung. PMID- 2707180 TI - Sex hormones influence growth and surfactant production in fetal lung explants. AB - Sex-related differences may be present during fetal lung growth and at the onset of surfactant synthesis. In this study we investigated the role of dihydrotestosterone (DHT) and estrogen (EST) on cell division and on labeled palmitate incorporation into disaturated phosphatidylcholine (DSPC) at various times of gestation. Using organ cultures of fetal rat lung from sexed littermates, it was shown that both DHT and EST reduce DNA synthesis only in tissue taken during the rapid growth phase from day 16 to 19 of gestation. From autoradiographic counts, epithelial cell division was most affected. Both hormones reduced DSPC synthesis in explants prepared at day 18, when levels are normally low. At day 19, DHT reduced palmitate incorporation into DSPC of female explants to the male level; subsequently DHT had no effect on any tissue. In contrast, the addition of EST stimulated DSPC synthesis 40% above controls in both male and female explants taken at day 20 only. The results suggest that sex differences seen in late fetal lung development may arise from the combined effects of slowed epithelial growth induced by these hormones followed by inhibition of DSPC synthesis by DHT and acceleration by EST at the crucial period when surfactant synthesis begins. PMID- 2707181 TI - Effect of histamine on tracheobronchial afferent and caudal mediastinal efferent lymph. AB - We prepared nine sheep with acute tracheobronchial afferent (TBN) and caudal mediastinal efferent (CMN) lymph fistulas. After a baseline period (B) in 3 sheep, we administered histamine (H) continuously for 4 h. In six sheep, we elevated left atrial pressure (PLA) and reestablished steady-state conditions prior to H administration. The afferent lymph to plasma protein concentration ratio (CA/CP) was significantly lower than the efferent ratio (CE/CP) during periods of B, H, elevated PLA, and elevated PLA with H. H administration increased lymph flow rates (QlA and QlE) and both CA/CP and CE/CP, albeit insignificantly. During elevated PLA, QlA and QlE increased, while CA/CP and CE/CP fell. QlE increased, while QlA did not change during elevated PLA with H. CE/CP increased from its PLA level. CA/CP did not increase. Afferent data suggest that histamine may increase pulmonary microvascular surface area, but does not alter the permeability of the pulmonary circulation. While we cannot exclude the possibility of an increase in pulmonary microvascular permeability from efferent results, the difference between TBN afferent and CMN efferent results likely represent the action of histamine at the CMN. PMID- 2707182 TI - Role of arachidonic acid metabolites in hypoxic contractions of isolated porcine pulmonary artery and vein. AB - Recently it has been proposed that hypoxic pulmonary vasoconstriction (HPV) is mediated by local release of sulfidopeptide leukotriene products of the lipoxygenase pathway of arachidonic acid metabolism. In the present study the response to reduced oxygen supply of isolated porcine lobar pulmonary artery and pulmonary vein spiral strips has been studied. Contractions of the pulmonary artery (mean maximum tension 66.9 +/- 13.0 mg, n = 10) required an increase in baseline tone of the preparation followed by exposure to anoxia (mean bath PO2 O +/- 3 mm Hg), whereas contractions of the pulmonary vein (mean maximum tension 75.2 +/- 13.3 mg, n = 10) could be elicited in response to hypoxia alone (mean bath PO2 40 +/- 4 mm Hg). Indomethacin (5.6 microM), a cyclooxygenase inhibitor, attenuated the arterial contraction, but the mechanism may have been independent of the cyclooxygenase pathway since phenidone, an inhibitor of both cyclooxygenase and lipoxygenase pathways, had no effect. Inhibition by FPL 55712, a leukotriene end-organ antagonist, was achieved only at a high concentration (20 microM). In the case of the pulmonary vein, both indomethacin and phenidone inhibited the contractile response, whereas FPL 55712 had no effect. Contractile responses to reduced oxygen supply can be induced in isolated porcine pulmonary artery and vein strips, but probably are not mediated by leukotrienes. PMID- 2707183 TI - Mucociliary transport and epithelial morphology with elongation and collapse in rat trachea. AB - Mucociliary clearance in the trachea depends on a close relationship between structure and function of the components of its mucociliary system. Current explanations of normal mucociliary function denote narrow tolerances to change in factors such as the depth of secretions lining the lumen and the distribution of cilia. This study centered on changes in airway length under physiological conditions in the rat. Following extension of the head, the length of the trachea increased 50% without change in diameter. The rate of mucociliary clearance did not change with head position, averaging 3.79 +/- 1.03 mm/min in the flexed and 3.81 +/- 1.10 mm/min in the extended position. Extension of the head caused surface epithelial cells to elongate longitudinally and to decrease in height. These changes were greater in ciliated cells than in mucus-containing cells, thus accentuating the degree of protrusion of the secretory cells into the lumen of the stretched trachea. It is proposed that, during head extension, the relative protrusion of secretory cells into the lumen added bulk to the volume otherwise occupied by luminal secretions, and that these consistent changes in cell geometry served to adjust the height of ciliary tips within the periciliary fluid, thus mitigating fluctuations in the depth of the fluid. It was concluded that the mucociliary system of tracheas subjected to substantial change in configuration supported clearance because spatial relationships of essence to mucociliary function were maintained. PMID- 2707184 TI - Transport across rat trachea in vitro after exposure to cytoskeleton-active drugs in vitro or to ozone in vivo. AB - Full-length tracheas from Sprague-Dawley rats were exposed to cytoskeleton-active drugs in short-term organ culture, and the permeability of the tracheal epithelium was measured by instilling radiotracers into the lumen and assay of the radioactivity appearing in the external bathing medium. In vitro treatment with cytochalasin D (cyto D, 2-10 x 10(-6) M) increased the rate of movement of [14C]mannitol across the epithelium. Exposure to vinblastine (VB, 10(-4) M) alone had no significant effect. However, VB in combination with cyto D increased the permeability in a dose-dependent manner. In vivo exposure to ozone (O3, 0.8 or 2.0 ppm, 2 h) had only a slight effect on the rate of movement of the tracer as measured in vitro immediately after exposure. At 24 h postexposure there was no significant difference in permeability between ozone- and air-exposed tracheas. Prior in vivo O3 exposure sensitized the tracheas to the in vitro effects of cyto D; treatment of O3-exposed tracheas with cyto D immediately after O3 exposure produced a greater than additive effect on permeability measured in vitro. VB at concentrations up to 10(-4) M had no enhancing effect on permeability in O3 exposed tracheas. Sham exposure to clean air did not affect permeability compared to untreated (shelf) controls. Electron microscopic studies demonstrated penetration of horseradish peroxidase into intercellular spaces in the tracheas treated in vitro with cyto D or cyto D plus VB. Cyto D is known to affect intracellular microfilaments that have attachments at or near the cell surface, while VB affects microtubules associated with internal cellular structures. Therefore, the synergistic effect on tracheal permeability observed with O3 and cyto D, but not with O3 and VB, suggests that O3 may change cell surface structures associated with the microfilamentous cytoskeleton. PMID- 2707185 TI - Transferrin stimulates proteoglycan accumulation by fetal lung cells in culture. AB - The role of transferrin in growth and the formation of extracellular matrix was investigated by comparing its effects on proteoglycan metabolism and cell proliferation in primary cultures of fetal rat lung fibroblasts and Type II epithelial cells. Transferrin specifically stimulated the accumulation of dermatan/chondroitin sulfate proteoglycans associated with the cells and matrix in a dose-dependent manner (0-200 micrograms/ml, r = .850 in fibroblasts and r = .810 in Type II cells). This effect was not due to increased synthesis since there was a corresponding decrease in proteoglycans and their degradation products released into the medium. The effect is probably mediated via an action on the proteoglycan core protein, since there was no effect of transferrin on enzyme activity promoting glycosaminoglycan synthesis on the synthetic initiator beta-D-xyloside. The effect of transferrin on proteoglycan distribution was not a secondary effect caused by changes in collagen synthesis and was not linked to cell proliferation or the concentration of Fe3+ ions in the culture medium. PMID- 2707186 TI - Secretion of fibronectin by mineral dust-derived alveolar macrophages and activated peritoneal macrophages. AB - The in vitro secretion of fibronectin by rat alveolar macrophages recovered following the intratracheal instillation of various mineral dusts was examined using a competitive enzyme-linked immunoassay (CELIA) method. Cells derived with the fibrogenic dusts DQ12 quartz and UICC crocidolite asbestos had elevated rates of fibronectin secretion when compared ith those derived from titanium dioxide or saline. The in vitro culture of alveolar macrophages with dusts did not lead to elevated rates of fibronectin secretion, suggesting that mechanisms other than the direct interaction between dusts and macrophages may be responsible for elevated rates of fibronectin secretion by cells exposed to fibrogenic dusts. This suggests that fibronectin deposition seen in pneumoconiotic lesions in immunohistochemical studies may in part have been derived from macrophages. Thioglycollate-induced activated mouse peritoneal macrophages secreted significantly less fibronectin than resident peritoneal macrophages, a finding contrasting with those of Tsukamoto et al. [7]. PMID- 2707188 TI - Symposium on the Health Effects of Acid Aerosols. October 19-21, 1987, Research Triangle Park, NC. Proceedings. PMID- 2707187 TI - Secretions from primary hamster tracheal surface epithelial cells in culture: mucin-like glycoproteins, proteoglycans, and lipids. AB - Surface epithelial cells dissociated from hamster tracheas and grown on a thick collagen gel in the presence of 5% fetal bovine serum become highly enriched with secretory cells at confluence. In the present communication, we have analyzed secretory products from this primary hamster tracheal surface epithelial (HTSE) cell culture. The secreted glycoconjugates included high-molecular-weight mucin like glycoproteins (HMW MLGP) and proteoglycans that comprised 22% and 5% of the total [3H]glycoconjugates secreted when [3H]glucosamine was added as a metabolic precursor. Among the proteoglycans were hyaluronic acids (53%), heparan sulfate proteoglycans (29%), and chrondroitin sulfate proteoglycans (18%). Chondroitin sulfates were mostly 4-sulfated. On the other hand, the secreted lipids included cholesterol, phospholipids, and glycolipids, and most of them were associated with HMW MLGP. PMID- 2707189 TI - Ventilatory lung function and chronic chest symptoms among the inhabitants of urban areas with various levels of acid aerosols: prospective study in Cracow. AB - The analysis carried out earlier in Cracow showed that the high level of SO2 and particulate matter (PM) alone cannot be responsible for an excess of chronic chest symptoms and faster lung function deterioration in the population at large. To check the hypothesis that acid aerosols present in the urban air may cause substantial damage of the lungs, data from a 13-year follow-up survey of chronic chest diseases in Cracow (1968-1981) have been reanalyzed. In the plan of the analysis, three areas of the city with various levels of sulfate and sulfur transformation ratio (STR) in the urban air have been defined. In each of the defined areas, the prevalence of chronic chest symptoms, as well as lung function decline, have been studied. In total, the lung function study group consisted of 1414 persons (584 males and 830 females). Those men who lived in the area with the higher sulfate and STR had lower FEV1 levels by about 151 mL than did the residents of the other areas, and this was equivalent to the effect of smoking. In females, the pattern was generally the same. In men, the FEV1 decline rate (mL/year) over the 13-year period was significantly faster by about 11 mL/year in the areas with higher and intermediate STR, which was again equivalent to the effect of smoking. It was found that the level of SO2 and PM in the urban air correlated with the symptom prevalence in women; however, it had no clear impact on lung function deterioration. PMID- 2707190 TI - Effects of inhaled acids on lung biochemistry. AB - Effects of respirable aerosols of sulfuric acid, ammonium sulfate, sodium sulfite, and ammonium persulfate on lungs of rats are reviewed. The literature regarding interactions between ozone or nitrogen dioxide and acidic aerosols (ammonium sulfate, sulfuric acid) is discussed. An unexpected interaction between nitrogen dioxide and sodium chloride aerosol is also discussed. An attempt is made to identify bases for prediction of how and when acid aerosols might potentiate effects of inhaled gases. PMID- 2707191 TI - Factors affecting the response of lung clearance systems to acid aerosols: role of exposure concentration, exposure time, and relative acidity. AB - The ability of the lungs to clear deposited material is essential for maintenance of lung homeostasis. Acid aerosols have been shown to alter the efficiency of this process. This paper assesses the role of acid aerosol exposure concentration (C), exposure time (T), and relative acidity in producing changes in clearance from both the tracheobronchial tree and respiratory region of the lungs of rabbits. The response was found to be due to total exposure, i.e., some combination form of C x T, and was also related to relative acidity. PMID- 2707192 TI - Sulfuric acid-induced changes in the physiology and structure of the tracheobronchial airways. AB - Sulfuric acid aerosols occur in the ambient particulate mode due to atmospheric conversion from sulfur dioxide (SO2). This paper describes the response of the rabbit tracheobronchial tree to daily exposures to sulfuric acid (H2SO4) aerosol, relating physiological and morphological parameters. Rabbits were exposed to filtered air (sham control) or to submicrometer-sized H2SO4 at 250 micrograms/m3 H2SO4, for 1 hr/day, 5 days/week, with sacrifices after 4, 8, and 12 months of acid (or sham) exposure; some rabbits were allowed a 3-month recovery after all exposures ended. H2SO4 produced a slowing of tracheobronchial mucociliary clearance during the first weeks of exposure; this change became significantly greater with continued exposures and did not improve after exposures ended. Airway hyperresponsiveness was evident by 4 months of acid exposure; the condition worsened by 8 months of exposure and appeared to stabilize after this time. Standard pulmonary mechanics parameters showed no significant trends with repeated acid exposure, except for a decline in dynamic lung compliance in animals exposed to acid for 12 months. Lung tissue samples obtained from exposed animals showed a shift toward a greater frequency of smaller airways compared to control, an increase in epithelial secretory cell density in smaller airways, and a shift from neutral to acidic glycoproteins in the secretory cells. The effect on airway diameter resolved after the exposures ceased, but the secretory cell response did not return to normal within the recovery period. No evidence of inflammatory cell infiltration was found due to H2SO4 exposure. Thus, significant alterations in the physiology of the tracheobronchial tree have been demonstrated due to repeated 1-hr exposures to a concentration of H2SO4 that is one-fourth the current 8-hr threshold limit value for exposure in the work environment. The cumulative dose inhaled by the rabbits is similar to current peak daily doses from ambient exposure in North America. The results obtained in the rabbit model provide insight into early changes in the tracheobronchial tree due to repeated irritant exposure and may be involved in the pathogenesis of chronic airway disease. PMID- 2707193 TI - Health effects of acid aerosols formed by atmospheric mixtures. AB - Under ambient conditions, sulfur and nitrogen oxides can react with photochemical products and airborne particles to form acidic vapors and aerosols. Inhalation toxicological studies were conducted, exposing laboratory animals, at rest and during exercise, to multicomponent atmospheric mixtures under conditions favorable to the formation of acidic reaction products. Effects of acid and ozone mixtures on early and late clearance of insoluble radioactive particles in the lungs of rats appeared to be dominated by the oxidant component (i.e., the mixture did cause effects that were significantly different from those of ozone alone). Histopathological evaluations showed that sulfuric acid particles alone did not cause inflammatory responses in centriacinar units of rat lung parenchyma (expressed in terms of percent lesion area) but did cause significant damage (cell killing followed by a wave of cell replication) in nasal respiratory epithelium, as measured by uptake of tritiated thymidine in the DNA of replicating cells. Mixtures of ozone and nitrogen dioxide, which form nitric acid, caused significant inflammatory responses in lung parenchyma (in excess of effects seen in rats exposed to ozone alone), but did not damage nasal epithelium. Mixtures containing acidic sulfate particles, ozone, and nitrogen dioxide damaged both lung parenchyma and nasal epithelia. In rats exposed at rest, the response of the lung appeared to be dominated by the oxidant gas-phase components, while responses in the nose were dominated by the acidic particles. In rats exposed at exercise, however, mixtures of ozone and sulfuric acid particles significantly (2.5-fold) elevated the degree of lung lesion formation over that seen in rats exposed to ozone alone under an identical exercise protocol. PMID- 2707194 TI - Furnace-generated acid aerosols: speciation and pulmonary effects. AB - Guinea pigs were exposed to ultrafine aerosols (less than 0.1 micron) of zinc oxide with a surface layer of sulfuric acid. These acid-coated aerosols are typical of primary emissions from smelters and coal combustors. Repeated daily 3 hr exposures for 5 days produce decrements in lung volumes and pulmonary diffusing capacity and elevations of lung weight/body weight ratio, protein, and number of neutrophils in pulmonary lavage fluid at concentrations of 20 micrograms/m3. A single 1-hr exposure to 20 micrograms/m3 causes increased bronchial reactivity. Higher concentrations of conventionally generated sulfuric acid mist are required to produce responses of similar magnitude. PMID- 2707195 TI - Acid fog: effects on respiratory function and symptoms in healthy and asthmatic volunteers. AB - Acidic air pollutants generally are dissolved in water droplets. Mean droplet diameter may range from more than 10 microns in dense fog to less than 1 micron at low relative humidity. Droplet size influences the deposition of inhaled acid within the respiratory tract and thus may influence toxicity. To help assess health risks from acid pollution, we performed controlled exposures of normal and asthmatic volunteers to sulfuric acid aerosols at nominal concentrations of 0 (control), 500, 1000, and 2000 micrograms/m3. Exposures lasted 1 hr with intermittent heavy exercise. Response was assessed by lung function tests and symptom questionnaires. Under foggy conditions (mean droplet size 10 microns, temperature 50 degrees F), no marked effects on lung function were found. However, both normal and asthmatic subjects showed statistically significant dose related increases in respiratory symptoms. In a separate study, normal subjects exposed at 70 degrees F with mean droplet size 0.9 microns showed no marked effect on function or symptoms. Asthmatics showed dose-related decrements in forced expiratory performance and increases in symptoms, most obvious at 1000 and 2000 micrograms/m3. The different results of the two studies probably reflect an influence of droplet size, but further investigation is needed to confirm this. The aggregate results suggest that only mild, if any, short-term respiratory irritant effects are likely at acid concentrations attained in ambient pollution. PMID- 2707196 TI - Effect of concentration and cumulative exposure of inhaled sulfuric acid on tracheobronchial particle clearance in healthy humans. AB - We have previously shown that 1-hr exposures to 0.5 microns sulfuric acid (H2SO4) mist at 100 and 1000 micrograms/m3 produced transient alterations of bronchial mucociliary clearance of monodispersed 7.6 and 4.2 microns mass median aerodynamic diameter gamma-tagged ferric oxide (Fe2O3) in healthy nonsmoking humans in a dose-dependent manner. To determine the role, if any, of the length of exposure, 10 healthy volunteers were exposed to 100 micrograms/m3 H2SO4 for 1 hr and 2 hr on separate occasions, 1 week apart, with measurements of their mucociliary clearance of 5.2 microns Fe2O3 particles inhaled both before and after the inhalation of the H2SO4. Their rate of bronchial mucociliary clearance was markedly reduced for both Fe2O3 aerosols, with slower clearance of the aerosol inhaled after the H2SO4 exposure. For the tagged Fe2O3 aerosol inhaled after exposure for 2 hr at 100 micrograms/m3 H2SO4, the tracheobronchial clearance halftime, (T50), tripled from control, and the reduced rate of clearance was still evident 3 hr after the end of exposure. The 1-hr 100 micrograms/m3 H2SO4 exposure doubled T50 from control, and the reduced rate of clearance lasted for about 2 hr after the end of exposure. These results indicate that the effect of doubling the length of exposure was as great or greater than an order of magnitude increase in the concentration of H2SO4. PMID- 2707197 TI - Acute lung function responses to ambient acid aerosol exposures in children. AB - We examined the relationship between lung function changes and ambient acid aerosol episodes in children attending a residential summer camp. Young females (112) performed daily spirometry, and 96 were assessed on one occasion for airway hyperresponsiveness using a methacholine bronchoprovocation test. Air quality measurements were performed on site and four distinct acid aerosol episodes were observed during the 41-day study. The maximum values observed during the 41-day study were: O3 at 143 ppb; H2SO4 at 47.7 micrograms/m3; and [H+] at 550 nmole/m3. Maximum decrements of 3.5 and 7% for FEV1 and PEF, respectively, were observed to be associated with the air pollution episodes. There was some evidence of a differential lung function response to the episodes where children with a positive response to a methacholine challenge had larger decrements compared to their nonresponsive counterparts. PMID- 2707198 TI - Review, discussion, and summary: toxicology. AB - The research presented in the toxicology session of the Symposium on the Health Effects of Acid Aerosols significantly advances our understanding of the health effects of acid aerosols and clearly illustrates the importance of animal inhalation toxicology to risk assessment. The description of the effects of acid on airway mucus buffering capacity and viscosity helps explain some of the mechanisms responsible for the effects of sulfuric acid on mucociliary clearance and pulmonary function observed in man and animals. Several of the papers illustrate that other pollutants interact with sulfuric acid (H2SO4), causing concern about exposure risks and helping in elucidating the effects observed in epidemiology studies that have not yet been duplicated in a laboratory. For example, H2SO4 absorbed in zinc oxide (ZnO) particles appears to be about a log more potent than H2SO4 alone in causing pulmonary function decrements. Low levels of H2SO4 and O3 were found to be synergistic in increasing collagen synthesis, implying a risk in development of lung fibrosis. More complex mixtures containing H2SO4 cause a variety of interactions, depending upon the end points examined and the chemistry of the mixture. Other reports indicate that dose rate and length of exposure issues are critical to toxicological outcomes. Animal data on mucociliary clearance, which parallels that of human data, was extended to show that concentration of exposure was more important than time of exposure in eliciting a response, although time played a significant role. A recent chronic study showed that H2SO4 caused effects that also can occur in the development of chronic bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707199 TI - Human health effects of exposure to airborne acid. AB - This paper summarizes and critiques a series of reports on the health effects of acid aerosol exposure, presented at the Symposium on the Health Effects of Acid Aerosols and compares these data to selected previous studies. The role of the two major defenses against acid aerosols, the conversion of acid to the ammonium salts by respiratory ammonia and buffering of acid by airway surface liquid are discussed in relation to airway acid burdens expected from typical inhalation exposures. The roles of particle size and hygroscopicity on airway deposition of aerosol are also included. The major health effects studied were the effects of acid aerosol on mucociliary clearance in healthy individuals and changes in lung function in asthmatics, an important sensitive subpopulation. The broad range of response in asthmatics suggests the need for further study. PMID- 2707200 TI - Risk assessment for acid aerosols. PMID- 2707201 TI - Overview of a workshop on quantitative models for developmental toxicity risk assessment. AB - A workshop was held to discuss potential advancements to improve the precision of risk estimates for developmental toxicity. This paper presents an overview of the discussions at the workshop, focusing on the risk assessment process and science policy considerations important in the use of quantitative models. Some of the pertinent biological considerations are reviewed, particularly those related to the repair capacity of the developing organism and how this affects the concept of a threshold for developmental toxicity effects, as well as the maternal and litter influences on developmental toxicity outcomes. Finally, the current status of use of quantitative approaches is described, possible short-term approaches are discussed, and future research needs in this area are outlined. PMID- 2707202 TI - Trend tests for proportional responses in developmental toxicity experiments. AB - The data from developmental toxicity experiments usually are very difficult to analyze statistically because of the lack of independence among littermates and the random nature of the litter size. Only a few of the models that have been proposed in the literature have accounted for both of these features. One of the models proposed by Van Ryzin is invoked to construct a test of trend (dose response). The construction is achieved via a statistical technique called isotonic regression, which is applied to the moment estimators derived by Van Ryzin. The trend test based on isotonic regression is relatively straightforward to calculate, and when the number of dose groups (including control) is four or less, the significance of the observed result is easily determined. An example, in which fetolethality is the end point of interest, demonstrates the test. PMID- 2707203 TI - Statistical analysis of epidemiologic data of pregnancy outcomes. AB - In this paper, a generalized logistic regression model for correlated observations is used to analyze epidemiologic data on the frequency of spontaneous abortion among a group of women office workers. The results are compared to those obtained from the use of the standard logistic regression model that assumes statistical independence among all the pregnancies contributed by one woman. In this example, the correlation among pregnancies from the same woman is fairly small and did not have a substantial impact on the magnitude of estimates of parameters of the model. This is due at least partly to the small average number of pregnancies contributed by each woman. PMID- 2707204 TI - Characterization of a developmental toxicity dose-response model. AB - The Rai and Van Ryzin dose-response model proposed for teratology experiments has been characterized for its appropriateness and applicability in modeling the dichotomous response data from developmental toxicity studies. Modifications were made in the initial probability statements to reflect more accurately biological events underlying developmental toxicity. Data sets used for the evaluation were obtained from the National Toxicology Program and U.S. EPA laboratories. The studies included developmental evaluations of ethylene glycol, diethylhexyl phthalate, di- and triethylene glycol dimethyl ethers, and nitrofen in rats, mice, or rabbits. Graphic examination and statistical evaluation demonstrate that this model is sensitive to the data when compared to directly measured experimental outcomes. The model was used to interpolate to low-risk dose levels, and comparisons were made between the values obtained and the no-observed-adverse effect levels (NOAELs) divided by an uncertainty factor. Our investigation suggests that the Rai and Van Ryzin model is sensitive to the developmental toxicity end points, prenatal deaths, and malformations, and appears to model closely their relationship to dose. PMID- 2707205 TI - Quantitative risk analysis for quantal reproductive and developmental effects. AB - Animal experiments are generally conducted at higher dose levels than anticipated human dose levels in order to elicit otherwise subtle changes in reproduction or developmental effects with relatively few animals. Based on animal data, regulatory strategy generally has been to postulate a no-observed-effect level (NOEL) for toxic effects and to divide this by a safety factor, usually 100, to establish acceptable levels for humans. Various authors have discussed the shortcomings of using NOEL and have suggested the use of an estimable effect level determined from a dose-response curve fitted to bioassay data, e.g., the dose at which 1% of the animals are adversely affected, and employing some form of conservative low dose extrapolation to control risks at lower doses. In this paper, 10 sets of bioassay data on fetal mortality or anomalies were used to compare the estimated upper limits of risk estimated at the NOEL/100 and the lower 95% confidence limit estimate of the dose producing adverse effects in 1% of the embryonic implants or fetuses divided by 100 (LED01/100). The latter quantity is expected to result in a risk (proportion affected) of less than 10( 4) (1 in 10,000). The estimated upper limits of risk associated with the NOEL/100 were from 2 x 10(-4) to 6 x 10(-4) for the 10 data sets investigated. PMID- 2707206 TI - Mass transfer rates of polycyclic aromatic hydrocarbons between micron-size particles and their environment--theoretical estimates. AB - This paper presents a mathematical model of how rapidly polycyclic aromatic hydrocarbons (PAHs) adsorb onto initially clean micron-size particles in the ambient air and how fast these substances are likely to be desorbed from the particles after deposition on the surface lining layer of the lung. Results show that, on the one hand, the very low gas-phase concentrations of PAHs in the ambient air should result in a comparatively slow transfer of such compounds to micron-size particles, a process that may last from minutes to hours. On the other hand, the comparatively high solubilities of PAHs in the lining layer of the lung should promote an almost instantaneous release of PAHs onto nonporous particles, and a release within a matter of minutes of most PAHs reversibly adsorbed onto the interior surfaces of porous particles. Two important conclusions can be drawn from this. First, the PAHs in tobacco smoke do not have time enough to interact in the gas phase with other airborne particles before these agents are inhaled into the smoker's lungs. Therefore, adsorption in the gas phase of PAHs onto asbestos fibers can hardly be a characteristic parameter in the mechanism behind the synergistic effect between tobacco smoking and asbestos exposure for the induction of bronchial cancer. Second, the release rate of reversibly adsorbed PAHs from their carrier particles in the lung seems to be so fast that this cannot be a parameter of importance in directly influencing the residence times of such substances in the lung. PMID- 2707207 TI - Summary of carcinogenic potency and positivity for 492 rodent carcinogens in the carcinogenic potency database. AB - A tabulation of carcinogenic potency (TD50) by species for 492 chemicals that induce tumors in rats or mice is presented. With the use of the Carcinogenic Potency Database, experimental results are summarized by indicating in which sex species groups the chemical was tested and the respective evaluations of carcinogenicity. A comparison of three summary measures of TD50 for chemicals with more than one positive experiment per species shows that the most potent TD50 value is similar to measures that average values or functions of values. This tabulation can be used to investigate associations between rodent potency and other factors such as mutagenicity, teratogenicity, chemical structure, and human exposure. PMID- 2707208 TI - Background on health effects of acid aerosols. AB - This introduction to the 1987 NIEHS-EPA Symposium on the Health Effects of Acid Aerosols reviews the state of our knowledge on this topic as of the close of the 1984 NIEHS Conference on the Health Effects of Acid Precipitation (Environmental Health Perspectives, Volume 63) and the results of some key studies completed since that time. These studies, together with the results of the studies presented in the papers that follow, provide a substantial increment in our knowledge of the health effects of acid aerosols. PMID- 2707209 TI - Comment on the significance of positive carcinogenicity studies using gavage as the route of exposure. AB - There is continuing controversy, extending into regulatory matters, over the significance to human health of positive results in carcinogenicity studies in animals using the gavage technique as the route of exposure. Our review of a nonrandom sample of 117 chemicals or chemical processes listed as known or reasonably anticipated to be carcinogenic in the National Toxicology Program's Third Annual Report on Carcinogens provides support for the validity of the gavage route in such studies. Twenty-three chemicals among the 117 substances and processes listed were positive by gavage. Twenty of these 23 chemicals were also appropriately studied by at least one other route of exposure. Thus, we were able to evaluate the extent to which positive gavage results were confirmed by another route of exposure in this sample. Nineteen (or 95%) of the twenty chemicals were positive for carcinogenicity by at least one other nongavage route in carcinogenicity bioassays. Moreover, in each of these 19 cases, positive carcinogenesis results were obtained by a nongavage route in the same species of animal where gavage administration led to the induction of cancer. All of the 23 gavage-positive chemicals induced tumors distal to the site of administration in at least one study, as did all 15 chemicals which were also positive by subcutaneous injection. We emphasize, however, the limited scope of our survey. We have not evaluated all chemicals that have tested positive by gavage and by at least one alternative route, nor have we assessed those chemicals found to be negative by the gavage route.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707210 TI - Exposures to acidic aerosols. AB - Ambient monitoring of acid aerosols in four U.S. cities and in a rural region of southern Ontario clearly show distinct periods of strong acidity. Measurements made in Kingston, TN, and Steubenville, OH, resulted in 24-hr H+ ion concentrations exceeding 100 nmole/m3 more than 10 times during summer months. Periods of elevated acidic aerosols occur less frequently in winter months. The H+ determined during episodic conditions in southern Ontario indicates that respiratory tract deposition can exceed the effects level reported in clinical studies. Observed 12-hr H+ concentrations exceeded 550 nmole/m3 (approximately 27 micrograms/m3 H2SO4). The maximum estimated 1-hr concentration exceeded 1500 nmole/m3 for H+ ions. At these concentrations, an active child might receive more than 2000 nmole of H+ ion in 12 hr and in excess of 900 nmole during the hour when H2SO4 exceeded 50 micrograms/m3. PMID- 2707211 TI - Long-range transport modeling of air pollution episodes. AB - The air quality network in the Netherlands is based on a regular grid with an interstation distance of 30 to 40 km. In or close to source areas, a higher station density is realized. Atmospheric transport models form an intrinsic part of the air quality monitoring system. The models are constructed in such a way that only routinely available meteorological input data are needed. The models are applied for interpretation and generalization of the measurements in terms of contributions of source categories. In scenario studies, the potential effect of abatement strategies is explored. The output of the models consists of concentration and deposition fields of NOx, NO2, SO2, sulfate, and nitrate on the scale of the Netherlands or on the scale of northwestern Europe. In the present version the models are not directly suitable to estimate exposures to acidic aerosols; however, in combination with limited aerosol measurements, the model predictions can be used to provide information on the spatial and temporal distribution of acidic aerosols as needed for exposure assessment. PMID- 2707212 TI - Studies of acid aerosols in six cities and in a new multi-city investigation: design issues. AB - Techniques for measuring acid aerosols in the ambient environment have been developed only recently. As part of the on-going Harvard Study on the Health Effects of Sulfur Dioxide and Respirable Particulates, we have developed monitoring equipment for acidic particles that can be used in multiple field settings. Preliminary data suggest that these strong acid aerosol measurements may correlate with respiratory symptoms more closely than similar measurements of particulate matter less than 15 microns in size. These results have led to the beginning of a U.S.-Canadian cooperative study to assess the chronic effects of acid aerosols on the health of North American children. Communities are being selected on the basis of anticipated levels of H2SO4 in ambient air along with predicted levels of ozone and nitrates. Each community will undergo a 1-year period of every other day, 24-hr monitoring with newly developed monitoring equipment that will allow for quantification of H+ ion concentrations, as well as for specific measures of ozone and acid fractions. At the end of the 1-year period, while measurements are still being made, approximately 600 children aged 7 to 11 in each of up to 24 communities will be assessed with standardized questionnaires completed by parents, and pulmonary function will be measured in the children while in school. By estimating chronic exposure from the year-long measurement of acid aerosols and consideration of specific criteria for selecting communities to study, we hope to minimize potential confounding to allow us to assess the chronic impact of strong acid in the atmosphere on the respiratory health of these children. PMID- 2707213 TI - Serum aspartate aminotransferase to alanine aminotransferase ratio in human and experimental alcoholic liver disease: relationship to histologic changes. AB - We studied the relationship between the ratio of serum aspartate aminotransferase (ASAT) to alanine aminotransferase (ALAT) and histologic changes in human and experimental alcoholic liver disease. The patient population included 52 hospitalized patients enrolled in a Veterans Administration Cooperative study. The experimental animal group consisted of male Wistar rats fed an ethanol-liquid diet. Of the 52 patients with alcoholic hepatitis, 33 had evidence of cirrhosis. The mean +/- SD for the ASAT/ALAT ratio in the group with alcoholic hepatitis and no cirrhosis was 1.47 +/- 0.84, the mean +/- SD in the group with hepatitis and cirrhosis was significantly higher (2.68 +/- 1.32, p less than 0.01). There was no difference in the ratio between the rats with and without liver fibrosis. The cause for the increased ASAT/ALAT ratio in serum in the presence of cirrhosis is unknown and may reflect more severe liver damage. PMID- 2707214 TI - Time-resolved fractionation of bone and liver alkaline phosphatase activities with a 'peeling-off' method. AB - A procedure for the selective fractionation of the bone and liver alkaline phosphatase activity in tissue extracts and human sera is proposed. Optimized conditions of the assay are: urea 3.7 mol/l in 0.5 mol/l DEA buffer, pH 9.8; 0.5 mmol/l MgCl2; 10.0 mmol/l p-nitrophenyl phosphate. The sample is diluted 1:20 in the reagent solution and the activity is recorded for 10 min at 37 degrees C. By means of a computerized or manual graphic analysis, based on 'peeling-off' the exponentials, the two differently urea-sensitive subforms are identified and the slow-(liver) and the fast-decaying (bone) activities are easily discriminated and their respective values calculated. Interference due to the intestinal isoenzyme can be also accounted for. The analytical variability is very satisfactory (within run CV = 7.5 and 4.5% for osseous and hepatic form, respectively; day-to day CV less than 10% for both). The lower limits of detection are about 10 U/l and the serum or plasma reference values together with the influence on the assay of hemoglobin and protein content are also investigated. PMID- 2707215 TI - Undernutrition in lepromatous leprosy. V. Severe nutritional deficit in lepromatous patients co-infected with pulmonary tuberculosis. AB - We have compared the nutritional status of patients with lepromatous leprosy coinfected with pulmonary tuberculosis (18 cases) with that of lepromatous leprosy (239 cases) and of pulmonary tuberculosis (21 cases) and with that of healthy controls. There was a severe weight loss and reduction of skinfold thickness in the patients with pulmonary tuberculosis as well as in lepromatous patients with associated pulmonary tuberculosis, but not in patients with lepromatous leprosy. Levels in sera of diet-dependent proteins, such as albumin, prealbumin and retinol binding protein, were significantly decreased in all three groups of patients; on the other hand, levels of the diet-independent proteins, such as the immunoglobulins, were raised in all the groups, particularly in the pulmonary tuberculosis patients as compared with healthy controls. Serum transferrin levels were decreased only in the tuberculosis patients with or without lepromatous leprosy, but not in patients with leprosy alone. While haemoglobin levels decreased in all patient groups, serum iron concentrations were reduced most in lepromatous patients concomitantly infected with pulmonary tuberculosis. Serum ferritin levels increased in the sera of pulmonary tuberculosis and lepromatous leprosy patients, but was severely reduced in lepromatous patients with associated pulmonary tuberculosis. Mean serum zinc and calcium levels were decreased in all three groups of patients, while the serum copper concentration was increased in all of them compared with healthy controls. Also, inorganic phosphorus was elevated in tuberculosis and lepromatous patients coinfected with pulmonary tuberculosis, but not in lepromatous patients. Serum calcitonin levels were increased in all patient groups indicating an inverse correlation between serum calcium and calcitonin levels. This is the first comparative report describing the status of macro- and micronutrients in two most important mycobacterial diseases of the third world countries. PMID- 2707216 TI - Bioimpedance or anthropometry? AB - The ability of bioimpedance (BIA) to predict body composition in comparison with anthropometric measurements (weight and height) was assessed on three groups of adult young women (n = 99) and one group of adult young men (n = 49). Body fat (BF) and fat-free mass (FFM) by densitometry were used as the reference data. Resistance and reactance separately or together were poor predictors of BF and FFM, explaining from 0 to a maximum of 21 per cent of the FFM variation in the different groups. BF followed the same pattern, though the percentage of variance explained by both variables was even lower. Height squared divided by resistance (H2/R) explained from 22 to 68 per cent of the FFM variation and from 0 to 40 per cent of BF variation. Height alone was comparable to H2/R explaining from 11 to 53 per cent of the FFM variance in the four groups studied. Body weight was found to be the best single predictor of body composition; it explained from 56 to 78 per cent of FFM and 37 to 82 per cent of BF variability. Using stepwise regression analysis with all women combined, weight accounted for 70 per cent of the total FFM variation, with height and H2/R contributing only another 5 per cent. The same was found in men (68 vs 73 per cent respectively). The reported equation of Segal et al. was applied to our group, yielding almost the same high FFM prediction (r2 greater than 0.7 and SEE less than 2.5 kg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707217 TI - Protein economy during human starvation. PMID- 2707218 TI - Nutritional adaptation and variability. AB - In current nutrition literature man's requirement for energy for a given status and pattern of physical activity and body mass is fixed. Available experimental data on the other hand show that it is variable and self-regulated over a considerable range. This homoeostatic range is associated with covariance of man's genotype with local environmental effect under a sustained perturbation of common external environment. The implication is that man can have his intake anywhere in the range without being under nutritional stress. Below the lower limit of this range man is under energy stress, growth is retarded and man adapts to small body size. Unlike the homoeostatic range, this long-term adaptation is heritable, but there is no evidence that work output equals energy intake in adaptation to low intake. On the contrary, small subjects on a lower plane of nutrition are found to be metabolically more efficient. Evidence is cited to show that it is the decrease in BMR in subjects with low intake which plays a major role in facilitating a higher level of metabolic efficiency for subjects undergoing energy stress. PMID- 2707219 TI - Comparison of plasma, mononuclear and polymorphonuclear leucocyte vitamin C levels in young and elderly women during depletion and supplementation. AB - The levels of vitamin C in plasma, mononuclear (MN) and polymorphonuclear (PMN) leucocytes were measured in healthy, free-living, young and elderly women on three occasions over an 8-10-week period: (a) at entry into the study, (b) following 5 weeks of dietary depletion of vitamin C, and (c) following 3 weeks of supplementation with 500 mg of vitamin C per day. The combined mean vitamin C levels (expressed as microgram/10(8) cells) in MN cells were higher than those found in PMN cells at all three times, although the difference was only statistically significant in the depleted state. There were no age-related differences in the levels of vitamin C in plasma, MN or PMN cells at any of the three times. Significant overall differences in vitamin C levels between the entry and depleted and the depleted and supplemented states were observed for plasma and PMN cells but not for MN cells, possibly indicating that plasma and PMN cells are more sensitive indicators of vitamin C status than MN cells. The mean levels of vitamin C found in plasma clearly do 'track' those found in MN and PMN cells. However, attempted correlations between plasma and MN, plasma and PMN, and MN and PMN vitamin C levels at each time proved to be non-significant. In addition, the changes in vitamin C levels from entry to depleted and from depleted to supplemented times were non-significant when comparing plasma to MN and plasma to PMN, whereas the MN vs PMN comparison indicated a significant change in vitamin C levels between the depleted and supplemented states.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707220 TI - Cigarette smokers do more than just smoke cigarettes. AB - In this study, we hypothesized that light and moderate-to-heavy cigarette smokers, when compared with nonsmokers, would exhibit significantly less healthy attitudes and behaviors on several dimensions relevant to the risk of coronary heart disease (CHD). A factor analysis of survey items measuring knowledge, attitudes, and behaviors in five CHD risk areas produced four major factors, which we labeled Attitudes (Factor 1), Health Consciousness (Factor 2), Knowledge (Factor 3), and Unhealthy Behaviors (Factor 4). Factor-based scales generated for each of these four factors were used in a one-way multivariate analysis of variance to examine differences between nonsmokers, light smokers, and moderate to-heavy smokers. Cigarette smokers versus nonsmokers exhibited less positive attitudes toward CHD risk behaviors, whereas moderate-to-heavy cigarette smokers, as compared with the light smokers and the nonsmokers, exhibited lower levels of health consciousness and enacted unhealthy behaviors at a greater frequency. The moderate-to-heavy cigarette smokers also exhibited a lower commitment to enact healthy behavioral changes in the immediate future, even after corrections were introduced for their lower frequency of healthy behaviors during the past week. Overall, these results support our hypothesis that cigarette smokers, particularly as they become more involved with cigarette smoking, do more than just smoke cigarettes; they exhibit a less healthy lifestyle as shown by cognitive, behavioral, and motivational dimensions related to cardiovascular health. PMID- 2707221 TI - Symptom awareness and blood glucose estimation in diabetic adults. AB - Self-regulation of diabetes depends in part on common-sense models of symptoms and blood glucose fluctuations. Symptom perception and subjective estimation of blood glucose were studied in 52 adult, difficult-to-control, non-insulin dependent diabetics using a structured interview and laboratory blood-glucose measurement. Most patients believed they could detect hyperglycemia. Symptoms linked by patients to hyperglycemic and hypoglycemic episodes did overlap with symptoms traditionally associated with those states. Some patients may experience dysphoria during glycemic swings to which multiple symptom labels are applicable, although prominent exceptions and idiosyncratic symptoms were evident. Estimation of current blood glucose using an ordinal scale suggested some capacity for discriminating blood glucose levels. Numerical estimates of Chemstrip values were correlated with actual values, but far too inaccurately for purposes of self regulation. Research is needed to clarify whether subjective symptom perception and blood glucose estimation helps or hinders self-regulation of diabetes. PMID- 2707222 TI - Consistency of adherence across regimen demands. AB - The extent to which adherence to one demand of the diabetic treatment regimen is related to adherence to other regimen demands was explored in a sample of 227 diabetic patients. Adherence to weight control, urine/blood testing, medication taking, symptom reporting, and safety demands was assessed using a variety of methods: (a) patients' report in relation to physician's criteria, (b) patients' report in relation to their own understanding of those criteria, (c) significant others' reports, (d) nurses' ratings, and (e) physicians' ratings. Based on attribution theory, it was proposed that informed others would view patients as more consistent than patients themselves did. Separate intercorrelation matrices were created for each method. The correlations, however, were uniformly low (most rs less than .25) and mean correlations did not differ significantly between matrices. The relative independence of adherence to different demands of the diabetic regimen has important implications for the conceptualization and measurement of treatment adherence. PMID- 2707223 TI - Mood changes associated with blood glucose fluctuations in insulin-dependent diabetes mellitus. AB - Individuals with insulin-dependent diabetes mellitus (IDDM) and their healthcare practitioners believe that extreme blood glucose (BG) fluctuations are characterized by changes in subjective mood states and emotional behavior, as well as physical symptoms. This study examined relationships between BG levels and self-reported mood in a group of 34 IDDM adults. The method followed a within subject, repeated-measures design employed in previous studies of physical symptoms associated with diabetic glucose. Four times each day, participants completed a mood/symptom checklist just prior to a self-measurement of BG until 40 checklists had been completed. Half the items on the checklist described physical symptoms and half described mood states. In addition, half the mood items described negative states and half described positive states. Within subject correlations and regressions showed that moods were related to BG for the majority of participants and that, like physical symptoms, mood-BG relationships were highly idiosyncratic. Low BG levels tended to be associated with negative mood states, primarily self-reported "nervousness." Positive mood items were almost always associated with high BG. High BG levels also frequently correlated with negative mood states, although the negative mood items that tended to relate to high glucose (anger, sadness) differed from those that tended to relate to low BG. The implications of these findings for self-treatment and glucose perception in the IDDM individual are discussed. PMID- 2707224 TI - Predicting receipt of social support: a longitudinal study of parents' reactions to their child's illness. AB - A sample of 101 women whose children required medical attention were interviewed at the time of initial hospital contact and again 1 year later. On the second occasion, their spouses were also interviewed for their assessment of their wives' personal and social characteristics. Greater personal resources, more intimate relations, and lower discomfort in seeking support were related to greater receipt of social support 1 year later. Chronic stress conditions were found, however, to diminish the effect of individuals' social characteristics on receipt of support. Spouses assessments showed moderate agreement with that of their wives, lending support to the validity of the findings. Implications for interventions in health-care settings were discussed. PMID- 2707225 TI - Family cigarette smoking and test performance by adolescents. AB - This research considers test performance by adolescents as a correlate of cigarette smoking by their families. Scores obtained by adolescents on the California Achievement Test decreased as the amount of cigarette smoking by other members of their families increased. The relationship was not accounted for by active cigarette smoking of the adolescent or by 20 other social and psychological variables. PMID- 2707226 TI - Muscle glycogen depletion patterns during draught work in Standardbred horses. AB - Muscle fibre recruitment was investigated during draught loaded exercise by studying glycogen depletion patterns from histochemical stains of muscle biopsies from the gluteus and semitendinosus muscles. Three Standardbred trotters performed several intervals of draught loaded exercise on a treadmill with 34 kp at a trot (7 m/sec) and with 34 and 80 kp, respectively at a walk (2m/sec). Exercise was continued until the horses were unwilling to continue. Glycogen depletion was seen in all three fibre types when trotting with 34 kp for 5 or 10 mins. When an equal weight resistance was pulled at a walk, glycogen depletion was first seen in type I fibres only, then followed by a small percentage of type IIA fibres after at least 1 h. When 80 kp was pulled at a walk both type I and IIA fibres showed glycogen depletion, and after at least 30 mins exercise a small percentage of type IIB fibres was also depleted. These results indicate that the muscle fibres are depleted, in order, from type I through IIA to IIB as the intensity or duration of draught work increases. PMID- 2707227 TI - Predictive utility of pre-partum temperature changes in the mare. AB - Rectal temperature was recorded from 22 mares at 0700, 1500 and 2300 h daily for seven days pre-partum and one day post partum. A circadian variation in rectal temperature was present with the lowest temperature recorded at 0700 h. Because of this, the mares were divided into three groups based on time of parturition; those foaling between 0700 and 1500 h (n = 2); between 1500 and 2300 h (n = 13); and between 2300 and 0700 h (n = 7). On the day prior to delivery (Day -1) the circadian pattern was absent because the nocturnal increase did not occur. A significant decrease in temperature was recorded prior to parturition in the group foaling between 1500 and 2300 h. A distinct decrease in temperature occurred in the majority of mares in the other two groups but this was not statistically significant. After parturition, rectal temperature increased to supranormal levels before returning to normal. PMID- 2707228 TI - Plasma plasminogen concentrations in clinically normal horses: the effect of age, sex and pregnancy. AB - Plasma concentrations of plasminogen were determined in 28 clinically normal horses, including 13 adult geldings, five non-pregnant mares, five pregnant mares and five yearlings (two fillies, three geldings). Plasminogen was quantitated by a chromogenic assay based on activation of plasmin by excess urokinase. The overall mean plasma plasminogen for these horses was 2.94 +/- 0.54 CTA units (casein units, as defined by the Committee on Thrombolytic Agents) per ml. There were no significant differences in mean plasma plasminogen values among adult geldings, non-pregnant mares, pregnant mares or yearling horses (P greater than 0.05). PMID- 2707229 TI - Thyroid hormone periodicity in healthy adult geldings. AB - Serum samples were collected from 10 healthy geldings every 4 h for three consecutive days and the triiodothyronine (T3) and thyroxine (T4) concentrations determined by radioimmunoassay. There were significant differences in the hormone concentrations related to time. The mean (+/- sd) T3 concentration peaked around 08.00 h at a level (54.06 +/- 14.02 ng/dl) significantly (P less than .001) higher than the lowest concentration (38.71 +/- 10.81 ng/dl) around midnight. Although the highest mean T3 level was 08.00 h, this value was not significantly different from the noon and 16.00 h levels. Likewise, the mean T3 level at midnight was not significantly different from the 20.00 h and 04.00 h levels, resulting in a plateau from 08.00 h to 16.00 h and a trough from 20.00 h to 04.00 h. The mean (+/- sd) T4 concentration peaked around 16.00 h at a level (2.43 +/- .81 micrograms/dl) significantly (P less than .01) higher than the lowest concentration (1.79 +/- .63 micrograms/dl) around 04.00 h. PMID- 2707230 TI - Congenital aneurysmal bone cyst in the mandible of a foal. PMID- 2707231 TI - Chylothorax in an Arabian filly. PMID- 2707232 TI - A preliminary report on the possible genetic basis of laryngeal hemiplegia. PMID- 2707233 TI - Survey of plasma free carnitine levels in 74 Thoroughbred horses at stud and in training. PMID- 2707234 TI - Indocyanine green clearance and estimation of plasma volume in the normal horse. PMID- 2707236 TI - Veterinary education in the UK: special needs for equine graduates. PMID- 2707235 TI - Partial divergence between airway inflammation and clinical signs in equine chronic pulmonary disease. PMID- 2707237 TI - Development of an equine nuclear medicine facility for gamma camera imaging. AB - A nuclear medicine facility constructed specifically for the application of a gamma camera system to the radioisotope imaging of bone, pulmonary circulation and ventilation in the horse is described. The gamma camera was previously used for human nuclear medicine, and a support for the gamma camera head was specifically designed for this work. Imaging protocols are suggested and the necessary materials for bone and lung studies are described. Images of bone and lung are shown and computer analysis of the data indicated. Imaging times are approximately 1 to 2 mins and typical bone and lung studies can be completed in 20 to 30 mins. PMID- 2707238 TI - Blood chemistry and skeletal muscle metabolic responses during and after different speeds and durations of trotting. AB - Eight standardbred horses trotted on a treadmill for 55 mins at a sub-maximal speed of 5m/sec and subsequently performed an exercise test consisting of 2 min intervals at increasing speed. Heart (HR) and respiratory (Rf) rates and venous blood samples were obtained before, during and for 5 mins after exercise. Gluteus medius muscle biopsies and rectal temperatures were taken before and after exercise. The mean HR was 132/min and the mean Rf was 156/min during the 5m/sec trotting. With 5m/sec exercise, plasma free fatty acids (FFA), glucose, creatinine and cortisol concentrations increased markedly. Blood lactate increased slightly and plasma potassium increased initially and then decreased with a lengthened duration of trotting. Within 5 mins post exercise plasma FFA, glucose and cortisol concentrations continued to rise, whereas creatinine and lactate levels declined slightly and potassium concentrations declined rapidly to below resting values. The mean intramuscular (im) glycogen utilisation was 86 mmol/kg, no significant changes occurred in creatine phosphate (CP), adenosine triphosphate (ATP) and glucose-6-phosphate (G-6-P) concentrations and muscle lactate decreased significantly. During the second exercise test mean HR was 215/min and Rf 126/min at top speed. No significant change was seen in plasma glucose whereas cortisol levels rose to a lesser extent, and creatinine lactate, ammonia and potassium concentrations to a greater extent, compared to 5 m/sec trotting. Post exercise, these parameters continued to increase except for creatinine which declined slightly and potassium which decreased rapidly. The mean im glycogen utilisation was 144 mmol/kg, ATP concentrations were unaltered, CP declined, lactate and G-6-P increased during exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707239 TI - The search for the ultimate equine sedative: are we 'Waiting for Godot'? Combined use of detomidine with opiates in the horse. PMID- 2707240 TI - A rapid, non-invasive method for measuring total respiratory impedance in the horse. AB - Total respiratory impedance was measured rapidly and noninvasively in conscious horses over the frequency range 3 to 40 Hz by the forced random noise method. The shape of curve of impedance versus frequency in horses was markedly different from that of humans. Respiratory resistance was readily found as the real part of impedence and both its absolute value and frequency dependence are useful indices of pulmonary function. It was difficult to obtain meaningful results in intubated animals with the method because of the mechanical properties of the endotracheal tube itself. PMID- 2707241 TI - Fully automated capillary isotachophoresis of proteins. AB - An apparatus for fully automated capillary isotachophoresis was constructed. A commercial apparatus (Shimadzu IP-2A) was modified in the electrolyte pumping system and the flow lines were simplified. An automatic sampler was used for sequential sampling. The equipment, pumps, the sampler, a high-voltage DC power supply, and a recorder, were controlled by a system controller which comprises a microcomputer and a BASIC program for time-control of the equipments. The apparatus was successfully used for the automated sequential analysis of human serum proteins. Forty serum samples were analyzed within 17 h without manual operation and for each sample the serum proteins were resolved into about twenty UV peaks or shoulders. PMID- 2707242 TI - Toward a steady-state pore limit electrophoresis dimension for native proteins in two-dimensional polyacrylamide gel electrophoresis. AB - Polyacrylamide gel electrophoresis in linear pore gradients (4.8 to 48% T, 5% CBis) provides for migration arrest, in a practical sense, after about 5000 Vh for proteins of 290 and 450 kDa, but not for smaller proteins over 20,000 Vh. The arrest is not due to inadequate field strength nor is it caused by water redistribution within pore gradient gels. The possibility is being discussed that exponential pore gradients, and a higher or a lower degree of crosslinking suggested by the literature may be remedies for the present failure to arrest the migration of smaller proteins. PMID- 2707243 TI - Program in BASIC for Ferguson plot analysis, using a personal computer: application to gel electrophoresis in a continuous buffer. AB - A program in BASIC suitable for personal computers is described which is applicable to gel electrophoresis conducted in a single (continuous) buffer. The curve fitting is to a polynomial function, allowing for an objective selection of the most appropriate curve type and order--linear, convex or concave--in the particular application. Results do not differ significantly from previous programs for evaluation of linear Ferguson plots or of curve fitting to an exponential function for evaluating convex plots, executed on mainframe computers such as the DEC-10 (Digital) and IBM 370 computers. Thus, the program combines original versatility with, for the first time, the possibility for widespread application of Ferguson plot analysis on personal computers. PMID- 2707244 TI - Vertical remission densitometry for the evaluation of nontransparent samples. AB - Gels dried onto filter paper or their blots on membranes are not suitable for densitometric evaluations in the transmission mode because these samples are nearly nontransparent. By scanning in the remission mode, evaluation with good results is possible. Data acquisition by a computer-controlled high speed scanning photometer and digital image processing affords a spatial resolution and accuracy similar to that in the transmission mode. The signal-to-background ratio decreases by 10-30% depending on the smoothness of the support. PMID- 2707245 TI - Mirror densitometry for higher sensitivity and resolution. AB - In order to increase the pathway of the light inside a gel (or autoradiogram) during scanning, it is placed on top of a mirror and the densitometry is performed in a vertical reflection mode. As the light passes the gel a second time after being reflected by the mirror, the absorbance is nearly doubled. This increase in absorbance results in higher sensitivity and resolution. PMID- 2707246 TI - Use of a polynomial exponential function to describe migration of proteins on sodium dodecyl sulfate-polyacrylamide gels. AB - Standard mixtures of proteins were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Polynomial regression analysis was used to fit curves to the data points obtained by plotting log10 of protein molecular weight versus electrophoretic mobility. Polynomials with orders ranging from 1 to 4 were generated. The coefficients of each equation were analyzed for statistical significance. It was found that a third order polynomial was the highest-order equation in which all coefficients contributed significantly to the prediction of molecular weights. Using this equation, it was possible to estimate the molecular weights of known proteins in the range from 97,400 to 14,400 with a maximum error of 1%, compared with a maximum error of 17% when a first-order equation was used to describe the migration of the standards. PMID- 2707247 TI - A simple method for accurately locating and cutting strips from the isoelectric focusing gel during two-dimensional electrophoresis using the PhastSystem. AB - A rapid and simple method has been developed for precisely locating and cutting 1 3 mm strips from the isoelectric focusing gel during two-dimensional electrophoresis using the PhastSystem. The protocol utilizes an easily constructed styrofoam template with marks to guide accurate cutting of the strips from the sample lanes. This system greatly enhances the reproducibility and quality of the two-dimensional patterns obtained. PMID- 2707248 TI - Self-sustaining limbic status epilepticus induced by 'continuous' hippocampal stimulation: electrographic and behavioral characteristics. AB - A model of status epilepticus centered in the limbic system and elicited by 'continuous' focal electrical stimulation of the hippocampus is presented. Under appropriate conditions, the status epilepticus persisted for many hours after discontinuing the electrical stimulus. The critical determinant for the establishment of this self-sustaining limbic status epilepticus (SSLSE) was the length of stimulation, rather than the side (left vs. right) of stimulation or kindling before stimulation. Observations, obtained from stimulus-free intervals spaced regularly during the stimulus protocol and from the period after stimulation had been completed, revealed a distinct and stereotyped electrographic progression of SSLSE though several stages. Brief monitoring periods throughout the stimulus protocol yielded electrographic criteria that predicted which animals would experience experience SSLSE. The presence of synchronous, stimulus-independent seizure activity bilaterally in the hippocampi during stimulation was necessary to establish SSLSE. Intense motor seizure activity, like that seen with kindled motor seizures, occurred intermittently during SSLSE. However, 'limbic' behavioral seizures identical to those seen after low doses of kainic acid or during the early stages of kindling were nearly continuous. These studies indicate that there is a predictable course to limbic status epilepticus and point to the hippocampus as a key element involved in initiating and maintaining this syndrome. PMID- 2707249 TI - Determination of the threshold for convulsions by direct cortical stimulation. AB - In this study we investigated whether determination of the convulsion threshold by electrical stimulation of the cortex could be used as a simple test for measuring anticonvulsant drug activity in unrestrained, unanaesthetized rats. Pulse trains delivered to electrodes implanted in the frontoparietal cortex elicited convulsions, similar to those seen in the classical electroshock tests. The threshold could be determined rapidly with pulse trains which increased in strength in a ramp-shaped fashion (bipolar pulses of 2 msec, 50 pulses/sec, increment 1.3 microA/pulse). The threshold was defined as the current needed to elicit forelimb clonus. Upon repeated stimulation the threshold declined from a value of about 600 microA to about 350 microA in 20 sessions. Thereafter, continued testing did not result in considerable changes in threshold. After stabilization, the convulsion threshold could be determined repeatedly with intervals as short as 5 min. Following i.p. injection of 5 mg/kg of diazepam an elevation of the threshold of 30% was observed 0.5 h after injection. After 5 daily injections, evidence for the development of complete tolerance was obtained. After i.v. injection of 8 mg/kg oxazepam, the threshold increase reached a peak level of 75% after 20 min. The changes in threshold followed arterial blood concentration of oxazepam, which was maximally 4.8 micrograms/ml immediately after injection. The threshold returned to baseline in approximately 6 h. The results of the present study show that with our procedure anticonvulsant drug activity can be accurately, rapidly and repeatedly determined in individual animals, both in acute and chronic experiments. PMID- 2707250 TI - Abnormalities in the levels of extracellular and tissue amino acids in the brain of the seizure-susceptible rat. AB - Basal and high potassium-stimulated release of endogenous amino acids was measured using brain dialysis in the hippocampus of urethane-anesthetized seizure resistant (SR) and seizure-susceptible (SS) rats. Moreover, the tissue level of amino acids was determined in the hippocampus, sensorimotor cortex, cerebellum and corpus striatum. The basal extracellular concentration of amino acids did not differ between SR and SS rats. However, aspartate release was higher, and taurine and phosphoethanolamine release was lower in SS rats during stimulation with 100 mM K+. Several strain differences were observed with regard to regional tissue levels of amino acids. Aspartate was significantly elevated in the hippocampus, cortex and cerebellum of SS animals, and the catecholamine precursor tyrosine was diminished in all regions examined. Other disparities included a depressed gamma aminobutyrate concentration in the hippocampus and cortex, slightly increased levels of phosphoethanolamine in the cerebellum and minor decreases in striatal and cortical taurine. Glutamate, glutamine, serine and alanine concentrations were not significantly altered in any brain area of the SS rat. The results confirm and extend previous findings on abnormalities in aspartate, taurine and phosphoethanolamine regulation in this model. In addition, decreased availability of tyrosine may provide a partial explanation for the well-documented deficiency in cerebral norepinephrine in the SS strain. PMID- 2707251 TI - Vigabatrin in complex partial seizures: a long-term study. AB - The efficacy and safety of oral vigabatrin (VGB) as add-on therapy in the long term treatment of poorly controlled epilepsy were evaluated in 19 patients with complex partial seizures, either with or without secondary generalization. The study was run with a single-blind, placebo-controlled, crossover design, and included 2 months of placebo and 13-15 months of treatment with VGB, at doses ranging from 1 to 4 g/day. Of the 14 patients who completed the trial, 2 were seizure free, in 5 seizure frequency dropped by more than 75% and in another 5 by more than 50% with respect to baseline. The decrease in seizure frequency in the group as a whole was significant at all observation points of the trial. Three patients were not entered into the long-term phase due to lack of improvement (an increase in seizure frequency was observed in one of them), and 2 were excluded later because improvement disappeared leading to unauthorized changes in comedication. Side effects were mild and never caused discontinuation of treatment. In conclusion, VGB showed a remarkable efficacy and safety in the long term treatment of complex partial seizures. PMID- 2707252 TI - Epilepsia arithmetices revisited. AB - Three patients whose epileptic seizures are precipitated by arithmetic calculations are reported and their clinical and EEG features analysed along with those of 7 previous cases. The seizure disorder, in general, was characterised by an onset, in adolescence, of myoclonic jerks with or without tonic-clonic seizures and generalised bisynchronous 2-5 Hz spike-and-wave discharges in the EEG. Problems involving processing of spatial information were among the tasks which induced the dysrhythmia. The specificity and the consistency of the seizure provoking stimuli suggest that in these patients the cortical areas responsible for calculations and related functions are abnormally hyperexcitable and the repeated stimulation during cognitive activities triggers seizure discharges. Two or our patients responded well to clobazam during a follow-up period of 6 months. PMID- 2707253 TI - The effects of acrylamide on mouse germ-line and somatic cell chromosomes. AB - The industrial chemical acrylamide is suspected to induce potentially heritable genetic damage. While several studies in rodents have indicated that this substance can damage spermiogenic cells, resulting in dominant lethals and heritable translocations, cytogenetic assessments of premeiotic and meiotic cells after exposure have produced equivocal results. In the present study, various cytogenetic endpoints in both somatic and germ-line cells from acrylamide-treated mice were evaluated. Sister chromatid exchanges and micronuclei, but not chromosome aberrations, were induced in spleen cells; synaptonemal complex irregularities (asynapsis), but not chromosome aberrations, were induced in germ cells. PMID- 2707254 TI - Sister chromatid exchanges induced by tertiary butyl hydroquinone in bone marrow cells of mice. AB - Tertiary butyl hydroquinone (TBHQ)--a phenolic antioxidant, was evaluated by assessing the induction of sister chromatid exchanges (SCEs) in bone marrow metaphase cells of mice. Six concentrations, 0.5, 2, 20, 50, 100, and 200 mg/kg, of TBHQ were injected intraperitoneally. A positive dose-response effect in the SCE frequency was observed using the Cochran-Armitage trend test. Two mg/kg of TBHQ was found to be the minimum effective dose. Study of the cell-cycle kinetics showed a delay in cell cycle induced by the higher concentrations of TBHQ. Thus, TBHQ was found to be a DNA damage-inducing agent and also a cytotoxic chemical in vivo in mice. PMID- 2707255 TI - Toxic effects of methyl methanesulfonate (MMS) on activated macrophages from chickens. AB - Adherent peritoneal exudate cells rich in macrophages were harvested from Cornell K-strain chickens 42 hr after i.p. stimulation with Sephadex G-50. Glass-adherent monolayers were obtained on coverslips and subjected to in vitro exposure to methyl methanesulfonate (MMS) at various doses for 1 hr. Solvent (0.17% ethanol final concentration) and sham (RPMI 1640 growth media) exposures were also performed. At selected times after exposure, the macrophages were analyzed for cell viability, adherence, DNA damage, and functional activity. Although MMS doses of 5 x 10(-3) M and 1 x 10(-3) M concentrations resulted in significant cytoxicity, 2 x 10(-4) M had no significant cytotoxic effect. However, this exposure resulted in DNA damage as measured by alkaline elution. Concomitant with the DNA damage was a significant decrease in the phagocytic activity of macrophages. Repair of MMS-induced DNA lesions in macrophages was indicated by a normal DNA alkaline elution profile 10 hr postrecovery. Functional activity of cells also returned to normal levels. In contrast, the incidence of Fc receptor positive cells detected by rosetting increased immediately after MMS exposure, and phagocytosis of opsonized SRBCs was not affected by 2 x 10(-4) M MMS treatment. Similarly, MMS treatment did not alter the acid phosphatase activity of macrophages. However, bactericidal ability of MMS-treated macrophages for unopsonized Escherichia coli was significantly depressed. These results suggest that the avian macrophage is a useful target cell for examining possible relationships between genotoxic and immunotoxic effects of environmental mutagens. PMID- 2707256 TI - The histidine residue of codon 715 is essential for function of elongation factor 2. AB - Several mutant cDNAs of elongation factor 2 (EF-2) were constructed by site directed mutagenesis and their products expressed in mouse cells were investigated. Amino acid substitution for the histidine residue of codon 715, which is modified post-translationally to diphthamide, resulted in non-functional EF-2 and this substitution did not render EF-2 resistant to Pseudomonas aeruginosa exotoxin A, which inactivates EF-2 transferring ADP-ribose to the diphthamide residue. These non-functional EF-2s with replacements of the histidine-715 residue showed various extents of inhibition of protein synthesis by competing with functional EF-2 in vivo. These results suggest that histidine 715 is essential for the translocase activity of EF-2 and that the region around diphthamide functions in recognition of, and/or binding to ribosomes. Substitution of proline for the alanine-713 residue and substitution of glutamine for the glycine-717 residue converted EF-2 to partially toxin-resistant forms. Two-dimensional gel analysis with fragment A of diphtheria toxin of these toxin resistant EF-2s revealed that their ADP-ribosylations by toxin were much less than that of wild-type EF-2. PMID- 2707257 TI - Analysis of N-acetyl-4-O-acetylneuraminic-acid-containing N-linked carbohydrate chains released by peptide-N4-(N-acetyl-beta-glucosaminyl)asparagine amidase F. Application to the structure determination of the carbohydrate chains of equine fibrinogen. AB - The carbohydrate chains of equine fibrinogen were enzymatically released by peptide-N4-(N-acetyl-beta-glucosaminyl)asparagine amidase F. The oligosaccharides obtained were fractionated by a combination of FPLC and HPLC and analyzed by 500 MHz 1H-NMR spectroscopy. Four monosialo and four disialo diantennary N acetyllactosamine type of carbohydrate chains occur: (formula; see text) PMID- 2707258 TI - Aspartate aminotransferase isoenzymes in Leptosphaeria michotii. Properties and intracellular location. AB - Two forms of aspartate aminotransferase were obtained from the fungus Leptosphaeria michotii and purified to a state of apparent homogeneity by a five step purification procedure ending with blue Ultrogel chromatography. Holoenzyme specific activities were 13430 and 9110 nkat oxalacetate/mg protein-1 and isoelectric points were 7.1 and 7.0 for forms A and B, respectively. Both isoenzymes were isologous dimers of Mr 92,000. They differed mainly in their Km for 2-oxoglutarate and aspartate, their ability to use cysteine sulfinate as a substrate and their ability in vitro to be specifically tightly associated as follows: form A with a malate dehydrogenase monomer of Mr 25,000; form B with an unidentified protein of Mr 40,000-44,000. Rabbit antiserum raised against the form A holoenzyme was not reactive against the form B holoenzyme and vice versa. Association of the holoenzyme with the complex essentially provoked a shift of the isoelectric point to 5.8 for form B [corrected] and to 5.2 for form B, without affecting kinetic parameters. In order to localize in situ the two transaminase forms, ultrastructural detection was carried out by immunogold staining of thin sections of Lowicryl-K4M-embedded colonies. Antiserum against form A essentially labelled cytoplasm and cell wall and, to some extent, mitochondria, while antiserum against form B heavily labelled mitochondria and cell wall and to a lesser extent cytoplasm. Moreover, mitochondria were isolated and purified by Percoll-density-gradient centrifugation. Only form A was identified in this subcellular fraction using ELISA. PMID- 2707259 TI - Neutral glycolipids of atherosclerotic plaques and unaffected human aorta tissue. AB - The composition, structure and localization of neutral glycosphingolipids of human aorta taken from subjects who had died after myocardial infarction were studied. Individual glycosphingolipids were purified by high-performance liquid chromatography and were characterized on the basis of their chromatographic mobility, carbohydrate composition, methylation analysis and by 1H-NMR spectroscopy. The main aortic glycosphingolipids were identified as glucosylceramide, lactosylceramide, globotriaosylceramide and globotetraosylceramide. Significant differences in the neutral glycosphingolipid composition of intima and media were detected. The neutral glycosphingolipid profile of medial plaques resembled that of unaffected media; however, significant differences were detected between intimal plaques and unaffected intima. Whereas the latter contained trihexosylceramide and globoside as the only neutral glycolipids, the intimal plaque glycolipids consisted mainly of glucosylceramide and also contained appreciable amounts of lactosylceramide which were completely absent in the unaffected intima. In comparison to intimal plaques, unaffected intima is characterized by a much higher content of cerebrosides terminating by beta-galactosyl residues which are known to interact with growth factors and other external stimuli. It thus seems possible that the proliferative activity of smooth muscle cells in atherosclerotic diseases is to some extent associated with their neutral glycolipid profile. PMID- 2707260 TI - Zonal distribution of fatty acid synthase in liver parenchyma of male and female rats. AB - 1. A sensitive radiochemical assay was established to determine the activity of fatty acid synthase in microdissected liver tissue of less than 1 microgram dry mass. 2. In female rats, the enzyme activity in perivenous tissue was twice that in periportal liver tissue while it was homogeneously distributed in livers of male animals. The overall activity was higher in female than in male animals. 3. The absolute activity, as well as the perivenous/periportal ratio, was reduced during starvation and in diabetes. They were greatly increased after refeeding to values above those observed in animals during normal feeding. 4. Ovariectomy or administration of testosterone to female rats resulted in a significant reduction of the zonal heterogeneity. 5. Castration or administration of estradiol to male animals was followed by an increase in the enzyme activity exclusively in the perivenous tissue, resulting in a zonal heterogeneity as observed in female rats. PMID- 2707261 TI - The primary structure of alcohol dehydrogenase from Drosophila lebanonensis. Extensive variation within insect 'short-chain' alcohol dehydrogenase lacking zinc. AB - Insect alcohol dehydrogenase is highly different from the well-known yeast and mammalian alcohol dehydrogenases. The enzyme from Drosophila lebanonensis has now been characterized by protein analysis and was found to have a 254-residue protein chain with an acetyl-blocked N-terminal Met. Comparisons with the structures of the enzyme from other species allows judgement of the extent of variability within the insect alcohol dehydrogenases. They have diverged to a considerable extent; two forms analyzed at the protein level differ at 18% of all residues, and all the known Drosophila alcohol dehydrogenase structures reveal differences at 72 positions. Some deviations, against a background similarity, in the extent of changes are noted among the parts corresponding to different exons. The structural variation within Drosophila is about as large as the one for the mammalian zinc-containing alcohol dehydrogenase. Consequently, the results illustrate Drosophila relationships and establish great variations also for group of alcohol dehydrogenases lacking zinc. PMID- 2707262 TI - Pyruvate-enhanced phosphorylation potential and inotropism in normoxic and postischemic isolated working heart. Near-complete prevention of reperfusion contractile failure. AB - Bioenergetic and hemodynamic consequences of cellular redox manipulations by 0.2 20 mM pyruvate were compared with those due to adrenergic stress (0.7-1.1 microM norepinephrine) using isolated working guinea-pig hearts under the conditions of normoxia, low-flow ischemia, and reperfusion. 5 mM glucose (+ 5 U/l insulin) + 5 mM lactate were the basal energy-yielding substrates. To stabilize left ventricular enddiastolic pressure, ventricular filling pressure was held at 12 cmH2O under all conditions; this preload control minimized Frank-Starling effects on ventricular inotropism. Global low-flow ischemia was induced by reducing aortic pressure to levels (20-10 cmH2O) below the coronary autoregulatory reserve. Reactants of the creatine kinase, including H+ and other key metabolites, were measured by enzymatic, HPLC, and polarographic techniques. In normoxic hearts, norepinephrine stimulations of inotropism, heart rate x pressure product, and oxygen consumption (MVO2) were associated with a fall in the cytosolic phosphorylation potential [( ATP]/[( ADP].[Pi]] as judged by the creatine kinase equilibrium. In contrast, infusion of excess pyruvate (5 mM) markedly increased [ATP]/[( ADP].[Pi]) and ventricular work output, while intracellular phosphate decreased; MVO2 remained constant under the same conditions. During reperfusion following ischemia, pyruvate effected striking and concentration-dependent increases in MVO2, phosphorylation potential, and inotropism. Pyruvate dehydrogenase flux was augmented during reperfusion hyperemia followed by near-complete recoveries of [ATP]/([ADP].[Pi]), contractile force, heart rate x pressure product, and MVO2 in the presence of 5-10 mM pyruvate. Pyruvate also attenuated ischemic adenylate degradation. Omission of glucose from the perfusion medium rendered pyruvate ineffective in postischemic hearts. Similarly, excess lactate (5-15 mM) or acetate (5 mM) failed to reenergize reperfused hearts and severe depressions of MVO2 and inotropism developed despite the presence of glucose. Apparently, subcellular redox manipulations by pyruvate dissociated stimulated mitochondrial respiration and increased inotropism from low cytosolic phosphorylation potentials. This was evidence against the extramitochondrial [ADP].[Pi]/[ATP] ratio being the primary factor in the control of mitochondrial respiration. The mechanism of pyruvate enhancement of inotropism during normoxia and reperfusion is probably multifactorial. Thermodynamic effects on subcellular [NADH]/[NAD+] ratios are coupled with a rise in the cytosolic [ATP]/[( ADP].[Pi]) ratio at constant (normoxia) or increased (reperfusion) MVO2.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2707263 TI - Interaction of beta-very-low-density lipoproteins with rat liver cells. AB - Cholesteryl-ester-rich very-low-density lipoproteins (beta-VLDL) are considered to be atherogenic because in vitro they can provoke cholesterol accumulation in macrophages. The greatest population of macrophages resides inside the liver and in the present study the rat beta-VLDL uptake by the various rat liver cell types is determined in vivo and compared to the uptake of rat VLDL. beta-VLDL isolated from cholesterol-fed rats was iodinated and injected into the rat. After 10 min of circulation, 45% of the injected beta-VLDL was found in the liver. A low temperature cell-isolation procedure shows that rat liver parenchymal cells form the major site for beta-VLDL uptake (96%) and, consequently, rat liver macrophages (nonparenchymal liver cells) do not perform a quantitatively significant role in the uptake of these lipoproteins. In vitro competition studies indicate that apolipoprotein (apo) E is the site recognised by liver parenchymal cells and even a 600-fold excess of apo-E-free human LDL was an ineffective competitor. Furthermore it can be demonstrated that induction of apo B,E receptors on liver parenchymal cells by estrogen treatment does not result in a significant increased uptake of beta-VLDL. These data show that recognition of beta-VLDL is presumably exerted by the remnant receptor. Intracellular processing of both the apolipoproteins and phospholipids of beta-VLDL was followed by subcellular distribution studies. It appears that, within 45 min, 75% of the apolipoproteins are degraded and subsequently released from the liver. In contrast the phospholipids remain associated with the liver for a prolonged time and a specific transfer to the mitochondrial fraction is found. It can be concluded that liver parenchymal cells form in vivo the major site for beta-VLDL uptake and it appears that recognition of beta-VLDL is coupled to internalization and processing of both the apolipoproteins and phospholipids by a route which involves the lysosomes. PMID- 2707264 TI - Effect of the microenvironment on the kinetic properties of immobilized enzymes. AB - A new immobilization method was developed in order to perform a systematic study of the influence of the microenvironment on the properties of immobilized enzymes. The enzyme, alcohol dehydrogenase, was first activated, then polypeptide arms of known composition were quantitatively grafted and finally the enzyme was covalently immobilized by co-polymerization of the activated ends of the peptide arms with acrylamide monomers. In this way, the polypeptide linker arms fully determine the properties of the microcavity of the gel in which the enzyme is immobilized by multipoint covalent linkages. The activation energy of the reaction was determined for different microenvironments, in solution as well as after immobilization. Kinetic parameters were also calculated and a new kinetic model was developed, allowing a correction for the diffusional restrictions. The results show that the diffusional restrictions on one hand, and the nature of the microenvironment on the other hand, interact in a dynamic way with the enzyme to determine its properties. Another key point to understanding the changes in the properties of the immobilized enzyme is to consider these proteins as dynamic structures, interacting physically and chemically with their microenvironment. PMID- 2707265 TI - Correlation between enzyme activity and hinge-bending domain displacement in 3 phosphoglycerate kinase. AB - Diffuse X-ray-scattering data give evidence for large-scale structural change in pig muscle 3-phosphoglycerate kinase upon substrate binding. Simultaneous binding of 3-phosphoglycerate and MgATP either to the unmodified enzyme or to its active methylated derivative leads to about an 0.1-nm decrease in radius of gyration. These data coincide well with the previous data for yeast 3-phosphoglycerate kinase. When, instead of methylation, the two reactive thiol groups of pig muscle 3-phosphoglycerate kinase are carboxamidomethylated, the enzyme becomes inactive and the radii of gyration of its 'apo' and 'holo' forms do not differ within limits of experimental error. Thus, a correlation exists between the activity of 3-phosphoglycerate kinase and its substrate-induced large-scale conformational change. This correlation is a strong argument in favor of the functional importance of domain locking in the reaction catalyzed by 3-phosphoglycerate kinase. PMID- 2707266 TI - Purification and characterization of trypsin from the poikilotherm Gadus morhua. AB - A serine protease shown to be trypsin was purified from the pyloric caeca of Atlantic cod (Gadus morhua), and resolved into three differently charged species by chromatofocusing (pI 6.6, 6.2 and 5.5). All three trypsins had similar molecular mass of 24.2 kDa. N-terminal amino acid sequence analysis of cod trypsin showed considerable similarity with other known trypsins, particularly with dogfish and some mammalian trypsins. The apparent Km values determined at 25 degrees C for the predominant form of Atlantic cod trypsin towards p-tosyl-L arginine methyl ester and N-benzoyl-L-arginine p-nitroanilide were 29 microM and 77 microM respectively, which are notably lower values than those determined for bovine trypsin (46 microM and 650 microM respectively). The difference was particularly striking when the amidase activity of the enzymes was compared. Furthermore, the kcat values determined for the Atlantic cold trypsins were consistently higher than the values determined for bovine trypsin. The higher catalytic efficiency (kcat/Km) of Atlantic cod trypsin as compared to bovine trypsin may reflect an evolutionary adaptation of the poikilothermic species to low environmental temperatures. PMID- 2707267 TI - On the within-population relationship between nutrition and serum lipids: the B.I.R.N.H. study. AB - A randomized study was performed in Belgium concerning the relationship between diet and serum lipids in 5485 men and 4856 women with a mean age of 49 years. In men 17.3% of total energy was provided by saturated fat, 15.2% by monounsaturated fat and 7.5% by polyunsaturated fat. The fat intake in women was very similar. The P/S ratio was 0.51 in men and 0.52 in women. The alcohol intake was significantly higher in men (5.2% of total energy) than in women (2% of total energy). In men and women total serum cholesterol increased with saturated fat intake (p less than 0.001) and decreased with polyunsaturated fat intake (p less than 0.01). Saturated fat intake raised the HDL-cholesterol level in men and women (p less than 0.001) and monounsaturated fat raised it in men only (p less than 0.01). Dietary cholesterol increased the HDL-cholesterol level in women only (p less than 0.01). HDL-cholesterol increased with alcohol consumption (p less than 0.001) and decreased with cigarette smoking (p less than 0.001). All these changes were adjusted for differences in age, height and weight. The study confirms the existence, within a population, of a significant relationship between fat intake and serum lipid levels. PMID- 2707268 TI - Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischaemic death. AB - Sudden ischaemic death results either from an episode of acute myocardial ischaemia consequent upon coronary thrombosis or from an arrhythmia arising within a scarred left ventricle. Very different proportions of these two groups have been reported in both clinical studies in resuscitated subjects with out-of hospital ventricular fibrillation, and in necropsy series. In 168 cases of sudden death due to ischaemic heart disease coming to necropsy 73 (43.5%) had mural intraluminal coronary thrombi, 50 (29.8%) had occlusive intraluminal thrombi, and 45 (26.7%) had no intraluminal thrombi, giving a ratio of 2.7:1 for those with and without coronary thrombosis. Single vessel disease, the presence of acute infarction at autopsy and prodromal symptoms were positively associated with the presence of coronary thrombosis. Conversely, the presence of old myocardial infarction at necropsy, a known clinical history of ischaemic heart disease and triple vessel disease were associated with the absence of acute thrombosis. The reported variation in the incidence of coronary thrombi in sudden ischaemic death can be largely explained by selection of subjects with those clinical characteristics which are positively or negatively associated with coronary thrombosis. PMID- 2707269 TI - Features of myocardial metabolism of some amino acids and ammonia in patients with coronary artery disease. AB - Fractional myocardial extraction/release of glutamate, glutamine, alanine, ammonia, asparagine, glucose and lactate was studied in 12 subjects with normal coronary anatomy (controls) and 28 patients with coronary artery disease (CAD) during rest and atrial pacing. At rest patients with CAD showed an increased myocardial extraction of glutamate, glucose and lactate and an augmented glutamine and alanine release compared with controls. In all CAD patients myocardial ammonia and asparagine release was found at rest, while all controls showed myocardial extraction of these compounds. Myocardial glutamate extraction correlated positively with glucose and lactate extraction, glutamine and alanine release and inversely with ammonia release in CAD patients at rest. In patients with two- and three-vessel disease pacing-induced ischaemia resulted in a pronounced decrease in myocardial glutamate extraction and glutamine release, augmented myocardial production of ammonia and asparagine and a conversion of lactate extraction into lactate release. During pacing myocardial glutamate extraction was related to alanine and glutamine release and correlated inversely with ammonia and lactate release in these patients. The results indicate that glutamate extraction is closely connected with glucose and lactate extraction and ammonia binding via glutamine formation in the hearts of CAD patients and, thus, with the energy supply of ischaemic myocardium. An assessment of myocardial exchange of the nitrogenous compounds we have studied, complimentary to lactate, is a promising biochemical test for the identification of ischaemic heart disease in man. PMID- 2707270 TI - Low-dose oral sotalol for monomorphic ventricular tachycardia: effects during programmed electrical stimulation and follow-up. AB - The effects of oral sotalol were compared with the findings obtained in the baseline study of a group of 26 consecutive patients with sustained monomorphic ventricular tachycardia or ventricular fibrillation and inducible ventricular tachycardia. The mean age was 62 years and the mean ejection fraction 33%. The number of non-inducible patients after sotalol administration (mean dose of 251 +/- 81 mg day-1) was 13 out of 21 (62%). The cycle length of the induced tachycardia changed from 293 +/- 32 to 303 +/- 41 ms (non-significant (NS]. The coupling interval of the first extrastimulus did not lengthen for the subgroup with persistent inducibility. The number of patients requiring defibrillation during the induction study did not decrease on (2/8) or off drugs (6/22). After the first administration of oral sotalol, two patients developed polymorphic ventricular tachycardia or torsade de pointes and one suffered from left ventricular failure. Long-term treatment with sotalol was given to 15 non inducible patients, and two inducible patients, combined with an AICD or a pacemaker. Over a mean follow-up period of 13 months, three recurrences were observed in these 17 patients, including the patient with the AICD. This represents an efficacy of 82% for patients chronically treated with a low dose of oral sotalol. PMID- 2707271 TI - Blood volume and right heart haemodynamics in abrupt hypotension following sublingual isosorbide dinitrate in acute myocardial infarction. AB - Arterial blood pressure and heart rate were measured in 43 patients with acute myocardial infarction and a systolic blood pressure greater than or equal to 120 mmHg during sublingual administration of 5 mg of isosorbide dinitrate. In 25 of them right heart haemodynamics were also measured. Severe (greater than or equal to 25%) hypotension developed in 12 patients (Group 1, systolic blood pressure 158 +/- 28 to 78 +/- 17 mmHg, mean +/- SD) but not in the remaining 31 (Group 2) and was accompanied by a fall in heart rate (82 +/- 20 to 70 +/- 22 beats min-1, P less than 0.05), in cardiac output (4.3 +/- 0.3 to 3.2 +/- 0.41 min-1, P less than 0.02, n = 5) and in systemic vascular resistances (2326 +/- 463 to 1532 +/- 442 dynes sec-1 cm.5, P less than 0.02) not present in Group 2. The reduction in right (Group 1, 8 +/- 3 to 3 +/- 1, vs. Group 2, 10 +/- 3 to 6 +/- 3 mmHg, P less than 0.005) and in left ventricular filling pressures (Group 1, 15 +/- 4 to 8 +/- 2, vs. Group 2, 18 +/- 6 to 13 +/- 5 mmHg, P less than 0.001) was more remarkable in Group 1. In this group there was also a high incidence of anterior infarction (9/12, 75%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707272 TI - Assessment of the optimal atrio-ventricular delay in DDD paced patients by impedance plethysmography. AB - The beneficial haemodynamic effects of sequential atrioventricular (AV) pacing have been clearly established and are dependent on the AV delay and pacing rate. However, the optimal AV delay is difficult to determine in each particular patient. We used a modified impedance plethysmographic method to assess variations in stroke volume for different AV delay and pacing rate settings. Impedance measurements showed a good correlation with CO2 rebreathing stroke volume measurements in VVI patients. Impedance variations were then used to set the optimal AV delay at different pacing rates in DDD patients. The inverse relationship between the optimal AV delay and the pacing rate has been accurately identified in most of the patients but is not predictable. In all cases, the cardiac output was higher in DDD mode at the optimal AV delay than in VVI mode. In some patients with a damaged myocardium, the stroke volume appeared to be highly sensitive to multiple AV delay settings. Impedance plethysmography can permit such repetitive non-invasive quick measurements, increasing the accuracy of optimal AV delay determination and is well suited for routine examination of patients with cardiac dual chamber pacemakers. PMID- 2707273 TI - Comparison of indirect and direct methods for determination of sinoatrial conduction time. AB - We have performed an electrophysiologic study (EPS) in 18 subjects (mean age 21 +/- 17 years) with normal sinus node function (group A) and in 15 patients (mean age 43 +/- 26 years) with sinus node dysfunction (group B). Three extrastimulus methods (both Strauss and Kirkorian methods and our modification of the extrastimulus method) were carried out in 31 patients of both groups and sinoatrial conduction times (SACTSTR, SACTKIR,SACTMOD) could be estimated in 27 of them. SACT by the Narula method (SACTNAR) was assessed in 25 patients of both groups. Sinus node electrograms (SNEs) were attempted in 22 patients and were obtained in 17 of them. Among the indirect methods, by comparison with SACTSTR in group A the best correlation was for SACTMOD (r = 0.81) and the weakest for SACTKIR (r = 0.67); there was no significant difference between SACTs estimated by Strauss and other methods. In group B the weakest correlation was also for SACTKIR (r = 0.68), whereas the correlations for both SACTMOD and SACTNAR were similar (r = 0.72 and r = 0.74, respectively); in this group SACT was significantly underestimated only by the Kirkorian method (P less than 0.01; sensitivity of 45%). By our method sensitivity was 82%, similar to both the Strauss and Narula methods (92 and 92%, respectively). By comparison of indirect methods with the direct measurement of SACT we have found similar good correlations for the Strauss, our own, and the Narula methods in group A (r = 0.81, r = 0.75, r = 0.79, respectively) and in group B (r = 0.81, r = 0.86, and r = 0.72, respectively); here too the weakest correlation was, in both groups, for the Kirkorian method (r = 0.67, and r = 0.68, respectively). The SACT in group B was the more significantly underestimated (P less than 0.001). Significant underestimation of SACT occurred also by our method and the Strauss method (P less than 0.01, and P less than 0.001, respectively), whereas the Narula method did not significantly underestimate the directly measured SACT. From the SNEs after atrial pacing we have shown the limitation of the Kirkorian method and observed the conspicuous beat-to-beat variability of SACTdirect' as the possible explanation of chaotic pattern of return cycles by the extrastimulus methods in some patients of group B.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2707274 TI - An accurate exercise lead system for bicycle ergometer tests. AB - In order to minimize muscle noise in the exercise electrocardiogram, Mason and Likar proposed a new lead system where the limb electrodes are instead placed on the trunk. The Mason-Likar system is widely used for both the resting ECG before exercise and recordings during exercise. Several studies have, however, reported great differences between this lead system and the standard lead system. This study shows greater R wave amplitudes in leads II, aVF and III, smaller R wave amplitudes in leads aVL and I and thus a vertical shift of the frontal plane QRS axis for the Mason-Likar system compared with the standard system. For many years another lead system for exercise tests with the bicycle ergometer has been used in our laboratory. The limb electrodes are placed at the proximal part of the arms and the left iliac crest. This lead system yields ECG signals with a low level of muscle noise. The differences between this lead system and the standard ECG are much less pronounced than the differences between the Mason-Likar ECG and standard ECG. We propose our lead system for exercise tests with the bicycle ergometer. PMID- 2707275 TI - Indications for pacemaker implantation in the Kearns-Sayre syndrome. AB - The Kearns-Sayre syndrome is a rare condition, characterized by progressive external ophthalmoplegia, retinal pigmentary degeneration and progressive impairment of cardiac conduction, which mainly determines the prognosis. Two young patients (aged 13 and 18 years) without symptoms of cardiac disease presented with an electrocardiogram showing sinus rhythm, a normal atrio ventricular conduction time, right bundle branch block and a left anterior fascicular block. Electrophysiologic investigation showed prolongation of His ventricular interval at rest, which further increased during atrial pacing. Because of the potential progression of the conduction abnormalities and threatening sudden death, we decided to implant a pacemaker in both patients. Ten months later one patient had become pacemaker-dependent. Prophylactic pacemaker therapy is advisable in patients suffering from the Kearns-Sayre syndrome, who have bifascicular block on the precordial electrocardiogram. PMID- 2707276 TI - Right heart failure due to an inter-atrial shunt after percutaneous mitral balloon dilatation. AB - Percutaneous mitral valve dilatation was performed in a 61-year-old female patient with severe mitral valve stenosis. The valve could be dilated, but a moderate left to right atrial shunt was present after the procedure. Although the mitral valve area had increased from 1 cm2 to 1.7 cm2, the patient presented 1 week later with right heart failure, explained by right heart volume overload resulting from the persistent shunt. Clinical status quickly improved with diuretics. Although this evolution has not been previously reported, it may be expected in older patients with decreased compliance of pulmonary arteries and right heart chambers. PMID- 2707277 TI - Oculo-cerebro-cutaneous syndrome: description of a new case. AB - A newborn girl is described with the following multiple congenital anomalies: an orbital cyst, cutaneous appendages, focal hypo-aplasia of the skin and multiple cerebral cysts. This case of oculo-cerebro-cutaneous syndrome is compared with four previously published cases. PMID- 2707278 TI - Relationships between essential fatty acid levels, pulmonary function and fat absorption in pre-adolescent cystic fibrosis children with good clinical scores. AB - Twenty-one pre-adolescent cystic fibrosis (CF) children with good clinical scores had significant (P less than 0.001) deficiencies of arachidonic (mean 3.8% of total plasma fatty acids +/- SD 1.4) and linoleic (18.1 +/- 6.3) acids compared with controls (6.0 +/- 1.0, and 27.6 +/- 3.9, respectively). Despite the presence of pulmonary involvement of varying severity in all the CF children, neither arachidonic nor linoleic acid levels correlated significantly with pulmonary function measured by spirometry. All children had adequate caloric and fat intakes, and the coefficient of fat absorption correlated with none of the deficient fatty acid levels. These findings suggest that deficiencies of arachidonic and linoleic acids are of minor importance in the early development of pulmonary involvement in CF, and that factors other than fat malabsorption and decreased dietary intake probably contribute to fatty acid deficiency. PMID- 2707279 TI - Reduced urinary serotonin excretion after intake of high doses of hypoxanthine. AB - Two healthy volunteers were treated with hypoxanthine 3 x 1 g and allopurinol 3 x 100 mg daily for 1 week. During this treatment serum oxypurine concentration and urinary oxypurine excretion increased as expected. No side effects were observed except for some mild daytime drowsiness and lethargy. Measurements of urinary serotonin (5-HT) excretion showed decreases to as much as 60% below initial values. Decreased urinary 5-HT excretion was also found in a patient with incomplete Lesch-Nyhan syndrome during treatment with high doses of hypoxanthine. His neurological symptoms improved slightly. The results suggest that high doses of hypoxanthine exert a nonspecific sedative effect on both patients with Lesch Nyhan syndrome and healthy controls. The cause is probably a reduced synthesis or release of 5-HT. PMID- 2707280 TI - Chronic renal failure in methylmalonic acidaemia. AB - The renal function of 12 patients with non vitamin B12 responsive methylmalonic acidaemia has been investigated. Eight patients had reduced glomerular filtration rates, but the plasma creatinine concentration was only raised in those with values of less than 40 ml/min per 1.73 m2 surface area. The reduction in glomerular filtration was a function of the age and the severity of the disease. Plasma urate concentrations were increased in four patients but this may be secondary to the renal disease rather than its cause. PMID- 2707281 TI - Ornithine transcarbamylase deficiency in a male: strict correlation between metabolic control and plasma arginine concentration. AB - In a male with a partial defect of ornithine transcarbamylase (OTC) we observed that maintenance of arginine supply was crucial for adequate metabolic control in conjunction with a low protein diet. The arginine supplement had to be given such that the concentrations of arginine and ornithine in plasma were above 50 mumol/l. It appears that arginine is needed not only as an essential amino acid for protein synthesis but also as a precursor of ornithine. In this patient the substitution thus aimed at increasing the intramitochondrial ornithine in order to reach a critical substrate concentration for the kinetically abnormal OTC. PMID- 2707282 TI - Do lung volumes change with sleep state in the neonate? AB - We have studied 12 healthy full-term babies, mean age 3.2 days, using physiological criteria--EEG, electrooculogram, electromyogram, respiratory regularity and visible movement--to assess sleep state, and a respiratory jacket to record changes in functional residual capacity (FRC). A total of 593 min of sleep data were analysed. Of the recordings, 39% were scored as quiet sleep, 40% as active and 21% as indeterminate sleep. The mean maximum variation in FRC overall was 29 ml (SD +/- 15.4 ml). Examination of these figures showed that FRC variations during sleep state changes were smaller than those seen within a defined sleep state. We conclude that changes in sleep state are not associated with variations in FRC. PMID- 2707283 TI - Idiopathic infantile arterial calcification with cardiac, renal and central nervous system involvement. AB - Idiopathic infantile arterial calcification was diagnosed in a 2 week old infant with failure to thrive associated with neurological, renal and cardiac signs. Therapy with diphosphonate resulted in a complete resolution of vascular calcifications. At the age of 2 years the child is doing well but requires medical treatment for arterial hypertension. PMID- 2707284 TI - Henoch-Schonlein nephritis. PMID- 2707285 TI - Kawasaki disease associated with idiopathic thrombocytopenic purpura. PMID- 2707286 TI - Juvenile chronic myeloid leukaemia and alpha-interferon. PMID- 2707287 TI - Progressive hemifacial atrophy with localized scleroderma. AB - We describe a patient with localized scleroderma in association with homolateral atrophy of the tongue and marked ipsilateral facial hemiatrophy which was confirmed histologically. CT scan coronal sections of the face showed severe atrophy of the tongue and facial muscles. The EMG studies failed to demonstrate a neurogenic or myogenic process. PMID- 2707288 TI - Chronic subdural hematoma in extremely aged patients. AB - 445 cases of chronic subdural hematomas have been operated on during the last 35 years (1951-1986). The ages of the patients ranged from 14 to 91 years and averaged 54 years. Two groups of patients were considered and compared: (A) extremely aged patients, who were over 75 years old, and (B) patients in their sixth decade of life whose age was in fact close to the mean age of chronic subdural hematoma patients in our experience. There were 35 cases (8% of the total number of cases) in group A and 113 cases (26%) in group B. Presumably etiological trauma was less severe in elderly patients who more frequently showed a background of hormonal derangement, such as liver and/or prostatic disease. Bilateral hematomas were detected more frequently in older patients. They usually presented with mental retardation, unlike younger patients who more frequently had symptoms and signs of increased intracranial pressure. Early postoperative complications occurred more frequently in older patients. However, this did not preclude obtaining good results in more than three quarters of them. The implications of these findings are discussed. PMID- 2707289 TI - Ataxia as the only delayed neurotoxic manifestation of organophosphate insecticide poisoning. AB - A patient is reported presenting a cerebellar disorder developing about 5 weeks after acute exposure to an organophosphate insecticide. Initially no major cholinergic features were observed. The ataxia of delayed onset was not accompanied by clinical or electrophysiological signs of polyneuropathy. The possible pathogenetic mechanisms are reviewed and discussed. This case illustrates the need to closely monitor all patients intoxicated with such chemicals for at least 5 weeks. One should not only keep in mind the well-known late-onset polyneuropathy, but also the less frequent delayed central nervous system effects, even in the milder cases where initial signs of acetylcholine excess are only minimally present or lacking. PMID- 2707290 TI - HTLV-I-associated myelopathy and adult T-cell leukemia cases in a family. AB - Familial cases of HTLV-I-associated myelopathy (HAM) and adult T-cell leukemia (ATL), developing in a daughter and father, respectively, are reported. The coexistence of both diseases in a family has not been reported before. This supports the recent findings that ATL and HAM may be brought about by an identical virus on an apparently different immunogenetic background. PMID- 2707291 TI - Genetic and clinical studies of Japanese patients with familial amyloid polyneuropathy. AB - We examined the DNA analysis of familial amyloid polyneuropathy (FAP) patients and their families from Nagano and Hiroshima prefectures in Japan using recombinant DNA techniques and compared the results with the clinical features. This study indicated that the valine-methionine change prealbumin gene was closely related to the clinical features of type 1 FAP. The DNA analysis was valuable for the definite diagnosis of type 1 FAP even in sporadic and asymptomatic cases. FAP patients from Iiyama city and Ogawa village area in the Nagano prefecture had the same mutation despite differences in clinical features. The onset of the sporadic FAP cases was later than that of the FAP patients who had family histories. PMID- 2707292 TI - Intracranial cavernous angiomas: diagnosis and therapy. AB - The authors reviewed the case histories of 10 patients with intracranial cavernous angiomas treated from 1985 till 1987. Two patients are described in detail and are illustrated by CT scan, MRI scan and angiography. The diagnostic and therapeutic problems of intracranial cavernous angiomas are discussed. PMID- 2707293 TI - Familial pseudotumor cerebri in male heterozygous twins. AB - Papilledema due to raised intracranial pressure in absence of intracranial mass arose roughly at the same time in 2 male heterozygous twins. The diagnosis of benign intracranial hypertension (BIH) was confirmed by the finding of normal cerebrospinal fluid and high opening pressure. Neurologic examination was normal. In both cases choroidal folds were evident. The relationship between BIH and genetic factors is discussed. PMID- 2707294 TI - Blink reflex in dyskinetic and nondyskinetic patients with Parkinson's disease. AB - An electrophysiological study of the blink Reflex was undertaken in 40 dyskinetic and 20 nondyskinetic patients with Parkinson's disease, who were matched for age, stage of disease, duration of illness and amount and nature of antiparkinsonian medication. We found that latencies of R2 responses (both ipsilateral and contralateral) were prolonged in the dyskinetic group compared to the nondyskinetic group. Moreover, the late response was more easily inhibited by conditioning stimulation in dyskinetic patients. This behavior of late response in dyskinetic parkinsonians may be attributed to the reinstatement of dopaminergic suppressive control over the segmental multisynaptic systems belonging to the reflex. PMID- 2707295 TI - Frontal lobe dysfunction in Parkinson's disease: prognostic value for dementia? AB - The purpose of this longitudinal study was to investigate if the presence of frontal motor deficits in parkinsonians without signs of global intellectual impairment may have a predictive value for the development of a progressive dementing process during the course of the illness. An examination of the higher level of motor organization, using skills thought to depend upon the integrity of the frontal regions, was performed by 30 parkinsonian patients who did not present any signs of general intellectual impairment. According to their performance, as compared with controls, they were divided into two subgroups: those with and those without frontal dysfunctions. After a mean period of 4 years, a second neuropsychological examination was carried out to assess any eventual change of mental status. The results suggest that frontal dysfunctions may be observed several years before the appearance of generalized intellectual impairment and may be considered one of the predictive factors for development of dementia in Parkinson's disease. Careful consideration of these defects during examination of motor abilities may be of value in the clinical management of parkinsonian patients. PMID- 2707296 TI - Is lumbar puncture indicated in examination of dizzy patients? AB - Routine cerebrospinal fluid (CSF) analysis was performed in 109 dizzy patients, who also had been examined by comprehensive neurological and otological methods. Altogether 31 patients (28%) had some abnormality in the CSF. These CSF findings, however, gave no clues as to the etiology of the symptom which could not be obtained by noninvasive methods as well. Hence, lumbar puncture is not recommended for the examination of dizzy patients. PMID- 2707297 TI - Transcranial unifocal stimulation in rabbit: subcutaneous and meningeal changes. AB - The possible acute morphological changes induced by electrical transcranial unifocal stimulation (eTCS) in the rabbit extracerebral tissues were studied by light and scanning electron microscopy. In order to do this, a wide range of electric stimuli with respect to those employed in the clinical practice were utilized. Either surface electrodes were attached to the scalp, or needle electrodes were infixed in the subcutaneous tissue. Beneath the cathode a blood extravasation was constantly observed in the subcutaneous tissue of the scalp; the different electrode arrays produced either a large hemorrhagic lesion or a few petechiae. Beneath the anode, the damage was limited to the scalp, or reached the meninges when stimuli longer than 0.2 ms were used. Irrespective of the electrode arrays, the scalp and the dura mater displayed hemorrhagic petechiae over a limited area about 2-3 mm in extent. Moreover, the leptomeningeal membrane was microscopically disrupted over an area less than 1 mm large; therein the squamous, overlapping cells were transformed into fusiform or macrophage-like cells. Unduly intense eTCS produces evident hemorrhagic lesions in the scalp and in the dura mater, whereas it induces microscopic, reactive changes in the leptomeninx. PMID- 2707298 TI - Demonstration by class I gene transfer that reduced susceptibility of human cells to natural killer cell-mediated lysis is inversely correlated with HLA class I antigen expression. AB - HLA antigen-loss mutants and class I gene transferents were used to analyze the influence of class I expression on natural killer (NK) cell-mediated lysis. Only HLA antigen-loss mutants that had lost expression of either HLA-A and HLA-B antigens (mutant .184) or of HLA-A, B and C antigens (mutant .221) were distinctly susceptible to NK-mediated lysis. Mutants with reduced expression of class II antigens but unaltered expression of class I antigens remained resistant to NK lysis. A direct demonstration of the effect of class I antigen expression on human cells was made by analyzing a variety of gene transferents of the HLA-A, B, C null mutant .221 expressing only one transferred HLA-A, B or C gene. These results specifically show that expression of class I antigens, with a possible preferential effect of HLA-B expression, reduces the susceptibility of mutant .221 to NK-mediated lysis. PMID- 2707299 TI - Effects of Ro 15-4513 on the motor impairment and hypnotic effects of ethanol and pentobarbital. AB - The selectivity of Ro 15-4513 in reversing the actions of sedative-hypnotic drugs was examined. The motor impairment induced by i.p. administration of 1.8 g/kg of ethanol was partially reversed by doses of Ro 15-4513 ranging from 2-8 mg/kg. Antagonism of the similar effect induced by 20 mg/kg of pentobarbital was observed only at the 8 mg/kg dose of Ro 15-4513. Treatment with 4 mg/kg of Ro 15 4513 shifted the dose-effect curve for motor impairment by ethanol to the right but did not affect the corresponding curve for pentobarbital. Ro 15-4513 also increased the onset latency and shortened the duration of sleep time induced by ethanol but not by pentobarbital. Blood ethanol and pentobarbital levels measured at 32 min after drug administration were not affected by Ro 15-4513. The selectivity of Ro 15-4513 and the mechanism(s) underlying its proconvulsant effect in reversing the actions of ethanol are discussed. PMID- 2707300 TI - Relaxing effects of adenosine in coronary artery in calcium-free medium. AB - Adenosine relaxes the coronary arteries of various species through A2 receptors. The mechanism(s) by which adenosine causes relaxation of the coronary smooth muscle through changes in intracellular Ca levels is not understood. Therefore, the aim of this study was to evaluate the vasodilatory action of adenosine in normal and in Ca-free medium and the effect of adenosine on 45Ca efflux in Ca free medium. Prostaglandin F2 alpha (10(-5) M) was used to induce tone in bovine coronary artery rings both in the presence and absence of Ca. Adenosine, 5'-N ethyl-carboxamide adenosine (NECA) and N6-L-phenyl-isopropyl adenosine (L-PIA) produced concentration-dependent relaxation of the coronary artery rings when precontracted with prostaglandin F2 alpha. Both in normal and Ca-free medium, the order of potency for adenosine analogs (NECA greater than L-PIA greater than adenosine) was similar and 8-phenyltheophylline antagonized the relaxation response to adenosine and its analogs. In Ca-free medium, the concentration response curves for adenosine and its analogs were shifted to the right, in a parallel fashion, from the curves obtained in Ca-containing solution. Removal of extracellular Ca reduced the maximum responses and slowed the rate of relaxation of adenosine and its analogs and the KB values for 8-phenyltheophylline were significantly increased. In Ca-free medium, adenosine was without an effect on 45Ca efflux in the presence of prostaglandin F2 alpha. The data suggest that the coronary vasodilatory action of adenosine has both extracellular Ca-dependent and -independent components. PMID- 2707301 TI - Involvement of 5-HT receptor subtypes in the discriminative stimulus properties of mescaline. AB - In order to further evaluate the extent to which particular 5-HT receptor subtypes (5-HT1, 5-HT2) might be involved in the behavioral effects of hallucinogenic drugs, rats were trained to discriminate mescaline (10 mg/kg i.p.) from saline and were given substitution (generalization) and combination (antagonism) tests with putatively selective serotonergic and related neuroactive compounds. The mescaline cue generalized to relatively high doses of the 5-HT2 agonists, 2,5-dimethoxy-4-methylamphetamine (DOM), LSD and psilocybin; the extent of generalization to 5-HT1 agonists (8-hydroxy-2-[diethylamino]tetralin (8 OHDPAT), RU-24969 and 8-hydroxy-2-[di-n-propylamino]tetralin (TFMPP] was unclear. Combinations of the training drug and sufficiently high doses of 5-HT2 antagonists (ketanserin, LY-53857, pirenperone) were followed by saline-lever responding; less selective central 5-HT (metergoline), and DA (SCH-23390, haloperidol) antagonists, did not block the mescaline cue. These data suggest that 5-HT2 receptors are involved in the stimulus properties of mescaline. PMID- 2707302 TI - Ca antagonistic and non-specific effects of diltiazem on the rat phrenic nerve diaphragm preparation. AB - The calcium antagonist diltiazem (2.8 X 10(-4) M) blocked the twitches of a rat phrenic nerve diaphragm preparation after a period of twitch potentiation. Its ability to block twitches was greater during indirect than direct stimulation. Experiments on the isolated phrenic nerve indicated that the excitability of the nerve was blocked. Diltiazem (2.3-9.0 X 10(-5) M) caused a similar inhibition of indirectly and directly elicited tetanic contractions and EMG. Experiments with d tubocurarine and lowered temperature disclosed a separate inhibition at the neuromuscular junction. High Ca2+ did not reverse the diltiazem-affected twitch or tetanic contractions, which suggests that they are non-specific effects. KCl (100 mM)-induced contractures were antagonized at low (2.3-4.5 X 10(-5) M) but not at high (1 mM) concentrations of diltiazem. Diltiazem depressed the initial phase of the two-phasic caffeine (10 mM) contracture and increased and accelerated the slow phase. Diltiazem greatly reduced the amplitude and duration of the caffeine-potentiated KCl contracture, and reduced and delayed the slow phase of the KCl-potentiated caffeine contracture. The effects on the combined contractures (caffeine-induced, KCl-potentiated) were partly antagonized by a high Ca2+ (2.2 X 10(-5) M) solution, which suggests that diltiazem has calcium antagonistic effects. PMID- 2707303 TI - Platelet-activating factor stimulates phosphatidylinositol hydrolysis in the rat myometrium. PMID- 2707304 TI - Interaction of DPI 201-106 with cardiac muscarinic receptors. AB - The effects of the new cardiotonic compound, DPI 201-106, on muscarinic responses and muscarinic receptor binding were studied in the guinea pig heart. DPI 201-106 exerted a pronounced anticholinergic action in isolated auricles and a moderate one in papillary muscles, which resembled the pattern of a functional antagonism. However, in competition binding experiments, DPI 201-106 inhibited binding of the specific muscarinic antagonist [3H]NMS with equal potency in atrial and ventricular homogenates (apparent KI = 0.7 mumol/l in atria and 1.2 mumol/l in ventricles). At higher concentrations (greater than 3 mumol/l), DPI 201-106 slowed the dissociation of [3H]NMS from cardiac muscarinic receptors, indicating that DPI 201-106 affects in addition a site allosteric to the muscarinic receptor. It is concluded that DPI 201-106 is able to inhibit cholinergic responses in the heart, not only by a functional antagonism but also by direct interaction with muscarinic receptors. PMID- 2707305 TI - Binding of the 5-HT3 ligand, [3H]GR65630, to rat area postrema, vagus nerve and the brains of several species. AB - The radiolabelled derivative of the potent and selective 5-HT3 receptor antagonist, GR65630, has been shown to label 5-HT3 receptors in homogenates of rat entorhinal cortex. We now report on the specific binding of this radioligand in homogenates of 16 discrete brain areas from several species and nine areas of human brain. We have further characterised specific binding to homogenates of rat area postrema and vagus nerve. In all species examined (rat, mouse, rabbit and ferret) the highest level of specific [3H]GR65630 (0.2 nM) binding was found in homogenates of the area postrema (26-83 fmol/mg protein). Binding in forebrain areas varied with species, Rat and mouse brain had relatively high levels of binding in cortical areas. The ferret and rat had relatively high levels in forebrain dopamine-containing areas. Of the areas of human brain examined the amygdala showed the highest level of specific [3H]GR65630 (0.2 nM) binding (3.0 fmol/mg protein). Specific [3H]GR65630 (0.05-2 nM) binding to homogenates of rat vagus nerve and area postrema was saturable (Bmax: vagus nerve 89.1 fmol/mg protein, area postrema 44.4 fmol/mg protein) and of high affinity (Kd: vagus nerve 0.50 nM, area postrema 0.24 nM). Selective 5-HT3 receptor agonists and antagonists potently inhibited [3H]GR65630 (0.2 nM) binding to homogenates of rat area postrema and vagus nerve. There was a close correlation between drug affinities in each area. PMID- 2707306 TI - Antidepressant action of imipramine and iprindole in mice is enhanced by inhibitors of enkephalin-degrading peptidases. AB - The implication that opioid peptides are involved in the action of the antidepressants imipramine and iprindole was investigated in mice by using the forced swimming test as an experimental model of depression. Both the drugs were found to shorten the immobility time in this test. This effect of imipramine and iprindole was reversed by the opiate antagonist naloxone. Moreover, when subeffective doses of either imipramine or iprindole were given together with an intracerebroventricular injection of an inhibitor of their degradation (thiorphan or bestatin), the immobility time was again decreased. Interestingly, the reduction of the time of immobility was found to be not related to the effect of the drugs on locomotor activity. These data might be taken as further evidence for the involvement of opioid peptides in the pharmacological action of antidepressant drugs. PMID- 2707307 TI - Fentanyl-induced airway hyperreactivity in the guinea pig. AB - The bronchopulmonary effects of fentanyl were studied in mechanically ventilated, paralyzed guinea pigs that had been anaesthetized with pentobarbitone sodium. Fentanyl did not alter the resting bronchial tone but enhanced the bronchoconstrictor effects of 5-hydroxytryptamine in a dose-related manner. The enhancement induced by 20 micrograms kg-1 fentanyl was suppressed by pretreatments with 0.5 mg kg-1 naloxone or 5 mg kg-1 propranolol, but did not change after 3 mg kg-1 atropine. The bronchoconstrictor responses to histamine were also enhanced by 20 micrograms kg-1 fentanyl. These results suggest that fentanyl-induced airway hyperreactivity is not mediated by an increase in vagal tone but is due to a reduction in the central sympathetic drive and/or in the levels of circulating catecholamines, which occurs through stimulation of opiate receptors. PMID- 2707308 TI - Chlorpropamide alters AVP-receptor binding of rat renal tubular membranes. AB - The effects of chlorpropamide on AVP-receptor binding in rat renal tubular basolateral membranes were investigated utilizing [3H][Arg8]vasopressin (AVP). Our data indicate that chlorpropamide alters AVP-receptor binding in a competitive manner. PMID- 2707309 TI - Antagonistic effects of caffeine and yohimbine in animal tests of anxiety. AB - The effect of a combination of caffeine and yohimbine was investigated in the social interaction, elevated plus-maze and punished-drinking tests of anxiety. Caffeine (40 mg/kg i.p.) had anxiogenic-like effects in the social interaction and plus-maze tests. Yohimbine (2.5 mg/kg i.p.) was anxiogenic-like in the plus maze and displayed anticonflict activity. Unexpectedly, caffeine and yohimbine antagonized each others' effects in the social interaction and elevated plus-maze tests. PMID- 2707310 TI - Age and cell density dependent changes of gangliosides in human diploid fibroblasts. AB - The gangliosides in human diploid fibroblasts--TIG-1, TIG-7, and IMR-90--were analysed at different cell densities at early and late passages to clarify the relationship between age and cell density dependent changes of the gangliosides. In early passages, the ganglioside concentrations increased with increase in cell density. At late passages, however, the concentrations were lower than those at the early passages either in the growing or confluent phase, and slightly increased with increase in cell density. The pattern of ganglioside compositions were apparently different between early and late passage cells either in growing or confluent state. In the early passages, GM3 and GD3 were major constituents, and GM2, GD1a, or the other more complex gangliosides were detected as minor components. With increase in cell density, the content of GM3 decreased, whereas GD3 and the others increased. At the late passages, however, GM3 was the major component, and GD3, GM2, or GD1a were minor, but the others were hardly detectable. The ganglioside pattern did not change with increase in cell density. Thus, the age-dependent changes of gangliosides could be distinguished from the cell density dependent alterations. PMID- 2707311 TI - Comparative effects of almitrine and raubasine, singly and in combination, on electroencephalographic activity in young and old rats. AB - A new method for quantification of electroencephalographic (EEG) signals was used to study the effects of almitrine and raubasine, alone and in combination, in two groups of six unanesthetized rats, aged 8 months (young) and 22 months (old). Coadministration of almitrine (7.5 mg/kg-1 i.p.) and raubasine (2.5 mg/kg-1 i.p.) induced an increased EEG power from 7 to 30 Hz; the frequencies concerned were identical in young and old rats, but the degree of their power variations was more marked in old rats. Almitrine induced a 20 to 50% increase in EEG power in young rats on nearly all spectral components. The effects of almitrine were only seen in the low-frequency range in old rats. Raubasine increased the EEG power in the 10 to 20 Hz frequency range; these effects were significantly greater in old rats. In both age groups, the effects on EEG power observed with coadministration of almitrine and raubasine were significantly different from those expected if raubasine and almitrine add their individual effects. These results show that a) almitrine and raubasine modify cortical electrical activity in a different manner as a function of age; b) the modification of the EEG activity induced by the coadministration is suggestive of an interaction between the cortical effects of each drug; and c) the modification of EEG power induced by the coadministration is qualitatively identical in young and old rats but quantitatively more marked in old rats. PMID- 2707312 TI - Tumor radiation responses and tumor oxygenation in aging mice. AB - EMT6 mouse mammary tumors transplanted into aging mice are less sensitive to radiation than are tumors growing in young adult animals. We hypothesized previously that this reflected a greater proportion of radiation resistant, hypoxic cells in the tumors of aging animals. The experiments reported here compare the radiation dose-response curves defining the survivals of tumor cells in aging mice and in young adult mice. Cell survival curves were assessed in normal air-breathing mice and in mice which had been asphyxiated with N2 to produce uniform hypoxia throughout the tumors. Analyses of these survival curves revealed that 41% of the viable malignant cells were severely hypoxic in tumors in aging mice, while only 19% of the tumor cells in young adult animals were radiobiologically hypoxic. This did not appear to reflect anemia in the old animals, as the hematocrits of young and aging tumor-bearing animals were similar. Treatment of aging animals with a perfluorochemical emulsion plus carbogen (95% O2/5% CO2) increased the radiation response of the tumors, apparently by improving tumor oxygenation and thereby decreasing the number of severely hypoxic, radiation resistant cells in the tumors. PMID- 2707313 TI - Biochemical changes related to aging in the senescence-accelerated mouse. AB - Several biochemical parameters reflecting the degree of senescence were compared between senile-prone (P) and resistant (R) strains of male senescence-accelerated mouse (SAM) at 11 to 12 months of age. Plasma testosterone in SAM-P amounted to half the concentration in SAM-R. In the liver and brain of SAM-P, the content of malondialdehyde (MDA) and the activity of monoamine oxidase B (MAO-B) were significantly higher than those in SAM-R. Moreover, large amounts of fluorescent lipofuscin were detected in the SAM-P liver. Compared with SAM-R, both membrane and cytosolic fractions from the SAM-P liver contained small amounts of protein and showed less activity of superoxide dismutase (SOD). The present findings suggest that the male SAM-P rapidly acquires biochemical changes which are considered to be part of the normal aging process. PMID- 2707314 TI - Life extension by dietary restriction in the bowl and doily spider, Frontinella pyramitela. AB - Longevity of free-living female adult bowl and doily spiders was compared with that of captive spiders fed at dietary regimes of one, three, and five Drosophila melanogaster per week. Adult females lived, on average, only 8 days in the field and the pattern of survivorship showed no evidence that senescence contributed to mortality. In the laboratory, mean adult life span was 81.3, 63.9, and 42.3 days on the one, three, and five Drosophila diets, respectively. Decreased feeding rate also delayed egg laying and reduced total fecundity. Survival and reproductive patterns indicated the manifestation of spider senescence at all laboratory feeding levels, with a younger onset of senescence at the higher feeding rates. PMID- 2707315 TI - Cellular site and mode of Fv-2 gene action. II. Conditional protection of Fv-2ss cells by admixture with Fv-2rr cells. AB - Fv-2ss marrow cells are protected in vivo from Friend virus-induced erythroleukemia by admixture with a preponderance of Fv-2rr marrow cells. This was demonstrated both in allophenic (mosaic) mice and in bone marrow chimeras constructed from C57BL/6 strains differing at Fv-2 and an enzyme marker (glucose phosphate isomerase). The bone marrow chimeras were constructed by injection of marrow cells from Fv-2ss mice into unirradiated Fv-2rr mice. Bone marrow chimeras derived from this procedure produced 1%-2% donor (Fv-2ss) erythrocytes; this level of chimerism was maintained indefinitely. All the bone marrow chimeras as well as allophenic mice with less than 20% Fv-2ss red cells failed to develop any of the symptoms of Friend disease after infection with the polycythemic strain of Friend virus. The Fv-2rr-mediated protection of Fv-2ss marrow cells could be reversed by pretreatment of the two types of chimeras with either monoclonal or polyclonal antithymocyte antisera. Chimeras treated with either reagent and infected with Friend virus developed symptoms of Friend disease and experienced a shift in their erythrocyte mosaic composition favoring cells of the susceptible genotype. These results are consistent with the notion that a functioning immune system plays a role in the Fv-2rr-mediated protection of Fv-2ss Friend virus target cells. Furthermore, these studies establish conditions whereby a small population of sensitive strain cells in an overwhelming background of resistant strain cells can be selectively expanded. Such conditions could be useful in efforts to clone the Fv-2 gene. PMID- 2707316 TI - A comparison of stem cell populations and hemoglobin switching in normal versus beta-thalassemic mice. AB - The hematopoietic stem cell concentrations in tissues of homozygous beta thalassemic and non-thalassemic fetuses and neonates were compared by using the spleen colony-forming units (CFU-S) assay. The relative quantities of embryonic and adult hemoglobins were also determined for fetuses. Beta-thalassemic fetuses had a reduced incidence of CFU-S in the liver throughout gestation, but after birth the beta-thalassemic neonates maintained a greater number of CFU-S in the liver for an extended period. The incidence of CFU-S in the bone marrow was not different for the two groups. The beta-thalassemic mice exhibited a significant expansion of CFU-S in the spleen beyond 11 days after birth. The switch from the synthesis of primarily embryonic to primarily adult hemoglobins in circulating erythrocytes in beta-thalassemic fetuses appeared later than the switch in normal fetuses. These observations establish that the developmental timing and expansion of hematopoiesis are perturbed in beta-thalassemic mice. PMID- 2707317 TI - Induction of macrophage-like differentiation of HL60 human myeloid leukemia cells by phorbol myristate acetate triggers an early decline in inositol lipid breakdown. AB - We have studied the metabolism and cellular levels of inositol lipids and their breakdown products, the inositol phosphates and diacylglycerol (DAG), in HL60 human myeloid leukemia cells. Changes in these species during phorbol myristate acetate (PMA)-induced differentiation to a macrophage-like phenotype were quantitated by isotopic labeling techniques. The slow, autonomous breakdown of inositol lipids detectable in uninduced cells was almost completely abolished between 3 and 6 h of PMA addition. The intracellular levels of the inositol phosphates were detectably reduced 1 h after PMA addition and continued to decline during the next 24 h. Also consistent with the reduced breakdown of inositol lipids, the molar ratio of these species showed a small but significant increase relative to other membrane lipids 24 h following PMA addition. However, the cellular DAG content increased gradually after PMA addition, presumably due to the cessation of cell proliferation and reduced utilization of DAG as a precursor for lipid synthesis. The results here suggest that the slow, autonomous generation of inositol lipid-derived second messengers may contribute to the stimulation of proliferation of HL60 cells and that the rapid PMA-induced inhibition of this pathway may precede the triggering of cellular differentiation in this system. PMID- 2707318 TI - Therapeutic activity of 1-beta-D-arabinofuranosylcytosine conjugates of lipids in WEHI-3B leukemia in mice. AB - Two new conjugates of 1-beta-D-arabinofuranosylcytosine (ara-C) and lipids were tested for therapeutic activity in myelomonocytic WEHI-3B leukemia in mice. Both conjugates were superior to equimolar mixtures of their respective parent compounds and to ara-C alone. IP treatment was found effective after either IP or IV transplantation of the leukemia. The thioether-linked lipid conjugate ara-CDP D,L-PTBA showed considerably higher efficacy than the ester-linked lipid conjugate ara-CDP-L-dipalmitin. The optimal therapeutic regimen of ara-CDP-D,L PTBA consisted of 60 mg/kg given IP qd 1-5 after transplantation of the WEHI-3B leukemia. PMID- 2707319 TI - In vitro growth of rat bone marrow BFU-E. AB - Pokeweed mitogen-stimulated rat spleen cells were identified as a reliable source of rat burst-promoting activity (PBA), which permitted development of a reproducible assay for rat bone marrow erythroid burst-forming units (BFU-E). Optimum BPA dose, assay time, cell dose, and erythropoietin requirements for rat BFU-E were identified. A serum-free assay and a method for stimulating endogenous bone marrow BPA were developed. Identification of sources of rat BPA and characterization of the rat BFU-E assay makes this species more useful for hematopoietic studies. The similarity of rat BFU-E to human and mouse BFU-E strengthens the validity of rat models for erythropoiesis. PMID- 2707320 TI - Plasticity in the barrel cortex of the adult mouse: effects of peripheral deprivation on GAD-immunoreactivity. AB - The whisker-to-barrel pathway of the adult mouse was used in a study on the effects of peripheral sensory deprivation on GAD-immunoreactivity in the somatosensory cortex. At varying periods of time after removal of a set of vibrissal follicles, mice were processed for immunohistochemistry using an antibody against GAD. In sections tangential to the cortical surface we observed, in the barrels whose follicles were removed, decreased immunoreactivity as early as three days after surgery. The decrease was due to a lesser numerical density of stained puncta and to less intense staining of those remaining. GAD-positive somata were also less intensely stained, whereas their number did not seem to be changed. The changes, apparent at 3 days after the surgery, were restricted to the barrels corresponding to the removed follicles and were maximal at 2-4 weeks. At longer survival times (until 7 months) the immunoreactivity returned to normal, coincident with the regeneration of peripheral nerve fibres in the absence of their follicles. We conclude that GAD-immunoreactivity in the barrel cortex swiftly reacts to modifications of neuronal activity evoked in the periphery. PMID- 2707321 TI - The functional development of input-output relationships in the rostral portion of the corpus callosum in the kitten. AB - Microstimulation of the rostral portion of the corpus callosum (CC) was carried out on 21 awake kittens ranging in age from 45 to 105 days to determine the age at which motor responses first appeared and that at which they assumed functional adult-like properties. Motor responses to microstimulation first appeared over an interval ranging from 78-86 days postnatally. As in adults, they consisted of discrete, well-localized contractions of shoulder, whisker, and eyelid muscles according to the stimulated sites. In the first days after their appearance, motor responses differed markedly from those in adults because: (a) they exhibited higher thresholds; (b) they did not faithfully follow pulse trains delivered at 10 s intervals; (c) they had variable and longer latencies. Thereafter, motor responses gradually became stable, faithfully followed suprathreshold stimulation delivered at 0.1/s frequency, and acquired lower thresholds and shorter latencies, until they exhibited adult-like properties at 93-100 days of age. Single-unit recordings were obtained from 138 fibres isolated in the same callosal region submitted to microstimulation in order to study the response properties of the callosal fibres to somatic stimuli in immature animals. On the basis of their reactivity to peripheral stimulation, fibres were classified into three main types: (1) unreactive units (58 fibres), which could not be driven by somatic stimuli. (2) Adult-like units (55 fibres), which were readily driven by somatic stimuli and were endowed with fixed and small receptive fields (RFs) indistinguishable from those of adults. (3) Immature units (25 fibres), which were unsteadily driven by somatic stimuli applied over large areas at the periphery. Neither the RFs nor the adequate stimuli could be reliably determined. This type of units was not found in the adult cat (Spidalieri et al. 1985). The proportion of unreactive units was the highest before the appearance of motor responses and gradually decreased, approaching the adult level after attaining adult-like motor responses. Conversely, the proportion of adult-like units was lowest before the appearance of motor responses and gradually increased, approaching the adult level after motor responses had acquired adult like properties. PMID- 2707322 TI - Selective listening modifies activity of the human auditory cortex. AB - We have studied the effect of selective listening on the neuromagnetic evoked activity of the human auditory cortex. In the word categorization experiment the stimuli were 5-letter words, each beginning with (k). Half of them were targets, i.e., names of animals or plants, and half other meaningful Finnish words. In the duration discrimination experiment equiprobable tones of 425 ms (targets) or 600 ms duration were presented. In both experiments the interstimulus interval (ISI) was 2.3 s and the stimuli of the two classes were presented randomly. Subjects either ignored the stimuli (reading condition) or counted the number of targets (listening condition). The magnetic field over the head was measured with a 7 channel 1st-order SQUID-gradiometer. The stimuli evoked a transient response followed by a sustained field. The transient response did not differ between the two conditions but the sustained field was significantly larger in the listening than reading condition; the increase began 120-200 ms after stimulus onset and continued for several hundred milliseconds. The equivalent source locations of both transient and sustained responses agreed with activation of the supratemporal auditory cortex. In the dichotic listening experiment 25-ms square wave stimuli were presented randomly and equiprobably either to the left or to the right ear at an ISI of 0.8-1 s, either alone or in presence of a speech masker. Counting the stimuli of either ear resulted in differences between responses to relevant and irrelevant sounds. The difference began 140-150 ms after stimulus onset and peaked at 200-240 ms. During monaural speech masking, N100m was larger for attended than ignored stimuli.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707323 TI - Two types of GABA-containing axon terminals in cerebellar glomeruli of cat: an immunogold-EM study. AB - Immunogold demonstration of GABA was used in ultrathin sections of cerebellar cortex of cat to identify GABA(+) profiles in cerebellar glomeruli. In addition to small, GABA-containing axonal varicosities found at the periphery of all glomeruli, a few complex glomeruli were found to contain a second type of GABA(+) terminal, with a mossy ending appearance. GABA(+) type "I" axon terminals, which were identified as the axonal arborization of local Golgi cells, contained ovoid, small synaptic vesicles. GABA(+) type "II" terminals, however, exhibited large, spheroid synaptic vesicles. Experimental evidence is provided that type "II" GABA(+) mossy like terminals are the endings of nucleocortical fibers. PMID- 2707324 TI - A comparison of homonymous and heteronymous connectivity in the spinal monosynaptic reflex arc of the cat. AB - Multi-unit spike triggered averaging was used to determine functional connectivity between spindle afferent fibers from the medial gastrocnemius muscle and the motoneurons innervating the medial (homonymous connections) and the lateral gastrocnemius-soleus muscle (heteronymous connections). As many as 288 possible connections between 24 motoneurons and 12 afferent fibers were studied in single, acute experiments. The influences of morphological and topographical factors, as well as of motoneuron species on functional connectivity were analysed. The probability that a motoneuron would receive functional connections from a given population of afferent fibers was related to its size and its proximity to the spinal entry level of the afferent fibers. The faster the axonal conduction velocity of the motoneuron (i.e. the larger the motoneuron) and the closer its location to the entry zone of the afferent fibers, the higher was its probability of receiving functional connections. The greater the conduction velocity (i.e. diameter) of a stretch receptor afferent fiber, the higher was its probability of making functional connections with motoneurons. These relationships were qualitatively similar for homonymous and heteronymous connections. 58% (233/399) of the Ia and group II afferents (combined) had functional connections with homonymous motoneurons, 32% (75/234) with heteronymous motoneurons. However, homonymous and heteronymous motoneurons of similar sizes were equally likely to receive functional connections when located at the same craniocaudal level. Differences in the locations and mean sizes of homonymous and heteronymous motoneurons however, cannot account completely for the observed overall differences in homonymous and heteronymous connectivity. PMID- 2707325 TI - Influences of morphology and topography of motoneurons and muscle spindle afferents on amplitude of single fiber excitatory postsynaptic potentials in cat. AB - Excitatory postsynaptic potentials (e.p.s. p.s.) elicited by impulses in single muscle spindle afferent fibers from the medial gastrocnemius (m.g.) muscle were recorded intracellularly from homonymous and heteronymous motoneurons in order to study factors that influence the amplitudes of such responses. Impulses in large afferent fibers elicited larger single-fiber e.p.s.p.s. than those in smaller afferents. Mean e.p.s.p. amplitudes were related exponentially to afferent conduction velocities of both Ia and spindle group II fibers. The closer a motoneuron was to the spinal entry point of an afferent fiber, the larger was the mean e.p.s.p. amplitude evoked in it. Impulses in the same afferent fiber elicited larger e.p.s.p.s in small than large motoneurons when the two cells were located at the same craniocaudal levels. Other factors being equal, the single fiber e.p.s.p.s evoked in homonymous and heteronymous motoneurons were approximately equal in amplitude. Relatively simple morphological and topographical explanations for the findings were advanced and their functional significance for orderly recruitment in partitioned and unpartitioned reflexes was described. PMID- 2707326 TI - Monosynaptic excitation of medullary inspiratory neurons by bulbospinal inspiratory neurons of the ventral respiratory group in the cat. AB - In Nembutal-anesthetized, immobilized, and artificially ventilated cats, we studied the connectivity of medullary collaterals of bulbospinal inspiratory (BS I) neurons in the ventral respiratory group (VRG). BS-I neurons which projected to the contralateral spinal cord were isolated extracellularly and intracellular recordings were made from the respiratory neurons in the contralateral VRG. The intracellular membrane potentials were averaged using extracellular spikes of the BS-I neurons as triggers (spike-triggered averaging method). Fast-rising and short-lasting depolarizing potentials locked to the triggering spikes were obtained and shown to be unitary EPSPs induced monosynaptically by the medullary collaterals of BS-I neurons. A total of 137 pairs were analyzed and unitary EPSPs were found in 11 pairs. Four BS-I neurons and 7 inspiratory vagal motoneurons received EPSPs from the medullary collaterals of BS-I neurons. These findings suggest that 1) BS-I neurons in the VRG drive medullary motoneurons of accessory respiratory muscles and phrenic or intercostal motoneurons simultaneously, 2) BS I neurons on both sides synchronize via the excitatory connections, and 3) the augmenting firing pattern of BS-I neurons might partly be produced by this reexcitatory connection within the population of BS-I neurons. PMID- 2707327 TI - Neural grafting to ischemic lesions of the adult rat hippocampus. AB - The purpose of this study was to examine the structural and connective integration of developing hippocampal neurons grafted to ischemic lesions of the adult rat hippocampus. The 4-vessel occlusion model was used to cause transient cerebral ischemia which damages CA1 pyramidal cells in the dorsal hippocampus, but spares nonpyramidal neurons and afferents in the area. One week later, cell suspensions were made from the CA1 region of fetal (E18-20) rats and injected stereotaxically into the lesion. The recipient brains were examined 6 weeks to 6 months later for survival, morphology, and intrinsic and extrinsic connections of the grafts. The methods used included cell stains, histochemical staining for acetylcholinesterase (AChE), immunocytochemical staining for neuropeptides (cholecystokinin (CCK), somatostatin (SS), enkephalin (Enk) and an astrocytic marker, glial fibrillary acidic protein (GFAP), as well as tracing by retrograde axonal transport of fluorochromes and light and electron microscopy of anterograde axonal degeneration. The grafts survived well (80%) and were often quite large. They were well integrated in the lesioned host brain area, contained both pyramidal cells and neuropeptidergic neurons and displayed a near normal GFAP immunoreactivity for astrocytes. The latter contrasted the dense gliosis of the host ischemic lesion. Judged by the AChE staining the grafts were innervated by cholinergic host septohippocampal fibers. Ingrowth of host hippocampal commissural fibers was demonstrated by Fink-Heimer staining for degenerating nerve terminals following acute lesions of the hippocampal commissures. At the ultrastructural level degenerating, electron dense terminals of host commissural origin were found even deep inside the graft neuropil in synaptic contact with mainly dendritic spines. A transplant efferent connection to the host brain was demonstrated by retrograde fluorochrome tracing and consisted of a homotypic projection to more posterior levels of the ipsilateral host CA1 and subiculum. Minor abnormal, efferent projections to the host dentate molecular layer were shown in Timm staining. We conclude that fetal CA1 neurons grafted to one week old ischemic lesions of the dorsal CA1 in adult rats become structurally well incorporated and can establish nerve connections with the host brain. PMID- 2707328 TI - An assessment of the existence of muscle synergies during load perturbations and intentional movements of the human arm. AB - A cross-correlation analysis was performed on EMG activities in elbow and shoulder flexors evoked by force perturbations acting in different directions on the forearm and during intentionally generated movements with the purpose of characterizing the temporal relationships between patterns of activation of different muscles. Qualitatively it was found that the shape of the cross correlation function differed from one experimental condition to the next. A principal component analysis permitted a quantitative assessment of this point. In general it was found that two principal components could account for the data. Furthermore when the cross-correlograms are represented in principal component space, there was no clustering of the data points. Several possible definitions of 'muscle synergies' are discussed from the perspective of this finding. It is concluded that the most restrictive definition is incompatible with the data. Less restrictive definitions, while compatible with the data, do not lead to a simplification of the control problem. PMID- 2707329 TI - Muscle blood flow changes during sleep as a function of fibre type composition. AB - In rabbits blood flow was measured in 19 muscles with the radioactive microsphere technique. Fibre type composition (SO, slow-twitch oxidative; FOG, fast-twitch oxidative-glycolytic; FG, fast-twitch glycolytic) was determined histochemically for the same muscles. While no significant changes occur in the transition from quiet wakefulness (QW) to synchronized sleep (SS), in desynchronized sleep (DS) blood flow decreases in SO and increases in FOG and FG fibres. These changes may be related to the changes in motor activity characteristic of DS: muscle atonia and twitches, respectively. PMID- 2707330 TI - Motion perception prominence alters anticipatory slow eye movements. AB - Perceived motion may be a stimulus for anticipatory slow eye movements. To test this possibility, the production of anticipatory slow eye movements in humans was studied using apparent motion stimuli. Short range apparent motion was produced with random dot stimuli and the anticipatory slow eye movements were isolated from the smooth pursuit responses by occasionally including trials in which the random dot stimulus did not appear. Long range apparent motion was produced with subjective contour stimuli. Both short range and long range apparent motion were found to be effective stimuli for anticipatory slow eye movements. The prominence of perceived motion was altered by changing the spatiotemporal displacement intervals in the short range apparent motion stimuli. Changing the subjective contours also changed the motion percepts of the long range apparent motion stimuli. With both stimuli, the peak anticipatory slow eye velocities that were achieved decreased as the prominence of the motion percepts decreased, while the time-course of the anticipatory responses were similar under the different conditions. These findings indicate that the expectation of perceived motion is necessary for anticipatory slow eye movements. PMID- 2707331 TI - Flash evoked potentials in the ectostriatum of the zebra finch: a current source density analysis. AB - Recent research has demonstrated that ipsilaterally visually evoked potentials (VEPs) can be measured within the ectostriatum, the telencephalic target area of the tectofugal visual pathway in birds. In this paper we systematically measured contra- and ipsilateral VEPs within the ectostriatal complex to obtain more detailed information on the processing of contra- and ipsilateral stimuli. The similarity of neighbouring VEPs at equal depth and a comparison of a one dimensional and a three dimensional analysis of current source-densities (CSDs) for identical coordinates suggested that a one dimensional current source-density analysis might be applicable. The one dimensional current source-density analysis demonstrated largely corresponding patterns in the sink-source sequences of the current source-density depth profiles for the contra- and ipsilateral stimulus responses. The occurrence of a large sink in the centre of the ectostriatal core, together with the results of multiunit recordings, shows that the ectostriatal core is the location of the generators for both the contra- and the ipsilaterally evoked responses. The occurrence of macroscopic sinks and sources and the fact that VEPs can be recorded from the ectostriatum shows that there is a higher degree of order in the ectostriatum than has been previously demonstrated by anatomical methods. The time coincidence between the maximum spike rate of multiunit responses, the negative peak of the evoked potential, and the large central sink demonstrates that the influence of ipsi- as well as of contralateral stimuli is predominantly excitatory. PMID- 2707332 TI - Unscheduled DNA synthesis in various types of cells of the mouse brain in vivo. AB - Very low incorporation of 3H-thymidine (TdR) into neurons and non-proliferating glial and endothelial cells in various brain areas of the adult mouse after 3H TdR injection and subsequent X-irradiation of the head with 45 Gy has been demonstrated autoradiographically after exposure times of 250 days. In accordance with biochemical studies this incorporation of 3H-TdR represents DNA repair synthesis or UDS (unscheduled DNA synthesis). However, 3H-TdR incorporation into nuclear DNA of non-proliferating cells in the brain was not only found in X irradiated but also in sham-irradiated mice. This suggests that spontaneous UDS also occurs. Up to now spontaneous UDS has been shown only in HeLa cells in vitro. Nearly all the various types of brain cells tested exhibited UDS after X irradiation as well as spontaneous UDS. After correcting the mean grain numbers per nucleus not only for background but also for beta-self-absorption, substantial differences became apparent in the extent of UDS between the individual types of cells. After X-irradiation, UDS was highest in Purkinje cells and hippocampal granular cells but comparable UDS was also found in endothelial cells, regardless of the different brain areas studied. The extent of spontaneous UDS is also quite different in the various cell types, being highest in neurons of different sites and considerably lower in endothelial and glial cells. PMID- 2707333 TI - Modifications of masticatory behavior after trigeminal deafferentation in the rabbit. AB - Bilateral trigeminal deafferentation was performed in the rabbit in order to assess the role of orofacial inputs in regulation of the pattern of jaw movements during chewing. After bilateral combined section of the maxillary and inferior alveolar nerves, the animals did not eat food by themselves in the first postoperative week. However, they could chew and swallow when food was inserted into the mouth by an experimenter. The pattern of jaw movements and associated EMG activities of masticatory muscles during chewing were modulated remarkably by deafferentation. These modifications include 1) decrease in the horizontal excursions of the mandible at the power phase, 2) decrease in the maximum gape, 3) insufficient occlusion at the power phase (or increase in the minimum gape), 4) irregular patterns of jaw movements, 5) facilitation of the chewing rate, 6) increase in the number of chewing cycles in a masticatory sequence (the process from acceptance of food to swallowing), and 7) decrease in jaw-closing muscle activities. The findings indicate that deafferentation of the trigeminal sensory branches reduced masticatory force. On the other hand, no significant change was seen in the animals with disruption of cutaneous sensations of the face due to bilateral section of the infraorbital and mental nerves. Intraoral sensations rather than extraoral sensations may thus be important for regulation of masticatory force and jaw movements during chewing. Jaw movements during chewing were also analyzed in the animals with either bilateral ablation of the cortical masticatory area (CMA) or bilateral lesion of the ventral posteromedial nucleus (VPM) of the thalamus in order to examine whether profound effects of trigeminal deafferentation are produced via the transcortical loop. The animals with lesion of either the CMA or VPM demonstrated disturbances in feeding behavior, including the dropping of ingested food from the mouth, elongation of a masticatory process, reduction in the chewing efficiency, etc. However, the pattern of jaw movements during chewing were essentially similar to that in the preoperative period. These results do not necessarily deny a contribution of the CMA to regulation of jaw movements but suggest that the transcortical feedback loop via the CMA and thalamic VPM nucleus would not primarily be responsible for pattern formation of jaw movements during chewing in the rabbit. Probably, the sensory feedback via the transcortical loop may indirectly facilitate activities of the brain stem CPG, which facilitates the chewing rhythm or enables masticatory sequences to be conducted smoothly. PMID- 2707334 TI - Specific modulation of the Hoffmann reflex cutaneous facilitation during a reaction-time task. AB - The Hoffmann (H) reflex and its facilitation produced by electrical stimulation of the sural area were examined before a ballistic extension of the right foot. Modulations of the cutaneous facilitation of the H reflex (CFH) were used to assess the control exerted over the transmission of low threshold cutaneous afferents. The time-course of H and CFH changes were investigated at the end of the foreperiod and during the premotor period, i.e. between the response signal and the onset of the electromyogram (EMG) of the soleus muscle. Four stimulation conditions were set up depending on whether the H reflex was elicited on the contracting or non-contracting limb, and whether cutaneous stimulation was ipsilateral or contralateral to the reflex. During the 100 ms preceding the response signal, the inhibition of the H reflex was more marked in the contracting limb than in the non-contracting limb. At the end of the foreperiod, the CFHs had a symmetric time course: the CFHs evoked by conditioning stimulation of the contracting limb were facilitated just before the response signal, while those produced by conditioning stimulation to the non-contracting limb were depressed. It is suggested that these variations are related to postural adjustments taking place before the movement is performed. As previously reported, the H reflex of the contracting limb exhibited a marked increase in amplitude over the 50 ms preceding the EMG. Reflex facilitations showed specific variations according to the ankle stimulated and the soleus muscle tested. The CFHs produced by stimulation of the non-contracting limb regained, at the end of the premotor period, a value close to their reference level recorded in trials without movement. The CFHs, produced by conditioning stimulation of the contracting limb were modulated differently according to whether the tested soleus muscle was contracting or not: when the CFH was tested on the contracting muscle, it was found to be depressed throughout the premotor period; this contrasted significantly with the isolated depression recorded on the non contracting muscle. Therefore, only the cutaneous afferents from the mobilized limb, modulating the H reflex of the same limb, were subject to a specific inhibition during the premotor period. Throughout the preparatory and premotor periods, negative correlations were observed between H and CFH amplitude, except just before the EMG onset in the condition where the H reflex was delivered to the contracting muscle and the cutaneous stimulation to the ankle of the non contracting limb: in this case, CFH amplitude increase paralleled that of the reflex amplitude.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2707335 TI - Observations bearing upon semi-circular canal dynamics. AB - It can be shown that following an angular velocity step stimulus delivered in darkness, the nystagmic responses can be effectively 'dumped' after any interval in time by the application of an appropriate step decrement in velocity. In practise the null velocity is bracketed between those step decrements inducing just detectable nystagmus to left and right and can be determined within a range of +/- 1.5 degrees s-1. With test stimuli of 22, 44, and 64 degrees s-1 the 'dump' velocities have been established at varying intervals in time on four normal subjects. Contrary to expectations the dump velocity/time relations for all three test stimuli follow a convergent linear course. The dump velocities are unaffected by fixation suppression of the nystagmus induced by the test stimuli. The seeming irrelevance of nystagmus generation to dump velocity values is confirmed by the good correspondence with the results of a separate study using the oculogyral illusion as a guide in place of nystagmus. These findings are difficult to relate to conventional concepts of cupular dynamics. PMID- 2707336 TI - Neural control of limb coordination. II. Hatching and walking motor output patterns in the absence of input from the brain. AB - This study examines the effect of removing input descending from the brain on the production of the distinctive leg motor patterns of walking and hatching by spinal circuitry of 0- to 3-day old posthatching chicks. Transection of the cervical spinal cord was performed and chicks were tested between 2 and 28 h after surgery. Walking with good weight support could be elicited from many spinal chicks when placed on a moving treadmill belt. In some cases, sensory stimulation resulting from tail and/or wing pinch was also used. Placing spinal chicks in the hatching position in glass eggs was sufficient to elicit hatching like leg movements in some animals. Wing pinch was used to elicit more or longer episodes of leg movements. Quantitative analyses of EMG recordings from 6 leg muscles were used to evaluate the changes in motor patterns after cervical spinal transection. Most of the characteristic features of walking and hatching are maintained after descending input from the brain is eliminated. Each muscle is activated in the double or single bursting pattern typical of the normal behavior. Characteristic phase relationships are also preserved. In addition, burst duration versus cycle period relationships seen during the normal behaviors are maintained in the spinal animals. This shows that circuitry located in the spinal cord can produce these distinctive aspects of the hatching and walking motor patterns in the absence of brain input. While many features of walking and hatching patterns were maintained in spinal animals, some changes were noted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707337 TI - In vitro dark adaptation and preservation of electrical light responses in the retina from bovine eyes. AB - A method is described which allows the in vitro dark adaptation of rod photoreceptors from cattle eyes, enucleated under ambient light in the slaughterhouse. Without in vitro dark adaptation these eyes are light adapted and cannot be used for certain delicate biochemical studies and for an electrophysiological characterisation of rod responses. The method is very simple and yields large amounts of dark adapted retinal material, allowing experiments that require bulk amounts of photoreceptor cells. The only source of dark adapted photoreceptors so far have been retinae from dark adapted laboratory animals, which had to be killed and processed under infrared light. Eye cups were opened under red light as soon as possible after their enucleation. Their vitreous humor was removed and their retina thoroughly rinsed with ringer's. Then the eye cup was placed in a moist, light-tight box, where dark adaptation took place. Photoreceptors could thus be kept alive for more than 24 h without showing signs of deterioration. Humidity and free access of oxygen to the retina were the only prerequisites for their survival. The physiological intactness of the photoreceptors and their degree of dark adaptation was demonstrated by measuring mass receptor potentials (ERGs). A simple device is described which can be used for the electrophysiological characterisation of these eyes. PMID- 2707338 TI - Electrophysiological analysis of dopamine cells from the substantia nigra pars compacta of circling rats. AB - Extracellular single unit recordings were obtained from dopamine cells in the substantia nigra pars compacta during forced locomotion on a circular turntable treadmill. Stainless steel wire electrodes, 18 microns diameter, insulated with Parylene C were used. During the entire recording session the rat was in the treadmill apparatus. The device was stopped while a cell was being sought. A cell was identified as dopaminergic by a frequency of 3 to 10 Hz and a biphasic or triphasic action potential of greater than 2 ms in duration. An attempt was made to record from cells under the following conditions: animal at rest, animal turning in one direction, at rest again, turning in the opposite direction and finally, at rest. If the cell was still firing after these recordings, haloperidol was injected i.p. to see that the presumed dopamine cell increased its firing rate. A cell was held for all the observations in 4 animals. In an additional 10 rats, recordings were made before, during and after movement in one direction. Three animals were recorded only before and during movement. In 6 of the total of 17 animals haloperidol was administered. Results showed that firing patterns of cells in awake animals were similar to those reported from dopamine cells of anesthetized rats. During either contralateral or ipsilateral turning the firing frequency and burst activity significantly increased. These results indicate that the activity of dopamine cells in substantia nigra is increased bilaterally during circling. PMID- 2707339 TI - The mosaic of the uncrossed retinal projection in the superior colliculus of the cat. AB - The uncrossed retinocollicular projection in the cat was labeled by axonal transport of horseradish peroxidase from the eye and visualized in tangential sections through the superior colliculus. The terminals of this pathway are distributed in clusters and form a mosaic pattern rather than stripes in the superficial collicular layers. It is suggested that the periodicity of this pattern relates to the smallest receptive field diameters across the visual field. PMID- 2707340 TI - Excitability of corticospinal neurons during tonic muscle contractions in man. AB - A magnetic stimulus applied to the human scalp over the motor cortex causes a short latency contraction of contralateral limb muscles. This is presumed to result from the indirect excitation of corticospinal neurons with monosynaptic connections to motoneurons. The excitability of these cortical neurons can be estimated from the magnitude of the postsynaptic potentials produced in spinal motoneurons by a given magnetic stimulus. In man the characteristics of these postsynaptic potentials can be derived from changes in the firing probability of single motor units. When a subject increases the level of a sustained voluntary contraction the excitability of the corticospinal neurons estimated in this way becomes less. We conclude that the additional synaptic input to motoneurons required to maintain a stronger muscle contraction comes from fiber systems other than the population of fast corticospinal neurons activated by magnetic stimulation. PMID- 2707341 TI - Endogenous dopamine modifies electroresponsiveness of pars compacta cells in the guinea pig substantia nigra in vitro. AB - In the nigrostriatal pathway, dopamine is released not only from striatal nerve terminals, but also locally from the dendrites of nigrostriatal neurones within the substantia nigra itself. Exogenous dopamine is known to inhibit the firing of these neurones when applied directly to the substantia nigra in micromolar concentrations: but the amounts used are probably much higher than the endogenous concentration of the transmitter. Moreover, the direct, local blockade of nigral dopamine autoreceptors has not been reported to affect the firing rates of these neurones. The electrophysiological effects of endogenous dopamine were therefore examined using intracellular recordings from the substantia nigra in vitro. When slices of the midbrain were pharmacologically depleted of endogenous dopamine, selective membrane properties of nigrostriatal neurones were altered in a manner consistent with the effects of the exogenous transmitter. Similar changes were observed in control slices on exposure to the dopamine antagonist haloperidol. It is concluded that endogenous dopamine normally exerts a tonic influence on the electrical properties of nigrostriatal neurones. PMID- 2707342 TI - Evidence for the delayed expression of a brainstem abnormality in albino ferrets. AB - Previous reports have suggested that neurons of the medial superior olivary nucleus in albino cats and rabbits are smaller than those in normally pigmented strains. In this investigation, the mean cross-sectional areas of neuronal perikarya in the medial superior olivary nucleus of pigmented and albino ferrets were compared at juvenile (14 weeks) and adult (greater than six months) ages. The mean cross-sectional area of the perikarya in adult albino ferrets was found to be 45% smaller than that of adult pigmented ferrets, confirming observations in cat and rabbit. The same comparison in juvenile ferrets, however, showed no significant differences. These results suggest that the mechanisms producing the abnormality of the auditory pathways differ from those responsible for the production of abnormal retinofugal pathways in albinos. PMID- 2707343 TI - Ia afferents of the antagonist are inhibited presynaptically before the onset of a ballistic muscle contraction in man. AB - The aim of the present investigation was to study whether the pre-movement inhibition of the H reflex in the antagonist of a ballistic voluntary contraction was due to a reduced activity of the motoneuronal pool of the antagonist, or to a reduced excitatory effect of the afferent volley reaching these motoneurons. Human subjects performed visually conditioned ballistic dorsal flexions of the ankle. The inhibition of the H reflex in the antagonist (soleus muscle) was similar if the muscle was initially relaxed or if there was a preexisting level of motor discharge. Since the soleus muscle was inhibited before movement onset in parallel with the H reflex inhibition, the relation between the level of a background activity and the size of superimposed H reflexes was studied. The finding that H reflexes were only slightly reduced in size with decreasing steady EMG levels could not explain the pre-movement inhibition, and it was concluded than an increased presynaptic inhibition of Ia terminals was the source of the H reflex inhibition. PMID- 2707344 TI - Directionally selective response of cells in the middle temporal area (MT) of the macaque monkey to the movement of equiluminous opponent color stimuli. AB - Based on the fact that a great majority of cells in the middle temporal (MT) area of the macaque respond to movement of luminance contours with directional selectivity, this area has been thought to be concerned with the analysis of visual motion. However, objects can be discriminated from the background not only by differences in luminance but also by differences in color. It is possible that color signals are also used for motion analysis in MT. In the present study, we examined whether MT cells respond to movement of a pattern composed of pure color contours. Using a color TV system, a moving color bar was displayed on a uniform background whose color was opponent with that of the bar. The main bar/background color combination we examined was magenta/cyan. Yellow/blue and cyan/magenta combinations were also examined for some cells. The response of MT cells to movements of opponent-color stimuli was recorded while the bar/background luminance ratio was changed from 1/10 to 10/1. In half of 89 cells tested in 3 monkeys, the response decreased considerably (disappeared completely in some cells) at a luminance ratio close to the human equiluminous condition. In the other half, a directional response persisted at any bar/background luminance ratio, though the response decreased to a varied extent (30-90% of the maximum response) near the ratio 1 (human equiluminous condition). The average magnitude of the equiluminous response to the magenta/cyan stimulus for the overall population was about 35% of the maximal response when the length of the bar (0.5 degrees in width) and the movement amplitude were set to be optimal for individual cells, i.e. smaller than 15 degrees and 10 degrees of visual angle, respectively. This fall to 23% when the bar length and movement amplitude were limited to 2 degrees. The same cell responded to pure color-contours of yellow/blue as well as of cyan/magenta combinations. Thus, MT can detect the direction of movement of pure color-contours, although the sensitivity is less than for luminance contours. PMID- 2707345 TI - Changing patterns of binocular visual connections in the intertectal system during development of the frog, Xenopus laevis. II. Abnormalities following early visual deprivation. AB - During normal metamorphic and post-metamorphic growth of the frog, Xenopus laevis, there is a major and orderly remodelling of the pattern of neuronal connections in the intertectal system. These changes preserve the spatial registration of binocular visual inputs to each optic tectum in the face of continuous changes in relative eye alignment (Grant and Keating 1989). We suggested that visual experience might be utilised by the intertectal system to effect the maturational remodelling of its connections, with particular involvement in maintaining binocular visual registration. To investigate this suggestion we studied the development of the intertectal system in animals that had been reared in total darkness from before the onset of function in the system. Visual deprivation did not affect the developmental ocular migration that normally occurs in Xenopus, nor did it affect the maturation of the contralateral visuotectal projection. Abnormalities were, however, observed in the ipsilateral visuotectal projection of all dark-reared animals studied, reflecting perturbation of the underlying intertectal system. The abnormalities included disorder and deficits in the projection, which became more marked with age. Quantitative analyses of the spatial registration of binocular visual inputs to the optic tectum revealed that, in all dark-reared animals studied, registration was both significantly poorer and systematically shifted compared to normal controls. Analysis of maturational changes in the pattern of intertectal connections in visually-deprived animals led to the conclusion that intrinsic developmental processes generate an initially well-organised intertectal system and programme much of its continuous expansion with age. Visual experience, however, is necessary for the large scale and orderly remodelling of the system which, during normal maturation, preserves binocular visual registration despite changes in interocular alignment. PMID- 2707346 TI - Neurochemical correlates of behavioural responses to frustrative nonreward in the rat: implications for the role of central noradrenergic neurones in behavioural adaptation to stress. AB - We tested whether the stress of nonreward has neurochemical effects on noradrenergic neurones which resemble those reported for other forms of stress. Rats trained to run in a straight runway for food reward were subjected to either 1 or 10 extinction trials. Half the rats in each group were injected before the start of acquisition with IP 6-hydroxydopamine to deplete peripheral noradrenaline stores. All animals were killed immediately after their final test in the runway, together with untrained controls. Noradenaline depletion had no behavioural or neurochemical effects. The rate of extinction in the 10-trial group, which was indexed by the slope of the linear regression of running time on trial, correlated negatively with both alpha 2- and beta-adrenoceptor number (Bmax). There were no differences between groups in cerebral cortical noradrenaline content, or alpha 2- or beta-adrenoceptor binding. These results substantially conflict with those predicted from Stone's hypothesis relating beta adrenoceptor sensitivity to the behavioural response to stress. A further finding was that alpha 2-, but not beta-adrenoceptor number, negatively correlated with levels of noradrenaline in the tissue, suggesting that noradrenaline is less involved in the regulation of beta- than in that of alpha 2-adrenoceptors. PMID- 2707347 TI - Suppression of OKN and VOR by afterimages and imaginary objects. AB - Optokinetic nystagmus (OKN) is suppressed if attention is directed to a centrally placed afterimage superimposed on a moving display. Imagining a stationary object has little or no effect. An afterimage does not provide the retinal slip and misfoveation error signals provided by a stationary object and we have shown that an effective error signal does not arise from occlusion or masking of the display by the afterimage. Although a lack of relative motion between afterimage and moving display could indicate when OKN gain is one, there is no unique relative motion signal associated with a gain of zero. Subjects could partially inhibit the vestibulo-ocular reflex (VOR) in the dark when they imagined a head-fixed object. They could suppress the response more effectively by attending to an afterimage, but the suppression was still only partial. When OKN and VOR were evoked simultaneously, pursuit movements of the eyes could not be suppressed until the vestibular inputs had subsided. We conclude that signals associated with OKN, are fully available to the mechanism that assesses the headcentric motion of objects but that signals associated with VOR are only partially available to that mechanism. PMID- 2707348 TI - An early outward conductance modulates the firing latency and frequency of neostriatal neurons of the rat brain. AB - An in vitro slice preparation was used to obtain intracellular recordings of neostriatal neurons. Indirect evidence for the presence of an early outward conductance in neostriatal neurons is presented. With near threshold stimulation neostriatal neurons fired very late during the pulse. The long firing latency was associated with a slow (ramp-like) depolarization. In the presence of TTX the slow depolarization was lost and outward-going rectification dominated the subthreshold response. This finding demonstrated that both, outward- and inward going conductances play a role during the ramp-like depolarization. Outward-going rectification during depolarizing responses could be further augmented if the depolarizing stimulus was preceded by a conditioning hyperpolarization. A conditioning hyperpolarization prolonged the firing latency and slowed the firing frequency. A conditioning depolarization had opposite effects. After TTX treatment, the response showed a hyperpolarizing "sag" when depolarizing stimulation was preceded by conditioning hyperpolarization. 4-AP (0.5-2.5 mM) blocked the effects of the conditioning hyperpolarization on the firing latency and on the voltage trajectory. 4-AP also disclosed a slow depolarization which could produce neuronal firing very early during the pulse. This depolarization was TTX-sensitive and Co++-insensitive. In contrast to 4-AP, TEA (20 mM) did not produce a reduction in the firing latency but disclosed a membrane oscillatory behavior most probably produced by the interplay of these opposing conductances: the slow inward (probably Na+) and the transient outward (probably K+). Repetitive firing during 4-AP treatment was of the "phasic-tonic" type with an initial burst riding on the initial Co++-insensitive slow depolarization and a somehow irregular train of spikes during the remainder of the stimulation. Action potentials during 4-AP treatment were followed by an afterdepolarization which dominated the initial part of the interspike interval. PMID- 2707349 TI - Demonstration of axonal branching of fibres from certain precerebellar nuclei to the cerebellar cortex and nuclei: a retrograde fluorescent double-labelling study in the cat. AB - The projections from certain brain stem precerebellar nuclei to the cerebellar cortex and nuclei have been examined in the cat by using the retrograde fluorescent double-labelling technique. Crystalline Fluoro-Gold was implanted into the left cerebellar nuclei from the contralateral side and rhodamine-B isothiocyanate was injected into the overlying cerebellar cortex. The inferior olive, the lateral reticular nucleus, and the reticular tegmental pontine nucleus all contained double- as well as single-labelled neurons, and it was concluded that these nuclei have a high number of neurons whose axons branch to both the cerebellar cortex and nuclei. The neurons in the paramedian reticular nucleus and the pontine nuclei proper appear to project only to the cerebellar cortex. PMID- 2707350 TI - The role of calcium in the repetitive firing of neostriatal neurons. AB - The Ca++ -dependence of the repetitive firing of neostriatal neurons was studied in an in vitro slice preparation of the rat neostriatum. Neuronal firing was evoked by injecting depolarizing currents of 100-200 ms duration. In normal conditions, the mode of firing was tonic and showed very little adaptation. The frequency-current relation was linear over a wide range of frequencies. The repetitive firing was first enhanced and later suppressed by Co++, Mn++ and Cd++. These effects on the repetitive firing by the Ca++ -channel blockers paralleled the suppression of the slow afterhyperpolarizing potential. The lowering (0.2 mM) of Ca++ had similar effects. In the presence of TEA (up to 10 mM), the cell fired both Na+ and Ca+ action potentials. The results suggest that, as in other CNS neurons of the vertebrate, in neostriatal neurons the slow afterhyperpolarizing potential (AHP) is due to a Ca++ -activated K+ -conductance, and that the AHP plays a crucial role in the repetitive firing of these neurons. PMID- 2707351 TI - Cognitive spatial-motor processes. 3. Motor cortical prediction of movement direction during an instructed delay period. AB - We studied the activity of 123 cells in the arm area of the motor cortex of three rhesus monkeys while the animals performed a 2-dimensional (2-D) step-tracking task with or without a delay interposed between a directional cue and a movement triggering signal. Movements of equal amplitude were made in eight directions on a planar working surface, from a central point to targets located equidistantly on a circle. The appearance of the target served as the cue, and its dimming, after a variable period of time (0.5-3.2 s), as the "go" stimulus to trigger the movement to the target; in a separate task, the target light appeared dim and the monkey moved its hand towards it without waiting. Population histograms were constructed for each direction after the spike trains of single trials were aligned to the onset of the cue. A significant increase (3-4x) in the population activity was observed 80-120 ms following the cue onset; since the minimum delay was 500 ms and the average reaction time approximately 300 ms, this increase in population activity occurred at least 680-720 ms before the onset of movement. A directional analysis (Georgopoulos et al. 1983, 1984) of the changes in population activity revealed that the population vector during the delay period pointed in the direction of movement that was to be made later. PMID- 2707352 TI - Considerable deficits in the detection performance of the cat after lesion of the suprasylvian visual cortex. AB - The ability of two cats to discriminate between two geometrical outline patterns in the presence of superimposed structured background was tested before and after bilateral removal of the lateral suprasylvian visual areas (PMLS, PLLS, AMLS, ALLS, part of area 7). There were mild deficits when patterns and background were kept stationary; these deficits may be due to a partial undercutting of areas 17, 18 and 19. However, there was a severe impairment in performance when the patterns were moving on a stationary background which may be due to loss of the suprasylvian visual areas. Movement of the background relative to the figure resulted in an intermediate detection deficit. PMID- 2707353 TI - Enhanced acoustic startle responding in rats with radiation-induced hippocampal granule cell hypoplasia. AB - Irradiation of the neonatal rat hippocampus reduces the proliferation of granule cells in the dentate gyrus and results in locomotor hyperactivity, behavioral perseveration and deficits on some learned tasks. In order to address the role of changes in stimulus salience and behavioral inhibition in animals with this type of brain damage, irradiated and normal rats were compared in their startle reactions to an acoustic stimulus. A portion of the brain of 10 rats was exposed to a fractionated total dose of 13 Gy during the first 16 days post partum. This procedure produced selective hypoplasia (91% reduction) of the granule cells in the hippocampal dentate gyrus. Other rats (N = 10) were sham irradiated. Sudden tones were presented to each adult rat at a rate of 1 every 30 s (spaced trials) during an initial 10-min session and 1 every 15 s (massed trials) during a subsequent session. Irradiated rats startled with a consistently higher amplitude than controls and were more likely to exhibit startle responses. These animals with hippocampal damage also failed to habituate to the startle stimulus and, under certain circumstances, showed potentiated startle responses after many tone presentations. PMID- 2707354 TI - Operant conditioning of primate triceps surae H-reflex produces reflex asymmetry. AB - Monkeys are able to increase or decrease triceps surae H-reflex when reward depends on reflex amplitude. Operantly conditioned change occurs over weeks and produces persistent alterations in the lumbosacral spinal cord which should be technically accessible substrates of primate memory. Previous work monitored and conditioned triceps surae H-reflex in one leg. To determine whether H-reflex conditioning in one leg affects the control leg, the present study monitored H reflexes in both legs while the reflex in one leg underwent HR increases or HR decreases conditioning. Under the HR increases mode, H-reflex increase was much greater in the HR increases leg than in the control leg. Under the HR decreases mode, H-reflex decrease was confined to the HR decreases leg. By showing that conditioning of one leg's H-reflex produces H-reflex asymmetry, the data further define the phenomenon and indicate that the other leg can serve as an internal control for physiologic and anatomic studies exploring the sites and mechanisms of the spinal cord memory substrates. PMID- 2707355 TI - Direct projection from the dorsal hypothalamic area to the nucleus raphe pallidus: a study using anterograde transport with Phaseolus vulgaris leucoagglutinin in the rat. AB - A hypothalamic projection to the nucleus raphe pallidus of the medulla was examined using the anterograde tracing technique based on Phaseolus vulgaris leucoagglutinin (PHA-L) in the rat. After the iontophoretic application of PHA-L to the dorsal hypothalamic area, labeled fibers that finally ended in the nucleus raphe pallidus were observed descending through the most medial part of the ventral tegmental area and the nucleus reticularis tegmenti pointis to reach the medial aspect of the pyramid. Many varicose fibers forming a loose plexus were observed in the nucleus raphe pallidus, especially ventrally. The ventral surface of the pyramid and the most ventral region of the nucleus reticularis paragigantocellularis lateralis (PGCL) contained labeled varicose fibers. At the electron microscopic level, the labeled profiles in the nucleus raphe pallidus were small-sized unmyelinated axons and axon terminals. Labeled axon terminals containing spherical synaptic vesicles formed synapses on spine-like protrusions or small-sized dendritic shafts. These results strongly indicate that neurons in the dorsal hypothalamic area have a direct connection with neurons in the nucleus raphe pallidus and the ventral part of the PGCL. The possible involvement of this pathway in cardiovascular regulation was discussed. PMID- 2707356 TI - Single-unit analysis of pattern-motion selective properties in the middle temporal visual area (MT). AB - The middle temporal visual area (MT) in macaque extrastriate cortex is characterized by a high proportion of neurons selective for the direction of stimulus motion, and is thus thought to play an important role in motion perception. Previous studies identified a population of cells in MT that appeared capable of coding the motion of whole visual patterns independent of the motions of contours within them (Gizzi et al. 1983; Movshon et al. 1985). These "pattern motion selective" neurons are unlike motion sensitive cells that have been observed at earlier stages of the visual system. Using very different criteria, we have also previously identified an apparently functionally distinct group of MT neurons (Albright 1984). We predicted that these "Type II" neurons correspond to the pattern-motion neurons. In the present study, we have applied both sets of criteria to individual neurons in MT and found that these two differently defined sets of cells actually form the same population. These results support the idea that MT contributes to a specialized type of motion processing which reflects the integrity of normal perception. PMID- 2707357 TI - Ultrastructural identification of synaptic terminals from cortical axons and from collateral axons of geniculo-cortical relay cells in the perigeniculate nucleus of the cat. AB - Electron microscopic analysis of sections of the perigeniculate nucleus (PGN) of the cat processed with horseradish peroxidase (HRP) histochemistry after massive injections of this enzyme in the visual cortex showed two types of synaptic terminals labeled with HRP reaction products. One type (RLD terminals) is characterized by round synaptic vesicles, large size, dark mitochondria and asymmetrical synaptic contacts with somata and dendrites. The second type (RSD terminals) is characterized by round synaptic vesicles, small size, dark mitochondria and asymmetrical synaptic contacts with dendrites. The HRP+ RSD terminals, which were also found in the dorsal lateral geniculate nucleus (LGN), are interpreted as terminals of cortical origin both in the PGN and LGN, since previous studies have identified cortical terminals as being of RSD type in the LGN and in other thalamic nuclei. The HRP+ RLD terminals are interpreted as synaptic terminals of collaterals axons of geniculocortical relay cells in the PGN labeled by retrograde transport of HRP from the cortex. In addition, in semithin and ultrathin sections somata in the PGN were never found labeled with HRP products indicating the absence of a PGN projection to the visual cortex. PMID- 2707358 TI - Spinocerebellar neurons and propriospinal neurons in the cervical spinal cord: a fluorescent double-labeling study in the rat and the cat. AB - In the cervical spinal cord of the rat and the cat, the distributions of spinocerebellar and of descending propriospinal neurons were investigated using the retrograde fluorescent double-labeling technique. Moreover, a search was made for the presence of neurons with both ascending spinocerebellar and descending propriospinal axoncollaterals. Diamidino Yellow Dihydrochloride (DY) was injected at T2, while True Blue (TB) (in rats) or Fast Blue (FB) (in cats) was injected in the cerebellum. The distributions of labeled neurons were very similar in the rat and the cat. DY-labeled propriospinal neurons, projecting to T2 or below, were most numerous in lamina I and laminae IV to VIII. In the rat, such neurons were also present in the lateral spinal nucleus (LSN). TB- or FB-labeled spinocerebellar neurons were concentrated in the central cervical nucleus (CCN) at C1-C4, in the central part of lamina VII at C5-T1, in the medial part of lamina VI and the adjoining dorsomedial part of lamina VII at C2/C3-T1, and in Clarke's column. They were also found in lamina V at C1 and C7-T1, and in lamina VIII at all levels. In both species only very few DY-TB/FB double-labeled neurons, representing neurons with branching axons, were observed; in C1-T1, only about 0.5% of all TB/FB-labeled spinocerebellar neurons and about 0.05% of all DY labeled descending propriospinal neurons were double-labeled. The double-labeled neurons were all located centrally in lamina VII at C5-T1, but even in that area they constituted not more than 1.5% (rat) and 4% (cat) of the labeled spinocerebellar neurons. These findings indicate that, in the cervical cord of the rat and the cat, descending propriospinal neurons and spinocerebellar neurons are to a large extent separate populations. PMID- 2707359 TI - Changing patterns of binocular visual connections in the intertectal system during development of the frog, Xenopus laevis. I. Normal maturational changes in response to changing binocular geometry. AB - During metamorphic and post-metamorphic life in the frog. Xenopus laevis, growth related changes in skull shape produce radical alterations in the spatial relationship between the two eyes. These changes in binocular visual geometry were measured using optical techniques. Between the onset of metamorphic climax at stage 60 and adulthood (2 or more years post-metamorphosis) each eye migrates nasally by 55 degrees and dorsally by 50 degrees with respect to the major body axes of the animal. As a result the nasotemporal extent of the binocular visual field increases from 30 degrees to 162 degrees between these ages. Electrophysiological methods were used to determine changes in the neural representation of the binocular visual field at the paired midbrain optic tecta and in the tectal projection of pairs of corresponding retinal loci at various developmental points between these ages. The proportion of each tectal surface devoted to the representation of the binocular visual field increases from 11% at stage 60 to 77% at adulthood. Retinal correspondence, and hence the tectal projection of corresponding retinal loci, undergoes radical alteration during this period. In normal adults an intertectal system of connections selectively links the tectal projection of corresponding retinal loci and thus provides a neuronal mechanism for integrating binocular visual information in the optic tecta. Electrophysiological methods were used to determine how the intertectal system accommodates the developmental challenge posed by the enlarging binocular visual field and changing retinal correspondence. Between stage 60 and adulthood the ipsilateral visuotectal projection which is the product of the intertectal system, increases in size as the binocular visual field and its tectal representation enlarges. Moreover, throughout this period, it provides a mechanism for integrating binocular visual information in the optic tecta by maintaining its spatial registration with the contralateral visuotectal projection from the other eye. Analysis of the pattern of functional intertectal connections reveals that during the course of normal maturation this system undergoes continuous processes of expansion and of orderly and major remodelling. PMID- 2707360 TI - Noradrenergic innervation of the substantia innominata: a light and electron microscopic analysis of dopamine beta-hydroxylase immunoreactive elements in the rat. AB - Noradrenergic input to the rat substantia innominata (SI) was analyzed in this study by immunocytochemical localization of dopamine beta-hydroxylase (DBH), the synthetic enzyme for noradrenaline. DBH immunoreactive (DBH+) axons ramified extensively within the SI and appeared to be contiguous with the DBH+ terminal fields within the bed nucleus of stria terminalis and the amygdaloid complex. DBH+ axons in the SI exhibited many large boutons en passant and boutons terminaux. These DBH+ boutons appeared much larger than those in the cerebral cortex, hippocampus, and thalamus. Electron microscopic analysis revealed that DBH+ boutons formed asymmetrical synapses with mainly dendrites, but also somata and spines of SI neurons. Dendrites which were postsynaptic to DBH+ boutons also formed synapses with many other unlabeled axon terminals. Since previous studies have shown that dendrites of SI cholinergic neurons formed few synapses, the present result suggests that the noradrenergic influence of SI cholinergic neurons may be mediated mainly by polysynaptic pathways. PMID- 2707361 TI - Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. AB - To test the clinical counterpart of the learned nonuse theory, 25 chronic hemiplegic stroke and head-injured patients with minimal to moderate upper extremity extensor muscle function were required to keep their uninvolved upper extremities within a hand-enclosed sling during waking hours over a 2-week interval. During this forced use period and for 1 year thereafter, changes in force or time-based measures among 21 functional tasks were compared to values at the sixth baseline session, a preintervention time when relearning had plateaued. Significant (P less than 0.05, Friedman's repeated measures followed by Tukey multiple comparison tests) changes were seen in 19 of the 21 tasks with most persisting at the 1-year follow-up. There were no apparent differences between right- and left-sided involvement or between stroke versus head injury clients (Mann-Whitney procedure). Ratings for quality of movement scored from videotapes presented in random order showed no change over time. These data suggest that learned nonuse does occur in select neurological patients and that this behavior can be reversed through application of a forced use paradigm. PMID- 2707362 TI - The connections from botzinger expiratory neurons to upper cervical inspiratory neurons in the cat. AB - These experiments examined possible inhibitory inputs to upper cervical inspiratory neurons from the expiratory neurons of the Botzinger complex. Eighty one Botzinger neurons were tested with antidromic mapping for a projection to the C1 segment of the spinal cord; 44/81 (54%) were found to project, 27/79 (34%) contralaterally, 17/68 (25%) ipsilaterally, and 1/66 (2%) both contralaterally and ipsilaterally. Antidromic mapping in contralateral C1 demonstrated the presence of a collateral in 3/15 (20%) of the Botzinger neurons tested, while 3/9 (33%) had collateral arborizations in ipsilateral C1. The collaterals mapped were not localized to the region of the upper cervical inspiratory neurons. Microstimulation in C3 (12-17 microA, 0.2-ms duration) at locations which produced short-latency (2.7-3.5 ms) inhibition of phrenic nerve discharge resulted in the short latency (3.0 ms) inhibition of 1/27 (3.7%) upper cervical inspiratory neurons as demonstrated by cross-correlation. It was concluded that while some upper cervical inspiratory neurons may be inhibited during expiration by the Botzinger expiratory neurons, this connection is not a strong one. PMID- 2707363 TI - Morphological and electrophysiological studies of human hippocampal transplants in the anterior eye chamber of athymic nude rats. AB - Human fetal hippocampal tissue from normal women was obtained following elective abortion in the 8th to the 11th week of gestation. The hippocampal tissue was transplanted to the anterior chamber of the eye of adult athymic nude rats, where it was allowed to develop for up to 9 months before histological and electrophysiological evaluation. The transplants were revascularized from the host iris and many grew extensively in oculo. Large neurons were present in all transplants. Immunohistochemical studies revealed glutamic acid decarboxylase containing terminals and clusters of gamma-aminobutyric acid-positive nerve cell bodies within the transplants, as well as scattered tyrosine hydroxylase-positive and acetylcholinesterase-containing fibers. Single neurons recorded extracellularly from transplants 4-9 months in oculo showed a slow spontaneous discharge, with both complex and single action potentials. Stimulation of the transplant surface evoked a small initial wave followed by a larger and longer lasting field potential, similar to that seen in hippocampus in situ. A conditioning-testing paradigm was used to evaluate the presence of inhibitory circuitry in the hippocampal transplants. Significant suppression of the evoked test response was seen with interstimulus intervals ranging from 20 to 500 ms. Superfusion of enkephalin (100-300 nM) or penicillin (1600 U/ml) increased slow wave activity, as did tetanic electrical stimulation. These treatments appeared to generate ictal-like activity, which in some cases persisted as interictal spikes. Illumination of the retina also increased neuronal activity, presumably by reflex activation of cholinergic afferents from the parasympathetic innervation of the iris. Taken together, our data suggest that fragments of hippocampus from aborted first trimester human fetuses, grafted to the eye chamber of rodent hosts, develop many organotypic histological and physiological features. This preparation may provide a unique means for the study of neurobiological properties of human brain in both normal and disease states. PMID- 2707364 TI - The effects of total and partial callosal agenesis on the development of morphological brain asymmetries in the BALB/cCF mouse. AB - The corpus callosum fails to develop in some mice of the BALB/cCF strain. We report here a study on cerebral morphological asymmetry in males of this particular strain in order to test the hypothesis that the normal development of the corpus callosum is responsible for the establishment of brain asymmetries. In 46 animals the dorsal area and the weight of each hemisphere were measured. In order to identify the animals with callosal defects and check for size anomalies of the anterior commissure, the hemispheres were cut into sagittal sections and stained with cresyl violet. Measures of sagittal area of the anterior commissure did not support the hypothesis that this commissure is enlarged when the corpus callosum is reduced or absent. In normal animals, the mean difference between left and right dorsal cortical areas showed a significant directional asymmetry, the left being consistently greater than the right. A similar pattern was found for weight. In mice with callosal defects there were no significant differences, either between the dorsal areas or between the weights of the hemispheres. However, data on the absolute values of the hemispheric differences indicated the presence of a nondirectional asymmetry not only in normal animals, but also in mice with callosal defects. Therefore, our data suggest that the ontogenesis of the corpus callosum plays a role in directing the development of cerebral asymmetries. PMID- 2707365 TI - GABAergic and cholinergic neurons exhibit high-affinity nerve growth factor binding in rat basal forebrain. AB - We have used dissociated, rat basal forebrain cultures to identify specific cell types that are potentially responsive to nerve growth factor (NGF). Expression of high-affinity NGF binding sites was examined. A subpopulation of cells containing choline acetyltransferase (CAT), the acetylcholine-synthesizing enzyme, exhibited high-affinity binding, employing combined immunocytochemistry and 125I-NGF radioautography. Unexpectedly, a gamma-aminobutyric acid (GABA)-containing cell group also expressed high-affinity binding. These cells that exhibit high affinity binding appear to be neurons since they stain positively with the neuron marker, neuron-specific enolase, and negatively with the nonneuron marker, glial fibrillary acidic protein. Our observations suggest that NGF may regulate multiple brain systems and functions that have yet to be explored. Conversely, only subsets of cholinergic or GABA neurons expressed high-affinity binding, suggesting that these transmitter populations are composed of differentially responsive subpopulations. PMID- 2707366 TI - Linkage of Charcot-Marie-Tooth neuropathy type 1a to chromosome 17. AB - Charcot-Marie-Tooth disease Type 1 (CMT) is an inherited neuropathy with known genetic heterogeneity, with at least one autosomal dominant form (CMT Type 1b) linked to the Duffy region of chromosome 1. Autosomal dominant families not demonstrating linkage to the Duffy blood group marker have been designated CMT Type 1a. We report linkage of six CMT Type 1a families to the chromosome 17 markers EW301 (D17S58) and pA10-41 (D17S71) with maximum LOD scores of zeta = 10.49 at theta (maximum recombination fraction) = 0.05 and zeta = 7.36 at theta = 0.06, respectively. PMID- 2707367 TI - Light-evoked cortical activity produced by illumination of intracranial retinal transplants: experimental studies in rats. AB - We have investigated whether information relayed through intracranial retinal transplants can elicit responses in the visual cortex of host rats. Embryonic retinae were transplanted over the midbrain of neonatal rats. Four to eight weeks later, the transplants were exposed and stimulated with light flashes. This photic stimulation elicited both evoked responses and multi-unit activity in area 18a of the visual cortex. Pathway tracing studies using horseradish peroxidase showed that these responses are transmitted to the cortex via the superior colliculus, the lateral division of the lateral posterior nucleus of the thalamus, and possibly the medial portion of the dorsal lateral geniculate nucleus. It is suggested that this pathway may be involved in complex transplant mediated visual behaviors. PMID- 2707368 TI - Cone monochromacy and a reversed Purkinje shift in the gerbil. AB - Retinal spectral sensitivity of the gerbil (Meriones unguiculatus) shows that this animal has a unique photoreceptor complement: there is only a single class of cone and the spectrum for these receptors is peak shifted toward the short wavelengths relative to the spectra obtained from rods. PMID- 2707369 TI - Flow microcalorimetry as a tool for an improved analysis of antibiotic activity: the different stages of chloramphenicol action. AB - Flow microcalorimetry in combination with photometric mass determination of staphylococci in suspension was used to reveal alterations in the intensity, extent and efficiency of bacterial metabolism during inhibition of protein synthesis by chloramphenicol. It could be demonstrated that these three parameters of metabolic activity were distinctly affected by this drug, and that the method described promises to be a more reliable tool for assaying the degree and the mode of bacteriostatic inhibition than the conventional determination of the minimum inhibitory concentration. PMID- 2707370 TI - Fungitoxicity of m-fluorophenylalanine-containing peptides towards Pythium ultimum. AB - The tripeptide L-m-fluorophenylalanyl-L-alanyl-L-alanine was much more fungitoxic towards Pythium ultimum than the dipeptide L-m-fluorophenylalanyl-L-alanine or m fluorophenylalanine. The fungitoxicity of the tripeptide was reduced by L-alanyl peptides and phenylalanine, but not by other amino acids. In contrast, the fungitoxicity of m-fluorophenylalanine was unaffected by peptides, and was antagonized by several amino acids. These results suggest the effective delivery of m-fluorophenylalanine into the cell by a tripeptide carrier. PMID- 2707371 TI - The presence of free D-amino acids in mouse tissues. AB - The presence of free D-amino acids in mouse kidney, liver, brain, heart, lung, thymus and serum has been shown with an enzymic microdetermination method. The D amino acid levels were higher in the extracts of kidney and liver than in those from other organs. PMID- 2707372 TI - Prothymosin alpha is not a nuclear polypeptide. AB - Using a radioimmunoassay for the NH2-terminus of prothymosin alpha, the crossreactive material was measured in subcellular fractions of calf thymus and liver. No significant amount of crossreactive material was found in the nucleus. This provides experimental evidence against a recent hypothesis, based on structural evidence, that prothymosin alpha is a nuclear polypeptide. PMID- 2707373 TI - Beta-methyl carboline, a benzodiazepine inverse agonist, attenuates the effect of triazolam on the circadian rhythm of locomotor activity. AB - The benzodiazepine triazolam, the benzodiazepine inverse agonist, beta-methyl carboline (beta-CCM) or both, were administered to adult male hamsters under conditions of constant light. When given alone, triazolam induced phase advances in the circadian activity rhythm of about 90 min, while beta-CCM when given alone, had no effect on phase of the activity rhythm. However, when triazolam and beta-CCM were given at the same time, the magnitude of the phase advances induced by triazolam were attenuated to about 30 min. These data, in conjunction with previous results, provide pharmacological evidence for a GABAergic system involved in the regulation of a central circadian pacemaker. PMID- 2707374 TI - The effects of vitamin A nutritional status on microsomal lipid peroxidation and alpha-tocopherol level in rat liver. AB - In vitamin A-deficient rats, liver glutathione peroxidase activity was decreased, alpha-tocopherol content was strongly enhanced, but microsomal liquid peroxidation remained unchanged. PMID- 2707375 TI - Inhibition of temperature-induced spermatogenic proliferation by a brain factor in hibernating Helix aspersa (Mollusca). AB - Ablation of the brain from hibernating Helix aspersa maintained at 25 degrees C causes a significant increase in the proliferation of male cells in the gonad, whereas the ablation of the optic tentacles has no effect. The brain, therefore, produces a factor which specifically inhibits the multiplication of spermatogonia and spermatocytes. PMID- 2707376 TI - Selected decrease of haemocytes of the freshwater snail Planorbarius corneus (L.) (Gastropoda, Pulmonata) after bacteria injection. AB - The decrease of haemolymph phagocytic cells (SH) in Planorbarius corneus after bacterial injection seems to be mediated by humoral factor(s) released into the haemolymph. SH show different adhesiveness in vitro in the presence of bacterial metabolic products. PMID- 2707377 TI - Presence-absence cycles of the mother and not light-darkness are the zeitgeber for the circadian rhythm of newborn mice. AB - The relative roles of conflicting zeitgebers [presence/absence (PA) cycles versus light/dark (LD) cycles] on entrainment of circadian rhythm of locomotor activity were tested in pups of the night active mouse Mus booduga. During the early days of the pups' life the PA cycles of the mother acted as a zeitgeber and entrained their activity rhythm, even though the LD cycles were available. Entrainment by LD cycles took place only when the pups' eyes opened and probably became functional. PMID- 2707379 TI - Luffolide, a novel anti-inflammatory terpene from the sponge Luffariella sp.. AB - Luffolide (4) is a minor metabolite of the sponge Luffariella sp. from Palau. The structure of luffolide was determined by single crystal X-ray analysis. Luffolide is relatively unstable and undergoes a complex cyclization reaction to give the hexacyclic products 5 and 6. Luffolide (4) has some of the anti-inflammatory properties of manoalide (1): this may help to define the chemical reaction between manoalide (1) and phospholipase A2. PMID- 2707378 TI - Effects of enterally- and parenterally-administered bombesin on intestinal luminal tryptic activity and protein in the suckling rat. AB - Because of the presence of bombesin-like immunoreactivity in milk, we investigated if enteral administration of bombesin affects the intestinal luminal content of trypsin and protein in 12-14-day-old rats. Bombesin (40 micrograms/kg), given either orogastrically or subcutaneously, produced a significant elevation in the intestinal content of trypsin activity. Thus, enterally-administered bombesin can produce acute biologic effects in suckling rats. PMID- 2707380 TI - Experimental pulmonary fibrosis induced by paraquat plus oxygen in rats: a morphologic and biochemical sequential study. AB - Changes in lung structure and collagen metabolism were studied at 1, 2, 3, 4, 6, and 8 weeks in a model of pulmonary fibrosis induced in rats with paraquat plus hyperoxia. Morphologic examination of the lungs revealed that the earliest lesions consisted of severe and irreversible endothelial and alveolar epithelial cell damage. Afterward, an inflammatory process took place, initially dominated by polymorphonuclear leukocytes and then by mononuclear cells, but with the constant presence of granulocytes. From the fourth week on there were fibroblast proliferation and a moderate increase of mast cells. In the early stages alveolitis was focal, but from the second week the lungs were diffusely affected with severe distortion of the architecture. Collagen content was moderately increased in the first 2 weeks and then showed a progressive increment until the end of the experiment. Collagen synthesis was significantly elevated from the fourth week, coinciding with interstitial fibroblast proliferation, although there were some animals that showed increased collagen production from the first week. Collagenolytic activity occurred in 3 stages: at 2 weeks there was increased collagen degradation, at 3, 4, and 6 weeks the values showed a trimodal behavior, and at 8 weeks almost all experimental rats presented an important decrease of collagenolysis. Thus, the development of lung fibrosis was associated first with increased rates of collagen synthesis and later with a decrease of collagen degradation. PMID- 2707381 TI - Interaction of hypoxia and carbon tetrachloride toxicity in hepatocyte monolayers. AB - The toxicity of carbon tetrachloride (CCl4) in monolayer cultures of primary hepatocytes was investigated at oxygen concentrations that prevail in the liver under conditions that range from normoxia to hypoxia: 0.5, 1, 2, and 20% O2. CCl4 was administered in the vapor phase at concentrations that produce aqueous concentrations at 37 degrees C of 0.4, 2.0, and 4.0 mM. Damage was assayed by leakage of aspartate transaminase and the inclusion of Trypan Blue immediately after the 2-hr incubation and after an additional 6-hr incubation in 20% O2. Only in the case of 0.5% O2 and 4 mM CCl4 were the monolayers damaged (18%) immediately after the 2-hr exposure; all other exposed cells were undamaged at that time point and the dose response of cell death as a function of CCl4 and oxygen concentration was not evident until the 6-hr time point. The monolayers exposed to 4 mM CCl4 and 1, 2, or 20% O2 exhibited little immediate damage but were all 100% dead 6 hr later. The monolayers exposed to 2 mM CCl4 and 0.5, 1, 2, or 20% O2 were 53, 48, 40, and 22 +/- 2% dead after 6 hr, respectively. These results suggest that effects of CCl4 exposure, for example alterations in the function or synthesis of essential proteins, require several hours to affect cell viability. PMID- 2707382 TI - Rubratoxin B mycotoxicosis in the Syrian hamster: ultrastructural alterations. AB - Rubratoxin B was given to Syrian hamsters as a single intraperitoneal dose of 0.4 mg/kg. Hamsters were killed at 1, 2, 4, and 6 hr after dosing, and the kidneys and liver were fixed by intravascular perfusion. Renal ultrastructural alterations were evident at 1 hr after treatment and were limited to the straight portion of the proximal tubule. The most prominent alterations were brush border disruption, dilation of smooth endoplasmic reticulum, mitochondrial swelling, cytoplasmic rarefaction, myelin figure formation, and swelling of basal interdigitating processes. Renal alterations were suggestive of damage to membrane structure and/or transport functions and interference with cellular bioenergetics. Hepatic alterations were not seen in the rubratoxin B-treated hamsters of this study. PMID- 2707383 TI - Behavioral correlates of renal damage and cardiac changes. AB - The locomotor activity (determined by open-field test) and analgesic response (measured by tail-flick latency) of rats were evaluated during exposure to novel stimuli and again after exposure to shock. The effects of shock stress on hearts and kidneys were evaluated. This study has found that the more active an animal is when exposed to a novel stimuli the more likely it is to develop renal damage or cardiac changes after shock. Shock stress was found to produce changes in locomotor activity and analgesic state, but shock did not correlate as well with cardiac changes as did the animal's response to novel stimuli. A novel system of evaluating renal damage, which correlated to behavioral changes and organ damage, is described. PMID- 2707384 TI - In vitro pharmacological purging of human bone marrow is enhanced by the use of lonidamine. AB - Lonidamine (LND), previously reported as a useful antitumor substance in combination with physical or chemical agents, has been studied for its capacity in increasing pharmacological elimination in vitro of residual tumor cells from human bone marrow. Different drugs were tested in association with LND against mixtures of human bone marrow and a tumor cell line, clonogenic human leukemic blast progenitors, and normal human bone marrow precursors. The results demonstrated that LND increased the efficacy of anthracycline derivatives (Adriamycin, Mitoxantrone) both on the tumor cell line and on the leukemic blast progenitors, while VP-16 or ASTA-Z 7654 was not affected by the same substance. The toxicity on normal stem cells reflected that of each drug and was not modified by the addition of LND. While a consistent dose-dependent CFU-GM reduction was observed immediately after treatment with the different drugs, a complete recovery was reached after 7 and 14 days of long-term marrow cultures. Because of the low toxicity and the efficacy demonstrated in association with certain agents in increasing tumor cell elimination in vitro, LND could play an important role in in vitro purging prior to autologous bone marrow transplantation. PMID- 2707385 TI - Physiological variables affecting collagen lattice contraction by human dermal fibroblasts. AB - Normal human dermal fibroblasts cultured in collagen lattices can compact that matrix by the process known as lattice contraction. That process is a model of the pathological one of scar contracture or wound contraction and is affected by several factors. Lattice contraction is promoted by the addition of adequate amounts of fetal bovine serum to the medium (maximum contraction with 10% serum). The process requires energy, of which glucose and pyruvate have been shown to be adequate sources. When glucose is used as the substrate, the major pathway of energy generation appears to be anaerobic metabolism. When pyruvate is the only substrate, aerobic metabolism may be crucial. The synthesis of DNA is not required for lattice contraction, while protein synthesis is, although the identities of the specific proteins are unknown. Impairment of calcium ion transport inhibits lattice contraction, and the specific inhibition of calmodulin calcium interactions by W-7 blocks contraction. W-7 at a concentration of 6 x 10( 6) M blocks lattice contraction completely, while it has no effect at any lower concentration. Impairing dynamic microtubule activity impairs contraction. Disrupting microfilaments by cytochalasin B completely blocks lattice contraction. Microfilament function and calcium-calmodulin may be linked by a mechanism involving myosin-ATPase. The process of cell-mediated lattice contraction requires the production of energy, protein synthesis, and a functional cytoskeleton. PMID- 2707386 TI - Enzymatic and nonenzymatic lipid peroxidation capacities and antioxidants in hypoxic and reoxygenated rat myocardium. AB - The effects of 60 min hypoxia and subsequent reoxygenation for 30 min on enzymatic (NADPH-dependent) and nonenzymatic (Fe2+/ascorbate-induced) lipid peroxidation capacities and on antioxidant levels were studied using Langendorff perfused rat hearts. The assays were done on the myolayer of the right ventricle (RV) and on the subepi- and subendomyolayers of the left ventricle (epi/endo LV) after normoxic, hypoxic, and reoxygenation phases. The region injured by hypoxia/reoxygenation was located mainly in endo LV, seen as a lesser penetration of the fluorescent dye fluorescein in the myocardium. The electron microscopic findings after reoxygenation revealed swelling of the mitochondria, amorphous mitochondrial structures, and formation of paracrystallines. The myofibrillar structure of the cells was disrupted and the cells showed marked fluid accumulation. Membrane structures were marginated and formed blebs and multilamellar bodies. Ultrastructural changes were most prominent in endo LV, especially after reoxygenation. The increase in leakage of lactate in the perfusate revealed the onset of anaerobic metabolism. Abrupt release of the cytoplasmic enzymes lactate dehydrogenase and creatine kinase at the beginning of the reoxygenation phase suggested cell membrane injury. The capacity for Fe2+/ascorbate-induced lipid peroxidation slightly increased in RV and that for NADPH-dependent, enzymatic lipid peroxidation in endo LV after reoxygenation. Catalase, glutathione peroxidase, and superoxide dismutase activities remained unchanged, whereas glucose-6-phosphate dehydrogenase activity decreased after reoxygenation in RV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707387 TI - Correlation among lung damage after radiation, amount of lipid peroxides, and antioxidant enzyme activities. AB - The correlation between lipid peroxidation and morphologic changes was examined in Sprague-Dawley rat lungs after 30 Gy single thoracic radiation. The rats were sacrificed every week until the end of the fifth week after radiation. The left lungs were used for the measurement of lipid peroxides and antioxidant enzymes activities. The right lungs were examined by light and electron microscopy. Amounts of lung lipid peroxides were within normal limits, and no cellular degenerative changes were observed in the lungs except for subendothelial and interstitial edema 2 weeks after radiation. Lipid peroxides drastically increased and marked degenerative cellular changes such as edematous swelling, vacuolation, and destruction of cell membranes occurred in the alveolar septa following the third week after radiation. The activities of catalase were significantly higher during the period from the second to the fifth week and those of superoxide dismutase and glutathione peroxidase increased at the end of the fifth week. Our results demonstrated that the acceleration of lipid peroxidation was well correlated with the morphologic expression of cell injury in the irradiated lungs. PMID- 2707388 TI - Morphological study of the effects of ozone on rat lung. II. Long-term exposure. AB - To evaluate the morphological changes observed in animals after prolonged ozone exposure, 56 male rats were exposed to a high ambient level of ozone (0.5 ppm) 6 hr a day, 6 days a week, for 2, 3, 5, and 12 months and examined by light and electron microscopy. Bronchitis and peribronchitis were observed throughout the exposure periods, and connective tissue around the bronchi thickened as a result of fibrosis. Some bronchiolar ciliated cells were in a degenerated condition and others in a reparative phase. Hyperplastic nodules were not found in the bronchioles, but hyperplasia of the bronchiolar epithelium was observed. Hyperplasia of lymphoid nodules around small vessels was prominent after 2 months of exposure. After 3 months of exposure, alveolar ducts were lined by type 2 cells, and after 12 months, by the bronchiolar epithelium consisting of both ciliated and nonciliated cells. Alveolar macrophages accumulated in the centriacinar alveoli. Fibrous strands were seen to be deposited in alveolar ducts after 3 months, and in bronchioles after 5 months. This fibrosis was due to an increment in collagen fibers. The degree of fibrosis increased with the length of ozone exposure. PMID- 2707389 TI - Lack of co-transmission of Rickettsia conorii and Ehrlichia canis in human beings in the south of France. AB - Ehrlichia canis is the agent of canine Ehrlichiosis, commonly known as canine tropical pancytopenia. This canine disease is frequent in our area, as is Mediterranean Spotted Fever in humans. Recently a few cases of human Ehrlichiosis have been described in the USA. The supposed vector of both diseases is Rhipicephalus sanguineus. In order to evaluate the co-transmission of these two diseases, we selected 498 human sera positive for R. conorii and tested them for Ehrlichia canis. None of them were positive, suggesting the lack of co transmission of the diseases. PMID- 2707390 TI - More on the enteropathogenic mechanisms of Plesiomonas shigelloides. PMID- 2707391 TI - Could streptococcal infection be one of the causes of Bell's palsy? PMID- 2707392 TI - Anticonvulsant drugs and malformations is there a drug specificity? AB - The distribution of anticonvulsant drug therapy was studied in 318 malformed infants with known histories of maternal epilepsy. Data on the infants was collected from six birth defect monitoring programs in Europe and South America. Use of specific types of anticonvulsants varies widely among reporting countries. Heterogeneity of drug-malformation distribution, was analyzed to determine whether use of specific drugs were linked to specific malformations. A significant association was seen between maternal use of valproic acid and spina bifida, and a weaker, non-significant one between carbamazepine and spina bifida. Facial clefts were associated with both diphenylhydantoin and phenobarbitone use and also with polytherapy. These differences indicate that the actual drug used is significant for the teratogenic process. The technique may be useful in analysis of other drug-related teratogenic questions. PMID- 2707393 TI - HTLV-1 seroprevalence in AIDS patients and in HIV-1 seropositive and seronegative subjects at risk for AIDS in northern Italy. AB - Sera of 1023 subjects belonging to categories at risk for AIDS, positive for HIV 1, were tested for antibodies to human T-cell leukemia virus (HTLV-1) by ELISA, Western blotting, and radioimmunoprecipitation (RIP) assay. Sera of these subjects were positive for antibodies to HTLV-1 in a percentage of 18.54%. Nine out of 18 sera from patients with AIDS had antibodies to HTLV-1 (50%). Sera of 207 intravenous drug abusers and 64 homosexual males, seronegative for HIV-1, were tested for antibodies to HTLV-1 and 6.7% of intravenous drug abusers and 7.8% of homosexual males were found to be HTLV-1 antibody positive, showing that HTLV-1 infection occurred independently of HIV-1 and HIV-2 infections. In fact the same HIV-1 seronegative patients were also tested for the presence of antibodies to HIV-2 and none of them was found to be positive. PMID- 2707394 TI - Screening of African sera stored for more than 17 years for HIV antibodies by site-directed serology. AB - Antibodies to Human Immunodeficiency Virus type 1 (HIV-1) and type 2 (HIV-2) were investigated, using site-directed enzyme immunoassay (ELISA), in 320 specimens obtained from three remote, African tribes during 1969-1971. Using HIV-1 E34/E32 ELISA and HIV-2 149 ELISA, assay were conducted on 101 serum specimens from the Korekore tribe of Zimbabwe, 93 specimens from the Mano tribe of Liberia, and 126 specimens from the Turkana tribe of Kenya; specimens which tested positive in ELISA were further tested by radioimmunoprecipitation assay (RIPA) and Western blot (WB). Two serum specimens from the Mano tribe of Liberia gave OD 492 nm values greater than 0.2 in HIV E34/E32 ELISA in all three runs. These two specimens reacted with HIV-1 envelope proteins gp160 and gp120 and the internal protein p24 in RIPA and WB; however, the reactivity was uncostant. All other serum specimens were negative for HIV-1 and HIV-2 antibodies. Site directed ELISA serology for HIV-1 and HIV-2 gave very low rates of false positive reactivity. Thus, reaction with HIV-1 antigen was identified in two persons of one tribe in Liberia in 1971, but HIV-2 antibodies were not detected in this tribe; HIV-1 and HIV-2 antibodies were absent during the late 1960's and early 1970's from two African tribes resident in Zimbabwe and Kenya. PMID- 2707395 TI - Isolation of Legionella pneumophila from hotels of Greece. AB - Twenty water samples collected from 6 hotels situated in various areas of Greece were examined for the presence of Legionella pneumophila and Legionella-like organisms. Five of the six hotels included in this investigation were associated with cases of legionellosis. Legionella pneumophila serogroups 1 and 8 were isolated from four of six hotels, mainly from the hot water supply system. This is the first isolation and identification of L. pneumophila in Greece. PMID- 2707396 TI - Effects of occupational exposure and smoking on respiratory symptomatology and PFT in healthy panelists and COPD patients. AB - A panel of 377 healthy adults and 920 COPD patients aged 30-65 years, is annually interviewed (ATS-NHLI health questionnaire) and performs pulmonary function test (PFT), which includes: FVC, FEV1, FEV1/FVC, PEF, FEF50 and FEF75. Baseline data analysis showed a more significant excess in respiratory symptoms (8.8% to 21.4%) and lower PFT (2.4% to 8.0%) among patients occupationally exposed to dust, than among healthy exposed panelists (-0.7% to 7.7% excess symptomatology and -0.3 to 5.8% lower PFT). Among patients a significant correlation between PFT and degree of occupational dust exposure was found. Significantly lower FEV1/FVC and excess in respiratory symptoms (with relative risks of 2.47-16.38) was present in healthy smokers vs. non smokers as compared with COPD patients. PMID- 2707397 TI - A retrospective cohort mortality study on workers of two thermoelectric power plants: fourteen-year follow-up results. AB - Although many studies have been performed to evaluate the environmental impact of coal energy production, few studies are available on the health risk for the people working in coal power plants. A retrospective cohort study was performed on the workers of two power plants near Venice (which use coal since 1968) in order to test the association between exposure to coal dust and ashes and mortality for all causes, all cancers, and respiratory and digestive cancer. One thousand three hundred seven male workers were followed up from 1968 to 1984. During this period 41 workers died; causes of death were collected from the local Mortality Registers and/or from the Hospital Records. The observed mortality of the study cohort was compared with the mortality expected from the Italian death rates in the same period. No Standardized Mortality Ratio (SMR) was found in excess in the working cohort with respect to the standard population for any of the investigated effects. PMID- 2707398 TI - Determinants of physical ability in 7th grade schoolchildren. AB - The aim of the study was to determine factors associated with running time in children aged 12 years, according to sex and sexual maturation of girls. The physical ability was measured, using a 1000 meter run in a group of 942 boys and girls aged 12. In addition, data was collected on family sports activities and the children's sports activities, using questionnaires for parents and children. Before the 1000 meter run, physical examination was carried out. Nutrition habits of the family in the home and outside were self-reported in a questionnaire. The mean time for run in boys was shorter by 40 seconds than that for girls. Premenarche girls ran significantly faster than postmenarche girls (p less than 0.05). The best predictors for short running time were triceps skinfold thickness and sport motivation of the children. Weaker correlation was observed between food variables, family characteristics and running time. The highest prediction of running time by the measured variables was found for postmenarche girls, explained by the high correlation of running time with the behavioral variables. In boys and premenarche girls, the best predictors for running time were the physical and physiological characteristics of the children. PMID- 2707399 TI - Portable oxygen therapy: use and benefit in hypoxaemic COPD patients on long-term oxygen therapy. AB - In 159 chronic obstructive pulmonary disease (COPD) patients (139 males, mean age 62 +/- 8 yrs, arterial oxygen tension (PaO2) 7.2 +/- 0.9 kPa), on long-term oxygen therapy (LTOT), we evaluated the effects of portable oxygen therapy both on the daily duration of oxygen therapy and on daily activities. They were given two types of LTOT at random: group A (n = 75), oxygen concentrators only (OC); group B (n = 84), either small oxygen cylinders plus OC (B1 = 51) or liquid oxygen (B2 = 33). The patients were followed-up for one year by means of: a) medical examination every three months; b) monthly home interviews concerning the daily duration of oxygen therapy, the utilization of the devices and the daily activities of the patients; c) a measurement of the daily oxygen usage. The results show that: 1) there are no significant clinical and functional differences between groups A and B at the onset of and throughout the study; 2) in group B the daily use of oxygen therapy is significantly longer than in group A (17 +/- 3.5 h.day-1 vs 14 +/- 3 h.day-1, p less than 0.01) without any difference between groups B1 and B2; 3) outdoor walking activities are different between groups A and B, at least in those patients using oxygen more than 18 h.day-1. Only 60% of patients in group B (55% of B1; 67% of B2) use their portable devices outdoors and for walking. No strict predictive criterion of this use is found in our study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707400 TI - Role of lung volumes in sleep apnoea-related oxygen desaturation. AB - We studied the influence of lung volumes on apnoea-induced desaturation in ten subjects with sleep apnoea syndrome. Lung volumes were measured by helium dilution in the sitting and supine position and closing volume with the single breath nitrogen washout test. To characterize the severity of apnoea-induced desaturations, we determined a desaturation curve for each patient. This curve was obtained by plotting the fall in arterial oxygen saturation (SaO2) reached at the end of each apnoea against the apnoea duration. From this curve we selected two indices: 1) the SaO2 fall following 30 s of obstructive apnoea (delta SaO2 30); and 2) the desaturation surface between 10-30 s of obstructive apnoea (DS 10 30). Both the delta SaO2 30 and the DS 10-30 were significantly correlated with the expiratory reserve volume (ERV), measured in the sitting (r = 0.77 and 0.65, respectively; p less than 0.05) and the supine positions (r = 0.96 and 0.87; p less than 0.005). A strong correlation was also observed with the difference between the supine ERV and the seated closing volume CV) (r = 0.99 with delta SaO2 30 and 0.89 with DS 10-30; p less than 0.005). Obesity influenced sitting and supine ERV values. We conclude that, among lung volumes, supine ERV and supine ERV-seated CV are the best indicators of the severity of apnoea-induced desaturation. PMID- 2707401 TI - Control of the larynx in patients with obstructive and restrictive pulmonary impairment. AB - To study changes in glottic movements associated with pulmonary functional abnormalities, we measured changes in glottic resistance (Rgl) during quiet tidal breathing in normal subjects (N), patients with chronic obstructive pulmonary disease (COPD) and patients with idiopathic pulmonary fibrosis (IPF). Changes in Rgl were measured with a non-invasive method using low frequency sound. Changes in Rgl were tightly coupled to changes in tidal volume and were reproducible in all subjects. Rgl was higher during expiration than during inspiration in N and COPD. COPD showed greater changes in Rgl between inspiration and expiration than did N. However, Rgl did not differ between inspiration and expiration in three of six IPF, and was lower during expiration than during inspiration in two of six IPF. We suggest that glottic movements during quiet tidal breathing change in association with the functional abnormalities of pulmonary diseases. PMID- 2707402 TI - Airway responses to hypertonic saline, exercise and histamine challenges in bronchial asthma. AB - The airway responses to histamine, exercise and ultrasonically nebulized hypertonic saline have been compared in ten asthmatic patients. The responses to hypertonic saline were not significantly different when the same volume of aerosol was given in a single dose or in 10 l aliquots, suggesting that the challenge is cumulative. The variability of the response to hypertonic saline challenge was not significantly different from that of exercise challenge. Response to hypertonic saline correlated significantly with exercise (r = 0.68, p less than 0.05) and with histamine response (r = 0.74, p less than 0.02), but the correlation between exercise and histamine was not statistically significant (r = 0.15, p greater than 0.1). These findings suggest that exercise-induced asthma has a closer relationship to bronchial responsiveness to hypertonic saline aerosol than it does to non-specific reactivity demonstrated by histamine challenge. PMID- 2707403 TI - A simultaneous single breath measurement of pulmonary diffusing capacity with nitric oxide and carbon monoxide. AB - Pulmonary diffusing capacity (DL) for carbon monoxide (CO) and nitric oxide (NO) were simultaneously measured in man using the single breath method, by adding 4O ppm of NO to the inspired gas and analysing the expirate for NO by a chemiluminescent method. The mean ratio of DLNO to DLCO in thirteen subjects was 4.3 (SD 0.3), mean DLNO = 49 mmol.min-1.kPa-1 (SD 10) and mean DLCO = 11 mmol.min 1.kPa-1 (SD 2). An increase in alveolar oxygen concentration from a mean of 18 to 68% in five subjects was associated with a 54% fall in DLCO but no change in DLNO. A reduction of lung volume from total lung capacity (TLC) (mean of 7 l) to a mean volume of 3.9 l in five subjects caused a fall in both DLNO (by 34%) and DLCO (by 8%). With 175 watts cycle exercise in three subjects the DLCO rose by 45% and DLNO by 25%. Since NO reacts much faster with haemoglobin than CO, DLNO should be influenced much less by reaction with haemoglobin, and perhaps represents a better index for the diffusing capacity of the alveolar-capillary membrane (Dm) than DLCO. PMID- 2707404 TI - The effect of breath size and posture on calibration of the respiratory inductive plethysmograph by multiple linear regression. AB - The accuracy of the respiratory inductive plethysmograph (Respitrace) for estimation of lung volume changes during quiet breathing and vital capacity (VC) manoeuvres was evaluated using a variant of the multiple linear regression (MLR) technique. We applied this technique successively on quiet breathing, on the whole VC, and on each of the four quarters of the VC separately. This was carried out in six body positions. The best estimation of tidal volumes was obtained when calibration factors calculated during quiet breathing were used. The best estimation of VC was obtained when the calibration factors were adapted to the level of lung inflation. These results indicate that, using a single position MLR calibration method, the Respitrace measures tidal and VC mouth volumes very accurately. The accuracy of this MLR method for estimation of the rib cage and abdominal contributions was validated by comparison with isovolume calibration factors. Both techniques gave very similar results during tidal breathing. However, the MLR calibration factors may have no physiological meaning (i.e. for volume partitioning) when they are calculated from VC manoeuvres, in which more than two degrees of freedom are involved. PMID- 2707405 TI - Effects of rebreathing conditions and body size on normal human lung tissue volume. AB - To evaluate the consequences of breathing pattern variations inherent to lung disease on the rebreathing measurement of lung tissue volume (Vt), we carried out a study of ten normal human subjects in whom we assessed the effects of changes in rebreathing volume (Vreb), additional deadspace volume (AVD), respiratory rate (RR), and body height. Vt and alveolar volume (VA) were determined from the end tidal concentrations of acetylene and helium. We performed Vt measurements using different combinations of Vreb (20, 30 and 50% of predicted vital capacity), of AVD (0, 100, and 200 ml) and of RR (10, 25, and 40 br.min-1). Only slow RR (10 br.min-1) resulted in a higher Vt (p less than 0.001). An increase in Vreb induced an increase in VA but not in Vt. VA and Vt were positively correlated with the height of the subjects. We conclude that, in normal subjects, Vt increases: 1) with the height of subjects; and 2) when the respiratory rate is low. Interpretation of Vt results must take into account these two variables. PMID- 2707406 TI - Comparison of the constant flow and occlusion methods for assessment of bronchoconstriction in guinea-pigs. AB - Assessments of total respiratory compliance (C) and conductance (G) with the constant inspiratory flow and the occlusion methods were compared in the basal state and during histamine or serotonin induced bronchoconstriction in 22 normal, anaesthetized, paralysed, mechanically ventilated guinea-pigs. In the basal state, no significant difference was found between the C and G values measured by both methods. During drug-induced bronchoconstriction, small but significant differences were observed between the respiratory parameters measured by the two methods, and expressed as the percentage ratio (R) to the corresponding basal values (respectively RCCF and RCOC, and RGCF and RGOC). This discrepancy, which was independent of the drug and of the dose, was probably attributable to a modification of the visco elastic properties of the lung due to either the mechanical ventilation or the infused drug. Nevertheless, this study demonstrates that both methods can be considered as equivalent for bronchoconstriction assessment because very strong correlations were found between RCCF and RCOC (r = 0.96, p less than 0.001) and between RGCF and RGOC (r = 0.97, p less than 0.001), and because the slopes of the linear relationships were not significantly different from unity in both cases. PMID- 2707407 TI - Lethal extrapulmonary mycobacteriosis. AB - A 60 yr old previously healthy man was treated for gradually elevating fever and rash followed by leucopenia and mycosis of the gastrointestinal tract; he died within 6 weeks of the first symptoms appearing. Histologic examination revealed disseminated tuberculosis of paratracheal lymph nodes, liver, spleen and bone marrow with the presence of acid fast bacilli by smear examination. Multiple colonies of the same strain of Mycobacterium kansasii were isolated by bacteriological examination of lymph node and spleen tissue. Neither macroscopical nor histological examination showed any evidence of lung tuberculosis. The final diagnosis of the described acute disease and rapid death was stated as generalized extrapulmonary mycobacteriosis, which is a rare observation. PMID- 2707408 TI - Muscle spasms and creatine phosphokinase elevation following salbutamol administration. PMID- 2707409 TI - [Clinico-pharmacologic analysis of the neurotropic action of tranquilizers]. AB - Clinical aspects of the neurotropic effect of tranquillizers are considered. The systemic differentiated analysis of the influence of these psychopharmacological agents on the functional characteristics of the neurological status and psychophysiological condition of patients with neurotic disturbances is carried out. Two types of the neurotropic effect of tranquillizers and their selective vegetotropic effect are discussed. The presented results indicate that the neurotropic action of the psychopharmacological agents is of induced medical character. PMID- 2707410 TI - [Effect of pharmacologic preparations on the electrical activity of cerebellar slices under hypoxia]. AB - The effects of some antihypoxants (piracetam, GABA, sodium hydroxybutyrate and gutimine) on the electrical activity of the cerebellar neurons (Purkinje cells) of rats and mice were studied in the surviving slices under normoxia and increasing hypoxia. All the agents were found to produce phase changes in the base-line electrical activity of neurons: alternation of hyperexcitation and inhibition. Under hypoxia GABA and sodium hydroxybutyrate exerted the direct protective action on neuron metabolism supporting its electrogenic function. In the in vitro conditions in contrast to in situ conditions gutimine was shown to behave as a prohypoxant. The possibility of using the brain slices as the test system to study the mechanisms of action of the agents and the prognostic criterion during selection of prohypoxants is discussed. PMID- 2707411 TI - [Effect of gamma-aminobutyric acid on the development of catatonia-like states in mice]. AB - Catatony-like states including periods of tonic immobility and locomotor paroxysms were induced in mice by a single pinch at the scruff of the neck. GABA positive drugs (aminooxyacetic acid 20 mg/kg, muscimol 0.5 mg/kg) increased the duration of periods of immobility as compared with control. GABA-negative drugs (thiosemicarbazide 5 mg/kg, bicuculline 3 mg/kg in combination with aminooxyacetic acid) increased only the number and duration of locomotor paroxysms. PMID- 2707412 TI - [Effect of liposome-incorporated tubocurarine on the EEG of experimental animals]. AB - The effect of tubocurarine enclosed in phosphatidylcholine and cholesterol liposomes on EEG of cats and rats was studied. Five to 15 minutes after its intravenous administration EEGs showed polyspike complexes as well as "peak-wave" complexes. Similar EEG changes were recorded on intracerebroventricular injection of tubocurarine solution. The absence of EEG changes after the injection is related to its poor permeability through the blood-brain barrier. The results obtained suggest that encapsulation of tubocurarine into liposomes facilitates its penetration through the blood-brain barrier. PMID- 2707413 TI - [The new cerebrovascular preparation pikamilon]. AB - Picamilon, a sodium salt of N-nicotinoyl-gamma-aminobutyric acid, was shown to induce a significant increase of cerebral blood flow in conscious cats. Picamilon was found to inhibit neurogenic spasms of cerebral vessels that was followed by suppression of tonic activity and reflectory discharges in sympathetic nerves. Picamilon led to restoration of the initial condition of cerebral hemodynamics disturbed by a previous administration of serotonin. PMID- 2707414 TI - [Effect of kavinton on systemic and regional hemodynamics in waking and anesthetized rats]. AB - The effect of cavinton (vinpocetine) on the systemic and regional hemodynamic parameters was studied by the radioactive microsphere technique in experiments on conscious and anesthetized rats. Intravenous administration of cavinton (10 mg/kg) was followed by the development of hypotension and bradycardia in conscious and anesthetized animals. Administration of cavinton to anesthetized rats increased the blood flow both in the brain and in most internal organs. In conscious animals the drug failed to increase the cerebral blood flow but increased the blood flow in the internal organs. It is suggested that dilation of the cerebral vessels under the influence of cavinton only in anesthetized rats could be related to a higher initial resistance of the cerebral vessels in anesthetized animals as compared with conscious ones. PMID- 2707415 TI - [Effect of synthetic prostaglandin E1 on the cardiac blood supply and systemic hemodynamics in acute myocardial ischemia]. AB - The effect of a native synthetic prostaglandin E1 on the blood supply and basic parameters of hemodynamics in acute myocardial ischemia induced by coronary artery occlusion was studied. It was found that the preparation in doses of 5 and 10 mg/kg increases the general and collateral coronary circulation by redistributing it into the endocardium of myocardial ischemic lesion. PGE1 increased the systolic discharge and the minute volume of the heart, enhanced the contractile myocardium activity. With an increase of the preparation dose its positive effect was not enhanced. PMID- 2707416 TI - [Effect of the calcium antagonists ryodipine and verapamil on the carnitine dependent metabolism of fatty acids in the rat heart]. AB - Riodipine (10 days, 10 mg/kg) was shown to prevent in rats an isoproterenol induced increase of free fatty acid concentration in the blood serum and heart and to promote normalization of long-chain acylcarnitine content in the heart. Under the same conditions verapamil caused an increase in free acid concentration in the blood serum and prevented their accumulation in the heart. Its ability to limit accumulation of long-chain acylcarnitine manifested itself in a lesser degree as compared to riodipine. Riodipine exerted no effect on oxidation of 1-14 C-palmitic acid by the rat heart homogenate, verapamil suppressed oxidation of this fatty acid. PMID- 2707417 TI - [The action of anaprilin and ketamine on fatty acid metabolism in the myocardium]. AB - The effects of anapriline, ketamine and anapriline administered during ketamine induced anesthesia on contents of lipid fractions and ATP in the heart and on oxidation of fatty acids by myocardial mytochondria were studied on 200 albino rats. Administration of ketamine in a dose of 50 mg/kg induced blockade of lipolysis and a decrease of ATP content in the heart. At oxidation of fatty acids a decrease of respiratory control due to an increase of the rate of controlled mitochondrial respiration was noted. Anapriline (1 mg/kg) induced lipolysis blockade and ATP accumulation in the myocardium. Fatty acid oxidation was followed by activation of all rates of mitochondrial respiration and an increase of phosphorylation efficiency coefficient. Anapriline administered during ketamine-induced anesthesia prevented an impairment of myocardial bioenergy developing under the influence of ketamine that manifested itself in an increase of phosphorylating respiration rate, phosphorylation efficiency coefficient and ATP content in the myocardium. PMID- 2707418 TI - [Effect of cardiac glycosides on myocardial contractile proteins]. AB - By using the method of the measurement of the degree of actomyosin superprecipitation of the rabbit cardiomyocytes it was shown that isolanide (0.1 mg/kg), adoniside (0.1 ml/kg), strophanthin K (0.05 mg/kg) and corglycon (0.15 mg/kg) prevented the allergic process-induced disturbance of ATP energy utilization by myocardial contractile proteins. PMID- 2707420 TI - [Localization of the action of furosemide and triamterene in the nephron by means of correlating their pharmacokinetics and pharmacodynamics]. AB - A comparative correlation of pharmacokinetics and pharmacodynamics of furosemide and triamterene was used to establish localization of the action of the former diuretic on the basal membrane and the action of the latter on the lumenal membrane. PMID- 2707419 TI - [Effect of trimecaine and its quaternary derivative G-103 on myocardial action potentials]. AB - The conventional microelectrode technique was used to study the effects of trimecaine and its quaternary derivative G-103 on the action potential in the rat myocardium. G-103 suppressed the maximal rate of the action potential depolarization at lower concentrations than trimecaine although its effect developed slower: t 1/2 = 25 and 5 min, respectively. G-103 abolished the tonic component of trimecaine-induced blockade and failed to alter the rate-dependent component. PMID- 2707421 TI - [Tubular secretion of cardiotrast in the progeny of rats receiving it throughout pregnancy]. AB - Administration of cardiotrast (50-80 mg twice a day subcutaneously) during pregnancy was shown to induce a significant suppression of tubular secretion of the xenobiotic in the offspring. When cardiotrast was given only in the postnatal period, tolerance failed to develop. PMID- 2707422 TI - [Effect of 11-deoxyprostaglandins E on the reproductive system]. AB - The pharmacological properties of 4 derivatives of 11-desoxy-prostaglandins E (uterotonic, luteolytic, hypotensive, anti-inflammatory, diarrhogenic ones and also acute toxicity) were studied. Compound I possessed the uterotonic activity which decreased with an alpha-chain elongation and a radical introduction into a benzene ring. Compounds I and II exhibited the luteotropic properties at low doses and the luteolytic ones at high doses. The compounds under study had the hypotensive activity due to the presence of a benzene ring in a W-chain. PMID- 2707423 TI - [Antihypoxic properties of GABA-containing vitamin derivatives]. AB - The antihypoxic properties of GABA-containing vitamin derivatives (pyridoxalphosphate-GABA, picamilone, pantogam, sodium homopantothenate) as compared with GABA were studied. All agents were found to increase mouse life expectancy under hypoxia in contrast to GABA. PMID- 2707424 TI - [Effect of fenilin on the enzyme activity of the monooxygenase system in the rat liver during a change in the feeding]. AB - In the August rats kept for 30 days on adequate and low protein diet there was studied the effect of a single intragastric administration of phenyline, an anticoagulant of indirect action, in a dose of 15 mg/kg on parameters of the liver monooxygenase system (N-demethylase of amidopyrine, N-hydroxylase of aniline, content of cytochromes P-450 and B5). The parameters of the rat liver monooxygenase system of the animals kept on low protein diet decreased. Under adequate diet phenyline increased the activity of N-demethylase after 12 and 24 hours. Under low protein diet the preparation normalized some parameters of the liver monooxygenase system after 12 and 24 hours and the activity of N demethylase and N-hydroxylase after 72 hours increased significantly. PMID- 2707425 TI - [Effect of the stimulation of lymphocyte adrenoreceptors on antitumor immunity in vitro]. AB - It was found that the stimulating effect of alpha-adrenomimetic mesatone in the test of lymphocyte adhesion inhibition in patients with rectum cancer in vitro was eliminated by beta-adrenergic blocker phentolamine and the inhibitory effect of beta-adrenergic antagonist propranolol. It was shown in vitro that lymphocyte chemoreceptor sensitivity to the stimulating effect of mesatone decreased and sensitivity to the inhibitory effect of isadrine increased in patients with advanced stages of rectum cancer. PMID- 2707426 TI - [Functional activity of the splenic cells in the late periods after the administration of antitumor preparations with various mechanisms of action]. AB - In experiments on CBA/Lac J mice it was found that the course administration of adriamycin (0.95 mg/kg), vinblastine (0.24 mg/kg) and cyclophosphan (27 mg/kg) in 1/10 LD50.10 causes persistent disturbances of the functional activity of the lymphoid tissue manifesting by inhibition of the proliferative response of the spleen lymphocytes to T- and B-cell mitogens one month and to a lesser extent three months after cytostatic action. The lymphotropic effect of adriamycin is due to the predominant damage of the functional activity of T-lymphocytes. Vinblastin suppresses T- and B-cell link of the immunity system and the inhibitory effect of cyclophosphan is directed mainly to B-cell population. PMID- 2707427 TI - [Effect of the antitumor preparations prospidin and spirobromin on the function of the liver lysosomal apparatus in mice]. AB - Antitumour drugs prospidine and spirobromine were shown to suppress the activity of the mouse liver lysosome enzymes in vivo and in experiments in vitro. The revealed effect was underlied by a decrease of lysosomal membrane permeability for the corresponding substrates and enzymes rather than a reduction of the catalytic activity of acid hydrolases. PMID- 2707428 TI - [A method for choosing preparations that reduce the toxicity of cytostatics in experimental chemotherapy of tumors]. AB - A special scale is proposed to evaluate the level of toxicity of drugs during experimental chemotherapy of tumours. The method allows to standardize somehow the choice of the drugs reducing the toxic action of cytostatics and also to compare different drugs to choose the most effective correctors of cytostatic therapy. PMID- 2707429 TI - [Pharmacokinetic characteristics of drug substance in liver denervation]. AB - In experiments on male rats the pharmacokinetics of antipyrine, hexenal and phenylbutazone was studied 7 days after the liver denervation produced by subdiaphragmatic vagotomy, sympathotomy and their combination. It was found that in all variants of the liver denervation there occurs an increase of the period of half-life and a decrease of clearance of the drugs. As the liver denervation practically does not change the degree of protein binding and the hepatic blood flow velocity, it is thought that suppression of the drug biotransformation in hepatocytes due to suppression of the activity of enzymes of their microsomal oxidative system underlies changes in the pharmacokinetics of drugs. PMID- 2707430 TI - [Transport of x-ray contrast media in isolated target and nontarget cells]. AB - It was found that the accumulation of 125I-bilignost by isolated hepatocytes as target cells is mediated by the saturated and unsaturated systems. In thymocytes as non-target cells no saturated system of 125I-bilignost absorption was detected. 125I-triombrast transport in isolated hepatocytes and thymocytes takes place by usual diffusion. PMID- 2707431 TI - [Determination of anticonvulsive preparations in the blood serum of patients by high-performance liquid chromatography]. AB - A method for simultaneous measurement of hexamydine, phenobarbital, diphenin and carbamazepine concentrations in serum using high performance liquid chromatography is described. The procedure employs acetonitrile extraction of anticonvulsants and chromatography of the extract under the following conditions: a column containing lichrosorb RP-8 10 microns (250 x 4 mm), mobile phase consisting of 30 vol.% ethanol solution in 0.01 M KH2PO4 pH 5.3, flow rate 0.5 ml/min, column temperature 30 degrees C, injection volume 20 microliters, detector wavelength 220 nm. Hexenal is used as an internal standard. The concentration range is 5-50 mg/l for phenobarbital, diphenin and carbamazepine and 5-30 mg/l for hexamydine. The relative standard deviation varies between 0.018 and 0.057 for therapeutic and toxic concentrations. PMID- 2707432 TI - [The occurrence of addiction to karbofos in the progeny of rats administered it during pregnancy]. AB - Female albino rats weighing 200-250 g received intragastrically carbophos solution in doses of 100, 10 and 5 mg/kg corresponding to 1/10, 1/100 and 1/200 of LD50 on the 11th, 13th, 15th and 17th days of pregnancy. Two-month old young rats were tested to determine addiction to carbophos. It was found that the body weights of the offspring of the rats given carbophos in doses of 10 and 5 mg/kg were musch less than in control. The studies showed that the antenatal administration of carbophos induces the development of addiction to the agent in the offspring (predominantly females). PMID- 2707433 TI - [Effect of sodium oxybutyrate on the development of a staphylococcal intoxication]. AB - Sodium oxybutyrate (200 and 400 mg/kg) was found to increase life expectancy of the animals poisoned with staphylococcus toxin. The improvement of the blood supply to the bulbar structure of the brain as well as normalization of hemorheological parameters probably underlie the protective effect of the drug. PMID- 2707434 TI - Purification and partial characterization of a lectin from the seeds of Trichosanthes kirilowii Maximowicz. AB - A lectin was purified from the seeds of Trichosanthes kirilowii, belonging to the family Cucurbitaceae, growing in China. The lectin is a glycoprotein of 57 kDa, consists of two subunits with apparent molecular masses of 37 and 25 kDa, is specific for galactose, and is not mitogenic for human lymphocytes. PMID- 2707435 TI - Identification of the high-molecular-mass mitochondrial oxaloacetate keto-enol tautomerase as inactive aconitase. AB - The homogeneous bovine heart mitochondrial high-molecular-mass oxaloacetate keto enol tautomerase [(1988) Biochim. Biophys. Acta 936, 10-19] is shown to be an iron-sulfur protein as revealed by the enzyme spectral properties and direct chemical determination of non-heme iron and acid-labile sulfur. The protein is capable of catalysing the aconitase reaction after treatment with ferrous ions under anaerobic conditions. Treatment of the 'activated' protein with N ethylmaleimide results in the simultaneous irreversible loss of the oxaloacetate keto-enol tautomerase and aconitase activities. The effects of some substrates and inhibitors on both activities show that the same catalytic site is involved in the oxaloacetate tautomerase and aconitase reactions. It is concluded that the protein previously described as a 80 kDa oxaloacetate keto-enol tautomerase is inactive aconitase. PMID- 2707436 TI - Leukotriene C4 inhibits ATP-dependent transport of glutathione S-conjugate across rat heart sarcolemma. Implication for leukotriene C4 translocation mediated by glutathione S-conjugate carrier. AB - Sarcolemmal vesicles prepared from rat heart exhibited ATP-dependent uptake of S (2,4-dinitrophenyl)glutathione (DNP-SG), which obeyed Michaelis-Menten kinetics with an apparent Km of 21 microM for DNP-SG and a Vmax of 0.27 nmol.10 min-1.mg protein-1. Several model glutathione S-conjugates inhibited DNP-SG uptake, but leukotriene C4 inhibited uptake much more significantly even at lower concentrations (competitive inhibition, Ki = 1.5 microM). However, leukotrienes D4 and E4, which lack the gamma-glutamyl moiety, were less effective. The results suggest that the ATP-dependent transport system has a high affinity for leukotriene C4, and may be responsible for the translocation of this compound. PMID- 2707437 TI - A new species of enkephalin precursor mRNA with a distinct 5'-untranslated region in haploid germ cells. AB - To elucidate the primary structure of preproenkephalin (A) mRNA expressed by haploid germ cells (round spermatids) in rat testis, we have screened a lambda gt11 cDNA library for preproenkephalin cDNA inserts. The largest cDNA insert contained a protein-coding sequence encoding 269 amino acid residues as well as 327 and 309 bases of the 5'- and 3'-untranslated regions, respectively. The protein-coding region plus 3'-untranslated region of the mRNA was over 99% homologous to that of brain preproenkephalin mRNA, whereas the 5'-untranslated region contained a distinct sequence including a partial sequence of intron A of the preproenkephalin gene [(1984) J. Biol. Chem. 259, 14301-14308; (1984) J. Biol. Chem. 259, 14309-14313]. Northern blot analysis using a 5'-end-specific probe showed that this type of preproenkephalin mRNA exists exclusively in the germ cells. PMID- 2707438 TI - Sequencing of peracetylated oligosaccharides by rotating-frame nuclear Overhauser enhancement spectroscopy. AB - A combination of two-dimensional total correlation spectroscopy (TOCSY) and rotating-frame nuclear Overhauser enhancement spectroscopy (ROESY) is suggested as the optimum strategy for determining the primary structure of peracetylated oligosaccharides. PMID- 2707439 TI - Methylation of hen erythrocyte DNA. AB - We have analysed the 5-methylcytosine content of hen erythrocyte DNA and found it to be lower than that of DNA from other chick tissues analysed. Erythrocyte DNA is also a better substrate for DNA methylase having a five-fold lower Km than DNA from white blood cells. This is probably because it contains a large number of hemimethylated sites. Thus the inverse correlation between methylation and gene expression does not apply to the chick red blood cell. PMID- 2707440 TI - Studies on the mechanism of inhibition of nuclear triiodothyronine binding by fatty acids. AB - Studies were designed to elucidate the mechanism by which unsaturated fatty acids inhibit the binding of triiodothyronine (T3) ro rat liver nuclei. The possibility of a direct interaction between oleic acid and T3 was excluded by dialysis experiments. Oleic acid inhibits nuclear T3 binding in a strictly competitive manner. The Ki value of oleic acid was approx. 10(4) times greater than that of T3. The inhibitory effect of oleic acid could be reversed by bovine serum albumin. PMID- 2707441 TI - Chicken red-sensitive cone visual pigment retains a binding domain for transducin. AB - Iodopsin (a red-sensitive cone visual pigment) and rhodopsin (a rod pigment) were isolated from chicken retina. They were separately reconstituted into phosphatidylcholine liposomes and then mixed with rod transducin (T alpha and T beta gamma) purified from bovine retina. Iodopsin enhanced, only when irradiated, the binding of GppNHp to T alpha to a similar extent to irradiated rhodopsin. Furthermore, the binding of GppNHp to T alpha in the presence of a photobleaching intermediate of iodopsin preferably required T beta gamma-2 rather than T beta gamma-1, which is very similar in profile to that in the presence of the intermediate of rhodopsin (J. Biol. Chem., in press). These results indicate that the binding domain for transducin in iodopsin should closely resemble that in rhodopsin. PMID- 2707442 TI - Level of protein kinase C activity correlates directly with resistance to adriamycin in murine fibrosarcoma cells. AB - In this report, we demonstrate a direct correlation between protein kinase C (PKC) activity and adriamycin (ADR) resistance in mouse fibrosarcoma cells. PKC activity was measured in four murine UV-2237M fibrosarcoma cell lines that differed in the degrees to which they expressed resistance to ADR, which is an inhibitor of PKC. A comparison of the four cell lines revealed a positive correlation between the level of PKC activity and resistance to ADR. Incubation of the cells with the PKC inhibitor H-7 produced a partial reversal of ADR resistance. Taken together, these results suggest a role for PKC in the mechanism of ADR resistance. PMID- 2707443 TI - Electric field-induced fusion of mitochondria. AB - Fusion of mitochondria in H-medium from rat liver was induced by the application of square-wave voltage with electric field strengths of 1-2.5 kV/cm and duration 100 microseconds. Electron micrographs showed that the newly fused mitochondria could contain up to five mitoplasts. The fusion yield was close to 12% and respiratory activity was enhanced. The electric field lines did not go through the inner membrane, however, when the electric field strength was greater than 3 kV/cm they did so, resulting in total destruction of the mitochondria. PMID- 2707444 TI - Arctic adaptation in reindeer. The energy saving of a hemoglobin. AB - Previous results [(1988) Arct. Med. Res. 47, 83-88] have shown that hemoglobin from reindeer is characterized by a low overall heat of oxygenation. This particular aspect has been investigated further in a series of precise oxygen equilibrium experiments. The results obtained show a peculiar dependence of the temperature effect on the fractional saturation of hemoglobin with oxygen, which could be regarded as a very interesting case of molecular adaptation to extreme environmental conditions. PMID- 2707445 TI - Trametes versicolor ligninase: isozyme sequence homology and substrate specificity. AB - The substrate specificity of three ligninase isozymes from the white-rot fungus Trametes versicolor has been investigated using stereochemically defined synthetic dimeric models for lignin. The isozymes have been found to attack non phenolic beta-O-4 as well as beta-1 lignin model compounds. This finding confirms the classification of the isozymes from T. versicolor as ligninases. The amino terminal residues of the three isozymes from T. versicolor have been determined using Edman degradation. Minor differences found between the sequences suggest the existence of several structural genes for ligninase in T versicolor. Comparisons have been made with the sequences of three previously reported ligninases from Phanerocompaete chrysosporium, another lignin-degrading fungus. One of the sequences from P. chrysosporium is distinctly more similar to the T. versicolor isozymes than to the other two sequences from P. chrysosporium. PMID- 2707446 TI - Spontaneous polymerization of the antibiotic peptide magainin 2. AB - We describe here the ability of the magainin 2 peptide to assemble spontaneously into characteristic 13-nm diameter filaments having a 30 nm periodic helical substructure. Optimal conditions for extensive polymerization into filaments of several hundred microns required low pH and high ionic strength. Polymerization of the magainin 2 peptide may be involved in its recently described in vitro membrane-disrupting and antibiotic activities. PMID- 2707447 TI - Calcium-dependent binding between calmodulin and lysozyme. AB - Calmodulin, an acidic protein that binds calcium with high affinity, has multiple roles in the activation of many enzymes involved in cellular regulation of eukaryotes. In this study we show that calmodulin binding to hen egg-white lysozyme, in a Ca2+-dependent way, was observed using electroblots incubated with biotinylated calmodulin and detected with avidin-alkaline phosphatase or for affinity chromatography on a gel calmodulin column. Antimicrobial activity of lysozyme was not modified in the presence of Ca2+-calmodulin. PMID- 2707448 TI - Deglycosylation of the chymotryptic collagen-binding fragment of human plasma fibronectin does not modify its affinity to denatured collagen. AB - N-Glycanase deglycosylation of purified 44 kDa chymotryptic collagen-binding domain from human plasma fibronectin does not significantly modify its behavior on gelatin affinity chromatography. This indicates that carbohydrates do not play any role in the binding affinity of fibronectin to collagen. The influence of changes in glycosylation on the biological functions of fibronectin is discussed. PMID- 2707449 TI - Enzymatic deglycosylation of the dendrotoxin-binding protein. AB - The neuronal membrane protein which binds the K+-channel ligands dendrotoxin, mast cell degranulating peptide, and beta-bungarotoxin was purified from rat brain membranes. When analysed on 10% SDS gel electrophoresis, the purified protein contained two peptides: the toxin-binding subunit of apparent Mr 90,000 and another peptide of Mr 38,000. Neuraminidase treatment reduced the Mr of the toxin-binding subunit to 70,000. Glycopeptidase F gave a further reduction to Mr 65,000. In contrast, the peptide of Mr 38,000 showed no change in Mr upon treatment with neuraminidase and/or glycopeptidase F. It is concluded that the toxin-binding subunit of the dendrotoxin-binding protein, a presumptive K+ channel, is a sialated membrane protein with a peptide core of, at most, Mr 65,000. PMID- 2707450 TI - Genetic code preferentially conserves long-range interactions among the amino acids. AB - The physical properties of amino acids were investigated in order to evaluate their possible relationship to the assignment of codons for amino acids in the genetic code. A comparison of the interconversion probability between amino acids and the distances between the amino acids for individual physical properties revealed a striking hierarchy among the physical properties. Surprisingly, it is the long-range/solvent interactions and not the short-range/stereochemical properties which are preferentially conserved in the genetic code. PMID- 2707451 TI - In vitro reconstitution of hnRNP particles. AB - The assembly of hnRNP-like particles was studied by in vitro reconstitution, UV crosslinking and CsCl-equilibrium centrifugation. Using total nuclear protein and RNA extracts from HeLa cells for RNP reconstitution, RNP particles sedimenting with the same buoyant density of p = 1.4 g/cm3 as 'native' 40 S core hnRNPs were obtained. Under the stringent reconstitution conditions used, hnRNP complexes containing only the Cl-core hnRNP protein could be identified. PMID- 2707452 TI - Monitoring the transport and phosphorylation of 2-deoxy-D-glucose in tumor cells in vivo and in vitro by 13C nuclear magnetic resonance spectroscopy. AB - We describe the use of 2-deoxy-D-[6-13C]glucose to follow simultaneously, by 13C NMR, both transport and phosphorylation to its 6-phosphate form, in MCF-7 breast cancer cells in vitro and in vivo in subcutaneous tumors in nude mice. PMID- 2707453 TI - Severe ovarian hyperstimulation syndrome: a reevaluated therapeutic approach. AB - During the 10 years 1978 to 1987, 33 patients were hospitalized because of moderate and severe ovarian hyperstimulation syndrome (OHSS) in 39 treatment cycles. Twenty-five treatment cycles ended in moderate OHSS (group A), 7 had severe OHSS without a significant amount of ascites (group B1), and 7 had severe OHSS with ascites (group B2). Groups A and B1 received intravascular volume expander, electrolytes replacement, and indomethacin up to 300 mg/day. The patients in group B2 had significant clinical and biochemical improvement after abdominal paracentesis. Urinary output and creatinine clearance improved significantly, and a decrease in hematocrit, blood osmolarity, and weight reduction were achieved. A strategy for treatment of OHSS based on consecutive ultrasonographic examination, clinical and biochemical evaluation, and abdominal paracentesis in severe OHSS with clinically significant ascites is suggested. PMID- 2707454 TI - Noninvasive evaluation of cardiovascular hemodynamics during multiple follicular stimulation, late luteal phase and early pregnancy. AB - A noninvasive hemodynamic study in three moments of the gamete intrafallopian transfer (GIFT) cycle was carried out on 25 patients: before beginning multiple follicular stimulation (MFS) (study I); after rapid increase of serum estradiol (E2) (study II); and 12 days after GIFT (study III). In the 25 patients, the rapid increase in E2 proved to be combined with a significant increase in the left ventricular end diastolic dimension (LVEDD), the left ventricular end systolic dimension, the heart rate (HR), the systolic index, the cardiac index, and a significant reduction in the mean arterial pressure, in the systolic arterial pressure and in the systemic vascular resistence index. In the 14 pregnant patients in study III, all of the hemodynamic parameters studied proved to be significantly modified with respect to study I. In the 11 nonpregnant patients between Studies I and III were no significant cardiovascular modifications except for a significant increase in LVEDD in Study III. It is concluded that, during MFS, the rapid increase in E2 is combined with hemodynamic modifications and that, in pregnancy, the cardiovascular adaptation modifications occur in the very early stages. PMID- 2707455 TI - Translocations are infrequent among couples having repeated spontaneous abortions but no other abnormal pregnancies. AB - During the years 1977 to 1986, cytogenetic studies were performed on 342 women and 297 men whose reproductive history included one or more first trimester spontaneous abortions. Thirty-nine women and 35 men experienced not only early fetal losses but also one or more stillborn infants, liveborn anomalous infants, or early neonatal deaths. Among the 303 women and 262 men evaluated solely because of repetitive abortions, only 1 woman and 1 man showed a translocation. Two translocations were detected among the 39 women and 35 men having not only repetitive abortions but also a stillborn infant, anomalous liveborn, or unexplained neonatal death. Only among the 25 women having abortions and other abnormal perinatal events was the frequency of translocations high (2/25 or 8%). Our data continue to indicate that balanced chromosomal translocations are relatively infrequent in individuals having repeated abortions but no other adverse perinatal outcome. PMID- 2707456 TI - Differences in the fertility of donor insemination recipients--a study to provide prognostic guidelines as to its success and outcome. AB - Data on 207 couples attending for donor insemination (DI) were analyzed to determine the differences in fertility of insemination recipients and to provide prognostic guidelines as to its success. This study has shown that DI recipients with no infertility factors whose partners were azoospermic had the highest fecundability (0.178), whereas those with no infertility factors whose partners were subfertile had the lowest fecundability (0.036). Donor insemination recipients with treated endometriosis and ovulatory dysfunction have significantly higher fecundability (0.093 and 0.091, respectively) than those with other infertility factors (0.021) such as fibroids, tubal disease, or a combination of infertility factors. This study provides prognostic guidelines for DI recipients as to its success. PMID- 2707457 TI - Videocinematography of fresh and cryopreserved embryos: a retrospective analysis of embryonic morphology and implantation. AB - Eleven morphologic criteria were studied from videotapes of 323 fresh and 103 thawed embryos. The proportion of thawed embryos (30/39; 77%) with more than one abnormality was (P = 0.03) higher than that of fresh embryos (5/13; 38%), despite similar implantation rates (18% and 15%, respectively). The best predictor of thawed embryo implantation was cell-cell adherence: when scored "positive," 11 of 17 women (65%) became pregnant, whereas none became pregnant (0/15; P = 0.0002) when blastomeres did not adhere. The total number of abnormalities for thawed embryos was an important prognostic. An increased percentage variation of zona pellucida thickness was the most important prognostic for fresh embryos. When the "best" embryo had a zona pellucida that varied more than 25%, 24 of 60 (40%) resulted in pregnancy; pregnancies were not induced (0/21) when the "best" embryo had less than 10% variation (P = 0.0003). PMID- 2707458 TI - Unexplained infertility: evaluation of treatment with clomiphene citrate and human chorionic gonadotropin. AB - A double-blind, randomized, prospective therapeutic trial was conducted in 148 couples with unexplained infertility. Treatment consisted of 4 consecutive months of placebo or clomiphene citrate (CC) (100 mg) by mouth on cycle days 5 to 9, and placebo or human chorionic gonadotropin (hCG) (5,000 IU) intramuscularly on cycle days 19, 22, 25, and 28. There were 14 pregnancies during the trial and 39 pregnancies during observation before and after the trial. Placebo treatment resulted in no pregnancies over 4 months. Clomiphene citrate was significantly better than placebo (P less than 0.04), with a pregnancy rate of 19% over the course of 4 months. The pregnancy rate with hCG either alone (11%) or in combination with CC (7.6%), was not significantly better than placebo. Treatment independent pregnancies, defined as those before treatment (but after enrollment), or more than 1 month after therapy, occurred in 16% of the couples, with a mean time to conception of 8.8 months. As part of their follow-up, 39 of the study couples subsequently underwent in vitro fertilization (IVF), and 43% were found to have a previously unrecognized male factor or fertilization defect. A pregnancy rate of 16% was achieved after a mean of 1.1 cycles in these 39 couples. The authors conclude that CC is useful in treating unexplained infertility and is a reasonable initial therapy. For couples who fail to conceive, IVF may be diagnostic as well as therapeutic. PMID- 2707459 TI - Ovarian superstimulation in the treatment of infertility due to peritubal and periovarian adhesions. AB - Forty-two women with peritubal and periovarian adhesions as the only cause of infertility were superstimulated with clomiphene citrate and human menopausal gonadotropin in 103 cycles. Superstimulation resulted in considerable increase in ovarian size, and change in the tubo-ovarian relationship. Twenty-two patients became pregnant, achieving a pregnancy rate of 21% per cycle and an overall rate of 52%. Hyperstimulation syndrome occurred in 85 cycles (82.5%). Four cases of tubal pregnancy were reported (3.8%). This line of treatment could be tried before resorting to microsurgery or in vitro fertilization and embryo transfer in patients with peritubal and periovarian adhesions with at least one patent tube. PMID- 2707460 TI - A prospective study of prognostic factors in in vitro fertilization and embryo transfer. AB - Multiple factors influence the outcome of in vitro fertilization and embryo transfer (IVF-ET). This prospective study was designed to assess their relative importance, in order to improve prognostic ability and treatment success. Prior to IVF-ET, couples were divided into "good" (GP) and "poor" (PP) prognosis groups according to female age, semen quality, previous response to stimulation, and embryo quality. The data obtained from 716 consecutive treatment cycles then were evaluated using univariate statistics and logistic regression, a technique designed to assess the relative contribution of significant factors. The pregnancy rate per GP cycle was 14.7%, compared with 5.4% per PP cycle (chi 1(2) = 12.7, P less than 0.001). The most important prognostic factors were female age, the pregnancy rate showing a linear decline after the age of 25, and previous failed fertilization due to abnormal sperm. The rate of pregnancy also declined after 14 or more follicles were aspirated and/or nine oocytes were retrieved. A formula for the probability of pregnancy, derived from the logistic regression, provides patients with a more accurate prognosis before treatment. PMID- 2707461 TI - Improved sperm concentration, motility, and fertilization rates following Ficoll treatment of sperm in a human in vitro fertilization program. AB - Duplicate sperm samples from the spouses of 54 patients admitted to an in vitro fertilization program were prepared by the swim-up and a simplified procedure using Ficoll. Cellsoft (CRYO Resources, New York, NY) sperm curvilinear velocities (microns/sec) and mean amplitude of lateral head displacement values (microns) equivalent to grade 1 and 2 visual sperm motility were significantly higher for Ficoll as compared with swim-up samples (P less than 0.01). Fertilization rates were significantly higher in the Ficoll as compared with the swim-up group for poor semen samples (grade less than 2: 58% versus 24%; P less than 0.01) and normal semen samples (grade greater than or equal to 2: 85% versus 78%; P less than 0.05). Ficoll sperm separation appears to be an excellent method of yielding increased fertilization rates in in vitro fertilization programs. PMID- 2707462 TI - Metoclopramide-mediated prolactin secretion in patients with idiopathic hypogonadotropic hypogonadism: effect of testosterone therapy. AB - The secretion of prolactin (PRL) after intravenous metoclopramide was evaluated in six prepubertal subjects with idiopathic isolated hypogonadotropic hypogonadism before and after repeated testosterone (T) injections. The PRL response to metoclopramide was markedly blunted before T treatment, but both the basal and metoclopramide-stimulated PRL secretion became normal after 4 to 15 months of intramuscular T enanthate, although in three of the subjects, serum T was low at the time of the repeat study. These results confirm that the pituitary lactotrophs are normal in this disorder and suggest that the attenuated response observed in the untreated patients is due to the chronic and persistent exposure of the lactotrophs to an environment low in T. The effect of exogenous T on the lactotrophs persists for several weeks after T is discontinued. PMID- 2707463 TI - General and anomalous sperm disappearance characteristics found in a large vasectomy series. AB - There is no accepted standard for the time after vasectomy before infertility is achieved. To help address this question, the records of 5,233 vasectomy patients who had had at least 12 ejaculations and had completed semen tests were reviewed. Seventy-five percent were able to fulfill a designated criterion for success by 4 months postoperatively, nearly 90% by 6 months, and nearly 99% by 1 year. Also found were a number of individual anomalies, including five instances of transient reappearance of sperm, four late spontaneous reversals after proof of success, and one late "delayed success" after evidence of failure. Patients can be reassured by the overall efficacy of male sterilization, but physicians also may wish to be aware of the possibility of capriciously intermittent-fitful sperm. PMID- 2707464 TI - Pretreatment of sperm with human follicular fluid for borderline male infertility. AB - To test the usefulness of human follicular fluid (FF) in treating male infertility, we incubated washed sperm specimens from 31 couples undergoing intrauterine insemination (IUI), for male and/or unexplained infertility, with either FF or Ham's F-10 medium (Gibco, Grand Island, NY), in alternating cycles in a randomized manner. Semen specimens from 28 men were incubated with either medium or FF. Incubations with FF have increased sperm penetration assay (SPA) scores from 24.8 +/- 17.3 to 34.3 +/- 13.6 (P less than 0.01). Incubation with heat-inactivized FF also has increased SPA scores, although to a lesser extent than noninactivized FF. Seventeen pregnancies occurred in the 31 couples treated by IUI (54.8%), 16 of them in FF-treated cycles (51.6%) and one in "control" IUI cycles (3.2%, P less than 0.01). All pregnancies occurred within four treatment cycles. Thus, IUI after sperm wash and preincubation with FF may be suggested for four to six cycles to couples with male factor and/or unexplained infertility who are reluctant to resort to artificial insemination by donor or adoption, before attempting the more costly and complex in vitro fertilization-embryo transfer procedure. PMID- 2707465 TI - Spermicidal effect of antagonists of platelet-activating factor. AB - A variety of antagonists of platelet-activating factor (PAF) have been examined for their ability to prevent pregnancy, by admixture with spermatozoa in vitro followed by insemination, or in vivo by administration to female rabbits. When the antagonists were added to the ejaculate at a concentration of 10(-4) M 30 minutes before insemination of the females, a significant failure of fertilization was seen only with CV-3988, U66985, and SRI 63-441--all structural analogs of PAF. Antagonists that were not structural analogs were not effective. All compounds to a lesser or greater extent caused some qualitative agglutination and loss of sperm motility, but these effects were not correlated with inhibition of fertilization. SRI 63-441 was the most effective compound and was subjected to further study. When given intravenously prior to ovulation (5 mg/kg at 1, 5, and 9 hours after the ovulating injection), no effect on fertilization was seen. If SRI 63-441 (40 mg in 0.5 ml aqueous solution) was instilled into the vagina 2 minutes before insemination, a highly significant reduction in the fertilization rate was achieved. It is concluded that these compounds act by an action on the sperm membrane rather than by direct PAF antagonism on spermatozoa. PMID- 2707466 TI - The toxic effect of short exposures to the atmospheric oxygen concentration on early mouse embryonic development. AB - When culture conditions of mouse preembryos include an O2 concentration of 20%, preembryos that initiate in vitro culture at the 1-cell stage have a lower survival rate than preembryos that are harvested for culture at the 2-cell stage. This "toxic" effect of O2 is not seen at 5% O2 concentrations, suggesting that atmospheric O2 concentrations are toxic to preembryos. The present study examined the effect of short-term exposures to 20% O2, as may occur during in vitro fertilization procedures. The results demonstrated that when 1-cell preembryos were exposed to the atmospheric oxygen concentration for as little as 1 hour, their development was inhibited. Furthermore, such toxic effects did not become apparent until after four to five divisions. The authors conclude that it is critical to minimize exposure of zygotes to the atmospheric O2 concentration for optimal development to continue past the 8- to 16-cell stage, at least in the mouse. PMID- 2707467 TI - Causes of donor rejection in a sperm banking program. AB - During a 2-year period, 93 men between the ages of 18 and 46 years were screened for sperm donation using a three-stage protocol. Thirty (32%) applicants became active donors. Eighty-five percent of the semen specimens from these men were successfully frozen, quarantined, and released for insemination. The three-stage protocol successfully eliminated most uncommitted or unqualified applicants in an efficient, cost-effective manner. Sperm cryopreservation increased the rejection of otherwise acceptable donors by 27%. PMID- 2707468 TI - Subclinical embryonic loss. PMID- 2707469 TI - [Comparative study of the sealing properties of retrograde amalgam root fillings using a microtechnic and the naked eye]. AB - The aim of the present investigation was to compare the quality of retrograde amalgam fillings made under the control of the naked eye and that of a stereomicroscope. The 58 extracted upper incisors used for study had been divided into two groups and were filled with one of the control methods. In both groups on 25 teeth the microleakage was assessed by dye diffusion, the surfaces of the remaining 4 teeth were subjected to SEM examination. The depths and angle belonging to the stained sections of the perimeter had been measured under a stereomicroscope with a magnification of 40 and the area affected was calculated. Significantly (p less than 0.001) less area was involved in the stereomicroscopic group (1.46 +/- 0.34 mm2) than in the naked eye group (3.89 +/- 1.80 mm2). The SEM photographs demonstrated the faults which can be eliminated by the use of a stereomicroscope and showed also those which derive from the physical and chemical properties of the amalgam. PMID- 2707470 TI - [An aide to constructional bite adjustment]. AB - Aim of the method is to facilitate the adjusting of constructional bite ceasing the constraint position of the jaw by means of air introduced from the exterior auditory meatus and water chargeable rubber ear plugs, respectively. PMID- 2707471 TI - Legislative action committee. PMID- 2707472 TI - Hemoperfusion treatment of massive isoniazid overdose. PMID- 2707473 TI - Common fallacies made in dealing with the terminally ill patient. PMID- 2707474 TI - Is there a solution to high health care costs? PMID- 2707475 TI - Effects of a defibrotide-heparin combination on some measures of haemostasis in healthy volunteers. AB - In an open-study design five healthy volunteers were first given 2500 IU sodium heparin intravenously and then, after 72 h, another injection of the same dosage of sodium heparin followed immediately by 400 mg defibrotide intravenously. In two separate experiments, prothrombin time, activated partial prothrombin time, antithrombin III, tissue plasminogen activator, its inhibitor and plasma heparin levels were measured at baseline and after 15 min in one experiment, and at baseline and after 2 h in the other experiment. The most important finding was that an interaction exists between heparin and defibrotide on haemostatic activity: activated partial prothrombin time was increased three-fold in volunteers given the defibrotide--heparin combination compared with volunteers given heparin alone. This statistically and clinically significant effect was evident 15 min after administration of defibrotide--heparin and was still present after 2 h. Possible explanations for this effect are discussed briefly. PMID- 2707476 TI - Thiamine and zinc in prevention or therapy of lead intoxication. AB - Thiamine, zinc or their combination given through gastric gavage were investigated for their ability to prevent or treat experimental lead toxicity in rats. Simultaneous dietary supplementation with thiamine plus zinc was found to be the most effective way of reducing the lead-induced inhibition of delta aminolevulinic acid dehydratase activity in blood, urinary, excretion of delta aminolevulinic acid and accumulation of lead in blood, liver and kidney. Prevention was more effective than post-lead exposure treatment which may be due mainly to the decrease in the absorption of lead in the gastro-intestinal tract in the presence of thiamine and/or zinc. PMID- 2707477 TI - Intravenous chlormethiazole in the management of primary trigeminal neuralgia resistant to conventional therapy. AB - The therapeutic efficacy of 0.8% chlormethiazole, administered as 3-10 intravenous infusions each lasting 5-6 h on alternate days, was assessed in an uncontrolled study of 16 patients, aged 44-82 years, with primary trigeminal neuralgia. Prior to entry into the study, patients showed a high frequency of neuralgic paroxysms (20-70 attacks/day) which were refractory to high dosages (1600-2000 mg/day) of carbamazepine. After treatment with chlormethiazole neuralgic paroxysms no longer occurred in five patients, were considerably reduced in intensity and frequency (less than or equal to 5 attacks/day) in six patients, moderately improved in two patients, slightly improved in one patient and showed no change in two patients. The relatively small number of cases and short post-treatment follow-up period limit the conclusions which can be drawn. These results indicate, however, that infusion with chlormethiazole is effective in the treatment of primary trigeminal neuralgia in patients for whom conventional therapy has been unsuccessful. PMID- 2707478 TI - Limbness in the early chick embryo lateral plate. AB - In order for the limb to be useful in the evaluation of early determinants of morphogenesis, it is necessary to understand some of the characteristics associated with "limbness" and, more importantly at the beginning at least, it is necessary to know what regions of the early embryo exhibit limbness qualities. Previous investigators have assumed, without direct experimental evidence, that the flank does not have limbness qualities, even at early stages of development. However, there are a few studies suggesting that the early flank does possess limbness qualities. The purpose of the present study was to determine how extensively the qualities of limbness exist in the early chick embryo. Tissues from the future neck, wing, flank, and leg regions were grafted to host celoms and evaluated for their abilities to form limbs. Limbs developed from all four regions of stage 11-14 embryos, but after stage 14 only grafts from the wing and leg regions formed limbs. PMID- 2707479 TI - Regulation in the numbers of tentacles of aggregated hydra cells. AB - Head formation was investigated during regeneration of dissociated and aggregated cells of Hydra magnipapillata. The surface area measured at the hollowing stage was found to be a useful quantity for characterizing the size of an aggregate. Four kinds of aggregates were examined, using tissue originating from (1) whole animals, (2) apical halves, (3) decapitated animals, and (4) decapitated animals allowed to regenerate for several hours before dissociation. For aggregate types (1), (2), and (4), not all the tentacles observed at an intermediate stage of the regeneration process were localized around hypostomes: the number of such body tentacles at the intermediate stage was comparable to that of the hypostomal tentacles and was approximately proportional to the surface area. These results and others suggest that the formation of body tentacles takes place independently of hypostome formation. However, for aggregate type (3), most of the tentacles appearing at the intermediate stage were hypostomal. The correlation between the surface area and the number of tentacles at the steady state apparently resulted from a regulation process by which body tentacles decreased and hypostomal tentacles increased. It is considered that the number of body tentacles appearing at an intermediate stage of regeneration would depend on the initial level of head-activation potential and that body tentacles are formed by the local fluctuation of head-activation potential. PMID- 2707480 TI - Cell lineage analysis of maize bundle sheath and mesophyll cells. AB - Maize leaves are divided into repeated longitudinal units consisting of vascular tissue, bundle sheath (BS), and mesophyll (M) cells. We have carried out a cell lineage analysis of these cell types using six spontaneous striping mutants of maize. We show that certain cell division patterns are preferentially utilized, but not required, to form the characteristic arrangement of cell types. Our data suggest that early in development a central cell layer is formed, most frequently by periclinal divisions in the adaxial subepidermal layer of the leaf primordium. Lateral and intermediate veins are initiated in this central layer, most often by divisions which contribute daughter cells to both the procambium and the ground meristem. These divisions generate "half vein" units which comprise half of the bundle sheath cells around a vein and a single adjacent M cell. We show that intermediate veins are multiclonal both in this transverse direction and along their lengths. BS cells are more closely related to M cells in the middle layer of the leaf than to those in the upper and lower subepidermal layers. An examination of sector boundaries has shown that photosynthetic differentiation in M cells is affected by the phenotype of neighboring BS cells. PMID- 2707482 TI - Action of foot activator on growth and differentiation of cells in hydra. AB - Foot activator is a small peptide found in hydra and specifically activates foot formation. I present a method for the further purification of foot activator by high-pressure liquid chromatography. The morphogenetically active fractions were assayed for their effect at the cellular level. Foot activator acts as a mitogen by pushing epithelial and interstitial cells, which are arrested in G2, into mitosis. In the presence of foot activator, epithelial stem cells are stimulated to differentiate into foot mucus cells, and interstitial nerve precursor cells differentiate into mature nerve cells. The interaction of foot activator with head activator in the development of hydra is discussed. PMID- 2707481 TI - The expression of embryonic primary mesenchyme genes of the sea urchin, Strongylocentrotus purpuratus, in the adult skeletogenic tissues of this and other species of echinoderms. AB - Adult tissues of the sea urchin, Strongylocentrotus purpuratus, were analyzed for the products of a set of genes whose expression, in the embryo, is restricted to the skeletogenic primary mesenchyme (PM). Three embryonic PM-specific mRNAs were found to be abundant in adult skeletal tissues (test and lantern), but not in a variety of soft tissues. Homologous mRNAs were also found in skeletal tissues of the congeneric sea urchin, S. droebachiensis, as well as a more distantly related echinoid, Dendraster excentricus, and an asteroid, Evasterias troschellii. The distributions of two of these RNAs were analyzed in regenerating spines of adult S. purpuratus using in situ hybridization. These gene products were localized primarily in the calcoblasts that accumulated at the regeneration site. In nonregenerating spines SpLM 18 RNAs, the most abundant of these gene products, were localized in a small population of noncalcoblast cells scattered through the spine shaft, and were absent from calcoblasts. These observations suggest that a program of gene expression associated with the process of calcification is conserved both developmentally through the period of metamorphosis and evolutionarily among the echinoderms. PMID- 2707483 TI - Somatic cell-oocyte interactions in mouse oogenesis: stage-specific regulation of mouse oocyte protein phosphorylation by granulosa cells. AB - The relative rate of synthesis of a number of proteins and the protein phosphorylation pattern of growing and fully grown oocytes were influenced by the presence of granulosa cells. In particular, a 74-kDa phosphorylated protein was detected only in granulosa cell-enclosed growing mouse oocytes. When reaggregated with granulosa cells, the growing oocyte displayed the phosphorylated form of the 74-kDa protein but when oocytes were cultured on Sertoli cell monolayers or in granulosa cell-conditioned medium the 74-kDa protein was not phosphorylated. We propose that (1) granulosa cells regulate protein phosphorylation in mouse oocytes; (2) a 74-kDa protein is phosphorylated only in growing oocytes when surrounded by granulosa cells; and (3) granulosa cells, but not Sertoli cells, are competent to send the appropriate "signal" to the growing oocyte. PMID- 2707484 TI - Lipopolysaccharide-stimulated rat brain macrophages release NGF in vitro. AB - Amoeboid microglial cells purified from primary cultures of embryonic rat brains and stimulated with bacterial lipopolysaccharides released high amounts of nerve growth factor. This finding suggests that brain macrophages play a major neurotrophic role during development, in adulthood, and in the regenerative events that follow localized lesions. PMID- 2707485 TI - Embryonic heart mesenchymal cell migration in laminin. AB - Laminin, a large glycoprotein and major component of basement membranes, influences cell adhesion, migration, morphology, and differentiation. A peptide sequence, YIGSR, from the B1 chain of laminin has been found to correspond to an active site for cell adhesion. We report here that cardiac mesenchymal cells migrate vigorously within three-dimensional gels of laminin and that the YIGSR peptide will completely abolish this migratory activity. In contrast, migration of the mesenchymal cells into three-dimensional gels composed of collagen or collagen + laminin is not effected by YIGSR or other peptides (GRGDS, GRGDTP) reported to mediate cellular adhesion. PMID- 2707486 TI - Neural fold formation at newly created boundaries between neural plate and epidermis in the axolotl. AB - According to a recent model, the cortical tractor model, neural fold and neural crest formation occurs at the boundary between neural plate and epidermis because random cell movements become organized at this site. If this is correct, then a fold should form at any boundary between epidermis and neural plate. To test that proposition, we created new boundaries in axolotl embryos by juxtaposing pieces of neural plate and epidermis that would not normally participate in fold formation. These boundaries were examined superficially and histologically for the presence of folds, permitting the following observations. Folds form at each newly created boundary, and as many folds form as there are boundaries. When two folds meet they fuse into a hollow "tube" of neural tissue covered by epidermis. Sections reveal that these ectopic folds and "tubes" are morphologically similar to their natural counterparts. Transplanting neural plate into epidermis produces nodules of neural tissue with central lumens and peripheral nerve fibers, and transplanting epidermis into neural plate causes the neural tube and the dorsal fin to bifurcate in the region of the graft. Tissue transplanted homotypically as a control integrates into the host tissue without forming folds. When tissue from a pigmented embryo is transplanted into an albino host, the presence of pigment allows the donor cells to be distinguished from those of the host. Mesenchymal cells and melanocytes originating from neural plate transplants indicate that neural crest cells form at these new boundaries. Thus, any boundary between neural plate and epidermis denotes the site of a neural fold, and the behavior of cells at this boundary appears to help fold the epithelium. Since folds can form in ectopic locations on an embryo, local interactions rather than classical neural induction appear to be responsible for the formation of neural folds and neural crest. PMID- 2707488 TI - Role of interstitial cell migration in generating position-dependent patterns of nerve cell differentiation in Hydra. AB - The role of interstitial cell migration in the formation of newly differentiated nerve cells was examined during head regeneration in Hydra magnipapillata. When distal tissue was removed from the body of a wild-type strain (105), nerve cell differentiation occurred at a rapid rate during the first 48 hr of regeneration, slowing after this point. Rapid nerve cell differentiation was due primarily to migration of interstitial cells, some of which appeared to be nerve cell precursors, into the regenerating head. The migration decreased considerably after the first 48 hr of regeneration. In reg-16, a mutant strain deficient in head regeneration, no migration of interstitial cells and hence no new nerve cell differentiation were observed in the regenerating tip. However, the interstitial cells of reg-16 were observed to migrate into regenerating tissue of strain 105. These observations suggest that the migration of nerve cell precursors plays an important role when the new nerve net is being established during head regeneration. PMID- 2707487 TI - Developmental expression and intracellular location of P400 protein characteristic of Purkinje cells in the mouse cerebellum. AB - The developmental expression and intracellular localization of a cerebellum characteristic 250-kDa glycoprotein, P400 protein, were studied by immunohistochemical and immunoblot methods using a monoclonal antibody against P400 protein. In the cerebellum of normal mouse, the expression of P400 protein increased from Postnatal Day 3 to Day 21. This enhancement of P400 protein expression occurred only in the Purkinje cells and proceeded with the growth of their dendritic arborization. Electron microscopic analysis indicated that P400 protein is present at the plasma membrane, the endoplasmic reticulum, and the postsynaptic densities of Purkinje cells. Immunohistochemistry of the cerebella of neurological mutant mice indicated that the Purkinje cells of reeler, weaver, and pcd mutant mice retain the ability to produce a large amount of P400 protein. However, the Purkinje cells of staggerer mutant mouse proved to be incapable of enhanced P400 protein expression. These results indicate that P400 protein is a Purkinje cell-characteristic plasma membrane-associated glycoprotein, which is also present at the postsynaptic density and endoplasmic reticulum and that the expression of P400 protein in Purkinje cells is closely associated with the growth of their dendritic arborization. PMID- 2707489 TI - Determination of numbers of osteoprogenitors present in isolated fetal rat calvaria cells in vitro. AB - When maintained in long-term cell culture in the presence of ascorbic acid and organic phosphate, single cell suspensions isolated from fetal rat calvaria form discrete, three-dimensional bone nodules. We have used limiting dilution analysis in microtiter wells to determine the number of osteoprogenitor cells expressing the capacity to form bone in the isolated mixed population, to examine the possibility of cooperativity among cell types in bone nodule formation, and to determine the effects of dexamethasone on osteoprogenitor cells. Cells plated at very low densities and screened for the presence or absence of bone nodules revealed a linear relationship (r = -00.997) between the number of cells plated and the number of bone nodules formed. The complete limiting dilution analyses showed that 1 of every 335 plated cells (0.30% of the cell population) has the capacity to form a bone nodule under standard culture conditions and when the actual numbers of nodules were quantitated from the same plated cell populations the ratio of nodules formed to plated cells was similar. Comparison of data from 13 different isolates of cells in which cells were plated into 35-mm dishes and number of nodules were determined indicated a mean +/- 95% confidence interval of one nodule for every 301 +/- 61 plated cells, consistent with the data obtained from the limiting dilution experiments. Dexamethasone increased the number of bone-forming cells to 1 in 225 cells, in contrast to 1 in 340 cells in the same population grown without added dexamethasone. The results suggest that approximately 0.30% of the cells in isolated rat calvaria populations are osteoprogenitor cells, that one osteoprogenitor cell gives rise to one bone nodule, that cooperativity between different cells in vitro is not necessary for bone formation, and that dexamethasone stimulates the expression of osteoprogenitor cells. PMID- 2707490 TI - Expression of a novel histone 2B during mouse spermiogenesis. AB - During mammalian spermiogenesis transitional proteins and protamines replace histones on the DNA as the chromatin condenses. While previous studies suggested that histone genes are inactive postmeiotically, we have shown both by steady state RNA analysis and nuclear run-off transcription assays that histone 2b (H2b) transcription occurs in mouse round spermatids. In addition, a novel H2b cDNA clone has been isolated from an adult mouse testes cDNA library. The sequence of this cDNA clone predicts a protein that is extremely similar to other mouse H2b proteins, except at the carboxyl-terminus where the testes H2b contains an additional 12 amino acids, seven of which are hydrophobic. In contrast to the replication-dependent histone mRNAs, the 3' untranslated region of this cDNA contains the poly(A) addition sequence (AAUAAA) upstream of a poly(A) tract. Furthermore, the conserved hairpin structure immediately upstream of replication dependent histone mRNA termini is not present. Northern blot analysis of RNA from embryonic, ovarian, spermatogenic, and a variety of somatic tissues reveals that this novel H2b transcript is spermatid specific. The H2b mRNA is in polyribosomes isolated from spermatogenic cells, strongly suggesting that it is translated during spermiogenesis. PMID- 2707491 TI - The mRNA encoding elongation factor 1-alpha (EF-1 alpha) is a major transcript at the midblastula transition in Xenopus. AB - A Xenopus laevis gastrula cDNA library has been screened in order to identify sequences that are expressed early in development. We find that the mRNA encoding translation elongation factor 1-alpha (EF-1 alpha) is synthesized in very large amounts in the early embryo. Transcription of EF-1 alpha mRNA commences at the midblastula transition (MBT), and new EF-1 alpha protein is synthesized very soon after this, as determined by the association of EF-1 alpha mRNA with polysomes. The nucleotide sequence of a full-length EF-1 alpha cDNA clone and the deduced amino acid sequence of Xenopus EF-1 alpha protein are presented. PMID- 2707492 TI - Alarm call responsivity of mallard ducklings: VIII. Interaction between developmental history and behavioral context. AB - Mallard ducklings (Anas platyrhynchos) inhibit their vocal behavior upon hearing the maternal alarm call of their species. The present study assesses the interaction of the ducklings' experiential history with the environment in which they are tested. If ducklings are reared and tested to the alarm call in small social groups, they respond by dramatically inhibiting their vocalizations. If, however, socially reared ducklings are tested to the alarm call individually in an open field, responsiveness drops precipitously. In addition, individually reared ducklings respond at a far greater level to the alarm call when tested individually, not in groups. Thus, there is an interaction between the rearing history and the testing environment such that the same rearing history leads to different behavioral outcomes depending on the context in which the ducklings are observed. This demonstrates the importance of behavioral context, in addition to developmental history, as one of the determinants of behavior. PMID- 2707493 TI - Sensory processing in the term and preterm infant: use of reflex modification procedures. AB - The present study uses the glabellar reflex and reflex modification procedures to assess acoustic and tactile sensory processing capabilities in the human neonate. Fourteen term infants and 28 clinically stable preterm infants were given identical test paradigms. Augmentation testing consisted of a 16 V dc tap presented simultaneously with a 90 dB SPL tone; inhibition testing consisted of a 16 V tap preceded 900 msec. by an identical tap. All 14 term infants showed augmentation with 8 of 14 at p less than 0.05 level and eleven of 14 showed significant inhibition at the 900 msec intertap interval. However, only 12 of 28 preterm infants demonstrated significant augmentation and none showed reliable inhibition. These data indicate that areas of the central nervous system that process sensory stimuli are not fully developed at the time of birth even in the term infant. Further, the neural system for augmentation and inhibition may be independent of each other. PMID- 2707494 TI - Lack of stability in neonatal adrenocortical reactivity because of rapid habituation of the adrenocortical response. AB - The purpose of the study was to examine the stability of the adrenocortical response to stimulation in the human neonate. Forty-nine healthy newborns were examined twice responding to discharge examinations performed on two consecutive days. The dependent measures were salivary and plasma cortisol and behavioral state. Little evidence of stability was obtained. Instead, the results showed significant elevations in cortisol only in response to the first discharge examination. No significant elevation in cortisol was noted to the second discharge examination although the newborns continued to exhibit behavioral distress. Time since delivery was not a significant factor in producing these results. The findings are discussed with regard to neonatal coping processes and the importance of novelty in regulating increases in adrenocortical activity. PMID- 2707495 TI - Ontogeny of conditioned inhibition of conditioned respiratory suppression in kittens. AB - Excitatory and inhibitory classical conditioning were examined in 4-week-old, 8 week-old, and 12-week-old kittens. Conditioned respiratory suppression (CRS) was a measure of conditioned fear. The inhibitory conditioning procedure was designed to model the schedule of events that normally accompanies successful coping behavior: The safety signal predicted the cancellation of shock that would otherwise follow the danger signal, rather than simply the absence of shock. Before training, the stimuli elicited small unconditioned respiratory suppression in the 4-week-old and 8-week-old kittens, but not in the juvenile, 12-week-old kittens. During training, danger signals came to elicit robust CRS after 3-4 sessions (20-30 trials) in every age group. Acquisition of inhibition of CRS was also observed within 2-3 days (20-30 trials). The effectiveness of inhibitory stimuli improved significantly with age. The safety signal also inhibited fear (CRS) elicited by a second danger signal. Thus, the kittens learned inhibition to the safety signal per se, rather than having learned to discriminate some nonreinforced configured cue from the danger signal presented alone. PMID- 2707496 TI - The performance of human infants on a measure of frontal cortex function, the delayed response task. AB - The Delayed Response task is the best-established marker of frontal lobe function in nonhuman primates. This article reports the developmental progression of human infants on that task. It is proposed that maturation of prefrontal cortex may make possible these age-related improvements in Delayed Response performance. This would suggest the importance of prefrontal cortex functioning very early in life. Twelve infants (6 male, 6 female) were tested longitudinally every two weeks from 6-12 months of age. Another 36 infants (18 male, 18 female) were tested only once: 12 each at 8, 10, and 12 months. We predicted that infants would improve on Delayed Response over these ages because infants' performance on AB improves during this time, and Delayed Response is very similar to AB. The AB task, devised by Piaget, is used to study cognitive development in infants. The ages over which AB performance improves are well established. In both AB and Delayed Response, the subject watches as the experimenter hides a desired object in one of two identical wells. After a brief delay, the subject is allowed to reach. In AB, the object is hidden in the same well on subsequent trials until the subject reaches to the correct well; then side of hiding is reversed and the procedure repeated. In Delayed Response, side of hiding is varied randomly over trials. In the present study of Delayed Response each testing session consisted of 16 trials (eight to the right, eight to the left). We found: (1) the developmental progression for Delayed Response is almost identical to that for AB. (2) Infants of 7 1/2-9 months fail Delayed Response under the same conditions and in the same ways as do monkeys with lesions of dorsolateral prefrontal cortex. It is therefore suggested that AB and Delayed Response require the same cognitive abilities, and that improved performance on these tasks provides an index of maturation of frontal cortex function. PMID- 2707497 TI - Early experience and maternal behavior in rats. AB - This study examined the effects of early experience (early weaning with group housing in sibling groups (EG), or early weaning plus social isolation (EI) from 14 to 24 days of age) on maternal, play, and social behaviors expressed during 5 days of sensitization at 24 days, and then later at 100 days of age. Our results showed that maternal behaviors at 24 days could be altered by these early experiences. At 24 days of age fewer EI animals retrieved compared with normally weaned controls (NW), but more showed play behavior in the presence of pups. EG animals showed intermediate levels of retrieving relative to NW controls, and no concomitant changes in play behaviors. When retested as adults, females in all groups showed similar levels of all maternal behaviors. But EI adults of both sexes showed persistent intrusion of play behaviors, and higher levels of rearing and undirected activity in the presence of neonates. Factor analyses revealed that previously sensitized adult males showed patterns of organization of maternal behaviors that resembled adult females rather than those shown by control males reared without sensitization experience. Previously sensitized females also showed a retention of the play behavior patterns characteristic of juveniles, not present in females without sensitization experience. These results show that social experience during the weaning period can affect the development of maternal and play behavior elicited by neonates during the juvenile period that persist into adulthood, and the juvenile sensitization experience exerts longterm effects on adult patterns of maternal behavior in both sexes. PMID- 2707498 TI - American Diabetes Association, Inc., 49th annual meeting. June 3-6, 1989, Detroit, Michigan. Abstracts. PMID- 2707499 TI - Importance weighted audibility and the recognition of hearing aid-processed speech. AB - The purpose of this study was to determine the extent of the agreement between the speech-recognition performance of normally hearing subjects with each of six linear hearing aids and the performance predicted for those aids by a carefully derived articulation index. Also investigated was how much of the remaining variability in average subject performance across hearing aids could be attributed to harmonic distortion. It was found that predicted performance and average observed performance never differed by more than 8.4 rau (mean = 2.3 rau) and that the articulation index procedure used alone accounted for 90 to 94% of the variance in averaged subject performance. PMID- 2707500 TI - Reversible sensorineural hearing loss in a stroke patient. AB - A case is presented of a patient with lateral pontine stroke which resulted in a moderate unilateral sensorineural hearing loss. ABR, word recognition scores, acoustic reflexes, neurological evaluation, and CT scan were consistent with brain stem lesion. Recovery of hearing, including acoustic reflexes and word recognition ability, occurred 2 months after the stroke. PMID- 2707501 TI - Perilymphatic fistulas in children: rationale for therapy. AB - We report 26 consecutive patients (32 ears) who were identified in a 2 year period (July 1, 1985-June 30, 1987) with unexplained sudden, fluctuating, or progressive sensorineural hearing loss (SNHL). All patients underwent an exploratory tympanotomy and a perilymphatic fistula was identified in 13 patients (14 ears). The mean change of 14 +/- 27 dB in speech reception threshold before and after surgery was significant at p = 0.08 among children with fistula and ranged from -30 to 80 dB. In children with sudden, progressive or fluctuating SNHL and multiple sensory deficits, including blindness or contralateral SNHL, or prior head trauma, prompt surgical exploration is mandatory. Additionally, the aggressive management of otitis media with effusion is essential in such patients to minimize fluctuations in hearing caused by superimposed conductive hearing loss. Caution must be exercised to separate fluctuating hearing loss from fluctuations in audiologic testing. PMID- 2707502 TI - Interaction of stimulus parameters on the auditory brain stem response: a normal variant. AB - The purpose of this investigation was to further define the effect that stimulus parameters of phase, intensity, and rate have in significantly reducing the wave V amplitude. Two separate experiments were conducted to determine whether an interactive effect exists and how robust the effect was on wave V. Results revealed that wave V amplitude was reduced to less than half the absolute amplitude of the wave IV-V complex in 9 of the 39 subjects. The phenomenon was dependent upon stimulus parameters of rarefaction phase, high intensity, and low repetition rate. Conversely, the phenomenon was independent of cochlear integrity, sex, and test equipment. The implications to diagnostic interpretation during routine auditory brain stem response testing are discussed. PMID- 2707503 TI - Comparison of the identifiability of the low intensity ABR and MLR in the mentally handicapped patient. AB - The auditory brain stem response and the middle latency response were recorded from low intensity click stimuli in 48 patients with mental handicaps. In the 23 patients (45 ears) with normal hearing thresholds, the ABR was found to have a lower test-retest variability than the MLR. This lower variability will correspond to higher identifiability at threshold. In the 25 patients with a hearing loss, four had MLRs recorded in ears with absent ABRs. In five of these ears no auditory response would have been detected if ABRs alone were recorded. Based on the above findings, the following recommendations can be made. Recording the ABR with open filters is the desired method for threshold detection in most subjects. If no response is obtained it is desirable to record a MLR. The recording of a MLR is probably more important in laboratories recording responses with steep filter slopes, since a greater portion of the slow wave activity, P phi (V) complex, will be phase shifted into the later portion of the time base. PMID- 2707504 TI - The auditory brain stem response interaural latency difference (ILD) in patients with brain stem lesions. AB - The ABR interaural latency difference (ILD) from 15 patients with brain stem lesions was compared to the ILDs from patients with VIIIth nerve tumors, cochlear pathology, and a normal control group. All patients in the study had to meet the criteria of bilaterally symmetrical hearing for pure-tone thresholds in order to offset the effect of hearing loss on the ILD. Although the ILDs for the brain stem lesion group were larger than for the cochlear or normal groups, they were significantly smaller than for the VIIIth nerve tumor group. It appears that the ILD is not as sensitive a measure for detecting brain stem involvement as VIIIth nerve tumors. PMID- 2707505 TI - Speech understanding in the elderly. AB - Both auditory and cognitive status were determined in 130 elderly persons, in the age range from 51 to 91 years. Data were analyzed from the standpoint of the congruence of auditory and cognitive deficits. The prevalence of central auditory processing disorder was 50%, and the prevalence of cognitive deficit was 41%. Findings in the two areas were congruent, however, in only 63% of the total sample. Central auditory status was abnormal in the presence of normal cognitive function in 23% of subjects. Central auditory status was normal in the presence of cognitive deficit in 14% of subjects. In general, results did not support the hypothesis that decline in speech understanding in the elderly can be explained as the consequence of concomitant cognitive decline. PMID- 2707506 TI - Word identification performance in the presence of competing speech and noise in learning disabled adults. AB - Eight learning disabled (LD) adults and eight control subjects identified monosyllabic words presented simultaneously in the presence of speech spectrum noise and three types of linguistic maskers. The performance of LD subjects was poorer than that of the control subjects under each masking condition. Word identification was poorest in the presence of speech noise for both groups. No difference in performance was seen as a function of the linguistic content of the competing speech maskers. These results suggest that LD subjects present greater susceptibility to acoustic masking relative to control subjects and may support the view that auditory-language deficits observed in LD individuals may be secondary to an underlying acoustic-phonetic disorder rather than a central phonologic disorder. LD college students may experience S/N ratios in the classroom that perpetuate or exacerbate their listening problems. PMID- 2707507 TI - Variability of most comfortable and uncomfortable loudness levels to speech stimuli in the hearing impaired. AB - Methods for determining hearing aid settings often incorporate measurements of most comfortable loudness (MCL) and uncomfortable loudness (UCL) levels. This study examined the variability of loudness measures and their correlation to threshold data, using speech stimuli presented to hearing-impaired subjects. MCLs, UCLs, speech reception, and speech detection thresholds were obtained from 50 subjects having sensorineural impairments. The stimuli were CID W-2 spondees spoken by three female clinicians. Three MCLs and UCLs were obtained within each session, using ascending runs and a closed-set response list. Fifteen subjects were retested twice over intervals ranging from a week to several months. Between session variability for the loudness measurements was less than or equal to 10 dB across sessions and speakers for the majority of subjects, with a tendency for the MCL and UCL to increase slightly over time. Significant variability was attributed to the use of live-voice presentation by different clinicians. High positive correlation was found between threshold and loudness data for subjects with relatively flat audiometric configurations but not for subjects demonstrating sharply sloping hearing losses. PMID- 2707508 TI - Elder abuse: a patient care problem for management. PMID- 2707509 TI - Alternative programs in a psycho-geriatric hospital. PMID- 2707510 TI - A dining experience program brings many benefits. PMID- 2707511 TI - Mandatory retirement has an uncertain future. PMID- 2707512 TI - How do we cure low staff morale? PMID- 2707513 TI - Dissent on "Z". PMID- 2707514 TI - Aid for AIDS research. PMID- 2707515 TI - Increased cholesterylester transfer activity in complicated type 1 (insulin dependent) diabetes mellitus--its relationship with serum lipids. AB - In Type 1 (insulin-dependent) diabetes mellitus, macrovascular complications and the increased risk for cardiovascular disease in patients with microvascular complications may be related to alterations in plasma cholesterylester transfer. The activity of cholesterylester transfer protein, which mediates cholesterylester transfer between lipoproteins and lipoprotein lipid levels, was assessed in 7 normolipidaemic control subjects, 7 Type 1 diabetic control subjects without complications, 11 Type 1 diabetic patients with microvascular complications (retinopathy, incipient nephropathy) and in 7 Type 1 diabetic patients with macrovascular atherosclerotic lesions. The cholesterylester transfer activity was 30% higher in the diabetic groups with macrovascular and microvascular lesions than in the 2 control groups. Very low + low density lipoprotein cholesterol was higher in the 3 diabetic groups than in the non diabetic control group. High density lipoprotein cholesterol was not different. The cholesterylester transfer activity was correlated positively with HbA1, urinary albumin excretion rate, serum cholesterol, very low + low density lipoprotein cholesterol and apolipoprotein B. The high density lipoprotein over very low + low density lipoprotein cholesterylester molar ratio was lower in the diabetic groups with micro- and macrovascular complications. A role for cholesterylester transfer activity in the lipoprotein abnormalities found in complicated Type 1 diabetes is suggested. A high cholesterylester transfer activity might be indicative of mechanisms which promote atherogenesis. PMID- 2707516 TI - The Swedish childhood diabetes study--results from a nine year case register and a one year case-referent study indicating that type 1 (insulin-dependent) diabetes mellitus is associated with both type 2 (non-insulin-dependent) diabetes mellitus and autoimmune disorders. AB - From July 1, 1977 to July 1, 1986, 3,503 incident cases of Type 1 (insulin dependent) diabetes mellitus were registered in the Swedish childhood diabetes study. Using data from this register and from a case-referent study, including all incident Type 1 diabetic children in Sweden during one year and, for each patient, two referent children matched according to age, sex and county, we have studied the associations between Type 1 diabetes and familial Type 1 and Type 2 (non-insulin-dependent) diabetes, thyroid, adrenal, allergic, rheumatic, heart and bowel disease. The mean annual incidence per 100,000 during the nine year period was 25.1 for boys and 23.5 for girls. In 8.5% of the patients, one parent had Type 1 diabetes, 73% of whom were fathers. Fifty-six of the patients (1.7%) had a parent with Type 2 diabetes. The prevalence of parental Type 1 diabetes tended to be higher in patients with younger age at onset; whereas, the opposite was found for patients with parental Type 2 diabetes. In the case-referent study, the age-adjusted odds ratio for Type 1 diabetes when a first and/or second degree relative had Type 1 diabetes was 5.5 (95% confidence limits 4.0-7.7), and in accordance with the findings of the case register, the odds ratio tended to be highest in patients with the youngest age at onset. Season at onset of the patients was not associated with parental Type 1 diabetes. The odds ratio for Type 1 diabetes was significantly increased 3.3 (95% confidence limits: 2.3-4.6) when Type 2 diabetes was reported in relatives (three generations).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707517 TI - Effects of chronic sodium salicylate feeding on the impaired glucagon and epinephrine responses to insulin-induced hypoglycaemia in streptozotocin diabetic rats. AB - The potential role of endogenous prostaglandins in glucagon and epinephrine responses to insulin-induced hypoglycaemia was studied in streptozotocin-diabetic and age-matched control adult male rats. Rats made diabetic with a single intravenous injection of streptozotocin (65 mg/kg) developed impaired glucagon and epinephrine responses to insulin-induced hypoglycaemia by 80-100 days. Plasma glucagon levels in response to insulin-induced hypoglycaemia in streptozotocin diabetic rats (167 +/- 67 pg/ml) were significantly lower (p less than 0.01) than those in control rats (929 +/- 272 pg/ml). Similarly, plasma epinephrine levels in hypoglycaemic state in streptozotocin-diabetic rats (11 +/- 8 pmol/ml) were also significantly lower (p less than 0.01) compared to control rats (37 +/- 13 pmol/ml). Streptozotocin-diabetic rats provided with sodium salicylate (25 mg/100 ml) in their drinking water from day one of diabetes exhibited prevention of the blunted glucagon and epinephrine responses to insulin-induced hypoglycaemia. About 80-100 days after the chronic sodium salicylate treatment in streptozotocin diabetic rats, both plasma glucagon levels (1080 +/- 169 pg/ml) and plasma epinephrine levels (39 +/- 8 pmol/ml) were essentially identical to plasma glucagon levels (1074 +/- 134 pg/ml) and plasma epinephrine levels (37 +/- 5 pmol/ml) in control rats in hypoglycaemic state. These animals also exhibited an improvement in the diabetic state in that they had less severe hyperglycaemia and lack of weight gain. These results suggest that the blunted glucagon and epinephrine responses to insulin-induced hypoglycaemia may be related to altered prostaglandin levels in streptozotocin-diabetes. PMID- 2707518 TI - The Swedish childhood diabetes study--social and perinatal determinants for diabetes in childhood. AB - Using the Swedish childhood diabetes register, a nationwide, case-referent study was performed from September 1, 1985 to August 31, 1986. Based on the information from a mailed questionnaire sent to all incident diabetic children and for each diabetic child - two referent children matched according to age, sex, and county, we have analysed perinatal events and aspects of the social environment as possible risk factors for Type 1 (insulin-dependent) diabetes in childhood. A significantly larger proportion of the mothers of the diabetic children were older than 40 years compared to those of the referent children (33% and 24%, p = 0.01 respectively). A smaller percentage of mothers of the diabetic children had a high educational level compared to mothers of referent children (10% and 15%, p = 0.03 respectively) and 39% of the fathers of the diabetic children were manual workers compared to 31% of the fathers of referent children (p = 0.03). Perinatal events did not differ between diabetic and referent children. In children 0-6 years, the duration of breast-feeding was significantly shorter in diabetic children than among referent children (median duration for diabetic children 5 months compared to 6 months for referent children p = 0.03). When considering the presence of Type 1 diabetes among relatives, maternal age over 40 years, low educational level of the mother, and the father being a manual worker as risk factors, the presence of 1 to 4 of any of these risk factors increased the relative risk for Type 1 diabetes cumulatively from 1.2-7.5.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707519 TI - Diabetic thick skin and stiff joints. PMID- 2707520 TI - [Treatment of alcoholic hepatitis with silymarin. A double-blind comparative study in 116 patients]. AB - A randomized double-blind trial of silymarin versus placebo was carried out in 116 patients with histologically proven alcoholic hepatitis, 58 of them with cirrhosis. Patients were not included in case of hepatic encephalopathy, contraindication to percutaneous liver biopsy, hepatocellular carcinoma, evident lack of discipline or refusal to enter the trial. Fifty-seven patients received silymarin orally 420 mg/day and 59 received placebo during 3 months. Biologic parameters were assessed in the serum, and a percutaneous liver biopsy was obtained at the start of the trial and 3 months later. Histologic scores of alcoholic hepatitis and fibrosis were established on each biopsy specimen by two independent pathologists. The 2 groups were comparable at inclusion; 26 p. 100 of patients were lost to follow-up at 3 months, abstinence was obtained in 46 p. 100 of patients at the end of the trial. These percentages were similar in the two groups. Four patients died of hepatic failure during the trial, 3 in the placebo group. Significant improvement in the score of alcoholic hepatitis and serum amino transferase activity, was noted in both groups during the trial, irrespective of treatment with silymarin or placebo. No side-effects were noted. Our results suggest that silymarin 420 mg/d is not clinically relevant in the treatment of moderate alcoholic hepatitis. PMID- 2707521 TI - [Anatomo-pathologic study of hepatic toxicity in intra-arterial hepatic chemotherapy]. AB - Intra-arterial hepatic chemotherapy is effective in the treatment of colorectal or endocrine carcinomas liver metastasis. However it is potentially toxic for the healthy liver. To check this, we studied non tumoral liver specimens in 14 patients treated by intra-arterial chemotherapy with 5 fluorouracil, 5 fluoro-2 deoxyuridine and an association of 5 fluorouracil and streptozotocin. The main hepatic lesions observed were: sclerosing cholangitis, central vein (dilatation and fibrosis) and moderate hepatocellular necrosis or cholestasis in the centrolobular area. Thus intra-arterial hepatic chemotherapy has important toxic effects on healthy liver, even if clinical and biological liver disturbances are minimal in most cases. Caution must be exercised in using this method. PMID- 2707522 TI - [Chronic hepatic encephalopathy in cirrhotic patients and spontaneous portacaval anastomosis. Portal angiographic and manometric study]. AB - Portal angiographic and manometric studies were prospectively carried out in 9 cirrhotic patients with spontaneous chronic portal-systemic encephalopathy. Hepatic encephalopathy presented as coma in 8 patients, and was the first manifestation of chronic liver disease in 6 cases. Hemodynamic studies showed a) a large single spontaneous portacaval anastomosis (gastrorenal, splenorenal, gradient (mean +/- SD = 16.3 +/- 5.4 mm Hg); c) a wedge hepatic venous pressure higher than portal pressure in 8 cases (difference: 1-11 mm Hg). PMID- 2707523 TI - [Measurement of the sus-hepatic pressure gradient in differential diagnosis of chronic persistent or active hepatitis]. AB - The value of the hepatic venous pressure gradient, measured during a transjugular liver biopsy procedure, was evaluated in the differential diagnosis of chronic persistent versus active hepatitis. The diagnosis of chronic persistent or active hepatitis was carried out according to classical clinical, biological, and above all pathological criteria. Patients with chronic active hepatitis were divided in to subgroups according to the degree of aggressivity and the presence of cirrhosis. Of the 70 patients studied, 13 had a gradient lower than 0.79 kPa, and all had chronic persistent hepatitis; 48 patients had a gradient higher than 0.93 kPa, they all had a chronic active hepatitis. For the 9 remaining patients, the gradient was between 0.79 and 0.93 kPa, 3 had persistent hepatitis, and 6 had active hepatitis. There was no significant variation of the gradient according to aggressivity in the subgroups of chronic active hepatitis. The gradient separated clearly chronic active hepatitis with or without cirrhosis. The measurement of the hepatic venous pressure gradient allows to differentiate between chronic persistent versus active hepatitis in 87 p. 100 of cases. This simple procedure offers a quick clue to diagnosis before obtaining histologic results. PMID- 2707524 TI - [Dysplasia states of the digestive tract and flow cytometry]. PMID- 2707525 TI - [The ergonovine test with injection of increasing doses in the diagnosis of chest pain]. AB - Ergonovine testing was performed in 40 patients with normal coronary angiograms (24 men, 16 women, mean age 53 years) complaining of chest pain. Esophageal and coronary spasm were assessed by simultaneous esophageal manometry, 12-lead-EKG and myocardial scintigraphy. Progressive doses of ergonovine were injected. Of the 17 patients experiencing chest pain during testing, coronary spasm occurred in 3 and esophageal motor disorders in 7 (peristaltic contraction waves of high amplitude in 3, diffuse esophageal spasm in 4). The dose necessary was more than 0.175 mg. No objective changes (EKG and manometry) were observed in the 7 remaining patients. PMID- 2707526 TI - [Gastroduodenal complications of hepatic intra-arterial chemotherapy of hepatic metastases of colorectal origin]. AB - Fifty-eight patients with colorectal liver metastases were treated by intra arterial hepatic chemotherapy (IAHC) containing 5 FU (n = 42) or FUDR (n = 16). Twenty-three patients (39.6 p. 100) complained of abdominal pain. In three of these patients, the course was complicated by digestive hemorrhage. Endoscopic explorations and angioscintigraphy were normal in 4, showed oesophagitis in 3, superficial gastritis or duodenitis in 8 (34.7 p. 100) and gastric (2) or duodenal ulceration (6) in 8 (34.7 p. 100). The duodenal ulceration was extensive and considered to be cause of hemorrhage in two cases. Duodenal perforation due to the catheter was discovered in two other cases, one of which was secondary to tumoral extension revealed by forceps biopsy. This patient died 3 months later. Surgical treatment was mandatory in the other case due to digestive hemorrhage but did not prevent death. Angioscintigraphy performed in 15 patients with gastroduodenal inflammation or ulceration was normal in 7 patients, revealed arterial thrombosis in 5 and an extra-hepatic perfusion in the gastroduodenal area in 3 : this was related to a small pyloric artery which was occluded secondarily. IAHC was continued there after. This experience underlines the importance of exploring patients with digestive symptoms during IAHC so that it may be temporarily discontinued while an inadequately positioned infusion catheter may be corrected should gastroduodenal ulceration occur. PMID- 2707528 TI - [Neuroma of the common bile duct]. PMID- 2707527 TI - [Effects of corticoids, 5-aminosalycilic acid and sucralfate on the potential difference of the rectum in inflammatory colitis in man]. AB - Glucocorticoids are able to increase ionic transport across the rectal mucosa and improve the potential difference (PD) which is known to be decreased in inflammatory bowel diseases in man. The aim of this study was to evaluate the effects of therapeutic enemas or parenteral drugs used in the treatment of inflammatory colitis, by means of rectal PD variations. Seventeen patients (10 women, 7 men, mean age 47 +/- 16 years) with chronic colitis and rectal involvement were studied (ulcerative colitis: n = 12, Crohn's disease n = 4, radiation proctocolitis : n = 1). In each patient, mean PD basal value was measured before treatment for 30 min; a few days later PD measurements were performed 5 h after either intravenous administration of hydrocortisone (HC i.v.: 100 mg) or local administration of therapeutic enemas: 5-aminosalicylate acid (5 ASA: 4 g), hydrocortisone (HC L: 100 mg) or sucralfate (S: 1 g). Statistical analysis used Student's T test for paired or unpaired data, the Mann-Whitney U or Wilcoxon test. PD increased from: - 30.7 mV to - 45.6 mV after HC i.v. (p less than 0.001), - 31.8 mV to - 48.7 mV after HC L (p = 0.01), - 29.8 mV to - 39.8 mV after 5-ASA (p less than 0.01) and - 20.6 mV to - 24.9 mV after sucralfate (NS) respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707529 TI - [Extracorporeal lithotripsy of gallbladder lithiasis: preliminary results of the EDAP lithotripsy apparatus]. PMID- 2707530 TI - [Splenic rupture caused by colonoscopy]. PMID- 2707531 TI - [Palliative electrocoagulation of stenosing cancer of the sigmoid colon]. PMID- 2707532 TI - [Mesenteric venous infarction and protein C deficiency]. PMID- 2707533 TI - [Pyopneumothorax disclosing perforation of gastric ulcer without associated peritonitis. Apropos of 2 cases]. PMID- 2707534 TI - The effect of glucagon on esophageal peristalsis and clearance. AB - The effect of 0.5 mg intravenous glucagon on esophageal peristalsis and transit of water and barium was studied in nine healthy subjects by concurrent videofluoroscopy and manometry. Glucagon lowered manometric peristaltic amplitude in both mid- and distal esophagus. This reached significance (p = 0.0075) in the distal 3 cm of the esophagus 2 min after the injection. The efficiency of esophageal stripping was also reduced (increased proximal escape on fluoroscopy), and became significant (p = 0.05) at 2 min after the injection of glucagon. PMID- 2707535 TI - Posterior mediastinal teratoma involving the esophagus. AB - Intrathoracic teratomas are difficult to diagnose on chest radiographs if they are noncalcified and located in an atypical site. We report an unusual case of posterior mediastinal teratoma that involved the esophageal wall. Features noted on computed tomography (CT) of the chest and barium examination of the esophagus are herein presented. PMID- 2707536 TI - The gastric air-fluid sign: aid in CT assessment of gastric wall thickening. AB - The differentiation of apparent gastric wall thickening due to incomplete gastric distention from true pathologic wall thickening can be difficult on computed tomographic (CT) scanning. We have observed a transition in gastric wall thickening that is often present at or slightly above the gastric air-fluid or air-contrast level. The apparently thickened gastric wall in the dependent portion of the stomach undergoes an abrupt change to normal thickness at or above the air-fluid level. Review of CT scans in 259 patients without known or suspected gastric pathologic conditions revealed this finding, termed the "gastric air-fluid sign," in 57 patients (22%). While not considered diagnostic, the presence of this sign may allow for a greater degree of confidence in the CT assessment of gastric wall thickening in an appropriate clinical setting. PMID- 2707537 TI - Gastric intramural pseudocyst: computed tomographic diagnosis. AB - The authors describe a case of pancreatic pseudocyst presenting as an intramural gastric mass on upper gastrointestinal examination (UGI) and computed tomography (CT) of the abdomen. The correct diagnosis of this rare entity was suggested preoperatively on the basis of the radiographic findings presented herein. PMID- 2707538 TI - Heterotopic gastric mucosa of the duodenum mimicking a duodenal cancer. AB - Heterotopic gastric mucosa of peculiar shape and located in the duodenum bore a close resemblance to superficial ulcerating cancer. Radiographic survey showed a flexible lesion with a mucosal pattern resembling area gastrica. Endoscopy revealed its color to be indistinguishable from that of the normal duodenal mucosa. These may be characteristic features of this abnormality. PMID- 2707539 TI - Complications of endoscopic retrograde sphincterotomy: computed tomographic evaluation. AB - Although the reported complication rate of endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is low, patients often experience abdominal pain postprocedure. When pain persists, or fever and leukocytosis develop, a procedure-related complication should be suspected. The authors reviewed a series of 36 patients referred to computed tomography (CT) for evaluation of possible complications following ERCP with sphincterotomy. Initial CT scans were obtained within 24 h in 19 patients, and during the second to seventh day in the remainder. Complications detected by CT included acute pancreatitis (23), duodenal perforation (11), retroperitoneal dissection of air (4), pneumoperitoneum (4), and development of retroperitoneal abscess (4). Eight patients had normal CT scans except for air and contrast material in the biliary tree. The severity and extent of injury were readily assessed by CT, and response to therapy effectively monitored by serial CT examinations. Thirty-one cases (31 of 36) were successfully managed conservatively with antibiotics, intravenous hydration, and restriction of oral intake. Four patients required surgical intervention for drainage of a retroperitoneal abscess (3) or a pseudocyst (1). A fifth patient required intensive care resuscitation for septic shock. We conclude that CT is the study of choice for evaluating the patient with suspected complication following ERCP and sphincterotomy. PMID- 2707540 TI - Perforation of the common bile duct during endoscopic sphincterotomy: recognition on computed tomography and successful percutaneous treatment. AB - Retroperitoneal common bile duct (CBD) perforation is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP). We describe such a case with delayed diagnosis made by computed tomography (CT) and successful percutaneous management of the injury. PMID- 2707541 TI - Percutaneous transhepatic biliary drainage: alternatives in left hepatic duct obstruction. AB - The left-lobe subxiphoid approach has been the standard way to drain left hepatic duct occlusion. A new, right-side biliary drainage approach is described. Five patients, among 25 patients with bilateral biliary obstruction, were treated by an internal-internal drainage system. Three types of internal-internal drainage techniques are described: internal-internal luminal, type 1; internal-internal luminal, type 2; and internal-internal transductal, type 3. All 5 patients succeeded in biliary drainage. The internal-internal biliary drainage technique, performed from the right-side approach, is effective, avoids additional liver puncture and tract dilatation, and allows the combination of several biliary drainage techniques, adding greatly to the flexibility when treating intrahepatic obstruction. No complications were observed in our small series but special precaution should be taken with the transductal technique due to the possibility of bleeding. PMID- 2707542 TI - The use of intravenous cholangiography in teaching hospitals: a survey. AB - Thirty academic radiology departments active in biliary imaging were surveyed to document how frequently intravenous cholangiography (IVC) was being performed. Over a 10-year period the number of examinations has decreased precipitously from approximately 1728 in 1976 to 8 in 1986. This coincides with the increased availability of alternative procedures. The availability of new contrast agents with improved diagnostic yield and decreased toxicity suggests that its use may have been prematurely abandoned. PMID- 2707543 TI - Echinococcal hepatic disease: magnetic resonance appearance. AB - The magnetic resonance (MR) appearance of an echinococcal hepatic cyst is described. A previous report has suggested that a low-intensity rim surrounding the cyst may be useful in differentiating hydatid cysts from other hepatic lesions. No such rim was identified in our case; however, MR was found to be superior to other modalities in delineating the internal contents of the hydatid cyst. PMID- 2707544 TI - Localized ileus of the proximal jejunum: a new sign for acute appendicitis. AB - A focal dilatation of a loop of small bowel has been identified in the left upper quadrant in a series of individuals with suspected appendicitis. Retrospective review of 100 cases of surgically proven appendicitis demonstrated this sign in 51. No previous description of this sign has been found. This finding is believed to be an early sign of appendicitis and may be a valuable adjunct in combination with a clinical history without other radiologic signs of appendicitis. The more conventional signs of appendicitis such as appendicolith and focal ileus of the terminal ileum reinforce the diagnosis. PMID- 2707545 TI - Benign cecal villous adenoma presenting as a bladder mass. AB - Involvement of contiguous organs by a neoplasm is ordinarily evidence of aggressive malignant behavior. A patient presented with a bladder mass found to be arising in the cecum and diagnosed as a benign villous adenoma. Growth down a diseased appendix is proposed to explain the apparent extension of a relatively nonaggressive lesion into an adjacent organ. PMID- 2707546 TI - Effects of hiatal hernia, reflux esophagitis, and glucagon on the quality of double-contrast esophagram. AB - The possible effect of hiatal hernia, reflux esophagitis, and glucagon on the quality of the double-contrast esophagram was studied in 177 patients. Overall, the quality of the double-contrast esophageal views were judged poor in 46 (26%) patients and good in 131 (74%). No significant improvement in quality was evident in patients receiving glucagon, or in those with hiatal hernia or documented reflux esophagitis. Although the presence of gastroesophageal reflux or the lowering of esophageal sphincter pressure by glucagon would be expected to promote gaseous reflux from the stomach, no improvement in the quality of the double-contrast views of the esophagus was evident in our study. PMID- 2707547 TI - Effect of cigarette smoking on the gastric mucosal blood volume index and hemoglobin oxygenation in man. AB - The acute effect of cigarette smoking on the gastric mucosal blood volume index and the oxygen saturation of hemoglobin (SO2) in the gastric mucosa was investigated in 12 young male volunteers using reflectance spectrophotometry during endoscopy. Six of these volunteers were habitual smokers who had smoked more than 20 cigarettes a day for more than five years. The others were non habitual smokers who smoked less than 20 cigarettes a year. The indices of mucosal blood volume and the mucosal blood SO2 level were calculated from the spectra obtained at the lesser curvature of the lower corpus of the stomach before and after cigarette smoking. The indices of mucosal blood volume and mucosal blood SO2 decreased significantly after one to three puffs of cigarette smoking in all subjects as compared to the value before smoking, and the degree of decrease in these parameters was significantly greater in the non-habitual smokers than in the habitual smokers. These results suggest that only one to three puffs of cigarette smoking causes a decrease in the mucosal blood volume and the mucosal blood SO2 which might be related to weakening of mucosal defensive factors. PMID- 2707548 TI - Effects of 5 beta-chol-3-en-24-oic acid, and lithocholic acid and its sulfates on prostaglandin E2 output in perfusion of the rat colon. AB - The effects of bile salts on the output of prostaglandin E2(PGE2) were studied in rats by colonic perfusion. Bile salts and their concentrations in infusates were as follows; chenodeoxycholic acid sodium salt (CDCNa), sulfolithocholic acid disodium salt (SLCNa) and sulfotaurolithocholic acid disodium salt (STLCNa) were at 1 mmol/l, lithocholic acid sodium salt (LCNa) was at 0.6 mmol/l, 5 beta-chol-3 en-24-oic acid sodium salt (delta 3Na) was at 0.006 mmol/l, and sulfoglycolithocholic acid disodium salt (SGLCNa) was at 0.8 mmol/l. Median values of PGE2 outputs were 40.9, 52.4, 65.5, trace, 7.6, 9.8 and 9.8 pg/10 min/cm in the CDCNa, LCNa, delta 3Na, SLCNa, STLCNa, SGLCNa and control groups, respectively (control vs CDCNa, LCNa, delta 3Na, SLCNa group, p less than 0.01 by median test). There was such a dissociation in PGE2 output and electrolyte concentration in the perfusates that high concentration of Na+ and Cl- ions was observed only in the SGLCNa group (p less than 0.01 by t-test compared with the control group), whereas in the remainder of the groups substantial net movement of electrolytes and water was not observed. Light microscopy showed no evidence of morphological damage in any group. These results indicated that CDCNa, LCNa and delta 3Na increased PGE2 outputs in the colon at low concentration without functional or morphological changes. PMID- 2707549 TI - Effects of bile acids on liver cell injury by cultured supernatant of activated liver adherents cells. AB - When heat-killed Propionibacterium acnes (P. acnes) is intravenously injected into mice followed by an intravenous injection of a small amount of lipopolysaccharide (LPS) 7 days later, most of the mice die of massive hepatic cell necrosis within 24 hours of LPS injection. In addition, when the liver adherent cells including Kupffer cells are separated from the mice 7 days after P. acnes injection and incubated in vitro with LPS, remarkable activity of the cytotoxic factor is found in the culture supernatant. This cytotoxic factor is thought to cause liver injury. Using this experimental model, the effects of various bile acids on liver cell injury were studied. As a result, ursodeoxycholic acid and dehydrocholic acid suppressed liver cell injury induced by the cytotoxic factor. However, cholic acid, deoxycholic acid and chenodeoxycholic acid did not have any hepatocytoprotective effects. PMID- 2707550 TI - Subcellular localization of aldehyde dehydrogenase isozymes in human liver. AB - The subcellular distribution of aldehyde dehydrogenase (ALDH) isozymes in human liver was studied by isoelectric focusing and biochemical procedures in biopsied liver specimens obtained during surgical procedures. Four types of ALDH isozymes (ALDH I, II, III and IV) were identified in human liver by isoelectric focusing. In 6 of the 13 livers examined, ALDH I was not detected, indicating that about half of the Japanese people may be classified as the unusual type. ALDH I, which exhibits a low Km with respect to acetaldehyde (Ac-CHO), was located mainly in the mitochondrial and cytosolic fractions. ALDH II (high Km for Ac-CHO) was found to be localized mainly in the microsomal and cytosolic fractions. ALDH III and IV (very high Km for Ac-CHO) were localized in all fractions, except for ALDH III in the microsomal fraction. Biochemical analysis indicates that low Km ALDH activity was localized in the mitochondrial and cytosolic fractions, while high Km and whole ALDH activities were detected in all 3 fractions. More than 80% of the low Km, high Km and whole ALDH activity was found in the cytosolic fraction. These distribution patterns were quite different from those in rats. These results indicate that the results obtained in animal experiments cannot be directly applied to humans and that the main site of Ac-CHO oxidation in the human liver is in the cytosol. PMID- 2707551 TI - Two different types of antimitochondrial antibodies (anti-M2 and anti-M4) may not differentiate primary biliary cirrhosis (PBC) with prominent piecemeal necrosis from classical PBC. AB - Clinical and morphological features in 13 patients with primary biliary cirrhosis (PBC) who had two different types of antimitochondrial antibodies (PBC-specific, anti-M2 and mixed-form, anti-M4) in serum tested, were studied. Patients were allocated to two groups purely on the basis of the presence or absence of prominent piecemeal necrosis (PN) to elucidate the clinical significance of PN for differentiating mixed forms of chronic active hepatitis and PBC from classical PBC. Histological staging showed 10 stage I and 3 stage II. All cases had histological features of chronic non-suppurative destructive cholangitis. Prominent PN was encountered in 8 and bridging hepatic necrosis in 6. Granulomas were present in all cases without PN, but only in 3 of 8 cases with PN. Antimitochondrial antibody (AMA) was positive in all cases and anti-M2 was also positive in all but one. On the contrary, anti-M4 was positive in 2. Both anti-M2 and anti-M4 were simultaneously positive in 2, of which PN was present in only one. Therefore, anti-M4 did not relate to the presence or morphological severity of PN in PBC. Simultaneous increases in IgG and IgM were prominent features in PBC with PN. PMID- 2707552 TI - Ultrastructural identification and clinical significance of light microscopic giant mitochondria in alcoholic liver injuries. AB - The identification and clinical significance of light microscopic giant mitochondria (GM) were investigated in liver biopsy specimens of 60 alcoholics. By light microscopic examinations using the same section and neighboring sections, we suggest that light microscopic GM correspond to the crystalloid bodies (CB) detected on ultrastructural observation. The reasons are as follows: (1) difference in stainability between eosinophilic light microscopic GM and acidbasophilic mitochondria; (2) similarity in morphological features and density of the round- and cigar-shaped types at the light microscopic level to those of CB at the electron microscopic level; (3) similarity of the area occupied in the hepatic cytoplasm at both light and electron microscopic levels; (4) the crystalline structure of CB in compatible with the subtype of Mallory body (MB); (5) a description of CB has been made at the electron microscopic level, although not yet at the light microscopic level. Moreover, we clinically observed that light microscopic GM seldom appeared either in early fatty liver of cases aged 35 or less or the late macronodular liver cirrhosis stage of alcoholic liver injuries while they were frequently recognized during the acute aggravation phase of the chronic stage (GPT: p less than 0.05). Furthermore, if one was to assume that MB is a change accompanying necrosis of the liver cells, the light microscopic GM might be a change accompanying degeneration of the cytoplasmic organelles. PMID- 2707553 TI - Experimental detachment of the canine bile duct to evaluate mechanisms of the dilated bile duct. AB - The factors inducing biliary dilatation were studied morphologically and functionally by cholangiography and cholangiomanometry in experimental models of chronic biliary dilatation. These models were produced by four methods: Constriction of the lower bile duct (Group 1), formalin infusion into the duodenal papilla (Group 2), detachment of the extrahepatic bile duct (Group 3), and sphincterotomy (Group 4). Biliary dilatation was observed in the first three groups but not in the fourth group. An increase in the intraductal pressure due to blockage of the biliary outflow tract was considered to be the cause of biliary dilatation in Group 1 and 2. In Group 3, the function of the lower bile duct, including the papilla was intact, and reduced resistance of the bile duct wall and due to the loss of the support from the surrounding connective tissue was considered to have induced biliary dilatation. These results suggest that experimental chronic biliary dilatation can be produced by two approaches: 1) Blockage of bile flow in the papilla or the bile duct, and 2) detachment of the bile duct without disturbing bile flow. PMID- 2707554 TI - Drug-induced mononucleosis-like hepatic injury in a patient with systemic lupus erythematosus. AB - A case of systemic lupus erythematosus (SLE) with mononucleosis-like hepatic injury was described. An emergent cesarean section was performed in a 25 yr-old house wife at 34 weeks gestation, followed by administration of several antibiotics. After the surgery she complained of high fever, hepatomegaly and dull right hypochondralgia, and mild liver dysfunction was also found. The liver biopsy showed prominent mononuclear cell infiltration in the sinusoids with minimum hepatocellular necrosis and mild triaditis, resembling hepatic lesion in infectious mononucleosis (mononucleosis-like injury). There were no clinical and serological features suggestive of infectious mononucleosis. This hepatic lesion was thought to be a manifestation of allergic reaction to drugs to which the lymphocyte stimulation test was found to be positive. Immunological abnormalities inherent in SLE might be related to occurrence of such allergic drug reaction. PMID- 2707555 TI - Effect of 15(R)-15-methyl PGE2 (arbaprostil) on duodenal bicarbonate secretion in rat. AB - The present study was designed to observe the effect of 15(R)-15-methyl PGE2 (arbaprostil) on duodenal bicarbonate secretion in male Wistar rats anesthetized with urethane. A proximal duodenal loop (1.5cm) was made and perfused with saline (pH4.5) in an air tight circle system. The pH and Pco2 of the perfusing fluid were measured continuously and the quantity of bicarbonate was calculated according to the Henderson-Hasselbalch equation. Vehicle or arbaprostil was injected intravenously as a bolus injection. The total output of bicarbonate in 30 min was as follows; control: 0.449 +/- 0.093 microEq (mean +/- SE); 1,10 and 100 mu/kg of arbaprostil: 0.752 +/- 0.218, 2.75 +/- 0.430 and 5.958 +/- 0.578 microEq respectively. Arbaprostil (10 and 100 micrograms/kg) increased the total output of bicarbonate significantly (p less than 0.001). The rate of secretion was also increased by arbaprostil. PMID- 2707556 TI - Do mild irritants protect surface epithelial cells of gastric mucosa against ethanol-induced damage in rat? An ultrastructural study of adaptive cytoprotection. PMID- 2707557 TI - Effect of tetraprenylacetone, a novel anti-ulcer agent, on healing process of ethanol-induced gastric injury in rat. PMID- 2707558 TI - Potential role of tumor necrosis factor (TNF) in an experimental model of massive liver necrosis. PMID- 2707559 TI - [Changes in the rheologic properties of erythrocytes in various hematologic diseases]. AB - Some rheological properties of red blood cells were investigated in certain hematological diseases, considering the factors inducing disorders in red blood cell aggregation, deformability and viscosity. It has been shown that these disorders are responsible for increased blood viscosity and microcirculatory disorders in some blood diseases. The changes in red blood cell rheological properties play a significant role in the pathogenesis of thrombohemorrhagic complications in certain hematological diseases. The study of rheological mechanisms regulating blood circulation is necessary for successful development of optimal programs for combined treatment of hematological patients. PMID- 2707560 TI - [Characteristics of the functional status of the liver in hemophilia]. AB - The liver function was studied in 135 patients with severe hemophilia A and B. It has been established that in hemophilia the liver is naturally involved into the pathological process. The liver function disorders are manifested as inflammatory and cytolytic syndromes. The incidence rate and degree of the shifts manifestation correlate with the disease duration. PMID- 2707561 TI - [Thrombotic diseases: their classification and laboratory diagnosis]. PMID- 2707562 TI - [Effect of nucleotide aggregants and anti-aggregants on the coagulation potential of blood plasma]. AB - The authors studied the influence of adenine and pyridine nucleotides on platelet aggregation and on the time of calcium-induced coagulation of citrate plasma, rich or poor in platelets, with deficiency of membrane fragments and its compensation with exogenous small-dispersed tissue thromboplastin. Calcium ions stimulated the conversion of small-dispersed inactive thromboplastin into a larger and more active substance. The antiaggregation agents AMP and NAD+ inhibited inclusion of phospholipid membrane fragments into the process of recalcified plasma coagulation, i.e. expressed an anticoagulant effect, while the aggregation agents (ADP, NADH) intensified their procoagulant action. PMID- 2707563 TI - [The pH of the culture medium as a factor regulating the functional properties of thrombocytes]. AB - Thrombin-induced time-dependent alteration of light-transmission was studied in platelet suspensions with varying pH in calcium-free media, and in the presence of calcium ions. It has been shown that thrombin-induced platelet aggregation and preaggregation stage character are determined by the pH-dependent structural and functional state of the platelet membrane systems. PMID- 2707564 TI - [Hemostatic changes after local exposure to low temperatures (frostbite)]. AB - Hemostatic blood potential was studied in experiments on 400 rats, 25 dogs and in 120 patients, during changes of CNS reactivity after intraventricular injection of reserpine, adrenaline, and irritation of the thalamus ventromedial nucleus (VMN) or its destruction. CNS reactivity in dogs changed after intraarterial injections of acetylcholine, reserpine, heparin and fibrinolysin solutions. It was shown that activation of adrenergic structures of the hypothalamus by intraventricular adrenaline injections, or the hypothalamus VMN irritation, stimulated coagulation and depressed anticoagulation mechanisms of the blood, and increased hemostatic blood potential, that led to rejection of frostbitten tissues. Activation of the hypothalamus cholinergic structures by intraventricular injections of reserpine, destruction of the hypothalamus VMN, and intraarterial injections of acetylcholine, reserpine, heparin, fibrilysin and contrycal mixtures stimulated the blood anticoagulation mechanisms, decreased the hemostatic potential, led to retention of cryodestructed tissues. PMID- 2707565 TI - [Immunocorrective treatment of idiopathic thrombocytopenic purpura by plasmapheresis]. AB - Patients with idiopathic thrombocytopenic purpura (ITP) tolerated well plasmapheresis. In no cases hemorrhage intensification was observed. An immediate clinical effect was recorded in all patients that correlated with the immunological parameters improvement in most of them. The platelet count significantly rose only in one patient immediately after the plasmapheresis course. The follow-up of the patients during 11-20 months has enabled revealing not only immediate clinical but also late hematological effect of plasmapheresis, that was manifest in a delayed rise of the platelet levels in most patients, and abolished resistance to glucocorticoids in one of them. It has been concluded that plasmapheresis produces immunocorrecting effect and could be used for the treatment of ITP patients. PMID- 2707566 TI - Evidence that the Na+-Ca2+ exchange system is related to the antiarrhythmic action of disopyramide. AB - 1. Disopyramide induced a concentration-dependent decrease in action potential amplitude and Vmax, and prolonged action potential durations (APD50 and APD90) in ventricular muscle. 2. Na+-loaded membrane vesicles isolated from canine ventricular muscle rapidly accumulated Ca2+. 3. Monensin (10(-5) M) abolished Na+ dependent Ca2+ uptake, and Na+ enhanced Ca2+ efflux. 4. Na+-Ca2+ exchange by membrane vesicles was more active in preparations pretreated with disopyramide (10(-5) M) than in control membranes. 5. The results suggest that disopyramide changes Na+ influx from Na+ channel mediated to Na+-Ca2+ exchange mediated. This is verified in part by increased Ca2+ efflux. PMID- 2707567 TI - Is metallothionein involved in deposition of cadmium in bile? AB - 1. By use of our metallothionein (Mt) antibody in Western blotting and techniques for investigating protein metal-binding capacity, the form and content of Mt in bile, collected from cadmium (Cd) treated rats, were studied. 2. It was found that bile is an excretory pathway for Mt from the liver. 3. However, only immunoreactive proteins of higher molecular weight, probably representing polymerized forms of Mt or Mt bound to other proteins, were detected. 4. No monomeric Mt was found. 5. Excretion of Mt is probably not of importance in biliary metal transport. PMID- 2707568 TI - Starvation and dehydration: effect on hypothalamic monoamines and serum LH and prolactin. AB - 1. Rats submitted to starvation or water deprivation showed a decrease in LH and prolactin serum levels. 2. 5-HT was increased without changes in DA and NA in cerebral cortex of starved rats. 3. Neurotransmitters did not change in hypothalamus of starved rats but water deprivation decreased NA and increased 5 HT. PMID- 2707569 TI - Sensory nerves and urinary bladder function: effects of diabetes, capsaicin and acrylamide treatment. AB - 1. A comparison was made of the proposed neurotoxic effects of acrylamide, capsaicin, and diabetes on rat urinary bladder pressure responses elicited by infusion of buffer into the organ (distension). 2. Treatment with capsaicin or acrylamide completely abolished the bladder pressure responses. 3. After 4 weeks of diuresis equivalent to that of the diabetic model, the pressure response was markedly diminished compared to control. This response was greatly increased following L-DOPA, which augments the micturition reflex. 4. After 4 weeks of streptozoticin-induced diabetes, the pressure response was slightly diminished compared to control and most closely resembled the response from the diuretic group treated with L-DOPA. PMID- 2707570 TI - Effects of amiodarone on barium-induced automatic activity in guinea pig ventricular muscle. AB - 1. The electrophysiological effects of a potent antiarrhythmic agent, amiodarone, on BaCl2-induced automaticity of guinea pig ventricular papillary muscle were studied by means of conventional microelectrode techniques. 2. BaCl2 (5 x 10(-4) M) depolarized the maximum diastolic potential of muscle preparation to about -62 mV and induced the spontaneous activity at rate of about 62 beats/min. 3. The application of amiodarone (4.4 x 10(-5) M to 1.1 x 10(-3) M) to the BaCl2-induced automatic muscle fibers decreased the spontaneous rate and slope of slow diastolic depolarization in a dose-dependent manner, associated with insignificant changes in action potential duration. 4. Amiodarone may exert the inhibitory effects of BaCl2-induced automaticity by decreasing steady-state conductance for the Na+ and Ca2+, probably thereby permitting the manifestation of antiarrhythmic properties in combination of its other actions. PMID- 2707571 TI - Diminished hypotensive response to isoproterenol in streptozotocin-diabetic rats. AB - 1. The cardiovascular reactivity of streptozotocin-diabetic rats has been evaluated with isoproterenol (ISO), a strong beta-adrenergic agonist able to produce, at large dose, myocardial infarction. 2. In the basal state, diabetic rats presented significantly lower heart rate (P less than 0.001), a decreased systolic (P less than 0.05) and an unaltered diastolic blood pressure compared to non-diabetics. 3. Following ISO stimulation, the chronotropic response was similar in both groups of rats, while the fall in systolic and diastolic pressure was markedly reduced compared to those of non-diabetic rats (P less than 0.001). 4. These results suggest that the vasodilation capacity of diabetic rats is diminished. PMID- 2707572 TI - Effects of centrally acting muscle relaxants on post-rotatory nystagmus in the rabbit. AB - 1. The effects of some centrally acting muscle relaxants on the post-rotatory nystagmus induced by rotatory stimulation were investigated in the rabbit, to examine the action of the drugs on vestibular function. 2. Tolperisone-HCl (5-10 mg/kg, i.v.) and baclofen (1-3 mg/kg, i.v.) decreased the number of post-rotatory nystagmus beats dose-dependently, whereas mephenesin (40-80 mg/kg, i.v.) and diazepam (0.5-1.0 mg/kg, i.v.) prolonged it dose-dependently. 3. The inhibitory effects of tolperisone-HCl and baclofen may provide some suggestions as to the mechanisms and sites of actions of centrally acting muscle relaxants, while the significance of the prolonging action of mephenesin remains unclear. 4. The prolonging action of diazepam is discussed with reference to GABAergic mechanisms. PMID- 2707573 TI - Proline and proline derivatives as anticonvulsants. AB - 1. The anticonvulsant properties of L-proline, of proline derivatives (trans-4 hydroxy-L-proline, cis-4-hydroxy-D-proline, 3,4-dehydro-D,L-proline) and of D- and L-pipecolic acid were studied alone and in combination with vigabatrin (R/S-4 aminohex-5-enoic acid). 3-Mercaptopropionic acid and pentylenetetrazol-induced convulsions in mice were used as animal models of epilepsy. 2. Proline and proline derivatives are weak anticonvulsants if given alone in doses up to 10 mmol/kg, however, they are capable of potentiating the anticonvulsant effects of vigabatrin, in a manner similar to that reported previously for glycine, and some glycine derivatives. Among the compounds tested, trans-4-hydroxy-L-proline was the most potent anticonvulsant in combination with the indirect GABA agonist vigabatrin. 3. A potential explanation for the synergistic anticonvulsant effect of the combination of the GABA agonist and proline is the presumed role of proline as inhibitory neurotransmitter, and/or its glutamate antagonistic effects. 4. The current study points out the lack of basic knowledge on the neurochemistry and pharmacology of proline and hydroxyproline. PMID- 2707574 TI - Possible subtypes of ATP receptor producing contraction of rat vas deferens, revealed by cross-desensitisation. AB - 1. Adenosine triphosphate (ATP), alpha beta-methylene ATP and the dinucleotides P1P4diadenosine tetraphosphate (AP4A) and P1P5-diadenosine pentaphosphate (AP5A) have been applied to preparations of the rat vas deferens in vitro in preliminary experiments designed to assess the feasibility of using such nucleotides to detect subtypes of the ATP receptor causing smooth muscle contractions. 2. Desensitisation to the dinucleotides induced a change in the profile of the response to ATP with the preferential loss of an early transient component. 3. Desensitisation to low concentrations of alpha beta-methylene ATP produced a greater loss of the later, slower component of contraction to ATP. 4. It is suggested that these components may therefore involve pharmacologically distinguishable nucleotide receptors. PMID- 2707575 TI - Do differences in innervation result in different post-synaptic responses to exogenous agonists? AB - 1. The pharmacological reactivity of the epididymal and prostatic portions of the rat vas deferens to BaCl2, phenylephrine and carbachol were recorded by isometric and isotonic technique. 2. The maximum response induced by the three agonists were similar at the epidiymal end, while at the prostatic portion phenylephrine produced a response 80% lower than that of barium and carbachol. 3. The pD2 value to agonists and the sensitivity to calcium channel blockers were lower at the prostatic end. 4. The data suggest that not only the pharmacological reactivity of the prostatic and epididymal portions differs, but also that the activity of the prostatic portion is much more reduced to alpha 1-agonists. PMID- 2707576 TI - Interaction between noradrenaline and diltiazem in rat isolated atria. AB - 1. The present study describes the effects of diltiazem (DIL) on noradrenaline (NA) activity in the isolated right atria of the rat. 2. Interactions between DIL and NA showed that DIL significantly shifted the concentration-response curve of NA to the right in a concentration-dependent manner. 3. The antagonist between DIL and NA is not consistent with a competitive antagonist since the slope is significantly lower than the unity. 4. A high calcium solution (4.5 mM) significantly increased the chronotropic effects of noradrenaline. 5. These results suggest that influx of calcium through calcium antagonist sensitive channels may be involved in linking of chronotropic responses to activation of alpha 1-adrenoceptors. PMID- 2707577 TI - Electrophysiological effects of lidocaine on isolated guinea pig Purkinje fibers: comparison with its effects on papillary muscle. AB - 1. The effects of lidocaine on action potentials of isolated guinea pig Purkinje fibers were examined and compared with those on the papillary muscle, by use of conventional microelectrode techniques. 2. Lidocaine 2.1 x 10(-4) M significantly depressed the resting membrane potential, amplitude, overshoot, maximum upstroke velocity, and duration of action potential of the Purkinje fibers stimulated at cycle length (CL) 1 sec, while the lower concentration (2.1 x 10(-5) M) produced no significant effect. 3. Various parameters of action potentials from the papillary muscle at CL = 1 sec were also depressed by lidocaine 2.1 x 10(-4) M, but the extent of the depression was less marked than in Purkinje fibers. 4. When the Purkinje fibers were stimulated at various CLs (0.3-10 sec), the shortening of action potential duration induced by lidocaine was more evident at slower stimulus rate. PMID- 2707578 TI - Influence of splanchnic nerve on reserpine action in avian adrenal medulla. AB - Reserpine at three doses (0.05, 0.2, and 0.8 mg/100 g body wt) has been injected intraperitoneally to seven unilaterally splanchnic denervated avian species, in order to ascertain the neural regulation of its action in avian adrenal medulla. The adrenomedullary catecholamines (CA) were estimated at 24 hr after reserpine injection. The findings revealed that reserpine at high doses caused 66-92% depletion of total CA from both the innervated and the denervated glands in all the species investigated. The low dose of reserpine in the passerine (common myna and bulbul) birds resulted in 40-84% reduction of both norepinephrine (NE) and epinephrine (E) from the adrenal glands irrespective of its nerve supply. As a contrast, it depleted 60-80% of both NE and E from the innervated glands as compared to 17-43% reduction from the denervated glands in nonpasserine (woodpecker, parakeet, and koel) birds. Interestingly, in other nonpasserine (pigeon and duck) birds, the low dose of reserpine depleted 66-71% of NE from the innervated glands as compared to only 2-13% reduction from the denervated glands. But in these birds, 60-85% depletion of E, however, occurred independent of neural regulation. The findings suggest that at high doses depletion of CA by reserpine is controlled by some nonneurogenic mechanisms. Generally speaking, at a low dose of reserpine, the splanchnic nerve probably modulates depletion of CA from the adrenal medulla of the nonpasserine birds while the same is governed by some nonneurogenic mechanisms in the passerine birds. PMID- 2707579 TI - 20-Hydroxyecdysone acts in the male pupa to commit accessory glands toward trehalase production in the adult mealworm beetle (Tenebrio molitor). AB - During postecdysial adult maturation, the bean-shaped accessory reproductive glands (BAGs) of adult male mealworm beetles produce increasing amounts of trehalase. In order to determine when the BAGs become competent to produce trehalase, we transplanted pupal BAGs into 0-day female adults. After 8 days, trehalase activity had increased in BAGs from 4- and 5-day pupae (at the time of the pupal ecdysteroid peak) but not in those from 1- and 2-day pupae (before the ecdysteroid peak). BAGs from 0- and 2-day pupae were exposed to 20 hydroxyecdysone in vitro before implantation into 0-day female adults. Increase in trehalase activity was dose dependent. Both dose (ED50, 5 x 10(-6) M) and exposure time (greater than 6 hr) of hormone required are greater for commitment than for acceleration of pupal cell cycling (T. Yaginuma, H. Kai, and G.M. Happ, 1988, Dev. Biol. 126, 173-181). Since trehalase activity increased markedly in isolated adult male abdomens, factors from the cephalic and thoracic centers are not required to sustain trehalase production in the adult BAGs. PMID- 2707580 TI - Effects of vertebrate prolactins and growth hormones on thyroxine 5' monodeiodination in the eel (Anguilla anguilla): a potential bioassay for growth hormone. AB - Growth hormones (GHs) and prolactins (Prls) purified from representatives of each vertebrate class from bony fish onwards were tested for their ability to stimulate in vivo peripheral deiodination of labeled thyroxine (T4*) into triiodo L-thyronine (T3*) in the eel. Plasma T3*/T4* ratio was used as parameter. All GHs significantly increased T3*/T4*, the magnitude of the response being unrelated to the phylogenic position of species. No significant stimulation was shown with the various Prl, with the exception of ovine Prl, suggesting a heterosomatotropic effect of this preparation in the eel. Furthermore, both tilapia and ovine GH produced a dose-related effect on plasma T3*, T4*, and T3*/T4*. The stimulation of the peripheral deiodination of T4* into T3* estimated in vivo in the eel could become a specific, sensitive, and rapid fish bioassay for GH. PMID- 2707581 TI - Induction of cloacal and dermal skin glands of tiger salamander larvae, (Ambystoma tigrinum): effects of testosterone and prolactin. AB - Treatment of male and female tiger salamander larvae with testosterone (0.3 micrograms/g body weight/day) induced precocious formation of ventral cloacal glands and stimulated proliferation and differentiation of mucous and granular (serous) glands in the ventral dermis of the skin. Lower doses of testosterone produced no visible glandular effects but did cause hyperemia and edema in the cloacal region. Prolactin (0.5 micrograms/g body weight/day) enhanced the action of testosterone on the cloacal glands, increasing both the amount of gland induced and the degree of glandular secretion. There was no apparent effect of prolactin alone on cloacal glands or any effect of prolactin with or without testosterone on the dermal glands. The possible homology of the amphibian ventral cloacal gland to the mammalian prostate gland is discussed. PMID- 2707582 TI - Increased levels of arginine vasotocin and neurophysin during nesting in sea turtles. AB - Arginine vasotocin (AVT) and neurophysin (NP) levels were measured by radioimmunoassay in two species of sea turtle, the olive ridley, Lepidochelys olivacea, and the loggerhead, Caretta caretta, during the brief period of nesting and oviposition. In both species, AVT was low in animals which were not reproductively active. AVT was also low at the time animals emerged from the surf to nest, but increased significantly during oviposition and then declined as the animals returned to the water. NP increased in concert with AVT, also reaching highest levels during oviposition. In both species, however, NP levels remained elevated over prenesting levels at the time of return to the water. These findings are consistent with the hypothesis that an AVT-neurophysin complex is released from the neurohypophysis during nesting, and that AVT is a physiological regulator of oviducal contractions in sea turtles. PMID- 2707583 TI - The complete amino acid sequence of growth hormone from the sea turtle (Chelonia mydas). AB - The complete amino acid sequence of growth hormone (GH) from a reptilian species (the sea turtle, Chelonia mydas) has been determined for the first time. The hormone was reduced, carboxymethylated, and subsequently cleaved in turn with cyanogen bromide and Staphylococcus aureus protease. The intact protein was also cleaved with lysyl endopeptidase and o-iodosobenzoic acid. The resulting fragments were exclusively separated by reversed-phase high-performance liquid chromatography and subjected to sequence analysis by automated gas-phase sequencer employing the Edman method. The sea turtle GH consist of 190 amino acid residues with two disulfide linkages formed between residues 52-160 and 180-188, and possesses a microheterogeneity, indicated by the presence or absence of an additional alanine residue at the N-terminus. Sequence identities of sea turtle GH to other species of GH are 89% with chicken GH, 79% with rat GH, 68% with blue shark GH, 58% with eel GH, 59% with human GH, and 40% with a teleostean GH such as chum salmon. On the basis of amino acid sequence comparisons, a molecular phylogenetic tree is proposed. PMID- 2707584 TI - The complete amino acid sequence of growth hormone of an elasmobranch, the blue shark (Prionace glauca). AB - The complete amino acid sequence of growth hormone (GH) from a phylogenetically ancient fish, the blue shark (Prionace glauca), was determined. The shark GH isolated from pituitary glands by U. J. Lewis, R. N. P. Singh, B. K. Seavey, R. Lasker, and G. E. Pickford (1972, Fish. Bull. 70, 933-939) was purified by reversed-phase high-performance liquid chromatography. The hormone was reduced, carboxymethylated, and subsequently cleaved in turn with cyanogen bromide and Staphylococcus aureus protease. The intact protein was also cleaved with lysyl endopeptidase and o-iodosobenzoic acid. The resulting peptide fragments were separated by rpHPLC and submitted to sequence analysis by automated and manual Edman methods. The shark GH consists of 183 amino acid residues with a calculated molecular weight of 21,081. Sequence comparisons revealed that the elasmobranch GH is considerably more similar to tetrapod GHs (e.g., 68% identity with sea turtle GH, 63% with chicken GH, and 58% with ovine GH) than teleostean GHs (e.g., 38% identities with salmon GH and 42% with bonito GH) except for eel GH (61% identity), and substantiates the earlier finding derived from the immunochemical and biological studies (Hayashida and Lewis, 1978) that the primitive fish are less diverged from the main line of vertebrate evolution leading to the tetrapod than are the modern bony fish. PMID- 2707585 TI - Isolation and characterization of growth hormone from Atlantic cod (Gadus morhua). AB - Growth hormone was purified from cod pituitary extract by a simple two-step procedure involving gel filtration and reversed-phase high-performance liquid chromatography (rpHPLC). At each stage of purification, fractions were monitored by rpHPLC, SDS-polyacrylamide gel electrophoresis, and immunoblotting using anti chum salmon growth hormone (GH) antiserum. The yield of purified hormone was 1.3 mg/g pituitary. Cod GH was found to exist in two monomeric forms (Mr = 20K and 22K) and dimeric forms (Mr = 40K and 42K). The two monomeric forms have a pI of 5.8, an identical amino acid composition, histidine as the N-terminal residue, and an identical lysyl endopeptidase peptide map. Staining with concanavalin A was observed on the 20K component only, but analysis for total reducing sugar did not confirm these results. Cod GH was found to be a potent stimulator of growth in juvenile rainbow trout which received intraperitoneal injections of the hormone. The partial amino acid sequence has been determined. PMID- 2707586 TI - Pineal and ocular influences on male and female turkeys: plasma luteinizing hormone and prolactin levels during gonadal development. AB - Plasma levels of prolactin (PRL) and luteinizing hormone (LH) were determined in pinealectomized (PX) and/or bilateral ocular enucleated (EX) turkey hens and toms during gonadal development. Measurements were obtained weekly for 6 weeks following photo-induced ovarian recrudescence in adult hens and biweekly from 12 to 34 weeks of age in sexually developing toms. Both hens and toms were maintained on a photoperiod of 16L:8D. Plasma PRL levels were significantly correlated with time (P less than 0.01) and were linear with significant slopes (P less than 0.01) in all treatment groups of hens and toms. However, the regression coefficients were positive for the hens and negative for the toms. Both PX and EX reduced PRL levels in the hens. PX did not significantly affect PRL levels of toms but EX depressed PRL levels. In hens LH was not correlated with weeks of photostimulation but in toms LH was positively correlated to age and linear with significant slopes in all treatment groups. There were no significant treatment effects on plasma LH levels of hens or toms. It was concluded that neither the pineal gland nor the eyes affect plasma LH levels of male turkeys during testicular development or female turkeys during photostimulated ovarian recrudescence. Although the eyes affected plasma PRL of both males and females during gonadal development, the pineal only influenced female PRL levels. PMID- 2707587 TI - Localization and characterization of prolactin-like immunoreactivity in the pituitary of the frog Rana ridibunda. AB - Distribution and quantification of PRL in the pituitary gland of the frog Rana ridibunda were investigated using a high-affinity antiserum raised against bullfrog prolactin (PRL). The immunoreactive PRL-producing cells were distributed throughout the pars distalis, the highest density of cells being observed in the rostral region of the adenohypophysis facing the neurointermediate lobe. The dorsal region of the pars distalis contained only a few scattered PRL immunoreactive cells. At the electron microscopic level, PRL-containing cells were visualized using the immunogold procedure. PRL-immunoreactive material was exclusively stored in secretory granules (size ranging from 200 to 700 nm in diameter). Neither the rough endoplasmic reticulum nor the Golgi apparatus were immunolabeled. Using a radioimmunoassay method we have compared the displacement curves obtained with bullfrog PRL and acetic extracts from Rana ridibunda pituitary. The two binding curves were not completely parallel, suggesting the existence of slight variations of the amino acid sequences of PRL in the two species. The concentration of PRL in the green frog adenohypophysis appeared somewhat higher (35.3 +/- 8.8 micrograms/mg protein) than that in the bullfrog pituitary. These results validate the use of an antiserum to bullfrog PRL to investigate the regulation of PRL secretion in Rana ridibunda. PMID- 2707588 TI - Interview assessment of critically Ill patients regarding resuscitation decisions. A case study in ethics research. AB - To examine how patients perceive and decide their resuscitation status, we monitored 113 admissions to a coronary care unit. We review the research process, including Institutional Review Board concerns, sampling bias and permission by physicians, informed consent, and the patient interview. In-depth psychiatric interviews on 16 patients demonstrated marked misperceptions about resuscitation procedures. Although standardized psychologic measures indicated distress in some of these critically ill patients, the interview itself induced no detected untoward physiologic or emotional reactions. This pilot study demonstrates the feasibility of assessing patients regarding resuscitation status and also identifies relevant methodologic problems to guide future research of resuscitation decision-making. PMID- 2707589 TI - Occupational therapy program development for medical-psychiatry units: a cognitive model. AB - Occupational therapy programs form an essential component of the overall treatment program on medical psychiatry units for patients with depression, physical debilitation, and cognitive dysfunction. This article outlines theoretical and practical aspects of developing an occupational therapy program for medical-psychiatric inpatients. Emphasis is placed on accurate assessment of cognitive and physical functioning to facilitate stratification of patients into appropriate therapeutic activities that are commensurate with their level of functioning. The theoretical basis and orientation of occupational therapy is also discussed vis-a-vis its relevance to the treatment of patients with concurrent medical and psychiatric illness. PMID- 2707590 TI - Nursing staff development and facility design for medical-psychiatry units. AB - Successful operation of a medical-psychiatry unit requires special considerations in nursing staff development and facility design. This article will discuss in detail issues related to the selection, training, and development of a medical psychiatry unit nursing staff. Organizational details regarding establishing schedules and staffing patterns are examined in detail. Additional areas reviewed are special adaptations in the architectural and physical facility design as well as the medications, equipment, and supplies needed to provide optimal medical and nursing care to the medical-psychiatric patient population. The essential diagnostic and clinical services that should be available for patients on a medical psychiatry unit are also defined. PMID- 2707591 TI - A suicide attempt following removal of conversion paralysis with amobarbital. PMID- 2707592 TI - An evaluation of patients who received an organic mental disorder diagnosis on a psychiatric consultation-liaison service. AB - The authors conducted comprehensive medical record reviews of 100 medical and surgical patients who received an organic mental disorder diagnosis by the Psychiatry Consultation-Liaison (C/L) Service of a large teaching hospital. The cases were randomly selected from among 182 patients with an organic mental disorder diagnosis, who, in turn, were drawn from 1085 consecutive psychiatric consultations conducted during a 1-year period. Dementia (34%) and delirium (32%) constituted the most common diagnoses. Approximately 78% of the patients were noted to have laboratory abnormalities (2.7 per patient), three quarters of which were routine tests. The mean age of patients without laboratory abnormalities (47.6 years) was 15 years younger than those with abnormal findings (62.6 years). The patients averaged 5.7 medications, with delirious patients averaging 7 medications and those with dementia, 4.5, a statistically significant difference. Patients with no laboratory abnormalities were receiving less medication (2.6) than those with abnormalities (6.5). PMID- 2707593 TI - Psychiatric consultation on an otolaryngology liaison service. AB - Otolaryngology patients (especially those with tracheostomies) present a significant challenge to psychiatrists from both a diagnostic and therapeutic standpoint. To date, no study has been made of psychiatric disorders among this important group of patients. At the Mount Sinai Medical Center, a liaison psychiatrist has been involved with a specialized otolaryngology cluster unit since 1979. Using a 384-item computerized database protocol developed at Mount Sinai, data on 139 otolaryngology patients were recorded and compared with 1662 "Other" inpatient psychiatric consultations on the medical and surgical services during 1980-1987. The otolaryngology patients as a group were more likely to be male (p = 0.011), married (p = 0.001) and employed (p less than 0.001). Cancer was the most common medical disorder, and the average level of stress as reported on DSM-III's Axis IV (5.1, severe) was significantly greater (p less than 0.0001) than that for the "Other." The most common psychiatric response was adjustment disorder (36%). The length of stay of those ENT patients seen in psychiatric consultation was 26.4 days, in contrast to 11.1 days for all ENT patients. However, the length of stay of those patients on ENT receiving a psychiatric consultation was not different from the "Other" psychiatric consultation cohort (26.3 days). Despite the higher level of stress, the incidence of significant psychiatric morbidity was lower for the ENT cohort. The primary effect of the liaison psychiatrist was to lower the threshold for case identification that enhanced the referral rate on the ENT unit. PMID- 2707594 TI - Incontinence management: in praise of sheaths. PMID- 2707595 TI - Child's play. PMID- 2707596 TI - A sense of freedom. Interview by Steve Wright. PMID- 2707597 TI - Drugs and the elderly: an end to isolation. PMID- 2707598 TI - Ageism--an old problem. PMID- 2707599 TI - Promoting continence--continence advice. PMID- 2707600 TI - Continuing care--collective security. PMID- 2707601 TI - A rich situation. PMID- 2707602 TI - Molecular analysis of the armadillo locus: uniformly distributed transcripts and a protein with novel internal repeats are associated with a Drosophila segment polarity gene. AB - During Drosophila embryogenesis, the segment polarity genes are required for the formation of specific pattern domains within each segment. Mutations in the armadillo (arm) gene primarily affect the posterior part of the segment and lead to the production of anterior structures within this region. To examine the molecular basis for these effects, we have cloned the arm region and identified the gene by germ-line transformation. The arm gene produces two types of very abundant 3.2-kb transcripts that differ only in their first exons. These RNAs appear to be formed by independent transcriptional initiation but have similar patterns of expression throughout development. Both arm transcripts are present in virtually all of the cell types contained in embryos, third-instar larvae, and adult ovaries, suggesting that arm may be required in all cells. In addition, the arm transcripts are uniformly distributed in embryonic segments, so the regional pattern defects associated with its embryonic phenotype may result from interactions between arm and other localized factors. Both arm RNAs encode the same 91-kD polypeptide. This protein has no probable secretory or membrane spanning regions and contains a series of novel internal repeats that are conserved in sequence, length, and spacing. Considering these results and previous genetic observations, we discuss potential roles for the arm gene in pattern formation processes. PMID- 2707603 TI - [Practice of hygienic standardization of industrial allergens in the air of the work area and ways of its improvement]. AB - Proceeding from the results of 8-year practical experience in hygienic standardization of industrial allergens (IA) in the workplace air it is pointed out that only substances for which sensitizing effect is a limiting criterion should be regarded as IA. It is demonstrated that IA are attributed to different hazardous classes according to which differential selection of safety factor is recommended. Highlighted is the necessity of developing new methods of IA hygienic standardization. PMID- 2707604 TI - [Tuberculin-cytochemical test in the differential diagnosis of silicosis and silicotuberculosis with intrathoracic adenopathy]. AB - Cytochemical tuberculin-associated shifts along with their prognostic evaluation were studied in 30 patients with silicosis and silicotuberculosis with intrathoracic adenopathy. The study revealed that a decrease of alkaline phosphatase activity of neutrophils, alpha-glycerophosphate dehydrogenase and succinate dehydrogenase lymphocytes could serve as an early indicator of tuberculosis process in the pulmonary tissue and intrathoracic lymph nodes. PMID- 2707605 TI - [Microbial contamination of the work area air at the tricot knitting mills]. AB - The study carried out during cold and warm periods of the year covered 2 knitting mills situated in different regions of Bulgaria. Workplace air microflora was characterized by a higher level of bacterial and fungal contamination during the warm period of the year compared to the cold one. Dust content in the work zone was analogous to that of microorganisms. Disease rate, its dynamics and structure were analyzed in order to determine the impact of air microbiology on workers' health status. PMID- 2707606 TI - [Experimental evaluation of the combined effect of the noise and aerosols in the air of steel mills]. AB - The analysis of 3 chronic experiments on white rats pertaining to the study of the combined effect of noise at 85 and 95 dBA and aerosols containing manganese, chromium, nickel oxides and SiO2 showed that there were noted the effects caused by their combined impact. The shifts were clearly marked in the state of the endocrine and cardiovascular systems. PMID- 2707607 TI - [Pulmonary surfactant system in dust-induced bronchitis]. AB - The study of surfactant effects and their biochemical composition in the expiration condensate covered 102 patients with dust bronchitis (DB). Decrease of surfactant effects and violation of the proportion of surfactant lipid fractions (increase in the percentage of free fat acids, triacylglyceride decrease) were noted along with the growth of DB severity and clearly defined pulmonary emphysema. PMID- 2707608 TI - [Structure and dynamics of systemic organization of the cardiorespiratory function during the adaptation process of miners to occupational factors in deep coal mines]. AB - Characteristics of the systems organization of the cardiorespiratory function were analyzed in miners of different age. The findings were compared to the data on labour turnover, work efficiency and the rate of cardiovascular diseases. It is indicated that an initial adaptation period in deep coal mines was accompanied by the stress of vegetative regulatory mechanisms, significant labour turnover and low work efficiency of miners. The stage of resistant adaptation was characterized by raising functional flexibility, decrease in labour turnover and elevation of the degree of professional work capacity. For miners aged 35 and older the process of systems restructuring of vegetative functions was followed by the decrease in labour efficiency and significant growth of cardiovascular diseases. PMID- 2707609 TI - [Impact of social and health factors in the forecast of work activity of female workers of pre-retirement and retirement age receiving social benefits]. AB - On the basis of a complex social and hygienic study along with the use of modern mathematical statistical methods the role of working and living conditions and health status of female workers having social benefits at chemical fibre production plants was demonstrated within the forecast of their labour activity when retired. Social factors, such as material remuneration and working conditions, were of primary importance in labour forecast for female workers before their retirement. Favourable working conditions and average material security level could ameliorate the labour forecast more than by 4 times. PMID- 2707610 TI - [Maximum allowable concentrations of hazardous substances in the air of work areas approved by the USSR Ministry of Public Health in 1987]. PMID- 2707611 TI - [New health standards for microclimate of industrial premises]. PMID- 2707612 TI - [Improvement of sanitary treatment of overalls of coal miners]. PMID- 2707613 TI - [Characteristics of functional changes in hearing analyzer of coal miners depending on energy and informational parameters of noise]. PMID- 2707615 TI - [Health-related standardization of work effort in operating tractors and agricultural machines]. PMID- 2707614 TI - [Appraisal of fabric and materials used in microorganism-protective overalls]. PMID- 2707616 TI - Reduction potentials of anthelmintic drugs: possible relationship to activity. AB - Electrochemical data were acquired for several categories of anthelmintic agents, namely, iminium-type ions, metal derivatives and chelators, quinones and iminoquinones, and nitroheterocycles. Reductions usually were in the favorable range of +0.2 to -0.7 V versus normal hydrogen electrode. The drug effect is believed to result in part from either the catalytic production of oxidative stress or disruption of helminth electron transport systems. Relevant literature results are discussed. PMID- 2707617 TI - 1,4-Reductive addition of glutathione to quinone epoxides. Mechanistic studies with h.p.l.c. with electrochemical detection under anaerobic and aerobic conditions. Evaluation of chemical reactivity in terms of autoxidation reactions. AB - The nucleophilic addition of GSH to quinonoid compounds, characterized as a 1,4 reductive addition of the Michael type, was studied with p-benzoquinone- and 1,4 naphthoquinone epoxides with different degree of methyl substitution. Identification and evaluation of molecular products from the above reaction were assessed by h.p.l.c. with either reductive or oxidative electrochemical detection, based on the redox properties retained in the molecular products formed. It was found that the degree of methyl substitution of the quinone epoxide, from either the 1,4-naphthoquinone- or p-benzoquinone epoxide series, determined their rate of reaction with GSH. The reductive addition implied the rearrangement of the quinone structure with opening of the epoxide ring yielding as the primary product a hydroxy-glutathionyl substituted adduct of either p benzohydroquinone or 1,4-naphthohydroquinone. The primary product undergoes elimination reactions and redox transitions which bring about a number of secondary molecular products. The distribution pattern of the latter depends on the degree of methyl substitution of the quinone epoxide studied and on the concentration of O2 in the solution. The occurrence of the hydroxy-substituent in position alpha, adjacent to the carbonyl group, enhances the autoxidation properties of the compound resulting in an augmented O2 consumption and H2O2 production. Therefore, it could be expected that the chemical reactivity of the products originating from the thiol-mediated nucleophilic addition to quinone epoxides would be of toxicological interest. PMID- 2707618 TI - Lipid peroxidation in human diseases: evidence of red cell oxidative stress after circulatory shock. AB - Erythrocytes obtained from human patients with circulatory shock of different aetiology consistently showed a strong increase in lipid peroxidation-derived aldehydes in comparison with red cells of normal adults. The highly toxic compound 4-hydroxynonenal has been recovered exclusively in the erythrocytes of the patients. PMID- 2707619 TI - The interactions between MnO2+/Mn3+ complexes and ascorbates. A pulse radiolysis study. AB - The reactivity between various MnO2+/Mn3+ complexes and ascorbic acid/ascorbate were studied using pulse radiolysis. Experimental results indicate that Mn3+ sulfate reacts with both AH2/AH- via metal-ascorbate complexes. MnO2+-formate and Mn3+-pyrophosphate both appear to react by electron transfer with no evidence of complex formation. All of these metal complexes, with the exception of Mn3+ pyrophosphate, react as fast or faster with ascorbate than free O2-. The significance of this observation in light of metal-induced oxygen toxicity will be discussed. PMID- 2707620 TI - Morphologic and functional correlates of plasma membrane injury during oxidant exposure. AB - Plasma membrane injury by exposure to hydrogen peroxide was examined in a renal epithelial cell line (LLC-PK1). Morphologic and functional parameters of plasma membrane integrity were studied in an attempt to eludicate the sequence of membrane alterations during the evolution of hydrogen peroxide-mediated injury. These parameters included plasma membrane potential and permeability, plasma membrane bleb formation, cellular size, and plating efficiency. Plasma membrane potential was the earliest parameter affected by hydrogen peroxide exposure. Half maximal depolarization occurred within 15-30 min of exposure to 1 mM, after 10-15 min exposure to 100 mM and after over 150 min exposure to 10 microM hydrogen peroxide. After exposure to 1 mM hydrogen peroxide, the following sequence of events was seen; increased plasma membrane blebbing (30 min), cell swelling (90 125 min) and increased plasma membrane permeability (150-240 min). After a 30 min exposure to 1 mM hydrogen peroxide, cellular plating efficiency, measured at 24 h, was reduced by 50% (P less than .001). These changes were accelerated, although their order of appearance was unchanged, at higher concentrations of hydrogen peroxide. We conclude that functional and morphologic expressions of cellular injury in this model occur in a defined sequence with plasma membrane depolarization representing the earliest marker of membrane injury during hydrogen peroxide exposure. PMID- 2707621 TI - Free radical pathology in chronic arterial disease. AB - The generation of toxic oxygen metabolites is more usually associated with inflammation. However, pathological free radical reactions can cause tissue damage by adversely affecting prostacyclin (PGI2) synthesis allowing initiation of coagulation. We have assessed changes in the red cell defence to toxic oxygen metabolite generation, viz measurement of glutathione concentration (GSH) and superoxide dismutase activity (SOD). GSH and SOD were measured in 20 patients with peripheral arterial disease, 22 patients with vasculitis, and 11 patients with angina, and compared to 17 matched controls. The 53 subjects with arterial disease had significantly lower SOD levels: in contrast GSH levels were significantly higher. Extracellularly plasma thiol levels (PSH) were low and caeruloplasmin (Cp) levels were high. We suggest that free radical pathology exists not only in inflammatory vascular disease but also in atherosclerosis. PMID- 2707622 TI - Oxidative damage and the preservation of organic artefacts. AB - Organic artefacts degrade by a number of mechanisms. Autoxidation is one of the most important and involves free radicals. The importance of free radical reactions in the degradation of paper and other cellulosic materials, rubber and other organics is described. In the case of paper, treatment with calcium and magnesium compounds can inhibit oxidation, while transition metals increase the rate. Antioxidants have not been used a great deal due to unwanted side effects. The Russell effect, a technique for detecting oxidation using photographic materials, is described. PMID- 2707623 TI - Increased hepatic lipid peroxidation with methionine toxicity in the rat. AB - Consumption of excess methionine by rats is known to cause membrane damage, liver enlargement and accumulation of iron in the spleen. In this study two groups (n = 5) of male, Wistar rats were pair-fed either a methionine supplemented (20.0 g/kg) or control (2.0 g/kg) diet for 7 weeks. Hepatic and erythrocyte copper-zinc superoxide dismutase activities were significantly reduced (P less than 0.05 and P less than 0.001 respectively) by methionine supplementation while the activities of catalase (P less than 0.01 and 0.05) and glutathione peroxidase (P less than 0.05) were significantly increased. Methionine supplementation also increased hepatic lipid peroxidation (P less than 0.01), as measured by the level of thiobarbituric acid reactive substances, and iron (P less than 0.001) concentrations. These changes are indicative of increased oxidative stress resulting from methionine toxicity. PMID- 2707624 TI - Lipoprotein oxidation and induction of ferroxidase activity in stored human extracellular fluids. AB - It was observed that during the storage of human extracellular fluids at -20 degrees C the azide-inhibitable ferroxidase activity of caeruloplasmin declined, whilst a new azide-resistant ferroxidase activity (ARFA) developed. The literature suggested that storage-induced ARFA might be due to either a poorly defined enzymatic activity of a low density lipoprotein (LDL) or to lipid peroxides formed within the different lipoprotein fractions. To study this further, the major lipoprotein classes were separated from human serum by density gradient centrifugation. After storage of the lipoprotein fractions, it was found that the LDL fraction had the highest specific activity of ARFA and the highest content of lipid peroxidation products, as assessed by diene conjugates. The ARFA of LDL correlated with its content of diene conjugates and TBA reactive material, which initially suggested that the Fe(II) oxidising activity of peroxidase LDL arose from the reduction of peroxides by Fe(II) in the classical reaction between the metal ion and free radical reduction of lipid peroxides. However, steady state kinetic analysis indicated an enzymic role of LDL in Fe(II) oxidation, with lipid peroxides acting as a substrate for the enzyme. These results indicate that LDL may contain a peroxidase activity, catalysing the oxidation of Fe(II) by lipid peroxides, as well as a ferrous oxidase activity where O2 is the oxidising substrate. PMID- 2707625 TI - Oxygen toxicity. The influence of adenine-nucleotides and phosphate on Fe2+ autoxidation. AB - FeCl2 in Na phosphate buffer autoxidizes forming active oxygen species which damage deoxyribose. Di- and triphosphate adenine-nucleotides inhibit both Fe2+ autoxidation and deoxyribose damage in Na phosphate buffer pH 7.4. The inhibition is related to the number of charges of the adenine-nucleotide molecule: ATP at pH 7.4 is a better inhibitor than ADP; at a pH (6.5) close to the pK's of the third and fourth charge of ADP and ATP, ADP inhibition is greatly decreased whereas ATP inhibition is slightly affected. The extent of ATP inhibition of Fe2+ autoxidation depends both on ATP/Mg2+ and ATP/Fe2+ ratios in the reaction mixture. Formation of a Fe2+-nucleotide complex appears to be the mechanism through which ATP and ADP inhibit autoxidation and thus the generation of active oxygen species. These findings are discussed in relation to physiological and pathological fluctuations of nucleotide concentrations. PMID- 2707626 TI - Lipid peroxidation. Definition of experimental conditions for selective study of the propagation and termination phases. AB - To find experimental conditions to selectively study the propagation phase of lipoperoxidation we studied the lipoperoxidation, catalyzed by FeCl2, of liposomes in a buffering condition where Fe2+ autoxidation and oxygen active species generation does not occur. Liposomes from egg yolk phosphatidylcholine, prepared by vortex mixing, do not oxidize Fe2+; on the contrary they oxidize Fe2+ when prepared by ultrasonic irradiation. Dimyristoyl phosphatidylcholine liposomes prepared by ultrasonic irradiation do not oxidize Fe2+. During sonication polyunsaturated fatty acid residues autoxidize and lipid hydroperoxides (LOOH) are generated. Only when LOOH are present in the liposomes Fe2+ oxidizes and its rate of oxidation depends on the amount of LOOH in the assay. The reaction results in the generation of both LOOH and thiobarbituric acid reactive material (TBAR); it is inhibited by butylated hydroxytoluene and has a acidic pH optimum; it is not inhibited by catalase and OH scavengers. The reaction studied, thus, appears to be the chain branching and propagation phase of lipoperoxidation. When we studied the dependence of Fe2+ oxidation, LOOH and TBAR generation on FeCl2 concentration, we observed that at high FeCl2 concentrations the termination phase of lipoperoxidation was prevalent. Thus, by selecting the appropriate FeCl2 concentration the proposed experimental system allows study of either the propagation or the termination phase of lipoperoxidation. PMID- 2707627 TI - Cysteine and crocin oxidation catalyzed by horseradish peroxidase. AB - The amino acid cysteine is oxidized by horseradish peroxidase, and the water soluble carotenoid crocin is bleached by cooxidation. The monophenol p hydroxyacetophenone stimulates oxygen uptake, cysteine oxidation and crocin bleaching, whereas its concentration does not change. Superoxide dismutase significantly enhances all these oxidative reactions. Addition of H2O2 is not required for these peroxidase-catalyzed oxidations. PMID- 2707628 TI - The effects of iron-mediated oxidative stress in isolated renal cortical brush border membrane vesicles at normothermic and hypothermic temperatures. AB - Experiments on renal cortical brush border membrane vesicles have been undertaken in order to assess the involvement of iron in oxidative stress at physiological temperatures and under conditions of hypothermia. A decrease in temperature stimulated iron-induced lipid peroxidation. The results are discussed in relation to the role of the oxidation state of the iron and iron(II)/iron(III) ratios in the initiation of peroxidative events. PMID- 2707629 TI - Measurement by HPLC of desferrioxamine-available iron in rabbit kidneys to assess the effect of ischaemia on the distribution of iron within the total pool. AB - A method for the determination of desferrioxamine-available iron in tissue fractions is described which involves incubation with desferrioxamine, extraction of desferrioxamine and its iron-bound form, ferrioxamine, and quantitation of these two forms of the drug by reversed-phase hplc analysis. Chelatable iron levels in the 1-10 microMolar region could be accurately and reproducibly measured using this technique. The desferrioxamine-available iron levels in both the cortex and medulla of rabbit kidneys were significantly elevated (up to 2 fold) after the organs had been subjected to 2 hours warm ischaemia or 24 hours cold storage at 0 degrees C in hypertonic citrate solution. There was no change in the total iron content of the tissues under these circumstances and thus a redistribution of intracellular iron to more available pools had presumably taken place as a result of ischaemia. This redistribution of iron may be an important factor in the initiation of peroxidative damage to cell membranes upon reperfusion of the organ with oxygen. PMID- 2707630 TI - Acid perfusion test: does it have a role in the assessment of non cardiac chest pain? AB - Using 24 hour pH monitoring as a reference standard, the usefulness of the acid perfusion (AP) test in predicting gastro-oesophageal reflux disease (GORD) was assessed in 71 non-cardiac chest pain (NCCP) patients and 23 endoscopic oesophagitis patients. Of the 71 NCCP patients, 35 had a positive AP test (of whom 20 had an abnormal 24 hour pH) and 36 had a negative AP test (of whom 14 had an abnormal 24 hour pH study). Thus, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the AP test in this group was 59%, 59%, 57%, and 61%, respectively. The corresponding values in the oesophagitis group were 85%, 67%, 94%, and 40%. In the NCCP group when heartburn alone was used as the positive criterion the PPV rose to 74%. When chest pain with or without heartburn was used, however, the PPV dropped to 38%. A 'symptom index' was used to define the number of chest pain episodes that were caused by acid reflux. Only 48% of AP test positive patients had demonstrable acid mediated chest pain. In the NCCP population with a normal oesophageal examination (1) AP test reproduction of chest pain is poorly predictive of GORD; (2) AP test reproduction of heartburn is more predictive of GORD but does not ensure that the chest pain is caused by GORD; (3) a negative AP test does not exclude GORD and (4) only 48% of AP test positive patients have demonstrable acid mediated chest pain. The ambulatory 24 hour pH test may have rendered the AP test obsolete in the assessment of GORD as the cause of NCCP. PMID- 2707631 TI - Enhancement by tetragastrin of experimental induction of gastric epithelium in the duodenum. AB - The effects of tetragastrin and truncal vagotomy on the incidence of gastric type epithelium in the duodenum by intraduodenal instillation of 5% NaOH solution were investigated in Wistar rats. Prolonged administration of 1 mg tetragastrin/kg body weight in depot form starting one week after NaOH treatment resulted in a significant increase in gastric acid secretion and the incidence and number of villi with gastric epithelium in the duodenum in experimental week 10. Villi with gastric epithelium were found in five (23%) of 22 rats in control group, whereas abnormal villi were found in 13 (59%) of 22 rats in the tetragastrin treated group (p less than 0.05). The average number of villi with gastric epithelium rose from 0.6 (0.4) per 100 villi in control rats to 2.4 (0.6) per 100 villi in tetragastrin treated rats (p less than 0.01). On histological examination, gastric type epithelium was most often found on stunted or flattened villi, and was always within the boundaries of the area of Brunner's glands. These mucosal changes reverted toward normal with time. In week 35, the incidence of gastric epithelium was significantly less than at week 10 (p less than 0.05). In contrast, no villi with gastric epithelium were found in vagotomised rats in week 10 (p less than 0.05). Vagotomy also caused a significant decrease in gastric acid secretion. These results show that exposure of the duodenal mucosa to high levels of gastric acid enhance the induction of gastric eithelium in the duodenum. PMID- 2707632 TI - Subclass distribution of mucosal IgG-producing cells in gastritis. AB - IgG-mediated immune reactions are probably involved in the maintenance of gastritis and glandular atrophy; the mucosal IgG-subclass pattern may therefore influence the effect of local hypersensitivity mechanisms. In this study the proportions of IgG1-, IgG2-, IgG3-, and IgG4-producing immunocytes were determined by paired immunofluorescence staining in specimens from simple gastritis, gastritis after Billroth II (BII) resection, and gastritis associated with dermatitis herpetiformis (DH). The results were related to histopathological degree of inflammation and atrophy. Generally, IgG1 immunocytes predominated (48 60%) in all types of gastritis. With increasing severity of inflammation, the IgG2-cell proportion was significantly increased from 4-6% to 26-34% in simple and BII gastritis, whereas the ratio of IgG1 immunocytes was correspondingly decreased from 58-69% to 38-43%. In the same types of gastritis the proportion of IgG3 cells was increased in association with severe (35-38%) compared with mild (15-23%) atrophy, whereas the proportion of IgG1 cells was correspondingly decreased. In severe gastritis associated with DH, the proportion of IgG1 cells was relatively high (60%) and that of IgG2 cells relatively low (13%), and severe atrophy did not seem to influence significantly the subclass proportions. PMID- 2707633 TI - Malignancy in coeliac disease--effect of a gluten free diet. AB - Two hundred and ten patients with coeliac disease previously reported from this unit were reviewed at the end of 1985 after a further 11 years of follow up. The initial review at the end of 1974 could not demonstrate that a gluten free diet (GFD) prevented these complications, probably because the time on diet was relatively short. The same series has therefore been kept under surveillance with the particular aim of assessing the effects of diet on malignancy after a further prolonged follow up period. Twelve new cancers have occurred: of which one was a carcinoma of the oesophagus and two lymphomas. Thirty nine cancers developed in 38 patients and of 69 deaths, 33 were the result of malignancy. A two-fold relative risk (RR) of cancer was found and was because of an increased risk of cancer of the mouth and pharynx (RR = 9.7, p less than 0.01, 95% confidence interval (CI) = 2.0-28.3), oesophagus (RR = 12.3, p less than 0.01, CI = 2.5 36.5), and of non-Hodgkin's lymphoma (RR = 42.7, p less than 0.001, CI = 19.6 81.4). The results indicate that for coeliac patients who have taken a GFD for five years or more the risk of developing cancer over all sites is not increased when compared with the general population. The risk is increased, however, in those taking a reduced gluten, or a normal diet, with an excess of cancers of the mouth, pharynx and oesophagus (RR = 22.7, p < 0.001), and also of lymphoma (RR = 77.8, p < 0.001). A significant decreasing trend in the excess morbidity rate over increasing use of a GFD was found. The results are suggestive of a protective role for a GFD against malignancy in coeliac disease and give further support for advising all patients to adhere to a strict GFD for life. PMID- 2707634 TI - Separate effects of irradiation and of graft-versus-host reaction on rat mucosal mast cells. AB - T cell mediated immune responses in the gut can produce enteropathy and malabsorption. We have investigated the relevance of mucosal mast cells (MMC) to the mechanisms of this enteropathy by using graft-versus-host reaction (GvHR) in the rat as a model of mucosal delayed type hypersensitivity. Measurements of mucosal architecture, intraepithelial lymphocytes (IEL) and MMC counts were performed in control and experimental rats, and release of rat mast cell protease II (RMCPII) into the bloodstream was used as an index of MMC activation. In unirradiated rats, jejunal MMC count was increased on day 14 of the GvHR (mean 272/mm2 v 182 in controls, p less than 0.01), as was serum RMCPII (p less than 0.01). Irradiated rats (4.5 Gy, reconstituted with isogeneic spleen cells) had low counts of IEL and crypt hyperplasia seven to 14 days after irradiation. Irradiated rats with GvHR (induced by ip injection of parental strain spleen cells) and studied on days 7, 10 and 14, had significant enteropathy with longer crypts and higher CCPR than matched irradiated animals (p less than 0.05 on day 14 when compared with irradiation alone). Intraepithelial lymphocytes counts, however, reflected only the effect of radiation. Irradiation, with or without GvHR, led to the virtual disappearance of jejunal MMC, undetectable jejunal RMCPII and very low levels of RMCPII in serum (all p less than 0.01 when compared with unirradiated controls). These experiments show that there is a modest expansion in jejunal MMC in unirradiated rats with semiallogeneic GvHR, whereas irradiation, alone or associated with GvHR, profoundly depletes MMC for at least two weeks. The enteropathy of GvHR can evolve in the virtual absence of MMC. PMID- 2707635 TI - Deposits of terminal complement complex (TCC) in muscularis mucosae and submucosal vessels in ulcerative colitis and Crohn's disease of the colon. AB - Extensively washed, ethanol fixed and paraffin embedded colonic specimens from 15 patients with ulcerative colitis (UC) and nine patients with Crohn's disease (CD) of the colon, ileal specimens from six patients with CD of the ileum, and histologically normal control specimens obtained from 10 patients operated for colonic carcinoma, were examined by immunohistochemistry with a monoclonal antibody specific for a neoepitope in the C9 part of the terminal complement complex (TCC). The submucosal blood vessels in inflammatory bowel disease (IBD) showed significantly more TCC positivity than the controls, and vascular TCC deposition was statistically related (p less than 0.001) to degree of inflammation. Five of the six ileal CD specimens contained likewise vascular TCC deposits. In addition, five UC specimens and one colonic CD specimen contained TCC-positive fibrils in the muscularis mucosae or submucosa. There was no significant difference in vascular TCC deposits between UC and CD. The results suggested that terminal complement activation takes place in the intestinal lesions of IBD. PMID- 2707636 TI - Disability from inflammatory bowel disease among employees in West Germany. AB - The statistics of the German social security system were used to analyse the epidemiology of inflammatory bowel disease (IBD) in Germany and to assess its impact on disability. Patients granted disability pension for IBD were compared with a control group of patients disabled from other causes. Crohn's disease and ulcerative colitis led to disability in significantly younger patients than other diseases. Disability from Crohn's disease was 2.0-fold more common in women than men (95% confidence interval: 1.8-2.3), while disability from ulcerative colitis was similar in both sexes. White collar employees were affected by both diseases more frequently than blue collar employees, the ratio being 1.3 (1.2-1.5) in Crohn's disease and 1.6 (1.4-1.8) in ulcerative colitis. Although IBD is relatively rare, it has severe socioeconomic implications, because compared with other diseases, predominantly young age groups become disabled. PMID- 2707637 TI - Motility of the jejunum after proctocolectomy and ileal pouch anastomosis. AB - Proctocolectomy with ileal pouch anastomosis could modify motility of the small intestine through two mechanisms: obstruction or bacterial overgrowth. Motility of the jejunum was measured in 11 patients with ileoanal anastomosis six (n = 6), or 12 (n = 5) months after closure of the loop ileostomy. Manometric recording from the jejunum were made during fasting (four hours) and after a liquid meal (one hour). These findings were compared with those of six healthy volunteers. Motor events were classified as follows: migrating motor complex (MMC), propagated contractions, or discrete clustered contractions. All patients were investigated for bacterial overgrowth (D-glucose breath test). Only two patients had bacterial overgrowth. The frequency of MMC remained unchanged after ileo-anal anastomosis (2.83 (0.37)/four hours) compared with normal volunteers (2.81 (0.29)/four hours). During fasting, four patients had numerous propagated contractions in the jejunum. This condition was associated in two with bacterial overgrowth and in two with intubation of the reservoir. Discrete clustered contractions were found in the seven patients studied postprandially (7.6 (2.5)/h), but not in volunteers. These seven patients emptied their pouch spontaneously and bacterial overgrowth was found in only one. As this motility pattern was previously described in partial small intestinal obstruction, it is postulated that discrete clustered contractions could be the consequence of a functional obstruction as a result of anastomosis of the small intestine to the high pressure zone of the anal sphincters. PMID- 2707639 TI - Effect of bile acid on anorectal function in man. AB - The effects of rectal infusions (500 ml) of deoxycholic acid (1 mmol/l, 3 mmol/l) or normal saline on basal anorectal motility and responses to rectal distension were studied in 11 normal volunteers. Deoxycholic acid (1 mmol/l) did not alter anorectal motor patterns under basal conditions but reduced the rectal volumes required to induce a desire to defecate (deoxycholic acid 76 (12) ml v saline 123 (12) ml; mean (SEM) p less than 0.01), and to produce anal relaxation (deoxycholic acid 83 (14) ml v saline 152 (24) ml; p less than 0.05) and perception of the rectal balloon (deoxycholic acid 56 (10) ml v saline 104 (17) ml; p less than 0.01) that were sustained for the period of distension (1 min). Seven of 10 subjects could not tolerate an infusion of 3 mmol/l deoxycholic acid. Between two and 30 minutes after the start of the infusion they experienced an extreme urge to defecate which was associated with large amplitude pressure waves in the rectal channels (amplitude 30 (5) mmHg, duration 0.7 (0.1) min, frequency 1.7 (0.4)/min). Such contractions were never seen during saline infusion. Thus, rectal infusion of deoxycholic acid at physiological concentrations increases the sensitivity of the rectum to distension, and promotes an urgent desire to defecate in normal subjects. PMID- 2707638 TI - Effect of calcium supplementation on mucosal cell proliferation in high risk patients for colon cancer. AB - Recent findings suggest that supplemental calcium could lower the abnormally high proliferation rate found in the colonic mucosa of subjects at high risk for colon cancer. In this double blind controlled study, this effect in volunteers previously operated upon for a colorectal adenocarcinoma was tested. Thirty subjects were randomised to receive either elemental calcium 1200 mg/day or a placebo. Mucosal proliferation was measured with tritiated thymidine labelling before and after the 30 day intervention period. Diets, faecal pH and the concentration of calcium and bile acids in the aqueous phase of feaces were also measured. Labelling index did not differ significantly in the two groups before intervention (placebo 4.0(2.4) v calcium 4.9(2.9), but the difference approached significance afterwards (4.4(2.4) v 6.5(3.4), p = 0.06). Individual changes occurring with intervention were tabulated and comparison of the means for the groups was not significant (delta = 0.3 vs delta = 1.8, p = 0.11). Calcium concentration, faecal pH and deoxycholic acid concentration increased in the calcium group (p = 0.02, 0.005 and 0.004 respectively). Calcium does not show any effect in decreasing colonic mucosal proliferation in this high risk group for colon cancer; it may increase faecal pH and the production of deoxycholic acid in the colon. PMID- 2707640 TI - Effect of glucocorticoid on liver regeneration after partial hepatectomy in the rat. AB - The increase in activities of hepatic thymidylate synthetase (EC 2.1.1.45) and thymidine kinase (EC 2.7.1.21), which catalyse the formation of thymidylate through the de novo and salvage pathways, respectively, were significantly suppressed during liver regeneration in rats which were given glucocorticoids (hydrocortisone and dexamethasone) or indomethacin. These drugs also prevented the augment of hepatic DNA content in 24 h regenerating liver. PMID- 2707641 TI - Barrett's ulcer: cause of spontaneous oesophageal perforation. AB - We report two patients, who presented within six months with the classic clinical picture of 'spontaneous' oesophageal perforation, which was caused by a perforated Barrett's ulcer. These two cases underline the importance of postoperative endoscopy in ruling out intrinsic oesophageal disease as the cause of the rupture in every patient, who survives this life threatening condition. PMID- 2707642 TI - Portal and mesenteric thrombosis revealing constitutional protein C deficiency. PMID- 2707643 TI - Nicotine and ulcerative colitis. PMID- 2707644 TI - Pancreatitis from intestinal reflux--again? PMID- 2707645 TI - Pathogenesis of haemorrhagic pancreatic necrosis (HPN). PMID- 2707646 TI - Chromosome examinations on a six-hour culture of unstimulated peripheral blood from a patient with childhood erythroleukaemia. AB - A six-hour culture of unstimulated peripheral blood from a patient with childhood erythroleukaemia was examined for chromosome karyotype. The characteristic chromosomal abnormalities of erythroleukaemia del (5q) and monosomy 7 were found in this case together with a marker chromosome and other chromosomal abnormalities. The results suggest the usefulness of this simple method in the cytogenetic diagnosis of some types of leukaemias. PMID- 2707647 TI - Dual effect of calcium on erythrocyte membrane contraction. AB - Effect of different calcium concentrations on erythrocyte ghost shape and size has been studied. Erythrocyte ghosts are smallest at approximately 10 microM of total calcium content and in the absence of EDTA; both decrease and increase of free Ca2+ results in expansion of ghosts. Changes in erythrocyte ghost size occur at equal Ca2+ concentrations which, as it has been already found, alter ATPase activity of contractile membrane protein. The possibility is discussed that under physiologic conditions contractile membrane protein causes weak membrane contraction which differs from aphysiologic membrane shrinkage brought about particularly by cross-bridges at high Ca2+ concentrations. PMID- 2707648 TI - Glutathione reductase in the south-western province of Saudi Arabia--genetic variation vs. acquired deficiency. AB - The activity of glutathione reductase (GR) is closely associated with the riboflavin level in diet. Dietary deficiency of this water-soluble vitamin causes glutathione reductase deficiency. Furthermore, a variable frequency of GR variants with reduced activity has been reported in several populations. In an attempt to determine GR deficiency due to genetic (GR variant) and acquired causes (riboflavin deficiency), red cell GR activity was estimated in 461 male and female Saudis from the South-Western province of Saudi Arabia. The frequency of genetic GR deficiency (GR variant) was 24.5% in Saudi males and 20.3% in females. The frequency of acquired GR deficiency (riboflavin deficiency) was 17.8% and 22.4%, respectively. Interaction between genetic GR deficiency and other genetic abnormalities, i.e. sickle cell gene and glucose-6-phosphate dehydrogenase deficiency were also estimated. No specific link could be demonstrated. PMID- 2707649 TI - [Changes in the hand in Ehlers-Danlos syndrome type IV]. AB - The authors report a lethal course of Ehlers-Danlos syndrome type IV. In this patient hypermobility of the finger joints had been seen. The patho-biochemical structure of fibrous tissue is discussed. PMID- 2707650 TI - [F. P. Weber syndrome of the hand. Clinical aspects--diagnosis--therapy]. AB - The syndrome of congenital arteriovenous fistula with proportional giantism is named after Frederik Parkes Weber. Its special localization in the hand is presented and the extension of surgical skeletalization into the microsurgical domain is discussed. The author reports on eight own cases and five skeletalization operations. PMID- 2707651 TI - [Autologous injection of fatty tissue following liposuction--not a method for breast augmentation]. AB - In recent years autologous fat transplantation employing liposuction has become an established method for correction of small soft tissue defects and irregularities of skin contour. Only a small amount of fat may be used because fat cells will be nourished by perifusion alone until neovascularisation occurs. Transplantation of a large amount of fat will result in fat necrosis. The inappropriate use of fat for breast augmentation after liposuction is described in a case report. PMID- 2707652 TI - [Clinical research in hand surgery: the problem and value of retrospective studies]. AB - Retrospective studies are still very important in clinical decision making although they present severe methodological deficiencies compared to controlled trials. Imprecise and incomplete data gathering, lack of homogeneity in the group studied, and lack of randomisation are the main drawbacks. Indications for retrospective studies and criteria for their execution are presented. PMID- 2707653 TI - [The importance of subclavian vein stenosis for the treatment of Dupuytren's contracture]. AB - The postoperative healing in cases of Dupuytren's contracture is not only influenced by the age of the patient and the progress of the disease, but also by the existence of other accompanying diseases and general and local factors. The appearance of postoperative edema and the so-called hand-finger-syndrome are also especially unfavorable, because these complications determine the duration of treatment and the functional results. As a cause for these postoperative complications a disorder of the subclavian vein could be found and documented by means of phlebography. Preoperative examination of the venous situation is therefore an important diagnostic step to determine indications and to allow an estimation of the postoperative course and the duration of treatment. Demonstration of cases and statistical evaluation of our patients over the last five years show the importance of this observation. PMID- 2707654 TI - [Trophic disorders following primary nerve sutures of the upper extremity]. AB - The frequency of different trophic alterations was examined in 120 patients with 143 primary nerve sutures. Trophic alterations are dependent on the age of the patients and the quality of sensory recovery. PMID- 2707655 TI - [Determining the position of the prosthesis using arthrography of the wrist joint]. AB - During the last twelve months twelve patients with different silicone prostheses of the wrist region underwent examination with arthrograms two to twenty-four months after the operation. The arthrography showed the relation of the implant to its surrounding structures. For either radiocarpal or intercarpal arthrography a very distant access was used. In eight patients the prostheses were surrounded entirely by contrast medium. There was no contrast-medium on one side of the implant in two patients. In one patient a complete disconnection from the capsule to the site of the prosthesis was seen. In one other patient there was evident shrinking of the capsule. Wrist arthrography was very helpful for the evaluation of further clinical proceeding and control of wrist-function. PMID- 2707656 TI - [Computerized tomography of the hand: examination technic, normal anatomy, indications]. AB - The results of 480 computed tomograms carried out in the hand are presented. The digital slice imaging technique shows following advantages: a) Imaging of the complex carpus without superimposition giving a better understanding of carpal biomechanics. b) Anatomically exact imaging of the soft tissues determined by density analysis. In the following states relevant information can be obtained by CT of the hand: 1. Posttraumatic states of the carpus such as scaphoid non-union, lunato-malacia in stages I and II, complex fracture dislocations, and carpal instabilities; 2. cystic transformation of the bone; 3. non-idiopathic CTS; 4. clinically unequivocal soft-tissue masses. In our institution conventional tomography has been largely replaced by carpal CT within a progressive diagnostic programme. Today CT is the best method for imaging soft-tissue masses of the hand. PMID- 2707657 TI - [Long-term follow-up of prosthetic heart valves]. AB - 257 patients underwent single or double heart valve replacement between 1964 1986. In 141 (55%) after isolated mitral valve replacement, operative mortality was 14.8% and after 5, 10, 15 and 20 years, actuarial survival was 84%, 70%, 59% and 44%, respectively. In 70 who underwent isolated aortic valve replacement, operative mortality was 7.1% and after 5, 10, 15 and 20 years, actuarial survival was 85%, 85%, 72% and 72%. In 46 who underwent combined aortic and mitral replacement, operative mortality was 4.3% and after 5, 10 and 15 years, actuarial survival was 78%, 71% and 71%. PMID- 2707658 TI - [Interventional electrophysiology: transcatheter electrical shock ablation for arrhythmias]. AB - Patients with supraventricular or ventricular tachyarrhythmias resistant to antiarrhythmic drugs are candidates for surgical ablation of the bundle of His, and of accessory pathways or ventricular or atrial foci responsible for the arrhythmia. During the past 6 years closed-chest catheter techniques have been devised that allow electrical shock ablation of the atrioventricular junction, accessory pathways, or foci responsible for arrhythmias. The promising results of these ablative procedures (especially of the atrioventricular junction and posteroseptal accessory pathways) justify their trial in suitable patients before cardiac electrosurgery. PMID- 2707659 TI - [Ischemic episodes during daily activities and progression of ischemic heart disease]. AB - In patients with coronary artery disease, ischemic episodes, the majority of which are silent, can be detected electrocardiographically during daily activities by Holter ambulatory monitoring. We here summarize our experience with the prognostic significance of such ischemic episodes, silent or symptomatic. In 356 patients the progression of ischemic heart disease was evaluated by clinical follow-up averaging 2 years. Death, infarction, unstable angina, referral for coronary bypass surgery or balloon angioplasty were significantly more common in those with ischemic episodes on Holter monitoring than in those without. Thus, in addition to the results of the treadmill exercise test and determinations of left ventricular ejection fraction, the appearance of ischemic episodes is also of prognostic significance. PMID- 2707660 TI - [Effect of tourniquet occlusion on peripheral blood pooling and ventricular function]. AB - Rotating tourniquets are traditionally part of the treatment of acute pulmonary edema. However, their effectiveness has been questioned. A radioisotope technique was therefore used to evaluate directly the increments in the blood volume of the leg after venous occlusion using a pressure of 60 mmHg in 26 patients with left ventricular (LV) dysfunction following myocardial infarction. The increment in mean radionuclide count at serial 15-second intervals (reflecting the blood volume in the leg distal to the occlusion) increased significantly from the pre occlusion value by 46 +/- 26% (p less than 0.0005). Thus satisfactory trapping of blood is achieved even in LV failure. However, mean ejection fraction decreased slightly but significantly from 0.23 +/- 0.10 to 0.21 +/- 0.10 (p less than 0.05), a decrease observed in 18 of the 26 patients. LV end-diastolic and end systolic volume equivalents tended to decrease slightly, but not in all patients. Mean stroke volume and cardiac output equivalents were reduced by 14% (p less than 0.0005), while calculated peripheral resistance increased significantly. The present study fails to support the hypothesis that preload reduction by tourniquets improves LV function. PMID- 2707661 TI - [Classification of acute myocardial ischemia by electrocardiography]. AB - Electrocardiographic recording during chest pain is usually performed for detection of myocardial ischemia and localization of the affected area. By analyzing changes in electrocardiograms recorded during chest pain, pathophysiological mechanisms of ischemia, prediction of coronary pathology, and the risk of evolution to myocardial infarction can be determined. Myocardial ischemia is caused by either an increase in O2 demand, reduction in coronary flow, or both. The former is manifested by tachycardia and in such patients measures should be taken to slow the heart rate. Patients with ischemia without tachycardia suffer from reduction of coronary flow and therapy should be aimed at increasing flow. We classify patients with ischemia but without tachycardia according to electrocardiographic patterns recorded during chest pain by precordial leads as follows: group 1, those with ST segment elevation and with positive T waves; group 2, ST segment depression and negative T waves; and group 3, ST depression and positive T waves. Group 1 patients have anterior wall ischemia and the left anterior descending artery is usually involved. They are possible candidates for coronary angiography. In group 2, the electrocardiographic changes reflect extensive subendocardial myocardial ischemia. We found severe coronary artery disease (LMCA or right main artery equivalent) in 69% of such patients, and the mortality in those with subsequent myocardial infarction was 77%, mainly due to pump failure. When this latter electrocardiographic pattern is found, intervention should be prompt, and surgery rather than angioplasty is usually necessary. Patients with ischemic ST depression maximal in V2-V3 should not be included in this group since these changes are reciprocal with posterolateral wall ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707662 TI - [Suspected acute coronary events in emergency room patients]. AB - Identification of patients in whom chest pain is due to an acute coronary event is among the most challenging problems in emergency medicine. Because of the dangers of missing the diagnosis in patients with a possibly fatal condition, emergency room (ER) physicians often admit patients for 'observation' or 'to rule out MI.' As a result of such a policy, only 30-50% of such patients admitted to the CCU may finally be diagnosed as having an acute myocardial infarction (AMI), resulting in deleterious medical, psychological and economic consequences for the others. A series of 2280 patients who were referred to the ER was followed for 2 weeks. 1362 (59.7%) of those admitted were discharged; 16.1% were hospitalized in the CCU and 83.9% in medical wards. 95 (64.6%) of those hospitalized in the CCU and 97 (12.7%) of those admitted to medical wards had an AMI. The proportion of cases in which hospitalization was unnecessary was 10.2% in the CCU and 29.8% in the medical wards. Unjustified discharges from the ER were 4.3% of referrals. These data are similar to those reported from the USA and from our first study in 1969. It is hoped that by using a triage algorithm in the ER, differentiation between chest pain due to coronary heart disease and that due to other causes will be more accurate and therefore the demand on scarce resources due to unnecessary admissions will be substantially reduced. PMID- 2707663 TI - [Severe left heart failure long after acquired arteriovenous fistula]. AB - Gunshot wounds and traumatic injuries are the main causes of acquired arteriovenous fistulas. The high cardiac output associated with such fistulas depends mainly on the size of the pathological communication and the degree of reduction in the systemic vascular resistance that results. Since the findings on cardiac examination in these patients may mimic those of valvular heart disease or dilated cardiomyopathy, careful attention should be paid to noncardiac physical findings, such as thrill and/or continuous murmur over the traumatic or surgical scar. We describe a 64-year-old man who developed severe left heart failure 39 years after a gunshot injury in the left lower quadrant of the abdomen. This had led to an acquired arteriovenous fistula between the left internal iliac artery and the left common iliac vein. PMID- 2707664 TI - [Echocardiographic diagnosis of anomalous origin of left coronary artery]. AB - Cross sectional and M-mode echocardiography is a well-established noninvasive technique in the diagnosis of dilated cardiomyopathy and is essential in the evaluation of its severity and progress. However, in most cases of dilated cardiomyopathy in children, it does not provide data suggestive of the etiology of the disease. In the rare congenital malformation, anomalous origin of the left coronary artery from the pulmonary artery, the echocardiographic techniques may suggest the diagnosis when the left coronary artery cannot be demonstrated to arise from its usual site, the left coronary sinus (as visualized in the short axis of the aortic root). A firm diagnosis can be made if the anomalous origin of the left coronary artery is identified in a cross-sectional view of the main pulmonary artery (left parasternal long axis view of the main pulmonary artery, Fig. 1). This was demonstrated in a 9-year-old girl by coronary and aortic angiography (Fig. 2a, b). Anatomical confirmation was made during corrective surgery 3 months later. The origin of the left coronary artery was at the left posterior aspect of the main pulmonary artery, just proximal to its bifurcation. This is an unusual origin in this anomaly in which the coronary artery has been reported to arise close to the pulmonary valve, but not distal, as in this case. PMID- 2707665 TI - [Annulo-aortic ectasia]. AB - Aortic regurgitation due to annular aortic ectasia was diagnosed in a 29-year-old woman with heart failure. The primary pathology of this disease is cystic medial necrosis of the ascending aorta with aneurysm formation and dilation of the aortic valve annulus. In successful surgical correction, the ascending aorta was replaced by a dacron prosthesis, the aortic valve by a prosthetic disc valve and the coronary arteries were reimplanted into the aortic graft. PMID- 2707666 TI - [Long-term follow-up of acute myocardial infarction after early intravenous streptokinase]. AB - In a series of 30 patients with acute myocardial infarction (AMI) intravenous streptokinase was given within 4 hours of the onset of chest pain. Cardiac catheterization and angiography were performed on the 6th day, and again 4 months after the acute episode. Residual coronary artery stenosis increased significantly (from 84 +/- 3% to 95 +/- 7%, p less than 0.05) in those who had stenosis of more than 80% in infarct-related arteries. In this subgroup, a higher incidence of complete occlusion was found at the second investigation than in the other patients (p less than 0.002). Those who had received early treatment with streptokinase or had residual stenosis of less than 75% showed improvement in regional function of the infarct area, confirmed at the second angiography. End systolic volume, regarded as a sensitive prognostic marker after myocardial infarction, correlated at the second investigation with residual coronary artery stenosis determined on day 6 (p less than 0.0016). Significant improvement in global ventricular function and return of regional function to normal was found in those who had received streptokinase within 2 hours of onset of pain, and in whom residual coronary artery stenosis was less than 75%. Early fibrinolytic treatment at the time of infarction is crucial for preservation of ventricular function and its later restoration. Coronary angiography 1 week after infarction detects high-risk patients who need early revascularization. PMID- 2707667 TI - [Riddle of the decline of heart disease mortality]. PMID- 2707668 TI - [Morbidity profiles among Ethiopian immigrants]. PMID- 2707670 TI - [Advertising by physicians]. PMID- 2707669 TI - [Decrease in admission to pediatric wards: the contribution of hospital-sponsored ambulatory services]. PMID- 2707671 TI - [Hair analysis--is it a meaningful tool?]. PMID- 2707672 TI - [The potential for changing refraction by changing shape and structure of the cornea]. PMID- 2707673 TI - [In-situ hybridization on chorionic villi chromosomes]. AB - Novel techniques for the prenatal diagnosis of inherited defects are currently being developed. The long-range aim is to be able to predict precisely, at an early stage of fetal development, the tendency of the fetus to develop multiple genetic, congenital or acquired diseases. We adapted the technique of gene mapping by in-situ hybridization for use with chromosomes from fetal chorionic villi sampling (CVS). Refined mapping of the genes coding for cholinesterase (CHE) in comparison with the haptoglobin and the transferrin receptor genes on CVS chromosomes Nos. 3 and 16 revealed 3 CHE genes in positions 3q21, 3q26, and 16q12. In view of genetic linkage data, at least 2 of these appear to be potentially active. These findings demonstrate that genes, for which molecularly cloned DNA probes are available, may be localized on CVS chromosomes by comparing their localization with that of known genes after in-situ hybridization. The implications for prenatal diagnosis are promising. PMID- 2707674 TI - [Autotransfusion of shed mediastinal blood after cardiac surgery]. AB - We have developed a technique for autotransfusion of shed mediastinal blood collected in the cardiotomy reservoir. Results in the first 50 consecutive patients in whom the system was employed were studied prospectively (group A) and were compared with those of the last 50 consecutive patients operated on before application of the new method (group B). The mean preoperative hematocrit (about 42%) and the total postoperative bleeding (about 11) were similar in both groups. Only 24 patients (48%) in group A required homologous blood transfusion, versus 43 (86%) in group B (p = 0.0001). This resulted in a 57% saving of blood units in group A (mean, 1.16 +/- 1.49 units per patient versus 2.72 +/- 1.99 in group B, p less than 0.0001). Foreign blood transfusion was thus avoided in 21 of the last 25 patients (84%) of group A. 7 days after operation, the mean hematocrit in group A was 30.9 +/- 4.3, compared with 33.0 +/- 3.8 in group B (p less than 0.001). Hemolytic jaundice occurred in 7 group B patients (14%) but in none in group A (p less than 0.01). A trend towards reduction in other complications was also demonstrated. We conclude that the use of foreign blood transfusions in those undergoing open heart surgery can be reduced significantly by this method, thus avoiding immediate transfusion reactions and minimizing the risks of late complications. PMID- 2707675 TI - [Perineoplasty for vulvar vestibulitis]. AB - 28 premenopausal women with severe dyspareunia were diagnosed as having vulvar vestibulitis. A modified perineoplasty, consisting of removal of the vestibule and exteriorization of the vagina to cover the denuded area and to relax a tight perineum, was performed. 70% of 26 women with adequate follow-up experienced significant relief of vulvar discomfort. In young women with dyspareunia, vestibulitis may be a significant, remediable, causative factor. PMID- 2707676 TI - [Successful replantation of a self-mutilated penis]. AB - Intentional self-mutilation of the genitals in males is exceedingly rare and the most recent review included only about 50 cases. The ideal way to handle such cases is by microsurgical techniques, but they require special equipment, instruments and training. We therefore developed a simple, standard technique which can be performed by general surgeons. We report a 19-year-old male in whom the technique was used successfully. PMID- 2707677 TI - [Fulminant hepatic failure due to hepatitis A]. AB - Fulminant hepatic failure accompanied by encephalopathy is a rare complication of acute liver disease, especially infection due to hepatitis A virus. We describe a 24-year-old woman and a 27-year-old man who developed this complication. One case presented with loss of consciousness and ended fatally. In the other the presenting symptoms were mental confusion and transient asterixis. Although hepatitis due to virus A is usually mild and the course favorable, one should be aware of the possibility of severe encephalopathy as a complication. PMID- 2707678 TI - [Lead poisoning in two families from a car battery workshop]. AB - Lead poisoning resulting from exposure to lead in a domestic car battery workshop is reported in 10 children in 2 families. 2 girls, aged 2 10/12 and 1 8/12 years, respectively, from 1 of the families were hospitalized for investigation of nausea, vomiting, progressive muscular weakness and peripheral neuropathy. Serum lead levels were 52 and 49 mcg/dl, respectively. Subsequent screening of all members of this family, as well as those of the other family who lived in the same house, revealed abnormally elevated levels of serum lead in all the members of both families. The 2 girls were treated with chelating agents and improved clinically and their serum lead levels decreased to 29 and 34 mcg/dl, respectively. The domestic workshop was closed and the 2 families moved to another neighborhood. These cases illustrate the need to screen all family members and contacts of patients with lead poisoning, as well as the hazards of the uncontrolled use of lead in domestic workshops. PMID- 2707680 TI - Discharge planning and other matters. PMID- 2707679 TI - Social work influence on interdisciplinary ethical decision making in health care settings. AB - Because of structural and philosophical changes in health care, social work practitioners are having to interact more with other practitioners in health care settings. Many of those interactions are interdisciplinary and often involve an understanding of the application of professional values and ethics. The authors have suggested that social workers' influence on ethical decision making is correlated directly to their ability to contribute to those decisions. In their study, the authors tested five independent variables and one dependent variable to show the factors that are related significantly to social workers' influence on ethical decision-making processes in multidisciplinary health care settings. PMID- 2707681 TI - Health promotion and illness prevention: a biopsychosocial perspective. AB - The biomedical model of disease, in which health is viewed as the absence of disease, is becoming obsolete. Burgeoning health care costs coupled with an increased focus on health promotion and illness prevention have created new demands on the health care delivery system. A biopsychosocial model of health care--in which disease is seen as an interplay between environmental, physical, behavioral, psychological, and social factors--can integrate mental health services into the primary care sector. Social workers, as primary providers of psychosocial care, can close the gap between physical health and mental health services. Strategies for implementing the biopsychosocial model, methods to evaluate its effectiveness, potential problems, and recommendations for future research are discussed. PMID- 2707682 TI - Social workers respond to the AIDS epidemic in an acute care hospital. AB - Acquired immune deficiency syndrome (AIDS) has had dramatic effects on hospital staff, particularly social workers. However, little documentation exists of how hospitals and their social work departments have responded to the myriad needs of people with human immunodeficiency virus-related conditions. Patterns of social work service delivery to 152 persons with AIDS at St. Luke's-Roosevelt Hospital Center in New York City were reviewed. Gaps were identified; in particular, social workers provided services to only 40 percent of the identified persons with AIDS. The need for staff education and training, dedicated resources for services to persons with AIDS, and increased out-of-hospital services are discussed. PMID- 2707683 TI - Munchausen syndrome by proxy. AB - Munchausen syndrome by proxy (MBP) is the deliberate induction or reporting of physical symptoms in a child. It is a form of child abuse that can result in death, iatrogenic disease, or the masking of a genuine illness. MBP is suggested by symptoms that do not follow the usual course of illness, particularly if the symptoms only occur in the presence of the same person. MBP may occur when caretakers (usually mothers) perceive that being the parent of a sick child will solve personal conflicts and be socially rewarded, or if life experiences have demonstrated that the price of love is physical illness. When MBP is suspected, the health care team needs to take aggressive action to confirm or disprove it and to protect the child. A social worker confronted with possible MBP must manage a difficult situation that often involves painful team issues as well as confusion over the nature of reality. PMID- 2707684 TI - Love, medicine, and money: issues of access, use, and advocacy. PMID- 2707685 TI - Child abuse and neglect: an instrument to assist with case referral decision making. AB - A decision-making instrument was developed to assist reporting agencies and individuals in determining which child abuse and neglect charges would require immediate reporting to a child protection agency and which could be managed initially by the reporting agency. The instrument comprises a matrix scoring system that combines the experience classification of the reporting source and the degree of harm reported. The matrix scoring system was tested for 1 year to evaluate child abuse and neglect cases reported to the New York State Central Registry and Special Services for Children. The goal of the decision-making instrument is to decrease the number of unnecessary reportings to overburdened agencies without jeopardizing the interests of the child. The instrument should assist reporting sources in developing a systematic approach to case referral decision making and should minimize the subjectivity of such decisions. PMID- 2707686 TI - Keratinolytic fungi of wadi Qena in Egypt. AB - Forty-six soil samples collected from different sites of wadi Qena were examined for keratinophilic fungi using the hair baiting technique. Thirty-two species in addition to one variety of each of A. nidulans and A. flavus which belong to eighteen genera were recovered. Aspergillus, Chrysosporium, Penicillium, Microsporum and Fusarium were the most frequent genera developed from baited soils. PMID- 2707687 TI - Hybridization and sexual stimulation in Trichophyton mentagrophytes. AB - Mating and sexual stimulation tests applied to 132 strains of this dermatophyte isolated in Czechoslovakia revealed among them strains of Arthroderma benhamiae (40 strains of the + mating type, one of the - mating type) and A. vanbreuseghemii (three strains of the + type, seven of the - type). No dependence was found concerning the anamorphic variety (T. mentagrophytes var. granulosum, var. interdigitale, var. mentagrophytes, var. quinckeanum), teleomorphic species, mating type and the clinical localization of dermatophytosis. Plausible reasons of different frequencies of the mating types are discussed. PMID- 2707688 TI - [Bone marrow micrometastases in colorectal cancers]. AB - To date, the detection of individual micrometastases or disseminated tumor cells has not been possible with conventional diagnostic procedures. With the aid of new immunocytochemical investigation, however, histogenetically different cells can now be detected in the bone marrow. The monoclonal antibody, cytokeratin component 18, is most suitable for the detection of micrometastases from colorectal carcinoma. In 22 out of 82 patients with colorectal carcinoma, we were able to detect CK2-positive cells. The incidence of these "micrometastases" is represented as a function of primary tumor size, lymph node involvement, distant metastasis, and degree of malignancy of the tumor, age and sex of the patient, and tumor localization. PMID- 2707689 TI - [The way out for linear ECG? Price reduction of processing instruments--the cheapest instrument of Bulgarian production]. PMID- 2707690 TI - [Cancer prevention by health education. Ways for promoting healthy behavior--no surplus of information]. PMID- 2707691 TI - [AIDS. HIV test: accuracy alone is not enough]. PMID- 2707692 TI - [Complications of cocaine transport in the gastrointestinal tract]. AB - Smuggling of cocaine in the intestinal tract is becoming more and more common. The risks entailed are discussed on the basis of a review of the literature and a description of a complicated case of mechanical ileus seen by the authors. PMID- 2707694 TI - [AIDS. Lower cholesterol values in HIV infected patients]. PMID- 2707693 TI - [Personal experiences with naturopathy. Wound treatment with plant substances. The process of wound healing--flavonoids, I]. PMID- 2707695 TI - [AIDS. Medical personnel: HIV infection can be prevented by careful behavior]. PMID- 2707696 TI - [AIDS in children. Neurologic damage before immunodeficiency]. PMID- 2707697 TI - [Malignant primary bone tumors. Diagnosis, therapy and results of treatment]. AB - Differences in the biological behavior of primary bone tumors have led to the development of differentiated treatment regimes. In recent years, a considerable improvement in the results of treatment has been accomplished, in particular by the introduction of adjuvant chemotherapy. The various therapeutic concepts for the three most common malignant bone tumors, osteosarcoma, chondrosarcoma and Ewing's sarcoma are described and, on the basis of the author's own results, discussed. PMID- 2707698 TI - [Hypertension--follow up in a rural practice]. AB - In a rural general practitioner's office, 286 patients with all WHO stages of hypertension, were followed up. It was found that hypertensive drugs are more commonly employed in daily practice as basal treatment among the general population. This treatment complies with the requirements of clinical medicine with respect to frequency, patient age, duration of treatment, effectiveness and drug combinations. PMID- 2707699 TI - [Mammary gland abscess in newborn infants]. PMID- 2707700 TI - [Personal experiences with naturopathy. Wound treatment with plant products. Wound medicines containing tannic acid (II)]. PMID- 2707701 TI - [Gastrointestinal diseases: patients ask the expert]. PMID- 2707702 TI - [AIDS. A 5 minute HIV AIDS test?]. PMID- 2707703 TI - [Prevention of recurrence in urinary bladder cancer--quo vadis?]. PMID- 2707704 TI - [Current health and legal problems in general practice and the hospital]. PMID- 2707705 TI - [Measures for preventing infection in general practice. 1: General hygiene]. PMID- 2707706 TI - [Measures for preventing infection in general practice. 2: Special hygiene in relation to AIDS]. PMID- 2707707 TI - [Hospital hygiene. New construction management requirements in the area of surgery and intensive care medicine]. PMID- 2707708 TI - [Civil rights responsibility for health accidents. Legal aspects in intensive care medicine]. PMID- 2707710 TI - [So that nobody loses face... Tips for managing group therapy--9]. PMID- 2707709 TI - [Responsibility for education in endoscopy interventions. Legal requirements]. PMID- 2707711 TI - [Drugs of choice in obstructive respiratory tract diseases. Prof. Dr. med. Dr. h. c. W. T. Ulmer, Bochum, establishes the role of modern beta 2-sympathomimetic drugs and the possibility for new aerosol technics]. PMID- 2707712 TI - [Schizophrenia and the theory of neural networks]. AB - Artificial neuronal networks increasingly serve the interpretation of neuro biological problems. Typically, neuronal networks store "associations". By a "store-matrix", which works like holography because it sums up many memories, a new impression is assigned to the most similar memory satisfying the criterion of minimal Hamming distance. Schizophrenia-like reactions arise in the case the neuronal network is overloaded with too many memories. Aside from the fascinating power of the model it needs to be criticized and possibly improved. "Ball" is both a spherical object and a dance. Although the semantical levels are at a great distance from each other, the Hamming distance of the binary coded chains of symbols "ball"-"ball" is zero. The investigation of schizophrenic disturbances shows that a few of them-inversing the model-assumptions-prefer associations by using the criterion of minimal Hamming distance. PMID- 2707713 TI - [Posturographic biofeedback training in equilibrium disorders]. AB - In addition to the usual physical training for treatment of ataxia, individually adaptable biofeedback training programs by means of a stationary posturographic platform and feedback via the screen of a connected microcomputer were developed, including not only static, but especially dynamic exercises. Through an open randomised study of 72 patients with ataxia of cerebellar, brainstem and vestibular origin the effect of this training was examined by analysing the training courses parameters, which were compared with the courses of 10 normal subjects, and by the patient and the physician rating the unsteadiness of stance and gait under everyday's conditions. In particular, a significant improvement of the common function could be shown at the biofeedback training group in comparison to the group only with physical training. It is therefore concluded, that this--highly accepted--training may be a valuable tool in neurological rehabilitation of atactic patients. PMID- 2707714 TI - [The problem of femoral neck fracture in multiple sclerosis]. AB - CASE REPORT: In a female MS-patient with severe osteoporosis a fracture of the femoral neck occurred while doing neurophysiological exercises. A lawsuit for damages followed and ended in settlement. The risk of femoral fracture in MS and an expert report are discussed. PMID- 2707716 TI - [Markers of schizophrenic language. A comparative patholinguistic study of dialogues with schizophrenic, manic, depressive and brain-damaged patients]. AB - Transcripts of dialogues with patients showing schizophrenic, manic, depressive or organic syndromes, 15 persons in each group, were analyzed in order to determine their degree of cohesion and coherence. The cohesion of a text is defined by the grammatical and lexical relation between its elements. Coherence, however, means that the sequence of sentences appears reasonable in the context of communicative action. There is a significantly higher incidence of incoherences in dialogues with schizophrenic patients than in dialogues with patients who show manic, depressive or organic syndromes. Schizophrenic language is conceived as a disorder in the implicitly dialogical structure of texts. This can be proven by these patients' inability to find communicative solutions for misunderstandings emerging during the interview. PMID- 2707715 TI - [Risk of cardiovascular mortality of hospitalized psychiatric patients]. AB - In a long-term study involving 783 psychic patients (361 men and 422 women) ranging in age between 40 and 70 years and hospitalised for extended periods of time, who had been examined for the incidence of cardiovascular diseases and risk factors, the cardiovascular mortality was registered for a period of 10 years. Using a multiple logistic model, an attempt was made at assessing the mortality risk in dependence on 14 parameters. The most conclusive predictor proved to be the pathological ECG which was seen to reflect seven times a higher risk. In addition to age and sex - the cardiovascular mortality of men was twice and a half that of women - hypertension and increased serum cholesterol levels among the known risk factors revealed a significant influence with little less than a doubling of the risk. On the other hand, a correlation to cardiovascular mortality was neither established for the kind of psychic disease nor for the kind of psychopharmacotherapy. PMID- 2707717 TI - Neurosurgeons and the supply of human organs. PMID- 2707718 TI - Views on health care: public opinion in three nations. PMID- 2707719 TI - GrantWatch: a conversation with Leighton E. Cluff. Interview by John K. Iglehart. PMID- 2707720 TI - Physician payment research efforts at HCFA. PMID- 2707721 TI - Priorities for medical education. PMID- 2707722 TI - Lab experience for medical students. PMID- 2707723 TI - Paying physicians in Canada: minding our Ps and Qs. PMID- 2707724 TI - Induction of cross-fertilization between sea urchin eggs and starfish sperm by polyethylene glycol treatment. AB - Cross-fertilization between sea urchin eggs (Strongylocentrotus nudus) and starfish sperm (Asterina pectinifera) was induced by treatment with polyethylene glycol (PEG). Without treatment with PEG, the denuded egg surface (jelly coat- and vitelline coat-free) engulfed the head of acrosome-reacted sperm; however, sperm penetration did not occur [Kyozuka and Osanai, 1988]. When these eggs were exposed briefly to PEG (molecular weight 3,000) in seawater, the sperm entered the egg by membrane fusion. Cortical granules were discharged, and embryogenesis began following sperm penetration. PEG did not induce parthenogenesis in Strongylocentrotus eggs. Egg activation is thus closely linked with gamete membrane fusion. PMID- 2707725 TI - In vitro capacitation and fertilizing ability of ejaculated rabbit sperm treated with lysophosphatidylcholine. AB - Four experiments were replicated 1) to establish dose-response relationships between lysophosphatidylcholine (LPC), sperm motility, and the acrosome reaction (AR), 2) to evaluate the influence of rabbit serum (RS) on these endpoints, 3) to compare buck differences in induction of the AR, and 4) to examine fertilizing ability in vitro of sperm tested under the first three objectives. Semen was collected from Dutch-belted rabbits, washed once by centrifugation, resuspended, and preincubated for 2 or 4 hr in a chemically defined medium (DM), DM plus 20% RS, or BSA-free DM plus 20% RS at 37 degrees C. At the end of preincubation LPC was added to the preincubated sperm at concentrations of from 0 to 100 micrograms/ml. Sperm were examined .5-4 hr later for AR and sperm motility. For in vitro fertilization, sperm and ova were coincubated in DM up to 24 hr after insemination and in a more complex medium for another 24 hr. Addition of LPC to 4 hr-preincubated sperm was more effective for inducing the AR than addition to 2 hr-preincubated sperm. A significant increase (P less than .05) in the AR occurred in 15 and 30 min following exposure to 100 and 80 micrograms of LPC per ml, respectively, but the higher concentration of LPC decreased sperm motility. Addition of 20% RS to DM with or without BSA surprisingly inhibited the AR but maintained sperm motility, as expected. Bucks differed (P less than .05) in the initial percentage and the induced percentage of AR sperm. For the AR the optimal concentration of LPC per ml was 80 micrograms, but for in vitro fertilization 60 micrograms tended to be superior. PMID- 2707726 TI - Capacitation of bovine spermatozoa by lysophospholipids and trypsin. AB - Bovine spermatozoa were incubated in vitro with lysophosphatidylserine (LPS), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), lysophosphatidylinositol (LPI), or trypsin. Capacitation of sperm was evaluated by penetration of the zonae pellucidae of dead bovine oocytes. Capacitation times could be shortened to 3 h or less by treatment of spermatozoa with each of these lysophospholipids (LPLs) (P less than .05). The maximum oocyte penetration percentages for individual LPLs were 40% for 10 microM LPS. 24% for 160 microM LPC, 31% for 320 microM LPE, and 19% for 320 microM LPI. Capacitation also was facilitated (P less than .01) by trypsin treatment of spermatozoa. Spermatozoa treated with 250 or 2,500 units/ml of trypsin penetrated more oocytes (17 and 18%) than spermatozoa treated with 0 or 25 units/ml of trypsin (0 and 3%). Spermatozoa treated with increasing concentrations of LPL showed a decrease in both the percentage of intact acrosomes and of progressively motile spermatozoa. Increasing levels of trypsin in the incubation medium also led to a decrease (P less than .05) in the percentages of intact acrosomes and a decrease (P less than .01) in the percentages of progressively motile spermatozoa. Percentages of live, ovulated oocytes fertilized by spermatozoa incubated for 1 h in LPS (86%, 6/7) were not different from those incubated for 24 h in control medium (71%, 5/7). Percentages of oocytes fertilized with both of these capacitation treatments were higher (P less than .05) than for oocytes exposed or killed or uncapacitated sperm. Rapid induction of capacitation and the acrosome reaction can be accomplished by exogenous treatment of bovine sperm with lysophospholipids or trypsin. PMID- 2707727 TI - The major component of the rat sperm fibrous sheath is a phosphoprotein. AB - The fibrous sheath from rat epididymal sperm was isolated by sequential extraction, first with Triton X-100 and dithiothreitol, and then with 6 M urea and dithiothreitol. The latter extraction procedure solubilized most of the sperm components, leaving the head and the fibrous sheath as the only intact structures. This material was purified by sucrose gradient centrifugation. Electron microscopy confirmed the purity of the isolated material and revealed the characteristic structural features of the fibrous sheath. Polyacrylamide gel electrophoresis (in the presence of sodium dodecyl sulfate) of the fibrillar material, showed a complex polypeptide composition. The polypeptides with molecular weights of 80,000, 24,000, and 11,500 accounted for about 65% of the total protein of the fibrous sheath. Peptide map analyses indicated that the components of molecular weights of 80,000 and 24,000 are unrelated to the polypeptides of similar size of the outer dense fibers. On the other hand, it appears that the fibrous sheath and the outer dense fibers share the polypeptide of 11,500 daltons. The component of 80,000 daltons contains on the average about 3 mol of phosphoserine per mol of polypeptide, indicating that the most abundant polypeptide of the fibrous sheath is a phosphoprotein. PMID- 2707728 TI - Crater defect in human spermatozoa. AB - This report describes the "crater defect" in human spermatozoa, a malformation that consists of a nuclear and acrosomal invagination present in 100% of the cells, whereas tail structure and motility are fairly normal. The defect occurs during spermiogenesis. A possible concomitance with abnormalities in the microtubular apparatus involved in the sperm molding is discussed. PMID- 2707730 TI - Parthenogenetic activation of mouse and rabbit eggs by electric stimulation in vitro. AB - The present study was undertaken to determine conditions for parthenogenetic activation of mouse and rabbit eggs by electric stimulation in vitro. The cumulus free eggs were submitted to square direct current pulses at output voltage of 1.0 to 2.5 kV/cm for 25 to 200 microseconds. The best conditions for the activation of mouse eggs were 1.5 kV/cm for 100 microseconds, in which 78% of eggs were activated, 32% of which developed to blastocysts in vitro. When the nonelectric solution (0.3M mannitol) was used for electric stimulation, the activation rate was quite low (16%). Optimal conditions for activation of rabbit eggs were 1.5 kV/cm for 200 microseconds, in which 77% of eggs were activated, 25% of which developed to blastocysts. Unlike mouse eggs, rabbit eggs frequently had three pronuclei after electric stimulation. It is clearly shown that electric stimulus can induce parthenogenetic activation of the mouse and rabbit eggs in vitro. PMID- 2707729 TI - Production of identical twins by separating two-cell rat embryos. AB - Rat identical twins were produced from two-cell embryos. In the presence of cytochalasin B, rat two-cell embryos could be separated efficiently into two blastomeres by micromanipulation. Isolated blastomeres, embedded in agar cylinders and cultivated in ligated rat oviducts for 3 days, developed to the morula or blastocyst stage. After removing the agar, pairs of developed one-half embryos were transferred into Day 1 oviducts or Day 4 uteri of pseudopregnant rats. The percentage of embryos, separated either in the presence or absence of cytochalasin B, that developed into live fetuses was higher in cases of uterine transfer than in cases of oviduct transfer (38% vs. 18%, 31% vs. 15%, respectively). Throughout the present experiment, nine pairs of identical twins were successfully produced. This is the first report of the production of identical rat twins by separating two-cell embryos. PMID- 2707732 TI - Expression and topographical localization of cell surface fucosyltransferase activity during epididymal sperm maturation in the mouse. AB - We have demonstrated previously that spermatogenic cells in the mouse testis have high levels of fucosyltransferase activity. Furthermore, a significant portion of this activity has been localized to the cell surface (Millette et al.: Cell Biology of the Testis and Epididymis, 1987). Differential expression of fucosyltransferases and their function as ecto-enzymes may be important in the processes of sperm maturation and fertilization in mammals. Accordingly, here we report the activity levels of fucosyltransferase (FT) in spermatozoa isolated from the mouse caput and cauda epididymides. Calculated on a per cell basis, spermatozoa from the caput epididymis have significantly more FT activity than do spermatozoa from the cauda epididymis (18.07 +/- 2.2 pmol/million cells compared with 2.8 +/- 0.09 pmol/million cells). Furthermore, caput sperm exhibit a more significant increase in FT activity when assayed in the presence of Nonidet P-40. Calculated on the basis of cell surface area, however, FT activity remains constant on the head portion of spermatozoa isolated from all portions of the male reproductive tract and from capacitated spermatozoa. Measurements of FT activity in extracts of isolated sperm tails from cells at different stages of maturation indicate a greatly diminished activity in tails from sperm in the cauda epididymis. The total sperm surface area is composed predominantly of the plasma membrane surrounding the flagellar apparatus. Therefore, our data demonstrate that FT activity is retained selectively on the different topological regions of sperm, with losses during sperm maturation in the epididymis being restricted to the tail segment. Maintenance of high levels of FT activity of the plasma membranes of the mouse sperm head raise the possibility that FT is indeed involved in some aspects of sperm-egg recognition. PMID- 2707731 TI - Protein carboxyl methyltransferase activity specific for age-modified aspartyl residues in mouse testes and ovaries: evidence for translation during spermiogenesis. AB - An antiserum prepared against the purified protein carboxyl methyltransferase (PCMT) from bovine brain has been used to compare testicular and ovarian levels of the enzyme and to study the regulation of PCMT concentrations during spermatogenesis. The PCMT, which specifically modifies age-damaged aspartyl residues, is present at a significantly higher concentration in mature mouse testis than in ovary. However, the PCMT is present at nearly equal concentrations in extracts of germ cell-deficient ovaries and testes obtained from mutant atrichosis/atrichosis mice. In normal testis, the concentration of the PCMT increases severalfold during the first 4-5 weeks after birth, paralleling the appearance and maturation of testicular germ cells. Both immunochemical and enzymatic measurements of PCMT specific activities in purified spermatogenic cell preparations indicate that PCMT levels are twofold and 3.5-fold higher in round spermatids and residual bodies, respectively, than in pachytene spermatocytes. The results are consistent with the enhanced synthesis and/or stability of the PCMT in spermatogenic cells and with the continued translation of the PCMT during the haploid portion of spermatogenesis. The relatively high levels of PCMT in spermatogenic cells may be important for the extensive metabolism of proteins accompanying spermatid condensation or for the repair of damaged proteins in translationally inactive spermatozoa. PMID- 2707733 TI - Effects of ultrasound on ovulation in the mouse. AB - In vitro fertilization and embryo transfer (IVF-ET) programs use ultrasound extensively for monitoring the growth of ovarian follicles and, subsequently, for confirming the presence of a fetal sac. There have been few reports of the effects of ultrasound on ovulation rates in mammals, and we report here that following exposure to continuous wave ultrasound at a spatial average intensity of 3.0 W/cm2 for five minutes, ovulation rates measured 10 days later were significantly reduced in mice. When temperature elevation of the exposed ovary was measured with a thermocouple, hyperthermia correlated with reduction in ovulation. PMID- 2707734 TI - Presence of covalently bound metabolites on rat hepatocyte plasma membrane proteins after administration of isaxonine, a drug leading to immunoallergic hepatitis in man. AB - Isaxonine and several other drugs transformed by cytochrome P-450 into reactive metabolites apparently lead to immunoallergic hepatitis in man. Protein epitopes modified by the covalent binding of the metabolites have been proposed as possible targets for the immune response. The purpose of this work was to determine whether covalently bound metabolites are indeed present on hepatocyte plasma membrane proteins. In a first series of experiments, rats were killed 15 or 60 min after administration of [2-14C]isaxonine (0.2 mmol.kg-1 i.p.), and various fractions were prepared from isolated hepatocytes; microsomal contamination of the plasma membrane fraction was 1.2% or less. At 60 min, the amount of isaxonine metabolite covalently bound per mg of protein was similar in plasma membranes (0.42 nmole metabolite.mg protein-1) and in microsomes (0.38); both values were decreased by about 70% in rats pretreated with piperonyl butoxide, an inhibitor of cytochrome P-450. At 15 min, however, covalent binding to plasma membrane proteins (0.06 nmole metabolite.mg protein-1) was only half of that to microsomal proteins (0.12). In a second series of experiments, [2-14C] isaxonine (0.1 mM) was incubated with NADPH, hepatic microsomes and plasma membranes. The reactive isaxonine metabolite became bound extensively to microsomal proteins, but not to plasma membrane proteins. These results show that administration of isaxonine leads to the presence of isaxonine adducts on the proteins of the hepatocyte plasma membrane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707735 TI - Hepatic mitochondrial oxidative metabolism and lipid peroxidation in experimental hexachlorobenzene-induced porphyria with dietary carbonyl iron overload. AB - Both human porphyria cutanea tarda and experimental hexachlorobenzene-induced porphyria are associated with hepatic injury and are potentiated by excess hepatic iron. The mechanisms whereby cellular injury occurs and the synergistic role of iron overload are unknown. In the present experiments, we studied hepatic mitochondrial function and lipid peroxidation in rats with hexachlorobenzene induced porphyria in which iron loading was achieved by dietary carbonyl iron supplementation. Female rats were treated for 8 weeks, receiving a chow diet supplemented with hexachlorobenzene (0.2%, w/w), carbonyl iron (1.0%, w/w) or hexachlorobenzene + iron. Hepatic total porphyrins were increased 100-fold in rats receiving hexachlorobenzene (hexachlorobenzene alone and hexachlorobenzene + Fe), and total hepatic iron was increased approximately 10-fold in rats receiving iron supplementation (Fe alone and hexachlorobenzene + Fe). There was a significant increase in mitochondrial lipid peroxidation in rats treated with hexachlorobenzene alone and hexachlorobenzene + Fe. A significant reduction in mitochondrial respiratory control ratios and in oxidative phosphorylation (ADP/O ratios) using glutamate and succinate as substrates was demonstrated when rats were treated with hexachlorobenzene + iron. The reductions in respiratory control ratios were due to a combination of an inhibitory defect in electron transport as evidenced by an irreversible decrease in State 3 respiration and an uncoupling effect as evidenced by an increase in State 4 respiration. These findings suggest that lipid peroxidation and mitochondrial dysfunction may contribute to the hepatotoxicity seen in hexachlorobenzene-induced porphyria. PMID- 2707736 TI - Serum type III procollagen peptide and laminin (Lam-P1) detect alcoholic hepatitis in chronic alcohol abusers. AB - The diagnosis of alcoholic hepatitis is difficult to establish by conventional clinical and laboratory methods, and a firm diagnosis relies on liver histology. Since there are severe limitations in following patients with repeated liver biopsies, noninvasive procedures are needed to assess the presence of alcoholic hepatitis in chronic alcohol abusers. It has been suggested that serum Type III procollagen peptide levels correlates with the degree of inflammation in chronic liver disease. Since inflammation is a major histological finding in alcoholic hepatitis, we therefore studied the usefulness of measuring serum Type III procollagen peptide and laminin values in 45 consecutive chronic alcohol abusers, with or without cirrhosis, in detecting those with alcoholic hepatitis. The results showed that both Type III procollagen peptide and laminin values were elevated in all of the patients with established liver damage. However, the values were highest in those with liver cirrhosis plus alcoholic hepatitis (Type III procollagen peptide 50.4 +/- 36.4 ng per ml vs. 8.1 +/- 2.6 in controls, p less than 0.01; laminin 4.50 +/- 1.49 units per liter vs. 1.24 +/- 0.26 units per liter in controls, p less than 0.01), followed by subjects with alcoholic hepatitis alone (Type III procollagen peptide 23.5 +/- 17.6 ng per ml, p less than 0.01; laminin 2.60 +/- 1.09 units per liter, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707737 TI - Sexual behavior in women with nonalcoholic liver disease. AB - Sexual behavior in women with liver disease was examined in 150 women to determine whether liver disease influenced sexual desire, frequency or performance. The average age of women studied was 53 years (range: 26 to 76 years), and a wide variety of liver diseases were represented. Sexual desire was reduced in 33%. Difficulty in becoming sexually aroused was noted by 18%. Orgasm during intercourse was not experienced by 25%. The frequency of sexual intercourse decreased since onset of disease in 27%. Dyspareunia was a complaint by 21%, most often attributed to decreased vaginal lubrication. Liver disease was considered a significant factor interfering with sexual function in 17%. No statistical difference was found between sexual desire or function in our study and in large studies of sexual behavior in women. Each category was subdivided by presence or absence of cirrhosis, pre- or postmenopausal state, laboratory values and duration of disease. Except for a greater number of postmenopausal women with complaints of painful intercourse, no statistical differences or trends were found. Nonalcoholic liver disease does not affect sexual desire, function or performance. Variables other than liver disease influence sexuality. Women with liver disease can thus be reassured that they can maintain normal sexual relations. PMID- 2707738 TI - Hepatic aldehyde dehydrogenase activity in liver diseases, with particular emphasis on alcoholic liver disease. AB - Hepatic aldehyde dehydrogenase isozyme activity was measured in 51 patients with various types of liver diseases, including 24 patients with alcoholic liver disease, to elucidate the relationship between hepatic aldehyde dehydrogenase activity and liver disease, especially alcoholic liver disease. The levels of low Km and total aldehyde dehydrogenase activity in the liver decreased both in alcoholic and nonalcoholic liver disease patients, who showed an isoelectric focusing pattern of the usual type. There was no significant difference in the aldehyde dehydrogenase activity between alcoholic and nonalcoholic liver disease. In alcoholic liver disease, the decrease in the activity was significantly correlated with the progression of liver histology. The activity in liver cirrhosis was significantly lower than that in the other types of alcoholic liver disease. In nonalcoholic liver disease patients, the unusual type of hepatic aldehyde dehydrogenase activity observed was not different from the unusual type observed in nonhepatobiliary disease patients. These results indicate that the reduction of hepatic low-Km aldehyde dehydrogenase activity is a change that occurs subsequent to liver damage. Genetic abnormality in aldehyde dehydrogenase may not be important in the pathogenesis of alcoholic liver injury. PMID- 2707740 TI - Expression of different members of heat shock protein 70 gene family in liver and hepatomas. AB - The levels of expression of some genes of the HSP 70 family have been assessed in rat liver and in a series of transplantable hepatomas with different growth rates, subjected to heat shock in vivo. For this purpose, the mRNAs for the constitutive cognate HSC 73, the heat-inducible HSP 70 and the glucose-regulated GRP 78 have been analyzed by: (i) translation in reticulocyte lysates; (ii) hybrid-selected translation, and (iii) Northern blot analysis. In comparison with the liver, the fast-growing 3924A hepatoma has an increased constitutive amount of HSC 73 mRNA and a lower induction of HSP 70 mRNA after heat shock. The behavior of the 9618A slow-growing hepatoma is more similar to that of the liver, indicating that the changes detected in the fast-growing hepatoma are correlated to the high growth rate of the tumor rather than to carcinogenesis. This conclusion is reinforced by the results obtained with Yoshida AH-130 cells, growing at two different rates imposed by the environment in which they develop. When the Yoshida hepatoma grows rapidly in the peritoneal cavity, constitutive expression of HSC 73 mRNA is high and the inducibility of HSP 70 mRNA is poor: the opposite occurs when the tumor grows slowly in the subcutaneous compartment. The amount of GRP 78 mRNA increases progressively from the liver to the fast growing hepatoma. The level of HSC 73 mRNA seems to correlate with the methylation state of the corresponding gene. PMID- 2707739 TI - Cytoskeletal organization and functional changes in monocytes from patients with chronic hepatitis B: relationship with viral replication. AB - Monocytes play an important role in the initiation and regulation of the antiviral immune response. These cells have a dense framework of intermediate filaments composed of vimentin monomers. In 35 patients with chronic hepatitis B, 26 healthy controls, seven patients with acute liver damage and eight patients with inactive HBsAg-negative cirrhosis, we investigated the expression of vimentin filaments, C3b and IgGFc receptors, HLA-DR molecules and the phagocytic activity in monocytes purified from venous blood. In the same subjects, we also studied the display of CD2, CD3 and CD5 on lymphocytes. In patients with chronic hepatitis B manifesting viral replication (n = 21; Group 1), the expression of vimentin filaments and the other functional monocyte parameters were decreased, whereas in patients in the nonreplicative phase of the disease (n = 14; Group 2) and in control cases with various forms of acute liver damage or inactive HBsAg negative cirrhosis, they were similar to those found in healthy subjects. In Group 1, there was also a selective defect in the display of CD3 on lymphocytes. The expression of this molecule correlated with the functional state of monocytes. In three patients with chronic hepatitis B that changed from the replicative to the nonreplicative phase of the disease, the expression of vimentin filaments in monocytes and of CD3 on lymphocytes increased to normal levels. On the other hand, the incubation of patients' monocytes with gamma interferon corrected the diminished expression of vimentin filaments and the other decreased functional parameters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707741 TI - Drug-induced allergic hepatitis: does isaxonine fall into this category? PMID- 2707742 TI - Hepatic vascular toxicity of dacarbazine (DTIC): not a rare complication. PMID- 2707743 TI - Don't give up on your grant application. PMID- 2707744 TI - Does vasodilatation promote ascites formation and portal hypertension? PMID- 2707745 TI - Malignant lymphoma in Hawaii-Japanese: a retrospective morphologic survey. AB - A retrospective morphologic survey (1973-1983) of 146 cases of malignant lymphoma among the Hawaii-Japanese (migrant Japanese and their offspring) was conducted to determine whether differences in the incidence and cytologic types of malignant lymphoma exist when compared to those of native Japanese (lifetime residents of Japan). The age-adjusted incidence rates for malignant lymphoma among the Hawaii Japanese were similar to rates for U.S. whites. However, higher rates for follicular centre cell (FCC) lymphoma with a follicular pattern were observed in the Hawaii-Japanese population when compared with rates for native Japanese. On the basis of the cytologic types of the Lukes-Collins classification, non Hodgkin's lymphomas among the Hawaii-Japanese resembled those of Western countries, rather than those of Japan. B-cell lymphomas predominated (72 per cent), while T-cell types comprised 23 per cent of cases. Follicular centre cell types were encountered most often (59 per cent), and the small cleaved FCC subtype was the most common (30 per cent). The high degree of follicularity (29 per cent) was at variance with the consistently low rates reported in Japan. This may be explained, in part, by higher rates of nodal lymphomas among the Hawaii Japanese. Of the T-cell lymphomas, diffuse large cell types (T-cell immunoblastic sarcoma, T-IBS), often with cytologic pleomorphism, were relatively frequently encountered (16 per cent), and comprised 15 per cent of non-Hodgkin's lymphomas; this observation necessitates special clinical and epidemiologic consideration in view of the large Japanese migration to Hawaii from HTLV-I endemic regions of southern Japan. No registered cases of non-Hodgkin's lymphoma or of Hodgkin's disease were documented in Hawaii-Japanese subjects under the age of 15 years. The age-adjusted incidence rates for Hodgkin's disease among the Hawaii-Japanese were similar with those of native Japanese. Nodular sclerosis was the most frequent histologic subtype. The difficulty in distinguishing between Hodgkin's disease and non-Hodgkin's lymphoma, particularly when immunologic cell surface markers are not available, is addressed. Low rates for chronic lymphocytic leukemia among the Hawaii-Japanese were confirmed. Not one well-documented case was identified in the 11-year period surveyed. PMID- 2707746 TI - In vitro chemosensitivity testing of leukemic cells: development of a semiautomated colorimetric assay. AB - A rapid chemosensitivity assay was developed, employing the human continuous leukemic cell lines HL 60, K 562, FLG 29.1. This automated colorimetric assay is based on the characteristic of viable, metabolically active cells to cleave p iodonitrotetrazolium violet (INT) into a red formazan derivative, whose optical density is readable at 492 nm by an automated microtiter-plate reader photometer. A linear relationship was found between the viable cell number and the optical density of INT cleaved by the cellular samples. Dead cells did not reduce INT and did not interfere with the formazan derivative generation and the photometric reading. Leukemic cell lines were also tested for INT formazan derivative generation after exposure to antileukemic drugs at various concentrations, representative of plasma levels obtainable in vivo. A dose-dependent inhibition was detected, with different sensitivity patterns, related both to the drugs and to the different cell lines. A significant correlation between the viable cell number and the amount of tetrazolium salt cleaved was also demonstrated after drug exposure. INT assay allows the processing of a great number of samples and gives the opportunity to screen several drugs, saving time and yielding fully reliable results. PMID- 2707747 TI - Histomorphological variations in systemic AA amyloidosis: clues of AA protein polymorphism. AB - The histological location of amyloid within various organs in 25 cases of systemic AA amyloidosis was studied with a view to determine whether different morphological patterns exist in this category of amyloidosis. Although morphological variations due to progressive severity of disease were observed, there were appreciable variations in the patterns of amyloid deposition in the kidney and spleen that could not be simply explained on those grounds. Eleven (61%) of 18 kidneys examined showed severe glomerular involvement with mild degrees of vascular deposition while the remaining seven showed predominantly vascular involvement. The glomerular pattern appeared to be more ominous, being significantly associated with severe proteinuria or chronic renal failure. In nine (69%) of 13 spleens examined, amyloid was confined to the walls of small and medium-sized arteries while in the remaining four, vascular involvement was less severe and amyloid was deposited mainly along the reticulin of the white pulp. Possible explanations for these different patterns included resorption and redistribution of amyloid within the body during the course of the disease, and variation in tissue deposition as a manifestation of polymorphism of amyloid proteins. The latter appeared more feasible in view of the recent demonstration of SAA polymorphism and AA heterogeneity in man. PMID- 2707748 TI - The pancreas in acute graft versus host disease in man. AB - Twenty-six bone marrow transplant recipients, 14 of whom had evidence of acute graft versus host disease at autopsy, were studied. The pancreas in four of these patients exhibited changes thought to be due to acute graft versus host disease. Pathognomonic findings were in exocrine ducts which showed marked epithelial cellular atypia associated with a mild lymphocytic infiltrate. This was accompanied by ulceration and intraluminal haemorrhage in severe cases. In three of these four cases ductal epithelium showed marked hyperexpression of class I and class II major histocompatibility complex molecules. By contrast islets were not inflamed, showed no evidence of endocrine cell damage and no abnormalities of major histocompatibility complex expression were seen. PMID- 2707749 TI - Bacterial lymphadenitis with the picture of a lymphoepithelioid cell lymphoma- Lennert's lymphoma. AB - Three cases with the typical light microscopic picture of lymphoepithelioid cell lymphoma (so-called Lennert's lymphoma) were investigated by electron microscopy. Surprisingly, Lennert's lymphoma could be excluded in two cases. These two cases exhibited, in addition to pleomorphic lymphocytes and epithelioid cells, macrophages with accumulations of bacteria, indicating that a bacterial infection was the cause of the disease. By comparing the typical case of Lennert's lymphoma with the other cases, we found several criteria for distinguishing between Lennert's lymphoma and bacterial lymphadenitis. In bacterial lymphadenitis: (1) small and medium-sized lymphocytes exhibited a wide cytological spectrum whereas the lymphocytes in Lennert's lymphoma were relatively uniform; the lymphocytes with prominent lysosome-like granules found in Lennert's lymphoma were not seen; (2) cytology and distribution of epithelioid cells were similar to those in Lennert's lymphoma; (3) epithelioid venules contained recirculating lymphocytes, which were rarely found in Lennert's lymphoma; (4) numerous interdigitating reticulum cells, fibroblasts and myofibroblasts were seen, but not in Lennert's lymphoma; (5) focal increase in reticulin fibres was the main difference in light microscopy; (6) rod-shaped bacteria were accumulated in the cytoplasm of a few macrophages. The presence of bacteria could not be demonstrated unequivocally by light microscopy. In both cases the large number of intracytoplasmic bacteria suggests that this unusual and until now unknown lymphadenitis is the result of an infection caused by facultative intracellular parasitic bacteria. The outcome of bacterial lymphadenitis that gives the false impression of Lennert's lymphoma is uncertain. Cure was achieved in one of our cases. The other patient died before therapy was commenced. PMID- 2707750 TI - Malignant rhabdoid tumour of the bladder with immunohistochemical and ultrastructural evidence suggesting histiocytic origin. AB - A malignant rhabdoid tumour of the bladder is reported from a girl aged 6. Detailed immunohistochemical and ultrastructural investigations provide evidence which suggests a histiocytic origin for this controversial neoplasm. PMID- 2707751 TI - Malignant transformation in endometriosis of the urinary bladder. AB - A case of primary intravesical endometrioid carcinoma is described, together with a review of the literature. This represents the fourth reported case of malignant transformation in vesical endometriosis. PMID- 2707752 TI - Multicystic peritoneal mesothelioma: a case report. AB - A case of recurrent cystic peritoneal mesothelioma is reported. Ultrastructurally the tumour cells showed abundant surface microvilli, desmosomes, intracytoplasmic filaments and well-developed basal lamina. The cells demonstrated positive staining for keratin peptides, vimentin and epithelial membrane antigen and, some of them, for carcinoembryonic antigen. No staining was demonstrable for a number of endothelial markers. The findings are in accord with the proposed mesothelial origin of the neoplasm and can be of help in the differential diagnosis of other multicystic neoplasms arising in the peritoneal cavity. PMID- 2707753 TI - Cryptosporidial infection presenting as an acute appendicitis. PMID- 2707754 TI - Pulmonary capillary haemangiomatosis diagnosed during life. PMID- 2707755 TI - 'Krukenberg' tumour of the testis. PMID- 2707756 TI - Mycobacterial infection mimicking inflammatory 'pseudotumour' of the lung. PMID- 2707757 TI - A case of metastatic malignant melanoma masquerading as disseminated mammary carcinoma. PMID- 2707759 TI - A note on book reviews. PMID- 2707758 TI - Allergic fungal sinusitis. PMID- 2707760 TI - Mucosubstances in medullary carcinoma of the thyroid. PMID- 2707761 TI - Peripheral T-cell lymphoma in childhood. A clinicopathological study of six cases. AB - A review of the pathological material from 42 children with non-Hodgkin's lymphoma seen over a 44 month period revealed 10 large cell tumours. Of these, six were classified as peripheral T-cell lymphoma, an entity rarely reported in childhood. Three patients were boys and three girls (median age 9.5 years), and extranodal presentation was a feature of two patients. Five had high-grade tumours; of these, three were classified as large cell anaplastic, Ki-1 positive and two as pleomorphic large cell. The remaining patient had a low-grade tumour of angioimmunoblastic type. T-cell subsets were examined in three cases and showed the following phenotypes: CD4-, CD8-; CD4+, CD8-; CD4-, CD8+. Three of the patients with high-grade tumours died, with a mean survival of 22 weeks. The remaining patients are alive and clinically disease-free for between 10 and 24 months after treatment. PMID- 2707762 TI - Langerhans cells in human lung tumours: an immunohistological study. AB - In an immunocytochemical study of 41 human lung tumours we have shown that Langerhans cells can be reliably identified using the anti-CD1 monoclonal antibody NA1/34. Langerhans cells are present in all the main varieties of human lung tumour although they are infrequent in both small cell carcinoma and carcinoid tumour. There is considerable variation in numbers of Langerhans cells in both adenocarcinomas and squamous cell carcinomas. In this study tumours were divided into those with high numbers of Langerhans cells (greater than 2 per high power field) and those with low numbers (less than 2 per high power field). Analysing these results against patient survival showed a markedly worse survival in those tumours with a high number of Langerhans cells for all the tumours as a single group and for squamous cell carcinoma as a single entity. PMID- 2707763 TI - Dysplasia and carcinoma in the rectal stump of total colitics who have undergone colectomy and ileo-rectal anastomosis. AB - From a group of 374 patients with ulcerative colitis who underwent colectomy and ileo-rectal anastomosis between 1952 and 1976, 104 presented for follow-up rectal biopsies over a 5 year period to 1986. These patients have been followed for an average of 28 years since the onset of the disease (range 11-56) and provide a unique model for the study of the development of carcinoma in colitis. A total of 443 biopsies was examined and epithelial morphology assessed according to the classification of Riddell et al. (1983). Five patients developed carcinoma of whom two showed dysplasia in biopsies taken a year or more before the diagnosis; one showed dysplasia 2 months before the appearance of cancer, another synchronous with it, and in the fifth patient dysplasia was not detected. Of 20 biopsies classified as 'indefinite for dysplasia, probably negative', 80% were associated with subsequent resolution, while of nine 'indefinite for dysplasia, probably positive' biopsies, eight (89%) were subsequently associated with either carcinoma (six) or dysplasia (two). The results emphasize the danger of absolute reliance upon dysplasia in assessing individual cancer risk in colitics, appear to demonstrate the usefulness of Riddell's classification and provide additional information on the natural history of dysplasia. PMID- 2707764 TI - A perspex grid for localization of non-palpable mammographic lesions in breast biopsies. AB - The examination of excised, non-palpable mammographic lesions in breast biopsies is a recognized problem for the pathologist. There may be difficulties in identifying the lesion macroscopically and in subsequent sampling. This paper describes a simple method for resolving these problems. The breast biopsy is attached to a perspex grid and then radiographed. Use of the grid co-ordinates assists appropriate sampling of the specimen. Advantages over previously described methods are discussed. PMID- 2707765 TI - 'Pseudoadenomatoid' tumour of prostate. PMID- 2707766 TI - Parosteal osteosarcoma of the skull. PMID- 2707767 TI - Immunohistochemistry of Hodgkin's disease. PMID- 2707768 TI - AgNORs in melanocytic dysplasia. PMID- 2707769 TI - Mammary carcinoma arising in benign axillary epithelial lymph node inclusions. PMID- 2707770 TI - Blues to apply standards to eight procedures. PMID- 2707771 TI - Billions in new debt challenges HCA management. PMID- 2707772 TI - Employers want more substance-abuse services. PMID- 2707773 TI - Nursing shortage eases: AHA data. PMID- 2707774 TI - Many surgeons unwilling to staff trauma centers. PMID- 2707775 TI - Medical staff cooperation key to JCAHO plans. PMID- 2707776 TI - Maxicare fallout: will CA Blue Cross be next? PMID- 2707777 TI - Provider exodus, lawsuit prompted Maxicare filing. PMID- 2707778 TI - Offsite-sterilization concept picks up steam. PMID- 2707779 TI - Hospitals saw patient margin vanish in 1988. PMID- 2707780 TI - Nursing information systems not up to par--yet. PMID- 2707781 TI - Passion, experience key to career changes. PMID- 2707782 TI - Anthropometric variation and the genetic structure of the Jirels of Nepal. AB - Anthropometric measurements (head length, head breadth, bizygomatic diameter, minimum frontal diameter, head circumference, and stature) for 526 adult Jirels are utilized to establish the pattern of phenotypic relationships between seven villages in eastern Nepal. An analytical framework is provided that justifies the interpretation of biological distances as minimum genetic distances. Using this approach, estimates of the minimum pairwise genetic distances between villages and the minimum FST for the population are derived from the purely phenotypic data. The FST obtained in this way is consistent with results obtained from other data available for this population, confirming the utility of phenetic analysis of quantitative traits for elucidating genetic structure. PMID- 2707783 TI - Changes in completed family size and reproductive span in Anabaptist populations. AB - The Anabaptist Amish, Hutterite and Mennonite peoples trace their origins to the Reformation. Although they share certain beliefs, such as adult baptism and the separation of church and state, each group is culturally unique. The Hutterite and Amish are highly fertile and their populations exhibit stable rates of growth. These demographic characteristics reflect communal living among the Hutterites and labor intensive farming practices among the Amish. The Mennonites are the most receptive Anabaptist group to outside socioeconomic influences and provide a demographic contrast to the more conservative Amish and Hutterites. Demographic data collected during a study of aging in Mennonite population samples from Goessel and Meridian, Kansas, 1980, and Henderson, Nebraska, 1981, formed the basis of a cohort analysis in order to assess fertility change over time. Completed family size has decreased significantly in all three communities since 1870. Since the early 1900's the mean age of the mother at first birth has fluctuated but the mean age of mother at the birth of the last child is decreasing significantly for the communities of Goessel and Henderson, thus effectively shortening the reproductive span. The pattern is somewhat different for Meridian, the most conservative of the three communities. PMID- 2707784 TI - Ethnic and family factors of some common diseases in early childhood. AB - The primary purpose of the present study was to examine the comparative incidence of some common diseases with unknown genetic components (e.g. newborn jaundice, urinary and respiratory tract infections) in infants of Israeli families of mixed and non-mixed ethnic origin. We also studied possible relationships between risk of these diseases and a number of anthropometric and demographic factors. Only the group of infants whose parents originated from North Africa and Middle East showed statistically significant differences: namely an increased level of total morbidity, of various comparisons of specific disease frequencies, and in total illness frequency, between infants from "mixed" and "non-mixed" families. In general, however, there was a positive correlation between frequency of healthy infants in "mixed" group and genetic distance between parents. Our findings also indicated a significant association between weight and head circumference of newborn infants respectively, and their illnesses, especially jaundice. PMID- 2707785 TI - Analysis of differential growth of the right and the left leg. AB - In spite of well documented standards for length and annual growth rates of the femur and tibia, there is little information on short term longitudinal bone growth. We investigated differential growth dynamics of the lower leg in 10 children, aged 6:3 to 14:2 years, by knemometry, a novel and non-invasive technique of accurate lower leg length measurement with a technical error of 0.09 to 0.16 mm. Mini growth spurts were detectable in 7 of the children and occurred synchroneously in both legs. Approximately half of the variance of the weekly lower leg length increments could be attributed to synchrony of leg length increments, but a significant amount of residual variance remained which exceeded the technical error of the measurements. Run-analysis of the individual series of right vs. left differences of the weekly lower leg length increments provided evidence for alternating periods of overgrowth of one leg compared to the contralateral side in 5 out of the 10 children. We concluded that there is suggestive evidence of partial independence of lower leg growth in the short term. PMID- 2707786 TI - Relationship between 17 Venezuelan counties estimated through communality of surnames. AB - The coefficients of relationship and the Euclidean distances between 17 Venezuelan counties were estimated based on the frequency distribution of surnames obtained from the 1984 Venezuelan register of electors. In general, the coefficients of relationship between counties within the same state were higher than those between counties from different states. Euclidean distances exhibited the opposite relationship. Spearman's correlation coefficients for 136 pairs of counties were estimated between geographic and Euclidean distances (r = 0.41), geographic distance and coefficient of relationship (r = -0.44) and between Euclidean distance and coefficient of relationship (r = -0.48). The effect of partial geographic isolation on the frequency distribution of surnames is shown in the State of Falcon, where an isthmus separates two counties of the peninsula from two others on the mainland, and in Merida, where the Venezuelan Andes separates three counties from the rest of the country. Our results suggest that Euclidean distances are less influenced by common surnames than the coefficients of relationship. They also indicate that in Venezuela a high proportion of the population has remained sedentary until recently, and this gives rise to the focal distribution of some surnames. PMID- 2707787 TI - Immunogenetic studies of two recently contacted populations from Papua New Guinea. AB - We have examined the HLA profiles of the Hagahai and the Haruai people, two linguistic groups in the remote western Schrader mountains who have only recently had administrative contact, and compared them with those of other populations in Papua New Guinea. None of the antigens detected in the two groups was found missing in other populations although significant differences in allele frequencies exist. Recent contact history does not appear to have played any significant role in shaping these differences. Similarly, no evidence of differential selection pressures contributing to HLA heterogeneity was found. The genetic profiles of the Hagahai and the Haruai appear to be a result of recent admixture between unrelated, genetically disparate groups. PMID- 2707788 TI - Biosocial responses to seasonal food stress in highland Peru. AB - This paper examines patterns of seasonal variation in food consumption and responses to food stress in the highland community of Nunoa, Peru. Dietary and anthropometric data collected from January through August of 1985 on a sample of 26 households (127 individuals) are analyzed. This study finds sharp seasonal differences in energy intake (pre-harvest = 1150 calories/day; post-harvest = 1519/day; p less than 0.01) associated with variation in the availability of locally-produced products (e.g., tubers and cereals). Seasonal energy reduction, however, does not uniformly affect all sectors of this population. Children experience little seasonal change in energy intake and have a more adequate pre harvest diet and better nutritional status than adults. The responses used to "protect" children from energy stress and minimize the overall impact of seasonal food scarcity on this community include: 1) reduction of pre-harvest household caloric needs through emigration of adolescent and adult males, 2) preferential allocation of food to children during the pre-harvest period, 3) seasonal reduction of activity levels and the year-round use of children for many productive activities, and 4) seasonal changes in meal patterns that minimize post-prandial energy loss during periods of stress. Evaluation of similar data from other anthropological populations underscores the diversity of responses to seasonal change in food availability. Moreover, these data indicate that the protection of children from seasonal energy stress is more common than previously thought. Variation in adaptive responses to food stress appears to be dependent upon 1) the nature of the subsistence economy, 2) the relative contributions of children and adults to household production, and 3) the demographic structure of the population. PMID- 2707789 TI - Coefficients of relationship by isonymy within and between the regions of Scotland. AB - The distribution of surnames for births, marriages and deaths in 1976 among residents of the 12 Local Government Regions of Scotland was analyzed in terms of the coefficient of relationship by isonymy, Ri. Differences between sexes and events for Ri within Regions were consistent with greater inter-Region mobility among males compared with females and among young adults compared with the elderly. There were near zero correlations of geographical distance with Ri between Regions based on all surnames or common surnames. With Ri based on rare surnames, there was a small though statistically nonsignificant negative correlation. The best-fitting two dimensional relationship derived from Ri values based on rare surnames showed a fair correspondence with the map of Scotland, indicating a degree of genetic isolation between the Regions. PMID- 2707790 TI - Flow cytometry for all mole-like abortion specimens. PMID- 2707791 TI - An impending shortage of community hospital pathologists. PMID- 2707793 TI - Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases. AB - The well-documented but rare primary papillary serous peritoneal tumors are difficult problems for the pathologist and the clinician. Because of their unusual location, these tumors are often classified as mesothelioma or advanced ovarian carcinoma. In this study, we report the clinicopathologic features of eight primary peritoneal serous papillary tumors and compare their histologic and ultrastructural features to 12 serous ovarian tumors and 16 epithelial mesotheliomas (two peritoneal and 14 pleural). The eight peritoneal serous papillary tumors occurred in women aged 19 to 75 years; two were serous tumors of low malignant potential (borderline) and six were serous carcinomas. The tumors were located in the mesosalpinx, left pelvis, omentum, and/or surface of the ovary. The two patients with borderline neoplasms had long disease-free survival (11 years and 20 years), while three of the four patients with carcinoma with more than 1 year of follow-up died of disease. The peritoneal serous papillary tumors were morphologically identical to serous ovarian tumors of equivalent grade. Well-differentiated papillary structures with distinct fibrovascular cores and one or several layers of columnar, crowded cells, dense overlapping nuclei with a long axis perpendicular to the surface of the papillary cores, and numerous psammoma bodies were features of the peritoneal and ovarian serous tumors. In contrast, the tubulo-alveolar, solid, or poorly defined papillary structures lined by well-spaced polygonal to cuboidal cells with abundant cytoplasm, absence of nuclear polarity, and infrequent psammoma bodies characterized the mesotheliomas. Epithelial mucin and carcinoembryonic antigen (CEA) immunoreactivity, when present, supported a diagnosis of serous tumor in these generally mucin-poor and CEA-negative neoplasms. Ultrastructurally, the cells of serous tumors had slender, straight microvilli of variable length interspersed with or without cilia, while the nonciliated cells of mesothelioma had long, exuberant, wavy microvilli. The morphologic and clinical features of the peritoneal papillary serous tumors are distinctive enough to warrant their separation from mesotheliomas. PMID- 2707792 TI - The biology of tetraploid hydatidiform moles: histopathology, cytogenetics, and flow cytometry. AB - We identified three cases of tetraploid hydatidiform moles (HM). A complete hydatidiform mole (CM) had a 92,XXXX karyotype. The two partial hydatidiform moles (PM) had karyotypes of 69,XXY/90,XXXY,-11,-13 and 92,XXYY, respectively. Study of chromosomal heteromorphisms in the 92,XXYY PM revealed two maternal and two paternal haploid sets. Flow cytometric analysis of nuclear DNA content from fresh placental tissue from the 69,XXY/90,XXXY,-11,-13 PM demonstrated distinct peaks in the triploid and tetraploid regions and an octaploid G2/M peak. Flow cytometric analysis of paraffin-embedded, fixed tissue was diagnostic of tetraploidy in the 92,XXXX CM and consistent with tetraploidy in the 92,XXYY PM. All three patients achieved spontaneous remission of elevated gonadotropin levels. These three cases of tetraploid HM do not fit into the usual patterns of diploid CM and triploid PM. We conclude that flow cytometric analysis of nuclear DNA may be used to identify polyploidy in fresh and paraffin-embedded, fixed placental tissues. Categorization of all molar placentas on the basis of ploidy presents rare opportunities to study the biology and natural history of gestational trophoblastic disease in tetraploid HM. PMID- 2707794 TI - Ultrastructure of the mucus-negative vacuolated cells in the metaplastic pyloric gland of the human stomach. AB - Mucus-negative vacuolated cells, often with apical cilia, were found in the metaplastic pyloric gland of the human stomach. These vacuoles were not stained by various mucus stains, but contained neutral fat. Electron microscopic observation revealed that the ciliated cells had prominent autophagosomes in the supranuclear region and sometimes had large vacuoles. These vacuoles were limited by a unit membrane and had electron-lucent contents consisting of small amounts of lipid droplets and lamellar bodies. The non-mucus vacuolated cells might correspond to the mature ciliated cells in which cystic degeneration of the autophagosomes occurred after digestion by lysosomal enzymes. PMID- 2707795 TI - Pregnancy hypertension, placental evidences of low uteroplacental blood flow, and spontaneous premature delivery. AB - This study was undertaken to determine if preeclampsia and low uteroplacental blood flow cause spontaneous preterm births. No non-invasive methods are currently available to accurately measure uteroplacental blood flow, so surrogates that are known to be associated with low uteroplacental flow were used. These are preeclampsia, placental infarcts, abnormally small placental villi, and excessive syncytial knots. Preeclampsia was associated with a frequency of spontaneous preterm births that was 41% greater than expected (P less than .001). Normotensive gestations with placental findings of low uteroplacental blood flow ended preterm 147% more frequently than expected, and when a woman had two such pregnancies in succession, the second had a particularly high frequency of spontaneous preterm delivery (64%). Overall, preeclampsia and placental findings of low uteroplacental blood flow were associated with 26% of the spontaneous preterm deliveries in this study. Preeclampsia and low uteroplacental blood flow may be major causes of preterm birth. PMID- 2707797 TI - Embryonic remnants of the umbilical cord: morphologic and clinical aspects. AB - Embryonic vestiges of the umbilical cord are classic findings in routine morphologic examination of the placenta. In order to evaluate their clinicopathologic significance, we examined samples from the fetal and placental ends of 1,000 umbilical cords and collected the principal clinical findings of the corresponding newborns. Microscopic evidence of embryonic remnants were found in 231 cases (23.1%) divided into remnants of the allantoic duct (63%), the omphalomesenteric duct (6.6%), and the embryonic vessels (30.4%), including one case of hemangioma and an accessory small artery. There were no significant clinical differences between the three vestigial groups, and no particular association with congenital malformations or perinatal complications. In 70.9% of the cases, the embryonic remnants were found at the fetal end of the umbilical cord, where most tumors of the cord develop. PMID- 2707796 TI - Surgical pathology of the lung in anti-basement membrane antibody-associated Goodpasture's syndrome. AB - We report the findings of lung biopsies from five patients with anti-basement membrane antibody-associated Goodpasture's syndrome (ABMA-GS). In four patients, pulmonary capillaritis with hemorrhage was found on lung biopsy, confirming that pulmonary capillaritis can be found in ABMA-GS. Although alveolar hemorrhage was the dominant pathologic finding in four of our five patients, all five patients had evidence of injury at the level of the alveolar wall, manifested by hyaline membranes and widening of alveolar walls by edematous connective tissue. In one of our patients, alveolar hemorrhage was only focal, and diffuse alveolar damage was the dominant pathologic finding. This pattern of lung disease has not been previously described in ABMA-GS. PMID- 2707798 TI - Female splenic-gonadal fusion of the discontinuous type. AB - Splenic-gonadal fusion is an extremely rare congenital anomaly that results from fusion between the splenic and gonadal anlage during embryonic development. Approximately 90 cases have been reported in the literature. The condition has been divided into two major subgroups: continuous splenic-gonadal fusion in which a continuous cord-like structure connects the spleen and the gonadal-mesonephric structures, and discontinuous splenic-gonadal fusion in which no such connection exists. We report a case of discontinuous splenic-gonadal fusion in an adult women with no evidence of other anomalies or malformations, the fifth reported case of splenic-gonadal fusion occurring in a female. To our knowledge, this is the first case of discontinuous splenic-gonadal fusion reported in a female patient, and the second case of splenic-gonadal fusion reported in an adult woman. PMID- 2707799 TI - Parosteal osteogenic sarcoma of bone with coexistent low- and high-grade sarcomatous components. AB - We report a case of parosteal osteogenic sarcoma with unusual histologic features; the intramedullary component is high-grade fibrosarcomatous osteogenic sarcoma, while the peripheral juxtacortical component is low-grade osteoblastic osteogenic sarcoma. PMID- 2707800 TI - Epithelial-lined (true) cyst of the adrenal gland: a case report. AB - A case of an epithelial-lined (true) adrenal cyst is reported. Although over 300 adrenal cysts have been reported in the literature, true cysts are rare. In this case, a 4.0 cm cyst lined by cuboidal to flattened cells with bland cytologic features was incidentally found at autopsy. Immunologic studies performed on formalin-fixed, paraffin-embedded sections demonstrated that the cells expressed keratins (AE1/AE3+, CAM 5.2+, and MAK-6+) and were negative for epithelial membrane antigen, vimentin, factor VIII, and desmin. Normal adrenal cortical and medullary cells did not express keratins, suggesting that the cyst lining was not derived from either adrenal cortex or medulla. A mesothelial origin, with a pathogenesis analogous to the formation of primary cysts of the spleen, is proposed. PMID- 2707801 TI - Retroperitoneal seminoma and intratubular germ cell neoplasia. AB - A 30-year-old man with a 6-month history of flank pain was found to have a large retroperitoneal seminoma. A subsequent ultrasound examination revealed an inhomogeneous echo pattern in the normal-sized right testicle, which on orchiectomy showed extensive intratubular germ cell neoplasia. Level sectioning of the entire testicle revealed no extratubular extension of the tumor cells. The retroperitoneal and testicular lesions could represent double primaries. However, the possibility exists that an apparently intratubular germ cell neoplasm may not actually be an in situ lesion and that the retroperitoneal tumor in our case represents a metastasis from the intratubular germ cell neoplasia of the testicle. PMID- 2707802 TI - New nomenclature for vulvar disease: International Society for the Study of Vulvar Disease. PMID- 2707803 TI - Association of specific syndromes with renal cystic disease. PMID- 2707804 TI - Accessory spleen in the head of the pancreas. PMID- 2707805 TI - Solid cell nest-associated C-cells: another possible explanation for "C-cell hyperplasia" adjacent to follicular cell tumors. PMID- 2707806 TI - Scientific authorship and interdepartmental communication: two reports of a single case. PMID- 2707807 TI - Supporting community access. PMID- 2707808 TI - "Involving the total health system". PMID- 2707809 TI - Gaining intersectoral support: the case of the People's School. PMID- 2707810 TI - WHO--Shanghai Collaborating Center in Health Education: strategic scheme for development. PMID- 2707811 TI - "Public health as if people matter". PMID- 2707813 TI - Health programmes and the community. PMID- 2707812 TI - Hygiene, health education and collaborative health practices in Nepal. PMID- 2707814 TI - Comprehension aids for on-line reading of expository text. AB - A chapter of expository text was presented on a CRT with optional "windowing" of definitions of selected words varying in relevance to each screen's main ideas. A test treatment was interposed to influence reading strategies. Dependent variables included text reading time, frequency of definition "calls," definition reading rates, and scores on a final comprehension test. Results indicate that a technical chapter can be read from a CRT with appreciable content retention. Subjects accessed 80% of available definitions, but those able to "call" content relevant definitions increased their frequency of definition "calls." Definition reading rate diminished; comprehension and processing time increased only for subjects accessing the theoretically relevant definitions. The results suggest how the use of definitions enhances the comprehension of on-line training manuals, texts, and help screens. "Callable" definitions need not include all low frequency technical concepts but only those relevant to reductive main ideas. PMID- 2707815 TI - The effects of preview and task symmetry on trunk muscle response to sudden loading. AB - The effect of warning time (preview) and task symmetry on the trunk muscular response to sudden loading conditions was investigated. Eleven subjects were asked to catch falling weights with four levels of preview (0, 100, 200, and 400 ms) in saggitally symmetric posture and asymmetric posture. For each of the eight muscles sampled with surface electrodes, the integrated electromyographic (EMG) signal was interpreted in terms of its peak value, mean value, onset rate, and lead/lag time with reference to the weight drop. Results show linear relationships between preview times and peak EMG, preview times and mean EMG, and preview times and lead times. The results show significant change when going from symmetric to asymmetric conditions across most dependent measures. Analysis of peak changes in compression were performed across all conditions but yielded unexpected results. PMID- 2707816 TI - Visual displays: the highlighting paradox. AB - Office computer users view well over a billion displays in a given year. The savings of only a fraction of a second in the time it takes users to process each display can potentially lead to enormous time and cost savings. In recent research investigators have shown that on average subjects are quicker to find a target option in a highlighted display than in a display without highlighting. Paradoxically, in related research other investigators have shown that subjects are slower to find a target in a highlighted display than in a display without highlighting. In an attempt to resolve this paradox, an additional set of experiments was performed. Results from these experiments suggest that in order to determine whether highlighting will be of benefit, one must know the type of highlighting, the level of highlighting validity, and the probability that subjects attend first to the highlighted options. PMID- 2707817 TI - Modeling the cognitive content of displays. AB - An approach for measuring the cognitive complexity of visual displays is discussed and applied to a dynamic display of avionic information. A semantic network formalism is used to model two interrelated knowledge systems, world knowledge and display knowledge. The information the operator receives during training about the general display format characteristics and the task requirements, along with other previously stored information, constitutes world knowledge. The semantic content of a particular configuration of information encountered during task performance constitutes display knowledge. Four orthogonal predictor measures of cognitive complexity were derived from the networks. In an experiment three of the orthogonal predictors were significantly correlated with task performance. After averaging across operators, the three significant predictors accounted for 99% of the variation of display effectiveness. Results indicate that a model of cognitive complexity based on a semantic network formalism may provide a useful technique for quantitatively evaluating the quality of competing display format concepts. PMID- 2707818 TI - Processing demands, effort, and individual differences in four different vigilance tasks. AB - In an attempt to specify the limiting conditions of the taxonomy of vigilance tasks, four tasks differing in memory load and in stimuli employed (sensory or cognitive) were compared. Electrodermal activity and subjective measures were used to determine the investment of effort. The data show that vigilance level and vigilance decrement dissociate. The level seems to relate to effort demand and investment; the decrement seems to be task driven, determined mainly by the type of stimuli used. Tasks employing unfamiliar stimuli showed a decline in sensitivity; "cognitive" tasks employing alphanumeric stimuli did not. Principal components analyses suggest that measures of speed and accuracy may reflect relatively independent systems. Subjective data showed that good performers expand more effort in difficult and complex tasks. Effortful processing seems to prevent rather than induce a decline in efficiency. PMID- 2707819 TI - Visual accommodation and target detection in the vicinity of a window post. AB - The visual environment of a driver in a car or a pilot in an airplane has intervening objects from the vehicle such as A-pillar posts between the windscreen and the doors in the car or cockpit pillars in the airplane. The presence of such objects can bias the observer's visual accommodation response because of the Mandelbaum effect (e.g., Owens, 1979). When subjects were allowed to focus toward a distance by looking through a large aperture in an intervening post, the detection (monocular) of a briefly presented distant target was found to be significantly better than when no aperture was present. When the size of the aperture was decreased from 2.3 to 1.15 deg diameter, target detection performance was significantly decreased and remained constant as further reduction of foveal cues was made. Although the detection results were generally in agreement with the visual accommodation results, detection accuracy changed significantly only with marked changes in accommodation. In addition to an accommodation bias, interference to target detection was also observed for those targets occurring at a laterally proximal position to the intervening object. PMID- 2707820 TI - Simultaneous adaptation to size, distance, and curvature underwater. AB - Perceptual adaptation to underwater size, distance, and curvature distortion was measured for four different adaptation conditions. These conditions consisted of (a) playing Chinese checkers underwater, (b) swimming with eyes open underwater, (c) viewing a square underwater, and (d) an air control. Significant adaptation to underwater distortions was recorded in all except the air control condition. In the viewing square condition a positive correlation between size and distance adaptation was noted. It was suggested that adaptation to curvature may have mediated the positive correlation. Possible applications for the training of divers are discussed. PMID- 2707822 TI - The pinning ceremony: to have or have not! PMID- 2707821 TI - Increasing the probability of NCLEX success. PMID- 2707823 TI - My special friend. PMID- 2707824 TI - The rape of a nurse. PMID- 2707826 TI - Shift work in nursing and circadian rhythms. PMID- 2707825 TI - Patient advocacy: should I or shouldn't I? PMID- 2707827 TI - Coming of age as a professional. PMID- 2707828 TI - Oncology nursing. PMID- 2707829 TI - Is stress ripping nurses apart? PMID- 2707830 TI - Nurses helping nurses. PMID- 2707832 TI - Nurses--take care of nursing! PMID- 2707831 TI - Identifying and coping with your stress. PMID- 2707833 TI - Patterns and implications of drug use by students of nursing. PMID- 2707834 TI - [Administration of cytostatic drugs by intra-arterial route. Theoretical basis]. AB - The Authors discuss the theoretical principles of the intra-arterial administration route of antineoplastic drug in the treatment of primaries or metastatic diseases. PMID- 2707835 TI - [Antiemetic and antinauseant effect of alizapride in patients subjected to antiblastic infusion chemotherapy in a day-hospital regime]. AB - A study about alizapride in out patients with nausea and vomiting during infusional antiblastic chemotherapy. PMID- 2707836 TI - [Diffusion of smoking among high school students at U.S.L. No. 18 of the Tuscan region]. AB - Between young people: 51% of male have never smoked, and only 38% of the females. If increase the age, increase also the percentage of whom that have had first meeting with cigarette smoke. Begin previously boys and they smoke more strongly. Today young people begin to smoke always more precociously, even if they are more informed. PMID- 2707837 TI - [Carcinoma of the vulva: our experience]. AB - The Authors report their experience on the vulvar carcinoma therapy. Patients showed, with high frequency, hypertension and diabetes. The 25.9% of the patients, furthermore, were obese. The surgery was the primary treatment, combined with chemiotherapy and radiotherapy in selected cases. The survival rate was 80% in I stage, while in the III and IV stage was very low, in spite of the use of chemotherapy. PMID- 2707838 TI - [Benign cystic mesothelioma of the peritoneum]. AB - A case of peritoneal cystic mesothelioma in a 40-yr-old woman is reported. The patient was operated on for signs of acute appendicitis. The lesion was made up of small, multiple, thin-walled cysts and both visceral and parietal layers of the peritoneum in the appendix region were involved. The lesion must be differentiated from other cystic lesions of the abdominal cavity and in particular from the multilocular lymphangioma. The diagnostic role of special techniques, such as immunohistochemistry and electron microscopy, in difficult cases is emphasized. PMID- 2707839 TI - [Cancer of the cervix uteri in pregnancy: surgical treatment with conservation of the ovaries. Clinical case]. AB - Authors report the case of 32 years old pregnant woman, who at the VI month of pregnancy developed an invasive carcinoma of the cervix uteri. It is hypothesized that surgical therapy according to Weirtheim-Meigs, without bilateral ovariectomy, consent the conservation of the reproductive function in the young women thought the development of the artificial insemination technics. PMID- 2707840 TI - Efficacy of tinidazole (Fasigyn) in giardiasis by parasitologic, biochemical, and gut transit studies. AB - Twenty patients (18 M, 2 F; age 16-32 yrs) with symptomatic giardiasis were treated with tinidazole: ten each with a dose of 150 mg twice daily for 7 days, and a single dose of 2 g (50 mg/kg). Stool examination by formalin-ether concentration method was carried out before and one month after treatment. Cure was defined as absence of G lamblia in the stools. Fecal fat excretion (100 g load) and D-xylose absorption (5 g load) were measured before treatment and, if abnormal, repeated one month after treatment. Gut transit time was measured before and one month after treatment by giving radio-opaque beads orally and following their progress fluoroscopically to complete elimination. Parasitologically, all 20 patients were cured. Clinically, there was marked to complete relief of symptoms. Concomitantly, there was significant (p less than 0.01) reduction in fecal fat excretion, improvement in D-xylose absorption, and increase in gut transit time. PMID- 2707841 TI - Leiomyoblastoma stomach. AB - Three patients with epithelioid leiomyomatous tumors (leiomyoblastomas) of the stomach are presented. PMID- 2707842 TI - Endoscopic vs surgical drainage of biliary tract in acute pyogenic cholangitis: a controlled study. PMID- 2707843 TI - Spontaneous mesenteric hematoma. PMID- 2707844 TI - Non-obstructive caecal perforation (Ogilvie's syndrome) after normal vaginal delivery. PMID- 2707845 TI - Cystic duplication of alimentary tract. PMID- 2707846 TI - Mucin histochemistry of the upper gastrointestinal tract. AB - Histochemically differentiated mucins have been studied in the mucosal lining of the esophagus and the stomach. Acid mucin was differentiated from neutral mucin by the alcian blue/PAS technique and sulphomucin by the high iron diamine/alcian blue technique. Neutral mucin secreted normally by the stomach mucosa was replaced by acid mucin in 17 of the 19 mucin secreting adenocarcinomas involving the lower third of the esophagus, and in 24 of the 28 mucin secreting gastric adenocarcinomas studied. The intestinal metaplasia (IM) seen in the gastric mucosa associated with adenocarcinoma, chronic gastric ulcer and chronic gastritis was classified according to the type of mucin secreted by the goblet cells. IM secreting sulphomucins was seen to be associated with gastric adenocarcinoma. PMID- 2707847 TI - Mucin histochemistry of the lower gastrointestinal tract. AB - Variations in the mucin secretion pattern in the mucosal lining of the colon and rectum have been studied. Mucins have been differentiated histochemically as neutral mucins, sialomucins and sulphomucins, using alcian blue/PAS and HID/alcian blue techniques. In the normal colonic mucosa, the goblet cells secrete predominantly sulphomucins with small amounts of sialomucins. Twenty one cases with benign lesions showed varying patterns of mucin secretion. In the 35 cases with adenocarcinoma studied, the transitional mucosa adjacent to the lesion showed a reversal of mucin secretion pattern, with an increase in sialomucins and a marked decrease in sulphomucins, suggesting a reaction to neoplasia. PMID- 2707848 TI - Drainage after elective cholecystectomy: a prospective study. AB - Prospective analysis of 100 consecutive patients who underwent elective cholecystectomy with drainage over a one year period is presented. Drainage after cholecystectomy detected bleeding and bile leak in four patients. Conservative management of bile leak was adequate in two patients while one patient with bleeding required re-exploration. Drainage did not increase morbidity in the form of wound infection, hospital stay or rate of other complications. After cholecystectomy routine drainage through the right flank is recommended. PMID- 2707849 TI - Tumor necrosis factor alpha is a cytotoxin induced by murine Chlamydia trachomatis infection. AB - A mouse model of pneumonia caused by murine Chlamydia trachomatis (mouse pneumonitis agent) was used to demonstrate that whole spleen cells from both nude athymic mice (nu/nu) and heterozygous mice (nu/+) produced tumor necrosis factor alpha in vitro in response to mouse pneumonitis agent antigen. The tumor necrosis factor alpha measured in these supernatants by immunoassay was shown to have bioactivity in a cytotoxic assay in which uninfected target cells were used. This cytotoxicity was distinct from the gamma interferon-related cytotoxicity against C. trachomatis-infected targets that we described previously. PMID- 2707850 TI - Campylobacter-Wolinella group organisms are the only oral bacteria that form arylsulfatase-active colonies on a synthetic indicator medium. AB - Most oral bacteria tested formed colonies on a chemically defined medium with a chromogenic arylsulfatase substrate. Arylsulfatase activity was, however, restricted to Campylobacter-Wolinella group organisms, including Wolinella recta, a possible periodontopathogen. W. recta was the only arylsulfatase-active species against which consistently high levels of antibody were detected in human sera. PMID- 2707851 TI - Expression of pertussis toxin in Bordetella bronchiseptica and Bordetella parapertussis carrying recombinant plasmids. AB - Pertussis toxin is produced only by strains of Bordetella pertussis. Cloned genes encoding pertussis toxin from B. pertussis were transferred into Bordetella bronchiseptica and Bordetella parapertussis by conjugation. These transconjugants expressed pertussis toxin at levels comparable to those expressed by B. pertussis. The toxin made by these strains was biologically active in the Chinese hamster cell clumping assay, contained all five subunits, and was mostly periplasmic. Toxin expression appeared to be modulated in the same way as are the vir-regulated genes of B. pertussis. Introduction of these plasmids into B. pertussis failed to produce hypertoxigenic strains. Instead, these transconjugants underwent plasmid loss, gene deletions, or conversion to the avirulent phase. PMID- 2707852 TI - Population genetics of human and animal enteric Campylobacter strains. AB - A total of 125 strains of Campylobacter jejuni and Campylobacter coli from human and animal hosts were analyzed by multilocus enzyme electrophoresis. Ten genetic loci were characterized by the electrophoretic mobilities of their products, and all were found to be polymorphic. The nine loci considered for genetic analysis had an average allele number of 6.9 and a mean genetic diversity of 0.634. The strains were grouped into 64 electrophoretic types (ETs) forming two principal clusters; the first cluster consisted of 50 ETs represented by 104 isolates of C.jejuni, and the second included 14 ETs represented by 21 isolates of C. coli. The genetic distance between the two species was 0.939. The data support the conclusions that (i) campylobacteriosis caused by C. jejuni and C. coli is a zoonosis, (ii) human and animal strains do not constitute subpopulations, and (iii) every animal strain may be considered a potential human pathogen. The frequency of intraspecies gene transfer seems to be moderately high whereas interspecies gene transfer is very rare at best, which suggests the existence of a biological barrier between C. jejuni and C. coli. PMID- 2707853 TI - Experimental Campylobacter jejuni infection in Macaca nemestrina. AB - Experimental infection of four specific-pathogen-free Macaca nemestrina monkeys (aged 3.5 and 4.5 months) with Campylobacter jejuni 81-176 caused acute diarrheal illness, characterized by fluid diarrhea, bloody stools, and fecal leukocytes, which lasted for approximately 7 to 11 days. Histologic examination of intestinal biopsies showed acute colitis characterized by infiltration of the mucosa with neutrophils and lymphocytes, and cryptitis. There were no histologic changes in the small intestine. Excretion of C. jejuni was demonstrated for 2 to 4 weeks postchallenge. Plasma antibodies to C. jejuni group antigen were elevated after challenge. Only mild diarrhea occurred after rechallenge with the same strain or with a heterologous C. jejuni strain (79-168) followed by further elevation in specific immunoglobulins A, M, and G. Four 1-year-old juvenile M. nemestrina monkeys which had experienced multiple infections with Campylobacter spp. did not exhibit illness when challenged with C. jejuni 81-176. All had elevated immunoglobulin A, M, and G plasma antibodies prior to challenge, and these humoral antibody levels were indicative of the immunity to challenge. The results demonstrate that C. jejuni infection in M. nemestrina caused colitis with clinical and pathologic results similar to those found in humans and indicate that prior infection protects against subsequent challenge. PMID- 2707854 TI - Antipneumococcal effects of C-reactive protein and monoclonal antibodies to pneumococcal cell wall and capsular antigens. AB - Antibodies to pneumococcal capsular polysaccharides are well known for their ability to protect against pneumococcal infection. Recent studies indicate that antibodies to cell wall antigens, including pneumococcal surface protein A and the phosphocholine (PC) determinant of teichoic acids as well as human C-reactive protein (which also binds to PC), can protect mice against pneumococcal infection. In the present study we compared the protective effects of these agents as measured by mouse protection, the blood bactericidal assay, and clearance of pneumococci from the blood and peritoneal cavity. Our findings extend previous results indicating that human C-reactive protein and antibodies to noncapsular antigens are generally less protective than anticapsular antibodies. The new results obtained indicate the following: (i) mouse protection studies with intraperitoneal and intravenous infections provide very similar results; (ii) monoclonal immunoglobulin G2a (IgG2a) antibodies to PC, like IgG1, IgG2b, and IgG3 antibodies to PC, are highly protective against pneumococcal infection in mice; (iii) human antibody to PC is able to protect against pneumococcal infection in mice; (iv) antibodies to PspA are effective at mediating blood and peritoneal clearance of pneumococci; (v) complement is required for the in vivo protective effects of both IgG and IgM antibodies to PC; (vi) IgG1, IgG2b, and IgG3 anti-PC antibodies all mediate complement-dependent lysis of PC-conjugated erythrocytes; and (vii) antibodies and human C-reactive proteins that are reactive with capsular antigens but not cell wall antigens are able to mediate significant antibacterial activity in the blood bactericidal assay. PMID- 2707855 TI - Cloning and expression of the leukotoxin gene from Actinobacillus actinomycetemcomitans. AB - The leukotoxin produced by Actinobacillus actinomycetemcomitans has been implicated in the etiology of juvenile periodontitis. To initiate a genetic analysis of the role of this protein in disease, we have cloned the leukotoxin gene in Escherichia coli. Recombinant colonies carrying toxin gene sequences were isolated by screening a genomic A. actinomycetemcomitans library with a DNA probe for the leukotoxin gene from a related bacterium, Pasteurella haemolytica. To demonstrate that the cloned A. actinomycetemcomitans DNA contained a functional leukotoxin gene, protein extracts of E. coli containing the A. actinomycetemcomitans clone were tested directly for leukotoxic activity against human cell lines in chromium release assays. A construct containing the entire cloned region produced a functional toxin. No cytotoxicity was seen when extracts from cells containing plasmids with deletions in the putative coding region were used. Furthermore, the toxin produced by the cloned gene has the same target cell specificity as the leukotoxin extracted directly from A. actinomycetemcomitans. These results indicate that sequences encoding a functional leukotoxin have been cloned and are expressed in E. coli. Southern blot analysis of DNA from leukotoxin-producing (Lkt+) and non-leukotoxin-producing (Lkt-) strains indicated that the Lkt- strain also contained a copy of the gene. PMID- 2707856 TI - Immunomodulatory activity of monophosphoryl lipid A in C3H/HeJ and C3H/HeSnJ mice. AB - Treatment with nontoxic monophosphoryl lipid A (MPL) derived from a polysaccharide-deficient, heptoseless Re mutant of either Salmonella typhimurium or Salmonella minnesota R595 enhanced the immunoglobulin M (IgM) anti-type III pneumococcal polysaccharide (SSS-III) antibody response of C3H/HeSnJ mice. Such an adjuvant effect was not observed in lipopolysaccharide-nonresponder C3H/HeJ mice. Nevertheless, C3H/HeJ spleen cells produced a weak mitogenic response to both preparations of MPL in vitro, and C3H/HeJ mice showed a significant increase in serum IgM levels without an increase in numbers of splenic IgM-secreting plaque-forming cells after in vivo treatment with MPL. A significant increase in serum IgG3 levels was accompanied by a transient decrease in serum IgG1 levels in C3H/HeSnJ mice given MPL; such non-antigen-specific polyclonal effects were not observed in C3H/HeJ or in athymic nu/nu mice. Since the enhanced antibody response to SSS-III has been attributed to the inactivation of suppressor T cells by MPL and since suppressor-T-cell activity is demonstrable in both C3H/HeSnJ and C3H/HeJ mice, these findings imply that (i) the suppressor T cells of C3H/HeJ mice are refractory to inactivation by MPL and (ii) some of the polyclonal and mitogenic effects produced in C3H/HeJ mice are due to the direct action of MPL on B lymphocytes. PMID- 2707857 TI - lcrH, a gene necessary for virulence of Yersinia pestis and for the normal response of Y. pestis to ATP and calcium. AB - We are investigating the functions of the three proteins encoded by the V operon (lcrGVH) of the low-calcium response virulence plasmid pCD1 of Yersinia pestis KIM5. The purpose of this study was to define the role of the 18-kilodalton protein encoded by lcrH, the third gene of the V operon. Using marker exchange mutagenesis, we constructed a Y. pestis mutant that failed to express the LcrH protein. This LcrH- mutant was "ATP blind" in that it failed to show altered growth and V-antigen expression at 37 degrees C when 18 mM ATP was present. It also showed only a partial response to 2.5 mM Ca2+. The parental Y. pestis strain showed full growth yield at 37 degrees C and depressed expression of V antigen and of yop (yersinial pCD1-encoded outer membrane protein) genes in response to ATP or Ca2+. In contrast, the LcrH- mutant failed to grow at 37 degrees C in the presence of ATP and showed only limited growth when Ca2+ was present. V-antigen expression in the mutant was not depressed by ATP and only partially depressed by Ca2+. These findings show that LcrH is necessary for the normal response of Y. pestis to ATP and that LcrH contributes to Ca2+ responsiveness. The mutant also showed abnormal yopJ expression, indicating that LcrH also is necessary for normal yop regulation. The LcrH- mutant was avirulent in mice, probably because of its compromised growth at 37 degrees C. These findings indicate that the responses of Y. pestis to ATP and Ca2+ are distinct and that lcrH encodes a protein that is an important mediator of Ca2+ and ATP regulation of pCD1-encoded virulence determinant(s) in Y. pestis. PMID- 2707858 TI - Tumor necrosis factor alpha and the anemia associated with murine malaria. AB - The anemia associated with malaria is complex, and multiple factors contribute to its severity. An increased destruction and a decreased production of erythrocytes are involved; however, the mechanisms responsible remain unclear. Tumor necrosis factor alpha (TNF-alpha), released by macrophages in response to infection, is thought to play a role through its ability to inhibit erythropoiesis. In these studies we have examined erythropoiesis in mice infected with Plasmodium berghei and in mice infused with recombinant TNF-alpha via implanted osmotic pumps. In both groups of mice there was (i) a reduction of pluripotent stem cells in the bone marrow and a concomitant increase in the spleen, (ii) a reduction of erythroid progenitor cells, and (iii) a reduced incorporation of 59Fe into erythrocytes. When P. berghei-infected mice were given antiserum against recombinant murine TNF, erythropoiesis was partially restored. There was a significant increase in bone marrow stem cells, erythroid progenitor cells, and 59Fe incorporation into erythrocytes in P. berghei-infected mice that had been treated with anti-TNF. How TNF may act, directly or indirectly, to inhibit erythropoiesis is not yet clear. These results demonstrate that TNF mediates, in part, the anemia associated with malaria. PMID- 2707859 TI - Antilipopolysaccharide factor from horseshoe crab, Tachypleus tridentatus, inhibits lipopolysaccharide activation of cultured human endothelial cells. AB - Antilipopolysaccharide (anti-LPS) factor is a basic protein that is purified from the hemocyte lysate of the Japanese and American horseshoe crabs (Tachypleus tridentatus and Limulus polyphemus). Anti-LPS factor has previously been reported to inhibit LPS-mediated activation of limulus factor C, lyse endotoxin-sensitized erythrocytes, and inhibit the growth of some gram-negative bacteria. In this study, we examine the ability of anti-LPS factor purified from T. tridentatus to inhibit the activation of cultured human endothelial cells by LPS. Anti-LPS factor inhibited the stimulation of endothelial adhesiveness for neutrophils by LPS in a dose-dependent manner. Maximum inhibition was achieved when anti-LPS factor was mixed with LPS prior to addition to the endothelial cell monolayers. Anti-LPS factor inhibited endothelial cell activation by LPS derived from Salmonella minnesota Re and Rc mutants as well as from the wild type (smooth), suggesting that it recognizes the lipid A moiety of LPS. PMID- 2707860 TI - Bacteroides gingivalis vesicles bind to and aggregate Actinomyces viscosus. AB - Isolated Bacteroides gingivalis 2561 vesicles aggregated suspensions of Actinomyces viscosus and Actinomyces naeslundii of all taxonomy clusters. Vesicles bound near A. viscosus cell walls and among its surface fibrils. Tritiated vesicles bound slightly better to saliva-coated hydroxyapatite (SHA) than to SHA coated with A. viscosus; saturation was approached at the concentrations that were tested. Pretreatment of A. viscosus-coated SHA with vesicles impaired the subsequent adherence of B. gingivalis whole cells. PMID- 2707861 TI - Cloning and sequence analysis of the major outer membrane protein genes of two Chlamydia psittaci strains. AB - We cloned and sequenced the gene encoding the major outer membrane protein (MOMP) of two Chlamydia psittaci strains, guinea pig inclusion conjunctivitis (GPIC) strain 1, and meningopneumonitis (Mn) strain Cal-10. Intraspecies alignment of the two C. psittaci MOMP genes revealed 80.6% similarity, and interspecies comparison of C. trachomatis and C. psittaci MOMP genes yielded about 68% similarity. As found previously for C. trachomatis MOMP sequences, stretches of predominantly conserved sequences of GPIC and Mn MOMPs were interrupted by four variable domains whose locations were identical to those of C. trachomatis MOMPs. Seven of eight cysteine residues were found at precisely the same positions in GPIC, Mn, and C. trachomatis MOMPs, emphasizing their importance in structure and function of the protein. Collectively, these results indicate that C. psittaci and C. trachomatis MOMP genes diverged from a common ancestor. PMID- 2707862 TI - Penetration of endothelial cell monolayers by Borrelia burgdorferi. AB - The ability of Borrelia burgdorferi, the agent of Lyme disease, to penetrate cultured human umbilical vein endothelial cell monolayers was investigated. After 4 h of coincubation, approximately 7.7% of added bacteria passed through the host cell monolayers. Electron microscopy revealed that the borreliae entered the endothelial cells and suggested that the organisms penetrated the host monolayers primarily by passing through them. PMID- 2707863 TI - Comparison of the genomes of pathogenic treponemes of human and animal origin. AB - The aim of this study was to compare the genomes of two strains of intestinal treponemes, which were isolated from patients suffering from intestinal disorders, with that of Treponema hyodysenteriae, the known etiological agent of swine dysentery (bloody scours). The guanine-plus-cytosine contents of the three DNAs were found to be 28.5 to 30.0%. DNA-DNA hybridization in liquid phase indicated a high degree of homology (56 to 95%) among the human strains and with T. hyodysenteriae. One of the human strains in particular displayed a very high homology (91 to 95%) with T. hyodysenteriae. The overall conclusion is that treponemal strains pathogenic for humans and animals are clustered within the same species (we propose T. hyodysenteriae), which suggests the possibility of exchange of pathogenic microorganisms between domestic animals and humans. PMID- 2707864 TI - Cathepsin D-like activity in neutrophils and monocytes. AB - Monocytes-macrophages and polymorphonuclear leukocytes contain an acid proteolytic enzyme that cleaves tritiated hemoglobin. The monocyte-macrophage derived enzymatic activity was completely inhibited by pepstatin A, a property of cathepsin D. Monocyte-derived macrophages developed detectable cathepsin D-like activity after 5 days in culture, and this activity coincided with the appearance of other known indicators of macrophage maturation. The cathepsin D activity further increased significantly with time after day 5 of culture. The proteinase activity extracted from neutrophils was only partially inhibitable by pepstatin A, which indicates that this activity is contributed by more than one proteolytic enzyme, including cathepsin D. Cathepsin D activity demonstrated in neutrophils and macrophages may be an important marker of phagocyte function. PMID- 2707865 TI - Neuraminidase-enhanced attachment of Bacteroides intermedius to human erythrocytes and buccal epithelial cells. AB - Bacteroides intermedius strains strongly agglutinated only neuraminidase-treated erythrocytes. The neuraminidase-dependent hemagglutinating activity of B. intermedius was abolished by heating or treating with protease. The adherence of these microorganisms to human buccal epithelial cells was enhanced by neuraminidase pretreatment of the cells (P less than 0.01). PMID- 2707866 TI - A new HPLC fluorimetric method to monitor urinary delta-aminolevulinic acid (ALA U) levels in workers exposed to lead. AB - A new sensitive HPLC method for the determination of urinary delta-aminolevulinic acid (ALA-U) was used to evaluate the relationship between blood-lead (Pb-B) and ALA-U levels in male workers exposed to lead. The differences between the ALA-U levels determined by this method (ALA-U-HP) and by a colorimetric method (ALA-U CL) are discussed. The HPLC method gave values similar to the ALA-U-CL values at high ALA-U level. However, at low blood-lead levels (58 +/- 22 micrograms/l, n = 23), the mean ALA-U-HP level corrected by urinary creatinine level was one-third of the corrected ALA-U-CL level (0.83 +/- 0.14 and 2.4 +/- 0.5 mg/g creatinine, respectively). A significant increase of the mean corrected ALA-U-HP level was observed at 162 +/- 22 micrograms/l Pb-B (P less than 0.05, n = 26), while that of ALA-U-CL was observed at 245 +/- 30 micrograms/l Pb-B (P less than 0.01, n = 37). The regression equation based on the logistic model fitted well to the relationship data between the Pb-B level and the percentage of the subjects with corrected ALA-U-HP above the cut-off point (1.12 mg/g creatinine) and the expected Pb-B level for 50% response was 270 micrograms/l Pb-B, while it did not fit well to the relationship data between Pb-B level and the percentage of the subjects with corrected ALA-U-CL above the cut-off point (3.5 mg/g creatinine).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707867 TI - Breath and blood levels of benzene, toluene, cumene and styrene in non occupational exposure. AB - Benzene, toluene, cumene and styrene were measured in the breath and blood of two groups of individuals. The first group included individuals belonging to a hospital staff, the second group included chemical workers who were not exposed to the abovementioned chemicals. The chemical workers were examined in plant infirmaries on the morning before the start of the workshift, and the hospital staff in the hospital infirmaries. One environmental air sample was taken in the infirmaries for each individual at the moment of the biological samplings. The environmental concentrations of benzene and styrene were significantly higher in the infirmaries of the chemical plant than in the infirmaries of the hospital. On the other hand, the environmental concentrations of toluene and cumene were not significantly different in the plant infirmaries and in the hospital infirmaries. In the hospital staff the alveolar concentrations of benzene, toluene and styrene were significantly lower than those in the chemical workers. In the hospital staff the blood concentrations of benzene, toluene and styrene were not significantly different from those in the chemical workers. Only the blood cumene concentration was significantly higher in the chemical workers. In hospital staff, smokers showed alveolar and blood concentrations of benzene and toluene that were significantly higher than those measured in the non smoker hospital staff. With reference to chemical workers, only alveolar benzene concentration was significantly higher in smokers than in non smokers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707868 TI - Effects of experimental and habitual lunch-size on performance, arousal, hunger and mood. AB - Twelve male students who normally ate a large lunch and 12 who normally ate only a light lunch performed a sustained attention task before and after eating a light lunch and before and after eating a heavy lunch. The speed and accuracy of performance were measured; so also were temperature, pulse rate and subjective estimates of tension, alertness and hunger. The changes brought about by the meals were examined. Speed alone showed no change over the lunch interval. Of the remaining seven measures, only temperature, which seems to reflect endogenous processes, was unaffected by the size of the lunch that was eaten. Accuracy, pulse rate and hunger were influenced by the size of the habitual lunch as well as by the size of the experimental lunch. Tension and alertness were responsive only to the size of the experimental lunch. The results are discussed in relation to diurnal rhythms, with a particular emphasis on the acquisition of endogenous component processes, as exemplified by habits of eating. PMID- 2707869 TI - Arc welders' respiratory health evolution over five years. AB - The respiratory health of 138 arc welders and 106 control subjects in the same company was studied in 1981 and in 1986. Most of the subjects welded mild steel using the Metal Inert Gas (MIG) process. The controls were workers in the same company, not exposed to any known pulmonary risk. The welders and controls in the analysis had not changed their professional activity nor their smoking habits during these five years. The examinations consisted of a questionnaire on respiratory symptoms, a thoracic auscultation, a chest X-ray and lung function tests: flow-volume curve and steady state CO transfer test. The examinations in 1986 confirmed the risk of non specific radiological impairment (pulmonary reticulo-micronodulation) and of obstruction in the small bronchi, which had already been observed in 1981 in the arc welders in this company. These impairments did not seem to have evolved more than in the controls, but do however justify regular surveillance of the respiratory health of arc welders. PMID- 2707870 TI - Pregnancy outcome in women working as dentists, dental assistants or dental technicians. AB - Pregnancy outcome in women with work in dentistry was studied using various central health registries. A total of 8157 infants born of dentists, dental assistants, or dental technicians in 1976 or 1982-1986 in Sweden were studied with respect to perinatal survival, low birthweight, and malformations and compared with all births. The only deviating finding was that of a significantly low perinatal death rate. Specifically, no increase in a risk for spina bifida was seen and the upper 95% confidence limit for the risk ratio was 2.1. A study was also made of hospitalized spontaneous abortions in women with these occupations in the years 1980-1981. No significant deviations from expected values were found. In a small study of only 78 such pregnancies in 1964-1965, no increase in spontaneous abortion rate was seen. Only one infant was malformed (anencephaly): both its parents worked as dental technicians. None of the mothers of 220 infants with a neural tube defect born in 1965-1967 in Sweden was a dentist. We find no indications that this occupation represents a significant reproduction hazard at the present time in Sweden. PMID- 2707872 TI - Daytime napping and its effects on alertness and short-term memory performance in shiftworkers. AB - Daytime napping and its effects on 145 female shiftworkers were studied by comparing the individual characteristics, alertness, and short-term memory performance of subjects who took or did not take naps. Of the subjects 56% (n = 82) took a nap before a night shift and 21% (n = 30) after a morning shift. After a morning shift, napping was more frequent among evening types and subjects living alone (not married). Before a night shift, daytime napping was not connected to individual characteristics, but the total sleep time of nappers during the preceding night was shorter than that of non-nappers. At 10.00 and at 04.00-08.00, at the end of the night shift, nappers were significantly more alert than subjects who had not taken naps. The length and timing of the daytime nap did not correlate to either alertness or performance during the following night. In a questionnaire, nappers before a night shift had less sleep disturbances than non-nappers. PMID- 2707871 TI - Urinary excretion of mutagens, thioethers and D-glucaric acid in workers exposed to bitumen fumes. AB - The authors carried out biological monitoring of the mutagenic/carcinogenic hazards associated with exposure to bitumen fumes during paving operations, analysing some biological parameters in the urine of a group of exposed workers. The urine samples were studied for mutagenicity by the Ames test and for thioethers concentration. D-Glucaric acid urine excretion was also determined to investigate the enzymatic induction potential of bitumens. Even though, in a previous environmental monitoring phase, a low content of mutagenic/carcinogenic compounds was found in bitumen and air samples, urinary mutagenicity data of exposed workers were statistically higher than those of a group of unexposed subjects. The urinary mutagenicity increased further if exposure to bitumens was associated with cigarette smoking. Thioethers were higher only in subjects exposed simultaneously to bitumens and cigarettes. D-Glucaric acid excretion did not increase significantly. The authors think that this type of coupled environmental and biological monitoring is a valid tool for a better evaluation of the mutagenic/carcinogenic exposure to bitumens or similar complex mixtures. PMID- 2707873 TI - High-frequency audiometry in the evaluation of critical noise intensity. AB - We investigated a total of 537 subjects (68 men, 469 women) working in the textile industry to ascertain their hearing level in the conventional hearing range as well as in the high-frequency (HF) range. The persons we tested work at three different noise-levels [80-84, 85-89, 90-94 dB (A), measured as leq). The differences in the hearing thresholds between this three groups mentioned were checked by means of discriminant analysis. The first hearing level changes at a noise-level below 90 dB (A) leq develop mainly in the HF range. In the conventional hearing range, however, the hearing levels remain unchanged even over long exposure times. Noise-induced hearing loss in the conventional range occurs only in the sound level group of 90 to 94 dB (A) leq without attaining any social importance. The tests show that, if the noise-level 90 dB (A) leq is not exceeded, no noise-induced hearing impairments involving social hearing loss are to be observed. Thus we assume that an auditory risk criterion of 85 dB (A) leq is sufficient to prevent hearing loss of any social importance. PMID- 2707875 TI - Allergy and inflammation 1988: from gene cloning to clinical practice. 17th Symposium of the Collegium Internationale Allergologicum. Fort-de-France, La Martinique, March 5-10, 1988. Proceedings. PMID- 2707874 TI - Sleep disorder symptoms among nurses and nursing aides. AB - Nurses and nursing aides (n = 418) currently working on a regular evening or day schedule were compared in terms of sleep disorder symptoms. The relationship between past nightwork and sleep disorder symptoms was also assessed. The prevalence of individual symptoms varied from 6 to 53%. Evening workers showed a pattern of sleep disorder compatible with sleep deprivation, whereas the pattern for day workers was more compatible with insomnia. Past nightwork was significantly associated with symptoms of day tiredness and the quantity of sleep obtained was influenced by past nightwork. The prevalence of a combination of four insomnia symptoms (initial, intermittent, and terminal insomnia and fatigue during the day) was 5.4% among current day workers but no cases were identified among evening workers. Among day workers, the trend for insomnia across levels of duration of past nightwork fell slightly short of conventional statistical significance (P = 0.09). The relationship between a combination of four symptoms was neither modified nor confounded by variables such as age, chronotype, intensity of past nightwork, and latency. In conclusion, although some sleep symptoms were associated with nightwork, a clear residual effect on a combination of symptoms could not be shown. PMID- 2707876 TI - Isotype-specific suppression of IgE synthesis in a human myeloma cell line (U 266) by an IgE-binding protein derived from normal human peripheral blood cells. AB - Human peripheral blood cells produce immunoglobulin-binding factors upon stimulation with purified protein derivative. The binding factors from 2 healthy individuals were purified by IgE affinity chromatography. IgE-suppressive activity was demonstrable using the IgE-producing human myeloma cell line U-266 as an assay system. The effect of the suppressive factor seems to be reversible, isotype specific, as the immunoglobulin synthesis in the IgGk-producing U-1958 myeloma line was not affected, and selective for the epsilon heavy chain. The results also suggest that this suppression is not the result of a decrease in DNA synthesis or suppression of protein synthesis in general. PMID- 2707877 TI - Conditioned media from cultured blood cells of atopic individuals can induce differentiation in the human basophilic leukemia cell line KU812. AB - The basophilic propagating activity was determined in conditioned media obtained from cell cultures of mononuclear cells from atopic and healthy individuals. The activity was analyzed as the capacity to induce differentiation in the human basophilic cell line KU812. The KU812 cells responded primarily to cultured media with histamine production and secondarily with granulation. Eight atopic individuals, 3 of whom having mild symptoms, with known birch allergies were selected together with 3 control individuals. Total and specific IgE were analyzed in sera, and basophil and eosinophil counts were determined from blood smears after Wright's staining. Significant differences between the symptomatic atopic individuals and the control group were obtained for eosinophil counts (p less than 0.05) and in the KU812 basophilic differentiation activity assay (p less than 0.01). No single test could significantly discriminate between symptomatic and nonsymptomatic individuals, but the KU812 cell assay in combination with the eosinophil count clearly distinguished the symptomatic individuals from the control group. Increased levels of IgE specific to birch allergen were only obtained in the atopic individuals (p less than 0.001). No difference in basophilic propagating activity was observed with supernatants from cells incubated with birch pollen allergen. Serum tested for basophilic propagating activity showed no or decreased values of inducing histamine production in the KU812 cell line. In conclusion, the KU812 assay for basophilic propagating activity was the most useful discriminating test to select symptomatic atopic individuals from nonsymptomatic atopic and control individuals. PMID- 2707878 TI - Effect of long-term administration of platelet-activating factor on pulmonary responsiveness and morphology in the guinea pig. AB - To further substantiate the possible role of platelet-activating factor (PAF) in the development of bronchial hyperreactivity, Alzet osmotic minipumps loaded with the autacoid or solvent alone were placed under the back skin of male Hartley guinea pigs and connected to the jugular vein for 15 days. As compared to the animals treated with solvent alone, guinea pigs receiving PAF (20 micrograms/kg/h, 15 days) exhibited a hyperresponsiveness to histamine that was not observed in those simultaneously treated with PAF and the PAF antagonist BN 52021. Lungs from PAF-treated animals were congestive in appearance, bronchi and bronchioli were contracted, Reisseisen muscles were markedly hypertrophied, and a muciparous metaplasia of the endothelium was observed. The number of eosinophils was significantly increased in the parenchyma, as was the number of mast cells in the peribronchial zones in the lungs from guinea pigs chronically treated with PAF. Lungs from control animals did not show morphologic alterations or eosinophil and mast cell infiltration. These data indicate that long-term treatment with PAF induces profound alterations in the respiratory system, resembling those observed in asthmatic patients. This result is in keeping with the possible role of this autacoid in the development of bronchial hyperreactivity. PMID- 2707879 TI - Effect of platelet-activating factor on monocyte activation and production of tumor necrosis factor. AB - The effect of platelet-activating factor (PAF) or human peripheral-blood-derived monocytes (PBM) was examined. The addition of PAF to monocyte cultures did not activate the cells to mediate cytotoxicity activity against 51Cr-labeled target cells. Furthermore, supernatants derived from the treated cultures were not cytotoxic. However, these supernatants contained tumor necrosis factor (TNF) when assayed by a sensitive radioimmunoassay. Further kinetic studies indicated that cytotoxic supernatant is detected at 2-4 h following PAF treatment but not overnight treatment, suggesting, perhaps, the presence of inhibitors interfering with the cytotoxic activity. Cells pretreated with PAF responded poorly to a second stimulation with phorbol myristate acetate whereas a secondary response was seen with cells pretreated with interferon-gamma. These results suggest that PAF is involved in regulating cytokine production by monocytes and thus plays a role in the immune response to foreign antigens. PMID- 2707881 TI - Specificities of IgE and IgG antibodies in patients with birch pollen allergy. AB - 58 sera from patients with established birch pollen allergy showed characteristic antibody-binding patterns in immunoblotting experiments. Regarding IgE, 56/58 patients recognized a protein of molecular weight (MW) 17 kilodaltons (kD), previously defined as Bet v I. 23/58 patients in addition reacted with a variety of 11 minor allergens with MWs ranging from 13 to 68 kD. A 13-kD protein was proved to represent an independent minor allergen. IgG binding in patients and healthy individuals was more pronounced on the minor allergens than on Bet v I. 3 different allergens were not detected by IgG of healthy individuals. In two dimensional electrophoresis/immunoblot, a monoclonal antibody and human IgE (in both cases directed against Bet v I) detected a very similar cluster of spots, probably representing isoallergens of Bet v I. PMID- 2707880 TI - Age-dependent changes of isotype and idiotype expression in the antibody response to the phosphorylcholine hapten in BALB/c mice. AB - The distribution of antibodies among different isotypes in an immune response to a given antigen reflects the immunoregulatory linkage of T and B cell compartments, the genetic background of an individual and the functional state of its immune system. In addition, idiotypes are markers for the clonal origin of antibodies and their genetic relationship. Therefore, we have analyzed the isotype patterns and development of the major idiotype (T15) in BALB/c mice of different ages, immunized with a T-cell-dependent phosphorylcholine conjugate. The response was dominated by mu, gamma 3 and gamma 1 isotypes. The proportion of these antibodies changed in the progress of immunization but not with age in the primary response. An age-dependent change of the isotype distribution was observed only in the memory response. The T15 idiotype was dominantly expressed in the primary response and decreased in the memory response by 80-95% independently of the age of the mice. The results demonstrate that 2 populations of anti-phosphorylcholine antibodies which both prefer particular isotypes are expressed according to the functional state of the T and B cell compartments with age. PMID- 2707882 TI - Inhalant allergy in asthmatic children: skin prick test, radioallergosorbent test and chemiluminescent assay compared with allergen levels in their mattress dusts. AB - Mattress dusts from the beds of 51 asthmatic children with positive skin tests to house dust mite were assayed for Der p I, Fel d I and certain viable fungi. The results of skin tests to grass, cat, dog, Alternaria, Aspergillus, Cladosporium and Penicillium, radioallergosorbent tests to cat, mite, dog and grass and the chemiluminescent assay were compared and correlations made with allergen concentrations in the dust. The sensitivity of the three tests appeared comparable (percentage agreement = 54.5-94), however, an increased level of allergen in the mattress dust was not a good indicator of the degree of sensitization of the child (p greater than 0.05). PMID- 2707883 TI - Effect of histamine on chemotaxis and phagocytosis of human alveolar macrophages and blood monocytes. AB - We studied in vitro the effect of histamine on the chemotactic and phagocytic abilities of human blood monocytes and alveolar macrophages. The chemotactic response to activated autologous serum, leukotriene B4 or N-formyl-methionine-L phenylalanine was similar for macrophages and monocytes. Incubation of monocytes with histamine in picomolar concentrations caused a significant chemotactic inhibition (about 25%). This effect was antagonized by cimetidine but not by promethazine. Histamine did not have an effect on alveolar macrophages chemotaxis or phagocytosis. Thus, histamine, in minute concentrations, exerts, in vitro, a partial inhibitory effect on monocyte chemotaxis through activation of H2-type receptors. PMID- 2707884 TI - Formation of oedema and accumulation of eosinophils in the guinea pig lung. Inhibition by inhaled beta-stimulants. AB - The action of the two beta-stimulants fenoterol and SOM 1122 (alpha-[[[3-(1 benzimidazolyl)-1, 1-dimethylpropyl]amino]methyl]-2-fluoro-4-hydroxybenzyl alcohol methane sulfonate) against inflammatory correlates of bronchial asthma was investigated by performing the following experiments: Passively sensitized guinea pigs were challenged by antigen aerosol under protection of mepyramine. The animal response was a 5- to 6-fold increase in the number of eosinophils in the bronchoalveolar lavage fluid after 1 or 2 days. In addition, increased microvascular permeability was elicited in guinea pig lungs after inhalation of a low concentration of histamine for 60 min. Both inflammatory reactions were inhibited by inhalation of remarkably low concentrations (0.004-0.04%) of the two beta-stimulants. These concentrations were 5 to 75 times lower than the EC50 values required for inhibition of acetylcholine-induced bronchoconstriction in the same species. The lung eosinophilia was not modified by inhibitors of lipoxygenase or cyclo-oxygenase. PMID- 2707885 TI - Antiasthmatic effects of onions. Prevention of platelet-activating factor induced bronchial hyperreactivity to histamine in guinea pigs by diphenylthiosulfinate. AB - Thiosulfinates are responsible for antiasthmatic and anti-inflammatory properties of onions. We tested the effect of diphenylthiosulfinate on platelet-activating factor (PAF)-induced bronchial hyperreactivity to histamine: According to a randomized crossover protocol, groups of 14 guinea pigs inhaled histamine, were then treated orally with either vehicle or with 10-100 mg/kg diphenylthiosulfinate, inhaled 1 microgram PAF, and thereafter the same histamine dose given prior to PAF. In the control group the histamine response increased threefold; in the treated group the histamine response decreased. The effect of 100 mg diphenylthiosulfinate lasted 12 h. Antihistamine effects were not demonstrable in this test system. We conclude that thiosulfinates inhibit PAF induced hyperreactivity. PMID- 2707886 TI - Effect of ricin on the proliferation of rat spleen and mesenteric lymph node cells. AB - The effect of the castor bean toxin, ricin, on rat spleen and mesenteric lymph node cell cultures was tested. Rat lymphocytes were cultured for 2 days in the presence of optimal doses of the mitogens phytohaemagglutinin, conconavalin A, and lipopolysaccharide. At concentrations of 10(-3) to 10(-5) mg/ml ricin, spontaneous and mitogen-driven proliferation were inhibited. At lower concentrations, spleen but not mesenteric lymph node cells showed enhanced proliferation. Studies are continuing to identify subpopulations of lymphocytes with increased or decreased sensitivity to ricin and their role in the regulation of IgE. PMID- 2707887 TI - Effect of neonatal or later capsaicin treatment on bronchial reactivity in sensitized rats. Relation to humoral changes. AB - Treatment of ovalbumin-sensitized rats with capsaicin resulted in altered bronchial reactivity to both ovalbumin and serotonin. The increase in bronchial reactivity to ovalbumin in neonatally capsaicin-treated rats compared to animals only sensitized may be influenced by the changed ratios of IgA, IgE, and IgG antibodies, together with the inflammation in the lung. Thus, capsaicin given neonatally inhibited the formation of antibodies, both specific titers and total levels, in bronchial lavage. PMID- 2707888 TI - IgG and IgE antibodies after immunotherapy with bee and wasp venom. AB - IgG and IgE antibody levels have been followed for a period of 2 years in patients receiving immunotherapy with bee and wasp venom. 106 adult patients who had had anaphylactic reactions to wasp stings had initially low IgG antibody levels to wasp venom which rose with therapy (p less than 0.001). IgE antibody levels also showed an initial rise but subsequently fell (p less than 0.001). The pattern was similar to that previously reported in children who had had anaphylactic reactions to bee stings, but who, after a course of immunotherapy, were able to tolerate stings with impunity. 60 adults who had had anaphylactic reactions to bee stings showed a different pattern, with initially high IgG antibody levels which did not rise further. Since two thirds of this group were beekeepers or members of beekeeper's families, the high initial IgG antibody levels could have been a response to the frequent stings to which such individuals are prone. The fact that high levels did not protect against anaphylaxis shows, however, that the classical concept of 'blocking antibody' is in need of revision. PMID- 2707889 TI - How to prevent allergic disease. I. Study of specific IgE, IgG, and IgG4 antibodies in serum of pregnant mothers, cord blood, and infants. AB - We have investigated methods for decreasing the number of allergic patients and have produced the following data. We compared mothers' total IgE levels and allergen-specific IgG and IgG4 levels in 72 paired cases. In mothers with high total IgE, the cord blood levels of IgG and IgG4 specific for egg, milk, and mite allergens were significantly higher than in mothers with low IgE levels. Mothers who took over 200 ml of milk per day showed a statistically higher level of milk specific IgG antibody. From our studies of IgE, IgG, and IgG4 antibody levels in atopic dermatitis patients, we conclude that specific IgG and IgG4 levels should be considered when eliminating offending foods. Infants with high egg-specific IgG antibody levels in cord blood were statistically more prone to develop allergic disease. PMID- 2707890 TI - Immune reactions in a changing environment. USA initiatives. AB - Environmental hazards occurring as an undesirable consequence of economic progress, urbanization and pollution have become a worldwide concern. In the US, this is evident from the campaign against smoking which has focused attention on the lung in part because the lung as a target organ is constantly exposed to many visible environmental hazards. On the other hand, environmental hazards which are not lethal, but cause their effects in an insidious fashion, may be difficult to study and identify. Among the disciplines available to assess adverse health consequences of xenobiotics ('strange' substances in our environment), application of modern immunological methods in concert with traditional toxicologic studies have to date demonstrated significant progress in drug allergy, food allergy, environmentally induced lung diseases and autoimmunity. These successes have come from the collaboration of immunologists, allergologists, pulmonologists, pharmacologists and toxicologists. In fact, a newer discipline of immunotoxicology has emerged in order to deal with these complex issues. The National Institutes of Health, through a series of workshops and research initiatives, and in collaboration with other US government agencies, including the Environmental Protection Agency, the National Institute of Environmental Health Sciences, and the National Academy of Sciences, is attempting to foster research aimed at enhancing progress in the field of immunotoxicology. The overall aim is to encourage the use of modern immunologic approaches to the study of the alleged harmful effects of xenobiotics on the immune system. Success will permit the development of improved diagnostic tools followed by initiatives concerned with prevention. Apart from their scientific implications the results are expected to have an impact on social, legal and economic issues within society. PMID- 2707891 TI - The third histamine receptor. Highly potent and selective ligands. AB - The third histamine receptor was first identified on brain neurons and seems also to be present in other cells such as the lung mast cells. Hence the novel and potent H3 receptor agonist (R)-alpha-methylhistamine might find therapeutic applications in allergic diseases. PMID- 2707892 TI - Random and not so random thoughts on becoming and being a statistic: professional and personal musings. AB - This article contains personal and professional musings on becoming and being an old woman. Becoming and being an old woman (I had no choice) and being a "gerontologist" (I had a choice), results in experiencing at least two realities, that of subject and that of researcher (an interesting word in itself). We daily face the leap across the chasm between science and personal experiences; between swimming in the subject pool and being a life guard or researcher into the life of guarded subjects. How permeable are the boundaries between subject and objectivity? Do gerontological data inform our experiences of becoming old? Are they providing us with norms for aging? Dear Virginia, there are age and sex norms and Enforcers enforce them. And, dear Virginia, there is more to life than research. PMID- 2707893 TI - Older widows and married women: their intimates and confidants. AB - Interview data obtained from 132 women sixty-five and older reveals that the widows and married women have a comparable number of primary friends. Being over age seventy-four influences the size of the friendship network for widows but not married women. The primary friendships of widows and married women parallel each other in terms of endurance and stability. Primary ties with men are the exception rather than the norm, for both widows and married women. Widows do differ from married women in that the former rely on confidant friends to a greater extent. Ties between older women and their confidants are characterized by norms of reciprocity. PMID- 2707894 TI - Sibling relationships in old age: a typology. AB - Sibling interactions in old age have received limited attention in social science literature. This article examines the different kinds of relationships which exist between siblings in old age and the ways in which each type meets or ignores the social and psychological needs of older people. Five types of sibling relationships emerged from data collected in open-ended, exploratory interviews with thirty men and thirty women over the age of sixty-five who had at least one living sibling. Each type reflects a discrete pattern of instrumental support, emotional support, and contact, as well as a different degree of closeness, envy, resentment, approval, and involvement with the sibling. The distribution of same sex and cross-sex dyads among the types suggests gender differences in sibling interactions based on the gender composition of the sibling dyad rather than on the gender of the respondent. PMID- 2707895 TI - A comparison of thematic apperceptions of sibling affiliation, conflict, and separation at two periods of adulthood. AB - The quality and stability of sibling relationships during adulthood were assessed by comparing TAT themes of sibling affiliation, conflict, and separation at the period of active child-rearing (CR) and the empty nest (EN). Thirty men and thirty women, divided equally between the two life stages, were randomly selected from a pool of individuals who had a same-sex, closely-spaced sibling. The Sibling Thematic Apperception Test (S-TAT) was developed to elicit underlying feelings about the relationship, because traditional methods of assessment have failed to tap its negative qualities. Contrary to previous findings, results showed no differences in affiliation or conflict theme frequencies between the CR and EN periods. Separation themes, however, were more frequent during the CR than the EN period, suggesting that concerns over separation from siblings reflect a developmental process which might be related to bonding with the family of procreation. Although there were no sex differences within life periods, women's stories about sisters across life period had more conflict themes than did men's stories about brothers. PMID- 2707896 TI - Caregiver response to Alzheimer's disease. AB - Research on Alzheimer's Disease caregivers has tried to find a link between 1) the length of time a caregiver has been giving care; or 2) the physical condition of the patient and the experiences and needs of the caregiver. This study found no significant correlation between length of time a caregiver had given care to a particular patient and the caregiver's subjective feelings of caregiver burden. It found a significant, moderate correlation between caregiver burden and the patient's functional ability. It found that caregivers' subjective feelings and needs best predict their feelings of burden. This report concludes with suggestions on how to improve support for caregivers in light of these findings. PMID- 2707897 TI - Friendships in later life: definitions and maintenance patterns. AB - This study examined the meaning and maintenance of friend relationships in later life. The sample consisted of forty-one males and seventy-four females, sixty years of age or older. Participants were asked a series of open-ended questions regarding their past and present relationships with their friends. While older men and women tended to agree on the characteristics of a friend, gender differences emerged when they were asked to differentiate between a "friend" and a "close friend." Older women were more likely to consider friends made earlier in their lives as still part of their friend network than were older men. Perceptions of current involvement with friends also differed depending upon the gender of the respondent. Discussion centered on the definition of friends in later life and gender differences found in maintenance patterns. PMID- 2707898 TI - The illusory home, or the 24 percent fallacy. AB - Although many elderly people live for years in nursing homes, death certificates routinely obliterate nursing home residence. Data gathered from records of one proprietary nursing home show that of 128 residents, from 45 percent to 66 percent could be classified as "permanent," depending on the definition. Nevertheless, the death certificates for those 128 residents list the nursing home as the residence for only 24 percent. This article explores that bias. PMID- 2707899 TI - Aging in the Soviet Union: a west Siberian perspective. AB - A half-year's residence in the Siberian industrial city of Kemerovo permitted a variety of ethnographic observations on the aged and aging. These were supplemented by interactions with medical personnel, as well as a review of the scanty literature (geriatrics is not a recognized medical specialty in the Soviet Union). The integration of the aged in families is noteworthy, as is the respect generally given them. But hard living conditions, difficulties of transportation, dietary inadequacies, and a severe paucity of specialized facilities present problems for the elderly. PMID- 2707900 TI - Elder maltreatment items, subgroups, and types: policy and practice implications. AB - An examination of 288 validated instances of elder maltreatment suggests that these phenomena pose questions as diverse as those faced in identifying child and spouse maltreatment. A partial typology is offered to guide further investigations. Implications for policy and practice suggest a cautious approach to value-laden issues while recognizing the need for intervention. PMID- 2707901 TI - A case-comparison analysis of elder abuse and neglect. AB - This study examines factors which contribute to elderly abuse and neglect by caregivers in a domestic setting. Methodological and conceptual variations and problems in previous studies have led to considerable confusion as to the determinants of this important social problem. A more rigorous research design was used in this study than has been previously employed. Fifty-nine abused elders from a model project site for the study of elderly abuse were compared with forty-nine non-abused clients from a home care program in the same agency. Using a research instrument designed by the authors, data related to the following aspects of the lives of the elders and their caregivers were collected: psychological status, stressful life events, social networks, mutual dependency, and the nature of their relationships. The study indicates that members of abusive families are more likely to have emotional problems which contribute to interpersonal difficulties. Abused elders are not more dependent on caregivers for many of their daily needs. However, the abused elderly and their caregivers have become increasingly interdependent prior to the onset of abuse because of the loss of other family members, increased social isolation, and the increased financial dependency of the perpetrator on the elderly person. PMID- 2707902 TI - The Kendrick Battery: sensitivity to survival effects. AB - In an effort to establish the sensitivity of the Kendrick Battery (KB) to mortality effects among institutionalized aged, the residualized pre-death KB scores (Digit Copying, Object Learning Subtests), as well as measures of affect (Zung Depression), and organicity (Luria Pathognomic Scale, Orientation Test) were compared in a sample of fifty-three elderly persons (M age = 82.7, SD = 7.76). Forty-two were female, eleven were male. Twenty-two of these individuals had subsequently died during an eighteen-month period following assessment. Six years after testing, thirty-six of these individuals had died. Step-wise discriminant analyses at each occasion yielded functions defined by the KB subtests, measures of organicity and depression, age of institutionalization, sex, and length of institutionalization that differentiated survivors and nonsurvivors. These data suggested that the Kendrick Battery subtests, measures of depression and organicity, in combination with length of institutionalization and age of admittance predict death among the elderly, for the most part, replicating previous research. PMID- 2707903 TI - Continuous transcutaneous gas monitoring in adults on regular dialysis treatment. AB - We tested a transcutaneous (tc) oxygen (O2) and carbon dioxide (CO2) sensor in 15 normal adults and in 20 patients on regular dialysis treatment (RDT). We compared the tc gas values (ptcO2, PtcCO2) with the gas tension values in arterial blood samples (PaO2, PaCO2), in normal adults and in RDT-patients at the end of a 30 min test and six times during RDT. During the test, PtcO2 correlated with PaO2 both in normal adults (r 0.72 p less than 0.01) and in RDT patients (r 0.41 p less than 0.05). PtcCO2 correlated with PaCO2 (r 0.59 in normal adults and r 0.76 in RDT). During 14 acetate dialyses the changes were expressed as % delta from time 0. % delta PaO2 was -12.7 at 60 min, + 4.8 at 240 min; % delta PtcO2 -6.0 at 60 min, + 9.7 at 240 min; % delta PaO2 -17.7 at 240 min, -1.8 1 h later; % delta PtcCO2 was -15.8 at 240 min, -3.2 1 h later. Both in normal adults and in RDT, patients there was a good relationship between PtcCO2 and PaCO2 values. In normal adults the absolute PtcO2 values were always lower than PaO2 (-14.4 +/- 10 mmHg); in RDT-patients this difference was more pronounced (-27.6 +/- 15.1) and is probably attributable to the lower Hb levels (6.7 +/- 1.1 vs 12.4 +/- 1.2). During RDT the pattern was the same between tc and gas tension values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707904 TI - Cardiac perforation by a guide wire during subclavian catheter insertion. AB - We report a patient in whom cardiac perforation was directly caused by a straight soft tipped guide wire used to introduce a subclavian dialysis catheter. We recommend the use of J tip guide wires to avoid this life threatening complication. PMID- 2707905 TI - Effect of oral adsorbent on blood metabolites in hepatic failure dogs. AB - AST-120 is a specially synthesized carbonaceous adsorbent for oral use. It mainly adsorbs low to middle molecules in the alimentary tract. In the present study, AST-120 was administered to hepatic failure dogs, and blood metabolites were analyzed by high performance liquid chromatography (HPLC). Thirty adult mongrel dogs underwent posta-cavae (P-C) shunts with 40% and 70% hepatectomies. They were divided into two groups, the AST group (n = 19) and control group (n = 11). The AST group received about 0.5 g/kg of the adsorbent intermittently with diet after the operation. The control group was fed the ordinary diet. Body weight, blood ammonia, plasma bile acids were measured, and blood metabolites were analyzed by the multi-column HPLC system. P-C shunt dogs with 70% hepatotectomies died within three months showing about 40-50% body weight loss. HPLC analysis of their plasma showed some specific peaks for middle molecules, about 3000-5000 daltons. After administration of the adsorbent, these peaks were not detected, so it was considered that these substances had been adsorbed. PMID- 2707906 TI - Enzymatic detoxification using lipophilic hollow-fiber membranes: IV. Glutathione conjugation reactions. AB - A hollow-fiber technique was used in the enzymatic glutathione conjugation of lipophilic toxins. Native enzyme was circulated on the external side of a lipophilic hollow-fiber membrane while the toxin-containing media (blood, plasma or aqueous solution) were circulated inside the fiber. Glutathione conjugation reactions were catalyzed by rat liver cytosol, with a specific glutathione transferase activity of 40 nmol/min/mg protein (acceptor: 1,2-epoxy-3-(p nitrophenoxy)propane). Clearance rates of 1,2-epoxy-3-(p-nitrophenoxy)propane, phenylglycidether, styrene oxide, cis-9, 10-epoxystearic acid, cis-9, 10 epoxystearic acid methyl ester, 5a, 6a-cholesterol oxide, 16-, 17a-pregnenolone oxide, and p-nitrobenzylchloride were 10.44, 13.37, 32.25, 7.60, 7.31, 3.92, 4.20 and 29.24 nmol/mg protein/h/cm2 hollow-fiber surface respectively. This technique makes possible glutathione conjugation reactions with crude enzyme preparations over long periods without loss of activity from covalent immobilization and without loss of cofactor from (auto)oxidation. The lipophilic membrane ensures the absence of hemolysis, immunological hazards and hormone loss, while elimination of the toxin is not impaired. PMID- 2707907 TI - Blood glucose measurement by infrared spectroscopy. AB - For the development of an implantable artificial endocrine pancreas, a sensor for blood glucose measurement is needed providing a long-term stability. This goal can be achieved by the application of infrared spectroscopy which, unlike electrochemical sensors, responds directly to the glucose molecule. An investigation under physiological conditions revealed five glucose absorption bands in the near and middle infrared range. These are 1040, 1085, 1109, 1160 and 1365 cm-1. Only the 1040 cm-1 frequency coincides with none of the other infrared active blood substances like proteins, lipids and urea. Nevertheless, the other absorption bands too, especially the 1109 cm-1 frequency, can be used for blood glucose measurement, if the superimposed absorptions are compensated. Methods for the compensation have been found. Technically feasible embodiments of an infrared glucose sensor are described. PMID- 2707908 TI - Sodium and dialysis: a deeper insight. PMID- 2707909 TI - Urea kinetic modelling by partial dialysate collection. AB - Conventional urea kinetic modelling (UKM) has several drawbacks, in particular the complexity of the required calculations and the need for accurate values of parameters which are difficult to measure, such as dialyzer clearance and blood flow. An alternative method of UKM is proposed based on collecting a small fraction of spent dialysate flow for 3 consecutive dialyses. Application of a urea mass balance to the 7 day period permits neglecting changes in body urea stores. Thus no blood sampling is required for most patients. The required calculations are simple and straightforward. The partial dialysate collection (PDC) method was compared to conventional UKM in a 3 patient, 15 week study. Protein catabolic rate (PCR) from PDC was a smooth curve and consistent with dietary estimation for each patient. Conventional UKM gave variable PCR results which were 17-27% higher on average. This discrepancy was attributed to overestimation of dialyzer clearance. PDC was concluded to be more convenient and accurate than conventional UKM and therefore ideal for routine clinical use. PMID- 2707910 TI - The spectrum of cardiovascular disease in the elderly. PMID- 2707911 TI - Epicardial coronary artery constriction with intravenous ethanol. AB - Although in vitro studies have demonstrated ethanol-induced coronary artery constriction, in vivo reports suggest an ethanol-related coronary dilator effect with increases in coronary blood flow. The principal difference in these studies is the demonstration of epicardial coronary constriction with ethanol, while dilation is described only in resistance vessels. Clinical studies have noted evidence of myocardial ischemia following ethanol ingestion in patients with coronary artery disease, suggesting ethanol-related constriction of diseased epicardial coronary arteries. This study hypothesized that intravenous ethanol would constrict canine epicardial coronary arteries while producing arteriolar resistance vessel dilatation. Ten closed-chest mongrel dogs weighing 24 +/- 1 kg (mean +/- SEM) were given 8 g of ethanol intravenously over 30 min. Left anterior descending and circumflex proximal artery diameters were measured by quantitative coronary angiography; myocardial flow was measured by Xenon washout, and myocardial flow distribution was measured with radioactive microspheres. Baseline proximal left anterior descending and circumflex artery areas were 6.3 +/- 0.5 and 5.8 +/- 0.4 mm2, respectively. Up to 30% left anterior descending and circumflex proximal artery narrowing was noted at 60 and 90 min following ethanol infusion. The constriction was reversed with nitroglycerin. There was a decrease in left anterior descending artery flow but no change in circumflex artery flow at 60 min. Blood ethanol level varied from 520 micrograms/ml initially to 205 micrograms/ml 90 min after the infusion terminated (intoxication = 1500 micrograms/ml). These data suggest that ethanol has significant vasoconstrictor action in vivo on epicardial coronary arteries. PMID- 2707912 TI - Painless versus painful myocardial ischemia: different left ventricular dysfunction detected by echocardiography. AB - The mechanism responsible for the absence of anginal pain in patients who have episodes of both painless and painful myocardial ischemia, still remains unknown. Does the pain depend on an overstimulation of receptive structures or is this symptom the product of the excitation of a well-defined receptive system? The aim of this work is to test the first hypothesis: whether silent attacks are accompanied by the same degree of mechanical impairment as symptomatic ones. The authors compared the echocardiographic left ventricular functional behavior in the same patient (6 patients) during painful and painless myocardial ischemia. The echocardiographic changes observed during silent ischemic attacks were significantly different from those detected during symptomatic attacks. The latter were characterized by a larger extension of the ischemic myocardium and, as a consequence, by a larger functional impairment. Symptomatic and asymptomatic ischemic attacks were recorded echocardiographically in the same patient during repeated attacks on the same day, and were always clearly differentiated by the degree of wall motion abnormalities. The echocardiographic monitoring during the ischemic attack seemed to confirm that the greater functional impairment preceded the onset of pain leading to the occurrence of this symptom. Nevertheless, it was impossible to identify a threshold value above which the ischemic attack will be symptomatic. Our data seem to indicate a close relationship between painful ischemia and a higher degree of ischemic damage. Thus, in patients with predominantly painful myocardial ischemia, the extension and the severity of ischemia could play an important role in determining this symptom. PMID- 2707913 TI - Immunosuppressive treatment in myocarditis. AB - Twenty patients (13 males and seven females) with a biopsy-proven diagnosis of myocarditis underwent a period of treatment with prednisone and azathioprine. The primary objective of the study was the observation of histologic changes which occur during treatment and after treatment withdrawal. The secondary objective was the detection, if any, of changes in left ventricular ejection fraction. Multiple endomyocardial biopsies were obtained and the treatment was adjusted in order to achieve complete disappearance of the myocardial inflammation. The histologic status was improved in all patients, although complete disappearance of the signs of active disease was seen in 15 patients only. Two patients died during the observation period. A clear relationship between histologic status and immunosuppression was established in some patients (50% of all cases showed a worsening after withdrawal from the treatment). An overall improvement of the ejection fraction was observed (from 0.37 +/- 0.14 to 0.46 +/- 0.17), but a direct effect of the treatment on the recovery of ventricular function cannot be stated. In some patients, however, a direct relationship between the histological changes and the changes in ejection fraction was seen. These data suggest that treatment with prednisone and azathioprine may be beneficial in some patients with biopsy-proven myocarditis and depressed ventricular function. PMID- 2707914 TI - Left main coronary artery disease: radionuclide angiographic function versus anatomic correlates with visual and quantitative angiographic methods. AB - The results of exercise radionuclide angiography in 29 patients with significant left main coronary artery stenosis were examined to correlate functional left ventricular performance with anatomic severity of left main coronary artery stenosis. Change in ejection fraction, regional wall motion, and peak ejection fraction were widely variable; none of these parameters correlated with severity of left main stenosis as assessed by visual or quantitative angiographic methods. Twenty-five patients (86%) had two or more of the following indicators of ischemia with exercise: chest pain, significant ST-segment depression, systolic hypotension, definite decrease in ejection fraction, or definite decline in regional wall motion. However, four patients (14%) had only mild abnormalities in ejection fraction and regional wall motion, although they did have hemodynamic and electrocardiographic evidence of severe ischemia. Exercise radionuclide angiography yields heterogeneous results in patients with significant left main coronary artery stenosis. Anatomically severe left main coronary artery stenosis is not always associated with mechanical evidence of severe ischemia. PMID- 2707915 TI - Right ventricular infarction: larger enzyme release with posterior than with anterior involvement. AB - To evaluate whether the right ventricle releases significant amount of cardiac enzymes during myocardial infarction, a clinicopathologic study of 50 patients with 60 infarcts was performed. Myocardial infarct size was determined at autopsy and compared with the corresponding peak serum lactate dehydrogenase and aspartate aminotransferase. Anterior and posterior infarcts had similar anatomic size, peak enzyme values, and coefficients of correlation (r = 0.86-0.88 versus r = 0.82-0.84 for lactate dehydrogenase). However, by disregarding the right ventricular infarct component considering the left ventricular infarction only, the coefficient of correlation between infarct size and peak serum lactate dehydrogenase decreased from r = 0.84 to r = 0.59 (P = 0.09), in 14 posterior infarcts while no change was observed in 24 anterior infarcts (r = 0.88). This indicates, that a considerable amount of enzymes released during posterior infarction originated from the right ventricle which was not the case for anterior infarction. PMID- 2707916 TI - Electrophysiologic actions and antifibrillatory efficacy of subacute left stellectomy in a conscious, post-infarction canine model of ischemic ventricular fibrillation. AB - The autonomic nervous system appears to modulate ventricular arrhythmias associated with acute myocardial ischemia. This study investigated the electrophysiologic effects and antifibrillatory actions of subacute left stellectomy in a conscious, post-infarction canine model of sudden cardiac death. Twenty-two dogs with a previous anterior wall myocardial infarction and inducible ventricular arrhythmias were randomized to undergo either left stellectomy (n = 12) or remain as sham-denervated controls (n = 10). Five to 7 days post left stellectomy, there were no significant changes in heart rate, electrocardiographic intervals or ventricular refractoriness compared to sham denervated controls. Acute posterolateral ischemia was produced in left stellectomy and sham-denervated dogs by anodal current-induced thrombosis via a previously positioned electrode in the left circumflex coronary artery. Ventricular fibrillation developed within 1 hour of the onset of ischemia (early ventricular fibrillation) in 3/12 (25%) left stellectomy dogs versus 8/10 (80%) sham-denervated controls (P less than 0.05). However, 24-hour mortality rate was 5/12 (42%) after left stellectomy versus 8/10 (80%) after sham denervation (P = 0.072). Small differences in regional myocardial norepinephrine content, which is a marker for neuronal integrity, occurred in the mid-posterolateral and mid anteroseptal regions of the left ventricle after left stellectomy. Overall norepinephrine concentration after left stellectomy was 409.70 +/- 9.90 ng/g vs 428.07 +/- 10.84 ng/g in sham controls (P = NS). In summary, subacute left stellectomy significantly reduces the incidence of ventricular fibrillation occurring within 1 hour of the onset of acute posterolateral ischemia at a distance to a previous myocardial infarction in conscious dogs, and tends to reduce the ischemic post-infarction mortality at 24 hours after the onset of ischemia. This protective effect of left stellectomy is not due to any alteration in cardiac electrophysiologic parameters measured prior to the development of acute posterolateral ischemia, nor is it related to regional denervation as determined by myocardial tissue concentration of residual norepinephrine. PMID- 2707918 TI - Endocarditis in an infant causing "tricuspid atresia". AB - A 3-month-old male infant died of tricuspid valve nonbacterial thrombotic endocarditis complicating disseminated intravascular coagulation. The vegetations were so extensive as to cause tricuspid atresia and led to congestive right ventricular failure terminating in death. The diagnosis was made only at post mortem. PMID- 2707917 TI - Ibopamine as a substitute for digitalis in patients with congestive heart failure on chronic digoxin therapy. Smith Kline and French Ibopamine Group. AB - The substitution of digoxin with ibopamine, a new inotropic and vasodilating agent, was evaluated in a multicenter study in 58 patients with mild-to-moderate congestive heart failure, stabilized on diuretics, and digoxin therapy. The study was a parallel, double-blind, randomized trial of four weeks duration in which half of the group continued the pre-study medication (diuretics and digoxin) and half of the group was treated with diuretics and ibopamine (100 mg, three times a day). At baseline evaluation, the two groups were similar for age, sex, underlying cardiac disease, duration of congestive heart failure, symptom score, cardiothoracic ratio, echocardiographic parameters of left ventricular function and exercise tolerance as measured by bicycle ergometry. After four weeks, no clinical deterioration was found in the patients treated with ibopamine in any measured parameter. There were two deaths during the study: a sudden death and one following an acute myocardial infarction. Both patients were on digoxin. This study suggests that in patients with mild-to-moderate congestive heart failure, ibopamine therapy may effectively and safely substitute digoxin therapy for up to four weeks, representing an option for patients requiring inotropic support but are at risk for potential digoxin toxicity. PMID- 2707919 TI - Intraoperative ultrasound monitoring of banding of the pulmonary trunk: a new technique? AB - We report an intraoperative real-time echo/Doppler study of the hemodynamic effects of banding of the pulmonary trunk in complete transposition seven years after a neonatal Mustard procedure. The patient had developed severe right ventricular failure. To prepare the left ventricle for an arterial switch procedure, banding of the pulmonary trunk was performed. While tightening the band, we monitored the pressure drop produced by using real time continuous wave Doppler interrogation. After banding, we used combined M-mode and cross-sectional echocardiography to image the left changes induced in left and right ventricular dimensions, shape and function by the acute change in hemodynamics. PMID- 2707920 TI - Dosage regimen of ranitidine in patients with renal impairment. AB - The validity of the Giusti-Hayton method for dosage regimen adjustment in patients with renal impairment was investigated using ranitidine. Five normal healthy volunteers received a single ranitidine recommended dose of 150 mg, and 20 patients with renal disease received single administration in doses individually calculated by the Giusti-Hayton method from each patient's creatinine clearance level, and the various pharmacokinetic parameters were compared. As a result, the area under the time-concentration curve 0----infinity (AUC0----infinity) in the renal disease patients was almost comparable to that in the normal healthy volunteers. The Giusti-Hayton method was considered useful to keep both the AUC0----infinity constant and the mean blood level of the drug in a steady state, in any degree of renal impairment. PMID- 2707921 TI - Nicardipine does not significantly affect serum digoxin concentrations at the steady state of patients with congestive heart failure. AB - Twenty patients in a stable condition suffering from congestive heart failure were treated with digoxin for at least three weeks and then with nicardipine concomitantly for five days. No statistically significant variation in serum digoxin concentrations determined at seven control times during a 24-hour period or in its mean concentration was found in the two groups of values examined before and after the concurrent nicardipine treatment. The mean increase of 6.8% in the AUC0----24h was not significant either. Since the maximum increase in serum digoxin concentrations at the steady state never exceeded 0.5 ng/ml, a toxic effect is not likely to occur in patients whose digoxin levels are normally monitored. PMID- 2707922 TI - Ibopamine: long-term safety study in patients with congestive heart failure. The Italian Ibopamine Working Group. AB - Ibopamine is a new orally active dopamine analogue with positive inotropic and vasodilating activity. The tolerability of the drug administered at the dose of 100 mg thrice daily for 12 months was studied in 302 patients with congestive heart failure, New York Heart Association (NYHA) class II and III. Of the 302 patients, 198 completed the study (65%); 59 patients (19%) were withdrawn for clinical events; 27 of them died (9%); 35 patients (12%) did not complete the study for non-compliance and 10 (3%) for protocol violations. Clinical events were generally related to the cardiovascular system and 85% of deaths were from cardiovascular causes. None of the deaths was considered related to treatment by the investigators. Clinically significant laboratory abnormalities were observed during the study in four patients only. This trial suggests that ibopamine is well tolerated in patients with congestive heart failure, NYHA class II and III, at the dose of 100 mg thrice daily for up to one year. PMID- 2707923 TI - Steady-state serum pharmacokinetics and bioequivalence of 500 mg oral versus 200 mg intravenous ciprofloxacin. AB - The pharmacokinetics of ciprofloxacin were examined after five days of treatment with 500 mg orally and 200 mg intravenously twice a day, in six healthy volunteers in an open, randomized crossover study. The ciprofloxacin concentrations were determined in serum by high performance liquid chromatography. The mean serum peak concentrations were obtained in 1 to 1.5 h by the oral route and the values reached were similar after the oral and intravenous dose (2.56 +/- 0.62 micrograms/ml and 2.6 +/- 0.67 micrograms/ml respectively). The terminal elimination half-life was about 4.5 h for oral form and 5 h for intravenous form. The absolute bioavailability of the oral ciprofloxacin was about 83%. PMID- 2707924 TI - Pharmacokinetics of ciprofloxacin in impaired liver function. AB - The pharmacokinetics of ciprofloxacin after a single 500 mg oral dose was studied in one group of healthy volunteers and in patients affected by liver cirrhosis and classified into three groups according to Child-Turcotte criteria. The serum concentrations were determined by an agar well diffusion assay 0.5, 1, 3, 6, 12 and 24 h after the administration of the drug. No significant differences were noticed in Cmax, Tmax, T1/2 and AUCtot in the group A and B of patients and in the control group. Class C patients showed on the other hand a Cmax 15-25% higher than in other groups (2.74 mcg/ml), a T1/2 1.12-1.42 hours longer than in other groups and a consequent much higher AUCtot (17.70 mcg/h/ml). The concomitant administration of diuretics of anti-H2 drugs was also evaluated as possible factors affecting the ciprofloxacin pharmacokinetics, but no significant differences were noticed. A mild or moderate impairment of the liver function did not affect the pharmacokinetics of ciprofloxacin, but the severe impairment of the liver function could affect its Cmax and serum half-life, so that further studies with multiple doses will be needed to evaluate if any dosage adjustment would be required in these patients. PMID- 2707925 TI - Pharmacokinetics of cefonicid in serum and its penetration into lung tissue, bronchial mucosa and pleura. AB - Cefonicid pharmacokinetics in serum and tissue penetration into the lung parenchyma, bronchial mucosa and pleura were studied in 39 patients undergoing lung excision for malignancy. Cefonicid concentrations in serum and tissues samples were assayed at different times after a single 1 g intramuscular administration. The concentrations observed were much higher than the reported minimal inhibitory concentrations for the microorganisms commonly responsible for bronchial and pulmonary infections and therapeutic concentrations were still detectable in the tissues 24 h after dosing. Kinetic findings demonstrated a similar half-life for cefonicid in tissues and in serum. These data provided a further kinetic explanation for the observed clinical efficacy of cefonicid with a single daily dose. PMID- 2707926 TI - Effect of heparin administration on flunitrazepam protein binding. AB - Non-esterified fatty acids have been shown to displace diazepam from its plasma binding sites both in vitro and in vivo. However, the binding of other benzodiazepines such as lorazepam is not affected in similar situations. Flunitrazepam exhibits a substantial degree of binding to plasma proteins, therefore it was deemed interesting to investigate the role of free fatty acids on flunitrazepam binding to human plasma proteins. Incubation of plasma with sodium oleate (1.5 and 3.0 microEq per ml) produced a decrease in the binding of flunitrazepam. The free fraction increased from 4.20 +/- 0.34 to 6.30 +/- 0.53 and to 22.18 +/- 1.28% respectively). Sodium heparin administration (10IU/kg, intravenously) increased free fatty acids levels and produced similar changes in the binding of flunitrazepam. After ten minutes of heparin administration free fatty acids increased from 0.16 +/- 0.03 mEq/l to 0.34 +/- 0.01 mEq/l and the free fraction of flunitrazepam in plasma increased from 3.70 +/- 0.22% to 6.20 +/ 1.24%. These binding data further support a relationship between increases in the concentrations of free fatty acids and decreases in the fraction of flunitrazepam bound to plasma proteins. PMID- 2707927 TI - Evidence of muscarinic receptor subtypes in airway smooth muscle of normal volunteers and of chronic obstructive pulmonary disease patients. AB - Since there have been only a few studies on muscarinic receptor subtypes in airway smooth muscle, the effect was investigated of pirenzepine on airways of patients with chronic obstructive pulmonary disease (COPD) and the functional responses compared from these patients with those from healthy subjects. Our data demonstrated that the therapy with pirenzepine significantly improved ventilatory function in patients with COPD. The data also suggested that this drug exerts its action on small airways, but not larger airways in normal subjects. It is possible that in healthy human beings pirenzepine produces mild bronchodilation by means of a vagal efferent blockade, while in patients with COPD, it may be effective because it not only decreases the activity of the vagal efferent pathway, but also decreases the sensitivity of vagal sensory endings and causes a vagal afferent blockade. PMID- 2707928 TI - Muscarinic M-1 receptors mediate the bronchial hyperresponsiveness during methacholine inhalation. AB - Several data suggest that muscarinic M-1 receptors are located on airway smooth muscle of human beings and dogs. Muscarinic M-1 receptors, whose stimulation is associated with enhancement of acetylcholine release, may also be located in the airway parasympathetic ganglia. To determine if postsynaptic muscarinic M-1 receptors mediate airway constriction, the action was compared of pirenzepine, that antagonizes selectively muscarinic M-1 receptors, and atropine, that blocks both muscarinic M-1 and M-2 receptors, on bronchial responses to methacholine inhalation in seven asthmatic patients. Pirenzepine and atropine gave protection against methacholine; however, the degree of protection by pirenzepine was significantly less than that given by atropine. Some inhibitory effect was obtained in all the patients studied after pirenzepine administration, even though some patients were only slight responders. The significant finding of the study is that pirenzepine partially inhibits the bronchospastic response to methacholine. This result suggests that muscarinic receptors on airway smooth muscle are also of the M-1 subtype. PMID- 2707929 TI - Rheological profile of nesosteine: a new mucoactive agent. AB - Nesosteine, a new agent shown to improve physical characteristics of bronchial mucus in animal models, has been studied in chronic bronchitic patients to confirm its effect on viscoelasticity of bronchial secretions. Sputum was collected from hypersecretory bronchitic patients in a stable condition before and after seven days of treatment with nesosteine (900 mg/day) or a placebo. At the end of treatment a significant (p less than 0.05) decrease was found in the viscosity in the nesosteine group: on the contrary, a slight, non-significant increase in viscosity was observed in the mucus samples of the placebo group. The improvement in rheological characteristics of the bronchial mucus in the patients treated with nesosteine was associated with an increase in mucus transport rate (mucociliary clearance) observed in the same samples. The findings indicate that nesosteine reduces mucus viscosity in chronic bronchitic patients and that this change induces also an improvement in mucociliary clearance. PMID- 2707930 TI - The role of the leader in managing the preoedipal patient in the group setting. AB - Preoedipal patients present a special problem in group treatment. This is because their difficulties arose largely before they learned to use words. Such patients are prone to act rather than talk. They do not respond well to interpretation. They must be approached and influenced through feelings. We can utilize the group to provide them with maturational experiences, helping them reach a more adult level of mental functioning so that our usual technical interventions can be brought into play. The paper discusses methods for enhancing this process, including reflection, emotional communication, using reconstruction to close developmental gaps, and immunization. PMID- 2707931 TI - An analysis of pretraining work behavior as a composition variable in group psychotherapy. AB - Pretraining work behavior was investigated as a composition variable for group psychotherapy. The work behavior of sixty-six outpatients in nine pretraining groups was measured. Six of the pretraining groups were recomposed into either high or low work therapy groups on the basis of the pretraining scores. The other three groups entered therapy intact. Audiotapes from the first six months were analyzed to assess therapy process. Outcome measures were administered before therapy and after six months of therapy. Hypotheses concerned the effects of composition on process and outcome and the relationship between pretraining work behavior and outcome. The results suggest that pretraining work behavior has merit as a composition variable and may have promise as a selection variable. Therapeutic uses of pretraining are discussed. PMID- 2707932 TI - Group properties and outcomes: a study of group norms in self-help groups for widows and widowers. AB - Despite the nearly universally shared agreement among group therapists about the importance of group norms, empirical studies have rarely demonstrated a positive relationship between specific norms in psychotherapy groups and patient benefit. The study explored this relationship by examining the linkages between norms, a specific therapeutic process, and patient outcome. Examined were seventy-two spousal bereavement groups. Subjects' responses to a thirty-one item behavioral inventory were used to define norms; outcomes were based upon Time 1/Time 2 differences on a series of eleven measures indexing depression, anxiety, somatic symptoms, abuse of psychotropic medication, coping mastery, well-being, self esteem, target problem rating, several measures of role stress and strain, and stigma. The findings suggest that normative characteristics were linked to a process, reciprocal social exchange, that influences positive outcomes. The results are preliminary, since they only serve to demonstrate such a relationship can exist. PMID- 2707933 TI - Peers and siblings: their neglect in analytic group psychotherapy. AB - Peer and sibling history, transference, and theory construction, have been neglected in analytic group psychotherapy. One main reason for this neglect has been the belief that current psychoanalytic theory, individual and group, sufficiently accounts for the understanding of peer and sibling phenomena. Furthermore, peer transferences in the therapy group have been considered derivative of transferences to the leader. An argument is made for considering peer and sibling history, transference, and theory construction important in their own right. This argument is supported by a therapy group example. Implications for practice and theory are discussed. PMID- 2707934 TI - Applications of cognitive testing to group therapies with the chronically mentally ill. AB - Appreciation of the various cognitive deficits displayed by many chronic patients offers an alternative way of understanding each patient's predicament and an alternative way of approaching group and milieu therapies with chronic patients. Case examples taken from a test protocol based on neuropsychological testing procedures illustrate the clinical information that can be obtained in this important, but relatively unexplored area. PMID- 2707936 TI - Therapist gender and the same-sex puberty age psychotherapy group. AB - Puberty is considered to be the most difficult developmental period to conduct psychotherapy. Group psychotherapy has special appeal for pubescents because of the anxiety experienced in individual psychotherapy with adults, and the mutual identification and support experienced with groups of same-sex peers. Although pubescents readily form cohesive groups, the emotional stress for the group therapists is intense and many therapists are reluctant to take on such groups. Close attention to the principles of developmental ego psychology suggests that pubescent groups will be more effective if conducted by group therapists of the same sex as the patients. PMID- 2707935 TI - Video self-portraits: a novel approach to group psychotherapy with young adults. AB - A group therapy model was formulated for exploring the intersubjective processes of adolescents and young adults whose group bonds had been fragmented by their severe emotional illnesses. The model involved having adolescents and young adults who were psychiatric inpatients make video self-portraits; that is, videotapes which focused on various aspects of their emotional pathology. These tapes were then presented before a larger group of nine patients for discussion. The video team method is shown to aid in self-disclosure and facilitate the working through of severe emotional conflicts in this age group. It is an especially useful method with more severely disturbed patients for whom narcissistic self pathology is a prominent feature. PMID- 2707937 TI - Activation of murine peritoneal macrophages by saikosaponin a, saikosaponin d and saikogenin d. AB - Macrophage activation by saikosaponins and saikogenins was investigated and compared with that by other saponins and macrophage stimulants. Saikosaponins a and d induced a marked cell accumulation in the peritoneal cavity when administered intraperitoneally. Among saikosaponins and saikogenins tested, saikosaponin d significantly activated peritoneal macrophages in terms of enhancement of phagocytic activity, increased level of cellular lysosomal enzyme (acid phosphatase), induction of cytostatic activity and expression of Ia antigen on the cell surface. The activities of saikosaponin d were much stronger than those of typical saponins ginsenoside Rg1 and glycyrrhizin and almost comparable with or somewhat weaker than those of lipopolysaccharide, a streptococcal preparation OK-432 and formalin-killed Propionibacterium acnes, indicating that saikosaponin d is a potent macrophage activator. PMID- 2707938 TI - A stereoselective blockade by naloxone of opioid and non-opioid-induced granulocyte activation. AB - Naloxone was found to prevent both opioid and non-opioid-induced migration of human granulocytes in a stereoselective way. Indeed, besides being able to inhibit morphine-induced migration, (-) but not (+), naloxone isomer proved to abolish either casein, serum of fMLP-induced chemotaxis. It is concluded that opioid-induced modulation of granulocyte migration is likely to be mediated through specific receptors, possibly of the mu type. Moreover, the antichemotactic effect of naloxone suggests an involvement of opioid receptors and/or endogenously released opioids in the mechanism of granulocyte activation by different chemoattractants. PMID- 2707940 TI - Platelet-derived growth factor and vascular proliferative lesions of the skin. PMID- 2707939 TI - Oral treatment with RU 41.740 (Biostim) in patients with advanced colorectal cancer: influence on the blood lymphocyte population. AB - Twelve patients with advanced colorectal carcinoma received oral treatment with RU 41.740, an immunomodulatory drug obtained from Klebsiella pneumoniae. The patients received three courses of RU 41.740, each consisting of 8 mg daily for 7 consecutive days, with free intervals of 3 weeks. This treatment did not significantly change the distribution of various lymphocyte subsets in the blood or the NK activity of the lymphocytes. However, PHA reactivity of purified lymphocytes increased significantly and exhibited a 2-3-fold enhancement 3 weeks after the last course. Such an increase was not observed in lymphocyte preparations which were not depleted of monocytes. It is concluded that 41.740 may be immunopharmacologically active in man when administered by the oral route. PMID- 2707941 TI - Urticarial papular and plaque eruptions. A noneczematous manifestation of allergic contact dermatitis. AB - A noneczematous eruption associated with allergic contact dermatitis is described. Five patients had disseminated erythematous urticarial papular and plaque eruptions secondary to contact allergy to two substances (four to proflavine and one to a permanent waving lotion). The eruption appeared to be similar to the previously described "erythema multiforme-like eruption" associated with allergic contact dermatitis. A review of the previous report indicated that the eruptions currently being reported do not have the typical clinical and histologic features of erythema multiforme. The term "urticarial papular and plaque eruption of contact allergy" is suggested to describe the eruption. The exact mechanism of the eruption remained speculative. PMID- 2707942 TI - Epidemiologic characteristics of scabies in the Israel Defense Force. AB - Scabies is not a notifiable disease in most countries. As a result the data on its epidemiologic characteristics are limited. In the Israel Defense Force, compulsory reporting of individual cases has been required for years, and in this study the epidemiology of the disease is examined for the years 1968-1988. A moderate epidemic occurred between 1969 and 1973, and was followed by a return to the previous low incidence. In 1982 a massive outbreak began, and peaked from 1985-1986. From 1987 to 1988, the incidence of infestation has markedly declined. A seasonal pattern of morbidity was evident during epidemic periods only; maximum incidence occurred during the winter months. These data are compared with those described in other countries and provide a more complete picture of the epidemiology of scabies based on individually reported cases. PMID- 2707943 TI - Squamous-cell carcinoma and lobomycosis (Jorge Lobo's disease). AB - Among the Cayabi Indians in Central Brazil, we found a high and unexpected prevalence of lobomycosis, which represents 21% of all the cases reported in the world medical literature until now. Most of the Cayabi patients have been observed for many years, and recently two developed cauliflower-like tumours in old lobomycosis scar lesions. The diagnosis of squamous cell carcinoma was confirmed histologically. In both cases, the tumor was surgically removed, but several months later tumors recurred in both patients. The appearance of squamous cell carcinoma in chronic scar lesions and ulcers of various etiologies has been reported by many authors, and should include lobomycosis. PMID- 2707944 TI - Exaggerated response to insect bites. An unusual cutaneous manifestation of chronic lymphocytic leukemia. PMID- 2707945 TI - Keratitis, ichthyosis, and deafness syndrome with development of multiple cutaneous neoplasms. PMID- 2707946 TI - Healing of necrobiotic ulcers with antiplatelet therapy. Correlation with plasma thromboxane levels. AB - Necrobiosis lipoidica in diabetics has been considered to be a cutaneous manifestation of diabetic microangiopathy. Seven diabetic patients with necrobiotic ulcers of recent onset that healed after administration of acetylsalicylic acid and dipyridamole had elevated thromboxane levels. Healing was associated with depression of the elevated thromboxane levels in all seven patients. PMID- 2707947 TI - International Foundation of Dermatology. PMID- 2707948 TI - Corticosteroid unresponsiveness in a case of pemphigus vulgaris. PMID- 2707949 TI - Eosinophilic pustular folliculitis effectively controlled with topical indomethacin. PMID- 2707950 TI - Inoculation: a likely route of leprosy transmission. PMID- 2707951 TI - Carcinoma of the lower uterine segment. Clinicopathologic analysis of 12 cases. AB - Clinicopathologic features of 12 tumors of the lower uterine segment (isthmus) were studied and the findings compared with data on 196 tumors of the corpus endometrium proper. The mean age of these Japanese patients with tumors of the isthmus was 47 years and that of the patients with tumors of the corpus endometrium was 55 years. Seven of the isthmic tumors (58%) were graded as 3 (poorly differentiated) with histologic features of adenosquamous carcinoma, and all 12 tumors showed myometrial invasion. Endometrial hyperplasia or atypical endometrial glands were found in the endometrium adjacent to the tumor in 11 women. Normal mucosal structures of the lower uterine segment were uninvolved, in the area between the tumor and the endocervix, in only three patients. Four patients died of the disease within 36 months after surgery. In a comparison with the usual endometrial tumors of the corpus, tumors of the lower uterine segment tended to be high-grade adenosquamous carcinomas and myometrial invasion was more extensive. The short-term follow-up revealed that lower uterine segment tumors carried an unfavorable prognosis. PMID- 2707952 TI - Changes in nuclear and nucleolar areas of endometrial glandular cells throughout the menstrual cycle. AB - Reproducible measures of the ultrastructural changes occurring throughout the normal human menstrual cycle are useful for defining and differentiating between normal and pathological states. Glandular endometrial functionalis epithelium obtained from five menstrual cycle subphases (early and late proliferative; and early, middle and late secretory) has been quantitated and compared for changes in nuclear and nucleolar size. These analyses indicate that (a) nuclear area significantly increases in the late secretory subphase, perhaps a requirement of endometrial regeneration; (b) nucleolar area peaks during the early secretory subphase, a necessary prelude for the later increased secretory activity; and (c) nucleolar area declines in the middle and late secretory subphases, probably due to falling hormone blood levels late in the cycle. In the proliferative phase, the majority of cells containing large nuclei and nucleoli have a relatively undeveloped cytoplasm, while the cytoplasm of those in the secretory phase contains glycogen. These cells were termed Stage 1 and 2 cells, respectively. The late secretory subphase contains some degenerating mature epithelial cells with large nuclei and small nucleoli as well as differentiated and regenerating cells with larger nucleoli. These measures establish a baseline of the normal changes in nuclear and nucleolar size as they occur throughout the normal human menstrual cycle. PMID- 2707953 TI - Immunohistologic detection of estrogen and progesterone receptors in disseminated peritoneal leiomyomatosis. AB - Disseminated peritoneal leiomyomatosis (DPL) is a rare clinicopathologic entity typically observed in women during pregnancy or immediately postpartum. Immunohistologic examinations of frozen as well as paraffin sections in three cases of DPL confirmed the myocytic character of the lesion and substantiated the hormonal influence on growth and regression of DPL nodules by detection of estrogen and progesterone receptors in the tumor cells. Implications of functional aspects as well as the benign clinical and morphologic feature of DPL are discussed in order to avoid inappropriate therapeutic measures. PMID- 2707954 TI - Leydig cell tumor of the ovary associated with endometrial carcinoma and containing 17 beta-hydroxysteroid dehydrogenase. AB - A case of ovarian Leydig cell tumor associated with adenocarcinoma of the endometrium in a 66-year-old woman is described herein, the eighth such case published. Clinically, both masculinizing and feminizing symptoms were observed: an increase in facial hair growth, slight baldness, clitoromegaly, and postmenopausal genital bleeding. Three biopsies of the endometrium during a 5 month preoperative period showed atypical hyperplasia. Surgically resected material contained a Leydig cell tumor of the left ovary and focal adenocarcinoma in atypical hyperplasia of the endometrium. Serum levels of androgens and estrogens measured by radioimmunoassay decreased after removal of the tumor. Immunohistochemical studies revealed that the Leydig cell tumor contained testosterone, estrogens, and 17 beta-hydroxysteroid dehydrogenase (HSD) in the cytoplasm. This is the first report of a Leydig cell tumor in which the localization of 17 beta-HSD was demonstrated immunohistochemically. PMID- 2707955 TI - Gonadoblastoma. Immunohistochemical and ultrastructural observations. AB - Gonadoblastoma is an unusual tumor that typically arises in a streak gonad or an abnormal testis of an individual having a Y chromosome. It is a mixed tumor composed of primitive germ cells and sex cord cells arranged in characteristic nests containing hyaline material. Whether the supportive gonadal sex cord cells are granulosa or Sertoli cells has not been clearly established, but one prior ultrastructural study favored Sertoli cell differentiation. Our studies indicate that the intermediate filaments of these cells react to monoclonal antibodies raised against cytokeratin and vimentin. The hyaline material reacts strongly with anti-laminin antibodies, indicating basement membrane material. Additionally, rodlike condensations of the intermediate filaments (historically called Charcot-Bottcher "crystalloids") were similar to those seen in the Sertoli cells of a series of postpubescent testes examined ultrastructurally. These findings support the Sertoli-like differentiation of these cells. PMID- 2707956 TI - Echinostoma caproni in mice: shedding of antigens from the surface of an intestinal trematode. AB - The surface antigens, which induce a serum antibody response during infection of mice with the intestinal trematode Echinostoma caproni, were examined. It was demonstrated that antigens are shed from the surface of juvenile and 4-week old adult E. caproni during in vitro culture. SDS-PAGE and Western blot analysis of in vitro shed and detergent solubilized surface antigens indicated that the four major antigens released from the surface of adult parasites had molecular masses of approximately 26,000, 66,000, 75,000 and 88,000. A modified ELISA technique showed the in vitro turn-over rate of the surface antigens to be very high, with a half-life of 8-15 min in both juvenile and adult E. caproni trematodes. Transmission electron microscopy of the surface of adult parasites revealed a highly active secreting tegument which was densely packed with membrane-bound vesicles, reflecting the high rate of shedding of the surface antigens. An attempt to immunize mice with detergent solubilized adult surface antigens failed to induce resistance to infection with metacercariae of E. caproni. PMID- 2707957 TI - Significance of the distribution of 57Co-vitamin B12 in Spirometra mansonoides (Cestoidea) during growth and differentiation in mammalian intermediate and definitive hosts. AB - The distribution of labeled cyanocobalamin (CN-[57Co]Cbl = [57Co]-vitamin B12) in pleurocercoids and adult tapeworms of Spirometra mansonoides was studied during development in mice 22 days days PI, respectively. Plerocercoid scolices, obtained by cutting away their bodies or by in vitro enzymatic dissolution of the bodies, were pulsed with CN- magnitude of 57Co Cbl for 1h at 37 degrees C and reimplanted subcutaneously into mice or given per os to cats. In regenerated plerocercoids, the highest concentration of magnitude of 57Co Cbl occurred in the scolex and then decreased posteriorly in the newly-formed tissues of the body. Approximately 60% of the total magnitude of 57Co Cbl present remained concentrated in the scolex following body regeneration plerocercoids and adult tapeworms of Spirometra mansonoides was studied during development in mice 22 days post-infection (PI) and in cats 16 days PI, respectively. Plerocercoid scolices, obtained by cutting away their bodies or by in vitro enzymatic dissolution of the bodies, were pulsed with CN-[57Co]Cbl for 1 h at 37 degrees C and reimplanted subcutaneously into mice or given per os to cats. In regenerated plerocercoids, the highest concentration of [57Co]Cbl occurred in the scolex and then decreased posteriorly in the newly-formed tissues of the body. Approximately 60% of the total [57Co]Cbl present remained concentrated in the scolex following body regeneration for up to 109 days PI. This high [57Co]Cbl concentration in the plerocercoid scolex was bound to protein and appears to be maintained by a complex homeostatic mechanism in association with directional transport of [57Co]Cbl to the scolex with ultimate depletion along the length of the body.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2707958 TI - Low molecular weight immunosuppressors secreted by adult Nematospiroides dubius. AB - Adult Nematospiroides dubius excretory-secretory products (ES) were collected from worms cultured in vitro, separated by sodium dodecyl sulphate- polyacrylamide gel electrophoresis (SDS-PAGE) into four fractions (FI-IV), electroeluted and assessed for their ability to inhibit the proliferation of mouse lymphocytes stimulated by mitogens in vitro. The proliferation of mitogen- and ES-stimulated mouse spleen lymphocytes from normal and infected mice was inhibited by low mol. wt ES F-IV (less than 26,000). PMID- 2707959 TI - Ultrastructural study of in vitro larval development of Echinococcus granulosus protoscoleces. AB - Through ultrastructural study of the morphological forms developed in vitro during protoscolex culture, we describe larval E. granulosus histogenesis. The transformation of the spined microtriches in the protoscolex into truncated microtriches that develop within the hydatid cyst is discussed. The paper also describes the mitochondria location change that occurs during the evolution; the mitochondria pass from the most internal area of the distal cytoplasm along the cytoplasmic extensions into the cytoplasm of tegumental cells. The ultrastructures of both the vesiculated protoscolex and the posterior bladder demonstrate that each state corresponds to the initial step on one of the two paths of in vitro vesicular development. PMID- 2707960 TI - Suppression of heterologous immunity by Nematospiroides dubius antigens in vitro. AB - The direct effect of the soluble antigens in the homogenate of adult Nematospiroides dubius (AH) on spleen cells from uninfected NIH mice was investigated using a Mishell-Dutton culture system. Parasite antigens were shown to reduce the plaque-forming cell (PFC) response to sheep red blood cells (SRBC) in a dose-dependent manner in vitro. A population of suppressor cells was demonstrated in the spleens of infected mice. Furthermore naive spleen cells cultured in the presence of AH gave rise to cells which depressed the PFC response of naive cells when subsequently cultured together in vitro. Treatment of these cell populations with anti-thy 1.2 plus complement did not impair suppressor activity, and it was concluded that cells expressing the T-cell phenotype were not involved. PMID- 2707961 TI - The relationship between ovine lymphocyte antigens and parasitological and production parameters in Romney sheep. AB - The occurrence of ovine lymphocyte antigen (OLA) types in two flocks of New Zealand Romney sheep was examined in relation to resistance to nematode parasites [as judged by faecal egg counts (FEC)], plasma pepsinogen levels, liveweight and weight gains. A panel of OLA-typing antisera (SY 1-16) which determine class 1 MHC antigens of the sheep was used. The OLA combination SY 1a + 1b was found exclusively in Romney sheep of both flocks having below average FEC, but was present in low frequency (5%). In one flock, sheep possessing this antigen combination had consistently lower FEC from weaning to 1 year of age than sheep without this combination. SY 6 occurred significantly more frequently in above average FEC sheep and was associated with significantly higher FEC during secondary challenge infection. Plasma pepsinogen levels were significantly lower in those sheep possessing SY 2 or SY 3 but these OLA types were not associated with lower than average FEC. No OLA type was associated with above average weight gain but in one flock sheep with SY 1b and SY 1a + 1b had significantly lower weight gains between weaning and 6 months of age than sheep without these OLA types. A similar association was not found in the other flock. Sheep in one flock with SY 16 were significantly heavier than those without this antigen. No other associations between OLA types and liveweight were found. PMID- 2707962 TI - Ultrastructural variation of Blastocystis hominis stocks in culture. AB - An ultrastructural study of 10 different Blastocystis hominis stocks was undertaken. Three distinct morphological forms, vacuolar, granular and amoeboid, were distinguished. Numerous variations in the organelles and general cell structure were observed between stocks. B. hominis displayed considerable size variation in the vacuolar forms, ranging from 4 to 63 micron. Thickness and density of the surface coat varied between different stocks. Beneath the surface coat the bilaminar cell membrane displayed electron-dense pits. The nature and quantity of the vacuolar contents varied, and in the granular form four morphologically different inclusions were seen. The organelles which showed the greatest variation between stocks were the mitochondria, varying in shape, electron-density, type of cristae and presence of inclusions. There was minimal variation between stocks with regard to endoplasmic reticulum, Golgi complex and nuclei. Budding of material between the cytoplasm and central vacuole was observed in some stocks. Indications of phagocytic behaviour of B. hominis were seen in the amoeboid form and in the vacuolar form of one stock. PMID- 2707963 TI - Soluble extracts from larval Ostertagia ostertagi modulating immune function. AB - BALB/c mice were immunized with Ostertagia ostertagi antigens and keyhole limpet hemocyanin (KLH) or sheep erythrocytes (SR) for evaluation of antibody production by enzyme linked immunosorbent assay (ELISA) or modified Jerne plaque assay. One semi-purified larval antigen caused both decreased anti-KLH serum antibody levels and fewer anti-SR IgM-secreting B cells. This antigen was shown to depress lymphocyte blastogenesis to Concanavalin A when added to cultured BALB/c splenic lymphocytes. PMID- 2707965 TI - Colorimetric quantitation of filarial viability. AB - A simple three-step colorimetric assay based on the tetrazolium salt MTT (3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) has been developed for quantifying filarial viability. Living (but not dead) filariae take up MTT and rapidly reduce it to formazan, so staining themselves dark blue. This colour change which is easily seen provides a rapid qualitative test for filarial viability. Quantitative data can be obtained by solubilizing formazan out of the worm with DMSO and measuring the absorbance of the resulting solution at 510 nm. To date the technique has been demonstrated in several species of filariae including Onchocerca volvulus. MTT reduction is thought to be selective for NADH dependent dehydrogenase activity in viable worms. The reaction occurs readily in all developmental stages of Dipetalonema viteae including fragments of filarial tissue. Enzyme activity in viable intact D. viteae appears to be primarily associated with the hypodermis/muscle cells, with minimal formazan formation in the gut and reproductive tracts. The application of this MTT assay as a parameter for quantifying in vitro drugs effects is described. Assay procedures have been developed and optimized with D. viteae and Brugia pahangi for the assessment of effects of macrofilariae and microfilarial release, and the activity of a range of antifilarial standards reported. Several potential applications of the technique to studies on filarial biology are discussed. PMID- 2707964 TI - Immunity in mice vaccinated with a molecular weight 60,000 glycoprotein secreted by adult Nematospiroides dubius. AB - A mol. wt 60,000 glycoprotein was purified from adult Nematospiroides dubius excretory-secretory products (ES) by polyacrylamide gel electrophoresis and electroelution and used to vaccinate BCF1 mice. This molecule is also released from the surface of the parasite and can be cleaved by pepsin. Mice immunized twice with ES 60,000 in Alum adjuvant harboured similar numbers of N. dubius as did control mice but voided 40% fewer parasite eggs in their faeces. The mol. wt 60,000 component in ES and from the surface of the parasite appears to influence how the parasite reproduces and may be important to its survival. PMID- 2707966 TI - Responses of NFR/N inbred mice to very low-dose infections with Ascaris suum. AB - Mice were evaluated for immunological responses and resistance to challenge infections after single infections. When given infections simultaneously with thiabendazole, larval migration to the liver and lungs was blocked but not when mice were given infections only. Enlargement of Peyer's patches was observed after infection followed by increased numbers of IgA-containing cells in the lamina propria of the intestines and increased levels of hepatobiliary IgA. Ig containing cells were variable in the spleens during the early phase of infection. The observed changes quickly returned to normal control levels and did not change throughout the rest of the experiment. Serum Ig levels did not change dramatically. Challenge with high doses of eggs indicated that mice given single very low-dose infections became highly resistant. PMID- 2707967 TI - Changes in anthelmintic resistance status of Haemonchus contortus and Trichostrongylus colubriformis exposed to different anthelmintic selection pressures in grazing sheep. AB - This experiment was designed to study, over a 5-year-period, the effect of different frequencies of treatment with three different anthelmintic groups, namely, benzimidazoles, levamisole and ivermectin, and different frequencies of alternation between them, on existing levels of anthelmintic resistance in the nematode parasites Haemonchus contortus and Trichostrongylus colubriformis of grazing sheep. No evidence of ivermectin resistance emerged, even in suppressively treated groups. Likewise, H. contortus failed to develop resistance to levamisole under a similar selection regimen. Thiabendazole was shown to select positively against levamisole resistance in T. colubriformis resulting in significantly greater susceptibility to this drug than for the natural reversion which occurred in the untreated control. There was no evidence that an anthelmintic treatment combined with a movement of sheep to pastures of low infectivity selected more rapidly for resistance than where the same number of treatments were given to set-stocked sheep. Rotation between anthelmintic groups at yearly intervals appeared to be more beneficial in delaying resistance than rotation of drugs with each treatment. PMID- 2707968 TI - Synthesis of a substrate of protein kinase C and its corresponding phosphopeptide. AB - The syntheses of a protein kinase C (PKC) peptide substrate, H-Lys-Arg-Thr-Leu Arg-OH, and a phosphopeptide analog of the synthetic substrate, H-Lys-Arg-Thr(P) Leu-Arg-OH, are reported. PKC phosphorylates the peptide with an apparent KM of 0.30 +/- 0.04 mM and an apparent Vmax equal to one-tenth that of histone III-S. The synthesis of the phosphopeptide features a recently developed convenient phosphorylation procedure for serine and threonine using N,N-diethylamino dibenzylphosphoramidite. A complete characterization of the PKC substrate and its corresponding phosphopeptide by C-H COSY 2D n.m.r. is included. PMID- 2707969 TI - Enkephalin-degrading enzyme inhibitors. Crucial role of the C-terminal residue on the inhibitory potencies of retro-hydroxamate dipeptides. AB - The retro-inversion of the amide bond in kelatorphan and analogs, the first series of complete inhibitors of enkephalin metabolism, led to compounds highly efficient only against the neutral endopeptidase 24-11 (NEP). In order to increase the recognition of the aminopeptidase N (APN) and dipeptidylaminopeptidase (DAP), without loss of affinity for NEP, the malonyl group of these retro-inhibitors was replaced by diversely substituted succinyl moieties. All the molecules synthesized are highly efficient NEP inhibitors with Ki's in the 0.2-1 nM range, indicating that NEP possesses a relatively large and not very selective S'2 subsite. In contrast, inhibition of DAP activity is crucially dependent on the size and the position of the substituent in the succinyl moiety. Inhibitory potencies in the nanomolar range are obtained with compounds containing a benzyl group in the alpha-position related to the retro amide bond. Finally, a relatively modest inhibition of APN was observed with Ki's in the 0.5-1 microM range for compounds with benzyl or cyclohexyl group in P'2 position. However, these data demonstrate that efficient and complete inhibition of enkephalin degradation can be obtained with hydroxamate dipeptides containing a retro amide bond. The analgesic potency of the most active inhibitors was measured using the hot plate test in mice. Significant antinociceptive responses were obtained but these effects were rather weaker than those expected from the in vitro inhibitory potencies of these compounds on the three enkephalin degrading enzymes. PMID- 2707970 TI - Synthesis of derivatives of phosphonic glutathione analogs. AB - Five analogs of S-t-butyl glutathione containing phosphonic analogs of glycine and glutamic acid were obtained by standard procedures of MA activation in solution. Simultaneous deprotection of phosphonic, carboxylic and amino groups was achieved in the silylation reaction. PMID- 2707971 TI - Synthesis and biological evaluation of human preproenkephalin (100-111) and its analogs. AB - The dodecapeptide sequence, Tyr-Gly-Gly-Phe-Met-Lys-Arg-Tyr-Gly-Gly-Phe-Met (BI), which is totally conserved in the primary structures of human, bovine, rat and toad preproenkephalins, has been synthesized by the solid-phase method. Coupling reactions were achieved by using symmetrical anhydrides of tert. butyloxycarbonylamino acids performed with N-tert.-butyl,N'-methylcarbodiimide. 6 Arg and 7-Lys analogs have also been obtained. The peptides show opiate activity in both GPI and MVD assay, and possess antinociceptive properties as estimated by the hot-plate test in mice when applied intracisternally. PMID- 2707972 TI - N.m.r studies of internal mobility in a cyclic tetrapeptide. AB - The conformation of cyclo(D-Phe-D-Pro-Ala-Pro) is reported. Measurements of spin lattice relaxation in the rotating frame indicate that this peptide is conformationally less mobile on the microsecond time scale than larger cyclic peptides previously studied. Libration of the Pro-Ala and Pro-Phe peptide bond planes is suggested as the source of the small exchange contributions to 1/T1p. PMID- 2707973 TI - Naso- and oropharyngeal dimensions in children with obstructive sleep apnea. AB - Sixty children (3-11 years) were evaluated to determine variations in naso- and oropharyngeal dimensions associated with tonsil and adenoid hypertrophy. The subjects were grouped according to tonsil size and a clinical history of chronic upper airway obstruction. Intraoperative measurements included oropharyngeal diameter, length of the hard and soft palates, width and arch of the hard palate, nasopharyngeal volume, as well as tonsil and adenoid weights and volumes. A significantly larger oropharyngeal diameter was found in children with small, non obstructing tonsils (P less than 0.01). Children with large, non-obstructing tonsils had a similar oropharyngeal diameter to those children with large, obstructing tonsils. However, tonsil volume, not weight, was increased in the children with large obstructing tonsils as compared to those with large non obstructing tonsils and small non-obstructing tonsils (P less than 0.04). A shorter soft palate was associated with larger, obstructing tonsils (P less than 0.004). The length of the hard palate was similar in all patients, however, a trend towards a higher arched palate was seen in patients with larger, obstructing tonsils. The distance from the soft palate to the posterior pharyngeal wall was greater in obstructed patients with adenotonsillar hypertrophy (P less than 0.003). In patients requiring adenoidectomy, the nasopharyngeal volume prior to adenoidectomy was significantly smaller in patients with obstructive symptoms (P less than 0.001). Postadenoidectomy, no significant difference was found in the nasopharynx volume amongst all subjects. These data indicate that subtle differences in oropharyngeal dimensions exist which along with increased lymphoid tissue volume, lead to the development of obstructive symptoms. Etiologic considerations are discussed. PMID- 2707974 TI - HIV protocol for the pediatric otolaryngology office. AB - With the increasing awareness and concern over the transmission of human immunodeficiency virus (HIV) to health care providers, the development of a reasonable approach to patient care is necessary with those suspected of or documented as being HIV-positive. Children are all too frequently the innocent victims of this deadly disease and will often require the services of the otolaryngologist for evaluation, diagnosis, and treatment. In order to provide appropriate care for these children and reduce the risk of possible contamination of health care professionals or other patients a protocol was established for the Pediatric Otolaryngology Division of Children's Hospital at Washington University. This protocol is discussed in detail with explanation of rationale and alternatives. PMID- 2707975 TI - Assessment of infant cry variability in high-risk infants. AB - Two studies were conducted to determine the relationship between variability in acoustic features of the infant cry and medical risk factors. In study 1, 3 groups of preterm infants (healthy, sick and CNS pathology) were compared with term infants at 40 weeks gestational age. The cry was analyzed by computer. The coefficient of variability of cry amplitude and the formant features of the cry differed among the groups of preterm infants. In study 2, 3 groups of term infants at low, moderate and high levels of hyperbilirubinemia were compared on the cry measures. More variability in the formant features of the cry was found in infants with higher levels of bilirubin. The correlation between the coefficient of variation in the cry formants and level of bilirubin was statistically significant. These two studies suggest that variability in the acoustic features of the cry relate to the medical status of the infant and may provide a measure of neurophysiological integrity. PMID- 2707976 TI - Thermal myringotomy versus grommets in the management of secretory otitis media. AB - This paper presents the findings of a study of thermal myringotomy compared with the insertion of a grommet, in 30 children with secretory otitis media. The procedure was found to be easy to perform and free from complications. It provided ventilation of the middle ear for up to 8 weeks. However, there was a recurrence of the middle ear effusion in 40% of the thermal myringotomy ears. On the other hand, grommets were very effective in eliminating effusion over a 6 month period. I was unable to identify any parameter that will predict which patients will remain free of effusion after ventilation with a thermal myringotomy. PMID- 2707977 TI - Otoscopic diagnosis of middle ear effusion in acute and non-acute otitis media. I. The value of different otoscopic findings. AB - To determine the value of different pneumotoscopic findings in diagnosing the middle ear effusion (MEE) of acute (AOM) and non-acute otitis media, 11,804 ear related visits of 2,911 unselected children at ages 0.5-2.5 years were analysed. About half of these were examined by an otolaryngologist in one, and half by a pediatrician in another, urban area. Myringotomy was always performed when MEE was suspected, and it confirmed the presence of MEE in 85% (otolaryngologist) and 82% (pediatrician) of altogether 5,462 acute and in 69% (both doctors) of 1,092 non-acute cases suspected. Redness of the tympanic membrane (TM) was found in only 18% and 27% of the visits with AOM, and it predicted MEE with only 60% and 51% probability, if seen in acute visits. Cloudiness of the TM was noticed in 81% and 67% of the visits with AOM; its specificity and the other calculated variables were good in regard to the diagnosing of MEE, especially in acute cases in both groups. Distinctly impaired mobility of the TM was of about the same diagnostic value, but its position reliably indicated MEE only when bulging. In AOM the colour or mobility of the TM was normal very rarely, but the position was normal in a third of the cases. Thus, although there were differences in the incidences of different otoscopic findings in the two study groups, the diagnostic value of certain pneumatic otoscopic findings, especially cloudiness and distinct hypomobility of the TM, seemed to be good in both groups. PMID- 2707978 TI - Actinomycosis of the middle ear. AB - Actinomycosis is an uncommon infection of the middle ear. Only 21 cases of actinomycosis of the middle ear have been reported in the English literature prior to this paper. The offending organism is Actinomyces israelii, which is an anaerobic, filamentous organism that is difficult to grow in culture. The infection is chronic and is seldom diagnosed prior to tympanomastoidectomy. The identification of small, yellow, glue-like masses, which are called sulfur granules, is often the key to making the diagnosis of actinomycosis of the middle ear. Following tympanomastoidectomy, penicillin is given orally for 3-6 months. PMID- 2707979 TI - Surgical treatment of infantile subglottic hemangioma. AB - Three cases of infantile subglottic hemangioma are described. Generally conservative management is favored by most authors. These present lesions were removed surgically by midline cricotracheotomy. Follow-up showed that all children were well and without complaints. The authors believe that besides management with the CO2 laser and short-term steroid therapy, operative treatment of infantile subglottic hemangioma is a valuable alternative which should receive more attention. All children were decannulated a few days after surgery. PMID- 2707980 TI - A comparison of primary nursing and team nursing in a geriatric long-term care setting. AB - The purpose of this study was to evaluate primary and team nursing on two 45-bed geriatric units. A 2 year longitudinal study with a quasi-experimental ABA cross over design and a staff survey, permitted comparisons of the two nursing systems on indices of patient well-being, nursing practice, staff morale and costs. Differences in nursing practice, in selected measures of patient well-being and in responses to the staff survey were positively associated with primary nursing. No differences emerged in relation to staff morale or costs. The benefits of primary nursing and implications for further research are discussed. PMID- 2707981 TI - Perception of nurses in expanded role. AB - This is a study aimed at identifying nurses' responsibilities and the perceptions of consumers of health care regarding the expanded roles of nurses in the delivery of primary health care through institutional clinics. Questionnaires were distributed to various categories of workers and students who were receiving care in the selected clinics attached to higher educational institutions, in order to determine the acceptability of nurses in expanded role. Responses of consumers revealed a high degree of acceptability of the nurse's expanded role, with Users scoring higher than Non-users. All the nurses involved had a positive perception of their role which they felt could be improved with the provision of necessary equipment and refresher courses at regular intervals. Other factors necessary for enhancing their role in the provision of primary health care are highlighted. PMID- 2707982 TI - "The best laid schemes...": an evaluation of the extension of midwifery training in Scotland. AB - A research project was undertaken to evaluate the extension of midwifery training in Scotland. The evaluative criterion used was the new midwives' employment decisions. The data on students' valuation of their training suggest that they regard their time as having been well spent and other data show that socialization into midwifery increased with the longer training. Confidence in midwifery skills did not change markedly in association with the extension of training. Certain benefits of the longer course anticipated among midwives, are shown by these data not to have happened. PMID- 2707983 TI - Use of a modified symptom distress scale in assessment of the cancer patient. AB - Symptom distress was assessed in a heterogeneous sample of cancer patients using a modified version of the McCorkle and Young (Cancer Nurs. 1, 373-378, 1978) Symptom Distress scale based on a linear analogue self-assessment (LASA) scale. Validity was assessed. Reliability, based on estimation of internal consistency (Cronbach's coefficient alpha), was high (alpha = 0.97) showing the tool to be reliable and effective in assessment of symptom distress. Of the 120 patients included 73% indicated significant distress from at least one symptom, 55% from two or more and 28% from at least five. Only 25% were suffering widespread or advanced disease suggesting that the incidence of symptom distress is not, of necessity, dependent on the extent of disease. The results obtained using the modified index were compared with those previously obtained by McCorkle and Young (1978) and showed marked similarities between the different cancer patient populations. This indicates that the modified scale is no less effective in assessing symptom distress but this has considerable advantages due to its simplicity and ease of administration. PMID- 2707984 TI - ICN offers AIDS expertise. PMID- 2707985 TI - Northern nurses take responsibility in the war against AIDS. PMID- 2707986 TI - The impact of technology: protection in Norway and Denmark. AB - The impact of technology on nurses and their work conditions has been a preoccupation of many national nurses' associations. The ease with which they have been able to solve the ensuing problems for nurses, improve their working environment and provide the necessary training has often depended on their respective country's basic laws and their bargaining muscle. Below are examples of how nurses can protect their rights under two different legal systems based on a report from Per Godtland Kristensen, executive director of the Norwegian Nurses Association (Norsk Sykepleier Forbund), and a recent survey by the Salaried Employees' and Civil Confederation (FTF) in Denmark. PMID- 2707987 TI - The coming of age in nursing care of the elderly. AB - Worldwide trends and developments point the way toward a restructuring of health care delivery systems to meet increased demands from the elderly and disabled. As nursing, by virtue of its unique position, can play a major role in gerontological care, below the authors present three models that optimize nursing care to ensure effective and efficient service. PMID- 2707988 TI - A proposed model for care of the elderly. AB - As it is easier to take a comprehensive view of an organization and its efforts in a small setting, attention is being directed toward a small community in North Zealand, Denmark, where a radical change in the care of the elderly has taken place. Below, Project Leader Lis Wagner describes the process, which includes training, dialogue and cooperation as the key factors for the project's successful outcome. PMID- 2707989 TI - How NNA international departments work--Part II. AB - How an international department is organized and its scope of activities vary according to the association and to the region. Below, three more examples of how NNAs handle their international responsibilities. In January-February the spotlight was on the UK's Royal College of Nursing and the Canadian Nurses Association. PMID- 2707990 TI - Assessment of the person with AIDS in the emergency department. AB - It is difficult to describe a "typical" clinical picture of a person with acquired immunodeficiency syndrome (AIDS) who is seen in the emergency department. The clinical course and the early clinical manifestations that lead to the initial diagnosis of AIDS vary greatly. Variability is the rule, because the patient with AIDS may manifest a wide range of signs and symptoms--from those associated with a minor illness to those indicative of a critical near-death state. Indeed, some patients with AIDS have no complaints or relatively minor constitutional complaints before becoming acutely compromised as a result of an overwhelming opportunistic infection. Other patients have a relatively short history (weeks to months) of vague, nonspecific complaints. PMID- 2707991 TI - Rectosigmoid resection without colostomy during primary cytoreductive surgery for ovarian carcinoma. AB - A nine year experience with rectosigmoid colectomy during primary cytoreductive surgery for epithelial ovarian cancer is reported. During the period 1979-1987, 20 patients underwent such resections with primary sutured end-to-end anastomosis without a protecting colostomy. Only one of these patients required a secondary colostomy. In a further five patients, anterior resection and reanastomosis was performed concomitant with additional bowel resections, again without diversion colostomy. Subsequent secondary colostomy for a recto-vaginal fistula was required in one. There were two post-operative deaths, both in the group who required bowel resections in addition to recto-sigmoid resection. Of the entire group of 25 patients, 12 (48%) are currently alive free of disease, with a median survival of 32 months. Excluding the two post-operative deaths (at 20 and 39 days), the median survival of the remaining 11 who subsequently died of recurrent disease, was 14 months. The Authors recommend that anterior resection with primary reanastomosis without a protecting colostomy, is performed during primary cytoreductive surgery for ovarian cancer in patients in whom such a procedure facilitates resection of all or nearly all their disease. PMID- 2707992 TI - Perforations of the extraperitoneal rectum during barium enema. AB - Rectal injuries during barium enema are uncommon but not unusual complications. Radiologists and surgeons must be able to recognize them, as early diagnosis is essential for effective treatment. The Authors discuss various aspects of problems arising from rectal perforation, and report their experience on seven cases. PMID- 2707993 TI - Postoperative peritoneal lavage in generalised peritonitis. A prospective analysis. AB - Fifty patients with generalised peritonitis were studied in the period between November 1984 and May 1986, 20 with postoperative peritoneal lavage and 30 with only conventional treatment. The study revealed that lavage could not reduce mortality. There was a large number of reperforation and anastomotic leak associated with it. Among patients who survived, lavage did however aid in rendering patients afebrile and in the return of the bowel sound early. Hospital stay was also reduced. We agree with earlier suggestions that the use of peritoneal lavage with its labour, intensiveness and potential complications is restricted to gross peritoneal contamination and its use in lesser degree of peritonitis is questionable. PMID- 2707994 TI - Retroperitoneal mesenteric cysts. AB - Retroperitoneal cysts are most commonly found in relation to the small bowel but may be found in the mesentery of the colon or in the omentum. Only a few hundred cases have been reported. In the present analysis four more cases are reported and the pertinent literature is reviewed. The diagnosis is made by clinical suspicion, barium meal and/or enema, sonography and axial computerized tomography. Treatment of choice is by enucleation of the cyst, if possible. Morbidity and mortality should be very low, because of recent advances in surgery and intensive care of the patient. PMID- 2707995 TI - Prophylactic appendicectomy during elective cholecystectomy: effects on morbidity. A prospective controlled study. AB - Prophylactic appendicectomy was performed on 56 consenting patients undergoing elective cholecystectomy. The control group consisted of 60 patients. Both groups were well matched in respect of age, sex, build and type of incision. All patients received a single i.v. dose of 1 g Cefazolin sodium and 500 mg Metronidazole at induction of anaesthesia. Postoperative wound sepsis occurred in 5.4% of the appendicectomy group and in 6.7% of the control group. Residual intra abdominal sepsis did not occur in either group. The mean duration of postoperative hospital stay was 9.1 days (SD +/- 1.63) in the appendicectomy group and 8.5 days (SD +/- 1.85) in the control group. These differences were not statistically significant. Six (10.7%) of the appendices removed were abnormal, including two with inflammation. The conclusion of this study is that prophylactic appendicectomy can be performed safely during elective cholecystectomy provided that it is done without undue manipulation and the patient is protected with an effective prophylactic antibiotic regimen. PMID- 2707996 TI - Peripancreatic vascular occlusions as a complication of pancreatitis. AB - In the case records of patients with a pancreatic inflammatory state (1,268 patients) during a 15-year period (1972-1986) we found 11 patients, who were diagnosed as having vascular obstruction in association with pancreatitis. The incidence was thus found to be 0.9%. This incidence was three times higher in chronic than in acute pancreatitis. Vessels near the head of the gland were the most frequently affected. Arteries predominated (64%). A laparotomy had been previously performed on seven patients. Thus manipulation of the pancreas may be an important co-factor in pathogenesis. Ten patients (91%) died. Only four (36%) were correctly diagnosed before autopsy. The diagnostics and clinical implications of various forms of vascular occlusions with pancreatitis are discussed. PMID- 2707997 TI - Obstructive jaundice secondary to intra-biliary rupture of hepatic hydatid cyst. AB - Of 58 cases of obstructive jaundice treated in a three year period, six were due to the intrabiliary rupture of hydatid cysts of the liver. Eosinophilia of more than 10%, raised alkaline phosphatase, positive indirect haemagglutination test were noted in all six cases. Plain X-ray of the abdomen, ultrasound, endoscopic retrograde cholangio-pancreatography and CT scan were useful modalities for definite pre-operative diagnosis. All patients had operative treatment which consisted of cyst drainage, partial pericystectomy, curettage of the remaining cavity which was stitched with tube drain, cholecystectomies, choledochotomy and T-tube drainage. They all recovered satisfactorily and without complications in a follow-up period of two years. PMID- 2707998 TI - Giant pseudopolyposis causing antegrade colonic obstruction. AB - A case is presented in which the development of massive pseudopolyps resulted in an antegrade colonic obstruction in a patient with Crohn's disease. Problems of diagnosis and management are discussed, with emphasis on the diagnostic and therapeutic roles of endoscopy and surgery in patients with these lesions. PMID- 2707999 TI - New tunneler for inserting long-term central venous catheters. AB - During insertion of a long-term central venous catheter, creation of the subcutaneous tunnel is a frequent cause of patient discomfort, as well as a potential source of complications. The following technique makes use of a new tunneler that, being only slightly larger than the catheter itself, minimizes discomfort and skin trauma, thus reducing the potential for hematoma formation and infection. PMID- 2708000 TI - Treatment of biliary fistulas and cholelithiasis: is endoscopic sphincterotomy acceptable in the paediatric age group? AB - Two children, both girls, aged 11 and 16 with a postoperative biliary fistula and cholelithiasis, choledochal cyst and common bile duct stones have undergone endoscopic sphincterotomy (EST), leading to a rapid recovery from their pathologies, thanks to cooperative work. In reviewing the literature we have not come across any cases of EST in our patients' age group. There were no complications during or immediately after endoscopic sphincterotomies. We believe that it has become an important and valuable rival to conventional surgical means with correct indications and in experienced hands. PMID- 2708001 TI - Prevention of postoperative wound dehiscence in high risk patients. A randomized comparison of internally applied resorbable polyglactin 910 mesh and externally applied polyamide fiber mesh. AB - This randomized prospective study was undertaken to compare the effectiveness of two methods used to prevent post-operative wound dehiscence in 100 high risk patients. Fifty patients were treated with a polyamide fiber mesh applied externally to the skin using a topical glue, while the other 50 patients were treated with a resorbable intraperitoneal mesh of polyglactin 910. Each patient had at least one of the following risk factors for wound dehiscence: undernutrition, malignancy, ascites, peritoneal infection, immunodepression, abdominal irradiation, repetitive surgical procedures through the same incision, or pulmonary disease. Judging criteria consisted of the development or absence of dehiscence and the frequency of abdominal wall complications. The percentage of wound dehiscence was significantly increased in patients with externally applied polyamide fiber mesh as compared to those with intraperitoneal polyglactin 910 mesh (p less than 0.01). Abdominal wall complications and the duration of healing did not vary significantly in frequency between the two groups. The intraperitoneal placement of a polyglactin mesh was more effective and better tolerated than external application of a polyamide fiber mesh. PMID- 2708002 TI - Successful management of ruptured mycotic abdominal aortic aneurysm in a child. AB - Mycotic aneurysm of the abdominal aorta is a serious disorder that generally carries a grave prognosis. A few survivors have been reported in adults but none in children. This report describes the successful management of ruptured mycotic abdominal aneurysm in a 10-year-old girl. The entire aneurysm was excised, and aortic continuity restored with low porosity bifurcated Dacron graft. With no macroscopic suppuration, we believe aortic continuity is a logical way to deal with this grave situation in children. Antibiotic cover was given pre and postoperatively for a total of six weeks. To our knowledge, this is the only surviving case in children in the literature. The pathogenesis and diagnosis of mycotic and infected aneurysm is discussed, and the literature has been reviewed. PMID- 2708003 TI - Destructive operation in obstetric practice in Nigeria. AB - An analysis of the use of destructive operation in obstetric practice at the University of Nigeria Teaching Hospital Enugu over a nine year period has been carried out. The hospital is the only Teaching Hospital in the State of six million people, and serves a dual role of tertiary and primary care centre. The incidence of destructive operation fell from 0.29% in the first three years to 0.06% and 0.05% in the second and third year periods respectively. The main indication for the operation was obstructed labour. The incidence of maternal morbidity and mortality was high and was related more to the indications for the destructive operation then the actual operation. Suggested methods for eliminating its use and complications include health education, provision of efficient obstetric services and adequate training of available manpower. PMID- 2708004 TI - Adhesive, invasive, and growth properties of selected metastatic variants of a murine large-cell lymphoma. AB - The adhesive, invasive, and growth properties of parental murine large-cell lymphoma cells of low metastatic potential (RAW117-P) were compared to in-vivo selected sublines of high metastatic potential to liver (RAW117-H10) or lung (RAW117-L17). Using small (approximately 0.5 mm3) pieces of syngeneic organ tissue (lung, liver, kidney) we found that RAW117-L17 cells selectively attached to and invaded lung tissue, whereas RAW117-H10 cells preferentially attached to and invaded liver tissue. We measured adhesion to microvessel endothelial cells established from syngeneic lung and liver and found that the RAW117-L17 cells bound to lung microvessel endothelial cells at significantly higher rates than the other lines, and RAW117-H10 and -L17 cells attached to hepatic sinusoidal endothelial cells at significantly faster rates than RAW117-P cells. Such organ specificity of adhesion was not found at the level of the subendothelial matrix, and the rates of adhesion of RAW117 cells to subendothelial matrix were lower than to endothelial cells. RAW117 cells of low or high metastatic potential bound to immobilized extracellular matrix components, such as fibronectin, at high rats, but adhesion to laminin or collagen IV was minimal. Previous studies indicated that RAW117 lines could proliferate in vitro in certain organ conditioned media under limiting serum conditions. We therefore examined the ability of a purified paracrine lung growth factor (LDGF-1) to stimulate growth of RAW117 cells in limiting serum-containing medium. The high lung-colonizing L17 line was stimulated to proliferate by LDGF-1 at faster rates than the other lines. The data support Paget's hypothesis that the organ specificity of tumor metastasis is determined by specific tumor cell and host properties. PMID- 2708005 TI - Potentiation and inhibition of tumor cell invasion by host cells and mediators. AB - A culture model for invasion of rat mesothelial cell layer by rat ascites hepatoma cells has been developed. By using this quantitative model, the preculture with macrophages (0.1 less than macrophage/tumor cell less than 1.0) was found to enhance both the in vitro and in vivo invasive potentials of the tumor cells. This potentiation appears to be mediated partly by oxygen radicals generated by the cocultured macrophages. The in vitro invasive capacity was also augmented by pretreating the tumor cells with TGF-beta or with activated platelets. A factor with anti-invasive potential (IIF) was extracted from rat liver. It inhibited the directed migration but not the growth of the tumor cells and was effective on their in vivo invasion and metastasis, as well. PMID- 2708006 TI - International Symposium on Cancer Progression and Metastasis. Proceedings of the 8th Sapporo Cancer Seminar. July 6-9, 1988, Sapporo. PMID- 2708007 TI - Novel synthetic heparin binding peptides of laminin and fibronectin which promote the adhesion of melanoma cells. AB - A synthetic peptide derived from the B1 chain of laminin, F-9, as well as two peptides derived from the 33-kilodalton fragment of fibronectin, I and II, directly promoted the adhesion of K-1735-M4 metastatic murine melanoma cells. In competition assays, adhesion of these cells to laminin was inhibited by excess soluble peptide F-9. Peptides F-9, I, and II specifically bound 3H-heparin, both by direct binding assays and indirect competition assays. 3H-heparin binding to peptide F-9 was specific as determined by competition with excess unlabeled heparin, dextran sulfate, and dermatan sulfate. These findings suggest that melanoma cell surface associated heparin-like molecules may act as receptors for these domains of laminin and fibronectin. PMID- 2708008 TI - Animal models in the evaluation of chemotherapeutic agents against HIV. 1st workshop held by the Cooperation AIDS Research Bayer and Hoechst. July 4-5, 1988, Bad Neuenahr, FRG. PMID- 2708009 TI - HIV infection of chimpanzees as a model for testing chemotherapeutics. AB - Following inoculation of chimpanzees, the human immunodeficiency virus (HIV) establishes a long-term persistent infection characterized by seroconversion and the presence in peripheral blood cells of recoverable virus which can be quantitated. Because most HIV-infected chimpanzees have developed no signs of clinical diseases or hematologic abnormalities, their virologic, serologic and other immune responses can be compared with those of asymptomatic HIV-infected persons. This analysis might lead to the identification of factors important in preventing the development of disease. There are now approximately 100 HIV infected chimpanzees in the United States, and many of these animals could be made available for testing chemotherapeutic agents for the ability to alter virus load or to enhance immune responses. PMID- 2708010 TI - HIV-2 in rhesus monkeys: serological, virological and clinical results. AB - Diseases induced by animal retroviruses are not considered to be good models for the human acquired immunodeficiency syndrome (AIDS) at present. The lack of an animal model for the human immunodeficiency virus (HIV) infection presents a main problem in the complete understanding of the pathogenesis of HIV-mediated diseases. Because of the homologies between simian immunodeficiency virus (SIV) and HIV-2, we inoculated rhesus monkeys with HIV-2 and HIV-2 adapted in vitro to monkey cells. One of the ten animals inoculated developed clinical symptoms that might be related to the infection with HIV-2. PMID- 2708011 TI - Special section on history of medicine. PMID- 2708012 TI - Vasculogenic impotence. PMID- 2708013 TI - Screening for depression among the elderly in Israel: an assessment of the Short Geriatric Depression Scale (S-GDS). AB - Depression is a common source of distress in the elderly. Screening for depression allows for accurate diagnosis and treatment by clinicians and enables prevalence estimates to be used for monitoring morbidity and health services. A screening instrument is required that is both easily administered and has been validated among the heterogenous population of community-dwelling elderly in Israel. This study assesses the suitability of a short screening test with high face validity, the Short Geriatric Depression Scale (S-GDS), in a Jerusalem community sample (n = 285). The test yielded a 34% prevalence rate for depression, which is similar to rates found in community studies elsewhere. The screening test correctly classified 72% (95% confidence interval, 60 to 84%) of those with depression in a diagnosed subsample of 71 subjects. The specificity was only 57% (95% confidence interval, 44 to 70%) which was probably due to confounding with early dementia. The S-GDS was more likely to classify as depressed those with no formal education, those of Middle Eastern origin, and women. Higher levels of sensitivity and specificity can be obtained by calibrating, the cutoff score based on the level of education. The internal consistency of the test was adequate for the community sample as a whole, as well as among various demographic subgroups. The stability of test responses was also significant. Guidelines for the development of an instrument more appropriate for the Israeli population are suggested. PMID- 2708014 TI - Lack of effect of ranitidine on rat hepatic blood flow. PMID- 2708015 TI - Association of elevated serum creatine kinase with lung disease and febrile illness. PMID- 2708016 TI - Chronic renal failure and macrocytosis. PMID- 2708017 TI - Diagnosis of common bile duct leakage by cholescintigraphy. PMID- 2708018 TI - Muscle, eye and brain syndrome--a distinct type of congenital muscular dystrophy? PMID- 2708019 TI - External ophthalmomyiasis caused by Oestrus ovis. PMID- 2708020 TI - Unusual "epilepsy" masking cardiac rhythm disturbances with reversible encephalographic changes. PMID- 2708021 TI - 18th annual meeting of the Israel Immunological Society. 26 May 1988, Beer Sheva, Israel. Abstracts of papers. PMID- 2708022 TI - Leishmaniasis after Adler and beyond. PMID- 2708023 TI - Bacterial meningitis with initial normal cerebrospinal fluid findings. AB - Seven pediatric patients with bacterial meningitis but with initial normal cerebrospinal fluid (CSF) findings are presented. They represent 6.5% of all cases with bacterial meningitis seen at our medical center during a 5-year period. In all cases, the duration of symptoms before the initial lumbar puncture was short (6-24 h). The case-fatality rate was 3/7 (43%) compared with 10/100 (10%) among children with abnormal initial CSF, despite early initiation of antibiotics. Bacterial meningitis with an initial normal CSF finding is not rare and may be associated with poor outcome. PMID- 2708024 TI - Effectiveness and absorption of rectal hydrocortisone acetate foam in nonspecific proctocolitis. AB - A 3-week open trial of rectal hydrocortisone acetate foam (Colifoam, Stafford Miller, UK) was conducted in 19 patients with active, nonspecific distal proctocolitis. Complete or near complete remission was observed in nine patients (47.4%). Absorption of hydrocortisone acetate from Colifoam was evaluated in 13 patients by measuring early morning serum cortisol before treatment and 12 and 36 h after the final dose. Normal cortisol values were observed in every instance, suggesting that the steroid component of Colifoam was not significantly absorbed. Colifoam seems to be an effective remedy for distal proctocolitis. Its specific advantages include ease of retention and apparent nonabsorption of the active component. PMID- 2708025 TI - Renal papillary necrosis in a child with rheumatic carditis treated with aspirin. AB - A child with rheumatic carditis developed acute renal failure due to renal papillary necrosis while receiving a short course of aspirin treatment. It is suggested that in this child the aspirin therapy predisposed the renal medulla to hypoxic damage induced by the carditis and congestive heart failure. It is therefore recommended that children receiving aspirin or other nonsteroidal anti inflammatory drugs, even for a short time, be closely observed and the drug discontinued of hypoxia is evident. Moreover, during illnesses tending to cause hypoxia such as carditis, aspirin or other nonsteroidal anti-inflammatory drugs are best avoided since they are additional risk factors for renal damage. PMID- 2708026 TI - Secondary hemochromatosis due to prolonged iron ingestion. AB - Cases of secondary hemochromatosis caused by excessive iron ingestion are very rare. In most instances there are associated factors known to cause iron overload, such as anemia, alcoholism or the presence of the hemochromatosis allele. We report a patient who developed secondary hemochromatosis, apparently due only to excessive iron ingestion. PMID- 2708027 TI - Segmental portal hypertension and polycythemia vera. AB - A patient known to have polycythemia vera developed recurrent melena and was found to have bleeding gastroesophageal varices. Selective superior mesenteric angiography suggested splenic vein thrombosis. Splenectomy led to the disappearance of the varices with no subsequent recurrence of bleeding. We believe this to be the first fully described case of polycythemia vera associated with segmental portal hypertension, and propose that polycythemia vera patients may develop "silent" segmental portal hypertension and that this should be taken into consideration when treating them. PMID- 2708028 TI - Steroid-dependent nephrotic syndrome in IgA nephropathy. PMID- 2708029 TI - Correlation between C-reactive protein and throat culture results in patients with pharyngitis. PMID- 2708030 TI - Treating constipation with phosphate enema: an unnecessary risk. PMID- 2708031 TI - Interstitial pregnancy--successful treatment with methotrexate. PMID- 2708032 TI - Biochemical characterization of a component in extracts of Viscum album enhancing human NK cytotoxicity. AB - Enhancement of human NK cytotoxicity in the presence of fresh Viscum album extract and some commercial V. album extracts Iscador correlated strictly with an increased formation of lytic effector cell/K562 tumor cell conjugates in the single-cell assay. Both activities were completely destroyed by pretreatment of V. album extracts with pectinase, hemicellulase, amyloglucosidase and alpha glucosidase, but not with proteases and RNase, i.e., the activities are linked to a polysaccharide. The active component in V. album extract was non-dialysable at a molecular weight cutoff of 10,000. Inhibition of both activities was observed with D-galacturonic acid, poly-galacturonic acid and pectins. The site of galacturonic acid-specific interaction could be identified on the effector cells. The rate of effector cell/tumor cell conjugate formation in the presence of V. album extracts, as well as the abrogation of both activities by pretreatment of V. album extracts with exoglycosidases specific for sugars other than galacturonic acid indicated an action of the NK cytotoxicity-enhancing component on the basis of a bridging mechanism. However, no conclusive results could be obtained for the structural specificity of the site interacting with the target cells. PMID- 2708033 TI - Effect of hydrazine sulfate on glucose-regulating enzymes in the normal and cancerous rat. AB - Glucokinase, hexokinase, fructose 1,6-bisphosphatase and phosphoenolpyruvate carboxykinase specific activities were monitored in liver cytosol from rats that had been made cancerous with 1,2-dimethylhydrazine and then treated with hydrazine sulfate. The presence of intestinal cancer, specifically, was confirmed by laparotomy and by histological analysis. Sustained changes in hexokinase and glucokinase specific activities were first evident during the latter weeks that the carcinogen was being administered. Upon subsequent treatment with hydrazine sulfate, glucokinase activity further decreased, and liver cytosolic phosphoenolpyruvate carboxykinase activity increased. Liver cytosolic hexokinase and fructose 1,6-bisphosphatase specific activities were not appreciably affected by the hydrazine sulfate treatment. These results indicate that hydrazine sulfate may influence carbohydrate metabolism at the level of selected liver enzymes not only with respect to gluconeogenesis, but also in terms of glucose uptake. PMID- 2708034 TI - Transsphenoidal surgery for pituitary tumors. PMID- 2708035 TI - Professional liability: let's try something new. PMID- 2708036 TI - Common diagnostic tests: use and interpretation. PMID- 2708037 TI - When headaches are good. AB - Occasionally patients with headache present with the complaint of "a really good one." This paper examines three cases of patients with migraine who often referred to their headaches as "good." When the patients were asked what made the headaches good, they immediately tried to clarify their terminology as "just a figure of speech" that really meant bad. Further exploration usually revealed the headache symptoms had indeed been "good" in a relative sense, in that it had somehow served to help the patient avoid a more unpleasant emotional situation. The headache may have allowed a "time out" or a forced period of rest in a hectic schedule, resolved a conflict for the patient in an acceptable way by becoming sick, or represented a suppressed or repressed affect, usually anger. When headaches are described as good, there may very well be something in the patient's life that is worse. PMID- 2708038 TI - EMG cranial muscle levels in headache sufferers before and during headache. AB - It has long been assumed that the origin of pain in 'muscle-contraction headache' lies in the peri-cranial muscles, especially in the frontales. Pain, it is assumed, is experienced when the muscles are in spasm. It is further assumed that learned reductions in muscle tone between headache episodes will reduce the probability of future pain episodes. In this experiment, details are given of EMG measures made on the frontal, occipital, and neck muscles of separate groups of migraine and tension headache subjects. The measures were made before the onset of head pain and later when the same subjects reported pain. As part of the experiment, subjects were exposed to an experimental stressor during the pain free period, and these results were compared with those of a group of non headache subjects. Results showed that the headache groups did not differ on any of the pre-headache measures. Neck muscle levels varied markedly when compared with control subjects who had comparatively low levels reactive to an experimental stressor. When the data taken during the headache phase were analysed according to diagnosis, the occipital muscle output was found to be significantly lower in the migraine group and higher in the tension group. PMID- 2708039 TI - Treatment of a cluster headache patient in a hyperbaric chamber. AB - A patient with severe cluster headaches was treated in a hyperbaric chamber on two occasions. Her symptoms had been refractory to other treatment modalities including conventional oxygen therapy. On both occasions her pain was promptly relieved while breathing 100% oxygen at two atmospheres of pressure. This is the first known reported case of a cluster headache treated with hyperbaric oxygen. A prospective study is needed to substantiate the efficacy of this treatment modality for cluster headaches. PMID- 2708041 TI - Cardiovascular sympathetic hypofunction in muscle contraction headache and migraine. AB - There have been some recent reports proposing that muscle contraction headache (MCH) and migraine are similar and may have a common etiology. It has been hypothesized that derangement of the autonomic nervous system (ANS) plays an important role in the pathogenesis of migraine. However, reports on the ANS function in MCH have rarely been submitted. Therefore, in this report, MCH patients were investigated as well as migraine patients. The cardiovascular reflex responses by orthostatic test, isometric work test and the pulse rate (R-R interval) variation in fifteen MCH patients and fifteen migraine patients were recorded during headache-free intervals. The plasma norepinephrine (NE) levels were also measured throughout the orthostatic tests. Fifteen healthy subjects served as the age-matched control group. In the MCH group and the migraine group, blood pressure immediately after going from the supine to the erect position decreased more significantly than in the control group. The basal NE level was significantly low in both the MCH group and the migraine group, in comparison with the control group. MCH patients as well as migraine patients showed cardiovascular sympathetic hypofunction. PMID- 2708040 TI - Migraine-like visual phenomena associated with cerebral venous thrombosis. AB - Two adults presented with new-onset migrainous-type visual disturbances and had angiographically demonstrated filling defects near the torcular Herophili. Neither patient had a visual field deficit nor cerebral computed tomography evidence of an occipital infarction. The association of migraine-like visual phenomena with cerebral venous thrombosis may provide insight into the pathogenesis of migraine. PMID- 2708042 TI - Aspartame as a dietary trigger of headache. AB - Many dietary factors have been implicated as possible precipitants of headache. There have been recent differences of opinion with regard to the effect of the artificial sweetener aspartame as a precipitant of headache. To assess the importance of aspartame as a dietary factor in headache, 190 consecutive patients of the Montefiore Medical Center Headache Unit were questioned about the effect of alcohol, carbohydrates and aspartame in triggering their headaches. Of the 171 patients who fully completed the survey, 49.7 percent reported alcohol as a precipitating factor, compared to 8.2 percent reporting aspartame and 2.3 percent reporting carbohydrates. Patients with migraine were significantly more likely to report alcohol as a triggering factor and also reported aspartame as a precipitant three times more often than those having other types of headache. The conflicting results of two recent placebo-control studies of aspartame and headache are discussed. We conclude that aspartame may be an important dietary trigger of headache in some people. PMID- 2708043 TI - Psychological aspects of weekend headache sufferers in comparison with migraine patients. AB - Sometimes the relaxation after stress may trigger a migraine attack. This is the principle that underlies that particular variant of migraine called "weekend headache". We hypothesize the presence in weekend headache prone subjects of a particular psychological background, different from that of common migraine sufferers. In order to detect possible differences supporting our hypothesis, we studied 104 new outpatients: 46 patients suffering from headache only on weekends (23 males and 23 females) and 58 matched common migraineurs (26 males and 32 females) with no weekend predilection. The psychological assessment was performed using the following psychometric tools: MMPI, BDI, STAIX1-X2. A clinical assessment of each patient was also carried out. Significant differences were found after statistically analyzing the test results. Most of the MMPI scales were found to be more elevated in both male and female weekend headache sufferers. From a clinical point of view, the weekend headache attacks proved to be similar to those of common migraine, but with a significantly higher incidence of concomitant symptoms. Our study confirms the important role that psychological factors play in the pathogenesis and clinical development of migraine and leads us to conclude that a psychic tension component is associated with the vascular one in weekend headache. PMID- 2708044 TI - The treatment of migraine with variable frequency photo-stimulation. AB - Variable Frequency Photo-stimulation (VFP) goggles are a form of portable stroboscope, using red Light Emitting Diodes to alternately illuminate the right and left eyes, with the eyelids closed, at a rate of 0.5 to 50 Hz. VFP goggles were used in the treatment of 7 patients with migraine headache. Of 50 migraine headaches recorded, 49 were rated by the patient as being helped and 36 as being stopped by using the VFP goggles. Treatment reduced the median duration of headache in all patients. The interval between migraine headaches appeared to be increased in the two cases with a follow up of more than 18 months. We conclude in this preliminary study that VFP appears to be effective in the treatment of migraine. PMID- 2708045 TI - Pupillary adrenergic sensitivity and idiopathic headache in pediatric patients. AB - Electronic pupillometry before and after phenylephrine eye drops was performed in 83 headache patients divided into two groups: Group A included 59 pediatric patients aged 5 to 16 years suffering from tension headache (TH = 8), common migraine (CM = 33) and classic migraine (CLM = 18); Group B comprised 24 adult patients aged 28 to 49 years suffering from CM. Comparisons were made with a group of healthy volunteer controls, 12 children and 15 adults, not suffering from headache. In Group A, only the CLM patients had significant mydriasis after phenylephrine; pupillary responses in the TH and CM cases did not differ significantly from the healthy controls, although there was an evident tendency for increased response in the CM by comparison with the TH cases. On the other hand, in Group B (adult CM) there was a significant pupillary hyper responsiveness to adrenergic receptor stimulation, higher than in the same clinical condition in the pediatric group. In pre-pharmacological testing conditions, a significantly higher percentage of anisocoria (p less than 0.05) and a significant reduction in mean pupil size (p less than 0.01) were only evident in adult migraineurs as compared with controls. These findings suggest that a subtle chronic sympathetic deficiency affecting the iris neuromuscular junction in some clinical forms of primary headache may be detected by pupillometry at an early age. Moreover, apart from a temporal factor responsible for a progressive sympathetic imbalance during development, there may be a more evident neural transmission disorder in migraine forms as opposed to tension forms. PMID- 2708046 TI - Prophylactic treatment of cluster headache with verapamil. AB - An open study of verapamil in cluster headache is reported. Forty-eight patients participated in the study of whom 33 (= 69%) improved more than 75%. No significant differences in response were observed between episodic and chronic cluster headache. PMID- 2708047 TI - Clinical and electrophysiological responses to dietary challenge in migraineurs. AB - Thirty eight patients with a history of diet-induced migraine were studied with recording of clinical responses, electroencephalography in resting state, in response to photic stimulation, and to hyperventilation and visual evoked potentials. Tests were carried out on an initial baseline day and on a second day, after challenge with chocolate, red wine, cheese, and fasting. Lateralized headache occurred in sixteen subjects (42%), four with scintillating scotomata. Electroencephalograms were abnormal on Day 1 and/or Day 2 in twelve subjects (32%), most abnormalities being non-specific slow waves. In three cases there were paroxysmal features. Electroencephalographic response to hyperventilation was calibrated and was found to be exaggerated in eight subjects (21%) on either Day 1 or Day 2; such response was not related to the occurrence of a headache. Photic simulation showed high frequency driving response (so called "H" response) in all 16 individuals who developed headache but in only 14 out of 22 (64%) who did not (p less than 0.01). Pattern reversal visual evoked responses were normal and failed to show any difference in latency or amplitude between headache responders and non-responders. PMID- 2708048 TI - The pericarotid region and cluster headache. PMID- 2708049 TI - The dark side of medication abuse. PMID- 2708050 TI - Proceedings of the First Symposium on the Biological Effects, Hazards and Protection from Non-ionizing Radiation in Outdoor Applications. 12-16 August 1987, Stockholm, Sweden. PMID- 2708051 TI - Near infrared laser ocular bioeffects. AB - Thresholds for laser chorioretinal injury in the red end of the visible spectrum and the near-infrared (IR-A) spectral regions are presented. An unpredicted wavelength dependence of the injury threshold for single Q-switched pulses is demonstrated. Four lasers were used to determine thresholds at 40 wavelengths between 532 nm and 1064 nm: a ruby laser, a neodymium:YAG-pumped dye laser, an erbium:YLF laser and an alexandrite laser. Despite many careful and repeated efforts to determine a cause for the variation due to possible variations in the lasers or other aspects of the experimental technique and due to biological absorption properties of the eye, there is no complete or obvious explanation for the significant variations of threshold with small changes in wavelength. The implications of these findings for laser safety standards are presented. PMID- 2708052 TI - Retinal damage thresholds from single-pulse laser exposures in the visible spectrum. AB - The risks of using lasers, particularly ocular hazards, have called for the definition of exposure limits. Our investigations involved the retinal effects of the laser beam in the visible spectrum and were directed toward verifying the limit values by defining the thresholds of retinal damage in experiments carried out on the rabbit and the monkey. The wavelengths emitted by the experimental set ups were 593 and 532 nm, the pulse durations were 600 and 40 ns, and the retinal image diameter varied from approximately 30 to 570 microns. A direct ophthalmoscopic observation and a method using fluorescein angiography were employed to detect a pathologic change in the retina. The energy correlates of retinal lesions were statistically analyzed by a method of probit analysis. The results showed that determining funduscopic thresholds is chiefly a function of the investigation technique used and the delay in observation after the exposure. Our results obtained with fluorescein angiography extrapolated to the human eye support the exposure limit established for intrabeam viewing, but not for an extended source laser which corresponds to a probability of damage increasing with the retinal image diameter. The exposure limit related to the experimental retinal spot size of 285 and 570 microns corresponds to damage probabilities of 7% and 32%, respectively. PMID- 2708053 TI - Clinical, pathological and photochemical studies of laser injury of the retina. AB - Nineteen cases of acute accidental laser injury of the human retina and two groups of laser workers with chronic retinal damage were reviewed. Most acute cases had macular injury and vision impairment; the chronic cases usually suffered from nonspecific eye complaints. Pathological and photochemical studies of laser injury to rabbit retina were also made following exposure to a 0.49-W Ar laser. The retinal pigment epithelial cells and photoreceptors were mildly damaged in the laser spot center, but the Bruch's membrane was still intact. Malondialdehyde (MDA), the main degradation product of lipid peroxidation of the retina, was assessed with fluorescence spectrophotometry. The level of MDA in the injured retina was significantly higher than that in control eyes, suggesting that thermal levels of Ar laser exposure can yield evidence of photochemical light damage mechanisms. PMID- 2708054 TI - Experimental studies of the injurious effects of Q-switched Nd:YAG lasers and their outdoor applications. AB - Comparison of the dose-response relationship of retinal damage induced by Q switched (Q-sw) Nd:YAG lasers was conducted for rabbits and monkeys. Experimental results indicated that the two probit regression lines were parallel to each other, and the damage threshold (ED50) ratio was approximately 1:3.57. Observations of the injurious effects of Q-sw Nd:YAG rangefinders--the total energy level being about 10-100 mJ--and their injurious distances are reported in this paper. A brief description is given of coagulative and hemorrhagic pathological changes under different exposure conditions and at various distances. PMID- 2708055 TI - Preliminary notes on vulnerability of the retina to injury from peripheral laser exposure conditions. AB - If laser exposures to the periphery of the retina from low-energy lasers cause a hemorrhage obscuring the optical pathway to the fovea, resulting in loss of visual function, the risks for soldiers on the battlefield may be greater than previously expected. Two off-axis experiments were undertaken to obtain an indication of the hazards involved in exposing the peripheral retina to visible laser irradiation. Both off-axis exposures caused immediate vitreal hemorrhages in the periphery. After 80 min, the hemorrhage in the first eye had diminished, and in the other it was significantly smaller than immediately after exposure; even the central hemorrhage was smaller. Another observation after 120 min revealed the same result. These results indicate that an obvious risk exists on the battlefield for peripheral hemorrhages due to lasers operating within the retinal hazard spectrum. However, it is necessary to make more observations to establish the findings firmly. PMID- 2708056 TI - Glare in aviation. AB - The control of high-speed aircraft is a demanding task in which rapid decisions, based on visually acquired information, must frequently be made. Glare, both direct and veiling, is a prime cause of visual degradation in flight. The visual effects of glare are discussed together with means of reducing its consequences. In addition, the visual sequelae of looking at a nuclear fireball are discussed together with means of providing protection. PMID- 2708057 TI - Damage thresholds of skin irradiated by ultraviolet lasers. AB - The effects of pulsed radiation on animal models were studied. Erythemic responses to laser radiation were observed macroscopically and were examined histologically by both light and electron microscopy. Based on statistical analysis of the biological data presented in this study, skin damage thresholds were calculated for short pulses with lasers at wavelengths of 265 nm and 308 nm. PMID- 2708058 TI - Clinical observations of six cases of laser injury to the eye. AB - During the last decade, five patients with laser injuries were examined at the University of Munich Eye Clinic, in addition to one laser-injury patient at the University of Erlangen Eye Clinic. From a review of these cases, it is possible to gain an insight into factors that led to the eye injuries and to predict the clinical sequelae of laser retinal injury. A possible means of treatment, using an ophthalmic Q-switched Nd:YAG laser, is suggested for some types of retinal injury involving vitreal hemorrhage. PMID- 2708059 TI - Ocular injuries from accidental laser exposure. AB - This report presents 29 cases of ocular injury (31 eyes) caused by accidental laser exposure. Twenty-eight eyes were injured during laser adjustment and alignment. Nineteen eyes were damaged by Q-switched lasers at a wavelength of 1064 nm. Macula damage occurred in 25 eyes. During the early phase after injury, there were different degrees of retinal coagulation, edema or hemorrhage in exposed spots and there occurred immediate reduction of visual acuity. Effusion of blood and exudate was absorbed in most injured eyes under treatment lasting several weeks; meanwhile, gray-white scars appeared. Macular holes appeared in seven cases a week after injury, thus extending the course of the injury. Nine cases (10 eyes) were followed-up for 4-10 y, during which time the condition of eight cases (nine eyes) remained stable. The causes of the laser accidents and the relationship between the damage effects and exposure doses were analyzed. PMID- 2708060 TI - Radiometry and laser safety standards. AB - The application of occupational limits (ELs) in the outdoor laser environment requires an understanding of the radiometric methods required to evaluate field exposures with respect to the ELs. The limiting aperture required to adequately specify the EL must always be kept in mind. Since all exposure limits are defined as a function of time, electro-optical detectors and instrumentation must have an adequate temporal response and have an absence of saturation effects. As a field expedient method thermally sensitive paper can also be employed to estimate the output radiant exposure of pulsed lasers. For evaluating potential ocular hazards in the retinal hazard spectral region (400 to 1400 nm), one should employ a 7-mm aperture. For evaluating potential hazards to the skin and the cornea, a 1-mm limiting aperture is justified. Although the impact of the 1-mm limiting aperture is to reduce the limiting power which is considered safe--the accessible emission limit for Class 1 laser products, it nevertheless is justified for field exposure of the eye, as has been shown in recent experimental studies of corneal injury. PMID- 2708061 TI - A laser radiation occupational health standard for the People's Republic of China. PMID- 2708062 TI - Evaluation of ocular protection filters in field situations. AB - A computer program has been developed to simulate eye movement during pursuit tracking to test the effectiveness of filters protecting the eyesight of individuals exposed to laser radiation. Two types of retinal damage are considered: macular lesions and retinal injury causing vitreous or subretinal hemorrhage. The retinal damage caused by optical radiation in the visible and near infrared of the spectrum differs from almost all other types of hazards in their proabilistic nature. That is, a small movement of the laser beam or change of eye position decreases or increases the probability of injury by several orders of magnitude. A laser beam combines the problem of a small source with extreme directionality with the probabilistic nature of this hazard location in space, and we now add the probabilistic nature of the action of the protective filter, i.e., a dependence upon angle of incidence. From this combination, an even more probabilistic picture of injury or disablement emerges. When it is necessary to plan the probabilities during military operations of mission fulfillment or injury with regard to various types of lasers in the battlefield ++environment, the problem must be analyzed very carefully. Our solution of the problem indicates the type of injuries to be expected and their dependence upon the various parameters of the angle of incidence of the lasers on the protective filters in the viewing system. PMID- 2708063 TI - Measurements of laser eye protective filters. PMID- 2708064 TI - Vulnerability of the retina to injury from a military ruby rangefinder at battlefield distances. AB - This study investigates the possibility of causing a vitreal hemorrhage with a standard ruby rangefinder at battlefield engagement distances when the laser is observed with the naked eye or through magnifying optics or filters. The experiments were undertaken on the eyes of anesthetized pigs. The pigs were anesthetized with Mebumal and given 0.5% thropicamid in the eyes. They were then exposed to the radiation from a standard military ruby rangefinder (pulsewidth 25 ns, pulse energy 180 mJ). The rangefinder was aligned with a He-Ne laser and a beamsplitter. Eight experiments were performed, each with several exposures. The range was varied from 0.5-850 m. Some of the experiments were made using the naked eye, some with a filter, some with binoculars (7 x 50) and some with a combination of filter and binoculars. The pulse energy was varied from 91-6500 muJ. Vitreal hemorrhages were caused at distances of 410 and 850 m when a pair of binoculars (7 x 50) was placed in front of the eyes. The intraocular energy varied between 1500 and 4400 microJ. Results indicate that there is a possibility of causing a vitreal hemorrhage in a soldier who is using standard field binoculars and looking in the direction of an ordinary military rangefinder at distances at least up to 850 m. PMID- 2708065 TI - New philosophies in control of laser hazards in the outdoors. AB - In 1969, the first laser safety guidance was published by the U.S. Army. Since that time, the approach to the analysis of potential laser hazards has changed in some ways, such as in the determination of appropriate exposure limits, in the use of optical viewing aids, and in regard to atmospheric attenuation. Approaches have not changed in regard to other factors, such as atmospheric scintillation and the use of probability. The author discusses the philosophy behind the changes and also discusses "eye-safe" lasers. PMID- 2708066 TI - Laser reflections from relatively flat specular surfaces. AB - A major element in laser range control procedures has been the control of stray reflections from glass reflectors which may be near the laser target. These hazardous reflections have been thought to extend as far as the direct beam for near grazing angles of incidence. Modern military laser rangefinders and designators can be hazardous to the unaided eye to distances of 10 km or even greater. For this reason, many square kilometers of laser range area have been necessary to conduct laser tests when flat specular reflectors may be present on targets. Fortunately, sophisticated pointing systems have been developed with these laser systems to ensure that the direct beam is confined to the immediate target area. In most cases, flat specular reflectors also have been eliminated from the immediate target area. In some instances, however, specular reflectors still exist near or on laser targets. For these special cases, a more definitive mathematical treatment of hazardous laser reflections is desired. The divergence of a laser beam which has been reflected from a flat specular surface is dependent on the size of the reflector, the divergence of the laser creating the reflection, and the curvature of the reflecting surface. It can be shown mathematically that the curvature of even an optical flat, a reference surface used to compare the flatness of other surfaces, will produce a significant additional beam spread, thereby reducing the hazards of reflected beams. The natural curvature of plate glass or window glass is much greater, reducing the hazards even further. The extent of the hazards for reflections of various types of lasers and reflecting surfaces is discussed. PMID- 2708067 TI - Microwave effects on the central nervous system--a study of radar mechanics. AB - Seventeen radar mechanics and engineers and 12 unexposed referents were examined, using extensive neurological, psychometric and neuropsychiatric techniques to determine whether there were any indications of central nervous system effects of microwave exposure. Pathological neurological findings were not more common in the exposed group than among the referents. In addition, the psychometric tests and the psychiatric rating scales did not reveal any statistically significant adverse effects of microwave exposure. The frequency of the occurrence of an increased protein band with an isoelectric point of 4.5 in the cerebrospinal fluid was higher among the men exposed to microwaves than among the referents. The nature and clinical significance of this or these proteins are still unclear. The time derivative of the magnetic flux density close to some of the transmitter units was surprisingly high (up to 350 T s-1). PMID- 2708068 TI - Coping with a coeliac diet after adolescence. AB - 42 out of 45 adults aged 18-26 years (93%) diagnosed in childhood as having coeliac disease (CD) returned a questionnaire reviewing how they coped with the diet. 27 (64%) still continued to take a strict gluten elimination diet, five had failed completely and ten partly keep it up. Those adhering to the diet more often demonstrated a good knowledge of both CD and the diet. Neither age at the time of diagnosis nor social class, education of the patients or present social status was observed to have any positive correlation with compliance with the diet. The results indicate a need for more practical education of patients in terms of short refreshment courses. PMID- 2708069 TI - Hypercalciuria in children with diabetes mellitus. AB - Seventeen of 75 diabetic children without nephropathy had urinary calcium excretion of more than 4 mg/kg/day. Neither diurnal variation in calciuria, nor correlations between calcium excretion and glucose excretion as well as HbA1 levels were observed. The findings suggest that about one quarter of diabetic children is at risk for hypercalciuria and may be for renal damage due to hyperexcretion of calcium. PMID- 2708070 TI - Behaviour and confidence of parents instructed in home management of febrile seizures by rectal diazepam. AB - The study was performed on a group of 91 children with their first febrile convulsion whose parents were then instructed in the use of rectal diazepam in the event of a further seizure. later, the families were periodically recalled for interviews. The aim was to study the acceptance and cooperation of the families, the psychological attitude and the relation between the findings and parents' educational level. At the end of the follow-up, 80% of the 91 families showed good cooperation and psychological benefits. There was no relationship between the findings at the end of the follow-up and families' educational level. Even in the presence of a favorable psychological attitude, recurrences of febrile convulsions were still a frightening experience for many parents. PMID- 2708071 TI - Ganglioneuroma in retropharyngeal location. Case report of a sixteen-month-old boy. AB - Case report of an unusual location of a ganglioneuroma in the retropharyngeal region. The tumor was successfully removed. PMID- 2708072 TI - Vitamin B6 resistant primary hyperoxaluria type I. Report of 5 cases. AB - Primary hyperoxaluria type I (PH I) is characterized by an excessive endogenous production and excretion of oxalic and glycolic acid. Prognosis of this "inborn error of metabolism" is not favorable due to calcium-oxalate depositions in kidney and other organs. Vitamin B6 administration and/or renal transplantation can greatly improve the prognosis, as reported in literature. In this article our experience with 5 patients with vitamin B6 resistant hyperoxaluria is reported. Symptomatology and progression of the primary disease are described. The results of treatment interfering with oxalate production and calcium-oxalate crystallization are given. Three patients underwent renal replacement therapy. In these, oxalosis developed during hemodialysis and progressed following transplantation; a disabling bone disease was the most severe complication. Outcome of transplantation was disappointing. In two out of three patients, there was recurrence of the primary disease in the graft. In only one of them long-term graft function was satisfying. However, even this good function could not prevent disabling symptoms of oxalosis. Therefore, evaluation of the results of transplantation should not only include data related to graft function and survival, but also the complications due to calcium-oxalate depositions in various organs. To prevent oxalosis, kidney transplantation should be performed before end stage renal disease is achieved in patients with vitamin B6 resistant PH I. PMID- 2708073 TI - Growth in a case of Russell-Silver syndrome treated for hypopituitarism. AB - The growth characteristics of Russell-Silver syndrome (RSS) include dwarfism of prenatal onset, moderate retardation of bone age and normal postnatal height velocity. We describe a case of hypopituitarism in a girl with typical RSS who suffered from a severe trauma at birth. Signs of hypopituitarism appeared during childhood. Before substitutive treatment, a short course of human growth hormone (hGH) induced a moderate rise in plasma IGF-I levels which was within the range observed in other pituitary dwarfs. Under replacement therapy, catch-up growth was similar to what is observed in other growth hormone deficient children. However, bone age matured much faster than chronological age. This observation appears to be a particular feature of RSS, possibly enhanced by hGH therapy. An improvement of adult height beyond the final height usually observed in RSS children without endocrine disturbances should therefore not be expected from hGH therapy. Growth hormone deficiency and RSS do not appear to be causally related. However, in each child with RSS, a particular attention should be given to a decreased height velocity, a severely delayed bone age as well as a history of major perinatal problems. Should one of these factors be found, a careful evaluation of the hypothalamo-pituitary axis ought to be performed with, accordingly, an appropriate substitutive therapy. PMID- 2708074 TI - [Menkes disease. Report of a case with pronounced involvement of connective tissues and changes in epidermal desmosomes]. AB - The authors describe a patient who presented from birth on a severe involvement of connective tissues with pathological fractures, lack of auricular cartilage, hyperlaxity of fingers and cutis laxa with deep folds, all suggestive of derangements of collagen and elastin. Hypothermia at 24 hours of age should have already indicated the possibility of Menkes' syndrome. From the 3rd month on, the patient presents a neurological deterioration and a myoclonic epilepsy which is resistant to treatment. Craniocerebral tomodensitometry revealed, with time, a cerebral atrophy and subdural hematomas. Angiodysplasia of a coronary artery was seen at cardiac echocardiography. Undetectable levels of serum copper and ceruloplasmin, and an increased uptake of copper by fibroblasts in vitro confirmed the diagnosis of Menkes' syndrome. Electron microscopy of a skin biopsy disclosed a desmosomal anomaly in the epidermis. Desmosomes stay apart suggesting an alteration of the interdesmosomal cement. PMID- 2708075 TI - Lactulose in trimethylaminuria, the fish-odour syndrome. AB - We have measured the urinary excretion of trimethylamine in two sisters with trimethylaminuria (the fish-odour syndrome). On a restricted diet the patients still excreted increased quantities of trimethylamine, and this did not alter following a fourteen-day course of lactulose. Dietary provocation produced a rise in urinary trimethylamine which was abolished by fourteen days' pretreatment with lactulose. The case histories illustrate the tendency for delay in reaching this diagnosis and the psychological damage caused by the condition. PMID- 2708076 TI - Monitoring of mutagenicity in cutting fluids during their recycled use. PMID- 2708077 TI - Vanadium intoxication inhibits sulfhydryl groups and glutathione in the rat brain. PMID- 2708078 TI - Pros and cons of dust-induced bronchitis as an occupational disease. PMID- 2708079 TI - Determination of urinary 2-thiothiazolidine-4-carboxylic acid by automated high performance liquid chromatography, as an index of carbon disulfide exposure. PMID- 2708080 TI - A study of magnetic field in the lung of workers in an asbestos factory. AB - Magnetic field at the chest in 93 male workers exposed to asbestos dust in an asbestos products factory in China was studied by local magnetization and flux gate gradiometry. The average field intensity at 12 measurement points over the anterior chest wall was compared among workers with and without asbestosis and among workers of different working age. The field intensity in workers with asbestosis and those suspected to have asbestosis on the basis of X-ray findings was significantly higher than that in workers without asbestosis. It was also found that the field intensity increased with working age. It is suggested that dynamic measurement of magnetic field in the lung of workers exposed to dust containing ferrimagnetic particles would at least serve as a quantitative method for estimating lung dust loads and be valuable for pneumoconiosis prevention. PMID- 2708081 TI - [Early rehabilitation of laryngectomized patients with the electrolarynx?]. AB - Seventy-three patients were asked to fill in a questionnaire to determine whether a laryngectomee can be rehabilitated better with the oesophageal voice or with the vibrator voice. This evaluation showed no significant difference between these two methods of voice rehabilitation. Patients rehabilitated with the vibrator learn oesophageal voice in addition without undue difficulties. Therefore, we recommend voice rehabilitation of the laryngectomee by both the above methods. PMID- 2708082 TI - [Objective determination of auditory threshold in the child]. AB - In children who are difficult to test with dubious behavioural-audiometric results, brainstem electric response audiometry (BERA) is today the method of choice for accurate determination of hearing threshold. Oral sedation with the shortacting neuroleptic chloroprothixene allows BERA to be performed on an outpatient basis. Thirty-six girls and 41 boys aged between 11 weeks and 12 years (median age 40 months) with inconsistent behavioural-audiometric findings were examined. Frequency-following responses were searched for in flat fast response curves. BERA proved to be a very sensitive method compared with behavioural audiometry and was reliable even for children who are difficult to evaluate clinically, and for asymmetrical auditory thresholds. In conjunction with the standard pedaudiological test battery, BERA improves diagnostic accuracy and causes little disturbance as an outpatient procedure. PMID- 2708083 TI - [Personal experiences with audiometric detection of perilymph fistulas]. AB - Rupture of the round window membrane is thought to be important in the pathogenesis of sudden hearing loss. In 1982 Fraser and Flood proposed an audiometric test to improve the indication for tympanoscopy which, in their experience, verified the diagnosis of perilymph fistulae in a high percentage of cases. Between 1 January 1986 and 30 June 1988 the above test was carried out on 74 patients at the ENT Department of the University of Hamburg. In 41 cases a tympanoscopy was performed. In 13 cases with a positive test result not a single perilymphatic fistula could be found intra-operatively, while in 3 cases of rupture the test was negative. In our experience this test is not helpful for the pre-operative assessment of tympanotomy in sudden hearing loss. PMID- 2708084 TI - [The concept of comprehensively oriented rehabilitation of laryngectomized patients]. AB - A comprehensive rehabilitation program for laryngectomized patients is presented, consisting of close cooperation between the ENT clinic, phoniatric department and post-operative reconvalescent institution. Four main points are emphasized: (1) rehabilitation with both the oesophageal voice and the vibrator voice; (2) involvement of the patient's partner in the whole rehabilitation program, including participation in the 4-week stay in a post-operative reconvalescent institution; (3) information for the employer about the special needs of a laryngectomee; (4) contact with the regional branch of the laryngectomees' association. PMID- 2708085 TI - [The comprehensively oriented complex rehabilitation of laryngectomized patients]. AB - We report 14 patients who took part in a specially designed comprehensive rehabilitation programme for the laryngectomee. Our results clearly indicate that it is only possible to carry out such a project successfully if there is intensive communication between all participants in the programme, including the patient and his/her partner. PMID- 2708086 TI - HLA genotypes and variant alleles in Sudanese families of Arab-Negroid tribal origin. AB - The indigenous population of the Blue Nile Province, Sudan, is an Arab-Negroid admixture, although some isolates of west African origin (Fallata) have begun to intermix with the indigenous population. Consanguineous marriages are common in these Muslim families. Members of 22 nuclear families were typed for HLA class I and II antigens using complement-dependent microcytotoxicity with Ninth International Workshop (9th WS) and local reagents. Considerable polymorphism was observed at each locus with a majority of the World Health Organization (WHO) recognized alleles represented in the parental sample, albeit at low frequency. Seven parental haplotypes carried A locus alleles which were not identical to WHO recognized specificities. All appeared to be Aw19-related specificities. Five B locus serologic variants were observed; all appeared distinct from WHO-recognized specificities. In one family we observed a new DR-DQ association; DR4 segregated with DQw2, rather than with DQw3. As has been observed for several other genetic systems in these tribes, considerable polymorphism was found for all class I and class II gene products in spite of a high level of consanguinity. Tribal admixture and/or a selective advantage in protecting the population against disease may account for this unexpectedly high level of heterozygosity. PMID- 2708087 TI - The major histocompatibility complex, MnLA, of pigtailed macaques: definition of fifteen specificities. AB - The major histocompatibility complex (MHC) of pigtailed macaques (Macaca nemestrina, Mn) is defined and designated as MnLA. Twenty-nine alloantisera were generated by fullsib alloimmunization and tested against a panel of 220 unrelated animals. The reactivities of different alloantisera were analyzed statistically in pairwise comparisons. Using 2 X 2 contingency tables, we calculated chi 2 independence, chi 2 allelism, and correlation coefficient values. Initially, specificities were defined by significant associations of certain sera, but some sera defined specificities individually. In all, 15 specificities were defined, and by family studies and negative correlation coefficients, a two-locus model was evident. Genetic analyses, together with statistical applications, revealed that the behavior of these specificities is consistent with the nature of MHC in other primate species, including man. PMID- 2708089 TI - UNECOM's humanities program: an education in caring. PMID- 2708088 TI - AIDS in children. PMID- 2708090 TI - Interferon alpha approved for Kaposi's sarcoma. PMID- 2708091 TI - Recombinant DNA HIV-1 latex agglutination test. PMID- 2708092 TI - Tumors of the pharyngomaxillary space. AB - A bulging of the soft palate should alert one to the possibility of a mass in the pharyngomaxillary space. Work-up includes CT scan or MRI and possible needle aspiration. Open biopsy should be avoided. Benign, mixed tumors are most commonly encountered. Surgical excision by external approach is generally advocated. PMID- 2708093 TI - Metastasis of prostate gland adenocarcinoma to penile and scrotal cutaneous tissues. AB - The metastatic sites of adenocarcinoma of the prostate are well documented. Bone metastasis is the most frequently encountered site. Skin metastasis is rarely reported. Its presence, however, is associated with a poor prognosis. The possible cause of cutaneous spread is discussed in the case report. The possible role that external-beam radiotherapy may play in this setting is also analyzed. PMID- 2708094 TI - Bowel obstruction secondary to mesenteric cyst formation. AB - A rare cause of intra-abdominal obstruction, mesenteric cysts derive from lymphatic tissue. The differential diagnosis should include mesenteric cyst when the patient presents with a history of multiple episodes of partial small-bowel obstruction or with an asymptomatic abdominal mass. A year-old girl was brought to the Family Practice Center with episodic, sharp, nonradiating, left-sided, mid upper-abdominal pain. Examination indicated a possible diagnosis of mesenteric adenitis. Due to variation in the signs and symptoms of the condition, it appears that the use of ultrasonography is the most effective, nonoperative method of evaluation. Ultrasonography appears to be the most effective, nonoperative method of evaluation. Surgery is the only definitive diagnostic and therapeutic modality. PMID- 2708095 TI - Sweet's syndrome associated with chronic myelogenous leukemia. AB - Sweet's syndrome is an acute febrile neutrophilic dermatosis. A wide variety of systemic signs and symptoms have been associated with it, but pulmonary involvement has been noted in only one previous report. Additionally, although Sweet's syndrome has been frequently associated with various malignancies, there is only one previous case reported with attendant chronic myelogenous leukemia. PMID- 2708096 TI - Teen suicide: when the troubled die young. PMID- 2708097 TI - Confusion over toxicity of poinsettia. PMID- 2708098 TI - Animal technicians--the glue that holds a practice together. PMID- 2708100 TI - Liposuction for cats? PMID- 2708099 TI - Nasal bone fractures in greyhounds. PMID- 2708101 TI - Regards commentary on animal rights as insensitive. PMID- 2708102 TI - Veterinarians should be aware of ecologic and environmental problems. PMID- 2708103 TI - Bovine somatotropins: benefits and risks. PMID- 2708104 TI - Veterinary medical education today. PMID- 2708105 TI - Narcissistic clients. PMID- 2708106 TI - Contribution of propylene glycol-induced Heinz body formation to anemia in cats. AB - Propylene glycol (PG) is a common preservative and source of synthetic carbohydrates in soft-moist pet foods. Propylene glycol was fed to cats for 5 weeks at concentrations found in commercial diets (1.6 g/kg of body weight; 12% of diet on a dry-weight basis) and for 3 weeks at concentrations exceeding usual intake (8 g/kg; 41% of diet). There was a dose-dependent increase in Heinz body percentage to 28% in cats fed the low dose of PG and to 92% in cats fed the high dose. Erythrocyte half-life, measured using [14C]-cyanate hemoglobin (Hb), decreased significantly (P less than 0.05) by 18.8% and 60% in cats fed the low and high PG doses, respectively. The PCV in cats fed the low dose was unaffected, whereas cats fed the high dose had a mean (+/- SEM) decrease in PCV from 33.5 +/- 1.05% to 26.3 +/- 1.45%, accompanied by punctate reticulocytosis and bone marrow erythroid hyperplasia. A dose-dependent increase in iron pigment was found in the liver and spleen of all cats. In cats fed the low dose of PG, erythrocyte reduced glutathione concentration actually increased from 7.02 +/- 0.56 to 9.74 +/- 0.69 mumol/g of Hb, but decreased to 2.96 +/- 0.27 mumol/g of Hb in cats fed the high dose. There was no significant increase in methemoglobin concentration. These results indicated that PG cannot be considered innocuous even at concentrations consumed by cats eating commercial diets. Heinz body-induced acceleration of RBC destruction develops in a dose-dependent manner, so that cats with greater food intake, ie, lactating queens and nursing kittens, are at greater risk for development of PG-induced Heinz body hemolytic anemia. PMID- 2708107 TI - Preservation of striated-muscle urethral sphincter function with use of a surgical technique for perineal urethrostomy in cats. AB - It has been reported that perineal urethrostomy resulted in impairment of striated-muscle urethral sphincter function in male cats, as measured by urethral pressure profilometry and electromyography (EMG). Our study was undertaken to describe and evaluate a surgical technique for perineal urethrostomy that reduces trauma to the urethral branches of the pudendal nerve. Perineal urethrostomy was performed on 10 healthy neutered cats after demonstrating that they had normal urethral sphincter function by urethral pressure profilometry (maximal urethral closure pressure [MUCP] = 151 +/- 52 cm of water) and EMG activity at the level of the striated-muscle sphincter before surgery. All cats had normal urethral sphincter function 1 week (MUCP = 194 +/- 19 cm of water, EMG activity present) and 3 weeks (MUCP greater than 200 cm of water, EMG activity present) after surgery. These results indicated that preservation of the urethral branches of the pudendal nerve during urethrostomy preserved striated-muscle urethral sphincter function. PMID- 2708108 TI - Microlithiasis associated with chronic bronchopneumonia in a cat. AB - Chronic bronchopneumonia associated with microlithiasis was diagnosed in a 9-year old domestic shorthair cat with a 3-month history of coughing and dyspnea. Thoracic radiography revealed multifocal patchy alveolar infiltrates in all lung fields. Numerous acellular, concentrically laminated, periodic acid-Schiff positive microliths were seen in mucus from tracheal washing. Microliths were composed primarily of calcium carbonate. A definite cause could not be identified. There was no response to treatment and the cat was euthanatized. Marked type-II alveolar cell proliferation, peribronchiolar smooth muscle proliferation, and alveolar microlithiasis were seen histologically. Microliths are rarely encountered in tracheal washings from companion animals. Their pathophysiologic properties and meaning remain to be established. PMID- 2708109 TI - Fragments of nasogastric tubes as esophageal foreign bodies in two horses. AB - Two horses were referred with fragments of nasogastric tubes as esophageal foreign bodies. Radiography and endoscopy were used to identify the location of the fragments. Portions of the tubes were retrieved by esophagotomy in 1 horse and by manual examination of the oral cavity in the other. Both tubes were friable in focal areas, but were quite pliable over most of the length of the tube. PMID- 2708110 TI - Synovial hernia as a possible complication of arthroscopic surgery in a horse. AB - A 3-year-old Standardbred gelding was referred for evaluation of a fluctuant swelling that developed over the dorsum of the carpus subsequent to arthroscopic surgery on that carpus. A synovial hernia was diagnosed and surgically repaired. Although complications secondary to arthroscopy are rare, synovial herniation can develop after arthroscopic surgery. The condition must be differentiated from the more common true bursitis or false bursitis that is commonly referred to as a hygroma. PMID- 2708111 TI - X-ray computed tomography-aided diagnosis of nasal adenocarcinoma, with extension to the skull and central nervous system, in a dog. AB - A dog with tonoclonic seizures, disorientation, and tetraparesis was evaluated by use of skull radiography. An advanced, highly aggressive process was centered within the caudal portion of the right nasal cavity. X-ray computed tomography further defined the mass to be occupying the caudal portion of the nasal cavity and frontal sinuses, with concurrent involvement of the adjacent turbinates and frontal, maxillary, and palatine bones. Despite the aggressive nature of the process, no alteration to the external contour of the cranium or nose was observed. Histologic examination revealed well-differentiated adenocarcinoma. PMID- 2708112 TI - Generalized skeletal involvement of a hematopoietic tumor in a dog. AB - Generalized polyostotic osteolytic lesions were caused by stage-5 multicentric lymphosarcoma in a dog. Findings were unique, because tumors of bone marrow do not usually result in diffuse bony changes detectable radiographically. PMID- 2708113 TI - Parosteal osteosarcoma of the mandible in a dog. AB - A mandibular parosteal osteosarcoma was diagnosed in a 7-year-old Collie with prolapse of the third eyelid. Diagnosis was made by histologic evaluation of a mass removed by surgical excision. The dog was euthanatized because of local recurrence of the tumor, with metastasis to the lungs. Parosteal osteosarcomas are rarely reported in dogs and usually involve long bones in human beings. PMID- 2708114 TI - Redefined type of elbow dysplasia involving calcified flexor tendons attached to the medial humeral epicondyle in three dogs. AB - Three dogs were found to have calcified flexor tendons attached to the medial humeral epicondyle. There were 2 types of calcification: one was associated with elbow dysplasia, and a second resulted from traumatic separation of a portion of the medial humeral epicondyle. PMID- 2708115 TI - Congenital central diabetes insipidus in two sibling Afghan hound pups. AB - Congenital central diabetes insipidus was determined to be the cause of polydipsia and polyuria in sibling pups. Both pups were lacking adequate plasma arginine vasopressin concentration, compared with that in control dogs. Microscopic abnormalities were confined to the brain and pituitary gland in one pup. Without breeding trials of these dogs or their relatives, it cannot be determined whether the cause was familial. PMID- 2708116 TI - Relation of endogenous Heinz bodies to disease and anemia in cats: 120 cases (1978-1987). AB - Disease diagnosis, age, sex, and selected hematologic variables were evaluated retrospectively in a population of feline patients with high number of circulating Heinz bodies. By comparing these cats with a control population and results of additional hematologic investigation on a subsample of the cats, we tested the hypotheses that endogenous Heinz body formation is increased in specific disease states and that endogenous Heinz bodies may contribute to anemia. There was strong correlation between diabetes mellitus, hyperthyroidism, and lymphoma and Heinz body formation. Diabetic cats, in particular, consistently had marked Heinz body formation. These diseases together accounted for nearly 40% of cats with Heinz body formation, but for less than 12% of cats of the control group. The PCV of cats with Heinz bodies (29.77 +/- 9.32%) was significantly (P less than 0.001) lower than that of control cats (35.33 +/- 8.08%). Polychromasia and punctate reticulocyte number were slightly increased in cats with Heinz body formation and correlated significantly (P less than 0.001) with PCV. A subsample of 13 of the cats had significant (P less than 0.006) inverse correlation between Heinz body percentage and erythrocyte reduced glutathione (GSH) concentration. Mean GSH concentration was significantly lower in cats with Heinz bodies, compared with that in a random cat population (5.28 +/- 1.67 mumol/g of hemoglobin vs 7.06 +/- 2.10 mumol/g of hemoglobin), in which GSH values followed normal distribution. Cats with Heinz body formation were older, and were more likely to be spayed. PMID- 2708118 TI - 1987 US veterinary practice income, expenses, and financial ratios. PMID- 2708117 TI - Horner's syndrome in dogs and cats: 49 cases (1980-1986). AB - Medical records of 49 dogs and cats with Horner's syndrome were reviewed. Causes included head, neck, and chest trauma, chronic otitis, cranial thoracic mass, and injury attributable to cleaning of the external ear canal. Cause could not be delineated in 54.5% of the dogs. Numerous diagnostic tests and pharmacologic challenge exposure with epinephrine were used to localize the site of injury. Resolution of all clinical signs was observed in 36 animals and required a mean of 7.7 weeks. PMID- 2708119 TI - What is your diagnosis? Absence of the radius. PMID- 2708120 TI - The pattern of LH release in the adult ram influences the testicular steroidogenic response to individual LH pulses and is regulated by testosterone negative feedback. AB - Two experiments were conducted with adult intact rams (approximately 58 kg in body weight) in the nonbreeding season to investigate interrelationships between LH and testosterone secretion. In Experiment 1, LH pulse frequency was increased from approximately two to six peaks per 8 hours (for 56 hours) by injecting (iv) 10 micrograms NIH-LH-S18 every 80 minutes. Induction of a breeding season peak frequency produced a progressive 3-fold increase (P less than 0.01) in mean serum testosterone levels to values during the last 8 hours of treatment (12.6 +/- 1.2 ng/ml) that were 50% of those in the fall. In response to LH pulsing, testosterone peak amplitude increased (P less than 0.05) from 3.5 +/- 0.8 ng/ml to 6.7 +/- 0.7 ng/ml. In Experiment 2, the mean testosterone level was increased to breeding season values (for 96 hours) by injecting (im) 5 mg testosterone every 4 hours. Mean LH levels and LH peak frequency were decreased (approximately 70%, P less than 0.01) following 36 hours of treatment, and the LH response to exogenous GnRH was decreased (approximately 45%, P less than 0.01) by the final 4 hours Results indicate that for rams in the nonbreeding season, the testicular steroidogenic response to individual LH pulses is enhanced when pulse frequency is increased. When blood testosterone is elevated to breeding season levels, LH pulse frequency is severely impaired, while pituitary responsiveness to GnRH is diminished, as in the fall. PMID- 2708121 TI - Effects of cocaine hydrochloride on reproductive function and sexual behavior of male rats and on the behavior of their offspring. AB - Cocaine hydrochloride (30, 15, or 0 mg/kg) was administered daily subcutaneously to male rats for a minimum of 72 days. Animals receiving the 15-mg/kg and 0-mg/kg doses were pair-fed with animals receiving the higher dose. A fourth group served as a nontreated ad libitum-fed control to assess the role of cocaine-associated decreases in food and water intake. Administration of cocaine resulted in dose related decreases in body weights, increases in locomotor activity, and decreases in estradiol levels. The high dose of cocaine was also associated with an increase in the percentage of spermatozoa with heads separated from tails. Cocaine did not affect sexual behavior, relative weights of the testis or accessory organs, histology of the testis, number of implantations, resorptions, fetal or newborn weight of offspring, or offspring weight at 21 days of age but did result in hyperactivity and increased perseverance in a T maze. PMID- 2708122 TI - Chronic ethanol ingestion during puberty alters the transient increase in testicular 5 alpha-reductase in the Swiss-Webster mouse. AB - Previous experiments with inbred mice showed that chronic ethanol treatment delays male pubertal development. An initial event in sexual maturation in the rat is a transient increase in 5 alpha-reductase. The present study was conducted to determine whether similar ethanol effects occur in outbred mice (Swiss Webster), to determine the ontological profile of testicular 5 alpha-reductase in the mouse, and to evaluate the effect of ethanol treatment on this enzyme. After 29 days of treatment with a liquid diet (beginning at age 20 days), reductions in the ethanol-treated mice as compared with the controls were noted in testicular weight (55.0 +/- 2.0 vs. 63.0 +/- 2.4 mg; P less than 0.01), epididymal sperm content (6.8 X 10(5) vs. 14.4 X 10(5); P less than 0.05), and sperm motility (45% vs. 57%; P less than 0.05). After 43 days, differences no longer existed. In chow fed mice, a substantial rise in 5 alpha-reductase (1 unit = 1 pmole DHT formed/45 min/mg testis) began at age 24 days. Activity peaked at approximately 65 units at 25 to 30 days and gradually declined to 6.4 +/- 0.8 units at 63 days. After 29 days treatment, 5 alpha-reductase of the pair-fed control group was 26.8 +/- 4.9 units, which decreased to a baseline value of 7.0 +/- 2.1 units after 43 days treatment. In contrast, 5 alpha-reductase of the ethanol-treated group remained at baseline levels after 29 days (7.7 +/- 2.3 units) and 43 days of treatment (7.6 +/- 2.3 units).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708123 TI - Effects of prolactin on luteinizing hormone-stimulated testosterone secretion in isolated perfused rat testis. AB - The direct peripheral effect of prolactin on LH-stimulated testosterone secretion was re-evaluated using the intact, isolated, perfused rat testis. In paired experiments, one testis was infused with the hormones being studied; the other testis of the same rat was used as the control. A dose-response curve of LH stimulated testosterone secretion was established first. A dose of 300 ng of LH, which was on the ascending portion of the dose-response curve, was selected so that both stimulatory and inhibitory effects of prolactin could be observed. Prolactin doses ranging from 0 ng to 3000 ng were then tested to determine alterations in LH-stimulated testosterone secretion. Prolactin inhibited LH stimulated testosterone secretion at low doses (less than 300 ng), but augmented LH action at high doses (greater than 1000 ng). These results showed that prolactin and LH interact with each other in a biphasic dose-dependent manner. PMID- 2708124 TI - 24-hour pulsatile and circadian patterns of cortisol secretion in alcoholic men. AB - Pulsatile and circadian patterns of cortisol secretion during acute (3 to 16 days) and chronic (29 to 39 days) abstinence were examined in alcoholic men with no clinical or laboratory evidence of hepatic dysfunction or nutritional deficiencies. Mean and integrated 24-hour serum concentrations of cortisol determined by sampling the blood every 20 minutes over a 24-hour period were increased in six out of 10 alcoholic subjects during acute abstinence when compared with normal controls. Sustained abstinence in seven subjects with follow up studies caused significant decreases in the mean maximal cortisol peak amplitude (13 +/- 1.0 SEM acutely vs. 10.3 +/- 0.52 micrograms/dl follow-up; P = 0.01), mean 24-hour serum cortisol concentrations (10.9 micrograms/dl +/- 1.2 vs. 8.5 micrograms/dl +/- 0.26; P = 0.047), interpulse valley mean (9.3 micrograms/dl +/- 0.88 vs. 6.5 micrograms/dl +/- 0.34; P = 0.007), and valley nadir (7.9 micrograms/dl +/- 0.69 vs. 5.4 micrograms/dl +/- 0.30; P = 0.0036) concentrations. Cortisol pulse frequency was normal. Although circadian cortisol rhythmicity was maintained in alcoholics, the timing of the circadian acrophase was delayed significantly (P = 0.006) during acute abstinence (1022 [clocktime] +/- 34 min) as compared with normal controls (0743 [clocktime] +/- 34 min), and the amplitude of circadian cortisol rhythms exceeded normal in five of 10 alcoholics. Analysis of data in one alcoholic subject by a new multiparameter deconvolution method demonstrated increases in secretory burst amplitude (0.64 microgram/dl +/- 0.08 SD), mass of cortisol released per burst (9.8 micrograms/dl +/- 1.2 SD), and daily endogenous cortisol production rate (22 mg +/- 2.4 SD) during acute abstinence. These values were statistically different when compared with seven normal controls and the subjects' values during sustained abstinence (P less than 0.02). In conclusion, the results of the present study suggest increased daily production of cortisol as a possible mechanism underlying the elevated serum cortisol concentrations in chronic alcoholics during acute abstinence. This abnormality is shown to be reversible with sustained abstinence from alcohol. PMID- 2708125 TI - Two-dimensional gel electrophoretic analysis of rat sperm membrane interaction with cauda epididymal fluid. AB - Two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) was used to analyze the polypeptide composition of rat cauda epididymal fluid, blood serum and membrane-enriched fractions of caput, corpus, and cauda epididymal spermatozoa. Several polypeptides were found in both cauda fluid and blood serum, and in both cauda fluid and epididymal spermatozoa. Prominent cauda epididymal fluid polypeptides that were associated with caput, corpus, and cauda sperm membranes were 32 and 33 kDa. Passage of spermatozoa from the caput to the cauda epididymidis was characterized by the loss of three glycopolypeptides of 32, 30 and 29 kDa, and by the addition of a 37-kDa glycopolypeptide. Incubation of intact caput, corpus and cauda spermatozoa with cauda epididymal fluid revealed major changes in the polypeptide maps of the incubation fluid and the membrane enriched fractions of caput and corpus, but not cauda spermatozoa. The incubation of cauda fluid with caput and corpus sperm cells was characterized by a loss of several polypeptides and the addition of a 24-kDa glycopolypeptide. The most striking change in spermatozoa incubated with cauda epididymal fluid was the addition of two glycopolypeptides of 32 and 33 kDa to the polypeptide maps of caput sperm cells. These data demonstrate that rat spermatozoa undergo surface modifications during epididymal maturation and that these modifications can be influenced by epididymal fluid. PMID- 2708126 TI - Induction of varicocele in the dog: I. Partial ligation of the left renal vein does not induce a varicocele in the dog. AB - Induction of varicocele was attempted by partial ligation of the left renal vein in 10 male dogs. The effects on sperm count, sperm motility, and sperm morphology, as well as on hemodynamics, were assessed. Furthermore, testicular, vascular, and kidney morphology was studied. Changes in the diameter and consistency of the left spermatic cord were found to be temporary. Total sperm count, sperm motility, and the total number of oval forms were not significantly altered. Hemodynamic studies revealed a renocaval pressure gradient, but retrograde flow in the distal part of the left testicular vein could not be observed by arteriography. A collateral network was found to compensate for the restricted left renal vein. Histologic examination revealed no damage to the seminiferous epithelium. Changes were not found in the kidney and left pampiniform plexus. Although some temporary changes induced by the partial ligation of the left renal vein are suggestive of varicocele, this hemodynamic study shows that the presented dog model does not mimic varicocele as encountered in man. PMID- 2708127 TI - Deacetylravidomycin N-oxide, a new antibiotic. Taxonomy and fermentation of the producing organism and isolation, structure and biological properties of the antibiotic. AB - Streptomyces ravidus S50905 was found to produce a new antibiotic, deacetylravidomycin N-oxide, together with ravidomycin and deacetylravidomycin in a culture medium containing sodium anthraquinone-beta-sulfonate. The structure of this new compound was determined from NMR and mass spectrometric data, and further confirmed by chemical synthesis from deacetylravidomycin. Deacetylravidomycin N-oxide was antitumor active against P388 leukemia and Meth A fibrosarcoma in a wide range of doses, and considerably less toxic than deacetylravidomycin. Its antibacterial activity was less potent than deacetylravidomycin. Ravidomycin N-oxide was also synthesized from ravidomycin and its biological properties were tested. PMID- 2708128 TI - Structure elucidation of ficellomycin. AB - The structure of ficellomycin, an antibiotic previously discovered by Argoudelis et al., is elucidated as valyl-2-[4-guanidyl-1-azabicyclo[3.1.0]hexan-2 yl]glycine (1) by NMR, MS, and derivatization studies. The 1 azabicyclo[3.1.0]hexane moiety in 1 represents an unusual ring system making ficellomycin a unique natural product compound. PMID- 2708129 TI - Synthesis and biological activity of a series of piperazine-2,3-dione containing penicillins and 6 alpha-formamidopenicillins. I. Derivatives substituted at C(5) or C(6) of the piperazine ring. AB - The synthesis and antibacterial activity of a series of penicillins and 6 alpha formamidopenicillins containing a C(5) or C(6)-substituted piperazine-2,3-dione moiety in the C(6)-beta-sidechain is described. PMID- 2708130 TI - Synthetic studies of 1-beta-methylcarbapenem antibiotics. AB - The diastereoselective synthesis of the 1-beta-methylcarbapenems, (1R,5R,6S)-6 ((R)-1-hydroxyethyl)-2-((S)-1-acetimidoylpyrrolidin-3 - ylthio)-1- methyl-1 carbapen-2-em-3-carboxylic acid and sodium (1R,5R,6S)-6-((R)-1-hydroxyethyl)-2-(5 chloro-2-oxobenzoxazolin-3- y l)-1- methyl-1-carbapen-2-em-3-carboxylate has been achieved. The key step was an aldol reaction between the achiral boron enolate which was generated from dibutylboron triflate and 3-propionyl-2 oxobenzoxazoline, and (3R,4R)-4-acetoxy-3-((R)-1-hydroxyethyl)azetizin-2-one. PMID- 2708131 TI - Deacylation of echinocandin B by Actinoplanes utahensis. AB - Echinocandin B (ECB) is a lipopeptide antifungal agent produced by several species of Aspergillus. The lipid side chain of cyclic lipopeptides is known to be an important determinant of their antibiotic activity and toxicity. Deacylation of another lipopeptide antibiotic, A21978C, had formerly been accomplished with Actinoplanes utahensis. In spite of the structural dissimilarities between the peptide cores and acyl side chains of A21978C and ECB, A. utahensis also removed the linoleoyl acyl unit from the amino terminus of ECB to yield the bioinactive cyclic peptide core, or "nucleus". The ECB nucleus, which contained a new titratable group at the N-terminus, was subsequently employed for chemical reacylation with other side chains to yield a variety of novel ECB analogs. One of these, cilofungin (LY121019), containing an N-(4-n octyloxybenzoyl)acyl unit, is currently undergoing clinical evaluation. PMID- 2708132 TI - Synthesis of new analogs of echinocandin B by enzymatic deacylation and chemical reacylation of the echinocandin B peptide: synthesis of the antifungal agent cilofungin (LY121019). AB - The antifungal antibiotic, echinocandin B (ECB), was modified by a sequential procedure in which the initial step involved enzymatic removal of the native N linoleoyl group from the N-terminus using an Actinoplanes utahensis culture. The resulting product, ECB nucleus, was reacylated using active esters or acid halides of various substituted acids to give a series of ECB analogs. These analogs possessed anti-Candida activity both in vitro and in vivo (mice). Other studies have shown that one of these, cilofungin, the 4-n-octyloxybenzoyl-ECB analog (LY121019), has excellent anti-Candida activity, low toxicity and is superior to other available antifungal antibiotics. PMID- 2708133 TI - Biosynthetic origin of the carbon skeleton and oxygen atoms of the LL-F28249 alpha, a potent antiparasitic macrolide. AB - The biosynthesis of LL-F28249 alpha in a culture of Streptomyces cyaneogriseus has been studied using 13C, 14C and 18O labeled precursors. A complete 13C NMR spectrum of F28249 alpha has been assigned. Incorporation studies using 13C labeled precursors indicate that the carbon skeleton of F28249 alpha is derived from seven acetate, six propionate and one 2-methylpropionate units. The origin of the oxygen atoms of F28249 alpha has been examined by feeding [1 13C,18O2]acetate, [1-13C,18O2]propionate, [2-13C]acetate/18O2 and 18O2 separately to the fermentation culture and analyzing the resulting labeled LL-F28249 alpha samples by 13C NMR, electron impact MS and chemical ionization MS. Out of a total of eight oxygen atoms in LL-F28249 alpha, four oxygen atoms are derived from acetate, three from propionate and one from molecular oxygen. PMID- 2708134 TI - Biosynthesis of monacolins: conversion of monacolin L to monacolin J by a monooxygenase of Monascus ruber. AB - The microbial metabolites monacolins J and L are specific inhibitors of 3-hydroxy 3-methylglutaryl CoA reductase, the rate-limiting enzyme in cholesterol synthesis. The producing strain Monascus ruber M 4681 was found to convert exogenously added monacolin L to J. In this hydroxylation reaction 18O2 was incorporated into monacolin L, giving [18O]-monacolin J. The cell-free extracts of M. ruber quantitatively hydroxylated monacolin L to J, and molecular oxygen was required for the hydroxylation. The enzyme was located in the microsomal fraction and specific for NADPH. The enzyme activity was inhibited by metyrapone, carbon monoxide, sulfhydryl reagents and cytochrome c. The results indicate that monacolin L is the precursor of monacolin J, and that a monooxygenase is involved in this reaction. PMID- 2708135 TI - Analysis of the promoter region of the cloned kanamycin resistance gene (kmr) from Streptomyces kanamyceticus. AB - The appropriate location and orientation of the kanamycin resistance gene (kmr) cloned on multicopy plasmids were determined by subcloning experiments. The transcription start site was identified by high-resolution S1 mapping and the kmr mRNA was shown to have a long leader of about 400 bp. An additional transcript upstream of the kmr gene was also detected, which ran in the opposite direction and overlapped 2 to 3 nucleotides with the kmr transcript. The presumptive promoter region of this physiologically unidentified RNA was similar to the Escherichia coli promoter consensus sequence both in the -10 and -35 regions, whereas the putative promoter region of the kmr gene exhibited sequence similarities in the -10 region to the promoters of the endoglycosidase H (endoH) and the viomycin phosphotransferase (vph) genes from Streptomyces. PMID- 2708136 TI - Expression of the kanamycin resistance gene in a kanamycin-producing strain of Streptomyces kanamyceticus. AB - The previously cloned kanamycin resistance gene (kmr) from Streptomyces kanamyceticus ISP5500 was shown to modify the 30S ribosomal subunit in a subunit exchange experiment. The kmr gene, which was normally repressed in S. kanamyceticus, appeared to be induced under growth conditions which activated kanamycin biosynthesis. S1 mapping analysis revealed that the expression of the kmr gene was regulated at the transcriptional level. Acetylation of kanamycin is another resistance mechanism in the kanamycin producer. However, unlike kmr mediated resistance, the enzyme which catalyzed acetylation was not regulated coordinately with kanamycin biosynthesis. PMID- 2708137 TI - The mode of action of cervinomycin in Staphylococcus aureus. AB - The mode of action of cervinomycin, which is a new antibiotic active against Gram positive bacteria including anaerobes, was studied in Staphylococcus aureus using triacetylcervinomycin A1 (ACVM), an acetyl derivative of cervinomycin A1. ACVM inhibited strongly the growth of the organism when it was added to a culture at the time of inoculation at a concentration of 1.0 micrograms/ml, but did not inhibit when added to a logarithmic phase culture even at 10.0 micrograms/ml. The antibiotic also inhibited the incorporation of labeled precursors of cell wall peptidoglycan (N-acetylglucosamine), RNA (uridine), DNA (thymidine) and protein (L-leucine) into both whole cell and acid-insoluble macromolecular fractions. ACVM stimulated the leakage of UV260-absorbing materials, amino acids and potassium ions from resting cells and protoplasts. Phospholipids partially reversed the inhibitory activity of ACVM in a growing culture. These findings suggest that ACVM interact with phospholipids in the cytoplasmic membrane and then interfere with the membrane transport system. PMID- 2708138 TI - Biological properties of ER 42859, a novel erythromycin derivative. AB - The antimicrobial activity of a new semi-synthetic oral erythromycin derivative, ER 42859, was evaluated in vitro and in vivo in comparison with erythromycin, spiramycin, josamycin, oleandomycin and the newer semi-synthetic derivatives flurithromycin, roxithromycin and A-56268. MIC values of ER 42859 were superior to those of roxithromycin, oleandomycin, josamycin and spiramycin but generally 2 fold poorer than those of erythromycin. The activity equalled that of erythromycin against Haemophilus influenzae and was superior to that of roxithromycin and A-56268 against this organism. MIC values of the compound were greatly influenced by pH due to the dibasic nature of the molecule. ER 42859 had markedly superior activity to erythromycin, spiramycin, josamycin, oleandomycin and flurithromycin against experimental infections in mice and similar activity to roxithromycin and A-56268. Blood and tissue levels were high and prolonged in rodents. In volunteers, blood levels were prolonged but inferior to those of erythromycin. PMID- 2708139 TI - New antibiotics, resorcinomycins A and B: antibacterial activity of resorcinomycin A against mycobacteria in vitro. AB - Resorcinomycin A, N-[(S)-alpha-guanidino-3,5-dihydroxy-4 isopropylphenylacetyl]glyci ne, S-RSM-A, a new antibiotic produced by Streptoverticillium roseoverticillatum, has an antibacterial spectrum directed towards mycobacterial species. It is not active against Gram-negative and Gram positive bacteria, except mycobacteria and weakly active against mycoplasmas. In vitro activities of the S-, R- and S,R-isomers of RSM-A against atypical mycobacterial strains were compared with those of streptomycin (SM) and kanamycin (KM) by 2-fold agar dilution methods using Middlebrook 7H10 agar medium. Although R-RSM-A and S,R-RSM-A were comparable or inferior to both antibiotics, the antimycobacterial activity of S-RSM-A was superior to that of SM and KM. PMID- 2708140 TI - 3-O-isobutyrylkinamycin C and 4-deacetyl-4-O-isobutyrylkinamycin C, new antibiotics produced by a Saccharothrix species. PMID- 2708141 TI - 5-Hydroxymethylblasticidin S and blasticidin S from Streptomyces setonii culture A83094. PMID- 2708142 TI - Discovery, production, and biological assay of an unusual flavenoid cofactor involved in lincomycin biosynthesis. PMID- 2708143 TI - Isolation and identification of 7,8-didemethyl-8-hydroxy-5-deazariboflavin, an unusual cosynthetic factor in streptomycetes, from Streptomyces lincolnensis. PMID- 2708144 TI - Structural studies on minor components of trienomycin group antibiotics trienomycins D and E. PMID- 2708145 TI - Structure determination of alphostatin, a novel alkaline phosphatase inhibitor. PMID- 2708146 TI - Studies on the biosynthesis of bialaphos (SF-1293). 9. Biochemical mechanism of C P bond formation in bialaphos: discovery of phosphoenolpyruvate phosphomutase which catalyzes the formation of phosphonopyruvate from phosphoenolpyruvate. PMID- 2708147 TI - Recoveries of whole-nerve AP thresholds, amplitudes and tuning curves in gerbils following noise exposure. AB - The recoveries of whole-nerve action potential (AP) thresholds, AP amplitudes and AP tuning curves in gerbils were monitored following two weeks of exposure to band-pass noise at 85 dBA. Recordings were made by means of electrodes chronically implanted in the subjects' bullas. The noise exposure caused threshold elevations in all of our subjects, with the greatest shifts occurring an octave or more above the 2 kHz upper cutoff frequency of the noise. The magnitudes of the shifts varied greatly (up to 26 dB) across subjects. Thresholds of animals with the smallest initial loss of sensitivity returned to pre-exposure values within 16 days, while those of animals with greater initial losses remained elevated beyond 16 days. AP amplitudes and AP tuning curves (APTCs) were most affected at frequencies where the initial threshold shifts were greatest. At these frequencies AP amplitudes were reduced, and APTCs showed broadened tips, reduced tip-to-tail ratios, and in some cases a shift in the frequency of the tip. These effects did not necessarily reverse with threshold recovery, suggesting that AP amplitudes and AP tuning curves are more sensitive indices of acoustic injury than are AP thresholds. PMID- 2708148 TI - Transient responses to tone bursts. AB - Investigating theoretical conditions under which linearly-operating tuned structures produce click-like transient responses to onsets and offsets of trapezoidal tone bursts, we come to the following conclusions: (1) each of the four corners of the trapezoidal tone burst is capable of eliciting such a response; (2) the amplitude of the response and its dependence on the frequency of the modulated tone both depend on the phase of the modulated sinusoid at the time a corner occurs; (3) such responses will arise in structures having sufficiently steep band edges, provided that the frequency of the modulated tone is well outside the pass band of the structure--for a corner in cosine phase, the sustained slope of the low-frequency band edge must be greater than zero and that of the high-frequency band edge must be greater than 12 dB/Oct, for a corner in sine phase the sustained slope of the low-frequency band edge must be greater than 6 dB/Oct and that of the high-frequency band edge must be greater than 18 dB/Oct; (4) they will not arise in response to tone bursts whose frequencies fall within the pass band of the structure; (5) nor will they arise in response to a trapezoidal tone burst of any frequency applied to structures (such as simple microphones or drivers) following second-order dynamics and having both spectral zeros at infinity. We present theoretically derived relationships between the amplitude of transient responses and the tone-burst frequency, not only for the corners of trapezoidal tone bursts, but also for tone bursts of more general shapes. We conclude that, owing to its extraordinarily steep high-frequency rolloff, the filter associated with each cochlear axon is well suited to extracting temporal information from onset or offset singularities in modulated tones whose frequencies are above the characteristic frequency of the filter. Applying the theory to observed onset and offset responses to high-intensity tone bursts in auditory afferents of the Mongolian gerbil, we conclude that some of the responses we observed must have been sculpted in part by cochlear nonlinearities. PMID- 2708149 TI - Coding of tone-pulse amplitude by single neurons in auditory cortex of albino rats (Rattus norvegicus). AB - We examined the neural representation of tone pulse amplitude in the auditory cortex of anesthetized albino rats. Rate-level functions for monaural, contralateral CF tones were obtained from single neurons. Most of these functions were saturating and monotonic in shape. The dynamic ranges of these functions were typically 5 to 35 dB in breadth, although the tail of this distribution extended to beyond 60 dB. The neurons with the widest dynamic ranges were usually those with the lowest CF thresholds. Nonmonotonic neurons were uncommon, and the nonmonotonicity was not as well developed as that seen in the cortex of cats and monkeys. For two individual rats, data are presented for neurons tuned to the same tone frequency in a single cerebral hemisphere. The CF thresholds of these neurons varied over a 50 dB range, and their collective dynamic ranges spanned at least 70 dB. These data provide a minimum estimate of the dynamic range of the cortical code for tone pulse amplitude in the rat. They suggest that there may be no serious mismatch between the neural and behavioral amplitude dynamic ranges. PMID- 2708150 TI - Objective evidence of tinnitus in auditory evoked magnetic fields. AB - The waveforms of the auditory evoked magnetic field in normal-hearing individuals and patients suffering from tinnitus are distinctly different. In tinnitus patients, the magnetic wave M200 (corresponding to the electric wave P200, or P2) is delayed and only poorly developed or even completely missing, while the amplitude of the magnetic wave M100 (corresponding to the electric wave N100, or N1) is significally augmented. A very characteristic feature turned out to be the amplitude ratio of the two waves M200 and M100. Below the age of 50, the amplitude ratio M200/M100 represents a clear-cut criterion to distinguish between tinnitus patients and individuals without tinnitus. In tinnitus patients, the ratio is less than 0.5, independent of age, whereas, in young and middle-aged normal-hearing individuals, it is greater than 0.5. Since in normal-hearing individuals the average amplitude ratio decreases linearly with age, the clusters of amplitude ratios of the two groups begin to overlap beyond the age of 50. The hypothesis is put forward that the decrease of the average amplitude ratio in normal-hearing individuals reflects a degenerative process, probably initiated by multiple exogenous and endogenous factors, which leads to sustained neural activity in the generators of wave M200 and eventually gives rise to the sensation of tinnitus. The absence or poor development of wave M200 is a concomitant phenomenon, resulting from the involved generators being less responsive to external stimuli. PMID- 2708151 TI - Interferometric measurement of the amplitude and phase of tympanic membrane vibrations in cat. AB - The amplitude and phase of the tympanic membrane and malleus vibrations were measured over a wide frequency range with a homodyne interferometer. When sound pressure was maintained constant near the tympanic membrane, the malleus frequency response followed the typical pattern up to 10 kHz as measured by previous investigators. At higher frequencies the response changes dramatically. Instead of decreasing with frequency, between 10 and 20 kHz the vibration amplitude oscillates around a value which is only about 20 dB lower than the low frequency plateau level. Measurements of malleus vibration at several points along its length indicate that its mode of vibration changes at high frequencies, and no longer consists of a simple rotational component. All points on the tympanic membrane vibrate in phase with the malleus up to a frequency of 1 kHz. Above 5 kHz discrete resonances are observed, and the response varies strongly with position on the tympanic membrane. PMID- 2708152 TI - The vessels of the stria vascularis: quantitative comparison of three rodent species. AB - The stria vascularis (SV) was quantitatively compared in three species commonly used in auditory research: guinea pig, mouse and gerbil. Measurements were obtained for surface area, cross-sectional area, length, width and thickness of SV. Surface area and length were proportional to the overall size of the cochlea in each species, but there was no significant difference between species in mean cross-sectional area. In guinea pig and mouse, there was no significant difference in thickness (endolymphatic surface to spiral ligament) and a similar pattern was observed for width (Reissner's membrane to spiral prominence): the width of SV increased from the apical end to a point 80% of the distance from the apex, then decreased to the basal end of SV. The thickness of gerbil SV was significantly less (P less than 0.001) and there was less of a gradient in width as compared to guinea pig and mouse. The vessels of SV were compared in terms of vascular density (vessels per unit area), rbc density (red blood cells per unit area), R/V (rbc density/vascular density), inter-vessel spacing and vessel diameter. Highly significant (P less than 0.001) differences between species were found in vascular density, RBC density and vessel diameter, but there were no differences between species for R/V or inter-vessel spacing. The results of this study may reflect differences in the metabolic requirements of SV among different species. PMID- 2708153 TI - Autoregulation of cochlear blood flow in normotensive and spontaneously hypertensive rats following intracerebroventricularly mediated adjustment of blood pressure. AB - Previous studies in our laboratory (Quirk et al., 1988) noted significantly impaired elevations in cochlear blood flow (CoBF) during systemic infusion of the potent vasoconstrictive agent angiotensin II (AII) in the spontaneously hypertensive rat (SHR) as compared with the normotensive Wistar-Kyoto (WKY) rat, despite similar increases in systemic blood pressure. We interpreted these results to suggest that SHRs have an exaggerated autoregulatory mechanism that controls blood supply to the cochlear vessels. However, an alternative explanation for these findings concerns the potential influence of the elevated baseline blood pressure of the SHR on CoBF. Specifically, if there is an absolute threshold blood pressure that triggers an autoregulatory response in the cochlea, then the SHRs would reach that threshold sooner than normotensive animals because they begin at a baseline blood pressure that is well above that of the WKY rat. The present study addressed this possibility by pharmacologically reducing SHR blood pressure to WKY baseline blood pressure and raising WKY to SHR baselines, followed by the infusion of previously utilized doses of AII. The results are consistent with previous findings and support our interpretation of an exaggerated autoregulation of cochlear blood supplying the SHR. PMID- 2708154 TI - Spiral ganglion cell density in young and old gerbils. AB - The Mongolian gerbil, like other mammalian species, has a decreased number of spiral ganglion cells as a function of age. This loss of cells was first seen in 24- to 30-month old animals in the basal end of the ganglion. In the oldest individuals the apical end of the ganglion was also affected. There were approximately 15-25% fewer cells in the affected areas in the 36- to 42-month old animals. In the oldest animals degeneration of the stria vascularis was seen in the apical turn and some degenerative changes in the organ of Corti were seen throughout the length of the cochlear duct. The aging pattern in the gerbil cochlea, is similar to that described for other species. Vacuoles, previously described in the gerbil cochlear nucleus, were also seen in the auditory nerve within the modiolus, but central to the Schwann-glial border in all animals. Vacuoles were not present within the spiral ganglion or the peripheral processes of the ganglion cells. Because the ganglion cell axons should be similar on either side of the Schwann-glial border, but the vacuoles were confined to the central nervous system, it is concluded that the degenerative process affects glial cells as opposed to neurons. PMID- 2708155 TI - An infracuticular network is not required for outer hair cell shortening. AB - The presence and distribution of filamentous actin was documented in normal and shortened isolated outer hair cells by use of fluorescently labeled phalloidin. In hair cells isolated from the guinea pig cochlea, an infracuticular network containing organized bundles of actin filaments is present in some, but not all, control cells and in some, but not all, cells after shortening. An infracuticular network of organized bundles of actin filaments is not present in control outer hair cells isolated from chinchilla or gerbil cochleas and it is never observed in any outer hair cells from these species even after shortening. Thus shortening of isolated outer hair cells is not correlated with the presence or the formation of organized bundles of actin filaments in an infracuticular network. PMID- 2708156 TI - The combined effect of cisplatin and furosemide on hearing function in guinea pigs. AB - The effect of the combined administration of cisplatin and furosemide on the electrophysiological hearing thresholds and endocochlear DC potential (EP) was studied in guinea pigs. A lack of interaction was found in animals given repeated intraperitoneal injections of a low dose of cisplatin with a pharmacological dose of furosemide. An ototoxic interaction occurred when a moderately high dose of cisplatin was administered intravenously at a time when the strial function was most affected by a very high dose of furosemide. The interaction was seen both as a decreased EP and a pronounced shift of auditory thresholds. It is concluded that the stria vascularis plays a role in the ototoxic mechanism of cisplatin. PMID- 2708157 TI - The ototoxic effect of cisplatin on guinea pigs in relation to dosage. AB - The effect on the electrophysiological hearing thresholds and the endocochlear DC potential (EP) was studied in four groups of guinea pigs receiving different doses of cisplatin. By multiple low-dose intraperitoneal injections a permanent hearing loss was produced without a permanent decrease of the EP. On the other hand, when cisplatin was given as a single high-dose intravenous injection, there was an impairment of the electrophysiological hearing thresholds and EP, depending upon the level of cisplatin dose. It is concluded that cisplatin induced hearing loss is not necessarily a sequela to a loss of EP. PMID- 2708158 TI - Evoked otoacoustic emissions as cochlear Bragg reflections. AB - The reflection of cochlear waves is mathematically described for various assumptions about the dependence of the echo-generating mechanism on place and frequency, without requiring knowledge of the physical details of the mechanism. Any 'wave-related' reflections, caused by intrinsic features of the resonance or active-feedback mechanism, cannot explain long group delays in an approximately shift-similar basilar membrane (BM). Only 'BM related' scattering due to inhomogenities is a possible explanation then. Reflection at a fixed point of the BM could cause only narrow-band evoked otoacoustic emissions (EOAEs). Long group delays in a wider frequency band can be obtained by assuming Bragg reflection at an approximately periodic inhomogenity of BM parameters, possibly due to spatial variations of active undamping. This explains the long delays, about inversely proportional to frequency, the decreasing instantaneous frequency, the often found multi-packet or modulated structure of echoes (vanishing at higher SPL), the spectra of simultaneous and delayed EOAEs and their relation to the threshold of hearing. These phenomena do not necessarily require multiple reflection due to middle/inner-ear mismatch. PMID- 2708159 TI - Rapid assessment of sound-evoked olivocochlear feedback: suppression of compound action potentials by contralateral sound. AB - The compound action potential (CAP) measured at the round window of anesthetized cats in response to low-level tone pips can be significantly suppressed by addition of tones or noise to the opposite ear. This contralateral-sound suppression disappears upon transection of the olivocochlear bundle. The frequency and level dependence of the suppression phenomenon are well explained by known sound-evoked discharge properties of single olivocochlear neurons. Thus, the contralateral-sound suppression of cochlear CAP should prove useful as a rapid measure of the magnitude of the sound-evoked efferent feedback to the cochlea. PMID- 2708160 TI - Autoimmune disease and cochlear pathology in the C3H/lpr strain mouse. AB - The C3H/lpr autoimmune strain mouse is a model for spontaneous systemic lupus erythematosus. Inner ear structure and function were examined during systemic autoimmune disease progression to identify correlated auditory system pathology. Onset of the systemic disease occurred at 2-3 months of age and was characterized by elevated serum immune complexes, cryoglobulins, and antinuclear antibodies. Coincident with the onset of autoimmune disease was degeneration of the stria vascularis. Early edema of the stria occurred in the apex and progressed basalward with duration of the disease. By 10 months of age, stria vascularis area was smaller and auditory brainstem response thresholds were elevated. No degeneration of hair cells was seen at any age, suggesting that the stria vascularis may be the primary anatomic site of autoimmune auditory damage in this mouse model. PMID- 2708161 TI - Stereociliary bundle morphology in organotypic cultures of the mouse cochlea. AB - Organotypic cultures of the neonatal mouse cochlea have a band of hair cells consisting of 3-5 rows of outer hair cells and a single row of inner hair cells. The outer hair cell stereociliary bundles show progressive differentiation from the apical to the basal ends of the band. Undifferentiated apical bundles have a disk-like array of short stereocilia resembling microvilli. Partially differentiated bundles are hemispherical with poorly organized rows of thickly clustered stereocilia, which gradually increase in height in the direction of the kinocilium. More differentiated bundles remain hemispherical with many microvilli like stereocilia, but have highly organized rows of sterocilia along the side nearest to the kinocilium, and well-defined height increments between the rows. Highly-differentiated, basal bundles usually have a 'V' or 'W' shape, although some can be almost polygonal. The basal bundles have 4-5 regular rows of stereocilia with a well-defined gradient in height across the rows, and very few microvilli-like stereocilia. Cross-links are only consistently observed in more differentiated bundles, where the rows of stereocilia are regular and have significant height increments across them. The links show a wide variety of forms and orientations not previously observed in other preparations. Spoke-like arrays of links project from the upper regions of many stereocilia and other stereocilia appear to bear distinct tip-to-side links, although with a variety of orientations. A similar variety of cross-links is observed in early postnatal cochleae in vivo, but not in the cochleae of adult mice, indicating that this variety may be a transient feature of sterociliary bundle development. In vitro, inner hair cell stereociliary bundles are often covered by overlying material from the developing tectorial membrane. The variations in morphology of inner hair cell bundles and their cross-links are similar to those of the outer hair cell bundles. PMID- 2708162 TI - Functional role of the olivo-cochlear bundle: a motor unit control system in the mammalian cochlea. AB - A fiber optic lever is applied to the measurement of the motion of the basilar membrane motion in guinea pigs. In response to intense tones from either ear, the motion includes a substantial summating shift in the mean position in addition to a travelling wave originally described by von Bekesy. His stroboscopic technique and most techniques used since have been concentrated upon measuring vibrations of the basilar membrane synchronous with the stimulus and have been insensitive to variations in the baseline position such as a summating component of motion analogous to the extracellular summating potential. In addition to the role of the outer hair cells in providing normal hearing sensitivity, they evidently play a role in regulating the mean position of the basilar membrane. For a fixed frequency, the polarity of the mean position varies systematically with sound level and place and summates with time since onset. Since these cells are the target cells for the olivocochlear bundle, homeostasis in the cochlea would appear to be linked efferent function and involve cochlear mechanics. The negative damping hypothesis asserts that hair cell activity is necessary for low thresholds. The results presented here demonstrate that OHC activity exists independent of neural thresholds. The discussion develops the concept that threshold losses are due to a mismatch of opposing tonic forces which normally maintain the mean position of the basilar membrane. Structure is examined in relation to function and the group of outer hair cells innervated by a single medial efferent neuron is identified as a motor unit. Implications of central control of individual motor units include peripheral involvement in selective attention tasks. PMID- 2708163 TI - The quantitative relation between sensory cell loss and hearing thresholds. AB - On the basis of experimental data obtained from 420 noise-exposed animals (chinchilla), the amount of sensory cell loss has been quantitatively related to the amount of permanent threshold shift at eight audiometric test frequencies between 0.125 and 16 kHz. The noise exposures, which varied extensively in spectrum, intensity and duration, produced permanent threshold shifts that ranged from 0 to 70 dB across a broad range of test frequencies. These data show: (1) consistent outer hair cell losses with less than 5 dB permanent threshold shifts (PTS) across all the test frequencies; (2) the first approximately 30 dB of PTS is established by losses of primarily outer hair cells; (3) in regions of the cochlea that transduce frequencies higher than or equal to 2 kHz, the three rows of outer hair cells show the same degree of loss for a given PTS, while in the 0.5 to 1.0 kHz region of the cochlea, the third row of outer hair cells (OHC) consistently shows less loss than do rows one and two; (4) appreciable inner hair cell (IHC) loss does not begin to appear until PTS exceeds approximately 30 dB; (5) in the virtual absence of OHC, hearing thresholds are least sensitive to IHC loss in the octave band centered at 4 kHz, i.e., the 4 kHz region can be as functional as other areas of the cochlea in spite of a greater amount of damage. The quantitative relation between cell loss and PTS varies as a function of test frequency in an orderly fashion. PMID- 2708164 TI - Evoked potential correlates of echolocation in the mustached bat, Pteronotus p. parnellii. AB - The biosonar signals of the greater mustached bats are characterized by a long constant frequency component that is preceded and terminated by frequency modulated components. It has generally been concluded that the terminal FM (TFM) is important for target ranging while the initial FM (IFM), or beginning of the signal, is relatively insignificant. With the aid of chronically implanted electrodes, acoustically evoked brainstem potentials were recorded from bats during simulated flight on a pendulum and when targets were placed at fixed distances from the bat's head. Distinct pulse- and echo-evoked potentials were recorded in relation to the onset of both the IFM and TFM, or the onset of the CF when no IFM was present. Echo-evoked potentials were often as high in amplitude as pulse-evoked potentials and the timing of the IFM- and TFM-pulse and echo evoked potentials seemed to accurately reflect target distance. Data indicate that the IFM, or signal onset, must be a significant part of the echo even though it is usually faint, overlaps the intense outgoing CF component, and returns to the ear when the middle ear muscles are contracting. PMID- 2708165 TI - Changes in spontaneous otoacoustic emissions produced by acoustic stimulation of the contralateral ear. AB - Spontaneous otoacoustic emissions (SOAEs) were measured in human ear canals before, during and after presentation of tonal stimuli to the contralateral ear. Stimuli were presented in 1/8 octave steps from 2 octaves below to 1 octave above the SOAE frequency at sound levels below the observed contralateral acoustic reflex threshold. For certain conditions there was an abrupt upward frequency shift at stimulus onset. For a fixed level the effect was frequency selective; the maximum frequency shift was obtained with tones approximately 1/2 octave below the SOAE. SOAE amplitude usually decreased but in some cases increased or remained unchanged. When amplitude changes were observed, the maximum shifts were observed for tones at or near the SOAE frequency. Changes in SOAEs were not observed for stimulus levels below 60 dB SPL. The effect is believed to be mediated by medial efferent neurons of the uncrossed olivocochlear bundle which arise in the medial region of the superior olivary complex and terminate on outer hair cells (OHCs). These results support those models which attribute SOAE generation to OHCs, and are indicative of an efferent influence on cochlear mechanics. A simple model is presented that proposes that efferent activity alters the tuning of the emission generator by causing changes in OHC membrane conductance. PMID- 2708166 TI - Behavior of spontaneous otoacoustic emissions following intense ipsilateral acoustic stimulation. AB - Following presentation of brief, intense pure tones spontaneous otoacoustic emissions (SOAEs) were reduced in frequency and/or amplitude. The effects were highly tuned with exposures between 1/8 and 5/8 of an octave below the SOAE producing the maximum changes. Exposure frequencies above the SOAE had no effect. The degree of tuning observed depended upon the post-exposure time sampled, with sharpness maximal between 3 and 120 s post-exposure. The effects increased nonlinearly as exposure level and duration were increased. The recovery functions were biphasic, the first phase being rapid and non-monotonic over about 2 min, while the second phase was monotonic and slow, sometimes taking several hours. These data are consistent with changes in outer hair cell (OHC) function and support the hypothesis that OHC changes underlie behavioral temporary threshold shift (TTS). PMID- 2708167 TI - Establishment of inner ear epithelial cell culture: isolation, growth and characterization. AB - Select epithelial regions of the bovine inner ear were established and maintained in cell culture. Marginal cells from the stria vascularis and dark cells from the posterior wall of the utricle were isolated, dissociated and placed in culture medium. Within 24 h, cellular islands of hexagonal-shaped, epithelial-like cells from both the stria vascularis and posterior utricular wall were readily identifiable by inverted light microscopy. Ultrastructural examination of both the cultured stria marginal cells and utricular dark cells revealed that both cell types had numerous microvilli on their apical surfaces and interdigitating infoldings of their basolateral surfaces. Apical tight junctional complexes were present between apposing cells. These findings demonstrate that inner ear bovine epithelial cells can be successfully isolated and maintained in culture, and that such cells retain certain of their in vivo morphological characteristics. PMID- 2708168 TI - Interaural sound pressure level differences associated with sound-source locations in the frontal hemifield of the domestic cat. AB - Interaural sound pressure level differences (ILDs) associated with a range of sound-source azimuths and elevations in the frontal hemifields of four cats were measured for each of seven pure-tone stimuli ranging in frequency from 2-32 kHz. The overall pattern of ILD across location at each frequency was remarkably similar in all cats. At 2, 4 and 8 kHz the relationships of ILD to azimuth and elevation were generally monotonic with ILD increasing with increasing azimuth. At 12 kHz and above, however, non-monotonic relationships developed and circumscribed regions of particularly large, positive and negative ILDs were apparent. That ILDs associated with many sound-source locations on the near side of the head are negative in sign has not been widely noted in the previous literature. The data obtained in this study were compared with those from previous studies and the acoustical mechanisms likely to have contributed to production of the observed ILDs were considered. Some implications of the data for auditory localization in three-dimensional space were discussed. PMID- 2708169 TI - An appraisal of the efficacy of pre-enrichment for the isolation of Campylobacter jejuni from water and food. AB - Cells of Campylobacter jejuni exposed to heating or freezing were progressively less able to grow at 43 degrees C, particularly on selective media. This influenced the recovery of damaged cells from naturally and artificially contaminated samples. With broth culture the isolation rate could be increased by pre-enrichment in basal or selective media at 37 degrees C for 4 h. With membrane filtration or surface plating techniques the inclusion of agents that quench toxic derivatives of oxygen was more important. PMID- 2708170 TI - Differentiation of Staphylococcus aureus from freshly slaughtered poultry and strains 'endemic' to processing plants by biochemical and physiological tests. AB - A comparison was made of 27 'endemic' strains of Staphylococcus aureus and 35 strains from freshly slaughtered birds, isolated at five commercial slaughterhouses processing chickens or turkeys. Of 112 biochemical and physiological tests used, 74 gave results which differed among the strains. Cluster analysis revealed several distinct groupings which were influenced by strain type, processing plant and bird origin; these included a single group at the 72% level of similarity containing most of the 'endemic' strains. In comparison with strains from freshly slaughtered birds, a higher proportion of 'endemic' strains produced fibrinolysin, alpha-glucosidase and urease and were beta-haemolytic on sheep-blood agar. The 'endemic' type also showed a greater tendency to coagulate human but not bovine plasma, and to produce mucoid growth and clumping. The last two properties, relevant to colonization of processing equipment, were less evident in heart infusion broth than in richer media or process water collected during defeathering of the birds. PMID- 2708171 TI - The pectinolytic enzyme of Selenomonas ruminantium. AB - A cell-bound pectinolytic enzyme was isolated from cells of Selenomonas ruminantium and purified about 360-fold. The optimum pH and temperature for enzyme activity was 7.0 and 40 degrees C. The enzyme degraded polymeric substrates by hydrolysis of digalacturonic acid units from the non-reducing end; the best substrate was nonagalacturonic acid. Unsaturated trigalacturonate was also degraded, but 30% slower than the saturated analogue. The enzyme was classified as a poly (1,4-alpha-D-galactosiduronate) digalacturono-hydrolase; EC 3.2.1.82. Another enzyme, hydrolysing digalacturonic acid to monomers, was also produced in a very small amount by this organism. PMID- 2708172 TI - Ecobehavioral characteristics of a pediatric burn injury unit. AB - Behavioral observations were conducted on 40 children admitted consecutively to an inpatient pediatric burn care unit (PBCU) over a 6-month period. Children's responses to the PBCU environment as well as adult responses to patients were assessed. Data indicated that children most frequently (a) were oriented and alert, (b) emitted vocalizations or verbalizations, (c) were environmentally engaged, (d) and demonstrated positive or neutral affective responding. Adult child interactions occurred during the majority of observations. Age was found to be significantly related to the type of distress response exhibited. Positive responses indicative of patient well-being were found to be associated with environmental engagement and the presence of other patients. In general, little evidence emerged to support the notion of a PBCU response pattern which resembles that observed in pediatric intensive care units (i.e., ICU syndrome). The use of observational methods for studying the behavioral adaptation of children in medical settings and the implications of the data for the design of interventions on PBCUs are discussed. PMID- 2708173 TI - Promoting safety belt use with traffic signs and prompters. AB - Two studies were conducted examining the stimulus-control effects of conventional traffic signs as prompts for motor vehicle driver safety belt use. Following pilot research which suggested that a traffic sign reading "Fasten Safety Belt" posted at a parking lot exit was effective in producing small increases in safety belt use, Study I demonstrated the superiority of having human prompters display such signs compared to simply posting the signs. Study II replicated the findings of Study I and found that posted signs became more effective in prompting safety belt use if simple posting was preceded by a period involving human prompters who displayed the signs. The results bear upon the development of more effective use of traffic signs in promoting safety belt use and in viewing such use as an instance of rule-governed behavior. PMID- 2708174 TI - Generalization of student question asking from special class to regular class settings. AB - This study investigated the use of videotaped exemplars taken from a regular education mathematics class to teach generalization of question asking. Three mildly handicapped fourth-grade students who asked few questions in the regular education class served as subjects. Measures of the frequency of question asking and percentage of accuracy on assignments were obtained in the regular class. Treatment included showing the videotapes to the subjects, structuring opportunities for rehearsing question asking, and providing feedback. The results showed training procedures implemented in the learning resource room were effective in increasing the level of participants' question asking and in improving their scores on assignments in the regular mathematics class. PMID- 2708175 TI - A comparison of time delay and decreasing prompt hierarchy strategies in teaching banking skills to students with moderate handicaps. AB - Four students with moderate handicaps were taught to cash checks and to use an automatic teller through either a decreasing prompt hierarchy or time delay procedure. The strategies were compared within a multielement design. Results indicated that both strategies led to the acquisition of the target tasks; however, the decreasing prompt hierarchy was more efficient. Four and 8-week follow-up probes indicated that the strategies were equally effective in producing maintenance of performance. PMID- 2708176 TI - An evaluation of gentle teaching and visual screening in the reduction of stereotypy. AB - Gentle teaching and visual screening techniques have been used to control severe behavior problems in persons with mental retardation. An alternating treatments design was used to compare gentle teaching, visual screening, and a task-training condition in the reduction of the high-level stereotypy of 3 persons with mental retardation. Following a baseline phase, a task-training condition using standard behavioral techniques was implemented to establish the effects of training the subjects on the tasks. Results showed a modest decrease in stereotypy. This phase was followed by an alternating treatments phase in which visual screening, gentle teaching, and baseline conditions were compared. Both procedures were superior to the control condition in reducing stereotypic behavior, with visual screening being more effective than gentle teaching. When compared with data from the prior phase, gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd, whose stereotypy increased during gentle teaching. Two succeeding phases in which visual screening was implemented across two and then all three daily conditions reduced stereotypy further to near-zero levels. An additional phase with 1 subject demonstrated that the treatment effects of visual screening were easily replicated across therapists. Mixed and idiosyncratic changes in collateral behaviors occurred. For example, "bonding," the goal of gentle teaching, occurred at the same low levels under both treatments, contrary to the predictions of gentle teaching's proponents. The results indicate that gentle teaching may not be the universal treatment of choice for stereotypy its proponents suggest, and that it requires further empirical evaluation. PMID- 2708177 TI - Evaluation of tactile prompts with a student who is deaf, blind, and mentally retarded. AB - We provided tactile cues to a student who was deaf, blind, and mentally retarded to guide her performance on a variety of packaging tasks. The student had previously received extensive training on multiple packaging and sequencing tasks through her vocational education program. Although she was able to complete these tasks, each change in materials necessitated that similar levels of retraining be conducted in order for her to perform revised tasks. Tactile cues were introduced and evaluated through a multiple baseline with sequential withdrawal design for two envelope-stuffing tasks and one bagging task. Results indicated that the tactile prompts were effective in guiding her performance on the training task and in promoting generalization to novel tasks and cues. Continued use of the cues was necessary to maintain the student's performance. Our findings suggest that tactile prompts function similarly to picture prompts and may be an effective alternative external prompting system for persons for whom picture prompts would not be appropriate. PMID- 2708178 TI - Natural methicillin resistance in comparison with that selected by in-vitro drug exposure in Staphylococcus aureus. AB - Methicillin resistant staphylococci selected during serial passage in increasing concentrations of methicillin were compared with an isogenic methicillin resistant strain carrying the methicillin resistance determinant (mec) found in clinical isolates of Staphylococcus aureus. Selection for methicillin resistance was followed by changes in the binding characteristic of penicillin binding proteins (PBPs) 2 and 4. There was no immunological nor genetic relationship between the mec-determined low affinity PBP2' and the PBPs of the in-vitro selected mutants. The Tn551 insertion omega 2003, which inactivates mec determined methicillin resistance, but which is not linked to mec, also partially reduced in-vitro selected methicillin resistance. This suggests that this methicillin resistance controlling factor contributes at least partially to methicillin resistance selected in vitro. PMID- 2708179 TI - Penicillin-aminoglycoside synergy and post-antibiotic effect for enterococci. AB - The post-antibiotic effect (PAE) on seven strains of enterococci was studied using a novel ATP method and conventional viable counting. There was a good correlation between the results of the two techniques. In strains exhibiting low level resistance to penicillin and streptomycin, PAEs of 1 to 2.4 h (mean 1.8 h) resulted from exposure to penicillin; shorter PAEs were induced by streptomycin (0.2-0.3 h; mean 0.2 h). Addition of streptomycin to pencillin increased the duration of penicillin-induced PAEs by two-fold to three-fold. Enterococci exhibiting high-level streptomycin resistance but low-level penicillin resistance did not exhibit a PAE with streptomycin but exhibited a short PAE with gentamicin (0.3-0.6 h). For these strains, the addition of gentamicin, but not streptomycin, to penicillin increased the penicillin-induced PAEs. Penicillin alone or in combination with streptomycin or gentamicin did not induce PAEs for a single strain of Enterococcus faecium which exhibited high-level resistance to both penicillin and streptomycin. During penicillin-induced PAEs, extracellular ATP was detectable and only during this time period were enterococci susceptible to the action of gentamicin. The addition of aminoglycosides to penicillin not only extended the PAE for enterococci but also the periods when organisms leaked ATP and were susceptible to growth inhibition by gentamicin. PMID- 2708180 TI - Cefixime, in-vitro activity, pharmacokinetics and tissue penetration. AB - The in-vitro activity of cefixime was studied with clinical isolates and compared with that of other agents. Cefixime exhibited good activity against the Enterobacteriaceae, Haemophilus influenzae, and Neisseria gonorrhoeae, including beta-lactamase producing strains. Activity was also high against Streptococcus pneumoniae and group A and group B beta-haemolytic streptococci. Staphylococcus aureus, faecal streptococci, anaerobic bacteria and Pseudomonas aeruginosa were not susceptible. Activity against susceptible isolates was comparable to cefotaxime and was normally superior to cefuroxime, cephalexin and amoxycillin. The pharmacokinetics of cefixime were studied in six healthy male volunteers, each receiving a 400 mg oral dose following an overnight fast. Tissue penetration of the antibiotic was estimated with a cantharides-induced blister method. The mean serum elimination half-life was 3.8 h, the mean peak concentration was 3.7 mg/l. Penetration into tissue fluid was rather slow [Tmax 6.7 h) but percentage penetration was high (132.6%). Urinary excretion was low with a 24 h recovery rate of less than 20%, though the concentrations achieved in urine exceeded the MICs of most common urinary tract pathogens for up to 24 h post-dose. PMID- 2708181 TI - In-vitro toxoplasmacidal activity of cationic electron carriers. AB - Exposing murine macrophages infected with the protozoan parasite Toxoplasma gondii to micromolar concentrations of some cationic electron carriers (dyes), resulted in complete killing of the intracellular parasites at concentrations at which these compounds did not seem toxic for the macrophages. The 50% inhibitory concentrations (with 95% confidence limits) were calculated as 0.26 (0.18-0.37), 1.35 (1-2.25), 0.45 (0.13-1.50), and 1.52 (0.91-2.53) microM for crystal violet, phenazine methosulphate, methylene blue and brilliant cresyl blue, respectively. The effects of these electron carriers did not appear to be the result of an enhancement of the natural antitoxoplasmic activity of the macrophages. None of the tested compounds was active against extracellular Tox. gondii as measured by ability to reinfect murine macrophages; thus, these dyes seem to act primarily on actively metabolizing, intracellular, Tox. gondii. Our data also suggest that the killing effect of the electron carriers was not related to the generation of reactive oxygen intermediates as judged by the inability of scavengers of these intermediates to block the activity against intracellular Tox. gondii. Further studies with related redox compounds would have an interesting chemotherapeutic perspective for treating toxoplasma infections. PMID- 2708183 TI - Pharmacokinetics of intraperitoneal ciprofloxacin in patients on CAPD. AB - The concentration of ciprofloxacin was assayed in plasma and peritoneal dialysate following intraperitoneal administration of the drug in the absence of bacterial peritonitis. After administration of a single dose of 5 mg/kg, ciprofloxacin was rapidly absorbed, producing a peak plasma concentration of 1.9 +/- 0.6 mg/l after 3-4 h with an apparent bioavailability of 0.84. In a separate study, following the administration of 25 mg/l for eight consecutive CAPD cycles the intraperitoneal concentration of ciprofloxacin fell to a mean of 8.4 +/- 4.6 mg/l after 4 h cycles and to a mean of 3.0 +/- 3.2 mg/l after 12 h cycles. During the period of administration the mean plasma concentration was 0.5 +/- 0.2 mg/l. Analysis of dialysate for 48 h after cessation of drug administration demonstrated ciprofloxacin to be present in effluent from only two of the six patients, confirming its poor peritoneal elimination. PMID- 2708182 TI - Echinococcus multilocularis metacestodes: biochemical and ultrastructural investigations on the effect of isatin (2-3 indoline dione) in vivo. AB - A study on the biochemical and ultrastructural effects of isatin on Echinococcus multilocularis metacestodes in Meriones unguiculatus is reported. In the metacestode, after an 18 day treatment period, the alkaline phosphatase and lactate dehydrogenase activities decreased and the acid phosphatase activity increased. Glucose and glycogen stores declined significantly. Examinations of the ultrastructure revealed an increase of lysosomes and phagocytic reactions. The protoscolesces were damaged and an abnormal striated process appeared. The tegumental cytoplasmic syncytium remained unaltered. These observations suggest that isatin derivatives may have a role in the chemotherapy of infections caused by Echinococcus spp. PMID- 2708184 TI - Treatment of acute uncomplicated urinary tract infections with single daily doses of cefuroxime axetil. AB - Cefuroxime axetil in a single daily dose of 250 mg for ten days was given to 75 women with symptoms of acute uncomplicated urinary tract infections. Fifty-nine women were found to have significant bacteriuria but one was excluded as urethral catheterization was required. The dose was taken at night with a milk drink. Ninety-five per cent of women had a clear urine during treatment. Compliance studies showed that antimicrobial activity was detectable in early morning urines up to 8-10 h after the dose. Post treatment, 93% of women were clear of their original infecting organism but five women had become reinfected with a different strain of Escherichia coli. At the six week follow up 98% of women were still clear although one further reinfection had occurred. The overall cure rate was 86%, including 11% reinfection. Adverse events developed in 17 (23%) of the 75 women with candida vaginitis (8) and diarrhoea (4) being most common. Cefuroxime axetil is a valuable therapy for the treatment of urinary tract infection particularly when due to beta-lactamase producing bacteria. PMID- 2708185 TI - Antibiotic inactivating enzymes from a clinical isolate of Agrobacterium radiobacter. PMID- 2708186 TI - Comparison of disc-diffusion and plate-incorporation susceptibility testing of gram-negative bacilli to ticarcillin, piperacillin and ticarcillin/clavulanate. PMID- 2708187 TI - Preferential axial flow during high-frequency oscillations: effects of gas density. AB - Allen et al. (J. Clin. Invest. 76: 620-629, 1985) reported that regional phasic lung distension during high-frequency oscillations (HFO) is substantially and systemically heterogeneous when both frequency (f) and tidal volume (VT) are large. They hypothesized that this phenomenon was attributable to central airway geometry and preferential axial flow induced therein by the momentum flux of the inspiratory gas stream. According to that hypothesis, the observed distribution of phasic lung distension would depend on the ratio VT/VD* (where VD* is an index of anatomic dead space), independent of gas density (rho), when f is scaled in proportion to lung resonant frequency, fo. To test this hypothesis, we used the methods of Allen et al. (ibid.) to study six excised dog lungs during HFO (f = 2 32 Hz; VT = 5-80 ml) using gases of different densities. Alveolar pressure excursions (PA) were measured as rho spanned a 12-fold range using He, air, and SF6. The apex-to-base and right-to-left ratios of PA were used as indexes of regional heterogeneity of phasic lung distension. For each gas at low f, distension of the lung base was favored slightly independent of VT, but at higher f distension of the lung apex was favored when VT was small, whereas distension of the lung base was favored when VT was large. In addition, we observed substantial right-to-left differences in apical lobes during oscillation at high f not seen before.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708188 TI - Both acute and chronic exercise enhance in vivo ethanol clearance in rats. AB - Rates of ethanol clearance were measured at rest and with acute exercise in four groups of female Sprague-Dawley rats. Two groups were trained to run on a motor driven rodent treadmill at 27 m/min, 1 h/day, 5 days/wk and were given a nutritionally balanced liquid diet; one of these groups received 35% calories as ethanol whereas in the other, sucrose was isocalorically substituted for the ethanol. Appropriate sedentary and nonethanol controls were also used. Clearance of a 1.75-g/kg ethanol dose injected intraperitoneally was determined by measuring ethanol levels in the blood each hour and utilizing these values in the Widmark equation (R. Teschke, F. Moreno, and A. Petrides, Biochem. Pharmacol. 30: 1745-1751, 1981) for calculating whole-body ethanol clearance. Rates of ethanol clearance were determined for each rat at 4 and 7 wk of training. The clearance tests at 4 wk included a 60-min period of running exercise, whereas the tests 3 wk later were conducted at rest. The results indicate that both acute exercise and exercise training can increase rates of in vivo ethanol clearance. In addition, the chronic exercise appeared to increase in vitro ethanol metabolism by hepatic microsomes without altering in vitro hepatic alcohol dehydrogenase activity. PMID- 2708189 TI - Diaphragm metabolism during supramaximal phrenic nerve stimulation. AB - The metabolic changes accompanying diaphragm fatigue caused by supramaximal stimulation of the phrenic nerves are incompletely described. In particular, we wished to determine whether the occurrence of anaerobic metabolism correlated with fatigue as defined by decline in force generation. In 10 anesthetized mechanically ventilated mongrel dogs we measured arterial pressure, transdiaphragmatic pressure (Pdi), phrenic arterial flow (Qdi-Doppler flow probe), arterial and phrenic venous blood gases, and lactate levels. From these we derived indexes of diaphragm O2 consumption (VO2) and lactate production. Bilateral phrenic nerve pacing was carried out (50 Hz, duty cycle 0.4, 24 contractions/min) for two 15-min pacing periods separated by a 45-min rest period. Over each pacing period Pdi decreased from approximately 16 to approximately 10 cmH2O (P less than 0.01, no significant difference between periods). Initially, during pacing, Qdi and VO2 each increased fivefold over prepacing base line. Qdi remained elevated at this level whereas VO2 decreased over the pacing period by approximately 25%. Hence, the change in VO2 over the pacing period was due primarily to changes in O2 extraction. During the first pacing period lactate production was observed early and declined throughout the pacing period. No lactate production was observed during the second pacing period, although Pdi, VO2, and Qdi responses were the same for both pacing periods. Phrenic venous PO2 remained greater than 30 Torr throughout both pacing periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708190 TI - Effect of dichloroacetate on lactate concentration in exercising humans. AB - The precise mechanism responsible for the increase in plasma lactate concentration during exercise in humans is not known. We have used dichloroacetate to test the hypothesis that a limitation in pyruvate dehydrogenase activity is responsible for the rise in plasma lactate. Dichloroacetate stimulates the activity of pyruvate dehydrogenase, which is normally the regulatory enzyme in the oxidation of glucose when tissue oxygenation is adequate. Six subjects were studied twice according to a randomized, crossover protocol, involving one test with saline infusion and another with dichloroacetate infusion. Exercise load on a bicycle ergometer was increased progressively until exhaustion. Blood samples were drawn each minute throughout exercise and periodically throughout 120 min of recovery. Dichloroacetate significantly lowered the lactate concentration during exercise performed at less than 80% of the average maximal O2 consumption. The peak concentration of lactate at exhaustion was not affected by dichloroacetate treatment, but dichloroacetate did lower lactate concentration throughout recovery. These results suggest that a limitation in pyruvate dehydrogenase activity contributes to the increase in plasma lactate during submaximal exercise and recovery. PMID- 2708191 TI - Involvement of ventral medullary surface in respiratory responses induced by 2,4 dinitrophenol. AB - We examined the contribution of the neural elements near the ventral medullary surface (VMS) to the respiratory response caused by 2,4-dinitrophenol (DNP). Two series of experiments were performed on 12 vagotomized and sinoaortic denervated cats. The first series examined the effect of focal cooling of the VMS on the respiratory response to DNP in four spontaneously breathing, anesthetized cats. When the VMS temperature was 37 degrees C, systemic administration of DNP increased minute ventilation under nearly isocapnic conditions, and focal cooling of the intermediate area of VMS to 20 degrees C attenuated the ventilatory augmentation caused by DNP. To eliminate the influence of anesthetics, a second group of experiments was performed on eight decerebrate, artificially ventilated cats while phrenic nerve activity was monitored as an index of respiration. AgNO3 (10%) was topically applied to the VMS until the respiratory response to inhaled CO2 was abolished. Apnea occurred in seven of eight cats after AgNO3, whereas in the remaining one animal, tidal phrenic activity decreased substantially. Systemic administration of DNP produced no respiratory excitation in any of the animals. On the other hand, rhythmic respiratory activity could be provoked by electrical stimulation of the mesencephalic locomotor area and carotid sinus nerve and by excitation of somatic afferents. Histological examination of the brain stem showed that the AgNO3 had penetrated no more than 350 microns from the ventral medullary surface. These results indicate superficial structures of the VMS are of potential importance in mediating the respiratory responses to hypermetabolism. PMID- 2708192 TI - Recovery of diaphragm function after laparotomy and chronic sonomicrometer implantation. AB - If sonomicrometry transducers could be implanted permanently into the diaphragm, direct measurements of costal and crural length and shortening could be made during recovery from the laparotomy and then indefinitely in an awake, non anesthetized mammal. We report results from six canines in which we successfully implanted transducers onto the left hemidiaphragm through a midline laparotomy and measured segmental shortening and ventilation at intervals through 22 days of postoperative recovery. After laparotomy, breathing pattern, including tidal volume, respiratory rate and mean inspiratory flow, stabilized by the 4th postoperative day (POD). Tidal shortening of costal and crural segments increased from 1.82 and 1.45% of end-expiratory length (%LFRC) on the 2nd POD to 5.32 and 8.56% LFRC, respectively, after a mean of 22 POD. Segmental shortening did not stabilize until 10 POD, and the recovery process displayed a sequence of segmental motions: lengthening, biphasic inspiratory lengthening-shortening, and increasing simple shortening. Three weeks after implantation, costal and crural segments were stable and shortening 5.32 and 8.56% LFRC, respectively, and capable of shortening 49% LFRC with maximal phrenic stimulation. In a pair of recovered animals, the initial postoperative dysfunction did not recur after a subsequent, simple laparotomy. At postmortem examination, the chronically implanted sonomicrometer transducers were found to have evoked only a thin fibrotic capsule within the diaphragm. PMID- 2708193 TI - Muscle energetics during prolonged cycling after exercise hypervolemia. AB - This study examined the question of whether increases in plasma volume (hypervolemia) induced through exercise affect muscle substrate utilization and muscle bioenergetics during prolonged heavy effort. Six untrained males (19-24 yr) were studied before and after 3 consecutive days of cycling (2 h/day at 65% of peak O2 consumption) performed in a cool environment (22-23 degrees C, 25-35% relative humidity). This protocol resulted in a 21.2% increase in plasma volume (P less than 0.05). During exercise no difference was found in the blood concentrations of glucose, lactate, and plasma free fatty acids at either 30, 60, 90, or 120 min of exercise before and after the hypervolemia. In contrast, blood alanine was higher (P less than 0.05) during both rest and exercise with hypervolemia. Measurement of muscle samples extracted by biopsy from the vastus lateralis muscle at rest and at 60 and 120 min of exercise indicated no effect of training on high-energy phosphate metabolism (ATP, ADP, creatine phosphate, creatine) or on selected glycolytic intermediate concentrations (glucose 1 phosphate, glucose 6-phosphate, fructose 6-phosphate, lactate). In contrast, training resulted in higher (P less than 0.05) muscle glucose and muscle glycogen concentrations. These changes were accompanied by blunting of the exercise induced increase (P less than 0.05) in both blood epinephrine and norepinephrine concentrations. Plasma glucagon and serum insulin were not affected by the training. The results indicate that exercise-induced hypervolemia did not alter muscle energy homeostasis. The reduction in muscle glycogen utilization appears to be an early adaptive response to training mediated either by an increase in blood glucose utilization or a decrease in anaerobic glycolysis. PMID- 2708194 TI - Ca2+-dependent facilitated shortening in isotonic contraction of trachealis muscle. AB - We compared isotonic shortening with isometric force generation as a function of external Ca2+ in 166 tracheal smooth muscle (TSM) strips from 27 mongrel dogs in vitro. Concentration-response curves were generated with muscarinic stimulation (acetylcholine, ACh), alpha-adrenergic receptor activation (norepinephrine after beta-adrenoceptor blockade, NE), serotonin (5-HT), and KCl-substituted Krebs Henseleit solution. The concentrations of 5-HT causing half-maximal shortening (ECS50, 1.54 +/- 0.14 X 10(-7) M) and half-maximal active isometric tension (ECT50, 1.72 +/- 0.30 X 10(-7) M) were similar (P = NS). Likewise, ECS50 (21.9 +/ 0.7 mM) and ECT50, (22.0 +/- 0.9 mM) were similar for KCl. In contrast, facilitated isotonic shortening (i.e., greater isotonic shortening for comparable degrees of force generation) was elicited with ACh and NE for all levels of force generation between 15 and 85% of maximum and for all concentrations of ACh from 3 X 10(-8) to 3 X 10(-5) M (P less than 0.05 for all points). Facilitated isotonic shortening also was elicited for all concentrations of NE from 10(-8) to 10(-6) M (P less than 0.05 for all points). Removal of Ca2+ from the perfusate substantially reduced the potency of ACh (P less than 0.001) and abolished differences between ECS50 (2.23 +/- 0.28 X 10(-5) M) and ECT50 (2.50 +/- 0.46 X 10(-5) M, P = NS). We demonstrate that for comparable degrees of force generation, muscarinic and alpha-adrenergic receptor activation cause greater isotonic shortening than KCl or 5-HT and that this facilitated shortening is associated with the concentration of external Ca2+. PMID- 2708195 TI - PAF-induced contraction of canine trachea mediated by 5-hydroxytryptamine in vivo. AB - We studied the secretory correlates of tracheal smooth muscle contraction caused by platelet-activating factor (PAF) in nine mongrel dogs in vivo. In five dogs, dose-response curves were generated by rapid intra-arterial injection of 10(-10) to 10(-6) mol PAF into the isolated tracheal circulation; tracheal contractile response was measured isometrically in situ. To examine the mechanism by which PAF elicits contraction of canine trachealis, concentrations of serotonin (5-HT) and histamine were assayed in the venous effluent as the arteriovenous difference (AVd) in mediator concentration across the airway for each level of contraction. PAF caused dose-related active tracheal tension to a maximum of 37.2 +/- 5.4 g/cm (10(-6) mol PAF). The AVd in 5-HT increased linearly from 0.20 +/- 0.05 (10(-9) mol PAF) to 3.5 +/- 0.3 ng/ml (10(-6) mol PAF) (P less than 0.005). In contrast, the AVd in histamine was insignificant and did not change with increasing doses of PAF. A positive correlation was obtained between the AVd in 5-HT and active tracheal tension (r = 0.92, P less than 0.001); there was no correlation between AVd in histamine and active tension (r = -0.16). PAF-induced parasympathetic activation was not mediated by 5-HT; contraction elicited by exogenous 5-HT was not affected by muscarinic blockade. We conclude that nonparasympathetically mediated contraction elicited acutely by PAF in dogs results at least in part from secondary release of serotonin and is not mediated by histamine. PMID- 2708196 TI - Effect of hindlimb suspension on VO2 max and regional blood flow responses to exercise. AB - Male rodents were studied before and after undergoing one of three treatment conditions for 9 days: 1) cage control (n = 15, CON), 2) horizontal suspension (n = 15, HOZ), and 3) head-down suspension (n = 18, HDT). Testing included measurements of maximal O2 uptake (VO2 max) and select cardiovascular responses to graded treadmill exercise. VO2 max expressed on an absolute basis (ml/min) was significantly decreased after HOZ (-14.1 +/- 2.5%) and HDT (-14.3 +/- 2.0%), while being essentially unchanged in CON (-1.0 +/- 3.3%). Significant reductions in body weight were observed after both HOZ (-10.1 +/- 4.2 g) and HDT (-22.5 +/- 3.3 g), whereas CON animals exhibited a significant increase in weight (10.4 +/- 3.8 g). As a result, when VO2 max was normalized for body weight, all groups exhibited similar significant reductions of 6-7%. Although no differences in heart rate and blood pressure response to graded exercise were observed, the HDT group exhibited greater increases in mesenteric resistance at the same absolute exercise intensity. Furthermore, both suspended groups had higher iliac resistance values during exercise at similar relative exercise conditions, suggesting that muscle blood flow during treadmill running may have been reduced after suspension. In general, the decrements associated with the HOZ and HDT conditions were similar. It was concluded that reduction in exercise capacity and altered cardiovascular responses to exercise observed after 6-9 days of suspension were attributable to a combination of hypokinesia, lack of hindlimb weight bearing, or restraint, rather than to hydrostatic influences associated with HDT. PMID- 2708197 TI - Vascular responses in forearm and calf to contralateral static exercises. AB - Ten normal subjects performed a 90-s isometric exercise [20, 30, and 40% of maximal voluntary contraction (MVC) of the flexor muscle of the right index finger or quadriceps muscle of the right leg. Contralateral forearm and calf blood flows (strain gauge plethysmography) and arterial blood pressure (auscultation) were measured simultaneously. Each exercise caused a decrease in forearm vascular resistance and a progressive increase in calf resistance. These changes were greatest with the 40% MVC. With finger exercise at 20 and 40% MVC, the percentage decreases in forearm vascular resistance from control were 12.3 and 22.7%, respectively (P less than 0.01). Similar decreases (9.5 and 24.9%, respectively; P less than 0.01) were noted with exercise of the quadriceps muscle. By contrast, the corresponding increases in calf vascular resistance were greater (P less than 0.01) with quadriceps exercise (13.3 and 55.4%, respectively) than with finger exercise (6.0 and 36.0%). Arrest of the circulation to the exercising muscles just before the exercise ended caused an abrupt increase in forearm vascular resistance and a decrease in calf resistance. These studies provide further evidence of the heterogeneity of responses of forearm and calf resistance vessels to certain cardiovascular stimuli. PMID- 2708198 TI - Force deficit of vascularized skeletal muscle grafts in rabbits. AB - Through autografting experiments on 9-g rectus femoris (RFM) muscles in rabbits, we substantiated a previous observation that the maximum isometric tetanic force (Po) and specific Po (N/cm2) of neurovascular-intact grafts are not different from grafts made with neurovascular repair. We then tested the hypotheses that the specific Po of vascularized grafts is significantly less than that of control RFM muscles and the deficit in the specific Po is associated with increases in connective tissue and interstitial space. The specific Po of the grafts was 65% of the value for control RFM muscles. Connective tissue protein concentration of grafts was 3.8 times greater than the control value of 16.6 +/- 3 micrograms/mg wet mass, but this only accounted for a 5% correction in specific Po. The volume of interstitial space did not differ between grafts and control muscles. We conclude that the deficit of 35% in specific Po of vascularized grafts compared with control values is partially explained by an increase in connective tissue, but a 30% unresolved deficit remains. PMID- 2708199 TI - Human breathing pattern responses to loading with increased background impedance. AB - We determined the influence of the background level of mechanical impedance on the respiratory responses to very small mechanical loads, at or below the threshold for conscious perception. We used a pseudorandom load application technique to estimate the immediate pattern responses from the zeroth lag of the cross correlation between the load application sequence and the respiratory pattern components of tidal volume (VT), inspiratory and expiratory time (TI and TE), and the instantaneous respiratory frequency (f), minute ventilation (VI), and mean inspiratory flow (VT/TI). Elevation of the background resistance served to reduce the TI and TE responses to small perturbations in resistance from those in the control background state, which resulted in generally smaller perturbations of f, VI, and VT/TI. Elevation of the background elastance, however, served to initiate a TI reduction not seen in the control state but did not appreciably affect the rest of the pattern responses to the load perturbations. Thus the neural reflexes involved in breath-by-breath pattern regulation are modulated by the background level of the respiratory impedance, as well as by the type and size of the load perturbation. PMID- 2708200 TI - Internal intercostal nerve discharges in the cat: influence of chemical stimuli. AB - We studied the influence of central and peripheral chemoreceptor stimulation on the activities of the phrenic and internal intercostal (iic) nerves in decerebrate, vagotomized, and paralyzed cats with bilateral pneumothoraces. Whole iic nerves of the rostral thorax (T2-T5) usually discharged during neural inspiration, whereas those of the caudal thorax (T7-T11) were primarily active during neural expiration. Filaments of rostral iic nerves that terminated in iic muscles generally discharged during expiration, suggesting that inspiratory activity recorded in whole iic nerves may have innervated other structures, possibly parasternal muscles. All nerves were phasically active at hyperoxic normocapnia and increased their activities systematically with hypercapnia. Isocapnic hypoxia or intra-arterial NaCN injection consistently increased phrenic and inspiratory iic nerve activities. In contrast, expiratory iic nerve discharges were either decreased (10 cats) or increased (7 cats) by hypoxia. Furthermore, expiratory responses to NaCN were highly variable and could not be predicted from the corresponding response to hypoxia. The results show that central and peripheral chemoreceptor stimulation can affect inspiratory and expiratory motoneuron activities differentially. The variable effects of hypoxia on expiratory iic nerve activity may reflect a relatively weak influence of carotid body afferents on expiratory bulbospinal neurons. However, the possibility that the magnitude of expiratory motoneuron activity is influenced by the intensity of the preceding centrally generated inspiratory discharge is also discussed. PMID- 2708201 TI - Evaluation of the mechanism of decreased airway responsiveness in lambs. AB - In this study we investigated three possible mechanisms for the decreased airway responsiveness (AR) found in young lambs. To evaluate aerosol delivery, 6 adult sheep (9 mo-3 yr old) and 12 lambs (4-8 wk old) were challenged with aerosol (aH) and intravenous histamine (ivH). Awake animals were intubated and studied in a plethysmograph, which measured dynamic compliance (Cdyn), resistance of the lung, and functional residual capacity. AR to histamine was measured by administration of increasing concentrations of histamine until a significant change in lung mechanics occurred or until the maximum dose of histamine was given. In all six adult sheep, the response to both aH and iVH was a decrease in Cdyn. In two lambs Cdyn was decreased with both aH and ivH, in five lambs with neither, in three lambs with aH only, and in two lambs with ivH only. To examine the role of beta adrenergic activity in determining AR, six adult sheep and six lambs received ivH and on a separate day ivH with propranolol pretreatment (p + ivH). The median effective dose of histamine that caused a reduction in Cdyn to 65% of normal saline control (ED65Cdyn) for the adult sheep given ivH was 3.60 (range 0.23 4.85) and 0.70 (range 0.49-8.0) micrograms.kg-1.min-1 for p + ivH (P = NS). The median ED65Cdyn for the six lambs was 8.0 micrograms.kg-1.min-1 for both ivH alone and p + ivH. To evaluate the role of airway smooth muscle (SM), AR to aH was quantitated in six adult sheep and six lambs, and then an open-lung biopsy was performed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708202 TI - Influence of overload on recovery of rat plantaris from partial denervation. AB - A functional index of neural adaptability is the capacity of motoneurons to extend and establish supernumerary connections with neighboring denervated muscle fibers. The purpose of this study was to guage this response in rat plantaris muscles subjected to increased levels of activity resulting from the surgical removal of the synergistic gastrocnemius and soleus muscles. Thirty-seven days of overload increased plantaris absolute (69%) and relative (82%) weight, whole muscle (35%) and individual fiber (37%) mean cross-sectional area, half relaxation time (1/2RT; 25%), and maximum tetanic tension (P0; 21%). In a separate group of animals that had undergone 30 days of overload, three-quarters of the plantaris muscle fibers were denervated by sectioning radicular nerve L4. At 7 days postlesion, contractile responses were obtained from sprouting motor units remaining in radicular nerve L5, and the results compared to a nonoverloaded group that had undergone this same procedure. Twitch time to peak tension and 1/2RT were prolonged in normal partially denervated (PD) and overloaded partially denervated (OPD) muscles, and this response was significantly greater in the overloaded muscles. Both PD and OPD muscles increased twitch tension (38%) and peak tension developed at 25 Hz (34%) to a similar extent, during recovery from partial denervation. These increases, attributable to sprouting of L5 motor axon collaterals, were matched in PD muscles with a corresponding increase in P0, a response which did not occur in OPD muscles. Additionally, a more extensive decrease in P0 occurred as a result of partial denervation in OPD muscles compared with whole muscle P0 of nondenervated muscle (L4 plus L5 stimulation).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708203 TI - Development of hypertension in rats during chronic exposure to cold. AB - Resting systolic, diastolic, and mean blood pressures (MBP), as well as heart rates, of unanesthetized, unrestrained, cold-acclimated (CA, 4 wk, 6 degrees C) rats were measured by direct arterial cannula and compared with those of controls maintained at 25 degrees C. Exposure to cold increased all these measurements significantly. Mean heart weight of CA rats was also increased significantly above that of controls. The responsiveness of MBP and heart rate to administration of the beta-adrenergic agonist, isoproterenol (3, 5, and 8 micrograms/kg ip), to unanesthetized, unrestrained, CA rats during exposure to air at 6 degrees C was similar to, and possibly less than, that of warm acclimated (WA) rats measured at 25 degrees C. Acute administration of the alpha adrenergic agonist, phenylephrine (100 micrograms/kg ip), to CA rats while in air at 6 degrees C induced less of a change in MBP from pretreatment level than was observed in WA rats. However, no differences were observed between groups when changes in heart rate from pretreatment level were compared. A similar statement may be made for a higher dose of phenylephrine (150 micrograms/kg ip), although MBP were elevated to higher levels in both groups with the higher dose. Abrupt exposure of WA rats to cold (6 degrees C) resulted in a sharp increase in heart rate and a more gradual increase in MBP over a period of 1 h. Removal of CA rats from 6 to 25 degrees C resulted in a gradual decrease in heart rate with no significant change in MBP during the ensuing hour.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708204 TI - Preferential fatigue of the rib cage muscles during inspiratory resistive loaded ventilation. AB - Because the inspiratory rib cage muscles are recruited during inspiratory resistive loaded breathing, we hypothesized that such loading would preferentially fatigue the rib cage muscles. We measured the pressure developed by the inspiratory rib cage muscles during maximal static inspiratory maneuvers (Pinsp) and the pressure developed by the diaphragm during maximal static open glottis expulsive maneuvers (Pdimax) in four human subjects, both before and after fatigue induced by an inspiratory resistive loaded breathing task. Tasks consisted of maintaining a target esophageal pressure, breathing frequency, and duty cycle for 3-5 min, after which the subjects maintained the highest esophageal pressure possible for an additional 5 min. After loading, Pinsp decreased in all subjects [control, -128 +/- 14 (SD) cmH2O; with fatigue, -102 +/ 18 cmH2O; P less than 0.001, paired t test]. Pdimax was unchanged (control, -192 +/- 23 cmH2O; fatigue, -195 +/- 27 cmH2O). These data suggest that 1) inability to sustain the target during loading resulted from fatigue of the inspiratory rib cage muscles, not diaphragm, and 2) simultaneous measurement of Pinsp and Pdimax may be useful in partitioning muscle fatigue into rib cage and diaphragmatic components. PMID- 2708206 TI - Pressure-volume properties of the upper airway of rabbits. AB - In 10 anesthetized rabbits the upper airway cephalad of the vocal cords was isolated from the distal airway and sealed. Static deflation pressure-volume data were recorded from the isolated upper airway. The relationship between pressure and volume in the upper airway was a straight line; the correlation coefficient (r) ranged from 0.97 to 1.00. The following quantities were derived from the data: the pressure-volume ratio (upper airway elastance, cmH2O/ml), the pressure in the airway at airway closure (closing pressure, cmH2O), and the airway volume at zero airway pressure (reserve volume, ml). Mean upper airway elastance was 8.13 +/- 1.45 [95% confidence intervals (CI)] cmH2O/ml, closing pressure was 6.93 +/- 1.53 (95% CI) cmH2O, and reserve volume was 0.74 +/- 0.15 (95% CI) ml. There was no significant correlation between elastance and closing pressure (r = 0.47, P greater than 0.1), but closing pressure and reserve volume were significantly correlated (r = 0.77, P less than 0.01). Pressure-volume data recorded from newly dead animals exhibited the same linear relationship between pressure and volume observed in living animals. It is concluded that the pressure volume properties of the isolated upper airway of the rabbit can be expressed as a single value for airway elastance, that estimation of pressure-volume properties over part of the volume range is representative of the whole volume range, and that pressure-volume properties are determined by passive elastic properties of the airway tissues. It appears that the resistance of the upper airway to collapse by negative intraluminal pressure is more dependent on the initial size of the airway than on its elastance. PMID- 2708205 TI - Influence of muscle activity on the elastance of the upper airway of rabbits. AB - This study sought to assess the effect of variations in upper airway muscle activity on upper airway pressure-volume properties. Upper airway elastance, closing pressure, and reserve volume were measured in the isolated upper airways of anesthetized rabbits under control conditions and after administration of gallamine (2 mg/kg iv) or after 10 min of spontaneous respiration of 7% CO2 in O2. Administration of gallamine to seven animals was associated with a fall in reserve volume from 0.94 +/- 0.24 to 0.69 +/- 0.17 (95% confidence interval) ml (P less than 0.01) and of closing pressure from -7.53 +/- 0.23 to -5.75 +/- 1.05 cmH2O (P less than 0.01), but airway elastance did not change significantly. Hypercapnia in seven animals was associated with a rise in elastance from 7.06 +/ 0.91 to 7.67 +/- 0.86 cmH2O/ml (P less than 0.001) and in reserve volume from 0.68 +/- 0.06 to 0.86 +/- 0.13 ml (P less than 0.05). Closing pressure also changed from -5.88 +/- 0.94 to -7.92 +/- 1.85 cmH2O. This change was correlated with the change in reserve volume but not with the change in elastance. In three animals exposed to hypercapnia, return to room air breathing was associated with return of elastance, reserve volume, and closing pressure to control levels. It is concluded that muscle activity in the upper airway affects both the size and elastance of the airway, but the dominant mechanism by which upper airway muscles increase the resistance of the upper airway to collapse is by increasing airway volume. PMID- 2708207 TI - Chemoreflex blunting of hypoxic pulmonary vasoconstriction is vagally mediated. AB - We investigated the role of the autonomic nervous system in the arterial chemoreceptor attenuation of hypoxic pulmonary vasoconstriction (HPV) using anesthetized dogs. Total pulmonary blood flow (Qt) and left pulmonary blood flow (Ql) were determined using electromagnetic flow probes. Carotid body chemoreceptors were perfused using blood pumped from an extracorporeal circuit containing an oxygenator. Four groups were used: 1) prevagotomy (control), 2) bilateral vagotomy, 3) post-atropine, and 4) post-propranolol. Left lung hypoxia decreased Ql/Qt from 42.9 +/- 2.9 to 28.1 +/- 3.0%, from 41.1 +/- 5.3 to 26.7 +/- 4.2%, from 38.6 +/- 1.3 to 22.2 +/- 2.4%, and from 48.2 +/- 4.2 to 28.5 +/- 3.7% in the four groups, respectively. Chemoreceptor stimulation during unilateral hypoxia increased Ql/Qt from 28.1 +/- 3.0 to 39.1 +/- 4.9% and from 28.5 +/- 3.7 to 40.6 +/- 3.7% in the control and propranolol groups. However, chemoreceptor stimulation had no effect on Ql/Qt during left lung hypoxia after vagotomy or atropine, as Ql/Qt went from 26.7 +/- 4.2 to 29.3 +/- 5.2% and from 22.2 +/- 2.4 to 24.1 +/- 1.5% in groups 2 and 3, respectively. Because chemoreceptor stimulation did not affect HPV in groups 2 and 3, we conclude that the chemoreceptor attenuation of HPV is mediated by the parasympathetic nervous system. PMID- 2708208 TI - Antigravity suit inflation: kidney function and cardiovascular and hormonal responses in men. AB - To investigate the effects of lower body positive pressure (LBPP) on kidney function while controlling certain cardiovascular and endocrine responses, seven men [35 +/- 2 (SE) yr] underwent 30 min of sitting and then 4.5 h of 70 degrees head-up tilt. An antigravity suit was applied (60 Torr legs, 30 Torr abdomen) during the last 3 h of tilt. A similar noninflation experiment was conducted where the suited subjects were tilted for 3.5 h. To provide adequate urine flow, the subjects were hydrated during the course of both experiments. Immediately after inflation, mean arterial pressure increased by 8 +/- 3 Torr and pulse rate decreased by 16 +/- 3 beats/min. Plasma renin activity and aldosterone were maximally suppressed (P less than 0.05) after 2.5 h of inflation. Plasma vasopressin decreased by 40-50% (P less than 0.05) and plasma sodium and potassium remained unchanged during both experiments. Glomerular filtration rate was not increased significantly by inflation, whereas inflation induced marked increases (P less than 0.05) in effective renal plasma flow (ERPF), urine flow, osmolar and free water clearances, and total and fractional sodium excretion. No such changes occurred during control. Thus, LBPP induces 1) a significant increase in ERPF and 2) significant changes in kidney excretory patterns similar to those observed during water immersion or the early phase of bed rest, situations that also result in central vascular volume expansion. PMID- 2708209 TI - Diastolic pressure determines autonomic responses to pressure perturbation in humans. AB - Arterial baroreceptors reflexly regulate sympathetic and heart rate responses to alteration of blood pressure. The primary mechanical determinant of arterial baroreceptor activity in humans remains unclear. We examined the influence of systolic, diastolic, pulse, and mean arterial pressures on efferent muscle sympathetic nerve activity (MSNA, microneurography) and heart rate responses during perturbation of arterial pressure in 10 normal human subjects [age 25 +/- 2 (SE) yr]. We directly measured arterial pressure, heart rate, and MSNA during intravenous vasodilator infusion (nitroprusside, 6 +/- 1 micrograms.kg-1.min-1, n = 6; or hydralazine, 16 +/- 2 mg, n = 4) while central venous pressure was held constant by simultaneous volume expansion. Changes in arterial pressures were compared with changes in heart rate and MSNA over 3-min periods of vasodilator infusion during which we observed increases in systolic and pulse pressures with simultaneous decreases in mean and diastolic pressures. During vasodilator infusion, there were increases in systolic (124.2 +/- 2.1 to 131.7 +/- 2.9 Torr, P less than 0.001) and pulse pressures (57.0 +/- 2.2 to 72.7 +/- 2.7 Torr, P less than 0.001) although mean arterial pressure fell (88.0 +/- 2.6 to 80.4 +/- 2.7 Torr, P less than 0.001) because of decreases in diastolic pressure (67.2 +/- 3.0 to 59.0 +/- 2.7 Torr, P less than 0.001). The changes in arterial pressures were accompanied by simultaneous increases in heart rate (66.4 +/- 3.0 to 92.6 +/- 4.8 beats/min, P less than 0.001) and MSNA (327 +/- 59 to 936 +/- 171 U, P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708210 TI - Validity of bioelectric impedance for body composition assessment in children. AB - Whole-body bioelectrical impedance analysis (BIA) was evaluated for its reliability and accuracy in estimating body composition in children. The hypothesis that the index, body height2 divided by resistance (RI), can accurately predict fat-free body mass (FFB) and percent fat (%FAT) in children was tested on 94 caucasian children 10-14 yr old. Criterion variables were FFB and %FAT estimated using multicomponent equations developed for children. BIA measurements (resistance and reactance) were found to be reliable. Prediction accuracy (standard error of the estimate, SEE) for FFB from RI alone was 2.6 kg and for %FAT from RI and body weight was 4.2%. For RI, anthropometric variables and reactance, the SEE improved to 1.9 kg FFB. For RI and anthropometric variables, the SEE was 3.3% FAT. For anthropometric variables alone, the SEE's were 2.1 kg FFB and 3.2% FAT. Adult FFB and %FAT prediction equations cross validated with this sample resulted in SEE's similar to those for adult samples. We conclude that RI together with anthropometry is a reliable and an acceptably accurate method of estimating FFB mass and %FAT in children. PMID- 2708211 TI - Effect of sleep and circadian cycle on sleep period energy expenditure. AB - Energy expenditure is lower during sleep than relaxed wakefulness. However, there is disagreement as to the particular metabolic changes that produce the difference. The present study assessed the contribution of sleep, circadian cycle, and the specific dynamic action effect of the evening meal to the sleep period fall in metabolic rate. Five subjects were tested for a total of nine nights under three conditions in a repeated-measures design. Subjects were confined to bed throughout their usual sleep period but were instructed to go to sleep 0, 3, or 6 h after their usual time for lights out. O2 consumption was measured in all conditions for the 0.5 h before and after each of the times for lights out and then throughout the sleep period after lights out. The results demonstrated that changes in energy expenditure during the sleep period are a function of both sleep and circadian cycle. In this study, the contribution of the two components was approximately equal. However, the effect of sleep was rapid asymptoting within 15 min of sleep onset, whereas that of circadian cycle was constant over the assessment period. PMID- 2708212 TI - Increased hemoglobin O2 affinity does not improve O2 consumption in hypoxemia. AB - We perfused an isolated rabbit hindlimb preparation with suspensions of human erythrocytes (RBC) having different O2 affinities. Our objective was to compare the effect of changes in P50, the PO2 at which hemoglobin is 50% saturated, on tissue O2 consumption during severe hypoxemia. A high-affinity (HA) group (n = 9) was perfused with RBC incubated in NaCNO (P50 = 21.4 +/- 1.9 Torr). This was compared with a low-affinity (LA) group (n = 9) perfused with rejuvenated RBC (P50 = 31.1 +/- 1.8 Torr). The arterial PO2 of the perfusate was decreased to approximately 24 Torr in both preparations. Perfusion flow and hemoglobin concentration were maintained constant. During hypoxemia arterial O2 saturation and total O2 transport (TO2) were greater in the HA than the LA group (P less than 0.05). O2 consumption and effluent venous PO2 decreased with hypoxemia in both groups to similar levels. Consequently, the LA group showed a greater O2 extraction ratio than the HA group (P less than 0.05). The ratio of phosphocreatine to inorganic phosphate, measured with 31P magnetic resonance spectroscopy, decreased at a comparable rate in both groups. As shown by a mathematical model of peripheral O2 transport, these experimental results can be explained on the basis of peripheral limitation to O2 diffusion. We conclude that increased hemoglobin affinity does not appreciably improve tissue oxygenation in hypoxemia, since the increase in TO2 is offset by diffusion limitation at the tissues. PMID- 2708213 TI - Regional pulmonary transit times in humans. AB - We measured the frequency distribution of erythrocyte (RBC) transit times in resected lobes of lungs in eight human subjects undergoing thoracotomy for peripheral lung tumors. RBC transit times were measured by the injection of radiolabeled blood flow and volume markers, which were counted in samples from the resected lung. In five of these subjects, the measurements from the resected lung were compared with preoperative measurements of the transit times of radiolabeled RBCs with a gamma camera-computer system. Time-activity curves from the cardiac chambers and the lung or its regions were obtained from which transit times were calculated by the centroid and deconvolution techniques. The reproducibility of transit times measured by this technique was assessed in another eight normal subjects, after sequential bolus injections of radiolabeled cells. The mean transit time of the upper lung region was longer (5.1 +/- 0.5 s) than that of the lower (4.1 +/- 0.6 s, P less than 0.05) in the preoperative study. Similarly, the mean transit time of the upper lung slice was longer (5.5 +/- 0.3 s) than that of the lower slice (3.8 +/- 0.3 s, P less than 0.05) in the resected lung specimens. We conclude that there was good agreement between these techniques and that there are long transit times in the upper regions of human lungs. PMID- 2708214 TI - Attenuation of hypoxic ventilation by hyperbaric O2: effects of pressure and exposure time. AB - Hyperoxia affects O2 chemoreception in the highly perfused carotid bodies and causes a reduction of the ventilatory hypoxic drive (HD) as was shown for anesthetized cats and awake rats. We looked for a quantitative description of such an effect on HD as a function of both O2 pressure and exposure duration. Ventilation of rats was measured using the barometric method before and after hyperbaric O2 (HBO) exposure, at either air, 80% O2, or 4% O2. We used three exposure durations: 180, 550 and 900 min. The O2 pressure ranged between 1.2 and 3.0 ATA. At each time duration we used four to five groups of rats at a range of O2 pressures that yielded the full scale of effect on HD but avoided obvious lasting difficulties in breathing. HBO caused a reduction of breathing frequency and elevation of tidal volume in both air and 80% O2 but almost no change in minute ventilation. Hypoxic minute ventilation (4% O2) decreased after HBO, mainly through reduced frequency. HD was described by a power function of O2 pressure for each HBO duration. HD did not decline below 20% of the full control response. Ventilatory HD diminution is pictured as a function of both O2 pressure and HBO duration. The dependency of HD on exposure time and on pressure is similar to other known toxic effects of HBO. PMID- 2708215 TI - Pulmonary and ventilatory responses to pregnancy, immersion, and exercise. AB - To examine the effects of pregnancy, immersion, and exercise during immersion on pulmonary function and ventilation, 12 women were studied at 15, 25, and 35 wk of pregnancy and 8-10 wk postpartum. Pulmonary function and ventilation were measured under three experimental conditions: after 20 min of rest on land (LR), after 20 min of rest during immersion to the level of the xiphoid (IR), and after 20 min of exercise during immersion at 60% of predicted maximal capacity (IE). Forced vital capacity remained relatively constant, except for a decrease at 15 wk, for the duration of pregnancy. Expiratory reserve volume decreased with a change in the pregnancy status and with the duration of pregnancy. However, the forced vital capacity was maintained by an increase in the inspiratory capacity during pregnancy. Forced expiratory volume for 1 s, expressed as percent of forced vital capacity, did not differ significantly between conditions or as a result of pregnancy. Forced vital capacity was lower during the IR trial compared with LR and IE trials. The decreased forced vital capacity of the IR trials was mediated by a decrease in the expiratory reserve volume. Whereas the inspiratory capacity increased during IR and IE compared with LR, the increase was not large enough to offset the decrease in the expiratory reserve volume. Resting immersion resulted in a significant decrease in maximal voluntary ventilation as did pregnancy. Pregnancy resulted in significant increases in minute ventilation (VE), which were related to increases in the O2 consumption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708216 TI - Effect of increased afterload on right ventricular function in newborn pigs. AB - The effect of a progressive increase in right ventricular (RV) afterload was studied in pigs less than 24 h (group I) and 3-5 days old (group III). RV load was applied to increase mean pulmonary arterial pressure (Ppa) until right to left shunt was observed. Initially, pigs in group I had a significantly lower systemic arterial pressure (Psa = 63 +/- 2 vs. 82 +/- 5 mmHg) and higher Ppa (30 +/- 1 vs. 23 +/- 2 mmHg) even though the RV stroke work (RVSW) was similar (54.3 +/- 10.8 vs. 32.4 +/- 2.1 mmHg/ml) to group II. After a progressive rise in afterload, pigs in group I could maintain a higher RV stroke volume than those in group II (1.3 +/- 0.3 vs. 0.4 +/- 0.1 ml; P less than 0.05). At shunt condition, the RVSW was increased by 21 +/- 14% of the initial value in group I vs. a 32 +/- 8% decrease in group II (P less than 0.05). The ductus arteriosus was constricted and right-to-left shunt was observed in all animals at the foramen ovale level even though Ppa exceeded Psa before the rise in the right atrial pressure in group I. Thus, as RV afterload is increased in the pig, the older animals' right ventricle is progressively less capable of maintaining pulmonary blood flow than animals within 24 h of birth. PMID- 2708217 TI - Diaphragm length adjustments with body position changes in the awake dog. AB - Sonomicrometry was used to measure end-expiratory length and tidal shortening of the costal and crural diaphragm in awake chronically instrumented dogs in the right lateral decubitus, standing, and sitting postures. End-expiratory length did not change significantly in standing but fell by 11.5% for the costal and by 14.4% for the crural segment in sitting, when compared with decubitus position. Tidal shortening of both segments did not change significantly in the three postures. From decubitus to sitting, diaphragmatic electromyogram (EMG) activity increased only in some dogs, not significantly for the group. The inspiratory swing of abdominal pressure was always positive in decubitus and negative in standing and sitting. In the latter two postures, abdominal pressure increased gradually during expiration and fell in inspiration, suggesting a phasic expiratory contraction of abdominal muscles. We conclude that diaphragmatic tidal shortening is maintained in the different postures assumed by the awake dog during resting breathing. It seems that the main compensatory mechanism for changes in diaphragmatic operational length is a phasic expiratory contraction of the abdominal muscles rather than an increase in diaphragmatic EMG activity. PMID- 2708218 TI - High-frequency oscillations within early and late phases of the phrenic neurogram. AB - Spectral analyses were performed on phrenic neurogram recordings from 18 cats to identify high-frequency oscillations (HFOs) inherent in the signals at different phases of inspiratory activity. Gating the analysis for the entire inspiratory phase resulted in dual spectral HFOs (27 and 83 Hz), both of which persisted when the analysis was repeated on the later phase of phrenic inspiratory activity alone (29 and 82 Hz). A third pass at the same data, gating for just the early phase of phrenic discharge, however, resulted in single spectral HFOs at the higher frequency only (86 Hz). Because both early and late recruited phrenic motoneurons carry both higher and lower spectral frequencies, these results demonstrate that the lower frequency HFO is distinctly delayed in onset compared with the higher frequency HFO, the latter of which is believed to have a brain stem origin. This delayed onset may be important in identifying the source of the lower frequency HFO, which appears to be specific to various respiratory efferent systems. PMID- 2708219 TI - Hyperoxia and moderate hypoxia fail to affect inspiratory muscle fatigue in humans. AB - Normal human subjects (n = 7) breathing 21% O2 (normoxia), 13% O2 (hypoxia), or 100% O2 (hyperoxia) performed repeated maximal inspiratory maneuvers (inspiratory duration = 1.5 s, total breath duration = 3.5 s) on an "isoflow" system, which delivered a constant mouth flow (1.25 or 1 l/s) while maintaining normocapnia (5.5% end-tidal CO2). Respective mean arterial O2 saturation values (ear lobe oximetry) were 98 +/- 1, 91 +/- 4 (P less than or equal to 0.01), and 99 +/- 1% (NS). Maximal mouth pressure (Pm) was measured during inspirations at rest and during a 10-min fatigue trial, and the Pm measurements obtained during the fatigue trials were fit to an exponential equation. The parameters of the equation included the time constant (tau), which describes the rate of decay of Pm from the initial pressure (Pi) to the asymptote, or "sustainable" pressure (Ps). The mean fraction of Pm remaining at the end of the fatigue trials (Ps/Pi) was 63 +/- 5%. No significant differences in Pi, Ps, or tau were observed between O2 treatments. This suggests that fatigue of the inspiratory muscles in normal humans occurs by a mechanism that is insensitive to changes in blood O2 content that occur during inspiration of O2 in the range of 13-100%. PMID- 2708220 TI - New evidence for active sodium transport from fluid-filled rat lungs. AB - The hypothesis that fluid reabsorption from the air spaces is mediated at least in part by active transport of Na+ was investigated in six sets of experiments conducted in isolated fluid-filled rat lungs. Fluid reabsorption was monitored by following the changes in the air space concentration of labeled albumin. We found that incorporation of bicarbonate rather than a nonvolatile buffer (N-2-hydroxy ethylpiperazine-N'-2-ethanesulfonic acid) in the air space solution more than doubled the rate of fluid reabsorption. Addition of 10(-4) M amiloride to the air space solution reduced the rate of fluid reabsorption over a 2-h experiment from 1.2 +/- 0.1 to 0.7 +/- 0.1 ml and decreased reabsorption of both labeled and unlabeled Na+ from the air spaces. To show that Na+ could be reabsorbed from the air spaces even if the concentrations of Na+ in the perfusate increased above those in the air space, mannitol (150 mM) was added to the perfusate and air space solutions and the concentrations of Na+ and Cl- were reduced to 90 and 60 mM, respectively. Mannitol diffuses across the pulmonary epithelium very slowly, and it osmotically restrained the movement of water out of the air spaces. Na+ concentrations in the perfusate increased by 10 +/- 2 mM, but concentrations in the air space remained unchanged. Despite an increasingly unfavorable concentration gradient for Na+, 0.2 mmol Na+ and 0.6 ml water were reabsorbed from the air spaces in 2 h. Ouabain (10(-4) M) did not appear to slow fluid reabsorption in the presence of mannitol, but it reduced K+ secretion into the air spaces and increased K+ appearance in the perfusate in a manner consistent with inhibition of Na+-K+-adenosinetriphosphatase at the basolateral surface of the epithelial cells. Fluid reabsorption was not altered when the lungs were exposed to a hypotonic solution (185 mM), but secretion of K+ into the air spaces was accelerated and K+ was lost from the perfusate. These experiments are consistent with active Na+ transport from the air spaces. PMID- 2708221 TI - Acute and chronic hypoxic pulmonary hypertension in guinea pigs. AB - To determine whether the strength of acute hypoxic vasoconstriction predicts the magnitude of chronic hypoxic pulmonary hypertension, we performed serial studies on guinea pigs. Unanesthetized, chronically catheterized guinea pigs increased mean pulmonary arterial pressure (PAP) from 11 +/- 0.5 to 13 +/- 0.7 Torr in acute hypoxia (10% O2 for 65 min). The response was maximal at 5 min, remained stable for 1 h, and was reversible on return to room air. Cardiac index did not change with acute hypoxia or recovery. Guinea pigs exposed to chronic hypoxia increased PAP, measured in room air 1 h after removal from the hypoxic chamber, to 18 +/- 1 Torr by 5 days with little further increase in PAP to 20 +/- 1 Torr after 21 days. Cardiac index fell from 273 +/- 12 to 206 +/- 7 ml.kg-1.min-1 (P less than 0.05) after 21 days of hypoxia. Medial thickness of pulmonary arteries adjacent to terminal bronchioles and alveolar ducts increased significantly by 10 days. The magnitude of the pulmonary vasoconstriction to acute hypoxia persisted and was unabated during the development and apparent stabilization of chronic hypoxic pulmonary hypertension, suggesting that if vasoconstriction is the stimulus for remodeling, then the importance of the stimulus lessens with duration of hypoxia. In individual animals followed serially, we found no correlation between the magnitude of the acute vasoconstrictor response before chronic hypoxia and the severity of chronic pulmonary hypertension that subsequently developed either because the initial response was small and variable or because vasoconstriction may not be the sole stimulus for vascular remodeling in the guinea pig. PMID- 2708222 TI - Relationship between respiratory muscle function and age, sex, and other factors. AB - To investigate the effects of gender and age on respiratory muscle function, 160 healthy volunteers (80 males, 80 females) were divided into four age groups. Twenty-eight of the male subjects were smokers. After the subjects were familiarized with the experimental procedure, respiratory muscle strength, inspiratory muscle endurance, and spirometric function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, tidal volume, breathing rate, and duty cycle, were measured. The respiratory muscle strength was indicated by the maximal static inspiratory and expiratory pressures (PImmax and PEmmax). Inspiratory muscle endurance was determined by the time the subject was able to sustain breathing against an inspiratory pressure load on a modified Nickerson-Keens device. The results showed that 1) except for inspiratory muscle endurance and FEV1/FVC, men had greater respiratory muscle and pulmonary functions than women, 2) respiratory muscle function and pulmonary function decreased with age, 3) smoking tended to lower duty cycle and FEV1/FVC and to enhance PE,mmax, and 4) inspiratory muscle endurance was greater in men who were physically active than in those who were sedentary. Therefore we conclude that there are sexual and age differences in respiratory muscle strength and pulmonary function and that smoking or physical activity may affect respiratory muscle function. PMID- 2708223 TI - Physiological factors associated with the lower maximal oxygen consumption of master runners. AB - We examined the hemodynamic factors associated with the lower maximal O2 consumption (VO2max) in older formerly elite distance runners. Heart rate and VO2 were measured during submaximal and maximal treadmill exercise in 11 master [66 +/- 8 (SD) yr] and 11 young (32 +/- 5 yr) male runners. Cardiac output was determined using acetylene rebreathing at 30, 50, 70, and 85% VO2max. Maximal cardiac output was estimated using submaximal stroke volume and maximal heart rate. VO2max was 36% lower in master runners (45.0 +/- 6.9 vs. 70.4 +/- 8.0 ml.kg 1.min-1, P less than or equal to 0.05), because of both a lower maximal cardiac output (18.2 +/- 3.5 vs. 25.4 +/- 1.7 l.min-1) and arteriovenous O2 difference (16.6 +/- 1.6 vs. 18.7 +/- 1.4 ml O2.100 ml blood-1, P less than or equal to 0.05). Reduced maximal heart rate (154.4 +/- 17.4 vs. 185 +/- 5.8 beats.min-1) and stroke volume (117.1 +/- 16.1 vs. 137.2 +/- 8.7 ml.beat-1) contributed to the lower cardiac output in the older athletes (P less than or equal 0.05). These data indicate that VO2max is lower in master runners because of a diminished capacity to deliver and extract O2 during exercise. PMID- 2708224 TI - Elastic characteristics of the airway wall. AB - To examine the elastic behavior of the upper airway, we obtained pressure-area plots from data gathered from acoustic images of the airway and measurements of mouth pressure during tidal breathing in 10 adult human volunteers (dA/dP). These plots revealed both tidal hysteresis and a change in slope as a function of distance along the airway. The slope of the regression line of the dA/dP plots decreased from the pharyngeal region to the trachea and became 0 at the thoracic inlet, the location of which was independently assessed. In most subjects the slope became negative distal to the thoracic inlet. Correlation coefficients between pressure and area approached 1 in the pharyngeal region and 0 at the thoracic inlet. When subjects breathed against a small resistive load (10 cmH2O.1(-1).s) pharyngeal, extrathoracic, and intrathoracic pressure-area plots were exaggerated but the slope at the thoracic inlet was unchanged. We conclude that this pressure-area characteristic defines regional differences in upper airway elasticity and delineates the transition point between the intra- and extrathoracic airways. PMID- 2708225 TI - Effects of tension, duty cycle, and arterial pressure on diaphragmatic blood flow in dogs. AB - We investigated the selective effects of changes in transdiaphragmatic pressure (Pdi) and duty cycle on diaphragmatic blood flow in supine dogs at normal arterial pressure (N), moderate hypotension (MH), and severe hypotension (SH) [mean arterial pressure (Part) of 116, 75, and 50 mmHg, respectively]. The diaphragm was paced at a rate of 12/min by bilateral phrenic nerve stimulation. Left phrenic (Qphr-T) and left internal mammary (Qim-T) arterial flows were measured by electromagnetic flow probes. Changes in Pdi and duty cycle were achieved by changing the stimulation frequencies and the duration of contraction, whereas Part changes were produced by bleeding. With N and at a duty cycle of 0.5, incremental increases in Pdi produced peaks in Qphr-T and Qim-T at 30% maximum diaphragmatic pressure (Pdimax) with a gradual decline at higher Pdi. With MH and SH, blood flow peaked at 10% Pdimax. At any given Pdi, blood flow was lower with MH and SH in comparison to N. The effect of duty cycle was tested at two levels of Pdi. With N and at low Pdi (25% Pdimax), blood flow rose progressively with increases in duty cycle, whereas at moderate Pdi level (50% Pdimax) blood flow peaked at a duty cycle of 0.3, with no increase thereafter. With MH, blood flow at low Pdi rose linearly with increasing duty cycle but to a lesser extent than with N, and at a moderate Pdi flow peaked at a duty cycle of 0.3. With SH, blood flow at low and moderate Pdi was limited at duty cycles greater than 0.3 and 0.1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708226 TI - Intracellular recordings of respiratory neurons in the lateral medulla of piglets. AB - Membrane potentials of respiratory neurons in the ventral respiratory group were recorded using intracellular techniques in the medulla of newborn piglets. Three types of neurons were demonstrated: inspiratory neurons with an augmenting pattern of spike activity during inspiration; postinspiratory neurons with a short decrementing firing pattern that started immediately after inspiration ended; and stage II expiratory neurons with an augmenting spiking pattern that began shortly after inspiratory termination and ended before onset of the next inspiration. When not firing, the membrane potential trajectories of each cell type revealed two complementary patterns of relative inhibition. This latter finding suggests arrival of inhibitory synaptic potentials during these periods. These findings suggest that the respiratory control mechanisms of the newborn piglet are organized in a three-phased manner similar to that of adult cats. PMID- 2708227 TI - Pitfalls of venous occlusion method for determination of capillary pressure in humans. AB - We tested the method of estimating capillary pressure from venous pressure transients obtained after sudden venous clamping in a hydrodynamic model. The basic principles were confirmed in the model, but it was found that when occlusion was caused over a relatively wide distance or in a predistended vessel, capillary pressure was overrated. This problem was due to volume backflow from the occlusion site, since it could be eliminated by placing a one-way valve upstream from the occlusion site. Upstream from the valve, the venous pressure transient accurately followed capillary pressure. Downstream, however, the reading of capillary pressure was impaired by the backflow volume squeezed between valve and occlusion clamp, which caused an immediate large pressure elevation. We also tested the method recently advanced to estimate capillary pressure in humans from venous pressure curves obtained after rapid venous occlusion with an air-filled compression cuff. With the cuff around the upper arm, venous pressure was recorded at different levels along the forearm. The tracings obtained from the dorsum of the hand and halfway along the forearm did not show the initial rapid upstrokes that might indicate the capillary pressure. Tracings obtained slightly below or above the cubital fossa were similar to those seen downstream from the one-way valve in the model. Extrapolation to zero-time, using the distally recorded curves as a template, yielded values equal to venous pressure. We conclude that although the problem of backflow can be circumvented by pressure recording distal from venous valves, the method of venous occlusion by a circular upper-arm cuff may not be appropriate to estimate capillary pressure in humans. PMID- 2708228 TI - Modulation of endothelial GSH concentrations: effect of exogenous GSH and GSH monoethyl ester. AB - We studied the effects of exogenous glutathione (GSH) and GSH monoethyl ester (GSH-MEE) on the enhancement of endothelial GSH concentrations. The preparation of GSH-MEE used contained 91% GSH-MEE, approximately 9% GSH diethyl ester (GSH DEE) and a trace amount of GSH. Both GSH and GSH-MEE markedly stimulated the intracellular concentrations of GSH in endothelial cells. GSH-MEE was more potent than GSH. The enhancement of endothelial GSH concentration by exogenous GSH was completely inhibited by buthionine sulfoximine (BSO), a potent inhibitor of gamma glutamylcysteine synthase, or acivicin (AT-125), an inhibitor of gamma-glutamyl transpeptidase, suggesting that it was due to the extracellular breakdown and subsequent intracellular resynthesis of GSH. In contrast, the effect of GSH-MEE was largely resistant to BSO and acivicin, suggesting that it was primarily due to transport of GSH-MEE followed by intracellular hydrolysis. The GSH-MEE preparation, which contained 9% GSH-DEE, at concentrations of 2 mM or higher caused vacuolization of endothelial cells. The enhancement of GSH concentrations by exogenous GSH, but not by GSH-MEE, protected endothelial cells against H2O2 induced injury. PMID- 2708229 TI - Methylene blue potentiates vascular reactivity in isolated rat lungs. AB - A bolus injection of methylene blue (1 mg), a guanylate cyclase inhibitor, or aspirin (3 mg) in the isolated rat lung preparation had little or no effect on resting perfusion pressure under normoxic condition. In contrast, methylene blue markedly potentiated hypoxic vasopressor response (4-fold) when injected before or during the alveolar hypoxic stimulation. Hemoglobin also potentiated the hypoxic pressor response. Similarly, methylene blue or aspirin augmented the pressor responses to angiotensin II (0.1-1 microgram). The increased hypoxic response induced by methylene blue was immediate and sustained. Methylene blue, when added during hypoxia in the presence of aspirin, further augmented the response to hypoxia compared with the enhanced hypoxic response observed with aspirin alone. Our results suggest that, in addition to the role of cyclooxygenase products, the pulmonary vascular bed may be regulated by endothelium-dependent factors that can be antagonized directly or indirectly by methylene blue. PMID- 2708230 TI - Influence of body temperature on histamine-induced bronchoconstriction in guinea pigs. AB - The effects of body temperature on histamine-induced bronchoconstriction were investigated in anesthetized, paralyzed, and mechanically ventilated guinea pigs. Four groups of guinea pigs were studied with constant body temperatures of 40, 38, 35, and 32 degrees C, respectively. Histamine was infused for 5 min at a rate of 50 ng.kg-1.s-1. Body cooling from 40 to 32 degrees C augmented the bronchomotor responses to histamine, which eventually rose almost fourfold. The enhancement of histamine-induced bronchoconstriction induced by body cooling was not suppressed by pretreating guinea pigs with 5 mg/kg hexamethonium or 5 mg/kg hexamethonium plus 3 mg/kg atropine; neither was the enhancement of histamine induced bronchoconstriction suppressed in pithed guinea pigs, demonstrating that the autonomic nervous system is not involved in potentiating bronchoconstriction at low body temperatures. These results suggest that, at low body temperatures, increased airway responsiveness to histamine may be because of some direct effect of temperature on bronchial airway smooth muscle. PMID- 2708231 TI - Effect of inhaled endotoxin on bronchial reactivity in asthmatic and normal subjects. AB - Endotoxins are released from the membrane of Gram-negative bacteria present in the environment and in oral and nasal cavities. They are proinflammatory substances that could participate in bronchial obstruction and hyperreactivity in asthmatic patients. This hypothesis was tested by using bronchial challenge tests with inhaled lipopolysaccharides (LPS) from Escherichia coli 026:B6 (22.2 micrograms total dose) followed by a histamine nonspecific challenge test and compared with a placebo procedure, in which the diluent was substituted for the LPS solution. In doing so we showed that LPS induces a slight but significant (P less than 0.01) bronchial obstruction (measured as forced expiratory volume in 1 s) in asthmatics (n = 8) but not in normal subjects (n = 6). The histamine hyperresponsiveness, expressed as the dosage of histamine necessary to decrease the bronchial specific conductance by 50%, was increased 5 h after LPS inhalation in asthmatics (P less than 0.05) but not in normal subjects. This effect of LPS on bronchial obstruction and hyperresponsiveness was observed in extrinsic (n = 6) as well as in intrinsic (n = 2) asthma. PMID- 2708232 TI - Taurine uptake by isolated alveolar macrophages and type II cells. AB - Evidence suggests that taurine may protect cellular membranes against oxidants (Gordon et al., Am. J. Pathol. 125: 585-600, 1986). The present study was conducted to determine if alveolar macrophages and type II cells (which are relatively resistant to oxidant injury) possess a specialized transport system for the accumulation of taurine. The results indicate that both cell types contain more taurine than plasma or whole lung. Taurine influx exhibited both carrier-mediated and simple diffusion components. Carrier-mediated uptake displayed saturation kinetics (Km = 26.3 and 22.5 microM, while Vmax = 33.2 and 4.9 pmol.10(6) cells-1.min-1 for macrophages and type II cells, respectively). Taurine uptake was dependent on extracellular sodium and inhibited by metabolic inhibitors or ouabain. Total taurine uptake by type II cells was lower than that of alveolar macrophages. However, type II cells exhibited a higher intercellular concentration of taurine (14 vs. 4 mM) because of a higher ratio of carrier mediated uptake to leakage than with alveolar macrophages. It is possible that this specialized transport system for taurine uptake may lend these cells resistant to oxidant injury. PMID- 2708233 TI - Transcriptional regulation of decreased protein synthesis during skeletal muscle unloading. AB - Muscle atrophy resulting from disuse is associated with marked decrements in protein synthesis. The objective of the present investigation was to determine levels of total muscle RNA and the content and composition of the mRNA fraction as a qualitative assessment of the potential regulatory role of transcriptional alterations in unloaded skeletal muscles. Hindlimb muscle unloading was produced by whole-body suspension of rats for up to 7 days. The soleus, gastrocnemius, and extensor digitorum longus (EDL) were excised from 1-, 3-, and 7-day suspended and pair-fed controls, and RNA was extracted by homogenization in 5 M guanidinium thiocyanate. Total RNA and mRNA contents were lower in soleus and gastrocnemius after 7 days of suspension compared with pair-fed controls, but total RNA and mRNA concentrations (per g muscle and per microgram total RNA, respectively) were unaltered. alpha-Actin mRNA, assessed by dot blot hybridization, was significantly reduced in soleus after 1 (37%), 3 (28%), and 7 (59%) days of suspension and in gastrocnemius after 3 (44%) and 7 (41%) days. However, alpha actin mRNA was unchanged in the EDL after suspension. Protein synthesis directed by RNA extracted from soleus and EDL indicated marked (30-400%) alterations in mRNAs coding for several small (15- to 25-kDa) proteins. The results of this study suggest that altered transcription and availability of specific mRNAs could contribute significantly to the regulation of protein synthesis during unloading of skeletal muscle. PMID- 2708234 TI - Cardiac triacylglycerol content and lipase activity during recovery from exercise. AB - Female rats swam for 2-h to determine the temporal relationship between triglyceride (TG) repletion and TG lipase activity in the heart during recovery from exercise. Immediately after the exercise, plasma free fatty acids (FFA) had increased from a resting value of 0.44 +/- 0.04 to 0.84 +/- 0.04 mM. Heart TG concentration was reduced 75%, whereas the glycogen level was decreased 34% below control. TG lipase activity was elevated 33% above control activity. One hour after the end of the exercise, lipolytic activity was still 26% above control and did not return to the resting level until the 4th h of recovery. The cardiac TG concentration was back to control levels by the 2nd h after the swim. Plasma FFA concentrations remained elevated during the first 4 h of recovery and were back to the control level by h 8. Cardiac glycogen was "supercompensated" during recovery h 1 and 2 and returned to the preexercise level by h 4. These data indicate that TG is being synthesized in the heart while lipolytic enzyme activity is elevated above control levels. This points out that the rate of TG synthesis is in excess of the hydrolysis. Since plasma FFA concentrations are elevated during periods of augmented TG synthesis, substrate availability, namely plasma FFA, may play a key role in regulating the size of the intracellular TG pool. PMID- 2708235 TI - Continuous increase in blood lactate concentration during different ramp exercise protocols. AB - The applicability of a continuous model description of the blood lactate concentration [( La-]) vs. O2 uptake (VO2) relationship was studied in nine healthy male volunteers during three different ramp exercise protocols. The work rate was increased at either 8, 15, or 50 W/min. The continuous model for [La-] = a + b exp(cVO2) was compared statistically with a previously proposed log-log transformation model for the [La-] and VO2 variables. It was found that the mean square error was significantly less for the continuous as opposed to the log-log model (P less than 0.01) by analysis of variance pooled across all three ramp slopes. The mean square errors from the individual ramp slopes were also significantly less for the continuous model by paired t test (P less than 0.05). It was observed that the major contributor to the increased error of the log-log model was at VO2's at or above the intersection point (lactate threshold) of the two linear log-transformed segments. The log-log transformation does not appear to relate to any physiological process. The lactate slope index, taken as the point where the slope of the relationship between [La-] and VO2 (i.e., d[La ]/dVO2) equaled 1, occurred at a mean VO2 of 2.25 and 2.37 l/min for the 15- and 8-W/min ramp slopes, respectively, but at 2.76 l/min for the 50-W/min ramp (P less than 0.05). It is concluded that [La-] increases as a continuous function with respect to VO2 across a wide range of ramp work rate slopes. PMID- 2708236 TI - Response of normal subjects to inspiratory resistive unloading. AB - The purpose of this study was to examine the role of the normal inspiratory resistive load in the regulation of respiratory motor output in resting conscious humans. We used a recently described device (J. Appl. Physiol. 62: 2491-2499, 1987) to make mouth pressure during inspiration positive and proportional to inspiratory flow, thus causing inspiratory resistive unloading (IRUL); the magnitude of IRUL (delta R = -3.0 cmH2O.1(-1).s) was set so as to unload most (approximately 86% of the normal inspiratory resistance. Six conscious normal humans were studied. Driving pressure (DP) was calculated according to the method of Younes et al. (J. Appl. Physiol. 51: 963-1001, 1981), which provides the equivalent of occlusion pressure at functional residual capacity throughout the breath. IRUL resulted in small but significant changes in minute ventilation (0.6 1/min) and in end-tidal CO2 concentration (-0.11%) with no significant change in tidal volume or respiratory frequency. There was a significant shortening of the duration (neural inspiratory time) of the rising phase of the DP waveform and the shape of the rising phase became more convex to the time axis. There was no change in the average rate of rise of DP or in the duration or shape of the declining phase. We conclude that 1) the normal inspiratory resistance is an important determinant of the duration and shape of the rising phase of DP and 2) the neural responses elicited by the normal inspiratory resistance are similar to those observed with added inspiratory resistive loads. PMID- 2708237 TI - Corticosteroids decrease airway hyperresponsiveness in the Basenji-Greyhound dog model of asthma. AB - Methacholine and citric acid responses were assessed before, during, and after 6 wk of oral treatment with either placebo or methylprednisolone (2 mg.kg-1.day-1) in 12 Basenji-Greyhound dogs. Bronchoalveolar lavage was performed in three dogs in each group before, during, and after pretreatment. Base-line airway resistance and dynamic compliance did not change with treatment in any of the groups. Placebo treatment had no demonstrable effect on methacholine and citric acid responsiveness. Methylprednisolone treatment abolished the constrictor response to citric acid during the 4th and 6th wk of treatment and significantly reduced methacholine responsiveness during the 3rd and 5th wk of treatment. Methylprednisolone treatment was associated with a marked reduction in the percent of eosinophils, but not mast cells, in the bronchoalveolar lavage fluid during the 7th wk. Blood eosinophil counts were also markedly reduced in the methylprednisolone-treated group compared with the placebo-treated group during the 7th wk. The decrease in numbers of eosinophils in blood and bronchoalveolar lavage fluid suggests interference with the inflammatory process as a possible mechanism for the observed reduction in airway hyperresponsiveness in the Basenji Greyhound dog. PMID- 2708238 TI - Critical pressures required for generation of forced expiratory wheezes. AB - Flow limitation (FL) has recently been shown to be a necessary condition for the generation of forced expiratory wheezes (FEW) in normal subjects. The present study was designed to investigate whether it is also a sufficient condition. To do so we studied the effects of varying expiratory effort on generation of FEW. Six normal subjects exhaled with varying force into an orifice in line with a high-impedance suction pump. Esophageal (Pes), airway opening, and transpulmonary (Ptp) pressures were measured alongside flow rate, lung volume, and tracheal lung sounds. In each subject a certain critical degree of effort had to be attained before FEW were generated. This effort, measured as Pes at the onset of wheezes, varied among the subjects (range -11 to 45 cmH2O). Similarly, a minimal Ptp had to be reached for FEW to evolve (mean +/- SD -34 +/- 12 cmH2O, range -18 to -50 cmH2O). These critical Pes and Ptp values were significantly higher than those required for FL. It was concluded that, in addition to the requirement for FL, sufficient levels of effort and negative Ptp must exist before FEW can be generated. By analogy to experimental and theoretical results from studies on flow-induced oscillations in self-supporting collapsible tubes, it was further concluded that these pressures are required to induce flattening of the intrathoracic airways downstream from the choke point. It is this configurational change that causes air speed to become equal to or exceed the critical gas velocity needed to induce oscillations in soft-walled tubes. PMID- 2708239 TI - Muscle plasticity: comparison of a 30-Hz burst with 10-Hz continuous stimulation. AB - The changes in the contractile properties induced by a 30-Hz phasic stimulation paradigm were measured and compared with the changes induced by a 10-Hz continuous stimulation paradigm. The study was performed on the tibialis anterior muscles of cats with one paradigm applied to one hindlimb muscle and the other to the contralateral limb. Both hindlimb muscles received the same number of stimuli in a day, making the average stimulation frequency 10 Hz. Two periods of daily stimulation were studied, 8 and 24 h/day. Muscles stimulated at 30 Hz produced greater overall tetanic tension and, during a prolonged stimulation test, exerted a greater mean tension than muscles stimulated at 10 Hz (50 and 32% increase for animals stimulated for 8 and 24 h/day, respectively). Muscle mass was least reduced and fewer pathological abnormalities were observed in the muscles stimulated at 30 Hz. There were no apparent differences in the histochemistry or biochemistry between muscles stimulated at 10 and 30 Hz, which could account for these differences in muscle properties. These results indicate the 30-Hz paradigm may be better suited than 10 Hz continuous stimulation for applications requiring sustained muscle tension such as correction of scoliosis or muscle conditioning for motor prostheses. PMID- 2708240 TI - Blunted hypoxic ventilatory drive in subjects susceptible to high-altitude pulmonary edema. AB - It has been proposed that subjects susceptible to high-altitude pulmonary edema (HAPE) show exaggerated hypoxemia with relative hypoventilation during the early period of high-altitude exposure. Some previous studies suggest the relationship between the blunted hypoxic ventilatory response (HVR) and HAPE. To examine whether all the HAPE-susceptible subjects consistently show blunted HVR at low altitude, we evaluated the conventional pulmonary function test, hypoxic ventilatory response (HVR), and hypercapnic ventilatory response (HCVR) in ten lowlanders who had a previous history of HAPE and compared these results with those of eight control lowlanders who had no history of HAPE. HVR was measured by the progressive isocapnic hypoxic method and was evaluated by the slope relating minute ventilation to arterial O2 saturation (delta VE/delta SaO2). HCVR was measured by the rebreathing method of Read. All measurements were done at Matsumoto, Japan (610 m). All the HAPE-susceptible subjects showed normal values in the pulmonary function test. In HCVR, HAPE-susceptible subjects showed relatively lower S value, but there was no significant difference between the two groups (1.74 +/- 1.16 vs. 2.19 +/- 0.4, P = NS). On the other hand, HAPE susceptible subjects showed significantly lower HVR than control subjects (-0.42 +/- 0.23 vs. -0.87 +/- 0.29, P less than 0.01). These results suggest that HAPE susceptible subjects more frequently show low HVR at low altitude. However, values for HVR were within the normal range in 2 of 10 HAPE-susceptible subjects. It would seem therefore that low HVR alone need not be a critical factor for HAPE. This could be one of several contributing factors. PMID- 2708241 TI - Effects of sleep deprivation on respiratory events during sleep in healthy infants. AB - This study was designed to determine the effects of sleep deprivation on respiratory events during sleep in healthy infants. Ten unsedated full-term infants (1-6 mo) were monitored polygraphically during "afternoon naps" on a control day and on the day after sleep deprivation. Respiratory events, i.e., central apnea, obstructive apnea and hypopnea, and periodic breathing were tabulated. Results for respiratory events were expressed as 1) indexes of the total number of respiratory events and of specific respiratory events per hour of total sleep (TST), "quiet" sleep (QS) and "active" sleep (AS) times; 2) total duration of total and specific respiratory events, expressed as a percentage of TST, QS, and AS times. After sleep deprivation, significant increases were observed for 1) respiratory event (P less than 0.001), central apnea (P less than 0.05), and obstructive respiratory event (P less than 0.01) indexes; 2) respiratory event time as a percentage of TST (P less than 0.002) and as a percentage of AS time (P less than 0.001); 3) obstructive respiratory event time as a percentage of TST (P less than 0.01), QS (P less than 0.05), and AS times (P less than 0.002). The present study shows that short-term sleep deprivation in healthy infants increases the number and timing of respiratory events, especially obstructive events in AS. PMID- 2708242 TI - Pharyngeal fluid clearance and aspiration preventive mechanisms in sleeping infants. AB - We sought to characterize ventilatory and airway protective responses to pharyngeal stimulation in young infants during sleep. We studied the various responses with respect to frequency of occurrence, effect of increased stimulus intensity, and relation of stimulus fluid to laryngeal structures. Two groups of infants were studied: healthy full-term infants (n = 5) and preterm infants with a history of prolonged apnea (n = 9). We used a nasopharyngeal catheter to deliver small boluses of warm saline (0.02-0.35 ml) to the oropharynx. Responses repeatedly observed in both infant groups included swallows, obstructed respiratory efforts, brief apnea, prolonged apnea, and cough. In both infant groups, swallows and obstructed breaths occurred frequently and cough and prolonged apnea infrequently. The functional significance of some response patterns was clear, whereas that of others was obscure. Larger stimulus volumes yielded more frequent responses (P less than 0.01), and preterm infants responded much more frequently than full-term infants (P less than 0.01). Prolonged apnea was a composite of the other responses and was much more common in preterm than full-term infants (P less than 0.01). The stimulus technique was performed under direct visualization of the airway in two deceased infants. The findings suggested that the relation of the piriform fossae to the interarytenoid notch is important in determining response frequency. Implications for regulation of the removal of upper airway secretions during sleep are discussed. PMID- 2708243 TI - Chest wall motion during spontaneous breathing and mechanical ventilation in dogs. AB - We measured the volume change of the thoracic cavity (delta Vth) and the volumes displaced by the diaphragm (delta Vdi) and rib cage (delta Vrc) in six pentobarbital-anesthetized dogs lying supine. A high-speed X-ray scanner (dynamic spatial reconstructor) provided three-dimensional images of the thorax during spontaneous breathing and during mechanical ventilation with paralysis. Tidal volume (VT) was measured by integrating gas flow. Changes in thoracic liquid volume (delta Vliq, presumably caused by changes in thoracic blood volume) were calculated as delta Vth - VT. Absolute volume displaced by the rib cage was not significantly different during the two modes of ventilation. During spontaneous breathing, thoracic blood volume increased during inspiration; delta Vliq was 12.3 +/- 4.1% of delta Vth. During mechanical ventilation, delta Vliq was nearly zero. Configuration of the relaxed chest wall was similar during muscular relaxation induced by either pharmacological paralysis or hyperventilation. Expiratory muscle activity produced 50 +/- 11% of the delta Vth during spontaneous breathing. We conclude that at constant VT the volume displaced by the rib cage is remarkably similar during the transition from spontaneous breathing to mechanical ventilation, while both diaphragmatic volume displacement and changes in intrathoracic blood volume decrease by a similar amount. PMID- 2708244 TI - Partitioning of pulmonary resistance in dogs: effect of tidal volume and frequency. AB - To determine the sensitivity of pulmonary resistance (RL) to changes in breathing frequency and tidal volume, we measured RL in intact anesthetized dogs over a range of breathing frequencies and tidal volumes centering around those encountered during quiet breathing. To investigate mechanisms responsible for changes in RL, the relative contribution of airway resistance (Raw) and tissue resistance (Rti) to RL at similar breathing frequencies and tidal volumes was studied in six excised, exsanguinated canine left lungs. Lung volume was sinusoidally varied, with tidal volumes of 10, 20, and 40% of vital capacity. Pressures were measured at three alveolar sites (PA) with alveolar capsules and at the airway opening (Pao). Measurements were made during oscillation at five frequencies between 5 and 45 min-1 at each tidal volume. Resistances were calculated by assuming a linear equation of motion and submitting lung volume, flow, Pao, and PA to a multiple linear regression. RL decreased with increasing frequency and decreased with increasing tidal volume in both isolated and intact lungs. In isolated lungs, Rti decreased with increasing frequency but was independent of tidal volume. Raw was independent of frequency but decreased with tidal volume. The contribution of Rti to RL ranged from 93 +/- 4% (SD) with low frequency and large tidal volume to 41 +/- 24% at high frequency and small tidal volume. We conclude that the RL is highly dependent on breathing frequency and less dependent on tidal volume during conditions similar to quiet breathing and that these findings are explained by changes in the relative contributions of Raw and Rti to RL. PMID- 2708245 TI - Regional mapping of gas transport during high-frequency and conventional ventilation. AB - The effects of changing tidal volume (VT) and frequency (f) on the distribution of ventilation during high-frequency ventilation (HFV) were assessed from the washout of nitrogen-13 by positron emission tomography. Six dogs, anesthetized and paralyzed, were studied in the supine position during conventional ventilation (CV) and during HFV at f of 3, 6, and 9 Hz. In CV and HFV at 6 Hz, VT was selected to achieve eucapnic arterial partial pressure of CO2 (37 +/- 3 Torr). At 3 and 9 Hz, VT was proportionally changed so that the product of VT and f remained constant and equal to that at 6 Hz. Mean residence time (MRT) of nitrogen-13 during washout was calculated for apical, midheart, and basal transverse sections of the lung and further analyzed for gravity-dependent, cephalocaudal and radial gradients. An index of local alveolar ventilation per unit of lung volume, or specific ventilation (spV), was calculated as the reciprocal of MRT. During CV vertical gradients of regional spV were seen in all sections with ventral (nondependent) regions less ventilated than dorsal (dependent) regions. Regional nonuniformity in gas transport was greatest for HFV at 3 and 6 Hz and lowest at 9 Hz and during CV. During HFV, a central region at the base of the lungs was preferentially ventilated, resulting in a regional time averaged tracer concentration equivalent to that of the main bronchi. Because the main bronchi were certainly receiving fresh gas, the presence of this preferentially ventilated area, whose ventilation increased with VT, strongly supports the hypothesis that direct convection of fresh gas is an important mechanism of gas transport during eucapnic HFV. Aside from the local effect of increasing overall lung ventilation, this central area probably served as an intermediate shuttle station for the transport of gas between mouth and deeper alveoli when VT was less than the anatomic dead space. PMID- 2708246 TI - Dissociation of maximal O2 uptake from O2 delivery in canine gastrocnemius in situ. AB - To test the hypothesis that maximal O2 uptake (VO2max) can be limited by O2 diffusion in the peripheral tissue, we kept O2 delivery [blood flow X arterial O2 content (CaO2)] to maximally contracting muscle equal between 1) low flow-high CaO2 and 2) high flow-low CaO2 conditions. The hypothesis predicts, because of differences in the capillary PO2 profile, that the former condition will result in both a higher VO2max and muscle effluent venous PO2 (PVO2). We studied the relations among VO2max, PVO2, and O2 delivery during maximal isometric contractions in isolated, in situ dog gastrocnemius muscle (n = 6) during these two conditions. O2 delivery was matched by varying arterial O2 partial pressure and adjusting flow to the muscle accordingly. A total of 18 matched O2 delivery pairs were obtained. As planned, O2 delivery was not significantly different between the two treatments. In contrast, VO2max was significantly higher [10.4 +/ 0.5 (SE) ml.100 g-1.min-1; P = 0.01], as was PVO2 (25 +/- 1 Torr; P less than 0.01) in the low flow-high CaO2 treatment compared with the high flow-low CaO2 treatment (9.1 +/- 0.4 ml.100 g-1.min-1 and 20 +/- 1 Torr, respectively). The rate of fatigue was greater in the high flow-low CaO2 condition, as was lactate output from the muscle and muscle lactate concentration. The results of this study show that VO2max is not uniquely dependent on O2 delivery and support the hypothesis that VO2max can be limited by peripheral tissue O2 diffusion. PMID- 2708247 TI - Baroreflex control of the rat tail circulation in normothermia and hyperthermia. AB - The role of thermoregulatory background in the baroreceptor reflex control of the tail circulation was investigated 1) in anesthetized rats with a constant flow technique and 2) in conscious rats by measuring tail blood flow (venous occlusion plethysmography). In series I, during normothermia, systemic intravenous phenylephrine infusion increased mean arterial pressure (MAP) by 61.0 +/- 3.6 mmHg and induced a reflex decrease in tail perfusion pressure (TPP) from 105.0 +/ 6.3 to 84.2 +/- 4.4 mmHg (P less than 0.005). Hyperthermia decreased TPP to 66.5 +/- 5.1 mmHg (P less than 0.001) and abolished the TPP response to increased MAP (P greater than 0.05). Increases in MAP via systemic infusion of whole blood caused reductions in TPP during normothermia but failed to reduce TPP further during hyperthermia. Graded decreases in MAP during both normothermia and hyperthermia caused tail vasoconstriction. The increase in TPP was greater (P less than 0.025) during hyperthermia. In series II, conscious animals showed similar responses to hemorrhage. Graded decreases in MAP produced graded decreases in tail vascular conductance (TVC, ml.100 ml-1.min-1.100 mmHg-1). The slope of the TVC-MAP relationship averaged 0.011 +/- 0.003 TVC U/mmHg during normothermia and was markedly steeper (P less than 0.01) during hyperthermia (1.99 +/- 0.39 TVC U/mmHg). Thus the participation of the cutaneous vasculature of the rat in baroreceptor reflexes depends on thermal status, probably through the level of background sympathetic vasoconstrictor nerve activity. PMID- 2708248 TI - Source of ethane in expirate of rats ventilated with 100% oxygen. AB - Ethane in alveolar expirate may have its source in organs other than the lung and be transported to the lung for elimination. We determined ethane production rates in rats (group I) ventilated with hydrocarbon-free air (HFA) before and after exsanguination. To determine whether the lung is the source of increased ethane production during exposure to 100% O2, we measured ethane in the expirate of nine exsanguinated, Sprague-Dawley rats (group II) mechanically ventilated with HFA and then with 100% O2. In all nine animals, ethane elimination rates on 100% O2 increased compared with HFA values. In five of the nine rats, HFA ventilation was reinstated after O2 (group III). In all five, ethane elimination fell with HFA ventilation compared with the value on 100%. Six rats with circulation intact were ventilated with HFA and then 100% O2 (group IV). Ethane production rate for group IV animals breathing HFA was not significantly different from the exsanguinated animals in group II while ventilated with HFA. The mean increase in ethane production for the group II animals was not significantly different from the group IV animals. Lung slices from four other rats (group V) were incubated in saline at 37 degrees C with FeCl2 (10 mg) added to enhance free radical formation. Paired lung samples from the same rat were incubated with either HFA or 100% O2. Headspace gas was analyzed chromatographically for ethane at 120 min. Mean ethane in the O2 samples was higher than for HFA. Rat lung tissue is the main source of increased ethane production during 100% O2 exposure. PMID- 2708249 TI - Spontaneous injury in isolated sheep lungs: role of perfusate leukocytes and platelets. AB - Perfusion of isolated sheep lungs with blood causes spontaneous edema and hypertension preceded by decreases in perfusate concentrations of leukocytes (WBC) and platelets (PLT). To determine whether these decreases were caused by pulmonary sequestration, we continuously measured blood flow and collected pulmonary arterial and left atrial blood for cell concentration measurements in six lungs early in perfusion. Significant sequestration occurred in the lung, but not in the extracorporeal circuit. To determine the contribution of these cells to spontaneous injury in this model, lungs perfused in situ with a constant flow (100 ml.kg-1.min-1) of homologous leukopenic (WBC = 540 mm-3, n = 8) or thrombocytopenic blood (PLT = 10,000 mm-3, n = 6) were compared with control lungs perfused with untreated homologous blood (WBC = 5,320, PLT = 422,000, n = 8). Perfusion of control lungs caused a rapid fall in WBC and PLT followed by transient increases in pulmonary arterial pressure, lung lymph flow, and perfusate concentrations of 6-ketoprostaglandin F1 alpha and thromboxane B2. The negative value of reservoir weight (delta W) was measured as an index of fluid entry into the lung extravascular space during perfusion. delta W increased rapidly for 60 min and then more gradually to 242 g at 180 min. This was accompanied by a rise in the lymph-to-plasma oncotic pressure ratio (pi L/pi P). Relative to control, leukopenic perfusion decreased the ratio of wet weight to dry weight, the intra- plus extravascular blood weight, and the incidence of bloody lymph. Thrombocytopenic perfusion increased lung lymph flow and the rate of delta W, decreased pi L/pi P and perfusate thromboxane B2, and delayed the peak pulmonary arterial pressure. These results suggest that perfusate leukocytes sequestered in the lung and contributed to hemorrhage but were not necessary for hypertension and edema. Platelets were an important source of thromboxane but protected against edema by an unknown mechanism. PMID- 2708250 TI - Verapamil: a novel probe of surfactant secretion from rat type II pneumocytes. AB - Surfactant from type II pneumocytes prevents the alveolar atelectasis found in both the neonatal and adult forms of respiratory distress syndrome. We have found that verapamil, a phenylalkene with calcium channel and alpha 1-receptor binding properties, has a multiphasic concentration effect on surfactant secretion from [3H]choline-labeled rat type II pneumocytes in culture. Verapamil (10(-8) M) caused a 24% stimulation of surfactant secretion, whereas an 8% inhibition was found at 10(-6) M and a 70% stimulation was found at 10(-4) M. Lactate dehydrogenase release occurred at 5 x 10(-4) M verapamil. Verapamil (10(-4) M) also produced a 100% increase in adenosine 3',5'-cyclic monophosphate (cAMP) in comparison with concentrations of less than or equal to 10(-6) M, an effect that could not be blocked by propranolol (10(-4) M). Verapamil (10(-6) M) increased the total formation of inositol phosphates (IP) by 23% in comparison with IP formation in control cells. Calcium influx was inhibited 15% by 10(-8) M verapamil and 37% by 10(-4) M verapamil. Calcium efflux was stimulated 44% by 10( 5) M verapamil. In combination with 50% effective concentrations (EC50) of terbutaline, phorbol ester, and ATP, the respective effects of verapamil (10(-4) M) on surfactant secretion were approximately additive. We conclude that verapamil has a novel multiphasic concentration effect on surfactant secretion, which appears to involve several signal transduction pathways including cAMP formation, IP formation, inhibition of calcium influx, and stimulation of calcium efflux. PMID- 2708251 TI - Cold and hyperosmolar fluids in canine trachea: vascular and smooth muscle tone and albumin flux. AB - We have studied the effects of liquids of various osmolalities and temperatures on the tracheal vasculature, smooth muscle tone, and transepithelial albumin flux. In 10 anesthetized dogs a 10- to 13-cm length of cervical trachea was cannulated to allow instillation of fluids into its lumen. The cranial tracheal arteries were perfused at constant flow, with monitoring of the perfusion pressures (Ptr) and the external tracheal diameter (Dtr). Control fluid was Krebs Henseleit solution (KH) with NaCl added to result in a 325-mosM solution (isotonic). Hypertonic solutions were KH with NaCl (warm hypertonic) or glucose (hypertonic glucose) added to result in a 800-mosM solution. All solutions were at 38 degrees C, with isotonic and the hypertonic NaCl solutions also given at 18 degrees C (cold isotonic and cold hypertonic). Fluorescent labeled albumin was given intravenously, and the change in fluorescence in the fluid was measured during each 15-min period. Changing from warm isotonic to cold isotonic decreased Dtr and Ptr. Changing from warm isotonic to warm hypertonic or hypertonic glucose decreased Ptr with no change in Dtr. The cold hypertonic responses were not different from cold isotonic responses. Warm hypertonic solution increased albumin flux into the tracheal lumen over a 15-min period to three times that of the control period, persisting for 15 min after replacement with warm isotonic solution. Cooling induces a vasodilation and smooth muscle contraction of the trachea, whereas hypertonic solutions result in vasodilation and, if osmolality is increased with NaCl, an increase in albumin flux into the tracheal lumen. PMID- 2708252 TI - Measurement of O2 consumption in isolated organs without venous cannulation. AB - A new two-sensor technique for measurement of O2 consumption in isolated organs without venous cannulation was successfully applied to the isolated rat heart. Because this technique eliminates the net exchange of O2 between venous effluent and the environment, measurement of the O2 concentration is conveniently made by use of a polarographic sensor in a collected pool of effluent at the bottom of a closed organ chamber. The method was validated against conventional techniques using cannulation of the pulmonary artery. The two-sensor technique allows O2 consumption measurements to be made in isolated organ preparations in which representative venous cannulation is prohibitively difficult, for example in organs with multiple venous drains, or those in which cannulation would be expected to cause excessive perturbation of physiological status. PMID- 2708253 TI - Upper airway muscle activity during nasal occlusion in newborn babies. AB - Submental electromyorgams (SM EMG) were recorded from 20 preterm babies (gestational age 30 +/- 2 wk, postmenstrual age at study 35 +/- 2 wk) (mean +/- SD) and 3 full-term infants (7-14 days old). SM EMG was evaluated during eupnea and brief experimental airway occlusion. Phasic inspiratory SM EMG was rarely seen during eupnea. SM EMG tended to increase on the first occluded effort, although this increase was not statistically significant in most babies. All infants showed progressive breath-by-breath augmentation of phasic SM EMG during occlusions in rapid-eye-movement (REM) as well as quiet (QS) sleep; phasic increases in SM EMG were similar during REM and QS occlusions in the majority (16/22) of babies. Periods of airway closure were detected during 24 occlusions in 5 infants; phasic SM EMG was reduced on these occasions. The results are consistent with the idea that recruitment of upper airway muscles contributes to the stability of the airway of the preterm human. PMID- 2708254 TI - Cellular uptake and processing of surfactant lipids and apoprotein SP-A by rat lung. AB - The intracellular pathways and the kinetics of metabolism of surfactant apoprotein and lipid, which may be recycled from the alveolar space, are largely unknown. We used a lipid-apoprotein complex made from liposomes of pure lipids in a ratio found in mammalian pulmonary surfactant plus surfactant apoprotein (SP-A, Mr = 26,000-36,000) to test some possible relationships in the recycling of these major surfactant components between intrapulmonary compartments. After intratracheal instillation of 80 microliters of an apoprotein-liposome mixture with separate radiolabels in the lipid and the apoprotein, rats were killed at times from 8 min to 4 h later. The lungs were lavaged with saline, and subcellular fractions were isolated on discontinuous sucrose density gradients. Both the [14C]lipid radiolabel and the 125I-apoprotein radiolabel demonstrated a time-dependent increase in radioactivity recovered in a lamellar body-enriched fraction. Uptake of the radiolabels into other subcellular fractions did not exhibit a clear-cut time dependence; more of the protein than the lipid radiolabel was found in the Golgi-rich and microsomal fractions. We conclude that both the lipid and apoprotein portions of lung surfactant are taken up by lung cells and are incorporated into secretory granules of the cells. PMID- 2708255 TI - Circulatory responses to heat after celiac ganglionectomy or adrenal demedullation. AB - Chloraloseanesthetized rats were implanted with Doppler flow probes on the mesenteric, renal, and external caudal arteries and were exposed to an ambient temperature of 40 degrees C. Heart rate, core (Tc) and tail-skin temperatures, and mean arterial blood pressure (MAP) were also monitored. Before heating, the celiac ganglion was removed (ganglionectomy) from one group of animals (n = 11) and a bilateral adrenal demedullation was performed in a second group (n = 14). As Tc progressively increased from 37 degrees C to 43 degrees C, MAP rose to a plateau then fell precipitously as Tc exceeded 41 degrees C. Ganglionectomy eliminated the rise in mesenteric resistance (P less than 0.05) and attenuated the rise in MAP compared with an intact control group (n = 11). Ganglionectomy also increased the heating rate (P less than 0.05) and reduced heat tolerance time (P less than 0.05). Demedullation attenuated the rise in both mesenteric resistance and MAP (P less than 0.05) and increased the rate of heating (P less than 0.05) compared with controls (n = 10). Renal and caudal resistance changes were similar in all groups. These data show the importance of intact adrenal medullas and sympathetic innervation to the splanchnic region in contributing to thermal tolerance in the rat. However, neither factor alone can explain splanchnic vasoconstriction during severe heat stress. PMID- 2708256 TI - Passive shortening of canine parasternal intercostals during breathing. AB - We have previously demonstrated that the shortening of the canine parasternal intercostals during inspiration results primarily from the muscles' own activation (J. Appl. Physiol. 64: 1546-1553, 1988). In the present studies, we have tested the hypothesis that other inspiratory rib cage muscles may contribute to the parasternal inspiratory shortening. Eight supine, spontaneously breathing dogs were studied. Changes in length of the third or fourth right parasternal intercostal were measured during quiet breathing and during single-breath airway occlusion first with the animal intact, then after selective denervation of the muscle, and finally after bilateral phrenicotomy. Denervating the parasternal virtually eliminated the muscle shortening during quiet inspiration and caused the muscle to lengthen during occluded breaths. After phrenicotomy, however, the parasternal, while being denervated, shortened again a significant amount during both quiet inspiration and occluded breaths. These data thus confirm that a component of the parasternal inspiratory shortening is not active and results from the action of other inspiratory rib cage muscles. Additional studies in four animals demonstrated that the scalene and serratus muscles do not play any role in this phenomenon; it must therefore result from the action of intrinsic rib cage muscles. PMID- 2708257 TI - Mechanical arrangement of the parasternal intercostals in the different interspaces. AB - When the parasternal intercostal in a single interspace is selectively denervated in dogs with diaphragmatic paralysis, it continues to shorten during both quiet and occluded inspiration. In the present studies, we have tested the hypothesis that this passive parasternal inspiratory shortening is due to the action of the other parasternal intercostals. Changes in length of the denervated third right parasternal were measured in eight supine phrenicotomized animals. We found that 1) the inspiratory muscle shortening increased after denervation of the third left parasternal but gradually decreased with denervation of the parasternals situated in the second, fourth, and fifth interspaces; 2) the muscle, however, always continued to shorten during inspiration, even after denervation of all the parasternals; 3) stimulating selectively the third left parasternal caused a muscle lengthening; and 4) bilateral stimulation of the parasternals in the second or the fourth interspace produced a muscle shortening. We conclude that 1) the two parasternals situated in the same interspace on both sides of the sternum are mechanically arranged in series, whereas the parasternals located in adjacent interspaces are mechanically arranged in parallel; and 2) if a denervated parasternal continues to shorten during inspiration, this is in part because of the action of the parasternals in the adjacent interspaces and in part because of other inspiratory muscles of the rib cage, possibly the external intercostals and the levator costae. PMID- 2708258 TI - Capillary tortuosity in skeletal muscles of mammals depends on muscle contraction. AB - Capillary orientation (anisotropy) was compared in hindlimb muscles of mammals of different size and/or different aerobic capacity (dog, goat, pony, and calf). All muscles were fixed by vascular perfusion at sarcomere lengths ranging from 1.5 to 2.7 micron. The ratios of capillary counts per fiber cross-sectional area on two sets of sections (0 and 90 degrees) to the muscle fiber axis were used to estimate capillary anisotropy and the coefficient c(K,0) relating 1) capillary counts on transverse sections (a commonly used parameter to assess muscle capillarity) and 2) capillary length per volume of fiber (i.e., capillary length density). Capillary orientation parallel to the muscle fiber axis decreased substantially with muscle fiber shortening. In muscles fixed at sarcomere lengths of 2.69 microns (dog vastus intermedius) and 1.52 microns (dog gastrocnemius), capillary tortuosity and branching added 7 and 64%, respectively, to capillary length density. The data obtained in this study are highly consistent with the previously demonstrated relationship between capillary anisotropy and sarcomere length in extended vs. contracted rat muscles, by use of the same method. Capillary anisotropy in mammalian locomotory muscles is curvilinearly related to sarcomere length. No systematic difference was found in capillary tortuosity with either body size, athletic ability, or aerobic capacity. Capillary tortuosity is a consequence of fiber shortening rather than an indicator of the O2 requirements of the tissue. PMID- 2708259 TI - Airway blood flow response to eucapnic dry air hyperventilation in sheep. AB - Eucapnic hyperventilation, breathing dry air, produces a two- to fivefold increase in airway blood flow in the dog. To determine whether airway blood flow responds similarly in the sheep we studied 16 anesthetized sheep. Seven sheep (1 7) were subjected to two 30-min periods of eucapnic hyperventilation breathing 1) warm humid air [100% relative humidity (rh)] followed by 2) warm dry air [0% rh] at 40 breaths/min. To determine whether there was a dose-response effect on blood flow of increasing levels of hyperventilation of dry air, another nine sheep (8 16) were subjected to four 30-min periods of eucapnic hyperventilation breathing warm humid O2 followed by warm dry O2 at 20 or 40 breaths/min in random sequence. Five minutes before the end of each period of hyperventilation, hemodynamics, blood gases, and tracheal mucosal temperature were measured, and tracheal and bronchial blood flows were determined by injection of 15- or 50-micron-diam radiolabeled microspheres. After the last measurements had been made, all sheep were killed, and the lungs and trachea were removed for determination of blood flow to trachea, bronchi, and parenchyma. In sheep 1-7, warm dry air hyperventilation at 40 breaths/min produced an increase in blood flow to trachea (7.6 +/- 3.5 to 17.0 +/- 6.2 ml/min, P less than 0.05) and bronchi (9.0 +/- 5.4 to 18.2 +/- 8.2 ml/min, P less than 0.05) but not to the parenchyma. When blood flow was compared with the two ventilatory rates (sheep 8-16), tracheal blood flow increased (9.1 +/- 3.3 to 18.2 +/- 6.1 ml/min, P less than 0.05) at a rate of 40 breaths/min but not at 20 breaths/min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708260 TI - Human recombinant tumor necrosis factor alpha infusion mimics endotoxemia in awake sheep. AB - The macrophage-derived cytokine tumor necrosis factor alpha (TNF alpha) has been proposed as the major mediator of endotoxin-induced injury. To examine whether a single infusion of human recombinant TNF alpha (rTNF alpha) reproduces the pulmonary effects of endotoxemia, we infused rTNF alpha (0.01 mg/kg) over 30 min into six chronically instrumented awake sheep and assessed the ensuing changes in hemodynamics, lung lymph flow and protein concentration, and number of peripheral blood and lung lymph leukocytes. In addition, levels of thromboxane B2, 6 ketoprostaglandin F1 alpha, prostaglandin E2, and leukotriene B4 were measured in lung lymph. Pulmonary arterial pressure (Ppa) peaked within 15 min of the start of rTNF alpha infusion [base-line Ppa = 22.0 +/- 1.5 (SE) cmH2O; after 15 min of rTNF alpha infusion, Ppa = 54.2 +/- 5.4] and then fell toward base line. The pulmonary hypertension was accompanied by hypoxemia and peripheral blood and lung lymph leukopenia, both of which persisted throughout the 4 h of study. These changes were followed by an increase in protein-rich lung lymph flow (base-line lymph protein clearance = 1.8 +/- 0.4 cmH2O; 3 h after rTNF alpha infusion, clearance = 5.6 +/- 1.2), consistent with an increase in pulmonary microvascular permeability. Cardiac output and left atrial pressure did not change significantly throughout the experiment. Light-microscopic examination of lung tissue at autopsy revealed congestion, neutrophil sequestration, and patchy interstitial edema. We conclude that rTNF alpha induces a response in awake sheep remarkable similar to that of endotoxemia. Because endotoxin is a known stimulant of TNF alpha production, TNF alpha may mediate endotoxin-induced lung injury. PMID- 2708261 TI - Calcium dependence of the thrombin-induced increase in endothelial albumin permeability. AB - We examined whether the increase in endothelial albumin permeability induced by alpha-thrombin is dependent on extracellular Ca2+ influx. Permeability of 125I albumin across confluent monolayers of cultured bovine pulmonary artery endothelial cells was measured before and after the addition of 0.1 microM alpha thrombin. In the presence of normal extracellular Ca2+ concentration ([Ca2+]o, 1000 microM), alpha-thrombin produced a 175 +/- 10% increase in 125I-albumin permeability. At lower [Ca2+]o (100, 10, 1, or less than 1 microM), alpha thrombin caused a 140% increase in permeability (P less than 0.005). LaCl3 (1 mM), which competes for Ca2+ entry, blunted 38% of the increase in permeability. Preloading endothelial monolayers with quin2 to buffer cytosolic Ca2+ (Cai2+) produced a dose-dependent inhibition of the increase in 125I-albumin permeability. Preincubation with nifedipine or verapamil was ineffective in reducing the thrombin-induced permeability increase. A 60 mM K+ isosmotic solution did not alter base-line endothelial permeability. alpha-Thrombin increased [Ca2+]i in a dose-dependent manner and the 45Ca2+ influx rate. Extracellular medium containing 60 mM K+ did not increase 45Ca2+ influx, and nifedipine did not block the rise in 45Ca2+ influx caused by alpha-thrombin. Ca2+ flux into endothelial cells induced by alpha-thrombin does not occur through voltage-sensitive channels but may involve receptor-operated channels. In conclusion, the increase in endothelial albumin permeability caused by alpha thrombin is dependent on Ca2+ influx and intracellular Ca2+ mobilization. PMID- 2708262 TI - Central venous O2 saturation and rate of arterial desaturation during obstructive apnea. AB - We examined the rate of fall of arterial O2 saturation (dSao2/dt) after apnea onset in four spontaneously breathing adult male baboons. We postulated that a lower mixed venous O2 saturation (Svo2) would steepen dSao2/dt by more rapid depletion of alveolar O2. Single isolated (NREP) and five or more sequential repetitive apneas (REP) were created by clamping an indwelling cuffed endotracheal tube at end expiration. Fiberoptic catheters were used for continuous monitoring of Sao2, Svo2, and cardiac output. The mean dSao2/dt for all duration NREP apneas was 0.60%/s. Mean dSao2/dt increased above base line for each consecutive REP apnea and was higher in 60 s than in 45 and 30 s REP apnea series. The increase in dSao2/dt corresponded closely with the fall in preapneic Svo2. Preapneic arterial O2 content fell during successive REP apneas but the maximal decrement from base line (1.3 ml/dl) was much less than the maximal decrement in preapneic mixed venous O2 content of 5.1 ml/dl. Preapneic cardiac output for NREP apneas and nadir cardiac output for REP apneas remained constant. Nadir cardiac output for NREP apneas showed higher values for longer duration apneas. We concluded that dSao2/dt is inversely related to preapneic Svo2. PMID- 2708263 TI - Role of microvascular pressure in reactive oxygen-induced lung edema. AB - O2 radicals are important in the pathogenesis of acute lung injury. The purpose of this investigation was to determine the role that microvascular pressure plays in edema induced by reactive O2 species generated by xanthine oxidase. In isolated rat lungs perfused with Krebs buffer plus 4% albumin, 5 mM glucose, and 2 mM xanthine at constant flow (13 ml/min), addition of xanthine oxidase (0.02 U/ml) caused a progressive increase in both pulmonary arterial and microvascular pressure (double occlusion method), which preceded the onset of edema. Both the pressure rise and edema formation were blocked by catalase, suggesting that vascular injury was related to H2O2 production. Lungs not exposed to free radicals that had microvascular pressure elevated to match that of the xanthine oxidase-perfused lungs showed only a small, reversible (nonedematous) weight gain. Lungs exposed to xanthine oxidase but perfused at constant microvascular pressure (5 Torr, similar to control lungs) showed a significant delay in protein rich edema formation. These data indicate that reactive O2 metabolites induced lung injury, which is accompanied by increased microvascular pressure. Although the rise in microvascular pressure was shown not to be essential for edema formation, it does play a role in acceleration of the rate of transvascular fluid loss. PMID- 2708264 TI - Specificity of esophageal electrode recordings of posterior cricoarytenoid muscle activity. AB - Esophageal electrodes have been used for recording the electromyographic (EMG) activity of the posterior cricoarytenoid muscle (PCA). To determine the specificity of this EMG technique, esophageal electrode recordings were compared with intramuscular recordings in eight anesthetized mongrel dogs. Intramuscular wire electrodes were placed in the right and left PCA, and the esophageal electrode was introduced through the nose or mouth and advanced into the upper esophagus. On direct visualization of the upper airway, the unshielded catheter electrode entered the esophagus on the right or left side. Cold block of the recurrent laryngeal nerve (RLN) ipsilateral to the esophageal electrode was associated with a marked decrease in recorded activity, whereas cold block of the contralateral RLN resulted only in a small reduction in activity. After supplemental doses of anesthesia were administered, bilateral RLN cold block essentially abolished the activity recorded with the intramuscular electrodes as well as that recorded with the esophageal electrode. Before supplemental doses of anesthesia were given, especially after vagotomy, the esophageal electrode, and in some cases the intramuscular electrodes, recorded phasic inspiratory activity not originating from the PCA. Therefore, one should be cautious in interpreting the activity recorded from esophageal electrodes as originating from the PCA, especially in conditions associated with increased respiratory efforts. PMID- 2708265 TI - Sympathetic response to exercise in various tissues with advancing age. AB - It was the purpose of this investigation to examine any age-related changes in norepinephrine turnover (NEt) in four tissues at rest and during exercise. Fischer 344 rats 6 (n = 20) and 25 mo of age (n = 20) were received from the National Institute on Aging. NEt was determined at rest, during 30 min of submaximal exercise, and at maximal exercise by administration of alpha-methyl-p tyrosine, a competitive inhibitor of tyrosine hydroxylase. Resting NE declined with age in both heart (38.2 vs. 30.5 ng.g-1.h-1) and liver (11.2 vs. 6.4 ng.g 1.h-1). NEt was greater in the older animals compared with the young animals in heart (120.9 vs. 169.5 ng.g-1.h-1), liver (23.1 vs. 38.9 ng.g-1.h-1), and adrenals (74.0 vs. 98.4 ng.mg-1.h-1) during submaximal exercise. In response to maximal exercise, NEt varied depending on age and tissue. It was concluded that, in response to exercise stress, the older animals generally demonstrated a higher NEt (reflecting elevated sympathetic activity) perhaps because of a decreased adrenergic receptor sensitivity and/or responsiveness. PMID- 2708266 TI - Changes in size and compliance of the calf after 30 days of simulated microgravity. AB - Increased leg venous compliance may contribute to postflight orthostatic intolerance in astronauts. We reported that leg compliance was inversely related to the size of the muscle compartment. The purpose of this study was to test the hypothesis that reduced muscle compartment after long-duration exposure to microgravity would cause increased leg compliance. Eight men, 31-45 yr old, were measured for vascular compliance of the calf and serial circumferences of the calf before and after 30 days of continuous 6 degrees head-down bed rest. Cross sectional areas (CSA) of muscle, fat, and bone compartments in the calf were determined before and after bed rest by computed tomography. From before to after bed rest, calculated calf volume (cm3) decreased (P less than 0.05) from 1,682 +/ 83 to 1,516 +/- 76. Calf muscle compartment CSA (cm2) also decreased (P less than 0.05) from 74.2 +/- 3.6 to 70.6 +/- 3.4; calf compliance (ml.100 ml-1.mmHg 1.100) increased (P less than 0.05) from 3.9 +/- .7 to 4.9 +/- .5. The percent change in calf compliance after bed rest was significantly correlated with changes in calf muscle compartment CSA (r = 0.72, P less than 0.05). The increased leg compliance observed after exposure to simulated microgravity can be partially explained by reduced muscle compartment. Countermeasures designed to minimize muscle atrophy in the lower extremities may be effective in ameliorating increased venous compliance and orthostatic intolerance after spaceflight. PMID- 2708267 TI - Eyewitness accuracy and confidence: within- versus between-subjects correlations. AB - Previous researchers using between-subjects comparisons have found eyewitness confidence and accuracy to be only negligibly correlated. In this study, we examined the predictive power of confidence in within-subject terms. Ninety-six subjects answered, and made confidence ratings for, a series of questions about a crime they witnessed. The average between-subjects and within-subject accuracy confidence correlations were comparably low: r = .14 (p less than .001) and r = .17 (p less than .001), respectively. Confidence is neither a useful predictor of the accuracy of a particular witness nor of the accuracy of particular statements made by the same witness. Another possible predictor of accuracy, response latency, correlated only negligibly with accuracy (r = -.09 within subjects), but more strongly with confidence (r = -.27 within subjects). This pattern was obtained for both between-subjects and within-subject comparisons. The theoretical and practical implications of these results are discussed. PMID- 2708268 TI - Fortieth annual meeting of the Tissue Culture Association. June 11-14, 1989. Orlando, FL. Abstracts. PMID- 2708269 TI - Liquid chromatographic determination of carminic acid in yogurt. AB - A reverse-phase liquid chromatographic method is described for the determination of carminic acid in yogurt. A C18 column is used with acetonitrile-1.19M formic acid (19 + 81) as mobile phase and diode array detection. Sample preparation includes deproteinization with papain and purification in a polyamide column. The relative standard deviation for repeated determinations of carminic acid in a commercial strawberry-flavored yogurt was 3.0%. Recoveries of carminic acid added to a natural-flavored yogurt ranged from 87.2 to 95.3% with a mean of 90.2%. The method permits measurement of amounts as low as 0.10 mg/kg. PMID- 2708271 TI - Colorimetric determination of tetracycline derivatives in pharmaceutical preparations. AB - A quick colorimetric method is reported for the determination of tetracycline derivatives such as oxytetracycline hydrochloride (OTCH), chlortetracycline hydrochloride (CTCH), methacycline hydrochloride (MCH), and doxycycline hydrochloride (DCH). The method involves complexation of the above derivatives with cupric chloride in alkaline medium. The yellowish green copper complexes of OTCH, CTCH, MCH, and DCH show maximum absorbance at 395, 410, 400, and 400 nm, respectively. The color intensity obeys Beer's law in the concentration range of 0-20 micrograms/mL. PMID- 2708270 TI - Determination of maduramicin by liquid chromatography with atomic absorption spectrometric detection. AB - A liquid chromatograph was interfaced to an atomic absorption spectrometer for the detection and quantitation of maduramicin in feed matrixes at the 1-8 ppm level. Ionophores in general form strong 1:1 products with various metal cations, yielding complexes that are insoluble in water but very soluble in organic solvents. Maduramicin, a carboxylic, polyalcohol, polyether antibiotic, is labeled with the sodium cation and analyzed by atomic absorption spectroscopy (AAS). The lower limit of detection is approximately 100-200 ng maduramicin sodium salt. Feeds containing 1-8 ppm maduramicin are extracted with acetone, the extract is passed through an alumina column, the column is eluted with acetonitrile-water (90 + 10), and the eluate is analyzed for maduramicin by liquid chromatography-AAS after concentration and conversion of maduramicin to the sodium salt. Recoveries of maduramicin averaged 89.5%. Liquid chromatography with AAS detection has been shown to be a sensitive and highly specific technique for the determination of ionophores in general and maduramicin in particular. PMID- 2708272 TI - Simultaneous liquid chromatographic determination of water-soluble vitamins, caffeine, and preservative in oral liquid tonics. AB - A rapid, simple, and reliable liquid chromatographic method has been developed for the simultaneous determination of nicotinamide (niacinamide), thiamine, riboflavin, riboflavin sodium phosphate, pyridoxine, caffeine, and sodium benzoate in commercial oral liquid tonics. The 7 components are separated on a reverse phase C18 column using a mobile phase of acetonitrile-0.01M potassium dihydrogen phosphate-triethylamine (8 + 91.5 + 0.5 v/v/v) containing 5mM sodium octanesulfonate and adjusted to pH 2.8 with phosphoric acid. Components are detected at 254 nm with attenuation 0.02 AUFS. Acetanilide is used as an internal standard. In addition to the 7 components mentioned, nicotinic acid (niacin), cyanocobalamin, and folic acid are also separated under the same conditions. Sample preparation involves only addition to internal standard solution and dilution with mobile phase and then filtration. Recoveries of the 7 components and cyanocobalamin from spiked preparations ranged from 97 to 104% with coefficients of variation of 0.9-4.2%. PMID- 2708273 TI - Liquid chromatographic methods for vitamins A and D in multivitamin-mineral formulations. AB - Liquid chromatographic screening procedures have been developed for the estimation of vitamins A and D in multivitamin-mineral tablet, capsule, gelatin capsule, and syrup formulations. The procedure can be used for measuring vitamin A present as either retinyl acetate or retinyl palmitate, and also for measuring the contribution to total vitamin A activity from 13-cis retinyl esters. The retinyl esters and their isomers are resolved from each other and their oxidation products. Ergocalciferol and cholecalciferol are not resolved from each other but they are resolved from other vitamin D isomers and from vitamins A, E, and K and their degradation products. Both assays use a 3 microns amino column, with a mobile phase of hexane for vitamin A and 1% isopropanol in hexane for vitamin D. The precision of replicate injections for vitamins A and D is better than 1% and the recovery from spiked syrups is better than 98%. The coefficient of variation for both assay methods is about 5%. Twenty formulations were analyzed for vitamin A and 24 were analyzed for vitamin D. PMID- 2708274 TI - Liquid chromatographic determination of seven antioxidants in dry food. AB - The liquid chromatographic determinative step of the official method for propyl gallate, trihydroxybutyrophenone, tert-butylhydroquinone, nordihydroguaiaretic acid, butylated hydroxyanisole (BHA), 3,5-di-tert-butyl-4-hydroxymethylphenol, and butylated hydroxytoluene (BHT) in fats and oils has been applied to their determination in a number of dry foods. A representative sample (10 g) is homogenized first with hexane (25 mL), then with 5 mL added water, and finally with 75 mL added acetonitrile. The hexane and acetonitrile are decanted, filtered, and separated; the hexane and rehydrated food are reextracted with 2 additional portions of acetonitrile, and the combined acetonitrile extracts are concentrated and diluted to 10 mL. An aliquot is analyzed as described in the official method, using a 150 x 4.6 mm 5 microns C-18 column. The need for rehydration to maximize the recovery of BHA and other antioxidants from marketplace dry food samples such as potato flakes, dry coffee whiteners, and dessert topping mixes was demonstrated. Rehydration was not required for cheese snacks, breakfast cereals, cake mixes, and some other foods. The need for rehydration should be determined by analyzing other foods with and without the addition of water. Potato and corn chips, popcorn and cheese snacks, breakfast cereals, dry beverage mixes, rice, potato flakes, french fried potatoes, and cake mixes were spiked with the above antioxidants at 10-50 ppm. Overall recoveries ranged from 64.3 to 105.6% and repeatabilities ranged from 0.7 to 10.8%. A total of 109 samples of the above foods were analyzed, and 64% contained detectable (greater than 1-2 ppm) antioxidants, mainly BHA and BHT. PMID- 2708275 TI - Comparison of the ion exclusion chromatographic method with the Monier-Williams method for determination of total sulfite in foods. AB - Experimental data comparing the alkali extraction/ion exclusion chromatographic method with the Monier-Williams method for determination of total sulfite are presented in (a) enzymatic and nonenzymatic browning systems, (b) vegetables containing naturally occurring sulfite, and (c) a carbohydrate-type food additive, erythorbic acid. Excellent agreement, with a linear correlation coefficient of 0.99, was observed in fresh potato samples homogenized with sulfite and allowed to react for different time intervals (enzymatic browning system). A good overall correlation was observed in dehydrated, sulfited apple samples heated for different times (nonenzymatic browning system); however, as heating time increased, higher results were obtained by the Monier-Williams method than by the alkali extraction/ion exclusion chromatographic method. The results of determining sulfite in the alkali trapping solution following acid distillation or acid treatment without heat suggested that this deviation was due to a fraction of sulfite bound to the browning reaction products in such a way that it was released by acid distillation but not by alkali extraction or acid treatment without heat. Similar behavior was demonstrated in cabbage with naturally occurring sulfite, which was released by acid distillation but not by alkali extraction or acid treatment without heat. The ion exclusion chromatographic method could overcome interference by the volatile caramelization reaction products in the Monier-Williams determination of erythorbic acid. PMID- 2708276 TI - Rapid headspace gas chromatographic method for assessment of oxidative stability of cooked chicken meat. AB - Experiments were conducted to determine the volatile compounds in cooked chicken meat using a static headspace gas chromatographic (GC) technique. Preheating conditions for samples in vials were tested at 70, 80, and 90 degrees C for 20 120 min at each temperature. The majority of the peaks increased in size as the temperature and time increased. Optimum conditions were established as preheating at 80 degrees C for 30 min followed by analysis on a packed column of 8% Poly MPE on Tenax GC with the temperature programmed from 50 to 200 degrees C at 10 degrees/min. Coefficients of variation for major peaks ranged from 8.3 to 14.7%. These results were compared with those obtained with a capillary column analysis of samples preheated at the same conditions. Cooked and stored chicken patties, pretreated with different levels of sodium tripolyphosphate, were analyzed by the thiobarbituric acid (TBA) method and the headspace GC technique. Significant positive correlations were obtained between TBA numbers and the areas of 3 major peaks of the headspace profiles, indicating the applicability of the rapid headspace GC method for the determination of oxidative changes in chicken meat. PMID- 2708277 TI - Determination of arsenic in beer by dry ashing, hydride generation atomic absorption spectroscopy. AB - A method has been developed for determination of arsenic in beer. Organic matter is destroyed by the dry-ashing technique, the ash is dissolved in HCl, and hydrides of arsenic are generated by addition of sodium borohydride prior to atomization in a flame-heated quartz cell and atomic absorption spectroscopy measurement. The analytical features of the method are detection limit 0.1 ng/g beer, precision 8%, and recovery 97 +/- 7%. The arsenic contents of different brands from Spain and other European countries were analyzed. In all samples, the arsenic levels found were well below maximum levels allowed in Spanish legislation (100 ng/g). The quantities of arsenic in Spanish beers do not differ from those found in foreign beers. No differences were found between bottled and canned beers, and no correlation exists between metal content and original specific gravity of the beers. PMID- 2708278 TI - Methods of analysis for toxic elements in food products. 1. Mineralization methods to determine heavy metals and arsenic according to the USSR standard. AB - Results of the work of 22 laboratories in the USSR on optimizing methods for mineralizing foods to determine Pb, Cd, As, Zn, Cu, Sn, and Fe are summarized. Recommendations are given on dry and wet mineralization as related to the analyte and the kind of food product. Optimum amounts of test portions for 22 food groups are also recommended according to the element of interest. PMID- 2708279 TI - Methods of analysis for toxic elements in food products. 2. Review of USSR standards on determinations of heavy metals and arsenic. AB - Methods of analysis prescribed by USSR standards for Hg, Pb, Zn, As, Cd, Cu, Fe, and Sn in foods are described: for Hg--colorimetry of tetraiodide mercurate and atomic absorption spectroscopy (AAS); for Pb, Cd, Zn, and Cu--polarography; for Cu--colorimetry with sodium diethyldithiocarbamate and zinc dibenzyldithiocarbamate; for As--colorimetry with silver diethyldithiocarbamate; for Sn--colorimetry with quercetin; and for Fe--colorimetry with o phenanthroline. All of the methods have the necessary metrological characteristics, including intralaboratory repeatability value (r), interlaboratory reproducibility value (R), minimum quantity of the element to be determined in the analytical test portion (MQSM), and the coefficients that account for mercury and arsenic losses during analysis. Establishing constant r- and R-values for the methods under consideration is expedient because (a) the methods suggested are used for safety purposes; and (b) the optimum amount of the element studied in the test sample is determined, to a certain degree, by the mass of the test portion. PMID- 2708280 TI - Methods of analysis for toxic elements in food products. 3. Limit of determination of methods for assuring safety. AB - To evaluate the suitability of the analytical methods used in determining food safety, a new metrological characteristic "MQS" is suggested. MQS is defined as the absolute minimum quantity in micrograms of a substance that can be determined in a test solution (solubilized test portion). MQS accounts for 2 factors: (a) the necessity for a reliable determination of ML (maximum permitted level, i.e., regulatory tolerance), and (b) the optimum quantity of test portion of a food product to be analyzed, and thus assists in evaluating the suitability of a method to assure food safety. The MQS of 8 toxic elements in any food are As, 3; Cd, 0.5; Cu, 20; Fe, 50; Hg, 0.2; Pb, 4; Sn, 200; Zn, 100 micrograms. To characterize the applicability of any given method, the specific minimum limit of determination, MQSM, must be established for each method. The method in question may be used to control food safety only if MQSM is less than MQS. MQSM values are given for the common polarographic and colorimetric methods for determining these elements. PMID- 2708281 TI - Temperature-independent pectin gel method for coliform determination in dairy products: collaborative study. AB - Ten laboratories participated in a collaborative study to compare a pectin-based violet red bile (VRB) method with the VRB agar-based standard method for estimation of coliform bacterial counts in 7 different dairy food groups: cream, cheddar cheese, cottage cheese, homogenized milk, raw milk, sour cream, and yogurt. Each laboratory analyzed 8 samples of each food group as sample pairs prepared at high, medium, and low inoculum levels, and an uninoculated control pair. Overall mean log counts were higher for the pectin gel method in 18 of 21 cases (7 samples at 3 inoculum levels); 12 results were significantly higher (P less than 0.01) than those for the VRB agar method. Of the 3 higher VRB agar method means, 2 were not significant at P less than 0.10, and one was of borderline significance (0.05 less than P less than 0.06). Repeatability variation (sr) favored the pectin gel method in 14 of 21 cases; 7 were highly significant differences (P less than 0.01). None of the 7 results favoring the VRB agar method was statistically significant. Reproducibility variation (sR) favored the pectin gel method in 14 of 21 results. These data indicate that the pectin gel method gives higher recovery of coliforms with better precision than does the VRB agar method, and strongly support the suitability of the pectin gel method as an alternative to the agar-based VRB method for coliform counts in dairy products. The pectin gel method has been adopted official first action. PMID- 2708282 TI - Purification of cyclopiazonic acid by liquid chromatography. AB - A purification procedure for cyclopiazonic acid has been developed, using sequential preparative and semi-preparative liquid chromatography. Crude cyclopiazonic acid (324 mg) was extracted from a 1 L fermentation medium with chloroform-methanol (80 + 20), dried, dissolved in chloroform, and chromatographed on an oxalic acid/silica preparative column with chloroform methanol (99 + 1) as the eluant. A semi-preparative oxalic acid/silica column and chloroform-methanol (99.5 + 0.5) were then used for rechromatography of the partially purified cyclopiazonic acid. This second chromatographic treatment yielded fractions from which cyclopiazonic acid was readily crystallized (106.7 mg; 33% recovery). Analytical chromatography was developed using an amino column in an ion-exchange mode, with a methanol-phosphate buffer eluant. Response was linear from 10 to 800 micrograms/injection of standard solutions. Cyclopiazonic acid chemically binds sodium from soda-lime vials. PMID- 2708283 TI - Determination of sterigmatocystin in barley by acetylation and liquid chromatography. AB - The estimation of sterigmatocystin by fluorescence liquid chromatographic analysis of the acetate derivative has eliminated the background interference normally encountered in analysis of underivatized sterigmatocystin in barley. Barley samples are extracted with acetonitrile-water; the extract is then washed with hexane, transferred to chloroform, and eluted from a silica gel column with cyclohexane-ethyl acetate. The extract is heated with pyridine and acetic anhydride for 3 h to give a stable derivative. Reverse-phase liquid chromatography, using a methanol-water mobile phase gradient and fluorescence detection, is the method of determination. Recoveries from barley samples spiked with 20, 110, 190, and 765 micrograms sterigmatocystin/kg were 31, 69, 75, and 96%, with coefficients of variation between 2.8 and 5.4%. Sterigmatocystin is confirmed by comparing retention times in underivatized extracts of samples and standards, using methanol-water (3 + 2) mobile phase and ultraviolet detection. PMID- 2708284 TI - Enzyme-linked immunosorbent assay for T-2 toxin metabolites in urine. AB - A direct competitive enzyme-linked immunosorbent assay (ELISA) for determination of total T-2 toxin metabolites in urine was developed. The assay involves coating anti-3-acetyl-neosolaniol-hemisuccinate-bovine serum albumin conjugate (anti-3-Ac NEOS-HS-BSA) antibody to the ELISA plate and using 3-Ac-NEOS-HS-peroxidase as the enzyme marker. Competitive ELISA revealed that the antibody had good cross reactivity with acetyldiacetoxyscirpenol (Ac-DAS), T-2 tetraol tetraacetate, 3' OH-Ac-T-2, 3-Ac-NEOS, and 3,4,15-triacetyl-12,13-epoxytrichothec-9-en-8-one (Ac-T 2-8-one), but less cross-reactivity with Ac-T-2 toxin and T-2 toxin. All metabolites of T-2 toxin in urine were converted to T-2 tetraol tetraacetate (T-2 4ol-4Ac) by acetylation of the sample extract before ELISA. To test the ELISA accuracy, a radioimmunoassay (RIA) was performed simultaneously. The linear portion of the standard curve of this direct ELISA for T-2-4ol-4Ac was 0.2-2.0 ng/mL, which was 10 times more sensitive than RIA. The minimum detection level for T-2-4ol-4Ac was 0.02 ng/mL (0.4 pg/assay) in the absence of urine sample. The overall analytical recoveries for T-2 toxin, HT-2, T-2-4ol, 3'-OH-HT-2, NEOS, and a mixture of these 5 toxins added to the urine samples in the ELISA at concentrations of 0.05 and 0.2 ng/mL were 87 and 94%, respectively. PMID- 2708285 TI - Liquid chromatographic method for quantitation of glyphosate and metabolite residues in organic and mineral soils, stream sediments, and hardwood foliage. AB - A liquid chromatographic method for determining glyphosate (GLYPH) and its major metabolite aminomethylphosphonic acid (AMPA) in various environmental substrates is described. Ion-exchange column chromatography is coupled with post-column ninhydrin derivatization and absorbance detection at 570 nm. Use of a valve switching technique allowed quantitation of both analytes in a single chromatographic run and eliminated slow-eluting, coextracted interferences. The method was successfully used to quantitate GLYPH and AMPA in organic and mineral soils, stream sediments, and foliage of 2 hardwood brush species. Mean recovery efficiencies for GLYPH as determined from fortified blank field samples were as follows: bottom sediment 84%, suspended sediment 66%, organic soils 79%, mineral soils 73%, alder leaf litter 81%, salmonberry leaf litter 84%, and artificial deposit collectors 87%. Precision for GLYPH determination was good with less than 14% coefficient of variation on mean recovery for all substrates. Limits of detection were lowest for sediments (0.01 microgram/g dry mass) and highest for foliage substrates (0.10 microgram/g dry mass). Using this system, 6 samples/person/day were routinely analyzed. PMID- 2708286 TI - Simultaneous gas chromatographic determination of carbofuran, metalaxyl, and simazine in soils. AB - A method for extraction, cleanup, and simultaneous gas chromatographic detection of carbofuran, metalaxyl, and simazine in soils has been developed. Pesticide residues were extracted from soil with acetone containing 10% 0.2M HCl-KCl buffer (pH 2.0), cleaned up with methylene chloride-carbonate buffer (pH 10.7) solvent partitioning and solid-phase extraction on disposable silica gel columns, and quantitated with gas chromatography using a Supelcowax 10 megabore capillary column and a nitrogen-selective detector. Method limits of detection were 0.02 microgram/g for the 3 pesticides in surface soils (0-30 cm depths) and 0.02, 0.02, and 0.005 microgram/g in soils below 30 cm (subsoils) for carbofuran, metalaxyl, and simazine, respectively. Recoveries for carbofuran, metalaxyl, and simazine were 92.6 +/- 5.5, 93.6 +/- 5.0, and 88.4 +/- 6.7%, respectively, when soil samples were spiked with pesticide concentrations ranging from 0.02 to 2.0 micrograms/g. PMID- 2708287 TI - Determination of acidic herbicides and related compounds in water and soil by capillary gas chromatography using a nitrogen-phosphorus detector. AB - Methods are described for the determination of acidic herbicides and related compounds in water and soil. Eight acidic herbicides and related compounds were extracted from water using either dichloromethane or an XAD-2 resin column. The acidic moieties were derivatized with 2-cyanoethyldimethyl(diethyl)aminosilane. The derivatized compounds were separated using capillary gas chromatography and quantitated using a nitrogen-phosphorus detector. Extraction from water using dichloromethane or an XAD-2 resin column resulted in recoveries greater than 90% at 0.1 ppb with an average coefficient of variation (CV) of 6%. In soils extracted with aqueous acetonitrile-acetic acid and partitioned into dichloromethane, recoveries at 500 ppb were greater than 75% with an average CV of 3.3%. The methods are rapid and there are few interferences. PMID- 2708288 TI - Determination of fluazifop-butyl and fluazifop acid in soybeans and soybean oil using liquid chromatography with oxidative amperometric detection. AB - A new method is described for the determination of the herbicide fluazifop-butyl, and its metabolite fluazifop acid, in soybeans and soybean oil as fluazifop acid. Liquid chromatography with amperometric detection (LC/AD) is used to determine fluazifop acid produced from the metabolism or base hydrolysis of fluazifop-butyl in soybeans and soybean oil. These foods were spiked with fluazifopbutyl at 0.05, 0.10, and 0.50 ppm and hydrolyzed with 0.2N NaOH in methanol. The hydrolysate (adjusted to pH less than or equal to 1) is extracted with dichloromethane and the extract is washed with 1.0% NaHCO3. The NaHCO3 is acidified to pH less than or equal to 1 and extracted with dichloromethane; the partitioning is repeated 2 more times. The dichloromethane is removed, mobile phase solvent is added, and aliquots are injected onto a PRP-1 liquid chromatographic column; fluazifop acid is separated from coextracted compounds and detected at an applied potential of + 1.25 V, using an amperometric electrochemical detector in the oxidation mode. Recoveries ranged from 69 +/- 6.5 to 101 +/- 18% and from 72 +/- 7.5 to 88 +/- 11% for soybeans and soybean oil, respectively. Accuracy of these recoveries was confirmed by use of 14C-radiolabeled fluazifop-butyl and by liquid scintillation spectrometry of the 14C-fluazifop acid released. PMID- 2708290 TI - Application of analytical standards in method development: selected chlorinated phenols and herbicides. AB - Pure analytical standards are key components in the successful development of accurate analytical methods. When such compounds are unavailable commercially, a laboratory synthesis activity can provide such materials for use in method development. An example of such an approach is the synthesis of ethyl ethers of chlorinated phenols and ethyl esters of several phenoxy herbicides. Individual synthesis steps and the characterization of such materials are described. The use of such analytical standards in method development is vital for defining method characteristics. In addition, such materials are helpful in diagnosing chromatographic and mass spectral problems in the course of this work. Key mass spectral information including parent and daughter scans obtained from these analytical standards by using tandem mass spectrometry provide the basis for a new analytical method with increased sensitivity and specificity. PMID- 2708289 TI - Ion-exchange chromatographic determination of hypoglycin A in canned ackee fruit. AB - An ion-exchange chromatographic method was developed to determine hypoglycin A (HG-A) levels in canned ackee fruit by using an amino acid analyzer. HG-A was extracted by homogenizing the sample in 80% alcohol. An isocratic buffer system, consisting of 30% sodium citrate buffer (pH 3.15) and 70% sodium chloride-sodium acetate buffer (pH 7.40) was used to obtain baseline separation between HG-A and the other amino acids. The system can detect HG-A levels as low as 4.8 micrograms/mL. HG-A levels in the edible portion of fruit in 6 cans ranged from 11.0 to 66.5 mg HG-A/can. Recoveries by standard addition averaged 102.5%. PMID- 2708291 TI - Zinc from oyster tissue as causative factor in mouse deaths in official bioassay for paralytic shellfish poison. AB - Toxicity (extreme weakness, body temperature drop, cyanosis, some slow deaths) in test mice, upon intraperitoneal injection of standard-method paralytic shellfish poison (PSP) extracts of some PSP-free oysters, is consistent with the relatively high levels of zinc in these extracts. As a rough guideline, the threshold for a toxic response corresponds to a drained tissue zinc level of over 900 micrograms/g. The identification of zinc as the substance responsible has been supported by inducing toxicity in control extracts by spiking with nontoxic levels of zinc, and by eliminating toxicity from toxic extracts by chemical removal (precipitation, ion exchange) of metals. PMID- 2708292 TI - Determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin in fish, using electron capture gas chromatography with confirmation by mass spectrometry: interlaboratory study. AB - An interlaboratory study of the determination of 2,3,7,8-tetrachlorodibenzo-p dioxin (2,3,7,8-TCDD) in fish was conducted by 6 analysts in 4 laboratories using high resolution gas chromatography with electron capture detection (HRGC-EC) for quantitative screening analysis. Samples consisted of 3 Great Lakes channel catfish homogenates containing different levels of bioincurred 2,3,7,8-TCDD; 1 of these was prepared in duplicate and another was prepared both with and without standard 2,3,7,8-TCDD fortification for a total of 5 samples per set. All methods used included addition of 1,3,7,8-TCDD surrogate (to correct for procedural losses) followed by ethanolic KOH digestion and hexane extraction. Certain cleanup steps used, including sulfuric acid washing and multidimensional column liquid chromatographic procedures, varied among laboratories. Mean HRGC-EC results for the bioincurred residues were 56.6, 25.2, and 7.7 pg/g (ppt) with corresponding relative standard deviations (RSDs) of 9.1, 18.6, and 53.2%. Average determination of standard 2,3,7,8-TCDD from the fortified sample (corrected for surrogate recoveries averaging 74.6%) was 106% of the added amount (30.9 pg/g) with 11.0% RSD. HRGC-multiple ion detection mass spectrometry (MS), monitoring 12 ions, was used for confirmation. With the exception of several results from 1 analyst, HRGC-MS and HRGC-EC quantitations were in good agreement. All but 1 result reported met all of the MS identity criteria. PMID- 2708293 TI - Pathophysiologic findings in nonretarded autism and receptive developmental language disorder. AB - In nonretarded autistic, receptive developmental language disordered, and normal subject groups, we recorded in auditory and visual target detection tasks two neurophysiological components of the event-related brain potential, Nc and P3b. Existent research shows that, in normals, Nc and P3b appear early in development, are associated with attention and memory processes, and are endogenous which means that they are triggered by internal, consciously initiated attentional and cognitive mechanisms and that they can be triggered even by the omission of sensory stimulation so long as it has meaning or importance for the subject. In this report, Nc and P3b were recorded in response to auditory and visual stimulation and to the omission of auditory and visual stimulation. Consistent with the hypothesis that non-retarded autism involves abnormal attentional and cognitive responses to important information, P3b was found to be smaller than normal and Nc was small and often absent in the nonretarded autistic group even under the condition when no auditory language or sensory processing was required. Receptive developmental language disorder has been linked with difficulties in processing sequences of auditory stimuli, and in this study P3b was found to be somewhat enlarged in this group even under the conditions when P3b was elicited by stimuli separated by 1 sec and also when P3b was elicited by the omission of stimulation. PMID- 2708294 TI - Infantile autism and computerized tomography brain-scan findings: specific versus nonspecific abnormalities. AB - The hypothesis that specific computerized tomography brain-scan findings are associated with infantile autism was tested in 45 cases and 19 controls. The autistic group was subdivided into serious and less-serious language-impaired subgroups. The analysis of Euclidean Distances, a type of cluster analysis, showed that neuroradiological parameters of cases and controls, including ventricular sizes, were on the whole significantly different, but no statistically significant difference appeared between the two autistic subgroups. But the analysis of variance of each neuroradiological parameter did not show any significant difference between autistics and controls. It was concluded that autism is nonspecifically associated with brain-scan abnormalities, and that other nonorganic, as well as organic, factors should be taken into account. PMID- 2708295 TI - Role taking and social competence in autism and mental retardation. AB - Recent data suggest that individuals with autism show deficits in social cognitive abilities when compared with nonautistic persons matched for mental age. These deficits have been proposed as a basis for the social interaction difficulties seen in autistic persons. In the present study, autistic youth were compared with a matched group of nonautistic mentally retarded youth on three role-taking tasks and three measures of social competence. Results indicated that the autistic group was relatively deficient on each of the social competence measures and on one of the role-taking measures. The role-taking measure on which the groups differed also correlated significantly with each of the social competence measures. Results were discussed in terms of the interplay between social cognitive abilities and social interaction. PMID- 2708297 TI - A social skills group for autistic children. AB - The evolution and preliminary evaluation of a social skills training group for 10 autistic children aged between 9 and 16 years was described. These children attended a special unit which aimed to integrate them into normal school provision. The paper consists of a description of the evolution of the group and the training methods employed and an evaluation of the effect of the group. This was accomplished by the use of a standard teacher's questionnaire. The results of the evaluation are described and the implications for further study of this means of helping autistic individuals discussed. PMID- 2708296 TI - Whole blood serotonin and tryptophan in autism: temporal stability and the effects of medication. AB - Whole blood serotonin (5-HT) was significantly increased in a drug-free autistic group (n = 17) compared to age- and sex-matched normal control (n = 20). Blood tryptophan (TRP) values and platelet counts were similar in unmedicated autistics and normal subjects; but whole blood concentrations of TRP were significantly lower, and 5-HT values tended to be lower in the medicated group compared to unmedicated autistics. Highly significant intraclass correlation coefficients and low mean percentage differences were found for repeated measures over a year's period of whole blood 5-HT and the platelet count in the unmedicated but not in the medicated group. Blood TRP values were highly variable over time in both the medicated and drug-free autistic groups. PMID- 2708298 TI - Indications for medical screening prior to behavioral programming for severely and profoundly mentally retarded clients. PMID- 2708299 TI - Autism resources at the higher education level in Indiana. PMID- 2708300 TI - Additional evidence for genetic component in autism. PMID- 2708302 TI - The Adolescent and Adult Psychoeducational Profile: assessment of adolescents and adults with severe developmental handicaps. AB - The purpose of this study was to determine the reliability and validity of the Adolescent and Adult Psychoeducational Profile (AAPEP), an assessment instrument designed for adolescents and adults with severe developmental handicaps. Subjects were 60 adolescents and adults, 30 with autism and 30 with mental retardation but without autism. The groups were matched on age and IQ. Results suggested high interrater reliability on all function areas of the AAPEP (Vocational Skills, Independent Functioning, Leisure Skills, Vocational Behavior, Functional Communication, Interpersonal Behavior) and on all three scales (Direct Observation, Home, School/Work). Validity measures suggested that the recommendations generated from the AAPEP were viewed by blind experts as more helpful than those already generated for the individual clients and contained in their Individual Education Programs (IEPs) or Individual Habilitation Plans (IHPs). Informal measures indicated that parents and/or group home staff also found AAPEP recommendations helpful. Finally, reliability and validity measures were also encouraging for moderately and severely handicapped adolescents and adults without autism. The AAPEP appears to be an effective new instrument for those working with older handicapped clients. PMID- 2708301 TI - Infantile autism and developmental receptive dysphasia: a comparative follow-up into middle childhood. AB - An interim follow-up study of a group of "higher functioning" boys with infantile autism and control group of boys with severe (receptive) developmental language disorder (or dysphasia) is reported. The boys were compared both initially and at follow-up for overall functioning in the areas of language, peer relationships, stereotyped behaviors, and disruptive public behaviors, as well as for the presence of a number of specific symptoms. In some respects, the behaviors that differentiated the groups initially did so also at follow-up, although there were important differences. Very few of the autistic boys had good language skills at follow-up, whereas nearly half of the dysphasic group were communicating well, a difference that is striking in view of the initial general similarity between the groups in terms of poor language functioning. However, some of the dysphasic children had developed greater difficulties in peer relationships. The implications for concepts of the nature of the deficit in severe receptive developmental language disorders are considered. PMID- 2708303 TI - Psychometric validity and clinical usefulness of the Vineland Adaptive Behavior Scales and the AAMD Adaptive Behavior Scale for an autistic sample. AB - Two prominent assessment measures of adaptive behavior were compared and evaluated in terms of their psychometric properties and their clinical usefulness for autistic children and adolescents. The AAMD Adaptive Behavior Scale-School Edition (Lambert & Windmiller, 1981) and the Vineland Adapative Behavior Scales (Sparrow, Balla, & Cicchetti, 1984) were compared in 15 autistic persons aged 8 to 18. Correlations between the two instruments revealed good concurrent validity. The psychometric properties of the tests were similar to those found in samples of mentally retarded persons. The use of adaptive behavior measures for autistic children and adolescents is encouraged. Clinical advantages and disadvantages of the two tests are discussed. PMID- 2708304 TI - A comparison of procedures in teaching self-help skills: increasing assistance, time delay, and observational learning. AB - The effectiveness and efficiency of two prompt-fading procedures were compared during the instruction of two self-help skills to four pairs of developmentally delayed preschoolers. In addition, the effect of observational learning was examined. Within a combined multiple probe and parallel treatments design, one member of each pair received direct instruction on the two skills. One skill was taught using an increasing assistance prompting procedure and the other skill was taught using a constant time delay procedure. The other member of the pair was prompted to observe the instruction, but was not taught directly. Reliability of scoring and procedural integrity were estimated, and social validity of outcomes considered. Findings indicated a slight but discernible advantage of using the time delay procedure rather than the increasing assistance procedure to teach complex, chained-response tasks. Further, considerable learning resulted solely from the observation of instruction. PMID- 2708305 TI - An alternative view of pronominal errors in autistic children. AB - Persistent pronominal errors in autistic children have been attributed either to a psychosocial deficit or to a linguistic or cognitive deficit. However, recent studies of normal children suggest that the failure to observe pronouns in speech addressed to another person is a major reason children show pronominal errors. The present study investigated if pronominal errors in autistic children can be explained by this alternative hypothesis. Children's attentiveness to the pronoun models and their imitative behaviors were examined under two modeling conditions. The nonaddressee condition provided children with systematic opportunities to observe pronoun models directed to another person as well as those directed to themselves. The addressee condition provided only systematic opportunities to observe pronoun models directed to children. Clear evidence for the alternative hypothesis was obtained for second person pronouns, suggesting that pronominal errors in autistic children can be interpreted within the framework of normal language development. PMID- 2708306 TI - The prevalence of autism in Nagoya, Japan: a total population study. AB - The prevalence rate of autism has been reported as 0.04% to 0.05%, but one recent study in Japan found prevalence of 0.16%. The authors have been involved in routine well-child medical examinations at 18 months of age, at the Midori Public Health Center in Nagoya. A statistical survey of diagnoses was made from April 1979 to March 1984 for the purpose of conducting an epidemiological study of autism. Of 12,263 children examined, 168 were identified as having developmental problems and, of these, 139 underwent a second examination. Autism was diagnosed in 16 of these children and a category called "autism suspected" was defined in an additional 10 of these 139 children. The 16 cases of autism gave a minimum prevalence of 0.13%, three times the usually reported rate. The validity of the higher prevalence rates is discussed. PMID- 2708307 TI - Plasmid structural instability associated with pC194 replication functions. AB - The hybrid plasmid pJS37 is composed of the streptococcal plasmid pLS1, which confers tetracycline resistance, and the staphylococcal plasmid pC194, which confers chloramphenicol resistance. When gram-positive bacteria containing pJS37 were grown in the presence of chloramphenicol, four different deleted derivatives accumulated. The deletions in the plasmid enhanced resistance to chloramphenicol by placing the cat gene of pC194 near promoters of pLS1. All four deletions shared a common endpoint that corresponded to the putative target site for DNA strand nicking by the pC194 replication protein, RepH. At the other, variable endpoint, the DNA sequence was similar to the putative RepH target sequence. Alteration of the RepH protein, by in vitro modification of the gene encoding it, eliminated this class of deletions. By extending a previously proposed model for the generation of a different but related class of deletions (B. Michel and S.D. Ehrlich, EMBO J. 5:3691-3696, 1986), a comprehensive model that could generate both classes of deletions is suggested. It proposes that a nicking-closing activity of the plasmid replication protein at its normal target site and, aberrantly, at sites with similar sequence can generate deletions either proximal or distal to the aberrant site during rolling-circle replication of the plasmid. PMID- 2708308 TI - Characterization of mutations of the bacteriophage P1 mod gene encoding the recognition subunit of the EcoP1 restriction and modification system. AB - This study characterized several mutations of the bacteriophage P1 mod gene. This gene codes for the subunit of the EcoP1 restriction enzyme that is responsible for DNA sequence recognition and for modification methylation. We cloned the mutant mod genes into expression vectors and purified the mutant proteins to near homogeneity. Two of the mutant mod genes studied were the c2 clear-plaque mutants described by Scott (Virology 41:66-71, 1970). These mutant proteins can recognize EcoP1 sites in DNA and direct restriction but are unable to modify DNA. Methylation assays as well as S-adenosylmethionine (SAM) binding studies showed that the c2 mutants are methylation deficient because they do not bind SAM, and we conclude that the mutations destroy the SAM-binding site. Both of the c2 mutations lie within a region of the EcoP1 mod gene that is not conserved when compared with the mod gene of the related EcoP15 system. EcoP15 and EcoP1 recognize different DNA sequences, and we believe that this region of the protein may code for the DNA-binding site of the enzyme. The other mutants characterized were made by site-directed mutagenesis at codon 240. Evidence is presented that one of them, Ser-240----Pro, simultaneously lost the capacity to bind SAM and may also have changed its DNA sequence specificity. PMID- 2708309 TI - Glutamate synthesis in Streptomyces coelicolor. AB - Both glutamate synthase (GOGAT) and glutamate dehydrogenase (GDH) are involved in glutamate synthesis in Streptomyces coelicolor. The highest levels of GDH were seen in extracts of cells grown with high levels of ammonium as the nitrogen source. GOGAT activity was reduced two- to threefold in extracts of cells grown with good sources of glutamate. S. coelicolor mutants deficient in GOGAT (Glt-) required glutamate for growth with L-alanine, asparagine, arginine, or histidine as the nitrogen source but grew like wild-type cells when ammonium, glutamine, or aspartate was the nitrogen source. The glt mutations were tightly linked to hisA1. Mutants deficient in both GOGAT and GDH (Gdh-) required glutamate for growth in all media. The gdh-5 mutation was mapped to the left region of the S. coelicolor chromosomal map, between proA1 and uraA1. PMID- 2708310 TI - Expressed genes for plant-type ribulose 1,5-bisphosphate carboxylase/oxygenase in the photosynthetic bacterium Chromatium vinosum, which possesses two complete sets of the genes. AB - Two sets of genes for the large and small subunits of ribulose 1,5-bisphosphate carboxylase/oxygenase (RuBisCO) were detected in the photosynthetic purple sulfur bacterium Chromatium vinosum by hybridization analysis with RuBisCO gene probes, cloned by using the lambda Fix vector, and designated rbcL-rbcS and rbcA-rbcB. rbcL and rbcA encode the large subunits, and rbcS and rbcB encode the small subunits. rbcL-rbcS was the same as that reported previously (A. M. Viale, H. Kobayashi, T. Takabe, and T. Akazawa, FEBS Lett. 192:283-288, 1985). A DNA fragment bearing rbcA-rbcB was subcloned in plasmid vectors and sequenced. We found that rbcB was located 177 base pairs downstream of the rbcA coding region, and both genes were preceded by plausible procaryotic ribosome-binding sites. rbcA and rbcD encoded polypeptides of 472 and 118 amino acids, respectively. Edman degradation analysis of the subunits of RuBisCO isolated from C. vinosum showed that rbcA-rbcB encoded the enzyme present in this bacterium. The large- and small-subunit polypeptides were posttranslationally processed to remove 2 and 1 amino acid residues from their N-termini, respectively. Among hetero-oligomeric RuBisCOs, the C. vinosum large subunit exhibited higher homology to that from cyanobacteria, eucaryotic algae, and higher plants (71.6 to 74.2%) than to that from the chemolithotrophic bacterium Alcaligenes eutrophus (56.6%). A similar situation has been observed for the C. vinosum small subunit, although the homology among small subunits from different organisms was lower than that among the large subunits. PMID- 2708311 TI - Nucleotide sequence and analysis of the plant-inducible locus pinF from Agrobacterium tumefaciens. AB - Several loci on the tumor-inducing plasmid from Agrobacterium tumefaciens were transcriptionally activated in the presence of wounded plant tissue or extracts. The inducible virulence loci were required for efficient tumor formation. In contrast, the plant-inducible locus pinF was not observed to be absolutely essential for virulence. Mutants in pinF showed an attenuated virulence on a variety of dicotyledonous hosts, and this attenuation became more pronounced with decreasing numbers of bacterial cells in the inoculum. The DNA sequence of a 5.5 kilobase region which included the pinF locus from the octopine-type tumor inducing plasmid A6 was determined. Four open reading frames consistent with the observed transcription of pinF were observed. Two of the open reading frames, pinF1 and pinF2, coded for polypeptides with relative molecular weights of 47,519 (pinF1) and 46,740 (pinF2). A comparison of the amino acid sequences of pinF1 and pinF2 indicated that they were similar to each other and to known polypeptide sequences for cytochrome P-450 enzymes. PMID- 2708313 TI - Cooperative binding of Agrobacterium tumefaciens VirE2 protein to single-stranded DNA. AB - The VirE2 protein of Agrobacterium tumefaciens Ti plasmid pTiA6 is a single stranded-DNA-binding protein. Density gradient centrifugation studies showed that it exists as a tetramer in solution. Monomeric VirE2 active in DNA binding could also be obtained by using a different protein isolation procedure. VirE2 was found to be thermolabile; brief incubation at 37 degrees C abolished its DNA binding activity. It was insensitive to the sulfhydryl-specific reagent N ethylmaleimide. Removal of the carboxy-terminal 37 residues of the 533-residue VirE2 polypeptide led to complete loss of DNA-binding activity; however, chimeric fusion proteins containing up to 125 residues of the VirE2 C terminus were inactive in DNA binding. In nuclease protection studies, VirE2 protected single stranded DNA against degradation by DNase I. Analysis of the DNA-VirE2 complex by electron microscopy demonstrated that VirE2 coats a single-stranded DNA molecule and that the binding of VirE2 to its substrate is cooperative. PMID- 2708312 TI - Extracellular secretion of cloned aerolysin and phospholipase by Aeromonas salmonicida. AB - The promoterless structural genes for aerolysin and the extracellular phospholipase of Aeromonas hydrophila were inserted into a multi-host-range expression vector and transferred into Aeromonas salmonicida and Escherichia coli. In both species, gene expression was under the control of the inducible tac promoter of the vector. Neither the phospholipase nor the aerolysin was released by intact E. coli. Instead, both proteins accumulated in the periplasm, leading to reduced growth and eventual cell death. When the aerolysin gene inserted into the vector contained its own promoter, the toxin was expressed constitutively by A. salmonicida but not by E. coli. Production of aerolysin and the phospholipase by A. salmonicida did not affect cell growth, and the proteins were correctly processed and exported by intact cells. Both proteins could also be detected in the periplasm, where their concentrations were considerably higher then they were outside the cells. Periplasmic aerolysin was rapidly released when cells were transferred to fresh medium, indicating that this compartment is part of the normal export pathway and that the protein is not shunted there as a consequence of overproduction. Plasmid-coded aerolysin did not appear to compete with the cell proteins for export components, as even when very large quantities of aerolysin were being exported by A. salmonicida, there was no effect on chromosomal protease release and only a modest reduction in the export of chromosomal phospholipase. PMID- 2708314 TI - Open reading frame 5 (ORF5), encoding a ferredoxinlike protein, and nifQ are cotranscribed with nifE, nifN, nifX, and ORF4 in Rhodobacter capsulatus. AB - DNA sequence analysis of a 1,600-base-pair fragment located downstream of nifENX in nif region A of Rhodobacter capsulatus revealed two additional open reading frames (ORFs): ORF5, encoding a ferredoxinlike protein, and nifQ. The ferredoxinlike gene product contained two cysteine motifs, typical of ferredoxins coordinating two 4Fe-4S clusters, but the distance between these two motifs was unusual for low-molecular-weight ferredoxins. The R. capsulatus nifQ gene product shared a high degree of homology with Klebsiella pneumoniae and Azotobacter vinelandii NifQ, including a typical cysteine motif located in the C-terminal part. nifQ insertion mutants and also an ORF5-nifQ double deletion mutant showed normal diazotrophic growth only in the presence of high concentrations of molybdate. This demonstrated that the gene encoding the ferredoxinlike protein is not essential for nitrogen fixation. No NifA-activated consensus promoter could be found in the intergenic region between nifENX-ORF4 and ORF5-nifQ. Analyses of a nifQ-lacZYA fusion revealed that transcription of nifQ was initiated at a promoter in front of nifE. In contrast to other nitrogen-fixing organisms, R. capsulatus nifE, nifN, nifX, ORF4, ORF5, and nifQ were organized in one transcriptional unit. PMID- 2708315 TI - Purification and characterization of oxalyl-coenzyme A decarboxylase from Oxalobacter formigenes. AB - Oxalyl-coenzyme A (oxalyl-CoA) decarboxylase was purified from Oxalobacter formigenes by high-pressure liquid chromatography with hydrophobic interaction chromatography, DEAE anion-exchange chromatography, and gel permeation chromatography. The enzyme is made up of four identical subunits (Mr, 65,000) to give the active enzyme (Mr, 260,000). The enzyme catalyzed the thiamine PPi dependent decarboxylation of oxalyl-CoA to formate and carbon dioxide. Apparent Km and Vmax values, respectively, were 0.24 mM and 0.25 mumol/min for oxalyl-CoA and 1.1 pM and 0.14 mumol/min for thiamine pyrophosphate. The maximum specific activity was 13.5 microM oxalyl-CoA decarboxylated per min per mg of protein. PMID- 2708316 TI - Identification and sequence of the basic replication region of a broad-host-range plasmid isolated from Thiobacillus ferrooxidans. AB - The minimum region required for replication of the broad-host-range Thiobacillus ferrooxidans plasmid pTF-FC2 in Escherichia coli was shown to be contained on a 2.05-kilobase fragment of DNA. A 184-base-pair fragment that was required in cis for plasmid replication was identified. This region was also involved in plasmid incompatibility. Nucleotide sequencing of this region revealed three perfectly conserved 22-base-pair tandemly repeated sequences. A comparison of this region with the equivalent region of the broad-host-range plasmid R1162 showed that the repeated sequences had 60% nucleotide homology. The 106-base-pair region immediately adjacent to the repeated sequences was 75% homologous. These plasmids were compatible. PMID- 2708317 TI - Mutational changes in physiochemical cell surface properties of plant-growth stimulating Pseudomonas spp. do not influence the attachment properties of the cells. AB - Bacteriophage-resistant mutant strains of the root-colonizing Pseudomonas strains WCS358 and WCS374 lack the O-antigenic side chain of the lipopolysaccharide, as was shown by the loss of the typical lipopolysaccharide ladder pattern after analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. These strains differed from their parent strains in cell surface hydrophobicity and in cell surface charge. The observed variation in these physicochemical characteristics could be explained by the differences in sugar composition. The mutant strains had no altered properties of adherence to sterile potato roots compared with their parental strains, nor were differences observed in the firm adhesion to hydrophilic, lipophilic, negatively charged, or positively charged artificial surfaces. These results show that neither physicochemical cell surface properties nor the presence of the O-antigenic side chain plays a major role in the firm adhesion of these bacterial cells to solid surfaces, including potato roots. PMID- 2708318 TI - Identification of a gene required for maturation of an extracellular lactococcal serine proteinase. AB - Directly upstream of the Lactococcus lactis subsp. cremoris Wg2 proteinase gene is an oppositely directed open reading frame (ORF1). The complete nucleotide sequence of ORF1, encoding a 33-kilodalton protein, was determined. A protein of approximately 32 kilodaltons was synthesized when ORF1 was expressed in Escherichia coli by using a T7 RNA polymerase-specific promoter. L. lactis subsp. lactis MG1363 transformants carrying the proteinase gene but lacking ORF1 were phenotypically proteinase deficient, unlike transformants carrying both the proteinase gene and ORF1. Synthesis and secretion of proteinase antigen by L. lactis could be detected with proteinase-directed monoclonal antibodies regardless of whether ORF1 was present. The requirement of ORF1 for proteinase activation was reflected in a reduction in the molecular weight of the secreted proteinase. Furthermore, deletion of the 130 C-terminal amino acids of the Wg2 proteinase prevented attachment of the enzyme to lactococcal cells. PMID- 2708319 TI - Basal-body-associated disks are additional structural elements of the flagellar apparatus isolated from Wolinella succinogenes. AB - The intact flagella of Wolinella succinogenes, a gram-negative, anaerobic bacterium with a single polar flagellum, were obtained by an improved procedure, introduced recently by Aizawa et al. (S.-J. Aizawa, G. E. Dean, C. J. Jones, R. M. Macnab, and S. Yamaguchi, J. Bacteriol. 161:836-849, 1985) for the flagellum of Salmonella typhimurium. Disks with a diameter of 130 +/- 30 nm, which were attached to the basal body of the isolated intact flagella, could be identified by electron microscopy as additional structural elements of the bacterial flagellar apparatus. In freeze-dried and metal-shadowed samples, two rings of the basal body were detected on one side and a terminal knob was located on the other side of the disks. Suspension of the flagellar apparatus in acidic solution dissociated the flagellar filaments, yielding hook-basal body complexes with and without the associated disks. If whole cells were subjected to low pH, double disks of the same diameter and with a central hole of about 13 nm could be isolated. Similar parallel disks could be seen also in negatively stained whole cells. When uranyl acetate was used for negative staining of the intact flagella, concentric rings were detected on the disks, similar to the concentric membrane rings found by Coulton and Murray (J. W. Coulton and R. G. E. Murray, J. Bacteriol. 136:1037-1049, 1978) on platelike arrays of proteins in outer membrane preparations of Aquaspirillum serpens. Because the disks of W. succinogenes can be isolated together with the flagellar hook-basal body complex, they appear to be basal-body-rather than secondary membrane-associated structures. It is possible that these disks are the bearing or stator of this rotary device. PMID- 2708320 TI - Function of alpha-D-glucosyl monophosphorylpolyprenol in biosynthesis of cell wall teichoic acids in Bacillus coagulans. AB - D-[alpha-14C]]glucosyl phosphorylpolyprenol ([ 14C]Glc-P-prenol) was formed from UDP-D-[14C]glucose in each of the membrane systems obtained from Bacillus coagulans AHU 1631 and AHU 1634 and two Bacillus megaterium strains. Membranes of these B. coagulans strains, which possess beta-D-glucosyl branches on the repeating units in their major cell wall teichoic acids, were shown to catalyze the transfer of the glucose residue from [14C]Glc-P-prenol to endogenous polymer. On the other hand, membranes of B. coagulans AHU 1366, which has no glucose substituents in the cell wall teichoic acid, exhibited neither [14C]Glc-P-prenol synthetase activity nor the activity of transferring glucose from [14C]Glc-P prenol to endogenous acceptor. The enzyme which catalyzes the polymer glycosylation in the former two B. coagulans strains was most active at pH 5.5 and in the presence of the Mg2+ ion. The apparent Km for [14C]Glc-P-prenol was 0.6 microM. Hydrogen fluoride hydrolysis of the [14C]glucose-linked polymer product yielded a major fragment identical to D-galactosyl-alpha(1----2)(D glucosyl-beta(1----1/3)) glycerol, the dephosphorylated repeating unit in the major cell wall teichoic acids of these B. coagulans strains. This result, together with the behavior of the radioactive polymer in chromatography on Sepharose CL-6B, DEAE-Sephacel, and Octyl-Sepharose CL-4B, led to the conclusion that [14C]Glc-P-prenol serves as an intermediate in the formation of beta-D glucosyl branches on the polymer chains of cell wall teichoic acids in B. coagulans. PMID- 2708321 TI - Biochemical characterization of avirulent Agrobacterium tumefaciens chvA mutants: synthesis and excretion of beta-(1-2)glucan. AB - The chvA gene product of Agrobacterium tumefaciens is required for virulence and attachment of bacteria to plant cells. Three chvA mutants were studied. In vivo, they were defective in the synthesis, accumulation, and secretion of beta-(1 2)glucan; however, the 235-kilodalton (kDa) protein known to be involved in the synthesis of beta-(1-2)glucan (A. Zorreguieta and R. Ugalde, J. Bacteriol. 167:947-951, 1986) was present and active in vitro. was present and active in vitro. Two molecular forms of cyclic beta-(1-2)glucan, designated types I and II, were resolved by gel chromatography. Type I beta-(1-2)glucan was substituted with nonglycosidic residues, and type II beta-(1-2)glucan was nonsubstituted. Wild type cells accumulated type I beta-(1-2)glucan, and chvA mutant cells accumulated mainly type II beta-(1-2)glucan and a small amount of type I beta-(1-2)glucan. Inner membranes of wild-type and chvA mutants formed in vitro type II nonsubstituted beta-(1-2)glucan. A 75-kDa inner membrane protein is proposed to be the chvA gene product. chvA mutant inner membranes had increased levels of 235 kDa protein; partial trypsin digestion patterns suggested that the 235-kDa protein (the gene product of the chvB region) and the gene product of the chvA region form a complex in the inner membrane that is involved in the synthesis, secretion, and modification of beta-(1-2)glucan. All of the defects assigned to the chvA mutation were restored after complementation with plasmid pCD522 containing the entire chvA region. PMID- 2708322 TI - Chemotaxis in the archaebacterium Methanococcus voltae. AB - The archaebacterium Methanococcus voltae, was shown to be chemotactic. Acetate, isoleucine, and leucine were identified as attractants; whereas histidine was not an attractant. A motile, generally nonchemotactic mutant was isolated. PMID- 2708323 TI - Electron transport and electrochemical proton gradient in membrane vesicles of Clostridium thermoautotrophicum. AB - Membrane vesicles of Clostridium thermoautotrophicum containing carbon monoxide dehydrogenase generated a proton motive force when exposed to CO. This proton motive force, with a value of -140 mV, consisted of only an electrical potential at pH 7.5 and above and of an electrical potential and pH gradient at a lower pH. The proton motive force drove the uptake of L-alanine by the vesicles to a concentration of 300 times that of the medium. PMID- 2708324 TI - Novel arrangement of rRNA genes in Mycoplasma gallisepticum: separation of the 16S gene of one set from the 23S and 5S genes. AB - Large restriction fragments from the DNA of Mycoplasma gallisepticum S6 and PG31, which were prepared by digestion with BglI, BssHII, SmaI, or XhoI and which were separated by pulsed-field electrophoresis, were hybridized with probes containing most, or different parts, of an rRNA operon of Mycoplasma capricolum. The results showed that the genomes contained three widely separated rRNA loci. One locus contained genes for all three rRNA species and another contained 23S and probably 5S rRNA genes, whereas the third appeared to have only a 16S rRNA gene. PMID- 2708325 TI - Expression and inducibility in Staphylococcus aureus of the mecA gene, which encodes a methicillin-resistant S. aureus-specific penicillin-binding protein. AB - A beta-lactam-sensitive strain of Staphylococcus aureus could be converted to methicillin resistance by the introduction of a plasmid carrying the 4.3-kilobase HindIII chromosomal DNA fragment which encoded the mecA gene from a methicillin resistant S. aureus. Transformant cells produced methicillin-resistant S. aureus specific penicillin-binding protein constitutively, and additional insertion of an inducible penicillinase plasmid caused production of the pencillin-binding protein to become inducible. PMID- 2708326 TI - Estrogen treatment increases phospholipid transfer activities in chicken liver. AB - The effect of subcutaneous beta-estradiol injection on liver phosphatidylcholine, phosphatidylethanolamine and phosphatidylinositol transfer activity of immature chicken has been determined. The estrogen administration significantly enhanced the transfer activity of both phosphatidylcholine (100%), phosphatidylethanolamine (160%), and phosphatidylinositol (150%). In vivo experiments revealed that the hormone-induced changes in liver lipid transfer activity were sensitive to a protein synthesis inhibitor, cycloheximide. A partial characterization of liver protein transfer on Sephacryl S-200 showed that multiple transfer proteins are involved in the beta-estradiol effect. This is the first time that hormonal modulation of phospholipid transfer activities is described, and the results suggest that the hepatic phospholipid transfer activities might be involved in the biosynthesis of plasma lipoproteins in vivo. PMID- 2708327 TI - Inhibitors of 2-ketoglutarate-dependent dioxygenases block aspartyl beta hydroxylation of recombinant human factor IX in several mammalian expression systems. AB - While a role has been ascribed to the gamma-carboxyglutamate (Gla) residues in vitamin K-dependent coagulation proteins and the enzyme catalyzing this posttranslational modification has been identified and partially characterized, both the functional significance of a second posttranslationally synthesized amino acid found in these proteins, beta-hydroxyaspartate (Hya), and the aspartyl beta-hydroxylating enzyme remain to be determined. We now report that inhibitors of 2-ketoglutarate-dependent dioxygenases, such as dipyridyl, o-phenanthroline, and pyridine 2,4-dicarboxylate, block hydroxylation of Asp64 in recombinant factor IX molecules produced in three different mammalian expression systems. This hydroxylation was not inhibited by the specific copper chelators 2,9 dimethylphenanthroline or D-penicillamine. The Gla levels in these proteins were unaffected by these compounds and demonstrate that carboxylation proceeds independently of hydroxylation. Using these Hya-deficient recombinant factor IX molecules we demonstrate that this residue does not play a significant role in factor IX binding to endothelial cells under equilibrium conditions. From additional binding studies we have concluded that the Gla domain of factor IX is a major cell binding domain of factor IX. Furthermore, in contrast to studies demonstrating a marked loss of one-stage clotting activity in recombinant factors IX following site-directed mutations of Asp64 to neutral or basic residues (Rees, D. J. G., Jones, I. M., Handford, P. A., Walter, S. J., Esnouf, M. P., Smith, K. J., and Brownlee, G. J. (1988) EMBO J. 7, 2053-2061), we have not found a decrease of one-stage clotting activity with Hya-deficient factor IX. Hya deficient proteins produced in this manner may prove to be more appropriate to elucidate the function of Hya than those produced by site-directed mutagenesis. PMID- 2708328 TI - Amino acid sequence of Mirabilis antiviral protein, total synthesis of its gene and expression in Escherichia coli. AB - We have determined the complete amino acid sequence of Mirabilis antiviral protein (MAP). MAP is composed of 250 amino acids having a combined molecular weight of 27,833 and contains 23 lysine residues and 7 arginine residues. The amino acid sequence of MAP has 24% homology with the Ricin D-A chain. To carry out systematic structure-function studies of MAP, we have accomplished the total synthesis of its gene. We designed a synthetic MAP gene containing 12 unique restriction sites that were on the average 65 base pairs apart. Thirty synthetic oligonucleotides were enzymatically joined to form DNA duplexes. These were strategically synthesized to have EcoRI and HindIII cohesive ends and were cloned in pUC19. Nine blocks of the synthetic fragments were assembled in pUC19 to form the MAP gene consisting of 759 base pairs. The correctness of the connecting reactions was confirmed by step-wise sequencing of each assembled fragment as well as the total gene. When expressed under control of the tac promoter in Escherichia coli, the synthetic gene gave a protein similar to the native MAP. This was confirmed by an enzyme-linked immunosorbent assay and Western blotting analysis. PMID- 2708329 TI - Direct evidence for intra- and intermolecular disulfide bond formation in the human glucocorticoid receptor. Inhibition of DNA binding and identification of a new receptor-associated protein. AB - We have investigated the potential for the steroid affinity-labeled human glucocorticoid receptor to form both intramolecular and intermolecular disulfide bonds. Glucocorticoid receptors labeled in intact HeLa S3 cells with the covalent affinity label [3H]dexamethasone mesylate ([3H]DM) were analyzed on denaturing 5 12% polyacrylamide gels under both nonreducing and reducing conditions. Under nonreducing conditions the affinity-labeled receptor migrated as a heterogeneous species having an average molecular mass of approximately 96 kDa whereas, under reducing conditions, the receptor migrated as a more discrete form. These data suggest that a reducing environment can influence the structure of the glucocorticoid receptor monomer and further imply that sulfhydryl groups within the affinity-labeled receptor are available for modification. To pursue this observation in greater detail, we tested the effect of oxidizing conditions on the structure of the glucocorticoid receptor. The presence of low concentrations (0.125-0.5 mM) of three oxidizing reagents (sodium tetrathionate, disulfiram, and iodosobenzoate) altered the migration of the affinity-labeled receptor resulting in forms of apparent lower molecular mass (as low as 78 kDa). This altered migration, not seen with most other cytosolic proteins, is consistent with the formation of intramolecular disulfide bonds within the receptor which presumably cause it to assume a folded conformation and migrate faster through the gel. At higher concentrations of these reagents (up to 5.0 mM), we also detect a saturably labeled [3H]DM band which has a higher molecular mass (approximately 140 kDa), indicating the formation of intermolecular disulfide bonds between the [3H]DM-labeled receptor and another closely associated protein(s) having a molecular mass of approximately 40 kDa. The effects which these oxidizing reagents have on glucocorticoid receptor structure are completely reversed upon the addition of dithiothreitol, indicating that the observed changes in migration do not reflect receptor proteolysis but rather a folding and unfolding within the receptor monomeric protein. We have also analyzed the effect of this oxidation/reduction on the function of the glucocorticoid receptor. Oxidation of the [3H]DM-labeled receptor complex with 0.5 mM sodium tetrathionate inhibited activation of receptor to a form capable of binding to DNA-cellulose. This inhibition can be reversed with dithiothreitol at 25 degrees C but not at 0 degrees C, suggesting that these oxidizing reagents are inhibitory at the transformation and/or activation steps.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2708330 TI - Binding of monoiodinated neuropeptide Y to hippocampal membranes and human neuroblastoma cell lines. AB - Monoiodinated radioligands of the homologous 36-amino acid peptides, neuropeptide Y (NPY) and peptide YY, were prepared by reverse phase high performance liquid chromatography with isocratic elution. [125I-Tyr1]- and [125I-Tyr36]monoiodoNPY bound equally well to a single class of high affinity binding sites on synaptosomal membranes prepared from porcine hippocampus (Kd = 1.0 X 10(-10) M) whereas iodine substitution in Tyr27, for example, partly interfered with the receptor binding. The receptors on the hippocampal membranes did not distinguish between neuropeptide Y and peptide YY either in their monoiodinated or in their unlabeled forms. Six out of twelve human neuroblastoma cell lines had high affinity binding sites for monoiodinated NPY ranging from 2 to 145 X 10(3) sites per cell. The NPY binding to three of the cell lines, SMS-MSN, SMS-KAN, and CHP 234 was of relatively high affinity (Kd = 1.3 to 6.1 X 10(-10) M), and, as in the hippocampal membranes, the long C-terminal fragment, NPY(13-36)peptide was also a relatively potent ligand for these receptors. Two other neuroblastoma cell lines, MC-IXC and CHP-212, expressed NPY receptors characterized by a lower affinity (Kd = 4.8 and 24.6 X 10(-9) M) and negligible cross-reactivity with the C-terminal fragment. It is concluded that monoiodinated radioligands of the tyrosine-rich neuropeptide Y can be prepared and that receptors for these ligands in two apparently different subtypes are found on a series of human neuroblastoma cell lines. PMID- 2708331 TI - Complete amino acid sequence and structure characterization of the taste modifying protein, miraculin. AB - The taste-modifying protein, miraculin, has the unusual property of modifying sour taste into sweet taste. The complete amino acid sequence of miraculin purified from miracle fruits by a newly developed method (Theerasilp, S., and Kurihara, Y. (1988) J. Biol. Chem. 263, 11536-11539) was determined by an automatic Edman degradation method. Miraculin was a single polypeptide with 191 amino acid residues. The calculated molecular weight based on the amino acid sequence and the carbohydrate content (13.9%) was 24,600. Asn-42 and Asn-186 were linked N-glycosidically to carbohydrate chains. High homology was found between the amino acid sequences of miraculin and soybean trypsin inhibitor. PMID- 2708332 TI - Regulation of Na+/K+/Cl- cotransport and [3H]bumetanide binding site density by phorbol esters in HT29 cells. AB - The involvement of protein kinase C in the regulation of Na+/K+/Cl- cotransport was investigated in cultured HT29 human colonic adenocarcinoma cells. We have demonstrated previously the presence of a Na+/K+/Cl- cotransport pathway in HT29 cells (Kim, H.D., Tsai, Y-S., Franklin, C.C., and Turner, J.T. (1989) Biochim. Biophys. Acta 946, 397-404). Treatment of cells with the phorbol esters phorbol 12-myristate 13-acetate (PMA) and phorbol 12,13-dibutyrate (PDBu) caused an increase in membrane-associated protein kinase C activity that was accompanied by a concomitant decrease in cytosolic protein kinase C activity. PMA also produced a rapid transient increase in cotransport to 137% of control values by 5 min followed by a progressive decrease to 19% of control values by 2 h. To determine the underlying mechanism for the reduction in Na+/K+/Cl- cotransport, changes in cotransporter number and/or affinity were determined in radioligand binding studies using [3H]bumetanide. PMA and PDBu produced essentially identical time- and dose-dependent decreases in specific [3H]bumetanide binding that were similar to the observed decreases in cotransport. Analysis of saturation and competition binding data indicated that the decrease in binding was due to a lowered Bmax with no change in affinity. Both the decrease in binding and the changes in cotransport elicited by PMA were prevented by the protein kinase inhibitor H7. These findings suggest that phorbol esters cause a decrease in the number of cotransporters in HT29 cells, resulting in a reduction in Na+/K+/Cl- cotransport activity. PMID- 2708333 TI - The binding of isocolchicine to tubulin. Mechanisms of ligand association with tubulin. AB - Isocolchicine is a structurally related isomer of colchicine altered in the methoxytropone C ring. In spite of virtual structural homology of colchicine and isocolchicine, isocolchicine is commonly believed to be inactive in binding to tubulin and inhibiting microtubule assembly. We have found that isocolchicine does indeed bind to the colchicine site on tubulin, as demonstrated by its ability to competitively inhibit [3H]colchicine binding to tubulin with a KI approximately 400 microM. Isocolchicine inhibits tubulin assembly into microtubules with an I50 of about 1 mM, but the affinity of isocolchicine for the colchicine receptor site, 5.5 +/- 0.9 x 10(3) M-1 at 23 degrees C, is much less (approximately 500-fold) than that of colchicine. Unlike colchicine, isocolchicine binds rapidly, and the absorption and fluorescence properties of the complex are only modestly altered compared to free ligand. It is proposed that the binding of isocolchicine to tubulin may be rationalized either in terms of conformational states of colchicinoids when liganded to tubulin or by the structural requirements for C-10 substituents for high affinity binding to the colchicine receptor. PMID- 2708334 TI - Cloning of a cDNA encoding porcine brain natriuretic peptide. AB - Complimentary DNA (cDNA) clones encoding porcine brain natriuretic peptide (BNP) were isolated from a porcine atrial cDNA library. The longest of the cDNA clones (1507 nucleotides) apparently originated from an unprocessed messenger RNA, since the nucleotide sequence encoding BNP-26 was interrupted by an intron of 554 nucleotides. A partial cDNA clone representing processed BNP mRNA was prepared by polymerase chain reaction. A comparison of the sequence of these two cDNAs reveals the presence of an additional intron within the sequence encoding the BNP precursor. The identification of these introns suggests that the BNP gene structure differs from the atrial natriuretic peptide gene in the location of intron 2. BNP mRNA encodes a propeptide of 131 amino acids, including a signal peptide domain (25 amino acids) and a prohormone domain (106 amino acids). Like atrial natriuretic peptide, the bioactive BNP sequence is localized at the carboxyl terminus of the prohormone. Although the carboxyl-terminal peptide sequences of porcine atrial natriuretic peptide and BNP are well conserved, there is relatively little homology within their propeptide regions. PMID- 2708335 TI - Transcription-dependent structural changes in the C-terminal domain of mammalian RNA polymerase subunit IIa/o. AB - The C-terminal domain of mammalian RNA polymerase subunit IIa consists of 52 tandem repeats of the consensus sequence Tyr-Ser-Pro-Thr-Ser-Pro-Ser. This C terminal domain is essentially unmodified in RNA polymerase IIA and extensively phosphorylated in RNA polymerase IIO. A monoclonal antibody directed against the C-terminal domain was shown by kinetic enzyme-linked immunosorbent assay to have a 10-fold higher reactivity with RNA polymerase IIA than with RNA polymerase IIO. The ability of increasing concentrations of this monoclonal antibody to inhibit the initiation and elongation phase of transcription was determined. Although both phases of the transcription reaction were inhibited, a 10-fold higher concentration of antibody was required to inhibit elongation than was required to inhibit initiation. These results support the hypothesis that RNA polymerase IIA, containing an unphosphorylated C-terminal domain, is involved in the formation of an initiated complex, whereas elongation is catalyzed by RNA polymerase IIO, containing a phosphorylated C-terminal domain. Further indication that the C terminal domain undergoes a structural change during the transcription cycle results from the observation that this domain is 3-fold more sensitive to clostripain cleavage in the elongation enzyme than in the free enzyme. PMID- 2708336 TI - Energy dependence of different steps in the autophagic-lysosomal pathway. AB - The energy dependence of the autophagic-lysosomal pathway was investigated in isolated rat hepatocytes, using electroinjected [14C]lactose as an autophagy probe and atractyloside to alter intracellular ATP levels. Since autophagocytosed lactose is hydrolyzed in lysosomes, several steps in the pathway could be analyzed. The following observations were made. 1) The overall autophagic degradation of electroinjected [14C]lactose was strongly energy-dependent. More than 85% inhibition was obtained when the ATP content decreased from the control value of 10 mumol/g dry weight to 4 mumol/g dry weight. 2) The initial step, i.e. the autophagic sequestration of [14C]lactose, measured in the presence of vinblastine to prevent transfer of lactose to lysosomes, was as sensitive to small changes in ATP as was the overall lactose degradation. 3) The steady state level of sequestered [14C]lactose remained constant as ATP decreased from 10 to 4 mumol/g dry weight, indicating that the sequestration step and some postsequestrational process were inhibited to a similar extent by ATP depletion. 4) The final step in the pathway, intralysosomal hydrolysis, was measured by allowing [14C]lactose to preaccumulate intralysosomally in the presence of the reversible lysosome inhibitor propylamine. Following propylamine removal and inhibition of further sequestration by 3-methyladenine, ATP-dependent hydrolysis of the intralysosomal [14C]lactose could be demonstrated. However, this hydrolysis step was not as sensitive to small changes in ATP as was the sequestration step or the overall autophagic lactose degradation. Control of the autophagic-lysosomal pathway in response to energy deprivation would therefore not seem to occur at the lysosomal level, but may be exerted both at the sequestration step and at a postsequestrational, prelysosomal step. PMID- 2708337 TI - Preliminary X-ray diffraction analysis of human chorionic gonadotropin. AB - Hexagonal bipyramidal crystals of deglycosylated human chorionic gonadotropin have been grown using the method of vapor diffusion against ammonium sulfate. These crystals grow to nearly 0.4 mm along each axis, diffract to better than 3.5 A resolution and are relatively stable to irradiation. The crystals belong to the hexagonal space group P6(1)22 or enantiomer, and have unit cell parameters a = b = 88.7 A and c = 177.3 A. PMID- 2708338 TI - Structure of the phosphosaccharide-inositol core of the Leishmania donovani lipophosphoglycan. AB - The phosphosaccharide-inositol core of the lipophosphoglycan of Leishmania donovani was generated by treatment of the glycoconjugate with mild acid and digestion with phosphatidylinositol-specific phospholipase C. The core was purified and examined by one- and two-dimensional 1H-1H NMR and by methylation analysis. From the results, the carbohydrate core was elucidated as a phosphosaccharide attached to the inositol residue of the lyso alkylphosphatidylinositol anchor of lipophosphoglycan as follows: PO4--- 6GalP(alpha 1----6)GalP(alpha 1----3)Galf(alpha 1----3)ManP(alpha 1--- 3)ManP(alpha 1----4)GlcNP(alpha 1----6)myo-inositol. The presence of an internal galactofuranose residue is highly unusual and the ManP(alpha 1----4)GlcNP(alpha 1 ---6)myo-inositol sequence is homologous to the respective portion of the glycosylphosphatidylinositol anchors reported for both the Trypanosoma brucei variant surface glycoprotein and the rat brain Thy-1 glycoprotein. PMID- 2708339 TI - ATP is required for the binding of precursor proteins to chloroplasts. AB - One of the first steps in the transport of nuclear-encoded, cytoplasmically synthesized precursor proteins into chloroplasts is a specific binding interaction between precursor proteins and the surface of the organelle. Although protein translocation into chloroplasts requires ATP hydrolysis, binding is generally thought to be energy independent. A more detailed investigation of precursor binding to the surface of chloroplasts showed that ATP was required for efficient binding. Protein translocation is known to require relatively high levels (1 mM or more) of ATP. As little as 50-100 microM ATP caused significant stimulation of precursor binding over controls with no ATP. Several different precursors were tested and all showed increased binding upon addition of low levels of ATP. Nonhydrolyzable analogs of ATP did not substitute for ATP, indicating that ATP hydrolysis was required for binding. A protonmotive force was not involved in the energy requirement for binding. Other (hydrolyzable) nucleotides could substitute for ATP but were less effective at stimulating binding. Binding was stimulated by ATP generated inside chloroplasts even when an ATP trap was present to destroy external ATP. We conclude that internal ATP is required for stimulation of precursor binding to chloroplasts. PMID- 2708340 TI - Internal ATP is the only energy requirement for the translocation of precursor proteins across chloroplastic membranes. AB - The energy requirements for the import of nuclear-encoded proteins into isolated chloroplasts have been reinvestigated. We have shown that, in contrast to protein import into mitochondria, the translocation of the precursors to ferredoxin, plastocyanin (prPC) and the small subunit of ribulose-1,5-bisphosphate carboxylase/oxygenase (prSS) across all chloroplastic membranes is independent of a protonmotive force and requires only ATP. This extends previous works in which investigations were limited to prSS and demonstrates that our results are probably general to all chloroplastic protein precursors. Our results are particularly interesting for the import of prPC, since in addition to the two envelope membranes, this protein must traverse the energy-transducing thylakoid membranes en route to its proper location in the thylakoid lumen. This lack of involvement of a protonmotive force, specifically of a transmembrane electric potential, demonstrates that separate mechanisms operate during the import of proteins into chloroplasts and mitochondria. We also examined the question of whether ATP is utilized inside or outside of chloroplasts during protein import. Previous attempts to resolve this question have resulted in conflicting answers. We found, by two independent approaches, that ATP for protein import is utilized inside chloroplasts. The implications of these results on the possible mechanisms of protein import into chloroplasts are discussed. PMID- 2708341 TI - Benzo[a]pyrene-DNA adducts inhibit translocation by the gene 4 protein of bacteriophage T7. AB - Bacteriophage T7 gene 4 protein is an essential component of the T7 DNA replication system, acting as both a primase and a helicase. The gene 4 protein has been shown to translocate along single-stranded DNA in the 5'----3' direction, using an energy source for this movement the hydrolysis of nucleoside 5'-triphosphates, preferably dTTP. Thus, measuring the rate and extent of dTTP hydrolysis provides a means to directly measure translocation. We have determined that the hydrolysis of dTTP by the gene 4 protein is strongly inhibited by the presence of benzo[a]pyrene (B[a]P) adducts on the DNA. Time course experiments on adduct-containing DNA show that after an initial burst of hydrolysis, which parallels what is observed on unmodified DNA, further hydrolysis abruptly ceases. Addition of excess unmodified DNA does not restore the hydrolysis activity. These data suggest that the gene 4 protein is blocked and sequestered on the DNA at the site of the adduct. This was confirmed by experiments in which gene 4 protein preferentially protected the radiolabeled adduct-containing DNA but not randomly labeled M13 DNA. The gene 4 protein bound to the B[a]P-modified DNA was isolated, and the complex was found only to contain dTTP. These results have been used to formulate a model for gene 4 protein translocation in which we speculate that the power stroke for unidirectional movement along the single-stranded DNA is the displacement of dTDP by dTTP. Finally, we observe a constant ratio of DNA synthesis to dTTP hydrolysis regardless of the number of B[a]P adducts in the template suggesting that a significant portion of the inhibition of DNA synthesis is a direct consequence of the inhibition of gene 4 translocation. PMID- 2708342 TI - In vitro repair of psoralen-DNA cross-links by RecA, UvrABC, and the 5' exonuclease of DNA polymerase I. AB - Psoralens produce DNA interstrand cross-links which are thought to be repaired via a sequential excision and recombination mechanism in Escherichia coli. The first round of incision by UvrABC has been characterized: it results in 11-base oligonucleotide cross-linked to an intact DNA strand (Van Houten, B., Gamper, B., Holbrook, S.R., Hearst, J.E., and Sancar, A. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 8077-8081). In the present work, DNA substrates containing 4'-hydroxymethyl 4,5',8-trimethylpsoralen (HMT) cross-links in defined positions are constructed and used to analyze the other steps in repair. It is shown that RecA protein mediates strand transfer past an oligonucleotide cross-linked to a single stranded DNA circle and that the resulting heteroduplex is a substrate for the UvrABC complex: it excises a double-stranded oligonucleotide which contains the HMT cross-link. It is also found that the first round of UvrABC incision does not lead directly to strand exchange but that an intervening step is needed. That step is carried out in vitro by the 5'-exonuclease activity of DNA polymerase I (pol I) which creates a single-stranded DNA region (a gap) at an incised cross link such that RecA can initiate strand exchange. Studies using cross-linked oligonucleotides showed that the gap produced by pol I results from the inability of the polymerase to add nucleotides to a 3'-OH end two to three nucleotides away from the furan side of an HMT cross-link. Pol I can, however, extend a 3'-OH end next to the pyrone side of the cross-link. Since UvrABC incises predominantly the furan side of psoralen cross-links in duplex DNA, this discrepancy has important consequences for repair. PMID- 2708343 TI - Olfactory-specific cytochrome P-450. cDNA cloning of a novel neuroepithelial enzyme possibly involved in chemoreception. AB - We isolated cDNA clones for cytochrome P-450 genes expressed in the olfactory neuroepithelium by screening a corresponding rat cDNA library. Sequence analysis and RNA blot hybridization revealed a new cytochrome P-450, designated cytochrome P-450olf1, which is the first reported cytochrome P-450 mRNA uniquely expressed in the chemosensory organ. Cytochrome P-450olf1 shows intermediate level of sequence similarity (38-53% identity) to several liver cytochrome P-450 enzymes, suggesting that it belongs to the cytochrome P-450II family, but defines a new subfamily (cytochrome P-450IIG) within it. Cytochrome P-450II enzymes are known to process diverse organic compounds, including odorants. This, together with the specificity of cytochrome P-450olf1 to the sensory neuroepithelium, may indicate a role for this protein in olfactory reception. PMID- 2708344 TI - Design, expression, and crystallization of recombinant lectin from the garden pea (Pisum sativum). AB - The propeptide form of the lectin from the garden pea (Pisum sativum agglutinin) has been expressed in Escherichia coli by attaching its cDNA to an inducible promoter. By a number of criteria, including the ability to form dimers, hemagglutination titer, Western blot, and enzyme-linked immunosorbent assay, the resulting propeptide molecule is virtually indistinguishable from the mature proteolytically processed lectin isolated from peas. Preliminary crystallization experiments using the recombinant propeptide lectin yield crystals in space group P2(1)2(1)2(1) with a = 64.8 A, b = 73.8 A, and c = 109.0 A (1 A = 0.1 nm) that diffract to 2.8-A resolution. This unit cell size is quite similar to the unit cell determined for native pea lectin, suggesting that the overall structure of the recombinant prolectin is virtually identical. PMID- 2708345 TI - Transcriptional and translational analysis of the murine 84- and 86-kDa heat shock proteins. AB - The mammalian 85-90-kDa heat shock protein(s) (hsp) have been shown to exist as two species of 84 and 86 kDa (Ullrich, S. J., Robinson, E. A., Law, L. W., Willingham, M., and Appella, E. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 3121 3125). Two cDNA clones corresponding to the two forms have been isolated which specifically hybridize to either a 2.85- or a 3.0-kilobase pair transcript corresponding to hsp 84 and 86, respectively (Moore, S. K., Kozak, C., Robinson, E. A., Ullrich, S. J., and Appella, E. (1987) Gene (Amst.) 56, 29-40, and this paper). The regulation of these hsp were examined in nontransformed NIH-3T3 and chemically transformed Meth A cells. The basal level of the hsp 84 mRNA transcript was approximately 2.5-fold greater than the hsp 86 transcript, with a corresponding ratio of hsp 84 to hsp 86 protein synthesis of approximately 2.5:1. After a transient heat shock (10 min, 44 degrees C), the rate of transcription of hsp 84 and 86 increased approximately 4.5- and approximately 7-fold, respectively, within 0.5 h and remained elevated for approximately 2 h. Northern blot analysis performed on NIH-3T3 and Meth A cells, during recovery from a transient heat shock, indicated that in both cells mRNA levels of both hsp increased rapidly, peaking at 5 h post-heat shock; hsp 84 and 86 transcripts were 1.5- and 2-fold higher than in non-heat-shocked cells, respectively. The increased rate of hsp synthesis after heat shock correlated with the increased levels of each transcript in both cell lines. In the transformed Meth A cells the basal mRNA, hsp synthesis, and steady state levels of each hsp in vitro were 2-3 fold higher than in the nontransformed NIH-3T3 cells. In Meth A tumors in vivo, the steady state level of hsp 84 was reduced compared to in vitro levels. Thus, in normal and in transformed murine cells, both hsp are heat-inducible, transcriptionally and translationally, with the transformed cells expressing higher levels of synthesis of both hsp 84 and 86. The data suggest that hsp 84 and 86 syntheses are primarily transcriptionally regulated. PMID- 2708346 TI - Oxysterol regulators of 3-hydroxy-3-methylglutaryl-CoA reductase in liver. Effect of dietary cholesterol. AB - Hepatic regulatory oxysterols were analyzed to determine which oxysterols were present in livers of mice fed a cholesterol-free diet and whether repression of 3 hydroxy-3-methylglutaryl-CoA reductase following cholesterol feeding was accompanied by an increase in one or more oxysterols. Analysis of free and esterified sterols from mice fed a cholesterol-free diet resulted in the identification and quantitation of six regulatory oxysterols: 24 hydroxycholesterol, 25-hydroxycholesterol, 26-hydroxycholesterol, 7 alpha hydroxycholesterol, 7 beta-hydroxycholesterol, and 7-ketocholesterol. Following the addition of cholesterol to the diet for 1 or 2 nights, hepatic 3-hydroxy-3 methylglutaryl-CoA reductase activity declined and the levels of oxysterols, especially those of the side-chain-hydroxylated sterols, increased. Total 3 hydroxy-3-methylglutaryl-CoA reductase repressor units attributable to identified free oxysterols increased 2.5- and 6-fold after 1 and 2 nights, respectively, of cholesterol feeding. The amounts of esterified 24-, 25-, and 26 hydroxycholesterol also increased, with the increase in esterified 24 hydroxycholesterol being the greatest. The 24-hydroxycholesterol was predominantly the 24S epimer and the 26-hydroxycholesterol was predominantly the 25R epimer, indicating enzymatic catalysis of their formation. The observed correlation between increased levels of regulatory oxysterols and repression of 3 hydroxy-3-methylglutaryl-CoA reductase in cholesterol-fed mice is consistent with a hypothesis that intracellular oxysterol metabolites regulate the level of the reductase. PMID- 2708347 TI - Induction of ornithine decarboxylase in rat liver by phorbol ester is mediated by prostanoids from Kupffer cells. AB - Administration of phorbol 12-myristate 13-acetate (PMA) to rats in vivo resulted in the induction of ornithine decarboxylase activity in the liver which could be blocked by preinjection of indomethacin, a cyclooxygenase inhibitor. In vitro administration of PMA to primary cultures of rat parenchymal cells did not lead to an induction of ornithine decarboxylase activity. It was investigated to what extent non-parenchymal liver cells could play an intermediary role in the expression of the PMA effect on ornithine decarboxylase activity in parenchymal liver cells. Addition of conditioned medium from PMA-activated Kupffer cells to cultured parenchymal cells led to the induction of ornithine decarboxylase activity in parenchymal cells. This effect was not observed with conditioned medium from untreated Kupffer cells or from Kupffer cells treated with PMA plus indomethacin. Conditioned media from PMA-treated or untreated endothelial liver cells were ineffective in the induction of ornithine decarboxylase activity in parenchymal liver cells. Prostaglandin D2, the main eicosanoid produced by Kupffer cells, was able to stimulate the synthesis of ornithine decarboxylase in parenchymal liver cells (up to 40-fold) in a dose-dependent way. Prostaglandin (PG) D2 appeared to be a more potent inducer of ornithine decarboxylase activity in parenchymal cells than PGE1 and PGE2. It is concluded that intercellular communication inside the liver mediated by prostaglandins derived from activated Kupffer cells may form a mechanism to induce synthesis of specific proteins in parenchymal cells. PMID- 2708348 TI - Importance of size, sulfation, and anticoagulant activity in the potentiation of acidic fibroblast growth factor by heparin. AB - Heparin was previously reported to potentiate the mitogenic activity of endothelial cell mitogens in a crude extract of bovine hypothalami (Thornton, S. C., Mueller, S. N., and Levine, E. M. (1983) Science 222, 623-625). We and others (Gospodarowicz, D., and Cheng, J. (1986) J. Cell. Physiol. 128, 475-484) have reported that the growth stimulatory effects of acidic fibroblast growth factor (aFGF) are potentiated in a similar manner. We have used these observations as the basis of an assay to characterize the importance of size, sulfation, and anticoagulant activity of heparin in mediating this effect. Partial nitrous acid depolymerization of heparin from porcine intestinal mucosa resulted in a mixture of heparin fragments, containing oligosaccharides ranging from disaccharides to polysaccharides of about 40 monosaccharides in length. This mixture was fractionated by ion exchange chromatography and gel permeation chromatography to obtain size-homogeneous oligosaccharides with different degrees of sulfation. Assay of these heparin-derived saccharides in the presence of a suboptimal concentration of aFGF revealed that a minimum chain length and a certain degree of sulfation is required in order to potentiate the action of aFGF. Low sulfate oligosaccharides (4-16 units) were unable to potentiate aFGF, whereas medium sulfate fractions of octadecasaccharides and larger were able to moderately potentiate aFGF. The potentiation of aFGF by the high sulfate fraction correlated with the saccharide size: 12 or more monosaccharide units were necessary to achieve potentiation equivalent to whole heparin, octa- and decasaccharides were mildly stimulatory, and hexasaccharides were without effect. In the absence of aFGF, intact heparin as well as all the oligosaccharides examined, inhibited the proliferation of capillary endothelial cells to approximately the same degree, between 20 and 50% inhibition. When a tetradecasaccharide was separated into a binding and a nonbinding fraction on matrix-bound antithrombin III, no difference was seen for these fractions in the endothelial cell proliferation assay. These results indicate that both size and sulfation of a heparin-derived oligosaccharide contribute to its ability to interact with aFGF and/or endothelial cells and that this interaction is independent of anticoagulant activity. In addition, our findings suggest that the inhibitory and potentiating effects of heparin on capillary endothelial cells have different structural requirements. PMID- 2708349 TI - Identification of a carcinoembryonic antigen gene family in the rat. Analysis of the N-terminal domains reveals immunoglobulin-like, hypervariable regions. AB - The existence of a carcinoembryonic antigen (CEA)-like gene family in rat has been demonstrated through isolation and sequencing of the N-terminal domain exons of presumably five discrete genes (rnCGM1-5). This finding will allow for the first time the study of functional and clinical aspects of the tumor marker CEA and related antigens in an animal model. Sequence comparison with the corresponding regions of members of the human CEA gene family revealed a relatively low similarity at the amino acid level, which indicates rapid divergence of the CEA gene family during evolution and explains the lack of cross reactivity of rat CEA-like antigens with antibodies directed against human CEA. The N-terminal domains of the rat CEA-like proteins show structural similarity to immunoglobulin variable domains, including the presence of hypervariable regions, which points to a possible receptor function of the CEA family members. Although so far only one of the five rat CEA-like genes could be shown to be transcriptionally active, multiple mRNA species derived from other members of the rat CEA-like gene family have been found to be differentially expressed in rat placenta and liver. PMID- 2708350 TI - Identification of rat ovarian nuclear factors that interact with the cAMP inducible lactate dehydrogenase A subunit promoter. AB - Utilizing the gel electrophoresis/DNA binding assay and a new technique of direct binding of radioactive DNA to protein blots, we have investigated putative factors selective for the cAMP-responsive element (CRE) of the lactate dehydrogenase A subunit promoter in rat ovary nuclear extracts. Analysis of linker-scanning mutants of lactate dehydrogenase A subunit promoter fragments by DNA binding assay identified DNA binding activity selective for the 11-nucleotide sequence 5' TCTGACGTCAG 3' located between positions -51 and -41 relative to the transcription initiation site. This sequence contains the previously identified CRE 5' TGACGTCA 3'. Probing of protein blots with radioactive promoter fragments containing the CRE demonstrated that ovarian nuclear extracts contain a protein of relative molecular mass 47,000 (Mr 47,000) which exhibits selective binding affinity for the CRE. The 47-kDa CRE binding protein was found to be present in comparable levels in the ovaries of normal and hypophysectomized rats. Furthermore, our data suggest the presence of a 37,000-dalton (Mr 37,000) protein which possesses selective binding affinity for part of the CRE sequence. The binding activity/level of the 37-kDa CRE binding protein appeared to be modulated by short-term hypophysectomy/follicle-stimulating hormone administration. These results provide evidence for the presence of CRE binding factors in rat ovarian nuclei, which may be involved in the molecular events responsible for transcriptional regulation of ovarian cAMP-inducible genes. PMID- 2708351 TI - Location of the inhibitory region of smooth muscle myosin light chain kinase. AB - Proteolysis by trypsin of gizzard myosin light chain kinase (MLC kinase) in the absence of Ca2+-calmodulin produced a 64,000-dalton inactive fragment which was converted to a 61,000-dalton Ca2+-calmodulin-independent active fragment. This confirmed previous results (Ikebe, M., Stepinska, M., Kemp, B. E., Means, A. R., and Hartshorne, D. J. (1987) J. Biol. Chem. 262, 13828-13834). On the other hand, proteolysis of MLC kinase in the presence of Ca2+-calmodulin initially produced a 66,000-dalton Ca2+-calmodulin-dependent active fragment which was converted to a 61,000-dalton Ca2+-calmodulin-independent active fragment with further proteolysis. The amino acid sequences from the N terminus of the 66,000-dalton, 64,000-dalton, and 61,000-dalton fragments were determined. The sequence was not found in the reported partial amino acid sequence of MLC kinase (C-terminal 60% of whole sequence) (Guerriero, V., Jr., Russo, M. A., Olson, N. J., Putkey, J. A., and Means, A. R. (1986) Biochemistry 25, 8372-8381), and, therefore, the cleavage sites are in the remaining 40% N-terminal portion of the sequence of MLC kinase. The C terminus of these MLC kinase fragments was determined by employing the carboxypeptidases A, B, and Y digestion followed by the amino acid analysis of the released amino acids. As a result, it was concluded that the C terminus of the 66,000-dalton, 64,000-dalton, and 61,000-dalton MLC kinase fragments are arginine 522, lysine 490 and arginine 494, and lysine 473, respectively. These results show that the inhibitory domain is in the amino acid sequence of 474-490, and that the amino acid sequence 494-522 confers the calmodulin-dependent kinase activity. PMID- 2708352 TI - Promoter sequences of the human transforming growth factor-beta 1 gene responsive to transforming growth factor-beta 1 autoinduction. AB - Two distinct regions of the transforming growth factor (TGF)-beta 1 promoter are responsive to autoregulation. Sequences located between nucleotides -454 to -323 and between the two major transcriptional start sites have positive regulatory activities and are induced by TGF-beta 1 in A-549 cells. The chloramphenicol acetyltransferase activity of the upstream human TGF-beta 1 promoter chloramphenicol acetyltransferase gene is increased 8- to 10-fold by treatment of cells with TGF-beta 1, whereas that of the second promoter is increased approximately 3- to 4-fold. Using an S1 nuclease protection assay of chloramphenicol acetyl-transferase mRNA, we found that the steady-state expression of chloramphenicol acetyltransferase mRNA also is markedly increased. Seven distinct factors present in nuclear extracts from A-549 cells interact with the sequences between -454 and -323, strongly supporting the involvement of sequence-specific transcription factors in the transcriptional autoactivation of the human TGF-beta 1 gene. PMID- 2708353 TI - Isolation and characterization of rat cytochrome P-450IIB gene family members. Use of the polymerase chain reaction to detect expression of a novel P-450 mRNA. AB - The rat cytochrome P-450IIB gene family consists of at least 10 members, 2 of which, P-450b and P-450e, have been well characterized and are activated transcriptionally by phenobarbital (PB) in the liver. The remaining genes in this family have not been studied extensively. In this report, data are presented that provide additional characterization of a P-450IIB gene, termed gene IV. The complete gene IV and flanking regions were isolated from a rat liver Charon 4A genomic library and subjected to a variety of analyses. Structural homology to the P-450b gene was confirmed by comparative restriction mapping and high stringency hybridization of gene IV fragments to probes comprising the entire cDNA for P-450b. The 5'-portion of gene IV, including its flanking region, was sequenced and contained an open reading frame for 58 amino acids which were 62% related to exon 1 of the P-450b/e genes. Typical TATA and CAAT promoter elements, as well as two Sp1 core sequences and a site related to a glucocorticoid responsive element were found in gene IV. Northern blot studies with an oligomer probe specific to gene IV sequence indicated a 4.3-kilobase pair polyadenylated transcript present at low levels in untreated rat liver and inducible approximately 6-fold by PB treatment. Primer extension experiments indicated that the transcription initiation site mapped to a position on gene IV that was analogous to that reported for the structurally similar P-450e gene. Due to the low levels of hepatic RNA expression, we employed the polymerase chain reaction to facilitate characterization of gene IV transcripts. The polymerase chain reaction data verified that gene IV transcripts were elevated after PB treatment. Significantly, the polymerase chain reaction results demonstrated that gene IV transcripts were associated with hepatic polysome fractions, indicating their active utilization in this tissue. Polymerase chain reaction analysis of RNA also indicated constitutive expression of gene IV transcripts in rat lung, kidney, and testis, as well as fetal rat liver. Together, these data show that gene IV is a transcribed member of the P-450IIB gene family and, like the well characterized P 450b and P-450e genes, is positively regulated by PB in rat liver. PMID- 2708354 TI - Synthesis of human progesterone receptors in T47D cells. Nascent A- and B receptors are active without a phosphorylation-dependent post-translational maturation step. AB - Human progesterone receptors (PR) are structurally complex. At basal states there are two forms: A-receptors of approximately 94 kDa and B-receptors which are triplets of approximately 114, 117, and 120 kDa. All the proteins bind hormone and are phosphorylated. By using PR-rich T47Dco human breast cancer cells, pulse labeling with [35S]methionine, and receptor immunopurification with anti-PR monoclonal antibodies, we show that PR are synthesized as single B-proteins of 114 kDa and single A-proteins of 94 kDa. The mature B-triplets form 6-10 h later by post-translational phosphorylation at sites restricted to the B-proteins. This slow maturation is not required for PR activation to hormone binding states, however, since A- and B-receptors that are less than 15 min old respond to progestins by undergoing transformation and nuclear binding accompanied by a rapid secondary phosphorylation common to both proteins. These studies explain the complex structure of the mature human B-receptors and the transformed A- and B-receptors, and address issues dealing with A- and B-proreceptor synthesis and receptor activation rates. PMID- 2708355 TI - Crystal structure of the complex of ribulose-1,5-bisphosphate carboxylase and a transition state analogue, 2-carboxy-D-arabinitol 1,5-bisphosphate. AB - The crystal structure of the binary complex of nonactivated ribulose-1,5 bisphosphate carboxylase/oxygenase from Rhodospirillum rubrum and a transition state analogue, 2-carboxy-D-arabinitol 1,5-bisphosphate has been determined to 2.6 A resolution with x-ray crystallographic methods. The transition state analogue binds in a rather extended conformation at the active site. The orientation of the transition state analogue within the active site could be determined from the electron density maps. The P1 phosphate group of the analogue binds at a site built up of residues from loops 5 and 6 of the alpha/beta-barrel. The phosphate group interacts with the side chains of the conserved residues Arg 288, His-321, and Ser-368 and with main chain nitrogens from residues Thr-322 and Gly-323. The second phosphate group of the transition state analogue binds at the opposite side of the barrel close to loops 1 and 8. Significant differences for the positions and interactions of the P2 phosphate group with the enzyme are found in the two subunits of the dimer. The different mode of binding for this phosphate group in the two subunits is interpreted as a consequence of different conformations of the polypeptide chain observed in loops 6 and 8. The P2 phosphate group interacts with the sidechains of Lys-166 and Lys-329. Loop 6, which is disordered in the nonactivated, nonliganded enzyme is considerably more ordered in one of the subunits, probably due to the interaction of the side chain of Lys-329 with the P2 phosphate group. Almost all oxygen atoms are hydrogen bonded to groups on the enzyme. The carboxyl group forms hydrogen bonds to the side chain of the conserved Asn-111. The binding of the transition state analogue to the nonactivated enzyme is different from the binding of the analogue to activated spinach ribulose-bisphosphate carboxylase. PMID- 2708356 TI - Hyperoxic exposure alters gene expression in the lung. Induction of the tissue inhibitor of metalloproteinases mRNA and other mRNAs. AB - Exposure to high concentrations of oxygen can result in tissue damage, particularly in the lung. Lung pathology induced by hyperoxia includes changes in lung cell populations and morphology. Presumably, alterations in gene expression underlie some of these cellular changes. In order to better understand the molecular basis of these events, a cDNA library was constructed from the mRNA of the lungs of a hyperoxia-exposed rabbit and differentially screened for clones corresponding to hyperoxia-induced messages. This approach has led to the isolation of four clones, three of which are presented in this communication. One clone corresponds to a message whose steady state levels were induced 6-fold and encodes the tissue inhibitor of metalloproteinases, a protein that plays a key role in the regulation of connective tissue turnover in some cells and potentiates erythroid development in others. PMID- 2708357 TI - Biosynthetic incorporation of [3H]ethanolamine into protein synthesis elongation factor 1 alpha reveals a new post-translational protein modification. AB - Biosynthetic incorporation of [3H]ethanolamine into proteins was assessed in the human erythroleukemia cell line K562. A single predominant labeled protein of about 50 kDa was observed following electrophoresis of cell extracts on polyacrylamide gels in the presence of sodium dodecyl sulfate. Subcellular fractionation showed this protein to distribute similarly to a 46-kDa [3H]ethanolamine-labeled protein reported previously (Tisdale, E. J., and Tartakoff, A. M. (1988) J. Biol. Chem. 263, 8244-8252). In particular, the protein was enriched in cytosolic and microsomal fractions relative to plasma membrane and thus did not appear to correspond to the class of proteins with glycoinositol phospholipid anchors, the only post-translational protein modification involving ethanolamine that had been described previously. Two dimensional polyacrylamide gel analysis involving isoelectric focusing followed by electrophoresis in sodium dodecyl sulfate indicated that the protein was very basic, and nitrocellulose blots of one- and two-dimensional gels subjected to 3H autoradiography and immunostaining with antisera to purified rabbit elongation factor (EF) 1 alpha revealed that the protein was EF-1 alpha. Copurification of rabbit EF-1 alpha and the [3H]ethanolamine-labeled protein from K562 cells further supported this identification. Analysis of tryptic fragments produced from the copurified proteins by reverse-phase high pressure liquid chromatography showed two radiolabeled peptides. Amino acid analysis demonstrated 1 residue of ethanolamine in each peptide, and peptide sequencing revealed that the ethanolamine-containing component(s) was attached to Glu301 and Glu374 in the EF 1 alpha protein sequence deduced from a human EF-1 alpha cDNA. These data confirm a new class of post-translational protein modifications involving ethanolamine. PMID- 2708358 TI - Resonance Raman evidence for tyrosine involvement in the radical site of galactose oxidase. AB - Resonance Raman data are reported for the redox-activated form of galactose oxidase from Dactylium dendroides. Excitation within the red (659 nm) and blue (457.9 nm) absorption bands leads to strong resonance enhancement of ligated tyrosine vibrational modes at 550, 1170, 1247, 1484, and 1595 cm-1. The ring mode frequencies are unusually low, indicating a decreased bond order in the ring. The spectra clearly differ in both frequencies and relative intensities from those characteristic of known aromatic pi-radicals. Enhancement of tyrosine ring modes on excitation within absorption bands previously associated with the presence of the radical in the active site suggests that the ligated tyrosine residue is present in the radical site and may stabilize this radical species through formation of a charge transfer complex. A dramatically different Raman spectrum is observed for the N3- adduct of galactose oxidase, exhibiting a single strong 1483 cm-1 feature. The intense visible-near IR absorption bands for galactose oxidase may derive from transitions within a charge transfer complex between an aromatic free radical and a tyrosine-copper complex. PMID- 2708359 TI - Synthesis of trypanosome hsp70 mRNA is resistant to disruption of trans-splicing by heat shock. AB - Synthesis of mRNA in trypanosomes involves an apparent trans-splicing reaction whereby a common 39-nucleotide mini-exon sequence is joined to the protein-coding exon of a mRNA precursor. We have previously shown (Muhich, M. L., and Boothroyd, J. C. (1988) Mol. Cell. Biol. 8, 3837-3846) that the trans-splicing pathway of Trypanosoma brucei is sensitive to disruption by severe heat shock. Here we demonstrate that the synthesis of heat shock protein 70 (hsp 70) mRNA in T. brucei is apparently resistant to the heat-induced disruption of splicing. The 5' ends of hsp 70 mRNAs are shown to be identical for molecules synthesized at either normal or heat shock temperatures, and in both cases, the 5'-terminal mini exon sequence is present. These results suggest that T. brucei has evolved a mechanism which directly compensates for the deleterious effects of heat shock on trans-splicing, one which allows for the continued mini-exon-dependent trans splicing of selected pre-mRNAs. PMID- 2708360 TI - Characterization of the mouse rod transducin alpha subunit gene. AB - A genomic clone spanning the mouse rod transducin alpha subunit (Tr alpha) gene has been isolated by screening a mouse genomic library with a bovine Tr alpha cDNA clone. The coding region of the mouse Tr alpha gene reveals an 88.7% nucleotide identify and 99.7% amino acid identity with bovine Tr alpha. The mouse Tr alpha gene is composed of 8 exons and 7 introns within its coding region. These introns are in the same locations as introns in human Gi alpha genes, that encode G proteins closely related to transducin. Primer extension, RNA sequencing, and S1 nuclease protection analyses indicate that the mouse Tr alpha gene transcription start site is 84 bases upstream of the initiation codon. Northern blot analysis shows that the mouse Tr alpha is expressed in the retina, but not in brain, kidney, liver, or heart. PMID- 2708361 TI - Cell type-specific expression of the human transferrin gene. Role of promoter, negative, and enhancer elements. AB - Transferrin (Tf), the iron transport protein of vertebrate serum, is mainly synthesized in the liver. cis-Acting DNA elements required for liver-specific expression of the human Tf gene were identified by transient and stable expression assays in human hepatoma (HepG2 and Hep3B) and epithelial carcinoma (HeLa) cell lines. Deletion analysis of the 5' DNA sequences of the gene have defined four functionally different regions: (a) A cell type-specific promoter located between positions -125 and -45 which interacts with two nuclear factors and is sufficient for liver-specific expression. (b) A distal promoter region from -620 to -125 base pairs containing positive and negative cis-acting elements which regulate the promoter activity. (c) A negative-acting region between -1.0 and -0.6 kilobase pairs which down-regulates transcription from the Tf promoter. (d) An enhancer located between -4.0 and -3.3 kilobase pairs which is more active in hepatoma than in HeLa cells. Thus, Tf gene expression is modulated by a combination of multiple positive and negative cis-acting elements. The expression results are discussed with respect to our previous description of the trans acting factors interacting with the proximal and distal promoter regions. PMID- 2708362 TI - Androgen synthesis and aromatization by equine corpus luteum microsomes. AB - Whereas mare corpus luteum does not produce androgens or estrogens in vivo, the incubation of mare corpus luteum microsomes with progesterone and NADPH resulted in 17 alpha-hydroxyprogesterone and estrogen production with a small yield of androstenedione. In the presence of an aromatase inhibitor (4 hydroxyandrostenedione), 17 alpha-hydroxyprogesterone and androstenedione were accumulated. Aromatization of testosterone and androstenedione occurred via stereospecific loss of the 1 beta, 2 beta hydrogen atoms and was inhibited by MgCl2, KCl, and EDTA. The Km of estrogen synthetase from equine corpus luteum for testosterone was 18.5 +/- 2.7 nM and for androstenedione was 11.5 +/- 1.5 nM. 19 Norandrogens were aromatized with a slightly higher efficiency than were androgens, but the affinity of the aromatase was lower for 19-norandrogens than for androgens. Our results suggest that aromatases from equine testis and corpus luteum are closely related enzymes. On the other hand, the question arises as to the relationship among the cell origin, the synthetizing abilities, and in vivo production of the corpus luteum in different mammalian species. PMID- 2708363 TI - Amino acid sequence of a low molecular weight, high affinity calcium-binding protein from the optic lobe of the squid Loligo pealei. AB - The amino acid sequence was determined for squid calcium-binding protein (CaBP), a low molecular weight, high affinity calcium-binding protein from squid optic lobe. The sequence shows this protein to consist of 149 amino acids with an N acetylated N terminus. The protein has a molecular weight of 16,894 and is homologous to calmodulin, which is also present in squid optic lobe (Head, J. F., Spielberg, S., and Kaminer, B. (1983) Biochem. J. 209, 797-802). When the sequences of squid CaBP and bovine brain calmodulin are appropriately aligned, the proteins are found to share 68% identity, with a single residue insertion in squid CaBP, between domains III and IV. The four-domain structure of calmodulin appears to be retained in squid CaBP, which is consistent with the previously reported presence of four calcium-binding sites per molecule (Sheldon, A., and Head, J. F. (1988) J. Biol. Chem. 263, 14384-14389). The two tyrosines of squid CaBP are located in different halves of the molecule, one at the position corresponding to Tyr-138 in calmodulin, the other in an equivalent position in domain II. In addition, squid CaBP exhibits several differences in the region corresponding to the long central helix of calmodulin. These differences include the replacement of Lys-77 by glycine, Asp-78 by proline, and Ser-81 by proline. The sequence of this portion of the squid CaBP molecule suggests the protein is unlikely to possess the continuous long central helix found in calmodulin. PMID- 2708364 TI - Cholesterol sulfate is a naturally occurring inhibitor of steroidogenesis in isolated rat adrenal mitochondria. AB - We previously reported (Lambeth, J. D., Xu, X. X., and Glover, M. (1987) J. Biol. Chem. 262, 9181-9188) that exogenously added cholesterol sulfate inhibits the conversion of cholesterol to pregnenolone in isolated adrenal mitochondria, and does so by affecting intramitochondrial cholesterol movement but not its subsequent metabolism to pregnenolone by cytochrome P-450scc. We now report that a major kinetic component of the inhibition is noncompetitive with respect to cholesterol, consistent with an allosteric effect at a site other than the substrate binding site of cytochrome P-450scc. We now also report that cholesterol sulfate is present as an endogenous compound in preparations of adrenal mitochondria. Its content varied from 0.05 to 0.8 nmol/mg protein. Cholesterol sulfate level correlated inversely with the mitochondrial cholesterol side-chain cleavage activity. Endogenous cholesterol sulfate thus appeared to account for the variable rates of pregnenolone synthesis which were seen in different mitochondrial preparations. Cholesterol sulfate was metabolized to pregnenolone sulfate by a mitochondrial side-chain cleavage system, but proved to be a relatively poor substrate for an extramitochondrial steroid sulfatase activity present in adrenal cortex. Confirming a role as a naturally occurring inhibitor, removal of endogenous mitochondrial cholesterol sulfate by metabolism to pregnenolone sulfate correlated with a 3-fold activation of cholesterol side chain cleavage. We suggest that cholesterol sulfate functions in steroidogenic tissues to regulate the magnitude of the steroidogenic response. PMID- 2708365 TI - Oxalate:formate exchange. The basis for energy coupling in Oxalobacter. AB - In the Gram-negative anaerobe, Oxalobacter formigenes, the generation of metabolic energy depends on the transport and decarboxylation of oxalate. We have now used assays of reconstitution to study the movements of oxalate and to characterize the exchange of oxalate with formate, its immediate metabolic derivative. Membranes of O. formigenes were solubilized with octyl-beta-D glucopyranoside in the presence of 20% glycerol and Escherichia coli phospholipid, and detergent extracts were reconstituted by detergent dilution. [14C]Oxalate was taken up by proteoliposomes loaded with unlabeled oxalate, but not by similarly loaded liposomes or by proteoliposomes containing sulfate in place of oxalate. Oxalate transport did not depend on the presence of sodium or potassium, nor was it affected by valinomycin (1 microM), nigericin (1 microM), or a proton conductor, carbonylcyanide-p-trifluoromethoxyphenylhydrazone (5 microM) when potassium was at equal concentration on either side of the membrane. Such data suggest the presence of an overall neutral oxalate self-exchange, independent of common cations or anions. Kinetic analysis of the reaction in proteoliposomes gave a Michaelis constant (Kt) for oxalate transport of 0.24 mM and a maximal velocity (Vmax) of 99 mumol/min/mg of protein. A direct exchange of oxalate and formate was indicated by the observations that formate inhibited oxalate transport and that delayed addition of formate released [14C]oxalate accumulated during oxalate exchange. Moreover, [14C]formate was taken up by oxalate-loaded proteoliposomes (but not liposomes), and this heterologous reaction could be blocked by external oxalate. Further studies, using formate loaded proteoliposomes, suggested that the heterologous exchange was electrogenic. Thus, for assays in which N-methylglucamine served as both internal and external cation, formate-loaded particles took up oxalate at a rate of 2.4 mumol/min/mg of protein. When external or internal N-methylglucamine was replaced by potassium in the presence of valinomycin, there was, respectively, a 7-fold stimulation or an 8-fold inhibition of oxalate accumulation, demonstrating that net negative charge moved in parallel with oxalate during the heterologous exchange. The work summarized here suggests the presence of an unusually rapid and electrogenic oxalate2-:formate1- antiport in membranes of O. formigenes. Since a proton is consumed during the intracellular decarboxylation that converts oxalate into formate plus CO2, antiport of oxalate and formate would play a central role in a biochemical cycle consisting of (a) oxalate influx, (b) oxalate decarboxylation, and (c) formate efflux.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2708366 TI - 7-Azidoactinomycin D: a novel probe for examining actinomycin D-DNA interactions. AB - The technique of photoaffinity labeling is applied to the actinomycin D system to provide a novel probe for the examination of the interactions of actinomycin D with nucleic acids. The capacity for covalent attachment of actinomycin D will aid greatly in the study of target-site specificities and the correlations of biological effects with biophysical DNA interactions. Through chemical modification of the parent actinomycin D molecule with a photoreactive azido substituent, a functional analog of the parent actinomycin D is generated having equilibrium binding properties identical to those of the parent molecule yet with the capacity to form a covalent attachment to DNA upon photolysis. The results presented here describe the noncovalent interactions of this photoreactive probe to DNA (absence of light) and compares the binding properties observed to those of the parent actinomycin D and 7-aminoactinomycin D analog. These studies demonstrate that the DNA binding properties (i.e. binding affinity, binding site size, and sequence specificity) retained by the 7-azidoactinomycin D, thus providing a suitable probe for examining actinomycin D-DNA interactions. PMID- 2708367 TI - Structural and spectroscopic characterization of exogenous ligand binding to isolated factor F430 and its configurational isomers. AB - Binding of axial ligands to the nickel(II) of isolated factor F430 from the methyl reductase enzyme of Methanobacterium thermoautotrophicum is demonstrated. Evidence of bis-ligand coordination is obtained from the x-ray absorption, optical, and resonance Raman spectral characterization of F430 and its 12,13 diepimeric isomer in the presence of a large excess of cyanide, pyridine, or 1 methylimidazole. Significant broadening and 5-10-nm red shifts of the main 430-nm optical absorption band and shifts of up to 30 cm-1 for the high-frequency Raman lines are observed upon coordination of these axial ligands. The Raman spectra of native F430 and the diepimer with a particular axial ligand are nearly identical. Nickel x-ray absorption edge spectra of the diepimer in the absence and presence of these exogenous ligands are indicative of conversion from a square-planar to a tetragonally distorted octahedral geometry. Analyses of the nickel extended x-ray absorption fine structure data for the ligated diepimer complexes yield detailed structural information for these complexes. Implications of these data with respect to the enzymatic mechanism and the structure of the enzyme-bound factor are discussed. PMID- 2708368 TI - Serum-stimulated cell growth causes oscillations in casein kinase II activity. AB - We have tested the effects of serum-stimulated growth of quiescent WI38 human lung fibroblasts on cellular casein kinase II (CK-II) activity. Using the casein kinase II synthetic substrate RRREEETEEE we find a transient 6-fold elevation in CK-II activity in cell homogenates within 30 min following serum stimulation. Additional cycles of CK-II activation and inactivation are seen at 12 and 24 h after stimulation. The oscillations in CK-II activity are largely independent of de novo protein synthesis, and, thus, are likely to reflect cycles of post translational activation and inhibition of the cellular kinase pool. In contrast to the activity profile of CK-II, we find that cyclic AMP-dependent protein kinase is rapidly inhibited upon serum-stimulation of WI38 cells. These results demonstrate that CK-II activity is subject to unique cellular regulation during proliferation and are consistent with the postulate that CK-II plays an important role in cell growth. PMID- 2708369 TI - Ribosome binding to inosine-substituted mRNAs in the absence of ATP and mRNA factors. AB - Incubating ribosomes and eukaryotic initiation factor eIF3 with an inosine substituted mRNA (where the mRNA secondary structure is strongly reduced) in the absence of ATP and other protein synthesis factors produces a 40 S ribosome.mRNA complex. When Met-tRNAMeti and eIF2 are added, a 60 S ribosome subunit attaches forming an 80 S ribosome.mRNA complex. ATP and the three mRNA factors, eIF4B, cap site factor, and eIF4A, strongly stimulate the attachment of the 60 S subunit. In the absence of Met-tRNAMeti, the 60-S subunit does not attach, and adding ATP and the mRNA factors inhibits the accumulation of 40 S ribosome.inosine mRNA complexes. These results indicate that a 40 S ribosome, probably in a complex with eIF3, has an intrinsic capacity to attach to mRNA. Further, they suggest that Met-tRNAMeti may interact in a subsequent step to stabilize the 40 S ribosome.mRNA complex and allow the attachment of a 60 S ribosome subunit. Although seen most clearly with the inosine-substituted mRNAs, the 40 S ribosome reaction is also obtained with "guanosine" mRNA. A 40 S ribosome attaches to guanosine mRNA without ATP and mRNA factors when an incubation mixture containing ribosomes, eIF3, and mRNA is fixed with glutaraldehyde. In addition, a 40 S ribosome.guanosine mRNA complex can be obtained without glutaraldehyde in incubations containing ATP and the three mRNA factors in the absence of Met tRNAMeti. The latter reaction is limited because of the instability of the 40 S ribosome.mRNA complex in the absence of Met-tRNA. Nevertheless, its authenticity is indicated by its full dependence upon ATP and the three mRNA factors. The lack of factor requirement for the formation of 40 S ribosome complexes with inosine substituted mRNAs indicates that ATP and the three mRNA factors function primarily to unwind the secondary structure of a guanosine mRNA. Data relevant to a role for ATP in facilitating ribosome migration on an mRNA are also discussed. PMID- 2708370 TI - Inhibitors of elastase and cathepsin G in Chediak-Higashi (beige) neutrophils. AB - Previous studies have established that mature neutrophils from the peritoneal cavity, blood, and bone marrow of beige (Chediak-Higashi syndrome) mice essentially lack activities of two lysosomal proteinases: elastase and cathepsin G. There are, however, significant levels of each enzyme in early neutrophil precursors in bone marrow. In the present experiments, it was found that the addition of extracts from mature beige neutrophils to extracts of normal neutrophils or to purified human neutrophil elastase and cathepsin G resulted in a significant inhibition of elastase and cathepsin G G activities. 125I-Labeled human neutrophil elastase formed high molecular mass complexes at 64 and 52 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis when added to beige neutrophil extracts. The molecular masses of the inhibitor-125I-elastase complexes suggested that the molecular masses of the inhibitors are approximately 36 and 24 kDa, respectively. These results were confirmed by gel filtration on Superose 12 under nondenaturing conditions. Cathepsin G was inhibited only by the 36-kDa component. The inhibitors formed a covalent complex with the active sites of elastase and cathepsin G. No inhibitory activity was present in mature neutrophil extracts of genetically normal mice or in extracts of bone marrow of beige mice. These results thus represent an unusual example of an enzyme deficiency state caused by the presence of excess inhibitors. Inactivation of neutrophil elastase and cathepsin G in mature circulating and tissue neutrophils may contribute to the increased susceptibility of Chediak-Higashi patients to infection. PMID- 2708371 TI - Purification and characterization of a Ca2+-dependent actin filament severing protein from bovine adrenal medulla. AB - We describe the purification of an actin regulatory protein from bovine adrenal medulla. This protein caused a dose-dependent decrease of the specific viscosity of actin solution within 30 s of its addition in a Ca2+-sensitive way. Sedimentation assays and the observation by electron microscopy showed that this effect was ascribable to the fragmentation of actin filaments. This protein apparently promoted nucleation of actin polymerization and increased the critical concentration of actin for polymerization nearly 5-fold, suggesting its binding to the barbed end of actin filaments. The inhibitory effect of this protein on the elongation of actin from the barbed end of the myosin subfragment S1-labeled actin seeds confirmed this suggestion. These properties are similar to those of gelsolin. However, the physicochemical properties of this protein having a single polypeptide chain with a molecular weight of 74,000, a Stokes radius of 3.9 nm, a sedimentation coefficient (s0(20),w) of 4.5 S, and an immunological characterization showed that this protein is different from gelsolin. PMID- 2708372 TI - Tryptic cleavage as a probe of conformational differences between active and inactive forms of ornithine aminotransferase. AB - Treatment of ornithine aminotransferase with trypsin resulted in rapid and complete loss of enzyme activity in a process that coincided with a reduction in subunit Mr of about 3000. However, electrophoresis showed that a substantial proportion of the enzyme had not been digested. The component of the preparation of ornithine aminotransferase that was insusceptible to trypsin contained a naturally occurring but enzymically inactive form of the enzyme, and when this had been removed, the remaining fully active enzyme was completely digested. Irreversible inactivation with a substrate analogue made all of the enzyme insusceptible to trypsin. The hydrolyzed enzyme still underwent a very slow half reaction with ornithine. Sequence analysis of the truncated protein, prepared by blotting from electrophoretic gels, showed that hydrolysis had occurred at peptide bond Lys26-Tyr27. PMID- 2708373 TI - Surface acid proteinase (gp63) of Leishmania mexicana. A metalloenzyme capable of protecting liposome-encapsulated proteins from phagolysosomal degradation by macrophages. AB - Acid proteinase activity is associated with the major surface glycoprotein (gp63) of both extracellular promastigotes and intracellular amastigotes of the parasitic protozoan, Leishmania mexicana. The enzyme purified by monoclonal affinity chromatography from promastigotes is strongly inhibited by metal ion chelators, which is reversible by the addition of Zn(II). This proteinase loses its activity after dialysis against 1,10-phenanthroline. The apoenzyme thus prepared is reactivated substantially by Zn(II) and partially by Cu(II), Cd(II), Co(II), or Ni(II). From the recently published structure of the gene encoding gp63, we identify hitherto unrecognized sequences, which can be aligned to the consensus zinc-binding sites of other known metalloproteinases. Anti-gp63 polyclonal antibodies, but not the monoclonals, precipitate similar molecules from amastigotes. These molecules differ slightly from gp63 in electrophoretic mobility but have similar endopeptidase activity. Phagolysosomal degradation by macrophages of proteins entrapped in liposomes is prevented by coating them with native gp63. This protection is lost with heat denaturation of gp63 to kill its enzymatic activity. The proteolytic activity of the metalloenzyme on the surface of these parasites may thus protect their membrane from cytolytic damages during their survival, differentiation, and multiplication in the phagolysosomes of macrophages. PMID- 2708374 TI - Transcriptional regulation of ferritin H and L subunits in adult erythroid and liver cells from the mouse. Unambiguous identification of mouse ferritin subunits and in vitro formation of the ferritin shells. AB - Ferritin H and L subunits present cell-specific features of structure, function, and transcriptional regulation. Mouse Friend erythroleukemia cells offer an interesting model to analyze the erythroid-specific expression of ferritin genes for comparison with the liver, an iron-storing tissue. cDNA clones for mouse ferritin H and L subunits have been isolated and sequenced. The two subunits have very similar calculated masses, 20.9 and 20.6 kDa for H and L, respectively. Electrophoretic analysis of the subunits encoded by the cDNA 1) allows unambiguous identification of mouse ferritin subunits; 2) clearly shows that mouse H and L chains can make heteropolymers in vitro; and 3) demonstrates that, at least in vitro, free subunits can coexist with subunits polymerized into complete shells. The mouse ferritin gene family displays a variable degree of complexity, ranging from three homologous sequences for the H genes to 10-14 homologous loci for the L genes. Transcription of ferritin genes exhibits tissue specific difference. Nuclear transcriptional run-off experiments show that the L gene is more actively transcribed in the liver than in Friend erythroleukemia cells at different stages of maturation. The accumulation of the H subunit mRNA which results from dimethyl sulfoxide induction of Friend cells is the consequence of an increase in the transcription rate of the H gene. However, the H gene mRNA is transcribed at a similar rate in the liver and in induced Friend cells although 5-fold more mRNA accumulates in these cells. Therefore, there is a tissue-specific regulation of mouse ferritin expression at both the transcription and mRNA stability levels. PMID- 2708375 TI - Monocyte synthesis of thrombospondin. The role of platelets. AB - Monocytes produce thrombospondin (TSP), a trimeric glycoprotein whose primary function is not yet clear. Platelet-poor monocytes (less than 1 platelet/50 monocytes) cultured with [35S]methionine produced [35S] TSP barely detectable by immunoprecipitation with either monoclonal or polyclonal antibody to TSP. Platelet-poor monocytes that had not been so thoroughly depleted of platelets (6 12 platelets/50 monocytes) synthesized readily detectable amounts of [35S] TSP. Addition of increasing numbers of washed platelets to platelet-poor monocytes resulted in increasing synthesis of [35S]TSP. This monocyte-platelet interaction was specific for cell type; neither neutrophils nor red cells could substitute for platelets. The induction of synthesis was specific for TSP; monocyte synthesis of three other proteins was not induced upon the addition of platelets. Platelet lysate or thrombin-induced platelet releasate could not substitute for intact platelets. In fact, platelet lysate inhibited [35S]TSP synthesis by monocyte-platelet cultures. This inhibition was not due to endotoxin contamination, interference with immunoprecipitation, or dilution of the [35S]methionine pool. Platelets required contact with monocytes to exert their effect, as culturing the cell populations with a filter between them prevented increased [35S]TSP synthesis. Monocyte-platelet interactions may serve to specifically increase monocyte synthesis of the adhesive protein, TSP. PMID- 2708376 TI - Purification of bacteriorhodopsin and characterization of mature and partially processed forms. AB - Bacteriorhodopsin (BR) essentially free of native lipids has been prepared in a highly stable state. Purple membrane was solubilized in Triton X-100 and BR was purified by size exclusion chromatography using 3 [cholamidopropyl)dimethylammonio]-2-hydroxyl-1-propanesulfonic acid (CHAPSO) detergent at pH 5. Molar ratios of phospholipid/BR ranged from 0.4 to 0.05 corresponding to 94-98% phospholipid removal. Purified BR has an absorbance ratio (A280nm/A548nm) of 1.5-1.6 in the dark-adapted state which is the highest purified BR/protein ratio reported to date. The purified BR in CHAPSO shows maximum stability in the pH range 5.0-5.5. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis profiles of native purple membrane and solubilized BR from most Halobacterium halobium JW-3 cultures show 3 higher molecular weight bands in addition to BR. Immunological staining and amino acid sequencing indicates that these additional proteins are partially processed forms of the BR precursor protein. The BR preprotein contains 13 additional amino acids on the NH2 terminus which are removed by post-translational processing in at least four steps. Isoelectric focusing separated most delipidated and non-delipidated BR samples into 8 bands. Incomplete BR post-translational processing BR is thought to be largely responsible for the multiplicity of isoelectric BR species. The principal components have pI values of 5.20 and 5.24 and both have absorption maxima at 550 nm, characteristic of detergent-solubilized BR. BR in Triton X-100 or nonylglucoside, delipidated BR in CHAPSO, and BR in intact purple membrane all have a dark-adapted ratio of 13-cis to all-trans-retinal of 1.9:1. PMID- 2708377 TI - Zymogen/enzyme discrimination using peptide chloromethyl ketones. AB - Glutamylglycinylarginyl chloromethyl ketone, tyrosylglycinylarginyl chloromethyl ketone, and phenylalanylprolylarginyl chloromethyl ketone have been labeled at their amino termini using fluorescein, rhodamine-X, lissamine-rhodamine, pyrene, and the 1,5-, 2,5-, and 2,6-dimethylaminonaphthalene-1-sulfonyl moieties. These peptidyl chloromethyl ketones have also been modified by incorporation of biotin and epsilon-amino caproyl biotin. The ability of these various chloromethyl ketones to be incorporated into a collection of zymogen-enzyme pairs has been evaluated using a variety of coagulation and fibrinolytic proteins. All labeled chloromethyl ketones were efficiently incorporated into the proteases tested, with the exception of urokinase which was refractory to inhibition by phenylalanylprolylarginyl chloromethyl ketone derivatives. No modification of any zymogen species was observed even under conditions designed to detect minimal reactivity. When enzymes were modified using chloromethyl ketones labeled with epsilon-amino caproyl biotin, the modified proteins readily reacted with avidin under a variety of different conditions. The observed reactivity with avidin was used in enzyme "blotting" following electrophoretic resolution of polypeptide chains and to remove active enzyme present in enzyme-zymogen mixtures. These reagents have been used to evaluate the potential for active site expression by the single-chain human factor VII molecule. Studies conducted with tissue factor, phospholipids, and calcium using factor X as substrate demonstrate that no activity can be obtained without initial activation of either factor X to factor Xa or factor VII to factor VIIa by an external source. We thus conclude that factor VII is a true zymogen, inert in the blood clotting process prior to its cleavage to factor VIIa. PMID- 2708378 TI - Isolation and partial sequencing of the human prothymosin alpha gene family. Evidence against export of the gene products. AB - Prothymosin alpha and thymosin alpha 1 are believed to be thymus-derived, hormone like materials with immunomodulatory functions performed outside the cell. These functions are inconsistent with the existence of a full length cDNA clone that does not encode an amino-terminal signal peptide or several consecutive hydrophobic residues. A study of the prothymosin alpha mRNAs and genes was undertaken in search of evidence for secreted forms of the protein. Prothymosin alpha mRNA was localized exclusively on free, rather than membrane-bound, polysomes. Upon screening cosmid and plasmid libraries totaling 2 X 10(6) clones, a gene family consisting of six members was identified. Sequence information from the 5'-ends of all the genes indicated that none encodes an amino-terminal signal peptide. One of the genes, apparently by means of alternate splicing, gives rise to two prothymosin alpha mRNAs, one of which has an additional internal glutamic acid codon with respect to the other. Comparison of the translated nucleic acid sequences of the five remaining genes with those encoded in the mRNAs revealed 30 98% homology in the first 50 amino acids. These five genes appear to be processed genes and/or pseudogenes. The localization of prothymosin alpha mRNAs on free polysomes, together with the partial nucleotide sequences of the genes, strongly suggest an intracellular function for prothymosin alpha. Therefore, the possibility must be raised that prothymosin alpha and its peptide derivatives act as xenobiotics when introduced into assays of immune function. PMID- 2708379 TI - Purification and some characteristics of nitric oxide reductase-containing vesicles from Paracoccus denitrificans. AB - Nitric oxide reductase of Paracoccus denitrificans was purified, with the use of 3-[(3-cholamidopropyl)dimethylammonio]-2-hydroxy-1-propanesulfonate (CHAPSO) detergent, as membrane vesicles of apparent Mr = 2-3 x 10(6). Fifty percent of the protein was a peptide of Mr = 34,000. Further fractionation with sodium dodecyl sulfate (SDS) resulted in vesicles in which the peptide constituted 90 95% of the protein. This peptide, which is rich in Ala, Gly, Ser, Asx, and Glx, is considered to be the peptide of nitric oxide reductase. The CHAPSO- and SDS fractionated preparations lost activity at 4 degrees C, pH 7.4, with half-times, respectively, of about 6 days and 4 h. Specific activities at 32 degrees C, pH 7.4, of about 0.33 mumol of NO x min-1 x mg-1 were realized after fractionation with CHAPSO in a phenazine methosulfate/ascorbate-based assay. The Km(NO) was less than or equal to 17 microM at pH 7.4. Rates decreased substantially below pH 5 and above pH 7.6. The preparations were free or almost free of cytochromes, exhibited otherwise no absorption bands in the visible region, contained no redox metals except for very small amounts of iron, were not inhibited by EDTA or some other common inhibitors of redox-metal enzymes, and were not observed to catalyze the reduction of nitrate, nitrite, or N2O. An absorption band at 274 nm in both the CHAPSO- and SDS-fractionated preparations was attributed to the presence of a solvent-soluble chromophore. N-Bromosuccinimide (NBS) inactivated the enzyme and bleached the chromophore both in the enzyme preparation and, after its purification, in 95% ethanol. NBS-inactivated enzyme could be reconstituted with purified chromophore, which alone seemed to have no nitric oxide reductase activity, but not with purified chromophore that had been reacted with NBS. Spectral changes interpretable as due to changes in redox state were not observed when enzyme was exposed to NO or certain reducing agents. PMID- 2708380 TI - Structural analysis of the FMN binding domain of NADPH-cytochrome P-450 oxidoreductase by site-directed mutagenesis. AB - Comparison of the amino acid sequence of rat liver NADPH-cytochrome P-450 oxidoreductase with that of flavoproteins of known three-dimensional structure suggested that residues Tyr-140 and Tyr-178 are involved in binding of FMN to the protein. To test this hypothesis, NADPH-cytochrome P-450 oxidoreductase was expressed in Escherichia coli using the expression-secretion vector pIN-III ompA3, and site-directed mutagenesis was employed to selectively alter these residues and demonstrate that they are major determinants of the FMN-binding site. Bacterial expression produced a membrane-bound 80-kDa protein containing 1 mol each of FMN and FAD per mol of enzyme, which reduced cytochrome c at a rate of 51.5 mumol/min/mg of protein and had absorption spectra and kinetic properties very similar to those of the rat liver enzyme. Replacement of Tyr-178 with aspartate abolished FMN binding and cytochrome c reductase activity. Incubation with FMN increased catalytic activity to a maximum of 8.6 mumol/min/mg of protein. Replacement of Tyr-140 with aspartate did not eliminate FMN binding, but reduced cytochrome c reductase activity about 5-fold, suggesting that FMN may be bound in a conformation which does not permit efficient electron transfer. Substitution of phenylalanine at either position 140 or 178 had no effect on FMN content or catalytic activity. The FAD level in the Asp-178 mutant was also decreased, suggesting that FAD binding is dependent upon FMN; FAD incorporation may occur co-translationally and require prior formation of an intact FMN domain. PMID- 2708381 TI - Isolation and characterization of the beta and epsilon subunit genes of mouse muscle acetylcholine receptor. AB - The genes coding for the beta and epsilon subunits of the mouse muscle nicotinic acetylcholine receptor (nAChR) were mapped by Southern blot analysis, and the entire loci for both genes cloned. The results indicate that they are single-copy genes. Both were sequenced to determine their size and structural organization. The beta subunit gene spans approximately 8 kilobases and is organized into 11 exons. A region containing cysteines, which are thought to form a disulfide bond and which are highly conserved, is encoded by one exon in all muscle acetylcholine receptor genes with the exception of the beta subunit gene, where it is split into two exons. The epsilon subunit gene spans 4.3 kilobases and contains 12 exons; it has the same structure as the gamma and delta nAChR genes. The intron-exon boundaries and exonic organization of the five known nAChR genes were compared. The analysis showed that the first 4 exons and the last exon of all muscle and brain nAChR subunit genes have the same boundaries, with the exception of a nAChR-related gene in Drosophila. PMID- 2708382 TI - Lamin B methylation and assembly into the nuclear envelope. AB - Lamin B is reversibly methyl-esterified and phosphorylated during the mammalian cell cycle. In order to study the role of methylation in lamin B function, we isolated mitotic cells in the presence of the microtubule inhibitor, nocodazole. Following removal of nocodazole, methylation of mitotic lamin B was found to precede its assembly into the nuclear envelope as cells exited mitosis. Very little additional methylation took place on assembled lamins. We were able to slow the rate of lamin B methylation with methylthioadenosine (MTA). A delay in lamin B methylation was accompanied by a corresponding delay in assembly of lamin B into the envelope. The delay was approximately 20-30 min beyond the typical 60 70 min usually required. Assembly of lamins A and C, which are not methylated, was also delayed by MTA, although to a lesser degree, suggesting that an interaction between the lamins is necessary for formation of the nuclear envelope. Chromatin decondensation was also slowed in the presence of MTA. Other inhibitors of methylation which had no inhibitory effect on the methyl esterification of lamin B were tested and found to have no effect on envelope assembly or chromatin decondensation. These results were obtained with Chinese hamster ovary cells as well as with the stem cell line, PC 13. Dephosphorylation of lamin B normally follows a time course similar to that of nuclear envelope assembly. In the presence of MTA, however, lamin B assembly was slowed with little effect on dephosphorylation. This resulted in a large population of dephosphorylated, but unassembled, lamin B protein, demonstrating that dephosphorylation is not sufficient for envelope assembly. The lack of effect on the time course of dephosphorylation also suggests that MTA is not acting upstream of the methylation event. PMID- 2708383 TI - Organization and expression of the rat kallikrein gene family. AB - We have cloned and characterized eight members of the kallikrein gene family from rat genomic DNA. Three of the cloned genes correspond to the previously characterized kallikrein family mRNAs PS, S2, and P1, which encode true kallikrein, tonin, and a novel kallikrein-like enzyme, respectively. In two cases, two kallikrein family genes are located on single genomic clones, suggesting close linkage of this family in the rat genome. Based on the total number of cloned genes and mRNAs, the minimum size of the rat family is 11 genes. Comparisons between the rat genes demonstrate a high degree of nucleotide sequence identity (greater than 80%) in exonic, intronic, and nearby flanking regions. This extensive sequence conservation not limited to clearly functional domains suggests that concerted evolution of this gene family has occurred. Despite the high overall sequence conservation among the rat family members, several discrete regions of high variability exist in the coding regions. We have defined the tissue-specific expression of the PS (true kallikrein), S2 (tonin), and S3 mRNAs with gene-specific oligonucleotide probes derived from these variant regions. PS is expressed in a wide range of tissues, while S2 mRNA is restricted to the submaxillary gland and S3 mRNA to the submaxillary and prostate glands. The high sequence conservation within the upstream flanking regions of these genes suggests that a small number of nucleotide differences determines the disparate transcriptional specificity of individual family members. PMID- 2708384 TI - cDNA structure and expression of bombyxin, an insulin-like brain secretory peptide of the silkmoth Bombyx mori. AB - Bombyxin, previously referred to as 4K-prothoracicotropic hormone, is a brain peptide of the silkmoth Bombyx mori, the amino acid sequence of which shows considerable homology with vertebrate insulin family peptides. Two independent clones have been isolated from a Bombyx larval brain cDNA library by using a synthetic oligonucleotide probe, one with the complete coding region for preprobombyxin (lambda Bb360) and the other covering the coding region, possibly for bombyxin, only partially (lambda Bb204). lambda Bb360 encodes preprobombyxin in the order of prepeptide/B-chain/proteolytic cleavage signal/C peptide/proteolytic cleavage signal/A-chain. This domain organization of preprobombyxin is the same as that of preproinsulins, suggesting that the tertiary structure and posttranslational modification mechanism are conserved through the evolution of bombyxin and insulin. Genomic Southern hybridization analyses using this cDNA as probe suggest that the Bombyx genome contains multiple copies of bombyxin gene. Northern hybridization analyses indicate that the concentration of lambda Bb360-type bombyxin mRNA in the bombyxin-producing cells is remarkably high (2.8 x 10(9) molecules/micrograms of total RNA), without undergoing appreciable change during larval-pupal development. PMID- 2708385 TI - Analysis of the glycosylation and phosphorylation of the lysosomal enzyme, beta hexosaminidase B, by site-directed mutagenesis. AB - Lysosomal enzymes require a mannose 6-phosphate recognition marker, constructed on asparagine-linked oligosaccharide chains, for targeting to lysosomes. We have identified the glycosylation sites of human beta-hexosaminidase B and have determined the influence of individual oligosaccharides on the phosphorylation, lysosomal targeting, and catalytic activity of the enzyme. The five potential glycosylation sites of the hexosaminidase beta-chain were modified individually by site-directed mutagenesis, and the constructs were expressed in COS 1 cells. By this analysis, we determined that four of the five potential sites were glycosylated. Two of the four oligosaccharides were preferentially phosphorylated. The absence of these two preferentially phosphorylated oligosaccharides resulted in greatly reduced amounts of the lysosomal form of the enzyme with increased secretion into the medium. The catalytic activity of beta hexosaminidase B was not significantly altered by the absence of individual oligosaccharides suggesting the folding and assembly of the enzyme was not disrupted. PMID- 2708386 TI - Phosphorylation of caldesmon in arterial smooth muscle. AB - We have isolated caldesmon (Mr = 145,000), by immunoprecipitation, from [32P]orthophosphate-loaded porcine carotid arteries. In resting muscles, caldesmon was phosphorylated to 0.45 mol of PO4/mol protein, while the 20,000 dalton myosin regulatory light chain (LC20) was phosphorylated to less than 0.05 mol/mol. After stimulation by KCl (110 mM) for 75 min and phorbol 12,13 dibutyrate (PDBu, 1 microM) for 60 min, caldesmon phosphorylation levels rose to 0.96 and 1.1 mol/mol, respectively. LC20 phosphorylation increased to 0.49 mol/mol at 1 min of stimulation by KCl and decreased to 0.17 mol/mol at 60 min. With PDBu, phosphate incorporation into LC20 rose only slightly, reaching 0.09 mol/mol after 90 min. Muscles contracted with histamine (10 microM) or ouabain (1 microM) also demonstrated elevated levels of phosphate incorporation into caldesmon. In these muscles, LC20 phosphorylation levels were less than 0.05 mol/mol. Three major phosphopeptides of indistinguishable mobility were identified on maps of caldesmon from resting, KCl-stimulated, and PDBu-stimulated muscles. There was, however, little similarity between the phosphopeptide maps of caldesmon phosphorylated in intact tissue and maps of purified caldesmon phosphorylated in vitro by protein kinase C (Ca2+/phospholipid-dependent enzyme) or Ca2+/calmodulin kinase II. PMID- 2708387 TI - Factors involved in specific transcription by mammalian RNA polymerase II. Role of factors IID and MLTF in transcription from the adenovirus major late and IVa2 promoters. AB - The role of the adenovirus major late upstream transcription factor (MLTF) in transcription from the adenovirus major late and the IVa2 promoters was studied. The transcription initiation site of the IVa2 promoter is located 210 nucleotides upstream from the CAP site of the major late promoter. Transcription from these two promoters occurs on different DNA strands. Thus, this divergent transcription suggests that the same factor could simultaneously regulate the expression of two different genes. This was investigated utilizing a reconstituted transcription system in vitro. The addition of MLTF to reaction mixtures containing the purified general transcription factors and the major late promoter resulted in a 10-12-fold stimulation of transcription. This stimulation was because of an increase of the stability of the preinitiation complex. MLTF allowed DNA template molecules to undergo multiple rounds of transcription. MLTF also stimulated transcription from the adenovirus-encoded IVa2 promoter. Surprisingly, reconstitution experiments indicated that transcription from the IVa2 promoter which does not have a TATA sequence required all the previously described general transcription factors, including TFIID, the TATA binding protein. The requirement for TFIID was demonstrated by reconstitution experiments as well as by oligonucleotide competition experiments. The implications of this observation are discussed. PMID- 2708388 TI - Characterization of the human parathyroid hormone-like peptide gene. Functional and evolutionary aspects. AB - The single-copy gene coding for the human parathyroid hormone-like peptide was isolated from a human placental genomic library. The gene spans 13 kilobases and contains seven exons. Exons I and II encode 5'-noncoding regions; each has its own transcription initiation site, and the two promoters are separated by over 1000 base pairs of genomic DNA. Exon III encodes the prepro-coding region, and exon IV encodes the mature peptide sequence. At the end of exon IV the splice site interrupts codon 139 of the mature peptide. Exon V, which is contiguous with exon IV, encodes a stop codon and a 3'-noncoding region. Exon VI encodes 34 additional amino acids, a stop codon, and a second 3'-noncoding region. Exon VII encodes two extra amino acids, a stop codon, and a third 3'-noncoding region. This genomic organization reveals how the multiple human parathyroid hormone-like peptide RNA transcripts, which have been observed, arise by both alternative splicing out of exons and use of multiple promoters. The mRNAs, which can potentially be formed from the primary transcript of this gene, could have one of three different carboxyl-terminal coding regions. The use of different exons to encode the different functional domains, 5'-noncoding region, pre-pro-coding region, and mature peptide region is identical to the organization of the human parathyroid hormone gene. This strongly suggests a common evolutionary origin of the two genes. PMID- 2708389 TI - Construction and nucleotide sequence of a cDNA encoding the full-length preprotein for human branched chain acyltransferase. AB - A cDNA (1.6 kilobases) for branched chain acyltransferase (E2b) isolated from a human liver library encoded only the amino-terminal half of the protein (Hummel, K. B., Litwer, S., Bradford, A. P., Aitken, A., Danner, D. J., and Yeaman, S. J. (1988) J. Biol. Chem. 263, 6165-6168). Here we report the isolation of other cDNAs which encode the carboxyl-terminal half of E2b and the construction of a cDNA which encodes the entire pre-E2b. cDNA from the original clone encoding the leader sequence, lipoate binding domain, and E3 binding domain was ligated to the cDNA from a clone which by restriction maps contained an additional 3' sequence. Both cDNAs used in the construct made a fusion protein in their original phage isolate recognized by antibodies to E2b. The nucleotide sequence of the constructed cDNA was determined, and the 1431 base pairs in the open reading frame encoded a protein of 477 amino acids. In vitro transcription and translation of this cDNA produced a 57-kDa protein recognized by E2b-specific antibodies. Mouse liver mitochondria imported and processed the 57-kDa protein to a 52-kDa antigenic protein which co-migrated with E2b isolated from tissue. Comparing the protein structure of this human pre-E2b protein with that for other acyltransferase proteins showed a similarity in structure throughout all the proteins suggesting evolutionary conservation. Branched chain acyltransferase from Pseudomonas putida showed the most similarity to human E2b. PMID- 2708390 TI - Physical properties of resistance vessel wall in peripheral blood flow regulation -I. Mathematical model. AB - A mathematical model is introduced to investigate the influence of the physical properties of the resistance vessel wall on the metabolic and myogenic mechanisms. The resistance vessel wall is assumed to have an elastic property and the elastic modulus to be a function of pressure (myogenic) and flow (metabolic). Blood is Poiseuille's flow. The resulting mathematical equations for pressure flow, pressure-diameter, pressure-wall tension and pressure-wall elastic modulus relationships introduced obey Laplace's law. Poiseuille's law and Hooke's law. In comparison with the experimental data (pressure diameter), the mathematical model is confirmed to explain well the dynamic behavior of the resistance vessel wall in vivo. PMID- 2708391 TI - Role of physical properties of resistance vessel wall in regulating peripheral blood flow--II. Structural and mechanical behavior. AB - In order to examine the structural and mechanical properties of the vessel wall resistance when subjected to autoregulatory flow control, a mechanical model for the vascular wall was derived from a mathematical model. The mechanical model was an analogue model which connected in series the Maxwell model (elastic modulus: K3) with the parallel elements of Hill's model (elastic modules: K2) and Hooke's elastic model (elastic modulus: K1); it was also mathematically equivalent to the Spring model (see part I). The structural and mechanical properties of the resistance vessel wall were characterized by the three elastic moduli (K1, alpha K2 and K3) [mmHg]. The parameter alpha was a modification factor of the elastic modulus K2 given by the myogenic mechanism. After a numerical analysis of the experimental data given by the mechanical model, we confirmed that the arterial pressure range for autoregulatory flow controls shifted to the upper region with an increase of the elastic modulus K1 and the flow regulation was reduced. PMID- 2708392 TI - Some geometric properties of the third metacarpal bone: a comparison between the thoroughbred and standardbred racehorse. AB - Geometric properties of the third metacarpal bone were compared between the young and adult Standardbred and Thoroughbred racehorse. The change in shape during growth and superimposed training was dramatic in both breeds but the Thoroughbred showed the greatest difference in the minimum moment of inertia as the animal matured. Males had larger moments of inertia throughout the length of the diaphysis than did females. The differences in geometric properties of the third metacarpal bone between the Thoroughbred and Standardbred were related to the incidence of fatigue fractures which are common in the racing Thoroughbred but uncommon in the Standardbred racehorse. PMID- 2708393 TI - Stiffness and strain energy criteria to evaluate the threshold of injury to an intervertebral joint. AB - This study is focused to evaluate the threshold of injury to an intervertebral joint based on its mechanical response. The load-deflection behavior of the intervertebral joint indicated non-linear and sigmoidal characteristics with continuously changing stiffness (a measure of the ability to withstand external force). The load corresponding to the point of zero stiffness was identified, according to the classical theories of mechanics, as the maximum load carrying capacity. Further, the initiation of trauma was defined to occur at the point on the load-deflection curve at which the stiffness begins to decrease for the first time. The load, stiffness and energy absorbing capabilities of normal and degenerated intervertebral joints at the initiation of trauma was determined. Axial compressive load experiments were conducted on nine intervertebral joints of fresh human male cadavers and the resulting load-deflection responses were transformed into stiffness-deflection responses using the derivative principle. Energy characteristics were also derived. Load, stiffness and energy at the initiation of trauma were found to be 9.0 kN, 2850 N mm-1, and 10.2 J for normal and 4.4 kN, 1642 N mm-1, and 5.8 J for degenerated segments, respectively. The load and energy values at failure were 11.0 kN, and 18.0 J for normal and 5.3 kN and 5.7 J for degenerated intervertebral joints, respectively. PMID- 2708394 TI - A three-dimensional kinematic and dynamic model of the lower limb. AB - A model describing the kinematics and dynamics of the lower limb is presented. The lower limb is modeled as a sequence of four rigid links connected by three universal rotary joints representing the hip, knee and ankle joints. Each joint is modeled as a sequence of three single axis rotational joints thus ascribing to the lower limb a total of 12 degrees of freedom. A method is described to measure the gait variables so that all nine angles can be computed based on the positions of nine markers placed on the subject during a gait study. The gait variables are then used in an iterative Newton-Euler formulation to compute the moments exerted about the axes of each joint during gait. PMID- 2708395 TI - Buckle muscle tension transducer: what does it measure? AB - The question is considered whether the strain of a buckle transducer attached to a muscle tendon provides a proportional measure of the force of the muscle acting directly on that tendon. It is shown that if muscle contains elastic and/or viscous elements in parallel with the force generator, the transducer strain may, under certain conditions, reflect other applied forces acting on the load (limb) in addition to the muscle force. PMID- 2708396 TI - An inexpensive strain gage amplifier and signal conditioner for biological applications. AB - The design and operation of a strain gage signal conditioning amplifier is described. The complete amplifier is based on the Analog Devices 2B30 module and features adjustable gain, bridge excitation voltage, bridge balance, d.c. offset and low-pass filtering. The ease of construction and low cost of this amplifier make it ideal for applications requiring a large number of signal channels. PMID- 2708397 TI - A stereophotogrammetric method for measurements of ligament structure. AB - A stereophotogrammetric method is presented to reconstruct the course of a curve in the three-dimensional space. This method is exclusively suitable as a non destructive tool to determine the surface fiberstructure of ligaments, tendons and other organised collagenous structures. In addition, it is a convenient tool to measure the geometry of articular surfaces and other complicated surface shapes. PMID- 2708398 TI - The apparent mass of the seated human body: vertical vibration. AB - Apparent mass frequency response functions of the seated human body have been measured with random vibration in the vertical direction at frequencies up to 20 Hz. A group of eight subjects was used to investigate some factors (footrest, backrest, posture, muscle tension, vibration magnitude) that may affect the apparent mass of a person; a group of 60 subjects (24 men, 24 women and 12 children) was used to investigate variability between people. Relative movement between the feet and the seat was found to affect the apparent mass at frequencies below resonance, particularly near zero-frequency. The resonance frequency generally increased with the use of a back rest, an erect posture and, in particular, increased muscle tension; but there was considerable intersubject variability in the changes. The magnitude of the vibration had a consistent effect: the resonance frequency decreased from about 6 to 4 Hz when the magnitude of the vibration was increased from 0.25 to 2.0 ms-2 r.m.s. The apparent masses of all the subjects were remarkably similar when normalized with respect to sitting weight. However, there were statistically significant correlations between apparent mass and some body characteristics (such as weight and age). PMID- 2708399 TI - The limitations of canine trabecular bone as a model for human: a biomechanical study. AB - Distal canine femurs were sectioned into 8 mm cubic specimens. Orthogonal compression tests were performed to preyield in two or three directions and to failure in a third. Apparent density and ash weight density were measured for a subset of specimens. The results were compared to the human distal femur results of Ciarelli et al. (Transactions of the 32nd Annual Meeting of the Orthopaedic Research Society, Vol. 11, p. 42, 1986). Quantitative similarities existed in the fraction of components comprising the trabecular tissue of the two species. Qualitative similarities were seen in the positional and anisotropic variation of the mechanical properties, and also in the form and strength of the relationships between the mean modulus and bone density, ultimate stress and density, and ultimate stress and modulus. However, significantly different regression equations resulted for the mean modulus-density, and ultimate stress modulus relationships, indicating that for the same density, canine trabecular bone displays a lower modulus than human, and may achieve greater compressive strains before failure. PMID- 2708400 TI - In vivo histologic and biomechanical characterization of a biodegradable particulate composite bone cement. AB - A biodegradable particulate composite bone cement consisting of a crosslinked gelatin matrix and tricalcium phosphate particles was implanted intraosseously in rabbits for up to 12 weeks. Cured cylindrical implants were inserted in holes drilled in the proximal tibial metaphysis. Sequential fluorochrome labeling and radiographs were done, and specimens were processed for decalcified and nondecalcified histology. At 4 weeks, the cross-sectional diameter of the implant was slightly greater than at implantation. There was considerable dissolution of the matrix and some new bone ingrowth. At 12 weeks, the diameter was reduced to half the original diameter and bone had grown throughout the matrix. In the distal femur, freshly mixed cement was used to stabilize an osteochondral fracture. Mechanical testing of the cement-stabilized fracture revealed a decrease in compressive strength and modulus at 4 weeks followed by an increase to greater than initial values at 12 weeks. Over time, the osteochondral fragment subsided into the underlying cement, but the subsidence did not correlate with mechanical strength. This osteochondral fracture model permits measurement of the overall material properties of a cement simultaneously weakened by resorption and reinforced by ingrowing bone. PMID- 2708401 TI - Platelet shape change and cytoskeletal reorganization on polyurethaneureas. AB - Understanding how platelet activation responses are affected by polymers having varied surface physicochemical properties can lead to improved materials for vascular applications. The in vitro responses of human platelets were studied upon adherence to four polyurethaneureas with different soft segments, as well as to Biomer, and to Formvar. Platelets were observed by video-enhanced light microscopy (VLM) as they adhered to polymer films. Platelets were subsequently prepared for high-voltage transmission electron microscopy (HVEM) to view the cytoskeleton and other ultrastructural features. Scanning electron microscopy (SEM) was then used to characterize cell surface morphology and to survey platelet populations. Shape change and cytoskeletal reorganization differed on the various surfaces. The extent of shape change and cytoskeletal reorganization was related to polyurethane surface energetic properties. While the most extensive shape change was observed on the hydrophilic and polar Formvar surface, the least shape change was observed on a polyethylene oxide soft segment polyurethane with similar surface-water energetic properties. Therefore properties other than surface-water energetics must be involved in determining platelet responses to different classes of polymers. HVEM also showed that cytoskeletal reorganization proceeded to completion only on Formvar. Polyurethane adherent platelets, although appearing fully spread by SEM or VLM, never exhibited complete cytoskeletal reorganization. PMID- 2708402 TI - Tissue biocompatibility of cellulose and its derivatives. AB - Tissue biocompatibility of cellulose and its derivatives was examined in two in vivo tests, one for absorbance by living tissue and one for foreign body reaction. The samples examined were regenerated celluloses and cellulose derivatives: methyl cellulose, ethyl cellulose, aminoethyl cellulose, hydroxyethyl cellulose, and cellulosic polyion complexes. The in vivo absorbance by living tissue was found to depend on the degree of crystallinity and the chemical structure of the sample. The foreign body reaction was relatively mild for all the samples examined, showing that cellulose can be converted to biocompatible materials by physical and/or chemical transformation. PMID- 2708403 TI - An evaluation of two configurations of tricalcium phosphate for treating craniotomies. AB - Biodegradable beta-tricalcium phosphate disks (TCP) of two configurations were inserted into 15-mm-diameter craniotomy wounds and nontreated control sites were evaluated in 60 rabbits. There were no adverse tissue reactions and no apparent difference in the clinical appearance of the 12- and 24-week implanted disks. By 36 weeks and continuing to 48 weeks, the omnidirectional TCP (OTCP) implants were degrading more rapidly than the unidirectional TCP (UTCP) implants, with degradation progressing centripetally and replacement by woven bone and maturing lamellar bone. Host-implant interface of both TCP configurations was a bone bond without interposed soft tissue. TCP disks may be clinically useful for craniotomy repair. PMID- 2708404 TI - Mechanical properties and short-term in-vivo evaluation of yttrium-oxide partially-stabilized zirconia. AB - Yttrium-oxide-partially-stabilized zirconia (YPSZ) belongs to a new class of ceramics exhibiting an improved toughness when compared to alumina. The toughening mechanism is related to a martensitic-like transformation of tetragonal metastable grains into a monoclinic state occurring at the crack tip. Specific tests showed that YPSZ exhibited a high bending strength (900-1200 MPa), a low Young's modulus (200 GPa), and a high toughness (KIC = 9-10 MN/m3/2). Its average grain size of 0.5 microns allows a surface roughness as low as 0.008 microns. Sterilization or aging in saline solution at room temperature for 100 days did not affect the toughness of this material. Cylindrical YPSZ samples, manufactured by cold isostatic pressing and sintering, were implanted in the paraspinal muscles in the rat up to 12 weeks. The tissue reaction was evaluated with reference to alumina (ISO requirements) by means of quantitative histomorphometry. No significant differences were found between YPSZ and alumina for both the membrane thickness and cell distributions surrounding the implants. PMID- 2708405 TI - Elastic and ultimate properties of acrylic bone cement reinforced with ultra-high molecular-weight polyethylene fibers. AB - A study of the fracture behavior of poly-(methyl methacrylate) (PMMA) bone cement reinforced with short ultra-high-molecular-weight polyethylene (Spectra 900) fibers is presented. Linear elastic and nonlinear elastic fracture mechanics results indicate that a significant reinforcing effect is obtained at fiber contents as low as 1% by weight, but beyond that concentration a plateau value is reached and the fracture toughness becomes insensitive to fiber content. The flexural strength and modulus are apparently not improved by the incorporation of polyethylene fibers in the acrylic cement, probably because of the presence of voids, the poor mixing practice and the weakness of the fiber/matrix interfacial bond. The present polyethylene/PMMA composite presents several advantages as compared to other composite cements, but overall the mechanical performance of this system resembles that of Kevlar 29/PMMA cement, with a few differences. Scanning electron microscopy reveals characteristic micromechanisms of energy absorption in Spectra 900/PMMA bone cement. A scheme for the strength of random fiber-reinforced composites, which is a simple extension of the Kelly and Tyson model for the strength of unidirectional composites, is presented and discussed. Young's modulus and the fracture toughness results are discussed in the framework of existing theories. More fundamental modeling treatments are needed in terms of fracture micromechanisms to understand and optimize the various mechanical properties with respect to structural parameters and cement preparation technique. PMID- 2708406 TI - Enhancement of the kinetics of the aeration of ethylene oxide sterilized polymers using microwave radiation. AB - Ethylene oxide (EO) is used extensively to sterilize medical supplies that are heat sensitive. EO residues in materials post sterilization can present a hazard to patients at the point of use. Protracted aeration (i.e. degassing) times are necessary post sterilization to reduce EO residues to an accepted level. The sorption of EO into polyvinylchloride was found to be an active process given that at sorption equilibrium (i.e. when the net flow of diffusant into the host material has reduced to zero) the number of molecules of EO per unit volume was greater in PVC than in its external environment. The diffusion coefficient (D) was concentration (c) dependent and the relationship which best describes this dependence was D(c) alpha ln c. The diffusion of EO was dramatically accelerated (as evidenced by a time saving in degassing of up to 400%) if microwave heating (2.45 GHz) was used instead of conventional heating for the same macroscopic temperature. The values of activation energy for diffusion were obtained from the respective Arrhenius plots of diffusion coefficient versus inverse temperature for each process. In general, even small reductions in activation energy can greatly increase the specific rate of reaction. The relative efficacy of microwaves in eliminating EO residues as evidenced by this data occurs as a result of microwaves reducing the activation energy for diffusion by almost a factor of two. The relative efficiency of microwave desorption compared to conventional aeration offers considerable gains in the cost-effectiveness of gas sterilization since it will permit a much greater throughput of material, thereby obviating the need for excessively large inventories of equipment. PMID- 2708407 TI - Transient adsorption of fibrinogen on foreign surfaces: similar behavior in plasma and whole blood. AB - The adsorption of fibrinogen from both human whole blood and plasma to a number of "foreign" surfaces is reported. Adsorption was measured as a function of plasma or blood dilution using radioiodine labeling. We showed previously that adsorption of fibrinogen from plasma exhibits a maximum at a plasma dilution of about 100:1, and have attributed this behavior to competition from other plasma proteins. (The same phenomenon is manifest as a time transient in fibrinogen adsorption.) In the present work we show that exactly the same trends are observed in whole blood. For each of the four surfaces, glass, siliconized glass, collagen-coated glass and polyethylene, the adsorption of fibrinogen as a function of dilution is the same in whole blood as in plasma. Each of these surfaces shows a unique dependence of fibrinogen adsorption on plasma or blood dilution. On cuprophane and a hydrophilic polyether urethane there is essentially no adsorption of fibrinogen from blood or plasma. For the hydrophilic polyurethane this result may be artifactual, but the absence of fibrinogen binding to cuprophane in blood or plasma is real since fibrinogen is found to be adsorbed in monolayer amounts from buffer. PMID- 2708408 TI - Platelet adhesion onto protein-coated and uncoated polyetherurethaneurea having tertiary amino groups in the substituents and its derivatives. AB - Interactions of platelet with novel polyetherurethaneurea and its heparinized derivative were investigated. Platelet adhesion onto the material and release of serotonin or adenosine phosphate from platelet-rich plasma (PRP) were suppressed by an introduction of amino groups to polyetherurethaneurea, by quaternization of the polymer, and further by heparinization of the polymer. When the material was precoated with one of major plasma proteins and the protein-coated materials were taken to contact with washed platelet suspension (WP), the dependence of platelet adhesion and activation on the properties of polymers was different from that observed for PRP interaction. Platelet adhesion and activation were promoted according to the nature of coating proteins in the order albumin less than gamma globulin less than fibrinogen and with increasing degree of denaturation of coating proteins. When the polymer materials were coated with proteins by immersing in aqueous solution containing two kinds of plasma proteins, adhesion behaviors of platelet were similar to those observed for PRP-uncoated material interaction. These experimental facts indicate that the selectivity of platelet for protein-coated material cannot be assessed by the interaction of WP with materials coated with a single kind of protein. It was concluded that material surface to which albumin is selectively adsorbed without denaturation does not stimulate adhering platelets for release reactions. PMID- 2708409 TI - A preliminary durability study of two types of low-profile pericardial bioprosthetic valves through the use of accelerated fatigue testing and flow characterization. AB - Bioprosthetic heart valves are being used more often because of certain advantages they have over artificial valves. The bioprostheses are less thrombogenic, cause a lower incidence of hemolysis, and usually fail in a slow progressive manner. A combination of flow characterization and accelerated testing was used to assess the durability of two types of pericardial valves, the Ionescu-Shiley Low Profile Mitral and the Carpentier-Edwards Low Profile Aortic valve. The flow characterization work was done in an aortic chamber designed for in vivo simulation. The function of the valve was monitored between different stages of the accelerated testing using laser Doppler anemometry. Accelerated testing was performed at 1300 cardiac cycles per minute, and physiologic conditions both in closing pressures and the ambient temperature were maintained. Results indicated a change in flow characteristics owing to cyclic loading of the leaflet tissue. The flow orifice increased over time leading to a decrease in peak velocity. Future developments in Doppler ultrasound may facilitate non invasive assessment of these peak velocity variations. Calcification of the tissue was not considered, since this was an in vitro study. PMID- 2708410 TI - Attachment and growth of fibroblast cells on polypeptide derivatives. AB - Attachment and growth of mouse fibroblast cells on polypeptide derivatives with different wettabilities were studied in the presence or absence of serum proteins. In the presence of serum, a peak level of cell attachment was observed for substrates with a contact angle of around 70 degrees. However, no relationship was found between cell attachment and water contact angle of the substrate in the absence of serum. Ca2+ -dependent cell attachment was observed on hydrophobic polypeptides in the absence of serum proteins. This suggests that Ca2+ -dependent membrane proteins function as mediators for cell attachment to hydrophobic polypeptides. In the presence of serum proteins, it was found that cell attachment is affected by the metabolism, Ca2+, and the cytoskeleton of the cell. Cell growth rate on hydrophilic polypeptide substrates was higher than that on intermediate or hydrophobic polypeptide substrates. This demonstrates that the strong interaction between cells and substrates will be unfavorable for a dewebbing process during mitosis. PMID- 2708411 TI - A model for the corrosion behavior of dental amalgams. AB - At high frequencies, electrochemical impedance behavior for corroding dental amalgams cannot be interpreted in terms of a simple Randles equivalent circuit. This may often be ascribed to the imperfect cell geometry resulting in a nonuniform current distribution. However, the insertion of a constant phase element (CPE) in the non-faradaic branch of the equivalent circuit offers a new scope for interpretation as the circuit provides an m-parameter corresponding to the degree of distortion. The decrease of m as a function of time was explained by a mathematical model reflecting an increasing number of pores. Moreover, that same model allows a better understanding of the passivating effect of NaHCO3 and of the differences between conventional and Cu-rich dental amalgams. PMID- 2708412 TI - Brain biocompatibility of a biodegradable, controlled-release polymer in rats. AB - We report the biocompatibility in the rat brain of a controlled-release, biodegradable polymer, the polyanhydride poly-[bis(p-carboxyphenoxy)propane sebacic acid] copolymer (PCPP-SA) in a 20:80 formulation. The biodegradable polyanhydride can be used for drug delivery directly into the brain, circumventing the difficulties posed by the blood-brain barrier and avoiding the consequences of having to administer toxic doses systematically to reach therapeutic doses in the central nervous system. The tissue reaction in the presence of PCPP-SA was compared to that seen with other standard neurosurgical implants. Fifty-six adult Sprague-Dawley rats were assigned to one of seven groups and underwent bilateral frontal lobe implantation of PCPP-SA (42 hemispheres), Surgicel (oxidized regenerated cellulose) (35 hemispheres), or Gelfoam (absorbable gelatin sponge) (35 hemispheres). None of the animals showed any behavioral changes or neurological deficits suggestive of either systemic or localized toxicity from the biodegradable polyanhydride, all surviving to the scheduled data of sacrifice. PCPP-SA evoked a well localized inflammatory reaction, comparable to that of Surgicel, which resolved as the PCPP-SA polymer degraded over five weeks. The biodegradable polyanhydride has been shown in this study to be nontoxic and biocompatible in the rat brain, when compared to standard neurosurgical implants. PMID- 2708413 TI - The interaction of cultured cells with membranes composed of random and block copolypeptides. AB - Random copolypeptides and block copolypeptides were synthesized, and an interaction between these polypeptide membranes and the cells was studied by a cell culture method (cell line, Ca. 9.22). In random copolypeptides composed of gamma-methyl L-glutamate and gamma-benzyl L-glutamate, cell attachment and cell growth depended on the monomer composition, and showed a maximum at around 70 mole % of benzyl glutamate. Block copolypeptide composed of L-methionine and oxyethylene exhibited low cell attachment and cell growth even at 10 mole % of oxyethylene content, compared to L-methionine homopolymer. ESCA study of the membrane suggested this result to be due to concentration of the poly(oxyethylene) block chain of the polymer on the surface of the membrane. Block copolypeptide composed of N5-(3-hydroxypropyl) L-glutamine and L-leucine exhibited low cell attachment and cell growth, while the corresponding random copolypeptide exhibited high cell attachment and cell growth. This difference is attributable to the microheterophase structure with the hydrophilic domains embedded in the hydrophobic matrix in the block copolypeptide membrane. PMID- 2708414 TI - Influence of antibiotic impregnation on the fatigue life of Simplex P and Palacos R acrylic bone cements, with and without centrifugation. AB - The fatigue properties of Simplex P and Palacos R bone cements were compared to their antibiotic impregnated counterparts AKZ* and Palacos R with gentamycin. The effect of porosity reduction by centrifugation of all four cement types was also assessed. Fifteen specimens of each cement type were prepared according to manufacturer's instructions and 15 additional specimens of each cement type were prepared by mixing the powder with chilled monomer (0 degrees C) and then centrifuging the cement immediately after mixing. Fifteen fully reversed tension compression fatigue tests were performed at 15 MPa in stress control for each cement preparation in vitro while simulating the in vivo state (37 degrees C and 100% humidity). The number of cycles to failure were recorded. There was no significant difference in the fatigue life of Palacos R and Simplex P when both cements were prepared in the standard fashion. The addition of 1/2 g of gentamycin to Palacos R did not significantly alter its fatigue properties. The addition of 0.5 g of erythromycin and 0.24 g of colistin did not decrease the fatigue life of Simplex P. Centrifugation significantly improved the fatigue properties of Simplex P and AKZ. The fatigue lives of Palacos R and Palacos R with gentamycin were not improved by centrifugation. The fatigue life of centrifuged Simplex P was significantly greater than the fatigue life of Palacos R and of Palacos R with gentamycin, whether the Palacos R based cements were centrifuged or not. PMID- 2708415 TI - In vitro platelet interactions with a heparin-polyvinyl alcohol hydrogel. AB - No difference in in vitro platelet reactivity was found between an immobilized heparin containing hydrogel (heparin-PVA) and the hydrogel without heparin (PVA), in a variety of experimental assays. There was no significant difference between the heparin-PVA and PVA coated polyethylene tubing in the number of 51Cr-labeled platelets, the extent of 14C serotonin release by the adherent platelets or in the degree of platelet count decrease after 1 h exposure to citrated canine whole blood in a Chandler loop system. Furthermore, adhesion and release values were lower than those observed with the uncoated polyethylene tubing (e.g., 9.3 +/- 4.3 plt/10(3) microns 2 on PVA; 18.3 +/- 4.6 plt/10(3) microns 2 on polyethylene). There was also no significant difference between heparin-PVA and PVA in bead column retention values with canine blood and with the previously reported washed human platelet adhesion/release values. Thus there appears to be no effect of the immobilized heparin by itself on the in vitro interactions of PVA with platelets, with the reactivity towards platelets dominated by that of the underlying substrate (i.e., PVA). PMID- 2708416 TI - Effect of heparin-PVA hydrogel on platelets in a chronic canine arterio-venous shunt. AB - Polyvinyl alcohol (PVA) hydrogel, with or without heparin, was reactive towards canine platelets in a chronic arteriovenous shunt as demonstrated by an increase in platelet regeneration time, a systemic decrease in platelet count and transient decrease in platelet serotonin content. Immobilized heparin (heparin PVA) had no effect whereas unmodified polyethylene was found to be unreactive despite similar levels of platelet deposition as measured by SEM and a higher in vitro reactivity (J. Biomed. Mater. Res., this issue). Twenty-centimeter lengths of hydrogel coated polyethylene tubing were inserted between the arterial and venous portions of the shunt and left in place for 4-6 days, without the complicating artifacts of anticoagulation, anesthesia, or surgical intervention. Regeneration time was measured as the return to normal platelet cyclooxygenase (co) activity after a single 240-mg dose of aspirin, with co activity measured in vitro as malondialdehyde production. Although measuring new platelet production, regeneration time is an indirect measure of platelet consumption, so that the reduced regeneration time seen here was presumed to reflect enhanced material associated consumption and thromboembolism. Like other hydrogels, PVA does not appear to be "thromboadherent" but it does appear thrombogenic. Immobilized heparin had no additional effect, presumably because the platelet response was dominated by the reactivity of the underlying substrate. PMID- 2708417 TI - The role of physical and chemical characteristics in assessing the performance of a new biological vascular graft. AB - Information obtained from physical and chemical characterization of vascular grafts can prove valuable in obtaining a preliminary assessment of potential in vivo performance. The data presented illustrate the concept and show that the new biological graft made from bovine ureters has adequate performance characteristics for use as a potentially successful vascular graft. PMID- 2708419 TI - The occurrence of acquired immunodeficiency syndrome and unsuspected human immunodeficiency virus in burn patients. AB - Although the risk of nosocomial transmission of human immunodeficiency virus remains low, burn center personnel may be at greater risk. Approximately 10% of burn patients admitted to an urban center were found to be positive to the human immunodeficiency virus, consistent with other findings of increased prevalence in trauma patients. "Universal" precautions adequate for other health care settings may not be sufficient in the burn center. Knowledge of a patient's human immunodeficiency virus status has important treatment implications. PMID- 2708418 TI - The effect of thermal injury on murine neutrophil oxidative metabolism. AB - The ability of polymorphonuclear leukocytes to kill bacteria and yeast is reflected by cellular chemiluminescence or similarly by the production of H2O2 during oxidative metabolism. With the use of flow cytometry and 2'7' dichlorodihydrofluorescein-diacetate, we determined the direct effect of thermal injury and the indirect effect of burn serum on murine polymorphonuclear leukocyte oxidative metabolism after stimulation on days 1, 5, and 10 after 25% total body surface area burn. Control or burn peritoneal leukocytes and 10% control or burn serum were incubated in vitro with 2'7' dichlorodihydrofluorescein-diacetate for 15 minutes, then stimulated with phorbol 12-myristate 13-acetate. The change in polymorphonuclear leukocyte fluorescence was calculated from fluorescence histograms before and after stimulation. The oxidative metabolism of burn polymorphonuclear leukocytes was clearly depressed on days 5 and 10 after burn injury. Control polymorphonuclear leukocytes in the presence of day 5 burn serum produced decreased levels of H2O2, returning to normal by day 10. In general, bactericidal activity is markedly depressed on days 5 and 10 after thermal injury and may be associated with increased risk of sepsis. PMID- 2708420 TI - Rehabilitative considerations for patients with severe Stevens-Johnson syndrome or toxic epidermal necrolysis. A case report. AB - Stevens-Johnson syndrome and toxic epidermal necrolysis are dermatologic disorders that demonstrate pathophysiologic similarities to partial-thickness burn injury and benefit from treatment in a multidisciplinary burn center. Although burn therapists frequently participate in the care of these patients, guidelines for rehabilitative intervention have not been previously identified. A case report highlights the potential rehabilitative complications and treatment interventions indicated for patients with severe forms of these conditions. PMID- 2708421 TI - Scald burns associated with tap water. PMID- 2708422 TI - Fire safe cigarettes. An update. PMID- 2708423 TI - Burn nurse retention. Elements of success. AB - With the national nursing shortage most acute in the critical care area, greater emphasis on effective recruitment and nurse retention is vital. Despite the high stress environment of a busy burn center, nursing turnover can be reduced to acceptable levels. The greatest "satisfiers" are centered around nursing issues such as schedule flexibility, nurse/patient ratio, and the center's reputation and standards. Salary and the physical plant environment were of little importance in comparison. PMID- 2708424 TI - The burn nurse shortage. A national survey. PMID- 2708425 TI - Cerebral revascularization by axillary-carotid bypass. AB - Revascularization for symptomatic proximal common carotid severe stenosis or occlusion frequently requires a bypass procedure. Subclavian-carotid bypass is probably the most frequently performed operation. In the past 5 years 13 patients underwent an alternative operation, axillary-carotid bypass, which may be technically easier than subclavian-carotid bypass and just as durable. The graft is placed under the clavicle, in an easily constructed tunnel not involving the true thoracic outlet, deep to the sternocleidomastoid muscle and internal jugular vein. Five distal anastomoses were made to the common carotid (2 greater saphenous vein, 2 Dacron and 1 Gortex grafts), 4 to the internal carotid (all vein) and 4 to the external carotid (all vein, 1 sequential with a end-side anastomosis to the ipsilateral vertebral). There were no perioperative deaths. One stroke occurred in a patient with a Dacron graft to the common carotid who also had a concomitant ipsilateral carotid endarterectomy. All grafts were open by Doppler exam at a mean follow-up of 2 1/2 years. Improved cerebral hemodynamics was confirmed in 11 patients by Gee oculoplethysmography. These early results support the use of the axillary artery as a donor for extracranial cerebral revascularization when the proximal common carotid is occluded or severely stenotic. PMID- 2708426 TI - Simultaneous carotid-vertebral reconstruction. AB - Vertebral atherosclerotic lesions frequently coexist with lesions in the carotid arteries. The most common cause of vertebrobasilar symptoms is hypoperfusion which may be relieved by correction of a critical carotid stenosis. A safe record with direct vertebral revascularization has led us to do simultaneous correction of lesions in the carotid and vertebral arteries through a single cervical incision. To evaluate combined carotid and vertebral reconstruction, procedures performed in a five-year period (1982 to 1987) were retrospectively studied. Thirty-six patients had combined carotid-vertebral reconstruction. In 10 patients, the primary indication was critical carotid disease; 26 patients had vertebrobasilar symptoms. The procedures performed were carotid endarterectomy with either vertebral reimplantation (22) or distal vertebral bypass (7), or external carotid angioplasty with either vertebral reimplantation (3) or distal vertebral bypass (4). Combined carotid-vertebral procedures are effective in relieving symptoms of hypoperfusion in the vertebrobasilar system. A specific lesson learned is that a distal vertebral bypass must not be done in conjunction with an external carotid angioplasty. PMID- 2708427 TI - Upper limb emboli. A review of 55 patients managed surgically. AB - During an eleven years period 1976-1986, 55 patients with emboli to the upper limb were managed at St. Laurence's Hospital. The presentation was classical for acute limb ischaemia in the majority while 27% presented 48 hours or more after the onset of symptoms. Four patients presented with gangrene. In 41 patients a source of embolus was readily identified: atrial fibrillation (33), recent myocardial infarct (5), subclavian artery aneurysm (2), left atrial myxoma (1). In the remaining 14 patients the source of the embolus was not initially apparent but investigation by echocardiography, 24 hour Holter monitoring and coagulation studies suggested a source in eight. Embolectomy was performed in 51 patients and amputation as a primary procedure in two. The patients with subclavian artery aneurysms were not treated surgically. A normal circulation was restored both clinically and angiographically in 43 patients, four of whom later died from myocardial infarction. Four of the remaining eight patients had residual arm claudication, three required amputation and one had an ischaemic contracture. The failure to restore a normal circulation was uniformly associated with delayed presentation or failure to adequately anticoagulate the patient with heparin. PMID- 2708428 TI - Early and late results of surgical treatment of coarctation of the aorta in the first three months of life. AB - Forty infants under 3 months of age underwent repair of coarctation of the aorta (CoA) during an 8-year period. Preoperatively, 55% of the patients received intensive circulatory and/or respiratory care, and surgical relief of CoA was effected within 24 hours of diagnosis. The last 38 patients were managed by simple repair of the CoA in patients with significant VSD (Group II), with the addition of pulmonary artery banding in patients with complex cardiac lesions with VSD, or patients with incremental risk factors in Group II. There were no intraoperative deaths, one (2.6%) postoperative, and four (11%) late deaths in the last 38 patients. Only one (2.9%) showed signs of recurrence in 34 patients followed for 10 to 104 (mean 46) months. Improvement in the survival rate in this study can be attributed to: (1) aggressive preoperative care, (2) early noninvasive diagnosis and operation, (3) refinement in the surgical technique, and (4) appropriate use of pulmonary artery banding. PMID- 2708429 TI - Acute traumatic rupture of the thoracic aorta: place of delayed surgical repair. AB - Acute traumatic rupture of the thoracic aorta (ATRTA) is considered as an emergency which requires immediate surgery. However surgical mortality is high with an average of 20% in the literature. Twenty seven patients were observed from 1973 to 1986. Three patients were not operated upon (Group I), twenty patients had immediate surgery (Group II) with 60% mortality, four patients underwent delayed surgery (Group III) with 25% mortality. Analysis of cause of death show that associated lesions were present in 72% of pts who did not survive and in only 37% among survivors. Associated lesions may be lethal initially (e.g. brain trauma) or they may be aggravated by the thoracic procedure. Complications from associated lesions may also compromise the outcome. It is well known that the majority of deaths from ATRTA occur within 24 hours. Immediate repair of the aortic lesion should be the rule when aortic rupture is isolated or associated with moderate injuries. It may be however that in some cases with severe and multiple associated lesions who survive the initial aortic injury, delayed repair of ATRTA could be considered. PMID- 2708430 TI - Progress in chronic mesenteric arterial ischemia. AB - Analysis of surgical treatment for chronic mesenteric arterial occlusive lesions in 45 patients between 1964 and 1986 has shown an evolution in diagnostic criteria, indications for operation, and surgical technique. Prior to 1976, a variety of surgical procedures (diaphragmatic crus release, arterial dilation, patch angioplasty, reimplantation, endarterectomy) were employed in treatment of patients with a wide range of symptoms and variation in number of mesenteric vessels involved. Since 1976, we have selected patients with "typical" symptoms (postprandial epigastric pain, fear of eating, weight loss) and 2 or 3 vessel disease, and have avoided surgery for celiac crus lesions. Typical symptoms were seldom present in isolated celiac artery crus compression, 4 of 15 pts (23%), but were often present with 2 or 3 vessel disease, 17 of 28 pts (61%, p = 0.03). Satisfactory resolution of pain was achieved in 18 of 24 pts with 2 or 3 vessel disease. We conclude that presence of "typical" symptoms and angiographic findings of 2 or 3 vessel disease are prerequisites for effective surgical treatment. Bypass graft is our surgical technique of choice, but the extent of arterial reconstruction required to relieve symptoms remains undefined. PMID- 2708431 TI - Retroperitoneal approach to aortic surgery. AB - The retroperitoneal approach has been recently advocated as an alternate approach to abdominal aortic surgery rather than the traditional transperitoneal approach. A comparative analysis of these two approaches was undertaken to clarify the differences. From June 1984 through June 1986, 172 patients underwent elective infrarenal abdominal aortic surgery on the Vascular Surgery Service at Eastern Virginia Medical School. One hundred nineteen were operated through a transperitoneal approach, and 53 through a retroperitoneal approach. The two groups were similar relative to age, sex, indications, risk factors and operations performed. The groups were then analyzed relative to operating time, blood transfusion, fluid replacement, ileus, morbidity, length of hospital stay, American Society of Anesthesiologists classification, and mortality. Significant differences were found: retroperitoneal patients had shorter operating time, shorter ileus, fewer cardiac complications, and shorter hospitalization than transperitoneal patients. This retrospective evaluation supports the conclusion that the retroperitoneal approach to abdominal aortic surgery is safe and beneficial in most patients. The retroperitoneal approach should therefore be given consideration in routine aortic surgery. PMID- 2708432 TI - Modified extraperitoneal approach to the abdominal aorta in exposure of the thoracoabdominal aorta. AB - A modified left transthoracic and retroperitoneal approach to the thoracoabdominal aorta without entering the peritoneal cavity is reported. The advantage of this modification is that the abdominal wall musculature is preserved intact except for the division of a small part of the transversus abdominis muscle. PMID- 2708433 TI - Alternative procedures to aortobifemoral bypass grafting. AB - The outcome of 175 bypass procedures performed on 174 patients with symptomatic aortoiliac occlusive disease during a five-year period were analyzed. Fifty-nine patients underwent a standard aortofemoral bypass and 116 patients underwent one of three alternative procedures consisting of femoro-femoral, iliofemoral, or axillofemoral bypass. The operative stress, morbidity, mortality and long-term results were compared. Although the aortofemoral group had a higher three-year cumulative patency rate (89% vs 81%), the alternative procedure group had a lower operative mortality (1.8% vs 7%). In addition, the patients in the alternative procedure group were slightly older, had a higher percentage of procedures performed for limb salvage, and had a less optimal run-off status, yet the complication rate was significantly less than that of the aortofemoral group (p less than 0.05). The use of these alternative procedures should be considered for patients with symptomatic aortoiliac disease, who represent a moderate operative risk as well as those in a high risk category. PMID- 2708434 TI - Plasma catecholamine concentration during and after aorto-femoral bypass grafting. AB - Mean arterial plasma concentration of norepinephrine and epinephrine [NE + E], increased from 2.84 nM (post-induction) to 7.50 nM at the end of an approximately 4-hour operation for aortofemoral bypass grafting (plus unilateral lumbar sympathectomy) in 13 men. It increased to 18.25 nM during the first hour of recovery, and fell to 9.58 nM by the next morning. Thus during recovery, arterial [NE + E], by exceeding the minimum of 10.6 nM [NE] necessary for vasoconstriction, is a probable contributor to postoperative vasospasm as previously hypothesized. PMID- 2708435 TI - Chemically processed bovine heterografts of the second generation as arterial substitutes: a comparative evaluation of three commercial prostheses. AB - The use of chemically processed bovine heterografts is primarily confined to the construction of arterio-venous blood accesses in those patients requiring hemodialysis, plasmapheresis or chemotherapy. The grafts of the first generation i.e. Artegraft and Solcograft are now being supplanted by those of the second generation i.e. Reinforced Artegraft, Solco P and NCGT. We have investigated these three types of arterial prostheses as a biomaterial in terms of sterility, inflammatory response and cytocompatibility and as a blood conduit in dogs in terms of patency and healing. For each type of graft, two implantations were carried out for durations of 4 hours, 24 hours, 48 hours, one week, two weeks, one month, three months, and six months. Therefore a total of 48 grafts were implanted. All grafts but five were patent at sacrifice: thromboses were observed in two Reinforced Artegraft (after two weeks and after one month) and in three NCGT (after 24 hours, after 48 hours, and after one month). Therefore the following patencies were observed: Reinforced Artegraft 14/16, Solco P 16/16 and NCGT 13/16. In all the patent grafts, the healing was reduced to the formation of a pannus along both anastomoses; thrombotic accumulations were observed on the surface defects of the grafts, particularly the NCGT graft. The Reinforced Artegraft presents only minor advantages over the previous Artegraft; the Solco P, somewhat more acceptable is no longer commercially available since the manufacturer withdrew it after early clinical failures. The improvements noted in the bovine heterografts of the second generation appear to be marginal as compared to those of the first generation. PMID- 2708436 TI - Scoring of vascular disease in the lower extremities. AB - Lack of standardisation in reporting the vascular status of patients leads to difficulties in comparing different series. A method of vascular scoring is presented, integrating symptoms, physical examination, vascular laboratory studies and arteriography. The score is expressed in a concise form by several letters and numbers supplying the relevant information as to the main segment involved, the severity of the ischaemia and the completeness of the examination. The files of 100 candidates for vascular surgery were recorded with the scoring method. Vascular indices were calculated by dividing the sum of points assigned to each item by the maximal available score. The internal consistency of the method was evaluated by computing separate indices for the three components of the scoring--clinical examination (CE), vascular laboratory (VL) and arteriography (AR)--and comparing them with the overall index and with each other. Correlation coefficients with the overall index were for CE 0.90, for VL 0.92 and for AR 0.75. The data on the 200 limbs were reviewed independently by three experienced vascular surgeons and ranked in order of increasing severity of ischaemia; the correlation coefficient between this ranking and one based solely on the scoring method was 0.91. A vascular scoring method may help create a mutual language among practitioners, enabling them to compare results and benefit from accumulating worldwide experience. PMID- 2708437 TI - The fate of extremities with flat lower calf pulse volume recordings. AB - The prognosis of patients with a flat (Class 5) or nearly flat (Class 4) pulse volume recording was studied in relation to the signs and symptoms of vascular disease in 517 patients. Within one year of follow up, 97.9% of 96 patients with jeopardized limbs and flat tracings required surgery, whereas 72.4% of 29 patients with no or minimal symptoms required reconstruction (p less than 0.001); 85.7% of patients with Class 4 tracings and jeopardized limbs required surgery, whereas 41.9% of those with minimal symptoms and Class 4 recordings developed need for reconstruction (p less than 0.001). The requirement for surgery Class 5 patients is significantly higher than in those with Class 4 tracings. The general trend of pulse volume recording amplitude to correlate with ankle systolic blood pressure was confirmed. One year mortality in Class 5 patients was 43.2%. The majority of patients with severely abnormal pulse volume recordings eventually come to surgical reconstruction. The timing of surgery is based on the clinical status of the jeopardized limb, not solely on the presence of a pulse volume tracing abnormality. PMID- 2708438 TI - Selection of amputation level and prediction of healing using transcutaneous tissue oxygen tension (PtcO2). AB - Pre-operative measurement of transcutaneous tissue oxygen tension (PtcO2) by reflecting oxygen delivery at proposed amputation sites may allow accurate prediction of post-operative healing. Thirty-eight patients requiring amputation had PtcO2 measured with a Clark electrode on the foot, anteriorly and posteriorly below knee and above the knee while lying supine. PtcO2 greater than 24 mmHg was chosen to predict healing and indicated 13 above-knee (AK) and 25 below-knee (BK) amputations. Clinical criteria indicated 12 AK and 26 BK amputations. PtcO2 and clinical judgement differed on five occasions, a lower amputation was indicated by PtcO2 twice and by clinical selection three times (PtcO2 16 mmHg). Amputation was performed at the more distal level indicated (25 BK, 13 AK). Foot PtcO2 in both groups did not differ significantly, 4.08 +/- 2.00 mmHg (BK) and 3.9 +/- 1.29 mmHg (AK) (p greater than 0.5), nor did above knee PtcO2 (p greater than 0.3). Anterior below knee PtcO2 in both groups differed significantly, 34.92 +/- 10.84 mmHg (BK) and 9.5 +/- 5.60 mmHg (AK) (p less than 0.001). Likewise, posterior PtcO2, 39.64 +/- 6.85 mmHg (BK) and 14.1 +/- 4.43 mmHg (AK) (p less than 0.001). Amputation sites healed primarily within two weeks except the site with a pre-operative PtcO2 of 16 mmHg, where healing was delayed and occurred by second intention. These results indicate that PtcO2 is a valid predictor of primary healing following amputation. PMID- 2708439 TI - Dual function of the distal arteriovenous fistula for maintenance of arterial and venous prosthetic graft patency in the lower extremity. AB - Venous hypertension, severe swelling, and tissue necrosis occurred in a limb previously subjected to distal arterial bypass plus adjunctive arteriovenous fistula. Occlusion of the popliteal vein had not been recognized during the early treatment period. Subsequent to identification of this mechanism, limb salvage was achieved with an interposition graft of the popliteal vein using externally supported PTFE. The prereconstruction venous pressure gradient of 29 cm H2O was virtually abolished immediately after reestablishing venous outflow. The distal arteriovenous fistula, initially established to maintain prosthetic arterial graft patency, now serves, in this case, a dual function by additionally maintaining prosthetic venous graft patency. An intact deep venous system is critical for achieving successful arterial reconstruction and to avoid the complications associated with an occluded outflow tract in the face of augmented inflow. PMID- 2708440 TI - Confirmation of infection of an aortic graft. AB - The presentation of an aortic graft infection may be dramatic in the form of an aortoenteric fistula or drainage of pus from the wound. Some cases may be more subtle with presentations of fever of unknown origin. Prior to embarking upon major operative repair for these suspected lesions, it is essential to confirm the presence of infection. Under CT control, a fine needle may be inserted into the peri-graft space, and cultures may be obtained. Further confirmation may be achieved by an injection of a small amount of contrast material which will demonstrate lack of incorporation of the graft into surrounding tissues. Prior confirmation of graft infection permits a staged procedure to repair this technique is illustrated with a case history. PMID- 2708441 TI - Abdominal aortic replacement with a left-sided inferior vena cava: transperitoneal and left retroperitoneal approaches. AB - An unsuspected left-sided inferior vena cava (IVC) can present a formidable challenge for the surgeon attempting aortic reconstructive surgery. A 73-year-old man with aorto-iliac occlusive disease and a 64-year-old man with a seven centimeter (cm) abdominal aortic aneurysm (AAA) each underwent an aorto-femoral bypass graft in the setting of a left-sided cava. In the former case the conventional transperitoneal approach was utilized and in the latter case the extended left retroperitoneal incision was employed. The technical details required in performing these procedures and the developmental anatomy of this and other major venous anomalies are discussed. PMID- 2708442 TI - Operative management of bilateral internal iliac artery aneurysms. AB - A case of bilateral internal iliac artery aneurysms in association with an infrarenal abdominal aortic aneurysm is presented. The implications of surgical repair of these lesions are considered, particularly with reference to interruption of pelvic blood flow. Reimplantation of the inferior mesenteric artery is recommended when internal iliac artery flow is compromised during aortic reconstruction. PMID- 2708443 TI - Phenol sympathectomy for symptomatic fibromuscular angiodysplasia of the lower limb. AB - Clinical manifestation of fibromuscular angiodysplasia of the lower extremities is often due to a spastic phase of the arteries, and may be severe enough to present as Raynaud's phenomenon. We describe a 37-year-old woman who suffered for a year from numbness and coldness of the foot and claudication over 30 meters. Angiography revealed fibromuscular angiodysplasia of the left superficial femoral artery, right anterior tibial artery and spastic changes in the peroneal artery. Phenol sympathectomy of the third lumbar ganglion resulted in dramatic relief of symptoms. PMID- 2708444 TI - Long-term clinical outcome of patients with tricuspid atresia. I. "Natural history". AB - The clinical course and outcome of 111 patients with tricuspid atresia, seen during 1972-1982, were reviewed. All clinical and investigation data, progress and management were analysed. The mean age at presentation was 21.9 +/- 8.8 days. Patients with reduced pulmonary blood flow presented earlier. Patients with normal or increased pulmonary blood flow usually presented in heart failure. "True" natural history was observed in 13 unoperated patients. Six of these died at the age of 7 days to 8 months (mean 32.2 days). Seven patients survived without surgery for 11 months to 24 years, the older ones developing pulmonary vascular obstructive disease. The overall mortality in the whole series was 32.4% (36/111), the mean age at death was 3.1 years (range 3 days-48 years). The mortality rate within the first year of life was 22.5%. The mean age of survivors at follow-up was 10.7 +/- 0.9 years (range 11 months-27 years). PMID- 2708445 TI - The management of cardiac surgical patients in a general surgical recovery ward. AB - A suitable combination of anaesthetic and surgical techniques has allowed the safe management of post-operative cardiac surgical patients to be conducted in a surgical recovery area rather than in the intensive care ward. The results of the first 103 patients so managed (aged 49 +/- 10.7 years) are presented. Coronary artery bypass grafts were performed on 98 patients, 4 patients underwent repair of atrial septal defect and on 1 patient a pulmonary valvotomy was performed. The complications and their management are described. PMID- 2708446 TI - The International Society for Cardiovascular Surgery (North American Chapter), 36th scientific meeting. Chicago, Illinois (U.S.A.), June 13 and 14, 1988. Abstracts. PMID- 2708447 TI - The Society for the Vascular Surgery, 42nd annual meeting. Chicago, Illinois (U.S.A.), June 13 and 14, 1988. Abstracts. PMID- 2708448 TI - Platelet-derived growth factor and angiotensin II cause increases in cytosolic free calcium by different mechanisms in vascular smooth muscle cells. AB - Platelet-derived growth factor (PDGF) and angiotensin II (AII) are thought to mediate their biological effects in vascular smooth muscle cells (VSMCs) by causing alterations in cytosolic free calcium ([ Ca2+]i). In this study we examine the pathways by which PDGF and AII alter [Ca2+]i in VSMCs. Addition of PDGF resulted in a rapid, transient, concentration-dependent increase in [Ca2+]i; this rise in [Ca2+]i was blocked completely by preincubation of cells with ethylene glycol-bis (beta-aminoethyl ether) N,N,N',N'-tetraacetic acid (EGTA) or CoCl2, by the voltage-sensitive Ca2+-channel antagonists verapamil or nifedipine, by 12-O-tetradecanoylphorbol-13-acetate (TPA), or by pertussis toxin. AII also caused an increase in [Ca2+]i; however, AII-stimulated alterations in [Ca2+]i displayed different kinetics compared with those caused by PDGF. Pretreatment of cells with 8-(diethylamine)-octyl-3,4,5-trimethyoxybenzoate hydrochloride (TMB 8), almost totally inhibited AII-induced increases in [Ca2+]i. EGTA or CoCl2 only slightly diminished AII-stimulated increases in [Ca2+]i. Nifedipine, verapamil, TPA, and pertussis toxin pretreatment were without effect on AII-induced increases in [Ca2+]i. PDGF and AII both stimulated increases in total inositol phosphate accumulation, although the one-half maximal concentration (ED50) for alterations in [Ca2+]i and phosphoinisitide hydrolysis differed by a factor of 10 for PDGF (3 X 10(-10) M for Ca2+ vs. 2.5 X 10(-9) M for phosphoinositide hydrolysis), but they were essentially identical for AII (7.5 X 10(-9) M for Ca2+ vs. 5.0 X 10(-9) M for phosphoinositide hydrolysis). PDGF stimulated mitogenesis (as measured by [3H]-thymidine incorporation into DNA) in VSMCs with an ED50 similar to that for PDGF-induced alterations in phosphoinositide hydrolysis. PDGF stimulated mitogenesis was blocked by pretreatment of cells with voltage sensitive Ca2+ channel blockers, TPA, or pertussis toxin. These results suggest that PDGF and AII cause alterations in [Ca2+]i in VSMCs by at least quantitatively distinct mechanisms. PDGF binding activates a pertussis-toxin sensitive Ca2+ influx into cells via voltage-sensitive Ca2+ channels (blocked by EGTA, verapamil, and nifedipine), as well as stimulating phosphoinositide hydrolysis leading to release of Ca2+ from intracellular stores. AII-induced alterations in [Ca2+]i are mainly the result of phosphoinositide hydrolysis and consequent entry of Ca2+ into the cytoplasm from intracellular stores. Our data also suggest that changes in [Ca2+]i caused by PDGF are required for PDGF stimulated mitogenesis. PMID- 2708449 TI - Permeabilization of transformed mouse fibroblasts by 3'-O-(4-benzoyl)benzoyl adenosine 5'-triphosphate and the desensitization of the process. AB - A photoreactive analogue of ATP, 3'-O-(4-benzoyl)benzoyl adenosine 5' triphosphate (BzATP) altered the plasma membrane permeability of transformed 3T6 mouse fibroblasts to normally impermeant molecules as previously reported for ATP, but at lower concentrations. BzATP-induced permeabilization was modulated by pH, temperature, and the ionic composition of the medium similar to the permeabilizing effects of ATP. Conditions known to enhance ATP-induced permeabilization, such as treatment with the mitochondrial uncoupler carbonyl cyanide-m-chlorophenylhydrazone (CCCP) or the Ca2+-calmodulin antagonist trifluoperazine also enhanced BzATP-induced permeabilization. Conditions inhibitory to ATP-induced permeabilization, including chloride replacement or treatment with furosemide or dithiothreitol (DTT), inhibited permeabilization induced by BzATP. The ionic strength of the medium modulated the responsiveness of the cells to ATP and BzATP; a decrease in the ionic strength below isotonicity increased the sensitivity of the cells to the nucleotides, whereas an increase in ionic strength above isotonicity inhibited permeabilization. Prolonged exposure to ATP under non-permeabilizing conditions caused the cells to become insensitive to ATP and BzATP. The densensitization phenomenon provides support for the theory that the permeabilization process is mediated by a receptor for ATP. PMID- 2708450 TI - Effect of donor age and prior sun exposure on growth inhibition of cultured human dermal fibroblasts by all trans-retinoic acid. AB - The effect of retinoic acid on human fibroblasts was studied in a cell culture model of chronologic aging and photoaging. During early exponential phase, all trans-retinoic acid significantly stimulated growth rate of adult arm-derived dermal fibroblasts but not of newborn or adult foreskin-derived fibroblasts. Retinoic acid also significantly reduced saturation density in most young adult arm-derived lines and all 24 lines derived from old adult arm and foreskin. However, four of ten young adult outer arm (relatively sun-exposed) and one of ten young adult inner arm (relatively sun-protected) fibroblasts lines increased their saturation density in response to retinoic acid. These data suggest that prior sun exposure and/or donor age may influence cellular responsiveness to retinoic acid. Neither the stimulatory nor the inhibitory effect of retinoic acid could be attributed to cell density, to breakdown of retinoic acid in culture, to nutrient depletion or to serum dependency. However, stationary phase fibroblasts from all sites (foreskin, inner and outer arm) showed an increase in filopodia and in intracellular actin after treatment with retinoic acid that was roughly proportional to the degree of growth inhibition, irrespective of donor age. We suggest that retinoic acid induces premature density dependent growth inhibition at least in part by increasing filopodia-mediated cell contact that is in turn directly related to an increase in fibrillar actin. PMID- 2708451 TI - Endothelial adherence under shear stress is dependent upon microfilament reorganization. AB - In response to externally applied shear stress, cultured endothelial monolayers develop prominent, axially-aligned, microfilamentous bundles, termed "stress fibers" (Dewey: Journal of Biomechanical Engineering 106:31-35, 1984; Franke et al.: Nature 81:570-580, 1984; Franke et al.: Klin. Wochenschr 64:989-992, 1986; Wechezak et al.: Laboratory Investigation 53:639-647, 1985). It is unclear, however, whether similar stress fibers develop in noncontiguous endothelial cells and whether these structures are necessary for adherence of individual cells under shear stress. It also is unknown what alterations occur in microtubules, intermediate filaments, and focal contacts as a consequence of shear stress. In this study, endothelial cells, free of intercellular contact, were exposed to 93 dynes/cm2 for 2 hr. With the aid of specific labeling probes and interference reflection microscopy, the distributional patterns of microfilaments, microtubules, intermediate filaments, and focal contacts were examined. Following shear stress, microfilament bundles and their associated focal contacts were concentrated in the proximal (relative to flow direction) cell regions. In contrast, microtubules were distributed uniformly within cell contours. Intermediate filaments displayed only an occasional tendency for accumulation at proximal edges. When cells were shear-tested in the presence of cytochalasin B to inhibit microfilament assembly, considerable cell loss occurred. Following inhibition of tubulin polymerization, no increase was observed in the percentage of cells lost due to shear over nontreated controls. Nocodazole-treated cells, however, were characterized by prominent stress fibers throughout the cell. These results indicate that stress fiber and focal contact reorganization represent major responses in isolated endothelial cells exposed to shear stress and that these cytoskeletal structures are necessary for adherence. PMID- 2708452 TI - Relationship of cytosolic ion fluxes and protein kinase C activation to platelet derived growth factor induced competence and growth in BALB/c-3T3 cells. AB - Platelet-derived growth factor (PDGF) and other agents that activate protein kinase C (PKC) rapidly alter cytosolic pH (pHi) and intracellular free calcium ([Ca++]i) in BALB/c-3T3 fibroblasts. To define whether changes in pHi or [Ca++]i are linked to PDGF-stimulated mitogenesis, these parameters were assessed in control and PKC depleted fibroblasts. PDGF addition to BALB/c-3T3 fibroblasts resulted in transient acidification of the cytoplasm followed by prolonged cytosolic alkalinization. Exposure of cells to 12-tetradecanoylphorbol-13-acetate (TPA), a phorbol ester that activates PKC, resulted in cytosolic alkalinization without prior acidification. Overnight incubation with 600 nM TPA decreased the total cell PKC histone phosphorylating activity in BALB/c-3T3 fibroblasts by greater than 90%. In PKC-deficient fibroblasts, TPA, and PDGF-induced alkalinization was abolished. In addition, the transient drop in pHi seen initially in control cells treated with PDGF is sustained to the point where pHi is fully 0.6-0.7 pH units below control cell values for up to 30 minutes. PDGF increased [Ca++]i threefold; this transient rise in [Ca++]i was only minimally affected (less than 15%) by lowering of the extracellular calcium level with ethylene glycol bis(b-aminoethyl ether)0 N,N,N' tetraacetic acid (EGTA) or blocking calcium influx with CoCl2. In contrast, 8-(diethylamine)-octyl-3,4,5 trimethoxybenzoate (TMB-8), an agent thought to inhibit calcium release from intracellular stores, substantially inhibited the rise in [Ca++]i caused by PDGF. TPA and 1-oleoyl-2-acetylglycerol (OAG) increased [Ca++]i but in contrast to PDGF this effect was blocked by pretreatment of cells with EGTA or CoCl2. In PKC deficient fibroblasts, PDGF still increased [Ca++]i and stimulated DNA synthesis as effectively as in controls. TPA and OAG however, no longer increased [Ca++]i. The continued ability of PDGF to stimulate DNA synthesis in the face of sustained acidification and the absence of PKC activity suggests that cytosolic alkalinization and PKC activation are not essential for PDGF-induced competence in BALB/c-3T3 fibroblasts. PMID- 2708453 TI - Analysis of cell variants showing differential susceptibilities to radiation- or chemical-induced neoplastic transformation: differences in their responses to growth factors. AB - The induction of DNA synthesis in quiescent, density-arrested Balb/c 3T3 cells is known to be controlled by the sequential action of at least two functionally distinct sets of growth factors, so-called "competence factors" and "progression factors." Here we examined this induction pathway in Balb/c 3T3 A31-I variants, which showed differential susceptibilities to radiation- and chemical-induced neoplastic transformation despite their similar susceptibilities to radiation- or chemical-induced cell killing and mutagenesis. DNA synthesis was acquired only with the exposure to progression factors in a highly susceptible cell variant (A31-1-13) whereas both competence factors and progression factors were required for a less susceptible cell variant (A31-I-1). The competent state constitutively produced by an autologous mechanism in the highly transformation-susceptible A31 I-13 cells suggests the existence of an endogenous promoter that acts for the expression of the transformed phenotype in an autocrine fashion when the cells have been initiated by radiation or chemical carcinogens. The growth factor requirements acting as a determining factor for susceptibilities to transformation are discussed. PMID- 2708454 TI - Characterization of the increased biological potency in BALB/C 3T3 cells of two analogs of human insulinlike growth factor I which have reduced affinity for the 28 K cell-derived binding protein. AB - We have characterized the biological activity of two analogs of insulinlike growth factor I (IGF I) which have significantly reduced affinity for the soluble 28 K binding proteins which are secreted by various cell types. The analogs, which were made by site-directed mutagenesis of a synthetic gene encoding for IGF I, are [Gln 3, Ala 4, Tyr 15, Leu 16] IGF I and an analog in which the first 16 amino acids of IGF I were replaced with the first 17 amino acids of insulin (B chain mutant). These two peptides have 100-fold and greater than 1,000-fold lower affinity, respectively, than IGF I for the 28 K binding protein present in the conditioned medium of two cell types, the clonal rat vascular smooth muscle line A10, and BALB/C 3T3 cells. The 28 K protein secreted by BALB/C 3T3 cells has fivefold-lower apparent affinity for both IGF I and [Gln 3, Ala 4, Tyr 15, Leu 16] IGF I than does the 28 K protein secreted by A 10 cells. Conditioned medium from these two cell types has similar amounts of unoccupied 28 K protein as evidenced by the ability of 125I-IGF I to specifically bind to and be covalently bound to the protein after treatment with the bifunctional cross-linking reagent disuccinimidyl suberate. In the presence of 0.1% calf serum, IGF I and [Gln 3, Ala 4, Tyr 15, Leu 16] IGF I stimulate DNA synthesis in A10 cells with ED50 = 0.4 nM, and in BALB/C 3T3 cells with ED50 = 10 nM and 1.3 nM, respectively. Thus, these peptides are equipotent in A10 cells, but the mutant peptide is ten times more active than IGF I in BALB/C 3T3 cells. A10 cells can be made ten times less sensitive to IGF I by performing the incubation in the presence of conditioned media from BALB/C 3T3 cells but not from A10 cells. The activity of [Gln 3, Ala 4, Tyr 15, Leu 16] IGF I is not altered under these conditions. Thus, the conditioned media, which contain 28 K proteins secreted by A10 cells and BALB/C 3T3 cells, have different effects on the biological action of IGF I. These data suggest that the 28 K binding proteins can have important effects on the sensitivity of tissues to IGF I and that the B-chain mutant and [Gln 3, Ala 4, Tyr 15, Leu 16] IGF I will be useful in assessing the biological role of these proteins. PMID- 2708455 TI - Evidence for two pathways of protein kinase C induction of 2ar expression: correlation with mitogenesis. AB - 2ar is a cDNA clone of an mRNA that is inducible by 12-0-tetradecanoylphorbol-13 acetate (TPA) in mouse JB6 epidermal cells. This mRNA is stably induced in confluent cells but only transiently induced in subconfluent cells; the elevated level of 2ar mRNA in TPA-treated cells appears to be the result of enhanced transcription (Smith and Denhardt: Journal of Cellular Biochemistry 34:13-22, 1987). Phorbol dibutyrate, teleocidin, and aplysiatoxin, which activate protein kinase C and are also tumor promoters, are shown here to induce 2ar to the same extent as TPA at both cell densities. The increased expression by TPA was prevented by cycloheximide and by H7, a specific inhibitor of protein kinase C. Epidermal growth factor, platelet-derived growth factor, and the nonphorbol promoter diethylhexylphthalate were more effective inducers in confluent than in subconfluent cultures. All-trans retinoic acid, dexamethasone and fluocinolone acetonide, inhibitors of tumor promotion, diminished 2ar induction in both acetonide, inhibitors of tumor promotion, diminished 2ar induction in both confluent and subconfluent cells. In TPA-treated subconfluent cultures indomethacin produced a slight inhibition, whereas difluoromethyl ornithine potentiated the induction. In TPA-treated confluent cultures, in contrast, indomethacin enhanced 2ar mRNA levels and difluoromethyl ornithine was inhibitory. We conclude that the protein kinase C-mediated induction of 2ar expression is controlled by different pathways in subconfluent cultures and confluent cultures, indicative of apparent changes in the regulation of gene expression as proliferating cells become quiescent. PMID- 2708456 TI - Effects of heat and other inducers of the stress response on protein degradation in Chinese hamster and Drosophila cells. AB - Many recent studies have suggested that heat and other inducers of the heat shock (stress) response in eukaryotic cells might result in the generation of abnormal proteins which would result in the overloading of protein degradation systems and the stabilization of proteins involved in positively regulating heat shock (hs) gene expression. In this study we have examined the effects different heat treatments and other hs inducers have on protein degradation in Chinese hamster ovary (CHO) and Drosophila Kc and Schneider cells. We have found that intermediate temperatures which induced the hs response (42 degrees C in CHO and 34 degrees C in Kc cells) did increase protein degradation rates whereas, higher temperatures which also induced the hs response (45 degrees C in CHO and 37 degrees C in Kc cells) initially increased but then decreased protein degradation rates. While these results are consistent with a model in which the protein degradation system is being overloaded and/or components of it are being depleted, we have found several conditions which induce hs proteins which rule out this mechanism. Exposure of either cell type to amino acid analogs (5 mM canavanine or 5 mM S-aminoethyl cysteine) resulted in the rapid degradation of those proteins which had incorporated the analogs in both CHO and Drosophila cells. However, the addition of analogs had little or no effect on the degradation of preexisting proteins, indicating that the introduction of abnormal proteins probably didn't overload the protein degradation system(s). The addition of 100 microM cadmium sulfate or 100 microM sodium arsenite had little or no effect on protein degradation rates in CHO cells even though both were good inducers of the hs proteins. Thus, exposure to inducers of the hs response does not universally increase protein degradation rates nor does it stabilize preexisting proteins. Therefore, the degradation of abnormal proteins is probably not involved in inducing the hs genes. PMID- 2708457 TI - Cortisol induction of metallothionein in primary culture of rainbow trout hepatocytes. AB - In the present experiment, metabolically active primary cultures of rainbow trout hepatocytes were utilized to study the inducibility of metallothionein after cortisol treatment. Glucocorticoid induction of metallothionein has previously only been demonstrated in mammalian systems. We now demonstrate the inducibility of rainbow trout metallothionein by cortisol treatment of primary hepatocytes. A 90% elevation above control levels was achieved within 8 days of treatment. Zinc treatment was performed to evaluate the system, and 100 microns zinc in the culture medium resulted in a 350% increase of the metallothionein levels. We conclude that primary culture of rainbow trout hepatocytes constitutes an efficient system for studies of MT induction kinetics. PMID- 2708458 TI - Nonterminally differentiated cells express decreased growth factor responsiveness. AB - In 3T3 T mesenchymal stem cells, at least four types of biological states exist that can mediate the control of cell differentiation and/or proliferation. These include the predifferentiation growth arrest state, the nonterminal differentiation state, the terminal differentiation state, and a growth arrest state induced by growth factor/serum deficiency. The current studies were performed to investigate the relative mitogenic responsiveness of cells at these four states and specifically to determine if nonterminally differentiated cells show decreased responsiveness to specific mitogens. Twenty-five different serum, plasma, and growth factor combinations were evaluated. The results show that undifferentiated, growth-arrested cells are highly responsive to numerous mitogens and that by definition terminally differentiated cells are not responsive to any mitogens. In contrast, nonterminally differentiated cells demonstrate a unique pattern of mitogenic responsiveness. Whereas nonterminally differentiated cells can be stimulated to proliferate by high concentrations of serum or plasma supplemented with growth factors, they cannot be stimulated to proliferate by combinations of multiple purified growth factors. These results suggest that the process of nonterminal differentiation is associated with a significant change in factors/cofactors required to stimulate cell proliferation and that these factors/cofactors are present in plasma. PMID- 2708459 TI - Expression of enzymatically active enkephalinase (neutral endopeptidase) in mammalian cells. AB - A cDNA encoding the rat enkephalinase protein (neutral endopeptidase; EC 3.4.24.11) has been constructed from overlapping lambda gt10 cDNA clones. This cDNA was inserted into an expression plasmid containing the cytomegalovirus enhancer and promoter. When transfected with this plasmid, Cos 7 cells transiently expressed the enkephalinase protein in a membrane-bound state. Recombinant enkephalinase recovered in solubilized extracts from transfected Cos 7 cells was enzymatically active and displayed properties similar to those of the native enzyme with respect to sensitivity to classical enkephalinase inhibitors. PMID- 2708460 TI - Does the lack of regression-associated mRNA expression render a rat ventral prostate epithelial cell line androgen independent? AB - A series of rapidly dividing epithelial (RDE) cell lines have been isolated from primary cultures of rat ventral prostate (RVP) epithelial cells. Unlike androgen dependent secretory epithelial cells, the RDE cells in culture do not express the androgen-dependent secretory proteins, nor do they express the androgen-repressed cell death sequences (TRPM-2) found in the epithelial cells during prostatic regression. Screening of a cDNA clone library established from RDE cell mRNA has yielded a number of RDE cell-specific sequences. One of these, RDE-.25 is a 250 base mRNA. The sequence of RDE-.25 shows considerable homology with the rat growth hormone gene and two murine oncogene sequences. We believe that the absence of androgen-repressed cell death sequence expression confers androgen independence for survival and growth, while the expression of RDE-.25 may represent an autocrine growth stimulus which greatly increases the rate of cell division in these cells. PMID- 2708461 TI - Novel gene exon homologous to pancreatic phospholipase A2: sequence and chromosomal mapping of both human genes. AB - We described previously the cloning and DNA sequence of the human gene encoding pancreatic phospholipase A2 [DNA 5, 519]. When pancreatic phospholipase A2 (PLA2) cDNA was used to screen a human genomic library, two classes of clones were obtained. One class encoded the pancreatic enzyme, and a second class encoded one exon of an apparently related PLA2. No additional PLA2 gene exons displayed sufficient homology to be detected by the probe. A homologous sequence in both rat and porcine genomic DNA was detected by DNA blot hybridization, and the corresponding gene fragments were cloned and sequenced. Within the deduced amino acid sequences, the presence of known functional residues along with the high degree of interspecies conservation suggests the genes encode a functional PLA2 enzyme form. The encoded sequence lacks Cys11, as do the "type II" viperid venom and other nonpancreatic mammalian PLA2 enzymes. The sequence is distinct from porcine intestinal PLA2 and appears not to be a direct homolog of the recently published rabbit ascites and rat platelet enzymes. Hybridization of DNA probes containing sequences from these genes to genomic DNA blots of mouse/human somatic cell hybrids permitted chromosomal assignment for both. The pancreatic gene mapped to human chromosome 12, and the homologous gene mapped to chromosome 1. PMID- 2708462 TI - Ontario Child Health Study: prevalence of attention deficit disorder with hyperactivity. AB - The objective of this paper is to present data from the Ontario Child Health Study on the prevalence of attention deficit disorder with hyperactivity (ADDH). The overall prevalence of ADDH was 9.0% in boys and 3.3% in girls. There were no significant differences in the prevalence of ADDH by age or urban-rural status, but the disorder was significantly more common in boys than in girls. The prevalence of various subtypes of ADDH was also explored: attention deficit with and without hyperactivity, situational vs pervasive ADDH, and ADDH with and without other disorders. The clinical implications of these findings are discussed. PMID- 2708463 TI - Preschoolers' responses to peers' distress and beliefs about bystander intervention. AB - The spontaneous responses of 27 3-5-yr-olds to the distress of their peers were recorded in the classroom. Individual interviews were also conducted to assess the children's understanding of social norms governing bystander intervention. Findings indicated that the children often paid attention to distressed peers, and many were capable of active intervention. Overall, however, a low rate of prosocial responding was observed. The interviews revealed that the children held systematic beliefs about how to aid a distressed companion, but did not believe they were supposed to help when competent adult caregivers were present. PMID- 2708464 TI - The consequences for preschool children of a parent's detention: a preliminary South African clinical study of caregivers' reports. AB - Semi-structured interviews on the consequences for preschool children of a parent's detention were conducted with primary caregivers of 19 South African children aged 2-6 yrs. Caregivers reported emotional problems, separation anxiety and fear as well as physical problems, aggression, secondary enuresis and developmental difficulties. Adaptive mechanisms are described. Fantasies focused chiefly on children's images of the detention situation, and on plans to alter current circumstances. Children who felt secure in the environment seemed generally to adjust better to the experience, particularly in the long term. PMID- 2708465 TI - Effects of preschool environments on nonverbal social behavior: toddlers' interpersonal distances to teachers and classmates change with environmental density, classroom design, and parent-child interactions. AB - Toddlers' interpersonal spacing patterns were studied in environments of different density and design. Results showed that an apparently spacious (74 m2) classroom may produce behavioral changes reminiscent of crowding in young children. When more space (864 m2) was available: (1) children increased interpersonal distances overall; (2) children aggregated more with classmates and teachers, fragmenting into subgroups which were separated from the class overall. With visual dividers added to the classroom to facilitate subgrouping, toddlers formed larger subgroups with teachers. Parent/child behavior during separation also affected distances: longer hand-holding and verbalization were found in children who stayed further from others. PMID- 2708466 TI - Severity of early separation and later abusive mothering in monkeys: what is the pathogenic threshold? AB - This study reports on a nonexperimentally induced case of infant abuse by a macaque mother living in a stable social group. The case is of particular interest because of the early experience of the abusive mother: she had been abandoned right after birth by her biological mother, adopted and reared by an adoptive mother who provided adequate maternal care. The abusive mother alternated violent abuse and attentive maternal care and was shown to have a very possessive relationship with her infant. This study raises questions about etiology of primate infant abuse and supports the view that maternal anxiety may play a role in precipitating abuse. PMID- 2708467 TI - Development of personality and intelligence in children with congenital heart disease. AB - One hundred and twenty-eight children with congenital heart disease (CHD) and 89 healthy controls were compared according to their development of personality and intelligence. Presence of physical disability in daily life was the independent variable for dividing children with CHD into two groups: children with physical handicap due to CHD (n = 77) have lower IQ scores than healthy children. Unexpectedly, in the parents' opinion they show no difference in behaviour patterns. On introspective examination, these cardiac patients showed an increased feeling of inferiority and of basic anxiety and a more impetuous behaviour as their way of self-protection, but a reduced need for independence due to parental overprotection was not confirmed. None of these observations could be detected in children with CHD who are physically fit (n = 51). PMID- 2708469 TI - Twelfth International Symposium on Column Liquid Chromatography. Part III. Washington, DC (U.S.A.), June 19-24, 1988. Proceedings. PMID- 2708468 TI - Responding to anger in aggressive and nonaggressive boys: a research note. AB - Responding to adults' behavior was examined in 40 first- through third-grade boys. Boys were divided into aggressive, nonaggressive and control groups. In the experimental conditions, boys were exposed to laboratory simulations of prosocial and angry interactions between adults. Following each simulation, boys were interviewed. Aggressive boys reported greater aggressiveness towards a hypothetical peer following exposure to anger and, across several indices, reported being more highly aroused. Based on reports of arousal, a high responding category of reacting to anger was created. High responders were more likely than other boys to have been from the aggressive group and reported more aggression towards a hypothetical peer. PMID- 2708470 TI - Analysis of steroids by capillary supercritical fluid chromatography with phosphorus-selective detection. AB - Steroids were derivatized with dimethylthiophosphinic chloride to produce steroidal thiophosphinic esters. A catalyst, 4-dimethylaminopyridine, was used to promote quantitative and reproducible thiophosphinic ester formation at low reaction temperatures. The derivatives were analyzed by capillary supercritical fluid chromatography (SFC) with phosphorus thermionic detection. The phosphorus thermionic detector exhibited linearity over 3-4 orders of magnitude. A sensitivity of 120 fg P/s was obtained for the dithiophosphinic ester of pregnanediol at a signal-to-noise ratio of 3. The efficiency of capillary SFC and the excellent sensitivity of the phosphorus thermionic detector were demonstrated by the analysis of steroids isolated from both human urine and plasma. PMID- 2708471 TI - Enantiomer resolution of D- and L-alpha-amino acid derivatives by supercritical fluid chromatography on novel chiral diamide phases with carbon dioxide. AB - The rapid resolution of racemic N-4-nitrobenzoylamino acid isopropyl esters was accomplished without the loss of enantioselectivity by supercritical fluid chromatography (SFC) on novel chiral valine-diamide phases with carbon dioxide and a polar methanol modifier. In each stationary phase, a chiral moiety was anchored to the silica gel surface by a long decamethylene spacer. The enantioselectivity in SFC was comparable to that in liquid chromatography using 2 propanol-n-hexane. The time required for analysis was less than 5 min, and the range of enantiomer resolution (Rs) was 10.8-1.25. On using 2-propanol in place of methanol the separation was improved, but was accompanied by a decrease in column efficiency. The end-capping effect of the remaining surface silanols on enantiomer resolution is discussed. PMID- 2708472 TI - Retention mechanisms in reversed-phase chromatography. Stationary phase bonding density and solute selectivity. AB - Chromatographic selectivity for small, non-polar solutes has been determined as a function of monomeric octadecyl stationary phase bonding density over the range 1.74-4.07 mumol/m2. Phenyl or shape selectivity increases with increasing bonding density, whereas methylene selectivity remains approximately constant. These findings are in agreement with the mean field statistical thermodynamic theory of Dill, which predicts that increased stationary phase chain density should lead to increased anisotropic chain ordering and increased solute-shape selectivity. These studies provide further evidence that partitioning, not adsorption, is the dominant mode of retention for small, non-polar molecules in reversed-phase liquid chromatography. PMID- 2708473 TI - Isocratic reversed-phase high-performance liquid chromatography of ribonucleotides, deoxynucleotides, cyclic nucleotides and deoxycyclic nucleotides. AB - An isocratic reversed-phase high-performance liquid chromatographic system is described for the separation of a relatively large number (greater than 20) of ribonucleotides, deoxynucleotides, cyclic nucleotides and deoxycyclic nucleotides. A 25 cm x 5 mm ODS-Hypersil (5 microns particle size) column was used with methanol-triethylammonium phosphate buffer as eluent. The effects of methanol content, pH, and ionic strength of the buffer on retention and resolution of the nucleotides have been studied. The applicability of the system was demonstrated by the analysis of nucleotides in cells and tissue extracts. PMID- 2708474 TI - Determination of elastase activity by reversed-phase high-performance liquid chromatography. AB - The action of elastase on elastin was measured by high-performance liquid chromatography with on-line post-column derivatization. After alkaline hydrolysis, a 20-ml sample was injected into a ODS-2 gel column. An elastin specific dipeptide, Val-Pro, and the internal standard, Gly-Leu, were eluted by a linear gradient of 0 to 10% of 1-propanol in 50 mM heptafluorobutyrate (pH 3) at a flow-rate of 1 ml/min. The eluent was reacted with fluorescamine, and the fluorescent products were measured. Retention times for Val-Pro and Gly-Leu were 17.33 and 23.54 min. The peak areas of 0.2-16 micrograms of Val-Pro gave a straight-line plot. Elastase activity was constant from 6 to 24 h and was 0.95 +/ 0.02 (S.D.) micrograms/h. The method may be useful for the measurement of the elastolytic activity in some diseased tissues. PMID- 2708475 TI - Determination of phenylalanine in river water by high-performance liquid chromatography. AB - The use of o-phthalaldehyde derivatisation of phenylalanine followed by high performance liquid chromatography with fluorescence detection as used for amino acid analysis in clinical laboratories was examined to assess its suitability for the monitoring of river pollution by the dairy industry by measuring the phenylalanine levels in river water. The method is described together with its statistical evaluation. PMID- 2708476 TI - High-performance liquid chromatographic separation of ring-oxidized metabolites of nitro-polycyclic aromatic hydrocarbons. AB - Nitro-polycyclic aromatic hydrocarbons (nitro-PAHs) are widespread genotoxic environmental pollutants, which require metabolic activation to exert their biological activities. Metabolism of nitro-PAHs generates ring-oxidized metabolites including epoxides, phenols, dihydrodiols and tetrahydrotetrols. Separation of the oxidized metabolites and related compounds of a series of isomeric nitro compounds derived from anthracene, benz[a]anthracene, benzo[a]pyrene and benzo[e]pyrene was studied by high-performance liquid chromatography (HPLC) of different types of columns (monomeric and polymeric; reversed-phase and normal-phase). In the reversed-phase HPLC system, the general elution order of these compounds is: parent nitro-PAHs greater than phenolic derivatives greater than epoxides greater than dihydrodiols greater than tetrahydrotetrols. Among the geometric isomers, trans-dihydrodiols with both hydroxyl groups at the quasiaxial positions were eluted earlier than those with the hydroxyl groups at the quasiequatorial positions. Orientation of the nitro substituent has also been found to be an important structural feature for determining the relative retention order. Among the geometric isomers of nitro PAHs and trans-dihydrodiols, the isomers with their nitro groups perpendicular or nearly perpendicular to the aromatic rings were eluted faster than the analogues with their nitro groups parallel or nearly parallel to the aromatic rings. Normal phase HPLC gave opposite retention order, but with different separability among some of the compounds. Therefore, combination of both reversed- and normal-phase HPLC provides efficient separation of the ring-oxidized derivatives of nitro PAHs. Results are also presented to compare the separation efficiency among different types of columns used. The results suggest that the polarity of solutes is the principal factor for determining their HPLC retention time. PMID- 2708477 TI - Separation of amino- and acetylamino-polycyclic aromatic hydrocarbons by reversed and normal-phase high-performance liquid chromatography. AB - In the field of chemical carcinogenesis, amino- and acetylamino-polycyclic aromatic hydrocarbons (PAHs) are among the most studied compounds. Many of these compounds have recently been detected in the environment. Presently, knowledge permitting predictions of the high-performance liquid chromatographic (HPLC) retention order of amino- and acetylamino-PAHs, particularly among their geometric isomers is lacking. In order to obtain a better understanding of the separation of these types of compounds, we have studied the separation of a series of structurally related amino- and acetylamino-PAHs derived from naphthalene, phenanthrene, anthracene, pyrene, benz[a]anthracene, benzo[a]pyrene, and benzo[e]pyrene by using reversed-phase and normal-phase HPLC columns of different types (monomeric, polymeric, and chiral stationary phase). The results indicate: (i) Pirkle-type chiral stationary phase columns and the Zorbax SIL column can efficiently separate both the amino-PAHs and acetylamino-PAHs; (ii) in general, there was no correlation between retention time and molecular size; (iii) when acetylamino-PAHs were separated on the monomeric Zorbax ODS column, the isomer with the acetylamino group located at the carbon position of higher electron density has a shorter retention time; and (iv) separation of the parent PAHs was better than that of the amino-PAHs and acetylamino-PAHs. Our results thus may provide useful information for the analysis of amino-PAHs, particularly for distinguishing the geometric isomers of environmental samples. PMID- 2708478 TI - Determination of pyrethroid residues on paddy rice by reversed-phase high performance liquid chromatography. AB - Several synthetic pyrethroids and the synergist piperonyl butoxide have been determined as aged residues on paddy rice by reversed-phase high-performance liquid chromatography with detection at 225 nm. These compounds are commonly used as protectants for stored grains. Studies on the comparative rates of extraction of both the pesticides and interfering material from the grain were conducted with acetone, methanol, and hexane as extracting solvents. Acetone was the best of these solvents because it provided quantitative extraction of the pesticides over a 48-h period, and did not give high levels of ballast material. Pyrethroids present in the extract at levels in excess of 0.5 microgram/ml could be determined by direct injection, but at lower concentrations, clean-up and preconcentration were required. Clean-up of acetone extracts was accomplished with either Florisil or alumina pre-columns, and up to a tenfold preconcentration was achieved by adsorption of the pesticide on a C18 pre-column, or by concentrating the extract through evaporation of the solvent. These approaches gave good recoveries and linear calibration plots. Detection limits were of the order of 0.05 microgram/ml. PMID- 2708479 TI - Preparation, high-performance liquid chromatographic separation and characterization of hexacarboxylic porphyrinogens. AB - A simple method for the preparation and reversed-phase high-performance liquid chromatographic separation of hexacarboxylic porphyrinogen isomers is described. Uroporphyrin I or III was partially decarboxylated in 0.5 M hydrochloric acid at 150 degrees C. Unreacted uroporphyrin and the hepta-, hexa- and pentacarboxylic porphyrins formed were esterified and then group-separated by thin-layer chromatography. After hydrolysis, the porphyrins were reduced to the corresponding porphyrinogens with 3% (w/w) sodium amalgam. The hexacarboxylic porphyrinogens were separated on an ODS-Hypersil column by elution with acetonitrile-methanol-1 M ammonium acetate, pH 5.16 (8:12:80, v/v/v) as mobile phase. Isomers were identified by high-performance liquid chromatography of the characteristic mixture of two pentacarboxylic porphyrins formed after partial decarboxylation of individual isomers. Except for the two type I isomers, resolution of the hexacarboxylic porphyrinogens was superior to that of the corresponding porphyrins. PMID- 2708480 TI - Improved enantiomeric separation of dihydrodiols of polycyclic aromatic hydrocarbons on chiral stationary phases by derivatization to O-methyl ethers. AB - K-region trans-dihydrodiol derivatives of phenanthrene, 1-methylphenanthrene, 4,5 methylenephenanthrene, pyrene, 1-bromopyrene, chrysene, benzo[c]phenanthrene, benz[a]anthracene, 1-, 4-, 6-, 7-, 11- and 12-methylbenz[a]anthracenes, 7,12 dimethylbenz[a]anthracene, 3-methylcholanthrene, and benzo[a]pyrene, and non-K region trans-3,4-dihydrodiols of benz[a]anthracene, chrysene, and 7,12 dimethylbenz[a]anthracene are converted to O-methyl ethers. Enantiomers of these O-methyl ethers are generally more efficiently separated on Pirkle's chiral stationary phases than the enantiomers of underivatized dihydrodiols. O-Methyl ethers are substantially less polar than dihydrodiols, and O-methyl ethers are eluted with shorter retention times. Eluents of lower polarity can hence be used. This enhances chiral interactions between chiral stationary phase and solutes, allowing improved separation of enantiomers. PMID- 2708481 TI - Determination of the enantiomers of alpha-amino acids and alpha-amino acid amides by high-performance liquid chromatography with a chiral mobile phase. AB - A high-performance liquid chromatographic method for the enantiomeric analysis of a mixture of an alpha-amino acid and the corresponding acid amide is described. Reversed-phase chromatography with copper(II) acetate and N,N-di-n-propyl-L alanine in the mobile phase are used for the separation. For Val and Val-NH2, several parameters affecting retention and enantioselectivity were investigated. The results indicate that by manipulation of pH, ionic strength, temperature, concentration of CuII, N,N-di-n-propyl-L-alanine and ion-pairing reagent, good control of enantiomeric separation can be achieved. For alpha-amino acid amides a mechanism is proposed which may account for the retention and enantioselectivity. Examples of enantiomeric analysis of mixtures of alpha-amino acids and alpha amino acid amides with aliphatic, aromatic and polar side-chains are given. The method can be used for the control of the enantiomeric purity of alpha-amino acids and the corresponding acid amides obtained by enantioselective synthesis. PMID- 2708482 TI - Application of an asymmetrical flow field-flow fractionation channel to the separation and characterization of proteins, plasmids, plasmid fragments, polysaccharides and unicellular algae. AB - The asymmetrical flow field-flow fractionation channel has been improved by introduction of a different sample loading method, downstream central injection, which reduces sample relaxation and focusing time considerably and allows the concentrations of material in the channel, thereby enabling the loading of very large sample volumes. The performance of the channel was demonstrated by the separation of a protein from its dimer, retention of nucleic acids, i.e., plasmids and enzymatically cleaved plasmids, hyaluronate and unicellular algae. PMID- 2708483 TI - Multidimensional gas chromatographic determination of cotinine as a marker compound for particulate-phase environmental tobacco smoke. AB - Multidimensional gas chromatographic analysis of air particles for the tobacco alkaloid cotinine is described. The analytical procedure requires little sample preparation. Unambiguous identification of cotinine and nicotine in cigarette smoke and indoor air samples was achieved by precise, reproducible retention times observed with two parallel analytical columns of different polarities and a nitrogen-specific detector. Further investigation of smoking and environmental variables is needed to validate the use of cotinine as a marker compound for environmental tobacco smoke particulate matter. PMID- 2708484 TI - Chromatographic evaluation of sorption and diffusion characteristics of glucose, maltose and maltotriose in silica gels. AB - Liquid chromatographic techniques were employed to evaluate the sorption and diffusion characteristics of glucose, maltose and maltotriose in silica gel. The equilibrium constants were found to decrease with increasing molecular size. The determined diffusion coefficient of glucose is comparable to that in the literature. The pore diffusivities decrease with increasing size of the carbohydrates at all temperatures. PMID- 2708485 TI - Improved cross-axis synchronous flow-through coil planet centrifuge for performing counter-current chromatography. I. Design of the apparatus and analysis of acceleration. AB - A novel design of the cross-axis synchronous flow-through coil planet centrifuge is introduced. The apparatus holds a pair of large coil holders symmetrically, one on each side of the rotary frame, at a lateral position 12.5 cm from the center of the holder shaft held 10 cm from the centrifuge axis. Mathematical analysis of acceleration generated by the planetary motion of the apparatus revealed a unique centrifugal force field which promises high retention of the stationary phase in the multilayer coil to perform efficient preparative-scale counter-current chromatography. PMID- 2708486 TI - Improved cross-axis synchronous flow-through coil planet centrifuge for performing counter-current chromatography. II. Studies on retention of stationary phase in short coils and preparative separations in multilayer coils. AB - Performance of the apparatus was evaluated in terms of stationary phase retention, partition efficiency and sample loading capacity. Preliminary studies with short coils revealed high retention of the stationary phase under a proper combination of the head-tail elution and planetary motion. Preparative capability of the apparatus was successfully demonstrated on efficient multigram separations of 2,4-dinitrophenyl amino acids, indole auxins, and bacitracin in a pair of large multilayer coils with a total capacity of 1.5 l. PMID- 2708487 TI - High-performance anion-exchange chromatography of proteins using aza-ether bonded silica-based phases. AB - The use of wide-pore silica-based hydrophilic aza-ether bonded phases for the chromatographic separation of proteins under anion-exchange conditions was studied. Polyether silanes containing terminal morpholine or piperazine derivatives are synthesized for attachment to the silica surface and provide a flexible approach to bonded phase design. In one instance, a quaternized amine support may be prepared by further derivatization of the methylpiperazine bonded phase. The supports provide high-performance anion-exchange chromatographic separations of proteins using gradients of increasing salt content, e.g., to 1.0 M sodium acetate at pH 7.0. The salt type and concentration can be varied to control protein retention while the buffer system used at pH 7.0 exerts a minimal influence on the separation. The anion exchangers may be reproducibly prepared and exhibit chromatographic retention stability at pH 7.5 for at least 2 months of operation. Acceptable capacity for protein on the bonded phase is demonstrated with high recovery of solute mass. The flexibility in anion exchanger design provides a probe of bonded ligand hydrophobic effects which can contribute in an undefined and deleterious manner to the desired ion-exchange separation. Taken together, these results provide a greater insight into the operating characteristics of anion exchangers, especially with regard to competing retention mechanisms. PMID- 2708488 TI - Determination of non-volatile N-nitrosamines in baby bottle rubber nipples and pacifiers by high-performance liquid chromatography-thermal energy analysis. AB - A method is described for the determination of non-volatile N-nitrosamines in baby bottle rubber nipples and pacifiers. It consists of extraction of the sample with dichloromethane in the presence of ascorbyl palmitate (an inhibitor of artifactual formation of nitrosamines), clean-up on silica or basic alumina, and final analysis by high-performance liquid chromatography-thermal energy analysis, a technique which is highly specific for N-nitroso compounds. The method worked well for the determination of four rubber-related non-volatile nitrosamines, namely, N-nitrosomethylphenylamine, N-nitrosoethylphenylamine, N nitrosodicyclohexylamine, and N-nitrosodibenzylamine (recoveries from spiked samples greater than 80%; detection limit, ca. 5 micrograms/kg for each). Eighteen out of twenty four samples analyzed were found to contain varying levels (mean, 41 micrograms/kg; range, 8-146 micrograms/kg) of N-nitrosodibenzylamine. The identity of the compound was confirmed by gas chromatography-thermal energy analysis as well as by gas chromatography-mass spectrometry analyses. PMID- 2708489 TI - Analysis of mucin by isotachophoresis. PMID- 2708490 TI - Bioautographic detection of T-2 and HT-2 toxins. PMID- 2708491 TI - Identification and purity determination of benzathine and embonate salts of some beta-lactam antibiotics by thin-layer chromatography. PMID- 2708492 TI - Protein A, hydroxyapatite and diethylaminoethyl: evaluation of three procedures for the preparative purification of monoclonal antibodies by high-performance liquid chromatography. AB - Three rapid, reproducible and feasible monoclonal antibody purification procedures by means of high-performance liquid chromatography have been evaluated. The stationary phases employed were high-performance hydroxyapatite, high-performance Protein A and high-performance anion-exchange resin. The purity of the final immunoglobulin preparations was determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions and, subsequently, by high-performance gel permeation chromatography. The immunoreactivity of purified monoclonal antibodies was determined by the radioimmunoassay method. PMID- 2708493 TI - Derivatization and high-performance liquid chromatographic determination of urinary glycolic acid. AB - A high-performance liquid chromatographic method for the determination of urinary glycolic acid is proposed, based on pre-column derivatization with phenylhydrazine coupled with the enzymatic oxidation of glycolate to glyoxylate. The phenylhydrazone formed is separated by liquid chromatography and detected at 324 nm. The minimum detectable concentration of glycolate was 10.0 mumol/l. The recovery of glycolate added to urine averaged 96.1%. The day-to-day coefficients of variation calculated by analysis of two urine samples with normal and high glycolate contents were 4.6 and 7.5%, respectively. Results of analyses of urine samples from healthy persons, idiopathic calcium stone formers and Type I primary hyperoxaluria patients are reported. PMID- 2708494 TI - High-performance liquid chromatographic evaluation of PCF 39, a new immunomodulator agent. AB - An high-performance liquid chromatographic analysis of PCF 39, N2-[5-(hypoxanthin 9-yl)pentyloxycarbonyl]-L-arginine, with ultraviolet detection, has been devised and validated. The main pharmacokinetic results encountered for rats treated intravenously with PCF 39 at a dose of 100 mg/kg are described. PMID- 2708495 TI - Gradient separation of PTH-amino acids employing supercritical CO2 and modifiers. AB - Twenty-four PTH-amino acids are rapidly and efficiently separated on a packed cyanopropyl Zorbax column by gradient elution of supercritical CO2 and tetramethylammonium hydroxide-modified methanol. Complete or partial resolution of 22 derivatives is observed with only valine coeluting with norleucine and lysine coeluting with asparagine. A wide variety of stationary phases and modifiers are investigated with supercritical CO2 in attempting to achieve the separation in less than 15 min. Critical to achieving a rapid and efficient separation is the control of modifier flow into the CO2. No modifier is required for elution of neutral PTH-amino acids. The addition of base plays a major role in the elution of acidic and basic PTH-amino acids. Peak tailing is minimized and the elution order of several peaks is altered upon incorporation of reagent into the mobile phase. PMID- 2708496 TI - Liquid chromatographic studies on the aqueous solution conformation of substituted benzamide drug models. AB - The aqueous solution conformation of a series of model benzamides related to the orthopramide dopamine receptor antagonists is evaluated by reversed-phase liquid chromatography (LC). The structure-retention relationship studies demonstrate the existence of an intramolecular hydrogen bond formed in aqueous solution for these compounds. The six-membered pseudoring formed by the association of the amide N-H and the oxygen of the 2-methoxy group (N-H...O) produces enhanced reversed-phase retention (increased capacity factors, k') relative to the 3- and 4-isomers. Deletion of either the acceptor oxygen or the donor N-H results in decreased C18 retention of the 2-isomer relative to the 3- and 4-isomers. These structure retention relationship studies reveal the value of reversed-phase LC methods for evaluation of the aqueous solution conformation of the orthopramide-type compounds. Further studies show that N-substituted 2-hydroxybenzamides are intramolecularly associated in aqueous solution through either N-H...O or O-H...O six-membered rings. The 6-methoxysalicylamides are believed to be stabilized through O-H to carbonyl oxygen bonding in addition to the N-H...O pseudoring. For the 2,6-dimethoxybenzamides, steric factors prevent methoxy-amide coplanarity, thus no intramolecular hydrogen bond is formed. The result is a dramatic decrease in retention for the 2,6-isomer relative to the other positional isomers. These studies suggest that remoxipride and related 2,6-dimethoxybenzamides cannot form the six-membered pseudoring believed to be topographically equivalent to the aromatic ring in dopamine. PMID- 2708497 TI - Inductively coupled plasma mass spectrometry and atomic emission spectrometry coupled to high-performance liquid chromatography for speciation and detection of organotin compounds. AB - Inductively coupled plasma mass spectrometry (ICP/MS) is utilized as a detector for several organotin species separated by high-performance liquid chromatography. Detection limits obtained by ICP/MS are 3 orders of magnitude lower than those obtained with inductively coupled plasma atomic emission spectrometry (ICP/AES) detection under the same chromatographic conditions. Chromatographic detection limits are higher than conventional solution nebulization for the same compound by a factor of 20. Ion-exchange chromatography yields linear response over 3 orders of magnitude, while ion pair chromatography gives a linear response of only 2 orders of magnitude as a result of poor resolution. The relative standard deviation for the injection of 20 ng of tin compounds is less than 10%. PMID- 2708498 TI - Discussion on biological and genetic identity. PMID- 2708499 TI - Pregnancy following intra-tubal insemination in a woman who ovulated prior to gamete intra-fallopian transfer (GIFT). AB - The present report describes the case of a woman scheduled to undergo gamete intra-Fallopian transfer (GIFT), but who was found to have ovulated at the time of laparoscopy. She became pregnant following intra-tubal insemination and the value and limitations of such a procedure are discussed. PMID- 2708500 TI - Is follicular fluid steroid content representative of follicular steroid secretion? AB - Nine oestrogen-active (E-A) and seven oestrogen-inactive (E-I) bovine follicles were superfused for 10 h. Levels of oestradiol (E2), testosterone (T) and progesterone (P4) were measured in superfusate and follicular fluid. No correlation between intrafollicular steroid concentrations of E2, T and P4 and the amount of these steroids detected in the superfusate was found in oestrogen active follicles, i.e. follicular fluid E2, T or P4 levels did not allow for any prediction of superfusate E2, T and P4 concentrations and vice versa. In contrast, E-I follicles showed a close correlation between intrafollicular and superfusate T and P, but not E2 levels. It is speculated that an alteration in intrafollicular regulatory mechanisms might explain the different findings for these two classes of follicles. PMID- 2708501 TI - Immunoreactive insulin-like growth factor I in human follicular fluid. AB - Recent studies in laboratory animals suggest that insulin-like growth factor I (IGF-I) plays an important role in the regulation of granulosa cell function. The purpose of the present study was to investigate the presence of immunoreactive IGF-I in human follicular fluid (FF) and compare the levels of follicular IGF-I (64 follicles) with those detectable in serum (n = 19) in hyperstimulated cycles from 25 infertile patients. Also, the FF IGF-I levels were correlated to corresponding follicular volume (n = 62) and oocyte maturation (n = 37). Levels of IGF-I were determined using a specific radioimmunoassay after acidification and extraction by reversed phase chromatography. Levels of IGF-I in serum were significantly higher than those in FF (37.1 +/- 10.1 versus 24.0 +/- 9.3 nmol/l, n = 19, P less than 0.001). A positive correlation was found between follicular and serum IGF-I concentrations (r = 0.73). No significant differences were found in FF IGF-I levels derived from follicles of different size or from follicles having oocytes with different grades of maturation. These data indicate that immunoreactive IGF-I is present in human FF in nanomolar concentrations and that FF IGF-I levels correlate with those detectable in serum. The source of FF IGF-I and its regulatory role in humans remains to be elucidated. PMID- 2708502 TI - Studies on chorionic gonadotrophin hormone in rhesus monkeys--disappearance rates. AB - The disappearance rate of macaque chorionic gonadotrophin (MCG) was investigated in six pregnant monkeys. The animals were hysterectomized with a rapid initial ligature of the uterine and ovarian vessels with minimal uterine manipulation. The entire procedure lasted less than 2 min. Blood samples were drawn before and after the hysterectomy (5, 20, 30, 45, 60, 90, 120 min), and MCG was measured in serum by radioimmunoassay. For all animals, a progressive decrease (rate of disappearance) of MCG values in serum was found, which appeared to follow a double exponential curve. Averaged curves produced disappearance rates of T1/2(1) = 17.2 h for the first compartment (72 h), and T1/2(2) = 87.1 h for the second compartment (156 h). The results suggest that the disappearance of MCG after interruption of pregnancy in rhesus monkey is very similar to that occurring in humans. These data demonstrate that the rhesus monkey is an excellent animal model to study the dynamics of placental hormone secretion in humans. PMID- 2708503 TI - In-vitro processing of sperm with autoantibodies and in-vitro fertilization results. AB - In-vitro fertilization and embryo transfer were carried out in twenty infertile couples with significant levels of anti-sperm antibodies on the ejaculated spermatozoa. Over 21 cycles (15 couples), 95 mature oocytes were collected and inseminated with spermatozoa obtained by swim-up migration after rapid dilution and washing of the ejaculates. An overall fertilization rate of 38.9% was obtained with these post-migration (PM) preparations. When greater than 70% of the inseminated spermatozoa were covered with both IgG and IgA antibodies, only 14% of the 43 oocytes were fertilized. A higher fertilization rate was obtained with the PM preparations containing less than 70% of spermatozoa coated with one or both classes of antibodies. Under these conditions 60% of the 52 oocytes were fertilized. Fertility rate correlated better with IgG than with IgA antibody levels. In order to decrease the proportion of antibody-coated spermatozoa in the inseminated populations, washed spermatozoa were immuno-adsorbed on Mage's plates before swim-up migration. Over 11 cycles (10 couples) 52 mature oocytes were inseminated with these post-migration immuno-depleted sperm preparations (PMP) containing less than 65% of antibody-coated spermatozoa: 31% of the oocytes were fertilized. This rate compares favourably to IVF results obtained with the PM preparations with greater than 70% of spermatozoa coated with both classes of antibodies. In five couples who had different IVF attempts with the two sperm preparations, the immuno-depletion resulted in a slight increase in the fertilization rates: 10% for the PM preparations versus 26% for the PMP preparations. Sperm binding to the zona pellucida was decreased in the majority of unsuccessful attempts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708504 TI - The occurrence of Chlamydia trachomatis in the semen of men participating in an IVF programme. AB - Chlamydia trachomatis is one of the most common causative agents of sexually transmitted diseases. The authors studied the occurrence of C. trachomatis in the semen of 184 asymptomatic men participating in the IVF programme. Twenty-six (14.1%) of the 184 tested were positive for C. trachomatis, these patients and their wives receiving doxycycline capsules twice, 100 mg on the first day and 100 mg/day for the following 13 days. This treatment was effective in 88.5% of the cases and in the rest, treatment continued with erithromycin 250 mg four times/day for 2 weeks. The authors compared the semen parameters (cell count, motility, morphology, bovine mucus penetration and hypo-osmotic swelling test) in the infected and non-infected groups and observed no significant difference between these two groups. PMID- 2708505 TI - Fertilization of human oocytes in capillary tubes with very small numbers of spermatozoa. AB - Human oocytes can be fertilized with high rates of success under in-vitro conditions even if only low numbers of spermatozoa are used. A culture system has been developed in which fertilization is performed in haematocrit capillary tubes (length 75 mm; i.d. 0.8-0.9 mm). Oocytes were fertilized in 5-10 microliters of different sperm suspensions containing a total of 500, 1000, 2000 and 4000 spermatozoa per oocyte (0.1-0.4 x 10(6) spermatozoa/ml). Oocytes were obtained from 10 patients participating in an in-vitro fertilization programme; of these, 32 oocytes were fertilized in capillary tubes and 32 oocytes were cultured using standard methods (1 ml culture medium in tissue culture tubes; 0.1-0.2 x 10(6) spermatozoa/ml). The overall fertilization rate of oocytes cultured in tissue culture tubes was 78% (25/32) and the fertilization rates in capillary tubes using 4000, 2000, 1000 or 500 spermatozoa per oocyte were 71% (5/7), 86% (6/7), 60% (6/10) and 50% (4/8), respectively. The fertilization rate of mature oocytes was higher compared with immature oocytes when fertilization was performed in culture tubes (83 and 63%) or in capillary tubes (74 and 44%). Fertilization in capillary tubes using a 10 microliter of oocyte and spermatozoa suspension compared to 5 microliters seemed to provide better culture conditions, resulting in higher fertilization and cleavage rates. These preliminary results indicate that fertilization of human oocytes under in-vitro conditions can be achieved even with very low numbers of spermatozoa. PMID- 2708506 TI - Successful embryo transfer of cryopreserved and in-vitro fertilized rabbit oocytes. AB - In-vitro fertilization experiments with frozen/thawed rabbit oocytes were performed to develop an effective technique to be used for the in-vitro fertilization of cryopreserved human oocytes. Ovulatory oocytes, collected from the oviduct of virgin does 13 h after induction of ovulation by HCG injection, were cryopreserved slowly to -30 degrees C and plunged directly into liquid nitrogen. A mixture of 1.5 M 1,3-propanediol and 0.1 M sucrose was used as a cryoprotectant. After thawing, the oocytes were incubated with in-vitro capacitated sperm for 5 h in defined Brackett's medium. Fertilized ova were cultured for an additional 20 h until the 4-to-8-cell stage was reached. These embryos were transferred to pseudopregnant recipient rabbits which were 'asynchronous' in the sense that they had been given an injection of HCG 30, 24 and 18 h before starting to do the embryo transfer. A 32% survival rate of frozen/thawed oocytes was achieved. The fertilization rate was 74% (181/264) in this study. A total of 53 embryos was transferred to the oviducts of six recipients of three different asynchronicity and four young were born. The highest implantation rate (including resorptions) of 18% could be achieved in this investigation by using -6 h asynchronous recipients, while the overall implantation rate was 9.4%. PMID- 2708507 TI - Pregnancies from fallopian replacement of immature eggs with delayed intrauterine insemination. AB - Gamete intrafallopian transfer requires that a woman should not only have patent tubes but should also have had mature eggs collected for replacement. Eggs must be collected as close to ovulation as possible, to give them a good chance of fertilizing upon replacing them directly into the tubes with the spermatozoa. Preliminary results from three patients who received Fallopian replacement of immature eggs followed by delayed intrauterine insemination indicate that maturation of eggs can occur in vivo in the Fallopian tubes. Intrauterine insemination at a later time when the eggs were judged to be mature has given rise to two pregnancies from the three patients with whom this procedure was adopted. PMID- 2708508 TI - Glucose phosphate isomerase activity in mouse and human eggs and pre-embryos. AB - We have measured the activity of glucose phosphate isomerase (GPI-1) in 12 unfertilized human eggs and five human pre-embryos relative to the GPI-1 activity in C57BL/OlaWs mouse eggs. The GPI-1 activity in the human eggs was approximately 6 times that in the C57BL mouse eggs. This implies that human eggs have approximately twice the activity per unit volume of the C57BL mouse eggs but no more than certain other strains of mice. The activity in five human pre-embryos, the most advanced of which was an early blastocyst, was similar to that seen in the human eggs. No change in GPI-1 activity was seen in mouse pre-embryos up to 2 1/2 days (8- to 12-cell stage) but the activity had declined by 3 1/2 days (compacted morula and early blastocyst stages). It seems that high levels of GPI 1 activity are maintained during the early preimplantation development of both species. PMID- 2708509 TI - Development of mouse embryos cryopreserved by an ultra-rapid method of freezing. AB - High concentrations of cryoprotectant combined with sucrose were utilized in an ultra-rapid freezing protocol for mouse preimplantation embryos. Dimethylsulphoxide (DMSO, 1.5 or 3.5 M) or propanediol (PROH, 1.5 or 3.0 M) combined with 0.25 M sucrose were used as freezing solutions. One-, 2- or 8-cell embryos were placed directly into these solutions at room temperature, loaded into straws and plunged into liquid nitrogen within 2-3 min. The straws were rapidly thawed and the embryos expelled into the solution in which they were frozen for 10 min. The cryoprotectants were then removed by single- or multi-step dilution. Survival and development of the embryos in vitro and in vivo were assessed. DMSO (1.5 M) and both concentrations of PROH were totally inadequate as a cryoprotectant in this freezing protocol. A concentration of 3.5 M DMSO gave high survival and development rates when a multi-step dilution procedure was used, but not with a single-step dilution. One-cell embryos gave 71% survival, 35% in-vitro development and 10% in-vivo viability; 2-cell embryos showed 87% survival, 77% in-vitro development and 66% in-vivo viability; and 8-cell embryos showed 97% survival, 87% in-vitro development and 62% in-vivo viability. The results for the 2- and 8-cell stages compared favourably with non-frozen controls, which had 71% in-vivo viability. This method of cryopreservation is therefore fast and viable. PMID- 2708510 TI - The frequency of chromosome anomalies in human preimplantation embryos after in vitro fertilization. AB - Previous studies have reported chromosome aberrations in human pre-embryos after in-vitro fertilization (IVF). Although the reason for these abnormalities is not clear, there is evidence that they can arise during gametogenesis, fertilization or cleavage. The present study has examined further the incidence of chromosome abnormalities in human pre-embryos after IVF, using oocytes recovered from normal volunteer women and from women undergoing infertility treatment in an embryo replacement programme. Chromosome preparations were performed for 75 pre-embryos. Of these 35 (47%) gave at least one metaphase in which analysis was possible. The overall incidence of abnormal pre-embryos was 40% (14/35). The absolute frequency of aberrations was 9% for trisomies, 3% for polyploidies, 26% for structural anomalies and 3% for hypodiploidies. Five pre-embryos were found to be mosaics, three of which had each one trisomic metaphase. In five of the pre-embryos multiple anomalies were found. In 13 of the 14 abnormal pre-embryos the aberrations were found in only one metaphase. The present study demonstrates that trisomic mosaicism may not be a rare event in human pre-embryos. Further evidence is provided that mitotic non-disjunction is important for the production of aberrations in human pre-embryos. PMID- 2708511 TI - Lactoferrin in human amniotic fluid. AB - The concentration of human lactoferrin (LF) was measured by radioimmunoassay or non-competitive avidin--biotin assay in amniotic fluid, cord blood and in the decidua, trophoblast, fetal membranes and umbilical cord. Amniotic fluid was obtained by amniocentesis, and cord blood and tissue samples were taken after delivery or elective Caesarean section. No detectable concentration of LF was found in amniotic fluid before week 20 of pregnancy. A significant increase in the LF concentration was observed around week 30 and it remained high until term. In cord blood, an undetectable or low concentration of LF was measured. In tissue specimens the amount of LF was highest in the decidua (9-95 micrograms/g), a moderate concentration was assayed in the amniotic (2-37 micrograms/) and chorion (2-26 micrograms/g) membrane and in the trophoblast (5-35 micrograms/g). In the umbilical cord, the concentration was less than 1 microgram/g. These results suggest a decidual origin of LF. The role of LF during pregnancy is discussed. PMID- 2708512 TI - Paracrystals of myosin rod. AB - To help understand the packing of myosin tails in the backbone of the vertebrate striated muscle thick filament, paracrystals of myosin rod, a proteolytic fragment corresponding to the whole myosin tail, have been examined by electron microscopy and image analysis. Two types of paracrystal were observed. Type I paracrystals were similar to those seen by Moos et al. (1975; J. molec. Biol. 97, 1-9). These showed a 14-nm axial repeat, but yielded no other structural information. Type II paracrystals were long, flexible ribbons with more regularity. When negatively stained they exhibited a weak 43-nm axial striation and appeared to be composed of a layer of narrow filaments. Optical diffraction showed that the paracrystals had a rectangular unit cell of dimensions 43 nm axially and 12.4 nm laterally. Transverse sections indicated a paracrystal depth similar to the lateral dimension of the unit cell. Each unit cell contained two filaments arranged antiparallel and related by a two-fold screw axis perpendicular to the length, and in the plane of the ribbon. The filaments probably consist of parallel rod molecules related by axial displacements of 43 nm and higher multiples of 43 nm. The nature of these paracrystals indicates that the myosin tail alone can form structures like thick filament subfilaments. Their structure, based on distinguishable parallel and antiparallel rod interactions, was sensitive to pH and divalent cations in a similar way to the ionic effects on the structure of thick filaments. This behaviour suggests that some of the interactions present in the paracrystal are the same as those in the thick filament. PMID- 2708513 TI - Identification and pattern of expression of a developmental isoform of troponin I in chicken and rat cardiac muscle. AB - A monoclonal antibody that reacts with all known isoforms of troponin I detected a single isoform of cardiac troponin I in both atrial and ventricular chambers of adult chicken and rat hearts in an immunoblotting analysis. Another isoform of troponin I in addition to the adult cardiac form, however, was present in all chambers of the heart during early development in both species. This developmental isoform appeared to have the same electrophoretic mobility on SDS tris glycine polyacrylamide gels as that observed for the adult slow skeletal muscle isoform. In the rat, only the developmental isoform of troponin I was present in the early foetal heart and small amounts of the adult cardiac isoform were not apparent until late in gestation, whereas the developmental and adult isoforms were expressed in approximately equal amounts throughout embryonic development in the chicken. The level of developmental isoform of troponin I in both the chicken and the rat hearts gradually decreased so that only small amounts of this variant were detectable two weeks after birth or post hatching. PMID- 2708514 TI - Neonatal electroencephalography and neuropathology. AB - One-hundred-eight EEGs from 47 newborn infants were compared with the postmortem neuropathological findings. The degree of EEG background abnormality had good correlation with the severity of the brain lesion; the more severe the EEG background abnormality, the more extensive and intensive the morphological change. Widespread encephalomalacia was demonstrated in six infants who manifested isoelectric tracings. In particular, cerebral cortex, corpus striatum, thalamus, midbrain, and pons were affected in all patients with this abnormal EEG pattern. Burst-suppression patterns, which were seen in seven infants, also correlated with multifocal severe brain damage, but there was no common structure that was consistently affected for all patients with this pattern. Positive rolandic sharp-wave transients (PRS) appeared highly specific for white matter lesions. All eight infants with PRS had white matter lesions. However, the sensitivity of PRS for white matter lesions was not high (32%), and the white matter lesions of PRS-positive patients were not necessarily composed of periventricular leukomalacia. The sensitivity of EEG asymmetry was also low (40%) for the focality of morphological change, although the specificity was relatively high (85%). The origin of seizure discharges, on the other hand, had poor correlation with the site of the brain lesion. PMID- 2708515 TI - Real-time intraoperative monitoring during neurosurgical and neuroradiological procedures. AB - A real-time intraoperative evoked potential (EP) monitoring system is described and evaluated. Unique features include (1) online artifact rejection to reduce noise contamination, (2) optimum digital filtering to improve the signal-to-noise ratio of the EP signal, (3) statistically defined confidence intervals to determine significant EP peak latency deviations, and (4) sliding windows of EP subaverages of various sizes to minimize feedback time to the surgeon. The reliability and validity of this system were determined by comparison with conventional intraoperative EP averaging and by examining the correlation of EP parameter changes with concurrent surgical and radiological manipulations. This system was clearly superior to conventional averaging systems. Reliable EPs could be obtained from neurologically compromised patients within the electrically hostile operating room environment, in cases in which conventional averaging failed to extract a stable EP signal. EP update times of 10-20 s were quite common and allowed direct moment-to-moment correlations with surgical and radiological events. Case histories are presented that show the utility of this system for aiding in the prevention of neurological complications. This utility is examined for neurosurgical and neuroradiological procedures involving spinal cord, brainstem, midbrain, and cortical structures, and affecting the somatosensory, motor, auditory, and visual system pathways. PMID- 2708516 TI - Clinical significance of periodic lateralized epileptiform discharges: relationship with status epilepticus. AB - A retrospective study was carried out in 147 patients who had been found to have periodic lateralized epileptiform discharges (PLEDs). Clinical, laboratory, radiological, and pathological correlation was performed for all patients. As in previously published works, we found a high correlation with cerebrovascular accidents in our population. A large number of patients, however, had no evidence of focal central nervous system pathology. An attempt was made to find a temporal relationship between the onset of seizure activity (or neurological dysfunction in those patients without seizure activity) and the recording of an EEG with PLEDs. We found that most of the EEGs with PLEDs were obtained within the first 4 days of seizure activity or status epilepticus condition. We postulate that the EEG phenomenon of PLEDs could be considered a part of the status epilepticus condition. Suggestive of this was the fact that the first EEG record obtained in one-third of our patients showed electrographic partial status epilepticus. In a small percentage of our patients, a transitional record showed first status epilepticus and then PLEDs. We found that PLEDs usually disappeared from the EEG tracing within 9 days post-ictus flash status. They were most frequently replaced by focal slowing or random spike activity. PMID- 2708517 TI - Measurement of muscle fiber conduction velocity in humans: techniques and applications. AB - Different methods of measuring human muscle fiber conduction velocity (MFCV) are outlined. A major division can be made between invasive (needle) and noninvasive [surface electromyographic (EMG)] recording techniques. The benefits and limitations associated with the different approaches are discussed. The conduction velocity of individual muscle fibers are measurable with needle recordings on routine EMG apparatus. Velocities measured with electrical stimulation of single fibers or bundle of fibers are in general lower than recordings made during voluntary contraction. With surface EMG, an average estimate of the MFCV from many fibers and motor units can be determined with computerized data analyses--both frequency and time domain approaches. The cross correlation method is widely used to calculate the time lag between two EMGs recorded along the muscle. Using the surface EMG-based methods, MFCV can be calculated at all contraction levels. Thus, the change in sarcolemmal function during local muscle fatigue can be assessed. Physiological factors influencing the MFCV and the utility of the MFCV estimation in clinical practice are discussed. Compared to nerve conduction velocity studies, the clinical interest in MFCV has been limited. PMID- 2708518 TI - A study of the interhemispheric correlation during sleep in elderly subjects. AB - The interhemispheric relationship during sleep in elderly subjects was studied throughout the night by a minute-by-minute computation of two linear correlation coefficients between right and left EEG activities. One of these coefficients (X delta) related to the 1-4-Hz band activity, and the other (X sigma) to the 12.5 14.5-Hz band activity. For five of the six subjects examined, it was found that the rapid-eye-movement (REM) mean values of both coefficients were significantly different from the nonrapid-eye-movement (NREM) values. A comparison between this elderly group and a control group of young subjects, examined previously, did not reveal any significant shift, either for the REM or for the NREM mean values of the coefficients. PMID- 2708519 TI - Ablation of human colon carcinoma in nude mice by 131I-labeled monoclonal anti carcinoembryonic antigen antibody F(ab')2 fragments. AB - Pooled F(ab')2 fragments of three MAbs against distinct epitopes of carcinoembryonic antigen (CEA) were used for radioimmunotherapy of nude mice bearing a subcutaneous human colon carcinoma xenograft. 9-10 d after transplantation when tumor nodules were in exponential growth, 36 mice were treated by intravenous injection of different amounts of 131I-labeled MAb F(ab')2. All 14 mice injected with a single dose of 2,200 (n = 10) or 2,800 microCi (n = 4) showed complete tumor remission. 8 of the 10 mice treated with 2,200 microCi survived in good health for 1 yr when they were killed and shown to be tumor free. Four of nine other mice treated with four fractionated doses of 400 microCi showed no tumor relapse for more than 9 mo. In contrast, all 15 mice injected with 1,600-3,000 microCi 131I-control IgG F(ab')2 showed tumor growth retardation of only 1-4 wk, and 15 of 16 mice injected with unlabeled anti-CEA MAb F(ab')2 showed unmodified tumor progression as compared with untreated mice. From tissue radioactivity distributions it was calculated that by an injection of 2,200 microCi 131I-MAb F(ab')2 a mean dose of 8,335 rad was selectively delivered to the tumor, while the tissue-absorbed radiation doses for the normal organs were: peripheral blood, 2,093; stomach, 1,668; kidney, 1,289; lung, 1,185; liver, 617; spleen, 501; small intestine, 427; large intestine, 367; bone, 337; and muscle, 198. These treatments were well tolerated since out of 19 mice with complete tumor remission only 4 required bone marrow transplantation and 17 were in good health for 6-12 mo of observation. The results demonstrate the selective destruction of established human colon carcinoma transplants by intravenous injection of either single or fractionated doses of 131I-MAb F(ab')2. PMID- 2708520 TI - Ca2+-activated K+ efflux limits complement-mediated lysis of human erythrocytes. AB - The lytic effect of complement on human erythrocytes has been reported by others to increase when Na+ is substituted for K+ in the external medium. In this paper we have investigated the hypothesis that net loss of K+ through a K+ transport pathway protects erythrocytes from complement-induced colloidosmotic swelling and lysis. Antibody-sensitized human erythrocytes containing different intracellular cation concentrations (nystatin treatment) were exposed to low concentrations of guinea pig serum in media of different cation composition; complement lysis was assessed by the release of hemoglobin and the volume of the surviving cells estimated by their density distribution profiles. Complement-dependent swelling and lysis of erythrocytes (a) were limited by the presence of an outwardly directed K+ electrochemical gradient and (b) were enhanced by carbocyanine, a specific inhibitor of the Ca2+-activated K+ transport pathway, and by absence of Ca2+ in the external medium. We propose that during complement activation a rising cytosolic calcium triggers the Ca2+-activated K+ permeability pathway, the Gardos effect, produces a net K+, Cl- and water loss, and thus limits the colloidosmotic swelling and lysis of erythrocytes. PMID- 2708521 TI - Physiologic regulation of the serum concentration of 1,25-dihydroxyvitamin D by phosphorus in normal men. AB - We asked this question: in normal humans, is either a normal dietary intake or normal serum concentration of phosphorus a determinant of the serum concentration of 1,25(OH)2D? In seven normal men whose dietary phosphorus was decreased from 2,300 to 625 mg/d, each intake for 8-9 d, under strictly controlled, normal metabolic conditions, we measured serum concentrations of 1,25(OH)2D daily, and concentrations of phosphorus hourly throughout a 24-h period, before and after restriction. Decreasing dietary phosphorus induced: (a) a 58% increase in serum levels of 1,25(OH)2D; (b) a 35% decrease in serum levels of phosphorus measured in the afternoon; (c) a 12% decrease in the 24-h mean serum level of phosphorus; but, (d) no decrease in morning fasting levels of phosphorus. Serum concentrations of 1,25(OH)2D varied inversely and significantly with 24-h mean concentrations of phosphorus (r = -0.77, P less than 0.001). When these data are combined with those of our prior study in which dietary phosphorus was varied over an extreme range, the relationship between serum levels of 1,25(OH)2D and 24 h mean serum levels of phosphorus is even stronger (r = -0.90, P less than 0.001). In the aggregate, the results demonstrate that in normal men, dietary phosphorus throughout a normal range and beyond, can finely regulate the renal production and serum concentration of 1,25(OH)2D, and provide evidence that this regulation is mediated by fine modulation of the serum concentration of phosphorus. PMID- 2708522 TI - Effects of cholecystectomy on the kinetics of primary and secondary bile acids. AB - Removal of the gallbladder is thought to increase formation and pool size of secondary bile acids, mainly deoxycholic acid (DCA), by increased exposure of primary bile acids (cholic acid [CA], chenodeoxycholic acid [CDCA]) to bacterial dehydroxylation in the intestine. We have tested this hypothesis by simultaneous determination of pool size and turnover of DCA, CA, and CDCA in nine women before and at various intervals after removal of a functioning gallbladder. An isotope dilution technique using marker bile acids labeled with stable isotopes (2H4-DCA, 13C-CA, 13C-CDCA) was used. After cholecystectomy, concentration and output of bile acids relative to bilirubin increased (P less than 0.02) in fasting duodenal bile and cholesterol saturation decreased by 27% (P less than 0.05) consistent with enhanced enterohepatic cycling of bile acids. Three months after removal of the gallbladder bile acid kinetics were in a new steady state: pool size and turnover of CDCA were unchanged. Synthesis of CA, the precursor of DCA, was diminished by 37% (P = 0.05), probably resulting from feedback inhibition by continuous transhepatic flux of bile acids. The fraction of CA transferred after 7 alpha-dehydroxylation to the DCA pool increased from 46 +/- 16 to 66 +/- 32% (P less than 0.05). However, this enhanced transfer did not lead to increased input or size of the DCA pool, because synthesis of the precursor CA had decreased. PMID- 2708523 TI - A low-protein diet restricts albumin synthesis in nephrotic rats. AB - High-protein diets increase albumin synthesis in rats with Heymann nephritis but albuminuria increases also, causing serum albumin concentration to be suppressed further than in nephrotic animals eating a low-protein diet. Experiments were designed to determine whether dietary protein augmentation directly stimulates albumin synthesis, or whether instead increased albumin synthesis is triggered by the decrease in serum albumin concentration. Evidence is presented that dietary protein augmentation directly stimulates albumin synthesis, accompanied by a proportional increase in steady-state hepatic albumin mRNA concentration (AlbmRNA) and by an increase in AlbmRNA transcription. When the increased albuminuria resulting from dietary protein augmentation is blunted with enalapril, serum albumin concentration is shown to increase in nephrotic rats. Both albumin synthesis and AlbmRNA increase in these animals despite the greater serum albumin concentration. Albumin synthesis correlates inversely with both serum albumin and serum oncotic pressure in nephrotic rats fed 40% protein, but does not correlate with serum albumin concentration in nephrotic rats fed 8.5% protein (LP), even when serum albumin concentration is reduced. Albumin masses are preserved in LP primarily because of reduced albuminuria. Reduced serum oncotic pressure and dietary protein augmentation combine to stimulate albumin synthesis in nephrotic rats at the level of gene transcription. PMID- 2708524 TI - Human mast cell carboxypeptidase. Purification and characterization. AB - A carboxypeptidase activity was recently identified in highly purified human lung mast cells and dispersed mast cells from skin. Using affinity chromatography with potato-tuber carboxypeptidase inhibitor as ligand, mast cell carboxypeptidase was purified to homogeneity from whole skin extracts. The purified enzyme yielded a single staining band of approximately 34,500 D on SDS-PAGE. Carboxypeptidase enzyme content estimated by determination of specific activity, was 0.5, 5, and 16 micrograms/10(6) mast cells from neonatal foreskin, adult facial skin, and adult foreskin, respectively. Human mast cell carboxypeptidase resembled bovine carboxypeptidase A with respect to hydrolysis of synthetic dipeptides and angiotensin I, but was distinguished from carboxypeptidase A in its inability to hydrolyze des-Arg9 bradykinin. The amino acid composition of human mast cell carboxypeptidase was similar to the composition of rat mast cell carboxypeptidase. The amino-terminal amino acid sequence of mast cell carboxypeptidase demonstrated 65% positional identity with human pancreatic carboxypeptidase B, but only 19% with human carboxypeptidase A. Thus, human mast cell carboxypeptidase is a novel member of the protein family of zinc-containing carboxypeptidases, in that it is functionally similar but not identical to bovine carboxypeptidase A, but has structural similarity to bovine and human pancreatic carboxypeptidase B. PMID- 2708525 TI - Aluminum-induced de novo bone formation in the beagle. A parathyroid hormone dependent event. AB - To examine the influence of osteoblast function on aluminum-induced neo osteogenesis in the mammalian species, we compared the effects of aluminum in sham-operated and thyroparathyroidectomized (TPTX) beagles. TPTX dogs received sufficient calcium carbonate and calcitriol to maintain normal plasma calcium and calcitriol levels, but developed evidence of decreased osteoblast recruitment and activity, including diminished osteoid-covered trabecular bone surface (3.22 +/- 0.21 vs. 10.95 +/- 1.30%) and a decreased osteoblast number (27.8 +/- 8.1 vs. 139.0 +/- 26.0/mm). Administration of aluminum (1.25 mg/kg i.v., three times/wk) increased the serum aluminum levels in both sham (1,087.0 +/- 276.0 vs. 2.7 +/- 0.8 micrograms/liter) and TPTX animals (2,786.0 +/- 569.0 vs. 3.6 +/- 0.8 micrograms/liter) above normal but did not alter the plasma calcium, creatinine, or PTH from control levels in either sham or TPTX dogs. After 8 wk of therapy, however, bone biopsies from sham-operated beagles displayed evidence of neo osteogenesis including an increased bone volume (47.0 +/- 1.0 vs. 30.4 +/- 0.9%) and trabecular number (4.1 +/- 0.2 vs. 3.2 +/- 0.2/mm). Much of the enhanced volume resulted from deposition of poorly mineralized woven bone (9.9 +/- 2.7%). In contrast, biopsies from aluminum-treated TPTX animals exhibited significantly less evidence of ectopic bone formation. In this regard, bone (35.5 +/- 1.7%) and woven tissue volume (1.4 +/- 0.8%) as well as trabecular number (3.3 +/- 0.1/mm) were significantly less than those of the aluminum-treated controls. These observations illustrate that aluminum reproducibly stimulates neo-osteogenesis and induces a positive bone balance. However, this effect apparently depends on the availability of a functional osteoblast pool which, if depleted by TPTX, limits the expression of aluminum-induced new bone formation. PMID- 2708526 TI - Extracellular adenosine triphosphate activates calcium mobilization in human phagocytic leukocytes and neutrophil/monocyte progenitor cells. AB - We have examined the ability of extracellular ATP to elicit intracellular Ca2+ mobilization in a broad range of human leukocytes at particular stages of hematopoietic differentiation. The average cytosolic [Ca2+] in various leukocyte populations was measured in Fura 2-loaded cell suspensions while the cytosolic [Ca2+] in individual, Indo 1-loaded leukocytes was assayed by flow cytometric methods. Utilizing normal blood- and marrow-derived cells, human leukemic cell lines, and mononuclear cell fractions derived from the blood of patients with various leukemias, we have found that ATP-induced Ca2+ mobilization appears restricted to leukocytes of neutrophil/monocyte ontogeny. Significant ATP-induced increases in cytosolic [Ca2+] were observed in neutrophils, monocytes, and myeloid progenitor cells as immature as myeloblasts, but not in lymphocytes. Extensive characterization of the ATP-induced changes in [Ca2+] observed in the HL-60 promyelocytic cell line have indicated these Ca2+-mobilizing effects of ATP can be correlated with an activation of inositol phospholipid breakdown via the occupation of P2-purinergic receptors Significantly, of the various agonists (FMLP, platelet-activating factor, LTB4, and ATP) which elicit equivalent and maximal Ca2+ mobilization in mature neutrophils and monocytes, ATP was the most efficacious stimulant of Ca2+ mobilization in immature neutrophil/monocyte precursors. Thus, expression of putative P2-purinergic receptors for ATP appears to precede expression of other receptor types known to activate the inositol phospholipid signaling cascades in terminally differentiated phagocytes. PMID- 2708527 TI - Correlation of fibrosis and transforming growth factor-beta type 2 levels in the eye. AB - Approximately 1 out of every 10 eyes undergoing surgery for retinal detachment develops excessive intraocular fibrosis that can lead to traction retinal detachment and ultimate blindness. This disease process has been termed proliferative vitreoretinopathy (PVR). The ability to monitor and grade this fibrotic response accurately within the eye as well as the ability to aspirate vitreous cavity fluid bathing the fibrotic tissue makes this an ideal setting in which to investigate the development of fibrosis. Although laboratory studies have recently shown that transforming growth factor-beta (TGF-beta) can enhance fibrosis, little clinical evidence is yet available correlating the level of this or other growth factors with the degree of fibrosis in a clinical setting. We have found that vitreous aspirates from eyes with intraocular fibrosis associated with PVR have more than three times the amount of TGF-beta (1,200 +/- 300 pM [SEM]) found in eyes with uncomplicated retinal detachments without intraocular fibrosis (360 +/- 91 pM [SEM]). Using an in vitro assay, 84-100% of the TGF-beta activity could be blocked with specific antibodies against TGF-beta 2, whereas only 10-21% could be blocked by specific antibodies against TGF-beta 1. TGF-beta 1 was used in an animal model of traction retinal detachment. Since beta 1 and beta 2 have essentially identical biologic effects and only human beta 1 was available in quantities required, beta 1 was chosen for these in vivo studies. The injection of TGF-beta1 plus fibronectin (FN) but not TGF-beta1 alone into the vitreous cavity of rabbits resulted in the increased formation of intraocular fibrosis and traction retinal detachments as compared to control eyes. In previous studies, intravitreal FN levels were also found to be elevated in eyes with intraocular fibrosis. PMID- 2708528 TI - Protein kinase C is activated in glomeruli from streptozotocin diabetic rats. Possible mediation by glucose. AB - Glomerular inositol content and the turnover of polyphosphoinositides was reduced by 58% in 1-2 wk streptozotocin diabetic rats. Addition of inositol to the incubation medium increased polyphosphoinositide turnover in glomeruli from diabetic rats to control values. Despite the reduction in inositol content and polyphosphoinositide turnover, protein kinase C was activated in glomeruli from diabetic rats, as assessed by an increase in the percentage of enzyme activity associated with the particulate cell fraction. Total protein kinase C activity was not different between glomeruli from control and diabetic rats. Treatment of diabetic rats with insulin to achieve near euglycemia prevented the increase in particulate protein kinase C. Moreover, incubation of glomeruli from control rats with glucose (100-1,000 mg/dl) resulted in a progressive increase in labeled diacylglycerol production and in the percentage of protein kinase C activity which was associated with the particulate fraction. These results support a role for hyperglycemia per se in the enhanced state of activation of protein kinase C seen in glomeruli from diabetic rats. Glucose did not appear to increase diacylglycerol by stimulating inositol phospholipid hydrolysis in glomeruli. Other pathways for diacylglycerol production, including de novo synthesis and phospholipase C mediated hydrolysis of phosphatidylcholine or phosphatidyl inositol-glycan are not excluded. PMID- 2708530 TI - Varying capacities for replication of rat adipocyte precursor clones and adipose tissue growth. AB - Rat adipocyte precursor populations contain clones varying in capacity for replication. In this study we explored factors controlling the frequency of clones of varying replicative capacities (clonal composition). We also explored the relationship between this frequency and fat depot growth. In perirenal and epididymal depots clonal composition was identical bilaterally; perirenal depots contained more extensively replicating clones. Although there were large interanimal differences in clonal composition, variation between animals was always in the same direction for both depots. Clonal composition was unaffected by undernutrition while with animal growth the frequency of the most extensively replicating clones was reduced. Differentiation of precursors occurred in all clones, while differentiation did not occur in skin fibroblasts cloned under identical conditions. Clonal composition and mature fat cell number were related in that fat cell numbers were identical bilaterally in both depots and increased more extensively with growth in perirenal than epididymal tissue. We conclude (a) that clonal composition of adipocyte precursor populations is regulated genetically and by age, (b) that this composition determines, at least in part, the capacity for adipose depot growth. PMID- 2708529 TI - Impaired oxygen utilization. A new mechanism for the hepatotoxicity of ethanol in sub-human primates. AB - The role of oxygenation in the pathogenesis of alcoholic liver injury was investigated in six baboons fed alcohol chronically and in six pair-fed controls. All animals fed alcohol developed fatty liver with, in addition, fibrosis in three. No evidence for hypoxia was found, both in the basal state and after ethanol at moderate (30 mM) or high (55 mM) levels, as shown by unchanged or even increased hepatic venous partial pressure of O2 and O2 saturation of hemoglobin in the tissue. In controls, ethanol administration resulted in enhanced O2 consumption (offset by a commitant increase in splanchnic blood flow), whereas in alcohol fed animals, there was no increase. At the moderate ethanol dose, the flow-independent O2 extraction, measured by reflectance spectroscopy on the liver surface, tended to increase in control animals only, whereas a significant decrease was observed after the high ethanol dose in the alcohol-treated baboons. This was associated with a marked shift in the mitochondrial redox level in the alcohol-fed (but not in control) baboons, with striking rises in splanchnic output of glutamic dehydrogenase and acetaldehyde, reflecting mitochondrial injury. Increased acetaldehyde, in turn, may aggravate the mitochondrial damage and exacerbate defective O2 utilization. Thus impaired O2 consumption rather than lack of O2 supply characterizes liver injury produced by high ethanol levels in baboons fed alcohol chronically. PMID- 2708531 TI - Differential expression of transforming growth factors alpha and beta in rat intestinal epithelial cells. AB - Expression of transforming growth factor alpha (TGF alpha), and transforming growth factor beta (TGF beta) was assessed in isolated primary rat intestinal epithelial cells as well as a rat intestinal crypt cell-derived cell line (IEC 6). A gradient in TGF beta was present, with high concentrations of a 2.5-kb transcript found in undifferentiated crypt cells and progressively lower amounts of the TGF beta transcript in increasingly differentiated villus cell populations. In contrast, the concentration of 4.5-kb TGF alpha transcript was higher in differentiated villus cells than in mitotically active, undifferentiated populations of crypt epithelial cells. The concentrations of transforming growth factors alpha and beta as determined by radioreceptor binding inhibition assay and direct assessment of transforming growth factor biological activity correlated with Northern blot analysis. Although gradients in the expression of the TGFs were present, equivalent binding was observed in the different intestinal cell populations when assessed with 125I-TGF beta and 125I EGF (TGF alpha). No EGF transcripts were detected in any intestinal cell population, suggesting that the true ligand of the EGF receptor was TGF alpha. IEC-6 cells expressed both TGF alpha and TGF beta transcripts. In addition to the transcripts identified in the primary intestinal cells, this cell line contained an additional larger TGF alpha transcript (4.8 kb) and smaller TGF beta transcripts (2.2 and 1.8 kb). TGF alpha and TGF beta may play a significant role in the regulation of the balance between proliferative and differentiated cell compartments in the intestinal epithelium through both autocrine and paracrine mechanisms. PMID- 2708532 TI - Computer-generated model surgery. An exacting approach to complex craniomaxillofacial disharmonies. AB - Description and applications are presented for a technique of craniomaxillofacial model surgery. The technique utilizes models created by and based on computer technology. This paper is based on the experience derived from 22 cases in which computer-generated models were used as the means of evaluation, presurgical planning and practice. PMID- 2708533 TI - On the feasibility of intraoral maxillo-malar osteotomy. AB - The maxillo-malar osteotomy is one of the osteotomies developed over the years to correct the deformities of the midface without modifying the nasal projection. After having for many years approached the osteotomy through the classic double access, intraoral and subciliary, we verified the feasibility of this osteotomy via an intraoral route only. For this purpose we modified slightly the classic osteotomy lines, however still including in the mobilized fragment the most prominent and therefore the most aesthetically important portion of the zygoma. At the lower orbital rim the medial osteotomy cut is performed with a fissure bur, the lateral one with an oscillating saw. Both the osteotomies are extended posteriorly in the orbital floor with a fine osteotome. Then, after having performed all other osteotomy cuts, the maxillo-malar complex is down-fractured. The residual thin bone structures which connect the maxillo-malar complex to the cranio-facial skeleton are broken during a careful downfracture, avoiding fracture between the maxilla and zygoma. The complex is advanced and stabilized with intermaxillary fixation, osteosynthesis and bone grafts. A bone graft to the orbital floor is unnecessary. PMID- 2708534 TI - Incidence of nasolacrimal injury and turbinectomy--associated atrophic rhinitis with Le Fort I osteotomies. AB - Injury to the lacrimal system can occur with trauma, craniofacial surgery, rhinoplasty and nasal antrostomy. Nasolacrimal duct injury may potentially occur with Le Fort I superior repositioning. Atrophic rhinitis is also a potential complication secondary to turbinectomy required during Le Fort I superior repositioning. A review of thirty-four cases over three years of Le Fort I osteotomies with superior repositioning found no postoperative lacrimal injury and no subsequent atrophic rhinitis associated with turbinectomy. An anatomical study relating the position of the nasolacrimal duct opening within the inferior meatus and the distance available for maxillary impaction is reviewed. PMID- 2708535 TI - Surgical treatment of fractures of the mandibular condylar neck. AB - In this paper, the authors describe their surgical procedures, the clinical management, and radiological evaluation of condylar neck fractures. The condylar neck is the site of approximately two-thirds of all mandibular fractures. These are treated either conservatively or by open reduction. Indications for open reduction are discussed. Approximately 5-30% of all condylar neck fractures are treated surgically, depending on the circumstances of each case. The role of open reduction is realignment of segments, early function and decreased post-operative complaints. It has been our experience that surgical treatment of selected condylar neck fractures is successful. PMID- 2708536 TI - Odontogenic carcinoma with sarcomatous proliferation. A case report. AB - An unusual case of odontogenic carcinoma of the mandible showing a sarcomatous proliferation is described. The tumour had caused invasive bone destruction with extension into the soft tissues of the cheek. It was successfully treated by resection of the mandible and radical neck dissection. Although ameloblastomatous features were observed in an infrabony area, the majority of the intrabony lesion consisted of a proliferation of epithelial cells arranged in fine strands or networks which were randomly scattered in a collagenous stroma in the periphery. The tumour cells assumed a fibroblastic appearance and were intermingled with stroma cells in the extrabony lesion. The lesion could not be placed in any of the three entities of odontogenic carcinoma in the WHO classification. PMID- 2708537 TI - A unilateral mesenchymal disorder of the head. AB - A hitherto undescribed group of lesions consisting of cystic bony lesions, exostosis, fibromatous lesion, unilateral tonsillar hypertrophy, epidermoid cyst (cholesteatoma) and hyperplasia of the mandible confined to the left side of the face is reported. The case may represent a variant of the Proteus syndrome. PMID- 2708538 TI - Effects of home-based, informal social support on child health. AB - To enhance mother-infant interaction, paraprofessional home visitors provided parents with emotional support, information, and help in using community resources during pregnancy and throughout the infants' first 14 months. This study reports effects on child health. Both home-visited women and controls made good use of well-child care. Home-visited women made greater use of sick-child care (p = 0.002), most of which was appropriate. The greater use of sick-child care was concentrated among mothers with moderate or high family stress, with whom home visitors had closer relationships. Case histories showed a variety of individual effects on parents. PMID- 2708539 TI - The development and preliminary evaluation of a screening test to detect school learning problems. AB - The Einstein Assessment of School-Related Skills was developed to aid pediatricians and other professionals in the identification of children who are at risk for, or are exhibiting, school learning difficulties. This brief (7-10 minutes) screening instrument measures reading, arithmetic, auditory memory, language cognition, and visual-motor abilities of children in grades K-5. The Einstein Assessment was standardized on 1665 nonhandicapped and 116 learning disabled children in grades K-5. The median percent of nonhandicapped children in grades 2-5 passing was 78% in the fall and 74% in the spring, compared with 18% and 14% of the learning-disabled children (numbers of diagnosed learning-disabled children in grades K-1 were too small for analysis). The median test-retest reliability coefficient was 0.94. These data provide preliminary support for the Einstein as a screening test for school learning difficulty. PMID- 2708540 TI - Psychosocial aspects of compliance in children and adolescents with asthma. AB - Thirty-eight children and adolescents (ages 7-17 years) with chronic asthma were evaluated on three measures of psychosocial and family adjustment. The children's average theophylline level and percentage of noncompliant theophylline levels (theophylline level less than 5 mg/dl) were correlated with behavior problems, perceived self-competence in controlling their conduct, general feelings of self worth, and family climate (cohesiveness vs. conflict; level of family organization and control). Regression analyses indicated that a combination of psychological adjustment, degree of family conflict versus cohesiveness, and the interaction of these two variables were predictive of compliance as measured by mean theophylline levels. Only psychological adjustment was associated with percent of noncompliant theophylline levels. Measures of self-worth, self competence in controlling conduct, and family organization were not related to medication compliance measures. PMID- 2708541 TI - School functioning and disease severity in boys with hemophilia. AB - There have been few recent studies investigating the scholastic progress of children with hemophilia. The advent of PL94-142, which ensures an appropriate educational program based on a child's specific learning disabilities, and home Factor VIII therapy, which increases the hemophiliac's school attendance and sense of freedom and control, might have had a positive impact on the academic performance of these patients. We investigated past and current educational functioning of 26 boys with hemophilia, using both parental and teacher reports. Twenty-two of these children were administered reading and math achievement tests. Results indicate that school absenteeism is a continuing problem for these children, with the average hemophiliac missing 18 school days in an academic year (median = 11 school days missed); one child had missed 77% of the year. Although these boys had normal intelligence and made average grades in school, six of the 22 tested performed more than two grade levels below expectations in reading and 10 performed greater than two grade levels below expectations in math. School underachievement did not necessarily correlate with disease severity (as indicated by serum factor level), school absenteeism, or grade point average. Although eight parents indicated that their children had past or current school problems, and teachers reported that greater than 50% of the group received special tutoring or classes for learning disabled students, six out of 22 (27%) performed below expectations in either math or reading and yet had no current individual educational remediation plan.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708542 TI - Intelligence and behavior problems in 5-year-olds in relation to representational abilities in the second year of life. AB - Assessments of sensorimotor skill, play, language, and developmental level were administered to 20 preterm and 20 full-term infants during sessions at 13 1/2 and 22 months of age. At 5-year follow-up, children were tested with the Wechsler Preschool and Primary Scale of Intelligence (WIPPSI) and the Developmental Test of Visual-Motor Integration (VMI). Behavior problems were also assessed. At 5 years, the preterm sample showed slight delays in cognitive functioning. Measures of development and language at 13 1/2 and 22 months and relational play at 22 months were most predictive of cognitive outcome. Children with behavior problems at 5 years differed from those without problems in terms of their play and language skills. These data suggest that measures of development, particularly language development, and of play are predictive of later cognitive and behavioral functioning. PMID- 2708543 TI - A home-monitoring program for parents of premature infants: a comparative study of the psychological effects. AB - Controversy characterizes the reported effects of home monitoring on parental well-being. However, past studies were largely retrospective and uncontrolled. The present prospective study compared the psychological effects of a home monitoring program on 40 parents of first-born premature infants with its effect on 30 parents of similar prematures and 32 parents of normal full-term infants. Home interviews conducted within 2 weeks after discharge were complemented with standardized instruments measuring psychological symptoms, life events, and family satisfaction. All of the parents of monitored infants participated in an educational and support program and did not report increased depression, anxiety, or other psychological symptoms, compared with parents of nonmonitored premature or full-term infants. These monitoring parents reported significantly more support than did other parent groups (p = 0.005). Surprisingly, parents of non monitored prematures reported higher psychological symptoms than those in either of the other study groups. Results suggest that a professional educational and support program protects the psychological well-being of parents of premature infants. PMID- 2708544 TI - Controversy. IV: Population pharmacokinetics, NONMEM and the pharmacokinetic screen; academic, industrial and regulatory perspectives. PMID- 2708545 TI - Blood pressure and blood pressure variability following withdrawal of propranolol and clonidine. AB - The effects of placebo, propranolol, and clonidine on blood pressure and blood pressure variability were examined in 14 subjects who had moderate essential hypertension. Hydrochlorothiazide was given throughout successive 4- to 5-week periods of placebo, propranolol, and clonidine administration. During each treatment period, subjects were admitted twice to the clinical research unit for 24-hour blood pressure monitoring performed during administration of placebo, propranolol and clonidine and repeated 1 to 2 weeks later during the first 24 hours after the abrupt cessation of placebo or drug administration. Blood pressure was recorded at 15-minute intervals using an automated noninvasive recorder (Arteriosonde, Roche, New Jersey). Systolic and diastolic blood pressure readings were averaged and the standard deviation taken as the measure of long term variability (LTV). Systolic and diastolic blood pressure in sequential overlapping blocks of seven readings were averaged and the standard deviation calculated. Short-term variability (STV) was estimated as the average of the standard deviations of the running means. During placebo administration and withdrawal, systolic and diastolic blood pressures as well as LTV and STV were unchanged. Systolic and diastolic pressures did not differ during propranolol administration from those during propranolol withdrawal or placebo withdrawal. Systolic and diastolic LTV and STV did not differ during propranolol administration and withdrawal from those observed during placebo administration or withdrawal. After clonidine withdrawal, both systolic and diastolic pressures increased to values significantly greater than during clonidine administration. These values were significantly greater than those observed after placebo withdrawal, thereby indicating rebound hypertension. After clonidine withdrawal, seven of fourteen subjects developed systolic pressure rebound; diastolic pressure rebound was observed in three patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708546 TI - Clinical pharmacokinetics of pinacidil, a potassium channel opener, in hypertension. AB - Pinacidil is a potassium channel opener that decreases blood pressure by reducing peripheral arterial resistance. In two multicenter trials, we studied the concentrations and apparent clearance of pinacidil (406 patients) and concentrations of its pyridyl-N-oxide metabolite (147 patients). Responding patients had plasma samples collected hourly for 12 hours on 2 occasions after weeks to months of treatment. Pinacidil dose was titrated from 12.5 to 75 mg b.i.d. The peak concentration of pinacidil and N-oxide and the area under the concentration-time curve (AUC) were proportional to the dose of pinacidil, with an average pinacidil concentration of 268 micrograms/L (1.02 microM) and N-oxide concentration of 172 micrograms/L (0.65 microM) for every 1 mg/kg pinacidil administered. Clearance of pinacidil (Clp = Dose/AUC) was 31 L/hr in patients younger than 45 years and 27 L/hr in those older than 60. Clp was significantly smaller in white patients compared with other races (Clp = 28 vs. 34 L/hr). Clp was significantly less in patients taking hydrochlorothiazide (27 vs. 31 L/hr) and greater in smokers (33 vs. 29 L/hr). Concomitant propranolol use did not influence Clp. PMID- 2708547 TI - Delayed elimination of digoxin antidotum determined by radioimmunoassay. AB - An observation of a treatment with digitalis antibodies (Fab-fragments) in a young child is presented. The elimination of this antidotum proved to be much slower than normally expected. In the patient's history, the disappearance of the Fab-fragments out of the blood lasted 142 days with a half-life of 15.6 days, whereas an elimination with a T1/2 of 28 hours is accepted. Probably there has been intracellular penetration of the antibodies into the liver, caused by concomitant diseases (Hepatitis A and B infections). An "in vitro" experiment is reported. It demonstrates the equimolar binding of the Fab-fragments for digoxin and shows that the elimination of the Fab-fragments can be established by a routine radioimmunoassay of digoxin, in an indirect way. PMID- 2708548 TI - Effects of coadministration of propafenone on the pharmacokinetics of digoxin in healthy volunteer subjects. AB - Previous reports have suggested an interaction between propafenone and digoxin. We investigated the pharmacokinetics of IV digoxin when given alone (Phase I), after pretreatment with propafenone 150 mg every 8 hours for seven days (Phase II), and after propafenone 300 mg every 8 hours for 7 days (Phase III). The total body clearance of digoxin during Phase I was 2.45 ml/min/kg and was 2.17 ml/min/kg during Phase II (NS) and decreased to 1.92 ml/min/kg during Phase III (P less than 0.05). The renal clearance and half-life of digoxin were not significantly altered by propafenone. There was a trend towards a decrease in the volume of distribution of digoxin from 9.43 L/kg in Phase I, to 9.33 L/kg in Phase II, and 8.02 L/kg in Phase III. Similarly there was a trend towards a decreased nonrenal clearance of digoxin from 1.21 ml/min/kg during Phase I to 1.01 ml/min/kg during Phase II and to 0.75 ml/min/kg during Phase III. The changes in volume of distribution and nonrenal clearance parallel each other resulting in no change in the elimination half-life of digoxin. It is postulated that the mechanism of this interaction is due to decreases in the volume of distribution and nonrenal elimination of digoxin by propafenone. The degree of this interaction was related to the dose of propafenone. The magnitude of this interaction may be greater in patients and, thus, may require a reduction in the digoxin dose. PMID- 2708549 TI - Thromboxane synthase activity and platelet function after furegrelate administration in man. AB - Furegrelate sodium (U-63,557A), a pyridine-derivative thromboxane synthase inhibitor, was administered orally in single doses of 200 to 1600 mg to normal male subjects. Furegrelate produced a dose-related inhibition of thromboxane synthesis for 8-12 hours when measured either ex vivo from platelet-rich plasma (PRP) or in vivo from urine. In general, the extent of thromboxane synthesis inhibition was greater in PRP than in urine. Furegrelate significantly inhibited platelet aggregation, but the effect was variable and measurements of thromboxane synthase did not predict the impact on platelet aggregation. Bleeding times and coagulation parameters were not altered significantly. Furegrelate was well absorbed orally with Tmax = 1 hr and t1/2 = 3.5 to 5 hrs. There was no marked metabolism; elimination was primarily by renal excretion of parent compound. Thus, furegrelate is an effective inhibitor of thromboxane synthase in man with a relatively long biologic and circulating half-life. PMID- 2708550 TI - Reduced renal clearance of oxypurinol during a 400 calorie protein-free diet. AB - A decrease in dietary protein intake lowers the clearance of a number of substances excreted principally by the kidney including uric acid and oxypurinol, the major metabolite of allopurinol. We studied the kinetics of uric acid and oxypurinol in seven healthy volunteers on a normal protein diet (2600 calories; 100 g protein) followed by a 400 calorie, protein-free diet. A 600 mg dose of allopurinol was given orally after 6 days of the normal protein diet and again after 2 days of the 400 calorie, protein-free diet. Two major findings emerged: first, the renal clearance of oxypurinol was reduced from 21.2 +/- 1.9 ml/min during the normal protein diet to 12.3 +/- 1.2 ml/min (P less than .05) during the 400 calorie, protein-free diet, and second, there was a striking diurnal difference in oxypurinol renal clearance with a 41% decrease in the oxypurinol clearance at night (8 PM to 8 AM) versus day (8 AM to 8 PM) on the 400 calorie, protein-free diet. PMID- 2708551 TI - Pharmacokinetics of buspirone in elderly subjects. AB - Twenty-four men and 24 women ages 20-77 years received a single 15 mg oral dose of buspirone followed by 4 days of 15 mg tid administration. Plasma concentrations of buspirone and 1-pyrimidinylpiperazine following both single and multiple dosing were determined by RIA and GCMS, respectively. There were no significant differences between the young and elderly of either gender with regard to buspirone AUC, Cmax, Tmax and half-life values. The 1-PP AUC values were higher for young of either gender compared to the corresponding group of elderly subjects and the 1-PP Cmax values were higher for women than men. These differences are unlikely to be of clinical significance. The buspirone and 1-PP AUC values for a dosing interval during multiple dosing are not significantly different than the respective single dose AUC values. Buspirone treatment was well-tolerated by all subjects even though the 45 mg/day dose was 3 times the recommended starting dose in clinical practice. Overall, the lack of marked or consistent differences in buspirone or 1-PP pharmacokinetics in elderly subjects compared to younger subjects of the same gender suggest there is no need to alter the initial dose of buspirone based solely on patient age. PMID- 2708552 TI - Effect of a high-fat meal on the bioavailability of a polymer-coated erythromycin particle tablet formulation. AB - The effect of food on the relative bioavailability of an erythromycin particles in-tablet formulation was studied in 27 healthy volunteers, using a four-way, crossover study design with the following treatments: one or two erythromycin capsules USP (Eryc, Parke-Davis), or one polymer-coated erythromycin particles-in tablet (PCE, Abbott) administered fasting or with a high-fat meal. Under fasting conditions the erythromycin particles-in-tablet and erythromycin capsule formulations are bioequivalent based on similar tmax and dose-normalized Cmax and AUC values. The rate and extent of absorption from the particles-in-tablet formulation, however, are dramatically reduced following administration with a meal. Mean Cmax and AUC values decreased by 73% and 72%, respectively, and seven subjects had no detectable erythromycin plasma concentrations for 16 hours following administration of the particles-in-tablet formulation with the high-fat meal. Greater than 40% of the subjects had nonfasting Cmax and AUC values that were less than 10% of those values following administration of the dose fasting. Cmax and AUC values in nonfasting subjects were within 75% to 125% of fasting values in only two and one of 27 subjects, respectively. The erythromycin particles-in-tablet formulation therefore should not be administered with meals. PMID- 2708553 TI - Phenylpropanolamine: a controversy unresolved. PMID- 2708554 TI - Intersubject variation in the pharmacokinetics of chlorpromazine in healthy men. AB - Interpatient variation in response to therapy with antipsychotic drugs is a major problem. This study was designed to assess the extent of variation in disease free subjects in whom known sources of variance were controlled as much as possible. The subjects were 32 healthy, nonsmoking males of European origin, aged 18-25 years, and weighing no more than +/- 15% from the ideal weight for height. After an overnight fast, each subject ingested 50 mg of chlorpromazine. Plasma samples were harvested over a 24-hour period during which the subjects were on a standardized, caffeine-free diet. Plasma levels of chlorpromazine were measured by gas-liquid chromatography-mass spectrometry. The results showed wide intersubject variation in all pharmacokinetic parameters including maximum concentration, area under the curve, and oral clearance. Furthermore, none of the data were normally distributed. For each pharmacokinetic parameter, the distribution was leptokurtotic and skewed. As a consequence, the geometric means provided better estimates of central tendency than the arithmetic means. It seems that a major proportion of intersubject variation is an inherent problem that cannot be accounted for by differences in race, diet, smoking habits, or concomitant drug ingestion. PMID- 2708555 TI - Management of monoamine oxidase inhibitor-associated insomnia with trazodone. AB - Monoamine oxidase inhibitors (MAOIs) have been reported to cause or exacerbate insomnia, sometimes requiring discontinuation despite adequate therapeutic response. The authors present a series of 13 cases of MAOI-associated insomnia managed with addition of trazodone. Twelve patients (92%) had an initial positive response, with nine (69%) able to continue on the combination of MAOI and trazodone without intolerable side effects. PMID- 2708556 TI - Use of buspirone in the treatment of schizophrenia. PMID- 2708557 TI - Side effects of trazodone in a geriatric population. PMID- 2708558 TI - A case of acute psychosis in temporal association with theophylline toxicity. PMID- 2708559 TI - Use of yohimbine to counteract nortriptyline-induced orthostatic hypotension. PMID- 2708560 TI - Tryptophan antagonism of stimulant-induced tics. PMID- 2708561 TI - Dose-related plasma levels of clozapine. PMID- 2708562 TI - Use of pillminders to dispense research medication. PMID- 2708563 TI - What is the duration for augmentation with T3 or lithium in resistant depression? PMID- 2708564 TI - Localization of vasoactive intestinal peptide- and peptide histidine isoleucine amide-like immunoreactivities in the rat superior cervical ganglion and its nerve trunks. AB - Electrical stimulation of the preganglionic cervical sympathetic trunk causes an increase in dopa synthesis in the postganglionic neurons in the superior cervical ganglion (SCG). This transsynaptic biochemical effect can be blocked only partially by cholinergic antagonists, suggesting the involvement of a noncholinergic preganglionic sympathetic neurotransmitter(s). A survey of a large number of possible candidates for this neurotransmitter revealed that, in addition to cholinergic agonists, only a small group of peptides (all members of the secretin-glucagon family) stimulated dopa synthesis in the SCG. The effective peptides included vasoactive intestinal peptide (VIP), peptide histidine isoleucine amide (PHI), and secretin. Consequently we looked for the presence of immunoreactivities for these three peptides in the SCG. VIP- and PHI-like immunoreactive fibers were found in the SCG and in its major pre- and postganglionic nerve trunks. The distributions of the two immunoreactivities were very similar. Immunoreactive fibers were seen both singly and in bundles. In some instances, fibers were found apposed to neuronal cell bodies in the ganglion, and occasionally dense plexuses of fibers were found surrounding the neurons. In addition, punctate immunoreactive profiles were found apposed to the neurons in what appeared to be terminal fields. A small number of immunoreactive neuronal cell bodies were also seen in the ganglion. In a few instances, it was possible to establish, in serial sections, that the same cell body was immunostained with both VIP and PHI antisera. No secretin like-immunoreactive fibers or cells were observed. The presence of VIP-like and PHI-like-immunoreactive fibers in the cervical sympathetic trunk and in the SCG strengthens the possibility that these peptides, or a related molecule(s), serve as preganglionic neurotransmitters in this ganglion. PMID- 2708565 TI - Comparative quantitative study of the hippocampal region of two closely related species of wild mice: interspecific and intraspecific variations in volumes of hippocampal components. AB - To investigate the structural changes in the hippocampal region (subiculum, Ammon's horn, and area dentata) associated with speciation, the volumes of homologous components of this region of the forebrain were compared in the two closely related murine rodent species, Apodemus flavicollis (yellow-necked wood mice) and A. sylvaticus (long-tailed field mice), and in two geographically separated groups of A. sylvaticus. With the exception of the mossy fiber zone, no significant differences were found in the relative sizes of the components of Ammon's horn. Significant interspecific differences were found in the deep subiculum, in the intermediate (medial perforant path) and deep (commissural associational) zones of the molecular layer of the area dentata, and in the hilus. A significant intraspecific difference was found in the combined intermediate and superficial (medial and lateral perforant path) zone of the dentate molecular layer. Differences found in the relative size of the hilus and the mossy fiber zone of Ammon's horn were complementary in that the combined volumes of these zones, which are both terminal fields of dentate granule cells, did not differ in the species. This finding provides evidence that the distribution of the terminal field of a projection system can be altered while the size of the terminal field is maintained. Within the hippocampal region, components of Ammon's horn appear well suited for quantitative comparative studies that span taxonomic units beyond the species level. In agreement with previous quantitative studies, differences in the volumes of components of Ammon's horn found in species of different orders are more likely to reflect phylogenetic trends rather than changes resulting from specializations of the particular species used. This is not true for the subiculum and the components of the area dentata. Experimentally induced changes in the connectivity of the hippocampal region are discussed in terms of the structural changes which may be responsible for the quantitative differences observed between the two species studied here. PMID- 2708566 TI - Endbulbs of held and spherical bushy cells in cats: morphological correlates with physiological properties. AB - Single auditory nerve fibers of type I spiral ganglion cells in cats were electrophysiologically characterized by recording with micropipettes inserted into the axon and then labeled by intracellular injections of horseradish peroxidase (HRP) through the same pipettes. This method for staining and studying single neurons allowed us to describe structure-function relationships for labeled endbulbs of Held and the somata of their postsynaptic spherical bushy cells. The silhouette areas of terminal endbulbs and the corresponding somata of spherical bushy cells were determined by planimetry from drawings made with a light microscope and drawing tube. On the presynaptic side, endbulb area is related to fiber characteristic frequency (CF, the frequency to which a fiber is most sensitive) such that the largest endbulbs arise from fibers having CFs between 1 and 4 kHz; smaller endbulbs can arise from fibers of any CF. Endbulb area is not correlated with fiber spontaneous discharge rate (SR). Dividing the endbulb's silhouette area by its silhouette perimeter, however, yields a "form factor" that is a reliable indicator of fiber SR: Endbulbs from fibers of low medium SR (less than or equal to 18 spikes/second) have form factor values less than 0.52, whereas endbulbs of high SR fibers (greater than 18 spikes/second) have values greater than 0.52. This form factor should therefore be predictive of SR groupings in auditory fibers for which physiological data are not available. On the postsynaptic side, the somata of spherical bushy cells receiving endbulbs from low-medium SR fibers are on average smaller than those receiving endbulbs from high SR fibers. In contrast, the nuclei of the spherical bushy cells are the same size regardless of presynaptic fiber SR. Some of the effects of low-medium SR fibers on their postsynaptic targets, when compared to those of high SR fibers, appear to be mimicked by effects of experimentally induced deprivation. PMID- 2708567 TI - Neural organization of the masseter muscle in the pig. AB - The neural organization of the pig masseter, an architecturally and functionally compartmentalized muscle, was investigated by using dissection, glycogen depletion, evoked electromyography, and counts of axon numbers at various levels along the masseteric nerve. The masseteric nerve enters the muscle as two rostral branches, which also supply the zygomatico-mandibularis, and a more caudal main branch, which soon divides into four terminal nerves with variable distributions. Stimulation of filaments containing roughly 50 extrafusal motor axons resulted in glycogen depletion of 5-20% of the muscle fibers in very small subvolumes of the masseter; the affected subvolumes were delimited by perimysium. Electromyography after stimulation of various branches of the nerve confirmed the distributions deduced from anatomy and further indicated that axons do not branch between the rostral and main nerve branches but may occasionally do so among the more distal terminal branches of the main branch. The proximal trunk of the masseteric nerve contains about 3,500 myelinated fibers with a bimodal size distribution. Approximately 1,000 of the larger fibers were estimated to be extrafusal motor axons. Along the proximal trunk of the nerve, fibers were constantly rearranged; coupled with the observation that the locations of motor unit territories were usually not related to the position of the stimulated axons within the nerve, this suggests that the nerve trunk is not strictly ordered somatotopically. PMID- 2708568 TI - Studies on the cellular architecture of the bed nuclei of the stria terminalis in the rat: I. Cytoarchitecture. AB - The cytoarchitecture of the bed nuclei of the stria terminalis (BST) in the adult male rat was examined in the three standard planes of section, and the results were compared with the distribution of immunohistochemical staining for a variety of neuropeptides in a companion paper (Ju et al.: J. Comp. Neurol. 280:603-621, '89). It is clear that the BST is an extremely complex mass of gray matter that can be parcellated most clearly into anterior and posterior divisions, which are separated by a more-or-less vertical septum of fibers associated with the stria terminalis. The anterior division can be further parcellated into dorsal, lateral, and ventral areas, and each of these areas, along with the posterior division, can be thought of as containing more-or-less discrete nuclei embedded within a relatively undifferentiated region. Thus, we have recognized a central core in the anterodorsal area; oval, juxtacapsular, and rhomboid nuclei in the anterolateral area; and fusiform, dorsomedial, dorsolateral, magnocellular, and ventral nuclei in the anteroventral area. The most obvious cell groups in the posterior division include the principal, interfascicular, transverse, premedullary, and dorsal nuclei. Problems associated with defining the limits of the BST, and with comparing our results with the earlier literature, are discussed. PMID- 2708569 TI - Hormonal control of neuron number in sexually dimorphic spinal nuclei of the rat: I. Testosterone-regulated death in the dorsolateral nucleus. AB - Adult male rats have substantially more motoneurons than do females in two motor nuclei in the lumbar spinal cord: the spinal nucleus of the bulbocavernosus (SNB) and the dorsolateral nucleus (DLN). Previous studies of the development of the SNB revealed that the sex difference in SNB motoneuron number is established through a differential motoneuron death which is under the control of androgens. In this study the development of the sexually dimorphic DLN was examined to test the hypothesis that early androgen action also determines the sex difference in DLN motoneuron number by regulating normally occurring motoneuron death. Because SNB motoneurons may migrate from the DLN, quantitative examination of DLN development was necessary in order to understand more completely the cellular mechanisms contributing to the establishment of dimorphic motoneuron number. At 5 days before birth, the number of motoneurons in the DLN is significantly higher than in adulthood in both sexes, and no sex difference is present. There is a decrease in motoneuron numbers prenatally in both sexes, which is consistent with the emigration of presumptive SNB motoneurons. Motoneuron number declines differentially through the first week of postnatal life and by postnatal day 10 motoneuron numbers are in the adult range and the sex difference is fully expressed. Females lose significantly more DLN motoneurons than males through a differential death as revealed by the higher incidence of degenerating cell profiles. Females treated with testosterone propionate have a male-typical motoneuron loss and incidence of degenerating cells. These results indicate that steroid hormones establish the sex difference in DLN motoneuron number by regulating normally occurring cell death. PMID- 2708570 TI - Hormonal control of neuron number in sexually dimorphic spinal nuclei of the rat: II. Development of the spinal nucleus of the bulbocavernosus in androgen insensitive (Tfm) rats. AB - The spinal nucleus of the bulbocavernosus (SNB) is a sexually dimorphic motor nucleus whose development is under the control of steroid hormones. The SNB contains many more motoneurons in adult male rats than in females, and this sex difference is produced by a sexually dimorphic motoneuron death which is regulated by androgens. To study further the role of androgens in the development of sex differences in SNB motoneuron number, we examined SNB development in males with the testicular feminization mutation (Tfm) which renders them insensitive to androgens. Counts of SNB motoneurons perinatally revealed that SNB development in normal male and female King-Holtzman rats was similar to that reported previously for Sprague-Dawley rats; SNB motoneuron number increased from initially low levels at embryonic day 18 through the day before birth, when motoneuron numbers in both sexes were substantially higher than adult levels. After this prenatal increase, motoneuron number declined in both sexes, until by postnatal day 10 motoneuron numbers were in their adult ranges and the sex difference was fully expressed. Females lost more motoneurons than did males during this period, and this loss was due to motoneuron death as revealed by counts of degenerating cells. SNB development in King-Holtzman Tfm males was similar to that of normal males through embryonic day 20, suggesting that androgens may not be necessary for the initial increase in motoneuron numbers in the SNB. Thereafter, SNB motoneuron numbers in Tfm males declined in a female-typical fashion; Tfm males and normal females did not differ at any postnatal age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708571 TI - Hormonal control of neuron number in sexually dimorphic spinal nuclei of the rat: III. Differential effects of the androgen dihydrotestosterone. AB - The spinal cord of the rat contains two sexually dimorphic nuclei: the spinal nucleus of the bulbocavernosus (SNB) and the dorsolateral nucleus (DLN). These nuclei and the perineal muscles they innervate are present in males but reduced or absent in females. The sex difference in motoneuron number in these nuclei is due to an androgen-regulated motoneuron death. Developing females treated with the androgen testosterone propionate (TP) have a fully masculine number of SNB and DLN motoneurons and retain the perineal muscles they would normally have lost. Paradoxically, females treated prenatally with the androgen dihydrotestosterone propionate (DHTP) also retain the perineal musculature but as adults lack the SNB motoneurons which would normally innervate them. The SNB target muscles retained by DHTP females are anomalously innervated by motoneurons in the DLN. Counts of motoneurons and degenerating cells in the developing SNB of DHTP-treated females showed that their feminine number is the result of a failure of DHTP to prevent the death of SNB motoneurons. Furthermore, the peak number of SNB motoneurons was below that of normal females, suggesting that DHTP treatment may also have inhibited motoneuronal migration. However, DHTP treatment fully masculinized both motoneuron number and degenerating cell counts in the DLN of these females, and it is this masculinized DLN that gives rise to the anomalous projection. Taken together, these results suggest that the effects of different androgens during development are specific and complex, involving the regulation of motoneuron death, migration, and specification of peripheral projections. PMID- 2708572 TI - Distribution of radioactive leucine following uptake by olfactory sensory neurons in normal and heteromorphic crayfish antennules. AB - Surgical excision of one of the compound eyes from juvenile crayfish leads to the regeneration of a heteromorphic antennule in 30% of the cases. Most of the heteromorphic antennules generated this way are bifurcate appendages possessing morphologically distinct medial and lateral branches. These structures are identical to the internal and external flagella of the normal antennules, and the homolog of the external flagellum bears aesthetascs supplied by olfactory sensory neurons. Autoradiographic analysis of the brain following exposure of heteromorphic antennules to tritiated leucine indicates that the supernumerary sensory axons transport the labeled amino acid into their central terminals at appropriate target locations within the ipsilateral olfactory lobe. The data suggest that olfactory input from heteromorphic antennules is incorporated into the organized central projection of olfactory afferents from the normal antennule. PMID- 2708573 TI - Afferent and efferent projections of the VIIIth cranial nerve in the lamprey Lampetra japonica. AB - Anterograde and retrograde transport of horseradish peroxidase was used to examine the afferent and efferent projections of the VIIIth cranial nerve in the lamprey Lampetra japonica. Ganglion cells of the VIIIth nerve are classified into three types on the basis of their morphology. The central processes of these ganglion cells enter the medulla in two groups: the anterior group (mostly thick fibers) and the posterior group (mostly thin fibers). Afferent fibers mainly terminate within the ipsilateral ventral and octavomotor nuclei of the octavolateralis area and within the granular and molecular layer of the cerebellum. Some fibers terminate in the contralateral cerebellum, the medial and dorsal nuclei of the octavolateralis area, the descending nucleus of the trigeminal nerve, some cranial motor nuclei, and the lateral octavus nucleus, which has not been described previously. This small nucleus is located beneath the descending nucleus of the trigeminal nerve near the obex. Within the ventral nucleus, thin fibers occupy the dorsal part and thick fibers occupy the ventral part. The basic projection pattern of the primary afferents of the VIIIth nerve in the lampreys was similar to that of gnathostome fishes that have been studied to date. Cell bodies of the efferent vestibular neurons are located between the ipsilateral trigeminal motor nucleus and the facial motor nucleus. The lateral location of these cell bodies differs from that of all other fish species that have been studied. PMID- 2708574 TI - Distribution of serotonin in the brain of the mormyrid teleost Gnathonemus petersii. AB - The distribution of serotonin-immunoreactive neurons and fibers was studied in the highly developed brain of the weakly electric fish Gnathonemus petersii with the aid of specific antibodies against serotonin. Serotoninergic cell bodies occur in three regions: the raphe region of the brainstem, the hypothalamus, and the transition zone between the dorsal thalamus and the pretectum. Serotoninergic raphe neurons are clustered in three groups: nucleus raphes superior, intermedius, and inferior. The latter has not been described in other teleosts and thus might be the source of the serotoninergic innervation of specific mormyrid electrosensory brain regions. Most hypothalamic serotoninergic neurons have cerebrospinal-fluid (CSF)-contacting processes and thus belong to the paraventricular organ (PVO), which in Gnathonemus is located around a number of small infundibular recesses. The distribution of serotonin in the PVO precisely matches the distribution of dopamine, as described previously. Serotoninergic cells in the thalamopretectal transition zone also have been described in other teleosts, but not in other vertebrate groups, and thus seem to represent a teleostean specialization. Serotoninergic fiber density is especially high in the medial forebrain bundle and surrounding preoptic and hypothalamic regions as well as in several telencephalic and preoptic subependymal plexus. Serotoninergic fibers appear to be almost completely absent in the large and differentiated corpus and valvula cerebelli. Comparison with the literature on teleostean serotoninergic innervation patterns reveals several mormyrid specializations, including the absence of serotonin in large parts of the mormyrid telencephalic lobes, a differentiated innervation pattern of distinct electrosensory and mechanosensory subnuclei of the torus semicircularis, a refined serotoninergic lamination pattern in the midbrain tectum, and a prominent innervation of the electrosensory lateral line lobe, the associated caudal cerebellar lobe, and the electromotor medullary relay nucleus. A distinct innervation of several types of (pre)motor neurons, such as the Mauthner cells and facial motor neurons, has not been reported previously for other teleosts. Consequently, the distribution of serotoninergic fibers as well as neurons in the mormyrid brain is substantially adapted to the high degree of differentiation of its electrosensory and telencephalic brain regions, but serotoninergic innervation is not involved in the circuitry of the most impressive part of the mormyrid brain; i.e., its large corpus and valvula cerebelli. PMID- 2708575 TI - Rapid changes in ultrastructure during deafferentation-induced dendritic atrophy. AB - This study describes qualitative and quantitative changes in dendritic ultrastructure during the rapid atrophy of nucleus laminaris (NL) dendrites following deafferentation. The dendrites of n. laminaris neurons in the chick auditory system are segregated into dorsal and ventral dendritic tufts, which receive spatially separated innervation from the ipsilateral and contralateral nucleus magnocellularis, respectively. We have previously shown that removing the input to the ventral side of NL results in the rapid atrophy of the ventral dendrites, whereas the nondeafferented dorsal dendrites of the same cells do not change in length. The ultrastructure of NL was examined in normal animals and after deafferentation. Changes in dendritic ultrastructure were not qualitatively apparent 4 hours after deafferentation. Between 12 and 48 hours the cytoplasm of the ventral dendrites became progressively more lucent, and a gap formed in the transition between the soma and ventral dendritic cytoplasm. Many of the dendrite tips, however, appeared normal even 2 days after deafferentation. Degeneration of dendrite plasma membrane was not visible until 2 days after deafferentation. On the other hand, quantitative measurements revealed a 30% decrease in microtubule density in the initial portion of the ventral dendrite by 4 hours, and a 50-60% decrease from 12 to 48 hours after deafferentation. Neurofilament density in the initial ventral dendrites decreased 50% by 12 hours, and 70% by 2 days after deafferentation. Many of the terminals of the severed afferents remained attached to the atrophying dendrite until 2 days after surgery, when they were in advanced stages of degeneration. Glia apparently were not involved in dendrite loss. The implications of these results on the role of cytoskeleton in the production and maintenance of dendritic shape are discussed. PMID- 2708576 TI - Changes in neuronal cell bodies in N. laminaris during deafferentation-induced dendritic atrophy. AB - N. laminaris dendrites begin to atrophy almost immediately after they are deafferented. Accompanying this rapid change in shape is a loss of microtubules and neurofilaments at the base of the dendrite, and a decrease in the density of the dendritic cytoplasm. However, degenerative changes in the dendritic plasma membrane were not evident until 2 days after deafferentation. Thus it was unknown what happened to the volume and membrane lost from the atrophying dendrites before this time. The soma was investigated in this study as a possible recipient of the volume of the atrophying dendrite. Soma size increased significantly by 2 hours after deafferentation and continued to increase for 1-8 days after deafferentation. The nucleus, which is normally concentric with the soma, moved continuously to the dorsal pole of the soma, toward the innervated side of the cell. The cytoplasm on the ventral side of the soma showed a decrease in density and loss of cytoskeleton similar to what was found in the initial portion of the ventral primary dendrites in the accompanying paper. These changes are interpreted as indicative of a rapid resorption of the ventral dendrite back into the soma following deafferentation. PMID- 2708577 TI - Spinocerebellar projections from the upper lumbar segments in the cat, as studied by anterograde transport of wheat germ agglutinin-horseradish peroxidase. AB - The projection fields of the dorsal spinocerebellar tract (DSCT) arising from Clarke's column, marginal neurons of Clarke's column, and lamina V neurons in the upper lumbar segments were studied by the anterograde transport of wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) in the cat. To label only these neuron groups with uncrossed ascending axons, the spinal cord was lesioned rostral and contralateral to the WGA-HRP injections. Following injections of WGA-HRP into the L1-L4 segments, labeled terminals were seen in sublobules Ia-VIc and VIIb-VIIIb, the simple lobule, the paramedian lobule, and the dorsal paraflocculus. About 70-80% and 20-30% of the total number of labeled terminals were in the anterior and the posterior lobe, respectively; the projections were predominantly ipsilateral to the cells of origin (about 87% or more labeled terminals of the total number in each of sublobules IIb-Va). The labeled terminals were abundant in sublobule IIb (6-11%), lobule III (12-27%), and sublobules IVa (14-17%) and IVb (14-21%). In the mediolateral extent of the lobules in the anterior lobe, the labeled terminals were most numerous between 1.1 and 3.0 mm lateral to the midline (45-75% of the total number of labeled terminals on the ipsilateral side). In the posterior lobe labeled terminals were numerous in sublobule VIIIb (13.6%) and sublobule C of the paramedian lobule (15 19%). The projection fields in the horizontal plane of the lobules were reconstructed from a series of cross sections through each lobule. In the anterior lobe the labeled terminals were distributed in eight major areas. In sublobules IIb-III, areas 1-3 were located within 1.0 mm of the midline in zone A of Voogd; areas 4-6, between 1.0 and 2.5 mm lateral to the midline in zones B-C1; and areas 7 and 8, lateral to 3.0 mm from the midline in zones C2 and C3. Areas 1 6 extended apicobasally in the middle part of the lobules. In sublobule VIIIb projections were confined to three longitudinal areas whereas in the paramedian lobule the projection areas were less distinct. The projection pattern of the lumbar DSCT was different from that of the thoracic DSCT reported previously. In the anterior lobe the thoracic DSCT projects to five areas in the medial (zone A) and the lateral part (zone B) of the vermis and to four areas in the intermediate region of the hemisphere (zones C1-C3). PMID- 2708578 TI - Serotoninergic neurons in the retina of Xenopus laevis: selective staining, identification, development, and content. AB - Uptake of 3H-serotonin followed by autoradiography, and uptake of the serotonin analog 5,7-dihydroxytryptamine (5,7-DHT), with subsequent staining, were each used to define a unique set of neurons in the retina of the African clawed frog, Xenopus laevis. Both techniques demonstrated the same population of neurons, on the basis of perikaryal size, shape, and position within the retina. Two classes of amacrine cells accumulated 5,7-DHT at the proximal (vitread) margin of the inner nuclear layer; the two classes were distinguished by the size of their perikarya. Two similar populations of cells, observed in the ganglion cell layer with lower frequency, may represent "displaced" counterparts of these two amacrine cell types. A class of bipolar cells whose perikarya were located in middle-to-distal regions of the inner nuclear layer also accumulated 5,7-DHT and 3H-serotonin. Processes of these cells contributed to a dense plexus of fine fibers that appeared evenly distributed throughout the inner plexiform layer. 3H Serotonin-accumulating cells first appeared in the developing retina at stage 35/36, a time immediately after retinal stratification but before elaboration of either plexiform layer. Electron microscopic analysis permitted an identification of 3H-serotonin-accumulating terminals in the inner plexiform layer. Serotonin labeled terminals containing conventional contacts, suggestive of amacrine cells, were presynaptic to unidentified processes and postsynaptic to bipolar cells. Labeled terminals containing ribbon contacts, indicative of bipolar cells, were postsynaptic to amacrine cells. The amount of serotonin contained in isolated retinas was 15 pmol/mg protein as measured by HPLC with electrochemical detection. We attempted to stimulate the release of accumulated 3H-serotonin from mature retinas by increasing the K+-concentration in the bathing medium. Although preloaded glycine is readily released from 14C-glycine-accumulating neurons, from the same retinas there was no calcium-dependent, K+-stimulated release of 3H serotonin. This finding suggests that serotonin and glycine are processed differently by retinal neurons, the consequence of which results in differing responses to 40 mM K+. PMID- 2708579 TI - Differential colocalization of neuropeptide Y- and methionine-enkephalin-Arg6 Gly7-Leu8-like immunoreactivity in catecholaminergic neurons in the rat brain stem. AB - The present study, using a combination of catecholamine (CA) histofluorescence and peptide immunocytochemistry in the same tissue sections, investigated the coexistence of neuropeptide Y (NPY) and methionine-enkephalin-Arg6-Gly7-Leu8 (MEAGL)-like immunoreactivity (LI) in catecholaminergic neurons of colchicine treated rat brain stems. Of the total number of catecholaminergic neurons in the A1/C1, A2/C2, A3, A4, and A6 regions approximately 83, 28, 98, 76, and 36%, respectively, contained both NPY-LI and CA. Of the total number of catecholaminergic neurons in A1/C1, A2/C2, A3, and A5 regions, approximately 47, 4, 8, and 17%, respectively, contained both MEAGL-LI and CA. Moreover, about 24% of the catecholaminergic neurons in the A1/C1 region contained both NPY- and MEAGL-LI. Neither the noradrenergic neurons (A7) in the pons nor any of the dopaminergic neurons in the midbrain (A8, A9, A10) contained NPY- or MEAGL-LI. Neurons containing both NPY- and MEAGL-like immunoreactive peptides without CA were not found in the rat brain stem. These findings indicate that catecholaminergic neurons in the brain stem of the rat can be subdivided into distinct subgroups on the basis of the coexistence of specific peptides. PMID- 2708580 TI - Role of commissural projections in the representation of bilateral auditory space in the barn owl's inferior colliculus. AB - The central nucleus of the barn owl's inferior colliculus (ICc) contains a representation of both the ipsilateral and contralateral auditory hemifields. The representation of ipsilateral space is found in the "core" of the ICc, a subdivision defined by the terminal field of nucleus laminaris, the avian analogue of the medial superior olivary nucleus. The representation of contralateral space is found in the lateral portion of the "shell" of the ICc. The shell surrounds the core and is defined by the terminal field of the nucleus angularis, one of the cochlear nuclei. The representation of ipsilateral space in the core of the ICc may be accounted for by the crossed projection from the nucleus laminaris because most of the nucleus laminaris is devoted to a representation of contralateral space. We present evidence to suggest that the representation of contralateral space is due to a commissural projection from the core of one side to the lateral shell of the opposite side. Injection of horseradish peroxidase (HRP) into the lateral portion of the ICc shell produced retrogradely labeled somata in the core of the opposite side. Injection of tritiated proline into the core produced anterograde label confined to the lateral shell, thus confirming the observations made with HRP. Thus, for example, the left ICc core, which contains predominantly a representation of the left hemifield, innervates the right lateral shell, endowing it with a representation of the left, or contralateral hemifield. The representation of contralateral space in the lateral shell is ultimately conveyed to the external nucleus of the inferior colliculus where it contributes the horizontal axis to a two-dimensional map of space. PMID- 2708581 TI - Ultrastructural analysis of axosomatic contacts on functionally identified primate spinothalamic tract neurons. AB - The morphology and frequency of axosomatic contacts on three functionally identified primate spinothalamic tract (STT) cells were analyzed at the electron microscopic level. The STT cells analyzed were wide-dynamic-range neurons responsive to activation of low- and high-threshold cutaneous afferents innervating the foot. The somas were located in the lateral border of lamina V; the dendritic trees were oriented dorsally and were very extensive. Numerous spinelike appendages were observed emanating from two of the cell bodies. Terminal types contacting the cell bodies were categorized at several different layers through each neuron. Six morphologically different terminal types were established following analysis of serial sections. Profiles classified as round (R) terminals containing round clear vesicles and zero or one dense-core vesicle made up over 50% of the total population in contact with the STT somas. Profiles containing round clear vesicles and two to four small-diameter dense-core vesicles (D1 category) made up approximately 10% of the population in contact with each soma. Flat (F) terminals with oblong or flattened clear vesicles made up approximately 8% of the population. The remaining three categories (D2, L1, and L2) distinguished by the number and size of the dense-core vesicles made up a small percentage of the total population in contact with the cell bodies. The distribution of terminal types on the soma proper versus somatic spines was also determined for one cell. The proportions of the six terminal types contacting the soma of these cells were very similar, although the physiological characteristics of each cell were different. However, the relative proportions of terminal types on these three lamina V STT cell bodies were different from those previously reported contacting somata in lamina V, suggesting that there may be a unique innervation of STT cells that differentiates them from other cell types in lamina V. PMID- 2708582 TI - Connectional analysis of the ipsilateral and contralateral afferent neurons of the superior temporal region in the rhesus monkey. AB - The interhemispheric and ipsilateral afferents of the superior temporal region (STR) were investigated with the aid of fluorescent retrograde tracers (Diamidino Yellow and Fast Blue). Different tracers were injected in selected cortical areas of the STR of each hemisphere of four rhesus monkeys. The results show that the interhemispheric afferents originate not only from the homotopic but also from heterotopic areas. The heterotopic areas giving rise to interhemispheric projections correspond to cortical areas of the origin of the ipsilateral projections. Although there is considerable overlap of labeled neurons of both afferent systems, only occasional double-labeled neurons are found. Whereas the laminar patterns of ipsilateral neurons of origin vary considerably, the interhemispheric projection neurons are located mainly in cortical layer III. This study provides additional information about the ipsilateral connectional organization of the superior temporal region. That is, the primary auditory area receives projections not only from adjacent lateral and medial cortical regions but also from adjoining rostral and caudal cortical regions. Thus, the highly differentiated primary auditory cortical area receives strong projections from the surrounding less-differentiated cortical regions. This connectional pattern is discussed from the perspective of the growth ring concept of cortical development. PMID- 2708583 TI - Neurogenesis of glutamic acid decarboxylase immunoreactive cells in the hippocampus of the mouse. I: Regio superior and regio inferior. AB - The neurogenetic gradients of neurons showing glutamic acid decarboxylase (GAD) immunoreactivity were determined in the regio superior and in the regio inferior of the mouse hippocampus. Pregnant C57Bl mice received pulse injections of (3H)thymidine from E11 through E17 (E0 being the day of mating). Distributions of (3H)thymidine-labeled, GAD-positive neurons in the different strata of the hippocampus proper were recorded in adult animals. GAD-positive neurons in this region are generated prenatally. Radial gradients of neurogenesis of GAD-positive cells are characterized by two main features: 1) with the exception of the stratum lacunosum-moleculare and its interface with the stratum radiatum, GAD positive neurons of the plexiform strata are generated before those destined for the pyramidal layer; 2) within the pyramidal layer, GAD-positive cells are positioned according to an inside-out sequence. In the transverse axis, neurogenesis of GAD-positive cells follows a regio inferior to regio superior gradient. This gradient is due to prolonged neurogenesis of GAD-positive cells for the pyramidal layer in the regio superior. Given the selective laminar disposition of the GABAergic interneurons in the hippocampus, the present authors explored whether or not the diverse types of these interneurons could have specific birth dates and concluded that no relationship exists between birth dates and adult phenotypes of GAD-immunoreactive cells in the mouse hippocampus proper. PMID- 2708584 TI - Neurogenesis of glutamic acid decarboxylase immunoreactive cells in the hippocampus of the mouse. II: Area dentata. AB - The temporal patterns of neurogenesis of cells showing glutamic acid decarboxylase (GAD) immunoreactivity were determined in the area dentata of the mouse. Pregnant C57Bl mice received pulse injections of (3H)thymidine from E11 through E17 (E0 being the day of mating). The distribution of (3H)thymidine labeled, GAD-positive neurons in the hilus and in the different strata of the fascia dentata (stratum infragranulosum, stratum granulosum, stratum moleculare) were recorded in adult animals. A radial gradient of neurogenesis of GAD-positive cells in the area dentata was not apparent. In the transverse axis, neurogenesis of GAD-positive cells seemed to follow a faint suprapyramidal to infrapyramidal gradient, which was due to differential timing of neurogenesis of GAD-positive cells destined for the stratum infragranulosum of the suprapyramidal and infrapyramidal blades of the fascia dentata. GABAergic neurons in the fascia dentata comprise a limited number of well-defined cell types. All of the different morphologic types of GAD-positive neurons present in the area dentata were generated prenatally. These diverse forms did not have specific times of neurogenesis. These results support the concept that the adult morphology of GAD positive cells in the area dentata of the mouse do not bear any relationship to their times of origin. PMID- 2708585 TI - Topographic organization of the central projections of the spiral ganglion in cats. AB - The morphological organization of inputs from restricted sectors of the cat cochlear spiral ganglion into the cochlear nucleus was studied by making focal extracellular injections of horseradish peroxidase (HRP) into the spiral ganglion. Injections resulted in Golgi-like labeling of a small cluster of spiral ganglion cells and their peripheral and central axons. Large injections involved most of the cells within Rosenthal's canal in sectors of the spiral ganglion innervating greater than or equal to 1 mm of the basilar membrane and resulted in narrow, complete laminae of labeled axons and preterminal fields within each cochlear nucleus subdivision. The positions of these bands were consistent with the "isofrequency laminae" appropriate for the frequencies represented at the injection sites, with high frequency laminae situated more dorsally, and lower frequencies progressively more ventral. A discrete projection to the small cell cap area was observed that was discontinuous with the main projection laminae in the ventral cochlear nuclei (VCN). In the dorsal cochlear nucleus, projecting fibers and terminals were excluded from the molecular cell layer. No labeled fibers entered the granule cell areas. In contrast to larger injections, very small HRP deposits labeled only part of an isofrequency lamina. Specifically, injections restricted to the scala tympani aspect of the spiral ganglion labeled only the lateral part of VCN isofrequency laminae, whereas injections limited to the scala vestibuli aspect of the ganglion labeled the medial aspect of the isofrequency planes. Thus these data indicate a previously unrecognized topographic representation of the vertical dimension of the spiral ganglion across VCN isofrequency laminae. Some possible functional implications of this projection organization are discussed. PMID- 2708586 TI - Developing retinotectal projection in larval goldfish. AB - The retinotectal projection in larval goldfish was studied with the aid of anterograde filling of optic fibers with HRP applied to the retina. The results show that optic fibers have already reached the tectum and begun to form terminal arbors in newly hatched fish. The projection is topographic in that fibers from local regions of the retina project to discrete patches of tectum, with the smallest patch covering 3.5% of the total surface area of tectal neuropil. Many fibers in young larvae have numerous short side branches along their length and only some of them show evidence of terminal sprouting. The arbors are approximately elliptical in shape and average about 1,500 microns 2. Growth cones are seen frequently. In older larvae, terminal arbors are larger and more highly branched, and they have begun to resemble those in adult fish. Fibers terminate in two strata; those in the upper layer are smaller (1,800 microns 2 on average) than those in the deeper stratum (4,000 microns 2 on average). The fraction of tectal surface area covered by individual arbors (the "tectal coverage") ranges from 1.5% to 3% of the total surface area of the tectal neuropil. In contrast, the tectal coverage of individual arbors in young adult goldfish is much smaller, ranging from 0.02% to 0.42% of tectal surface area (Stuermer, '84, and unpublished). This apparent increase in precision of the map in older animals is not due to retraction of arbors, which are slightly larger in adults, but is accounted for by overall tectal growth: the tectal neuropil in goldfish increases in area by about 250-fold during this period (Raymond, '86). PMID- 2708587 TI - Immunohistochemical localization of choline acetyltransferase in the chicken mesencephalon. AB - Choline acetyltransferase, a specific marker for cholinergic neurons, has been immunohistochemically localized in the mesencephalon and in the caudal diencephalon of the chicken. A complete series of transverse sections through the mesencephalon is presented. In the diencephalon, cholinergic fibers were found in the stria medullaris, the fasciculus retroflexus, and the ventral portion of the supraoptic decussation. The nucleus triangularis and the nucleus geniculatus lateralis, pars ventralis also contained cholinergic fibers. Small cholinergic cell bodies were found in the medial habenula. In the pretectum, cholinergic fibers innervated the nucleus lentiformis mesencephali and the tectal gray. The nucleus spiriformis lateralis also contained cholinergic fibers, while most of the cell bodies in the nucleus spiriformis medialis were cholinergic. In the mesencephalon, labelled fibers were found in the nucleus intercollicularis and in all layers of the optic tectum except the stratum opticum. The highest density of tectal cholinergic fibers was in the stratum griseum et fibrosum superficiale (SGFS), layer f. Radial cells located in SGFS, layer i were also cholinergic. In the isthmic nuclei, cholinergic fibers were found in the pars magnocellularis, while the pars parvicellularis and the nucleus semilunaris contained labelled cells. The oculomotor, Edinger-Westphal, trochlear, and trigeminal motor nuclei all had cholinergic cell bodies. Cholinergic axons were present in the oculomotor and trochlear nerves. In the tegmentum, cell bodies were labelled in the nucleus mesencephalicus profundus, pars ventralis, while the nucleus interpeduncularis had dense cholinergic innervation. Our localization of cholinergic cell bodies and fibers has been compared with earlier autoradiographic and anatomical studies to help define cholinergic systems in the avian brain. For example, the results indicate that the chicken may have a cholinergic habenulointerpeduncular system similar to that reported in the rat. Establishing the cholinergic systems within the avian midbrain is important for designing future neurophysiological and pharmacological studies of cholinergic transmission in this region. PMID- 2708588 TI - Gustatory innervation in the rabbit: central distribution of sensory and motor components of the chorda tympani, glossopharyngeal, and superior laryngeal nerves. AB - Although rabbits have been used extensively in neurophysiological studies of the gustatory system, there is little information about the anatomical organization of taste in this species. Afferent and efferent central connections of three nerves innervating oral or laryngeal taste buds in the rabbit, including the chorda tympani (CT), the lingual-tonsillar branch of the glossopharyngeal (IX), and the superior laryngeal nerve (SLN), were traced by means of horseradish peroxidase neurohistochemistry. After entering the brainstem, most afferent fibers of CT, IX, and SLN turned caudally in the solitary tract, with fibers of the CT terminating in the nucleus of the solitary tract from 1.0 mm rostral to 3.8 mm caudal to the caudal border of the dorsal cochlear nucleus. There was terminal label from the CT also in the principal trigeminal nucleus. There was terminal label from the CT also in the principal trigeminal nucleus and the oral and intermediate divisions of the spinal trigeminal nucleus. Preganglionic parasympathetic cell bodies of the superior salivatory nucleus were labeled retrogradely in the reticular formation ventral to the rostral pole of the solitary nucleus. Afferent fibers of the IXth nerve terminated in the solitary nucleus from 0.6 mm rostral to 5.0 mm caudal to the caudal border of the dorsal cochlear nucleus. There were also labeled terminals in the principal trigeminal nucleus and in all three divisions of the spinal trigeminal nucleus. Cell bodies composing the inferior salivatory nucleus were labeled in and around the solitary nucleus and subadjacent reticular formation just rostral to the caudal border of the dorsal cochlear nucleus. There were also a few lightly labeled cells within the nucleus ambiguus at its most rostral extent. Afferent fibers of the SLN terminated in the solitary nucleus from 1.2 to 6.8 mm caudal to the dorsal cochlear nucleus. There was also some terminal label in the intermediate and caudal divisions of the spinal trigeminal nucleus. Many cells were retrogradely labeled in the nucleus ambiguus following application of HRP to the SLN and a few cells were labeled in and around the solitary nucleus just caudal to the dorsal cochlear nucleus. These three nerves show an overlapping rostral to caudal distribution of afferent input within the nucleus of the solitary tract that may be related to their gustatory and visceral functions. PMID- 2708589 TI - Light microscopic study of degenerating cobalt-filled optic axons in goldfish: role of microglia and radial glia in debris removal. AB - Labeling severed axons with cobaltous-lysine ultimately leads to the degeneration of their distal segments. The present study was designed to determine whether microglia and radial glia have comparable roles in the elimination of degenerating axons. Another purpose was to determine whether the cobalt could escape from degenerating axons and enter intact neuronal cells. Optic axons were filled with cobaltous-lysine for 1 day and the retinal projections were examined from 1 to 106 days later. Optimal filling was obtained 1 day postlabeling. The number of filled axons in the optic tract was significantly reduced at the 2-day time point, indicating that many axons had disintegrated. Many axons contained large swellings that resembled cells. However, transneuronally labeled neuronal cells were never observed. Labeled, rounded microglia appeared among the degenerating axons at the 3-day time point, and the microglia changed shape at 5 days. They became elongated and manifested many processes. In addition, the microglia began to move toward, and entered, the ventricles and vasculature. Virtually all the labeled debris was removed between 17 and 28 days following the application of cobalt. The rapidity with which the axons were removed suggests that the cobalt accelerates the degenerative process either directly, or indirectly by accelerating the arrival of phagocytic cells. Radial glia appeared to play a smaller role in debris elimination. They took up labeled debris to a lesser degree than microglia and were briefly labeled. Interestingly, radial glia did not take up cobalt when it was injected intracranially and diffused through the brain. A previous claim of an axosomatic retinotectal projection to cells deep in the stratum periventriculare of a teleost fish is reinterpreted to represent cobalt within radial glia. PMID- 2708590 TI - Tyrosine phosphorylation in the postnatal rat brain: a developmental, immunohistochemical study. AB - We have used antibodies against phosphotyrosine to probe 50-microns cerebellar sections from rats of various ages as well as sections of adult brainstem, cerebrum, and olfactory bulb to investigate the developmental appearance of this phosphorylation system as revealed by light microscopy. While the overall intensity of staining in the cerebellum was highest at 7 days, the pattern of staining in the adult is quite disparate from that seen in younger animals. From 10 to 21 days postnatal, staining is associated primarily with the white matter and/or the lower premigratory zone of the external granular layer and adjacent formative molecular layer. While the temporal and spatial appearance of phosphotyrosine immunoreactivity corresponds well to the established patterns of axonal growth in these areas, we cannot at the light level ascertain whether the immunoreactivity is intrinsic or extrinsic to the growing fibers. In animals 28 days and older, however, staining is restricted to a subpopulation of multipolar cells distributed throughout the cerebellum, as well as the olfactory bulb, cerebrum, and brainstem. The phosphotyrosine-positive cells in the adult cerebellum are not comparable to glial-fibrillary-acidic-protein-immunoreactive elements with regard to morphology or distribution, and they fail to colocalize with neuronal somata stained with anti-microtubule-protein-2 antibodies. While it appears that the radial fibers of the Bergmann glia in the external granular layer stain at 7 days, there is no staining detected in the mitotically active neuroblasts of this layer at any age. We conclude that in the immature cerebellum, the majority of tyrosine phosphorylation detectable by this method may be involved in the formation and growth of axonal processes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708591 TI - Diagonal band projection towards the hypothalamic supraoptic nucleus: light and electron microscopic observations in the rat. AB - Supraoptic nucleus (SON) neurons receive a prominent gamma-amino-butyric acid (GABA) input. This study evaluated the hypothesis, partly on the basis of recent electrophysiological data, that this innervation might arise from GABAergic neurons located in the ventral diagonal band of Broca area. For retrograde transport studies, pentobarbital-anesthetized male Long-Evans rats received 0.03 0.20-microliter injections of a suspension of rhodamine tagged latex microspheres into the SON. In two cases where such injections were confined to the SON, less than 60 retrogradely labeled neurons were detected in the ipsilateral diagonal band. In three animals where injections extended into the perinuclear zone around the SON, more than 2,000 retrogradely labeled cells were counted in the ipsilateral diagonal band. For anterograde transport studies, another group of animals received either 30% horseradish peroxidase (HRP) in 0.5% poly-L-ornithine (0.05-0.10 microliter injections) or Phaseolus vulgarus (iontophoresed from a 2% solution) into the diagonal band. After survivals of 18-24 hours (HRP) or 5 days (PHAL-L) labeled axon terminals invested the perinuclear zone above the SON. The presence of just a single fiber within the nucleus indicated a minor projection to the SON itself. The HRP-injected material was processed for ultrastructural examination and revealed dense HRP-labeled axon terminals in this perinuclear zone, most often (98%) forming axodendritic appositions. A postembedding colloidal gold technique to visualize GABA-synthesizing terminals revealed that fewer than 5% of these perinuclear HRP-labeled terminals also exhibited GABA-like immunoreactivity. Within the SON, where GABAergic axon terminals are abundant, few (less than 5%) GABAergic terminals contained HRP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708592 TI - Structure-function relationships in rat brainstem subnucleus interpolaris: III. Local circuit neurons. AB - Intracellular recording, electrical stimulation, receptive field mapping, and intracellular injection of horseradish peroxidase were used to assess the response properties, collateral projections, and morphology of 44 local circuit (LC) neurons in the subnucleus interpolaris (Sp Vi) of the trigeminal brainstem complex of the rat. LC neurons were defined as those with axons restricted to brainstem areas receiving trigeminal primary afferent fibers. Thus, none were antidromically activated from the thalamus, tectum, or cerebellum, and their axons could be seen terminating exclusively within the trigeminal brainstem complex or reticular formation. All neurons sampled were discharged by innocuous or noxious mechanical stimulation of a restricted portion of the face or mouth. They were classified functionally as sensitive to vibrissae (N = 22), nociceptors (N = 9), guard hairs (N = 7), hairy skin (N = 3), or periodontia (N = 3). Fifty percent of the stained neurons were vibrissa sensitive. Twenty-one of these 22 responded to deflection of only one vibrissa. The remaining functional groups also had small receptive fields. Intracellular staining revealed a consistency in vibrissa-sensitive LC morphology. Somata were small to medium in size and multipolar. Their axons had an initial transverse trajectory and gave off recurrent collaterals which arborized extensively in the region of the soma. The parent axon then bifurcated. One branch traveled rostrally to subnucleus principalis while the other branch traveled caudally to subnucleus caudalis. The branches periodically sent collaterals into regions of the trigeminal complex corresponding to the transverse position of the soma. Dendrites extended 440 +/- 140 microns rostrocaudally, forming a tree with a transverse perimeter of 459 +/- 226 microns. Distal dendrites were thin and sinuous, had few spines, and extensively arborized adjacent to the soma. They ended in multiple swellings connected by slender processes. The stereotyped morphology of vibrissa-sensitive LC neurons differed from the variable morphologies of LC neurons activated by nociceptors, guard hairs, hairy skin, or periodontia. Although no group of neurons in one of these categories displayed a distinguishing morphological characteristic, they collectively had features which distinguished them from the vibrissa-sensitive neurons. Non-vibrissa-responsive neurons generally had more expansive, but less circular, dendritic and recurrent axonal arbors; dendrites had more spines, and axons often sent endings into the reticular formation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2708593 TI - Structure-function relationships in rat brainstem subnucleus interpolaris: IV. Projection neurons. AB - In a companion paper (Jacquin et al., '89), the structure and function of local circuit (LC) neurons in spinal trigeminal (V) subnucleus interpolaris (Sp Vi) were described. The present report provides similar data for 44 projection neurons in Sp Vi. Of these, 25 thalamic, 16 cerebellar, 2 superior collicular, and 1 inferior olivary projecting neurons were studied. The majority responded to vibrissa(e) deflection, and all except 4 of these had multivibrissae receptive fields. The remainder were responsive to either guard hair deflection or indentation of glabrous skin. Latencies to V ganglion shocks were suggestive of monosynaptic activation from the periphery. Sp Vi projection neurons were topographically organized in a manner consistent with that of their primary afferent inputs. Nonvibrissa sensitive cells had diverse morphologies. Morphometric analyses of the more heavily sampled thalamic and cerebellar projecting, vibrissa(e)-sensitive cells indicated the following. (1) As compared to LC neurons, projection neurons had bigger receptive fields, cell bodies, dendritic trees, and axons; less circular dendritic trees; a greater preponderance of spiny dendrites and fewer axon collaterals in Sp Vi. (2) Dendritic tree extent correlated significantly with receptive field size, thus suggesting that dendritic tree size is one mechanism contributing to receptive field size in vibrissae-sensitive projection neurons. (3) V thalamic cells had significantly bigger receptive fields and dendritic trees, and also give off more local axon collaterals, than V cerebellar neurons. Collicular and inferior olivary projecting neurons shared structural and functional attributes with other Sp Vi long-range projecting cells. Structure-function relationships exist for vibrissa-sensitive projection neurons in Sp Vi. The relevant parameters correlating with projection neuron morphology are receptive field size and projection status, whereas for Sp Vi LC neurons the relevant correlative parameter is peripheral receptor association. PMID- 2708594 TI - Structure-function relationships in rat brainstem subnucleus interpolaris: V. Functional consequences of neonatal infraorbital nerve section. AB - In a prior study (Jacquin et al., '86c), the response properties and projections of neonatally axotomized trigeminal (V) primary afferents were studied in the adult rat. Here, single-unit recording, electrical stimulation, and receptive field (RF) mapping techniques were also used to assess the functional consequences of neonatal infraorbital nerve section upon postsynaptic cells in V brainstem subnucleus interpolaris (SpVi). Of 904 cells studied, 385 were from normal adults and 519 were from neonatally deafferented adults. Infraorbital nerve section at birth resulted in: (1) a substantial reduction in those areas of SpVi containing cells with infraorbital RFs, and only a slight increase in areas solely responsive to noninfraorbital surfaces, (2) an absence of orderly topography within cells expressing regenerate primary afferent inputs, (3) a slight increase in mean discharge latency to V ganglion or thalamic shocks, (4) an increased relative percentage of cells orthodromically activated by diencephalic or cerebellar shocks, (5) a decreased relative percentage of mystacial vibrissa-sensitive local circuit neurons, with a corresponding increase in local circuit nociceptors and unresponsive cells, (6) an increased relative percentage of mystacial nociceptors, virbrissae, guard hair, and/or skin sensitive cells projecting to thalamus and/or cerebellum, (7) an increased percentage of local circuit neurons with RFs including more than one vibrissa, whereas projection neurons did not differ from normal in the number of vibrissae composing their RFs, and (8) an increased relative percentage of cells expressing interdivisional and intermodality convergence, split RFs, spontaneous activity, directional high velocity, and neuroma sensitivity. Thus neonatal nerve section produces changes in topography, inputs, projection status, and responses of surviving postsynaptic neurons. Although many of these centrally observed alterations can be attributed to altered peripheral projections in axotomized V primary afferents, others must reflect central reorganization. The central mechanisms responsible for the synthesis of deafferentation-induced RFs remain to be elucidated. PMID- 2708595 TI - Morphology of augmenting inspiratory neurons of the ventral respiratory group in the cat. AB - The present study examined, in Nembutal-anesthetized and artificially ventilated cats, the morphologic properties of the inspiratory neurons of the ventral respiratory group (VRG). Horseradish peroxidase (HRP) was injected into 21 augmenting inspiratory or late inspiratory neurons with peak firing rates in the late inspiratory phase. The majority of the stained neurons were antidromically activated by stimulation of the cervical cord. Thirteen somata, located within or around the nucleus ambiguus (AMB), between 100 microns caudally and 2,000 microns rostrally to the obex, were stained. In ten cases, the stem axons issuing from the cells of origin coursed medially to cross the midline without giving off any axonal collaterals. Three neurons gave rise to axonal collaterals on the ipsilateral side, distributing boutons in the medullary reticular formation, in the vicinity of the AMB, hypoglossal nucleus, solitary tract, and dorsal motor nucleus of the vagus. In eight neurons, only the axons were labeled; in four of these, which were antidromically activated from the spinal cord, the stem axons crossed the midline 2,000-3,000 microns rostral to the obex and descended in the reticular formation around the AMB down to the cervical cord. They issued several axonal collaterals, distributing terminal boutons at the level of the caudal end of the retrofacial nucleus and about 1,000 microns rostral and caudal from the obex. Terminals were found mainly in and around the AMB, and a few were found in the vicinity of the dorsal motor nucleus of the vagus. The remaining four nonactivated axons distributed their terminal boutons widely in the reticular formation around the AMB. Thus, the augmenting inspiratory neurons of the VRG were shown to project not only to the spinal cord, but also to the VRG, hypoglossal nucleus, and dorsal motor nucleus of the vagus. PMID- 2708596 TI - Early postnatal development of vasoactive intestinal polypeptide- and peptide histidine isoleucine-immunoreactive structures in the cat visual cortex. AB - The early postnatal development of neurons containing vasoactive intestinal polypeptide (VIP) and peptide histidine isoleucine (PHI) has been analyzed in visual areas 17 and 18 of cats aged from postnatal day (P) 0 to adulthood. Neuronal types are established mainly by axonal criteria. Both peptides occur in the same neuronal types and display the same postnatal chronology of appearance. Several cell types are transient, which means that they are present in the cortex only for a limited period of development. According to their chronology of appearance the VIP/PHI-immunoreactive (ir) cell types are grouped into three neuronal populations. The first population comprises six cell types which appear early in postnatal life. The pseudohorsetail cells of layer I possess a vertically descending axon which initially gives rise to recurrent collaterals, then forms a bundle passing layers III to V, and finally, horizontal terminal fibers in layer VI. The neurons differentiate at P 4 and disappear by degeneration around P 30. The neurons with columnar dendritic fields of layers IV/V are characterized by a vertical arrangement of long dendrites ascending or descending parallel to each other, thus forming an up to 600 microns long dendritic column. Their axons always descend and terminate in broad fields in layer VI. The neurons appear at P 7 and are present until P 20. The multipolar neurons of layer VI occur in isolated positions and have broad axonal territories. The neurons differentiate at P 7 and persist into adulthood. Bitufted to multipolar neurons of layers II/III have axons descending as a single fiber to layer VI, where they terminate. The neurons appear at P 12 and persist into adulthood. The four cell types described above issue a vertically oriented fiber architecture in layers II-V and a horizontal terminal plexus in layer VI which is dense during the second, third and fourth week. Concurrent with the disappearance of the two transient types the number of descending axonal bundles and the density of the layer VI plexus is reduced, but the latter is maintained during adulthood by the two persisting cell types. Two further cell types belong to the first population: The transient bipolar cells of layers IV, V, and VI have long dendrites which extend through the entire cortical width. Their axons always descend, leave the gray matter, and apparently terminate in the upper white matter. The neurons differentiate concurrently with the pseudohorsetail cells at P 4, are very frequent during the following weeks, and eventually disappear at P 30.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2708597 TI - Quantitative analysis of the number and distribution of neurons richly innervated by GABA-immunoreactive axons in the rat superior cervical ganglion. AB - The superior cervical ganglion of rats contains a considerable number of nerve fibers with GABA-like immunoreactivity which show a nonuniform distribution within the ganglion. The topography of these fibers has been analyzed by using antibodies raised against GABA-BSA-glutaraldehyde complexes. GABA-positive axons and axon varicosities accumulated around a subpopulation of principal ganglion cells forming basketlike patterns. These neurons richly innervated by GABA positive axons (RIG-neurons) in turn were aggregated in patches with strong immunoreactivity. The size and packing density of the patches containing RIG neurons and GABA-positive axons approaching them had rostral-to-caudal and medial to-lateral gradients. Similar patterns were found in right and left ganglia. In five ganglia, a quantitative analysis revealed on average 1,344 RIG-neurons per ganglion representing about 5% of the total neuron population, with small variations (standard deviation 122) despite the highly variable shape of the ganglia. The distribution of RIG-neurons resembles that of neurons sending their axons into the internal carotid nerve. To check this possible correlation, HRP was injected into the eye and applied to the transected external carotid nerve. Double staining for the retrogradely transported peroxidase and GABA immunohistochemistry revealed that RIG-neurons formed a small subpopulation of retrogradely labelled neurons in both experiments. This suggests that RIG-neurons innervate various target organs. This conclusion is in agreement with the observation that RIG-neurons also exist in other sympathetic ganglia. Data presented suggest that sympathetic ganglion cells can be classified on the basis of non-uniform innervation patterns formed by axons that use different neurotransmitters. PMID- 2708598 TI - Connections of the ventral granular frontal cortex of macaques with perisylvian premotor and somatosensory areas: anatomical evidence for somatic representation in primate frontal association cortex. AB - In macaque monkeys with injections of tritiated amino acids or horseradish peroxidase in the ventrolateral granular frontal cortex, we observed extensive anterograde and retrograde labeling of the premotor and somatosensory cortex in and around the lateral sulcus. Comparable labeling was not present with large and small control injections of the dorsal granular cortex. Cytoarchitectonic evaluation of the perisylvian cortex in the three cases examined in detail indicated that labeled areas included the ventral premotor cortex (area 6V); the precentral opercular and orbitofrontal opercular areas (PrCO and OFO); the second somatosensory area (S-II); the opercular cortex immediately anterior to S-II, possibly corresponding to area 2 of the S-I complex; and the central part of the insular cortex, including portions of the granular and dysgranular insular fields (Ig, Idg). Labeling was particularly dense and extensive in areas 6V, S-II, and OFO. Lighter labeling was also present in the rostral inferior parietal lobule (areas 7b and POa). The distribution of label within perisylvian areas was not uniform: certain parts were heavily labeled, while other parts were lightly labeled or unlabeled. Comparison of label distribution with published accounts of the somatotopy of these areas indicates that forelimb and orofacial representations were selectively labeled. Further, our results, taken together with other recent anatomical findings (e.g., Matelli et al.: Journal of Comparative Neurology 251:281-298, 1987; Barbas and Pandya: Journal of Comparative Neurology 256:211-228, 1987) suggest strongly that there is a network of interconnected forelimb and orofacial representations in macaque cortex, involving the ventral granular frontal cortex, area 6V, OFO, opercular area 2, S II, the central insula, and area 7b. Each injection of frontal cortex which labeled the perisylvian somatic cortex involved the cortex of the ventral rim of the principal sulcus (PSvr). The cortex surrounding the PSvr does not stand out as a distinct area in Nissl-stained material. However, examination of myelin stained sections prepared from uninjected hemispheres with the Gallyas technique revealed the existence of a distinct zone centered on the PSvr. This myeloarchitectonic area, which we term area 46vr, is more heavily myelinated than the ventral bank and fundus of the principal sulcus (area 46v) but is less heavily myelinated than the ventral (inferior) convexity (area 12). Involvement of area 46vr in our injections was probably responsible for the strong labeling observed in perisylvian somatic areas.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2708599 TI - The global world--a domain for development in adolescence? AB - Two cases studies are presented for the purpose of providing material for theoretical discussion on the development of adolescents in the nuclear age. The two cases originate from a study of 15 girls who were followed from the age of 15 16 to 17-18. Both cases showed an initial concern about nuclear war in earlier adolescence, but their subsequent development proceeded in opposite directions. The first case demonstrates how privatization and turning away from global issues might develop in one's mind and way of life. The second case demonstrates widening interests and activities in the global domain. The cases are analysed using the Vygotskian concepts of internalization and the zone of proximal development. It is suggested that the development of mass media has created a new zone of proximal development in adolescence, the global domain. It is suggested further that an integrated world view is a developmental potential inherent in the global domain. PMID- 2708600 TI - Transitions in the nuclear age: late adolescence to early adulthood. AB - College students, subjects in a 1983 study on reaction to that threat of nuclear war, participated in a follow-up study to investigate the changes that occur from late adolescence to early adulthood. The 41 subjects again completed the Nuclear War Attitude Survey (NWAS II) and, additionally, a second questionnaire and to 1 to 2 1/2 hour individual interview during which they were asked to explain changes in their answers to the NWAS II. Compared to their previous responses to the NWAS II, the responses of these young adults showed statistically significant decreases in the frequency they reported thinking about the possibility of nuclear war, their estimation of the likelihood of a nuclear war, and their intention to contact the news media to express their views. The researchers hypothesize that the major reasons for changes in response were (1) developmental differences, (2) the campus culture, (3) the political climate, (4) the media climate and (5) lack of engagement with the democratic process. PMID- 2708601 TI - Relationships between the life values of U.S. college students and their cognitive/affective responses to the threat of nuclear war. AB - The present study was designed to examine relationships between the life values of 399 U.S. college students and their nuclear war-related thoughts, feelings, and behaviors. The students completed four scales from the Life Values Inventory: (i.e. Conventionally Defined Success [CDS]; Religious Faith and Devotion [RFD]; Activist Pursuit of Social Causes [APSC]; Materialistic Orientation [MO]), the Satisfaction With Life Scale, four scales from the Nuclear War Inventory--Nuclear Distress; Salience; Weapons Opposition; Personal Efficacy--and a single behavioral measure of approach toward information concerning nuclear weapons. Consistent with theory regarding the influence of values and commitments on attitudes and behavior, APSC was found to be positively associated with all five nuclear war measures. Additionally, MO was negatively related to Personal Efficacy and Information Approach, and CDS was positively associated with Nuclear Distress. The only value dimension which covaried significantly with general life satisfaction was RFD. Results are discussed with respect to the recent rise in conservative and materialistically-oriented values among American college students. PMID- 2708602 TI - A longitudinal study of the hopes and worries of adolescents. AB - This paper describes a longitudinal questionnaire study of the future hopes and worries of 547, 11- and 14-year-olds from Nottingham, England. Results from interviews with 152 of the 14-year-olds are also presented. More than half of the teenagers spontaneously expressed hopes for and worries about employment and unemployment. One third of adolescents, and more boys than girls, were concerned about war, including nuclear war. Proportions of pupils worried about unemployment, own mortality, lack of money and AIDS increased significantly with age. Interview and questionnaire findings were in general agreement. However, worries such as exam failure, childbirth and unhappy marriage were more prominent at interview and mentioned significantly more frequently by girls than boys. Worries about employment and nuclear war appear to predominate throughout adolescence, but are not the sole concern of this age group. Consideration should be given to discussing teenage worries in the context of school/family based educational ventures. PMID- 2708603 TI - Adolescent ego development: relationship to family cohesion and adaptability. AB - Adolescence has been a focus of research for several decades. Recently, a portion of this body of research has addressed the relationship between adolescent development and family functioning. The intent of much of this research has been the attempt to determine how family dynamics influence the developmental processes of adolescents. Adolescents' perceptions of family cohesion and adaptability, as well as their levels of satisfaction with those perceptions, have been correlated with ego development within a sample of middle adolescents. Adaptability and cohesion were found to be significantly related to ego development, but interactions among the two variables, as well as with family structure were important. PMID- 2708604 TI - The adolescent as forgiver. AB - A social cognitive developmental model of forgiveness is described and tested in two studies, the second being a replication of the first. In study 1, 59 subjects in grades 4, 7, 10, college and in adulthood were given a forgiveness interview that assessed six stages of forgiveness development, Rest's DIT measure of justice development, and a religiosity scale. As predicted, there were strong age trends for forgiveness and justice. Both forgiveness and justice were related but distinct constructs. The more one practiced one's faith, the higher one was in forgiveness stage. Study 2, with 60 subjects, replicated the above findings. The studies give strong evidence that people's understanding of forgiveness develops with age. Implications for adolescent development are drawn. PMID- 2708605 TI - The Psychotherapy Research Project of the Menninger Foundation: an overview. AB - Studied processes and outcomes of psychoanalysis and psychoanalytic psychotherapy, both expressive and supportive. 42 Ss were followed via initial, termination, and follow-up studies over the entire natural course of treatment, with 100% follow-up 2-3 years posttermination. Some follow-ups extended over the 30-year life span of the study. Detailed case histories and life histories were obtained from all 42 Ss. Psychoanalyses achieved more limited outcomes than predicted; psychotherapies often achieved more than predicted. Supportive mechanisms infiltrated all therapies, psychoanalyses included, and accounted for more of the achieved outcomes (including structural changes) than anticipated. An expanded new categorization of supportive therapeutic mechanisms is proposed, along with an elaboration of expressive therapeutic mechanisms. PMID- 2708606 TI - Observed family interactions among subtypes of eating disorders using structural analysis of social behavior. AB - Compared observations of family interactions among anorexic, bulimic-anorexic, bulimic, and normal families. A total of 74 family triads participated, including father, mother, and teenage daughter. Each family was videotaped during a 10-min discussion of the daughter's separation from the family. These tapes were coded using Benjamin's structural analysis of social behavior (SASB) model and observational schema. The results showed that the SASB methodology differentiated clinical from normal families and that there were unique patterns among subtypes of eating disorders. Specifically, parents of anorexics communicated a double message of nurturant affection combined with neglect of their daughter's needs to express themselves and their feelings. Anorexic daughters, in turn, were ambivalent about disclosing their feelings versus submitting to their parents. In contrast, bulimics and their parents were hostilely enmeshed and, for them, this appeared to undermine the daughter's separation and self-assertion. These findings are consistent with current theory and research on anorexia and bulimia. PMID- 2708607 TI - Cognitive-behavioral and response-prevention treatments for bulimia nervosa. AB - This study was designed to assess the additive effects of major components of cognitive-behavioral treatment for bulimia nervosa. Seventy-seven female patients with bulimia nervosa were allocated at random to one of four conditions: wait list control, self-monitoring of caloric intake and purging behaviors, cognitive behavioral treatment, and cognitive-behavioral treatment combined with response prevention of vomiting. In the treatment conditions, participants were seen individually for fourteen 1-hr sessions over a 4-month period. All the treatment groups showed significant improvement, whereas the wait-list control group did not. Cognitive-behavioral treatment was, however, the most successful in reducing purging and in promoting positive psychological changes. Fifty-six percent of participants in this condition ceased binge eating and purging by the end of treatment, and the frequency of purging declined by 77.2% during the same period. Of the three treatment conditions, only cognitive-behavioral treatment was superior to the wait-list control. At the 6-month follow-up, 59% of the cognitive behavioral group were abstinent, and purging had declined by 80%. Cognitive behavioral treatment was significantly superior to the other treatment groups at this time. Thus, the addition of response prevention of vomiting did not enhance the efficacy of cognitive-behavioral treatment, and the evidence suggests that it may have had a deleterious effect. PMID- 2708608 TI - Predicting rapid relapse following treatment for chemical dependence: a matched subjects design. AB - Explored the prognostic significance of treatment and posttreatment variables on rapid relapse following residential treatment for chemical dependence. 54 persons were identified as 3-month treatment failures by the criteria of 1-3 months of alcohol/drug use in combination with alcohol/drug-related consequences and poor life adjustment. To limit heterogeneity, these persons were matched on MMPI scores with persons who were 3-month outcome successes. Additionally, these MMPI patterns were classified as near normal or indicative of psychiatric symptoms. Multivariate statistics revealed a high level of outcome predictability; continued emotional turmoil (depression, anxiety, and sleep problems) posttreatment was strongly related to failure among the psychiatric MMPI group. Failure to engage in a continuing posttreatment aftercare plan was associated with failure among persons in the near-normal MMPI group. Research approaches that attempt to limit heterogeneity among alcoholics appear to have promise in uncovering powerful prognostic indicators. PMID- 2708609 TI - Links from emotional distress to adolescent drug use: a path model. AB - Administered anonymous surveys asking about drug use, emotional distress, and peer drug associations to 11th and 12th grade high school students (N = 563). Emotional distress variables accounted for only 4.8% of the variance in drug use. The addition of peer drug associations as a predictor variable increased the variance accounted for to 43.4%. A path model of adolescent drug use based on peer cluster theory was tested using LISREL, and this provided a good fit with the data. As predicted, peer drug associations dominated the prediction of drug use and mediated the effect of emotional distress on drug use, with the exception of a small residual path directly from anger to drug use. The hypothesis that young people take drugs to alleviate emotional distress does not hold up well; emotional distress variables, with the exception of anger, produced only very small and indirect links to drug use. PMID- 2708610 TI - Impact of an educational support group on family participants who take care of their schizophrenic relatives. AB - Using a stress-coping framework, we designed a six-session educational support group offering family caretakers information about schizophrenia, training in problem-solving skills for managing patient behavior, and greater access to social support and community resources. Subjects were recruited though local community mental health centers; 24 subjects participated in one of five identically structured caretakers' groups and another 24 subjects served as matched controls. Results of the multivariate analysis of covariance indicated a significant difference between the experimental and control caretakers following the intervention. Caretakers of the educational support group reported significantly reduced anxiety and personal distress and significantly more active coping behaviors (increased use of community resources and better management of home life with their schizophrenic family member). However, no changes were reported in the frequency of their negative feelings toward their mentally ill family member or in their generalized sense of self-efficacy. PMID- 2708611 TI - Parental problem-solving skills, stress, and dietary compliance in phenylketonuria. AB - Parents of 30 children with phenylketonuria (PKU) who were classified as being in good dietary control (compliant, measured as within the medically acceptable range of blood phenylalanine levels of 2-10 mg) or poor dietary control (noncompliant, measured as either below or above medically acceptable 2-10 mg blood phenylalanine levels) engaged in verbal and written problem-solving situations under conditions of both high and low time-pressure induced stress. Overall, compliant parents gave higher quality verbal and written problem-solving solutions than noncompliant parents. Stress reduced the quality of problem solving in both compliant and noncompliant parents, but even under high stress, compliant parents demonstrated better problem-solving abilities than noncompliant parents. The potential importance of these findings for preventive intervention in PKU families is discussed. PMID- 2708612 TI - Discriminant analysis of risk factors for sexual victimization among a national sample of college women. AB - Examined the accuracy with which rape and lesser sexual assaults were predicted among a representative national sample of 2,723 college women. A total of 14 risk variables operationalized three vulnerability hypotheses: (a) vulnerability creating traumatic experiences, (b) social-psychological vulnerability, and (c) vulnerability-enhancing situations. Each hypothesis was tested individually, and a composite model was developed via discriminant analysis. Only the traumatic experiences variables clearly improved over the base rates in identifying rape victims, but risk variables from each vulnerability hypothesis met criteria for inclusion in the composite model. A risk profile emerged that characterized only 10% of the women, but among them the risk of rape was twice the rate of women without the profile. The concept of traumatic sexualization was used to explain this finding. However, the vast majority of sexually victimized women (75-91%) could not be differentiated from nonvictims. PMID- 2708613 TI - Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia. AB - We assessed neuropsychologically 106 children with acute lymphoblastic leukemia (ALL) who had all received cranial irradiation for the prevention of central nervous system (CNS) leukemia 1-13 years previously. Children were assessed for adverse late effects of their therapy, using age-appropriate Wechsler measures of overall intellectual ability and supplementary tests. Forty-five siblings near in age to the patients were tested as controls. The patients who had had the most intensive central nervous system (CNS) prophylaxis were found to have a WISC-R Full Scale IQ 17 points lower than the sibling control group. Performance IQ was more affected than verbal IQ. The patients were more easily distracted and less able to concentrate. The severity of the aftereffects was related to younger age at the time of CNS prophylaxis and to a higher dose of cranial irradiation but not to time since CNS prophylaxis. CNS prophylaxis using a combination of cranial irradiation and intrathecal methotrexate has lowered the incidence of CNS relapse in childhood ALL but is associated with considerable long-term morbidity in survivors. PMID- 2708614 TI - The premature aging hypothesis: old before its time? AB - This study tested the hypothesis that alcoholism results in premature aging of memory functioning. It was proposed that support for the premature aging hypothesis must come from qualitative as well as quantitative similarities between younger alcoholics and older controls. The California Verbal Learning Test (CVLT) was administered to young and old alcoholics and to young and old controls. The CVLT provides measures of recall, recognition, learning strategies, and error types. Alcoholism and aging produced similar levels of immediate and delayed free recall. However, poor recognition memory and more frequent intrusion and false positive errors were associated with alcoholism but not with aging. Qualitative differences in error types between alcoholism and aging were also found. Results indicated that alcoholism and aging produce independent verbal learning decrements. PMID- 2708615 TI - Psychosocial functioning of learning-disabled children: replicability of statistically derived subtypes. AB - The PIC scores of 132 learning-disabled children between the ages of 6 and 12 years were investigated using Q-factor analysis, four hierarchical-agglomerative clustering techniques, and one iterative partitioning clustering technique. Results revealed excellent correspondence between the subtypes derived by all grouping methods in terms of both misclassifications and mean PIC profile similarity of the subtypes across techniques. The mean PIC profile of one subtype indicated normal psychosocial adjustment; a second subtype exhibited evidence of significant internalized psychopathology; a third subtype had a mean PIC profile suggestive of externalized psychosocial maladjustment. These subtypes were virtually identical to three subtypes reported by Porter and Rourke (1985) in another study of learning-disabled children. The results indicate that learning disabled children comprise a heterogeneous population in terms of psychosocial functioning and that subtypes of learning-disabled children with similar patterns of socioemotional adjustment can be recovered reliably from this population across samples and statistical grouping techniques. PMID- 2708616 TI - Sequential analyses of therapist-client interaction during change events: a task focused approach. AB - In this article, we describe a task-focused approach that uses sequential analyses as deductive techniques for studying therapist-client interactions in the context of clinical microtheories of change events. The methodology is demonstrated in a study of a class of change events in client-centered therapy referred to as the resolution of problematic reactions. Logit-loglinear analysis and binomial z scores were used to test the effects of therapist behavior, assessed by therapist vocal quality and by the therapist task-relevant system, on client process assessed by client vocal quality and by the Experiencing Scale. The results indicated (a) that therapist productive voice facilitated a shift from poor to productive client voice and a shift from low to intermediate experiencing and (b) that therapist task-specific interventions directed toward resolution facilitated shifts to high experiencing. This task-focused approach to sequential analyses has the potential to yield clinically and theoretically relevant findings. PMID- 2708617 TI - Forty years later: long-term consequences of massive traumatization as manifested by Holocaust survivors from the city and the Kibbutz. AB - The present study explored the differences between male and female Holocaust survivors (n = 34) and controls (n = 34) who were similar to the survivors but had not been victims of the Holocaust. Half of the respondents were from the city and the other half were from the Kibbutz. The main dependent measures included the CAQ, the TSCS, and a specially designed Centrality of Family scale. Survivors were worse off psychologically than comparison individuals on the quality of emotional life, on emotional expression, and on the quality of interpersonal relations. Also, survivors assigned relatively greater value to their postwar families. City survivors seem to be worse off than Kibbutz survivors, and male survivors from the city had the lowest scores on several key subscales. These data were corroborated and extended by a content analysis of an open-ended interview conducted after the objective measures had been completed. The findings and their implications for understanding the effects of massive traumatization over individuals' life cycles are discussed. PMID- 2708618 TI - Cognitive-behavioral treatment of recurrent nonspecific abdominal pain in children: an analysis of generalization, maintenance, and side effects. AB - From 10% to 15% of school-aged children experience recurring abdominal pain. This study evaluated the efficacy of a cognitive-behavioral program for the treatment of nonspecific recurrent abdominal pain (RAP) using a controlled group design. The multicomponent treatment program consisted of differential reinforcement of well behavior, cognitive coping skills training, and various generalization enhancement procedures. Multiple measures of pain intensity and pain behavior were conducted, including children's self-monitoring, parent observation, teacher observation, and observation by independent observers. Results showed that both the experimental and the control groups reduced their levels of pain. However, the treated group improved more quickly, the effects generalized to the school setting, and a larger proportion of subjects were completely pain-free by 3 months follow-up (87.5% vs. 37.5%). There was no evidence for any negative side effects of treatment. PMID- 2708619 TI - Sex bias in the diagnosis of histrionic and antisocial personality disorders. AB - The differential prevalence of the histrionic and antisocial personality disorders among men and women has been attributed both to sex biases and to actual variation in disorder base rates. The present study assessed the bias and base rate explanations and examined whether sex biases are minimized by the relatively explicit diagnostic criteria in the DSM-III. Psychologists (N = 354) either diagnosed 9 DSM-III disorders from case histories that varied in the ambiguity of the antisocial and histrionic personality disorder diagnoses or rated the degree to which specific features extracted from the case histories met 10 histrionic and antisocial diagnostic criteria. The sex of the patient was either male, female, or unspecified. Sex biases were evident for the diagnoses but not for the diagnostic criteria. The results are discussed with respect to base rate effects, sex biases, and the construction of diagnostic criteria. PMID- 2708620 TI - Self-reported hostility as a function of offense characteristics and response style in a sexual offender population. AB - The Buss-Durkee Hostility Inventory (BDHI), the Hostility Toward Women Scale (HTWS), and the Minnesota Multiphasic Personality Inventory (MMPI) Social Desirability and Defensiveness scales were examined in a sample of 239 sexual offenders, 23 of whom had previously been studied. Sexual offenders against adolescents and adults had higher BDHI scores than sexual offenders against children. However, multiple regression equations revealed that the MMPI Defensiveness scale accounted for more of the shared variance in both types of self-reported hostility than did the maturity of the subjects' victims or the level of force used in the commission of the sexual offenses. Social desirability was significantly associated with the HTWS but not with the BDHI. PMID- 2708621 TI - Prediction of eventual suicide in psychiatric inpatients by clinical ratings of hopelessness. AB - A 9-point clinical rating scale was used to assess the severity of hopelessness in 141 patients hospitalized with suicidal ideation. The patients were followed from 5 to 10 years, and 10 (7.1%) eventually committed suicide. The mean hopelessness rating for the patients committing suicide was significantly higher than that for the patients not committing suicide. A cutoff score of 6 or above successfully predicted 9 (90.0%) of those committing suicide. The results supported previous findings in which self-reported hopelessness on the Beck Hopelessness Scale was reported to predict suicide in both psychiatric outpatients and inpatients. PMID- 2708622 TI - Comparison of the Halstead Category Test and the revised Category Test: comment on Russell and Levy. AB - Russell and Levy recently published an article describing a new shortened version of the Halstead Category Test. They compared their revised Category Test (RCAT) with the Category Test (CAT) and reported it to be highly correlated with and as accurate as the CAT in predicting the presence or absence of brain damage. However, they substantially modified the CAT and claimed the two versions to be comparable without having administered the RCAT to a single person. This comment critiques their revision from a theoretical perspective and additionally questions the methodology reported by the authors to establish the RCAT's validity. We conclude that the Russell and Levy modifications of the CAT make the RCAT a new, different, and as yet unvalidated instrument. Suggestions are offered for future research in the area of modifying the CAT or its scoring system. PMID- 2708623 TI - Divisional abstracts, supported by the International College of Dentists. PMID- 2708624 TI - Monitoring for insecticide resistance in field-collected strains of the German cockroach (Dictyoptera: Blattellidae). AB - Forty-five field-collected strains of German cockroaches, Blattella germanica were tested for resistance to 12 different insecticides by the time-mortality response method in comparison with a known susceptible strain. Only low to moderate resistance to diazinon, chlorpyrifos, and acephate was detected. Resistance to malathion was widespread; about half of the strains tested showed high resistance. High resistance to the carbamates propoxur and bendiocarb also occurred. High resistance was uncommon with propoxur, but about 35 strains were highly resistant to bendiocarb. High resistance to pyrethrins was observed in about of the strains tested. Resistance to the pyrethroids allethrin, permethrin, phenothrin, fenvalerate, and cyfluthrin was detected in some of the strains examined. All of the strains tested were susceptible to one or more of the insecticides used. These results indicate that, although resistance is a serious problem in this species, satisfactory control should be possible by selection of an appropriate insecticide. PMID- 2708625 TI - Improved filter paper test for detecting and quantifying increased esterase activity in organophosphate-resistant mosquitoes (Diptera: Culicidae). AB - A previously described filter paper test procedure for detecting of esterases involved in organophosphate insecticide resistance in the Culex pipiens L. complex was modified to permit quantification of esterase activity and resistance in single insects. The new procedure, FP/Est test, was used to survey organophosphate resistance in 11 field collections from seven states. Clear discrimination of increased activity was possible by visual inspection and by densitometric analysis. The proportion of insects with susceptible-like esterase activity was strongly correlated with (and often was not significantly different from) the proportion found to be susceptible by bioassay with chlorpyrifos, temephos, fenthion, and malathion, indicating that the FP/Est test is a reliable method for detecting and monitoring of organophosphate resistance. In addition, the 90th percentile of esterase activity in each collection was significantly correlated with the LC90 of each of the four insecticides, suggesting that the FP/Est test also can be used as a rough estimate of resistance levels. Application of the FP/Est test to monitor resistance caused by increased esterase activity in mosquitoes and agricultural pests is discussed. PMID- 2708626 TI - Parasites that attack stable fly and house fly (Diptera: Muscidae) puparia during the winter on dairies in northwestern Florida. AB - Throughout the winter and early spring months, stable fly, Stomoxys calcitrans (L.), and house fly, Musca domestica L., puparia were collected from silage, hay, and manure from six dairies in northwestern Florida and evaluated for parasitism. Of the puparia producing flies or parasites, 23% of the stable flies and 46% of the house flies were parasitized. The predominant parasite observed attacking muscoid flies (76% for stable flies and 58% for house flies) was Spalangia cameroni Perkins. Muscidifurax sp. was recovered from 11 and 36% of the stable fly and house fly pupae, respectively. Other parasite species encountered were Spalangia endius Walker and S. nigroaenea Curtis. Significantly more parasitized fly pupae were collected from silage than from hay residues or manure. Winter and early spring parasite populations in northwestern Florida appear to be present as long as viable fly pupae are available to support the developing parasites. PMID- 2708627 TI - Circadian rhythm of cat flea (Siphonaptera: Pulicidae) locomotion unaffected by ultrasound. AB - Cat fleas, Ctenocephalides felis (Bouche), had a circadian rhythm of locomotion that peaked during the last 2 h of the photophase and declined to a lower level that was maintained throughout the scotophase. Activity was lowest during the first 8 h of photophase. The circadian rhythm of these fleas was not affected by an ultrasonic pest control device. PMID- 2708628 TI - Reduced productivity in adult yellowfever mosquito (Diptera: Culicidae) populations. AB - Male and female Aedes aegypti (L.) mosquitoes of the laboratory strain ROCK were irradiated with 130 mw of argon 514.5 nm laser microbeams for 0.04, 0.25, 0.4, and 0.5 s, respectively. Egg production, percentage hatch, and productivity (average number of adults surviving after 3 wk) were used to assess mutagenic effects. Mortality was high for males in all laser radiation groups and increased with time of exposure. Except for the group treated for 0.25 s, significant reductions in total F1 progeny also were demonstrated for all other experimentals when male parents were exposed to laser radiation. Females showed a high mortality when subjected to 0.4- and 0.5-s laser radiation. No F1 progeny were produced when parental females were exposed for 0.25, 0.4, and 0.5 s. Numbers of F1 progeny from females exposed to 0.04 s of laser radiation were significantly reduced. A comparison of weekly mean number of progeny showed that the important differences in productivity occurred during the first and second week, respectively, when either male or female adult parents were subjected to laser radiation. PMID- 2708629 TI - Effect of selection pressure on the cholinesterase of Boophilus microplus (Acari: Ixodidae) resistant to coumaphos. AB - The effect of selection pressure on the cholinesterase (AChE) activity of two strains of Boophilus microplus (Canestrini) resistant to coumaphos was monitored. Total AChE and protein was determined from three generations of resistant ticks and a susceptible strain. The effect of an AChE inhibitor, coroxon (the oxygen analog of coumaphos), was also determined. The resistance of the susceptible strain (Escondido) to coumaphos remained relatively unchanged throughout the study. The Tuxpan strain lost some of its resistance to coumaphos as the generations proceeded (AChE increased instead of decreased). The Tuxtla strain became more resistant to coumaphos as the generations proceeded (AChE increased). PMID- 2708630 TI - Walk-through trap for control of horn flies (Diptera: Muscidae) on pastured cattle. AB - A walk-through fly trap designed in 1938 by W. G. Bruce was tested for two field seasons in Missouri. Screened elements along both sides of the device functioned as cone traps, thereby catching horn flies, Haematobia irritans (L.), as they were swept from cattle by strips of carpet hung from the roof. Horn fly control on pastured cattle averaged 54 and 73% when they were afforded access to the trap. Analyses of Diptera captured in the trap indicated that horn flies comprised the most abundant species; face flies, Musca autumnalis De Geer, stable flies, Stomoxys calcitrans (L.), and others were present in smaller numbers. Cattle were not reluctant to use the trap, and no structural problems were observed during the experiment. PMID- 2708631 TI - Relative attractiveness of paired BL and BLB fluorescent bulbs for house and stable flies (Diptera: Muscidae). AB - Blacklight (BL) and blacklight blue (BLB) fluorescent bulbs were combined in an electrocuting fly trap and compared with BL or BLB bulbs alone for fly attraction. Combinations of BL and BLB bulbs did not attract more house flies, Musca domestica, or stable flies, Stomoxys calcitrans than were attracted by BL bulbs used alone. PMID- 2708632 TI - Ovicidal activity of topically applied acaricides against eggs of the southern cattle tick (Acari: Ixodidae). AB - Ovicidal activity of coumaphos, diazinon, dioxathion, chlorpyrifos, and crotoxyphos applied topically at 0.125, 0.25, and 0.5% (AI) to 1-d-old, 10-d-old, and 20-d-old eggs of southern cattle tick, Boophilus microplus (Canestrini), was determined. All acaricides produced some disruption of hatching of eggs in all age classes. Coumaphos, diazinon, dioxathion, and chlorpyrifos were most effective in reducing egg hatch of 1-d-old eggs but had little effect against 10- or 20-d-old eggs. Although crotoxyphos was comparable with other acaricides in reducing hatch in 1-d-old eggs, it caused significantly greater mortality (greater than or equal to 94.6%) in 20-d-old eggs than other compounds tested. Crotoxyphos applied at 0.5% (AI) is the only acaricide tested that provided sufficient ovicidal activity in all three egg age classes (greater than or equal to 85% reduction of hatch). PMID- 2708633 TI - Comment on Holloway and McNally's (1987) "Effects of Anxiety Sensitivity on the Response to Hyperventilation". AB - Holloway and McNally (1987) found that normals with high scores on the Anxiety Sensitivity Index (ASI), an instrument developed to assess beliefs regarding the adverse consequences of anxiety, reported more anxiety and more frequent and intense somatic sensations following hyperventilation than did normals with low scores on the ASI. They concluded that this result provides support for the construct validity of the ASI and thus for the construct of anxiety sensitivity. Nevertheless, we argue that (a) the developers of the ASI have conflated beliefs regarding the adverse consequences of anxiety with fear of these consequences, (b) the accumulated evidence for the construct validity of the ASI is weak, and (c) Holloway and McNally's design and analyses do not permit them to exclude the more parsimonious explanation that trait anxiety accounts for their findings. Implications for research on anxiety sensitivity are discussed. PMID- 2708634 TI - Self-discrepancies in clinical depression and social phobia: cognitive structures that underlie emotional disorders? AB - Previous research indicates that self-discrepancies are cognitive structures that can induce emotional discomfort. The present study compared clinically depressed and social phobic subjects (plus controls) to determine whether different self discrepancies were associated with the two disorders. In Part 1, it was shown that the depressives possessed the greatest discrepancy between their actual and ideal/own self-states, whereas the social phobics possessed the greatest discrepancy between their actual and ought/other self-states. In a later, ostensibly unrelated study, subjects responded verbally to questions about other people while their mood changes, skin conductance responses, and verbalizations were recorded. The questions included attributes from the subject's ideal and ought self-states that were mismatches with attributes from his or her actual self, as well as mismatch attributes from other subjects. Priming with self referential mismatches induced momentary syndromes of dejection or agitation (depending on the type of mismatch). The depressives and social phobics showed the greatest increases in dejection and agitation, respectively, according to their dominant self-discrepancy. The results suggest that specific cognitive structures may underlie clinical depression and anxiety. PMID- 2708635 TI - Depression and marital functioning: an examination of specificity and gender differences. AB - Recent work has emphasized the importance of assessing the marital relationships of depressed persons. The present study was designed to examine the specificity to clinical depression of problematic marital functioning and to assess potential gender differences in the marital relationships and spousal interactions of depressed persons. Depressed psychiatric patients, nondepressed medical patients, and nondepressed community control subjects and their spouses completed measures of marital satisfaction and then participated in a 20-min marital interaction task. Subjects then completed measures assessing their postinteraction mood and perceptions of their spouses, and the interactions were scored with respect to the frequency of occurrence of a number of behaviors. The depressed couples differed from the community controls on virtually every measure of marital functioning. Furthermore, although the medical patients and their spouses also reported marital dissatisfaction and exhibited dysfunctional interactional behavior, only the depressed couples were characterized by negative affect following the interactions and by negative appraisals of their spouses' behaviors. This negative affect was particularly pronounced for the depressed women. Implications of these results are discussed and directions for further research are offered. PMID- 2708636 TI - Psychosis proneness and clinical psychopathology: examination of the correlates of schizotypy. AB - The present report examined the associations between the Perceptual Aberration Scale (PAS), a prominent psychometric index of hypothetical psychosis proneness, and several measures of clinical psychopathology in a nonpsychotic psychiatric sample (N = 101). Patients were examined by experienced clinicians using structured psychiatric interviews to assess DSM-III-R Axis I and II conditions and rated for anxiety, depression, severity of illness, and current adult social competence. Elevated scores on the PAS were most closely associated with anxiety and depression as well as schizotypal, schizoid, avoidant, and obsessive compulsive personality disorder symptomatology. Hierarchical regression analysis identified schizotypal symptoms and anxiety as the two underlying psychopathological processes most useful in explaining variance in PAS scores. Results are interpreted as supporting both the clinical relevance and research utility of the PAS and enhancing the construct validity of Meehl's model of schizotypy. PMID- 2708637 TI - Interpretation of homophones related to threat in anxiety states. AB - In previous studies, we have established that anxiety states are characterized by an attentional bias that favors the processing of threatening stimuli. In the present study we extend this finding to ambiguous stimuli, specifically, homophones with spellings that correspond to either a threatening or a neutral meaning. As predicted, clinically anxious subjects used the threatening spellings relatively more than did controls, whereas recovered subjects were intermediate in this respect. Threatening words were associated with greater skin conductance responses than were neutral words, but the groups did not differ in their electrodermal reactions to homophones. We take these findings as evidence that, although the different meanings of ambiguous stimuli may be processed in parallel by all subjects, an interpretive bias operates such that anxiety-prone individuals tend to become preferentially aware of the more threatening meaning of such events. PMID- 2708638 TI - Interhemispheric transfer in schizophrenics, depressives, and normals with schizoid tendencies. AB - Although several studies suggest that schizophrenics suffer from an impairment in the interhemispheric transfer (IHT) of information, methodological weaknesses in these studies preclude clear interpretation of their results. This study addresses these criticisms in order to provide a clearer test of the IHT theory. Schizophrenics, depressives, normal controls, and normals with schizoid tendencies were assessed on five measures of IHT (verbal and nonverbal dichotic listening, intermanual transfer, bimanual block design, finger sequence repetition) and two measures of unilateral hemispheric processing (lateral eye movements, auditory thresholds). Results consistently failed to support an IHT deficit interpretation of schizophrenia. Schizoid normals had a significantly greater right-ear advantage on verbal dichotic listening than both psychiatric groups, a result suggesting enhanced left-hemisphere activation in schizoid normals. It is concluded that the IHT theory requires stronger empirical substantiation than has been obtained to date to warrant further consideration as a central theory of schizophrenia. PMID- 2708639 TI - What is the mechanism by which suicide attempts predispose to later suicide attempts? A mathematical model. AB - A state dependence model of serial behavior suggests that each occurrence increases the subsequent likelihood of that behavior being repeated. A heterogeneity model, by contrast, suggests that the likelihood of a behavior occurring is predetermined, and uninfluenced by intervening occurrences. We have applied the random-effects probit model of Gibbons and Bock (1987) to examine the fit of the state dependence and heterogeneity models to longitudinal data on suicide attempts by 928 patients with affective disorder. Heterogeneity but not state dependence was required to model these data. The findings suggest that when considering patients with moderate to severe major affective disorder, the clinician should not interpret the absence of any recent suicide attempts to mean that the patient is at relatively low risk for attempting suicide in the future. An implication of the heterogeneity model is that suicide attempts made many years ago may have equal value to recent attempts when estimating an individual's "predisposition" to nonlethal attempts in the future. PMID- 2708640 TI - Failure to find differences in drinking behavior as a function of familial risk for alcoholism: a replication. AB - Groups of high-risk (alcoholic fathers), middle-risk (second-degree alcoholic relatives) and low-risk (no first- or second-degree alcoholic relatives) male college students were compared with respect to drinking behavior, sociodemographic variables, personality, cognitive functioning, and mental health and drug use problems in themselves and in family members. The groups differed significantly on only one of a number of sociodemographic variables. No significant group differences were revealed in drinking behavior, or alcohol related symptoms or consequences. High-risk subjects reported significantly more childhood attentional and social problems than did low-risk subjects. No group differences were found with respect to other childhood problem behaviors, cognitive functioning, subject or family drug use, or mental health problems. The findings are discussed in terms of the questions they raise concerning the results of high-risk studies and the contribution of genetic factors to alcoholism. PMID- 2708641 TI - The effect of subliminal oedipal and competitive stimulation on dart throwing: another miss. AB - Silverman and his associates have reported that subliminal presentation of oedipally relevant competitive stimuli can modify dart-throwing performance in male subjects. This study replicated their paradigm, but also examined the effects on performance of nonoedipal competitive stimuli. Our results failed to support Silverman's. Both types of subliminally presented competitive stimuli failed to have any systematic effect on dart-throwing performance. PMID- 2708642 TI - Is there atypical handedness in schizophrenia? AB - Ninety-three schizophrenic patients and 105 normal controls were tested in a single session on an 8-item repeat-administration handedness test. The schizophrenic group, in contrast to the normal controls, showed a shift in the distribution away from right-handedness, which was due to an increase in the proportion of mixed-handers. Additional analyses revealed that the increase in mixed-handedness was largely due to an increase of within-item variability in the schizophrenic group, which we refer to as ambiguous handedness. Nearly 20% of the schizophrenic patients were inconsistent on 3 or more items compared with 3.8% of the normal controls. This increased incidence of atypical handedness is discussed within the context of disorders of attention and neurodevelopment. PMID- 2708643 TI - Models of positive and negative symptoms in schizophrenia: an empirical evaluation of latent structures. AB - The present investigation empirically evaluated three competing models of the relations between positive and negative symptoms in schizophrenia, namely the severity-liability model (Gottesman, McGuffin, & Farmer, 1987), Andreasen's unidimensional bipolar model (Andreasen & Olsen, 1982), and Crow's independent dual-process model (Crow, 1980a, 1980b). Using positive and negative symptom ratings based on 220 schizophrenic subjects, the results of a LISREL VI (Joreskog & Sorbom, 1984) confirmatory factor analysis revealed that Crow's model of positive and negative symptoms provided the best fit to the observed data among the three models. The severity-liability model provided a modest fit to observed data, and Andreasen's model fit the data poorly. Results are interpreted as supporting the validity of the positive and negative symptom distinction in schizophrenia and as providing substantive empirical support for Crow's independent dual-process model. The methodological advantages of confirmatory factor analysis in the specification and evaluation of theoretical models in experimental and developmental psychopathology are discussed. PMID- 2708644 TI - Hypnotic blindness: a behavioral and experiential analysis. AB - This research examined the influence of visual information on a decision task that subjects were administered during hypnotically suggested blindness. Real, hypnotizable subjects and simulating, unhypnotizable subjects were tested in two experiments. Experiment 1 focused on behavioral responses, and Experiment 2 focused on experiential reactions. In both experiments, the findings indicated that the behavioral responses of reals were influenced by visual information despite their reported blindness. The behavioral responses of reals and simulators were essentially similar. The experiential data in Experiment 2 provided information about the phenomenal nature of subjects' reported blindness. The experimental reactions of reals and simulators were essentially different. The research is discussed in terms of the issues that need to be considered in the development of a model of hypnotic blindness. PMID- 2708645 TI - Maternal depression and child adjustment: a longitudinal analysis. AB - This study examined the relation between maternal depression and child adjustment. Two major issues were addressed. First, to assess the specificity to depression of observed child adjustment difficulties, four groups of female subjects were included: clinically depressed psychiatric patients, nondepressed psychiatric patients, nondepressed medical patients, and nondepressed nonpatients. Second, to assess the stability of the observed effects, data were collected early in the patients' treatment and again approximately 8 weeks later. The results indicated that the depressed mothers described their children as having various behavior problems; interestingly, interviewers also rated these children as demonstrating disturbed behavior. Although the offspring of the depressed mothers were the most impaired children in the sample, the lack of significant differences between children of the depressed and the nondepressed psychiatric patients suggests that child adjustment is more strongly related to the presence of maternal psychopathology than it is to diagnostic status. Finally, children of the psychiatric patients continued to demonstrate problems at the second assessment. Implications of these results for models of depression are discussed, and directions for future research are offered. PMID- 2708646 TI - Relations of sociotropic and autonomous personality characteristics to specific symptoms in depressed patients. AB - A number of writers have suggested that two sets of personality characteristics are associated both with vulnerabilities to depression in response to different classes of events and with different clinical presentations of depression. The present study examined the relations between levels of sociotropic and autonomous personality characteristics and specific, theoretically derived clusters of symptoms in 80 unipolar depressed patients. As was predicted, sociotropy was related to the cluster of symptoms associated with the concept of anxious reactive depression and was unrelated to the autonomous symptoms cluster. In contrast, the predicted relations of autonomous personality characteristics and symptoms were not found. These results support the idea that the symptom picture in depression may be related to personality characteristics, but they also suggest that the measurement of autonomy may require revision. PMID- 2708647 TI - Restraint and internal responsiveness: effects of placebo manipulations of hunger state on eating. AB - Restrained and unrestrained subjects were given a "vitamin" (placebo) prior to an ad-lib taste test. Subjects were either told nothing about the placebo or told that previous subjects had reported that the vitamin had made them feel either hungry or full. As predicted, restrained subjects, in two separate studies, behaved in accordance with placebo messages, eating more when given "hungry" messages than when given "full" messages. Unrestrained subjects showed an apparent reverse-placebo effect; they ate less ice cream when given "hungry" information than when given "full" information. Hunger ratings did not parallel eating behavior; possible explanations for this discrepancy are considered. We conclude that unresponsiveness to internal hunger state, and an overreliance on external cognitive cues, characterizes restrained but not unrestrained individuals. PMID- 2708649 TI - Effects of eating abnormalities and gender on perceptions of desirable body shape. AB - Men and women differ when choosing the figure drawings that most resemble (a) their own current figures (CURRENT), (b) their ideal figures (IDEAL), and (c) the figure thought most attractive to the opposite sex (OPPOSITE) (Fallon & Rozin, 1985). In the present experiment, women with high Eating Attitude Test (EAT) scores, indicating abnormal eating patterns, choose differently from those with low scores. All women's IDEAL and OPPOSITE figures are thinner than their CURRENT figures, whereas men rate all three nearly identically. Only the high-scoring women choose an IDEAL figure thinner than their OPPOSITE. This suggests that whereas men are satisfied with their figures, women desire to be thinner than they think they are, and women with abnormal eating behaviors desire to be even thinner than what they think men find attractive. PMID- 2708648 TI - Depression versus anxiety: a test of the content-specificity hypothesis. AB - Beck's cognitive model predicts that depressed and anxious individuals can be differentiated on the basis of their cognitions regarding their self, world, and future. The present experiment used a trait-rating and incidental recall paradigm to test this "content-specificity" hypothesis. Clinically depressed, anxious, and psychiatric control subjects were presented with depression-relevant and anxiety relevant trait adjectives, and initially judged whether the adjectives were self descriptive prior to a free-recall task. Depressed subjects judged and recalled more negative depression-relevant stimuli than did the anxious and control subjects, and they were the only group to judge and recall more negative than positive depression-relevant stimuli. The anxious subjects recalled more negative than positive anxiety-relevant adjectives. The depressed subjects, however, also showed evidence of biased processing for anxiety-relevant stimuli. The findings were interpreted as providing support for the content-specificity hypothesis for depression, and minimal support of the hypothesis for anxiety. PMID- 2708650 TI - Body-image disturbances in bulimia nervosa: influences of actual body size. AB - This study evaluated body-image distortion and ideal body-size preferences in 423 nonbulimic women and 108 bulimics. Analyses of covariance were utilized to compare the bulimic and nonbulimic groups on measures of current and ideal body size. Weight was used as a covariate to evaluate the influence of actual body size on perception of current body size and selection of ideal body size. Bulimics chose current body sizes that were significantly larger than those picked by nonbulimics regardless of actual body size. Bulimics also chose thinner ideal body sizes than did nonbulimics, regardless of actual body size. These results suggest that body-image distortion and extreme preference for thinness are a fundamental characteristic of bulimia nervosa. These results were discussed in terms of how perception of a large body size and preference for a very thin body size might interact to produce a high degree of dissatisfaction and overconcern with body size in bulimia nervosa. PMID- 2708651 TI - Probability of relapse after recovery from an episode of depression. AB - Examined relapse rates in those individuals who have experienced an episode of unipolar depression as a function of the number of previous episodes, gender, age at onset of the episode (less than 40 vs. greater than 40), time since a previous episode, and depression level at time of interview. From of 6,742 participants, 2,046 were interviewed; of these, 1,130 had at least one, 513 reported a second and 173 reported a third episode. The probability for relapse was positively related to number of previous episodes, being female, depression level at time of interview, but not to age at onset (less than 40 vs. greater than 40). Women were also more likely to have more severe episodes. Participants with elevated depression symptoms reported a greater number of previous episodes. Following the first episode, there was a decline in hazard rate for men but not women; following the second episode, there was no change in vulnerability for men; for women, the results were ambiguous. PMID- 2708652 TI - General behavior inventory identification of unipolar and bipolar affective conditions in a nonclinical university population. AB - Validated the General Behavior Inventory (GBI), revised to identify unipolar as well as bipolar affective conditions, in a nonclinical sample (n = 201) against naive, interview-derived diagnoses. For bipolar and unipolar conditions, respectively, the GBI had high positive (.94, .87) and negative (.99, .93) predictive power with the effect of prevalence considered, adequate sensitivity (.78, .76), high specificity (.99, .99), and adequate selection ratios for sampling of affective and nonaffective subjects from nonclinical populations for research purposes. The utility of the GBI in several different research contexts is discussed. PMID- 2708653 TI - Frontal brain asymmetry predicts infants' response to maternal separation. AB - Examined whether certain features of infant temperament might be related to individual differences in the asymmetry of resting frontal activation. EEG was recorded from the left and right frontal and parietal scalp regions of 13 normal 10-month-old infants. Infant behavior was then observed during a brief period of maternal separation. Those infants who cried in response to maternal separation showed greater right frontal activation during the preceding baseline period compared with infants who did not cry. Frontal activation asymmetry may be a state-independent marker for individual differences in threshold of reactivity to stressful events and vulnerability to particular emotions. PMID- 2708654 TI - The surreptitious observation design: an experimental paradigm for distinguishing artifact from essence in hypnosis. AB - Administered a hypnotic induction and 5 standard hypnotic suggestions twice via audiotape to a group of high-hypnotizable subjects and a group of low hypnotizable simulators. During the first administration, subjects were led to believe that they were alone. However, their behavior was surreptitiously recorded on videotape and observed on a video monitor. The second administration occurred in the presence of an experimenter who had not been informed of group assignment. When unaware that they were being observed, simulators were significantly less responsive to suggestions than they were when openly observed. In contrast, the behavior of nonsimulating subjects was not affected by the presence of an experimenter. These data indicate that the responses of highly hypnotizable subjects to standard hypnotic suggestions cannot be accounted for in terms of simple compliance with experimental demand. PMID- 2708655 TI - Reality versus suggestion: pseudomemory in hypnotizable and simulating subjects. AB - Assigned hypnotizable (N = 56) and simulating Ss (N = 44) to 1 of 4 conditions: heard a phone ring and conversation, received a suggestion to hear a phone ring and conversation, received a suggestion and heard a phone ring and conversation, or neither heard a phone nor received a suggestion. Hypnotizable Ss successfully discriminated objective events from suggested sources of input. When Ss received a suggestion to hear a phone ring, only 11.5% indicated it actually rang in their open-ended reports; in response to a forced-choice question, none did so. In spontaneous reports, none of the hypnotizable Ss who heard a phone ring indicated it was suggested; only one did so in response to a forced-choice item (vs. 2 simulators). In the no-phone/no-suggestion condition, more simulators than hypnotizable Ss indicated that a phone rang or was suggested. PMID- 2708656 TI - Sexual arousal and arousability in a sexual offender population. AB - Assessed penile erections in response to descriptions of consenting sex, rape, and nonsexual assault among 78 inpatient male sexual offenders. All forms of sexual arousal were positively correlated, and sexual arousal to consenting stimuli exceeded arousal to coercive stimuli. Subjects who were able to completely inhibit their arousal exhibited less arousal to sexual assault stimuli than did subjects who were unable to completely inhibit arousal when both groups were not instructed to inhibit arousal. Inhibitory ability covaried with victim maturity, and with months spent in a treatment program. The maturity of the victims in the subjects' sexual offenses was not significantly related to sexual arousal. Thus, sexual offenders' sexual arousal as assessed by physiological measures may be more a function of arousability variables than of actual offending behaviors. PMID- 2708657 TI - The effects of depression on structural aspects of the recall of prose. AB - Investigated depressed patients' memory for stories. This indicated that although normal Ss showed particularly good recall for units central to the structure of the story, this did not hold for depressed Ss. In contrast, effects of centrality were comparable in high- and low-IQ Ss and effects of imageability of story units were comparable in both depressed and normal Ss. These results are consistent with the hypothesis that depressed patients do not use structure to organize stories when encoding them. A failure to identify central aspects of material and selectively recall them is likely to be a handicap to everyday functioning. PMID- 2708658 TI - Sociotropy/autonomy and vulnerability to specific life events in patients with unipolar depression and bipolar disorders. AB - Followed samples of unipolar and bipolar patients for a 6-month period, with independent assessment of symptoms and life events. Patients were initially categorized into subtypes using Beck's Sociotropy/Autonomy Scale, with the prediction that onset or exacerbation of symptoms, as well as more total symptoms, would occur for sociotropic individuals experiencing more negative interpersonal events than achievement events, and for autonomous-achievement patients experiencing more achievement events than interpersonal events. Results were confirmed for unipolars, indicating that the course of disorder was associated with the occurrence of personally meaningful life events, but not for bipolars. Further research is recommended to examine whether the effect is equally robust for both subtypes of unipolars, whether longer study duration may be required for bipolars, and whether a cognitive self-schema mechanism may account for the specific vulnerability to a subset of stressful events. PMID- 2708659 TI - Comparing borderline definitions: DSM-III borderline and schizotypal personality disorders. AB - Compared the two types of borderline disorder formally defined by DSM-III, borderline personality disorder and schizotypal personality disorder, at the diagnostic category and individual criterion level. Unlike previous research in this area, which has focused on inpatient and outpatient populations, the sample was a psychometrically defined, nonpatient sample including Ss meeting DSM-III criteria for each disorder. The results indicated that the two diagnostic categories each define a type of borderline with distinctive combinations of features. Perceptual and cognitive distortion, however, seem to be present in both and define an area of overlap between the two disorders. The implications of these findings for the revision of the SPD diagnostic criteria in DSM-III-R are discussed, and the theoretical separation of two subtypes of borderline personality is affirmed. PMID- 2708660 TI - Hypnosis, the timing of its introduction, and acceptance of misleading information. AB - Allocated independent sets of 16 Ss to a crossed 2 (level of susceptibility: high, low) x 2 (information: misleading, nonmisleading) x 2 (state instruction: hypnosis, walking) design to examine the prediction that hypnosis will facilitate memory distortion when hypnotic instruction precedes the exposure of Ss to incorrect, misleading information. E. F. Loftus's recognition procedures were used to focus on the predicted effect. Free recall was also examined for memory distortion effects. Results indicated the presence of significant memory distortion for both recognition and free-recall memories. The distortion effects accompanying hypnosis, however, were not reliably greater than those accompanying waking instruction. Results are examined in relation to the operation of multiple parameters affecting memory distortion in hypnosis. Pertinent factors include the procedures for testing the effects of distortion and the level of Ss' aptitude for hypnosis. PMID- 2708661 TI - Cerebral laterality and depression: differences in perceptual asymmetry among diagnostic subtypes. AB - Examined the influence of diagnostic subtype of depression on perceptual asymmetry for dichotic listening and visual tachistoscopic tasks. A total of 65 unmedicated patients with major depressive disorders and 30 normal controls were tested on a verbal and nonverbal task in each modality. Patients diagnosed according to the DSM-III with melancholia had abnormal perceptual asymmetry for dichotic nonsense syllable and complex tone tasks. In contrast, patients having a nonmelancholic "atypical depression" (reactivity of mood with preserved pleasure capacity and associated features) did not differ from normal controls on these tasks, but had an increased incidence of left handedness. Bipolar depression (history of hypomania) differed from unipolar depression in showing abnormal perceptual asymmetry for a tachistoscopic dot enumeration task. Alterations of perceptual asymmetry in melancholia and bipolar depression were consistent with hypothesized right hemisphere dysfunction. PMID- 2708662 TI - Dependency, self-criticism, and depressive attributional style. AB - Dependency and self-criticism have been proposed as independent factors in depression. Investigated whether depressive individuals characterized by dependency and self-criticism, respectively, differ with regard to internality of causal attributions for negative events. Sixty psychiatric outpatients completed the Depressive Experiences Questionnaire, the Beck Depression Inventory, the semantic differential, and the Attributional Style Questionnaire. Dependency and self-criticism correlated positively with internality and with each other (p less than .0001). Findings did not support the specificity of dependency and self criticism as subtypes of depression. PMID- 2708663 TI - The validity of the DSM-III posttraumatic stress disorder classification as applied to children. AB - Tested three groups of children: The first group (n = 231) presented with posttraumatic stress disorder (PTSD), the second group (n = 32) presented with simple phobia (i.e., test phobia), and the third group (n = 35) was made up of nonclinical controls. The subjects marked the Revised Children's Manifest Anxiety Scale (RCMAS), Children's Depression Inventory (CDI) and their conduct was rated against the Conners Teacher Rating Scale (CTRS) criteria. A MANOVA evinced significant group and gender differences. No significant interaction effects were noted. Univariate F tests and Bonferroni posttests revealed that the PTSD cases evinced markedly higher RCMAS, CDI, and CTRS scores than their phobic and nonphobic peers. Analogously, the RCMAS and CDI scores of the phobia cases were appreciably greater than the control groups. On the other hand, the CTRS scores of the test phobia and control groups were not significantly different. PMID- 2708664 TI - Is anxiety sensitivity distinguishable from trait anxiety? Reply to Lilienfeld, Jacob, and Turner (1989). AB - Lilienfeld, Jacob, and Turner (1989) questioned the conceptual and empirical distinction between anxiety sensitivity and trait anxiety, and suggested that results attributed to anxiety sensitivity are more parsimoniously explained by trait anxiety. In the present article, I clarify the theoretical distinction between these constructs, and provide further data that support this distinction. PMID- 2708665 TI - An acoustic head simulator for hearing protector evaluation. I: Design and construction. AB - As an alternative to subjective methods, an acoustic head simulator was constructed for hearing protector evaluation. The primary purpose of the device is for hearing protector testing and research under high-level steady-state and impulse noise environments. The design is based on the KEMAR manikin and therefore approximates the physical dimensions and the acoustical eardrum impedance of the median human adult. The head simulator includes a mechanical reproduction of the human circumaural and intraaural tissues with a silicone rubber material. A compliant head-neck system was constructed to approximate the vibrational characteristics of the human head in a sound field in order to simulate the inertia effect of earmuffs. The bone-conducted sounds are not mechanically reproduced in the design. Applications for the device are reported in a companion article [C. Giguere and H. Kunov, J. Acoust. Soc. Am. 85, 1197 1205 (1989)]. PMID- 2708666 TI - An acoustic head simulator for hearing protector evaluation. II: Measurements in steady-state and impulse noise environments. AB - The attenuation characteristics of hearing protection devices (HPDs) were measured using a modular acoustic head simulator. The effect in changes in the head configuration was assessed in a steady-state diffuse sound field. The use of artificial circumaural skin had a relatively small influence on the insertion loss of earmuffs (max. 6-7 dB at low frequencies). This contrasts to the very large effects found for the artificial intraaural skin on the insertion loss of earplugs (in excess of 40 dB at low frequencies for some devices). Results were also compared with real-ear attenuation at threshold (REAT) data (ANSI S3.19 1974). In general, there is good agreement between the two methods, especially for earmuffs. Design improvements are proposed for earplugs. The result of an exploratory study aimed at measuring the complex (amplitude and phase) insertion loss of HPDs using an impulse noise source are also reported. PMID- 2708667 TI - Hazard from weapons impulses: histological and electrophysiological evidence. AB - Current methods of rating the hazard of weapons impulses for the ear have recently been challenged by electrophysiological data from experiments with animal ears which indicate that the hazard from low-frequency impulses is much lower than the hazard from higher frequency impulses (Dancer et al., 1981; Price, 1986b). To supplement these data, histological data are reported here for 51 cats that were exposed on one occasion to either rifle or howitzer impulses at peak pressures from 145 to 155 dB or 153 to 166 dB, respectively. Histological procedures (scanning electron and light microscopy) were carried out over 2 months after the exposure and after electrophysiological measures had been made. For both types of impulse the losses tended to be in the middle of the cochlea in focused lesions, even though the spectral peaks of the acoustic stimuli had been at about 80 Hz (howitzer) and 1000 Hz (rifle). Outer hair cells were more susceptible than the inner hair cells and interindividual differences in effects were large. Furthermore, the two impulse sources were equally hazardous when the peak pressure of the rifle impulse was lower than the peak pressure of the howitzer impulse by about 9 dB. In terms of A-weighted energy, the exposures were equally hazardous when the rifle exposure contained about 35 times less energy than the howitzer exposure. The histological data are thus consistent with the electrophysiological data, which indicate that present standards for impulse noise exposure may overrate the hazard of low-frequency impulses relative to impulses in the midrange. PMID- 2708668 TI - Noise susceptibility and immunity of phase locking in amphibian auditory-nerve fibers. AB - Recordings from auditory-nerve fibers in the anesthetized frog revealed that addition of broadband noise results in a reduction in the ability of a fiber to phase lock to a continuous pure tone. In particular, our results suggest that: (i) there is a threshold below which masking noise has little or no effect on vector strength (VS); then with increasing masking noise level, VS appears to decrease monotonically for all test frequencies (TFs); (ii) there exist subpopulations of auditory-nerve fibers in the frog for which the deterioration of phase locking to tones in wideband noise depends critically on the relationship of the TF to the fiber's CF. Specifically, in one subpopulation (43% of the fibers studied), the rate of VS decrease with increasing levels of masking noise is greater for CF tones than it is for TFs greater than CF. The net result is a "crossing" of the VS versus masking noise functions (e.g., Fig. 6); (iii) there exists a small subpopulation of amphibian papillar (a.p.) fibers for which the rate of VS decrease with increasing levels of masking noise is less for TFs less than CF than it is for CF tones (e.g., Fig. 5); (iv) there is a pronounced noise-induced phase lead for TFs greater than CF, whereas, for stimulus tones at or below CF, the preferred firing phase is nearly noise-level independent; (v) the remainder of the sample consists of fibers in which the VS-falloff rates appear to be test-frequency independent; (vi) addition of wideband masking noise to a CF tone, and increasing the CF-tone level in the absence of noise, produced (qualitatively) similar effects on the preferred firing phase of auditory-nerve fibers (e.g., Figs. 1 and 7). Thus amphibian auditory-nerve fibers appear to be energy detectors, i.e., exhibit phase shifts corresponding to the total energy within the filter passband defined by the frequency-threshold curve. PMID- 2708669 TI - Detection of temporal gaps in sinusoids by normally hearing and hearing-impaired subjects. AB - A two-alternative forced-choice task was used to measure psychometric functions for the detection of temporal gaps in a 1-kHz, 400-ms sinusoidal signal. The signal always started and finished at a positive-going zero crossing, and the gap duration was varied from 0.5 to 6.0 ms in 0.5-ms steps. The signal level was 80 dB SPL, and a spectrally shaped noise was used to mask splatter associated with the abrupt onset and offset of the signal. Two subjects with normal hearing, two subjects with unilateral cochlear hearing loss, and two subjects with bilateral cochlear hearing loss were tested. The impaired ears had confirmed reductions in frequency selectivity at 1 kHz. For the normal ears, the psychometric functions were nonmonotonic, showing minima for gap durations corresponding to integer multiples of the signal period (n ms, where n is a positive integer) and maxima for durations corresponding to (n - 0.5) ms. For the impaired ears, the psychometric functions showed only small (nonsignificant) nonmonotonicities. Performance overall was slightly worse for the impaired than for the normal ears. The main features of the results could be accounted for using a model consisting of a bandpass filter (the auditory filter), a square-law device, and a sliding temporal integrator. Consistent with the data, the model demonstrates that, although a broader auditory filter has a faster transient response, this does not necessarily lead to improved performance in a gap detection task. The model also indicates that gap thresholds do not provide a direct measure of temporal resolution, since they depend at least partly on intensity resolution. PMID- 2708670 TI - Comodulation masking release using SAM tonal complex maskers: effects of modulation depth and signal position. AB - The purpose of this investigation was to examine two stimulus parameters that were reasoned to be of importance to comodulation masking release (CMR). The first was the degree of fluctuation, or depth of modulation, in the masker bands, and the second was the temporal position of the signal with respect to the modulations of the masker. The investigation began by demonstrating the efficacy of sinusoidally amplitude-modulated (SAM) tonal complex maskers in eliciting CMR. "Nine-band" maskers, 650 ms in duration, were constructed by adding together nine SAM tones spaced at 100-Hz intervals from 300 to 1100 Hz. The rate of modulation for each SAM tone was 10 Hz, and the depth of modulation was 100%. Using such maskers, it was shown that when the on-frequency SAM tone had a modulation depth of 100%, the threshold for a 250-ms, 700-Hz tone improved monotonically as the modulation depths of the flanking SAM tones increased from 0% to 100%. When the on-frequency SAM tone had a modulation depth of 63%, some listeners performed optimally when the flanking SAM tones also exhibited a modulation depth of 63%, whereas others performed best when the flankers had modulation depths of 100%. With regard to signal position, a typical CMR effect was observed when the signal, consisting of a train of three 50-ms, 700-Hz tone bursts, was placed in the dips of the on-frequency masker. However, when the signal was placed at the peaks of the envelope, an increase in masking was observed for a comodulated masker.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708671 TI - Detection thresholds for sinusoidal frequency modulation. AB - An adaptive forced-choice procedure was used to measure, in four normal-hearing subjects, detection thresholds for sinusoidal frequency modulation as a function of carrier frequency (fc, from 250 to 4000 Hz) and modulation frequency (fmod. from 1 to 64 Hz). The results show that, for a wide range of fmod values, fc and fmod have almost independent effects on the thresholds when the thresholds are expressed as just-noticeable frequency swings and plotted on a log scale. In two subjects, the effect of fc on the thresholds was compared to the effect of standard frequency on the frequency just noticeable differences (jnd's) of successive and steady tones. In agreement with previous data [H. Fastl, J. Acoust. Soc. Am. 63, 275-277 (1978)], it was found that the two effects are significantly different if the frequency jnd's are measured with long-duration tones. However, it was also found that the two effects are similar if the frequency jnd's are measured with 25-ms tones. These results support the idea that, at least for low fmod values, the detection of continuous and periodic frequency modulations is mediated by a pitch-sampling process using a temporal window of about 25 ms. PMID- 2708672 TI - Frequency difference limens in normal and sensorineural hearing impaired chinchillas. AB - This study assessed normal frequency discrimination ability in the chinchilla and determined how this ability changes as a function of an experimentally induced sensorineural hearing loss. Four chinchillas were trained by the methods of positive reinforcement to report absolute thresholds and frequency difference limens (FDLs). Subjects were then treated with the aminoglycosidic antibiotic amikacin until a 30-dB hearing loss was measured at 10.0 kHz. Absolute and frequency difference thresholds were determined during and after drug treatment. When post-drug thresholds had stabilized, subjects were sacrificed and their cochleas stained, embedded in plastic, microdissected, and viewed with phase contrast microscopy to permit examination of the cochlear tissue. Post-drug data suggest that frequency discrimination at a high frequency is unaffected by a 40- to 45-dB sensorineural hearing loss, considerable hair cell damage, and the resultant disruption of the cochlear micromechanics. The data, in concert with previously published reports, suggest that FDLs may be less affected by a high frequency sensorineural hearing loss than by a low-frequency sensorineural hearing loss. PMID- 2708673 TI - The cricothyroid muscle in voicing control. AB - Initiation and maintenance of vibrations of the vocal folds require suitable conditions of adduction, longitudinal tension, and transglottal airflow. Thus manipulation of adduction/abduction, stiffening/slackening, or degree of transglottal flow may, in principle, be used to determine the voicing status of a speech segment. This study explores the control of voicing and voicelessness in speech with particular reference to the role of changes in the longitudinal tension of the vocal folds, as indicated by cricothyroid (CT) muscle activity. Electromyographic recordings were made from the CT muscle in two speakers of American English and one speaker of Dutch. The linguistic material consisted of reiterant speech made up of CV syllables where the consonants were voiced and voiceless stops, fricatives, and affricates. Comparison of CT activity associated with the voiced and voiceless consonants indicated a higher level for the voiceless consonants than for their voiced cognates. Measurements of the fundamental frequency (F0) at the beginning of a vowel following the consonant show the common pattern of higher F0 after voiceless consonants. For one subject, there was no difference in cricothyroid activity for voiced and voiceless affricates; in this case, the consonant-induced variations in the F0 of the following vowel were also less robust. Consideration of timing relationships between the EMG curves for voiced and voiceless consonants suggests that the differences most likely reflect control of vocal-fold tension for maintenance or suppression of phonatory vibrations. The same mechanism also seems to contribute to the well-known difference in F0 at the beginning of vowels following voiced and voiceless consonants. PMID- 2708674 TI - Performance characterization of human pitch control system: an acoustic approach. AB - The performance of the human pitch control system was characterized by measurement of the speed of pitch shift and pitch shift response speed (inverse of reaction time) at various initial pitch and loudness levels. Data from three nonsinger adult male subjects and one professional singer suggest a strong inverse correlation (r greater than 0.78) between initial pitch and rate of pitch rise. This study showed no significant relation between initial loudness and rate of pitch rise. Also, vocal response speed showed no significant relation with either initial pitch or loudness. However, it is suggested that pitch shift response speed might be related to the second formant frequency of the target vowel. A composite index of pitch control performance capacity was defined as the product of response speed and vocal fold contractile velocity. From experimental data, the composite index was able to reflect a distinct 74% superior performance by the professional singer (relative to the average maximum performance capacity of nonsingers). It is suggested that the product-based composite index of performance capacity can serve as a sensitive means for vocal proficiency determination. PMID- 2708675 TI - Comments on "Speech Understanding and Aging". AB - The hypothesis advanced by the CHABA Working Group on Speech Understanding and Aging [J. Acoust. Soc. Am. 83, 859-895 (1986)] that the systematic decline in speech understanding with age might be explained by concomitant decline in extra auditory cognitive factors was tested by examining speech audiometric findings in patients with dementia. The fact that performance was consistent with normal central auditory function in 12 of 23 such patients, in spite of deficits in immediate memory for spoken material, tolerance of distraction, mental tracking and sequencing, cognitive flexibility, and set shifting argues against the hypothesis that speech understanding deficits in the elderly can be explained as the simple consequence of cognitive decline. PMID- 2708676 TI - Is it necessary to measure hearing protector attenuation at 3.15 and 6.3 kHz? AB - The real-ear attenuation data for 81 different hearing protectors were analyzed with respect to the errors that would arise if, instead of averaging the 1/3 octave-band results at 3.15 and 4 kHz and 6.3 and 8 kHz, respectively, the octave band attenuation at 4 and 8 kHz was estimated from only the 1/3-octave-band data at those two frequencies. Errors as large as 3-4 dB were found to occur in rare instances, but more typically were in the range of 0.5-1.5 dB. However, in terms of computation of an overall noise reduction rating such as the NRR, the effect of excluding the 3.15- and 6.3-kHz data led to errors that averaged only 0.1 dB and never exceeded 0.3 dB, except in one instance, where the error was 0.6 dB. It was concluded that there is little value in measuring real-ear attenuation in a diffuse sound field at the frequencies of 3.15 and 6.3 kHz for applications in which hearing protector attenuation data are normally utilized. PMID- 2708677 TI - Calculation of a "narrowed" autocorrelation function. AB - A method of calculating an autocorrelation function with extremely narrow peaks is described. This is done by including terms in the autocorrelation expression corresponding to delays at 2 tau, 3 tau, etc., in addition to the usual term with delay tau. Implications in the frequency domain are explored. Graphs of this autocorrelation function for a number of violin sound samples, including a two octave scale, vibrato, and glissando, are presented. Graphs of the autocorrelation function for some synthetic sound samples are also included. PMID- 2708678 TI - Effects of acoustic overstimulation on spectral and temporal processing in the amphibian auditory nerve. AB - Activity of isolated auditory-nerve fibers in tree frogs (Eleutherodactylus coqui) exposed to continuous 3-min tones of different intensities at their characteristic frequencies (CFs) was recorded. Period histograms show a retardation in the preferred phase of discharge during and after the cessation of the exposure. Postexposure phase shift is concomitant with an elevation in CF thresholds and related to the level of tone exposure above threshold. Vector strength does not show comparable trends of change; postexposure shifts are related to preexposure CF thresholds. Recovery of phase retardation is rapid; units exposed to successive 3-min tones of the same intensities with intervals of 10-14 min between exposures experienced similar changes in their patterns of temporal discharge. Micromechanical changes affecting stereocilia stiffness or structural alterations in the tectorial membrane of the amphibian papilla may underly the transitory phase shifts observed in traumatized anuran auditory fibers. PMID- 2708679 TI - Temporal resolution in frog auditory-nerve fibers. AB - Sinusoidally amplitude-modulated (SAM) noise was monaurally presented to the neotropical frog, Eleutherodactylus coqui, while recording intracellularly from auditory-nerve fibers. Neuronal phase locking was measured to the SAM noise envelope in the form of a period histogram. The modulation depth was changed (in 10% steps) until the threshold modulation depth was determined. This was repeated for various modulation frequencies (20-1200 Hz) and different levels of SAM noise (34-64 dB/Hz). From these data, temporal modulation transfer functions (TMTFs) were produced and minimum integration time (MIT) for each auditory fiber was calculated. The median MIT was 0.42 ms (lower quartile 0.32, upper quartile 0.68 ms). A noise level-dependent effect was noted on the shape of the TMTF as well as the minimum integration time. The latter results may be explained as a loss in spectral resolution with increasing noise level, which is consistent with the correlation that was found between minimum integration time and bandwidth. PMID- 2708680 TI - Responses of "high-spontaneous" auditory-nerve fibers to consonant-vowel syllables in noise. AB - Responses of "high-spontaneous" single auditory-nerve fibers in anesthetized cat to nine different spoken stop and nasal consonant-vowel syllables presented in four different levels of speech-shaped noise are reported. The temporal information contained in the responses was analyzed using "composite" spectrograms and pseudo-3D spatial-frequency plots. Spectral characteristics of both consonant and vowel segments of the CV syllables were strongly encoded at S/N ratios of 30 and 20 dB. At S/N = 10 dB, formant information during the vowel segments was all that was reliably detectable in most cases. Even at S/N = 0 dB, most vowel formants were detectable, but only with relatively long analysis windows (40 ms). The increases (and decreases) in discharge rate during various phases of the responses were also determined. The rate responses to the "release" and to the voicing of the stop-consonant syllables were quite robust, being detectable at least half of the time, even at the highest noise level. Comparisons with psychoacoustic studies using similar stimuli are made. PMID- 2708681 TI - Temporal overshoot in simultaneous-masked psychophysical tuning curves from normal and hearing-impaired listeners. AB - Simultaneous-masked psychophysical tuning curves (PTCs) were obtained from normal hearing and sensorineural hearing-impaired listeners. The 20-ms signal was presented at the onset or at the temporal center of the 400-ms masker. For the normal-hearing listeners, as shown previously [S. P. Bacon and B. C. J. Moore, J. Acoust. Soc. Am. 80, 1638-1645 (1986)], the PTCs were sharper on the high frequency side for a signal in the temporal center of the masker. For the hearing impaired listeners, however, the shape of the PTC was virtually independent of the temporal position of the signal. These data suggest that the mechanisms responsible for sharpening the PTC with time in normal-hearing listeners are ineffective in listeners with moderate-to-severe sensorineural hearing loss. PMID- 2708682 TI - Auditory filter characteristics and consonant recognition for hearing-impaired listeners. AB - To examine the association between frequency resolution and speech recognition, auditory filter parameters and stop-consonant recognition were determined for 9 normal-hearing and 24 hearing-impaired subjects. In an earlier investigation, the relationship between stop-consonant recognition and the articulation index (AI) had been established on normal-hearing listeners. Based on AI predictions, speech presentation levels for each subject in this experiment were selected to obtain a wide range of recognition scores. This strategy provides a method of interpreting speech-recognition performance among listeners who vary in magnitude and configuration of hearing loss by assuming that conditions which yield equal audible spectra will result in equivalent performance. It was reasoned that an association between frequency resolution and consonant recognition may be more appropriately estimated if hearing-impaired listeners' performance was measured under conditions that assured equivalent audibility of the speech stimuli. Derived auditory filter parameters indicated that filter widths and dynamic ranges were strongly associated with threshold. Stop-consonant recognition scores for most hearing-impaired listeners were not significantly poorer than predicted by the AI model. Furthermore, differences between observed recognition scores and those predicted by the AI were not associated with auditory filter characteristics, suggesting that frequency resolution and speech recognition may appear to be associated primarily because both are degraded by threshold elevation. PMID- 2708683 TI - Frequency selectivity in amplitude-modulation detection. PMID- 2708684 TI - The growth of and recovery from TTS in human subjects exposed to impact noise. AB - It is now recognized that temporary threshold shift (TTS) grows to an asymptotic level (ATS) after a prolonged exposure to steady-state and intermittent noise. Few studies have been conducted to verify this process of acquisition for impact noise. However, results obtained on animals have demonstrated that an asymptote is reached after 1-2 h of exposure. These results have been confirmed in the present study on four human subjects using a 470-ms (B duration) impact noise at a rate of 1 pps. The above pattern of acquisition has been retested on two subjects exposed to the same impact for periods of 15-150 min. An ATS of 15-20 dB was measured (Lp = 102-104 dBA) after 30-60 min of exposure. Recovery curves were determined for each exposure duration. They appeared to follow a logarithmic function of post-exposure time. It took from 30-50 min for one subject and from 4 5 h for the other to completely recover. The time for total recovery did not seem to vary as a function of exposure time. Implications are drawn for damage risk criteria and for the study of the effects of impact noise on hearing. PMID- 2708685 TI - Frequency discrimination near the spectral edge of simultaneous and forward maskers. AB - The effects of the presence of an amplitude discontinuity in the spectrum of a noise masker on frequency discrimination performance were examined. First, detection thresholds as a function of masker level were obtained for pure-tone signals masked by either simultaneous or forward white and low-pass maskers. Then frequency discrimination thresholds were obtained using four masker levels that were chosen to yield predetermined masked thresholds, with signal levels corresponding to each of three sensation levels above these masked thresholds. The principal results indicate that frequency discrimination is poorer in simultaneous low-pass noise than in simultaneous white noise, and that this difference in performance increases with increasing sensation level and with increasing masker level. These results are inconsistent with an explanation based on the pitches generated at spectral edges ("edge pitch"), pitch shifts, or disruption of phase-locking information, but are generally consistent with an explanation based on lateral suppression. It is proposed that a release from suppression may occur in filtered noise backgrounds at high noise levels and at high sensation levels. The reduced suppression may result in poorer frequency discrimination due, in part, to reduced signal detectability. PMID- 2708687 TI - Vocal fundamental frequency characteristics during the first two years of life. AB - Vocal fundamental frequency (Fo) characteristics were sampled for a group of seven young children. The children were followed longitudinally for a 12-month period, spanning preword, single-word, and multiword vocalizations. The Fo characteristics were analyzed with reference to chronological age, vocalization length, and lexicon size. Measures of average Fo and Fo variability changed little during the 12-month period for each child. A rising-falling intonation contour was the most prevalent Fo contour among the children. In general, the influence of vocalization length and language acquisition on measures of Fo was negligible. It is suggested that relative uniformity in vocal Fo exists in early vocalizations across preword and meaningful speech periods. PMID- 2708686 TI - Physiologic and acoustic differences between male and female voices. AB - Comparison is drawn between male and female larynges on the basis of overall size, vocal fold membranous length, elastic properties of tissue, and prephonatory glottal shape. Two scale factors are proposed that are useful for explaining differences in fundamental frequency, sound power, mean airflow, and glottal efficiency. Fundamental frequency is scaled primarily according to the membranous length of the vocal folds (scale factor of 1.6), whereas mean airflow, sound power, glottal efficiency, and amplitude of vibration include another scale factor (1.2) that relates to overall larynx size. Some explanations are given for observed sex differences in glottographic waveforms. In particular, the simulated (computer-modeled) vocal fold contact area is used to infer male-female differences in the shape of the glottis. The female glottis appears to converge more linearly (from bottom to top) than the male glottis, primarily because of medial surface bulging of the male vocal folds. PMID- 2708688 TI - Duration of frication noise required for identification of English fricatives. AB - Natural speech consonant-vowel (CV) syllables [( f, s, theta, s, v, z, o] followed by [i, u, a]) were computer edited to include 20-70 ms of their frication noise in 10-ms steps as measured from their onset, as well as the entire frication noise. These stimuli, and the entire syllables, were presented to 12 subjects for consonant identification. Results show that the listener does not require the entire fricative-vowel syllable in order to correctly perceive a fricative. The required frication duration depends on the particular fricative, ranging from approximately 30 ms for [s, z] to 50 ms for [f, s, v], while [theta, o] are identified with reasonable accuracy in only the full frication and syllable conditions. Analysis in terms of the linguistic features of voicing, place, and manner of articulation revealed that fricative identification in terms of place of articulation is much more affected by a decrease in frication duration than identification in terms of voicing and manner of articulation. PMID- 2708689 TI - Perceptual differences between vowels located in a limited phonetic space. AB - The perception of subphonemic differences between vowels was investigated using multidimensional scaling techniques. Three experiments were conducted with natural-sounding synthetic stimuli generated by linear predictive coding (LPC) formant synthesizers. In the first experiment, vowel sets near the pairs (i-I), (epsilon-ae), or (u-U) were synthesized containing 11 vowels each. Listeners judged the dissimilarities between all pairs of vowels within a set several times. These perceptual differences were mapped into distances between the vowels in an n-dimensional space using two-way multidimensional scaling. Results for each vowel set showed that the physical stimulus space, which was specified by the two parameters F1 and F2, was always mapped into a two-dimensional perceptual space. The best metric for modeling the perceptual distances was the Euclidean distance between F1 and F2 in barks. The second experiment investigated the perception of the same vowels from the first experiment, but embedded in a consonantal context. Following the same procedures as experiment 1, listeners' perception of the (bv) dissimilarities was not different from their perception of the isolated vowel dissimilarities. The third experiment investigated dissimilarity judgments for the three vowels (ae-alpha-lambda) located symmetrically in the F1 X F2 vowel space. While the perceptual space was again two dimensional, the influence of phonetic identity on vowel difference judgments was observed. Implications for determining metrics for subphonemic vowel differences using multidimensional scaling are discussed. PMID- 2708690 TI - Could temporal order differences underlie 2-month-olds' discrimination of English voicing contrasts? AB - Previous studies have shown that infants discriminate voice onset time (VOT) differences for certain speech contrasts categorically. In addition, investigations of nonspeech processing by infants also yield evidence of categorical discrimination of temporal-order differences. These findings have led some researchers to argue that common auditory mechanisms underlie the infant's discrimination of timing differences in speech and nonspeech contrasts [e.g., Jusczyk et al., J. Acoust. Soc. Am. 67, 262-270 (1980)]. Nevertheless, some discrepancies in the location of the infant's category boundaries for different kinds of contrasts have been noted [e.g., Eilers et al. (1980)]. Because different procedures were used to study the different kinds of contrasts, interpretation of the discrepancies between the studies has been difficult. In the present study, three different continua were examined: [ba]-[pa] stimuli, which differed in VOT; [du]-[tu] stimuli, which differed in VOT but which lacked format transitions; nonspeech formant onset time (FOT) stimuli that varied in the time that lower harmonics increased in amplitude. An experiment with adults indicated a close match between the perceptual boundaries for the three series. Similarly, tests with 2-month-old infants using high amplitude sucking procedure yielded estimates of perceptual category boundaries at between 20 and 40 ms for all three stimulus series. PMID- 2708691 TI - Minimum audible movement angle: marking the end points of the path traveled by a moving sound source. AB - Four experienced subjects were tested on their ability to discriminate the direction of motion or the order of events in a single-interval, two-alternative, forced-choice adaptive paradigm. Two conditions, employing a broadband "pink" noise (500-8000 Hz), were examined: (1) A continuous noise was available from the moving sound source during the entire period of travel; and (2) 10-ms noise pulses were presented from the moving source at the beginning and end of the arc traveled (during the interpulse interval the source was inactive). Minimum audible movement angle (MAMA) thresholds were significantly lower when the moving source was active throughout the period of travel (0.914 degrees) than when only the end points of the arc of travel were "marked" (1.604 degrees). These results do not support the notion that the discrimination of motion can be reduced to a simple comparison of the location of the source at signal onset and the position of the source at signal offset. The MAMA thresholds obtained with broadband noise in the current experiment are considerably lower than the thresholds previously observed with tonal targets. PMID- 2708692 TI - Comments on "Earphones in Audiometry" [Zwislocki et al., J. Acoust. Soc. Am. 83, 1688-1689 (1988)]. AB - The Zwislocki et al. ["Earphones in Audiometry," J. Acoust. Soc. Am. 83, 1688 1689 (1988)] Letter to the Editor states that insert earphones have some unresolved technical problems, such as limited frequency response, limited dynamic range and power handling capability, intersubject variability, and hygiene safety. In evaluating circumaural earphones, Zwislocki et al. say that the lack of a standard coupler disqualifies them for audiometry. Since this letter carries the weight of a CHABA committee recommendation, these issues are commented on herein. Section I was written primarily by Mead Killion and Sec. II primarily by Edgar Villchur. For brevity throughout, the authors of the Zwislocki et al. letter will be referred to as "the authors." PMID- 2708693 TI - Crime on campus: is it a policy issue? PMID- 2708694 TI - Establishing a research program and teaching undergraduates: are they compatible? PMID- 2708695 TI - 'Reductionism' or invisibility for nursing? PMID- 2708696 TI - Frances Payne Bolton School of Nursing's new paradigm for international health: think globally and act locally. PMID- 2708697 TI - Liability for cost containment? PMID- 2708698 TI - Issues surrounding RN/BSN education: a view from nursing service. PMID- 2708699 TI - Why do we care? PMID- 2708700 TI - Professional practice for the extended care environment: learning from one model and its implementation. AB - This article describes a model of professional nursing governance in an 800-bed long-term care facility and discusses the model's implications for nursing education. Seventy registered nurses, 330 ancillary staff, and 50 other health professionals provide care for about 100 residential, 350 intermediate, and 350 skilled nursing care patients in the facility. The governance model includes a registered nurse organization that determines all standards for nursing practice, policies governing practice, and nursing clinical programming. Each registered nurse has 24-hour, seven-days-a-week authority and accountability for a patient caseload. Average annual turnover of registered nurses is 5 per cent, and the average length of employment among the nurses is 7.5 years. Since the model was implemented, measures of patient welfare have increased. Experience with the governance model indicates that nursing education curricula need to increase students' (1) understanding of professional autonomy and accountability, (2) understanding of the role of nursing diagnoses and interventions to structure nursing knowledge, (3) skills of diagnostic and intervention reasoning, (4) consensus decision-making abilities, (5) knowledge of organizational structures and mechanisms for governance, and (6) mastery of technical intervention skills. PMID- 2708701 TI - The issue of aging faculty in higher education. AB - The aging of faculty in higher education is upon us. Certain features of the trend could become problematic over the next 20 years. This issue holds particular relevance for nurse educators as they strive to establish and maintain a foothold in the collegiate milieu, simultaneously facing the impact of the aging trend and associated events. In addition to consideration of the ramifications of the aging faculty and with particular regard for nursing faculty in higher education, certain strategies may be available to allay the detrimental outcomes often associated with the issue of aging faculty in higher education. PMID- 2708702 TI - Knowledge and attitudes about acquired immunodeficiency syndrome in nursing and nonnursing groups. AB - A study was undertaken to determine the difference in knowledge and attitudes about acquired immunodeficiency syndrome (AIDS) in nursing and nonnursing groups, and to determine the effect that knowledge acquisition would have on attitudes about AIDS. The total study population consisted of 60 registered nurses, 50 baccalaureate nursing students, 42 liberal arts college students, and 30 nonnurse adults. An AIDS knowledge and attitude assess test was developed and used in the study. Univariate descriptive methodology, descriptive correlational analysis, and a pretest-posttest design were used. Phase I showed that professional nurses with graduate degrees have the highest knowledge base and the most positive attitudes about AIDS; and that nursing students' attitudes are more similar to the attitudes of nonnursing students than of professional nurses. Phase II showed that people's attitudes about AIDS could be changed by increasing their knowledge levels, and nursing students showed more increase in knowledge and more significant changes in attitudes following education than liberal arts college students. PMID- 2708703 TI - Exploring the future of clinical dental ethics: a summary of the Odontographic Society of Chicago Centennial Symposium. PMID- 2708704 TI - Leadership. Convocation address. PMID- 2708705 TI - The role of the practitioner in leadership. PMID- 2708706 TI - Leadership role in education. PMID- 2708707 TI - Moral dimensions of leadership. PMID- 2708708 TI - The health professional as a citizen. PMID- 2708709 TI - Campaign for the 90's--a success story. PMID- 2708710 TI - The future of dental practice. PMID- 2708711 TI - Factors influencing future dental practice. PMID- 2708712 TI - The impact of advances in research. PMID- 2708713 TI - The future for dental schools. PMID- 2708714 TI - Chemical dependency. There are 18,000 dentists who need our special attention (Part I). PMID- 2708715 TI - An open letter to the profession. PMID- 2708716 TI - Fluoride gels. PMID- 2708717 TI - Red man syndrome. PMID- 2708718 TI - Problems of recent graduates. PMID- 2708719 TI - Ethics and patient initiative. PMID- 2708720 TI - Buying back the dream. PMID- 2708721 TI - The dental work force: meeting the public's and the profession's needs. PMID- 2708722 TI - In the beginning: the young dentist. PMID- 2708723 TI - Allergic reaction to orthodontic wire: report of case. AB - This case illustrates the importance of a thorough clinical history and the benefit of histopathologic examination. The history of contact allergy to jewelry provided an early clue, and the microscopic features confirmed the clinical impression of allergic stomatitis. PMID- 2708724 TI - Multiple external root resorption. AB - Presented is an unusual case of multiple external root resorption. Although the cause of this resorption was not determined, several possibilities are presented. Trauma from occlusion, periodontal and pulpal inflammation, and resorption of idiopathic origin are all discussed as possible causes. PMID- 2708725 TI - The effect of L-tryptophan supplementation and dietary instruction on chronic myofascial pain. AB - Effects of L-tryptophan supplementation and dietary manipulation were tested on patients with chronic myofascial pain around the temporomandibular joints. In this study, however, reduction of chronic pain reported in previous similar studies was not duplicated. No significant reduction in pain was noted in the groups receiving tryptophan and dietary manipulation compared with control groups. PMID- 2708726 TI - Well-circumscribed, radiopaque, and radiolucent lesion of the anterior maxilla. AB - In the case reported here, compound composite odontoma was found in a 63-year-old man. Considering the growth characteristics of odontoma, it is likely that this lesion was of at least 45-50 years' duration. The typically asymptomatic nature of the odontoma and its location, apical to the canine and lateral incisor roots, explain why it was not noticed by the patient nor detected by a dentist for many years. Because definitive diagnosis of odontoma is possible only after histopathological examination of the lesion, surgical excision is advised. PMID- 2708727 TI - Report of dental society program activity regarding liaison with dental assisting, hygiene, and laboratory technology organizations. Council on Dental Practice. AB - With underlying changes in population demographics and dental practice patterns, as discussed in the joint report (Reports 1988: 117), there appears to be an increased need to continue to monitor and develop activities related to dental staff manpower. Results of this liaison survey can be used to assist in that manpower planning. It can be seen from these survey responses that constituent and component dental societies are logically dividing the program activities among the ADA, state, and local groups. For example, ADA and national resources are available for overall problem identification and membership surveys. States are primarily conducting committee meetings with organizations, publishing articles and presenting seminars. Activities such as health fairs and scholarship programs are easily developed and conducted locally. States are urged to communicate freely with local and ADA organizations to ensure that duplication of activities and resources is minimized. PMID- 2708728 TI - Dietary influences on cardiovascular disease risk in anabolic steroid-using and nonusing bodybuilders. AB - Recent studies have described an association between high-risk lipoprotein profiles and anabolic steroid abuse by athletes. However, none have included a comprehensive evaluation of diet as a confounding variable. The risk of cardiovascular disease (CVD) and its associations with drug abuse, dietary patterns, and training regimens were evaluated in 18 steroid-using (SU) and 17 non-steroid-using (NSU; no history of drug use or greater than or equal to 1 year drug-free) male bodybuilders. CVD risk was also evaluated in 10 control males. Fasting serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL) and HDL subfractions 2 and 3, low-density (LDL) and very-low-density (VLDL) lipoprotein cholesterol, apoproteins (APO) A-1 and B, and triglycerides (TG) were analyzed at baseline (greater than or equal to 6 months drug-free) and the peak of steroid self-administration in SU. NSU were tested at similar times. Baseline CVD risk factor ratios (TC/HDL) were elevated (greater than 4.97) in 44% of SU and 24% of NSU. When baseline LDL and HDL values were compared to National Cholesterol Education Program CVD risk guidelines, these percentages stayed the same. At the peak of steroid administration significant changes were observed in LDL (22% increase), HDL (63% decrease), HDL-2 (86% decrease), HDL-3 (54% decrease), and TC/HDL (85% increase). No similar measures were observed among NSU or controls. Diets of all bodybuilders were similar, and included a daily intake of 5739 (+/- 2500) kcal, 324 (+/- 163) g protein, 637 (+/- 259) g carbohydrate, 214 (+/- 109) g fat, 5 (+/- 8) g alcohol, 1413 (+/- 1151) mg cholesterol, and a P/S ratio of 0.6 (+/- 0.3). Significant relationships between dietary fats and serum lipids were observed in the NSU. Polyunsaturated fatty acids were correlated with TG and VLDL (r = 0.69; p = 0.01), and TC/HDL (r = 0.06; p = 0.04). Total fats were correlated with TG (r = 0.57; p = 0.05), HDL-3 (r = -0.62; p = 0.04), and VLDL (r = 0.57; p = 0.05), and saturated fats with HDL-3 (r = 0.59; p = 0.055). Diet was moderately associated with lipoproteins in SU, but steroids had a much greater influence on CVD risk. Despite disease promoting diets NSU had relatively average CVD risk that may be attributed to protective effects of rigorous training. PMID- 2708729 TI - Alterations of serum and urinary carnitine profiles in cancer patients: hypothesis of possible significance. AB - The present study examined the serum and urinary carnitine concentrations of 21 cancer patients with metastatic disease and 13 healthy age-matched controls by taking three consecutive samples during an 8-week period. The serum concentrations of all fractions of carnitine were significantly lower in the female cancer patients than in the female controls. The concentrations of urinary carnitine fractions were relatively higher in the total cancer population; however, only acid-insoluble acylcarnitine (AIAC) was statistically significant. The renal clearance of acid-soluble acylcarnitine (ASAC) and AIAC was significantly greater in cancer subjects than in controls. Significant inverse relationships were established between the ASAC and AIAC clearances and their respective serum concentrations. The renal tubular reabsorption of AIAC was significantly less in cancer patients than in control subjects as indicated by the fractional excretion of carnitine. The increased clearance of acylcarnitine and excretion of large amounts of AIAC are proposed to be a response to chemotherapy and represent a loss of energy to the cancer patient. PMID- 2708730 TI - Lipases in human milk: effect of gestational age and length of lactation on enzyme activity. AB - Human milk contains two lipases, bile salt-stimulated lipase (BSSL) and lipoprotein lipase (LPL). In the mammary gland, LPL provides long-chain fatty acid for milk fat synthesis. LPL has no known function in milk, but has been implicated in milk fat hydrolysis during cold storage. BSSL may have an important role in infant fat digestion. The aims of the present studies were to assess (1) the methodological validity of using whole milk to analyze BSSL activity, (2) the longitudinal variation of BSSL and LPL activity in the milk of mothers delivering premature and full-term infants, and (3) the stability of BSSL and LPL activity during cold storage. Diluted whole milk and purified BSSL were shown to have similar characteristics. LPL activity was equally stable at -20 and -70 degrees C, whereas BSSL activity was higher in milks stored at -70 than at -20 degrees C (38.8 +/- 0.88 vs 33.3 +/- 0.87 U/ml milk, respectively; 1U = 1 mumol free fatty acid release/min). Levels of BSSL activity in preterm and term milk were similar. LPL activity tended to be higher in term milk. Overall, BSSL activity showed significant longitudinal variation, being highest at 1 and 3 weeks of lactation (43.2 +/- 0.04 and 42.6 +/- 1.03 U/ml milk, respectively). For LPL, the longitudinal pattern of activity depended upon the length of pregnancy. Implications for infant nutrition and mammary gland biology are discussed. PMID- 2708731 TI - Nutritional complications in an infant fed exclusively on homemade sesame seed emulsion. AB - A 3-month-old infant was exclusively fed a high calorie homemade sesame seed emulsion for 4 weeks. As a result of the milk content, the infant developed hypermagnesemia, hypokalemia, hyponatremia, and hypovitaminosis C. Although the mixture was highly caloric and the infant's intake was good, he showed profound failure to thrive. Analysis of the emulsion indicated that this complication was primarily due to the heterogeneity of the emulsion's caloric content resulting from a settling process which occurred after the emulsion was placed in the infant's bottle. This settling resulted in the portion containing the most calories being the last to reach the infant's mouth. These findings indicate that whenever a vegetarian diet is provided to a bottle-fed infant, the potential heterogeneity of the mixture's caloric content, as well as the contents themselves, should be considered. PMID- 2708732 TI - Re: The influence of vitamin supplements of micronutrient levels in healthy elderly subjects. PMID- 2708733 TI - Transient partial growth hormone deficiency due to zinc deficiency. AB - We present here a 13-year-old boy with partial growth hormone deficiency due to chronic mild zinc deficiency. When zinc administration was started, his growth rate, growth hormone levels, and plasma zinc concentrations increased significantly. His poor dietary intake resulted in chronic mild zinc deficiency, which in turn could be the cause of a further loss of appetite and growth retardation. There was also a possibility of renal zinc wasting which may have contributed to zinc deficiency. Zinc deficiency should be carefully ruled out in patients with growth retardation. PMID- 2708734 TI - The effect of cat removal on allergen content in household-dust samples. AB - To evaluate the effect of cat removal on cat-allergen content in the home, serial house dust samples were collected from 15 homes during a 9- to 43-week period after cat removal. Samples were obtained with a hand-held vacuum cleaner, and allergen content was quantitated by a radioimmunoassay specific for the major cat allergen, Fe1 d I. Baseline Fe1 d I content ranged from 7.8 Food and Drug Administration units per gram of dust to 436.7 U/gm (median 61.2 U/gm), consistent with levels found in homes with a pet cat. Fe1 d I levels declined gradually in most homes, and by 20 to 24 weeks after cat removal, eight of 15 reached levels consistent with levels found in control homes without cats. In two of those homes, allergen levels fell much more rapidly after aggressive environmental control measures were undertaken. In the other seven homes, however, the decline occurred at a much slower rate, with three homes demonstrating persistent elevations in Fe1 d I content for 20 or more weeks. These data demonstrate that the task of allergen elimination from an indoor environment is extremely difficult, even when the source of a specific allergen can be identified and removed. PMID- 2708735 TI - Safety and immunogenicity of immunotherapy with accelerated dosage schedules of polymerized grass and ragweed in patients with dual inhalant sensitivity. AB - Immunotherapy with individually polymerized grasses (IPG) and immunotherapy with polymerized ragweed (PRW) have been demonstrated to be immunogenic and safe and to result in lowering of symptom-medication scores compared to placebo. We conducted this study to evaluate the immunogenicity and safety of immunotherapy with concomitantly administered accelerated dosage schedules of IPG and PRW in 12 patients with dual inhalant sensitivities. Patients were treated in nine weekly visits with IPG, comprising 71,950 PNU; they were treated in 11 weekly visits with PRW comprising 2955 allergy units. Eleven additional patients who had been previously treated with IPG received only PRW. There were no systemic reactions and no clinically significant changes in routine laboratory parameters, including hepatic and renal functions, with injections. There were significant rises in IgG titers by ELISA to each grass-pollen allergen administered, orchard, timothy, and Bermuda, and in total antibody binding of antigen E. Changes in IgE against orchard, timothy, Bermuda, and antigen E were minor. Thus, IPG and PRW administered concomitantly in accelerated dosage schedules are safe and immunogenic in patients with dual inhalant sensitivities. PMID- 2708736 TI - Highly atopic children: formation of IgE antibody to food protein, especially peanut. AB - Highly atopic infants often form IgE antibodies toward multiple food protein in the first 2 years of life. They begin producing IgE antibody to inhalant allergens between the first and second year of life. We hypothesized that highly atopic children would be at significant risk of sensitization to peanut. We defined high atopy as serum IgE greater than or equal to 10 times 1 SD from normal plus multiple positive RASTs. In this study we have characterized the immunologic status of 141 patients by measuring total serum IgE and specific IgE to several allergens, including peanut. These data demonstrated that, independent of clinical history, a positive RAST to peanut was more common in the highly atopic category compared to the low atopy category. Significantly more patients who were highly atopic and had a positive peanut RAST had a positive RAST for egg or milk compared to low atopic patients. More significantly, 33 of the patients had never knowingly received peanut, yet 21 (63.6%) had a positive RAST for peanut, whereas seven (21.2%) had a peanut antibody in the highest RAST category. All these seven patients were considered highly atopic according to the definition above, and three were younger than 2 years of age. These results suggest that highly atopic infants are at special risk for sensitization to peanut, even when they have never received peanut, and that characterization of immunologic sensitization to milk, egg, and peanut will identify the highly atopic infant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708737 TI - Correlations between levels of mite and cat allergens in settled and airborne dust. AB - Thirty homes in Rochester, Minn., 20 of which housed cats, were studied to compare cat and mite allergen concentrations in airborne and settled dust. With Air Sentinels in the bedroom and living room for airborne collections, and a Sample Vac for collections from living room carpet and bedroom mattress, immunochemical quantifications of each were made with various radiometric assays with polyclonal and monoclonal antibodies. The most significant correlations were found between airborne mite in the bedroom and living room (p less than 0.001) and airborne mite in the bedroom and dust from the bedroom mattress (p less than 0.001). Most houses had specific epitopes of both Dermatophagoides pteronyssinus and D. farinae, but D. farinae was present in greater amounts. In seven houses we found greater than 10 micrograms of group I mite allergen per gram of settled dust, indicating that some houses in Minnesota have concentrations of mite allergens high enough to cause allergic disease, even in the winter. Clinical interpretation of these data on air levels is hampered by uncertainty as to whether symptoms are more closely related to average steady-state exposure, which we measured, or to brief heavy concentrations. Further epidemiologic studies are needed to define the concentration of mite and cat allergens in the air that are risk factors for allergic disease. The concentration of cat allergen correlated with mite allergen in the air, but not in settled dust, presumably reflecting the fact that both are influenced by ventilation rate. PMID- 2708738 TI - Immunoprint analysis of Calvatia cyathiformis allergens. I. Reactivity with individual sera. AB - Basidiomycete allergens have received scant attention to date, compared to allergens from deuteromycetes. This is true even though in previous studies, 32% of atopic patients with respiratory allergies were skin test reactive to basidiospore extracts. Since sufficient quantities of Calvatia cyathiformis spores were available, their allergens were sequentially fractionated by gel filtration (GF) and hydrophobic interaction chromatography (HIC). Unfractionated extract (crude), GF, and HIC fractions were electrofocused in polyacrylamide gel (pH 3.5 to 9.5) and immunoprinted onto CNBr-activated nitrocellulose (0.2 microns) filters. Sera from 19 skin prick test positive and 10 negative subjects, with comparable total IgE levels, were used to screen individual strips of each blot. Blots were reacted with 125I-labeled anti-IgE and analyzed by autoradiography. IgE from 79%, 89%, and 89% of the positive sera bound to crude extract, GF, and HIC, respectively; IgE from none of the negative sera bound to crude extract. A series of bands (pH 3.6 to 4.6) reacted with 63%, one band (pH 6.6) reacted with 68%, and one band (pH 9.3) reacted with 63% of the sera tested. These studies demonstrate at least three important groups of allergens in C. cyathiformis spores. This characterization allows assignment of initial C. cyathiformis allergen designations and development of a purification protocol. PMID- 2708739 TI - Hypereosinophilia, neurologic, and gastrointestinal symptoms after bee-pollen ingestion. AB - A patient developed hypereosinophilia (13,440 cells per cubic millimeter) 6 weeks after beginning the ingestion of bee pollen. Symptoms included generalized malaise, headache, nausea, abdominal pain diarrhea, generalized pruritus, and decreased memory. Evaluation revealed no other known cause for the patient's hypereosinophilia, which resolved after bee-pollen ingestion was stopped. The product contained a mixture of entomophilous and anemophilous pollens to which the patient was skin test positive. An open challenge with the bee pollen later reproduced the presenting symptoms with a concomitant rise of the eosinophil count from 207 to 890 cells per cubic millimeter. The patient has since remained well avoiding bee pollen. This study strongly suggests that hypereosinophilia with attendant pathophysiologic disturbances may be an adverse reaction to bee pollen ingestion in atopic individuals. PMID- 2708740 TI - Immunotherapy with a standardized Dermatophagoides pteronyssinus extract. Systemic reactions during the rush protocol in patients suffering from asthma. AB - Specific immunotherapy can induce severe systemic reactions (SRs), especially in patients with asthma. It also appears that potent standardized extracts may be more often involved in the generation of SRs than other extracts. Since these SRs may be potentially life threatening, it is desirable to predict their onset. A prospective study was carried out in 125 mite-allergic subjects with asthma ranging in age from 4 to 57 years to assess the incidence of SRs during a rush immunotherapy (RIT) protocol and maintenance injections and to attempt to predict the onset of the SRs. All patients received the same standardized extract of Dermatophagoides pteronyssinus with the same RIT and the same maintenance dose (3000 BU in subjects older than 10 years and 1500 BU in children younger than 10 years). Patients were carefully monitored during the RIT protocol, and possible SRs were followed for up to 2 hours after injections. Patients then received maintenance injections for a mean duration of 18.2 +/- 5.6 months. During maintenance injections, patients were under supervision of a physician for 30 minutes. Within 2 weeks before the RIT, all patients older than 6 years had a pulmonary function test, skin prick test end point with the standardized D. pteronyssinus extract, and RAST. The severity of asthma was examined with the score of Aas. Forty-seven patients had an SR during the RIT protocol: four mild generalized urticaria, 35 asthma exacerbations, and eight anaphylactic shocks. None of the patients had to be admitted to an intensive care unit. Most SRs started within 15 minutes, and none of the SRs started 45 minutes or later after the last injection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708741 TI - High-molecular-weight kininogen is cleaved in active erythema multiforme. AB - Erythema multiforme (EM) is an inflammatory disorder of the skin, which may include mucous membrane involvement, that features target (iris) lesions. Mediators specifically involved in EM are not well characterized; its pathogenesis remains enigmatic. In this study, evidence for participation of kinins in the pathophysiology of inflammation in EM was investigated by assessing cleavage of high-molecular-weight kininogen (HMWK) in plasma. These data were compared with analyses of plasmas from patients with serum sickness, chronic idiopathic urticaria/angioedema, and from normal control subjects. Patients with EM demonstrated significant levels of circulating cleaved HMWK in plasma during active disease (p less than 0.01), which declined during remission/recovery. Plasmas from patients with EM obtained during active disease also demonstrated significant levels of 94 kd C1 inhibitor (p less than 0.01) and C1 inhibitor kallikrein complexes. Patients with serum sickness and chronic idiopathic urticaria/angioedema did not demonstrate these findings and did not differ from normal control subjects (p = not significant). Although the kininogenase responsible for HMWK cleavage in EM has not been conclusively demonstrated, these findings suggest that HMWK cleavage resulted from activation of the contact system and that some of the manifestations of EM in selected patients may in part be accounted for by inflammatory and proinflammatory actions of kinins. Based on these preliminary findings, it will be important to establish whether or not HMWK cleavage in EM is a general finding in patients with this disorder. Further investigation is needed to characterize more clearly kininogenase activity and elucidate the possible role of kinin generation in EM. PMID- 2708742 TI - Double-blind, placebo-controlled study of nicergoline in the treatment of pruritus in patients receiving maintenance hemodialysis. AB - Pruritus is a common symptom among patients undergoing long-term hemodialysis. The effect of nicergoline, an ergoline, on pruritus was studied in products released during dialysis. In a first experiment series, 20 age-matched normal individuals, 25 patients receiving hemodialysis without pruritus, and 15 patients receiving hemodialysis with pruritus had intradermal tests with 500 micrograms of papaverine. All patients with pruritus had a small papaverine skin test response, and mean values were significantly (p less than 0.0001, Mann-Whitney U test) smaller in patients with pruritus. All patients with pruritus entered in a crossover, double-blind trial with nicergoline. In a first period of six dialyses, they received either nicergoline (daily oral dose, 30 mg, and intravenous dose during dialyses, 5 mg) or placebo. In the second period of six dialyses, patients received the crossover treatment. Nicergoline was effective in 13/15 patients, eight of these patients having a complete remission of pruritus. When nicergoline was stopped, patients relapsed within 24 to 48 hours. All patients who improved during the trial were then treated with a daily dose of 30 mg of nicergoline for 6 months. Seven patients had a complete remission, five had moderate symptoms, and one patient relapsed. This study demonstrated that some hemodialyzed patients with pruritus of unknown etiology had improvement with nicergoline. PMID- 2708743 TI - Cellular and humoral observations in a patient with allergic bronchopulmonary aspergillosis during a nonasthmatic exacerbation. AB - A patient is described with an asymptomatic exacerbation of allergic bronchopulmonary aspergillosis (ABPA), clinically characterized by pulmonary infiltrates, with absence of obstructive reactions and a short period of hemoptysis 2 weeks before hospitalization. Cell counts and antibody concentrations were measured in serum, and bronchoalveolar fluid (BAF) samples and values were compared with data from previous periods of symptomatic exacerbations. During the asymptomatic exacerbation, concentrations of antibody to Aspergillus fumigatus, total IgE, and precipitating antibodies were elevated in peripheral blood. No quantitative differences in specific antibody concentrations (IgE, IgG, IgA, and IgM) against A. fumigatus were found between sera from symptomatic and asymptomatic periods of ABPA. In contrast to observations in the serum, protein concentrations in BAL fluid were normal during the asymptomatic period, whereas high concentrations were found during the symptomatic phases. Local antibody concentrations (in BAF) were characterized by high levels of IgA antibodies against A. fumigatus. During asymptomatic and symptomatic phases, eosinophils were elevated in peripheral blood, in sputum, in BAF, and highly elevated in tissue biopsy specimens. Activated eosinophils were found, as indicated by the presence of light-density cells in the circulation and monoclonal antieosinophil cationic protein binding to bronchoalveolar lavage eosinophils. In contrast to the symptomatic phase of ABPA in 1980, demonstrating aspecific airway reactivity to several pharmacologically active substances, no such hyperreactivity was found during the asymptomatic phase of ABPA in 1986. It is proposed that the asymptomatic infiltrative phase of ABPA is an intermediate stage that can develop into a symptomatic phase after prolonged and intensified infiltration of eosinophils. Mediators from the inflammatory cells may be involved in the induction of bronchial hyperresponsiveness. After induction of this hyperreactive stage of the airways, additional liberation of mediators from either eosinophils and/or mast cells will lead to a symptomatic (obstructive) phase of ABPA. PMID- 2708744 TI - Identification of two distinct allergenic sites on ryegrass-pollen allergen, Lol p IV. AB - Lol p IV is an important allergen of ryegrass pollen. For the immunochemical identification of antigenic and/or allergenic site(s), murine monoclonal antibodies (MAbs) were prepared against Lol p IV. The hybridoma cell-culture supernatants were screened for anti-Lol p IV antibodies by a combination of ELISA and Western immunoblot analyses. The MAbs were finally purified from ascites on a Mono Q ion-exchange column. In a competitive radioimmunoassay with Lol p IV as the solid phase and 125I-labeled MAbs, it was established that MAbs 90, 91, 92, 93, and 94, although they differed in their relative affinities, recognized in common with one another an epitope designated as antigenic site A, whereas MAb 12 recognized a different epitope referred to as site B. Sites A and B were also demonstrated to constitute allergenic determinants of Lol p IV. Differences in the repertoire of specificities of the human IgE antibodies directed to Lol p IV were also demonstrated. Interestingly, it was found that sera from both allergic as well as from nonatopic individuals had IgG antibodies to sites A and/or B. PMID- 2708745 TI - Regarding an article by Milavetz et al. PMID- 2708746 TI - Air poisoning. PMID- 2708747 TI - Moving ahead in 1989. PMID- 2708749 TI - Women and smoking. Successful primary prevention programs. PMID- 2708748 TI - Diary of a smokebuster. PMID- 2708750 TI - Women and smoking. How to operate on your own hospital. PMID- 2708751 TI - Women and smoking. Needed global actions. PMID- 2708752 TI - Women and smoking. Mobilize your community. PMID- 2708753 TI - Passive smoking is risky. PMID- 2708754 TI - Facts on women and smoking. PMID- 2708756 TI - Women and smoking. Who needs equal rights? PMID- 2708755 TI - Smoking and pregnancy. PMID- 2708757 TI - Women and smoking. Promoting cessation. PMID- 2708758 TI - Women and smoking. Success in the land of Lake Wobegon. PMID- 2708759 TI - Disposable contact lenses--boon or boondoggle? PMID- 2708760 TI - What is a contact lens prescription? PMID- 2708761 TI - Toric base curve rotation on toric corneas. PMID- 2708762 TI - A legal history of optometry. PMID- 2708763 TI - Diabetes. PMID- 2708764 TI - Clinical experience with the Tangent Streak RGP bifocal contact lens. AB - Eighty-one screened presbyopic subjects were fitted with the Tangent Streak Bifocal (TSB) rigid gas permeable contact lens. Sixty subjects received lenses, and of this group, 42 (70%) have worn the lens successfully for 6 months or longer. Failures mainly resulted from discomfort and occasionally, reduced visual quality. Successful subjects were particularly pleased with their crisp vision at distance and near. The TSB may be the lens of choice for those presbyopic patients who require high definition visual quality at distance and near. PMID- 2708765 TI - Investigation of the Alges bifocal. AB - A prospective study was undertaken to evaluate the success rate in fitting the Alges bifocal contact lens, and to determine which subject characteristics were associated with success. Fifty-eight presbyopic subjects with healthy eyes were included in the study. Thirteen subjects (22.4%) were screened out and discontinued after the fitting examination because of visual problems. Lenses were dispensed to 45 subjects (the dispensed group). Thirteen of these subjects were discontinued. Thirty-two subjects (71.1%) were considered successful after wearing their optimum lenses for 1 month. The successful group was interviewed by telephone after 3 months of wear. Two of these subjects were actually a "qualified" success. After 9 months, the successful group was again interviewed by telephone. Twenty-four subjects of the dispensed group were still considered to be optimally successful, five subjects were considered to be a "qualified" success and three subjects had discontinued lens wear. Our success rate for screened patients after 9 months was 64.4%. Two subject characteristics that were associated with success were a previous history of contact lens wear (p = 0.0065) and a near-point stereoacuity better than 100 s of arc with the Alges lens (p = 0.01). PMID- 2708767 TI - Effects of interocular blur suppression ability on monovision task performance. AB - Suppression of anisometropic blur induced by monovision contact lenses was examined in 18 presbyopic subjects. Suppression ability was quantified by reducing the contrast of a bright test target, viewed by subjects wearing a monovision correction, until the blurred image was suppressed. Subjective success with monovision was evaluated using a patient survey and no correlation to blur suppression ability was found. Objective success was evaluated in terms of performance at three near work tasks, each requiring a different level of stereoscopic localization. A significant correlation was found between card filing performance (requiring a moderate level of stereopsis) and blur suppression ability. Correcting either the dominant or non-dominant eye for near in the monovision correction did not significantly affect blur suppression ability. There was no evidence for adaptation to monovision in terms of increasing blur suppression ability over time. PMID- 2708766 TI - The effect of time, patching, and lens flexibility on RGP lens adherence. AB - The effects of time, eye patching, and lens flexibility on rigid lens adherence was evaluated in five overnight, in-laboratory test sessions. Patching was investigated with a group of 11 subjects in two overnight test sessions. Sleep time and lens flexibility were investigated in three separate overnight test sessions with two groups of subjects wearing two lens types of fluorosilicone materials (Dk 92 and 60). Adherence occurred in a significant portion of eyes within a 2-hour time period, and the incidence increased throughout the night. There was no significant difference between the incidence of adherence for lenses of a flexible material compared to lenses of a more rigid material (p greater than 0.6, X2 test), nor did patching have a significant influence on the incidence of adherence. The mechanism of lens adherence may be related to several factors including arbitrary lens movement to a peripheral corneal position, the creation of a geometric spacing between the lens and the eye, lid forces producing a negative pressure, and an increase in tear viscosity throughout the night. PMID- 2708768 TI - Contact lens induced giant papillary conjunctivitis: a retrospective study. AB - In this retrospective epidemiological study, records from the Contact Lens Department of SUNY College of Optometry were randomly selected and reviewed. An association between contact lens induced giant papillary conjunctivitis (GPC) and a FDA classified sub-category was found. Younger patients were shown to have a higher risk of developing GPC. Gender and tear film break-up time were not found to be associated with the condition. The mean replacement time for hydrogels was 10.8 +/- 9.2 months with no significant differences among contact lens polymer types. The GPC phenomenon was almost exclusively bilateral with a mean onset time of 31.4 months after commencing lens wear. A model for the development of GPC based on tear film interactions with the hydrogel lens surface is presented. A model for the tear film's interaction with the hydrogel contact lens in situ is offered. PMID- 2708769 TI - Soft contact lens and corneal changes associated with Visine use. AB - Sixteen subjects were fit with Cibasoft clear daily wear contact lenses and were asked to use two drops of tetrahydrozoline (Visine) twice a day for 4 months on one eye. Visual acuity, lens coloration, and slit lamp results were compared to baseline data between the test and control eye of each subject. Visual acuity and lens coloration results showed statistically insignificant changes from baseline. However, clinically important changes in corneal integrity were noted in 26.7% of the subjects. PMID- 2708770 TI - The traumatic element in the typical dream of feeling embarrassed at being naked. AB - Material is presented from three cases, where analysis of repetitive dreams of feeling embarrassment at being partially or totally naked was an important feature of the treatment. The indifference by the other people in the dream to the dreamer's nakedness was initially linked to perceived transference slights at the hands of the analyst, and later to repeated episodes of actually being treated indifferently at the hands of the parents. This indifference was related to latency or adolescent attempts by the patients to gain love or attention from the parents by exhibitionistic means. The stereotypical presentation of the manifest content of these dreams is seen as evidence for their underlying traumatic roots. Such dreams are likened to the typical examination dreams described by Freud, which have also been noted by others to have traumatic roots. This finding is consistent with my own work with certain repetitive manifest dream configurations and with Freud's (1920) reevaluation of his theory of dreams in Beyond the Pleasure Principle, wherein he noted that dreams of patients suffering from traumatic neurosis often manifestly repeated the traumatic situation in an attempt to master it retrospectively. PMID- 2708771 TI - Pseudostupidity and analyzability. AB - This paper seeks to heighten awareness of pseudostupidity and the potential analyzability of patients who manifest it by defining and explicating it, reviewing the literature, and presenting in detail the psychoanalytic treatment of a pseudostupid patient. Pseudostupidity is caused by an inhibition of the integration and synthesis of thoughts resulting in a discrepancy between intellectual capacity and apparent intellect. The patient's pseudostupidity was determined in part by his need to prevent his being more successful than father, i.e., defeating his oedipal rival. Knowing and learning were instinctualized. The patient libidinally and defensively identified with father's passive, masochistic position. He needed to frustrate the analyst as he had felt excited and frustrated by his parents' nudity and thwarted by his inhibitions. He wanted to cause the analyst to feel as helpless as he, the patient, felt. Countertransference frustration was relevant and clinically useful in the analysis. Interpretation of evolving relevant issues led to more anxiety and guilt, less pseudostupidity, a heightened alliance, and eventual working through. Negative therapeutic reactions followed the resolution of pseudostupidity. PMID- 2708772 TI - On a type of heterosexuality, and the fluidity of object relations. AB - This paper delineates a form of heterosexuality whose underlying psychological structure resembles that of perversions. It is characterized by: idealization of instinctual processes, whereby the ego subordinates the object to the actualization of the instinctual event itself; heightened narcissism in an otherwise neurotic ego organization; multiple intrapsychic uses of the object; a special kind of defensive organization; an experienced victory over the superego and associated elevation of certain aspects of the ego ideal; and a resultant alteration in the nature of close interpersonal relationships. I use clinical vignettes from both male and female patients in psychoanalysis to focus on the phenomena in question. The thinking of Chassequet-Smirgel, Freud, Khan, Rangell, Socarides, and others is used in an attempt to gain an encompassing perspective. It is emphasized that patients demonstrating this form of heterosexuality do not possess a perversion per se, but demonstrate a character neurosis which integrates certain perverse mechanisms into its defensive organization. These mechanisms can be isolated and studied in psychoanalytic treatment, with the potential for illuminating their defensive and mood-regulating functions, and eventual working through and resolution of the intrapsychic conflicts underlying them. Some comments on the implications of this form of sexuality for our contemporary culture are included. PMID- 2708773 TI - Changing psychic structure through treatment. Panel reports. PMID- 2708774 TI - Current concepts of adult psychic structure. Panel reports. PMID- 2708775 TI - The opening phase of psychoanalysis. Panel reports. PMID- 2708776 TI - Our changing science. PMID- 2708777 TI - Motivation, personality organization, and the four psychologies of psychoanalysis. AB - Four psychologies currently significant in psychoanalytic thinking are described. An attempt is made to (a) advance developmental proposals describing how the phenomena of each of the four achieve motivational status in the intrapsychic life of the individual and (b) develop a model for the understanding of personality organization across the four psychologies, based on the development of personal hierarchies that establish which issues are superordinate and which subordinate. Taken together, these two points are used to suggest that the four psychologies may not simply represent differing perspectives on intrapsychic phenomena (though they do that, in part) but that they also, simultaneously, represent relatively independent ways in which intrapsychic life is organized. PMID- 2708778 TI - How dreams are told: secondary revision--the critic, the editor, and the plagiarist. AB - Secondary revision is a highly provocative concept arising out of Freud's attempts to explain the construction of dreams, but it remains relatively ill defined. It includes three related, yet by no means identical aspects of the process by which the dream acquires its more or less final form during the experiencing, the remembering, and the telling. It represents one of the most interesting hypotheses dealing with the fluid world between sleeping and waking, a field which still presents us with a host of unanswered questions. Secondary revision not only reflects the higher levels of the dreamer's mental functioning superimposed on his biological substructure, but it also operates as a sensitive indicator of the cultural factors which have helped mold his personality. These factors include both the subculture of the analytic situation and the impact of society in the larger sense. I make reference to individual dreamers in analysis and to the world of dreams recorded in the past from our own and other cultures. PMID- 2708779 TI - Pains and gains: a study of forced terminations. AB - The forced termination of psychoanalysis, such as occurs when the analyst makes a geographic move, uniquely disrupts the analytic setting. This paper recounts the author's experience of terminating a full-time private practice of psychoanalysis and psychoanalytic therapy for such a move. The limited literature on the subject is reviewed with a focus on the use of technical variation in the forced termination situation. The author delineates three areas of interaction with patients where technical variation proved in her experience to be of value: dealing with countertransference and counter-reaction, providing information about the move, and the consideration and process of referral for continued therapy. As opposed to what would be predicted from a classical psychoanalytic perspective, the use of such technical maneuvers seemed to facilitate rather than impede analytic work. These variations in technique served at crucial times to maintain the analytic alliance, to preserve the patient's capacity to recognize and make use of transference, and to provide avenues for resolving past traumas in the transference and the actual loss of the analyst. The concept of the analyst as a new or useable object is proposed as providing a theoretical framework for understanding these observations. PMID- 2708780 TI - Electron microscopic study of cardiac ganglia in human fetuses. AB - The early events in the development of the heart ganglia and nerves in human fetuses ranging from 5 to 12 weeks of gestation age were studied by transmission electron microscopy. The first neuroblasts in the atrial mesenchyme differ from surrounding cells in the presence of short cisternae of rough endoplasmic reticulum and in the absence of glycogen particles. The most valuable criterion for identification of neuroblasts is the presence of contacts with preganglionic nerve terminals. Only ganglia composed of compact aggregations of neuronal cells and nerve terminals have a complete glial sheath. The first signs of synapse formation were seen in 5-week-old fetuses; well developed synapses with many synaptic vesicles were found from the 8th week of gestation onwards. These were predominantly axodendritic synapses. It is proposed that synaptogenesis begins with the appearance of osmiophilic zones at the sites of interneuronal contacts, then synaptic vesicles move by axonal transport to reach the preformed specialized junctions and stop in axonal presynaptic varicosities. PMID- 2708781 TI - The vesicle content of catecholamine-containing axons in the rectum of the domestic fowl: effect of permanganate and chromaffin fixations. AB - The ultrastructural appearance of catecholamine-containing (CA) axon profiles in the rectum of the domestic fowl was compared following fixation using the chromaffin reaction or potassium permanganate. As described previously, after chromaffin fixation CA-axons in the perivascular plexuses contained many small granular vesicles (SGV) and variable numbers of large granular vesicles (LGV), whereas those in the non-vascular sites contained few small vesicles and were characterised by the presence of elongated LGV. Following fixation in potassium permanganate, CA-axons in both the non-vascular and vascular sites contained many SGV. The SGV were accompanied by variable numbers of large round vesicles which were often devoid of a core. Large vesicles comprised 16 and 26%, respectively, of total vesicles in the vascular and non-vascular axon profiles. The total number of vesicles per CA-axon profile in both the vascular and non-vascular site was not dependent on fixation procedure. It is concluded that the vesicle content of CA-axon profiles in the rectum of the domestic fowl is dependent on the fixative employed. PMID- 2708782 TI - Selective vagal postganglionic innervation of the sinoatrial and atrioventricular nodes in the non-human primate. AB - The distribution of parasympathetic postganglionic nerves to the atrioventricular (AVN) and sinoatrial nodal (SAN) regions was investigated in the non-human primate heart. Eight male monkeys (Macaca fascicularis) weighing 5.5-7.0 kg. were anesthetized (alpha-chloralose, 50 mg/kg and urethane, 500 mg/kg) and instrumented to measure arterial pressure, electrocardiogram, atrial and ventricular electrograms. The cervical vagi were electrically stimulated (20 Hz, 4 V, 2 ms) before and after selective denervation (D) of the AVN and/or SAN. Vagal stimulation was repeated during atrial pacing to assess parasympathetic modulation of AVN conduction. Ablation of parasympathetic pathways to the AVN, accomplished by the disruption of the epicardial fat and surface muscle layer at the junction of the inferior vena cava and inferior left atrium eliminated (P less than 0.01) the dromotropic effects of vagal stimulation without affecting the heart rate response (right vagus, before D, paced: atrial rate 218.0 +/- 6.3, ventricular rate 67.1 +/- 23.7; after D: atrial rate 210.3 +/- 6.4, ventricular rate 210.3 +/- 6.4 beats/min, means +/- S.D.). In sharp contrast, surgical dissection of the fat pad overlying the right pulmonary vein-superior vena cava junction significantly (P greater than 0.01) attenuated negative chronotropic effects of vagal stimulation (left vagus, before D the R-R interval increased by 832.7 +/- 146.4 ms, 209.5% increase; after D 37.4 +/- 18.0 ms, 8.8% increase). These data demonstrate discrete vagal efferent pathways innervate both the SAN and AVN regions of the non-human primate heart. PMID- 2708783 TI - Salivary changes associated with seasickness. AB - Salivary composition and flow rate were measured in 13 healthy male volunteers exposed to a real seasickness situation. The flow rates of whole unstimulated and stimulated saliva were significantly reduced at sea in about 80% of the subjects. Salivary flow rate was negatively correlated with seasickness severity. These results contrast with the classic concept of increased salivation during seasickness. At sea, the potassium concentration of both unstimulated and stimulated saliva was significantly reduced, while sodium concentration was consistently elevated. The sodium and protein concentrations were positively correlated with seasickness severity. Thus, objective measurements of salivary flow rate and composition may be recommended for evaluation of the seasickness syndrome. PMID- 2708784 TI - Studies of the inhibitory non-adrenergic neuromuscular transmission in the smooth muscle of the normal human intestine and from a case of Hirschsprung's disease. AB - A modified sucrose-gap method was used to study both non-adrenergic inhibitory neuromuscular transmission and effects of adenosine 5'-triphosphate (ATP) on isolated smooth muscle preparations from the human intestine. It was found that non-adrenergic inhibition in the circular smooth muscle layer was of larger amplitude than in the longitudinal layer. Study of the ionic mechanisms underlying non-adrenergic inhibition indicated that an increase in K+ conductance was responsible for the generation of non-adrenergic inhibitory junction potentials (IJPs). The results suggest that the inhibitory actions of the endogenous neurotransmitter and exogenous ATP are due to increases in Ca2+ dependent K+ conductance. The K+-channel blockers tetraethylammonium and 4 aminopyridine had no effect on IJPs or ATP, while apamin slightly decreased both the amplitude of the IJP and the hyperpolarization of the circular smooth muscle caused by ATP. These results are consistent with the purinergic hypothesis of non adrenergic inhibition. In addition to inhibitory purinoceptors, the existence of excitatory purinoceptors was identified in the longitudinal muscle, activation of which probably caused an increase in Na+-conductance. The excitatory purinoceptor mediated contraction in the longitudinal muscle from the constricted region of large intestine from patients with Hirschsprung's disease was greater than that found in control specimens. It is possible that excitatory purinoceptors play a role in the pathophysiology of Hirschsprung's disease. PMID- 2708785 TI - Heart rate and coronary flow effects on the cardiac response to sympathetic stimulation. AB - We studied the effects of changes in heart rate and coronary blood flow on the decay of the cardiac inotropic response to sympathetic stimulation in 10 anesthetized dogs. After we induced complete heart block, we paced the ventricles at rates of 90, 120 and 150.min-1. At each pacing frequency, we perfused the left main coronary artery with blood at a baseline flow and at a flow 85% above the baseline rate. At each combination of pacing frequency and flow, we stimulated the left ansa subclavia supramaximally at a frequency of 5 Hz for 2 min. To assess the rate of norepinephrine removal from the ventricular myocardium, we measured the 50% decay time of the left ventricular inotropic response [(dP/dt)max] immediately after cessation of sympathetic stimulation. We found that the inotropic response decayed faster (P = 0.03) when the coronary artery blood flow was high than when the flow was baseline. The effect of heart rate on the decay of the left ventricular inotropic response depended on the level of the coronary blood flow. When the blood flow was baseline, the inotropic response decayed more rapidly (P = 0.001) when the heart rate was 150.min-1 than when it was 90 or 120.min-1. However, when the flow was high, heart rate did not affect the response decay significantly. We conclude that the mechanical contraction of the ventricles facilitates the washout of norepinephrine from the cardiac interstitium and into the coronary circulation by virtue of a massaging action. PMID- 2708786 TI - Cardiovascular autonomic function in multiple sclerosis. AB - The autonomic nervous function of the cardiovascular system was investigated by non-invasive methods in 30 multiple sclerosis patients between 20 and 50 years of age. The results were compared to those of 30 healthy controls in the same age group. Minor abnormalities of parasympathetic and sympathetic function occurred. Heart rate variation at deep breathing was reduced and more than half of the patients had abnormal responses during an orthostatic procedure, mainly as an increased rise in heart rate. Decreased rise in blood pressure at sustained handgrip was also demonstrated. The abnormalities correlated poorly with other clinical signs and symptoms in the patients. PMID- 2708787 TI - Neuropeptide Y-like immunoreactivity of plasma during hypoglycaemia in man. AB - Previous studies have demonstrated that plasma Neuropeptide Y-like immunoreactivity (NPY-LI) increases after activation of sympathetic nerves. To test the hypothesis that the adrenal medulla may also be a significant source of circulating plasma NPY-LI and to determine if NPY is co-released with adrenal catecholamines, we have measured the peripheral venous concentrations of NPY-LI, adrenaline and noradrenaline in six patients, before and after induction of hypoglycaemia as part of pituitary function tests that also tested gonadotrophin and thyroid stimulating hormone release. The plasma adrenaline concentration was increased approximately 15 times (p less than 0.05) relative to baseline at 30 mins and remained elevated for the 90 minutes of the study. The plasma concentration of both noradrenaline and NPY-LI remained unchanged. These results failed to demonstrate an increase in the amount of NPY-LI released into the plasma during stimulation of the adrenal medulla with hypoglycaemic stress in man. They do not support significant co-release of NPY with adrenaline from the adrenal medulla in man, nor a physiological role for NPY as an adrenal hormone in human subjects in this situation. PMID- 2708788 TI - Residues in fish exposed to sublethal doses of endosulfan and fish collected from cotton growing area. AB - A one step extraction and cleanup procedure for determining endosulfan in fish was investigated. Minced Fish was mixed with trisodium citrate, disodium hydrogen orthophosphate and sodium sulphate into a dry powdery mixture, which was eluted through silicic acid and alumina with a mixture of dichloromethane and hexane. The eluate was concentrated and chromatographed on GLC using an EC detector without further cleanup. Three species of fresh water fish exposed to 0.7-16 micrograms/litre-1 technical grade endosulfan in tanks for various periods of time were found to concentrate both alpha and beta endosulfan and metabolise them to sulfate, diol, ether and lactone. Fish collected from Gwydir River in the cotton growing area in summer (Dec. 1986-Feb. 1987) were found to contain endosulfan residues suggesting endosulfan is quite stable in the environment and can cause residues. PMID- 2708789 TI - Mercury induced time-dependent alterations in lipid profiles and lipid peroxidation in different body organs of cat-fish Heteropneustes fossilis. AB - The effects of mercuric chloride (HgCl2) on lipid profiles and lipid peroxidation in different body organs of fresh water cat-fish Heteropneustes fossilis were studied. The daily exposure of HgCl2 0.2 mg/L for 10, 20 and 30 days depleted the total lipids in brain. But the content of phospholipids enhanced significantly at 30 days. Significant diminution in C/P ratio was discernible with 30 days of exposure following mercury toxicosis. Liver exhibited elevated levels of total lipids, phospholipids, cholesterol and C/P ratio. Interestingly kidney showed marked decrease in the concentration of total lipids, cholesterol and C/P ratio at higher exposure. However, the phospholipid values increased during the longer exposure. The content of total lipids and phospholipids was high in muscle but the level of cholesterol and C/P ratio were depleted. Significant increment in lipid peroxidation was discernible in brain, liver and muscle. In kidney the rate of lipid peroxidation was significantly reduced. The results suggest that exposure of HgCl2 enhances the peroxidation of endogenous lipids in brain, liver and muscle. Interestingly the lipid contents are affected differently in different body organs. PMID- 2708790 TI - Death in the nursing home: senescence, infection and other causes. AB - 1. Clinical reasons for death in a skilled nursing home continue to show infectious causes as the leading etiology. 2. The concept of senescence is probably overlooked as a legitimate explanation for death in elderly patients. Senescence can be defined as a protracted and progressive decline of multiple body functions not attributable to one specific etiology and culminating in the patient's death. 3. The majority of deaths occurred within the first year after admission to the skilled nursing home setting. 4. The majority of deaths among the patients in this study occurred in the nursing home setting, not the hospital. PMID- 2708791 TI - Fear of senility: the nurse's role in managing reversible confusion. AB - 1. Acute illnesses in the elderly often cause reversible confusion. 2. Agitated and unsafe behavior is an attempt by the confused elderly to maintain self-image and physical and psychological integrity. 3. Ebersole and Hess' humanistic framework can guide the nurse to prioritize and meet the needs of the confused elderly. PMID- 2708792 TI - An aggressive approach to promoting health responsibility. AB - 1. A self-care framework is appropriate for nursing assessment of health promoting lifestyle practices among older adults. 2. Older adults do accept responsibility for their own health and practice preventative and health promoting behaviors. 3. This group of adults does plan changes in health habits. A significant number are able to sustain change in habits over time. 4. Nurses are not perceived as sources of health-promoting information or support for health activities by this age group. Nurses need to be more aggressive promoters of health for all adults to retain this very important component of nursing practice. PMID- 2708793 TI - Comfort and the hospitalized chronically ill. AB - 1. Although comfort is a word nurses use in their daily practice to describe a nursing measure, an outcome, and a goal, there has been very little research to determine the meaning of comfort from the patient's perspective. 2. The institutionalized elderly in this study described their comfort according to five themes: disease process; self-esteem; positioning; approach and attitudes of staff; and hospital life. So, as well as the physical component of comfort, the elderly viewed their comfort equally in terms of their relationships with others, their environment, and their feelings. 3. In order to best meet the patient's needs for comfort, the nurse should clarify the meaning of comfort with the patient so that he/she may individualize care. PMID- 2708794 TI - Circadian rhythms: charting oral temperatures to spot abnormalities. AB - 1. A normal daily variation in body temperature is found in the elderly. Normal oral temperature in an older person is lower than in a younger person, and the temperature peaks in the early afternoon and is lowest in the early morning hours before awakening. 2. Elderly subjects may be more prone to hypothermia in the early morning hours when their body temperature is naturally lower. Bathing may cause the body temperature to drop up to 1 degree C and add to this risk. 3. Many factors should be considered when analyzing temperature data for the determination of fever. Time of day, as well as symptoms of infection, should be considered. 4. Disturbances in circadian temperature rhythms accompany central nervous system dysfunction and may be an early indicator of other illnesses. PMID- 2708795 TI - RNs: Rx essential in nursing home care. PMID- 2708796 TI - Using guided imagery to combat postsurgical depression. AB - 1. Guided Imagery is an independent nursing intervention that has been used successfully in older adults to decrease the stress associated with illness and hospitalization. 2. Depression is one of the most common mental disorders in the elderly. It is related to feelings of helplessness, hopelessness, and sensory deprivation. 3. Discharge teaching that is individualized, realistic, and age related is the most effective with older adults. 4. The results of this study indicate that discharge teaching using guided imagery has the potential to decrease depression in older adults after discharge from the hospital. PMID- 2708797 TI - Transmission and control of methicillin-resistant Staphylococcus aureus in a skilled nursing facility. AB - Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly frequent in both acute care facilities (ACFs) and skilled nursing facilities (SNFs). Admissions to SNFs from ACFs with endemic MRSA are one likely source of infection in SNFs. The occurrence of MRSA in SNFs and the relative roles of ACFs and SNFs in MRSA transmission have not been well characterized. We conducted an epidemiologic investigation in an SNF reporting a high incidence of MRSA cases and found that the prevalence of MRSA exceeded that reported in acute care settings. Fifteen (9.1%) of the 164 residents were colonized or infected with MRSA. Risk factors for MRSA identified through a prevalence case-control study were nasogastric intubation (odds ratio = 5.5; 95% confidence interval = 1.2, 26.4), antibiotic therapy (OR = 3.9; CI = 1.2, 13.0), and hospitalization in an acute care facility within the previous six months (OR = 2.9; CI = 0.9, 9.7). During a three-month period, 6 of 100 new admissions were MRSA-positive; all positive patients were from ACFs. Five new cases also emerged from previously MRSA-negative residents. SNF residents are often discharged to ACFs. Transmission of MRSA within the SNF and the transfer of patients to ACFs increases the reservoir of potentially infective patients and the potential for MRSA infections in ACFs. Modest control measures, including targeted surveillance culturing and cohorting of colonized residents, may minimize MRSA transmission in the SNF and decrease the reservoir of MRSA in the community. PMID- 2708798 TI - Blood contamination of medical records. PMID- 2708799 TI - Infection control in Canada. AB - The information presented here reflects the activities of those organizations and agencies with the most impact on infection control in Canada. There are, however, numerous other organizations both on a national and provincial level that also play important roles in infection control. Although great strides have been made in infection control in Canada, we still have much to do to raise the profile of this important activity. PMID- 2708800 TI - Analysis of matched samples. PMID- 2708801 TI - Prospective multihospital surveillance studies--a controversy. PMID- 2708802 TI - Oxacillin-resistant S aureus. PMID- 2708803 TI - Evaluation of thyroid function in the critically ill. PMID- 2708804 TI - Cancer pain syndromes. PMID- 2708805 TI - Decision to withhold or withdraw support. AB - This decision-making process is inherently uncomfortable. The recognition and open discussions of the issues are relatively new. There is legal and practice precedent for withholding and withdrawing therapies and support. Institutions must now abide by Joint Commission guidelines while individual physicians are permitted to practice within their own conscience. Patients' best interests must be served, but it should be accepted that permitting the dying process to evolve while attending to comfort is not only an acceptable but desirable strategy. Finally, physicians must play an active and pivotal role as the facilitators of proper care. The details of proper medical care should be physician prescribed. PMID- 2708806 TI - Multiple prescription rule affects Schedule II drugs. PMID- 2708807 TI - Health care insurance cost increases to continue. PMID- 2708808 TI - Cyclosporine A inhibits relaxation but does not induce vasoconstriction in human subcutaneous resistance vessels. AB - The effects of cyclosporine on the functional characteristics of human subcutaneous resistance vessels were investigated. Resistance vessels were obtained from normal subjects undergoing routine surgery. Incubation with cyclosporine did not alter the resting tone of the vessels, but decreased the maximum contractile response and the sensitivity of the vessels to stimulation with exogenous noradrenaline and potassium. Cyclosporine decreased the rate of spontaneous relaxation and inhibited endothelium-dependent relaxation as assessed by the response to acetylcholine. Paradoxically, endothelium-independent relaxation as assessed by the response to sodium nitroprusside was augmented. Hypertension induced by cyclosporine may, in part, be explained by a reduction in relaxation of peripheral resistance vessels. PMID- 2708809 TI - Changes in platelet function due to hypertension: comparison of experimental hypertension with spontaneous hypertension in rats. AB - In washed platelets both from DOCA-salt and renal hypertensive rats, there was a marked decrease in thrombin-induced aggregation and secretion responses compared with those of respective controls. Concomitantly, the platelets showed attenuated malondialdehyde (MDA) formation and reduced serotonin contents, suggesting the presence of degranulated platelets in the circulation due to hypertension. In platelets from stroke-prone spontaneously hypertensive rats (SHRSP) at early hypertensive stages, thrombin-induced aggregation and secretion responses were similarly reduced. However, the platelet hypofunctions did not accompany reduced MDA formation and serotonin contents. Properties of platelets obtained from SHRSP at late hypertensive stages resembled those of platelets from experimentally hypertensive rats. These results suggest that the mechanisms of platelet hypofunction differ between experimental hypertension and spontaneous hypertension in their early stages. The hypo-aggregability observed in experimental hypertension appears to be secondary to the hypertension, whereas that seen in spontaneous hypertension seems to be a primary defect and not secondary to hypertension at early stages of hypertension. PMID- 2708810 TI - Effect of felodipine on blood pressure and vascular reactivity in stroke-prone spontaneously hypertensive rats. AB - Isolated tail arteries from stroke-prone spontaneously hypertensive rats (SHRSP), but not from normotensive Wistar-Kyoto rats (WKY), exhibit oscillatory contractions in response to norepinephrine. Previous studies indicate that the mechanism for these oscillations involves altered membrane calcium and/or potassium handling, and that this vascular change is a genetic defect associated with hypertension in SHRSP. The purpose of this experiment was to determine whether treatment of SHRSP with the calcium entry blocker felodipine would alter oscillatory activity. Adult SHRSP and WKY rats were treated orally with felodipine for 8 weeks. Felodipine treatment produced a significant decrease in blood pressure in SHRSP (control SHRSP: 240 +/- 7 mmHg, n = 6; felodipine-treated SHRSP: 164 +/- 8 mmHg, n = 5, P less than 0.05; tail-cuff method). Helically-cut tail artery strips from all rats were mounted in tissue baths for isometric force recording and exposed to norepinephrine (6 x 10(-9) to 6 x 10(-6) mol/l) for 20 min at each concentration. Oscillatory activity was defined as the sum of the magnitudes of all phasic contractions occurring during the final 10 min of norepinephrine incubation. Oscillatory activity was markedly reduced in tail arteries from felodipine-treated SHRSP when compared with control SHRSP. Felodipine also inhibited oscillatory activity when added directly to the tissue bath. It seems, therefore, that felodipine may lower blood pressure in SHRSP, at least in part, by correcting the genetic defect responsible for oscillatory activity. PMID- 2708811 TI - Manipulation of cytochrome P-450 dependent renal thromboxane synthase activity in spontaneously hypertensive rats. AB - Thromboxane synthase is a cytochrome P-450-like enzyme requiring an iron-centered oxygen attack of the prostaglandin endoperoxide substrate (PGH2) for subsequent thromboxane A2 (TxA2) formation. The activity and levels of P-450 enzymes can be manipulated by decreasing heme availability. Stannous chloride (SnCl2) selectively induces renal heme oxygenase activity, depleting heme and decreasing hemoprotein synthesis. We therefore manipulated the renal cytochrome P-450 system to influence thromboxane synthase activity, as measured by the conversion of 14C PGH2 to thromboxane B2 (TxB2) in renal cortical microsomes from spontaneously hypertensive rats (SHR). Seven-week-old SHR were treated subcutaneously with SnCl2 (1, 10 and 15 mg/100 g body weight) for 4 consecutive days, and cortical microsomal heme oxygenase activity, heme content, P-450 content, thromboxane synthase activity and systolic blood pressure were measured. Heme oxygenase activity was significantly increased from 1058 +/- 62 nmol/mg protein in controls to 3125 +/- 918, 5057 +/- 690--and 4236 +/- 581 nmol/mg protein in SHR treated with 1, 10 and 15 mg/100 g body weight SnCl2, respectively. The increase in heme oxygenase activity was associated with corresponding decreases in heme content (0.29 mumol/mg protein, for control to 0.12 mumol/mg protein for SHR treated with SnCl2, 10 mg/100 g body weight) and cytochrome P-450 content (0.18 +/- 0.1 nmol/mg protein for control to 0.06 +/- 0.01 nmol/mg protein for SHR treated with SnCl2 10 mg/100 g body weight). The reduction in heme and P-450 content was associated with a reduction in thromboxane synthase activity, i.e., decreases of 38, 35 and 47% from control levels at doses of 1, 10 and 15 mg/100 g body weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708812 TI - Evidence for the presence of angiotensins in normal, unstimulated alveolar macrophages and monocytes. AB - The presence of angiotensins was demonstrated in normal unstimulated alveolar macrophages and monocytes from both mice and rats. These peptides were partially purified from cell homogenates by ion exchange chromatography and identified as being [Ile5] angiotensin I (Ang I), [Ile5] angiotensin II (Ang II) and to a lesser extent [Ile4] angiotensin III (Ang III) using high performance liquid chromatography (HPLC). Based on the present data both alveolar macrophages and monocytes expressed Ang I as quantified by a specific and sensitive radio immunoassay (RIA) from the HPLC eluates. In contrast to this, alveolar macrophages from both mice and rats exhibited a fairly low, if detectable Ang II content. It seems reasonable to suggest that, in contrast to monocytes, macrophages do not generate and/or incorporate Ang II appreciably, at least in their resting stage. Although it is still not obvious whether these mononuclear phagocytes generate or simply capture angiotensin(s) from the blood pool or from the tissues; they must serve as in vivo target cells for the angiotensin system, at least for the plasma or tissue clearance of these molecules. PMID- 2708813 TI - Limited baroreflex control of heart rate in young stroke-prone spontaneously hypertensive rats. AB - Controversy regarding possible differences of baroreflex gain in spontaneously hypertensive rats (SHR) and their relationship to the rise in blood pressure may be due in part to variations in the methods used to assess baroreflex function. In this study, we have compared the baroreflex control of heart rate in normotensive (Wistar-Kyoto, WKY) and stroke-prone spontaneously hypertensive (SHRSP) rats at 1 and at 7 months of age. Mean arterial pressure and heart rate were monitored in conscious rats following implantation of arterial and venous catheters. Phenylephrine and nitroprusside were given intravenously and the peak responses of mean arterial pressure and heart rate were recorded. In the young rats, these recordings were repeated under anaesthesia. Individual slopes for responses to phenylephrine or nitroprusside were obtained by linear regression. A single relationship covering both sets of responses was also obtained by fitting the data to a sigmoidal curve. The latter approach enabled the baroreflex to be represented as a single function which has a single determinant of gain, operates within defined limits and can be readily related to resting mean arterial pressure and heart rate. This approach demonstrated that: (1) in adult SHRSP, the baroreflex had reset to operate at higher resting levels of mean arterial pressure; (2) the range of heart rate control was smaller in both young and adult SHRSP compared with WKY; (3) average gain was slightly, but not significantly lower in adult SHRSP; (4) anaesthesia reduced heart rate range and average gain in both strains of rat.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708814 TI - The measurement of internal pH in resistance arterioles: evidence that intracellular pH is more alkaline in SHR than WKY animals. AB - In order to investigate whether resistance arterioles from spontaneously hypertensive rats (SHR) were more alkaline than those from Wistar-Kyoto rats (WKY), mesenteric arterioles were mounted in a myograph and loaded with the pH sensitive dye 2',7'-bis (carboxyethyl)5,6-carboxyfluorescein (BCECF). At 5 weeks of age the arterioles from SHR were significantly more alkaline compared with WKY vessels, at a time when the blood pressure was rising and media:lumen ratio was increasing in the hypertension-prone animals. At 12 weeks this difference was not present due to a non-significant rise in intracellular pH in WKY arterioles. Activation of the vessels with high K+ depolarizing solution or noradrenaline induced an acid change in pH but no subsequent alkalinization was apparent. These results suggest that resistance arterioles from SHR are more alkaline than WKY vessels when the blood pressure is rising and their structural architecture is being modified, and the alkaline cytoplasmic pH may be contributing to the generation of the structural excess seen in these vessels in established hypertension. PMID- 2708816 TI - Histometric assessment of renal arterioles during DOCA and post-DOCA hypertension and hydralazine treatment in rats. AB - It is now well established that structural changes in resistance vessels contribute to the long-term maintenance of many forms of hypertension. This study measured the time course of structural change in smaller resistance vessels during the development of deoxycorticosterone acetates (DOCA) hypertension and after cessation of DOCA in Wistar rats by histometric assessment of cross sections of renal arterioles. The relationship of structural change to blood pressure was assessed by preventing hypertension during DOCA treatment with hydralazine. Blood pressure rose progressively during DOCA treatment reaching 192 +/- 3 mmHg compared with 132 +/- 2 mmHg in controls after 10 weeks. Five and 10 weeks after cessation of DOCA, following 10 weeks of DOCA treatment, post-DOCA reversal of hypertension was only partial. Medial area to internal elastic lamina (IEL) radius ratio, wall to lumen ratio and intimal area to IEL radius ratio of renal arterioles increased progressively during 10 weeks of DOCA treatment with partial reversal of the increased medial area and wall to lumen ratio 5 weeks post-DOCA. Hydralazine completely prevented hypertension in DOCA rats and also largely prevented structural change. PMID- 2708815 TI - Phenylephrine, vasopressin and angiotensin II as determinants of proto-oncogene and heat-shock protein gene expression in adult rat heart and aorta. AB - The expression of two oncogenes (conc) c-myc and c-fos, coding for nuclear proteins which play a regulatory role in growth and differentiation, and of two genes coding for two heat shock proteins (HSP) 68 (molecular weight 68,000) and 70 (molecular weight 70,000), which have a protective function during stress, have been investigated by Northern blot analysis of the total RNA, extracted from adult rat ventricle and aorta. (1) The two onc transcripts are absent from these tissues but their expression can be enhanced by a pretreatment with cycloheximide. (2) The HSP70 is, in part, constitutive, while HSP68 is not; both are thermo-inducible in an isolated coronary perfused rat heart. (3) The four messenger RNA (mRNA) are expressed in both ventricles and aorta, 1 or 2 hours after i.p. injection of 6 mg/kg phenylephrine or 12 IU/kg of vasopressin. (4) They are also induced by a continuous or discontinuous injection of angiotensin II (7.5 micrograms/kg per min) for 1-2 h, but only in the aorta. The lack of ventricular response to angiotensin II in rat ventricles has been attributed to the lack of angiotensin II receptors in this tissue. This indicates that, in addition to mechanical factors, circulating hormones which have in common the use of the phosphoinositol pathway, may activate the expression of genes coding for regulatory proteins. This may play a role in the genesis of both ventricular and aortic hypertrophy. PMID- 2708817 TI - Effects of smoking and physical exercise on platelet free cytosolic calcium in healthy normotensive volunteers. AB - Platelet free cytosolic calcium (PFCC) was measured in 21 healthy volunteers before and after cigarette smoking or physical exercise. The aim was to investigate whether acute blood pressure changes and increases in circulating levels of catecholamines and vasopressin modify PFCC. PFCC was determined using the Quin-2 method. Following cigarette smoking, significant increases in blood pressure, heart rate, plasma epinephrine (35 +/- 18 pg/ml before versus 51 +/- 31 pg/ml after smoking, P less than 0.05, mean +/- s.d.) and vasopressin levels (0.8 +/- 0.3 pg/ml before and 4.2 +/- 4.1 pg/ml after smoking, P less than 0.001) were observed. However, despite these acute hormonal and hemodynamic changes, PFCC remained stable at 156 +/- 55 nmol/l prior to the study and 157 +/- 29 nmol/l and 156 +/- 38 nmol/l at 20 and 80 min post-smoking, respectively. Acute physical exercise led to an increase in heart rate and systolic blood pressure but to a decrease in diastolic pressure. Moreover, a marked increase in plasma norepinephrine levels was observed after exercise (213 +/- 71 pg/ml before versus 747 +/- 501 pg/ml after exercise, P +/- 0.001). Again, PFCC was stable at 185 +/- 56 nmol/l at baseline versus 188 +/- 51 nmol/l at 20 min and 155 +/- 26 nmol/l at 80 min after exercise. These results therefore demonstrate that PFCC is not influenced acutely either by blood pressure increases, or by elevations in circulating catecholamine and vasopressin concentrations. PMID- 2708818 TI - An analysis of spontaneous hypertension in spontaneously hypertensive rats by means of new recombinant inbred strains. AB - The mode of blood pressure inheritance and some genetic markers of spontaneous hypertension were evaluated in a new set of recombinant inbred (RI) strains obtained by crossing of normotensive (BN.lx) and hypertensive (SHR) progenitor strains. Blood pressure values of RI strains were continuously distributed between both progenitor strains, although normotensive strains slightly prevailed. Statistical analysis suggested that there are three major genes and multiple minor genes responsible of the determination of spontaneous hypertension. The association between blood pressure and gene(s) within RT1 complex or gene(s) closely linked to it was found by RI strain analysis. This suggestion was confirmed by the detection of significant difference in blood pressure between SHR and SHR.1N congenic strains. Our results indicate that RT1 complex gene(s) may be involved in the development of high blood pressure. PMID- 2708819 TI - Factors determining sodium chloride sensitivity of patients with essential hypertension: evaluation by multivariate analysis. AB - Factors which determine sodium chloride sensitivity, defined as the difference between the mean blood pressure after 1 week of a low sodium chloride diet (3 g/day) and that after 1 week of a high sodium chloride diet (20 g/day), were studied in 60 inpatients with essential hypertension using a multivariate analysis. The sodium chloride sensitivity was independently correlated with the change in erythrocyte sodium concentration (r = 0.47) and with the change in plasma renin activity (r = 0.29); but it was not related to basal blood pressure, the change in plasma volume of the change in plasma norepinephrine concentration. These data suggest that both intracellular sodium accumulation and inadequate suppression of the renin-angiotensin system may be independently involved in the elevation of blood pressure after sodium chloride loading. We could not find the independent importance of volume retention, hyperadrenergic activity or basal blood pressure in the sodium chloride sensitivity. PMID- 2708820 TI - Enhanced sympathoadrenal reactivity to haemorrhagic stress in DOCA-salt hypertensive rats. AB - The effect of haemorrhagic hypotension on plasma catecholamine levels was studied in anesthetized normotensive and DOCA-salt hypertensive rats. The basal levels of plasma norepinephrine (NE) were significantly higher in DOCA-salt hypertensive rats than in normotensive rats. Moreover, the elevations in plasma NE and epinephrine (E) levels induced by haemorrhagic hypotension were found to be markedly potentiated in DOCA-salt hypertensive rats. Pretreatment with the re uptake blocker (desmethylimipramine) increased both basal and haemorrhage NE levels in DOCA-salt hypertensive as well as in normotensive rats. Consequently, basal and haemorrhage NE plasma levels remained significantly higher in the DOCA salt hypertensive animals than in the normotensive rats even following neuronal re-uptake blockage. This suggests that the elevated NE concentrations found in the plasma of DOCA-salt hypertensive rats both under basal condition and during haemorrhagic hypotension do not reflect a defective re-uptake. Moreover, in contrast with what is observed in normotensive animals, bilateral adrenalectomy did not induce any increase in basal or haemorrhage NE levels in the DOCA-salt hypertensive rats. This constitutes yet more evidence supporting the existence of an impaired balance of the sympatho-adrenal axis in this hypertension model. The present study therefore suggests that the potentiated plasma catecholamine response to haemorrhage in DOCA-salt hypertensive rats is the consequence of an increased sympathoadrenal reactivity and not of an altered neuronal uptake. This hyperreactivity may result from an impaired regulation of the sympatho-adrenal axis in that hypertension model. PMID- 2708821 TI - Stimulation of human synovial fibroblast DNA synthesis by platelet-derived growth factor and fibroblast growth factor. Differences to the activation by IL-1. AB - The pronounced synovial hyperplasia often found in the joints of patients with rheumatoid arthritis could be explained partially by the action of monocyte macrophage polypeptides (monokines). This report demonstrates that two cytokines which may be derived from monocyte-macrophage populations, namely platelet derived growth factor (PDGF) and basic fibroblast growth factor (bFGF), stimulate the DNA synthesis and proliferation of human synovial fibroblast-like cells cultured in low (i.e., 1%) fetal bovine serum. Epidermal growth factor, insulin like growth factor-I, insulin-like growth factor-II (multiplication stimulating activity) and substance P were inactive. Unlike IL-1, PDGF and FGF do not also stimulate PGE2, plasminogen activator, and hyaluronic acid levels. Thus PDGF and FGF, arising from stimulated monocyte-macrophages, may play a role in the stimulation of mesenchymal cell proliferation that often accompanies chronic inflammatory arthritic disease. The synovial cells respond to a variety of cytokines in different ways suggesting multiple-signaling pathways. PMID- 2708822 TI - Complete nucleotide sequence of a unique HLA class I C locus product expressed on the human choriocarcinoma cell line BeWo. AB - We have used Northern blot analysis to detect mRNA from class I HLA genes in the human choriocarcinoma cell line BeWo, which has been previously shown to express an atypical HLA class I molecule, in the absence of HLA A and B. Hybridization was seen with three class I DNA probes, the strongest being seen with the probe pC800, which corresponds to an 800-bp section of the Cw3 gene. We have made cDNA libraries from BeWo cells and screened for positive clones by using class I DNA probes. Of the clones isolated, we determined the complete sequence of one and partial sequence of five shorter clones. They all code for an identical C locus related product, which does not correspond to published C locus sequences. PMID- 2708823 TI - Quantification of IgG and IgG4 antibodies to bee venom phospholipase A2 by competitive inhibition in ELISA. AB - Phospholipase A2 (PLA) is the major antigen of bee venom. Individuals often stung by bees, such as bee keepers, show a restricted immune response mainly of anti PLA IgG4 antibodies. In contrast, patients allergic to bee venom produce high levels of PLA-specific IgE. This isotype restriction, the clinical relevance and the well defined structure of the PLA antigen, provide a useful model for the study of the principles regulating isotype expression in the human antibody response. A fundamental requirement for such studies is the availability of quantitative and sensitive assays to measure PLA-specific antibodies. Here we describe an ELISA method for direct isotype-specific quantification of anti-PLA IgG and IgG4 antibodies. Serum containing anti-PLA IgG antibodies was added at a predetermined dilution to PLA coated microtiter plates. Then mouse monoclonal antibodies to human IgG or IgG4 and different concentrations of purified human IgG and IgG4, respectively, were added simultaneously. The concentration of anti PLA IgG and IgG4 antibodies in the serum was calculated from the resulting inhibition curve. Additionally, an analytical method to compare unknown antibody samples with a standard in ELISA - avoiding problems of different affinities - is described. Using the technique described here, isotype-specific quantification of anti-PLA antibodies can be performed at a sensitivity of approximately 70 pg/ml with a reproducibility range of 10-15%. PMID- 2708824 TI - Preparation of monoclonal antibodies against methamphetamine. AB - 15 monoclonal antibodies against methamphetamine (MA) were obtained from hybridoma clones by the fusion of mouse 653 myeloma cells with the spleen cells of the immunized mice. The monoclonal antibodies exhibited different cross reactivities against MA-related compounds and one antibody (MA-15 Ab) was highly specific against MA. A competitive inhibition enzyme-linked immunosorbent assay was established and the detection limit for MA was approximately 20 ng/ml. PMID- 2708825 TI - Characterization of liposome suspensions by flow cytometry. AB - Novel approaches to drug delivery and induction of immune responses using liposomes have received much attention in recent years. Liposomes, however, are not a singular entity, but can be produced with a diverse group of phospholipids that form microspheres of different sizes, physical structure, electrochemical characteristics, and most importantly, physiologic properties. The purpose of this study was to establish the usefulness of flow cytometry as a convenient, rapid method for assessing the relative size and uniformity of liposomal preparations. Liposomes were made from phospholipid suspensions by sonication alone, or sonication followed by microemulsification. Forward laser light scatter (FSC) analysis of liposomal preparations by flow cytometry indicated that microemulsification produced homogeneous, small vesicles which were less than 1 micron in diameter, compared to the more heterogeneous sized liposomes generated by sonication alone. Transmission electron micrographs of the liposomal preparations were used to confirm the FSC results and showed that liposomes prepared by microemulsification were homogeneous, unilamellar vesicles which exhibited a mean diameter of 99.8 nm, whereas the sonicated-only preparation was more heterogeneous in size, exhibiting a mean diameter of 154.1 nm. Analysis of various liposome preparations by FSC during a 9 week storage period showed that small vesicles were relatively stable. We conclude that flow cytometry using FSC analysis provides a rapid, reproducible and convenient method to evaluate the relative size, uniformity and stability of liposomes. PMID- 2708826 TI - Comparison of different ELISAs for the detection of monoclonal antibodies to human interferon-alpha. Implications for antibody screening. AB - Three enzyme-linked immunosorbent assays (ELISA) were compared in the initial screening of some 400 hybridoma supernatants for antibodies to a recombinant human interferon-alpha subtype, 4a (IFN-alpha 4a). In these assays, (i) the antigen was coated directly to polystyrene microtitre plates (ELISA-PS), (ii) the antigen was coated directly to nitrocellulose (ELISA-NC), or (iii) the antigen and mouse antibody were reacted in solution and the resulting complex immobilized to a solid support precoated with polyclonal rabbit anti-IFN-alpha antibody (ELISA-SW). The ELISA-PS detected eight antibodies, the ELISA-NC 15 and the ELISA SW 18. The interferon specificity of the MAbs detected by each of the ELISAs was confirmed by neutralization of IFN-alpha antiviral activity and Western immunoblotting analysis. The results suggest that in ELISAs, the presentation of an antigen and its recognition by antibodies is substantially influenced by the method used in the immobilization of antigen and the type of solid support used. The ELISA-SW proved optimal for screening hybridoma supernatants for antibodies to IFN-alpha 4a, and is recommended for screening for antibodies to other soluble antigens. PMID- 2708827 TI - Optimizing the solid-phase immunofiltration assay. A rapid alternative to immunoassays. AB - The technical variables of the solid-phase immunofiltration assay (SPIA) for the detection of antibodies bound to antigens on a solid-phase filter have been investigated. The binding to solid-phase filters of 125I-labelled axial filament proteins derived from Treponema phagedenis and the optimal conditions for blocking non-specific protein binding were analysed. Axial filament was applied to nitrocellulose, Hybond Nylon and Zeta Probe. After extensive rinsing, the highest amount (68%) of axial filament was observed bound to Zeta Probe. However, blocking non-specific protein binding by pre-wetting the filter with rinsing buffer containing 0.5% Tween 20, prevented the binding of protein to the filter only when nitrocellulose was used as solid phase. Tween 20 (0.5%) in the rinsing and incubation solutions was found to be necessary for the reduction of non specific binding of contaminants in turbid sera. However, the use of such solutions resulted in a substantial leakage of antigen (47%) during rinsing procedures. Binding of antigen-specific antibody was analysed using 125I-labelled protein A. The maximal possible binding of the antibody occurred within 5 min when the antibody solution was filtered. For optimal binding of 125I-labelled protein A an incubation time of 1 h was needed. It is suggested that solid-phase immunofiltration may provide a rapid alternative for radioimmunoassays or enzyme immunoassays for the detection of specific antibodies. PMID- 2708828 TI - In vivo localization of lymphocytes labelled with low concentrations of Hoechst 33342. AB - Hoechst 33342 (HO 33342) is a fluorescent dye which binds specifically to DNA and can be used to label lymphocytes for in vivo migration studies. Lymphocytes were treated with varying concentrations of HO 33342 and assayed in vitro for effects on viability, mitogen-stimulated proliferation, and motility. In vivo traffic studies were performed to determine a dye concentration with minimal toxicity for lymphocytes, but sufficient fluorescence for detection of cells in frozen sections. The concentration reported to yield quantitative staining of nuclear DNA (10.7 microM, or 6 micrograms/ml) reduced motility and proliferative response, and resulted in an altered lymphocyte migration pattern compared to untreated lymphocytes. A concentration of 0.25 microM, however, produced no toxicity in the in vitro assays, and an in vivo migration pattern similar to that of untreated cells; lymphocytes stained with 0.25 microM HO 33342 for 30 min were readily observable in histological sections. This study indicates that the concentration of HO 33342 optimal for DNA staining may exert deleterious effects on in vivo lymphocyte traffic studies, and that far lower dye concentrations are more suitable for such studies. PMID- 2708829 TI - The management of children born to human immunodeficiency virus seropositive women. AB - Increasing numbers of children born to human immunodeficiency virus (HIV) antibody-positive women are being identified, but guidelines as to their management are lacking. We have therefore established a paediatric counselling and screening clinic for managing such children in Edinburgh. During a period of 3 years, 49 infants and children of 43 HIV seropositive women have been seen. After a median follow-up period of 23 months, four children were found to have clinical evidence of HIV disease which was non-specific and could have been missed had they not been regularly monitored. Thus, close surveillance of infants born to seropositive women is important. Identifying a single clinic where this is done has allowed experience to accumulate on issues beyond the medical management of these infants as well as contributing to the clinical care of infants with symptoms. Based on this experience, we have developed guidelines for managing children born to HIV antibody-positive women. PMID- 2708830 TI - The nasopharyngeal bacterial flora in the sudden infant death syndrome. AB - The nasopharyngeal bacterial flora in babies who had died of the sudden infant death syndrome (SIDS) (n = 46) and in healthy infants aged 2 weeks to 6 months (n = 46) is described. Of those who had died, 41.3% carried Staphylococcus aureus (95% confidence limits: 27.3-55.3%) compared with 28.3% of healthy infants (95% confidence limits: 15.3-41.3%). The isolation rate of streptococci was 78.3% in cases (95% confidence limits: 66.4-90.2%) and 32.6% in healthy infants (95% confidence limits: 19.1-46.1%) (significant difference P less than 0.0001). Enterobacteria were isolated from 45.6% of cases (95% confidence limits: 31.2 60%) but only 2.2% of healthy infants (95% confidence limits 0-6.4%) (significant difference, P less than 0.0001). These results indicate a disordered nasopharyngeal flora in SIDS. They also provide baseline data for investigating the hypothesis that common bacterial toxins are involved in the pathogenesis of SIDS. PMID- 2708832 TI - Citrobacter freundii bacteraemia presenting as typhoid fever. AB - Citrobacter infections usually arise opportunistically in immunocompromised persons. We report the case of a young man in whom Citrobacter freundii caused a primary invasive illness similar to typhoid fever. PMID- 2708831 TI - Autoimmune neutropenia and thrombocytopenia associated with development of antibodies to human immunodeficiency virus. AB - We report on two patients with acute human immunodeficiency virus (HIV) infection, who developed an infectious mononucleosis-like clinical episode with thrombocytopenia and granulocytopenia. In both cases we detected the presence of IgG antigranulocyte antibodies and in one case the presence of IgG, IgM and IgA antiplatelet antibodies. The mechanisms of these cytopenias are discussed. The association between such autoimmune cytopenias and acute HIV infection has not been previously reported. We suggest testing for HIV seroconversion in patients with a seronegative infectious mononucleosis-like syndrome belonging to groups with a high risk for HIV infection. PMID- 2708834 TI - Malaria in spite of chemoprophylaxis. PMID- 2708833 TI - Mycoplasma hominis as a respiratory pathogen in X-linked hypogammaglobulinaemia. AB - We report a case of lower respiratory tract infection with Mycoplasma hominis in a patient with X-linked hypogammaglobulinaemia. PMID- 2708835 TI - Aetiology of fulminant hepatitis in children. PMID- 2708836 TI - Non-menstrual toxic shock syndrome complicating orthopaedic surgery. PMID- 2708837 TI - Simple samples for diagnosing influenza. PMID- 2708838 TI - Infectious Diseases Eradication Advisor. PMID- 2708839 TI - Use of laser vaporization for management of extensive genital tract condyloma acuminata during pregnancy. PMID- 2708840 TI - Cervicovaginal infection with group B streptococci among pregnant Mexican women. PMID- 2708841 TI - Disseminated candidiasis in a drug addict not using heroin. PMID- 2708842 TI - Melioidosis: a major cause of community-acquired septicemia in northeastern Thailand. AB - In a prospective study of all patients with Pseudomonas pseudomallei infections admitted to a large provincial hospital in northeastern Thailand, 63 cases of septicemic melioidosis and 206 patients with other community-acquired septicemias were documented during a 1-y period. Apart from P. pseudomallei, the spectrum of bacteria isolated from blood cultures and the overall mortality (32%) were similar to those previously reported elsewhere. Death from septicemia was associated with failure to develop a leukocytosis or pyrexia over 38 degrees C, azotemia, hypoglycemia, and jaundice. Septicemic melioidosis presented mainly in the rainy season, occurred predominantly in rice farmers or their families, and was significantly associated with preexisting diabetes mellitus or renal failure (P = .03). Blood-borne pneumonia and visceral abscesses were common and the mortality was high (68%; P less than .001). The response to appropriate treatment was slow (median fever clearance time 5.5 d) and the median duration of hospital stay was 4 w. Septicemic melioidosis is a major cause of morbidity and mortality in northeast Thailand. PMID- 2708843 TI - Netilmicin in the treatment of gram-negative bacteremia: single daily versus multiple daily dosage. AB - Seventy patients with culture-proven bacteremia with gram-negative rods were randomly treated with either a single (S) dose daily or multiple (M) doses daily of netilmicin. All bacterial strains were susceptible to the antibiotic. No differences were found with respect to efficacy. Therapy for bacteremia failed in two M patients, but bacteria persisted in 17 (10 S, 7 M) at the primary infection site. In 12 there was an anatomic or physiologic factor contributing to this persistence. One S patient showed mild nephrotoxicity, but ototoxicity was not found in any of the 35 patients who underwent serial audiography. Mild reversible rises of transaminases were found in 5 of 35 S patients and in 3 of 34 M patients. Once-daily administration of netilmicin seems to be as effective and as safe as conventional multiple daily doses. PMID- 2708844 TI - Bronchopulmonary cross-colonization and infection related to mycobacterial contamination of suction valves of bronchoscopes. AB - Recurrent episodes of mycobacterial cross-contamination of bronchoscopy specimens were identified in a large, tertiary-care referral center. One episode was followed by active pulmonary infection due to Mycobacterium tuberculosis. Initial epidemiologic investigation implicated the flexible fiberoptic bronchoscopes. In experiments, bronchoscopes and related equipment were exposed to a saline suspension of M. fortuitum (10(5)-10(7)/mL). Bronchoscopes were readily sterilized by routine cleaning and disinfection procedures, but the spring operated suction valves remained contaminated, even after a 30-min exposure to 2% glutaraldehyde or after passage through a commercial bronchoscope washer. These results indicate that suction valves that have been heavily contaminated with mycobacterial organisms cannot be reliably disinfected with commercially available glutaraldehyde. Suction valves have since been routinely autoclaved after each use. No additional episodes of cross-contamination or infection have occurred over 24 mo of surveillance. PMID- 2708845 TI - Bacteremia associated with percutaneous extraction of biliary tract stones. PMID- 2708846 TI - Comparative efficacy of amoxicillin-clavulanate, cloxacillin, and vancomycin against methicillin-sensitive and methicillin-resistant Staphylococcus aureus endocarditis in rats. PMID- 2708847 TI - Serum IgG and IgM responses in mumps infection as measured by ELISA using a guinea pig capture antibody raised by intranasal immunization. PMID- 2708848 TI - The histopathological picture of concomitant infection with Leishmania major and Toxoplasma gondii in albino mice. AB - Zoonotic cutaneous leishmaniasis caused by L. major and toxoplasmosis caused by T. gondii are prevalent among man and animals in several localities in Egypt particularly in the Nile Delta and Sinai. Double infection may take place. In this paper, it was intended to study the concomitant infection in albino mice. The results showed that the clinical and histopathological pictures differ in concomitant infection from that shown by infection with either parasite alone. Therefore leishmaniasis and toxoplasmosis must be diagnosed parasitologically. PMID- 2708849 TI - A preliminary survey of parasitic infections and nutritional status among school children in Riyadh, Saudi Arabia. AB - A total of 320 school children in the Model Institute of the Capital in Riyadh, were clinically and parasitologically examined. Thirty-five (10.94%) had intestinal parasites. Entamoeba coli (61.91%) was found more frequently among the commensals, while Giardia lamblia (28.57%) was the most common pathogenic parasite. All urines were parasite free. The low infection rate with Gardia could be explained by the good physical and nutritional status and better sanitary and living conditions. PMID- 2708850 TI - Effect of Schistosoma mansoni infection, starvation and molluscicides on acid phosphate, transaminases and total protein in tissues and hemolymph of Biomphalaria alexandrina. AB - The activities of GOT and GPT in the hemolymph of B. alexandrina were significantly decreased by S. mansoni infection. However, the total protein concentration and AcP activity were increased. Although the snail starvation decreased AcP activity in the ovotestis, it increased GOT activity in the other organs of the snails. On the other hand, the snail feeding after starvation increased significantly AcP activity in ovotestis. Natural and synthetic molluscicides inhibited the activities of GOT and GPT, however, they increased the total protein concentrations and AcP activities in the examined organs. PMID- 2708851 TI - Experimental trichinosis in alloxan induced diabetes in mice. AB - The course of Trichinella spiralis infection was studied in Alloxan induced diabetes in mice. The number of Trichinella larvae in muscles of infected animals was estimated by digestion of whole carcases and compared with control non diabetic group. Histopathological study of infected muscles was also done. It was found that diabetic mice developed very heavy muscle parasitism and their larval count was high compared with non diabetic animals. Besides, there was heavy inflammatory cellular reaction around poorly encapsulated larvae. Mortality rate was 100% by day 45 in diabetic mice while control animals survived during the period of observation which was 3 months. These data indicated that hyperglycaemia significantly increased parasitisaemia and mortality in mice infected with T. spiralis. PMID- 2708852 TI - Estimates of Egyptian culcine longevity in nature altered by fluctuations in biting population density. AB - Estimates of vectorial capacity (VC) depend upon longevity of mosquito field populations, and expected longevity is estimated from the parity rate of the population. Seasonal variation in parity rates confound estimates of longevity which may not reflect actual population survival but are induced by changes in the rate of emergence of female mosquitoes. By comparing parity rates and biting activity in natural population of 2 Culicine mosquitoes, Culex pipiens and Cx. antennatus, we found that parity rate was low in the beginning of the season and high at the end. Parity rate appeared least affected during the weeks with maximal daily biting activity. We conclude that estimates of VC are most accurately determined for the two vector species studied when mosquito biting activity is maximal. PMID- 2708853 TI - A review of genus Eumegacetes Looss, 1900 (Eumegacetidae), with description of species from the Egyptian house sparrow: Passer d. niloticus. AB - Genus Eumegacetes is briefly reviewed E. (Anterovitellum) sp. is described from Passer domesticus niloticus caught from Sharkiya Governorate, North Delta, which represents the first host and new locality. A key is proposed to differentiate the three species of the genus known so far from Egypt. PMID- 2708854 TI - Toxicity of colocynithin and hydrated colocynithin from alcoholic extract of Citrullus colocynthis pulp. AB - The comparative toxicity of the alcoholic extract of Citrullus colocynthis pulp; colocynithin and hydrated colocynithin have been isolated and tried against seven insect species. The American cockroaches were more susceptible for both compounds than the German one, adult honey bee were more affected with Colocynithin than adult housefly. while hydrated colocynithin was more toxic to housefly than honey bee, cotton leafworm was less affected with both toxicants. Bed bug was less affected with Colocynithin than mosquito, but V.V. with hydrated Colocynithin. A direct parallel relation was found between toxicity and rate of penetration. PMID- 2708855 TI - Serum and intestinal immunoglobulins in heterophyiasis. AB - Serum and intestinal immunoglobulins are determined in 50 patients with heterophyiasis. The most outstanding findings were highly elevated IgE levels in serum but not in intestinal contents. Increased serum IgM, IgG and IgE were detected, while only intestinal IgM, IgG and IgA were elevated. An inverse relationship between serum and intestinal IgM, IgG and IgA and the load of infection was proved. PMID- 2708857 TI - A microfilaria in a stray cat from Assiut, Egypt. AB - During a survey for helminth parasites among stray cats in Assiut area, microfilariae were detected. The morphology of the microfilarias was described. PMID- 2708856 TI - Antiparietal cell antibodies in gastritis associated with chronic liver diseases. AB - Thirty patients with gastritis associated with chronic liver disease and ten normal controls were the subject of this study. Pathologically about 18 were diagnosed as chronic atrophic gastritis, 10 as chronic superficial gastritis, 1 as gastric atrophy and 1 as hypertrophic gastritis. Parietal cell antibodies (PCA) were detected (IFA) in 2 cases with no significant relation. PMID- 2708858 TI - A study on intestinal helminths causing human anaemia in Cairo. AB - Haematological and biochemical studies were done for 50 urban and rural Egyptians, from Cairo, suffering from Ancylostoma duodenale, Ascaris lumbricoides, Enterobius vermicularis, Hymenolepis nana, Schistoosma mansoni and Taenia saginata. Anaemia of varying degrees was noticed in all cases. The lowest Hb% and hematocrit value and highest eosinophilia were found in cases of ancylostomiasis with severe hypochromia compared with the other parasitic infections. Total blood protein was normal in all cases, except in 2 cases of S. mansoni, it was higher. Blood cholesterol and blood urea showed no deviation. PMID- 2708859 TI - Ecological studies on the solitary ectoparasitoid Dirhinus wohlfahrtiae Ferriere (Hymenoptera: Chalcididae). AB - While Dirhinus wohlfahrtiae was abundant at the moderate weather, it could not be recovered during winter months. The life cycle required 22.86 days at 25 +/- 2 degrees C and 65 +/- 5% R.H., longevity of adult males and females was equal to 35.78 and 39.83 day respectively. Under a constant relative humidity (67%), the development and multiplication of the parasitoid was more optimum at 25 degrees C than at 18 and 35 degrees C. PMID- 2708860 TI - Taxonomic studies of subfamily Phaoniinae (Muscidae, Diptera) in Egypt. AB - Subfamily Phaoniinae is represented in Egypt by 22 species under 9 genera. Synthesiomyia nudiseta (Wulp.) and Ophyra leucostoma (Wied.) are identified and recorded for the first time in Egypt. PMID- 2708861 TI - Studies on biting midges of the genus Culicoides in the Suez Canal Zone. AB - The importance of the biting midges of the genus Culicoides being in their role as vector of non periodic filarial worms of the genus Mansonella and Dipetalonema to man and pathogenic virus to livestock. Besides, their painful bite may disappear within an hour or cause an appreciable systemic reaction. In this paper, the four species recorded in the Suez Canal Zone (C. schultzei, C. puncticollis, C. pallidipennis & C. distinctipennis) were redescribed. Also, the hours of activity of the most common and abundant species, C. schultzei was studied. C. neavei Austin, 1912, representing a new record in Egypt. PMID- 2708862 TI - A preliminary observation on in vitro inhibitory effect of cyclosporin-A upon growth of Leishmania tropica promastigotes. AB - Cyclosporin-A, an immunomodulatory drug was assessed for its leishmanicidal activity in vitro. A Sudanese strain of L. tropica has been used in this study. The results obtained suggested a weak leishmanicidal action of this drug on L. tropica promastigotes. PMID- 2708863 TI - A comparison of two techniques for the quantitative determination of oocysts in faecal samples. AB - Coccidial oocysts (Eimeria tenella) were counted in faecal samples (n = 2 * 101) from two broiler anticoccidial battery trials. A direct flotation technique using zinc sulphate solution and an indirect technique using sodium chloride solution for the examination of samples stored in potassium dichromate were compared. Both techniques were correlated (P less than 0.001) and showed little difference in sensitivity. With the indirect method, oocyst counts were slightly lower ( 1.53%), but the difference between the experimental groups was not significant (Wilcoxon test (pair difference test), p less than 0.083). Advantages and disadvantages of both methods are discussed. PMID- 2708864 TI - IgE level in parasitic diseases before and after specific therapy. AB - Fifty patients (3-12 years old) with parasitic infestation vz: E. histolytica, Oxyuris, H. nana, Ascaris and mixed infection were compared to ten healthy age and sex matched normal school children. They were subjected to stool and urine analysis total and differential white count, serum protein and serum IgE estimation before and after the specific treatment. The absolute eosinophilic count was high during infestation in all groups and significantly decreased after treatment (P less than 0.01). The serum IgE showed a significant increase during infestation in all groups. It decreased significantly after treatment in Entamoeba histolytica, Hymenolepis nana, and Ascaris groups (P less than 0.025). It decreased but with insignificant difference in Oxyuris and mixed infection groups probably due to the ease of reinfection and the need for longer duration of therapy. It was concluded that both serum IgE elevation and eosinophilia are important hallmarks of intestinal parasitic infections and the absolute eosinophilic count could be earlier indicator for responsiveness to treatment. PMID- 2708865 TI - Four methods in diagnosing protozoal parasites in stool. AB - Stool examination by 4 different methods showed that zinc sulphate floatation technique was more or less the best. PMID- 2708866 TI - A case report of human trichinosis in Tanta. PMID- 2708867 TI - Biological and haematological changes in experimental cryptosporidiosis. AB - In experimentally infected laboratory-bred white rats, Cryptosporidium infection rate was higher among immunosuppressed (75%) than immunocompetent ones (37.5%) with statistically insignificant difference. Cryptosporidiosis was found to be a fatal disease especially in immunosuppressed rats (50%). There was also marked flourishing of the infection as revealed by high intensity of infection in immunosuppressed than the immunocompetent rats (363 and 82.7 oocysts/pellet respectively). In spite of the severe disease, cyclophosphamide appeared to have no effect on the prepatent period. In both immunosuppressed and immunocompetent infected rats, there was a decrease in the total leucocytic count with marked lymphocytopaenia. This indicates decreased resistance to infection, thus higher oocyst counts in the pellets. PMID- 2708868 TI - Tapeworms of quails (Coturnix coturnix) in Egypt. AB - The intestines of 150 grey quails (Coturnix coturnix) were examined at postmortem, for tapeworms infestation. Two species of cestodes were collected Raillietina echinobothrida and Choanotaenia infundibulum. The prevalence, average number of worms per bird and their morphology were reported. Its worth to mention that quail was found to be a new host for R. echinobothrida. PMID- 2708869 TI - An immunoserological study among blood donors of Makkah region, Saudi Arabia. AB - Blood services are inevitable and life-saving. Therefore all measures should be taken to guarantee that the donated blood is pathogen free. The present study intends to throw some light on the prevalence of some infectious and parasitic diseases among blood donors, whether Saudi or expatriates residing in Makkah region (Makkah and Jeddah cities). Results of this work indicate that hepatatis B is one of the most important problems involved in blood services in this region. On the contrary sexually transmitted diseases like syphilis and AIDS do not comprise a real health problem so far. However, periodic check-up and intensive health education are of utmost importance. Hydatidosis does not constitute a real problem as dogs are mostly avoided in this region. PMID- 2708870 TI - Antibiotics for vaginal oocyte aspiration. PMID- 2708871 TI - The impact of high progesterone levels in the follicular phase of in vitro fertilization (IVF) cycles: a comparative study. AB - Estrogen (E2) and plasma progesterone (P4) levels are valuable parameters for follicular development in in vitro fertilization (IVF) cycles. Furthermore, the progesterone concentration prior to, during, and following human chorionic gonadotropin (hCG) administration is an important marker for the detection of early luteinization and premature ovulation. The pattern of hormonal profile in relation to the number of oocytes retrieved, fertilized, and cleaved and the fate of the pregnancies achieved were compared in three groups of patients treated by the same protocol. Group I included 22 women who conceived with high progesterone levels on day hCG + 1 (P4, greater than 2.5 ng/ml). Group II included 43 women who conceived with low P4 values (P4, less than 2.5 ng/ml), while group III included 46 patients in whom no pregnancies occurred. A significant decrease in fertilization, cleavage, and pregnancy rates was observed in patients with high progesterone levels on day hCG + 1, compared to those with normal levels. Nevertheless, it is suggested that cycles with high P4 levels in the preovulatory phase should not be canceled, as a fair chance for pregnancy still exists. PMID- 2708872 TI - Lack of correlation of immunosuppressive activity secreted by human in vitro fertilized (IVF) ova with successful pregnancy. AB - The high rate of implantation failure in humans following in vitro fertilization (IVF) has been attributed to a lack of production of immunosuppressive factors by cleaved embryos, rendering them vulnerable to maternal immune attack just before or around implantation. Systemic as well as blastocyst-secreted suppressor factors have been described and claimed to be responsible for successful pregnancy. Experimentally, we have screened in a double-blind fashion the suppressive activity of human embryo culture media (B2 Menezo system, France) in which zygotes after decoronization were individually cultured during 24 hr on lymphocyte proliferation as well as natural killer (NK) activity. Suppressive activity in media from cleaved and uncleaved ova did not differ significantly, and activity in media from transferred embryos was not correlated significantly with successful pregnancy. The implications of these data are discussed. PMID- 2708873 TI - An 18-month survey of infertility treatment by in vitro fertilization, gamete and zygote intrafallopian transfer, and replacement of frozen-thawed embryos. AB - An 18-month survey of infertility treatment by in vitro fertilization (IVF) and related procedures at the Centre for Reproductive Medicine of the Vrije Universiteit Brussel is described. During this period, 1326 treatment cycles were started in patients with long-standing infertility and 1135 oocyte retrievals were performed in 771 different patients. IVF and embryo transfer (ET) after laparoscopic (N = 793) or ultrasonically guided (N = 342) ovum pickup, gamete intrafallopian transfer (GIFT; N = 284), or zygote intrafallopian transfer (ZIFT; N = 15) combined with IVF as well as the replacement of cryopreserved embryos yielded an overall pregnancy rate of 21.8% per started cycle. Echographic and laparoscopic oocyte retrieval gave similar results except for a higher fertilization rate after echographic-guided retrieval. For in vitro fertilization and embryo transfer an overall pregnancy rate of 26% per transfer was obtained. For GIFT and ZIFT the pregnancy rates were, respectively, 27.8 and 46.7% per replacement. For each procedure one-third of the pregnancies aborted. After the replacement of frozen and thawed embryos, during a natural cycle, a significantly lower fetal loss was observed. PMID- 2708874 TI - The effect of clomiphene citrate on human preovulatory oocyte maturation in vivo. AB - Sixty-four infertile women underwent diagnostic laparoscopy in the periovulatory period at time-bracketed intervals following their endogenous luteinizing hormone (LH) surge. Forty-eight of these women were studied during natural cycles and 16 had mild oligoovulation and were administered clomiphene citrate (CC) to regulate their cycles. No patient received human chorionic gonadotropin. No patient was undergoing either in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT). Follicle puncture was performed and the oocytes were observed immediately for stage of maturation. Oocytes obtained from follicles exposed to CC were found to require an increased interval of time to reach metaphase I compared to oocytes obtained from natural cycles (27.75 +/- 2.2 vs 22.5 hr; mean +/- SE). Furthermore, the interval of time required for metaphase I oocytes to achieve metaphase II was statistically significantly shortened for CC cycles (2.4 hr for CC vs 10 hr for natural cycles. Nevertheless, there was no difference between natural and CC cycles in the time interval between LH surge onset and ovulation. These in vivo findings suggest a direct effect of CC on human oocyte maturation and may help explain the well-established discrepancy between the relatively high ovulation rate and the relatively low conception rate in clomiphene-induced cycles. PMID- 2708875 TI - Development of spare human preimplantation embryos in vitro: an analysis of the correlations among gross morphology, cleavage rates, and development to the blastocyst. AB - Following in vitro fertilization, the criteria commonly used to select human embryos for transfer are the cleavage rate and gross morphology, the contention being that those embryos which divide more rapidly and have regular, spherical blastomeres are more likely to lead to a pregnancy. In order to assess the validity of this assumption, the development in vitro of spare embryos was investigated. Eggs and embryos were cultured in Earle's balanced salt solution containing 10% heat-inactivated patient's serum, and insemination was performed at 40 hr post human chorionic gonadotropin (hCG). At 82-90 hr post hCG, up to four embryos were transferred. Any spare embryos were cultured in the same medium for up to 6 days and scored daily for cell number and morphology using a "quality" scale of 4-1 according to degree of fragmentation and shape of the blastomeres. Of 317 fertilized eggs, 55 (17%) developed to the fully expanded blastocyst stage. The remaining embryos ceased development at the one-cell (6; 2%), two-cell (49; 15%), four-cell (110; 35%), eight-cell (61; 19%), and cavitating morula (36; 11%) stages. The relationship between developmental arrest and gross morphology is discussed. PMID- 2708876 TI - On the diagnostic value of the hypoosmotic sperm swelling test in an in vitro fertilization (IVF) program. AB - The ability of the hypoosmotic sperm swelling (HOS) test to identify nonfertilizing sperm samples in a group of 50 couples undergoing in vitro fertilization (IVF) was investigated. The findings indicate that the HOS test is not significantly more useful than any of the standard semen variables for this purpose. PMID- 2708877 TI - The hemizona assay (HZA): a predictor of human sperm fertilizing potential in in vitro fertilization (IVF) treatment. AB - The hemizona assay (HZA) was developed to assess human sperm fertilizing potential. This blinded study investigated the relationship between sperm binding to the hemizona and in vitro fertilization (IVF) success (36 patients). Nonliving human oocytes were recovered from excised ovaries and stored. Each zona pellucida was cut into equal hemispheres by micromanipulation. For the HZA, one droplet exposed a hemizona to abnormal spermatozoa, while the control droplet contained the matching hemizona and spermatozoa from normal semen. After 4 hr, the number of tightly bound spermatozoa was counted. Binding to the hemizona was significantly higher for those having IVF success (mean of 36.1 +/- 7, versus 10.4 +/- 4 from the failure group; P less than 0.05). Fewer sperm from the failure group had a strictly normal morphology (3.2 versus 12.7%; P less than 0.05, Kruger method). Tight zona binding was significantly correlated with the percentage motile sperm, percentage normal morphology, and seminal sperm concentration. These results enhanced our confidence that the HZA is diagnostic for identification of patients at high risk of failing to achieve fertilization in vitro. PMID- 2708878 TI - Ovarian hyperstimulation inhibits embryo implantation in the mouse. AB - Embryo implantation is dependent on the synchronous development of the embryo and of the endometrium. Pharmacologic doses of estrogens change endometrial histology and are known to inhibit implantation. During controlled ovarian hyperstimulation, such as occurs during an in vitro fertilization cycle, serum estradiol levels may be elevated to as much as three to six times those found during spontaneous cycles. Serum progesterone levels are also increased and may counteract the elevated estradiol levels. The overall effect of ovarian stimulation on implantation is therefore not known. To study this question, we developed a mouse embryo donation model. Donor embryos were obtained in the late morula to early blastocyst stage from hyperstimulated mated mice. The donated embryos were then transferred to the uteri of two groups of recipient mice. The study group underwent ovarian hyperstimulation with pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) (OHR group), while the controls were allowed to cycle spontaneously (SR group). All recipient mice underwent cervical stimulation to induce a pseudopregnant state. Five embryos were transferred to the left uterine horn of each of nine OHR mice and seven SR mice. A higher implantation rate was noted in the SR group than in the OHR group (50 +/- 12 vs 8 +/- 4%, P less than 0.001). Our data suggest that, in the mouse, ovarian hyperstimulation impedes implantation by causing adverse changes in uterine receptivity. PMID- 2708879 TI - Laser therapy in the management of benign and malignant tumours in the colon and rectum. AB - Since 1983 the Neodymium-YAG laser has been used endoscopically to treat 93 patients with inoperable colorectal carcinoma and 18 patients with benign sessile adenomas. In an additional 11 patients with colorectal cancer, photodynamic therapy (PDT) has been applied using an argon-pumped dye laser. Objective and subjective measurements of quality of life have shown the beneficial effects of the Nd-YAG laser in the relief of symptoms, and four patients have apparently been rendered disease free. Benign tumours also respond to Nd-YAG ablation but close histological supervision is necessary to detect malignant transformation at an early stage. Although PDT may offer a potential for cure in small inoperable tumours, it seems likely that Nd-YAG laser treatment will remain the laser option of choice for advanced bulky tumours. PMID- 2708880 TI - Soiling: anorectal function and results of treatment. AB - Forty-five patients with soiling but without faecal incontinence were evaluated by means of anorectal function investigations (anal manometry, rectal capacity and saline infusion test). The causes of soiling and the effect of treatment on both soiling and anorectal function were studied. The results were compared with a control group of 161 patients without soiling or incontinence. The diagnoses were haemorrhoids (10), mucosal prolapse (7), rectal prolapse (6), fistulae (5), proctitis (3), faecal impaction (2), rectocele with intussusception (2), scars after fistulectomy (2) and others (8). Simple inspection and proctoscopy were generally sufficient to establish a diagnosis. For two patients the diagnosis rectocele was made after defaecography. Anorectal test results did not differ between the soiling and control group, did not contribute to establish a diagnosis and did not change after treatment. Only patients with a rectal prolapse had abnormal results in anorectal function tests: a low basal sphincter pressure and a limited continence reserve. Appropriate therapy resulted in complete recovery (44%) or improvement of symptoms (29%). PMID- 2708881 TI - The natural history of symptomatic haemorrhoids. AB - In order to calculate the prognosis for a person who has developed a first episode of second degree haemorrhoids, 186 patients were randomly assigned to either no active treatment (expectant management) (n = 91) or rubber band ligation (n = 98) and reviewed every 6 months. The median follow-up period was 48 months in both groups with a range from 6-48 months in the banding group and from 18-48 months in the expectant management group. Rubber band ligation was performed at most three times with three weekly intervals. There were 6 treatment failures in the banding group in contrast to 31 in the expectant management group (p less than 0.01). The calculated recurrence rate by actuarial analysis among patients initially cured by rubber band ligation was 33% (95% confidence limits: 23-45) at four years and 61% (95% confidence limits: 48-74) in the expectant management group (p less than 0.05). It is concluded that rubber band ligation of symptomatic second degree haemorrhoids in up to three single treatments at three weekly intervals at the time of diagnosis significantly altered the prognosis without causing significant morbidity. However, 25% of the patients treated by expectant management never developed another episode during the four years observation time. PMID- 2708882 TI - Differences in anal sensation in continent and incontinent patients with perineal descent. AB - Neuropathic damage secondary to pelvic floor descent is considered to be an important aetiological factor in idiopathic faecal incontinence. Perineal descent however does not necessarily result in a loss of motor function or incontinence. To elucidate the role of anal sensation in the continence mechanism we measured mucosal electrosensitivity and thermal sensitivity in normal controls and in both continent and incontinent patients with perineal descent. A catheter carrying two platinum electrodes was used to assess mucosal electrosensitivity and a water perfused thermode 1 cm long to measure thermal sensory thresholds. In addition, routine anal manometry was performed. The degree of perineal descent and anorectal angle was assessed radiographically. Anal sensation was largely preserved in continent patients with perineal descent (Controls vs continent perineal descent, Mucosal electrosensitivity (ma), lower anal canal: 4 (2-7) vs 5 (2.6-8) ns; middle anal canal 4 (2-7) vs 4.2 (2-15) ns; upper anal canal 6.5 (4 13) vs 8.3 (3.6-16) p less than 0.05, thermal sensitivity, median threshold (degrees C), lower anal canal 0.92 (0.5-2.5) vs 0.95 (0.3-3.6) ns; middle anal canal 0.83 (0.4-1.5) vs 0.75 (0.2-2) ns; upper anal canal 0.98 (0.6-2.4) vs 2.2 (0.5-4.8) p less than 0.05). There was a severe impairment of anal sensation in the incontinent patients with perineal descent despite a greater degree of perineal descent in the continent group. Loss of anal sensation is associated with the development of incontinence and is likely to be involved in the pathogenesis of the condition. PMID- 2708883 TI - The clinical and functional outcome after restorative proctocolectomy. A prospective study in 100 patients. AB - One hundred consecutive patients treated by restorative proctocolectomy with construction of an ileo-anal anastomosis and a J-shaped (n = 90) or an S-shaped ileal reservoir were studied prospectively to evaluate postoperative complications and functional outcome and to search for factors that might influence results. There were no deaths. Postoperative complications requiring surgery were pelvic sepsis (3 patients), pouch-related fistula (2), peritonitis following ileostomy closure (3) and small bowel obstruction (6), with an overall relaparotomy rate of 14%. The cumulative risk of pouchitis was 30% at 2 years. The average stool frequency decreased gradually, stabilizing at about five evacuations/24 h after 1 year. At that time 9% of patients still had greater than or equal to 7 day-time evacuations and 40% had night evacuations (greater than 1/week). These parameters did not improve further with time. Mucous soiling, a frequent problem initially, also diminished with time, occurring in 30% of patients at 1 year. At 2 years, however, this mucous leak occurred in only 20%, suggesting that improvement of continence can be expected to occur even beyond one year. Despite defects in function patient satisfaction was generally excellent. So far only three patients have preferred conversion to an ileostomy. To establish which factors might influence the functional results a specially designed scoring system, combining all functional variables, was used. It was shown that results deteriorated with increasing age and that elderly women tended to have a poorer result than elderly men. Sex, previous parity or postoperative complications appeared not to affect the functional outcome. Male sexual disturbances occurred in 8%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708884 TI - Rubber band ligation for piles can be disastrous in HIV-positive patients. AB - We report a patient with haemorrhoids treated with rubber band ligation who developed a huge supralevator abscess. A diverting sigmoidostomy had to be established as surgical drainage via the rectum was not adequate. Eventually the patient accepted the HIV-testing which proved positive. Six months later the sigmoidostomy was still needed as the abscess cavity remained large. We conclude that rubber band ligation in HIV-positive patients should be abandoned. PMID- 2708886 TI - Silicone intraocular lens implants and circular anterior capsulotomy (capsulorhexis). AB - Anterior circular capsulorhexis is used to guarantee accurate placement and stability for the flexible silicone intraocular lens. The smaller wound needed for this procedure allows for immediate postoperative bending by the patient. The visual results achieved with this implant are excellent. PMID- 2708885 TI - Transverse pelvic floor division for the posterior approach to the rectum and anus. AB - The posterior approach to the rectum can be enhanced by a transverse division of the pelvic floor muscles. In a series of 51 patients the pelvic floor between the anus and the coccyx was opened in a transverse direction giving access to the pelvirectal space and the sphincter muscles. The approach which enabled an extensive exposure was used for posterior rectotomy (10 cases), nodal excision from the mesorectum and lateral ligaments (2 cases), postanal repair (3 cases), exploration or excision of complex high and fistula (4 cases), abdomino-trans sphincteric resection of rectal carcinoma (13 cases) and local excision (19 cases). The results with respect to wound healing and anorectal function were satisfactory. PMID- 2708887 TI - MRI of soft tissue vascular malformations. AB - Magnetic resonance imaging (MRI) is constantly progressing as an important imaging modality for the evaluation of the cardiovascular system and vascular malformations. Due to its superior contrast resolution and sensitivity, MRI is able to differentiate between fat, muscle, bone, and vascular structures. It provides three-dimensional information without the use of ionizing radiation or invasive procedures. We evaluated 11 vascular malformations by MRI using Spin Echo T1 and T2 weighted images. MRI provided more information than computerized tomography, and, in many instances, obviated the need for angiography. PMID- 2708888 TI - Pernicious anemia and juvenile-onset diabetes mellitus in an adolescent: a case report. AB - We report a case of a 15-year-old black boy who developed juvenile-onset pernicious anemia in association with insulin-dependent diabetes mellitus. He had both intrinsic factor and parietal cell antibodies in addition to anti-islet cell surface antibodies. The existence of pernicious anemia and diabetes mellitus in such a young child makes this an unusual case. PMID- 2708889 TI - Regular education initiative. PMID- 2708890 TI - Longitudinal research on the behavioral characteristics of children with learning disabilities. AB - This paper summarizes a program of research on the behavioral characteristics of children with learning disabilities (LD) compared to average achievers. Longitudinal studies over a 3-year period beginning in the first and second grades showed that children with LD, as a heterogeneous group, displayed a persistent pattern of maladaptive classroom behavior that distinguished them from average achieving peers and that was associated with continued underachievement over time. Subsequently, children with LD in the longitudinal sample were clustered into seven different subtypes that represented attention problems, conduct and classroom management problems, withdrawn-dependent behavior, and normal behavior. Although no differences in achievement were found initially between behavioral subtypes, children in the attention and conduct problem subtypes had poorer academic outcomes 3 years later compared to those in the withdrawn subtype and those who had no significant behavior problems. The collective findings from this research are discussed in terms of the developmental relationship between learning disabilities, attention disorders, and social/emotional problems, and implications are drawn for a greater focus on behavioral interventions in special education and prevention efforts in the early grades. PMID- 2708891 TI - Assisted assessment: a taxonomy of approaches and an outline of strengths and weaknesses. AB - Traditional approaches to both the assessment of student abilities and the design of instructional programs have recently come under strong attack. Of particular concern to many is the nature of the link between assessment and instruction. Some of the criticisms are reviewed, and a set of alternative approaches designed to overcome the difficulties is presented. The major focus is on dynamic, as opposed to static, assessment. A major feature of these approaches is the provision, to the student, of some form of assistance designed to influence performance and hence reveal students' potential for change. Within this general approach, specific applications differ along three dimensions. The first, focus, refers to the goal of evaluating change itself or the processes presumed to underlie change. The second, intervention, refers to the fact that the assistance included in the assessment can be given in either a standardized or clinical fashion. And the third, target, reflects the fact that assessment can be aimed at either domain-general or domain-specific skills. The distinct approaches that have been developed are categorized, and their respective strengths and weaknesses discussed. Suggestions for future research are made. PMID- 2708892 TI - Cognitive and behavioral characteristics of children with learning disabilities: concluding comments. PMID- 2708893 TI - A childhood learning disability that predisposes those afflicted to adolescent and adult depression and suicide risk. AB - A particular subtype of learning disability (nonverbal learning disability) is described. This subtype of individuals with learning disability is seen to be at particular risk for depression and suicide. The origins of the study of this subtype of learning disability, its incidence in various forms of neurological disease, disorder, and dysfunction, and its behavioral and socioemotional manifestations (including its association with significant internalized forms of psychopathology) are described. A case history of a young woman who manifests this disability and who has attempted suicide on three occasions is also presented. PMID- 2708894 TI - Nonverbal learning disabilities and suicide: classification leads to prevention. PMID- 2708895 TI - Adult suicide versus coping with nonverbal learning disorder. PMID- 2708896 TI - On the neuropsychology of suicide. PMID- 2708897 TI - Nonverbal learning disabilities, socioemotional disturbance, and suicide: a reply to Fletcher, Kowalchuk and King, and Bigler. PMID- 2708898 TI - A comparison of students with learning disabilities to low achieving and higher achieving students on three dimensions of social competence. AB - Research continues to accumulate attesting to the fact that many children with learning disabilities are experiencing social difficulties in school. Nonetheless, it is also clear that achievement deficits, with or without the presence of a handicapping condition, are also related to social problems in the classroom. Several studies attempting to clarify the relative roles of handicapping condition and achievement in social adjustment have produced mixed results. The purpose of the present study was to clarify this issue further by examining the social differences between elementary school students with learning disabilities and other low achieving and higher achieving children on three social dimensions: sociometric status, behavior as rated by teachers, and self ratings of social competence. The results indicated that the children with learning disabilities may be a higher risk socially than their low achieving and higher achieving peers. Variables that may account for these results are discussed as well as directions for future research. PMID- 2708899 TI - Writing disorders and their relationship to reading-writing methods: a longitudinal study. AB - This study was designed to investigate some writing disorders shown by children who have been taught by different methods of reading and writing. Methods differ in that some emphasize the processes of decoding bottom-up (e.g., syllabic and phonic method) while others stress top-down processes, that is, they put greater emphasis on meaning (e.g., global-natural method). A longitudinal study using a sample of 260 school children was performed. The children were of both sexes from public and private schools and from different socioeconomic backgrounds. It was found that the pupils who learn by a global-natural method make errors that relate more to reproductive aspects of information. In contrast, the pupils who learned by the phonic and syllabic methods made more errors of meaning. PMID- 2708900 TI - The medical profession and AIDS. PMID- 2708901 TI - AIDS and the response of organized medicine. PMID- 2708902 TI - AIDS at the frontier. United States immigration policy. PMID- 2708903 TI - Child welfare agencies. Possible bases of liability for placement of children with AIDS in adoptive or foster homes. PMID- 2708904 TI - AIDS and the law. A summary and conclusion. PMID- 2708905 TI - AIDS and medical education. PMID- 2708906 TI - HIV infection and the ethics of clinical care. PMID- 2708908 TI - Outreach and counseling efforts for high risk partners of HIV infected individuals. PMID- 2708907 TI - AIDS and the physician's duty to treat. PMID- 2708909 TI - AIDS: a plague on institutional health policy development. PMID- 2708910 TI - AIDS and the insurance industry. The debate within the debate. PMID- 2708912 TI - Inhibition by monoclonal anticomplement receptor type 1 on interactions between senescent human red blood cells and monocytic-macrophagic cells. AB - The effect of different murine monoclonal antibodies (Mab) specific for the glycoprotein complement receptor type 1 (CR1), type 2 (CR2), and type 3 (CR3) on the adhesion to and on the phagocytosis of human senescent red blood cells (S RBC) by monocytes or by monocyte-derived macrophages (M phi) was investigated. Murine Mab anti-CR3 (anti-Leu 15 and OKM1) were found to inhibit, in the same order of magnitude, on one hand, the Fc receptors (FcR)-dependent rosetting and phagocytosis, and, on the other hand, the S-RBC rosetting and phagocytosis by adherent monocytes. Thus, the specific involvement of the CR3 epitopes recognized by Mab anti-Leu 15 or by OKM1 in the interactions between S-RBC and monocyte/macrophage could not be demonstrated. Murine Mab anti-CR1 was found to be a significant inhibitor of binding to and of phagocytosis of S-RBC (but not of young [Y] RBC) by monocytes or M phi, whereas Mab OKM5 carrying the same isotype as Mab anti-CR1, but a different specificity, was devoid of any significant inhibitory effect. Furthermore, Y-RBC or S-RBC opsonized with Mab anti-CR1 did not form FcR-dependent rosettes and were not internalized by monocytes; in addition, preincubation of phagocytes with Mab anti-CR1 did not inhibit FcR dependent rosetting and phagocytosis. These results suggest that the effect of anti-CR1 is mediated through a specific binding to CR1 and not through an FcR blockade. As the role of specifically bound IgG on phagocytosis of human S-RBC by macrophages has previously been demonstrated by several authors, the present study suggests that monocyte-macrophage complement receptor type 1 may act in synergy with Fc receptors in the recognition of S-RBC by macrophages. It is shown in addition that the tripeptide Arg-Gly-Asp, identical to the region of iC3b recognized by CR3 and by several adhesion-promoting receptors that are structurally similar to CR3, such as fibronectin or vitronectin, is a significant inhibitor of the binding to and the phagocytosis of S-RBC by monocytic macrophagic cells. PMID- 2708911 TI - Interactions of pseudorabies virus with swine alveolar macrophages: effects of virus infection on cell functions. AB - In order to assess the effect of pseudorabies virus (PRV) infection on the function of swine alveolar macrophages (AM), lung lavage cells were cultured, infected with one of six strains of PRV, and various activities were measured. Activity measurement included viability, phagocytosis of yeast, phagosome lysosome fusion, phagocytosis of opsonized particles, and superoxide release. AM were infected with 5 x 10(-3) PFU/cell, and the comparative assessment of functions was performed at 18-20 h postinfection. Cell viability in PRV-infected cultures ranged from 79 to 94% of the viability in noninfected cultures. Phagocytosis of yeast was significantly reduced only in the AM cultures infected with the strain S-62. Phagosome-lysosome fusion was depressed in cultures infected with the strains S-62, 4892, 3816, and BUK. The phagocytosis of opsonized sheep red blood cells showed significant differences between noninfected and PRV-infected cultures in all cases except cultures infected with the strain PRV-C. The O2 release after stimulation with opsonized zymosan was significantly reduced in all the PRV-infected cultures. The effect of PRV infection on AM functions that are related to the bacterial activity of such cells suggests that PRV-induced AM dysfunction might have a role in the increased susceptibility of PRV-infected pigs to bacterial pneumonia. PMID- 2708913 TI - Activated Langerhans cells release tumor necrosis factor. AB - Langerhans cells act as antigen-presenting cells in immune reactions in the skin. What other roles they may play in inflammation is less well defined. We have tested whether these cells can produce TNF-alpha, an important mediator of inflammation. Resting Langerhans cells produce less than 0.1 U TNF-alpha/ml. Langerhans cells stimulated with phorbol myristate acetate (PMA) and lipopolysaccharide (LPS) release 4-5 U TNF-alpha/ml. Specificity of the released TNF-alpha in an L929 cytotoxicity assay was confirmed by using neutralizing anti TNF-alpha monoclonal antibodies, and the identity of TNF-alpha was further confirmed by Northern blot hybridization with an TNF-alpha oligomer DNA probe. Activated Langerhans cells may contribute to inflammation in the skin by releasing TNF-alpha, which is known to effect fibroblast growth, endothelial cell activation, and lymphocyte function. PMID- 2708914 TI - Increased creatine kinase (CK) MB isoenzyme in patients with "normal" total CK activity suspected of acute myocardial infarction. AB - Many laboratories screen patients suspected of acute myocardial infarction (AMI) with a test for total creatine kinase (CK) and perform testing for CK-MB isoenzyme only in patients with elevated total CK. To find out whether this practice could result in missing patients with AMI who can have "normal" (within the reference interval) total CK with increased CK-MB (greater than or equal to 5%), we prospectively and sequentially monitored CK and CK-MB in patients admitted for suspected AMI. We found that 12.5% of patients with the final diagnosis of AMI had initially low total CK and high CK-MB (as determined by electrophoresis), but the majority of these patients showed subsequently increased total CK above the reference value. It is suggested that the presence of CK-MB in patients with low total CK does not represent a laboratory error and most of these patients have AMI. Total CK assay could be abandoned in favor of CK MB testing in patients suspected of AMI. PMID- 2708915 TI - On stochastic compartmental models. AB - The statistical averaging of compartmental models with parameters being random processes is derived for the case of vanishing input and uniformly bounded input. The difference of resulting models is discussed. PMID- 2708916 TI - Diffusion approximations of the two-locus Wright-Fisher model. AB - Diffusion approximations are established for the multiallelic, two-locus Wright Fisher model for mutation, selection, and random genetic drift in a finite, panmictic, monoecious, diploid population. All four combinations of weak or strong selection and tight or loose linkage are treated, though the proof in the case of strong selection and loose linkage is incomplete. Under certain conditions, explicit formulas are obtained for the stationary distributions of the two diffusions with loose linkage. PMID- 2708917 TI - Statistical modelling of mitochondrial power supply. AB - By experiment and theory, formulae are derived to calculate the response of mitochondrial power supply, in flux and potential, to an ATP consuming enzyme load, incorporating effects of varying amounts of (i) enzyme, (ii) total circulating adenylate, and (iii) inhibition of the ATP/ADP translocase. The formulae, which apply between about 20% and 80% of maximum respiration, are the same as for the current and voltage of an electrical circuit in which a battery with potential, linear in the logarithm of the total adenylate, charges another battery whose opposing potential is also linear in the same logarithm, through three resistances. These resistances produce loss of potential due to dis equilibrium of (i) intramitochondrial oxidative phosphorylation, (ii) the ATP/ADP translocase, and (iii) the ATP-consuming enzyme load. The model is represented geometrically by the following configuration: when potential is plotted against flux, the points lie on two pencils of lines each concurrent at zero respiration, the two pencils describing the respective characteristics of the mitochondrion and enzyme. Control coefficients and elasticities are calculated from the formulae. PMID- 2708918 TI - An epidemiological model with a delay and a nonlinear incidence rate. AB - An epidemiological model with both a time delay in the removed class and a nonlinear incidence rate is analysed to determine the equilibria and their stability. This model is for diseases where individuals are first susceptible, then infected, then removed with temporary immunity and then susceptible again when they lose their immunity. There are multiple equilibria for some parameter values, and, for certain of these, periodic solutions arise by Hopf bifurcation from the large nontrivial equilibrium state. PMID- 2708919 TI - Numerical simulation of a stochastic model for cancerous cells submitted to chemotherapy. AB - A stochastic model is proposed to study the problem of inherent resistance by cell populations when chemotherapeutic agents are used to control tumor growth. Stochastic differential equations are introduced and numerically integrated to simulate expected response to the chemotherapeutic strategies as a function of different parameters. Satisfactory demonstration runs of the model indicate that it could represent a useful tool in verifying the results of experimental and clinical chemotherapy courses and planning treatment strategies. Some types of behaviour are illustrated graphically. PMID- 2708920 TI - Walking through the valley. PMID- 2708921 TI - Evolution and current status of surgery for morbid obesity: Part II. AB - Persons who are 20 percent or more over ideal weight have a greatly increased risk of premature death as well as being subject to a range of debilitating diseases. When a person reaches 100 pounds or more above ideal weight, he or she may become a potential candidate for surgery to promote weight loss and maintenance of weight loss, with its accompanying improvement in related medical problems. The earliest successful surgical procedure, jejunoileal bypass, is no longer done because better bariatric surgical procedures have been developed. Gastric bypass is an efficient successful procedure for producing extensive long term weight loss, but it is difficult to perform and may have a high rate of complications in inexperienced hands. Vertical banded gastroplasty appears to be the safest procedure in the variatric surgeon's repertoire at this time for the management of medical problems related to morbid obesity. PMID- 2708922 TI - Neurosurgical experience with Nd:YAG laser. PMID- 2708923 TI - Science and serendipity: the morphology of the conduction system and surgery for supraventricular arrhythmia. PMID- 2708924 TI - Successful implementation of Maximum Surgical Blood Order Schedule. AB - A Maximum Surgical Blood Order Schedule (MSBOS) is a schedule of commonly performed elective surgical procedures listing the maximum number of units of blood to be crossmatched preoperatively. A MSBOS reduces the preoperative crossmatching of blood in surgical cases in which there is less likelihood of blood transfusion. The reduction in crossmatched units of blood saves hospital time and money. This study presents the steps required to institute a MSBOS. Savings in reduced crossmatch charges were calculated. After a review of 1400 operations, a MSBOS listing 35 operative procedures was established at the Medical Center of Central Georgia. Staff compliance was greater than 99%, crossmatch to transfusion ratio was reduced from 5:1 to 2:1, and our annual savings was greater than $110,000 in reduced crossmatch charges. PMID- 2708925 TI - Revisiting Georgia's medical malpractice arbitration statute. PMID- 2708926 TI - Treatment of early stage vocal cord carcinoma. AB - The cure rates for early stage vocal cord cancer are excellent with primary radiotherapy. Voice quality remains as good or becomes better than prior to treatment. For the local failures that do occur, surgical salvage will yield ultimate cure rates of about 95% for T1 and 90% for T2 tumors. PMID- 2708927 TI - Anatomic localization of a single electrical source within the boundary of the human torso. AB - A closed prolate ellipsoid was used to approximate the surface of the Rush torso model to permit recovery of the site and orientation of known dipoles in 15 cardiac locations. Localization was found to be reasonably close, usually within 2 cm. When body surface potential maps of 37 subjects with right ventricular pacemakers were similarly treated, the discrepancy between known pacemaker site and the site of earliest activation was relatively large (mean, greater than 4 cm) and rapidly increased within the ensuing millisecond. The discrepancy not only emphasizes the wide variation in body shape and tissue distribution in living subjects, but also points to probable physical separation between stimulus site and earliest detectable activation site because of ischemia, infarction, or myocardial response to variation in current strength of the stimulus. PMID- 2708928 TI - A comparison of serial 49-lead precordial ECG maps and standard 6-lead precordial ECGs in patients with acute anterior Q wave myocardial infarction. AB - A comparison of 265 pairs of standard ECGs and 49-lead precordial maps in 20 patients with ST-segment elevations in anterior ECG leads on admission who eventually were diagnosed as having suffered an anterior Q wave myocardial infarction was carried out to investigate the diagnostic performance provided by the standard ECG in serial studies. Ten patients received intravenous methylprednisolone and 10 were given placebo on admission, and paired map standard ECG studies were done. ST-segment elevations were taken as an index of ischemic injury and reduction of R wave amplitude or development of Q waves as a marker of developing necrosis. Methods of measurements and derivation of ECG parameters used in the analysis were the same for the standard ECGs and maps. Comparisons of percent change of five ECG-derived variables between 13 time points and admission, as assessed by the six precordial leads of the standard ECGs and the paired 49-lead maps, were made for the entire data base. A separate analysis to assess the performance of the standard ECG was carried out in a comparison of the methylprednisolone and placebo subgroups. In this latter assessment results of comparisons of the standard ECGs from the treatment and placebo cohorts were similar to the conclusions from the comparisons of the corresponding 49-lead maps. Comparisons for the entire 265 pairs of tracings by the two ECG systems demonstrated that the standard ECG is adequate to monitor quantitatively the ischemic injury and necrosis as reflected by the ECG in serial studies throughout the hospitalization and can be effectively employed in lieu of multilead precordial maps in the evaluation of therapeutic modalities for patients with anterior Q wave myocardial infarction. PMID- 2708929 TI - Changes in T wave morphology during hypercalcemia and its relation to the severity of hypercalcemia. AB - The effect of hypercalcemia on T wave morphology, polarity, and amplitude was studied in 14 patients with a primary diagnosis of malignant lymphoma (8 patients), adult T-cell leukemia (5 patients), and Hodgkin's disease (1 patient). Hypercalcemia was severe to extreme in 11 (14.9-22.8 mg/dl), moderate in 1 (13.4 mg/dl), and mild in 2 (11.8 and 12.2 mg/dl) patients. Ten of the 11 patients (91%) with severe hypercalcemia showed inverted, biphasic, and notched T waves, mainly in the chest leads. Notched T waves were observed in all 10 of these patients in anterior to lateral, mid to lateral, or lateral chest leads. Biphasic and/or inverted T waves in anterior or anterior to midchest leads were present in 4 of these 10 patients who had extreme hypercalcemia (greater than 16 mg/dl). Changes in T wave morphology were not observed in moderate or mild hypercalcemia. T wave amplitude showed significant inverse correlation with serum calcium (T mV vs Ca, r = -0.60, p less than 0.001; T/R ratio vs Ca, r = -0.68, p less than 0.001; n = 35). Decrease in T wave amplitude was marked in severe hypercalcemia (p less than 0.0001) and moderate hypercalcemia, but there was no change in mild hypercalcemia. Changes in T wave morphology, polarity, and amplitude either appeared with development of hypercalcemia or disappeared with normalization of serum calcium level. It was concluded that in addition to shortening the QT interval, severe to extreme hypercalcemia can cause development of inverted, biphasic, or notched T wave with a marked decrease in amplitude of T waves. PMID- 2708930 TI - Transient ST-segment elevation in subarachnoid hemorrhage. AB - Electrocardiographic manifestation mimicking the hyperacute phase of myocardial infarction and the electrical alternans of the elevated ST-segment in association with subarachnoid hemorrhage were reported in two patients with no evidence of heart disease. In both cases the ST-segment changes were transient and there were no persistent changes suggestive of underlying myocardial damage or ischemia. These findings suggested that the electrocardiographic changes were probably secondary to subarachnoid hemorrhage and not an expression of primary myocardial disease. The electrocardiographic abnormalities could be explained by altered autonomic activity to coronary arteries or directly to the myocardium. PMID- 2708931 TI - Postexercise electrocardiographic and clinical changes in patients with sick sinus syndrome. AB - Forty patients with sick sinus syndrome, 15 women and 25 men with a mean age of 53.83 +/- 13.34 years, were studied using a maximal graded bicycle stress test. None of the patients were using a pacemaker or being treated with drugs that would interfere with the sinus node function; one patient had family myocardiopathy and eight suffered from essential hypertension. All patients, including those suffering from very marked bradycardia (less than 40 beats/min) responded to the increased effort with increased heart rate. The exercise test was stopped in 22 patients (55%) after the appearance of clinical signs and in 4 (10%) after ST-segment depression greater than 1 mm. Eight (20%) finished the stress test after reaching the maximal heart rate according to age, due to an increase in sinus rate. The exercise produced or increased extrasystoles in five patients (12.5%), but only one was forced to suspend the test. The Q-T interval, corrected for heart rate according to Bazett's formula (QTc), was measured on the resting ECG before the start of the test and on the ECG recorded immediately following the end of the exercise in all patients, except one with atrial fibrillation. In 24 patients (60%), a QTc mean increase of 0.040 +/- 0.022 sec was observed at the end of the stress test. Fourteen (35%) had the usual shortening due to the increase in heart rate. One patient showed no variation of the QTc. A lengthening of the QTc at the end of the exercise in more than half of the patients was the most intriguing electrocardiographic change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2708932 TI - Paroxysmal atrial fibrillation with and without primary atrial vulnerability. Clinical and electrophysiological differences. AB - Primary atrial vulnerability defined as induction of repetitive atrial firing by a single atrial extrastimulus cannot always be demonstrated in patients with paroxysmal atrial fibrillation. The authors studied the electrophysiological differences between paroxysmal atrial fibrillation with and without primary atrial vulnerability. In 14 of 31 patients with documented history of atrial fibrillation, single extrastimulation at the high right atrium initiated repetitive atrial firing defined as rapid disorganized atrial activity continuing longer than 1 second. In the 14 patients with vulnerable atrium, the atrial effective and functional refractory were periods significantly shorter and the duration of the local atrial electrogram of the premature beat was longer and was fractionated. The % sinus node recovery time was longer in patients without vulnerability. Nine of the 17 patients without atrial vulnerability had sinus node dysfunction, and 4 of the remaining 8 patients had a repetitive type of atrial automatic tachycardia. In contrast, only 3 (21%) of the 14 patients with vulnerability had sinus node dysfunction, and none showed repetitive atrial tachycardia. The high prevalence of sinus node dysfunction or repetitive type of atrial automatic tachycardia in patients without primary atrial vulnerability suggests that these transient electrophysiological modifications which are not dealt with in the basic conditions may have a role in the enhancement of atrial vulnerability. PMID- 2708933 TI - Electrocardiographic and hemodynamic effects of intravenous cocaine in awake and anesthetized dogs. AB - Graded bolus and infusion doses of cocaine were given to 18 dogs, 6 under general anesthesia and 12 awake, to determine the range of hemodynamic and electrocardiographic effects. Blood pressure, electrocardiographic measurements, cocaine plasma levels, temperature, electrolytes, and arterial blood gases were measured before and after the initial bolus and/or infusion at 10 minutes and each 30 minutes up to a maximum of 180 minutes. At the end of the infusion, a single large intravenous terminal bolus of cocaine was given. The hemodynamic and electrocardiographic changes occurred by 10 minutes after the bolus and resolved by 30 minutes, independent of the infusion rate and dose. Only anesthetized dogs could tolerate the highest cocaine doses. Three ranges of bolus doses were given: the lowest range was the average initial bolus dose received by the awake group; the intermediate range was the average initial bolus dose received by the anesthetized group; and the highest range was the average terminal bolus dose. The heart rate changes were unpredictable and did not change significantly at any dose range. The blood pressure increased in the lowest dose range, remained unchanged at intermediate doses, and fell at the highest doses in four of six dogs. Electrocardiographic intervals increased as the dose range increased. Only at the highest doses did potentially lethal ventricular arrhythmia (ventricular tachycardia and an idioventricular escape rhythm) occur. Intravenous cocaine causes hemodynamic and electrocardiographic effects that are related to the dose and rate of administration. At high doses, hypotension, arrhythmia, and electrocardiographic changes consistent with infranodal and/or intraventricular conduction slowing can occur. PMID- 2708934 TI - Three types of atrioventricular reciprocating tachycardia using bilateral accessory pathways in a patient with Wolff-Parkinson-White syndrome. AB - Electrophysiologic studies were performed on a patient with Wolff-Parkinson-White syndrome and recurrent supraventricular tachycardia. Bilateral accessory pathways capable of antegrade and retrograde conduction and three different types of atrioventricular (AV) reciprocating tachycardia were demonstrated. One type of narrow QRS tachycardia used the normal AV pathway for antegrade conduction and the left-sided accessory pathway for retrograde conduction. Two types of wide QRS tachycardia (one with right bundle branch block and one with left bundle branch block) used both accessory pathways for antegrade and retrograde conduction, respectively, and were independent of the normal AV pathway. The data showed that bilateral accessory pathways have different electrophysiologic properties and participate in three different types of AV reciprocating tachycardia. PMID- 2708935 TI - Pacemaker therapy for academic medicine. AB - Both the clinical practice and the administrative environments of academic medicine have become progressively more complex. Although management methods for dealing with the administrative intricacies are commonly not part of academic training, guidelines may be derived from medical practice. The authors identify specific parallels and analogies between recent developments in the design of pacemakers and the requirements of organizations that implant them. PMID- 2708936 TI - Differential effects of pentobarbital and cocaine on punished and nonpunished responding. AB - Similar rates of punished and nonpunished responding, maintained with equated rates of reinforcement, were established in pairs of rats. One subject of each pair was exposed to a random-ratio schedule of food presentation. The interreinforcement intervals for this subject comprised the intervals of a random interval schedule of reinforcement for the other (yoked) rat. The random-ratio schedule maintained rates of responding higher than those maintained by the same rate of reinforcement schedule according to the yoked random-interval contingency. A random-ratio schedule of electric foot shock added to the random ratio schedule of food presentation suppressed rates of responding such that similar rates of responding were observed in rats of both groups. Pentobarbital (3.0 to 17.0 mg/kg) increased punished responding at doses that had little effect on or decreased nonpunished responding, whereas cocaine (5.6 to 30 mg/kg) increased nonpunished responding at doses that decreased or did not alter punished responding. Qualitatively different effects of pharmacological agents on punished and nonpunished responding can be obtained using procedures that generate similar rates and temporal patterns of punished and nonpunished responding. The effects of pentobarbital and cocaine on responding can be determined by factors other than simply the baseline rate of responding. PMID- 2708937 TI - Discrete and continuous measures of dimensional stimulus control. AB - In two sets of experiments, we examined dimensional stimulus control of pigeons' responses to a visual flicker-rate continuum. In the first experiment, responses to a single key were reinforced periodically during stimuli from one half of the stimulus continuum, and responses during other stimuli were extinguished. In the second experiment, two response keys were simultaneously available, with reinforcement for each response alternative associated with different halves of the stimulus continuum. Conditions of the second experiment involved either free operant or discrete-trial stimulus presentations. Results from these experiments show that positive dimensional contrast appeared in discrimination tasks with one or two response alternatives, but only with free-operant procedures. In addition, discrimination between stimulus classes established by differential reinforcement was assessed as accurately by continuous rate measures as by discrete response choice in the two-alternative situation. The general implication of these experiments is that response rate measures, when properly applied, may reveal sources of variation within stimulus classes, such as dimensional contrast, that are not evident with discrete measures. PMID- 2708938 TI - Repeated acquisition of behavioral chains: response sequences or conditional discriminations? AB - The purpose of this study was to determine whether pigeons learn a sequence of positional responses or a series of conditional discriminations under a repeated acquisition-of-behavioral-chains procedure. Three pigeons were trained under a repeated-acquisition procedure in which three different key colors served as stimuli correlated with the three steps in a chain. The order of presentation of the three stimuli was altered during the latter part of each test session after acquisition had occurred. If the pigeons had acquired a response sequence, the pattern of responding should remain the same as in the initial portion of the test session. However, if the pigeons had acquired a conditional discrimination, the response pattern should change in accordance with the changed order of the key colors. Although the results of this study do not rule out the possibility that the subjects acquired, to some degree, a response sequence, the results suggest that the behavior of pigeons under a repeated-acquisition-of-behavioral chains procedure is controlled primarily by conditional discriminative stimuli. PMID- 2708939 TI - Relative pitch perception in the European starling (Sturnus vulgaris): further evidence for an elusive phenomenon. AB - Relative pitch perception in animals has been difficult to demonstrate. This failing is due in part to stimulus sets that make an absolute pitch solution viable. In Experiment 1, starlings failed to acquire a discrimination that could be solved only on the basis of relative pitch. In Experiment 2, starlings were trained on a smaller set of pitch patterns, for which both absolute and relative pitch solutions were available, then tested with three series of unreinforced probe stimuli. Series 1 assessed stimulus control by absolute pitch. In Series 2, absolute pitch cues dictated one response, and relative pitch cues dictated a different response. Results indicate that starlings extract relative pitch from artificial pitch patterns only after acquiring a discrimination that permits both absolute and relative pitch solutions. Results are discussed in terms of the relative salience of absolute and relative pitch. PMID- 2708940 TI - Contextual conditioning and the control of copulatory behavior by species specific sign stimuli in male Japanese quail. AB - Three experiments were conducted to identify species-specific sign stimuli sufficient to elicit copulatory behavior in male Japanese quail and to determine how learning is involved in the control of behavior by these sign stimuli. In Experiment 1, sexually experienced subjects were tested for copulatory behavior with a live female quail and with a model consisting of a female quail's head and neck mounted in front of a foam pad. Comparable levels of copulatory behavior were observed in the two tests, indicating that static visual cues provided by a female quail's head and neck are sufficient to elicit copulatory behavior in this species. Experiment 2 showed that male birds that previously received numerous opportunities to copulate with a live female quail in the test situation were significantly more likely to copulate with the head + neck model than were sexually inexperienced subjects. Experiment 3 showed that prior sexual experience with live quail facilitated responding to the head + neck model only if the sexual experience was provided in the same place where subjects were later tested with the model. This last finding suggests that sexual experience facilitates control of copulatory behavior by species-specific sign stimuli through contextual conditioning. Contextual conditioning may lower the threshold for sexual behavior with the result that a stimulus as impoverished as an immobile model containing only the head and neck of a female quail becomes sufficient to elicit normal levels of copulatory behavior. The results are also discussed as an example of conditioned stimulus facilitation of responding to an unconditioned stimulus. PMID- 2708941 TI - Changes in energy expenditure and work during response acquisition in rats. AB - The principle of least effort predicts that behavior will tend to maximum efficiency. To test this prediction, changes in the energy expended (VO2) and work performed per reinforcement were monitored continuously as rats learned to press a beam with a criterion force for liquid food rewards. All 12 subjects exhibited significant decreases in energy expended per reinforcement over the 16 days of observation. Of these, 10 subjects also decreased the work performed per reinforcement. Analyses of motor performance were undertaken to determine how motor programs for changing efficiency were generated. The 10 animals showing decreased work reinforcement also exhibited significant decreases in the variability of temporal and kinetic response features and in mean response magnitude (time integral of force or work per response) as a function of practice. Adjustments in work output were primarily accomplished by modifying temporal response features (response duration and, initially, interresponse time). The kinetic features (response recruitment and peak force) remained relatively constant for these animals. The remaining 2 subjects differed in that response recruitment increased after Day 9, resulting in progressively larger amounts of work being performed to earn each reinforcement, and the interval between successive reinforcements decreased. PMID- 2708942 TI - A test of the melioration theory of matching. AB - Melioration theory entails that matching in concurrent schedules occurs because the subjects equalize the local reinforcement rates (reinforcers received for each alternative divided by the time allocated to each alternative). The role of local reinforcement rates was tested by using multiple schedules in which one component involved an alternative with a high absolute rate of reinforcement and a low local reinforcement rate while the second component involved an alternative with a low absolute rate and a high local rate. These alternatives were then presented simultaneously in probe trials to determine preference between them. Contrary to melioration, the absolute rate of reinforcement, not the local rate, was the controlling variable. PMID- 2708943 TI - Comparison of sulphated glycosaminoglycan and hyaluronate synthesis and secretion in cultured hepatocytes, fat storing cells, and Kupffer cells. AB - The extracellular matrix of normal liver contains several types of proteoglycans including heparan sulphate, chondroitin sulphate isomers, dermatan sulphate, and the glycosaminoglycan, hyaluronic acid. In the present study both the synthesis and secretion as well as the pattern of radioactively labeled proteoglycans and hyaluronic acid of hepatocytes, fat-storing cells (Ito cells), and Kupffer cells maintained in monolayer cultures under mostly identical conditions were compared to assess their relative contribution to hepatic proteoglycan synthesis. Fat storing cells were identified as the main type of cell producing and secreting proteoglycan and hyaluronic acid. More than 70% of labeled proteoglycan and hyaluronic acid were secreted into the medium. Heparan sulphate is the main type of proteoglycan in hepatocytes, whereas in the medium of fat-storing cells, chondroitin sulphate and dermatan sulphate comprise the major fractions. Hyaluronic acid was not detectable in hepatocyte cultures and found only in low amounts in the medium of Kupffer cells. The results point to a stringent quantitative and qualitative cellular compartmentation of proteoglycan synthesis in liver with fat-storing cells as the most important cell type for matrix proteoglycan and hyaluronic acid production. PMID- 2708944 TI - An enzymic assay for uric acid in serum and urine compared with HPLC. AB - We evaluated a colorimetric method for the assay of uric acid in serum or urine, which utilises a Trinder chromogenic system modified by the inclusion of 2,4,6 tribromo-3-hydroxybenzoic acid for oxidative coupling to p-aminophenazone. Colour development (Amax: 512 nm) is complete within five minutes. Measurement of a sample blank is not needed. The procedure involves pre-incubation with ascorbic acid oxidase and detergent to eliminate interference by ascorbic acid and to abolish turbidity due to lipaemia; this pretreatment was effective up to 1.14 mmol/l ascorbate and up to at least 25 mmol/l triacylglycerol. Interference by icteric sera was insignificant up to about 170 mumol/l bilirubin. The method is linear up to at least 1428 mumol/l. In human serum and urine the procedure correlates well with HPLC and the uricase p-aminophenazone method on the SMAC analyser. Within-run and between-run imprecisions of the enzymic test were higher than for HPLC, but did not exceed 1.2% (CV) and 2.5% (CV), respectively. PMID- 2708945 TI - Radioimmunoassay for immunoreactive non-collagenous domain of type IV collagen (NC1) in serum: normal pregnancy and preeclampsia. AB - The use of a magnetic separation agent in a modified radioimmunoassay for the non collagenous cross-linked region (NC1) of basement membrane collagen is described. The rabbit anti-NC1 serum employed in the assay revealed a binding behaviour similar to that reported recently (Mark et al. (1985) Eur. J. Biochem. 146, 555 562; Schuppan et al. (1986) J. Clin. Invest. 78, 241-248) with respect to the integrity of NC1-disulphide bridges, affinity to NC1 subunits and lack of reactivity with other determinants of type IV collagen. Immunoreactive serum NC1, which increased towards the end of gestation, showed a broad peak during the second trimester of pregnancy. In preeclampsia, immunoreactive serum-NC1 was slightly elevated. PMID- 2708946 TI - The diagnosis of CSF fistulae on the basis of detection of beta 2-transferrin by polyacrylamide gel electrophoresis and immunoblotting. AB - A sensitive method is described for the detection of beta 2-transferrin, a transferrin-variant found only in cerebrospinal fluid (CSF). The determination of beta 2-transferrin, whose presence is characteristic of CSF-admixtures in secretions, is performed in three steps. The proteins of the secretion are separated by polyacrylamide gel electrophoresis and then transferred electrophoretically onto a nitrocellulose sheet. Finally, the transferrins on the nitrocellulose sheet are specifically detected by an antibody reaction. The bands are visualized either by using antibodies conjugated with peroxidase or by protein A gold. With the exception of certain cases (Ritchie, R. F. & Smith, R. (1976) Clin. Chem. 22, 497-499; Gorg, A. et al. (1983) Human Genetics 64, 222 226) beta 2-transferrin is found only in cerebrospinal fluid, and not in other body fluids. Therefore the detection of beta 2-transferrin can be used for the diagnosis of rhino- and otoliquorrhea. The advantage of this method is that beta 2-transferrin can be unequivocally identified by the use of a relatively small amount of technical equipment. CSF can therefore be clearly identified in secretions. An additional advantage of the method is its high sensitivity. PMID- 2708947 TI - Fate mapping the avian neural plate with quail/chick chimeras: origin of prospective median wedge cells. AB - The origin of prospective M cells, which are median neuroepithelial cells that become wedge-shaped during bending of the neural plate and eventually form the midline floor of the neural tube, was determined by constructing quail/chick chimeras and using the quail nucleolar marker to identify quail donor cells in chick host blastoderms. Two possible sites of prospective M-cell origin in the epiblast were examined: a single, midline rudiment located just rostral to Hensen's node and paired rudiments flanking the cranial part of the primitive streak. Our results suggest that M cells arise exclusively from the midline, prenodal rudiment. From this rudiment, M cells extend caudally throughout the entire length of the neuroepithelium. This new information on the origin of prospective M cells will aid in the analysis of their role in neurulation. PMID- 2708948 TI - Seasonality of serum testosterone levels and sperm density in Tursiops truncatus. AB - We trained a mature male bottlenose dolphin, Tursiops truncatus, to provide semen samples on command. After completion of the 10-week training period, semen was collected twice weekly and blood was sampled twice monthly for a period of 28 months. Total sperm per ejaculate ranged from near 0 to 54.6 x 10(9) (n = 1332). Sperm densities from each session ranged from no sperm to 1,587 x 10(6)/ml (n = 241). Testosterone levels ranged from 1.1 to 54.4 ng/ml (n = 79). Seasonal variations were observed in total sperm per ejaculate, sperm density per ml of ejaculate, and in serum testosterone levels. Peak sperm densities were detected during September and October of three consecutive breeding seasons. Serum testosterone levels peaked in June, decreased during July and August, and were lowest in September and October, the period of greatest sperm density. Peak sperm production and density were coincident with the peak period of breeding activity but at a time when serum testosterone levels were lowest. PMID- 2708949 TI - Induction of the acrosome reaction in ejaculated goat spermatozoa by preincubation in chemically defined medium. AB - The aim of the present study was to examine the effects of the elimination of energy substrate from the medium and the effects of the preincubation vessel, temperature, and time on the induction of the acrosome reaction in ejaculated goat spermatozoa in chemically defined medium. Washed spermatozoa were resuspended in Brackett-Oliphant (BO) medium or substrate-free BO medium to give a high concentration and preincubated in open test tubes or sealed glass tubes at 37.0 or 39.5 degrees C for 1, 2, or 3 h. Sperm acrosome reaction was evaluated using a simplified triple-stain technique and a hamster test. It was found that the goat sperm acrosome reaction occurred more readily in the sealed glass tubes than in open test tubes, in substrate-free BO medium than in BO medium, and at 39.5 than at 37.0 degrees C. During preincubation with substrate-free BO medium in sealed glass tubes at 39.5 degrees C, the optimum time necessary to induce the acrosome reaction in goat spermatozoa was 2-3 h. PMID- 2708950 TI - Catecholamine release by catecholamines in the eel does not require the presence of brain or anterior spinal cord. AB - The catecholamine-producing chromaffin cells of the American eel are strongly innervated by fibers, which, by ultrastructural criteria, seem to be cholinergic. However, neither removal of the brain nor removal of the brain combined with extirpation of the anterior spinal cord prevents the release of catecholamines into the circulation by catecholamines. It appears that the chromaffin cells are controlled by both nervous and humoral stimuli, and that at least some of the latter do not require the presence of "preganglionic" innervation. PMID- 2708951 TI - Lack of proliferative response in denervated, reamputated limb regenerates of larval Ambystoma. AB - This paper describes the response of early four-digit regenerates of axolotls to reamputation and denervation. Reamputation of innervated regenerates led to sharp increases in 3H-thymidine labeling index (LI) and mitotic index (MI) on days 2-5 post-reamputation. This resembles the response of innervated limbs following initial amputation. Regenerates that were denervated at the time of reamputation exhibited no proliferative response through day 5. This is in marked contrast to denervated, original amputation limb stumps, in which LI and MI rise for several days (as in innervated stumps) before falling to background levels. Although myelin was scarce near the level of reamputation, the lack of proliferation cannot be explained solely on that basis. The results are consistent with the possibility that the "neurotrophic factor" that causes stump and blastema cell mitosis is not present in unamputated limbs but is made in response to amputation. PMID- 2708952 TI - Sites of zona pellucida shedding by mouse embryo other than muran trophectoderm. AB - The sites at which a mouse embryo sheds the zona pellucida in preparation for its hatching were investigated in vitro. Of all cases examined, 24% shedding occurred at the mural site, 24% at the inner cell mass site, 17% at the equatorial site, and 35% at other sites. It thus appears reasonable to conclude that there is no particular site destined for shedding and the site at which it does take place in vitro is irrelevant to that at which the uterus later becomes attached. Expressing its frequency in terms of a unit of area indicated shedding to occur markedly at the axis penetrating the inner cell mass and mural trophectoderm. The ratio of hatching frequency along this axis to that at other areas was determined as 7:1. PMID- 2708953 TI - Monitoring of metabolic responses of intact Haliotis (abalones) under salinity stress by 31P surface probe localized NMR. AB - Surface probe localized 31P NMR spectroscopy was employed to record the metabolic responses of the foot of intact Haliotis cracherodii and H. rufescens (black and red abalones) under hyper- and hypoosmotic stresses. Use of the surface probe allowed spectral localization on the foot of intact abalones, facilitated monitoring of different sizes of animals, and minimized constraints on aquatic chamber design normally imposed by homogeneous-field probes. Generally, hyperosmotic stress (51%) elicited more rapid changes of phosphate metabolites than hypoosmotic stress (17%). As with the well-studied hypoxic stress in intact mammalian and excised molluscan tissue, both salinity treatments caused drops in the phosphagen and increases in inorganic phosphate levels. However, osmotic stress was distinct from hypoxic stress in that intracellular pH did not change and nucleotide triphosphate (NTP) concentrations dropped immediately. Although these findings are preliminary, they demonstrate the utility of the surface probe approach for studies of environmental stress in intact marine invertebrates. PMID- 2708954 TI - Discussion of "Identification of Wooden Instrument by Scanning Electron Microscopy from Splinters Left in Victim". PMID- 2708955 TI - A study of sex identification of trace, dried bloodstains using a Y-chromosome specific deoxyribonucleic acid (DNA) probe. AB - A new method is discussed which examines trace, dried bloodstains by gel in situ hybridization using a Y-chromosome-specific deoxyribonucleic acid (DNA) probe to determine the sex of the bloodstain for forensic medicine application. The complete DNA is transferred directly by electrophoresis onto the gel intact, bypassing the possibilities of impurities contaminating the sample and of DNA degradation. The method has proven accurate for small (2.5-mm-diameter) samples aged up to eight years and is quick, simple, and easily read. PMID- 2708956 TI - Upper cervical trauma in motor vehicle collisions. AB - Motor vehicle collisions can cause a variety of injuries in pedestrians and vehicle occupants. Fatal and nonfatal trauma to the upper cervical spine, that is, atlanto-occipital junction, atlas and axis, can be part of this spectrum. Certain distinctive injuries (for example, "hangman's fracture") which occur result from the unique anatomic structure of this area and the various disruptive forces such as extension, distraction (tension), compression (axial loading), shear, and inertia generated during collision. Correlation of autopsy findings or radiological information of these cervical injuries or both with scene investigation can be informative not only in the determination of morbidity and mortality, but also in the assessment of injury mechanisms and improvements in occupant protection. PMID- 2708957 TI - When doctors divulge: is there a "threat from within" to psychiatric confidentiality? AB - Psychiatrists, as a profession, have always asserted the central importance of confidentiality. The American Psychiatric Association (APA), in its recently released "Guidelines on Confidentiality," reaffirms this position. In an age of progressive erosion of the traditional psychiatrist-patient confidentiality, the threat to confidentiality is invariably perceived as exogenous, emanating from external sources such as the legal system, third-party payers, and peer review organizations. In rare instances, there appears to be a threat from within, when the psychiatrist (or nonpsychiatrist physician dealing with a psychiatric patient) deliberately chooses to divulge the patient's confidential communications in the absence of any clearcut legal requirement to do so (and against the express wishes of the patient). Four case examples of these unusual breaches of confidentiality are presented. The author concludes that although significant assaults on patient confidentiality are occurring from without, it is quite rare for such violations to come from within the profession itself. PMID- 2708958 TI - Use of glue gun in forensic anthropology and pathologic bone reconstruction cases. AB - Fragmented "wet" bone material can be rapidly reconstructed with a minimum amount of specimen preparation using hot melt adhesives and commercially available electric glue guns. The reconstruction of fragmented bone aids in the analysis and interpretation of extensive trauma cases. PMID- 2708959 TI - Use of the cranial base in the identification of fire victims. AB - Techniques exist for using the cranial base to estimate the race and sex of skeletalized individuals in forensic science cases. The applicability of these techniques to remains of fire victims has been uncertain because of possible cranial-base shrinkage that may result from burning. To determine the amount of shrinkage resulting from low-temperature burning (less than 800 degrees C), the cranial bases of eight dissecting room cadavers were measured, the bones then burned, and the cranial fragments remeasured. The wet-bone measurements were compared to the burned-bone measurements, and the percentage of shrinkage was calculated. The average change from wet to burned bone is less than 1.00%, a figure in agreement with other published studies. Since a change of 1.00% is less than intraobserver error, it is argued that low-temperature burning--such as an average house fire--does not significantly impair the accuracy of the identification techniques. Therefore, the techniques should be applicable to many fire victims. PMID- 2708960 TI - Isoelectrophoretogram of gazelle hemoglobin--a suggested tool for proving hunting offenses. AB - Hunting gazelle is an offense according to Israeli law. When comparative isoelectric focusing was performed on bloodstains made from gazelle, goat, sheep, and cow blood, the pattern obtained from gazelle hemoglobin differed from those of the other animals tested. The use of this difference in hemoglobin pattern is suggested as a means to identify gazelle blood in hunting offense cases. PMID- 2708961 TI - Tissue distribution of cocaine in a pregnant woman. AB - Reports of cocaine-related obstetrical problems, including abruptio placentae and spontaneous abortion, have become increasingly evident in the medical literature; however, little is known about tissue distribution of cocaine in the pregnant woman. We report the toxicologic results of distribution studies performed on a pregnant woman and her fetus. Maternal/fetal cocaine concentration ratios were high when comparing blood (9:1), brain (6:5), and kidney (10:6). Possible explanations of the mechanism for lower fetal cocaine concentrations may include uterine vasoconstriction, incomplete maternal/fetal equalibration, or rapid placental/fetal clearance. PMID- 2708963 TI - Concealment of the body in drug deaths. AB - Discovery of a concealed body often leads to the assumption that the manner of death was homicide. However, in cases where death has resulted from illicit drug use or drug abuse, the body may be concealed to protect persons involved in drug abuse or drug marketing. PMID- 2708962 TI - Two six-shot suicides in close geographic and temporal proximity. AB - Two six-shot suicides are reported that occurred in adjoining counties in Ohio eleven-and-one-half weeks apart. There is no indication of any connection between victims, and it is doubtful that the second individual knew of the first death since there was no news media coverage of the first death. The most significant points of commonality between the two cases are the location of the gunshot wounds (anterior chest and upper abdomen) and the responses of disbelief from those outside the medicolegal professions. Knowledge of such cases with a high number of shots and more than one fatal wound can assist death investigators in confronting similar cases. PMID- 2708964 TI - Lung embolism with liquid silicone. AB - A lung embolism was reported in a case involving death following repeated injections of liquid silicone for aesthetic reasons. The liquid extracted from the sites of injection was identified as methylsilicone using infrared spectrophotometry, and the presence of silicone in vacuoles in the lung was verified by scanning electron microscopy with energy dispersive X-ray analysis (EDXA). A study has been carried out with rats after intravenous and subcutaneous injections of methylsilicone. PMID- 2708965 TI - Category breadth and memory in younger and older adults. PMID- 2708966 TI - The relation of hostile nonverbal communication styles to popularity in preadolescent children. AB - Some assumptions of interpersonal theory were tested among a population of preadolescent children. Children were videotaped while interacting with a same sex peer, and their verbal and nonverbal communications were judged by other peers who were not participants in the study. Children rated as socially unattractive by their peers had communication styles characterized by nonverbal visual hostility. These results support the assumption that negative nonverbal communications are associated with relationship difficulties. PMID- 2708967 TI - The child's perceptions of familial relationships: convergence between two assessment techniques. AB - Children's (N = 28) perceptions of familial relationships were investigated with the Family Environment Scale (FES) and the Network of Relationships Inventory (NRI). The FES assesses overall impressions of the family, and the NRI measures perceptions of individual relationships. Because current family systems theory indicates that positive individual relationships within a dyad (e.g., child mother) should be related to an overall favorable impression of the family system, we hypothesized that these two instruments should demonstrate convergence on selected dimensions. Results indicated that positive or negative relationships with an individual family member were related to how the child perceived the overall family system, supporting our hypothesis. PMID- 2708968 TI - Differences in the behavior and development of profoundly and severely retarded adults. AB - Smeets, ter Laak, Jansen, & Hakker (1980) assessed the behavioral strategies of severely and profoundly retarded adults with four sets of tasks. In this study, the strategies are reconsidered based on three analyses of the individual tasks. The analyses produced the same results and prompted a redefinition of Strategy 2 and a more limited description of Strategy 3. In addition, the strategies are renamed as levels to emphasize their description of ascending levels of competence and behavioral complexity rather than of the stimulus condition. The relevance of these levels for the diagnosis and training of the profoundly and severely retarded is discussed. PMID- 2708969 TI - Impulsivity and long-term prognosis of psychiatric patients with anorexia nervosa/bulimia nervosa. AB - Few if any reliable indicators of long-term outcome have been found in eating disorders. Impulsivity was the strongest predictor in the present study of 35 adults with anorexia nervosa or bulimia nervosa. This variable accounted for 25% of anorectic symptoms at 2 to 3 years follow-up and 14% at 4 to 6 years (Eating Attitudes Test). The relationship was specific insofar as impulsivity predicted neither depression nor overall mental health. Cognitive impairment may be one reason for the poor prognosis of impulsive patients. PMID- 2708970 TI - Exposure plus prevention of bingeing vs. exposure plus prevention of vomiting in bulimia nervosa. A crossover study. AB - In a crossover study, 11 bulimic patients divided into two groups of six and five patients underwent six sessions of exposure and response prevention of bingeing (ERPB) or exposure and response prevention of vomiting (ERPV) over 3 weeks. After a buffer period of 3 weeks, they were crossed over to six sessions of the other treatment. High drop-out rates, particularly during the ERPB phases, precluded full use of the crossover design. The two treatments yielded similar reduction in binge-vomit frequencies and in other between-session measures. Within-session measures, however, showed significant differences between the two treatments. ERPB was less time-consuming and led to greater reductions of urges to binge, anxiety, and liking of food. Overall improvement of patients in both groups was reasonable and further supports the usefulness of exposure techniques in the treatment of bulimic patients. PMID- 2708971 TI - The relationship between thought disorder and psychotic symptoms in borderline personality disorder. AB - Often patients with personality and affective disorder are troubled by psychotic and psychotic-like symptoms. Predicting a course that includes such symptoms, and subsequently adjusting treatment to take into consideration the added difficulties presented by psychosis, is clinically important. In the current study, a measure of thought disorder, the Thought Disorder Index (TDI), significantly predicted prospective psychotic and psychotic-like symptoms in a sample of 49 personality and affective disorder patients. Multiple regressions demonstrated that the TDI had predictive value above and beyond that of a clinical interview. The high prevalence of psychotic symptoms was most striking in patients with borderline personality disorder. PMID- 2708972 TI - Comorbidity for borderline and schizotypal personality disorders. A study of alcoholic women. AB - Twenty-six women alcoholics who fulfilled the criteria for a pure borderline personality disorder (BPD) were compared with 16 women alcoholics who also fulfilled the criteria of a schizotypal personality disorder (called mixed borderline disorder, MBD) based on personal interviews including SADS, SIB, Childhood Environment Scale (CES), and the Premorbid Adjustment Scale (PAC). The MBD women had fewer alcoholic relatives, poorer relationships with parents and siblings, a more deviant score on CES and PAC, a higher incidence of nervous children, and a poorer social network. They also reported more losses and a greater frequency of depressive symptoms during childhood and adolescence, earlier contact with psychiatry, and more frequent hospitalizations. They had a higher frequency of a nonalcoholic axis I disorder (mainly depressive and anxiety disorders), as well as a greater frequency of a paranoid personality disorder. The results show that the MBD women were more psychopathologically disturbed and support a possible link between MBD and affective disorders. The findings also indicate that MBD may be a clinical entity that should be differentiated from the pure BPD group both in clinical work and forthcoming research. PMID- 2708974 TI - Obsessive-compulsive symptoms in a patient with multiple sclerosis. PMID- 2708973 TI - Melatonin and cortisol "switches" during mania, depression, and euthymia in a drug-free bipolar patient. AB - Low melatonin and elevated cortisol levels have typically been reported during depression. The evidence that the converse is true during mania has been less well documented. In a single case design, repeated measures of nocturnal melatonin and cortisol were taken during mania, depression, and euthymia. Elevated levels of melatonin during mania and elevated cortisol levels during depression were the principal findings. There also did not appear to be any marked change in circadian rhythm of hormone output during the three clinical states. The implications of these findings in relation to noradrenergic dysfunction are discussed. PMID- 2708975 TI - A clinical study of patients who manifest early change in a private psychiatric hospital. PMID- 2708976 TI - Psychiatric morbidity among the children of Abou Seer. PMID- 2708977 TI - Suggestions for the DSM-IV criteria for substance use disorders. PMID- 2708978 TI - Effects of running the Boston marathon on plasma concentrations of large neutral amino acids. AB - Plasma large neutral amino acid concentrations were measured in thirty-seven subjects before and after completing the Boston Marathon. Concentrations of tyrosine, phenylalanine, and methionine increased, as did their "plasma ratios" (i.e., the ratio of each amino acid's concentration to the summed plasma concentrations of the other large neutral amino acids which compete with it for brain uptake). No changes were noted in the plasma concentrations of tryptophan, leucine, isoleucine, nor valine; however, the "plasma ratios" of acid patterns may influence neurotransmitter synthesis. PMID- 2708979 TI - Low temperature in the golden hamster accelerates the gonadal atrophy induced by short photoperiod but does not affect the daily pattern of melatonin secretion. AB - Male golden hamsters were exposed to short photoperiod at either 20 degrees C or 5 degrees C. After 4 weeks a complete gonadal inhibition was observed in animals kept at 5 degrees C while in animals kept at 20 degrees C such an inhibition was much less. No significant difference in the pattern of pineal and plasma melatonin concentrations was observed between hamsters kept at 20 degrees C and 5 degrees C. If in the golden hamster pineal melatonin secretion is implicated in the transduction of the photoperiodic information, it is probably not implicated in the transduction of thermal information. PMID- 2708980 TI - Song-related brain regions in the red-winged blackbird are affected by sex and season but not repertoire size. AB - Previous work in songbirds has delimited a neural system responsible for song production and control. Earlier studies have suggested that functional capacity in the song system may be related to the mass of the system in an animal's brain, and that adult plasticity in this neural system may be related to adult capacity for behavioral modification. We now test these hypotheses in adult red-winged blackbirds (Agelaius phoeniceus), a species in which song is produced primarily by males, new song types are added to the male's repertoire in adulthood, and there are substantial differences among males in song complexity. We find that the song system in males is much larger than in females. Song system nuclei become smaller in both sexes as the animals experience shorter days. We do not find any association between repertoire size and size of any of the song system structures examined. Thus, although sex differences in song may be related to differences between sexes in the mass of song system structures, individual differences in song do not appear to be directly related to mass within males. Seasonal change in song system structures in male redwings is consistent with there being a relation between adult plasticity in anatomy and in behavior; the large seasonal change in these structures in females suggests large seasonal changes in the function of these nuclei. PMID- 2708981 TI - Aedes bahamensis: its invasion of south Florida and association with Aedes aegypti. AB - The exotic mosquito, Aedes bahamensis, is now well-established in south Florida, where it is widely distributed throughout Dade and southern Broward Counties in both urban and rural areas east of the Everglades. When discarded automobile tires were sampled in areas near human habitation, larvae and pupae of Ae. bahamensis were frequently found in association with immature Ae. aegypti. Elsewhere, however, Ae. bahamensis generally occurred in the absence of Ae. aegypti. The persistence of Ae. bahamensis populations at specific sites was documented in egg collections from ovitraps and in larval samples from the water retained in discarded tires. PMID- 2708982 TI - Body size of Culicoides variipennis (Diptera: Ceratopogonidae) in relation to bloodmeal size estimates and the ingestion of Onchocerca cervicalis (Nematoda: Filarioidea) microfiliariae. PMID- 2708983 TI - Evaluation of the effect of varying mosquito emergence on the efficiency of emergence traps over enclosed environments. PMID- 2708984 TI - Prevalence of parasitism of adult Aedes vexans by a mermithid (Nematoda: Mermithidae) in Oklahoma. PMID- 2708985 TI - Culex erraticus: a host for Dirofilaria immitis. PMID- 2708986 TI - Further extension of the range of the rock pool mosquito, Aedes atropalpus, via tire breeding. AB - In the past, Aedes atropalpus was limited to those areas of the eastern U.S. and Canada that had rivers or shorelines with large rocks containing rock pools. In the last 10 years, many new records of larval breeding in scrap tires have accumulated. We present records of larval breeding in non-rock pool containers for 54 counties; most are far from the original range. The species has not only found a new habitat but has greatly extended its range via commercial transport of scrap tires. PMID- 2708987 TI - Effects of various factors on the efficiency of minnow traps to sample mosquitofish (Gambusia affinis) and green sunfish (Lepomis cyanellus) populations. AB - The effects of various factors on the efficiency of the Gee minnow trap to sample populations of mosquitofish, Gambusia affinis, in both rice field enclosures and a laboratory tank were assessed. Immature green sunfish, Lepomis cyanellus, were assessed in the laboratory tank only. Trap efficiency (percent catch) was greater for larger mosquitofish [greater than or equal to 35 mm total length (TL)] than for smaller mosquitofish. Immature green sunfish (25-40 mm TL) were caught at higher rates than either size class of mosquitofish. In the laboratory, trap efficiency increased with increasing mosquitofish density, but density had no effect in field enclosures. Vegetation did not affect trap efficiency. Minnow traps, lying on the substrate, caught a similar percent of available mosquitofish when water depths were 8 and 16 cm but a significantly smaller percent when 24 cm. In contrast, green sunfish, assessed at 8 and 24 cm, were trapped at a higher rate at 24 cm. These results demonstrate the importance of determining the effects of environmental factors on trap efficiency before using direct trap counts to assess effects of these factors on fish abundance. PMID- 2708988 TI - Culicoides (Diptera: Ceratopogonidae) species in southeastern Nebraska. AB - Twenty-four species of Culicoides were collected between April and September of 1986 from Nemaha and Richardson counties of southeastern Nebraska using New Jersey light traps and tree hole sampling. Light trap samples were dominated by C. crepuscularis (42.4%), C. stellifer (29.6%), C. haematopotus (17.4%), C. variipennis (4.1%) and C. obsoletus (2.8%). Culicoides guttipennis and C. villosipennis were the most common of the 9 tree hole species collected. New state records for Nebraska were obtained for C. lahillei, C. riggsi, C. footei, C. paraensis, C. nanus, C. spinosus, C. biguttatus and C. piliferus. PMID- 2708989 TI - Irritability to DDT of natural populations of the primary malaria vectors in Colombia. AB - Natural populations of Anopheles albimanus, An. darlingi and An. nuneztovari were tested for their irritability to DDT in different regions of Colombia. Individual anophelines were exposed to filter papers impregnated with 2% DDT and irritability was determined based on the number of flights a mosquito made in 15 min. All three species showed variability in their irritability to DDT. Anopheles albimanus showed irritability only in Bolivar, but not in three other regions. Anopheles darlingi showed no irritability in neither the Atlantico nor Llanos regions, while An. nuneztovari showed irritability in the Oriente but not in Uraba. The irritability to DDT shown in some populations of An. albimanus and An. nuneztovari may reduce the effectiveness of residual applications of this insecticide by causing the mosquitoes to seek untreated surfaces and/or leave the house to rest outdoors and thus avoid a lethal dose. PMID- 2708990 TI - Residual activity of permethrin on cattle as determined by mosquito bioassays. AB - The residual effectiveness against laboratory-reared female Anopheles quadrimaculatus mosquitoes of a synthetic pyrethroid (permethrin) applied to cattle was determined. Twenty-four-hour postexposure mortality and the degree of successful blood engorgement were determined by exposing mosquitoes for 10 min to cattle. Three replicated assays were conducted and mortality determined at 1, 2, 5, 7, 14 and 21 days after each treatment with an oil-based formulation of permethrin (DeLice) or with an emulsifiable concentrate (Atroban) applied at label rates. Mosquito mortality ranged from 79 to 85% (1 day postapplication) to 12-38% (21 days postapplication). PMID- 2708991 TI - Preliminary report of microsporidia in Simuliidae larvae from Argentina. AB - Amblyospora bracteata, Polydispyrenia simulii, and 3 other undescribed microsporidia are reported from 11 species of neotropical blackfly larvae collected from streams in Buenos Aires (eastern) and Neuquen (southwestern) provinces of Argentina. Preliminary light and electron microscopy studies indicate that 2 of the undescribed species belong in the family Thelohaniidae and the third species is placed in the family Caudosporidae. Ten species of Argentine blackflies are recorded as new host records for A. bracteata and P. simulii. PMID- 2708992 TI - Evaluation of the cotton fabric model for screening topical mosquito repellents. AB - The data of King (1954) were analyzed by rank correlation methods to determine if the results of tests of candidate mosquito repellents on cotton fabric were correlated with the results of tests of the same compounds on the skin. The coefficient of rank correlation was statistically significant (P less than 0.01) for tests against salt marsh mosquitoes, Aedes sollicitans and Ae. taeniorhynchus, and yellow fever mosquitoes, Ae. aegypti, but not for tests against malaria mosquitoes, Anopheles quadrimaculatus. The coefficient of rank correlation was small (rs less than or equal to 0.40), and it was concluded that cotton fabric is not an efficient model for the skin in repellent screening programs. PMID- 2708993 TI - Personal protection afforded by controlled-release topical repellents and permethrin-treated clothing against natural populations of Aedes taeniorhynchus. AB - Field tests evaluated repellent formulations containing deet in combination with permethrin-impregnated or untreated military uniforms against Aedes taeniorhynchus. No significant difference was determined between repellents in duration of protection whether or not permethrin-treated clothing was worn, but there were differences in efficacy relative to site of application. The head was the site of shorter duration of protection regardless of repellent tested. On repellent-treated skin, 12-30% of the bites were on arms, whereas 70-88% were on the head. When military repellent was used, the head was bitten 35% more often than with experimental repellents. On untreated clothing 80% of bites were through pants and 20% through shirts. Mean bites through untreated clothing were 0.7 bites/min/person (42/hr), whereas mean bites through permethrin-impregnated clothing were 0.0004/min/person (0.02/hr). Protection by permethrin-treated clothing relative to untreated clothing was 99.9%. PMID- 2708994 TI - Infection of a field population of Aedes cantator with a polymorphic microsporidium, Amblyospora connecticus via release of the intermediate copepod host, Acanthocyclops vernalis. AB - The microsporidium Amblyospora connecticus was successfully introduced into a larval field population of Aedes cantator via the release of the infected intermediate copepod host, Acanthocyclops vernalis. The tests were conducted in 3 steel drums that were centrally placed within a salt marsh pool that supports breeding populations of both hosts. A total of 2.7 X 10(4) 2nd-instar Ae. cantator larvae were exposed to spore doses ranging from 2.0 X 10(3) to 2.8 X 10(4) spores/larva through the release of more than 2,000 live infected copepods. The majority of infections were acquired by 2nd- and 3rd-instar larvae during the first 3 weeks of exposure, and maximum infection rates ranging from 16 to 24% were obtained by the time of pupation. PMID- 2708995 TI - Repellency of two controlled-release formulations of deet against Anopheles quadrimaculatus and Aedes taeniorhynchus mosquitoes. AB - Two experimental controlled-release repellent formulations containing 35% (3M) and 44% (Biotek) deet, respectively, were compared with a 75% standard formulation of deet used by the military. The military repellent was equal to or significantly better than the formulations in duration of protection against 2 mosquito species in laboratory and field tests, but the formulations contained only 47-59% the amount of deet in the military repellent. In all cases high levels of protection (greater than 95%) were measured, but because of high densities of biting mosquitoes in field tests, this level did not necessarily indicate few bites. In terms of mean bites/test/day by Anopheles quadrimaculatus in caged tests, the military repellent had fewest (2) and Biotek had most (41). PMID- 2708996 TI - Aedes albopictus larvae collected from tree holes in southern Indiana. PMID- 2708997 TI - Substrate preference of Simuliidae larvae in the field in India. PMID- 2708998 TI - Effectiveness of alternative larviciding and adulticiding methods to reduce Culex populations in Marion County, Indiana. PMID- 2708999 TI - Interaction of vanadium(V) oxoanions with ovalbumin and transfusion gelatin. AB - Vanadate(V) anions have been found to modulate the activity of a large number of enzymes. To elucidate these interactions, a physico-chemical study of the binding of meta-vanadate(V) with two typical proteins ovalbumin and transfusion gelatin has been taken up. The binding has been investigated by polarographic method at pHs 7.5 and 9.3, and at 30 degrees C. Values of intrinsic association constant, standard Gibb's free energy change, and the number of amino acids involved in these bindings are reported. Analysis of the binding sites has been done. PMID- 2709000 TI - Subcellular distribution of copper in the kidneys of normal, copper-poisoned, and thiomolybdate-treated sheep. AB - Twenty-seven sheep given either copper (Cu) and/or tetrathiomolybdate (TM) were used to study the subcellular distribution of Cu within the kidney and to monitor the location of lysosomes within the subcellular fractions using acid phosphatase (AP) as a marker enzyme. Copper dosing alone increased the Cu content in the liver and the kidneys. The administration of intravenous TM prevented the development of chronic copper poisoning (CCP) in sheep, reduced the rate of accumulation of Cu in the liver of Cu-dosed animals, but increased the Cu content of kidneys in both the control and Cu-dosed sheep. The total amount of Cu that accumulated in the kidneys of sheep given TM appears to depend on several factors: a) liver Cu concentration, b) Cu intake, and c) dosage of TM. Thus, the highest Cu concentration was found in the kidneys of sheep that continued to receive Cu orally at the same time as they were given TM. The intracellular distribution of Cu and AP in the kidneys showed that in the control sheep given neither Cu or TM, the highest proportion of Cu was in the cytosol fraction, and the highest specific activity of AP was in the light mitochondrial (lysosomal) fraction. Dosing with Cu markedly increased the Cu concentration and greatly elevated the total activity of AP in the heavier fractions, i.e., the nuclear (N) and heavy mitochondrial (MH). Thus, the increase in Cu observed in the N and MH fractions was not caused by an accumulation of Cu by nuclei and mitochondria, but was due to an accumulation of Cu by lysosomes that sedimented with the heavier fractions. The intracellular distribution of Cu in the kidneys of TM-treated sheep was similar to that seen in Cu-loaded sheep. Although Cu accumulated readily in the kidneys of animals receiving TM, kidney function tests showed neither glomerular nor tubular functional impairment. PMID- 2709001 TI - Distribution of Cu, Zn, and Fe in the soluble fraction of the kidney in normal, copper-poisoned, and thiomolybdate-treated sheep. AB - Twenty-seven sheep were used in two experiments to study the distribution of copper (Cu), zinc (Zn), and iron (Fe) in the kidney cytosol of control, Cu loaded, and thiomolybdate (TM)-treated sheep. A comparison was made of the patterns of distribution on Sephadex G-75 of Cu, Zn, and Fe from the cytosol of fresh and frozen kidneys and after thawing of frozen cytosol. In both Cu-dosed and TM-treated sheep, the absolute level of Cu increased in the cytosol, but the percent of Cu decreased. The percent recovery of Cu from the frozen kidney was comparable to that from fresh kidney, but the extraction of Cu from the supernatant of frozen cytosol was approximately 10% less. This was due to a loss of Cu in a precipitate that formed when the frozen cytosol was thawed. Most of the Cu in the cytosol from the kidney of Cu-loaded sheep was in a metallothionein (MT)-like protein fraction and was trichloroacetic acid (TCA) soluble. In contrast, that from the cytosol of TM-treated sheep was mostly in a high molecular weight fraction that was TCA insoluble. The chromatograms obtained from cytosol derived from frozen kidneys, or cytosol that had itself been frozen, contained a similar distribution of Cu, Zn, and Fe, but the peak heights were lower in the latter samples. PMID- 2709002 TI - Release of iron from ferritin molecules and their iron-cores by 3 hydroxypyridinone chelators in vitro. AB - Ferritin molecules contain 24 subunits forming a shell around an inorganic iron core. Release of iron(III) from ferritin and its isolated iron-cores by a series of hydroxypyridinone chelators with high affinities for iron(III) has been compared. The results collectively suggest that the chelators act by penetrating the protein shell and interacting directly with the iron-core in ferritin. Iron(III) is probably removed bound to a single ligand, but once outside the protein shell, the trihydroxypyridinone iron(III) complex predominates. The order of effectiveness of a group of pyridinones found for iron removal from ferritin molecules in solution differs from that obtained with hepatocytes in culture or with whole animals, where membrane solubility and other factors may modulate the response. PMID- 2709003 TI - Binding of inositol hexakisphosphate to the oxygenated derivative of dromedary (Camelus dromedarius) and human hemoglobin: 31P-NMR study. AB - Binding of inositol hexakisphosphate (IHP) to the oxygenated derivative of dromedary (Camelus dromedarius) and human hemoglobin (Hb) was investigated by 31P NMR. The results obtained show that dromedary Hb binds, with different affinity, two IHP molecules per tetramer at distinct sites, while human Hb binds only one IHP molecule per tetramer. PMID- 2709004 TI - Structural and functional diversity of copper-metallothioneins from the American lobster Homarus americanus. AB - The role of copper metallothionein (CuMT) in copper metabolism and metalloenzyme activation is poorly understood. We have chosen marine crustaceans, in which a direct correlation exists between levels of Cu(I)MT and Cu(I)-hemocyanin during the molt cycle (Engel and Brouwer, Biol. Bull. 173, 239-251, 1987) as unique model systems to study the involvement of MTs in metalloprotein activation and degradation. We have isolated three low-molecular weight, cysteine-rich copper proteins from the American lobster Homarus americanus, which we designate as CuMT 1, CuMT-2, and CuMT-3, respectively. As a first attempt to fully characterize these proteins, we have determined the sequence of the first 56 amino acids of CuMT-1. The results show this protein to belong to the class I MTs, i.e., related in primary structure to equine renal MT. CuMT-1 cannot transfer its copper to copper-depleted apohemocyanin. CuMT-2 belongs to the same class of MTs as CuMT-1, but CuMT-3 does not. The latter can reactivate lobster hemocyanin containing reduced amounts of Cu(I). Spectroscopic studies show that Cu(I) transfer from CuMT-3 to apohemocyanin initially results in the formation of distorted binuclear copper sites, which subsequently slowly return to their native stereochemical configuration. Finally, we present evidence that shows that the class I MTs in marine crustacea are involved in the sequestration of elevated levels of heavy metal ions. These observations strongly suggest that the different forms of MT have different biological functions. PMID- 2709005 TI - Solvent effect on MCD of Fe(III) heme complexes: magnetic circular dichroism spectra of five-coordinated high-spin iron(III) protoporphyrin-IX-dimethylester in the visible region and their environmental effect. A characterization of the visible electronic transitions in Fe(III) high-spin porphyrins. AB - Magnetic circular dichroism (MCD) spectra were observed to characterize the nature of the visible bands for high-spin Fe(III) protoheme derivatives with p nitrothiophenolate, p-nitrophenolate, and methoxy anion as the fifth ligands in several solvents. The visible MCD bands for p-nitrophenolate heme were very sensitive to the solvent polarity, but that those for p-nitrothiophenolate heme and methoxy heme were not dependent on solvent polarity. Thus, both the two visible MCD band positions and the magnitudes were dependent on ET value (a solvent polarity parameter) in the former complex, but not in the latter two complexes. The results are consistent with previously proposed electronic structures of high-spin Fe(III) heme complexes. PMID- 2709006 TI - Effect of 6-phosphogluconate on phosphoglucose isomerase in rat brain in vitro and in vivo. AB - The activity of phosphoglucose isomerase, its kinetic properties, and the effect of 6-phosphogluconate on its activity in the forward (glucose 6-phosphate--- fructose 6-phosphate) and the reverse (fructose 6-phosphate----glucose 6 phosphate) reactions were determined in adult rat brain in vitro. The activity of phosphoglucose isomerase (in nmol/min/mg of whole brain protein) was 1,865 +/- 20 in the forward reaction and 1,756 +/- 32 in the reverse reaction at pH 7.5. It was 1,992 +/- 28 and 2,620 +/- 46, respectively, at pH 8.5. The apparent Km and Vmax of phosphoglucose isomerase were 0.593 +/- 0.031 mM and 2,291 +/- 61 nmol/min/mg of protein, respectively, for glucose 6-phosphate and 0.095 +/- 0.013 mM and 2,035 +/- 98 nmol/min/mg of protein, respectively, for fructose 6 phosphate. The activity of phosphoglucose isomerase was inhibited intensely and competitively by 6-phosphogluconate, with an apparent Ki of 0.048 +/- 0.005 mM for glucose 6-phosphate and 0.042 +/- 0.004 mM for fructose 6-phosphate as the substrate. With glucose 6-phosphate as the substrate, at concentrations from 0.05 to 0.5 mM, the activity of the enzyme was inhibited completely in the presence of 0.5-2.0 mM 6-phosphogluconate. With 0.05-0.2 mM fructose 6-phosphate as the substrate, it was inhibited greater than or equal to 85% at the same concentrations of the inhibitor. No significant changes were observed in the values of Km, Vmax, and Ki for phosphoglucose isomerase in the brain of 6 aminonicotinamide-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709007 TI - Alterations in protective enzymes against peroxidation in the central and peripheral nervous system of control and dysmyelinating mutant mice. AB - The activities of peroxide-detoxifying enzymes such as superoxide dismutase (SOD), glutathione peroxidase, glutathione reductase, and catalase were measured in the nervous system of neurological dysmyelinating mutants: quaking (Qk), shiverer (Shi), and trembler (Tr) mice. Cu/Zn-SOD activity was higher in the cerebellum of Qk and Shi mice (by 53% and 106%, respectively) in comparison with controls, but it was the same in the cerebellum of Tr mice and their corresponding controls. In contrast, there was no difference in the level of Cu/Zn-SOD activity in the cerebrum of Qk, Shi, and Tr mice and their respective controls. Mn-SOD activity was the same among all the mutants compared to control animals in both cerebrum and cerebellum. In Shi cerebellum, glutathione peroxidase and glutathione reductase activities were slightly decreased (a 21.6% and a 13.2% diminution, respectively), whereas catalase activity in cerebrum and cerebellum was the same among mutants and control mice. In the sciatic nerve from Tr mice, all the enzymatic activities were enhanced: sixfold increase for total SOD, and 2.4-fold, 3.5-fold, and 1.8-fold increase for glutathione peroxidase, glutathione reductase, and catalase, respectively. PMID- 2709008 TI - Na+ dependence of tyrosine transport across the synaptosomal membrane reflects changes in the morphology of synaptosomes. AB - The Na+ dependence of tyrosine uptake into rat brain synaptosomes and synaptosomal plasma membrane vesicles (SPMV) was examined in the present study. At low tyrosine concentrations, the isoosmotic substitution of Na+ by sucrose in the incubation medium led to an increase of tyrosine uptake in synaptosomes and to a decrease in SPMV. The removal of extracellular Ca2+ and Mg2+ and addition of isoosmotic sucrose completely prevented the augmented tyrosine uptake in Na+-free incubated synaptosomes. Morphological differences were found at the electron microscopic level when synaptosomes were incubated in Na+-free and Na+-containing media. The internal volume measured for synaptosomes incubated in a Na+-free medium was almost half of that obtained in a Na+-containing medium, in good agreement with the observations made with the electron microscope. Also, the omission of Ca2+ and Mg2+ resulted in a specific swelling of only the synaptosomes incubated in Na+-free medium. When synaptosomes and SPMV were preloaded with several neutral amino acids, the tyrosine uptake rate was greatly increased, indicating fully operational exchange mechanisms for these amino acids. We propose that the enhancement of high-affinity synaptosomal tyrosine uptake observed in Na+-free medium is a consequence of a specific shrinkage of the synaptosomes and a parallel increase of the exchange rate with endogenous neutral amino acids. PMID- 2709009 TI - Changes in histamine metabolism in the brains of mice with streptozotocin-induced diabetes. AB - Histamine (HA) metabolism in the brain of mice with streptozotocin (STZ)-induced diabetes was examined. The levels of tele-methylhistamine (t-MH), a major metabolite of brain HA, significantly increased 3 and 4 weeks after STZ injection. However, the HA turnover rates in the diabetic mice, determined from the accumulation of t-MH after the administration of pargyline, were not different from the control values when the animals were allowed free access to food. When the mice were starved for 15 h 4 weeks after STZ treatment, the brain levels of L-histidine decreased significantly, whereas HA turnover increased significantly. Such changes were not observed in starved control mice. Histidine decarboxylase or HA N-methyltransferase activity did not change after starvation in either diabetic or control mice. These results show that the histaminergic (HAergic) activity in the brains of diabetic mice remains within normal range as long as the animals are allowed free access to food. However, they also indicate that a marked enhancement of HAergic activity accompanied by a decrease in the brain L-histidine level occurs in starved diabetic mice. PMID- 2709010 TI - Characterization of binding sites for the angiotensin II antagonist 125I [Sarc1,Ile8]-angiotensin II on murine neuroblastoma N1E-115 cells. AB - The murine neuroblastoma N1E-115 cell line contains binding sites for the angiotensin II (Ang II) receptor antagonist 125I-[Sarc1,Ile8]-Ang II (125I SARILE). Binding of 125I-SARILE to N1E-115 membranes was rapid, reversible, and specific for Ang II-related peptides. The rank order potency of 125I-SARILE binding was the following: [Sarc1]-Ang II = [Sarc1,Ile8]-Ang II greater than Ang II greater than Ang III = [Sarc1,Thr8]-Ang II much greater than Ang I. Scatchard analysis of membranes prepared from confluent monolayers revealed a homogenous population of high affinity (KD = 383 +/- 60 pM) binding sites with a Bmax of 25.4 +/- 1.6 fmol/mg of protein. Moreover, the density, but not the affinity, of the binding sites increased as the cells progressed from logarithmic to stationary growth in culture. Finally, agonist, but not antagonist, binding to N1E-115 cells was regulated by guanine nucleotides. Collectively, these results suggest that the murine neuroblastoma N1E-115 cell line may provide a useful model in which to investigate the signal transduction mechanisms utilized by neuronal Ang II receptors. PMID- 2709011 TI - Formation of ganglioside GD1b-lactone in rat brain from intracisternally administered GD1b. AB - The presence of ganglioside GD1b, in lactone form GD1b-L, was ascertained in rat brain. The possible formation of GD1b-L from GD1b in brain was explored by the intracisternal injection of GD1b, 3H-labelled at the level of the terminal galactose. This was followed by recognition of the radioactive gangliosides formed at different times (1, 3, and 7 days) after injection. Whereas at 0 time after injection the only radioactive ganglioside was GD1b, after 1, 3, and 7 days other radioactive gangliosides were also found, thus indicating GD1b penetration into the brain tissue, followed by metabolic processing. Besides GD1b, the following radioactive gangliosides were recognized: GM1 and GM2, derived from GD1b degradation; GT1b, formed by the direct sialylation of GD1b; and GD1b-L, produced by metabolic lactonization. The radioactivity carried by GD1b-L was maximal 3 days after injection; its time course was different from that of the other gangliosides, suggesting that the process of lactonization is separate from that of both degradation and glycosylation. Under the same experimental conditions, some radioactive gangliosides also appeared in the liver, although in much smaller amounts than in brain. Radioactive GD1b-L could not be detected in liver, thus indicating that metabolic lactonization is a tissue- or organ specific process. PMID- 2709012 TI - Biochemical aspects of chick embryo retina development: the effects of glucocorticoids. AB - In chick embryo retina during development, DNA synthesis and the activities of DNA polymerase, thymidine kinase, thymidylate synthetase, and ornithine decarboxylase (ODC) declined in parallel from day 7 to 12. The administration in ovo of hydrocortisone reduced significantly, particularly at 8-10 days of incubation, both DNA synthesis and the four enzyme activities tested. The effect was dose dependent, reaching the maximum with 50-100 nmol of hydrocortisone, 8-16 h after treatment. The highest inhibition was found for ODC activity (70%), followed by thymidine kinase activity (62%) and DNA synthesis (45%), whereas activities of DNA polymerase and thymidylate synthetase were reduced only by 30%. The inhibitory effect was exerted by all the glucocorticoids tested, with dexamethasone and hydrocortisone being the most efficacious. The results support the view that glucocorticoids reduce the proliferative events in chick embryo retina, particularly at 8-10 days of embryonic life. PMID- 2709013 TI - Utilization of high-density lipoprotein sphingomyelin by the developing and mature brain in the rat. AB - Utilization of very long chain saturated fatty acids by brain was studied by injecting 20-day-old and adult rats with high-density lipoprotein containing [stearic or lignoceric acid-14C, (methyl-3H)choline]sphingomyelin. Labeling was followed for 24 h. Very small amounts of 14C were recovered in the brain of all rats, and there was no preferential uptake of lignoceric acid. Approximately 20% of the entrapped 14C was located in the form of unchanged sphingomyelin 24 h after injection. This result shows that the rat brain utilizes very little very long chain fatty acids (greater than or equal to 20 C atoms) from high-density lipoprotein sphingomyelin, even during the myelinating period. The [3H]choline moiety from sphingomyelin was recovered in brain phosphatidylcholine in a higher proportion in comparison with the 14C uptake. The brain 3H increased throughout the studied period in all experiments, but was much higher in the myelinating brain than in the mature brain. From the radioactivity distribution in liver and plasma lipids, it is clear that the choline 3H in the brain originates from either double-labeled phosphatidylcholine of lipoproteins or tritiated lysophosphatidylcholine bound to albumin, both synthesized by the liver. PMID- 2709014 TI - Development and ageing of the rat nigrostriatal dopamine system studied with fast cyclic voltammetry. AB - Fast cyclic voltammetry at carbon fibre microelectrodes was used to measure electrically stimulated dopamine release in the striatum of anaesthetised young, adult, and senescent Wistar rats. By alteration of stimulus parameters and by use of nomifensine, investigation of dopamine release, uptake, and compartmentalisation within the striatum was possible. The rate of dopamine release was highest in adult rats. No difference was observed between young and old animals. The size of the releasable (newly synthesised) dopamine pool was also largest in the adult group, again with no significant difference occurring between young and aged rats. The rate of dopamine uptake was highest in adult rats, although, when expressed as a function of dopamine release, young and aged rats showed proportionally greater uptake. Nomifensine (10 mg/kg i.p.) increased dopamine release by mobilising the inert storage pool to a greater extent in young than in adult rats, whereas the effect of the drug on uptake was similar in all age groups. The functional significance and possible explanation of these results are discussed. PMID- 2709015 TI - Interactions between alpha-latrotoxin and trivalent cations in rat striatal synaptosomal preparations. AB - The interactions between alpha-latrotoxin (alpha-LTx), a neurosecretagogue purified from the venom of the black widow spider, and the trivalent cations Al3+, Y3+, La3+, Gd3+, and Yb3+ were investigated in rat striatal synaptosomal preparations. All trivalent cations tested were inhibitors of alpha-LTx-induced [3H]dopamine [( 3H]DA) release (order of potency: Yb3+ greater than Gd3+ approximately Y3+ greater than La3+ greater than Al3+). Only with Al3+ could inhibition of [3H]DA release be attributed to a block of 125I-alpha-LTx specific binding to synaptosomal preparations. The inhibitory effect of trivalent ions was reversible provided synaptosomes were washed with buffer containing EDTA. Trivalent ions also inhibited alpha-LTx-induced [3H]DA release at times when alpha-LTx-stimulated release was already evident. alpha-LTx-induced synaptosomal membrane depolarization was blocked by La3+, but not affected by Gd3+, Y3+, and Yb3+. alpha-LTx-stimulated uptake of 45Ca2+ was inhibited by all trivalent cations tested. These results demonstrate that there exist at least three means by which trivalent cations can inhibit alpha-LTx action in rat striatal synaptosomal preparations: (1) inhibition of alpha-LTx binding (Al3+); (2) inhibition of alpha-LTx-induced depolarization (La3+); and (3) inhibition of alpha-LTx-induced 45Ca2+ uptake (Gd3+, Y3+, Yb3+, La3+). PMID- 2709016 TI - Rat brain slices produce and liberate kynurenic acid upon exposure to L kynurenine. AB - The incorporation of L-kynurenine (L-KYN) into kynurenic acid (KYNA) was examined in rat brain slices. KYNA was measured in the slices and in the incubation medium after purification by ion-exchange and HPLC chromatography. In pilot experiments, the formation of KYNA was confirmed by gas chromatography. KYNA was produced stereoselectively from L-KYN, and approximately 90% of the newly synthesized KYNA was recovered from the incubation medium. Intracellular KYNA was not actively retained by the tissue and was lost from the cells upon repeated washes. Thus, regulation of the levels of extracellular KYNA appears to occur at the level of L KYN uptake and/or kynurenine transaminase, the biosynthetic enzyme of KYNA. KYNA production from L-KYN was linear up to 4 h and reached a plateau at a L-KYN concentration of 250 microM. The process was effectively inhibited by the transaminase inhibitor aminooxyacetic acid (IC50, approximately 25 microM), and showed pronounced regional distribution (hippocampus greater than cortical areas greater than thalamus much greater than cerebellum). The conversion of L-KYN to KYNA was dependent on oxygenation and on the presence of glucose in the incubation medium. Neither deletion of Ca2+ or Mg2+ nor addition of 20 mM Mg2+ had any effect. However, KYNA production was significantly attenuated in the absence of Cl- or in the presence of 50 mM K+ in the incubation medium. In Na+ free medium, the production of KYNA from L-KYN was increased by 30%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709017 TI - Differential effect of stress on in vivo dopamine release in striatum, nucleus accumbens, and medial frontal cortex. AB - Microdialysis was used to assess extracellular dopamine in striatum, nucleus accumbens, and medial frontal cortex of unanesthetized rats both under resting conditions and in response to intermittent tail-shock stress. The dopamine metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid also were measured. The resting extracellular concentration of dopamine was estimated to be approximately 10 nM in striatum, 11 nM in nucleus accumbens, and 3 nM in medial frontal cortex. In contrast, the resting extracellular levels of 3,4 dihydroxyphenylacetic acid and homovanillic acid were in the low micromolar range. Intermittent tail-shock stress increased extracellular dopamine relative to baseline by 25% in striatum, 39% in nucleus accumbens, and 95% in medial frontal cortex. 3,4-Dihydroxyphenylacetic acid and homovanillic acid also were generally increased by stress, although there was a great deal of variability in these responses. These data provide direct in vivo evidence for the global activation of dopaminergic systems by stress and support the concept that there exist regional variations in the regulation of dopamine release. PMID- 2709019 TI - Multiple sclerosis following optic neuritis in Chile. AB - Twenty three unselected cases of optic neuritis were re-examined between 2 and 18 years after the onset of the disease, with a mean of 9.7 years. Only 8/23 (35%) had unilateral non-recurrent disease. One patient only (4.3%) went on to develop multiple sclerosis. These findings support the impression that demyelinating disease varies considerably in Latin America compared with northern industrialised countries. PMID- 2709018 TI - Does signal-attenuation on high-field T2-weighted MRI of the brain reflect regional cerebral iron deposition? Observations on the relationship between regional cerebral water proton T2 values and iron levels. AB - T2-weighted MRI shows attenuated signals from the basal ganglia, such signal attenuation being more evident at high magnetic field strengths of 1.5 tesla (T). The basal ganglia contain high levels of iron, and it has been suggested that these iron deposits lead to shortening of bulk water T2 protons via a mechanism involving diffusion of water through local magnetic field gradients generated by the iron. This mechanism generates a relaxation contribution that is proportional to the square of the applied static field B0, and if it is significant the relaxation rate 1/T2 should be strongly dependent on Bo. T2-weighted MRI would then provide a potential means of imaging regional cerebral iron levels at field strengths that are high enough for this mechanism to be important. The bulk water proton spin-spin relaxation times (T2) of samples from caudate nucleus, frontal cortex, and white matter, taken from fresh cerebral necropsy material of four subjects dying of non-neurological conditions, and one subject with Parkinson's disease have been measured. T2 values were compared with regional cerebral iron content. At high field strengths (2.35 T and 8.5 T) no significant variation in regional cerebral water proton T2 values was found; caudate, cortex and white matter had similar water proton spin-spin relaxation times in spite of the variation in their iron content. Increasing the field strength from 2.35 T to 8.5 T resulted in a generalised 50% decrease in mean regional cerebral T2 values, as opposed to the 13-fold decrease expected if T2 relaxation was dominated by a mechanism that is dependent on B02. It was thus not possible to provide evidence that iron deposition per se is responsible for the attenuated signal obtained from the basal ganglia in T2-weighted MRI. PMID- 2709020 TI - Lumbar extradural arachnoid cyst presenting as a conus lesion in a man aged 77 years. PMID- 2709021 TI - Comparison of the Westmead PTA Scale and the Glasgow Coma Scale as predictors of neuropsychological outcome following extremely severe blunt head injury. PMID- 2709022 TI - Acute encephalopathy in adult as delayed presentation of occupational lead intoxication. PMID- 2709023 TI - Severe aggravation of blepharospasm in Fisher's syndrome. PMID- 2709024 TI - Orthostatic tremor: diagnostic entity or variant of essential tremor? PMID- 2709025 TI - Serum vitamin E concentrations in adult-onset spinocerebellar degeneration. PMID- 2709026 TI - Serum vitamin E concentrations in degenerative ataxias. PMID- 2709027 TI - Paroxysmal choreoathetosis as presenting symptom of diabetes mellitus. PMID- 2709028 TI - Subdural haematoma upon straining. PMID- 2709029 TI - Rapid development of occlusion hydrocephalus by intraventricular fat possibly derived from a ruptured dermoid cyst. PMID- 2709030 TI - Cerebral venous thrombosis in hereditary protein C deficiency. PMID- 2709031 TI - Geometrical optics of the retinal image stabilisation device. PMID- 2709032 TI - Proceedings of the joint meeting of the Society of British Neurological Surgeons (112th meeting), the Neurosurgical Society of Australia and the Neuroanaesthetists Travelling Club. Oxford, 14-15 April, 1988. Abstracts. PMID- 2709033 TI - Quantitative magnetic resonance imaging in multiple sclerosis: the effect of high dose intravenous methylprednisolone. AB - Magnetic resonance imaging was performed on 50 patients with clinically definite or probable multiple sclerosis before and 15 days after starting treatment with intravenous methylprednisolone (0.5 g daily for 5 days). Scans were abnormal in 49 patients. New lesions had appeared on the second scan in nine individuals and in seven a single pre-existing lesion appeared to have become smaller but in no case were lesions seen to disappear. Two patients showed both reduction in the size of an abnormal area and development of a single new lesion indicating that corticosteroids do not appear rapidly to alter the process underlying plaque formation. Measurements of relaxation times were performed in 12 randomly selected patients. All showed elevated values in normal appearing white matter but not cortex before treatment compared with 18 healthy controls. After treatment a significant decrease of T1 and T2 was observed in cortex, and of T1 alone in normal appearing white matter. No significant change could be detected within lesions, a finding attributed to the wide range of relaxation values observed at these sites before treatment. Since brain water content is increased in normal appearing white matter of multiple sclerosis patients, and is significantly reduced by high-dose methylprednisolone, resolution of oedema may contribute to the rapid spontaneous or corticosteroid induced symptomatic recovery that characterises the disease in its early stages. PMID- 2709034 TI - Visual evoked potentials in the assessment of patients with non-functioning chromophobe adenomas. AB - The results of visual evoked potential (VEP) examination in 34 patients with histologically confirmed chromophobe adenoma are described and discussed in relation to the clinical, radiological and surgical findings. The VEP is shown to be a reliable method of assessing the function of the intracranial visual pathways which is often more sensitive than conventional methods of examination. PMID- 2709035 TI - Encephalopathy, deafness and blindness in young women: a distinct retinocochleocerebral arteriolopathy? AB - Three young women (aged 18 years, 19 years and 19 years) who developed progressive neuropsychic and neurologic disturbances with hearing loss and multifocal retinal artery branch occlusions are reported. This retinocochleocerebral syndrome has been reported previously only in 12 young North American women. Its pathogenesis is unknown, but an atypical viral infection of the vessel walls has been suggested. Abnormalities of T lymphocytes subsets in blood in one of the patients suggested an immunological dysfunction, but all other tests, including immunological reactions on brain and skin biopsies, were negative or non-specific. Steroids and immunosuppressive agents have been advocated on an empirical basis, but the second patient showed a substantial recovery without any therapy and the third gradually deteriorated despite azathioprine, cyclophosphamide, prednisone and plasma exchanges. This retinocochleocerebral syndrome probably corresponds to an arteriolopathy of unknown nature. PMID- 2709036 TI - Vestibulo-ocular abnormalities in spasmodic torticollis before and after botulinum toxin injections. AB - In order to establish whether vestibular abnormalities often found in spasmodic torticollis are secondary to the abnormal head posture, the vestibulo-ocular reflex (VOR) was studied in eight patients before and after correction of head posture with botulinum toxin. Eye movements were recorded in the dark during sinusoidal and velocity step rotation. Four patients showed a significantly asymmetric response, with the slow phase of the VOR more active ipsilateral to the torticollis (chin). Despite significant improvement of the head posture in all patients for up to 10 weeks following treatment, no correction of the vestibular asymmetry occurred. This suggests that the VOR abnormalities are not caused by the head posture itself. We interpret the findings as evidence of primary involvement of the vestibular system in torticollis and we postulate a widespread derangement of the sensory-motor mechanisms controlling head posture in this disease. PMID- 2709037 TI - Frozen shoulder and other shoulder disturbances in Parkinson's disease. AB - The frequency of shoulder disturbances, particularly frozen shoulder, has not been assessed previously in Parkinson's disease. In a survey of 150 patients compared with 60 matched control subjects a significantly higher incidence of both a history of shoulder complaints (43% vs. 23%) and frozen shoulder (12.7% vs. 1.7%) was found in the Parkinson's disease population. Those developing a frozen shoulder had initial disease symptoms indicative of akinesia twice as frequently as tremor while the ratio was reversed in those without frozen shoulder. In at least 8% of the patients frozen shoulder was the first symptom of disease, occurring 0-2 years prior to the onset of more commonly recognised features. Parkinson's disease should be added to the list of causes of frozen shoulder, and clinicians must be aware that the latter is often the presenting symptom of Parkinson's disease. PMID- 2709038 TI - Asymmetry of substantia nigra neuronal loss in Parkinson's disease and its relevance to the mechanism of levodopa related motor fluctuations. AB - A pathological study of 21 patients with Parkinson's disease of asymmetrical onset revealed significant asymmetry of degeneration of the substantia nigra with greater neuronal loss contralateral to the initially affected body side. It has previously been suggested that decline in duration of effectiveness of levodopa doses in Parkinsonian patients with motor oscillations is caused by loss of nigro striatal dopaminergic terminals with consequent reduction in striatal dopamine storage capacity. If this is true, duration of levodopa motor response should be shorter on the more severely affected body side in patients with asymmetrical disease, as loss of contralateral striatal dopamine storage capacity should be greater. Serial motor evaluations in 20 patients with asymmetrical Parkinson's disease failed to reveal any such asymmetry of duration of motor response to levodopa. It is suggested that striatal dopamine storage is not an important determinant of duration of clinical response to levodopa doses. PMID- 2709039 TI - Severely threatening events and marked life difficulties preceding onset or exacerbation of multiple sclerosis. AB - Information was obtained on stressful life circumstances, using the Life Events and Difficulties Schedule (LEDS) from 39 patients with early multiple sclerosis and 40 matched nonpatient volunteers. The proportion of multiple sclerosis patients who experienced marked life adversity in the year prior to onset of symptoms was significantly higher than for nonpatients in the year before interview (77% vs. 35%). The excess in marked life stress was most evident in the 6 months before onset. Such stressors might explain the timing of symptom exacerbation for some patients with multiple sclerosis, perhaps by perturbing an already unstable neuroimmunological system. PMID- 2709040 TI - Efficacy of sinemet CR4 in subgroups of patients with Parkinson's disease. AB - The efficacy of Sinemet CR4 (50/200) was compared to standard Sinemet (25/100) in an open label crossover study in 22 patients with Parkinson's disease. All patients experienced end of dose failure and 11 had dyskinesia. Unified Parkinson's disease, Hoehn and Yahr, Schwab and England scores, number of hours on per day, number of hours of dyskinesia per day, daily dose of levodopa, and number of doses per day were monitored at the end of each treatment period and the results compared. The only significant difference in these parameters between the CR4 and standard Sinemet treatment periods in the entire group was a decrease in hours of dyskinesia per day. Two subgroups of CR4 responders were specifically examined. The first subgroup was characterised by a significant increase in on time per day with CR4 therapy. These patients had an older age of onset of Parkinson's disease and a shorter duration of disease and fluctuations than the rest of the patients. The second subgroup was characterised by the presence of dyskinesia with standard Sinemet therapy and a significant decrease in hours of dyskinesia per day with CR4 therapy. Both subgroups required a significantly higher daily dose of levodopa while on CR4. It is concluded that CR4 may be useful in increasing hours on per day in subgroups of Parkinson's disease patients who have less severe fluctuations. It may also be useful in decreasing the number of hours of dyskinesia per day. PMID- 2709041 TI - Physiological analysis of asterixis: silent period locked averaging. AB - Asterixis was studied in nine patients, using a new electrophysiological technique: silent period locked averaging (SPLA). There were two types of electromyographic (EMG) silence in the movements clinically judged as asterixis. The jerky movement in one of the two types might be caused by the silent period after the subclinical cortical myoclonus. SPLA would be useful for studying asterixis as well as other EMG silences. PMID- 2709042 TI - Cerebral cortical potentials to pure non-painful temperature stimulation: an objective technique for the assessment of small fibre pathway in man. AB - In six healthy subjects cortical potentials were evoked by rapidly changing heating or cooling stimuli to the hand. Recordings were made from the contralateral scalp area overlying the sensori-motor cortex, referred to a frontal reference. The potential averaged from 25 stimuli comprised a large positive wave with a mean amplitude of 9.2, SD 1.1 microV for heat and 8.8 SD 1.2 micro V for cold stimulation. The heat evoked potentials had longer peak latencies (range: 280-350 ms) than those elicited by cold stimuli (range: 178-200 ms). A lower amplitude positive wave of a longer latency was also recorded to both modes of stimulation over the corresponding ipsilateral cortex. Cortical thermal evoked potentials were absent in two patients, one with severe selective small fibre neuropathy and the other with syringomyelia, both of whom had high thermal thresholds demonstrated by the technique of Jamal et al. Cerebral potentials evoked by thermal stimuli may represent an alternative approach to the investigation of the central projections of the human small fibre system with both clinical and research potential. PMID- 2709043 TI - Light and electron microscopic immunocytochemical analysis of the noradrenaline innervation of the rat visual cortex. AB - Immunocytochemistry with an antiserum against noradrenaline was used to examine the organization and morphology of noradrenergic axons in the rat visual cortex. Observations with the light microscope confirmed earlier reports concerning the distribution pattern of noradrenergic fibres, and provided some further clues about their intracortical organization. Particularly striking was the finding of fibres which followed an oscillating course within the boundaries of layers II-IV as they ran in the mediolateral direction. Examination of the morphological characteristics of noradrenaline-containing axon terminals in serial ultrathin sections has provided further evidence that the vast majority (87.6%) form conventional synapses in the visual and frontoparietal cortex, and has given clues about the postsynaptic elements involved in these synaptic contacts; they are, in decreasing frequency, spines, dendritic shafts of various diameters, and pyramidal and non-pyramidal somata. In addition, a few labelled terminals were visualized in close association with intracerebral capillaries. PMID- 2709044 TI - Ultrastructural relationships of serotonin and GABA terminals in the rat suprachiasmatic nucleus. Evidence for a close interconnection between the two afferent systems. AB - Serotonin (5-HT) and gamma-aminobutyric acid (GABA) nerve endings were identified in the rat suprachiasmatic nucleus (SCN) by combined [3H]5-HT uptake radioautography and glutamate decarboxylase (GAD) immunocytochemistry at the electron microscope level. In areas of good overlap between radioautographic and immunocytochemical labellings, there were no axonal varicosities exhibiting both labellings, indicating that 5-HT and GABA are not co-localized in the SCN. The systematic survey in these areas of all profiles that had accumulated [3H]5-HT and of all GAD-immunoreactive varicosities allowed the analysis of 247 of the former and 896, i.e. an almost four-fold greater number, of the latter. This seems concordant with the view that GABA endings would be the most numerous of all classes of nerve terminals so far identified in the SCN. More than 22% of the [3H]5-HT labelled profiles showed the membrane specialization typically associated with synaptic junctions. Thereby, it was possible to evaluate that about 45% of the 5-HT terminals actually form a synapse in the SCN. Some 37% of the GAD-positive varicose profiles which could be formally interpreted also showed well differentiated synaptic contacts, suggesting that the GABAergic innervation of the SCN could be entirely junctional. Whereas 5-HT terminals usually innervated only one dendritic or somatic element, a convergence of several GABAergic terminals onto the same postsynaptic target also receiving a 5 HT input was frequently observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709045 TI - Visualization of polyribosomes in the postsynaptic area of the squid giant synapse by electron spectroscopic imaging. AB - Giant axons from squids (Loligo vulgaris and Loligo pealii) were studied by conventional electron microscopy and by electron spectroscopic imaging: electrons with a characteristic energy loss due to interaction with phosphorus atoms were used to image phosphorus-rich elements such as ribosomes. Patches of granular material were seen in the proximal region of giant axons, especially in the postsynaptic area of the giant synapse, but not on the presynaptic side. They were rare or absent in the more distal part of the axon. With electron spectroscopic imaging the patches emitted strong phosphorus signals, indistinguishable from signals of ribosomes in neuronal perikarya, confirming their identification as RNA-rich elements. In the part of the axon near the perikarya in the giant fibre lobe, the patches consisted of sacs of rough endoplasmic reticulum. It is suggested that patches of rough endoplasmic reticulum are transported to the synaptic region where ribosomes detach from the cisterns and aggregate into polyribosomes. PMID- 2709046 TI - Ribbon synapses of the mammalian retina contain two types of synaptic bodies- ribbons and spheres. AB - The present paper reports that the synaptic bodies of the retinal ribbon synapses in rat, guinea pig, golden hamster and mouse are a heterogeneous population of organelles. In addition to the well-known synaptic ribbons sensu stricto which consist of a platelike electron-dense central structure surrounded by electron lucent synaptic vesicles, there are what is termed synaptic spheres, in which the core is not platelike, but round to oval. In rat retinae procured at day, ribbons outnumbered spheres by a factor of 4. At night spheres were not seen in photoreceptor cells. Spheres, like ribbons, may lie some distance from the synaptic site, perhaps indicating transit from their site of origin to the synapse. At night ribbons are longer than at daytime. In addition to the previously described connecting stalks between synaptic vesicles and the electron dense ribbons, the presence of filamentous stalks between adjacent synaptic vesicles is described. The latter stalks, depending on their presence or absence, may influence the position of the synaptic vesicles in relation to the synaptic body and/or the presynaptic membrane. It is concluded that the plasticity of retinal synapses cannot be fully appreciated unless the temporal changes of ribbons, spheres and the connecting stalks are taken into consideration. PMID- 2709047 TI - Ultrastructural metabolic activity following quick-freezing and freeze substitution in tetrahydrofuran in the superior cervical ganglion. AB - A method of quick-freezing and freeze-substitution has been developed for localizing diffusible substances such as 2-deoxyglucose-6-phosphate (2-DG-6-P) ultrastructurally in neural tissue. Quick-freezing under pressure provides well preserved tissue down to 30-35 microns from the surface. This allows blocks of neural tissue to be quick-frozen and analysed for diffusible substances in areas removed from the freezing face. Freeze-substitution in tetrahydrofuran following quick-freezing was found to dissolve and remove 2-deoxyglucose (2-DG) but not 2 DG-6-P. Consequently, this technique extends the ability to analyse localization of glucose utilization to postsynaptic as well as presynaptic sites. We have applied the technique to isolated superior cervical ganglion while provoking selective increases in energy metabolism. Exposure to an elevated extracellular potassium (12 mM) concentration produced a pattern of metabolic activity with enhanced neuropil labelling (neuronal and glial processes). With antidromic stimulation of the external carotid nerves, deoxyglucose uptake in neuronal and glial soma in the caudal portion of the ganglion was enhanced more than neuropil labelling. This caudal region corresponds to the region of origin of the cell bodies of the external carotid nerve. Results from this technique suggest that the contribution of glia to overall rate of energy metabolism may be significant and that this is a promising method for correlating the relationship between functional activity and cellular electrical activity. PMID- 2709048 TI - Nucleolar organization in granule cell neurons of the rat cerebellum. AB - The present light and electron microscopic study deals with the morphology and cytochemical properties of the nucleolus in mature granule cells of the rat cerebellum. Nucleolar organization has been examined by several different methodological approaches: (a) determination of the number of nucleoli per cell from smear preparations, (b) morphometric estimation of nucleolar size, and (c) ultrastructural and cytochemical characterization of nucleolar components. The mean number of nucleoli per cell was found to be 1.46 +/- 0.02 (mean +/- SEM). The morphometric measurement of the nucleolar area showed an average value of 0.359 +/- 0.07 microns 2 (mean +/- SDM). At the electron microscope level, most granule cell nucleoli displayed a fine texture which does not differ substantially from the 'ring-shaped' configuration usually found in cells with low levels of protein synthesis activity; i.e., a large round fibrillar centre surrounded by the dense fibrillar component, and small masses of granular component segregated from the preceding constituents. The meaning of this nucleolar configuration is discussed in the light of recent ultrastructural and biochemical data on nucleolar function. A relationship between this pattern of nucleolar organization and metabolic characteristics of the granule cells is suggested. PMID- 2709049 TI - Lamellar bodies are markers of cholinergic neurons in ferret nucleus basalis. AB - Lamellar bodies are composed of stacks of closely-packed, ribosome-free cisterns which are in continuity with the rough endoplasmic reticulum. In the ferret nucleus basalis stained for choline acetyltransferase it was shown, by correlating light with electron microscopy, that only the cholinergic cells there possess lamellar bodies. The significance of lamellar bodies in the cholinergic neurons of the nucleus basalis is not known, but these structures may reflect a peculiar aspect of the functioning of the cholinergic cells which will need to be investigated further. PMID- 2709050 TI - Investigation of unilateral facial weakness: magnetic stimulation of the proximal facial nerve and of the face-associated motor cortex. AB - Twenty-four patients with unilateral facial weakness of various aetiologies were investigated using a magnetic stimulator to stimulate the proximal segment of the facial nerve directly (short latency response) and also to activate the facial motoneurons bilaterally via corticonuclear pathways by placing the stimulating coil over the motor cortex (long latency responses). Electromyographic recordings were taken from both mentalis muscles using concentric needle electrodes. Seventeen patients were investigated at various times after onset of idiopathic facial palsy (Bell's palsy). In the acute stage (less than 5 days after onset) short and long latency responses on the paretic side were abnormal, being absent in all but one patient, in whom the short latency response was delayed. These abnormal responses were the earliest neurographic correlate for nerve conduction block. In 4 out of 9 patients seen up to 30 days after onset of palsy, trans synaptically evoked long latency responses were absent. In patients examined more than 2 months after onset, long latency responses could always be obtained and, in 5 of 8 patients, short latency responses could also be elicited, indicating a return of the direct excitability of the nerve. Five patients with cerebral hemisphere lesions causing mild unilateral facial weakness had absent long latency responses when stimulating over the affected hemisphere, but normal bilateral long latency responses following stimulation over the unaffected cerebral hemisphere; short latency responses were normal. Magnetic stimulation of the brain and of the facial nerve can differentiate between central and peripheral causes of unilateral facial weakness and may prove useful in the early assessment of the degree of conduction block in Bell's palsy. PMID- 2709051 TI - Degenerative neurological disorders associated with deficiency of glutamate dehydrogenase. AB - The activity of glutamate dehydrogenase, the enzyme of glutamate degradation, was measured in platelets of 27 healthy controls and 85 patients with different degenerative cerebellar and/or basal ganglia disorders. A group of 7 patients was selected with slowly progressive multiple-system atrophy, in whom a clinical diagnosis of olivopontocerebellar atrophy appeared tenable, with decreased activity of glutamate dehydrogenase (38% of the mean control value). In 4 patients data on inheritance were compatible with the genetic pattern of autosomal recessive inheritance, while 3 patients were sporadic cases. In an effort to define this group of patients more precisely, it is suggested that decreased activity of glutamate dehydrogenase induces an increase in extracellular glutamate levels in the central nervous system with subsequent development of excitotoxicity. PMID- 2709052 TI - MRI findings of inferior olives in palatal myoclonus. AB - Four patients with palatal myoclonus (PM) were studied with magnetic resonance imaging (MRI). Increased signal intensity and bilateral enlargement of the inferior olives were recognized in two patients with bilateral PM, pontine haemorrhage and neuro-Behcet disease, and a similar olivary change on the contralateral side was noted in a case of pontine infarction with unilateral PM. These findings were consistent with the pathology. The changes were more obvious in proton density-weighted images than in T2-weighted images, which thus differ from the changes in common gliosis. The other patient with the syndrome of PM and progressive ataxia did not show any olivary change. These changes on MRI are considered to indicate pseudo-hypertrophy of the inferior olives, although this is not consistently shown by the imaging method. PMID- 2709053 TI - Cavernous angioma of the optic tract. AB - A cavernous angioma of the right optic tract in a 35-year-old man is presented. The patient suffered from headaches and had a left homonymous visual field defect after subarachnoid haemorrhage and an intracerebral haematoma in the right temporomedial region, revealed by computed tomography (CT). Follow-up CT showed a small contrast-enhanced lesion in the right suprasellar and parasellar cistern. Angiography on three occasions did not reveal a vascular lesion. Magnetic resonance imaging was helpful both for diagnosis and planning surgical therapy. It showed typical signs of a cavernous angioma of the right optic tract; the diagnosis was confirmed by surgery and histological examination. This appears to be the first reported case of a cavernous angioma of the optic tract. PMID- 2709054 TI - Effect of cannabinoids on spasticity and ataxia in multiple sclerosis. AB - The chronic motor handicaps of a 30-year-old multiple sclerosis patient acutely improved while he smoked a marihuana cigarette. This effect was quantitatively assessed by means of clinical rating, electromyographic investigation of the leg flexor reflexes and electromagnetic recording of the hand action tremor. It is concluded that cannabinoids may have powerful beneficial effects on both spasticity and ataxia that warrant further evaluation. PMID- 2709055 TI - Acute respiratory failure in polymyositis. PMID- 2709056 TI - Migraine as a defect of brain oxidative metabolism: a hypothesis. PMID- 2709057 TI - The formation of prostaglandins in the postmortem cerebral cortex of Alzheimer type dementia patients. AB - The formation of arachidonic acid metabolites [prostaglandin (PG)D2, PGE2, PGF2 alpha, 6oxo-PGF1 alpha and thromboxane (TX)B2] has been examined in the frontal, temporal, and parieto-occipital regions of the cortex in the postmortem brains from five patients with a pathologically verified Alzheimer-type dementia (ATD) and in eight, age-matched controls. The study disclosed that the amount of PGD2 and TXB2 found in the ATD brains was greater than in controls, and that the formation of PGD2 was significantly increased in the frontal cortex of the ATD brains. Other PG metabolites, however, showed no significant changes in the ATD group. Since it is known that PGD2 is synthesized mainly in neurons, our results seem to suggest that the preserved cortical neurons in the ATD brain have an accelerated PGD2 production. PMID- 2709058 TI - Clinico-neurological investigations in the fra(X) form of mental retardation. AB - A clinical, neurological and electroencephalographic investigation was undertaken in 29 previously cytogenetically verified hemizygous males with the fra(X) form of mental retardation (age range 3.5 to 59 years); in addition, 6 heterozygous females were examined. All male patients displayed the known physical aspects of this syndrome together with associated abnormalities of the palate, skeleton, connective tissue and endocrine system. The most prominent neurological features were different forms of oculomotor disturbances, minor motor and pyramidal signs, incoordination, muscle hypotonia, gait and speech abnormalities. There was no increased frequency either in seizures or in epileptic EEG discharges. Some patients had a slowing of background activity in EEG. About 50% of all patients displayed autistic-like behaviour, short attention span and/or hyperactivity. In accordance with the literature, the findings indicate that there are no neurological, electroencephalographic or neuroradiological features which occur specifically in this syndrome. The need to differentiate the findings from those resulting from encephalopathic mechanisms during the gestational and perinatal period is stressed. A distinct typing of seizures and EEG changes is needed in each patient, before definite conclusions about an association of seizures and fra(X) syndrome are drawn. In view of the lack of correlation between IQ and the clinical-neurological measures, a more practical approach to quantifying the mental impairment is proposed. PMID- 2709059 TI - Cardiac arrhythmias in the differential diagnosis of epilepsy. AB - Symptomatic attacks or seizures associated with cardiac arrhythmias may cause difficulty in differential diagnosis. Two patients are reported in whom disturbances of cardiac conduction induced attacks which clinically resembled attacks of psychogenic and epileptic origin and were abolished after implantation of a demand-type pacemaker. A third patient is described who had epileptic seizures resulting in cardiac arrhythmias. In the differential diagnosis of these cases, simultaneous ambulatory EEG and ECG recording was essential. PMID- 2709060 TI - Coenzyme Q in serum and muscle of 5 patients with Kearns-Sayre syndrome and 12 patients with ophthalmoplegia plus. AB - Coenzyme Q10 (CoQ) was measured in serum and muscle of 17 patients with ophthalmoplegia plus (including 5 patients with Kearns-Sayre syndrome), in muscle of 9 patients with neurogenic atrophies, 5 patients with myositis, and 5 patients with progressive muscular dystrophies (including 1 patient with oculopharyngeal dystrophy), and in serum and muscle of normal controls. CoQ was markedly decreased in serum and muscle of 1 patient with Kearns-Sayre syndrome and treatment with CoQ resulted in a significant clinical improvement. The other 4 patients with Kearns-Sayre syndrome and the patients with ophthalmoplegia plus exhibited normal concentrations of CoQ in serum and muscle. CoQ levels in muscle of patients with progressive muscular dystrophies, myositis or neurogenic atrophies were within the normal range. Concentrations of CoQ in serum and muscle of normal controls were independent of age and showed no sex difference. The data indicate that CoQ deficiency might be the specific cause of mitochondrial encephalomyopathy in 1 patient but it was not the underlying defect common to all cases with Kearns-Sayre syndrome and ophthalmoplegia plus, although the possibility of a focal CoQ deficiency affecting only single muscle fibres cannot be excluded. PMID- 2709061 TI - Alteration in autonomic function and cardiovascular regulation in amyotrophic lateral sclerosis. AB - Autonomic function mediating cardiovascular regulation was evaluated in amyotrophic lateral sclerosis (ALS) in comparison with Shy-Drager syndrome. The subjects were 14 normal controls and 9 patients each with ALS and Shy-Drager syndrome. To evaluate the autonomic function in detail, a new series of quantitative autonomic function tests was conducted, in conjunction with conventional tests. In patients with ALS, the data indicated subclinical sympathetic hyperfunction and parasympathetic (vagal) hypofunction, probably resulting in cardiovascular dysfunction. PMID- 2709062 TI - The Hamburg Stroke Data Bank: goals, design and preliminary results. AB - A stroke data bank has been developed which consists of 1500 items, including clinical and laboratory findings, past medical history, treatment and outcome. In addition to previously published registries, the Hamburg Stroke Data Bank allows storage of time-dependent data: multiple findings can be entered at different times after stroke onset. The data bank runs on any MS-DOS microcomputer and can be operated without computer knowledge. The stroke registry is conceived to support a prospective, local, multicentre study of stroke. This paper describes objectives, data bank structure and preliminary results of the pilot phase, which includes data of 441 patients with completed stroke and reversible ischaemic deficits. Demographic characteristics, incidence of stroke types, associated risk factors and outcome are evaluated. PMID- 2709063 TI - Amantadine sulphate in treating Parkinson's disease: clinical effects, psychometric tests and serum concentrations. AB - Intravenous administration of amantadine has been shown to be a quick-acting and highly effective method of treating patients with Parkinson's disease. The duration of this therapeutic effect during long-term oral treatment has, however, remained controversial. Therefore, the effect of intravenous treatment was compared with long-term oral treatment over a period of 6 months. Clinical scores and psychometrically determined dexterity improved significantly during 10-day infusion therapy (200 mg amantadine sulphate/day). This improvement was successfully maintained by oral treatment (600 mg/day). A decrease in effectiveness was not observed. Reaction times were within the normal range for the age group involved and did not change significantly during the course of the study. Amantadine serum concentration during the infusion period ranged between 500 and 1000 micrograms/l and produced values nearly half as high as those obtained during oral treatment (600 mg/day). There was a constant relationship (quotient: 1.3) between serum and cerebrospinal fluid concentration. Considerable inter-individual variations were noted. A significant inter-individual correlation between serum concentration and clinical and psychological improvement was not discernible. PMID- 2709064 TI - Analysis of oligoclonal antibody bands against individual HIV structural proteins in the CSF of patients infected with HIV. AB - Intrathecal antibody responses to HIV were investigated by a highly sensitive immunoblot assay. Serum and CSF specimens were tested for reactivity with the recombinant HIV gag proteins p15, p17 and p24 and with the recombinant transmembrane protein p41. Autochthonous production of virus-specific IgG to one or more HIV structural proteins was seen in 8 of 10 asymptomatic seropositive subjects, in 3 of 4 men with AIDS-related complex, and in 9 of 13 patients with AIDS. These results were consonant with an elevated CSF/serum antibody ratio to total HIV antigen. The high frequency of local HIV-specific antibody synthesis in seropositive individuals without related clinical symptoms indicates an early involvement of the CNS in HIV infections. PMID- 2709065 TI - Congenital myopathy with myasthenic features and congenital cataract in two siblings. AB - Two siblings with congenital myopathy showing myasthenic manifestations together with congenital cataract are reported. Their muscle weakness fluctuated and was alleviated by edrophonium chloride. Their serum creatine kinase activity was elevated, and the waning phenomenon was observed on repetitive nerve stimulation. Biopsied muscle showed degenerative changes with type 1 fibre predominance and abnormal morphology of neuromuscular junctions. PMID- 2709066 TI - Good recovery after sublethal ethylene glycol intoxication: serial EEG and CT findings. AB - The case of a young man with sublethal ethylene glycol poisoning is reported. Complete recovery occurred after 12 days of deep coma and a prolonged flaccid tetraplegia. The lesions of gross degree in the CNS, demonstrated by serial CT, resolved and electrophysiological testing as well as neuromuscular signs improved. The recovery, clinically and radiographically, over 35 days was dramatic. Ethylene glycol intoxication should always be considered in the differential diagnosis of acute severe encephalopathy because complete recovery is possible with correct therapy. PMID- 2709067 TI - Preparatory processes in a case of hemi-parkinsonism. AB - Reaction times and movement times were recorded in a subject with parkinsonian symptoms confined largely to the left side of the body. Advance information concerning the movement was varied, being with complete, partial or no preparation. The results suggest that processing of preparation for the movement is not qualitatively different for the more affected side, but is substantially slowed. PMID- 2709068 TI - Radiological studies of the cheiro-oral syndrome. AB - Four cases of the cheiro-oral syndrome are reported, with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible lesion. In each case, angiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed. The lesion was found in the thalamus in three cases and in the pons in one. Infarction had occurred in three cases and haemorrhage in one. Angiography revealed normal findings in all cases. CT at the onset of the symptoms demonstrated a small haemorrhage in the thalamus in one case but was not helpful in the others, and MRI was required to identify infarction. The anatomical sites responsible for the cheiro-oral syndrome have been reported to be in the central gyrus, in the thalamus, and in the brain stem. The clinical symptoms and signs reported in the literature and in our four cases are reviewed to evaluate aetiological factors and clinical features according to the three different sites of lesions causing this syndrome. PMID- 2709069 TI - Cerebral infarction in patients with transient ischemic attacks. AB - Cranial computed tomography of 284 patients with transient ischemic attacks (TIAs) and without previous stroke was evaluated. The sample population included patients with carotid and/or vertebrobasilar TIAs. Computed tomography revealed cerebral infarction in 34 patients, including 5 with multiple infarctions. The lesion location was consistent with TIA symptoms in 16 patients. In another 16 patients, however, the lesion location did not correspond to the TIA symptoms; these lesions were attributed to previous silent infarctions. Two patients with multiple infarctions had both symptomatic and asymptomatic lesions. Age and carotid stenosis were each significantly related to an increased chance of detecting cerebral infarction (either symptomatic or asymptomatic). No significant relationship between race, gender, hypertension, diabetes, cardiac disease, or smoking and the incidence of infarction was found by either univariate or multivariate analyses. PMID- 2709070 TI - Anti-HTLV-I antibodies in the serum and CSF from amyotrophic lateral sclerosis patients: negative findings. PMID- 2709071 TI - Coma during azidothymidine therapy for AIDS. PMID- 2709072 TI - Bilateral facial paresis with Sjogren's syndrome. PMID- 2709073 TI - Pure sensory stroke and cheiro-oral syndrome. PMID- 2709074 TI - Clinically definite multiple sclerosis in a Zairian woman of mixed race. PMID- 2709075 TI - Ozone trends in Atlanta, Georgia: have emission controls been effective? AB - Nine years of summertime ozone data from the Atlanta metropolitan area are analyzed and compared to local emissions of volatile organic carbon and nitrogen oxides. Trends from 1979 to 1987 were studied for the number of days per year ozone exceeded the NAAQS standard, the second-highest ozone level observed per year, and the first quartile summertime average ozone observed, as well as the mean difference between the ozone level observed downwind and upwind of the city. Because this last parameter is sensitive to chemical factors but relatively insensitive to the number of days each year with meteorological conditions conducive to ozone formation, its trend may be best suited for determining how effective emission controls have been in reducing O3 in the Atlanta area. In spite of the fact that sizeable reductions have been claimed for volatile organic carbon emissions over the past several years, the data give no indication that ozone levels have decreased and in fact imply that summertime ozone production may have increased. The results imply that either emissions have not decreased as much as has been claimed or that ozone is not sensitive to anthropogenic volatile organic carbon emissions. In either event, a reevaluation of our nation's strategy for O3 abatement in Atlanta and comparable cities is needed. PMID- 2709076 TI - Monitoring of parts-per-billion levels of formaldehyde using a diffusive sampler. AB - A diffusive sampler for formaldehyde originally designed for use in personal monitoring of worker exposure has been evaluated for static measurement of low formaldehyde levels in indoor air. The sampler consists of a 37-mm glass fiber filter impregnated with 2,4-dinitrophenylhydrazine and phosphoric acid and mounted in a polystyrene filter cassette. Formaldehyde is sampled by controlled diffusion and subsequent hydrazone formation on the filter. The hydrazone is eluted from the filter with acetonitrile and analyzed by liquid chromatography and a UV detector. The diffusive sampler was evaluated for static (area) sampling in several industries, offices, and homes with formaldehyde levels of 6-200 ppb. Results from diffusive samplers were compared with results from pumped samplers. Even at low wind velocities (less than 0.01 m.s-1) there was good agreement between pumped and diffusive samples. The sensitivity will be 1 ppb in a 24-h sample, making the sampler especially useful for indoor air monitoring of low formaldehyde levels. PMID- 2709077 TI - Speciation of arsenic in ambient aerosols collected in Los Angeles. AB - First-time measurements of the potentially toxic inorganic species of arsenic (arsenite and arsenate) have been obtained in fine (less than 2.5 microns AD) and coarse (greater than 2.5 microns AD) atmospheric particles in the Los Angeles area. A recently developed method that includes procedures for sample collection, preparation, and analysis was used in this study. Size-fractionated aerosol samples were collected with a high-volume dichotomous virtual impactor that employed polytetrafluoroethylene filters. Results were obtained for the recovery of arsenic standards added to unexposed and collected filters. Data from this study, indicated that the recently developed speciation method can be used to determine concentrations of As(III) and As(V) in atmospheric particulate matter samples. Size-fractionated aerosol samples were collected in the city of Industry during January and February 1987. In most samples, As(III) and As(V) were above the detection limit (approximately 1 ng m-3 of either species) in both aerosol size fractions. A greater portion (about 75 percent) of the two species were observed in the fine particles. The As(III)/As(V) ratio for both particle sizes was close to 1 (i.e., an equal mixture of both species). Comparison of total suspended particulate arsenic measured by the speciation method to that measured by a routine California Air Resources Board-approved procedure showed good agreement (r = 0.94), indicating both methods were approximately equivalent for the collection and analysis of aerosol arsenic. PMID- 2709079 TI - Problems with the Popperian approach: a response to Pearce and Crawford-Brown. PMID- 2709078 TI - Critical discussion in epidemiology: problems with the Popperian approach. AB - There has been a renewed interest in the philosophical and scientific basis of epidemiology in recent years. In particular, it has been argued that Popper's philosophy should be adopted by epidemiologists, an assertion that has met with some scepticism. However, most criticisms of Popper's approach have been from an inductivist viewpoint, concerned with the generation of theories, whereas Popper's concern is with the testing of theories, and the two schools have been largely "talking past each other". We present a critique of Popper from within his own domain of interest. Examples are presented to show that Popper's philosophy is incomplete even for the physical sciences on which it is based, and that it is particularly inappropriate for epidemiology. Popper's approach makes sense only under the narrow way he has chosen to define science, and thus provides only a possible answer to a small set of fundamental problems of science and its use in society. The recent Popperian "trend" has a positive aspect in that it has fostered deductive thinking, and exposed the shortcomings of induction. However, the restrictive Popperian framework actually inhibits discussion despite its veneer of "critical discussion". A more pluralistic approach is needed at this stage of the development of epidemiology. PMID- 2709081 TI - Validation of the survey of work styles: a profile measure of the type A behaviour pattern. AB - The present study compares the Type A classification accuracy of the Jenkins Activity Survey (JAS), The Framingham Type A Scale, and a new Type A behaviour pattern (TABP) measure. The Survey of Work Styles (SWS), a self-report measure of the TABP, was developed using a construct approach to scale construction. It consists of six content scales. Impatience, Anger, Work Involvement, Time Urgency, Job Dissatisfaction and Competitiveness. In addition to the six content scales, a seventh scale, Scale A, is comprised of items empirically selected to relate to the Rosenman Structured Interview. In the present study the SWS was found to be significantly related to both the JAS, and the Framingham Type A Scale in a sample of 163 business managers. Median reliability of the SWS subscales was 0.82, and for the total scale 0.90. Discriminant function analysis using cross validational jackknifing procedures resulted in a classification accuracy of 83% of the Type A managers in relation to the Structured Interview. Classification using the SWS was found to correlate significantly higher with the Structured Interview than did either classification with the JAS or with the Framingham Type A Scale. Modal profile analysis yielded three independent bipolar typal dimensions, indicating that a single dimension or classification of the TABP represents an oversimplification of a complex behaviour pattern. These results support the reconceptualization of the TABP in terms of distinct facets and profile patterns. PMID- 2709080 TI - Effects on blood pressure of a decrease in sodium use in institutional food preparation: the Exeter-Andover Project. AB - To judge the effect on blood pressure, sodium intake of students at two boarding high schools was reduced by 15-20% through changes in food purchasing and in preparation practices in the schools' kitchens. Students were not asked to change their usual eating habits. Each school served alternately as the control or intervention school for one school year. Blood pressure was monitored among 341 subjects during control years and 309 subjects during intervention years. Analysis of blood pressure differences between early in the school year and near the end of the school year, with adjustment for sex and initial blood pressure, showed the effect of the dietary intervention to be -1.7 mmHg for systolic (95% CI = -0.6, -2.9, p = 0.003) and -1.5 mmHg for diastolic pressure (95% CI = -0.6, 2.5, p = 0.002). Such modest and easily attainable changes in sodium intake, if maintained, could have a significant effect on the future risk of essential hypertension among young people. PMID- 2709082 TI - Trends in mortality from coronary heart disease and stroke among U.S. veterans; 1954-1979. AB - A cohort of nearly 300,000 insured veterans (Dorn Cohort), experienced a much greater percent decline in CHD death rate over the period, 1954-1979, than the population of the U.S., while for stroke, the percent decline in death rate was virtually the same as the U.S. For CHD, greater percent declines were noted over the study period for non-smokers compared to cigarette smokers, for professionals compared to non-professionals and for persons with high socioeconomic scores (SES) compared to those with low scores. In each group, younger persons experienced greater percent declines than older persons. For stroke, non-smokers experienced a somewhat greater percent decline in rate than smokers but this did not hold true for all age groups. Unlike CHD, professionals experienced a smaller percent decline in their stroke death rate than non-professionals, as did persons with high SES compared to those with low SES. The contradictory patterns observed for the two diseases with respect to occupation and SES suggest that the risk factors for stroke and coronary heart disease are not exactly the same. Throughout, the findings were much more convincing for CHD than for stroke. PMID- 2709083 TI - Serum uric acid and 11.5-year mortality of middle-aged women: findings of the Chicago Heart Association Detection Project in Industry. AB - The relationships of serum uric acid to mortality from all causes, the cardiovascular diseases, and cancer were evaluated in 6797 white women age 35-64 years followed for an average of 11.5 years in the Chicago Heart Association Detection Project in Industry (CHA). Serum uric acid levels at baseline were strongly and significantly associated with all causes mortality in this cohort, with control for multiple risk factors and with exclusion of hypertensives on treatment. When the analysis was performed on age-specific groups 35-44, 45-54, and 55-64 years of age, the association was observed primarily in women in the oldest age group. All cardiovascular deaths, deaths due to coronary heart disease, and all cancer deaths were also associated with serum uric acid levels in the 55-64 year old group. The relationships persisted with control for multiple risk factors and with exclusion of treated hypertensives. A site specific analysis of cancer deaths demonstrated elevations in mean serum uric acid levels for nearly all sites. Differences in mean serum uric acid levels between decedents and survivors tended to be largest in the first 5 years of follow-up for the cardiovascular deaths, but for cancer decedents they tended to be larger for subsequent years of follow-up. As an initial report on the association of serum uric acid and cancer in women in this age group, the results of this study require confirmation. Although hormonal influences may play a role, pathophysiologic mechanisms relating serum uric acid to mortality in white women aged 55-64 are currently unknown. PMID- 2709084 TI - Plotting and discussion of rate ratios and relative risk estimates. PMID- 2709085 TI - Doxorubicin as adjuvant therapy for breast cancer: answers or more questions? PMID- 2709086 TI - Now we tell--but how well? PMID- 2709087 TI - Telling the diagnosis of cancer. AB - Although a concensus has emerged in this country that patients should be told when cancer is discovered, no data is available to indicate how and where patients are currently told that they have cancer. Fifty-five patients undergoing anticancer therapy were therefore interviewed to learn how this process occurs. The majority of patients were told by surgeons (74%) and only a minority by primary care physicians (11%). Most were told in a traditional medical setting (42% in the doctor's office, 17% in a hospital room), but 23% were told over the telephone and 19% in the recovery room. Two indicators of patient satisfaction with the telling process suggested that different sites of telling were not equivalent. Patients told over the telephone or in the recovery room were more likely to describe the telling in negative terms and less likely to describe their doctors as being helpful in understanding their illness than those told in a doctor's office or in their hospital bed. This pilot study indicates considerable variation in this aspect of patient care and suggests directions for future research. To determine whether interviews that explore these issues with cancer patients are unpleasant or stressful, patients' reactions to being subjects in this study were sought. Patients asked directly at the completion of the interview or surveyed 2 to 4 months later said the interview had been helpful and/or a positive experience. None expressed negative feelings about participating. Concerns about the psychological harm resulting from such study of this patient group do not appear to be warranted and should not impede future research. PMID- 2709088 TI - Treatment of metastatic prostatic cancer with low-dose prednisone: evaluation of pain and quality of life as pragmatic indices of response. AB - Thirty-seven men with symptomatic bone metastases from prostate cancer that had progressed following earlier treatment with estrogens and/or orchidectomy were treated with low-dose prednisone (7.5 to 10 mg daily). The rationale for this treatment was that some patients might still have hormone-sensitive disease that was stimulated by weak androgens of adrenal origin, and that these androgens could be suppressed by prednisone through its negative feedback on secretion of adrenocorticotrophic hormone (ACTH). Response to treatment was assessed by requirement for analgesics, by the McGill-Melzack pain questionnaire, and by a series of 17 linear analog self-assessment (LASA) scales relating to pain and to various aspects of quality of life. Fourteen patients (38%) had improvement in indices used to assess pain at 1 month after starting prednisone, and seven patients (19%) maintained this improvement for 3 to 30 months (median, 4 months). Reduction in pain was associated with improvement in other dimensions of quality of life, and in the scale for overall well-being. Prednisone treatment led to a decrease in the concentration of serum testosterone in seven of nine patients where it was not initially suppressed below 2 nmol/L, and caused a decrease in serum levels of androstenedione and dehydroepiandrosterone sulfate in more than 50% of patients. Symptomatic response was associated with a decrease in serum concentration of adrenal androgens. We conclude that (1) low-dose prednisone may cause useful relief of pain in some patients with advanced prostatic cancer; (2) relief of pain was associated with suppression of adrenal androgens; and (3) measures of pain and quality of life can be used to assess possible benefits of systemic therapy in patients with metastatic prostate cancer. PMID- 2709089 TI - The prognostic significance of residual pigmentation following radiotherapy of epidemic Kaposi's sarcoma. AB - The response to radiotherapy of epidemic Kaposi's sarcoma (EKS) is unusual in that irradiated regions are frequently left with a persistent purple stain, reminiscent of the color of the original tumor, but with no tumor mass. To date there are no published data to indicate whether the persistence of pigmentation can be predicted beforehand or if it has any prognostic import. We reviewed the response to treatment of 118 EKS lesions that were irradiated at New York University (NYU) Medical Center between 1981 and 1986. A total of 86 responded to treatment by complete clearance of the mass. Of these, 29 left residual purple pigmentation within the treatment portal, while 57 did not. Complete response (CR; without residual pigmentation) occurred more often in patients who had higher Karnofsky scores at the time of treatment. However, in terms of ultimate local control or survival, there were no differences between patients whose lesions cleared completely v those in whom pigmentation remained. We conclude that persistent pigmentation represents only a benign remnant of irradiated EKS and has no prognostic import. PMID- 2709090 TI - Patient-specific dose rate for continuous infusion high-dose cytarabine in relapsed acute myelogenous leukemia. AB - We hypothesized that the steady-state concentration of intracellular cytarabine 5'-triphosphate (ara-CTPss) in leukemia cells is proportional to the dose rate of cytarabine (ara-C) during continuous infusion. To evaluate this possibility, patients with acute myelogenous leukemia in relapse were treated with two sequential schedules of serially increasing ara-C dose rates over a total of 36 hours. Schedule I consisted of serial infusions of 250, 500, and 750 mg/m2 each over 12 hours. Subsequently, patients entered on schedule II received 500, 1,000, and 1,500 mg/m2 serially, each over 12 hours. Steady-state levels of ara-CTP were achieved within four hours after beginning ara-C infusion and, in separate studies of a single ara-C dose rate, were shown to be maintained beyond 36 hours. Four patients treated with schedule I and two patients treated with schedule II showed a linear dose rate-dependent increase-of ara-CTPss at all three dose rates. The cells of one patient on schedule I and two patients on schedule II had a dose rate-dependent ara-CTPss increase only over the first two dose levels, while no increase or lower ara-CTPss was observed at the third dose rate. The ara CTPss of one patient on schedule II did not change. These results suggest that there is a proportionality between the continuous infusion dose rate of ara-C and the ara-CTPss in circulating leukemia cells within the dose range of 250 to 1,000 mg/m2 over 12 hours. This opens the possibility that pharmacologic determinations may be used to redirect the ara-C dose rate to achieve a desired ara-CTPss level in leukemia blasts during therapy. PMID- 2709091 TI - A phase I study of intraarterial iododeoxyuridine in patients with colorectal liver metastases. AB - Regional delivery of iododeoxyuridine (IdUrd) to patients with colorectal liver metastases was examined in a phase I study. The maximum-tolerated intraarterial (IA) dose (MTD) was 1,333 mg/m2/d administered continuously for 14 days. The dose limiting toxicity was thrombocytopenia. Thrombocytopenia and leukopenia were correlated with the amount of IdUrd incorporated into DNA of peripheral granulocytes. In contrast to our experience with 5-fluorodeoxyuridine, there was no evidence of hepatobiliary toxicity. In 11 patients who received IA IdUrd alone, seven had a greater than or equal to 50% decrease in carcinoembryonic antigen (CEA) levels, with five having tumor volume reductions of 65%, 48%, 46%, 44%, and 27%. Thus, IA IdUrd alone has antitumor efficacy. Patients subsequently received IdUrd in combination with external beam radiation to a total dose of 2,400 cGy without acute local toxicity. In addition to these favorable clinical findings, we have previously shown that IdUrd is selectively incorporated into tumor DNA compared with normal liver in these patients. Further phase II evaluations of this approach are warranted. PMID- 2709092 TI - Intraperitoneal chemotherapy for ovarian carcinoma. PMID- 2709093 TI - Whole-cell patch-clamp analysis of voltage-dependent calcium conductances in cultured embryonic rat hippocampal neurons. AB - 1. Voltage-dependent calcium currents in embryonic (E18) hippocampal neurons cultured for 1-14 days were investigated using the whole-cell patch-clamp technique. 2. Calcium currents were isolated by removing K+ from both the internal and external solutions. In most recordings the external solution contained tetrodotoxin, tetraethylammonium ions, and low concentrations of Na+, whereas the internal solution contained the large cations and anions, N-methyl-D glucamine and methanesulphonate, and an adenosine 5'-triphosphate (ATP) regenerating system (Forscher and Oxford, 1985) to retard "run-down" of Ca currents. 3. Under these conditions, the sustained inward current triggered during depolarizing steps was enhanced when extracellular [Ca2+] ([Ca2+]0) was raised from 2 to 10 mM and abolished when [Ca2+]0 was lowered to 0.1 mM or by addition of Co2+ ions. These results indicate that the inward current was carried primarily by Ca2+ ions and was designated ICa. This current may be comparable to the "high-voltage-activated" Ca current described in other preparations. 4. In cells cultured for 1-3 days, ICa was small or absent (less than 20 pA for cells 1 day in culture and less than 80 pA for cells 3 days in culture). Although ICa decayed considerably during depolarizing steps, there was little evidence of the transient calcium current (T current) that was recorded in approximately 40% of cells cultured longer than 6 days. Maximal (i.e., the largest) ICa increased from 20 to 80 pA in 1- to 3-day cells to 150-450 pA in cells cultured for longer than 6 days. 5. The decay of ICa elicited by depolarizations from holding potentials of -60 mV or more negative was usually greatest for the maximal ICa. Replacement of extracellular Ca2+ (4 mM) with Ba2+ (2 mM) resulted in a substantial decrease in the extent of decay of ICa and a shift of the I-V relation in the hyperpolarizing direction. 6. Qualitative data obtained from experiments in which different levels of internal Ca2+ buffering were employed demonstrated that, on average, the decay of ICa was reduced as the capacity and/or rate of buffering was increased. The mean decay of ICa in cells buffered with 5 mM 1,2-bis(o aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (BAPTA) was 9 +/- 7 (SD) %, (n = 12) and 25 +/- 12%, (n = 12) for cells buffered with the same concentration of ethyleneglycol bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709094 TI - Cytometric analysis of the thalamic ventralis intermedius nucleus in humans. AB - 1. The cytoarchitecture and the exact borders of the thalamic ventralis intermedius (Vim) nucleus of humans as originally delineated by Hassler (17) have been studied on the basis of stereotaxic coordinates correlated with Nissl- and Golgi-impregnated sections, using a microscopic image analyzer. 2. The Vim nucleus forms part of a relatively "cell-sparse zone" which includes the other ventrolateral thalamic subnuclei. It is distinguished by the presence of darkly stained, large and medium sized, angular cells with areas of approximately 500 1,000 microns 2 and 300-400 microns 2, respectively, and a cell density of approximately 50-90 (mean 65)/mm2 in 50-microns-thick sections. 3. Both sets of neurons have the characteristics of thalamocortical relay neurons in Golgi preparations. Large neurons have rectangular or square somata 30-50 microns diam and are concentrated mainly in the lateral and ventral two-thirds of the nucleus. The medium neurons have square to round somata, 15-25 microns diam, and are distributed homogeneously through the nucleus. The total dendritic arborization of both types is usually symmetrical in all directions and at least 500-600 microns diam. 4. The borders between the Vim nucleus and the Nucleus ventrooralis (Vo) and between the Vim nucleus and the Nucleus ventrocaudalis internus (Vci) are clearly identified by clearcut differences in cell size and cell density. The borders between the Vim nucleus and the Nucleus ventrooralis internus (Voi) and between the Vim nucleus and the Nucleus zentrolateralis intermedius (Zim) are quite obscure, and these nuclei, with Vim, seem to be parts of the large cell sparse zone comparable to that described in monkeys as VLp or VL. The border between the Vim nucleus and the Nucleus ventrocaudalis externus anterior (Vcea) is also unclear but the increased cell density and intermingling of small and medium-to-small neurons with large neurons are the major features that distinguish the Vcea nucleus from the Vim nucleus cytometrically. 5. The position and anatomic organization of the human Vim nucleus make it likely that it is the region in which kinesthetic response were recorded in the accompanying paper but extension of the recording sites into the Vcea nucleus cannot be ruled out. PMID- 2709095 TI - Further physiological observations on the ventralis intermedius neurons in the human thalamus. AB - 1. During the course of stereotaxic thalamotomy for 56 cases with tremor mainly due to Parkinson's disease and essential tremor, extracellular recordings were made from the thalamic ventralis intermedius (Vim) nucleus under local anesthesia. These procedures have been justified as an essential technique to achieve the best therapeutic results by a selective coagulation. These physiological observations provide important information about the functional organization of the ventrolateral thalamic mass in humans. 2. Using Leksell's stereotaxic apparatus, a pair of semimicroelectrodes was introduced simultaneously to the thalamic ventral lateral region from the prefrontal area. The Vim nucleus was identified tentatively by characteristic high background activity which contrasted to that found in its rostral part and by superimposed large amplitude spontaneously active units. 3. In this high activity zone, 135 units (approximately 1/5 of the recorded units) responded to natural stimulation applied to contralateral body parts. Among them, approximately 90% responded to a passive or active movement of a joint. Several lines of evidence suggested that probably muscle receptors were responsible. 4. The rest of units (approximately 10%) responded to light touch applied to contralateral skin surface. Convergent responses between kinesthetic and tactile units were never encountered. Also, kinesthetic and tactile neurons were geographically separated. The latter were found always at the end of our oblique trajectory, following the kinesthetic neurons. 5. Neurons with sensory responses were clustered mostly within the confines of the Vim nucleus, probably extending caudally to the ventrocaudalis externus anterior of Hassler. Evidence for a somatotopic representation in the Vim nucleus was obtained. 6. Electrical stimulation of the appropriate peripheral nerve produced responses of the same thalamic unit(s) that responded to natural stimulation. The latency to upper limb nerve stimulation was between approximately 10 and 20 ms. It was almost fixed in a given case. 7. It is concluded that the Vim nucleus receives kinesthetic afferent input from the contralateral body parts (mainly from the muscle receptor) and may be concerned with muscle sense. This may explain why a small, selective coagulation of the physiologically identified Vim has such a constant effect on several different kinds of tremor. PMID- 2709096 TI - Activity-dependent disinhibition. I. Repetitive stimulation reduces IPSP driving force and conductance in the hippocampus in vitro. AB - 1. Intracellular recording techniques were used to investigate the mechanisms underlying the activity-dependent lability of inhibitory synaptic potentials indirectly evoked in CA3 pyramidal neurons by stimulation of the mossy fiber afferent pathway in organotypic slice cultures of hippocampus. 2. Repetitive stimulation (3-10 Hz, 30-60 s) was found to reduce the amplitude of the inhibitory postsynaptic potential (IPSP) and occasionally lead to repetitive, epileptiform discharge. 3. Under single-electrode voltage-clamp, the current underlying the inhibitory postsynaptic potential (IPSC) was found to have the same reversal potential (EIPSC) as the response to iontophoretically applied gamma-aminobutyric acid (EGABA), and both were blocked by bicuculline. Reducing the extracellular Cl- concentration from 153 to 89 mM shifted EGABA in the depolarizing direction by 9 mV from -64.7 to -55.6 mV, an amount close to that predicted by the Nernst equation. We therefore presume that the IPSC is mediated by GABA and that the reversal potentials of both are equal to ECl-. 4. Under single-electrode voltage-clamp, repetitive stimulation (3-10 Hz, 30-60 s) was found to cause a mean decrease in the conductance underlying the IPSC (gIPSC) of 22%. This decrease was independent of the membrane potential at which stimuli were delivered. 5. Under single-electrode voltage-clamp, repetitive stimulation (3-10 Hz, 30-60 s) was found to cause a 2-8 mV depolarizing shift in EIPSC when the membrane potential was held constant 5-15 mV depolarized from EIPSC. The mean decrease in IPSC driving force was 49%. If membrane potential was held 10-20 mV hyperpolarized from EIPSC, there was no change in driving force. 6. Currents activated by iontophoretically applied GABA were decreased in amplitude following repetitive stimulation at depolarized, but not hyperpolarized, holding potentials. 7. The decrease in IPSC driving force following repetitive stimulation at depolarized holding potentials was less after decreasing the extracellular K+ concentration from 5.8 to 1 mM. 8. We conclude that the decrease in driving force following repetitive stimulation results from an increase in the intracellular Cl- concentration, and that the activity-dependent decrease in gIPSC results from a decrease in presynaptic release rather than from postsynaptic receptor desensitization. PMID- 2709097 TI - Activity-dependent disinhibition. II. Effects of extracellular potassium, furosemide, and membrane potential on ECl- in hippocampal CA3 neurons. AB - 1. Single-electrode voltage-clamp recordings were made from CA3 pyramidal cells in organotypic hippocampal slice cultures for measurement of membrane currents underlying both the gamma-aminobutyric acid (GABA)-mediated, Cl- -dependent inhibitory postsynaptic potential (IPSC), evoked in response to stimulation of the mossy fiber pathway, and responses to iontophoretically applied GABA. Their reversal potentials are presumed to equal the equilibrium potential for Cl- (37). Mechanisms underlying activity-dependent increases in the intracellular concentration of Cl- ([Cl-]i) were investigated by describing active and passive pathways for Cl- influx and efflux. 2. During 99-s applications of GABA, driving force declined by 51% due to increases in [Cl-]i; thus passive Cl- influx through GABA-activated pathways can significantly affect [Cl-]i. 3. Decreasing the extracellular K+ concentration ([K+]o) from 5.8 to 1 mM caused a rapid hyperpolarizing shift in the mean IPSC reversal potential (EIPSC) from -67.6 to 81.9 mV, even when membrane potential (Vm) was maintained constant and depolarized with respect to EIPSC. 4. Decreasing [K+]o from 5.8 to 1 mM caused a rapid hyperpolarizing shift in the mean GABA reversal potential (EGABA) from 64.7 to -81.1 mV, even when Vm was maintained constant and depolarized with respect to EGABA. Reducing the extracellular Cl- concentration from 153 to 89 mM, while maintaining [K+]o constant at 1 mM, shifted the mean EGABA from -81.1 to 66.2 mV, an amount close to that predicted by the Nernst equation for Cl-. We conclude that reducing [K+]o caused a hyperpolarizing shift in EGABA and EIPSC by decreasing [Cl-]i. 5. The shift of EIPSC and EGABA upon alteration of [K+]o did not result from contamination of the responses by additional K+-mediated components because it was unaffected by block of K+ channels with intracellular Cs+. 6. Reducing the extracellular Na+ concentration from 141 to 70 mM had no effect on EGABA. 7. Furosemide, bath-applied at 5 X 10(-4) M while holding Vm depolarized with respect to EIPSC, caused a rapid, reversible decrease in IPSC driving force averaging 69%, consistent with the presence of a furosemide sensitive outward Cl- -transport system. 8. Reducing [K+]o from 5.8 to 1 mM in the presence of 5 X 10(-4) M furosemide produced a smaller shift of EIPSC from 61.0 to -71.2 mV, however, after washout of furosemide from [K+]o = 1 mM saline, EIPSC shifted further to -89.8 mV.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709098 TI - Monkey primary motor and premotor cortex: single-cell activity related to prior information about direction and extent of an intended movement. AB - 1. This study was devoted to the neuronal processes underlying the construction of the motor program. Two monkeys were trained in a choice reaction time task to perform precise wrist flexion and extension movements of small and large extent. During a trial, the first visual signal, the preparatory signal (PS), informed the animal completely, partially, or not at all about direction and/or extent of the forthcoming movement. After a constant waiting period, a second visual signal, the response signal (RS), was illuminated calling for execution of the requested movement. 2. Reaction time (RT) and movement time (MT) measurements during the training as well as the recording sessions revealed that providing prior information about movement parameters strongly affected RT, but only slightly affected MT. Reaction time decreased in relation to the amount (number of movement parameters precued) and the type of prior information. Providing information about movement direction shortened RT much more than providing information about movement extent. Behavioral data support a parametric conception of motor programming, i.e., that the programming of the different movement parameters results from assembling separate processes of different duration. These results are compatible with the model in which programming processes are serially and hierachically ordered, movement direction being processed before movement extent. 3. Single-cell recording techniques were used to study neuronal activity of the primary motor (MI) and the premotor (PM) cortex, contralateral to the active arm. The activity of 155 neurons of MI and 158 neurons of PM was recorded during performance of the task. Of these 313 neurons, only 14 neurons did not change their activity during execution of the task. Two hundred and seven neurons whose activity changes were related to movement direction and/or movement extent have been selected for the further study. They were classified into three main groups: 1) execution-related neurons (49 in MI, 27 in PM), 2) preparation- and execution-related neurons (48 in MI, 54 in PM), and 3) preparation-related neurons (8 in MI, 21 in PM). 4. Directionally selective, execution-related neurons were found to be more frequently located within MI (81/105, 77.1%) than within PM (55/102, 53.9%), whereas directionally selective, preparation-related neurons appeared to be more frequently located within PM (47/102, 46.1%) than within MI (24/105, 22.9%).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709099 TI - Muscle afferent contribution to control of paw shakes in normal cats. AB - 1. The discharge of various hindlimb muscle afferents was recorded during paw shakes in normal cats with the use of floating dorsal root electrodes. 2. Muscle spindle group Ia-afferents and tendon organ group Ib-afferents fired during muscle lengthening, reaching very high peak discharge rates and then silencing at or shortly after the onset of shortening. The timing of Ia firing was consistent with the predictions of a linear model as well as the responses of Ia endings subjected to identical length variations in separate anesthetized cats. 3. In the latter "reconstruction" experiments, waxing and waning dynamic fusimotor action straddling whole paw-shake sequences gave the most consistent matches with the data from the normal cats. The reproducibility of the inferred fusimotor action justifies the inclusion of paw shakes as a class of movement in which fusimotor set is high. 4. The peak ensemble Ia activity from single hindlimb muscles was estimated to be approximately 20 kiloimpulses/s (Kips). Ankle extensor and hamstrings length variations were nearly in phase in the first cycles of a paw shake sequence. From published data on spindle populations in these muscles, this indicated that peak Ia input to the spinal cord exceeded 0.2 megaimpulses/s (Mips). 5. The phase relationship between origin-to-insertion muscle length and Ia firing during paw shakes was little affected by doubling or tripling the moment of inertia of the foot. We argue that this refutes the notion that in paw shakes phase reversals occur between muscle fibers and tendons in the muscles studied. 6. Inertial loading of the foot led to small but significant reductions in mean paw-shake frequency. This is consistent with an afferent contribution to the generation of these movements. 7. We conclude that in paw shakes in normal cats, the CNS "chooses" to sensitize Ia-afferents to muscle length variations by increasing dynamic fusimotor action. The resulting ensemble Ia input is very large and is likely to play a significant role in reflexly shaping the alpha motoneuronal activity responsible for the paw shakes. PMID- 2709100 TI - Memory traces in primate spinal cord produced by operant conditioning of H reflex. AB - 1. Study of memory traces in higher animals requires experimental models possessing well-localized and technically accessible memory traces--plasticity responsible for behavioral change, not dependent on control from elsewhere, and open to detailed investigation. Our purpose has been to develop such a model based on the wholly spinal, largely monosynaptic path of the spinal stretch reflex. Previous studies described operant conditioning of this reflex and of its electrical analog, the H-reflex. In this study, we sought to determine whether conditioning causes changes in the spinal cord that affect the reflex and are not dependent on continued supraspinal influence, and thus qualify as memory traces. 2. Sixteen monkeys underwent chronic conditioning of the triceps surae H-reflex. Eight were rewarded for increasing H-reflex amplitude (HR increases mode), and eight were rewarded for decreasing it (HR decreases mode). In each animal, the other leg was an internal control. Over several months of conditioning, H-reflex amplitude in the conditioned leg rose in HR increases animals and fell in HR decreases animals. H-reflex amplitude in the control leg changed little. 3. After HR increases or HR decreases conditioning, each animal was deeply anesthetized and surgically prepared. The reflex response to supramaximal dorsal root stimulation was measured from the triceps surae nerve as percent of response to supramaximal ventral root stimulation, which was the maximum possible response. Data from both legs were collected before and for up to 3 days after thoracic (T9 10) cord transection. The animal remained deeply anesthetized throughout and was killed by overdose. 4. The reflex asymmetries produced by conditioning were still present several days after transection removed supraspinal influence: reflexes of HR increases animals were significantly larger in HR increases legs than in control legs and reflexes of HR decreases animals were significantly smaller in HR decreases legs than in control legs. 5. Reflex amplitude was much greater in the control legs of anesthetized HR decreases animals than in the control legs of anesthetized HR increases animals. 6. Chronic conditioning had at least two effects on the spinal cord. The first effect, task-appropriate reflex asymmetry, was evident both in the awake behaving animal and in the anesthetized transected animal. The second effect, larger control leg reflexes in HR decreases than in HR increases animals, was evident only in the anesthetized animal. By removing supraspinal control, anesthesia and transection revealed a previously hidden effect of conditioning.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709101 TI - Urinary bladder and hindlimb afferent input inhibits activity of primate T2-T5 spinothalamic tract neurons. AB - 1. Extracellular recordings were made from 41 spinothalamic tract (STT) neurons on the left side of the T2-T5 spinal segments of 20 monkeys (Macaca fascicularis) anesthetized with alpha-chloralose. Manipulation of the left triceps-chest region and electrical stimulation of cardiopulmonary sympathetic afferent fibers excited these cells. 2. Isotonic urinary bladder distensions (UBD) to pressures between 20 and 80 cmH2O reduced the spontaneous activity in 33 of 41 cells. Cell activity was significantly reduced by UBD at 20 cmH2O. Distensions to 40, 60, and 80 cmH2O produced progressively greater reductions in spontaneous discharge. Activity was decreased throughout distension in 29 cells (tonic inhibition) and at the onset of distension in 3 neurons (phasic inhibition). In one cell, inhibition followed a brief excitation at the onset of distension (phasic excitation-tonic inhibition). Spontaneous bladder contractions also inhibited STT cell activity. 3. Inhibition by UBD was observed in STT cells characterized as wide dynamic range, high threshold, and high threshold inhibitory. No correlation existed between cell type or laminar location and inhibition by urinary bladder distension. Cells excited by cardiopulmonary sympathetic afferent A delta- and C fibers had a significantly greater tendency to be inhibited by UBD (17 of 18) than cells activated by A delta- but not C-fibers (13 of 20). 4. Urinary bladder distension and pinch of the hindlimbs also reduced activity of STT cells excited by input from cardiopulmonary sympathetic afferents and from the proximal forelimb. 5. Urinary bladder distension to 40, 60, or 80 cmH2O produced a greater absolute but smaller relative reduction in the firing frequency of STT cells as spontaneous activity increased. Thus the magnitude of this inhibitory effect may depend on whether the inhibitory effect is measured as an absolute or relative change in cell activity. 6. Convergent inhibitory input from somatic regions also was observed. Noxious pinch of the hamstring region of the right hindlimb decreased activity in 32 of 39 cells. Left hindlimb pinch inhibited 21 of 38 cells, and 15 of 29 cells were inhibited by right triceps pinch. 7. Convergent inhibitory input from the hamstring region of the hindlimbs and from the urinary bladder to upper thoracic STT cells may be important for coding the intensity and location of noxious visceral and somatic stimuli and for organizing the appropriate sequence of motor responses when multiple noxious stimuli are present. PMID- 2709102 TI - Electrophysiological properties and synaptic responses in the deep layers of the human epileptogenic neocortex in vitro. AB - 1. Neocortical slices of the first and second temporal gyrus and frontal lobe, removed in human epileptic patients for the relief of intractable seizures, were maintained in vitro at 35 +/- 1 degrees C. Electrophysiological properties of neurons in the deep layers (1,800-2,600 micron below the pial surface) were studied with conventional intracellular recording and stimulation techniques. Synaptic responses were evoked by extracellular focal stimuli. Intracellular injections of some cells with the fluorescent dye Lucifer yellow revealed large spiny pyramidal neurons. 2. Values of input resistance, resting membrane potential (Vm), and action-potential amplitude were similar for neurons in different cortical regions. These parameters were also similar when neurons were grouped in accordance to the degree of electrographic epileptiform activity displayed by the cortical tissue in situ. 3. Inward rectification occurred when neurons were depolarized by 5-15 mV positive to the resting Vm. This rectification was abolished by extracellular application of tetrodotoxin (TTX, 1 microM), but was still observed in the presence of the Ca2+-channel blocker Cd2+ (2 mM). Pulses of hyperpolarizing current elicited a slowly developing inward rectification, called anomalous rectification, which was insensitive to TTX, but blocked by extracellular application of Cs+ (1-2 mM). 4. Intracellular injection of depolarizing square pulses of current (0.1-4 s) evoked repetitive firing. In most cells the firing rate decreased smoothly for tens of milliseconds (i.e., it adapted) before reaching a steady level. Plots of the relation between frequency of the repetitive firing and injected current (f-I curve) displayed two linear segments for the early intervals as well as for the adapted and/or the steady firing. The slope of the initial, steeper linear segment of the f-I curve computed during the early intervals and during the adapted firing was 163 +/- 51 and 56 +/- 27 (SD) Hz/nA, respectively. 5. A long-lasting (up to 8 s) afterhyperpolarization (AHP) followed the repetitive firing induced by square pulses of depolarizing current. Its amplitude was directly proportional to the amount of current injected, it was sensitive to changes in the Vm, and it had an equilibrium potential 10-40 mV negative to the resting Vm. This value plus the fact that the AHP could be recorded with KCl-filled microelectrodes suggested that it was caused by an increase in conductance to K+ ions. Bath application of the Ca2+ channel blockers Cd2+ (2 mM) or Mn2+ (2 mM) decreased and eventually blocked the AHP.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709103 TI - EPSPs in rat neocortical neurons in vitro. I. Electrophysiological evidence for two distinct EPSPs. AB - 1. To investigate excitatory postsynaptic potentials (EPSPs), intracellular recordings were performed in layer II/III neurons of the rat medial frontal cortex. The average resting membrane potential of the neurons was more than -75 mV and their average input resistance was greater than 20 M omega. The amplitudes of the action potentials evoked by injection of depolarizing current pulses were greater than 100 mV. The electrophysiological properties of the neurons recorded were similar to those of regular-spiking pyramidal cells. 2. Current-voltage relationships, determined by injecting inward and outward current pulses, displayed considerable inward rectification in both the depolarizing and hyperpolarizing directions. The steady-state input resistance increased with depolarization and decreased with hyperpolarization, concomitant with increases and decreases, respectively, in the membrane time constant. 3. Postsynaptic potentials were evoked by electrical stimulation via a bipolar electrode positioned in layer IV of the neocortex. Stimulus-response relationships, determined by gradually increasing the stimulus intensity, were consistent among the population of neurons examined. A short-latency EPSP [early EPSP (eEPSP)] was the response with the lowest threshold. Amplitudes of the eEPSP ranged from 4 to 8 mV. Following a hyperpolarization of the membrane potential, the amplitude of the eEPSP decreased. Upon depolarization, a slight increase in amplitude and duration was observed, accompanied by a significant increase in time to peak. 4. The membrane current underlying the eEPSP (eEPSC) was measured using the single electrode voltage-clamp method. The amplitude of the eEPSC was apparently independent of the membrane potential in 8 of 12 neurons tested. In the other 4 neurons, the amplitude of the eEPSC increased with hyperpolarization and decreased with depolarization. 5. Higher stimulus intensities evoked, in addition to the eEPSP, a delayed EPSP [late EPSP (lEPSP)] in greater than 90% of the neurons tested. The amplitude of the lEPSP ranged from 12 to 20 mV, and the latency varied between 20 and 60 ms. The amplitude of the lEPSP varied with membrane potential, decreasing with depolarization and increasing following hyperpolarization. The membrane current underlying the lEPSP (lEPSC) displayed a similar voltage dependence. 6. At stimulus intensities that led to the activation of inhibitory postsynaptic potentials (IPSPs), the lEPSP was no longer observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709104 TI - Topographical distribution and functional properties of cortically induced rhythmical jaw movements in the monkey (Macaca fascicularis). AB - 1. The lateral part of the pericentral cortex of both hemispheres in three awake monkeys was explored with intracortical microstimulation (ICMS) using short trains (T/S; 200-microseconds pulses at 333 Hz for 35 ms, less than or equal to microA) and long trains (C/S; 200-microseconds pulses at 50 Hz for 3 s, less than or equal to 60 microA). In both hemispheres of one of these monkeys, the responsiveness of single cortical neurons to stimulation of the orofacial region was tested at the same intracortical sites where ICMS was applied. 2. Movements were evoked from four physiologically defined cortical regions: the primary face motor cortex (MI), the primary face somatosensory cortex (SI), the principal part of the cortical masticatory area (CMAp) which was located in the precentral gyrus lateral to MI, and a deep part of the cortical masticatory area (CMAd) which was located in the inferior face of the frontal operculum. 3. Two types of cortically induced movements were observed: a single twitch movement and EMG activity of the orofacial muscles that was evoked by T/S at a short latency (10-45 ms) and rhythmical jaw movements (RJMs) which were only evoked by C/S. 4. RJMs were evoked at C/S frequencies ranging from 20 to 300 Hz. At movement threshold, the frequency of the cortically induced RJMs varied from 0.7 to 1.5 Hz and usually increased with the increase of C/S intensity up to 2 times movement threshold. The vertical amplitude of RJMs was also stimulus dependent, and at movement threshold it ranged from 3 to 9 mm. 5. The movement patterns of the cortically induced RJMs remained constant during the course of C/S but could be differentiated in the frontal plane into ipsilateral- (RJMi), vertical-(RJMv), and contralateral- (RJMc) directed movements. These three different patterns of RJMs were associated with different patterns of masticatory muscle activity. 6. Each cortical region contained many sites from which RJMs could be induced (so called RJM sites). The RJMi sites were more numerous than RJMc sites in all regions except SI and were located anterolateral or lateral to the RJMc sites in each region; the RJMv sites were scattered throughout each cortical region. 7. In MI, C/S elicited RJMs from 94 intracortical sites from which short-latency twitch movements could also be evoked by T/S.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709105 TI - Activity of hippocampal formation neurons in the monkey related to a conditional spatial response task. AB - To analyze neurophysiologically the functions of the primate hippocampus, the activity of 905 single hippocampal formation neurons was analyzed in two rhesus monkeys performing a conditional spatial response task known to be impaired in monkeys and in man by damage to the hippocampus or fornix. In the task, the monkey learned to make one spatial response, touching a screen three times when he saw one visual stimulus on the video monitor, and a different spatial response, of withdrawing his hand from the screen, when a different visual stimulus was shown. Fourteen percent of the neurons fired differentially to one or the other of the stimulus-spatial response associations. The mean latency of these differential responses was 154 +/- 44 (SD) ms. The firing of these neurons was shown to reflect a combination of the particular stimulus and the particular response associated by learning in the stimulus-response association task and could not be accounted for by the motor requirements of the task, nor wholly the stimulus aspects of the task, as demonstrated by testing their firing in related visual discrimination tasks. Responsive neurons were found throughout the hippocampal formation, but were particularly concentrated in the subicular complex and the CA3 subfield. These results show that single hippocampal neurons respond to combinations of the visual stimuli and the spatial responses with which they must become associated in conditional spatial response tasks and are consistent with the suggestion that part of the mechanism of this learning involves associations between visual stimuli and spatial responses learned by single hippocampal neurons. PMID- 2709106 TI - Electrophysiological connections between the hippocampus and entorhinal cortex in patients with complex partial seizures. AB - The electrophysiological properties of the neural pathways between the hippocampus and the entorhinal cortex were studied intraoperatively in 31 patients undergoing anterior temporal lobectomy for medically intractable complex partial seizures. The hippocampus, removed en bloc, was studied histologically and the pathology was correlated with the electrophysiological findings. In 29 of the patients, entorhinal stimulation evoked a characteristic positive-negative potential in the hippocampus. The entorhinal-evoked hippocampal response closely resembled, or was identical to, the spontaneously occurring hippocampal interictal spike discharge. In patients with Ammon's horn sclerosis in whom there was a major loss of neurons in the hippocampal subfields CA1, CA3, and CA4, the evoked responses were of simple morphology and long latency (mean 21.9 msec to the peak of the first potential). In patients with a ganglioglioma in whom the hippocampus was histologically normal, the evoked responses were of greater complexity and shorter latency (mean 11.8 msec). Stimulation at a single entorhinal site evoked similar waveforms at different hippocampal recording sites. Conversely, stimulation at different entorhinal sites evoked similar responses at a single hippocampal recording site. Stimulation of the hippocampus evoked a potential in the entorhinal cortex and, in some instances, in the amygdala, insula, and lateral temporal cortex. These connections may produce a positive feedback loop that favors seizure generation. PMID- 2709107 TI - Immunoreactive S-antigen in cerebrospinal fluid: a marker of pineal parenchymal tumors? AB - This investigation evaluated the possibility that the occurrence of S-antigen in cerebrospinal fluid (CSF) might be used as a preoperative marker of pineal parenchymal tumors (pineoblastoma and pineocytoma). Such a marker could provide a means of preoperatively differentiating these neoplasms from pineal region tumors of other origin. The S-antigen, also known as the 48-kD protein or arrestin, is a highly antigenic protein originally found in the retina and pineal gland. In the retinal photoreceptors and submammalian pineal photoreceptors the protein is thought to be involved in phototransduction; its function in the mammalian pinealocyte is unknown. S-Antigen immunoreactivity also occurs in certain neoplastic cells of retinoblastomas, pineocytomas, pineoblastomas, and cerebellar medulloblastomas. This study included a group of 13 patients with tumors of the pineal region. Samples of CSF were obtained preoperatively and analyzed for the S antigen using western blot technology. Tumor biopsy material was classified according to conventional neurohistological criteria and was also examined by immunocytochemical techniques for the presence of the S-antigen. S-Antigen immunoreactivity was found in the preoperative CSF of the one patient found to have pineocytoma; tumor tissue removed from this patient was the only neoplastic tissue examined in this study which contained S-Antigen immunoreactive tumor cells. Furthermore, hydroxyindole-O-methyltransferase activity was detectable in the pineocytoma but not in three other pineal tumors, and melatonin levels in the CSF of the pineocytoma patient were the highest in the patient group examined. These preliminary results suggest that testing for S-antigen in CSF might be useful in characterizing and treating tumors of the pineal region and, when identified in conjunction with other markers, it might also help to better define pineal parenchymal tumors. This study needs confirmation with a larger number of patients. If this approach is eventually found to be a reliable predictor of pineal cell tumors, it may supplant the need for surgical biopsies before initiating appropriate adjunctive therapy. PMID- 2709108 TI - Chemotherapy as the initial treatment of spinal cord compression due to disseminated neuroblastoma. AB - During a 12-month trial period, all children attending the Hospitals for Sick Children, London, England, for management of spinal cord compression due to disseminated neuroblastoma were given chemotherapy as initial treatment rather than radiotherapy or laminectomy. Response to treatment was evaluated by a neurosurgeon as well as by oncologists. Four children were treated in this way and all made a full recovery of spinal cord function. PMID- 2709109 TI - Hyperfractionated radiation therapy for brain-stem glioma: a phase I-II trial. AB - Fifty-three patients (19 adults and 34 children) harboring brain-stem glioma were treated with hyperfractionated radiation therapy (100 cGy twice a day, 5 days/wk, to a total dose of 7200 cGy). For the entire group, the median time to tumor progression (TTP) was 59 weeks (adults 66 weeks, children 44 weeks) and the median survival time was 74 weeks (adults 92 weeks, children 64 weeks). Statistically significant prognostic factors associated with a decrease in TTP and median survival times (adults less than children) were: patient's age, a clinical history of less than 2 months, widespread brain-stem dysfunction, and a diffuse tumor as seen on magnetic resonance imaging. A finding of glioblastoma multiforme at histological analysis was associated with a statistical trend toward poorer survival, but in general tumor histology was not predictive of outcome. No evidence of an increase in acute or delayed radiation toxicity was seen with this fractionation schedule and total dose. This study suggests that hyperfractionation prolongs the TTP and survival time for many patients with brain-stem glioma. However, there remains a group of patients who are only moderately helped by this technique and for whom more aggressive treatment is warranted. PMID- 2709110 TI - Correlation of histopathological features and proliferative potential of gliomas. AB - One hundred fifty-two intracranial gliomas of various types were reviewed in order to correlate the histopathological features with the proliferative potential of each tumor as reflected by the bromodeoxyuridine (BUdR) labeling index (LI). Patients undergoing surgical removal of gliomas were given a 30 minute intravenous infusion of BUdR (150 to 200 mg/sq m) to label S-phase tumor cells. The tumor specimens were stained immunohistochemically for BUdR and processed for routine histopathological diagnosis. The BUdR LI was calculated as the percentage of labeled cells among cells analyzed. Twenty-seven histological features in three categories (degenerative, vascular, and cellular changes) were considered. A significantly higher BUdR LI (p less than 0.05) was found in tumors with necrosis than in those without this feature; tumors with both coagulative and liquefactive necrosis had the highest BUdR LI (p less than 0.05). Increased vascularity was also associated with a higher BUdR LI (p less than 0.05). Although tumors with abnormal mitotic figures had a significantly higher BUdR LI than those without, the number of mitoses did not correlate with a higher BUdR LI. These results suggest that the number of mitoses is not a good indicator of tumor growth rate. Necrosis and increased vascularity should be heavily weighted in predicting the proliferative potential of individual gliomas. PMID- 2709111 TI - A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results. AB - As survival rates have risen for children with malignant primary brain tumors, so has the concern that many survivors have significant permanent cognitive deficits. Cranial irradiation (CRT) has been implicated as the major cause for cognitive dysfunction. To clarify the etiology, incidence, and severity of intellectual compromise in children with brain tumors after CRT, a prospective study was undertaken comparing the neuropsychological outcome in 18 consecutive children with malignant brain tumors treated with CRT to outcome in 14 children harboring brain tumors in similar sites in the nervous system who had not received CRT. Children with cortical or subcortical brain tumors were not eligible for study. Neuropsychological testing was performed after surgery prior to radiotherapy, after radiotherapy, and at 1- and 2-year intervals thereafter. Children who had received CRT had a mean full-scale intelligence quotient (FSIQ) of 105 at diagnosis which fell to 91 by Year 2. Similar declines were noted in their performance intelligence quotient (IQ) and verbal IQ. After CRT, patients demonstrated a statistically significant decline from baseline in FSIQ (p less than 0.02) and verbal IQ (p less than 0.04). Children who had not received CRT did not demonstrate a fall in any cognitive parameter over time. The decline between baseline testing and testing performed at Year 2 in patients who had CRT was inversely correlated with age (p less than 0.02), as younger children demonstrated the greatest loss of intelligence. Children less than 7 years of age at diagnosis had a mean decline in FSIQ of 25 points 2 years posttreatment. No other clinical parameter correlated with the overall IQ or decline in IQ. After CRT, children demonstrated a wide range of dysfunction including deficits in fine motor, visual-motor, and visual-spatial skills and memory difficulties. After CRT, children with brain tumors also demonstrated a fall in a wide range of achievement scores and an increased need, over time, for special help in school. The 2-year results of this study suggest that children with brain tumors treated with CRT are cognitively impaired and that these deficits worsen over time. The younger the child is at the time of treatment, the greater is the likelihood and severity of damage. These children, although not retarded, have a multitude of neurocognitive deficits which detrimentally affects school performance. New treatment strategies are needed for children with malignant brain tumors. PMID- 2709112 TI - Recanalization of spinal arteriovenous malformations following embolization. AB - Recently, therapeutic embolization has been advocated as the treatment of choice for arteriovenous malformations (AVM's) of the spine. However, no study has established lasting benefit from this procedure or determined the incidence of recanalization, as occurs with cerebral AVM's. In this study, six patients were followed periodically after complete obliteration of their AVM's by particulate embolization was shown by immediate arteriography. The study group included three men (aged 59 to 72 years) with spinal dural arteriovenous (AV) fistulas and three women (aged 27 to 38 years) with intramedullary glomus-type spinal cord AVM's. The patients were treated by embolization with 100- to 1000-microns diameter polyvinyl alcohol particles. Clinical improvement, most commonly manifesting as increased lower-extremity strength, occurred in all patients after embolization. However, recurrent symptoms, including weakness, numbness, and urinary incontinence, occurred within 2 and 8 months in two of the three patients with dural AV fistulas and within 2 months in two of the three patients with glomus AVM's, prompting radiological reevaluation. Spinal arteriography revealed recanalization of the AV fistulas and spinal AVM's in five patients. Magnetic resonance (MR) imaging demonstrated a signal-void area caused by intramedullary AVM's. This area disappeared after embolic occlusion, but recurred after delayed recanalization, indicating restored flow through the AVM. Embolization provides only temporary treatment for many spinal AVM's. After embolic occlusion, delayed reassessment with arteriography and/or MR imaging is indicated, particularly if the symptoms persist or recur. Surgical excision of spinal AVM's provides the only therapeutic means to eliminate flow through the AVM permanently in most patients, and should be considered the treatment of choice when feasible. PMID- 2709113 TI - Lumboperitoneal shunt combined with myelotomy for treatment of syringohydromyelia. AB - This study was undertaken to investigate whether a direct communication between the fourth ventricle and the syrinx exists in the majority of patients with syringohydromelia and whether intraspinal pressure plays a role in the pathogenesis of this disorder. A series of 13 patients with syringohydromyelia delineated by magnetic resonance (MR) imaging was reviewed, and the intracranial pressure (ICP) and lumbar spinal pressure (LSP) were recorded concomitantly in three patients. Lumboperitoneal shunting was performed in seven patients, six of whom also underwent myelotomy of the caudal spinal cord. Magnetic resonance imaging visualized a cerebrospinal fluid (CSF) channel connecting the fourth ventricle with the syrinx in only one of the 13 patients, and in the remaining 12 patients it revealed a long segment of the spinal cord free of syrinx below the fourth ventricle. This finding is in accordance with recent MR studies of syringohydromyelia. The concomitant recording of ICP and LSP in our patients who had myelomeningocele and Chiari II malformation showed findings contradicting the reports of Williams. Lumbar spinal pressure was equal to ICP under steady-state conditions, and was elevated by straining or crying more markedly than ICP. Craniospinal pressure dissociation with ICP greater than with LSP, as described by Williams, was not observed. Lumboperitoneal shunting concomitant with myelotomy and syringopleural shunting 1 month after myelotomy resulted in marked and sustained shrinkage of the syrinx and neurological improvement in four patients. It was concluded that the majority of patients with syringohydromyelia and Chiari malformation lack a direct communication connecting the fourth ventricle with the syrinx. The results suggest that CSF moves under pressure into the spinal cord, contributing to the formation and maintenance of the syrinx, and that LP shunting combined with myelotomy can effect shrinkage of the syrinx. PMID- 2709114 TI - Neurilemomas of the trigeminal nerve. AB - Sixteen patients with trigeminal neurilemoma have been treated at the University Health Center of Pittsburgh during the last 15 years. Two patients had middle fossa tumors arising from the trigeminal ganglion, four had posterior fossa tumors arising from the trigeminal roots, six had "hourglass" lesions extending above and below the tentorium and involving the trigeminal ganglion and its roots, and four had tumors arising from the trigeminal branches and extending through the superior orbital fissure, foramen rotundum, or foramen ovale. In seven patients, tumor had also invaded the cavernous sinus. The clinical and radiographic features of these tumors, the operative approaches employed, and the postoperative outcome are discussed. Complete tumor excision was achieved in 12 patients; all 12 remain free of recurrence 3 to 157 months after surgery. In contrast, all four patients who underwent subtotal tumor excision showed progressive neurological deterioration from regrowth of residual tumor within 3 years of the initial surgery. Two of these four subsequently had total tumor excision and both are disease-free 23 and 34 months after the second procedure. Major morbidity developed in only one of the 16 patients. There were no operative deaths. Nine patients had preserved or improved trigeminal function after treatment. PMID- 2709115 TI - Treatment of vein of Galen aneurysmal malformation. AB - The authors report the case of a vein of Galen aneurysmal malformation in a 1 year-old baby presenting with an enlarging head. The lesion was a direct arteriovenous fistula in a dilated vein of Galen and was treated by complete embolization in one session. Four months after occlusion of the shunt, the ectatic vein of Galen and torcular were normal, and the head circumference had stabilized. This case serves as an opportunity to emphasize the quality of results that can be obtained with endovascular techniques. Proper analysis of the vein of Galen angioarchitecture allows planning for appropriate treatment with the lowest possible risk of morbidity and mortality. PMID- 2709116 TI - Transvenous copper wire insertion for dural arteriovenous malformations of cavernous sinus. AB - Therapeutic embolization by means of transvenous copper wire insertion was performed in five patients with dural arteriovenous malformations (AVM's) of the cavernous sinus. In each case, angiograms had shown that the AVM's were supplied from both internal and external carotid arteries, which was thought to render complete transarterial embolization difficult. A No. 2.5 French Teflon catheter was introduced into the affected cavernous sinus through the superior ophthalmic or internal jugular vein with the aid of a flexible mini guide wire. Copper wires were pushed by the guide wire into the cavernous sinus until the disappearance or a sufficient decrease in the arteriovenous shunt was noted. The patients' symptoms resolved or improved without any severe complications. Angiography revealed complete disappearance of the lesion immediately after treatment in three cases and follow-up angiography taken within 8 months showed no arteriovenous shunt in any patient. This method is a promising treatment for dural AVM's when conventional transarterial embolization is thought to be difficult. PMID- 2709117 TI - Early changes of intracranial pressure, perfusion pressure, and blood flow after acute head injury. Part 1: An experimental study of the underlying pathophysiology. AB - The present study examines intracranial pressure (ICP), cerebral perfusion pressure (CPP), and cerebral circulation immediately after experimental head injury in an animal model. The underlying systemic hemodynamic changes were also observed. To produce a standardized head injury, a fluid-percussion device was applied to the dura at the midline of 10 piglets. Seven other nontraumatized animals served as a control group. Hemodynamic parameters as well as ICP and CPP were recorded on-line, one value every 1.4 seconds. Cerebral blood flow (CBF) and cerebral vascular resistance (CVR) were measured three times using a microsphere technique. Immediately after head injury, the traumatized animals showed a sudden increase in ICP, with a maximum of 40 torr at 3 to 5 minutes, while there was a pronounced decrease in CPP from 85 to 40 torr. The CBF in the various brain areas fell from 55 to 22 ml/min/100 gm within 5 minutes after the impact, and CVR increased to 300% of control values within 90 minutes. The findings of this study demonstrated that cerebral circulation is critically jeopardized within a few minutes after trauma. This, in combination with a subsequent increase in CVR, makes the early development of ischemic brain damage very likely. In traumatized patients, treatment prior to hospital admission must therefore be directed at prevention of this fatal course. PMID- 2709118 TI - The effect of hypothermia on regional spinal cord blood flow in rats. AB - Spinal cord ischemia may accompany surgical procedures on the aorta or vertebral column. Regional spinal cord blood flow (SCBF) was measured at five vertebral levels in the spinal cords of pentobarbital-anesthetized rats based on the distribution of intravenously injected carbon-14-labeled butanol. In seven normal rats, mean SCBF (+/- standard error of the mean) ranged from 52.7 +/- 5.4 to 68.5 +/- 4.9 ml.min-1.100 gm-1 (depending on the level, being lowest at the thoracic levels) and mean arterial blood pressure (MABP) was 126 mm Hg. Corporal hypothermia (mean rectal temperature 28.1 degrees +/- 0.6 degrees C) was induced by cold exposure in seven other rats, and SCBF, measured immediately thereafter, was significantly elevated at all five levels by 52% to 69% compared to the normal group. However, MABP was elevated in the hypothermic group to 165 +/- 4 mm Hg (p less than 0.0001). Therefore, in seven additional hypothermic rats, MABP was maintained at the control level by withdrawal of arterial blood as necessary. In these animals, SCBF at all levels was still significantly elevated compared with the normal group and the values were nearly identical to those measured in the hypertensive hypothermic rats. It was concluded that hemodynamic autoregulation of SCBF is impaired in the presence of moderate systemic hypothermia in pentobarbital-anesthetized rats. PMID- 2709119 TI - The effect of furosemide on intracranial pressure and hemorrhage in preterm rabbits. AB - The hypothesis that intracranial hypotension due to excessive postnatal fluid loss places the premature infant at risk for germinal matrix and intraventricular hemorrhage (GM-IVH) was tested in preterm rabbits delivered at 28 and 29 days of gestation (term 32 days). Furosemide administered to newborn pups induced a diuresis that resulted in a 11% to 22% loss in body weight and a concomitant decline in muscle water (13% to 16%) and sodium (18% to 21%). Paradoxically, no change occurred in the water or electrolyte content of the brain even though cerebrospinal fluid and brain tissue pressure, but not blood pressure, declined. These changes were absent in littermates treated with saline. Microscopic examination of brain sections revealed a greater incidence of intracranial hemorrhage, particularly in the germinal matrix and choroid plexus, in furosemide treated than in saline-treated preterm rabbit pups. These results are consistent with the hypothesis that intracranial hypotension promotes the incidence of GH IVH in preterm animals. PMID- 2709120 TI - The effect of atherosclerosis on endothelium-dependent relaxation in the aorta and intracranial arteries of rabbits. AB - The effect of hypercholesterolemia on vascular responsiveness was studied in isolated rabbit arteries. The arteries of animals maintained on a cholesterol rich (1%) diet for 6 months had more pronounced intimal lesion than those receiving the diet for 3 months. The aortas were more severely damaged than the carotid or basilar arteries. Segments of the arteries were mounted in organ chambers for isometric tension recording or for measurement of the endothelium derived relaxing factor. Endothelium-independent relaxation induced by glyceryl trinitrate was not affected even in the most severely damaged arteries; endothelium-dependent relaxation in response to acetylcholine (ACh) and A23187 was progressively inhibited as the degree of fatty streak formation increased. In the carotid arteries, mean (+/- standard deviation) relaxation induced by 10(-5) M of ACh (expressed as a percentage of the maximum relaxation induced by 10(-4) M of papaverine) decreased from 87.33% +/- 6.30% in control tissues to 60.90% +/- 4.64% in vessels from animals subjected to 6 months of hypercholesterolemia (p less than 0.01); in the aortas, mean relaxation due to 10(-5) M of ACh was 85.08% +/- 8.03% in control tissues and 41.35% +/- 13.68% in hypercholesterolemic tissues (p less than 0.01). In the carotid arteries, mean relaxation induced by 10(-7) M of A23187 decreased from 95.81% +/- 3.58% in control tissues to 55.95% +/- 2.81% in hypercholesterolemic tissues (p less than 0.01); in the aortas, relaxation in response to 10(-7) M of A23187 was 73.73% +/- 4.35% in control tissues and 29.35% +/- 6.77% in hypercholesterolemic tissues (p less than 0.01). Intimal lesions were not produced in the basilar arteries even in rabbits with 12 months of hypercholesterolemia, and endothelium-dependent relaxation was preserved. PMID- 2709121 TI - Surgical treatment of progressive visual loss in traumatic optic neuropathy. Report of two cases. AB - In two patients with traumatic optic neuropathy progressive visual loss was reversed by surgical decompression of the optic nerve sheath. The first patient with hemorrhage beneath the optic nerve sheath had progressive loss of vision from counting fingers to no light perception within 24 hours after the injury. Surgical evacuation of the hematoma improved visual acuity to 8/30. The second patient had progressive visual loss from 20/20 to 20/400 within the 1st week after injury. Drainage of an arachnoid cyst of the optic nerve sheath improved visual acuity to 20/25. Computerized axial tomography disclosed the hemorrhage in the first case and enlargement of the optic nerve sheath in the second. While the management of traumatic optic neuropathy is controversial, surgical intervention for an arachnoid cyst and hematoma involving the optic nerve is clearly beneficial. PMID- 2709122 TI - Moyamoya-like disease associated with a lenticulostriate region aneurysm. Case report. AB - A case of moyamoya-like disease associated with an intracerebral hemorrhage and an unusual aneurysm is reported. The patient's clinical status and the initial and follow-up angiographic appearance of the aneurysm are presented. The etiology of the moyamoya phenomenon and of associated aneurysms is discussed. PMID- 2709123 TI - Magnetic resonance imaging in myelocystoceles. Report of two cases. AB - Two cases of terminal myelocystocele, a rare localized cystic dilatation of the caudal spinal central canal, are reviewed. Magnetic resonance imaging is a useful diagnostic tool for its evaluation. Terminal myelocystocele consists of the following: a myelocystocele which contains a "trumpet-like" flaring of the distal spinal cord central canal and thus is partially lined by ependymal tissue; a meningocele or dilated subarachnoid space located around the myelocystocele, which bulges into the subcutaneous region; and fibrolipomatous tissue surrounding the two cysts. This condition is usually associated with abnormalities of the vertebral column and sacrum as well as compression of the spinal cord and meningocele by a fibrous band. There is a possible relationship of the myelocystocele to teratogens such as loperamide HCl and retinoic acid, although the exact etiology of this entity is not known. PMID- 2709124 TI - Treatment of spontaneous cerebrospinal fluid leak with epidural blood patch. Case report. AB - A case of spontaneous cerebrospinal fluid (CSF) leak from a sacral nerve root sleeve is reported. The leak resulted in CSF hypotension, which failed to resolve with prolonged bed rest. An epidural blood patch using autologous blood placed percutaneously via the caudal canal was successful in treating the problem. PMID- 2709125 TI - Timing of aneurysm surgery. PMID- 2709126 TI - In vitro BUdR labeling of brain-tumor specimens. PMID- 2709127 TI - Delayed tethered cord syndrome after myelomeningocele repair. PMID- 2709128 TI - Orbital decompression for dysthyroid orbitopathy. PMID- 2709129 TI - Electrophysiological localization of the human sensorimotor cortex. PMID- 2709130 TI - Use of Peldri II (a fluorocarbon solid at room temperature) as an alternative to critical point drying for biological tissues. AB - A new chemical, Peldri II, is evaluated as a compound for drying soft biological tissues for scanning electron microscopy. Peldri II, a fluorocarbon, is a solid at room temperature and is a liquid above 25 degrees C. Cells or tissues are embedded in Peldri II by immersing them in the liquid form and allowing it to solidify. Once solidified, Peldri II will sublime with or without vacuum to dry tissues, probably without introducing surface tension. Several types of cells and tissues have been examined to compare preservation with Peldri II and critical point drying techniques. No differences were detected between the two techniques when normal surface structures were examined. Peldri II appears to be a significant improvement over hexamethyldisilazane as a drying agent for scanning electron microscopy. It is also very convenient for drying large numbers of samples. PMID- 2709131 TI - Quantitative analytical electron microscopy of multiphase alloys. AB - In this paper, we present a technique for analysis of composition gradients, using an analytical electron microscope, within the primary phase of a two-phase alloy for the case where the second-phase particle size is similar to the size of the irradiated volume. If the composition difference between the two phases is large, the detected compositional fluctuations associated with varying phase fractions may mask any underlying composition gradient of the primary phase. The analysis technique was used to determine grain boundary chromium concentration gradients in a nickel-base superalloy, alloy X-750. The technique may also be of use in other alloy systems. PMID- 2709132 TI - Preparation of collagen gel matrices for light and electron microscopy. AB - Cells grown on type I hydrated collagen gels require special techniques for sample preparation and processing in order to optimize the removal of all reagents from the collagen matrix and prevent artifactual shrinkage. This method includes cutting out a small block of the collagen gel, postfixation, and transfer to a scintillation vial for further processing. These additional steps ensure that all sides of the block will come in contact with solutions and reduces the possibility of reagent trapping within the collagen matrix. Additionally, in our study the collagen gel and endothelial cells that form a monolayer on the surface are oriented to allow the microtomist greater assurance of cutting true cross sections, thus saving time and increasing reproducibility. The dehydration sequence is also modified, with an increase in the times and additional steps, especially in the higher concentrations of dehydrant. PMID- 2709133 TI - Extraction of carbon 14-labeled compounds from plant tissue during processing for electron microscopy. AB - Loss of 14C-labeled compounds from bean leaf tissue was monitored during all the stages of routine specimen preparation. No significant differences in extraction were associated with the use of acetone, ethanol, or dioxane as dehydration fluids. Fixation at low temperature increased the loss of label. Prolonged fixation in glutaraldehyde increased the loss, but fixation in osmium solutions for periods as long as 4 hr had no influence on extraction. Buffer rinses and dehydration fluids caused appreciable amounts of label to be extracted. The use of propylene oxide as transition fluid resulted in low extraction. Some embedding media caused the loss of small amounts of labeled compounds, but one of the media tested (LR-white) extracted significant amounts of label. PMID- 2709134 TI - A variation of transmission electron microscope sample preparation for VLSI analysis. AB - Sample preparation for VLSI analysis is often slow due to long ion milling time and because the location of the thin area of the sample is difficult to control. By modifying the standard techniques used with a VCR Group (and perhaps other) mechanical dimpler, the ion milling time can be reduced to less than 30 min. and the location on the thinned area reasonably controlled. These modifications involve the use of a radiused edge on the dimpling tool, a rubber O-ring on the polishing tool, and not rotating the sample platen during polishing. The modifications to the dimpling and polishing tools allow more control of the geometry of the dimple, while not rotating the sample platen allows a thinner sample to be produced and permits the use of the sample translation micrometers to shift the location of the thinned area during polishing. The quality of samples produced using this modified procedure is equivalent to that obtained with the more standard methods. PMID- 2709135 TI - Improved preservation of bacterial capsule for electron microscopy. PMID- 2709136 TI - Use of a gelatin substrate for viewing sessile aquatic organisms by scanning electron microscopy. PMID- 2709137 TI - An ultrathin sectioning alignment tool with application to cell monolayers. AB - Details are given concerning the construction and use of a simple tool to help align a specimen block face in the vertical axis for subsequent ultrathin sectioning. Further instructions are given for the preparation of cell monolayers for ultrathin sectioning. The advantage is simple, repetitive and quick alignment of the specimen block face for ultrathin sectioning. PMID- 2709138 TI - Stereo-imaging made easy. AB - A new stereo-imaging technique is described. This new technique uses both secondary electron and back scatter electron detectors simultaneously for imaging the fracture surfaces, pictures of which are used in stereo-imaging. PMID- 2709139 TI - Transmission electron microscopy of undecalcified bone. PMID- 2709140 TI - A new technique for preparing metal/oxide TEM cross sections. PMID- 2709141 TI - Calibration methods for quantitative image processing in electron microscopy. AB - An image can be represented digitally as a matrix of numbers. When those numbers are linearly related to a property of the object, such as mass per unit area, a simple integration of an image area leads to a total of that property, such as the mass of a particle that is represented in a selected area. Following techniques pioneered by Bahr and Zeitler, we illustrate the use of photographic densitometry of films exposed in an electron microscope to measure electron scattering. The transmission of an electron micrograph will be linear with respect to mass thickness for a particular value of background brightfield density, hence allowing determination of the mass of microscopic particles. We show here a digital computer method for conveniently establishing the linear condition by quantitative image processing using micrographs of polystyrene spheres. The method also serves to produce calibration curves for cases where the transfer from transmission to mass thickness is not linear. We also illustrate how an inexpensive computer is used to display and integrate regions of micrographs to determine particle mass. PMID- 2709143 TI - Abstracts presented at the National Perinatal Association--California Perinatal Association annual meeting. October 8-11, San Diego, California. PMID- 2709142 TI - Fetal maturity/gestational age evaluation. PMID- 2709144 TI - Abstracts presented at the National Perinatal Association-California Perinatal Association annual meeting. October 8-11, 1988, San Diego, California. PMID- 2709145 TI - Human Milk Banking Association of North America. PMID- 2709146 TI - Survival rate for 68 infants with birthweights less than 801 g. PMID- 2709147 TI - Protocol on ventilatory assistance in the neonate. PMID- 2709148 TI - Lung maturational agents and surfactant treatments: are they complementary in preterm infants? AB - Maternal corticosteroid treatments are used by many obstetric services in selected cases of preterm labor to induce lung maturation. This maturational strategy, however, has not received universal acceptance and often is used without much enthusiasm because such treatments do not prevent respiratory distress syndrome (RDS) in many infants. This article develops the thesis that the effects of maternal corticosteroid treatments are not primarily on the surfactant system, but rather on other aspects of lung development. The question posed by the title has not been answered by published clinical trials, but a growing body of experimental research with animal models indicates that strategies to induce lung maturation and to treat infants with surfactant will be complementary. An added benefit of the use of lung maturational agents should be the induction of maturational responses in other organ systems in the fetus. PMID- 2709149 TI - Anencephalic infants: life expectancy and organ donation. AB - Between 1978 and 1982, 205 anencephalic infants weighing more than 2,500 g were born alive in California. Although typically none were offered significant support, almost 9% lived more than one week. It seems reasonable to assume that modern intensive care would have increased survival times dramatically. In fact, preliminary data from centers specializing in neonatal organ transplantation demonstrate that seven to 14 days of ventilatory support can be accomplished for anencephalic infants without occurrence of brainstem death. Given these data and medical information that clearly establishes anencephalic infants as a "special case" of children who have not suffered brain death but could reasonably be used as organ donors, we believe that parents who wish to do so should be allowed to continue ventilatory support for their anencephalic children for whatever period of time is necessary to find organ recipients and arrange for organ donation. Arbitrary cutoff points for intensive care and artificial criteria for brain death should not be necessary to allow the use of anencephalic infants as organ donors. We believe that current laws should be changed to permit this scenario. PMID- 2709150 TI - Appropriateness of antenatal referrals to a regional perinatal center. AB - In an ideal system, all women should receive perinatal care adequate to their needs. For specific high-risk groups, this can only be accomplished by antenatal referral to another source of care. The appropriateness of antenatal referrals for patients at risk for premature delivery (less than or equal to 34 weeks) was studied. Records of 122 women in preterm labor and/or with premature rupture of membranes (PROM) presenting to two level I rural hospitals located 60 miles from the regional perinatal center (RPC) were reviewed. Fifty-three patients were not referred and were delivered of 59 infants within 24 hours of admission. Cervical dilatation greater than or equal to 4 cm (34 patients), vaginal bleeding (6 patients), extreme prematurity (6 patients), and advanced labor (7 patients) precluded referrals. Realistically, two of these patients should have been referred. Twenty-two of the 59 infants weighed less than or equal to 1,500 g at birth, 17 weighed 1,501-2,000 g, and 20 weighed greater than or equal to 2,000 g. Five infants died in the hospital, two during the first month and three later. Twenty-two percent had Apgar scores of less than or equal to 3 at 5 minutes. Thirty-four infants were transported to a level III neonatal intensive care unit (NICU). Fourteen of the 69 antenatal referrals required hospitalization (average 11 days), were returned to their local hospital, and delivered at term. Forty four patients were delivered within 24 hours and 11 between 1 day and 9 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709151 TI - The effectiveness of a cardiopulmonary resuscitation program for mothers of newborn infants. AB - To investigate the effectiveness of a 15-minute videotape on how to perform cardiopulmonary resuscitation (CPR) on a newborn infant, 28 mothers of normal term babies completed a 12-item test on infant CPR before, immediately after, and 4-6 weeks after viewing the videotape. Statistical analysis showed that the videotape significantly improved scores on the first post-test as compared with the pre-test. At final testing, scores were significantly lower than at the first post-test, but still significantly higher than the pre-test scores. CPR education should be adopted by all institutions providing obstetrical care. PMID- 2709152 TI - Neonatal intensive care and pediatric rehabilitation: a joint program for care of chronically ill infants. AB - A joint program involving a traditional neonatal intensive care unit and a pediatric rehabilitation unit was developed to care for the increasing number of infants with chronic illnesses requiring long-term specialized care. The program emphasizes provision of a more normal, age-appropriate environment, parent education, and opportunities for extended parent-child interaction. PMID- 2709153 TI - Intensive care monitoring of pulmonary mechanics for preterm infants undergoing mechanical ventilation. AB - Changing lung dynamics and ventilator settings were studied prospectively from onset of respiratory distress syndrome in 32 very low birthweight infants (790 1,460 g, mean 1,173 g). Infants were studied in the first and second week of life using pneumotachography for dynamic compliance and lung resistance calculated from spontaneous breaths. Infants were ventilated to maintain pH at or above 7.30, PCO2 40-50 torr, and PO2 50-70 torr. Eleven infants developed chronic lung disease (CLD). In the first week, CLD infants had lower compliance (0.87 vs. 1.01 mL/cm H2O) and higher resistance (94.23 vs. 76.29 cm H2O/L/sec) than non-CLD infants. CLD infants required greater mean airway pressure (9.56 vs. 7.02 cm H2O; P = .05) and higher peak inspiratory pressures (21.85 vs. 15.71 cm H2O; P = .01). Oxygen requirements were greater for CLD infants (FIO2 0.59 vs. 0.45, P = .05). During the second week compliance for CLD infants improved (1.00) and resistance decreased slightly (92.23), but peak inspiratory pressure settings remained higher for CLD infants (19.60 vs. 14.95 cm H2O; P = .02). Although pulmonary mechanics remained stable for both groups, infants exposed to continuously greater peak inspiratory pressure and oxygen concentration proved susceptible to CLD. Developing a match of ventilator settings to improve pulmonary mechanics may lessen CLD of infancy. PMID- 2709154 TI - One-lung high-frequency ventilation in the management of an acquired neonatal pulmonary cyst. AB - Pulmonary cystic lesions presenting in the neonatal period can be congenital in origin, such as cystic adenomatoid malformation and congenital lobar emphysema, or they can be acquired. With recent advances in the support of premature infants with respiratory distress syndrome (RDS), acquired cystic lesions such as pulmonary interstitial emphysema (PIE), lobar emphysema, and parenchymal cysts have become more common. Several treatments have been proposed for these acquired lesions. We report what we believe to be the first case in which unilateral high frequency ventilation (HFV) combined with low-rate intermittent mandatory ventilation (IMV) has been used to successfully manage an acquired lung cyst in a newborn. PMID- 2709155 TI - Emergency use of uncrossmatched red cells in neonatal intensive care infants. AB - In very rare situations, a newborn will be delivered with severe unrecognized life-threatening anemia. Two infants with severe anemia with differing etiologies were deemed to require emergency uncrossmatched O-negative blood. In one infant, the blood transfused was incompatible for the minor antigen that had caused the isoimmune hemolytic anemia. We report on the indications, potential risks and benefits in giving uncrossmatched O-negative blood to term infants with life threatening anemia. PMID- 2709156 TI - Human rights and the omission or cessation of treatment for infants. AB - Advances in neonatal medicine have led to the survival of children who suffer pain and psychosocial deficits. There are those who justify the continued existence of these children by denying that there is a minimal quality of life below which life is not worth living or by claiming that we cannot judge the quality of life of another. Both of these viewpoints are found wanting. What is proposed is that infants are persons and that personhood confers human rights which include the right to die. The nature of human rights yields a general criterion by which to determine when the omission or cessation of treatment for infants is morally required. PMID- 2709157 TI - Time to heal? Time to die? . . . Most certainly, time to speak. PMID- 2709158 TI - The right to die vs death in the best interests of the infant. PMID- 2709159 TI - Polemics in perinatology: arguing with geniuses. PMID- 2709160 TI - Mortality from leukemia and other diseases among workers at a petroleum refinery. AB - This study evaluates the mortality experience of 9484 white men who worked at a petroleum refinery. We compared the numbers of deaths among these men during the period 1940 through 1984 with the numbers expected on the basis of the mortality rates of US white men. Overall, there were 2874 observed compared with 3568 expected deaths (standardized mortality ratio, 77). Mortality rates for most major cause of death categories and most cancers were also lower than expected. However, there was a statistically significant 50% excess of leukemia deaths (44 observed/29.6 expected). Lymphocytic leukemia was increased both among men hired before 1940 and among men hired in 1940 or later. In contrast, myelocytic leukemia was increased only among men hired in 1940 or later. The restriction of the myelocytic leukemia excess to men hired in 1940 or later may be related to process changes which occurred at the refinery after 1940 and which resulted in an increased percentage of benzene in certain refinery streams. The presence of an excess of lymphocytic leukemia, but not myelocytic leukemia, among men hired before 1940 suggests that some factor other than benzene was responsible for the former condition. PMID- 2709161 TI - Reproductive outcomes of pregnant workers employed at 36 reinforced plastics companies. II. Lowered birth weight. AB - The authors analyzed the birth weights of infants whose mothers worked during pregnancy in the reinforced plastics industry, where styrene monomer is a primary chemical exposure. Reproductive and work histories were taken by telephone interview from 1535 women employed between 1974 and 1981 at 36 companies. The questionnaire was based on one used by the National Institute for Occupational Safety and Health, and indices of styrene exposure were derived from an historical set of 1500 industrial hygiene samples from the study companies. There was not a significant dose-response trend in decreasing average birth weights. However, women who worked at the most highly exposed jobs--such as laminators, rollers, or spray-up operators at boat manufacturing companies--had offspring with adjusted birth weights of 4% less than the offspring of unexposed women (95% confidence interval = -7.7% to +0.6%) after adjustment for other factors. PMID- 2709162 TI - Update of mortality among chemical workers with potential exposure to the higher chlorinated dioxins. AB - This study provided 2 additional years of follow-up through 1984 for a previously studied cohort of 2192 employees potentially exposed to chlorinated dioxins. A separate analysis was done of the subgroup of 323 workers who had chloracne. No clear evidence was found for a causal association between any cause of death and potential occupational exposures to the higher chlorinated phenols, derivative products, or the chlorinated dioxins. Particular focus was directed at mortality from cancers of the stomach, liver, connective and other soft tissue, nasal and nasopharynx, and the lymphomas. Analyses by various indices of exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin and hexa- to octachlorinated dioxins did not show deaths from these cancers to have been disproportionately distributed among the workers considered to have had the highest exposures. PMID- 2709163 TI - Strategies for risk evaluation of sudden cardiac incapacitation in men in occupations affecting public safety. AB - Sudden cardiac incapacitation occurring during critically stressful circumstances in men engaged in a variety of occupations may compromise public safety. Since the primary cause of this incapacitation is usually heart disease, more effective medical screening has been advocated. We report the annual incidence of sudden cardiac incapacitation in four clinical groups--4105 healthy men (Group I), 537 men with atypical chest pain syndromes (Group II), 1374 hypertensive men (Group III), and 2373 men with clinically manifest coronary heart disease (Group IV)- who have been examined and tested by maximal exercise with the Bruce protocol in Seattle community practice. Five strategies for prospective risk assessment are presented in these groups, namely age alone, clinical diagnosis before testing, the combination of both parameters, exercise-enhanced risk assessment, and the exercise criteria proposed by a Task Force for Ischemic Heart Disease (Bethesda Conference XVIII, 1986). We conclude that the exercise-enhanced risk assessment is the most effective of these strategies. PMID- 2709165 TI - Spontaneous abortions among semiconductor manufacturers. PMID- 2709164 TI - Lung injury in dimethyl sulfate poisoning. AB - Two manual laborers were exposed to dimethyl sulfate during work and sustained mucosal injury to the eyes and respiratory tract. In one of them, noncardiogenic pulmonary edema occurred and improved with high-dose methylprednisolone. On follow-up for 10 months, this patient developed persistent productive cough with no evidence of bronchiectasis or bronchial hyperreactivity. PMID- 2709166 TI - Changing employees' dietary and exercise practices: an experimental study in a small company. AB - The purpose of this study was to determine the effect of educational and environmental strategies on the employees' dietary and exercise practices, their satisfaction with their health practices, and their perception of organizational support for good health practices. Employees from the treatment company were randomly assigned to three intervention groups with varying levels of potency. A control company was tested to observe societal changes occurring during the program. All three intervention groups made significant changes in their health status. Except for the need to target employees with high cholesterol readings for individual counseling, the findings suggested that providing employees with feedback about their health status, persuasive information about risk reduction, and a supportive environment can result in significant changes with a minimum of professional involvement. PMID- 2709167 TI - Development and testing of a new measure of health status for clinical trials in heart failure. AB - The authors developed a new measure of subjective health status for patients with heart failure. Eighty-eight patients with heart failure were asked about the impact of their condition on 123 items related to physical and emotional function. The most frequently chosen and important items were included in a 16 item Chronic Heart Failure Questionnaire (CHQ) that examines dyspnea during daily activities, fatigue, and emotional function. The CHQ was tested in a controlled trial of digoxin in heart failure patients in sinus rhythm. When administered serially to 25 patients in the run-in phase of the trial, the CHQ proved reproducible. Subsequently, CHQ results distinguished those who reported improvement or deterioration from those who did not. The CHQ showed moderate correlations with patient global ratings, walk test scores, and clinical assessments of heart failure. The authors conclude that the CHQ may be useful for measuring health status in clinical trials in heart failure. PMID- 2709168 TI - House officer interviewing techniques: impact on data elicitation and patient perceptions. AB - The relationships among physicians' interviewing techniques, the amount and type of data gathered, and patients' perceptions of the interviewing process were studied. Thirty-one Internal Medicine house officers each interviewed one of three standardized patients. The house officers' thoroughness of data collection was assessed by the patients and by a trained evaluator. A videotape of each interview was analyzed at the National Board of Medical Examiners using the interaction analysis system for interview evaluation, ISIE-81, to define house officers' interviewing techniques. From the physicians' problem-solving perspective, data elicitation was positively related to the length of the interview, asking psychosocial questions, the use of narrow questions, and the amount of time the patient talked. The patients' assessments of house officers' data-gathering thoroughness were also positively influenced by interview length, the use of narrow questions, and inquiries about their psychosocial histories. The use of broad questions by the house officer was positively related to the patient's feelings about and reaction to the interaction. This study potentially explains some of the differences that appear to exist between patients' and physicians' judgments about and perceptions of the medical interviewing process. PMID- 2709169 TI - The teacher simulation exercise: changes in physician teaching emphasis and strategy. The SGIM Task Force on the Medical Interview. AB - OBJECTIVES: The objective of the study was to determine the effect of a faculty development course in teaching medical interviewing on participants' ability to provide effective feedback to interviewers. DESIGN: The study used a non concurrent control group design which randomized subjects into two groups before the intervention. The two groups completed different pre-tests; each group then completed the other group's pre-test as its post-test. The post-course scores of one group were compared with the pre-course scores of the other group to establish differences. SETTING: The research was conducted at the 1985 faculty development course sponsored by the SGIM Task Force on the Medical Interview. PARTICIPANTS: 49 of 52 teachers of medical interviewing attending the course completed the study. INTERVENTION: The week-long intervention consisted of a variety of educational activities which assisted the participants in defining and actively pursuing their learning objectives in interviewing, teaching, and self awareness. MEASUREMENTS AND MAIN RESULTS: In their assessment of two videotaped segments of initial medical visits, participants were more likely after the course to comment on the interviewer's lack of attention to patient affect (69.0% versus 27.2%, p = 0.005 in one segment) and somewhat more likely to identify teaching strategies that actively involved the interviewer (47.2% vs. 35.0%, p = 0.09 in one segment). Both shifts were congruent with assessments made by course faculty. CONCLUSIONS: Faculty development can influence teachers to recognize the need to provide feedback on skills that expert teachers would emphasize. The non concurrent control group design provides an innovative approach to common constraints in evaluating faculty development courses. PMID- 2709170 TI - On speaking a foreign language. PMID- 2709171 TI - The internist of the future. PMID- 2709172 TI - Residency training in the inpatient setting: a new dilemma for internal medicine. PMID- 2709174 TI - Professional responsibility. PMID- 2709173 TI - Evaluating internists' clinical competence. PMID- 2709175 TI - Allocation and the physician: the impacts of aging and AIDS. PMID- 2709176 TI - Rolling boulders and prescribing pills: caring for diabetic patients. PMID- 2709177 TI - Panic disorder and misdiagnosis of mitral valve prolapse. PMID- 2709178 TI - Spontaneous rupture of the liver during pregnancy: a case report. AB - Hepatic congestion resulting in hepatic rupture during pregnancy is a rare yet catastrophic event carrying a 60 to 70% maternal mortality rate. With preeclampsia and associated epigastric pain continuing to be a major problem confronting pregnant women, hepatic congestion may be more prevalent than believed. Current etiology, treatment, and characteristics of women who experience hepatic rupture are examined. A case report and nursing protocol are presented. PMID- 2709179 TI - Nursing interventions for the first three postpartum months. AB - The transition to parenthood has been viewed as a crisis, yet families often have little contact with health-care professionals during the early postpartum months. What factors influence adaptation to parenthood and what nursing interventions facilitate the transition? A selective literature review is presented of the more commonly recognized interventions, including home visits, group support, and telephone support. Recommendations follow. PMID- 2709180 TI - Effects of heat and cold on the perineum after episiotomy/laceration. AB - The Redness Edema Ecchymosis Discharge Approximation (REEDA) tool, devised to evaluate postpartum healing of the perineum following an episiotomy/laceration, was used to evaluate the effects of heat and cold on the perineum during the first 24 hours after delivery. Ninety patients were randomly assigned to one of three treatment groups. Treatment consisted of 30 subjects applying a warm perineal pack, 30 applying a cold perineal pack, and 30 taking a warm sitz bath. Analysis of variance indicated no difference in the REEDA score before or two hours after treatment. A Pearson r correlation indicated the REEDA score was associated with a laceration and not with infant weight. Although these findings do not support assumptions from the literature, this study provides baseline data and trends for future study. PMID- 2709182 TI - Can we prevent development of essential hypertension? Satellite symposium of the twelfth scientific meeting of the International Society of Hypertension. 22 May 1988, Kyoto, Japan. PMID- 2709181 TI - RCT controversy. PMID- 2709183 TI - Determinants of blood pressure in childhood and adolescence. AB - Relationships between blood pressure and dietary factors were investigated in 434 boys and 450 girls aged 9 years. Dietary data were obtained from a food-frequency questionnaire which was completed by parents. This was used to estimate daily energy intake and the intake of 14 nutrients considered likely to influence blood pressure. Blood pressure was tested for relationships to absolute and calorie adjusted intakes of each nutrient after adjustment for age, weight, height, socio economic status and the month of examination. Ambient temperature was the most important determinant of blood pressure, an increase of 10 degrees C being associated with a 6-7 mmHg fall in blood pressure. Diastolic blood pressure in boys was negatively related to energy intake and to calorie-adjusted fibre intake. Mean adjusted diastolic blood pressure in boys in the top fibre intake quartile was 2.5 mmHg lower than that in the lowest quartile. Systolic blood pressure in girls was negatively related to calorie-adjusted intakes of protein. There were no relationships between blood pressure and calorie-adjusted intakes of fats, carbohydrates, sodium, potassium, calcium or magnesium. PMID- 2709184 TI - Quantitative analysis of systolic blood pressure tracking during childhood and adolescence using a tracking index: the Shimane Heart Study. AB - We used a tracking index to carry out a quantitative analysis of blood pressure tracking in children and adolescents. The index was calculated according to changes in blood pressure quintiles for the whole population during the observation period. The study population consisted of 463 Japanese children living in Izumo, who were examined every 3 years from 6 to 12 years of age in cohort 1, and from 9 to 15 years of age in cohort 2. In both sexes, the tracking index decreased transiently during the period from 9 to 12 years of age and increased again thereafter. The index was higher in girls than in boys except for the period from 12 to 15 years. Correlation coefficients between blood pressure at the first and that at the second examination increased with age in both sexes. We conclude that the tracking index could quantify the degree of tracking. Systolic blood pressure tracked well during childhood and adolescence, and the degree of tracking increased after the age of 12 years in both sexes. PMID- 2709185 TI - The significance of physical development on the blood pressure curve of children between 6 and 9 years of age and its relationship with familial aggregation. AB - Arterial blood pressure values of 3109 children between 6 and 9 years of age in the city of Rio de Janeiro were analysed according to low, medium and high socio economic levels. At medium and high socio-economic levels, arterial pressures, weight and height were higher than those observed in children of a lower socio economic level. Blood pressure was best correlated to body weight. The aggregation of arterial pressure, weight and height was compared between family members of children with percentiles below 50 and above 90. Systolic blood pressure and weight were significantly lower in family members with a percentile below 50. We conclude that there is a need for a long-term follow-up of these children and their families, in order to improve our knowledge of the mechanisms involved in the origin of arterial hypertension. PMID- 2709186 TI - Exercise testing in children as a diagnostic tool of future hypertension: the Odense Schoolchild Study. AB - Systolic blood pressure response and double product (systolic blood pressure x heart rate) response to a progressive maximal exercise test were evaluated in two groups of children aged 8 to 10 years. One group (normal children, n = 68) consisted of children randomly selected from a subset of the population with a resting blood pressure below the 95th percentile, and the other group (high blood pressure, n = 64) included children with a resting blood pressure at or above the 95th percentile. A rise in systolic blood pressure and in the double product was observed during the ergometric performance in both boys and girls in the normal group, and a similar response was observed in the high blood pressure group. These results suggest that the blood pressure response to exercise in childhood gives no further information about the risk of developing hypertension than a blood pressure measurement at rest. PMID- 2709187 TI - The influence of cold temperatures on the progression of hypertension: an epidemiological study. AB - In order to clarify the relationship between cold temperatures and the progression of hypertension, a prospective epidemiological study was carried out in a cold area of Hokkaido, Japan. We analysed the findings in 909 subjects, who were followed up for 8 years (1977 to 1985). The difference between the mean blood pressure in winter and in summer in the first year was significantly and positively correlated with the difference between the mean blood pressure in the first and in the eighth year. The winter/summer difference was significantly higher in the group with progressive hypertension than in the other groups. The pressor response to exposure to cold was significantly greater in hypertensives, and tended to be higher in borderline hypertensives compared with normotensives. From these results, we conclude that a cold environment might increase the inhabitants' blood pressure levels, and the difference between a subject's blood pressure in winter and summer may predict future hypertension. PMID- 2709188 TI - Blood pressure in Ethiopian immigrants in Israel: comparison with resident Israelis. AB - Blood pressure was examined in 483 Ethiopian immigrants a few weeks after their arrival in Israel. The results were compared with those from a group of 171 Ethiopian immigrants who came to Israel 2-3 years earlier. Mean blood pressure was significantly higher in the veteran immigrants, whose weight was also greater. Both groups had lower blood pressure than the resident Israeli population. PMID- 2709189 TI - Genetic and environmental approaches to the prevention of hypertension. AB - While the familial and genetic nature of hypertension has long been recognized, the mechanisms involved are not clear. Recent studies suggest that an environmental factor, increased dietary sodium intake, may be required for the expression of this genetically determined form of hypertension. The evidence for this conclusion is based on physiological studies of humoral factors, renal function and the blood pressure response to sodium and volume expansion and reduction in several carefully characterized human populations. PMID- 2709190 TI - A hypothesis for the pathogenesis of essential hypertension: the initiating factors. AB - A longitudinal study of rural-urban migration from a low blood pressure community was completed in 1985. It is suggested that the rapid increase in blood pressure observed with acculturation in this study constitutes a new dynamic model for the early phase of human essential hypertension. Analysis of data derived from this study indicates that increases in dietary sodium, weight gain and sympathetic tone (possibly reflecting acute environmental stress) are important determinants of the early blood pressure rise. It is proposed that a defence reaction occurs in response to environmental stress which maintains or increases cardiorenal sympathetic outflow, thereby overriding the negative feedback inhibition of sympathetic activity which otherwise occurs when dietary sodium is suddenly increased. The antinatriuretic response results in an early volume-dependent rise in blood pressure. We also propose that variation in individual blood pressure responses to migration may be explained not only by quantum differences in the two environmental factors, but also by a genetically-determined failure of adaptation to the combined effects of these stimuli on renal tubular reabsorption of sodium. PMID- 2709191 TI - Influence of variations in edge blur on minimally distinct border judgments: a theoretical and empirical investigation. AB - Minimally distinct border (MDB) settings were made for white-chromatic borders that varied from 1 to 32 arcmin in the space constant of Gaussian blur. The spectral characteristics, additivity, and variability of the MDB judgments remained essentially unchanged across all degrees of edge blur up to and including a space constant of 8 arcmin. For space constants of 16 and 32 arcmin, the variability of the settings increased dramatically, but no consistent trends toward changes in spectral characteristics or additivity were found. Predictions of visual response to edge blur were derived from Wilson and Gelb's six-channel model of spatial vision [J. Opt. Soc. Am. A 1, 124 (1984)]. The fits of these calculations to the data suggest that either a single low- to mid-spatial frequency-tuned channel mediates MDB judgments over a wide range of variations of edge blur or else the channels that jointly mediate these judgments are importantly similar in their chromatic characteristics. PMID- 2709192 TI - Perceptual detectability of ocular accommodation microfluctuations. AB - When the eye fixates a stationary stimulus, the power of the lens is known to change rapidly and continuously. Although the basic characteristics of this fluctuating activity are known and the influencing factors have been identified, their exact role in the control of accommodation is uncertain. It is thought that, for the fluctuations to be useful, a detectable change in the retinal image is necessary, yet an accommodation response can be provoked by a stimulus change of only 0.1 D, well within the ocular depth of focus as conventionally measured. In this study we examine whether the fluctuations of accommodation are able to provide perceptual sign information or whether the presence of a sensorimotor mechanism utilizing subthreshold blur is required. Normal accommodation fluctuations for steady-state viewing were recorded using an infrared optometer and subsequently were used to drive a Badal stimulus optometer. The perceptual threshold of the fluctuation signal for an eye under cycloplegia was then determined. The threshold for the detection of the fluctuations at optimal focus was not significantly different from the root-mean-square value of the actual response. Hence a portion of the fluctuations more than spans the dead space (depth of focus) and is therefore capable of providing information to control accommodation without the need for a subthreshold mechanism. PMID- 2709193 TI - Two processes control variations in flicker sensitivity over the life span. AB - Flicker thresholds were measured in an automated paradigm at several temporal frequencies for the critical fusion frequency in more than 1000 observers of ages 5-75 years. The results can be described by two processes. The first process was a uniform increase in sensitivity at all frequencies, at a rate that would double sensitivity every 10 years, up to the age of 16 years. In the second process the data indicated that after the age of 16 years the visual response showed gradual slowing but little sensitivity decrease for the remainder of the life span. PMID- 2709194 TI - Speechreading with reduced vision: a problem of aging. AB - Presbycusis, a progressive loss of hearing in the elderly, causes people to become dependent on vision for understanding spoken language at the same time that visual disorders of aging compromise their vision. This combination of sensory losses disrupts the lives of millions of elderly Americans but remains virtually unstudied. We tested the ability of hearing and hearing-impaired adults to understand sentences spoken by an actress without sound. She was seen through various amounts of dioptric blur. Both young and elderly adults were relatively unaffected by as much as 4 D of blur. They quickly adjusted to new levels of blur, showing improved performance within a few minutes. Ocular pathologies altered the effect of blur on speechreading. PMID- 2709195 TI - Binocular summation of hyperacuity tasks. AB - Binocular summation was studied with two different hyperacuity tests, a bisection test and a vernier-type test. The summation factor differed between the two tests and depended on the test configuration. In the bisection test, binocular summation increased with decreasing line separation, and for the largest separation binocular inhibition was found. In the vernier test summation was essentially more constant for different separations. It is argued that, for a bisection test with a small intertarget distance, the hyperacuity thresholds involve a component of intensity discrimination that is due to overlapping retinal line-spread functions. An additional, unexplained finding was that in a vertically oriented three-dot alignment test the monocularly perceived alignment always occurred while the center dot was displaced toward the nasal side. PMID- 2709196 TI - Motion processing by chromatic and achromatic visual pathways. AB - We describe a family of stimuli consisting of colored bars of different orientations, which, when presented in rapid succession, may elicit unambiguous motion perception. These stimuli permitted the isolation of directional spatiotemporal information extracted from oriented luminance clues, from nonoriented chromatic-plus-luminance clues, or, when the stimuli were presented under equiluminant conditions, from pure chromatic clues. As a general rule, matching of orientation induces weaker motion-detection performances than does matching of color. When the orientation clues are in competition with the chromatic ones, motion perception based on the former is always overridden by motion perception based on the latter. We indirectly isolated an oriented chromatic mechanism that also contributes to motion perception. We finally showed that, under equiluminant conditions, matching of orientation across different colors is inefficient in eliciting motion perception, either because motion information is extracted poorly across different chromatic channels or because such channels show little orientational selectivity. Because motion strength determined by each of the manipulated attributes follows different functions with the displacement (or velocity) of the stimuli, we propose the existence of three underlying mechanisms, a luminance mechanism, a chromatic-plus-luminance mechanism, and a pure chromatic mechanism, each of which provides motion information. PMID- 2709197 TI - In situ saphenous vein grafts for limb salvage. PMID- 2709198 TI - Somatosensory evoked potentials for orthopaedic spine trauma. AB - Monitoring somatosensory evoked potentials (SSEPs) for intraoperative assessment of spinal cord activity provides a reliable and valid measure of sensory function during manipulation of structures placing cord function at risk. We describe a multichannel technique with artifact reductions that has proved successful in 415 spine cases including 146 posttraumatic injuries. Accurate prediction of sensory function in near or at 100% of cases is possible. No patient has recovered with less than the predicted sensory function. Statistics and cases are presented. A professional-level consultant role for SSEP monitoring is suggested as necessary for valid use of the technique. PMID- 2709199 TI - Magnetic resonance imaging in the evaluation of a gunshot wound to the cervical spine. AB - A patient in the second trimester of pregnancy sustained a gunshot wound of the upper cervical spine with a partial Brown-Sequard syndrome. The patient's condition was evaluated by conventional roentgenography, computed axial tomography (CT), and magnetic resonance imaging (MRI). The MRI alone clearly demonstrated the relationship of the bullet and the spinal cord, whereas the CT image was obliterated by metal artifacts. The bullet was removed from the spinal canal by a posterior approach with the patient in the sitting position and in skeletal cervical traction. The neurological status of the patient improved markedly after the surgery. PMID- 2709200 TI - Internal fixation of the unstable cervical spine using posterior Roy-Camille plates: preliminary report. AB - We reviewed 13 cases of unstable cervical spine treated by stabilization with posterior Roy-Camille plates and fusion. The patients were treated between 1985 1988. Six patients had acute traumatic episodes, three patients had posttraumatic instabilities, one patient had laminectomy for cervical spondylotic myelopathy, and three patients had metastatic bone disease. All had successful fusion in approximately 3 months without complications. The indications and techniques of posterior Roy-Camille plating are outlined. PMID- 2709201 TI - The clinician's ability to evaluate the strength of healing fractures from plain radiographs. AB - The present study was designed to analyze the usefulness of plain radiographs in evaluating bone healing. Rabbit tibiae were osteotomized, externally fixed, and allowed to heal for 3-8 weeks. Bones were harvested, x-rayed, and tested to failure in a dynamic torsion tester. AP and lateral radiographs of 10 rabbit tibia pairs and 10 individual rabbit tibiae were selected randomly for use in a questionnaire, given to 93 physicians who routinely assess fracture healing to evaluate clinicians' ability to assess bone strength. The results indicated that clinicians can differentiate the relative strength of bones by comparing two sets of radiographs. However, the strength determination from a single set of radiographs of a fracture is unreliable, the tendency being to evaluate the fracture to be weaker than it actually is. PMID- 2709202 TI - Nonunion of acetabular fractures: evaluation with interactive multiplanar CT. AB - Nonunions involving fractures of the acetabulum are reportedly rare, with few citings and little discussion in the literature. It is possible that acetabular nonunions go undetected because imaging of the acetabulum is difficult by conventional radiography. We report two cases of fracture nonunion involving the weight-bearing surface of the acetabulum diagnosed with the aid of computed tomography (CT) and a newly developed interactive 2D/3D orthotool (copyright and trademark of the Body CT Imaging Laboratory, Department of Radiology, The Johns Hopkins Medical Institutions) that uniquely processes and reformats routine CT data. The interactive 2D/3D orthotool is a sophisticated computer program that allows dynamic viewing of standard multiplanar reconstructions in the axial, coronal, and sagittal planes as well as multiple oblique projections. The 2D/3D orthotool provides on screen correlation of two-dimensional multiplanar images with three-dimensional reconstructions of the pelvis. The authors found this capability ideally suited for studying fractures with off-axis orientation such as those through the acetabular dome, greatly facilitating the diagnosis of nonunion. PMID- 2709203 TI - Uppsala screw fixation versus the von Bahr technique in displaced cervical hip fractures: preliminary report. AB - A study of 75 patients with displaced cervical hip fractures was done utilizing two different multiple pinning techniques with threaded screws. One was the refined method of internal fixation by which the strongest bone of the femoral head was utilized to increase the stability of the fracture, and the other was the von Bahr method. As much as possible, other factors influencing healing were standardized in both groups. Forty-three of the patients were treated with the refined method and 32 with the von Bahr method. Complications occurred in 5 of 43 patients in the group treated with the new method, compared with 12 of 32 patients in the von Bahr group. Early redisplacement and nonunion were more common in the von Bahr group. Late segmental collapse was the same in both groups. In our opinion the early complications of redisplacement and nonunion are due to poor stability of the fracture. With the new, refined method, it is possible to reduce these complications. PMID- 2709204 TI - Mechanical effects of intramedullary reaming in pinned osteotomies in rats. AB - The biomechanical effects of intramedullary reaming on the healing of femoral osteotomies were studied. In rats, transverse osteotomies at the midshaft of both femurs were made. On the left side only, reaming of the medullary cavity was performed, and the osteotomies were then stabilized by intramedullary pinning. At 15, 30, 60, and 90 days after osteotomy, the production of callus, the bending moment, and the bending rigidity were evaluated. There were no significant differences in these biomechanical parameters between the right unreamed and the left reamed femurs during the experimental period. The results indicate that reaming of the medullary cavity of diaphyseal bone does not significantly impair or improve the healing of pinned osteotomies in rats. PMID- 2709205 TI - Mechanical properties and material characteristics of orthopaedic casting material. AB - In this study, two types of orthopaedic casting materials were evaluated: the Johnson & Johnson Specialist plaster bandage and the 3M Scotch-cast Plus fiber glass bandage. The materials were evaluated using tensile tests to determine the elastic modulus, yield strength, and ultimate tensile strength. To determine the structural characteristics and stiffness of a cylindrical cast, each material was formed around a foam cylinder core and tested in a four-point bend jig. A computer-based model using the finite element method (FEM) was developed for a cylindrical cast of both types and compared with the experimental findings. A second FEM model with loads applied at the periphery was performed to simulate the clinical observations of plaster bandage breakdown at the ends of a cast. It is with these tests that the two bandage materials were compared and evaluated. It was concluded that the plaster bandage, while initially stiffer than the fiber glass bandage, had much lower yield stress. This implies that the plaster cast may break down under loads that would leave the fiber glass cast intact. It was also determined that the plaster bandage load displacement curve is bilinear. The bilinear characteristic of the plaster bandage explains its breakdown at the ends of a cast. PMID- 2709206 TI - Efficacy of antibiotics in low-velocity gunshot fractures. AB - We have investigated the efficacy of intravenous antibiotic therapy as a prophylactic measure to prevent infection following low-velocity gunshot fractures. Ninety-six consecutive patients were randomized prospectively to either an antibiotic group (Group I) or a nonantibiotic group (Group II) and were followed in a special gunshot wound clinic. Only patients with fractures that could be treated by closed techniques and did not require internal fixation were included. Sixty-seven patients (73 fractures) were followed radiographically. At follow-up, 36 fractures in Group 1 and 37 fractures in Group II comprised the study group. A total of two infections, one in each group, was documented. No significant infection prophylaxis was demonstrated by the use of intravenous antibiotics in these injuries. PMID- 2709207 TI - Four cases of injury involving soda vending machines. AB - Injuries resulting from rocking soda vending machines are severe and potentially fatal. Four cases of significant trauma stemming from soda vending machine accidents are reported: One patient died, one is disabled, and two healed uneventfully. As a result, we recommend securing heavy soda vending machines to prevent further injuries. To our knowledge, this is the first report on a mechanism of injury resulting from soda machines. PMID- 2709208 TI - Neuroleptic malignant syndrome in the multiple trauma patient. AB - A 25-year-old multiply traumatized patient developed neuroleptic malignant syndrome (NMS) secondary to the use of Haldol. The diagnosis was delayed due to poor recognition of the syndrome, risking a fatal outcome. The signs and symptoms of the syndrome are presented along with the pathophysiology and the available treatments for NMS. PMID- 2709209 TI - Three-dimensional computed tomography in evaluation of occipital condyle fracture. AB - Fracture of the occipital condyle is a rare sequela of craniocervical trauma. The diagnosis can be suspected in an injured patient with disproportionate torticollis, uncertain evidence of subluxation, and lower cranial nerve symptoms. Standard radiographic diagnosis of this fracture is difficult owing to its superimposition on other bony structures. Film tomography or computed tomography (CT) is usually required to identify the fracture. We report a case of occipital condyle fracture initially masked by atlantoaxial subluxation, but then best demonstrated by three-dimensional CT. PMID- 2709210 TI - Complex volar distal radioulnar joint dislocation occurring in a Galeazzi fracture. AB - The Galeazzi fracture-dislocation of the forearm consists of a transverse or short oblique fracture of the radius at the junction of the middle and distal thirds with an associated subluxation or dislocation of the distal radioulnar joint. Anatomic reduction with rigid internal fixation of the radius typically produces anatomic reduction of the distal radioulnar joint and is the favored treatment. At least three cases of a mechanically blocked distal radioulnar joint requiring open reduction through a separate exposure have been reported. In all three cases there was dorsal displacement of the ulna. We report a case of an irreducible volar dislocation of the distal radioulnar joint following open anatomic reduction of the radius. PMID- 2709211 TI - Getting rid of bugs, drugs, and trash. PMID- 2709212 TI - The current status of TMJ arthroscopy. PMID- 2709213 TI - Arthroscopic surgery of the temporomandibular joint: report of 64 patients with long-term follow-up. AB - One hundred temporomandibular joints (64 patients) were examined arthroscopically. Complications from the procedure were low (4%). Eighty joints (50 patients) received superior compartment sweep and lavage. Patients with anteriorly displaced nonreducing discs (closed lock) had the highest success rate (83%) from this procedure when evaluated 9 to 30 months later. PMID- 2709214 TI - Factors contributing to relapse in rigidly fixed mandibular setbacks. AB - The incidence of, and factors accounting for, relapse in 25 subjects who underwent mandibular setbacks via a bilateral sagittal split osteotomy with rigid fixation were studied. Fourteen had single-jaw operations, and the remaining 11 had concomitant maxillary procedures. Cephalometric radiographs were reviewed preoperatively, immediately postoperatively, and 6 months to 3 years after surgery. Relapse was defined as forward movement of pogonion during the postoperative period. No difference in the movement of the mandible in one- or two-jaw cases was noted. Even with excellent occlusal results, there was a tendency for the mandible (chin point) to rotate forward. In the one-jaw cases 43.7% relapse was noted, whereas 53.4% was seen in the two-jaw cases. A regression analysis showed that the magnitude of setback was the single factor that significantly predicted relapse in one-jaw cases, whereas alteration of the proximal segment accounted for relapse in two-jaw procedures. These results seem interrelated when considering alterations in the spatial arrangement of the muscular tissues and their attachments. PMID- 2709215 TI - The effect of orthognathic surgery on occlusal force. AB - To investigate the effect of orthognathic surgery on occlusal force, such force was measured during maximum effort, chewing, and swallowing in 70 patients who had superior repositioning of the maxilla and/or mandibular advancement or setback. Larger changes in occlusal force than could be accounted for by the altered geometry were observed in all groups. Of 15 patients who had only superior repositioning of the maxilla, ten had greater than 20% increase in occlusal force, three had little change, and two showed a greater than 20% decrease. When the mandible was advanced, 11 of 34 patients had greater than 20% increase in maximum biting force, 11 had little or no change, and 12 had greater than 20% decrease. When the mandible was set back, six of the 21 patients had greater than 20% increase, nine had little or no change, and six had greater than 20% decrease. It appears that considerable change in bit force, which is not primarily related to jaw geometry, occurs after orthognathic surgery. PMID- 2709216 TI - Comparison of preoperative and postoperative diflunisal for suppression of postoperative pain. AB - Despite the demonstrated therapeutic advantage of preoperatively administered nonsteroidal anti-inflammatory agents (NSAIAs) in suppressing postoperative pain, clinicians are reluctant to administer these drugs orally before surgical procedures performed using sedation or general anesthesia. Using a within subject, crossover experimental design, this study compared the analgesic efficacies of an NSAIA, diflunisal 1,000 mg, administered either 30 minutes preoperatively or 30 minutes postoperatively to 20 patients undergoing the removal of impacted third molars. Pain intensity was assessed preoperatively and postoperatively for eight hours using category-rating and visual analog scales. Treatment with diflunisal 30 minutes after completion of surgery proved to be just as effective in suppressing postsurgical pain as presurgical administration. Administration of an NSAID in the immediate postoperative period may be indicated for optimum postoperative analgesia for patients in whom preoperative oral intake is contraindicated. PMID- 2709217 TI - Short-term experience with the subperiosteal tissue expander in reconstruction of the mandibular alveolar ridge. AB - A review of 35 patients in whom a subperiosteal tissue expander was used before reconstruction of the alveolar ridge with hydroxylapatite granules is presented. The mean increase in mandibular height was 8.4 mm as measured on true lateral cephalometric radiographs. Secondary preprosthetic surgery was necessary in two cases. PMID- 2709218 TI - Early soft tissue ingrowth into porous block hydroxyapatite. AB - A dog model was used to determine the rate of soft tissue infiltration into porous block hydroxyapatite (PBHA) in order to provide a scientific basis for treatment of exposed implants. Ten mongrel dogs underwent alveolar ridge augmentation with PBHA and were killed at various times up to 21 days. Significant soft tissue ingrowth had occurred by 14 days and was complete by day 21. Bone formation was also seen as early as 14 days. PMID- 2709219 TI - Zygomatic and mandibular augmentation with proplast and porous hydroxyapatite in rhesus monkeys. AB - Using an extraoral approach, subperiosteal pockets were created bilaterally over the zygomatic and mandibular regions in six Rhesus monkeys. One side of each animal received a Proplast I (Vitek Inc, Houston) implant and the contralateral side received an equivalent sized block of porous hydroxyapatite (HA). The animals were followed clinically and radiographically. Two animals were killed postoperatively at 3, 6, and 12 months, respectively. The implants were retrieved en bloc and halved. Half of each specimen was decalcified, embedded in paraffin, and stained. The other half was embedded in plastic, and sections were stained or carbon-coated for histometry scanning under electron microscopy. Clinical evaluation revealed that porous HA implants were more stable than Proplast implants. The Proplast implants showed complete encapsulation by infiltration with fibrovascular connective tissue, and progressive fragmentation with giant cell reactions. The porous HA implants were united to the underlying cortex by bony ingrowth. The volume of implants sampled within 2.5 mm of the underlying cortex contained 42.5% HA matrix and 23.8% bony ingrowth, and the surface area of the HA matrix (9.7 mm2/mm3) was 47.8% covered by bony ingrowth. No giant cell response, fragmentation, or biodegradation was observed or measured in the porous HA implants. The data from this primate model further substantiate previous canine studies and permit more reliable estimation of clinical performance. These results provide comparative data that can contribute to the decision-making process in selecting clinical implants. PMID- 2709220 TI - In vitro evaluation of ampicillin-gentamicin interactions. AB - Ampicillin at a concentration of 100 micrograms/mL was combined in vitro with either gentamicin 10 micrograms/mL in serum, 0.01 mol/L phosphate-buffered saline at 37 degrees C, or water at room temperature (25 degrees C). At these concentrations, which represent the peak prophylactic serum concentrations likely to be achieved by a 70-kg person after parenteral administration of 1.5 mg/kg gentamicin and 2 g of ampicillin, no clinically significant inactivating effects of these antibiotics on each other were observed over a period of six hours. PMID- 2709221 TI - Intraoral Hodgkin's disease. AB - An 85-year-old woman presented with an intraoral lesion involving the edentulous soft tissue of the mandibular alveolar crest between the first premolar and first molar teeth. Diagnosis was made with the aid of a biopsy. The gallium scan and CT scan were used successfully for noninvasive staging. However, initial treatment was delayed due to the patient's wishes, overall poor health, and decreased tolerance to both radiation and chemotherapy. This resulted in spread of the disease leading to her death. PMID- 2709222 TI - Adenocarcinoma of the esophagus presenting as a mandibular metastasis. PMID- 2709223 TI - Metastatic carcinoma of the mandibular condyle presenting as temporomandibular joint syndrome. PMID- 2709224 TI - Delayed management of a mandibular vascular malformation. PMID- 2709225 TI - Oculocardiac reflex during treatment of an orbital blowout fracture. PMID- 2709226 TI - Mandibular infected buccal cyst: report of two cases. AB - Two cases of mandibular infected buccal cyst are presented. A thorough review of the literature reveals that this is a fairly new entity with the first cases reported by Stoneman and Worth in 1983. PMID- 2709227 TI - Modification of the technique for placement of titanium plasma sprayed (TPS) screw implants. AB - Several modifications of instrumentation and technique are offered to improve the ease of application of TPS screws and enhance the success of the technique. PMID- 2709229 TI - Proper treatment of odontogenic myxoma. PMID- 2709228 TI - An animal model for TMJ arthroscopy. PMID- 2709230 TI - The future of oral and maxillofacial surgery. PMID- 2709231 TI - Who should determine the future of our specialty? PMID- 2709232 TI - Concern for the future of our specialty. PMID- 2709233 TI - Making two equal one. PMID- 2709234 TI - Halting the trend toward a double degree. PMID- 2709235 TI - The effects of changes in the education of oral and maxillofacial surgeons. PMID- 2709236 TI - Particle counting errors. PMID- 2709237 TI - Process control in freeze drying: determination of the end point of sublimation drying by an electronic moisture sensor. AB - The end point of sublimation drying, or primary drying, is an important control point in the freeze drying process. Traditionally, the end of sublimation drying is determined by product temperature response, the rapid rise in product temperature after the temperature sensor loses thermal contact with ice being taken as evidence of the complete removal of ice from that container. However, the product temperature is measured by temperature sensors placed in a relatively small number of vials, and product in these vials can behave differently than the batch as a whole. There is clearly a need for an alternate method for end point detection which depends on a property of the batch as a whole. The partial pressure of water vapor in the drying chamber could serve as such a property. During sublimation drying, the partial pressure of water vapor in the drying chamber is high (close to the total pressure), but when the rapid evolution of water vapor ceases with the conclusion of sublimation drying, the partial pressure of water sharply decreases. In this research, an electronic moisture sensor is employed to monitor the partial pressure of water during the freeze drying process. The moisture sensor response provides a convenient and reliable method for determination of the end point of sublimation drying for the batch as a whole. The moisture sensor method has sufficient sensitivity to detect the presence of as few as 0.3% of the vials in a batch having residual ice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709238 TI - Accelerated extractable studies of borosilicate glass containers. AB - This article describes the use of an accelerated extractable procedure for borosilicate glass containers. The procedure, which is very similar to a protocol developed by a PDA Task Force, includes the monitoring of Si, Na, K, Al, Ba, Ca, Mg, Fe, and Zn in the extracts as well as measurements of pH change and total extractables. Unlike the PDA protocol, which uses H2O as the sole extraction solution, the procedure outlined in this report used a variety of unbuffered (pH congruent to 4, H2O, pH congruent to 6.5, pH congruent to 8.0, pH congruent to 9.5, and pH congruent to 10.4) and buffered (pH = 8 and pH = 10) aqueous extraction media. Studies were completed for several borosilicate glasses, including a mixture of tubing vials, molded vials, and ampoules from US and European suppliers. Results of these studies are presented in this article and are discussed in terms of the interactions between borosilicate glasses and aqueous solutions. PMID- 2709239 TI - Effects of excipients on the crystallization of pharmaceutical compounds during lyophilization. AB - Many drug compounds fail to crystallize during lyophilization, producing the less stable amorphous form. During a study to screen various excipient materials for their effect on crystallinity, the addition of certain excipients (glycine, alanine, serine, methionine, urea, and niacinamide) to aqueous solutions of atropine sulfate, cefoxitin sodium, cefotaxime sodium, cefazolin sodium, doxycycline hyclate, procainamide hydrochloride, lactose, and polyvinylpyrrolidone induced these compounds to crystallize during the freeze drying process. Crystallinity was determined by microscopic examination under polarized light. This method of producing a crystalline freeze dried solid could prove useful in the production of stable, cost-effective freeze dried pharmaceuticals. PMID- 2709240 TI - Stability of vinca alkaloid anticancer drugs in three commonly used infusion fluids. AB - The chemical stabilities of the vinca alkaloid anticancer drugs vinblastine, vincristine, and vindesine have been studied in three commonly used infusion fluids at 4 and 25 degrees C. The infusion fluids were: 0.9% sodium chloride, 5% dextrose, and Ringer's Lactate injection. Stability has been measured by using a stability-indicating high performance liquid chromatographic assay with ultraviolet detection. At 4 degrees C no significant degradation of the vinca alkaloids occurred within a storage period of three weeks. The stability tests at 25 degrees C also revealed that vinblastine, vincristine, and vindesine are stable (greater than 95% remained) when stored for three weeks at this temperature in 5% dextrose, 0.9% sodium chloride, or Ringer's Lactate infusion fluids. PMID- 2709241 TI - Quantitative and mechanistic measurements of parenteral vial container/closure integrity. Leakage quantitation. AB - Leakage across the parenteral vial/closure seal interface is quantitatively measured in terms of mass of gas per unit time using a differential pressure method of leakage measurement. With this test system, uncoated, Purcoat coated, and film coated closures are compared for their ability to seal nondefective and defective vial surfaces. Correlations are made between closure sealing performance and rubber viscoelasticity, closure coating material type and thickness, and crimped vial residual seal force. PMID- 2709242 TI - Cleanliness assessment of supplier-cleaned stoppers. AB - The particulate levels found on supplier microcleaned rubber closures were compared to those of stoppers processed by a pharmaceutical manufacturer. The particle monitoring was performed using two official compendial methods: light blockage using a HIAC/ROYCO counter, and optical microscopy using a polarizing research microscope. The supplier-microcleaned stoppers were found to contain relatively few particles per stopper by both instrumental and microscopic counting. The cleaning process used by the pharmaceutical manufacturer was effective in reducing the particle load on their stoppers by factors of 2 to 20 fold as compared to the unwashed stoppers for the different size ranges measured. However, the supplier-microcleaned stoppers were found to be cleaner than those processed by the pharmaceutical manufacturer by a factor of 10 to 20 times for particle sizes greater than 10 microns using the instrumental method. Differences in the counts by microscopic and light blockage methods were attributed to the sampling and agitation procedures. Both the supplier-microcleaned and manufacturer's processed closures were found to meet the USP XXI limits for allowable particulate contamination in small volume parenterals. PMID- 2709243 TI - Chlorpromazine derivatives: agents that modify signal transduction mechanisms in intestinal secretion. PMID- 2709244 TI - The use of serum levels of procollagen propeptides to predict growth velocity. PMID- 2709245 TI - Serum antibodies to exogenous proteins: the significance? PMID- 2709246 TI - Patterns of gastroesophageal reflux (GER) in patients with apparent life threatening events. AB - The incidence and temporal patterns of gastroesophageal reflux (GER) in infants presenting with an apparent life-threatening event (ALTE) was compared with GER characteristics of infants evaluated for persistent emesis, utilizing continuous 24 h intraesophageal pH monitoring. These data indicate that the incidence of significant GER was similar in both groups, despite the absence of a clinical vomiting history in 46% of ALTE patients. Furthermore, infants with ALTE demonstrate a significantly higher incidence of sleep reflux when compared with control infants presenting with vomiting alone (27 vs. 0%, p less than 0.001). Awake GER beyond the first two postprandial hours was not observed in either study group. Monitoring results, therefore, indicate that significant GER is common in infants with ALTE; and these infants manifest an apparently unique pattern of GER distinct from that observed in age-matched controls with GER alone. Possible relationships between GER in ALTE patients and the development/onset of apneic episodes are discussed. PMID- 2709248 TI - Clinical features of gastroduodenal Crohn's disease in adolescents. AB - Ten cases of gastroduodenal inflammation were diagnosed by endoscopy among a series of 196 children with evidence of Crohn's disease involving other regions of the intestinal tract. Endoscopic and histologic confirmation of upper gastrointestinal tract involvement was performed only in those cases with suggestive symptoms. The mean age at presentation in the 10 cases with gastroduodenal inflammation was 14.6 +/- 1.9 (+/- SD) years, with involvement identified at the time of initial diagnosis of Crohn's disease in five of the 10. Eight of 10 cases occurred in boys. The major presenting symptoms were weight loss in five cases, epigastric pain in three, and recurrent vomiting in two. Hematemesis and melena occurred in only one of the 10 cases. Endoscopic and histological evidence of mucosal inflammation was seen in all 10 cases. Three of 10 cases had noncaseating granuloma present in biopsies of the stomach or duodenum. Two cases also had endoscopic and histological evidence of esophageal involvement. All cases were initially treated with oral corticosteroids, and in each instance a good clinical response was noted. Sucralfate (n = 1), 6 mercaptopurine (n = 1), and H2 receptor antagonists (n = 3) were used as adjunct therapy. After follow-up for 2.7 years (range, 0.5-5.5 years), none of the 10 cases required surgical intervention. Therefore, at least in the short-term, the outlook for adolescents with gastroduodenal Crohn's disease appears to be good and their medical management need not differ from those patients with Crohn's disease involving only more distal portions of the small intestine. PMID- 2709247 TI - Chronic duodenal ulcer in children: clinical observation and response to treatment. AB - Chronic duodenal ulcer is diagnosed more frequently in children since recent advances in panendoscopy techniques. From 1976 to 1986, chronic duodenal ulcer was diagnosed in 33 children in this hospital. There was a marked male preponderance (male: female = 4.5:1). Family history for peptic ulcer was positive in 36% of the patients. The important element of emotional stress was identified in 39% of the patients. Thirty patients received medical treatment, and 26 were observed for more than 1 year (1-10 years). In 11 children, medication was changed because of symptom recurrence and change in the mode of treatment. The patients were divided into three groups with different treatment regimens: antacid (12 cases), cytoprotective agent (sucralfate, 17 cases), and histamine H2-receptor antagonist (cimetidine, eight cases). The response to short term (eight-week) therapy was similarly good (83-94%) in the three treatment groups. However, sucralfate is superior to antacid in the ongoing maintenance therapy of chronic duodenal ulcer in childhood. Because chronic duodenal ulcer recurred frequently, it is crucial to give long-term maintenance therapy. PMID- 2709249 TI - Dietary origin of retained H+ in infants with acquired monosaccharide intolerance. AB - Net external acid balance was studied in 12 malnourished infants with chronic diarrhea (some of whom had acquired monosaccharide intolerance). When the infants achieved an adequate energy intake from a formula that contained either glucose or glucose polymers, seven developed metabolic acidosis and five remained free of acidosis. During the study, the acidotic infants produced a significant excess of acid (3.7 +/- 2 vs. 0.5 +/- 2 mEq/kg/day, p less than 0.005). The amount they excreted in urine (2.9 +/- 2 mEq/kg/day), however, was similar to that excreted by nonacidotic infants (2.7 +/- 2 mEq/kg/day) and indicated renal inability to reduce the excess acid load. The net effect was hydrogen ion (H+) retention (+0.8 +/- 0.8 vs. -2.2 +/- 0.8 mEq/kg/day, p less than 0.001). Good correlation existed between the net acid balance and the acid-base measurement in the blood. We speculate that (a) the increased acid load was a consequence of colonic bacterial production of volatile fatty acids from carbohydrate malabsorbed from the small bowel and (b) the renal incapacity to excrete H+ probably was secondary to potassium and phosphate depletion. PMID- 2709250 TI - Enzyme-linked immunosorbent assay and immunoblotting determination of antibody response to major component proteins of soybeans in patients with soy protein intolerance. AB - To evaluate the role of food-specific antibody response to soy protein and its fractions in patients with soy protein intolerance, allergen-specific IgG and IgE to these proteins were measured by enzyme-linked immunosorbent assays (ELISAS) and immunoblotting. A crude soy extract and the 7S, 11S, and whey fractions were isolated from commercial defatted soy flakes. Of 23 patients who underwent standardized soy challenges, seven were positive. The ELISA results showed no statistically different responses between the challenge-positive and challenge negative groups in IgG or IgE specific to either the crude soy extract or the 7S, 11S, and whey fractions (p greater than .3 for all variables). In comparing the soy-positive patients, the level of IgE specific for 7S and 11S was significantly different compared with whey; the level of IgE specific for crude soy extract and 7S was significantly different compared with whey. The immunoblots reveal that IgG and IgE are present in varying amounts to multiple fractions of the soy protein. The study does not provide evidence for a pathogenic role of serum food specific antibodies in soy protein intolerance. PMID- 2709251 TI - Serum and rectal mucosal copper status in acute and chronic diarrhea. AB - Serum and rectal mucosal copper content was estimated in children (6-18 months old) with acute diarrhea (group I: n = 50), chronic diarrhea (group II: n = 25), extraintestinal infections (group III: n = 15), and apparently healthy controls (group IV: n = 20). The sex and nutritional status of various groups was comparable. The mean serum copper levels in acute diarrhea and infected control groups were comparable, but significantly (p less than 0.001) greater in comparison to chronic diarrhea and healthy control groups. The tissue copper in group II was significantly (p less than 0.001) lower than other groups, which were comparable. There was a significant negative correlation between serum copper and diarrheal duration (r = -0.615; p less than 0.001). Repeat estimation at discharge in 38 patients (25 in group I and 13 in group II) revealed a significant (p less than 0.05) reduction in the serum and tissue copper content during this period. Among the 23 infants (16 in group I and 7 in group II) evaluated 2-3 weeks after discharge, there was an increase in copper values of tissue alone (p less than 0.05) in group I and both serum and tissue (p less than 0.05) in group II. It is concluded that elevation of serum copper in acute diarrhea is a nonspecific response to infection; infants with chronic but not acute diarrhea are copper depleted at presentation; and with the continuation of diarrhea, there is a progressive depletion of copper. PMID- 2709252 TI - Bone mineralization and mineral homeostasis in very low-birth-weight infants fed either human milk or fortified human milk. AB - Abnormalities in bone mineral metabolism are frequently found in very low-birth weight infants, especially if fed breast milk. To assess the efficacy of a breast milk fortifier in the feeding of these very small infants, very low-birth-weight babies (between 1,000 g-1,500 g at birth) were randomly assigned to one of two groups on day 4 of life. The fortified group received the fortifier mixed in equal proportions with their own mother's milk, while the breast-milk group received only their own mother's milk. All infants received an oral vitamin D supplement of 750 IU/day. The study was continued until the infants weighed 1,800 g, at which stage breast feeding was encouraged. Thirty infants in the breast milk group and 29 in the fortified group completed the study. Infants in the fortified group had significantly lower alkaline phosphatase values, a greater bone mineral content (BMC) and BMC/bone width ratio, and lower urinary calcium excretion than the breast-milk group at a weight of 1,800 g. At follow-up study 3 months after delivery, when most of the infants in both groups had been breast fed for at least 6 weeks, the breast-milk group's biochemical and BMC abnormalities were almost totally corrected and were now similar to those of the fortified group. Thus, the addition of the fortifier to breast milk during the first 4-6 weeks of life decreased the biochemical evidence of abnormal bone mineral homeostasis and increased BMC in very low-birth-weight infants. By 3 months of age, however, the breast-milk group had almost totally corrected its abnormalities. PMID- 2709253 TI - Serum transferrin levels in the longitudinal assessment of protein-energy status in preterm infants. AB - We prospectively measured serum transferrin levels weekly from birth until discharge in 33 preterm newborn infants hospitalized on the newborn intensive care unit (n = 130 weeks) to study whether transferrin levels accurately reflect recent nutritional intakes and predict subsequent changes in anthropometric measurements and serum protein levels. Mean daily protein and caloric intakes were no greater during weeks when transferrin levels increased than when levels decreased. There were weak but statistically significant linear relationships between protein intake and transferrin levels (r = 0.24, p less than 0.01), caloric intake and transferrin levels (r = 0.27, p less than 0.01), and magnitudes of weekly changes in protein intake and transferrin levels (r = 0.31, p less than 0.001), and magnitudes of weekly changes in caloric intake and transferrin levels (r = 0.27, p less than 0.01). Transferrin levels did not reflect same-week weight or midarm circumference (MAC) gains, nor did they predict the following week's gains. Mean anthropometric measurement gains were similar following weeks when transferrin levels increased or decreased. There were no positive linear relationships between the magnitudes of changes in transferrin levels and same-week weight gain (r = -0.35), same-week MAC gain (r = -0.27), or following-week MAC gain (r = 0.01). Weak correlations were found with following-week albumin levels (r = 0.32, p less than 0.001) and with same-week transthyretin levels (r = 0.44, p less than 0.001). Weekly serum transferrin levels are not useful for longitudinal surveillance of protein-energy status in preterm infants. PMID- 2709254 TI - Evaluation of infant feeding in acute gastroenteritis. AB - Sixty-eight bottle-fed babies under 9 months of age with mild acute gastroenteritis were observed to evaluate current feeding regimens following acute gastroenteritis in infancy. All babies were fed for 24 h with a glucose electrolyte mixture (GEM) and then randomly assigned to either a gradual reintroduction to their normal milk, i.e., slow regrade; immediate return to full strength formula; or a rapid regrade to a hypoallergenic whey hydrolysate formula. All groups were well matched for age, sex, ethnic origin, nutritional state, and degree of hydration. There was no significance difference in stool frequency or reducing substances, vomiting, and duration of hospital stay between the three groups. Many infants (6/24) refused to take the whey hydrolysate formula, presumably because of unpalatability. Weight gain was more rapid when full-strength milk was given. Clinical relapse developed in 12 (17%) of patients. An enteric pathogen was detected in eight of this group and cow's milk protein intolerance in three (one from each feeding group). No infant had clinically significant lactose intolerance, in marked contrast to previous experience at Queen Elizabeth Hospital. In this group of previously healthy, well-nourished babies with mild acute gastroenteritis, there was no advantage in regrading slowly to milk or a hypoallergenic formula. An immediate return to normal formula 24 h after GEM feeding was well tolerated and simpler for parents. PMID- 2709255 TI - Effect of esophageal ligation on the growth of fetal rabbits. AB - Controversy continues regarding the nutritional value to the fetus of swallowed amniotic fluid. To clarify this issue further, esophageal ligations were performed to prevent deglutition in utero in 63 fetal rabbits during the final trimester of pregnancy. Compared with sham-operated littermate controls, the fetuses that were ligated for periods of 4, 5, or 6 days showed significant reductions in weight of 6.1, 18.9, and 9.2%, respectively. These results compare well with the magnitude of weight reduction seen clinically in patients with esophageal atresia. Significant but less consistent reductions were also noted in crown-rump length and biparietal diameter. No significant differences were seen in either body composition or gastrointestinal tract histology. These results indicate that swallowed amniotic fluid does play a role in fetal nutrition and may be particularly important in the later stages of gestation when placental function is limited. PMID- 2709256 TI - Fatal multisystem disease with immune enteropathy heralded by juvenile rheumatoid arthritis. AB - The prognosis of juvenile rheumatoid arthritis (JRA) is generally good, although premature death occurs in a subset of children. Secondary infections, chronic amyloidosis, and heart disease have been reported as common causes. Our experience indicates that JRA can also herald the development of a severe immune enteropathy. In the case presented, typical JRA was followed by fulminant hepatitis; skin rashes; recurrent, severe, watery diarrhea; malabsorption; and ultimately death. Biopsies of the small bowel exposed to the patient's serum revealed deposition of complement and immunoglobulins in the epithelium. Although not widely appreciated, JRA can herald a multisystem syndrome characterized by severe immune enteropathy. PMID- 2709257 TI - Pneumococcal colitis: report of a case with radiologic and endoscopic findings. AB - Gastrointestinal symptoms and signs have been reported in association with pneumococcal infection for many years. Only rarely has Streptococcus pneumoniae been reported as a bowel pathogen. We report the clinical, radiographic, colonoscopic, and pathologic features of a case of pneumococcal colitis in an otherwise healthy 3.5-year-old female. PMID- 2709259 TI - Endoscopic capsule biopsy of the small intestine. PMID- 2709258 TI - Comparison of oral rehydration solutions. PMID- 2709260 TI - The role of placental lactogen in the regulation of fetal metabolism and growth. PMID- 2709261 TI - Reflux and related phenomena. PMID- 2709262 TI - Hepatobiliary scintigraphy and the string test in the evaluation of neonatal cholestasis. AB - We evaluated [99mTc]diisopropylphenyl-carbamoylmethylimidodiacetic acid ([99mTc]DISIDA) cholescintigraphy with measurement of duodenal fluid radioactivity collected by the string test in patients with neonatal cholestasis. Twenty-six infants with prolonged jaundice and acholic stools were studied prospectively. Twelve patients had neonatal hepatitis, 12 biliary atresia, and one each Alagille syndrome and alpha 1-antitrypsin deficiency liver disease. All infants except the biliary atresia patients and four of the neonatal hepatitis patients revealed bowel activity on scan 6 h after tracer administration. At 24 h, three of these latter patients with neonatal hepatitis and two of the patients with biliary atresia revealed bowel activity. String radioactive counts for neonatal hepatitis ranged from 99,574 to 967,205 cpm (374,504 +/- 232,210 cpm; mean +/- SD) and for biliary atresia from 8,342 to 370,346 cpm (117,149 +/- 98,698 cpm; mean +/- SD). While neither test alone was capable of correctly differentiating among all patients, those patients with biliary atresia had either a negative hepatobiliary scan at 24 h or string radioactive count below 197,007 cpm. Disparity between the hepatobiliary scan and the string radioactive counts mandates further diagnostic investigation. These data suggest that simultaneous administration of the string test with hepatobiliary scintigraphy is advantageous in the evaluation of infants with cholestatic jaundice. PMID- 2709263 TI - Vitamin K1 and K2 in infant human liver. AB - It is not known to what extent humans store vitamin K in liver. We measured hepatic concentrations of vitamin K1 (phylloquinone) and K2 (menaquinones) in 11 human livers (eight infants and three adults). Relatively small amounts of vitamin K were found in the liver at any age compared to other fat soluble vitamins. Vitamin K1 was the predominant form with much smaller concentrations of vitamin K2. Long-chain menaquinones (vitamin K2) were readily identified in most liver specimens. Hepatic vitamin K2 concentrations also increased with increasing age. These observations have implications for vitamin K supplementation in infants. PMID- 2709264 TI - Selective precipitation of 14 kDa stone/thread proteins by concentration of pancreaticobiliary secretions: relevance to pancreatic ductal obstruction, pancreatic failure, and CF. AB - Concentrated proteins in pancreatic juice could precipitate and plug pancreatic ducts, initiating pancreatic disease. In cystic fibrosis (CF), pancreatic fluid secretion is impaired due to defective anion transport and proteins are hyperconcentrated. To determine whether proteins in pancreatic secretions precipitate selectively or nonspecifically, duodenal secretions were obtained from subjects with and without cystic fibrosis, during pancreatic stimulation with cholecystokinin (CCK) and secretin, dialyzed against phosphate-buffered saline (PBS), and concentrated in stages by ultrafiltration. Precipitates obtained by centrifugation at 15,600 g for 10 min at 4 degrees C were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The only protein band regularly enriched in precipitates from 10 CF and 9 non-CF samples had an Mr of approximately 14,000. Monoclonal antibodies, raised independently in two laboratories against either pancreatic stone protein (PSP) or pancreatic thread protein (PTP), reacted with the Mr 14,000 protein(s). Differential extraction of PTP and PSP by 0.1N HCl and 10% sodium citrate produced Mr 14,000 products that reacted equally with each monoclonal antibody (MAB). Two-dimensional gel electrophoresis demonstrated two Mr 14,000 spots in each extract with pI's of 5.8 and 6.0. Each spot reacted equivalently with the MABs for PSP and PTP. PSP/PTP type proteins are sparingly soluble in pancreatic secretions and could contribute to protein plugging in pancreatic disease. PMID- 2709265 TI - Effect of cisapride on esophageal pH monitoring in children with reflux associated bronchopulmonary disease. AB - Clinical evaluation and prolonged esophageal pH monitoring were performed before and during treatment with cisapride (0.3 mg/kg t.i.d.) for 1 month in 19 children with reflux-associated bronchopulmonary disease. Results (mean +/- SEM) show that cisapride significantly decreases the frequency of long duration (greater than 5 min) reflux episodes (from 9.7 +/- 0.7 to 5.7 +/- 1.2), the percentage of total time pH was less than 4 (from 15.9 +/- 2.5 to 7.7 +/- 1.1%), the percentage of time pH was less than 4 at night (from 18.0 +/- 3.9 to 4.9 +/- 1.5%), the duration of the longest reflux episodes (from 44.5 +/- 6.4 to 19.7 +/- 2.7 min), as well as the duration of reflux at night (from 100.1 +/- 28.0 to 28.2 +/- 10.1 min). The frequency of reflux episodes, however, remains unaffected by cisapride. Cough fits at night disappeared completely in 12 out of 13 children. We conclude that cisapride given for 1 month significantly decreased gastroesophageal reflux as well as cough episodes at night. PMID- 2709266 TI - Three-year growth and developmental follow-up of very low birth weight infants fed own mother's milk, a premature infant formula, or one of two standard formulas. AB - A cohort of 40 very low birth weight (VLBW) infants was followed until they reached 3 years of age. These infants were originally part of a feeding trial in the early postnatal period whereby they were fed either their own mother's milk, a standard whey-predominant formula, a casein-predominant formula, or a premature formula. Those fed the latter formula grew significantly better while in the hospital and had no biochemical derangements. At 3 years of age, there were no significant intergroup differences with respect to growth or development. There was a positive correlation between head growth in hospital and weight at 3 years, but there were no other significant relationships between early postnatal growth and growth parameters at 3 years. Socioeconomic status was the only predictor of developmental scores at 3 years of age. No adverse effects from early metabolic acidosis or alterations of amino acid profiles during the neonatal period were detectable at 3 years of age. However, the small sample size of this study may have missed true differences in outcome measures at 3 years, and larger studies are required to examine these questions further. PMID- 2709268 TI - The effect of aminophylline on gastrointestinal blood flow and oxygen metabolism in the conscious newborn lamb. AB - Aminophylline, widely used in the neonatal period, has been reported to be associated with necrotizing enterocolitis. We hypothesized that aminophylline might alter gastrointestinal blood flow and oxygen delivery. The effects of this drug on gastrointestinal (GI) blood flow and oxygen delivery, consumption, and extraction were examined using the radioactive microsphere method in ten chronically catheterized, unanesthetized lambs aged 5-12 days. While cardiac output and systemic oxygen consumption did not change, we found statistically significant increases (p less than 0.05) in small intestinal blood flow as a function of lamb weight and as a percentage of cardiac output. Splanchnic oxygen consumption also increased significantly. The oxygen reserve available to the GI tract can be compromised by aminophylline at levels similar to those used in the human neonate for treatment of apnea. PMID- 2709267 TI - Nutrient balance in the preterm infant. 3. Effect of balance duration on outcome measurements. AB - To determine the effect of balance duration on outcome measurements 18 84-h balances were performed in a group of formula-fed preterm infants (birth weight = 1,362 +/- 125 g; gestational age = 32.3 +/- 1.7 weeks). Each 84-h balance was broken into contiguous 48- and 36-h periods. Comparisons (paired t tests, paired variance tests, and linear regression analysis) were made between the 48-h and 36 h (paired t and F tests) and between the 48-h and 84-h collections (simple linear regression). Nitrogen absorption (mean +/- SD) during 48-h collection (365 +/- 58 mg/kg/day and 87 +/- 3%) was not significantly different from that of the 36-h collection (381 +/- 66 mg/kg/day and 84 +/- 4%). Nitrogen retention during the 48 h collection (301 +/- 59 mg/kg/day, 72 +/- 6%) also was not significantly different from that of the 36-h collection (318 +/- 64 mg/kg/day, 72 +/- 6%). Moreover, nitrogen absorption and retention during the 48-h collection were significantly related (p less than 0.0001 for linear regression comparisons) to that of the 84-h collection. Similar observations were noted for calcium, phosphorus, magnesium, zinc, and copper absorption and retention. We conclude that a 48-h collection may be used in place of an 84-h collection without compromising the accuracy of the balance data in the enterally fed preterm infant. PMID- 2709269 TI - A swine model for studying intestinal circulation of the newborn. AB - We describe a newborn swine model to study intestinal hemodynamics of developing mammals. The preparation is designed to allow measurement of perfusion pressure and blood flow in an isolated segment of ileum under controlled conditions. Piglets in this study had a mean blood pressure of 65 +/- 14 (SD) mm Hg and mean intestinal blood flow of 80 +/- 20 (SD) ml/100 g/min at an average age and weight of 6.1 +/- 3 (SD) days and 1,718 +/- 427 (SD) g (n = 21). Experiments were performed to evaluate the effects of common physiologic perturbations: (a) Increased venous pressure caused a decrease in blood flow proportional to the lower perfusion pressure, but the relative change in vascular resistance was greater than the blood flow change. This effect, suggestive of a myogenic response, was significantly greater at a venous pressure increase of 20 cm of water over baseline compared with an increase of 10 cm water. (b) Gradual decrease in mesenteric artery blood pressure by clamping resulted in proportional decreases in blood flow. The calculated peripheral vascular resistance remained constant at blood pressure greater than 50 mm Hg and then increased as blood pressure decreased. (c) Stimulation of periarterial, postganglionic nerves surrounding the mesenteric artery produced a characteristic initial vasoconstriction followed by "autoregulatory escape." Frequency response tests using trains of stimulation of 6 ms and 12 V demonstrated responses starting at 2 Hz and maximal at 16 Hz. We suggest that this model should be applicable to a number of physiologic studies including assessment of water and nutrient flux in the intestine concomitant to changes in the circulation. PMID- 2709270 TI - Bilirubinuria: an early indicator of gallbladder hydrops associated with Kawasaki disease. AB - We report four cases of gallbladder hydrops associated with Kawasaki disease diagnosed over a 7.5 year period. Despite varying clinical presentations, all four of these patients had the common finding of bilirubinuria prior to clinical symptoms or at the time of admission. Review of 40 other cases of Kawasaki disease without evidence of hydrops over this time period revealed that urinalysis had been performed in each and bilirubinuria was present in only one case. Bilirubinuria appears to be an early indicator of hydrops in these patients. PMID- 2709271 TI - Aneurysmal dilatation of the portal vein. AB - In the following study, a case involving an aneurysmal dilatation of the portal vein is reported. The 5-year-old boy had a 2 month history of intermittent abdominal pain. A segmental dilatation of the portal vein was noted in the sonographic examination. The portal vein aneurysm diagnosis was later confirmed by superior mesenteric angiography and computed tomography. In our review of the literature, less than 30 cases of portal venous aneurysm have been reported. To our knowledge, this is the youngest case with such an anomaly. PMID- 2709272 TI - Acute self-limited colitis associated with Cryptosporidium in an immunocompetent patient. AB - A case report of acute self-limiting colitis associated with enteric Cryptosporidium infection in an immunocompetent child is presented. This case broadens the spectrum of symptoms and manifestation of Cryptosporidium infection in a normal human host. PMID- 2709273 TI - Measurement of plasma prednisolone level to evaluate a prednisone treatment failure in an adolescent with Crohn's disease. AB - A 14-year-old boy experienced multiple hospitalizations because of symptoms due to Crohn's disease involving the stomach, duodenum, and ileum. He maintained that oral corticosteroids were not effective for control of his symptoms. However, i.v. corticosteroids always relieved his symptoms. To resolve the question of noncompliance versus altered corticosteroid absorption or metabolism, our patient underwent an oral prednisone absorption study. Prednisolone, the active metabolite of prednisone, was measured in his plasma using a high-pressure liquid chromatography technique. The results led to the discovery of an elaborate deception by the patient and his subsequent need for psychotherapy. This report documents the importance of measuring plasma prednisolone concentrations to diagnose noncompliance, especially in adolescents who are overly concerned about their body image. PMID- 2709274 TI - Iopamidol enema mimicking bowel perforation. PMID- 2709275 TI - Low molecular weight markers do not reflect intestinal macromolecular permeability. PMID- 2709276 TI - "Which eye will you be straightening, doctor?". PMID- 2709277 TI - A hemorrhagic form of Zone I retinopathy of prematurity. AB - A premature infant who had vascularized only Zone I developed bilateral progressive hemorrhaging in the posterior poles. Subsequently, vitreous hemorrhages and retinal detachments occurred without any progression through Stages I, II, or III of retinopathy of prematurity. This clinical presentation has not been reported previously. These findings suggest profound underlying abnormalities of funduscopically normal Zone I retinal vasculature. Pathologic findings were consistent with end-stage retinopathy of prematurity. PMID- 2709278 TI - Assessment of vision and amblyopia by preferential looking tests after early surgery for unilateral congenital cataracts. AB - Preferential looking tests obtained over the first 3 years were used to evaluate the development of visual acuity of 21 patients who underwent surgery for unilateral congenital cataracts and fitting of contact lenses before age 6 months. Mean acuity of the aphakic eyes improved rapidly in the first year; however, between the end of the first year and the end of the third year there was no improvement in mean aphakic acuity. Consistent with this, the percentage of patients who were amblyopic by the criterion interocular difference in acuity (IOD) of 0.5 octaves (oct) or greater was 94% at the first test age near the onset of occlusion therapy, decreased to 72% at the end of year 1, and increased to 89% by the end of year 3. Variations in occlusion therapy appear to account for these results: mean hours of occlusion per day were 6.2 in year 1, 4.4 in year 2, and 2.7 hours in year 3. Furthermore, the IOD at age 1 year was negatively correlated with hours of occlusion in the first year and the IOD at age 3 years was negatively correlated with cumulated hours of occlusion over all 3 years. That is, the less the amount of occlusion therapy, the greater the IOD. The patients' ages at time of surgery did not account for any further variance in these results than that accounted for by occlusion therapy. This study demonstrates that PL acuity measurement can aid in monitoring the response to occlusion therapy of infants with deprivation amblyopia due to unilateral congenital cataracts. PMID- 2709279 TI - Unilateral congenital cataract: binocular status after treatment. AB - We describe the binocular status of four patients, aged 5, 6, 10, and 13 years, who had a unilateral congenital cataract removed in the first few months of life. A contact lens had been fitted in all cases and was worn continuously. The normal eye was occluded for approximately 90% of the waking day until at least the age of 4 years. Two patients developed an esotropia and two an exotropia. Best corrected visual acuity is 20/40 or better in both the aphakic and the normal eye. The patients' binocular status was assessed with a full eye examination, tests for fusion in free space with prism neutralization, tests for stereopsis, and examination on the Clement Clarke synoptophore. All patients showed simultaneous perception but no real fusion, resulting in diplopia. A vertical bobbing effect was noted at the angle of neutralization similar to that reported by us in cases of central fusion disruption. PMID- 2709280 TI - Residual incomitant DVD following large bilateral superior rectus recession. AB - A recent survey of 25 experienced strabismus surgeons indicated that a very large superior rectus recession is the procedure of choice for DVD. We report a series of seven patients who exhibited a persistent DVD following large superior rectus recession. Furthermore, the DVD was markedly incomitant, much greater in adduction than in abduction. This residual DVD would mimic inferior oblique overaction on version testing, although proving to be purely DVD on critical observation. This "overaction" is apparently due to the marked weakening of the superior rectus and was not always predictive of the location and amount of persistent DVD. This previously unreported complication of large superior rectus recession is important to recognize so that alternative surgical approaches may be contemplated. It is hoped that more accurate observations and measurements both preoperatively and postoperatively will lead to a more orderly approach to DVD surgery. PMID- 2709281 TI - Optic disc drusen and primary megalencephaly in children. AB - Three patients with primary megalencephaly were identified among 40 children seen in our clinic with pseudopapilledema due to optic disc drusen. These patients were genetically unrelated and did not have cutaneous hemangiomas, distinguishing their condition from the Riley-Smith syndrome. Although the nature of the relationship between optic disc drusen and primary megalencephaly is not clear, we feel that the two conditions have more than a chance association. A clinically important consideration is that the concomitant occurrence of pseudopapilledema due to optic disc drusen and a large head due to primary megalencephaly may lead to an erroneous diagnosis of increased intracranial pressure in children. PMID- 2709282 TI - Topical anesthesia for strabismus surgery. AB - Twenty-two adults underwent strabismus surgery under topical anesthesia over the past 4 years. Benefits of this technique include avoidance of certain hazards of general and retrobulbar anesthesia, the ability to adjust eye position to the patient's satisfaction on the operative table, and expanded options for patients unwilling to undergo general anesthesia. The major disadvantages are the possibility of increased patient discomfort. Patient selection is important. PMID- 2709283 TI - The use of part-time occlusion for early onset unilateral exotropia. AB - Eleven patients (9 months to 5 years of age) with intermittent or constant exotropia of predominantly one eye on distant gaze were studied to investigate the effect of part-time occlusion. No patient had constant exotropia on near fixation. Visual acuity was found to be equal in both eyes. All patients were treated by part-time patching of the non-deviating eye from four to six hours a day and tapered as appropriate. If exotropia recurred after conversion to a heterophoria, part-time occlusion was reinstated. With occlusion, all patients converted to hetero- or orthophoria, at least temporarily. Mean follow-up (to last visit or surgical intervention) was 22 months (range 3 to 37 months). Three patients (27%) later developed constant exotropia (mean 28.3 months after beginning occlusion) and underwent surgery. Three patients (27%) became and remain orthophoric without further patching. Part-time occlusion for preschool patients with exodeviations that are predominantly unilateral can postpone surgical intervention and convert exotropia to orthophoria or exophoria. PMID- 2709284 TI - Visual pathway abnormalities in albinism and infantile nystagmus: VECPs and stereoacuity measurements. AB - The visual pathway of albinos is characterized by abnormal optic nerve fiber decussation with increased contralateral projection. This results in hemispheric asymmetry of monocular visually evoked cortical potentials (VECPs) and may be related to lack of stereopsis. Flash VECP, Random Dot E (RDE), and Titmus stereotest data were collected from 40 nystagmus patients, 19 albino and 21 with normal pigmentation. Data were compared with results obtained from 19 race- and age-matched normal subjects. All albino patients demonstrated hemispheric VECP asymmetries exceeding +/- 2.0 standard deviations from the normal mean, showing either delayed ipsilateral P latency (88%), reduced ipsilateral P amplitude (59%), or both (47%). None of the normally pigmented infantile nystagmus patients exceeded this criteria on either VECP measure. While only one albinotic patient showed positive RDE and stereofly results, 86% of normally pigmented nystagmus patients passed the stereofly test, 60% demonstrated 400 sec (Titmus) stereopsis, and 66% showed positive RDE results. These findings reveal that normally pigmented infantile nystagmus patients have variable degrees of stereopsis and no excessive abnormalities of optic nerve fiber decussation as evidenced by flash VECP. Additionally, this study verifies visual pathway abnormalities and the lack of stereopsis in albino nystagmus patients. PMID- 2709285 TI - Primary disorders of the lymphatic vessels--a unified concept. AB - Congenital defects of lymphatics constitute a spectrum of disorders that may manifest with a variety of clinical presentations including lymphedema, chylous effusions, lymphangiomatous malformations with cystic masses and localized gigantism, and intestinal lymphangiectasia with malabsorption. These entities constitute a relatively rare group of disorders, the origin of which remains somewhat controversial, but in some it appears to be due to early lymphatic obstruction. Five cases are described, which demonstrate the anatomical pathology of these entities. A classification and description of the defects is also presented. An attempt is made to present a unified theory of origin for this seemingly diverse group of diseases. While these entities may be challenging from a diagnostic and therapeutic standpoint, a wide variety of imaging modalities, which includes lymphography, computed tomography scanning, and ultrasound, may be used to diagnose the extent and internal structural characteristics of the abnormalities. PMID- 2709286 TI - Chest wall deformity in patients with repaired esophageal atresia. AB - Chest wall deformities developed after thoracotomy for esophageal atresia, in 77 of 232 patients (33%) who did not have a congenital vertebral anomaly. Anterior chest wall asymmetry was present in 47, scoliosis in 18 and a combination of both in 12 patients. Scoliosis was convex away from the incision in two thirds of those affected. Anterior chest wall deformity was more common in patients greater than 25 years of age, and scoliosis was more common in patients who had had multiple thoracotomies. Breast surgery to minimize inequality was required in three female patients, and spinal surgery in one patient. Twenty-two of 53 patients with a congenital vertebral anomaly developed scoliosis, eight of whom required surgery. The scoliosis was probably the result of the vertebral anomaly in these patients, who are particularly at risk for progressive deformity. PMID- 2709287 TI - Gastroesophageal dysfunction in Cornelia de Lange syndrome. AB - Children with Cornelia de Lange (CDL) syndrome present with feeding problems related to swallowing incoordination, poor esophageal motility, and gastroesophageal reflux (GER). These abnormalities of esophageal function result in failure to thrive and life-threatening aspiration pneumonia. Severe GER was documented in four patients with CDL syndrome. Three were managed successfully with an antireflux procedure (Nissen fundoplication) and a concomitant feeding gastrostomy. These observations confirm the high incidence of abnormal esophageal function in patients with CDL syndrome, and suggest that an antireflux procedure and feeding gastrostomy are important considerations in their clinical management. PMID- 2709288 TI - A simplified method for autoregulation of blood flow in the extracorporeal membrane oxygenation circuit. AB - The ability of autoregulate blood flow in the extracorporeal membrane oxygenation (ECMO) circuit is critical to prevent cavitation and air embolism. Conventional circuits have used a spring-loaded mechanical switching device that interrupts the flow of power to the roller head when falling venous return collapses the venous bladder. This device has been less than desirable due to being poorly adjustable, subject to sporadic flow in periods of hypovolemia, and not commercially available. An improved alternative is reported using a commercially available pressure monitor and computerized switching device, which, when attached to the venous reservoir or bladder, has the ability to autoregulate blood flow in the ECMO circuit by smoothly regulating the roller head velocity. Experience with this system in the laboratory employing a swine model, and in 35 infants, is reported without device-related complications. PMID- 2709289 TI - Early detection and simplified management of obstructed Hickman and Broviac catheters. AB - Thrombotic occlusion of Hickman and Broviac central venous catheters is a serious obstacle to their long-term use. Because resistance to flow (R) through a catheter of lumen radius, r, is proportional to 1/r4, we hypothesized that measurement of R would provide an objective and sensitive monitor for partial occlusions. Our measurements showed that median R at a flow of 17 mL/min was 0.7 cmH2O/mL/min in normally functioning Hickman catheters, and 4.1 cmH2O/mL/min in Broviac catheters. In obstructed catheters, which by subjective standards resisted flushing or blood withdrawal, median R was 3.0 cmH2O/mL/min for Hickman and 5.6 cmH2O/mL/min for Broviac catheters, representing significant increases. In a series of obstructed lines in which urokinase was administered, R decreased from 7.7 to 4.5 in Hickman catheters and from 5.6 to 4.2 in obstructed Broviac catheters. The elevated resistance in Hickman catheters after urokinase suggested that residual catheter obstruction was present even though catheter function returned to normal. Elevated R was seen with abnormal venograms in seven of 13 patients. Four patients had normal R values and abnormal venograms, and two patients had elevated R values with normal venograms. Measurement of resistance in Hickman and Broviac catheters provides a simple technique that can supplement or replace venography in the serial assessment and treatment of partial obstruction. PMID- 2709290 TI - Bilateral hydrothorax complicating central venous catheterization in a child: case report. AB - It is necessary to consider catheter-related events when a previously stable patient has an acute change in cardiopulmonary status, regardless of the duration of catheter use; and to recognize that hydrothorax from vein perforation may be bilateral, necessitating bilateral drainage procedures. PMID- 2709291 TI - The influence of various amino acids on the extrahepatic bile ducts in newborn mice--an experimental study. AB - Excess proline in adult animals is associated with extrahepatic biliary hyperplasia. Possible therapeutic application of this amino acid in biliary atresia was postulated. In order to test whether excess proline had an influence on the development of the extrahepatic bile ducts, pregnant mice were injected daily with various amino acids. One day and 1 week after delivery, the extrahepatic bile ducts of the newborn mice were studied and the number of epithelial cells per cross section was determined. Neither proline nor any other amino acid had an influence on the proliferation of extrahepatic bile ducts. PMID- 2709292 TI - Granulation at the porta hepatis following hepatic portoenterostomy for biliary atresia: the healing of experimental hepatoenterostomy. AB - After hepatic portoenterostomy for biliary atresia, granulation that formed at the porta hepatis caused biliary obstruction in seven out of 27 patients (26%). Six of the seven developed the complication during the first 6 weeks after surgery. The mortality rate was 29% (2/7). Among the same group, the incidence and mortality rate of ascending cholangitis was 19% (5/27) and 20% (1/5), respectively. The features characteristic of biliary obstruction caused by granulation, as compared with those of ascending cholangitis, were the absence of signs of infection and the lack of response to medical treatment. Quantitative analysis of the healing process of an experimental hepatoenterostomy in the rat showed that the mean thickness of the granulation formed at the anastomotic site (area, 5 x 20 mm) decreased almost constantly--from 1.49 mm on day 7 to 0.64 mm on day 42. Mucosa covered 20% of the granulation on day 7, 55% on day 14, 63% on day 21, 76% on day 28, and 92% on day 42. The increase in coverage was greatest during the second postoperative week. The results suggested that the healing of the hepatoenteostomy should be almost complete within 6 weeks. The operative method and postoperative management to prevent excessive granulation should be chosen so as to decrease the incidence of postoperative biliary obstruction. PMID- 2709293 TI - Adrenocortical tumors in childhood: a report of four cases. AB - In the last 10 years, four children with adrenocortical tumors were treated in our hospital. Three of them had symptoms of adrenogenital virilizing syndrome, and another, nonfunctional, was found during a routine examination. A diagnosis of adrenocortical tumor was established given the symptoms, hormonal tests, and radiologic studies. Two of the tumors were located in the left side, and the histologic diagnosis was pleomorphic cortical adenoma; the ones that affected the right side were adenocarcinomas. All the patients were treated by surgery and none received chemotherapy. At both presurgical and postsurgical stages, the patients were treated with cortisol. All four children have had a favorable course, with normal growth and the disappearance of public hair and hirsutism; however, macrogenitals still persist. PMID- 2709294 TI - Total colectomy and ileorectal anastomosis in the treatment of total colonic aganglionosis: a long-term follow-up study of six patients. AB - Six patients with total colonic aganglionosis (TCA) with ileal involvement were treated with a total colectomy and ileorectal anastomosis according to Rehbein. Follow-up lasted from 1 to 7 years and showed no mortality. Postoperative management consisted of total parenteral nutrition initially, followed by gradual introduction of oral feeding beginning with a low-osmolarity low-residue diet, the use of loperamide, an adequate oral intake of salt, and regular bowel deflation. Major postoperative complications disappeared and all patients demonstrated weight gain by the end of the first postoperative year, with normal feeding and two to three soft stools per day. PMID- 2709295 TI - Familial achalasia in two siblings: significance of possible hereditary role. AB - Familial achalasia in siblings has been reported previously. We describe the clinical and radiographic findings in two siblings with achalasia. A discussion of the possible hereditary influence in achalasia is presented as well as a pertinent review of the literature. PMID- 2709296 TI - Fetus in fetu: a case report and review of the literature. AB - A cystic tumor was first found in the abdomen of a Taiwanese girl at the age of 9 months. The tumor gradually increased in size and caused no symptoms until the girl was 7 years of age, when surgical removal was carried out. Pathological examination disclosed two "fetuses" within the fibrous sac. The pathogenesis of fetus in fetu and its differentiation from retroperitoneal teratoma are still controversial issues. Further work needs to be done to elucidate whether it is a natural progression of the twinning process to teratoma or the inclusion of a monozygotic diamniotic twin within the bearer. PMID- 2709297 TI - Jugular phlebectasia. AB - The most common cause of a mass in the neck that appears only during straining is a laryngocele. However, the rare jugular phlebectasia may present in a similar manner. Dilatation of the internal jugular vein with a Valsalva maneuver suggests a mechanical obstruction in the neck or mediastinum, but the exact cause is still unknown. Nevertheless, dilated internal jugular veins have been excised, as in the case reported here, and found to have thinning of the wall but no associated abnormality. PMID- 2709298 TI - Congenital left atrial aneurysm in an infant. AB - Congenital left atrial aneurysm, without associated cardiac abnormalities, is a rare defect. We report the case of a large left atrial aneurysm filling almost the entire left hemothorax. This is the first report of this anomaly occurring in an infant less than 1 year of age. PMID- 2709299 TI - Ductus arteriosus aneurysm: an unusual mediastinal mass. AB - The following is a case report of a ductus arteriosus aneurysm in a newborn. Its various appearance on different imaging modalities, including chest x-ray, computed tomography scan, magnetic resonance imaging, and angiography, are demonstrated. The differential diagnosis of this mediastinal mass, complications related to ductus aneurysms and the appropriate radiographic workup are discussed. PMID- 2709300 TI - Reinterpreting the Myers-Briggs Type Indicator from the perspective of the five factor model of personality. AB - The Myers-Briggs Type Indicator (MBTI; Myers & McCaulley, 1985) was evaluated from the perspectives of Jung's theory of psychological types and the five-factor model of personality as measured by self-reports and peer ratings on the NEO Personality Inventory (NEO-PI; Costa & McCrae, 1985b). Data were provided by 267 men and 201 women ages 19 to 93. Consistent with earlier research and evaluations, there was no support for the view that the MBTI measures truly dichotomous preferences or qualitatively distinct types; instead, the instrument measures four relatively independent dimensions. The interpretation of the Judging-Perceiving index was also called into question. The data suggest that Jung's theory is either incorrect or inadequately operationalized by the MBTI and cannot provide a sound basis for interpreting it. However, correlational analyses showed that the four MBTI indices did measure aspects of four of the five major dimensions of normal personality. The five-factor model provides an alternative basis for interpreting MBTI findings within a broader, more commonly shared conceptual framework. PMID- 2709301 TI - The role of sympathy and altruistic personality traits in helping: a reexamination. AB - The purposes of this study were (a) to examine the role of social evaluative concerns in the self-report of sympathy and in the relation of sympathy to helping; and (b) to determine the role of "altruistic personality" traits and situationally induced vicarious emotional responses in the intention to help. Dispositional and situational self-reports of sympathy and other vicarious emotional reactions were obtained for persons who also were given the opportunity to assist a needy other. Moreover, dispositional measures of concern with social evaluation and an altruistic orientation were obtained, and a bogus pipeline manipulation was instituted for half the study participants. Both dispositional and situational self-reported sympathy were positively related to helping, as were other personality indices viewed as reflecting altruistic characteristics. The relations for the dispositional indices of sympathy were not due solely to social evaluative concerns or to other egoistic concerns. The effects on intended helping of dispositional sympathy, perspective taking, and the tendency to ascribe responsibility for others to the self appeared to be both direct and mediated by situational sympathetic responding. Finally, situational sadness did not mediate the effects of sympathetic responsiveness. PMID- 2709302 TI - Gender and sex-role influences on children's self-esteem. AB - This study examined direct and moderating influences of gender and sex-role orientations on children's general self-esteem. Moderating influences of these variables on the prediction of self-esteem were examined with respect to two sets of competence beliefs regarding school achievement: perceived capacities and perceived strategies for doing well in school. One hundred nineteen fourth-, fifth-, and sixth-grade children were assessed using the Perceived Competence Scale for Children (Harter, 1982), the Multidimensional Measure of Children's Perceptions of Control (Connell, 1985), and the Children's Personal Attributes Questionnaire (Hall & Halberstadt, 1980). Correlational and hierarchical multiple regression analyses indicated that upper elementary schoolchildren's general self esteem is (a) marginally related to biological gender, with boys showing a slight advantage; (b) significantly related to masculinity and androgyny; and (c) predicted more strongly by perceived capacities to do schoolwork in girls than in boys, and by perceived (lack of) strategies for academic success in nontraditionally sex-typed children than in traditionally sex-typed children. Of the two nontraditionally sex-typed groups, androgynous children were found to have more positive school competence beliefs than were undifferentiated children. PMID- 2709303 TI - Evidence of high concentrations of melatonin in lateral ventricular cerebrospinal fluid of sheep. AB - In this study we examined the cerebrospinal fluid (CSF) for regional differences in the concentration of melatonin. Cerebrospinal fluid samples were collected at hourly intervals from either the lateral ventricle or the cisterna magna of nine Merino ewes and were compared against jugular plasma. The study revealed that the CSF of the cisterna magna and the lateral ventricle had temporal patterns of melatonin that were similar to those found in jugular plasma. However, the concentrations of melatonin within the CSF obtained from the lateral ventricle were one order of magnitude higher than those of the jugular plasma, as verified by gas chromatography and mass spectrometry, while the melatonin concentrations within the CSF obtained from the cisterna magna were comparable to those of the jugular plasma. The data from this study suggest that there may be regional differences in the concentration of melatonin within the CSF and indicate that this medium is an important route of transport for melatonin from the pineal gland to putative target tissues. PMID- 2709304 TI - Plasma prolactin concentrations in pinealectomized ewes receiving melatonin treatment and in pineal intact ewes maintained under a non-24-hour photoperiod. AB - We have investigated the profiles of prolactin secretion in relation to onset of breeding activity in Suffolk-Cross ewes with artificially modified melatonin rhythms. With treatments commencing in midsummer, groups of ewes were 1) subjected to a 8L:16D photoperiod, 2) maintained under a "short" (6L:16D) photoperiod repeated over a 22-h cycle that induces an elevation in plasma melatonin that does not endure for the entire dark phase, 3) pinealectomized (pnx) to abolish plasma melatonin levels, and 4) pinealectomized and treated with a melatonin implant (subcutaneous) to provide a constant (no 24-h rhythm) elevation in plasma melatonin. The onset of breeding activity was significantly advanced in both the 8L:16D and pnx/implant groups compared to the 6L:16D and untreated pnx ewes. The two latter groups displayed a normal timing in seasonal breeding activity. Low and high plasma prolactin levels corresponded with short and long photoperiods during both the 24 and 22-h cycles. There was no clearcut "seasonal" rhythm in plasma prolactin in either of the pnx groups. A clear differentiation was seen between reproductive response and prolactin response, particularly in the case of ewes monitored on 22-h cycles of short photoperiod. PMID- 2709305 TI - Preliminary observations on the suppression of nocturnal plasma melatonin levels by short-term administration of diazepam in humans. AB - Several studies suggest that GABAergic mechanisms may be involved in the modulation of melatonin secretion. However, conflicting results have been reported in animal studies; in humans the issue has not been widely investigated. In the present study, using a double-blind design, six healthy men received orally, at midnight, 10 mg of diazepam, a GABAergic agent, or placebo, on two different occasions 1 week apart. Blood samples were collected, in the dark, immediately before the drug administration, and at 12:30, 1, 2, 3, and 4 AM. Serum melatonin was measured by a radioimmunological method with [125I]melatonin as a tracer. Two-way ANOVA with repeated measurements disclosed a significant effect for treatment (P less than 0.01), for time (P less than 0.0004), and for treatment X time interaction (P less than 0.05). Following diazepam administration, serum melatonin levels observed at 2, 3, and 4 AM were significantly lower than the corresponding values following placebo (P less than 0.002 at 2 and 4 AM; P less than 0.03 at 3 AM [Students' paired t test]). These results show that nocturnal blood melatonin levels may be suppressed by the acute administration of a GABAergic agent, suggesting that GABA may be involved in the modulation of pineal activity in man. PMID- 2709306 TI - Inhibition of the catalytic activity of bovine pineal gland hydroxyindole-O methyltransferase (EC 2.1.1.4) by estrone, estradiol, progesterone, and testosterone but not pteridines. AB - The effect of pteridines and sex hormones on hydroxyindole-O-methyltransferase (HIOMT) catalysis was examined. Equivalent quantities of partially purified bovine HIOMT was incubated in the presence and absence of the various test substances and the results fitted to the Michaelis-Menten equation. The pteridines (triampterene and xanthopterin) had no noticeable effect on HIOMT catalysis, while all the sex hormones examined were found to be competitive inhibitors of the enzyme with respect to the hydroxy-substrate. Testosterone concentrations causing noticeable inhibition were above physiological while estrone, estradiol, and progesterone all caused inhibition within the physiological range; estrone was the most potent and progesterone the least potent inhibitor. The possible significance of these findings are discussed. PMID- 2709307 TI - Preferences as expectation-driven inferences: effects of affective expectations on affective experience. AB - Presents a model arguing that affect and emotion are often formed in an expectation-driven fashion. A pilot study and 2 experiments manipulated undergraduate Ss' affective expectations (e.g., how funny they expected a set of cartoons to be) and whether Ss' expectations were confirmed (e.g., whether the cartoons really were funny). When the value of a stimulus was consistent with an affective expectation, people formed evaluations relatively quickly. Even when the value of a stimulus was discrepant from an affective expectation, people sometimes assimilated the value of the stimulus to their expectations. Other times, such as when making a more fine-grained evaluation of the cartoons, people noticed that they were discrepant from their affective expectations. Under these conditions, people appeared to have more difficulty forming preferences. They took longer to evaluate and spent more time thinking about the cartoons. PMID- 2709308 TI - The structure of interpersonal traits: Wiggins's circumplex and the five-factor model. AB - Using a sample of 315 adult men and women, self-reports on Wiggins's revised Interpersonal Adjective Scales were jointly factored with self-reports, peer ratings, and spouse ratings on the NEO Personality Inventory to examine the relations between the two models. Results suggest that the interpersonal circumplex is defined by the two dimensions of Extraversion and Agreeableness, and that the circular ordering of variables is not an artifact of response biases or cognitive schemata. Circumplex and dimensional models appear to complement each other in describing the structure of personality, and both may be useful to social psychologists in understanding interpersonal behavior. PMID- 2709309 TI - Spouse criticism and support: their association with coping and psychological adjustment among women with rheumatoid arthritis. AB - Examined whether psychological adjustment of women with rheumatoid arthritis would be related to the support and criticism the patient received from the husband. Interviews were conducted with the husbands of 103 women with rheumatoid arthritis. Spouse interviews were content coded for critical remarks. Wives completed a revised version of the Ways of Coping Scale and a scale of the perceived supportiveness of the spouse. Husbands completed rating scales assessing their perceived vulnerability to illness and the degree of burden they experienced in providing assistance to their wives. Path analyses revealed that patient adjustment was significantly related to the attitude of the spouse. Patients with a highly critical spouse engaged in more maladaptive coping behaviors and reported a poorer psychological adjustment. Independent of spousal criticism, patients who perceived their spouse as being supportive engaged in more adaptive coping. A path model was fit to the data that suggested that the spouse may affect adjustment indirectly through influencing the patient's selection of adaptive or maladaptive coping responses. PMID- 2709310 TI - Does emotionality predict stress? Findings from the normative aging study. AB - Investigated whether emotionality, assessed in 1975, predicted the reporting of both objective stress (life events) and subjective stress (hassles) 10 years later, and how emotionality affected the relation between both objective and subjective stress and mental health. The sample consisted of 1,159 older men, participants in the Normative Aging Study. Path analysis revealed that the reporting of stress was confounded with personality: Individuals higher in emotionality reported both more life events and more hassles. Furthermore, individuals higher in emotionality exhibited slightly higher levels of symptoms under stress than did individuals lower in emotionality. Nonetheless, both stress measures contributed independent variance to the prediction of psychological symptoms, even controlling for prior levels of emotionality. Implications for the assessment of stress are discussed. PMID- 2709311 TI - Optimism, neuroticism, coping, and symptom reports: an alternative interpretation of the Life Orientation Test. AB - Found in two studies that the Life Orientation Test (LOT) had limited discriminant validity relative to measures of neuroticism. Furthermore, although previous correlations of the LOT with measures of symptom reports and coping behaviors were replicated, these correlations were eliminated when neuroticism was controlled. In contrast, the correlations of symptoms and coping with neuroticism remained significant when LOT scores were controlled. Thus, the LOT is virtually indistinguishable from measures of neuroticism, and previously reported findings using this scale are perhaps more parsimoniously interpreted as reflecting neuroticism rather than optimism. These findings are discussed in terms of existing support for models of optimism and self-control and general methodological issues in studies of personality and health. PMID- 2709312 TI - Reduction of testosterone, androstendione and their derivatives by Aphanocladium album. AB - A strain of Aphanocladium album reduces the C-3 carbonyl group in testosterone or androstendione to to 3 alpha-allyl alcohol. In some derivatives of these steroids the same carbonyl group is reduced to allyl alcohol with stereospecificity, depending on whether chlorine at C-4 or a 17 alpha-methyl group is present. On the other hand, the presence of C-4 methyl group, a C-19 hydroxy group, a C-17 acetyl one, or a double bond conjugated with the 4-en-3- ketone system totally inhibits the formation of allyl alcohols at C-3. At the same time, the C-17 carbonyl group in androstendione or in its derivatives is reduced to a respective 17 beta-alcohol. In the derivatives with an additional 2-exomethylene group the double bond at this group is reduced. PMID- 2709313 TI - Ultrastructure of Borrelia burgdorferi in tissues of patients with Lyme disease. AB - Spirochetal organisms were sought in 18 skin and 4 synovial membrane specimens obtained by biopsy from 22 Lyme disease patients. The presence of spirochetes in body tissues was histologically demonstrated in one patient with lymphadenosis benigna cutis, one patient with acrodermatitis chronica atrophicans and in one patient with active arthritis. The organisms were 5-30 microns long and 0.12-0.25 microns thick, had 8 or 11 flagella arising from both ends of the body, and their ultrastructure was analogous to that of cultured Borrelia burgdorferi strains. They were located intra- or perivascularly, or in the collagenous connective tissue of the skin and synovium. This implies that Lyme spirochetes may have a potential to survive in body tissues and cause injury to blood vessels. PMID- 2709314 TI - Distribution of drugs in polymers loaded by swelling. AB - Ethylene:vinyl acetate pellets were loaded at 20 degrees C by swelling the polymer with 1 and 3% (w/v) chloroformic solutions of tolbutamide. The energy dispersive X-ray analysis showed different concentrations of the tolbutamide sulfur in the pellets sections according to the loading time. At the beginning of the loading process, the sulfur in the pellets showed two concentration peaks which later joined in the center of the section before reaching a homogeneous distribution. The concentration peaks might depend on a drug sieving process as the solution flow reaches a less swollen inner area. Therefore, the concentration distribution of the drug would be affected by the size of the polymer network, which is related to the volume of the solvent in the polymer. Another possible explanation of these concentration profiles is that they could be a result of the solvent evaporation process. The concentration distribution of the drug becomes homogeneous only after the complete swelling of all of the polymer. PMID- 2709315 TI - Physical characterization of the methanol solvate of urapidil. AB - The methanol solvate of urapidil was prepared and characterized by means of differential scanning calorimetry, thermogravimetric analysis, infrared spectroscopy, X-ray powder diffraction, intrinsic dissolution rate, and solution calorimetry. The stoichiometry of the urapidil:methanol solvate was found to be 1:1. The crystal and molecular structures were determined from three-dimensional X-ray data. The stability of the solvate under different storage conditions was also determined. PMID- 2709316 TI - Effects of sinker shapes on dissolution profiles. AB - In dissolution testing, according to the U.S. Pharmacopeia, a nonreactive stainless steel wire helix is typically used to sink dosage forms that would otherwise float. The objective of this investigation was to determine if other sinker shapes will influence the rate, extent, or variability of dissolution. Criteria for the optimal sinker were defined. Various new sinker designs were fabricated, tested, and classified. Four classes of sinker shapes were defined: longitudinal, lateral, screen enclosures, and internal weights. Longitudinal sinkers contact the dosage forms on the long axis. Lateral sinkers either wrap around or contact capsule dosage forms in the middle, such as the line where the top and bottom halves of a capsule shell come together. Screen enclosures are of two types: either a wire cage, which holds the entire capsule, or a circular piece of wire screen placed on top of the capsule. Internal weights consist of two steel ball bearings, one inserted into each end of the capsule. The investigation consisted of four studies: (1) visual observation of the dissolution performance using 12 different sinkers; (2) the effect on drug release from nine classified sinkers on two different capsule formulations; (3) side-by-side comparison between the selected optimal longitudinal U clip and the wire helix lateral type sinkers; and (4) hydrodynamic effects caused by the use of the longitudinal U clip and the wire helix lateral type sinkers in the absence of capsule shells. We concluded that capsules sunk with either of the two longitudinal sinkers, the U clip or the paper clip, have faster, more complete dissolution and less variable results than did lateral type sinkers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709317 TI - Residual ethylene oxide determination in polymethyl methacrylate disks and intraocular lenses by headspace gas analysis and N,N-dimethylformamide extraction. AB - The residue in an ethylene oxide (EO)-exposed polymethyl methacrylate (PMMA) material [flat disk and intraocular lens (IOL)] was determined using three methods: semiautomatic and manual headspace methods and N,N-dimethylformamide (DMF) solvent extraction. Results from the analysis of three different sample configurations at three different EO concentrations are compared. Results from the DMF extraction of PMMA indicate that the headspace methods at 100 degrees C are not exhaustive with respect to recovery of total residual ethylene oxide. Furthermore, the manual headspace method appears to be slightly more effective than the semiautomatic injection headspace method. Sorption of EO and subsequent extraction is related to the surface area-to-volume ratio of the sample, with higher concentrations observed in samples with the high ratio. PMID- 2709318 TI - Determination of doxycycline in bovine tissues and body fluids by high performance liquid chromatography using photodiode array ultraviolet-visible detection. AB - A sensitive and selective high-performance liquid chromatographic assay was developed to quantitate doxycycline concentrations in bovine tissues and body fluids. The method involved sonication of doxycycline-spiked minced tissues with appropriate solutions to extract tissue-bound drug. Acetonitrile:85% phosphoric acid:water (20:2:78) was added to doxycycline-spiked serum or urine. The mixtures were ultrafiltered through 30,000 or 10,000 Da molecular weight cutoff microseparation systems. Separation was obtained by a reversed-phase microbore column. Absorbance of the column effluent was measured by an ultraviolet-visible photodiode array detector scanning from 235 to 380 nm and/or a photometric detector operated at 268 or 345 nm. Chromatographic peak homogeneity was evaluated by three-dimensional spectrochromatograms, contour maps, and absorbance ratios. PMID- 2709319 TI - Identification of components in iodinated glycerol. AB - Iodinated glycerol (CAS no. 5634-39-9), therapeutically used as an expectorant and source of organically bound iodine, was analyzed to determine the purity and composition of the chemical samples used in carcinogenicity and toxicity studies. The manufactured product is described by the patent and chemical literature as a mixture of two isomeric iodopropylideneglycerols (structures 1 and 2). The results of our studies, however, indicate that the two principal components of the product were 3-iodo-1,2-propanediol (IPD) and glycerol (GLY). Analyses from GC-MS (full scan electron impact) and carbon-13 nuclear magnetic resonance spectrometry provided conclusive identification of these components. The quantification of IPD and GLY in one of two samples of commercial product using GC-flame ionization detection indicated concentrations of 33 and 17%, respectively (Sample A). Similar concentrations were determined for a second sample from the same source (Sample B), which was a gratis sample procured approximately nine years after Sample A. Numerous minor components were also observed in these two samples. These components were tentatively identified as condensation products of glycerol and iodine-containing analogues. The iodopropylideneglycerol compounds, described in the patent, were not observed in either of the two samples. PMID- 2709320 TI - Degradation kinetics of (+/-)-4'-ethyl-2-methyl-3-(1-pyrrolidinyl)propiophenone hydrochloride (HY-770) and structure-stability relationship among its analogues in aqueous solution. AB - The kinetics and pathways for degradation of (+/-)-4'-ethyl-2-methyl-3-(1 pyrrolidinyl)propiophenone hydrochloride (HY-770; 1), a newly developed muscle relaxing agent, and its analogues were studied in aqueous solution at 50 degrees C, ionic strength 0.5 M, and pH 8.0-12.0. Compound 1 and its four analogues followed pseudo-first-order degradation kinetics at constant pH and temperature. From the analysis of the pH degradation-rate profiles, it is evident that specific hydroxide ion-catalyzed degradations of ionized and un-ionized species occur for 1 and its structural analogue, 3'-fluoro-2-methyl-3-(1 pyrrolidinyl)propiophenone hydrochloride (HN-961; 5). The hydroxide ion-catalyzed degradation of the ionized species was found to be 100 times faster than that of the un-ionized species and to be the major process at pH less than 9.0. On the contrary, 1 was extremely stable in 0.5 M HCl at 50 degrees C, suggesting that the hydronium ion-catalyzed degradation and the spontaneous degradation of the ionized species is negligible. The Arrhenius plot for the degradation of 1 at 35 50 degrees C and pH 9.0 showed that the apparent energy of activation was 22.0 kcal/mol. The degradation rates of the five structural analogues were significantly dependent on the electron withdrawing effect of the benzene substituents of the molecule. PMID- 2709321 TI - Quantitative analysis of trazodone hydrochloride in tablets by an ion-selective electrode. AB - A simple assay procedure for the quantitation of trazodone hydrochloride in tablets, without prior separation, has been developed using a trazodone-selective electrode. The electrode was based on a trazodone:tetrakis(p-chlorophenyl)borate ion-pair complex, dioctyl phthalate, and polyvinyl chloride matrix that were mounted on a PTFE membrane. The electrode showed a near-Nernstian response in the range of 10(-2) to 5 x 10(-6) M trazodone over the pH range of 2.5 to 5.0, with a cationic slope of 58 mV/concentration decade. The durability of the electrode and the reproducibility of the performance among the electrodes were sufficient. The electrode was used for the determination of the pKa value of trazodone. The selectivity of the electrode to a number of interferences was investigated. Many inorganic cations (alkali and alkaline earth metals) and pharmaceutical excipients did not interfere, but some organic ammonium compounds interfered according to their extractability. Determination of 10 to 3000 micrograms/mL of trazodone hydrochloride in aqueous solution showed an average recovery of 100.6% (mean standard deviation 0.4%) by direct potentiometry. This assay was applied to determine trazodone hydrochloride in tablets and the results compared favorably with those obtained by high-performance liquid chromatography. PMID- 2709322 TI - Antitumor imide derivatives of 7-oxabicyclo[2.2.1]heptane-2,3-dimethyl-2,3 dicarboxylic acid. AB - The imide and methylimide derivatives of 7-oxobicyclo[2.2.1]heptane-2,3-dimethyl 2,3-dicarboxylic acid were synthesized and shown to have antitumor inhibitory activity (growth inhibition) against the KB cell line. The compounds were prepared according to standard procedures. Interest in the respective imide derivatives stemmed from their structural relationship to antitumor-active derivatives of 7-oxobicyclo[2.2.1]heptane-2,3-dicarboxylic acid which lacked 2,3 dimethyl substituents or which were derivatives of isoindolines and lacked the carbonyl groups. PMID- 2709323 TI - Preparation of controlled-release microspheres of ibuprofen with acrylic polymers by a novel quasi-emulsion solvent diffusion method. AB - A novel quasi-emulsion solvent diffusion method to prepare the controlled-release microspheres of ibuprofen with acrylic polymers has been developed. An ethanol solution of ibuprofen and acrylic resin was poured into aqueous medium with stirring. The finely dispersed ethanolic droplet-like coacervates formed in aqueous medium were gradually solidified and transformed into microspheres during agitation. The size of microspheres was determined by the concentrations of drug and polymer and the agitation speed of the system. The flowability, the packability, and the compressibility of the resultant microspheres were much improved compared with the raw crystals of the drug. The drug release rate from the microspheres could be controlled by the type and the concentration of polymer formulated. A unique principle of the present method and the resultant microspheres, having a matrix- or sponge-like texture, can provide characteristic advantages compared with a conventional reservoir-type device drug, like a microcapsule. PMID- 2709324 TI - Stability of parenteral ceftriaxone disodium solutions in frozen and liquid states: effect of freezing and microwave thawing. AB - The stability of ceftriaxone disodium solutions stored in glass bottles was tested in two parenteral solvents (0.9% NaCl; 5% dextrose) at two concentration rates (10 and 50 mg/mL) and three temperatures (-22 degrees C, 5 degrees C, room temperature). The solutions, which had been initially frozen, were thawed at room temperature or by exposure to microwave radiations. The stability of each sample was determined by a quantitative bacteriological agar gel diffusion assay and by high-performance liquid chromatography. The results of this study indicate that admixtures of ceftriaxone disodium at the concentration rates tested can be frozen for six months without a significant loss in antibiotic activity. At room temperature, the stability is dependent on the concentration of ceftriaxone disodium. At 5 degrees C, the stability is related to the concentration of ceftriaxone and of the solvent. The results obtained by both analytical methods are very close. In order to perform routine assays, the high-performance liquid chromatography method was chosen on the basis of its rapidity and reproducibility. PMID- 2709325 TI - Analysis of consecutive pseudo-first-order reactions. II: Calculation of the rate constants from the co-product or co-reactant data. AB - The co-product or co-reactant data for a two-step pseudo-first-order consecutive reaction gives unique shape profiles for the natural logarithm of the concentration versus time plots, based on the ratio of two rate constants (k2/k1), for theoretical data without error. But, in the presence of a +/- 2.0% random error in the simulated data, the ability to distinguish between different shapes disappears. A comprehensive analysis shows that accurate rate constants can be obtained only in a limited range of k2/k1 ratios. Reliable rate constants can be obtained when k2/k1 less than 0.5. Two special cases, k1 approximately 2k2 and k2 much greater than k1, cannot be distinguished from each other and could lead to erroneous conclusions if additional information is not used to identify the correct ratio. When k2/k1 greater than 0.5, the calculated parameters are extremely sensitive to experimental errors, and other techniques involving the concentrations of starting material and intermediate should be used to obtain the rate constants. PMID- 2709326 TI - Effects of anorectic drugs on the topography of feeding behavior in baboons. AB - Food intake of six adult male baboons (Papio c. anubis) was monitored during daily experimental sessions lasting 22 hr. Food was available under a chain schedule with two-components. After completion of the first "procurement component" 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 10 min in which no response occurred, the consumption component was terminated. When given p.o. 45 to 60 min before the start of the daily session, anorectic drugs, with the exception of (+/-)-phenylpropanolamine, produced dose-dependent decreases in food intake, with the following order of potency: phentermine greater than mazindol greater than diethylpropion greater than phendimetrazine = chlortermine = phenmetrazine = chlorphentermine. Feeding topography was differentially affected by drug administration. The latency to the first meal was increased by all of the drugs except chlorphentermine. Only diethylpropion, phendimetrazine and mazindol decreased the number of daily meals, whereas only diethylpropion, phendimetrazine, phenmetrazine and clortermine decreased the size of the first meal. Mazindol was the only anorectic drug tested that did not decrease intake during the first 8 hr of the session. (+/-) phenylpropanolamine did not decrease food intake in the tested dose range. Phencyclidine, by decreasing intake during the first 8 hr, but not the entire 22 hr session, affected feeding topography differently than the anorectic drugs. In contrast to anorectic drug administration, decreases in food intake after phencyclidine administration were followed by caloric compensation for this initial decrease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709327 TI - Nonlinear dopamine pharmacokinetics in pediatric patients. AB - Dopamine steady-state concentrations were determined in 15 pediatric patients from 3 days to eight years of age receiving continuous infusions of dopamine. The first-order kinetic model does not accurately describe the kinetics of dopamine in these patients based on the finding that clearance varied as a function of concentration. A saturable protein binding model is described and provides a more accurate description of the behavior of the data. Using multivariate analysis, changes in dopamine kinetics were found as a function of weight. Furthermore, the co-administration of dobutamine altered the kinetics of dopamine. These data support the use of free dopamine concentrations rather than total concentration for studies of dopamine pharmacokinetics. Evaluation of total clearance of dopamine is of limited value, and changes in protein binding and intrinsic clearance must be considered in future studies of this drug. PMID- 2709328 TI - Schedule induction of drug intake: differential responsiveness to agents with abuse potential. AB - In previous research, two groups of rats exposed to a fixed time (FT) 1-min schedule of food-pellet delivery exhibited equal schedule-induced polydipsia for water vehicle and a 0.05 mg/ml solution of midazolam, respectively. Exposure to FT schedule values greater than 1 min (3 and 5 min) resulted in greater milliliter per pellet intakes of midazolam than of water, perhaps reflecting the reinforcing efficacy of the drug. To determine if drugs with unequivocal reinforcing efficacy display similar elevations at the larger FT values, solutions of cocaine and ethanol, but also of the equivocally reinforcing agents chlordiazepoxide and flurazepam, as well as water, were offered to groups of rats at concentrations isoacceptable under FT 1-min schedule-induction conditions. Under the FT 1-min schedule, separate groups of rats drank equal and excessive amounts of water, cocaine (0.15 mg/ml), ethanol (2.5% v/v), chlordiazepoxide (0.25 mg/ml) and flurazepam (0.175 mg/ml). Differential group milliliter per pellet intakes occurred under larger FT values: ethanol, cocaine and midazolam yielded greater values than water, chlordiazepoxide or flurazepam. Schedule induced drug intake perhaps offers a method for evaluating the oral abuse potential of a drug under conditions which generate a variety of behavioral excesses and may potentiate intrinsic reinforcing efficacy. PMID- 2709329 TI - Effect of 1-(m-chlorophenyl)piperazine and 1-(m-trifluoromethylphenyl)piperazine on locomotor activity. AB - The piperazine-type 5-hydroxytryptamine (5-HT) agonists 1-(m trifluoromethylphenyl)piperazine (TFMPP), 1-(m-chlorophenyl)-piperazine (m-CPP), 1-(p-chlorophenyl)piperazine (p-CPP) and MK-212 [6-chloro-2-(1 piperazinyl)pyrazine], produced a dose-dependent suppression of spontaneous ambulatory behavior in rats. Pretreatment with the 5-HT antagonists metergoline, methysergide or mianserin, but not selective 5-HT2 or catecholamine antagonists, blocked the reduction of activity caused by TFMPP suggesting that the stimulation of 5-HT receptors was involved in causing this behavioral effect. Other behavioral signs of 5-HT receptor stimulation, such as the 5-HT behavioral syndrome or head-shaking behavior, were not observed in rats injected with TFMPP, m-CPP or MK-212 except at toxic doses. The ability of piperazine agonists to reduce locomotor activity in rats was altered by long-term changes in 5-HT neurotransmission. The destruction of 5-HT neurons by i.v.t. injection of the neurotoxin 5,7-dihydroxytryptamine potentiated the ability of m-CPP to inhibit ambulatory behavior. On the other hand, elevating 5-HT content by administering the monoamine oxidase inhibitors phenelzine or nialamide for 7 days reduced the ability of m-CPP to suppress locomotor activity. Acute administration of the monoamine oxidase inhibitors, or chronic administration of other antidepressants such as desmethylimipramine or iprindole, failed to alter m-CPPs activity suppressant effects. These studies suggest that chronic changes in 5-HT neurotransmission produce compensatory changes which alter the behavioral response to these piperazine agonists. Taken together with other evidence that both TFMPP and m-CPP are agonists at 5-HT1B and 5-HT1C receptors, the effects of TFMPP and m-CPP on locomotor activity may be associated with the selective activation of 5-HT1C, or possibly 5-HT1B, receptors. PMID- 2709330 TI - Comparative inhibitory effects of various physostigmine analogs against acetyl- and butyrylcholinesterases. AB - A number of carbamoyl- and N(1)-substituted analogs of physostigmine were synthesized and their in vitro potencies (IC50 values) vs. human erythrocyte and brain (cerebral cortex and caudate nucleus) acetylcholinesterase (AChE) and electric eel AChE and against human brain and plasma butyrylcholinesterase (BChE) were compared to the potencies of physostigmine and other traditional anticholinesterases. In general, increasingly hydrophobic, simple nonbranching carbamoyl groups (as in octyl-, butyl- and benzylcarbamoyl eseroline) did not greatly alter potency vs. AChE whereas increasingly hydrophobic N(1) substitutions [i.e., N(1)-allyl-, -phenethyl and -benzylphysostigmine] decreased potency vs. AChE. In contrast, increasing the hydrophobicity of both the carbamoyl and N(1) groups increased the potency of the compound against BChE. Furthermore, quaternarization at the N(1) position (physostigmine methosulfate) increased potency vs. AChE but reduced potency vs. BChE. Bulky, branched carbamoyl groups (e.g., N-benzyl-N-benzyl-allophanyl eseroline) were all poor anticholinesterases. N-phenylcarbamoyl eseroline was as potent as benzylcarbamoyl eseroline against AChE yet was 50 to 100 times less potent than the benzyl analog vs. BChE. Therefore, the phenyl substitution appears to increase greatly the selectivity of the compound for AChE. Although it is not possible to determine whether physostigmine analogs that are potent in vitro might be of interest in vivo, these results do show that the structure of physostigmine can be changed significantly while retaining biological activity. PMID- 2709331 TI - Muscarinic actions and receptor binding of the enantiomers of BM 130, an alkylating analog of oxotremorine. AB - The enantiomers of the oxotremorine analog N-[4-(2-chloromethylpyrrolidine)-2 butynyl]-2-pyrrolidone (BM 130) were synthesized. The LD50 values of (+)- and (-) BM 130 in mice (i.v.) were 10.4 +/- 1.4 and 13.5 +/- 1.9 mumol/kg, respectively. Atropine and N-methylatropine poorly protected against the lethal effects, suggesting that they were nonmuscarinic in nature. When administered i.v. to mice, (+)- and (-)-BM 130 were equipotent in producing peripheral and central muscarinic effects. ED50 values were 1.3 to 1.4, 2.8 to 3.2 and 0.20 to 0.26 mumol/kg, respectively, for salivation, tremor and analgesia (tail-flick assay). After i.p. injection, tremor was not observed and analgesic potency was reduced more than 10-fold compared to the i.v. route. The aziridinium ions [(+)- and (-) BM 130A], formed by spontaneous cyclization of (+)- and (-)-BM 130, were virtually equipotent in eliciting contractions of the isolated guinea pig ileum and in causing salivation in mice. Their LD50 values in mice (i.v.) were 1.1 +/- 0.2 and 2.1 +/- 0.3 mumol/kg, respectively. The enantiomers of BM 130A had similar affinity for muscarinic receptors in the rat cerebral cortex as measured by competitive inhibition of (-)-[3H]N-methylscopolamine binding at 0 degrees C. The rate constants for alkylation of muscarinic receptors, obtained at 37 degrees C by measuring the decline in (-)-[3H]-3-quinuclidinyl benzilate binding to cortical homogenates that had been treated with various concentrations of (+)- and (-)-BM 130A for 20, 45 or 90 min, differed significantly for the two enantiomers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709332 TI - Regional brain abnormalities in norepinephrine uptake and dopamine beta hydroxylase activity in the genetically epilepsy-prone rat. AB - Two markers for noradrenergic neurons: 1) desmethylimipramine sensitive norepinephrine (NE) uptake and 2) dopamine beta-hydroxylase activity were compared in various brain regions of normal and genetically epilepsy-prone rats (GEPR). These studies were designed to characterize further the nature of the noradrenergic deficit in GEPRs, which has been described as a reduction in steady state NE levels. The high affinity (desmethylimipramine-sensitive) uptake of 3H NE into crude synaptosomes was found to be significantly reduced in widespread areas of the GEPR forebrain including cortex, hippocampus, amygdala and hypothalamus. GEPRs also displayed a reduced uptake of 3H-NE in synaptosomes from the inferior colliculus, a structure that has been implicated in the audiogenic seizure, but other regions of the brain stem (reticular formation, cochlear nucleus, cerebellum) failed to reveal abnormalities in NE uptake. Reductions in dopamine beta-hydroxylase activity seemed to parallel the reductions in NE uptake regionally (except for the caudate nucleus), and both deficits (uptake and dopamine beta-hydroxylase) were similar in magnitude to the decrements in steady state NE levels reported previously. The present findings therefore support the concept that there is a reduction in the number of noradrenergic terminals in most structures receiving noradrenergic innervations in the GEPR brain. PMID- 2709333 TI - Parallel first-order and Michaelis-Menten elimination kinetics of ethanol. Respective role of alcohol dehydrogenase (ADH), non-ADH and first-order pathways. AB - Elimination kinetics of ethanol without (control group) and with pyrazole [alcohol dehydrogenase (ADH) inhibitor] pretreatment was studied with changing the i.v. dose amount to evaluate the respective role of ADH and non-ADH pathways in a rabbit. The moment analysis of the blood ethanol concentration-time curves showed that the normalized area under the blood ethanol concentration-time curve and the first moment increase with increasing dose amount in the control and pyrazole-pretreated groups. These increases suggested the capacity-limited elimination of ethanol through pyrazole-insensitive non-ADH pathways as well as through ADH pathway as pyrazole would fully block the oxidation of ethanol through ADH pathway. The simultaneous multiline fitting using time curves after five different doses also was attempted to determine the pharmacokinetic model by the application of minimum Akaike's information criterion estimation. Akaike's information criterion, consequently, showed the minimum for a two-compartment model with parallel first-order and Michaelis-Menten elimination kinetics. The computer analysis using this model yielded almost the same values of the volume of distribution and of the first-order elimination rate constant between both groups. The distribution of ethanol and the first-order elimination process were not influenced by pyrazole treatment. Km (0.57 mg/ml) of the pyrazole-pretreated group was higher than Km (0.03 mg/ml) of the control group. These results suggest that ADH pathway is readily saturated and non-ADH pathways are unsaturated over the wide range of concentration. The first-order process as well as non-ADH pathways are concluded to occupy the considerable part in the ethanol elimination at higher blood concentration. PMID- 2709334 TI - Early increases in pulmonary mRNA encoding procollagens and transforming growth factor-beta in mice sensitive to cyclophosphamide-induced pulmonary fibrosis. AB - Pulmonary fibrosis was induced 7 weeks after a single i.p. injection of cyclophosphamide (200 mg/kg b.wt.) in BALB/c mice; C57Bl/6 mice were unaffected. There was a corresponding strain variation in the effects of cyclophosphamide on levels of pulmonary mRNA encoding alpha 2I and alpha 1III procollagen, and transforming growth factor-beta. In BALB/c mice, the ratios of alpha 2I and alpha 1III procollagen mRNA to polyadenylated RNA were increased 1 week after cyclophosphamide injection. No increases in levels of either procollagen mRNA occurred in C57Bl/6 mice. The ratio of fibronectin mRNA to polyadenylated RNA was elevated to a similar extent in both murine strains during the 1st week after cyclophosphamide treatment. The pulmonary content of transforming growth factor beta mRNA and its ratio to polyadenylated RNA increased 2-fold at 1 and 2 weeks in BALB/c but not C57Bl/6 mice. Thus, collagen accumulation in cyclophosphamide sensitive mice is preceded by increased pulmonary alpha 2I and alpha 1III procollagen mRNA. The early strain selective elevation of transforming growth factor-beta mRNA in response to cyclophosphamide suggests a role, in vivo, for transforming growth factor-beta in drug-induced pulmonary fibrosis. PMID- 2709335 TI - Stimulation of histamine H2 receptor in rat hypothalamus releases endogenous norepinephrine. AB - The effect of histamine (HA) on the release of endogenous norepinephrine (NE) from superfused rat hypothalamic and striatal slices was assessed. Measurements were made by high-performance liquid chromatography with electrochemical detection. Superfusion with HA (0.1-80 microM) resulted in a concentration dependent increase (10-220%) of NE release from hypothalamus but was ineffective in the striatum. The process was Ca++-dependent and was unaffected by blockade of monoamine oxidase. The H2 agonists, dimaprit (50 microM) and impromidine (10 microM), increased NE release from hypothalamic slices 3-fold and 2-fold, respectively. Tiotidine (10 microM), an H2 antagonist, did not alter the spontaneous release of NE but completely abolished the effect of dimaprit. To increase the ability of the tissue to sustain NE release on repeated stimulation, tyrosine was added to the perfusion medium. Under these conditions 10 microM HA produced, in two consecutive stimuli, a 1.9-fold increase. Two consecutive stimuli by 80 microM HA elicited a 3.2- and a 2.9-fold increase. Under the same conditions, 50 microM ranitidine, another H2 antagonist, but not pyrilamine, an H1 antagonist, completely blocked the effect of 10 microM HA. Although NE release was increased in the presence of tyrosine, tyrosine did not increase the tissue levels of NE. These experiments imply that H2 receptor activation increases release of NE from the rat hypothalamus. Since in the hypothalamic slice, noradrenergic nerve endings are cut from their cell bodies, the modulatory event must have occurred at the nerve terminals. PMID- 2709336 TI - Differential inhibition by ergonovine of norepinephrine release in the coronary artery and saphenous vein of the dog. AB - Experiments were performed to determine the effect of ergonovine on adrenergic neurotransmission in the blood vessel wall. Strips of canine left circumflex coronary arteries and saphenous veins were incubated with [3H]norepinephrine and suspended for superfusion. Ergonovine (10(-6) M) decreased the overflow of [3H] norepinephrine to a modest degree in the coronary artery, whereas a profound inhibition of overflow was observed in the saphenous vein. Methiothepin, but not rauwolscine, reversed the inhibitory effect of ergonovine in both blood vessels. Treatment with atropine or droperidol did not alter the response to ergonovine in the coronary artery. The results demonstrate that ergonovine, by activating prejunctional serotonergic receptors, inhibits adrenergic neurotransmission to a greater extent in the saphenous vein than in the coronary artery. The differential effect of ergonovine on norepinephrine release in these vessels may provide evidence for heterogeneity in the prejunctional modulation of adrenergic neurotransmission. PMID- 2709337 TI - Effect of diltiazem on regional oxygenation of reperfused myocardium. AB - Reperfusion after 2 hr of experimental ischemia results in reduced blood flow to the reperfused region, as well as elevated regional O2 extraction in that region. The aim of the present study was to determine whether diltiazem, administered during reperfusion, can improve regional blood flow and lower O2 extraction in the previously occluded region. In open-chest anesthetized dogs, 2-hr occlusion of the left anterior descending coronary artery was followed by a 4-hr period of reperfusion. In 7 of the 15 animals, diltiazem (0.45 micrograms/kg/min) was infused i.v. during the reperfusion period; this was preceded by a loading dose of 0.18 micrograms/kg 10 min before release. Small artery and vein O2 saturations obtained microspectrophotometrically were combined with regional blood flow measurements using radioactive microspheres to determine regional myocardial O2 consumption. In both groups, coronary occlusion lowered regional flow to a similar level. After a 4-hr reperfusion, flow to the subendocardial region of treated hearts was significantly greater than that to the untreated reperfused myocardium (75.6 +/- 46.4 vs. 40.3 +/- 25.8 ml/min/100 g), and did not differ from the preocclusion level. The subendocardium/subepicardium flow ratio was reversed in occluded and untreated reperfused myocardium (subendocardium flow less than subepicardium flow), but was not reversed in treated reperfused regions. Myocardial oxygen extraction was 11.0 +/- 2.4 ml of O2/100 ml of blood in the untreated reperfused subendocardium, and was significantly decreased to 8.5 +/- 0.9 ml of O2/100 ml in the treated subendocardium. The proportion of individual veins having O2 saturations below 25% was significantly reduced by diltiazem treatment from 45.2 to 22.7%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709338 TI - Comparison of ribosomal and isozymic phylogenies of tetrahymenine ciliates. AB - A recent analysis of sequence variations in ribosomal RNA's from 31 species of tetrahymenine ciliates groups them into 9 sets referred to as "ribosets." These species associations are not well correlated with the distributions of distinctive morphological characteristics. The phylogenetic structure suggests that modern "pyriform" tetrahymenines may be paraphyletic survivors of primitive design and that the morphologically distinctive forms may include examples of convergent evolution of derived forms. Alternatively, the common ancestor may have been a polymorphic species that has lost its plasticity in some derived lineages. In an attempt to test the ribosomal phylogeny, we here compare it with a phylogeny based on isozymic variation. The main features of the ribosomal and isozymic phylogenies are similar. The carnivorous (macrostome-forming) species are widely scattered in both, as are the bacteriophagous pyriform species. Isozymic and ribosomal analyses are optimally useful, however, in different contexts. Isozymic variations can distinguish species that are ribosomally identical. Ribosomal variations provide more secure evaluations of distant relationships. PMID- 2709339 TI - Glutathione in Tetrahymena thermophila. AB - In Tetrahymena, glutathione is synthesized from the same precursors as it is in higher animals and is present in similar intracellular concentrations. The intracellular thiol-disulfide ratio is also identical to that of mammalian tissues, due to the activity of glutathione reductase. The intracellular GSH level was found to be dependent on the sulfur-containing amino acids in the chemically defined medium. PMID- 2709340 TI - Two classes of channel-specific toxins from funnel web spider venom. AB - 1. The paralytic effects and neuromuscular actions of Agelenopsis aperta venom on insects were analyzed biochemically and electrophysiologically. 2. Paralysis caused by Agelenopsis venom is correlated with two effects on neuromuscular transmission: postsynaptic inhibition and presynaptic excitation. These effects are explained by the actions of two classes of toxins purified by RPLC, the alpha and mu-agatoxins. 3. The alpha-agatoxins are low molecular weight, acylpolyamines which cause rapid, reversible paralysis correlated with use dependent postsynaptic block of EPSPs and ionophoretic glutamate potentials. The mu-agatoxins are cysteine-rich polypeptides which cause irreversible paralysis and repetitive action potentials originating in presynaptic axons or nerve terminals. 4. The joint actions of the alpha- and mu-agatoxins lead to significantly higher rates of paralysis than are obtained by either toxin class alone, and this may relate to enhancement by excitatory mu-agatoxins of use dependent block caused by alpha-agatoxins. PMID- 2709341 TI - Spectral sensitivity in jumping spiders (Araneae, Salticidae). AB - 1. We report here a psychophysical technique for studying the spectral sensitivity of jumping spiders (family Salticidae), based on a newly discovered oculomotor reflex. 2. Our results, obtained from Maevia inclemens (Salticidae), are compatible with electrophysiological findings of retinal cells maximally sensitive in the green and ultraviolet regions of the spectrum. 3. Sensitivity to longer wavelengths (greater than 650 nm) has been controversial. In our study jumping spiders are shown to have a broad spectral sensitivity function extending from the ultraviolet (330 nm) to the deep red (700 nm). PMID- 2709342 TI - GABAergic inhibition shapes temporal and spatial response properties of pyramidal cells in the electrosensory lateral line lobe of gymnotiform fish. AB - 1. The amplitude-coding pyramidal neurons of the first-order nucleus in weakly electric gymnotiform fish (Eigenmannia), the electrosensory lateral line lobe (ELL), exhibit 2 major physiological transformations of primary afferent input. Pyramidal cells rapidly adapt to a step change in amplitude, and they have a center/surround receptive-field organization. This study examined the physiological role of GABAergic inhibition on pyramidal cells. GABAergic synapses onto the somata of pyramidal cells primarily originate from granule-cell interneurons along with descending input. 2. Pyramidal cells fall into two physiologically distinct categories: E units, which are excited by a rise in stimulus amplitude, and I units, which are inhibited by a rise in stimulus amplitude. Microiontophoretic application of bicuculline methiodide onto both types of pyramidal cells increased the time constant of adaptation, defined as the time required for the neuron's response to decay to 37% of its maximum value, by 70-90%. The peak firing rate of E units to a step increase in stimulus amplitude increased by 49%, while the firing rate of I units did not change significantly. 3. Bicuculline application demonstrated that GABAergic inhibition may contribute to the strict segregation of E and I response properties. In the presence of bicuculline, many E units (normally excited only by stimulus amplitude increases) became excited by both increases and decreases; many I units (normally excited only by amplitude decreases) also became excited to increases. 4. The size of the excitatory receptive-field of E units was not affected by bicuculline, although response magnitude increased. The inhibitory surround increased in spatial extent by 175% with bicuculline administration. Neither the size of the I unit receptive-field center nor the response magnitude changed in the presence of bicuculline. The antagonistic surround of I units, however, increased by 49%. 5. The anatomy of the ELL is well understood (see Carr and Maler 1986). The physiological results obtained in this study, along with the results of Bastian (1986a, b), further our understanding of the functional role of the ELL circuitry. Our results suggest that spatial and temporal response properties of pyramidal cells are regulated by different but interacting inhibitory interneurons, some of which use GABA as a neurotransmitter. The activity of these interneurons is in turn controlled by descending feedback systems. PMID- 2709343 TI - Spectral and polarized light sensitivity of photoreceptors in the compound eye of the cricket (Gryllus bimaculatus). AB - Retinula cells in the compound eye of the cricket (Gryllus bimaculatus) were recorded intracellularly and stained with Lucifer yellow. Two different methods were used to determine the spectral sensitivity of these cells: a) the spectral scanning method, and b) the conventional flash method. Three spectral types, with S(lambda)-curves close to the rhodopsin-absorption functions, were found with lambda max at 332 nm (UV), 445 nm (blue) and 515 nm (green), respectively. Blue receptors were only recorded in the anatomically specialized dorsal rim area (DRA), and UV and green receptors in the dorsal region of the pigmented part of the eye, whereby green receptors were only found in the ventral eye. On the basis of these results, model calculations are presented for di- and trichromatic colour vision in the cricket. The fluorescence markings revealed green receptors whose axons project with short visual fibres to the lamina, and a UV receptor with a long visual fibre which projects through the lamina to the medulla. The blue receptors send their axons either to the lamina and medulla (long visual fibres) or only to the lamina (short visual fibres). The temporal dynamics of the three receptor types were examined. The blue receptors lack a phasic component of the receptor potential, and the time from stimulus on-set to peak potential is strongly increased compared to the UV and green receptors. Light adaptation reduces the latency to less than half of the dark adapted state. Spectral adaptation experiments revealed an 'unidirectional coupling' between UV and green receptors, and it was found that polarization sensitivity (PS) in blue cells was much higher (PS = 6.5 +/- 1.5) than that of UV (PS = 1.76 +/- 0.05) and green (2.26 +/- 0.57) receptors. The functional aspects of the three receptor types are discussed with respect to the presented physiological and morphological data. PMID- 2709344 TI - Bi-coordinate sound localization by the barn owl. AB - 1. Binaurally time-shifted and intensity-unbalanced noise, delivered through earphones, induced owls to respond with a head-orienting behavior similar to that which occurs to free field auditory stimuli. 2. Owls derived the azimuthal and elevational coordinates of a sound from a combination of interaural time difference (ITD) and interaural intensity difference (IID). 3. IID and ITD each contained information about the azimuth and elevation of the signal. Thus, IID and ITD formed a coordinate system in which the axes were non-orthogonal. 4. ITD was a strong determinant of azimuth, and IID was a strong determinant of elevation, of elicited head turn. PMID- 2709345 TI - Computers and psychiatric clients. PMID- 2709346 TI - Caring for clients with legal charges on a voluntary psychiatric unit. PMID- 2709347 TI - Drug abuse. A self-care deficit. PMID- 2709348 TI - The clinical nurse specialist on the psychiatric team. PMID- 2709349 TI - Tardive dyskinesia. A reader responds. PMID- 2709350 TI - Social skills training. A program to help schizophrenic clients cope. PMID- 2709351 TI - Leg pain: an uncommon presentation of perforated diverticular disease. AB - Five cases of perforated diverticular disease are described in which pain in the thigh or leg was the predominant symptom. In four patients pyrexia or leucocytosis were present and three patients ultimately developed surgical emphysema in the left thigh. In retroperitoneal perforation of the colon, the symptoms in the leg may overshadow those in the abdomen and lead to delay in diagnosis. PMID- 2709352 TI - Is long-term follow-up of all colorectal cancer necessary? AB - To assess the value of long-term clinical follow-up of patients after 'curative' colorectal resections, 114 such patients were studied. Of the 100 patients in whom full follow-up was possible, 38% suffered a recurrence and less than 25% of these were discovered at a routine outpatient attendance. No long-term cures were achieved as a result of treatment of any recurrence. Indefinite follow-up of all patients by simple clinical assessment in the outpatient clinic after colorectal resection appears to be of limited value. More intensive short-term follow-up of high-risk groups may provide a greater yield of treatable recurrences. Adoption of this policy should lead to improved efficiency for the hospital in terms of time saved in outpatient attendance and the concentration of resources on those most likely to benefit from follow-up. PMID- 2709353 TI - Obstructing carcinoma of the left colon managed by subtotal colectomy. AB - Obstructing carcinomas of the left colon are traditionally managed with a staged resection, as immediate colonic anastomosis is associated with a high risk of anastomotic dehiscence. We have prospectively performed total or subtotal colectomy in 18 consecutive patients presenting with obstruction at or distal to the splenic flexure. The operative mortality was 11%, which compared favourably with the results of other methods of surgical management. The procedure is safe and no cases of anastomotic dehiscence occurred. Subtotal colectomy achieves in a single procedure relief of the obstruction, tumour resection and restoration of gut continuity whilst allowing resection of synchronous lesions and eliminating the risk of metachronous tumour. Frequent liquid stool was not a significant sequel of a subtotal colectomy in this series. PMID- 2709354 TI - Staging laparotomy in early Hodgkin's disease: a surgical view. AB - Fifty consecutive patients with early Hodgkin's disease underwent staging laparotomy. There were no deaths and most complications were minor. As a consequence, 17 (34%) patients were upstaged from clinical stage I or II to pathological stage III or IV. Subdiaphragmatic disease was found in five out of 22 patients with nodular sclerosing, seven out of ten with lymphocyte predominant and four out of 13 patients with mixed cellularity histological type. The age, sex, preoperative clinical stage and mediastinal involvement did not correlate with the presence of intra-abdominal disease. Among 15 patients with a normal preoperative computed tomography (CT) scan, nine had intra-abdominal disease at laparotomy and all three patients with suggested subdiaphragmatic involvement by the CT scan examination were clear. The surgeon's ability to diagnose early involvement at laparotomy was also limited. There seems to be a continued need for staging laparotomy to ensure adequate treatment of one-third of patients with early Hodgkin's disease. PMID- 2709356 TI - Surgical management of patent ductus arteriosus. A review of 413 cases. AB - Ligation under controlled hypotension is a simple, quick and effective surgical management of patent ductus arteriosus. In this study 413 cases are reviewed: clinical presentations, cardiac catheterization and operative findings are studied in relation to the surgical procedures. Ligation of the ductus was the treatment of choice in 357 cases irrespective of the age and size of the ductus with only four instances of recanalization which needed religation. Other procedures included division and suture, patch aortoplasty, transaortic patch and transpulmonary closure under profound hypothermia and arrest. There were two deaths and only five major types of morbidities described. PMID- 2709355 TI - Epidural adhesions after chymopapain chemonucleolysis. AB - Epidural adhesions were discovered in seven of nine patients undergoing surgery for failed chymopapain chemonucleolysis. Clinically the adhesions were very vascular, prolific and adherent to the nerve root, dura and the porieties. The histological composition was similar to the normal tissues of the epidural space from the post-mortem controls and also to adhesions discovered at surgery in a non-injected patient, except that there was an increase in fibrous tissue, which was poorly cellular. There was no evidence of an inflammatory infiltrate. Such adhesions may partly explain the failure of chemonucleolysis and prejudice the success of surgery by potentiating further adhesion formation. PMID- 2709357 TI - A quarter of a century of portasystemic shunting for oesophageal varices. AB - Seventy-three patients who had received portasystemic shunts were reviewed to assess the current role of this procedure in the treatment of portal hypertension. Survival at 1, 5 and 10 years was 85%, 68% and 45% respectively. Survival was significantly greater (P less than 0.001) in Child's grade A patients compared with Child's grade B patients and in non-alcoholics compared with alcoholics. Previously absent encephalopathy developed in 43% of those with non-selective shunts compared with 21% of those with selective shunts. Six of the 12 patients who experienced recurrent variceal haemorrhage had associated shunt thrombosis: five of these required further shunts or oesophageal transection to control their bleeding and the other patient died before further surgery could be instituted. Shunt surgery still has a role in the treatment of a small number of carefully selected patients with portal hypertension. PMID- 2709358 TI - Carcinoma of the penis--the Groote Schuur Hospital experience. AB - The records of 62 patients with carcinoma of the penis seen at Groote Schuur Hospital between 1968 and 1985 were analysed retrospectively. Jackson's staging system was used - 44% of patients were stage 1, 27% stage 2, 19% stage 3 and 10% stage 4. The results of treatment in each stage are outlined. Overall 65% of patients were alive and free of disease at follow-up while 24% died. The overall five-year survival rate was 56%. The management of the inguinal nodes is discussed. Early sentinel node biopsy is recommended, as clinical inguinal node assessment is inaccurate and late detection of inguinal node metastases is associated with a poor prognosis. PMID- 2709359 TI - Adenolymphoma of the larynx. PMID- 2709360 TI - Gastrobronchial fistula and pancreatic heterotopia. PMID- 2709361 TI - Fixation of undisplaced femoral neck fractures using a cannulated screw system: technique of minimal trauma. PMID- 2709362 TI - Obturating anorectal tube for transanal resection of rectal tumours. PMID- 2709363 TI - Vascular complications of diagnostic angiography via limb arteries. PMID- 2709364 TI - Appraisal of the Angelchik anti-reflux prosthesis based on clinical and manometric data and pH monitoring. AB - Data are presented from manometric and prolonged pH monitoring studies in 11 patients in whom the Angelchik anti-reflux prosthesis was inserted for control of symptomatic gastro-oesophageal reflux. Symptomatic and objective improvement was seen in the majority of our patients, although three suffered major side effects (erosion of prosthesis into the stomach in two, severe dysphagia in one). Impaired lower oesophageal sphincter relaxation noted after operation may explain both the transient dysphagia observed in five patients and the reduction in reflux episodes. Improvement in oesophageal acid clearance may result from fixation of the oesophagus within the abdomen by the device. While continued use of the prosthesis should be viewed with caution, it is effective and may have a place in the management of selected patients. PMID- 2709365 TI - Reaction paper to "The Future of Public Health" report: a missed opportunity. PMID- 2709366 TI - Effects of flossing on plaque and gingivitis in third grade schoolchildren. AB - The purpose of this investigation was to determine whether flossing, as an adjunct to toothbrushing, performed in a school-based program can contribute significantly to a reduction in gingivitis. Four volunteer third grade classrooms (n = 112) were randomly assigned to finger-floss, looped-floss, flossholder, and brushing-only control group. Measures taken at baseline and in four weeks included gingival (GI), plaque (PI), and flossing dexterity indices (FDI). Results using ANOVA showed no differences in PI among groups. However, both brushing-only and finger-floss groups showed GI scores significantly lower than the looped-floss group. A repeated measures ANOVA revealed that the finger-floss group improved gingivitis scores most over time, while the flossholder group improved scores the least. The ANCOVA results with FDI showed that at the final measurement, looped-floss manual dexterity was rated significantly better than finger-floss and that both groups were rated better than flossholder. Final indications are that toothbrushing alone can produce clinical results similar to use of a combination of toothbrushing and flossing. PMID- 2709367 TI - Development of the Occupational Safety and Health Administration's proposed standard to protect workers from contracting bloodborne diseases in the workplace. AB - The Occupational Safety and Health Administration (OSHA) is in the process of developing a health standard to protect workers by reducing occupational exposure to hepatitis B virus, human immunodeficiency virus, and other bloodborne pathogens. This article reviews the history of the standard, the steps involved in OSHA standard development, and--most specifically--how the dental professional can participate in this process. PMID- 2709368 TI - Comments by the American Association of Public Health Dentistry on dental activities of the Department of Health and Human Services. PMID- 2709369 TI - Reaction paper to "The Future of Public Health" report: implications for public health dentistry. PMID- 2709370 TI - 18-cycloalkyl analogues of enisoprost. AB - By use of standard cuprate methodology, a series of 18-cycloalkyl analogues of enisoprost was prepared in an effort to impede omega chain metabolism and prolong duration of gastric antisecretory activity. An initial product of omega chain oxidation, the C-20 hydroxy analogue, was also synthesized for pharmacological comparison. The cyclopropyl, cyclobutyl, and cyclopentyl analogues were approximately one-fourth as potent as enisoprost in inhibiting gastric acid secretion, while the cyclohexyl and cycloheptyl analogues showed very weak activity, and the 20-hydroxy compound was inactive at a dose 100 times the ED50 of enisoprost. The cyclobutyl compound had a longer duration of antisecretory action than enisoprost and the other cycloalkyl analogues. The cycloalkyl analogues unexpectedly possessed low diarrheogenic activity in rats. PMID- 2709371 TI - 2,3-Dihydro-5-benzofuranols as antioxidant-based inhibitors of leukotriene biosynthesis. AB - The enzymes that catalyze the oxidative metabolism of arachidonic acid have provided fertile ground for the development of useful therapeutic agents for nearly a quarter century. Inhibitors of the enzyme cyclooxygenase prevent the formation of the prostaglandins and thromboxanes and are clinically useful antiinflammatories and peripheral analgesics. More recently it has been discovered that the enzyme 5-lipoxygenase is the first step in the formation of a series of biologically important metabolites of arachidonic acid, the leukotrienes. Evidence suggests that an inhibitor of 5-lipoxygenase may be a useful therapeutic agent in the treatment of asthma, immediate hypersensitivity, and inflammation. Various antioxidants have been examined as inhibitors of 5 lipoxygenase in vitro. We were intrigued by recent reports that the 2,3-dihydro-5 benzofuranol ring system maximizes the stereoelectronic effects necessary for efficient hydrogen atom abstraction by peroxyl radicals. In this study we describe the synthesis of over 50 new 2,3-dihydro-5-benzofuranols and their biological evaluation as inhibitors of leukotriene biosynthesis in isolated human polymorphonuclear leukocytes. We show that the 2,3-dihydro-5-benzofuranol ring system, although not a potent inhibitor of leukotriene biosynthesis in itself, can provide a useful template for the design of antioxidant-based inhibitors of leukotriene biosynthesis. Furthermore, within a structural class the potency of a given analogue can be predicted on the basis of its overall calculated lipophilicity (log P). The data are interpreted in terms of a model in which the observed inhibition by this class of inhibitors is dependent on the intrinsic ability of the antioxidant to reduce the enzyme and on the fraction of the inhibitor that is partitioned into the membrane. PMID- 2709372 TI - In vitro antiproliferative activity of 4-substituted 2-(2 hydroxyphenyl)thiazolines on murine leukemia cells. AB - Two previously synthesized and two structurally novel thiazoline iron chelators are described. N4-Benzyl-N1,N8-bis[[2-(2-hydroxyphenyl)thiazolin-4-yl]carbonyl] homospermidine (5) proved to be the most potent antiproliferative and cytocidal compound in the series with in vitro IC50 values of 3 and 1 microM on L1210 and P388 murine cell lines. The N4-acetyl analogue 7 was considerably less active than 5 with IC50 and cell viability values that were similar to those of the structurally simple thiazolines 2 and 3. The antiproliferative activity of 3 and 7 could be substantially reduced or ablated by delivery to cell suspensions as a 1:1 molar mixture with FeCl3, while the activity of 5 was unaffected by Fe(III) chelation. As expected, 3 induced a G1/S cell cycle block at the 100 microM block consistent with interference with DNA synthesis while 10 microM 5 did not affect L1210 cell cycle distribution. Tritiated thymidine incorporation studies confirmed that 5 was incapable of interfering with DNA synthesis at concentrations below 40 microM. Alkaline elution studies indicate that 5 does not cause DNA strand breaks in vitro at concentrations of 10 microM. The N4-benzyl group of 5 appears to impart in vitro potency as the N4-acetyl analogue 7 lacks comparable in vitro antiproliferative and cytocidal activity. PMID- 2709373 TI - Electrophilic derivatives of purines as irreversible inhibitors of A1 adenosine receptors. AB - Functionalized congeners derived from 1,3-dipropyl-8-phenylxanthine and from N6 phenyladenosine were derivatized to contain electrophilic groups (isothiocyanate, N-hydroxysuccinimide ester, maleimide, sulfonyl chloride, or alpha-haloacyl group) capable of reaction with nucleophiles on biopolymers. The goal was to inhibit chemically the A1 adenosine receptor by using reactive agonist and antagonist ligands. Some of the electrophilic derivatives were synthesized through acylation of amine-functionalized congeners using hetero- or homobifunctional reagents available for protein cross-linking. The affinity for A1 adenosine receptors was evaluated in competitive binding assays by using rat and bovine brain membranes. Several xanthine and adenosine thiourea derivatives prepared from 1,3- and 1,4-phenylene diisothiocyanate (DITC) were potent irreversible inhibitors of adenosine receptors. Derivatives of m-DITC, at concentrations between 10 and 500 nM, irreversibly eliminated binding at 90% of the A1-receptor sites. Receptor affinity of both xanthine and adenosine derivatives containing distal phenylthiourea substituents was diminished by electron-donating groups on the ring. PMID- 2709374 TI - Aromatic dienoyl tetramic acids. Novel antibacterial agents with activity against anaerobes and staphylococci. AB - Streptolydigin (1) and tirandamycin A (2) are typical members of the naturally occurring class of 3-dienoyl tetramic acids. These compounds, which possess potent antibacterial activity particularly against anaerobes, have been shown to inhibit bacterial RNA polymerase. In contrast, tenuazonic acid (5), which lacks a complex dioxabicyclononane moiety and diene chromophore present in 1 and 2, exhibits essentially no antimicrobial activity and has no effect on bacterial RNA polymerase, suggesting that one or both of these structural features may be critical for antibacterial activity. In this paper, we report on a novel series of synthetic dienoyl tetramic acids that lack a complex dioxabicyclononane unit. Several of these compounds, particularly 8T-W, exhibit potent antimicrobial activity against Gram-positive and Gram-negative anaerobes as well as staphylococci. We will discuss the structure-activity relationship for this series of compounds which, in contrast to their natural counterparts, do not inhibit significantly RNA polymerase. We will also discuss preliminary results on the biochemical and microbiological properties of this series of compounds, several of which moderately inhibit supercoiling by DNA gyrase isolated from E. coli H560, although this enzyme has not been established as their target in whole cells. Compound 8W, which is not cross-resistant with DNA gyrase subunit A or B inhibitors or tirandamycin, has also been demonstrated to be rapidly bactericidal. PMID- 2709375 TI - New hydrogen-bond potentials for use in determining energetically favorable binding sites on molecules of known structure. AB - An empirical energy function designed to calculate the interaction energy of a chemical probe group, such as a carbonyl oxygen or an amine nitrogen atom, with a target molecule has been developed. This function is used to determine the sites where ligands, such as drugs, may bind to a chosen target molecule which may be a protein, a nucleic acid, a polysaccharide, or a small organic molecule. The energy function is composed of a Lennard-Jones, an electrostatic and a hydrogen bonding term. The latter is dependent on the length and orientation of the hydrogen bond and also on the chemical nature of the hydrogen-bonding atoms. These terms have been formulated by fitting to experimental observations of hydrogen bonds in crystal structures. In the calculations, thermal motion of the hydrogen-bonding hydrogen atoms and lone-pair electrons may be taken into account. For example, in a alcoholic hydroxyl group, the hydrogen may rotate around the C-O bond at the observed tetrahedral angle. In a histidine residue, a hydrogen atom may be bonded to either of the two imidazole nitrogens and movement of this hydrogen will cause a redistribution of charge which is dependent on the nature of the probe group and the surrounding environment. The shape of some of the energy functions is demonstrated on molecules of pharmacological interest. PMID- 2709376 TI - Retinobenzoic acids. 3. Structure-activity relationships of retinoidal azobenzene 4-carboxylic acids and stilbene-4-carboxylic acids. AB - Alkyl-substituted azobenzene-4-carboxylic acids are potent differentiation inducers of human promyelocytic leukemia cell line HL-60 to mature granulocytes. Their structure-activity relationships are very similar to those of other retinoidal benzoic acids which are generally represented by 4 and named retinobenzoic acids. The structure-activity relationships of azobenzenecarboxylic acids can also be applied to the known retinoid TTNPB (3). Thus, (E)-4-[2-(3,4 diisopropylphenyl)-1-propenyl]benzoic acid (St30 (28] and (E)-4-[2-(3-tert butylphenyl)ethenyl]benzoic acid (St40 (29], the acyclic alkyl analogues of TTNPB, are nearly as active as retinoic acid. Among the oxidatively derived compounds (Az90, Ep series and Ox series) of azobenzene- or stilbenecarboxylic acids, Az90 (71) and Ep80 (61) have strong activities. However, all the bishydroxylated derivatives of TTNPB are inactive, while a diketo analogue Ox580 (69) has only weak potency. The activities of conformationally restricted compounds of TTNPB offer some information on the stereochemistry of the active form of these retinoidal compounds. PMID- 2709377 TI - Peripherally acting enkephalin analogues. 2. Polar tri- and tetrapeptides. AB - The design, synthesis, and biological activity of a series of D-Arg2-enkephalin derived tetrapeptide amides and tripeptide aralkylamides are reported. These polar analogues were designed to be excluded from the central nervous system with their action thus limited to peripheral opioid receptors. The effects of the nature of the aromatic ring, aryl ring substitution, and aralkylamine chain length on activity were investigated; in a number of cases the N-terminal amino group of Tyr1 was converted to a guanidino group to further increase hydrophilicity. The peptides were all synthesized by classical solution methodology. The opioid activity of the peptides was assessed in vitro on the guinea pig ileum and their antinociceptive activity was determined in vivo in chemically induced writhing models (peripheral activity) and in the hot-plate test (central activity), in rodents. That the analgesic effects were predominantly mediated in the periphery was demonstrated by antagonism of antinociception by the peripheral opioid antagonist N-methylnalorphine and by comparison of the activities in the writhing and hot-plate tests. As a class, the tetrapeptides were more potent than the tripeptides; N alpha-amidination generally increased activity. A number of compounds exhibited very potent opioid activity and had the desired pharmacological profile, indicating a high degree of peripheral selectivity. PMID- 2709378 TI - Dynamics and thermodynamics of the counterion effect in a 7H-pyridocarbazole dimer (ditercalinium). Hypothesis of a nonbisintercalative binding mode to calf thymus DNA at high drug/base ratio. AB - Ditercalinium, a 7H-pyridocarbazole dimer designed to bisintercalate into DNA, forms tight ion pairs in water with inorganic and organic anions. The thermodynamics and kinetics of the acetate-ditercalinium pairing has been investigated by means of T-jump spectroscopy. The formation of the pair has a constant estimated to 1000 M-1 and proceeds via a fast two-step mechanism with a relaxation time of 12 microseconds (acetate pH 5) to 50 microseconds (cacodylate, pH 7.5) involving an intermediate solvent-separated ion pair. A strong association of ditercalinium to cardiolipid has been observed and is expected to be involved in the respiratory chain inhibition induced by ditercalinium (unpublished results). Direct estimates of the binding constants of the drug to calf thymus DNA were obtained by means of UV titrations at high drug/base ratio (greater than 0.17). The maximum number of binding sites per base both at pH 5 and pH 7.5 was found to be 0.22, a value consistent with monointercalation as expected from the prediction of Shafer's model for the interaction of bifunctional ligands to DNA. This work also supports the hypothesis that significant ionic binding may account for the ditercalinium/DNA interaction at high base/drug ratios (0.2). PMID- 2709379 TI - A multisubstrate adduct inhibitor of a purine biosynthetic enzyme with a picomolar dissociation constant. PMID- 2709380 TI - Synthesis of 5-[1-hydroxy(or methoxy)-2-bromo(or chloro)ethyl]-2'-deoxyuridines and related halohydrin analogues with antiviral and cytotoxic activity. AB - A series of new 5-(1-hydroxy-2-haloethyl)-2'-deoxyuridines (3, 6, 8) were synthesized in 60-70% yields by addition of HOX (X = Br, Cl, I) to the vinyl substituent of the respective 5-vinyl-2'-deoxyuridines (2, 5, 7). Treatment of 3a,b with methanolic sulfuric acid afforded the corresponding 5-(1-methoxy-2 haloethyl)-2'-(deoxyuridines (4a,b). The 5-(1-hydroxy-2-chloroethyl) (3b), 5-(1 methoxy-2-bromoethyl) (4a), 5-(1-hydroxy-2-bromo-2-(ethoxycarbonyl)ethyl) (6a), and 5-(1-hydroxy-2-iodo-2-(ethoxycarbonyl)ethyl) (6b) derivatives exhibited in vitro antiviral activity (ID50 = 0.1-1 microgram/mL range) against herpes simplex virus type 1 (HSV-1). 5-(1-Hydroxy-2-bromo-2-(ethoxycarbonyl)-ethyl)-2' deoxyuridine (6a) was the most active cytotoxic agent in the in vitro L1210 screen exhibiting an ED50 of 11 micrograms/mL relative to melphalan (ED50 = 0.15 micrograms/mL). PMID- 2709381 TI - Synthesis and biological evaluation of certain C-4 substituted pyrazolo[3,4 b]pyridine nucleosides. AB - A series of C-4 substituted pyrazolo[3,4-b]pyridine nucleosides have been synthesized and evaluated for their biological activity. Successful synthesis of various C-4 substituted pyrazolo[3,4-b]pyridine nucleosides involves nucleophilic displacement by a suitable nucleophile at the C-4 position of 4-chloro-1H pyrazolo[3,4-b]pyridine (5), followed by glycosylation of the sodium salt of the C-4 substituted pyrazolo[3,4-b]pyridines with a protected alpha halopentofuranose. Use of this methodology furnished a simple and direct route to the beta-D-ribofuranosyl, beta-D-arabinofuranosyl, and 2-deoxy-beta-D-erythro pentofuranosyl nucleosides of C-4 substituted pyrazolo[3,4-b]pyridines, wherein the C-4 substituent was azido, amino, methoxy, chloro, or oxo. The regiospecificity of these glycosylations was determined on the basis of UV data and the anomeric configuration was established by 1H NMR analysis. Conclusive structural assignment was made by a single-crystal X-ray diffraction study of three compounds, 15, 31, and 42, as representatives of ribo-2'-deoxy-, and aranucleosides, respectively. The stereospecific attachment of all three alpha halogenoses appears to occur by a Walden inversion (SN2 mechanism) at the C-1 carbon of the halogenose by the anionic N-1 of pyrazolo[3,4-b]pyridine. All deprotected nucleosides were tested against various viruses and tumor cells in culture. The effects of these compounds on de novo purine and pyrimidine nucleotide biosynthesis was also evaluated. Among the compounds tested, 4-chloro 1-beta-D-ribofuranosylpyrazolo[3,4-b]pyridine (16) and 1-beta-D-ribofuranosyl-4,7 dihydro-4-oxopyrazolo[3,4-b]pyridine (19) were found to be moderately cytotoxic to L1210 and WI-L2 in culture. PMID- 2709382 TI - The binding of benzenesulfonamides to carbonic anhydrase enzyme. A molecular mechanics study and quantitative structure-activity relationships. AB - Molecular mechanics methods have been applied to study the interaction between a series of 20 deprotonated benzenesulfonamides and the enzyme carbonic anhydrase. The different contributions to the binding energy have been evaluated and correlated with experimental inhibition data and molecular orbital indices of the sulfonamides in their bound conformation. The results suggest that the discrimination shown by the enzyme toward these inhibitors is dominated by the short-range van der Waals forces. PMID- 2709384 TI - Design and synthesis of inhibitors of N8-acetylspermidine deacetylase. AB - Analogues of N8-acetylspermidine (1) were synthesized as potential inhibitors of the cytoplasmic enzyme N8-acetylspermidine deacetylase. The compounds were assayed for their ability to inhibit the deacetylation of 1 in a cytosolic fraction from rat liver. The apparent Ki values were determined by Dixon plots. The apparent Km of 1 for this enzyme is 11.0 microM. It was found that compounds which lacked the N1 or the N4 of spermidine were less effective at competing for the enzyme than the substrate. All compounds with acyl substituents larger than acetyl were less potent inhibitors than the corresponding acetylated derivatives. Thus, the enzyme's selectivity as a deacetylase seems to be attributable to steric hindrance which occurs with larger acyl groups. The N8 of the substrate is not essential for its binding to the enzyme. Replacement of N8 with a CH2 group gives the ketone 14, which has an apparent Ki of 0.18 microM, 60-fold lower than the apparent Km of 1. The inhibitory potency of 14 is retained in compounds substituted at the N1 position. The N1,N1-dimethyl and the N1,N1-diethyl analogues (15 and 16) of 14 have apparent Ki values of 0.096 and 0.10 microM, respectively. These agents are the most potent inhibitors of N8-acetylspermidine deacetylase reported, and they are promising tools for use in determining the physiological function of N8-acetylspermidine deacetylation. PMID- 2709383 TI - Synthesis and pharmacological evaluation of 4,4-disubstituted piperidines. AB - A new class of piperidine derivatives is added to the increasing family of compounds related to fentanyl and carfentanil. Herein, we describe the synthesis and pharmacology of a number of 1-(arylethyl)-4-(acylamino)-4-[(acyloxy) methyl]piperidines such as 9, 15, and 23. As expected, many of these congeners of fentanyl are extremely potent narcotic agonists. The aim of the study was to identify short-acting analgesic agents (i.e. less than 6 min in the mouse hot plate assay) for possible use in the surgical theater. Many of the drugs proved to be of intermediate and long duration (i.e. 6-15 min and greater than 15 min, respectively). In addition to analgesic activity, many of the compounds exhibited anesthetic properties as well. The structure-activity relationship for these entities is presented and discussed. PMID- 2709385 TI - Renal vasodilators. The role of the 4-substituent in isoquinolin-3-ol cardiovascular agents: 4-ureido derivatives of isoquinolin-3-ol with selective renal vasodilator properties. AB - The synthesis and cardiovascular evaluation of a series of isoquinolin-3-ol derivatives bearing a variety of nitrogen substituents (amino, acylamino, carbamate, and ureido) at C-4 are described. Certain of these compounds have a selective renal vasodilating profile and have minimal effects on arterial blood pressure or heart rate when administered intravenously in the instrumented anesthetized dog. The most potent renal vasodilator in the series is 4 (allylureido)-6,7-dimethoxyisoquinolin-3-ol (38), which at a dose of 1.2 mg/kg iv produces a 97% maximal increase in renal blood flow without significant hypotensive or chronotropic effects. Structure-activity observations on the nature of the 4-substituent and the alkoxy substitution pattern in the aromatic ring of the isoquinolinol nucleus are discussed. PMID- 2709386 TI - Enzyme-linked immunosorbent assay to detect antigens of Dirofilaria immitis (Spirunida: Filariidae) larvae in Aedes albopictus and Culex tritaeniorhynchus (Diptera: Culicidae). AB - An enzyme-linked immunosorbent assay (ELISA) method was developed for detecting the larval antigens of Dirofilaria immitis (Leidy) in Aedes albopictus (Skuse) and Culex tritaeniorhynchus Giles to replace the conventional dissection method. The assay was sensitive enough to detect 21.3 ng/ml (2.13 ng per microplate well) or more of the soluble antigen obtained from adult worms and an antigen amount corresponding to at least one larva at any developing stage. No inhibitory effect of host tissues was observed on the ELISA reaction even when the homogenate of 20 mosquitoes was included in the 1-ml ELISA diluent. Moreover, third-stage larval antigen could be detected readily when mixed with up to 100 mosquito heads. The ELISA method has been effective in field surveys of mosquito populations with low filarial infection rates. PMID- 2709387 TI - Competence of a rabbit-feeding Ixodes (Acari: Ixodidae) as a vector of the Lyme disease spirochete. AB - We compared the development of the Lyme disease spirochete, Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt and Brenner, in subadult rabbit-feeding Ixodes dentatus Marx with that in mouse-feeding I. dammini Spielman, Clifford, Piesman and Corwin. Rabbits were infected with spirochetes by the bites of I. dammini that had been infected naturally in a zoonotic site. Larval ticks of both species were permitted to engorge simultaneously on each of these infected hosts. Spirochetes were present in the guts of about half of the resulting nymphal I. dentatus and most of the I. dammini that developed. An experimentally infected nymphal I. dentatus, in turn, infected a rabbit. Because I. dentatus feeds solely on rabbits, and these hosts may be extraordinarily abundant in nature, this tick provides potential for a hidden enzootic cycle of natural Lyme disease transmission. PMID- 2709388 TI - Overwintering survival of Aedes albopictus (Diptera: Culicidae) eggs in Indiana. AB - Eggs of 12 strains of Aedes albopictus (Skuse), two strains of A. aegypti L., and one strain of A. triseriatus (Say) were tested for ability to overwinter at three outdoor locations in Indiana. Some survival of A. albopictus eggs was observed during the winters of 1986-1987 and 1987-1988. A. triseriatus had greater overwintering ability than A. albopictus; A. aegypti did not survive at all locations. Prolonged cold-conditioning and photoperiodically induced diapause increased the overwintering ability of A. albopictus eggs. Strains of A. albopictus from northern Asia and North America showed higher overwintering survival rates than A. albopictus strains from tropical Asia, Hawaii, and Brazil; strains from Indiana had greater ability to overwinter than those from Texas, Louisiana, and Florida. Results are discussed in relation to the overwintering limits of this species in the United States. PMID- 2709389 TI - Ixodes dammini (Acari: Ixodidae) in Indiana. AB - Ixodes dammini Spielman, Clifford, Piesman and Corwin is reported from Indiana for the first time. Four specimens were taken from deer and one from a dog. All specimens are adult females and all were collected in 1987. The significance of this finding is discussed. PMID- 2709390 TI - Effect of cocaine in tissues on the development rate of Boettcherisca peregrina (Diptera: Sarcophagidae). AB - Larvae of the flesh fly, Boettcherisca peregrina (Robineau-Desvoidy), were reared on the tissue of rabbits to study the effects of cocaine and benzoylecognine on development rates. The rabbits were given 35, 69, and 137 mg of cocaine through cardiac puncture. From hours 30 to 70, larvae developed more rapidly on tissue containing cocaine, benzoylecognine, or both, from rabbits injected with 69 and 137 mg of cocaine than on tissue from rabbits injected with 35 mg of cocaine or no cocaine. Total development times required for pupation and adult eclosion were shortened correspondingly. Differences observed in the rate of development were sufficient to alter postmortem interval estimates based on larval development in decomposing human tissues by up to 24 h. PMID- 2709391 TI - Dichotomous electrophoretic taxonomic key for identification of sibling species A, B, and C of the Anopheles quadrimaculatus complex (Diptera: Culicidae). AB - Samples of 17 populations of Anopheles quadrimaculatus Say from Florida, Alabama, Arkansas, Louisiana, Mississippi, Tennessee, New York, and New Jersey were analyzed for genetic variability at 33 enzyme loci. Statistical analysis of electromorph frequency distributions indicated that sympatric sibling (morphologically indistinguishable) species occurred in about 59% of the populations tested. The association of polytene chromosome and electrophoretic patterns of individual field-collected females confirmed species-specific diagnostic allozymes, which were useful in identifying sibling species A, B, and C and in estimating the proportions of each species at the 17 collection sites. A dichotomous electrophoretic key is presented for the identification of sibling species of the An. quadrimaculatus complex. The electrophoretic method is better than the ovarian polytene chromosome method, because mosquitoes of both sexes and females irrespective of their gonotrophic condition can be identified. PMID- 2709392 TI - Deleted Yq in the sterile son of a man with a satellited Y chromosome (Yqs). AB - Disturbed spermatogenesis and azoospermia are reported in a man with a deleted Y chromosome. The anomalous Y chromosome appears in the karyotype as a small metacentric marker. In situ hybridisation using three different Y specific DNA probes shows that deletion at Yq11 has resulted in loss of all distal heterochromatin. The sterility of the patient indicates loss also of the azoospermia factor (AZF) located at the Yq distal euchromatic/heterochromatic interface. Microspread and air dried meiotic preparations show a severe impairment of spermatogenesis but rare cells are seen to be progressing to the late prophase stage. The testicular histology shows most of the seminiferous tubules to be completely hyalinised. The father and a fertile brother of the proband show a satellited Y chromosome (Yqs) in their karyotypes. The case appears to be the first of its kind reported in which a father with a satellited Y chromosome has produced a son carrying a different Y chromosome anomaly. The possible derivation of the one from the other is discussed. PMID- 2709393 TI - Does lumbosacral spina bifida arise by failure of neural folding or by defective canalisation? AB - The aim of this study was to determine whether open lumbosacral spina bifida results from an abnormality of neural folding (primary neurulation) or medullary cord canalisation (secondary neurulation). Homozygous curly tail (ct) mouse embryos were studied as a model system for human neural tube defects. The rostral end of the spina bifida was found to lie at the level of somites 27 to 32 in over 90% of affected ct/ct embryos. Indian ink marking experiments using non-mutant embryos showed that the posterior neuropore closes, and primary neurulation is completed, at the level of somites 32 to 34. Since neurulation in mammals progresses in a craniocaudal sequence, without overlap between regions of primary and secondary neurulation, we conclude that spina bifida in ct/ct embryos arises initially as a defect of primary neurulation. The position of posterior neuropore closure in human embryos is estimated to lie at the level of the future second sacral segment indicating that in humans, as in the ct mouse, lumbosacral spina bifida usually arises as a defect of posterior neuropore closure. Cranial NTD affect females predominantly, whereas lower spinal NTD are more common in males, both in humans and ct mice. We offer an explanation for this phenomenon based on (a) differences in the effect of embryonic growth retardation on the likelihood that an embryo will develop either cranial or lower spinal NTD and (b) differences in the rate of growth and development of male and female embryos at the time of neurulation. PMID- 2709394 TI - Distribution of haptoglobin phenotypes in oesophageal and gastric cancer. AB - Haptoglobin (Hp) phenotypes were studied in 72 oesophageal and 104 gastric cancer patients and compared with 100 healthy controls to see if there is any association between oesophageal and gastric cancer and haptoglobin type. There was a significantly increased frequency of Hp 2-1 (59.7%) and Hp 2-2 (91.3%) in oesophageal and gastric cancer patients. Our results suggest that genetic factors play a role in the aetiology and pathogenesis of gastrointestinal tract malignancy. PMID- 2709395 TI - Unilateral absence of the hand in second cousins. AB - This paper reports two second cousins with absence of the left hand. PMID- 2709397 TI - Absent or hypoplastic extraocular muscles? PMID- 2709396 TI - Identification and characterisation of a small marker chromosome using non isotopic in situ hybridisation with X and Y specific probes. AB - A 13 year old male with mild mental retardation, obesity, and poor secondary sexual differentiation was found to have a 46,X,+,mar karyotype. In situ hybridisation with X and Y specific probes proved the marker to be composed of Y centromeric and short arm material. PMID- 2709398 TI - Chimpanzees in captivity: humane handling and breeding within the confines imposed by medical research and testing. Position paper for the Jane Goodall Institute Workshop on Psychological Well-Being of Captive Chimpanzees 1st to 3rd December, 1987. PMID- 2709399 TI - Movement characteristics of ejaculated sperm from cynomolgus monkeys (Macaca fascicularis) analyzed by manual and automated computerized image analysis. AB - Sperm motility is an important indicator of male reproductive function. An automated computerized system was used to measure the movement characteristics of cynomolgus monkey sperm. Swimming velocities were in good agreement with data derived from tracking sperm heads manually with a digitizer, but sperm counting by the system was erroneous. In some ejaculates, there were two subpopulations of sperm with different curvilinear velocities, linearities of swim-paths, and lateral movements of the heads. PMID- 2709400 TI - Energy filtered STEM imaging of thick biological sections. AB - Energy filtered imaging of thick biological specimens was analysed using a dedicated STEM fitted with an energy loss spectrometer and interfaced with a sophisticated data collection setup. All images were digital, thus permitting a quantitative analysis of the data. We also present a mathematical explanation of the data, which is useful in predicting the quality of thick specimen images formed with energy filtered electrons. It is known that increasing specimen thickness leads to a decrease of the zero energy loss intensity and an increase in higher (multiply scattered) energy loss electrons. We show that contrast decreases gradually with increased energy loss but, most important, the signal to noise ratio is maximal at an energy loss position slightly below the intensity maximum. This is the optimal position for imaging thick specimens. Moreover our studies confirm that the following parameters have similar effects on the energy loss spectra: (1) increased thickness (t); (2) higher average Z number elements (or lower mean free path); and (3) lower primary voltage (V0). PMID- 2709401 TI - Magnification changes produced by cover slip compensation rings on microscope objectives. PMID- 2709402 TI - Examination of mucosal surfaces by scanning electron microscopy before and after removal of debris. AB - A rapid method is described whereby gastrointestinal biopsy specimen surfaces can be examined by scanning electron microscopy with overlying tract contents (debris) intact, and also re-examined after cleaning to determine the structure of the underlying mucosal surface. The conductive coating of gold is removed using mercury, a non-wetting agent. The specimen surface is suitably cleaned of debris after a brief ultrasonication in absolute ethanol which mixes with the transitional fluid (CO2) used for critical point drying. PMID- 2709403 TI - Phospholipid, nature's own slide and cover slip for cryo-electron microscopy. AB - Thin films of surface-active compounds, with or without particulate material, can be obtained by immersing and withdrawing a bare specimen grid from a solution/suspension of the compound. Immediately after withdrawing the grid, thinning of the film starts. Thinning is initially powered by gravity and capillary forces and will proceed in thin films (less than 100 nm) driven by intermolecular forces until the London-van der Waals attractive forces come to an equilibrium with electrostatic repulsion of similarly charged surfaces of the film. With small unilamellar vesicles prepared from the phospholipid dimyristoyl phosphatidyl choline (DMPC) the draining behaviour of these films was studied by cryo-electron microscopy. Small unilamellar vesicles were observed within the film as well as the coalescence of these vesicles into sheets ('leaky' membrane fusion). Sheets dominate the images when films are allowed to drain for longer periods (greater than 3 min). Thin films were formed on grids from catalase crystals suspended in a DMPC suspension and vitrified by cooling. High-resolution information was obtained by electron diffraction at low temperature and under low dose conditions from catalase crystals surrounded by small vesicles as well as from catalase crystals surrounded by sheets of DMPC. In the latter case the water content drops from 99% (DMPC in small vesicles) to less than 30% (DMPC in sheets) during draining. Ferritin was added to a DMPC suspension and thin films were prepared and vitrified. After prolonged draining ferritin molecules were deposited in layers with a stepwise increase in thickness. Draining of thin films has thus a dehydrating effect as well as a sorting and ordering effect. These effects must be considered when using surface-active compounds at air-water interfaces as a slide and cover slip for electron microscopy. PMID- 2709404 TI - A no-moving-parts video rate laser beam scanning type 2 confocal reflected/transmission microscope. PMID- 2709405 TI - Three-dimensional visualization methods for confocal microscopy. AB - Three-dimensional images of microscopic objects can be obtained by confocal scanning laser microscopy (CSLM). The imaging process in a CSLM consists of sampling a specific volume in the object and storing the result in a three dimensional memory array of a digital computer. Methods are needed to visualize these images. In this paper three methods are discussed, each suitable in a specific area of application. For purposes where realistic rendering of solid or semi-transparent objects is required, an algorithm based on simulation of a fluorescence process is most suitable. When speed is essential, as for interactive purposes, a simple procedure to generate anaglyphs can be used. Both methods have in common that they require no previous interpretation or analysis of the image. When the study of an object imaged by CSLM involves analysis in terms of a geometrical model, sophisticated graphics techniques can be used to display the results of the analysis. PMID- 2709406 TI - Three-dimensional molecular distribution in single cells analysed using the digital imaging microscope. AB - Cellular changes in molecular distribution are believed to underly a wide range of cell functions. In order to investigate changes in molecular distribution in single cells utilizing fluorescent probes we have developed a digital imaging microscope. The system, consisting of both hardware and software, automatically acquires 3-D data sets consisting of optical sections and then processes such data to facilitate the analysis of molecular distribution in single cells. The first major step in processing reverses distortion introduced principally by the optics of the fluorescent microscope. Various procedures for accomplishing this task are compared and a method based on regularization theory is shown to give superior results for several different 3-D images. Following this step features of interest are automatically extracted from 3-D images utilizing an artificial 3 D visual system. This artificial visual system utilize a system of spatial filters to identify regional characteristics of images, the information obtained from these filters being used to identify and characterize clusters of molecules within the image. This information is then utilized to construct a 3-D graphical model of molecular distribution in single cells. Such models are displayed in 3-D and may further analysed utilizing interactive 3-D computer graphics. These methods are illustrated by results obtained regarding alpha-actinin distribution in single smooth muscle cells. PMID- 2709407 TI - Three-dimensional imaging in confocal systems. AB - We discuss the origin of the three-dimensional imaging characteristics of confocal optical systems. Several methods of information display are considered. The important practical question concerning the correct choice of limiting detector aperture is also considered. PMID- 2709408 TI - A confocal laser microscope scanner for digital recording of optical serial sections. AB - A confocal laser microscope scanner developed at our institute is described. Since an ordinary microscope is used, it is easy to view the specimen prior to scanning. Confocal imaging is obtained by laser spot illuminatin, and by focusing the reflected or fluorescent light from the specimen onto a pinhole aperture in front of the detector (a photomultiplier tube). Two rotating mirrors are used to scan the laser beam in a raster pattern. The scanner is controlled by a microprocessor which coordinated scanning, data display, and data transfer to a host computer equipped with an array processor. Digital images with up to 1024x1024 pixels and 256 grey levels can be recorded. The optical sectioning property of confocal scanning is used to record thin (about 1 microm) sections of a specimen without the need for mechanical sectioning. By using computer-control to adjust the focus of the microscope, a stack of consecutive sections can be automatically recorded. A computer is then used to display the 3-D structure of the specimen. It is also possible to obtain quantitative information, both geometric and photometric. In addition to confocal laser scanning, it is easy to perform non-confocal laser scanning, or to use conventional microscopic illumination techniques for (non-confocal) scanning. The design has proved reliable and stable, requiring very few adjustments and realignments. Results obtained with this scanner are reported, and some limitations of the technique are discussed. PMID- 2709409 TI - Three-dimensional X-ray microscopy with accurate registration of tomographic sections. AB - X-ray microtomography has been used to study the internal flaws and external shape of a 0.75 X 1 mm copper sulphate crystal at a resolution of 25 microns. The problems of accurate tomographic reconstruction and the subsequent registration of the reconstructed sections to give a complete 3-D image are considered when the position of the axis of rotation of the specimen varies slightly between projections. PMID- 2709410 TI - Reconstruction from stereo and multiple tilt electron microscope images of thick sections of embedded biological specimens using computer graphic methods. AB - The extraction and display of 3-D information using modern computer graphic equipment in the electron microscope is presented. Thick specimens were imaged at 400 kV. Modelling of vectors and the tilting of surfaces is discussed as is the accuracy of reconstructions. PMID- 2709411 TI - Recent trends in pulmonary resection. AB - The charts of 131 consecutive pulmonary resections were reviewed at the Jackson VA Medical Center and analyzed for trends in etiology, pathology and types of resection. Analysis of this group, as well as follow-up, are presented. We feel that this review has delineated some current trends in pulmonary resectional surgery and identified some areas for progress in the future. Only by careful assessment of one's work can one evaluate performance and plan for the future. PMID- 2709412 TI - Access to quality care for all Mississippians--the future. PMID- 2709413 TI - With compassion and respect for human dignity. PMID- 2709414 TI - Program offers supplementary counseling for HIV-positive persons. PMID- 2709415 TI - Hematogenous osteomyelitis and septic arthritis in children: a ten year review. PMID- 2709416 TI - Drug abuse and the physician. PMID- 2709417 TI - No property right to due process hearing. PMID- 2709418 TI - Ultrastructural changes in the seminiferous epithelium of two seasonally reproducing bats (Mammalia: Chiroptera). AB - The Sertoli cells of the Cape horseshoe bat (Rhinolophus capensis) and Schreiber's long-fingered bat (Miniopterus schreibersii) undergo marked changes in ultrastructure related to stages in the spermatogenic cycle. The amount of lipid stored in the Sertoli cells varies annually and is at a maximum from just after spermiation to early in the following spermatogenic cycle. During spermatogenesis, the diameter of the lipid droplets decreases, reaching a minimum prior to spermiation. Sertoli cells exhibit a marked apicobasal differentiation, particularly in the vicinity of developing late spermatids, where the cytoplasm of the Sertoli cell is packed with smooth endoplasmic reticulum. The possible roles of lipid droplets and smooth endoplasmic reticulum. The possible roles of lipid droplets and smooth endoplasmic reticulum in steroidogenesis by Sertoli cells are discussed. Junctional complexes occur between Sertoli cells and spermatogonia, are apparently absent from between Sertoli cells and spermatocytes, and are restricted to the region of the developing acrosome in the spermatids. Annulate lamellae, which occur commonly in the developing germinal cells and less frequently in the Sertoli cells, may be associated with the production of microtubules, which are present in both spermatids and Sertoli cells. PMID- 2709419 TI - Architecture and consequent physiological properties of the semitendinosus muscle in domestic goats. AB - Morphological and physiological analyses confirm that the semitendinosus muscle of goats contains two separate compartments in series, each with distinct innervation. These compartments of the muscle are in turn composed of short fibers (approximately four fibers in series in the proximal compartment and seven to eight fibers in the distal compartment) which overlap each other for more than 30% of their length, with much of the overlapping portions consisting of slender tails that terminate at one-tenth of the midfiber diameter. Groups of fibers are associated into relatively narrow bands that run end-to-end in each compartment. The data suggest that the maximum length of muscle fibers may be limited; even the fibers of parallel-fibered muscles may not scale with the dimension of the animal. PMID- 2709421 TI - A review: new discoveries allow oncogenes to reclaim limelight. PMID- 2709420 TI - Tumor cell societies. PMID- 2709422 TI - Many factors contribute to racial differences in cancer experience. PMID- 2709423 TI - Genotypic and phenotypic evidence of clonal interactions in murine tumor cells. AB - The stability of mixed tumor cell populations has been described in terms of phenotypic characteristics such as metastatic potential, immunogenicity, and drug resistance. We have extended these analyses to the molecular level in a model that uses transfection of the hemagglutinin antigen (HA) gene of influenza virus into murine CT-26 colorectal carcinoma cells. Transfection was followed by fluorescence-activated cell sorting (FACS) to select a parent population with expression of high levels of HA. We characterized this population (FACS-3) and four derived clones (5, 6, 9, and 18) over time with regard to phenotypic characteristics: immunogenicity and cross-protection against tumor challenge, cell surface expression of HA, evidence of HA gene amplification, and levels of HA mRNA. During 6 months in culture, the FACS-3 parent cells remained stable, but the individual clones varied for all of the parameters assessed. Among the clones, all possible molecular variations occurred, including changes in HA gene copy number (increased in clone 5 and decreased in clone 18), gene rearrangement (clone 5), decrease in HA mRNA (clones 6, 9, and 18), increase in HA mRNA (clone 5), and an abnormality in translational control or a posttranslational error. In all cases, the molecular changes correlated with cell surface HA expression, immunogenicity, and cross-protective potential. We conclude that in vitro clonal interactions play a role in stabilizing heterogeneity in this system. These studies show that even in the absence of selection, clonal interactions may alter the phenotype of tumors by increasing malignant progression or impeding tumor growth. PMID- 2709424 TI - Lack of comparability between binding of monoclonal antibodies to melanoma cells in vitro and localization in vivo. AB - The affinity and specificity of monoclonal antibodies (MAbs) to tumor-associated antigens are often determined by in vitro assays. The specific binding of two anti-human melanoma antibodies (96.5 and ZME-018) and a control antibody (ZCE 025) to three human melanoma cell lines (DX3, A375-M, and Hs294t) was examined under in vitro conditions and compared to in vivo localization of 111In-labeled antibodies to the same cells growing as solid tumors in the subcutis of nude mice. The in vitro binding of the specific MAbs to the tumor cells did not predict in vivo localization. Under in vitro conditions, MAb ZME-018 bound to all three cell lines at levels exceeding that of 96.5, yet ZME-018 did not show superior localization to subcutaneous tumors. MAb 96.5 bound to cultured DX3 cells at levels exceeding those observed with A375-M cells. Yet, 96.5 localized better to A375-M xenografts in nude mice than to DX3 or Hs294t xenografts. Antigen expression differed between in vitro and in vivo growing cells, as evidenced by alteration in binding of 96.5 to tumor cells dissociated from solid subcutaneous tumors. Collectively, the data suggest that in vitro parameters do not predict the clinically relevant localization of MAbs to tumors. PMID- 2709425 TI - On capital punishment. PMID- 2709426 TI - Cancer rate differentials between blacks and whites of three metropolitan areas. AB - This article presents a comparison of the cancer incidence and mortality rates for the populations of the metropolitan areas of Los Angeles, Atlanta, and Nashville. The results reveal that cancer of the lung, prostate, breast, and cervix should be of major concern to all, but especially to blacks and residents of Nashville. The findings have specific implications for the prevention of cancer in the black population of the United States. PMID- 2709427 TI - Circumstances of sexual and physical victimization of black psychiatric outpatients. AB - A sample of 54 adult psychiatric outpatients, previously identified as victims of sexual or physical assault, were interviewed regarding their childhood and adult victimization experiences. Patients were questioned about the nature of the assaults, their relationship to the perpetrator(s), the number of assaults suffered in each relationship, and whether the assault(s) occurred before or after the onset of their mental illness. Eighty percent of the sample had experienced major physical assault as an adult and 59% had experienced major physical assault as a child; 37% and 31%, respectively, reported major sexual assault as a child and as an adult. Women were more likely than men to report physical and sexual assault as an adult and sexual assault as a child. Childhood assault most often occurred before the onset of the patient's mental illness; whereas, adult sexual assault for women and physical and sexual assault for men was as likely to occur after the onset of the psychiatric disorder, suggesting an increased vulnerability to victimization for the adult mentally ill. PMID- 2709428 TI - Exploring the persistent black risk of low birthweight: findings from the GLOWBS Study. AB - Results are presented from the Galveston Low Birthweight Survey (GLOWBS) Study, a tri-ethnic survey (N = 1,179) of live, single births, conducted in Galveston, Texas, from 1986 to 1987. Four principal findings emerged pointing to a persistent black risk for low birthweight (less than 2,500g). First, black infants (2,997g) have significantly lower mean birthweight than either Anglos (3,281g) or Hispanics (3,270g). Second, blacks are at significantly higher risk of low birthweight than nonblacks (risk ratio = 1.71). Third, despite controlling for a variety of pregnancy- and health-related, psychosocial, socioeconomic, and health services factors (including even gestational length), being black still exerts a significant, inverse effect on birthweight (beta = -0.137). Fourth, of the above factors only gestational length (R2 = 0.39) accounts for more than a negligible amount of the total variance in birthweight among blacks. These findings are discussed, and several lines of follow-up research are proposed. PMID- 2709429 TI - Cystic fibrosis in blacks in Washington, DC: fifteen years' experience. AB - Controversies exist regarding the clinical presentation and characteristics of cystic fibrosis (CF) in American blacks. Between 1971 and 1986, 188 patients with CF (165 whites, 20 blacks, and 3 others) seen at Children's Hospital National Medical Center, Washington, DC, were evaluated for age at diagnosis, duration of symptoms prior to diagnosis, clinical presentations, initial sputum culture results, and weight and height at diagnosis. Comparisons between black and white patients revealed no statistically significant differences in average age at diagnosis, average duration of symptoms prior to diagnosis, average sweat electrolyte concentrations, or sputum culture results. A breakdown of presenting symptoms by race showed some points of disparity. About twice as many black patients as white patients (40% v 22%) presented with only pulmonary symptoms, whereas slightly more whites presented with only gastrointestinal symptoms (46% v 35%). Those patients presenting with a combination of symptomatology were equally distributed by race (25% black, 21% white). At diagnosis, age-adjusted weight percentiles were significantly lower for black patients than for white patients (chi 2 = 9.60, P less than or equal to 0.05). Although the authors agree that CF is relatively rare among blacks, a high index of suspicion is essential for early diagnosis. PMID- 2709430 TI - Is there evidence for a racial difference in misdiagnosis in patients explored for appendicitis? AB - A retrospective review was conducted to determine if there were identifiable racial markers in patients who were explored and misdiagnosed as having appendicitis. Between May 1983 and May 1987, 100 patients were explored for appendicitis. There were 65 whites and 35 blacks with a male predominance in each group. The age range was 4 to 70 years with a mean of 47 years; 30% of each group was in the pediatric age range (less than 17 years old). Eight patients had a normal appendix including two blacks: a 20-year-old male with no pathologic diagnosis and a 42-year-old female with a ruptured cornual pregnancy. Although the sample size was small, there was a trend toward a lower white blood cell count in blacks when appendicitis was confirmed at surgery (11,000 cells/microL +/- 3,000 v 17,000 cells/microL +/- 3,000). The following conclusions can be drawn: (1) the accuracy of diagnosis should be considerably lower than the 20% commonly quoted; (2) the likelihood of an incorrect diagnosis appears to be higher in adults in both groups without a sexual predilection; and (3) there may be a trend toward a higher initial white blood count in whites compared with blacks with acute appendicitis. PMID- 2709431 TI - Assessment of compliance with the expanded program on immunization schedule in King Khalid University Hospital. AB - Analysis of 1,068 immunization records was carried out to assess the degree of compliance with the expanded program on immunization (EPI) schedule in King Khalid University Hospital. The overall compliance was found to be 66%, whereas individual vaccine compliance ranged between 28% to 88%. These results show that the EPI schedule is not strictly followed in this institution. A modification of the EPI schedule and the consideration of other strategies are suggested to achieve 100% coverage by 1990. PMID- 2709432 TI - Effects of decreased dietary salt intake on blood pressure in preschool children. AB - Salt-restricted preschool black children, 4 to 5 years of age, were found to have significantly lower diastolic and systolic blood pressures than a matched group on a regular diet. The one exception was the systolic readings for the group of female children; no significant difference between restricted and regular salt diets was found. PMID- 2709433 TI - Wandering spleen presenting as an adnexal mass. AB - Wandering spleen is an uncommon entity. The authors report the fifth case of wandering spleen presenting as a left adnexal mass. PMID- 2709434 TI - Higher retention of manganese in suckling than in adult rats is not due to maturational differences in manganese uptake by rat small intestine. AB - To test the hypothesis that the high absorption of manganese (Mn) in suckling rats compared to weanling rats is due in part to maturational differences in mucosal cell uptake of Mn, uptake kinetics of Mn were examined in isolated brush border membrane vesicles prepared from the small intestine of rats at various ages (d 14, d 18, d 21). Initial uptake of Mn was rapid by vesicles from all age groups and reached an equilibrium plateau by 5 min in vesicles from suckling rats (d 14) and 10 min in vesicles from weanling rats (d 18, d 21). Uptake of Mn was associated with an osmotically active space. Uptake velocity was similar in all age groups and was nonsaturable at Mn concentration of 1-90 microM. The data were representative of a diffusional transport process. Mn uptake did not appear to be influenced by a putative ligand, L-histidine. However, incubations that included ascorbate did result in increased uptake of Mn by membrane vesicles. The results do not support the hypothesis that age-related differences in Mn retention in rats are due to maturational differences in the transport of Mn across small intestinal brush-border membranes. PMID- 2709435 TI - Multistrain experiments for screening toxic substances. AB - The advantages of using homogeneous experimental groups (inbred animal strains) and of using multiple groups within an experiment, based on the power of the Mantel-Haenszel test, were investigated. A simulation experiment was performed to empirically calculate the power of a one-sided Mantel-Haenszel test for multistrain experiments. In each case, the power of the multistrain experiment was compared to the (empirical) expected value, over strains, of the power where each strain is tested individually. In the simulation, use of subgroups, each having different response rates, resulted in an increase in power where a chemical exposure caused an average increase of effects in 10% or more of the animals across strains. PMID- 2709436 TI - Cutaneous absorption and decontamination of [3H]T-2 toxin in the rat model. AB - Cutaneous absorption and decontamination of [3H]T-2 mycotoxin using various treatment modalities incorporating water, detergent, sprays, and scrubbing of application sites were examined in the rat model at 5, 30, 60, and 1440 min (24 h) postexposure. Rats were killed immediately after treatment and radiolabeled T 2 remaining in full-thickness skin samples were determined. Absorption and decontamination were followed over time, and decontaminating treatment modalities were evaluated for efficacy. Less than 1% of the applied dose was absorbed in 5 min, and 50% was absorbed in 24 h. At 5 min, 99.5 +/- 0.05% of nonabsorbed (residual) [3H]T-2 was removed, and 58 +/- 5.2% of residual toxin was removed at 24 h with a 2.5% detergent/water spray. When treatment modalities were evaluated at 60 min, a 2.5% detergent/water scrub followed by a detergent/water spray produced optimal decontamination by removing 81 +/- 2.2% of residual toxin. All treatment modalities using detergent and/or water removed significant amounts of toxin (p less than or equal to .0001); a dry scrub was not efficacious. Treatment should be initiated as soon as possible after exposure for best results. However, the stratum corneum acts as a reservoir for the toxin, and decontamination should be carried out even if delayed several hours or days after exposure. Dermal absorption pharmacokinetics found in these studies are similar to those described for other low-molecular-weight compounds, and the decontamination results from T 2 toxin should be applicable to other, similar toxic substances. PMID- 2709437 TI - Cardiotoxic effects of the combined use of caffeine and isoproterenol in the minipig. AB - Beta agonists such as isoproterenol are widely used in the treatment of acute asthmatic attacks. It would not be unexpected that some patients receiving isoproterenol might have ingested caffeine as an over-the-counter drug or beverage. This study explores the possible interaction between these two drugs. Anesthetized minipigs were injected with 0.5 mg/kg caffeine iv followed by a 10 min infusion of 1 microgram/kg.min isoproterenol. Heart rate, EKG, respiration, and blood pressure were recorded continuously and the animals were sacrificed at 72 h. The two drugs in combination produced subtle changes in heart rate and blood pressure with significant alteration in the EKG tracing (premature ventricular contractions and extrasystoles). These changes persisted for 8 to 24 h. At autopsy both gross and microscopic lesions were noted in 10 of the 13 minipig hearts receiving the combination of drugs. This was not true of the six minipigs given only caffeine or the eight minipigs receiving only the infusion of isoproterenol. No changes in EKG tracings or pathologies were noted with caffeine and only two of eight animals infused with isoproterenol showed any lesions. Results indicate that doses of caffeine equivalent to that expected from drinking a cup of coffee appear to increase the toxicity of isoproterenol to a point that EKG changes and myocardial pathologies are observed. PMID- 2709438 TI - Comparison of the effects of diisopropylfluorophosphate, sarin, soman, and tabun on toxicity and brain acetylcholinesterase activity in mice. AB - The LD50s and ED50s for inhibition of acetylcholinesterase (AChE) in whole mouse brain by DFP (diisopropylfluorophosphate), sarin (methylphosphonofluoridic acid 1 methyl ethyl ester), soman (methylphosphonofluoridic acid 1,2,2-trimethyl propyl ester), and tabun (dimethylphosphoramidocyanidic acid ethyl ester) were compared after iv administration. The LD50s of DFP, sarin, soman, and tabun in ICR (Institute for Cancer Research) mice were 3.40, 0.109, 0.042, and 0.287 mg/kg, respectively. The recovery of AChE activity in whole mouse brain after sub-LD50 doses of these agents was slow and did not reach control values by 14 d after iv administration. AChE activity was inhibited in a dose-dependent manner in whole mouse brain, as well as in six brain regions (cortex, hippocampus, striatum, midbrain, medulla-pons, and cerebellum). None of these brain areas appeared to be particularly sensitive to AChE inhibition. The ED50s for DFP, sarin, soman, and tabun for inhibition of AChE in whole mouse brain were approximately 19, 38, 69, and 66% of their respective LD50s. Because of the differential potencies between lethality and inhibition of AChE, it is concluded that the lethality of these agents is due to more factors than simply the inhibition of AChE within the brain. PMID- 2709439 TI - Concerted role of carboxylesterases in the potentiation of carbofuran toxicity by iso-OMPA pretreatment. AB - Pretreatment of rats with the nonspecific esterase inhibitor iso-OMPA (1 mg/kg sc) 1 h prior to carbofuran (2,3-dihydro-2,2-dimethyl-7-benzofuranyl N methylcarbamate, 0.5 mg/kg sc) administration potentiated carbofuran toxicity by more than threefold. Neither iso-OMPA nor carbofuran in the given doses produced any gross toxic signs. Rats receiving combined treatment, however, showed severe hypercholinergic signs (salivation, tremors, muscle fasciculations, and convulsions) within 5-10 min following carbofuran administration, and the severity was comparatively greater than that observed with an acute dose of carbofuran (1.5 mg/kg sc). Rats pretreated with iso-OMPA (0.5 mg/kg) died within 10-15 min following the acute dose of carbofuran (1.5 mg/kg). Each drug when given alone (1.0 mg/kg iso-OMPA, 0.5 mg/kg carbofuran) caused a significant (p less than .01) inhibition of carboxylesterase (CarbE) activity in brain structures (cortex, stem, striatum, and hippocampus), skeletal muscle (hemidiaphragm), liver, and plasma, whereas acetylcholinesterase (AChE) activity remained significantly (p greater than .01) unchanged. The maximal CarbE inactivation in plasma (less than 14% remaining activity) following either drug indicated a tremendous nonspecific binding to non-AChE serine-containing enzymes. iso-OMPA pretreatment markedly potentiated carbofuran's anticholinesterase activity both in neuronal and in nonneuronal tissues. It can be concluded that iso-OMPA pretreatment potentiates carbofuran toxicity either by preventing nonspecific binding of carbofuran to CarbE and/or possibly by inhibiting its detoxification. PMID- 2709440 TI - In vitro influence of molybdenum on benzo[a]pyrene metabolism in hepatic and pulmonary rat microsomes. AB - Our study presents the in vitro molybdenum influence on benzo[a]pyrene (BaP) microsomal metabolism. Addition of various concentrations of different molybdenum salts [MoS2, MoCl5, (NH4)6Mo7O24 . 4H2O] to liver and lung microsomal fractions of rats previously treated with 3-methylcholanthrene produces a decrease in the different BaP metabolites assessed by high-performance liquid chromatography (HPLC) analysis. This inhibition varies, depending on the considered metabolite and in relation to both the molybdenum level and the origin of the microsomal suspension. The minimum effective concentration is 0.26 and 0.52 mM Mo from liver and lung, respectively. The inhibitory potencies of the +5 (chloride) and +6 (ammonium heptamolybdate) molybdenum compounds are comparable; that of the sulfide is lower. PMID- 2709441 TI - Effect of altered dose rate on NO2 uptake and transformation in isolated lungs. AB - While the pulmonary toxicity of NO2 is clearly established, the mechanism by which it is removed from inspired air is poorly understood. Uptake is most likely dependent on chemical reaction since, despite limited per se gaseous NO2 aqueous solubility, uptake proceeds rapidly without ready saturation. We utilized an isolated perfused rat lung model to characterize the effect of dose rate on uptake and transformation. Dose rate was varied via alterations in inspired concentration, tidal volume, and ventilation frequency. Dose equaled the total amount inhaled, uptake the amount removed from inspired air, and transformation the amount of NO2- that accumulated in the perfusate. We found a linear proportionality between both inspired concentration (4-20 ppm) and minute ventilation (45-130 ml/min) and uptake. Fractional uptakes (65%) were similar for all groups. Regression of combined concentration and minute ventilation data yielded a linear relationship between total inspired dose (25-330 micrograms NO2) and both uptake (r2 = 0.99) and transformation (r2 = 0.98). Testing of the functional descriptions resulted in measured uptakes and transformation that fell within a few percentage points of those predicted. We conclude that in acutely exposed isolated lungs (1) NO2 uptake is dependent on total inhaled dose rather than on the variables which serve to affect dose rate, (2) transformation is related to both total inspired dose and uptake, and (3) uptake is more accurately described using a regression equation rather than by use of fractional uptakes. PMID- 2709442 TI - Modulation of acetylcholine release by nicotinic receptors in the rat brain. AB - Since physostigmine (Phy) is presently used in the experimental treatment of Alzheimer disease (AD) patients by means of intracerebral ventricular (i.c.v.) administration, we designed a study to determine the effect of the drug administered by the same route on the cholinergic system of the rat brain. Particularly, we studied the involvement of nicotinic cholinergic function. The specific conditions required in this experiment were achieved by a series of short-lasting periods of acetylcholinesterase (AChE) inhibition leading to short lasting increases of acetylcholine (ACh). These were produced by periodic i.c.v. injections of Phy. At 7 days of Phy administration, a small effect on 3H-nicotine binding was seen only in the striatum of the injected side. In rats treated for 13 days, we observed a 120% increase in the stimulated release of 3H-ACh in hippocampal slices of the injected side of the brain. There also was a significant 88% increase in 3H-nicotinic binding in the hippocampus of the same side while muscarinic binding was unchanged. These results suggest a process of upregulation of presynaptic nicotinic autoreceptors in the hippocampus modulating ACh release but no effect on the muscarinic receptors. Our results also suggest that pulses of ACh in analogy to nicotinic stimulation can cause protracted desensitization and eventually inactivation of the receptor leading to its up regulation. These results are consistent with findings on the release of ACh from cortical biopsies and of a sustained ACh release in the CSF of AD patients following the same treatment. PMID- 2709443 TI - Potassium-stimulated calcium uptake in astrocytes and its potent inhibition by nimodipine. AB - Elevation of the extracellular potassium concentration above its "resting" level of 5.4 mM stimulated uptake of 45Ca2+ in primary cultures of astrocytes. This effect was only observed when cells were exposed to excess potassium shortly after their exposure to 45Ca2+ and was potently inhibited (IC50 congruent to 3 nM) by the calcium channel blocker nimodipine. In contrast, nimodipine exerted little effect on unstimulated basal uptake of 45Ca2+. These findings suggest that the therapeutic benefit of calcium channel blockers in epilepsy may result in part from the ability of these drugs to prevent calcium entry into astrocytes during seizures when the extracellular potassium is elevated four- to fivefold above normal. PMID- 2709444 TI - Detection and partial biochemical characterization of a novel 57,500 dalton protein in rat brain myelin. AB - Using a monoclonal antibody (P6C3) derived from mice immunized with partially delipidated rat myelin, we detected a single 57.5 kDa protein species (BT57.5) positioned between alpha- and beta-tubulin on nitrocellulose containing electrophoretically separated rat brain myelin proteins. The kinetics of incorporation of 14C-labeled BT57.5 and myelin basic protein into myelin was similar in rats injected intracranially with [14C]amino acids to radioactively label these proteins. Immunoblotting of the separated proteins of the myelinlike fraction of rat brain with the anti-BT57.5 monoclonal antibody occasionally revealed a faint band corresponding to BT57.5 but consistently showed a more prominent protein band that migrated slightly ahead of BT57.5. When the myelin and myelinlike fraction were isolated from rats injected with [14C] amino acids, labeling of the prominent anti-BT57.5 binding protein in the myelinlike fraction preceded that of BT57.5 in myelin, reaching a peak of labeling and then decreasing before BT57.5 reached its peak level. Thus, the prominent anti-BT57.5 protein in the myelinlike fraction might be a metabolic precursor of BT57.5 in myelin or the myelinlike fraction is simply turning over more rapidly and is distinct from the myelin fraction. BT57.5 was detectable in rat, mouse, guinea pig, bovine, and human CNS myelin but not rabbit and was detectable in the peripheral nervous system only in myelin of rats and humans. Finally, in extensively purified myelin, BT57.5 appeared to copurify with myelin basic protein, suggesting that BT57.5 is a constituent of myelin rather than an artifact arising during brain homogenization procedures. PMID- 2709446 TI - Compartmentalization of acetylcholinesterase in the chick retina. AB - Using selective inhibitor treatments, we have studied the distribution of asymmetric (A) and globular (G) forms of acetylcholinesterase (AChE) in the extra and intracellular compartments of chick retina, a specialized region of chick central nervous system (CNS). Our results show that the chick retinal collagen tailed AChE (an example of class II asymmetric molecular forms) is essentially an extracellular form of the enzyme; this is the first demonstration of the extracellular localization of asymmetric AChE in the vertebrate CNS. The active site of most of the hydrophobic, membrane-bound G4-form is also exposed to the external environment. In turn, the smaller molecular weight G-forms (G2 and G1) are localized within the cells, where they may represent intermediate components in the assembly or degradation of the more complex enzymatic molecular species. Histoenzymatic ultrastructural techniques show internal AChE in amacrine as well as in ganglion cell bodies, and external enzyme, specifically associated with synapses and axons, in the inner plexiform layer. The probable cooperation of the extracellular A12-forms and the membrane-bound G species (mainly G4) of the enzyme to the hydrolysis of acetylcholine (ACh) released into the external compartment is suggested and discussed. PMID- 2709445 TI - Conditioned media of regenerating fish optic nerves modulate laminin levels in glial cells. AB - Adult injured optic nerves of mammals show an increased distribution of laminin in the extracellular matrix after application of soluble substances in the form of conditioned media originating from growing nerves (Zak, et al., 1987). This increase could result from direct or an indirect activation of glial cells or from activation of other cellular elements. In the present study, we show that the conditioned media derived from regenerating fish optic nerves contain factors that directly modulate the level of laminin in C-6 glioma cells. The identity of the laminin was confirmed by metabolic labeling of the treated cells with [35S]methionine and by subsequent immunoprecipitation and gel electrophoresis. The level of other extracellular matrix proteins, such as fibronectin, is also increased. The significance of the presence of glial-activating substances in the conditioned media of regenerating nerves for the process of regeneration is discussed. PMID- 2709447 TI - Pre- and post-natal ontogeny of serotonergic projections to the rat spinal cord. AB - The development of 5-hydroxytryptamine (5-HT) innervation in the spinal cord was studied from embryonic day 14 (E14) to adulthood. Sprague-Dawley rats were fixed by perfusion with 5% glutaraldehyde in cacodylate-sodium metabisulfite buffer, and vibratome sections were processed for immunocytochemistry with a 5-HT antiserum. For electron microscopy, the sections were flat-embedded in araldite, and thin sectioning was performed. 5-HT neurons caudally directed from raphe nuclei invade the spinal cord at E14 and reach the caudalmost levels by E16-E17. In longitudinal sections, axons are seen by E15, at cervical and upper thoracic levels, to invade the presumptive gray matter from the anterior and lateral funiculi. The invasion process occurred either by sharp angulation of the axon or by branching of a collateral. By E16, at thoracic level the anterior horn and the intermediolateral columns are profusely innervated by very thin, varicose fibers; synapses are seen at E17 and E18 using EM. 5-HT immunoreactive boutons are involved here. After birth, 5-HT innervation of these two areas evolves progressively from a diffuse network to a more restricted pattern, especially at the thoracic level for the intermediolateral column and at cervical and lumbar levels for the anterior horn. The adult pattern is reached by postnatal day 21 (P21). The growth of axons toward the dorsal horn becomes noticeable by E19 at all spinal levels, when fibers invade the neck of the horn from the lateral funiculus, and innervation proceeds diffusely until P5. At P7, thin fibers course dorsally and laterally along the border of the gray matter and ramify profusely in layers I and II. The adult pattern is also reached in the dorsal horn by P21. These results are discussed in relation to the postnatal maturation of motor and sensory circuits and to the development of transplanted raphe neurons in the rat spinal cord. PMID- 2709448 TI - Acute effects of lithium on catecholamines, serotonin, and their major metabolites in discrete brain regions. AB - The acute effects of lithium on the central catecholamine and serotonin systems were investigated in well-defined cortical areas in the rat: the anterior cingulate cortex (CIN), the piriform-entorhinal region (PiEn), and the primary visual area (VIS) as well as in the hippocampus (HIP), the neostriatum (CPU; caudateputamen), and the olfactory bulbs (OBs). In these microdissected regions, the catecholamines noradrenaline (NA) and dopamine (DA), the indoleamine 5 hydroxytryptamine (5-HT; serotonin), as well as some of their major metabolites (3-methoxy-4-hydroxyphenylglycol; 3,4-dihydroxyphenylacetic acid; homovanillic acid; 3-methoxytyramine; 5-hydroxy-1-tryptophan; and 5-hydroxyindole-3-acetic acid) were assayed by using high-performance liquid chromatography (HPLC) with electrochemical detection. One hour after the administration of lithium chloride (2 and 10 mEq/kg; i.p.) the endogenous NA levels increased in the CIN and PiEn cortices, in the HIP, and in the CPU. The DA contents remained unchanged in the CPU, HIP, OB, and VIS cortex but were increased in the CIN and PiEn regions. These increases in cortical DA levels were accompanied by reductions in HVA and DOPAC. The levels of HVA and DOPAC but not 3-MT were also reduced in the CPU, in spite of a normal DA content. The discrepancies between changes of DA and the levels of its metabolites indicate changes in the turnover rates as well as an action of lithium on DA synthesis and/or storage in the nigrostriatal and mesocortical systems. The 5-HT contents were also increased by lithium throughout all regions, except for the OB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709449 TI - A volume-dependent, chloride-sensitive component of taurine release stimulated by potassium from retina. AB - Chick retinas exposed to 56 mM KCl showed marked swelling of cells and synaptic structures, detected by morphological examination as well as by measurements of cell water content. Retinal cell swelling is prevented by omission of chloride. Potassium chloride, 56 mM, elicited the efflux of [3H]taurine by a process that is partly calcium-dependent, highly chloride-dependent (80%), and sensitive to furosemide. The release of [3H]dopamine under the same conditions is completely calcium-dependent and increases in the absence of chloride. The chloride dependent component of [3H]taurine efflux seems related to increases in volume changes since it is markedly reduced when cell swelling is prevented either by maintaining constant the K X Cl product (Donnan equilibrium) or by making the solution hypertonic with mannitol. Omission of calcium and of chloride showed additive effects, practically suppressing the potassium-stimulated release of taurine. These results suggest that the potassium-stimulated efflux of [3H]taurine consists of a large component associated to changes in cell volume and a small component probably related to the depolarizing effects of potassium. PMID- 2709450 TI - Injury in U.S. Army helicopter crashes October 1979-September 1985. AB - All U.S. Army class A and B mishaps of four types of helicopters occurring from 1 October 1979 through 30 September 1985 were reviewed. During this 6-year period, there were 298 crashes involving 303 aircraft. There were 1,060 individuals aboard the crashed aircraft and 611 were injured, 136 fatally. The most common cause of injury was the "secondary impact" caused by collapse of structure into occupied areas, by inadequate restraint of the occupants which allowed them to flail into structure, or by a combination of both mechanisms. Injury solely related to acceleration occurred infrequently. The most frequently injured body regions in survivable crashes were the head (28%) and extremities (43%). Injury patterns are compared for different helicopter types and related to differences in design. Basic principles of crash injury protection, including individual protection by helmets, seatbelts, and airbags, and structural modifications to minimize injury potential, as well as crashworthy fuel systems, are reviewed, and recommendations are made to increase the crashworthiness of helicopters, such as adapting designs and standards on the basis of active field investigations. PMID- 2709451 TI - Trauma registry and trauma center biases in injury research. AB - Trauma centers and trauma registries have become important sources of data for trauma research. In their present form, both have serious biases in data selection, however, that can affect epidemiologic research results. This prospective study of 601 woodworking-related injuries seen at a trauma center involved a diverse population, a wide range of severities, both inpatients and outpatients, and primary versus referred patients. Eighty-eight per cent were outpatients and thus excluded by traditional trauma registries. Only 6% of primary patients, but 43% of referred patients, were hospitalized. Eighty-nine per cent of outpatients, and 28% of inpatients had AIS of 1. However, among primary patients 79% or more of lost or altered days of work, home, or recreational activity during 6 months postinjury occurred among ambulatory patients. Substantial differences were shown between hospitalized and ambulatory patients, and between primary and referred patients, in type of activity at time of injury, and in anatomic location and injury type. Trauma registry collection and analysis methods for epidemiologic research need substantial restructuring if they are to truly represent the tremendous problem of injury in our society. PMID- 2709452 TI - The role of CT scan in evaluation for laparotomy in patients with stab wounds of the abdomen. AB - Not every patient with a penetrating stab wound of the abdomen requires laparotomy. This report evaluates use of computerized tomographic (CT) scan in assessment of stable asymptomatic patients, with penetrating abdominal stab wounds, as an indicator of the necessity of abdominal exploration. In a prospective study, 50 patients with abdominal stab wounds were treated successfully with observation only, after admission abdominal CT scan interpretation was negative for pathology in 45 patients. In the remaining five it was of such minor nature that conservative management was justified (Series I). Twenty-eight stable asymptomatic patients with penetrating stab wounds of the abdomen comparable to the ones in Series I had CT scan on admission, and then underwent exploratory laparotomy independent of their CT scan findings (Series II). Of these 28 patients, 22 had correct CT scan findings verified by laparotomy, three were false positive for intra-abdominal injury resulting in negative explorations, and three patients had such nonspecific findings as fluid or air in the abdomen incompatible with precise organ injury identification. Our study shows that CT scan in patients with abdominal stab wounds identifies solid organ injury with great specificity and sensitivity, evaluates the retroperitoneum well, and detects peritoneal penetration by demonstrating intraperitoneal fluid or air. CT scan was unreliable in detection of bowel injury and does not demonstrate diaphragmatic injuries. PMID- 2709453 TI - Unintentional firearm deaths in California. AB - We conducted a two-part study of unintentional firearm deaths in California. First, we analyzed death certificate data for the 688 unintentional firearm deaths of California residents occurring during 1977-1983. Mortality rates were 7.5 for males, 0.9 for females, 4.8 for whites, and 5.3 for blacks, all per million persons per year. Males ages 15-24 had the highest rate (17 per million persons per year). We then investigated the 131 childhood deaths in greater detail, using coroners' or medical examiners' reports. Most of these shootings occurred at a residence. Handguns were involved more frequently than predicted by their reported availability in homes in the region. Almost two thirds of child deaths resulted from head wounds, reinforcing the importance of primary prevention. At least 40% of child deaths in this study appeared in part to be attributable to defects in firearm performance or current firearm design practices, suggesting that improvements should be sought and mandated. PMID- 2709454 TI - A diagnostic outcome study of children and adolescents with severe burns. AB - The results of a diagnostic outcome study of children and adolescents with severe burns are presented. The positive research findings include evidence of present and lifetime full and partial anxiety and depressive disorders and statistically significant within-sample, burn-related, and demographic differences. The negative findings are less depression and post-traumatic stress disorder by DSM III criteria than expected, the presence of a subgroup of severely burned children who appeared to be functioning well with only a few or no diagnoses, and absence of significant differences on many variables on within-group comparisons. Based on these data, periodic psychiatric evaluation or reevaluation and specifically targeted followup treatment are indicated for many burned children, adolescents, and their families. PMID- 2709455 TI - Metabolic and thermoregulatory responses to burn wound colonization. AB - This study was designed to determine whether there is a relationship between bacterial colonization of the burn wound and resting oxygen consumption (VO2) and colonic temperature (Tc) in burned rats. Resting VO2, Tc, and blood, spleen, and wound cultures were monitored for 2 weeks after 30% total body surface full thickness burns. The wounds of 53 animals were seeded with 10(8) nonvirulent P. aeruginosa (NVP) at the time of injury, while the wounds of 33 rats were allowed to colonize spontaneously. The seeded wounds contained 10(6) colony forming units/gm (CFU/gm) by the fourth postburn day (PBD), while the unseeded wounds did not reach this level of colonization until after the first week postinjury. Wound seeding accelerated the metabolic and thermoregulatory responses to injury. Average VO2 and Tc of the seeded group were above the unseeded group on PBD's 3-4 and 7-8, but there were no significant differences between groups on PBD's 14-15. Although the unseeded animals were hypermetabolic during the first week, they remained afebrile. There was a significant correlation between wound bacterial counts and the increase in resting VO2 of 44 nonbacteremic animals, but variations in the data suggest that factors other than number of viable wound bacteria affect this relationship. Changes in Tc were unrelated to wound bacterial count but were correlated with changes in VO2. Taken together, the data suggest that bacteria in the burn wound contribute to the rise in energy expenditure following thermal injury. PMID- 2709456 TI - Effect of a hypertonic lactated Ringer's solution on intracranial pressure and cerebral water content in a model of traumatic brain injury. AB - There has recently been an increased interest in the use of hypertonic solutions for fluid resuscitation of trauma victims. In this study, we examined the acute cerebral effects of a hypertonic lactated Ringer's solution (measured osmolality = 469 mOsm/kg) in an animal model of traumatic brain injury. Following the production of a cerebral cryogenic lesion, eight New Zealand white rabbits were randomized to undergo hemodilution with either lactated Ringer's (measured osmolality = 254 mOsm/kg) or hypertonic lactated Ringer's. Over the course of the experiment the lactated Ringer's group required significantly more fluid than the hypertonic group to maintain stable central venous and mean arterial pressure (245 +/- 5 ml vs. 132 +/- 20 ml; p less than 0.0001). Osmolality increased in the hypertonic group by 13.5 +/- 3.3 mOsm/kg whereas it decreased in the lactated Ringer's group by 5.5 +/- 2.6 mOsm/kg. Intracranial pressure increased in both groups over the course of the experiment but the increase in pressure was greater in the lactated Ringer's group than the hypertonic group (9.5 +/- 2.4 mm Hg vs. 1.7 +/- 1.5 mm Hg; p less than 0.001). Brain water content was significantly increased in the region of the lesion as assayed by both the wet/dry weight method and cortical specific gravity determinations, but there was no difference between the two treatment groups. Water content of the nonlesioned hemisphere was significantly less in the hypertonic group. This study suggests that hypertonic saline solutions may be useful for the resuscitation of hypovolemic patients with localized brain injury. PMID- 2709457 TI - Injury to the elderly in road traffic accidents. AB - It is widely accepted that the elderly are more vulnerable to trauma than other groups. We examined our records of more than 6,000 accident cases, 312 over 65 years of age, and found that not only were older people more likely to sustain more serious injury in any given accident, but that the risk of life was significantly greater for a given injury severity. The mortality rate for all grades of injury rose from approximately 1% in the age group less than 20 years old to almost 11% in the age group more than 70. As none of the existing injury scales take age into account when predicting the outcome, it is suggested that such scales should be weighted to reflect more accurately the likely outcome or injury in the elderly. PMID- 2709458 TI - Treatment of femoral shaft fractures with the Hoffmann external fixator in prepuberty. AB - Twenty-two children with femoral shaft fractures, between the age of 10 and 14 years, were treated with the Hoffmann external fixation apparatus from 1980 to 1985. This method of treatment is very simple. It requires less surgical exposure and allows earlier ambulation and easy nursing care. In addition, it makes patients comfortable in multiple trauma conditions. The average time to union and removal of fixators was 72 days (range, 44 to 80 days). There were no deep wound infections, nonunions, or rotationary deformities. On followup, all patients regained the range of motion of knee joints in 3 months without significant leg length discrepancy or radiographic evidence of growth disturbance. The device may serve as an alternative method for femoral shaft fractures in prepuberty, especially in areas of tropical climate. PMID- 2709459 TI - The frequency and significance of thoracic injuries detected on abdominal CT scans of multiple trauma patients. AB - Of 174 multiple trauma patients undergoing abdominal CT examination for suspected abdominal trauma, 65 patients had 109 chest injuries detected by abdominal CT, chest film, or both examinations. Forty-one patients had 55 chest injuries at the base of the thorax which were not detected on the initial chest film. The most frequent chest injuries detected only by CT were pneumothroax, fracture (rib, thoracic spine, and sternum), lung contusion, aspiration pneumonia, hemothorax, and post-traumatic atelectasis. Seven patients whose chest injury initially was seen only at abdominal CT required treatment of the injury, suggesting that a variety of chest injuries which may vitally affect patients can be detected early in multiple trauma patients by abdominal CT, and that all abdominal trauma CT scans should be scrutinized for signs of a chest injury. PMID- 2709460 TI - Surgical cricothyrotomy in the field: experience of a helicopter transport team. AB - A retrospective analysis of 3,500 helicopter missions revealed 20 patients who required cricothyrotomy in the field for emergency airway access. Five patients who were in cardiopulmonary arrest succumbed despite cricothyrotomy, all with adequate airway control (Trauma Score, 2.8; ISS, 55.6). Seven of 12 patients with oral, maxillofacial, or cervical trauma survived (Trauma Score, 9.6; ISS, 48.25). There were no instances of bleeding, malposition, airway obstruction, or dysphonia after decannulation in the survivors. Autopsy revealed no serious airway pathology or compromise in those who expired. Surgical cricothyrotomy can successfully be performed in the field by a nurse/physician helicopter transport team. When conventional airway maneuvers are unsuccessful we recommend cricothyrotomy for emergency airway access. PMID- 2709461 TI - The selective management of penetrating wounds of the back. AB - Fifty patients with penetrating wounds of the back were prospectively evaluated and managed selectively on the basis of physical examination. Despite the theoretic problems of evaluating the retroperitoneum, physical examination was found to be a reliable method of determining the need for laparotomy. Every patient who had a significant injury had evidence for this on initial physical examination and no patient judged to have a normal examination required laparotomy. The negative laparotomy rate was 4% and no patients died as a result of delayed surgical intervention. Careful physical examination and surgical judgment allow for safe management of penetrating back wounds. PMID- 2709462 TI - Coverage of acute vascular injuries of the axilla and groin with transposition muscle flaps: case reports. AB - Acute axillary or groin vascular injuries caused by farm machinery or shotgun blasts are often associated with extensive soft-tissue loss. Coverage of the repaired blood vessels with healthy tissue is necessary to avoid infection, desiccation, pseudoaneurysm, and rupture. Adjacent muscles are not always available to rotate for coverage, due to unacceptable functional loss, or injury to the principal vascular pedicle. We used proximally based trunk musculature with vascular pedicles out of the areas of injury to achieve coverage of four extensive axillary wounds and one extensive groin wound. Arterial repair only was performed in three axillary wounds. Combined arterial and venous repair were performed in one groin wound and one axillary wound. Followup ranging from 9 months to 5 years revealed no vascular failure or soft-tissue complications. We conclude that coverage of vascular repairs and soft-tissue defects with viable muscle is necessary in cases of extensive injury. Adjacent muscle is preferred for coverage, but when this is unavailable, coverage can still be achieved using more proximally pedicled muscles of the trunk. PMID- 2709463 TI - Mauling by pit bull terriers: case report. AB - A child with extensive soft-tissue defects following an attack by four pit bull terriers is presented. Some future procedures are required and she will have a permanent gait disability. The multidisciplinary management of this patient is described. The escalating problem of dog attacks in the United States is discussed. It is hoped that increased physician and public awareness will expedite the enactment and enforcement of effective vicious-dog legislation. PMID- 2709464 TI - Case report: transthoracic retrograde venous bullet embolization. AB - The embolism of bullets in the venous system is an uncommon complication of penetrating missile injuries. Retrograde transthoracic venous bullet embolization is exceedingly rare. This report describes embolization of a small-caliber bullet from the left subclavian vein to a branch of the right popliteal vein. The patient was treated successfully without surgery. PMID- 2709465 TI - Lower limb salvage with autoclaved autogenous tibial diaphysis: case report. AB - A massive crush injury of the lower extremity associated with avulsion of a 30-cm segment of the diaphysis of the tibia is reported. The patient refused consideration of amputation. Therefore, in this unique case, the noncomminuted fragment was autoclaved and replaced as a nonvascularized autogenous graft. Graft host union was observed without complication, leading to full weight-bearing ambulation with a molded orthosis within 1 year of the injury. PMID- 2709466 TI - Thoracic aorta rupture as the cause of paraplegia: a diagnostic dilemma (case report). AB - An unusual case of traumatic aortic transection in an 8-year-old boy: the child presented with paraplegia after being struck by an automobile and thrown into a telephone pole. No bony abnormalities were noted on radiologic examination. The case emphasizes the importance of a high risk index of suspicion and the mechanism of injury. PMID- 2709467 TI - Transection of the inferior vena cava from blunt thoracic trauma: case reports. AB - Blunt thoracic trauma is a frequent cause of death in multiple trauma victims. Myocardial rupture may occur in up to 65% of patients who die with thoracic injuries. Two cases are presented with intrapericardial transection of the inferior vena cava, pericardial rupture, and myocardial rupture from blunt thoracic trauma. Both patients died. PMID- 2709468 TI - What ever happened to patient confidentiality? PMID- 2709469 TI - Inpatient treatment of the mentally ill substance abuser: some medicolegal concerns. AB - Alcohol and drug abuses complicate medicolegal issues in psychiatry by blurring the boundaries between medicine and law. Furthermore, the usual tests for the applicability of either legal or medical measures often cannot be applied to the dually diagnosed. Specific quandaries arise with involuntary hospitalization and treatment, and with evaluating patients for the courts. The author discusses these problems, introducing the concept of state-dependent competency, using a case vignette to illustrate several points. Legal theories of behavior assume freedom of action; medical theories assume determinism. Phenomena of addiction defy such distinctions and thus may pose difficulties that cannot reliably be assigned either a medical or a legal remedy. PMID- 2709470 TI - Kids and cocaine--a treatment dilemma. AB - Despite aggressive efforts to recruit into treatment cocaine users 21 years and younger, we obtained only 12 such clients over a period of 9 months, while recruiting 122 adult cocaine clients during a comparable time frame. An examination of admissions data for the city, state, and nation indicated that our experience was typical. However, data from the most recent national household survey indicate that, to the extent need for treatment is determined by frequency of cocaine use, we should anticipate a much greater proportion of admissions to treatment to come from persons 21 years of age and younger. Yet, there appears to be an under-recruitment of youth into treatment, particularly evidenced by low rates of self-referral for juvenile as compared to older treatment admissions. Younger cocaine users may be less severely impaired and/or dependent, or may be more reluctant to use the treatment resources available. Whatever the barriers are to getting help, it becomes the special task of agencies and individuals in the community to help assure that younger cocaine users will obtain the assistance they need. Four community resources are seen as particularly relevant: family, schools, the medical community, and public agencies in the areas of health, social services, and criminal justice. The capacity of each to take action and possible impediments to that action are discussed. PMID- 2709471 TI - The diagnosis of alcohol, cocaine, and other drug dependence in an inpatient treatment population. AB - The diagnosis of alcohol, cocaine, and other drug dependence in inpatient treatment populations is important to identify for clinical prognosis, treatment, and genetic research. The use of alcohol by cocaine addicts is a common cause for relapse to cocaine. The treatment of cocaine addiction is simplified if alcohol dependence is also present because the same methods can be used for both. In this study, 94% of those patients who qualified for the diagnosis of cocaine dependence were also diagnosed as having alcohol and other drug dependence. The demographic characteristics of these cocaine addicts (n = 413) compared to those patients with the diagnosis of alcohol dependence only (n = 677) and alcohol dependence and drug dependence other than cocaine (n = 453). PMID- 2709472 TI - A common cause of alcoholism. AB - A common cause of alcoholism is the nonalcoholic. At least half of the nonalcoholics have a family member who is not alcoholic. The classic "enabler" is the caretaker of the alcoholic. Without the enabler, alcoholism would dwindle. The so-called innocent bystanders are not consciously intending to harm the alcoholic. Most of the time there is no conscious intention to help the alcoholic continue drinking and inflicting self-destruction. The innocent bystander must become guilty. The guilty must confront the alcoholic with the consequences of alcoholism. The concerned must refuse to make excuses for the alcoholic's failure and resentment. The innocent bystander may lack willpower more than the alcoholic by refusing to look alcoholism in the eye. PMID- 2709473 TI - Inpatient cocaine abusers: an analysis of psychological and demographic variables. AB - One hundred cocaine abusers were evaluated with a full battery of psychological tests (Shipley Institute of Living Scale, MMPI, Millon Clinical Multiaxial Inventory, Rorschach, Beck Depression Inventory) by Norman J. Lesswing, Ph.D. These patients were treated in a 6-week program on a chemical dependency unit at the Benjamin Rush Center in Syracuse, New York, from 1984 to 1986. Information was gathered across a wide range of demographic and clinical variables (age, sex, marital status, race, education, family history, and cross addiction), and psychological features (MMPI profile types, intellectual functioning, personality disorders, depression ratings, and Rorschach variables). Results are presented through comprehensive description of the sample across these patient and psychometric characteristics with use of summary statistics. Support was not found for the notion that cocaine abusers are self-medicating affective disorders, but evidence for high frequency of personality disorders was revealed. Cross addiction and abuse of alcohol and other substances were very frequent. PMID- 2709475 TI - Cliffside: Four Winds--Westchester's program for psychiatric chemical dependency treatment. PMID- 2709474 TI - Predictors of alcoholics' acquisition of treatment-related knowledge. AB - Only modest relationships have been found between cognitive functioning and treatment outcome; there is some indication of better prediction of within treatment progress. The current study attempted to determine whether either cognitive or sociodemographic/alcohol-related variables were predictive of learning in educational treatment. Eighty-seven male alcoholics were exposed to one hour of instruction on the medical effects of alcohol. Sociodemographic, alcohol-related, and cognitive functioning measures were obtained at the outset of treatment. Knowledge was assessed 24 hours prior to and 24 hours and three weeks after the intervention. Statistically significant increases in knowledge were found both 24 hours and three weeks following the educational intervention; retention of information declined significantly from 24 hours to three weeks post intervention. Discriminant function analyses using either seven cognitive variables or six alcohol-related/sociodemographic variables significantly discriminated between learners and nonlearners 24 hours after the intervention. The weighted composite of measures in each of the analyses was able to successfully differentiate learners from nonlearners in over 70% of the cases. The findings suggest that the clinician may be able to employ a limited number of variables to differentiate between patients who will and will not be able to acquire knowledge from educational interventions. PMID- 2709476 TI - The Israeli residential center for alcoholics 1982-1987. AB - This paper touches upon three primary topics: description of the treatment methods and approaches that have proven to be most useful and successful in Israel's only residential center for alcoholics; summary of recent findings about the characteristics of alcoholics that have been treated at the residential center during the years 1982-1987 (the findings revealed a high percentage of married alcoholics and of unemployment) and some details about the follow-up investigation and the evaluation of the effectiveness of the center's treatment modality. The relatively high abstention rate - 40.9% of all patients (51.2% of those who completed treatment) - is the most important result of the study. Thus, this article integrates research data and relevant features of the Israeli residential treatment experience, in which the emphasis on involving the family is greater than elsewhere. PMID- 2709477 TI - The psychotherapy of dually diagnosed patients. AB - A model of psychotherapy with dual diagnosis patients is presented. This therapy is divided into 3 phases: achieving sobriety, maintaining abstinence, and advanced recovery. In each of these phases, dual diagnosis patients require many specialized techniques, which are discussed. After sobriety, psychotherapy is behavioral and supportive. When abstinence is stabilized, then psychodynamic principles can be integrated into an approach that recognizes the role played by potential return to substance abuse. Abstinence is even more critical in dual diagnosis patients than in uncomplicated substance abusers. In advanced recovery, more traditional psychotherapy can be done, particularly in nonpsychotic patients. PMID- 2709478 TI - Severe reversible myopathy due to typhoid. AB - An 18-year-old Black male presented to hospital with a fever and inability to walk due to severe proximal myopathy. He was found to have typhoid, and marked elevation of the creatine phosphokinase with myoglobinuria was recorded. After appropriate antibiotic therapy the creatine phosphokinase level returned to normal and the patient made a complete recovery. Although neuropsychiatric manifestations have been commonly recorded in typhoid, the complication of a myopathy has not been frequently noted. PMID- 2709479 TI - Continuous monitoring of child mortality from clinic records. AB - A simple method is described for estimating childhood mortality when mothers are seen at or soon after a birth. The main bias in the method arises from omission of reports from mothers not contacted in the immediate postnatal period. Recent work indicates that the key question on the survival of the preceding born child might be usefully included in household surveys. A comparison between data from Tari, Papua New Guinea on childhood mortality collected as part of a regular community surveillance scheme and the results from asking the supplementary question in clinics indicates that the simpler preceding birth technique appears to give good results quickly and cheaply. PMID- 2709480 TI - Effect of Campylobacter jejuni extracts and culture supernatants on cell culture. AB - This study reports the effect of culture supernatants and extracts of Campylobacter jejuni isolated in Bangladesh from patients with gastroenteritis, asymptomatic carriers, poultry, and animals on tissue culture system. Isolates from patients produced morphologic changes on HeLa, Vero and Y1 adrenal cell lines. Incorporation of polymyxin B in the culture medium enhanced the effect on cell lines significantly and sonicated extracts of the organisms had an even more significant effect. Almost all sonicated extracts of patients' isolates had effect on HeLa cells. Animal isolates, using identical conditions, had much less effect on cell lines whereas isolates from asymptomatic carriers produced almost no effect. This toxicity of the patients' isolates might indicate some relation to pathogenic strains. PMID- 2709481 TI - Caesarean section morbidity at district level in Zimbabwe. AB - The incidence of complications related to Caesarean section was studied among 643 patients operated in four hospitals in Zimbabwe. Major complications were recorded in 15% of the patients and minor complications in 27%. Among these complications, infection morbidity played the leading role. Only 53% of Caesarean section were devoid of complication or need of blood transfusion. It is concluded that in a Third World environment, Caesarean section carries a substantial risk of operative and post-operative complications. PMID- 2709482 TI - Characterization and significance of Aeromonas spp. isolated from diarrhoeic stools in Nigeria. AB - During a 12-month study period (January-December 1986), 12 Aeromonas strains (eight A. hydrophila and four A. sobria) were isolated from the 400 diarrhoeic and 200 non-diarrhoeic stools examined. Isolates were characterized for frequency of phenotypic properties associated with virulence using the suckling mouse test for enterotoxin assay; haemolysis of rabbit erythrocytes for haemolysin production, and haemagglutination of human group A cells (HA) for presence of colonization factor antigens (CFA). All seven A. hydrophila and three A. sobria strains isolated from diarrhoeic stools produced enterotoxin. All, except one A. sobria strain from a diarrhoeic stool, produced haemolysin in titres greater than 4. Fifty per cent of strains from diarrhoeic stools and 100% of strains from non diarrhoeic stools were HA positive. All HA reactions were sensitive to mannose and galactose. The frequency of enterotoxin-producing aeromonads was significantly higher (P less than 0.05) in diarrhoeic patients than in non diarrhoeic controls. There was no significant difference (P greater than 0.05) in the frequency of haemolysin and HA production between diarrhoeic and non diarrhoeic strains. PMID- 2709483 TI - Clinical profile of acute rheumatic fever in children. AB - A prospective study was done to determine the clinical profile of acute rheumatic fever in the first attacks and in recurrences separately. The data were compared with those from other countries. Eighty children were in their first attack while 46 had recurrences. Arthritis, the most common manifestations, was seen in 61 per cent of patients with first attack followed by carditis in 41 per cent, chorea in 28 per cent and subcutaneous nodules in 3 per cent. However, in the recurrences, arthritis was present in 52 per cent, carditis in 81 per cent, chorea in 11 per cent, and nodules in 4 per cent of cases. In both the groups, no case with erythema marginatum was seen. The results show that in the first attack the clinical picture broadly resembles that in European and North American countries. The presenting symptoms and signs are different during recurrence. PMID- 2709484 TI - The bacterial content of infant weaning foods and water in rural northern Thailand. AB - Samples of weaning food and supplementary water were collected for analysis of bacterial content from among a random sample of 65 infants under the age of 1 year living in a rural area of northern Thailand. Using geometric means, mean total bacterial count of infant's drinking water was 351 organisms/ml (95 per cent CIs 170-770), and the most probable number (MPN) of faecal coliforms/ml was 47 (95 per cent CIs 19-78). Mean total bacterial count of weaning foods was 38,000 (95 per cent CIs 25,000-59,000) organisms/g with 10 per cent recording counts greater than 1,000,000 organisms/g. Bacterial counts were similar to those reported in weaning food and water in other developing countries, and were above internationally recommended 'safe' levels. The bacterial count of water was not affected by boiling, due to poor cleaning and frequent re-use of utensils. Weaning foods were contaminated during preparation, in part through premastication and also via mode of cleaning of utensils. PMID- 2709485 TI - Antibody response of infants in tropics to five doses of oral polio vaccine. AB - Sixty-two infants 1-12 months of age were administered five doses of trivalent oral polio vaccine (TOPV) at intervals of 4 weeks. The seroconversion achieved were 88.7, 93.5 and 96.5 per cent for type I, II, and III polioviruses. These seroconversion rates are significantly better when compared to seroconversion achieved after two and three doses of trivalent oral polio vaccine. Factors which were considered in previous studies to be responsible for low seroconversion rates viz. interference by enteroviruses, breast feeding, malnutrition, and age were found to be insignificant when five doses of oral polio vaccine were given. It is possible that these effects were overcome by increasing the number of doses of trivalent oral polio vaccine. PMID- 2709486 TI - Parturient fundal height and its relation to fetal weight. AB - Fundal heights of parous and non-parous women were measured in early singleton labour and grouped according to level of presenting fetal part. The birth-weights were recorded and related to fundal heights in each group. Regression lines were drawn corresponding to different probabilities of a given minimum birth-weight. It was concluded that a single measurement particularly in early pre-term labour might give a useful and simple estimate of expected fetal weight. PMID- 2709487 TI - Zinc concentrations in human milk during lactation: a 6-month longitudinal study in southern Brazil. AB - Human milk zinc concentrations from women of low socioeconomic status in Ribeirao Preto, Southern Brazil, were studied. A group of 23 mothers, 17 multiparae and six primiparae aged from 17 to 39 years, were included in a 6-month longitudinal study. A total of 192 samples were collected starting from colostrum and then at 15-day intervals until the end of the sixth month of lactation. Initial zinc values (0.47 +/- 0.10 mg/dl) fell by about 40 per cent during the second week of lactation to 0.28 +/- 0.06 mg/dl, the decrease progressively increasing up to the 24th week (0.11 +/- 0.03 mg/dl). Zinc values were significantly higher in the colostrum than in any of the later collections (P less than 0.05). The values obtained at 15 days were significantly higher (P less than 0.05) than those obtained later, except for those obtained on the 30th day, which were higher than all of those, obtained later (P less than 0.05). The values obtained after 75 days of nursing, although steadily decreasing, were not statistically different. The data of the present study demonstrate a significant reduction in zinc levels during lactation, the amount of zinc provided by breast-milk being lower than those recommended by the recommended dietary allowance in the United States. PMID- 2709488 TI - Lessons for national health systems from small-scale projects: a case study from Tanzania. AB - A number of health projects have helped to establish the conceptual framework for Primary Health Care. Since the main difficulties in establishing Primary Health Care nationally arise with regard to planning, organization, and management, the replicability of such projects nationally is made easy if these difficulties are addressed at the level of the basic administrative unit in the country. In most countries it is the district. District level projects also give a more realistic account of the structures needed for planning, management, the logistics, lines of communication, intersectoral activities, and so on. This paper gives an account of a district level project in Tanzania and the lessons derived from it for the national health system relevant to Primary Health Care. PMID- 2709489 TI - Recurrence of persistent diarrhoea in Guatemalan children. PMID- 2709490 TI - Breast feeding, post-partum amenorrhoea and birth interval in rural Bangladesh. PMID- 2709491 TI - Effect of an oral rehydration solution with glycine and glycylglycine in infants with acute diarrhoea. PMID- 2709492 TI - Sonographic sign suggesting the prenatal diagnosis of coarctation of the aorta. AB - Coarctation of the aorta is a serious heart defect that can be successfully treated if identified early. Actual narrowing of the aortic isthmus is very difficult if not impossible to demonstrate on prenatal sonography; however, the indirect sign of discrepant ventricular sizes (right ventricle [RV] greater than left ventricle [LV]) is potentially useful to identify fetuses at risk for having coarctation of the aorta. We report on nine fetuses, 18 to 38 weeks gestation, in which the left ventricle was smaller than the right ventricle. After birth, four of the nine had coarctation of the aorta. One infant with Down's syndrome had a patent ductus arteriosus as well as foramen ovale. Another infant had a small left ventricle and parachute mitral valve but no coarctation. The last three infants had a normal cardiac workup at birth. We conclude that a small left ventricle compared to the right ventricle on prenatal sonography can be a sign of congenital heart disease and that one of the defects that can give this appearance is aortic coarctation. Careful neonatal follow-up is warranted. PMID- 2709493 TI - Radiographic assessment of renal trauma: a 10-year prospective study of patient selection. AB - To develop criteria to determine which patients require radiographic assessment after blunt renal trauma, we studied prospectively 1,146 consecutive patients with either blunt (1,007) or penetrating (139) renal trauma between 1977 and 1987. Based on our preliminary results from 1977 to 1983, in which none of the 221 patients with blunt trauma and microscopic hematuria without shock had significant renal injuries, we designed a prospective study to determine if such patients could be managed safely without radiographic staging. During the last 10 years significant renal injuries were found in 44 patients (4.4 per cent) with blunt trauma and gross hematuria or microscopic hematuria associated with shock, and in 88 patients (63 per cent) with penetrating trauma. No significant injuries occurred in the 812 patients with blunt trauma and microscopic hematuria without shock, 404 of whom had complete radiographic assessment and 408 of whom did not. There were no delayed operations or significant sequelae related to the renal injury in these patients. We conclude that complete radiographic staging is mandatory in patients with penetrating trauma to the flank or abdomen and in patients with blunt trauma associated with either gross hematuria or microscopic hematuria and shock. However, patients with blunt trauma, microscopic hematuria and no shock who do not have associated major intra-abdominal injuries can be managed safely without excretory urography. PMID- 2709494 TI - Iatrogenic lithotripsy failure: penetration of shock waves through tape. AB - Foam tape used to protect epidural catheters during immersion in a Dornier HM3 lithotriptor was identified retrospectively as the cause of poor stone fragmentation. Studies of shock wave penetration through various protective type materials indicate that a particular water repellant tape is least likely to impair shock wave penetration. PMID- 2709495 TI - The kidney-ureter stone sexual paradox: a possible explanation. AB - The greater frequency of renal stones seen on excretory urograms in women, compared with the greater frequency of ureteral stones in men has been termed a sexual paradox. We assessed stone composition and weight, and sex as possible explanatory factors. A total of 4,014 renal and ureteral calculi was analyzed. For the 3,119 calculi in which only calcium oxalate and/or phosphate was detected by infrared and wet chemical analysis, there was a strong relationship between the oxalate-to-phosphate weight ratio and sex (p less than 0.0001). The mean weight for phosphate stones was 330 mg. but for oxalate stones it was 107 mg. Male-to-female ratios were 2.7, 2.2 and 1.8 for stone weight groups of 20 or less, 21 to 100 and more than 100 mg. The male-to-female ratio was 0.87 for the 171 stones containing magnesium ammonium phosphate; the average weight was 508 mg. for men and 1,560 mg. for women. The tendency for phosphate stones to be heavier and relatively more common in women compared to predominantly oxalate stones may partly account for the sexual paradox. PMID- 2709496 TI - Replacement of the bladder by the urethral Kock pouch: functional results, urodynamics and radiological features. AB - After cystoprostatectomy for cancer of the bladder 43 men were provided with a detubularized, low pressure ileal reservoir (Kock pouch) connected to the urethra. Reflux was prevented by an intussusception valve. There was no operative mortality and few early complications. At followup the mean postoperative observation time was 13 months, with a range of 5 to 20 months. Late complications included manifestations of local tumor recurrence or distant metastases in 9 patients within 6 months postoperatively, which made adequate functional evaluation impossible. In 18 patients reflux to the upper urinary tract due to eversion or sliding of the antireflux valve occurred at various postoperative intervals. In 16 of these patients incontinence developed as a consequence of the reflux. Surgical correction of the failing antireflux valve restored reflux prevention and continence. Within 3 to 6 months the capacity of the reservoirs had reached an ultimate volume of approximately 600 ml. Pressure waves exceeding 40 cm. water seldom occurred in the mature reservoirs and then only at high filling volumes. The mean urethral resting resistance to flow was 64 cm. water. The configuration and function of the upper urinary tract improved or stabilized postoperatively. Of 34 evaluable patients 30 were continent during the day with a voiding frequency of 3 to 5 times and dry at night with a frequency of 0 to 2. PMID- 2709497 TI - Cocaine and lidocaine as topical urethral anesthetics. AB - To evaluate the efficacy of topical cocaine combined with lidocaine as a urethral anesthetic, a double-blind, randomized, prospective study was performed comparing lidocaine combined with cocaine or placebo in male outpatient cystoscopy. Evaluations were based on a scale of 1 to 10, with 1 representing no discomfort and 10 extreme discomfort as judged by the patient, and 1 representing the best tolerance and 10 extreme intolerance as judged by the physician. Patients who received lidocaine plus cocaine reported a mean score of 3.33 for over-all discomfort of cystoscopy. This was not significantly different than for lidocaine alone. This finding indicates a lack of a summation effect in combining topical anesthetics. Patients undergoing repeat examinations were no more comfortable than those undergoing initial cystoscopy but older patients tolerated the procedure significantly better than younger patients. PMID- 2709498 TI - A new treatment for urethral strictures: a permanently implanted urethral stent. AB - We describe a new urethral stent, originally developed for endovascular use, that we have implanted into 8 patients with urethral strictures. The stent is woven in the form of a tubular mesh from surgical grade stainless steel wire and is self expanding when released from its small diameter delivery catheter. All patients have been treated successfully with a good caliber urethra visible on urethrography and direct endoscopy, and with improved urine flow rates. Mean followup of these patients is 8 months (range 6 months to 1 year). Urethroscopy had demonstrated complete epithelial covering of the implant at 4 to 6 months. Although the followup is short it seems that this simple technique may offer a lasting treatment for many urethral strictures. PMID- 2709499 TI - Diluted epinephrine solution for the treatment of priapism. AB - We report our experience with 18 consecutive cases of priapism treated with intracorporeal irrigations of dilute epinephrine solution. Of the 18 patients 16 were treated successfully. The 2 failures had priapism 36 hours and 5 days in duration, respectively. PMID- 2709500 TI - Assessment of screening for prostate cancer using the digital rectal examination. AB - An early detection study for prostate cancer was initiated to determine the effect of routine digital rectal examinations on the stage of prostate cancer at diagnosis. A prostate biopsy was recommended if induration, asymmetry or nodules were detected on the digital examination. During a 6-year period 4,160 examinations were performed on 2,131 men more than 45 years old. A prostate biopsy was performed on 144 men and 36 malignant tumors were detected, of which 68 per cent were clinically localized. Pelvic lymph node metastases were found in 6 per cent of the surgically staged cancer patients and in 10 per cent of the patients who had a high grade tumor. Surgical staging revealed that 50 per cent of the patients with clinical stage B disease were upstaged to stage C or D1 disease. These results suggest that mass screening programs using digital examination may not add sufficient benefit over conventional medical care to warrant the expense. Definitive proof that screening can lower the mortality rate from prostate cancer can be obtained only by a prospective randomized clinical trial. PMID- 2709501 TI - The versatility of the posterior lumbotomy approach in infants. AB - The versatility of the posterior lumbotomy approach to the upper urinary tract in infants is reviewed. A total of 32 procedures in 25 patients was performed. Nine different types of operations were performed ranging from upper pole heminephrectomy to ureterolysis. Surgical techniques and outcome are reviewed. PMID- 2709502 TI - Transient ureteral dilatation associated with infantile infectious sacroiliitis. AB - We report a case of ureteral dilatation associated with septic arthritis of the ipsilateral sacroiliac joint in an infant. Recognition, diagnosis and management of this uncommon entity are discussed. PMID- 2709503 TI - Sleep cystometries in children with nocturnal enuresis. AB - A combined analysis was done of sleep and bladder filling during sleep. Cystometry did not specifically affect sleep, since most of the cystometry studies in cases of enuresis did not lead to sleep stage changes on electroencephalography. Bladder instability was not accompanied by lighter sleep. Increasing patient age did not appear to have any influence on sleep or bladder behavior. We conclude that it is possible to provoke enuresis at any sleep stage and that sleep is unaffected by bladder filling in enuretic patients. PMID- 2709504 TI - Experience with the Kropp anti-incontinence procedure. AB - The experience of 2 surgeons working independently at separate institutions is reported to demonstrate the use of the Kropp urethral lengthening and implantation procedure. This experience includes 18 patients between 6 and 19 years old (median age 11.6 years) with neurogenic bladder dysfunction. The etiology of the neuropathic bladder was myelodysplasia in 16 patients and sacral agenesis in 2. There were 10 boys and 8 girls. All patients had failed trials of clean intermittent catheterization with adjunctive pharmacological manipulation. Incontinence was a significant social problem. Of the 18 patients 2 had undergone prior urinary diversion and the Kropp procedure was used as part of undiversion. One patient had had 2 previous failed attempts at continence using an artificial urinary sphincter. Augmentation cystoplasty was an adjunctive maneuver in 14 patients; ileum was used in 8, sigmoid in 4 and the ileocecum in 2 (both of whom had been diverted previously). The bladder capacity in the 4 patients in whom augmentation was not performed ranged from 200 to 450 ml. Of the 18 patients 17 achieved a good result and 14 were considered to have achieved an excellent result. The 1 failure is the patient who previously had failed to gain control with an artificial sphincter. Of the 4 patients who did not undergo bladder augmentation 3 required adjunctive anticholinergics to achieve continence. PMID- 2709505 TI - Needle biopsy in the diagnosis of testicular leukemia in children. AB - Aggressive chemotherapy in patients with acute lymphoblastic leukemia has resulted in a marked upsurge in patient survival. In the course of their management, testicular biopsy and rebiopsy have an important role. We evaluated the histological findings in 50 sets of open wedge and simultaneous needle core biopsy specimens from 44 testes of children with acute lymphoblastic leukemia to determine the accuracy of the needle biopsy technique in the evaluation of testis involvement in acute lymphoblastic leukemia. We conclude that needle biopsy of the testis in acute lymphoblastic leukemia is highly accurate and correlates well with the conventional open wedge biopsy, and it may have a role in the management of children with acute lymphoblastic leukemia. PMID- 2709506 TI - Giant hydronephrosis of a duplex system associated with ureteral ectopia. AB - Giant hydronephrosis is an infrequent urological entity. To our knowledge, only 1 case has been reported previously that was associated with a duplicated collecting system and ureteral ectopia. PMID- 2709507 TI - Simultaneous diversion of the urinary and fecal streams utilizing a single abdominal stoma: the double-barreled wet colostomy. AB - A new technique to achieve simultaneous diversion of the urinary and fecal streams using a single abdominal stoma is described. The procedure consists of the construction of a diverting loop colostomy with division of the colon approximately 10 to 15 cm. distal to the stoma. The segment of colon distal to the stoma, the urine limb, acts as a urinary conduit. To date 3 patients have undergone the procedure with followup of 3, 13 and 18 months. Neither upper tract infection nor upper tract deterioration has occurred. The potential role of this procedure to treat a difficult group of patients is discussed. PMID- 2709508 TI - Persistent acid-fast bacilli following intravesical bacillus Calmette-Guerin. AB - Intravesical bacillus Calmette-Guerin immunotherapy has great efficacy in the treatment of superficial transitional cell carcinoma of the bladder. We report a case of persistent acid-fast bacilli contained within granulomas of the bladder, prostate and epididymides 1 year after treatment with intravesical bacillus Calmette-Guerin. Although commonly encountered immediately after therapy, there are no reported cases of persistent acid-fast bacilli following intravesical administration of bacillus Calmette-Guerin. PMID- 2709509 TI - Phallic reconstruction during exenterative surgery for invasive urethral carcinoma. AB - A technique is described for phallic reconstruction after wide surgical excision of squamous cell carcinoma of the bulbomembranous urethra. Two cases in which this technique was used are presented with followup information at 9 and 12 months. PMID- 2709510 TI - Tuberculous epididymitis occurring 35 years after renal tuberculosis. AB - An unusual case of tuberculous epididymitis occurring 35 years after renal tuberculosis is reported. The possible mechanisms of this delayed presentation of the epididymal lesion are discussed. This case emphasizes the importance of adequate treatment as well as long-term followup of patients with genitourinary tuberculosis. PMID- 2709511 TI - Acute intestinal pseudo-obstruction (Ogilvie's syndrome) complicating radical retropubic prostatectomy. AB - We report 3 cases of acute colonic pseudo-obstruction in the immediate post radical retropubic prostatectomy patient. We have not found this syndrome reported in this clinical setting, and suggest that it results from an imbalance in the autonomic innervation of the distal colon secondary to noxious afferent parasympathetic stimulation from the region of the prostate gland. Treatment guidelines are summarized stressing early recognition and conservative management of this potentially fatal complication. PMID- 2709513 TI - Re: Specific gravity test strips used in monitoring urine concentrations of urolithiasis patients. PMID- 2709512 TI - Re: Effect of silver oxide/trichloroisocyanuric acid antimicrobial urinary drainage system on catheter-associated bacteriuria. PMID- 2709514 TI - Extracorporeal shock wave lithotripsy is a surgical operation, albeit noninvasive. PMID- 2709515 TI - This month in Investigative Urology: urinary reservoirs and pelvic malignancy. PMID- 2709516 TI - Effects of castration and diabetes mellitus on cholinergic responsiveness and muscarinic receptors in the rat vas deferens. AB - Studies were carried out to compare the effects of diabetes mellitus and castration on the muscarinic responsiveness of rat vasa deferentia. One and two months after castration or after streptozotocin-induced diabetes, there were significant decreases in serum testosterone levels, accompanied by significant decreases in vas deferens weights, protein contents, and protein concentrations. However, contractile responses of vasa deferentia from streptozotocin-diabetic or castrated rats to carbachol were significantly increased compared to controls. These changes were accompanied by increases in Kd and decreases in Bmax (pm/tissue) for 3H-quinuclidinyl benzilate (QNB) binding. Contractile responses and QNB binding were also studied in the spontaneously diabetic BB/W or rat, a less severely diabetic model than the streptozotocin-diabetic rat. Ninety days after the onset of diabetes in the BB rat, there was an increase in the contractile response to carbachol. There were qualitatively similar but smaller changes in vas deferens weights, protein contents, protein concentrations, and QNB binding than in the streptozotocin-diabetic rats. The data show that diabetes and castration increased the contractile responses of vasa deferentia despite decreases in protein content and in the number of muscarinic receptors. The results suggest that muscarinic receptor-effector coupling is more efficient in vasa deferentia from castrated or diabetic rats, resulting in a greater contractile response to cholinergic agonists. PMID- 2709517 TI - Neodymium: YAG laser specifications for safe intravesical therapy. AB - The depth of penetration of a laser beam is a critical factor in determining the therapeutic potential and risks of treatment. Variable parameters of laser energy were applied endoscopically in dog bladders. Although there was a clear trend toward greater depth of necrosis with increased energy, marked variability occurred within each set of energy specifications. Full thickness injuries with penetration depths up to five mm. were observed in some animals at all energy levels above 120 joules. A number of variables affect the penetration depth of a Nd:YAG laser, some of which are difficult to control with precision in an endoscopic setting. PMID- 2709518 TI - Bladder filling in mice: an experimental in vivo model to evaluate the reservoir function of the urinary bladder in a long term study. AB - We report a simple, reproducible, and low-invasive in vivo method for repeated examination of bladder well properties in mice. Over a period of 21 days transurethral bladder fillings were performed every second day on the same animal. Analysis of the bladder volume at an intravesical pressure of 10 and 20 mm. Hg and at the leakage point showed no trend during the 21 day study period with regard to changes in bladder volume. The model has been applied to a group of mice treated with a single fraction bladder irradiation dose of 20 Gy. These mice were investigated repeatedly during the following year. The end point selected for data evaluation in the irradiated group of mice was a 50% decrease in bladder volume at an intravesical pressure of 20 mm. Hg relative to the control value (bladder volume before irradiation). The results clearly demonstrate a biphasic change in the bladder reservoir function, in the form of an acute, reversible change, a period of normalization and then a late irreversible damage. The latter stage is consistent with the clinically found contracted bladder. In a control group there was no significant change in bladder volume during the study period of more than 200 days. The model thus appears feasible for future studies of bladder irradiation damage. PMID- 2709519 TI - Effects of extracorporeal shock wave lithotripsy on the structure and function of rabbit kidney. AB - An animal model was developed to investigate the effect of extracorporeal shock wave lithotripsy (ESWL) on a normal kidney. Rabbits were treated with 3,000 shock waves at 18 kV to each kidney. Blood and urine samples were collected daily before and after shock wave treatment. Serum levels of hemoglobin, creatinine, lactic dehydrogenase (LDH), creatinine phosphokinase (CPK), and total protein were determined. Urine determination of volume, total protein, hemoglobin, and creatinine were also made. All kidneys, after sacrifice, were subjected to histologic analysis. The average pre-treatment creatinine clearance of our rabbits was 8.3 ml./min. After the treatment, a significant (p less than 0.01) reduction in creatinine clearance was noted for four days. The reduction was to 0.61 ml./min. on day one, 0.87 on day two, 1.04 on day three, and so forth. Urine hemoglobin rose significantly (p less than 0.01) for the first three days from 0.0 to 1.5 gm./dl. Histologic examination at seven days showed focal subcapsular hemorrhage, tubular dilation, and interstitial hemorrhage. Histologic evaluation at two months revealed focal interstitial fibrosis. In conclusion, this study reveals that shock waves to the kidney have short term physiologic effects on renal function and permanent focal histologic effects, which do not effect long term physiologic function. Further research on the effects of ESWL on renal function and structure could be facilitated with the use of this model. PMID- 2709520 TI - Surface interaction between glycosaminoglycans and calcium oxalate. AB - Molecules and macromolecules are known to alter the process of crystallization, either through inhibition or promotion of nucleation, growth, and/or aggregation. One particular group of macromolecules, glycosaminoglycans (GAGs), has been of interest in our laboratory. The GAGs chondroitin A, chondroitin C, heparan sulfate, dermatan sulfate, hyaluronic acid, and keratan sulfate have all been shown to be inhibitors of calcium oxalate crystallization. Heparin, the only GAG which is not naturally present in urine, is the most potent inhibitor of all GAGs. Using the method of Langmuir isotherm adsorption, we studied the adsorption of certain GAGs onto calcium oxalate crystals. Under standardized conditions, heparin, chondroitin C, hyaluronic acid, and pentosan polysulfate (a synthetic polyanionic molecule similar to, but a weaker inhibitor than, heparin) were adsorbed onto calcium oxalate. The total amount of GAG required to maximally cover the crystal surface, as well as the equilibrium concentration at which surface was half-covered with GAG (inversely related to the desorption energy) were measured. Chondroitin C was adsorbed in the greatest amount, followed by heparin, pentosan polysulfate, and finally hyaluronic acid. Using the method of fiducial limits, the only insignificant difference was between heparin and chondroitin C, and between hyaluronic acid and pentosan polysulfate. Pentosan polysulfate required significantly higher equilibrium concentration than heparin and hyaluronic acid to cover half of the surface of the calcium oxalate crystals. The principle of Langmuir isotherm adsorption can be useful in predicting the effects of macromolecules on crystallization. Weaker inhibitors bind with less affinity than do stronger inhibitors. Further work is underway to characterize other inhibitors and promoters. PMID- 2709521 TI - Comparison of saphenous vein patch, polytetrafluoroethylene patch, and direct arteriotomy closure after carotid endarterectomy. Part I. Perioperative results. AB - To evaluate the perioperative outcomes and the immediate increases in size after patch closure, 140 carotid endarterectomies were randomized into one of three groups: direct no-patch closure, saphenous vein patch closure, and polytetrafluoroethylene patch closure. Seven patients (4.4%) experienced signs of cerebral ischemia in the immediate postoperative period. In three cases this was transient and reversible. In the other four reexploration was undertaken and carotid thrombosis was corrected by thrombectomy. The condition of one of these patients deteriorated to a permanent stroke, whereas the other patients made a complete recovery. Neurologic complications were more frequent in the no-patch group, but the differences between the groups were not significant. The incidence of perioperative internal carotid stenosis, aneurysmal dilatation, and other morphologic abnormalities was assessed in 131 intravenous digital subtraction angiograms taken before the patient was discharged from the hospital. Eight (17.0%) of the endarterectomies in the no-patch group were narrowed by 30% to 50% diameter stenosis, whereas none of the patched arteries had more than 30% stenosis. In contrast, dilatation of the common or internal carotid artery to more than twice the measured diameter was absent in non-patched arteries but was present in seven (17.0%) saphenous patch closures and four (9.23%) polytetrafluoroethylene patch closures. We conclude that patch closure after carotid endarterectomy is less likely to cause stenosis in the perioperative period. Poly-tetrafluoroethylene patches resist dilatation better than do saphenous vein patches and are less likely to become aneurysmal. PMID- 2709522 TI - Initial human evaluation of argon laser-assisted vascular anastomoses. AB - Forearm Brescia-Cimino arteriovenous fistulas were chosen for the initial clinical evaluation of argon laser-assisted anastomosis of human vessels. Ten patients with chronic renal failure had side-to-side radial artery/cephalic vein fistulas fused by laser. Incisions 1.2 to 1.5 cm in length were made in adjacent segments of artery and vein and were aligned for application of laser energy by four 6-0 polypropylene sutures. The sutures divided each fistula into four segments that were 5.0 to 6.5 mm long. Each segment was sealed satisfactorily in 75 to 100 seconds by use of 0.5 W, 1130 to 1520 joule/cm2 argon laser energy fluence. Seven (17.5%) of 40 bonds required an additional 7-0 biodegradable suture to close small gaps that did not fuse adequately. Serial prospective follow-up studies of the patients by physical examination and duplex scanning for periods of 12 to 20 months (15.4 +/- 2.8, n = 7) postoperatively have shown uniformly patent, compliant anastomoses with no evidence of hematomas, false aneurysms, or luminal narrowing. Histologic examination of two patent fistulas that were excised during revision procedures at 4 and 5 months postoperatively showed healing of the entire circumference of the anastomosis similar to that noted in extensive preclinical canine studies. We conclude from these preliminary results that argon laser vascular tissue fusion is possible in humans when reliable primary sealing of vascular anastomoses is achieved, and that healing occurs without aneurysmal dilatation during follow-up of up to 20 months. PMID- 2709523 TI - Enhancing the carotenoid content of atherosclerotic plaque: implications for laser therapy. AB - Selective laser ablation of human atherosclerotic plaque is possible because endogenous carotenoid pigments found in atherosclerotic plaque confer a twofold preferential absorption of laser radiation at 450 to 500 nm. In this study, patients with carotid endarterectomy were pretreated with oral beta carotene to determine if the carotenoid content and therefore laser selectivity of plaque could be increased in vivo. Beta carotene-treated patients had a significant, nearly twofold increase in their plaque carotenoid concentration, which increased from 0.22 to 0.40 microgram beta carotene/mg cholesterol. These results suggest that selective ablation of atherosclerotic plaque may be enhanced by pretreating patients with doses of oral beta carotene for short periods of time. PMID- 2709524 TI - Surgical correction of descending thoracic aortic aneurysms under simple aortic cross-clamping. AB - Between June 1983 and December 1987, 52 patients underwent resection of a descending thoracic aortic aneurysm under simple aortic cross-clamping without the use of shunting or bypass techniques. The 30-day mortality rate was 11.5%; 4.8% for elective cases and 36.5% for patients operated on in emergency. Two patients (4%) had spinal cord injury. One patient had paraplegia, and the other had mild paraparesis but completely recovered. Both patients were operated on for ruptured aneurysms. Four patients (7.5%) had severe postoperative renal dysfunction that was strongly related to intraoperative hypotension. The cumulative proportional survival rate was 81% at 1 year and 66% at 2 years for the total group. 85% at 1 year and 72% at 2 years for the patients first seen with nonruptured aneurysms. Aneurysms of the descending thoracic aorta can be safely resected without the use of shunting or bypass techniques. Surgery definitely improves the outcome for these patients who have a poor prognosis if left untreated. PMID- 2709525 TI - Heparin-induced platelet activation: the role of thromboxane A2 synthesis and the extent of platelet granule release in two patients. AB - Heparin-induced thrombosis is due to an immune-mediated activation of circulating platelets and has significant clinical implications for patients with vascular disease. The purpose of this article was (1) to define the biochemical mechanisms of heparin-induced platelet activation (HIPA) and (2) to determine the relationship between thromboxane A2 (TxA2) synthesis and platelet granule release. In two patients with confirmed HIPA, heparin (3 U/ml) induced extensive platelet aggregation (61.5%), release of 14C-serotonin (81.5% of releasable 14C serotonin, a dense granule marker) and platelet factor 4 (63.7% of releasable platelet factor 4, an alpha granule marker) and generation of TxB2, a stable metabolite of TxA2 (100% relative to serum control). In one patient heparin did not induce release of n-acetyl-beta-glucosaminadase (N-AC, a lysosomal granule marker), and aspirin (4 mmol/L), which abolished TxA2 synthesis, prevented aggregation and granule release. In the second patient heparin did induce release of N-AC (39.7% of releasable N-AC) and aspirin, despite abolishing TxA2 synthesis, did not prevent aggregation or granule release. In contrast, by elevating intracellular cyclic adenosine monophosphate, iloprost (0.01 mumol/L), a stable prostacyclin analogue, prevented heparin-induced aggregation, granule release, and TxB2 generation in both patients. Thus we show (1) HIPA can proceed independently of TxA2 synthesis; (2) heparin in certain patients can release lysosomal hydrolases, thus mimicking strong platelet agonists such as thrombin; and (3) iloprost but not aspirin prevents HIPA regardless of the biochemical pathways involved. PMID- 2709526 TI - The effect of cigarette smoking on rabbit aortic elastase activity. AB - Twenty rabbits were divided into three groups: (1) cage controls, (2) machine controls, and (3) cigarette exposed. The cigarette-exposed group was exposed to two 2-R1 reference cigarettes a day for 6 weeks on a Walton-II (Process and Instruments Corp., Brooklyn, N.Y.) smoking machine. Rabbits in the machine control group were placed in the smoking machine for the same period of time without cigarettes. Cage control animals were not placed in the smoking machine. Aortic elastase was significantly higher in the cigarette-exposed group (21.11 +/ 6.15) compared to both the cage control group (3.11 +/- 1.11) and machine control group (14.66 +/- 4.69). Aortic elastase in the machine control group was significantly higher in smoke-exposed rabbits than in both cage control and machine control rabbits. These data indicate that cigarette smoking increases aortic elastase activity in rabbits. If these data were to be extrapolated to humans, then patients with abdominal aortic aneurysms who smoke may have an accelerated rate of aneurysm growth or earlier rupture or both. PMID- 2709527 TI - Silent myocardial ischemia in patients undergoing peripheral vascular surgery: incidence and association with perioperative cardiac morbidity and mortality. AB - Atherosclerosis is a systemic disorder and coronary artery disease is highly prevalent in patients treated for lower-extremity obstructive vascular disease. Myocardial ischemia and infarction represent the most frequent and most clinically important complications of surgical procedures for lower-extremity revascularization. Despite attempts in several areas, no practical, sensitive, and specific method for identifying patients at highest risk for myocardial events postoperatively has been found before now. This study reports observations on a consecutive series of 50 patients who underwent continuous perioperative electrocardiographic monitoring with a microprocessor-based electrocardiographic ischemia monitor. Thirty-eight percent of the patients were found to have episodes of ischemia; most of these episodes were painless and would not otherwise have been recognized. Ischemia was most prominent in the postoperative rather than the preoperative or intraoperative phases. Tachycardia was often associated with ischemia. Significantly more cardiac-related morbidity and deaths occurred in patients who were documented to have silent myocardial ischemia. In fact, no cardiac events occurred in the 31 patients without ischemia (p less than 0.02). This type of ischemia monitoring represents a potential method for segregating patients at high risk for cardiac-related morbidity and death during lower-extremity revascularization. PMID- 2709528 TI - Ankle and foot fasciotomy: an adjunctive technique to optimize limb salvage after revascularization for acute ischemia. AB - Some patients with severely ischemic lower limbs continued to have severe ischemic changes in the foot after revascularization procedures and appropriate four leg compartment fasciotomies. Rather than abandon efforts at limb salvage, we performed adjunctive fasciotomies of the ankle and foot in 11 of these patients. These included five cases of acute traumatic superficial femoral or popliteal artery occlusions (three penetrating injuries; two blunt injuries) requiring primary repair or interposition vein graft; three cases of penetrating injury to all infrapopliteal arteries requiring tibiotibial vein bypasses; two cases of iatrogenic thrombosis of the common femoral artery requiring thrombectomy and patch angioplasty; and one case of a traumatically amputated leg requiring replantation. All bypasses remained patent after the distal fasciotomies. Limb salvage and good functional results were achieved in 10 of the 11 patients from 4 to 28 months postoperatively. One patient required a below knee amputation because of bleeding from an infected graft. Thus fasciotomy of the ankle and foot should be considered during acute revascularizations when a distal bypass occludes without obvious reasons, or when the foot remains ischemic or shows signs of compartment syndrome unrelieved by standard leg fasciotomy. PMID- 2709529 TI - Perioperative and late outcome in patients with left ventricular ejection fraction of 35% or less who require major vascular surgery. PMID- 2709530 TI - Wound complications after in situ bypass. PMID- 2709531 TI - Is boxing a risk factor for Alzheimer's? PMID- 2709532 TI - Does densitometry have a predictive role in osteoporosis? Studies may give answer. PMID- 2709533 TI - Silicone gel appears inexplicably to flatten, lighten hypertrophic scars from burns. PMID- 2709534 TI - From the Food and Drug Administration. PMID- 2709535 TI - From the Alcohol, Drug Abuse, and Mental Health Administration. PMID- 2709536 TI - Leads from the MMWR. Update: acquired immunodeficiency syndrome--United States, 1981-1988. PMID- 2709537 TI - Diarrheal deaths in American children. PMID- 2709538 TI - Warnings in tobacco advertisements: Marlboro Man vs Surgeon General. PMID- 2709539 TI - Hard-core smokers. PMID- 2709540 TI - Clove cigarettes. PMID- 2709541 TI - The computer-stored medical record. PMID- 2709542 TI - The cost of hospitalizations for firearm injuries. PMID- 2709543 TI - Adequate enzyme replacement after total pancreatectomy. PMID- 2709544 TI - Anabolic steroid use among male high school seniors. PMID- 2709545 TI - The aging thyroid. The use of thyroid hormone in older persons. AB - The overall prevalence of thyroid hormone use in an unselected population of older adults (n = 2575; average age, 68.6 years) was 6.9% (10.0% in women and 2.3% in men). Eighty-one percent of women taking it were doing so for appropriate indications, eg, hypothyroidism, while 12% were not, eg, for obesity or high serum cholesterol; more men (29%) were taking it inappropriately. Inappropriate use was associated with desiccated thyroid more than with thyroxine. After follow up averaging 6.9 years, 58% of inappropriate users were still taking it. Underuse also occurred. Thirty-seven percent of those definitely hypothyroid had a clearly elevated serum thyrotropin level (greater than 10 mU/L) despite thyroid therapy. Thyroid therapy is common in the elderly; most is appropriate. When inappropriate use occurs, it is more common in men and more often associated with desiccated thyroid, still commonly used in this age group. In chronic users of thyroid hormone, it is important to review currently appropriate indications and to measure serum thyrotropin levels to assess the adequacy of treatment of primary hypothyroidism. PMID- 2709546 TI - Risk factors for recurrent nonsyncopal falls. A prospective study. AB - Falls are a major threat to the health of older persons. We evaluated potential risk factors for falls in 325 community-dwelling persons aged 60 years or older who had fallen during the previous year, then followed up weekly for 1 year to ascertain nonsyncopal falls and their consequences. Risk factors for having a single fall were few and relatively weak, but multiple falls were more predictable. In multivariate analyses, we found increased odds of two or more falls for persons who had difficulty standing up from a chair, difficulty performing a tandem walk, arthritis, Parkinson's disease, three or more falls during the previous year, and a fall with injury during the previous year, and for whites. The proportion of subjects with two or more falls per year increased from 0.10 for those with none or one of these risk factors to 0.69 for those with four or more risk factors. Among older persons with a history of a recent fall, the risk of multiple nonsyncopal falls can be predicted from a few simple questions and examinations. PMID- 2709547 TI - Thyroid hormone treatment: new insights into an old therapy. PMID- 2709548 TI - A piece of my mind. The empty times. PMID- 2709549 TI - Air Force, Army, Navy physicians face unusual variety of challenges. PMID- 2709550 TI - Military medical 'commuting' may mean flying 12 hours to a turnkey hospital in mid-Europe. PMID- 2709551 TI - Now and then, even rugged Marines may need a few good physicians. PMID- 2709552 TI - Coast Guard turns to Public Health Service, civilian physicians to meet medical needs. PMID- 2709553 TI - Like other segments of culture, military has had to come to grips with drug abuse problems. PMID- 2709554 TI - Pacific is far-flung region for US military but medical care spans the vast distances. PMID- 2709555 TI - Physician must rely on remote-duty corpsman when patient is deep in, or far across, sea. PMID- 2709556 TI - Academy provides training in many aspects of military medicine and its applications. PMID- 2709557 TI - Newest in long tradition of hospital ships originally were launched as supertankers. PMID- 2709558 TI - Front line, sources of conflict all too close for US military physicians in divided Korea. PMID- 2709559 TI - Blending with surroundings, 'NAMRU' aids hosts while studying disease threats to US military. PMID- 2709560 TI - Army emphasizes burn research, treatment; Air Force provides rapid transportation. PMID- 2709561 TI - At US Army and Air Force bases in Europe, babies and broken bones head medical care list. PMID- 2709562 TI - Venerable Presidio houses varied medical, research programs for Army. PMID- 2709563 TI - Ocean's bottom more distant (in a sense) than moon's behind, say some researchers. PMID- 2709564 TI - Getting bugs out of military operations is job of environmental health specialty team. PMID- 2709566 TI - CONTEMPO '89. PMID- 2709565 TI - When the enemy is the environment, medical research may help provide effective defense. PMID- 2709567 TI - Allergy and immunology. PMID- 2709568 TI - Anesthesiology. PMID- 2709569 TI - Cardiovascular disease. PMID- 2709570 TI - Colon and rectal surgery. PMID- 2709571 TI - Computers. PMID- 2709572 TI - Critical care medicine. PMID- 2709573 TI - Dermatology. PMID- 2709574 TI - Economics. PMID- 2709575 TI - Emergency medicine. PMID- 2709576 TI - Ethics. PMID- 2709577 TI - Family practice. PMID- 2709578 TI - Geriatrics. PMID- 2709579 TI - Internal medicine. PMID- 2709580 TI - Neurological surgery. PMID- 2709581 TI - Neurology. PMID- 2709582 TI - Nutrition and fitness. PMID- 2709583 TI - Obstetrics and gynecology. PMID- 2709584 TI - Oncology. PMID- 2709585 TI - Ophthalmology. PMID- 2709586 TI - Orthopedic surgery. PMID- 2709587 TI - Otolaryngology--head and neck surgery. PMID- 2709588 TI - Pathology. PMID- 2709589 TI - Pediatrics. PMID- 2709590 TI - Physical medicine and rehabilitation. PMID- 2709591 TI - Plastic surgery. PMID- 2709592 TI - Preventive medicine. PMID- 2709593 TI - Professional liability. PMID- 2709594 TI - Radiology. PMID- 2709595 TI - Rheumatology. PMID- 2709596 TI - Sexology. PMID- 2709597 TI - Substance abuse. PMID- 2709598 TI - Urology. PMID- 2709599 TI - Resting energy expenditure in patients with alcoholic hepatitis. AB - Patients with alcoholic hepatitis are typically malnourished. A hypermetabolic state would explain, at least in part, the muscle wasting observed in these patients. However, data on hypermetabolism in liver disease are limited and conflicting. In this study, we evaluated measured energy expenditure (MEE) vs predicted energy expenditure (PEE), and MEE in relation to urinary creatinine excretion in 20 patients with moderate and severe alcoholic hepatitis, and 20 controls. Patients with alcoholic hepatitis had depressed creatinine height index (moderate 66%, severe 78%) demonstrating muscle depletion. Patients with alcoholic hepatitis also had depressed mean serum albumin concentrations, the moderate group 2.6 g/dl and the severe group 2.0 g/dl. The mean values for measured energy expenditure in moderate alcoholic hepatitis patients, severe alcoholic hepatitis patients, and the control group were: 1556 kcal, 1878 kcal, and 1943 kcal, respectively. The mean measured energy expenditures per g of creatinine for the same groups were: 1520 kcal, 1813 kcal, and 1043 kcal, respectively. The mean measured energy expenditure/predicted energy expenditure ratio was not increased in alcoholic hepatitis patients compared to controls. However, when related to urinary creatinine excretion, the alcoholic hepatitis patients had a mean measured energy expenditure that was 55% higher than controls. In conclusion, whereas the measured energy expenditure to predicted energy expenditure ratio was not elevated in alcoholic hepatitis patients compared to controls, the measured energy expenditure per gram of creatinine was significantly increased in alcoholic hepatitis patients, supporting the concept of alcoholic hepatitis as a hypermetabolic state. PMID- 2709600 TI - Effects of enterectomy on postoperative visceral organ glucose exchange. AB - The effects of a 60% small-bowel resection on postoperative visceral organ glucose exchange was studied in order to gain further understanding of the role of the intestinal tract as a supplier of gluconeogenic substrate to the liver following operative stress. We determined the flux of glucose across the gastrointestinal tract, liver, and kidneys in 20 postoperative dogs. With enterectomy portal bloodflow and total hepatic bloodflow were diminished by 33% and 25%, respectively. Arterial glucose was slightly lower in the enterectomized group 6 hr following the operation. Intestinal glucose uptake was diminished by more than 50% in the enterectomized dogs (p less than 0.01). Net hepatic glucose release fell from 22 mumole/kg/min to 8 mumole/kg/min (p less than 0.01). In control animals the kidney was an organ of slight glucose uptake while in the enterectomized group, the kidney released glucose at the rate of 4.1 mumole/kg/min (p less than 0.05). The data suggest that the gut is an important supplier of gluconeogenic precursors to the liver which are used to support gluconeogenesis in the postoperative period. The ability of the kidney to accelerate glucose production in this setting suggests that metabolic adaptation and cooperation between organs occurs during organ absence or dysfunction which helps preserve glucose homeostasis. PMID- 2709601 TI - Iron nutrition in childhood malignancy. AB - Status of iron nutrition along with demographic, anthropometric, dietary, and biochemical parameters were recorded in 98 pediatric cancer patients at the time of referral. Dietary intake in each patient was analyzed for calories, protein, and iron. Blood specimens were analyzed for hemoglobin (Hgb), hematocrit (Hct), iron, total iron-binding capacity (TIBC), transferrin, and ferritin. Dietary intake measures were assessed according to each subject's Recommended Dietary Allowance (RDA). The results were compared among three diagnostic groups, namely, benign, solid tumor, and hematopoietic. The nutrient lowest in intake was iron. The overall measures revealed significant differences between the benign and hematopoietic groups in all parameters except TIBC and transferrin. A correlation coefficient of 0.55 (p less than 10(-5) between transferrin and TIBC was generated in our patients. Significant differences were noted for ferritin in the acute lymphocytic leukemia (p = 0.0001) and lymphoma (p = 0.0007) groups when compared with the benign group. A correlation coefficient of 0.55 (p less than 10(-5) was generated in our patients. A 3-month follow-up assessment was conducted in order to document the effects of therapy. Tumor response and progression was compared to changes in ferritin levels from baseline to follow up. Our results support the literature, that ferritin is a sensitive tumor marker in various malignancies. PMID- 2709602 TI - A mortality risk index for men in a Veterans Administration extended care facility. AB - the purpose of this study was to develop (phase I) and validate (phase II) a mortality prognostic index, based on the annual clinical data base, for the men of this Veterans Administration extended care facility. The study population during phase I consisted of 123 men who were residing in three of the seven wards of the facility in August 1984. Sixty-six of these individuals were institutionalized because of a chronic neurologic (50) or medical (15) disorder ("nonpsychiatric group"). In 57 men, the reason for institutionalization was a chronic psychosis (schizophrenia, 53; manic depressive illness, 4) ("psychiatric group"). During August to October 1984, a comprehensive clinical data base comprising 70 attributes (including diagnoses and drugs) was collected. Deaths were recorded during the next 14 months. Death rate during the 14 months of observation was 33.3% in the nonpsychiatric group, and only 1.7% in the psychiatric group. In the nonpsychiatric men, univariate analysis yielded six attributes significantly correlated with death rate: serum cholesterol level, hematocrit, hemoglobin, midarm muscle circumference, triceps skinfold, and number of morbidity episodes. After serum cholesterol and hematocrit had been entered into a multivariate analysis model, none of the other four attributes contributed significant information about death rate. The multivariate analysis led to a mortality risk index (MRI) for nonpsychiatric patients, MRI = [hematocrit in %] + 10% [serum cholesterol in mg/dl]. As MRI varied from less than 50 to greater than 65, death rate in the nonpsychiatric group varied in parallel from 86 11%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709603 TI - [Anesthetic management in surgery of a descending aortic aneurysm in an eighteen month-old boy]. AB - Aortic aneurysm occurs rarely in childhood. Most aneurysms in children are associated with conditions such as Marfan's syndrome, coarctation of the aorta, Ehlers-Danlos syndrome and neurofibromatosis. We report a case of descending thoracic-abdominal aortic aneurysm in an eighteen month old boy with a mask-like face, ocular hypertelorism, blepharoptosis, a high arched palate and low set ears. He was scheduled for a bypass graft of the descending thoracic and abdominal aorta under partial cardiopulmonary bypass. High dose morphine anesthesia (2mg/kg) was employed and halothane was used to control the blood pressure. To our knowledge, anesthetic management of such an infant had not been reported. Therefore, we anesthetized this child according to anesthetic managements for adult cases considering carefully the boy's multiple anomalies. Anesthetic managements for the surgery of aortic aneurysms in childhood are discussed. PMID- 2709604 TI - [A case report of a patient who developed cyanosis and significant decrease in PtcO2 caused by a contraction of the ductus arteriosus]. AB - A 2-day-old male baby with patent ductus arteriosus and pulmonary atresia had an emergency anoplasty because of anal atresia. During the operation, anesthesia was maintained satisfactorily with 1-2% halothane and 70% nitrous oxide in oxygen, accompanied with continuous infusion of prostaglandin E1 (PGE1). However, after the inspired oxygen concentration was changed to 100% from 30% at the end of the operation, transcutaneous partial pressure of oxygen (PtcO2) began to decrease progressively, developing cyanosis and sinus bradycardia. Immediately the inspiratory concentration of oxygen was returned to 30% from 100% and the infusion rate of PGE1 was increased from 2 micrograms. kg-1.min-1. Atropine 0.2mg was also administered intravenously. A few minutes after this therapy, a gradual increase in PtcO2 was observed, and he recovered from cyanosis and respiratory arrest. In this case, we suspect that the cyanosis developed because of the contraction of PDA. In summary, anesthetic management of a patient with pulmonary atresia and PDA is described. The PtcO2 should be monitored continuously and the inspiration of pure oxygen should be avoided. Continuous infusion of PGE1 may be one of the effective measures to dilate PDA. PMID- 2709605 TI - [Brachial plexus block]. PMID- 2709606 TI - [Sympathetic skin response as an objective indicator of sympathetic activity]. AB - Sympathetic excitement is not rarely accompanied by sweating over the palm or sole, and this sudatory reaction is often depressed by atropine. But, there was no simple way for quantitative expression of sympathetic activity. As an objective indicator of sympathetic activity, sympathetic skin response (SSR) was studied in 17 volunteers and 5 patients in the pain clinic. SSR was evoked by square wave electric stimulation through a pair of surface electrodes placed on the unilateral forearm. SSR recorded with a surface electrode was much larger than that was taken with a needle electrode inserted deep under the skin, and was markedly reduced by an intravenous administration of atropine sulfate 0.5mg for about 10 min. These findings support the hypothesis that the SSR is developed by an action potential of eccrine glands of a cholinergic nature. Unilateral stellate ganglion block abolished SSR in the ipsilateral palm indicating that the efferent impulse of palmal SSR is transmitted via cervical sympathetic ganglion. Inhalation of 0.1MAC halothane or enflurane in air reduced the height of SSR within 10 minutes. They obtunded SSR dose-dependently, and almost completely abolished at a concentration of 0.3 MAC. SSR may be useful to evaluate sympathetic activity under various conditions, such as under the effect of sedatives, analgesics and general anesthetics, and to evaluate the effects of a nerve block or other drugs which were used to obtund the nociceptive afferent stimuli to the sympathetic center of the brain. PMID- 2709607 TI - [EEG analysis of high-dose fentanyl anesthesia--a comparison of rapid sequence anesthesia and the conventional method]. AB - Twenty-one patients who underwent cardiac surgery were assigned to receive high dose fentanyl rapid sequence anesthesia or conventional high-dose fentanyl anesthesia. In conventional method group, power of delta wave decreased with respect to time. But in rapid sequence group, no decrease was seen until the end of operation. Good maintenance of delta wave in rapid sequence group may be achieved by higher plasma fentanyl concentration and the absence of acute tolerance. In conclusion, high-dose fentanyl rapid sequence anesthesia is a useful method for cardiac surgery. PMID- 2709608 TI - [The effects of dopamine and amrinone on myocardial oxygen demand-supply relationship in dogs with coronary artery stenosis]. AB - This study examined the effects of dopamine (DA) and amrinone (AM) on myocardial oxygen demand-supply relationship in coronary artery stenotic areas (40-60% reduction of coronary blood flow by a constrictor) by measuring myocardial oxygen tension (PmO2) after administration of either DA or AM in twelve dogs. The results were as follow; 1) PmO2 showed no significant changes with either DA or AM, but it showed a significant inverse correlation with HR with DA or AM. Thus changes in HR affected the myocardial oxygen balance. 2) AM showed strong coronary vasodilating action in non-stenotic areas and possibly led to 'steal'. 3) Looking at indicators of myocardial ischemia, MAP/HR was significantly correlated with PmO2, and it reflected the myocardial oxygen demand-supply relationship better than RPP or DPTI/TTI. When DA or AM is used in patients with coronary artery disease, both drugs seem to maintain myocardial oxygen balance unless they cause tachycardia. Caution is required in the administration of AM because of the possibility of 'steal'. PMID- 2709609 TI - [Pharmacokinetics and the lung uptake of lidocaine during epidural anesthesia]. AB - In order to investigate the pharmacokinetics of lidocaine especially the lung uptake during epidural anesthesia, we measured the lidocaine concentrations of arterial and central venous blood simultaneously using a homogeneous enzyme immunoassay. Then the lung extraction ratio was calculated as (1-arterial lidocaine concentration/central venous lidocaine concentration) X 100%. With only epidural anesthesia, the lung uptake of lidocaine was above 30% during the first 40 minutes, but was less after additional administration. After general anesthesia with thiamylal, enflurane, nitrous oxide and oxygen, the lung uptake was 30 approximately 40% following initial and additional administrations. There was a positive correlation between the lung extraction ratio and the central venous lidocaine concentration 5 minutes after the initial administration. Having used laryngotracheal lidocaine spray during endotracheal intubation, the lung extraction ratio could not be calculated since this resulted in direct lidocaine administration to the lungs. In conclusion, the lung plays an important role in keeping the arterial lidocaine concentration low. PMID- 2709610 TI - [Sleep disturbances complicated by surgical stress; a questionnaire survey of 50 patients]. AB - A questionnaire survey of sleep disturbances was undertaken in 50 adult surgical patients to examine the prevalence of insomnias complicated with surgical stress. The survey about nocturnal sleep conditions was performed for consecutive four nights from two days before surgery. Defining early awakenings, difficulty of initiating or maintaining of sleep as manifestations of insomnias, the incidence of insomnias amounted to 72.9% on the night of two days before surgery, 72.0% on the night before surgery, 86.0% on the night of surgery, and 86.6% on the first night after surgery. High incidence of sleep disturbances complicated with surgical stress is noteworthy in the field of perioperative care. PMID- 2709611 TI - [Effect of sevoflurane on respiratory impedance measured by the forced oscillation method with random noise input]. AB - This study was performed to investigate the effect of sevoflurane, a new inhalation anesthetic, on the respiratory impedance measured by forced oscillation method with random noise input. Random noise (1 to approximately 25Hz) oscillated by a loudspeaker was imposed on the respiratory system of dogs through a tracheostomy and the oscillatory pressure wave and flow wave were monitored at the same point with a pressure transducer and a pneumotachograph. This procedure was repeated during inhalation of 100%-oxygen, 2.0%-then 4.0% sevoflurane-oxygen mixture, respectively. Impedance was calculated with fast Fourier transform by spectrum analyzer and a personal computer. During inhalation of 4.0%-sevoflurane-oxygen mixture, respiratory impedance especially respiratory resistance decreased at the high frequency area (6to approximately 20Hz), but 2.0%-sevoflurane-oxygen mixture did not cause a significant change of respiratory impedance. This study suggests that inhalation of an anesthetic concentration of sevoflurane produces weak bronchodilation compared with halothane or enflurane. PMID- 2709612 TI - [Distribution of the enkephalin neuron system in the rat thalamus; an immunohistochemical analysis]. AB - Met-and Leu-enkephalin immunoreactive structures in the rat thalamus were investigated by indirect immunofluorescent method. Both structures showed similar distributions. Distribution: A large number of enkephalin-like immunoreactive (ENKI) terminals were observed in the antero-ventral nucleus (AV), the region between the parataenial nucleus, the antero-medial thalamic nucleus and ventral part of the ventral nucleus. ENKI cells were seen in the medial thalamic nucleus and ventral nucleus of the lateral geniculate body. Furthermore, ENKI cells are seen at the pars parvicellular of the posterior commissure and the lateral posterior thalamic nucleus detected only following pretreatment with colchicine. Fiber connection: The origin of ENKI terminals in the AV was examined by means of experimental manipulations. Injections of HRP (horseradish peroxidase) into the AV resulted in labeling of the MM (medial mammillary nucleus pars medialis) and MMC (medial mammillary nucleus pars centralis) but not the PM (premammillary nucleus). Destruction of the MM, where a number of ENKI neurons were seen, resulted in a disappearance of ENKI terminals in the ipsilateral AV. These findings suggest that MM is a major source of ENKI terminals in the AV. PMID- 2709613 TI - [The care of severe burns: emergency period management to rehabilitation]. PMID- 2709614 TI - [The use of PGE1 in an elderly patient with mitral valve regurgitation during general anesthesia]. AB - PGE1 has a beneficial effect on cardiac failure with mitral valve regurgitation by decreasing the "after load". An 82-year-old female had a total cystectomy of a bladder tumor. The preoperative standard 12 lead electrocardiogram showed atrial fibrillation and incomplete right bundle branch block. The preoperative echocardiogram showed regurgitation of both mitral valve and tricuspid valve. Under heavy premedication, we intubated with fentanyl and pancuronium bromide, maintained anesthesia with enflurane. After incision, both pulmonary artery pressure and pulmonary capillary wedge pressure increased, and cardiac index decreased. Continuous injection of 100ng.kg-1.min-1 PGE1 made pulmonary artery pressure and pulmonary capillary wedge pressure to decrease, and cardiac index to increase. PaO2, however, decreased apparently. PGE1 was effective for cardiac failure with mitral valve regurgitation associated with pulmonary hypertension. But attention must be given to the decrease in PaO2. PMID- 2709615 TI - [An anesthetic experience with a patient with ornithine transcarbamylase deficiency]. AB - We report an anesthetic experience with ornithine transcarbamylase deficiency. The patient was 26 years of age who underwent open biopsy of the liver for a definitive diagnosis. OTC deficiency is an X-linked disorder of urea cycle. One of the anesthetic problems is how to control the blood ammonia level resulting in neurological damage which occurs following anesthesia and surgery. Recently it has been advocated that benzoate is effective to prevent hyperammonemia in patients with OTC deficiency. As patients with this disease are frequently complicated with hepatic dysfunction, anesthetics which may cause hepatic damage such as halothane should be avoided. PMID- 2709616 TI - [Use of fosfomycin tablets in the treatment of purulent skin diseases]. AB - Fourteen patients with purulent skin diseases were treated orally with fosfomycin (FOM) 1.5-3 g in the tablet form for 1 week to determine its efficacy and safety. The results obtained are summarized as follows. 1. The clinical efficacy rate was 71.4%. A bacteriological eradication rate of 71.4% was obtained. 2. As adverse reactions 3 patients experienced diarrhea and abdominal pain. But in all of these patients, symptoms were relieved with a reduction in dosage. 3. Taking the efficacy and the safety into account, utility rate was assessed to be 71.4%. From these results it is considered that FOM tablets are useful equally to conventional FOM capsules. PMID- 2709617 TI - [Effects of prophylactically used latamoxef with tobramycin against postoperative infections on therapeutic drug monitoring and renal function in the field of obstetrics and gynecology]. AB - Latamoxef (LMOX) and tobramycin (TOB) were administered to 50 patients via intravenous drip infusion to prevent postoperative infections in the field of obstetrics and gynecology. Blood levels of TOB were determined, and effects of the combined use of TOB and LMOX on renal functions were clinically studied. The results obtained are summarized as follows: 1. Determination of blood levels of TOB after intravenous drip infusion of 90 mg TOB with 1 g LMOX revealed a peak at the end of drip infusion, and thereafter the levels decreased rapidly. The maximum level and the level upon commencement of the next administration were within the safe range. 2. Clinical laboratory test before and after surgery using markers of renal functions (BUN, creatinine, beta 2-MG and NAG) revealed a tendency for slight increases in BUN and NAG, but no significant differences were shown. 3. There were no abnormalities in other clinical laboratory parameters or any appearance of subjective or objective side effects. PMID- 2709618 TI - [Pharmacokinetics of arbekacin in healthy volunteers and patients with renal insufficiency]. AB - Pharmacokinetics of arbekacin (HBK), a new aminoglycoside, was studied. Serum concentrations and urinary excretion were determined after single intravenous drip infusion of 100 mg HBK for 1 hour to healthy volunteers and patients with renal insufficiency of various kinds. The drug concentration was determined with bioassay, fluorescence polarization immunoassay (FPIA) and high-performance liquid chromatography (HPLC). Pharmacokinetic analysis was made in accordance with the two-compartment open model, and 24-hour endogenous creatinine clearance (Ccr) was used as the renal function index. In all cases peak serum levels were detected 1 hour after administration, and similar values were noted regardless of subjects' proficiencies of renal function. However, the serum clearance during beta-phase tended to be prolonged parallel with the degree of renal insufficiency. The excretion of HBK into urine was prolonged and cumulative recovery tended to be decreased in association with the decreased valued of Ccr. PMID- 2709620 TI - [Guidance of patients with myocardial infarction following discharge from the hospital]. PMID- 2709619 TI - [Pharmacokinetic and clinical studies of cefodizime in the field of obstetrics and gynecology]. AB - Cefodizime (THR-221, CDZM), a new antibiotic, was studied pharmacokinetically and clinically. The results obtained are summarized as follows: 1. Concentrations of CDZM in internal genital tissues were quite high after an intravenous infusion. 2. Clinical effects of the therapy with CDZM using intravenous infusion twice daily were evaluated in 1 patient with endometritis, 2 patients with pyometra, 1 patient with extragenital abscess and 1 patient with BARTHOLIN'S gland abscess. Clinical responses were good in all 5 patients. No side effects nor abnormal laboratory test values due to the drug were noted. PMID- 2709621 TI - [Basic study on the prevention of bedsores in aged patients--incidence and factors responsible for the development of bedsores among aged institutionalized patients]. PMID- 2709622 TI - [Nursing of patients on respirators. Timing in exchanging respirator circuits and maintenance care]. PMID- 2709623 TI - [Nursing study on self care by diabetic patients. 1. The purpose and methods in nursing studies on self care by diabetic patients]. PMID- 2709624 TI - [Nursing of patients on respirators. Mouth washing of patients on respirators]. PMID- 2709625 TI - [Nursing of patients on respirators. Innovation in the prevention of complications associated with tracheal aspiration]. PMID- 2709626 TI - [Nursing of patients on respirators. Introduction of music to ease the patients' stress]. PMID- 2709627 TI - [Nursing of patients on respirators. Factors responsible for removal of the respirator tube by the patient and methods for prevention]. PMID- 2709628 TI - [Nursing of a patient with acute postoperative respiratory insufficiency requiring the use of a respirator]. PMID- 2709629 TI - [Nursing of a patient on a respirator who became agitated during the postoperative period]. PMID- 2709630 TI - [Nursing of a patient with chronic respiratory insufficiency who had difficulty in weaning]. PMID- 2709631 TI - [Nursing of a child with respiratory distress syndrome who required high frequency ventilation (HFV)]. PMID- 2709632 TI - [Nursing and support for the family of a patient with a cognition disorder and dependent on a respirator for an extended period]. PMID- 2709633 TI - [Nursing and support for the family of a patient with amyotrophic lateral sclerosis who was dependent on a respirator for an extended period]. PMID- 2709635 TI - [Nursing of patients on respirators. Problems associated with the nursing of patients on respirators]. PMID- 2709634 TI - [Nursing of patients on respirators. High-frequency artificial ventilation- indication and methods of application]. PMID- 2709636 TI - [Questions and answers on nursing technology in neurology. Apprehension of a patient with facial paralysis on postoperative recovery]. PMID- 2709637 TI - [Questions and answers on nursing technology related to respiratory diseases. Care related to effective oxygen inhalation therapy]. PMID- 2709638 TI - [Questions and answers on nursing technology related to circulatory diseases. Arrhythmia observed during bedside monitoring]. PMID- 2709639 TI - [Questions and answers on nursing technology in gastroenterology. Management of the surgical wound of enterostomy and skin care]. PMID- 2709640 TI - [Questions and answers on nursing technology in urology. Management of indwelling catheters used for extended periods]. PMID- 2709641 TI - [Questions and answers in nursing technology involved in diseases of the motor system. Exchange of sheets on the second day following total hip replacement]. PMID- 2709642 TI - [Questions and answers on nursing technology in pediatrics. Hygienic care of a boy dependent on a respirator for an extended period]. PMID- 2709643 TI - [Questions and answers on nursing technology in gyneco-obstetrics. Ambulatory care and guidance of an expectant mother with hyperemesis gravidarum persisting into the 7th month of pregnancy]. PMID- 2709644 TI - [Questions and answers on nursing technology in emergency care. Obtaining personal information on a patient found unconscious on a street]. PMID- 2709645 TI - [Questions and answers on nursing technology in psychiatry. Refusal of medication and human rights of a patient who voluntarily committed herself]. PMID- 2709646 TI - [Abnormalities in water-electrolyte and acid-base balances]. PMID- 2709647 TI - Gastrointestinal helminth fauna of Japanese moles, Mogera spp. AB - One trematode, Echinostoma macrorchis, 2 cestodes, Hymenolepis diminuta and Choanotaenia spasskii and 5 nematodes, Parastrongyloides winchesi, Tricholinstowia talpae, Heterakis spumosa, Trichuris sp. and Capillaria soricis were obtained from 129 Mogera wogura, 233 M. kobeae and 28 M. tokudae, which were collected from almost all over Japan. All present cases were new host and locality records. The discovery of T. talpae in Japan shows the wide distribution of this species from Japan to Europe. PMID- 2709648 TI - Traumatic trochanteric bursitis. AB - The trochanteric bursa is anatomically quite susceptible to traumatic injury. However, specific reports of traumatic trochanteric bursitis in the literature are lacking. This may be due to failure to recognize this condition and to differentiate it from other pain syndromes involving the hip. This case report demonstrates the clinical presentation and management of traumatic trochanteric bursitis. PMID- 2709649 TI - Extracorporeal shock wave lithotripsy: a study of renal stone differences. AB - The extracorporeal shock wave lithotriptor (ESWL or lithotriptor) is a new, revolutionary, noninvasive method of treating renal calculi. It offers a safer, cheaper and more effective method of treatment compared to the traditional open surgery. Its history dates back only to 1980--and to 1985 at HCA Wesley Medical Center in Wichita, where research is just beginning. Initial research focused on ESWL versus traditional open surgery, but more recent research is investigating elements within the ESWL treatment. This article presents an investigation of renal stone size in relation to number of ESWL treatments needed per stone, number of shock waves per treatment, length of hospital stay post-lithotripsy, and hospital costs per length of stay during HCA Wesley's first year of operation. The subjects in this study consisted of approximately every third patient who received an ESWL treatment and were grouped according to stone sizes of less than 2 cm and those greater than 2 cm. A questionnaire was used, and after data were collected from the patient's charts and billing, a t-test for independent samples was used for analysis. PMID- 2709650 TI - Aortic stenosis. III: Doppler evaluation. PMID- 2709651 TI - Physician countersuits. PMID- 2709652 TI - [Cross-resistance relationships of antituberculosis drugs in Mycobacterium avium complex]. AB - At present, infection caused by Mycobacterium avium complex is usually treated by chemotherapy of antituberculosis drugs. However, cross-resistance relationships of antituberculosis drugs in the M. avium complex have not yet been studied. In the present study, we studied on this subject using three strains which were isolated from sputum specimens of patients who were not treated by any antituberculosis drugs: strain 13008 (serotype 20), strain 13016 (serotype 4) and strain 13034 (serotype 18). The methods used for isolating mutants resistant to rifampicin, isoniazid, ethambutol, streptomycin, kanamycin and/or enviomycin were described previously (Tsukamura, M: Kekkaku 62: 445-458, 1987). Mutants resistant to ethionamide were isolated from strains 13008 and 13016 at a rate of 10(-6) and mutants resistant to kitasamycin at a rate of 10(-5) to 10(-6) (these were not isolated from strain 13034). In contrast, mutants resistant to minocycline were isolated from strain 13034 only at a rate of 10(-4). Susceptibility testings to antituberculosis drugs were carried out as follows. Bacterial suspensions, 10 mg wet weight/ml, were prepared from ten day-old cultures of the strains growing on Ogawa egg medium slants. Each 0.02 ml-sample of the suspensions was inoculated onto Ogawa egg medium with or without a drug by a spiral loop. The media inoculated were incubated at 37 degrees C for 14 days. Minimal inhibitory concentration was determined as a concentration, on which no membraneous growth could occur. The results are shown in Tables 1 to 3. Cross-resistance relationships were observed only between ethionamide and isoniazid. Ethionamide resistant mutant strains were resistant to isoniazid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709653 TI - [Serological diagnosis of pulmonary aspergillosis by ELISA]. AB - Pulmonary aspergillosis usually develops on the basis of systemic immunosuppression and/or local impairments of respiratory system. Diagnosis of pulmonary aspergillosis has many difficulties. Chest X-ray findings of most cases are complicated with pre-existing changes due to the underlying diseases, and the detection rate of the pathogenic fungi from clinical specimens is unsatisfactorily low. Therefore, immunological or serological diagnosis is urgently required and precipitation-in-gel method has been widely applied. In this report, we compared clinical usefulness of the determination of anti aspergillus antibodies by ELISA with that of precipitation-in-gel method. ELISA was carried out according to the method previously reported by us (Yamamoto S. et al.: Kekkaku 62: 549, 1987). About two-thirds of 45 healthy adults (control) did not show any detectable IgG anti-aspergillus antibody and mean of IgG anti aspergillus antibody titer of the control group was 28.97. Patients, who had shown positive culture of fungus or was clinically diagnosed or strongly suspected as pulmonary aspergillosis, showed significantly high anti-aspergillus IgG antibody titer in comparison with the control group. Further, patients who were positive in precipitation-in-gel tests showed significantly higher IgG antibody titers than those who were negative in that test. IgG antibody titer determined by ELISA corresponded with clinical diagnosis much more exactly than the results of precipitation-in-gel test. Further, the results obtained by ELISA were objective and quantitative in comparison with the latter test. We concluded that ELISA was much superior to precipitation-in-gel test and that ELISA IgG antibody titers 2500 or more were confirmative and those between 570 and 2500 were strongly suggestive for the diagnosis of aspergillosis. IgM anti-aspergillus antibody titers were not different among healthy control group and patient groups, and could not be used for the diagnosis. PMID- 2709654 TI - [Two cases of tuberculous peritonitis and clinical significance of serum CA-125]. AB - We had recently experienced two cases of tuberculous peritonitis. One was suspected of ovarian cancer but finally diagnosed as tuberculosis by the exploratory laparotomy. The other was found out casually at the operation of benign ovarian tumor. Both cases accompanied with pulmonary tuberculosis. Tuberculous peritonitis should be considered in the differential diagnosis in patients with abdominal disorders. Remarkable elevation of serum CA-125 related to ovarian cancer was found in both cases. It was suggested that level of serum CA-125 might be useful for diagnosis and monitoring of the disease. PMID- 2709655 TI - [A case of Mycobacterium scrofulaceum lung infection occurring in old lung tuberculosis lesion]. AB - A 68-year-old man was admitted because of a persistent productive cough of 6 weeks' duration and detection of acid-fast bacilli from sputum. Based on chest roentgenograms and isolation of Mycobacterium scrofulaceum from sputum, on admission, a diagnosis of Mycobacterium scrofulaceum lung infection was made. Although the organisms were resistant to 0.1 microgram/ml of INH, 2.5 micrograms/ml of EB and 10 micrograms/ml of RFP, sputum converted to negative by the use of INH (0.4 g/day), EB (0.5 g/day) and RFP (0.3 g/day) for 2 months. The incidence rate of nontuberculous lung mycobacteriosis seems to be increasing recently. This is partially considered to be due to an increase of various strains of nontuberculous mycobacteria in the environment. A striking advance of clinical medicine and changes in the constitution of human society and environment surrounding us produce an increase in the number of compromised hosts. The lung disease due to Mycobacterium scrofulaceum, a kind of opportunistic pathogen, is considered to be increasing in a wide variety of compromised hosts in the future. PMID- 2709656 TI - [Image diagnosis of pulmonary tuberculosis]. PMID- 2709657 TI - Effect of sulfate on calcium and magnesium homeostasis following urinary diversion. AB - The present investigation was undertaken to elucidate the mechanisms of renal calcium and magnesium wastage in patients with urinary diversion through intestinal segments. Patients with urinary intestinal diversions demonstrated a hyperchloremic metabolic acidosis, increased serum sulfate and phosphate, and increased urinary excretion of calcium, phosphate, sulfate, and magnesium. A study was conducted in rats utilizing oral or intravenous loads of various solutes to investigate the possible mechanisms of these findings in patients. Ammonium enhances renal sulfate excretion and intestinal sulfate absorption. Increased filtered loads of sulfate inhibit renal tubule sodium and calcium reabsorption. Dietary ammonium and sulfate result in increased serum phosphorous concentrations. Ammonium appears to directly inhibit renal magnesium reabsorption. Renal tubule dysfunction resulting from relieved obstruction appears to enhance the inhibitory effect of sulfate on renal sodium and calcium reabsorption but does not alter the effect of ammonium on renal magnesium excretion. Taken together, these findings suggest that patients with hyperchloremic metabolic acidosis from the chronic reabsorption of ammonium chloride by intestinal urinary diversions may also reabsorb urinary sulfate. This load of ammonium and sulfate inhibits renal calcium and magnesium reabsorption. PMID- 2709658 TI - The simulation of continuous arteriovenous hemodialysis with a mathematical model. AB - We have developed a mathematical model that predicts the performance of continuous arteriovenous hemodialysis. Given patient (plasma protein concentration, hematocrit, mean arterial pressure, central venous pressure) and circuit (flow resistance, membrane hydraulic permeability, dialyzer mass transfer coefficient, ultrafiltrate column height, dialysate flow rate) characteristics as inputs, predictions of hydraulic and oncotic pressure distribution, filtration rate, blood flow, total, diffusive, and convective urea clearances are provided. The model was tested by perfusing a circuit with bovine blood under conditions of pure ultrafiltration, zero net ultrafiltration and dialysis, or combined ultrafiltration and dialysis (countercurrent dialysate flow at rates of 10, 20, and 30 ml/min). In order to permit computation, membrane hydraulic permeability and flow resistances were measured. Dialyzer mass transfer coefficient for urea could not be measured directly and so was determined by fitting model predictions to measured urea clearances. For all conditions of operation, a urea mass transfer coefficient of 0.014 cm/min successfully simulated the data. Predictions of blood flow, filtrate generation rate, and circuit pressure distribution were accurate. At lower dialysate flow rates, urea clearance approximated the sum of dialysate flow and filtration rate. At higher dialysate flows, however, departure from this ideal blood-dialysate equilibrium was observed. Model predictions regarding the relative contributions of diffusion and convection to urea clearance were explored. Under conditions of nearly perfect equilibration of urea between blood and dialysate at the blood inlet, the model predicts that the diffusive clearance of urea will increase with increasing rate of filtration and may exceed the rate of dialysate inflow. PMID- 2709659 TI - Abstracts. American Society of Nephrology. San Antonio, TX, USA, December 11-14, 1988. PMID- 2709660 TI - Elevated glucose alters paracellular transport of cultured human proximal tubule cells. AB - Cultures of human proximal tubule cells were exposed to elevated concentrations of glucose and dome formation was assessed over a 22 day period of growth. Cultures grown on 5.5 mM glucose formed five domes per microscopic field while those exposed to elevated glucose concentrations (11.0 mM to 27.5 mM) formed only two to three domes per field. The areas of the domes formed by the cells grown on elevated glucose concentrations were reduced as compared to those formed on 5.5 mM glucose. An analysis of the electrical properties of cells grown on elevated glucose concentrations by Ussing chamber technique disclosed a marked reduction in potential difference, short circuit current, and resistance compared to cells grown on 5.5 mM glucose. Routine ultrastructural analysis disclosed that cells grown on elevated glucose concentrations appeared to have fewer tight junction complexes. Further examination utilizing freeze fracture methodology demonstrated that cells grown on elevated glucose concentrations averaged two to three sealing strands per junction as compared to an average of five sealing strands for cells grown on 5.5 mM glucose. The cells grown on elevated glucose concentrations were also noted to possess a greater number of gap junctions. These results demonstrate that elevated glucose concentrations can alter the paracellular route, and possibly the transcellular route, of transport regulation in cultured human proximal tubule cells. PMID- 2709661 TI - Effects of reduced renal mass on tissue lipids and renal injury in hyperlipidemic rats. AB - Increasing evidence from experimental models of chronic renal failure suggests that abnormalities in lipid metabolism may contribute to progressive renal injury. In the present study, hyperlipidemic obese, and normolipemic lean Zucker rats were subjected to unilateral nephrectomy or sham surgery at eight weeks of age. After 32 weeks, renal injury was greater in obese than in lean rats, and injury was made worse by nephrectomy. Among the major lipid classes, increased renal cortical cholesteryl esters were positively correlated with the degree of renal injury, suggesting that mechanisms analogous to those thought to be important in the pathogenesis of atherosclerosis may cause renal injury. Among phospholipid fatty acids, the ratio of oleic to linoleic acids (18:1/18:2) was strongly linked to both glomerular (r = 0.83, P less than 0.01) and tubulo interstitial (rr = 0.80, P less than 0.01) injury, suggesting a possible role for a relative essential fatty acid deficiency in renal injury. There were also strong, negative associations between eicosapentaenoic acid levels and glomerular (r = -0.63, P less than 0.01) and tubulointerstitial (r = -0.71, P less than .01) injury. Altogether, these results suggest that specific abnormalities in renal lipid metabolism may be important in the pathogenesis of chronic, progressive renal injury. PMID- 2709662 TI - Brain dehydration and neurologic deterioration after rapid correction of hyponatremia. AB - We made rats severely hyponatremic, varying the rate of onset and duration of the disturbance, and then compared rapid correction to slow correction. An acute fall in the plasma Na to 106 mEq/liter within seven hours caused seizures and coma, but these findings resolved and survival was 100% after either rapid or slow correction. A more gradual fall in plasma Na to 95 mEq/liter in three days caused neither seizures nor coma. Measurements of brain water and electrolytes showed that adaptive losses of brain Na and K (maximally depleted within seven hours) and slower losses of non-electrolyte solutes progressively reduced brain edema. After three days of hyponatremia, rapid correction to 119 mEq/liter with 1 M NaCl or to 129 mEq/liter by withdrawing DDAVP caused brain dehydration because lost brain K and non-electrolyte solutes were recovered slowly. This treatment was followed by a delayed onset of severe neurologic findings, demyelinating brain lesions and a mortality rate of over 40%. Slow correction (0.3 mEq/liter/hr) avoided these complications and permitted 100% survival. We conclude that the rat adapts quickly to hyponatremia and can survive with extremely low plasma sodium concentrations for prolonged periods. Although rapid correction is well tolerated when hyponatremia is of brief duration, it may cause brain damage in animals that have had time to more fully adapt to the disturbance. PMID- 2709663 TI - Effect of thromboxane synthesis inhibition in a model of membranous nephropathy. AB - The effect of the thromboxane synthesis inhibitor UK 38485 on glomerular filtration rate (GFR) and proteinuria was evaluated in a rat model of unilateral membranous nephropathy. Two and 24 hours following perfusion of kidneys with cationized human IgG and i.v. administration of anti-human IgG-antiserum (in situ ICGN), glomerular thromboxane B2 (TxB2) formation was significantly higher (2 hr: 448 +/- 116 pg/mg protein/min; 24 hr: 173 +/- 21 pg/mg protein/min) compared to control (C) kidneys (2 hr: 173 +/- 21 pg/mg protein/min, P less than 0.005; 24 hr: 154 +/- 17 pg/mg protein/min, P less than 0.025). Two and seven days after induction of ICGN these differences were no longer present. Pretreatment with the thromboxane synthesis inhibitor UK 38485 prevented the decrease in GFR, which occurred two hours after induction of the glomerular disease (without UK: 161 +/- 31; with UK 325 +/- 21 microliters/100 g body wt/min). This UK 38485 effect on GFR was no longer detectable at 24 hours, two days and seven days. Initiation of glomerular immune injury was followed by significant proteinuria which averaged 250 +/- 85 mg/24 hr at day two. UK 38485 treatment, which reduced TxB2 formation in isolated glomeruli by 90% did not influence proteinuria. These data demonstrate that induction of heterologous, in situ immune complex glomerulonephritis stimulates glomerular thromboxane B2 formation, an effect which partially modulates the decrease in GFR at two hours. Thromboxane, however, does not seem to play a role in the mediation of proteinuria in this animal model. PMID- 2709664 TI - Renal function following acute renal failure in childhood: a long term follow-up study. AB - We measured glomerular and tubular function in 10 children, aged 7 to 19 years, 7 to 12 years after apparent recovery from their episodes of acute renal failure. Although glomerular filtration rate was normal in all, filtration fraction (inulin clearance/PAH clearance) was elevated in six of eight patients. Segmental tubular sodium transport was assessed using clearance techniques during hypotonic saline diuresis; both proximal and distal sodium reabsorption were normal when compared with age-appropriate normal standards. Tubular reabsorption of phosphate, glucose and amino acids were also normal, as were urinary concentrating and diluting capacity and distal tubular hydrogen ion secretion. We conclude that, despite normal glomerular filtration rate, glomerular function is abnormal in a significant number of children who have apparently recovered completely from ARF, probably due to destruction of a proportion of the total nephron population, predominantly those located in the superficial layers of the cortex. PMID- 2709665 TI - Urine glyceraldehyde excretion is elevated in the renal Fanconi syndrome. AB - We analyzed urinary constituents using GC/MS in 16 children with the renal Fanconi syndrome and 13 normal individuals. Urine glyceraldehyde levels were strikingly elevated in the renal Fanconi syndrome group (mean 5.1 +/- 4.8 mg/mg creatinine) compared to levels in the normal group (mean 0.04 +/- 0.04 mg/mg creatinine, P less than 0.001). Urine lactate levels were also elevated in the renal Fanconi syndrome group (mean 2.3 +/- 2.6 mg/mg creatinine) compared to normals (mean 0.01 +/- 0.01 mg/mg creatinine, P less than 0.003). Only small elevations of glyceraldehyde and lactate were found in urine from children with other renal disorders. Serum levels of glyceraldehyde and lactate were no greater in individuals with the Fanconi syndrome than in the normals. The fractional reabsorption of both glyceraldehyde and lactate was virtually complete in the normals, but was markedly impaired in the Fanconi syndrome patients where, in some cases, glyceraldehyde excretion greatly exceeded the excretion of creatinine. We conclude that marked glyceraldehyde excretion is a previously unrecognized feature of the renal Fanconi syndrome which may result from disordered proximal tubular glycolytic metabolism. Further studies will be required to determine the role of glyceraldehyde loss in the pathogenesis of this generalized disturbance of proximal tubular function. PMID- 2709666 TI - Unilateral nephrectomy and glomerular solute transport in the dog. AB - The influence of compensatory hyperfunction that occurs following unilateral nephrectomy on glomerular solute transport was determined in awake, unanesthetized dogs by renal clearance studies. Two groups of dogs were studied using different test solutes: group I (N = 5) using inulin, iothalamate, creatinine and sodium p-aminohippurate; and group II (N = 6) using creatinine, neutral dextran (3000 to 50,000 daltons) and sodium p-aminohippurate. Compensatory hyperfunction, as assessed by the increase in creatinine clearance per kidney, was 43 +/- 7% and 39 +/- 11% in the group I and II dogs, respectively. The inulin to creatinine and iothalamate to creatinine clearance ratios in the group I dogs were 0.93 +/- 0.07 and 1.00 +/- 0.04 before unilateral nephrectomy. The respective values after unilateral nephrectomy of 0.86 +/- 0.04 and 0.89 +/- 0.05 were lower but not statistically different. In the group II dogs, dextran to creatinine clearance ratios (dextran fractional clearance) over the molecular weight range studied also did not change significantly following unilateral nephrectomy. The magnitude of the change in dextran fractional clearance following unilateral nephrectomy was qualitatively consistent with that predicted by previous models of glomerular macromolecular transport based on membrane pore theory. A lack of quantitative agreement with these models, however, precluded a calculation of the changes in glomerular functional parameters following unilateral nephrectomy. Significant alterations in fractional clearance for neutral macromolecules do not occur following unilateral nephrectomy in the dog. PMID- 2709667 TI - Peritonitis in peritoneal dialysis: bacterial colonization by biofilm spread along the catheter surface. AB - We have used modern techniques of direct microscopic examination and quantitative bacterial recovery to show the existence of a route of bacterial colonization along the external and internal surfaces of Tenckhoff catheters implanted in experimental animals. The external route of progressive bacterial colonization extends from the cutaneous exit site through the dacron cuff and into the peritoneum. Bacterial growth along this route consists primarily of glycocalyx enclosed bacterial biofilms adherent to catheter and tissue surfaces, and this surface colonization may or may not give rise to peritoneal infection in which free-living bacteria are found in the peritoneal fluid. The rate of this progressive bacterial colonization depends on the degree of bacterial contamination of the exit site at the time of implantation. Exit site sterilization (hibitane) delays the process while inoculation with rabbit skin strains of Staphylococcus epidermidis accelerates it. Even with optimal implantation techniques, bacterial colonization proceeds via this subcutaneous route so that most Tenckhoff catheter surfaces are covered with a bacterial biofilm, consisting predominantly of gram positive cocci, within three weeks after the implantation of these devices. The rate of bacterial biofilm development on both surfaces of these Tenckhoff catheters, the bacterial colonization of peritoneal tissues, and the dissemination of bacteria into the peritoneal fluid are all significantly accelerated by dialysis in this experimental animal model of continuous ambulatory peritoneal dialysis (CAPD). PMID- 2709668 TI - Functional changes of monocytes due to dialysis membranes. AB - The functional effects directly induced by dialysis membranes on peripheral monocytes were analyzed in a plasma-free model of simulated dialysis using Cuprophan, cuprammonium rayon, polyacrylonitrile, polymethylmetacrilate and polysulphone membranes. A severe reduction of monocyte phagocytosis of IgG-coated erythrocytes was found by using Cuprophan and cuproammonium rayon. The cytofluorimetric analysis of several cell surface receptors, involved in the immune phagocytosis and recognizable by five quoted monoclonal antibodies, did not reveal any significant change. The defective phagocytosis of the IgG-coated erythrocytes by monocytes, due to the exposure to cellulose-derived membranes, was paralleled by an impaired interiorization of heat-aggregated human immunoglobulins, as analyzed by electron microscopy. The cell membrane binding of aggregated immunoglobulins was found to be unaffected. The defect was associated to a remarkably depressed generation of reactive oxygen species after Zymosan stimulation. Therefore, the defective immune phagocytosis induced by exposure of monocytes to cellulosic membranes was not due to a receptor rearrangement or an impaired binding of ingestible particles, but to a reduced internalization capacity probably related to an energy source exhaustion (as shown by the lack of response to stimuli able to induce oxidizing species production). These features are similar to those described in monocytes from acute systemic lupus erythematosus patients. PMID- 2709669 TI - Actions of cyclosporin A on cultured rat mesangial cells. AB - The effects of cyclosporin A (CsA) on planar surface area of cultured rat mesangial cells (PCSA) and cross-sectional area of isolated rat glomeruli (GCSA) were tested. The same experiments were performed after preincubation with platelet activating factor (PAF) antagonists (BN 52021, alprazolam) or calcium channel blockers (verapamil). Areas of cells or glomeruli were analyzed by a computer-assisted method. CsA reduced PCSA in a time-dependent (significant effects began at 15 min, about 12% of reduction with 10(-6) M CsA) and dose dependent (no effect at 10(-9) M CsA, maximal reduction of about 30% at 60 min of incubation with 10(-7) M CsA) fashion. BN 52021 (5.10(-5) M) and alprazolam (10( 5) M) completely inhibited the reduction of mesangial cell area induced by CsA. Verapamil (10(-5) M) only partially inhibited this action. Glomerular cross sectional area decreased after 30 minutes of incubation with 10(-6) M CsA (1.45 +/- 0.02 vs. 1.55 +/- 0.02 m2.10(-8), P less than 0.001), an effect that was inhibited by BN 52021 or verapamil. In addition, 10(-6) M CsA increased PAF production by isolated rat glomeruli (425 +/- 80 pg/mg vs. 198 +/- 13 pg/mg in control glomeruli, P less than 0.01), an effect which was not inhibited by verapamil. These results suggest that CsA could reduce GFR by decreasing the glomerular ultrafiltration coefficient, perhaps as a consequence of the contraction of mesangial cells. PAF seems to play a pivotal role in the genesis of this action. PMID- 2709671 TI - Progression of renal insufficiency: role of blood pressure. AB - The effect of blood pressure on progression of renal insufficiency was examined in a large group of patients who eventually required dialysis. Out of 198 consecutive new chronic dialysis patients, 86 had sufficient data predialysis to determine rates of progression of renal insufficiency by reciprocal creatinine versus time plots. Average plasma creatinine at first contact was 3.8 +/- 0.2 mg/dl and at the time of dialysis was 11.4 +/- 0.4 mg/dl. Mean duration of follow up was 33.4 +/- 2.5 months and the average rate of decline in reciprocal creatinine was -0.009 +/- 0.001 dl/mg month. Patients were stratified by average value of diastolic blood pressure measured in clinic. Patients in the lowest quartile had a rate of decline in reciprocal creatinine of -0.007 +/- 0.001 dl/mg month, which was slower than that of patients in the third and fourth quartiles, 0.010 +/- 0.001 and -0.011 +/- -0.002 dl/mg month, respectively (P less than 0.05). In individual patients, a mean diastolic BP of less than 90 mm Hg was associated with a rate of decline in reciprocal creatinine of -0.006 +/- 0.001 dl/mg month which was significantly less than the rate of -0.009 +/- 0.001 when the diastolic BP was greater than 90 mm Hg. Thus, in a large group of patients who have progressed to ESRD, there is an association between control of diastolic blood pressure and a slower rate of decline in renal function. PMID- 2709670 TI - Glomerular hemodynamic changes vs. hypertrophy in experimental glomerular sclerosis. AB - In a variety of recent studies in animals with chronic renal diseases, investigators have found a tight correlation between the elevation in glomerular pressures and flows versus glomerular hypertrophy. To investigate a possible causal link between the glomerular hyperfunction and hypertrophy, we studied the functional and morphological sequelae of nephrectomy and those of unilateral ureteral diversion (UD) into the peritoneal cavity (that is, removal of renal clearance function while keeping the kidney tissue in situ). In all nine experimental groups of 54 Munich-Wistar rats, 2/3 of the renal mass was removed from the left kidney by ligation of two or three branches of the left renal artery. In addition, right nephrectomy (NPX) was performed in Groups 1B, 2B and 3B or UD in Groups 1C, 2C and 3C. The right kidney was left untouched in control groups, Groups 1A, 2A and 3A. Micropuncture measurements and histological studies were performed at four days (Groups 1A, 1B and 1C), two weeks (Groups 2A, 2B and 2C) or four weeks (Groups 3A, 3B and 3C). At both four days and two weeks, NPX and UD groups had marked and comparable degrees of glomerular hypertension, hyperperfusion and hyperfiltration compared to the control group in the left kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709672 TI - The clinical utility of renal concentrating capacity in polycystic kidney disease. AB - We studied 177 adult nonazotemic subjects with autosomal dominant polycystic kidney disease (ADPKD) and 123 unaffected family members (NADPKD). In order to assess the factors influencing renal concentrating capacity maximal urinary osmolality (UOsm) after overnight water deprivation and vasopressin was measured. UOsm was reduced in ADPKD (680 +/- 14) compared to NADPKD subjects (812 +/- 13 mOsm/kg). A greater severity of the architectural abnormality as assessed by cyst number and size and remaining volume of normal parenchyma was associated with a greater impairment of renal concentrating capacity. The concentrating defect was present in the youngest ADPKD subjects and the rate of decline of concentrating capacity with age in ADPKD paralleled that in NADPKD subjects. Based on the initial 135 subjects studied, we developed an algorithm for diagnostic screening for ADPKD utilizing blood pressure, serum creatinine and UOsm designed to maximize sensitivity. When applied to a subsequent population of 165 adults, 121 with ADPKD and 44 unaffected relatives, this algorithm would have spared 20% of unaffected subjects from the cost of ultrasound while failing to detect less than 2% of affected subjects. This simple protocol thus offers a rapid and inexpensive way to screen for ADPKD. PMID- 2709673 TI - Effect of energy intake on nutritional status in maintenance hemodialysis patients. AB - Although maintenance hemodialysis (MHD) patients are often wasted, little is known about their dietary energy needs. We studied four men and two women in a clinical research center while they received diets providing 45, 35 and 25 kcal/kg desirable body weight/day; diets were fed, in random order, for 21 to 23 days each. Protein intake, 1.13 +/- 0.02 (SEM) g protein/kg/day, was similar with all three diets. Body weight rose with 45 and 35 kcal/kg/day (P less than 0.05) and fell with 25 kcal/kg/day (P less than 0.05). Nitrogen balance, adjusted for estimated unmeasured losses, was neutral with 45 and 35 kcal/kg/day and negative with 25 kcal/kg/day. Balance was neutral or positive in 6 of 6, 4 of 6, and 0 of 6 patients fed 45, 35, 25 kcal/kg/day, respectively. Nitrogen balance, many plasma amino acids and changes in body weight, mid-arm circumference, mid-arm muscle area and body fat each correlated with energy intake. Resting energy expenditure was normal. The energy intake estimated from regression equations to maintain neutral nitrogen balance was 38.5 kcal/kg desirable weight/day; for body fat and weight, it was 32 kcal/kg/day. These data suggest that MHD patients have normal energy expenditure and approximately normal requirements for maintenance of protein balance, body weight and body fat. An average energy intake of about 38 kcal/kg desirable weight/day may be necessary to maintain nitrogen balance in these patients. PMID- 2709674 TI - Iron status in patients receiving erythropoietin for dialysis-associated anemia. AB - Adequate body iron stores are crucial to assuring rapid and complete response to recombinant human erythropoietin (rHuEPO). In the present study, markers of iron storage were examined in 27 patients with normochromic, normocytic anemia undergoing acute rHuEPO (150 to 300 U/kg t.i.w.) treatment for anemia. We calculated projected iron needed for new hemoglobin synthesis from the difference between initial and target hemoglobin concentrations, initial iron reserves available from initial serum ferritin levels, and net projected surplus or deficit from the difference between needs and reserves. Of 22 patients predicted to develop iron deficiency (mean projected deficit 268 +/- 70 mg), 20 developed evidence of exhausted iron stores (transferrin %sat less than 16 or ferritin less than 30 micrograms/liter) before reaching target hemoglobin; two predicted to become deficient (projected deficit less than 100 mg) did not; and all five predicted to avoid iron deficiency (mean projected surplus 177 +/- 20 mg) remained iron replete. During acute rHuEPO therapy net body iron balance remained neutral in patients receiving no iron supplements and increased 5 mg/kg in patients prescribed oral ferrous sulfate. However, in patients given iron dextran i.v. less than 60% of elemental iron administered became measurable as iron stores or usable for hemoglobin synthesis. PMID- 2709676 TI - Italian Society of Nephrology. Messina-Giardini Naxos, Italy, June 8-11, 1988. Abstracts. PMID- 2709675 TI - The Australian Society of Nephrology. Twenty-fourth annual meeting. Sydney, Australia, New South Wales, Australia, 11-13 May 1988. Abstracts. PMID- 2709677 TI - P-31 nuclear magnetic resonance spectral changes in obstructed or dehydrated kidney. AB - Rat kidneys subjected to urinary obstruction or dehydration in vivo both develop marked increases in the area under a peak resonating in the phosphodiester region on their P-31 nuclear magnetic resonance spectra. The chemical species responsible for these changes were assessed using physiologic manipulations which altered the concentration of phosphate in the urine or increased the urine pH. Obstructed kidneys of rats fed a normal diet had a 140 +/- 50% increase in a peak resonating at 3.31 +/- 0.05 ppm after three hours of obstruction (P less than 0.01). Low phosphate diet which decreased urine phosphate concentration by 98% virtually eliminated this increase in peak area, where saline diuresis which decreased urine phosphate concentration by 50% markedly attenuated it. Acute phosphate loading which doubled urine phosphate concentration markedly accentuated the increase in peak area. Alkalinizing the urine with acetazolamide (changing urine pH from 6.2 +/- 0.2 to 8.0 +/- 0.1) shifted the resonance frequency of this increasing peak from 3.31 +/- 0.06 to 5.45 +/- 0.11 ppm (P less than 0.01). Rats fed a normal diet developed increases (57 +/- 15%, P less than 0.05) in a peak resonating at 2.84 +/- 0.03 ppm following 48 hours of dehydration. Rats fed a low phosphate diet had a comparable increase in the relative area of this peak (46 +/- 16%, P less than 0.05). Alkalinization of the urine did not affect the position or intensity of this peak under conditions of dehydration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709678 TI - Metabolic clearance rate and production rate of calcitriol in uremia. AB - We have previously demonstrated that while both normal humans and dogs tightly control serum calcitriol levels after 25(OH)D administration, anephric humans and 5/6 nephrectomized dogs significantly increase circulating 1,25(OH)2D when supraphysiological concentrations of 25(OH)D are reached in serum. Plasma 1,25(OH)2D level is determined not only by its rate of production but also by its rate of degradation. To further characterize the mechanisms involved in the responses to 25(OH)D therapy in normal circumstances and in chronic uremia, we measured metabolic clearance rate (MCR) and production rate (PR) of 1,25(OH)2D in normal dogs and in dogs with moderate and severe renal failure, at normal and supraphysiological serum concentrations of 25(OH)D. Basal MCR in uremic dogs, either with moderate or with severe renal failure, did not differ significantly from normals (6.7 +/- 0.7, 6.8 +/- 0.4 and 6.8 +/- 0.3 ml/min, respectively). Oral 25(OH)D administration for two weeks did not affect MCR either in normal animals or in both groups of uremic dogs. 25(OH)D treatment did not affect production rates in normal dogs and in animals with moderate renal failure (with normal basal values of 1,25(OH)2D), but significantly increased 1,25(OH)2D production from 0.13 +/- 0.01 to 0.25 +/- 0.04 micrograms/day (P less than 0.05) in dogs with severe renal insufficiency. These data suggest that it is the basal level of 1,25(OH)2D which regulates the synthesis of 1,25(OH)2D in response to 25(OH)D administration in normal and uremic animals. PMID- 2709679 TI - The delayed effect of growth hormone on renal function in humans. AB - Growth hormone is reported to increase renal plasma flow (RPF) and glomerular filtration rate (GFR) in some but not all studies. The discrepant results could be due to a delay in the effects of growth hormone on renal function. We therefore examined whether a growth hormone injection does increase RPF and GFR, whether this increase is delayed, and whether elevation in RPF and GFR is associated with increased plasma levels of insulin-like growth factor I (IGF-I). Seven normal adults received a single intramuscular injection of growth hormone, 0.15 mg/kg, and serial PAH and inulin clearances were then monitored for three consecutive days. Plasma growth hormone levels peaked an average of 2.25 hours after injection, at 128 +/- 12 SEM ng/ml, and then began to decrease; on the second day values were only slightly elevated and on the third day they were not different from baseline. Plasma IGF-I, analyzed by direct radioimmunoassay, did not change on the first day during 5.5 hours of measurements after injection. By the second day, plasma IGF-I was elevated to over twice baseline levels (P less than 0.05) and remained elevated on the third day (P less than 0.05). RPF and GFR did not change from baseline (546 +/- 19 and 100 +/- 3 ml/min/1.73 m2, respectively) during the 5.5 hours after injection on the first day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709680 TI - Intraerythrocytic pH variations during hemodialysis: a 31P NMR study. AB - Before hemodialysis, patients have an intraerythrocytic pH (pHi) and an extracellular pH, measured in whole blood (pHo), which are lower than those of healthy controls. During bicarbonate hemodialysis, pHi values continuously increase, approaching a normal value at the end of the session. Concomitantly, pHo values follow similar variations. During acetate hemodialysis, pHi values exhibit a steep initial decrease, reaching a minimum after about 15 minutes. Concurrently, however, pHo values decrease only slightly. This phenomenon seems to originate in the intraerythrocytic medium and might be due to a shift in intracellular CO2/bicarbonate equilibrium. This drop in pHi exhibits interpatient variability, suggesting that the magnitude of pH decrease would be correlated with the degree of the problems observed in some patients undergoing acetate hemodialysis. PMID- 2709682 TI - South African Renal Congress. Durban, South Africa, July 10-14, 1988. Abstracts. PMID- 2709681 TI - Successful use of double-lumen, silicone rubber catheters for permanent hemodialysis access. PMID- 2709683 TI - Tubular basement membrane change occurs pari passu with the development of cyst formation. AB - Our previous studies have shown that 2-amino-4,5-diphenyl thiazole hydrochloride (DPT) administered orally to rats induces a urine concentrating defect (within 1 to 2 days) and progressive, but reversible, cystic change of all collecting tubules (prominent between 4 and 8 weeks). Cystic change was characterized by tubular cell and basement membrane changes consisting of alterations in cellular biosynthetic/secretory organelles, followed by thickening of the basement membrane with marked reduction (approximately 50%) of the de novo synthesis of sulfated proteoglycans, suggesting that altered synthesis of tubular basement membrane plays a role in the development of cystic disease. In this study, following the administration of [14C]-DPT in vivo, a major urinary metabolite (greater than 70%) was isolated by HPLC and characterized by gas chromatographic mass spectral and NMR analyses as 2-amino-4-hydroxyphenyl-5 phenyl thiazole, designated phenol II. Phenol II was synthesized and administered orally to rats for four days to compare its biological effects with DPT. Phenol II induced a significantly greater impairment of concentrating ability and tubular cystic transformation than DPT. At day 5, in phenol II treated animals, basement membranes lining cysts were thickened several-fold and exhibited extensive loss and disorder of ruthenium red binding sites, indicative of loss of sulfated proteoglycans (heparin sulfate proteoglycan). The basement membrane changes occurred in tandem with the development of cystic transformation and strongly suggests that the basement membrane has a key role in the pathogenesis of PKD. The findings support the hypothesis that PKD may be due to a defect in the synthesis/degradation of one or more basement membrane components (sulfated proteoglycans) resulting in faulty tubular morphogenesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709684 TI - Phlorizin-induced glycosuria does not prevent gentamicin nephrotoxicity in rats. AB - Because rats with streptozotocin-induced diabetes mellitus (DM) have a high solute diuresis (glycosuria of 10 to 12 g/day), we have suggested that this may in part be responsible for their resistance to gentamicin-induced acute renal failure (ARF). The protection from gentamicin nephrotoxicity was studied in non diabetic rats with chronic solute diuresis induced by blockage of tubular glucose reabsorption with phlorizin (P). DM rats with mild glycosuria (similar in degree to that of the P treated animals) were also studied. Unanesthetized adult female, Sprague-Dawley rats were divided in four groups and studied for 15 days. Group 1 (P alone) received P, 360 mg/day, for 15 days; Group II (P + gentamicin); Group III (gentamicin alone) and Group IV (mild DM + gentamicin). Nephrotoxic doses (40 mg/kg body wt/day) of gentamicin were injected during the last nine days of study to the animals of groups II to IV. In Group I, P induced a moderate and stable glycosuria (3.9 +/- 0.1 g/day, SE), and no functional or morphologic evidence of renal dysfunction (baseline CCr 2.1 +/- 0.1 ml/min, undetectable lysozymuria) or damage (tubular necrosis score [maximum 4], zero). In Group II, P did not prevent gentamicin-ARF (maximal decrease in CCr at day 9.89%, P less than 0.001; peak lysozymuria, 1863 +/- 321 micrograms/day; and tubular necrosis score, 3.9 +/- 0.1). These values were not different from those of Group III: maximal decrease in CCr 73% (P less than 0.001); lysozymuria, 2147 +/- 701 micrograms/day; tubular necrosis score, 3.8 +/- 0.1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709685 TI - 1,25(OH)2 vitamin D3 inhibits parathyroid cell proliferation in experimental uremia. AB - Parathyroid cell proliferation and parathyroid hyperplasia are features of renal secondary hyperparathyroidism. Since parathyroids have recently been recognized as an important target for 1,25(OH)2D3, the effects of administration of variable doses of 1,25(OH)2D3 on ex vivo radiothymidine incorporation in the parathyroid glands, on parathyroid cell mitoses, on parathyroid weight, morphometric indices and on parathyroid protein/DNA ratio were examined in rats with uremia (subtotal nephrectomy; NX) or with calcium deficiency. 3H-thymidine incorporation (3 hr; 37 degrees C; PBS with 10 mmol glucose) was elevated in NX animals, that is, 204 +/- 51 dpm/micrograms DNA versus 96 +/- 28 in controls. In vivo pretreatment with 1,25(OH)2D3, either by intermittent i.p. injection or by osmotic minipump, dose dependently decreased 3H-thymidine incorporation and parathyroid cell mitoses without affecting morphometric indices of parathyroid cells. Prophylactic administration (i.p.) of 1,25(OH)2D3, starting on the day of nephrectomy, prevented parathyroid hyperplasia (NX + 1,25(OH)2D3 0.84 micrograms tissue/g body wt vs. 1.25 micrograms in untreated NX and 0.54 in ad libitum fed controls), but 10 days of treatment beginning on the 21st day of uremia did not reverse existing hyperplasia (NX + 1,25(OH)2D3 1.5 micrograms/g body wt vs. 1.37 micrograms in untreated NX and 0.56 micrograms in ad libitum fed controls). The inhibitory effect was specific for 1,25(OH)2D3 and not imitated by Dexamethason. However, the effect was not specific for parathyroid hyperplasia of uremia, since similar inhibition of 3H-thymidine incorporation by 1,25(OH)2D3 was also observed in rats on low calcium diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709686 TI - Symposium on the pathogenetic mechanisms in nephritis. PMID- 2709687 TI - [Further studies of diabetic microangiopathy in children with insulin-dependent diabetes mellitus. Electron microscopy studies]. AB - Electronmicroscopy examinations of the skin vessels were performed in 20 well compensated children with insulin-dependent diabetes mellitus (14 girls and 6 boys ages from 4 to 18 years). The results were compared with 10 healthy ones. In 17 patients the electron-microscopic picture was pathologic, with varying of intensity. Structurally, the most relevant changes were represented by thickening of the basal membrane (in some cases with its multiplication), swelling of endothelial cells, decrease in number of pinocytic vesicules and presence of deposits with increased electron density in the pericarion and the perivascular space. Vascular disturbances may develop very early, sometimes in the first month after manifestation of the disease. The authors suggest, that further investigations are necessary to elucidate the nature of the observed changes. An intensification of insulin therapy would be also considered. PMID- 2709688 TI - [Transient hyperphosphatasemia in childhood]. AB - During hospitalisation four infants were found to have a marked increase in serum alkaline phosphatase, which could be attributed neither to clinical nor paraclinical diseases and is considered transitory hyperphosphatasaemia. This phenomenon is briefly discussed on the basis of the literature. The children should be protected from extensive diagnostical measures. PMID- 2709689 TI - [Radiation dosage of premature infants caused by roentgen imaging of the thorax]. AB - The X-ray pictures of the thorax from premature infants must be prepared by conditions of neonatal intensive care. For this X-ray pictures are available very often single-puls generators only. The radiation exposure is dependent prominently on the type of the generator. The radiation exposure was compared between single-puls generators and 6-puls generators. The dosimetry was performed with CaF2-thermoluminescent dosimeters. The results of measurement demonstrated: In the radiation fields the radiation exposure is considerable higher by the single-puls generators than by the 6-puls generators. The indication to X-ray pictures of the thorax from premature infants under conditions of bed-side with single-puls generators must be very accuratly. PMID- 2709690 TI - [Generalized herpesvirus infection with severe consumption coagulopathy in a newborn infant]. AB - In a mature newborn the symptoms of a disseminated HSV infection were evident at the 6th day of life. Later on bleeding occurred as a result of severe consumption coagulopathy. During treatment with Acyclovir the bleeding situation was controlled by fibrinogen replacement. The infant survived and is under normal psychologic and motorical development now. The treatment result is taken for the good virostatic efficacy of Acyclovir. It inhibits the DNA polymerases and therefore the DNA replication within the herpes viruses selectively. This high degree of selectivity is caused by its selective penetration into the infected cells, its faster transformation by the viral thymidine kinase as well as by its stronger affinity for HSV coded polymerase in detail. The diagnosis had been confirmed by detection of herpes viruses within the blister fluid and cerebrospinal fluid as well as by serological findings. PMID- 2709691 TI - [Recommendation for vitamin K administration in the newborn infant for the prevention of hemorrhage caused by vitamin K deficiency]. PMID- 2709692 TI - [Controlled laparostomy in the treatment of peritonitis]. PMID- 2709693 TI - [A method of forming an end-to-end invaginated entero-colonic anastomosis using a shuttle suture]. PMID- 2709694 TI - [A method of closure of the duodenal stump]. PMID- 2709695 TI - [An injection needle for the endoscope]. PMID- 2709696 TI - [A modification of Henrich's method in the treatment of postoperative hernia of the right ileal region]. PMID- 2709697 TI - [Is appendectomy always indicated when using an operative approach in the right ileal region?]. PMID- 2709698 TI - [A combination of acute appendicitis with suppuration of a urachal cyst]. PMID- 2709699 TI - [Hemangioma of the ileum causing triple invagination of the small intestine]. PMID- 2709700 TI - [Strangulation of a myxoma of the vermiform process in an umbilical hernia]. PMID- 2709701 TI - [Strangulation of an internal abdominal hernia]. PMID- 2709702 TI - [A giant cyst of the adrenal gland]. PMID- 2709703 TI - [Fournier's disease]. PMID- 2709704 TI - [Simultaneous wounds of the common carotid artery, the internal jugular vein and the cervical region of the esophagus]. PMID- 2709705 TI - [Means of reducing mortality in acute appendicitis]. AB - The results of operative interventions conducted for acute appendicitis in 81,656 patients are analysed. Postoperative mortality reduced from 0.2 to 0.08% in the last decade. Peritonitis and intraabdominal abscesses accounted for 60.9% of fatal outcomes, thrombosis of the pulmonary artery--for 7.8%, intestinal fistulas -for 2.6%, and hemorrhages--for 1.7%. Improved training of doctors of emergency ambulance service, district medical officers, pediatricians, and specialists in infectious diseases in the diagnosis of acute surgical diseases is a reliable reserve in reducing the frequency of diagnostic errors in patients with acute appendicitis. PMID- 2709706 TI - [A rare cause of extravasal compression of the axillary artery]. PMID- 2709707 TI - [Causes of postoperative mortality in acute appendicitis]. AB - The authors analyse 14,041 patients who were operated on for acute appendicitis, 41 (0.29%) of whom died. Among the patients who died 56.1% were of elderly and old age. Delayed call for the doctor and diagnostic errors of the medical personnel are the main causes of postoperative mortality. It is pointed out that the therapeutic-tactical and therapeutic-technical errors of surgeons are due to an atypical course of appendicitis and its complications, marked pathomorphological changes in the abdominal cavity, insufficient qualification of young surgeons, and unjustified refusal of the help of experienced specialists. PMID- 2709708 TI - [The motor activity of the gastrointestinal tract in acute appendicitis]. AB - From study of electrogastrograms in 92 patients with acute appendicitis before and in various periods after appendectomy conducted under local or halothane nitrous-oxide-oxygen anesthesia, the authors conclude that electrogastrography may be used in complex with other methods for prognosticating the possibility of the occurrence of postoperative paresis. They point to the preventive significance of general anesthesia in the development of postoperative pareses. Percutaneous electrostimulation had a favourable effect in 12 patients with paresis developing after appendectomy. PMID- 2709709 TI - [Outlook for the development of emergency endoscopy]. AB - According to the object of emergency endoscopy, the author discusses the advances achieved in some fields of medicine owing to introduction of the methods of diagnostic and therapeutic endoscopy into practice. He fixes special attention on the fact that the use of modern methods of emergency endoscopy may reduce sharply the mortality and the incidence of complications in the most commonly encountered diseases and affections. Methods of therapeutic surgical endoscopy allow some patients to be spared the traditional surgical interventions. The main prospects of the development of emergency endoscopy are linked with the organization of its service. PMID- 2709710 TI - [Combination therapy of acute intestinal obstruction]. AB - The article discusses the results of complex surgical treatment of 108 patients with acute intestinal obstruction which was caused by benign lesions in 64 and by malignant tumors of the rectum in 44 patients. Twenty-three persons (21.2%) died after palliative and radical operations. The main causes of death were intoxication (52.2% of fatal cases) and peritonitis (26.1%). Hemosorption is the most effective measure for the prevention and treatment of the endogenous intoxication syndrome in the postoperative period. A brief therapeutic effect or inefficacy of hemosorption is evidence of persistence of the pathological process in the abdominal cavity. PMID- 2709712 TI - [Anatomo-surgical variants of reno-portal anastomoses]. PMID- 2709711 TI - [Pathogenesis of the cytopenia syndrome in patients with cirrhosis of the liver complicated by portal hypertension]. AB - One of the main causes of cytopenia and cellular immunodeficiency in patients with cirrhosis of the liver and portal hypertension is increased portal pressure, which, in turn, induces increased storage of formed elements in the spleen. Shunting operations producing a stable decompressive effect correct cytopenia similar to splenectomy but at the same time are devoid of the menacing postoperative complications characteristic of splenectomy. PMID- 2709713 TI - [Use of arachidene and alpha-tocopherol in the preoperative management of patients with peptic ulcer]. AB - It was established that concurrent use of arachidene and alpha-tocopherol in the commonly applied preoperative management of patients with peptic ulcer normalizes HCl secretion and the content of cytoprotective biological regulators of PGE2 and prostacyclin in the gastric juice. The level of thromboxane B2, lipoperoxides, and oxidized glutathione reduces significantly. It was also found that selective proximal vagotomy may in itself promote normalization of these metabolic indices. PMID- 2709714 TI - [Complex evaluation of the healing of intestinal anastomoses in the early postoperative period]. AB - Eighty-six patients were subjected to complex examination in the immediate postoperative period to check the condition of intestinal anastomoses. In 58 (67.4%) patients inflammation in the zone of the anastomosis was found to be negligible and produced no specific clinical manifestations; 28 (32.6%) patients had marked inflammatory changes in the region of the anastomosis. This condition, interpreted as anastomositis, is favourable for the development of incompetence of the sutures of the anastomosis, which was diagnosed in 4.7% of patients. Timely diagnosis of anastomositis and application of a complex of nonoperative measures is conducive to reduction of the frequency of postoperative complications and mortality. PMID- 2709715 TI - [Treatment of chronic paraproctitis]. AB - Clinical observations over 51 patients with chronic paraproctitis are analysed. In view of the growing incidence of this disease today, the authors point out the practical significance of medical rehabilitation of patients and tha advantages of operation for excision of fistulas with the application of a complete suture to the wound and early active management of patients after the operation. PMID- 2709716 TI - [Incompetence of the anal sphincter]. AB - The indications for and the results of treatment of 18 patients with sphincter ani incompetence are discussed. Sixteen patients had II and III degree incompetence. Fifteen patients were treated by operation, the late-term results were studied in 12, good functional results were achieved in 10 patients. Timely recognition of the disease and referring the patients to a proctologist facilitates the improvement of the results of treatment. PMID- 2709717 TI - [Clinico-morphologic data in decompensated colonic stasis]. AB - The authors studied the results of surgical treatment of 97 patients with complicated form of the decompensated stage of chronic colonic stasis. The choice of the method and volume of the operation is determined by the location and spread of the stasis in the colon. Histological examination of material removed during the operation revealed predominantly dystrophic changes of the ganglionic cells of the musculo-intestinal plexus and hypertrophy and sclerosis of the muscular coat of the colon. The operation produced a good and satisfactory effect in 83.4% of patients. PMID- 2709718 TI - [Long-term results of endoscopic polypectomy of the colon]. AB - Follow-up of 835 patients in periods of 1 to 11 years after endoscopic removal of polyps from the large intestine revealed no new tumors in 44.2% of them. More than half of patients had new polyps (45.3%) and carcinoma (4.1%) in various periods. The number of cases with new tumors increases with the increase of the duration of the dynamic follow-up. PMID- 2709719 TI - [Acupuncture reflex therapy in the treatment of coccygodynia]. AB - A complex of measures including physiotherapy, procaine-alcohol blockades, and massage of the coccyx and muscles of the pelvic floor were used in the treatment of 37 patients. Acupuncture reflex therapy was applied in addition in 24 patients. The complex method led to stable recovery of most of the patients. PMID- 2709720 TI - [Femoral hernia following inguinal hernioplasty]. AB - Study of 194 cases with femoral hernias showed that in 8.25% they developed after inguinal hernioplasty. The anatomical features of the zone of the inguinofemoral junction were studied in 15 operations. The anatomical elements were weak in more than 50% of patients, triangular inguinal spaces and interligamentary spaces more than 4 cm in width were found in two thirds of patients. Operative treatment for plastic repair was accomplished with the strongest anatomical elements of this zone with restoration of their physiological directions and application of autologous dermoplasty. PMID- 2709721 TI - [Controversial problems of the terminology and classification of relaparotomy]. PMID- 2709722 TI - [Semi-open and open methods of treating disseminated purulent peritonitis]. PMID- 2709723 TI - [X-ray therapy of inflammatory complications in patients following surgery of the abdominal organs]. PMID- 2709724 TI - [Closed active drainage of postoperative and postinjection suppurative complications]. PMID- 2709725 TI - [Errors in the diagnosis of acute surgical diseases of the abdominal organs in false strangulated hernia]. PMID- 2709726 TI - [Treatment of patients with gastroduodenal hemorrhage]. PMID- 2709727 TI - [Anterior seromyotomy of the corpus and fundus of the stomach in combination with posterior selective vagotomy in the treatment of duodenal ulcer]. PMID- 2709728 TI - [Jejunostomy in the surgical treatment of the sequelae of combined chemical burns of the esophagus and stomach]. PMID- 2709729 TI - [Resection of the acid-producing portion of the stomach as a method of treating Zollinger-Ellison syndrome]. PMID- 2709730 TI - [The choice of approach in simultaneous operations on the retroperitoneal space and the abdominal cavity]. PMID- 2709731 TI - [Surgical anatomy of the neurovascular elements of the thigh muscles used in sphincteroplasty]. PMID- 2709732 TI - [Pars plana vitrectomy in chronic uveitis in the child]. AB - In five children aged between 8 and 14, suffering from chronic recurrent uveitis of undetermined etiology, pars plana vitrectomy was performed in order to halt progression of the disease. Postoperatively there was a clear improvement in vision in all five patients, and in the follow-up period of 5 to 26 months there were no further recurrences of uveitis in the eyes which had been treated. These observations support the assumption that vitrectomy has a favorable effect not only in adults but also in children with therapy-resistant uveitis. PMID- 2709733 TI - [Classification and importance of cystoid macular edema in pseudophakia]. AB - In a prospective study the authors attempted to establish the incidence of cystoid macular edema (CME) in uncomplicated intracapsular cataract extraction with implantation of Choyce Mark IX lenses. Fluorescein angiography was performed after eight days, six weeks, six months, and at least one year post-operatively. Any edema found was classified as Grade I to III. Grade III CME was demonstrated in 4% of the cases studied after six weeks, though not after six months or one year, respectively. After one year, Grade II was found in 2% and Grade I in 15%, respectively. However, visual function was not impaired. At no time was there any correlation between the severity of the macular edema and visual acuity: all combinations are possible. Grade III CME evidently only impairs visual function if it persists for a prolonged period of time. Hyperfluorescence in the late phase of the angiogram permits the breakdown of the blood-aqueous barrier to be estimated semi-quantitatively. PMID- 2709734 TI - [Periphlebitis retinae ("Rucker")--a symptom of disseminated encephalomyelitis]. AB - Within a group of neuro-ophthalmic patients (147 patients with either florid or cured optic neuritis (ON), five (3.4%) were found to be suffering from retinal periphlebitis "Rucker". Of these five patients, three were also suffering from Encephalomyelitis disseminata (E.d.). One patient had ON without E.d.; in another there were sufficient grounds for a tentative diagnosis of ON during the follow up period. The relatively low percentage of patients with retinal periphlebitis associated with a basic demyelinating condition can be attributed primarily to the fact that the group of patients examined consisted of neuro-ophthalmic patients in most of whom the basic disease manifested itself for the first time. The multi-focal processes involved in demyelinating diseases become apparent through inflammatory focuses with varying degrees of activity, often in the same eye. PMID- 2709735 TI - [2 new possibilities for using balloon occlusion in relation to the indentation effect]. AB - Two new applications of the balloon are described which exploit its variable indentation: in the first case, the volume is reduced by withdrawal of fluid; in the second it is increased by additional injection. In both cases the procedure consists in two steps performed in subconjunctival anesthesia. In the first case the balloon provides intraocular space prior to gas injection (giant tear detachment). In the first step the balloon is inserted into the parabulbar space. After one to two hours this results in a deep indentation of the globe. In the second step the balloon indentation is used to compensate for the rise in IOP induced by the gas injection. With this "balloongasprocedure", a kind of fluid gas-exchange is performed by injecting 1.0 ml of an expanding perfluorocarbon gas without prior drainage or pars plana vitrectomy. In the second case, the balloon is used in cases of detachment to interrupt retinal circulation prior to occlusion of a recurrently hemorrhaging vessel using the laser. In the first step, the tear is tamponaded by the parabulbar balloon and with this, the artery crossing the horseshoe tear is attached as well. In the second step, by increasing the balloon volume, retinal circulation is interrupted prior to occlusion of the artery by laser with reduced risk of hemorrhage. In both applications of the balloon a relatively complex detachment operation is divided into two smaller principle of less risky procedures on the surgery in small steps. PMID- 2709736 TI - [The course of the superficial temporal artery. Anatomic studies as a prerequisite to arterial biopsy]. AB - The superficial temporal artery, together with its branches, was dissected in 161 half-heads, and the course of these vessels mapped against a newly-developed grid which can be adapted to conform to the proportions of each individual skull. The practical aim of this investigation was to establish the position of that incision which has the highest probability of being well-placed for taking a biopsy from the frontal branch of the artery. In 86.3% of the authors' specimens it was possible to reach this vessel through a 2.5 cm incision running up-ward and posteriorward at an angle of 45 degrees to the "upper horizontal line" from a point 1-1.5 cm behind the intersection of this line with the "lateral border of the orbit". The commonest type of ramification, with two terminal branches, was found in 94.6% of the specimens. Type 2 (with three terminal branches) occurred in 2.5% and Type 3 (with a single terminal branch) also in 2.5% of the cases. The level of the bifurcation of the superficial temporal artery varied between a point 2 cm below the "German horizontal line" and a second point 2 cm above the "upper horizontal line". The main trunk of the vessel was found to make an angle of 82.2 degrees with the "German horizontal line", its frontal branch running upward and anteriorward at an angle of 40 degrees to this line. PMID- 2709737 TI - [Disturbance of binocular vision by wiper smears on windshields]. AB - Sunlight or light from other sources can be scattered and refracted by the smears left on windshields by wipers. Under certain circumstances the resulting light phenomena can disturb binocular vision and distract the driver's attention. PMID- 2709738 TI - [Amplitude reaction in binocular cortical visual evoked potentials in anamorphotic image relations]. AB - The correction of astigmatism by means of spectacle lenses involves anamorphotic distorsions. Dramatic changes in image formation can be detected in the VECP. PMID- 2709739 TI - [Incorporation of 15N in VLDL and LDL: in vivo synthesis of apolipoprotein B in the post-absorptive and fasting state]. AB - In vivo synthesis of apolipoprotein B 100 (ApoB) was recently determined in man using stable isotopes. With this procedure we analyzed (1) the effect of fasting on synthesis of ApoB from very low density lipoprotein (VLDL) and (2) tracer enrichment in low density lipoprotein (LDL). After a 36-hour fasting period and in the post-absorptive state 4 healthy subjects were given a priming dose (8.7 mumol/kg) of 15N glycine followed by a constant infusion (10 mumol/kg/h for 8 h) to achieve 5% tracer enrichment in the plasma pool of glycine. The K-values, i.e. fractional synthetic rates/hr of ApoB from VLDL were 0.53 +/- 0.26 vs. 0.43 +/- 0.16 (p greater than 0.05). Tracer enrichment in ApoB from LDL at the end of the infusions was 0.19% vs. 1.46% in ApoB from VLDL. The results indicate that (1) in young healthy postabsorptive individuals about 40% of ApoB from VLDL in plasma is synthesized per hour, (2) fasting does not materially affect fractional ApoB synthesis and (3) at 5% 15N enrichment in plasma glycine, tracer enrichment in ApoB from LDL is at the lower limit of detection for the procedure employed. PMID- 2709740 TI - [Hyperthyroidism caused by a hormone-producing follicular thyroid cancer]. AB - A well differentiated carcinoma of the thyroid is usually less productive with respect to thyroid hormones than normal thyroid tissue. Very rarely, it happens though that a metastatic follicular carcinoma of the thyroid produces hyperthyroidism as the following example illustrates. In our patient with follicular thyroid carcinoma the radioiodine scan demonstrated an increased uptake of 123I in the right thyroid lobe but also in a lung metastasis, even before thyroidectomy. In contrast, the iodine uptake of the left - normal - thyroid lobe was suppressed. Following thyroidectomy the levels of the thyroid hormones were normal and only dropped into the hypothyroid range after the beginning of the therapy with radioiodine. Hence we conclude that the metastases of a thyroid carcinoma can attain the hormone secretion of a normal thyroid gland and take up more radioiodine than normal thyroid tissue. PMID- 2709741 TI - Acute renal failure due to uric acid nephropathy in a patient with renal hypouricemia. AB - This report is about a 23-year-old man who required hemodialysis in connection with an acute renal failure resulting from uric acid nephropathy without hyperuricemia. After recovering renal function he showed extreme hypouricemia (0.1-0.3 mg/dl) and elevated uric acid clearance (100-300 ml/min). The fractional excretion of uric acid (Cua/Ccr) could be suppressed by oral pyrazinamide and enhanced by probenecid. As no other renal tubular or metabolic abnormalities were detected, it is suggested that a markedly increased renal tubular urate secretion was responsible for the hypouricemia and also for the rare side-effect of an uric acid nephropathy in this patient. PMID- 2709742 TI - [Differential indications for uricosuric drugs and allopurinol]. PMID- 2709743 TI - Decrease of the inhibition of lipid peroxidation by glutathione-dependent system in erythrocytes of non-insulin dependent diabetics. AB - The inhibition of lipid peroxidation of erythrocyte membranes by glutathione dependent protection was studied in patients with non-insulin dependent diabetes mellitus. Incubation of red cells from diabetics with 1.5 mM t-butyl hydroperoxide resulted in a lipid peroxidation increase greater than that of normal controls. Glutathione-dependent and glutathione-independent protection against oxidative damage was examined using an artificial system, in which erythrocyte ghosts were incubated with t-butyl peroxide and dialysed hemolysate in the presence or the absence of 2 mM glutathione. The glutathione-dependent protection of hemolysate from diabetics was approximately 70% of that from normal controls. The results suggest that decrease in glutathione-dependent protection against lipid peroxidation, along with decrease in glutathione levels, increases oxidative damage in erythrocyte membranes taken from diabetic patients. PMID- 2709744 TI - Pharmacokinetics of isosorbide dinitrate, isosorbide-2-nitrate and isosorbide-5 nitrate in renal insufficiency after repeated oral dosage. AB - The pharmacokinetics of isosorbide dinitrate (ISDN) and its two active metabolites isosorbide-2-nitrate (IS-2-N) and isosorbide-5-nitrate (IS-5-N) were studied in 20 patients with normal and impaired renal function after repeated oral doses of standard 20 mg tablets ISDN t.i.d. Blood samples were taken in the steady-state on days 2 and 14, and the plasma concentrations were measured by electron capture capillary gas chromatography. We found a wide variation of pharmacokinetic parameters (AUCss0-8 and t1/2) of ISDN, IS-2-N, and IS-5-N in our patients. No correlation was detected between AUCss0-8 or t1/2 and the degree of renal insufficiency. No drug accumulation was observed after 14 days of administration. PMID- 2709745 TI - Progressive dilated cardiomyopathy in a patient with longstanding and complete prednisone-induced hematological remission of idiopathic hypereosinophilic syndrome. AB - A female patient is described in whom the diagnosis of idiopathic hypereosinophilic syndrome (HES) with heart disease and peripheral neuropathy was made at the age of 32 years. Although prednisone induced a prompt and longstanding complete hematological remission, progressive and eventually intractable heart failure developed, and the patient died 6 years later. Endomyocardial biopsy at diagnosis showed infiltration with intact and disintegrated eosinophils and Charcot-Leyden crystals. Echocardiographic follow up (including Doppler-Echocardiography) revealed mitral regurgitation with thickening and impaired motility of the posterior mitral leaflet, as well as progressive dilated cardiomyopathy. At autopsy, a diffuse interstitial fibrosis with patchy prominence in an eccentric hypertrophic and highly dilated heart was found. There were no significant endocardial thickening and no mural thrombi. In contrast to the findings of the initial endomyocardial biopsy, autopsy revealed no eosinophilic infiltrate. In this case, eosinophil-induced heart disease manifested as dilated cardiomyopathy, without endocardial fibrosis as originally described by Loffler. We speculate, that eosinophils have been deposited predominantly in the myocard at an early stage of disease, and - activated locally - secreted their granule proteins producing an initial damage to capillary endothelial cells and myocytes. After prednisone-induced clearance of eosinophils from blood and tissues, progressive, self-perpetuating interstitial fibrosis of the myocard and loss of myocytes eventually resulted in end-stage dilated cardiomyopathy. PMID- 2709746 TI - [Histomorphologic study of the bones of monkeys after 14-day anti-orthostatic hypokinesia]. AB - Using a semi-automatic image analyzer MOP Videoplan, a quantitative histomorphometric investigation of sponge bone of tibial metaphyses, iliac crests and lumbar vertebrae of monkeys kept for 14 days in the head-down position (at 10 degrees) was carried out. This exposure was found to cause spongy bone reduction in all the above bones. The lowered number and activity of osteoblasts as well as the reduced amount of osteoids during the exposure give evidence that the inhibition of bone neoformation makes a significant contribution to osteopenia. The involvement of osteoclast resorption in the spongiosa reduction during head-down tilt needs further study because in our experiments the osteoclast number or acid phosphatase activity did not grow significantly. PMID- 2709747 TI - [Effect of alpha-hydroxydimethyl-gamma-aminopropylidene bisphosphonate on the bone tissue of rats during hypokinesia]. AB - The preventive effect of alpha-hydroxydimethyl-gamma-aminopropylidene bis phosphonate was investigated histomorphometrically. The agent was injected subcutaneously to rats before hypokinesia at a dose of 5 mg/kg or during 35-day hypokinesia at a dose of 0.005 or 0.01 mg/kg daily. Regardless of the treatment protocol, the agent prevented osteoporosis and did not affect the epiphyseal growth plate. The agent modified significantly the bone cell count: osteoblasts decreased and osteoclasts increased. It is concluded that when compared to xydiphone (hydroxyethylidene bis-phosphoric acid), the agent proves several hundred times more effective. It is assumed that the agent modifies the relation between bone formation and bone resorption. Its osteotropic effect manifests as inhibition of bone resorption. PMID- 2709748 TI - [Circadian rhythm of blood acetylcholinesterase after administration of organophosphate compounds during hypokinesia]. AB - Circadian and ultradian rhythms of blood acetylcholinesterase (ACE) and rectal temperature were investigated during hypokinesia and administration of a toxic organic phosphate compound in various doses. Hypokinesia was found to produce a strong desynchronizing effect on ACE and thermal regulation. It is maintained that the use of chemicals with a well documented mechanism of action may yield reliable information about biorhythm restructuring in response to exogenous effects. It is emphasized that biorhythm changes should be taken into consideration when arranging work schedules in hypokinetic conditions. PMID- 2709749 TI - [Synthetic speech and its perception in complex acoustic conditions]. AB - Perception of synthetic speech in noise conditions has certain specific features which largely determine noise resistance of synthetic verbal communication. On the one hand, noise resistance of synthetic speech is lower than that of natural speech. This has been demonstrated by the study of the masking effect of 90 and 100 dB noise on natural and synthetic speech. On the other hand, there are methods of speech synthesis that seem very promising. Phonetic analysis of natural and synthetic syllables has shown that noise resistance of synthetic syllables is higher than that of natural syllables but perception of blended speech displays an inverse correlation. This demonstrates the fact that perception of verbal signals under noise conditions is based on the sensory relations that differ from those simulated by synthetic communication. PMID- 2709750 TI - [Mathematical modeling of cyclic kinetics of hematopoiesis]. AB - Mathematical models of the time course of formation of platelets, erythrocytes, granulocytes and lymph cells of mammals have been developed. They are systems of nonlinear differential equations where concentrations of mature blood cells and their bone marrow precursors are the variables. The models represent the main stages in the development of the various types of blood cells and allow for specific formation of red and white blood cells. Verification with the aid of oscilation theory methods and computer-aided numerical calculations have shown that the models reproduce all dynamic variations of the hemopoietic system, including stable fluctuations of concentrations of the various types of blood cells and their precursors (limiting cycles). Calculated parameters of stable fluctuations are in good agreement with experimental data. Within the framework of the models the origination of limiting cycles is described and their interpretation is given. These models can be used to simulate monthly biologic rhythms inherent in the various types of hemopoiesis as well as to analyze flight biomedical data and to discriminate space flight effects on hemopoiesis. PMID- 2709751 TI - [Effect of a hypogeomagnetic field on warm-blooded animals]. AB - This paper presents the study of the effect of a 3-month exposure of adult male rats of the Wistar strain to the hypogeomagnetic field (the shielding factor = 172.5) on their behavior, learning ability, cardiovascular function and work capacity. It was found that the exposure led to a significant decrease of work capacity, endurance and behavioral activity as well as to a significant increase of heart rate and time of conditioned reflex development. The above changes remained within physiological limits due to which they can be viewed as adaptation variations. PMID- 2709752 TI - [Stimulating effect of long-term small-dose radiation on lymphopoiesis in mammals]. AB - Mathematical models of lymphopoietic variations in mammals exposed to acute and chronic irradiation have been developed. They are based on the cheilone theory of hemopoiesis regulation. The models are systems of 9 nonlinear differential equations. They give a qualitative and quantitative description of lymphocytes in peripheral blood and their precursors in bone marrow of irradiated mammals. These models have for the first time simulated the stimulating effect of prolonged irradiation with small dose rates on recovery processes in the lymphopoietic system. PMID- 2709753 TI - [Various indicators of brain metabolism during hypoxia and hyperthermia]. AB - Hypoxic, thermal and radiation tolerance of rats exposed to hypoxia and overheating for 4 to 22 days was measured. Activities of succinic dehydrogenase, lactate dehydrogenase and alkaline phosphomonoesterase as well as water content in the brain were examined biochemically and histochemically. Brain tolerance and metabolism varied in a phasic manner. Both specific and nonspecific adaptive reactions were identified. A direct correlation was established between hypoxic tolerance and aerobic oxidation decrease as well as enzyme-dependent transport in cerebral vascular walls. A relationship between CNS radiation tolerance and permeability of the blood-brain barrier was detected. PMID- 2709754 TI - [Study of the activity of various systems of neurohumoral body regulation and ways of its correction in an arid area]. AB - The sympatho-adrenal system, i.e. its hormonal and mediator components, were examined in test subjects who made a 23-day expedition across a desert. The activity of the system was modified using food supplements: whey protein concentrate (50 g) and polyvitamins (Komplivit). It was found that in the arid area the hormonal and mediator components of the sympatho-adrenal system were stimulated. The stimulation degree was reduced by the food supplements which can be used to help the human body get adapted to an arid environment. PMID- 2709755 TI - [Hygienic aspects of wash water reclamation systems]. AB - The quality of reclaimed wash water and the composition of used wash water can be best determined by pH, oxygen chemical index, electric conductivity and chlorides that show individual variations but are sex-independent. Wash water contained mostly staphylococci and small amounts of sarcines, diplococci and micrococci. The use of washing and disinfecting agents may significantly modify the microbial characteristics of wash water, reducing noticeably its microbial content and increasing the content of organic substances and chlorides due to chemicals they include and due to more effective removal of sebaceous secretion. It is indicated that chemical components of washing and disinfecting agents that produce organic contaminants should be given special attention when developing a wash water reclamation system. PMID- 2709756 TI - [Effectiveness of urine-preserving agents used in water reclamation systems]. AB - The antimicrobial activity of 11 chemicals of different classes was investigated having in view their potential use as urine conserving agents onboard space flying vehicles. The investigations were performed on 8 bacterial cultures, including spore-forming, urease-active bacteria and microorganisms that typically occur in the spacecraft environment. Out of the chemical tested, five haloid containing agents, primarily oxidative agents, showed the largest spectrum of antimicrobial action and highest bactericidal effect. These agents are recommended to be used as urine conserving agents in water reclamation systems during space flights. PMID- 2709757 TI - [Positive and negative effects of "antihypoxic agents" on hypoxia tolerance and the aggregative function of thrombocytes in relation to the duration of the adaptation to altitude]. PMID- 2709758 TI - [Carbohydrates and lipids in the blood serum and liver of rats exposed to repeated hypokinesia]. PMID- 2709759 TI - [Changes in the jaws of rats after a 7-day flight on "Kosmos-1667"]. PMID- 2709760 TI - [Effect of vibration and impact and radial loads on blood enzyme activity in monkeys]. PMID- 2709762 TI - [What are we afraid of?]. PMID- 2709761 TI - [A question of public health--breast feeding]. PMID- 2709763 TI - [Nutritional aspects (breast feeding)]. PMID- 2709764 TI - [The importance of a comfortable position]. PMID- 2709765 TI - [The commercialization of substitutes for human milk. The International Code]. PMID- 2709767 TI - [The psychiatric prison]. PMID- 2709766 TI - [Nursing care in the prison environment]. PMID- 2709768 TI - [Reflections on the constantly growing task of caring for the aged. On aging and growing]. PMID- 2709770 TI - [Considerations on the understanding of role and status of nursing personnel in psychiatric hospitals. Structural changes are required]. PMID- 2709769 TI - [Suffering ... and willingly follow the flow of events]. PMID- 2709771 TI - [10,000 foreign registered nurses]. PMID- 2709772 TI - [Professional-patient: the dilemma of truth (2)]. PMID- 2709773 TI - [Supervision--the other view]. PMID- 2709774 TI - [Bodily hygiene as distress or its opposite. Does bodily hygiene have to be stressful?]. PMID- 2709775 TI - [Research for better care]. PMID- 2709776 TI - [Psychologic pain is meaningful]. PMID- 2709777 TI - [Study on stress and work satisfaction in nursing personnel. High stress scientifically proven]. PMID- 2709778 TI - [Continued education of nurses' assistants to nurses in geriatric nursing. From certificate of ability to diploma]. PMID- 2709779 TI - [1989, the year of all these non-educations?]. PMID- 2709780 TI - [What about anesthesia?]. PMID- 2709781 TI - [Are you afraid of tests?]. PMID- 2709782 TI - [Evaluation of students' knowledge: changing the way of studying]. PMID- 2709783 TI - [Services in home assistance: "The new movement in the sphere of health"]. PMID- 2709784 TI - [The nursing process (Part 2)]. PMID- 2709785 TI - [Documentation and care planning: what do they look like in practice?]. PMID- 2709786 TI - [Disorders in language development in children]. PMID- 2709787 TI - [Perception and self perception in nursing]. PMID- 2709788 TI - [Early diagnosis and early therapy in language development disorders]. PMID- 2709789 TI - [Treatment of nocturnal cervical migraine by special neck positioning]. PMID- 2709790 TI - [The 7 life anxieties and how to overcome them]. PMID- 2709791 TI - [Against outdated structures]. PMID- 2709792 TI - Cell-mediated and humoral immune responses in mice during experimental infection with Mycoplasma pulmonis. AB - Cell-mediated and humoral immune responses in mice after challenge exposure with Mycoplasma pulmonis were investigated. The cell-mediated immune response was determined by means of the delayed-type footpad swelling and the humoral immune response by means of the indirect haemagglutination test. Delayed-type footpad swelling and serum antibody titres were detected at one week after the challenge exposure and persisted for 7 weeks until the end of the experiment. However, there was a poor correlation between the degree of delayed-type footpad swelling and that of serum antibody titre. Delayed-type footpad swelling in mice with gross pneumonic lesions was less than that of mice with no gross lesions. A weak negative linear correlation was observed between the delayed-type footpad swelling and the number of M. pulmonis isolated from lungs. PMID- 2709793 TI - Lymphoid organ weights and organ:body weight ratios of growing beagles. AB - Although dogs, especially beagles, are used extensively in biological and clinical investigations, the literature dealing with normal biological measurements of their lymphoid organs is scanty. This study was undertaken to provide the information on the weight of lymphoid organs of beagles. The thymus, spleen, and prescapular, popliteal, and mesenteric lymph nodes of 95 normal beagle dogs, from one day to 11 months of age, were weighed and compared with body weights. The weight of the thymus and spleen increased drastically at and after 2 months of age, although the organ:body weight ratios remained the same at 2 months of age and decreased afterward. Similar increases in the weight of the mesenteric lymph node complex, but with an increase in the organ:body weight ratio, occurred also at and after 2 months of age, reflecting the importance of the gut-associated lymphoid organs after weaning. The increases in the size of the cutaneous nodes, prescapular and popliteal, were less pronounced and their organ:body weight ratios remained the same from birth through 11 months of age. PMID- 2709794 TI - Reversal of fentanyl/fluanisone neuroleptanalgesia in the rabbit using mixed agonist/antagonist opioids. AB - The reversal of the neuroleptanalgesic combination of fentanyl/fluanisone using mixed agonist/antagonist opioids has been investigated in the rabbit. All of the compounds studied (naloxone, nalbuphine, meptazinol, butorphanol, buprenorphine, pentazocine, doxapram) reversed the respiratory depression and sedation produced by fentanyl/fluanisone. Fentanyl/fluanisone produced profound analgesia for 180 min, which was rapidly and completely antagonized by naloxone. The mixed agonist/antagonist opioids produced a reduction in the degree of analgesia but, in contrast to naloxone, analgesic activity persisted from 120 min (meptazinol) to 420 min (buprenorphine). Administration of buprenorphine to rabbits anaesthetized with fentanyl/fluanisone and midazolam confirmed that the reversal of respiratory depression was accompanied by the return of arterial pH, PCO2 and PCO2 to preanaesthetic values. The use of neuroleptanalgesic anaesthetic regimens, which have been shown to provide effective surgical anaesthesia, combined with reversal using a mixed agonist/antagonist opioid to provide postoperative analgesia, appears to be a valuable refinement of current laboratory animal anaesthetic practice. PMID- 2709796 TI - A new method of bile duct cannulation allowing bile collection and re-infusion in the conscious rat. AB - A technique is described for collection of bile from the surgically-prepared, conscious rat after a postoperative recovery period of 7 days. This model can also be used to study enterohepatic recirculation. PMID- 2709795 TI - An effective combination of anaesthetics for 6-h experimentation in the golden Syrian hamster. AB - The anaesthetics described for use in hamsters to date are suitable for the performance of short-term experimentation. However, an anaesthetic regimen was required which would provide a stable preparation for 6 h and hence, a suitable combination was developed. In the first set of experiments, the effect of anaesthetics (chloralose, urethane, and pentobarbital) were examined alone and in combination on arterial blood measurements. In the second set of experiments the effect of the combination of anaesthetics on arterial blood measurements and minute ventilation was examined for up to 6 h. Chloralose, urethane and pentobarbital when used alone in the hamster were considered inadequate for our needs. Chloralose did not produce adequate surgical anaesthesia whereas urethane and pentobarbital resulted in marked respiratory depression. Urethane also produced a trend towards metabolic acidosis. In contrast, the combination of agents resulted in surgical anaesthesia and the arterial blood measurements were adequate. Further, the use of the combination of anaesthetics in hamsters resulted in a stable preparation where arterial blood measurements and minute ventilation were maintained in a good range for up to 6 h. The combination of chloralose, urethane and sodium pentobarbital in hamsters should prove useful in long-term non-recovery experimentation which requires early surgical intervention, minimal respiratory depression and an even depth of anaesthesia. PMID- 2709797 TI - Effects of dietary protein and butylated hydroxytoluene on the kidneys of rats. AB - Semipurified diet using Na-caseinate or lactalbumin as the only protein source was given to female rats to study the influence of nephrocalcinosis on butylated hydroxytoluene (BHT) induced kidney damage. The study showed, that BHT induces nephropathy in female rats irrespective of the diet used. Pronounced nephrocalcinosis was only found in rats fed the Na-caseinate diet. Thus, this study does not indicate a connection between the development of the BHT nephropathy and nephrocalcinosis. The results from this study once more stress the influence of the diet on reaction of the animal to experimental procedures. PMID- 2709798 TI - A method of remote physiological monitoring of a fully mobile primate in a single animal cage. AB - A system was designed to allow the physiological monitoring of a fully mobile, unstressed baboon (Papio anubis) in a single animal cage for the purpose of measuring the changes occurring in a hyperbaric environment. It was required to operate for at least three months, both inside a pressure chamber and outside, and to measure the following parameters: electroencephalogram (EEG, three channels), electrooculogram (EOG), electromyelogram (EMG, two channels), electrocardiogram (ECG), arterial blood pressure, respiration and body temperature. Also in the system were catheters through which blood samples could be taken and intravenous drugs given. The overall system consisted of a harness and jacket, an umbilical and back pack, a combined electrical and fluid transmission swivel and a monitoring implant and catheters. PMID- 2709799 TI - Osteoarthrosis in guinea pigs: histopathologic and scanning electron microscopic features. AB - Spontaneous cartilage degeneration of the femorotibial joint of male Hartley guinea pigs, 61 to 365 days old, was studied by light microscopy (LM) and scanning electron microscopy (SEM) to determine the incidence, age at onset, and to characterize the early changes. Knee joints of 61 day old animals were histologically and ultrastructurally normal. Focal minimal degeneration characterized by cell and proteoglycan loss with surface fibrillation was first observed by LM on the medial tibial plateau (MTP) in two of five 89 day old animals. Mild lesions characterized by focal surface disruption, primarily in the area of medial tibial plateau not covered by the meniscus, were observed in three of five 89 day old animals by SEM. Light microscopic alterations in knee joints of 4, 5, and 6 month old animals consisted of varying degrees of focal chondrocyte death, decreased toluidine blue matrix staining, and surface fibrillation. Small chondrocytic clones were first observed in medial tibial cartilage of 6 month old animals with moderate focal degeneration. Ultrastructurally, 4, 5, and 6 month old animals generally had moderate to severe fibrillation involving primarily the area of the medial tibial plateau not covered by the meniscus. Tibial osteophyte formation, mild synovial hyperplasia, medial femoral and meniscal cartilage degeneration, were first seen by LM in 9 month old animals. Lesions in 1 year old animals were similar, but more severe and included subchondral sclerosis of medial tibial and femoral bone. Bilateral fibrillation of greater than 50% of the medial tibial articular surface was observed in all 1 year old animals by SEM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709800 TI - An evaluation of distress following intraperitoneal immunization with Freund's adjuvant in mice. AB - Intraperitoneal immunization with Freund's adjuvant is frequently used to stimulate antibody production in mice. To evaluate the clinical and pathological effects of this technique, mice were immunized intraperitoneally with complete Freund's adjuvant and albumin, and the injection repeated 3-4 weeks later using incomplete Freund's adjuvant. This regimen induced a mean antibody titer against albumin of 1:280 within 7 days after booster immunization and increased the abdominal width, abdominal circumference and spleen weights of immunized animals. Food intake and body weight decreased after immunization, but returned to control levels within 1-2 weeks. Open-field activity was not affected. Neutrophilia, eosinophilia and monocytosis were present 7 days after immunization and persisted for the duration of the study. Gross and histopathological lesions included multiple granulomatous abdominal adhesions and lymphoid hyperplasia. Thus, intraperitoneal immunization with Freund's adjuvant and albumin produced some adverse effects in the animal (weight loss, neutrophilia and granulomatous peritonitis). However, the animals did not appear to be severely or chronically impaired, since food intake, body weight and locomotor activity were within normal limits for most of the post-immunization period. PMID- 2709801 TI - Retroviral particles in radionuclide-induced murine osteosarcomas: mouse strain related differences. AB - Twenty-six osteosarcomas from strain NMRI mice and twenty-six osteosarcomas from (C3H x 101)F1 hybrid mice were investigated by electron microscopy for the presence of retroviral particles. The bone tumors had been induced by the incorporation of the short-lived bone-seeking radionuclides 224Ra, 223Ra, or 227Th. All of the 26 osteosarcomas from NMRI mice contained retrovirus-like intracisternal type A particles in varying quantities. No type C retrovirus particles could be detected. In contrast, most of the 26 osteosarcomas from (C3H x 101)F1 mice contained budding, immature, and mature type C virus particles predominantly in large quantities. Intracisternal type A particles were also present in all tumors from these mice, but were found only occasionally after extensive search. The mouse strain-related differences in the presence of intracisternal type A particles and type C virus particles in the bone tumors do not provide evidence of an etiological relation of these particles to radionuclide-induced osteosarcomagenesis. Some of the mature type C virus particles observed in osteosarcoma tissue from the hybrid mice were atypical in structure and size. Such pleomorphic particles are probably associated with the spontaneous osteomagenesis which occurs in untreated old (C3H x 101)F1 mice. PMID- 2709802 TI - Creeping: a new mutant rat with neurological disease. AB - We describe a new mutant rat, named creeping, that exhibits severe ataxia characterized by a creeping posture due to the inability to stand up. Affected animals can be recognized at 14.8 +/- 1.6 (mean +/- SD) days of age and die within 35 days after birth. There are no sex differences in phenotype. The breeding data suggest that the abnormal locomotion is caused by an autosomal recessive gene. We have tentatively named the gene creeping (cre). The cerebellum of affected rats is much smaller than that of normal littermates. The cerebellar lobes of the mutant are barely formed. The notable histopathological changes are disarrangement of neuronal cells in the cerebellum and cerebral cortices, although the several cell types that are present in the cortices of normal rats are also found in the cortex of the creeping rats. The same type of change is also present in the hippocampus and fascia dentata. PMID- 2709803 TI - Idiopathic cardiomyopathy in C3Hf/Bd mice. AB - Male and female 16 to 18 month old C3Hf/Bd mice in a dermal carcinogenicity study were moribund or died at earlier time points than the expected 24 to 30 months. Clinical signs observed in both treated and control animals included dyspnea, lethargy, and death. Lesions seen in treated as well as control mice were cardiomegaly with myocardial degeneration and necrosis, hydrothorax and pulmonary edema, and ascites and chronic passive congestion of the liver. Mice were negative for serologic, bacteriologic and microscopic evidence of viruses, bacteria and protozoa which can induce heart lesions. Possible causes of the cardiomyopathy include metabolic, degenerative, genetic or undetermined infectious disease. PMID- 2709804 TI - Blood pressure and other physiological responses in awake and anesthetized guinea pigs. AB - The effect of combinations of injectable anesthetics on mean arterial blood pressure, blood gases, heart rate and respiration of the guinea pig (NIH Outbred strain) was investigated. After a 30 minute period in which baseline resting cardiorespiratory measurements were obtained, five groups of six pigmented animals having indwelling carotid cannulas were anesthetized with (a) ketamine hydrochloride (30 mg/kg, im)/xylazine (5 mg/kg, im); (b) sodium pentobarbital (15 mg/kg, ip)/fentanyl-droperidol (0.4 mg/kg, im); (c) diazepam (5mg/kg, ip)/fentanyl citrate (0.32 mg/kg, im); (d) diazepam (5 mg/kg, ip)/alphaxalone alphadolone acetate (45 mg/kg, im); or (e) 1% alpha-chloralose-40% urethane (0.8 ml/100g, ip). Animals were not respirated artificially and no supplemental doses of anesthetic were given. Resting blood pressure in awake animals was measured over time for as long as cannulas remained patent (109 measurements). Mean resting blood pressure, for this strain of guinea pigs, was determined to be 53.1 +/- 4.2 mmHg. There was no indication that mean arterial blood pressure changed with age in animals varying in weight from 215 g to 550 g. Under diazepam/fentanyl, blood pressure rose significantly above resting level to a mean of 71.1 +/- 6.1 mmHg. With the other four combinations, blood pressure stabilized near, but below pre-anesthesia levels (ketamine/xylazine 47.1 +/- 6.8 mmHg; pentobarbital/fentanyl-droperidol, 46.9 +/- 3.2 mmHg; diazepam/alphaxalone alphadolone, 47.8 +/- 4.8 mmHg; chloralose-urethane, 51.0 +/- 1.2 mmHg). Under diazepam/alphaxalone-alphadolone and chloralose-urethane, respiration was depressed and blood gas levels deviated from normal to the extent that artificial ventilation would be necessary to maintain an adequate physiological state. PMID- 2709805 TI - Use of a fluid dispensing apparatus for bronchoalveolar lavage in mice. AB - The volume of the mouse lung is small, so bronchoalveolar lavage (BAL) in mice is generally performed with 1 ml syringes to infuse smaller volumes of fluid. Multiple infusions are required to obtain enough recovered fluid for multiple analyses. This paper introduces the use of one type of a simple fluid dispensing apparatus as an infusion device. It proved to be a faster and a less tedious method than the syringe infusion method. The results of studies in normal mice using both infusion techniques showed no differences between the two with respect to the recovery of cells and protein and to differential leukocyte counts. Thus, the results obtained with this device can be compared with those previously obtained with syringes. PMID- 2709806 TI - Chronic central vein catheterization for intraoperative and long-term venous access in swine. AB - Chronic venous access and repeated blood sampling for research purposes in large swine ideally should be possible without sedation, restraint or direct venipuncture of deep vessels. An operative technique of cranial vena cava catheterization and chronic catheter maintenance methods are described which were used successfully in the placement of 11 silicone rubber catheters in 10 animals. All were used for repeated blood sampling, as well as intraoperative infusion of medications and large fluid volumes. Long term patency was excellent with 10 catheters patent at the end of the study interval, up to 14 weeks after insertion. Serial blood sampling was accomplished easily without restraint. Catheter damage, infection or malfunction was rare. Proper maintenance and careful aseptic blood sampling render the cranial vena cava catheter a safe and reliable alternative to direct venipuncture in swine. PMID- 2709807 TI - Diagnostic exercise: limb swellings in a dog. PMID- 2709808 TI - Severity of cerebellar hypoplasia is predictable from total plasma bilirubin level at 3 to 7 days of age in jaundiced Gunn rats. PMID- 2709809 TI - Iatrogenic puncture of enlarged seminal vesicles in aged C57BL/6 mice. PMID- 2709810 TI - Hematologic and serum chemistry values in Callicebus moloch cupreus. PMID- 2709811 TI - Spectrum of bacterial pathogens transmitted by Pharaoh's ants. PMID- 2709812 TI - Gluten-induced experimental IgA glomerulopathy. AB - The effect of alimentary gluten and of its lectin-like fraction gliadin in inducing IgA mesangial deposits in BALB/c mice was investigated. In the pilot study G1 (4 mice), G2 (4 mice) and G3 (6 mice) received ovalbumin, human gamma globulins, and crude gluten, respectively. The antigens, 1 mg/ml, were given in drinking water for 14 weeks. G4 (20 mice) were fed with standard mouse fodder. Gluten, as well as other alimentary antigens, induced IgA mesangial deposits with intense IgA staining in each animal, however a positive IgA staining was also observed in 10 of 20 adult controls. Antigliadin IgA antibodies were detected in renal tissue eluates from gluten-immunized mice but were found in eluates from control animals too. IgA deposits and antigliadin IgA in renal tissue were also observed in 3 of 7 adult mice (G7) fed for 30 weeks with standard fodder, then for 1 month with a protein-free diet supplemented with 20% amino acids. Conversely, there were no IgA mesangial deposits or IgA anti-gliadin antibodies in renal eluates of 1- or 2-week-old mice (G5 and G6). For the definitive protocol, 4-week-old BALB/c mice were selected and fed with basal glutenfree diet. G8 (14 mice) did not receive any alimentary immunogen in the drinking water, whereas G9 (15 mice) and G10 (15 mice) received ovalbumin and gliadin, respectively. G11 (15 mice) had standard gluten-containing diet. IgA deposits semiquantified by immunofluorescence scores were found to be significantly greater in G9 and G10 than in G8 (Student' t-test p1 less than 0.003, Mann Whitney test p2 less than 0.001 and p1 less than 0.01, p2 less than 0.007, respectively), and in G11 than in G8 (p1 and p2 less than 0.05). The presence of positive IgA staining (greater than or equal to 2/6 scores) was significantly less frequent in G8 in comparison to G9 (chi-square test p3 less than 0.002), G10 (p3 less than 0.02) and G11 (p3 less than 0.04). Total serum IgA were significantly higher in orally immunized G9 and G10 than in G8 control mice (p1 less than 0.005, p2 less than 0.002). Anti-gliadin IgA in circulation as well as in renal deposit eluates were significantly increased in gluten-eating mice (G10 and G11) as compared with the gluten-free control group G8. These observations indicate that gliadin does induce IgA immune deposits in BALB/c mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709813 TI - Chromogranin A and B messenger ribonucleic acids in pituitary and other normal and neoplastic human endocrine tissues. AB - The distribution of the messenger ribonucleic acids (mRNAs) for chromogranin A and B was analyzed by in situ hybridization in normal and neoplastic endocrine tissues using frozen and paraffin tissue sections. Combined in situ hybridization and immunochemical staining was also done on tissue sections from the same cases using a monoclonal antibody against chromogranin A (LK2H10). Most endocrine tumors expressed chromogranin A and B mRNAs as well as chromogranin A protein. Normal pituitary expressed chromogranin A and B mRNAs and chromogranin A protein in the anterior pituitary gland. Most of these cells were gonadotropic hormone producing cells. Prolactinomas (5/5) did not express chromogranin A mRNA or protein, but contained chromogranin B mRNA. Null cell or nonfunctional adenomas (8/8) expressed chromogranin A and B mRNAs and reacted with antibody LK2H10. In some tumors such as Merkel cell carcinomas, insulinomas, and parathyroid adenomas, a stronger signal for chromogranin A mRNA was detected than for the immunoreactive proteins. These results indicate that in situ hybridization complements immunochemical techniques in the analysis of endocrine cells and neoplasms. The gene products for chromogranin A and B are widely distributed in many endocrine cells and tumors, but some neoplasms such as prolactinomas have a differential distribution of chromogranin A and B mRNA and proteins. PMID- 2709814 TI - Ultrastructural localization of the Charcot-Leyden crystal protein (lysophospholipase) to granules and intragranular crystals in mature human basophils. AB - Human blood basophils have been shown to form Charcot-Leyden crystals (CLC) and to contain quantities of CLC protein comparable to the eosinophil (Ackerman SJ, Weil GJ, Gleich GJ, J Exp Med 155:1597, 1982). We examined the subcellular localization of CLC protein in human basophils from peripheral blood using an ultrastructural postembedding immunogold method and affinity chromatography purified polyclonal primary antibody to purified human eosinophil CLC protein. We found CLC protein to be uniquely associated with the main, large, particle-filled granule population of human basophils and particularly within intragranular Charcot-Leyden crystals in these granules. Rarely, CLC protein was localized within small, smooth perigranular vesicles. Neutrophils, lymphocytes, and monocytes present in preparations stained for the CLC protein were negative as were controls for the specificity of the immunogold staining. Mature eosinophils contained small numbers of positive crystalloid-free primary granules, as previously reported (Dvorak AM, Letourneau L, Login GR, Weler PF, Ackerman SJ, Blood 72:150, 1988). The presence of CLC protein in hexagonal and pyramidal crystals regularly present in activated types II and III basophils suggests two possibilities currently being investigated. Like eosinophils, basophils could synthesize CLC protein, or eosinophil-derived CLC protein could be internalized and stored in basophil granules. Regardless of the mechanism for acquisition of CLC protein (lysophospholipase) by basophils, the identification and subcellular localization of this enzyme in basophils requires that it be considered in basophil cell biology as well as in the pathobiology of basophil-rich reactions. PMID- 2709815 TI - Seroprevalence of human immunodeficiency virus in mental health patients. AB - In contrast to the published data on Human Immunodeficiency Virus (HIV) infection in parenteral drug abusers, there is a paucity of data on prison inmates and virtually none on psychiatric inpatients. Because our facility serves each of these patients groups, we designed an anonymous seroprevalance study. We tested 1,496 unduplicated sera using sequential enzyme-linked immunosorbent assay (ELISA) and Western blot tests. The overall prevalence of Western blot positive serum was 0.53%. The prevalence rates for the different services of our hospital, Corrections, Detoxification Program, and general Department of Mental Health inpatients, were 4.62%, 0.99%, and 0.25% respectively. While these data demonstrate the increased prevalence of HIV infection among prison inmates, they fail to show a greater prevalence among South Carolina psychiatric inpatients than among general hospital patients. PMID- 2709816 TI - Lymphomatoid papulosis: mostly benign but potentially malignant--a case report with a fatal outcome. PMID- 2709817 TI - Project Readiness II: some results from a physical fitness and health enhancement program for law enforcement personnel. PMID- 2709818 TI - Ciprofloxacin: panacea or blunder drug? PMID- 2709819 TI - Clinical experience with ciprofloxacin: analysis of a multi-practice study. AB - In a multi-practice study of 113 patients treated with ciprofloxacin (mean daily dosage, 995 mg per day; mean duration of treatment, 9.6 days) for a variety of infections, 14 were microbiologically proven. Of these, bacteriologic cure and/or improvement resulted in 92.9% of cases. For all 113 infections, clinical cure and/or improvement resulted in 97.1% of cases. A total of 17 infections were classified as chronic. Therapy with ciprofloxacin was discontinued in three (2.6%) of 113 patients because of adverse effects. Overall, there were 5/113 (4.4%) adverse reactions (ADRs). Only one ADR was related definitely to ciprofloxacin therapy. Two ADRs were definitely not related; in two the relationship was uncertain. Two patients of the five (40%) elected to continue ciprofloxacin therapy despite mild side effects. PMID- 2709820 TI - Newborn screening for HIV antibody. PMID- 2709821 TI - Peer review where it counts. PMID- 2709822 TI - Confirmation and quantitation of barbiturates in human urine by gas chromatography/mass spectrometry. AB - A sensitive, reliable, rapid quantitative method was developed for the N,N' dimethyl derivatives of the 5,5'-disubstituted barbiturates (NNDM-barbiturates) after liquid-liquid extraction of 0.5-mL urine volumes. Each barbiturate was identified by GC/MS through the retention time for the total ion current and selected ion monitoring of four ion currents for each analyte. Quantitation was achieved through the base peak ion ratios for each NNDM barbiturate/tolylbarbiturate (IS) over the concentration range 20-250 ng/mL (0.4 to 5 ng injected into the GC/MS). The limit of detection for all the barbiturates (p less than 0.01) was 20 ng/mL (0.4 ng total). The extraction efficiency ranged from 75 to 84% for all the barbiturates. The coefficient of variation of the barbiturates for the within-day run was 2.5 to 4.8% and between days was 6.7 to 8.6%. The percentage abundances of the ion current ratios for each NNDM barbiturate was determined and found to be fully stable over a one-week period. This method is currently in routine use in our laboratory for the GC/MS confirmation of presumably positive barbiturate urine samples. PMID- 2709823 TI - Gas chromatography/electron impact mass fragmentometric determination of urinary 6-acetylmorphine, a metabolite of heroin. AB - A procedure for detection and quantification of urinary 6-acetylmorphine (6-AM), a metabolite of heroin, is described. After initial solvent extraction from urine, the 6-AM was purified either by acid-base liquid-liquid extraction or by solid-phase extraction techniques. The 6-AM was then derivatized to its propionyl ester, which was characterized by gas chromatography/mass spectrometry in the electron impact mode. Confirmation of 6-AM was accomplished by comparing retention times and relative abundances of selected ions with that of a standard. Quantification was based on 6-[2H3]acetyl-N-[2H3]methylnormophine (6-[2H6]AM) as internal standard. Excellent linearity was obtained in the concentration range 1 100 ng/mL. The overall yield after solvent extraction and acid-base purification ranged from 79 to 82%; for solvent extraction and solid-phase purification, it was 92 to 95%. The limit of detection was 810 pg/mL. Within-run and between-run CVs for 6-AM at concentrations in the range 1-100 ng/mL were generally less than 5% and less than 10%, respectively. PMID- 2709824 TI - Determination of ethylene glycol in postmortem blood by capillary gas chromatography. AB - A simple procedure for the determination of ethylene glycol in blood by capillary gas chromatography was developed. The proteins are precipitated by the addition of perchloric acid which includes the internal standard 1,2-butanediol. The extract is neutralized and the solution is directly injected. The assay is linear and the precision, expressed as coefficient of variation, is 4-11% (within run). The detection limit is about 0.05 g/L. The method also seems applicable for the determination of ethylene glycol in urine. PMID- 2709825 TI - Evaluation of a multiple-variable thin-layer and reversed-phase thin-layer chromatographic scheme for identification of basic and neutral drugs in an emergency toxicology setting. AB - An analytical scheme composed of one normal-phase thin-layer chromatographic (TLC) method, one reversed-phase thin-layer chromatographic (RPTLC) method, and sequential analyte detection through four stages of color reactions is described. Eighty-one basic or neutral drugs were analyzed with this scheme and seventy-four were uniquely characterized with 95% confidence. Six of the remaining seven formed three unresolved pairs. The scheme was evaluated by mean list length analysis and shown to offer analyte resolution similar to that of a scheme of TLC and gas chromatography (GC) with nonspecific detection. Nine out of ten unknowns from the field of eighty-one drugs were uniquely identified with 95% confidence by the TLC/RPTLC scheme. The tenth unknown was not completely resolved from its isomer, but was statistically the more probable candidate. PMID- 2709826 TI - Evaluation of current derivative spectrophotometric methodology for the determination of percent carboxyhemoglobin saturation in postmortem blood samples. AB - Carbon monoxide intoxication continues to be a commonly encountered cause of death in most areas of Canada. The forensic nature of the samples in these cases presents special problems that are not normally encountered in clinical determinations. A study was undertaken to assess various methods of determining the percent carboxyhemoglobin saturation in blood, more specifically, those using derivative spectrophotometric measurements in the Soret region of the UV spectrum. At the same time, other studies were carried out: the effects of storage time on the carboxyhemoglobin levels; evaluation of sample containers; comparison of percent carboxyhemoglobin saturation in blood samples taken ante mortem and post-mortem. Blood for the study was obtained from laboratory animals that were exposed to carbon monoxide before death. PMID- 2709827 TI - Identification and quantification of trihexyphenidyl and its hydroxylated metabolite by gas chromatography with nitrogen-phosphorus detection. AB - A sensitive and specific assay for the simultaneous quantification of trihexyphenidyl and its hydroxylated metabolite in plasma and urine is described. The method is based on the extraction of the drugs with an organic solvent and separation on a 3% OV-17 Chromosorb Q column in a gas chromatograph equipped with a nitrogen-phosphorus detector. The procedure employs SKF 525 A as the internal standard and requires no derivatization. The detection limit was found to be 2 ng/mL for trihexyphenidyl and 1 ng/mL for its metabolite. The precision of the assay procedure for both compounds is about 4 to 7%. PMID- 2709828 TI - Mercaptoethanol poisoning: report of a fatal case and analytical determinations. AB - A suicide due to oral intake of 2-mercaptoethanol is reported. High concentrations of 2-mercaptoethanol and its metabolite 2-mercaptoacetate were found by gas chromatography in the urine and gastric content of the victim. These compounds were also identified by gas chromatography/mass spectrometry. Increased amounts of inorganic sulfate were furthermore found in the urine. Case history and autopsy findings are presented, and the metabolism of 2-mercaptoethanol is discussed. PMID- 2709829 TI - 3,3'-dichlorobenzidine. PMID- 2709830 TI - Identification of diuron and four of its metabolites in human postmortem plasma and urine by LC/MS with a moving-belt interface. AB - Unknown compounds that were not amenable to GC/MS were found during routine benzodiazepine HPLC screening in a postmortem case. The apparent thermolability made the application of liquid chromatography with mass spectrometry mandatory. The moving-belt interface was used because of its value for identification based on the use of both electron impact and chemical ionization, which provided information on both structure and molecular weight. The herbicide diuron and four of its metabolites were identified in plasma and urine and had a total concentration as high as 100 mg/L. Metabolism via demethylation and hydroxylation appeared to be the major routes. PMID- 2709831 TI - A comparison of symbol transparency in nonspeaking persons with intellectual disabilities. AB - This investigation compared the transparency of 11 different types of symbols representing objects with 40 nonspeaking subjects who experienced various degrees of intellectual disability. The subjects included a number of individuals with physical impairments or autism in addition to mild, moderate, or severe mental retardation. The symbol sets included: nonidentical objects, miniature objects, identical colored photographs, nonidentical colored photographs, black-and-white photographs, Picture Communication Symbols (PCS), Picsyms, Rebus, Self-Talk, Blissymbols, and written words. Statistical analyses indicated that real objects were more readily recognized than were any of the symbol sets and that Blissymbols and written words were more difficult than were any of the other sets. In addition, the results suggest the existence of a hierarchy of difficulty at the object (noun) level for the symbol sets assessed. The results are discussed in terms of their implications for selecting an initial symbol set for nonspeaking individuals. In addition, some suggestions for using the assessment protocols in clinical practice are presented, along with future research implications. PMID- 2709832 TI - Facilitating word-finding skills of language-impaired children. AB - Two language-impaired children and their controls participated in a preliminary study designed to examine the effects of treatment on word-finding skills. The 2 children participated in activities designed to improve the elaboration and/or retrieval of the training words, whereas their controls received a therapeutic regimen that did not target word-finding skills. Treatment effects were apparent, with the greatest gains associated with activities focusing on both elaboration and retrieval. Although the findings were promising, several procedural details complicated interpretation of the data. PMID- 2709833 TI - Final consonant repetition: a linguistic perspective. AB - A case of final consonant repetition in the speech of a normal child is presented. It is argued that this production pattern is the result of a convergence of phonological factors, including phonetic constraints and cognitively based rule generation, rather than a pathologic process. Final consonant repetition is discussed relative to natural languages and other cases of rule generation in normal children and relative to earlier cases examining this pattern in terms of models of dysfluency. Additionally, the clinical ramifications of the findings are discussed. PMID- 2709834 TI - Familial aggregation in specific language impairment. AB - Self-report data from the families of children participating in the San Diego Longitudinal Study of specific developmental language impairment were used to assess familial aggregation in the disorder. Families of impaired children reported higher rates of affected first-degree relatives than did families of matched controls. Significantly higher incidence of maternal and paternal childhood language and/or learning disabilities, as well as sibling disability rates, were reported. The extent to which familial aggregation reflects genetic or environmental influences in specific language disorders remains to be determined. PMID- 2709835 TI - A comparison of audiometric test methods for 2-year-old children. AB - Visual reinforcement audiometry (VRA), visual reinforcement operant conditioning audiometry (VROCA), and play audiometry were compared in terms of conditionability and number of responses obtained prior to habituation on normal 2-year-old (24-27 months) children. Results indicated that a higher percentage of children could be conditioned to VRA than to either VROCA or play audiometry. Results also indicated that for children who could be conditioned, the play audiometry group showed more responses prior to habituation than were obtained from the other two groups. PMID- 2709836 TI - Relationships among behavioral, environmental, and affective communication variables: a canonical analysis of the CPHI. AB - Relationships among the four content domains assessed by the Communication Profile for the Hearing Imparied (Demorest & Erdman, 1986, 1987) were examined in two samples (N = 433 and N = 486) drawn from the Aural Rehabilitation Program at Walter Reed Army Medical Center. Communication performance was weakly related to communication environment, communication strategies, and personal adjustment (average canonical r = .34). However, strong associations were observed among the latter three areas (average canonical r = .59). Eight specific relationships were identified. The nature of these relationships and implications for clinical intervention are discussed. PMID- 2709837 TI - Clinical modification of the tracheostoma breathing valve for voice restoration. AB - The development of the tracheostoma breathing valve and its use in conjunction with tracheoesophageal (TE) puncture prostheses has offered an important option to laryngectomized patients who undergo surgical-prosthetic voice restoration. Despite advantages that the tracheostoma breathing valve provides, some TE speakers are unable to utilize the device although they are successful users of the TE puncture voice prosthesis. This paper presents a safe, simple, and successful modification of the tracheostoma breathing valve in a single patient who demonstrated anatomical limitations for its use. Modification procedures are presented and clinical implications are discussed. PMID- 2709838 TI - Perception of voiceless fricatives by children with a functional articulation disorder. AB - The two studies presented here examine the relationship between speech perception and speech production errors in children who have a functional articulation disorder. In both experiments, speech perception was assessed with a word identification test, based upon a synthesized continuum of speech stimuli, contrasting the specific phonemes that were associated with production errors in our sample of articulation-disordered subjects. Experiment 1 required subjects to identify words that contrasted the phonemes /s/ and /S/. In this test, adults, normal speaking 5-year-olds, and some articulation-disordered 5-year-olds identified the words seat and sheet appropriately and reliably. However, a subgroup of articulation-disordered children were unable to identify the test stimuli appropriately. Experiment 2 required a second group of subjects to identify words that contrasted the phonemes /s/ and /theta/. Although both adults and normal speaking children responded appropriately to the words sick and thick, in this test, none of the articulation-disordered children was able to identify these words appropriately. It is concluded that, for a subgroup of children who have a functional articulation disorder, production errors may reflect speech perception errors. PMID- 2709839 TI - Comparisons of perceptual and acoustic characteristics of tracheoesophageal and excellent esophageal speech. AB - The results of recent studies have established significant acoustic differences between tracheoesophageal (TE) and conventional esophageal speech. Listener preferences and acoustic differences between TE and excellent esophageal speech were examined in the present investigation. Although, as a group, TE speech was characterized by longer extended phonation, more syllables per breath, and increased intensity, there were no significant differences in listener preference between the groups. PMID- 2709840 TI - A profile analysis approach to interpretation of the Carrow Auditory-Visual Abilities Test. AB - This paper describes a profile analysis procedure for use with the Carrow Auditory-Visual Abilities Test (CAVAT). The visual-auditory dichotomy, supported by factor analysis, is examined at one level of analysis. Critical values derived from the standard error of measurement of the difference (Sem/D) for each battery are provided allowing the identification of reliable and abnormal visual-auditory discrepancies. At another level of analysis, a procedure for profile analysis is outlined and critical values are included to facilitate the identification of relative strengths and weaknesses at the subtest level. Test results from 2 preschool children are examined and contrasted to illustrate the utility of the CAVAT in the identification of systematic modality preferences. PMID- 2709841 TI - A comparison of the age-MLU relation in normal and specifically language-impaired preschool children. AB - The relation between age and mean length of utterance in morphemes (MLU) was evaluated in a sample of 48 preschool children between 24 and 50 months of age. Twenty-four of these children were diagnosed as having a specific language impairment, and 24 were considered language normal. The groups were matched on age, race, sex, and parental education level. A majority of the children in each group were from lower-middle-class backgrounds. MLU was derived from 20-min mother-child conversations as the dyad engaged in free play. The results showed that (a) age and MLU were significantly correlated in the normal group (r = .75) and in the group of specifically language-impaired children (r = .77), (b) the predicted MLU of the language-impaired group was lower than that of the normal group across the age range, and (c) the rate of MLU change in each group was similar. The age-MLU relation observed in the lower-middle-class normal children compared favorably to that reported previously for middle- to upper-middle-class children (Miller & Chapman, 1981). The finding that MLU changed at a similar rate in the normal and language-impaired groups is evaluated in light of the observation that childhood language disability is usually associated with slower rates of language development. PMID- 2709842 TI - Tabletop versus microcomputer-assisted speech management: stabilization phase. AB - Few controlled data are available on the efficacy of microcomputers for speech management with children. The focus of this second report in a study series using microcomputers with speech-delayed children (Shriberg, Kwiatkowski, & Snyder, 1986) is on the response stabilization stage of speech management. Two repeated measures designs were conducted with two samples of preschool children (n = 18) to compare tabletop management with comparable computer-assisted activities. Findings indicate that response stabilization tasks in the two intervention modes were equally effective, efficient, and engaging. Additional analyses suggest that the two modes engage the children in different ways, however, and that children may have individual needs for mode-specific features. PMID- 2709843 TI - Cephalometric and cineradiographic study of deviant resonance in hearing-impaired speakers. AB - To study physiological basis for deviant resonance in hearing-impaired speakers, cephalometric roentgenography and cineradiography were applied to analyze oral/pharyngeal relationships during vowels produced in isolation and within a sentence context. The films, synchronized with sound recording, were traced and measured for 10 normal hearing and 4 hearing-impaired women with deviant resonance. Vocal tract conformations and dimensions were defined by measures of the lips, tongue, mandible, velum, hyoid bone, epiglottis, and laryngeal sinus. Means, standard deviations, and analyses of variance were applied to facilitate descriptions and comparisons between the groups. The hearing-impaired speakers had near normal lip openings for /i/ and /u/ but more open positions for /a/. The tongue tended to retract for the front vowel and front for the back vowel /u/. For high vowels, most of the hearing-impaired speakers had an elevated hyoid, an unusually large vertical dimension between hyoid and laryngeal sinus, and a retracted tongue root, which was associated with a marked retraction or deflection of the epiglottis toward the pharyngeal wall. The cine analysis of the normal hearing speakers showed rather well defined and consistent shifts in tongue position for the front vowels produced in the sentence context. The hearing-impaired speakers with deviant resonance showed greater variation among speakers in tongue body position and a significant retrusion of the dorsum of the tongue at a site significantly lower than observed in hearing speakers. The consistent tongue root retraction during static as well as dynamic speech production is interpreted as support for Boone's hypothesized cause of pharyngeal resonance in speech of the hearing impaired. PMID- 2709844 TI - External ear resonance characteristics in children. AB - External ear resonance characteristics were determined for 78 children ages 3-13 using an ear canal probe tube microphone system. The average peak resonant frequency was 2848 Hz (range: 1774-4039), and the average measured gain at the eardrum was 18.9 dB (range: 11.5-26.7). Correlations of average peak resonant frequency and peak resonant amplitudes with age, height, weight, head circumference, and/or canal opening area were poor. These values are very similar to the adult data reported by Shaw (1974). Slight deviations can be attributed, in part, to the different sound field calibration methods used. PMID- 2709845 TI - Modeling versus modeling plus evoked production training: a comparison of two language intervention methods. AB - The effectiveness of two language intervention procedures, modeling versus modeling plus evoked production, was compared using a single-subject alternating treatments design. Four language-disordered children (5:5-6:11) participated in the study, consisting of four baseline sessions and 10-14 training sessions. There was no marked difference in the effectiveness of the modeling procedure and the modeling plus evoked production procedure as measured by performance on generalization probes following each training session. In fact, the highest levels of accuracy attained under the two training procedures were quite comparable. There was a tendency, however, for the modeling plus evoked production treatment to result in a slightly more stable pattern of acquisition for 3 of the subjects. Although steps were taken to minimize multiple-treatment interference, the possibility of these effects must be considered, and caution should be taken in interpreting these findings to mean that these two intervention methods would produce equivalent results when administered independently. PMID- 2709846 TI - Age and laryngeal airway resistance during vowel production. AB - An investigation was conducted to determine if laryngeal valving economy, as reflected in measures of laryngeal airway resistance during vowel production, varies across adulthood. Sixty healthy men were studied, 10 from each of six age groups--25, 35, 45, 55, 65, and 75 years (+/- 2 years). Results indicated that there are age-related differences in laryngeal airway resistance during vowel production and that these differences are characterized by a lower mean resistance in 75-year-old men than in younger men of the ages studied. This finding provides insight into the impact of age on laryngeal function and has important implications for the evaluation and management of men with voice disorders. PMID- 2709847 TI - Science and theory in communication disorders: a response to Siegel and Ingham (1987) PMID- 2709848 TI - On statements and overstatements: a response to Bench (1989) PMID- 2709849 TI - Critique of Siegel: the limits of "The Limits of Science in Communication Disorders". PMID- 2709850 TI - The Limits of Science in Communication Disorders: a reply to Siegel. PMID- 2709851 TI - A manifestation of theophylline toxicity. PMID- 2709853 TI - Opposition to nationalized (socialized) health care. PMID- 2709852 TI - Percutaneous retrieval of a Hickman catheter fragment. PMID- 2709854 TI - Rigid fixation of complex facial fractures. PMID- 2709855 TI - A near-fatal poisoning. PMID- 2709856 TI - Tennessee WIC infant formula rebate program update. PMID- 2709857 TI - The continuing dilemma of general thoracic surgery. Where to now? PMID- 2709858 TI - Prevention of reperfusion injury in the neonatal heart with leukocyte-depleted blood. AB - Activated leukocytes release oxygen free radicals and cause microvascular occlusion. This experiment tests the hypothesis that reperfusion with leukocyte depleted blood reduces injury after extended ischemic preservation. An in vitro model consisting of an isolated, working neonatal piglet heart and an adolescent support pig was used. Hearts were arrested with a cold crystalloid cardioplegic solution, excised, and stored in 4 degrees C saline for 12 hours. Two groups were compared. In group 1 piglets (n = 8), reperfused with whole blood, the maximum stroke work index was 0.91 +/- 0.29 x 10(3) erg/gm (mean +/- standard error of the mean). Group 2 piglets (n = 6), reperfused with blood depleted of leukocytes by a polyester filter, had a maximum stroke work index of 11.6 +/- 1.0 x 10(3) erg/gm. This difference was highly significant (p less than 0.0001). Group 1 exhibited severe injury with myofibrillar necrosis, mitochondrial disruption, nuclear chromatin clumping, and moderate interstitial edema. Group 2 had normal ultrastructure on electron microscopic examination. We conclude that reperfusion with leukocyte-depleted blood prevents reperfusion injury and results in excellent myocardial function after long-term heart preservation. PMID- 2709859 TI - The outcome of surgical treatment of hypertrophic obstructive cardiomyopathy. Experience over 15 years. AB - From 1972 through 1987, 115 patients between the ages of 1 and 83 years (mean, 44.5 years) underwent operation for hypertrophic obstructive cardiomyopathy. Methods of relief of left ventricular outflow obstruction were septal myectomy/myotomy (n = 109), mitral valve replacement (n = 4), and myectomy/myotomy plus mitral valve replacement (n = 2); concomitant procedures included coronary artery bypass (n = 19) and aortic valve replacement (n = 9). Systolic gradient (peak-to-peak) from the left ventricle to the aorta decreased from 70 +/- 38 mm Hg (mean +/- standard deviation) to 9 +/- 11 mm Hg. There were six hospital deaths, for an overall operative risk of 5.2%; one death occurred among 83 patients less than age 65 years (operative risk, 1.2%), and five deaths occurred in 32 older patients (operative risk, 15.6%; p = 0.008 for difference between age groups). Four (22.2%) of 18 patients with a residual gradient greater than 15 mm Hg died, compared with two (2.1%) of 97 patients with a lower gradient (p = 0.003). Follow-up ranged from 0.5 to 16 years (mean, 5.1 years), and 5-year actuarial survival rate, including hospital deaths, was 84% +/- 4%. The 5-year survival rate was decreased in patients who had operative procedures other than myectomy/myotomy (69% versus 91%, p less than 0.005) and in patients aged 65 years or older (54% versus 93%, p less than 0.005). No correlation was found between preoperative symptoms, functional class, left ventricle-aorta pressure gradient, or mitral valve insufficiency and operative or late mortality. Preoperative symptoms were relieved in 57 (76%) of 75 patients with dyspnea, 49 (83%) of 59 patients with angina, and 22 (96%) of 23 patients with syncope. This experience confirms the effectiveness of operation for relief of symptoms in patients with the obstructive form of hypertrophic cardiomyopathy. The current operative mortality rate is low, especially in patients less than 65 years of age (1.2%). Our experience suggests that incomplete relief of left ventricular outflow obstruction may increase the risk of early postoperative death. PMID- 2709860 TI - Primary isolated aortic valve replacement. Early and late results. AB - A total of 1689 consecutive patients underwent isolated aortic valve replacement at the Cleveland Clinic Foundation from 1972 through 1986. There were 57 (3.4%) in-hospital deaths. Multivariate analysis identified advanced age (p = 0.0014), preoperative blood urea nitrogen level greater than 25 mg/100 ml (p = 0.008), New York Heart Association function class (p = 0.015), and preoperative atrial fibrillation (p = 0.04) as independent variables associated with increased in hospital mortality and the use of cardioplegia for myocardial protection (p = 0.006) as a factor decreasing mortality. Follow-up documented survival rates of 85% and 66% and event-free survival rates of 71% and 43% at 5 and 10 postoperative years, respectively. Advanced age, moderate or severe impairment of left ventricular function, coronary artery disease, and preoperative blood urea nitrogen level greater than 25 mg/100 ml were associated with decreased late survival and event-free survival (all p less than 0.05). Patients with bioprostheses had better survival (p = 0.003) and event-free survival (p = 0.0007) rates than patients with mechanical valves. Patients with bioprostheses had superior results only if not receiving warfarin, and they experienced more reoperations and endocarditis; those with mechanical prostheses had more strokes, myocardial infarctions, bleeding complications, and thromboembolic events. Analysis of patients grouped according to age at operation showed that bioprostheses were associated with improved survival and event-free survival for patients 40 years older or older. Younger patients experienced more reoperations and episodes of endocarditis, and older patients more thromboembolic complications. We conclude that 10-year results after isolated aortic valve replacement are influenced by both patient-related and management-related variables, and the impact of these factors is different for patients of different ages. PMID- 2709861 TI - Metastasectomy for soft tissue sarcoma. Further evidence for efficacy and prognostic indicators. AB - Between 1982 and 1987, 74 patients (46 men and 28 women) had exploration for presumed metastases from high-grade soft tissue sarcoma of the head/neck, extremity, or trunk. Ages ranged from 11 to 75 years (median 38 years). Thirty (41%) had multiple procedures for recurrences (range two to six explorations). Median postthoracotomy time for the group of patients with histologically confirmed sarcoma (n = 63) was 20.3 months. Patients rendered free of disease at initial thoracotomy had significantly longer postthoracotomy survival times (26.8 months median) than those with unresectable metastatic disease (9 months median); p2 less than 0.0001). The prognostic significance of age, sex, location of primary tumor, disease-free interval, number of nodules on preoperative computed tomograms or conventional linear tomograms, number of metastases resected, and the use of postoperative chemotherapy were analyzed. In a univariate analysis, sex, age, and location of the primary tumor did not impact significantly on survival, nor did the use of postoperative chemotherapy. Initial disease-free interval of 1 year or less was associated with a significantly shorter survival time, and patients with five nodules or fewer on preoperative computed tomography had significantly longer survival times than patients with six nodules or more. Patients with three nodules or fewer on linear tomography had a longer postthoracotomy survival time than patients with four nodules or more. In patients whose malignant disease could be completely resected, the number of nodules resected at thoracotomy did not impact on long-term survival. According to proportional-hazards modeling, disease-free interval, sex, resectability, and truncal location were found to associate with length of survival after metastasis removal. We conclude that pulmonary metastasis resection in patients with soft tissue sarcoma is associated with long-term survival, and consistent indicators can define which patients may benefit from these interventions. PMID- 2709862 TI - Extracorporeal membrane oxygenation for neonatal respiratory failure. A report of 50 cases. AB - From February 1985 through June 1987, 50 newborn infants in whom maximal ventilator therapy failed (80% predicted mortality) were treated with extracorporeal membrane oxygenation (ECMO) according to the following inclusion criteria: arterial oxygen tension less than 50 torr (alveolar-arterial oxygen gradient greater than 630 torr) for 2 hours or arterial oxygen tension less than 60 torr (alveolar-arterial oxygen gradient greater than 620 torr) for 8 hours. Criteria for exclusion from ECMO therapy included birth weight less than 2000 gm, gestational age less than 35 weeks, presence of intracranial hemorrhage, presence of other major congenital anomalies including cyanotic heart disease, and high levels of ventilatory support for more than 7 days. Mean birth weight was 3.28 +/ 0.56 kg, mean gestational age was 39.6 +/- 1.7 weeks, and mean age at the start of ECMO was 48.6 +/- 36.9 hours. Meconium aspiration, usually associated with persistent pulmonary hypertension, was the most common cause of pulmonary failure (62%). Mean pre-ECMO arterial oxygen tension during maximal ventilatory and pharmacologic support was 34.5 +/- 14.5 torr. Mean ventilatory support immediately before the institution of ECMO was as follows: peak inspiratory pressure 46.8 +/- 9.9 cm H2O, positive end-expiratory pressure 4.6 +/- 1.6 cm H2O, and intermittent mandatory ventilation rate 101.0 +/- 22.7 breaths/min with all patients receiving an inspired oxygen fraction of 1.0. Lung management to prevent pulmonary atelectasis during ECMO consisted of moderate levels of positive end-expiratory pressure (mean 10.3 +/- 2.6 cm H2O, range 8 to 14 in 94% of patients. Other mean ventilator parameters during ECMO were as follows: peak inspiratory pressure 22.8 +/- 1.6 cm H2O, intermittent mandatory ventilation rate 11.8 +/- 2.9, and inspired oxygen fraction 0.21. The overall long-term patient survival rate was 90%. Mean values for arterial blood gases and ventilator settings immediately after the discontinuation of ECMO were as follows: oxygen tension 78.4 +/- 22.1 torr, pH 7.39 +/- 0.10, carbon dioxide tension 37.4 +/- 10.7 torr, peak inspiratory pressure 25.2 +/- 3.9 cm H2O, positive end-expiratory pressure 5.6 +/- 1.2 cm H2O, and intermittent mandatory ventilation rate 41.3 +/- 12.6 with an inspired oxygen fraction of 0.42 +/- 0.17. Despite slightly higher levels of ventilator support (peak inspiratory pressure 46.8 versus 45.0 cm H2O, not significant) mean pre-ECMO oxygen tension was significantly lower than that reported from the National ECMO Registry (34.5 versus 42.0 torr, p less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2709863 TI - Laser-assisted parenchyma-sparing pulmonary resection. AB - The neodymium:yttrium-aluminum-garnet laser is an excellent tool for removing lesions while sparing surrounding normal tissue. Local excision of 32 pulmonary lesions in 26 patients was performed with the Nd:YAG laser. Fourteen patients had moderate to severe impairment of pulmonary function: average forced vital capacity = 2.2 +/- 0.3 L and forced expiratory volume in 1 second = 1.3 +/- 0.3 L. Limited thoracotomy was used in the last 23 patients. The resected lesions included 16 primary malignant tumors: nine adenocarcinomas, five squamous carcinomas, and two large cell carcinomas. Eight of these lesions were classified as T1 N0, seven were T2 N0; and one was T1 N2. There were 10 metastatic lesions: three lymphomas, two adenocarcinomas, two leiomyosarcomas, and one case each of melanoma, squamous cell carcinoma, and renal cell carcinoma. There were six benign lesions: three granulomas, two hamartomas, and one carcinoid. Twelve lesions were deep seated, could not have been removed by wedge resection or segmentectomy, and would have necessitated lobectomy without this technique. With the laser, the lesion could be precisely excised with minimal loss of lung parenchyma. Mean operating time was 80 +/- 20 minutes; laser resection time was 15 +/- 8 minutes. Resection necessitated 10,000 to 20,000 J. Total blood loss was minimal (less than 100 ml). Chest tubes were always used and remained in place 5 +/- 2 days. The mean hospitalization time was 10 +/- 2 days. Pulmonary function testing, perform 6 weeks to 6 months after discharge, showed no significant difference from preoperative levels. To date, there have been no local recurrences (longest follow-up 2 years). The Nd:YAG laser is an excellent adjunct for pulmonary resection in patients who have marginal pulmonary function or who have deep parenchymal lesions not amenable to wedge resection. The operative technique for laser resection is presented. PMID- 2709864 TI - The effects of deep hypothermic cardiopulmonary bypass and total circulatory arrest on cerebral blood flow in infants and children. AB - Cardiopulmonary bypass management in infants and children involves extensive alterations in temperature, hemodilution, and perfusion pressure, with occasional periods of circulatory arrest. Despite the use of these biologic extremes of temperature and perfusion, their effects on cerebral blood flow are unknown. This study was designed to examine the relationship of mean arterial pressure and nasopharyngeal temperature to cerebral blood flow during deep hypothermic cardiopulmonary bypass (18 degrees to 22 degrees C) with and without periods of total circulatory arrest. Cerebral blood flow was measured before, during, and after deep hypothermic cardiopulmonary bypass using xenon clearance techniques in 25 children, aged 2 days to 60 months. Fourteen patients underwent repair with circulatory arrest. There was a highly significant correlation of cerebral blood flow with temperature during cardiopulmonary bypass (p = 0.007). During deep hypothermic bypass there was a significant association between cerebral blood flow and mean arterial pressure (p = 0.027). In infants undergoing repair with deep hypothermia alone, cerebral blood flow returned to prebypass levels in the rewarming phase of bypass. However, in patients undergoing repair with circulatory arrest, no significant increase in cerebral blood flow during rewarming or even after bypass was observed (p = 0.01). These data show that deep hypothermic cardiopulmonary bypass significantly decreases cerebral blood flow because of temperature reduction. Under conditions of deep hypothermia, cerebral pressure-flow autoregulation is lost. This study also demonstrates that cerebral reperfusion after deep hypothermia is impaired if the patient is exposed to a period of total circulatory arrest. PMID- 2709865 TI - Definitive repair in patients with pulmonary atresia and intact ventricular septum. AB - Between 1977 and 1988, 22 patients underwent definitive repair for pulmonary atresia with intact ventricular septum. Fifteen underwent biventricular repair (mean age 24 months). All had mild to moderate right ventricular hypoplasia at the time of definitive repair. Repair consisted of closure of the atrial septal defect with enlargement of the right ventricular cavity and outflow tract with a patch in eight, insertion of a valved homograft in three, and superior vena cava pulmonary artery connection in four. There was one operative death (7%). Seven patients had severe right ventricular hypoplasia at the time of definitive repair and underwent a Fontan procedure (mean age 46 months). In two a valved connection was made to the right ventricle and in five a right atrial-pulmonary artery nonvalved connection. There were two operative deaths (29%). Three patients had right ventricular-coronary sinusoids: Two of them underwent a Fontan procedure and one a biventricular repair. We conclude that with adequate early palliation a biventricular repair may be successfully performed for patients with mild or moderate right ventricular hypoplasia, and the Fontan procedure may be used for those with severe right ventricular hypoplasia. PMID- 2709866 TI - Annular destruction in acute bacterial endocarditis. Surgical techniques to meet the challenge. AB - Destruction and disruption of ventricular-aortic or mitral-aortic continuity in the presence of acute infection of the annular tissue is a significant surgical challenge. Among 82 patients who underwent surgical treatment for acute endocarditis over a 10-year period, 15 (18.2%) had extensive destruction of the anulus necessitating special reconstructive techniques for treatment. Surgical treatment involved removal of all infected tissue including annular elements followed by appropriate restoration of the anulus for safe anchoring of the prosthetic valve. The reconstruction of the anulus consisted of the following: a Teflon felt patch inside and outside the aorta or ventricle, or both, for secure attachment of the prosthesis (felt aortic root, in three patients with native valve endocarditis), valved composite graft replacement of the aortic root for ventricular-aortic discontinuity (Bentall procedure, in eight patients with prosthetic valve endocarditis), composite patch reconstruction of the mitral anulus and the ascending aorta to restore mitral-aortic continuity (mitral-aortic composite patch in two patients with mitral-aortic prosthetic valve endocarditis), and direct suture of the sewing skirts of the mitral and aortic prostheses to restore the defect (attached skirts, in one patient with mitral aortic native valve endocarditis). There was one hospital death caused by multiple organ failure. The most common complication was heart block. Two late deaths were due to reinfection resulting from continued intravenous drug abuse. One patient with a felt aortic root repair required late reoperation for subannular aneurysm. Eleven patients were followed up from 7 months to 66 months and are alive and well without complications. This experience indicates that these seemingly radical surgical techniques can be used in these desperately ill patients with safety and good long-term results. They offer the only lasting solution for major disruption in cardiac anatomy in the presence of infection. PMID- 2709867 TI - Different oxygenators for cardiopulmonary bypass lead to varying degrees of human complement activation in vitro. AB - Complement activation was studied in vitro with six different membrane and bubble oxygenators for cardiopulmonary bypass. There was a similar increase in terminal (C5 to C9) activation with all oxygenators (p less than 0.001), ranging from 281% (117% to 444%) to 453% (225% to 680%) after 60 minutes (median and 95% confidence intervals). C3 activation was not observed with a hollow fiber membrane and a soft shell bubble oxygenator. On the other hand, a capillary membrane, a sheet membrane, a nonporous membrane, and a hard shell bubble oxygenator all induced a similar increase in C3 activation (p less than 0.01), ranging from 107% (23% to 346%) to 272% (88% to 395%) after 60 minutes. The differences in C3 activation could not be explained by the blood contact materials or any other single factor known to induce activation, which suggests that overall complement activation during cardiopulmonary bypass is a multifactorial effect. The tubing set per se induced only minor C3 activation but contributed to the overall formation of terminal complement complex. The study further indicates that an arterial line blood filter prevents activated neutrophils from being reinfused to the patient and should be used regardless of type of oxygenator. PMID- 2709869 TI - Extended operation for lung cancer invading the aortic arch and superior vena cava. PMID- 2709868 TI - Tricuspid valve avulsion or excision for right ventricular decompression in pulmonary atresia with intact ventricular septum. AB - Retrograde right ventricular decompression through the tricuspid valve, by damaging or excising the valve, was attempted in five patients with pulmonary atresia, intact ventricular septum, and severely hypoplastic right ventricle. Two patients were neonates in critical condition, one of whom had received previous palliation with a shunt; the other neonate had received pulmonary valvotomy plus shunt followed by repeat valvotomy plus shunt ligation. Three patients were infants or children who had undergone placement of isolated neonatal shunts. One procedure was performed during cardiac catheterization. Three patients survived. In one, tricuspid avulsion and a Rashkind septostomy were done by percutaneous methods; in two patients, tricuspid excision plus bidirectional cavopulmonary anastomosis was done by open operation. At restudy, all showed subsystemic pressure in the right ventricle and diminution or disappearance of sinusoids. One also showed improvement of left ventricular function. Incorporation of a small right ventricle in the right atrium at the time of the two orthoterminal palliations seemed, at least, innocuous. Right ventricular decompression by tricuspid avulsion or excision could be suggested for all patients with pulmonary atresia, intact ventricular septum, hypersystemic hypoplastic right ventricle, and major sinusoids without right ventricular dependent coronary circulation in whom the outlet portion of the right ventricle is not functional. PMID- 2709870 TI - Segmental tricuspid annuloplasty: a new technique. PMID- 2709871 TI - Aortic compliance as a predictor of surgical results in aortic regurgitation. PMID- 2709872 TI - Treatment of pulmonary vasospasm with prazosin after atrial septal defect closure in a child. PMID- 2709873 TI - Aortico-left ventricular tunnel: successful diagnostic and surgical approach to the oldest patient in the literature. PMID- 2709874 TI - Human acute lymphoblastic leukemia cell lines with characteristics of intraclonal variation in B-cell differentiation stage. AB - The acute lymphoblastic cell lines designated BAL-KHc and BAL-KHs were established from the peripheral blood of a Japanese female patient with a B-cell acute lymphoblastic leukemia. The BAL-KHc and BAL-KHs exhibited B-cell characteristics with positive cell markers for CD19, CD20, CD21 and HLA-DR antigens. Immunoglobulin with gamma and kappa chains was demonstrated on the cultured and fresh leukemia cells respectively. The cells lacked the Epstein-Barr virus genome and expressed abnormal chromosome constitutions including a t(8;14)(q24;q32). These results suggested that the cell lines present B-cell characteristics. The BAL-KHc cells showed different cell growth characteristics and cell surface marker profile compared to those of the BAL-KHs. These variations suggest that the BAL-KHc cells were probably frozen at a different stage of B-cell maturation from those of BAL-KHs, although both cell lines originated from the cells in the same peripheral blood sample of the patient. PMID- 2709875 TI - Stimulation of CFU-Mk colony growth by normal plasma and plasma from myelodysplastic patients. AB - The ability of plasma from myelodysplastic patients to support the clonal growth of normal megakaryocyte progenitors (CFU-Mk) was compared with that of plasma from normal subjects. The resultant megakaryocyte colonies were expressed as a plasma factor index megakaryocyte (PFI-Mk). All cultures included PHA-LCM and medium conditioned by the human bladder carcinoma cell line 5637, and some of them had EPO. PFI-Mk (MDS) was significantly lower than PFI-Mk (normal), both with and without EPO. A positive correlation was found between megakaryocyte and platelet count in normal subjects, but was not present in MDS patients. There was no correlation between platelet count and PFI-Mk in neither group. In MDS there was a negative correlation between megakaryocyte number and PFI-Mk, both with and without EPO. Although, the mean megakaryocyte number in MDS and in normal bone marrow was similar, the proportion of immature megakaryocytes was much higher in MDS. Previous work indicates an abnormal clonal origin of megakaryocytes in MDS. The present study suggests that abnormal plasma factors affects megakaryocytopoiesis in this condition. PMID- 2709876 TI - Treatment of fetal bovine serum with activated charcoal enhances spontaneous differentiation of murine erythroleukemia cells. AB - We established a spontaneous differentiation system for murine erythroleukemia cells, MELC-DS19, with high inducibility (80%). The spontaneous differentiation reflected the cells' loss of proliferative capacity. However, this phenomenon was only observed using a subclone, i.e. DS19-sc4, with an inducer-mediated commitment to terminal cell differentiation that was not suppressed by dexamethasone. Essential aspects of the system are the low initial cell density (less than 10(4)/ml) and the use of fetal bovine serum (FBS) treated with activated charcoal instead of ordinary FBS. This system is useful for studying the molecular basis of the spontaneous differentiation of MELC as well as the erythropoiesis regulating factor of sera. PMID- 2709877 TI - Tissue specificity in the expression of Friend erythroleukemic virus sequences in infected mouse tissues. AB - The SQA cell line produces Friend leukemia virus that remains leukemogenic after serial passages in vitro. The state of the provirus and its expression were investigated in newborn and adult mouse tissues, using probes specific for ecotropic and xenotropic sequences. Genomic ecotropic and xenotropic sequences were similar in size in spleen and liver of infected and control animals but appear amplified in infected tissues. Expression of these sequences however differed. Several species of xenotropic and ecotropic-specific RNAs were detected in infected spleens, in SQA cells and in the liver of newborn infected animals but were absent in infected adult liver and control tissues. These results suggest that activation and expression of ecotropic and xenotropic endogenous sequences may play a role in pathogenesis of the disease. PMID- 2709878 TI - Noradrenaline depletion protects cholinergic neurons in rat hippocampus against AF64A-induced damage. AB - The role of the noradrenergic system in the cholinotoxicity of ethylcholine aziridinium ion (AF64A) was studied in rats. Male Sprague-Dawley rats were treated with the noradrenergic neurotoxin DSP-4 (N-(2-chloroethyl)-n-ethyl-2 bromobenzylamine; 50 mg/kg i.p.) in the presence of the serotonin uptake inhibitor fluoxetine, 14 days prior to bilateral intracerebroventricular injection of AF64A (2 nmol/lateral ventricle). In rats in which noradrenaline (NA) was depleted by 94%, the loss of acetylcholine (ACh) in hippocampus induced by AF64A was significantly attenuated (p less than 0.02). However, when there was only a partial depletion of NA (50% reduction), the AF64A-induced loss of ACh was a pronounced as in rats with intact noradrenergic function. These findings indicate that the noradrenergic lesion has to be complete before a protective effect is apparent. Moreover, they imply that noradrenergic input is involved in AF64A-induced cholinergic damage in the hippocampus. PMID- 2709879 TI - A non-stereotaxic method for olfactory bulb kindling reveals distinct kindling rates among inbred mouse strains. AB - A simple method for olfactory bulb kindling in the unrestrained mouse is described. Twisted wire electrodes attached to a dip-socket head assembly were implanted in the olfactory bulb. A ground lead was secured to a single skull screw and implantation was visually guided into the olfactory bulb. In all properly implanted preparations, stimulation produced an afterdischarge with behavioral responses which progressed to fully kindled convulsions. Location within the olfactory bulb did not affect the kindling rate. With this technique, mice from the C57BL/6J, C3H/He and DBA/2 inbred strains were kindled. Within each strain, kindling parameters were closely distributed about the group mean. Kindling rates in C3H and DBA inbred strains were significantly different from each other, but not significantly different from those reported in amygdala kindling. PMID- 2709880 TI - Pulsed linear acceleration as a vestibular stimulus in electrophysiological investigations. AB - A simple method of generating precisely defined pulsed linear acceleration stimuli was developed and used to study vestibular responses to cranial acceleration. Electromechanical shakers were coupled to a stimulus platform. The platform, in turn, was used to couple stimuli to the skull. Movements were controlled by a voltage waveform (V(t] applied to shakers. Software algorithms were used to synthesize voltage functions (V(t]. The resulting acceleration was monitored [a(t)] and used to generate velocity [v(t)] and position [x(t)] functions (first and second integrals of a(t), respectively). The characteristics of stimuli used in physiological experiments are described. The system provides precise control of the timing and amplitude of acceleration, velocity and position pulses to the cranium and has proved to be valuable in developing noninvasive electrophysiological measures of peripheral and central vestibular function. PMID- 2709881 TI - In vitro and in vivo transplantation of fetal rat brain cells following incubation with various anatomic tracing substances. AB - Implantation of fetal brain regional anlage into host brains ('brain transplantation') holds promise as a plausible treatment for certain human neurodegenerative disorders. Improvements in experimental brain transplantation techniques include: (1) utilization of brain cells in tissue culture as opposed to freshly prepared cell suspensions as a transplantation source, (2) prelabeling of fetal brain cells with inert, non-toxic tracer substances to allow subsequent (a) unequivocal identification of those cells as being fetally derived, and (b) anatomical and immunohistochemical identification of transplanted neurons, and (3) development of in vitro models for transplantation to allow physiological studies of connections formed between fetal neurons and host brain tissue. We examined the ability of brain cell suspensions derived from rat fetuses 15-17 gestational days old to accumulate and retain anatomic tracing substances, including Phaseolus vulgaris leucoagglutinin (PHA-L), rhodamine-labeled latex microspheres (RLM) and fluorogold (FG). All tracers were rapidly accumulated by fetal brain cells, but only PHA-L and RLM were retained following implantation into adult hosts or in tissue culture in vitro. PHA-L-labeled fetal brain cells transplanted in vivo showed morphological characteristics similar to fetal neurons kept in tissue culture in vitro. RLM- or PHA-L-labeled fetal brain cells can be co-cultured with rat brain slices maintained in long-term roller culture. This in vitro system will allow identification and physiological or immunohistochemical study of interactions between fetally derived and host brain neurons. PMID- 2709882 TI - Chronic access to endoneurial space using an arterial autograft. AB - A technique for direct chronic infusion of compounds onto peripheral axons has been investigated in the rat sciatic nerve. A 2 cm segment of the femoral artery was removed and one end inserted into the endoneurial space of the contralateral peroneal nerve fascicle of the same animal. The other end of the artery was connected to a catheter system to allow infusion into the endoneurium, thus bypassing the barrier that the perineurium presents to hydrophilic compounds. The patency of this arterial access system was evaluated by the ability of 20 microliters of 2% lidocaine to inhibit the toe-spreading reflex. The results of the study were that the infusion system remained operational for 3-7 days after transplantation. There were histologic changes in the nerve but there were no functional deficits due to the surgery. Although a long-term endoneurial infusion was not achieved, the limited access time to the axons might be long enough for applications such as the delivery of nerve growth factors to injured nerve. PMID- 2709883 TI - There is no simple adequate sampling scheme for estimating the myelinated fibre size distribution in human peripheral nerve: a statistical ultrastructural study. AB - Morphometric studies of peripheral nerves (PN) usually involve some sampling of the myelinated fibres (MF). In order to scrutinize the statistical properties of the sampling processes in common use and the reliability of the resulting estimates, a quantitative analysis of human superficial peroneal nerves from 8 different normal subjects was undertaken at the ultrastructural level, both in terms of MF spatial distribution and of their size distribution. This study used sampling rates involving more than 10% of the whole myelinated fibre population observed in each nerve fascicle. However, in nearly all the fascicles evaluated, the sampling fluctuations are so high that neither the number of axons nor their diameter distribution can be assessed with enough accuracy. A systematic study of the myelinated fibres shows that the spatial distribution of their size is not uniform. This marked heterogeneity in the MF size distribution imposes measurement of large enough samples (500 or 600 MFs usually represent about one half or two-thirds of the whole MF population) in a way to secure a reliable enough estimate of the density and size distributions. However, the practical usefulness of sampling schemes requiring more than one-half of the whole MF population in a nerve fascicle, is questionable. PMID- 2709884 TI - A monolithic patch-clamping amplifier with capacitive feedback. AB - Patch-clamping is an established method for directly measuring ionic transport through cellular membranes with sufficient resolution to observe open/close transitions of individual channel molecules. This paper describes an alternative technique for patch-clamping which uses a capacitor as the transimpedance element. This approach eliminates bandwidth and saturation limitations experienced with resistive patch-clamping amplifiers. A complete monolithic design featuring an on-chip operational amplifier, a capacitor array with gain ranging from 30 pF down to 0.03 pF, and reset and gain ranging switches has been fabricated using 5 microns CMOS technology. It is shown that the voltage noise of the CMOS operational amplifier limits the overall noise performance, but that performance competitive with conventional instruments can be achieved over a 10 kHz bandwidth, at least for small input capacitances (less than or equal to 5 pF). Results are presented along with an analysis and comparison of noise performance using both resistive and capacitive elements. PMID- 2709885 TI - A fractal analysis of cell images. AB - Methods of digital image analysis have been adapted to measure the fractal dimension of cellular profiles. The fractal dimension is suggested as a useful measure of the complexity of a contour. Three methods produce similar results when applied to constructed, near-ideal fractal figures. Comparison of the measurements for a variety of image types indicates the measurement accuracy in each case and may help in interpreting the results when applied to real, non ideal cell images of unknown fractal dimension. Two of the methods are currently adopted as appropriate for use on neuronal contours. A correlation exists between the complexity of these contours and the magnitude of the estimated fractal dimension. PMID- 2709886 TI - [Excessive intake of fats and cholesterol in hypercholesterolemic individuals. Effects of dietary intervention on plasma lipids and lipoprotein cholesterol]. AB - Preliminary evidences suggest that both the frequency of ischemic heart disease and the plasma cholesterol levels are increasing in the Spanish population, whose dietary habits are becoming progressively "westernized". In the present work we used the food frequency method to evaluate the dietary habits of 30 hypercholesterolemic subjects. These and another 65 free-living individuals of both sexes, ages 18-77 yrs, with plasma cholesterol 301 +/- 41 mg/dl or 7.80 +/- 1.06 mmol/l (means +/- SD) were submitted to a hypolipidemic diet similar to the mediterranean diet in order to assess effects on plasma lipids and lipoprotein cholesterol. The usual diet contained (% kcal/day): total fat 37, saturated fat (S) 12, monoinsaturated fat 16 and poliinsaturated fat (P) 6, with P/S = 0.5 and a daily cholesterol intake of 506 mg. During dietary intervention, respective changes were: -7%, -5%, -1%, +2%, +0.6, and -304 mg. After a 3 - month dietary period, significant (p less than 0.001) decreases occurred in total plasma cholesterol (-40 mg/dl or -1.04 mmol/l, -14%), LDL-cholesterol (-35 mg/dl or 0.91 mmol/l, -16%) and triglycerides (-5 mg/dl or -0.28 mmol/l, -14%), while HDL cholesterol and body weight did not change. Similar effects were obtained when diet was continued for 1 yr in a subgroup of 40 individuals. The responses of plasma cholesterol to dietary change had a normal distribution, with 17% hyporresponses and 15% hyperresponses. A marked decrease (-36%) of plasma triglycerides was observed in 12 subjects with IIb hyperlipidemia. The total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios improved in both men and women.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709887 TI - [Prospective study of 75 episodes of sepsis in hemodialysed patients]. AB - During a 38-month period the bacteremias developing in patients on hemodialysis from three centers of the Barcelona area were evaluated to assess their incidence, characteristics, and response to therapy. In the overall 13376 months of hemodialysis of the study, 75 episodes of bacteremia were detected in 64 patients; this amounts to an incidence of 5.6 episodes per 1000 hemodialysis months. The most common sources of becteremia were intravenous catheters (44%), which were mainly used as temporary vascular access, followed by the definitive vascular access (26%), the genitourinary system (10%), and the lung (6%). Twenty seven episodes of bacteremia developed in 24 patients in whom dialysis had been started in the two previous months (11% of the overall number of new patients), and, in them, 77% originated in an intravenous catheter, while this was the origin of bacteremia in only 23% of the remaining patients. 72% of bacteremias were caused by gram positive organisms, particularly Staphylococcus aureus and Staphylococcus epidermidis (60%), followed, in frequency order, by aerobic gram negative bacilli (25%), particularly Escherichia coli and Pseudomonas. Stpahylococci were significantly associated with the vascular access, either if this was a catheter or not (81% of instances), while gram negative bacilli were associated with sources different from the vascular access (48% of instances). Severe complications included 2 cases of aortic valve endocarditis, one hemorrhagic shock caused by rupture of an infected vascular access, and one suppurative phlebitis associated with a hemodialysis catheter. Staphylococcal sepsis was randomly treated with vancomycin or vancomycin plus gentamicin, without differences in the results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709888 TI - [Analysis of response to treatment. Considerations on changing prognostic variables (time-dependent)]. AB - In the prognostic evaluations the initial variables, obtained at the time of diagnosis, and the evolutive or time-dependent variables, that appear during the course of the disease, should be clearly differentiated. If this separation is not strictly maintained inaccurate results may be obtained. The errors resulting from the use of an inappropriate methodology are illustrated in the present article on the basis of two series of patients. On the other hand, the advantages and shortcomings of alternative methods, which are valid for prognostic studies with evolutive or time-dependent variables, are discussed. Finally, recommendations are given for the particular instance where the response to therapy in a therapeutic trial is being assessed. PMID- 2709889 TI - [Reversibility of alcoholic myocardiopathy with abstinence: presentation of 2 cases]. AB - The sustained alcohol intake results in the development of a dilated cardiomyopathy; its pathogenesis and prognostic and evolutive factors have not yet been completely defined. It is classically considered that alcoholic cardiomyopathy has a poor prognosis, as two thirds of patients die within three years. However, in recent years some isolated cases of clinical reversibility after short abstinence periods have been reported without identification of the involved factors. Two chronic alcoholic patients are reported with congestive heart failure at admission; a diagnosis of alcoholic cardiomyopathy was made after cardiac catheterization and endomyocardial biopsy. The morphometric study of endomyocardial biopsy showed a preservation of the myofibrillary fraction with mild fibrosis. The clinical outcome was favorable: after three months of alcoholic abstinence, a complete clinical recovery with definite improvement of echocardiographic parameters and left ventricular ejection fraction in the radionuclide ventriculography were observed. Finally, the factors that appear to be involved in the presence or absence of reversibility of this type of cardiomyopathy are discussed. PMID- 2709890 TI - [Calculating the number of patients necessary for designing a clinical study]. PMID- 2709891 TI - [Traffic accidents and drug abuse]. PMID- 2709892 TI - [Behavior of serum CA 72.4 in patients with non-tumor pathologies. Preliminary results]. PMID- 2709894 TI - [Pharmacologic iatrogenesis and criteria of imputability]. PMID- 2709893 TI - [Absence of HTLV-1 infection in drug addicts in Vizcaya]. PMID- 2709895 TI - [Dyspnea, chest pain and respiratory insufficiency in a 68-year-old man]. PMID- 2709896 TI - [Anemia and primary hyperparathyroidism]. PMID- 2709897 TI - [Warthin's tumor a prelymphomatous lesion?]. PMID- 2709898 TI - [Adenosine deaminase and boutonneuse fever]. PMID- 2709899 TI - [Dysplastic nevus syndrome: diagnosis as prevention of melanoma]. PMID- 2709900 TI - [Usefulness of temporal artery biopsy: analysis of 100 cases]. AB - We have evaluated 100 biopsies of temporal artery carried out in the Hospital La Paz from 1972 to 1986. On the basis of the histological result and the final diagnosis we divided the patients in five groups: I, temporal arteritis/polymyalgia rheumatica with positive biopsy, 11 cases; II, temporal arteritis without polymyalgia symptoms and with positive biopsy, 16 cases; III, temporal arteritis with negative biopsy, 7 cases; IV, polymyalgia with negative biopsy, 14 cases; and V, other diagnoses, 43 cases. The number of diagnoses of temporal arteritis/polymyalgia rheumatica has increased throughout the recent years, although the positive biopsies/overall biopsies ratio has remained constant. Certain symptoms such as claudication, headache, amaurosis and Raynaud's phenomenon have a high predictive value of a positive result, but their sensitivity is low. In the 25 patients with polymyalgia, biopsy was positive in 11, out of which 4 did not have features of temporal arteritis. Biopsy was positive in 4 out of the 9 patients in whom it was repeated in the contralateral side. The diagnostic yield was higher in those cases in whom it was indicated for classical temporal arteritis symptoms, but we emphasize that there was a 19% positive rate in patients who presented with fever of unknown origin, while it was only 5.5% in those in whom a constitutional syndrome was being evaluated. We conclude that the use of temporal biopsy should be more widespread, as its cost is low and it has no side effects; therefore, it can achieve a great benefit for the patient with a shorter and less expensive hospital stay. PMID- 2709901 TI - [A dose-response study of the chronic effect of ketoconazole on androgen and cortisol secretion in women with hyperandrogenism]. AB - We have previously shown that ketoconazole may inhibit the androgen synthesis, but the risk to induce a blockade in the cortisol synthesis and/or hepatic abnormalities makes it mandatory to look for the least dose that is able to inhibit androgen production without inducing other abnormalities. To this end, we studied the levels of 17-alpha-hydroxyprogesterone (17, alpha-OH-P), dehydroepiandrosterone sulphate (DHEA-S), delta 4-androstenedione (delta 4-A), total (tT) and free (fT) testosterone, and the cortisol response to ACTH in 13 women with hyperandrogenism, before and after ketoconazole therapy at dosages of 400, 600, and 800 mg/day. Although with the 400 mg regimen a reduction in the levels of androstenedione and free and total testosterone was already observed, it was of small amount and it was not until the 600 mg regimen that androgen levels became normal. Thus, DHEAS-S was reduced from 3.672 +/- 1.013 to 2.216 +/- 756 ng/ml (p less than 0.05); delta 4-A was reduced from 392 +/- 80 to 283 +/- 79 ng/ml (p less than 0.01); tT was reduced from 1.5 +/- 0.78 to 0.7 +/- 0.1 ng/ml (p less than 0.05), and fT from 5.5 +/- 1.0 to 2.7 +/- 1.3 pg/ml (p less than 0.001). By contrast, 17 alpha-OH-P increased from 1.7 +/- 1.3 to 4.7 +/- 1.3 ng/ml (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709902 TI - [Diagnostic efficacy of temporal artery biopsy]. PMID- 2709903 TI - [Arterial hypertension, nephrosclerosis and calcium antagonists]. PMID- 2709904 TI - [Carcinoma of unknown origin. Diagnostic study of 48 cases and its clinical yield]. AB - Forty-eight patients fulfilling the criteria for carcinoma of unknown origin (CUO) between April 1983 and December 1987 were retrospectively analyzed. Mean age was 62 (33-83). Twenty-seven were males (56%) and 21 females (44%). The most common site of metastasis was the bone (35%), followed by the liver (19%) and lymph nodes (19%). 58% of cases were adenocarcinomas. Overall 274 studies for the detection of the primary tumor were carried out, the diagnosis being achieved in 10 cases (3.65%) which corresponded to lung neoplasms (5 cases), prostatic adenocarcinoma with negative markers (2 cases), bile duct neoplasms (2 cases) and pancreatic carcinoma (1 case). In our series, the most useful studies were computed tomography (CT) and fibrobronchoscopy. The necropsy, carried out in 11 patients, yielded 8 additional diagnoses: pulmonary neoplasm (one case), gastric adenocarcinoma (2 cases), malignant melanoma (2 cases), small intestine neoplasm (one case), parotid cancer (one case) and hepatocarcinoma (one case). Thirty-five patients were treated with chemotherapy and/or radiation; 12 objective responses (3 complete and 9 partial) were achieved, with a median duration of the response of 10 months (range 0.2-78 +). In view of the low diagnostic yield of the studies in patients with CUO we feel that the diagnostic study may be limited to CT scan with evaluation of the possible usefulness of bronchoscopy in individual patients. Regarding therapy, it is to be noted that there was a tendency for a longer survival in patients who responded. PMID- 2709905 TI - [Use of antimicrobial agents and prevalence of infection at the Clinical University Hospital of Zaragoza]. AB - Two cross-sectional prevalence studies have been performed on april 10 and June 12, 1986, at the Hospital Clinico Universitario of Zaragoza in order to gather information about the use and consumption of antimicrobial drugs and the degree of hospital infection. On these days, of the 726 and 717 patients admitted to the hospital, 29.3% and 26.3% were treated with antimicrobial drugs and, of these, 31.4% and 23.8% respectively, with associate drugs (above all empirical purposes and for respiratory infections), aminoglycosides being the most common. The indication of antimicrobial drugs was distributed in the following manner on both days: prophylactic 28.7% and 25.1%, empirical 42.3% and 56.9% and therapeutical 27.9% and 17.6%. The prophylactic treatments were correct in 46.1% and 36.6% of the cases, and of those 74.3% and 71.6% were for surgical prophylaxis; the average time was 3.5 and 4.5 days on each day studied. The most commonly used antimicrobial drugs were, in decreased order: gentamicin, amoxycilin, ampicillin, cefoxitin, pipemidic acid and cefamandol. The consumption was 1.36 and 1.29 drugs per patient on each day. The most common routes of administration were I.V. and oral. The intervals and dosages were generally respected. The most frequent were respiratory and urinary infections, and of these, 21% and 32% of the respiratory infections were nosocomial as were 23% and 32% of the urinary infection. 7.1% and 4.3% of the patients admitted developed a hospital-acquired infection on each day. The most frequent isolated germs were Escherichia coli and Pseudomonas aeruginosa. There were no adverse reactions to the antimicrobial drugs documented. PMID- 2709906 TI - [Incidence of hospital infections at a university hospital]. AB - To evaluate the real status of the hospital acquired infection in the Hospital Clinico Universitario of Salamanca, we have carried out a study of incidence during three years, which was based on the program of continuous active infection surveillance of the Preventive Medicine Service. The overall incidence rate was 4.8%. The incidence rates for infective localizations were 2.3% for urinary tract infection, 1.0% for surgical wound infection, 0.6% for pneumonias and 0.5% for bacteremias. The most common infection was urinary tract infection, which amounted to 46.5% of the overall instances. The highest rates for services were those from Intensive Care Unit (14.4%), Hematology (10.5%) and Surgery (7.0%). In 302 patients, representing 9.8% of the infected patients, more than one infection was detected. The program of continuous surveillance of hospital acquired infection is a method that allows the acquisition of permanent information about the real status of this problem at any time, as well as the implementation of the adequate preventive measures in each case. PMID- 2709907 TI - [Control of nosocomial infections: who? how? and how much does it cost?]. PMID- 2709908 TI - [The placebo effect: between mind and brain]. PMID- 2709909 TI - [Causalgia in patients treated with anticoagulants]. PMID- 2709910 TI - [Prevalence of smoking among medical professionals]. PMID- 2709911 TI - [Small impact of information about acquired immunodeficiency syndrome on the behavior of populations with known risk factors]. PMID- 2709912 TI - [Developing ischemic ictus: anticoagulative treatment with perfusion of heparin]. PMID- 2709913 TI - [Non-pseudotumoral focal inflammatory myopathy]. PMID- 2709914 TI - [Hyporeninemic hypoaldosteronism and acquired immunodeficiency syndrome]. PMID- 2709915 TI - [Muckle-Wells syndrome. Apropos of a case]. PMID- 2709916 TI - A study of reference parameters in the CFY (remote Sprague-Dawley) rat. AB - The reference parameters for 10- and 19-week old CFY (remote Sprague-Dawley) rats fed powdered feed have been studied: growth curves, food consumption, ophthalmoscopy, results of urinalyses and hematological and biochemical assays, and absolute and relative organ weights. Detailed information is given of instrumentation and methods employed, of the animals, strain and environment, and of blood-sampling technique. In general, the results obtained were similar to those previously reported in literature. PMID- 2709917 TI - Subnanogram GC/NPD method for the determination of sparteine in biological fluids. AB - A gas chromatographic method is presented for identification and quantification of sparteine in biological fluids using cyclizine as an internal standard. No derivation is necessary and after a single alkaline extraction, GC analysis of sparteine is achieved in less than 8 min. A subnanogram limit of detection is allowed by the use of a nitrogen phosphorous detector (NPD). This method is simple, reproducible, selective, and applicable in both clinical and pharmacokinetic studies. PMID- 2709918 TI - Acceptability of visual analogue scales in the clinical setting: a comparison with verbal rating scales in postoperative pain. AB - Pain is the clinical symptom most difficult to evaluate. Although clinical trials methodology have permitted assessment of pain objectively through rating scales, these strategies have not been used in clinical setting. The present study was undertaken to determine if visual analogue scales could be useful in the measurement of postoperative pain in usual medical practice. The study comprised 212 patients with abdominal, orthopedic or gynecological surgical procedures within the previous 24 h. Patients evaluated their pain using a verbal rating scale (VRS) of five points or a visual analogue scale (VAS) of 10 cm. The investigators also evaluated patient pain through a VAS. The results obtained showed that a high correlation between VRS and VAS could be established in all patients (p less than 0.001). The VAS of patients and researchers were also found to be highly correlated (p less than 0.001). When values of each group were compared by pain intensity a total agreement of VAS scores at low pain level could be established, but differences were found at high pain intensity levels, suggesting that physicians scored lower than patients when pain was severe to unbearable. It is concluded that VAS could be a reliable method to assess pain in clinical setting. PMID- 2709919 TI - Pharmacological activity, blood and tissue levels of indomethacin after single oral administration of two long-acting forms in the rat. AB - The duration of pharmacological action in the rat (carrageenin edema inhibition) of a long-acting indomethacin form (Dolcidium PL) was compared to that of a reference long-acting indomethacin form after a single oral dose (3 mg/kg) considered as the ED50 value and compatible with clinical use. Kinetic comparison of both forms was achieved in the blood and at the level of the inflammatory site. There was an identical bioavailability, but the rate of indomethacin release from the test preparation was significantly slower than that of the reference form. Greater pharmacological potency and significantly longer duration of action were also demonstrated for the former, indicating that this novel formulation exhibited better sustained release characteristics than the reference form, and thus exerted an optimal pharmacological effect (over 24 hr). Since there is a high degree of correlation of clinical efficacy with potency in the rat foot edema test, better effectiveness of Dolcidium PL should be expected in man. The reduction in peak plasma level of indomethacin should improve its tolerability as well. PMID- 2709920 TI - Effect of dopamine receptor antagonist on in vivo dopamine release induced by intrastriatal perfusion with methamphetamine in freely moving rats. AB - In order to investigate a regulatory role of dopamine receptors in drug-induced release in the striatum, we determined dopamine and its metabolites in dialysates simultaneously with behavioral observations following intrastriatal perfusion with methamphetamine using the transstriatal dialysis method in freely moving rats. Intrastriatal perfusion with methamphetamine (5, 50, 500 microM) for 40 min produced a marked increase in dopamine release and a slight reduction in 3,4 dihydroxyphenylacetic acid release. No significant changes in spontaneous motor activity were observed after methamphetamine at concentrations up to 500 microM. Methamphetamine-induced dopamine release was not affected by the selective D1 receptor antagonist SCH 23390 (1 microM), but was markedly enhanced by the selective D2-receptor antagonist sulpiride (1 microM), at a concentration that did not change the basal level. Intrastriatal pretreatment with kainic acid (1 micrograms into bilateral striata) slightly affected the dopamine release induced by methamphetamine. These results suggest that methamphetamine-induced dopamine release is regulated by both pre- and postsynaptic D-2 receptors in the striatum in vivo. PMID- 2709921 TI - Histamine and its actions on isolated tissues of lower vertebrates. AB - The response to histamine (Hi) of isolated organs such as the intestinal tract and heart, obtained from certain lower vertebrates, was investigated phylogenetically and compared with the response to acetylcholine (ACh), 5 hydroxytryptamine and epinephrine (Ep). Contractions induced by Hi (10(-4) M) were not noticeable in any of the intestinal strips of fish and amphibians tested, although ACh produced marked contractions in all preparations even at 10( 6) M. Contractile responses of intestinal preparations to Hi were elicited from reptiles, and seemed to be associated with the H1 receptor in many species but not with the H2 receptor. In isolated fish auricles, neither inotropic nor chronotropic responses were produced by Hi. In bullfrogs and in the majority of species, including reptiles and higher classes, a marked positive inotropic response was elicited via H1 or H2 receptors, but in some animals chronotropic effect was less impressive. The effects of ACh and Ep on heart preparations were remarkable in almost all species tested. When the Hi contents in various tissues were studied comparatively, a determinant stage of Hi appearance in the tissue coincided with the stage in which a definite Hi response emerged in isolated organs. PMID- 2709922 TI - Exploratory behavior and the dual activity of some psychoactive drugs. Part 5. Alcohol. AB - Alcohol is reported to impair acquisition and learning processes and it is considered a depressant of the brain activities impairing rapidity and consistency of some behaviors. The experiments reported here are concerned with the exploratory performances of the already described subpopulations of Albino mice under the effect of alcohols of different types. PMID- 2709924 TI - [Stasis--what is it? Better information from consulting physicians is necessary for useful statements from X-ray specialists]. PMID- 2709923 TI - [Better marketing of steroid preparations]. PMID- 2709925 TI - [The new infectious diseases law: transmission of intestinal infections- guidelines used in the city of stockholm]. PMID- 2709926 TI - [Does the diet of hunter-gatherers prevent cardiovascular disease?]. PMID- 2709927 TI - [Rheumatologic diagnosis did exist before 1974]. PMID- 2709928 TI - [Cholesterol--more difficult to measure than to lower? High demands are placed on laboratory methods]. PMID- 2709929 TI - [Embolization caused by an air-gun missile presented diagnostic problems]. PMID- 2709930 TI - [Is Mollaret's meningitis caused by herpes simplex virus type 2?]. AB - Mollaret's meningitis is characterised by recurrent, brief episodes of serous meningitis with symptom-free intervals. Although viral etiology has been suspected, no pathogenic agent has hitherto been found. Using the immunoblot technique, we found IgG antibodies of intrathecal origin against the HSV-2 specific protein, gG2, in a patient with Mollaret's meningitis. Since being put on prophylactic acyclovir treatment twelve months ago, the patient has had no further episodes of meningitis. Because of the similarities between Mollaret's meningitis, recurrent HSV-2 meningitis, and the findings in the case reported here, HSV-2 is suggested as a possible cause of Mollaret's meningitis in general. PMID- 2709931 TI - [Intrauterine growth retardation--is our classification valid?]. PMID- 2709932 TI - [Vaccines today and tomorrow. Vaccination trends in developing countries: 90 per cent of children will be vaccinated by the year of 2000]. PMID- 2709933 TI - The transoropalatal approach to the atlantoaxial-clival region: considerations for the head and neck surgeon. AB - The transoropalatal approach to the atlantoaxial-clival area provides excellent exposure for neurosurgical decompression and fusion procedures. The technique has been effectively applied in the treatment of bony and soft tissue abnormalities of the anterior spinal region. Although this approach is safe and reliable, it is not part of the otolaryngologist's usual surgical armamentarium. In the present study, we describe the case histories of five patients who underwent resection of the odontoid process for cervicomedullary compression. Neurological compromise was manifested by progressive upper and/or lower extremity paresis in all patients. In each patient, a transoropalatal approach was used. The surgical technique is discussed, and the prevention of possible sequelae, including velopharyngeal incompetence and palatal or pharyngeal wound dehiscence, is addressed. PMID- 2709934 TI - Management of bilateral acoustic tumors. AB - Bilateral acoustic tumors (Neurofibromatosis 2) have now been shown to arise in patients with gene abnormalities separate from those with von Recklinghausen's disease (Neurofibromatosis 1). The management of patients with this disease has long posed a particularly challenging problem for the neurotologist. This retrospective study reviews our series of 38 patients and updates a previous report. Thirty-four patients underwent surgical excision of tumors on one or both sides. Hearing conservation was attempted in 20 with hearing preservation possible in eight. Recent advances in understanding the hereditary etiology of this disease, changing methods for diagnosis, preferred surgical techniques, and guidelines for appropriate patient management are discussed. PMID- 2709935 TI - Small fenestra stapedotomies with and without KTP laser: a comparison. AB - The results of 33 small fenestra stapedotomies performed using conventional techniques were compared with the results of 33 stapedotomies performed using the argon or KTP laser. The ossicular chain was reconstructed using a Teflon wire piston of 0.6 mm diameter, and follow-up was at least 1 year. Over-closure of the air-bone gap or closure to within 10 dB was accomplished in 91% of the laser treated group versus 72% of the conventionally treated group (p less than 0.10). The hearing results were statistically better in the laser group (p less than 0.05). Transient delayed vestibular symptoms, lasting from 1 to 3 weeks, were present in 39% of the laser-treated group and in 12% of the patients treated by conventional techniques (p less than 0.05). The KTP laser stapedotomy, using a micromanipulator mounted on the microscope, is a safe, efficient technique that reduces some of the technical difficulties associated with conventional stapes surgery. The main advantage of the laser is that it enables the surgeon to make an atraumatic, bloodless opening in a fixed or mobile stapes footplate without mechanical manipulation of the stapes. Using a lower wattage to vaporize the footplate and waiting several seconds between laser bursts may decrease the incidence of postoperative vestibular symptoms. The use of the KTP laser in stapes surgery represents a major advance in surgery for otosclerosis. PMID- 2709936 TI - Speech restoration and complications of primary versus secondary tracheoesophageal puncture following total laryngectomy. AB - The tracheoesophageal (TE) fistula with a speech prosthesis has become the method of choice for vocal rehabilitation in many postlaryngectomy patients. Several modifications of the procedure have been described including primary TE puncture at the time of laryngectomy. Fear of increased risk of complications has kept the primary procedure from widespread usage. Our series of 95 TE fistula procedures from 1980 to 1988 revealed 33 to be primary and 62 secondary. Eighty-five percent (85%) (28 of 33) patients in the primary group achieved long-term satisfactory speech (1 year or more of follow-up). Complications occurred in 36% of this group of patients. The success rate for the secondary group was 69% (43 of 62), while the complication rate was 21%. There were no instances of death, sepsis, or mediastinitis associated with either primary or secondary TE fistula patients. It appears that the primary TE fistula can be performed as safely and effectively as the secondary procedure. PMID- 2709938 TI - Transcutaneous Teflon injection for paralytic dysphonia. AB - Transcutaneous Teflon augmentation of the vocal cord was performed 21 times in 19 patients with unilateral vocal cord paralysis. The larynx was visualized using flexible fiberoptic video-endoscopy and, after local anesthesia to the skin over the cricothyroid membrane, an 18-gauge 2-inch needle was introduced through the cricothyroid membrane. Under fiberoptic visualization, the needle was inserted into the paralyzed vocal cord through its undersurface. Teflon was injected with a syringe to produce medialization of the vocal cord. The position of the vocal cord and voice quality were monitored throughout the procedure. No complications were encountered. All patients experienced a reduction in breathiness of voice that was rated as a significant improvement by the patient and surgeon. Two patients required reinjection of Teflon for optimal improvement. PMID- 2709937 TI - Management of neurovascular complications in extended skull base surgery. AB - Combined oncologic approaches to the skull base now permit resection of extensive basicranial neoplasms. Despite advances in microsurgical techniques, disabling or life-threatening complications are still encountered in such surgery. Successful management of these sequelae is dependent upon meticulous intraoperative care and compulsive postoperative clinical assessment. Perioperative neurovascular complications were recorded in 154 consecutive skull base procedures. The most frequent severe complication was cerebral edema, which occasionally required surgical intervention. Dysphagia was the most common complication noted in the late postoperative period. Based upon this review, the management and methods found to minimize the incidence of various perioperative neurovascular complications related to extended skull base surgery are described. PMID- 2709939 TI - Computer-aided three-dimensional reconstruction and measurement of the round window niche. AB - The goal of this study was to clarify the three-dimensional shape of the round window niche and to measure this structure three-dimensionally using the computer aided reconstruction method we developed. The equipment used in this study included a personal computer (NEC 98-XA), a high-resolution 14-inch color CRT, a digitizer (Hitachi HDG-1111), and a printer. We studied five normal temporal bones obtained from five individuals with negative otologic histories, who had been 5 months and 14, 15, 18, and 59 years old at death. In each case the round window niche was located posteroinferior to the round window. The round window niches had wide openings to the middle ear cavity that became narrower near the aperture; thus, the round window niche seemed to be shaped like a pouch. The maximal diameter of the round window niche was 2.98 +/- 0.23 mm. The shortest distance between the aperture of the round window niche and the margin of the round window was 0.66 +/- 0.16 mm. The volume of the round window niche, on average, was 4.65 +/- 0.67 mm3. The volume of the round window niche was found to be correlated with the area of the round window. PMID- 2709940 TI - Lateral skull base surgery for cancer. AB - The management of malignant tumors of the lateral skull base remains a challenging problem. Sixty-two patients underwent lateral skull base resection for cancer. Preoperative evaluation included complete neurotologic examination, CT scan, MRI, and carotid angiography. During surgery, the nasopharynx, the posterior maxilla, the infratemporal fossa structures, the mandibular ramus, and the parotid gland were resected en bloc. Reconstruction of the surgical defect was performed using pectoralis and/or rhombotrapezius myocutaneous flaps. Although the overall cure rate was not greatly improved, patients with lateral skull base malignancies now enjoy extended periods of palliation and a better quality of life. PMID- 2709941 TI - Phonatory characteristics following surgical treatment of severe polypoid degeneration. AB - This paper summarizes the results of our research into the efficacy of phonosurgery. Our study group consisted of 25 women whose severe, bilateral polypoid degeneration was managed surgically by one of the following methods: Hirano's technique, mechanical stripping, or CO2 laser enucleation. We found that all three procedures improved the voice. Surgery increased the average speaking fundamental frequency level substantially and improved the phonational range. Listeners' judgments about the appropriateness of vocal pitch and severity of hoarseness also changed positively following surgery. No one method was clearly better than another in improving the voice. However, patients treated using Hirano's method experienced the most rapid return of functional voice use, probably because the procedure is less traumatic and promotes more rapid healing than mechanical stripping or laser removal. PMID- 2709942 TI - Is the nasal cycle an artifact? The role of asymmetrical postures. AB - Both the nasal cycle and postural asymmetries between the lateral halves of the body will cause the patent cavity of the nasal airway to change sides. Therefore, the cycle might result from adjustments of posture during prolonged periods of nasal resistance measurements. Posterior rhinometric measurements of unilateral nasal resistance were made three times for 5 to 7 hours on a patient in whom 11 periods of lateral recumbency had not induced nasal resistance changes. A nasal cycle was observed. It is concluded that the cycle is not the product of asymmetrical body pressures. PMID- 2709943 TI - Evaluation of prostaglandin E1 therapy for sudden deafness. AB - Prostaglandin E1, a vasodilator and potent inhibitor of platelet aggregation, was administered by intravenous drip infusion to 51 patients who had sudden deafness. The results were compared with results from 362 patients who received no prostaglandin E1 therapy. There was no significant difference in outcome between patients who received prostaglandin E1 therapy and those who did not receive prostaglandin E1 therapy. PMID- 2709944 TI - Percutaneous retrograde intubation. PMID- 2709945 TI - Use of a modified microdrill in endoscopic sinus surgery for improved exposure and reduced adhesions. PMID- 2709946 TI - Acrylic nasal septal obturators for nasal septal perforations. PMID- 2709947 TI - The facial nerve and the branchial cleft: surgical challenge. PMID- 2709948 TI - [Campylobacter pylori compels re-thinking]. PMID- 2709949 TI - [Campylobacter pylori and gastritis--the density of colonization and degree of inflammation. A semiquantitative and morphometric study]. AB - Gastric biopsies of 1000 patients were grouped according to their diagnoses, special interest was devoted to type B-gastritis. Density of Campylobacter pylori colonization was determined semiquantitatively after Warthin-Starry silver impregnation. Bacteria could never be seen in normal mucosa. In B-gastritis statistics proved a significant correlation between bacterial colonization density and degree of inflammation. In 60 selected cases this close interrelation could be objectified by morphometry. The larger the quantity of bacteria per biopsy area the greater must be its deleterious effect on the mucus layer and the superficial epithelium. Active, chronic gastritis is characteristic of Campylobacter pylori colonisation. There can be no doubt that Campylobacter pylori plays a decisive role concerning the aetiology of type B-gastritis. PMID- 2709950 TI - [Deglutition disorders]. PMID- 2709951 TI - [Solitary primary amyloid tumor of the rectum]. AB - Solitary primary amyloidtumor of the rectum. Gastrointestinal involvement of AL and AA amyloidosis is common and shows a broad variety of clinical appearance. We report a case of amyloidosis manifestated as a sole large rectum tumor and discuss the therapeutic procedure. PMID- 2709952 TI - Hepatitis B virus replication in hepatitis B and D coinfection. AB - The clinical course, changes in liver function tests and the behaviour of viral markers over the course of time have been examined in 45 patients with acute hepatitis B and 14 patients with acute hepatitis caused by B and D viruses coinfection. There were no significant differences either in the clinical course or in the liver function tests, in the two groups. The changes in serum viral markers were as follows: HBV-DNA was the first marker to disappear; this was closely followed by HBeAg, and HBsAg was the last marker to become negative, during convalescence. This pattern was not altered by Delta coinfection. When we quantified serum HBV-DNA in both groups of patients, we found that Delta virus infection led to parital inhibition of HBV replication, so that serum HBV-DNA levels were significantly lower in those patients with acute hepatitis B who were simultaneously infected with Delta virus. PMID- 2709953 TI - Alcoholic foamy degeneration in Spain. Prevalence and clinico-pathological features. AB - Among 389 consecutive chronic alcoholics in whom a liver biopsy was performed for diagnostic purposes, nine patients (2.3%) had histological changes of "alcoholic foamy degeneration" (AFD), characterized by numerous small fat droplets in the swollen hepatocytes of the centrilobular area. In five cases, there were non specific clinical features, while the other four cases presented acute hepatic decompensation with jaundice and a reduced prothrombin activity. Seven patients had high serum lipid concentrations including hypertriglyceridemia and hypercholesterolemia, which improved after withdrawal of alcohol intake. In conclusion, AFD has a broad clinicopathological spectrum including asymptomatic patients and other cases with severe liver decompensation manifested by jaundice and reduced prothrombin activity. AFD is usually associated with hyperlipemia. PMID- 2709955 TI - Continent urinary diversion for improved quality of life. PMID- 2709956 TI - Medical exemption provision of Maryland's safety-belt-use law. PMID- 2709954 TI - The streaming liver IV: DNA content of the hepatocyte increases with its age. AB - Hepatocyte age was estimated from its distance from the portal tract. We have previously shown that hepatocytes are formed adjacent to the portal tract and stream toward the terminal hepatic vein, advancing at a daily velocity of 2 microns. Thus, the farther a cell from the portal tract, the older it is. This relationship between cell age and distance served here for the study of age dependent changes in the hepatocyte, particularly nuclear area and DNA content. DNA content was derived from the absorbance of Feulgen-stained nuclei in 5 microns-thick tissue sections. Absorbance and nuclear area were measured with a cytophotometer. Since most nuclei of the tissue section were sliced, DNA content was estimated also in intact nuclei which were sampled by fine needle aspiration, and stained with either Feulgen or propidium iodide. Feulgen-stained nuclei were scanned by a cytophotometer, while the DNA content of propidium iodide-stained nuclei was measured by flow cytometry. Absorbance was expressed in relationship to the mean absorbance of diploid periportal littoral cells. Littoral absorbance was defined as one absorbance unit. A high correlation between nuclear absorbance and area was observed in nuclear suspensions (adjusted r-square 0.79), so that nuclear area may serve as a good predictor of nuclear DNA content, which is valuable in routine sections which are stained with H and E. Most periportal hepatocytes were polyploid and their mean absorbance was 1.68 units. Nuclear absorbance increased with cell distance from the portal tract. Within 100 microns it rose from 1.68 to 1.92 units. Nuclear area increased by 13%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709957 TI - [Densitometry of tomograms in evaluating the results of radiotherapy of peripheral cancer of the lung]. PMID- 2709958 TI - [Individualization of the dosimetric requirements of intracavitary irradiation in the radiotherapy of gynecologic patients]. AB - The authors proposed a method of dosimetric planning in intracavitary irradiation taking into account the individual features of a patient, including the status of the uterus during the introduction of radiation sources into its cavity. To simulate the dynamics of a resultant uterus shift a special device was developed to obtain information required for individual planning. The proposed method is aimed at the prevention of undesirable radiation reactions and complications in healthy organs. PMID- 2709959 TI - [Intratumoral and parametric administration of metronidazole in the radiotherapy of cancer of the cervix]. AB - The paper is concerned with analysis of the results of radiation therapy of cervical cancer and intratumoral administration of metronidazole (124 patients with tumors, Stage IIB and III). At the end of the treatment, complete tumor regression in the intervention group (with metronidazole) was noted in 91% (irrespective of a stage of disease), in the control group (without metronidazole)--in 51% of the patients. PMID- 2709960 TI - [Scintigraphy of the myocardium with 201Tl and equilibrium ventriculography in thromboembolism of the pulmonary artery]. AB - The results of scintigraphy of the right ventricular myocardium with 201T1 and equilibrium ventriculography were described in patients with the acute stage of thromboembolism of the pulmonary artery and chronic post-embolism pulmonary hypertension. A method of quantitative assessment of a degree of right ventricular hypertrophy and dilatation was proposed. Some regularities in the pulmonary heart formation were revealed with regard to a period of disease and the gravity of hemodynamic disturbances in the lesser circulation. PMID- 2709961 TI - [Evaluation of the severity of damage of the lungs in chronic nonspecific diseases based on a microstructural analysis of scintigrams]. AB - Structural analysis of scintigraphic images was used for assessment of the severity of lung affection in 57 patients with mild, average and severe types of asthma and chronic pneumonia. The results of common methods and microstructural analysis were compared. The use of the latter made it possible to reveal structures which were typical of a various degree of severity in chronic diseases. PMID- 2709962 TI - [A method of processing scintigrams of the thyroid gland]. AB - The authors proposed a method of mathematical processing of thyroid scintigrams, ensuring enlarged sizes of the gland image, removal of background zones, the effective use of shades in images, and automatic computation of a difference of drug accumulation by the thyroid lobes. The solution of these problems minimized the effects of some negative factors limiting the accuracy of deciphering thyroid scintigrams. The method was implemented in the form of an automated program THYROI written in FORTRAN and designed for PDP-11 and NOVA-3 computers. Thyroid image processing lasts 1 min., the results are recorded on paper or a Polaroid film in an enlarged form. The program can be translated into other mathematical languages and applied to computers of other types. PMID- 2709963 TI - [The functional state of the thyroid gland in cancer of the larynx]. AB - The paper is concerned with comparative evaluation of the influence of some therapeutic methods, based on the use of different radiation sources, dose fractionation regimens and radiomodifiers, on thyroid function in laryngeal cancer patients. Thyroid function was retrospectively assessed with regard to a course of disease within 2 yrs. after a radical course of radiation or combined therapy. Concomitant gamma-neutron therapy and radiotherapy in combined radiomodification were shown to produce the most inhibitory effect. Irrespective of a course of disease after a therapeutic course thyroid function in laryngeal cancer patients is decreased within 2 yrs. of observation. PMID- 2709964 TI - [A set of equipment suitable for gamma teletherapy units]. AB - A set of equipment for Soviet gamma-beam teletherapy units of all types can be supplied to a medical institution both as a complete unit and in separate parts. The set contains a kit of protective blocks, a kit of V-shaped filters, grid diaphragms, rasters, collimators and blocking devices. The equipment, its technical and dosimetric characteristics are described. PMID- 2709965 TI - [The use of a time-dose-fractionation model for stepwise control of radiotherapy of malignant tumors]. AB - The problem of step-by-step control of radiotherapy of malignant tumors was solved on the basis of Ellis' concept, widely used in radiology. A new method for determining step parameters was proposed. An algorithm and an example of the calculation of parameters of a course of therapy in case of a heterogeneous tumor were given. PMID- 2709966 TI - [The dose field in the high-gradient area of a 137Cs source]. PMID- 2709968 TI - [Deontologic problems in medical radiology]. PMID- 2709967 TI - [Aseptic femur head necrosis following chemoradiotherapy of lymphogranulomatosis]. PMID- 2709969 TI - A computerized resolution of scheduling conflicts. AB - Residency training programs in Internal Medicine require resident attendance in a continuity clinic. This inevitably engenders conflicts between scheduling in the ambulatory clinic and the required teaching activities of the in-patient services. Some of the conflicts can be resolved by allowing the in-patient service directors to indicate preferred plans for their residents to attend in the continuity clinic. With this plan, scheduling becomes quite complicated. A computer program is presented with coordinates these service requests with ambulatory clinic scheduling. As a result, a given resident may have his/her clinic day changed on different rotations. The program automatically arbitrates conflicts and publishes the attendance dates for the entire academic year. This information is supplied to the appointment desk so that patients can be scheduled accordingly. This system has resulted in a 74% continuity rate and improved satisfaction by both residents and staff. PMID- 2709970 TI - The advantages of a microcomputer-based procedure log. AB - Residency training programs in Internal Medicine have come under increasing pressure to document the diagnostic and therapeutic procedures performed by their residents. We initially attempted to do this by asking the residents to fill out log books. We were disappointed in this method because the residents did not keep the log books up-to-date and because the program and division directors did not receive ongoing feedback. We therefore changed to a microcomputer-based procedure log. We have been pleased with this system not only because the information is more complete, but because we are able to use the cumulative data generated in ways we did not originally anticipate. For example, the data can be used to improve quality assurance and to make adjustments in our educational efforts. The method would seem readily applicable to any residency training program and could easily be useful to any non-teaching hospital required to document the performance of procedures for purposes of staff privileges and quality assurance. PMID- 2709971 TI - A convertible perinatal database. AB - This is a description of the process and outcome in the development of a large perinatal database. The database is relatively unique, as it utilizes a convenient paper format for initial data entry that can easily serve, in the absence of a computer, as a very complete obstetric and neonatal medical record. With the addition of a moderately priced microcomputer, the database is converted into a computerized medical record that provides admission notes for the labor suite and the nursery, and discharge summaries for abortion, non-delivery, delivery, newborn nursery, and intensive care nursery admissions. The development of the paper forms, the choice of data-entry clerks over health-care providers for computer input, the design of the software to ease use and economize on storage requirements, and the use of the database in research projects are described. PMID- 2709972 TI - The Macintosh in medicine. PMID- 2709973 TI - MEDLOG. PMID- 2709974 TI - Computereyes video image digitizer. PMID- 2709975 TI - Nutritional, physiological, and menstrual status of distance runners. AB - Amenorrheic runners (AR; N = 8), regularly menstruating runners (RMR; N = 9), and regularly menstruating sedentary controls (RMSC; N = 7) were compared for plasma progesterone levels, plasma lipid levels, menstrual cycle characteristics, physical characteristics, and nutritional adequacy to determine whether exercise training was the major factor associated with menstrual cycle disturbances. Plasma progesterone levels were significantly lower in the AR group subjects than those found during either the follicular or luteal phases of the menstrual cycle for either the RMR or the RMSC subjects. The RMR subjects had a shorter luteal phase length relative to their cycle length than did the RMSC subjects. The AR subjects consumed significantly less fat, red meat, and total calories than did the RMR subjects, while the RMSC subjects consumed significantly less total calories than did the RMR subjects. Serum LDL-C was significantly higher in the AR subjects when compared to that of the RMR subjects, while serum HDL-C was significantly higher for both the AR and RMR subjects when compared to that obtained for the RMSC subjects. The nutritional inadequacy would appear to separate the AR from the RMR, and, thus, the exercise training performed by the athletes at the time of the present investigation alone does not appear to be the major factor associated with athletic amenorrhea. PMID- 2709976 TI - Women's soccer injuries in relation to the menstrual cycle and oral contraceptive use. AB - During 1984, 86 women soccer players answered detailed questionnaires concerning contraceptive use, menstruation data, premenstrual and menstrual symptoms, and data concerning soccer activities including injuries. This prospective study showed that women soccer players were more susceptible to traumatic injuries during the premenstrual and menstrual period compared to the rest of the menstrual cycle (P less than 0.05), especially among players with premenstrual symptoms such as irritability/irascibility, swelling/discomfort in the breasts, and swelling/congestion in the abdomen. It was also found that women using contraceptive pills had a lower rate of traumatic injuries (P less than 0.05) compared to women who were not on the Pill. The results can be explained by the fact that oral contraceptives ameliorate some symptoms of the premenstrual and menstrual period which might also affect coordination and hence the risk of injury. PMID- 2709977 TI - Running-related injury prevention through innate impact-moderating behavior. AB - The purpose of these experiments was to test the Robbins and Hanna hypothesis, which relates differences in discomfort from localized deformation at certain positions on the plantar surface to protective behavior (intrinsic foot shock absorption). A penetrometer was used to quantify the relations between localized load and pain and between load and depth of deformation. The magnitude of load required to elicit pain varied significantly (P less than 0.005) in relation to position on the plantar surface. With a load of 9 kg and a 10 mm spherical end on the penetrometer, 6% of the sample reported pain at the heelpad, 32% at the distal first digit, and 66% at the first metatarsal-phalangeal joint. This pattern was predicted by the Robbins and Hanna thesis. Two deformation patterns were observed which were best explained by deformation constraint by tight trabecular tethering of the epithelial membrane at the heelpad and distal first digit and unrestricted deformation due to loose trabecular tethering of the epithelial membrane at the first metatarsal-phalangeal joint. These data provide insight into how, when barefoot, the plantar surface resists perforation yet provides protection to local bony structures. These data further support the notion that plantar sensory feedback plays a central role in safe and effective locomotion. PMID- 2709978 TI - Enkephalin metabolism: effect of acute exercise stress and cardiovascular fitness. AB - Inhibition of enkephalin hydrolysis by catecholamines in vitro suggested that local and/or humoral factors released during exercise might facilitate opiate responses by reducing the rate of opiate peptide inactivation. Several measures of enkephalin hydrolysis were determined in blood samples obtained from subjects designated as trained (VO2max, 64.3 +/- 1.6 ml.min-1.kg-1) and un-trained (VO2max, 37.4 +/- ml.min-1.kg-1) both at rest and after maximal exercise stress tests. Enkephalin hydrolyzing activity assessed under optimal conditions was equally distributed between plasma and intact red cells; however, hydrolysis by red cells increased dramatically following osmotic release of red cell contents. There were no apparent differences in enzyme concentration or its distribution between cells and plasma when comparing trained and untrained subjects; P greater than 0.05. There was also no statistical effect of maximal exercise on these measures in either group. However, when the sequential disappearance of enkephalin added to whole blood in vitro was evaluated, blood from trained subjects degraded the enkephalin more slowly than blood from untrained subjects and had half-lives in vitro 30-50% longer both before and after the exercise test; P less than 0.05. Since enzyme concentrations between the groups were similar, the longer half-lives suggest that circulating factors were responsible for moderating the rate of enkephalin metabolism in vivo and that these factors were more concentrated in trained subjects. This would facilitate opiate responses in trained subjects and perhaps provide them with added tolerance for the effort associated with elite performance levels. PMID- 2709979 TI - Effect of caffeine on glycogenolysis during exercise in endurance trained rats. AB - Caffeine has been reported to enhance performance by increasing lipid oxidation and sparing liver and muscle glycogen in human subjects during prolonged endurance exercise. In the present study, the effects of intravenous caffeine on the liver and muscle glycogenolysis during exercise in endurance trained rats were investigated. Male endurance trained rats (2 h.d-1 for 6-7 wk) were given injections of 5 mg.kg-1 caffeine (5 CAF), 25 mg.kg-1 caffeine (25 CAF), or 0.9% sodium chloride (SAL) and were run on the treadmill for 45 min, 90 min, or until exhaustion at 26 m.min-1 up a 15% grade. Intravenous caffeine did not enhance the endurance run time: 5 CAF = 149 +/- 14 min, 25 CAF = 152 +/- 10 min, and SAL = 176 +/- 10 min. Caffeine did not influence the rate of liver glycogenolysis during exercise [liver glycogen (mmol glucose units.g-1) after 90 min: 5 CAF = 139 +/- 26, 25 CAF = 133 +/- 25, and SAL = 120 +/- 32]. Liver cAMP, muscle glycogen, plasma free fatty acids, blood glucose, and lactate were likewise not affected by caffeine [plasma free fatty acids (mM) after 90 min: 5 CAF = 0.42 +/- 0.04, 25 CAF = 0.45 +/- 0.07, and SAL = 0.41 +/- 0.05]. These data indicate that intravenous caffeine does not enhance the endurance run time or alter the plasma free fatty acids or liver and muscle glycogen utilization in endurance trained rats. PMID- 2709980 TI - Relation of plasma volume change to intensity of weight lifting. AB - To determine the relation of plasma volume change to intensity of weight lifting, blood samples were obtained from 15 males [mean (+/- SD) age = 22.3 +/- 3.2 yr; height = 176.3 +/- 6.9 cm; weight = 73.0 +/- 11.7 kg] before and over a 60-min period following weight lifting at four different intensities [40, 50, 60, and 70% of one-repetition maximum (1-RM)]. Weight lifting consisted of completing three circuits of four exercises (bench press, bent-over row, arm curl, and parallel squat), with 10 repetitions of each exercise performed over a 30-s period followed by 30 s of rest. Mean (+/- SE) oxygen uptakes (VO2) during weight lifting at the four intensities were 1.31 +/- 0.04, 1.50 +/- 0.07, 1.72 +/- 0.07, and 1.86 +/- 0.08 1.min-1, or 33-47% of treadmill-determined VO2max, respectively. Mean (+/- SE) blood lactates were 6.5 +/- 0.5, 8.7 +/- 0.5, 9.4 +/- 0.6, and 12.0 +/- 0.6 mmol.1(-1), respectively. Mean (+/- SE) heart rates (HR) were 124 +/- 4, 134 +/- 4, 148 +/- 5, and 161 +/- 4 bpm, or 63-82% of treadmill determined HRmax, respectively. Plasma volume decreased linearly in relation to intensity of weight lifting with mean responses of -7.7 +/- 0.8, -10.7 +/- 0.8, 12.1 +/- 0.9, and -13.9 +/- 0.8% at 40, 50, 60, and 70% of 1-RM, respectively. It was concluded that plasma volume decreases linearly in relation to intensity (%1 RM) of weight lifting and that the relation is similar to that reported for dynamic, low-resistance exercise such as cycling and running. PMID- 2709981 TI - Effects of a belt on intra-abdominal pressure during weight lifting. AB - Intra-abdominal pressure (IAP) has been widely hypothesized to reduce potentially injurious compressive forces on spinal discs during lifting. To investigate the effects of a standard lifting belt on IAP and lifting mechanics, IAP and vertical ground reaction force (GRF) were monitored by computer using a catheter transducer and force platform while nine subjects aged 28.2 +/- 6.6 yr dead lifted a barbell both with and without a lifting belt at 90% of maximum. Both IAP and GRF rose sharply from the time force was first exerted on the bar until shortly after it left the floor, after which GRF usually plateaued while IAP either plateaued or declined. IAP rose significantly (P less than 0.05) earlier with than without the belt. When the belt was worn, IAP rose significantly earlier than did GRF. Both with and without the belt, IAP ended its initial surge significantly earlier than did GRF. Variables significantly greater with than without a belt included peak IAP, area under the IAP vs time curve from start of initial IAP surge to lift-off, peak rate of IAP increase after the end of its initial surge, and average IAP from lift-off to life completion. In contrast, average rate of IAP increase during its initial surge was significantly lower with the belt. Correlations are presented which provide additional information about relationships among the variables. Results suggest that the use of a lifting belt increases IAP, which may reduce disc compressive force and improve lifting safety. PMID- 2709982 TI - Metabolic and cardiorespiratory responses relative to the anaerobic threshold. AB - The present study has compared the metabolic and cardiorespiratory responses for two groups of male subjects during 20 min of exercise at the anaerobic threshold (AT), at AT + 1/3, and at AT + 2/3 of the difference (delta) between AT and VO2max. A log-log transformation of the lactate (LA)-power output relationship was used to define AT and divide subjects into a high (N = 7, AT = 51.9 +/- 1.5% VO2max) and low (N = 5; AT = 41.9 +/- 1.8% VO2max) AT group. No differences were observed between groups during exercise at AT for VE.VO2-(1), VE.VCO2(-1), pH, pCO2, blood LA, and plasma strong ions Na+, K+, and Cl-. Although blood LA values were significantly elevated for the low AT subjects (2.3 +/- 0.6 mmol.l-1) compared with the high AT group (1.0 +/- 0.1 mmol.l-1) during exercise at AT + 1/3 delta, no other differences between groups were noted. In contrast, marked differences were observed between groups during exercise at AT + 2/3 delta. The high AT group showed no change in VE (79.1 +/- 4.8 l.min-1), pH (7.367 +/- 0.01), pCO2 (37.3 +/- 1.2 mm Hg), and blood LA (2.9 +/- 0.3 mmol.l-1) during the final 10 min of the 20 min exercise test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709983 TI - Effects of bat composition, grip firmness, and impact location on postimpact ball velocity. AB - The purpose of this investigation was to examine the effects of bat composition (aluminum and wooden), impact location [center of percussion (COP), center of gravity (COG), and end of the bat (E)], and grip firmness [tight (T) and no tension (NT)] on postimpact ball velocity. With the bats placed alternately in NT and T conditions, baseballs were delivered at a speed of 27.1 m.s-1 from a pitching machine positioned 1.5 m from the bat. High-speed photography (400 fps) was performed using a Locam camera positioned 7.54 m from and perpendicular to the principal plane of ball movement. A three-way ANCOVA revealed significant (P less than 0.01) differences in postimpact ball velocity between the three impact locations, with the COP yielding the greatest values, followed by the COG and E. Moreover, there was a significant (P less than 0.01) grip vs bat interaction. A simple-effects procedure revealed the following results: 1) the T grip produced greater (P less than 0.01) velocities than the NT grip across the aluminum (Al) bat; 2) there was no difference (P greater than 0.01) between the T and NT grips across the wooden (W) bat; 3) the W bat produced greater (P less than 0.01) velocities than the Al bat across the NT grip; and 4) there was no difference (P greater than 0.01) between the Al and W bats across the T grip.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2709984 TI - A three-dimensional analysis of angular momentum in the hammer throw. AB - Eight hammer throwers were studied using three-dimensional cinematography. The local term of angular momentum of each thrower (HTL) followed a wide conical path, while the remote term (HTR) and the hammer angular momentum (HH) followed much narrower conical paths. HT, the sum of HTL and HTR, followed a conical path similar to that of HTL, although with smaller amplitude. HH was half of a cycle out of phase with HT. It was also larger but followed a narrower conical path. As a result, the conical paths of HH and HT counteracted each other, and HS, the total angular momentum vector of the thrower-hammer system, had little conical motion. The paths of the angular momentum vectors, the trunk tilt, and the height of the hammer plane relative to the system center of mass were interrelated. Some throwers kept the hammer plane high and the trunk tilting back in all the turns; other throwers kept the hammer plane low and the trunk tilting forward in the early turns, but the hammer plane rose in their late turns and the trunk tilted back. Two theories were proposed to explain why the athletes who had forward trunk tilt in the early turns tilted backward in the final part of the throw. PMID- 2709985 TI - Predictors of competitive trait anxiety in male youth sport participants. AB - This field study examined intrapersonal and significant adult factors related to the levels of dispositional or competitive trait anxiety experienced by 9- to 14 yr-old male participants of a competitive wrestling program. Competitive trait anxiety (CTA) is a personality disposition which reflects the tendency to experience stress in situations involving competitive sport (20). Multiple regression analyses of questionnaire data revealed that boys with more frequent somatic competitive trait anxiety symptoms 1) had lower self-esteem, 2) reported greater upset if they performed poorly, and 3) expressed a greater preference for avoiding a tournament match. Investigated cognitive anxiety symptoms involved characteristic precompetitive worries about failure and worries about adult expectations and evaluation. Youngsters with more frequent worries about failure placed greater importance on wrestling well and felt greater upset when they performed poorly, in comparison with boys who worried less frequently about failure. More frequent adult-related worries were predicted by greater personal upset for poor performance and perceptions of 1) greater parental and coach shame and upset, 2) more negative adult evaluations, and 3) greater parental pressure to wrestle. PMID- 2709986 TI - Failure of target heart rate to accurately monitor intensity during aerobic dance. AB - Fourteen untrained females (age 19 +/- 1, range 18-21) were studied to examine the heart rate-VO2 relationship during a single aerobic dance training session. These findings were used to help explain the changes in VO2max resulting from an aerobic dance training program. VO2max and body composition were determined before and after an 8 wk training period. In addition, the heart rate-VO2 responses to an aerobic dance training session were monitored and compared to the heart rate responses of treadmill jogging performed at the same VO2. The aerobic dance session elicited a significantly lower oxygen pulse than did treadmill exercise (7.2 +/- 0.3 vs 8.1 +/- 0.8 ml.beat-1; P less than 0.01). There were no significant changes in percent body fat, whereas VO2max increased by 11% (34.4 +/ 0.9 vs 38.1 +/- 0.8 ml.kg-1.min-1; P less than 0.05). No significant changes in any of the parameters tested were observed in 10 untrained controls. These findings indicate that the heart rate elicited from aerobic dance represents a lower relative exercise intensity (VO2) than that of running. Therefore, the assumption that aerobic dance training produces the same cardiovascular adaptations as running training when performed at the same target rate may be unwarranted. PMID- 2709987 TI - Analysis of wheelchair track performances. PMID- 2709988 TI - Increased rf power absorption in MR imaging due to rf coupling between body coil and surface coil. AB - Fears have been voiced that excessive tissue heating could occur in the event that first, a surface coil is placed with its axis parallel to the transmitting rf field leading to a maximal coupling of the two coils and second, the decoupling circuit of the surface coil breaks down. To avoid an rf coupling of the transmitting body coil to the receive-only surface coil, conventionally applied surface coils are equipped with an active electronic rf decoupling circuit. In extensive worst-case experiments on phantoms we have shown that no tissue heating occurs for surface coils which are equipped with semiconductor varicap diodes for tuning and matching. These coils should be safe for patient applications even if the decoupling circuit fails. Surface coils equipped with mechanically variable capacitors are generally passively decoupled. To simulate the worst-case situation phantom experiments were performed in which a surface coil of this type having no passive decoupling circuit was coupled to the transmitter coil by its geometric position. Theoretical calculations, in agreement with the experimental results achieved during a 15-min measurement in a 1.5-T MRI whole-body imager, show that a significant rf power deposition in the tissue underneath the coil wire occurs, leading typically to a local specific absorption rate of 24 W/kg and a local temperature rise of 5.2 degrees C. PMID- 2709989 TI - A fast method for T1 fitting. AB - When NMR signal amplitudes achieved from spin-echo sequences with several different repetition times are used to calculate T1, this can be done rapidly by calculating the time coordinate of the center of gravity of the data and determining which T1 should theoretically give this value. In particular, when a large number of similar calculations are made, the time gain may be massive. Simulations suggested that this procedure is only slightly less accurate than least-squares fitting, and far more rapid. The procedure may also be useful in other types of T1 determination. PMID- 2709990 TI - Water suppression with B0 field gradient homospoil pulses in high-resolution NMR spectroscopy. AB - The combination of a frequency nonselective excitation suppression method (1331 sequence) with selective excitation followed by gradient-induced dephasing of water transverse magnetization yielded suppression ratios of greater than 10,000:1. The need for gradient preemphasis and correction of B0 field shifts is discussed. The suppression efficiency of this method compared favorably to results obtained using the CPMG spin-echo technique to observe metabolite resonances in a urine sample. PMID- 2709991 TI - The unequivocal determination of lactic acid using a one-dimensional zero-quantum coherence-transfer technique. AB - A method based on zero-quantum coherence transfer for spectral editing of metabolites in aqueous solution in a one-dimensional experiment is described. Water suppression factors of approximately 8000 were achieved by the use of pulsed B0 field gradients and excellent editing was obtained in a single acquisition. The methyl resonances of both lactate and acetaldehyde were readily observed in a mouse brain homogenate by generating zero-quantum coherence using Gaussian pulses for selective excitation of the respective CH resonances. PMID- 2709992 TI - Three-dimensional phase contrast angiography. AB - Bipolar flow-encoding gradients can be used in a three-dimensional magnetic resonance imaging procedure to provide a noninvasive measure of in vivo blood flow. The resulting volume angiogram is a three-dimensional data matrix which can be retrospectively analyzed and displayed in a variety of ways. This angiographic technique provides good suppression of signals arising from stationary tissue, thereby permitting the visualization of small vessels having relatively slow flow. This suppression is obtained by modulating the amplitude of the flow encoding gradient pulse to either cancel the stationary tissue signal or displace it relative to the flow signal in the volume image. PMID- 2709993 TI - A method for correctly setting the rf flip angle. AB - Currently the accepted method for setting the correct rf power levels to achieve 90 degrees and 180 degrees rf pulses for MR imaging is to peak the echo amplitude of a rf spin-echo sequence. The echo amplitude of this alpha-2 alpha pulse sequence is proportional to sin3 (alpha) and has a relatively broad maximum. Recently another method for setting the rf flip angle by maximizing the ratio of the stimulated echo to the primary echo amplitudes (in a 3 alpha sequence) demonstrated accuracy similar to that of the spin-echo method using a shorter repetition time. We present a new, more sensitive, and more accurate method for setting the correct rf power levels for 90 degrees and 180 degrees rf pulses. In this method, based upon the stimulated echo pulse sequence, we are able to accurately set the rf power to within +/- 0.1 dB by minimizing the signal amplitude of the third spin echo. This null method works for both selective and nonselective rf pulses of flip angle 90 degrees or 180 degrees, allowing the user to accurately adjust the relative amplitudes of the four rf pulse types within a single pulse sequence. PMID- 2709994 TI - Magnetic resonance imaging with adiabatic pulses using a single surface coil for RF transmission and signal detection. AB - In order to overcome the problems that arise from nonuniform B1 fields, there has been interest in developing pulses that are insensitive to large variations in RF power. Pulses derived from adiabatic passage principles that can execute spin inversion, excitation, and 90 degrees and 180 degrees plane rotations in the presence of B1 inhomogeneities have recently been described. When driven with optimized modulation functions, these pulses can execute uniform excitation, refocusing, and slice-selective inversion over a 10-fold or greater variation in B1 magnitude. This insensitivity to B1 strength enables the execution of T1- and/or T2-weighted spin-echo imaging experiments using coils, such as the surface coil, with extremely inhomogeneous B1 profiles. We have successfully acquired images with these pulses at 200 MHz using a single surface coil as the transmitter and receiver. Images of the slice definition, the region over which the excitation and refocusing pulses operate with a surface coil, and brain images obtained with slice planes perpendicular to the plane of the surface coil are presented. Results demonstrate that these pulses can be transmitted with a surface coil to yield high-quality T1- and/or T2-weighted images without B1 artifacts. PMID- 2709995 TI - In vivo functioning of creatine phosphokinase in human forearm muscle, studied by 31P NMR saturation transfer. AB - 31P nuclear magnetic resonance (NMR) saturation transfer has been used to measure enzymatic flux through the creatine phosphokinase reaction in the direction of ATP synthesis in the human forearm muscle flexor digitorum superficialis. Modification of the ratio method for measurement of spin-lattice relaxation (R. Freeman, H.D.W. Hill, and R. Kaptein, J. Magn. Reson. 7, 82(1972]was tested and used to appreciably shorten the duration of the measurement. Under conditions of steady state work intracellular pH decreased slightly by 0.06 units and the spin lattice relaxation time of phosphocreatine in muscle was unchanged, while flux from phosphocreatine to ATP was 64 +/- 10% of the resting value. This is contrary to the increase in flux of 155% predicted from previous saturation transfer studies carried out in vitro on rabbit skeletal muscle creatine phosphokinase using metabolite concentrations to mimic those in vivo (E.A. Shoubridge, J.L. Bland, and G.K. Radda, Biochim. Biophys. Acta 805, 72 (1984]. This discrepancy could be accounted for by an underestimation of the ADP concentrations to which the enzyme is exposed due to inaccurate assumptions about the total metabolite concentrations, or possibly by compartmentation of creatine phosphokinase and its reactants. PMID- 2709996 TI - NMR characteristics of "visible" intracellular myocardial potassium in perfused rat hearts. AB - Nuclear magnetic resonance (NMR) spectroscopy provides a unique view of ions through its noninvasive character and relaxation time measurements. Several previous studies have demonstrated that only approximately 20% of cardiac intracellular potassium is visible with current NMR techniques. This study investigates the NMR visible intracellular potassium in a perfused rat heart preparation. When shift reagents were used to separate the intra- and extracellular signals, an intracellular T1 of 11.8 +/- 0.6 ms, and an intracellular T2 with two time constants of 1.3 +/- 0.6 ms (33 +/- 8%) and 10.1 +/- 1.9 ms (67 +/- 4%) were measured. Curve stripping techniques used to separate the intra- and extracellular components of a bulk relaxation decay yielded an intracellular T1 of 8.4 +/- 0.3 ms and an intracellular T2 with two time constants of 1.1 +/- 0.6 ms (38 +/- 10%) and 8.0 +/- 1.6 ms (62 +/- 12%). These results demonstrate that there are at least two distinct pools of potassium within the cardiac cell in slow exchange with each other on the NMR time scale. Studies with an enriched 41K perfusate demonstrated that the exchange rate for the visible intra- and extracellular potassium is on the order of 15 min. PMID- 2709997 TI - A 31P NMR study of the GI tract: effect of fructose loading and measurement of transverse relaxation times. AB - The effect of fructose loading on high-energy phosphates in the jejunum, ileum, and large intestine of rats was studied using 31P NMR. Following fructose loading, an increase in the intensity of the PME resonance was observed in the jejunum, indicating an accumulation of fructose-1-phosphate. There were no significant changes in ATP or Pi. This demonstrates that the activity of fructokinase in the jejunum can be monitored by 31P NMR. Fructose loading had no detectable effect on metabolite levels in the ileum and large intestine. Resolution of intestinal spectra was poor due to unusually large linewidths and the presence of broad underlying signals. To study the mechanism of line broadening, the T2's of the phosphorus resonances were measured using a solenoidal coil. The T2's of the ATP, Pi, PME, and PCr resonances were much longer than the T2's, suggesting that the linewidths of these resonances are primarily due to susceptibility gradients and/or compartmentation of metabolites. Other signals, particularly in the PDE region, were homogeneously broadened and had very short T2's. Spin echoes obtained with evolution times of 1 to 4 ms suppressed these broad components, with little loss of intensity in the inhomogeneously broadened resonances; as a result, resolution was improved. PMID- 2709998 TI - NMR relaxation of water in hydrogel polymers: a model for tissue. AB - The NMR relaxation rates of a class of hydrated polymers (hydrogels) have been investigated over a wide range of frequencies (0.01 to 60 MHz) and compositions. The gels comprise long chains of polytetramethylene oxide diol crosslinked by copolymers of dimethylacrylamide and methylmethacrylate. The longitudinal relaxation rate dispersion curves of these materials are very similar to those shown by human tissues and they can be altered in flexible fashion by changing the polymer content. By substitution of the water by deuterium oxide, the contribution of intermolecular cross-relaxation effects has been shown to account for two-thirds the total water relaxation rate. With their close similarity to tissue relaxation behavior, hydrogels of differing compositions are particularly well-suited to MRI phantoms and test objects. PMID- 2709999 TI - Reversibility of chronic alcohol cardiac depression: 31P magnetic resonance spectroscopy in hamsters. AB - In order to investigate the reversibility of chronic alcohol cardiac depression, hamsters were fed with 50% ethanol for 3 1/2 months, reaching serum alcohol levels of 0.13 +/- 0.11 g/dl (mean +/- SD). Alcohol was then withdrawn for 2 days. Isolated hearts were perfused according to a modified Langendorff method. Energy metabolites were studied using 31P magnetic resonance spectroscopy of isolated perfused hearts standardized by HPLC analysis of freeze-clamped tissue. Total intracellular calcium [Ca2+]i was measured with atomic absorption spectrophotometry, marking the extracellular space in vivo with K(CoEDTA). In alcohol-treated hamster hearts developed pressure was significantly depressed compared to controls. End-diastolic pressure was significantly increased. Coronary flow was not changed, whereas oxygen consumption and high-energy phosphate levels were significantly depressed. Intracellular pH was significantly decreased. [Ca2+]i was significantly increased. Heart weights were significantly lower. After alcohol withdrawal ventricular function, high-energy phosphate levels, and [Ca2+]i were not significantly different from control. The results indicate that chronic alcohol consumption depresses ventricular function and energy levels and also leads to myocardial acidosis. The increase in intracellular calcium likely causes mitochondrial dysfunction. Withdrawal of alcohol is associated with reversibility of functional and energetic cardiac depression. PMID- 2710000 TI - The use of band-selectable digital filtering in magnetic resonance image enhancement. AB - Manipulation of the data describing two-dimensional magnetic resonance (MR) images can be used to zoom an image, decrease image noise and artifacts by modeling, or emphasize object edges in the field of view. In this paper, a two dimensional band-selectable digital filtering (2D-BSDF) technique is detailed. This can be used to decrease the computational burden and increase algorithm stability associated with such data manipulation. Many display devices have the ability of expanding an image by pixel or linear interpolation. Application of the efficient zooming fast Fourier transformation algorithms provides a superior quality sinc-function interpolated image. In 2D-BSDF, the ideal rectangular windows used in sinc-function interpolation are replaced by windows with a more gradual roll-off. This gradual roll-off results in a slight degradation of the image edges but substantially reduces the computation time. Modeling of MRI data has been attempted to remove noise and artifacts from the image. These algorithms are computationally expensive and frequently unstable because of the high model orders required. The 2D-BSDF can be used to prepare a reduced data set, without loss of information. A lower order model may be applied to the subset and computation times approaching that required for normal fast Fourier transform algorithms result. The absence of noise and signal from objects outside the region of interest can considerably enhance the stability of the modeling algorithms. The use of BSDF is equally applicable when used in association with the modeling of 2D NMR spectroscopy data or with edge enhancement or any other data manipulation of magnetic resonance imaging images. In this paper an explanation of 1D-BSDF is provided and an algorithm for 2D-BSDF is developed. A comparison of filter designs and computational times is given when applying the technique to zooming and modeling of MR images. Images from medical MRI data are provided. PMID- 2710001 TI - Magnetic resonance imaging using a ribbonator: hand and wrist. AB - A modified version of a single-turn solenoid with rectangular symmetry, which we call a ribbonator, provides excellent magnetic resonance images of the hand and wrist when used as both the transmitter and the receiver in a 1.5-T clinical imaging system. The very high RF efficiency provides excellent signal-to-noise and anatomical resolution. Design equations and RF properties of the resonator are discussed. PMID- 2710002 TI - Hybrid methods of chemical-shift imaging. AB - We propose a family of hybrid chemical-shift sequences which combines two physical principles for water/lipid separation to minimize artifacts introduced by B0 and B1 inhomogeneities. Hybrid sequences provide improved species discrimination over earlier methods without resorting to postprocessing while maintaining a multislice/multiecho capability. PMID- 2710003 TI - Addendum to "rapid local rectangular views and magnifications: reduced phase encoding of orthogonally excited spin echoes". AB - Attention is called to a previous work of Feinberg et al. on inner volume MRI, a work which was not known to the present authors when preparing a recent similar manuscript on imaging local fields of view. The rationale is discussed for tandemly offsetting the reconstruction window and excited volume. PMID- 2710004 TI - Comparison of the signal-to-noise ratio at 1.5 and 2.0 T using a whole-body system. AB - Signal-to-noise ratios for 1H, 31P, and 13C signals at 1.5 and 2.0 T were compared using a whole-body system with a fast rampable magnet. Results indicate that SNR lies within the predicted values of linear and 7/4th power dependency with the applied magnetic field, for lossy and lossless samples, respectively. PMID- 2710005 TI - In vivo 1H NMR spectroscopy of an intracerebral glioma in the rat. AB - High-resolution 1H surface coil NMR spectroscopy (MRS) was used to evaluate in vivo the cerebral metabolism changes in rat brain induced by a glial tumor growing in situ. Tumor cells (C6 glioma cells) were stereotaxically placed in the right hemisphere superficially. 1H MRS was performed using 5-mm surface coils implanted over the right hemisphere and the water was suppressed using a binomial sequence. As the intracerebral tumor size increased, there was a marked decrease in the N-acetyl aspartate level and an increase in the 1.3 ppm peak. Edition of this peak showed that lactate increased but lipids increased much more than lactate. Moreover the ratio between the choline-phosphocholine and creatine phosphocreatine peaks changed. This study demonstrates that high-resolution surface coil 1H MRS can be used to monitor changes in metabolism associated with growth of an experimentally induced rat brain tumor in situ. PMID- 2710007 TI - Use of solvent suppression technique to enhance changes due to susceptibility variations in magnetic resonance imaging. AB - This communication describes the use of a binomial pulse sequence designed from solvent suppression in proton spectroscopy to convert the small frequency changes associated with field variations into significant amplitude changes in magnetic resonance images. This technique can be used to demonstrate tissue susceptibility change. PMID- 2710006 TI - A method for direct in vivo measurement of drug concentrations from a single 2H NMR spectrum. AB - The use of 2H-labeled drugs provides a measure of drug concentration in situ directly from a single 2H NMR spectrum obtained with any antenna by correcting only for differential saturation effects. The limit of detection for a drug labeled with three equivalent deuterons is roughly 0.5 mM. PMID- 2710008 TI - MRI of "diffusion" in the human brain: new results using a modified CE-FAST sequence. AB - "Diffusion-weighted"MRI in the normal human brain and in a patient with a cerebral metastasis is demonstrated. The method employed was a modified CE-FAST sequence with imaging times of only 6-10 s using a conventional 1.5-T whole-body MRI system (Siemens Magnetom). As with previous phantom and animal studies, the use of strong gradients together with macroscopic motions in vivo causes unavoidable artifacts in diffusion-weighted images of the human brain. While these artifacts are shown to be considerably reduced by averaging of 8-16 images, the resulting diffusion contrast is compromised by unknown signal losses due to motion. PMID- 2710009 TI - Variable excitation angle AFP pulses. AB - RF pulses employing the principle of adiabatic fast passage are finding increasing application with surface coils. A small modification to existing AFP pulses that allows the excitation angle to be chosen largely independently of B1 strength is described here. Rapid 3D imaging applications of such pulses are presented. PMID- 2710010 TI - The uncommon longitudinal relaxation dispersion of human brain white matter. AB - Human brain white matter exhibits an uncommonly strong dispersion of 1/T1 at high fields. An additional relaxation pathway via the myelin lipids, which are not directly visible to medical NMR due to their fast T2 decay, is proposed. Relaxation dispersion data are successfully analyzed on the basis of this model. PMID- 2710011 TI - Chlordiazepoxide metabolite accumulation in liver disease. AB - Chlordiazepoxide 40mg daily was used to prevent delerium tremens in a 64-year-old female with alcoholic liver disease. After 20 days, the drug was stopped because of the onset of progressive drowsiness. The kinetics of chloridazepoxide were within the predicted range for patients with liver disease, but the elimination half-lives of desmethylchlordiazepoxide and demoxepam were greatly prolonged at 346 hours and 150 hours, respectively. It is suggested that metabolite accumulation may have contributed to the coma, which is an unusual reaction to chlordiazepoxide. PMID- 2710012 TI - The killing thought in the eugenic era and today: a commentary on Hollander's essay. PMID- 2710013 TI - Response to Wolfensberger and Heifetz. PMID- 2710014 TI - Comparison of treatments to teach number matching skills to adults with moderate mental retardation. AB - The effectiveness of the Dial-A-Phone (D-A-P) instructional package plus a least intrusive prompt hierarchy was compared to a least intrusive prompt hierarchy alone for teaching adults with moderate developmental disabilities to match digits of personal phone numbers with digits on a rotary dial telephone. Instructional programs were administered in the context of an alternating treatments design. The dependent variable was the percentage of digits matched independently per session (21 digits per session). Results suggest that although a least intrusive prompt hierarchy alone produced findings similar to the D-A-P plus prompts procedure for one subject, the D-A-P plus prompts package was the most effective in helping both subjects to match digits independently. Strategies for individualizing the D-A-P program were discussed. PMID- 2710015 TI - Misleading cues in the diagnosis of mental retardation and infantile autism in the preschool child. AB - The diagnosis of behavioral and cognitive disorders in preschool children is difficult. Infantile austism is more likely to be diagnosed than is mental retardation. Yet most children with infantile autism are also mentally retarded, and many of those with severe and profound mental retardation show autistic behavior. Factors misleading professionals into overlooking mental retardation when assessing preschool children were discussed, and essential components in the management of preschool children with behavioral, developmental, or cognitive deviations were examined. PMID- 2710016 TI - Misconceptions relating to mental retardation. AB - An updated version of a 9-item questionnaire concerning misconceptions about mental retardation originally developed by Winthrop and Taylor (1956) was administered to a total of 558 individuals from heterogenous samples. The relations of the demographic, experimental, and contact characteristics of the respondents in the 1986 sample to their misconceptions score were explored as were differences in the distributions of the percentages of endorsements of the nine misconceptions for the samples in 1956 and 1986. PMID- 2710017 TI - Provision of respite care for children with developmental disabilities: changes in maternal coping and stress over time. AB - Changes were examined in maternal coping resources and stress over time as a consequence of the provision of respite care for their children with developmental disabilities. Users and nonusers of home-based respite services were matched and compared. Results showed that services were associated with an immediate significant reduction in maternal stress. Even though there were changes over time in coping resources and stress reported by mothers, the respite care group showed overall consistent benefits as compared to those not receiving services. Findings were interpreted with respect to their implications for research and interventions. PMID- 2710018 TI - Chaos in cancer. PMID- 2710019 TI - Vitamin B-12: placebo or neglected therapeutic tool? AB - Patients with normal serum vitamin B-12 levels were given injections of hydroxocobalamin (vitamin B-12b) interspersed with injections of sterile water. Those who felt better with B-12b had additional injections to establish the amount of B-12b that gave the maximum feeling of well-being. Serum vitamin B-12 tests were performed to record the level at which the patients felt best. On the same day they took a Multiphasic Personality Inventory (MMPI), an objective computerized psychological test. Hydroxocobalamin injections were then discontinued for 5 to 7 days. The patients took another serum vitamin B-12 test and another MMPI. With the higher vitamin B-12 levels, the MMPI patterns were at or closer to normal. With lower serum vitamin B-12 levels, MMPI patterns showed much more emotional distress. The author suspects that vitamin B-12 dependency disorders are common and are neglected by the medical profession. PMID- 2710020 TI - An animal analogue of forced unilateral nostril breathing: relevance for physiology and pharmacology. AB - Since forced unilateral nostril breathing activates the contralateral brain hemisphere, an animal analogue of this technique could be provided by methylmethacrylate gluing large plastic pellets in either the right or left nostrils in a group of rats. A large number of physiological, pharmacological, and immunological parameters may be differentially affected. PMID- 2710021 TI - Understanding the pathogenesis of the restless legs syndrome at the level of the dopamine receptor. Are we about to identify the neurochemical deficiency causing schizophrenia? AB - According to a recent hypothesis, the restless legs syndrome is thought to be due to a caffeine-like substance produced by the human body (1). Some researchers have reported a case of familial restless legs that had high concentration of free dopamine in the cerebrospinal fluid (2). Other researchers have noticed the beneficial effect of opioids in the treatment of the restless legs syndrome (3). In this article, I am compiling information reconciling the findings of those researchers with the hypothesis that proposes that the restless legs syndrome is due to a caffeine-like substance produced by the human body. Also, I am addressing the pathogenesis of the restless legs syndrome at the level of the dopamine receptors in the central nervous system. Understanding this pathogenesis probably will help in identifying the neurochemical deficiency causing schizophrenia. PMID- 2710022 TI - The relationship of subtle differences in fasting serum triglycerides with subtle differences in the electrocardiogram: a study of the PR interval. AB - The nonmedical community has long recognized the well-observed fact that both medical and nonmedical matters can be expressed in gradations. Witness the continuum from hot to cold, from mad to glad, from fat to thin as but a few simple confirmations. In contrast, the medical establishment, by act if not by word, still struggles to establish absolutes. This is well-exemplified by such diagnoses as diabetes mellitus or no diabetes mellitus even though common sense would suggest that there must be degrees of this metabolic problem (possibly 21 or 32 percent diabetes mellitus). This report underlines the presence and importance of degrees of lipid metabolism versus degrees of electrocardiopathy. Additionally, this experiment suggest that such relationships become more meaningful as one focuses onto the subtleties of such a relationship. PMID- 2710023 TI - Possible steroid withdrawal syndrome following short Synacthen test--a personal report. AB - Symptoms not attributable either to disease rebound or to adrenal suppression have been reported both in patients receiving steroids when long-term therapy has been stopped and in normal volunteers after single oral doses of prednisolone or intravenous equivalents. This so-called steroid withdrawal syndrome remains poorly understood. It has not previously been reported following exposure to increased levels of endogenous steroids after diagnostic administration of synthetic adrenocorticotrophic hormone (ACTH). The author's personal experience of an apparent steroid withdrawal reaction following a short Synacthen test is described. It is suggested that as yet unidentified individual factors must play a role in determining whether steroid withdrawal symptoms occur. Closer observation of other subjects after the Synacthen test might reveal other instances of steroid withdrawal symptomatology following this common diagnostic procedure. PMID- 2710024 TI - Serum urate level and cancer. AB - Histograms of the serum uric acid level of cancer patients (n = 501) and healthy controls (n = 15150) are compared. The statistical evaluation of the data yields significantly lower uric acid levels for cancer patients than for healthy persons (P less than 0.0001 for males, P less than 0.001 for females). These results support the theory that reactive species of oxygen (singlet oxygen and oxygen radicals) play an important role during carcinogenesis. PMID- 2710025 TI - On the nature of myopia and the mechanism of accommodation. AB - An experiment in which pressure was applied to the globe of the eye by artificially-induced contraction of the superior oblique muscles produced two effects: 1) Dual vision, consisting of two separate, superimposed, retinal images, one blurred and one clear; and 2) A 5 diopter increase in myopia. It was concluded that the pressure, transmitted through the sclera to the vitreous, forced the vitreous against the back of the lens, flattening the periphery but not the axial (central) region, resulting in a high degree of negative spherical aberration, combined with accommodation. This suggests that accommodation can be actuated by contraction of the extraocular muscles. When the pressure was released, it took several years for the dual image to subside. This suggests that when the lens is released after a long period of accommodation, the return to the unaccommodated state is extremely slow, and that a significant factor in the etiology of myopia is repeated long periods of accommodation in which periods of rest are insufficient to allow the lens to return completely to the unaccommodated state. PMID- 2710026 TI - Nicardipine--a new calcium-entry blocker. PMID- 2710027 TI - Immunoelectron microscopic localization of dentin gamma-carboxyglutamic acid containing proteins in differentiating rat odontoblasts. AB - The intracellular synthesis of the dentin-gamma-carboxyglutamic acid-containing proteins (DGPs) by rat odontoblasts was investigated at the electron microscopic level using a sensitive pre-embedding immunoperoxidase technique. The DGPs were detected in the rough endoplasmic reticulum and secretory vesicles, but not in the Golgi apparatus of the odontoblasts, while dentin matrix is not yet reactive. These results suggest that the DGPs synthesis is independent of mineral deposition. PMID- 2710028 TI - Changes in desmosine and pyridinoline crosslinks during rapid synthesis and degradation of elastin and collagen in the rat uterus. AB - The wet weight of the rat uterus increased 8-fold during pregnancy and fell by 70% within 5 days postpartum. Uterine collagen increased about 5-fold during pregnancy and also fell by 70% within 5 days. The crosslink pyridinoline remained constant at 0.28 mole/mole collagen at every time point, with the possible exception of 11-12 days of pregnancy. The pyridinoline link can therefore form within the short time span of a few days, a feature presumed to be necessary to maintain the full mechanical strength of the uterus during labor. Uterine elastin increased about 8-fold during pregnancy, but the desmosines did not keep pace and fell from a normal value of 1.43 mole/mole elastin to a low of 0.89 at term. Moreover, elastin content reached a maximum several days prior to parturition and then declined continuously to 5 days postpartum. During this decline there was a selective loss of the poorly crosslinked elastin. The desmosines cannot be used as a direct measure of uterine elastin content, because of their continuously changing levels. Desmosines and pyridinoline were measured both by ELISA and by the amino acid analyzer. The two methods gave almost identical results when elastin and collagen were first separated from each other. PMID- 2710029 TI - Biochemical characterization of elastin in neointimal hyperplasia of rabbit aorta. AB - Elastin synthesized in response to vascular injury was characterized in terms of its amino acid composition, the biosynthetic labeling of the desmosines and of the heat coacervable polypeptides present in the 2 M urea extract. Neointimal hyperplasia of the chronic variety was induced in rabbit aorta by superficial mechanical lesions. At 4 months following injury the reendothelialized neointimal thickening and the media were excised. Aliquot samples were incubated with [3H] lysine, extracted with 2 M urea, 0.1 M Tris, pH 7.4 and hydrolysed with collagenase. In the residue of the digests the [3H] desmosines were quantified after electrophoretic separation. Elastin was purified from the nonlabeled aliquots of the media and neointimal hyperplasia. It accounted for 60% and 25% of the dry weight of the media and the neointima respectively. Elastin isolated from the media and the neointima had essentially the same amino acid composition. The incorporation of [3H] lysine into desmosines and into coacervable polypeptides indicated that the synthesis of crosslinked elastin is still active in the hyperplasia at 4 months following injury. PMID- 2710030 TI - Collagen in the extracellular matrix of cultured scleroderma skin fibroblasts: changes related to ascorbic acid-treatment. AB - The synthesis of collagen and its deposition into the extracellular matrix were studied in scleroderma and normal skin fibroblast cultures using immunocytochemistry, electron microscopy and electrophoretic analysis. Indirect immunofluorescence localized type I collagen to intracellular granules of normal skin fibroblasts but not to the extracellular matrix. A 48-h ascorbic acid treatment of scleroderma and normal skin fibroblasts induced the appearance of fibrillar, collagen-containing deposits in the extracellular space as indicated by indirect immunofluorescence and electron microscopy. Interestingly, similar type I collagen-containing fibrils were observed in cultures of scleroderma skin fibroblasts even without preceding ascorbic acid treatment. Electrophoretic analysis revealed that ascorbic acid increases the conversion of procollagen to collagen to same extent both in scleroderma and control cell layers. The accumulation of collagen to the cell layer of scleroderma fibroblasts was increased when compared to normal skin fibroblasts; whereas the relative conversion of procollagen to collagen was identical in scleroderma and normal fibroblasts. The results show that the conversion of procollagen to collagen in the cell layers of both scleroderma and normal skin fibroblasts is dependent on ascorbic acid, due to improved secretion of procollagen molecules in the presence of ascorbic acid. PMID- 2710031 TI - Cells isolated from fetal rat calvaria by isopycnic separation express different collagen phenotypes. AB - Calvaria from 20-21 day old fetuses were obtained under sterile conditions and the endo- and exoperiosteum stripped off. Cells were dispersed by sequential collagenase-DNase treatment and suspended in 0.5% low Tm agarose in the presence of DMEM supplement with 10% FCS. After 4-5 days of incubation some 30% of these cells showed active synthesis of metachromatic extracellular matrix. Cells from skin, muscle and periosteum failed to show metachromatic matrix positive colonies to a comparable extent. The phenotypic expression of these cells was determined by analysis of collagen types. Eleven day old cultures were incubated in the presence of [3H]-proline plus beta-aminopropionitrile and ascorbic acid and the collagen extracted analyzed by polyacrylamide electrophoresis of their intact chains or CNBr-derived peptides. The results show that anchorage independence is a requirement for calvaria cells to express type II collagen. Type I collagen was preferentially expressed in monolayer culture or when pre-attached to a substrate before being cultured in agarose. Type II collagen was the predominant collagen when cells were cultured in agarose. Further characterization of cell populations was achieved by isopycnic centrifugation in a percoll gradient. Cell fractions were tested for their collagen phenotype when cultured in agarose. Cells recovered from densities 1.04 g/ml or higher synthesized type II collagen, while cells with densities lower than 1.04 g/ml synthesized mainly type I collagen. Isopycnic centrifugation appears to be a novel method for separation of phenotypically different cells from a heterogeneous population in fetal calvaria. The high density cell fractions may represent a mixture of pre-chondrocytes as well as pluripotential cells. PMID- 2710032 TI - Cell attachment activity of the 44 kilodalton bone phosphoprotein is not restricted to bone cells. AB - Proteins that promote cell migration, attachment and spreading are considered to play an important role in the regulation of cell function. Recently, a 44 kilodalton bone phosphoprotein (44K BPP) was shown to enhance the attachment of gingival fibroblasts and osteoblasts in vitro. The potential importance of this attachment protein in the regulation of mineralized tissue homeostasis prompted us to evaluate its ability to promote the attachment and migration of several other cell types. All the fibroblast cell lines and non-transformed calvaria cell lines assayed exhibited enhanced attachment and spreading in response to 44K BPP. Rat osteosarcoma cells (ROS 17/2.8) expressing osteoblast-like features, exhibited enhanced attachment in response to 44K BPP, while non-osteoblast-like cells (ROS 25/1) obtained from the same osteosarcoma did not. Two epithelial cell lines, CCL4 and A431, demonstrated enhanced attachment when exposed to fibronectin or laminin, but not 44K BPP. Another epithelial-like cell line, HT 1080, derived from a fibrosarcoma, showed enhanced attachment in the presence of all three attachment proteins. Fibronectin, but not 44K BPP, promoted the chemotactic migration of fibroblasts. These studies indicate that the role of 44K BPP attachment protein in the regulation of cell behavior is not restricted to bone cells. PMID- 2710033 TI - Anisotropic and biomechanical properties of tendons modified by exercise and denervation: aggregation and macromolecular order in collagen bundles. AB - For the purpose of determining the changes in tensile strength and levels of macromolecular orientation in collagen bundles as a result of mechanical stimuli, rats were submitted to different experimental treatments such as physical exercise and muscular denervation. After these treatments the Achilles tendons of the animals were submitted to biomechanical and biophysical testing. An analysis of the "stress"-strain curves indicated that the tendons of trained animals possessed superior tensile strength characteristics as compared to their controls. The form birefringence curves (FBC) of the collagen bundles in these tendons also showed an increase in their state of aggregation of the extracellular matrix elements, while maintaining their levels of crystallinity. Average values of tensile strength were even higher in the tendons of denervated animals. An accentuation of the profile of the FBC was also observed in these tendons. The determination of the biomechanical and biophysical modifications can contribute to the understanding of the probable control mechanisms of the aggregation state patterns of the fibrous elements of the extracellular matrix. PMID- 2710034 TI - Diabetes induces the formation of large diameter collagen fibrils in the sciatic nerves of BB rats. AB - Diabetes mellitus (DM) is known to be associated with widespread connective tissue changes. However, the connective tissue of peripheral nerves in diabetes has gained little attention. Thickening of the basement membranes of Schwann, perineurial and endothelial cells suggests a perturbation in the metabolism of type IV collagen. We studied the ultrastructure of endoneurial collagen fibrils in the sciatic nerves of spontaneously diabetic BB rats and found that the fibrils in the diabetic rats were significantly thicker than in the age and sex matched non-diabetic BB rats, both in the proximal (52.6 vs. 46.1 nm) and the distal part (52.4 vs. 45.5 nm) of the nerve, respectively. The mechanism for the thickening of endoneurial collagen fibrils remains unknown, but conceivably involves changes in the biochemical composition of the nerve connective tissue matrix: e.g. altered metabolism of type I and/or type III collagen, increased glycosylation of the collagen molecules, or changes in the glycosaminoglycan content of the ground substance. PMID- 2710035 TI - Sirius red polarization method is useful to visualize the organization of connective tissues but not the molecular composition of their fibrous polymers. AB - There are several reports in the literature where the sirius red polarization method is used to identify the molecular type of collagen in tissue sections. We present evidence that such way of interpretation is erroneous. The sirius red polarization method is useful to visualize the organization of connective tissues and not to identify the molecular nature of their fibrous polymers. PMID- 2710036 TI - [Effect of the Pechenezhskiy reservoir on species distribution and number of blood-sucking Diptera]. AB - Studies of the fauna, density and specificity of formation of the blood-sucking Diptera habitats have demonstrated rapid reduction of biotopes and the density of insects in the first years after the construction of the reservoir. In the following years aggravation of the entomological situation was observed, relative stability being attained only by the 20th year of the reservoir' functioning. Further increase in anthropogenic impact may lead to entomologic changes in the area. PMID- 2710037 TI - [The role of a scraped substrate in the nutrition of Anopheles mosquito larvae]. AB - It was stated that the larvae of three Anopheles species could successfully develop srapping the substrate for their feeding. The possible depth of scrapping for nutritional purposes was identified for each species. It was demonstrated that the larvae kept in as thin water layer were able to pick the foster from the bottom. The findings revealed the possibility to increase the density of keeping twice as much and, therefore, to increase the efficacy of used equipment and working space in insectariums. PMID- 2710038 TI - [A method of accounting for blood-sucking mosquitos with the use of a dark bell and removable sack]. AB - The data on registration with the use of dark bell and insect net with removable sacks were comparatively assessed with regard to the various exposition time of atractives. Practicability of exposure reduction from 5 to 2 minutes in a dark bell registration method was proved as was the reduction of net-flapping from 100 to 50 times. To calculate the number of mosquitos might be caught with use of one of the aforementioned methods against the number caught with the other (regardless the region of the country and mosquito species) the authors suggested the following regression equations: y-2.6 +/- 43 or x-0.4y +/- 17 (where x- the number of net-caught mosquitos, y- the number of mosquitos caught by the use of dark-bell method. PMID- 2710039 TI - [Combined methods of controlling medically significant arthropods]. PMID- 2710040 TI - [Age-related changes in the sensitivity of mosquito species to DDT]. AB - The effect of age on the level of resistance to DDT was studied on laboratory mosquito strains of An. sacharovi, An. atroparvus, Ae. aegypti, C. p. molestus. The highest resistance level was observed in juvenile mosquitos 0-1 days after flying out. The trend towards the increase in sensitivity with age common for all mosquito species is revealed. PMID- 2710041 TI - [Criteria for assessing the relative and specific activity of insecticides]. AB - Relative activity of chemicals and their specific activity coefficients are suggested as the criteria for comparative assessment of insecticidal properties of substances. Values of the afore-mentioned parameters of 34 chemicals compared to a standard are presented for 3 insect species: red cockroaches, house flies and bed-bugs. PMID- 2710042 TI - [The effect of alcistine on the pre-imago phases of mosquito development]. AB - The effect of alcistine on pre-imago stages of mosquito development is studied. High ovicidal and larvicidal effect as well as the types of alterations during the moult are determined. The author established the periods of effective and residual action of the chemical. In situ tests proved the feasibility of using alcistine against mosquitos' larva in natural water basins. PMID- 2710043 TI - [Insecticidal activity of pyrethroids for houseflies and German cockroaches]. AB - Insecticidal and knock-down effects of eight pyrethroids, belonging to 2 types as to their chemical structure and specific action towards the nervous system, on the domestic flies' and German cockroaches' imago were assessed comparatively. Pyrethroids of the 2nd type, especially deltametrine, proved to be more effective against domestic flies as well as German cockroaches. Activity of the pyrethroids of the 1st type featured rapid knock-down effect and was practically independent from varying concentrations. The knock-down was reversible even at high concentrations. In case of the 2nd type of pyrethroids, the knock-down effect was concentration-dependent. Domestic flies, on the whole, were more sensitive to the effect of pyrethroids of the 1st type. The use of pyrethroids of the 2nd type against nonflying sinathropic insects would be advisable because they produce a higher insecticidal effect as well as irreversible knock-down. PMID- 2710044 TI - [The use of the 2600H high-pressure paint-sprayer for killing insects]. AB - Physical and mechanical parameters of the paint-sprayer 2600H were studied under laboratory conditions. Studies of the feasibility of using this device for desinsection were performed under real conditions in moderate--and hot-climate areas. High efficiency of POC and pyrethroids spraying for home mosquito and fly control was demonstrated. High pressure paint-sprayer treatment ensured a longer residual effect than "Automax". The use of the sprayer for desinsection may save time and labour. PMID- 2710045 TI - [The use of flannel flags for collecting fleas at the entrances of rodent holes in the steppes]. AB - Flannel flags (100 X 200 mm) were tested for fleas collection directly at the entrances of rodents' holes in the steppe region. The method proved to be most effective compared to some other wide-spread techniques. Flannel flags assured the highest number of insects collected during quantitative assessment of fleas' populations. Some insects belonging to other systematic groups can be also collected using the flags. Various number of fleas at the holes' entrances was revealed by this method of collection. PMID- 2710046 TI - [A comparative assessment of methods of collecting and long-term storage of ixodidae ticks]. AB - A humid bandage 130 mm wide turned to be the best kind of "chamber" for the collection of Ixodidae in nature and their maintenance under laboratory conditions, as it was demonstrated by studies of Ixodus persulcatus imago ticks. PMID- 2710047 TI - [Multi-year changes in the morbidity of tick-borne encephalitis in the Irkutsk region]. AB - Correlation and cluster analysis of data on the number of tick-borne encephalitis cases in the Irkutsk region collected for a 31-year period allowed the authors to distinguish three areas with various morbidity dynamics, physical and geographical conditions and level of land development. Long-term morbidity prognosis is presented. PMID- 2710048 TI - [Cyclical changes in the number of Ixodes persulcatus in Udmurtia]. AB - Analysis involving autocorrelation functions indicated the presence of cyclic components in the changes in I. persulcatus population as well as in certain climatic parameters. Three orders of cycles are distinguished, their mean duration comprising 5.5; 11.1 and 22.2 years. High number peaks of I. persulcatus repeated with a mean period of 22 years in 1938-1942, 1959-1964 and 1983-1986, coinciding with the periods of solar energy decline in odd 11-year cycles. According to the established regularity, the next considerable rise in I. persulcatus number should be expected in 2003-2009 with a peak in 2004-2006. PMID- 2710049 TI - [First detection of Anopheles species mosquitoes breeding in water-filled cellars]. AB - Studies of the breeding of blood-sucking mosquitos in water-filled cellars of Astrakhan were carried out in 1980-1986 using routine entomological techniques of assessment, collection and determination of blood-sucking mosquitos. In July, 1986, Anopheles sp. breeding in the cellars of 2 multistory buildings was registered along with commonly observed breeding of C. pipiens. The rate of preimago development stages of Anopheles sp. was 2 to 10 sp. per 1 cubic meter of water surface. Water-filled cellars are full of ground water mixed with sewage. It increases epidemiological value of the fact of mosquitos' breeding in populated areas, which should be taken into account during mosquito control. PMID- 2710050 TI - [Ineffectiveness of bacterial insecticides against egg laying by female mosquitoes]. AB - Insecticides on the base of Bacillus thuringiensis and B. sphaericus proved to be ineffective against laying of eggs by female mosquitoes in the water containing these formulations. PMID- 2710051 TI - [The appearance of the Culex pipiens molestus Forsk. mosquito (Diptera: Culicidae) in the town of Pechora (Komi, ASSR)]. AB - For the first time there were revealed man-attacking Culex pipiens molestus breeding in the basements of residential houses with an impaired water-supply in the town of Pechora. The fact evidenced the continuing penetration of these posquitos to the north of the European part of the USSR. PMID- 2710052 TI - [Spontaneous regression of lung metastasis in renal cell carcinoma with expectoration of a part of the metastasis]. PMID- 2710053 TI - [Autonomic neuropathy in diabetes mellitus, chronic renal failure and liver cirrhosis]. AB - Chronic diseases (diabetes mellitus, end stage renal failure on hemodialysis, post-hepatitic liver cirrhosis) caused autonomic neuropathy in 34 of 65 cases. The frequency of autonomic neuropathy was 14 of 30 diabetics (typ I and typ II), twelve of 19 patients on dialysis, and eight of 16 non-alcoholic liver cirrhotics. We did not find a correlation between the tests of the cardiovascular and of the gastrointestinal system. The distribution of the neuropathic changes was undependent of the underlying disorder. Using appropriate tests, alterations of the autonomic functions can be discovered frequently even in asymptomatic patients. At least two pathological test results are necessary to reach a significant difference between patients and healthy controls. This indicates that the diagnosis of autonomic neuropathy should rely on two or more pathological test results. The evidence of autonomic neuropathy identifies a population of high risk patients. PMID- 2710054 TI - [New aspects of the diagnosis of pancreatic cancer by determination of granulocyte elastase]. AB - Elastase determination via elastase-alpha 1-antitrypsin-complex is recommended for the prognosis of septic infections. Since it is described that elastase values are increased in the serum of tumor patients it was the aim of the investigations to test elastase in the serum of different surgical tumor patients postoperatively. For comparison patients with septic complications as well as patients without any postoperative complication were also tested. It could be shown that in septic patients elastase values are markedly increased. They were measured at 390 ng/ml in mean, whereas patients without complications after operation had only values of 229 ng/ml. Elastase values in tumor patients were only slightly increased (290 ng/ml). It was, however, generally noticed that patients with pancreas head carcinoma showed regularly markedly increased elastase values (375 ng/ml). From this it was concluded that the determination of elastase values in tumor patients gives no reliable information except in patients with pancreas head carcinoma. In these patients the determination of the elastase could be helpful especially because the normal enzyme diagnosis is often misleading. PMID- 2710055 TI - [Paraneoplastic syndrome in kidney cancer]. AB - In a prospective study 60 patients suffering from histologically confirmed renal cell carcinoma were examined on paraneoplastic alterations. The following parameters were determined: Stauffer-syndrome (BSG, total protein with serum electrophoresis, alcaline phosphatase, gamma-GT, Quick values), total and ionized calcium, parathormone, calcitonin, hemoglobin, thrombocytes, LDH, IgE and arterial blood pressure. Compared to the findings obtained by other authors, we saw paraneoplastic syndromes only rarely. There was no correlation found to the stage of the tumor or to prognosis. In only four out of 60 patients paraneoplastic led to the diagnosis "renal carcinoma". With the exception of BGS, which was raised in 75% of the patients, paraneoplastic parameters are not suitable for the screening or the early diagnosis of renal carcinomas. PMID- 2710056 TI - [Hypercalcemic crisis and multiple osteolyses in an elderly patient]. PMID- 2710057 TI - Investing to maximize after-tax dollars. AB - There are many tax-saving options still available to the practicing physician. The material contained in this article is a brief introduction to some of these options. To fully utilize any tax-saving provision, a full understanding of that provision is essential. Therefore, it is important that doctors seek professional advice before implementing a tax-reduction plan, including those discussed in this article. PMID- 2710058 TI - High marks for zidovudine. PMID- 2710059 TI - Alternatives and tradeoffs for physicians. PMID- 2710060 TI - Secrets of surviving mid-life M.D. Malaise. Interview by Richard L. Reece. PMID- 2710061 TI - It takes two: a husband-and-wife interview. Interview by Richard L. Reece. PMID- 2710062 TI - Opposing the RCT proposal. PMID- 2710063 TI - From the news room. PMID- 2710065 TI - From the Mayor's office. PMID- 2710064 TI - From the other side of the fence--managed care. PMID- 2710066 TI - Ramsey County Medical Society puts doctors on display. PMID- 2710067 TI - Our evolving payment system. Who will pay for health care? PMID- 2710068 TI - Contract law for physicians. The basics. AB - As part of the Minnesota Medical Association's ongoing contract review process, this article provides information to help educate physicians about the major managed care contracts being offered to them. The information provided is not intended to, nor should it be a substitute for legal advice pertaining to an individual's practice and specific contracts with third parties. The MMA will not be making recommendations regarding the merits of any particular contract. A decision to enter into a contract rests with the physician and his or her clinic in consultation with private legal counsel. PMID- 2710069 TI - [Computerized reconstruction of the spatial organization of enamel rods]. AB - Morphometric reliefs on the enamel of the lower incisor of albino rats in correspondence with the prism compaction area during the first third of the ameloblastic modulation phase have been carried out. The reliefs were done on the longitudinal and median fracture plane and on the transversal fracture plane 8 mm from the cervical ansa. Measurements of the diameters of the honeycomb pits were carried out during the deposition phase, following removal of the ameloblastic coat. The data obtained were fed into an Apple Macintosh 512K/800 computer to obtain the geometric reconstruction of an isolated prism, the relations between each portion of the prism and the respective pits and a graphic example of the architectural organization of the enamel. It was shown that each prism consists of three distinct portion, just as there are three types of honeycomb pit. The external orifice of each pit is complementary to the interdigitant portion of the Tomes process, so the study of the pits may be used to evaluate the spatial orientation of the rods and not the morphology of their section. Cross-over between rows of contiguous rods occurs throughout the thickness of the internal enamel layer. The enamel possesses a particularly suitable structure for the transformation of surface type tangential forces into stresses or prevalently compression type. PMID- 2710071 TI - [Stomatologic pathology in HIV infection. Preliminary data]. AB - In order to investigate the clinical oral manifestations associated with Acquired Immunodeficiency Syndrome (AIDS) and AIDS-related conditions, 922 male subjects were studied in a closed community (inmates). 669 were drug-abusers, 24 homosexual or bisexual men, 86 drug-abusers and homosexual or bisexual men, 143 without risk behaviour. Only 120 patients had antibodies to human immunodeficiency virus type I. All were throughly examined for evidence of oral disorders. The major finding was that almost all with AIDS and AIDS-related complex had oral manifestations one AIDS-patient was affected with hairy leukoplakia. PMID- 2710070 TI - [Polyamines in tumors of the oral cavity]. AB - The polyamines putrescine, spermidine and spermine are essential for normal growth and differentiation and the activity of the enzymes participating in their synthesis and catabolism are markedly modified in actively proliferating cells in vitro and in vivo. In some neoplastic cells a good correlation is observed between polyamine concentration and histology, so that a potential usefulness as diagnostic and prognostic markers has been suggested. In the study of ornithine decarboxylase, S-adenosylmethionine decarboxylase and spermidine acetyltransferase activities and of polyamine concentration in tumors of the oral cavity we have shown a marked increase in the tumor cells. In the epulis the ratio spermidine/spermine is inverted, so that it could be useful in differentiating benign from malign tumors. PMID- 2710072 TI - [Pleomorphic adenoma of the parotid gland. Cases contribution]. AB - Data relating to a series of 23 pleiomorphous adenomas of the parotid (19 primary forms and 4 previously operated recurrences) are reported. The ages most affected are the 4th, 5th and 6th decades with a higher incidence of females. The most commonly adopted surgery was extracapsular enucleoresection of the tumour (17 cases) followed by superficial parotidectomy (4 cases) and total parotidectomy (2 cases). No significant post-operative complications were observed. Anesthetic results were excellent. No recurrences were observed during follow-up. PMID- 2710073 TI - [Clinico-surgical evaluation of dental elements in bone inclusions]. AB - Dental inclusions are assessed on the basis of clinical and operating statistics relating to the years 1981-1985 and comprising 815 patients and 1445 treated teeth. The results confirm the predominance of inclusions among female patients and the prevalence of the mandibular site; the most frequently included teeth are the lower eighths followed by the upper eighths, the upper canines and the second lower premolars. Inclusions are bilateral in most cases. These findings are in substantial agreement with the epidemiological data recorded in the literature. The operating series shows that the type of surgical treatment varies with the localisation of the tooth (anterior or posterior), its relationship with contigous teeth and with the surrounding anatomical structures and the age of the patient. Teeth in the posterior sector are usually extracted. At young age, germectomy is carried out for orthodontic purposes; at mature age, teeth are extracted to prevent the formation of periodontal pockets and the aggravation of caries and their complications. On the other hand, for teeth in the anterior sector, surgery is usually merely the first stage in treatment and is followed by treatment of orthodontic type with traction, in view of the important aesthetic and functional role of the labial teeth. PMID- 2710074 TI - [Degranulation test of basophils with scalar concentrations of 3% carbocaine. Evaluation of clinical cases with test over 40%]. AB - On the basis of 3 clinical cases, the diagnostic contribution of the basophil degranulation test in the screening of allergical pathologies of dental interest is evaluated. PMID- 2710075 TI - [Evaluation of the clinical effectiveness of biofeedback EMG on muscular relaxation and painful symptomatology]. AB - The therapeutic effectiveness of EMG biofeedback on muscular relaxation and pain symptomatology has been analysed in a group of 24 dysfunctional patients presenting consecutively at the Prosthesis Department of the Odontostomatological Clinic. A good level of muscular relaxation was achieved in 22 cases; pain symptomatology disappeared totally in 19 and reduced considerably in 3 of 24 patients examined. Therapy failed in 2 cases. The method thus presents unquestionable therapeutic value in dysfunctional patients, particularly in cases with symptomatology that is mainly due to muscular hyperactivity. PMID- 2710076 TI - [Clinical and therapeutic considerations on a case of hemangiopericytoma of the cheek]. AB - The paper reports on a case of recurrent hemangiopericytoma of the cheek, discusses the results of hyperthermia combined with intra-arterial chemotherapy after the postoperative recurrence and draws significant conclusions about the therapeutic approach to this type of tumour. PMID- 2710077 TI - [Traumatic laceration of facial nerve and Stenone duct. A clinical case]. AB - After a brief review of the main operating techniques employed in the reconstruction of the facial nerve and Stenone's duct lacerated by trauma, a clinical case in which the two lesions are associated is reported. Suture of the lacerated nervous branches and attachment of the salivary fistula to the oral mucosa using a silicon drainage applied for a few days permitted functional recovery of neuronal activity and salivation. PMID- 2710078 TI - [Bone remodelling after condylar fractures in children]. AB - The results of functional treatment of condylar fractures in children are reported. Ten patients were subjected to a radiographic study. Long-term follow up shows a very good osseus remodelling of fractured condyles. PMID- 2710079 TI - [Diagnosis and therapeutic programming of mandibular symphysis dysmorphisms in patients with dento-osseous malformations]. AB - Alterations in chin position in dentoskeletal dysmorphias are considering with a review of the literature on the prognosis of surgical treatment in dysmorphias of the chin symphysis. The treatment protocol then presented offers the possibility of programming the restoration of the correct physiological relationship between the bone bases and the correction of the aesthetic defects produced by dysmorphias of the chin symphysis on a single pre-operative graph. The problem in such programming lies in the extensive changes necessary to the bone and skin parameters during the functional operation that are difficult to foresee and quantify preoperatively. PMID- 2710080 TI - [Clinical and statistical study on the value of the sugar cube test in the measurement of the degree of radio-induced xerostomia]. AB - Personal experience with the sugar cube test for evaluating the degree of xerostomy induced by radiation therapy carried out by means of 60Co photons on volumes including the parotid glands is reported. The execution technique is described and the processing of data deriving from a series of 480 tests carried out in 60 patients suffering from head-neck cancers reported. On the basis of experience it is maintained that the test presents the following advantages: simple execution, maximum tolerance, easy evaluation, possibility of numerically quantifying and graphically evidencing the course of xerostomy; in conclusion, it is considered that this can be advantageously adopted for both research and practical clinico-therapeutic purposes. PMID- 2710081 TI - [Use of Lyodura in fractures of the orbital floor]. AB - After a brief review of reported techniques for the reconstruction of substance losses of slight or modest proportions at the orbital floor using autogenic, homogeneous, heterogeneous and alloplastic grafts, personal experience with this type of surgery employing lyophilised human dura mater is reported. It is considered that Lyodura can be considered the material of choice by virtue of its strength, handiness and the absence of tissue reactions. 38 fractures of the orbital floor were treated from 1980 to 1986 with osteosynthesis of the border and insertion of lyophilised dura mater to make up for bone loss. In the immediate postoperative period and in later controls, there was no evidence of complications or phenomena of intolerance to the material. The patients treated were followed up a short time later. Clinical and X-ray data confirmed the validity in time of the technique and material employed long-term. PMID- 2710082 TI - [Traumatic pathology of the temporo-mandibular articulation. Clinical study of 55 cases]. AB - Fifty-five cases of condyle fracture have been followed up and the value of non surgical reduction treatment of fractures assessed with respect to recent proposals to treat the same conditions surgically. PMID- 2710083 TI - [Relationship between injury dynamics and site of maxillofacial fractures. Comparative study of 100 cases]. AB - One hundred cases of facial mass fractures observed in the period April-September 1988 have been assessed using a clinico-anamnestic type investigation. Among trauma patients there is a prevalence of male patients aged between 10 and 30. Fractures located at the middle third and mandible occur in a practically equivalent number. Most traumas are the result of road accidents, following by falls. A good degree of correlation was observed between trauma aetiology and dynamics on the one hand and type and gravity of fractures on the other. Direct fractures, with greatest comminution of fragments prevail in high speed traumas; indirect fractures are most frequent in low speed traumas (cyclists and accidental). PMID- 2710084 TI - [Joint and functional changes in the masticatory system in chronic rheumatoid arthritis in adults. Preliminary study]. AB - A clinical and radiological study has been carried out to highlight signs and symptoms of mandibular dysfunction in a sample of 66 adult patients suffering from chronic rheumatoid arthritis. Data were quantified on the basis of Helkimo indices. Prevalence proved significantly high, particularly as regards joint crepitus, reduced mandibular mobility, pain in the masticatory muscles and macroglossia. It did not seem to be linked to age. Rather it presented a definite predominance of the female sex, confirmed by comparison with a sample of nonrheumatic controls. Contemporaneous X-ray examination showed a bilateral location, in many cases remodelling and reabsorption of the condyle, an increase in the articular space and erosion of the fossa, at times reduction in the space and sclerosis, dependent on a superimposed degenerative arthrosis (usually more painful). Generally speaking, however, there was a coincidence between severity of clinical dysfunction and seriousness of the morphological lesions whereas subjective symptoms were relatively independent. The need for polyspecialistic cooperation and a multidisciplinary therapeutic approach is reiterated. PMID- 2710085 TI - [A case of mandibular chondrosarcoma]. AB - The Authors report a new case of chondrosarcoma of the mandible. After stressing the rarity of the tumour in the facial bones, they discuss the treatment problem. They propose a surgical approach as long as metastases are absent and recommend radio and chemotherapy just for palliation of advanced cases. PMID- 2710086 TI - [Bone inclusion and ectopia of a superior incisor. Clinical case]. AB - A case of inclusion and ectopia of a superior incisor resolved with the aid of a removable apparatus in reported. PMID- 2710087 TI - [The sign of induced bleeding in the evaluation of individual susceptibility to periodontal disease. Experimental study in diabetic and non-diabetic patients]. AB - The most recent hypotheses on the pathogenesis of periodontal disease have underlined the great importance exerted by individual susceptibility to the disease. The ability of a high ratio between bleeding index and plaque index as a way of identifying subjects at risk has been investigated, the values of this ratio being compared in a group of diabetic patients and in a group of non diabetics with periodontal lesions of similar extent. The results obtained confirmed those of other Authors, testifying to the good capability of the bleeding/plaque ratio to identify patients with a high risk of developing advanced forms of periodontal disease. PMID- 2710088 TI - [Fluoroprophylaxis of dental caries. Current status in the provinces of Genoa and Savona]. AB - A total of 60 pediatricians from the districts of Genova and Savona, randomly selected, responded to a survey designed to determine several aspects of their attitude toward the prevention of dental caries and particularly the use of fluoride supplement (table II). The survey demonstrated (table III) that 80% of the physicians prescribe fluoride without knowing the fluoride content in the water supply of their region. Therefore, the dosage schedule used by 56% of the physicians is higher than the optimal, 27.5% is lower and only 16.5% use the optimal dosage as recommended by the American Academy of Pediatric, Committee on Nutrition. PMID- 2710089 TI - [Electromyographic evaluation of muscular tension in dysfunctional subjects in relation to normal subjects]. AB - Electromyography has been used to analyse the myoelectric activity of the masticatory muscles in 130 dysfunctional patients in comparison with normal subjects. Of the muscles examined, those presenting greater basal tension were also identified. Myoelectric activity proved greater, at postural values, in dysfunctional patients; by contrast, subjects without craniomandibular symptomatology presented normally low initial values. As for the analysis of the muscular group presenting greater tension, analysis of the results did not produce statistically significant percentages pointing to the prevalence of one muscular group over another. PMID- 2710090 TI - [Intra-arterial chemotherapy. Presentation of a method to insure patency of the catheter]. AB - Following some brief remarks on the main techniques of antineoplastic chemotherapy, a simple technique for guaranteeing patency of the endarterial catheter is presented. Using a special microchannel infusor, it was possible to prevent catheter obstruction in 100% of the cases treated. PMID- 2710091 TI - [Comparative study of manual and mechanical insertion of self-threading parapulpal pins]. AB - Analysis of the traction resistance of 18 TMS Link-Plus self-threading pulp pins (Whaledent Int.) some inserted manually, others using a low-speed device in a group of extracted teeth revealed no statistically significant differences between the two groups. It therefore seems that the tiny fractures observed under microscopic examination are caused by the threading mechanism per se and not by the way it is carried out. PMID- 2710092 TI - [In vitro antibiotic sensitivity of several species of oral spirochetes]. AB - Results of a series of "in vitro" antibiotic susceptibility tests on some strains of oral Treponema are presented. Different antimicrobial agents have shown different results and only tetracycline and erythromycin have shown consistent antibacterial properties. Surprisingly penicillin has allowed a latent "in vitro" growth of the tested Treponema. The Authors conclude that, according to the data presented, a revision of the current criteria of the antimicrobial therapy for the oral infections associated with the presence of species of Treponema is needed. PMID- 2710093 TI - [Bilaminar technic in the treatment of gingival recessions]. AB - Bilaminar procedures represent an evolution in the treatment of marginal tissue recessions. A connective tissue graft removed from the palate and over which a pedicle flap is sutured, is used in these procedures. The advantages of these new procedures are: 1) sure predictability of graft survival to which a double-blood supply is guaranteed; 2) primary intention healing at the donor site, with minimum post-operative discomfort; 3) excellent esthetic results consisting of better color blending between graft and adjacent tissues and absence of keloid- like scars, very common after free gingival grafts. PMID- 2710094 TI - [Fracture of the mandibular condyle in childhood]. AB - Cases of mandibular condyle fracture have been reported in patients in evolutive age. Conservative and rehabilitative treatment was carried out with excellent anatomofunctional results in the course of growth. PMID- 2710095 TI - [Clinico-surgical evaluation of supernumerary dental anomalies]. AB - The pathology of extra teeth is evaluated on the basis of clinico-operative statistics for the years 1981-1985 and comprising 88 patients for a total of 115 treated teeth. The data obtained confirm the higher frequency of extra teeth in male patients. The most frequent site is easily the frontal sector of the upper arch. At that level, especially in males, two more or less symmetrical extra teeth are not infrequent. These data are in substantial agreement with the epidemiological data reported in the literature. Extra teeth are usually treated by surgical removal followed by orthodontic treatment to correct malformations caused by them and to recover the functional and aesthetic role of the upper front teeth. PMID- 2710096 TI - [Response of facial soft tissues following interventions of mandibular regression. Frontal examination]. AB - The variation of certain fundamental aesthetic parameters in patients (5) subjected to mandibular regression (Obwegeser-Dal Pont) is examined. The patients suffered from IIIrd class malocclusion. The examination was carried out on facial photographs (ratio 1:1) in front view. PMID- 2710097 TI - [Several cases of benign neoplasms of the parotid gland (excluding pleiomorphic adenomas)]. AB - A series of 7 patients (4 males, 3 females) suffering from benign, non pleiomorphous neoplasia of the parotid observed in the period 1963-1983 is reported. The most commonly adopted surgery was extracapsular enucleo-resection. No post-operative complications were observed. No recurrences were encountered during follow-up. PMID- 2710098 TI - [Apicoectomy: comparison between 2 case series]. AB - Data on 2 series of apicectomies performed in 1966-69 and 1978-82 respectively are compared. The comparison was based on clinical assessments and radiographic findings in patients given a repeated check-up a later date. Similar results were obtained in the two series, confirming the importance of scrupulous pre-operative endodontic treatment combined with the use of non-absorbable canal material. It is felt that this, combined with a scrupulously precise periapical surgical technique will ensure total success in all cases. PMID- 2710099 TI - Differential expression within a family of novel wound-induced genes in potato. AB - Wounding in higher plants leads to an increased synthesis of specific messenger RNAs. A cDNA clone complementary to a wound-induced message from potato tubers was used to isolate a lambda clone from a genomic library of Solanum tuberosum var. Maris Piper. DNA sequence analysis has shown that this single genomic clone contains two novel wound-induced genes, called win1 and win2, organised in close tandem array. The coding sequences of these two genes are highly homologous and are interrupted by a single intron. However, the sequences of the introns and flanking regions have diverged widely. Win1 and win2 encode cysteine-rich proteins of 200 and 211 amino-acids, respectively, which show striking homologies to several chitin-binding proteins. Southern analysis of genomic DNA has shown that win1 and win2 are members of a small multi-gene family which is estimated to have a minimum of five members per haploid genome of Maris Piper and appears to be conserved within the Solanaceae. We have shown by Northern analysis and S1 mapping that the two genes exhibit differential organ-specific expression after the wounding of a potato plant. PMID- 2710100 TI - Molecular cloning of resistance genes and architecture of a linked gene cluster involved in biosynthesis of oxytetracycline by Streptomyces rimosus. AB - The isolation of mutants of Streptomyces rimosus which were blocked in oxytetracycline (OTC) production was described previously. The genes for the early steps of antibiotic biosynthesis mapped together. Genomic DNA fragments of S. rimosus which conferred resistance to OTC and complemented all of these non producing mutants have been cloned. The cloned DNA is physically linked within approximately 30 kb of the genome of S. rimosus. The gene cluster is flanked at each end by a resistance gene each of which, independently, can confer resistance to the antibiotic. In OTC-sensitive strains of S. rimosus, the entire gene cluster including both resistance genes has been deleted. Complementation of blocked mutants by cloned DNA fragments in multi-copy vectors was often masked by a secondary effect of switching off antibiotic production in strains otherwise competent to produce OTC. This adverse effect on OTC production was not observed with recombinants using low copy-number vectors. PMID- 2710101 TI - Cloning and analysis of fs(1) Ya, a maternal effect gene required for the initiation of Drosophila embryogenesis. AB - The maternal effect locus fs(1) Ya is required for the fusion of the apposed sperm and egg pronuclei (syngamy) following fertilization in Drosophila. It is tightly linked to another complementation group, fs(1) Yb, needed for both oogenesis and embryogenesis. We have isolated a set of overlapping cloned sequences in the 3B4-6 region of the X chromosome encompassing the fs(1) Ya-fs(1) Yb region. A single 2.4 kb maternal transcript is encoded within this region, and an 8.5 kb DNA fragment that contains this transcript complements both fs(1) Ya and fs(1) Yb mutations. Northern and in situ hybridization analyses show that the maternal transcript is only present in nurse cells and oocytes beginning in previtellogenic stages, and is evenly distributed in the cytoplasm of 0-2 h syncytial embryos. The transcript is not detected in later stages of embryonic development. This expression pattern correlates closely with the genetic and developmental characteristics expected of the fs(1) Ya gene product. PMID- 2710102 TI - Sequences responsible for the tissue specific promoter activity of a pea legumin gene in tobacco. AB - Maturing pea cotyledons accumulate large quantities of storage proteins at a specific time in seed development. To examine the sequences responsible for this regulated expression, a series of deletion mutants of the legA major seed storage protein gene were made and transferred to tobacco using the Bin19 disarmed Agrobacterium vector system. A promoter sequence of 97 bp including the CAAT and TATA boxes was insufficient for expression. Expression was first detected in a construct with 549 bp of upstream flanking sequence which contained the the leg box element, a 28 bp conserved sequence found in the legumin-type genes of several legume species. Constructs containing -833 and -1203 bp of promoter sequence significantly increased levels of expression. All expressing constructs preserved seed specificity and temporal regulation. The results indicate that promoter sequences between positions -97 and -549 bp are responsible for promoter activity, seed specificity, and temporal regulation of the pea legA gene. Sequences between positions -549 and -1203 bp appear to function as enhancer-like elements, to increase expression. PMID- 2710103 TI - A NADH dehydrogenase subunit gene is co-transcribed with the abnormal Petunia mitochondrial gene associated with cytoplasmic male sterility. AB - DNA sequence analysis 3' to the Petunia S-pcf coding region has resulted in the identification of an open reading frame similar to mammalian mitochondrial genes for subunit 3 of the NADH dehydrogenase complex (nad3). Both the abnormal fused gene S-pcf and S-nad3 fall within the mitochondrial DNA region previously shown to be associated with cytoplasmic male sterility (CMS). The S-nad3 sequence, co transcribed with S-pcf, is present in only one copy within the Petunia CMS genome. A homologous transcribed sequence from the mitochondrial genome of a fertile Petunia line has been identified. The coding region of the two genes are identical and they share homology for at least 800 bp downstream. The genes diverge 117 bp upstream of the nad3 start codon. Transcripts of the S-pcf/S-nad3 transcripts are similar in tissues of a fertility-restored line and a CMS line. PMID- 2710104 TI - An element with long terminal repeats and its variant arrangements in the genome of Lilium henryi. AB - A 9.35 kbp element with long terminal direct repeats (LTRs) of 2.4 kbp has been characterized from the large genome of Lilium henryi. The organization of the element, named del, was examined in 20 fragments from a genomic DNA library constructed using phage EMBL3. Five fragments apparently contained full 9.35 kbp elements while in 11 del was recovered in part. Two clones carried tandem arrangements of del, with single LTRs and internal sequences alternating, and one insert contained a solo LTR. Evidence suggests that these arrangements, which can arise by unequal crossing over, have a genomic rather than a cloning origin. Finally, one cloned fragment had a complex del arrangement yet to be fully defined. Limited sequencing of five LTRs (from a full del, a tandem arrangement and a solo LTR) indicates that the consensus termini are 5'TGT...ACA3', with del sequences flanked by a 5 bp tandem repeat. Thus del shares properties with retrotransposons such as the copia family of Drosophila and Ty of yeast. However with more than 13,000 copies per genome it seems del has been amplified more than is usual for such elements. PMID- 2710105 TI - afsB stimulates transcription of the actinorhodin biosynthetic pathway in Streptomyces coelicolor A3(2) and Streptomyces lividans. AB - The pleiotropic regulatory gene, afsB, from Streptomyces coelicolor A3(2), possibly encoding a DNA-binding protein, is required for actinorhodin production in this organism. Northern blot hybridization using a DNA fragment covering part of the set of cloned actinorhodin biosynthetic gene cluster (act) as the probe showed lack of the act transcripts in an afsB-negative mutant of S. coelicolor A3(2); the transcripts were restored on introduction of a cloned afsB gene. Introduction of the cloned afsB gene into Streptomyces lividans stimulated transcription of the act genes under conditions in which they are normally silent in this strain, leading to production of actinorhodin in large quantity. These data show that afsB exerts its positive regulatory effect by means of transcriptional stimulation of its target genes. PMID- 2710106 TI - Mutational analysis of the Bradyrhizobium japonicum common nod genes and further nod box-linked genomic DNA regions. AB - By insertional and deletional marker replacement mutagenesis the common nod region of Bradyrhizobium japonicum was examined for the presence of additional, essential nodulation genes. An open reading frame located in the 800 bp large intergenic region between nodD1 and nodA did not appear to be essential for nodulation of soybean. Furthermore, a strain with a deletion of the nodI- and nodJ-like genes downstream of nodC had a Nod+ phenotype. A mutant with a 1.7 kb deletion immediately downstream of nodD1 considerably delayed the onset of nodulation. This region carried a second copy of nodD (nodD2). A nodD1-nodD2 double mutant had a similar phenotype to the nodD2 mutant. Using a 22-mer oligonucleotide probe partially identical to the nod box sequence, a total of six hybridizing regions were identified in B. japonicum genomic DNA and isolated from a cosmid library. Sequencing of the hybridizing regions revealed that at least three of them represented true nod box sequences whereas the others showed considerable deviations from the consensus sequence. One of the three nod box sequences was the one known to be associated with nodA, whereas the other two were located 60 to 70 kb away from nif cluster I. A deletion of one of these two sequences plus adjacent DNA material (mutant delta 308) led to a reduced nodulation on Vigna radiata but not on soybean. Thus, this region is probably involved in the determination of host specificity. PMID- 2710107 TI - Expression of the CAM-form of phospho(enol)pyruvate carboxylase and nucleotide sequence of a full length cDNA from Mesembryanthemum crystallinum. AB - We have determined the complete nucleotide sequence of a full length cDNA encoding the Crassulacean acid metabolism (CAM) isogene of phospho(enol)pyruvate carboxylase (PEPCase). The cDNA clone, 3348 bp in length, was obtained from mRNA isolated from Mesembryanthemum crystallinum (common ice plant) which had undergone salt stress and subsequent induction of CAM. The long open reading frame encodes PEPCase (EC 4.1.1.31) with a predicted molecular mass of 110533 daltons. The deduced amino acid sequence of the ice plant PEPCase is most similar to that from maize having an amino acid identity of 74.9%. Sequence identity in corresponding regions of the PEPCase proteins from Escherichia coli and the cyanobacterium Anacystis nidulans are 41.4% and 33.5%, respectively. A compilation of the four amino acid sequences permitted the identification of phylogenetically conserved regions within the proteins which may play a role in the function of this important enzyme in plant metabolism. Gene specific probes from 3' coding and noncoding regions of the cDNA clone used to probe genomic Southern blots established that this PEPCase gene is present in one copy in the nuclear genome of M. crystallinum. Transcripts arising from this gene increase dramatically when M. crystallinum is irrigated with 0.5 M NaCl, a stress which induces this plant to switch the primary fixation of CO2 from C3 (Calvin cycle) to CAM mode. The salt-induced mRNA encodes a PEPCase isoform which is undetectable in plants in the C3 mode as demonstrated by Northern hybridization. PMID- 2710108 TI - The DNA sequence of the Rhodobacter capsulatus ntrA, ntrB and ntrC gene analogues required for nitrogen fixation. AB - We have determined the DNA sequence for the genes nifR1, nifR2 and nifR4 in the photosynthetic bacterium Rhodobacter capsulatus. These genes regulate transcription of the nifHDK operon and so limit the expression of nitrogen fixation activity to periods of low environmental concentrations of both oxygen and fixed nitrogen. The sequences of these three genes are similar to components of the ntr regulation system in Escherichia coli and Klebsiella pneumoniae. The two-component regulatory system of ntrB and ntrC in E. coli is represented by nifR2 and nifR1 in R. capsulatus and nifR4 in R. capsulatus is the equivalent of the E. coli ntr-related sigma factor ntrA. PMID- 2710109 TI - Chinese hamster ovary cell mutants with multiple glycosylation defects for production of glycoproteins with minimal carbohydrate heterogeneity. AB - The production of glycoproteins with carbohydrates of defined structure and minimal heterogeneity is important for functional studies of mammalian carbohydrates. To facilitate such studies, several Chinese hamster ovary mutants that carry between two and four glycosylation mutations were developed. All of the lines grew readily in culture despite the drastic simplification of their surface carbohydrates. Therefore, both endogenous glycoproteins and those introduced by transfection can be obtained with specifically tailored carbohydrates. The lectin resistance properties of the mutants showed that each line expresses a novel array of cell surface carbohydrates useful for identifying specific roles for carbohydrates in cellular interactions. In addition, they showed that the epistatic relationships among different glycosylation mutations are not entirely predictable, providing insight into the complexity of the carbohydrate structures at the Chinese hamster ovary cell surface. PMID- 2710110 TI - The replication advantage of a free linear rRNA gene is restored by somatic recombination in Tetrahymena thermophila. AB - The autonomously replicating rRNA genes (rDNA) in the somatic nucleus of Tetrahymena thermophila are maintained at a copy number of approximately 10(4) per nucleus. A mutant in which the replication properties of this molecule were altered was isolated and characterized. This mutation of inbred strain C3, named rmm4, was shown to have the same effect on rDNA replication and to be associated with the same 1-base-pair (bp) deletion as the previously reported, independently derived rmm1 mutation (D. L. Larson, E. H. Blackburn, P. C. Yaeger, and E. Orias, Cell 47:229-240, 1986). The rDNA of inbred strain B, which is at a replicational disadvantage compared with wild-type C3 rDNA, has a 42-bp deletion. This deletion is separated by 25 bp from the 1-bp deletion of rmm4 or rmm1. Southern blot analysis and DNA sequencing revealed that during prolonged vegetative divisions of C3-rmm4/B-rmm heterozygotes, somatic recombination produced rDNAs lacking both the rmm4-associated deletion and the 42-bp deletion. In somatic nuclei in which this rare recombinational event had occurred, all 10(4) copies of nonrecombinant rDNA were eventually replaced by the recombinant rDNA. The results prove that each of the two deletions is the genetic determinant of the observed replication disadvantage. We propose that the analysis of somatically recombinant rDNAs can be used as a general method in locating other mutations which affect rDNA propagation in T. thermophilia. PMID- 2710111 TI - The major low-molecular-weight heat shock protein in chloroplasts shows antigenic conservation among diverse higher plant species. AB - Several plant species are known to synthesize low-molecular-weight nucleus encoded heat shock proteins (HSPs) which localize to chloroplasts. DNA sequence analysis of chloroplast HSP cDNAs from pea (Pisum sativum) and soybean (Glycine max) has shown that the carboxyl-terminal halves of these proteins are homologous to low-molecular-weight HSPs from a wide range of eucaryotes (E. Vierling, R. T. Nagao, A. E. DeRocher, and L. M. Harris, EMBO J. 7:575-581, 1988). We used a pea cDNA to construct fusion proteins containing either the carboxyl-terminal heat shock domain or the amino-terminal domain of the chloroplast HSP. The fusion proteins were overexpressed in Escherichia coli and used to produce choloroplast HSP-specific polyclonal antibodies. The carboxyl-terminal antibodies recognized chloroplast HSP precursor proteins from pea and from three divergent plant species, Arabidopsis thaliana, petunia (Petunia hybrida), and maize (Zea mays). The amino-terminal antibodies recognized effectively only the pea precursor. When intact plants of each species were subjected to a heat stress regime mimicking field growth conditions, significant levels of the mature forms of the chloroplast HSPs accumulated in pea, A. thaliana, and maize. The levels of accumulated HSPs remained unchanged for 12 h following the stress treatment. We conclude that the synthesis of chloroplast-localized HSPs is an important component of the stree response in all higher plants and that chloroplast HSPs from dicotyledonous and monocotyledonous plants have a conserved carboxyl terminal domain. PMID- 2710112 TI - Molecular genetics of androgen-inducible RP2 gene transcription in the mouse kidney. AB - Androgen control of the RP2 gene in the mouse kidney has been modified during evolution. In inbred mice (Mus domesticus), the concentrations of mRNAs encoded by RP2 undergo a 10- to 12-fold induction in response to testosterone; in other Mus species (e.g., Mus hortulanus and Mus caroli), induction ranges from none to about two- to fourfold. In this communication, we show that androgens induced RP2 transcription in M. domesticus, although this induction may not have fully accounted for the increase in mRNA levels. Reduced mRNA inducibility in M. hortulanus and in several other species was associated with an absence of transcriptional induction. Analysis of an interspecies backcross population indicated that the difference in RP2 inducibility between M. domesticus and M. hortulanus was due to a single Mendelian locus tightly linked (0 of 47 recombinants) to RP2. The RP2 gene was found to contain at least two promoters, only one of which was highly sensitive to testosterone. These results indicate that induction of the RP2 mRNAs, as well as interspecies variations in RP2 inducibility, are primarily a consequence of effects on this promoter. PMID- 2710113 TI - The C-terminal domain of transcription factor IIIA interacts differently with different 5S RNA genes. AB - DNase I footprints and affinity measurements showed that the C-terminal arm of Xenopus transcription factor IIIA interacts differently with different Xenopus 5S DNAs, forming three distinct types of transcription factor IIIA-5S DNA complexes: a somatic type, a major-oocyte (and pseudogene) type, and a trace-oocyte type. Site-directed mutagenesis on the major-oocyte 5S gene revealed that somatic-type changes at positions 53, 55, and 56 changed the structure of the transcription factor IIIA-5S DNA complex from major-oocyte to somatic, and a single trace oocyte change at position 56 caused the change from major-oocyte to trace-oocyte complex. We further show that the somatic-type changes are accompanied by a marked enhancement in the rate of 5S RNA transcription, and we discuss the possible biological relevance of these findings. PMID- 2710114 TI - The sarcomeric actin CArG-binding factor is indistinguishable from the c-fos serum response factor. AB - The c-fos serum response element (SRE) and a sarcomeric actin promoter element (CArG box) are similar in sequence and are recognized, respectively, by the serum response factor (SRF) and the CArG-binding factor (CBF). Although the transcriptional controls for the c-fos and sarcomeric actin genes are rather different, SRF and CBF have been found to be indistinguishable by all criteria tested. They exhibited similar chromatographic properties, sedimentation rates, and temperature stabilities. In mobility shift assays, the SRE competed more strongly than the actin CArG box for formation of either the SRF-SRE or the CBF CArG complex. The symmetric inverted repeat of the left side of the Xenopus cytoskeletal actin SRE also competed, even more strongly, for each complex. The site-specific binding of each protein was inhibited both by orthophenanthroline, whose effects were reversed by zinc addition, and by treatment with potato acid phosphatase. Furthermore, immune serum raised against the c-fos SRF also recognized the actin CBF. We discuss how transcriptional control of these diverse genes might be obtained with a single similar factor. PMID- 2710115 TI - High-resolution mapping of replication fork movement through the amplified dihydrofolate reductase domain in CHO cells by in-gel renaturation analysis. AB - Utilizing an in vivo labeling method on synchronized cultures, we have previously defined a 28-kilobase (kb) replication initiation locus in the amplified dihydrofolate reductase domain of a methotrexate-resistant Chinese hamster ovary cell line (CHOC 400) (N. H. Heintz and J. L. Hamlin, Proc. Natl. Acad. Sci. USA 79:4083-4087, 1982; N. H. Heintz and J. L. Hamlin, Biochemistry 22:3552-3557, 1983; N. H. Heintz, J. D. Milbrandt, K. S. Greisen, and J. L. Hamlin, Nature [London] 302:439-441, 1983). To locate the origin of replication in this 243-kb amplicon with more precision, we used an in-gel renaturation procedure (I. Roninson, Nucleic Acids Res. 11:5413-5431, 1983) to examine the labeling pattern of restriction fragments from the amplicon in the early S phase. This method eliminates background labeling from single-copy sequences and allows quantitation of the relative radioactivity in individual fragments. We used this procedure to follow the movement of replication forks through the amplicons, to roughly localize the initiation locus, and to estimate the rate of fork travel. We also used a slight modification of this method (termed hybridization enhancement) to illuminate the labeling pattern of smaller restriction fragments derived solely from the initiation locus itself, thereby increasing resolution. Our preliminary results suggest that there are actually two distinct initiation sites in the amplicon that are separated by approximately 22 kb. PMID- 2710116 TI - Replication in the amplified dihydrofolate reductase domain in CHO cells may initiate at two distinct sites, one of which is a repetitive sequence element. AB - To study initiation of DNA replication in mammalian chromosomes, we have established a methotrexate-resistant Chinese hamster ovary cell line (CHOC 400) that contains approximately 1,000 copies of the early replicating dihydrofolate reductase (DHFR) domain. We have previously shown that DNA replication in the prevalent 243-kilobase (kb) amplicon type in this cell line initiates somewhere within a 28-kb region located downstream from the DHFR gene. In an attempt to localize the origin of replication with more precision, we blocked the progress of replication forks emanating from origins at the beginning of the S phase by the introduction of trioxsalen cross-links at 1- to 5-kb intervals in the parental double-stranded DNA. The small DNA fragments synthesized under these conditions (which should be centered around replication origins) were then used as hybridization probes on digests of cosmids and plasmids from the DHFR domain. These studies suggested that in cells synchronized by this regimen, DNA replication initiates at two separate sites within the previously defined 28-kb replication initiation locus, in general agreement with results described in the accompanying paper (T.-H. Leu and J. L. Hamlin, Mol. Cell. Biol. 9:523-531, 1989). One of these sites contains a repeated DNA sequence element that is found at or near many other initiation sites in the genome, since it was also highly enriched in the early replicating DNA isolated from cross-linked CHO cells that contain only two copies of the DHFR domain. PMID- 2710117 TI - Differential regulation of rat beta-casein-chloramphenicol acetyltransferase fusion gene expression in transgenic mice. AB - Previous studies in our laboratory have demonstrated the mammary-specific expression of the entire rat beta-casein gene with 3.5 kilobases (kb) of 5' and 3.0 kb of 3' DNA in transgenic mice (Lee et al., Nucleic Acids Res. 16:1027-1041, 1988). In an attempt to localize sequences that dictate this specificity, lines of transgenic mice carrying two different rat beta-casein promoter-bacterial chloramphenicol acetyltransferase (cat) fusion genes have been established. Twenty and eight lines of transgenic mice carrying two fusion genes containing either 2.3 or 0.5 kb, respectively, of 5'-flanking DNA of the rat beta-casein gene along with noncoding exon I and 0.5 kb of intron A were identified, most of which transmitted the transgenes to their offspring in a Mendelian pattern. CAT activity was detected predominantly in the lactating mammary gland of female transgenic mice but not in the male mammary fat pad. A several-hundred-fold variation in the level of cat expression was observed in the mammary gland of different lines of mice, presumably due to the site of integration of the transgenes. CAT activity was increased in the mammary gland during development from virgin to midpregnancy and lactation. Unexpectedly, the casein-cat transgenes were also expressed in the thymus of different lines of both male and female mice, in some cases at levels equivalent to those observed in the mammary gland, and in contrast to the mammary gland, CAT activity was decreased during pregnancy and lactation in the thymus. Thus, 0.5 kb of 5'-flanking DNA of the rat beta-casein gene along with noncoding exon I and 0.5 kb of intron A are sufficient to target bacterial cat gene expression to the mammary gland of lactating mice. PMID- 2710118 TI - Opposite replication polarity of the germ line c-myc gene in HeLa cells compared with that of two Burkitt lymphoma cell lines. AB - To study the cell type specificity of the direction of replication of the human c myc genes and the relationship of replication polarity to transcriptional activity, we analyzed the directions of replication of the c-myc genes in two Burkitt lymphoma cell lines, CA46 and ST486, and in HeLa cells. On the basis of in vitro runoff replication of forks initiated in intact cells, we found that transcribed c-myc genes in the germ line configuration in HeLa cells were replicated in the direction of transcription from origins in the 5'-flanking DNA, while the repressed, unrearranged c-myc genes of CA46 and ST486 cells were replicated in the antitranscriptional direction. In contrast, the transcribed c myc genes of CA46 cells were replicated in the transcriptional direction, while the translocated, amplified c-myc genes of ST486 cells showed no preferred polarity of replication. The data also provided evidence for the existence of an endogenous barrier to DNA polymerases in the flanking DNA immediately 5' to the HeLa c-myc genes. PMID- 2710119 TI - Chimeric 3-hydroxy-3-methylglutaryl coenzyme A reductase-dihydrofolate reductase genes display bidirectional expression and unidirectional regulation in stably transfected cells. AB - We have constructed hybrid dihydrofolate reductase (DHFR) genes which are controlled by the sterol-responsive hamster 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase promoter. Stable transfection frequencies of these chimeric templates into a DHFR-deficient Chinese hamster cell line indicate that the HMG CoA reductase promoter fragment confers DHFR transformation irrespective of its orientation relative to a downstream murine DHFR cDNA. Sterol-regulated levels of DHFR RNA and protein are detected from hybrid genes which carry a properly oriented promoter fragment. Constructions which invert this HMG CoA reductase promoter, however, generate DHFR RNA levels which do not respond to sterols. In the context of these transfected fusion genes, we present evidence of divergent opposite-strand transcription initiating from the HMG CoA reductase 5' fragment. In contrast, the endogenous HMG CoA reductase promoter region shows no apparent evidence of such bidirectional activity. PMID- 2710120 TI - Definition of the human raf amino-terminal regulatory region by deletion mutagenesis. AB - Activation of transforming potential of the cellular raf gene has uniformly been associated with the deletion of amino-terminal coding sequences. In order to determine whether 5' truncation alone could activate cellular raf, we constructed 21 human c-raf-1 cDNAs with variable BAL 31-generated deletions distal to a Moloney murine sarcoma virus long terminal repeat and a consensus translation initiation sequence. The deletions ranged from 136 to 1,399 nucleotides of coding sequence and shortened the 648-amino-acid raf protein by 44 to 465 amino acids. The full-length c-raf-1 cDNA was nontransforming upon transfection of NIH 3T3 cells, as were four mutants with deletions of 142 or fewer amino acids. Seven of nine mutants with deletions of 154 to 273 amino acids induced transformation with efficiencies ranging from 0.25 to 70 foci per micrograms of DNA. Mutants with deletions of 303 to 324 amino acids displayed high transforming activities (comparable with that of v-raf), with a peak activity of 2,400 foci per microgram of DNA when 305 amino acids were deleted. Deletions of greater than 383 amino acids, extending into the raf kinase domain, lacked transforming activity. Northern (RNA) blotting and immunoprecipitation assays indicated that transfected NIH cells expressed raf RNAs and proteins of the expected sizes. Thus, 5' truncation alone can activate raf transforming potential, with a sharp peak of activation around amino acid 300. Analysis of three raf genes previously detected by transfection of tumor DNAs indicated that these genes were activated by recombination in raf intron 7 and encoded fusion proteins containing amino terminal non-raf sequences. The extend of deletion of raf sequences in these recombinant genes corresponded to BAL 31 mutants which did not display high transforming activity, suggesting that the fused non-raf coding sequences may also contribute to biological activity. PMID- 2710121 TI - Physical linkage of mouse lambda genes by pulsed-field gel electrophoresis suggests that the rearrangement process favors proximate target sequences. AB - The first complete map of a mammalian immunoglobulin gene locus is presented. Mouse lambda genes were mapped by pulsed-field gel electrophoresis. The gene order is V2-Vx-C2-C4-V1-C3-C1. The distance between V2 or Vx and the C2-C4 cluster is 74 or 55 kilobases (kb), respectively, whereas that between V1 and C3 C1 is only 19 kb; V2 and C3-C1 are at least 190 kb apart. Thus, the distances between the lambda subloci are inversely proportional to their frequencies of rearrangement. The related gene lambda 5 is not within the 500 kb of the lambda locus mapped here. PMID- 2710122 TI - Octamer transcription factors 1 and 2 each bind to two different functional elements in the immunoglobulin heavy-chain promoter. AB - Immunoglobulin heavy-chain genes contain two conserved sequence elements 5' to the site of transcription initiation: the octamer ATGCAAAT and the heptamer CTCATGA. Both of these elements are required for normal cell-specific promoter function. The present study demonstrates that both the ubiquitous and lymphoid cell-specific octamer transcription factors (OTF-1 and OTF-2, respectively) interact specifically with each of the two conserved sequence elements, forming either homo- or heterodimeric complexes. This was surprising, since the heptamer and octamer sequence motifs bear no obvious similarity to each other. Binding of either factor to the octamer element occurred independently. However, OTF interaction with the heptamer sequence appeared to require the presence of an intact octamer motif and occurred with a spacing of either 2 or 14 base pairs between the two elements, suggesting coordinate binding resulting from protein protein interactions. The degeneracy in sequences recognized by the OTFs may be important in widening the range over which gene expression can be modulated and in establishing cell type specificity. PMID- 2710123 TI - Proteins binding to site C2 (muE3) in the immunoglobulin heavy-chain enhancer exist in multiple oligomeric forms. AB - We describe the purification to near homogeneity of proteins binding to site C2 (muE3) in the immunoglobulin heavy-chain enhancer. Proteins binding to this site produce four protein-DNA complexes which are distinguished by their mobility in gel retardation assays and their elution properties in an anion exchange column. DNA affinity-purified preparations of three chromatographically separated pools, containing different subsets of the four complexes, each contained three polypeptides of 42.5, 44, and 45 kilodaltons (kDa). UV crosslinking of protein to enhancer DNA demonstrated that site C2-binding activities in the three different pools bound DNA through proteins of similar sizes (about 45 kDa), even though the protein-DNA complexes formed by these binding activities were quite distinct. Gel exclusion chromatography and equilibrium binding analyses indicated that the distinct protein-DNA complexes were due to different oligomeric forms of the individual subunits and that a larger multimeric form bound with high affinity to the heavy-chain enhancer site C2, while a smaller species had a much lower affinity for heavy-chain enhancer sequences. Purified protein has been used to map high-affinity binding sites for site C2-binding proteins within an immunoglobulin heavy-chain promoter and at site KE3 in the kappa light-chain enhancer. PMID- 2710124 TI - Dual functions of a cis-acting element within the rat prolactin gene promoter. AB - Within the promoter region of the rat prolactin gene lies a TA-rich imperfect palindrome. The possible functions of the 18-base-pair symmetrical sequence were investigated by using an in vitro transcription system. Prolactin templates with and without the palindrome were transcriptionally assayed in both pituitary and nonpituitary extracts. Our results indicated that the palindromic sequence has at least two functions in the regulation of prolactin transcription. PMID- 2710125 TI - Methylation of replicating and nonreplicating DNA in the ciliate Tetrahymena thermophila. AB - Methylation of adenine in replicating and nonreplicating DNA of the ciliate Tetrahymena thermophila was examined. In growing cells, 87% of the methylation occurred on the newly replicated daughter strand, but methylation was also detectable on the parental strand. Methylation of nonreplicating DNA from starved cells was demonstrated. PMID- 2710126 TI - Structural organization of upstream exons and distribution of transcription start sites in the chicken c-myb gene. AB - We mapped and sequenced three upstream exons of the chicken c-myb gene and the regions flanking the first coding exon. We found multiple potential binding sites for transcription factors in the 5'-noncoding region, a T-rich stretch of 78 base pairs (bp) (68% T) in the first intron, and four fairly long open reading frames in the antisense direction of the first coding exon and its flanking regions. Three major transcription start sites, contained within a single 11-bp region, were identified by S1 nuclease analysis and primer extension. A sequence comparison of the avian and murine c-myb genes revealed a highly conserved sequence of 124 bp in the 5'-noncoding region. Its location between the putative transcription factor binding sites and the major transcription start sites suggests that it may play an important regulatory role in c-myb expression. PMID- 2710127 TI - Induction of beta-polymerase mRNA by DNA-damaging agents in Chinese hamster ovary cells. AB - Only a few of the genes involved in DNA repair in mammalian cells have been isolated, and induction of a DNA repair gene in response to DNA damage has not yet been established. DNA polymerase beta (beta-polymerase) appears to have a synthetic role in DNA repair after certain types of DNA damage. Here we show that the level of beta-polymerase mRNA is increased in CHO cells after treatment with several DNA-damaging agents. PMID- 2710128 TI - Transforming growth factor alpha: an aromatic side chain at position 38 is essential for biological activity. AB - Site-directed mutagenesis has been performed in the human transforming growth factor alpha gene. When tyrosine 38 is mutated into phenylalanine or tryptophane, biological activity is retained. In contrast, other alterations between cysteine 34 and cysteine 43 and disruption of disulfide bonds 8 to 21 and 34 to 43 resulted in loss of activities. The presence of an aromatic side chain at position 38 of transforming growth factor alpha seems to be essential for its activity. PMID- 2710129 TI - Cell cycle regulation of H2b histone octamer DNA-binding activity in Chinese hamster lung fibroblasts. AB - The promoter regions of H2b histone genes contain a 14-base-pair element which includes the octamer ATTTGCAT. Mutational analysis has implicated the octamer element in the cell cycle-dependent expression of H2b histone genes. In this report, we address the question of whether the DNA-binding activity of the octamer transcription factor is itself cell cycle regulated. By using a gel mobility shift assay, we measured the relative amounts of octamer-binding activity during various phases of the cell cycle in serum-synchronized Chinese hamster fibroblasts. We found that the activity increased approximately fivefold between late G1 phase and early S phase and then decreased threefold between late S phase and G2 phase. These cell cycle-dependent changes in octamer DNA-binding activity may in part account for the selective transcription of H2b histone genes in late G1 and S phases. PMID- 2710130 TI - Elevated expression of basic fibroblast growth factor messenger ribonucleic acid in acoustic neuromas. AB - Human tumors were analyzed for the presence of mRNA coding for basic fibroblast growth factor (basic FGF). Basic FGF transcript levels were consistently elevated in schwannoma samples (five acoustic neuromas and two spinal schwannomas) ranging from 9- to 22-fold higher than the average level of expression in four benign meningioma samples. Acidic extracts of acoustic neuromas contained a potent mitogen which bound to heparin-Sepharose, eluted at 2 M NaCl, and cross-reacted with an N-terminal specific anti-basic FGF antiserum. The present findings indicate that basic FGF appears to be the major heparin-binding endothelial cell mitogen in acoustic neuromas. Southern restriction analysis revealed no evidence of amplification or rearrangement of the gene for basic FGF in schwannomas or in the astrocytoma cell line U87-MG. These findings demonstrate a tumor-specific elevation in basic FGF transcript levels in tumors of Schwann cell origin and suggest that increased transcription or stabilization of basic FGF mRNA may play an autocrine role in the development and progression of these tumors. PMID- 2710131 TI - Mutations in signal sequence cleavage domain of preproparathyroid hormone alter protein translocation, signal sequence cleavage, and membrane-binding properties. AB - Signal sequences, known to mediate the targeting of nascent secreted proteins to membranes, share common structural domains: a positively charged amino-terminus, a hydrophobic core, and a signal cleavage domain. Mutations have been introduced into the cDNA encoding the signal sequence of the mammalian protein preproparathyroid hormone to analyze the roles played by the signal cleavage domain in secretion. Two mutant genes were constructed missing the entire six residue propeptide sequence and several residues of the signal cleavage domain. The effects of these mutations on signal function were assessed after expression in clonal cell lines and in a transcription-linked translation system. Alterations in the signal cleavage domain resulted in reduced translocation and signal cleavage. Furthermore, in one mutant, the removal of the signal cleavage domain converted the signal into a membrane anchor sequence. The nonhydrophobic sequences at the end of the signal sequence thus crucially affect the translocation, cleavage, and membrane-binding properties of signal sequences. PMID- 2710132 TI - Region-specific antiglucocorticoid receptor antibodies selectively recognize the activated form of the ligand-occupied receptor and inhibit the binding of activated complexes to deoxyribonucleic acid. AB - A synthetic 18-amino acid peptide (Cys500-Lys517) was used to raise polyclonal antibodies in rabbits to the glucocorticoid receptor (GR). The sequence of this peptide is identical to that of residues 500-517 of the rat and 481-498 of the human GR. This sequence overlaps the carboxy-terminal end of the core DNA-binding domain and the amino-terminus of the hinge region of the receptor. Antiserum (AP64) was obtained which recognized both human and rat GR, as determined by immunoblots of receptors immunopurified with authentic anti-GR antibodies, immunoadsorption of both specific [3H]dexamethasone-bound GR and 98K receptors that were specifically covalently labeled by [3H]dexamethasone mesylate, and AP64 induced shifts in the elution position of monomeric [3H]dexamethasone-bound GR from Sephacryl S-300. The specificity of AP64 was demonstrated by the ability of the immunizing peptide, but not a peptide of similar length, to inhibit both the antibody-induced change in elution position from Sephacryl S-300 and the antibody mediated immobilization of [3H]dexamethasone-bound complexes by protein-A. Further studies indicated that AP64 did not react with native steroid-free GR or with steroidbound (or affinity-labeled) unactivated GR, but did selectively associated with monomeric activated, steroid-bound (or affinity labeled) complexes. AP64 also inhibited the DNA binding of activated complexes in a manner that was specifically blocked by the immunizing peptide. Collectively, these data allow the direct localization of a structural region of the GR that is occluded in the unactivated complex but exposed as a result of activation. PMID- 2710133 TI - Binding of transforming growth factor-beta to cell surface proteins varies with cell type. AB - Transforming growth factor-beta (TGF beta 1 and TGF beta 2) bind to several different cell surface proteins, including a high Mr proteoglycan. We found that on primary and early passage cultures of fibroblasts, chondroblasts, and osteoblasts TGF beta 1 binds to both the high Mr proteoglycan and to lower Mr components, whereas on epithelial, endothelial, and lymphoid-derived cells TGF beta 1 only binds to the lower Mr species. With cell lines, this distinction is lost. Further analysis indicated that binding to the high Mr proteoglycan is not necessary for TGF beta 1 induced regulation of DNA, collagen and fibronectin synthesis, change in cell morphology, or reorganization of the actin cytoskeleton. We propose that the lower Mr components are the active receptors mediating these events. PMID- 2710134 TI - Developmental regulation of rat brain/Hep G2 glucose transporter gene expression. AB - The developmental regulation of rat brain-derived/Hep G2 glucose transporter gene expression was studied by means of Northern blot hybridization, using a rat brain glucose transporter cDNA probe, in order to directly quantify steady state glucose transporter mRNA levels. The results obtained showed different tissue specific patterns of glucose transporter mRNA levels during ontogenesis; while in brain there was a sustained increase in the levels of the message from 20 days embryogenesis until 50 days postnatal, other organs such as heart, lung, liver, and muscle expressed maximal levels of the glucose transporter mRNA in 20-day fetuses and 1-day neonates, decreasing subsequently to very low levels. The relative expression of the glucose transporter mRNA in the different tissues, at both fetal and adult stages, was analyzed using a solution hybridization-RNase protection assay. This approach revealed that, while the heart expresses the highest levels of glucose transporter mRNA at 20 days of fetal life, the brain shows the highest levels at the adult stage. These results indicate a tissue specific ontogenic pattern of glucose transporter gene expression, suggesting a developmental role for this glucose transporter gene product. PMID- 2710135 TI - Nucleotide sequence of the DNA complementary to avian (chicken) preproparathyroid hormone mRNA and the deduced sequence of the hormone precursor. AB - The nucleotide sequence of avian (chicken) prepro-PTH (prepro-PTH) mRNA was determined from a 2.3-kilobase fragment of complementary chicken parathyroid DNA cloned in E. coli MM 924. Northern blot analysis of chicken parathyroid mRNA, using both bovine and chicken cDNA probes, showed that the mRNA (2.3 kilobases) for chicken hormone precursor was approximately 3 times the size of mRNA for mammalian prepro-PTH. Cleavage of the cloned DNA with restriction endonuclease Pstl resulted in three fragments, each of which was subjected to sequence determination. The hormone sequence deduced from the DNA showed that chicken prepro-PTH mRNA encoded a 119-amino acid precursor which included a 25-amino acid signal sequence, a six-residue prohormone peptide, and an 88-amino acid hormone. The hormonal peptide was four residues longer than all known mammalian homologs and included gene deletions and insertions. There was significant homology of sequence in the biologically active 1-34 region with mammalian hormones, but much less in the middle and carboxyl-terminal regions. This is the first nonmammalian PTH sequence to be determined and should prove useful in studying evolution of the gene as well as structure-function relationships of the hormone. PMID- 2710136 TI - The glucocorticoid antagonist 17 alpha-methyltestosterone binds to the 10 S glucocorticoid receptor and blocks agonist-mediated dissociation of the 10 S oligomer to the 4 S deoxyribonucleic acid-binding subunit. AB - The glucocorticoid antagonist 17 alpha-methyltestosterone inhibits binding of the agonist [3H]triamcinolone acetonide ot the glocucorticoid receptor in cytosol prepared from rat pituitary tumor GH1 cells. Competitive binding studies indicate that the dissociation constant for 17 alpha-methyltestosterone is about 1 microM. After incubation of intact GH1 cells with 10 nM [3H]triamcinolone acetonide at 37 C and subsequent cell fractionation at 4 C, three glucocorticoid receptor forms are observed: cytosolic 10 S receptor, cytosolic 4 S receptor, and nuclear receptor. Concurrent incubation with 17 alpha-methyltestosterone reduces the amount of [3H]triamcinolone acetonide bound to each of these receptor forms. Ligand-exchange assays performed at 0 C in intact cells using [3H]triamcinolone acetonide show that the exchangeable antagonist is associated predominantly with cytosolic 10 S receptor. Immunochemical analysis using monoclonal antibody BuGR2 indicates that 17 alpha-methyltestosterone does not cause substantial accumulation of glucocorticoid receptors in GH1 cell nuclei and, when present together with agonist, reduces nuclear accumulation of receptor seen with agonist alone. Results from dense amino acid labeling studies show that unlike [3H]triamcinolone acetonide, 17 alpha-methyltestosterone does not reduce the total amount of cellular glucocorticoid receptor and does not reduce receptor half-life. These results are consistent with a model for glucocorticoid receptor transformation in which binding of agonist promotes the dissociation of an oligomeric 10 S cytosolic receptor protein to its DNA-binding 4 S subunit. The antagonist 17 alpha-methyltestosterone competes with agonist for binding to the 10 S cytosolic receptor but does not appear to promote dissociation of the oligomer, thus inhibiting agonist-mediated nuclear actions of the glucocorticoid receptor. PMID- 2710137 TI - Hormone-induced changes in the in vitro DNA-binding activity of the chicken progesterone receptor. AB - Previous analyses have indicated that steroid hormone receptors undergo an allosteric change in structure upon binding by the steroid ligand. This structural change was envisioned as an intramolecular unmasking of the protein's DNA-binding domain, thus allowing the receptor to function in gene regulation. We report an analysis of the effect of hormone on the DNA-binding activity of the chicken progesterone receptor. Using an isocratic elution of DNA affinity columns we show that unliganded receptor (aporeceptor) can bind a 23-basepair progesterone response element with high affinity and a high degree of sequence preference. Hormone causes a 1.5-fold increase in affinity for the PRE sequence and a 2-fold decrease in affinity for non-specific DNA. Kinetic analysis of the off-rate of receptor-DNA complexes is consistent with this minor effect of hormone. In addition, gel retardation analysis of receptor-progesterone response element complexes further substantiates that hormone is not required for sequence specific DNA binding. These results indicate that hormone is not necessary for the progesterone receptor to fold into a conformation that recognizes specific gene regulatory sequences. PMID- 2710138 TI - The effects of a constitutive expression of transforming growth factor-alpha on the growth of MCF-7 human breast cancer cells in vitro and in vivo. AB - It has been suggested that transforming growth factor-alpha (TGF-alpha) is a mitogenic autocrine growth factor for human breast cancer cells, responsible for mediating the mitogenic effects of 17 beta-estradiol (E2) in responsive cells. To test this hypothesis we have introduced eukaryotic expression vectors directing the expression of TGF-alpha mRNA into E2-responsive MCF-7 human breast cancer cells. Transfected cells produce levels of TGF-alpha equivalent to or greater than those produced by both E2-stimulated MCF-7 cells and hormone-independent MDA MB-231 cells. One transfected clone (H8) secretes sufficient TGF-alpha to fully down-regulate EGF-R expression. However, both of the transfected clones that constitutively secrete elevated levels of TGF-alpha (A8 and H8) respond to E2 stimulation in vitro by increasing the rate of cellular proliferation and inducing PGR synthesis. The basal proliferative capacity of H8 and A8 cells is equivalent to that of the parental cells and to cells transfected only with the G418 (neomycin) resistance gene. Furthermore, the TGF-alpha cDNA-transfected clones do not form tumors in ovariectomized athymic nude mice without E2 supplementation. Thus, the precise role of TGF-alpha in mediating either the in vivo or the in vitro mitogenic effects of E2 in MCF-7 human breast cancer cells remains unclear. While TGF-alpha expression may be essential, it is not sufficient alone to induce the fully E2-independent phenotype. Thus, TGF-alpha may function in combination with other E2-induced growth factors to control breast cancer proliferation and tumorigenesis. PMID- 2710139 TI - Expression of three forms of thyroid hormone receptor in human tissues. AB - At least two thyroid hormone receptor (hTR) genes are present in humans, but the significance of this multiplicity is unknown. These receptors could have differences in tissue distribution or possess different functions. We studied the distribution and abundance of three hTR mRNAs (hTR beta, hTR alpha 1, and hTR alpha 2) by Northern blot analysis. Three mRNAs were expressed in all tissues examined. hTR beta was strongly expressed in brain and prostate predominantly as a 10.0-kilobase (kb) mRNA. This mRNA was also expressed in thyroid and was much less abundant in liver, kidney, placenta, tonsil, and spleen. hTR alpha 1 is represented by two mRNAs with sizes of 6.0 and 3.2 kb. The 6.0-kb mRNA was constantly less abundant than the 3.2-kb mRNA. hTR alpha 2 was detected as a single mRNA with a size of 3.2 kb, using a probe unique for this mRNA. Both hTR alpha 1 and hTR alpha 2 were strongly expressed in brain, prostate, and thyroid and much less in other tissues. The relative amounts of the three hTR mRNAs were roughly parallel in each tissue. It is of interest that none of these hTRs was abundant in liver, which is the major thyroid hormone-responsive organ. Another hTR may be present in liver. PMID- 2710140 TI - Rat corticosteroid binding globulin: primary structure and messenger ribonucleic acid levels in the liver under different physiological conditions. AB - Rat corticosteroid binding globulin (CBG) cDNAs were isolated from a lambda gt11 liver cDNA library. When rat hepatic mRNA was hybrid selected and translated in vitro, a major product reacted with antibodies against rat CBG and its Mr (approximately 43,000) was consistent with a nonglycosylated, CBG precursor polypeptide. Two overlapping cDNAs produced a 1,432 nucleotide sequence with an open reading frame comprising 396 amino acids. This includes a potential signal peptide of 22 residues followed by the amino terminus of purified rat CBG. Rat CBG therefore contains 374 amino acids (Mr = 42,196), and has six consensus sites for N-glycosylation. There is 60% identity in the primary structures of rat and human CBG over 383 residues that comprise the human sequence. Furthermore, the single cysteine in rat CBG corresponds to one of two cysteines in human CBG, and this may be significant because a cysteine is located in the human CBG steroid binding site. Northern analysis of RNA from various rat tissues revealed an approximate 1.8 kilobase CBG mRNA only in the liver. Its relative abundance in a pregnant rat was only 30% higher than in an adult female; approximately 3-fold higher than in an adult male, and 25-fold higher than in the fetuses from the same animal. Southern analysis of rat genomic DNA suggests the presence of a single gene for CBG. PMID- 2710141 TI - The molecular cloning of the complementary deoxyribonucleic acid for bovine vitamin D-dependent calcium-binding protein: structure of the full-length protein and evidence for homologies with other calcium-binding proteins of the troponin-C superfamily of proteins. AB - We have cloned the cDNA for bovine intestinal vitamin D-dependent calcium-binding protein and, based on the sequence of the DNA, have deduced the structure of the full-length protein. The sequence of the cDNA clone predicts a protein comprised of 78 amino acids with a mol wt of 8788. The mRNA for the protein in bovine duodenum is about 500-600 bases in length. The protein sequence of bovine intestinal calcium-binding protein is 87% homologous with the sequence of porcine intestinal vitamin D-dependent calcium-binding protein and 81% homologous with the sequence of rat intestinal vitamin D-dependent calcium-binding protein. Hydrophilicity plots of the proteins noted above show that despite differences in amino acid sequence the proteins have similar patterns. In addition, the predicted secondary structure of the proteins is similar. Bovine intestinal calcium-binding protein shows 48.6% homology with the alpha-chain and 38.2% homology with the beta-chain of bovine S-100 protein and a similar high degree of homology with the beta-chain of human S-100 protein. The protein also demonstrates 36-43% homology with parvalbumin alpha and beta from various species and with troponin-C. There is some homology with the 28K vitamin D-dependent calcium-binding proteins. Vitamin D-dependent bovine intestinal calcium-binding protein is closely related to other mammalian intestinal calcium-binding proteins and to the S-100 proteins, parvalbumins, and troponin-C. PMID- 2710142 TI - Hereditary increased muscle mechanical irritability and progressive contracture with stretch-induced electromyographic activity. AB - A son and mother are reported with autosomal dominantly transmitted painless, increased mechanical irritability in the limb and trunk muscles and progressive finger contracture. Immediately after a tap, muscle swelling appeared. With light tapping, wavelike muscle surface movements appeared. Progressive contractures developed first in the proximal interphalangeal finger joints and subsequently involving the lower arm muscles. The contractures disappeared in the local curare test. No spontaneous activity was recorded on concentric needle recording. Serial repetitive activity was recorded with fine wire electrode recording, induced by muscle stretch, performed by percussion hammer blows or by prolonged finger grasp. A slight, irritative peripheral nervous lesion could be the cause. The chronic sensorimotor polyneuropathy may be also a part of the syndrome. PMID- 2710143 TI - Proportions and sizes of muscle fiber types in the hamster diaphragm. AB - This study demonstrated that there was interanimal and interregional variability of proportions and sizes of the muscle fiber types in the hamster diaphragm. Muscle fiber type proportions and sizes were determined for each side (right, left), surface (abdominal, thoracic), and region (sternal, anterior costal, posterior costal, crural) in six hamsters. There was marked regional and surface to-surface variability and some interanimal variability in proportions and sizes of fiber type within the hamster diaphragm. The sternal and costal regions were relatively homogeneous. However, there were differences in both proportions and sizes of fiber types between the thoracic surface of the crural region and the abdominal surface of the crural region. These two surfaces of the crural region differed from the rest of the diaphragm. For muscle fiber type proportions, type 2a fibers demonstrated the most interanimal variability. Muscle fiber size varied little between animals. PMID- 2710144 TI - Ankle dorsiflexor twitch properties in malignant hyperthermia. AB - A noninvasive method to diagnose malignant hyperthermia (MH) was sought. To this end, in vivo isometric twitch properties of the ankle dorsiflexor muscles were studied in three groups: (1) MH-susceptible patients (n = 12), (2) relatives (n = 12) of MH-susceptible patients who were judged to be MH resistant, and (3) a group of normal volunteers (n = 42) chosen from the community. Twitch properties were studied under resting state conditions and with 1 or 2 Hz stimulation to produce the negative staircase twitch response. There was a high degree of overlap between the ranges of the measured twitch parameters of all groups. Thus, the techniques presented in this study have no value in diagnosing susceptibility to MH. Several physiological features of human isometric twitch properties were demonstrated: (1) slowing of twitch speed with advancing age, (2) strong positive correlation between body weight and twitch torque, and (3) a negative staircase response typical of that described in other mammalian twitch studies. PMID- 2710145 TI - Recording sound from human skeletal muscle: technical and physiological aspects. AB - In order to examine technical factors that influence muscle sound recording, single twitches of muscle were utilized since their waveforms were likely to be reproducible. We observed that satisfactory recordings could be made with either Archer air interface, or Hewlett-Packard direct contact sensor, microphones. Firm contact and stability between the microphone and the skin surface were particularly important. Frequencies below 20 Hz, the lower limit of the human auditory range, must be recorded, since they account for at least 90% of the power of the muscle sound wave. The chief frequencies were below 4 Hz. The sound wave produced by a maximal twitch of human thenar muscle induced by median nerve stimulation at the wrist is maximal in amplitude over the center and recedes to near zero at the margins of the muscle. It is preceded by the muscle compound action potential and is followed by the force curve, recorded with a strain gauge attached to the thumb. The sound resembles force in total time course, and it increases with increasing strengths of nerve stimulation. However, it differs in its latency, phase relationships, and response to nerve stimulation at different frequencies. Some of the features of muscle sound suggest it relates to both the active contractile and the parallel elastic components of muscle during a twitch contraction, but not the series elastic component. PMID- 2710146 TI - Evaluation of an automatic method of measuring features of motor unit action potentials. AB - This study was performed to evaluate an automatic method of motor unit action potential (MUAP) analysis developed in our laboratory. MUAPs were recorded from the biceps brachii muscle of 68 normal subjects and 122 patients with nerve or muscle disease. The values of mean MUAP durations from normal subjects obtained by automatic analysis were similar to those reported in the literature. However, the normal range of MUAP amplitude and the incidence of polyphasic MUAPs were much higher. Normal ranges of mean MUAP area, area/amplitude ratio, and the number of turns were also defined. Automatic analysis demonstrated an abnormality of at least one MUAP feature in 70% of patients. There was concordance between automated analysis and visual assessment of MUAPs in 76% of patients with neuropathy but in only 50% of patients with myopathy. The relationships between different MUAP features seen in neuropathy and myopathy are explained in physiologic terms. PMID- 2710147 TI - Fibrillatory activity and other membrane changes in partially denervated muscles. AB - Rat soleus muscles were partially or totally denervated by sectioning the radicular nerve L5 or the radicular nerves L3 through L6, respectively. Three days after these procedures, fibrillation potentials were not observed in the case of partial denervation, whereas they were clearly detectable after total denervation. At later times, spontaneous spike activity also developed in the partially denervated muscles. The difference in time of onset of fibrillation between partially and totally denervated muscles was confirmed by a more gradual increase in the number of acetylcholine receptors and a greater sensitivity to tetrodotoxin of the former muscles. These differences between partially and totally denervated muscles are interpreted on the basis of the different amounts of nerve breakdown products generated in the two situations. PMID- 2710148 TI - Tunisian severe childhood muscular dystrophy: a normal spinal cord and anterior horn neurons. PMID- 2710149 TI - Brachial plexus neuropathy. PMID- 2710150 TI - Myoadenylate deaminase deficiency: fact and fancy. PMID- 2710151 TI - The single-fiber EMG in the Lambert-Eaton myasthenic syndrome. PMID- 2710152 TI - Myotonic mice: effects of tubocurarine on muscle contractility. PMID- 2710153 TI - Muscle function in patients with primary hyperparathyroidism. AB - The muscle contraction of the anterior tibial muscle was investigated by measurements of electrically stimulated and computer-analyzed muscle twitches in 18 unselected patients with primary hyperparathyroidism (HPT) and in 20 healthy control persons. The HPT patients had a lower muscle twitch tension (TT) at single stimulation, compared with the control group [76 +/- 24 N (SD) and 99 +/- 33 N respectively, P less than 0.05]. At high-frequency stimulation the difference in muscle force increased, and at 20 Hz stimulation the force in the HPT patients was 73% of that in the controls (P less than 0.01). There were no differences between the HPT patients and the control persons in neither contraction time nor half relaxation time at single muscle twitch nor in twitch potentiation after 20 and 90 seconds maximal voluntary contraction. The results indicate that patients with primary HPT have an impaired muscle function of probable importance for their symptoms of weakness and generalized fatigue. PMID- 2710154 TI - Central core disease: ultrastructure of the sarcoplasmic reticulum and T-tubules. AB - The modified Golgi staining method was used to study the sarcoplasmic reticulum (SR) and t- tubules of skeletal muscle in central core disease. Significant pathological changes were documented in both of these organelles in seven patients. Pathological changes were seen in both core and non-core regions, with the abnormalities being greatest in the cores. In noncore regions, distortions in the normal anatomy were minor. In cores, there was much more significant distortion of the normal anatomy and also an increase in the amount of SR and number of t-tubules. PMID- 2710155 TI - Pityriasis versicolor--epidemiological and therapeutical study. AB - Seventy-six patients with extensive pityriasis versicolor were divided into 3 groups and treated orally with ketoconazole, 200 mg daily, for 10, 20 or 30 days respectively. 50 patients out of this number completed the study. After 6 months, 46 patients were checked up. Eight of them developed relapses effectively treated with ketoconazole for another 15 days. Six out of these 8 patients belonged to the first group using ketoconazole for 20 days only. On the basis of this observation, we do not consider a 10 days' treatment to be sufficient and recommend that the patient should be treated for at least 20 days. As a preventive measure we recommend a daily bath with salicylic acid and sulphur soap. The frequency of the infection was higher in males (71.4%) than in females (28.6%). The youngest of the male patients was 4 months of age and the oldest 70 years. The youngest female was 4 months old and the oldest 50 years. Pityriasis versicolor was found to be predominant in the age group of 21--30 years. The sites most commonly involved were back, chest and the upper extremities. PMID- 2710156 TI - Dermatomycosis in dogs. AB - During the routine examination of dogs for cutaneous lesions, 205 dogs were screened for fungi other than dermatophytes. Twenty-two dogs (10.8%) revealed the presence of non-dermatophytic fungi suspicious for representing the etiologic agents of the skin lesions. The fungi isolated were Alternaria sp. (2.9%), Penicillium sp. (2.4%), Aspergillus fumigatus (2.0%), Mucor sp. (1.5%), Cladosporium sp. (1.5%) and Fusarium sp. (0.5%). No dermatophyte was isolated in association with these fungi. The incidence of these infections was found to be greater in warm and humid climate. PMID- 2710157 TI - Physiological characteristics of environmental isolates of pathogenic dematiaceous fungi. AB - A total of 39 environmental isolates of pathogenic dematiaceous fungi (Fonsecaea pedrosoi: 14 isolates, Phialophora verrucosa: 6, Cladosporium carrionii: 9, Exophiala jeanselmei: 2, Ramichloridium subulatum: 6, Cladosporium tenuissimum: 1 and Phaeoisaria clematidis: 1) were evaluated for their various physiological characteristics including the ability to produce extracellular enzymes. Significant physiological characteristics included the ability of isolates of all the species except C. tenuissimum to decompose tyrosine, lyse human red blood cells, conversion of R. subulatum from filamentous to yeast form when cultured on Czapek-Dox agar and also on blood agar and the growth of C. tenuissimum on Sabouraud dextrose agar incorporating 3.6 M NaCl. Isolates of all the species except those of C. carrionii produced lipase, while only the isolates of P. verrucosa, E. jeanselmei and Ph. clematidis were positive for phospholipase. PMID- 2710158 TI - Infection ability of watermolds in some temperate fishes of Himalaya, India. AB - Infection ability tests of four species of the Saprolegniales viz., Brevilegnia subclavata Couch, Geolegnia inflata Coker & Braxton, Protoachlya oryzae Khulbe and Scoliolegnia centrica Khulbe were made by artificial inoculation experiments. Except Geolegnia inflata, all the three species parasitized the test fishes (Carassius auratus L., Puntius conchonius Ham., P. ticto Ham. and Nemacheilus rupicola). Two chemicals, namely boric acid and potassium permanganate were effective at 0.1 to 0.15 M concentrations against parasitic watermolds. PMID- 2710159 TI - Some remarks concerning Trichophyton proliferans. AB - We have had the opportunity to study an dermatophyte isolated from the face of a woman, as a result of a fall on the ground. We identified the strain as Trichophyton proliferans whose characteristics, together with a review of the works published about this dermatophyte, lead us to believe that we are dealing with an independent species and not a synonym of T. mentagrophytes var. erinacei. PMID- 2710160 TI - [Microsporum canis infection in rabbits and its transmission to humans]. AB - The infection of the capillitium of an 8-year old child due to Microsporum canis is described. The child occasionally visited its mother working at an animal farm. The focus of the infection was found in farm rabbits infected by M. canis. A contamination of the environment (cages and floors) by the above mentioned dermatophyte could also be demonstrated. The infection was transferred to an animal feeder as well. The infection focus was eliminated by strict disinfection and sanitary measures. The importance of the mycological examination of animals with focal loss of hair is stressed. PMID- 2710161 TI - Tinea capitis caused by Microsporum canis in an adult. AB - The authors report a case of tinea capitis in a woman aged 49, with a previous history of discoid lupus erythematosus. The pathogenic agent was Microsporum canis. The patient was cured after two months therapy with griseofulvin and local antimycotics. PMID- 2710162 TI - Succinate-dependent energy generation in Ascaris suum mitochondria. AB - Phosphorylation in isolated Ascaris suum mitochondria was much greater in the presence of malate than succinate, but, in the absence of added adenine nucleotides, incubations in succinate resulted in substantial elevations in intramitochondrial ATP levels. Succinate-dependent phosphorylation was stimulated aerobically and this stimulation was due almost entirely to a site I, rotenone sensitive, phosphorylation. Increased substrate level phosphorylation, coupled to propionate formation, or additional sites of electron-transport associated ATP synthesis were not significant. Under aerobic conditions, 14CO2 evolution from 1,4-[14C]succinate was stimulated and NADH/NAD+ ratios were elevated, but the formation of [14C]propionate was unchanged. It appears that succinate was metabolized to pyruvate and acetate, and NADH, generated from the decarboxylations of malate and pyruvate, was the primary source of reducing power fueling electron-transport. The terminal oxidase and final electron-acceptor are still not clearly defined. However, ferricyanide, H2O2, and 100% oxygen all stimulated succinate-dependent phosphorylation. A possible role for cytochrome c peroxidase in A. suum mitochondrial metabolism is discussed. PMID- 2710163 TI - Identification of a developmentally regulated cysteine protease of Trypanosoma brucei. AB - Trypanosoma brucei undergoes dramatic metabolic changes during differentiation from the mammalian bloodstream form into the procyclic form of the insect midgut. Because modulation of protein degradation is likely to be important during this process we studied T. brucei for life cycle mediated proteolysis. We detected an increase in the activity of a 28 kDa protease as pleomorphic GUTat 3.1 trypanosomes differentiate in the mammalian bloodstream from long slenders into short stumpies. Short stumpy trypanosomes hydrolyse z-Phe-Arg-AMC 12 fold more actively than either long slenders or procyclics. The 28 kDa protease is activated by dithiothreitol and is inhibited by trans-epoxysuccinyl-L-leucyl amido(4-guanidino) butane (E-64), indicating that it is a cysteine protease. The proteolytic activity of monomorphic ILTat 1.4 trypanosomes does not increase during mammalian parasitemia. If monomorphic ILTat 1.4 trypanosomes are induced to differentiate into short stumpies by exposure to difluoromethylornithine, however, the activity of the 28 kDa cysteine protease increases 8 fold. This suggests that polyamine depletion induces the 28 kDa cysteine protease and that its expression may be regulated by mechanism not previously described in protozoa. PMID- 2710164 TI - Expression site associated genes of Trypanosoma brucei rhodesiense. AB - Upstream of at least some telomere-linked genes for the variant surface glycoproteins (VSGs) of African trypanosomes are expression site associated genes (ESAGs) whose transcription is co-ordinated with the transcription of the adjacent VSG gene [Cully et al. (1985) Cell 42, 173-182]. The function of the corresponding ESAG proteins is not known. Here we show the sequences of two members of the ESAG-I family that are upstream of the VSG genes expressed in metacyclic variant antigen types 4 and 7 of Trypanosoma brucei rhodesiense. The corresponding metacyclic ESAG-I proteins of about 330 amino acids display extensive positional identity both with each other and with two other ESAG-I proteins of Trypanosoma brucei brucei. Only about 7% of the positions are occupied by a different amino acid in each of the four putative ESAG proteins while 40% of the positions are identical. Thus, the ESAG-I proteins are much more highly conserved than are the VSGs studied to date. PMID- 2710165 TI - Phosphorylation of fructose bisphosphate aldolase in Trypanosoma brucei. AB - Methods were developed for in vivo labelling of trypanosome proteins with inorganic phosphate and the labelling of fructose bisphosphate aldolase and variant surface glycoprotein was investigated. It was found that the large pool size of phosphate in trypanosomes precludes detailed kinetic analyses. Aldolase contains low levels of phosphoserine but the function of this phosphorylation has yet to be determined. PMID- 2710166 TI - Cloning of cDNAs encoding a 28 kilodalton antigen of Toxoplasma gondii. AB - By screening cDNA libraries in lambda gt11 with antibodies raised against the previously described protective F3G3 antigen of Toxoplasma gondii, and subsequently screening with nucleic acid probes, we have isolated cDNA clones that encode a 28 kDa antigen of T. gondii that is likely one of the two antigenic components of the F3G3 antigen. The gene apparently exists as a single copy in the tachyzoite haploid genome of the three strains of T. gondii examined. Northern blot analyses revealed that the cDNAs hybridize with a major T. gondii RNA species of 1.1 kb. Together the cDNAs encompass 1051 bp of cDNA sequence containing an open reading frame with the capacity to encode a 28 kDa protein. Antibodies that were affinity purified using recombinant fusion proteins produced by two of the clones reacted on protein blots of whole T. gondii lysate with a single antigen having an apparent molecular mass of 28 kDa. Both recombinant fusion proteins reacted with IgG antibodies in sera of mice and humans infected with T. gondii and therefore might be useful for the development of diagnostic assays for T. gondii infection. PMID- 2710167 TI - Repetitive DNA probes for the detection of Babesia equi. AB - This report describes DNA probes for the identification of Babesia equi. A genomic library of B. equi was constructed in pUC13. Several clones were identified that hybridized strongly to B. equi DNA. Clone pBE33 hybridized specifically to B. equi DNA and did not hybridize to horse DNA nor to DNA from Babesia caballi, Babesia bovis or Babesia bigemina. Two subclones of pBE33 (pSB20 and pEH21) containing B. equi repetitive sequences, could detect 0.49 ng and 0.97 ng B. equi DNA, respectively. PMID- 2710168 TI - Rapid changes in the expression of a gene encoding a calcium-binding protein in Schistosoma mansoni. AB - Genes expressed in a stage-specific manner may help us understand the molecular events controlling the complex life cycle of schistosomes. cDNA and genomic clones encoding a calcium-binding protein (CaBP) were obtained from cercariae and their sequence determined. The encoded protein (69 amino acids long) shows clear resemblance to the domain structure and organization of CaBP molecules. It contains two typical calcium-binding loops, the distance between which is identical to the length conserved in other CaBP molecules. In addition, the schistosome CaBP shows Ca2+-dependent electrophoretic mobility (increased with Ca2+-ions and decreased with EGTA). Northern blots revealed expression of the CaBP gene in cercariae but not in sporocyst or worm (developmental stages preceding and following cercaria). The preferential expression of this CaBP in the cercaria raises questions as to what cercaria-specific function(s) it performs. The structure of the gene is similar to that in other eukaryotes, and one intron interrupts the coding sequence. The region of the cap site was determined, and there was no evidence of the spliced leader sequence found in the mRNAs of other parasites. The CaBP reveals a rapid change in gene expression, since the mRNA is missing in the parasite residing in infected snails, but is readily detected in cercariae 1 h after shedding. We identified other genes which are turned on (like the CaBP) or shut off within the short period of transition from cercariae in the snail to free-swimming cercariae. PMID- 2710169 TI - Structural alterations of chromosome 2 in Leishmania major as evidence for diploidy, including spontaneous amplification of the mini-exon array. AB - We have utilized pulsed field electrophoresis to characterize several karyotypic alterations in Leishmania major. Promastigotes of the LT252 line contain three small chromosomes, of 300, 350 and 385 kb. Quantitative densitometry of ethidium bromide-stained gels suggest that these chromosomes are present in equal levels (2:2:2). Two derivatives of this line, one appearing spontaneously (LT252 delta) and one obtained following selection with methotrexate (11-MTXR20), exhibit altered levels of these chromosomes, in the ratio of 2:1:3, respectively. The variant pattern in both lines is due to an increase in size of chromosome 2, yielding a new chromosome similar in size to chromosome 3. The enlarged chromosome 2 of the LT252 delta line is a result of amplification of the mini exon gene array normally located on this chromosome, which increases from about 93 to 150 copies of the 0.44-kb mini-exon tandem repeat, as shown by quantitative hybridization and sizing of the mini-exon array. In contrast, the increased size of chromosome 2 within the methotrexate-resistant mutant 11-MTXR20 is not due to mini-exon amplification. In both variant lines, there are equal levels of the wild-type and enlarged chromosome 2, and the wild-type chromosome 2 is now present at 50% of the level of chromosome 1. These and other data suggest that Leishmania is diploid for chromosomes bearing housekeeping genes such as the mini exon locus. PMID- 2710170 TI - H DNA amplification in Leishmania resistant to both arsenite and methotrexate. PMID- 2710171 TI - Colonies of procyclic Trypanosoma brucei on semi-solid agarose plates. PMID- 2710172 TI - Community outbreaks of asthma associated with inhalation of soybean dust. Toxicoepidemiological Committee. AB - Since 1981, 26 outbreaks of asthma have been detected in the city of Barcelona. The geographic clustering of cases close to the harbor led us to consider the harbor as the probable source of the outbreaks. We therefore studied the association between the unloading of 26 products from ships in the harbor and outbreaks of asthma in 1985 and 1986. All 13 asthma-epidemic days in these two years coincided with the unloading of soybeans (lower 95 percent confidence limit of the risk ratio, 7.2). Of the remaining 25 products, only the unloading of wheat was related to the epidemics of asthma, although when adjusted for the unloading of soybeans the relation was not statistically significant. High pressure areas and mild southeasterly to southwesterly winds, which favored the movement of air from the harbor to the city, were registered on all epidemic days. Particles of starch and episperm cells that were recovered from air samplers placed in the city had morphologic characteristics identical to those of soybean particles. Furthermore, the lack of bag filters at the top of one of the harbor silos into which soybeans were unloaded allowed the release of soybean dust into the air. We conclude that these outbreaks of asthma in Barcelona were caused by the inhalation of soybean dust released during the unloading of soybeans at the city harbor. PMID- 2710173 TI - Effect of the time of administration of calcium acetate on phosphorus binding. AB - Phosphorus binders are given to patients with renal failure to increase gastrointestinal excretion of phosphorus. To determine the relative importance of the binding of dietary as compared with endogenous phosphorus and to determine the optimal dose schedule, we gave either 4.4 g of calcium acetate (25 mmol of calcium) or a placebo to six normal subjects on each of seven different schedules in a randomized sequence. The net gastrointestinal balance of phosphorus and calcium was determined by a one-day lavage technique. After a meal containing approximately 12 mmol of phosphorus, the mean phosphorus absorption (+/- SE) measured 9.17 +/- 0.36 mmol (78 percent) with placebo but decreased to 3.81 +/- 0.58 mmol (31 percent) when calcium acetate was given immediately before the meal (representing binding of 5.36 +/- 0.77 mmol of phosphorus). Similar binding was observed when calcium acetate was given immediately after the meal and when half the dose was given before and half after the meal. In contrast, when calcium acetate was given two hours after the meal or while the subject was fasting, phosphorus binding was reduced to 2.00 +/- 0.52 mmol and 1.81 +/- 0.84 mmol, respectively. Calcium absorption from calcium acetate averaged 21 +/- 1 percent when the binder was given with a meal; absorption from calcium acetate averaged 40 +/- 4 percent when the binder was given while the subject was fasting. We conclude that calcium acetate increases fecal excretion of phosphorus by binding both dietary and endogenous phosphorus, but the binding of dietary phosphorus is quantitatively much more important. For the most efficient phosphorus binding, calcium (and presumably other phosphorus-binding cations) should be given with meals. PMID- 2710174 TI - Eustrongylidiasis--a parasitic infection acquired by eating sushi. PMID- 2710175 TI - Control of serum phosphorus in uremia. PMID- 2710176 TI - The state of outcome research: are we on target? PMID- 2710177 TI - The dangers of eating raw fish. PMID- 2710178 TI - Antibodies to HIV in saliva. PMID- 2710179 TI - HTLV-I infection and arthropod vectors. PMID- 2710180 TI - Hypoparathyroidism and the DiGeorge syndrome. PMID- 2710181 TI - Kikuchi's disease as a cause of fever of unknown origin. PMID- 2710182 TI - Case 43-1988. PMID- 2710183 TI - Puncture of the trachea during catheterization of the subclavian vein. PMID- 2710184 TI - Smoking cessation in older patients with coronary artery disease. PMID- 2710185 TI - Health and medical care in Ethiopia. PMID- 2710186 TI - Superstar ophthalmology and HMOs. PMID- 2710188 TI - Abbreviations in the medical literature. PMID- 2710187 TI - Paging patterns: a nurse's view. PMID- 2710189 TI - Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. AB - Diabetic nephropathy develops in less than half of all patients with diabetes. To study heredity as a possible risk factor for diabetic kidney disease, we examined the concordance rates for diabetic nephropathy in two sets of families in which both probands and siblings had diabetes mellitus. In one set, the probands (n = 11) had no evidence of diabetic nephropathy, with normal creatinine clearance and a urinary albumin excretion rate below 45 mg per day. In the other set, the probands (n = 26) had undergone kidney transplantation because of diabetic nephropathy. Evidence of nephropathy was found in 2 of the 12 diabetic siblings of the probands without nephropathy (17 percent). Of the 29 diabetic siblings of probands with diabetic nephropathy, 24 (83 percent) had evidence of nephropathy (P less than 0.001), including 12 with end-stage renal disease. No significant differences were noted between the sibling groups with respect to the duration of diabetes, blood pressure, glycemic control, or glycosylated hemoglobin levels. Logistic regression analysis found nephropathy in the proband to be the only factor significantly predictive of the renal status of the diabetic sibling. We conclude that diabetic nephropathy occurs in familial clusters. This is consistent with the hypothesis that heredity helps to determine susceptibility to diabetic nephropathy. However, this study cannot rule out the possible influences of environmental factors shared by siblings. PMID- 2710190 TI - Transmission of retroviruses by transfusion of screened blood in patients undergoing cardiac surgery. AB - We determined the rates of seroconversion to human immunodeficiency virus type 1 (HIV-1) and human T-cell leukemia virus Type I (HTLV-I) in a cohort of patients receiving transfusions of blood components screened for antibody to HIV-1. Preoperative and postoperative serum samples were collected from 4163 adults undergoing cardiac surgery who received 36,282 transfusions of blood components. The postoperative samples from all patients were tested for serologic evidence of HIV-1 infection, and those that were positive were compared with the corresponding preoperative samples. One case of HIV-1 transmission by transfusion of screened blood components was identified; two preexisting HIV-1 infections were found. Samples from 2749 patients were tested similarly for serologic evidence of HTLV-I infection; these patients received 20,963 units of blood components. Five new cases and two preexisting cases of HTLV-I infection were detected. The observed risk of HIV-1 transmission by transfusion was 0.003 percent per unit; the risk of HTLV-I transmission was 0.024 percent per unit. We conclude that there is a very small risk of HTLV-I infection from transfused blood products that have been screened for antibodies to HIV-1, but that it is nearly 10-fold higher than the risk of HIV-1 infection. PMID- 2710191 TI - Variations in rates of hospitalization of children in three urban communities. AB - Hospitalization accounts for a large portion of the expenditures for child health care, and differences in the rate of hospitalization may produce important variations in the cost of that care. We studied the rates of hospitalization in Boston, Rochester (N.Y.), and New Haven (Conn.) in 1982. We assigned the risk of hospitalization in Rochester a score of 1.00. Boston children were hospitalized at more than twice the rate of Rochester children for most medical diagnostic categories (relative risk, 2.65; 95 percent confidence interval, 2.53 to 2.78), and the rate for the New Haven group was intermediate (relative risk, 1.80; 95 percent confidence interval, 1.68 to 1.93). Rates of inpatient surgery differed less (Boston relative risk, 1.12; New Haven relative risk, 0.93). The relative risks of hospitalization (as compared with Rochester children) for Boston and New Haven children, respectively, were 3.8 and 2.3 for asthma, 6.1 and 2.9 for toxic ingestions, and 2.6 and 2.7 for head injuries. Fractures of the femur, appendicitis, and bacterial meningitis (conditions uniformly treated in the hospital) had similar rates of hospitalization across the three cities, but the relative risk of hospitalization for aseptic meningitis was 3.7 in Boston. The rates of hospitalization of children in all three communities were below the national averages in 1982. Although this study does not define the reasons for the variation in rates of hospitalization, it is possible that they were related in part to differences in socioeconomic status or access to primary care. The implications of these data for the cost and quality of pediatric care therefore remain to be determined. PMID- 2710192 TI - Treatment of pulmonary hemangiomatosis with recombinant interferon alfa-2a. PMID- 2710193 TI - What do regional variations in the rates of hospitalization of children really mean? PMID- 2710194 TI - Redundant publication. PMID- 2710195 TI - Handgun regulations, crime, assaults, and homicide: a tale of two cities. PMID- 2710196 TI - Testosterone treatment for delayed growth. PMID- 2710197 TI - Medium-chain acyl-CoA dehydrogenase deficiency. PMID- 2710198 TI - Hyperkalemia during treatment with HMG-CoA reductase inhibitor. PMID- 2710199 TI - Severe anogenital warts in a child with HIV infection. PMID- 2710200 TI - The effects of liability fears. PMID- 2710201 TI - Publication of closely related reports. PMID- 2710202 TI - Longitudinal electrophysiologic assessment of asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern. AB - Although most asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern have a good prognosis, some die suddenly. The mechanism of sudden death is usually ventricular fibrillation, which is triggered by atrial fibrillation with a rapid ventricular response rate. Electrophysiologic testing has been proposed to identify asymptomatic patients who may be at risk for sudden death. Meaningful application of such testing requires a knowledge of whether the electrophysiologic measurements are reproducible over time. Consequently, we performed electrophysiologic studies on two occasions at least 36 months apart (mean +/- SD, 54.7 +/- 14) in 29 asymptomatic patients with the pattern. Twenty-seven patients remained asymptomatic, and sustained supraventricular tachycardia developed in two during the follow-up period. Nine patients (31 percent) lost the capacity for preexcitation and anterograde conduction over the accessory pathway, which produces the Wolff-Parkinson-White pattern. The others had little change in measurements of conduction over the accessory pathway. Patients who lost conduction over the accessory pathway tended to be older (mean +/- SD, 50 +/- 18 vs. 39 +/- 11 years; P = 0.06) than patients who retained preexcitation, and they had longer anterograde effective refractory periods at the first assessment (414 +/- 158 vs. 295 +/- 27 msec; P = 0.003). We conclude that a considerable number of asymptomatic patients with the Wolff Parkinson-White pattern lose their capacity for anterograde conduction over the accessory pathway. This loss of capacity probably contributes to the low mortality among asymptomatic patients. PMID- 2710204 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 19-1989. A 41-year-old woman with mitral stenosis, exertional dyspnea, and persistent hoarseness. PMID- 2710203 TI - The case for wider use of testing for HIV infection. PMID- 2710205 TI - Analgesic nephropathy--a preventable renal disease. PMID- 2710206 TI - Vasoactive intestinal polypeptide and asthma. PMID- 2710207 TI - Plasma triglyceride levels and coronary disease. PMID- 2710208 TI - Seronegative Lyme disease. PMID- 2710209 TI - Reinterpretation of human immunodeficiency virus western blot patterns. PMID- 2710210 TI - IgA antigliadin antibodies as a possible marker for IgA mesangial glomerulonephritis in adults with primary glomerulonephritis. PMID- 2710211 TI - Case 46-1988: myelolipoma of adrenal gland. PMID- 2710212 TI - Elevated levels of creatine kinase BB isoenzyme in three patients with adult osteopetrosis. PMID- 2710213 TI - Ultraviolet radiation and formation of cataracts. PMID- 2710214 TI - Health effects of involuntary smoking. PMID- 2710215 TI - Kidney dialysis treatment for victims of the Armenian earthquake. PMID- 2710216 TI - Task Force on Sexually Transmitted Diseases (STDs and AIDS) PMID- 2710217 TI - STD quiz. PMID- 2710218 TI - Syphilis. The resurgence of an old disease. PMID- 2710219 TI - Gonorrhea: an overview for North Carolina physicians. PMID- 2710220 TI - Chlamydial infections. PMID- 2710222 TI - What everyone should know about AIDS. PMID- 2710221 TI - Heart disease. Cholesterol. PMID- 2710223 TI - AIDS: recommendations and policy statements. PMID- 2710224 TI - Human immunodeficiency virus infection. PMID- 2710225 TI - Neurosyphilis--forgotten but not gone. PMID- 2710226 TI - Viral hepatitis. An important sexually transmitted disease. AB - Hepatitis B is an important sexually transmitted disease. The availability of a safe and effective vaccine has unfortunately had little impact on controlling this disease nationwide or in North Carolina, chiefly because target groups have proven difficult to reach. Both HAV and NANB can be transmitted sexually, but are much less important than HBV. PMID- 2710227 TI - The role of chemotherapy for node negative breast cancer. PMID- 2710228 TI - Ethical ambiguities of our time. PMID- 2710229 TI - [Hot feelings about cold thyroid nodules]. PMID- 2710230 TI - [Quality assurance in a mass screening project of breast cancer]. PMID- 2710231 TI - [Treatment of isolated ulnar shaft fractures using Sarmiento's method]. AB - Twenty-three patients with an isolated fracture of the ulnar shaft were treated by functional bracing as proposed by Sarmiento. Complete functional recovery was achieved quickly in all cases. No pseudarthroses occurred. In those cases in which the ulna had healed with some angulation, no clear restriction of rotation of the forearm was observed. The patients tolerated the treatment well. It is concluded that functional bracing of isolated fractures of the ulnar shaft is an elegant method of treatment with a minimal risk of complications. It is important that associated dislocation of the head of the radius is excluded before the treatment is instituted. PMID- 2710232 TI - [Diagnosis and treatment of malignant histiocytosis]. AB - Of twelve patients with malignant histiocytosis admitted between 1974 and 1987, clinical symptoms, diagnostic procedures and the course of the disease were retrospectively evaluated. Predominant findings at physical examination were fever (11/12), splenomegaly (12/12), hepatomegaly (8/12), and lymphadenopathy (8/12). Laboratory findings included anaemia, leukocytopenia, thrombocytopenia, high lactate dehydrogenase, and jaundice. Positive diagnostic procedures included biopsies or aspirates of bone marrow (11/12), spleen (6/10), liver (7/9), lymph node (4/4), skin (1/2), lung (1/1) and blood (2/12). In seven patients treated with combination chemotherapy an average survival of 540 days was observed, while two long-term disease-free survivals were accomplished. PMID- 2710233 TI - [Ophthalmologic complications of low-dosage tamoxifen in the treatment of breast carcinoma]. AB - Two out of 20 patients treated for metastatic or non-metastatic breast cancer with tamoxifen (20 mg 2 dd) developed bilateral secondary tapetoretinal degeneration. In one patient in whom the medication was stopped there was still slight progression of degeneration afterwards. In the other patient tamoxifen was continued under strict ophthalmological control. The total doses have been 7.3 g and 43.8 g respectively. PMID- 2710234 TI - [Respiratory depression following controlled-release morphine sulfate tablets]. AB - Controlled release morphine sulfate (MS Contin) is a relatively new oral preparation for the relief of chronic severe (cancer) pain. We describe a patient with severe neuralgia who experienced respiratory depression after ingestion of one single dose of morphine sulfate (20 mg). Administration of nalorphine chloride resulted in instant normalisation of respiratory function. This case illustrates respiratory depression as an adverse effect of MS Contin. PMID- 2710235 TI - [Medical policy concerning the results of cytologic screening studies of the cervix uteri]. PMID- 2710236 TI - [Antithrombotic agents]. PMID- 2710237 TI - [HIV-seropositive blood donors in 1988]. PMID- 2710238 TI - [AIDS 1982-1988]. PMID- 2710239 TI - [Dermatofibrosarcoma protuberans; not an innocent skin tumor]. PMID- 2710240 TI - [Rabies and bats: how should it be managed?]. PMID- 2710241 TI - [The female condom]. PMID- 2710242 TI - [Mortality risk after intrauterine and after neonatal transport]. AB - In a Dutch national collaborative study of 1338 newborn infants born in 1983 with a gestational age of less than 32 weeks and (or) a birth weight of less than 1500 g, a comparison was made of maternal transport to university perinatal centres and delivery in local general hospitals on the one hand, and neonatal transport to those centres and treatment in regional general hospitals on the other. The mortality risk was investigated by means of logistic regression analysis. The results show that maternal transport was accompanied by a statistically significantly lower mortality risk. The mortality risk after neonatal transport, compared with that after treatment in regional hospitals, was also lower although not significantly. Mortality risk after neonatal transport was significantly associated with increasing transportation distance. The results of the study confirm that referral by maternal transport offers the best prospects for high risk preterm babies. PMID- 2710243 TI - [Systematic competency training as preparation for clerkship]. PMID- 2710244 TI - [Questions in the education of clinical clerks]. PMID- 2710245 TI - [Experiences with kidney dialysis in the disaster area of Armenia]. PMID- 2710246 TI - [A first aid visit: primary or secondary health care?]. PMID- 2710247 TI - [Medicine, servant of charity]. PMID- 2710248 TI - [Initial symptoms in post-streptococcal glomerulonephritis]. PMID- 2710249 TI - [Transplantation of cells to the brain in the treatment of Parkinson disease]. PMID- 2710250 TI - [Jet lag: what is it and what can be done about it?]. PMID- 2710251 TI - [Meniscus injuries, symptoms and treatment]. PMID- 2710252 TI - [Variation and inconsistency in the evaluation of experiments by medical ethics committees]. AB - To detect the standards applied by research review boards the files of 22 boards were analysed. Furthermore, three research protocols arranged for the purpose were submitted to 21 boards. The most remarkable finding is the great variation and inconsistency in the standards applied by the boards. Sometimes this leads to incompatible decisions on the same research project. In other cases decisions of boards are against Dutch law. Inconsistency exists between various boards, as well as within boards. Several instruments are proposed to reduce both forms of inconsistency. PMID- 2710253 TI - [The effect of flurbiprofen in acute ankle distortions]. AB - The efficacy of flurbiprofen was studied by means of a double-blind randomized clinical trial involving 50 patients with an acute lateral ankle distortion (grade I). It could not be demonstrated that the NSAID shortened the duration of convalescence after this injury. Neither the pain nor the swelling showed a statistically significant decrease. Side effects were more frequent in patients treated with flurbiprofen. In view of these findings use of flurbiprofen in the treatment of acute ankle distortions is to be regarded as inadvisable. PMID- 2710254 TI - [Multiple tumors in the midline of the brain with endocrine dysfunction]. AB - A patient is reported with hypothalamic-pituitary dysfunction due to multiple cerebral midline tumours of germinoma type. The symptomatology and differential diagnosis are reviewed. The necessity of stereotactic biopsy is discussed. The treatment of these tumours as proposed in recent literature is mentioned, with special reference to radiotherapy (cranial and spinal) and chemotherapy. PMID- 2710255 TI - [Fear of sanctions?]. PMID- 2710257 TI - [Medicine and language]. PMID- 2710256 TI - [Post-traumatic stress syndrome: not only in war victims]. PMID- 2710258 TI - [Disposable contact lenses]. PMID- 2710259 TI - Smoking and liability. PMID- 2710260 TI - Acute episode of schizophrenia as a reaction to colostomy. PMID- 2710261 TI - Clinical diagnostic imaging. Cerebral venous thrombosis. PMID- 2710262 TI - Brachiocephalic fistulas for vascular access. PMID- 2710263 TI - Serum calcium and parathyroid hormone derangements in rhabdomyolysis. PMID- 2710264 TI - Anemia and chronic renal failure: the possible role of the oxidative state of glutathione. AB - The authors have investigated the oxidative state of glutathione in red blood cells (RBC) and plasma from patients affected by chronic renal failure (CRF) and from age-matched healthy subjects. RBC-reduced glutathione (GSH) levels were significantly lower in CRF patients than in healthy subjects. Oxidized glutathione (GSSG) levels in plasma from CRF patients were higher than in plasma from controls. GSSG levels in RBC were similar in both groups. No differences were noted in GSH plasma levels between patients and controls. The GSSG/GSH ratios in RBC were similar in the two groups; on the contrary, the GSSG/GSH ratio in plasma was significantly higher in CRF patients. High levels of GSSG in plasma could exert two important effects on RBC: (1) inhibition of glucose-6-phosphate dehydrogenase activity, with a consequent alteration of the glutathione system; (2) GSSG easily reacts with hemoglobin to produce hemoglobin-glutathione mixed disulfides, with a consequent protein aggregation and precipitation. In vitro experiments have shown that RBC from CRF patients easily lyse when incubated with their same plasma, but not when incubated in saline buffer. Our results seem to demonstrate that plasma from CRF patients contains various oxidants which could affect the integrity of the glutathione system in RBC. This alteration could play a role in the pathogenesis of anemia in uremic patients. PMID- 2710265 TI - Excretion of hippuran into acquired renal cysts in chronic hemodialysis patient. PMID- 2710266 TI - Ranitidine bioavailability and disposition kinetics in patients undergoing chronic hemodialysis. AB - The absorption and disposition of single-dose intravenous (i.v.) and oral ranitidine were evaluated in 6 patients undergoing chronic hemodialysis. Ranitidine was given as either 50 mg (0.16 mM) i.v. or 150 mg (0.48 mM) tablets 4 h prior to hemodialysis according to a randomized cross-over design with tests separated by 2 weeks. Following i.v. administration, the peak serum ranitidine concentration was 761 +/- 207 micrograms/l (mean +/- SD) and the observed peak after the oral dose was 833 +/- 206 micrograms/l at 3.5 +/- 1.2 h. To convert micrograms/l to microM/l, divide by 314. The terminal elimination rate constants for the i.v. and oral doses were 0.062 +/- 0.013 and 0.058 +/- 0.004 h-1, respectively, with an apparent volume of distribution of 139.6 +/- 35.3 liters and total body clearance 8.5 +/- 1.6 liters/h for the i.v. dose. Hemodialysis clearances during the i.v. and oral studies were 3.2 +/- 0.9 and 3.1 +/- 1.0 liters/h, respectively, and the mean amount removed by hemodialysis following i.v. administration was 3.9 +/- 2.7 mg. The bioavailability of ranitidine was 54.3 +/- 13.5%. Based on these single-dose data, a daily oral dose of 150 mg ranitidine in patients with end-stage renal disease should provide a mean ranitidine serum concentration of approximately 350 micrograms/l with less than 10% of body stores of ranitidine being lost during any dialysis session. PMID- 2710267 TI - Protein-restricted diets in diabetic nephropathy. AB - Low-protein diets in nondiabetic renal failure may slow the progressive loss of renal function in some patients, but few studies have detailed the nutritional consequences of these diets in patients with diabetic nephropathy. We studied 7 patients with insulin-dependent diabetes mellitus and chronic renal insufficiency [mean +/- SEM creatinine clearance (S, U): 28.3 +/- 6.5 ml/min (0.47 +/- 0.11 ml/s x 1.73/A)] for 15 weeks who were prescribed a diet of 0.6 g protein/kg ideal body weight. Midarm muscle circumference (24.1 +/- 1.8 at onset vs. 24.5 +/- 1.5 cm at completion), triceps skinfold thickness (21.6 +/- 3.1 vs. 21.0 +/- 1.5 mm), body weight (71.8 +/- 4.1 vs. 71.2 +/- 4.6 kg), and serum albumin [3.0 +/- 0.1 vs. 3.2 +/- 0.1 g/dl (30 +/- 1 vs. 32 +/- 1 g/l)] remained stable. Based on urinary nitrogen excretion, diet diaries overestimated the degree of dietary protein restriction; there was good adherence to the diet as evidenced by a reduction in urinary urea nitrogen (average 32%). Blood glucose control was maintained despite increased carbohydrate intake. On average, creatinine clearance did not change significantly, but proteinuria diminished slightly (1.8 +/- 0.2 vs. 1.5 +/- 0.6 g/day). These results indicate that 0.6 g/kg/day protein diets did not cause protein depletion in insulin-dependent diabetic patients. Longer-term studies are indicated to assess more fully the efficacy of these dietary regimens in reducing proteinuria or benefiting diabetic nephropathy. PMID- 2710268 TI - Significant increase of IQ-type heterocyclic amines, dietary carcinogens in the plasma of patients with uremia just before induction of hemodialysis treatment. AB - The concentrations of 2-amino-3-methylimidazo(4,5-f) quinoline (IQ) and 2-amino 3,8-dimethylimidazo(4,5-f)quinoxaline (MeIQx), a family of mutagenic and carcinogenic heterocyclic amines, in the plasma of normal subjects (10 cases), patients with uremia receiving maintenance hemodialysis treatment (9 cases) and patients with uremia just before induction of hemodialysis treatment (5 cases) were determined by a high-performance liquid chromatography method. The plasma levels of IQ and MeIQx in uremic patients just before induction of hemodialysis treatment were 12.6 +/- 4.1 nM (mean +/- S.D., n = 5) and 10.0 +/- 2.3 nM (n = 5), respectively. In patients with uremia receiving maintenance hemodialysis treatment, IQ and MeIQx were detected in 4 and 2 out of 9 cases, respectively and the levels of those in the plasma were 4.1 nM (n = 4) and 1.7 nM (n = 2), respectively. However, IQ and MeIQx could not be detected in all normal subjects. These results indicate that uremic patients just before induction of hemodialysis treatment are actually exposed to higher levels of the carcinogenic heterocyclic amines, as compared with normal subjects and uremic patients receiving maintenance hemodialysis treatment. PMID- 2710269 TI - Acute renal failure following cocaine abuse. AB - Three healthy adult males developed acute renal failure following cocaine abuse. Muscle pain, tenderness, elevated levels of serum muscle enzymes, heme-positive urine and the presence of pigmented granular casts in urine all indicated occurrence of rhabdomyolysis. One of them developed acute compartmental syndrome of the left leg and required emergency fasciotomy. The course of renal failure and fast recovery were suggestive of acute tubular necrosis in all 3 patients. A possible role of cocaine in the aggravation of renal and/or muscle ischemia has been speculated. PMID- 2710270 TI - Hypercalcaemia as a manifestation of malignant urothelial change in analgesic nephropathy. AB - We report two cases of patients with analgesic nephropathy presenting with the symptoms of hypercalcaemia, and who were found to have transitional cell carcinomas of the renal pelvis. On removal of the tumours, calcium levels fell to normal, indicating that a humoral factor produced by the tumour caused the hypercalcaemia. We suggest that hypercalcaemia in a patient with analgesic nephropathy may indicate a malignant change, and that serum calcium should be assessed when such patients are reviewed. PMID- 2710271 TI - Generalized lymphadenopathy in continuous ambulatory peritoneal dialysis patients associated with Staphylococcus epidermidis infection. AB - In patients utilizing continuous ambulatory peritoneal dialysis (CAPD), Staphylococcus epidermidis is the most prevalent organism isolated from peritoneal and exit site infections [1] although clinically significant systemic infection is unusual. We report 2 patients undergoing CAPD who developed generalized lymphadenopathy following peritonitis and exit site infection with S. epidermidis isolated from the excised lymph nodes. We conclude that catheter related S. epidermidis infection may result in generalized lymphadenopathy due to dissemination of the infective focus. PMID- 2710272 TI - Primary hypomagnesemia with a probable double magnesium transport defect. AB - We describe a boy with a neonatally diagnosed primary nonfamilial hypomagnesemia. Oral supplementation of large quantities of magnesium salts was required to maintain low normal serum magnesium levels. Lately, a further increase in the oral supplementation had to be administered in order to avoid seizures. A thorough investigation was conducted. Both an intestinal and urinary magnesium wasting was noticed. The rarity of this simultaneous double transport defect merit its description. PMID- 2710273 TI - Behcet's syndrome associated with minimal change glomerulonephritis and renal vein thrombosis. AB - A 35-year-old Kashmiri male with a 12-year history of recurrent aphthous ulcers of the mouth and scrotal ulcers was admitted with pedal edema, facial puffiness and proteinuria. Kidney biopsy showed minimal change glomerulonephritis. During hospitalization he developed erythema nodosum and left renal vein thrombosis and features of right cerebral thrombosis. He improved with a course of heparin and prednisolone. In this report a case of Behcet's syndrome with minimal change glomerulonephritis and left renal vein thrombosis is presented. PMID- 2710275 TI - Zinc metabolism in nephrotic syndrome. PMID- 2710274 TI - Management of hyperphosphatemia with calcium citrate in hemodialysis patients. PMID- 2710276 TI - Metastatic renal cell carcinoma in a hemodialysis patient with acquired renal cystic disease. PMID- 2710277 TI - Activation of astrocytic lysosomal proteinases by factors released by mononuclear leukocytes. AB - Lysosomal proteinases are increased in the tissue lesions of experimental allergic encephalomyelitis and have been implicated in the degradation of myelin proteins. The cellular origins of the increased proteinases are not known but reactive astrocytes found in areas of increased activity are candidate cells. To evaluate the potential of astrocytes as the source of these proteinases, cathepsin B (CB) and cathepsin D (CD) levels were measured in lysates of cultured astrocytes from neonatal rats. Because astrocytes are activated by inflammatory mediators in demyelinating lesions the effect of activation on proteinase levels was examined. Culture supernatants from mononuclear leukocytes stimulated with either concanavalin A or phytohemagglutinin (PHA) induced significant increases in the astrocytic proteinases. Neither PHA alone, interleukin-1, interleukin-2, nor gamma-interferon induced significant increases. Fractions of the supernatant from PHA stimulated mononuclear leukocytes were tested and activity was found in fractions corresponding to a molecular weight of 45-50,000. These studies demonstrate that astrocytes contain significant amounts of CB and CD activity which can be increased by a factor or factors released by activated mononuclear leukocytes. PMID- 2710278 TI - Uptake and K+-stimulated release of [14C]glycine from frog retinal synaptosomal fractions. AB - The uptake of [14C]glycine and the effect of depolarizing potassium concentrations on its release was investigated in the whole frog retina and its synaptosomal fractions. The uptake of [14C]glycine in retina and synaptosomal fractions was found to be saturable as well as energy and Na+-dependent. The Km value for glycine uptake was found to be 46 microM for P2 fraction and 100 microM for P1 fraction, with a Vmax of 3.5 and 3.8 nmol/mg protein/min respectively. The release of [14C]glycine from P1 and P2 synaptosomal fractions was markedly increased by raising potassium concentration in the medium, in a partially Ca2+ dependent manner. Evoked glycine release was 50% reduced when calcium was omitted from the medium. The K+-stimulated release of glycine from P2 fraction was significantly reduced in the presence of TTX. The cellular origin of the P1 and P2 synaptosomal fractions releasing glycine is discussed. PMID- 2710279 TI - The amino acid composition of the zinc-induced metallothionein isoforms in rat brain. AB - Recent investigation from this laboratory has identified in the rat brain a zinc inducible and actinomycin D-inhibited metallothionein with an elution volume (Ve/Vo) of 2.08 and a molecular weight of smaller than 10,000 daltons. Furthermore, purification of the zinc-induced metallothionein by ion exchange chromatography on DEAE-Sephadex A-25 columns produced two isoforms, eluting, respectively, at 68 and 130 mM of Tris-acetate buffer, pH 7.5. In this paper, we report that zinc-induced metallothionein produces also two distinct isoforms on reverse phase high performance liquid chromatography that exhibit retention times of 17.23 and 18.53 minutes, respectively. Brain metallothionein was characterized further by studies showing that the zinc-induced metallothionein incorporated a large quantity of [35S]cysteine and that isoforms I and II contain 17 and 18 cysteine residues, respectively, while being devoid of any arginine, histidine, leucine, phenylalanine or tyrosine. The precise functions of the brain metallothionein isoforms, which may be related to the transport and homeostasis of essential elements such as zinc and copper, remain to be elucidated. PMID- 2710281 TI - In vitro localization of the protein synthesis defect associated with experimental phenylketonuria. AB - We have used a cell-free system derived from hamster brain to investigate protein synthesis during experimental phenylketonuria. In such a system the elongation inhibitor emetine impeded translation in extracts derived from both treated and control animals. On the other hand the initiation inhibitor aurintricarboxylic acid showed no effects on protein synthesis activity of treated hamsters, although it was severely inhibiting in controls. This suggests that initiation is the altered step in brain protein synthesis failure consecutive to phenylketonuria. PMID- 2710280 TI - Involvement of brain stem noradrenergic neurons in the development of hypertension in spontaneously hypertensive rats. AB - This study attempted to investigate the possible involvement of the brain stem noradrenergic system in the development of hypertension in spontaneously hypertensive rats. Steady-state norepinephrine, dopamine, serotonin and 5 hydroxyindoleacetic acid concentrations and norepinephrine turnover were determined in the individual brain stem nuclei using high performance liquid chromatography with electrochemical detection. Decreased norepinephrine contents in the nucleus tractus solitarii in spontaneously hypertensive rats compared with Wistar-Kyoto rats at the age of 4, 8, and 16 weeks were demonstrated. In later stages (8 and 16 weeks), increased norepinephrine levels were observed in the nucleus reticularis gigantocellularis, the A1 and A5 areas. Norepinephrine turnover was not different between spontaneously hypertensive rats and Wistar Kyoto rats in the nucleus tractus solitarii at the age of 4 and 16 weeks and increased in the nucleus reticularis gigantocellularis of spontaneously hypertensive rats at 16 weeks. Our results indicate that altered norepinephrine metabolism in the specific brain stem nuclei, especially the consistently decreased norepinephrine in the nucleus tractus solitarii of spontaneously hypertensive rats, contribute to the development of genetic hypertension. PMID- 2710282 TI - [Studies on the operative factors affecting the reduction of chronic subdural hematoma, with special reference to the residual air in the hematoma cavity]. AB - The authors previously reported the effect of preoperative factors affecting the reduction of chronic subdural hematoma. In this report, we evaluated some operative factors, including operative methods, duration of drainage, and residual air volume, with newly developed CT volumetry technique. As described before, the hematoma volume reduces exponentially. An exponential curve was fitted to the reduction curve using the least square method, and its half reduction days (HRD) was calculated. This HRD represents a mathematical indicator of the reduction rate of CSDH. Using this technique, the relationship between this HRD and operative method, the duration of drainage and the volume of the postoperative residual air were examined in 61 patients. Operative method (burr hole or small craniotomy) has no correlation with HRD. The duration of drainage also has no correlation. However, the volume of the residual air was highly correlated with the reduction rate of hematoma (r = 0.430; p less than 0.01). These results suggest that the residual air in the hematoma cavity may delay the reduction rate of the hematoma. Based on these results, the authors pay attention to the following points; 1) Less invasive burr hole method should be selected. 2) Patient's head position should be controlled to make the burr hole at the highest level in the operative field. 3) Hematoma cavity should be filled with saline as much as possible. 4) The inner membrane should never be injured, as it may cause tension pneumocephalus. Moreover, the drainage of cerebrospinal fluid may reduce the counter pressure and it leads to the delay of the hematoma reduction. PMID- 2710283 TI - [MRI of acute cerebral infarction]. AB - Sequential changes of magnetic resonance imaging (MRI) in sixteen patients with acute cerebral infarction are studied in comparison with the findings of computed tomography (CT). The sixteen patients were examined within 36 hours from the onset of symptoms on resistive type MRI (0.15T) using T1 weighted image (IR2000/500) and T2 weighted image (SE2000/80), and on CT. In general, large infarcted lesions of the cortex-subcortex seemed to be visualized earlier than small lesions of the basal ganglia and brainstem. In 8 patients, the infarcted lesions were detected on MRI earlier than on CT. For example, early detecting time within 12 hours were 2, 6, 7, and 10 hours after onset. In two patients of this group, lesions were detected on T2-weighted image earlier than on T1 weighted image. In two cases, small lesions of the brainstem were detected only on MRI. The size of abnormal findings gradually developed and reached a maximum on days 5 to 7 sequentially. The difference between infarction and perifocal edema was not clear even on MRI. The changes gradually subsided and assumed a stable size after about 2 months. Contrast enhancement effect was observed in four patients. In two of these cases, the signal intensity of T2-weighted imaging was decreased just at the region which was enhanced with contrast medium. MRI is useful for early diagnosis of ischemic cerebral infarction, and may elucidate some aspects of the pathophysiology of ischemic stroke. PMID- 2710284 TI - [Somatosensory evoked potentials over the unaffected hemisphere in patients with unilateral intracerebral hematoma]. AB - Somatosensory evoked potentials (SEPs) recorded from the unaffected hemispheres were studied in patients of less than one month after the onset of unilateral intracerebral hematoma. We examined 66 SEPs obtained from 49 patients with putaminal hemorrhage (midline shift 0-15 mm), 38 SEPs from 25 patients with thalamic hemorrhage (midline shift 0-8 mm), and 14 SEPs from 10 patients with subcortical hemorrhage (midline shift 0-12 mm). These examinations were made after electrical stimulation of the median nerve at the wrist by using square waves of 0.2 msec in duration delivered at a rate of 3 Hz. We analyzed the first cortical potential N 20 recorded from the contralateral scalp over the unaffected hemisphere with reference on Fpz. N 20 peak latency was compared with the maximum shift of the midline structure such as in foramen of Monro or third ventricle in computed tomogram. Also with the site of the hematoma and the disturbance of consciousness. N 20 peak latency was not correlated with the degree of the midline shift in all the patients. There was abnormal prolongation of N 20 peak latency in one SEP of one patient, and disappearance of N 20 in two SEPs of two patients with putaminal hemorrhage. Abnormal prolongation of N 20 peak latency was found in 3 SEPs of 3 patients with thalamic hemorrhage. There was no disappearance of N 20 in patients with thalamic hemorrhage. There was no abnormal prolongation or disappearance of N 20 peak latency in patients with subcortical hemorrhage. In two of five patients showing stuporous state, disappearance of N 20 was found.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710285 TI - [Relationship between directions of cerebellar retractions and cochlear and vestibular nerve injuries]. AB - It is said that lateral-to-medial retraction of the cerebellar hemisphere is hazardous because, by this retraction, avulsion injury of the cochlear nerve and internal auditory artery may be caused. Caudal-to-rostral retraction of the cerebellar hemisphere is, therefore, recommended in operations in the CP angle such as microvascular decompression procedures. From the results of our present study, however, it can be said caudal-to-rostral retraction can easily cause vestibular nerve damage. However, rostral-to-caudal retraction may damage the cochlear nerve just as lateral-to-medial retraction does. These differences of the eighth nerve injuries according to directions of cerebellar retractions are explicable from the fact that the vestibule and vestibular nerve are located posterior to the cochlea and cochlear nerve. Most of dysequilibrium appearing after manipulations in the CP angle may be due to vestibular nerve damage avulsion of the vestibular nerve and its accompanying vessels from the vestibular apparatus. PMID- 2710286 TI - [Transverse sinus thrombosis accompanied by intracerebellar hemorrhage: a case report]. AB - This case report deals with transverse sinus thrombosis accompanied by intracerebellar hemorrhage. A 33-year-old woman had sudden onset of headache, vomiting, and disturbance of consciousness. Computed Tomography (CT) scan showed left intracerebellar hematoma, while vertebral angiography revealed no visualization of the transverse sinus and cerebellar cortical veins on the left side. Evacuation of the intracerebellar hematoma along with decompression of the posterior fossa was carried out. Findings of the histopathological examination of the operation specimen showed the cortical veins to be filled with fresh thrombus and softened cerebellar parenchyma mixed with many small clots. Until now, cases such as hemorrhagic infarction in the cerebellum, due to transverse sinus thrombosis have not yet been reported. It is considered that there is much more collateral circulation in the infratentorial region rather than in the supratentorial region. This indicates that cerebellum hemorrhagic infarction rarely occurs due to transverse sinus thrombosis. In our case, the inflammation of the cortical veins (thrombophlebitis) was thought to have disturbed the collateral circulation in the cerebellum. PMID- 2710287 TI - [Partially thrombosed radiculomeningeal arterio-venous fistula in spinomedullary junction]. AB - A 58-year-old man was admitted to our hospital because of tetraparesis of fairly sudden onset. He had had difficulty in miction since 6 months earlier. MRI study showed a high intensity area in front of the medulla and a low intensity "vessel like" shadow in front of the upper cervical region on T1-weighted image. The dorsal part of the medulla and cervical spinal cord showed diffuse low intensity signals in T1-weighted image. The intra-axial lesion appeared as high intensity signals in T2-weighted image. Angiography revealed a huge dilated vascular malformation fed by a third part of the right vertebral artery. The lesion in front of the medulla was not opacified. His neurological status progressively deteriorated, resulting in combined respiratory distress. Emergency surgery was performed only for posterior decompression. Although postoperative balloon catheterization was scheduled, he died of gastric perforation and pancreas necrosis one month after the operation. At the autopsy, it was found that the feeding artery of the AVM was branched from the junction of V3 and V4 of the right vertebral artery, where the artery penetrates the dura mater. The meningeal artery was engorged, and the radicular vein of C1 was markedly dilated due to the retrograde filling. The premedullary vessel was thrombosed, but the cervical part of the AVM showed eccentric hypertrophy of the wall and a partially organized thrombus. Intra-axially, the posterior funiculus was markedly destroyed and the spinal cord was edematous and subnecrotic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710288 TI - [Histological diagnosis of brain tumors: (1) Ependymoma]. PMID- 2710289 TI - [A case of vacuolated meningioma]. AB - A rare case of falx meningioma with extensive vacuolization was reported. A 57 year-old woman was admitted to Okayama University Hospital because of numbness in her left lower limb. A plain CT scan showed a hypodense mass in the right frontal region with marked enhancement after contrast medium injection. MRI on T1 weighted images showed low intense mass with the so-called "peritumoral band" of low intensity at the periphery of the mass. Angiogram showed a mass effect and a tumor stain fed by the right pericallosal artery and left middle meningeal artery. The mass was excised en bloc. Microscopic examination demonstrated tumor cells with varied sized vacuoles, which were mostly fat-negative, except for small islands with typical meningothelial cells in the periphery of the tumor. Ultrastructurally, there were two kinds of vacuole in the tumor cells. The smaller, round vacuoles were in the cytoplasm, while the larger ones were in the extracellular space. The cell processes had developed junctional complex, and numerous cytoplasmic filaments were evident. With these findings, this mass was diagnosed as vacuolated meningioma. It is important especially in frozen section not to misdiagnose the tumor as liposarcoma, chordoma, metastatic brain tumor and so on. PMID- 2710290 TI - [Epithelial cysts of the central nervous system: report of two cases]. AB - Two cases of epithelial cyst are reported. Case 1. A 68-year-old female visited our hospital with a complaint of decreased visual acuity, 0.04 in the left eye, in September 1986. Visual field examination showed bitemporal hemianopsia. CT scan demonstrated nonenhancing cystic lesion involving the suprasellar region. By a right frontotemporal craniotomy, the suprasellar cyst was explored. The wall of the cyst was partially removed to relieve pressure against both optic nerves and chiasma. Histologically, the cyst wall was lined with a single layer of non ciliated cuboidal epithelium. Electron microscopic study revealed a number of microvilli, continuous basement membrane and desmosomes. Case 2. A 40-year-old female was admitted to our hospital because of sensory disturbance in the left hand for several years. She had an episode of convulsive seizure with a loss of consciousness. Neurological examination revealed hypesthesia of the left hand. CT scan showed non-enhancing right frontoparietal cystic lesion compressing the right lateral ventricle to the left. By a right frontoparietal craniotomy, the cystic lesion was explored. The cyst existed beneath an arachnoid membrane and contained CSF-like clear fluid. The cyst wall was resected, as far as possible, to obtain communication with normal subarachnoid CSF space. Histologically, by light and electron microscopic study, the cyst was considered to be an epithelial cyst. A correct diagnosis is difficult because other cystic lesions such as arachnoid cysts and craniopharyngioma are of similar low density and appear the same on CT scan. It is impossible to diagnose such an epithelial cyst by relying on neuroradiological study alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710291 TI - Suppressing effect of cysteamine on the TSH-stimulated mitotic activity of the rat thyroid follicular cells in vivo. AB - We have examined the effect of the thiol agent-cysteamine, known to deplete the hypothalamus, the pancreas, the gut of somatostatin--on the basal and TSH stimulated mitotic activity of the thyroid follicular cells (TFC) in adult male rats in vivo. The animals of different groups were administered cysteamine alone (300 mg/kg BW, s.c.), TSH alone (2IU, i.p.), or cysteamine with TSH jointly, the former agent being injected 2 hrs prior to the latter. In order to evaluate the thyroid mitotic activity, the metaphase-arrest technique was used in the study. It was shown that: 1. TSH significantly increased the mitotic activity of TFC, as compared to controls, 2. cysteamine alone had no effect on the TFC proliferation, 3. unexpectedly, cysteamine, when administered 2 hrs prior to TSH, suppressed the stimulatory effect of TSH on the mitotic activity of TFC. PMID- 2710292 TI - Isolation of neurosecretory granules containing vasotocin, mesotocin, MSEL- and VLDV-neurophysins from goose neurohypophysis. AB - Neurosecretory granules have been isolated from goose posterior pituitaries and their contents have been analyzed by reverse-phase high-pressure liquid chromatography and polyacrylamide gel electrophoresis. Vasotocin and mesotocin have been identified by their biological activities and their retention times compared with those of synthetic peptides. MSEL- and VLDV-neurophysins have been characterized by their N-terminal sequences, their electrophoretic migrations and their retention times, compared with those of purified goose neurophysins. In contrast to the two-step processing of mammalian provasopressin, processing of the vasotocin - MSEL-neurophysin precursor appears to involve only one cleavage giving the hormone and a "big" MSEL-neurophysin homologous to mammalian MSEL neurophysin extended by copeptin. PMID- 2710293 TI - Protection of endogenous enkephalin degradation from peptidases in human serum by actinonin. AB - This paper describes a new method for detecting the endogenous enkephalin level in human serum without interference from serum peptidases and contaminating proteins. The method consists of a combination of addition of a peptidase inhibitor, actinonin to serum and dialysis. The activity of enkephalin degrading enzymes was completely abolished by actinonin. Furthermore, contaminating proteins which interfered with RIA assay of enkephalins were removed by the dialysis process. This combination process enabled precise detection of the concentration of enkephalin-like substances in human serum. The mean normal serum level of leucine-enkephalin assayed by this method in 12 healthy volunteers was 93.4 pg/ml. PMID- 2710294 TI - Comparison of intimal platelet accumulation in cerebral arteries in two experimental models of subarachnoid hemorrhage. AB - Intimal accumulation of indium-111-labeled platelets in the middle cerebral arteries was examined in two different models of experimental subarachnoid hemorrhage (SAH) in the cat. SAH was produced in 7 subjects by a transorbital rupture of the right middle cerebral artery (RMCA) and in 10 subjects by the transorbital cisternal injection of 2 ml of autologous arterial blood around the RMCA. Animals in both experimental groups were sacrificed at 2, 4, 24, and 48 hours after SAH. The radioactivity (in counts per minute) of the RMCA segment was divided by that of the left middle cerebral artery (LMCA) to produce a radioactivity ratio (RMCA/LMCA). This radioactivity ratio was determined for each animal and was scored as positive if it was 1.25 or greater, and as negative if it was less than 1.25. The scores derived from the radioactivity ratios in both experimental SAH groups were mostly positive (86 and 70%, respectively) and were significantly different (P less than 0.05) from those of intact controls (n = 7) or sham-operated controls (n = 5; n = 4). There was, however, no significant difference (P = 0.35) between the scores of the two experimental groups in the first 48 hours after SAH. The results indicate that subarachnoid blood placed upon the adventitial surface of intact cerebral arteries activates platelet aggregation to a degree comparable to that which occurs after mechanical vessel rupture in the acute stages of SAH. We suggest that the noxious agents responsible for arterial injury and subsequent intimal platelet aggregation after SAH exert their influence primarily from the abluminal surface of the cerebral artery. PMID- 2710295 TI - Vascular abnormalities in the neck associated with intracranial aneurysms. AB - In 102 cases of ruptured intracranial aneurysms, the cervical as well as the cranial areas were explored by angiography. Loops in the course of the cervical vessels were present in 28 patients; features of fibromuscular dysplasia were present in 31 patients; and in 50 patients, no abnormalities were observed. In 7 patients, both cervical anomalies were present. Loops were associated with single aneurysms (95%), located primarily on the anterior communicating artery (76%), predominantly in men (M/F = 1.6). Aneurysms with fibromuscular dysplasia affected women more than men (F/M = 7), were frequently multiple (58%), and were located mainly on the intracranial part of the internal carotid and vertebral arteries (51%). These data suggest new concepts of aneurysm formation from inherited diseases and should permit the detection of some aneurysms before rupture. PMID- 2710296 TI - Microsurgical anatomy of the venous drainage into the superior sagittal sinus. AB - Ten unfixed human brains were examined under an operating microscope to evaluate the feasibility of reimplanting the parasagittal veins into the superior sagittal sinus. On average, there were 6.5 veins draining the surface of each hemisphere in the anterior frontal region, 3 veins draining each posterior frontal region, 4 veins draining each parietal region, and 1 vein draining each occipital region. The veins were most frequently 0.1 to 1.0 mm in diameter, but were as large as 3.0 mm in the anterior frontal and occipital regions, 3.5 mm in the parietal region, and 5.0 mm in the posterior frontal region. The mean vein length between the superior sagittal sinus and the first lateral attachment was 3.0 to 7.4 mm; individual veins were as long as 30.0 mm. The 20 hemispheres contained a total of 5 veins in the anterior frontal region, 7 veins in the posterior frontal region, and 8 veins in the parietal region that appeared to have an adequate diameter and length for microsurgical reimplantation into the superior sagittal sinus. The superior sagittal sinus had a mean width of 4.3 mm and depth of 3.6 mm in the midanterior frontal region and enlarged to a mean width of 9.9 mm and depth of 6.8 mm in the midoccipital region. In all sites, the sinus appeared to be structurally compatible with vein reimplantation. In 3 cases, veins 2.8 to 4.6 mm in diameter were reimplanted microsurgically into the sinus; in each case, the anastomosis was technically satisfactory and patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710297 TI - Electrophrenic respiration in patients with high quadriplegia. AB - After determining that 15 patients with high spinal cord injuries who were permanently apneic had viable phrenic nerves, electrophrenic respiration units were implanted. Thirteen of the patients (86%) achieved full-time respiration and two more achieved half-time respiration. Despite the loss of 8 patients to unrelated problems, 7 now use electrophrenic respiration continuously, one having done so for 16 years. The patient selection criteria, neurophysiological evaluation method, surgical procedure, postoperative care, and methods for diagnosis of system failures are presented. A comparison of the cervical and thoracic procedures is made. The cervical approach is preferred. Complications consisted primarily of equipment failures. For the external components there were several cases of antenna connection and battery connection failures. The implanted receivers failed in 6 cases with an average lifetime of 48 months, ranging from 24 to 108 months. In one case fibrosis around the electrode resulted in failure to stimulate the phrenic nerve effectively. In another case, infection required removal of the system which was reimplanted later and has continued to provide successful ventilation. PMID- 2710298 TI - The infant whiplash-shake injury syndrome: a clinical and pathological study. AB - The cases of 13 infants (median age, 3 months) who sustained nonaccidental trauma were reviewed. All presented with profound neurological impairment, seizures, retinal hemorrhages, and intracranial subarachnoid and/or subdural hemorrhages. Of 8 infants who died, autopsy was performed on 6. No patient had a skull fracture, and only one had an extracalvarial contusion. Five of the 6 patients on whom autopsy was performed had injuries at the cervicomedullary junction consisting of sub- or epidural hematomas of the cervical spinal cord with proximal spinal cord contusions. The authors conclude that direct cranial trauma is not an essential element of the injury mechanism in young patients who sustain severe whiplash-shake injuries. In addition to the classic injuries reported to occur with the shaken-baby syndrome, hemorrhages and contusions of the high cervical spinal cord may contribute to morbidity and mortality. PMID- 2710299 TI - Immunohistochemistry of human malignant astrocytoma cells xenografted to rat brain: apolipoprotein E. AB - Fresh xenografted human malignant astrocytoma cells migrate throughout the host rat brain. Cells from three Grade 3 human malignant astrocytomas were prelabeled with Phaseolus vulgaris leucoagglutinin (PHAL) and then xenografted into implantation pockets in rat host cerebral cortex. The human malignant astrocytoma cells in the host brain were immunocytochemically double-labeled for the presence of PHAL, which is used as a marker for graft derived cells, and either glial fibrillary acidic protein (GFAP), a specific marker for astrocytes and astrocytoma cells, or apolipoprotein E (APOE) 7 days, 14 days, 21 days, and 1 month later. Fresh human malignant astrocytoma cells (Grade 3 and 4) contained APOE and GFAP. The xenografted cells preserved APOE and GFAP in the host. PHAL double-labeled human malignant astrocytoma cells were found on the glia limitans along the entire circumference of the brain, in the corpus callosum, internal capsule, entopeduncular nucleus, optic tract, and median eminence. In addition, astrocytoma cells were observed in the cingulum, habenula, arcuate, and supraoptic nucleus. Astrocytoma cells entered the space of Virchow-Robin, migrated along parenchymal blood vessels and between the ependymal and subependymal layers of the third and lateral ventricles. APOE was a consistent marker for the migrating human malignant astrocytoma cells, but not an exclusive marker of the xenografted cells, since host rat reactive astrocytes also expressed APOE. PMID- 2710300 TI - Intracranial meningiomas in the aged: surgical outcome in the era of computed tomography. AB - Seventy-five patients older than 60 years of age underwent surgical resection of intracranial meningiomas during a 10-year period at a single institution. All patients had a computed tomographic scan preoperatively, and all were followed for at least 3 months postoperatively. There were 50 patients 61 to 70 years of age (Group A), and 25 patients older than 70 years (Group B). Sixteen patients (21%) were asymptomatic, and no patient was severely disabled preoperatively. Operative morbidity and mortality and outcome at 3 months were assessed and correlated with age, preoperative neurological status, and tumor size and location. Operative mortality was 6.6% (6% in Group A; 8% in Group B). Perioperative morbidity (including medical and surgical complications and worsening in neurological status) was 48% (46% in Group A; 52% in Group B). Neurological status 3 months after surgery was improved by at least one grade as compared to before surgery in 40% of patients (38% in Group A; 44% in Group B), unchanged in 29% (34% in Group A; 20% in Group B), and worsened in 31% (28% in Group A; 36% in Group B). While nearly half of the patients were asymptomatic 3 months after surgery, 11 patients (15%) had died or remained seriously disabled. Outcome at 3 months correlated significantly with low neurological grade preoperatively and with a tumor location over the cortical convexity. There was no significant correlation with age or tumor size. We conclude that resection of intracranial meningiomas is associated with significant morbidity and mortality in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710301 TI - Microneurosurgical treatment of intracranial dermoid and epidermoid tumors. AB - Forty-three patients with intracranial, intradural dermoid (8) and epidermoid (35) tumors underwent radical surgical resection utilizing strict microneurosurgical technique. The average age was 37.3 years for the patients with epidermoid tumors and 36.2 years for the patients with dermoid tumors. The male to female ratio was 3:2 for the epidermoid group and 3:1 for the dermoid group. Common clinical presentations included cerebellar dysfunction, cranial nerve impairment, and seizures. Typically, computed tomography scans revealed the epidermoid tumors (30 cases studied) as nonhomogeneous hypodense lesions with irregular borders and without contrast enhancement. The dermoid tumors (7 cases studied) had a similar appearance, but with a wider range of attenuation values. Magnetic resonance imaging findings for the epidermoid tumors (6 cases studied) consisted of increased T1 and increased T2 relaxation times. Supratentorial tumors were excised by the pterional (frontosphenotemporal) approach, mesencephalic tumors by either a supratentorial posterior interhemispheric transtentorial approach or an infratentorial/supracerebellar method, and posterior fossa tumors by either a medially or laterally positioned suboccipital osteoplastic craniotomy. One epidermoid tumor and one dermoid tumor were considered to be subtotally resected because of dense adherences left attached to vital structures; the remaining 41 tumors were completely excised. The most frequent complications were aseptic/chemical meningitis and transient cranial nerve palsies. There were no perioperative deaths. Mean follow-up was 5.2 years. Eighty-six percent of patients reported good to excellent results. No patient had experienced symptomatic or radiographic evidence of recurrence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710302 TI - Clinical course and surgical prognosis of 33 cases of intracranial epidermoid tumors. AB - Thirty-three cases of intracranial epidermoid tumors treated during the past 25 years were analyzed with regard to clinical manifestations, recurrence rates related to the extent of surgery, and long-term survival rates. Epidermoid tumors caused various symptoms, especially in the cerebellopontine angle (15 cases), of which a transient remission of symptoms was observed in 4 cases (23.5%). The average time from initial symptoms to surgery was much shorter in suprasellar region and third ventricular locations (average of 11 months) than in other locations (average of 7 years). In 28 patients (84.9%), the tumor was removed totally or subtotally. Most of the patients could lead an independent and useful life after operation (93.1%). Among the 29 patients in a long-term follow-up survey, seven tumors recurred after an average interval of 8 years and 10 months (from the first to second operation) and 12 years and 6 months (from the second to third operation). Patients with recurrent tumors were successfully treated, and excellent functional prognosis was observed even after the second or third operation. The 20-year survival rate was 92.8% (Kaplan-Meier method). PMID- 2710303 TI - Osteoblastic meningioma of the fourth ventricle. AB - Meningiomas of the fourth ventricle are rare neoplasms. Only meningothelial and fibroblastic subtypes, purportedly arising from the tela choroidea, have been described. In this report we describe clinical, neuroradiological and pathological findings in a 52-year-old man with mild hydrocephalus produced by a large, calcified, osteoblastic meningioma of the fourth ventricle. PMID- 2710304 TI - Intracranial plasma cell granuloma. AB - An exceptional case of intracranial plasma cell granuloma, located in the right frontoparietal convexity in a 16-year-old boy is reported. Reports of these rare inflammatory lesions locate them primarily in the lungs and in other regions of the body, and only exceptionally in the nervous system; indeed, only three intracranial cases and one other arising from the spinal meninges have been reported. The computed tomographic and surgical aspects suggested a falx meningioma in our case. The pathological diagnosis differentiating these from other intracranial lesions with a plasma cell component, including meningioma with plasma cell infiltration and plasmacytoma, is discussed. PMID- 2710305 TI - Treatment of fractures of the vertebral limbus and spinal stenosis in five adolescents and five adults. AB - Fractures of the vertebral limbus occur between the vertebral ring apophyses and the cartilaginous rim of the superior or inferior margins of the vertebral end plates. These fractures are typically seen in adolescents or young adults, since fusion in this area is not complete until the ages of 18 to 25. Of 85 cases reported, 24 occurred in adolescents. The authors present the clinical, neurodiagnostic, and surgical management of fractures of the vertebral limbus and coincident segmental spinal stenosis in a group of 5 adolescents and 5 adults. An additional category for fractures of the vertebral limbus is proposed, namely, a lesion that is not confined to the superior or inferior margins of the vertebral end plates, but that spans the full length of the vertebral body. PMID- 2710306 TI - Superior sagittal sinus infection with Petriellidium boydii: case report. AB - A case of infection of the superior sagittal sinus with Petriellidium boydii is reported. This relatively common fungal pathogen rarely invades the central nervous system. Immunological compromise and poor personal hygiene seem to be common attributes shared by this patient and the 4 previous patients reported to have suffered invasion of the central nervous system by this organism. This report is unique in that it is the first demonstrating apparent hematogenous dissemination of this organism to the central nervous system. PMID- 2710307 TI - Castleman's disease manifesting in the central nervous system: case report with immunological studies. AB - Castleman's disease is an uncommon lymphoproliferative disorder that manifests itself as a local or generalized tumor-like condition affecting both lymph nodes and nonnodal tissues, usually in the chest or abdomen. Only two prior examples involving the central nervous system had been reported when this patient was encountered. Very recently, three additional cases have been reported by Severson et al. We report the sixth case of Castleman's disease affecting the central nervous system, which occurred in a 63-year-old woman in whom the diagnosis was made after craniotomy for a mass lesion involving the dura over the frontal regions. Neuroradiological, clinical, and immunopathological characteristics of the case are presented. The lesion was treated with cranial irradiation and the patient is alive and symptom free three years after initial treatment. PMID- 2710308 TI - The small midline occipital encephalomeningocele: definition of a syndrome. AB - An unusual group of encephalomeningoceles is described. Two children were noted at birth to have a raised area of abnormal skin at the occipital midline. Both of these lesions were found to perforate the superior sagittal sinus and to end between the leaves of the falx cerebri, and to contain a small amount of abnormal cerebral tissue with no connection to either occipital lobe. Previous case reports are reviewed; these lesions are true encephalomeningoceles, rather than glial heterotopias. The embryology of such lesions is considered, and likely differs from the much more common occipital encephalocele arising from one or both occipital lobes. PMID- 2710309 TI - Occult intrasacral meningocele: clinical and radiographic diagnosis. AB - We evaluated four patients who had occult intrasacral meningocele with multimodality radiographic imaging techniques. The clinical features, radiological findings, gross appearances of the lesion at surgery, surgical technique, histopathological features of the cyst wall, and surgical outcome are described. The role of magnetic resonance imaging in the preoperative evaluation compared with standard radiographic techniques is discussed. Theories regarding the pathogenesis of this lesion are reviewed. PMID- 2710310 TI - Subependymoma of the cervical spinal cord. AB - A case of subependymoma of the spinal cord in the cervical region is presented. Our experience with this patient and the seven cases of spinal cord subependymoma previously reported show that this tumor predominates in the cervical region and in males (3:1). Although radical removal is considered the rational goal of treatment, larger experience is necessary to know both the rate of growth and prognosis of subependymomas when these tumors arise within the spinal cord. PMID- 2710311 TI - Experience with the ultrasonic surgical aspirator in a cavernous hemangioma of the cavernous sinus. AB - A patient with a cavernous hemangioma of the cavernous sinus was operated upon using the Cavitron Ultrasonic Surgical Aspirator (CUSA). Intracapsular subtotal removal of the tumor was accomplished efficiently with the CUSA. At the end of the procedure, however, the CUSA penetrated not only the capsule of the tumor, but also the wall of the internal carotid artery. Advantages and disadvantages of CUSA surgery for cavernous hemangiomas of the cavernous sinus are discussed. PMID- 2710313 TI - Use of the linear accelerator for neurosurgery. PMID- 2710312 TI - Primary spinal extradural hydatid cyst. AB - We report a rare case of spinal cord compression caused by a primary extradural hydatid cyst. PMID- 2710314 TI - Role of aspiration cytology in the diagnosis of cystic hydatid disease. PMID- 2710315 TI - Early aneurysm surgery. PMID- 2710316 TI - Extending the limits of complex learning in organic amnesia: computer training in a vocational domain. AB - This study explored the limits of learning that could be achieved by an amnesic patient in a complex real-world domain. Using a cuing procedure known as the method of vanishing cues, a severely amnesic encephalitic patient was taught over 250 discrete pieces of new information concerning the rules and procedures for performing a task involving data entry into a computer. Subsequently, she was able to use this acquired knowledge to perform the task accurately and efficiently in the workplace. These results suggest that amnesic patients' preserved learning abilities can be extended well beyond what has been reported previously. PMID- 2710317 TI - Reach training selectively alters dendritic branching in subpopulations of layer II-III pyramids in rat motor-somatosensory forelimb cortex. AB - We have previously reported that training rats to reach for bits of cookies resulted in an increase in dendritic length and branching complexity in the apical branches of layer V pyramidal cells within the motor-sensory forelimb cortex. In this paper, we describe the effects of reach training upon the basilar branches of two subpopulations of pyramidal cells in layers II and III. The two subpopulations of pyramids are distinguishable by morphological characteristics and location within layers II and III. The basilar dendrites of one subtype, the forked apical pyramid, are selectively altered in size and complexity during reach training; whereas the other subtype, the single shaft apical cells, do not measurably change during training. Based upon these findings, we postulate that these cells may have different roles in governing the reaching behavior. PMID- 2710318 TI - Mnemonic and neuropathological effects of occluding the posterior cerebral artery in Macaca mulatta. AB - To investigate experimentally the mnemonic and neuropathological effects of blockage of the posterior cerebral arteries (PCA), a cerebrovascular accident that can lead to global anterograde amnesia in humans, we permanently occluded these arteries bilaterally in six monkeys and then evaluated their performance on a visual recognition task, after which we assessed the extent of their ischemic infarcts. The latter showed substantial individual variation, ranging from almost no damage in one case to massive unilateral injury of both the ventromedial o occipitotemporal cortex and hippocampal formation in another. In the four remaining cases, however, the infarcts fell within a narrow range, being confined almost entirely to the hippocampal formation and parahippocampal gyrus, and then only to restricted portions of these structures, unilaterally in one case, and bilaterally in the three others. Performance on the recognition task was related to the presence and bilaterality of the hippocampal injury. Thus, the case without any hippocampal damage performed at a rate equal to that of normal controls; the case with unilateral hippocampal damage was mildly impaired; and the three cases with bilateral infarctions, involving between 20 and 55% of the hippocampal formation, showed substantial impairment, with scores averaging 20% below those of normal controls. The only subfields of the hippocampus damaged in common in these cases were CA1 and CA2. Paradoxically, the memory loss found in these three animals with only partial bilateral hippocampal damage was significantly greater than that found in animals with total bilateral ablation of the hippocampal formation, whose scores averaged only 10% below those of normal controls. Possible explanations for this extremely puzzling outcome are proposed. PMID- 2710319 TI - Evidence of foveal splitting in a commissurotomy patient. AB - A bilateral projection of the central fovea, produced by naso-temporal overlap at the retinal vertical meridian, has been proposed as the anatomical basis of macular sparing. To evaluate this claim, a commissurotomy patient was required to compare target figures presented 1 degrees or less from the retinal midline with reference figures presented 2.5 degrees from the midline in the same or opposite visual field. The subject judged whether the target and reference were the same or different. It was found that the subject's fovea was effectively split with respect to the cerebral hemispheres; targets in the same visual field as the reference were readily matched with the reference, but accuracy dropped to chance for targets in the opposite field. Ways of reconciling this data with anatomical evidence of nasotemporal overlap and reports of macular sparing are discussed. PMID- 2710320 TI - Aimed movements to visual targets in hemiplegic and normal children: is the "good" hand of children with infantile hemiplegia also normal? AB - The accuracy, reaction and movement time of pointing movements to visual targets were examined in children aged 3-13 yr with infantile hemiplegia and compared to those of comparably aged normal children. Hemiplegic children pointed with the "good" hand (i.e. ipsilateral to the lesion). Half the normal children used the preferred hand, half the non-preferred hand. Movements were made with unrestricted/restricted visual feedback, when movement distance was short/medium/long, and when number of target alternatives were 2/4/8. Normal children using the preferred hand were more accurate but reacted more slowly than children using the non-preferred hand. The performance of most of the hemiplegic children with bilateral and/or unilateral lesions was impaired; degree of accuracy was related to the extent of the brain lesion; and reaction time was related to the level of intelligence. It was concluded that unilateral lesions in children can result in bilateral visuomotor impairment. PMID- 2710321 TI - Event-related potentials in children with specific visual cognitive disability. AB - Event-related potentials (ERPs) elicited by novel and well memorized non-verbal visual patterns were recorded over the right and left hemispheres from ten children with Specific Visual Cognitive Disability (SVCD) and ten matched Control subjects (C). ERPs of SVCD children were generally longer in latency (particularly N2) and decreased in amplitude (particularly P3) relative to the ERPs of Cs. No hemisphere differences were observed in the SVCD group, while the latency of N2 in the C group tended to be slightly shorter and the amplitude of P3 was significantly larger over the right than over the left hemisphere. The results are discussed in terms of deficits in visual learning and visual pattern analysis. The different hemispheric pattern in SVCD children as compared to Cs is suggested to be a symptom secondary to basic visual cognitive deficits. PMID- 2710322 TI - Influence of spatial frequency and handedness on hemispheric asymmetry in visually steady-state evoked potentials. AB - Recent suggestions on the involvement of the spatial frequency of visual stimuli in the hemispheric lateralization were investigated by recording steady-state evoked potentials in two groups of subjects: five right-handers and five left handers. Sinusoidal gratings at spatial frequency of 0.5, 1, 3, 4, 6, 8, 10, 12 or 16 cpd were phase reversed at 4 Hz or 12 Hz. Evoked potentials recorded from temporal leads over each hemisphere were submitted to a FFT analysis. Results concern the amplitude of the fundamental component. In right-handers, the temporal frequency was the deciding factor of the lateralization: the evoked activities were greatest in the RH at 4 Hz and in the LH at 12 Hz. This effect was obvious for the range of spatial frequencies from 3-12 cpd. Results, discussed in terms of global/local information, suggested the existence of two transient and sustained systems. In left-handers, both the spatial and temporal parameters were relevant to the lateralization. A spatio-temporal interaction was observed which was reversed at 6 cpd. PMID- 2710323 TI - Selective attention in Alzheimer's disease: characterizing cognitive subgroups of patients. AB - Picture recognition was studied in 20 patients with AD and in 20 control subjects, using a procedure that matched these groups for initial performance. The groups did not differ significantly in overall forgetting, although 10 patients displayed improved recognition performance 72 hr after learning. These same patients were impaired in a test of attentional focusing, as revealed by post hoc analyses. A predictive experiment involving 20 new patients with AD confirmed the initial findings: a subgroup of patients displayed improved recognition performance 72 hr after learning and impairments in attentional focusing. Neuropsychological tests thus identify a subgroup of patients with impaired selective attention, perhaps related to locus coeruleus neuropathology. PMID- 2710324 TI - Explicit and implicit remembering: when is learning preserved in amnesia? AB - Amnesic patients can learn and retain a variety of skills. To investigate what distinguishes tasks that are within the learning abilities of amnesic patients from those that are not, we administered two tests to individuals with Korsakoff's syndrome and two control groups. One was a visual reaction time task with an embedded repeating sequence of stimulus positions. Response times of Korsakoff patients indicated that they learned this sequence and retained it normally for a week. The second task was a tactual stylus maze in which all blind alleys were blocked. Korsakoff patients were impaired in learning this maze, as assessed by the time required to trace it. Differences between the two tasks are outlined and the implications of these differences are discussed. PMID- 2710325 TI - Unilateral attention deficits and hemispheric asymmetries in the control of visual attention. AB - The present study sought to determine the roles of the two hemispheres in arousal and the selective components of attention. Ten patients with left and right parietal lesions and ten with left and right temporal lesions participated in the experiment. The hypothesis that posterior parietal lesions, whether left or right, cause two selective attentional deficits, namely, a reduced reactivity to stimuli in the visual field contralateral to the lesion, and a reduced reactivity to any stimulus which occupies a relative contralateral spatial position, was tested by asking the patient to tilt their head either to the left or to the right by 90 degrees and to respond to two stimuli displayed above and on either side of fixation mark. The arousal component of attention was studied by analysing the overall RT to visual stimuli independent of their spatial positions. The results showed that (1) patients with either left or right parietal damage are impaired in shifting attention from the ipsilateral to the contralateral visual field, and, within each visual field, in a direction contraversive to the lesion and (2) these two attentional deficits are more severe after right than after left parietal damage. Furthermore, the results show that the difficulty in maintaining a high level of alertness is a specific deficit of patients with right hemispheric lesion and not of patients with an extinction syndrome, insofar as there is no significant difference in overall RT between patients with parietal and temporal lesions. PMID- 2710326 TI - Reduction of cutaneous reaction time by directing eyes towards the source of stimulation. AB - Reaction time to expected lateral cutaneous stimulation was measured in Man when the eyes were directed (1) towards the stimulated area, (2) towards another point within the same hemispace and (3) towards the other hemispace. As performance was better in the first case, this suggests that compatible eye postural activity reinforces the effect of spatial attention. PMID- 2710327 TI - Maintenance of long-term potentiation in rat dentate gyrus requires protein synthesis but not messenger RNA synthesis immediately post-tetanization. AB - The involvement of new protein and messenger ribonucleic acid synthesis in long term potentiation was studied in the anaesthetized rat dentate gyrus using several inhibitors of protein synthesis (anisomycin, emetine, cycloheximide and puromycin) and an inhibitor of messenger ribonucleic acid synthesis (actinomycin D). When injected for 1 h just prior to tetanization, the four inhibitors of protein synthesis produced a mild reduction of long-term potentiation of the excitatory postsynaptic potential measured 10 min after tetanization. Anisomycin produced a significantly faster decay of long-term potentiation, while the other inhibitors had more moderate effects. Actinomycin D failed to affect long-term potentiation. In a second experiment, the time-dependency of the anisomycin effect was examined. Anisomycin injected immediately after tetanization promoted decay of long-term potentiation, but when injected after a 15-min delay, the drug had no effect. Inhibition of protein synthesis for 4 h prior to tetanization did not have any more effect on long-term potentiation than inhibition for 1 h. In no experiment was long-term potentiation of the population spike affected by drug manipulation. These results suggest that for long-term potentiation of the excitatory postsynaptic potential to be maintained for at least 3 h proteins must be synthesized from already existing messenger ribonucleic acid, and that this synthesis is mostly completed within 15 min after tetanization. PMID- 2710328 TI - Neuronal activity in the subcortically denervated hippocampus: a chronic model for epilepsy. AB - Spontaneous and evoked field potentials and cellular discharges were studied in the subcortically denervated hippocampus of the freely moving rat. The fimbria fornix, the ventral hippocampal commissure, and the supracallosal afferent fibers were removed by aspiration, and recordings were made 3-5 months after the lesion. Two types of spontaneous interictal spikes were observed. Type 1 interictal spike had identical depth distribution to physiological sharp waves but they were shorter in duration (less than 40 ms), larger in amplitude (greater than 2.5 mV) and population spikes were riding on the main deflection. Type 2 interictal spikes were negative in the stratum oriens and positive in the pyramidal layer and stratum radiatum of both CA1 and CA3. The amplitude of both types of interictal spikes could exceed 6 mV. We suggest that interictal spikes were initiated randomly in different subpopulations of the CA2-3 region and the location of the initiating population burst determined the polarity and amplitude of the extracellular interictal spike. Repetitive stimulation of the perforant path (5 Hz, 6 s) evoked markedly uniform afterdischarges in both intact and fimbria fornix-deprived rats. The threshold of afterdischarges was significantly lower, the seizure spread to the contralateral hippocampus was slower, and secondary afterdischarges lasted significantly longer in the lesioned rats. We suggest that under physiological conditions the electrical stability of the hippocampus is ensured by the feed-forward inhibitory action of subcortical afferents. Removal of tonic inhibitory influences and/or sprouting of local axon collaterals allows extreme synchronization and reverberation of information in the entorhinal-hippocampal-entorhinal cortex circuitry. The presence of interictal spikes and increased susceptibility to seizures for several months after the lesion offers the fimbria-fornix-deprived hippocampus a useful chronic preparation to study the mechanisms of limbic epilepsy. PMID- 2710329 TI - Simultaneous recording of local electrical activity, partial oxygen tension and temperature in the rat hippocampus with a chamber-type microelectrode. Effects of anaesthesia, ischemia and epilepsy. AB - A miniature multiple thin-film recording sensor was used to measure simultaneously the electrical activity, oxygen content and temperature of brain tissue. The chamber-type potential sensor was an Ag/AgCl electrode covered by an Si3N4 (silicon nitride) chamber. The chamber-type oxygen sensor consisted of an Au-Ag/AgCl two-electrode electrochemical cell embedded in an electrolyte-filled Si3N4 chamber. The temperature sensor was a thin-film germanium resistor. The different sensors were spaced 300 microns apart. Anaesthetics (pentobarbital, chloral hydrate, chlornembutal, halothane) were shown to depress electrical activity and to increase local oxygen tension in the hippocampus. Halothane, but not the other anaesthetics, also increased the current output of the oxygen sensor when tested in saline bath, indicating that the apparent increase in measured oxygen levels during halothane anaesthesia was partly due to an electrochemical effect of halothane on the oxygen sensors. The decrease of tissue oxygen consumption produced by the other anaesthetics is likely to be the result of metabolic depression. Cerebral ischemia, evoked by cauterization of the vertebral arteries and occlusion of the carotid arteries for 30 min, resulted in the disappearance of both spontaneous and evoked electrical activity in the hippocampus and a decrease of both local temperature and oxygen tension. There was a marked overshoot of the oxygen tension to above preocclusion level following the release of the carotid arteries. As soon as electrical activity returned, the oxygen tension fell again, often below the lowest level seen during the ischemic period. This secondary decrease of oxygen level could be reversed by administration of supplementary small doses of anaesthetic. The anaesthetic induced increase in oxygen tension was accompanied by a marked decrease in electroencephalogram amplitude and frequency. During electrically induced seizures a decrease in hippocampal oxygen content occurred and was accompanied by an increase of local temperature. Since the rectal temperature was kept constant, the changes in temperature are likely to reflect changes in blood perfusion of the recorded area. These findings are in agreement with previous observations made with conventional electrodes. In addition, the miniature size of the chamber type microelectrode assembly allows a correlated monitoring of parallel physiological changes with high spatial and temporal resolution during anaesthesia, ischemia and epilepsy. PMID- 2710330 TI - Postnatal development of GABA-mediated synaptic inhibition in rat hippocampus. AB - Developmental alterations in GABAergic synaptic transmission were examined physiologically and biochemically in hippocampus of rats from 3 days of age to adulthood. Neither antidromic nor orthodromic stimulation could elicit identifiable inhibitory postsynaptic potentials in CA1 neurons in slices from rats 5 or 6 days of age. In contrast, at this age these stimuli result in large inhibitory postsynaptic potentials in CA3 pyramidal cells. In the latter cells orthodromic stimulation produced a brief monosynaptic excitatory postsynaptic potential which was followed by a large prolonged biphasic hyperpolarization. These signals were strikingly similar to those recorded in 1-month-old rats. In addition, large recurrent inhibitory postsynaptic potentials were produced by antidromic stimulation. By postnatal day 9 similar inhibitory postsynaptic potentials could be elicited in a majority of neurons of the CA1 subfield. As in mature pyramidal cells, application of GABA antagonists, such as bicuculline, selectively eliminated the antidromic inhibitory postsynaptic potential and the first component of the biphasic inhibitory postsynaptic potential generated by stimulation of stratum radiatum. In the CA3 subfield, this blockade of GABA receptors resulted in prolonged afterdischarges in slices from immature but not month-old rats. Measurements of the equilibrium potential and the conductance of antidromic inhibitory postsynaptic potentials in CA3 neurons were very similar when made during the first postnatal week and at 1 month of age. While on days 10 11 the equilibrium potential was very similar to measurements made at these other ages, the conductance was 3-4 times greater. The activity of glutamate decarboxylase, the synthetic enzyme for GABA, was very low at 3 days in hippocampus, and increased until 30 days of age at which time adult values were obtained. By comparison, hippocampal GABA levels were high early in postnatal life. Glutamate decarboxylase activities in microdissected CA3 and CA1 subfields were similar in immature hippocampus. These results demonstrate dramatic differences in the ontogenesis of functional GABAergic inhibitory synaptic transmission in the CA1 and CA3 subfields of rat hippocampus. The late development of GABA-mediated synaptic inhibition in the CA1 subfield could play a role in the susceptibility of immature hippocampus to seizures. However, the large GABA-mediated inhibitory postsynaptic potentials present in the CA3 subfield at the same age have a critical role in dampening neuronal excitability.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2710331 TI - Long-term loss of paired pulse inhibition in the kainic acid-lesioned hippocampus of the rat. AB - A paired pulse stimulation protocol was employed to examine the loss of inhibition in the hippocampus of the kainic acid-treated rat in vivo. Extracellular recordings were obtained from the CA1 pyramidal cell layer 1, 4, 8 and 16 weeks after a unilateral intracerebroventricular injection of kainic acid. Recordings were made both ipsilateral and contralateral to the site of kainic acid injection. The results demonstrated a loss of paired pulse inhibition in hippocampal CA1 area ipsilateral to the site of kainic acid injection which did not alter over 16 weeks. While the contralateral hippocampus showed no change 1 week after kainic acid injection, a reduction of paired pulse inhibition was seen after 4, 8 and 16 weeks. It is therefore apparent that the effects of kainic acid on the state of inhibition of the hippocampus are long-lasting and, furthermore, that the response to an injection of kainic acid is widespread, affecting the inhibitory control of the contralateral hippocampus. PMID- 2710332 TI - The supraoptic nucleus: afferents from areas involved in control of body fluid homeostasis. AB - Physiological evidence indicates that the supraoptic nucleus may be an important integrating region for information relating to body fluid homeostasis. It is known that the supraoptic nucleus receives neural influences from brain receptive zones for plasma osmolality and angiotensin II, as well as from relay centers for blood pressure and blood volume. It is also known that these influences interact to modulate vasopressin release from the supraoptic nucleus. Therefore, a detailed investigation of the neurochemical afferents to the supraoptic nucleus from regions of the lamina terminalis and the brainstem was undertaken. Injection of a fluorescent retrograde tracer, doxorubicin, into the supraoptic nucleus was combined with histochemistry of angiotensin II and catecholamines. Following supraoptic nucleus injection, retrograde label was found in forebrain neurons of the subfornical organ, median preoptic nucleus, and organum vasculosum of the lamina terminals. Some labeled cells in the subfornical organ and organum vasculosum of the lamina terminalis were also found to contain angiotensin II immunoreactivity. In the brainstem, retrograde label was found in neurons of the A1, A2 and A6 cell groups. Many of these cells were also found to contain catecholamine fluorescence or tyrosine hydroxylase immunoreactivity. Corroboration of the A2 projection was obtained by lesions of this nucleus, which reduced catecholamine fluorescence in the supraoptic nucleus. These findings provide an anatomical basis for the functional observations that the supraoptic nucleus plays a key integrative role in the maintenance of body fluid homeostasis. PMID- 2710333 TI - Histamine-immunoreactive nerve fibers in the rat brain. AB - A new immunohistochemical method that utilizes carbodiimide as a tissue fixative was applied to study the distribution of histamine-immunoreactive neuronal fibers and terminals in the rat brain. Immunoreactive fibers were observed in almost all major regions of the brain. They were most numerous in the different hypothalamic nuclei. Dense networks of immunoreactive fibers were also seen in the medial septum, nucleus of the diagonal band and ventral tegmental area. A moderate density of fibers was seen throughout the cerebral cortex, in some parts of the olfactory bulb and tubercle, bed nucleus of the stria terminalis, amygdala, basal parts of the hippocampus, inferior and superior colliculi, substantia nigra, lateral and medial parabrachial nucleus, and the nucleus of the solitary tract. Few histamine-immunoreactive fibers were seen in most parts of the caudate putamen, most thalamic nuclei, most pontine and ventral medullary nuclei. Histamine-immunoreactive neuronal cell bodies were found exclusively in the tuberomammillary nucleus, in agreement with previous reports. The results provide evidence for a widespread distribution of histamine-containing nerve fibers and terminals in the rat brain. Although immunohistochemical localization of histamine does not give direct evidence of a functional role of histamine in any brain area, this distribution suggests involvement in functions of the limbic system including the septal nuclei, hypothalamus and amygdala. The relatively dense histamine-immunoreactive fiber networks in the colliculi and dorsal cochlear nucleus indicate that this amine may play a role in visual functions and hearing. The paucity of immunoreactive fibers in the pontine and medullary areas suggests that the caudal projections originating from the tuberomammillary complex are minor ones compared to the major rostral projections. Several fiber projections originating from the tuberomammillary complex could be deduced from serial frontal, sagittal and horizontal sections. They contained fibers that crossed the midline at several levels of the brain. The results provide information on the target areas of the histaminergic neurons and form a basis for the examination of cellular contracts between the histaminergic neurons and other cells. PMID- 2710334 TI - Cholinergic projections to the substantia nigra from the pedunculopontine and laterodorsal tegmental nuclei. AB - The cholinergic innervation of the compact and reticular parts of the substantia nigra in the rat was investigated by use of highly sensitive retrograde and anterograde tract-tracing methods in combination with choline acetyltransferase immunohistochemistry. The fluorescent tracers True Blue, propidium iodide, or fluorogold were infused preferentially into either nigral subnucleus. Cells positive for choline acetyltransferase and retrograde tracer were found in both the pedunculopontine and laterodorsal tegmental nuclei, although considerably more double-labeled somata were observed in the former than in the latter component of the pontomesencephalotegmental cholinergic complex. Approximately 2 3 times more cholinergic cells were labeled in the peduculopontine and laterodorsal tegmental nuclei when tracer injections were centered in the compact nigral subdivision than when infusions of about the same size were confined totally to the reticular part. Infusions of the anterogradely transported tracer Phaseolus vulgaris leucoagglutinin into the pontomesencephalotegmental cholinergic complex resulted in uptake and transport of that label to both nigral subnuclei, and some of the Phaseolus vulgaris leucoagglutinin-accumulating somata and proximal processes also demonstrated choline acetyltransferase-like immunoreactivity. The Phaseolus vulgaris agglutinin-labeled entities in the substantia nigra exhibited terminal-like profiles that were reminiscent of the pattern of nigral choline acetyltransferase-positive puncta demonstrated immunohistochemically by use of nickel ammonium sulfate enhancement of the final reaction product in the avidin-biotin procedure. These observations strongly support the contention that the pontomesencephalotegmental cholinergic complex is the major source of cholinergic projections to both the compact and reticular portions of the rat substantia nigra. PMID- 2710335 TI - The relationship between coherence and nonlinear characteristics in Renshaw cell responses to random motor axon stimulation. AB - Cat spinal Renshaw cells were activated by stimulating muscle nerves or ventral roots with random (pseudo-Poisson) patterns of brief electrical stimuli. This input pattern is optimal for a comparative study in both the frequency- and time domain. The frequency-dependent variable of particular interest in this study was the coherence as a measure of the degree to which signal transmission is linear and noise-free; it was estimated via spectral analysis. Time-domain analysis consisted of calculating peri-stimulus time histograms in order to estimate the amount of nonlinearity in the cell responses to pairs of stimuli. The main result was that the amount of nonlinearity measured in this way did not profoundly depress the coherence. Two types of peri-stimulus time histogram were calculated: the "conventional" peri-stimulus time histogram (as a reference) computed with respect to all the stimuli in a train, and the "conditional" peri-stimulus time histogram computed with respect to the second in pairs of stimuli which were separated from each other by varied intervals delta. The latter type of peri stimulus time histogram showed that Renshaw cell responses to stimuli were conditioned by preceding stimuli, which could facilitate (at small delta s) and/or more often depress (up to several hundreds of milliseconds) the subsequent responses in a nonlinear manner. The objective of this study was to test the hypothesis that nonlinear characteristics contribute significantly to depress the coherence from its optimal value (1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710336 TI - Differences in the fiber composition of the pyramidal tract in two- and 14-month old rats. AB - The present study is aimed at an electron-microscopic morphometrical analysis of the pyramidal tract of 14-month-old rats at the level of the pyramis medullae and the second cervical segment, and a comparison with data obtained for rats of two months of age. Between 2 and 14 months of age there is, at the level of the pyramis medullae of the left pyramidal tract, a statistically significant increase of the number of myelinated fibers, from 91,000 to 118,000, whereas the total number of unmyelinated fibers decreases from 133,000 to 101,000. On the right side at the same level there is no statistically significant change in the number of myelinated fibers, whereas there is a significant decrease of unmyelinated fibers at this side, from 148,000 to 89,000. At the second cervical level, a statistically significant increase in the number of myelinated fibers has been noted at both sides (from 43,000 to 60,000) between 2 and 14 months, whereas the mean total number of unmyelinated fibers at this level decreases somewhat (from 35,000 to 28,000), but is not statistically significant. Several processes which might be involved in the age-related changes observed are discussed, including the possibility of a shift from unmyelinated fibers to myelinated ones, withdrawal of corticobulbar fibers and ongoing outgrowth of myelinated corticofugal fibers after two months of age, and a summarizing scheme is presented. We conclude that the pyramidal tract of the rat changes in composition after the age of two months and that continuing outgrowth of myelinated corticospinal fibers is an important aspect of this continuing development. PMID- 2710337 TI - The cellular localization of adenosine receptors in rat neostriatum. AB - Using quantitative autoradiography of ligand binding sites combined with lesions of specific neuronal pathways, the cellular locations of A1 and A2 adenosine receptors, as well as a third binding site for the adenosine receptor ligand, [3H]N-ethylcarboxamidoadenosine, and a nucleoside transporter were investigated in rat neostriatum. Intrastriatal kainic acid administration resulted in the loss of 50% of A1 adenosine receptors and virtually abolished ligand binding to A2 receptors. A small reduction in [3H]cyclohexyladenosine binding to striatal A1 receptors was found after lesioning the corticostriatal input. A2 receptor sites were unaffected by this treatment. Destruction of dopaminergic neurons using 6 hydroxydopamine or the raphestriatal serotoninergic input using 5,7 dihydroxytryptamine affected neither A1 nor A2 binding sites. These results indicate the localization of both A1 and A2 adenosine receptors on neurons intrinsic to the neostriatum and probably postsynaptic to the dopaminergic input. In addition, a binding site for [3H]N-ethylcarboxamidoadenosine which is not affected by the adenosine receptor agonist, R-phenylisopropyladenosine, was also partly abolished after kainic acid injection. In contrast, no significant change in the binding of the nucleoside transporter ligand, [3H]nitrobenzylthioinosine, was observed after any lesions, indicating the widespread association of this site with various cell types. PMID- 2710338 TI - Amphetamine, cocaine, phencyclidine and nomifensine increase extracellular dopamine concentrations preferentially in the nucleus accumbens of freely moving rats. AB - The effect of systemically administered amphetamine, cocaine, phencyclidine and nomifensine on the extracellular concentrations of dopamine in freely moving rats was estimated by microdialysis in the nucleus accumbens and in the dorsal caudate. All the drugs tested stimulated dopamine output in both areas but more effectively in the accumbens as compared to the caudate. Low doses of cocaine (1.0 mg/kg s.c.) stimulated dopamine output only in the nucleus accumbens. Nomifensine (1.25-5.0 mg/kg s.c.) increased by a similar extent peak dopamine output in the two dopaminergic areas but the duration of the effect was longer in the accumbens as compared to the caudate. The effect of cocaine, phencyclidine and nomifensine was prevented by systemic gamma-butyrolactone (700 mg/kg i.p.) and by omitting Ca2+ from the Ringer used for dialysis, the effect of amphetamine was insensitive to these manipulations. Thus, in contrast with amphetamine, cocaine, phencyclidine and nomifensine increase synaptic dopamine concentrations in vivo by a mechanism which depends on intact activity of dopaminergic neurons and by an exocytotic process. PMID- 2710339 TI - Heterogeneous distribution of polysialylated neuronal-cell adhesion molecule during post-natal development and in the adult: an immunohistochemical study in the rat brain. AB - A monoclonal antibody raised against the capsular polysaccharides of meningococcus B was used for immunohistochemical studies in the rat brain, with particular focus on the substantia nigra. This antibody recognizes polysialic acid residues specifically associated with the neuronal-cell adhesion molecule, and reacts with the highly sialylated embryonic neuronal-cell adhesion molecule, but not with the weakly sialylated adult form of the molecule. Immunoreactivity to this monoclonal antibody was intense and widespread in the brain of 1-10-day old hooded rats. Immunolabeling was associated with cell membranes and present in the intersomata space. In sections from 16- and 25-day-old rats, marked heterogeneity in the level of immunostaining appeared among individual brain nuclei. Areas devoid of labeling with the anti-meningococcus antibody still expressed immunoreactivity to a polyclonal anti-neuronal-cell adhesion molecule antibody. This suggests that the loss of immunostaining with the monoclonal antibody did not correspond to a loss of expression of neuronal-cell adhesion molecule, but to a maturation from the embryonic to the adult form of the molecule, occurring at different rates in various brain regions. In 2-month-old rats, immunolabeling with the monoclonal antibody was still present in discrete brain areas, including the substantia nigra, suggesting that the presence of highly sialylated neuronal-cell adhesion molecule outlasts post-natal development in those brain regions. It is proposed that neuronal-cell adhesion molecule associated polysialic residues may play a role in neuronal plasticity in restricted areas of the adult brain. PMID- 2710340 TI - Histamine H2 receptor mediates postsynaptic excitation and presynaptic inhibition in submucous plexus neurons of the guinea-pig. AB - Intracellular recordings were made from submucous plexus neurons of the guinea pig cecum maintained in vitro. Histamine (0.3-10 microM) produced a dose dependent membrane depolarization (congruent to 13 mV with 3 microM) in about 28% of the cells tested; most of these cells showed a prominent calcium-activated potassium conductance (AH cells). The depolarization was due primarily to an inactivation of potassium conductance which is available at the resting membrane potential of -60 mV. Peak amplitude of the fast excitatory postsynaptic potential was depressed by histamine (0.1-10 microM) in a dose-dependent manner (congruent to 62% depression with 1 microM). This was observed even in those cells in which histamine did not produce any membrane depolarizations (mostly S cells). The depression of the fast excitatory postsynaptic potential resulted from the presynaptic inhibition of acetylcholine release. Histamine also reduced the amplitude of the non-cholinergic, presumably peptidergic, slow excitatory postsynaptic potential by suppressing peptide release from presynaptic nerve terminals. Peak amplitude of the adrenergic inhibitory synaptic potential was not depressed by histamine suggesting that histamine receptors are not present on presynaptic terminals of sympathetic nerve fibres. Both postsynaptic and presynaptic actions of histamine were blocked by cimetidine or ranitidine but not by pyrilamine implying that H2 receptors are involved. PMID- 2710341 TI - Partial denervation of the rat soleus muscle at two different developmental stages. AB - Rat soleus muscles were partially denervated at two developmental stages. The L5 ventral ramus was sectioned in rats which were 4-6 days old, when the motor unit size of soleus muscles was still large, and at 17-19 days, when motor unit territory reached its adult value. The response of axons in the L4 ventral ramus to this procedure was then investigated. The removal of the L5 ventral ramus at 4 6 days results in an initial brief increase of motor unit size, after which the motor units retain the territory they occupied at 4-6 days. After removal of the L5 ventral ramus at 17-19 days, the L4 ventral ramus is able to expand to occupy a territory comparable in size to that of animals operated at 4-6 days. In both cases the final percentage of mean motor unit tension is two- to three-fold greater than that in normal muscles. Although the final motor unit territory is similar for both groups, it is achieved by different mechanisms. In animals operated on at 4-6 days the normal elimination of terminals does not occur, and the large neonatal motor units are retained, whereas in animals operated on at 17 19 days the peripheral field of L4 axons expands by axonal sprouting. PMID- 2710342 TI - Localization of angiotensin II binding sites in the bovine adrenal medulla using a labelled specific antagonist. AB - Angiotensin II binding sites have been localized in sections of bovine adrenal glands and on living cultured bovine adrenal medullary cells using [125I] [Sar1,Ile8]-angiotensin II and autoradiographic techniques. Binding sites were observed over both adrenaline and noradrenaline chromaffin cells. However, they were present in higher density over adrenaline cells, as determined by the distribution of phenylethanolamine N-methyltransferase mRNA by in situ hybridization histochemistry and of glyoxylic acid-induced fluorescence of noradrenaline. Binding sites were also observed in low density over nerve tracts within the bovine adrenal gland. Living cultured bovine adrenal medullary cells possessed angiotensin II binding sites. Not all cells were labelled. At least 73% of identified dispersed chromaffin cells in these cultures were labelled. Some chromaffin cells were not labelled with the ligand, and at least some non chromaffin cells in the cultures did possess angiotensin II binding sites. The results provide direct anatomical support for the known ability of angiotensin II to elicit catecholamine secretion from perfused adrenal glands and from cultured adrenal chromaffin cells. They also suggest that some of the effects of angiotensin II on calcium fluxes and second messenger levels measured in cultured adrenal medullary cell preparations may be due to angiotensin II acting on non chromaffin cells present in these cultures. PMID- 2710343 TI - A quantitative ultrastructural analysis of neurotensin-like immunoreactive terminals in the midbrain periaqueductal gray: analysis of their possible relationship to periaqueductal gray-raphe magnus projection neurons. AB - The periaqueductal gray of the rat contains significant levels of the putative peptide neurotransmitter neurotensin. The profound anti-nociceptive effects of neurotensin injected into the periaqueductal gray may involve a population of periaqueductal gray neurons having descending projections to the rostral ventral medulla, including nucleus raphe magnus and adjacent reticular nuclei. In this study, electron microscopic immunocytochemistry was used to examine the ultrastructure of periaqueductal gray axon terminals containing neurotensin-like immunoreactive material and to obtain quantitative data regarding the relationship of such terminals to other elements of the neuropil. Of particular interest was the interaction between neurotensin-like immunoreactive terminals and retrogradely labeled neurons that project to nucleus raphe magnus and adjacent reticular nuclei. Within the periaqueductal gray, the sites of retrograde and immuno-labeling were consistent with previous reports. The neurotensin-immunoreactive structures were predominantly axon fibers and terminals. In the ventrocaudal periaqueductal gray, the mean diameter of neurotensin-containing terminals was 0.93 +/- 0.02 micron and they comprised a volume fraction of 0.0010. Most of the neurotensin-positive terminals examined (74.2%) were in contact with or closely apposed to dendrites. The most common anatomical configuration observed was a single neurotensin-immunoreactive terminal juxtaposed to three dendrites. Only 2% of immunoreactive terminals were apposed to perikarya. Neurotensin-immunoreactive terminals were observed to form symmetrical synapses and 96.4% of such terminals were axodendritic. Occasional multiple neurotensin-immunoreactive terminals associated with single dendrites were observed. Although neurotensin-like immunoreactive terminals were quite prominent, only a small percentage made synaptic contact with periaqueductal gray neurons that project to the nucleus raphe magnus and adjacent reticular formation. Among the population of periaqueductal gray neurons retrogradely labeled from nucleus raphe magnus and adjacent reticular nuclei, the frequency of direct synaptic contact by neurotensin-immunoreactive terminals was 2%. These data suggest that the periaqueductal gray circuitry by which neurotensin ultimately affects descending pathways is complex and may involve a population of local circuit neurons whose transmitters and connections remain to be elucidated. PMID- 2710344 TI - Excitatory influence of the accessory olfactory bulb on tuberoinfundibular arcuate neurons of female mice and its modulation by oestrogen. AB - The role of the accessory olfactory bulb in conveying pheromonal information to tuberoinfundibular arcuate neurons was examined electrophysiologically in chloral hydrate-anaesthetized, oestrogen (0.5 micrograms in silastic capsules)-treated and untreated ovariectomized Balb/c female mice. Electrical stimulation of the accessory olfactory bulb orthodromically excited part of tuberoinfundibular neurons which were antidromically stimulated from the median eminence and histologically verified as being located within the arcuate nucleus. No inhibitions followed accessory bulb stimulation. The excitatory response to accessory bulb stimulation was reversibly blocked by the local anaesthetic lignocaine infused into the amygdala. The percentage of tuberoinfundibular arcuate neurons responding to accessory bulb stimulation was significantly higher in oestrogen-treated than in untreated animals. There was no difference between the two groups for the antidromic activation threshold, spontaneous firing rate, absolute refractory period or frequency of successful antidromic propagation into the soma of tuberoinfundibular arcuate neurons. In oestrogen-treated preparations, tuberoinfundibular arcuate neurons responsive and unresponsive to accessory bulb stimulation could be distinguished by the frequency of successful antidromic propagation into the soma. These studies demonstrate that olfactory relay neurons in the accessory olfactory bulb act to enhance the activity of a subpopulation of tuberoinfundibular arcuate neurons via the amygdala and that this neural transmission is modulated by oestrogen. PMID- 2710345 TI - The effects of nerve growth factor on the development of septal cholinergic neurons in reaggregate cell cultures. AB - Recent studies suggest that nerve growth factor is present within the central nervous system where it may exert selective trophic effects on cholinergic neurons. We have measured the effects of nerve growth factor on septal cholinergic neurons in three-dimensional reaggregating cell cultures, a system which closely simulates the cellular environment in situ. Septal cells obtained from 15-day-old mouse embryos were dissociated into a single cell suspension and then allowed to reaggregate in culture in a rotary incubator shaker. After 17 days in culture, half of the reaggregates from a flask were sonicated for measurement of choline acetyltransferase activity, and the remaining reaggregates were processed for acetylcholinesterase histochemistry. Addition of nerve growth factor to medium containing septal reaggregates resulted in greater than a three fold increase in choline acetyltransferase activity and in the number of acetylcholinesterase-positive cells, as well as an enhancement in the staining of acetylcholinesterase-positive fibers. All of these effects of nerve growth factor could be neutralized by antibodies to nerve growth factor. In order to evaluate the possible role of endogenous hippocampal-derived nerve growth factor, antiserum to nerve growth factor was added to the culture media containing septal hippocampal coaggregates. After 21 days in culture, the presence of nerve growth factor antibodies did not qualitatively affect the pattern or density of cholinergic fibers observed. Synapse formation between cholinergic axons and hippocampal target cells was still in evidence as revealed by electron microscopy. However, there was a modest decrease in choline acetyltransferase activity (20%) and cholinergic cell number (30%) when compared with coaggregates grown in culture medium either without nerve growth factor antiserum or with non immune serum. The magnitude of these effects was markedly less than the effects observed when exogenous nerve growth factor was added to septal cells grown alone in reaggregate culture. These results suggest that nerve growth factor may play a role during central cholinergic development, but that additional trophic mechanisms are likely to be required. PMID- 2710346 TI - Acetylcholinesterase in immature thalamic neurons: relation to afferentation, development, regulation and cellular distribution. AB - The transient appearance of intense acetylcholinesterase reactivity in some immature, noncholinergic neurons has not been adequately explained. In this study two questions were investigated that relate to several possible roles for acetylcholinesterase. First, what factors influence the onset and maintenance of reactivity? Second, what are the temporal and spatial features of the cellular expression in relation to stages of neuronal development? Using light- and electron-microscopic histochemical methods, the non-cholinergic ventrobasal complex in thalamus of the immature rat was examined. Ultrastructural observations on fetal ventrobasal complex demonstrated that the onset of acetylcholinesterase reactivity precedes ingrowth of most extrinsic afferents. These inputs are, therefore, unlikely to provide the signal for onset. In transplants and explants, acetylcholinesterase persisted in ventrobasal complex neurons independent of their principal afferents. However, afferentation can affect reactivity. The patterned variation in intensity, characteristic of infant ventrobasal complex, was dramatically altered by unilateral interruption of its afferentation. The changes in intensity patterning could reflect changes in acetylcholinesterase metabolism, since postnatal treatment with an irreversible inhibitor (diisofluorophosphate) in vivo demonstrated resynthesis of acetylcholinesterase. The period of peak intensity of acetylcholinesterase reactivity normally began abruptly at 18 days of gestation +/- 12 h and continued until 4-6 days postnatally. This period follows neurogenesis and migration, but precedes active synaptogenesis. It coincides with outgrowth and initial contacting of cell processes in the ventrobasal complex. The timing complements the ultrastructural finding that acetylcholinesterase-dependent reaction product most commonly is localized to small patches of surface membrane, where distal processes contact each other, non-synaptically. Together these data suggest three points. First, that the expression of acetylcholinesterase in the immature ventrobasal complex neuron is probably under active metabolic control, responsive to both intrinsic and environmental factors. Second, that acetylcholinesterase expression is unlikely to result from a transient cholinergic input. Third, that the temporal and spatial characteristics of histochemical reactivity enable exclusion of several previously suggested explanations for the occurrence of acetylcholinesterase in the ventrobasal complex.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2710347 TI - Opposite influences of dopaminergic pathways to the prefrontal cortex or the septum on the dopaminergic transmission in the nucleus accumbens. An in vivo voltammetric study. AB - Modulation of dopaminergic transmission in the nucleus accumbens by the dopaminergic pathways reaching the prefrontal cortex (anteromedian and the suprarhinal parts) and the lateral septum was investigated. Changes in dopaminergic transmission in the nucleus accumbens were assessed by in vivo voltammetry using pretreated carbon fiber electrodes. This technique allows the selective detection of 3,4-dihydroxyphenylacetic acid, the main presynaptic metabolite of dopamine. Dopaminergic transmission in the prefrontal cortex (anteromedian and suprarhinal parts) and the lateral septum was altered by local injection of the dopaminergic agonist (d-amphetamine) and the dopaminergic antagonists (alpha-flupenthixol and sulpiride). Pharmacological interventions, either stimulation or blockade, in the anteromedian and suprarhinal parts of the prefrontal cortex induced, respectively, a decrease or an increase in extracellular 3,4-dihydroxyphenylacetic acid in the nucleus accumbens. The same pharmacological interventions in the lateral septum had exactly opposite effects in the nucleus accumbens. The inhibitory action of the mesocortical and mesorhinal dopaminergic projections and the facilitatory action of the mesoseptal dopaminergic projection on dopaminergic input in the nucleus accumbens were shown to rely on the activity of inhibitory fugal pathways which could be blocked by local injection of tetrodotoxin in the three structures. In a previous work, it was demonstrated that dopaminergic projections in the amygdala exert an inhibitory influence on dopaminergic transmission in the nucleus accumbens. Thus the present results suggest that functional interdependence between the different dopaminergic pathway arising in the ventral mesencephalon is a general property of this neuronal group. Data obtained after manipulation of dopaminergic transmission in these various projection areas may need to be interpret in a different light. Similarly, neurological and psychiatric observations may need to be reconsidered in view of the interdependence of the dopaminergic mesencephalic pathways. PMID- 2710348 TI - In vivo electrochemical studies of monoamine release in the medial prefrontal cortex of the rat. AB - The magnitude and duration of release of monoamines evoked by local applications of potassium were measured in vivo in the medial prefrontal cortex using high speed chronoamperometry. Typical electrochemical signals reflecting released of electroactive species ranging from 0.5 to 3.0 microM and lasting 90-120 s were detected at a variety of dorsal-ventral and anterior-posterior electrode placements in the medial prefrontal cortex. The magnitude of the reduction current measured following the oxidation reaction suggests a contribution of both serotonin and dopamine to the electrochemical signal, dopamine serving as the predominant monoamine in the medial prefrontal cortex proper and serotonin appearing to predominant in the more posterior regions of the frontal cortex. This conclusion was reinforced by the fact that unilateral 6-hydroxydopamine lesions of ascending dopamine fibers almost completely abolished electrochemical signals in the ipsilateral but not in the contralateral medial prefrontal cortex. The present study provides an in vivo characterization of monoamine release in the mesocortical dopamine terminal field, where it has been suggested that psychomotor stimulants may produce some of their positive reinforcing effects. PMID- 2710349 TI - Transneuronal retrograde degeneration of retinal ganglion cells after damage to striate cortex in macaque monkeys: selective loss of P beta cells. AB - We examined the retinae of two monkeys whose left striate cortex had been removed eight years previously and compared the transneuronally degenerated hemiretina of each eye with the normal hemiretina, and with the retinae of normal monkeys. All retinae were prepared as whole mounts. One from each pair was stained with Cresyl Violet; the other was reacted for horseradish peroxidase two days after placing pellets of the enzyme in the optic nerve. Measurements of ganglion cell density in the Nissl-stained retina of the contralateral right eye showed that approximately 80% of retinal ganglion cells were missing in the central 30 degrees of the degenerated hemiretinae. More peripherally the percentage loss was less extensive. Measurements of cell soma size and dendritic field size of peroxidase-labelled classified surviving cells in the degenerated temporal hemiretina of the ipsilateral eye showed them to be morphologically normal. In comparison with the normal hemiretina, however, the mean soma size at three selected eccentricities was larger than normal, suggesting selective loss of smaller ganglion cells. Classification of peroxidase-labelled ganglion cells in the normal and degenerated hemiretinae revealed that the population of P beta cells was reduced by as much as 85% in the degenerated region. There was comparable change in the density of P alpha or P gamma cells. The degeneration of the great majority of P beta cells, which are believed to be the morphological substrate of ganglion cells with small and colour-opponent receptive fields, must set limits on the visual sensitivity and discrimination that survive damage to striate cortex. PMID- 2710350 TI - A preliminary MRI study of the geometry of brain displacement and level of consciousness with acute intracranial masses. AB - We determined the horizontal and vertical components of brain displacement on coronal MRIs in 10 patients with acute supratentorial masses. The vertical distances from the superior sagittal sinus to the pontomesencephalic junction (PMJ) and from the vertical midline of the brain to the PMJ did not differ from measurements in 30 patients without masses. Horizontal displacement of the 3rd ventricle (mean, 5.2 mm) exceeded vertical displacement of the PMJ (mean, 1.2 mm) in all but 1 patient. Total brain displacement near the incisura increased from 3 mm in awake patients to 6 to 13 mm in stuporous and comatose patients and remained predominantly horizontal. Uncal herniation, seen only in a patient who was imaged a day after the onset of coma, did not appear to be the immediate cause of brainstem compression but was accompanied by prominent lateral distortion above the tentorium. This preliminary study suggests that most patients with acute unilateral masses have upper brainstem distortion due predominantly to horizontal shift at or above the tentorium. PMID- 2710351 TI - Differential effects of prednisone and cyclophosphamide on autoantibodies in human neuromuscular disorders. AB - We compared the effects of treatment of patients with prednisone or cyclophosphamide on a series of different types of autoantibodies. Levels of antiacetylcholine receptor (anti-AChR) antibodies and of antibodies to GM1 and GD1a gangliosides were measured in patients with a variety of neuromuscular disorders before and after treatment. Most patients had several autoantibodies present. We showed that prednisone treatment resulted in a reduction in titers of anti-AChR but not antiganglioside antibodies. Cyclophosphamide treatment produced a reduction of antiganglioside antibody titers. An intravenous and oral regimen was more effective than a single intravenous course of cyclophosphamide. We conclude that an immunosuppressive medication such as prednisone may reduce levels of some autoantibodies while producing no change in others, even in an individual patient. In addition, cyclophosphamide can suppress autoantibodies that prednisone does not. These differences in immunopharmacologic responses suggest that there are several distinct mechanisms of autoantibody production in humans. The utility of immunosuppressive medications in specific disease processes may be related in part to the mechanism of production of pathogenic antibodies. PMID- 2710352 TI - Psychologic and social adjustment to epilepsy in Rochester, Minnesota. AB - The psychologic and social aspects of epilepsy have rarely been assessed in community-based samples. We administered the Washington Psychosocial Seizure Inventory in 1985-1986 to 125 nonretarded adults, 18 to 59 years of age, who in 1980 had active epilepsy and resided in Rochester, Minnesota. Individuals having seizures or taking anticonvulsant medications within the past 12 months had somewhat poorer adjustment than those without recent seizures or medications, but even this more severely affected group appeared relatively well adjusted. PMID- 2710353 TI - The Canadian Neurological Scale: validation and reliability assessment. AB - The Canadian Neurological Scale (CNS) was designed to monitor mentation and motor functions in stroke patients. We assessed its validity and reliability on a group of 157 patients with a diagnosis of acute cerebrovascular accident. We determined validity by (1) correlating scale items and total score with the standard neurologic examination; (2) exploring the scale's predictive power with different end points at 6 months--the initial CNS was a significant predictor of outcome; (3) showing that the CNS had higher correlation coefficients with the initial neurologic examination than the Glasgow Coma Scale; and (4) assessing the responsiveness of the scale to change in the neurologic status of stroke patients. Interobserver reliability, measured by kappa statistics on each scale item, was good. Accordingly, we established the validity and reliability of the CNS for its use in clinical studies and in the care of stroke patients. PMID- 2710354 TI - Heterotopic neurons in spinal cord of patients with ALS. AB - Monoclonal antibody 44.1, an immunocytochemical marker for neurons, identified heterotopically located, multipolar neurons deep within the spinal cord white matter of patients with amyotrophic lateral sclerosis. Displaced neurons were most numerous in the ventral outflow and lateral corticospinal tract regions of all cord levels. These changes may be the result of aberrant neuronal migration during spinal cord development. PMID- 2710355 TI - Congenital paucity of secondary synaptic clefts (CPSC) syndrome in 2 adult sibs. AB - We studied 2 elderly sibs with a congenital form of myasthenia who had ptosis since early childhood. The extraocular muscles were weak and the proximal limb muscles became slowly weaker throughout life. Laboratory investigations of biopsies of intercostal muscle from these patients showed the following abnormalities: the amplitude of miniature end-plate potentials was small and the binding of 125I-alpha-bungarotoxin at the end-plate area was reduced, suggesting a considerable reduction of acetylcholine receptors (AChRs). Secondary synaptic clefts were scarce, whereas the number of end-plates per muscle fiber was increased. There was no indication of impaired transmitter release as the quantal content was within the range of controls. We conclude that these patients suffered from the congenital paucity of secondary synaptic clefts (CPSC) syndrome, described recently in 2 cases of myasthenic children, and suggest that the CPSC syndrome is a developmental disorder in which a deficiency of AChRs may be caused by a decreased clustering or insertion of AChRs. The increased number of end-plates per muscle fiber in both patients could serve as a compensatory mechanism. PMID- 2710356 TI - Environmental factors and Parkinson's disease: a case-control study in China. AB - We studied the role of environment in the development of Parkinson's disease (PD) in China, where industrialization is relatively recent and the population geographically stable. Using a case-control method, we investigated the relationship between PD and exposure to the following factors before disease onset: place of residence, source of drinking water, environmental and occupational exposure to various agricultural and industrial processes. Occupational or residential exposure to industrial chemicals, printing plants, or quarries was associated with an increased risk of developing PD. In contrast, living in villages and exposure to the common accompaniments of village life, wheat growing and pig raising, were associated with a decreased risk for PD. PD cases and controls did not differ with respect to other factors investigated. These findings are consistent with the hypothesis that environmental exposure to certain industrial chemicals may be related to the development of PD. PMID- 2710357 TI - Apraxia in Alzheimer's disease. AB - We studied apraxia in 28 patients with senile dementia of the Alzheimer type (SDAT). Although SDAT patients were impaired compared with age-matched controls on tests of ideomotor and ideational apraxia, not all types of movements were affected to the same degree. Limb transitive movements were especially vulnerable, while limb intransitive, buccofacial, and axial movements were relatively spared. When pantomiming limb transitive movements, SDAT patients made frequent body part as object and spatial errors. There was no significant difference between performance on verbal command and imitation, but there was considerable improvement with the use of actual objects. Disorders of skilled movement in SDAT were qualitatively similar to the apraxic syndromes following left parietal damage. Apraxia in SDAT suggests posterior left hemisphere cortical involvement and may be apparent even in patients with good language functions. PMID- 2710358 TI - Stroke in the Lehigh Valley: combined risk factors for recurrent ischemic stroke. AB - We used the Lehigh Valley Stroke Register and a logistic regression model for the odds ratio to study the relative contribution of several factors, considered jointly, to the risk of recurrent ischemic stroke. The factors were hypertension (HT), transient ischemic attack (TIA), myocardial infarction (MI), other heart diseases (OHD), diabetes mellitus (DM), age, and sex. Among these factors MI, OHD, and TIA constituted significantly greater risk than HTN, DM, age, or sex for ischemic stroke recurrence. PMID- 2710359 TI - Antibodies against fetal muscle proteins in serum from patients with amyotrophic lateral sclerosis. AB - The serum from 30 patients with amyotrophic lateral sclerosis and 30 controls was tested by immunoblot with protein extracts obtained from fetal muscle, adult muscle, and denervated muscle. Results with adult and denervated muscle confirm previous reports that show a lack of particular reactivity of ALS serum when compared with control serum. However, we found reacting bands 5 times more frequently with ALS than with controls in the immunoblot with protein extract from rat fetal muscle; we confirmed reactivity by immunoperoxidase staining in frozen sections of fetal muscle. Our results point to the possibility of an immune reaction in ALS patients against ephemeral proteins of muscle that are present in large quantities at early stages of muscle differentiation and innervation. PMID- 2710360 TI - Kearns-Sayre syndrome and complex II deficiency. AB - A 25-year-old woman with Kearns-Sayre syndrome (KSS) had complete external ophthalmoplegia, short stature, ataxia, cardiac conduction defects, and pigmentary retinopathy. Muscle biopsy revealed ragged-red fibers. Electron microscopy showed increased numbers of mitochondria with disordered structure and paracrystalline inclusions. Enzymatic analysis revealed a deficiency of complex II of the mitochondrial respiratory chain, and, more specifically, a deficiency of succinic dehydrogenase, although both subunits of this enzyme proved to be present by immunologic analysis. Therapy with vitamin cofactors did not result in short-term improvement. This appears to be the first report of complex II deficiency in a patient with KSS. PMID- 2710361 TI - Use of 31P magnetic resonance spectroscopy to characterize evolving brain damage after perinatal asphyxia. AB - We investigated postasphyxial brain damage with 31P magnetic resonance spectroscopy (MRS) and correlated it with neurologic assessment and standard laboratory evaluation during the first 10 months of life in 1 infant, baby G. We compared these observations to 31P MRS data from 7 healthy term newborns, 1 normal infant examined serially over the first 8.5 months of life, and 5 other term infants following perinatal asphyxia. MRS noninvasively provides biochemical correlates of the evolution of brain damage following perinatal asphyxia and suggests that pH derived from the inorganic phosphate peak may serve as a marker for brain injury. PMID- 2710362 TI - Whose responsibility? A call for active participation. 1989 American Academy of Neurology presidential address. PMID- 2710363 TI - Clinical neuromythology VI. Au clair de lacune: holy, wholly, holey logic. PMID- 2710364 TI - Sensory tics in Tourette's syndrome. AB - Sensory tics are localized uncomfortable sensations for which patients attempt to obtain relief by producing movements or vocalizations. We report 3 patients with Tourette's syndrome (TS) and sensory tics to illustrate this poorly recognized symptom. A survey of 34 randomly selected TS patients indicates that sensory tics are common and should be considered part of a clinical spectrum of tics and associated sensory phenomena. PMID- 2710365 TI - Gadolinium-enhanced MRI: a superior technique for the diagnosis of intraspinal metastases. AB - Intraspinal medullary metastases are difficult to demonstrate radiographically. We describe the value of gadolinium-DTPA-enhanced magnetic resonance imaging in the diagnosis of intraspinal medullary metastases. This safe, sensitive procedure should be a requisite study in myelogram-negative patients with symptomatology indicative of a cord lesion. PMID- 2710366 TI - Early CT reevaluation after empiric praziquantel therapy in neurocysticercosis. AB - Neurocysticercosis can be difficult to diagnose in patients with negative serologic studies and single parenchymal cysts. To avoid surgical intervention, we empirically administered praziquantel to 2 children with isolated cysts and observed complete resolution of the lesions within 1 month after treatment. Early CT reevaluation following empiric praziquantel therapy can be an effective tool in the diagnosis of neurocysticercosis in patients with single parenchymal lesions. PMID- 2710367 TI - Late onset of distinct neurologic syndromes in galactosemic siblings. AB - We discuss siblings with galactose-1-phosphate uridyl transferase deficiency who developed neurologic complications after the age of 30. One has partial complex seizures and the other has generalized seizures, progressive ataxia, and apraxia. As more galactosemic children survive into adulthood, more neurologic complications may become more prevalent. PMID- 2710369 TI - Toward a definition of Parkinson's disease. PMID- 2710368 TI - Nerve conduction study of human tetrodotoxication. AB - We carried out serial nerve conduction studies in a patient with tetrodotoxication caused by ingesting pufferfish. Conduction velocities and amplitudes of muscle and sensory nerve action potentials were equally affected. Neither temporal dispersion nor focal conduction block occurred. The proximal (F wave) motor latencies were also prolonged. These abnormalities rapidly improved in parallel with clinical recovery and with the decrease in the urinary excretion of tetrodotoxin (TTX). These results indicate that TTX equally and reversibly affects myelinated nerve fibers throughout the entire length of the axon by lowering the conductance of sodium currents at nodes of Ranvier. PMID- 2710370 TI - Laxative abuse causing hypermagnesemia, quadriparesis, and neuromuscular junction defect. PMID- 2710371 TI - Bilateral Bell's palsy at the time of HIV seroconversion. PMID- 2710372 TI - Successful treatment of HSV encephalitis during pregnancy. PMID- 2710373 TI - Treatment of Friedreich's ataxia with amantadine. PMID- 2710374 TI - [Esophageal alkaline reflux]. PMID- 2710375 TI - [The Angelchik prosthesis in the treatment of hiatal hernia and gastro-esophageal reflux. Motives of a choice]. PMID- 2710376 TI - [Therapeutic strategies in corrosive disease of the upper digestive tract (SDT)]. PMID- 2710377 TI - [Benign tumors of the esophagus]. PMID- 2710378 TI - [Bile duct calculi. Comparison of surgical and endoscopic therapy]. PMID- 2710379 TI - [Malignant tumors of the exocrine pancreas. Strategies of treatment]. PMID- 2710380 TI - [Assessment of severity of acute pancreatitis. Computerized method of evaluation]. PMID- 2710381 TI - [Endocrino-metabolic response to anesthesia and surgical stress]. PMID- 2710382 TI - [Emergency surgical department]. PMID- 2710383 TI - [Evaluation of risk in surgery. Proposal of an original method]. PMID- 2710384 TI - [Round table on acute cholecystitis: emergency or delayed intervention]. PMID- 2710385 TI - [Problems of donations of organs from corpses 20 years after the first transplant in Italy]. PMID- 2710386 TI - [Concepts on dynamic staging of neoplasms of the colon and rectum]. PMID- 2710387 TI - [New approaches to the staging of solid neoplasms]. PMID- 2710388 TI - [Thyroid nodule: surgical strategy]. PMID- 2710389 TI - [Thyroid nodule: current approaches]. PMID- 2710390 TI - [Surgical treatment of carcinoma of the thoracic esophagus]. PMID- 2710391 TI - Maternal responsiveness: characteristics and consequences. PMID- 2710392 TI - Maternal responsiveness and cognitive development in children. PMID- 2710393 TI - Maternal responsiveness with preterm infants and later competency. PMID- 2710394 TI - Modulation of catecholamine metabolism in synaptosomes by a neuroregulatory factor from mammalian brain. AB - Incubation of synaptosomes from rat brain with bovine brain extract caused inhibition of oxidative deamination of dopamine, decreased formation of 3,4 dihydroxyphenylacetic acid, increased formation of norepinephrine and its N methyl derivatives and increased release of catecholamines. Omission of Ca2+ from the extrasynaptosomal medium completely blocked the brain extract induced release of [3H]catecholamines and decreased, by about 80%, the effect on changes in catecholamine metabolism. Chromatography of the brain extract on Sephadex-G25 columns resulted in an active compound eluting at the position expected for compounds with molecular weights in the region of 1500 to 2500 Da. PMID- 2710395 TI - Vasoactive intestinal polypeptide-immunoreactive neurons in the main olfactory bulb of the hedgehog (Erinaceus europaeus). AB - Vasoactive intestinal polypeptide (VIP) immunoreactivity was localized by the indirect antibody enzyme method (PAP technique) in the main olfactory bulb of the hedgehog. Most VIP-immunoreactive cells were located in the glomerular layer and throughout the external plexiform layer. Fewer cells were observed in the granule cell layer. At the morphological level they exhibit the characteristics of periglomerular, external tufted, superficial short axon, horizontal and Van Gehuchten cells. It should be mentioned that another specific neuronal type was found in the inner third of the external plexiform layer, which is not described in other animals. These results revealed that a high number of intrinsic neuronal types of the olfactory bulb of the hedgehog display a strong VIP immunoreactivity. PMID- 2710396 TI - Immunocytochemical evidence that vigabatrin in rats causes GABA accumulation in glial cells of the retina. AB - Vigabatrin (gamma-vinyl-GABA, GVG) is an irreversible inhibitor of GABA aminotransferase (GABA-T) that is under clinical trial as an antiepileptic drug. Rats were injected (i.p.) with GVG and killed 18 h later. GVG administration reduced retinal GABA-T activity to undetectable levels and increased the GABA content 5-fold. Immunocytochemistry using a GABA antiserum clearly revealed the presence of GABA-IR in the glial Muller cells of retinas from GVG-treated rats but not from controls. This experiment indicates that the administration of drugs which inhibit GABA-T may cause the accumulation of GABA in retinal cells that do not normally possess enough endogenous GABA to be detected by immunocytochemistry. PMID- 2710397 TI - Fetal cortical transplants reduce the thalamic atrophy induced by frontal cortical lesions in newborn rats. AB - Fetal neocortical tissue was grafted into frontal cortex lesion cavities made in newborn rats. After survival periods extending up to 14 months, volumetric measurements of the total thalamus and of the lateral, medial and anterior thalamic compartments showed an amelioration of the thalamic atrophy that normally is found after cortical lesions. These results correspond to previous findings demonstrating interconnections between fetal cortical transplants and the host thalamus. PMID- 2710398 TI - Impaired responsiveness of paraventricular neurosecretory neurons to osmotic stimulation in rats after local anesthesia of the subfornical organ. AB - Extracellular recordings were obtained from 32 phasically active neurosecretory cells in the hypothalamic paraventricular nucleus (PVN) of urethane-anesthetized male rats. None of the PVN cells changed their activity to intracarotid infusions of isotonic saline (0.15 M NaCl solution, 0.05 ml). Of these PVN neurons, 26 displayed an increase in neuronal activity following intracarotid infusions of hypertonic saline (0.2 M NaCl solution, 0.05 ml), while the remainder were unresponsive. Microinjection of the local anesthetic lidocaine into the subfornical organ (SFO) reversibly diminished the excitatory response to the infusions of hypertonic saline in 10 out of 15 PVN neurons tested, whereas the injection of lidocaine into the vicinity of the SFO (n = 4) or the third ventricle (n = 4) did not cause a marked change. These results show an involvement of the SFO in the mechanism of osmotic activation of putative vasopressin (AVP)-secreting neurons in the PVN. PMID- 2710399 TI - Responses of motor cortex neurons to visual stimulation in the alert monkey. AB - Evidence for visually evoked activity in single neurons of area 4 is presented. These neurons modulated their activity in relation to stimuli moving across the visual field of the monkey, without showing habituation. Some of them even had direction sensitivity. Their activity was independent of eye movements and unrelated to muscle contractions. The visually activated neurons were distributed throughout the depth of motor cortex. PMID- 2710400 TI - Pineal 5-methoxytryptophol rhythms in the box turtle: effect of photoperiod and environmental temperature. AB - The effect of different photoperiods and temperatures on pineal 5 methoxytryptophol (ML) content was investigated in male box turtles, Terrapene carolina triunguis. A rhythm in pineal ML was evident in the long photoperiod (18 h light (L)-6 h dark (D] with high daytime levels of 178 +/- 48 pg/gland (means +/- S.E.M.) which dropped to 38 +/- 6 pg/gland during lights off. In the short photoperiod (8L:16D) no clearcut ML rhythm was observed. Diurnal (10.00-12.00 h) ML concentrations rose linearly (P less than 0.05) with increasing ambient temperatures (5, 15, 20 and 27 degrees C). Day/night differences in ML levels, however, were not significant. Pineal ML in the box turtle thus seems to be modified by the photoperiod and, to a lesser extent, by temperature. PMID- 2710401 TI - Specific petit mal anticonvulsants reduce calcium currents in thalamic neurons. AB - Low-threshold calcium current (LTCC) in thalamic neurons is important in generation of normal thalamocortical rhythms, and may be involved in the genesis of abnormal activities such as spike-wave discharges that characterize petit mal epilepsy. Ethosuximide and dimethadione, anticonvulsants effective in petit mal, reduced the LTCC when applied to thalamic neurons at clinically relevant concentrations. Therapeutic concentrations of phenytoin and carbamazepine, drugs ineffective in the control of petit mal, had minimal effects on calcium conductances. Reduction in LTCC may be an important mechanism of action by which specific petit mal anticonvulsants depress spike-wave activity. PMID- 2710402 TI - Critical period for androgenic regulation of soma size of sexually dimorphic motoneurons in rat lumbar spinal cord. AB - In the rat spinal nucleus of the bulbocavernosus (SNB), androgens are known to act during early critical periods to regulate the number and size of motoneurons that innervate perineal muscles, and to produce sex differences in these attributes. The present study determined the end of the critical period for androgenic regulation of SNB soma size in female rats. Intact female rats received injections of testosterone propionate or oil during 1 of 4 postnatal periods, and were compared to control males and females. In adulthood, all rats were gonadectomized, treated with androgen and then sacrificed. The somatic areas of SNB motoneurons were measured. The results suggest that the soma size is increased by androgen treatment only if it is given before about day 12 after birth. PMID- 2710403 TI - Satellite cells surrounding axotomised rat dorsal root ganglion cells increase expression of a GFAP-like protein. AB - Segments of sciatic nerve, 8-10 mm long, were removed from the left thigh of adult Sprague-Dawley rats. One day to 6 weeks after operation the animals were killed and the 4th and 5th lumbar dorsal root ganglia dissected out on both the operated and the unoperated side. A monoclonal and two polyclonal antibodies to glial fibrillary acidic protein (GFAP) were used to localize GFAP-like molecules in cryostat sections of the ganglia by means of indirect immunofluorescence. Expression of GFAP in satellite cells, demonstrable by the binding of polyclonal antibodies, had increased noticeably by three days post operation and remained at a high level throughout the remaining period of the experiment. Whereas on the unoperated side only about 15% of the neurons in the ganglia were surrounded by GFAP-positive satellite cells, on the operated side about 88% of the neurons were surrounded by GFAP-positive cells. Satellite cells could not be labelled with the monoclonal antibodies to GFAP. PMID- 2710404 TI - Paraventricular nucleus efferents mediating photoperiodism in male golden hamsters. AB - Knife cuts were placed around the paraventricular nucleus of the hypothalamus (PVN) in an effort to identify the pathways mediating gonadal regression in male golden hamsters housed in a short photoperiod. Horizontal cuts dorsal to the PVN only affected photoperiodic responsiveness if they actually damaged the PVN. Coronal cuts caudal to the PVN had no effect on testes regression. Parasagittal cuts adjacent to the medial PVN had little or no effect on gonadal regression induced by short photoperiod. We conclude that efferents of the PVN arising dorsally or medially are not necessary for photoperiodic control of testes function, whereas projections from or through the lateral PVN region descending towards the spinal cord are important. PMID- 2710405 TI - Three-dimensional structure of the presynaptic nerve ending in the ciliary ganglion of the chick embryo: a scanning electron microscopic study. AB - Presynaptic nerve endings in the ciliary ganglia of chick embryos are 3 dimensionally examined by scanning electron microscopy. Underdeveloped nerve endings attached to the lateral side of the ciliary cells are spoon-like, and show an irregular surface texture and marginal outline with many slender processes and pores. Well-developed nerve endings embracing more than half of the surface of the ciliary cell are cup-like, and show a smooth surface texture and a linear marginal outline with few slender processes and pores. The slender processes come into intimate contact with each other at the margin of the spoon like nerve endings or cross the pores, seemingly expanding and smoothing the nerve endings. Cytoplasmic processes of the ciliary cells are also described. PMID- 2710406 TI - The projection pattern of forepaw nerves to the cuneate nucleus of the raccoon. AB - The transganglionic transport of horseradish peroxidase (HRP) was used to determine the projection pattern within the cuneate nucleus of the 4 major nerves innervating the forepaw of the raccoon, a carnivore noted for its tactile and manipulative abilities. The two nerves innervating the dorsal, hairy skin and claws (the radial and dorsal ulnar nerves) projected to the marginal rim of the cuneate nucleus, but not to the middle cluster region or to the caudal region of the nucleus. The two nerves innervating glabrous skin (median and ulnar) projected heavily to the cluster region as well as to rostral and caudal levels of the nucleus. This organization, with dorsal nerves ending above the ventral nerves, is similar in the raccoon, rat and tree squirrel, but reversed in the cat. However, the medio-lateral topography is similar in all species with the ulnar and dorsal ulnar nerves projecting medially within the nucleus compared to the median and radial nerves. PMID- 2710407 TI - Cell type-specific distribution of cathepsin B and D immunoreactivity within the rabbit retina. AB - The cellular localization of cathepsin B and D immunoreactivity was demonstrated at the light microscopic level in the retina of adult rabbits by use of the peroxidase-antiperoxidase technique. Antisera were raised against rat liver enzymes. Whereas cathepsin D immunoreactivity was confined to Muller (glial) cells, cathepsin B was demonstrated in some, but not all, neuronal cell types. It is proposed that the two enzymes might carry different functions within the neuronal versus glial compartment. PMID- 2710408 TI - Correlation between the size of song control nuclei and plumage color change in orange bishop birds. AB - Adult male orange bishop birds (Euplectes franciscanus) develop beautiful nuptial plumage during the breeding season, but have the same sober plumage as the female during the non-breeding season. The male conspecific song is highly stereotyped during nuptial plumage. Large volume differences were found in two song control nuclei in the cerebrum between the male and female during the breeding season, and in the same nuclei of the males during the breeding and non-breeding seasons. The seasonal changes in the size of cerebral song control nuclei were dominant in the male and may not correlate with the improvement or modification of the song repertories. PMID- 2710409 TI - Chronically isolated lumbar half spinal cord, produced by hemisection and longitudinal myelotomy, generates locomotor activities of the ipsilateral hindlimb of the cat. AB - The lumbar spinal cord of the cat was hemisected (at L2 or L3) as well as longitudinally myelotomized so as to make one side of the lumbar cord 'isolated' chronically from both descending and contralateral influences. The chronic cats began to stand up with their two forelimbs and one hindlimb, contralateral to the hemisection, and to walk with the 3 legs 14 days on average after the two operations. After another 20 days following the 3-leg movement the 'isolated' leg resumed to stand and walk. These results show that half of the lumbar cord can generate a locomotor pattern which was presumably reactivated from peripheral afferent impulses. PMID- 2710410 TI - 2-Amino-4-phosphonobutyrate selectively eliminates late phases of long-term potentiation in rat hippocampus. AB - The possible involvement of 2-amino-4-phosphonobutyrate (APB) recognition sites in mechanisms enabling the maintenance of long-term potentiation (LTP) was investigated in rat hippocampal slices. The action of D(-)- and L(+)-isomers of APB was tested on orthodromic EPSP and spike responses recorded extracellularly from CA1 pyramidal cells. If a moderate concentration (50 microM) of one or the other APB isomer was present during tetanization, posttetanic and early long-term potentiation developed nearly normally. However, from 2h onward LTP of both EPSP and spike potentiation was eliminated in an irreversible manner (8 h experiment). D-APB (L-isomer not tested) applied shortly after tetanization caused nearly the same delayed decline of LTP. No consistent effects of APB were seen in non tetanized slices. Considering previous findings these data suggest that besides the obligatory NMDA receptor activation an APB-sensitive component expressed during and after tetanization is a necessary step for subsequent mechanisms enabling the late maintenance of LTP. PMID- 2710411 TI - Dantrolene-Na (Dantrium) blocks induction of long-term potentiation in hippocampal slices. AB - Long-term potentiation (LTP) is characterized by a long lasting increase in the efficacy of neurotransmission which may consist of two phases. First an induction phase, with an absolute requirement for post-synaptic activation. Second, a maintenance phase, possibly involving pre-synaptic mechanisms. An essential function for calcium ions in the induction of LTP has been established and a particular emphasis has been placed on the role of N-methyl-D-aspartate (NMDA) receptor activation in gating a postsynaptic influx of calcium. We now report that pharmacological blockade of intraneuronal calcium release with 20 microM dantrolene-sodium (dantrium) completely blocks the induction of LTP in the CA1 region of the rat hippocampal slice. This drug inhibits calcium release from the sarcoplasmic reticulum and also diminishes the rise in intraneuronal calcium ion concentrations elicited by NMDA receptor activation in cultured CA1 pyramidal cells. Dantrolene does not block NMDA gated membrane currents or voltage activated Ca2+ currents in these cells. We suggest that release of intraneuronal calcium, rather than calcium influx may be the critical post-synaptic feature underlying LTP induction. We do not however exclude a pre-synaptic involvement in the specificity and/or maintenance of long-term potentiation. PMID- 2710413 TI - Spontaneous epileptiform discharges in isolated human cortical slices from epileptic patients. AB - Human epileptic in vitro brain slices were obtained at ablative neurosurgical procedures and examined for spontaneous extracellular field potentials. Electrical events resembling interictal spikes and seizure discharges were observed in tissue from the electrocorticographic epileptic foci, but not in control tissue. It appears that important differences between the epileptic focus and normal tissue are maintained in vitro. PMID- 2710412 TI - Effect of scopolamine and HP 029, a cholinesterase inhibitor, on long-term potentiation in hippocampal slices of the guinea pig. AB - The effect of scopolamine and a cholinesterase inhibitor on long-term potentiation (LTP) of population spikes was studied in a guinea pig hippocampal slice preparation. After brief application of each drug (10 min), LTP in CA1 and CA3 was induced by tetanus stimulation delivered to commissural/associational fibers and mossy fibers, respectively. Scopolamine at concentration of 10 microM had no effect on LTP in CA1 but significantly suppressed LTP in CA3. The cholinesterase inhibitor, 9-amino-1,2,3,4-tetrahydroacridine-1-ol maleate (HP 029) at concentration of 10 microM significantly enhanced LTP both in CA1 and CA3. These results suggest that the cholinergic system is involved in producing LTP in CA3. Another mechanism of the effect of HP 029 on LTP in CA1 is discussed. PMID- 2710414 TI - Apomorphine-induced inhibition of substantia nigra dopamine neurons: effects of unilateral injection through the internal carotid artery. AB - Possible indirect components in the inhibition of firing of A9 dopamine neurons induced by systemic apomorphine were studied using unilateral drug administration through the internal carotid artery, known to irrigate only the ipsilateral mid- and forebrain. When compared to intravenous injection, unilateral intracarotid administration inhibited ipsilateral neurons with a marked decrease of both the latency (less than 1 s) and the dose required for complete inhibition, whereas contralateral neurons were not affected. This suggests a first-pass central effect of apomorphine, presumably associated with brain extraction. Thus, peripheral and hindbrain targets do not seem to contribute to the inhibitory effect of low doses of systemic apomorphine. An intranigral possible mode of action is discussed in view of the particular arrangement of dopaminergic dendrites within the zona reticulata. PMID- 2710415 TI - Differences in dopamine release and metabolism in rat striatal subregions following acute clozapine using in vivo microdialysis. AB - This study examined and compared the effects of acute clozapine administration over a range of doses on the release of dopamine (DA) and its metabolite 3,4 dihydroxyphenylacetic acid (DOPAC) in dorsolateral and fundus striata. Basal extracellular DA levels were significantly higher in the dorsolateral striatum. However, DOPAC levels were similar in both regions. Acute treatment with clozapine (40 mg/kg) was associated with an increase in extracellular dopamine in the dorsolateral striatum but not in the fundus. In contrast, an increase in extracellular DOPAC was seen in both regions following all doses of the drug; however, clozapine was more potent in the dorsolateral striatum than in the fundus. These results illustrate the functional heterogeneity of the striatum and in addition, indicate a possible dissociation between the effect of acute clozapine on DA release and DA metabolism. PMID- 2710416 TI - Do event-related potentials reveal the mechanism of the auditory sensory memory in the human brain? AB - Event-related brain potentials (ERP) to task-irrelevant tone pips presented at short intervals were recorded from the scalp of normal human subjects. Infrequent decrements in stimulus intensity elicited the mismatch negativity (MMN) which was larger in amplitude and shorter in latency the softer the deviant stimulus was. The results obtained imply memory representations which develop automatically and accurately represent the physical features of the repetitive stimulus. These memory traces appear to be those of the acoustic sensory memory, the 'echoic' memory. When an input does not match with such a trace the MMN is generated. PMID- 2710417 TI - Diagnostic dilemma of aortic aneurysms: internist's perspective. PMID- 2710418 TI - Upright and supine flow-volume curves in patients with OSA. PMID- 2710420 TI - Physician peer review in New Jersey. PMID- 2710419 TI - A physician's duty to disclose that his patient has AIDS. PMID- 2710421 TI - Physician involvement. PMID- 2710422 TI - Teaching psychiatry to primary care residents in a community hospital. PMID- 2710423 TI - Critical period of bilirubin-induced cerebellar hypoplasia in a new Sprague Dawley strain of jaundiced Gunn rats. AB - Homozygous (j/j) and heterozygous (j/+) newborn Gunn rats of the Sprague-Dawley strain were photoirradiated for 24 h at scheduled postnatal days and the effects of irradiation on the cerebellar development were examined at 30 days of life. Improvement of the survival rate was the most notable effect of photoirradiation. A single 24-h dose of photoirradiation during a period of postnatal days 4-11 effectively prevented hypoplasia in the j/j rat cerebellum. No prevention by light was observed at days 3 and 12. It was found that the most effective day of irradiation on the cerebellar development of j/j rats was centered on postnatal day 7. When plasma bilirubin was assessed during the period of postnatal days 7 10, a distinct diminution of the concentration was observed, restricted to only the period of the light treatment. Although there were some differences in the effective day as well as in the degree of efficacy of phototherapy among cerebellar lobules or sublobules, day 7 was the most critical for cerebellar hypoplasia due to bilirubin. PMID- 2710424 TI - Eye movements induced by microinjection of GABA agonist in the rat substantia nigra pars reticulata. AB - Injection of muscimol (GABA agonist) in the substantia nigra pars reticulata (SNr) of the alert rat induced a continual repetition of fast eye movements to the contralateral side, each of which was followed by a slow returning movement. The fast eye movements were similar to spontaneous saccades. Larger saccades were accompanied by contralateral neck muscle activity. We suggest that the SNr plays an important role in control of eye movements in the rat. PMID- 2710425 TI - Long-lasting afterdischarge of alpha-motoneurons after muscle vibration or electrical stimulation of group I afferent fibers in the anemically decerebrated cat. AB - Experiments were performed on anemically decerebrated cats. Motoneuronal activity in the spinal cord was intracellularly or extracellulary recorded and muscle vibration or electrical stimulation of the peripheral nerve was applied for 1 s every 2 s. Such stimulation elicited monosynaptic responses and afterdischarge, a response which lasts after cessation of the stimuli. Stimulus frequencies from 50 to 200 Hz were effective in eliciting the afterdischarge, while frequencies higher or lower than this range of stimulation were ineffective. The interspike intervals of the motoneuron afterdischarge were almost constant and did not correspond to the stimulus frequency. The mean intervals obtained from the motoneurons examined ranged from 70 to 120 ms. Power spectrum analysis of the membrane potential ripples recorded immediately after stimulation revealed increased activity at 38 and 62 Hz components. Since the spike interval of the afterdischarge in this motoneuron was 80 ms, the interval was almost equal to 5- and 3-fold the cyclic time of the increased frequency components. This indicates that the interval of afterdischarge was determined by the specifically increased frequency components of the membrane potential ripples. PMID- 2710426 TI - Axonal transport studied in a single vertebrate neuron: the giant electromotor neuron of the electric catfish, Malapterurus electricus. AB - Axonal transport was studied using a single vertebrate neuron, the giant electromotor neuron of the electric catfish, Malapterurus electricus. The electric organs of this strongly electric fish are innervated by two neurons whose axons form one electric nerve each. After injection of [35S]methionine into the spinal cord at the level of the two perikarya radioactively labelled material is exported by fast flow as a small wave with a velocity of 5.8 mm/h and a somal release time of 91 min (29 degrees C). Slow flow investigated between 15 and 39 days had a velocity of 1.36 mm/d at 29 degrees C. Analysis of radiolabelled proteins by polyacrylamide gel electrophoresis revealed different patterns of labelling between slow and fast flow. The relative molecular mass of the two major proteins labelled on slow flow correspond to actin and tubulin. Labelled proteins of higher relative molecular mass may correspond to neurofilament proteins. Our results suggest that this vertebrate single-neuron and single-axon system can be used successfully for axonal transport studies. PMID- 2710427 TI - Influence of the organophosphorus compound DFP on inhibitory motor systems and esterase activity in the spinal cord of cats. AB - In high spinal cats, the acute time-dependent changes of both the activity of spinal reflex pathways and the activity of three different esterases (acetylcholinesterase, carboxylesterase and neurotoxicant target enzyme) in the spinal cord were investigated after intravenous application of the organophosphorus compound di-isopropyl phosphofluoridate (DFP). There is no general depression of spinal reflexes by DFP. While the recurrent inhibition is completely abolished for a long time and the reflexes to a flexor (PBSt) are depressed but with a shorter recovery time, the reflexes to an extensor (GS) are distinctly less depressed or even facilitated. Reflex pathways from skin afferents to motoneurones did not react in a uniform way to DFP, e.g. inhibitory nociceptive pathways were less affected than excitatory ones. Esterase activities were heavily depressed and recovered with different time courses. The acute DFP action cannot be explained by a uniform intoxication of all spinal functions but probably emerges from a differential action on different interneuronal systems. PMID- 2710428 TI - Stimulation parameters influencing climbing fibre induced long-term depression of parallel fibre synapses. AB - It has been demonstrated that conjunctive stimulation of cerebellar climbing fibres and parallel fibres induces a long-term depression (LTD) of the transmission from the activated parallel fibres to Purkinje cells. The aim of the present investigation with extracellular recordings from single Purkinje cells was to study factors influencing the induction of LTD. Climbing fibres and parallel fibres were conjunctively stimulated with a constant time interval between the climbing fibre and parallel fibre stimuli. It was demonstrated that the maximal effective time interval between climbing fibre and parallel fibre activation for induction of LTD was between 125 and 250 ms. It was also demonstrated that the amplitude of the LTD depended on the stimulation frequency. The LTD induced by conjunctive stimulation at 1 and 2 Hz had a similar size whereas the LTD induced by 4 Hz was stronger. PMID- 2710429 TI - The arrangement of actin filaments in the postsynaptic cytoplasm of the cerebellar cortex revealed by quick-freeze deep-etch electron microscopy. AB - The cytoskeletal architecture of the postsynaptic cytoplasm in the cerebellar cortex of mice and rats was observed by quick-freeze, deep-etch electron microscopy. The postsynaptic cytoplasm was mainly filled with a network of actin filaments (approximately 8 nm in width). The tips of the actin filaments were closely associated with the true inner side of the postsynaptic membranes. However, the organization of the actin filaments was distinct depending on the types of synapses. In axosomatic synapses the actin filaments tended to run randomly and form a network while in the postsynaptic spine, such as Purkinje cell dendritic spines, the actin filaments were mainly arranged parallel to the stalk of the spines. Only a few actin filaments were found in the postsynaptic cytoplasm of some axodendritic synapses such as mossy fiber-granule cell synapses. In most cases a mesh of fine strands (approximately 6 nm in width) and granular substances was observed just underneath the postsynaptic membranes which also associated with actin filaments. The arrangement of actin filaments in the spine does not support the possibility of constriction of spines as a basis for long-term depression (LTD). PMID- 2710430 TI - New strategies for preterm labor. AB - Preterm birth is the leading cause of perinatal mortality and morbidity despite the technological advances in neonatology and maternal-fetal medicine. Risk factors have been tabulated that can help identify the woman at risk for preterm birth. Past medical history, present pregnancy events, and demographic/environmental characteristics can help the practitioner select women who need special care to help prevent or reduce the effects of premature delivery. Recently, new concepts of risk have been identified through research, and emphasis needs to shift from intervention to prevention of the low birth weight infant. Past and present management of premature labor is discussed. New research protocols are presented. Strategies for nurses working in family planning or obstetrical areas are discussed, demonstrating areas for interventions from a prevention-oriented nursing base. PMID- 2710432 TI - Battling AIDS through behavior modification. PMID- 2710431 TI - Overseas relief organizations: a guide for health care providers. AB - Spending time overseas providing health care to people in disaster or famine related situations can be a very rewarding experience. This article presents lists of various organizations available for health care professionals who wish to spend time in relief work. The lists include qualifications and/or professional needs, locations, lengths of service, and focuses of the organizations. Some of these organizations provide a stipend for the relief worker. In others, the entire cost of the experience must be paid for by the volunteer. Guidelines are given to assist the prospective relief worker in looking for an appropriate agency, such as to obtain a complete job description; know the details of living arrangements; make sure you have compatible philosophies; ask about health concerns; find out if adequate health insurance is provided; and gain knowledge of the culture (e.g., especially about customs, relationships of nationals to relief workers, and religious beliefs). Interested health care providers can write to any of the organizations to obtain further information. PMID- 2710433 TI - The challenge of change. PMID- 2710434 TI - Reflections on the New York do-not-resuscitate law. PMID- 2710435 TI - Typhlitis. PMID- 2710436 TI - Variations in the delivery of medical care in central New York. AB - This paper presents an application of the Wennberg small area analysis methodology to the experience of a metropolitan county in upstate New York. It illustrates how these techniques can be used cooperatively by physicians and business to address purchaser concerns such as the impact of ambulatory surgery, the potential need for preadmission review and second opinion programs, and the contribution of high cost procedures to overall utilization and cost. The study found that use rates for most diagnoses and procedures were substantially below statewide norms, representing an annual savings of more than +30 million. It also found ambulatory surgery was effectively used as an alternative to hospitalization, and that high use rate areas involved high cost procedures targeted by second opinion and preadmission review programs. PMID- 2710437 TI - The living will: does it protect the rights of the terminally ill? PMID- 2710439 TI - Himself, Mrs Plucker, and the rites of spring. PMID- 2710438 TI - Fetal therapy and surgery. Fetal rights versus maternal obligations. PMID- 2710440 TI - Typhlitis occurring in a myelodysplastic syndrome. PMID- 2710441 TI - Campylobacter fetus as a pulmonary pathogen in man. Case report of post pneumonectomy empyema. PMID- 2710442 TI - Enterococcal meningitis: a subacute presentation. PMID- 2710444 TI - Empty lifeboat. PMID- 2710443 TI - Temporary insanity and premenstrual syndrome. PMID- 2710445 TI - Adult day care centers for elderly patients. PMID- 2710446 TI - Three hundred admissions to the Waikato Hospital intensive therapy unit- survival, costs, and quality of life after two years. AB - Three hundred consecutive admissions 13 years of age and above who entered the Waikato Hospital intensive therapy unit, were followed up after two years. Their degree of illness was similar to that in other intensive care units. At two years, 26% of the patients were dead. Maori admissions and death rates more than doubled those of the nonMaori. Once admitted, the proportion dying was identical in both groups. The average stay in ITU was 6.3 days. The average stay in hospital including ITU, was 28 days. One hundred and fifty-nine people (168 admissions) were traced and questioned about their quality of life. Seventy-four percent had a good quality, 19% were affected, and 7% had a severely affected quality of life. Preliminary estimates of cost suggest that the average ITU cost per patient is about $9500, and the average total hospital cost for any patient entering ITU is about $20,000. PMID- 2710447 TI - A study of friendship in general practice. PMID- 2710448 TI - Vaccination against influenza and pneumococcal disease--are we doing our best? PMID- 2710449 TI - Cancer registration and confidentiality. PMID- 2710450 TI - Spinal stenosis and ischaemic leg pain. PMID- 2710451 TI - Follow up of alcohol and other drug dependents treated with psychodrama. PMID- 2710452 TI - Influenza vaccination. PMID- 2710453 TI - Why are we sick? PMID- 2710454 TI - Alcohol and local authorities. PMID- 2710455 TI - Marketing medicine. PMID- 2710457 TI - Royal New Zealand College of General Practitioners ethical committee. PMID- 2710456 TI - Acyclovir and herpes zoster. PMID- 2710458 TI - Abnormal erythrocytes in myalgic encephalomyelitis. PMID- 2710459 TI - Prescription charges in rural practices: difficulties encountered in prescribing. PMID- 2710460 TI - Vaginal breech delivery--inaccurate reporting. PMID- 2710461 TI - Life insurance and AIDS. PMID- 2710462 TI - OSHA updates standard. PMID- 2710463 TI - OSHA issues PEL standard. PMID- 2710465 TI - States ask for data. PMID- 2710464 TI - Nurses 'disturbed' by new regulations. PMID- 2710466 TI - Infection affects workers. PMID- 2710467 TI - Law restricts smoking. PMID- 2710468 TI - Doctor exposed to AIDS. PMID- 2710469 TI - Employee health programs will thrive if they reflect employees' interests. PMID- 2710470 TI - Outside stress factors may underlie variations in workplace productivity. PMID- 2710471 TI - Identifying stressors is necessary to combat potential health problems. PMID- 2710472 TI - Asbestos inhalation and cigarette smoking make a lethal combination. PMID- 2710473 TI - Lab workers face greater risk. PMID- 2710474 TI - New York to limit medical work hours. PMID- 2710475 TI - Four-year analysis of platinum and anthracycline combination for ovarian cancer. AB - Eighty-nine patients with advanced ovarian cancer have been treated with a combination of cis-platinum (50 mg/m2) + an anthracycline (adriamycin 50 mg/m2 in 26 patients, or epirubicin 60 mg/m2 in 63 patients). The treatment was repeated every 28 days for a maximum of 12 cycles. Seventy-nine were evaluable for response. CR was achieved in 19 (24%) patients (2 clinical and 17 after a second look evaluation) and a PR in 31 (39%) for an estimated median duration of 43 and 10 months, respectively. Nine patients who achieved CR and 2 out of 10 non evaluable patients were alive without any evidence of disease after a median follow-up of 36 months (range 29-53). The treatment was generally well tolerated. The multivariate actuarial 4-year analysis by Cox's proportional hazards model shows that residual tumor and performance status have an independent prognostic value on survival. The combination of CP + an anthracycline (and in particular epirubicin) is an effective and generally well tolerated treatment for ovarian cancer. Only patients with initial minimal residual disease and achieving CR are candidates for long-term survival. PMID- 2710476 TI - Evaluation of the ovarian cancer antigen, Ca-125, as a tumor marker. AB - The presence of the Ca-125 antigen was tested in the serum of 46 patients with ovarian cancer in order to determine the prognostic value of preoperative levels and its usefulness for monitoring the clinical response in longitudinal studies; survival (S) and progression-free survival (PFS) were also evaluated. In our series, the specificity of the assay in normal subjects and in patients with benign gynecological diseases is 99.3 and 73.2% respectively, and the sensitivity is 91.9%. Preoperative Ca-125 levels are not correlated with S and PFS, whereas an advantage in S and PFS is clearly shown for patients in whom the marker level decreases after treatment. Serial determinations of Ca-125 serum levels provide a reliable test to assess response to therapy and to predict disease progression. PMID- 2710477 TI - Modulation of mitoxantrone cytotoxicity by verapamil in human chronic myeloid leukemia cells. AB - Calcium channel-blocking agent verapamil has been established to be an effective drug to modulate the action of many anticancer drugs. In this study, we examined the effect of verapamil on the cytotoxicity of mitoxantrone in human chronic myeloid leukemia (CML) cells. Mitoxantrone alone exhibited dose-dependent inhibition of DNA biosynthesis in CML cells. The addition of verapamil (3.3 microM) enhanced the responsiveness of CML cells to mitoxantrone (1 microgram/ml) cytotoxicity indicated by significant increased inhibition of thymidine incorporation (p less than 0.001). The present study demonstrates the possible efficacy of verapamil in the chemotherapy of CML with mitoxantrone. PMID- 2710478 TI - Effects of tauromustine, a water-soluble nitrosourea compound on NMU-1 murine lung tumor. AB - This study assessed the antitumor activity of 1-(2-chloroethyl)-3-/2 (dimethylaminosulfonyl)ethyl-1-nitrosourea (TCNU), a newly soluble nitrosourea, on NMU-1 lung tumor, a transplantable murine model poorly sensitive to BCNU. TCNU delivered orally was more effective after weekly than after biweekly treatments. When TCNU was given weekly intravenously, its therapeutic index was higher than after oral treatment. Compared with BCNU, TCNU showed superior antitumor effects on NMU-1 murine lung tumor. In this experimental model, TCNU activity was comparable to that of drugs active on human lung cancer. PMID- 2710479 TI - Influence of adjuvant chemotherapy for operable breast cancer on results of treatment at relapse. AB - The influence of adjuvant chemotherapy (ACT) for operable breast cancer on the results of systemic therapy at relapse was retrospectively studied in 62 patients with recurrent disease. 32 had been treated with ACT [ACT (+) group] and the others had not [ACT (-) group]. The response rate (CR + PR) to the first treatment was 22% in the ACT (+) group and 43% in ACT (-) group. It is suggested that relapsing patients with a history of ACT respond poorly to the treatment as compared to those not receiving it. PMID- 2710480 TI - Relation between delay and survival in 596 patients with breast cancer. AB - To evaluate the influence of delay between first symptom and first treatment upon survival the medical records of 596 patients with breast cancer were reviewed. The following intervals were considered: less than 3 months; 3-6 months and greater than 6 months. Patients in the less than 3 months delay group had a better distribution by clinical stages and a 10-year survival rate higher than those in the longer delay groups (p = 0.034). However, within each stage no statistically significant difference in survival according to delay was observed. A Cox multivariate analysis revealed that performance status and stage of disease were independent predictors of survival, but not delay. Assuming the best prognosis for patients with clinical stages I and II and less than 3 months delay, the group with longer delay times had 15 deaths over what would have been predicted. This adverse effect was observed almost exclusively among patients over age 50 (14/15). PMID- 2710481 TI - 5-Fluorouracil, doxorubicin (adriamycin) and mitomycin-C (FAM) in advanced gastric cancer: observations on response, patient characteristics, myelosuppression and delivered dosage. AB - Forty-four patients with advanced gastric adenocarcinoma were treated with the fluorouracil, adriamycin and mitomycin-C (FAM) regimen. One was excluded from response evaluation. Partial (PR) and minor (MR) response rates were 7 and 9% respectively. These patients enjoyed remission for a median of 7.0 months. Stabilization (S) occurred in 25% and lasted a median of 6.0 months. No response (NR) was associated with a median survival of 3 months (p less than 0.001). The predominant pretreatment factors to affect survival were diagnosis to treatment interval and initial CEA serum level. Performance status influenced survival less markedly. Toxicity was mainly myelosuppression, which resulted in death of one patient. 'Responders' had marrow suppression more frequently than NR. Comparison of PR + MR, PR + MR + S and NR patient groups showed median minimum WBC counts of 1.4 x 10(3), 2.6 x 10(3) and 4.3 x 10(3) per mm3 respectively. Leukopenia (less than 3,000/mm3) was associated with a median survival advantage of 9.5 versus 3.5 months (p less than 0.05) and did not depend significantly on given FAM dosage. The median dosage of FAM agents delivered to nonresponders was reduced. A trend of dose-response (including dose-survival) relationship was found but was inconclusive statistically. PMID- 2710482 TI - Phase II trial of recombinant alpha-2b interferon in the treatment of metastatic skin melanoma. AB - A pilot study was undertaken to evaluate toxicity and activity of recombinant alpha-2b interferon in patients with metastatic malignant melanoma. Interferon was administered at the dosage of 10 x 10(6) IU/m2, 3 times a week i.m. 21 patients entered the study, 17 pretreated with chemotherapy and/or immunotherapy and 6 untreated. We obtained 3 partial responses (14.3%; 95% CL, 3.0-36.3%); 9 patients had stable disease. All patients experienced flue-like symptoms and fever; most fatigue and worsening of performance status. Recombinant interferon alpha-2b at the dosage and schedule used has limited but definite activity in metastatic malignant melanoma; the substantial subjective toxicity must be taken into consideration. Further trials testing recombinant alpha interferon in combination with chemotherapeutic agents, like DTIC, are warranted. PMID- 2710483 TI - Postoperative thyroglobulin level determination to follow up patients with highly differentiated thyroid cancer. AB - The highly differentiated thyroid tumours account for 0.80% of all human malignancies. The papillary and follicular tumour tissues of this tumour type are relatively benign, hormone-dependent and beside their treatment specificity they secrete the tumour-specific thyroglobulin. This it becomes possible to follow the development of metastases, the effectiveness of therapy applied as well as the history of the disease. The authors studied the change of thyroglobulin level in 153 patients with highly differentiated thyroid cancer. In 29 of 32 metastatic patients a pathologically elevated (70-100 ng/ml) thyroglobulin level was observed. This proves the 91% specificity of the method in verified metastatic tumours. Compared to the total body scintigraphy 3 false-negative and 6 false positive cases were found. The authors establish that, irrespective of the site of metastasis, the thyroglobulin level is higher in the follicular than in the papillary subtype. It is concluded that the measurement of the serum thyroglobulin level is a suitable marker of the highly differentiated thyroid cancer since it indicates local recurrence or distant metastases by a significant increase while therapy-resultant tumour diminution is accompanied by a marked decrease. PMID- 2710484 TI - Why measuring quality of care, a vitally important task, is presently being done improperly. PMID- 2710485 TI - Occult plastic intraocular foreign body. AB - A 34-year-old man was evaluated for posttraumatic endophthalmitis with hypopyon. A previous CT scan of the orbit along with B-scan ultrasonogram failed to confirm the presence of an intraocular foreign body. Nevertheless, at the time of vitrectomy, a polyvinyl chloride (PVC) plastic foreign body was encountered. The atypical posttraumatic uveitis that developed was apparently secondary to the PVC material, as the inflammation cleared rapidly following removal of the foreign body. This case illustrates the necessity for maintaining a high level of suspicion for the possibility of an intraocular foreign body in the event of ocular trauma, even in the presence of unconfirming ancillary tests. PMID- 2710486 TI - Locating cut medial canaliculi by direct injection of sodium hyaluronate into the lacrimal sac. AB - Locating the cut medial ends of canaliculi after trauma or surgery can be difficult. In cases of double canalicular or common canalicular lacerations, injection of sodium hyaluronate (Healon) directly into the lacrimal sac may help pinpoint the medial openings. PMID- 2710487 TI - Therapeutic ultrasound for refractory glaucoma: a three-center study. AB - We present the results of therapeutic ultrasound for refractory glaucoma in a three-center study over 1 year. One hundred fifty-eight eyes were treated, with a mean follow-up of 8.0 months. The mean fall in intraocular pressure was 38.4%. Life table analysis for three success criteria are presented. Success varied between 66% and 72% at the mean follow-up time. Complications occurred in 11.4%, including phthisis bulbi in 0.6% and persistent hypotony in 2.5%. There was a mean loss of less than one line of visual acuity. Therapeutic ultrasound appears to be safe and effective for treatment of refractory glaucoma. PMID- 2710488 TI - Balloon catheter dilatation in lacrimal surgery. AB - We performed balloon catheter dilatation in four patients with a failed dacryocystorhinostomy. Epiphora was relieved and a patent lacrimal drainage system was achieved after the procedure in three of the four. The fourth patient had a transient partial response. Epiphora recurring in one patient 3 1/2 months after the procedure responded to a second dilatation. PMID- 2710489 TI - Lacrimal catheterization. AB - A new atraumatic technique for identifying the medial cut end of a surgically lacerated canaliculus is described. It offers the advantage of allowing the surgeon to pass a stent through the canaliculus only, without surgically manipulating the lacrimal sac or nasolacrimal duct or damaging the ipsilateral canaliculus. PMID- 2710490 TI - Applicator for cyanoacrylate tissue adhesive. AB - Cyanoacrylate tissue adhesive (CTA) is very useful for emergency treatment of corneal perforations. Lack of Food and Drug Administration approval as well as concerns about toxicity from the application of large amounts of glue, however, have limited its use. It is difficult to apply a sufficiently small amount of glue or to achieve a water tight seal using published techniques of glue application. We have found a commercially available micropipette (used in dental work) to be more effective than other methods of CTA application. With this apparatus, precise and accurate placement of minimal amounts of CTA at the slit lamp is consistently possible. PMID- 2710491 TI - Focal scleral thinning after transscleral Nd:YAG cyclophotocoagulation. AB - Transscleral neodymium (Nd):YAG cyclophotocoagulation, a new cyclodestructive procedure for controlling intraocular pressure in patients with refractory glaucoma, is designed to penetrate the sclera and selectively destroy the ciliary body and processes without damaging the overlying tissue. Complications include conjunctival edema, corneal edema, iritis, gas in the anterior chamber, pain, hyphema, hypopyon, vitreous hemorrhage, and cataract. We present a case in which a patient developed focal areas of scleral thinning 6 weeks after transscleral Nd:YAG cyclophotocoagulation. The possibility of scleral damage or thinning should be kept in mind when performing the procedure. PMID- 2710492 TI - Suction-cup occluder for amblyopia therapy. PMID- 2710493 TI - Contact transscleral irradiation of the human chorioretina with continuous-wave Nd:YAG laser. AB - We performed contact transscleral chorioretinal photocoagulations with a continuous-wave Nd:YAG laser on two human eyes affected by choroidal melanomas. An optical-fiber system without any focalization tip was used to deliver the laser energy by placing the fiber in contact with the sclera in the position corresponding to the chorioretinal area to be photocoagulated. With a power of 4 W and an exposure time of 0.5 s, frank white coagulations were obtained. Histological and ultrastructural examination evidenced that the choroidal pigment and the retinal pigment epithelium were the target structures of the radiation. No substantial alterations of the sclera were noted while a good adhesion between the retina and the pigment epithelium cells was observed. The results obtained show that transscleral contact lasers may be safely used in the treatment of some pathologies of the ocular fundus. PMID- 2710494 TI - Photographic and spectroscopic correlations of human cataracts. AB - Intracapsular cataracts obtained within 3 h after surgical extraction were photographed with the CCRG technique and immediately subjected to fluorescence spectroscopy followed by 31P- and 13C-nuclear magnetic resonance (NMR) spectroscopy. Fluorescence spectroscopy demonstrates an excellent correlation between nontryptophan fluorescence intensities and lens color. An interesting correlation was also observed between the degree of light scatter as determined by the 290-nm excitation peak for intrinsic lens tryptophan fluorescence and the CCRG (photographic) appearance of these cataractous lenses. Based on 100 cataracts analyzed, there is a strong correlation between this kind of light scattering measurement and the type and degree of lens opacification. A similar correlation is evident with the 31P-NMR organophosphate profiles in the lenses in which the sugar phosphate levels are elevated only in diabetic patients with cataracts ('diabetic cataracts'). Aside from fluorescence and 31P-NMR spectroscopy, selected lenses were also incubated with 5.5 nM 13C-glucose as soon as they were obtained, and the foregoing spectroscopy was performed, followed by 13C-NMR analyses to detect and monitor for sorbitol accumulation in young versus old normal lenses and in diabetic cataracts. These studies clearly demonstrate a direct correlation between nontryptophan-fluorescent chromophore levels, light scattering (determined by tryptophan excitation peaks), lens age and cataract type. In addition, the organophosphate profiles clearly delineate the diabetic cataracts, and the 13C-NMR spectra correlate well with the age-related decrease in aldose reductase activity. PMID- 2710495 TI - Effect of cefazolin on the corneal endothelium. An experimental study. AB - Cefazolin sodium was injected into the anterior chamber of the rabbit eye in order to evaluate its effect upon the corneal endothelium. Endothelial toxicity was evaluated by contact specular microscopy and transmission electron microscopy 48 h after injection. The results suggest that doses of 1 and 2 mg of cefazolin are nontoxic to the corneal endothelium. Endothelial toxicity occurred when 5 and 10 mg of cefazolin were injected. PMID- 2710496 TI - Sustained decreases in systemic blood pressure do not cause ocular hypotension. AB - The unilateral, topical administration of certain ocular hypotensive agents, notably clonidine, is reported to result in a bilateral decrease in intraocular pressure. It has been previously proposed that such bilateral ocular hypotensive responses may be centrally mediated. However, the possible influence of blood pressure changes on intraocular pressure has remained a complicating factor in determining mechanisms of action. In order to further clarify the potential relationship between systemic blood pressure changes and intraocular pressure, the effects of two systemic antihypertensive drugs were determined in the conscious rabbit. Topical, unilateral administration of either hydralazine or prizidilol did not lower the intraocular pressure of either eye. A bolus intravenous injection of either hydralazine or prizidilol caused substantial systemic hypotension that persisted for at least 3 h, but no decreases in intraocular pressure occurred. These studies indicate that sustained decreases in systemic blood pressure of approximately 15 mm Hg do not result in ocular hypotension. PMID- 2710497 TI - Effect of indomethacin and prednisolone on the disruption of the blood-aqueous barrier after hyperthermia on the rabbit eye by focused ultrasound. AB - In 24 rabbits both eyes were treated in the perilimbic area with hyperthermia by focussed ultrasound at a frequency of 4.65 MHz. The intra-ocular pressure (IOP) decreased significantly in all eyes. The effect of pre-treatment with indomethacin and prednisolone on the inflammatory response induced by the insonification was assessed by determination of protein in the aqueous humour 2 h after ultrasound treatment. Local pre-treatment with indomethacin but not with prednisolone was followed by less increase in protein concentration of the aqueous humour as compared to placebo-treated controls. The IOP was not influenced significantly by the drug pre-treatments. PMID- 2710498 TI - Cytoskeleton, adhesion, and extracellular matrix of fetal human retinal pigmented epithelial cells in culture. AB - Small sheets of human retinal pigmented epithelial (RPE) cells isolated from 6- to 9-week-old fetal human eyes were used to establish RPE cells in culture. After 4-5 days in culture the RPE cells in various parts of a colony were examined by immunofluorescence and fluorescence microscopy to determine the distribution of the cytoskeletal proteins tubulin, myosin, F-actin, vimentin, and cytokeratin and the extracellular matrix proteins laminin and type IV collagen. The extracellular matrix components laminin and type IV collagen, which are abundant underneath the RPE cells in the centre of the colony, progressively decrease in amount towards the edge of the colony. Microtubules labeled by antisera to tubulin were present in the cytoplasm of RPE cells throughout the colony. F-actin and myosin were found in stress fibres in the RPE cells at the edge of the colony and in compact circumferential rings circumscribing the apical ends in RPE cells in the centre of the colony. Examination of cell-substratum adhesion patterns by interference reflection microscopy showed that focal contacts were present only in RPE cells at the edge of the colony where they were located at the ends of the stress fibres. The large focal adhesions previously observed in colonies of chick RPE cells, however, were not seen in human RPE cells. Human RPE cells throughout the colony had cytokeratin-containing intermediate filaments as well as vimentin containing intermediate filaments, whereas only the latter were observed in chick RPE cells. These results indicate that in the general organization of the cytoskeleton and in the distribution of the extracellular matrix components, laminin and type IV collagen, colonies of human RPE cells are similar but not identical to colonies of chick RPE cells. PMID- 2710499 TI - Microendoscopy of the anterior segment vasculature in the rabbit eye. AB - Intraocular microendoscopy is introduced as a new method which allows a direct in vivo observation of the microvasculature of the eye. Using video equipment, a quantitative evaluation of changes in vessel diameters, e.g. after administration of vasoactive agents, and an estimation of blood oxygenation are possible. Experimental studies with fluorescent dyes can also be performed using special filters. In albino rabbits, no apparent vascular disturbances were observed under certain experimental conditions. Touching a ciliary process with the tip of the endoscope immediately resulted in a vasodilation and stoppage of blood flow, surprisingly in the affected area only. After epinephrine, the locally traumatized ciliary processes remained unchanged while the vessels of the neighboring ciliary processes constricted intensely. After reduction of the intraocular pressure the major ciliary processes began to swell. A leakage of fluorescein-dextran was only found in the iridial ciliary processes. PMID- 2710500 TI - Metastasis of bronchial carcinoid tumour to choroid. AB - A rare case of metastatic carcinoid tumour of the choroid is presented. Techniques used to identify the nature of the neoplasm (immunohistochemical or histochemical stains) and the numerous substances possibly secreted by the neoplastic cells (PAP immunocytochemical technique) are discussed. PMID- 2710501 TI - Comparative study of argon laser trabeculoplasty in primary open-angle and pseudoexfoliation glaucoma. AB - In 93 phakic eyes--52 eyes with primary open-angle and 41 eyes with exfoliation glaucoma--with increased intraocular pressure, argon laser trabeculoplasty was performed. Fifty to sixty burns were made over 180 degrees of the lower trabecular meshwork. During the follow-up period, visual acuity, intraocular pressure, medication changes and the need for surgery were studied. In 25 eyes a second laser treatment was performed over 180 degrees of the upper trabecular meshwork. Intraocular pressure control was obtained in 81% of the eyes with primary open-angel glaucoma and 71% of the eyes with pseudoexfoliation glaucoma. The average reduction of pressure obtained after laser trabeculoplasty was 9.22 mm Hg for the group of eyes with primary open-angle glaucoma and 13.42 mm Hg for the group of eyes with pseudoexfoliation glaucoma (p less than 0.001). Reduction in medical treatment was obtained in 27 eyes from the 71 eyes with successful reduction of the intraocular pressure. In 6 eyes with successful results after argon laser trabeculoplasty, cataract extraction was performed. The intraocular pressure remained normal in all eyes after the operation. PMID- 2710502 TI - [Effect of carteolol and timolol eyedrops on the pressure tolerance of the optic nerve head]. AB - In a planned, randomized, double blind study ocular perfusion pressures were measured before and after a 3-day regimen of 2% carteolol hydrochloride or 0.5% timolol maleate. A pressure tolerance test was also carried out. The results of this test revealed the critical pressure: it is the artificially increased intraocular pressure at which the visual function (monitored by visually evoked cortical potentials) is reduced to 20% of its initial value. The ocular perfusion pressures are affected by both drugs. They are more clearly reduced by carteolol than by timolol. The critical pressure is affected by both drugs too. After application of carteolol, the critical pressure is clearly lower than after application of timolol. The difference is statistically significant (p less than 0.05). PMID- 2710503 TI - Retinal leakage in retinal vein occlusion: reduction after hyperbaric oxygen. AB - A 54-year-old woman with a history of bilateral central retinal vein occlusion, probably due to an inflammatory process, developed a hemispheric retinal vein occlusion with cystoid macular edema in her only seeing eye. Five months later, in the absence of improvement in vision and macular edema, she received on two occasions a 2-weekly course of twice daily 100% hyperbaric oxygen. After each course retinal leakage, as assessed by vitreous fluorophotometry, decreased from abnormal to the normal range while visual acuity improved by two lines. The possible implications are discussed. PMID- 2710504 TI - Intraocular foreign bodies. 297 consecutive cases. AB - The records of 297 patients with intraocular foreign body (IOFB) injuries were analyzed in a retrospective study ranging from 1956 to 1985, and the data of the three decades were compared. 62% of the IOFB were located in the vitreous, 13.5% in the posterior sclera. There was no significant difference between Haab's and Hirschberg's methods in removing the IOFB. In 6.7% an enucleation followed the primary operation, half of these due to postoperative infection. The number of injuries with IOFB has declined. The postoperative improvement of visual acuity has doubled in the last decade compared to the first. The importance of removing the IOFB is stressed, as an unsuccessful attempt considerably worsens the prognosis. 5 of the 297 cases were female, which emphasizes the causative occupational factor. Hammering was the commonest cause of IOFB (80%). None were wearing protective goggles. The importance of wearing protective goggles should be stressed in health education programs. PMID- 2710505 TI - Relations between visual acuity, refraction and the pattern reversal visual evoked cortical potential in aphakia. AB - The investigations included 20 aphakic patients. Relations were established between visual acuity, refraction and the pattern reversal visual-evoked cortical potentials (PRVECP). Close correlations were found between the three values. The optimum correction for obtaining best visual acuity, the skiascopic value, and the correction value for obtaining the largest PRVECP amplitude at minimum peak time differ by an average of 0.5 dptr. PMID- 2710506 TI - Clinical and electrophysiological abnormalities in the visual system in myotonic dystrophy. AB - The investigation comprised 16 patients with verified myotonic dystrophy. The patients were examined ophthalmologically, by electroretinography (ERG) and pattern visual-evoked potentials (VEPs). The results were compared to those of a normal control group. More than 50% of the patients had changes in their lenses or retinas, and the ERGs and VEPs were frequently abnormal. No statistical relation was found between the clinical and electrophysiological findings, and the pattern of abnormalities seemed to vary at random. The number of abnormal clinical and electrophysiological findings increased slightly with the age of the patients, but no statistically significant relation was found either to the patients' age or the duration of the disease. PMID- 2710507 TI - Speed of accommodation and age. AB - The time needed to change accommodation from a near to a far target or from a far to a near target (0.457 and 5.486 m) was measured with a psychophysical threshold procedure in 65 U.S. Navy fighter pilots. The age of the pilots ranged from 24 to 44 years. The speed of accommodative change, far-to-near (FN), slowed with age in a statistically significant fashion; however, near-to-far (NF) did not appreciably slow with age. The intrasubject variability was greater FN than NF but there was not a statistically significant dependence of variability upon age. PMID- 2710508 TI - Reliability of corneal oxygen flux measurements. AB - Serial oxygen flux measurements were obtained from the same cornea of 5 human subjects after exposure to ambient air, a test gas mixture (2% oxygen, balance nitrogen) and 100% nitrogen at 2 individual measurement sessions. Analysis of variance (ANOVA) of the individual flux measurements for the test gas indicates that there were significant differences in corneal oxygen flux rates among subjects and sessions. Referencing the flux data for the test gas to the data for ambient air reduced the variability of data between sessions, although significant intersubject differences were still present. By referencing the flux data for the test gas to the concurrent air and nitrogen data, differences among subjects, as well as sessions, were reduced to the extent that they were not statistically significant. Standardization of data is important in the interpretation of corneal oxygen flux data so that intersubject and intersession differences can be minimized. PMID- 2710509 TI - Effects of ultraviolet radiation on the oxygen uptake rate of the rabbit cornea. AB - Ultraviolet radiation (UVR) has been demonstrated to be involved in a number of adverse ocular effects. One aspect of UVR-induced corneal stress only recently documented is an alteration of epithelial energy metabolite levels. In this study, in order to examine wavelength and dose dependency issues concerning metabolic effects of UVR, exposures were made at four different wavelengths (290, 300, 310 and 360 nm) and five different mean radiant exposures (0.05, 0.10, 0.15, 0.20, and 0.25 J.cm-2). Pre- and postexposure levels of relative metabolic activity of the corneal epithelium were monitored in vivo by recording the corneal oxygen uptake rate with a micropolarographic electrode. A paired difference analysis demonstrated a decrease in relative corneal metabolic activity that was both wavelength- and dose-dependent. These relative metabolic effects provide some insight toward the understanding of underlying damage mechanisms, and imply a broader radiant energy susceptibility range of the eye than previously thought. PMID- 2710510 TI - Twin channel infrared optometer for recording binocular accommodation. AB - A twin channel infrared (IR) optometer for recording accommodation from each eye is described. Some modifications to a conventional single channel optometer design are necessary to facilitate binocular recording. The optometer incorporates an on-line microcomputer for data acquisition and processing. Processing includes power spectrum and correlation analysis, and a facility for performing cursor controlled measurement of time delays. Accommodation responses recorded are shown to be independent of horizontal eye movements, and little affected by the drug used for mydriasis. PMID- 2710511 TI - Classification of the surface appearance characteristics of contact lenses in vivo. PMID- 2710512 TI - Monocular accommodative facility testing reliability. AB - Recently, concern has been expressed about accommodative facility testing reliability, especially for subjects rated initially as failing. Our study evaluated an extended testing period's effect on reliability. Subjects, ages 8 to 12 years, were tested for an initial 1-min period; to identify two groups; high fails (greater than 6, but less than 11 cpm, N = 30) and low fails (less than 6 cpm, N = 30), and then for an additional 2 min. Mean rate change analysis showed both high and low fail groups improved their accommodative facility over extended testing (1.29 and 0.87 cpm, respectively), although no significant difference was found between the groups. In contrast, test-retest correlations indicate a higher reliability for the baseline rates among low fail (r = 0.720) as compared to high fail (r = 0.402) subjects. The difference between groups became more evident when diagnostic classification was monitored over the 3-min testing period, with 73.3% of the low fails remaining low fails, and 43.4% of the high fails reached the pass criterion. The 1-min testing method appears more reliable if the initial rate is less than 6 cpm. For patients whose initial rate is between 6 and 11 cpm, extended testing (1 additional min) may be needed to arrive at an accurate diagnosis, especially if presenting symptoms are absent. PMID- 2710513 TI - Reliability of assessing the cup/disc ratio using a 90 D lens photograph. AB - The reliability of estimating the cup to disc (C/D) ratio using a retinal camera photograph was compared to the same task using a photograph taken with the slit lamp and +90 D lens. Twenty observers (10 optometry students, 10 faculty members) were asked to judge the C/D ratio of four eyes by the two photographic methods. When comparing the two clinically accepted photographic methods, statistically significant differences were noted for the vertical dimension estimate in two of four eyes. However, these differences were not clinically significant. C/D ratio estimates with the retinal camera photograph were typically larger than those of the slitlamp and +90 D lens photograph. Neither photographic method provided an advantage or disadvantage to clinicians with different levels of experience. PMID- 2710514 TI - Microwave disinfection of soft contact lenses. AB - We evaluated the effectiveness and convenience of microwave irradiation as a method of disinfecting soft contact lenses. Soft contact lenses from each of the four Food and Drug Administration (FDA) categories were placed in sterile vials and immersed in 2 ml of saline which had been contaminated with one of three common species of bacteria. The contaminated lens vials were placed in a standard 600 W microwave oven and exposed to microwave irradiation times ranging from 30 to 180 s. Significant reductions in bacteria colony counts were found after 30 s of microwave irradiation. Few of the bacteria survived 60 s of microwave exposure and none survived 90 s. Our findings indicate that microwave disinfection can be an effective and rapid means of killing bacteria on soft lenses and in the storage solution. However, further studies are necessary to determine the minimum exposure time required, the effect of microwave disinfection on other microorganisms, and the effect of microwave irradiation on contact lens polymers and lens dimensions. PMID- 2710515 TI - A unifying parameter to describe the clinical mechanics of hydrogel contact lenses. AB - We studied the relation of postlens squeeze pressure to the clinical fit of hydrogel contact lenses. This relation was statistically significant (p less than 0.01) for a variety of contact lenses currently prescribed over a range of thickness, water content, back central optic radius, diameter, and back vertex power. The squeeze pressure provided a useful parameter to describe and compare the clinical fit of hydrogel contact lenses and a model with which the fit of a lens to an eye could be predicted. There was virtually no movement of the contact lenses across the eye when the squeeze pressure was more than -14 mm H2O (-1370 dynes/cm2). However, the mechanics of the lens motion when the squeeze pressure was less than this critical pressure appeared to be related to a more complicated combination of the squeeze pressure and the other forces in the eye-lens system. PMID- 2710516 TI - Factors influencing vision with rigid gas permeable alternating bifocals. AB - This study assessed the fitting and visual performance of a rigid, gas permeable (RGP), monocentric, alternating bifocal. Fourteen presbyopic eyes each wore 24 different lenses consisting of all combinations of 2 diameters, 2 segment heights, 2 prism ballasts, and 3 fitting relations. The influence of parameter selection on visual performance and the usefulness of clinical measurements in predicting visual performance were determined statistically by multivariate logistic regression. Our results showed that prism, segment height, and the fitting relation can influence distance and near visual performance. Lens movement, postblink segment positioning, and return time were the most useful measured predictors of visual performance. PMID- 2710517 TI - Fixation disparity. AB - Fixation disparity may be a symptom of binocular stress or a purposeful error signal to drive vergence eye movements. Two similar units for detecting fixation disparity (Mallett and Sheedy units) are compared and evaluated. The Mallett unit was found to be more reliable, with similar readings in symptom-free subjects, whereas the Sheedy unit gave a larger spread of fixation disparity measurements and appears to be less useful than the Mallett unit for routine clinical use. The exact role of fixation disparity remains unresolved. Fixation disparity has two components in symptomatic subjects; the vergence signal component and an oculomotor imbalance component. PMID- 2710518 TI - Intraocular lenses in uveitis patients. PMID- 2710519 TI - Contact lenses for visual rehabilitation after corneal laceration repair. AB - A contact lens fitting was tried after corneal laceration repair in 26 eyes. The mean patient age was 25 years; 22 eyes were aphakic and there were 23 males. Many patients had been referred for penetrating keratoplasty. Intact sutures in 13 eyes did not hinder contact lens fitting which was performed within 6 months in 12 cases. A contact lens was fit and successfully worn in 21 eyes (81%) and was fit in the remaining five patients, but not worn because of suboptimal vision (4 eyes) or an unsatisfactory fit (1 eye). Success rates were higher for small, peripheral lesions and in younger patients. Visual acuity was at least 20/30 in 12 patients and follow-up averaged 10.1 months. A contact lens can usually be fit after corneal lacerations, despite aphakia, with good visual results, thereby avoiding penetrating keratoplasty and intraocular lens implantation. PMID- 2710520 TI - Scleral grafting for necrotizing scleritis. AB - Although systemic immunosuppressive chemotherapy is effective in halting progressive necrotizing scleritis, the onset of its action may be too slow to prevent profound scleral thinning and/or traumatic or spontaneous perforation. Scleral homografts may be used to maintain the integrity of the globe until immunosuppressive drugs can take effect. The authors reviewed their experience with scleral homografts in 12 patients with progressive necrotizing scleritis; eight (all with autoimmune disease) had concomitant chemotherapy and four (two with autoimmune disease) did not. Grafts remained stable in patients receiving both surgical and drug therapy over a mean follow-up of 12 months. One graft melted after discontinuation of chemotherapy, but regrafting and renewed immunosuppression salvaged the eye. Grafts in two of the patients not initially given chemotherapy melted rapidly (within 14 and 45 days, respectively). Both eyes were salvaged by regrafting and/or addition of chemotherapy. Though rarely successful by itself against necrotizing scleritis, scleral grafting is a useful adjunct to chemotherapy. PMID- 2710521 TI - Polychromatic corneal and conjunctival crystals secondary to clofazimine therapy in a leper. AB - A 67-year-old man had a diagnosis of dapsone-resistant lepromatous leprosy. He received clofazimine (Lamprene) at a dosage of 100 mg twice daily. After 3 years of therapy, results of slit-lamp examination disclosed myriad polychromatic crystals diffusely involving the cornea and perilimbal conjunctiva of both eyes. Thick sections (1 micron) from a conjunctival biopsy showed numerous rectangular to-rhomboidal crystals within stromal fibroblasts and macrophages. By electron microscopy, these cells contained elongated, membrane-bound, cleft-like spaces that corresponded to the sites where crystals had been present previously. Additionally, complex lipid inclusions were observed in mesenchymal cells as well as in endothelial cells and pericytes of blood vessels. The ocular side effects of clofazimine therapy are reviewed. Clofazimine-induced keratopathy should be included in the differential diagnosis of patients with polychromatic crystalline deposits in the corneas. To the best of the authors' knowledge, this complication of clofazimine therapy has not been described previously. PMID- 2710522 TI - Visual field change in low-tension glaucoma over a five-year follow-up. AB - There is some evidence that the nature and progression of disease in low-tension glaucoma may be distinct from other open-angle glaucomas. The authors assessed visual field change by retrospective case review of all patients treated for low tension glaucoma by the Glaucoma Service, Wills Eye Hospital, for at least 5 years. Sixty-two glaucomatous eyes of 36 patients were identified. All eyes were treated medically and 40 (65%) underwent at least one surgical procedure. Twenty eight eyes (47%) had initial field loss confined to a single hemi-field and in the remainder both hemi-fields were involved. Thirty of 57 eyes (53%) showed progression at 3 years and 38 (62%) of 57 had progressed by 5 years. A dense scotoma extending from the nasal periphery toward fixation was the most common visual field defect. The rate of field change in this population is significantly greater than in a cohort of primary open-angle glaucoma patients also seen at Wills Eye Hospital, but who had elevated intraocular pressures. Patterns of field loss and rate of progression in this low-tension glaucoma population suggest that the natural history of low-tension glaucoma differs from high-tension open-angle glaucoma. PMID- 2710523 TI - Visual field loss in migraine. AB - Ocular symptoms are a common, though transient, initial component of migraine. Although permanent visual loss has been reported in a limited number of patients, detailed evaluations of the visual field using current techniques have not been conducted. This study examined the prevalence of visual field loss in patients with migraine, using an automated static perimeter. All patients had at least a 2 year history of migraine (as diagnosed by a neurologist) and no ocular problems (by history or as determined by a visual screening examination consisting of acuity, intraocular pressure [IOP], and evaluation of the disc). The authors' results for 60 migraine patients showed that 21 (35%) had some form of visual field abnormality (P less than 0.05). The prevalence of visual field loss was greater with increasing age and duration of disease. These results suggest that visual field loss from migraine may be more common than previously considered. This information also may be useful in elucidating the relationship between migraine and certain vascular conditions of the eye. PMID- 2710524 TI - Long-term morphologic effects of antiglaucoma drugs on the conjunctiva and Tenon's capsule in glaucomatous patients. AB - Conjunctival and Tenon's capsule biopsies from two patient groups were quantitatively analyzed by light microscopy. Group A consisted of 20 patients with a primary glaucoma for whom surgery was a planned primary treatment modality. Group B was comprised of 20 patients with a primary glaucoma who had received at least two types of antiglaucoma topical medication, for a minimum of 1 year (mean, 7.7 years) before surgery. All slides were examined by two masked observers. A significant increase in the number of macrophages, lymphocytes, mast cells, and fibroblasts in the conjunctiva and Tenon's capsule and a significant decrease in the number of epithelial goblet cells were seen in the group that received long-term drop therapy. These results suggest that exhaustive medical therapy, before surgery is offered, increases the number of tissue inflammatory cells. It is possible this may enhance the risk of external bleb scarring and filtration surgery failure. PMID- 2710525 TI - Risk factors for the development of Tenon's capsule cysts after trabeculectomy. AB - Tenon's capsule cysts (TCCs) are a complication of glaucoma filtering surgery. They are frequently associated with substantial elevations in intraocular pressure (IOP) beginning 2 to 8 weeks postoperatively. To determine the incidence and possible risk factors for the development of TCCs, case records of all patients who received trabeculectomy over a 4-year period at the Wills Eye Hospital were reviewed. The incidence of TCCs was 28% in those who underwent trabeculectomy. Characteristics of patients after trabeculectomy in whom TCCs developed were compared with patients after trabeculectomy in whom TCCs did not develop. Both univariate and multivariate techniques were used to assess the association of characteristics associated with the development of TCCs. Factors associated with increased risk (P less than 0.05) were: history of prior TCCs, argon laser trabeculoplasty, male gender, and the use of preoperative sympathomimetics. The use of a compression shell was associated with decreased risk (P less than 0.05). PMID- 2710526 TI - The spectrum of cavitary optic disc anomalies in a family. AB - The current classification of cavitary optic disc anomalies including the morphologically related entities--optic nerve pit, morning glory disc anomaly, coloboma of the optic nerve, and retinochoroidal coloboma involving the optic nerve--is inexact and confusing. Traditionally, these disc abnormalities have been regarded as distinct morphologic anomalies. Thirty-five members of a five generation kindred with autosomal dominantly inherited optic disc anomalies were examined. Observed abnormalities in this pedigree comprised a spectrum of morphologic variants ranging from large anomalous discs to typical pits and colobomas. The findings in this family suggest a variable expression of a single autosomal dominant defect rather than the chance occurrence of three separate, distinct, but morphologically similar entities occurring in a single pedigree. PMID- 2710527 TI - Idiopathic true exfoliation of the lens capsule. AB - The ophthalmic literature of the past half century contains relatively few reports of true exfoliation of the lens capsule, reflecting a reduction in the occupation-related occurrence of "glassblower's cataract." The authors report 11 eyes (7 patients) with a diaphanous membrane arising from the anterior lens capsule, which they have identified by slit-lamp biomicroscopy. None of the seven patients had had extended exposure to an infrared-emitting heat source or ocular trauma; one patient with bilateral true exfoliation of the lens capsule had a history of unilateral herpes simplex keratitis. The average age of these patients at the time of diagnosis was 85.4 years. Identification of these 11 eyes by two ophthalmologists during a 6-year period suggests that idiopathic true exfoliation of the lens capsule has been underdetected, under-reported, or both. PMID- 2710528 TI - Differences in contributory factors among hemicentral, central, and branch retinal vein occlusions. AB - Hemicentral retinal vein occlusion (HRVO) is an anatomic variant of central retinal vein occlusion (CRVO) and thus different from branch retinal vein occlusion (BRVO). Therefore, the risk factors for HRVO should be similar to those of CRVO and different from those of BRVO. To test this, the authors compared 15 demographic and clinical variables of 28 HRVO patients with those of 117 CRVO and 214 BRVO patients. Mean age of onset and sex ratio were not significantly different among the groups. Elevated erythrocyte sedimentation rate (ESR) (P = 0.019) and elevated intraocular pressure (IOP) (P = 0.025) were significantly more prevalent in the HRVO than the BRVO group. In addition, when the authors compared CRVO with BRVO, elevated ESR (P = 0.003), elevated IOP (P = 0.015), and positive purified protein derivative (PPD) (P = 0.003) were significantly more prevalent in the CRVO than the BRVO group, whereas hypertension (P = 0.03) and hyperopia (P = 0.008) were significantly more prevalent in the BRVO group. However, of the variables tested between HRVO and CRVO patients, no significant differences were found. PMID- 2710529 TI - Diminished foveal sensitivity may predict the development of advanced age-related macular degeneration. AB - Visual function testing was performed on one eye with drusen from each of 18 elderly patients in 1984. Eleven patients had advanced age-related macular degeneration (AMD) in the fellow eye, and seven had only bilateral drusen. These patients were all followed prospectively (median, 45 months), at which time one eye had a new vessel membrane, three eyes had pigment epithelial detachments, and one eye had geographic atrophy. Only two of these five eyes had AMD-related visual loss in the fellow eye in 1984. The degree of loss of foveal dark-adapted sensitivity in 1984 predicted which patients developed advanced AMD with 100% sensitivity and 92% specificity. The presence of high-risk drusen characteristics in 1984 predicted the development of advanced AMD with 100% sensitivity but only 55% specificity. For this small group of patients, foveal dark-adapted sensitivity loss was an excellent predictor of the subsequent development of advanced AMD in eyes with drusen. A prospective study of a large group of patients with drusen is being undertaken to validate this finding. PMID- 2710530 TI - Recurrence of posterior uveal melanoma after 60Co episcleral plaque therapy. AB - The authors analyzed the clinical and follow-up data on 277 selected patients with primary choroidal or ciliochoroidal melanoma who were treated with 60Co plaque radiotherapy between 1976 and 1982. Local recurrence of the irradiated melanoma developed in 39 (14%) patients during the follow-up interval. The 5-year tumor recurrence rate (Kaplan-Meier) was estimated to be 12%. Multivariate prognostic factor analysis (Cox proportional hazards modeling) identified the largest linear tumor dimension and proximity of the posterior margin of the tumor to the optic nerve head as predictors of recurrence. The 5-year survival rate of patients whose tumors recurred (58%) was significantly (log-rank test P = 0.0023) worse than that of patients whose tumor remained clinically controlled (82%). PMID- 2710531 TI - Secondary causes of premacular fibrosis. AB - The records of 187 consecutive patients (206 eyes) with a diagnosis of secondary premacular fibrosis were reviewed. The mean patient age was 63.2 years; 96 (51.3%) patients were men. The most common surgical causes in 175 eyes were cataract extraction with or without implant, 73 (41.7%); scleral buckle, 33 (18.9%); both cataract extraction with implant and scleral buckle (in separate surgical sessions), 20 (11.4%); argon laser procedures, 17 (9.7%); and retinal cryopexy, 14 (8.0%). The most common nonsurgical causes in 31 eyes were blunt ocular trauma, 12 (38.7%); uveitis, 9 (29.0%); and retinal vein occlusion, 5 (16.1%). Initial visual acuity was 20/100 or better in 120 of the 206 eyes (58.3%). After a minimum follow-up period of 6 months (mean, 44.2 months), 72 of 101 eyes (71.3%) had stable or improved visual acuity without surgical intervention. Of 32 eyes that underwent vitrectomy with membrane stripping, 25 of 26 eyes (96.2%) followed for a mean period of 24 months (minimum, 6 months) had stable or improved visual acuity. Of 157 eyes that did not undergo vitrectomy, 143 (91.1%) had partial or complete posterior detachment. Fifty-eight of 148 eyes (39.2%) had angiographic cystoid macular edema; however, vitreous traction at the macula was not a significant cause of cystoid macular edema (CME) in these eyes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710532 TI - Turnover of sulphur compounds in the endolymphatic sac: an autoradiographic study in the Mongolian gerbil. AB - Complex macromolecules are suggested to play an important role for the function of the endolymphatic sac (ES). As proposed in previous experimental studies, proteoglycans are supposed to be present in the ES. As they are composed of a proteic core linked to chains of glycosaminoglycans, chemical identification of the glycosaminoglycans is of particular importance, bearing in mind that all but hyaluronic acid contain sulphur. In order to follow the short-term turnover of sulphur in the ES, an autoradiographic study has been carried out in the Mongolian gerbil using 35S as tracer. Radioactive labelling of the gerbilline ES was controlled 15, 20, 30 and 60 min after intraperitoneal injection. While the first signs of the presence of radioactive sulphur were noticed after 20 min in the blood vessels and in the basal aspect of the ES epithelium, after 60 min it was possible to observe the presence of the tracer both within the epithelial cell layer as well as in the lumen of the ES. These findings are consistent with the presence of a fast turnover of sulphur molecules in the gerbilline ES. PMID- 2710533 TI - Late results of surgery in different cholesteatoma types. AB - Our series of 740 cholesteatomas, operated during the period 1969 to 1980, were seen at follow-up several times with a median observation period of 9.2 years (range 3-21 years). There were; 273 attic cholesteatomas with retraction (perforation) of Shrapnell's membrane; 271 sinus cholesteatomas with superioposterior retraction (perforation) of pars tensa, and 196 tensa retraction cholesteatomas extending from a retraction of the whole pars tensa. The late results were analyzed for each type separately, and compared. The recurrence rate was lowest (6.6%) in attic cholesteatoma and highest (13.3%) in tensa retraction cholesteatoma. In all three types no residual cholesteatomas were detected after the 4th postoperative year, whereas recurrent cholesteatomas occurred up to 10 years after surgery. The reoperation rate was lowest (15%) in attic cholesteatoma and almost the same (21%) in sinus and tensa retraction cholesteatoma. The hearing results were best in attic cholesteatoma and poorest in tensa retraction cholesteatoma. It is concluded that cholesteatoma surgery should be individualized and that both the canal wall up and canal wall down methods have their place in cholesteatoma surgery. PMID- 2710534 TI - Bacterial flora in the nasopharynx and nasal cavity of healthy young men. AB - The bacterial flora of the nose and nasopharynx was studied in 86 healthy young men. Common pathogens (Haemophilus influenzae and Streptococcus pneumoniae) were isolated from only 6% of all 172 nasal cavities. The same pathogens were isolated from 27% of 86 nasopharyngeal samples. H. influenzae dominated over S. pneumoniae both in the nose and the nasopharynx. No culture either from the nose or nasopharynx grew Streptococcus pyogenes. Potentially pathogenic bacteria, non group-A hemolytic streptococci and various groups of Neisseria meningitidis were isolated from the nasopharynx in 20% of the subjects. According to the present study healthy adults do not carry group-A hemolytic streptococci in the nose and seldom if ever in the pharynx. Thus, isolation of S. pyogenes by bacterial culture is suggestive of a bacterial infection by this agent at these sites. Isolation of hemolytic streptococci other than group A from the pharynx does not necessarily indicate bacterial infection, and the same holds true for H. influenzae and S. pneumoniae. PMID- 2710535 TI - Repeat mediastinoscopy. AB - The author reports 18 cases with repeated mediastinoscopy. The surgical procedure was performed twice on 16 patients and three times on 2 patients. Mediastinal shadow was the indication in 6 patients and bronchogenic carcinoma in 3 patients. Average time lag between the procedures was 35 months. In 56% of the cases, repeated mediastinoscopy was regarded as positive. Strong peritracheal fibrosis disturbing the procedure was verified in 16 patients. No complications were observed. PMID- 2710536 TI - Assessment of head shaking test in neuro-otological practice. AB - The head shaking test (HST) is an important test in neuro-otological diagnosis. In our study of 277 patients complaining of dizziness we verified this importance. The results thus obtained were compared with the results recorded in 73 normal subjects. Head shaking nystagmus was observed in 73 patients. Of these 73 cases, 42 involved central diseases and 31 cases involved peripheral diseases. Head shaking nystagmus was observed in 7 subjects of the control group. A highly significant correlation was noted between head shaking nystagmus and positional nystagmus, between head shaking nystagmus and the caloric test and between head shaking nystagmus and all the other spontaneous types of nystagmus that were investigated (eyes open in light/gaze straight ahead; eyes open behind Frenzel's glasses; eyes closed; eyes open in darkness). No correlation was found between head shaking nystagmus and cervical nystagmus and positioning nystagmus. The sensitivity of head shaking nystagmus, in comparison with other types of spontaneous nystagmus, was found to be slightly higher in cases with peripheral lesions than in those with central lesions. These data confirm the diagnostic importance of this simple test. It is also important to keep in mind that the HST has no importance for topodiagnostic purposes. PMID- 2710537 TI - Functional changes in the inner ear in renal insufficiency. An experimental study in the rat. AB - In acute uremia the auditory brainstem response thresholds in the rat (n = 10) became primarily affected in the low-frequency area. As time elapsed in uremia, even the high-frequency thresholds became impaired. In most animals the latencies for wave 2 at the threshold level increased during the first 48 h concomitant with the impairment of thresholds. After 72 h of uremia, the latencies were shortened as compared with the control values. PMID- 2710538 TI - Human otoconial crystal growth. An approach from morphological and morphometric data. AB - The otoconium genesis was evaluated by morphometric procedures using transmission and scanning electron-microscopic techniques for human fetuses of 50, 110, 134, 173, 210, 220 and 232 mm crown-rump length. Different otoconial crystalline habits were found. For the elongated otoconia (hexagonal prism) different parameters were measured: (1) the mean cleavage angle value of the terminal rhombohedron was 102 (SD 0.65), which was independent of the fetal age; (2) large and short axes show a linear growing law in function of the fetal age, and (3) the otoconial volume grows following a quadratic law. A hypothesis about the physicochemical growth conditions is postulated. PMID- 2710539 TI - Microcomputer programs for video stimulation of eye movements. AB - Programs have been developed for the Commodore 64/128, Amiga and BBC Acorn (Master) microcomputers to generate stimuli for eye movements on a television screen. The stimuli comprise eye movement calibration and the saccade, smooth pursuit and optokinetic tests. PMID- 2710540 TI - Preparation of human temporal bone for immunohistochemical investigation. AB - Successful treatment of progressive sensorineural hearing loss with corticosteroids and cyclophosphamide has promoted the notion of a new entity 'autoimmune hearing loss'. In this context, we have examined sera of patients suffering from idiopathic sensorineural hearing loss, in order to study the binding of humoral antibodies to structures of the normal human inner ear. Investigations were carried out with indirect fluorescence techniques on temporal bones obtained at autopsy. To minimize the possibility of artifacts, we suggested that indirect immunofluorescence with the patients' sera should yield a reproducible positivity on sections of at least three normal temporal bones. In this study, we describe a method for removal and preparation of human temporal bone which ensures reproducible immunohistochemical results. PMID- 2710541 TI - Gas permeability of round window membrane. AB - The perilymphatic oxygen tension in the scala tympani was measured with a polarographic technique after various gases were insufflated into the middle ear cavity of 7 guinea pigs. Pure oxygen, insufflated into the middle ear cavity, easily permeated the round window membrane and elevated the perilymphatic oxygen tension. Oxygen transport to the inner ear, other than by the inner ear vessels, was confirmed. The inner ear function may partially be maintained by oxygenation through this route. PMID- 2710542 TI - Hydrocortisone applied into the round window niche causes electrophysiological dysfunction of the inner ear. AB - A suspension of 2% hydrocortisone, micronized in sterile water, was instilled through a perforation in the tympanic membrane into the round window (RW) niche of 9 healthy rats once a day for 5 consecutive days. Three animals were used as controls, and were exposed to sterile water only instilled into the RW niche. Auditory brainstem response (ABR) thresholds were determined for eight frequencies: 2, 4, 6, 8, 12, 16, 20 and 31.5 kHz. Hydrocortisone caused impaired ABR thresholds in the frequency range of 12-31.5 kHz after 5 days of instillation. The impaired thresholds remained unchanged for 2 months, indicating irreversible electrophysiological changes in the inner ear. No morphological damage could be detected in the cochlea by means of light microscopy or transmission electron microscopy. However, hydrocortisone delayed the healing of the perforated tympanic membrane. PMID- 2710543 TI - [Morphologic and clinical aspects of chronic gastric erosions]. AB - Chronic erosions of the stomach are mostly papular lesions of the gastric mucosa with large base, 0.5-1 cm in diameter, often with superficial central depression covered with fibrin, less frequently without it. The typical site of lesion is the antrum the chronic erosions are here manifold, solitary forms are infrequent. In the course of 5694 gastroduodenoscopies the authors observed in 198 patients (5.2%) typical endoscopic picture of chronic erosions. In biopsy samples volcano type lesions of the mucous membrane characteristic of the disease were found. According to the results the chronic erosions of the stomach are lesions of aspecific symptomatology, the disturbance of the mucosal barrier cannot be made probable. It is important to know the morphological characteristics of the rather frequent independent entity also for separating it from adenomas. Malignant transformation was not found in the material of the authors. PMID- 2710544 TI - [Surgical colpo-suspension (Burch's method) in the management of female stress incontinence]. AB - Colposuspension operation was carried out with Burch's technique for the treatment of stress incontinence of women. The results and experiences of the authors are described. Detailed urodynamic examination was carried out before the operation. Fifty-five operations of this type were performed during three and a half years: complete continence was reached in 51 cases and 4 cases showed improvement. The authors are of the opinion that this surgical technique offers better results than the vaginally performed interventions. PMID- 2710545 TI - [Lymphocytic choriomeningitis causing unilateral deafness]. AB - Lymphocytic choriomeningitis is generally a benign disease passing off without complication. The authors describe a case where the disease appeared in the form of febrile infection and caused permanent unilateral deafness. In connection with this case the authors review briefly the clinical aspects, diagnostic difficulties of lymphocytic choriomeningitis virus infection and wish to draw the attention to the possibility of a lymphocytic choriomeningitis infection in the background of parainfluenza diseases occurring mainly in cold months. PMID- 2710546 TI - [Computers in nursing]. PMID- 2710547 TI - [New nursing school at the Gmunden Hospital]. PMID- 2710548 TI - [Alzheimer's disease]. PMID- 2710549 TI - [No fear of hospitals]. PMID- 2710550 TI - State funds counties for HIV counseling, testing. PMID- 2710551 TI - Treating the chemically impaired medical family. AB - This is the second of a two-part series on impairment in medical families. Here the authors describe how the family can participate in the recognition, treatment, and recovery of a chemically impaired physician. Last month they examined the stresses put on a family by having a physician for a spouse or parent. PMID- 2710552 TI - Medical education now includes humanities. AB - Since the 1960s, more than 80 percent of our nation's medical schools have added some form of humanities instruction to their course selections. While not all schools require students to take these courses, most at least offer elective classes or lecture series in the humanities. Here is a review of what medical schools in Pennsylvania are offering their students. PMID- 2710553 TI - 'Never give up,' radiation oncologist says. PMID- 2710554 TI - Looking beyond cost containment. AB - Legislators, third parties, physicians, and patients alike have spent countless hours in recent years searching for a way to contain rising medical costs. Here we look at how controlling overutilization of services may lead to cost containment. PMID- 2710555 TI - State survey tests knowledge of AIDS. PMID- 2710556 TI - [Antibiotic sensitivity of Campylobacter jejuni and Campylobacter coli strains with special reference to sensitivity to erythromycin and neomycin]. AB - 166 strains of C. jejuni and 46 strains of C. coli were typed against 14 antibiotics using the agar diffusion test. All strains were resistant against Penicillin G, Oxacillin and Rifampicin. Susceptibility were found against Chloramphenicol, Erythromycin, Neomycin, Oxytetracyclin, Streptomycin and Gentamycin. The minimal inhibition concentration was performed for Erythromycin and Neomycin. All strains tested were inhibited by less than or equal to 2 micrograms/ml Neomycin, one strain was resistant against 4 micrograms/ml Erythromycin. PMID- 2710557 TI - Psychophysical observations on patients with neuropathic pain relieved by a sympathetic block. AB - Patients with sympathetically maintained pain (SMP) were tested with noxious heat pulses, innocuous mechanical stimuli, and transcutaneous electrical nerve stimulation before and during local anesthetic sympathetic blocks that relieved their pain. The perceived intensity of the pain evoked by these stimuli was measured by the patients' responses on a visual analog scale and compared to the responses obtained when the same stimuli were applied to contralateral normal skin. In 5 of 7 patients tested, graded noxious heat stimuli (43-51 degrees C) applied to painful skin resulted in heat-pain intensity ratings that were essentially identical to the responses obtained when the same stimuli were applied to the normal side. Of the remaining two patients, one was clearly hypoalgesic for heat-pain and the other was probably hyperalgesic. The normal and subnormal heat-evoked responses obtained from abnormal skin were unchanged during completely successful sympathetic blocks. Trains of noxious heat pulses (52 degrees C) evoked summation of the second pain sensation in each of the 4 patients tested. This summation effect was normal and unaffected by a sympathetic block. Four of the patients had allodynia evoked by mechanical stimulation. In each of the 3 allodynia cases tested, transcutaneous nerve stimulation at an intensity that was at threshold for detection evoked burning pain and a coexistent sensation of tingle, indicating that both sensations were due to the activation of A beta axons. Patients without touch-evoked pain reported that electrical stimuli at threshold for detection produced only the sensation of tingle. The pains evoked by touch and by threshold-strength nerve stimulation were eliminated during sympathetic block. In patients with allodynia, trains of gentle mechanical stimuli and trains of threshold-strength electrical nerve stimuli produced summation of the intensity of the burning pain sensation when the stimuli were presented at 0.3 Hz. These results add to a growing body of evidence indicating that the touch-evoked pain of some patients is due to abnormal central activity evoked by input from A beta low-threshold mechanoreceptors. The coexistence of A beta-evoked pain with normal heat-evoked pain and normal heat-pain summation suggests that the central abnormality cannot be a simple hypersensitivity of wide-dynamic-range neurons. The effect of sympathetic blockade on A beta-evoked pain and its summation suggests that the crucial sympathetic interaction may take place centrally. The results show that there is considerable heterogeneity of sensory abnormalities among patients with SMP.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2710558 TI - Pain from renal/ureteral calculosis: evaluation of sensory thresholds in the lumbar area. AB - Patients with unilateral renal/ureteral calculosis who had suffered a few painful attacks were examined. In the pain-free period, muscular, subcutaneous and cutaneous sensory thresholds to electrical stimulation were measured in the lumbar region (metamer L1) on both sides: (1) pain thresholds were lower on the affected side with respect to both the contralateral side and control thresholds recorded in normal subjects; (2) the greatest decrease in threshold was in the muscle (even the sensation of sustained contraction was no longer detectable), followed by subcutaneous tissue, and the smallest decrease was in the skin. PMID- 2710559 TI - Lumbar epidurography and epidural analgesia in cancer patients. AB - In an attempt to clarify the correlation between the spread of a local anesthetic and a radiographic contrast medium in the epidural space, a lumbar epidural catheter was inserted in 21 cancer patients. In group I, 10 patients, a single dose of bupivacaine 0.5%, 8 ml, was injected. The epidural block was evaluated by assessing loss of pin-prick sensation. The following day a contrast medium, iohexol 180 mg I/ml, 1.2 ml, was injected and the position of the catheter determined. A second dose of iohexol 180 mg I/ml, 8 ml, was injected and epidurograms were taken. The vertebral spread was measured in cephalad and caudad directions from the catheter tip. Group II, 11 patients, underwent the same procedures as group I with the exception of the volumes injected. On the first day they were given bupivacaine 0.5%, 16 ml, and on the second day iohexol 180 mg I/ml, 1.2 ml by 16 ml. In both groups the position of the patients was supine and the speed of injection standardized. In group I there was no statistically significant correlation between the spread of contrast medium and the extension of the epidural block either in the cephalad or in the caudad direction. In group II there was a statistically significant correlation in both the cephalad and caudad direction. It is concluded that epidurography can provide an estimate of the epidural block, but cannot predict the exact segmental distribution of the block. PMID- 2710560 TI - An empirical taxometric alternative to traditional classification of temporomandibular disorders. AB - A number of investigators have suggested that the generic classification temporomandibular disorders (TMD) may consist of several subsets of patients. Two primary factors are to be significant in discriminating subgroups, namely, presence or absence of TM joint abnormalities and psychological characteristics such as traits, maladaptive behavioral patterns, and gross psychopathology. Few attempts, however, have been made to integrate psychosocial and behavioral parameters in order to identify a taxonomy of TMD patients and, subsequently, to examine the differentiation of subgroups on oral dysfunction/structural abnormalities (OD/SA). The primary purpose of this paper was to develop and cross validate an empirically derived classification system of TMD patients. The first study identified three unique subgroups of TMD patients, labeled 'dysfunctional,' 'interpersonally distressed,' and 'adaptative copers.' A second study cross validated and confirmed the uniqueness and accuracy of the taxonomy. Subsequent analyses were performed that demonstrated that these groups were not distinguishable on the basis of any measures of OD/SA. The taxonomy identified is compared and contrasted with other reported subgroups of TMD patients and the implications of this classification system for treatment of TMD patients are discussed. PMID- 2710561 TI - Pain responses to perineuromal injection of normal saline, gallamine, and lidocaine in humans. AB - Rat neurons have shown an increase of spontaneously active fibers to systemically administered potassium channel blocking agents such as tetraethylammonium chloride (TEA) and gallamine. Neuroma formation and spontaneous activity have been associated with autotomy in rats and pain in humans. To evaluate the chemosensitivity of human neurons to potassium channel blocking agents, 9 subjects with neuroma pain underwent perineuromal injection in a single-blinded fashion of normal saline, gallamine, and lidocaine. Sodium had no effect on control pain levels, while gallamine significantly increased and lidocaine significantly decreased pain from control levels. Three of 4 patients with accompanying phantom limb pain noted an increase in pain after the injection of gallamine. The data suggest that peripheral input plays a modulating but not solitary role in both neuroma and phantom limb pain. Agents which increase potassium channel permeability or decrease sodium influx would be predicted to decreased perceived pain. PMID- 2710562 TI - Pain management as an antidepressant: long-term resolution of pain-associated depression. AB - Of 100 consecutive patients admitted to a pain management program for patients without malignant disease who had chronic pain, 54 were definitely or probably depressed and 46 were not depressed by Research Diagnostic Criteria. As a result of 98% improvement of depression and low frequency (2%) of new development of depression, 98 of the original 100 patients were not depressed at the time of dismissal. This progress was maintained at long-term follow-up (average, 11.6 months): 89 of 100 patients remained non-depressed. PMID- 2710563 TI - Pain of first-trimester abortion: a study of psychosocial and medical predictors. AB - Pain during first-trimester abortion by suction-curettage under local anesthesia alone was measured with the McGill Pain Questionnaire (MPQ), and verbal and visual analogue scales in 109 women. The average intensity of abortion pain ranked among moderately intense pain recorded with the MPQ. However, the pain scores had a wide range and appeared influenced by several demographic, psychosocial and medical variables. A correlation/stratified multiple regression design was used to examine the sources of individual variability in pain reports. The results indicated that over a third of the variance in pain reports could be predicted by a set of variables which included the patient's age, self-reports of pre-operative depression, anxiety, fear, low pain tolerance, social and moral concerns, and gynecological characteristics such as uterus retroversion, menstrual pain and gestational age. Pain scores were significantly higher for women who reported moderate to severe levels of pre-abortion depression and for younger patients (13-17 years); other psychosocial and gynecological features made small additional contributions to the prediction of pain scores. The implications of the results are discussed in relation to pain management strategies and underscore the special needs of each woman facing an abortion. PMID- 2710564 TI - An empirical assessment of pain beliefs. AB - Pain beliefs represent patients' own conceptualizations of what pain is and what pain means for them. Such beliefs may be discordant with current scientific understanding and may serve to adversely affect compliance with modern methods of chronic pain treatment. This study attempts to assess several of the core dimensions around which pain beliefs develop and examines the relationship between pain beliefs and behavioral manifestations of the pain experience. An empirically and factorially derived product of this study, the Pain Beliefs and Perceptions Inventory (PBAPI) assess 3 dimensions of pain beliefs: (1) self blame, (2) perception of pain as mysterious, and (3) beliefs about the duration of pain. These core pain beliefs were found to be predictive of subjective pain intensity, multidisciplinary chronic pain treatment compliance, poor self-esteem, somatization and psychological distress, and associated with attributions about health locus of control. PMID- 2710565 TI - Opioid pseudoaddiction--an iatrogenic syndrome. AB - A case is presented of a 17-year-old with leukemia, pneumonia and chest-wall pain. Inadequate treatment of the patient's pain led to behavioral changes similar to those seen with idiopathic opioid psychologic dependence (addiction). The term pseudoaddiction is introduced to describe the iatrogenic syndrome of abnormal behavior developing as a direct consequence of inadequate pain management. The natural history of pseudoaddiction includes progression through 3 characteristic phases including: (1) inadequate prescription of analgesics to meet the primary pain stimulus, (2) escalation of analgesic demands by the patient associated with behavioral changes to convince others of the pain's severity, and (3) a crisis of mistrust between the patient and the health care team. Treatment strategies include establishing trust between the patient and the health care team and providing appropriate and timely analgesics to control the patient's level of pain. PMID- 2710566 TI - Phenytoin in reflex sympathetic dystrophy. PMID- 2710567 TI - The concept of primary fibromyalgia. PMID- 2710568 TI - Evaluation of closed container flash sterilization system. AB - Flash sterilization is a rapid, effective procedure for providing sterile instruments for surgery; however, aseptic transport of an unwrapped sterile tray is a major problem. This study tested the effectiveness of using a closed container for flash sterilization, and found the closed container to be an effective alternative to the traditional open tray for flash sterilization and transportation of sterile supplies. PMID- 2710569 TI - Predeposit autologous blood for elective orthopaedic surgery. AB - Patients undergoing orthopaedic surgery may require blood transfusion both during and after surgery. The news media has made the transmissibility of blood-borne diseases well-known, undermining patient confidence in blood transfusion. Predeposit autologous blood is an excellent alternative for elective surgical procedure if the patient meets standard criteria. Nurses need to be aware of the different types of blood programs available in their community and can assist with patient education concerning blood donation, iron supplementation and dietary changes. Nurses can be important patient advocates for predeposit autologous blood programs. PMID- 2710570 TI - Physical child abuse. AB - This article discusses the background and main indicators of physical child abuse. The author points out the role of orthopaedic nurses in identifying possibly abused children and bringing their suspicions to those with responsibility for investigation of and services to families in trouble. An outline of the major forms of abuse is included, as well as a brief discussion of the role of a "mandated reporter" and the reluctance often experienced by professionals to get involved with what seems to be a "family problem." PMID- 2710571 TI - The role of ergonomics in the elimination and prevention of work-related musculoskeletal problems. AB - Ergonomics, the study of the relationship between the human and the environment, can be effectively applied to identify those aspects of a job that lead to the injuries and to the design or redesign of a job to prevent injury. This article addresses the importance of ergonomics in the prevention of work-related musculoskeletal injuries and the questions the orthopaedic nurse should ask to assist in the design of safer workplaces. PMID- 2710573 TI - Research design. PMID- 2710572 TI - Development of the orthopaedic nurses certification examination. AB - The certification examination for orthopaedic nurses was developed by the Orthopaedic Nurses Certification Board and the Committee for Test Development with guidance from the National League for Nursing Test Services. The construction of a written examination is a complex task and is part of the continuing responsibility of the Orthopaedic Nurses Certification Board. This paper focuses on the process of actual test construction: the organization, development, evaluation, and quality of test items. PMID- 2710574 TI - Medicinal leech therapy: a case study. AB - Essential to the outcome of the replantation of digits is adequate arterial inflow and venous outflow. A nonoperative solution to the problem of venous insufficiency is leeching. The leech relieves venous congestion while attached, as the hirudin released by the leech continues to decongest the digit for 1-2 more hours. The emphasis of this article is a case study using leeches for venous congestion as an alternative to surgery. PMID- 2710575 TI - Anatomical gift donation. AB - To effectively address the issue of anatomical gift donation, nurses need to be knowledgeable about the laws governing it, the donation process, and dealing with people in crisis. Supporting bereaved families in a sensitive and caring manner becomes a major facet of nursing care. PMID- 2710576 TI - Spinal headache: cause and care. AB - Patients undergoing spinal anesthesia or myelography are at risk for developing a spinal headache that can be incapacitating and anxiety producing. Nursing staff knowledgeable about spinal headaches can contribute to the patient's recovery. This article discusses the etiology, symptoms, treatment, and appropriate nursing care for a patient with a spinal headache. PMID- 2710577 TI - Samples and populations. PMID- 2710578 TI - Telephone documentation. PMID- 2710579 TI - Diagnostic imaging of tarsal and metatarsal stress fractures. Part II. AB - As the preoccupation with physical fitness grows in this country, the problem of "stress fracture" has become more clinically significant. Reliable techniques for imaging the musculoskeletal system have also continued to grow, allowing the clinician to better diagnose and manage this condition. However, the radiographic findings of stress fracture are sometimes difficult to interpret. This review compares plain radiography, scintigraphy, CT, and MRI in the imaging of stress fractures. PMID- 2710580 TI - Scapular osteomyelitis. An unusual complication following subacromial corticosteroid injection. AB - Impingement syndrome is a common disorder of the shoulder. Most patients respond to conservative treatment consisting of rest, ice/heat, anti-inflammatory agents, and physical therapy. Subacromial corticosteroid injection may be used when other forms of conservative treatment fail. A case is reported involving a 29-year-old man who developed scapular osteomyelitis following subacromial corticosteroid injection. Successful treatment consisted of surgical debridement followed by a combination of intravenous and oral antibiotic therapy. Strict adherence to aseptic technique is emphasized for performing subacromial corticosteroid injection. PMID- 2710581 TI - Fractures of the cervical spine in patients with ankylosing spondylitis. AB - Fractures of the cervical spine in patients with ankylosing spondylitis are rare, and few such cases have appeared in the literature. We present three new cases of fracture of an ankylosed cervical spine. PMID- 2710582 TI - Ulnar tunnel syndrome caused by an accessory palmaris muscle. AB - A case of ulnar nerve compression at the wrist caused by an accessory palmaris brevis muscle is presented. At operation, the muscle belly was excised and both Guyon's and the carpal tunnels released. The patient experienced complete relief of symptoms. PMID- 2710583 TI - Pediatric update #7. The orthopaedic manifestations of head injury in children. AB - The incidence of significant head injury has been estimated at 220/100,000 children. Over 90% of these will recover with little residual disability. The purpose of this study is to re-examine the small but significant percentage of head injured children with permanent total body involvement to identify patterns of deformity and temporal sequences and to develop preventive treatment regimens. Sixteen head injured children with residual spastic quadriplegia were examined. All exhibited musculoskeletal abnormalities. Hip adduction contractures were most common leading to hip subluxation in eight children, followed by pes equinus, scoliosis, pelvic obliquity, and knee flexion contracture. The average time to onset of permanent foot deformity was 11 months after head injury, for scoliosis an average of 22 months postinjury, and for hip subluxation an average of 31 months postinjury. Hamstring contractures occurred later, at an average of 37 months, but caused the most interference with good seating. The physical problems of the head injured child have some similarities to those of the child with cerebral palsy, but with distinct differences. An aggressive surgical approach to prevention and treatment of fixed deformity in these children is recommended at an early stage with postoperative orthotic management and stable seating in abduction. PMID- 2710584 TI - Tips of the trade #10. Timesaving instruments for removing the distal interlock of a Brooker-Wills femoral intramedullary rod. AB - Removing the distal fixation wings (interlock) of a Brooker-Wills femoral intramedullary rod can be a time-consuming and difficult procedure. If the granulation tissue in the proximal aspect of the intramedullary rod is hypertrophic and scarred in, the screw-in extractor device used for removal of the distal fixation wings is sometimes difficult to engage. We always have two instruments available in the operating room to aid in the removal of the distal fixation wings: a large- or medium-sized arthroscopic alligator clamp grabber and head-lamp or flashlight. We believe that these significantly help reduce the time necessary to remove the granulation tissue and allow better visualization of the screw-in site on the distal fixation wing device for placement of extractor, thus ensuring a shorter procedure. PMID- 2710585 TI - Practical infection control for human immunodeficiency virus infection in children. PMID- 2710586 TI - Clinical and laboratory findings of spotted fever in Israeli children. AB - In a prospective study of 70 Israeli children with spotted fever the major clinical features were fever (100%), skin rash (98.5%), myalgia (54%) and vomiting (40%). Thrombocytopenia (75%) and hyponatremia (62.5%) were common, but were not associated with increased mortality. Antibodies to Rickettsia conorii were detected by the indirect immunofluorescent antibody assay. In one patient Rickettsia was grown from blood. Contacts with dogs were reported in 17 of 40 patients questioned, and in only 2 was a canine tick bite obvious. Hospitalization was required in 11 (16%) patients. There was 1 fatality. The rickettsia responsible for spotted fever in Israel appears to be an antigenic variant of R. conorii. Early recognition and treatment of this disease permits rapid eradication of the rickettsiae and facilitates complete recovery. PMID- 2710587 TI - How experimental drugs are tested in humans. PMID- 2710588 TI - Frequency and duration of handwashing in a neonatal intensive care unit. PMID- 2710589 TI - Eosinophilic lymphadenitis in Lyme disease. PMID- 2710590 TI - Bronchocentric granulomatosis in a nonasthmatic adolescent. PMID- 2710591 TI - Acute rheumatic pericarditis. PMID- 2710592 TI - Periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis. PMID- 2710593 TI - Potential toxicity of tobramycin given daily in a single large dose. PMID- 2710594 TI - [Short- and long-term effects of radiation on the health status of children]. PMID- 2710595 TI - [Hereditary syndromes accompanied by pronounced deformity of the spine]. PMID- 2710596 TI - [Familial nephrotic syndrome]. PMID- 2710597 TI - [Neurological and neuropsychological characteristics of the functional turn in the critical preschool period]. AB - A total of 124 preschool children aged 5 to 6 years attending kindergartens or placed into children's homes were subjected to neurologic and neuropsychologic examinations. The alterations revealed were inconclusive and of various kinds. On the one hand, they were characterized by an increase by 5 to 6 years of age in the frequency of the minimal signs of pyramidal and cerebellar failure and of the phenomenon of mirror movements and writing. On the other hand, those alterations were marked by improved readings of the higher psychic functions. On electroneuromyography the interage differences were confirmed by a decrease of the motosensory ratio in children aged 5 years as compared to those aged 4 and 6 years. The alterations described were given the name of the "functional turn" which as the most important stage in the critical preschool period includes both progressive evolutionary jump and functional unbalance associated with rearrangement of the functions of the body or a system. PMID- 2710598 TI - [Characteristics of higher nervous activity in young children, cholesterol metabolism and state of the adrenal cortex]. AB - The relationship was established between cholesterol metabolism, adrenocortical function and the typological features of the higher nervous activity in children. Cholesterol metabolism was found to correlate with the type of the higher nervous activity. The children with deficient force and mobility of the nervous processes showed a decrease of glucocorticoid function of the adrenal cortex, proneness to an elevation of the cholesterol level in blood serum and delay of its excretion with feces. This dictates the necessity of developing special diets for the group of children under consideration. PMID- 2710599 TI - [Current approaches to the study of psychosomatic effects on the pathology of the cardiovascular system in children]. AB - A total of 131 children suffering from hereditary predisposition to coronary heart disease, 70 subjects with dysfunction of the and 120 subjects with dysfunction of the vegetative nervous system and low blood pressure were examined. The examination of the children included a study of the cardiovascular system and the vegetative nervous system as well as psychological studies. The cardiovascular system response to the psychoemotional teleplay test was measured in addition. It has been demonstrated that the psychoneurosomatic interrelations are implicated in the occurrence of the main most prevalent cardiovascular diseases in children. This determines approaches to the treatment and prevention of arterial high and low blood pressure and cardiac rhythm disorders. PMID- 2710600 TI - [State of lipid peroxidation system and antioxidant defense in acute respiratory viral infection in children and the principles of pathogenetic therapy]. AB - Summary. Altogether 187 young children presenting with acute respiratory viral infection were examined for lipid peroxidation and antioxidant defense. The principles of the pathogenetically validated antioxidant treatment are discussed. PMID- 2710601 TI - [Main trends in the control of hereditary diseases in childhood]. AB - The results of the activity of the Department for Congenital and Hereditary Diseases of the Moscow Research Institute of Pediatrics and Childhood Surgery of the Ministry of Public Health of the RSFSR point to the efficacy of the work of the Centre for Hereditary Pathology of that Institute in the field of the diagnosis, treatment and prevention of hereditary diseases of children. The prospects of further studies are outlined. PMID- 2710602 TI - [Clinical aspects of metabolic nephropathies, interstitial nephritis and urolithiasis in calciphylaxis]. AB - The problem of abacterial nephropathies associated with impaired calcium metabolism is discussed from the standpoint of membranous pathology. The data are presented on the similarity of the calciphylaxis pathogenesis described for the first time by H. Selye to calcium nephrolithiasis. The disease is viewed as the result of pronounced modification of the phospholipid layer of cell membranes under the influence of peroxidation, phospholipase activity and other processes induced by calcium-regulating hormones (parathyroid hormone, D3 and calcitonin). It is assumed that the clinical manifestations of renal pathology during calciphylaxis depend on the hereditary and environmental factors that determine the gravity of membranous pathology of renal cells. Recommendations as to the treatment and prevention of renal pathology during calciphylaxis based on the results of the authors' own experience are given. PMID- 2710603 TI - [Features of thrombophilia in nephrotic syndrome in children]. AB - A comprehensive study was made of the hemostatic system in 25 children with the nephrotic syndrome and combined forms of glomerulonephritis. Hypercoagulation and a number of factors preventing thrombosis formation were revealed, namely the presence of so-called thrombin-resistant blocked fibrinogen, a rise of the total antithrombin potential at the expense of proteins differing from antithrombin III, sufficient reserves of plasminogen, and a moderate increase of fibrin degradation products. PMID- 2710604 TI - [Dysplastic bases of the development of kidney diseases in childhood]. AB - Altogether 412 children aged 1 to 15 years with chronic nephropathies of various etiology were examined. Methods of clinical morphology were applied. It is marked that in 42 percent of cases the development of glomerular and interstitial nephropathies was caused by foregoing disorders in the formation of the renal structure, chiefly at the tissue and cell levels. It is assumed that the majority of those disorders are multifactorial in nature. Alterations in cell membranes and in supramembraneous biopolymeric layers were also seen, being associated with the definite clinical symptomatology. It is stressed that of paramount importance is the design of the methods of stimulating therapy for correction of renal developmental abnormalities with a decrease of the risk of immunopathologic responses, chronic inflammation and nephrosclerosis. PMID- 2710605 TI - [Scientific-technological progress in pediatrics]. PMID- 2710606 TI - [X-ray evaluation of renal function in children with hydronephrosis as a criterion in the selection of therapeutic tactics]. AB - The anatomic parameters of the kidneys and the rate of glomerular filtration were measured in 77 children with unilateral hydronephrosis and in 27 children with nonobstructive diseases of the urinary tract according to the clearance of an opaque medium during excretory urography. Alterations in the anatomic parameters of the kidneys in obstructive affection did not reflect the gravity of functional disorders. It has been established that there is a possibility of carrying out a separate assessment of filtration function of the hydronephrotic and contralateral kidneys. A new diagnostic criterion is offered, namely an index of relative clearance, which enables one to measure the degree of compensatory phenomena in the preserved glomeruli and the extent of sclerotic process. It has been demonstrated that accurate measurement of the functional parameters of the affected kidney should underlie the treatment choice in children with unilateral hydronephrosis. PMID- 2710607 TI - [Clinico-endoscopic characteristics and laboratory diagnosis of chronic Campylobacter gastritis in childhood]. AB - Altogether 31 children with chronic gastritis were examined. Three diagnostic tests were employed for detecting Campylobacter pylori. The clinical signs of the disease and the endoscopic features of the gastric mucosa are described. PMID- 2710608 TI - [State of the autonomic nervous system in children with disorders of the motor evacuatory function of the upper part of the gastrointestinal tract]. AB - The suprasegmental and segmental parts of the vegetative nervous system were examined in children with duodenogastric and gastroesophageal refluxes. The relationship between dysfunction of the vegetative nervous system and the occurrence of motor disorders in the upper part of the gastrointestinal tract is suggested. PMID- 2710609 TI - [Clinico-laboratory parallels in children with aggravated heredity of cholelithiasis]. AB - A comprehensive examination of children with aggravated heredity regarding cholelithiasis revealed in the majority of them the first stage of cholelithiasis, namely abnormalities in physicochemical properties of the bile. It is demonstrated that formation of the pathology under consideration is promoted by combination of such factors as hereditary aggravation regarding cholelithiasis, complications of the perinatal period, vegetative disturbance, biliary dyskinesia, and derangement of the intestinal flora. PMID- 2710610 TI - [Molecular-cytogenetic diagnosis of hereditary diseases associated with diverse anomalies of X chromosome]. PMID- 2710611 TI - [Cytomorphological diagnosis of secondary omentitis in destructive appendicitis in children]. PMID- 2710612 TI - [Antiallergic action of dimephosphon and its use in the treatment of atopic bronchial asthma and pollinosis in children]. PMID- 2710613 TI - [A computerized system in the health care of child population]. PMID- 2710614 TI - [Current problems of sanatorium and health resort treatment of children]. PMID- 2710615 TI - [Evaluation of pediatricians' knowledge in the field of medical genetics]. PMID- 2710616 TI - On the role of competing word units in visual word recognition: the neighborhood frequency effect. AB - Current models of word recognition generally assume that word units orthographically similar to a stimulus word are involved in the visual recognition of this word. We refer to this set of orthographically similar words as an orthographic neighborhood. Two experiments are presented that investigate the ways in which the composition of this neighborhood can affect word recognition. The data indicate that the presence in the neighborhood of at least one unit of higher frequency than the stimulus word itself results in interference in stimulus word processing. Lexical decision latencies (Experiment 1) and gaze durations (Experiment 2) to words with one neighbor of higher frequency were significantly longer than to words without a more frequent neighbor. This neighborhood frequency effect is discussed in terms of the different types of candidate selection process postulated by contemporary models of visual word recognition. PMID- 2710617 TI - Covert visual attention and extrafoveal information use during object identification. AB - Three experiments are reported that examined the relationship between covert visual attention and a viewer's ability to use extrafoveal visual information during object identification. Subjects looked at arrays of four objects while their eye movements were recorded. Their task was to identify the objects in the array for an immediate probe memory test. During viewing, the number and location of objects visible during given fixations were manipulated. In Experiments 1 and 2, we found that multiple extrafoveal previews of an object did not afford any more benefit than a single extrafoveal preview, as assessed by means of time of fixation on the objects. In Experiment 3, we found evidence for a model in which extrafoveal information acquired during a fixation derives primarily from the location toward which the eyes will move next. The results are discussed in terms of their implications for the relationship between covert visual attention and extrafoveal information use, and a sequential attention model is proposed. PMID- 2710618 TI - The effects of physical work, mental work, and quantity on children's time perception. AB - An experiment was conducted to examine the effects of work and quantity cues on children's time perception. Ninety-seven children in kindergarten and Grades 2, 4, and 6 lifted and transferred pipes under eight different conditions, after which they reproduced the perceived time taken to move the pipes. The conditions varied by quantity (two/four pipes), by mental work (no-matching/matching), and by physical work (light/heavy pipes). Significant main effects were found for quantity, physical work, and mental work, and for the quantity x age and mental work x physical work interactions. These results can help to disentangle possible confounds among these variables in the classic Piagetian experiments about their effects on time judgment and perception. PMID- 2710619 TI - Spatial S-R compatibility with orthogonal stimulus-response relationship. AB - Spatial stimulus-response (S-R) compatibility with unimanual two-finger choice reactions was investigated under conditions in which the spatial orientation of response keys was either parallel to or perpendicular to the orientation of the stimuli. Subjects responded to green or red lights in the left or right visual field (irrelevant stimulus location). The response keys were oriented horizontally on the left or right side of the body midline parallel to the stimuli, and were pressed with the palms facing down (Condition A), or were oriented orthogonally to the stimuli in the midsaggital plane, either horizontally and pressed with palms facing down (B) or facing up (C), or vertically and pressed with palms facing the body (D). The results for Condition A demonstrate the usual spatial S-R compatibility effect between field of stimulation and spatial position of responding finger. For Conditions B and D, a strong reaction time advantage still obtained for those stimulus-finger pairings that are compatible under Condition A. Condition C revealed an RT advantage for the opposite pairings. This shift of the compatibility effect from Condition B to Condition C indicates that the left/right distinction of fingers does not follow a simple, fixed spatio-anatomical mapping rule. The results are discussed within the framework of a hierarchical model of spatial S-R compatibility, with spatial coding and spatio-anatomical mapping as factors. PMID- 2710621 TI - Dynamic form perception in the bending hourglass: effects of contrast reversal and visual persistence. AB - As a white hourglass moves across a black background, the middle appears to lag behind its true position, resulting in the apparent bending of the axis of the hourglass. No such distortion occurs with a black hourglass moving across a white background. The results of two experiments support a visual persistence hypothesis, as opposed to a latency hypothesis. PMID- 2710620 TI - Bias effects on magnitude and ratio estimation power function exponents. AB - A bias model of relative judgment was used to derive a ratio estimation (RE) power function, and its effectiveness in providing estimates of exponents free of the effects of standards was evaluated. The RE bias model was compared with the simple RE power function that ignores bias. Results showed that when bias was not taken into account, estimates of exponents exhibited the usual effects of standards observed in previous research. However, the introduction of bias parameters into the RE power function virtually eliminated these effects. Exponents calculated from "equal-range segments" (e.g., low stimulus range vs. high stimulus range) judged by magnitude estimation (ME) were examined: the effects of equal-range segments on exponents were much stronger for ME than standards were for RE, using the bias model. PMID- 2710622 TI - Discovering phonetic coherence in acoustic patterns. AB - Despite spectral and temporal discontinuities in the speech signal, listeners normally report coherent phonetic patterns corresponding to the phonemes of a language that they know. What is the basis for the internal coherence of phonetic segments? According to one account, listeners achieve coherence by extracting and integrating discrete cues; according to another, coherence arises automatically from general principles of auditory form perception; according to a third, listeners perceive speech patterns as coherent because they are the acoustic consequences of coordinated articulatory gestures in a familiar language. We tested these accounts in three experiments by training listeners to hear a continuum of three-tone, modulated sine wave patterns, modeled after a minimal pair contrast between three-formant synthetic speech syllables, either as distorted speech signals carrying a phonetic contrast (speech listeners) or as distorted musical chords carrying a nonspeech auditory contrast (music listeners). The music listeners could neither integrate the sine wave patterns nor perceive their auditory coherence to arrive at consistent, categorical percepts, whereas the speech listeners judged the patterns as speech almost as reliably as the synthetic syllables on which they were modeled. The outcome is consistent with the hypothesis that listeners perceive the phonetic coherence of a speech signal by recognizing acoustic patterns that reflect the coordinated articulatory gestures from which they arose. PMID- 2710623 TI - Duration, time constant, and decay of the linear motion aftereffect as a function of inspection duration. AB - Subjects rated the strength of the motion aftereffect (MAE) produced by the upward motion of a horizontal grating in two experiments. Inspection periods ranged from 30 to 900 sec in Experiment 1 and from 20 to 120 sec in Experiment 2. A minimum of 22 h elapsed between trials. The decay time constant increased as the square root of the inspection duration for values between 1 min and 15 min of inspection. The ratings suggested that the MAEs consisted of three phases: an initial maximum-strength phase, a decay phase, and a tail. The duration of all three phases increased and the decay rate decreased with increasing inspection duration over the entire range. The results indicate that duration, time constant, and decay rate are not fixed properties of the motion-processing channels in the visual system. PMID- 2710624 TI - Temporal integration of acoustic and cutaneous stimuli shown in the blink reflex. AB - Temporal integration of pairs of brief blink-eliciting acoustic and cutaneous stimuli was investigated to determine if there was integration of stimuli from different modalities. Reflexes elicited by a tone burst or by a brief electrical shock to the supraorbital nerve followed by a second tone burst or shock at short stimulus onset asynchronies (SOAs) were larger and faster than control reflexes elicited by a single stimulus identical to the lead stimulus of the stimulus pairs. Reflex amplitude was augmented at longer SOAs where there was no effect on latency. Temporal integration was evident for all stimulus pairs, showing that it is due, at least in part, to processes that occur outside specific sensory pathways. Heterogeneous stimulus pairs produced greater reflex enhancement than did homogeneous stimulus pairs. This finding was examined further in Experiment 2, which showed that reflex enhancement with pairs of acoustic pulses was unaffected by the frequency of the second stimulus, suggesting that sensory masking was not acting to suppress reflex expression with acoustic pulse pairs. Integration of reflexogenic acoustic stimuli shown in the blink reflex is restricted to shorter intervals than is integration of acoustic stimuli shown by psychophysical procedures, suggesting that the two methods reflect different aspects of stimulus processing. Integration of reflexogenic stimuli may result from summation of activity associated more directly with reflex expression than with perceptual awareness. PMID- 2710625 TI - Display organization and the detection of horizontal line segments. AB - Observers searched for a horizontal line segment through displays containing varying numbers of elements differing from the target and from each other in terms of orientation. These elements were always positioned on imaginary concentric circles centered in the middle of the display. They were allocated to these positions either randomly or in such a way that their orientation was equal to that of the tangent to the circle at that position. The search for the target line appeared to proceed spatially in parallel with the latter class of displays, and serially with the former. These findings are explained and discussed within the context of the attentive-preattentive dichotomy that characterizes spatial vision. PMID- 2710626 TI - The distinction among dependence, specificity, and contingency in the orientation and length domains. PMID- 2710627 TI - Distributional versus error-filled procedures for transformation. PMID- 2710628 TI - Further tests of an exemplar-similarity approach to relating identification and categorization. AB - Further tests were provided of an exemplar-similarity model for relating the identification and categorization of separable-dimension stimuli (Nosofsky, 1986). On the basis of confusion errors in an identification paradigm, a multidimensional scaling (MDS) solution was derived for a set of 16 separable dimension stimuli. This MDS solution was then used in conjunction with the exemplar-similarity model to accurately predict performance in four separate categorization paradigms with the same stimuli. A key to achieving the accurate quantitative fits was the assumption that a selective attention process systematically modifies similarities among exemplars across different category structures. The tests reported go well beyond earlier ones (Nosofsky, 1986) in demonstrating the generalizability and utility of the theoretical approach. Implications of the results for alternative quantitative models of classification performance, including Ashby and Perrin's (1988) general recognition theory, were also considered. PMID- 2710629 TI - The perception of temporal deviations in isochronic patterns. AB - In a study of perceptual synchronization with an isochronic sequence, subjects were given the following task: They heard an isochronic sequence of tones in which the last interval was either correct or too long. Their task was to detect irregularity. The independent variables were the number of tones heard and the time interval between them. The dependent variable was the difference limen (DL) for the detectability of the irregularity. Two experiments were performed in this study, differing in the way in which the trials were blocked: In Experiment 1, stimuli with the same period were presented in blocks, whereas in Experiment 2, the period of the stimulus was randomized. The results show that in Experiment 1 the number of tones in the stimulus did not affect the detectability of the anisochrony. In Experiment 2, the number of the DL was a decreasing function of the number of tones heard. Moreover, the decrease of the DL was larger than one would expect from a simple model of information integration, which assumes that subjects improve their performance by averaging their percepts of the first intervals in the sequence. The difference between this task and experiments on the discrimination of temporal intervals is discussed. PMID- 2710630 TI - Panum's fusional area estimated with a criterion-free technique. AB - It has been reported that criterion-free estimates of the upper disparity limits for fusion of line targets are small enough to be accounted for by monocular vernier sensitivity. However, targets such as lines, which contain high spatial frequencies, may ensure small fusion limits, since fusion limits obtained with criterion-dependent methods for narrow-band targets, such as sinusoids or difference-of-Gaussian luminance profiles, are proportional to target spatial periods. Experiment 1 therefore explored whether criterion-free methods give fusion limits for narrow-band targets that can be accounted for by vernier sensitivity. Vertical fusion limits were estimated by a method that forced observers to discriminate a disparate sinusoidal grating from an immediately adjacent zero-disparity grating. Fusion limits were too large to be explained by monocular vernier thresholds obtained for the same targets. In addition, fusion limits were not affected by large changes in target contrast, whereas vernier thresholds increased as contrast was decreased. The results of Experiment 1 also argued against interocular suppression as the cause of single vision, since vernier offsets that were visible when viewed monocularly were invisible under binocular viewing conditions. In Experiment 2, manual adjustment of disparities yielded fusion limits little different from those obtained with the forced-choice method of Experiment 1, demonstrating that it is possible to design adjustment methods for assessing fusion limits that are as sensitive as forced-choice methods. In Experiment 3, large reductions in target contrast, which have the effect of decreasing disparity sensitivity, did not alter fusion limits, disconfirming the idea that fusion limits estimated with discriminative procedures represent disparity-detection thresholds. In Experiment 4, disparities were adjusted until a just noticeable difference in grating contrast appeared. These disparities were larger than fusion limits, indicating that fusion limits did not represent a change in apparent contrast arising from disparity limitations of binocular summation. Together, the four experiments support the existence of binocular fusion as a unique category of sensory performance, disconfirm several nonfusional explanations of single vision, and support the use of criterion-free as well as adjustment methods in measuring fusion limits. PMID- 2710631 TI - Effects of peripheral circular contours on dynamic spatial orientation. AB - The rod-and-frame effect (RFE) was investigated with the use of a frame that oscillated about an axis at its center at five different frequencies, ranging from .013 to .213 Hz. The resultant RFE shifted continuously with the roll motion of the frame, and it was significantly larger at the lowest frequency (.013 Hz) than under comparable static conditions. The dynamic RFE was lowest at the higher oscillation frequencies. Oscillatory roll vection--apparent self-motion--was reported by 3 of the 9 subjects when the frame was oscillating at its highest frequency (.213 Hz). The subjects yielded large increases in the RFE during the sessions with reports of vection. Surrounding the kinetic frame with a circular contour eliminated all reports of vection and significantly interacted with frequency to reduce the RFE--but only at low frequencies. The reduction amounted to 21.2% averaged over all 9 subjects at the three lowest frequencies. A surrounding contour, therefore, suppressed low-frequency kinetic visual orientation information that might otherwise have produced larger changes in apparent self-orientation and perceived vertical. Vection-sensitive subjects differed from nonvection subjects by exhibiting (1) a high-frequency fall-off in real-motion gain, (2) a high-frequency enhancement in illusory-motion gain, and (3) only a small and nonsignificant increase in illusory-movement phase lag with increases in frequency. PMID- 2710632 TI - An analysis of auditory alphabet confusions. AB - The present study, using the nonhierarchical overlapping clustering algorithm MAPCLUS to fit the Shepard-Arabie (1979) ADCLUS model, attempted to derive a set of features that would accurately describe the auditory alphabet confusions present in the data matrices of Conrad (1964) and Hull (1973). Separate nine cluster solutions accounted for 80% and 89% of the variance in the matrices, respectively. The clusters revealed that the most frequently confused letter names contained common vowels and phonetically similar consonants. Further analyses using INDCLUS, an individual differences extension of the MAPCLUS algorithm and ADCLUS model, indicated that while the patterns of errors in the two matrices were remarkably similar, some differences were also apparent. These differences reflected the differing amounts of background noise present in the two studies. PMID- 2710633 TI - Effects of preceding context on discrimination of voice onset times. AB - When discriminating pairs of speech stimuli from an acoustic voice onset time (VOT) continuum (for example, one ranging from /ba/ to /pa/), English-speaking subjects show a characteristic performance peak in the region of the phonemic category boundary. We demonstrate that this "category boundary effect" is reduced or eliminated when the stimuli are preceded by /s/. This suppression does not seem to be due to the absence of a phonological voicing contrast for stop consonants following /s/, since it is also obtained when the /s/ terminates a preceding word and (to a lesser extent) when broadband noise is substituted for the fricative noise. The suppression is stronger, however, when the noise has the acoustic properties of a syllable-initial /s/, all else being equal. We hypothesize that these properties make the noise cohere with the following speech signal, which makes it difficult for listeners to focus on the VOT differences to be discriminated. PMID- 2710634 TI - Vowel quality changes produced by surrounding tone sequences. AB - In three experiments, we examined whether energy at the same frequency as one of a vowel's harmonics in the F1 region can be captured by a preceding or following sequence of tones. The position of the /I/-/E/ phoneme boundary along an F1 continuum was used to assess the extent of capture. The first two experiments showed that a sequence of tones at 500 Hz (56-msec duration at 10/sec) can perceptually remove added energy at 500 Hz from a steady vowel (F0 = 125 Hz) that forms part of the sequence. The effect is detectable with one preceding tone, asymptotes with four, and is greater when two tones follow the vowel than when none do. Rising and falling sequences of tones (at 62.5-Hz intervals or at whole tone intervals) differ in their effect. Falling sequences behave much like constant tones at 500 Hz but with less effect, whereas rising sequences show no evidence of removing the added tone. The second experiment replicated the first and also showed that when the vowel is embedded in a rising or a falling sequence of tones that continue after it, the following tones have no effect. The third experiment suggested that the different effects found with rising versus falling sequences are qualitatively predictable on the basis of the additive effects of their constituent tones rather than by virtue of their contour. The experiments indicated that sequences of repeating tones are much more effective at capturing a harmonic from a vowel than are sequences that follow a simple pattern. This result may reflect the operation of a principle of least commitment in auditory grouping. PMID- 2710635 TI - Interference in localizing tactile stimuli. AB - A series of experiments investigated the ability of subjects to localize a tactile stimulus in the presence of an additional, extraneous tactile stimulus. The subject's task was to localize a tactile stimulus (target) presented at one of several locations on his or her left index fingerpad. The target stimulus, generated on a 6 x 24 array of stimulators, was presented either by itself or in the presence of an extraneous stimulus (masker) that either preceded or followed the target. The localizability of the target was affected by the temporal separation between the target and masker in much the same way as previous studies have shown identification of tactile patterns to be affected. Unlike previous identification results, presenting the masking stimulus to the same location as the target interfered with localizability, although not as much as did presenting the masker to a different location. The results are discussed in terms of their implications for identification and discrimination of tactile patterns. PMID- 2710636 TI - Processing redundant signals: coactivation, divided attention, or what? AB - The evidence for and against a redundancy gain in reaction time (RT) when the target is repeated in the visual display is reviewed. We consider the relevance of redundancy gains under these circumstances to the question of whether attention can be simultaneously directed to separate locations in the visual field. In the present experiments, two capital letters were the target stimuli in a two-alternative forced-choice RT paradigm. In addition to the usual conditions of single-target trials, trials on which the target is repeated in the display, and trials on which the target occurs with a noise letter, we introduced the innovation of a condition in which both targets occur in the display. In our two experiments, RT was fastest with single-target displays and slowest with displays containing a target and a noise letter. There was no significant difference in RT to displays in which the target was repeated and displays in which both targets were presented. Both conditions showed a redundancy gain when compared with displays containing a target and a noise letter. The lack of response competition in the both-targets condition and the overall pattern of the results were well explained by a unitary attentional focus that serially processed the letters in the display. Analyses of minima and maxima RTs were consistent with this interpretation. PMID- 2710637 TI - Auditory apparent motion under binaural and monaural listening conditions. AB - This investigation examined the ability of listeners to perceive apparent motion under binaural and monaural listening conditions. Fifty-millisecond broadband noise sources were presented through two speakers separated in space by either 10 degrees, 40 degrees, or 160 degrees, centered about the subject's midline. On each trial, the sources were temporally separated by 1 of 12 interstimulus onset intervals (ISOIs). Six listeners were asked to place their experience of these sounds into one of five categories (single sound, simultaneous sounds, continuous motion, broken motion, or successive sounds), and to indicate either the proper temporal sequence of presentation or the direction of motion, depending on whether or not motion was perceived. Each listener was tested at all spatial separations under binaural and monaural listening conditions. Motion was perceived in the binaural listening condition at all spatial separations tested for ISOIs between 20 and 130 msec. In the monaural listening condition, motion was reliably heard by all subjects at 10 degrees and 40 degrees for the same range of ISOIs. At 160 degrees, only 3 of the 6 subjects consistently reported motion. However, when motion was perceived in the monaural condition, the direction of motion could not be determined. PMID- 2710638 TI - Pharmaceutisch Weekblad Scientific edition and the European Society of Clinical Pharmacy. PMID- 2710639 TI - Evaluation of a novel cellulose powder as a filler-binder for direct compression of tablets. AB - A novel form of cellulose powder was evaluated as a filler-binder in tablets. The particle, powder, flow and binding properties of this experimental cellulose material were compared with those of two commercial microcrystalline celluloses, Avicel PH 101 and Emcocel. The effect of various storage conditions on the physical stability of tablets compressed from celluloses was also evaluated. The particle size and shape of experimental cellulose powder differed markedly from those of microcrystalline celluloses. Experimental cellulose contained mainly large and roughly spherical agglomerates of particles, among which were few smaller regularly shaped particles. Because of spherical particle shape, the experimental cellulose powder flowed better than microcrystalline celluloses, which consisted of much more irregularly shaped particles. Experimental cellulose formed stronger tablets than microcrystalline celluloses. It also acted more effectively than microcrystalline celluloses as a binding material in tablets containing poorly compressible ascorbic acid and acetaminophenone. This may be due to the extensive surface area of the particles of experimental cellulose powder. The specific surface area of this material was over 50 times as great as that of microcrystalline celluloses. This indicates an extremely porous structure of cellulose agglomerates. Tablets containing experimental cellulose powder were able to resist a permanent loss in tablet strength at different storage conditions better than tablets containing microcrystalline celluloses. According to the results of this study an experimental agglomerated form of cellulose powder is a very advantageous material as a filler-binder for direct compression of tablets. PMID- 2710640 TI - Formulation and stability of a beclomethasone dipropionate enema. AB - A beclomethasone dipropionate (BDP) enema and a BDP/mesalazine combination enema (containing 2 mg BDP and 1 g mesalazine and 2 mg BDP, respectively per 40 ml) were formulated. BDP and mesalazine were suspended in a carbomer-water gel. No degradation of BDP was measured during the storage period of the BDP enema (4 weeks at 20 degrees C) and of the BDP/mesalazine enema (44 days at 4 degrees C, 20 degrees C and 37 degrees C, respectively). Progressive darkening of colour occurred for the BDP/mesalazine enema during storage at 20 degrees C and at 37 degrees C, probably induced by mesalazine degradation products. Only very slight colouring was observed at 4 degrees C. Hardly any precipitation of BDP and mesalazine was seen during the storage period and the enemas could easily be resuspended. PMID- 2710641 TI - A comparison of carbamazepine divitabs with carbamazepine normal formulation in psychiatric and oligophrenic patients. Preliminary pharmacokinetic results. AB - In an open, randomized, two-centre, cross-over study 20 patients formerly adjusted to a stable oral twice daily 200-600 mg carbamazepine dose, used ordinary tablets and divitabs (a new sustained-release formulation) for periods of three weeks, whereafter the serum level courses of carbamazepine and its metabolite carbamazepine-10,11-epoxide were measured. The mean peak/mean trough carbamazepine-serum concentration ratio was slightly lower after the intake of divitabs in comparison to normal formulation: 1.14 +/- 0.447 versus 1.23 +/- 0.545 (mean +/- SD). The mean trough levels of carbamazepine and its metabolite were 9% and 16% lower in the case of divitabs. In patients with peak/trough carbamazepine-serum level ratios of at least 1.30 after the intake of normal formulation, divitabs had a significant advantage. PMID- 2710642 TI - [Results of the definitive treatment of autonomy in iodine deficiency goiter]. AB - In order to evaluate the efficacy of, and the risk associated with, the definite treatment of euthyroid goiter with autonomy, the data of 88 patients treated between 1982 and 1986 (50 by subtotal thyroidectomy; 38 by 131I-treatment, mean radiation dose 200 Gy without protection by thyroxine) were analyzed in a retrospective study. The following criteria were used before and after treatment: the results of scintigraphy under suppression qualitatively (in focal autonomy) and quantitatively (global thyroid uptake) (TcUs), the means of FT4I, FT3I and delta TSH after TRH, the improvement of mechanical signs and symptoms and the decrease of thyroid volume. Measured by TcUs and delta TSH, autonomy could be removed completely in 85-90% of all patients. Surgery was slightly more successful (100%) compared to treatment by 131I (75-80%). This was also true for removal of mechanical symptoms and reduction of the goiter. The incidence of manifest hypothyroidism was greater after surgery (16%) than after 131I treatment (3%). At a higher grade of autonomy (TcUs greater than 3.2%) surgery was more effective (95-100%) than treatment with 131I (60-70%) but at a higher risk of hypothyroidism (24 vs 0%). It is imperative to improve the methods of estimating the amount of 131I to be administered in euthyroid goiter with autonomy. Selection of patients with autonomy in euthyroid goiter for definite treatment is difficult, since until now their risk to become hyperthyroid cannot be predicted properly. PMID- 2710643 TI - Scintigraphy of the parathyroid glands with 201TI: experience with 250 operated patients. AB - Parathyroid scintigraphy confirmed its validity in the preoperative localization of enlarged parathyroids, showing a sensitivity of 82% in a series of 250 patients suffering from primary hyperparathyroidism and successfully operated on. The glands better visualized were in an ectopic site or they were completely or partially outside the thyroid so that they were easily visible without employing digital image subtraction. This is nevertheless necessary to visualize parathyroids in a retrothyroid site but some problems arise, related not only to movements of the patient but also to the instrumentation to perform a correct image subtraction. PMID- 2710644 TI - [Indications for MIBG scintigraphy in the diagnosis of neuroblastoma]. AB - The significance and indications of MIBG scintigraphy are critically assessed. The results are compared with the results of whole-body bone scintigraphy, computed tomography (CT) and magnetic resonance tomography (MRT), and are related to values of catecholamine metabolites in 24-h urines. In our patients (10 histologically proven cases) MIBG scintigraphy turned out to be most useful in tumor follow-up. In contrast, the significance was much lower in primary tumor diagnosis and tumor staging as the exact primary diagnosis was established by other means such as CT, MRT, MDP whole-body scan, urine chemistry and bone marrow biopsy in all cases. MIBG scintigraphy in diagnostic imaging of neuroblastoma is an additive diagnostic tool and is called for in (1) tumour follow-up (progress, recurrencies, metastases); (2) primary diagnosis if the primary tumour has not been localized by means of CT or MRT; and (3) tumour staging to differentiate stage IV disease from lower stages as long as stage IV disease has not been established by bone-marrow biopsy or MDP whole-body scan. PMID- 2710645 TI - Inhibition of benzo[a]pyrene-induced forestomach neoplasia in mice by citrus limonoids. AB - The limonoids, limonin and nomilin, are bitter principles found in common edible citrus fruits. Nomilin, when given three times (at 5 and 10 mg per animal) every two days, induced increased glutathione S-transferase activity 2.48 and 3.44 times over the control, respectively, in the liver of female ICR/Ha mice. The increases of GST activity in the small intestinal mucosa were 3.00 and 4.17, respectively, over the control. Limonin, when given at the same dose levels, was not active in the liver. However, marginal activity was obtained in the small intestinal mucosa. Nomilin, which is the more active enzyme inducer, was found to inhibit benzo[a]pyrene (BP)-induced neoplasia in the forestomach of ICR/Ha mice. The number of mice with tumors was reduced from 100 to 72%, and the number of tumors per mouse was significantly decreased as a result of nomilin treatment. Limonin, which is a weak enzyme inducer, was less potent as an inhibitor of BP induced neoplasia. These findings suggest limonoids as a class of regularly consumed natural products may be effective chemopreventive agents. PMID- 2710646 TI - Changes in food intake and stomach contents of tumor-bearing rats after treatment with dopamine antagonists. AB - The appetite-stimulating (orexigenic) potential of the peripheral dopamine (DA) receptor antagonist domperidone was compared with that of the central DA antagonist pimozide in anorexic, tumor-bearing rats. DA antagonists were administered via the intraperitoneal route on Days 7-15 after the subcutaneous implantation of the Walker 256 carcinosarcoma. The doses of domperidone injected were 0.05 and 0.1 mg/kg once daily and 0.1 mg/kg twice daily. The dose of pimozide given was 0.1 mg/kg daily. While all doses of DA antagonists caused an initial drop in body weight and food intake, the body weight of pimozide-injected animals was not reduced significantly (in the early stages of drug treatment) as it was with the various doses of domperidone. There was significantly more food in the stomachs of domperidone- and pimozide-treated animals compared with those of the vehicle-treated, tumor-bearing animals at the time of sacrifice. These results indicate that short- and long-term satiety factors, in addition to gastric motility, should be considered when assessing the orexigenic potential of various drugs. PMID- 2710647 TI - Effect of dietary lipids on hepatic and plasma beta-carotene and vitamin A levels in rats fed beta-carotene. AB - Diets low in carotenoids have been associated with greater risks of developing certain cancers. Diets high in fats, especially unsaturated fats, have also been associated with increased risks of developing cancer. This study was undertaken to evaluate the effect of fat type on the beta-carotene status in a rat model. Rats were fed diets containing 2 g/kg beta-carotene or placebo and either 10% lard or corn oil for 13-16 weeks. Plasma vitamin A was unaffected by the dietary regimes. Liver vitamin A levels were significantly increased in the beta-carotene groups and were greater in the lard-fed animals. No detectable level of plasma beta-carotene was found in the rats fed placebo diets. In animals given dietary beta-carotene, plasma beta-carotene levels were significantly reduced in the group fed corn oil compared to the group fed lard. Liver beta-carotene levels were higher in the groups fed corn oil. The results suggest that the type of dietary fat can significantly affect the circulating and tissue levels of beta carotene. PMID- 2710648 TI - Fish consumption and breast cancer risk: an ecological study. AB - There is experimental evidence that fish oils protect against mammary carcinogens in animals. However, there has been little investigation of the possible relevance of this finding to breast cancer in humans. We compared breast cancer incidence and mortality rates with estimates of the consumption of fish and other foods and nutrients in the countries for which reliable data are available. The results showed an inverse association between percent calories from fish and breast cancer rates that was consistent with a protective effect. This analysis confirmed the finding of others that dietary fat is strongly associated with international variation in breast cancer rates. It also showed that of the dietary components considered, percent calories from fish was the factor most strongly correlated with breast cancer rates after statistical adjustment for dietary fat intake. This result is therefore in accord with animal experimental data and suggests that the omega-3 fatty acids contained in certain fish may protect against breast cancer. PMID- 2710649 TI - Studies on the effects of vitamin E on neuroblastoma N1E 115. AB - The effects of DL-alpha-tocopherol and DL-alpha-tocopherol succinate on neuroblastoma N1E 115 cells were studied. Tocopherol had no growth-arresting properties, whereas its succinate ester derivative inhibited growth at concentrations greater than or equal to 20 microM. The succinate derivative was taken up somewhat more readily than free tocopherol; however, for any equal uptake of both forms of vitamin E, only the succinate derivative could affect growth. Tocopherol succinate was taken up without marked conversion to tocopherol. Following uptake, plasma membrane and organelle fractions contained most of the vitamin E derivatives; however, the particulate and membrane fractions were about twice as enriched in the succinate derivative as in free tocopherol. On the other hand, a proportionally higher amount of unconjugated vitamin E was recovered in the cytosol fraction. Fluorescence polarization studies indicated no differences in the overall fluidity of the plasma membranes treated or not treated with either form of vitamin E. The data point to the functionality of the free carboxyl group of the succinate derivative as a basis for the difference in potency of the two forms of vitamin E. PMID- 2710650 TI - A comparison of two diet history questionnaires that measure usual food intake. AB - This study was conducted during the preparation of a case-control study on patients with adenomatous polyps or cancer of the large bowel. It was done to compare two dietary history methods for assessing individual current dietary intakes. Subjects were interviewed concerning their food consumption by meal in one of the questionnaires and by broad food groups in the other questionnaire. Two groups of 20 volunteers, comparable according to sex and age, were interviewed by a dietitian who used one of the questionnaires. Data on diets obtained with the questionnaire were compared with those of a 14-day dietary record. The subjects were informed of the importance of the validation procedure. Whatever the type of questionnaire, mean daily intakes of nutrients and foods were rather similar for the questionnaires and for the 14-day records. Thus, there were more significant correlations between the questionnaire by meal and the record than between the questionnaire by food group and the record. When using tertiles, it appears that the questionnaire by meal was better at classifying individuals with regard to their food intake than the questionnaire by food groups. Although extrapolating these results to a patient population is not straightforward, it seemed likely that interviewing patients on diet without using a pattern of meals would prove even less reliable than for healthy subjects. The questionnaire by meal was preferred to the questionnaire by food groups for the ongoing case-control study. Further studies are needed to know whether these results could be extrapolated to studies on past diet and to non Latin populations. PMID- 2710651 TI - Dietary factors in the risk of bladder cancer. AB - The relationship between selected dietary factors and the risk of bladder cancer was investigated in a case-control study conducted in northern Italy. The study included 163 cases and 181 controls who were hospitalized for acute, nonneoplastic or urinary tract diseases. The frequency of consumption of green vegetables and carrots was lower in the cases; thus, the estimated relative risks for the upper vs. the lower tertiles were 0.6 for green vegetables and 0.5 for carrots. Significant inverse trends in risk emerged with estimated carotenoid (as well as retinoid) intake. The apparent protection conveyed by vitamin A was stronger in current smokers. The risk of bladder cancer was not related to scores of fat and measures of alcohol consumption; the risk was elevated in coffee drinkers (although there was no tendency to rise with higher consumption), but it was reduced in tea drinkers. These findings were not explainable in terms of selection, information, or confounding bias. Thus, although available information is too uncertain for any precise definition of specific (micro)nutrients related to bladder cancer risk, the confirmation that several aspects of a less-affluent diet adversely affect the risk is still of interest in terms of a better understanding of bladder carcinogenesis. PMID- 2710652 TI - Errors of measurement. PMID- 2710653 TI - The effect of dietary fat on metastasis of the Lewis lung carcinoma and the BALB/c mammary carcinoma. AB - The effect of feeding mice diets high in beef tallow (high in saturated fat) or corn oil (high in polyunsaturated fat) on the production of lung metastases by the Lewis lung carcinoma and the BALB/c mammary tumor was determined. Diets were fed ad libitum, and the mice fed the high-fat (24.6%) diets consumed more calories and gained more weight than those fed the control (5%) diets. With the Lewis lung carcinoma, we found that both high-fat diets significantly increased the growth of the primary tumor in the footpad as well as the number of spontaneous metastases produced after the primary was removed; this was in comparison with results from the appropriate control diets. With the BALB/c mammary tumor, the high-fat beef tallow diet (but not the corn oil diet) significantly increased the number of lung metastases formed after tail vein injection. In addition, the group given the control corn oil diet had more metastases than the group given the control beef tallow diet. Overall, these studies showed that the consumption of high-fat/high-calorie diets increased metastasis compared to the consumption of high-fat/high-calorie diets increased metastasis compared to the consumption of low-fat diets. However, the results varied depending on the tumor model used and the type of fat. PMID- 2710654 TI - The effect of diets enriched in cabbage and collards on murine pulmonary metastasis. AB - Feeding mice with diets enriched in dried cruciferous vegetables (cabbage and collards) resulted in a significant decrease in the number of pulmonary metastases after the animals were injected intravenously with mammary tumor cells. No differences in weight gain or calorie consumption were seen between the mice fed the different diets. These results support other evidence that diets high in cruciferous vegetables may be beneficial in cancer prevention. PMID- 2710655 TI - Natural defense systems of fasting rats against tumor cells. AB - The effect of fasting on naturally cytotoxic cells in rat liver and rat spleen was investigated. Neither fasting 100% (nor 50%) for eight days nor 100% overnight significantly reduced this natural cytotoxicity. Target cells YAC-1, P815, and WEHI-164 cells were used in a chromium release assay. Assuming that YAC 1 cells are preferentially killed by "true" natural killer cells, P815 by macrophages, and WEHI-164 by so-called natural cytotoxic cells, our results indicate that none of these subsets of naturally cytotoxic cells are hampered or stimulated by the fasting regimens used. PMID- 2710656 TI - Long-term (24-year) recall reliability in cancer cases and controls using a 21 item food frequency questionnaire. AB - The following two questions concerning diet recall were addressed when studying 117 incident cancer cases and 99 controls from the Adventist Mortality Study. Are recalls of past dietary habits reliable? Does recall ability differ between cancer cases and controls? Two sets of dietary data were compared using the American Cancer Society's food frequency questionnaire--as reported in 1960 and recalled in 1984. Ability to recall 21 key food items was evaluated both for individual foods and a combination of all foods by comparing recall scores. The comparison revealed that among food groups, 24-year recall ability varied greatly. There was no significant difference in recall ability between cancer incident cases and controls after controlling for factors that may be related to recall ability (e.g., age, education, and sex). Also, there was no significant difference in recall ability among subjects with or without other chronic diseases likely to affect diet pattern. The results revealed no significant differences in recall ability by sex and body mass index; however, significant differences by vegetarian status and diet stability were found. Significant differences by educational level were found only in univariate analysis. PMID- 2710657 TI - Determinants of long-term (24-year) diet recall ability using a 21-item food frequency questionnaire. AB - This study sought to determine how well individuals are able to recall accurately their food habits of 24 years ago and identify those factors that are predictive of recall ability. We investigated the self-reported dietary intakes of 216 people, one-half of whom were vegetarians, including cancer cases and controls. We compared 21 key food items reported in 1960 with the same data reported in 1984. Recall ability was the highest for persons with stable diets. Vegetarian status, education, and church attendance were the other significant determinants of exact recall; age and church attendances were the only significant determinants of recall error. After excluding nonusers of particular foods, we found a positive correlation between frequency of use and recall ability. PMID- 2710658 TI - Serum levels of beta-carotene, vitamin A, and zinc in male lung cancer cases and controls. AB - The mean serum levels of beta-carotene and vitamin A in a multivariate analysis of data from 64 histologically confirmed male lung cancer cases were statistically significantly lower than those from 63 randomly selected male hospital controls, who were admitted for small surgical operations (p values for both beta-carotene and vitamin A less than 0.001). The mean serum levels of zinc were not statistically significantly different between cases and controls (p = 0.10). The levels of beta-carotene, vitamin A, or zinc were not statistically significantly influenced by either the extent of the cancer (p = 0.45) or the cancer cell type (p = 0.06). The possible biological significance of these findings is discussed briefly. PMID- 2710660 TI - Rapid screening of organosulfur agents for potential chemopreventive activity using the murine NA assay. AB - The chemopreventive efficacy of 11 organosulfur compounds was assessed using the murine nuclear aberration (NA) assay in C57BL/6J mice. The sulfur compounds were introduced by stomach gavage. Benzo[a]pyrene (BP), which is a carcinogen known to a) undergo biotransformation by pathways mediated by P-450 and b) induce NA in the intestine, was used as the challenge. All animals were killed 48 hours after BP injection, and NA per crypt were scored. The results indicated that several agents were active in inhibiting BP nucleotoxicity to the colon, most notably, allyl mercaptan, benzyl mercaptan, and phenylethyl mercaptan. The NA assay was useful in effectively prescreening certain compounds for potential interactions with chemical carcinogens, thus serving as one indicator of chemopreventive activity. PMID- 2710659 TI - Influence of dietary cis and trans fats on DMH-induced colon tumors, steroid excretion, and eicosanoid production in rats prone to colon cancer. AB - The effect of geometrical isomerism of dietary fats on colon tumorigenesis was studied in male and female rats of a strain prone to colon cancer (Wistar-Furth Osaka). The rats were fed purified diets containing either partially hydrogenated corn oil (trans fat) or high-oleic safflower (cis fat) at the 5% level for one week and received a single oral dose of 1,2-dimethylhydrazine. The difference in the fatty acid composition of dietary fats was confined solely to the geometry of octadecenoate. An appropriate level of linoleic acid (2% of total energy) was supplied. After about 60 weeks, neither fat-type nor sex-dependent differences in the incidence of colon and small intestinal tumors was observed. The fecal excretion of neutral but not acidic steroids was higher in male rats fed the trans fat than in those fed the cis fat, but the composition remained almost unchanged. Aortic production of prostacyclin and the plasma concentration of thromboxane B2 were not influenced by dietary fats, although these were significantly higher in females, irregardless of the fat source. Thus, trans fat behaved much like the cis fat in various parameters, except for steroid excretion. PMID- 2710661 TI - Prehospital pediatric endotracheal intubation performance review. AB - Pediatric prehospital care was reviewed over a one-year period to determine success rate, causes of unsuccessful attempts, and complications of performing endotracheal intubation. The Milwaukee County Emergency Medicine Technician Paramedics (EMT-Ps) responded to 1467 pediatric (less than 19 years of age) patient calls. This accounted for 11% of the patients who received EMT-P care during the study period. Of the 63 patients requiring pediatric endotracheal intubation, 49 (78%) were successfully intubated. Of the 42 pulseless nonbreathing (PNB) patients, 39 (93%) were successfully Of the 21 patients judged to be in impending respiratory failure, 10 (48%) were successfully intubated. Common difficulties in intubating the PNB patient included inability to visualize the glottis and cords secondary to mucus and/or vomitus, use of inappropriately small endotracheal tubes, and accidental extubation during transport. Difficulties in intubating impending respiratory failure patients included patient resistance and seizure activity. We recommend that the EMT-P training curriculum include a review of these difficulties and that prehospital pediatric endotracheal intubation performance be monitored and reviewed with the EMT-Ps. PMID- 2710662 TI - Duration of fever prior to onset of a simple febrile seizure: a predictor of significant illness and neurologic course. AB - This study tested the hypothesis that the duration of fever prior to the onset of a simple febrile seizure may be an important clinical variable with respect to patient outcome. The duration of fever prior to seizure according to patient history was defined as either long (greater than or equal to 24 hours) or short (less than 24 hours). We hypothesized that simple febrile seizures which occur with a history of a fever of long duration (LDF) are more likely to be associated with a significant illness at presentation or a subsequent neurologically abnormal course than are simple febrile seizures which occur with a history of a fever or short duration (SDF). Of 100 cases which met study criteria for simple febrile seizures, nine had a LDF and 91 had a SDF prior to the development of a seizure. No statistical differences in age, sex, maximum fever recorded in the emergency department, duration of seizure, WBC, or electrolytes were found between patients with SDF and LDF (P less than 0.01). Of the nine patients with a LDF, all had either a significant illness at the time of initial visit or a subsequent neurologically abnormal course. Of the 91 patients with a SDF, 88 had a good outcome, while two had a significant illness at the time of visit, and one had a subsequent neurologically abnormal course. These results suggest that children with a history of LDF prior to the occurrence of a simple febrile seizure are more likely to have a serious illness at presentation or a subsequent neurologically abnormal course than are children with seizures which occur with a history of SDF. PMID- 2710663 TI - Naphthalene-induced hemolysis in a black female toddler deficient in glucose-6 phosphate dehydrogenase. AB - Hemolysis following accidental ingestion of naphthalene in black females deficient in glucose-6-phosphate dehydrogenase (G-6-PD) has not been previously reported. A 20-month-old black female is presented and the literature reviewed. Although G-6-PD deficiency is X-linked, health care providers must be aware that hemolysis may occur in females who are deficient in G-6-PD after exposure to naphthalene. PMID- 2710664 TI - Hydrostatic pressure-induced colon trauma from a pool whip. AB - Hydrostatic pressure-induced colon injury is a rare occurrence in the pediatric population. We present a case of massive hydroperitoneum following a pool whip induced injury. Although tension pneumoperitoneum or hydroperitoneum is rare, prompt recognition and surgical intervention are essential. PMID- 2710665 TI - Multifocal necrotizing fasciitis in varicella. AB - We describe a two-year-old patient who developed severe necrotizing fasciitis in three nonadjacent sites of his extremities during varicella. The recovery of purulent material by aspiration of deep soft tissues after seven days of fever, leukocytosis, and no response to antimicrobial therapy raised the suspicion of this diagnosis. The patient recovered following surgical drainage, debridement, and subsequent skin grafts. It is emphasized that early diagnosis of this severe complication is important since early surgical intervention decreases morbidity and facilitates recovery. PMID- 2710666 TI - Near-miss asphyxiation from a toy ball: a small parts failure. AB - The case report of a near-fatal asphyxiation of an 11-month-old child by a 26 mm (diameter) toy ball is presented. The lack of compliance with existing Consumer Product Safety Commission standards for small parts is discussed, and a recommendation is made regarding the coloring of ingestible objects. PMID- 2710667 TI - Knotting of a bladder catheter. AB - A case of knotting of a bladder catheter inserted to closely monitor a critically ill child is presented. The literature is reviewed, revealing knotting to be an unusual complication of this common pediatric procedure. Risk factors for knotting are discussed, and precautionary recommendations are presented. PMID- 2710668 TI - Toxic shock syndrome associated with poison oak dermatitis. AB - Toxic shock syndrome commonly occurs in menstruating women, but it is known to be associated with a variety of staphylococcal infections. We report a case of nonmenstrual toxic shock syndrome in an 11-year-old male who presented with altered consciousness and infected poison oak dermatitis of the feet. This is the first reported case of toxic shock syndrome associated with poison oak dermatitis. The signs and symptoms, laboratory findings, and treatment of toxic shock syndrome are reviewed. PMID- 2710669 TI - Blow to face. PMID- 2710670 TI - Prehospital use of intraosseous infusion by paramedics. AB - Vascular access in young children frequently proves difficult in the prehospital setting. To assess the feasibility of training paramedics in the placement of intraosseous (IO) lines as an alternative to intravenous (IV) access, this pilot project studied a training program and treatment protocol for prehospital IO use. Paramedics underwent a training program in IO placement. Patients enrolled were less than five years of age and in cardiac arrest. During a 10-month period, paramedics attempted 12 IO placements, of which 10 (85%) were successful, nine on the first attempt. Although no patients achieved long-term survival, three were initially resuscitated from arrest. Paramedics can be trained in IO placement, and IO infusion can be used in prehospital pediatric care. Training methods, limitations, and implications for future use are discussed. PMID- 2710671 TI - Merit badge medicine: the good, the bad, and the evil. PMID- 2710672 TI - Emergency approach to the removal of foreign bodies from the eye, ear and nose. PMID- 2710674 TI - Childhood diabetes--from impasse to epidemiology. PMID- 2710673 TI - Prospective evaluation of selective criteria for imaging among children with suspected blunt renal trauma. AB - The evaluation of children with suspected blunt renal injury relies mainly on clinical assessment, urinalysis, and imaging studies. Because imaging studies rarely influence management, yet entail both risk and expense, we investigated a protocol to define their appropriate use. During a one-year period, children seen in the emergency department underwent a mandated radiographic evaluation for renal injury only if they had (a) severe injuries or (b) a urinalysis with greater than 20 RBC/hpf. Thirty-two children were enrolled; 16 had imaging studies that detected four abnormalities, ie, three contusions and one incidental finding of renal papillary necrosis. All children with abnormal imaging studies had greater than 20 RBC on urinalysis. None of the 16 children who were not studied radiographically developed complications related to renal trauma during short-term follow-up. Our findings support earlier recommendations for limiting the use of imaging for suspected blunt renal trauma in children with minor to moderate injuries and hematuria of less than or equal to 20 RBC/hpf. PMID- 2710675 TI - Neural tube defects and Chernobyl? PMID- 2710676 TI - The study of risk habits in reproductive and perinatal epidemiologic research: the use of a donor inseminated population of women. AB - In this study we assess whether a population of donor inseminated women (ADI) provides an efficient alternative to an open population of women of reproductive age to study the effects of risk habits (cigarette smoking and alcohol consumption) on reproductive and perinatal health. An ADI population can be prospectively monitored before and after pregnancy; women enter the programme because of their husband's infertility. In the pilot clinic every couple asking for first insemination was requested to fill in a self-administered questionnaire on risk habits and the use of medicine. Medical histories of both the man and woman were taken. In 1986 and 1987, 519 women entered the programme. The response rate was 95%. Distribution of the exposure variables of the women currently smoking (52%) and currently drinking (68%) compared well with a general population survey from the town of Rotterdam. With regard to their risk habits and reproductive health, the population of women married to totally infertile men seems representative of women of reproductive age from an open population. PMID- 2710677 TI - Pregnant women at work: rest periods to prevent preterm birth? AB - The aim of this study is to identify social preventive measures in an attempt to prevent pre-term birth in pregnant women who work under strenuous conditions. A study carried out in 50 factories allowed us to gather data on 1168 pregnancies that occurred during 1 year and to study the modifications in working conditions now granted to pregnant women in many firms in France. We observed a significant relationship between 'episodes of sick leave' prescribed especially for fatigue (without any pathological reason) and a lower preterm birth rate. The potential benefit of rest-periods, granted to pregnant women working in strenuous conditions, is discussed. PMID- 2710678 TI - Birthweight of single livebirths and weight specific early neonatal mortality in Hungary and Norway. AB - Comparisons of birthweights of single livebirths in Hungary and Norway reveal distributions to have similar shapes; however, in the case of Hungary the distribution is shifted to the left, i.e. towards lower weights. In the registration of pregnancy outcomes, almost identical definitions are applied in the two countries, and the observed difference in distributions of birthweights is taken to reflect that Norwegian livebirths, are on average about 300 g heavier than Hungarian livebirths. Employing the method of analysis of birthweight and perinatal mortality suggested by Wilcox & Russell, it can be demonstrated that the proportions of births in the residual distributions of birthweights in the two countries are of the same magnitude and that the relative differences in first week mortality risks are similar for all birthweights. These results are taken to support the conclusion that to use a cut-off point of 2500 g in defining low birthweight, which will result in a two fold higher proportion of such infants in Hungary compared to Norway, is unwarranted, as it will falsely convey the impression of relatively more obstetric and paediatric problems in Hungary. PMID- 2710679 TI - The Greek National Perinatal Survey. II: Socioeconomic factors and perinatal mortality in Greece. AB - Information concerning all 10,859 singleton deliveries in Greece in April 1983, were analysed to assess the contribution of socioeconomic factors to the perinatal mortality rate. Statistically significant associations were initially found with parental education, parental ages, duration of marriage, paternal occupation and parity. There was no association with maternal smoking habit, maternal occupation during pregnancy, type of health insurance or housing conditions. Once logistic regression analyses had taken account of the strong parity effect (P less than 0.0001), only a moderate association with maternal age (P less than 0.05) remained statistically significant, together with a marginally significant (P less than 0.05) association with maternal education level. Mothers who were moderately well educated had the lowest risk of loosing their baby. It is concluded that traditional measures of social deprivation appeared to have little effect on perinatal mortality in Greece in 1983. PMID- 2710680 TI - Changing incidence of neural tube defects in Aegean Turkey. AB - The incidence of neural tube defects was monitored among all live- and still births delivered between June 1986 and July 1988. In all there were 19,115 total births. The incidence of neural tube defects (NTD) was 1.9 per 1000 among those whose conception time was prior to May 1986. However, in conceptions occurring in May, June and July 1986, the NTD rate increased to a level of 8.9 per 1000, subsequently gradually declining to previous levels within 9 months. This dramatic change in incidence, which parallels a previous finding from Turkey, suggests that this finding may be associated with the Chernobyl disaster of May 1986. PMID- 2710681 TI - Women's disorders. PMID- 2710682 TI - Ciliogenesis and ciliation of the respiratory epithelium in the human fetal cartilaginous trachea. AB - Ciliogenesis of the respiratory epithelium in the human cartilaginous trachea start during the 12th week of gestation. Ciliary shafts are first seen under the scanning electron microscope during the 13th week. Unlike its membranous counterpart, ciliary shafts appear all over the epithelial surface at almost the same time. Epithelial cells destined to become ciliated cells first develop numerous long and thin microvilli. A process of individual cell extrusion and proliferation of neuroepithelial bodies around the carinal angle precede ciliation in the respiratory epithelium of the cartilaginous trachea. Epithelial cell differentiation patterns in both the cartilaginous and membranous trachea are different. The mechanisms involved in modulating cell differentiation are currently under investigation. PMID- 2710683 TI - A combined immunohistochemical and histochemical approach on the differential diagnosis of giant cell epiphyseal neoplasms. AB - The histological similarities and the common localization are the main causes of difficulties concerning the differential diagnosis between giant cell tumor of bone and chondroblastoma. The purpose of the present study was to detect whether histochemistry and/or immunohistochemistry could help to make the distinction between these two entities easier. The study was based on cases of chondroblastoma and giant cell tumor of bone from patients in the 2nd and 3rd decades of life. Histochemical detection of special intracellular and extracellular components (glycogen, glycosaminoglycans) as well as immunohistochemical investigation using various tumor markers (S-100, NSE, a-1 ACT, lysozyme, fibronectin) were performed on parallel paraffin sections. The presence of abundant intracytoplasmic glycogen granules and the immunoreactivity of the cells of chondroblastoma with S-100 and NSE, together with the presence of acidic sulfated glycosaminoglycans in the stroma, could help the differential diagnosis of this tumor from giant cell tumor of bone. PMID- 2710684 TI - Distribution of vitamin B12 R-binder in lung tumors. Implications for cell differentiation. AB - Expression of vitamin B12 R-binder, a specific binding protein for vitamin B12, was studied immunohistochemically in normal lung tissues and 107 lung tumors of various types. In normal tissues, vitamin B12 R-binder (R-binder) expression was restricted to the mucous cells of bronchial or bronchiolar epithelium and submucosal glands as well as to nonciliated bronchiolar (Clara) cells. Among lung carcinomas, 38% of squamous cell carcinomas, 42% of adenocarcinomas and 23% of large cell carcinomas showed positive staining for R-binder whereas small cell carcinomas did not. These findings offer the possibility that a majority of the histologic types of lung carcinoma have common histogenetical characteristics with mucous or Clara cells. Of the bronchial gland tumors, R-binder could be detected in a mucoepidermoid carcinoma but not in adenoid cystic carcinomas. Epithelial components in both pulmonary blastomas and hamartomas showed a reactivity for R-binder, suggesting that these tumors contained components composed of cells with bronchiolar cell differentiation. The immunohistochemical examination of lung tumors, using anti-R-binder antibody, may have some implications in the cell differentiation of lung tumors. PMID- 2710685 TI - Therapy-relevant discrepancies between diagnoses of institutional pathologists and experienced hematopathologists in the diagnosis of malignant lymphoma. AB - We have studied therapy-relevant discrepancies in the diagnoses of institutional pathologists and a panel of 4 experienced hematopathologists in 375 cases from patients with malignant lymphoma. Two hundred and fifty four cases (68%) were contributed by non-panel pathologists and 121 (32%) by individual panel pathologists. Overall, in 24% (91/375) of the cases, therapy-relevant discrepancies were present between institutional pathologists and panel diagnoses. Thirty-four percent (87/254) therapy-relevant discrepancies were present in cases contributed by non-panel pathologists, whereas in only 3% (4/121) discrepancies were found in cases forwarded by individual panel pathologists. The percentages erroneously diagnosed Hodgkin's disease by non panel pathologists and individual panel pathologists were 8 and 0% respectively and faulty diagnosed Non-Hodgkin lymphomas 5 and 0%, whereas the number of consultation cases, in which the referring pathologist was not certain of his diagnosis, appeared to be 24 and 3% for non-panel and panel pathologists respectively. In addition, in 14% of panel confirmed NHL contributed by non-panel pathologists, therapy-relevant discrepancies in the degree of malignancy grading according to the Working Formulation were present, whereas no discrepancies in malignancy grading were noted between individual panel members and panel diagnoses. Apart from extensive hematopathological experience, a reason for the higher diagnostic accuracy of the panel pathologists could well be the frequency in which the diagnoses were supplemented by immunophenotyping: in 22% of the cases from non-panel pathologists and 63% of the cases from panel pathologists immunophenotyping on frozen sections was carried out.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710686 TI - A method for routine approach to laryngeal and hypopharyngeal surgical specimens by whole organ sections in the horizontal plane. AB - A procedure of pathological analysis of laryngopharyngeal specimens by whole organ sections in the horizontal plane was developed and evaluated. The use of a fast decalcifying and fixative solution allowed both an easier sectioning of the whole organ and thin (5-6 microns) histological whole organ sections of laryngo pharyngectomy specimens. The complete procedure required 5 to 10 days for each case. A preliminary examination of 39 surgical laryngopharyngectomy specimens with laryngeal or hypopharyngeal carcinomas showed that most of the normal structures were histologically identifiable on whole organ horizontal histological sections. The data of the local neoplastic spread related to the main sites of origin were in accordance with the results obtained by other studies using whole organ sections in the coronal or vertical planes. In conclusion, with this procedure it is possible to obtain, in a reasonably short time, thin histological horizontal whole organ sections allowing an adequate and complete assessment of the microscopic characteristics of the tumor and of the tridimensional relationships of the neoplasm with the host organ; moreover, by this procedure pathological data may be compared with preoperative CT or MR scans in patients with laryngeal and hypopharyngeal carcinomas. PMID- 2710687 TI - Multilocular renal cyst. Scanning and transmission electron microscopic observations. AB - A multilocular renal cyst in a boy aged one year and four months is presented, with particular attention being paid to the nature of the epithelial lining cells. Light and transmission electron microscopy showed the cyst to be lined by a single layer of flattened or cuboidal epithelial cells of relatively uniform morphology. Neither embryonic elements nor nephroblastomatous foci were noted in the intervening stroma. The scanning electron microscopy showed hitherto undescribed surface morphological features of the epithelial lining cells: They were characterized by the presence of one or, occasionally two centrally positioned long cilia and by variably oriented microvilli. The observations presented here suggested that the lining cells of the cyst most closely resembled the principal cells of the collecting ducts, especially those located in the inner medulla of the kidney. An unexpected finding was the additional occurrence of a giant bullous lesion in the right lung of this patient. PMID- 2710688 TI - Thyroid inclusion in the lung. Metastasis of an occult papillary carcinoma or ectopia? AB - The incidental autopsy finding of a thyroid inclusion in the lung of a 26-year old man, accompanied by an occult papillary carcinoma (OPC) in the thyroid gland, raises the question about the possibility of true thyroid ectopia in the lung vs. metastasis of an OPC. Based on the embryonic development of the thyroid gland and the known thyroid ectopias, as well as on statistical figures on OPCs and their metastases, both possibilities are discussed. The histological pattern of the thyroid inclusion and the lack of regional nodal metastases argue in favour of ectopia, even though a definitive conclusion cannot be drawn. PMID- 2710689 TI - Aberrant response in vitro of hormone-responsive prostate cancer cells to antiandrogens. AB - Antiandrogens are in use alone and in combination with other agents as hormonal therapy for prostate cancer. We conducted studies on the androgen-responsive human prostate cancer cell line LNCaP to determine the direct effects of three antiandrogens (hydroxyflutamide, RU23908, and cyproterone acetate) on hormone responsive human prostate cancer cells in culture. Dihydrotestosterone (DHT) stimulated the growth of LNCaP cells in a dose-dependent fashion. These cells contained approximately 31,000 high-affinity (Kd = 9 x 10(-10) M) androgen binding sites per cell. In the absence of any androgenic stimulation, all three antiandrogens tested showed agonistic properties by increasing the cell number and uptake of [3H]-thymidine. Competitive uptake studies using [3H]-R1881, a nonmetabolized androgen, showed that the three antiandrogens inhibited specific R1881 uptake with IC50s of 0.9 x 10(-7) M for hydroxyflutamide, 2 x 10(-7) M for RU23908, and 1 x 10(-7) M for cyproterone acetate. It is not known whether these unexpected agonistic effects are due to an altered receptor, previously unmasked agonistic properties of the antiandrogens, or emergence of a hypersensitive clone of cells. PMID- 2710690 TI - Case-control study of prostatic cancer in Kyoto, Japan: demographic and some lifestyle risk factors. AB - Demographic risk factors for prostatic cancer were examined in a case-control study of 100 triplets of prostatic cancer patients and age-, hospital-, and admission date-matched control series of benign prostatic hyperplasia (BPH) patients and general hospital patients. A higher risk of prostatic cancer was associated with the following factors: 1) long-term occupation in transport or communication (relative risk [RR] = 4.92, 95% confidence interval [CI]: 1.18 20.5) as compared with hospital controls; 2) the wife having a lower educational level (RR = 1.88, 95%CI: 1.02-3.45) as compared with hospital controls; 3) no past episode of hypertension as compared with BPH controls (RR = 2.30, 95%CI: 1.27-4.15); 4) having several sisters (more than four) as compared with both BPH and hospital controls (RR = 3.82, 95%CI: 1.35-10.8 and RR = 2.94, 95%CI: 1.08 8.03 respectively); 5) dense body hair as compared with hospital controls (RR = 4.28, 95%CI: 1.19-15.4). No significant links were found with blood type, daily drug use, head hair, skin color, body type, smoking habits, religion, body weight, and mental characteristics. PMID- 2710691 TI - Cytochemical characterization of cuprolinic blue-stained proteoglycans in the epithelial-stromal interface of the guinea pig lateral prostate. AB - Three types (T1, T2, T3) of proteoglycan (PG) filaments, as demonstrated by cuprolinic blue (CB) under critical electrolyte concentration method in the epithelial-stromal interface of the guinea pig lateral prostate, were characterized cytochemically by using a number of glycosaminoglycan(GAG) degrading enzymes and nitrous acid. The results showed that T1 filaments located in basement membranes of the epithelium, endothelium, and smooth muscle cells, were removed by nitrous acid, heparitinase, and pronase but resistant to chondroitinase (Ch)-ABC and Ch-AC, heparinase, neuraminidase, and Streptomyces (S) hyaluronidase. The T1 filaments, therefore, contain heparan sulfate. The T2 filaments closely linked to collagen fibrils were removed by Ch-ABC, Ch-ABC plus S-hyaluronidase, and pronase but were resistant to nitrous acid, heparitinase, heparinase, neuraminidase, and S-hyaluronidase. These show that T2 filaments are rich in dermatan sulfate. The T3 filaments in the interstitial spaces and on the surface of fibroblasts were removed by Ch-ABC, Ch-AC, and pronase but were resistant to heparitinase, heparinase, hyaluronidase, neuraminidase, and nitrous acid. They are, therefore, rich in chondroitin sulfate. PMID- 2710693 TI - Double contrast arthrography of the knee: a comparison to clinical diagnosis and arthroscopic findings. PMID- 2710692 TI - Single-drug parenteral estrogen treatment in prostatic cancer: a study of two maintenance-dose regimens. AB - Treatment of 17 patients with prostatic cancer with 320 mg polyestradiol phosphate (PEP) as intramuscular injections every fourth week suppressed serum testosterone (T) values to orchidectomy levels within 1 month, and serum estradiol-17 beta (E2) rose to a mean level of 2,456 pmol/liter after 6 months. Following 6 months of treatment, the PEP dose was reduced to 80 mg/4 weeks in 9 and 160 mg/4 weeks in eight patients. Mean T levels, increased significantly after dose reduction in both groups and were above the upper orchidectomy limit at 1 month after dose reduction in the 80 mg group. Mean T levels, however, remained below this level at 5 months in the 160 mg group. Dose reduction caused a rise in gonadotropin levels in the 80 mg but not in the 160 mg group. While 320 mg/4 weeks may be a suitable initial dosage, doses less than or equal to 160 mg/4 weeks are insufficient as maintenance dosages if orchidectomy values of T are required. PMID- 2710694 TI - Knee braces. PMID- 2710695 TI - Controlling anterior tibial displacement under static load: a comparison of two braces. PMID- 2710696 TI - Manipulation in the treatment of frozen shoulder. PMID- 2710697 TI - Hip fractures in children. A long-term follow up of 17 cases. AB - Late results (average 18 years posttrauma) after hip fractures in 17 children are reported. The average age at the time of fractures was 8.5 years (range 2 to 15 years). The treatment was conservative for undisplaced or slightly displaced transcervical and cervicotrochanteric fractures (Delbet's Type II and III) as well as for intertrochanteric fractures (Delbet's Type IV). The overall complication rate was 25%. Avascular necrosis of the femoral head was seen in two hips, premature epiphyseal closure with leg shortening in two cases, and a coxa vara in one hip. These complications only had resulted in few symptoms at follow up. PMID- 2710698 TI - Traumatic hip dislocation in children. Follow up of 13 cases. AB - Thirteen cases of traumatic anterior and posterior hip dislocations in children were treated during a period of 25 years. All of them were available for follow up from 5 to 26 years postinjury. Twelve of the patients had their dislocation reduced within six hours after the injury. None of them developed any complication, and the range of movement was the same as in the noninjured hip. One patient, who had his hip reduced 37 hours after the injury, experienced pain due to osteoarthritis 7 years after the injury at the age of 21 years. PMID- 2710699 TI - The Charnley total hip arthroplasty in juvenile rheumatoid arthritis patients. AB - A follow up of 27 consecutive total hip arthroplasties in 16 patients with juvenile rheumatoid arthritis was performed. The mean age at surgery was 18 years, and the average follow-up period was 64 months. No serious early complications were recorded, but three deep infections developed from 6 to 18 months after the arthroplasty, all requiring revision. The clinical results were good at follow up, as 20 hips were free of pain and 7 had only slight pain. Most of the patients had improved their walking ability and the range of motion in the hip as well. A poor correlation was, however, shown between the clinical and the roentgenographical results, as there was one femoral implant that was definitely loose and four more hips that had components which were probably loose. The frequency of infections might have been reduced by using antibiotic prophylaxis during surgery in all the cases; the frequency of aseptic loosening might also have been reduced by improved cementing techniques. Because of high loosening rate without clinical symptoms, it is recommended to follow the patients roentgenographically to make revision surgery possible while the bone stock still is sufficient. PMID- 2710700 TI - Arthroscopy in diagnosis and treatment of hip disorders. AB - Fourteen hip arthroscopies between January 1985 and May 1988 were reviewed. Included were ten women and four men with an age ranging from 12 to 76 years. Indications were avascular necrosis; loose bodies; osteoarthrosis, arthritis, or pain; and snapping hip. The diagnosis was verified in five cases, including arthroscopic removal of a loose body in one and resection of a plica bridging the space between the femoral head and acetabular roof in two patients. The diagnosis was rejected in three cases. In five cases, no pathologic changes were found. One arthroscopy was inconclusive because of a narrow field of vision in a dysplastic hip. No serious complications occurred. Hip arthroscopy is useful in diagnostics and surgical treatment of selected hip disorders. The rehabilitation time is short. Hip arthroscopy is, however, a technically demanding procedure. PMID- 2710701 TI - Alternatives in the treatment of ipsilateral fractures of the hip and femur. AB - Eight cases of ipsilateral femoral neck and shaft fractures were reviewed. The diagnosis of the femoral neck fracture was delayed in two cases. Seven of the femoral shaft fractures were comminuted. In six cases, both fractures were treated with rigid internal fixation. A combination of traction and internal fixation was used in two cases. Two cases of avascular necrosis of the femoral head were observed. The fracture reduction was insufficient in both cases and the diagnosis of femoral neck fracture was delayed in one case. A radiograph of the pelvis is mandatory in high-velocity trauma victims. Ipsilateral fractures of the femoral neck and shaft should be stabilized by internal fixation as early as possible. Intramedullary locked nailing seems to be an attractive alternative in the treatment of the comminuted femoral shaft fracture. PMID- 2710702 TI - Early radiolucencies following cemented total hip replacement. Influence of postoperative treatment with indomethacin. AB - The influence of treatment with indomethacin in the first 6 postoperative weeks on the incidence of early loosening and radiolucencies following cemented total hip replacement were studied in 102 hips. Ninety-nine hips in 99 patients without postoperative antiinflammatory treatment served as control group. One year after surgery, two patients in the indomethacin group and five patients in the control group were suspected of having loosening of one or both prosthetic components. However, no patients had a revision. The lateral acetabular cement-bone interface most frequently showed a radiolucent line. Concerning the incidence of radiolucent lines in any acetabular or femoral cement-bone interface zone, no difference could be shown between the two groups. When evaluated 1 year after surgery, postoperative treatment with indomethacin does not increase the incidence of aseptic loosening or cement-bone interface radiolucencies in cemented total hip replacement. PMID- 2710703 TI - Osteoarthritis after Colles' fracture. AB - Fifty-six patients with displaced Colles' fractures were examined 7 years after fracture. Slight radiographic changes of osteoarthritis were seen in 17 cases, moderate changes in 7 cases, and severe arthrosis in 1 case. At follow up, the occurrence of osteoarthritis was not related to radial shortening or residual dorsal angulation; it did show, however, a high correlation to the initial displacement of the fracture and the age of the patient. Radiographic osteoarthritis also influenced the function of the wrist, especially in the older patients. PMID- 2710704 TI - Correction of hallux valgus and metatarsus primus varus. Using the Cedell technique. AB - The Cedell procedure consists of: a proximal valgus osteotomy of the first metatarsal bone to correct the metatarsus primus varus, a soft tissue plasty at the first metatarsophalangeal joint with lateral release, and tightening of the medial capsule to correct the hallux valgus. A total of 45 operations in 31 patients (2 men and 29 women) were performed. Forty-one of these operations were followed. The average age at surgery was 24 years (range 16 to 43 years), and the average follow-up time was 23 months (range 8 to 56 months). The postoperative decrease in the intermetatarsal angle averaged 10 degrees, and the average decrease in the metatarsophalangeal angle was 26 degrees. Only a few postoperative complications were observed. At the time of follow up, 75% of the patients had no pain, 23% had only slight pain, and 2% had severe pain. Ninety five percent were cosmetically satisfied with the operation. The Cedell operative technique has proved to be an effective procedure to correct the combined hallux valgus and metatarsus primus varus in younger patients. PMID- 2710705 TI - The use of anesthesia for surgical treatment of Achilles tendon rupture. AB - The influence of the type of anesthesia on the treatment and final results of Achilles tendon surgery was investigated. Open repair of Achilles tendon rupture was performed using general or spinal anesthesia in 80 patients and local anesthesia in 42 patients. Surgery using local anesthesia was very acceptable to the patients and was less resource-demanding than surgery using general anesthesia. The functional result was good in both groups and only minor differences in the functional results between the two groups were found. PMID- 2710706 TI - 99mTc-DPD uptake in juvenile hemarthrosis. Scintimetry and autoradiography of the knee in dogs. AB - The pathogenesis of subchondral bone lesions and growth plate affection in hemophilic arthropathy was studied in puppies by means of repeated regional 99mTc diphosphonate scintimetry and contact autoradiography. Unilateral hemarthrosis of the knee was induced by biweekly intraarticular injections of autologous blood for 12 weeks. Hemarthrosis caused an early (2 to 4 weeks) decrease in uptake of 99mTc-diphosphonate in the juxtaarticular growth plates (ratio 0.7) and a delayed (8 to 10 weeks) increase in epiphyseal uptake (ratio 1.5). In a recovery phase after hemarthrosis, growth plate uptake returned to normal, while the epiphyseal uptake remained elevated for 8 to 10 weeks. By contact autoradiography, the growth plate uptake was localized to the calcification layer at the metaphyseal aspect of the growth plates, while the epiphyseal uptake mainly was seen in the thin subchondral and subsynovial bone layer and around osteophytes. The changes in uptake of 99mTc-diphosphonate following hemarthrosis for 3 months were reversible and could be ascribed to the presence of synovial inflammation. PMID- 2710707 TI - Recurrent anterior dislocation of the shoulder. A comparison of the results after the Bankart and the Putti-Platt procedures. AB - A retrospective comparison of the results after the Bankart and the Putti-Platt procedures in the treatment of recurrent anterior dislocation of the shoulder showed no significant differences in the rate of redislocation or in the limitation of outward rotation. The dislocation recurrence rate after surgery was 13% for the Bankart procedure and 22% for the Putti-Platt procedure. Only 67% of the patients were satisfied with the operation. The poor results seem to be due to the fact that the operations were performed by 16 different surgeons who had varying approaches to the operations. PMID- 2710708 TI - Dislocation of the elbow: an experimental study of the ligamentous injuries. AB - The stability of human cadaveric elbow specimens was investigated using an experimental apparatus. Posterior dislocation of the elbow could only be produced when a combined valgus and external rotatory torque was applied to the specimen. None of the elbows were dislocated during varus and internal rotatory torque or in the extreme positions. In ten elbow specimens with an experimentally produced posterior dislocation, simultaneous rupture of the anterior part of the medial collateral ligament and the annular ligament were the most frequent findings. A lateral collateral ligament tear was only seen in two cases. Posterior elbow dislocation seems to be due to a combined valgus and external rotatory stress to the semiflexed elbow, resulting in a bilateral ligamentous injury. PMID- 2710709 TI - Occipitocervical fusion for the unstable rheumatoid neck. PMID- 2710710 TI - Greater trochanteric nonunion from a gunshot injury: a case report. PMID- 2710711 TI - The Ilizarov technique. PMID- 2710712 TI - Infected tibial pseudarthrosis. A 2-year follow up on patients treated by the Ilizarov technique. AB - The Ilizarov technique with a circular external fixator was used in the treatment of infected tibial nonunions. This is a report on 13 patients with a 2-year follow up after removal of the external fixation. There was no debridement of the site of nonunion performed. Union was obtained in all cases. There was no recurrence of infection at follow up. The Ilizarov technique provides the orthopedic surgeon with another alternative in the treatment of complicated tibial nonunions and their associated problems. PMID- 2710713 TI - The structure and development of osteogenetic repair tissue according to Ilizarov Technique in man. Characterization of extracellular matrix. AB - Distraction osteogenesis by the method of Ilizarov has permitted the study of bone formation. This is an analysis of 64 human biopsies in patients who were undergoing tibial lengthening by the method of Ilizarov. After analysis by conventional and polarized light microscopy, four stages of bone formation were identified. Bone formation is of the direct type with no cartilaginous phase. PMID- 2710714 TI - Femoral endoprosthesis fixation with a soft, flexible low modulus stem coating. Four to six year clinical results. AB - Fifty-nine patients received 62 femoral endoprostheses exhibiting a 2 mm thick, low modulus (soft), porous stem coating in a total hip arthroplasty. Follow up ranged from 36 to 69 months (average 60 months). There were 26 male and 33 female patients whose ages ranged from 29 to 75 and 39 to 72 years, respectively (average 57 years). All patients were operated on without trochanteric osteotomy. Initial stabilization was obtained by uniform press-fit and collar/neck osteotomy contact at implantation; secondary stabilization derived from soft tissue ingrowth into the stem coating. Four implants in four patients were deleted from the scored population because of unrelated deaths or loss to follow up. By the Harris scoring system, 48 of the 58 implants (82.7%) were rated excellent or good, 58.6% and 24.1% respectively. Seven were rated poor (12.1%), of which six (10.3%) have been revised. Other revisions included one hip for secondary sepsis (1.7%), one post-traumatic fracture (1.7%), and one intraoperative technical error (1.7%). PMID- 2710715 TI - Preoperative crossmatch guidelines for total hip arthroplasty. AB - The use of crossmatch guidelines has become commonplace as a means of guiding surgeons to efficient preoperative blood ordering. To further refine existing guidelines for a major elective procedure, a number of specific characteristics of 175 patients who underwent 189 total hip arthroplasties were correlated with blood use by univariate and multivariate analyses. The findings of this study demonstrate that for patients with no detectable red cell alloantibody, four units of blood should be crossmatched and reserved preoperatively if the patient is undergoing exchange arthroplasty, or undergoing a transtrochanteric procedure. All other patients with no detectable red cell alloantibody should have two units of blood reserved preoperatively. Proper preoperative crossmatch ordering can result in more labor-efficient and thrifty use of transfusion services, as well as increased effectiveness of autologous predeposit programs. PMID- 2710716 TI - Treatment of hemophilic pseudotumor with radical debridement and free tissue transfer. A case report. PMID- 2710718 TI - Two views of the use of methylmethacrylate for stabilization of the cervical spine. PMID- 2710717 TI - Problems with detachable broaches. A report of two cases. PMID- 2710719 TI - Pseudomalignant myositis ossificans. AB - PMO is characterized by the following: no history of antecedent trauma, localized expanding soft tissue mass, peripheral calcification surrounding a radiolucent center on plain radiographs and CT scans, microscopic evidence of zonation, and self limited natural history. PMID- 2710720 TI - Answer please. Giant cell tumor of bone. PMID- 2710721 TI - The study of giant cell tumors in bone. AB - Twelve samples of giant cell tumor of bone were incubated in the authors' laboratory. The activity of the cells was documented by means of time lapse cinemicrography. The multinuclear giant cells (MGCs) with undegenerating nuclei migrating from the explants had active ameboid movement and continuously changed their shapes. The majority of them kept splitting themselves into smaller MGCs until mononuclear cells formed, which were indistinguishable from the original stromal cells in morphology and could take up tritiated thymidine as shown by autoradiography. This splitting process of MGCs is mainly responsible for their vanishing in culture. The authors believe that an MGC is one of the true neoplastic elements. MGCs are present merely in the form of a syncytium derived from neoplastic stromal cells. In culture, the factors maintaining the syncytium are lost and the process opposite to cell fusion appears. Therefore, from a morphological view, MGCs and neoplastic stromal cells are homologous. PMID- 2710722 TI - Brucellosis contracted during foreign travel. AB - Brucellosis, a bacterial infection, is rarely seen in the United States. It occurs mostly in people who work with domestic animals and animal products. However, this patient became infected while in Yugoslavia, and diagnosis was delayed by the gap between appearance of symptoms and positive results of serologic tests. Brucellosis should be suspected in a patient with unexplained fever, especially if he or she has traveled to a country where unpasteurized dairy products are common. PMID- 2710723 TI - Running up the bill. $170 isn't chicken feed, even in an ER. PMID- 2710724 TI - When hay fever doesn't quit. Diagnosing seasonal and perennial allergic rhinitis. AB - Seasonal allergic rhinitis is usually easily diagnosed by the seasonal nature of characteristic symptoms combined with evidence of appropriate specific IgE antibodies. Perennial allergic rhinitis, however, may present a diagnostic challenge. The physician may find IgE antibodies to allergens perennially encountered by the patient and should look for other causes of chronic rhinitis. Examination of nasal secretions can be a diagnostic aid, but measurements of eosinophils and total IgE in serum have limited diagnostic value. PMID- 2710725 TI - Immediate and late side effects of hay fever. Physical and psychosocial problems. PMID- 2710726 TI - Cardiac disease in diabetes. AB - The current approach to cardiac disease recognizes that the cardiovascular problems of diabetic patients have both a coronary artery atherosclerotic component and an independent myocardial component. The presence of the myocardial component has become more apparent in recent years, and a full understanding of the balance between the two components is necessary for proper treatment of the cardiac problems of patients with diabetes. PMID- 2710727 TI - Pap smears. Do them right and every year--forever! AB - The Pap smear is still an important screening test for cervical cytologic abnormalities. When performed according to appropriate screening protocols (with special attention to high-risk women), the test can help to identify mild dysplasia early, before it progresses to a malignant state. Correct technique in obtaining the smear and accurate reporting by a competent cytologic laboratory are critical for valid results. PMID- 2710728 TI - Persistent urticaria caused by a common coloring agent. AB - As this case illustrates, foods or drugs may be ignored as possible causes of urticaria when they are not commonly accepted offenders or when they previously have been consumed with no adverse effect. In some instances, an additive or dye in a food or drug may be responsible for the reaction. In addition, a change of brands or dosage form of a drug may provoke urticaria or other reactions in sensitive individuals. PMID- 2710729 TI - Is this orbital or periorbital cellulitis? PMID- 2710730 TI - Do you think ... radial keratotomy is a good alternative to glasses or contact lenses? PMID- 2710731 TI - Commonsense advice on treating nail disorders. AB - Most nail disorders seen by primary care physicians are due to maceration, dryness, trauma, or infection. Some cases may be treated simply by having the patient remove a bandage to allow the skin to dry; other cases, such as subungual abscess, require local anesthesia and drainage for relief. Fungal infections may need to be treated for as long as a year. Patients with a tumor under the nail should be referred to a specialist. PMID- 2710733 TI - US trade policy on tobacco. PMID- 2710732 TI - Drug testing. PMID- 2710734 TI - Oral poliovirus vaccine. PMID- 2710735 TI - A friend in need. PMID- 2710736 TI - [Clinical experiences with late mothers and their wished for children]. AB - By way of introduction, this article considers the growth of the desire for a child and problems of counter-transference among older, but in terms of motherhood younger parents. The discussion concerns disturbance of the mother child relationship among 34 child psychiatry patients whose mothers were between 37 and 44 years of age when they were born. The article expresses the view that late motherhood, beginning shortly before the end of the reproductive phase, is related to a particular problem of inner maturation among late mothers. With the birth of a child, late mothers enter into a state of sustained partial regression that endangers active adjustment and the maternal care of the child during all developmental phases. The mother's need to be more or less mothered herself by her child is a sign of the mother's difficulties in detaching herself from her own mother. As a result of the causal disturbance in the process of maturation toward a maternal identity, problems in the relationship between both late and minority-age mothers reveal many similarities, though there are also fundamental differences between the two. PMID- 2710737 TI - [The course of enuresis in childhood and adolescence]. AB - The outcome of 103 enuretics after a mean follow-up of 2.7 years showed remission of wetting in 63%. The figures varied considerably for different subgroups. Enuresis in association with conduct disorders had the worst outcome. Girls showed better response to treatment. A high score of behaviour abnormalities was related to poor outcome. A global outcome measure at follow-up added further information to remission rates. PMID- 2710738 TI - [Assessment of temperament in children]. AB - This paper describes the development of a questionnaire to assess the temperament of infants and preschool-children. A German version of the "Toddler Temperament Scale" (Fullard, McDevitt & Carey, 1984) was administered to 80 mothers of children hospitalized to undergo elective surgery. The factor structure of the questionnaire is quite heterogeneous, and it corresponds well with a priori conceptualizations regarding children's temperament structure. The predictive validity of the questionnaire is evidenced by theoretically meaningful temperament related changes in the children's behavior after their dismissal from hospital. PMID- 2710739 TI - [Present-day families--anti-family families?]. AB - Alternative forms of living had their origin in the 1968-movement, which opposed directly the family. Meanwhile, this critical impulse has born many divergent forms of alternative living. Some of them have a family-analogue character together with a critical intention towards families. Thus, they are called here "Anti-Family-Families". They meet difficulties which can neither be understood by clinical theory of neurosis nor by a theory of family dynamics alone; a reconsideration of cultural and societal change must be included. This influence of change on therapeutic process is an unanswered challenge for the family therapist, who meets the influence of alternatively changed family life even in the treatment of "normal" families. PMID- 2710740 TI - [Prevention--a promising goal or illusory task for institutional child guidance, adolescent and family counseling?]. AB - Beginning with some comments on prevention as a concept that is en vogue the meaning of the concept in scientific literature is described. Hereafter the field of prevention is differentiated. Primary and general forms of prevention as well as secondary and specific forms of prevention are specified. Preventive activities in the field of child-guidance, youth- and family-counselling are shown. As an example for these activities a small survey is reported followed by remarks about the critical approach of community health proponents towards the position of institutionalized child-guidance and youth- and family-counselling within the field of psycho-social services. Next the work with clients of lower class background is characterized. Finally some primary preventive activities of social-political relevance basing on the practical experience of institutionalized child-guidance, youth- and family-counselling are given. PMID- 2710741 TI - Ethical problems in prenatal diagnosis: a cross-cultural survey of medical geneticists in 18 nations. AB - In order to provide a basis for international discussion of ethics among geneticists, we surveyed the responses of medical geneticists to a questionnaire describing 14 hypothetical cases that posed ethical dilemmas. The cases were selected through discussions with leading geneticists in 12 nations, as representative of the most difficult problems of moral choice experienced in practice. Six cases involved indications for prenatal diagnosis or disclosure of information. All medical geneticists in each of 18 nations were included. Of 1053 asked to participate, 677 (64 per cent) responded. A large majority (83 per cent) would perform prenatal diagnosis for parents who oppose abortion but request the service. A smaller majority (63 per cent) would do so for maternal anxiety, and a minority (25 per cent) would perform for sex selection in the absence of X-linked disease. Most would disclose conflicting controversial, or ambiguous test results, and two-thirds would disclose colleagues' differences of opinion. PMID- 2710742 TI - First-trimester diagnosis of Menkes disease: intermediate copper values in chorionic villi from three affected male fetuses. AB - Chorionic villus samples with copper contents of 1.91, 4.2, 5.6, and 6.3 ng/mg were observed in four cases with male karyotypes. These values were outside the range for unaffected males (0.30-0.85 ng/mg), and three of them were outside the control range (0.20-2.39 ng/mg). But these three values were below the values previously observed for affected Menkes fetuses (12.0-24.8 ng/mg). Follow-up by 64Cu uptake studies on the amniotic fluid cells was performed in three of these cases. A combination of 64Cu uptake and chase experiments on the amniotic fluid cells showed more convincingly than 64Cu uptake per se the direct copper values of 4.2 and 5.6 ng/mg to correspond to affected fetuses. Amniotic fluid cells from the male fetus with the CV copper value of 1.9 ng/mg showed normal results. The CV copper value of 6.3 ng/mg was considered pathognomonic for Menkes disease. The pregnancy was terminated, and the diagnosis was confirmed on fetal fibroblasts. Maternal deciduum prepared from the placentae showed in one of the cases with an affected fetus copper values ranging from 1.5 to 5.7 ng/mg. In six additional diagnostic cases, the copper content was determined in both CV samples and maternal deciduum. In three of these cases with normal CV sample copper, maternal decidua values of 4.85-7.8 ng/mg copper were observed. These results show that maternal deciduum contamination of a CV sample could cause a false-positive diagnosis. PMID- 2710743 TI - Amniotic fluid acetylcholinesterase measurements: comparing immunochemical and polyacrylamide gel techniques. AB - In the present study, a recently reported immunochemical technique for measuring acetylcholinesterase (AChE) in amniotic fluid utilizing the 4F19 antibody was compared with the widely utilized polyacrylamide gel technique to determine whether the immunochemical assay provided an advantage in separating unaffected pregnancies from those associated with open spina bifida (OSB) and open ventral wall defects (OVWD). The study included (1) 73 amniotic fluid samples from unaffected pregnancies [alpha-fetoprotein (AFP) less than 2 MoM] with no visible gel AChE band, (2) nine bloodstained samples from unaffected pregnancies (AFP 2.2 4.0 MoM) with visible gel AChE bands, (3) 18 samples associated with OSB (AFP 2.2 7.0 MoM) with visible gel AChE bands, and (4) 20 samples associated with OVWD (AFP 3.2-53.5 MoM) with visible gel AChE bands. The immunochemical assay produced ranges of measurements in the four respective categories as follows: (1) 2-60 arbitrary units (AU): (2) 14-69 AU, (3) 61-593 AU, and (4) 22-476 AU. Eight of the nine unaffected pregnancies with visible gel AChE bands had immunochemical measurements below the highest measurement for the samples with no visible AChE band (60 AU), as did five out of 20 OVWD pregnancies. Two of the OSB cases had values of 61 and 62 AU. These data indicate that the 4F19 specific monoclonal antibody to AChE is capable of distinguishing unaffected from affected pregnancies with reasonable reliability but that more work needs to be done to establish the extent of overlap between the unaffected and affected populations. PMID- 2710744 TI - First-trimester amniotic fluid acetylcholinesterase electrophoresis. AB - Acetylcholinesterase (AChE) gel electrophoresis was performed on normal amniotic fluids obtained at 4-15 weeks of pregnancy. Until 8 weeks, all the fluids were AChE-positive; the percentage of positive specimens decreased from 9 until 11 weeks and no positive specimen was found after 12 weeks. This method may allow early prenatal diagnosis of neural tube defects after the 12th week. PMID- 2710745 TI - Normal ranges of the activities of ten different enzymes in 100 independent preparations of chorionic villi. Comparison of specimens from induced abortions, biopsies, and cultured cells. AB - In order to obtain a large set of normal control values, the activities of three cytosolic enzymes of purine metabolism and seven lysosomal enzymes were determined in homogenates of chorionic villi derived from induced abortions of normal pregnancies (7th-12th week) in about 100 individual cases. Possible reasons for the rather wide ranges of normal distributions of enzyme activities are discussed. The values are compared: (1) with available data in the literature; (2) with activities determined in decidual homogenates prepared from the same samples; (3) with activities of cells of cultures established and grown from villi in the same samples; and (4) with enzyme activities measured in chorionic biopsies using the same methods. Implications for the prenatal diagnosis of the associated metabolic diseases are considered. PMID- 2710746 TI - Chorionic villus sampling--short-term versus long-term culture in a subtle 2; 18 translocation. AB - Prenatal diagnosis on chorionic villous tissue was performed for a woman with the karyotype 46,XX,t(2;18)(q32;q12)--a subtle 'difficult' translocation. The case illustrates the necessity of good quality cytogenetics for accurate prenatal diagnosis. For chorionic villi this can be obtained only with long-term culture. PMID- 2710747 TI - Another case of completely discordant findings at CVS. PMID- 2710748 TI - The use of Streptococcus zymogenes for estimating tryptophan and methionine bioavailability in 17 foods. AB - As part of a cooperative study assessing amino acid bioavailability and/or protein quality, the provisional method of Boyne et al. (Brit J Nutr 21: 181-206) was used to assay 17 protein sources for methionine and tryptophan availability with S. zymogenes. Pronase was used as the predigesting enzyme. Product composition was found to affect reproducibility. The microbial assay results correlated positively with results from rat growth studies on the same foods (p = 0.05), and were generally accurate in identifying products of lower protein quality. Defatting four high-fat products increased microbial values in the methionine assay, but only the chicken franks and the sausage values in the tryptophan assay. Heating non-fat milk increased methionine values slightly. Low values for rolled oats were further reduced by finer grinding. PMID- 2710750 TI - A collaborative study of methods of protein evaluation: introductory paper. AB - The USDA's collaborative study of methods of protein quality evaluation is introduced. It was intended primarily to provide a basis for the evaluation of possibly improved procedures for the labelling of foods as a source of dietary protein. In general, the usefulness of in vitro digestibility procedures has been confirmed, but problems remained for the in vitro evaluation of heat-damaged materials and of some types of pinto beans. PMID- 2710749 TI - Digestibility of protein and amino acids in selected foods as determined by a rat balance method. AB - Values (%) for true digestibility of crude protein and individual amino acids in 20 selected foods were determined by the rat balance (fecal) method. The products were fed as the sole source of protein in diets containing 8% crude protein (N x 6.25). Lowest true protein digestibility values (79-84) were obtained for pinto beans, kidney beans and lentils; intermediate values (89-92) were obtained for chick peas, beef stew, skim milk (over heated), rolled oats, whole wheat cereal, and pea protein concentrate; and highest values (94-100) were obtained for sausage, macaroni-cheese, rice-wheat gluten cereal, skim milk, tuna, soy isolate, peanut butter, chicken frankfurters, beef salami, casein and casein + methionine. In animal foods, peanut butter and soy isolate, the differences between true digestibility of crude protein and most individual amino acids were less than 5%. However, the values for true digestibility of methionine and cystine were up to 44% lower than those of crude protein in pinto beans, kidney beans, lentils, chick peas and pea concentrate. In these legumes, digestibility of crude protein was not a good predictor of digestibility of the limiting amino acids. PMID- 2710751 TI - Relationship between amino acid scores and protein quality indices based on rat growth. AB - Protein efficiency ratio (PER), relative PER (RPER), net protein ratio (NPR) and relative NPR (RNPR) values, and amino acid scores were calculated for 20 food products (casein, casein + Met, beef salami, skim milk, tuna, chicken frankfuters, sausage, heated skim milk, peanut butter, rolled oats, soy isolate, chick peas, pea concentrate, kidney beans, wheat cereal, pinto bean, lentils, rice-wheat gluten cereal, macaroni-cheese, and beef stew). In most cases, PER, RPER, NPR or RNPR ranked the products in the same order and positive correlations among the protein quality methods were highly significant (r = 0.98-0.99). Amino acid scores (based on the first limiting amino acid, Lys-Met-Cys, Lys-Met-Cys-Trp or lys-Met-Cys-Trp-Thr) were positively correlated to the PER, RPER, NPR or RNPR data (r = 0.61-0.75). Inclusion of the correction for true digestibility of protein improved the correlations between amino acid scores and the indices based on rat growth. The correlations were especially high between Lys-Met-Cys scores (corrected for true digestibility of protein) and PER, RPER, NPR or RNPR (r = 0.86-0.91). Inclusion of the correction for true digestibility of individual amino acids did not result in further improvements of the correlations in most cases. It is concluded that adjusting amino acid scores for true digestibility of protein would be sufficient and further correction for digestibility of amino acids would be unnecessary in mixed diets. PMID- 2710752 TI - Protein efficiency ratios and net protein ratios of selected protein foods. AB - As a part of a cooperative study initiated to assess both in vitro and in vivo protein quality methods, the protein efficiency ratio (PER) and net protein ratios (NPR) of 15 different protein sources were determined. Male weanling Sprague-Dawley rats were fed a 10% protein diet. Fourteen-day NPR and relative NPR (RNPR) values and 14- and 28-day PER and relative PER (RPER) values were calculated for each protein source. When protein quality values were expressed relative to ANRC casein, the 14- and 28-day PER data ranked the protein sources essentially in the same order. RPER values of nonfat dried skim milk (unheated) and tuna were more than 100% that of casein; nonfat dried skim milk (heated), chickpeas, and breakfast sausage were between 50 and 70% of that of casein; and pinto beans and rice-wheat gluten cereal did not support substantial growth of the rat. The NPR method did not always rank the protein sources in the same order as the PER method. For the poor quality proteins, RNPR values were much higher than the RPER values; however, the RNPR and RPER values agreed closely for high quality protein sources. PMID- 2710753 TI - Digestibilities of the protein in various foods as determined in vitro by an immobilized digestive enzyme assay (IDEA). AB - The digestibility of the protein in various foods or food components was analyzed using an immobilized digestive enzyme assay (IDEA) system. The assay consists of two bioreactors, one containing pepsin and the other containing trypsin, chymotrypsin and intestinal mucosa peptidases. The fraction of the peptide bonds hydrolyzed during an extent of hydrolysis assay was correlated with independent in vivo determinations of the digestibilities. A correlation coefficient of 0.80 was obtained. The derived linear regression equation can be used to predict digestibility. The method is sensitive to structural modification of protein, as for example, those caused by effects of heat treatment. PMID- 2710754 TI - Rat bioassays for methionine availability in 16 food sources. AB - Methionine availabilities of 16 test proteins were assessed by comparing ten day rat growth response to the test diets and reference (casein) diets. In a preliminary study, various concentrations of methionine and cystine were fed to determine methionine requirements and effect of excess cystine. Results indicated a methionine requirement of about 550 mg per 100 g diet. Cystine had a sparing affect of 50-55%, i.e., about 300 mg could be used to meet methionine requirements. Further additions of cystine (up to 2.6 times methionine) did not affect rat growth. Methionine availabilities were excellent (88-100%) for 15 of the 16 test foods; only pinto beans (58%) were low, but prior evidence indicates that the poor growth response was due to some factor other than availability. PMID- 2710755 TI - Bioavailability of tryptophan in selected foods by rat growth assay. AB - Tryptophan bioavailabilities were estimated in 16 protein sources using 10 day rat growth assays with casein as the reference protein. Growth responses of rats fed test food diets were compared to growth responses of rats fed basal diets with graded levels of tryptophan ranging from 50 to 100 mg of tryptophan/100 g diet. Estimates of tryptophan availabilities were 85-100% for all products except whole wheat cereal (73%) and pinto beans (59%). Results of a previous study on lysine availability indicated that poor response to pinto beans was due either to poor digestibility or to the presence of some unidentified growth inhibitor. PMID- 2710756 TI - Cardiovascular risk factors among black schoolchildren: comparisons among four Know Your Body studies. AB - Baseline cardiovascular risk factor variables were obtained from 1,041 black District of Columbia children in Grades 4-6 as part of a Know Your Body evaluation project. Screening included height, weight, triceps skinfold measurements, systolic and diastolic blood pressures, step-test for fitness, serum cholesterol, high-density lipoprotein cholesterol and thiocyanate. Results were compared with those in three other Know Your Body studies, Bronx, New York, Westchester, New York, and Los Angeles, and indicated that District of Columbia black children are more likely to have high cholesterol levels and to fail the fitness test than black children in the other studies. In the District of Columbia, obese children had significantly higher total serum cholesterol, systolic, diastolic, and high-density lipoprotein levels, and were less fit than other District of Columbia children; almost three-fourths of all of the children had one or more risk factors. Socioeconomic status was negatively correlated with diastolic blood pressure, skinfold thickness, and cholesterol levels and was positively correlated with high-density lipoprotein cholesterol. Rates of obesity and diastolic blood pressure were consistent with Bronx and Westchester comparisons suggesting that socioeconomic status interacts with ethnicity to determine risk factor levels. The existence of children with multiple risk factors in all of the Know Your Body studies supports the need for early intervention. PMID- 2710757 TI - Barriers to screening for cancer of the cervix. AB - Despite the widespread availability and demonstrated efficacy of screening with the Papanicolaou smear, many women are screened irregularly or not at all. This study was designed to identify the barriers that prevent those women at risk for cervical cancer from being screened. Complete cervical cytology screening histories were taken during a population-based case-control study of invasive squamous cell carcinoma of the cervix involving 200 patients and their matched neighborhood controls. Smears taken during the previous 5 years were verified whenever possible. Ordinal logistic regression analysis was used to identify seven factors that significantly (P less than 0.05) and independently predicted regular recent screening among both cases and controls [failure to understand the importance and screening nature of cervical smears (-), expressed fears of embarrassment (-), having had a urogenital infection (+), number of pregnancies during the last 5 years (+), the number of pregnancies for which no prenatal care was sought (-), and knowledge of the recommended screening interval (+)], two variables that predicted screening among cases but not controls [age (-) and number of years of oral contraceptives use (+)], and one that predicted screening only among controls [years of living in the United States (+)]. Education, income, Latin heritage, being married, having a regular physician for one's medical care, and all other methods of birth control were significant predictors of screening in the univariate analyses, but were explained by the other more powerful predictors in the multivariate analysis. PMID- 2710758 TI - Toward an effective school health education policy: a call for legislative and educational reform. PMID- 2710759 TI - American Health Foundation proposed model legislation: comprehensive school health education program. PMID- 2710760 TI - A multivariate study of determinants of vigorous exercise in a community sample. AB - The purpose of this study was to explore the associations between several social learning theory variables and self-reported vigorous exercise and to consider the implications for exercise promotion. A random sample of adults in San Diego, California, was surveyed by mail. The 2,053 respondents (response rate, 43.4%) overrepresented Caucasian, affluent, and well-educated groups. A model of 24 variables accounted for 0.27 of the variance in exercise, and results strongly supported social learning theory. The strongest correlates were self-efficacy (i.e., confidence in the ability to exercise in specific situations), perceived barriers to exercise, modeling, dietary habits, support from friends, and age. Smoking was inversely associated with exercise in men only. We encourage researchers to conduct intervention trials to test the hypotheses generated in this study. PMID- 2710761 TI - Is Italy losing the "Mediterranean advantage?" Report on the Gubbio population study: cardiovascular risk factors at baseline. Gubbio Collaborative Study Group. AB - The coronary heart disease mortality rate in Italy--lower than in many other industrialized countries--has changed little in the last 20 years, whereas in the United States, a major decline in deaths resulting from coronary heart disease has occurred. These differing trends have reduced considerably the gap between the two countries in coronary mortality rates. Several recent population studies in Italy have found a change in the previously more favorable risk factor profile. In the northern hill town of Gubbio, studied in 1983-1985, median serum cholesterol level of men ages 40-59 was 223 mg/dl, considerably higher than was found in the 1960 Italian population samples of the Seven Countries Study (197 206 mg/dl). In the earlier study, the cholesterol levels in the Italian men who were still mainly consuming the traditional Mediterranean diet were 30-40 mg/dl lower than in the U.S. sample. The 1980 Gubbio levels, however, were at least as high as those of their U.S. contemporaries. Cigarette smoking was much higher among the middle-aged men of Gubbio than among a similar U.S. population sample (56% vs 36%). Hypertension prevalence was high, and several risk factors for hypertension--obesity, high salt intake, and alcohol--were common in the Gubbio as well as in other recent Italian population studies. The changing coronary risk profile in Italy, which now includes higher population levels of serum cholesterol as well as the other major coronary heart disease risk factors of cigarette smoking and hypertension, threatens to reduce markedly the "Mediterranean advantage" enjoyed by Italy in the past. PMID- 2710762 TI - Physicians' perceptions of their role in cardiovascular risk reduction. AB - Fifty randomly selected family physicians were interviewed to evaluate the role of primary care physicians in the reduction and control of cardiovascular risk in their patients. The interview schedule, developed from the PRECEDE framework, incorporated three categories of factors modifying behavior: predisposing, reinforcing, and enabling. In relation to high blood pressure, elevated serum cholesterol, and smoking, physicians were questioned regarding (a) knowledge and beliefs of desirable practice, (b) perceptions of personal ability, (c) factors that affect their preventive performance, and (d) perceptions of their own role and those of other resources. Physicians believed all three risk factors to be modifiable, and that reduced cardiovascular risk could prolong life and improve quality of life. Participants perceived themselves most effective in reducing high blood pressure, followed by serum cholesterol reduction and smoking cessation. Relationships with patients, patient compliance, personal committment, and belief in the efficacy of risk reduction were most frequently perceived to contribute to effectiveness. Physicians perceived themselves least skilled in enhancing patient compliance and achieving behavior change. Most physicians were committed to cardiovascular disease prevention and saw their own role as central. Contributions of other resources were not well understood. The effect of these complex and interacting perceptions has implications for attempts to enhance physicians' preventive activities. PMID- 2710763 TI - The development, implementation, evaluation, and future directions of a chronic disease prevention program for children: the "Know Your Body" studies. AB - In 1975, the American Health Foundation initiated the development, implementation, and evaluation of a school-based, teacher-delivered program of the primary prevention of heart disease, cancer, and stroke. The aims of this program, entitled "Know Your Body," are to modify favorably the population distributions of risk factors for chronic disease through changes in diet, physical activity, and cigarette smoking. After more than a decade of investigation, this program has been found to be feasible and acceptable to school personnel, students, and parents, and appears to have had favorable effects on prevention-related knowledge, dietary intake, obesity, blood cholesterol levels, and the rate of initiation of cigarette smoking among diverse populations of school children in the New York City area. If these findings can be replicated, the widespread implementation of such programs has the potential to reduce the population risk for the future development of the nation's leading causes of premature mortality. PMID- 2710764 TI - Banning smoking in a children's hospital: are employees supportive? AB - This study surveyed 762 professional and auxiliary employees in a large urban children's hospital to assess readiness for a total ban on smoking. The prevalence of never smokers was 63.1%, former smokers was 21.1%, and current smokers was 15.1%. Among nonsmokers, 83% indicated that a children's hospital should be smoke-free. The attitudes of former smokers were almost identical to those of never smokers. Less than half of current smokers (43%) agreed with a ban on smoking which suggests some support for a smoke-free setting even among smokers. In multivariate analysis, smokers, however, were eight times less likely to agree with such a policy, independent of age, sex, and occupation. This study suggests that the majority of employees are supportive of a total ban on smoking but that special efforts to help smokers stop smoking may enhance the effectiveness of a policy banning smoking in a children's health care facility. PMID- 2710765 TI - [Imaging and measurement of global and regional airflow in the lung using a radioactive gas]. AB - In this paper it is shown how "circumscribed" movements of air within the lungs, such as those occurring during respiration, can be visualized and measured with the aid of the radio-active gas krypton 81 m. With this new examination technique, the previously employed procedures used for investigating the lungs have been expanded: In the imaging procedures sector, function patterns of regional ventilation can now be recognized, while the diagnostic evaluation of pulmonary function is complemented by the regional identification of disturbed and undisturbed ventilation. The equipment required for the examination is available in any nuclear medical department, and the methodology is relatively simple. The use of such studies is described on the basis of two clinical cases: The findings obtained with this new procedure clearly demonstrate the expansion of the diagnostic evaluation, and already point to the indications. Since 1982, we have carried out some 1,500 investigations of pulmonary ventilation. On the basis of the experience thus gained, a spectrum of indications can be established, and this is represented in the "Discussion". The inert gas, krypton, which is both odourless and chemically inert and has optimal physical properties for nuclear medical studies, has been shown by our investigations to be highly suitable for sophisticated analyses of pulmonary function, also in the severe-ill patient. Properly and rationally employed, the procedure is economical, and the radiation exposure low. PMID- 2710766 TI - [Bronchocentric granulomatosis]. AB - We describe the case of a 53-year-old woman patient with recurrent attacks of fever, in whom, both roentgenologically and computer-tomographically, a shadow was found in the anterior upper lobe segment of the right lung, and a presumptive diagnosis of a tumour in underlying retention pneumonia was established. For this reason, this segment was resected. The histologic work-up of the surgical specimen revealed bronchocentric granulomatosis. The clinical and morphological findings, together with differential diagnostic considerations of this relatively rare disease, are discussed. PMID- 2710767 TI - [Changes in the bronchial musculature in chronic obstructive respiratory tract diseases]. AB - Changes in the bronchial musculature in patients with chronic obstructive lung disease, were submitted to a systematic electron-microscopic investigation. A marked interstitial fibrosis with degenerative changes affecting the muscle cells was observed. The formal pathogenetic course of these changes can be reconstructed on the basis of numerous individual findings. The muscle cells are progressively "ensheathed" in a disorderly fine-filamentous basic structure (matrix), and in collagenous fibres. As a result, the contact surfaces between the muscle cells are disturbed, and the nerve endings "displaced" from the muscle cells. This fibrosis is associated with a protracted "shrivelling" of the individual muscle cells. The changes involving the muscles of the bronchial wall are comparable with those seen in the smooth muscles of blood vessels involved in arteriosclerosis. The morphological changes to the muscles of the bronchi described in this paper strongly suggest that protracted fibrosis formation, coupled with the degradation of muscle cells, contribute to a loss of elasticity of the bronchial wall in chronic obstructive lung disease. PMID- 2710768 TI - [Effect of passive smoking on bronchial reactivity in school children]. AB - Passive smoking on the part of children leads to an increase in the incidence of upper airway infections in early childhood, an elevated incidence of childhood asthma, and an aggravation of existing asthma. We investigated the bronchial reactivity of 80 healthy, symptom-free schoolchildren, 44 from smoking families (SF), 36 from non-smoking families (NF), employing treadmill exercise during which the subjects inhaled cooled air (-2 degrees C), and compared the results obtained with those found in a group of 27 children with asthma (A). A positive bronchial reaction (50 per cent Raw increase following exercise on the treadmill) was observed significantly more frequently in the SF group than in the NF group (22 out of 44 children as compared with 10 out of 36 children, p less than 0.05); both groups differed significantly from the group of asthmatics (21 out of 27 children). It is concluded that bronchial hyperreactivity occurs more frequently in clinically healthy, passively smoking children as compared with a control group. PMID- 2710769 TI - [Persulfate asthma in hairdressers]. AB - At the a two-year apprenticeship, a young female hairdresser developed rhinoconjunctivitis and bronchial asthma, induced by a hair bleach containing the substance persulphate. On each occasion, her symptoms occurred in the form of an immediate reaction. The causative role of the bleach was demonstrated with the aid of an inhalation challenge test. In addition, the prick test produced a positive reaction vis-a-vis persulphate. The long latency period and the positive prick test might militate in favour of an allergic pathomechanism. PMID- 2710770 TI - Host-parasite relationship of Trypanosoma corvi in Ornithomyia avicularia. AB - The first description of an electron microscopic study of Trypanosoma corvi in the vector Ornithomyia avicularia is reported. There is a close association between vector and parasite in the midgut, ileum and rectum of the vector. The midgut distribution of parasites is determined by the peritrophic membrane, which confines the early infection to the endoperitrophic space. Parasites escape from the ruptured region of the peritrophic membrane at the pylorus to gain access to the ectoperitrophic space, where intense multiplication occurs. The resulting, smaller epimastigotes attach to the cuticle in the pylorus, ileum and rectum, where they continue multiplying to give rise to mature, short, stumpy trypomastigotes (metacyclics) that are not attached. Attachment to these cuticularly lined regions occurs by the formation of dense, hemidesmosome-like plaques at the extremities of the expanded flagella. A fibrous matrix surrounds the parasites in the ileum. For the first time, intracellular midgut forms are reported for T. corvi in O. avicularia. These parasites enter the cells between the microvilli and penetrate deeply between the folds of the midgut. In the midgut of O. avicularia, the cells of a mycetome region are packed with Rickettsia-like organisms. The significance of these intracellular parasites in the relationship of T. corvi in O. avicularia remains unknown. PMID- 2710771 TI - Efficacy of experimental trypanocidal compounds against a multiple drug-resistant Trypanosoma brucei brucei stock in mice. AB - Several experimental trypanocidal compounds, 6-amidino-2-(4-amidinophenyl)indole dilactate (DAPI), DL-alpha-difluoromethylornithine (DFMO), 2-(dimethylamino)-4' [(1-methyl-2-nitroimidazole-5-yl) methoxy] aceto-anilide (Ro 15-0216), sinefungin, and triacetylbenzene-tris(guanylhydrazone)trimethanesulfonate hydrate (TBG-MS) were tested to evaluate their ability to cure mouse infections with a multiple drug-resistant Trypanosoma brucei brucei stock (CP 547). This stock proved to be drug-resistant against diminazene aceturate, homidium chloride, isometamidium, quinapyramine sulfate, Mel B, and pentamidine isethionate but fully sensitive to suramin. Compared with the sensitive stock CP 462, the drug resistant stock CP 547 was completely resistant to 16-fold the curative dose of sinefungin and partially resistant to 4-fold the curative dose of DAPI and to 13 fold the curative dose of TBG-MS, a dose that killed 25% of the animals due to its toxicity. Ro 15-0216 cured all mice when 18 times the usual curative dose level was given. DFMO was equally effective against both stocks. PMID- 2710772 TI - Effects of infection with Eimeria labbeana on some serum constituents and liver glycogen in the palm dove (Streptopelia senegalensis aegyptiaca). AB - The concentrations of total serum proteins, total lipids, glucose, and liver glycogen were determined in normal as well as Eimeria-infected palm doves. A highly significant increase in total serum protein concentration was observed in infected birds as compared with that seen in noninfected doves. There was an increase in total serum lipids subsequent to infection, but this was only significant in females. No significant increase in serum glucose concentration was observed in infected male or female birds. However, an insignificant decrease in the liver glycogen level of both male and female infected doves was observed. PMID- 2710773 TI - Aminopeptidase activity in the brains of mice with chronic Toxoplasma gondii infections. AB - Aminopeptidase activity on beta-naphthylamide (NA) substrates was assayed in brain extracts from normal and Toxoplasma gondii-infected mice at 4 months postinfection. Correlations of levels of aminopeptidase activity, Toxoplasma specific antibody production, and the number of brain cysts were studied in normal and Toxoplasma-infected mice. The Toxoplasma-specific antibody and the formation of cysts were markedly enhanced in the parasite-infected mice. The highest levels of activity for the NA substrates tested were observed in normal mice. In contrast, the activity levels were significantly lower in T. gondii infected mice than in the corresponding normal mice. These results suggest an association between chronic toxoplasmosis and aminopeptidase activity in the parasite-infected host brain. PMID- 2710774 TI - Some aspects of Leucocytozoon caulleryi reinfection in chickens. AB - The role of first- and second-generation schizonts in acquired immunity to Leucocytozoon caulleryi in chickens was studied. The chickens, which had recovered from a primary infection with various doses of sporozoites at 22-95 days of age, were challenged with sporozoites. First-generation merozoites were found in all of the challenged chickens, but no second-generation merozoites and gametocytes were seen in 30 of 32 chickens challenged with sporozoites. Almost all of the chickens that had recovered from a primary infection with sporozoites showed complete resistance to reinfection, and those that had recovered from a primary infection with first-generation merozoites showed resistance to reinfection with sporozoites. These results indicate that the second-generation schizont of L. caulleryi appears to be more immunogenic than the first-generation schizont and that some immune factors acquired by the chickens in the second generation of schizogony may inhibit the development of second-generation schizonts. PMID- 2710775 TI - Alterations in hemolymph components in Biomphalaria glabrata during long-term infection with Schistosoma mansoni. AB - Total protein, hemoglobin, glucose, and urea concentrations in hemolymph of Biomphalaria glabrata were studied during a 12-week infection of the snails with Schistosoma mansoni. The results suggest an equilibrium between host and parasite metabolism, which is reached after about 6 weeks of infection. During the period studied, the protein spectrum of infected snails showed no difference in quality compared with that of noninfected snails; all fractions were present, and no additional fractions appeared. Only the lipoprotein fraction increased fourfold in the 1st week of infection, decreasing during the 2nd week to concentrations that were also found in noninfected individuals. No further significant alterations could be detected until week 12 postinfection (PI). PMID- 2710776 TI - Scanning electron microscopic study of four Diphyllobothrium species. AB - Three-dimensional observation was carried out on plerocercoids and adults of Diphyllobothrium dendriticum, D. ditremum, D. latum, and D. vogeli using scanning electron microscopy. The species-specific differences between plerocercoids were recognized in the shapes of the whole body, scolex, and bothrium and the wrinkle pattern on the body surface. The differences between adult worms were also observed in the shapes of the scolex, neck, and genital papillae around the genital pore and the pattern on the egg surface. The significance of species specificity in the three-dimensional morphology of diphyllobothriid cestodes is briefly discussed. PMID- 2710777 TI - Localisation of Plasmodium chabaudi antigens by cryomicrotomy using monoclonal antibodies and the immunogold-silver staining method for light microscopy. PMID- 2710778 TI - Protein structure analysis and development of databases. PMID- 2710779 TI - Chemical and computer graphics studies on the topography of the ribonuclease A active site cleft. A model of the enzyme-pentanucleotide substrate complex. AB - The affinity labelling of bovine pancreatic ribonuclease A with 6-chloropurine 5' ribonucleotide allowed us to postulate the existence of a new phosphate-binding subsite, P2, adjacent to the main purine-binding subsite. The study of this reaction in greater detail together with the study of a complex of the enzyme with the pentanucleotide pApUpApApG by means of model building and computer graphics indicate that at least five phosphate groups of the RNA molecule can interact with five positive regions of the enzyme. In each one a lysine residue is present: Lys-104, -66, -41, -7 and -37 appear sequentially in the 5'----3' direction. The distance between each lysine is 0.7-0.8 nm, the same distance as that found between the phosphate groups on the RNA molecule. The study also enabled many amino acid residues of the enzyme to be described as forming part of, or being near, the different binding subsites. PMID- 2710780 TI - A relational database of protein structures designed for flexible enquiries about conformation. AB - A relational database of protein structure has been developed to enable rapid and flexible enquiries about the occurrence of many aspects of protein architecture. The coordinates of 294 proteins from the Brookhaven Data Bank have been processed by standard computer programs to generate many additional terms that quantify aspects of protein structure. These terms include solvent accessibility, main chain and side-chain dihedral angles, and secondary structure. In a relational database, the information is stored in tables with columns holding the different terms and rows holding the different entries for the terms. The different relational base tables store the information about the protein coordinate set, the different chains in the protein, the amino acid residues and ligands, the atomic coordinates, the salt bridges, the hydrogen bonds, the disulphide bridges and the close tertiary contacts. The database was established under ORACLE management system. Enquiries are constructed in ORACLE using SQL (structured query language) which is simple to use and alleviates the need for extensive computer programs. A single table can be searched for entries that meet various criteria, e.g. all protein solved to better than a given resolution. The power of the database occurs when several tables, or the entries in a single table, are cross-correlated. For example the dihedral angles of proline in the fourth position in an alpha-helix in high resolution structures can be rapidly obtained. The structural database provides a powerful tool to obtain empirical rules about protein conformation. This database of protein structures is part of a joint project between Birkbeck College and Leeds University to establish an integrated data resource of protein sequences and structures (ISIS) that encodes the complex patterns of residues and coordinates that define protein conformation. The entire data resource (ISIS) will provide a system to guide all areas of protein modelling including structure prediction, site-directed mutagenesis and de novo protein design. The availability of ISIS is described in the paper. PMID- 2710781 TI - Prediction of protein secondary structure based on physical theory. Histones. AB - Secondary structures of histones H1, H2A, H2B, H3, H4 and H5 have been calculated by the computer program ALB based on a molecular theory of protein secondary structure. The predicted secondary structures of all histones are predominantly alpha-helical. The calculated secondary structure of linker histones H1 and H5 is close to that previously obtained from two-dimensional NMR data. For each of the core histones (H2A, H2B, H3, H4) one long alpha-helix and several short ones have been predicted. These long helices can be identified with rods in the low resolution electron density map. PMID- 2710782 TI - Point mutations modifying the thrombin inhibition kinetics and antithrombotic activity in vivo of recombinant hirudin. AB - The hirudin variant HV2 was modified by in vitro site-specific mutagenesis of HV2 cDNA to generate HV2(Asn-47----Lys), HV2(Asn-47----Arg) and HV2(Lys-35----Thr, Asn-47----Lys). Residues 35 and 47 are positioned respectively within the finger and prothrombin-like domains of hirudin, both of which have been suggested as thrombin binding sites. The modified polypeptides were synthesized in Saccharomyces cerevisiae using a secretion vector and purified from culture supernatants. By analysis of the human alpha-thrombin:hirudin inhibition reaction in steady-state conditions it was shown that the dissociation constants for HV2(Lys-47) and HV2(Arg-47) were 5- to 14-fold lower than for unmodified HV2, whereas mutation of Lys-35 did not significantly alter the inhibition kinetics. Furthermore, HV2(Lys-47), whose sequence is identical to a natural hirudin variant, displayed enhanced anti-thrombotic activity in vivo, having a 100-fold lower ED50 compared to HV2 in the rabbit Wessler venous thrombosis model. These results support a role for the prothrombin-like domain in thrombin binding and, moreover, demonstrate that in vivo antithrombotic efficiency correlates with the dissociation constant of the inhibition reaction. PMID- 2710783 TI - Evidence for the involvement of tyrosine-69 in the control of stereospecificity of porcine pancreatic phospholipase A2. AB - We have studied the role of Tyr-69 of porcine pancreatic phospholipase A2 in catalysis and substrate binding, using site-directed mutagenesis. A mutant was constructed containing Phe at position 69. Kinetic characterization revealed that the Phe-69 mutant has retained enzymatic activity on monomeric and micellar substrates, and that the mutation has only minor effects on kcat and Km. This shows that Tyr-69 plays no role in the true catalytic events during substrate hydrolysis. In contrast, the mutation has a profound influence on the stereospecificity of the enzyme. Whereas the wild-type phospholipase A2 is only able to catalyse the degradation of sn-3 phospholipids, the Phe-69 mutant hydrolyses both the sn-3 isomers and, at a low (1-2%) rate, the sn-1 isomers. Despite the fact that the stereospecificity of the mutant phospholipase has been altered, Phe-69 phospholipase still requires Ca2+ ions as a cofactor and also retains its specificity for the sn-2 ester bond. Our data suggest that in porcine pancreatic phospholipase A2 the hydroxyl group of Tyr-69 serves to fix and orient the phosphate group of phospholipid monomers by hydrogen bonding. Because no such interaction can occur between the Phe-69 side-chain and the phosphate moiety of the substrate monomer, the mutant enzyme loses part of its stereospecificity but not its positional specificity. PMID- 2710784 TI - High level expression of a synthetic gene coding for IgG-binding domain B of Staphylococcal protein A. AB - A gene coding for one of the IgG-binding domains of Staphylococcal protein A, designated domain B, was chemically synthesized. This gene was tandemly repeated to give dimeric and tetrameric domain B genes by the use of two restriction enzymes which gave blunt ends. The genes were highly expressed in Escherichia coli to afford a large amount of dimeric and tetrameric domain B proteins. The single domain B protein was efficiently produced as a fusion protein with a salmon growth hormone fragment. The fusion protein was converted to monomeric domain B by cyanogen bromide cleavage. The CD spectra of the monomeric, dimeric and tetrameric domain B proteins were essentially the same as that of native form protein A, showing that their secondary structures were very similar. The dimeric and tetrameric domain B proteins formed precipitates with IgG as protein A. This system permits the efficient production of mutated single and multiple IgG binding domains which can be used to study structural changes and protein A immunoglobulin interactions. PMID- 2710785 TI - A novel dialysis procedure for the crystallization of proteins. AB - Various dialysis methods are commonly employed for the crystallization of proteins. Typical procedures include the use of dialysis bags, dialysis buttons or Zeppezauer microdiffusion cells. The general principle involved is that the protein solution is gradually brought to a point of supersaturation by imposing a gradient of ionic strength or organic solvent concentration across the wall of the dialysis membrane. However, in some cases, the imposition of this gradient across the dialysis membrane can result in the formation of a large number of crystal nucleation sites, thereby giving rise to a reduction in the maximum size of the crystals which can be obtained. A novel 'double-dialysis' procedure which incorporates a second dialysis membrane, thus reducing the rate of equilibration in the crystallization experiment, has been developed in our laboratory. The system has been employed successfully on the delta toxin of Staphylococcus aureus resulting in a useful increase in crystal size. A more quantitative analysis of the technique has been carried out on rat liver malic enzyme. The results of a limited series of crystallization trials with this protein have shown that employment of the 'double-dialysis' technique allows a fine control of the rate of crystal nucleation and therefore provides a mechanism for the controlled growth of large crystals. PMID- 2710786 TI - Striking sequence similarity among sialic acid-binding lectin, pancreatic ribonucleases, and angiogenin: possible structural and functional relationships. AB - We found that a sialic acid-binding lectin (SABL) from bullfrog egg bears a remarkable degree of similarity with human angiogenin and the pancreatic ribonucleases (EC 3.1.27.5). Based on (1) the conservation of several disulfide bond-forming cysteines, (2) a cluster of nonpolar residues, and (3) a number of active-site residues of bovine ribonuclease, we propose that SABL has essentially the same secondary and tertiary structures and very likely has ribonuclease activity. Other possible physiological roles are discussed. PMID- 2710787 TI - Structural and functional consequences of amino acid substitutions in hemoglobin as manifested in natural and artificial mutants. AB - Compiled data for more than 440 natural human hemoglobin mutants with single amino acid substitutions indicate that molecular properties (oxygen binding, structural stability, ease of autooxidization, etc.) of more than half of them are altered in some way and that the mode of alteration is closely related to the region within the hemoglobin molecule in which the substitution takes place. The present study gives a quantitative basis for the correlations. By means of protein engineering, including site-directed mutagenesis, several artificial mutants of human hemoglobin were prepared and their oxygen binding properties were studied to investigate the functional consequences of the amino acid substitutions which have not yet been isolated in natural mutants. These artificial mutants gave straight-forward information regarding the major factors regulating the oxygen affinity of heme and the identification of a Bohr group in the alpha chain. On the other hand the mutants, which were designed to test some hypotheses for the molecular evolution in hemoglobin, did not necessarily give the results predicted from accumulated structure-function data obtained from the study of natural mutants and X-ray crystallographic analyses. PMID- 2710788 TI - Rapid evolutionary repair of base mispairings in stem regions of eukaryotic 5S rRNA. AB - An extensive set of 216 eukaryotic 5S rRNA sequences are compared and the previous observations, that (i) invariable base positions are located primarily in loop regions and (ii) stem regions are more variable but the number of mispairings is kept small, are confirmed. On the basis of a comparison of the contemporary sequences, evolutionary processes of base substitutions in stem regions are discussed. It is found that there is no evident selective pressure to keep a particular kind of base pair in stem regions and individual bases may change freely as long as mispairings are kept few. It is also found that the secondary structure of 5S rRNA has been maintained stable by an equilibrium between base pair formation- and destruction-substitutions and that the low occurrence of mispairings in stem regions is attributable to a high value (ca. 90) of the equilibrium constant. The present analyses suggest a structure function relationship of the eukaryotic 5S rRNA; stem regions structurally help loop regions to interact well with other ribosomal components and therefore, there is a marked selection pressure to maintain the secondary structure under the evolutionary noise of mutation. PMID- 2710789 TI - The pattern of delivery and distribution of coronary venous retroinfusate in canine hearts. AB - The delivery and distribution of retroinfusate premixed with radionuclide microspheres (15 microns) in the coronary venous system of canine hearts was studied in in vitro and in vivo experiments. Results showed that about 51-85% of the retroinfusate was shunted directly by vessels greater than 15 microns in diameter to the right heart in cases of isolated heart study, while the remaining 21-42% passed through intramyocardial capillaries with obvious nutritional effects. In the closed-chest experiments, 95% of the retroinfusate was bypassed to the right heart; less than 5% went through the intramyocardial microcirculation system. Intramyocardial distribution pattern of the retroinfusate indicated a predominant supply to the left ventricular free wall. There was a preferential distribution of the retroinfusate to the ischemic area with a subendo subepi blood flow ratio of up to 1.79 +/- 0.21 post-LAD occlusion. PMID- 2710790 TI - Correlation study of left atrial pressure and pulmonary rheogram. AB - In order to observe correlations between LAP and PRG data, we placed small inflated balloons in the left atria of dogs to change LAP. We found good correlations between LAP and Q-6 interval (r = 0.88, P less than 0.001), b-s interval (r = -0.78, P less than 0.001), Hs (r = -0.59, P less than 0.001), Hs X b-s interval (r = -0.65, P less than 0.001), and HD/Hs (r = 0.50, P less than 0.001). The mechanisms of change of these parameters were investigated and corresponding regression equations derived. The authors point out that D wave enlargement and HD/Hs increase are determinant indices of LAP elevation and may be used to estimate LAP and to differentiate LAP elevation from simple pulmonary hypertension. Therefore, we conclude that PRG may reflect changes of pressure or volume in the pulmonary vein and thus provide a noninvasive method of monitoring cardiac preload and the pulmonary cycle. In addition, this research may provide the experimental basis for employing PRG in the study of such pathological processes as mitral valve lesion, left heart failure, etc. PMID- 2710791 TI - A multivariate analysis of pathologic factors influencing prognosis of colorectal cancer in 1067 cases. AB - Multivariate analysis (risk state analysis) was performed to evaluate the single and joint effects of pathologic variables on the survivals of 1067 cases of colorectal carcinoma. Nineteen of the twenty-eight variables analyzed were found to have statistically significant prognostic value, with over half having a strong influence on prognosis. The first seven, ranked in order of their effects on survival, are metastasis in lymph nodes, depth of invasion, histologic grading, lymphocyte infiltration of the cancer, GH (immune response in regional lymph nodes), growth pattern and fibrous proliferation around the cancer. The joint effects of combinations of these major variables are even more striking than those of single ones. PMID- 2710792 TI - Preoperative diagnosis and management of pheochromocytoma. AB - To improve the diagnosis and management of pheochromocytoma, the results from a comparative study of 34 patients with pheochromocytoma, 33 patients with essential hypertension and 36 normal volunteers are presented. Our data suggest that clinical characteristics indicate the possibility of pheochromocytoma only, while the definite diagnosis of pheochromocytoma must be based on comprehensive analysis of all data obtained from both clinical and laboratory studies. The plasma concentration of free norepinephrine in peripheral veins is helpful in establishing the presence or absence of pheochromocytoma. Both CT scan and meta-I 131-iodobenzylguanidine images are useful noninvasive techniques for localization of pheochromocytoma. Phenoxybenzamine is of benefit in both diagnosis and management of patients with pheochromocytoma. PMID- 2710793 TI - Clinical effect of immunologic bacterio-vaccine on essential hypertension (100 cases report). PMID- 2710794 TI - Production and application of monoclonal antibodies to polyamine--spermidine McAb. PMID- 2710795 TI - Prolonged hemopoiesis of murine bone marrow derived epithelioid cells in vitro. AB - We previously reported the isolation of a murine bone marrow derived stromal cell line, TC-1, and two sublines derived from this line. The monolayer of one subline, TC-1-C-3, directly supported the growth of nonadherent marrow cells in Dexter culture system for eight weeks. We report here the mechanism of the stromal cell effect on hemopoiesis in a long-term bone marrow culture system. When the hemopoietic blasts attach to the TC-1-C-3 cells, they are surrounded by the stromal cell cytoplasm within two hours and develop into cell clusters in a week. The developing hemopoietic cells show cell differentiation towards the granulocytic lineage. A key function of the epithelioid stromal cell, then, is to provide a 'niche' or 'envelope' for stem cells which supports long-term hemopoiesis in the Dexter culture system. PMID- 2710796 TI - The role of thromboxane A2 (TxA2) in allergic cutaneous reactions and the effect of (E)-3-[p-(1H-imidazol-1-ylmethyl) phenyl]-2-propenoic acid hydrochloride (OKY 046), a TxA2 synthetase inhibitor. AB - To study the role of thromboxane A2 (TxA2) in cutaneous allergic reactions, the effect of (E)-3-[p-(1H-Imidazol-1-ylmethyl)phenyl]-2-propenoic acid hydrochloride (OKY-046), a selective TxA2 synthetase inhibitor, on cutaneous reactions in rats and mice was studied. Simultaneously, the effect of 9,11-methanoepoxy prostaglandin H2 (U-46619), a stable analogue of TxA2, on capillary permeability in mouse and rat skin was investigated. Passive cutaneous anaphylaxis (PCA) in mouse ear was clearly inhibited by OKY-046 but not by indomethacin. The inhibitory action of OKY-046 was not influenced by pretreatment with indomethacin. Moreover, prostaglandin I2, which accumulated as a result of the inhibition of TxA2 synthetase, did not affect the PCA. But, the dye leakages caused by histamine, serotonin and leukotriene C4 in mouse ear were clearly inhibited by OKY-046. In addition, OKY-046 inhibited rat reversed cutaneous anaphylaxis, but its inhibitory action was not affected by pretreatment with indomethacin. Contrary to the above results, rat footpad passive Arthus reaction and mouse footpad tuberculin delayed hypersensitivity reaction were not affected by OKY-046. Additionally, U-46619 did not cause an increase of capillary permeability in either mouse and rat skin. These results suggest a slight role of TxA2 in cutaneous allergic reactions in mice and rats and the efficacy of OKY-046 on Type I and II reactions regardless of the inhibition of TxA2 synthetase activity. PMID- 2710797 TI - Glucocorticoid-treatment does not influence the synthesis of thromboxane B2 and bicyclo-PGE2 in humans. AB - It has been reported that the anti-inflammatory action of glucocorticoids is due to the inhibition of phospholipases. Consequently, after high-dose steroid treatment in humans a decrease in cyclooxygenase products should be expected. In 15 patients (10 males, 5 females, 29-62 y) undergoing 6-methyl-prednisolone treatment (40-80 mg daily) for various clinical reasons and in 5 healthy volunteers (4 male, 1 female, 28-37 y) receiving 500 mg 6-methyl-prednisolone daily for 3 days plasma- and serum-thromboxane B2 (TXB2), as well as bicyclo prostaglandin E2 (bicyclo-PGE2) were monitored over 3 weeks. In the entire follow up period, however, no significant change in either serum- or plasma-TXB2 or bicyclo-PGE2 could be measured in either, patients and volunteers, under glucocorticoid-treatment. These findings indicate that even high-dose glucocorticoid-treatment does not affect the serum- and plasma-metabolites of the eicosanoids examined. It is concluded that in humans a significant inhibition of phospholipases by glucocorticoids and subsequently reduced formation of cyclooxygenase products seems to be rather unlikely. PMID- 2710798 TI - Effect of UV-B irradiation on release of arachidonic acid from B-16 melanoma cells. AB - B-16 melanoma cells in culture were prelabeled with (3H)-arachidonate, and exposed to UV radiation. Immediately after irradiation the cells released labeled materials. This UV-stimulated release was inhibited by mepacrine (20 microM) and calmodulin inhibitor W7 (0.5 microM). To determine the influence of extracellular Ca2+ on the UV-stimulated release, experiments were made with media containing various concentrations of Ca2+. The release decreased significantly at lower Ca2+ concentrations. These results suggest that Ca2+-calmodulin-dependent phospholipase A2 was involved in UV-stimulated release of radiolabeled materials, possibly arachidonic acid and its metabolites, from the cells. PMID- 2710799 TI - Oleic acid lung injury increases plasma prostaglandin levels. AB - To determine whether lung injury causes increased plasma prostaglandin (PG) levels, 35 rabbits received oleic acid and 35 served as controls. Half of each group also received 4 ml/kg of Intralipid over one hour and at least five in each subgroup received indomethacin 7.5 mg/kg. Arterial and venous plasma concentrations of PGE2, 6-keto-PGF1 alpha, and PGF2 alpha-M were measured. Venous PGE2 was significantly higher in the oleic acid-injured than in the normal lung group, 1560 +/- 270 (Mean +/- SEM) versus 880 +/- 140 pg/ml (p less than .05). Plasma levels were reduced by 50% with indomethacin, but PGE2 levels remained significantly higher than in the normal lung group, 850 +/- 180 versus 480 +/- 60 for arterial (p less than .05) and 820 +/- 140 versus 480 +/- 80 for venous (p less than .05), respectively. PGF2 alpha-M levels were significantly higher in the lung injury group, 240 +/- 50 versus 50 +/- 40 pg/ml for arterial (p less than .05) and 220 +/- 50 versus 95 +/- 40 for venous (p less than .05), respectively. These lung injury-related increases in PGE2 and PGF2 alpha-M appear related both to increased pulmonary production and to decreased pulmonary clearance. With Intralipid infusion, however, arterial PGE2 increased by 500 +/- 260 pg/ml compared to baseline (p less than .05) with no change in venous PGE2, indicating in this instance that the increase in arterial PGE2 levels is related to increased pulmonary production. PMID- 2710800 TI - Arachidonic acid release and prostaglandin biosynthesis in synchronized rat embryo fibroblasts. AB - Arachidonic acid (AA) release and prostaglandin (PG) biosynthesis were studied in rat embryo fibroblasts (R 129) synchronized by double thymidine-excess block. Whatever the culture medium was (medium 199 supplemented with 10% fetal calf serum (FCS) or 1% FCS plus 0.1% bovine serum albumin (BSA], AA release rapidly increased until the 4th hour of the cell cycle (S phase), remained on a plateau in G2M and G1 phases and did not increase again in the S phase of the following cell cycle. Time course and amplitude of AA release in synchronized cells did not differ from what it was observed after the simple renewal of the culture medium in asynchronous cells. So AA release seemed to be independent of the cell cycle. By contrast, PGE2 and PGF2 alpha biosynthesis clearly increased in the S phase of two consecutive cell cycles, indicating that cyclooxygenase activity and not phospholipase A2 activity vary according to the cell cycle. PMID- 2710802 TI - [Medicinal plants, an imprudent natural apothecary]. PMID- 2710801 TI - Effect of onion and ginger consumption on platelet thromboxane production in humans. AB - The effects of onion and ginger consumption on platelet thromboxane production were examined. Volunteers, all Danish women, consumed either 70 g raw onion or 5 g raw ginger daily for a period of 7 days. Each participant in each (onion or ginger) group served as her own control. TxB2 determination was made in serum obtained after blood clotting. The following are the results. TxB2 (pmol/ml serum): (i) onion group--before consumption 910 +/- 327, after consumption 1005 +/- 713 (Mean +/- SD, N = 5); (ii) ginger consumption 782 +/- 482, after consumption 498 +/- 164 (Mean +/- SD, N = 7). PMID- 2710803 TI - [Analgesics and narcotics before 1600. A nearly unknown chapter in drug history]. PMID- 2710804 TI - [How does a fungus make penicillin? Current research, trends in beta lactam antibiotics. Biosynthesis of penicillin and cephalosporin]. PMID- 2710805 TI - Are there consequences to be drawn from clinical depression research for the development of new antidepressant drugs? PMID- 2710806 TI - Psychotoxic effects of ofloxacin. AB - Two cases of organic psychosis, induced by the new chemotherapeutic agent ofloxacin (Tarivid), are described. According to DSM-III-R and ICD 10 (draft, 1987) both cases present as different, yet well-defined diagnostic categories: the new diagnostic systems appear to be superior and markedly more differentiated than ICD-9, since they provide a more exact and comprehensive description and more specific diagnostic allocation, especially in substance-specific syndromes. The possible involvement of GABAergic and monaminergic mechanisms in this psychotic symptomatology and their relationship to hypersynchronous states are discussed in detail. PMID- 2710807 TI - Factors contributing to erythrocyte lithium-sodium countertransport activity in lithium-treated bipolar patients. AB - Clinical and biochemical factors related to the activity of the erythrocyte lithium-sodium countertransport (LSC) system were investigated during lithium prophylaxis in 27 patients (13 male, 14 female) with bipolar affective illness. No relationship was found between erythrocyte LSC and such factors as age, gender, duration of lithium prophylaxis, quality of prophylactic lithium response, and family history of affective illness. There was a significant negative correlation between the activity of LSC and the magnitude of the erythrocyte lithium ratio both in whole group and in female patients. In seven patients with concomitant hypertension, the relationship between high activity of LSC and hypertension was not demonstrated. The levels of total cholesterol, HDL cholesterol, triglycerides, and potassium related neither to LSC activity nor to hypertension. Erythrocyte LSC in patients with lower TSH levels were significantly reduced compared to patients with higher TSH. The values of TSH were negatively correlated with T4 but not with T3. Concentrations of T3 were positively correlated with plasma total cholesterol levels. These results are discussed in the view of recent findings on erythrocyte LSC. PMID- 2710808 TI - High dose tranylcypromine therapy for refractory depression. AB - A substantial number of depressed patients will experience a chronic, treatment resistant affective disorder. Aggressive treatment of these patients with various drug combinations, unconventional antidepressants, or electroconvulsive therapy has met with only partial success. There remains a pressing need to identify more effective methods of utilizing "first-line" antidepressant agents to achieve a more rapid therapeutic action. To this end, we initiated a study using high doses of the MAO inhibitor tranylcypromine, at a range of 90 mg to 170 mg daily, in seven refractory depressed patients who had failed to respond to at least three prior treatments regimens. Four out of seven subjects (57%), who had failed to respond to a mean of 8 +/- 5 prior treatment, had a complete response, and one patient had a partial response to high dose tranylcypromine. The mean SD maximum tranylcypromine dose for the responders was 112 +/- 16 mg daily (range 90 mg to 130 mg). Response did not appear to be a function of severity of illness, duration of present episode, or the number of prior treatment failures. Overall, the side effect profile was favorable, and no "cheese reactions" were encountered. These observations are of clinical significance and suggest the need for further controlled studies using high doses of tranylcypromine. PMID- 2710809 TI - Bradycardia due to biperiden. AB - In a 38-year-old male patient suffering from a severe postzosteric trigeminal neuralgia, intravenous application of 10 mg biperiden lactate led to a long lasting paradoxical reaction characterized by considerable bradycardia, dysarthria, and dysphagia. The heart rate was back to normal within 12 hours upon administration of orciprenaline under cardiac monitoring in an intensive care unit. Bradycardia induced by biperiden is attributed to the speed of injection and to a dose-related dual effect of atropine-like drugs on muscarine receptors. PMID- 2710810 TI - DST in chronic pain patients not suffering from major depression. AB - The relationship between chronic pain and depression is complex, and nonorganic chronic pain has been hypothesised (at least in some cases) as the expression of an underlying affective disturbance. Postdexamethasone cortisol nonsuppression was assessed in two groups of patients with chronic organic (n = 43) and nonorganic (n = 20) pain, none of them suffering from a major depressive disorder. Non-suppression occurred in 16.3% of the organic group and 20% of the nonorganic one. No difference emerged between the two groups for mean postdexamethasone cortisol values. The DST test results did not suggest the existence of a close relationship between chronic pain and major depressive disorder; however, a wider relationship between chronic pain and affective disturbances, at least in a subgroup of patients, cannot be ruled out. PMID- 2710811 TI - Nitrogen-15 NMR studies of rat liver in vitro and in vivo. AB - In the present 2.1 T15N NMR study two different kinds of experiments are presented. In one we show that metabolic reactions of 15N-labelled glycine can be followed in the isolated rat liver. In the second we demonstrate that [15N]glycine can be detected using NMR in vivo. For quantification and identification of glycine and metabolites 15N-isotope analysis (emission spectrometry technique) was used. To our knowledge, this is the first demonstration of 15N NMR for study of the metabolism of 15N-labelled compounds in vivo. PMID- 2710812 TI - A perception experiment to assess the clinical accuracy of various methods of obtaining cardiac phase images. AB - Five methods of obtaining cardiac phase (and phase-like) images are compared. These are single-harmonic Fourier phase imaging; time-to-minimum using a two harmonic fit to each dixel; time-to-minimum using four weighted harmonics; composite factorial phase imaging; and individual factorial phase imaging. Polaroid prints of phase images for both gated equilibrium studies (using all methods) and first-pass studies (first and last methods only) were shown to observers who were asked to rate the images according to their confidence of an abnormality presenting. A receiver operating characteristic (ROC) analysis was performed. For gated studies composite factorial phase imaging appears to be best, while all methods are significantly better than single-harmonic Fourier phase imaging. For first-pass studies individual factorial phase imaging appears to be superior to single-harmonic Fourier phase imaging. PMID- 2710813 TI - Optimisation of density and contrast yielded by multiformat photographic imagers used for scintigraphy. AB - The maximum optical density (MOD) and contrast (characterised by an effective gamma, gamma eff) yielded by multiformat photographic imagers used for scintigraphy, was determined by densitometry of a computer image, which consisted of a pattern of uniform squares containing known counts. A series of clinical scintigrams were photographed using various MOD and gamma eff values, and were graded by three experienced clinicians. It was found that a MOD of 1.6 and a gamma eff of 2.9 yielded optimal images for general use if bone scintigrams are also to be photographed. Lesion detectability in phantom images using extreme MOD and gamma eff values that were still clinically acceptable was determined. At very low false-positive rates (less than or equal to 1%) the higher gamma eff yielded a significantly greater lesion detectability (p = 0.02) at an information density of 2200 counts cm-2 in accordance with White-head's theory. It is concluded that quantification and optimisation of density and contrast factors are important and that the technique described enables quality control of multiformat imagers with respect to these factors. PMID- 2710814 TI - The design and evaluation of an automated system for monitoring 133Xe in room air. AB - The radioactive gas 133Xe is widely used for ventilation imaging. This paper describes a system for continuous monitoring of the air concentration of 133Xe. The instrument consisted of a sodium iodide scintillation detector, a scaler/ratemeter and a data logger. The crystal was mounted inside a lead shield and enclosed in a perspex cylinder. A fan at one end of the cylinder drew room air into a shielded active volume via an inlet aperture designed to generate turbulent flow with no stagnant areas. The instrument was rendered relatively insensitive to external radiation by positioning the energy window over the 31 keV peak in the 133Xe spectrum. The detector sensitivity was approximately 2 s-1 per MBq m-3, with a typical background count rate of 0.12 s-1. The system was therefore capable of detecting a concentration of 0.06 MBq m-3 in a one-minute sampling interval. Results collected at five centres demonstrated that the eight hour time-averaged concentrations were much less than the derived air concentration (DAC) for occupationally exposed persons (mean values 0.4 to 1.5% of the DAC), but that transient concentrations were extremely variable (mean values 7 to 24% of the DAC). PMID- 2710815 TI - Effects of helium-neon laser irradiation on skin resistance and pain in patients with trigger points in the neck or back. AB - The purpose of this double-blind study was to ascertain the effects of helium neon (He-Ne) laser irradiation on skin resistance and pain in patients with trigger points in the neck or low back. This study entailed a partial replication of a previous study by Snyder-Mackler and associates that determined the use of the He-Ne laser increased skin resistance overlying a trigger point. Twenty-four patients were randomly assigned to either a treatment or a control group and received three 20-second applications of laser irradiation or placebo "stimulation," respectively. Pretreatment and posttreatment skin resistance and pain measurements (via visual analog scale) were taken during each session. Results indicated a statistically significant increase in skin resistance (p less than .001) and a decrease in pain (p less than .005) following laser treatment. There was not a significant correlation between skin resistance and pain across subjects. These data substantiate the previous findings of Snyder-Mackler and associates and demonstrate a reduction in pain. Helium-neon laser treatment, therefore, may be an effective adjunct to conventional physical therapy of these patients. PMID- 2710816 TI - Tracking ability of hemiparetic and healthy subjects. AB - The purpose of this descriptive study was to investigate differences in tracking ability between the involved and uninvolved hands of hemiparetic (n = 10) and healthy (n = 10) subjects. The subjects tracked a sine-wave target pattern by flexing and extending their index finger metacarpophalangeal joints. The amplitudes of the target patterns were proportional to each subject's active range of motion. The root-mean-square (RMS) of the vertical distance between the target and response lines was expressed as a percentage of the RMS of the target pattern and subtracted from 100 to give an index of each subject's accuracy. The authors used t tests to compare the uninvolved and involved hands of the hemiparetic subjects (p greater than .05), the dominant and nondominant hands of the healthy subjects (p greater than .05), and the uninvolved hands of the hemiparetic subjects with the dominant hands of the healthy subjects (p less than .005). This study indicates that within the available active ROM, finger tracking ability is impaired bilaterally in hemiparetic subjects. The implication for physical therapists is that treatment strategies for improving motor control should be directed bilaterally. PMID- 2710817 TI - Cooperative education in a physical therapy curriculum. AB - Cooperative education is an educational strategy in which students alternate academic periods with periods of paid employment in their field of study. Research involving students in various majors shows that students, faculty, and employers benefit from cooperative education. Graduates of cooperative education programs have higher levels of interpersonal skills, clearer career goals, and more realistic job expectations than their counterparts without cooperative education experience. This article describes cooperative education and its goals, objectives, and benefits; presents one model of cooperative education; and suggests how cooperative education may benefit a physical therapy curriculum. PMID- 2710818 TI - Gathering storms. PMID- 2710819 TI - Comments and clarification by MICRO-FLEX Systems. PMID- 2710820 TI - Scoliosis screening. PMID- 2710821 TI - MARATHON update. PMID- 2710822 TI - Photochemical reduction of 5-bromouracil by cysteine derivatives and coupling of 5-bromouracil to cystine derivatives. AB - Irradiation of pH 7, aqueous solutions of 5-bromouracil (BU) in the presence of cysteine peptide-like derivatives at 308 nm using a XeCl excimer laser yielded initial formation of only uracil (U) and the corresponding cystine derivative. Continued irradiation yielded an S-uracilylcysteinyl adduct as well as additional U and cystine derivative. Similar irradiation of a solution of BU and a cystine derivative yielded initial formation of U and the S-uracilylcysteinyl adduct. Formation of these products as well as secondary products of uracil photochemistry was observed upon irradiation of the respective solutions with 254 nm light. With 308 nm laser excitation, U-Cys adduct formation and reduction of BU to U are proposed to occur via initial electron transfer from the disulfide of the cystine derivative to triplet BU. The quantum yield of BU destruction with 308 nm excitation in the presence of cystine derivative is 1.1 X 10(-3). Reaction of triplet BU with the cysteine derivative does not yield U-Cys adduct but U and cystine derivative. A possible byproduct of reduction of triplet BU to U by a cysteinyl residue in a protein BU-DNA complex is a sulphenyl bromide which might yield a protein-DNA crosslink via nucleophilic substitution on sulfur by a nucleophilic site in DNA. PMID- 2710823 TI - Phosphorescence maxima and triplet state lifetimes of NAD+ and epsilon-NAD+ in ternary complexes with horse liver alcohol dehydrogenase. AB - This paper describes the phosphorescence emission and decay times of NAD+ and its fluorescent etheno derivative, epsilon-NAD+, in the pyrazole ternary complex with horse liver alcohol dehydrogenase (ADH). We show that the epsilon-NAD+ triplet state, as well as the tryptophan triplet state, can be utilized to monitor the coenzyme-enzyme interaction. The decays of NAD+ and AMP are single exponential, and the lifetimes are the same within experimental error. The phosphorescence lifetimes, evaluated as single exponentials, are slightly shorter in epsilon-NAD+ than they are in epsilon-AMP. Whereas the decay of epsilon-AMP was adequately fit by a single exponential with a time constant of very close to 0.5 s, it was necessary to fit the decay of epsilon-NAD+ to a double exponential. Ternary complexes with NAD+ excited at 297 nm exhibit decay kinetics nearly identical to those of ADH by itself. On the other hand, when excitation of the epsilon-NAD+ ternary complex is provided at 313 nm, where there is very little absorption by either tryptophan residue, the decay law of the ternary complex is similar to that of epsilon-NAD+ in solution. Our results demonstrate that NAD+ and epsilon NAD+ quench tryptophan phosphorescence in ADH. Normalizing the phosphorescence intensity to the 0-0 vibronic band assigned to Trp-15 (blue-edge), we calculate a 21% decrease in the phosphorescence associated with Trp-314 at stoichiometric saturation of the coenzyme binding sites with NAD+ in the ternary complex. When the active sites are saturated with epsilon-NAD+, the relative phosphorescence due to Trp-314 decreases by 63%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710824 TI - Laser flash spectroscopy of methylene blue with nucleic acids. Effects of ionic strength and pH. AB - Laser flash spectroscopic measurements were made on methylene blue complexed to the synthetic polynucleotides poly[d(G-C)] and poly[d(A-T)] in solutions of varying ionic strength and pH. Triplet decay rates and rates of triplet quenching by oxygen have been measured for the polymer/dye solutions. The triplet decay and oxygen quenching rates of methylene blue in complex with poly[d(A-T)] are much less sensitive than those with poly[d(G-C)] with respect to variations in ionic strength. It is also shown that protonation of the triplet state of MB+ with poly[d(A-T)] is slower than that of free dye. These results indicate strong binding of the dye to poly[d(A-T)]. Excitation of the MB+/poly[d(A-T)] complex at 665 nm yielded single exponential decay kinetics, in contrast with excitation at 600 nm where double exponential kinetics were measured. This is tentatively assigned to excitation of dye dimer bound to this polymer. PMID- 2710825 TI - Photosensitization with derivatives of chlorophyll. AB - The properties of several chlorophyll derivatives were examined: the methyl esters of pheophorbide A, pheophorbide B and pheophytin. In spite of structural differences, all products were equally effective sensitizers in vitro and were localized equally well by murine tumors in vivo after 1 h. But only the pheophytins persisted at neoplastic loci for 24 h. There was no evidence of hydrolysis of the methyl esters, but the phytyl ester linkage was labile in vivo. PMID- 2710826 TI - Effect of ultraviolet radiation on the energy metabolism of the corneal epithelium of the rabbit. AB - The present research was directed at quantifying possible alterations in corneal epithelial metabolic activity secondary to in vivo exposure to ultraviolet radiation (UVR). Microfluorometric energy metabolite assays on microgram (microgram) sized, freeze-dried tissue samples were used as an in vitro means of assessing overall metabolic activity in the epithelium of control rabbit corneas and in the epithelium of UVR-exposed rabbit corneas 2 min after discontinuation of exposure. The specific assays were for glucose, glycogen, adenosine triphosphate (ATP), and phosphocreatine (PCr). The radiant exposures were kept constant at 0.05 J cm-2 for all UVR wavelengths utilized (290, 300, 310 and 360 nm). Experimental UVR exposure conditions served to increase epithelial glucose and glycogen concentrations. Although the epithelial ATP concentrations were unchanged, the epithelial PCr concentrations (a high energy phosphate bond reservoir) decreased as a result of UVR exposure. Overall, the data demonstrate a decrease in corneal epithelial metabolic activity, which may be wavelength dependent, as a result of UVR exposure. It is suggested that immediate metabolic stress can be responsible for the pattern of epithelial cell loss seen in photokeratitis. PMID- 2710827 TI - Long-term effects of a single dose of ultraviolet-B on albino rabbit cornea--I. in vivo analyses. AB - Both eyes of female albino rabbits (1.9 kg) were exposed to a single dose of UV-B (300 +/- 9 nm; 0.125 J/cm2 total dose) between 13.30 and 15.00 h. The average irradiance was 209 +/- 4 microW/cm2 delivered over 612 +/- 13 s. At various time periods thereafter (every 12 h for 3 days, 6, 7, 14, 28, 42, 56, 112, 224 and 336 days post-irradiation), the animals were subjected to a full slit lamp examination to evaluate the status of the cornea and the anterior segment along with optical or ultrasonic pachometry of central corneal thickness. The results were compared with studies on age-matched rabbits over the same time period. In response to the UV-B irradiation, the corneas showed a modest edema (20% increase in central corneal thickness) that peaked at 48 h. Nearly normal central corneal thickness returned in 6 days and followed by a secondary very slight swelling (less than 5%) that resolved by 14 days. The edema was accompanied by keratitis over the same period. Thereafter, both control and UV-B irradiated corneas progressively increased in thickness with age. Biomicroscopy also revealed the appearance of granular opacities in the corneal epithelium that peaked at 72-96 h and resolved over 28 days. In addition, very small microdot opacities of the corneal epithelium were present in the UV-B irradiated corneas that reached maximum at 72 h but persisted to some degree throughout the evaluation period. Biomicroscopy also revealed a progressive disruption of the homogeneous nature of the corneal stroma by the appearance of large 'bread crumb'-like opacities that started at 72 h and was still present at the end of the evaluation period. These results suggest that long-term evaluation of the cornea is important after acute UV-B exposure and indicate that acute exposure to UV-R can produce corneal changes resembling those reported following chronic exposure to UV-R-rich environments. PMID- 2710828 TI - Pectoralis minor: a unique muscle for correction of facial palsy. AB - The author introduced this muscle for the first time almost a decade ago, and this is the first extensive description of the intricate microanatomy of this complex but unique microneurovascular muscle unit. Advantages and disadvantages and indications and contraindications for its use in facial paralysis are presented in detail from an extensive clinical experience of almost 50 such microneurovascular transfers. Pitfalls that the reconstructive microsurgeon should beware and strengths in using this muscle for facial palsy are highlighted. The detailed operative approach is presented, with promise of undetectable scars and minimal functional loss. The strategies for how to inset this muscle unit in the new recipient site are given, along with the thought processes involved in selecting the actual sites of anchoring the muscle to reproduce a mirror image of the contralateral normal face. Finally, an exemplary clinical case demonstrating the use of the pectoralis minor muscle for both eye and lower face reanimation is presented in detail, demonstrating the dual nerve supply and the resulting independent eye and smile movements with total lack of mass action and/or synkinesis. Restorations of eye blink and of a symmetrical and coordinated smile are the frequent rewards of using this unique muscle for the correction of facial palsy. PMID- 2710829 TI - Long-term results following the repair of palatal clefts: a comparison of three different techniques. AB - A series of 109 patients was divided according to type of palatal defect, technique of repair (pushback, von Langenbeck, or pushback with island flap), results of standardized multifactorial speech analyses, and effectiveness of primary and secondary operations. Sixty-five patients (60 percent) showed improved speech after the initial repair, with 49 of these rated as "good." Forty five percent improved after the von Langenbeck operation, 57 percent improved after the pushback procedure, and 53 percent improved after the pushback/island flap repair. Persistent hypernasal speech was treated with superiorly based pharyngeal flaps in 18 patients with uniform success (p less than or equal to 0.001). The worst results (after all three techniques) followed the repair of bilateral complete clefts. This experience has tempered our expectations in dealing with cleft palate patients, especially those having bilateral defects. PMID- 2710830 TI - Lengthening the aesthetically short nose. AB - An aesthetically short nose is defined as a developmental deformity in which the nose appears foreshortened. It is characterized by a decreased distance from the nasofrontal angle (NFA) to the tip-defining points (TDP) and an increased nasolabial angle with increased nostril show. A method is described and illustrated for lengthening the aesthetically short nose by rotating the nasal tip in an inferior direction. This rotation results in an actual lengthening, as well as an illusion of lengthening of the nose. PMID- 2710831 TI - An algorithm for correcting the asymmetrical nose. AB - Correction of the twisted nose forms the watershed of aesthetic and reconstructive rhinoplasty, combining and requiring elements of each. Faced with this formidable task, surgeons have fashioned a great number of techniques, many of which rely for their cardinal step on cutting, fracturing, or scoring the dorsal septal strut. While highly satisfactory results have been achieved with these methods, the constant problem of loss of dorsal support remains. It is possible in many cases to align the crooked nose while leaving intact osteocartilaginous dorsal support. The key determination to be made is the preoperative aesthetic balance, itself a product of bridge height and nasal base size. Once nasal aesthetics have been established, the algorithm proceeds as follows: First, resect the dorsum in the area of the deviation until the dorsal septal edge is sufficiently close to the midline to allow camouflage of the remaining asymmetry. Second, perform the septal resection necessary for the airway, preserving a continuous dorsal strut. Third, augment according to (a) the support needed for the dorsum, middle vault, columella, and tip and (b) the aesthetic balance that must be restored. PMID- 2710832 TI - The role of gingival mucoperiosteal flaps in the repair of alveolar clefts. AB - Secondary bone grafting of alveolar clefts has become a well-established procedure. However, little attention has been given to the soft-tissue coverage of these grafts. We present our experience with 32 patients in which gingival mucoperiosteal flaps were used exclusively in conjunction with bone grafting for patients with residual alveolar clefts. The indications and timing of the procedure as well as the steps of the technique are presented. The advantages of bone grafting at the stage of mixed dentition and the superiority of gingival mucoperiosteal flaps, including teeth eruption through the graft, additional teeth support, dental hygiene and aesthetic appearance of the alveolar ridge, are discussed. Our results are compared with those obtained with similar or other techniques. PMID- 2710833 TI - Immediate breast reconstruction: reducing the risks. AB - One-hundred and sixty-five consecutive immediate breast reconstructions in 157 patients were reviewed. Reconstructions were performed with tissue expanders (53 percent) or immediate gel prostheses (47 percent). Immediate reconstruction was associated with an 18 percent rate of implant loss. Certain risk factors were identified at the p less than 0.05 level using immediate gel implants: failure to achieve complete muscle coverage of the implant, smoking at the time of surgery, initial gel implants of 400 ml or more volume, and age. Expander loss was increased by detaching the pectoralis major (p less than 0.05) and probably by lack of complete muscle coverage in general. Chemotherapy, history of previous smoking, and clinical stage of the carcinoma did not seem to affect reconstructive success. Smoking and patient age should be considered during patient selection for immediate reconstruction. Muscle coverage of the prosthesis should always be attempted. Muscle coverage is mandatory in the smoker. Gel implants of 400 ml or more volume are to be avoided at the initial operation. This approach should enable all surgeons to achieve lower rates of implant loss. PMID- 2710834 TI - The VY tensor fasciae latae musculocutaneous flap. AB - When first introduced in 1978, the tensor fasciae latae flap was used both as a free-tissue transfer and as a local rotational flap. Its use as a free flap has diminished as other more appropriate flaps for free-tissue transfer have been described. The tensor fasciae latae flap has remained, however, an instrumental flap in the coverage of anterior and posterior soft-tissue defects around the hip region. The purpose of this paper is to present a new design of the tensor fasciae latae flap in the coverage of trochanteric pressure sores. By essentially creating a VY advancement flap into the trochanteric defect with the tensor fasciae latae, one can cover the trochanteric defect with the best-vascularized portion of the flap and avoid the dog-ear deformity. PMID- 2710835 TI - Dermofluorometry: thresholds for predicting flap survival. AB - The dye fluorescence index (DFI) has been cited as an accurate predictor of skin flap survival. However, two thresholds, one each for flap survival and flap necrosis, have been advocated. A DFI of less than 15 to 20 percent predicts failure, and a DFI greater than 35 to 50 percent predicts survival. Values of 20 to 35 percent indicate an uncertain outcome. The present study was undertaken (1) to determine the optimum threshold for flap survival prediction in pigs, and (2) to compare dermofluorometry with flap blood flow as measured by radioactive microspheres. Dermofluorometry was found to be an accurate (90 percent) and repeatable predictor of skin and fasciocutaneous flap survival in pigs. At 2 and 5 hours after flap elevation, the optimum DFI thresholds are 7 and 27 percent, respectively. This reflects the dynamic nature of circulation in acute skin flaps and the increased dye delivery over time. Using these calculated thresholds, a high degree of correlation was found with survival estimated at 24 hours. Dermofluorometry also was correlated with the blood flow index. Thus not only is it an accurate flap monitor, but a quantitative estimate of flap blood flow can be obtained. PMID- 2710836 TI - Microvascular surgical experimental thrombosis model: rationale and design. AB - The rationale for the design of surgical models of microvascular thrombosis is discussed, and a new model, the arterial inversion graft (AIG), is described and evaluated in the New Zealand white rabbit. Femoral artery segments of predetermined length are excised, gently turned inside-out, and resutured into their native position. Blood flow is restored, and at varying time intervals, vessel patency is assessed through the direct "milking test." In this study, three groups of 20 arterial inversion grafts of 2, 5, and 10 mm in length are created and evaluated for patency at 1 hour and again at 7 days. The incidence of femoral artery occlusion in this model appears to be an increasing function of arterial inversion graft length both at 1 hour--30 percent (2 mm), 80 percent (5 mm), and 100 percent (10 mm)--and at 7 days--65 percent (2 mm), 90 percent (5 mm), and 100 percent (10 mm). This proportionality suggests the arterial inversion graft may be adjusted in length to provide an incidence of vessel occlusion best suited to the needs of any particular experiment. PMID- 2710837 TI - Sterility in unsterilized surgical adhesive tape. AB - Providing a barrier to infectious organisms, sterile surgical adhesive tape has been used to close wounds for almost 20 years. The possibility that prepackaged unsterilized tape could be used for similar purposes is suggested by this study. Samples (480) were taken from 120 rolls that had been left in plastic surgical suite cabinets for 2 weeks. Aerobes and anaerobes were evaluated using tryptic soy agar with 5% sheep blood, while yeast and fungi were checked with Sabouraud dextrose agar. Sterility of sticky and smooth inner surfaces is shown to be a significant finding (p less than 0.01). It is concluded that prepackaged unsterilized surgical adhesive tape can be used to approximate wound edges without being a source of contamination (the sterile tape is 5600 percent more expensive). Wound closure in this manner would benefit the patient in the field, in the emergency room, or in third world countries where the supply of sterile tape is limited. PMID- 2710838 TI - Better care--more hostility. PMID- 2710839 TI - The use of tissue expansion in lower extremity wounds in paraplegic patients. AB - A report of the use of tissue expansion in the lower extremity of paraplegic patients is presented with over 1-year follow-up in two cases. Expansion was accomplished without difficulty and without compromise of skin integrity when performed carefully and slowly. It is important to observe the overlying skin for capillary refill. Pain, which may limit expansion in neurologically intact patients, is not a factor in paraplegics. By using tissue expansion, more risky, longer procedures using myocutaneous flaps or microvascular tissue transfers may be unnecessary, and reliable, durable, full-thickness coverage is obtained in two short procedures. PMID- 2710840 TI - A reliable method for monitoring the microvascular patency of free jejunal transfers in reconstructing the pharynx and cervical esophagus. AB - Reconstruction of the pharynx and esophagus with revascularized segments of jejunum remains a time-proven entity. Most thromboses and subsequent flap failures have occurred within the first 24 hours after revascularization of the flap. What would therefore be desirable is a safe, proven monitoring system to assess the patency of the microvascular anastomoses and subsequent viability of the transferred bowel segment. This paper reports on such a monitoring system, which involves the creation of a surgical window on the anterior cervical flap. The jejunal serosa is tacked to this window, and a thin split-thickness skin graft is placed directly on the bowel. The technique is simple, safe, efficacious, and leaves no significant defect. PMID- 2710841 TI - VY bipedicle flap for resurfacing the nasal supratip region. AB - A procedure for the coverage of surgically created supratip defects up to 1.5 cm in diameter is described utilizing a VY bipedicle flap of nasal skin. PMID- 2710842 TI - The S nipple-areola reconstruction. AB - Nipple reconstruction is performed as a last stage in breast reconstruction following mastectomy. Various methods of nipple reconstruction have been described, most of them utilizing either free composite grafts or local flaps. The main problem encountered using either method is the gradual absorption and flattening of the nipple. The technique we used in reconstructing 22 nipples, in preference over the various methods accepted in breast reconstruction, achieves a long-standing, protruding nipple constructed from two large local flaps raised from an S-shape design. The technique is simple and permits freedom in choosing the height of the nipple, even in the presence of a mastectomy scar. The size of the nipple thereby constructed is in excess of what was expected. Shrinkage occurs during the first 2 months, and the resulting size is more than adequate. The areola is reconstructed by a full-thickness skin graft harvested from a nonhairy area of the upper inner thigh. The local flaps lack the necessary color, which is achieved by tattooing. PMID- 2710843 TI - Intradermal tattoo as an adjunct to nipple-areola reconstruction. AB - Improving results in breast reconstruction have encouraged more authentic restoration of the lost nipple-areola. While recreation of nipple shape can be reliably achieved, appropriate color has remained elusive, except when a composite nipple graft has been harvested from the normal breast, often at a significant aesthetic, emotional, and oncologic cost. Extensive experience with intradermal tattooing of the nipple-areola in over 100 patients over a 5-year period has shown this technique to be exceptionally safe and effective. Both medical-grade and commercial machines are available at varying prices, and medical-grade pigments may be obtained in a variety of authentic flesh tones derived from titanium or iron oxides. In nearly every case, tattooing has helped with either nipple-areola color, size, shape, or position, without any significant complications. Some degree of tattoo fading is common, requiring occasional late touch-ups and, more rarely, complete retattooing. PMID- 2710844 TI - The questionable value of free muscle grafts. PMID- 2710845 TI - Caulking gun for tissue expansion. PMID- 2710846 TI - Creating an inframammary crease with a liposuction cannula. PMID- 2710847 TI - Placing granules of hydrocolloid into wounds. PMID- 2710848 TI - Suction lipoplasty of silicone-injected breasts: a warning. PMID- 2710849 TI - Managing the patient with infection around a polyurethane implant. PMID- 2710850 TI - Continuing medical education and international romance. PMID- 2710851 TI - W-plasty: make it easy. PMID- 2710852 TI - Congenital infiltrating lipomatosis. PMID- 2710853 TI - [The social dependence of the long-term patient--a study in social psychiatric ambulatory care]. AB - 56 mostly schizophrenic longterm patients of a community based outpatient facility were questioned about their autonomy referring to living, working and finances, to their dependence on parents, partners, relatives and professional helpers in accomplishing every-day tasks to their social contacts and to their contentment. Only 11% of the patients live with parents and 4% are financially dependent from them. Parents are only helping by accomplishing every-day tasks, when the patients are living with them. Even then patients accomplish more than half of their affairs by themselves. However there is a strong emotional tie on parents. Professional helpers, mostly working in halfway facilities, relieve relatives in a high degree. 36% of the patients live single and are very independent, they accomplish 82% of their affairs by themselves. 23% live with a partner, who helps probably not more than he would do with a healthy partner. 3/4 of the patients are content with their living conditions. Possible explanations are discussed. The investigated patients, mostly quite impaired, are altogether far more autonomous than expected. We think that this is due to a comprehensive social network of outpatient treatment and halfway facilities combined with a sufficient invalidity insurance. This network seems to lighten the burden of the relatives, mainly the parents, as demanded by the family-burden-literature. PMID- 2710854 TI - [A progress report from institutional ambulatory care]. AB - After representing the legal and institutional frame there follows a working report of the ambulance of the PKH Riedstadt. The tasks of out-patient services as they are described in the Psychiatrie-Enquete are the starting point to look at teamwork, treating experiences, change of numbers of hospitalisation and change of time to stay in the hospital. The expectations concerning patients with psychosis and retarded patients with mental illness are fulfilled, but not those concerning patients with organic brain damages or addiction. Possible arguments are discussed. PMID- 2710855 TI - [Complementing and replacing the clinic sensibly--on the management, effectiveness and indications for a complementary psychiatric residence. Results of a 1-year prospective evaluation study]. AB - The complementary psychiatric (home) area is a relatively new branch of institutional psychiatry, the therapeutic evaluation and integration of which into everyday psychiatric thinking and acting has not yet become a reality. The evaluative study presented here covered 53 inmates and concerned their everyday life, the success of the treatment, predictors and perspectives. A gradual change in the means and aims of psychiatric rehabilitation seems to be materializing: the (re-)integration of the subject into his family of origin or into the psychosocial network will probably become more important than just reinstating the patient into his original place and kind of work. For the future it appears desirable that the inmates and the equipment are financially secured, that the entire setup is integrated into the system of psychiatric institutions, and that the method can be applied to further groups of patients. PMID- 2710856 TI - [Family groups and family self-help groups for schizophrenic patients. Concepts, establishment, problems in implementation]. AB - In Munster/W.-Germany the effect of therapeutical work with relatives of young schizophrenic patients is investigated in a government supported prospective study. In this paper we reveal therapeutical concepts and difficulties dealing with the formation and guidance of the relatives groups. After a personal interview about one third of the relatives was interested in relatives groups (151 relatives of 99 patients). Relatives of younger patients with a shorter duration of illness were somewhat more interested. During the one-year-period of group-work about one third of the relatives left the groups. The motivation for a regular participation dependent on the symptoms of the patients. A special training produced better motivation for taking part in long-term self-help groups. PMID- 2710857 TI - [Inpatient rehabilitation of chronic schizophrenic patients with a behavior therapy token reinforcement program]. AB - The efficacy of a token economy system was assessed in a study involving 76 chronic schizophrenics who were inpatients during a treatment period of four years. The interrelations between therapeutic success on the one hand, and socio economic as well as course of disease-related factors on the other were studied, including psychopathology and the efficacy of token economy. PMID- 2710858 TI - [Experiences in community social psychiatric ambulatory care]. AB - In the first part of the article, the most important principles of action are described that determined the work done so far in the outpatient department of the Sociopsychiatric Clinic Berne. From this work the idea developed that psychiatric long-term patients would best be cared for by a care system divided into sectors and linked first of all to a community mental health centre. First experiences collected in a community health centre project in Berne are described. Details are given in respect of the location and arrangement of the available rooms and space. The central importance of the round table for the work of the medical and nursing staff with the patients, their families and the entire social environment is stressed. The authors try to explain their mode of working and their attitude on the examples of first contact with the patients and the handling of a crisis situation. It is the aim of this sociopsychiatric work to ensure maximum possible autonomy and self-responsibility of the patients. PMID- 2710859 TI - Noradrenergic function and hypothalamic-pituitary-adrenal axis activity in adolescents with major depressive disorder. AB - Levels of plasma norepinephrine (NE), free 3-methoxy-4-hydroxyphenylglycol (MHPG), and cortisol in adolescents with major depressive disorder (10 girls, 1 boy; mean +/- SD age = 16.4 +/- 1.6 years, range = 14-19 years) did not differ significantly from those in a group of healthy adolescents (17 girls, 12 boys; mean +/- SD age = 15.9 +/- 1.5 years, range = 12-18 years). No correlations were observed between these variables and age within the adolescent groups. However, when the adolescent data were viewed in combination with data previously obtained for an adult population (De Villiers et al., 1987), significant positive correlations between the variables were observed within the patient group. A moderate positive correlation with age was also observed for patients' NE and free MHPG levels. No such correlations were observed for the combined control group. When groups were partitioned into three age categories, it became apparent that differences in the three variables between the patient and the control groups were restricted to elderly subjects (greater than 50 years). In adults (21 50 years old), only the patients' NE levels were significantly elevated. These findings suggest that duration of illness may be important in determining the full expression of the biochemical abnormality in major depression. PMID- 2710860 TI - Cerebral structure in borderline personality disorder. AB - Computed tomographic (CT) scans of brains of patients with borderline personality disorder and normal volunteers were analyzed for ventricle-brain ratios, third ventricular size, and evidence of frontal lobe atrophy. There were no significant differences between the two groups on any of these measures except for a narrower third ventricle in borderline patients, which could be accounted for by the narrower third ventricle observed in female subjects overall. While borderline patients may show signs of subtle neurological dysfunction, they do not show evidence of structural brain pathology. PMID- 2710861 TI - Polysomnographic parameters in first-degree relatives of unipolar probands. AB - We present polysomnographic data for psychiatrically asymptomatic first-degree relatives of unipolar depressed probands. Relatives were classified by proband rapid eye movement (REM) latency (reduced/nonreduced) and by personal REM latency (reduced/nonreduced). Reduced REM latency relatives, whether defined by the proband or by their own REM latency, had polysomnographic alterations consistent with those found in depressed patients, although none of these relatives was depressed at assessment. Reduced REM latency relatives with a history of unipolar depression were compared to reduced REM latency relatives with no history of depression. Virtually no polysomnographic differences were found. Polysomnographic alterations may be stable antecedents of the onset of depression. PMID- 2710862 TI - Depressive symptomatology among Mexican-American adults: an examination with the CES-D Scale. AB - The presence and persistence of specific depressive symptomatology among a large sample of Mexican-American adults (n = 3,084) were examined with the Center for Epidemiologic Studies Depression (CES-D) Scale. Compared to studies of Anglos, a substantially larger percentage reported persistent hopelessness about the future (29%), self-depreciation (21%), and lack of enjoyment out of life (14%). The prevalence of these symptoms was higher among those who had not adapted to mainstream American society and among older participants. Women were generally more distressed than men. Factor analyses of the items demonstrated a slightly different factor structure than previously obtained with Anglos. For both sexes and for those under age 30 and ages 30-59, the items "loneliness," "sadness," and "crying" loaded on a common factor. The tendency for these items to group together was stronger for those exhibiting a low or medium degree of cultural adaptation than for those exhibiting a high degree of adaptation. Discussion focuses on the cultural variation of response to items on the CES-D. PMID- 2710863 TI - Attenuation of response to antidepressants in animals induced by reduction in food intake. AB - A salient feature of depression is eating disorders (reduced appetite and caloric intake) and/or weight loss. In the present study, reduction in food intake in rats, resulting in moderate weight loss, markedly attenuated the ability of various antidepressant drugs to reverse depressive-like behaviors: escape deficits provoked by previous exposure to uncontrollable stress. Further data support the notion that hypofunctioning of central noradrenergic processes, perhaps linked to reduced thyroid hormone levels, might contribute to such an altered response to antidepressants. These findings suggest that current nutritional status, even with marginal weight loss, could be an intervening factor in the delayed therapeutic response to antidepressants and/or in drug resistant depression. PMID- 2710864 TI - Comparison of early and delayed inpatient dexamethasone suppression tests. AB - Ninety-five inpatients completed a dexamethasone suppression test (DST) within 72 hours after admission and again after at least 1 week of medication-free hospital care. The frequency of cortisol nonsuppression in patients with endogenous depression (ED) was high and not significantly different at both tests. In patients with diagnoses other than ED, the higher rate of cortisol nonsuppression at the first DST was associated with a significant decrease in test specificity. Change in postdexamethasone cortisol levels at repeat testing was associated with a decrease in depressive symptomatology, but was not related to weight change during hospitalization. PMID- 2710865 TI - Rating affective flattening from videotaped interviews. AB - Semistructured interviews with 28 schizophrenic patients were videotaped. The affective flattening section of the Scale for the Assessment of Negative Symptoms (SANS) was rated after each interview. At a later date, each videotape was rated by three raters as well as the interviewer. Reliability was estimated within and across rating conditions by intraclass correlation. Comparison of reliability scores across rating conditions indicated that the videotape medium had little effect on the ability of raters to rate affective flattening similarly. PMID- 2710866 TI - Spatial attention in hypothetically psychosis-prone college students. AB - This study tested the hypothesis that psychosis-prone individuals show patterns of visual search that suggest a lateralized cerebral hemispheric abnormality, similar to one hypothesized by Venables (1980) to underlie cognitive dysfunction in schizophrenia. Self-report measures of psychiatric vulnerability were completed by 881 college students. Experimental subjects (n = 73) were those with high scores on one of four psychosis-proneness scales. Control subjects (n = 33) scored within 0.5 SD of the mean on all scales. Subjects were tested using verbal and nonverbal visual search tasks designed to detect abnormalities in the spatial distribution of attention. When searching random arrays of nonverbal stimuli, 53% of the experimental subjects used an erratic search strategy similar to that typically observed in right-brain-damaged patients, compared with 23% of controls. The most deviant search patterns were shown by subjects who scored high on Physical Anhedonia and Perceptual Aberration-Magical Ideation. The results suggest that early development of schizophrenic disorder might be associated with dysfunction of right-hemispheric mechanisms of attentional control. PMID- 2710867 TI - Perinatal complications and genetic loading in schizophrenia: preliminary findings. AB - History of perinatal complications (PCs) and first degree family history (FH) of psychiatric illness were examined in groups of schizophrenic/schizoaffective (n = 21) and bipolar (n = 10) patients. PCs were significantly more frequent in the schizophrenic and schizoaffective patients than in bipolar patients. An inverse relationship was found between PCs and FH status, with FH-positive patients having significantly fewer PCs than the FH-negative group. This relationship persisted when the bipolar patients were excluded. Findings emphasize the etiological importance of genetics and perinatal events in the psychoses, and support the validity of a familial/sporadic distinction. PMID- 2710868 TI - Effects of brief naps on mood and sleep in sleep-deprived depressed patients. AB - To determine the effects of brief naps on mood and electroencephalographic (EEG) sleep in sleep-deprived depressed patients, data from 19 hospitalized patients with depression were analyzed; all were kept awake from 0700h until the following day, when they were allowed 10-min naps at either 0830h or 1500h. Six of the patients showed a clinically significant improvement (greater than 40% change) on the Hamilton Rating Scale for Depression (HRSD) before the nap after all-night sleep deprivation, and the group as a whole showed a significant improvement on the HRSD, the Profile of Mood States, and the Brief Psychiatric Rating Scale subscale for depression. Naps did not alter mood in the responders, but did improve measured depression on the HRSD in the non-responders. Morning and afternoon naps did not differ significantly in their effects on mood or nap sleep. On the recovery sleep, patients who were classified as responders after the nap showed a significantly greater increase in delta (Stage 3 + 4) sleep compared with baseline than nonresponders. PMID- 2710869 TI - Clonidine-induced growth hormone secretion in elderly patients with senile dementia of the Alzheimer type and major depressive disorder. AB - This study was undertaken to assess the value of growth hormone (GH) response to clonidine as a tool in the differential diagnosis between depression and dementia. This response is known to be blunted in depression, and neurochemical changes observed in senile dementia of the Alzheimer type (SDAT) could lead to an up-regulation of GH secretion. No difference was observed between GH response in depressed and demented patients. Together with studies on GH basal secretion in Alzheimer's disease, this finding suggests that the final consequence of SDAT related changes in an accentuation of the effects of aging on GH reactivity. PMID- 2710870 TI - The Neurological Evaluation Scale (NES): a structured instrument for the assessment of neurological signs in schizophrenia. AB - The significance of neurological signs in schizophrenia is poorly understood. In part, this may reflect the marked variability in the methods of ascertainment in previous studies. The Neurological Evaluation Scale (NES) is designed to standardize the assessment of neurological impairment in schizophrenia. The battery consists of 26 items. Data on the interrater reliability for total score, functional areas of interest, and individual items are presented. Preliminary validity data demonstrate the ability of the battery to discriminate patients with schizophrenia from nonpsychiatric controls. PMID- 2710871 TI - Light suppression of melatonin in unipolar depressed patients. AB - The effects of nocturnal light (500 lux) exposure on plasma melatonin were studied in seven men suffering from unipolar depression and in seven healthy men. Both groups showed significant declines in plasma melatonin concentrations during 1 hour's light exposure. Differential group declines were not detected. PMID- 2710872 TI - Lactate response in patients with primary major depression. PMID- 2710873 TI - Association between abnormal REM sleep and negative symptoms in schizophrenia. PMID- 2710874 TI - Health complaints, stress, and distress: exploring the central role of negative affectivity. AB - Most current models in health psychology assume that stress adversely affects physical health. We re-examined this assumption by reviewing extensive data from the literature and from six samples of our own, in which we collected measures of personality, health and fitness, stress, and current emotional functioning. Results indicate that self-report health measures reflect a pervasive mood disposition of negative affectivity (NA); self-report stress scales also contain a substantial NA component. However, although NA is correlated with health compliant scales, it is not strongly or consistently related to actual, long-term health status, and thus will act as a general nuisance factor in health research. Because self-report measures of stress and health both contain a significant NA component, correlations between such measures likely overestimate the true association between stress and health. Results demonstrate the importance of including different types of health measures in health psychology research. PMID- 2710875 TI - Computational approaches to color constancy: adaptive and ontogenetic considerations. AB - Recent computational approaches to color constancy can be realized using a two stage model of color vision. Adaptation at both the sensor stage and the second or reflectance channel stage is necessary to compute illuminant-invariant reflectance estimates. von Kries adaptation is shown to contribute significantly toward reducing, but not completely eliminating, the need for adaptation at the second stage. Examples of computations from the model using daylight illuminants, simulated natural reflectance functions, and putative human spectral sensitivity functions are shown. The ontogenetic plausibility of these models is also discussed. The role of the second-stage transformation in estimating surface reflectance is compared with the role of opponent color transformations in decorrelating primary receptor outputs. PMID- 2710876 TI - Social skills of formerly institutionalized mentally retarded persons. PMID- 2710877 TI - Academic achievement of children of divorced parents. AB - This study investigated the academic achievement of 242 pupils whose parents were divorced and 713 pupils whose parents were neither divorced nor separated. The subjects were in the age range of 13 to 17 yr., with a mean age of 15.6 yr. and they were chosen at random from the total Standard 7 population of Transkei, South Africa. A questionnaire was administered to 1,021 pupils to identify the children of parents divorced or separated and neither divorced nor separated. Analysis of variance indicated that the academic achievement of children whose parents were divorced or separated was significantly lower than that of the children whose parents were neither divorced nor separated. PMID- 2710879 TI - Human physical aggression as a function of magnitude of frustration: indirect support and a possible confounding influence. AB - An experiment was performed to test whether thwarting close to the goal leads to higher levels of frustration and higher levels of aggression than thwarting far from the goal in a slightly modified version of the Buss' "aggression machine." Subjects first calibrated a shock scale and were then put in a situation in which they could give electric shocks to a confederate under an acceptable pretext. It was not possible to confirm the specific hypothesis directly but a positive correlation was found between over-all self-rated subjective frustration and a measure of total aggression supporting a general frustration-aggression hypothesis. However, it was also found that the initial calibration of the shock scale correlated positively with the measure of total aggression, indicating the possible confounding influences are operative in this kind of paradigm. PMID- 2710878 TI - Sex differences in drinking patterns and behaviours among college students in Singapore. AB - The drinking patterns and behaviours of 1,160 students at the National University of Singapore were studied to assess differences among men and women. Analysis suggests men more than women use alcohol and exhibit more problem behaviour resulting from its use. PMID- 2710880 TI - Community mental health ideology of preprofessional students. AB - Adherence to the ideology of mental health was measured in a cluster sample of preprofessional students in four majors: psychology, social work, rehabilitation and health education. Mean inventory scores for the four groups did not differ significantly. PMID- 2710881 TI - Effects of alcohol on variability-contingent reinforcement in human subjects. AB - Subjects responded under LAG-5 reinforcement conditions after consuming alcohol in table wine (0.4 g/kg ethanol). For reinforcement (points), a four-response sequence from two buttons was required which differed from the previous five sequences of four responses. In addition, some subjects responded under restricted conditions in which sequences were limited to those of moving a cursor within a 3 x 3 matrix, while other subjects had no such restrictions. Also some subjects worked alone while others were accompanied by an experimenter. Analysis showed that compared to controls, men in the unrestricted condition who received alcohol showed increased uncertainty in responding while comparable women receiving alcohol showed a decrease in uncertainty of responding. The results are discussed in terms of previous work on alcohol and behavioral variability. PMID- 2710882 TI - Comments on 'Call for a follow-up study of experiments on long-term deprivation of human infants' by Micha Razel. AB - Razel's examination of the early work of McGraw and the Dennises puts a heavy requirement on studies of single subjects and on some possible interpretations for which, unfortunately, documentation is insufficient. Further, the Dennises placed more emphasis on the autotelic quality of motor mastery than Razel notes. Rather than looking for these persons whose behavior was studied long ago, direct study of motor mastery by systematic provision of enrichment conditions during early development is more likely to be instructive and a better use of scientific resources. PMID- 2710883 TI - Relation of cognitive functioning to daily living skills in a geriatric population. AB - A modified version of the Community Competence Scale was administered along with the Wechsler Adult Intelligence Scale--Revised (WAIS--R) to 40 geriatric patients with suspected dementia. Scores on the Competence Scale, a measure of functional daily living skills, were correlated .72 with Full Scale IQs and .77 with Verbal IQs and moderately correlated (.55) with Performance IQs. A number of significant correlations were found between WAIS--R subtests and subscales of the competence instrument. Means and standard deviations for the 10 Competence subscale and total scores are presented. PMID- 2710884 TI - Predicting nursing GPA and national council licensure examination for registered nurses (NCLEX-RN): a thorough analysis. AB - The study involved prediction of GPA in a nursing program and NCLEX-RN licensure score following completion of the program. The sample included 155 students who completed and 34 who failed to complete a baccalaureate nursing program for the 1984-1986 years. The best set of predictors of nursing GPA included ACT composite score, anatomy grade, and chemistry grade, R = .73. The best set of predictors of NCLEX-RN included ACT composite score, high school percentile rank, nursing GPA, and chemistry grade, R = .68. Classification of withdrawn and completing groups and also pass and fail NCLEX-RN performance via discriminant analysis provided results comparable to those of previous research; however, residual analysis indicated very large residuals for those withdrawing from the program as well as those who failed the licensure exam. An alternative to discriminant analysis for classifying students is suggested. PMID- 2710885 TI - Interactions among affect, cognition, and visuomotor coordination as measured in words and symbols. AB - The associative frequencies of responses to stimulus words during free and controlled forced-choice word-association tests correlate well with each other and with assessments of the affective character (emotional content) of the stimulus words for the test subjects (Osgood Index) for three samples of volunteer French undergraduate students (ns = 200, 64, and 72). These indices correlate negatively with the subjects' performance on Digit Symbol Substitution tests. Neisser's theory of schemata and Edelman's theory of neuronal group selection may provide insight into this relationship. If the associative frequency of a subject's response decreased, the affective content of the word stimulus (as perceived by the subject) diminished as well. This relationship was associated with a relatively higher score on Digit Symbol Substitution. Conversely, it was observed that subjects whose responses were characterized by high associative frequencies (whether the response was spontaneous or forced choice) rated the stimulus words as having a relatively stronger affective content or emotional character and performed less well on Digit Symbol Substitution. PMID- 2710886 TI - There's more in a number than you think: new validity data for the Global Assessment Scale. AB - Holcomb and Otto (1988) recently suggested that the widely used Global Assessment Scale may have ". . . questionable validity as an index of psychopathology." The present paper points out procedural and conceptual problems in their study and presents extensive evidence supporting the concurrent and predictive validity of the scale. PMID- 2710887 TI - Association of population growth, technological development and social integration on rates of personal violence (suicide and homicide). PMID- 2710888 TI - College students' relationships with grandparents. AB - Literature on the role and attitudes of grandparents is increasing, even as is the number of grandparents. However, data on the attitudes of grandchildren toward their grandparents are spare. This article reports attitudes of 574 college students toward their grandparents. Their geographic closeness to at least one grandparent, and their patterns and motivations for contacting their grandparents are included. PMID- 2710889 TI - The Men's Adult Life Experiences Inventory: an instrument for assessing developmental concerns of middle age. AB - This article describes the development and testing of a new 97-item self-report instrument assessing the frequency and intensity of 11 developmentally related domains of concerns of middle-aged men. These include relationships (child, parents, wife, friends), job, health, sex, leisure, death, pressures of time, and self-reflection. The psychometric properties of the instrument, as well as potential uses, are discussed. PMID- 2710890 TI - AIDS education and policies among Southern Baptist church leaders in the state of Texas. AB - A survey was conducted to assess the knowledge and attitudes of 67 preschool and children's directors of the Southern Baptist Convention of Texas during a statewide meeting on AIDS. Data on church policies regarding AIDS and AIDS education were also obtained from the participants. PMID- 2710891 TI - Study of ideal-self discrepancy and observed social behaviors in a therapeutic community. AB - This descriptive study explored relations between ideal self-discrepancy (often referred to as self-esteem or self-concept) and behaviors observed in 27 residents of a therapeutic community for polydrug users. The Sliding Person Test (SPERT), an abstract, nonverbal measure of self-reported, ideal self-discrepancy was administered three times a week, for seven consecutive weeks to 27 subjects after regularly scheduled group meetings. Data were charted on graphs to reveal fluctuations of ideal self-discrepancy and incidences of observed, documented changes in behavior. Analysis suggests the instrument detects some changes in ideal self-discrepancy congruent with transitional behaviors. In more than half of the cases, fluctuation of 25% or more in discrepancy between ideal self concept and at-the-moment self-concept was directly related to an observed change in behavior or residents' transition in the hierarchy of the program's structure. Implications for validity and reliability issues concerning measures of ideal self-discrepancy are briefly discussed. PMID- 2710892 TI - Agoraphobia with and without current panic attacks. AB - MMPI and SCL-90-R profiles of agoraphobics with and without current panic attacks are presented. Agoraphobics with current panic attacks were more elevated on Psychopathic Deviate (4), Psychasthenia (7), and Social Introversion (0) scales of the MMPI. On the SCL-90-R agoraphobics with current panic attacks had higher scores on Interpersonal Sensitivity, Anxiety, Phobic Anxiety, and Total/90. PMID- 2710893 TI - Type A, locus of control, and stress: another case in point. AB - It has been recommended that a stress measure be included in studies seeking to clarify the Type A behavior pattern to identify moderator effects. This was tested, and a stress-moderating effect of externality among Type As was found along with the absence of relation between Type A status and locus of control. PMID- 2710894 TI - A factorial, reliability, and validity study of the Devereux Elementary School Behavior Rating Scale. AB - This investigation explored the factor structure, reliability, and validity of the Devereux Elementary School Behavior Rating Scale, employing a large (n = 648) sample of children. Factor analysis suggested that the Devereux scale can be described by four factors, which were named Disruptive-Oppositional, Poor Comprehension-Disattention, Cooperative-Initiating, and Performance Anxiety. All four factors showed high internal consistency, and three of the four were stable over a 17-mo. period. Correlations of the four factors with academic achievement, IQ, socioeconomic status, and peer ratings of social competence are presented. All four factors showed significant relations with these variables, with Poor Comprehension-Disattention the strongest of all. Multiple regression analysis indicated that the Poor Comprehension-Disattention factor accounted for significant variance in academic achievement even after IQ was taken into account. Large differences between classroom means on the factor scores suggested that Devereux ratings for individual students may need to be interpreted cautiously. PMID- 2710895 TI - On the use of the WISC-R supplementary subtests as alternates. AB - If a regularly administered WISC-R subtest cannot be administered properly or is invalidated, the manual suggests that a supplementary subtest, either Digit Span or Mazes, can serve as a substitute, but perhaps prorating the sum of scaled scores on the remaining subtests would be better. Data from the WISC-R standardization sample were analyzed to investigate the psychometric properties of these two variants of the standard procedure. Proration consistently resulted in higher validities (i.e., correlations between scores on the variant Verbal, Performance, or Full Scale and scores on the corresponding original scale), whereas substitution almost as consistently resulted in higher reliabilities, but in both cases the differences were small. Examiners may decide for themselves whether or not to use the supplementary subtests as alternates. PMID- 2710896 TI - Further evidence of construct validity for the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire. PMID- 2710897 TI - Applicability of Kubler-Ross's stages of dying to the suicidal individual: a review of the literature. AB - Evidence from the literature is presented that suicidal people may experience the emotions described by Kubler-Ross in her description of the dying process. PMID- 2710898 TI - It may be lonely at the top but it's less stressful: psychological burnout in public schools. AB - This investigation compared levels of psychological burnout and its antecedents and consequences among teachers, department heads, and principals from a single school board. The data showed that increased stress and burnout were associated with decreased administrative responsibilities. Possible explanations for these findings are provided. PMID- 2710899 TI - Secondary enuresis in institutionalized conduct-disordered children. AB - The incidence of secondary enuresis in 16 institutionalized conduct-disordered children was examined. In contrast to a control group of 16 noninstitutionalized conduct-disordered children, the former showed significantly more enuretic behaviour. Also, enuresis began within 6 mo. of the children's separation from their families, suggesting this problem is very likely related to the emotional trauma surrounding the change in living conditions. However, the small number of subjects limits further interpretation of the findings. PMID- 2710900 TI - Evaluating dental faculty performance: perceptions of dental school deans. AB - In this study 57 deans in 67 United States and Canadian Dental Schools ranked, in decreasing order of importance, 12 performance criteria and then ranked the same 12 criteria as they perceived faculty would rank them. Agreement between the deans' two global rankings gave a Spearman's rank-order correlation of .92. Although the general level of agreement between the two perceptual ranks was significant, several important discrepancies in rank order were identified. Deans perceived that faculty would rank number of publications first and classroom, clinical, and laboratory teaching third. Deans personally ranked classroom, clinical, and laboratory teaching as first and number of publications as fourth. Implications of the discrepancy between the perceived importance of research productivity and teaching in faculty evaluation were discussed with respect to the increasing emphasis placed on research for dental faculty within the university. PMID- 2710901 TI - Stress in relation to satisfaction with leisure experienced by those performing in therapeutic recreation. PMID- 2710902 TI - Body dysmorphic disorder: implications for its validity as a DSM-III-R clinical syndrome. AB - A sample of 258 college students responded to three items in Likert-format designed by the authors to elicit information relating directly to the three criteria for body-dysmorphic disorder described in DSM-III-R (1987). 70% of the participants endorsed some agreement with an item regarding dissatisfaction with some aspect(s) of their bodies. 46% indicated some preoccupation with this aspect of their appearance, and 48% indicated some exaggeration of their perceived body image. Sex differences were significant on all three items. 28% of the sample endorsed all three of the items taken together. These results raise questions about the utility of a diagnosis which, as it is currently defined, could conceivably apply to a large percentage of the population and which disproportionately targets women. PMID- 2710903 TI - Comparison of nominal recall (standard) and multiple-choice methods for administration of WISC-R information subtest: a preliminary study indicating a learning effect of multiple-choice testing. AB - The Wechsler Intelligence Scale for Children--Revised (WISC--R) Information subtest was administered to learning disabled children using two methods of administration, the standard (recall) method and a multiple-choice format. Those children who were tested first with the multiple-choice format and subsequently with the standard format did better on the standard format than expected. This preliminary study suggests a learning effect of such multiple-choice testing and the desirability of further research being undertaken. PMID- 2710904 TI - Suicide and homicide rates in Hungary and Czechoslovakia during the suppression of dissent. PMID- 2710905 TI - Fertility rates and suicide: time series and regional studies. PMID- 2710907 TI - Effects of aerobic exercise training on hemodynamic responses during psychosocial stress in normotensive and borderline hypertensive type A men: a preliminary report. AB - This study assessed the effects of aerobic exercise training on cardiovascular responses to a 5-min reaction time competition task. Twenty-seven Type A men (aged 30-56) participated in this randomized study in which 14 underwent supervised aerobic training and 13 strength training, with sessions scheduled three times per week for 12 consecutive weeks. Aerobic exercise training was associated with a 13.6% increase in VO2max compared to 2.9% for the strength group. The effects of aerobic exercise training were most evident in subjects whose initial casual blood pressure readings fell in the borderline hypertensive range (N = 5). These individuals exhibited a general reduction in diastolic blood pressure (i.e., during rest, competition, and recovery) which was associated with a fall in both heart rate and total peripheral vascular resistance. Furthermore, diastolic pressure reactivity to the competition task was attenuated in borderline hypertensive subjects who underwent aerobic conditioning. These data are interpreted as preliminary findings suggesting that borderline hypertensives may be particularly responsive to the cardiovascular benefits of aerobic conditioning. For patients who have progressed to this stage of hypertensive disease, aerobic exercise may be of ameliorative value. PMID- 2710906 TI - Type A behavior in healthy males and females as related to physiological reactivity and blood lipids. AB - Type A behavior was assessed in 30 men and 30 women (ages 30-50) by a Videotaped Structured Interview (VSI). Scores for total Type A behavior as well as subcomponents (competitiveness, time urgency, hostility) were examined in relation to cardiovascular and neuroendocrine reactivity during a work day (change from a work-free day) and during laboratory-induced stress (change from resting condition). In addition, Type A and Type B males and females were compared with regard to total serum cholesterol, LDL and HDL cholesterol, and triglycerides. The results showed relationships between 1) competitiveness/hostility and physiological reactivity at work in men, 2) total Type A behavior (and hostility) and serum cholesterol in men, and 3) hostility and serum cholesterol in women. As expected, the association between Type A behavior and physiological measurements was more pronounced for "extreme" Type A and B men and women (upper and lower 10 subjects, respectively) than for the total groups of each sex. PMID- 2710908 TI - Self-reference and coronary heart disease incidence in the Western Collaborative Group Study. AB - Previous research has indicated that the spoken frequency of the self-references "I," "me," and "my" in a structured interview was prospectively related to coronary heart disease (CHD). To assess whether the findings would replicate in another population, we conducted a case-control analysis of 750 structured interviews from the Western Collaborative Group Study. To measure self references, auditors counted all first person pronouns (I, me, my) and clauses spoken in the audiotaped baseline structured interviews. Matched multiple logistic regression analyses, with or without adjustment for major CHD risk variables, indicated that those who incurred CHD did not self-reference more frequently or densely than the CHD-free control subjects. Type As spoke more clauses and more total self-references but did not have a higher density of self references than Type Bs. The results question both the method for measuring self references and the hypothesis that self-referencing are associated with CHD. PMID- 2710909 TI - Behavioral treatment of essential hypertension: a comparison between cognitive therapy and biofeedback of heart rate. AB - The efficacy and the mechanisms of action of two behavioral treatments for essential hypertension were compared: cognitive group therapy for anger control and biofeedback for heart rate control. The cognitive therapy aimed at lowering the "general anger" level and helping overt expression of "anger out;" heart rate biofeedback aimed at slowing heart rate in stress situations. Ninety-seven essential hypertensive patients were randomly assigned to three groups; after 20 dropouts, 77 patients fully participated in the study: cognitive treatment (N = 30), biofeedback (N = 27), and control (no treatment, N = 20). The treatments were held in 17 weekly sessions; during treatment, blood pressure was measured once a month, and during follow-up after 1 and 6 months. The anger level and heart rate control were assessed at the beginning and the end of treatment. The main results were: 1) a significant decrease of blood pressure for both treatments as compared with control, 2) a significant decrease of blood pressure with heart rate biofeedback as compared with cognitive therapy, and 3) a better control in anger achieved with cognitive therapy and a lesser control in heart rate as compared with biofeedback. PMID- 2710910 TI - Perimenstrual symptoms: time course of symptom intensity in relation to endocrinologically defined segments of the menstrual cycle. AB - This investigation assessed the syndromal nature of menstrual cycle changes in women who experience significant cyclicity of mood by exploring the time course of different symptoms in relation to endocrinologically defined segments of the menstrual cycle. Participants were accepted into the protocol on the basis of a prospectively documented history of perimenstrual mood change. The protocol included completion of the Daily Life Experiences Questionnaire and blood sampling during three menstrual cycles. The syndromal nature of menstrual cycle changes was explored by determining the types of symptoms which fluctuated in relation to five endocrinologically defined segments of the menstrual cycle, and the time course of the symptom changes. The results further document the temporal association between the luteal phase and the onset of perimenstrual symptoms and suggest that the syndromal nature of menstrual cycle-related changes may differ for women who experience different intensities of cyclical mood. PMID- 2710911 TI - Psychological characteristics of individuals high and low in their ability to cope with tinnitus. AB - Seventy-seven individuals with tinnitus were assessed with a variety of standardized psychological tests and scales assessing subjective loudness, annoyance, and ability to cope with the tinnitus. Significant correlations were found between coping ability and psychological test scores. Based on their responses on the coping scale, subjects were classified as "high copers" (N = 45) or "low copers" (N = 32). For comparison purposes, the two tinnitus groups were also compared to a group of chronic pain (headache) patients (N = 34) and to a group of nonheadache/non-tinnitus controls (N = 65). Results revealed the low coping tinnitus subjects to be significantly more psychologically distressed than the high copers. Of interest, the low copers were very similar in their psychological profiles to the chronic pain patients, while the high copers were similar to the non-patient control subjects. Implications of these results are discussed. PMID- 2710912 TI - Aerobic exercise or strength and flexibility training was associated with both reduced overt behavioral manifestations of the type A behavior pattern and self reported type A traits. PMID- 2710913 TI - Behavioral medicine in the general hospital. AB - The application of behavioral procedures to the treatment of medical disorder has greatly expanded the techniques available to the psychiatrist practicing in the general hospital. While there are diverse behavioral strategies that have proven quite useful, the bases for these are limited and readily implemented in the hospital setting. In this paper, the behavioral methods of assessment and various strategies of treatment of medical, psychophysiological, and "psychosomatic" disorders are overviewed. PMID- 2710914 TI - Somatic symptoms in multiple personality disorder. AB - A structured interview, the Dissociative Disorders Interview Schedule, was administered to 20 patients with multiple personality disorder, 20 with panic disorder, 20 with eating disorders, and 20 with schizophrenia. The frequencies of somatization disorder and of individual somatic symptoms in the four groups were compared. The multiple-personality patients reported more somatic symptoms than the other groups. Of the 20 multiple-personality patients, seven met the criteria for somatization disorder. The average number of somatic symptoms per multiple personality patient was 13.5. PMID- 2710915 TI - Subtypes of anorgasmia via mathematical taxonomy. AB - Seventy-six women who presented with a principal complaint of anorgasmia were partitioned into four distinct subtypes on the basis of psychosexual and psychological symptoms using hierarchical cluster analysis, a mathematical taxonomic method. The classification was accomplished with data from the Derogatis Sexual Functioning Inventory (DSFI) and the Brief Symptom Inventory (BSI). Comparisons involving age, race, marital status, and social class demonstrated no significant differences between the four subtypes; however, statistical analyses of psychosexual, psychological symptom, and chart-review variables (including psychiatric diagnosis) revealed very significant distinctions between the four groups. From the resulting typology, anorgasmic subtypes were presumptively identified as "low desire" (n = 21), "histrionic/marital conflict" (n = 20) "psychiatric disorder" (n = 12) and "constitutional" (n = 16). Implications of the typology for etiologic and optimal treatment decisions concerning anorgasmia are discussed. PMID- 2710916 TI - Physical illness encountered in patients with eating disorders. AB - Careful evaluation for medical illness with a severity rating scale of 276 eating disorder patients admitted to hospital revealed that patients with anorexia and bulimia were at risk for developing medical complications. Severe cardiovascular complications were most likely to occur in eating-disorder patients who were also diuretic and/or laxative abusers. Forty percent of patients with bulimia had significant medical complications. The findings suggest that a medical work-up should be carefully undertaken in both anorexic and bulimic patients admitted to hospital. A mixed history of severe anorexia nervosa alternating with periods of bulimia was most likely to lead to severe life-threatening illness. Seventy percent of the bulimic patients admitted required some medical treatment. Five percent were considered severely medically ill, while 34% suffered from a significant medical disorder. Ten percent of patients with restrictive anorexia or anorexia alternating with binge/purge required intensive care unit (ICU) placement. Most illnesses requiring medical treatment were unknown to the patient and the patient's physician at the time of admission. PMID- 2710917 TI - Psychological factors in the choice of treatment for breast cancer. AB - For several years women with an early diagnosis of breast cancer have been able to choose between two equally effective treatments: modified radical mastectomy and the breast-conserving treatment of lumpectomy plus radiation therapy. This study investigated the psychological factors that become involved when a woman chooses between treatments. Many more anticipatory concerns about body image, disfigurement, femininity, and the ability (or inability) to handle emotionally a mastectomy were expressed by lumpectomy/radiation therapy patients than by mastectomy patients. Those lumpectomy-radiation therapy patients who chose the treatment against medical advice were also found to be more concerned than the others about treatment effects on sexuality. PMID- 2710919 TI - Psychotherapy of the patient with an HIV infection: some ethical and therapeutic dilemmas. PMID- 2710918 TI - Prescribing efficiently in nursing homes. AB - Giving medications in nursing homes is time consuming and expensive. The orders for medications in a community nursing home were examined to determine if nursing time could be saved by consolidating the administration of medications. Nineteen percent of the medication administration visits could be eliminated by this method according to the independent judgments of two physicians. This could save up to $19,000 in nursing time per year, and the time could be redirected to other nursing activities that could improve the quality of care in nursing homes. PMID- 2710920 TI - Specific components of bedside manner in the general hospital psychiatric consultation: 12 concrete suggestions. PMID- 2710921 TI - Toward a comprehensive psychiatry/behavioral science curriculum for primary care residents. PMID- 2710922 TI - Chewing and spitting associated with a protein sparing modified fast and psychosocial stressors. PMID- 2710923 TI - Severe respiratory depression from patient-controlled analgesia in renal failure. PMID- 2710924 TI - A case of skin and ear self-mutilation. PMID- 2710925 TI - Noncompliance rates in a private practice setting. PMID- 2710926 TI - The value of computed tomography in the diagnosis of the prehepatic portal hypertension. AB - The dynamic computed tomography (CT) is used by the authors in a complex system of investigations. It is preceded by a diagnosis stage which determines the "normal" character of the liver and it is followed by the angiographic exploration for the cases with surgical indication. 36 patients with CT diagnosis of prehepatic portal hypertension were studied; from these patients, 24 had an angiographic confirmation and 16 of them were operated. The most valuable CT signs which have been found by the authors were: the study of the portal vein at the hilum level and in the distal parapancreatic region, the hypoplasia of the left hepatic lobe and the absence of the ascites. The other signs were considered less important, only the localization of the porto-systemic shunts being to a certain degree important for surgery. It is underlined the early age of the patients (69% are under 30 years old). The diagnosis concordance was in the studied group 100% for the positive diagnosis of the syndrome, but only 79% for the localization of the obstruction. CT is the most innocuous diagnostic procedure which obtains a maximum of data on the portal system morphology. PMID- 2710927 TI - [Respiratory activity of the lungs as a sign of exacerbation of a lung tuberculoma]. AB - From the clinical and roentgenological data of 82 patients with tuberculoma (progressing 55, stationary 27) the roentgenopneumopolygraphic semiotics of regional and generalized ventilation disorders is derived. In a non-active tuberculoma lung tissue often shows a regional hyperfunction. In the progress of the tuberculous process the symptoms of "surrounding hypoventilation" near the tuberculoma is seen. After ulceration of the tuberculoma sub- and segmentary zones of reduced respiratory function appear together with biomechanic respiration disorder, indicated by reduced planimetric and amplimetric respiratory parameters. A complex evaluation of respiratory parameters can serve as an objective criterion for the early detection of a reactivation of lung tuberculosis. PMID- 2710928 TI - [Changes in the breast in Hodgkin's and non-Hodgkin's lymphoma]. AB - The results of mammography, infrared thermography, cytology and histology are compared for 13 patients with secondary Hodgkin's disease and for 4 patients with primary and 9 with secondary Non-Hodgkin lymphoma. It was found, that an accurate diagnosis can be achieved only by cytology and histology PMID- 2710929 TI - [X-ray diagnosis of small breast cancers]. AB - The incidence of breast carcinoma is steadily increasing in the developed countries. Mortality increases with tumour size. For a reduced mortality early detection must be achieved. Mammography is of high diagnostic value for the detection of small breast carcinoma. PMID- 2710930 TI - [A retrospective analysis of x-ray changes of the hip joint]. AB - In 74 patients who had an endoprothesis implanted for a radiologically defined coxarthrosis preoperative radiographs were compared with contact radiographs of the resected femur head. In case of a reduction of the radiological width of the articular cavity an evaluation of the underlying cartilage damage at the femur head and the acetabulum is possible in one half of the cases. We were able to confirm cysts on the post-resection radiographs in 85.1% of the cases. Small bone fragments interpreted as necrosis, bone sclerosis and small indents of the femur head were confirmed in 70% of the cases. In the resected joint 7.8% more erosions were found than in-vivo. Sclerotic atrophy was seen twice as often in the resected joint than in-vivo. A comparison of the trabecules of the spongiosa for the evaluation of bone structure is possible only in part with the method described here. PMID- 2710931 TI - [Experiences with CT-guided percutaneous drainage of pyogenic liver abscesses]. AB - 32 CT-guided percutaneous drainages of bacterial liver abscesses in 25 patients accomplished definitive sanitation in 18 of them (72%). In 7 cases surgical revision was required. Percutaneous drainage of abscesses was able to achieve a temporal improvement in these cases and therefore was an effective pre-surgical measure. There were no complications primarily due to the method itself. The average dwell-time of catheters during drainage of curative percutaneous drainage was 22.5 days. The new therapy concept has proven to be of little discomfort and complications together with high therapeutic effectiveness. PMID- 2710932 TI - Two cases of pseudohypoparathyroidism in a family with type E brachydactylia. AB - The authors described two sisters with pseudohypoparathyroidism, who had shortening of the metacarpal and metatarsal bones, irregular shortening of the phalanges, resulting in brachydactylia; short stature, moon-like face, in association with manifestation of tetany and metabolic anomalies (hypocalcemia and hyperphosphatemia in one of the patients). Investigation into the genealogy of the patients ascertained their father and grandmother to be of the same constitutional type: small in stature, moon-like face, shortened metacarpal bones (less marked); in the absence of any manifestations of tetany and metabolic anomalies. Evidently, in genealogies with type E brachydactylia of pure form one may expect the occurrence of disorders of the type of pseudohypoparathyroidism. As regards differential diagnosis, consideration should be given in hypoparathyroidism, pseudo-pseudohypoparathyroidism, and other syndromes with brachydactylia. PMID- 2710933 TI - [Choice of x-ray diagnostic methods in chronic odontogenic sinusitis]. AB - On the basis of our experiences the selection of diagnostic methods for chronic odontogenic sinusitis is discussed. The selection is based on the primary sign, the reduced transparency of the sinus, detected with conventional radiography. Its purpose is the determination of the extent and nature of the opacity. Conventional methods, contrast investigations, conventional and computed tomography are used. PMID- 2710934 TI - [Radiodiagnostic methods in the postmortem study of a dicephalus masculinus]. AB - With conventional radiography and with CT several malformations were detected in a dicephalus masculinus. The most important were: 2 spinal medullas in a common spinal canal (TH1 to L4), hydrocephalus of both lateral ventricles and of the third ventricle, prolaps of the left hepatic lobe into the left thoracic cavity, two aortic arcs, one large internal jugular vein, and twin bases of the vertebrae TH1 to L5. The dicephalus had not only a double head, but also two cervices connected by a falx. PMID- 2710935 TI - [Conventional myelography--a benefit-risk estimation]. AB - While the benefit and methodic risk of conventional myelography (KMG) are known, a radiation risk of 0.04 to 0.9 annual radiation induced cancers can be estimated for all inhabitants of the GDR, dependent from the investigated region and the used technique. An optimized technique can reduce the radiation burden to 50 or 25%. With comparable values of benefit and radiation risk spinal CT and KMG are not contradictory but complementary investigations. Alternative methods (MRT, US) must not be discussed from the standpoint of radiation burden, but according to their availability and their methodic limitations. PMID- 2710936 TI - [Changes in the spatial frequency spectrum of the image as a means of diagnosing pathologic changes of the nasal sinuses]. AB - A conventional radiograph can be processed by simple devices in three ways, resulting in a different spatial frequency content of the processed image. Methods of isotopic and non-isotopic high-pass filtration allow a differentiation of relevant detail. We investigated 335 patients with various disorders of the nasal sinuses and a high effectiveness of these methods was found for polypous sinusitis, cysts and malignant tumours. PMID- 2710937 TI - [Idiopathic osteoporosis?]. PMID- 2710938 TI - [Eve and Adam--is a partnership between the male and female actually possible?]. AB - Whereas the girl can pattern the formation of her post-oedipal gender-typical selfrepresentation on the model of her mother, the boy must give up the maternal object and turn to the father. The author believes that the reorientation consumes energy which the boy lacks when forming his ego structures, his frustration tolerance, his capacity for relationships. This deficit model is invoked to explain the commonly deplored typically male behavioral and attitudinal characteristics. PMID- 2710939 TI - [Narcissism: origin and goal of the ego. Reflections of Lou Andreas-Salome]. AB - The author presents Andreas-Salome's theoretically relevant, though largely neglected writings. She devoted special interest to narcissism. Her contributions to this topic are discussed in relation to Freud's corresponding texts, with whom she maintained an enduring friendship. General reference is made to the more recent psychoanalytic debate about narcissism. PMID- 2710940 TI - Covert attention and eye movements during reading. AB - Eye movements were monitored during the reading of spatially transformed text in order to examine covert attentional processes in reading. In some conditions, the sequence of letters within a word was congruent with (i.e. in the same direction as) the sequence of words in the sentence; in other conditions the direction of letters within words and the direction of words in the sentence were incongruent. In addition, the window of visible text was varied so that in some conditions only the fixated word (and all preceding words) were visible, whereas in other conditions the fixated word and the succeeding word were both visible. Readers were able to extract more parafoveal information from text when the words themselves were normal than when the letters within the words were transformed. However, with practice, readers were able to use some parafoveal information even when the words were transformed. The most important finding was that the congruity of the word and letter order had no reliable effect on the ability to extract parafoveal information and influenced reading performance only when the words themselves were normal. We conclude that covert attention in reading is not a letter-by-letter scan that sweeps across the page, but either an asymmetric spotlight held constant on each fixation or a shifting of an attentional spotlight extending across multiletter units (possibly words) with the direction of shifts of attention closely coupled to the direction of eye movements. PMID- 2710941 TI - Food hoarding behaviour in the golden hamster (Mesocricetus auratus): effects of body weight loss and hoard-size discrimination. AB - Two experiments investigated some of the factors that influence food hoarding behaviour in the golden hamster (Mesocricetus auratus). In Experiment 1, hamsters given limited access to food failed to increase the amount of food they consumed at each meal. Instead, they exhibited a significant increase in the amount of food taken to hoard during the limited access period, and this permitted hamsters who were allowed to retain their hoard to maintain body weight at levels comparable to free-feeding controls. Hamsters that were not allowed to retain hoarded food rapidly lost body weight. There was also an inverse correlation between body weight and amount of food taken to hoard in all hamsters given limited access to food, suggesting that body weight loss was one factor directly related to increased hoarding during periods of limited food accessibility. Experiment 2 investigated the effect of hoard-size discrimination on food hoarding in hamsters by artificially manipulating hoard size. The results suggested that hoarding behaviour could be influenced by artificially depleting and repleting the hoard, and this factor appears to influence hoarding in the absence of any significant changes in body weight. These results are discussed in relation to the kinds of adaptive feeding strategies that hamsters may utilize in their natural environment. PMID- 2710942 TI - Glottic and supraglottic carcinoma: a retrospective comparison of radiotherapy alone with sandwich therapy in 366 patients. AB - From 1971 through 1982, 442 patients with laryngeal carcinoma were seen at the Leiden University Hospital. They were treated either with radiotherapy alone, sandwich therapy (pre- and postoperative radiotherapy) or by surgery followed by postoperative irradiation. Three hundred and sixty-six patients with glottic or supraglottic tumours could be analysed with respect to two different treatments, complications of treatment and some prognostic factors. Two endpoints of analysis were used: disease-free interval and survival to cancer death. In patients with glottic or supraglottic carcinoma, the survival of patients with advanced disease, treated with radiotherapy only, was worse as compared to the survival of the same category of patients who were treated with sandwich therapy (p less than 0.005). In patients with small glottic tumours, radiotherapy alone was mostly used. In small supraglottic tumours, the survival with both therapy policies was equal. Persistent hoarseness in patients with small glottic tumours, treated with radiotherapy only, is of predictive value for the development of a recurrence (p less than 0.001). There was no influence on prognosis of histological differentiation of the tumour. It appeared that interruption of radiotherapy for more than two days had an adverse effect on survival in patients with glottic carcinoma (p = 0.0001). Finally, the occurrence of second malignancies was analysed. It was found that 19% had a second malignancy. Almost 60% of them were lung cancers. PMID- 2710943 TI - Radiation therapy of skin carcinomas: results of a hypofractionated irradiation schedule in 675 cases followed more than 2 years. AB - Six hundred and seventy-five cases of cutaneous epidermoid carcinomas of the face (excluding the lips, ears and eyelids) were treated with superficial irradiation therapy according to an original dose and time schedule (3 fractions of 1020 R over 14 days), with correction for RBE. The reference dose was always set at the deepest portion of the tumor (100% isodose including the lesion) and surface dose was limited to 125% of the depth dose. The energy used varied according to the thickness of the tumor, and the size of the irradiation fields according to the diameter of the tumor. All other parameters remained constant. The results after a minimum follow-up of 2 years show that the failure rate was low (less than 4%) and could be corrected in 85% of cases. Ninety per cent of recurrences appeared within 3 years; they were central and most frequently observed in nasal locations and basal cell carcinomas. Complications were rare (fewer than 3% of cases), and the majority were cured by medical treatment. Cosmetic results were satisfactory in over 90% of cases. The method used for expression of the dose permits a clear and coherent interpretation of the results: complications and sequelae were closely correlated with the irradiated surface and volume. The hypofractionated irradiation protocol described in this paper offers a simple, ambulatory method for the treatment of cutaneous epidermoid carcinomas of the face which have a particularly high incidence among the elderly. The majority of patients can be treated in this way.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710944 TI - Radiosensitivity of pre-irradiated mouse skin to second courses of single and multi-fractionated irradiation--skin shrinkage. AB - The hind legs of mice were re-irradiated with various gamma-ray doses in single or multi-fractionated exposures 6 or 12 months after conditioning irradiation was administered using a variety of treatment schedules. Dose-response relationships were evaluated to ascertain "residual injuries", permissible doses during the second treatments. Fifty to 60 days after the second treatments, the degrees of shrinkage of the skin on the dorsal aspects of the hind legs were measured and used as endpoints. The residual injuries were affected by the biologically effective doses, or by the treatment schedules of not only the first, but also the second exposure. The higher the biologically effective doses, the greater were the residual injuries. Compared to the previously untreated skin, the pre irradiated skin was relatively radioresistant to the second course of treatments, regardless of the treatment schedule used. The response of the pre-treated skin to a given test dose (25 or 40 Gy) lessened with increasing dose for each treatment schedule used during the first treatment course. PMID- 2710945 TI - Manual reconstruction of tumor volumes from CT scans for radiotherapy planning. AB - Using a computed tomographic scan to construct a tumor volume on a simulation film has become an important part of radiation therapy treatment planning. Techniques for reconstruction of brain tumor volumes from computed tomographic scans onto simulation films are discussed. A technique for reconstructing by hand the tumor volume projection at a different angle from the plane of the computed tomographic scan is outlined. Ignoring beam divergence simplifies reconstruction, allowing it to be done by hand but introduces an additional error of at most 0.06, 0.15, 0.26 and 0.42 cm for tumors with maximum diameters of 5, 7.5, 10 and 12.5 cm, respectively. This technique provides the capability for limited 3 dimensional volume reconstruction of small tumors without the use of the computer. PMID- 2710946 TI - Precision and accuracy in radiotherapy. PMID- 2710947 TI - Is there an influence of overall treatment time in the response of lung to fractionated radiotherapy? PMID- 2710948 TI - Postoperative radical radiotherapy with concurrent weekly intra-arterial cis platinum for treatment of malignant glioma: a pilot study. AB - Twelve patients with histologically proven malignant glioma have been treated with a combination of intra-arterial (IA) cis-platinum (CDDP) and radical radiation therapy (RT). Chemotherapy consisted of intracarotid (IC) CDDP, 40-60 mg/m2, weekly, repeated for 3-5 treatments. Radiation therapy consisted of whole brain irradiation 5000 cGy in 5 weeks, plus a cone-down boost (1000 cGy in one week) to the primary tumour lesion. Ocular toxicity derived from IC chemotherapy was observed in 3 out of 41 procedures analyzed (7%). Results in tumour response assessed by computed tomography (CT) showed 5 complete remissions, 6 partial remissions and one patient was not evaluable. The median survival time for the entire group was 10 months. Median survival time in patients with complete response is 17 months, and 10 months in patients with partial response. Four patients are still alive with a follow-up ranging from 6+ to 27+ months. PMID- 2710949 TI - Stage III Hodgkin's disease--long-term results following chemotherapy, radiotherapy and combined modality therapy. AB - 215 patients with stage III Hodgkin's disease (HD) were treated at the Royal Marsden Hospital between 1963 and 1985 (median follow-up 9 years). The actuarial 5- and 10-year survival was 77 and 65%, respectively with 55 and 48% 5 and 10 year disease-free survival. Of 13 variables tested, age was the only independent prognostic indicator for survival on multivariate analysis. Patients aged under 40, 40-59 and over 60 years had a 10-year survival of 76, 41 and 8%, respectively (p much less than 0.001). Ninety-one patients were initially treated with combined chemotherapy and radiotherapy (combined modality therapy, CMT), 73 patients with radiotherapy (RT) and 51 patients with chemotherapy (CT) alone. Patients under 40 years treated with CMT achieved the best disease-free survival (10 year disease-free survival: CMT 68%; RT 38%; CT 45%). The observed survival advantage for CMT was not statistically significant. In patients aged greater than 40 there was no survival or disease-free survival advantage following CMT. Analysis of recurrence pattern confirmed that CMT improves initial disease control both at previously involved and uninvolved sites. Recurrences at previously uninvolved sites continued up to 6 years following CT, up to 8 years following CMT and up to 14 years after RT alone. These results indicate that only long-term follow-up gives the true picture of stage III HD. PMID- 2710950 TI - Is elective neck treatment indicated for T2N0 squamous cell carcinoma of the glottic larynx? AB - This is an analysis of 98 patients with T2N0 squamous cell carcinoma of the glottic larynx treated with radiation therapy. Patients received irradiation to the primary lesion alone; the neck was not treated electively. All patients had at least 2 years of follow-up; patients who died within 2 years from treatment with the neck continuously disease-free were excluded from the analysis. The rate of control of neck disease following irradiation was as follows: primary site continuously disease-free, 73/75 (97%); primary tumor recurrence, 18/23 (78%). Salvage treatment was successful in 4 of 7 patients who developed recurrent disease in the neck. We conclude that elective treatment to the clinically negative neck is not indicated for patients with T2N0 squamous cell carcinoma of the glottic larynx. However, patients who develop a local recurrence following irradiation have a substantial risk of harboring disease in the neck and should undergo a neck dissection in conjunction with the surgical procedure selected to resect the recurrent disease at the primary site. PMID- 2710951 TI - Radiation therapy of seminoma: 17-year experience at the Joint Center for Radiation Therapy. AB - One hundred and sixteen patients with stage I and II primary testicular seminoma were treated at the Joint Center for Radiation Therapy (JCRT) between 1968 and 1984. Complete follow-up is available for 114 patients (98%) with a median follow up time of 6 years. Actuarial relapse-free survival (RFS) and survival for the entire group at 10 years were 94 and 86%, respectively, with 27 patients still at risk beyond 10 years. Actuarial RFS and survival at 10 years by stage were 97 and 92% for stage I, 93 and 81% for stage IIa, 100 and 100% for stage IIb, but only 75 and 51% for stage IIc. The difference in actuarial survival between stage IIc patients and stage I, IIa and IIb patients was significant (p less than 0.01). These results indicate that radiation therapy is excellent treatment for stage I and II seminomas as long as the largest mass of disease is not greater than 5 cm (stage IIc). Patients with stage IIc seminoma are now treated with cisplatin containing combination chemotherapy followed by radiation therapy to areas of bulk disease. Although the majority of patients with stage II disease in this series received mediastinal irradiation, this is no longer recommended at the JCRT. PMID- 2710952 TI - Radiotherapy or surgery for T2N0M0 glottic carcinoma? A decision-analytic approach. AB - Decision analysis was used to evaluate the results of treatment of T2N0M0 glottic carcinoma as presented in the literature. Based on mean values for recurrence, salvage eligibility after recurrence and salvage success, the 5-year survival after radiotherapy and surgery proved to be almost identical, 85 and 86%. If the recurrence rates and the salvage rates were varied, a marginal advantage for surgery in small tumours (T2a) and a major advantage in more extended (T2b) tumours was seen if only survival is considered. To take the quality of speech into account, a utility analysis was performed. A utility scale was defined ranging from 0.0 as the value for death, to 1.0 for a successfully irradiated patient with preservation of normal speech. A utility of 0.99 or less for the laryngectomized patient would favour radiotherapy over surgery for all T2 tumours. In patients with T2b tumours and in extreme circumstances, e.g. if failure rates of radiotherapy are extremely high or if recurrence rates after surgery are extremely low, an exact assessment of patient utilities may be pivotal. Under normal circumstances radiotherapy is preferred for T2N0M0 glottic carcinoma if both survival and the quality of speech are taken into account. PMID- 2710953 TI - The impact of stage and treatment modality on the likelihood of second malignancies and hematopoietic disorders in Hodgkin's disease. AB - Two hundred patients treated with curative intent for Hodgkin's disease between October 1964 and April 1984 at a single institution were studied retrospectively for development of second malignancies. The minimum follow-up was 2 years (median, 11 years). The staging distribution was IA-B, 61; IIA, 54; IIB, 20; IIIA, 46; and IIIB, 19. Sixty-one percent of the patients had laparotomy. Initial management was irradiation alone (RA) in 143 patients and a combination of chemotherapy and irradiation (CB) in 57 patients. Actuarial 10-year survival rates were 82%, IA-B; 78%, IIA; 66%, IIB; 66%, IIIA; and 24%, IIIB. Cause specific deaths due to Hodgkin's disease or complications of initial or salvage therapy occurred in 3% of IA-B patients, 18% of IIA-B patients, and 35% of IIIA-B patients. One patient had a prior T3N1 squamous cell carcinoma of the retromolar trigone, and a second was diagnosed with concurrent Hodgkin's disease and granulocytic sarcoma. Subsequent solid tumors have occurred in six patients from 5 to 21 years after treatment, including papillary carcinoma of the thyroid, renal cell carcinoma, unilateral breast carcinoma, cervix carcinoma in situ, and lung carcinoma after RA, and bilateral breast carcinoma after CB. Seven fatal hematopoietic disorders (HPDs) were observed, including four acute leukemias, one dysmyeloproliferative syndrome (DMPS), one autoimmune hemolytic anemia, and one aplastic anemia. Two occurred in patients initially managed with RA who subsequently required chemotherapy for relapse. Five HPDs occurred in patients initially managed with CB who never relapsed. All HPDs were observed between 2 and 7.5 years after administration of chemotherapy. Statistical analysis of the data using a rerandomization test on Gehan ranks of treatment and clinical variables showed significant correlations between development of a secondary HPD and (1) initial management with CB; (2) higher doses of chemotherapy; and (3) more advanced disease, particularly IIIB. When only the five events generally associated with treatment (i.e. the four leukemias and one DMPS) were considered, there was a significant correlation with exposure to chemotherapy and presentation with advanced disease. The patient population was small so that interdependence between treatment factors and initial extent of disease in affecting the risk of a secondary HPD cannot be discounted but should be further investigated with larger patient populations. PMID- 2710954 TI - The labelling index: a prognostic factor in head and neck carcinoma. AB - The thymidine labelling index (LI), representing the percentage of cells in the DNA-synthesis phase, was measured in vitro prior to therapy in 87 patients with squamous cell carcinoma of the head and neck, who were treated between 1977 and 1982. The LI was not related to patient age, site of the tumour, clinical stage or histological grade. Overall survival was 44.5%. Univariate analysis demonstrated that survival was affected by the following factors: (1) age: patients older than 55 had a better outcome (p = 0.03); (2) site of the tumour (p = 0.005): laryngeal tumours had the best survival; (3) clinical stage (p = 0.05). Histological grade did not influence the survival (p = 0.41). Patients having a tumour LI higher than 15.5% (mean + 1 S.D.) had a significantly lower survival than patients with lower tumour LI (p = 0.008). A multivariate analysis using the Cox model showed that clinical stage and LI kept their prognostic impact with regard to survival. Finally, survival after relapse was lower in patients with a high tumour LI. These results demonstrate that a high tumour proliferation rate is an additional factor influencing the disease outcome in head and neck carcinoma. Patients with bad prognosis defined by this parameter could be offered a more energetic treatment. PMID- 2710955 TI - Hematological effects in dogs after irradiation of the lower part of the body with a single myeloablative dose. AB - The lower body of dogs, containing approximately 30% of the total bone marrow, was exposed to 300 kV X-rays with a single myeloablative dose of 11.7 Gy, whereas the upper body was shielded by a lead box. The results of the present study are discussed in connection with recently published results obtained after irradiation of the upper body (UBI), containing approximately 70% of the total bone marrow mass. The main findings are as follows: (1) the nadir in the blood concentration of thrombocytes, lymphocytes, and granulocytes strongly depends on the volume of irradiated bone marrow; (2) apart from some quantitative differences, the time-related pattern of changes in the concentration of granulocyte/macrophage progenitor cells (GM-CFC) in irradiated and shielded bone marrow sites is very similar after irradiation of the lower part of the body (LBI) and UBI, i.e. is apparently independent of the relative amount of damaged bone marrow at volumes applied in the present models; (3) the concentration of GM CFC in the blood after LBI shows a transient increase during the first phase of most rapid bone marrow GM-CFC regeneration, i.e. between day 7 and day 23; the magnitude of this transient increase obviously depends on the fraction of irradiated bone marrow. PMID- 2710956 TI - Hematological effects in dogs after sequential irradiation of the upper and lower part of the body with single myeloablative doses. AB - The compensating mechanisms determining the tolerance of the hemopoietic system to sequential hemibody irradiation (HBI) with large single doses, the regeneration of the irradiated bone marrow and the long-term effects of such treatment were studied in dogs. The main emphasis was laid on the determination of the granulocyte/macrophage progenitor cells (GM-CFC) in the bone marrow and blood. The general pattern of events in the GM-CFC compartment after each exposure was similar. Irradiation with a dose of 11.7 Gy of the upper body (UBI), that involved the abrogation of approximately 70% of the total active marrow, was followed by an immediate increase in the proliferation and differentiation of GM CFC in the protected bone marrow. Repopulation of the GM-CFC in the irradiated sites most probably due to seeding of hemopoietic cells from the protected marrow already became evident at day 7 after UBI. At day 56 after UBI, when the irradiation of the lower body (LBI) was performed, the GM-CFC had recovered to between 30 and 40% of their pre-treatment values. Despite this incomplete regeneration, the GM-CFC compartment responded to LBI in a similar way as the GM CFC had in the protected (normal) marrow after UBI, i.e. by an increased proliferation for at least 21 days. Already at day 7, the bone marrow of the iliac crest that had been exposed to LBI showed a considerable number of GM-CFC. Within no more than 370 days all the bone marrow sites irradiated during either the first or the second treatment had regained their normal GM-CFC values. PMID- 2710957 TI - Incidence and latency of radiation reactions. PMID- 2710958 TI - Addition of steroids to embryo-uterine monolayer co-culture enhances embryo survival and implantation in vitro. AB - Co-culture with a mixed cell monolayer established from trypsinized uterine tissue increased the numbers of embryos developing in a minimum essential medium beyond the hatching blastocyst stage in the 5-day period of culture to 56.0% (343/613) compared with 30.2% (93/308) for embryos cultured in medium alone. The inclusion of progesterone (3.2 x 10(-6), 3.2 x 10(-5), or 3.2 x 10(-4) M) or oestradiol (3.7 x 10(-5) M) to the co-cultures increased the mean percentage of embryos developing to the advanced stages to 72.7-78.4%. The addition of progesterone (3.2 x 10(-6) M) together with oestradiol (3.7 x 10(-5) M) resulted in additional improvement to a mean of 86.5% (787/910, P less than 0.001) but the combination was without significant effect on embryos cultured in media alone. Blastocyst viability was not impaired by co-culture as assessed in embryo survival following surgical transfer to pseudopregnant recipients. This study confirms the feasibility of establishing co-culture systems to facilitate investigation of pre-implantation events in vitro and highlights a role of steroid hormones in enhancing the capacity of uterine cells to support pre implantation-stage embryos. PMID- 2710959 TI - Sex steroid levels and Leydig cell ultrastructure of the male common sheath-tail bat, Taphozous georgianus. AB - Male sheath-tail bats were collected from central Queensland over a 12-month period. Plasma testosterone levels peaked in August, coincident with an increase in the volume of the accessory glands and ampulla/seminal vesicle secretion. Peak spermatogenesis occurred in summer and autumn and declined in the face of maximal testosterone levels in winter. Levels of androstenedione and 5 alpha dihydrotestosterone were high compared with testosterone levels and showed no significant seasonal changes. Ultrastructural examination of Leydig cell cytoplasm revealed numerous lipid droplets and mitochondria, and an abundant smooth endoplasmic reticulum. There were no seasonal changes in Leydig cell ultrastructure. The anomalous reproductive pattern in this species is consistent with the imposition of a cold-induced winter spermatogenic shutdown, on a framework of continuous spermatogenesis, with spring peaks in testosterone and accessory gland activity. PMID- 2710960 TI - Luteinizing hormone in the Kowari, Dasyuroides byrnei (Marsupialia:Dasyuridae), during the oestrous cycle and pregnancy, and the effects of gonadectomy in male and female. AB - A heterologous double antibody radioimmunoassay has been validated for measurement of LH in plasma of a dasyurid marsupial. Basal concentrations in the oestrous cycle of female kowaris were in the range of 0.5-2.0 ng NIH-oLH-S19 mL 1. Many animals showed elevated LH concentrations (3.0-12.0 ng mL-1) between 8 and 15 days before oestrous but no pre-ovulatory surge was detected. Gonadectomy resulted in greatly increased concentrations of LH, and decreases in testosterone and progesterone concentrations in male and female respectively. In the female LH values ranged from 10-50 ng mL-1 but in the male LH values were greater than 50 ng mL-1. PMID- 2710961 TI - Plasma progesterone and body weight in the pregnant and non-pregnant kowari, Dasyuroides byrnei (Marsupialia:Dasyuridae). AB - Female kowaris are seasonal breeders (May-November) with a gestation of 32.5 +/- 1.8 days (mean +/- s.d., n = 35). The oestrus cycle including pregnancy is 59.0 +/- 6.7 days in duration (mean +/- s.d., n = 12) and is not significantly different from the non-pregnant cycle of 60.3 +/- 7.1 days (mean +/- s.d., n = 15) (P greater than 0.1). Animals maintained on a fixed diet show an increase and fall in body weight before oestrus and again at the end of the oestrous cycle or a pregnancy; these changes correlate closely with progesterone concentration. Plasma progesterone concentration and body weight were measured in six kowaris undergoing an oestrous cycle then a pregnancy in the breeding season of 1981. The basal concentration (mean +/- s.d.) of progesterone prior to the breeding season was 0.35 +/- 0.21 ng mL-1. There were mean rises of 1.84 +/- 1.1 and 2.47 +/- 1.5 ng mL-1, respectively, before the first and second oestrous periods which had declined to near basal levels by the day of oestrus. Peak values of 9.9-11.5 ng mL-1 were measured between days 23 and 30 of oestrous cycle and pregnancy. The pattern of changes in body weight and plasma progesterone concentration was similar in pregnant and non-pregnant animals but the decline in weight and progesterone occurred earlier in pregnant kowaris. PMID- 2710962 TI - Purification of the pancreatic cholecystokinin receptor. AB - We have previously shown that the pancreatic cholecystokinin (CCK) receptor can be solubilized in 1% digitonin. In this study, digitonin-solubilized CCK receptors from rat pancreas were purified using sequential affinity chromatography on ricin-II agarose and on AffiGel-CCK. Electrophoresis of the radioiodinated purified receptors on SDS-polyacrylamide gels followed by autoradiography revealed two proteins: a major band of Mr = 80,000-90,000, and a minor band of Mr = 55,000. Through the purification procedure, the receptors preserved their agonist specificity (CCK-8 less than CCK-33 less than desulfated CCK-8 less than CCK-4) and binding affinity. Scatchard transformations of binding data for the purified receptor preparation were best fit by linear plots compatible with a single class of binding sites with Kd = 9.4 nM. The estimated purification was about 80,000 fold and consistent with the expected Bmax for a pure Mr = 80,000 protein binding one CCK molecule. This two-step purification procedure opens the possibility for molecular studies of the CCK receptor. PMID- 2710963 TI - Effects of neuropeptides on gastric acid and duodenal bicarbonate secretions in freely moving rats. AB - The central nervous system effects of neuropeptides on gastric acid and duodenal bicarbonate secretions were examined. In freely moving rats, i.c.v. administration of thyrotropin-releasing hormone (TRH), human gastrin-17 (hG-17) and the somatostatin analogue, desAA 1,2,4,5,12,13 [D-Trp8]somatostatin (ODT8 SS), significantly increased gastric acid secretion, while vasoactive intestinal peptide (VIP) had no effect. In the order of potency and efficacy, the following peptides decreased acid secretion: bombesin (BOM) greater than calcitonin gene related peptide (CGRP) greater than calcitonin (CT) greater than corticotropin releasing factor (CRF) greater than beta-endorphin (beta-END) greater than neurotensin (NT). In anesthetized rats, none of these peptides significantly altered proximal duodenal bicarbonate secretion. In awake, freely moving rats, cerebroventricular administration of CGRP significantly decreased while ODT8-SS, TRH and CRF significantly increased duodenal bicarbonate secretion. beta Endorphin, VIP, CT, BOM, NT and hG-17 given i.c.v. did not significantly alter the bicarbonate response. These results indicate that neuropeptides administered into the central nervous system modulate gastric acid as well as duodenal bicarbonate secretions in awake, freely moving rats in a differentiated fashion. CGRP inhibits both acid and bicarbonate secretions, a somatostatin analogue and TRH both stimulate acid and bicarbonate secretions and CRF inhibits gastric acid but stimulates duodenal bicarbonate secretions. PMID- 2710964 TI - [Investigation of radiation facilities suffering from the 1982 Chiba-touhooki earthquake. Radiation Protection Supervisors Committee, Japan Radioisotope Association]. PMID- 2710965 TI - [Introduction to genetic engineering experiments. Appendix. Analysis of genetic information using a computer]. PMID- 2710966 TI - [Evaluation of left atrial function by 99mTc gated blood pool scan]. AB - 99mTc gated blood pool scans were studied to assess the left atrial function. Relationship between filling time and rapid emptying time was y = 0.695 x + 109 (r = 0.761, p less than 0.05, n = 14) in LAO and LPO projections. On the other hand, relationship between slow filling and rapid emptying time was good closely (y = 0.846 x + 16.9 (p less than 0.01, r = 0.975, n = 8] in standard and retrograde acquisition. To assess the left atrial function by standard acquisition in LAO projection should be available for clinical use. PMID- 2710967 TI - [A method of calculating photon dose equivalent based on the revised technical standards of the Radiologic Protection Law (1)--conversion from absorbed dose in air to dose equivalent in shielding calculations]. PMID- 2710968 TI - [Supraclavicular plexus blockade using prilocaine in patients with chronic anemia]. AB - It has not yet been clarified whether prilocaine-induced methemoglobinemia is a problem in patients with chronic anemia. We therefore performed supraclavicular brachial blockade for upper limb surgery (6 mg/kg prilocaine 2% + 0.1 IU vasopressin/ml) in ten female patients with chronic renal failure (mean Hb 8.19%) requiring hemodialysis. Before the blockade, a catheter was inserted into the opposite internal jugular vein and blood samples were drawn before and 10, 15, 20, 30, 45, 60, 90, 120 and 180 min after injection. Plasma prilocaine concentrations and methemoglobin levels were within the ranges measured by other authors in healthy patients. There was no correlation between plasma prilocaine levels and methemoglobinemia. We therefore consider prilocaine to be a safe local anesthetic in patients with renal failure and chronic anemia. PMID- 2710969 TI - [Chronic subdural hematoma following spinal anesthesia]. AB - A chronic subdural hematoma was observed 4 weeks after spinal anesthesia. The 70 year-old patient complained of severe, long-lasting headache soon after lumbar puncture. The later symptoms of hemiparesis and aphasia were first misinterpreted as a cerebral vascular accident. After evacuation of the hematoma the patient recovered. Long-lasting, severe headaches after lumbar puncture may be caused by a chronic subdural hematoma, a very rare complication. Risk groups are elderly patients and alcoholics, but every age group can be affected, including parturient women who deliver under spinal anesthesia. The diagnostic procedure of choice is computerized tomography (CAT). The application of contrast medium might be necessary if the CAT scan appears suspicious for a hematoma with the same density as the brain tissue. Because this complication is so rare informing the patient before spinal anesthesia does not seem to be necessary. According to expert opinions, a connection between lumbar puncture and subdural hematoma should be possible. In elderly patients and alcoholics, a pre-existing subdural hematoma may be possibly present. PMID- 2710970 TI - [A space-occupying hemorrhage following spinal anesthesia in the presence of an undiagnosed small spinal tumor (ependymoma)]. AB - Space-occupying subarachnoid bleeding after atraumatic puncture of the spinal canal for spinal anesthesia in a patient with no coagulation disorders or anticoagulant therapy is described. The hematoma was caused by puncturing a previously undiagnosed small spinal ependymoma. A thorough and specific preoperative evaluation is of importance to minimize the risks associated with spinal anesthesia. PMID- 2710971 TI - Interspecific scaling of toxicity data: a question of interpretation. PMID- 2710972 TI - Perceived fairness in risk management: Bayesian implications for AIDS testing. PMID- 2710973 TI - Additive and multiplicative models and multistage carcinogenesis theory. AB - In light of the Armitage-Doll multistage carcinogenesis theory, this paper examines the assumption that an additive relative risk relationship is indicative of two carcinogens that affect the same stage in the cancer process. We present formulas to compute excess cancer risks for a variety of patterns for limited exposure durations to two carcinogens that affect the first and penultimate stages; and using an index of synergy proposed by Thomas (1982), we find a number of these patterns to produce additive, or nearly additive, relative risk relationships. The consistent feature of these patterns is that the two exposure periods are of short duration and occur close together. PMID- 2710974 TI - [Relation of alcohol consumption and blood lipids and apolipoproteins--a study of a population of 3,897 wage-earners from the Lyon region]. AB - Between June 1982, and September 1984, a survey was conducted among 3,897 employees in the Region of Lyon to study the relationship between alcohol consumption and serum concentrations of total cholesterol and triglycerides. In 400 randomly selected men, the following data were also obtained: concentrations of the cholesterol of the high density lipoproteins (HDL) and of their subfractions, and concentrations of the apoproteins A-I, A-II and B. All these biochemical concentrations increased, more or less, with alcohol consumption. Relative to non drinkers, the concentrations increased among males who declared drinking more than 80 grams of alcohol per day: for total cholesterol, by 10.0%; for triglycerides, by 24.7%; for HDL-cholesterol, by 26.7%; for HDL2-cholesterol, by 76.0%; for HDL3-cholesterol, by 15.0%; for apoprotein A-I, by 30.0%; for apoprotein A-II, by 52.2%; for apoprotein B, by 5.1%. These results, with the limitations inherent in a cross-sectional study, suggest that regular consumption of alcohol raises the concentrations of blood lipid components, both atherogenic and non-atherogenic. PMID- 2710975 TI - Adolescent hypertension: a follow-up study in the community. AB - This study evaluates the acceptability, the predictive value and the utility of a hypertension screening programme for Swiss adolescents from 16 to 19 years of age, using private physicians' records as an end-point: 3,386 young people had their blood pressure (BP) measured in a standardized way: 113 teenagers were sent to their private physician, 14 patients were considered to be hypertensive, and 29 others borderline hypertensive. The predictive value of the test is 38%; the prevalence of hypertension in the screened population is 1.3%; no secondary hypertension was detected. The acceptability of the programme is good, its predictive value fair, but its utility can be questioned because of the low prevalence of hypertension in this age group and the absence of secondary or very high hypertension. PMID- 2710976 TI - [A model for evaluating screening tests. The case of colorectal tumors]. AB - The results of numerous studies on screening are restricted to crude estimates of the predictive value of different tests. This is notely the case for early diagnosis of colorectal adenoma and cancer. The reference examination is in principle a total colonoscopy. Usually, it is not performed on the subjects for which the screening test gives a negative result. Moreover, the distribution according to age and sex is not taken into account. Both variables are strongly associated with the prevalence of the disease. After a presentation of the problems arising from screening evaluation performed in such situations, a method is proposed for comparing different tests in several populations. An estimate of the expected number of cases within a fictitious control group matched for age and sex with the people whose the test result is positive is computed according to an hypothesis on the duration of asymptomatic cancer and using available descriptive data on symptomatic cancer incidence and on the prevalence of adenoma in the population. The selection power of the test, i.e. the number of observed cases divided by the number of expected cases, is proposed as a standardized parameter for measuring and comparing the validity of screening tests. The method is illustrated by an example of its application procedure. The discussion stresses the limitations of such an approach. PMID- 2710977 TI - [Absence of a relationship between senile dementia and parental age. A case report survey in Upper Normandy]. PMID- 2710978 TI - [A cause of death study using family surveys: validity of the obtained information]. PMID- 2710979 TI - [Epidural blood patch and headache after dural puncture: it's never too late]. PMID- 2710980 TI - [Comparison of venous pressure in the external jugular vein and the superior vena cava during anesthesia]. AB - Venous pressure between the external jugular vein (EJV), and the superior caval vein (SCV) was compared in 15 patients, free of cardiorespiratory disease and undergoing abdominal surgery. In each patient data was taken in four different positions: A) anaesthetized patient in supine position and mechanical ventilation; B) anaesthetized patient in Trendelenburg position and mechanical ventilation; C) anaesthetized patient in anti-Trendelenburg and mechanical ventilation, and D) awake patient in supine position and spontaneous ventilation. A short, thick catheter with unique end lumen was used for EJV, and a long catheter from the basilic vein, to the SCV. Significant differences between mean and standard deviations of EJV and SCV were not founded. Linea correlation for the 4 positions was performed (r = 0.97, 0.91, 0.88 and 0.60 respectively) being significant for A-B y C positions. 4.5 cm H2O was the maximal difference obtained between SCV and EJV for A, B and C positions, and 10 cm H2O the maximal difference for the D position. The mean changes between the positions A-B, A-C and A-D was compared and significant differences (p less than or equal to 0.001) for A-C were seen, whereas A-B did not attain significant differences. We conclude that the EJV cannulation, with a short and thick catheter, allow the central venous pressure control during anaesthesia, in supine position, Trendelenburg and anti-Trendelenburg, but not during the recovery. PMID- 2710981 TI - [Current situation of anesthesiology and resuscitation in Spain. National Survey (II): surgical units]. AB - We have studied the data from the surgical blocks of 170 hospitals. Hospitals have been classified in three groups according their size (less than 500 beds, from 500 to 1,000 beds and greater than 1,000 beds). A second criterium of classification was the distinction between public and private hospitals. The geographical distribution of the hospitals was our third criterium of classification. We report the results concerning the anaesthetic techniques applied, the availability of the human resources, the physical space and installations, the instrumental equipment, some of the surgical specialties developed in the hospitals, and the characteristics of their recovery rooms. PMID- 2710982 TI - [Epidural anesthesia for cesarean section in a patient with Eisenmenger's syndrome]. AB - A case of a 21 year old pregnant patient with a Eisenmenger's syndrome is reported. She was in her 38th weeks of pregnancy and submitted to a cesarean section under epidural anaesthesia. In spite of a FiO2 1 administered through a nonrebreathing mask, she presented refractory hypoxemia. Hypotension during delivering was observed and treated with sympathomimetic drugs. Four days later, the patient presented a pulmonary thromboembolic clinical phenomena and died. Eisenmenger's syndrome during pregnancy is reviewed. Maternal mortality rate is higher in cesarean section (75%) when compared with vaginal delivery. We conclude that epidural anaesthesia can be an useful technique for these patients under a careful hemodynamic management and a proper dose of local anaesthetics. PMID- 2710983 TI - [Acute respiratory insufficiency following thymectomy: an unusual cause]. AB - We describe the case of a patient with an acute respiratory failure during the postoperative period of a timectomy. Myasthenic syndrome was excluded and bilateral diaphragmatic paralyze was diagnosticated. Incidence, etiology, symptoms, diagnostic and treatment of phrenic paralysis are reviewed. PMID- 2710985 TI - [Cephalic migration of methadone administered by the spinal route]. PMID- 2710984 TI - [Cardiorespiratory failure caused by delayed dural perforation]. AB - The epidural administration of drugs is today a common approach to chronic pain therapy. Many patients benefit from this therapeutic modality. However, the more extensively this method is used, the bigger are the number of reported complications. In this case we describe a time-delayed dural tap and a secondary respiratory arrest on a patient with an epidural cervical catheter for treatment of a postherpetic neuralgia. PMID- 2710986 TI - [Correlation between the concentration of plasma lactic acid and other cardiorespiratory parameters in hypoxic patients]. AB - We carried out a study in a group of 20 patients; this group was made up of 16 women and 4 men. All patients were under controlled ventilation and the relation between partial pressure of oxygen and the fraction of oxygen to be inhaled was equal or less than 150. A Swan-Ganz catheter was implanted in the pulmonary artery and another catheter in a radial artery. We determined the cardiac output, oxygen saturation in mixed venous blood and blood levels of lactic acid. We calculated the oxygen supply, oxygen consumption and tissue extraction of oxygen. We could to point out that there is a positive and significative correlation between lactic acid blood levels and cardiac output, oxygen consumption and oxygen extraction (p less than 0.001); negative and significative between acid blood levels and oxygen supply (p less than 0.025) and oxygen saturation in mixed venous blood (p less than 0.001). Finally we observed that when the lactic acid blood levels went up, decrease in oxygen saturation in mixed venous blood is more acute that increase in cardiac output. PMID- 2710987 TI - [Morphologic changes in ileoanal reservoirs 2 years after their construction]. AB - A study was made of the histologic changes in the mucosa of the ileoanal reservoirs of 10 patients who 2 years earlier had undergone ileoanal anastomosis with a J reservoir for ulcerative colitis (CU). In biopsies of the reservoirs were evaluated: 1) basic morphologic changes; 2) morphometric differences with respect to normal ileal mucosa; 3) the immunohistochemical pattern (IHQ) (IgA, IgG, IgM and CEA) of the reservoir mucosa as compared to normal ileum, active ulcerative colitis. Crohn's disease and celiaca; 4) the possible existence of atypias or dysplasias of the reservoir mucosa; and 5) the number of argentaffin cells per field. The basic morphologic alteration consisted of colonic metaplasia. Reservoir biopsies exhibited partial (8 cases) or subtotal atrophy (2 cases) of the mucosa. With respect to the normal ileum there was a decrease in villi height (p less than 0.05), an increase in crypt depth (p less than 0.05) and a higher index of mucosal regeneration, with a larger number of cells and mitoses per crypt (p less than 0.05). Fifty percent of the reservoirs presented a chronic inflammatory pattern with an acute component in 30% of them. The immunohistochemical pattern of the reservoirs not inflamed was similar to that of normal ileum (IgA much greater than IgM greater than IgG) and that of the inflamed reservoirs was similar to that of intestinal inflammatory disease (marked increase in the IgG. CEA (similar to what?) an alteration of local immune homeostasis could have of the genesis of pictures of "pouchitis". No alarming signs of atypia or dysplasia were found, nor changes in the population of argentaffin cells. PMID- 2710988 TI - [Perforated diverticulitis of the colon: diagnosis and treatment]. AB - Twelve cases are presented of perforated diverticulitis that required emergency surgical intervention. The present guidelines for surgical action are indicated for the different situations originated by perforated diverticulitis: localized peritonitis (pericolonic abscess), suppurated peritonitis and fecaloid peritonitis. The Hartman technique is explained as the method of choice for patients with generalized peritonitis. PMID- 2710989 TI - [Cancer of the gallbladder]. AB - A retrospective study was made of cancer of the gallbladder over a 10-year period, during which 874 operations of the biliary tract were performed, 26 for gallbladder neoplasm (2.97%). Of the 26 patients studied, 22 (84.6%) were women, mean age at appearance of the tumor being 63.9 years. In 77% of the patients the time of evolution of the symptoms was less than a year, a men of 3.6 months. The principal symptom was abdominal pain, encountered in 96% of patients, followed by nausea and vomiting (65.4%). Fifty-eight percent of patients had gallstones and 46% had metastases at the time of operation. In 23% of the patients only laparotomy and biopsy could be performed, 42% underwent cholecystectomy and 34% cholecystectomy and drainage of the biliary tract. Of the 26 patients in our study, 24 (92%) had adenocarcinoma. PMID- 2710991 TI - [Alkaline phosphatases and their metabolism in digestive diseases]. PMID- 2710990 TI - [Odditis. Pathologic reality or tactics necessity]. AB - In 14 patients with secondary odditis, a biopsy of the papilla was studied, in one case encountering moderate peri and intrafascicular fibrosis and in another, erosion of the papillary mucosa with impaction of biliary material. In 6 biopsies obtained from patients with perforated liver cysticerocosis, submucosal edema of the biliary tree was observed in only 3. On the basis of these studies an analysis is made of the different percentages published, which are highly variable, and results are compared to those reported in larger series. Papillary affectation in lithiasis was related to trauma produced by impaction or expulsion of calculi and the indications for realization of sphincteroplasty or biliodigestive derivation are listed, showing a tendency toward a progressively greater restriction of surgery. The absence of sphincter disease in hepatic cysticercosis perforated into the biliary tract is signalled, the only alterations being edema, which is reversible with treatment of cysticercosis. PMID- 2710992 TI - [Localized giant pseudopolyposis in Crohn disease]. AB - A case is presented of Crohn's disease of prolonged evolution in a 32-year-old male, with clinical manifestations of intermittent obstruction due to localized giant pseudopolyposis in the colon. The bibliography is reviewed, anatomophathologic aspects are analyzed and the problems of differential diagnosis are remarked. PMID- 2710993 TI - [Ultrastructural study of the colon after massive intestinal resection in rats]. AB - The modifications suffered by the colon after massive intestinal resection (RIM) have been barely studied, especially from the ultrastructural point of view. On the basis of optical microscope studies we planned this experimental study to evaluate fundamentally the ultrastructural changes in the colonic mucosa and its cellular elements. A total of 115 Wistar rats weighing 350 to 550 grams were used. Twenty animals constituted group 0 (controls), 30 underwent intestinal section (group I) and 65 were submitted to resection of 90% of the intestine (group II). After weighing, the animals were sacrificed by groups on days 15, 30, 45 and 60 of the operation to obtain histologic samples of the ascendant colon for study by transmission (MET) and scanning (MEB) electron microscopy. All the animals resected showed statistically significant weight loss (p less than 0.001), an expression of short intestine syndrome. Groups 0 (controls) and I (intestinal section) did not evidence important ultrastructural changes. In contrast, although in the initial electron microscopic scan the colonic mucosal surface offered a normal aspect, at 45 days it presented irregularities, without the appearance of villi. Days 60 there were deep folds and the mucosal surface had acquired a foliaceous aspect similar to that of the surface of the small intestine of the rat. The abundance of microorganisms adhered to the surface, constituting clumps of bacteria, was striking. Transmission electron microscopy confirmed the greater number and height of the enterocytes, covered by well developed apical microvilli with dimensions that increased throughout the experiment. The cellular nuclei are voluminous and occasionally have various nucleoli. The cytoplasm showed changes that affected fundamentally the mitochondria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2710994 TI - [Ductal adenocarcinoma of the head of the pancreas: associated pathology of body and tail]. AB - Histologic study of the body and tail of the pancreas in a patient in whom total duodenopancreatectomy was carried out for ductal adenocarcinoma of the head (ADC) demonstrates the existence of dysplasia of the pancreatic duct in its entire length associated with intente parenchymal atrophy. It is considered that cephalic duodenopancreatectomy in ductal adenocarcinoma of the head of the pancreas should be based on an adequate anatomic, histologic and functional evaluation of the residual pancreas. PMID- 2710995 TI - [Variation of C3 in ascitic fluid from cirrhotic patients subjected to intestinal sterilization or selective intestinal decontamination]. AB - Patients with liver cirrhosis with ascites and low levels of C3 and Total Proteins in ascitic fluid show a greater predisposition to the development of spontaneous bacterial peritonitis. The variation of C3 and Total Proteins levels in ascitic fluid in two groups of patients with liver cirrhosis was studied. Group I (n = 14) underwent intestinal sterilization (n = 7) or selective intestinal decontamination (= 7). Group II was a control. A statistically significant increase in C3 (p less than 0.01) and Total Proteins (p less than 0.015) levels in ascitic fluid in Group I patients was found. There were no changes in the control group. The incidence of side effects was higher in those patients who underwent intestinal sterilization. Our results suggest that selective intestinal decontamination may be useful as a prophylactic measure against spontaneous bacterial peritonitis in those patients with liver cirrhosis at high risk of infection by increasing the bactericidal capacity of ascitic fluid. PMID- 2710996 TI - [Secondary and residual choledocholithiasis. Our experience]. AB - A retrospective study was made of 780 patients who underwent surgery of the biliary tract for lithiasis between 1973 and 1984; of them, 110 (14.1%) presented secondary choledocholithiasis and 14, residual choledocholithiasis. The decade of highest incidence of choledocholithiasis was 60 to 70 years; the proportion of women-men was 2:1. The predominant symptom was biliary colic, which occurred in 99% of patients; jaundice appeared in 65% of cases. In 5.6% of patients choledocholithiasis was complicated with suppurative cholangitis. The operation most frequently practiced was choledochotomy with extraction of calculi and closure on a Kehr tube, performed in 50% of patients, followed by transduodenal sphincteropapillotomy in 31% of patients. In 32 patients complications occurred during the immediate postoperative period, representing a morbidity of 22.5% and a mortality of 3.2%. The most frequent complications were of infectious nature. PMID- 2710997 TI - [Immunoglobulins and the complement system in colorectal cancer]. AB - In the present paper is studied the concentration in peripheral blood of immunoglobulins IgG, IgA, IgM and factors C3 and C4 of the complement system in a group of 120 patients with colorectal cancer operated on with radical intention. Preoperative values are compared to postoperative results and the values obtained on diagnosis of tumoral recurrence with the object of describing possible immunologic alterations existent in the patient with colorectal carcinoma. It is concluded that there are no significant relations between the biochemical parameters studied and age, sex, tumoral localization and Duke's clinical stages. Patients with pre and postoperative IgA values above normal present a poor prognosis, with an associated recurrence of 60% (p = 0.001) and 80% (p = 0.000), respectively; postoperative C3 levels above normal also represent a factor of poor prognosis, recurrence appearing in 80% (p = 0.001) and metastases in 85% (p = 0.000). PMID- 2710998 TI - [Gastric acid secretion plays a role in food and water ingestion in mice]. AB - The influence of blockade of the SAG on food and water intake was studied in the mouse. Proglumide (a gastrin receptor antagonist), the combination of proglumide plus cimetidine (inhibitor of the H2 histamine receptors), proglumide plus vagotomy and the simultaneous action of proglumide plus cimetidine plus vagotomy were used in order to get total inhibition of the gastric acid secretion. Statistical analysis shows that food intake experiences a significant increase by the action of proglumide, proglumide plus cimetidine, proglumide plus vagotomy and proglumide plus cimetidine plus vagotomy in comparison to the control group. However, water intake was significantly lower in proglumide plus cimetidine and proglumide plus vagotomy animals with respect to the other groups studied. In addition, proglumide plus cimetidine plus vagotomy increased significantly water intake in relation to the other groups studied. No changes were found in the body weight of the groups studied. We conclude that SAG plays a role in food and water intake in the mouse and both behaviors are interdependent processes. PMID- 2710999 TI - [A 12-year retrospective study of 114 cases of proximal gastric vagotomy]. AB - We present 114 cases of proximal gastric vagotomy (VGP), performed between December 1975 an December 1986 (11 years) and followed-up until December 1987 (12 years). An hundred patients underwent elective surgery and 14 emergency. We obtained good results in 97 patients (85.83%) moderate in 10 (8.85%) and poor in six (5.30%) with one mortality (0.87%) due to causes not related to the operation. We emphasize the surgical indication and technique, which, if correctly established, make proximal gastric vagotomy the ideal surgical intervention for gastroduodenal ulcer. PMID- 2711000 TI - [Is it possible to relate reflux esophagitis to epidermoid carcinoma of the esophagus?]. AB - The authors present a retrospective study of 120 cases of epidermoid carcinoma of the esophagus, in which they proposed to investigate the etiopathogenic relation between gastroesophageal reflux and noplastic development. A statistically significant relation was found between esophagitis and cancer of the distal esophageal third, indicating the need for vigilance of patients with reflux and for randomized prospective studies to clarify the problem definitively. PMID- 2711001 TI - [Solitary extramedullary plasmocytoma of the small intestine]. AB - A case is presented of PES of the small intestine debuting with subocclusive crises. After the preoperative study the patient was diagnosed as probable neoplasm of the small intestine. In the operation was confirmed an annular stenosing ileal tumor that respected the serosa. Ample intestinal resection was practiced with a normal postoperative recovery. The pathology report indicated plasmocytoma, the immunoperoxidase technique being negative. The existence of multiple myeloma and other lesions at a distance was excluded. Almost a year after the operation the patient remains asymptomatic and free of recurrence. A review of the literature is offered. PMID- 2711002 TI - [Angiodysplasia of the terminal ileum]. AB - Angiodysplasia, a recently discovered disease, is a pathology of scant incidence in our environment and difficult to find because of the inconclusiveness of diagnostic proofs. The disease, generally related to adults and the elderly, and preferentially located in the large intestine, does not always manifest this way. The case we present is one of the youngest in the world literature and of ectopic localization in the terminal ileum. This confirms the enigmatic aspect of this pathology, which still has characteristics to be delimited. Its etiology, incidence and prevalence are unknown and there are no unanimous criteria for its classification or possible association with other pathologies. PMID- 2711003 TI - [Spontaneous cholecystocolonic fistulas. Presentation of 5 cases]. AB - From 1979 to 1987, 5 patients with cholecystocolonic fistula were operated on in our service, which represents 25% of a total of 20 external biliodigestive fistulas complied over this period. Admission was as an emergency in 4 of the 5 patients (80%), and in one for elective programmed surgery. External biliodigestive fistula was suspected in 3 patients (60%) and biliocolonic fistula in one (20%), on observing aerobilia and leakage of contrast into the hepatic angle of the colon. On two occasions (40%) associated choledocholithiasis was detected, by means of echographic study in one case and intraoperative cholangiography in the other. Antecedents of biliary pathology were present in 3 of our 5 observations (60%), with a mean time of evolution of 12 years. PMID- 2711004 TI - [Microcystic cystadenoma of the pancreas]. AB - Cystadenoma of the pancreas is a rare tumor. In the surgery unit of the Hospital de la "Santa Cruz y San Pablo", of 18 cases of cephalic duodeno-pancreatectomy in the last nine years, we have only observed one case of cystadenoma. The patient was a 70 year-old woman, hypertensive and very obese, who had few symptoms and was diagnosed as pancreatic tumor by echography. CAT, ERCP and abdominal arteriography confirmed the diagnosis. Needle biopsy guided by echography and CAT was negative for malignant cells. In the operation, needle and trucut biopsy revealed benign cystadenoma. Cephalic duodenopancreatectomy was performed. The postoperative period was difficult, and the patient required reoperation within hours for intraperitoneal hemorrhage and again, eight days later, for dehiscence of the pancreatic suture. Finally she recuperated and was released at 38 days. Of all the types of proliferative pancreatic cysts, microcystic or serous adenoma is benign, as compared to mucinous cyst, of clearly malignant potential. However, needle biopsy rarely provides differential diagnosis. In some cases of high surgical risk, the indication for resection can be dubious if the cyst lies in the region of the pancreatic head and its benign nature can be demonstrated. PMID- 2711005 TI - [Gastric lymphomas. Our cases]. PMID- 2711006 TI - [Celiac disease in the elderly: an infrequently diagnosed entity]. PMID- 2711007 TI - [An infrequent cause of intestinal sub-occlusion]. PMID- 2711008 TI - [Acute simultaneous hepatitis caused by A and B virus]. PMID- 2711009 TI - [Medical treatment of single hepatic abscess caused by anaerobic germ in a previously healthy patient]. PMID- 2711010 TI - [Clinical experience in a case of chronic myeloid leukemia in accelerated phase treated with beta-interferon]. AB - The Authors report an alternative approach to treatment in CML with beta interferon in patients in whom other traditional drugs failed. The accelerated stage of the illness was well controlled with return to chronic phase. PMID- 2711011 TI - [Diffuse neoplastic infiltration of leptomeninges by malignant pleural mesothelioma]. AB - A 65 year-old-man, diagnosed with malignant pleural mesothelioma, developed polymorphic neurologic symptoms and signs indicating involvement of cranial and spinal nerves. Necropsy disclosed a diffuse neoplastic invasion of the leptomeninges with no other neural metastases. PMID- 2711012 TI - [High-dose immunoglobulins in immune thrombocytopenic purpura]. AB - Twenty-four patients with immune thrombocytopenic purpura (ITP) were treated with high doses of intravenous immunoglobulin (Ig). Increase in platelets was observed in all the patients. The maximum value was reached between the seventh and the twelfth day of treatment. The mean number of platelets was 18 x 10(9)/l before the treatment and 150 x 10(9)/l after the treatment. The effect was transient; in fact, a fall in the platelets was observed after 18 days of treatment. Our study confirms that high doses Ig is an effective treatment of ITP, but the high cost and the temporary effect limit its use only in those cases in which other treatments are ineffective or contraindicated. PMID- 2711013 TI - [Problem of definition of embolic risk in the procedure of elective cardioversion of atrial fibrillation]. PMID- 2711014 TI - [Migraine and food]. AB - The frequency of migraine has been studied in adult patients with suspected adverse reaction to foods. Migraine was present in 41 out of 300 patients (13.6%). 38 of these 41 subjects have been treated with elimination diet; 25 (65.7%) obtained a significant improvement of migraine and subsequently, performed challenge test. 24 patients were affected by food intolerance and only one by food allergy. The remaining 13 non-responder subjects suffering from migraine have been subsequently submitted to pharmacological treatment. PMID- 2711015 TI - [Celiac disease in insulin-dependent diabetes mellitus and insulin-independent diabetes mellitus]. AB - The IgA antigliadin antibodies AGA title was detected in 37 patients with IDDM, mean age 32.59 +/- 14.71, where mean duration of disease was 8.76 +/- 9.62 years, and 29 patients with NIDDM, mean age 55.31 +/- 14.71, where disease lasted 11.5 +/- 5.55 years. A group of 51 normal pts. was employed as control. In IDDM group 2 cases on 37 showed high AGA title (case n. 1 and n. 2) but just the case n. 1 where IDDM lasted 16 years, showed an histologic picture of coeliac disease (partial villous atrophy), while in the case n. 2 where IDDM was at the onset, the histologic picture was normal. The increase of AGA title in the IDDM at the onset is rarely associated with coeliac disease, but it seems to be an aspecific response. Viceversa an increased AGA title is in IDDM for greater than 1 years often associated with coeliac disease. In NIDDM no high AGA title was found. The prevalence of coeliac disease in our patients with IDDM was 1:37 and we suggest that diabetics be screened routinely for antigliadin antibody. PMID- 2711016 TI - [Application of bioelectric impedance measurement in the evaluation of body fat]. AB - We compared the data referring to the percentage of body fat in 40 healthy adults (20 males and 20 females) of different weight, aged between 18 and 33 years, measured by biological impedance analysis and skinfold thickness measurement. Of these, 26 were shown to be of normal weight, 9 overweight and 5 underweight according to the body mass index (Weight/Height). All subjects were analysed for bioelectrical impedance with a BIA-103 (Ryl-Detroit) appliance and the skinfolds were measured with a Harpenden Caliper. The correlation between the values obtained with the two methods was shown to be linear and highly significant for both sexes (males: r = 0.71; females: r = 0.77). The study also showed that the content of body fat was higher than the mean values indicated in the literature for the age range considered in 23% of the males and 31% of the females of normal weight. PMID- 2711017 TI - [Congenital absence of pericardium in a case of a variant of Marfan syndrome]. AB - We describe a case of congenital absence of the pericardium of a 42 year-old patient with a variant of Marfan's Syndrome involving the skeletal and cardiovascular system. The diagnosis was formulated not only through an accurate clinical examination, but also through non-invasive tests like a standard radiography of the chest, an echocardiography M-mode and 2-D and a doppler analysis. PMID- 2711018 TI - [Current problems of infectious endocarditis. Clinico-diagnostic considerations on 17 cases]. AB - Seventeen cases of Infective Endocarditis diagnosed over a seven-year period by clinical-echocardiographic criteria in a Division of General Medicine are reviewed. More significant aspects regard the observation of the disease in some subjects at risk (elderly persons, patients with normal native valves affected by cirrhosis, by intravenous drugs abuse, by haematological neoplasms), the diagnostic difficulties in cases with oligosymptomatic or atypical beginning, and the frequent negative blood cultures. The value and the limitations of echocardiography and some aspects of therapy are discussed. PMID- 2711019 TI - [2 clinical cases of hypopotassemia during treatment with indapamide]. AB - Indapamide, an antihypertensive drug with diuretic and vasodilative effect, causes a reduction in plasmatic potassium concentration that is generally moderate and not such as to cause damages. In the present article two cases are described that showed severe changes due to hypokalaemia resulting from treatment with indapamide. PMID- 2711020 TI - [A case of severe recurrent transient granulocytopenia during hemofiltration: possible pathogenetic interpretations]. AB - The authors report a case of severe granulocytopenia without increased susceptibility to infections in a patient with IRC (chronic renal failure) on hemofiltration treatment. The possible pathogenetic mechanisms are examined. The phenomenon is probably due to an altered compartmentation of neutrophils; the temporariness and the quick correction of the granulocytopenia explain the lack of clinical manifestations. PMID- 2711021 TI - Gender and race differentials in elderly migration. AB - A number of studies have provided evidence that elderly migration in the United States is strongly selective in terms of the characteristics of the migrants. Such characteristics as age, gender, and race are commonly used in examinations of migrant selectivity, but the differences in spatial behavior of these subpopulations are still poorly understood. This article uses state-to-state migration data, categorized by age, gender, and race, to explore the comparative patterns of origins, destinations, and migration propensities, with a focus on the southeastern states of the country. PMID- 2711022 TI - The ADEA amendment and public support for older workers. AB - The purpose of this research is to examine Americans' beliefs about older adults at work before and after the amendment of the Age Discrimination in Employment Act (ADEA) in 1978. Two models are considered for understanding the relationship between age strata and public support for older workers: the group benefit model and the civil liberty model. The analysis gives general support to the civil liberty model: (1) age differences are related to the beliefs so that more recent cohorts are more likely than earlier ones to favor the work privileges and opportunities for older people and (2) Americans in general grew more favorable toward and concerned about older workers during the period surrounding the passage of the ADEA Amendment in 1978. Women were more likely than were men to support the privileges of older people to work regardless of age or competition for jobs by younger people. PMID- 2711023 TI - Antecedents and consequences of remarriage in later life. AB - Using the Retirement History Study (RHS), respondents were identified who entered the study widowed or divorced, and then remarried. Respondents were also identified who entered the study as married, became widowed or divorced, and then remarried. In the latter case, because of limitations of the RHS, only males were observed. With some matching relevant to the types of analyses carried out, comparison groups were selected, providing an opportunity to examine both antecedents and consequences of remarriage. PMID- 2711024 TI - Prevention of oxidative injury to cardiac phospholipid by membrane-active "stabilizing agents". AB - Three lipophilic, membrane-active "stabilizing agents," cepharanthine, chlorpromazine, and trifluoperazine, were found to protect myocardial membrane phospholipid from peroxidative injury. The compounds prevented, in a concentration-dependent manner, the cardiac phospholipid peroxidation which resulted from lipid exposure to superoxide-dependent, iron-promoted oxygen radical chemistry of the type thought to be a causative factor in ischemic reperfusion tissue damage. Chlorpromazine's antiperoxidant IC50 (i.e., concentration at which peroxidation was inhibited by 50%) was 180 microM; the antiperoxidant potencies of cepharanthine (IC50 = 90 microM) and trifluoperazine (IC 50 = 100 microM) were some two-fold greater. These agents, at effective antiperoxidant concentrations, did not inhibit the enzymatic superoxide source, xanthine oxidase, scavenge superoxide radical, or act like a chain-breaking antioxidant. The data raise a possibility that the these three membrane-active compounds, as lipophilic anesthetics, may exert antiperoxidant effects by inducing structural changes in the lipid-rich (membrane or liposome) target of free radical attack. PMID- 2711025 TI - Form-specific degradation of cytochrome P-450 by lipid peroxidation in rat liver microsomes. AB - Microsomal lipid peroxidation caused decreases in the activities of ethylmorphine N-demethylase and testosterone 6 beta-hydroxylase more markedly than aniline hydroxylase, p-phenetidine O-deethylase and testosterone 2 alpha- and 16 alpha hydroxylases. Results of sodium dodecylsulfate-polyacrylamide gel electrophoresis of liver microsomes showed that proteins with molecular weights between 47kDa and 50kDa in liver microsomes were sensitively degraded by lipid peroxidation. Western-blot analysis of liver microsomes with antibodies to P-448-H, P-450 male and P-450 PB-1 which corresponded to P-450d, P-450h and P-450 PCN, respectively, showed that the amount of P-450 PB-1 was decreased more markedly by lipid peroxidation as compared to those of P-450 male and P-448-H. It seemed, therefore, likely that the stability of cytochrome P-450 to lipid peroxidation varies dependent on the forms of cytochrome P-450. PMID- 2711026 TI - Animal behavioral and neurochemical effects of the CNS toxic amino acid antitumor agent, acivicin. AB - The investigational amino acid antitumor agent, acivicin, has been reported to cause dose-related and reversible CNS toxicity in humans characterized by sedation, ataxia, hallucinations, personality changes, and other symptoms. In a series of studies aimed at characterizing this toxicity, we investigated several species as potential animal models, determined the effects of acivicin on neuronal action potentials, and measured drug effects on the brain content of several putative amino acid neurotransmitters. In mice, we were unable to demonstrate any effects of acivicin in a battery of tests used in identifying and classifying CNS-active agents of potential therapeutic utility. In rats, unlike phencyclidine and certain other psychotomimetic drugs, acivicin produced no impairment of shock avoidance or brightness discrimination in animals trained on an automated Y-maze. In contrast to the rodent species, acivicin effects were perceived as resembling those of cyclazocine by rhesus monkeys trained to discriminate between psychoactive drugs and saline by food reinforcement. Cats treated with acivicin exhibited dose-related symptoms of sedation, somnolence, and ataxia. Iontophoretically applied acivicin was shown to have no effect on the spontaneous firing rate of dorsal horn interneurones in spinal cats. At the time of peak CNS symptoms in cats treated with 100 mg/kg acivicin, content of gamma aminobutyric acid (GABA; nmoles/mg protein) was elevated from 57-140% in cerebellum, diencephalon, midbrain, and corpus callosum compared to control animals. Brain contents of glutamate, glutamine, and aspartate were not altered in cats experiencing neurotoxicity. These studies have shown that some symptoms of acivicin CNS toxicity are shared by humans and higher non-human species such as the cat and the monkey but not by rodents. Acivicin itself is apparently not a CNS excitant or depressant, but metabolites of the drug could be. Acivicin may also cause increases in the GABA content of localized regions of brain. PMID- 2711027 TI - Stereoselective disposition of nilvadipine, a new dihydropyridine calcium antagonist, in the rat and dog. AB - The stereoselective disposition of nilvadipine (NV), a new 1,4-dihydropyridine calcium antagonist, was determined in male and female rats, and male dogs. After oral dosing of racemic NV to male rats, the maximum plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) of the pharmacologically more potent (+)-NV were 0.59-0.60 times those of (-)-NV. The apparent oral clearance (CLo) ratio of (+)- to (-)-NV was 1.69. The plasma elimination of the enantiomers were similar. In female rats, the plasma concentrations and pharmacokinetic parameters of the enantiomers did not significantly differ. In orally-dosed dogs, the Cmax and AUC of (+)-NV were 3.13 and 3.83 respectively times greater than those of (-)-NV. The enantiomeric ratio of CLo was 0.27, and the half-lives of the enantiomers were similar. After intravenous dosing to dogs, the plasma concentrations of (+)- and (-)-NV declined biexponentially with similar t1/2 beta values. The AUC of (+)-NV was 1.56 times more than that of (-) NV. The enantiomeric ratios of systemic clearance and volume of distribution at steady state were 0.64 and 0.81, respectively. Thus, the stereoselective disposition of NV was species-dependent and sex-related in rats, and was dosing route-dependent in dogs. The free fraction value for protein binding of (+)-NV in dog plasma was only 0.50-0.51 times that of (-)-NV. The enantiomeric ratios of those values in male and female rat plasma were 1.14 and 0.98, respectively. PMID- 2711028 TI - Immunoassay detection of drugs in racing horses. IX. Detection of detomidine in equine blood and urine by radioimmunoassay. AB - Detomidine is a potent non-narcotic sedative agent which is currently in the process of being approved for veterinary clinical use in the United States. Since no effective screening method in horses is available for detomidine, we have developed an 125I radioimmunoassay for detomidine in equine blood and urine as part of a panel of tests for illegal drugs in performance horses. Our 125I radioimmunoassay has an I-50 for detomidine of approximately 2 ng/ml. Our assay shows limited cross-reactivity with the pharmacodynamically similar xylazine, but does not cross-react with acepromazine, epinephrine, haloperidol or promazine. The plasma kinetic data from clinical (greater than or equal to 5 mg/horse) as well as sub-clinical doses indicate first-order elimination in a dose-dependent manner. Within the first 30 minutes after intravenous (IV) administration of 30 mg/horse, plasma levels peak at approximately 20 ng/ml and then decline with an apparent plasma half-life of 25 minutes. Diuresis can occur with administration of clinical doses of detomidine and this effect was accounted for in the analysis of urine samples. Using this method, administration of 30 mg/horse can be readily detected in equine urine for up to 8 hours after IV injection. Additionally, doses as low as 0.5 mg/horse can be detected for short periods of time in blood and urine with use of this assay. Utilization of this assay by research scientists and forensic analysts will allow for the establishment of proper guidelines and controls regarding detomidine administration to performance horses and assurance of compliance with these guidelines. PMID- 2711029 TI - Cellulose sulfate increases blood concentration of kinins in rats. AB - Intravenous injection of cellulose sulfate (CS) in rats induced a dose-dependent decrease of blood pressure accompanied by a concomitant increase of circulating levels of immunoreactive bradykinin (BK) from a level of 52 pg/mL of blood in control animals to 400 pg/mL in the group injected with 3.0 mg/kg of CS. An increase of desArg9BK was also observed while the blood concentration of BK(1-7) remained constant. Kinins contents in acidic extracts of lungs increased slightly while renal kinins from the same animals showed a slight decrease. The results suggest that plasma kallikrein-kinin system mediates CS-induced hypotension and that glandular kallikreins do not participate to the hypotensive action of CS. PMID- 2711030 TI - Binding studies of four free base porphyrins and six iron (+3) porphyrins with human serum albumin. AB - The binding stoichiometry and binding equilibria of human serum albumin with water-soluble four free base porphyrins and six chloroiron (+3) porphyrins have been determined in 0.1M phosphate buffer, pH 7.2, by fluorescence quenching and filtration methods. The binding stoichiometry is observed to be 1:1, porphyrin to protein. The dissociation constants, Kd, between the porphyrins and the protein are found to be 1-4 microM. A binding mechanism between the protein and the porphyrins has been presented. PMID- 2711031 TI - Toxicity of 1,2-diethylhydrazine fed to turkey poults. AB - Toxic effects of 1,2-diethylhydrazine, a putative furazolidone metabolite, were determined in turkey poults 2 to 5 weeks of age. The drug was administered either in the drinking water or by gastric intubation. Toxic effects included depression of growth, decreased feed intake, and increased feed conversion. There was no evidence of an induced cardiomyopathy. These findings indicate that the etiology of furazolidone toxicity involves more than one mechanism. PMID- 2711032 TI - Homocysteine thiolactone: failure to detect in human serum or plasma. AB - Attempts to repeat the observation that homocysteine thiolactone is present in normal human serum or plasma (at concentrations ranging from 32 to 6,700 microM) (1) have been unsuccessful. PMID- 2711033 TI - Homocysteinemia and arteriosclerosis: failure to isolate homocysteine thiolactone from plasma and lipoproteins. PMID- 2711034 TI - The effect of intracoronary diltiazem on regional myocardial function and development of infarcts in porcine hearts. AB - The effect of intracoronary (i.c.) pretreatment with diltiazem on regional myocardial function and the development of infarcts was investigated in regionally ischemic, reperfused porcine hearts. The left anterior descending coronary artery (LAD) was distally ligated in 16 pigs for 20-90 min followed by 24 h of reperfusion. Eight pigs were treated with increasing doses of i.c. diltiazem (0.375 mg/min, 0.75 mg/min, 1 mg/min) prior to ischemia. Eight pigs served as controls. Regional myocardial function was assessed by implanted ultrasonic crystals. Infarct size was determined as ratio of infarcted (tetrazolium stain) to ischemic myocardium (dye technique). I.c. diltiazem mainly depressed early systolic shortening (isovolumetric contraction) and lengthening during the first half of diastole. Pretreatment with this calcium antagonist significantly delayed the development of infarcts. In control experiments, a mean infarct size of 74% was found after 45-min ischemia. At that time no infarction was observed in the treated group, where infarcts started to evolve after 60-min ischemia. It is concluded that the favorable action of i.c. diltiazem can mainly be ascribed to a reduced myocardial oxygen consumption at the onset of ischemia. PMID- 2711035 TI - Effects of propylene glycol on redox state of the perfused rat liver--a note of caution. AB - Propylene glycol is used as a solvent for bile salts in studies on their biologic effects on the liver. While using this solvent (32-64 mmol/l) in the isolated perfused rat liver, we found a significant change in the extramitochondrial redox system as indicated by a fivefold increase of the lactate pyruvate ratio in the perfusate. The increase was due to an increased uptake of pyruvate (0.8 mumol/g/min) and to a release of lactate (1.8 mumol/g/min). The intramitochondrial redox state was affected to a lesser degree as estimated by the beta-hydroxybutyrate acetoacetate ratio (twofold increase). These abnormalities resemble those induced by similar concentrations of ethanol. We suggest, therefore, that investigators studying bile acids should be aware of this artifact which causes significant alterations in cellular energy systems and enzyme activities. PMID- 2711036 TI - Effect of vanadium on bone metabolism in weanling rats: zinc prevents the toxic effect of vanadium. AB - The effect of vanadium on bone metabolism was investigated in the femoral diaphysis of weanling rats. Vanadium pentoxide (1.0-20.0 mumol V/100 g b.wt.) was administered orally for 3 days. The doses of 15.0 and 20.0 mumol V/100 g caused a significant increase in serum calcium concentration. Bone alkaline phosphatase activity was increased significantly by the doses of 1.0-20.0 mumol V/100 g, while bone acid phosphatase activity was not altered significantly. Bone DNA content was increased significantly by the dose of 1.0-10.0 mumol V/100 g. Bone calcium content was not altered significantly by administration of vanadium. The increase in serum calcium concentration caused by administration of vanadium (20.0 mumol/100 g) was prevented completely by simultaneous injection of zinc sulfate (15.3 mumol Zn/100 g) for 3 days, although zinc alone did not have any effect. Administration of zinc (15.3 mumol/100 g) produced an appreciable increase in bone alkaline phosphatase activity, DNA content, and calcium content. These increases were not enhanced significantly by simultaneous injection of vanadium (2.0 and 20.0 mumol V/100 g). The present study indicates that a comparatively low dose of vanadium may play a nutritional role in bone formation of weanling rats, and that zinc can prevent the relevation of the toxic effect of vanadium with higher doses. PMID- 2711037 TI - "Reversible gastric banding" in surgical treatment of morbid obesity--results of animal experiments. AB - The basic principle of "reversible gastric banding" as a new surgical approach to morbid obesity treatment is the creation of a small fundus reservoir using a silicone cuff which is coiled around the stomach close to the cardia. The extent of obstruction corresponds to the amount of liquid in the cuff which can be varied by puncture of a valve implanted in the subcutis. The reversibility of gastric obstruction is the great advantage of this method as compared to vertical banded gastroplasty or gastric bypass. We studied this method in animal experiments using seven "Gottinger Minipigs". In two animals the objectives of the study were reached, the observed complications, mostly caused by the nature of the test animal, are analyzed and discussed. To our knowledge, this is the first report in the literature on animal experiments in bariatric surgery. PMID- 2711038 TI - New techniques of analyzing the healing process of artificial vascular grafts, transmural vascularization, and endothelialization. AB - Beside traditional techniques (light, immunofluorescence, transmission electron (TEM)- and scanning electron microscopy (SEM), a new more sensitive method for producing microcorrosion casts using a polyester-based resin has been developed. The SEM analyses of the microcorrosion casts of alloplastic vascular grafts was realized in an absolutely stable stage of polymerization. For the first time, a transprosthetic vascularization could be shown in great three-dimensional detail. The importance of a complete and rapid endothelialization of artificial vascular grafts is discussed. PMID- 2711039 TI - The chick chorioallantoic membrane as test system for biocompatible materials. AB - Biologic and non-biologic materials clinically used as hemostyptica, as vascular prostheses, or as temporary skin substitutes were implanted to the chick chorioallantoic membrane (CAM) during days 9-14 of incubation. The histological study revealed an intact CAM after application of cellulose gauze (Tabotamp). The fibrin tissue adhesive (Tissucol), the collagen sponge (Tachotop), or the gelatin sponge (Gelfoam) induced different amounts of connective tissue. Some fibroblasts were about to grow into the fibrin adhesive. Fibroblasts and capillaries filled the interstices of the collagen sponge poorly, and in the case of the gelatin sponge markedly. Neutrophils and giant cells of the foreign body type occurred more often in the gelatin sponge than in the collagen sponge. With regard to the non-biologic materials, expanded polytetrafluorethylene induced squamous metaplasia of the chorionic epithelium. Dacron caused ulceration with the onset of connective tissue ingrowth, based on a reaction of giant cells of the foreign body type. Polyurethane foam (SYSpur-derm) showed bleeding into the implant due to spikes of the material. Eosinophilic granulocytes were absent in all materials studied. The results are related to different clinical findings. The correlation allows consideration of the CAM as an in vivo model in screening materials for their biocompatibility and their connective tissue reaction. PMID- 2711040 TI - Simulated weightlessness and bone metabolism: decrease of alkaline phosphatase activity in the femoral diaphysis of rats. AB - The effect of simulated weightlessness on bone metabolism was investigated in the skeletal unloading for up to 9 days. The skeletal unloading was designed by using the model of hindlimb hang in rats. The food ingestion of rats with the skeletal unloading was not altered in comparison to that of normal rats. Calcium concentration in the serum was not significantly altered by the skeletal unloading for 9 days, while the serum inorganic phosphorus concentration was significantly decreased at 6 and 9 days. Calcium content in the femoral diaphysis was not altered by the skeletal unloading for 9 days. However, the activities of alkaline and acid phosphatases in the femoral diaphysis were markedly decreased by the skeletal unloading. The decrease in bone alkaline phosphatase activity was seen at 2 days with the skeletal unloading. The present results demonstrate that the skeletal unloading with hindlimb hang can induce the disorder of bone metabolism. This model is useful for studying the effects of simulated weightlessness on bone metabolism. PMID- 2711041 TI - Antibodies to HIV2 in genital secretions. AB - In order to study the local immune response to HIV2, three exclusively heterosexual, infected West African patients were selected: one male with full blown AIDS, one female with ARC and one healthy HIV2-carrier female. Sera and genital secretions were obtained and tested for anti-HIV2 IgG and IgA antibodies by Western blotting. In semen and in vaginal secretions, IgG antibodies directed against all viral antigens were detected. In comparison with the IgG response, local IgA antibody response was less intense and heterogenous. Two out of 3 patients had local antibodies of the IgA class directed against the envelope glycoprotein GP105. Such antibodies of both the IgG and IgA classes in genital secretions could play a protective role in heterosexual transmission of HIV2. PMID- 2711042 TI - General aspects of the 1987 Rift Valley fever epidemic in Mauritania. PMID- 2711043 TI - Isolation of the Rift Valley fever virus by inoculation into Aedes pseudoscutellaris cells: comparison with other diagnostic methods. AB - The Rift Valley fever epidemic, which arose in the south of Mauritania beginning on October 15, 1987, enabled a comparative study of different diagnostic methods among humans. During the first two weeks of the epidemic, four parallel methods were used: inoculation into Aedes pseudoscutellaris cells, inoculation intracerebrally into suckling mice, tests by immunocapture of the circulating antigen and detection of type IgM gammaglobulins. Of 370 examined sera, 181 showed at least one marker of recent infection. Inoculation into A. pseudoscutellaris cells was by far the most sensitive and easiest method to use. Detection of the antigen by immunocapture was also a useful technique, since it allowed quick aetiological diagnosis or examination of sera conserved under poor conditions. However, its sensitivity was weak, as it could only detect 26% of positive cases. Vero cells used on a limited scale, in this particular case seemed less sensitive than A. pseudoscutellaris cells. Of a total of 991 sera, 221 diagnoses were reported by discovery of the virus and 271 by detection of specific IgM. In every case, A. pseudoscutellaris cells seemed most appropriate as the system of reference. PMID- 2711044 TI - Rapid detection of Rift Valley fever antigen in the serum of infected lambs. PMID- 2711045 TI - Assessment of an rDNA probe filter hybridization assay for the detection of Rift Valley fever virus RNA in human serum samples from the Mauritanian epidemic. AB - The Rift Valley fever virus (RVFV) epidemic that occurred in southern Mauritania during the 1987 rainy season provided a unique opportunity to test and evaluate a recently developed, M-segment-specific, nucleic acid filter hybridization assay on a large collection of infected human serum samples. It afforded the opportunity to compare the procedure with two other methods for detecting virus: virus isolation and antigen detection by ELISA. The filter hybridization procedure employed a polyethylene-glycol-precipitation and proteinase-K-digestion sample treatment step developed specifically for preparing serum samples for hybridization. The procedure was less sensitive for detecting RVFV in the Mauritanian human viremic samples than in sera from experimentally infected monkeys used to evaluate this procedure. It was also less sensitive than an antigen detection procedure used to test the Mauritanian samples. However, we were able to detect virus RNA in a significant proportion of the virus-isolation positive samples. Advances in sample preparation, labelling and detection procedures, and hybridization methods will improve the sensitivity, precision and ease of use of this assay and increase its value as a diagnostic tool. PMID- 2711046 TI - Rapid diagnosis of Rift Valley fever: a comparison of methods for the direct detection of viral antigen in human sera. AB - Human sera collected during the 1987 Rift Valley fever (RVF) epidemic in the Senegal River basin were analysed using three enzyme immunoassays to establish the best method for rapid diagnosis of RVF. A biotin-avidin-enhanced antigen detection method utilizing monoclonal antibodies proved most sensitive. Eighty two viremic human sera were tested, and this assay detected antigen in 29.3% of the samples. PMID- 2711047 TI - Rift Valley fever among domestic animals in the recent West African outbreak. AB - Severe haemorrhagic disease among the human population of the Senegal River Basin brought the Rift Valley fever virus (RVFV) outbreak of 1987 to the attention of science. As in previous RVFV outbreaks, local herdsmen reported a high incidence of abortion and disease in their livestock. Serum samples were obtained from domestic animal populations from areas near Rosso, the best studied focus of human infection, as well as other areas distant from known human disease. Among animals from the area of high incidence of human disease, antibody prevalence was as high as 85%, with approximately 80% of the sera positive for both RVFV IgG- and viral-specific IgM antibodies. In contrast, human populations in the same area had lower RVFV antibody prevalences, 40% or less, with 90% also being IgM positive. Sera from livestock in coastal areas 280 km south of the epidemic area were negative for RVFV antibodies. Thus, the detection of RVFV specific IgG and IgM antibodies provided evidence of recent disease activity without the requirement to establish pre-disease antibody levels in populations or individuals and without viral isolation. Subsequently, detection of modest levels of IgG and IgM in the Ferlo region, 130 km south of the Senegal River flood plain, established that RVFV transmission also occurred in another area of the basin. Similar serological testing of domestic ungulates in The Gambia, 340 km south of Rosso, demonstrated antibody prevalence consistent with a lower level of recent transmission of RVFV, i.e., 24% IgG-positive with 6% of the positive sera also having RVFV-specific IgM. PMID- 2711048 TI - Effect of maternal exposure to smoke on gas diffusion capacity in neonatal rat. AB - Offspring of control and experimental (chronically exposed to whole cigarette smoke) rats were sacrificed on 15th postnatal day. Pulmonary tissues were processed for quantitative electron microscopic analyses. Arithmetic and harmonic mean thicknesses were directly measured and diffusion capacity was derived for separate layers (tissue, plasma, erythrocyte) and the entire lung. Experimental offspring showed a greater volume density of interstitium in parenchyma (P less than 0.04), arithmetic (P less than 0.05) and harmonic (P less than 0.009) mean thicknesses. Diffusion capacities for lungs of both animal groups, however, were similar (0.00543 and 0.0054 cm3 O2.min-1.mm Hg-1.g body weight-1 for control and experimental lungs respectively). Experimental tissue appeared better adapted for optimal exchange of gases (P less than 0.05), as indicated by corrugation index (ratio between arithmetic and harmonic mean thicknesses) than for the control counterpart. In spite of induced alterations in several developmental processes by a presently used experimental procedure, tissue capacity for transport of gases was not significantly changed in either the alveolo-capillary membrane or the entire lung. PMID- 2711049 TI - Is airway closure caused by a liquid film instability? AB - A physical model for small airway closure is developed, based on the assumption that closure occurs as a result of a surface tension-induced instability of the thin liquid film lining the airways. To distinguish this mechanism from others involving airway compliance, experiments were performed in rigid tubes, 1 mm in diameter, with length-to-diameter ratios between one and ten. Oil was added to the film in small increments and photographed at each stage. For total liquid volumes (V) less than some critical value (Vc) surface tension draws the oil into an axi-symmetric film on the tube walls leaving the lumen relatively unobstructed. When V exceeds Vc, the film becomes unstable and collapses, bridging the lumen and causing obstruction. The ratio of Vc to the tube diameter cubed was found to be approximately 0.7 for the entire range of tube lengths studied. These experimental findings were then used to predict airway closure in a morphometric model of the bronchial tree. Assuming that the liquid film at TLC is 10 microns and that the volume of each airway varies in direct proportion to lung volume, the model predicts that airway closure will first occur in the terminal bronchioles at a lung volume of 23% TLC, in approximate agreement with observed values of residual volume. PMID- 2711050 TI - Entrainment of the respiratory rhythm by periodic lung inflation during vagal cooling. AB - The aim of this study was to determine whether pulmonary receptors other than slowly adapting stretch receptors are capable of entraining the respiratory rhythm when periodically stimulated during artificial ventilation. Experiments were performed on anaesthetised (urethane, 1.5 g/kg) and paralysed (pancuronium bromide, 0.1 mg/kg) rabbits. Vagi were cooled in order to block conduction in the myelinated fibres innervating slowly adapting receptors. The effectiveness of this cooling was assimilated to the absence of the Hering-Breuer inflation reflex and the presence of the deflation reflex. Our results indicate that under such conditions: (1) harmonic entrainment (one phrenic burst for one pump period) can be observed, (2) the range of harmonic entrainment is more limited when the vagi are cooled, and (3) during harmonic entrainment the inspiratory duration and phrenic activity are similar to what is observed at the same period with intact vagi, whereas vagal cooling modifies the phase difference between the phrenic burst and the pump. We have concluded that periodic input from rapidly adapting receptors and/or vagal C-fibres can entrain the respiratory rhythm as does input from slowly adapting receptors but with different patterns as evidenced by phase relationship. PMID- 2711051 TI - Individuality of breathing patterns in adults assessed over time. AB - Sixteen healthy adult subjects underwent two studies separated by 4-5 years to test whether their resting pattern of breathing was reproducible over time. From breath-by-breath analysis of airflow, measured with a pneumotachometer, the pattern of breathing was quantified in terms of individual respiratory variables; inspiratory time (TI), expiratory time (TE), total breath duration (TTOT), tidal volume (VT), VT/TI, TI/TTOT, and by taking TI, TE and VT all together (TRIAD). Also, the shape of the entire airflow profile was quantified by harmonic analysis (ASTER). A statistical analysis was designed to compare differences between the 1st and the 2nd recording within individuals with those differences observed between random pairs of recordings from the two studies in the same 16 individuals. It was found that all variables were significantly more similar within-individuals than between-individuals; this is best demonstrated when considering the ASTER and/or the TRIAD. It was concluded that the individuality of breathing pattern is maintained over a long period despite changes in smoking habit, weight, mild respiratory diseases, and other changes which occurred between the two studies in our subjects. PMID- 2711052 TI - The breathing patterns of identical twins. AB - The resting breathing patterns of healthy adult identical twins were compared to see if there was any possible genetic component in the determination of this pattern. From breath-by-breath analysis of airflow, measured with a pneumotachometer (9 pairs of twins), the pattern of breathing was quantified in terms of individual respiratory variables; inspiratory time (TI), expiratory time (TE), total breath duration (TTOT), VT/TI, TI/TTOT, and by taking TI, TE and VT all together (TRIAD). Also, the airflow shape was quantified by harmonic analysis (ASTER). A second study was performed under more strictly defined conditions of rest and where the respiratory variables were estimated with respiratory inductance plethysmography to eliminate the possible effect of a facemask (5 pairs of twins). In each study, for each variable, the differences within twin pairs were compared to the differences within random-pairs from the same subject population. In both studies, there were highly significant similarities within twin-pairs in the pattern of breathing, being best demonstrated when the entire 'shape' of the pneumotachogram (ASTER) or the spirogram (TRIAD) was considered. PMID- 2711053 TI - Breathing pattern during exercise in untrained children. AB - Breathing pattern during exercise on a cycle ergometer was studied in 18 untrained children aged from 6 to 15 years of age (9 boys, 9 girls). Oxygen uptake, tidal volume, minute ventilation, all normalized for body weight (VO2BW, VT BW, VE BW), respiratory frequency (f), inspiratory (TI) and expiratory (TE) times, ratio TI over total duration of the respiratory cycle (TI/TTOT) and mean inspiratory flow (VT BW/TI) were measured: (1) at rest (W0) and at the highest load (maximal cardiac rate) of an incremental exercise (W1); (2) in steady state conditions, at 50% of W1 (W1/2) and at 2/3 of W1 (W2/3). VO2BW, VT BW, VE BW, TI/TTOT, VT BW/TI increased significantly (P less than 0.01) from W0 to W1. Behaviour of f and TI were different from the latter parameters: f increased and TI decreased significantly from W0 to W1/2 (P less than 0.01) and from W1/2 to W2/3 (P less than 0.01) but remained similar at W2/3 and W1. We observed a relationship between VO2 BW and VT BW/TI, and between VT BW and TI/TTOT at each step of workload. We conclude that untrained children adapt the pattern of breathing during exercise, as at rest, to metabolic demand. However, the increase in f and the decrease in TI are limited at maximal workload. PMID- 2711054 TI - Variations in flow and intraalveolar pressure during jet ventilation: theoretical and experimental analysis. AB - Alteration in flow and pressure in a chest-lung model during jet ventilation was studied from a theoretical and experimental standpoint. The model consisted of a stiff box, with an inserted cast of the bronchial tree, simulating either normal or low compliance of the human chest-lung. Airway resistances in the model could be altered. A constant driving flow (Vd) was applied through the opening of the trachea at various rates. The driving flow drew in a constant flow (entrained flow = Ve) and increased the box pressure (PA), which in turn induced an increasing back flow (Vr). Vd, Ve-Vr and PA were measured. Theoretical analysis of time variation in box pressure showed a monoexponential pattern which was confirmed experimentally. Tr, the time at which back flow and entrained flow become equal could be predicted taking the physical characteristics of the experimental set-up and the values of Vd and Ve into account. Tr values depended mainly on the compliance of the experimental set-up. Increasing the resistances was found to reduce Ve. In practice, the efficiency of jet ventilation for gas exchange at a frequency below 4 Hz is known to be mainly related to the volume of gas flowing in the trachea towards the alveoli. This efficiency generally depends on the values of Tr and the inspiratory period (TI). A value of TI less than or equal to Tr will thus improve the jet ventilation efficiency. PMID- 2711055 TI - Cardiac output effects of high-frequency oscillatory ventilation in normal dogs. AB - We compared the hemodynamic effects of high-frequency oscillatory ventilation (HFOV) with conventional continuous positive pressure ventilation (CPPV). Six mongrel dogs were anesthetized with chloralose and evaluated over a range of mean airway pressures (Pao) during CPPV and HFOV. Pao during HFOV was measured by allowing alveolar pressure to come into equilibrium with airway opening pressure and was set to equal mean Pao during CPPV. Pao during CPPV was set by adding positive end-expiratory pressure (PEEP) of 0, 5, 10, and 15 cm H2O. Transmural pulmonary capillary wedge pressures (Pwp) were maintained at near 11 mm Hg in both groups during all four ventilatory periods. Cardiac output as measured in triplicate by thermal dilution was similar between HFOV and CPPV at each level of mean airway pressure. After matching mean airway pressure and transmural Pwp we were unable to find any sparing effect of HFOV on cardiac output over a wide range of airway pressures. We conclude that there is not an independent effect of HFOV on cardiac output. PMID- 2711057 TI - Symposium on Statistics in Surveillance. May 1988. PMID- 2711056 TI - Q fever pneumonia. AB - Pneumonia is one of several clinical syndromes that results from inhalation of Coxiella burnetii. This microorganism, the etiologic agent of "Q" (query) fever, infects a wide range of animals and insects. Cattle, sheep, goats, and cats are the reservoirs whereby this agent is spread to humans. High concentrations of C burnetii are present in the placenta and at parturition, the organism is shed into the environment to be inhaled by humans. Following an incubation period that ranges from four to 30 days (mean 14 days), fever, headache, malaise, and cough ensue. The clinical presentation of pneumonia may range from a mild to a severe illness--the latter with the clinical picture of rapidly progressive pneumonia. There are no characteristic features of Q fever pneumonia but the severe headache and the epidemiological history should serve as clues. Treatment with tetracycline or rifampin for two weeks usually results in cure. Many cases of Q fever pneumonia remit without antibiotic therapy. The diagnosis is usually confirmed serologically using a complement fixation or microimmunofluorescence test. PMID- 2711058 TI - An application of a mathematical model to adjust for time lag in case reporting. AB - In a dynamic, fluctuating surveillance system, the time lag of case reporting often causes an artificial plateau in an epidemic curve. Arbitrarily ignoring data reported in the most recent period to avoid this bias causes the loss of valuable information. In this report, we propose an application of a mathematical model to adjust for the underreporting bias owing to the time lag of the reporting process. We present an example using the acquired immunodeficiency syndrome incidence data for the homosexual group in the San Francisco surveillance system to illustrate and evaluate prospectively this proposed technique. The results show that the adjusted incidence obtained with the model agrees reasonably well with the true incidence, except for the last month of the period under consideration. PMID- 2711059 TI - A model-based approach to the imputation of missing data: home injury incidences. AB - Missing or incomplete data cases are a problem in all types of statistical analyses. In disease surveillance, this problem inhibits determining the actual incidence of a disease event and monitoring the disease occurrence. Several statistical techniques have been developed to impute values for incomplete data cases. We present a model-based approach to the imputation of missing data elements as applied to determining the incidence of home injury deaths. PMID- 2711060 TI - An analysis of disease surveillance data that uses the geographic locations of the reporting units. AB - The primary purpose of a disease surveillance system is to provide data for the detection of changes in the incidence of the disease. Methods for the analysis of data from surveillance systems are reviewed. A new procedure is proposed for use when the system includes geographically dispersed reporting units, such as hospitals or administrative regions. The method is based on the cusum statistic, and combines information from different units according to their geographic relationships. PMID- 2711061 TI - Analysis of surveillance data: a rationale for statistical tests with comments on confidence intervals and statistical models. AB - In the examination of differences between subgroups in surveillance data, whether through simple counting or through sophisticated statistical modelling, the comparison is not between simple random samples from two or more populations. The rationale for statistical tests rests on an appeal to a model of random permutation of demographic and disease factors for the observed population during the surveillance period. The testing evaluates chance as a possible explanation for the observed results. In the analysis of internal structure in a surveillance data set, statistical tests produce a conceptually simple result that lends itself to concise presentation and flexible interpretation. Tests limit emphasis on probabilistic manipulation and on parameter estimates. They cannot stand alone, and thus encourage descriptive presentation of observations. In contrast, statistical models and confidence intervals emphasize parameters rather than distributions and compete with the data for limited space. PMID- 2711062 TI - Analysis of surveillance data with Poisson regression: a case study. AB - One way to examine the ability of a statistical technique to detect changes in surveillance data is to analyse data sets with known changes and observe how accurately these changes can be detected. The elimination of restrictions on legal abortions should have reduced mortality associated with abortions, particularly mortality associated with illegal abortions. The sensitivity of Poisson regression to detect changes in abortion associated mortality from 1962 to 1984 was assessed for the entire United States of America and for specific states. Although it is clear that this change occurred using data from the entire United States, only the largest of the individual state data sets examined (370 events over 23 years) consistently demonstrated the expected pattern. Inconsistent patterns were found in data sets from two states with between one fourth and one-half this number of events. The legal change was not detected at all in three states with a small number of events (1 event per year or less). From this case study, a minimum of two or three events per year seems to be necessary before Poisson regression can detect outliers. Comparisons of the four tests used suggest that tests based on model deviance are superior to tests based on comparison of observed and expected number of events. PMID- 2711063 TI - A surveillance system based on a short memory scheme. AB - A surveillance system is proposed to detect an increase in the mean of a Poisson distribution of cases of a disease. This system, called short memory (SM), is based on conditional binomial tests which are performed sequentially at fixed time intervals. The probability of rejection at each test defines the run length distribution which has a geometric tail. A standard SM scheme outperforms other SM schemes. The CUSUM outperforms the SM schemes when the baseline mean is specified correctly. This type of misspecification does not affect the SM scheme. PMID- 2711064 TI - The application of time series forecasting methods to an estimation problem using provisional mortality statistics. AB - Provisional estimates of mortality for selected causes of death are published each month by the National Center for Health Statistics. These estimates are based upon a ten per cent sample of death certificates in the United States. Final mortality results, based upon all the death certificates for a calendar year, are available one to two years after publication of the provisional estimates. This paper explores the potential of time series forecasting techniques for improving mortality estimates by using the correlation structure between the provisional and final series to obtain mortality estimates that are expected to be closer to final values than currently used provisional estimates. PMID- 2711065 TI - A time series analysis of gonorrhea surveillance data. AB - Gonorrhea is the most frequently reported communicable disease in the United States. In response to rapidly rising rates in the late 1960s, the Public Health Service instituted a gonorrhea control programme. An important component of the programme is the screening of women for gonococcal infections. We use a time series intervention model to estimate the initial increase in reporting of cases in women associated with the control programme. From the middle 1970s to the middle 1980s, a regular seasonal pattern in the data is conspicuous. We use a second time series model to quantify the seasonal variation during this period and to construct forecasts. PMID- 2711066 TI - Time series analysis of syphilis surveillance data. AB - To manage a public health programme effectively it is necessary to set objectives and priorities according to the resources available. To utilize available resources optimally in a disease control programme we should both estimate the present and predict the future magnitude of the health problem. The CDC has an effective programme to control syphilis, a sexually transmitted disease. To keep track of control activities, CDC receives the number of syphilis cases from all states every three months. Primary and secondary syphilis cases declined from an all time high of 106,539 cases in 1947 to 6399 cases in 1956. Since then, syphilis cases increased to 27,921 in 1986. Congenital syphilis cases declined from 17,600 in 1941 to 239 in 1983, but increased to 408 in 1986. We built time series models for primary and secondary syphilis cases in men and women and congenital syphilis cases in children under one year of age. These models were used to forecast syphilis cases in all three categories. This analysis suggests that no change in the trend of male syphilis cases has occurred, but syphilis cases in women and congenital syphilis cases in children under one year of age during 1987 have increased. PMID- 2711067 TI - Monitoring data quality through comparisons between data systems. AB - Since its creation in 1960, the National Center for Health Statistics (NCHS) has placed a high value on the quality of the information and statistics collected and published by its data systems. An important component of a comprehensive data quality monitoring system for a statistical agency such as NCHS is the comparison of statistics between data systems. Between-data-systems comparisons are used to monitor the consistency and comparability of statistics across data systems and between NCHS data systems and outside sources of data. This paper focuses on between-data-systems comparisons and describes a number of methodological analyses that can be used to evaluate data quality. The methodological analyses presented include the evaluation of time trends, the estimation of survey method effects, the evaluation of response error, the measurement of definitional and concept effects, and the detection of inconsistencies between data systems. The paper concludes with a discussion of the complexities of the between-data-systems comparisons and an assessment of the net benefits from such comparisons. PMID- 2711068 TI - Estimating trends in the effectiveness of seat belts in saving lives, 1975-1985. AB - We examine the effectiveness of seat-belt systems for preventing mortality in automobile crashes. In particular, we examine whether seat-belt effectiveness has been constant over this period and conclude that there has been a trend toward an increased effectiveness of seat-belt systems. The relative odds of death associated with wearing seat belts dropped from 0.80 in 1975 to 0.34 in 1985. This trend results from improvements in both the type and design of seat belts and from additional design changes, such as padded dashboards and collapsible steering columns, that protect occupants at the time of collision. PMID- 2711069 TI - [How to interpret a diagnostic test]. PMID- 2711070 TI - [The economics of health planning or social medicine revisited? 1. The conceptual framework]. AB - Born in the nineteenth century, social medicine has already evolved through several steps. Indeed, having started as a community approach of the most deprived population groups, it has been progressively reoriented through the study of the most rational ways to give medical care to large target groups. Recently it has studied the impact of individual life health status and quality of life. The laws of functioning applicable to these approaches are those coming from liberal and planified economical theories while health planning has developed more and more sophisticated and convincing methodologies. PMID- 2711071 TI - [Idiopathic retroperitoneal fibrosis]. AB - Reviewing three recent cases of idiopathic retroperitoneal fibrosis, we describe the clinical symptoms, the evolution, the biological data and the histological features. We emphasize the importance of C.T. scan in the investigation of such patients. Treatment was either surgical or medical. PMID- 2711072 TI - [Pleuro-parenchymatous asbestosis. The value of bronchoalveolar lavage fluid analysis]. PMID- 2711073 TI - [Physical therapy of patients in general practice. Role of the main groups of physical therapy methods in acute and chronic problems of the locomotor system]. AB - The choice of a treatment concept in physical therapy largely depends on whether the presenting functional disorder is of an acute or of a chronic nature. The classification acute or chronic has to be made according to two criteria: acute or chronic course in time/acute or chronic type of disorder. The main concern of physical therapy is prophylaxis of chronic disorders. Chronification of symptoms quite often leads to human tragedy and, moreover, to higher costs, since the total medical and social costs for the chronic cases are higher than those for acute cases. The general practitioner has an important function in the prophylaxis of chronic musculoskeletal disorders. Three to four weeks after the onset of the symptoms he should perform a special evaluation of every patient, thereby assessing the risk of chronification. When a chronic course is considered to be probable, an activating treatment concept should be initiated which in general comprises the following components: comprehensive information and instruction, active exercising (especially training therapy), self mobilization and soonest possible return to work within the limits of stress the condition can be exposed to. PMID- 2711074 TI - [Health benefits and risks in sports: the other side of the coin]. AB - Regular exercise has varied health effects, ranging from well-documented benefits to suggested risks. Probably the most important benefit is the reduction of the risk of coronary death by approximately one half among male exercisers, who also have a slightly elevated life-expectancy. This cardioprotective effect of physical exercise is not offset by the immediate increase in risk of sudden death during strenuous exercise. Sports-related complaints and injuries of the locomotor system must however also be born in mind. Different sports have different injury rates, but often a dose-effect relationship can be seen within one type of activity. The long-term effects of exercise on bones and joints are of uncertain dignity, since they may range from desirable prevention of osteoporosis to sports-induced premature osteoarthritis. The potentially important health effects of exercise at old age are largely unknown. From a prevention perspective, one to two weekly hours of vigorous exercise or an additional energy expenditure of at least 1000 kcal per week (also with moderate intensity exercise such as walking) can safely be recommended. At present, only one third to one half of the adult Swiss population are physically that active. PMID- 2711075 TI - [Incidents in sports diving]. AB - Barotrauma of the ear is the most frequent incident in sport-diving. In some cases, inner ear disorders appear. Barotrauma with rupture of the lung can provoke gas embolism into the central nervous system and unconsciousness. Gas embolism into the spinal cord and decompression sickness of the spinal cord provoke practically the same neurological disturbances. The lower half of the body is mostly affected. Drowning in sport-diving is mostly the result of loss of consciousness resulting from hypoxia or hyperoxia, nitrogen-narcosis or gas embolism into the brain. Inner ear disorders, gas embolism in the brain or the spinal cord, decompression sickness of the spinal cord or the muscles and joints require treatment in the pressure chamber with hyperbaric oxygen. This treatment remains effective even if started some days after the dive. PMID- 2711076 TI - [Biomechanics in sports]. AB - Sports are often practised nowadays in balance for a non challenging profession or as means to counteract stressful life style. This desirable and reasonable development calls however for a critical assessment of biomechanical factors contributing to stress and admissible load of the human locomotor system. Considerate training renders excessive strain of the skeleton, cartilage and vertebral column virtually impossible. In view of the time required for adaptive processes this statement has to be combined with an appeal for appropriate training to those seeking compensation in physical exercise. Especially young people and middle-aged persons experiencing so called midlife-crisis tend to practise unbalanced and excessive sportive activity. PMID- 2711077 TI - [Sports as therapy]. AB - The risk of athletic physical activity is low if high risk patients are excluded. These patients have to undergo operation or intensive drug treatment before active rehabilitation. The benefit of physical rehabilitation is mainly an increase in the quality and enjoyment of life. A decrease in cardiac morbidity and mortality is less clearly documented. A secondary prophylactic effect of rehabilitation is proven by studies in healthy populations, but the increase in life-span is small. Therefore a lifetime prescription of physical activity should be considered in each individual, but seems to be justifiable only in those patients who enjoy physical activity. PMID- 2711078 TI - [Developments in drugs and populations at risk]. AB - No therapeutic effectiveness without unwanted side-effects. This well-known problem persists in spite of modern methods for development of new drugs. Therefore no drug-therapy should be initiated without exact risk-benefit analysis. Especially for drugs introduced recently, effectiveness is better defined than tolerance. In the USA annual costs of 3 million $ due to drug-side effects have been estimated, indicating an immense socio-economic relevance next to medical or personal aspects. Therefore effective means and strategies should be accepted and used: General reduction of drug consumption, avoidance of polytherapy with respect to known and unknown interaction of side-effects, strict observation of proper indications, amelioration of surveillance for recently introduced drugs and better consideration of special populations at risk. PMID- 2711079 TI - [Superior gluteal nerve entrapment neuropathy]. AB - We observed two female patients suffering from chronic gluteal pain of mechanical origin, without paresthesia. In the first case, the muscular pain was associated with weakness of hip abduction and with tenderness of the middle gluteal muscle. An electromyography, a principal examination, confirmed a diagnosis of entrapment of the superior gluteal nerve in one case and of the distal branch in the other. The proposed treatment, as in the case of neuropathic entrapment of the median nerve at the wrist, consists of a local infiltration of corticosteroids. If the symptoms persist, surgical intervention to free the nerve is indicated. For our first patient the clinical and electromyography cure has been completed. The neuropathy by chronic compression of a nerve in the gluteal area seems to be rare, but one has to consider further investigations in the case of chronic gluteal pain. PMID- 2711080 TI - [Group therapy with elderly patients with dementia]. AB - In the work with the demented hospitalised elderly, mostly suffering from senile dementia of Alzheimer's type, we introduced group therapy. As known from the literature the group setting and the group leader must undergo important changes in the work with the demented elderly in comparison to the therapeutical work with the nondemented elderly. Our experiences, different evaluations attempts and the limitations of this therapeutical approach will be discussed. PMID- 2711081 TI - [Upper abdominal pain]. AB - We report a female patient in whom the false diagnosis of acute pancreatitis was made, based on intensive epigastric pain and a four fold increase of amylase. The normal values for lipase and decreased values for the urinary amylase were suggestive of a constellation of macroamylasemia. Further investigations revealed a fresh ulcer in the bulbus duodeni as cause of the epigastric pain. With a therapy of cimetidine and antacids painlessness could be achieved within few days. PMID- 2711082 TI - [A case from practice (134). Patient: Mr. J.D., 1956, electrician]. PMID- 2711083 TI - State of the art of lasers in oncologic surgery. AB - The laser first described by Shawlow and Townes in 1957 was built by Ted Maiman in 1960. Many forms of lasers rapidly evolved using solids, liquids, and gasses from the medium. Applications in many fields grew rapidly; medicine has been in the forefront. Many branches of medicine found applications in surgical oncology, pulmonary, dermatology, vascular surgery, and, now, infectious diseases using this modality. This paper discusses part of the benefits for research and treatment of cancer. PMID- 2711084 TI - Management of endobronchial tumors: a comparative study. AB - Between September 1982 and July 1987 we treated 102 patients with endobronchial or endotracheal disease with one or a combination of the following modalities: CO2 laser, Nd:YAG laser, and photodynamic therapy (PDT). Many patients had multiple treatments and treatment sites. In all, 259 Nd:YAG treatments were performed on 154 sites in 80 patients, 118 PDT treatments were performed on 87 sites in 45 patients, and nine CO2 treatments were performed on nine sites in nine patients. Of the 71 patients who died, 19 lived longer than 6 months, and seven lived longer than 1 year. A total of 11 patients have survived for more than 1 year, including four who are still alive 18, 22, 33, and 54 months after treatment. Five patients achieved a status of "no evidence of disease," and at autopsy, two others had no evidence of disease to the treated site. All seven of these patients were treated with PDT only. There were no intraoperative deaths or cases of intraoperative bleeding or smoke with PDT. Eight patients died from pulmonary hemorrhage 2 to 9 weeks after treatment. Four had been treated with Nd:YAG therapy alone and four with PDT alone. Evaluation of the survival rate in this study must consider that this therapy involves severely ill patients with a high potential for intraoperative or perioperative fatality. Some patients who were near death before treatment have enjoyed quality survival for over 1 year. PMID- 2711085 TI - Contact YAG laser system in abdominal surgery, in particular hepatic and pancreatic surgery. AB - The SLT contact Nd:YAG laser system offers a new method of obtaining a hemostatic incision through the anterior abdominal wall and a surgical tool for performing various intraabdominal resectional procedures. Advantages include reduction in intraoperative bleeding, reduced tissue damage, and tactile sensation with a reduction in laser power requirements. Sterile disposable laser scalpels, fibers, synthetic sapphire probes, and a user friendly laser system offer a new dimension in intraabdominal surgery, especially relating to liver and pancreatic surgery. Potentially, all general surgical procedures could use the SLT contact laser, which may, in the future, replace conventional electrocautery and the surgical steel scalpel. Cost containment and improved quality of care will probably be the driving forces for its acceptance. PMID- 2711086 TI - Physiological sleep tendency and ability to maintain alertness at night. AB - The maintenance of wakefulness test (MWT) and repeated test of sustained wakefulness (RTSW) were compared to the multiple sleep latency test (MSLT) during nighttime hours to evaluate differential sensitivity to variation in physiologic sleepiness/alertness. The degree of sleepiness varied by time of night and was further manipulated by varying prior sleep. Seven healthy normal sleepers were evaluated on the MWT, RTSW, MSLT, a digit symbol substitution test and the Wilkinson addition test in a protocol beginning at 2200 h and terminating at 0830 the following morning. A counterbalanced, crossover design compared an evening nap condition to a no-nap condition. The MWT and RTSW discriminated between nap and no-nap conditions, but the MSLT did not. This suggests that in some situations the MWT and RTSW may be more sensitive to changes in physiologic sleepiness/alertness than the MSLT. The data are discussed in terms of possible methodologic limits of the MSLT and the relationship between physiologic sleep tendency and the capacity to maintain alertness. PMID- 2711087 TI - Effects of intravenous catheter on sleep in healthy men and in depressed patients. AB - The effects of intravenous catheter and nocturnal blood samplings at frequent intervals on sleep electroencephalogram (EEG) variables were investigated in 8 male healthy controls and 12 depressed patients, who were studied in the same experimental conditions. After one night of habituation, sleep was recorded during 4 consecutive nights in the sleep laboratory. A catheter was inserted around noon the day before the fourth night, and blood was sampled every 15 min for 25 h. The night-to-night comparison of sleep EEG variables did not show significant sleep continuity modifications in the control subjects, other than a weak trend toward an increase in nocturnal awakenings during the night with the catheter. A lengthening of sleep onset latency during the fourth night was found in the depressed patients. No significant changes were detected in percentage of rapid eye movement (REM) sleep in the two groups. However, a gradual increase in Stage 3 was observed across the 4 nights in the control subjects. These results indicate that intravenous blood sampling via a catheter can be performed without inducing significant disruption of sleep length and structure. PMID- 2711088 TI - Two methods of scoring sleep with the Oxford Medilog 9000: comparison to conventional paper scoring. AB - This study evaluated two methods of scoring taped polysomnographic data directly on the Medilog 9000 scanner: (a) screen-by-screen scoring, and (b) rapid screen scoring. Sixteen overnight polysomnograms recorded on Medilog 9000 recorders were scored using the above two methods and were also printed on paper for conventional paper scoring. Interscorer agreement was 87.8% for paper scoring, 85.5% for screen-by-screen scoring, and 84.2% for rapid screen scoring. Comparison of screen-by-screen scoring with paper scoring revealed small absolute deviations and correlations of r greater than 0.90 for all sleep parameters, with the exception of brief (less than 2 min) awakenings (r = 0.69). Rapid screen scoring resulted in slightly lower correlations and greater deviations from paper scoring on several sleep parameters, but appeared acceptable for most clinical purposes and greatly reduced the required scoring time. Although some statistically significant differences between scoring methods were observed, the size of effect was small and of doubtful clinical importance. These findings suggest that polysomnographic data recorded on Medilog 9000 recorders can be reliably and accurately scored on the Medilog scanner, obviating the laborious task of printing the taped data on paper. PMID- 2711089 TI - Sleep EEG evaluation: a comparison of results obtained by visual scoring and automatic analysis with the Oxford sleep stager. AB - Oxford Medical has introduced an automatic sleep stager based on the stage scoring criteria by Rechtschaffen and Kales. With our study we intended to examine whether the results of the stager (version 3.0) match those of the visual evaluation by two independent raters. We also wanted to test the reliability of this automatic sleep stage-scoring system. Ten somnopolygrams of subjects without sleep disturbances served as a basis for the comparison. Each sleep recording was scored twice automatically by the stager, twice visually by the first rater, and once by the second rater. The two automatic analyses of the somnopolygrams differed by 4.3% in a total of 13,850 epochs (1 epoch delta 20 s) regarding sleep stage scoring. The difference between the first and the second visual evaluation by the same rater amounted to 5.7%, whereas the results of the two independent raters deviated by 8.7%. Compared with the results of the visual analysis reached as a consensus by both raters--the so-called optimized visual analysis--the stager showed a 26.9% difference. The automatic analysis scored fewer epochs as stages wake, rapid eye movement (REM), and 2 and more as stages 1, 3, and 4. The sleep stager's frequent difficulty in identifying stage wake correctly as well as its incorrect allocation to other stages--mainly stage REM--could lead to misinterpretations of sleep recordings, whereas the increase in stages 1, 3, and 4, as compared with visual scoring, was negligible. PMID- 2711090 TI - Automatic versus visual EEG sleep staging in preadolescent children. AB - Ambulant sleep polygrams were obtained from 14 normal subjects (9 boys and 5 girls) and from 3 boys with attention deficit disorder. The children were aged 8 12 years. Two consecutive nights were recorded with an eight-channel electroencephalographic (EEG) tape cassette recorder. The results were analyzed automatically by the Oxford Medilog 9000 Sleep Stager and by visual scoring from the Medilog Display Unit. Twenty-seven nights were analyzed; 7 nights were excluded because of electrode problems or other technical failures. The main sleep stage shifts and the length of sleep cycles as measured from the hypnogram of the automatic printout agreed well with corresponding values from our visual scoring. In the automatic scoring, rapid eye movement (REM) sleep time was shorter and slow wave sleep was longer than in the visual rating. This can be explained partly by specific properties of the EEG in this age group. The Oxford Medilog 9000 sleep stager can be used to survey sleep quality, but the results must be carefully checked visually. In cases of EEG pathology or sleep abnormalities in childhood it is doubtful if any time or labor is saved by using automatic scoring. PMID- 2711091 TI - Nightcap: a home-based sleep monitoring system. AB - In an attempt to offer a home-based adjunct to traditional sleep laboratory methods, we developed a system to monitor sleep, and to predict algorithmically non-rapid-eye-movement (NREM) and rapid-eye-movement (REM) sleep states, using eye and body motility as the only parameters. Eye movement was measured using a strain gauge transducer applied to the eyelid of subjects, while body movement was measured using a piezo-ceramic phono cartridge. Both transducers were mounted on a tennis headband, along with electronics that amplified, filtered, and digitized the signals. Digital pulse signals were input to a portable computer in minute-long epochs, and state-predicting algorithms were run based on this motility data. Four subjects were monitored in the sleep lab with both our headgear and standard polysomnography. Hand-scored sleep records were compared with those predicted by computer algorithms. Algorithm-predicted states agreed with hand-scored ones an average of 85.57% (SEM +/- 1.7%). Mean values for sleep onset and REM latency were within 1.6 and 10.8 min of polysomnographic records, respectively. These results are encouraging, and suggest that this system could provide a comfortable, subject operable, and inexpensive method for the evaluation of sleep at home. PMID- 2711092 TI - Decreased slow-wave and paradoxical sleep in a rat chronic pain model. AB - Diurnal sleep-wake patterns in the normal and the adjuvant arthritic rat were measured during the first 3 h of both light and dark periods. During the hours of maximal sleep in the normal rat, arthritic rats showed a significant increase in wakefulness (Wake), a shift to non-rapid-eye-movement (NREM) stages with lower amplitudes (LS and HS1), and a large reduction of NREM sleep with the highest amplitude (HS2) and paradoxical sleep. Arthritic rats also showed marked sleep fragmentation manifested by more episodes of Wake, LS, and HS1 and shorter episodes of HS2 during both the light and the dark periods. Thus, arthritic rats cannot sustain long periods of sleep. In contrast to control rats, arthritic rats lacked a diurnal variation in Wake, total sleep, and electroencephalographic (EEG) delta activity. They also showed a decrease in overall EEG amplitude. In addition, there was a positive correlation between the severity of arthritis and the percentages of NREM sleep with low (LS) and moderate (HS1) amplitude. Thus, the decline in EEG amplitude could indicate a deficit of EEG generating mechanisms or some aspect of disease severity, such as pain. PMID- 2711093 TI - Munchausen syndrome by proxy and sleep disorders medicine. AB - Munchausen syndrome by proxy is a factitious disorder of childhood in which a parent fabricates medical history or produces signs of illness in a child to keep the child in a sick role. Since approximately half of all cases of Munchausen syndrome by proxy are presentations of central nervous system illness, such as excessive daytime sleepiness and near-miss sudden infant death syndrome, sleep disorders centers are likely diagnostic consultants for the evaluation of children involved in this disorder. We review characteristics that may suggest that a particular case has an increased likelihood of Munchausen syndrome by proxy. The recent presentations of two cases of Munchausen syndrome by proxy to sleep disorders centers are discussed as examples. PMID- 2711094 TI - Monoamine interactions in narcolepsy and hypersomnia: reanalysis. PMID- 2711095 TI - Episodic nocturnal wanderings. PMID- 2711096 TI - Reverse first night effect in insomnia. AB - This study evaluates the reverse first night effect (FNE) in insomniacs. All insomniacs evaluated at the Dartmouth Sleep Disorders Center between 1975 and 1980 were studied if they met specific criteria (n = 89). First night effects were assessed using the following four variables: sleep efficiency, sleep latency, percentage of rapid eye movement (REM) sleep, and REM latency. The 20 subjects who showed the strongest normal FNE were compared with the 20 showing the strongest reverse FNE. The two groups were similar in age, sex, and most aspects of reported home sleep. They differed in their sleep on night 1, but on nights 2 and 3 their sleep was quite similar. Both groups overestimated their sleep latencies on night 1 (by subjective reports) but unlike the normal FNE group, the reverse FNE patients very accurately assessed their sleep latency on nights 2 and 3. Reverse FNE patients had significantly higher scores than normal FNE patients on the Minnesota Multiphasic Personality Inventory (MMPI) K (defensiveness, guardedness) and Pa (paranoia) scales, and they were less depressed, marginally less anxious, and somewhat more sensation-seeking and more susceptible to boredom. This study concluded that evaluations using only 1 night in the laboratory may be missing the larger picture of a patient's insomnia. When data from only 1 laboratory night are available for an insomniac, care should be taken with the label of "subjective complaint without objective findings" in patients who are defensive, guarded, and sensation-seeking. PMID- 2711097 TI - Research towards global control and prevention of tuberculosis with an emphasis on vaccine development. A Fogarty International Center Workshop, Bethesda, Maryland, 3-5 November 1987. Proceedings. PMID- 2711098 TI - Pathogenesis of tuberculosis: clinical and epidemiologic perspective. AB - Mycobacterium tuberculosis is one of several pathogens that confer resistance to reinfection, but its persistence presents a constant threat to the host. In countries where the incidence of tuberculosis is low, most cases appear to be caused by recrudescence of old infection. The ability of the organism to produce protection against a new infection, at least in theory, affords an opportunity to induce resistance by vaccination. Although exogenous reinfection is documented in a recent paper, data from a recent outbreak of tuberculosis in Arkansas show no evidence of reinfection in the face of documented serious spread of infection to persons who were not reactive to tuberculin. Presently available vaccines have not proven to be reliable in producing resistance. Thus, a search for a means of conferring the ability to mount a quick immune response when the organism is encountered appears to be worthwhile. PMID- 2711099 TI - The golden age of pharmacology. PMID- 2711100 TI - Dispensing narcotics. PMID- 2711101 TI - [Fibrosing mediastinitis]. AB - Fibrosing mediastinitis is a rare entity either idiopathic or caused by granulomatous disease. Plain film findings mainly show widening of the upper half of the anterior mediastinum, whereas CT delineates more clearly the exact location of the mediastinal mass and the extent of compromise of mediastinal structures. Although vessels surrounded by the fibrous mass are typically smoothly bordered and only rarely displaced, diagnosis can only be suspected together with the patients history and clinical course. PMID- 2711102 TI - [Radiology in ear, nose and throat medicine--the clinical picture of ear diseases and demands on the radiologist]. AB - Due to the hidden location of the ear, deep inside the head, the otologist often requires the collaboration of the radiologist for the diagnosis of ear diseases. Arranged in an anatomical classification (outer, middle and inner ear), such problems are discussed with regard to their clinical appearance. PMID- 2711103 TI - [The clinical picture of paranasal sinus diseases and demands made by the ear, nose and throat physician on the radiologist]. AB - We know today that chronic and recurrent sinusitis is caused by obstruction of the infundibulum in the anterior ethmoid bone. The primary goal of modern microscopic and endoscopic surgery for paranasal sinusitis by infundibulotomy is the restoration of ventilation and drainage of the sinuses. Meticulous radiographic delineation of the small structures of the hiatus semilunaris by computed tomography coupled with endoscopic evaluation is the most important diagnostic method. In the majority of cases the coronal plane is preferred. The axial plane is mandatory only for evaluation of the frontal sinuses. PMID- 2711104 TI - [Paranasal sinus diseases--potentials and limitations of radiology]. AB - The indications for conventional plain x-ray films, computed tomography in axial and/or coronary projection and magnetic resonance tomography are discussed on the basis of case reports on inflammatory, tumorous and tumour-like diseases of the paranasal sinuses. PMID- 2711105 TI - [The influence of breathing technic on the visualization of lung metastases in computed tomography]. AB - The importance of CT imaging in maximum inspiratory position for the identification of lung metastases is emphasised. In a woman patient suffering from respiratory insufficiency and hypernephroma and clinically suspected of lung metastases, it became necessary to produce two computed tomographs of the thorax at short intervals to clarify the number and size of the pulmonary foci. Since the first examination could not be conducted in a position of maximum inspiration because the patient was short of breath, the procedure was repeated six days later after intensive breathing exercises and subjective improvement of the patient's feeling tone. It was found that three of the four pulmonary metastases could not be seen on the technically unsatisfactory tomographs of the first examination, or could be detected only retrospectively. PMID- 2711106 TI - [Spontaneous arterial recanalization--a case report]. AB - Spontaneous thrombolysis with recanalisation of peripheral arterial vessels is a well-known, albeit rare phenomenon. The probable mechanisms of this phenomenon is the activation of local fibrinolytic processes by local mediators of the vascular endothelial cells. Vascular stenoses of atherosclerotic origin are also subject to regression, depending on the plasma LDL level. Reangiography is indicated for determining further therapy planning if there is a change in clinical signs towards either improvement or deterioration. Reangiography is imperative if the previous angiography was performed before more than three months. PMID- 2711107 TI - [Documentation of medical images using a laser camera]. AB - For today's and tomorrow's high developed imaging systems CT, MR, DSA, NM, US, DR we need equally highly developed recording equipment to produce high-grade quality "hard copies" at the end of the image transfer chain. For this reason we present a new laser image recording technique with Laser Imager and its operational principle. The Video Imagers (multiformat cameras) used until now are no longer up to date due to their disadvantages for imaging documentation of high resolution imaging systems. The direct exposure of a single-emulsion-silver halogenide transparency film with laser light, produces low-noise distortion-free and homogeneous documentation images. The size of the matrix of 4000 x 5000 pixel and 12 bit image depth guarantees the use of the Laser Imager also for future imaging systems with a higher size matrix than is now usual. The modulated accessories such as Multi-Modality Unit (MMU) and Multi-Console Laser Switch (MCLS) guarantees a flexible and more economic use of the Laser Imager. PMID- 2711108 TI - [Primary hyperparathyroidism in the elderly subject. 42 surgically treated cases]. PMID- 2711109 TI - [Specificity of the type II anti-collagen response in the mouse MRL-lpr/lpr. Immunoblotting study]. PMID- 2711110 TI - [Professional dancing and coxarthrosis]. PMID- 2711111 TI - [Lumbar neurinoma with corporeal-pedicle development. Apropos of a case]. PMID- 2711112 TI - [Isolated Paget's disease of the hand. Apropos of a new case]. PMID- 2711113 TI - [Spondylodiscitis caused by Fusobacterium nucleatum. Apropos of 1 case]. PMID- 2711114 TI - [Does the pseudomyopathic form of ankylosing spondylitis exist?]. PMID- 2711115 TI - [Peripheral facial paralysis disclosing Horton's disease]. PMID- 2711116 TI - [Chronic brucellar osteomyelitis of the humerus]. PMID- 2711117 TI - [Sciatica cured by vitamin B12]. PMID- 2711118 TI - Psychoacoustic abilities of subjects with unilateral and bilateral cochlear hearing impairments and their relationship to the ability to understand speech. AB - This paper is concerned with deficits in the ability to distinguish sounds, which accompany hearing loss of cochlear origin, and with the relationship of those deficits to the ability to understand speech in quiet and in background noise. Nine subjects with moderate unilateral cochlear hearing loss and 6 with moderate bilateral cochlear hearing loss took part in a series of psychoacoustic and speech perception tests. The impaired ears showed deficits in several of the psychoacoustic tests, including: detection of temporal gaps in bands of noise; frequency discrimination of pure tones; frequency discrimination of complex tones; and frequency selectivity as measured by the masking of tones by notched noise. The impaired ears showed near-normal performance in the detection of changes in intensity and for detecting temporal gaps in sinusoidal signals. Speech reception thresholds (SRTs--defined as the level of speech required for 50% intelligibility) were measured both in quiet and in speech-shaped noise, and were invariably higher for the impaired than for the normal ears. Correlational analysis, principal-components analysis and multiple-regression analysis were used to explore the relationships between the psychoacoustic measures and the SRTs. The results suggest that SRTs in quiet are determined primarily by absolute thresholds as measured by the pure-tone audiogram. SRTs in noise are related more to supra-threshold discrimination abilities, such as the detection of temporal gaps in noise and the frequency discrimination of pure and complex tones, and to age. Possible clinical applications of the results are briefly discussed. PMID- 2711119 TI - Formation and early prenatal location of the human mental foramen. AB - The formation and early prenatal location of the human mental foramen was investigated on 43 human fetuses. Histochemical methods supplemented by macroscopic visualization were used. Similar studies on the mental foramen were not available in the literature. The study demonstrated constancy in the developmental sequence of the bony structures in the region of the mental foramen. The formation of the mental foramen was described and related to general developmental parameters such as CRL and CNO values (skeletal maturity indexes of the hand and foot). The study indicated that the very early position of the mental foramen was in the region of the interstitial bone between the primary canine and the primary first molar. A positional change in the dorsal direction was described during the first half of the prenatal period. PMID- 2711120 TI - Effect of the antineoplastic agents doxorubicin and methotrexate on rat caries and secondary dentin formation. AB - Because childhood cancer and/or its therapy is known to increase both dental caries and developmental defects in enamel, this experimental study was carried out to obtain information on the effect of two frequently used anticancer drugs, doxorubicin and methotrexate, on fissure caries and dentinal metabolism in healthy rats. Both drugs significantly reduced caries prevalence in the rat molars, the dentinal lesions that developed also being smaller than in the controls. Secondary dentin formation was slightly reduced, probably because of the lower caries prevalence in the rat molars and/or because of the action of the drugs. Thus, these two drugs could scarcely have been the reason for the increased caries activity in cancer patients. PMID- 2711121 TI - Systematic analysis of gingival state and salivary variables as predictors of caries from 5 to 7 years of age. AB - The aim was to assess the caries predictive ability of gingival state, salivary counts of lactobacilli and S. mutans, salivary secretion rate and buffer capacity of the saliva from the ages of 5 to 7 yr. The material comprised 105 children who were examined once a year. All available screening levels were systematically tested for the single variables as well as for combinations of two or three variables. The screening levels were set where the highest possible sensitivity and specificity were reached simultaneously. The predictive values for positive and negative tests were then calculated. The S. mutans count turned out to have the best combination of sensitivity (0.41) and specificity (0.83). The single variables gingival state and S. mutans had constant screening levels, while the values for lactobacilli and buffer capacity varied. The saliva secretion rate could not be measured at 5 yr of age. Systematic analyses of predictive ability of combinations of two or three variables were then performed and did not result in any clinically significant improvements of the predictive ability. The observed low predictive ability might be explained by the fact that 1) many children changed their habits during the period of investigation and 2) they were examined and treated once a year according to their individual needs, which meant variations in conservative as well as in preventive treatment. PMID- 2711122 TI - Outer membranous vesicles and leukotoxic activity of Actinobacillus actinomycetemcomitans from subjects with different periodontal status. AB - Strains of A. actinomycetemcomitans (A.a) from juvenile periodontitis patients (JP), adult periodontitis patients (AP), and 14-yr-old healthy children were tested for the correlation between leukotoxin activity and the number of outer membranous vesicles measured in electron micrographs. To determine the potential for connective tissue destruction following the interaction of polymorphonuclear leukocytes (PMN) with the bacteria, the lysosomal release of neutrophil elastase was assessed. The highest potential to kill leukocytes and to release lysosomal elastase from them was observed in the strains isolated from JP patients. No correlation existed between leukotoxic activity and the number of outer membranous vesicles per bacterium when the data from A.a. strains from all sources were combined. Furthermore, no significant differences were found between the numbers of outer membranous vesicles in the three groups tested. The only significant correlation between the number of vesicles and leukotoxicity was found in the A.a. strains derived from the mouths of healthy children. PMID- 2711123 TI - Panoramic screening for dental anomalies assessed by professionals with identical and different backgrounds. AB - The aim of the present study was to evaluate how dental professionals with identical and different backgrounds assess dental anomalies viewed on panoramic radiographs. 101 panoramic radiographs performed of 9-to-10-yr-old children were examined independently by three orthodontists and two radiologists. All observers agreed on the recording of number and identification of congenitally missing permanent teeth. The observers' assessments of malpositioned teeth, teeth in infraocclusion, and primary teeth with atypical/non root resorption varied, however, to a great extent. Two of the orthodontists seemed to report only major deviations from normality (in 38 and 51 of the children respectively) while one reported several more findings (in 85 children). The radiologists reported abnormal findings in 80 and 88 children respectively. In only three children were no dental anomalies reported by any observer. The inconsistent reporting of the majority of dental anomalies (except for agenesis) in children, even among members of subgroups with a similar educational background (e.g. orthodontists), substantiates the need for an evaluation of the expedience of panoramic screening. PMID- 2711124 TI - Hypersensitivity reactions to dental materials in a referred group of patients. AB - 151 patients referred to the Department of Oral Diagnosis, University of Umea, for investigation regarding potential side-effects of dental materials were subjected to epicutaneous testing at a dermatology clinic. Twelve persons in this group had oral mucosal changes. Among the 151 patients 39 women and 7 men had positive skin reactions to one or more of the test substances used. The majority of the positive reactions were related to metals, particularly nickel, but a number of positive reactions to organic test substances were also noted. In many cases the substance which caused the positive skin reaction was also a known constituent of the restorative or prosthetic materials present in the oral cavity of the patient concerned. The clinical relevance of such findings should, however, be evaluated with great caution and this and connected problems are discussed. PMID- 2711125 TI - Chromatographic separation of alkaline phosphatase from dental enamel. AB - Alkaline phosphatase (AP) was prepared from partly mineralized bovine enamel by extraction in phosphate buffer, centrifugation and various chromatographic techniques. Chromatofocusing showed that the enamel enzyme possessed five isoelectric points at the acid pH level ranging from pH 5.7 to pH 4.4. Three enzyme peaks were eluted using low pressure chromatography with a Bio-gel column. With a HPLC gel filtration column the separation of the enamel extract resulted in only one peak with AP activity. The fractions of this peak were used to produce an antibody against bovine AP. PMID- 2711126 TI - Blood pressure in childhood and adolescence. Proceedings of the XXXIst scientific meeting, Danish Society of Hypertension. Copenhagen, February 5, 1988. PMID- 2711127 TI - Blood pressure and physical fitness in school children. PMID- 2711128 TI - The consequences of the familial dispositions of the blood pressure in children and young people. PMID- 2711129 TI - Familial aggregation of blood pressure in children. PMID- 2711130 TI - Tracking of blood pressures. PMID- 2711131 TI - Blood pressure measurement in childhood and adolescence. International recommendations and normal limits of blood pressure. AB - BLOOD PRESSURE MEASUREMENTS IN CHILDREN SHOULD BE BASED ON THE FOLLOWING RULES: 1. Resting period prior to readings should be about 5-10 minutes. In children under 5 years of age, lying position should be used. In older children sitting position is most suitable. 2. Either flush method or ultrasound technique should be used in newborn. Auscultatory blood pressure is suitable in other children. 3. Width of cuff should be based on circumference of the arm, and not on arm-length: (width = 120% of diameter = 40% of circumference, i.e., 3, 6, 9, 12, or 15 cm). Length of cuff-bladder = circumference or more. 4. Diastolic blood pressure should be read at muffling of Korotkoff sounds (phase IV). 5. Although some agreement exists between different studies, it is obvious, that definition of "normal blood pressure" in children is dependent on the methodological factors involved in the measurement of blood pressure. PMID- 2711132 TI - Geographical variations in cardiovascular mortality in Finland, 1961-1985. AB - Mortality from diseases of the circulatory organs in Finland during the period 1961-1985 is examined by communes, separate analyses being made for ischaemic heart disease (IHD) and cerebral vascular accidents (CVA). Data on deaths are abstracted from the 0.58 million death certificates referring to these conditions, and information on demographic variables is taken from the 1950 and 1970 population censuses. There was a sharp frontier separating the area of high mortality in Eastern and Northern Finland from the area of low mortality in Western Finland, the difference between the extreme quintiles being 2-3-fold. Mortality from IHD and CVA increased with the proportion of the lowest social class and with crowdedness in the commune, being lower in communes with high proportions of the higher social classes. In-migration was associated with a lowering in mortality whereas the opposite was true for out-migration. The regional variations in IHD and CVA are explicable in terms of major social factors to a certain extent, but not exhaustively. The detailed geographical pattern of deaths shows a similarity to the history of settlement of Finland, but it is not possible to separate social and genetic influences within the scope of the present study. PMID- 2711133 TI - The Copenhagen City Heart Study. Osterbroundersogelsen. A book of tables with data from the first examination (1976-78) and a five year follow-up (1981-83). The Copenhagen City Heart Study Group. PMID- 2711134 TI - Depressed mood and intra-hemispheric location of lesion in right hemisphere stroke patients. AB - 42 stroke patients with verified right hemisphere lesions were studied. Depressed mood was measured by means of a global rating scale, and an inventory administered as a structured interview. As measured by the global ratings and one of the inventory subscales, patients with deep, retrorolandic lesions showed significantly more depressed mood than other patients. The findings are discussed in the light of current relevant research, and implications for management of depressed mood in stroke patients are suggested. PMID- 2711135 TI - Muscle adaptive changes in post-polio subjects. AB - Nineteen post-polio subjects (9 men and 10 women) aged 41-65 years were studied by means of muscle strength measurements (Cybex) of knee extension and muscle biopsies of the vastus lateralis for morphometric, histopathological and enzymatic analyses. Data from a reference group of 10 male subjects, age 42-51 years, are also given. Fourteen of the post-polio subjects had experienced a post polio syndrome-like drop in function. All had had polio at least 25 years earlier. In nine of the 19 subjects, type I fibers accounted for more than 70% of the total. There was a significant negative correlation between muscle strength and the percentage of type I fibers in women. Large cross-section areas of muscle fibers were found, with an average mean fiber area of 8 microns 2 X 10(3). It is assumed that the large muscle fiber areas are due to an extreme use of the remaining muscle fibers in post-polio subjects with low muscle strength. There were significant negative correlations between muscle strength values and mean fiber area in men. Most subjects had single atrophic fibers; groups of atrophic fibers were less common. Internal nuclei and splitting were seen in about half of the subjects. The activity of citrate synthase was low, but normal for glycolytic enzymes. PMID- 2711136 TI - X-linked Duchenne muscular dystrophy. Motor functions and prognosis. AB - 69 patients with x-linked Duchenne Muscular Dystrophy (DMD) were included in a retrospective investigation from 1975-1986. A mean profile of the decline of the motor functions was made by using the median age at which the patients were unable to perform specific motor functions by request. It was found that 81.2% of the personal profiles followed the pattern shown in the mean profile of the disease and that DMD is progressing in a uniform way, but with a different progression rate in every DMD patient. Good correlation between two motor functions made it possible to predict a personal prognosis of the decline of the motor functions in the DMD patient. No correlation between late walkers (later than 18 months) and rapid progression was found. PMID- 2711137 TI - Isometric and isokinetic knee extension and flexion torque in men and women aged 20-70. AB - An investigation was made of the influence of age and sex on peak muscle torque in knee extension and flexion during maximal isokinetic and isometric contraction. The study was performed on both legs of 139 clinically healthy men and 141 clinically healthy women aged 20, 30, 40, 50, 60 or 70 years. Maximum knee extension and flexion muscle torque (Newtonmetre, Nm) was measured isokinetically at various angles of velocity (12, 90 and 150 degrees/s) and isometrically under standardized conditions (Cybex II). No significant differences were found between the right and the left leg in the whole material. Muscle torque was higher in men than in women in all age groups (p less than 0.001). Both isokinetic and isometric torque decreased with age in both sexes. Isokinetic torque decreased significantly (p less than 0.05) between 20 and 30 years of age in men and between 40 and 50 years of age in women (at all velocities studied; p less than 0.05). A significant decrease (p less than 0.05) was found between the ages of 60 and 70 years in both sexes. Maximum isometric torque showed a significant decrease (p less than 0.05) between 60 and 70 years in men and women. There were no significant differences in isokinetic or isometric torque between moderately active and inactive men or women. Significant correlations were found between muscle torque and body weight, height and body surface area. PMID- 2711138 TI - Intra-articular temperature measurements after superficial heating. AB - Superficial heating of the joint is widely used in various rheumatic conditions and is considered as decreasing the intra-articular temperature. This study shows that heating the joint with hot pack significantly increases the articular temperature from 35.2 +/- 1.5 degrees C (mean +/- SD) to 36.4 +/- 1.0 degrees C (p less than 0.001), while intra-cavity temperature of the contralateral unheated knee joint did not change significantly. Since such elevation of temperature of one degree C is liable to enhance the inflammatory process, the use of superficial heating has to be carefully reconsidered in acute and chronic inflammatory joint diseases. PMID- 2711139 TI - Effects of continuous and pulsed microwave irradiation on distribution of heat in the gluteal region of minipigs. A comparative study. AB - Eleven experiments were conducted on minipigs for the purpose of determining heat distribution in tissue exposed to therapeutic doses of microwaves. Temperatures were measured by means of coated thermocouples from the cutis, subcutis, musculature, and periost. Irradiation was applied to intensities of 10 W, 40 W and 60 W by means of a "Radarmed 12 S 251" circular emitter and to 60 W, 100 W and 140 W, using a trough emitter. Maximum temperature in superficial tissue layers was reached after five to ten minutes of microwave exposure. The temperature rise in the cutis and subcutis was steeper and at a higher rate than that in the muscles. Continuation of microwave irradiation did not cause any further rise in temperature, which was attributed to induction of hyperaemia. No difference regarding heat distribution was found to exist between pulsed and continuous irradiation at equal wattage. PMID- 2711140 TI - Psychological aspects of early and late discharge after hospital delivery. An interview study of 44 families. AB - Early discharge after hospital delivery is common in other countries. In Sweden it was not introduced until recent years. Previous investigations have mainly focused on medical risk factors. However, few investigations have been done regarding psychological factors. This study, comprising 44 families (7 primaparae and 37 multiparae) in an early discharge group (discharge 0-2 days after hospital birth) and a late discharge group (discharge 5-6 days), indicates that parents in the early discharge group had more negative experiences of their earlier postpartum stay. The mothers in the early discharge group experienced less sibling revalry compared to the mothers in the control group. There were no other differences between the groups. The parents were equally satisfied with their choices in both groups. Early discharge, as a voluntary alternative, presents an increased service for parents, since the parents may choose the most suitable postpartum care. PMID- 2711142 TI - Social class and sickness absence. PMID- 2711141 TI - The Tromso Heart Study: family approach to intervention on CHD. Feasibility of risk factor reduction in high-risk persons--project description. AB - Intervention on high risk persons for CHD has shown varying results depending on the effectiveness of the intervention. Most studies have concentrated on the high risk person only. The present study focuses on the high-risk family as an entity. 1,373 high-risk men, 30-55 years, were identified on the basis of high total cholesterol and/or low relative HDL (HDL-cholesterol/tot. cholesterol) in the Tromso II screening in 1979/80, and randomly allocated to intervention or control group. The 673 men in the intervention group and their families, were offered advice to reduce their risk during two home visits and later by quarterly newsletters. Follow-up blood samples drawn 1.5 years following the home-visit, show a small reduction in total cholesterol and an increase in the ratio of HDL cholesterol/total cholesterol. Both the intervention and control group were invited to the examination in connection with the Tromso III screening in 1986/87 and are being followed for 10 years on cardiovascular morbidity and mortality. PMID- 2711143 TI - What protects a child during migration? AB - Protective factors for mental health during migration were studied in school-aged children and adolescents who had returned from Sweden to Finland during the years 1984-85. Each of the 320 migrant children and adolescents was assigned a control from the same class at school, matched by age and sex, and a non-migrant. Information was gathered from the parents, teachers and children themselves. The returning migrant children and adolescents more often lacked a father than did the controls, and returning migrant boys more often had psychiatric disorders in their teachers' estimations than did the controls, but no such difference was found among the girls. Good adaptation to this change in life was enhanced by good family relationships, good peer relationships, verbalisation ability, good cognitive abilities, as indicated by school achievements, and a clear linguistic identity. PMID- 2711144 TI - Greek immigrant children in southern Sweden in comparison with Greek and Swedish children. I. General living conditions. AB - Greek immigrant children belonging to the second generation of immigrants in Sweden have been compared with Swedish children and Greek children in Greece regarding general living conditions. Interviews were performed in the homes of all participants. The parents in the two Greek groups had the lowest educational level. The yearly salary of immigrant families was similar to that of the Swedish families. Immigrant and Swedish parents worked outside their homes to the same extent, Greek immigrant mothers fulltime, Swedish mothers mostly part time. For economical reasons the immigrant parents looked after their children within the family while the Swedish families almost always utilized community day care facilities. The immigrant families had fewer children than the Swedish and Greek rural families and their dwellings were smaller. Corporal punishment was a common method of upbringing in Greece and among the immigrants. The immigrant families had extremely few contacts with Swedish families. A majority of the immigrant families were unsure about their future in Sweden, whether or not to stay. In conclusion, the Greek immigrant group in many respects had adapted to Swedish customs but they had also at the same time retained much of the Greek cultural characteristics. PMID- 2711145 TI - HIV infectiousness and the AIDS epidemic. AB - The paper outlines a theory of the AIDS epidemic based on assumptions regarding the changes in infectiousness over the life cycle of the disease. It proposes a short initial period of infectiousness, followed by a long dormant period, which is in turn succeeded by another period of infectiousness, longer than the first period. Each of the two periods of infectiousness can generate an associated epidemic. It is suggested that the Western homosexual epidemic is based on initial stage infectiousness, while the African heterosexual epidemic is mainly the result of end stage infectiousness. PMID- 2711146 TI - Mortality and social class in Sweden--exploring a new epidemiological tool. AB - Total mortality, mortality from coronary heart disease (CHD), cerebrovascular disease, and other causes of death, were examined for three social groups and ten socio-economic groups in Sweden. The study included all subjects born in the country between 1896 and 1940 who were economically active in 1960-1.9 million men and 0.7 million women. Information on social and socio-economic status, and other social and demographic characteristics, was obtained from the 1960 Census. Information on cause-specific mortality during the period 1961-68 was obtained from a record linkage with the Cause of Death Registry. The analyses were based on 112,469 deaths and 21 million person years at risk. Information on smoking habits was obtained from a sample of 55,000 from the Census population. CHD mortality for women was high among manual workers, SMR = 110 (95% confidence limits 104-117), and low among non-manual workers, SMR = 84 (78-91). CNS-vascular mortality for women was also high among manual workers, SMR = 107 (110-115), and low among non-manual workers, SMR = 89 (82-97). Heavy smoking was more common among non-manual workers in both sexes, which may have contributed to a reverse social class gradient among men, with non-manual male workers being at higher risk for CHD than manual male workers. Farmers (and agricultural workers) generally had a low mortality. Other self-employed men and women had a high total mortality, a high mortality from CHD and CNS-vascular disease--and a high proportion of heavy smokers. There remain differences in mortality between social and socio-economic groups which cannot be explained by smoking habits, age, gender, urbanization, region of residence and martial status. PMID- 2711147 TI - Mortality among criminals with suspected mental disturbance. AB - Mortality rates and cause of death are reported from a long-term follow-up study of 620 Swedish criminals who were subjects of a forensic psychiatric examination in 1965-1968. The results show that there is an increased mortality rate in criminals mainly due to violent deaths (suicides, accidents) and diseases related to alcohol abuse. The increased mortality was found in all age groups throughout the follow-up period of 13-16 years. The total mortality was 17%. An analysis of different mortality risk factors showed that drug abuse, type of crime (violent crimes or property crimes) and criminal recidivism did not further increase the mortality risk. There were relatively few deaths due to overdose of drugs. Alcohol abuse increased the mortality rate significantly. PMID- 2711148 TI - Evaluation of a system for injury surveillance in Swedish emergency care. AB - A system for continuous and periodic injury surveillance in Swedish emergency care has been evaluated based on a case study of accidental injuries on 2,454 farms during a one year period. The evaluation procedure comprised registry completeness, measurement errors, trend analysis and calculation of risk. The results indicate that the structure of the registry system permits analysis of registry completeness, but further development is needed concerning the staffing and organising problem. The importance of registry inclusion criteria when one is comparing different injury surveillance systems was noted. Limitations applied to calculation of accident frequency rates per million hours work. The results show that there will be a high drop-out rate if the collection of data is not simultaneously combined with an injury control programme. The registry system could serve as a basis for periodic surveys and trend analysis. Further development of a continuous system based on reporting immediately at the injury reception centre should be considered. A coordinated system involving both continuous and periodic data seems to leave the flexibility both to identify certain risk environments or risk groups and to analyse the circumstances involved of specific accidental injuries, e.g. in agriculture. PMID- 2711150 TI - School health services as prescribed and practised--do they correspond? AB - The purpose of this study was to elucidate the correspondence between officially prescribed objectives of the school health service and the actual practice. The health and contacts with the school health service during one school year of 383 children from two school management areas in Uppsala were studied through school health records and interviews with the school nurse. The results showed that the children's physical health and development were followed up continuously and were carefully documented. Their psychosocial status was well known by a nurse familiar with the area but documented only to a minor extent. There was a relationship between psychosocial problems, male sex and low social class. Children with psychosocial problems did not visit the school health clinic to any major extent. The official objective to promote psychosocial health did not seem to correspond to existing programmes and routines. PMID- 2711149 TI - Sickness absenteeism in an engineering industry--an analysis with special reference to absence for neck and upper extremity symptoms. AB - Neck and upper extremity symptoms (NES) are reported to increase among industrial workers. In order to quantify sickness absenteeism and relate it to some factors a questionnaire study was performed among 2,814 workers occupied at a Swedish engineering industry. Questions pertaining to age, sex, worker category, work with vibrating handtools, type of job and smoking habits were analyzed and correlated to sickness absenteeism for the previous year (1983). We found that the average days lost for personal illness was 17.2 days; 16.2 for men and 23.5 days for women. Ninety-four persons, 77 men and 17 women comprising 3.0% of all employees were sicklisted for NES corresponding to 3.3% of total sickness time lost. Blue-collar workers were sicklisted for NES five times more often than white collar workers and women in type 3 jobs (high NE stress), twice that of men occupied in the same type of job. Smokers had significantly higher absenteeism than non-smokers for any reason studied including NES. The study indicated a high prevalence of present NES problems (23%) but also that NES as a cause of leave of absence was relatively rare (3%). PMID- 2711151 TI - Use of health services after a myocardial infarction. AB - Short-term and long-term use of physician consultations and rehospitalizations were studied in 383 myocardial infarction (MI) patients in relation to demographic, medical, and psychological factors. Short-term (i.e. within 6 months post-MI) utilization of physicians was only related to patients' health locus of control. In comparison, a higher number of physician consultations 3-5 years after the MI was independently related to female sex, more non-cardiac limitations before the MI, more complications during hospitalization, less cardiac lifestyle knowledge, and higher levels of anxiety and depression short time after the MI. Every second patient was readmitted to the hospital before the 3-5 years follow-up but only 14% suffered a non-fatal reinfarction. More rehospitalizations were independently related to a higher number of previous hospitalizations for heart disease, more pre-MI cardiac limitations, less cardiac lifestyle knowledge, and higher initial level of emotional distress. Discriminant analysis identified female sex and patients' initial expectations of reduced emotional control as the best predictor variables for a rehospitalization caused by chest pain without a new infarction, whereas a reinfarction was best discriminated by the number of previous hospitalizations for heart disease. We conclude that psychological factors influence health services utilization to a comparable extent as medical factors. These findings may indicate a greater need for long-term professional support in patients with less initial cognitive and emotional control. PMID- 2711152 TI - [The surgical treatment of lumbar canal stenosis]. AB - In a retrospective study of the results, 2 and 4 years after operation, of 52 cases of narrow lumbar canal, the most frequent preoperative symptoms were low back pain (82.7%), neurogenic claudication (61.5%) and sciatica (61.5%). 21 patients had a herniated disk in addition to the narrow canal. Sciatica was more frequent in this group than in narrow lumbar canal alone, where neurogenic claudication was more frequent. All patients underwent decompressive laminectomy, most often at level L4-L5. No spondylodesis was required. After 4.9 months, 84% of the patients were improved or cured. After more than 2 years 90% of the patients were cured of low back pain and 92% were cured of sciatica, but 22% were still under limitation in walking. PMID- 2711153 TI - [Obstruction ileus caused by mushrooms]. AB - Since 1982 we have performed surgery in 2 cases of obstruction ileus caused by fungi. Both patients had stenosis of the gut, due to adhesions and Crohn's disease respectively. Unless carefully chewed, mushrooms keep their shape and almost their size in the bowel, and can thus become jammed in a stenosis and cause ileus. High risk patients should be advised to avoid eating mushrooms or else to chew them very carefully. PMID- 2711154 TI - [Practical consequences of ambulatory registration of blood pressure]. AB - Ambulatory recorded blood pressure (BP) has been shown to correlate better with secondary target-organ damage than casual blood pressure, and has demonstrated that ambulatory BP cannot be predicted on the basis of casual BP measurements by the physician. To assess whether these recordings have practical repercussions on diagnosis and treatment, 182 patients (74 female/108 male) aged 16 to 84 years (mean 51.9 +/- 14.8 SD), all referred by their physicians to the investigation unit of the hospital, underwent ambulatory BP measurements using the portable Remler M2000 BP recorder. The mean systolic blood pressure was above 140 mm Hg in 96 patients (53%) and the mean diastolic blood pressure above 90 mm Hg in 81 (45%). -3 to 9 months later, multiple choice questionnaires were sent to the 34 physicians who had referred patients and had meanwhile received recording results without comments. The questions were designed ascertain the indication for BP recording in each patient and the changes undertaken in the light of the results. In 27% of the cases the assumed diagnosis was not confirmed and in 40.8% of the cases the planned or prescribed treatment was obviated or withdrawn. This percentage corresponds to the data previously published describing 30 to 40% of patients as hypertensive only in the physician's office. This latter percentage shows that ambulatory BP recordings contribute to the practical assessment of patients with mild to moderate elevation of office BP. PMID- 2711155 TI - [Blood pressure lowering action and tolerance of ketanserin in mono- or combination therapy]. AB - The antihypertensive efficacy and tolerability of the 5HT2-receptor antagonist ketanserin was investigated in 188 patients aged 41 to 82 years with mild to moderate essential hypertension. Ketanserin was given as monotherapy (n = 107) as well as in combination with either the diuretic hydrochlorothiazide/amiloride (n = 42) or the betablocker atenolol (n = 39) for 12 weeks. Compared to placebo, ketanserin lowered systolic blood pressure by 11 +/- 16 (SD), 9 +/- 13 and 9 +/- 11 mm Hg (p less than 0.01 for all) and diastolic blood pressure by 9 +/- 10, 10 +/- 9 and 7 +/- 9 mm Hg (p less than 0.001 for all), in the three treatment groups; body weight, serum sodium, potassium, uric acid, cholesterol and triglycerides remained unchanged. The incidence of withdrawals due to unwanted effects was 4% on ketanserin monotherapy, and 12% and 10% on the diuretic/ketanserin and the betablocker/ketanserin combination respectively. Well being during ketanserin therapy was improved in the older patients in particular; sleep disturbances, daytime fatigue and overall weakness decreased. Ketanserin was well tolerated in combination with the diuretic, whereas in combination with the betablocker the occurrence of dry mouth and stuffy nose was slightly higher. Ketanserin proved to be an effective antihypertensive drug comparable to other blood pressure lowering agents. It can be combined advantageously with a potassium sparing diuretic or a betablocker. The greater efficacy and tolerability in patients greater than or equal to 60 years qualify ketanserin primarily as an antihypertensive agent for older patients. PMID- 2711156 TI - [Cachexia, pain and muscle weakness in a 69-year-old woman]. AB - The case is reported of a 69-year-old woman who for the last 2 years of her life had severe muscle weakness (with elevated muscular enzymes), thyroid abnormalities (autoantibodies and increase in TSH) and a slowly growing mass in the anterior mediastinum. She died in cardiogenic shock. The diagnosis of "nodular polymyositis" (painful nodules palpable in the muscles) with heart involvement was strongly suspected. The thyroid abnormalities were considered to be "biological thyroiditis" i.e. a "disease" frequent in normal females (5-10%) and, after differential diagnosis of anterior mediastinal masses, the diagnosis of thymoma was adopted in view of its frequent association with autoimmune diseases. Moreover, in rare cases of thymoma associated with polymyositis, histology has disclosed "giant cell polymyositis". Autopsy revealed giant cell polymyositis, a thymoma and lymphocytic infiltration of the thyroid. PMID- 2711157 TI - [A single infusion of Pamidronate (APD) in Paget's disease of bone]. AB - Bisphosphonates are strong inhibitors of bone resorption and have become the treatment of choice of Paget's disease of bone. Second generation compounds such as amino-hydroxypropylene bisphosphonate (Pamidronate or APD) have not been found to impair bone mineralization, but to induce sustained remission of Paget's disease after short or medium courses. Gastrointestinal side effects may limit compliance. Therefore, 11 patients with mild but symptomatic Paget's disease of bone were treated with APD administered as a single intravenous infusion of 60 mg over 24 hours. The follow-up, with clinical and biochemical evaluations, was between 6 months and one year. Clinical improvement and normalization of biochemical parameters were observed in all patients. On average, plasma alkaline phosphatase activity fell progressively and significantly from 256 +/- 29 U/l (means +/- SEM) to 97 +/- 6 U/l after 6 months and to 102 +/- 11 U/l after one year (normal less than 120 U/l). Urinary excretion of hydroxy-proline decreased within 7 days to normal (from 4.3 +/- 0.5 mumol/lGF to 1.7 +/- 0.2 mumol/lGF, normal less than 2.2). Thereafter it remained within the normal range until one year later (1.8 +/- 0.2 mumol/lGF after 6 months and 1.9 +/- 0.3 mumol/lGF after 1 year). Side effects were negligible, with only a transient increase in body temperature in 2 patients. When bone scintigraphy was repeated after 6 months it revealed a marked decrease in the activity of the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711158 TI - [Atrioventricular block in Lyme carditis]. AB - Lyme disease, due to infection with Borrelia burgdorferi transmitted by ticks, is most frequently manifested by arthritis and neurological complications. In approximately 8% of cases, however, carditis, usually reflected in AV block, is the leading symptom. The case histories of 2 males and 1 female aged 23 to 37 years with AV block caused by Borrelia burgdorferi are presented. Main symptoms were exertional dyspnea, palpitations, dizziness and syncope. One patient was treated with diclofenac and two with penicillin. The course was uniformally benign and cardiac abnormalities disappeared within 1-3 weeks. PMID- 2711159 TI - [Retrospective study of permanent cardiac stimulation in patients over 80 years of age]. AB - Out of 833 pacemakers implanted between 1979 and 1983, 228 were in patients aged over 80 years (137 aged 80-84, 79 85-89, and 12 90-93). Indication for cardiac stimulation was high-grade atrioventricular (av) block in 47%, sick sinus syndrome in 38%, low ventricular response in atrial fibrillation in 13% and hypersensitivity of the carotid sinus in 1%. An average follow-up period of 29.5 months (18-78 months), focusing special interest on quality of life, revealed that of the 199 patients (87%) who were independent at the time of implantation, 29 (15%) became dependent on social services during the follow-up and during the same period 49 (21%) were rehospitalized (88 hospitalizations) for reasons other than pacemaker problems. During the first year after implantation the mortality in the "paced" population was higher than in the general population of the same age groups; thereafter the survival curves run almost parallel. Mortality does not differ between persons paced for av block of for sinus node disease. We conclude that cardiac stimulation in patients aged over 80 years allows them to preserve their lifestyle and independence when compared to the general population, with the same rate of survival. PMID- 2711160 TI - [Acute monoblastic leukemia complicated by fatal splenic rupture following initiation of chemotherapy]. AB - Fatal chemotherapy splenic rupture is a rare event in acute leukemia. We report on a patient with acute monoblastic leukemia who developed splenic rupture 13 hours after the initiation of aggressive chemotherapy. Histologic studies of the spleen showed diffuse capsular infiltration and disseminated areas of subcapsular necrosis. Lysis of the leukemic cells and release of their enzymatic content, induced by the chemotherapy, probably led to proteolytic injury of the splenic capsule. We suggest that this mechanism may be an important pathogenetic factor in the occurrence of splenic rupture in patients with acute leukemia. PMID- 2711161 TI - [Treatment of anemia in hemodialysis patients using recombinant human erythropoietin: advantages and disadvantages]. AB - 18 anemic patients undergoing maintenance hemodialysis were treated with recombinant human erythropoietin (EPO) 1-3 times per week for 10.7 +/- 3 months. 4 patients underwent renal transplantation whereas 14 patients could be followed up during 12 months of EPO treatment. Hemoglobin concentration rose (from 7.0 +/- 0.7 to 11.0 +/- 1.1 g/dl, p less than 0.001) with an EPO maintenance dose of 298 units/kg/week. Blood transfusions were totally eliminated. 12 patients without iron overload required iron supplements. In the course of an infectious episode and notwithstanding an increase in EPO dosage, 2 patients exhibited a fall in hemoglobin which rose again after successful treatment of the infection. The few complications observed in connection with the rise in hemoglobin were: 1. deterioration of arterial hypertension in 7/18 with hypertensive encephalopathy in 3 patients, 2. thrombotic occlusion of the vascular hemodialysis access (a-v fistula) in 3/18, 3. periarticular inflammation with calcified deposits due to an elevated calcium-phosphorus product of 6.8 mmol/l in 4/18, 4. occurrence of hyperkalemia (6.9 +/- 0.3 mmol/l) in 7/18. These complications were more frequent during the first 3 months. They were corrected with close monitoring, drug therapy for hypertension, and intensification of dialysis and of treatment with phosphate binding substances, with the result that no differences were found in 14 patients before and after 12 months of treatment with EPO (blood pressure 133 +/- 25/77 +/- 9 vs 139 +/- 26/79 +/- 13 mm Hg [ns], potassium 5.4 +/- 0.4 vs 5.6 +/- 1.0 mmol/l [ns] and calcium-phosphorus product 4.3 +/- 1.0 vs 4.6 +/- 1.3 [ns]).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711162 TI - [Long-term results following surgery of gallbladder carcinoma]. AB - 41 patients with gallbladder carcinoma surgically treated from 1975 until 1987 were analyzed retrospectively. In this period we found a frequency of gallbladder cancer of 1.1% among all cholecystectomies. Preoperative diagnostic methods prompted suspicion of a tumor of the gallbladder in only 24%. 66% of the tumors were resectable. The cumulative survival rate at 1 year was 30% and at 5 years 8%. Long-term cures in 3 patients - 6, 8 and 13 years after resection - were achieved by cholecystectomy alone. PMID- 2711163 TI - [Lung embolism during and following long-distance flights ("economy class syndrome")]. AB - Two cases of venous thrombosis and pulmonary embolism during or after intercontinental air travel occurring in two sisters with venous thromboembolic risk factors are presented. In one the outcome was fatal. In the present era of mass tourism the probably underestimated risk of thromboembolism in air travel should be kept in mind. As prophylactic measures leg exercises, walking and high fluid intake during the flight are recommended. Sleeping in the sitting position should be avoided. For persons at high risk, prophylactic anticoagulation may be considered. PMID- 2711164 TI - [Swiss Society of Cardiology, Swiss Society of Pneumology, joint annual meeting. Lugano, 27-29 April 1989. Abstracts]. PMID- 2711165 TI - [What is your diagnosis? Key-Gaskell syndrome]. AB - The first case of Key-Gaskell syndrome in Switzerland has been described. The disease is mainly characterized by damaged autonomous ganglia. Lesions of the parasympathicus account for dry mucous membranes, mydriasis, paralysis of the bladder, megaesophagus and paralysis of the remaining gastrointestinal tract. Lesions of the sympathicus are explained by bradycardia and prolapse of the third eyelid. Until now the etiology of the disease is not known. PMID- 2711166 TI - [Key-Gaskell syndrome in a cat in Switzerland]. AB - As far as the authors know this is the first case of Key-Gaskell-syndrome being described in Switzerland. The clinical signs of megaoesophagus, anorexia, constipation, dryness of all mucous membranes, reduced tear production, protrusion of the membrana nictitans, mydriasis, regurgitation and bradycardia are pathognomonic and can't be mistaken by any other disease. The subject of the Key-Gaskell-syndrome is a dysfunction of the autonomic nervous system. Histopathological changes are exclusively related to the autonomic nervous system and to neurons of some nuclei in the cranial nerves. Less severe changes can be found in the neurons of the spinal cord or in the dorsal root ganglia. The etiology remains still unclear. There is a relationship to the grass sickness syndrome in horses and to dysautonomia of man and dog. PMID- 2711167 TI - [The effectiveness of the new morantel sustained-release trilaminate bolus against gastrointestinal nematode infections in cattle in their first grazing period]. AB - The efficacy of a recently developed Morantel-Sustained-Release-Trilaminate-Bolus (Paratect Flex Bolus [PFB]-Pfizer Inc.) against gastrointestinal nematode infections in cattle was assessed by monitoring faecal egg counts (EpG), herbage larval counts, serum pepsinogen levels and liveweight gains in first season calves. In two field trials (1987 and 1988), a PFB-Bolus was administered to two different groups of animals (1987: 15 calves; 1988:13 calves) at turnout (29 May 1987; 26 May 1988), control groups were included. In 1988, 13 calves received for comparison an Oxfendazole-Release-Bolus (Systamex Intervall Bolus [OXF]-Coopers Inc.). All groups were grazed on adjacent but separately fenced pastures throughout the season, until housing (27 October 1987; 15 October 1988). When compared with controls, the PFB-groups showed significantly lower EpG values and consequently, lower herbage larval counts throughout the season in both trials. From day 30 after turnout, the PFB-group had significantly lower serum pepsinogen levels, which reflects the low degree of abomasal damage in these animals. When compared to controls, the PFB-treated animals showed significantly higher weight performances. The mean weight-gain benefit of PFB-treated animals was +12.5 kg (p less than 0.05) and +21.1 kg (p less than 0.005) in 1987 and 1988, resp. No difference occurred between PFB-treated and OXF-treated calves, the latter outperformed the control animals by +21.6 kg (p less than 0.005). PMID- 2711169 TI - Avoidable mortality in European countries--1974-1978. PMID- 2711168 TI - [Epidemiologic, clinical and pathologo-anatomic studies of the inflammation of the carpal joint extensors in cattle]. AB - A retrospective study of 24 cases of inflammation of carpal extensors (m. extensor carpi radialis, m. extensor digitorum communis, m. abductor digiti I longus) was conducted. The findings of anamnestic, clinical, and post-mortem investigations are described. Half of the patients were first calf heifers at the ages of 2 1/2 to 3 years. The rest of the animals were older cows (with one exception). In all of the young cows the disease had become apparent within 11 weeks post partum. The most striking clinical finding is the posture of the animals when lying down: the affected forelimbs are extended forward. Palpation reveals a homogeneous firm swelling of the cranial portion of the forearm. Most of the patients also had pododermatitis in hind and/or front legs, and exhibited signs of a systemic reaction in the form of "polysynovitis" and raised serum total protein concentrations. Post mortem examination revealed a hemorrhagic edematous impregnation of the distal part of the radial carpal extensor muscle and particularly of its fascia. The tendon and tendon sheath had unclear contours and were swollen. Histologically the lesions are typical of subacute granulating inflammation. As to the cause, it is assumed that the ailment is a significant complication of some other disease of the locomotion system. Type and localization of the lesions suggest a traumatic etiology. Therapeutic results have been unsatisfactory. PMID- 2711170 TI - The basic and advanced cardiopulmonary resuscitation skills of trained hospital nursing staff. AB - The cardiopulmonary resuscitation skills of 105 trained hospital nurses were tested. Both basic and, for the first time in the UK, advanced skills were examined; basic skills were assessed by practical evaluation with a standard manikin and advanced knowledge by multiple choice questionnaire. No nurse adequately performed all four practical skills tested. Knowledge of the ventilatory aspects of resuscitation, defibrillation and advanced technique and drug management were also found to be poor. The findings add further support to adequate training of nurses in resuscitation skills. We describe a solution to overcome the heavy demands of such teaching and suggest that the same model be applied to the training of medical staff in resuscitation skills. PMID- 2711171 TI - Stroke distance--an improved measure of cardiovascular function. PMID- 2711172 TI - Brain damage in fatal non-missile head injury in relation to age and type of injury. AB - Brain damage in a series of 635 fatal non-missile head injuries has been analysed with particular reference to the age of the patient and the type of injury. The differences in the type of brain damage in relation to age were less than we had anticipated, lending further support to the contention that the aged brain has a reduced potential for recovery. The analysis confirms the relationship between road traffic accidents, diffuse axonal injury, gliding contusions and 'basal ganglia' haematomas, and the importance of diffuse brain swelling resulting from a head injury in children. PMID- 2711173 TI - Post neonatal mortality rates--Scotland. AB - Post Neonatal Mortality Rates in Scotland have been equal to those of North and South England since 1975. In this respect there is no longer any inequality in health. However, Social Class V still has a higher rate than Social Class I and the rate for illegitimates is the same as for Social Class V. As a result the illegitimate rate remains much higher than that for legitimates in spite of the enormous increase in illegitimate number since 1960. With 18% of all live births now born illegitimate they represent infant (social) deprivation better than Social Class V--which now constitutes only 5% of live births. PMID- 2711174 TI - Probable Crohn's colitis mimicking ischaemic colitis in a young adult. AB - The features on barium enema of ischaemic colitis is characteristic and the radiological sign of "thumb printing" thought to be almost pathognomonic of the condition. We report a case of inflammatory bowel disease, probably Crohn's disease mimicking these radiological features. This has not to our knowledge been previously documented. PMID- 2711175 TI - Malignant angioendotheliosis--an unusual cause of stroke. AB - We report a case of malignant angioendotheliosis in a 63-year-old female who presented with a right hemiparesis. This diagnosis should be considered when multi-focal neurological signs develop in association with a progressive deterioration of mental state and conscious level. PMID- 2711176 TI - Argininosuccinic aciduria--an underdiagnosed cause of neonatal death? AB - We describe a case of neonatal argininosuccinic aciduria, a condition we suggest is underdiagnosed. Although the clinical presentation can be of overwhelming septicaemia, certain routine biochemical investigations are indicative of this inborn error of urea cycle metabolism. PMID- 2711178 TI - Physicians role in the use of safety belts. PMID- 2711179 TI - Accessing the biomedical literature: the South Dakota Med-Fax Network. AB - Librarians developed a plan for a medical information network based upon the needs of South Dakota physicians as revealed in a 1984 survey. The South Dakota Med-Fax Network received private funding in 1987 and became operational in 1988. The Network incorporates interactive simultaneous remote on-line database searching (ISRS) and telefacsimile transmission to expedite the identification and delivery of medical literature to South Dakota physicians. At present, the Network is composed of sixteen institutional sites. Individual physicians may establish their own sites if they provide an IBM compatible personal computer with a modem and purchase a telecommunications software package. The Network will provide training and follow-up support. Use patterns to date demonstrate that telefacsimile transmission is instrumental in reducing significantly the time necessary to deliver journal literature and that ISRS searching is the method of choice in the Network's remote sites. PMID- 2711177 TI - Leptospira icterohaemorrhagiae infection presenting as acute renal failure. AB - The features of leptospiral infection should be sought in all cases of acute renal failure since management depends on the recognition of the clinical syndrome and serological confirmation is usually delayed. Hepatic and renal involvement is usual but renal failure without significant derangement of liver function is described. PMID- 2711180 TI - Thoughts on rural health. PMID- 2711181 TI - Biotechnology regulation. PMID- 2711182 TI - "L'affaire Pasteur" prompts Canadian outcry. PMID- 2711183 TI - The role of cis-acting promoter elements in tissue-specific albumin gene expression. AB - The mouse albumin gene promoter has six closely spaced binding sites for nuclear proteins that are located between the TATA motif and nucleotide position -170. In vitro transcription with liver or spleen nuclear extracts of templates containing either mutated or polymerized albumin promoter elements establishes a hierarchy of the different protein binding sites for tissue-specific albumin gene transcription. The HNF-1 and C/EBP binding sites strongly activate transcription in a tissue-specific manner. The NF-Y binding site has a lower activation potential and is less specific, being equally efficient in liver and spleen nuclear extracts. The remaining elements are relatively weak activator sites. PMID- 2711184 TI - A direct repeat is a hotspot for large-scale deletion of human mitochondrial DNA. AB - Kearns-Sayre syndrome (KSS) and progressive external ophthalmoplegia (PEO) are related neuromuscular disorders characterized by ocular myopathy and ophthalmoplegia. Almost all patients with KSS and about half with PEO harbor large deletions in their mitochondrial genomes. The deletions differ in both size and location, except for one, 5 kilobases long, that is found in more than one third of all patients examined. This common deletion was found to be flanked by a perfect 13-base pair direct repeat in the normal mitochondrial genome. This result suggests that homologous recombination deleting large regions of intervening mitochondrial DNA, which previously had been observed only in lower eukaryotes and plants, operates in mammalian mitochondrial genomes as well, and is at least one cause of the deletions found in these two related mitochondrial myopathies. PMID- 2711185 TI - Modulation of rod-cone coupling by light. AB - Although electrical coupling between rods and cones in the retina has been assumed to be static, it has now been shown that rod-cone coupling can be strengthened by light. Increment threshold measurements reveal that cone input to rods increases progressively as background light becomes brighter. Current injection into cones produces larger responses in adjacent rods in the presence of background light than in darkness. Weak coupling under dark-adapted conditions facilitates synaptic transmission of small rod signals, and strong coupling under light-adapted conditions enhances transmission of large cone signals. PMID- 2711186 TI - The incremental threshold of the rod visual system and Weber's law. AB - The incremental threshold of the isolated rod visual system is believed, under certain conditions, to obey Weber's law (that is, to increase in direct proportion to the intensity of the background). This relation was tested at several background wavelengths, over an intensity range for which the target was seen only by the rods. Although the slope on long-wavelength background approximates unity (that is, Weber's law on log-log coordinates), it averages less than 0.8 on short- and middle-wavelength backgrounds. This is the same value as that found for the thresholds of a typical, complete achromat--who lacks cone vision--regardless of background wavelength. These results force the conclusion that Weber's law for incremental threshold detection is achieved not by the rods alone but only by the rods acting together with the cones. PMID- 2711187 TI - Oxidation-reduction and the molecular mechanism of a regulatory RNA-protein interaction. AB - Iron-responsive elements (IREs) are RNA motifs that have been identified within the 5' untranslated region of ferritin messenger RNA and the 3' untranslated region of transferrin receptor mRNA. A single IRE mediates iron-dependent control of ferritin translation, whereas multiple IREs are found in the region of the transferrin receptor mRNA responsible for iron-dependent control of mRNA stability. A cytosolic protein binds in vitro to the IREs of both mRNAs. The IRE binding protein (IRE-BP) is shown to require free sulfhydryl groups for its specific interaction with the IRE. Treatment of lysates with reducing agents increases the binding activity, whereas agents that block sulfhydryls inhibit binding. Iron starvation, leading to decreased ferritin translation, results in increased binding activity, which is explained by an increase in the fraction of the IRE-BP that is in a fully reduced state. PMID- 2711188 TI - [Injury tolerance of the human skull in relation to simulation of impact acceleration]. AB - A mathematical torso-neck-head model was used to simulate frontal and lateral head impact. The model consisted of nine rigid bodies representing the torso, the seven vertebrae, and the head. The external force acting during impact was described by a triangular force-time function. The impact conditions were varied, i.e., the mass of the head (1.5 and 5.5 kg), the mass (0.1 and 1.0 kg) and velocity (10, 30, and 50 m/s) of the impacting body, and the elasticity (0.5 and 1.0) of the impact. The computer simulations produced linear and angular head accelerations, which were compared with the tolerance level for injury and used to determine the tolerance curves which discriminate between "safe" and "unsafe" acceleration. For the linear head acceleration, the tolerance level was 1000 as defined by the Head Injury Criterion, and for the angular head acceleration the tolerance level was 1800 rad/s2. Our results showed that the risk of head injury was lower for linear head acceleration than for angular head acceleration, and it was lower for frontal impact than for lateral impact. PMID- 2711189 TI - [Morphology of bone threads following implantation of 2 mm AO miniscrews in the midfacial area]. AB - How well an osteosynthesis screw holds depends on the amount of friction between the thread flank of the screw and the bone thread. Factors undermining the mechanical integrity of the bone thread, such as cracks, can lead to reduced friction and consequently less ability to hold. To investigate the micromorphology of the bone thread in the thin bone of the midface, 131 bony implant beds of 2-mm AO miniscrews and 10 drill holes which had been pretapped but received no screws were studied by incident light and scanning electron microscopy. The angle of insertion of the screws was varied to assess the effect this has on the implant bed surface. In 30 of the 131 implant beds the insertion axis of the screws corresponded to the axis of the threaded or unthreaded drill holes. Sixty-six of the screws had been inserted at an inclination of greater than or equal to 10 degrees to the axis of the pretapped hole. Twenty pretapped implant beds had an inclination between 0 degrees and 10 degrees to the drill hole. Finally, 15 bone threads formed by inclining the screws upon insertion into untapped drill holes were also studied. Both pretapped and untapped implant bed surfaces were damaged with cracks, as well as signs of squashing, crushing and shearing stress. The extent of the damage often varied in the different implant beds as well as at different locations in the same implant bed. The pretapped implant beds seemed to have a relatively smoother surface when the drill or threader and the screws had the same axis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711190 TI - [The scaphoid-trapezium-trapezoid arthrosis. A clinical study 1982-1985]. AB - The present study deals with patients in whom the diagnostic procedures applied in rhizoid arthrosis were considered to reveal scaphoid-trapezium-trapezoid (STT) arthrosis. Between 1982 and 1985, 21 of 396 rhizoid arthrosis patients developed symptoms of STT arthosis. Examination of the case histories showed that in 20 STT patients the pathogenesis included trauma. In addition, the majority of these 396 patients (71.5%) had to be retreated because of new traumata and the resultant problems. The time lapse between the first trauma considered sufficiently severe to have caused STT arthrosis and its diagnosis was up to 7.1 years. Our improved facilities for diagnosis of pathologic conditions of the wrist enabled us to distinguish four types of STT arthrosis. Persistent complex instability of the capsular ligament appears to be the major cause of post-traumatic STT arthrosis. Extended diagnostic techniques based on standardized radiograms allow the development of a design for treatment aimed at preventing posttraumatic STT of the hand as far as possible. PMID- 2711191 TI - [Bundle nailing as an alternative treatment indication in pathologic fractures of the humerus]. AB - In patients with multiple bone metastases of malignant tumors, bundle-nailing according to Hackethal is a fast and non-traumatic way of stabilizing existing or impending pathological fractures. It is also a therapeutic alternative in benign lesions, provided it is genuinely indicated and is performed correctly. Either as primary treatment following resection (sometimes with spongioplasty) or as secondary treatment, i.e. stabilization, it can be a valuable technique. Between 1976 and 1986 we performed 14 operations in our hospital using this technique. The tumor was malignant in 11 cases, benign in 3 and unclear in 1 case. The incidence of unfavorable results due to corrosion has been reduced recently, in particular since titanium has been used. PMID- 2711192 TI - [Pathologic fractures in dialysis-associated amyloidosis]. AB - A correlation could be demonstrated between four pathological femoral neck fractures in patients who regularly underwent hemodialysis; cystic bone deposits of beta-2-microglobulin amyloid were also found. The characteristic symptom complex includes painful arthralgia of the shoulder, carpal tunnel syndrome, pain in the hip and recurrent knee effusions. The first step in the diagnostic procedure is to demonstrate cystic defects in skeletal radiographs. Then a biopsy of the cystic bone lesion is needed for histological verification of beta-2 microglobulin. The surgical treatment is total joint replacement or augmented composite osteosynthesis due to poor regeneration capacity in the amyloid bone lesion. PMID- 2711193 TI - [Late results following tibial fractures in childhood]. AB - At the Department of Pediatric Surgery, University of Munich, 440 children between 2 months and 16 years old were treated for lower leg fractures between 1976 and 1985. In 93% of the cases, conservative therapy was administered. Between 2 and 12 years later, 110 patients (including all of those in whom the course was complicated) underwent a follow-up examination. Very good and good results were found in 76.4% of cases and satisfactory results in 18.2%. Unsatisfactory findings such as discrepancies in leg length and the consequences of compartment syndrome were found in 5.4%. Our results support the conservative treatment of such fractures; if there are special indications, the course of therapy can be supplemented effectively by osteosynthesis. PMID- 2711194 TI - [The peroneus brevis muscle flap-plasty. A simple procedure for covering fibular soft tissue defects after osteosynthesis]. AB - Fractures in the region of the ankle associated with soft tissue trauma often present a problem for the traumatologist. After osteosynthetic repair, primary closure of the skin may be prevented by soft tissue oedema or a local circulatory disorder. However, it is necessary for the wound to be closed in such a way that the fibula and metal implant are covered with vital soft tissue. The peroneus brevis muscle flap represents a local and simple method of covering soft tissue defects in the region of the distal fibula. With help of this flap it is possible to cover defects of up to 20 x 4 cm without disinsertion of the tendon. After performing anatomical studies, we successfully performed the above-mentioned technique on 21 patients. At no stage did we observe ischaemia or necrosis of the muscle flap. Our modification of the peroneus brevis muscle flap is a reliable and simple method for routine management of soft tissue defects in the fibular region by the traumatologist. PMID- 2711195 TI - [Comment on the contribution by Th. Joka et al.: Early diagnosis of lung contusion by bronchoscopy. Unfallchirurg (1987) 90:286]. PMID- 2711196 TI - [Intra-articular fracture of the calcaneus. Classification, assessment and surgical procedures]. AB - Our experience with open reduction of calcaneus fractures and internal stabilization without joint transfixation (n = 83) has shown us that the following features are mandatory in order to obtain normal postoperative foot statics and dynamics, normal joint mobility, and normal foot function: (1) restoration of the normal height, length and width of the calcaneus; (2) reduction of all joint surfaces and (3) stable screw- or H-plate osteosynthesis, allowing functional treatment later. Our own fracture classification (X fragment/Y-joint fracture) allowed us to determine the type of fracture, its severity, and the prognosis, as well as the choice of operative treatment. A detailed +/- 200-point follow-up scoring system assured operative quality control and comparability of results. The complications were: 9 cases of superficial wound-edge necrosis (8%), 2 hematomas requiring revision, and 1 deep bone infection (1.2%). During our first operative period (1983-1985, mostly unilateral medial approach and trans-articular K-wire fixation), we had only 50% good-to excellent results. During the second period (1986-1988, bilateral, extended lateral approach and stable screw/H-plate osteosynthesis), 76.5% (29 of 51 patients) had good-to-excellent results. Our experience thus indicates that our operative treatment principles can be recommended for patients who are either professionally active or active in sports. PMID- 2711197 TI - [Dislocation fractures of the Chopart and Lisfranc joint]. AB - Dislocation fractures of Chopart's and Lisfranc's (mediotarsal) articulation result from the effects of impact and, because there are many possible complications, require a high level of experience on the part of the treating traumatologist. To avoid residual joint incongruities and intra-articular osteochondral fragments with subsequent early arthrosis and the corresponding complaints, the indications for open reduction and functionally stable osteosynthesis should be broad. The osteosynthesis can be achieved by transfixation with adjustable screws and 3.5 or 2.7 mm screws suitable for small fragments. This permits postoperative treatment to be carried out with a walking cast rather than a full plaster cast. In emergency patients with multiple injuries, dislocation fractures in the tarsal region require immediate and definitive treatment in order to avoid grave consequences and pain severe enough to influence the quality of life. PMID- 2711198 TI - A brief overview of nuclear medicine in China. AB - The year 1956 witnessed the birth of Nuclear Medicine in China, when the first course, Biomedical Applications of Isotopes, was offered in our country by the Peking Union Medical College (PUMC). This course was preceded by a training course in nuclear instruments in which students learned to construct the radiation detection devices required for performing experiments using radioisotopes. In 1958, several courses in clinical nuclear medicine brought up the first generation of nuclear medicine physicians in China. Historically, some of the chief events include: (1) operation of the first reactor, producing 33 radioactive isotopes in 1958; (2) first linear scanner built in 1960; (3) setting up an organization for the control of radiopharmaceuticals in 1961; (4) distribution of the first batch of cyclotron-produced isotopes in 1963; (5) development and use of the first radioimmunoassay (RIA) procedure in 1963; (6) production of tritium in 1964; (7) production of 99.8% enriched heavy water in 1965; (8) supply of 99mTc and 113mIn generators in 1972; (9) first gamma camera imported in 1972 and first homemade gamma camera installed in 1977; (10) founding of Chinese Society of Nuclear Medicine (CSNM) in 1980; (11) publication of the Chinese Journal of Nuclear Medicine beginning in 1981; (12) first single photon emission computed tomography (SPECT) imported in 1983. At present, there are 556 nuclear medicine departments in China with 4,000 staff.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711199 TI - Skeletal uptake of indium 111-labeled white blood cells. PMID- 2711200 TI - Evaluation of the hypertensive patient. PMID- 2711201 TI - The biology of cancer, Part 1. PMID- 2711202 TI - Navelbine. Portions of this supplement were presented at a symposium. Lugano, Switzerland, October 31, 1988. PMID- 2711203 TI - Experimental antitumor activity of Navelbine. PMID- 2711204 TI - Phase-II study of Navelbine in advanced breast cancer. PMID- 2711205 TI - Unusual radiographic manifestations of chondrodysplasia punctata. AB - We present six cases of chondrodysplasia punctata with radiographic findings that are either very rare or previously unreported in this entity. PMID- 2711206 TI - Osteomesopyknosis. Report of two new cases. AB - Two inherited cases of osteomesopyknosis are reported. This is an autosomal dominant osteosclerosis described by Maroteaux in 1980; its radiological abnormalities consist of increased density of the vertebral plates, pelvis, and sometimes of the upper part of the femur. Osteomesopyknosis, usually discovered incidentally on radiographic examination, is a mild form of familial osteosclerosis and must be distinguished from osteopetrosis which carries a worse prognosis. PMID- 2711207 TI - Idiopathic punctate necrosis of the phalanges of the feet. AB - Small areas of discrete radiolucency surrounded by well-defined margins of sclerosis are incidental asymptomatic findings in the proximal phalanges of the feet, usually in young males. Histologic examination of similar lesions discovered in the feet of cadavers shows fat necrosis. Although the etiology of these lesions is as yet unproven, musculoskeletal stress is suggested. PMID- 2711208 TI - Computed tomography arthrography in traumatic hip dislocation. Intra-articular and capsular findings. AB - The newer diagnostic modalities such as computed tomography and magnetic resonance imaging are becoming increasingly used in the evaluation of joint trauma. The combination of computed tomography and arthrography can also be of significant diagnostic value in certain specific situations. In our case report, we describe its use in post-traumatic recurrent hip dislocation and its value, not only in depicting a posterior capsular tear, but also in the diagnosis of an internal joint derangement which may contribute to incongruous reduction of the hip joint. PMID- 2711210 TI - Case report 519: Histiocytoid hemangioendothelioma of right 10th rib. PMID- 2711209 TI - Case report 518: Periosteal chondroma of scapula. PMID- 2711211 TI - Case report 520: Primary epithelioid hemangioendothelioma of bone (polyostotic). PMID- 2711212 TI - Case report 521: Histiocytoid hemangioma of the distal end of the right humerus. PMID- 2711213 TI - Case report 522: Concurrent adjacent osteochondroma and enchondroma. PMID- 2711214 TI - Case report 523: Osteoblastic osteosarcoma of the navicular. PMID- 2711215 TI - Case report 524: 1. Giant Tarlov (perineurial) cysts of lumbosacral spine. 2. Metastatic carcinoma (from lung) of the right ilium. PMID- 2711216 TI - Inflammatory metachronous hyperostosis of the clavicle and femur in children. Report of two cases, one with long-term follow-up. AB - Two preteenage girls developed painful swelling of the left clavicle. This was followed by painful swelling of the femur, 7 months later in one girl and 8 years later in the other. Radiographic studies showed a predominantly sclerotic process in one patient and destruction associated with cortical thickening in the other. The patients received analgesic medications only, followed by gradual healing with cortical and medullary sclerosis. Long-term follow-up suggests that the condition is self-limited and that, with or without treatment, the bones eventually return to normal. Although the etiology of the lesions remains unknown, the radiographic features suggest an inflammatory reaction. PMID- 2711217 TI - Perceptions from epidemiologic research in an endemic war. AB - Several endemic wars have developed since the second world war. In these wars, like endemic diseases, war becomes an accepted and expected activity incorporated into the lives of a large proportion of the population. This paper illustrates some of the special problems of epidemiologic research in an endemic war based on a number of studies conducted in Lebanon over the past decade. The special problems faced by epidemiologists in an endemic war include; a situation of dynamic change where long term planning is next to impossible, the military sensitivities involved in data collection, and the compromises one has to make with scientific rigor. The paper concludes with a perspective for action by health professionals in wartime. It recommends preventive action in wartime in addition to relief and an involvement in the search for alternative approaches to conflict resolution. PMID- 2711218 TI - Violence, conflict and health in Africa. AB - This study attempts to examine the impact of incessant violence and political conflicts on the development of health services in Africa. Specifically, how do violent activities and conflicts, such as wars, affect health care infrastructures and health policies in Africa? The paper further examines the consequences of violence and conflicts on the health of refugees. The paper concludes that African states would develop better health policies for their citizens in the absence of violence and conflicts. PMID- 2711219 TI - Political violence and Eritrean health care. AB - In both colonial and post-colonial eras, the creation of nation states has often been accompanied by conflict and violence in Third World countries, particularly if such attempts have ignored previously existing cultural, religious and/or ethical differences. The illegitimacy of national state construction becomes even more apparent when the attempt is associated with conflicting geopolitical interests of the 'super-powers', as is in the case of the Horn of Africa. The 27 years of armed struggle of Eritrea to free itself from Ethiopian domination is a consequence of previous and continuing attempts to create a nation state serve the interests of the ex-colonialists and 'super-powers' at the expense of the needs and desires of the people. Throughout the 27 years of struggle with its inevitable disruption of civilian life and service provisions, Eritrea has continued to develop a needs-based health care system. The Eritrean People's Liberation Front (EPLF) has developed a health care system which directly involves the people themselves. Through careful selection of priorities and a national allocation system for the distribution of scarce resources, it has provided remarkably effective emergency services, primary care and preventive health services. Such an approach has avoided the errors committed by many other Third World countries who, through copying modern western medical care systems, developed secondary and tertiary medical care facilities which were irrelevant to the health care needs of the vast majority of their populations. PMID- 2711220 TI - Life experiences, response styles and mental health among mothers and children in Beirut, Lebanon. AB - A sample of 152 women living in Beirut, Lebanon was studied to determine the relationship between life experiences, mothers' depression, and children's health and behavior. Measures of the perceived negative impact of both war and nonwar related events, measures of available social support, sociodemographic variables, coping or response strategies and displacement were used to predict mothers' depressive symptomatology and their children's health. The level of perceived negative impact of war-related events was found to be strongly associated with higher levels of depressive symptomatology among mothers. More surprising was the relative importance of experiences unrelated to the war in predicting higher levels of depressive symptoms. Among the most noteworthy of the findings was the association between the use of an emotional response style and the measure of psychological dysfunction. Finally, the level of a mother's depressive symptomatology was found to be the best predictor of her child's reported morbidity, with higher levels of symptoms associated with higher levels of morbidity. PMID- 2711221 TI - 'There is no sea, only fish': effects of United States policy on the health of the displaced in El Salvador. AB - The poor health status of El Salvador's displaced is a direct result of government policy which defines civilians as legitimate military targets. The effects of this 'strategic hamlet' policy on health is vividly seen in five areas of concern: war related trauma, infectious diseases, malnutrition and insufficient health services due to the repression of health providers and lack of resources. This report documents the major causes of mortality and morbidity among the 500,000 displaced in El Salvador and discusses the efforts of government and private organizations to meet their health needs. Health services for the displaced are primarily provided by private voluntary organizations which base their work on active neutrality. However, neutrality has become almost as dangerous as active opposition. The active repression of health workers by government security forces has exacerbated the already severe shortage of health care services for the displaced. PMID- 2711222 TI - Health needs of older adults displaced to Sudan by war and famine: questioning current targeting practices in health relief. AB - The high rates of death, disability and illness and the scarcity of resources associated with relief operations for victims of oppression, war and famine have led to some support systems of triage for health and nutritional care in relief. Two vulnerable groups have often been given priority for targeting in health relief--young children and their mothers. This paper reports the findings of a study of the health needs of another vulnerable group, older adults, among those who had been recently displaced to Sudan in 1984-1985 by the war and famine in Tigray region of Ethiopia. The study attempted to determine the extent to which morbidity events and migration affected the life-style of older adults and the socio-economic support mechanisms which were available to them. The findings indicate that older adults (those over 45 years of age) were a very small proportion of the population and that over half of those aged 60 years and over (defined as 'elderly' in this paper) had been left behind in Tigray. This may well indicate that disability, illness or both, forced many older adults, particularly those most in need, to remain in Tigray. Among older adults living in Sudan, high levels of minor disability, social isolation and total economic dependency indicated vulnerability, but older adults had not been specifically considered in health policies and plans. Their primary needs were basic--for cloth, food, shelter, transport, seeds, oxen and farming tools. We conclude that priority in relief should be to support individuals, families and entire communities by adequately providing for basic needs. Furthermore, international relief agencies should give equal consideration to those who remain in their homes and those who migrate for assistance. This approach would take into consideration quality of life, not just the number of lives saved among those who reach the camps and shelters, and would assume responsibility for 'Health for All', not just for selected 'vulnerable groups'. PMID- 2711223 TI - Baseline health care for refugees in The Netherlands. AB - In the Netherlands there are some 20,000 refugees from different parts of the world (e.g. Vietnam, Latin America). Most of them have experienced a form of organized violence. The somatic and psychosocial complaints of the refugees are comparable to those of Dutch war victims. They are mostly of an aspecific kind and making a diagnosis can be difficult because of the culturally different presentation of ill being. In order to help general practitioners in making a diagnosis the Refugee Health Centre (CGV) has made a classification of complaints according to whether or not they have a specific cause. It is clear from the literature that there are different opinions about the causes of the somatic complaints. As far as the psychic complaints are concerned it is remarkable that in our pilot study (n = 135) only 6% of the examined refugees suffer from a classical picture of the post-traumatic stress disorder; in a number of cases the picture is limited to some components only. Psychosocial complaints of refugees are subdivided and described. The philosophy of the CGV-treatment is to give assistance as much as possible in the refugee's neighbourhood; so that the clinician(s) will become part of the refugee's new social network. Another very important aspect of the assistance given is preventing medicalization of psychological problems. The basis of help is a recognition of the problems and complaints of the refugee. The structure of the Dutch health care, built up in 'lines', is very often very confusing for a refugee; this confusion can cause communication difficulties between refugee and clinician. To develop methods of treatment, definition and registration of complaints and problems can be a first step. PMID- 2711224 TI - The effects of torture and political repression in a sample of Chilean families. AB - This paper analyzes the sociological and psychological characteristics of 24 families before, during and after suffering direct repression. The sample is from families who received assistance from a multi-professional health team in Santiago de Chile. Direct repression includes one or several of the following acts against one or more family members: detention, kidnapping, disappearance, exile, imprisonment, intimidation. All our cases were tortured. After describing the repressive events suffered, the paper examines the impact of repression on social mobility of the families and on the occupational status of adult members. In the last section the authors discuss individual and group behavior changes and adjustments, and variations in the interpersonal relations within the families. PMID- 2711225 TI - Sadness, depression and social reciprocity in highland Ecuador. AB - Pena or llaqui in the Quechua area of Ecuador refers to a state of sadness and depression experienced following a variety of life events. This paper tries to explain why there is an elaborate discourse on such feelings in this culture. It is argued that the Quechuas stress the ideal of social reciprocity in human encounters and are accordingly sensitive to disturbances in social relationships. We observe that they pay a great deal of attention to the victim of pena and that they try to improve relationships with the social network and the family. The indigenous theory on pena also points to the importance of bodily elements closely associated to the psychological conditions. We conclude that knowledge of status relationships are important to understand the emotions experienced when loss occurs. PMID- 2711226 TI - In the shadow of biomedicine: self medication in two Ecuadorian pharmacies. AB - In Ecuador, as in most Third World nations, thousands of different prescription only pharmaceuticals can be bought without a doctor's prescription. But how often does self medication actually occur? This study documents 619 prescription drug sales in two Ecuadorian pharmacies. In 51% of these sales, customers in fact present no prescription. Many of the drugs sold this way have serious side effects and must be used with care. Ecuadorian law greatly restricts information on drug packaging about side effects, indications, contraindications, schedule and dosage. Although the pharmacies differ with respect to self medication rates, drug choices, and clerk-customer interactions, both show the existence of a 'shadow system of biomedicine' in which prescription drugs are used without physician consultation. In view of the dominant role that transnational corporations play in Third World pharmaceuticals usage, this analysis incorporates a political economic perspective. PMID- 2711227 TI - The assessment of diviners and their knowledge by civil servants in southwestern Nigeria. AB - Belief systems are continuously being modified through the interpretations individuals give to the cultural order. The present study investigates the evaluations which educated Nigerians have of diviners and their knowledge claims. Two hundred civil servants in Abeokuta, a state capital in the Southwestern region, were asked to assess diviners. It was discovered that diviners are believed to have access to supernatural knowledge and that this knowledge is seen as medically useful. Further development of the diviner's knowledge was endorsed by 70% of the sample. The respondents were however ambivalent towards diviners as persons or the bearers of the knowledge. They (diviners) are believed to have become unduly materialistic and prone to dubious activities. The implications of these findings for social change were then considered. PMID- 2711228 TI - Cosmopolitical obstetrics: some insights from the training of traditional midwives. AB - In most countries of the third world, strategies for development in the health sector include efforts to upgrade the skills of village level health care workers, including traditional birth attendants (TBAs). In spite of several decades of experience, training programs for TBAs have not been particularly successful. Drawing on data from several years of ethnographic fieldwork with Maya midwives in Yucatan and on participation in government-sponsored training courses for indigenous midwives, this paper examines some of the reasons underlying this failure. Paramount among these are differences in world view and the misapplication of didactic modes of teaching in situations where learning in the apprenticeship mode is more appropriate and culturally customary. PMID- 2711229 TI - Views of what's wrong: diagnosis and patients' concepts of illness. AB - A group of women were interviewed about their construction of their illness experiences before they saw a physician and subsequently over a period of several months following consultation. It was found that the physician's input was one of many components of their post-consultation understanding of their illnesses. The women built up their understandings in an interactive process, drawing significantly on their prior histories, ongoing experiences and social worlds. They continually tried out, adjusted and reworked the construction of their illnesses to adapt them to the exigencies of everyday life. We conclude that illness explanations are dynamic entities whose adequacy is determined by their usefulness within the extra-medical social environment. PMID- 2711230 TI - Knowledge about AIDS and self-reported behaviour among Zimbabwean secondary school pupils. AB - Knowledge about AIDS and self-reported sexual behaviour was studied among 1532 (893 male, 633 female) Zimbabwean secondary school pupils drawn from 12 schools. Most subjects knew that AIDS is fatal and incurable. However, over 40% of subjects believed that most people with AIDS in Africa are homosexual. Over 40% of respondents did not know that many HIV seropositive individuals look healthy. Nearly 40% of participants believed that HIV can be contracted from toilet seats and 54% of subjects believed that mosquitos can transmit HIV. Pupils from homes in urban areas were better informed about AIDS than were those from homes in rural areas. Forty-six percent of males and nearly 3% of females were reportedly sexually experienced. It is suggested that female under-reporting of sexual activity occurred. Nearly 16% of males reported coital experience with a prostitute. The implications of these findings for future AIDS awareness campaigns in Zimbabwe are considered. PMID- 2711231 TI - Food taboos in maternal and child health: the views of traditional healers in Ile Ife, Nigeria. AB - This paper reports the interviews with 82 randomly selected healers in Ile-Ife about food taboos in relation to maternal and child health. The healers were asked to list the childhood ailments they treat most often and the food proscriptions and prescriptions associated with these ailments. Of particular interest in the study was the fact that these food proscriptions and prescriptions form an integral part of traditional medical procedures in that relapses or slow rate of recovery are sometimes attributed to a break of these food norms. Moreover, these proscriptions and prescriptions reflect: (i) the healers' concept of the various childhood diseases and (ii) the healers' belief in the respect for the traditional Yoruba gods in health matters. It was further noted that although these taboos reinforce the beliefs in traditional medicine, their relevance from the point of view of the health of the clientele needs further investigation. PMID- 2711232 TI - [Problems of evaluating the delivery of health care by qualitative characteristics]. AB - According to the decision of the CPSU Central Committee and the Council of Ministers of the USSR, the transition to planning and assessing the work of health bodies and facilities by qualitative characteristics has been approved. The latter included the level of general and communicable morbidity, temporary disability, invalidism, mortality, sanitary and epidemiologic well-being. The existing documents on the medical network and manpower contain no evidence on such qualitative characteristics. Numerous institutions are engaged in the collection of basic medical, vital, sanitary and ecologic data. They have no uniform technique of collecting the information, carrying out calculations and comparison of a number of indices, providing the information to the bodies and facilities concerned, especially at the city and regional levels. Thus, health statistics had the similar shortcomings as those stated in the Party and government document "On the measures on radical improvement of the science of statistics in the country". Proceeding from the long-term applied studies the examples of such shortcomings hindering the assessment of health care by qualitative characteristics under new conditions of economic management are given. The proposals aimed at raising reliability and analytical value of health statistics as an important instrument of management are set forth. PMID- 2711233 TI - [Objectives of public health organs and institutions with regard to the implementation of the "Main guidelines for the development and health protection of the population and the perestroika of public health in the 12th Five-Year Period and during the period up to the year 2000"]. PMID- 2711234 TI - [CASMSP (Complex Automated system of Mass Screening of the Population) as an information basis for the evaluation of health of the population]. AB - On the basis of the periodic medical check-up of 1385 adults carried out by means of the Computerized Automated System of Medical Aid to the Population there were calculated the integral indices, i.e., an index of deviation (ID) and a dip angle of ID, describing the health status of the population. Calculation alternatives are given along with the ID use for information supply on health status of the population according to the established aims. Simplicity of the calculation procedure and a sufficient degree of information content promote the application of the proposed indices to health care. PMID- 2711235 TI - [Hospitalization of farm workers with lesions of the nervous system]. AB - The established rate of hospital admissions of 32.4 +/- 0.8 per 1000 farmers reflects with certain reliability the demand for inpatient care among working farmers with nervous diseases. The extension of the system of admissions to hospital under rural conditions serves as an effective measure of the control of work losses in agriculture. PMID- 2711237 TI - [The role of primary medical services in the implementation of the Expanded Immunization Program of the WHO]. PMID- 2711236 TI - [Activities of a day hospital of the city polyclinic]. AB - Highlighted is the experience gained in the organization of a day hospital created for general and neurologic patients at Polyclinic N 166 of the Krasnogvardeisk region of Moscow. The preliminary outcomes of the treatment of 167 patients are briefly analyzed. The results of the study on the population's opinion on the exapediency of day hospitals are provided. It is pointed out that treatment in a day hospital is regarded as an advanced form of medical care. PMID- 2711238 TI - Pull-off strength of gardner-Wells tongs from cadaveric crania. AB - Failure of attachment ("pull-off") of Gardner-Wells tongs from the cranium occasionally occurs, and may cause problems, especially in cases of significant cervical spinal instability. The optimal method for Gardner-Wells tongs attachment is not well defined: the effect on pull-off strength of stem protrusion of the spring-loaded pin, and user accuracy in setting stem protrusion do not appear to be documented in the medical literature. The authors measured pull-off strength from five fresh cadaveric crania, for each of five stem protrusion settings. In a related experiment, staff surgeons were asked to follow the standard instructions for applying clinically available Gardner-Wells tongs (smooth, unmarked indicator stems on the spring-loaded pins), after which the actual stem protrusion lengths were recorded. When the indicator stem protruded 1.0 mm (manufacturer's recommendation), the mean pull-off strength (+/- standard deviation [SD] was 137 +/- 34 pounds (610 +/- 151 N). Even with stem protrusions as low as 0.25 mm, the lowest pull-off strength was 60 pounds. Failures of fixation occurring with traction loads of 35 to 50 pounds are almost surely associated with stem protrusions of less than 0.25 mm. Even without an indicator line on the stem at 1 mm, all of the 13 orthopaedists tested produced an actual stem protrusion of 0.37 mm or more. Secure attachment of larger cranial traction loads requires careful attention to pin tightening. Proper location on the skull and the risk of penetration through the inner table must also be kept in mind. PMID- 2711239 TI - Comparison of halo complications in adults and children. AB - A retrospective analysis of 128 patients who underwent halo vest application for a variety of cervical spine problems was undertaken to determine complications associated with its use. Ninety-three (72%) were available for review. In comparison with a recent report, the complication rate was much lower. Only 8% of adults had major problems, consisting of pin tract infection and significant pin loosening requiring replacement. However, 39% (5 of 13) children had major problems. This report details our method of halo application and follow-up care. PMID- 2711240 TI - Validity of clinical tests in the diagnosis of root compression in cervical disc disease. AB - The purpose of this study was to test the validity of three clinical tests (the neck compression, the axial manual traction, and the shoulder abduction test) in the diagnosis of root compression in 43 patients with cervical disc disease. The validity was investigated regarding radicular pain, neurologic signs, and root compression signs in myelography. All tests were highly specific for the validity parameters. However, the sensitivity was low; it ranged from 26 to 50% for the three single validity parameters in roots C6-8, and from 40 to 64% for combined neurologic and radiologic signs. It is concluded that, despite low sensitivity, these tests are a valuable aid in the clinical examination of a patient with neck and arm pain. PMID- 2711241 TI - Method for determining vertebral body positions in the sagittal plane using skin markers. AB - A method by which the location of vertebral bodies can be estimated from the external profile of the spine in the sagittal plane is described. The technique involves a normalization of the curve from T1 to L5 and approximation using a cubic spline. Mapping functions are developed that enable the transformation of a skin profile to a vertebral centroid curve. Data were obtained for 13 subjects between the ages of 13 and 17 who had undergone lateral spinal radiographs with radiopaque skin markers over the vertebral spinal processes. Results suggested that vertebral body centroids could be estimated from the skin profile to a precision having a standard error of the estimate of 0.4 cm. This was improved to 0.2 cm if the lumbar curve were considered separately. PMID- 2711242 TI - The comparative results of treatment in idiopathic thoracolumbar and lumbar scoliosis using the Harrington, Dwyer, and Zielke instrumentations. AB - Forty-five patients with idiopathic thoracolumbar or lumbar scoliosis were treated with the Harrington, Dwyer, or Zielke instrumentation and fusion. The Harrington group achieved a 55% correction of the primary curves, while the Dwyer and the Zielke groups achieved 88 and 91%, respectively. Overcorrection of the curves occurred in a total of nine cases in the latter two groups. The Dwyer and Zielke instrumentations enabled better correction of the curves with a shorter fusion. At subsequent follow-up, the 'adding on' phenomenon as a result of the shorter fusion in the Dwyer group was unchanged, while that in the Zielke group became gradually resolved. The Zielke instrumentation appears to be the apparatus of choice for treatment of thoracolumbar and lumbar scoliosis. PMID- 2711243 TI - Luque fixation to the sacral ala using the Dunn-McCarthy modification. AB - The Galveston-Luque technique of fixation to the pelvis requires solid bone and a strong pelvis. Because the majority of neuromuscular patients who require fixation to the pelvis have a weak and thin illum, an alternative to the Galveston technique was sought. A technique of rod contouring was developed that takes advantage of the reliable, stout bone of the sacral ala for fixation. Twenty-four patients have been instrumented with Luque rods and fused to the sacrum over the past 4 years using the technique. There have been no complications in this short follow-up. PMID- 2711244 TI - Magnetic resonance imaging of spinal injury. AB - Magnetic resonance imaging (MRI) was performed on 30 patients following spinal injury (SI). Spin-echo sequences and surface coils were used for all patients. Plain radiographs, high-resolution computed tomography (CT), and MRI were compared for the delineation of bone, disc, and ligament injury, measurement of sagittal spinal canal diameter and subluxation, epidural hematoma, and spinal cord structure. Myelography or intrathecal contrast-enhanced CT were not performed on any of these patients. Magnetic resonance imaging accurately delineated intraspinal pathology in two of four patients with acute penetrating SI, and was normal in the other two patients. In 16 patients with acute nonpenetrating SI, MRI was superior to CT for visualizing injuries to discs, ligaments, and the spinal cord, while CT was superior to MRI in characterizing bony injury. Computed tomography and MRI provided similar measurements of subluxation in six of six patients and of sagittal spinal canal diameter in three of four patients. In ten patients with chronic SI, MRI demonstrated post traumatic cysts, myelomalacia, spinal cord edema, and the presence or absence of spinal cord compression. In patients with acute penetrating SI and chronic SI, MRI provided comprehensive clinical information. In patients with acute nonpenetrating SI, the information obtained by MRI complemented the data given by plain radiographs and CT, allowing clinical decisions to be made without the need of invasive imaging modalities. PMID- 2711245 TI - Connective tissue changes of the multifidus muscle in patients with lumbar disc herniation. An immunohistologic study of collagen types I and III and fibronectin. AB - The connective tissue components, Types I and III collagen fibronectin, were immunohistologically analyzed using their specific antibodies for localization and semiquantitative estimation in 24 patients (11 women and 13 men, all under 55 years of age) operated on for herniated lumbar intervertebral disc. Nine cadavers without known back problems (2 women, 7 men) served as controls. In controls, Type I collagen was present in the endo- and perimysial structures of the muscle, more conspiciously in the former. Type III collagen, together with fibronectin, were more abundant in the perimysium than in the endomysium. Thickening of these structures was not evident in the controls. In most patients Types I and III collagen and fibronectin distribution was similar to that of the controls. However, fibrotic changes of both and endo- and perimysial structures involved all Types I and III collagen and fibronectin in ten cases. In two patients an increase in Type I collagen staining intensity in the endomysium was recorded and thickening of the endomysial structures was observed in six patients. There were correlations with the severity of the connective tissue structural changes to atrophy of the muscle and furthermore to disability of the patient in the 1-year postoperative check-up. These findings suggest that if marked fibrosis of the muscle occurs, it can be a factor impairing recovery from the disease during the long-term postoperative course. PMID- 2711246 TI - A comparison of actual and apparent lumbar lordosis in black and white adult females. AB - The purposes of this study were to investigate differences in lumbar lordosis in black and white adult females and to explain the clinical impression that blacks have a greater lordosis than whites. An actual lumbosacral lordosis angle (ALS) was measured from a standing right lateral lumbosacral radiograph using the angle formed from the intersection of lines drawn across the top of the second lumbar vertebral body (L2) and across the top of the sacrum. An actual lumbo-lumbar angle (ALL) was measured in the same manner, except the second line was drawn across the bottom of the fifth vertebral body (L5). To determine whether gluteal prominence gives a false impression of increased lumbar lordosis, an apparent lordosis (APL) measurement was taken, measuring the distance from the subject's greater trochanter to the most posterior aspect of the buttocks. No significant differences were found in ALS or ALL between 25 black and 27 white adult female subjects (ALS, P = 0.26; ALL, P = 0.41). Significant differences were found between black and white APL, with blacks demonstrating a larger APL than whites (P less than 0.01). A high correlation was noted between ALS and ALL in both blacks (0.70, P less than 0.01) and whites (0.77, P less than 0.01). The investigators therefore contend that the clinician's assumption that blacks have a greater lordosis than whites is based on an apparent increased lordosis due to more prominent buttocks (APL). PMID- 2711247 TI - Roentgenographic evaluation of lumbar spine flexion-extension in asymptomatic individuals. AB - An experimental clinical study of angulatory and translational lumbar spine intervertebral motion was performed using flexion-extension radiographs obtained in the lateral plane. These "bending" films were obtained from 59 asymptomatic individuals undergoing routine pre-employment examination. Results indicate that there is 7 to 14 degrees of angulatory motion present in the lumbar spine but a large range of values exist so that norms of angulatory motion cannot be more precisely defined. There are 2 to 3 mm of translational motion present in the lumbar spine at each intervertebral level. Twenty percent of this study's asymptomatic subjects had 4 mm or more translational motion at the L4-5 interspace and at least 10% had 3 mm or greater motion at all levels except L5 S1. These results challenge conclusions based on earlier studies and call into question the use of lumbar flexion-extension bending films as a primary determinant of lumbar segmental stability. PMID- 2711248 TI - Comparison of MRI to contrast CT in the diagnosis of spinal stenosis. AB - Retrospectively, the MR (magnetic resonance) and contrast CT (computed tomography examinations of 41 patients (123 segments) were objectively scored to evaluate spinal stenosis and disc degeneration. Five categories to evaluate stenosis included the facet joint, foramina, central canal, disc on sagittal section, and disc on axial section. In addition, the ability to demonstrate spondylolysis was compared. The examinations were interpreted by a single observer blinded to the results. Comparisons show 96.6% agreement between MR and contrast CT in the diagnosis of spinal stenosis. Magnetic resonance showed disc degeneration in 74 of 123 segments, while CT showed disc degeneration disease in 27 of 123 segments. Spondylolysis was recognized at three segments on both MR and CT. In conclusion, MR and contrast CT are comparable in their abilities to demonstrate spinal stenosis, and MR is more sensitive in demonstrating disc degeneration. PMID- 2711249 TI - Symptomatic spondylolisthesis in adults: four decades later. AB - An average follow-up of 40 years was obtained for 12 patients with spondylolisthesis treated at Hines Veterans Administration Hospital between 1944 and 1951. In each case, the slip had been Grade 1 and at the L5-S1 level. Five had been treated conservatively and seven surgically with a Hibbs fusion from L4 to S1. Of the conservatively managed patients, all functioned well during their working years, although one did have chronic, nondisabling, low-back pain. This same patient demonstrated radiographic evidence of progression to a Grade 2 spondylolisthesis. Among those undergoing surgery, the poor results were confined to those patients whose fusion attempts failed. Management for low-grade spondylolisthesis should be conservative where possible. When the low-back pain is disabling and surgery becomes necessary, failure to obtain a fusion portends a poor clinical result. PMID- 2711250 TI - Metastatic pheochromocytoma of the cervical spine. PMID- 2711251 TI - Intravertebral vacuum cleft in the fifth lumbar vertebra. PMID- 2711252 TI - [Program for selective dissemination of information in support of priority health problems. II]. AB - Mexico's National Health Information and Documentation Center (CENIDS), planned and designed a Selective Dissemination of Information Program in support of Priority Health Problems (DSI-APS). After one year of the implementation phase of this Program, an evaluation survey was conducted in order to measure its impact. Two questionnaires were sent to the institutional managers (C-I) and to the end users (C-II). A total of 54 questionnaires (CI and CII) were sent via air mail to both the Health and the Education Sectors. Fifty (92.59%) responses were obtained from CI and 242 from CII. (CII could be reproduced as many times as needed). The results indicated the topics of more demand by the institutions and by the users. Eighty one per cent of the end-users scored over eight (scale 1-10) their degree of satisfaction when using the topics. Seventy two per cent of the institutions reported being unable to pay for this service; however, 93% of the end-users state that the Program should continue. It was detected that the topics represent an important support to "research" and "delivery of health care" activities. Finally, it was recommended to carry out specific studies so as to reformulate search strategies; satisfy selective needs, considering the impact obtained; and optimize existent resources. PMID- 2711253 TI - [Basic disorders in human communication]. AB - This paper specifies the areas and disorders that concern human communication medicine. The frequency of the diverse disorders is analyzed in relation to age and sex, and the distribution in group ages of several disabling diseases is also discussed. PMID- 2711254 TI - [Model of a program of clinical investigation at the first level of medical care]. AB - A major commitment of educational institutions in the health field is to train professionals capable of meeting the needs of society. In order to achieve this goal it is necessary to develop research programs related to field service and thoroughly integrated to the teaching-learning process. In this regard, we propose a model for the implementation and development of a clinical research program for the primary level of health care. This model can be adapted or modified according to the particular needs of the community, leading to the establishment of a dynamic and continuous system based on feedback obtained from scientific data. On the other hand, it assures the delivery of high quality health care services to the community. PMID- 2711255 TI - [Future strategies for prevention of diseases]. AB - This paper discusses the future strategies for the prevention of disease. The author presents three basic ideas. The first is that in public health it is increasingly important to evaluate critically the costs and benefits of different preventive strategies. Second, it is highly desirable to use new advances in biology to create more effective, safer, and possibly less expensive preventives. Third, it is increasingly important to utilize modern means of communication to reach the public to promote change toward healthier behaviours. PMID- 2711256 TI - [Differential mortality by sex. Causes and behavior of respiratory and gastroenteric infections in Mexico]. AB - The differential in mortality by sex has not been broadly studied in Mexico. In this work mortality by sex in under one year old children and infants by federal entity for the main infectious diseases during 1980-1982 was analyzed. The results showed that the rate of mortality by sex (RMS) for under one year old children was higher than one, which means that there is a male over-mortality for that group of age. In the one to four year old children group, there were three entities that showed over-mortality among women. The analysis of the proportional mortality revealed that 40 to 50 percent of deaths in under one year old children were due to gastroenteral and respiratory infections. The probable causes of the male over-mortality observed and the need to determine the regional patterns of mortality are also discussed. PMID- 2711257 TI - [Preferences on family composition among youngsters from Monterrey, Mexico]. AB - In order to evaluate the effect of social and biological factors on family size (FS) and secondary sex ratio (SSR) in the families that they would desire to procreate as well as in the ones to which they belong, 1,518 unmarried persons of both sexes, students and workers, who reside in the metropolitan area of Monterrey, Mexico were interviewed. It was found that the average FS desired by the unmarried males and females, independently of their socioeconomic level and years of schooling, were 3.19 and 3.04, which are lower than half the FS of 6.81 observed in the families to which they belong. Both males and females in all the socioeconomic levels and years of schooling, would desire to procreate a larger number of male children: SSR of 0.576 and 0.524, which are higher than the 0.498 observed in the families to which they belong. Also they manifested a strong preference for the birth order of the sex of their children, being of males for the first (SSR of 0.924 and 0.838) and of females for the second (SSR of 0.301 and 0.269). The fact that all children would be of the same sex did not change the desired FS in about 80% of the persons, but in the remainder 20% the desired FS would be increased to an average of five children. In order to reduce the growth rate it would be convenient to offer special counseling on family planning to these persons. In conclusion, the obtained information indicates that aside from the socioeconomic, cultural and biological factors, probably the family planning programs have had a positive influence on the persons that in the near future will start their reproductive stage, and it is possible to anticipate a reduction on the growth rate for the next generation. PMID- 2711258 TI - [Tuberculosis surveys in Guerrero and new estimates of the magnitude of tuberculosis infection in Mexico]. AB - Tuberculosis infection surveys are carried out by tuberculin skin test (Mantoux) which is a simple, cheap, valid and reliable procedure for the estimation of prevalence and incidence rates. In 1987 a survey was undertaken in children of 6 7 years old who attended the elementary school and who were not vaccinated (BCG) in the region of Iguala, Mexico. Out of 6,095 children of such age group, just 531 were not vaccinated, thus the prevalence figure was 2.5% (CL05 = 0.1%, 5.3%). On the basis of the findings by Izaguirre et al, 26 years ago, who reported that about 10% of the children of this age group were infected, it can be estimated that the annual risk of infection is about three newly infected each year per 1,000 population. It is necessary to provide better estimates of the whole tuberculosis incidence rate. PMID- 2711259 TI - [Sanitary control of food in Mexico city]. AB - This work was undertaken as to avoid health risks to tourism in the "XIIth Soccer World Cup, Mexico 86". The above project was carried out through proper quality control of foods, drinking water as well as a definite care of personal hygiene of all those involved in the catering business (132 restaurants were included). The mentioned report informs only of the work of the National Public Health Laboratory in the Sanitary Epidemiological Program. The following products were analyzed: 133 water samples, 272 animated and nonliving surfaces, and 399 foods. Twenty seven percent of water samples were rejected, as well as 85% of the different surfaces and 60% of the food samples. High counts of mesophilic aerobics, followed by coliforms, S. aureus and Salmonella sp., were the principal specimens encountered. Therefore, it was suggested the permanent development of a sanitary epidemiological program. PMID- 2711260 TI - [New hospitals of the program for reconstruction and reorganization of health services in the metropolitan area]. AB - This article describes the stages in the building of the general hospitals of 144 beds included in the Health Services Reconstruction and Reordering Program. The Program is being carried out by the Health Ministry in the metropolitan area of Mexico City, emphasizing the reordering sense of the activities developed to cope with the observed unbalances in the distribution of health services among the various zones in the area. The article examines also the coordination among the internal units of the Health Ministry and other agencies in the Health Sector. Finally, the lessons of the experience derived from those processes are discussed. PMID- 2711261 TI - [Quality assurance following the x-ray ordinance]. PMID- 2711262 TI - [Pre-filtration of an x-ray source and the radiation exposure of patients]. PMID- 2711263 TI - Recent perspectives on the pathogenesis and chemotherapy of rheumatoid arthritis. PMID- 2711264 TI - Blood doping. PMID- 2711265 TI - The moral validity of medical practice in South Africa and challenges for the future. PMID- 2711266 TI - Indications for aspiration of amoebic liver abscess. AB - A two-part study was undertaken to determine whether aspiration of amoebic liver abscess (ALA) prevents complications. Eighty patients studied prospectively were randomised into aspiration or non-aspiration groups and were treated with metronidazole. Common factors in patients with complicated diseases were determined to formulate and test indications for aspiration. Records of all patients with ALA admitted to King Edward VIII Hospital, Durban, between October 1983 and December 1984 were analysed to test the validity of the criteria derived from the first part of the study. The findings suggest that aspiration influences the course and outcome of ALA and that the criteria are valid although not necessarily complete. PMID- 2711267 TI - Placental bed morphology in black women with eclampsia. AB - Histopathological changes in the placental bed were studied in 7 primigravid patients with eclampsia and compared with those in 17 normotensive patients. Normal morphological changes, which included trophoblastic invasion of spiral arterioles of the decidual and myometrial segments, were noted in the biopsy specimens taken from normotensive patients but were not seen in the specimens obtained from patients with eclampsia. PMID- 2711268 TI - DNA ploidy in papillary tumours of the breast. AB - The DNA content of benign and malignant papillary tumours of the breast as well as a group of papillary tumours where this distinction could not be made with certainty was measured by flow cytometry. All the benign papillomas were diploid; 5 of 19 carcinomas were aneuploid; and 1 of 15 tumours of undecided type was also aneuploid. Comparison of the DNA indices, proliferation indices and coefficients of variation were of no value in distinguishing between benign and malignant specimens. PMID- 2711269 TI - AIDS clinic--a year on. AB - In March 1987 a clinic under the auspices of the South African Medical Research Council's AIDS Research Unit was established. In the first year of its existence certain issues were identified. These are discussed and a model for future clinics is proposed. PMID- 2711270 TI - Health authorities' support for creches. AB - A study was undertaken to determine the extent of creche services in rural areas of southern Africa, the level of support from the health authorities and their understanding of the function of and legislation pertaining to creches in the light of the explosive expansion of preschool child-care services in both rural and urban areas. One hundred hospitals, serving mostly rural health wards, were surveyed using a postal questionnaire and the response rate was 85%. Sixty hospitals reported that creches were in existence in their health wards and 45 claimed to be providing health care on a regular basis. Forty-one respondents were completely unaware of legislation regulating creche services and most of the remaining 19 misquoted the legislation. Most respondents perceived the role of the creche as providing a place of safety for the children of working parents but only 21 identified education as an important creche function. It is concluded that there is a lack of awareness of the role of creches in rural areas and also inadequate support for creche services. PMID- 2711271 TI - The 'evening syndrome'--a sign of failure in providing sufficient geriatric amenities. AB - Emergency wards are under pressure most of the hours of the day and night. When patients arrive during the working hours of outpatient clinics it is possible to divert some of them. Once the clinics are closed, all patients that arrive at the casualty department are examined. Families that have elderly disabled persons at home often then bring the disabled to the emergency ward on some pretext of acute distress and then disappear, leaving the elderly person in the care of the hospital. The responsibility of providing sufficient geriatric institutions rests with departments of health, municipalities, and medical aid societies. Until such provision is made, hospitals will remain overcrowded with people who only require good auxiliary nursing care. PMID- 2711272 TI - Oral ketoconazole and flucytosine for neonatal systemic candidiasis. AB - A neonate who developed systemic candidiasis was successfully treated with oral ketoconazole (Nizoral; Janssen) and flucytosine (Alcobon; Roche). The potential benefits of this combination are discussed. PMID- 2711273 TI - Phaeochromocytoma in pregnancy. A report of 3 cases. AB - The coincidence of phaeochromocytoma and pregnancy is rare and potentially lethal. Three cases are reported; in 2 the fetus had died before the patient presented. With early diagnosis and appropriate treatment there should be no maternal mortality, and the fetal mortality rate should be reduced to less than 20%. PMID- 2711274 TI - Meningococcaemia complicated by myocarditis. A report of 2 cases. AB - Two cases of myocarditis complicating meningococcal septicaemia are presented. Neisseria meningitidis infection with bacteraemia is a common entity but the important complication of myocarditis has not often been described. The autopsy findings in 1 of the 2 patients described further illustrates the significance of myocarditis. The pathology, clinical presentation and management of this complication are briefly discussed. PMID- 2711275 TI - Hyperparathyroidism presenting as a large bone tumour. A case report. AB - A 59-year-old man, who presented to hospital with a large expansile bone tumour over the left elbow and a mass in the right side of the neck, was eventually found to have parathyroid adenoma manifesting clinically as severe hypercalcaemia. Histological examination of a section of the neck mass showed parathyroid adenoma and the bone biopsy specimen revealed a 'brown tumour', consistent with hyperparathyroid bone disease. PMID- 2711276 TI - Endobronchial tuberculosis. A report on 15 cases. AB - Fifteen patients were diagnosed between 1973 and 1987 at Hacettepe University Hospital as having endobronchial tuberculosis. They were subjected to bronchoscopy because of provisional diagnoses of primary bronchogenic carcinoma in 7 cases, bronchial asthma in 3 cases, tuberculosis in 2 cases and hydatid cyst, foreign body aspiration and bronchiectasis in 1 case each. In those patients in whom the initial clinical diagnosis was primary bronchogenic carcinoma, it was difficult to differentiate endobronchial tuberculosis either by radiography or bronchoscopy. PMID- 2711277 TI - Oculomotor nerve palsy precipitating acute angle-closure glaucoma. A case report. AB - A case of acute angle-closure glaucoma precipitated by oculomotor nerve palsy in a patient with shallow anterior chambers is reported. The different ways in which a palsy of the oculomotor nerve can influence the intra-ocular pressure are discussed. PMID- 2711278 TI - An epidemic of pertussis syndrome in Cape Town. PMID- 2711279 TI - [Abnormal hemoglobins in Negroid Ecuadorian populations]. AB - The prevalence of hemoglobinopathies was determined in the black race located in two distinct geographical areas in Ecuador; in the coastal province of Esmeraldas, particularly the Santiago basin (Rio Cayapas and Rio Onzoles) and in the province of Imbabura, particularly in the intermoutain valley, Valle de Chota. A total of 2038 blood samples were analyzed, 1734 in Esmeraldas and 304 in Inbabura, of which 23.2% (473 individuals) were found to be carriers of abnormal hemoglobins, 25.4% (441) in Esmeraldas and 10.5% (32) in Imbabura. The abnormal hemoglobins found in Esmeraldas were Hb AS (19.2%), Hb AC (5.0%), Hb SS (0.6%) and Hb SC (0.5%) while in Imbabura only Hb AS (9.5%) and Hb AC (0.9%) were found. The factors that could influence the difference in prevalence found in the two geographical areas are discussed. PMID- 2711280 TI - [Evaluation of the first program of external quality control in hematology of the Spanish Hematology and Hemotherapy Association. Experience of 1 year's activity]. AB - The External Quality Control Programme in Haematology (EQCP-H) comprises a monthly remittance of two whole-blood control samples for evaluating red cell count (RBC), white cell count (WBC), platelet count (PC), haematocrit (HT), haemoglobin rate (HB) and red cell indices (MCV, MHC, MCHC), as well as lyophilized plasma for prothrombin time (PT), partial thromboplastin time (PTT) and fibrinogen (F) determination. The participant laboratories were classified for each determination in accordance with the methods used. The evaluation was made on the basis of 1986 data, the number of participants being 230, from Public Health (54%) and private 46%) laboratories. A mean (means) or target value, along with the standard deviation (SD), was obtained for the results received in the Organising Centre for each parameter. In order to find deviation of individual results with respect to means, a deviation index (DI) was calculated with regard to the whole group and to those laboratories using the same methods. The graphic evaluation of the results was plotted on a Youden diagram. The active participation was 58.3 +/- 5.7%, ranging from 33% (PC) to 74% (RBC, HB, HT and MCV). Upon evaluating the whole programme, stress was laid on the global variation coefficient (VC%) attained for each parameter and those pertaining to the analytical systems employed, grouped in accordance with the methodological principles. Global VC% ranged between 3.6% (HB) and 31.9% (PTT), and the values corresponding to the analytical procedure used were below 4% for RBC, HB, MCV and MCHC in automatic systems and also for HB and MCV in semiautomatic systems. Although the working period of EQPC-H is too short to draw definitive conclusions on the improvement it may induce in the methodological quality, the high VC% values found for WBC, PC and manual determination of HB, along with the unacceptable values for PT, PTT and F, should be stressed. PMID- 2711281 TI - [Deficiency of folates in pregnancy: effect of supplementary folic acid]. AB - Higher folate needs are present during pregnancy, which may lead to tissular deficiency in the mother and to depleted newborn folate reserves. The aim of this work was to assess the prevalence of folate deficiency and to establish the rates of serum and red cell folate in two groups of mothers and newborn infants, one receiving only iron and the other iron and folate during pregnancy. The rates of serum and red cell folate found at the end of pregnancy were significantly higher in the group which received folate; however, the percentage of cases with tissular folate deficiency was low in both groups, with no significant difference (3.8% and 1.3%, respectively). These findings, along with the lack of effect of supplemental folate on erythropoiesis, pose some questions on the usefulness of supplemental folate during pregnancy in our country. PMID- 2711282 TI - [Hematologic significance of erythrocytic macrocytosis: prospective analysis of 109 successively studied cases]. AB - The aim of the present work was to perform a prospective analysis of the significance of macrocytic red cells through the study of all patients with MCV higher than 105 fl (those treated with cytotoxic or immunosuppressing drugs were excluded). Conventional clinical, haematologic and biochemical studies were carried out on every patient, along with B12 and folate levels, bone marrow examination and bone marrow karyotype and, whenever B12 deficiency was present, complete Schilling's test. Special attention was paid to the aetiological inquiry and post-therapeutical course. A series of 109 patients was collected. Decreased serum B12 rates with abnormal Schilling's test and response to parenteral therapy were present in 26 cases (24%). Of them, 22 fulfilled the diagnostic criteria for Biermer's anaemia, while in the remaining 4 there was impaired intestinal absorption. Serum or red-cell folate deficiency was found in 34 other cases (31%). Alcoholism was present in 20 of them, abnormal diet in 10, malabsorption syndrome in 2, and excessive demands in 2 others. Hence, vitamin deficiency underlay macrocytosis in 60/109 cases (55%). In the remaining 49 cases (45%) macrocytosis was not accompanying folate or B12 deficiency. Of these, severe liver disease was found in 16 patients (alcoholic in 15 and post-hepatitis in 1 case), with increased serum B12 in 10 cases and increased serum or erythrocytic folate in 3 others. Nineteen patients within this group had primary myelodysplastic syndromes (RA, 8; SRA, 4; RAEB, 7), and the remaining 14 cases had several haematological (AIHA, 4; CLL, 1, T-cell lymphoma 1, M-6, 1, and myelofibrosis with myeloid metaplasia, 2) or non-haematological diseases (heart insufficiency, 2; COPD,3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711283 TI - [Evaluation of a totally automated alternative system for determining the rate of erythrocyte sedimentation]. AB - The Ves-MaticR system (VS) for evaluating erythrocyte sedimentation rate (ESR) is compared to Westergren method. A good correlation between both methods is obtained in spite of small differences observed; the accuracy of the VS is also studied. Concerning the time variation, a small reduction of the ESR in the first seven hours is observed, being significant at 24 hours. The most important advantages of the VS are the near complete disappearance of the contamination risk, the reduction of the time employed in setting up, sedimentation and reading, and the reliability. PMID- 2711284 TI - [Prediction of survival in myelodysplastic syndrome. Analysis of 2 scoring systems with prognostic value]. AB - The wide prognostic variability of myelodysplastic syndromes (MDS) complicates decision-making regarding the choice and evaluation of alternative treatments to transfusional and antiinfectious supportive measures. Due to its simplicity the Bournemouth scoring system seems to have achieved wide acceptance for establishing the prognosis in MDS patients. The aims of this study were to examine the Bournemouth system in a series of 370 patients with MDS and to evaluate the capability of the prognostic index recently proposed by our group to better define the outcome predicted by the former. The Bournemouth scoring system identified 3 risk groups, A (0-1 points), B (2-3 points) and C (4 points), in the whole series (p less than 0.0001) and it allowed us to stratify refractory anemia (RA), RA with excess of blasts (RAEB) and RAEB in transformation (RAEB-t) patients into two distinct prognostic groups (p = 0.03 and p = 0.01, respectively). This scoring system did not show a significant value in RA with ringed sideroblasts (RARS) and chronic myelomonocytic leukemia (CMML) patients (p greater than 0.05). Our prognostic index clearly segregated patients in the whole series into low- (0-1 points), intermediate- (2-3 points) and high-risk (4-5 points) groups (p less than 0.00001) as well as stratifying ARSA (p = 0.0005), CMML (p less than 0.0001) and RAEB and RAEB-t patients (p less than 0.00001) into different prognostic subset, although it failed to demonstrate a significant predictive value in RA patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711285 TI - [Determination of free erythrocyte protoporphyrin in thalassemic trait]. AB - Free erythrocyte protoporphirin (FEP), along with diverse haematologic and iron metabolism data, were determined in 60 carriers of the thalassaemic trait (29 beta and 31 delta beta). FEP rates were significantly higher in thalassaemia carriers (39.04 +/- 14.12 micrograms/dl) than in a control group (24.95 +/- 4.70 micrograms/dl) (p less than 0.05). No correlation between FEP and any other iron metabolism parameter, or the severity of anaemia, was found. No FEP differences appeared between the beta (41.06 +/- 16.5 micrograms/dl) and delta beta (37.1 +/- 11.06 micrograms/dl) traits, so, although FEP rates are increased in thalassaemia carriers, they are useless in differentiating between the commonest thalassaemic forms in our country. PMID- 2711286 TI - [Evaluation of erythrocyte deformability in carriers of thalassemic trait with the Hanss' hemorheometer]. AB - Red-cell deformability was assessed with the Hanss' haemorheometer in 63 carriers of the thalassaemic trait (20 beta and 43 delta beta). Impaired deformability (rigidity index 10.5 +/- 1.4) was present in 80% of the carriers of both beta- and delta beta-traits, as compared with a control group (rigidity index 8.7 +/- 0.6). No correlation was found between such indices and several parameters capable of influencing upon red-cell deformability, namely, MCV, MCH, RDW and MDA. The possibility of any impairment of lipid compounds in red cell membrane is suggested as a cause of decreased deformability in thalassaemia carriers. PMID- 2711287 TI - [Absence of fibronectin in a 40-day-old child who died as a result of septicemia with disseminated intravascular coagulation]. AB - A new born infant who died when he was 40 days old, after urinary infection, septicemia and disseminated intravascular coagulation (DIC) is reported. The concentration of fibronectin (FN) was undetectable (less than 1.1 mg/dl). His mother and one sister had also decreased levels (19 and 19.5 mg/dl), although inside normal limits, when they were compared to simultaneously studied normal controls (27 +/- 8). There were not infections, coagulation disturbs neither keloid scars in the family. A patient cousin also died at the first days of life. The deficiency of our case was much more important that FN levels found in 23 children with sepsis and DIC (range 6-38 mg/dl), therefore it is possible he had a primary deficiency. The investigation of FN levels in all newborns with severe infections or other disturbs is recommended, since these patients could be benefit from purified FN or cryoprecipitate therapy. PMID- 2711288 TI - [Bone marrow biopsy and sarcoidosis]. PMID- 2711289 TI - [Emergency treatment of idiopathic thrombocytopenic purpura]. PMID- 2711290 TI - [High doses of ARA C in the treatment of acute leukemia]. PMID- 2711291 TI - A look at very early retirees. PMID- 2711292 TI - Net worth and financial assets of age groups in 1984. PMID- 2711293 TI - Comparative analysis of retroperitoneal and transperitoneal aortic replacement for aneurysm. AB - Transabdominal aortic replacement is the most widely accepted surgical approach in the treatment of infrarenal abdominal aortic aneurysms (AAA) with an enviable mortality rate of 2 to 5 per cent. This approach, however, is attended by significant intraoperative loss of fluid and subsequent translocation as well as impaired postoperative pulmonary function and ileus. Although the retroperitoneal exposure of the aorta was used for the first repair of an AAA by Dubost and has been championed more recently by others, it has not been widely accepted. Experience suggests, however, that the exposure is as good and that postoperative morbidity is significantly less than that with the transperitoneal approach. In the past five years, we have surgically treated 299 AAA, 106 by the transabdominal route and 193 by the extended retroperitoneal approach. In 133 of the 193 patients upon whom the retroperitoneal approach was used, the aneurysm was left intact after division of the infrarenal aorta for an end to end proximal anastomosis of an aortoaortic to iliac to femoral bypass. There has been a significant reduction in the intraoperative replacement of fluid and blood, in postoperative respiratory support, in length of time in the intensive care unit and in occurrence of postoperative ileus when compared with the transabdominal endoaneurysmorrhaphy approach. Furthermore, the exposure, particularly upon the obese patient, is superior. Findings from this experience using the retroperitoneal approach for repair of AAA indicate that it results in less over all physiologic disturbance of the patient. PMID- 2711294 TI - Temporary elevation of CA 125 after abdominal surgical treatment for benign disease and cancer. AB - Analyses of preoperative and one to seven day postoperative determinations of CA 19-9, carcinoembryonic antigen (CEA) and CA 125 levels in 873 patients indicate that postoperative CA 19-9 and CEA serum levels were within the expected technical variance of the preoperative assay values in patients who were considered to have negative findings (below the reference value) from these tests preoperatively. If the test results were preoperatively positive in patients with cancer, they decreased postoperatively to or below normal reference values, unless the operation was palliative and significant tumor removal was not possible. For patients with a preoperative positive CA 125 level (greater than 35 units per mililiter), the postoperative serum levels were comparable with the CEA and CA 19-9 result. However, when the preoperative CA 125 level was within normal limits, 62 per cent of the patients had postoperative elevations, often to levels of less than 35 units per milliliter. Sequential postoperative determinations of CA 125 in 21 patients revealed that maximum levels of CA 125 were seen about two to four hours after the operation and that elevations persisted for as long as three months. Inferential evidence suggests that postoperative increases in serum CA 125 occur from incision and healing of the peritoneum and omentum by de novo synthesis of this antigen rather than shedding from tissues. Patients with CA 125 negative results and with carcinoma of the ovary having postoperative increases of this antigen within two months of the operation may pose a difficult problem in interpretations, and such patients require further investigation. PMID- 2711295 TI - Carney's complex of primary pigmented nodular adrenocortical disease and pigmentous and myxomatous lesions. AB - A complex of primary pigmented nodular adrenocortical hyperplasia associated with myxomatous masses and pigmented lesions of the skin was recently described by Carney. Herein, we describe three patients with Carney's complex seen at our institution. Two patients presented with Cushing's syndrome and one patient with atrial myxoma. The diagnosis was revealed in all three because of an awareness of the disease in association with primary adrenocortical hyperplasia. Because Cushing's syndrome and atrial myxomas are life-threatening components of the disease and can occur metachronously, an early diagnosis in combination with the appropriate treatment is mandatory, and follow-up measures should be taken to define the natural course of events in the disease. PMID- 2711296 TI - Management of gallstone pancreatitis during pregnancy and the postpartum period. AB - In a 22 year study, 21 women had acute pancreatitis develop during pregnancy (11 women) or within six weeks post partum (ten women). Gallstones were the cause of the pancreatitis in all. Operation during the acute attack of pancreatitis was required in only two. Acute pancreatitis subsided in the remaining 19 patients; they were operated upon during the second trimester or the early postpartum period. During pregnancy, surgical treatment for gallstone pancreatitis should consist of cholecystectomy and exploration of the common bile duct without operative cholangiography. During the postpartum period, operative cholangiography is used to determine whether or not exploration of the common bile duct is necessary. Acute pancreatitis associated with pregnancy is "gallstone" pancreatitis; there is no evidence that pregnancy is a specific etiologic factor in pancreatitis. As opposed to nonoperative treatment of symptomatic gallstone pancreatitis in pregnancy, which is accompanied by maternal morbidity or fetal mortality, surgical treatment during the optimal time of the second trimester or early postpartum period was associated with no maternal morbidity or fetal mortality and no recurrent pancreatitis. PMID- 2711297 TI - Metabolism of D lactate in patients receiving hypertonic sodium lactate solution. AB - The use of hypertonic saline solutions for resuscitation of patients with a decreased extracellular fluid volume is generating more clinical interest. One of the solutions, hypertonic lactated Ringer's solution (HLS), contains lactate in both the D(-) and L(+) forms. Because humans lack D lactate dehydrogenase, the metabolism of D lactate in patients receiving large amounts of lactate in a clinical setting was examined. Three patients undergoing extensive aortic surgical procedures and receiving HLS for replacement of perioperative fluid loss were studied. These patients were given an average of 27 grams of D lactate in a 24 hour period and excreted 8 per cent of the total dose in the urine. The average maximum elevation of D lactate in the serum of 3.53 millimoles per liter. Pharmacokinetic analysis revealed a half-life of D lactate in the serum of 36.4 minutes. The volume of distribution was 20 per cent of the body weight. These results demonstrate that D lactate is metabolized rapidly even when given in large amounts to humans during the perioperative period. Whether or not this metabolism occurs during hypoperfusion is not known. PMID- 2711298 TI - Technical considerations in distal pancreatectomy with splenic preservation. AB - Splenic preservation may be attempted when distal pancreatectomy is performed for nonmalignant disease. The splenic artery and vein can be preserved with meticulous control of the multiple small, thin-walled branches that tether these vessels to the pancreas, allowing splenic salvage. Mobilization of the spleen into the operative field, ligation of the short gastric vessels and splenectomy are not performed. Thus, the operative procedure may be accomplished in carefully selected patients with little increase in operative time or blood loss over conventional distal pancreatectomy with splenectomy. PMID- 2711299 TI - Use of Cavitron surgical aspirator for debulking of diaphragmatic metastases in patients with advanced carcinoma of the ovaries. PMID- 2711300 TI - Avoidance of injury to the left hepatic duct during parenchymal dissection for hepatic trisegmentectomy. AB - A simplified and safe technique is described herein for the dissection of the feedback structures to the medial segment of the left lobe, while preserving the integrity of the remaining left hepatic bile duct during the dissection for right hepatic trisegmentectomy. This is accomplished by passing a biliary probe into the main left hepatic duct from the stump of the right hepatic duct. Use of this technique during the performance of a hepatic trisegmentectomy expedites the hepatic dissection and decreases the potential for intraoperative injuries of the remaining bile duct to the lateral segment of the left lobe of the liver. In addition, irrigation of the left hepatic bile duct through the open right duct stump may demonstrate leakages of bile that may be repaired, leading to a decreased over-all morbidity in the subsequent postoperative period. PMID- 2711301 TI - The concepts, procedures, and problems related in endoscopic laser therapy of early gastric cancer. A retrospective study on early gastric cancer. AB - We report 34 cases of early gastric cancer in which endoscopic laser therapy was performed at the Kitasato University Hospital. The problems encountered were the size and location of the tumor, the presence of lymphatic metastasis or concomitant disorders, and technical problems associated with the irradiation procedure. Of the 34 cases, 22 cases were considered as completely cured (no malignancy was detected after laser therapy), 11 cases were incompletely cured (malignant cells were detected after laser therapy), and 1 case was undetermined. PMID- 2711302 TI - Endoscopic sclerosis of the cardia affects gastroesophageal reflux. AB - Gastroesophageal reflux disease remains a disorder of unknown etiology associated with abnormal function of the lower esophageal sphincter (LES) and other physiological co-factors of the pathologic reflux. Effective operations for reflux are designed to reinforce the anti-reflux barrier and alter the tendency towards abnormal reflux. We have postulated that the most important component of these procedures is the prevention of distraction of the lowermost components of the LES at the onset of a potential reflux episode. Distraction of the LES causes shortening of the effective sphincter mechanism and can initiate experimental reflux events. In this study we used endoscopic sclerosis of the submucosal space at the cardia as a means of reducing distraction of the cardia in the hope that this would reduce abnormal reflux events. Canine gastroesophageal reflux was induced by intravenous atropine and monitored by continuous esophageal pH monitoring. Sclerosis of the cardia prevented gastroesophageal reflux, without measurable effect on the LES pressure or length. Endoscopic sclerosis of the cardia may be a useful technique in the control of human gastroesophageal reflux. PMID- 2711303 TI - Safety of endoscopy in the immediate postoperative period following gastric anastomosis. AB - The safety of gastrointestinal endoscopy in the immediate postoperative period following partial gastrectomy was assessed in ten dogs. Endoscopy was performed preoperatively and at 1, 2, 3, and 7 days postoperatively. The mean pressures required to perform an adequate endoscopy varied from 17 to 20 mm Hg. Following partial gastrectomy, the abdominal wall was closed with a zipper to facilitate inspection of the gastric anastomosis. No leakage of air or intra-abdominal abscesses were seen following endoscopy. The results of this study suggest that endoscopy can be safely performed in the immediate postgastrectomy period. PMID- 2711304 TI - Endoscopic decompression in "toxic megacolon". AB - Endoscopic decompression of the bowel in "toxic megacolon" is presented in two cases as an alternative procedure to Turnbull's technique using multiple bowel fistulas. In our opinion this technique seems to be a substantial improvement in the treatment of "toxic megacolon" and may even help to prevent ileotomy-colotomy in some cases. PMID- 2711305 TI - Colonoscopic treatment of sigmoid volvulus. AB - Sigmoid volvulus commonly presents with signs of bowel obstruction. In the absence of an exact preoperative diagnosis, these patients have to undergo urgent surgery. We report a case of sigmoid volvulus diagnosed radiologically and managed by endoscopic derotation. When the cause of the obstruction is known to be due to sigmoid volvulus, surgery can be avoided by careful endoscopic derotation of the sigmoid colon. PMID- 2711306 TI - Predictive value of visual evoked potentials in unilateral optic nerve injury. AB - Forty-five patients with posttraumatic unilateral blindness were prospectively analyzed. The computed tomography scan was normal in all and an optic canal fracture was recorded in only one patient. Visual evoked potentials were performed within 48 hours of initial evaluation and repeated within 7 to 10 days. Five patients had normal visual evoked potentials and 15 patients had abnormal responses. No visual evoked potentials were recorded in 25 patients. Five patients with normal visual evoked potentials had good visual recovery. Thirteen of the 15 patients with abnormal responses also showed significant visual improvement. This study showed that positive visual evoked potentials were reliable in predicting the visual outcome; 90% of the patients with positive visual evoked potentials had complete or partial visual recovery. PMID- 2711307 TI - Changes in cerebral hemodynamics following encephalo-duro-arterio-synangiosis (EDAS) in young patients with moyamoya disease. AB - To evaluate the effect of encephalo-duro-arterio-synangiosis, (EDAS), we obtained follow-up angiograms and measured regional cerebral blood flow in 21 young patients with Moyamoya disease. Carotid fork stenosis continued to progress after EDAS, although angiography demonstrated a marked increase in the number of middle cerebral artery branches via implanted arteries. Preoperative cortical blood flow was lower than normal. The post-EDAS increases in hemispheric and cortical flow were significant in patients with transient ischemic attacks, but not in patients with infarction. The increase in cortical flow at the site of EDAS was first noted 2 weeks after EDAS. PMID- 2711308 TI - Spinal cord blood flow measured by 14C-iodoantipyrine autoradiography during and after graded spinal cord compression in rats. AB - The relations between degree of thoracic spinal cord compression causing myelographic block, reversible paraparesis, and extinction of the sensory evoked potential on one hand, and spinal cord blood flow on the other, were investigated. This was done in rats using the blocking weight-technique and 14C iodoantipyrine autoradiography. A load of 9 g caused myelographic block. Five minutes of compression with that load caused a reduction of spinal cord blood flow to about 25%, but 5 and 60 minutes after the compression spinal cord blood flow was restored to 60% of the pretrauma value. A load of 35 g for 5 minutes caused transient paraparesis. Recovery to about 30% was observed 5 and 60 minutes thereafter. During compression at a load of 55 g, which caused almost total extinction of sensory evoked potential and irreversible paraplegia, spinal cord blood flow under the load ceased. The results indicate that myelographic block occurs at a load which does not cause irreversible paraparesis and that a load which permits sensory evoked potential to be elicited results in potentially salvageable damage. PMID- 2711309 TI - Prophylactic anticonvulsants for prevention of immediate and early postcraniotomy seizures. AB - Phenytoin (15 mg/kg) was administered intravenously to 189 patients shortly before their intracranial, supratentorial surgery was completed. Intravenous phenytoin of 5-6 mg/kg/day in three divided doses was administered daily for the first 3 postoperative days. Therapeutic serum levels (10-20 micrograms/mL) were achieved in 113 (59.8%) patients. An equally constituted, randomized control group of 185 patients received a placebo under identical conditions. The group receiving phenytoin had only one immediate and two early postoperative seizures. The 185 controls had four immediate and nine early postoperative seizures. None of the follow-up computed tomography scans of the patients with seizures showed postoperative hematoma. One patient had a significant tension pneumocranium, a possible cause of postoperative seizures. To avoid a decrease in the serum anticonvulsant level due to intraoperative blood loss, it is suggested that for patients who need an urgent or emergent craniotomy, prophylatic anticonvulsant medication should be given at least 20 minutes before completion of wound closure. PMID- 2711310 TI - Malignant transformation of recurrent meningioma with pulmonary metastases. AB - A patient presented with a histologically benign intracranial meningioma which, after multiple recurrences, underwent malignant transformation. The patient survived 18 years following initial presentation. Pulmonary metastases were present over the final 8 years. Eleven subtotal resections of the meningioma were performed, including exenteration of the right eye and a thoracotomy. Radiation therapy and chemotherapy were relatively ineffective. The problem and treatment of recurrent meningiomas is briefly reviewed. PMID- 2711311 TI - Cerebellar hemangioblastoma and primary hyperparathyroidism. AB - The authors report the case of a 52-year-old woman presenting with cerebellar hemangioblastoma and primary hyperparathyroidism. It is the second reported case involving this new association. The relationship between these two tumors is discussed. PMID- 2711312 TI - Multiple distinct intracranial tumors: association of pinealoma and craniopharyngioma. Case report. AB - We report the case of a patient with multiple primary brain neoplasms. A pinealoma was treated with radiotherapy and surgical resection in 1983. In 1987, a craniopharyngioma was resected surgically. Various possible determinants of multiple brain tumors have been described in the literature and are discussed. The possibility of an unknown underlying pathologic mechanism predisposing to multiple malignancies must be considered, but we are unable to conclude that this particular occurrence is more than a random chance finding. PMID- 2711313 TI - Adult aqueductal stenosis presenting as double incontinence: a case report with magnetic resonance imaging. AB - An unusual case of adult-onset aqueduct stenosis is discussed. The patient presented with a 3-year history of bowel and bladder incontinence without associated dementia, gait disturbance, headache, visual loss, or hypothalamic dysfunction. The absence of the midportion of the sylvian aqueduct in this patient is verified by magnetic resonance imaging. PMID- 2711314 TI - Intracranial glossopharyngeal neurinomas. Report of two cases with special emphasis on computed tomography and magnetic resonance imaging findings. AB - Two patients with intracranial glossopharyngeal neurinoma are described. In both patients, neurologic signs and findings of conventional radiologic and computed tomography examinations suggested a diagnosis of acoustic neurinoma. Magnetic resonance imaging, however, definitely indicated that the mass had actually arisen from the lower cranial nerves. This was confirmed at operation. The superb sensitivity and specificity of magnetic resonance imaging in the diagnosis of posterior fossa extraaxial mass are emphasized. PMID- 2711315 TI - Extradural nasal and orbital extension of malignant glioma. Case report. AB - A rare case of extradural nasal and orbital extension of malignant glioma is presented. The development of malignant changes was observed during 10 years. The mode of transdural extension was via the olfactory nerve, where it was directly destructive in all four cases that have been reported to date. The biological malignancy of transdurally extending glioma is also described. PMID- 2711316 TI - Pulsatile dysesthesia and an axillary artery pseudoaneurysm associated with a penetrating axillary artery injury. AB - A patient is presented in whom an uncommon subjective complaint of pulsatile dysesthesia (periodic dysesthesias following a radicular pattern and occurring simultaneously with the transmitted pulse) occurred following a gunshot wound to the axilla. The patient's symptoms were relieved by the surgical obliteration of a pseudoaneurysm of the axillary artery. PMID- 2711317 TI - Late hypoglossal nerve palsy following fracture of the occipital condyle. AB - Fracture of the occipital condyle is a rare problem that can easily be overlooked. We report a patient with occipital condyle fracture who was neurologically intact on admission, and who developed hypoglossal nerve palsy in the late posttraumatic period. The diagnosis was facilitated by the aid of computed tomography. PMID- 2711318 TI - Congenital giant pigmented nevus and intracranial arteriovenous malformation. AB - We describe a case with congenital giant pigmented nevus and intracranial arteriovenous malformation. This association should be included in the spectrum of neurocutaneous syndromes related to congenital giant pigmented nevus. PMID- 2711319 TI - Large meningioma of the foramen magnum in a 4-year-old child. AB - The case of a 4-year-old boy with 4 months' history of progressive quadriplegia is presented. The neuroradiological work-up, which included computed tomography scanning and magnetic resonance imaging, showed changes consistent with the diagnosis of a large mass lesion in the area of the foramen magnum. At operation a meningioma was completely excised. There was a gradual and almost complete neurological recovery. PMID- 2711320 TI - Preservation of craniotomy bone flaps under the scalp. PMID- 2711321 TI - Venous angiomas. PMID- 2711322 TI - [Functional anatomy of the upper ankle joint]. AB - The ankle joint is regarded as a hinged joint with a range of motion of about 60 degrees. The shape of the trochlea tali varies, so the axis of rotation and the compensative movements of the fibula do. The ligamentous stabilizers of the medial side are thicker than the lateral ones. At the other hand, the lateral malleolus is more voluminous than the medial one. The lig. fibulotalare ant. is a reinforcement of the joint capsule, the lig. fibulocalcaneare has no connection to the jointcapsule, the lig. fibulotalare post. is partially running through the joint. In neutral- and plantarflexed position, the lig. fibulocalcaneare forms a groove which takes up the tendon sheat of the peroneal tendson. In dorsalextended position the tendons are pushed laterally by the tense ligament. This mechanism supports the peroneal tendon luxation in dorsal extension. PMID- 2711323 TI - [Changes in the skeleton of the middle foot caused by professional classical dancing]. AB - On half and three-quarter points, the most frequent foot positions in dance, the metatarsals form an extension of the lower leg. In 54% of 56 professional male and female dancers whose feet were examined, this extraordinary stress leads to pronounced thickening of the cortex of the second metatarsal and in 6%, of the third metatarsal as well. There are no symptoms. Hypertrophy of the bone occurs in response to the additional stress imposed by dancing. Dancing on points is not the triggering factor, since male and female dancers are equally affected. COMPLICATIONS: Under intensive stress of dancing, pain can develop in the medial portion of Lisfrans joint and endanger the dancer's career. Skeletal scintigraphy in such cases reveals increased metabolism of the bone at the base of the second metatarsal as well as in the cuneiforme intermedium. The development of this overstress on the second ray is favored by the following factors: Primarily by the congenital pes cavus which makes correct stressing of the foot in dancing impossible; a relatively long second metatarsal, or possibly the third metatarsal as well; - by an excessively large antetorsion angle of the neck of the femur, which makes correct positioning of the foot in the five positions of classical dance impossible; - by overstressing the half-points position in teaching, or by unfavorable training conditions, especially floors that are too hard. No treatment of these painful complications is possible if they are caused by anatomical factors. In other cases, several month's rest, changing ballet technique, and improved conditions regarding the ballet floor can result in an improvement. Even then, relapses are not infrequent, however. PMID- 2711324 TI - [Figure skating in high performance sports]. AB - A top performance figure skater is compleled to expose his postural and locomotor system to maximum stress. To achieve the high level of performance that is expected from him, his training schedule must be most exacting. Parallel to this there is an enhanced risk of a sports accident and of damage to health conditioned by sports activities. We report on the results of a study conducted with 67 active and former top performance figure skaters in respect of joint mobility of the lower extremities, sports injuries and damage caused by sports. The type and rate of incidence of sports injuries and sports damage are described and compared with epidemiological data of the average population, the hobby figure skater, and related types of sports. PMID- 2711325 TI - [Muscular imbalance in elite swimmers and the resulting sports damage of the lumbar spine and knee joints]. AB - Elite swimmers often show typical sportspecific lesions, the cause of which is thought to be technical faults, overtraining, or wrong use of training equipment. In order to look for additional causes in the development of these sports lesions, 46 male and female elite swimmers of the 1st and 2nd swimming division (1. and 2. Bundesliga) were examined orthopaedically. Especially by using Janda's "Functional Muscular Diagnostics", specific muscular imbalances can be found. This paper demonstrates a relation between these muscular imbalances and the typical sports lesions of the locomotor system. PMID- 2711326 TI - [Injuries and damage caused by excess stress in body building and power lifting]. AB - A questionnaire, designed to elict information about training programs, experience and injury profile, was administered to 358 bodybuilders and 60 powerlifters. This was followed by a clinical orthopedic and radiological examination. The upper extremity, particulary the shoulder and elbow joint, showed the highest injury rate. More than 40% of all injuries occurred in this area. The low back region and the knee were other sites of elevated injury occurrences. Muscular injuries (muscle pulls, tendonitis, sprains) were perceived to account for 83.6% of all injury types. Powerlifting showed a twice as high injury rate as bodybuilding, probably of grounds of a more uniform training program. Weight-training should be associated with a sports-related medical care and supervised by knowledgeable people, who can instruct the athletes in proper lifting techniques and protect them from injury which can result from incorrect weight-training. PMID- 2711327 TI - [Parosteal osteosarcoma as a cause of chronic knee pain in an athlete]. AB - The present case of a rare, however existing disease, which remained undetected for years, is to underline the necessity of diligent diagnosis. We report about a 23-year-old football player who complained about permanent pain in the right knee from the age of 13. In spite of repeated sports- and orthopedic-specific examinations correct diagnosis could only be established eight years after the onset of the symptoms. Differential diagnosis and the present mode of the therapy of this tumor close to the knee joint are demonstrated. PMID- 2711329 TI - Proceedings of the EORTC-Heavy Particles Therapy Group meeting. European Organization for Research on Treatment of Cancer. Munich, October 16th-17th, 1987. PMID- 2711328 TI - [Osseous avulsion of the opponens pollicis muscle. Case report of a rare injury in skiing]. AB - Two cases in which the M. opponens pollicis was ruptured with a bony fragment are reported. In each case the injury, which occurred in young people (24-29 years of age), was the outcome of a fall during alpine skiing, whereby the hand hit the icy slope. Operative treatment was necessary due to the intense subjective pain which followed a significant thenar hematoma. PMID- 2711330 TI - Radiobiological intercomparisons of fast neutron beams used in therapy. AB - A research program was performed at Louvain-la-Neuve to systematically determine the RBE of fast neutrons for the growth inhibition in Vicia faba bean roots and for the regeneration of the intestinal crypts in mice. The following neutron beams were compared p(75) + Be, p(65) + Be, p(45) + Be, p(34) + Be, d(20) + Be, and d(50) + Be. The RBE-variation as a function of neutron energy is larger for the Vicia faba system than for the regeneration of the intestinal crypt cells. This can be related to the inherent differency of the biological systems, but also to the different dose ranges involved (0.33 to 0.56 Gy and 7.66 to 8.56 Gy, respectively). In the high energy range explored, defined by the reactions p(75) + Be to p(34) + Be RBE varies only between 0.92 and 1.28 for Vicia faba and 0.96 and 1.12 for crypt cells normalized to the p(65) + Be beam. By contrast the RBE at lower energy beams (d(20) + Be and d(14.5) + Be) reaches values between 1.5 and 1.6 Finally fractionation has shown to be likely more important at the high energy beams. PMID- 2711331 TI - Early repair kinetics of intestine and lung in mice, after fast neutron and photon irradiation. AB - Early repair (Elkind repair) kinetics of an early and a late responding tissue after gamma and d(50) + Be neutron irradiation were compared in mice. LD50 at five days after abdominal irradiation and LD50 at 180 days after thoracic irradiation were chosen as biological endpoints to study intestinal and lung tolerance, respectively. Elkind repair is assessed from the additional dose Dr to reach LD50 when a single dose Ds is split into two equal fractions Di separated by time intervals "i" ranging from 0 to 24 hours (Dr = 2Di-Ds). Dr is greater for lung than for intestine after both gamma and neutron irradiations. Our data are consistent with an exponential early repair with an half-life (T 1/2) of 0.5 h for intestine and 1.5 to 2 h for lung. PMID- 2711332 TI - Biological effectiveness of neutrons and pi-mesons in gut, bone, and transplantable tumours. AB - At the Munich RENT-facility a screening project was performed to define the biological characteristics of a fission neutron beam envisaged for radiotherapy. The quantitative endpoints used were jejunal crypt survival, late rectal stenosis in rats, osseous healing in traumatized rat femur and regrowth delay of murine transplantable tumours. The results obtained in normal tissues (with the possible exception of bone) demonstrate a high RBE, in accordance with the well documented dependence of RBE on neutron energy. The RBE-values measured in tumours after single dose treatment endorsed the high effectiveness, although--as has been the case with other beams--they gave no conclusive evidence of a therapeutic advantage. Nevertheless, the specific beam characteristics, i.e. a high RBE at the surface and a fast decline of the biologically effective depth dose suggest possible advantages of the RENT beam when applied in the treatment of selected superficial tumours. PMID- 2711333 TI - Response of the R3327-AT1 Dunning prostate tumor to fast neutrons and cobalt-60. AB - Reasons why neutron therapy may be successful include tumor's rate of proliferation, state of oxygenation at time of onset of radiation and the efficacy of reoxygenation during therapy, inherent radioresistance and repair capacity. In an effort to better understand the action of neutrons on tumor tissues we started studies with the Dunning rat prostate tumor system. This tumor system has sublines available with differing histologies, doubling times, hormone dependency and metastatic potential. The present report pertains to anaplastic carcinoma R3327-AT1 subline. The tumors transplanted into the distal thigh received single doses of 8 through 15 Gy of 14.5 MeV neutrons and 18 through 30 Gy Co-60 after they had reached a volume of about 450 mm3. The tumors exhibited a dose dependent retardation in further growth. An RBE of 3 was estimated by comparing the time required for a tumor to reach a normalized value of five times the initial treatment volume. We plan to extend our studies to include a slower growing well differentiated subline. PMID- 2711334 TI - Tolerance of spinal cord, lung and rectum after fractionated pions and X-rays. AB - The chronic and late effects of fractionated negative pi-mesons (pions) and X rays were investigated in rat spinal cord and rectum, and in mouse lung. Range modulated pions with a 6 cm Bragg peak were used at an average dose-rate of 0.2 Gy/min. Control studies were performed with 250 kV or 300 kV X-rays. The following functional and histological endpoints were used: paralysis and white matter necrosis after spinal cord irradiation, ulceration and fibrosis of the rectum, breathing frequency and pneumonitis after lung irradiation. The presence of a large low-LET component was reflected by a significant dose-rate effect for spinal cord and lung. This resulted in RBE values smaller than unity for single doses, since the reference X-irradiations were done at high dose-rate. For small fraction sizes and short exposure times the influence of the dose-rate is insignificant. The RBE values at pion doses of 1 to 2 Gy per fraction were found to be not higher than 1.5 for all tissues studied. These values are similar compared to published data for acute effects. This is in contrast to the effects of neutrons, which in general show higher RBE's for late effects. It can be concluded from our studies that the radiobiological characteristic of pions in a spread Bragg peak are influenced by the low-LET component of the beam. Unlike with neutrons, there are no significant differences between the RBE values for late and acute effects. PMID- 2711335 TI - Variation in neutron (42 MeVd-Be) RBE with dose/fraction for early and late reactions in the normal tissues of the pig. PMID- 2711336 TI - Cytometry, a possible tool for assessment of tumor response. PMID- 2711337 TI - Neutron therapy at Hammersmith Hospital 1970 to 1985. A re-examination of results. AB - Since the Hammersmith cyclotron was removed, the earlier therapy results have been extensively re-examined. The overall experiences can be summarized as follows: 1. A total neutron dose of 1560 cGy given in twelve equally spaced fractions over 20 days seems to be the optimum. Neutrons, therefore, provide a treatment option with great advantage with respect to patient management. 2. Rapid tumour regression is an important often ignored effect, leading to a quick relief of pain and other serious symptoms in the patient. 3. Due to the high incidence of complete regression complicated surgery can be avoided in many cases. Tissue deficits can be often covered by modern methods of surgery repair. 4. Local control rates are as high as 60 to 80% of the advanced tumours. They improve the quality of life and reduce the cost of continuing patients' care. PMID- 2711338 TI - First experiences with fission neutrons in the radiation therapy of cancer patients. AB - 16 patients have been treated until October 1987 at the mixed reactor beam of the RENT-facility in Munich-Garching. All of them received a single dose of 200 to 250 cGy after complete conventional radiotherapy and in same cases also surgery because of the lack of complete tumor resection or local tumor control after radiation control. The ages ranged from 40 to 84 years. The follow-up amounted between two and 28 months, 8.5 months on the average. The tumors selected appeared to be particularly suitable because of their growth in poorly perfused tissues, after the previous surgery and/or radiotherapy. All cases are briefly reported. The general experience from the very limited study is promising. The local effects to the tumor tissue so far are impressive. No severe side effects which could be related to the RENT-session were observed until now. PMID- 2711339 TI - Neutron therapy of soft tissue sarcoma at Louvain-la-Neuve (interim results 1987). AB - The results of fast neutron therapy of soft tissue sarcoma at the cyclotron of Louvain-la-Neuve are reviewed. 75 patients were analysed, the follow-up ranged from six to 102 months (mean: 30.7 months). 47 patients were treated after radical surgery. A local control rate of 91.5% (43/47) was achieved, and 70% of the patients are alive. 28 patients were irradiated with gross tumour present at the time of neutron therapy (recurrence, incomplete resection, inoperable): a local control was achieved in 5/28 cases (18%), and 68% of the patients are alive. A complication rate of 16% was recorded which was directly related to the treatment volume. PMID- 2711340 TI - Neutron therapy of soft tissue sarcomas and status report from the Radiotherapy Department of the Hamburg University Hospital. AB - After change of management at the Radiotherapy Department of the University of Hamburg also a change in treatment policy resulted. Of 72 patients treated since then 63 had soft-tissue sarcomas (at 83 localisations) and 13 adenoid-cystic carcinomas, only ten were treated for other indications. Neutrons only were applied in contrast to many boost applications in the past. The total doses administered were between 13.6 and 16 Gy and the doses per fraction between 0.8 and 1.2 Gy depending on tumor mass and localisation. To compare the treatment modalities all earlier treated patients with soft tissue sarcomas were reexamined and the results critically compared to earlier reported ones. There were considerable differences in the side effects found now and reported earlier. Moderate or severe fibrosis was found in 13% of the cases who received less than 13.4 Gy and in 54% of the cases who received a higher total dose. In the new series up to now only in 15 cases local recurrences and in eleven cases distant metastases occurred. Nothing can be yet said on the late effects. PMID- 2711341 TI - Comments about the late effects of fast neutron therapy at the Hamburg University DT generator. PMID- 2711342 TI - Neutron therapy of low grade "pencil" gliomas of the spinal cord: a review of ten cases. AB - Between 1980 and 1986 ten patients (two males, eight females, median age: 35 years) with spongioblastomas and ependymomas grade I of the spinal cord were treated with fast neutrons from the d(14) + Be reaction after incomplete tumour surgery. Eight patients received three weekly fractions of 0.7 to 1.33 Gy and two patients four weekly fractions of 0.8 Gy to total doses of 7.4 to 10.4 Gy. Two complete and six partial remissions of ataxia and motor disturbances were observed. Bladder dysfunctions in five patients cleared up partially in three cases. In two patients the symptomatology remained unchanged. After a follow-up of eight to 88 months two initially complete and two out of six partial remission were maintained. No severe late effects of the skin have been determined. In summary it is concluded that for incompletely resected "pencil"-gliomas fast neutron therapy seems to be a feasible treatment modality. PMID- 2711343 TI - High energy neutron therapy programme at the Douglas Cyclotron Centre, Clatterbridge Hospital. AB - Preliminary results are reviewed on the outcome of patients treated within two randomized studies with either p(60) + Be-neutrons or photons. Since April 1987 67 patients have been treated of which twelve have been included in a randomized study on head and neck cancer and 40 on pelvic cancer. The clinical treatment planning is presented in detail and discussed. The results presented are considered to be very preliminary, so that no attempt has been made to analyse and discuss them in detail. PMID- 2711344 TI - Combined neutron-photon-therapy of locally recurrent rectosigmoidal tumors. AB - 21 patients with unresectable recurrent adenocarcinoma of the rectum were treated with combined photon-neutron radiation therapy. 40 Gy photon were given to the whole pelvis followed by a boost field of 6.6 or 10 Gy utilizing 14 MeV monoenergetic neutrons. The latter was given with an arc therapy technique whereby the dose output fluctuations normally encountered during gantry rotation were compensated for by a computer guided system. All patients had severe pain symptoms before therapy. Twelve patients had a full remission of the symptoms and nine reported considerable relief of pain during follow-up examination. In three patients, further pain symptoms developed after six, seven, and nine months due to renewed tumor progression. In spite of the relative high neutron doses applied, side effects with the arc-technique remained minimal and did not exceed those encountered with photon therapy alone. Although the total follow-up time is relatively short at a maximum of 20 months, with a mean time of 8.5 months, the preliminary results so far are extremely optimistic leading us to further pursue the study. PMID- 2711345 TI - A method for selective evaluation of the effectiveness of fast neutrons in radiotherapy. AB - A methology is proposed for extracting and analyzing specific fast neutron effects on radiotherapy. This should be applied to the 1,500 patients treated at NIRS, Chiba in the past ten years. As the patients have been treated with different modalities based on generally combined radiation or neutron boost techniques at first the biologically equivalent doses per fraction for the photon and neutron component according to the Ellis concept were derived. In a second step treatment parameters, as the dose components and total dose as well as diagnostic parameters (tumor typing, grading and staging) will be related to the clinical outcome (survival, local control etc.). This may be done by multivariate discriminant or survival analysis. PMID- 2711346 TI - Recent developments in neutron capture therapy. AB - The conditions for the possible initiation of clinical trials with neutron capture therapy at a number of locations in the U.S. is reviewed. There are several new technical developments or plans at the Brookhaven Medical Research Reactor (BMRR), the Power Burst Facility (PBF) at INEL, the Massachusetts Institute of Technology Reactor (MITR) and the Georgia Institute of Technology Research Reactor (GTRR). Emphasis is on the development of epithermal beams for the treatment of deepseated tumors with neutron fluxes in between 10(9) to 10(10) n/cm2s. Therapeutic dose gains, defined as the ratio of tumour dose to maximum normal tissue dose in the treatment volume are expected to be between 2 and 4, depending on the degree of suppression of fast neutron dose. Boron concentrations considered in this case in the tumour are around 35 micrograms 10B/g and tumour/normal tissue concentrations are around 10. The compound development throughout three generations is discussed. The compound proposed nowadays, Na2B12H11SH (or BSH), employed in the treatments in Japan, will likely be replaced in the future by analogous of biomolecules being enriched in the tumour by physiological pathways. Examples are p-boronophenylalanine or boronated porphyrius. The most promising solution envisaged would be the employment of tumour cell specific brononated monoclonal antibodies. Finally the mode of therapy is discussed which will likely be based on a fractioned scheme, to achieve optimized results. PMID- 2711347 TI - Popping eyes. PMID- 2711348 TI - Government playing hardball on MD antitrust activity. PMID- 2711349 TI - Sclerosing cholangitis and oxalate urolithiasis in ulcerative colitis. AB - We report a 56-year-old man with sclerosing cholangitis and oxalate urolithiasis. These complications occurred five years after proctocolectomy and ileostomy were performed for ulcerative colitis. Two years before, at the time of proctocolectomy, there was no clinical or biochemical evidence of liver abnormality. The occurrence and progression of sclerosing cholangitis five years after proctocolectomy is unusual. Also unusual is the occurrence of oxalate urolithiasis; more common in ulcerative colitis, especially after ileostomy, are uric acid stones. PMID- 2711350 TI - Encouraging trends in lung cancer mortality in Texas, 1970 to 1986. AB - Trends in lung cancer mortality among white and black men and women in Texas for the years 1970 to 1986 offer some measure of optimism. A decline in mortality for men and women aged 35 to 44 years and for men aged 45 to 54 years is now evident. However, the rates in older men and women continue to rise. Following a long trend of ascending death rates, a plateau in the overall age-adjusted death rates among white men is now suggested. A similar decline for women will probably not be evident until early in the next century. These patterns are consistent with profound changes that have occurred in the prevalence of cigarette smoking over the past 30 years. It is urgent to maintain the momentum by emphasizing smoking cessation and prevention programs. PMID- 2711351 TI - The federal antitrust laws--a primer for physicians. PMID- 2711352 TI - Multivariate measures of similarity and niche overlap. AB - Niche overlap measures are used to assess the similarity in resource use by two species. Recently researchers have used niche overlap measures as summary measures and for making inferences, typically about competition for resources. The problem of estimating niche overlap when the niches are multivariate normal distributions with equal covariance matrices has previously been studied. In this work, the assumption of equal covariance matrices is relaxed. Two general measures of similarity are evaluated assuming general multivariate normal distributions. Commonly used measures of overlap are given as special cases of these two general measures. The question of bias in estimating these measures is discussed and shown to be a potential problem, especially when there are many redundant variables or if sample sizes are small. PMID- 2711353 TI - [Blood collection in pigs]. AB - Reasons for and methods of collection of blood in pigs are reviewed. The best method is punction of the external jugular vein after correct fixation of the animal. A number of instances of materials used in various age groups are presented. Finally, possible complications following collection of blood are summarised. PMID- 2711354 TI - [Pyometra in an ovariectomized cat following treatment with proligestone]. AB - A nine-year-old cat was presented for a purulent vaginal discharge which had been present for five months. She had been ovariectomised at the age of one; for the last two years she was treated with proligestone because of a dermatological condition. A pyometra was found to be present on laparotomy. PMID- 2711355 TI - [What should the therapy be in a horse with a cough?]. PMID- 2711356 TI - [Genetic manipulation of agricultural domestic animals. High time for a broad social discussion]. PMID- 2711357 TI - [On the way to an optimal system of meat inspection for slaughtering pigs]. AB - A brief historical review of meat inspection is followed by a discussion of the objectives of meat inspection and the possibility of achieving an optimum form of inspection. In the EC system of meat inspection no requirements with respect to information supplied by the farmer are incorporated. The current system of meat inspection is based on relatively rigid legal requirements. Particularly, examination of meat for veterinary drug residues may involve difficulties in testing and give rise to financial problems. Assuming the producer of slaughtered animals to be the first to be responsible for the wholesomeness and the quality of the products delivered, he should also have the opportunity to bear this responsibility. However, this responsibility should be rewarded. A method by which a warranted system of meat inspection could be built up in addition to the regular EC system of meat inspection is suggested. PMID- 2711358 TI - [A case of nitrite poisoning in hens of medium weight laying parent stock]. AB - As a result of a combined high temperature, almost complete calm, very limited ventilation, which was due to the secluded location of the poultry house, nitrite (NO2) poisoning occurred in the medium heavy layer parent stock. Nitrite and nitrate (NO3) had formed on and in hanging drinking containers, as NH3 dissolved in the drinking water and was converted into nitrite and nitrate. The feed intake decreased from 125 grams (ad libitum) to +/- 15 grams daily per bird. Egg production was reduced from 78 per cent to 0.5 per cent. Poisoning was associated with mortality of the hens. later on, the birds recovered completely. PMID- 2711359 TI - [Lumbosacral epidural anesthesia in dogs]. AB - The technique of epidural anaesthesia is described in the present paper. In addition, the relationship between external features and the dosage of the local anaesthetic was studied. In this study, epidurography was used to visualise the cranial extension of the anaesthetic solution in the vertebral canal. It is concluded that the most reliable parameter is the length of the spinal column. Cases in which the use of epidural anaesthesia is indicated, are stated. PMID- 2711361 TI - [Ethics in veterinary medicine and animal experiments]. PMID- 2711360 TI - [Can the treating veterinarian do a necropsy against the owner's will?]. PMID- 2711362 TI - [Atrophic rhinitis: assessing the length of swine heads in the slaughtering line up in determining the incidence and degree of conchae atrophy]. PMID- 2711363 TI - [The Veterinary Service Board. Internal market (1992). Care for a healthy free traffic in animals and animal products]. PMID- 2711364 TI - [Growth stimulation and growth treatment in patients with cleft lip, jaw and palate]. AB - Both in animal-experimental and in clinical research it has been demonstrated that early, extensive surgery on cleft palate patients has a growth inhibitory effect. Study of skulls of non-operated cleft palate patients seems to confirm this experience. A method of conservative, multidisciplinary treatment of cleft palate patients for which the application of the 'growth stimulator' is essential, is described briefly. During 18 years experience has been obtained with this therapy. It is very important that treatment starts as soon as possible after birth. After the introduction of the treatment method as described the number and the severity of the anatomical deviations in the nasomaxillary complex has been reduced considerably. In literature the incidence of crossbite is often chosen as the criterion for the mutual comparison of the results of cleft palate therapies. Patients treated with 'growth stimulators' show more than 50% less crossbite than groups of patients treated with other methods as described in literature. PMID- 2711365 TI - [Ritalin: a stimulating drug in the treatment of children with minimal brain dysfunction (MBD)]. AB - Children with Minimal Brain Dysfunction (MBD) are vulnerable in society. Therapy consists of a combination of behaviour modification techniques, function training, psychotherapy, family therapy and counseling of parents and teachers. This way of treatment is not appropriate for all children with MBD. Some of them need additional therapy with a psychotropic drug e.g. methylphenidate (Ritalin). We describe a procedure to establish, whether Ritalin improves the therapeutic impact in a specific child. Eight children enrolled the program. In seven Ritalin improved the therapeutic possibilities for a longer period of time. The dose for an optimal therapeutic effect varied individually, and was relatively low (0.4 0.8 kg/kg/dg). The hypothesis concerning the effect of psychotropic drugs in MBD and the pharmacological properties of Ritalin are discussed. We believe this procedure to be applicable in any multidisciplinary setting, experienced with behavioural and learning problems in childhood. PMID- 2711366 TI - [The aluminum level of infant food; effect of the preparation method. Consequences in kidney dysfunction?]. AB - Stimulated by reports in literature concerning high aluminium content of human milk formulas, ten Dutch formulas were investigated. The aluminium content appeared to be rather low. Conventional home preparation induced a pronounced rise of aluminium content (3 to 100 fold). Even in this way prepared, milk formula is safe. PMID- 2711367 TI - [Neonatal hemangiomatosis with prolonged icterus]. AB - A six week old girl with multiple cutaneous haemangiomas and cholestatic jaundice is described. An exploratory laparotomy revealed neither extra- nor intrahepatic biliary atresia. The diagnosis of a diffuse neonatal haemangiomatosis was made. Prednison therapy induced an almost complete normalization of the liverfunction disturbances. Surgical therapy is not the recommended approach for neonatal haemangiomatosis with cholestatic jaundice. PMID- 2711368 TI - [A loud second heart sound]. AB - When a loud second heart sound is heard in a child, the possibility of pulmonary hypertension must be borne in mind. The second heart sound is also loud in patients with congenitally corrected transposition (CGT) because of the anterior position of the aortic valve. Therefore, it is difficult to distinguish the relatively rare isolated CGT from cardiac disease with high pressure in the pulmonary artery. We discuss this diagnostic problem on the basis of a two year old boy with a loud second heart sound. PMID- 2711369 TI - Haplotypes bearing HLA-A, -B, and -DR: Bf and C4 genes in rheumatoid arthritis families. AB - We have compared haplotypes bearing HLA-A, -B, -DR; Bf and C4 genes in 54 rheumatoid arthritis (RA) and 24 control families. There was no statistically significant differences in C4A or C4B gene frequencies between RA and control groups, although there were trends for C4B*Q0 to be reduced and C4B2 to be increased in DR4 positive RA compared with DR4 positive controls. The lack of any strong association between C4 variants and RA overall makes it unlikely that the association between RA and genes within the MHS represents a direct effect of variants within the C4A or C4B loci themselves. On comparison of DR4-bearing haplotypes, the haplotype B15-BfS-DR4 was increased fourfold and the B44-Bfs-DR4 haplotype was less frequent in the RA group. When C4 variants were also considered, the haplotype B44-C4B*Q0-C4A3-BfS-DR4 was nine times less frequent in RA patients than in controls. The observation that different DR4 bearing haplotypes may confer either increased or decreased susceptibility to RA suggests either that it is unlikely that DR4 itself is involved in the disease process or that specific haplotypic combinations are important. Thirty-two RA patients were HLA-DR4 negative. No single DR4 negative haplotype was found to confer significantly increased susceptibility to RA. PMID- 2711370 TI - Recombinations in the HLA system. PMID- 2711371 TI - Definition of the HLA-Aw43 antigen. AB - The HLA antigen Aw43 has been observed only in Southern African populations. In order to confirm its identity and clarify its definition, ten cells with this specificity were shipped to laboratories in England, the United States of America and Australia to be tested with the sera from the 10th International Histocompatibility Workshop. The results of tests on nine of these cells which were sufficiently viable indicated that HLA-Aw43 is a distinct serological specificity which could be distinguished from both the A10 cross-reacting group (A25, A26 and Aw34) and A29. The Aw43 specificity segregated in two South African Negro families, and occurred commonly in association with Bw70. The occurrence of HLA-Aw43 in South African Caucasoids, in contrast to its absence in other Caucasoid groups, is probably due to genetic admixture with indigenous South African populations. PMID- 2711372 TI - Monoclonal antibody defining tax protein of human T-cell leukemia virus type-I. AB - We prepared a monoclonal antibody (MAb), Lt-4, which recognizes a tax protein expressed in HTLV-I-infected cells. Indirect immunofluorescence staining showed that the antigen recognized by Lt-4 MAb located mainly in the nuclei of HTLV-I infected T cell lines such as HUT102, TCL-As2, MT-1 and MT-2, and also weakly in the cytoplasm of MT-2 cell line. Lt-4 MAb did not react with two HTLV-I uninfected T cell lines tested and fresh and PHA-activated peripheral blood lymphocytes (PBL) of several normal donors. Furthermore, Lt-4 MAb stained the nuclei of HeLa cells infected with a recombinant vaccinia virus encoding the tax but not with a wild type vaccinia virus. In Western blot (WB) and radioimmunoprecipitation analyses, Lt-4 MAb detected a 40 kDa molecule (p40) in HUT102 and TCL-As2 cells, and p40 and p68 in MT-2 cells. These results show that Lt-4 MAb is highly specific for the tax protein. PMID- 2711373 TI - Characteristics of the fastest isometric knee extension in patients with spinocerebellar degenerations. AB - The force output of the knee extensor muscles and its time course were measured in nine patients with spinocerebellar degenerations and age-matched 10 normal subjects during the fastest and strongest isometric contraction. The time from the rise of tension to its maximum, FTmax, was definitely long in the SCD compared to the normal group, whereas the peak tension was not different between the two groups. FTmax of the SCD group was not related to the rate of tension development and the maximum tension nor to the degree of ataxia, suggesting that the prolongation of FTmax was a characteristic feature of cerebellar lesions. PMID- 2711374 TI - Collapse and reexpansion of lungs increase microvascular permeability in sheep. AB - The pathogenesis of reexpansion pulmonary edema has not been well studied. We tested the hypothesis that both long term collapse and subsequent reexpansion of the lungs cause reexpansion pulmonary edema by increasing pulmonary microvascular permeability. We investigated lymph dynamics in 15 experiments on collapsed lung and 10 experiments after lung reexpansion in 14 unanesthetized sheep with chronic lymph fistulas. We found that 24-hr left lung collapse increased lymph flow through the caudal mediastinal lymph node from the baseline of 1.71 +/- 0.97 (mean +/- S.D.) g/15 min to 2.01 +/- 0.99 g/15 min, although 2-hr collapse did not affect lymph flow. The L/P ratio did not fall below baseline in either experiment. Pulmonary arterial pressure increased by only about 6 cmH2O both in 2 hr and 24-hr collapse. Reexpansion after 24-hr lung collapse also increased lymph flow from the baseline of 1.64 +/- 0.52 g/15 min to 3.20 +/- 0.79 g/15 min during the first 2 hr after reexpansion. The lymph-to-plasma protein concentration ratio did not fall below the baseline. Reexpansion after 2-hr collapse did not affect these variables. We conclude that both long term lung collapse and subsequent reexpansion lead to reexpansion pulmonary edema by increasing pulmonary microvascular permeability. PMID- 2711375 TI - The effects of elevated potassium on sympathetic ganglion cells in culture. AB - Effects of a high potassium (40 mM) medium on the survival and differentiation of sympathetic ganglion cells from chick embryos were studied in dissociated cell culture. In the high potassium medium, survival of the sympathetic ganglion neurons was improved and catecholamine fluorescence of the nerve fibers increased with several days in culture, while acetylcholinesterase activity was slightly positive. In contrast, in the control medium, catecholamine fluorescence was only faintly observed, while acetylcholinesterase became strongly positive. Catecholamine fluorescence was intensified by increasing the potassium concentration in a medium, while it was diminished by reversing the potassium level back to the normal one. The effect of the high potassium medium on catecholamine fluorescence was reduced by Ca++ influx inhibitors, diltiazem or Mg++. It is suggested that the high potassium medium increased the survival rate and prevented the sympathetic neurons from becoming cholinergic and allowed them to develop their adrenergic properties presumably through an increased level of the intracellular Ca++ due to Ca++ entry. PMID- 2711376 TI - Vasoactive intestinal polypeptide stimulates cholecystokinin secretion in perfused rat duodenum. AB - We examined the effect of vasoactive intestinal polypeptide (VIP) on cholecystokinin (CCK) secretion from the isolated perfused rat duodenum. VIP stimulated CCK secretion mono-phasically in a concentration-dependent manner in concentrations ranging from 10(-9) to 10(-7) M, and 10(-7) M of VIP led to an increment of 82 +/- 25.8 fmole/3 min. The stimulatory effect of VIP on CCK was not inhibited by 10(-5) M atropine. These results suggest that VIP may directly stimulate CCK secretion from the duodenum and work as a non-cholinergic, peptidergic neurotransmitter. PMID- 2711377 TI - Endoscopic examination for pancreatic fistula. AB - We have conducted endoscopic examination in 5 cases of postoperative pancreatic fistula, and discuss its clinical significance. The examination provided not only an observation of the fistula but also opportunity to irrigate the fistula for removal of foreign substances. The biopsy permitted histological examination for necrotic substances and the fistulous wall. Endoscopy made it easy to introduce a drain into the affected site and to judge when to remove the drain. Closure of the fistula was also attainable using fibrin glue. Consequently, the fistulas were closed within 1 month from the examination in all cases but one, in which death resulted due to carcinoma. The examination is an easy and safe technique. PMID- 2711378 TI - A case of refetoff syndrome: selective venous sampling for TSH is useful in differentiating thyroid hormone resistance from TSH secreting tumor. AB - A 22-year old man with a goiter and clinical manifestations of mild thyrotoxicosis (finger tremor, palpitation, tachycardia) was diagnosed as a syndrome of inappropriate secretion of TSH. Serum concentrations of T4, free T4, T3 and TSH were 24.1 micrograms/100 ml, 4.07 ng/100 ml, 261 ng/100 ml and 1.72 microU/ml, respectively. Thyroidal 131I uptake at 24 hr was 80%. The BMR was within the normal range. He had a normal TSH response to TRH (500 micrograms) with a peak level of 23.8 microU/ml. The basal level of alpha-subunit of TSH was not elevated (0.35 ng/ml). Oral 1-T3 administration (75 and 150 micrograms daily) raised serum T3 concentration, reduced basal TSH and blunted TSH response to TRH. The diurnal variation of TSH was maintained. There was no evidence of abnormalities in the secretion of other pituitary hormones. These findings were compatible with thyroid hormone resistance. However, the presence of a microadenoma in the pituitary gland was suspected with CT scan. Bilateral and simultaneous venous sampling for TSH from inferior petrosal sinus showed no gradient in TSH concentration indicating that a TSH secreting pituitary tumor was unlikely. These data suggest that inappropriate TSH secretion in the present patient is resulted from resistance to thyroid hormone. In the present study selective venous sampling is useful to differentiate the thyroid hormone resistance from a TSH secreting tumor. PMID- 2711379 TI - Change in P wave height during progressive exercise in patients with chronic obstructive pulmonary disease. AB - We examined changes in P wave height in lead II of electrocardiogram during progressive exercise in patients with chronic obstructive pulmonary disease (COPD), and obtained the slope (delta P/delta VO2, %/ml/min) of the regression line calculated from the relationship between percent change of P wave height and oxygen consumption (VO2). Four COPD patients, who had a decrease over 5 mmHg in arterial oxygen tension (PaO2) at maximal exercise (group A), had significantly greater slope (0.45 +/- 0.14%/ml/min, mean +/- S.E.) than in five COPD patients (group B, 0.14 +/- 0.05), who did not have a decrease over 5 mmHg in PaO2 at maximal exercise. The increase in P wave height during exercise was inhibited by oxygen inhalation at the given VO2 in group A. These findings suggest that increase in P wave height during exercise in COPD patients may be correlated with hypoxemia during exercise. PMID- 2711380 TI - Evaluation of recombinant human tumor necrosis factor by scheduled intratumoral administration in mice bearing transplantable tumors. AB - The antitumor effect of recombinant human tumor necrosis factor (rTNF) was examined against Meth A fibrosarcoma in BALB/c mice and Sarcoma-180 in ddY mice. Significant hemorrhagic necrosis in tumor tissues occurred within 24 hr when optimal rTNF (1,000 to 5,000 units per mouse) was injected intratumorally on day 5 after intradermal inoculation of 5 x 10(5) tumor cells. Complete tumor regression resulted when two repeated courses of administration a week, each for 3 consecutive days, were given. For this marked effect to occur, however, initial tumor weight should not be greater than 1 g. When the initial tumor was greater than 1 g the surgical removal of tumor tissues was conducted and followed by rTNF administration. This caused hemorrhagic necrosis and the regression was the case with smaller tumors. When the cured mice were rechallenged with same tumors, more than 60% of mice rejected the tumors in a specific manner. In spite of such demonstration of specific immunity, well-known immunological effector mechanisms such as augmentation of natural killer cell activity, activation of antibody dependent cellular cytotoxicity or induction of interferon activity by rTNF were not detected in normal and tumor-bearing mice, suggesting that the activation of immunoregulatory cells by TNF itself may not involve at least in an early stage of TNF treatment. These results suggest that rTNF is a potent therapeutic agent for a certain solid tumor when the protocol of administration is optimized. PMID- 2711381 TI - Almitrine bismesylate reduces hypoxic pulmonary vasoconstriction in isolated rat lungs. AB - The purpose of this study is to test how almitrine bismesylate (Alm) affects the function of pulmonary vasculature during normoxic ventilation, and whether low doses of Alm not causing detectable vasoconstriction during normoxic ventilation potentiate hypoxic pulmonary vasoconstriction (HPVC). Isolated Wistar male rat lungs were perfused with homologous blood at constant flow, and venous and ventilatory pressure. In the first experiment, after equilibration, dose-response curves to Alm (from 0 to 1000 ng/ml, n = 10) were measured under the ventilation with normoxic gas mixture (21% O2, 5% CO2, 74% N2). It was found that Alm causes a dose-dependent pulmonary vasoconstriction. In the second experiment, low doses of Alm (125 mg/ml) or diluent of Alm (malic acid) was injected to the blood reservoir. This doses of Alm did not cause significant vasoconstriction during normoxic gas ventilation compared with malic acid. After stabilization of pulmonary arterial pressure, the lungs were exposed to three cycles of normoxia (10 min) and hypoxia (10 min) through ventilation with gas containing 21% or 2% O2 and 5% CO2. It was observed that low doses of Alm significantly reduce HPVC (p less than 0.05) on the later periods of the first and the second hypoxic challenges. However, no significant difference was revealed among two groups in the third hypoxic challenge. Directly measured blood Alm concentration was significantly lower in the third challenge than in the first challenge. Responses to angiotensin II were not decreased by Alm. In conclusion, high doses of Alm constrict pulmonary vasculature dose-dependently, and low doses of the drug not causing vasoconstriction during normoxia reduce HPVC in rat. PMID- 2711382 TI - Quantitative assay of lentinan in human blood with the limulus colorimetric test. AB - A conventional limulus test detects not only endotoxin but also beta (1----3) glucan. Therefore, using a quantitative limulus test (the limulus colorimetric test) we studied the pharmacokinetics of lentinan, an antitumor beta (1----3) glucan, in the blood of 10 health volunteers and three patients with advanced gastric cancer. The calibration curve of lentinan in the human plasma was linear in the range of 0 to 100 ng/ml. When incubated with human plasma at 37 degrees C in vitro, lentinan had the recovery of almost 100% as compared to the initial concentration even after 60-min incubation, indicating the stability of lentinan in human plasma. When 1 mg of lentinan was intravenously administered over a 2 hr period, lentinan concentration reached the maximum levels (50-80 ng/ml) at the end of the drip infusion and decreased gradually thereafter. In the near future, the more appropriate modes of lentinan administration will be determined by further investigation of its kinetics in the human body. PMID- 2711383 TI - Carrageenan-induced pulmonary emphysema of rabbit. AB - A transbronchial injection of 0.75% carrageenan in physiologic saline induced pneumonia followed by emphysema in the insulted lobe. In the stages of pneumonia, scattered infiltration of polymorphonuclear leukocytes was seen throughout the affected lobe within a few days of treatment; later this was replaced by the accumulation of carrageenan-laden macrophages, which lasted for one to two months. Enlargement of alveoli and alveolar ducts appeared 2 weeks to 2 months after the treatment, and pulmonary emphysema was observed at 4 months. The lobes that were not treated with carrageenan were normal in appearance during both the pneumonia and the emphysema. Morphometric analysis of the lung at 4 months showed decrease of the alveoli and/or alveolar ducts and enlargement of their luminal spaces, also suggesting the development of emphysema. In contrast to various kinds of elastases that are known to produce emphysematous changes in animals, the elastolytic activity of carrageenan solution did not show any such effects, although in the homogenate of the lobes given carrageenan, a moderate but significant increase in the proteinase activities of alveolar macrophages are said to occur (Bowers et al. 1985). It was suggested that carrageenan-induced emphysema is a chronic disorder associated with both carrageenan toxicity and accumulated carrageenan-laden macrophages in the insulted lobes. PMID- 2711384 TI - The response of normal and failing heart to externally applied vibration in the canine open chest preparation. AB - We examined the left ventricular functional response to externally applied vibration using four canine open chest preparations. A sinusoidal 30 Hz vibration (2.7 mm in amplitude) was applied to the ventricular epicardium at each level of propranolol-induced myocardial depression. External vibration in control conditions induced no significant change either in peak left ventricular pressure (LVP) or in stroke volume (SV). With propranolol, 0.1 and 0.3 mg/kg, peak LVP and SV were depressed by the application of external vibration, even though there was no significant change of these values in the nonvibrating condition compared to control. We conclude that the ventricular response to vibration depends on the underlying myocardial viability. PMID- 2711385 TI - Immunochemical characterization of the antigen recognized by the murine monoclonal antibody A7 against human colorectal cancer. AB - The nature of the antigen recognized by the murine monoclonal antibody A7 (Mab A7) against human colorectal carcinoma was investigated using immunochemical and biochemical techniques. Binding activity of 125I-labeled Mab A7 was examined using various human cancer cell lines. Mab A7 gave the highly specific binding to colon cancer cell lines, SW1116 and WiDr, and gave only a very weak or no reactivity to gastric cancer cell lines, pancreas cell lines or lung cancer cell lines. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting of the extractable antigen from SW1116 showed a single band at approximately 45,000 dalton formed by 125I-labeled Mab A7. Treatment of SW1116 with sodium periodate, pronase and ficin resulted in the loss of antigenic activity. These data strongly suggest that the antigen recognized by Mab A7 is composed of glycoprotein. Competitive binding analysis to the surface of the colon cancer cell line using polyclonal anti-CEA and Mab A7 as well as immunoblotting analysis using monoclonal anti-CEA and Mab A7 suggested that the antigen recognized by Mab A7 was different from CEA. Moreover, this antigen was also found in surgical specimens of colorectal cancer patients and its molecular property was identical to the antigen extracted from SW1116. PMID- 2711386 TI - Cysteine conjugate beta-lyase of rat kidney cytosol: characterization, immunocytochemical localization, and correlation with hexachlorobutadiene nephrotoxicity. AB - Cysteine conjugate beta-lyase (beta-lyase) was purified to electrophoretic homogeneity from the kidney cytosol of male Wistar rats. The highly purified enzyme exhibited a monomeric molecular weight of 50,000 Da and was active in the alpha-beta elimination of cysteine conjugates including S-(1,2-dichlorovinyl)-L cysteine (DCVC), S-(1,1,2,2-tetrafluoroethyl)-L-cysteine (TFEC), and S-(2 benzothiazolyl)-L-cysteine, particularly toward DCVC and TFEC. The purified enzyme also exhibited glutamine transaminase K activity with phenylalanine and alpha-keto-gamma-methiolbutyrate as substrates. An antibody was raised to the purified rat protein in sheep and the crude immune serum affinity purified, yielding a specific antibody that recognized only the beta-lyase protein in whole kidney homogenates. Immunocytochemical studies on rat kidney sections stained with the purified antibody revealed that the cytosolic beta-lyase enzyme was mainly localized in the pars recta of the proximal tubule in untreated rats. This localization is coincident with the site-specific kidney necrosis produced by hexachloro-1,3-butadiene (HCBD). These results indicate that the tissue localization of beta-lyase in the proximal tubule plays an important role in determining the specific nephrotoxicity produced by halogenated alkenes such as HCBD. PMID- 2711387 TI - Effects of paraquat on canine bronchoalveolar lavage fluid. AB - Bronchoalveolar lavage (BAL) recovers the epithelial lung fluid of the lower respiratory tract. In this study, we have used BAL to detect early pulmonary injury in beagle dogs following an intravenous infusion of 10 mg paraquat dichloride/kg bodyweight. Bronchoalveolar lavage was performed twice in 11 dogs, 60 hr before and 34 hr after an intravenous infusion of paraquat dichloride (n = 8) or saline (n = 3). The dogs were studied in three groups: (1) paraquat only (n = 4); (2) paraquat plus hemoperfusion (n = 4); and (3) hemoperfusion only (n = 3). Because hemoperfusion, a treatment used for paraquat poisoning, could have effects on BAL independent of paraquat, we evaluated the effects on BAL fluid of this procedure performed separately from and together with administration of paraquat. We examined cytology, proteins, enzymes, and glutathione in the BAL fluid and expressed all results per milliliter of aspirated lavage fluid. Hemoperfusion did not alter the BAL fluid. In contrast, in dogs studied 34 hr after administration of paraquat, total cell counts, alveolar macrophage and neutrophil counts, and concentrations of total protein, albumin, ACE, LDH, and ALP were increased. Bronchoalveolar lavage in the dog provides an excellent tool with which to detect early paraquat-induced pulmonary injury. The same technique could be useful for sequential monitoring of other types of pulmonary disease and injury. PMID- 2711388 TI - The metabolism and testicular toxicity of cyclohexylamine in rats and mice during chronic dietary administration. AB - Cyclohexylamine hydrochloride has been given in the diet to mice and to Wistar and DA rats for 13 weeks, to provide a constant intake of 400 mg of the base/kg/day. Significantly decreased food intake and body weight gain were found in both strains of rats but not mice. The metabolism of [14C]cyclohexylamine was widely different in Wistar and DA rats and in rats and mice, and these differences were not altered appreciably by chronic intake for 13 weeks. The differences in metabolism resulted in marked and persistent differences in the concentrations of the hydroxylated metabolites in the plasma and testes of treated animals with Wistar much greater than DA much greater than mice. After 7 and 13 weeks testicular atrophy was demonstrated in both strains of rats given cyclohexylamine diet by a decrease in organ weight and by histological changes. DA rats appeared more sensitive to testicular toxicity from cyclohexylamine than Wistar rats, while mice showed no evidence of testicular damage. These data show that the development of testicular toxicity is not related to the extent of hydroxylation. The concentrations of cyclohexylamine in the plasma and testes of the treated animals were lower in mice than in either strain of rats despite a similar daily intake. This suggests that species differences in pharmacokinetics may contribute to the apparent difference in sensitivity to testicular toxicity. PMID- 2711389 TI - Fate of cadmium in rat renal tubules: a micropuncture study. AB - Free-flow micropuncture was carried out in superficial nephrons of Munich-Wistar type rats infused acutely with Cd acetate (CdA) or Cd-DTPA (141 microM Cd). Fluid obtained from Bowman's space (BS) or end-proximal tubule sites was analyzed for Cd and inulin. The fluid/plasma Cd concentration ratio in BS averaged 0.2 and 1.0 during CdA and Cd-DTPA infusions, respectively. End-proximal tubule fractional excretion of Cd during CdA infusion averaged 0.34. Previous administration of CdA (1.0 mg/kg, 48 hr before micropuncture) increased the level of circulating Cd metallothioneins, as measured by radioimmunoassay, but did not affect the luminal tubular uptake of Cd during CdA infusion. No net transepithelial movement of Cd DTPA was measured. It is concluded that Cd ultrafiltered during inorganic Cd administration is taken up to a large extent by the convoluted part of proximal tubules. PMID- 2711390 TI - Effects of sodium salts of phenobarbital and barbital on development of bladder tumors in male F344/NCr rats pretreated with either N-[4-(5-nitro-2-furyl)-2 thiazolyl]formamide or N-nitrosobutyl-4-hydroxybutylamine. AB - Promoting effects of sodium salts of phenobarbital (NaPB) and barbital (NaBB) on the development of bladder tumors were investigated in F344 male rats initiated with N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) or N-nitrosobutyl-4 hydroxybutylamine (BBN). To initiate with FANFT, rats were fed 0.2% FANFT mixed in diet for either 2 or 6 weeks and 2 weeks later were offered diet containing 1000 ppm of NaPB or NaBB. Rats were killed either at 52 or 68 weeks of age. To initiate with BBN, rats were given 0.05% BBN in drinking water for 4 weeks and beginning 1 day later were fed NaBB mixed in diet at 1000 ppm for up to 52 weeks. NaBB promoted bladder carcinogenesis initiated by either FANFT or BBN; the incidence and average number of simple or preneoplastic nodular (PN) hyperplasias, papillomas, and carcinomas per 10 cm of urothelium were significantly increased in the groups receiving NaBB following exposure to FANFT for 6 weeks (p less than 0.05) or BBN for 4 weeks (p less than 0.01). No such effect was seen in rats fed FANFT for only 2 weeks. NaPB also significantly increased (p less than 0.05) the frequency of preneoplastic PN hyperplasias but not the average number of papillomas and carcinomas per 10 cm of urothelium in rats fed FANFT for 6 weeks. NaBB was an effective promoter of bladder carcinogenesis under these experimental conditions, as expected from its known promoting effect on transitional epithelium of the renal pelvis, but NaPB in contrast did not affect the incidence or multiplicity of bladder papillomas or carcinomas under these conditions. NaPB could be considered a promoter for bladder urothelium only by the less rigorous criterion that it increased the frequency of preneoplastic PN hyperplasia. PMID- 2711391 TI - Identification of ethanol-inducible P450 isozyme 3a (P450IIE1) as a benzene and phenol hydroxylase. AB - In this report, the identity of the cytochrome P450 isozyme(s) catalyzing the hydroxylation of benzene and the major hydroxylated metabolite of benzene, phenol, was investigated using rabbit hepatic microsomes and six purified isozymes of hepatic P450. Microsomes from acetone-treated rabbits showed about a 5-fold induction of benzene hydroxylation to phenol and hydroquinone. This increase correlated with the increase in form 3a determined immunochemically (about 7-fold). Antibody to isozyme 3a inhibited greater than 90% of the benzene and phenol hydroxylase activity of hepatic microsomes from acetone-treated rabbits. At high benzene concentrations (2 mM) in the presence of cytochrome b5, form 3a was 1.3 times more active than form 2 and 7- to 10-fold more active than forms 3b, 3c, 4, and 6. At lower benzene concentrations (about 0.3 mM) form 3a was 5-fold more active than form 2. Furthermore, form 3a was the only isozyme to produce significant quantities of hydroquinone as did microsomes from acetone treated rabbits. When phenol was used as the substrate, hydroquinone was the only product detected, and acetone treatment induced its formation 4- to 5-fold. Purified form 3a was 20- to 30-fold more active than the next most active isozyme, form 6, depending on the presence or absence of cytochrome b5. These results suggest that isozyme 3a (P450IIE1) is a low-Km benzene hydroxylase and the principal phenol hydroxylase in rabbit hepatic microsomes. As a result, the induction of isozyme 3a could potentiate the toxicity of benzene by catalyzing an increase in the formation of both phenol and hydroquinone. PMID- 2711392 TI - Comparison of acute ozone-induced nasal and pulmonary inflammatory responses in rats. AB - The centriacinar pulmonary lesion induced by ozone has been extensively characterized, but little is known about the effects of this oxidant gas in the upper airways. The present study was designed to compare the effects of acute ozone exposure in the nose and lungs of rats. We examined the cellular inflammatory responses in the nasal cavity and lower respiratory tract by means of nasal and bronchoalveolar lavage and morphometric quantitation of neutrophils within the nasal mucosa and pulmonary terminal bronchioloalveolar duct regions (i.e., centriacinar). Rats were exposed to 0.0, 0.12, 0.8, or 1.5 ppm ozone for 6 hr and were sacrificed immediately or 3, 18, 42, or 66 hr following exposure. Eighteen hours after exposure, increased numbers of neutrophils, as compared to controls, were recovered from nasal lavage fluid (NLF) of rats exposed to 0.12 ppm ozone. There was no change in the number of neutrophils recovered from bronchoalveolar lavage fluid (BALF) at any time after exposure. Rats exposed to 0.8 ppm ozone had more neutrophils in NLF than controls immediately after exposure, but no concomitant increase in BALF neutrophils at that time. However, as the number of neutrophils in BALF increased (maximum at 42 hr), the number of neutrophils recovered from NLF decreased (minimum at 42 hr). Rats exposed to 1.5 ppm ozone had no significant increases in nasal neutrophils in NLF at any time after exposure but had greatly increased numbers of neutrophils in BALF 3, 18, and 42 hr after exposure. The number of neutrophils recovered by nasal and bronchoalveolar lavage accurately reflected the tissue neutrophil response at sites within the nasal cavity and lung that were injured by acute ozone exposure. Our results suggest that at high ozone concentrations (0.8 and 1.5 ppm), the acute nasal inflammatory response is attenuated by a simultaneous, competing, inflammatory response within the centriacinar region of the lung. Analysis of nasal lavage fluid for changes in cellular composition may be a useful indicator of acute exposure to ambient levels of ozone, but at higher ozone levels, the nasal cellular inflammatory response may underestimate the effects of ozone on nasal and pulmonary epithelia. PMID- 2711393 TI - Pulmonary disposition of inhaled NO2-nitrogen in isolated rat lungs. AB - Nitrogen dioxide (NO2) is a relatively insoluble, reactive gas that, on inhalation, generates a diverse array of pulmonary toxic effects. Its uptake and transformation in isolated lungs have been shown to be proportional to inspired dose and associated with significant accumulations of the nitrite ion. However, not all absorbed NO2 is directly detectable as soluble nitrite. To further characterize its uptake and chemical disposition, we determined the chemical fate of 15NO2-nitrogen in isolated perfused (red cell-free) rat lungs that were exposed to 20 ppm 15NO2 for 60 min. Total excess 15N (relative to unexposed controls) was determined by isotope ratio mass spectrometry and total nitrogen analysis. Excess 15N was detected in whole lungs and in soluble and insoluble fractions but not in the total lipid pool. Perfusate excess 15N and nitrate correlated and accounted for all absorbed NO2 not detectable in tissue fractions. Exogenously instilled [15N]nitrite distributed within lung tissue, bound to insoluble elements, and diffused to the vascular space similar to NO2-nitrogen. Instilled [15N]nitrate did not distribute or bind like NO2-nitrogen or nitrite. Dialysis (1000 molecular weight cutoff) of cytosol, membranes, and perfusate removed excess 15N and nitrite derived from NO2, nitrite, or nitrate sources. We conclude that in isolated lungs, inhaled NO2 (1) undergoes rapid uptake and transformation in sites accessible to the pulmonary circulation; (2) does not form stable addition products with lipids; and (3) forms small-molecular-weight soluble reaction product(s) that behave similarly to nitrite, most likely indicating predominant univalent reduction of NO2 via initial hydrogen abstraction and subsequent HNO2 dissociation. PMID- 2711394 TI - Mechanism of allyl formate-induced hepatotoxicity in rainbow trout. AB - Hepatotoxicity of allyl formate (AF) was studied in trout, to characterize the response of the teleost liver to a mammalian periportal hepatotoxicant. A dose dependent decrease in liver nonprotein sulfhydryl (NPSH) concentration was observed at 3, 6, and 24 hr following 9.5, 28, and 95 mg/kg) AF with maximal depression seen at 6 hr (51, 40, and 29% control, respectively). Further evidence for glutathione (GSH) protection against AF toxicity was seen when diethylmaleate, a GSH depleting agent (0.6 ml/kg ip), administered 30 min prior to AF (9.5 and 28 mg/kg), increased AF hepatotoxicity (10-fold shift in the dose response effect on SGPT). Also, N-acetyl-L-cysteine (150 mg/kg ip), a GSH precursor, protected liver against AF toxicity when injected 5 min prior to and 1, 5, and 9 hr after AF (28 and 95 mg/kg). Pyrazole (375 mg/kg ip), an alcohol dehydrogenase inhibitor, given 4 hr before AF (95 mg/kg), attenuated the histopathological effect of AF. These results indicate that AF, once bioactivated by alcohol dehydrogenase, causes significant toxicity in trout liver. GSH protects against AF-induced effects since greater than 50% decreases in liver GSH are required before toxicity is expressed. PMID- 2711395 TI - Acute exposure to formaldehyde induces hepatic metallothionein synthesis in mice. AB - Humans risk inadvertent intraperitoneal or intravenous exposure to formaldehyde (HCHO), commonly used for disinfection of implanted or extracorporeal medical devices. Various chemical and physical stresses are known to induce hepatic metallothionein. This study examined the effect of acute parenteral administration of HCHO on induction of hepatic metallothionein synthesis. Adult male CF1 mice were administered HCHO ip and hepatic metallothionein was quantified by the cadmium-radioassay method. HCHO (50 mg/kg) increased hepatic metallothionein as early as 8 hr after dosing with maximal levels (27-fold increase) occurring at 72 hr. Metallothionein concentrations were elevated (15 fold) 24 hr after 50 or 100 mg HCHO/kg but not at lower dosages. Concomitant elevations in hepatic zinc and copper content were observed. No increases in metallothionein were observed in kidney, pancreas, or intestine 24 hr after HCHO administration (100 mg/kg, ip). Induction of metallothionein by HCHO may reflect direct de novo synthesis since the response was abolished by pretreatment with the RNA synthesis inhibitor, actinomycin D. HCHO induction of metallothionein also does not appear to be mediated by stress-induced release of corticosteroids or catecholamines from the adrenal since the response was unaltered in adrenalectomized mice. Interference with the glutathione (GSH)-dependent oxidation of HCHO by reducing hepatic GSH concentrations to 40% of control after a 2-hr pretreatment with phorone decreased the metallothionein induction response to HCHO by 33%. This result suggests that the induction may be partially due to a HCHO metabolite, e.g., formate. Confirmation of metallothionein synthesis was obtained following spectral and chromatographic analysis. Thus, HCHO and/or a metabolite produces a marked increase in hepatic metallothionein and alters hepatic zinc and copper homeostasis, all of which are transient responses. Although HCHO was only mildly hepatotoxic at the highest dose (as evidenced by an increase in plasma alanine aminotransferase activity), such changes in metallothionein synthesis and essential metal homeostasis may be part of a cellular repair mechanism operant after acute toxic cell injury. PMID- 2711396 TI - Characterization of cis-platinum-induced Sertoli cell dysfunction in rodents. AB - The present study examined the effects of dosage and frequency of cis-platinum administration on various aspects of Sertoli cell function and its correlation with the status of spermatogenesis in rats 1 and 9 weeks after the initial drug administration. Adult male Sprague-Dawley rats were administered cis-platinum (10 mg/kg) intraperitoneally as a single dose or as five daily doses of 2 mg/kg. Electron microscopic observation of testicular tissues fixed in the presence of lanthanum revealed that cis-platinum administration resulted in leakage of the Sertoli cell tight junctions. This occurred as early as 24 hr after the five daily injections, and persisted at least 40 days. Testicular androgen-binding protein (ABP) content was not significantly affected by either treatment regimen after 1 or 9 weeks of recovery. On the other hand, serum ABP values were significantly elevated after 9 weeks of recovery. In addition, the increased sodium and decreased potassium concentrations in seminiferous tubular fluid noted in cis-platinum-treated animals were also indicative of abnormal Sertoli cell secretory function. Degeneration of spermatogenic cells was noted as early as 5 days after the last drug administration; and partial restoration of spermatogenesis was noted after 40 days of recovery. We conclude that in rats both morphological and biochemical properties of Sertoli cells are affected by cis-platinum administration. These changes in Sertoli cell function may be responsible for the cis-platinum-induced impairment of spermatogenesis in these animals. PMID- 2711397 TI - Cloned rainbow trout liver P(1)450 complementary DNA as a potential environmental monitor. AB - A technique is proposed for the biological monitoring of pollutants in aquatic environments by use of a complementary DNA (cDNA) probe. The induction of hepatic cytochrome P(1)450 mRNA has been investigated utilizing pfP(1)450-3', a 3' specific 1.5 kb cDNA clone derived from 3-methylcholanthrene-inducible mRNA of rainbow trout. A time course of induction of both the hybridizable mRNA and hepatic monooxygenase catalytic activity in rainbow trout with a known inducer in fish, beta-naphthoflavone, was studied. The cDNA probe was also shown to hybridize with induced mRNA of brook trout, scup, garter snake, painted turtle, and rat demonstrating the suitability of the probe for examining induction of mRNA in various species. The results of these experiments suggest that the cDNA probe may be useful as a biological monitoring tool for determining the presence and effects of chemical pollutants which are inducers of hepatic microsomal monooxygenase activity. The probe may have the potential to be applied as an early warning system in the monitoring of water quality. PMID- 2711398 TI - Unilateral depletion of testicular glutathione levels in the rat following intratesticular injections of diethylmaleate and buthionine sulfoximine. AB - A method was developed to selectively deplete glutathione (GSH) in a single rat testis. Using intratesticular injections of a mixture of two GSH-depleting agents, diethylmaleate and buthionine sulfoximine, testicular GSH levels were decreased to 33-54% of control 2 hr after injection and remained suppressed for 24 hr. GSH levels in the contralateral testis and liver were not affected by this treatment. Comparisons between GSH-depleted and vehicle-injected (contralateral) testes, evaluated 2 weeks later, showed that although testis and epididymal weights and cauda epididymal sperm reserves were slightly reduced (to greater than or equal to 90% of controls), no changes were seen in testicular spermatid counts or in the morphology or motility of cauda epididymal sperm. An increase in histologically abnormal tubules localized to the injection site occurred in some GSH-depleted testes; however, the proportion of normal tubules containing step 19 spermatids was not affected. Thus, intratesticular injections of GSH-depleting agents selectively lowered GSH levels in the treated testis, with minimal adverse effects. This protocol can now be applied to investigate specific roles of GSH in the testes, particularly with regard to the possible modulation of the effects of testicular toxicants. PMID- 2711399 TI - Lipid peroxidation: a possible mechanism of trichloroethylene-induced nephrotoxicity. AB - The purpose of this study was to investigate whether lipid peroxidation plays a role in (TCE) trichloroethylene-induced nephrotoxicity in mice at different oxygen concentrations. Male NMRI mice (25-30 g) were treated i.p. with TCE in a dosage of 125-1000 mg/kg in sesame oil. To determine the TCE-induced depletion of reduced glutathione (GSH) in the kidney cortex and liver tissue, mice were given 1000 mg/kg TCE i.p., then killed between 0 and 6 h after TCE administration and GSH was measured was non-protein sulfhydryls. In another series of experiments, mice were administered 125 to 1000 mg/kg TCE i.p. with or without a 2 h i.p. pretreatment with 1500 mg/kg L-buthionine-S-R-sulfoximine (BSO). Mice were then exposed to a 10, 15, 20 or 100% oxygen atmosphere for 3 h and lipid peroxidation in vivo was measured as exhalation of ethane. Subsequently, mice were killed and malondialdehyde (MDA) generation was measured in the liver and kidney cortex. Ethane evolution was estimated by gas chromatography and MDA was determined as thiobarbituric acid reactive substances. In a further series of experiments mice were treated in the same manner as for ethane and MDA determination and the changes in blood urea nitrogen (BUN) and accumulation of the organic ion p aminohippurate (PAH) were determined. PAH accumulation by renal cortical slices were measured as the slice to medium (S/M) ratio. Six hours after administration of 1000 mg/kg TCE to mice, GSH was significantly depleted to about 60% of control in the kidney cortex but not in the liver. Three hours after TCE administration, MDA content in the kidney cortex and ethane exhalation increased in a dose dependent manner only under a 10% oxygen atmosphere. Under the same experimental conditions, MDA content remained unchanged in the liver. BSO depletion of GSH prior TCE administration induced an increase of the MDA content in the kidney cortex and an increase of the ethane exhalation in vivo. At 10% oxygen concentration, TCE induced a dose-dependent increase in BUN and a dose-dependent decrease of PAH accumulation by the renal cortical slices. Thus, the results of the present study suggest that, under hypoxic conditions, lipid peroxidation plays a role in TCE nephrotoxicity. PMID- 2711400 TI - The developmental toxicity of uranium in mice. AB - To evaluate the developmental toxicity of uranium, 5 groups of 20 pregnant Swiss mice were given by gavage daily doses of 0, 5, 10, 25 and 50 mg/kg of uranyl acetate dihydrate on gestational days 6-15. Cesarean sections were performed on all females on gestation day 18. Fetuses were examined for external, visceral, and skeletal abnormalities. The results indicated that such exposure resulted in maternal toxicity as evidenced by reduced weight gain and food consumption during treatment, and increased relative liver weight. There were no treatment-related effects on the number of implantation sites per dam, or on the incidence of postimplantation loss (resorptions plus dead fetuses). The number of live fetuses per litter and the fetal sex ratio were not affected by the treatment. However, dose-related fetal toxicity, consisting primarily of reduced fetal body weight and body length, and an increased incidence of abnormalities was observed. Malformations (cleft palate, bipartite sternebrae) and developmental variations (reduced ossification and unossified skeletal variations) were noted at the 25 and 50 mg/kg per day test levels. Therefore, administration of uranyl acetate dihydrate during organogenesis in mice produced maternal toxicity at 5, 10, 25 and 50 mg/kg per day. The "no observable effect level" (NOEL) for fetotoxicity including teratogenicity was below 5 mg/kg per day, as some anomalies were observed at this dose. There was no evidence of embryolethality at any dosage level used in this study. PMID- 2711401 TI - Toxicity of cadmium oxide instilled into the rat lung. I. Metabolism of cadmium oxide in the lung and its effects on essential elements. AB - The metabolism of cadmium oxide (CdO, insoluble form) and cadmium chloride (CdCl2, soluble form) instilled intratracheally into the rat lung was investigated. CdO might be solubilized rapidly in the lung and consequently pulmonary clearance rate of CdO was not so different from that of CdCl2. At a dose of 5 micrograms Cd/rat about 20% of the dose was translocated to the liver within 12 h, whereas gradual and consistent accumulation of Cd was observed in the kidney up to 7 days. Both pulmonary clearance and translocation of Cd to the liver were accelerated with the dose of instilled CdO, however, Cd accumulated in the kidney was proportional to the dose. Lung weight was increased by the instillation of CdO. Lung essential elements such as S, P, Mg, Zn and Mn were not affected in the inflammatory-reparative proliferative process, but Cu content of unit lung weight was slightly decreased. PMID- 2711402 TI - The toxicity, distribution and excretion of ricin holotoxin in rats. AB - The distribution and excretion of the plant toxin ricin were studied in rats after intravenous injection. 125I-labelled ricin was equal in toxicity to native ricin. Following injection, the liver was the major organ of localisation - 46% of injected dose at 0.5 h. The spleen and muscle were next with 9.9% and 13%, respectively, at 0.5 h. Ricin was relatively concentrated in the spleen (33% of injected dose/g of tissue) compared with the liver (7.4%/g) and the bone marrow (5.5%/g). The concentration in the lymph nodes was very low (1.2%/g). Ricin was quickly cleared from the animal; only 11% of the initial radioactivity remained 24 h later with 70% excreted in the urine. Excretion into the intestine via the bile duct was less than 5% by 24 h, 10-12% of the radioactivity was found in the intestinal contents or intestinal wall between 3 h and 12 h, and much of this was reabsorbed since less than 2% was recovered in faeces. PMID- 2711403 TI - The choroid plexus as a target site for cadmium toxicity following chronic exposure in the adult mouse: an ultrastructural study. AB - The effects on the choroid plexus (CP) of chronic (22 weeks) exposure to 1, 10 or 100 ppm Cd2+ in the drinking water was studied in adult mice. The CP from these mice was examined using scanning and transmission electron microscopy. The mice receiving 10 or 100 ppm Cd2+ showed a dose dependent reduction in fluid intake and weight loss. The CP from animals receiving 100 ppm Cd2+ showed severe degenerative changes characterized by loss of microvilli, rupturing of the apical surface, increased cytoplasmic vacuolation and cellular debris. There was also an increase in cellular blebbing and increased dark/light cell ratio. Cerebrospinal fluid analysis revealed an increased protein content. The mice receiving 10 ppm Cd2+ showed similar but less severe degenerative changes. The 1 ppm Cd2+ group were indistinguishable from controls. These results suggest that it would be appropriate to examine CP function in individuals excessively exposed to Cd. PMID- 2711404 TI - Toxicity of cadmium oxide instilled into the rat lung. II. Inflammatory responses in broncho-alveolar lavage fluid. AB - Biochemical and cytological responses in the broncho-alveolar lavage fluid were investigated after instillation of cadmium oxide (CdO) or cadmium chloride (CdCl2) into the rat lung. Although biochemical responses of the lung to CdO were similar to the CdCl2-exposed lung, cytological response was more sensitive to CdO than CdCl2. Increases of lactate dehydrogenase, protein content and number of cells in the lavage fluid were proportional to the dose over the range of 0.5-10 micrograms Cd/rat. beta-Glucuronidase activity in the fluid increased with dose at low doses of Cd, but the activity did not continue to increase above 2 micrograms Cd/rat. A dose-response profile of phosphorus content in the lavage fluid, which might indicate amount of surfactant produced by Type II cells was similar to that observed for beta-glucuronidase in CdO-treated rats. Thus, tolerable level of instilled CdO for the rat lung was about 2 micrograms Cd/rat. PMID- 2711405 TI - Interspecies comparison of pharmacokinetic profile and bioavailability of (+/-) gossypol in male Fischer-344 rats and male B6C3F mice. AB - Gossypol is a naturally occurring yellow substance in cotton plant that has male reproductive toxicity both in humans and some experimental animal species. Interspecies oral bioavailability and pharmacokinetic profile of (+/-)-gossypol were compared in male Fischer-344 rats and B6C3F mice after a 1) single intravenous dose, 2) single oral dose, and 3) 14 consecutive, daily, oral doses; all doses were 10 and 50 mg/kg rats and mice, respectively. In both species, the intravenous plasma (+/-)-gossypol concentrations showed a triexponential pattern, indicating a 3-compartment, open-model system. The apparent half-life of elimination of (+/-)-gossypol following intravenous injection was 9.1 h and 7.7 h in rats and mice, respectively. The total plasma clearance (Cl), volume of distribution (Vd), and AUCplasma after a single intravenous injection were 1.84 and 1.23 l/h per kg, 0.20 and 1.74 l/kg, and 36.0 and 115.8 mg.h/l, in rats and mice, respectively. The bioavailability of a single, oral dose of (+/-)-gossypol was 86% and 14.3% in rats and mice, respectively. In rats the change in plasma (+/-)-gossypol concentration after a single, dose was monophasic; multiple doses showed a biphasic pattern. In mice a single, dose of (+/-)-gossypol showed a biexponential plasma concentration pattern; daily dosing was monoexponential and was eliminated twice as fast as the single dose. Also, multiple doses of (+/-) gossypol in the mouse were eliminated 7 times faster than in the rat. These findings are consistent with previous results that daily, oral dosing of (+/-) gossypol, but not a single dose, produces infertility in the male rat, while the mouse is insensitive to (+/-)-gossypol action. The results of this study indicate that differential sensitivity of rats and mice to the contraceptive action of (+/ )-gossypol may be related, at least in part, to its pharmacokinetic profiles in both species. PMID- 2711406 TI - Factors associated with reduced fertility and implantation rates in females mated to acrylamide-treated rats. AB - A series of studies was conducted to examine the role of copulatory dysfunction, spermatotoxicity, and/or impaired fertilization in the reduced rates of fertility and implantation observed in females mated to acrylamide-treated male rats. In initial experiments, males were gavaged with 0, 5, 15, 30, 45, or 60 mg/kg acrylamide (ACR) for 5 days and then mated serially to naive females. ACR treatment reduced fertility and increased pre- and post-implantation loss, primarily over the first 3 weeks post-treatment. The effects at Week 1 appeared to result from an interference in sperm transport as demonstrated by the absence of sperm in the uteri of females following a single ejaculation by ACR-treated male rats. The effect however was transient, with recovery of fertility in all but the 60 mg/kg group by Week 2. Attempts to explain the reduced rate of implantation concentrated on characterizing changes in measures of ejaculated sperm count and various motility parameters and evaluating sperm fertilizing ability. Males were again dosed acutely with ACR (p.o.). ACR produced statistically significant, but modest, alterations in sperm motility at Week 3. More prominent was the marked decrease in the number of fertilized ova recovered from females mated to ACR-treated males at Week 3. These data suggest that events critical to the fertilizing ability of the sperm appear to play a major role in the reduced reproductive competence associated with ACR treatment in male rats. PMID- 2711407 TI - Cytotoxicity of an organic hydroperoxide and cellular antioxidant defense system against hydroperoxides in cultured mammalian cells. AB - The cytotoxicity of an organic hydroperoxide, tert-butyl hydroperoxide (t-BHP), was evaluated by inhibition of cell growth and of colony formation in cultured Chinese hamster V79 cells depleted or not depleted of cell glutathione (GSH). The hydroperoxide was cytostatic as shown by a marked decrease of mitotic cells, hence with a very low ability to form a colony. By depletion of GSH in the cells a killing effect of the hydroperoxide appeared. Iron chelation by O phenanthroline markedly suppressed both inhibition of cell growth and of colony formation by t-BHP, indicating participation of divalent iron in the induction of cytotoxicity. Likewise, the pretreatment of GSH-depleted cells with cysteamine, an effective radical scavenger but without action as an electron donor in GSH peroxidase (GSH-Px) reaction, partly suppressed t-BHP-induced cell growth inhibition. These results suggest involvement of iron-catalyzed radical reaction in the induction of cytotoxicity by t-BHP. The inhibition of incorporation of tritiated thymidine and uridine by t-BHP was a little more sensitive than inhibition of leucine incorporation. GSH depletion evenly enhanced inhibition of incorporation of those precursors by t-BHP. The sensitivity to t-BHP of the cells with increased activity of GSH-Px by 1.5-2 times of control, which was achieved by treatment with 60 nM Na2SeO3, was not different from that of the cells with normal activity of the enzyme. On the other hand, t-BHP selectively inhibited GSH Px activity without effect on glutathione reductase activity. These observations suggest that the cellular antioxidant system can not efficiently play a protective role against exogenous hydroperoxides and also that the increased cytotoxicity of t-BHP by GSH depletion is due strongly to a decrease of cell GSH as a radical scavenger than as an electron donor in GSH-Px reaction. PMID- 2711408 TI - Comparisons of the toxicity of CdCl2 and Cd-metallothionein in isolated rat hepatocytes. AB - In the intact animal, inorganic Cd distributes mainly to the liver and produces hepatotoxicity, while Cd-metallothionein (CdMT) distributes primarily to the kidney and produces nephrotoxicity. CdMT has also been demonstrated to be more toxic than Cd in cultured kidney cells, but it is not known if CdMT is more toxic to all cultured cells or if there is a good correlation between in vitro and in vivo toxicity. Therefore, hepatocytes, which were isolated and grown in monolayer culture for 24 h, were incubated with CdCl2 (1-100 microM) or CdMT (3-100 microM Cd). The intracellular K+ content was quantitated 24 h later as an index of toxicity. The K+ concentration of the hepatocytes was decreased 50% by 4 microM CdCl2, whereas 25 microM CdMT was required to produce similar injury. In the intact animal, zinc induces the synthesis of MT and decreases the hepatotoxicity of Cd. ZnCl2 added to the media (100 microM) for 24 h before exposure to Cd or CdMT increased the intracellular MT concentration 700%. This elevation in MT reduced the toxicity of CdCl2 approximately 80% but did not alter the toxicity of CdMT. In summary, CdCl2 is more toxic to cultured hepatocytes than Cd-MT, and MT induction decreases the toxicity of CdCl2 in hepatocytes, as has been observed in the intact animal. This indicates that cultured hepatocytes appear to be an excellent model for examining the hepatotoxicity of Cd. PMID- 2711409 TI - Inhibition of benzo[a]pyrene-7,8-diol formation in vitro by complex organic mixtures. AB - Coal-derived complex organic mixtures [COM] with boiling points greater than or equal to 370 degrees C (greater than or equal to 700 degrees F) are known to inhibit both mouse skin tumor initiation by benzo[a]pyrene [BAP], and BAP-induced bacterial mutagenesis. We have examined the effects of 5 COM, with boiling points of 149-370 degrees C (300-700 degrees F), 370-398 degrees C (700-750 degrees F), 398-426 degrees C (750-800 degrees F), 426-454 degrees C (800-850 degrees F), and greater than 454 degrees C (greater than 850 degrees F), on both the rate and the route of BAP metabolism by rat liver homogenates in vitro. When co-metabolized in 40:1 excess with BAP, all of the COM reduced the rate of BAP metabolism. The 149 370 degrees C (300-700 degrees F) COM reduced the initial rate of BAP metabolism to 34% of the rate for BAP alone, while the four higher-boiling COM reduced it to 6.3-9.3% of the rate for BAP alone. In addition, the 2 highest-boiling COM (426 454 degrees C and greater than 454 degrees C boiling points) were found to reduce the percentage of BAP metabolized to BAP-7,8-diol, in comparison to incubations using BAP alone. The 370-398 degrees C and 398-426 degrees C COM did not alter the percentage of BAP metabolized to BAP-7,8-diol, while the 149-370 degrees C COM increased it. Both the general inhibition of BAP metabolism (by all of the COM), and the specific inhibition of BAP-7,8-diol formation (by the highest boiling COM) may play a role in the inhibition of formation of BAP-induced skin tumors by these materials. PMID- 2711410 TI - Comparative studies on the protein composition of hymenopteran venom reservoirs. AB - The proteins of venom reservoirs from 25 hymenopteran species from 21 genera were investigated with regard to their protein composition and immunological similarities. It was found that low mol. wt proteins and polypeptides are typical for the venoms of ants, social wasps and bees. Six species of ichneumonoid parasitic wasps lack these low mol. wt proteins. Except for bee venoms none of the low mol. wt proteins contain mannose. The venoms of ichneumonoid parasites and ants contained primarily acidic proteins, whereas those of social wasps and bees contained abundant neutral and basic proteins. Immunological analysis showed that a number of venom proteins from parasitic braconid (Chelonus) wasps shared conserved immunoreactive determinants with the venom proteins of higher Hymenoptera, including some not of parasitic habit. Implications of phylogenetic relationships among hymenopteran species are discussed. PMID- 2711411 TI - Comparison of the binding characteristics of two different preparations of tetanus toxin to rat brain membranes. AB - Two different preparations of tetanus toxin (HTT and WTT) were iodinated, and their binding to rat brain membranes characterized. Under optimal binding conditions (25 mM Tris-acetate, pH 6.0), both preparations bound to a large number of high affinity sites, thought to be gangliosides. Binding constants were identical. However, in a physiological buffer (Krebs-Ringer, pH 7.4) binding of the two toxin preparations showed a number of differences. Under these conditions we have previously shown that HTT binding is markedly reduced, and that there are two classes of sites, a small number of heat-, sialidase- and protease-sensitive high affinity sites, and a larger number of sialidase-sensitive, heat- and protease-resistant lower affinity sites, probably gangliosides (PIERCE et al. (1986) Biochem. J. 236, 845-852). Although WTT bound to these same two sites, it displayed a higher affinity for the protease-resistant site than did HTT. WTT also bound to free or immobilized trisialoganglioside with higher affinity than HTT, consistent with the view that the protease-resistant site represents binding to ganglioside. In contrast, both toxin preparations bound to the protease sensitive site with similar affinities. These observations may explain the four to five-fold higher levels of WTT binding to brain membranes, and the fact that a smaller percentage of total WTT binding is protease sensitive. Despite their different ganglioside-binding properties, both toxin preparations showed comparable neurotoxic activities, and appeared identical on SDS gels. PMID- 2711412 TI - Changes in spinal cord reflexes following subchronic exposure to soman and sarin. AB - The organophosphorus agents soman and sarin were administered subchronically and the spinal monosynaptic (MSR) and dorsal root (DRR) reflexes were assessed in spinal cord-transected cats. Neither soman nor sarin produced behavioral signs of delayed neurotoxicity. However, both soman and sarin significantly reduced the area under the MSR and DRR with only minimal changes in the excitability of the potentials as determined using quipazine, a serotonin agonist. The changes observed in these reflexes resulting from soman or sarin exposure are discussed in relation to alterations in the central terminals of primary afferent neurons. PMID- 2711413 TI - Mode of metabolism is altered in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) treated rats. AB - Male Sprague-Dawley rats were fed either a high-fat (HF) or a high-carbohydrate (HC) diet and subsequently injected with either 2,3,7,8-tetrachlorodibenzo-p dioxin (TCDD) (125 micrograms/kg) or vehicle (pair-fed controls). In all TCDD treated animals, a reduction in caloric intake was evident as early as 1 day after dosage. Respiratory quotients (RQ) were determined at 5-day intervals. Their pattern for the HC-fed but not for the HF-fed TCDD-treated rats was different from that of the corresponding pair-fed controls. After an initial parallel decrease the RQ values remained low for TCDD-treated rats whereas they increased again for pair-fed controls. Serum total thyroxine (T4) was significantly lower in TCDD-treated animals and this reduction was not influenced by the composition of the diet. Serum triiodothyronine (T3) was neither altered by diet nor by TCDD. Thymic atrophy was as severe in pair-fed as in TCDD-treated rats fed the HC diet but not in rats fed the HF diet. Our results suggest that TCDD-treated rats are in a different mode of metabolism from pair-fed rats and that this difference is related to gluconeogenesis. PMID- 2711414 TI - Influence of vitamin B6 status on aspects of lead poisoning in rats. AB - The effects of vitamin B6 status and lead (Pb) toxicity on aspects of glutathione (GSH) metabolism in rats were examined in a 2 x 2 factorial experiment. The administration of 2000 ppm Pb as Pb acetate.3H2O significantly (P less than 0.05) increased hepatic GSH levels in rats receiving B6-adequate (+B6) but decreased GSH in rats fed B6-deficient (-B6) diets. The addition of Pb to the +B6 diet also increased hepatic glutathione reductase (GSSG-R) activity. Plasma pyridoxal phosphate (PLP), cystathionine and valine levels were decreased by the -B6 diets independent of the presence of Pb. Plasma arginine, alanine, serine and proline levels were increased by Pb in both -B6 and +B6 groups. Glycine levels were increased in -B6 rats only in the absence of Pb while taurine was decreased by Pb only in +B6 rats. There were significant -B6 x Pb interactions for hepatic GSH, cysteine and GSSG-R as well as plasma valine, glycine and proline. These results suggest an influence of B6 status on Pb-induced changes in hepatic GSH, possibly through its role as a co-factor for enzymes involved in amino acid metabolism. PMID- 2711415 TI - Relationship between hepatic glutathione content and carbon tetrachloride-induced hepatotoxicity in vivo. AB - The relationship between carbon tetrachloride (CCl4)-induced hepatotoxicity and hepatic glutathione (GSH) content was investigated in fed and fasted rats. The elevation of serum glutamic-pyruvic transaminase (GTP) activity by CCl4 treatment was enhanced by fasting. Although the hepatic GSH content fo 12-hour-fasted rats was higher than that of fed rats determined at 6 p.m., the serum GPT activity of the former was higher than that of the latter. Starvation had no effect on the activities of hepatic glutathione peroxidase (GSH-Px) and glutathione reductase (GR). The results suggest that the potentiation of hepatic injury by CCl4 cannot be related to hepatic GSH content. PMID- 2711416 TI - Contraceptive use and fertility decline in Chogoria, Kenya. AB - This article describes the results pertaining to fertility and family planning from a 1985 survey conducted in the catchment area of Chogoria Hospital in central Kenya. Current contraceptive prevalence was found to be quite high, 43 percent as opposed to 17 percent for Kenya as a whole. The total fertility rate of 5.2 births per woman was 2.5 births lower than the national rate. Very few women reported wanting to have large numbers of children or thinking that fate or God should determine family size. Although these data cannot conclusively demonstrate that the family planning program operating in the area has been responsible for reduced fertility there, they do provide some support for this hypothesis. PMID- 2711417 TI - The correlation between family planning program inputs and contraceptive use in Indonesia. AB - Using 1980 Census and 1986 service statistics program inputs, this paper evaluates the net correlation of socioeconomic, region, and program variables with 1987 contraceptive prevalence and method-specific use rates for Indonesian regencies and municipalities. The region variables--primarily, though not exclusively, reflecting program design and maturity--correlate most strongly with the contraceptive prevalence rates. Field-worker activities, field-worker supervisor activities, and community-based distributors also have a correlation with these rates. Pill use is highest in the areas that are predominantly Islamic and least developed, whereas the pattern is reversed for use of the IUD, condom, and other modern methods (mainly female sterilization). The findings are assessed in terms of their implications for policymaking. PMID- 2711419 TI - Strategies for studying suicide and suicidal behavior. PMID- 2711418 TI - Consumers of oral contraceptives in a social marketing program in Honduras. AB - This paper presents data on the characteristics of oral contraceptive users in Honduras, obtained from a point-of-purchase survey conducted in pharmacies in 1986. The oral contraceptive Perla, provided by the Social Marketing Program, accounted for 42 percent of sales. Forty-five percent of those using Perla were considered "new" users; either they were purchasing contraceptives for the first time or had used only Perla. Almost half of those who switched to Perla previously had obtained their orals in the noncommercial sector. Brand substitution occurred among users of commercial brands at about the same rate as among Perla users (51 percent versus 55 percent). Most women switching contraceptives did so within two months of their last purchase. PMID- 2711420 TI - Studying adolescent suicidal ideation and behavior in primary care settings. PMID- 2711421 TI - Why isn't a mouse more like a man? PMID- 2711422 TI - In situ hybridization using biotin-labeled probes. PMID- 2711423 TI - Endocrine changes and haemodynamic stability after brain death. PMID- 2711424 TI - Intermediate normothermic perfusion during cold storage of ischemically injured kidneys. PMID- 2711425 TI - Assessment of post-ischemic changes in intrarenal blood flow distribution. PMID- 2711426 TI - Effect of xanthine oxydase inhibition on warm ischemic lesions of the liver. PMID- 2711427 TI - Role of free radicals in entero-hepatic dysfunction caused by portal circulatory disturbance: effect of SOD derivative. PMID- 2711428 TI - Different cytoprotective effects of calcium blockers in hypothermic liver preservation. PMID- 2711429 TI - Evaluation of simplified variants of the UW solution using the isolated perfused rabbit liver. PMID- 2711430 TI - Protective effect of alpha tocopherol on Ca2+ regulation by microsomal fractions isolated from preserved rat livers. PMID- 2711431 TI - Prevention of liver damage by using free radical scavengers and changes in plasma PG levels during liver ischemia. PMID- 2711432 TI - Changes in activity of oxygen free radical scavengers and in levels of endogenous antioxidants during hepatic ischemia and subsequent reperfusion. PMID- 2711434 TI - Biochemical differences between Ringer's lactate and Collins' solution in hepatic preservation: detection by 31P magnetic resonance spectroscopy. PMID- 2711433 TI - Liver preservation: 31P and 13C NMR spectroscopic assessment of liver energy and metabolism after cold storage in Collins, Marshall, Ringer's lactate, UW and modified UW solutions. PMID- 2711435 TI - Prevention of pulmonary edema in autoperfusing heart-lung preparation by FUT-175 and leukocyte depletion. PMID- 2711436 TI - Improved cardioplegia using new perfusates. PMID- 2711437 TI - Value of polyethylene glycol (PEG) and horseradish peroxidase (HRP) for hypothermic rabbit heart perfusion. PMID- 2711438 TI - Changes in the weight of the pancreas during preservation in various solutions. PMID- 2711439 TI - A new simple two layer (Euro-Collins' solution/perfluorochemical) cold storage method for pancreas preservation. PMID- 2711440 TI - Ischemia and saphenous vein endothelial integrity. PMID- 2711441 TI - Vascular changes following hypothermic preservation. AB - This study identifies ultrastructural changes in the endothelium due to hypothermic HP-5 perfusion. These changes appear to be reversible and a manifestation of hypothermic hypoxia. This data provides a basis for improving perfusion techniques in both hypothermic preservation and cryoprotectant introduction and removal for cryopreservation. PMID- 2711442 TI - Ethics and priorities of organ procurement and allocation. PMID- 2711443 TI - Ethics in different cultures: the 'west'. PMID- 2711444 TI - Role of the transplant co-ordinator and multiple organ donation in the UK. PMID- 2711445 TI - The role of blacks in blood donation and the organ and tissue transplantation process. PMID- 2711446 TI - The delicate question of the donor family. PMID- 2711447 TI - The attitudes of young men to cadaveric organ donation and transplantation: the influence of background factors and information. PMID- 2711448 TI - Kidney transplantation in insulin dependent diabetic patients: improved survival and rehabilitation. AB - Between 1977 and 1986, 50 insulin-dependent diabetic patients received a kidney transplant, 19 from living related donors and 31 from cadaveric donors. Cumulative patient survival was 81% and graft survival was 64% and 33% for living related and cadaveric donor kidneys, respectively, at five years. These results are comparable to that of nondiabetic patients. While physical performance and visual acuity significantly improved after a successful kidney transplantation, neuropathies and angiopathies might not improve. Physical performance improved even in those patients whose nerve conduction time had deteriorated. These findings suggest that kidney transplantation is an effective means of improving survival and rehabilitation of diabetic patients with end-stage renal disease. PMID- 2711449 TI - The assessment of actual cellular damage in postischemic acute renal failure. PMID- 2711450 TI - Use of hepatic protein synthesis rate in acute ischemic liver to assess degrees of ischemic injury. PMID- 2711451 TI - Alloantigenic systems in the rat. Seventh international workshop. Yanuca Island, Fiji, August 6-13, 1988. Proceedings. PMID- 2711452 TI - Immunogenicity of lymphoid cells and vascularized organs for the non-MHC antigen EAG-1. PMID- 2711453 TI - Quantitative variation in immunoglobulin G (Igsr-1) in LEC rats associated with spontaneous hepatitis and hepatoma. PMID- 2711454 TI - MHC class I antigens in rat pregnancy: biochemical comparison between the pregnancy-associated (Pa) antigen and the classic class I MHC antigen RT1.Aa in the rat. PMID- 2711455 TI - Allogeneic lymphocyte cytotoxicity in New Zealand nude rats. PMID- 2711456 TI - Development of a prophylactic regime using long-acting tetracycline for the control of redwater and heartwater in susceptible cattle moved into an endemic area. AB - Thirty young crossbred steers were purchased from a tick-borne disease-free farm in South Africa, shown to be serologically negative to Babesia bigemina/bovis and Cowdria ruminantium, and moved to an experimental farm where babesiosis and heartwater were known to be endemic. The animals were allowed to graze as a herd on tick-infested areas of the farm for 90 days from the beginning of April but were separated into three groups of 10 for treatment. One group received a prophylactic regime of two injections of 20 mg/kg of a long-acting oxytetracycline on days 7 and 14 after introduction, one received a regime of three similar injections on days 7, 14 and 21 and the other group remained untreated prophylactically. The animals were observed early each morning in a crush, rectal temperatures being taken daily and blood smears when clinical signs of disease occurred. When clinical disease was confirmed in individual animals appropriate therapeutic treatment was implemented. In addition tick counts were made weekly. All untreated control animals required treatment for redwater between days 23 and 32 and eight of them then contracted heartwater of which five died despite therapy. Four animals from the group receiving two injections of oxytetracycline and one receiving three injections also contracted redwater but rather later. During the initial 35 day assessment period it was noticed that the majority of Boophilus ticks failed to engorge on the oxytetracycline-treated animals. In the second phase of the trial theileriosis (T. mutans-type) became evident in many animals and appeared to precipitate new or recrudescent clinical redwater and heartwater in several of them.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711457 TI - Populations of the cattle tick (Boophilus microplus) on purebred Nellore, Ibage and Nellore X European crossbreds in the Brazilian savanna. AB - Studies on purebred Nellore cattle and their crosses with Fleckvieh, Chianina, Charolais and the Ibage breed (5/8 Aberdeen Angus, 3/8 Nellore) during 39 months in the field gave mean daily counts for engorging female ticks of 3.3, 25.2, 22.2, 21.0 and 59.7 per animal respectively. Annual fluctuations were similar in all groups; with the exception of the purebred Nellore mean counts are at levels considered dangerous for the stability of enzootic tick fever. PMID- 2711458 TI - Reproductive performance of three fat-tailed breeds of sheep mated to native, Corriedale and Targhee rams. AB - Reproduction and lamb production of three fat-tailed, carpet-wool Iranian breeds of sheep; Karakul (130 ewes), Mehraban (103) and Baluchi (119) were studied. The ewes were mated either as purebreds or with Corriedale or Targhee rams. The overall least-squares means for ewes mated (showed oestrus) or ewes exposed, ewes lambed or ewes mated, lambs born of ewes lambing (prolificacy), lambs born alive of total lambs born, lambs weaned of live lambs born, lambs weaned (75 days of age) of ewes mated, kg lamb weaned per ewe mated and kg lamb weaned per 100 kg ewe mated were 98.3%, 93.5%, 103.1%, 94.9%, 97.8%, 90.0%, 18.2 kg and 38.4 kg respectively. The native breeds were not different for any of the traits studied except for prolificacy which was higher in Mehraban than in Karakul. Purebred matings did not differ from the crossbred matings for any of the traits concerning the number of lambs but crossbreeding improved kg lamb weaned per ewe mated (9.2%, P = 0.08) and kg lamb weaned per 100 kg ewe mated (10.0%, P less than 0.05). Among the three native breeds Karakul showed the largest improvement when crossed with the exotic rams for the traits concerning kg lambs weaned. Corriedale and Targhee rams had similar effects on all the traits studied. A lower percentage of virgin ewes showed oestrus, had a lower twinning rate and productivity compared with the mature ones. Sex was not a significant source of variation in lamb livability. PMID- 2711459 TI - Effects of endoparasites on the growth rate of Sudanese sheep and cattle. PMID- 2711460 TI - Cassava root meal in diets for growing rabbits. AB - The effects of substituting imported cassava root meal for barley meal in rations for growing rabbits were examined. Four diets were used. Diet 1 contained 500 g/kg barley meal, the remainder of the diet consisted of soya bean meal, barley straw, vitamins and minerals. Diets 2, 3 and 4 contained increasing amounts of cassava root meal in place of barley meal at 165, 335 and 500 g/kg respectively with L-lysine and DL methionine supplements. A growth trial was carried out using 48 individually caged rabbits from 0.8 kg to 2.0 kg and the digestibilities of the diets were determined in balance trials. Growth rates were similar on all treatments (41.6, 43.1, 40.6 and 41.0 g/d respectively, s.e.d. 2.39), as were dry matter food conversion ratios (2.27:1 overall). The cassava meal appeared to have a digestible energy approximately 1.6 MJ/kg DM higher than that of the barley meal. There appeared to be no adverse effects of feeding diets containing 500 g/kg cassava root meal on animal health. The intrinsic variability in chemical composition of cassava root products is discussed. PMID- 2711461 TI - Growth of Mashona cattle on range in Zimbabwe. I. Environmental influences on liveweight and weight gain. AB - Data from 1,456 purebred Mashona calves were analysed to determine environmental influences on growth rate and liveweight at birth, weaning (205 days) and 18 months of age. Calves were born between mid-September and mid-December each year. Year of birth was highly significant for all traits (P less than 0.001). Pre weaning liveweight and weight gain increased as age of dam increased to seven years after which growth tended to decline. Post-weaning compensatory growth was apparent in calves of young dams. Male calves grew faster and were heavier at all stages than female calves (P less than 0.001). Calves from previously non lactating cows grew more rapidly and were heavier at all ages than those from previously lactating cows. Birth weight increased as calving season advanced and calves born late maintained their growth advantage until 18 months of age. The results indicate that environmental influences experienced in early life persist long after weaning. PMID- 2711462 TI - Notes on the routine intravenous use of isometamidium in the control of bovine trypanosomiasis on the Kenya coast. AB - Various chemotherapeutic regimes were used to control trypanosomiasis in 3,000 Boran cattle on an estate on the Kenya coast. Recently the therapeutic use of isometamidium by the intravenous route was adopted to treat individual trypanosome-infected cattle. This was in order to overcome tissue reactions encountered after intramuscular injection and also to control a "thin cow" syndrome attributed to chronic trypanosomiasis. Toxic side effects were eliminated by careful attention to the intravenous technique which was safely used in calves, pregnant cattle and bulls. Weekly blood sampling and treatments of infected individuals resulted in a reduction of cases from 2,187 to 208 out of 46,495 and 46,329 samples examined in 1985 and 1986 respectively. The standard of management was very high and although this routine successfully controlled bovine trypanosomiasis on this estate its application elsewhere is likely to be limited. PMID- 2711463 TI - Detection of antibody to mycoplasma F38 in goat sera by an enzyme-linked immunosorbent assay. AB - An indirect enzyme-linked immunosorbent assay (ELISA) was developed to screen goat sera at a single dilution for antibody to mycoplasma F38. Antibody was detected in sera of six convalescent goats following experimental infection. Antibody was also detected in 34 sera three to four weeks after vaccination. No antibody was detected in 164 sera from goats without a history of vaccination or infection with contagious caprine pleuropneumonia. The ELISA was more sensitive than the complement fixation test in detecting antibody in vaccinated goats. PMID- 2711464 TI - An epidemiological model of rinderpest. I. Description of the model. AB - The development of an epidemiological model of rinderpest in cattle and wildlife populations is described. The model uses a state-transition structure, incorporating a stochastic element through the use of Monte-Carlo methods modified to allow large populations to be simulated. The potential applications include the estimation of "safe" host population immunity rates and the design of cost-effective rinderpest vaccination programmes. PMID- 2711465 TI - An epidemiological model of rinderpest. II. Simulations of the behaviour of rinderpest virus in populations. AB - Fixed parameters for different hypothetical strains of rinderpest virus (RV) and different susceptible populations are described together with details of their derivation. Simulations were then carried out in a computer model to determine the effects that varying these parameters would have on the behaviour of RV in the different populations. The results indicated that virulent strains of RV are more likely to behave in epidemic fashion whereas milder strains tend towards persistence and the establishment of endemicity. High herd immunity levels prevent virus transmission and low herd immunity levels encourage epidemic transmission. Intermediate levels of immunity assist the establishment of endemicity. The virus is able to persist in large populations for longer than in small populations. Different vaccination strategies were also investigated. In areas where vaccination is inefficient annual vaccination of all stock may be the best policy for inducing high levels of herd immunity. In endemic areas and in herds recovering from epidemics the prevalence of clinically affected animals may be very low. In these situations veterinary officers are more likely to find clinical cases by examining cattle for mouth lesions rather than by checking for diarrhoea or high mortalities. PMID- 2711466 TI - Evidence of Kimberley virus infection of cattle in China. PMID- 2711467 TI - A new serovar of Pasteurella haemolytica from sheep in Syria. PMID- 2711468 TI - Monoclonal immunoglobulin gene rearrangement in peripheral lymphocytes of a patient with multiple myeloma. AB - We analyzed the immunoglobulin (Ig) heavy chain gene rearrangement in the peripheral blood lymphocytes of a patient with multiple myeloma (MM). Although the morphological and immunological examination did not reveal the presence of circulating plasma cells, a monoclonal Ig gene rearrangement was detected. This observation indicates that a monoclonal expansion of circulating B cells was present in the peripheral lymphocytes of this patient. PMID- 2711469 TI - Post-traumatic localization of HIV-related Kaposi's sarcoma: a case report. AB - A case is reported of HIV-related Kaposi's sarcoma of the skin which occurred on a traumatized area. Such a case has not been previously described. The probable pathogenetic role of vasal growth factors produced by platelets, macrophages and lymphocytes' is emphasized. PMID- 2711470 TI - The role of magnetic resonance imaging in the evaluation of neoplastic lesions of the breast. AB - Thirty-seven patients were evaluated for suspected breast cancer by magnetic resonance imaging (MRI) using 0.5- and 1.5-Tesla. We examined the patterns in breast images and the use of MRI in evaluating neoplasms. At the moment the cost/benefit ratio is unfavorable, mainly because of the availability of alternative methods of high accuracy and low cost, like mammography and ultrasonography. Furthermore fine needle aspiration biopsy is not possible with MRI. The widespread use of MRI for breast pathology seems not to be justified by the results obtained. PMID- 2711471 TI - "T" category and operable breast cancer prognosis. AB - The authors report on 4,034 consecutively operated breast cancer cases, evaluating the correlation between clinical T category and long term survival. Age and pathologic nodal status were also considered as independent prognostic factors. Univeriate and multivariate (Cox's) analysis confirmed N status as the most powerful single prognostic indicator and did not reveal any prognostic correlation with age. T category was a strong prognostic indicator, independently of N status, the 10 year overall survival of T1, T2 or T3-4 cases being 0.86, 0.76 and 0.73 in N- and 0.73, 0.56 and 0.35 in N+ subgroups respectively. T category should be carefully considered not only in deciding the extent of surgical excision but also in planning adjuvant postoperative treatment. PMID- 2711472 TI - Morphological characterization of Lewis lung carcinoma (3LL). A light and electron microscopic study. AB - Primary tumor and its metastases of subcutaneously injected Lewis lung carcinoma (3LL) of the mouse were examined by light and electron microscopy. Although the optical appearance, in both cases, was of a indifferentiated carcinoma, the ultrastructural observation showed characteristic intracytoplasmic myelinoid bodies similar to those seen in type II pneumocytes in normal lung. These findings suggest that Lewis lung carcinoma is a carcinoma derived from granular pneumocytes equivalent to human alveolar cell carcinoma. The histological and embryological aspects of type II pneumocytes that could explain the histogenesis of this tumor are discussed. PMID- 2711473 TI - Nucleolar organizer regions in normal skeletal muscle and benign and malignant rhabdomyoblastic tumors. AB - The silver staining of interphase nucleolar organizer regions (NORs) has been shown to have an important application in diagnostic histopathology for distinguishing some benign from malignant conditions. In this study, normal fetal and adult skeletal muscles and tissue from fetal and adult rhabdomyomas as well as rhabdomyosarcomas were stained with the silver method for NORs. The morphologic distribution of NORs in rhabdomyosarcomas was found to be very different from that in normal skeletal muscles. In addition, cases of rhabdomyoma were easily differentiated from rhabdomyosarcomas. Statistical analysis of data, from all cases, regarding the diameter of NORs and number per nucleus confirmed these observations. PMID- 2711474 TI - Postoperative radiotherapy in locally advanced head and neck cancer. AB - This retrospective study was conducted on 255 consecutive patients with locally advanced squamous-cell carcinoma of the oral cavity, oropharynx, larynx or hypopharynx, treated at the Radiotherapy Department of Pordenone General Hospital between January 1975 and December 1985. All patients underwent radical surgery followed, after an interval ranging from 10 days to 2.9 months, by radiotherapy given either through a 6 MeV linear accelerator or a cobalt-60 unit. Field extension and dose delivered were comparable in relation to stage and involvement of the surgical resection margins. The aims of the study were to evaluate the survival rate and to analyze the clinical parameters which can influence the disease-free survival. The adjusted overall 5-year survival rate was 71%; stage, performance status at diagnosis, and site of the primary tumor were significant factors in determining patient prognosis, whereas infiltration of resection margins was not significant in determining loco-regional control of disease. Seventy-five patients relapsed and 67 died of cancer-related diseases whereas death in 52 patients was not related to the head and neck cancer. The combined modality treatment consisting of surgery followed by radiotherapy was well tolerated and proved to be effective in the treatment of locally advanced head and neck tumors. PMID- 2711475 TI - Malignant parotid tumors. Diagnostic considerations and therapeutic suggestions. AB - This paper presents our experience of the problem of diagnosis and surgical treatment of malignant parotid tumors, based on a retrospective evaluation of a series of 478 parotid tumors, of which 100 were malignant. Out of 75 primaris malignant tumors of epithelial origin, 35 belonged to the "epidermoid" group (adenocarcinomas, undifferentiated carcinomas, malignant mixed tumors, squamous cell carcinoma), 20 were mucoepidermoid carcinomas, 15 adenoid cystic carcinomas and 5 were acinic cell carcinoma. Altogether, 58.7% of the treated patients do not at the moment present evidence of disease; 33.3% are dead from the disease or are alive with active disease; 5.3% are dead from other causes and 2.7% are lost to follow-up. Underlining the importance of histologic examination of the swelling by intraoperative biopsy, the authors propose a diagnostic and therapeutic protocol. PMID- 2711476 TI - Favorable long term results in patients with small differentiated thyroid cancer not treated with radioiodine. AB - Data on a group of 110 patients with differentiated thyroid cancer not treated by radioiodine are reported. Most of them had intrathyroid (stage I) papillary or capsuled follicular cancer of less than 3 cm diameters. They all received thyroxine at TSH suppressive doses. The follow-up ranged between 4 and 25 years, mean 8.7. No patient died of tumor. Two very old patients died free of disease. Four recurrences occurred, within 8 years, all in patients over 45 years, all local or nodal, all papillary, 3 out of 4 after total thyroidectomy. This study shows that radioiodine therapy may be avoided and that lobectomy may be sufficient in patients under 45 years with small papillary or capsuled follicular cancer. PMID- 2711477 TI - Effects of 5-FU and cis-DDP combination on human colorectal tumor xenografts. AB - The antitumor efficacy of the cis-diamminedichloroplatinum (cisDDP) and 5 fluorouracil (5FU) combination was evaluated in a panel of eight human colorectal carcinoma xenografts. Tumors differed in origin (primary or metastatic), differentiation degree and chemotherapy treatment. Xenografts were treated with repeated i.v. injections of cisDDP, 5FU, or both drugs at 24-h interval. Compared with controls, cisDDP achieved a significant tumor growth inhibition in five out of eight tumor lines, and 5FU in four out of seven. One of two unresponsive tumor lines was significantly inhibited by the combination, that was also more effective than either drug alone (p less than 0.05) in one responsive xenograft. Comparing the effects of the combination according to which drug was administered first, lower drug doses were tolerated using the cisDDP-5FU sequence, but the antitumor effects were similar at equitoxic doses. These results indicate a potential therapeutic benefit of the cisDDP-5FU combination for colorectal carcinoma patients and show that toxicity of the combination is influenced by the drug sequence. PMID- 2711478 TI - Follow-up of a sessile juvenile polyp of the colon: a case report. AB - The aim of this case report is to underline some unusual features of a colonic juvenile polyp found in a young adult: lack of symptoms, site, sessile morphology and increase in site (greater than 50% in 2 years). The usefulness of the radiological survey to indicate endoscopic polypectomy is emphasized. PMID- 2711479 TI - CA 125 reliability in predicting ovarian cancer recurrence. AB - The predictive value of CA 125 assay for recurrence in ovarian cancer patients in follow-up was analyzed in a study from April 1984 through June 1987. Forty-two patients with no evidence of disease (NED), with positive antigen levels at diagnosis and negative at the end of active treatment, were considered eligible for the analysis. Median follow-up time was 16 months (range, 5-34). Outcome analysis revealed 19 cases still NED: 16 had normal CA 125 levels (less than 35 U/ml). The 3 patients with positive antigen titers were intensively investigated with no evidence of recurrence. Twenty-three cases had disease recurrence: 13 of them had elevated marker levels prior to relapse diagnosis, with a median lead time of 5 months (range, 2-13). In contrast, 10 patients had positive titers at or soon after the recurrence. Test sensitivity was therefore 56% and specificity 84%. Predictive value for recurrence of elevated CA 125 levels was 0.81. PMID- 2711480 TI - Primary melanoma of the ovary in a 25 year old primigravida--a case report. AB - A 25 year old primigravida with edema of the left foot and fetal distress during 36 weeks gestational period underwent an emergency lower segment cesarian section (LSCS). During surgery ascites and a left ovarian tumor with omental seedlings were observed. Cytopathology of the ascitic fluid, histopathology of the ovarian tumor and the omental seedlings showed features of a malignant melanoma, further confirmed at electron microscopy. Considering the age of the patient and the intra-abdominal restriction of metastasis of the neoplasms this tumor appeared to be a primary melanoma of the ovary. This case is reported since there is no reference to a pure melanoma of the ovary occurring in a young primigravida in the literature. PMID- 2711481 TI - Dental elements in mature teratomas of the ovary: scanning electron microscope ultrastructure. AB - Seventy-two teeth from 10 ovarian mature teratomas and 12 unerupted and erupted teeth from subjects aged 8 to 21 years were examined at the scanning electron microscope to evaluate the morphologic and histogenetic differences. The ultrastructure of the teratomatous teeth was similar to that of the corresponding orthotopic tissues. Despite this similarity the morphology of the teratomatous teeth was much less well defined, attesting to the inductive effect of the contiguous tissues that are normally present in the oral cavity. PMID- 2711482 TI - Superficial spreading melanoma with a nodular area: antigenic phenotype of the radial and vertical growth areas. AB - We investigated antigenic features associated with different tumor progression steps in primary melanoma, interpreted as different patterns of growth (radial and vertical) in the same and in different lesions. Thirty-eight primary melanomas were examined: 18 superficial spreading malanomas, 13 superficial spreading melanomas with a nodular area and 7 nodular melanomas. 225.28,763.74, CL.203, VF19LL209, VF19LL217, Q5.13, W6.32 and anti-HLA-DR monoclonal antibodies were used. Phenotypic differences between radial and vertical growth areas were observed but no statistical significance could be found. PMID- 2711483 TI - [Are there too many cases of bacterial gastroenteritis?]. PMID- 2711484 TI - [CFC gases in medicinal sprays]. AB - In 1987, approximately 1.18 million aerosol dispensers for medicinal use were sold in Denmark. These contained approximately 29 tons of completely halogenized CFC gases ("Freon") and the preparations were employed for the treatment of bronchial asthma and rhinitis. The possibilities of substitutes are discussed in this article. Preparations are already available which do not contain CFC. Producers of CFC are also attempting to develop new aerosol gases which do not damage the environment. Perhaps these will be found in medicinal preparations in the future. PMID- 2711485 TI - [Referrals for carotid surgery during the period 1977-1986. The referral pattern for patients with carotid stenosis in the catchment region of the University Hospital in Copenhagen, assessed during a 10-year period]. AB - Although carotid endarterectomy has been carried out for over 30 years, there are as yet no investigations which prove the value of this form of treatment with certainty. Attitudes to carotid surgery also vary greatly. The authors have assessed this variation during the period 1977-1986 on the basis of the lists of patients admitted to the Department of Vascular Surgery in the University Hospital. Patients from Funen and Jutland were excluded from the material because endarterectomy is also carried out in hospitals in these regions. A total of 720 patients from two extensive municipalities and six counties were admitted. During the period involved, increase in the number of referrals and also in the number of operations carried out occurred until 1984. After this, and in accordance with the global more restrictive attitudes, fewer patients were referred. Great regional variations were found as 8-10 as many patients per 100,000 inhabitants between 50 and 70 years were referred from the Municipality of Copenhagen as from the county which referred fewest patients. It is concluded that there are considerable differences in the treatment of patients with carotid stenosis within the catchment region of the University Hospital in Copenhagen. PMID- 2711486 TI - [Magnesium and long-term diuretic therapy]. AB - Thiazides and loop diuretics, facilitate the loss of Mg and K resulting in increased excretion in the urine. Although serum-K and serum-Mg values in patients receiving long-term treatment for hypertension or incompensated heart disease usually are normal, muscle-Mg and muscle-K contents are reduced in around 50% of these patients. Mg deficiency increases K loss and K/Mg deficiencies are frequently observed simultaneously. K repletion is often difficult if the accompanying Mg deficiency is not corrected simultaneously. The K/Mg loss from the muscles is accompanied by reduced concentration of Na,K-pumps. These disturbances may produce muscle symptoms, increased sensitivity to digitalis, inhibition of growth and possibly arrhythmias. Evaluation of the K and Mg status during diuretic treatment should be preferentially based on tissue determinations. The muscle biopsy method is rapid, reliable and may reveal conditions of deficiency. In several cases, oral supplements of Mg have proved to be adequate to restore the normal K/Mg status. PMID- 2711487 TI - [Fractures of the thoracolumbar spine. Surgical treatment using the Harrington Luque method]. AB - In the period of 1984-87 five women and 20 men aged 15 to 67, underwent open reduction and stabilization of thoraco-lumbar spine fractures with Harrington or Luque rods, segmental wires and interlaminar bone-chips. Half the patients had complete spinal cord lesions and these remained so. Criteria for instability were based on the three-column concept, the demand for early mobilization (10 days), or progression in neurological deficits. No operative complications nor deterioration in neurological findings occurred. Fusion and stability was obtained in all cases. Incomplete cord lesions and, particularly, cauda equina lesions improved substantially. Open reduction and stabilization in the early postinjury period performed by cooperation between a neurosurgeon and an orthopedic surgeon in centres experienced in the treatment of paraplegia is recommended. PMID- 2711488 TI - [Organization and management of a department for patients with paraplegia. Patient clientele during the first 2 years]. AB - Since January 1st 1985 seven, later only four, beds in the neurosurgical department, Rigshospitalet, were used to care for the problems associated with spinal cord or cauda equina damage. In the first two years, 21 women and 95 men aged 15 to 75 were treated in collaboration with an out-patient clinic and a rehabilitation hospital for patients with spinal cord injuries. Forty-five were admitted in the acute phase. Unstable fractures/dislocations were treated with spondylodesis in 22. General principles of management included intermittent catheterization, turning every 2-3 hours and anticoagulation therapy. Spinal stability was obtained in all cases submitted to operation. Incomplete lesions from medullary cone or cauda equina improved substantially, while complete spinal cord lesions remained so (in 27 patients). Next to urinary infection and concretions decubitus was the most frequent reason for admission in later phases in the remaining 71 patients 6 months to 40 years after the injury. Comprehensive, specialized care for patients with para- or tetraplegia in the acute phase and also in later phases can reduce the number of complications and the economic costs, encourage research work and reduce insecurity for the patients. PMID- 2711489 TI - [Fatal septicemia caused by Salmonella dublin]. AB - A case of Salmonella Dublin infection which ran a lethal course in a woman aged 49 years is described. Salmonella Dublin was first isolated in Denmark in recent years and appears to be associated with more serious clinical pictures than the other zoonotic Salmonella serotypes. The incidence of S. Dublin is increasing particularly in France and Belgium. It was first isolated from human cases in Denmark in recent years. In the clinical microbiological department in the County of Copenhagen, S. Dublin constitutes approximately 1% of the zoonotic Salmonella serotypes which are isolated from faeces while it is one of the commonest Salmonella serotypes isolated from blood. PMID- 2711490 TI - [Hyperpyrexia following poisoning with a monoamine oxidase inhibitor]. AB - A 35-year old woman took 1 gram of isocarboxazide (Marplan) with suicidal intent. She was admitted to hospital approximately six hours later with nystagmus, generalized hypertonia and jaw trismus. Four hours after admission, she became comatose with poor ventilation, increasing rigidity of all muscles and temperature rising to 41.1 degrees C. She was intubated and ventilated. Dantrolen was used for muscular relaxation but because of minor unfavourable experience with dantrolen pancuron was employed instead. After this, the temperature fell and the patient became relaxed. After two days, she was extubated and transferred to psychiatric care in a normal physical state. It is concluded that a non depolarizing neuromuscular blocking drug should be used in patients with hyperpyrexia caused by MAOI overdose, because of the generally more favourable experience with these drugs and because of the potential hepatoxicity of dantrolen. PMID- 2711491 TI - [Acute infection caused by the human immune deficiency virus (HIV) during the practice of safe sex]. AB - On the basis of two cases of acute HIV infection, diagnosed in two patients who only employed "safe sex", HIV-infection prophylaxis in the high and low risk groups is discussed. PMID- 2711492 TI - [The thin membrane syndrome. A cause of asymptomatic microscopic hematuria]. AB - The use of urinary diagnostic strips with high sensitivity for hemoglobin has revealed microscopic hematuria in individuals with no symptoms or signs of illness. The thin membrane syndrome may be a frequent cause of such asymptomatic hematuria, and this diagnosis is particularly topical in the case of glomerular hematuria, i.e. with a dysmorphic erythrocyte picture on urinary microscopy. The thin membrane syndrome represents a new entity with an uncertain prognosis. The distinction between thin membrane syndrome and Alport's disease is important but difficult. Modern immunochemical investigations may be helpful in this regard. Until more information is available concerning the thin membrane syndrome, regular control of blood pressure, serum creatinine, urinary sediment and urinary protein is recommended in these patients. PMID- 2711493 TI - [Hereditary eye diseases]. PMID- 2711494 TI - [Terminal care--the task is solved by primary health service]. PMID- 2711495 TI - [Child abuse and the lack of care]. PMID- 2711496 TI - [Child abuse and the lack of care. 1. An epidemiologic study from the Danish forensic officers, Institute of Forensic Medicine and the Medico-legal Council during 1970-1979]. AB - The object of this investigation was to undertake an epidemiological study of the cases of child abuse and neglect, which resulted in contact with a forensic officer, an Institute of Forensic Medicine or the Medico-Legal Council during the period of 1970-79. A total of 901 children aged 0-17 years were registered in this retrospective investigation. One hundred and sixty-four children (51% boys) were physically or emotionally abused or neglected. 75% were 0-7 years old. Seven hundred and thirty-seven children (8% boys) were sexually abused. 75% were over seven years of age. In the first group (physical abuse), information was frequently available about prior abuse of the index-child, siblings and conflicts between the parents. In 27% of the cases the abuser was the mother, 21% the father, 14% stepfather, 3% daycaretaker, while the remainder were combinations or unknown. The lesions were often bruises or attempted strangulation. Thirty-six children in this group died. In the second group (sexual abuse), there was often information of previous sexual abuse of the index-child and siblings. The perpetrator was always male. In 47% of the cases the perpetrator was unknown to the child. In the rest of the cases the perpetrator was a relative, friend of the family or person known to the child. In about half the cases the abuse consisted of vaginal penetration or intercrural rubbing. In 24 cases strangulation was part of the abuse, but no fatal cases occurred. In seven cases, the abuse resulted in venerial disease, in six cases pregnancy and 68 cases of lesions of the hymen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711497 TI - [Child abuse and the lack of care. 2. An epidemiologic and social pediatric study of fatal child abuse and neglect in Denmark in 1970-1979]. AB - The object of this investigation was to undertake an epidemiological, clinical and social pediatric study of cases of fatal child abuse and neglect in order to use the information in preventive work. A total of 38 children aged 0-13 years were registered in this retrospective study from all Danish forensic officers, pediatric departments, institutes of forensic medicine and the medico-legal council. At least 21% of the children had a history of failure to thrive and at least 21% had a chronic disease or handicap. At least 1/3 had been subjected to previous abuse and at least 11% of the siblings also. A minimum of 1/3 of the mothers and 18% of the fathers had a chronic physical or mental disease and most of the families came from the lower social groups. In nearly 1/3 of the cases, the crisis which precipitated the abuse was caused by the child's behaviour and, in nearly 1/3 of the cases, information was available about stressing factors in the adult concerned. The primary cause of death was head injury and, in order of frequency, intraabdominal injury, strangulation, drowning and neglect. Difficulties in the definition of fatal child abuse and neglect are the reasons for different incidences in various countries, but the present investigation showed an incidence of 0.8 child deaths from fatal child abuse per million inhabitants per year. In Denmark, at least four children die every year on account of child abuse. PMID- 2711498 TI - [Regional distribution of birth weights in Denmark during the period 1979-1983]. AB - We investigated the geographical distribution of birthweights among liveborn infants in Denmark for the years 1979-1983, using the Medical Birth Register of the Danish National Board of Health. The investigation includes 272,361 liveborn children. The birthweight varies with the sex of the child, and with the age and parity of the mother. In the analysis of geographical variation of birthweight correction was made for these factors. We found an association between birthweight and urbanization, the lowest average birthweight being found in the capital, and the highest in the rural areas. Further, the average birthweight was higher in the western than in the eastern part of Denmark, especially in Northern Jutland and in Aarhus County. Geographical variation in gestational age explains part of the geographical variation in birthweight, but part of the variation must be explained by variation in the growth of fetuses. The role of genetic variation, variation in living conditions, and variation in the conduct of the health services is discussed. We found an unexpected association between the average birthweight in the counties, and neonatal mortality; the counties with high average birthweights also had a significantly increased neonatal mortalities. PMID- 2711499 TI - [Gynecomastia. A follow-up study]. AB - Classification of gynaecomastia as physiological/idiopathic is traditionally carried out by exclusion on the basis of the case history and results of the clinical examination. Out of 138 consecutive patients with gynaecomastia referred by general practitioners to the Surgical Gastroenterological Department K in Odense Hospital during the period 1978-1981 for treatment, 98 patients (71%) were classified in this manner. Following a period of observation ranging from four months to ten years, average 7.5 years, diseases were demonstrated in five of the physiological/idiopathic cases which were perhaps the causes of gynaecomastia. Employment of an extensive paraclinical programme of investigation would probably have resulted in demonstration of the underlying disease in three cases but would scarcely have improved the prognosis despite the possibility for earlier institution of treatment. Routine employment of extensive paraclinical investigations of selected patients with gynaecomastia of this type cannot be recommended on account of the limited diagnostic and therapeutic results. Classification of gynaecomastia based on the case history and clinical examination appears to be sufficiently exact in patients referred by general practitioners for treatment to a surgical department. PMID- 2711500 TI - [Body height in a population of children in Greater Copenhagen 7 to 18 years of age in 1981 and 1985. The Osterbro child study]. AB - As part of the childrens' section of the Osterbro investigation, a quantity of standard health information concerning 736 boys and girls in 1981 and 892 in 1985 was collected. Review of these values revealed a significantly greater average height (greater than 3 cm) for boys in the age group 8-16 years and for girls aged 7-15 years than in previously published materials. The final height at about the age of 18 years for both girls and boys was not found to deviate significantly from previous results. The height/weight relationship remained unchanged. Current adjustments of the normal curves for childrens' growth should be made and/or an assessment of how well the subpopulation concerned is in agreement with the national average. PMID- 2711501 TI - [A new cause of accidents resulting from the use of air-powered tools]. AB - Air-powered tools are employed increasingly frequently in industry and involve new possibilities for occupational accidents. A new mechanism of trauma is described where the cause is failure of the snap connection between the tool and the air pipeline. The pipeline and the connection are hurled away from the tool with great force and can hit persons in the vicinity. During the period 1.1.1984 to 31.12.1986, 33 accidents of this type were registered with the workers' supervision authorities. 63% of these consisted to trauma to the neck, head and eyes. As prophylaxis, the present authors suggest a safety chain between the tool and the pipeline and a valve which interrupts the air supply when the pressure in the system falls. PMID- 2711502 TI - [The heavily increasing costs of drugs]. PMID- 2711503 TI - [Treatment with anticoagulants--rapid or slow cessation of medication?]. PMID- 2711504 TI - [Evaluation of quality in health services]. AB - In recent years, the population and professional people have become increasingly aware of the need for a more systematic assessment of quality in health service. On basis of this, a Danish workshop was held in 1988 concerning scientific methods of assessing quality in the health sector. This review provides an introduction to the expressions "assessment of quality" and "insurance of quality" in the health sector. The main points from the workshop are quoted and concrete examples of assessment of quality in the Danish health service are given. It is concluded that after a couple of decades in which health political analyses and decisions have primarily been concentrated on productivity and efficacy, we may consider insurance of quality as an instrument for decision making in the current adjustment of the health service to the changes in knowledge, attitudes and technology. PMID- 2711505 TI - [Bronchial asthma and pregnancy]. AB - In pregnancy complicated by asthma, the greatest risk to the fetus is severe and uncontrolled bronchospasm resulting in hypoxia. For this reason, the priority in management of the pregnant asthmatic should be effective control of the asthmatic symptoms. In general, the management of the pregnant asthmatic does not differ from that of the non-pregnant patient. Virtually none of the commonly used asthma medications are totally contraindicated in pregnancy and lactation if their use is justified by the severity of the asthma in pregnancy. Avoiding of recently introduced drugs, for which safety in pregnancy has not been adequately established, and using an inhaled route in preference to the oral route of administration are recommended. PMID- 2711506 TI - [Child abuse and the lack of care. 3. A study from the Medico-legal Council during 1970-1979]. AB - The object of this investigation was to study cases of child abuse and neglect presented to the Danish Medico-Legal Council during 1970 through 1979. A total of 38 children were registered in this retrospective study. The material consisted of 17 boys, 19 girls and two cases where the sex was not stated. The perpetrator was the biological father in ten cases, the mother in 13 cases, in two cases the stepfather, in two cases a babysitter, four cases where the perpetrator was known to the family, one case unknown to the victim and six cases where the perpetrator was not identified. The questions to the Medico-Legal Council where 24 cases were concerned were a discrepant history and evaluation of the lesions, six cases of a pharmacological nature, six cases where evaluation of the perpetrators mental state was required and two cases where the Council was asked to estimate whether the child would have survived, if correct treatment had been instituted in time. Evaluation was multidisciplinary, the expedition time fair and the answers to police and judicial system relevant, even though some of the doctors were reluctant to state definitely, whether child abuse was concerned. It is recommended that a forensic officer and a pediatrician should always participate in the evaluation. PMID- 2711507 TI - [Children and domestic fights. A review of 105 social reports]. AB - The object of this investigation was to describe the conditions for children in families with domestic rows on the basis of 105 social reports made by the Copenhagen police during a period of one year. A total of 162 children were involved in domestic rows. The typical family had 1-2 children. In 14% of the cases, the domestic rows were reported by the child. In connection with the domestic rows, violence to the women occurred in just under half of the cases and to the children in 6%. In 77% of the cases of domestic rows, at least one of the adults was under the influence of alcohol/medicine/narcotics. The mental and somatic conditions of the children were not fully described in the social reports. The investigation revealed that the children were primarily the victims of passive violence which may damage their ability to form emotional relationships with others and thus may injure development of their personalities. The legal compulsory notification according to Danish Law is emphasized and it is pointed out that notification is only relevant in this connection when it results in action from the social and health authorities. PMID- 2711508 TI - [Patellar fractures. Modified tension band osteosynthesis]. AB - In a retrospective investigation, the ability of modified tension band osteosynthesis to retain 45 reduced fractures of the patella and the functional end result was studied. Postoperatively, 24 patients were immobilized in plaster casts for 0-14 days and the remainder for 25-56 days. Postoperative radiographs revealed nine fractures (four transverse, three comminuted and two pole fractures) with fragment displacements exceeding 2-3 millimeters. Among these, three fractures had secondary dislocation and, further, one exactly reduced pole fracture dislocated. Operation was complicated with infection in four cases: two superficial wound infections, one subcutaneous fistula and one pyarthron. Operative release of adhesions was performed in five cases, two patients were patellectomized and one required a condyle prosthesis. At follow-up 18-80 months after the injury, 37 patients were examined clinically. Among 29 patients without concomitant injuries, seven patients were free of symptoms and 13 patients were without any pain. Free knee movement and quadriceps atrophy less than or equal to 1.5 cm was found in 17 patients. The modified tension band can retain adequately reduced transverse and comminuted fractures of the patella, probably also without plaster immobilisation. Dislocated fracture of the patella is a serious lesion, which must be treated with care. PMID- 2711509 TI - [Bone scintigraphy in patients with hip joint prostheses. Use of bone scintigraphy in hip pain after total hip replacement]. AB - A retrospective investigation was undertaken to assess the value of bone scintigraphy with 99mtechnetium methylene-diphosphonate in patients referred with hip pain after total hip replacement. The material comprized 68 patients with a total of 68 prostheses. This review revealed that 10/25 of the patients with pathological scintigrams and 6/28 of the patients with normal scintigrams were submitted to replacement of the prostheses. In the way in which it was carried out and interpreted in this department, scintigraphy was of limited value in selection of the patients who required replacement of the prostheses. PMID- 2711510 TI - [Clinical aspects of spinal anesthesia administered using 0.5% isobar bupivacaine (Maracine) at the L2/L3 or L4/L5 level]. AB - The effect of employing different interspaces for lumbar puncture during spinal anaesthesia was evaluated in 40 patients receiving 4 ml of 0.5% plain bupivacaine at level L2/L3 or L4/L5. No differences were observed in onset, spread or duration of analgesia. Furthermore, we found that only 80% of the patients, independently of the interspace used, had a cephalad spread to T8 and conclude that spinal anaesthesia using plain bupivacaine is not ideal for supraumbilical surgery. PMID- 2711511 TI - [Readmitted patients at a medical ward. 1. Health conditions]. AB - The object of this investigation was to describe the health and social-medical conditions of readmitted patients and to assess which of these conditions was the main reason for readmission. A total of 166 patients (with an average age of 73 years) readmitted to the ward within three months of the last discharge from the ward were interviewed about their health, social and housing conditions in the period prior to admission. In this first report from the investigation it was found that 57% were readmitted within one month. 71% stated that they had experienced symptoms from the heart and/or respiratory system and 52% had experienced symptoms from the locomotor system. Only 13% did not receive any daily prescription drugs. Approximately 1/3 considered their health to be good and 1/3 poor, respectively. These results were compared with the data available in the literature about the health conditions of non-hospitalized elderly persons. It was demonstrated that the readmitted patients had more health complaints, a more extensive medication and considered their health worse. PMID- 2711512 TI - [Readmitted patients at a medical ward. 2. Social and housing conditions]. AB - The object of this investigation was to describe the health and social medical conditions of elderly readmitted patients and to assess which of these conditions was the main reason for readmission. A total of 166 patients (with an average age of 73 years) who were readmitted to the ward within three months of the previous discharge were interviewed about their health, social and housing conditions during the period prior to admission. The interviews were conducted in the second half of 1987. In this second report from the investigation it was found that 84% lived in flats with good facilities. 50% lived alone, 57% received at least one form of public assistance (ie home help, home nursing etc.). The interviewers considered that social and housing conditions were the only reason for 12% of the readmissions and were contributory causes in 15% of the readmissions. It is concluded that health reasons were the primary reasons for the present readmission. PMID- 2711513 TI - [Intervertebral disk prolapse as an unusual cause of Horner's syndrome]. AB - A case of protrusion of the first thoracic intervertebral disc is presented. The patient suffered from severe acute pain in the chest and left arm. Horner's syndrome was present, probably due to compression of the preganglionic sympathetic fibres as they leave the spinal cord through the anterior root. The diagnosis was confirmed by myelography and CT scanning. The prolapsed disc was removed by laminectomy and the symptoms resolved. PMID- 2711514 TI - [Torticollis--an unusual origin]. AB - On account of left-sided chronic otitis with cholesteatoma an otherwise healthy eight year-old girl underwent an otological operation lasting five hours. The course was technically uncomplicated. Postoperatively, persistent torticollis with turning of the head to the right was observed. X-ray and CT-scanning revealed atlanto-axial subluxation. No other cause than the rotation of the head during the operation was demonstrated. It is concluded that subluxation should be considered if torticollis is present after operations during which the head has been rotated. PMID- 2711515 TI - [Mental stimulation of a patient with Wernicke-Korsakoff's syndrome]. AB - A mental stimulation programme employed in a woman aged 37 years suffering from Wernicke-Korsakoff's syndrome is described. This resulted in such improvement of her condition that full-time institutionalization could be avoided. PMID- 2711516 TI - [Dr. Schlanbusch and the fear of hypercholesterolemia]. PMID- 2711517 TI - Circular harmonic averaging of noisy single-molecule images. AB - A new method for averaging of noisy single-molecule images has been developed. Averaging is done over the circular harmonic components of the images instead of over the images themselves. Those images which show different molecules or molecules in different projections can be separated into classes by comparing the power of their circular harmonic components, which is rotationally invariant. Orientational alignment, based on the rotational correlation of each image with all others, and averaging is performed separately for each class. Applying a quality measure to the circular harmonic averages allows separation of significant and nonsignificant components. Computer simulations indicate that the method is quite stable against noise. One of the main advantages of "circular harmonic averaging" over existing methods is that no reference images are needed in the averaging procedure. PMID- 2711518 TI - Abstracts of papers presented at the annual conference of The Netherlands Society of Electron Microscopy. 30 November 1988-2 December 1988, Kerkrade, The Netherlands. PMID- 2711519 TI - Electron-beam-induced spectroscopies with high spatial resolution. Selected papers from the NSF/CNRS workshop. Aussois, France, 28 February-5 March 1988. PMID- 2711520 TI - A corrected double-deflection electron spectrometer equipped with a parallel recording system. AB - A new type of Electron-Energy-Loss Spectrometer has been designed and built in order to fulfill the requirements for spectroscopic methods and new imaging modes in a STEM. A parallel recording system has been coupled with the spectrometer. The figures of performance were measured and compared to those that had been calculated. PMID- 2711521 TI - Filtered dark-field and pure Z-contrast: two novel imaging modes in a Scanning Transmission Electron Microscope. AB - For the investigation of biological objects with a Scanning Transmission Electron Microscope (STEM) the dark-field imaging mode is the one used most often. We will show, regarding calculations that we have done which took into account the finite angle of the illumination and multiple scattering processes, that the collected amount of inelastically scattered electrons with an annular dark-field detector is higher then normally expected. According to the above calculations, we designed a new detection system to enable us to acquire three different images (inelastic, filtered dark-field and filtered bright-field) simultaneously. PMID- 2711522 TI - Electron spectroscopic imaging of frozen-hydrated sections. PMID- 2711523 TI - Multivariate statistical analysis of electron probe microanalytical data on cell nuclear constituents. AB - A multivariate statistical analysis (the principal component analysis) has been used to process electron probe microanalytical data from cell nuclei. Fifty-seven measurements from different areas of chromatin and nucleolus in follicular rat cells have been studied. The variables are the X-ray characteristic signals for P, S, Al, Fe, Cu and Zn. This method demonstrates three groups of individuals - the chromatin area which is associated with a stronger concentration of P and two groups of nucleolar areas, one of them being connected with a higher content in S, Al and Zn. This high degree of correlation between these three elements proves the chemical affinity of the metals with the protein, S being the signature for proteins. PMID- 2711524 TI - [Structure and function of the "neosynovial membrane." Light and transmission electron microscopy studies of regenerated synovial membranes following surgical synovectomy]. AB - Regenerating synovium from seven patients was examined by light- and transmission electron microscopy. Superficial layers of the "neosynovium" are composed of histocytes, fibroblasts and intermedium cells, developing out of undifferentiated mesenchymal perivascular connective tissue cells. There is no closed cell-layer, as known from mesothelia, endothelia and epithelia. Our results are similar to those of normal synovium and the so-called "pseudo-synovium" of pseudarthroses. So superficial layers of these tissues are comparable specialized connective tissues. According to experimental results in animals, in patients there will develop a "neosynovium" comparable to the original synovium in structure and function. These results confirm synovectomy as a possible operative treatment in patients. PMID- 2711525 TI - [Complications of Redon drainage following hip joint replacement operations--an analysis of the causes]. AB - After the introduction of Redon high-vacuum drainage, a considerable decrease in post-operative haematomas has been noted. But some of the complications could not be prevented by using the Redon system. They were in fact the result of it. The Redon system cannot be classified as a "closed" wound drainage. During bottle replacement, the system must be disconnected. An effective closed system must remain absolutely tight from application to removal of the drain so no possibility exists of contamination/infection from the outside. After introduction of a continuously absolutely closed system in a prospective study with three different systems the influence after hip joint arthroplasty operations on wound healing was investigated. The wounds were drained with the Redon high-vacuum system or the newly developed, permanently closed drainage system with maximum obtainable low pressure of 80% vacuum and 50% vacuum. Here the maximum obtainable vacuum builds up slowly in relation to the accumulated amount of wound fluids. The loss of low pressure in Redon systems differs between the drains. In the intra-articular drains the mixture of air and blood results in a linear decrease and follows not a hyperbola like in subcutaneous drains. Because of the high suction at the beginning of the Redon drainage necrotic muscle cells adhere to the outside of the drain openings and clogs them up mechanically. The stronger the suction effect on the tissue, the more fatty live cells and small vessels enter the lumen of the drain in the Redon system and 80% vacuum. This mechanisms result in bleeding from the drain canal after removal of the drain and "secondary" haematomas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711526 TI - [Para-articular surgical interventions of the hip--a mechanical problem]. AB - From the analysis of a case report the author draws the following conclusions: Combining a perfect reduction with a valgus intertrochanteric osteotomy and a stable fixation ensures almost certainly against non union and probably against a high rate of avascular necrosis in cases of subcapital fractures of the neck of the femur. However, increased compressive stresses must be expected in the joint, above all in obese patients or if the joint surfaces are not congruent. Therefore, unloading is recommended and a secondary varus intertrochanteric osteotomy should be carried out as soon as bony union is achieved. Pauwels' intertrochanteric osteotomy constitutes a sensible treatment of osteoarthritis of the hip and gives amazingly long term good results if the weight bearing surfaces of the joint can be increased and the articular pressure is thus considerably reduced. The cyst in the femoral head results from fractures of cancellous trabeculae subjected to stresses which are beyond of functional adaptation. PMID- 2711527 TI - [Method of treating femur head dislocation fractures]. AB - The fracture and dislocation of the head of the femur is still an uncommon accident, however, involving many complications. To avoid secondary damage a closed reduction should be obtained as soon as possible and with great care. Osteosynthesis of the femur head fragments is desireable for congruency of the joint surfaces and to prevent post traumatic arthrosis. Only this treatment allows for functional physical therapy. Type 3 fractures in patients over 65 and also multiple fractures of the femur head should be treated with a prosthesis implant. In young people primary reconstruction of the joint should be attempted in every case. PMID- 2711528 TI - [Follow-up studies and results of dorsal stabilization of unstable spinal fractures]. AB - Temporary dorsal plate spondylodesis with transpedunclar screwing has proved successful in the therapy of recent unstable injuries to the spine. This method allows a considerable reconstruction and stabilization of the vertebral body as well as an early mobilization of the patient. The mobility of the spine will not be essentially reduced if the spondylodesis plates are removed early, i.e. six to nine months after their insertion. PMID- 2711529 TI - [Treatment of fresh subcutaneous flexor tendon rupture of the distal joint of long fingers with temporary bone wire arthrodesis]. AB - Drop-finger at the distal joint or mallet-finger from injury occurs because of the extensor apparatus is so much weaker than the flexor tendon that it breaks under strain. We report on 100 cases treated by internal splinting with longitudinal applied Kirschner wire in the distal and middle phalanx of the finger. It affords an absolute immobilisation of the distal interphalangeal joint in slight hyperextension with relaxation of the extensor apparatus. The wire was removed after six weeks. The results evaluated in 76 patients by follow-up four to 84 months were classified as excellent in 86.8% (full range of motion), good in 11.9% (loss of motion 5 to 15 degrees), and poor in 1.3% (loss of motion more than 15 degrees). The excellent and good results emphasize that internal splinting in ruptures of the extensor apparatus near the distal interphalangeal joint. PMID- 2711530 TI - [Only unity of action will permit AIDS to be conquered]. PMID- 2711531 TI - [Continuous peritoneal dialysis in children]. AB - Thirty-two uremic children were treated by chronic peritoneal dialysis (CPD) since February 1982. Fifteen chose chronic ambulatory peritoneal dialysis (CCPD) while the 17 others were treated by continuous cycle peritoneal dialysis (CCPD). To this day, 10 patients (31%) are alive with a functioning kidney transplant, 16 (50%) are still treated by CPD awaiting a transplant, 5 have died (16%) and one went back to hemodialysis (3%). Complication in ranking order were peritonitis, mechanical drainage problems of the catheter and hernias. Linear growth was from good to excellent in the majority of patients. Globally, CPD was found to be attractive mainly because it allows a good quality of life. PMID- 2711532 TI - [Estimation of PaO2 using pulsatile oximetry and the HbO2 dissociation curve in the premature infant]. AB - An estimation of arterial PO2 from pulse oximetry using oxyhemoglobin dissociation curve. Forty blood specimens were drawn from umbilical arteries of the neonates having a pulse sensor attached to either foot or hand. The sensor was connected to a Nellcor-N100C in twenty cases and to an Ohmeda Biox-3700 for the remaining. Mean birth weight was 1,513 g, mean gestational age 32.4 weeks, and foetal hemoglobin ranged from 54.8 to 100%. Oxyhemoglobin dissociation curves were drawn for each arterial sample to obtain P50 and estimated PO2. The estimated PaO2 was the PO2 corresponding, on the oxyhemoglobin dissociation curve, to the pulse oximeter saturation reading. Mean difference between blood saturation and pulse oximeter saturation of 1.2% was obtained with Nellcor and of 3.9% with Ohmeda. Arterial and estimated PO2 comparison gave a mean + S.E.M. difference of 4.6 +/- 1.3 torr for all cases. This represents less than 8% error in estimating PaO2 from pulse oximetry. We suggest the following polynomial equation Y = 4250 - 10.4X + 0.069X2 for using pulse oximetry (X) to evaluate PaO2 (Y) in premature infants. PMID- 2711533 TI - [Total androgen blockade: an argument in favor]. PMID- 2711534 TI - [Menopause: an efficacious therapeutic approach necessitates a global philosophy. Interview by Robert Henry]. PMID- 2711535 TI - A prospective area-based study of the outcome of pregnancy in rural Tanzania. AB - A prospective area-based study on the outcome of pregnancy was carried out in the rural village of Ilula in Tanzania. A coverage of 99% (n = 719) regarding the ultimate outcome for mother and child was achieved, including deliveries that took place in hospital (9%), at the dispensary (67%) and at home (23%). There were four maternal deaths (6/1,000). The mean birth weight for singletons was 3,070 g and the low birth weight (less than 2,500 g) rate 13%. From a gestational age of 37 weeks onwards there was a definite slowing of fetal growth. Perinatal mortality rate was 82 per 1,000 born, half of the deaths occurring in low birth weight babies. Twinning occurred in 3.5% and the mean length of gestation at delivery for these pregnancies was 35.5 weeks. Twins constituted 6.8% of newborns but accounted for 23.0% of perinatal losses, making twin pregnancy a major contributor to perinatal mortality. Post-term pregnancies carried no significant increase in mortality. It is concluded that reliable area-based data on the outcome of pregnancy in Tanzania can be obtained at village level, with good coverage of the study population, by properly instructed and motivated local staff with moderate supervisory support. PMID- 2711536 TI - DiGeorge syndrome in a child with partial monosomy of chromosome 22. AB - A girl with severe neonatal hypocalcaemia, thymic hypoplasia, congenital heart disease and mental retardation in combination with a partial monosomy of chromosome 22, del(22)(pter-q11.3), is reported. Nine other patients with an association between partial monosomy 22 and a DiGeorge syndrome have been reported earlier, and this combination probably constitutes a deletion syndrome similar to the Prader-Willi and the aniridia-Wilms' tumour syndromes. However, the deletion of chromosome 22 is mostly due to a translocation, with trisomy for another chromosomal segment. Such a mechanism may explain the different clinical features seen in patients with partial monosomy 22. In the present case there was an unbalanced translocation with a probable trisomy of the short arm of chromosome 20 combined with the partial monosomy 22. Cytogenetic investigation with high resolution banding techniques is indicated in patients with thymic aplasia and suspected DiGeorge syndrome. PMID- 2711537 TI - The small-for-gestational-age infant: obstetrical management and perinatal outcome. AB - In order to study whether antenatal detection and supervision of small for gestational-age (SGA) infants favours the prognosis, the obstetrical management and perinatal outcomes of all SGA infants born in Uppsala county between 1980 and 1985 were reviewed. Data on 154 mothers and their well-shaped, single-born SGA infants (less than -2 SD) were analysed. Twenty-three mothers delivering SGA infants were admitted to the hospital due to maternal diseases ("complicated SGA pregnancies"). Fetal well-being was regularly monitored in all these pregnancies. In the symptom-free SGA pregnancies (n = 131), fetal well-being was regularly monitored in 69 pregnancies whereas in 62 it was not. There were eight stillborn SGA infants. These infants were all delivered by mothers with symptom-free pregnancies, not supervised with regard to fetal well-being. In the neonatal period, 15 SGA infants either suffered from postpartal asphyxia (Apgar 5' less than 7) or from a severe disease (meconium aspiration, convulsions, idiopathic respiratory distress syndrome or septicemia). Seven SGA infants (of whom two died postnatally) delivered by mothers with complicated pregnancies and eight SGA infants not supervised with regard to fetal well-being during pregnancy, suffered from one or more of these complications. In symptom-free SGA pregnancies, regularly supervised with regard to fetal well-being, all SGA infants (n = 69) escaped these severe neonatal problems. PMID- 2711538 TI - Radiation dose in assessment of tibial torsion with a mobile C-arm fluoroscope. AB - The absorbed dose to the skin was measured in adult patients undergoing fluoroscopy with a mobile C-arm fluoroscope for determination of tibial torsion. Two methods suitable for routine measurement of tibial torsion were investigated in this respect. The mean absorbed doses for assessment of torsion in one extremity were found to be 5.3 and 5.5 mGy respectively. No scattered radiation to the contralateral foot or symphysis of patient was recorded. The examiner received no measureable dose on any occasion. PMID- 2711539 TI - Influence of vibration on work performance during ergometer cycling. AB - With a view to investigating how vibration affects dynamic working capacity, exercise tests were performed both with and without superimposed vibration. The performance of 8 healthy, non-smoking 20-year-old males exercising on a cycle ergometer at a constant load was studied on four occasions, with and without vibration in a randomly chosen order. The frequency of the vibration, which was applied vertically through the pedals, was 20 Hz and the acceleration was 20 m/s2 RMS. The handlebars and saddle of the cycle were insulated from the vibration. The exercise time averaged 47 min with vibration and 60 min without. The vibratory stress reduced the exercise time by 13 +/- 2.9 min (mean +/- SEM) (P less than 0.005). The average heart rate when the exercise was stopped was 180.3 beats/min with vibration and 180.7 beats/min without. The systolic blood pressure after 20 min averaged 188 mm Hg with vibration and 187 mm Hg without vibration. Both with and without vibration, 6 of the 8 subjects stated that leg fatigue was the cause of their inability to continue pedalling longer. Our conclusion is that in the performance of dynamic muscular work endurance may decrease under the influence of vibration. PMID- 2711540 TI - Analysis of haemorheological variables--methodology and reference values. AB - Routine methods are proposed for the analysis of haemorheologic variables with only one instrument, a Low Shear 30 rotational couette viscometer. The variables are plasma viscosity, whole blood apparent viscosity, erythrocyte aggregation tendency and erythrocyte fluidity. These variables, in addition to erythrocyte volume fraction, were analysed in a population of 83 healthy hospital staff subjects. The following means and standard deviations were found: Erythrocyte volume fraction, women 42 +/- 3%, men 46 +/- 2%; Plasma viscosity 1.31 +/- 0.07 mPa.s; Whole blood apparent viscosity, women 4.3 +/- 0.4 mPa.s, men 4.8 +/- 0.3 mPa.s; Erythrocyte aggregation tendency 1.00 +/- 0.10; Erythrocyte fluidity 122 +/- 10 Pa-1.s-1. PMID- 2711541 TI - High ventilatory response to hypoxia in hypertensive patients with sleep apnea. AB - The ventilatory response to hypoxia (VRH) in relation to daytime arterial blood pressure was studied in 37 patients with the sleep apnea syndrome (SAS). The patients were divided into hypertensives (n = 16) and normotensives (n = 21). The hypertensive group had a significantly higher VRH (ventilatory increase 1.48 1/min BTPS per percent decrease in arterial oxygen saturation) than the normotensive group (0.69 1/min/%, P less than 0.01). The observed difference raises the question whether a high chemoreceptor sensitivity to hypoxaemia can contribute in causing arterial hypertension among cases with SAS. PMID- 2711542 TI - Plasma pyridoxal phosphate levels in newborn infants, their mothers and in the mothers' breast milk. AB - Plasma pyridoxal phosphate (PLP) was determined in 10 newborn infants (two pairs of twins), their 8 mothers, and in addition in the mothers' breast milk. Mothers who did not take extra vitamin B-6 during pregnancy had lower levels of PLP both in plasma and in their milk. The infants' PLP decreased during the first two weeks of life when receiving only their mothers' milk. None of the mothers nor the infants showed any clinical signs of vitamin B-6 deficiency. PMID- 2711543 TI - Urogenital trauma. PMID- 2711544 TI - Ureteral injury. AB - The management of ureteral injuries resulting from external violence or surgery is usually straightforward and is primarily a problem of recognition and development of a treatment plan that allows either repair of the injury away from the site of pathology or conservative drainage and diversion. However, decisions as to the proper therapy can be complicated by legal, economic, and emotional considerations, which make management of these patients difficult. In the last 5 years, endoscopic manipulation of the ureter for the treatment of stones and stricture has become commonplace. Perforation of the ureter occurs in as many as 20 per cent of cases. Sequelae from these inadvertent injuries are rare, particularly if the injury is managed by proximal diversion with percutaneous nephrostomy and placement of a ureteral stent. Three to ten days of drainage is usually all that is required to heal these injuries. The ureter, of course, may also be avulsed during the course of basket extraction of stone, and open operative correction would then be required. The ureter is a delicate structure. To paraphrase a famous patriot, force in the cause of ureteral stone extraction or ureteral catheterization is a vice! PMID- 2711545 TI - Management of extraperitoneal bladder rupture. AB - Extraperitoneal bladder ruptures secondary to blunt trauma are caused by fractures of the bony pelvis 95 per cent of the time. A static cystogram is the only way to diagnose the lesion definitely. We have treated our 41 patients successfully with catheter drainage alone despite extensive urinary extravasation. Eighty-seven per cent of the ruptures will be healed in 10 days, and virtually all will be healed in 3 weeks. PMID- 2711546 TI - Intraperitoneal rupture of the bladder. AB - Intraperitoneal bladder ruptures are usually injuries of violent deceleration, although spontaneous ruptures have occurred in near-term pregnancies. Once diagnosis is established by a static cystogram and withdrawal films, exploration of the abdomen and repair of the bladder rupture are indicated. Complications are usually from associated injuries and not from suprapubic drainage. PMID- 2711547 TI - Primary realignment of the disrupted prostatomembranous urethra. AB - Urethral scarring resulting in stricture formation can be avoided or minimized by proper treatment after injury. On presentation of the trauma patient, the possibility of such injury must be suspected and the urethra evaluated prior to any attempts at catheter placement. Diversion in all cases of posterior urethral injury should be by a suprapubic tube, with any urinary extravasation drained at the site of the injury. If the patient's general condition allows it, the disrupted urethra should be realigned by a catheter after the puboprostatic ligaments have been divided. These measures allow the prostate to return to the urogenital diaphragm without tension and in line with the distal urethra. Until the prostate is released, no amount of traction will reapproximate the urethra, and after it is released, traction is not necessary. The suprapubic catheter provides diversion, preventing further complications caused by urinary extravasation; urethral alignment minimizes subsequent stricture formation. When the stricture develops, if it is urodynamically significant, it can be repaired in 4 to 6 months. If one is fortunate, the stricture will be short and amenable to internal urethrotomy. If not, open reconstruction will be greatly facilitated by the attempts to guide the distracted ends of the urethra together. PMID- 2711548 TI - Pubectomy in repair of membranous urethral stricture. AB - The use of pubectomy in the repair of urethral strictures has not been favored because of the supposed excessive blood loss and operative time and long-term pain. However, in our experience with 30 patients with traumatic urethral rupture, we have found that pubectomy provides excellent exposure with a mean blood loss of 800 ml and few postoperative problems. The technique should nonetheless be reserved for selected patients and performed only by experienced surgeons. PMID- 2711549 TI - Endoscopic reconstruction of traumatic urethral transections. AB - Total traumatic urethral transections can be reconstructed endoscopically if the obliterated segment is short (less than 3 cm). A small trocar is passed under radiographic control, and balloon dilatation is performed over a guidewire. Scar is resected, and triamcinolone is injected. An additional urethrotomy is usually required later. Ten patients have had this technique of reconstruction. Seven have good results with long-term follow-up; three are voiding well but have only short follow-up. PMID- 2711550 TI - Visual urethrotomy in the management of the obliterated membranous urethra. AB - Delayed direct-vision internal urethrotomy is a reasonable first treatment of the traumatically obliterated posterior urethra. Postoperative continence is achieved if the bladder neck is competent on preoperative cystogram. Simultaneous suprapubic and transurethral instrumentation most accurately define the length of obliterated urethra, and rectal examination determines any prostatic displacement. Half the patients will require repeat endoscopic surgery for significant stricture, and all require long-term follow-up to assure urethral patency. Potency is not affected by the procedure. Urethrotomy failure should not preclude a subsequent open procedure. PMID- 2711551 TI - Current indications and technique of two-stage repair for membranous urethral strictures. AB - At present, the indications for two-stage repair for membranous urethral strictures are limited. However, there are situations where two-stage reconstruction is the procedure of choice. It certainly should be considered in those patients who present with marked scarring in the perineum from previous attempts at urethral reconstruction or from the initial trauma, such as might be encountered following perineal burns or gunshot wounds. It is also successful in those patients in whom the anterior urethra has previously been damaged and cannot be mobilized or is not healthy enough to permit a tension-free end-to-end anastomosis and in patients who have perineal abscesses, infected fistulae, or infected urethral diverticula with or without calculi. The technique selected in these complicated cases must ensure adequate drainage of infected material as well as provide an excellent blood supply for the graft. PMID- 2711552 TI - Ileal conduit in era of systemic chemotherapy. AB - The records of 62 patients with invasive transitional cell carcinoma of the bladder whose planned treatment was radical cystectomy with ileal conduit urinary diversion and postoperative systemic chemotherapy were reviewed. Seven of the patients received radical cystectomy but not postoperative chemotherapy as planned, 3 of them (5%) for reasons directly related to complications from the urinary diversion. Fifty-five patients received the planned postoperative chemotherapy. Complications during chemotherapy that were related to the ileal conduit were urinary tract infection in 37 percent and stenosis at the ureteroileal anastomosis requiring percutaneous nephrostomy in 3.6 percent. Chemotherapy was not discontinued in any patient, however, because of complications specifically related to the urinary diversion. We conclude that the ileal conduit is well tolerated by patients who require systemic chemotherapy and is, today, the simplest, safest, and best diversion method when systemic chemotherapy is to follow radical cystoprostatectomy. PMID- 2711553 TI - Prognostic significance of DNA ploidy in carcinoma of prostate. AB - Flow cytometry was used to measure the DNA content in archived paraffin-embedded human prostatic cancer tissue for 69 patients with known outcomes that presented between 1975 and 1982. Of these, 51 patients had clinically localized lesions and were surgically staged prior to radical prostatectomy, while 18 patients presented with advanced Stage D2 disease. Thirty-six of 37 (97.3%) pathologic Stage B lesions were diploid. In contrast, the majority (72.2%) of patients with metastatic disease had aneuploid tumors. The average Gleason grade for aneuploid tumors was 8.2 +/- 1.98 versus 5.5 +/- 1.89 for diploid tumors (p less than 0.01). For 51 patients with clinically localized tumors, 13.9 percent of diploid tumors with a low Gleason sum (2 to 6) had extracapsular spread of tumor or regional lymph node involvement compared with 83.3 percent of aneuploid tumors with high Gleason scores (7 to 10). The addition of DNA ploidy to degree of glandular differentiation may enhance the prognostic evaluation of prostatic tumors and eventually improve our ability to select patients who are likely to benefit from radical prostatectomy. PMID- 2711554 TI - Which renal lacerations will heal satisfactorily with nonsurgical management? AB - If there was a correlation between the type of renal laceration and its healing, and if radiologic evaluation on admission could accurately diagnose the type of renal laceration present, then surgical intervention could be reserved for those renal lacerations that will not heal satisfactorily by themselves. We reviewed the outcome of initially conservative or immediate operative treatment of renal laceration in 122 patients. Thirty-six patients were managed initially without operation. All fifteen cortical lacerations and all five deep lacerations that created only a small parenchymal defect healed themselves, with 4 of the 16 patients available for follow-up having hypertension. In contrast, six deep lacerations that caused large parenchymal defects, six disrupted poles or segments, and four split kidneys did not have satisfactory healing with conservative management, necessitating delayed renal surgery, or causing hypertension or both. Because computed tomography on admission can accurately diagnose the site and extent of a renal laceration, it should be possible to decide early which patients truly will benefit from conservative management. PMID- 2711555 TI - Comparison of extracorporeal shock-wave lithotripsy and surgical lithotomy regarding patient satisfaction. AB - A series of 19 patients who underwent extracorporeal shock-wave lithotripsy (ESWL) for urolithiasis was compared with 26 patients who were treated with surgical lithotomy (SL). A historical clinical trial was conducted using hospital chart records and telephone interviews to determine differences in outcome between the two groups. The ESWL group had significantly (p less than 0.05) shorter duration of post-procedural pain, fewer requirements for pain medications, and decreased anxiety toward repetition of the procedure than did the SL group. In addition, the ESWL group had significantly (p less than 0.05) shorter hospital stays, faster return to work on discharge from the hospital, and less physical limitation after the procedure. There was no appreciable difference in the occurrence of post-procedure urinary tract infections or in the patient's perception of the effectiveness of the procedure. These findings support the conclusion that treatment of urolithiasis by ESWL, is preferable to open flank SL. PMID- 2711556 TI - Intravesical bacillus Calmette-Guerin and second primary malignancies. AB - In an effort to answer the question, "Does intravesical bacillus Calmette-Guerin (BCG) therapy increase the incidence of second primary malignancies," the records of 153 patients treated with BCG for carcinoma in situ of the urinary bladder were reviewed. The weight of the available evidence suggests that intravesical BCG does not increase the incidence of second primary malignancies. While this question should be investigated, at the present time it appears that the advantage of intravesical BCG for high-risk patients with superficial bladder cancer outweighs the known disadvantages. PMID- 2711557 TI - [Surgical treatment of osteomyelitis of the frontal bone and the walls of the frontal sinus]. AB - Having in view observations made during surgical treatment of 21 patients with frontal bone osteomyelitis of traumatic (18 patients) and rhinogenic (3 patients) origin, three varieties of osteomyelitis can be distinguished, viz. osteomyelitis of frontal squama, osteomyelitis of frontal sinus wall, and mixed osteomyelitis involving nasal bones. Three therapeutic approaches are recommended: closed healing of the wound after dissecting the fistula and removal of osteomyelitic bone lesions, drainage of frontal sinuses via the frontonasal anastomosis, and tamponade of the cavity, that developed after the resection of the pathological focus, with the host muscle tissue. In advanced osteomyelitis of the frontal sinus walls, preference should be given to the neurosurgical approach with a wide revision of the pathological focus, removal of the mucosa, suppurative epidural layers and further formation of an enlarged frontonasal anastomosis and prolonged drainage of the cavity for 24 to 30 days. When treating osteomyelitis of frontal squama with its significant enlargement, the most efficient method is tamponade of the cavity formed by the hard membrane, skin and bone with the host muscle. Small osteomyelitic lesions of the frontal bone can be removed by dissecting the fistula, 3-4 day draining and suturing the wound. PMID- 2711558 TI - [Microflora of the paratonsillar abscesses]. AB - The species composition of aerobic and anaerobic microflora of paratonsillar abscesses was investigated in 20 patients. It was found that obligate nonspore forming anaerobic bacteria predominated in the pus of the abscess cavity. Anaerobic infection was diagnosed rapidly by gas-liquid chromatography. Anaerobic bacteria were shown to be highly sensitive to clindamycin and metronidazol. PMID- 2711559 TI - [Chondroma of the nose and paranasal sinuses and its clinical characteristics]. AB - Typical clinical features of nasal and paranasal sinus chondromas are discussed having in view 12 history cases. The authors give support to the concept that benign chondroma may transform to malignant neoplasm. Tumor relapses may occur if surgical intervention fails due to morphological abnormalities of the tumor. The tumor consists of lobules that may grow beyond the primary connective tissue capsule penetrating complex structures of the skull. Patients with nasal and paranasal chondromas need early and radical operation and a close follow-up with the purpose of detecting minor signs of recurrences and performing, if necessary, repeated operations until the tumor becomes incurable. PMID- 2711560 TI - [Prevention of the development of laryngeal tumors]. PMID- 2711561 TI - [Significance of reflexogenic areas of the larynx in the treatment of professional singers]. PMID- 2711562 TI - [Rhinogenic thrombosis of the cavernous sinus caused by chemotherapy]. PMID- 2711563 TI - [Rhinosporidiosis of the nasopharynx]. PMID- 2711564 TI - [A sign of an opening in the intersinus septum in frontal sinusitis]. PMID- 2711565 TI - [Lidocaine-induced anaphylactic shock during tonsillectomy]. PMID- 2711566 TI - [Contact thermometry and color liquid-crystalline thermography in the complex examination of patients with tonsillitis and acute sinusitis]. PMID- 2711567 TI - [Characteristics of ORL pathology in Burundi]. PMID- 2711568 TI - Morphologic changes in the mammary gland of megestrol acetate-treated and untreated cats: a retrospective study. AB - Abnormal mammary gland growth is a side effect of progestin therapy in some cats. In this retrospective study, the nature and significance of morphologic changes in the mammary gland of 17 megestrol acetate (MA)-treated cats were compared to mammary lesions in 97 untreated cats. Fourteen out of 17 MA-treated cats had non neoplastic mammary lesions including fibroepithelial hyperplasia (nine cats), lobular hyperplasia (three cats), and duct ectasia (two cats); whereas three MA treated cats had mammary neoplasms including one adenoma and two carcinomas. Although MA has been causally linked to mammary cancer in cats, only mammary fibroepithelial hyperplasia was clearly associated with MA therapy in this study. Fibroepithelial hyperplasia occurred in older (average age 8.1 years) neutered male and female cats in the MA-treated group and in younger (average age 2.1 years) female cats in the untreated group. Morphologically, both intraductal and solid fibroepithelial growth patterns were seen. Intraductal fibroepithelial hyperplasia was further subdivided into papillary and circumferential types. An apparent greater association between MA therapy and the intraductal types of fibroepithelial hyperplasia was noted. Furthermore, it appears likely that mammary lobular hyperplasia also is linked to MA therapy. Possible mammatrophic effects of MA and other growth-promoting agents in the cat are discussed. PMID- 2711569 TI - Feline oral neoplasia: a ten-year survey. AB - A retrospective histological study was conducted on 371 neoplasms of the oral cavity in cats. Oral neoplasia accounted for 10% of feline neoplasms identified during the survey period. Eighty-nine percent of the oral neoplasms were malignant. Twenty different oral neoplasms were found. The most common were squamous cell carcinoma (61.2%), fibrosarcoma (12.9%), and fibromatous epulis of periodontal ligament origin (7.8%). PMID- 2711570 TI - Renal medullary amyloidosis in Dorcas gazelles. AB - Between January 1976 and September 1987 renal medullary amyloidosis (RMA) was diagnosed in 17 Dorcas gazelles; the necropsy prevalence rate was 17/32 (53%). The most severe amyloid deposits were in the renal medulla; glomeruli were spared. Renal cortical lesions of interstitial fibrosis and tubular atrophy and dilatation significantly correlated with RMA (P less than 0.01) and were considered to be secondary changes. There were varying degrees of lymphoplasmacytic inflammation and tubular cast formation which did not significantly correlate with RMA. Amyloid was confirmed histochemically and by electron microscopy and was identified as AA type by the permanganate method. Progressive renal failure was the cause of death or necessitated euthanasia in 7/17 (41%) gazelles. RMA in Dorcas gazelles does not appear to be familial. A high prevalence of chronic or recurring Actinomyces (Corynebacterium) pyogenes infections may be an important factor. PMID- 2711571 TI - Intestinal trichomonads (Tritrichomonas mobilensis) in the natural host Saimiri sciureus and Saimiri boliviensis. AB - A retrospective study of cecal and colonic tissues from 28 squirrel monkeys (Saimiri sciureus and Saimiri boliviensis) demonstrated enteric trichomonads within luminal crypts. Twenty-one of 28 (75%) had trichomonads in the mucosal epithelium either in cup-like depressions or intraepithelial vacuoles. Organisms were also beneath the superficial luminal mucosal epithelium and between the basement membrane and crypt epithelial cells. Immunoperoxidase staining also identified organisms within the lamina propria and submucosa. Additional histologic changes included mucosal ulceration, multifocal cryptitis, and focal epithelial necrosis. Most areas containing trichomonads did not have an associated inflammatory response. PMID- 2711572 TI - A protein toxin from Pasteurella multocida type D causes acute and chronic hepatic toxicity in rats. AB - Pasteurella toxin given subcutaneously to rats caused severe liver damage and growth suppression in doses as low as 15.6 ng. Toxin was lethal at and above 31.25 ng. Survival times were dose-dependent, and lesions differed with time of survival after toxin. Rats dead of acute toxicity had focal hepatic necrosis. Liver lesions were associated with diffuse endothelial damage, intravascular trapping of leukocytes, and degeneration of hepatocytes (characterized by glycogen depletion, development of vacuoles, and eosinophilic cytoplasmic inclusions). Endothelial cells, Kupffer cells, and macrophages had evidence of activation, e.g., increased cellular size with increases in Golgi vesicles, granules, and lysosomes. Rats with chronic toxicity (survival greater than 150 hr) had cirrhosis, intestinal villous atrophy, and markedly reduced body weight and fat. These data show that the rat is highly sensitive to toxins of Pasteurella multocida, and that even low doses of toxin cause liver injury and growth suppression. PMID- 2711573 TI - Experimental African swine fever: evidence of the virus in interstitial tissues of the kidney. PMID- 2711574 TI - Cytoplasmic fragmentation associated with lymphoid leukemia in ruminants: interference with electronic determination of platelet concentration. PMID- 2711575 TI - Testicular leiomyoma in a ram. PMID- 2711577 TI - Riley working party and veterinary manpower. PMID- 2711576 TI - Hyperplastic endometrial polyps in a two-year-old filly. PMID- 2711579 TI - Serological survey of the incidence of Hypoderma bovis in cattle in 1988. AB - Sera from 74,502 cattle from 3087 farms in England and Wales were tested for the presence of antibodies against Hypoderma bovis in the spring of 1988. Twenty-nine positive sera were identified on 18 premises and these animals were treated; an examination of 6030 sera taken from 108 neighbouring herds identified another 17 seropositive animals on 10 farms in Devon, Cornwall, Lancashire, Shropshire and Powys, indicating that these counties still harbour populations of warble fly. PMID- 2711578 TI - Comparison of the effects of two lathyrogens on the reproductive system of the laying hen. AB - The effects of two lathyrogens (beta-aminopropionitrile and semicarbazide) on the reproductive system of the laying hen were compared by measuring the changes in the ovary and oviduct associated with a diminished egg production rate. The laying hens were fed diets containing either beta-aminopropionitrile, the toxic constituent of certain legume seeds in the genus Lathyrus or semicarbazide to induce lathyrogenic effects in which reduced egg production was one of the toxic effects. The gross examination of the reproductive system of the hens revealed that ovarian activity was greatly impaired. The reduced egg production after feeding beta-aminopropionitrile was due to the reduced growth rate of the ovary, and in the case of semicarbazide, to the atresia of large yolky follicles. PMID- 2711580 TI - Idiopathic septic gonitis in five Holstein-Friesian heifers. AB - Five cases of gonitis in young cows are reported. In all cases lameness was severe with no weight bearing on the affected limbs. The joints were swollen. No organisms were isolated from the fluids aspirated from the joints but cytological examination showed large numbers of neutrophils, and biochemical analysis showed increases in the activities of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and lactate dehydrogenase. PMID- 2711581 TI - Hydropericarditis syndrome in broiler chickens in Pakistan. PMID- 2711582 TI - Abortion in guinea pigs. PMID- 2711583 TI - Riley recommendations. PMID- 2711584 TI - RSPCA advertisements. PMID- 2711585 TI - Veterinary opinion. PMID- 2711587 TI - Improving standards in veterinary practice--laboratory testing. PMID- 2711586 TI - Veterinary role in public health. PMID- 2711589 TI - Medicines (medicated animal feeding stuffs) regulations 1988. PMID- 2711588 TI - Emergency treatment of horses: RCVS warning. PMID- 2711590 TI - Lords condemn schools closure proposals. PMID- 2711591 TI - Building a practice. Employment law. PMID- 2711592 TI - Development of a microcomputer system for recording veterinary visits, preparing accounts, and as an aid to herd fertility and herd health schemes. AB - A computerised method of recording clinical information from farm animal practice visits and using it for herd fertility visits, herd health schemes, the investigation of disease outbreaks and as a source of data for epidemiological studies was developed in the University of Liverpool farm animal practice. The system stores clinical and reproductive information in a data base from which data can be readily extracted and analysed, and monthly bills produced. PMID- 2711593 TI - Distribution of histological lesions in the equine endometrium. AB - The distribution of histopathological lesions in the equine endometrium was examined to investigate the representativeness of a single biopsy specimen in terms of the whole endometrium. Five sections from each of 110 uteri obtained from slaughtered mares were evaluated microscopically and classified according to a four-category grading system used for endometrial biopsies. Depending on the extent of agreement between the categories of the homologous sections, the uteri were considered to show either good agreement (81 uteri; 73.6 per cent), moderate agreement (26 uteri; 23.6 per cent) or poor agreement (three uteri; 2.7 per cent). All the homologous sections of the group showing moderate agreement were within two adjacent categories. Disagreements were more often due to variations in the distribution of fibrotic lesions than to variations in the degree of chronic infiltrative lesions. There was no seasonal effect on the apparent degree or distribution of lesions. In most cases the examination of a single biopsy, when combined with a thorough clinical examination, should provide adequate information about the condition of a mare's endometrium. PMID- 2711594 TI - Riley recommendations. PMID- 2711595 TI - Homoeopathy. PMID- 2711596 TI - Acupuncture versus surgery in canine thoracolumbar disc disease. PMID- 2711597 TI - Rare condition in a rottweiler. PMID- 2711598 TI - Prescription only medicines. PMID- 2711599 TI - Seeing practice. PMID- 2711600 TI - Veterinary remuneration. PMID- 2711601 TI - Toxicity of isolated Lantana (Lantana camara L) constituents to male and female guinea pigs. AB - A toxin fraction was obtained from Lantana camara L (red variety) leaves by batch extraction and column chromatography on silica gel (60-120 mesh). The main constituents of the toxin preparation were lantadene A and lantadene B and it was devoid of reduced lantadene A. Oral administration (125 mg/kg bwt) of the toxin to male and female guinea pigs caused icterus and photosensitization within 48 hr. All the affected animals had hepatomegaly and significant increases in conjugated and unconjugated bilirubin in blood plasma. The intoxicated animals of either sex had marked increases in acid phosphatase activity which was inhibited 45.77% and 49.35% by 1 mM tartrate in male and female animals respectively. The corresponding inhibition of acid phosphatase activity in control male and female guinea pigs was 15.91% and 20.33% respectively. PMID- 2711602 TI - Effect of yohimbine on xylazine-induced diuresis in rats. AB - Intraperitoneal (ip) administration of xylazine (1-6 mg/kg) in male rats significantly increased urine flow over a 2-hr period in a dose-dependent manner, while urine osmolality was significantly decreased. Xylazine at 4.5 and 6 mg/kg significantly increased sodium excretion, whereas the 3 and 6 mg/kg doses of xylazine significantly increased potassium excretion. Yohimbine injected ip at 0.5 or 1 mg/kg 15 min before xylazine (6 mg/kg, ip) significantly decreased urine flow by 44% and 64% respectively. Yohimbine also prevented the increase in sodium and potassium excretion induced by xylazine. The data indicate that yohimbine is of value in controlling the diuretic effect of xylazine in rats. PMID- 2711603 TI - Neurotoxicity in rats sub-chronically exposed to low levels of lead. AB - Pregnant rats (for prenatal exposure), 5-day-old rats, and 5-week-old rats were exposed orally to lead acetate daily for 10 weeks. Lead values in the brain of animals from all three lead-exposed groups were similar. Brain norepinephrine (NE) and GABA levels and glutamate decarboxylase (GAD) activity were decreased, and brain glutamate (glu), glutamine + asparagine (gln/asn), and tyrosine (tyr) levels, and monoamine oxidase (MAO) activities were increased in rats prenatally or 5 days postnatally exposed to lead. Brain ammonia, alanine (ala), aspartic acid (asp), and dopamine (DA) values were not affected by the prenatal or 5-day postnatal lead treatment. Brain uptake index (BUI) values for glu were significantly elevated in rats exposed to lead prenatally or 5 days after birth. Exposure of 5-week-old rats to lead did not affect the brain catecholamine and amino acid levels. These results suggest that the brains of young rats were more sensitive to lead exposure than the brains of adult rats, although the accumulation of lead in brain was not affected by age. PMID- 2711604 TI - Secondary copper deficiency in cattle caused by molybdenum contamination of fodder: a case history. AB - In a herd of cattle located in central Hungary, illness and subsequent death of cows was observed. The cause of these losses was molybdenum-induced secondary copper deficiency. The origin of the environmental molybdenum was used motor oil containing molybdenum bisulfide as an additive. This split motor oil polluted the cow's pasture located on the side of a railway bed near the farm. Before the illnesses and deaths, the animals were grazing for at least 2 weeks in the contaminated area. The ill animals were recumbent and unable to rise. There was no response to treatment with 10 g calcium gluconate iv. Cows which died showed no specific lesions on necropsy. The clinical chemistry investigations showed anemia, minimal caeruloplasmin activity in the blood, and high molybdenum concentrations in the rumen contents, liver and kidney. Copper concentrations were low in liver, kidney and blood serum. The seriously ill cows died in spite of 100 mg copper glycinate injections, but the asymptomatic animals remained alive. Molybdenum pollution can cause acute clinical disease and subsequent death by interfering with copper metabolism. PMID- 2711605 TI - Kochia (Kochia scoparia) toxicosis in cattle: results of four experimental grazing trials. AB - Four kochia grazing trials were completed over a period of 3 years. Yearling steers were allowed to graze pure stands of irrigated and fertilized kochia (Kochia scoparia) for periods of 14 to 105 days. A total of 116 steers were given kochia as their sole forage. Twenty control steers were allowed to graze native grass pasture, and 20 steers were allowed to graze both native grass and kochia pastures. Steers grazing only kochia lost weight or gained poorly compared with control steers grazing native grass. Steers that grazed both kochia and native grass had intermediate rates of gain. Signs of toxicosis were observed only in steers grazing kochia alone. Considerable variability in the degree of toxicosis was observed from one year to another. Morbidity in the steers grazing only kochia varied from 0% (Trial 4) to 28% (Trial 1), and mortality varied from 0% (Trials 3 and 4) to 10% (Trial 2). The most common signs observed in clinically affected steers were depression, dehydration, weight loss, muscular weakness, photosensitization, ocular discharge, and crusty muzzle. In all 4 trials, significant elevations in serum glutamic oxaloacetic transaminase (GOT) and serum gamma glutamyl transpeptidase (GGT) were observed in steers grazing kochia. In 3 of the 4 trials, significant elevations in serum bilirubin, serum calcium, and serum protein were also observed in kochia-fed steers. Necropsies were performed on 6 of 9 steers that died or were euthanized. The primary pathologic findings were severe chronic nephrosis (5 steers) and degenerative hepatopathy (5 steers).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711606 TI - Transient testicular degeneration in rams fed locoweed (Astragalus lentiginosus). AB - Locoweed (Astragalus lentiginosus) fed to mature rams induced transient degenerative changes in the seminiferous, epididymal and vas deferens epithelium. There were changes in behavior and loss of condition in the treatment rams. Observed libido was reduced. Estimated percent abnormal sperm was significantly (P less than 0.05) higher in the locoweed-fed rams than in the controls. Increased retained proximal cytoplasmic droplets, separation of the heads and tails of the spermatozoa, and reduced sperm motility were observed. Serum SGOT (serum glutamic oxaloacetic transaminase) levels were significantly (P less than 0.01) elevated, and WBC (white blood cell) counts were decreased (P less than 0.01). Grossly no changes were observed. Histologically there were advanced lesions of foamy cytoplasmic vacuolation in all tissues taken at necropsy, but particularly in the epithelium of the seminiferous tubules, epididymis and vas deferens. Reduced spermatozoa production was evident. Testicular changes were transient and rams appeared clinically normal 70 days after locoweed feeding was terminated; however, there was slight residual atrophy of the germinal epithelium at necropsy. PMID- 2711607 TI - Effect of a high affinity aluminosilicate sorbent on prevention of aflatoxicosis in growing pigs. AB - Adding 0.5% hydrated sodium calcium aluminosilicate to diets formulated with aflatoxin-contaminated corn significantly reduced the detrimental effects of the mycotoxin on live weight gains and feed intake. Hepatocellular changes normally associated with aflatoxin consumption could not be detected histopathologically in liver sections from pigs fed contaminated diets plus the aluminosilicate sorbent. PMID- 2711608 TI - Clinico-biochemical studies on acute toxic nephropathy in goats due to uranyl nitrate. AB - Acute toxic nephropathy was produced in 6 healthy goats by injecting intravenously 1% uranyl nitrate (UN) (15 mg/kg body weight). The early painful clinical signs simulating shock progressed with subnormal temperature, slow shallow respiration and arrhythmic pulse followed by death due to respiratory failure within 96 to 120 hr. All the affected goats had normocytic normochromic anemia, leucocytosis, neutrophilia with left shift eosinopenia, decreased monocytes and presence of 1-2% reticulocytes in the peripheral blood smears. On blood chemical analysis, a uniform and continuous rise was seen in serum creatinine with a concomitant daily increase of serum urea and uric acid. Simultaneous analysis of urine indicated polyuria leading to oliguria, acidic pH, albuminuria, glycosuria with presence of neutrophils, RBC's, epithelial and fatty casts, increase of triple phosphate, and cystine crystals reflecting acute damage of kidneys in the affected goats. PMID- 2711609 TI - Effects of various levels of dietary vitamin E on broiler chicks. AB - Graded dosages of vitamin E (37.5, 50 or 100 ppm) fed Lohmann-type broiler chicks resulted in decreased growth rates, enlarged livers and kidneys, hemorrhages on the medial surface of the thigh, and congestion in the heart and intestines. Serum SDH and GDH activities and uric acid concentrations were significantly increased and serum total protein concentration was decreased in all dosed groups. Leucocytosis and anemia occurred in excess vitamin E-fed broiler chicks. PMID- 2711610 TI - Accidental Conium maculata poisoning in the rabbit. PMID- 2711611 TI - A case of an accidental exposure to a veterinary insecticide product formulation. AB - A veterinary technician while opening a package was accidentally exposed to a commercial canned product formulation containing insecticides and solvents. The patient was twice briefly treated and released as an outpatient from 2 different hospitals on the first and second day after the exposure. However, on the fourth day, as some of the symptoms (headache, nausea, vomiting, diarrhea, difficult breathing) persisted, the patient was admitted to another hospital. The patient was treated for exposure to organophosphates and solvents and was released after 13 days. The patient developed diabetes insipidus, a condition which lasted for approximately 1 year. The cause of the temporary development of diabetes insipidus is not understood. There is a need to prevent and minimize such accidental exposures in future. PMID- 2711612 TI - Ills from work, environment challenge physician skills. PMID- 2711613 TI - Poison treatment formulary. PMID- 2711614 TI - Ciguatera in a young baby. PMID- 2711615 TI - Detailed diagnoses and procedures, National Hospital Discharge Survey, 1987. AB - This report presents statistics on conditions diagnosed and surgical and nonsurgical procedures performed in non-Federal short-stay hospitals. The statistics are based on data collected through the National Hospital Discharge Survey from a national sample of the hospital records of discharged patients. Estimates of first-listed diagnoses, all-listed diagnoses, days of care for first listed diagnoses, and all-listed procedures are shown by sex and age of patient and geographic region of hospital. PMID- 2711616 TI - [The effect of sodium levels in dialysis solutions on the distribution of total body water during hemodialysis]. AB - Thirty-seven haemodialyses with ultrafiltration were performed (3000 ml/6 hours). using three sodium concentrations (140, 145 and 150 mmol/l) in the dialysate solution in 16 hyperhydrated patients during a long-term dialysis program. The amount of eliminated sodium during haemodialysis depended on the sodium concentration in the dialysate solution. The reduction of the volume of total body water corresponded to ultrafiltration. When a sodium concentration of 150 mmol/l in the dialysate solution was used, the smallest diminution of extracellular fluid and greatest diminution of intracellular fluid was observed. At the same time the greatest transport of water from the intracellular into the extracellular fluid was recorded. A sodium concentration of 145 and 150 mmol/l in the dialysate solution gave rise to positive values of sodium-free water and of sodium-free water clearance. Sodium-free water and of sodium-free water clearance correlated directly with the sodium concentration in the dialysate solution and inversely with the amount of eliminated sodium. The patients were free from complaints during haemodialyses and no significant blood pressure changes were found. The dialysate solution with the sodium concentrations used is suitable for a long-term dialysis programme; the authors recommend, however, to use individual sodium concentrations, depending on the patient's clinical condition. PMID- 2711617 TI - [Comparison of the degree of chronic gastritis in the resected gastric body with histologic findings in postoperative gastric biopsy]. AB - In resected portions of the stomach we find chronic atrophic gastritis of the corpus only in 10% of the patients with duodenal ulcers, and chronic inflammatory changes are, contrary to patients with a gastric ulcer, less marked. The difference is statistically significant. Consistent with some other authors, we find that great progression of chronic inflammatory changes occurs in patients operated on account of duodenal ulcers in the course of the first three years after operation. From six cases of regression of chronic inflammatory changes after operation, in two cases undetected atrophic gastritis was involved which was present in a severe form in the body of the resected portion beyond the vicinity of the gastric ulcer. According to the author's findings regression of atrophic gastritis is possible. The high score of chronic inflammatory changes in the antrum of gastric resectates (3.54) and in the close vicinity of gastric ulcers (4.0) confirms the frequency of severe antral gastritis in peptic ulceration and the intensity of the focal inflammation in the vicinity of gastric ulcers. PMID- 2711618 TI - [Results of treatment of peptic ulcers using Gastrozepine and antacids in the endoscopic picture]. AB - The authors investigated the therapeutic results in gastroduodenal ulcers in 96 patients treated with Gastrozepin (Slovakofarma), using daily doses of 75 mg combined with antacids. The examinations were made by means of a videogastroscope of Welch-Allyn Co. with subsequent control after four weeks, and if the ulcer was not healed, after two-week intervals. During the first examination they recorded the size of the ulcer and during check-up examinations the stage of healing. In a group of 51 men with a mean age of 44.4 years the incidence of duodenal ulcers was 29 cases (59.6%) and gastric ulcers 22 cases (43.1%). In a group of 45 women with a mean age of 51.4 years duodenal ulcers were detected in 24 (53.3%) and gastric ulcers in 21 (46.7%). After one-month treatment of 53 duodenal ulcers 44 (83%) healed by a scars. Healing of small and medium sized defects was excellent, they healed in 93.6%, while large defects only in 33.3%. Of 43 gastric ulcers after one month treatment 31 healed (72.1%) by a scar. Small and medium-sized defects healed in 80.5% and large ones only in 28.6%. With the exception of one case all were in an advanced stage of healing with a tendency of complete healing with scare formation. PMID- 2711619 TI - [Indications for liver resection]. AB - In a group of 103 resections of the liver made in 1978-1987 at the Surgical Clinic of the Medical Faculty of Hygiene, Charles University the authors evaluated the diagnostic possibilities of circumscribed hepatic lesions. They evaluated orientational and aimed methods which make it possible to plan the extent of the surgical operation. The diagnostic system elaborated by the authors makes it possible to outline the indications more accurately and serves the elaboration of the tactics of the operation proper. PMID- 2711620 TI - [Determination of lactoferrin in the diagnosis of diseases of the pancreas]. AB - In 29 patients with chronic pancreatitis, 15 patients with malignant tumours of the pancreas and in 30 controls lactoferrin in fluid aspirated from the duodenum was assessed during the cholecystokinin-secretin (CCK-S) test. As compared with the control group, its concentration is significantly higher in patients with chronic pancreatitis, but not in patients with malignant tumours of the pancreas. It is probable that estimation of lactoferrin in the CCK-S test may prove helpful in the differential diagnosis of pancreatic disease. PMID- 2711621 TI - [Evaluation of long-term immunotherapy in patients with lupus nephritis]. AB - In 177 patients with lupus nephritis in the course of three decades three methods of immunotherapy were used the effect of which was evaluated retrospectively. When the criterium of the survival period was used, it was revealed that from a group of 66 patients treated only with glucocorticoids (mainly prednisone by the oral route) less than 60% survived five years the onset of lupus nephritis, only 33% survived 10 years. From a group of 81 patients treated with glucocorticoids and cytostatics (mostly cyclophosphamide by the oral route) 80% survived five years and 50% ten years, while in a group of 30 patients treated with glucocorticoids, cyclophosphamide and levamisole 90% survive five years and as many as 70% ten years from the onset of lupus nephritis. From the onset of SLE however as many as 80% survived ten years in all three analyzed groups, which provides evidence that lupus nephritis accounts for the greatest mortality in patients with SLE, as renal failure was the cause of death in one third of the patients. As to complications, secondary infections were recorded in almost 30% of the patients, incl. 9% lethal ones, non-infections complications less than 5%. The authors discuss assumed mechanism of the action of combined immunotherapy, which holds a priority position, as compared with glucocorticoid monotherapy. PMID- 2711622 TI - [Pharmacologic restoration of sinus rhythm in atrial flutter and fibrillation]. AB - Restoration of the sinus rhythm in atrial fibrillation and flutter can be achieved by cardioversion, using an electric discharge, or by medicamentous treatment. Medicamentous treatment is based above all on a combination of antiarrhythmic drugs. By the concurrent administration of quinidine, verapamil and digoxin restoration of the sinus rhythm is achieved in 80% patients, on average after 37 hours at plasma quinidine levels of 2.57 +/- 1.4 (SD) micrograms/ml and digoxin levels of 1.90 +/- 1.3 (SD) nmol/l. Restoration of the sinus rhythm in atrial flutter calls for higher quinidine and digoxin levels than in atrial fibrillation (p less than 0.01). Prolonged persistence of the sinus rhythm during treatment with maintenance doses of quinidine, verapamil and digoxin is not satisfactory so far and after 12 months the sinus rhythm persists only in 30% of the patients where the rhythm was originally restored. PMID- 2711623 TI - [Frequency of carcinoma in thyroid cysts]. AB - The view that cystic thyroid nodes are as a rule benign is disproved by reports from the recent literature which quote an incidence of 17-32% of malignancies in conjunction with thyroid cysts. In 66 patients, investigated by the authors, with thyroid lesions confirmed on biopsy four suffered from thyroid carcinoma (two follicular, one papillary and one solid to anaplastic), i.e. a malignancy in 6%. In the literature it is recommended to follow up on a long-term basis patients with cysts which after thin-needle biopsy do not recede adequately or refill. Biopsies must be repeated, as the cytological yield of biopsies in these instances is not as reliable as in solid nodes. A haemorrhagic appearance of the bioptic specimen and anamnestic data on previous irradiation in the head or neck area are also considered risk factors. PMID- 2711624 TI - [Light reflex rheography--a new examination method in phlebology]. AB - The author discusses a new non-invasive method of examination of the venous system of the lower extremities. He explains the physical principle of the method and the practical procedure. He describes the curve in subjects with a healthy venous system and the curve in different grades of venous insufficiency. The diagnostic value of the examination, in particular in combination of native and occlusion tests, is emphasized. One advantage is that the apparatus can be connected with a ultrasonic flowmeter and thus the acoustic signal can be recorded on paper. By combining these two methods, the majority of venous diseases can be diagnosed by non-invasive procedures. In the conclusion the author summarizes hitherto assembled experience with this progressive examination method. PMID- 2711625 TI - [Various clinical courses of hypersensitivity vasculitis with eosinophilia]. AB - The authors present three case-histories of patients who were followed up for prolonged periods and where the diagnosis of hypersensitive vasculitis was made. During the follow up period it was not possible to prove development into a different group of vasculitis or to detect a hitherto latent associated disease. Another common sign of the investigated patients was eosinophilia repeatedly found in peripheral blood, bone marrow and tissues. According to clinical criteria the above patients could not be included in groups of known types of vasculitis which are associated with eosinophilia. The patients differed significantly as to clinical manifestations of the disease, the response to different therapeutic approaches and some laboratory immunological indicators. The authors discuss the possible participation of eosinophilia in the tissue damage. PMID- 2711626 TI - [Diabetes insipidus as the first cause of myelodysplastic syndrome]. AB - The concurrent occurrence of myelodysplastic syndrome and diabetes insipidus is very rare. In the available literature so far only three cases were described. In acute leukaemia the concurrence of the two diseases is rare. The authors describe two cases of concurrent diabetes insipidus and myelodysplastic syndrome with typical clinical and laboratory symptoms. A 27-year-old man with refractory anaemia (according to the FAB classification of myelodysplastic syndrome) died after 10 months from complications of acute leukaemia. In a 58-year-old female patients with refractory anaemia after two years remission the condition deteriorated and developed into RASEB (refractory anaemia with excess of blast cells) according to the FAB classification with partial remission of the disease after cytostatic treatment. During permanent substitution treatment (Adiuretin Spofa) diabetes insipidus was compensated in both diseases. PMID- 2711627 TI - [Less common causes of chronic tubulointerstitial nephritis complicated by acquired Fanconi syndrome]. AB - The authors describe an uncommon form of the disease in a 25-year-old man who developed renal failure on the background of tubulointerstitial nephritis combined with acquired Fanconi syndrome. The authors analyze in detail the results of the laboratory examination and present differential diagnostic reflections which lead, after elimination of other possibilities, to the final diagnosis of immunity-mediated, viral antigen-conditioned tubulointerstitial nephritis. PMID- 2711628 TI - [Ways to develop the rehabilitative trend in public health]. PMID- 2711629 TI - [The action of electromagnetic radiation at frequencies of 420, 540 and 600 MHz on the course of the tumor process and the death of animals with a transplanted RShM-5 tumor]. PMID- 2711630 TI - [The immune and hormonal effects of the local action of microwaves of different intensities]. AB - The trend in immune and hormonal parameters in thyroid, adrenal and transcerebral exposure to microwaves with intensity of 120, 240 and 480 mW/cm2 was studied in rabbits. The thyroid exposure to 120 and 240 mW/cm2 microwaves lead to immunostimulation, while adrenal and transcerebral one induced immunosuppression. The exposure to 240 mW/cm2 and 480 mW/cm2 microwaves resulted in damage to the tissues in 56 and 100% of the animals, respectively. The latter irradiation appeared lethal for 25% of the rabbits. 120 mW/cm2 MV proved safe as there were no signs of edema and necrosis seen with more intensive microwaves. The authors suggest to employ microwaves of 120 mW/cm2 intensity for endocrine glands irradiation to produce an immunomodulating effect. PMID- 2711631 TI - [Use of a method of regulated breathing to improve pulmonary respiratory function and to enhance the efficacy of aerosol therapy]. AB - A new technique of controlled respiration is proposed which warrants longer exposure of the bronchi, bronchioles and alveoli in the lungs to chemotherapeutic drugs. These penetrate deeply into the target pulmonary tissue affected in lobar left- or right-side pneumonias, pulmonary atelectases. The technique promotes more efficient and less durable treatment in patients with respiratory and pulmonary disorders. PMID- 2711632 TI - [Comparative effectiveness of the sanatorium treatment of patients with bronchopulmonary diseases in the Leningrad health resort zone and at the climatotherapy sanatoria of Yalta and Kislovodsk]. AB - Upon the comparison for Leningrad citizens, CNPD sanatorium treatment in climatic conditions of Leningrad Region was inferior in noway to that in southern climates of Yalta and Kislovodsk resorts as regards to relevant therapeutic response. PMID- 2711633 TI - [The sanatorium-health resort rehabilitation of patients with chronic nonspecific lung diseases on the southern coast of the Crimea]. PMID- 2711634 TI - [Impulse decimeter-wave therapy of patients with chronic nonspecific lung diseases at the medical rehabilitation stage]. PMID- 2711635 TI - [Thermovibrotherapy in the combined rehabilitation of children with a history of acute pneumonia]. AB - A clinical response and the effect on local bronchopulmonary immunity have been assessed for thermotherapy and vibrotherapeutics used in convalescent young children who had acute pneumonia. The clinical and immunological appearance of the children was found to improve due to combined rehabilitation measures involving thermovibrotherapy. PMID- 2711636 TI - [Effect of the UV irradiation of autologous blood on the humoral link in the immune response of patients with chronic inflammatory processes]. AB - Autotransfusions of blood exposed to UV radiation for chronic inflammatory disease were found to normalize immunoglobulins (Ig) and immune complexes (IC) serum levels. A linear and invert correlations were revealed for large IC--IgG, IgM concentration, and small IC--IgM concentration, respectively. PMID- 2711637 TI - [Experience with the use of an ultrahigh-frequency alternating magnetic field in periodontitis]. PMID- 2711638 TI - [The importance of individualized physical training in the rehabilitation of patients with arterial hypotension]. AB - Essential hypotension patients whose 2-year program of rehabilitation included continuous physical training according to individual multifactorial programs or relevant training combined with drug therapy showed more favourable clinical response. Threshold muscular load and everyday motor activity rose more significantly when compared to those in patients who received chemotherapy alone. PMID- 2711639 TI - [Therapeutic physical exercise in the preoperative preparation of patients with obliterative vascular diseases of the legs]. PMID- 2711640 TI - [Optimization of the loading in therapeutic physical exercise for patients with initial cerebral atherosclerosis]. AB - A technique is described of muscular load optimization in the course of therapeutic physical training for rehabilitation of patients with early cerebral atherosclerosis aged 40-59. PMID- 2711641 TI - [The basic principles of the health resort rehabilitation of patients with obstructive lung pathology]. PMID- 2711642 TI - [The role of the time factor in the radon therapy of patients with juvenile rheumatoid arthritis]. PMID- 2711643 TI - [A method for determining the thermal recovery capacity of human skin]. PMID- 2711644 TI - [Experience in organizing rehabilitative treatment in a polyclinic]. PMID- 2711645 TI - [Therapeutic physical exercise in the combined therapy of patients with disorders of urination and of the urodynamics of the urinary tract]. PMID- 2711646 TI - [Cytologic examination of nasal secretions in workers in the amino acid production industry]. AB - Cytological changes of the nasal secretion in workers of the amino acid production were manifested by increased emigration of leucocytes including cells of immune response, desquamation of cover epithelium, dystrophic and necrotic changes in the cells. The cytological method furthers establishing an exact diagnosis of clinically clear diseases and revealing latent processes including allergic states of the nasal mucosa. PMID- 2711647 TI - [Indicators of nonspecific resistance of the body in patients with erysipelas]. AB - A study is presented of indices of unspecific resistance of the body in 63 patients with erysipelas during the acute period of the disease and during recovery. In the acute period of the disease all patients revealed depending on the degree of endogenous intoxication: reduction of the content of fibronectin in the blood, significant reduction of the resistance of erythrocytes--increase of the per cent of peroxidation hemolysis, increase of the content of malonic dialdehyde--an index of disorders of lipid peroxidation, increased content middlemolecular peptides, circulating immune complexes and products of fibrin fibrinogen degradation. The authors substantiate the expediency of using sodium thiosulfate possessing detoxicating, antiinflammatory and antiallergic antioxidant properties and the capacity to bind circulating immune complexes. PMID- 2711648 TI - [Oxygen-dependent indicators of phagocytosis in an infection caused by Trychophyton rubrum]. AB - A clinico-cytochemical investigation of 27 patients with rubrophytia revealed a suppression of phagocytic activity of neutrophils conjugated with inhibition of the nitroblue tetrazolium test. It was confirmed that inclusion into the therapeutic complex of chlorophyllipt allows to level the intraleucocytic metabolic disbalance, to achieve enhanced regression of clinical manifestations of mycosis. PMID- 2711649 TI - [The effect of mercasolyl on immunologic indicators in patients with diffuse toxic goiter]. AB - A study of system of cellular and humoral immunity, unspecific defense in 187 patients with diffuse toxic goiter before and after treatment with mercasolyl revealed that despite the clinical effect, the agent did not essentially influence the content and functional activity of T-lymphocytes. The effect was more favourable on the content of immunoglobulins, titer of antithyroid antibodies. This was observed in mild and average severe course of the disease. It is suggested that mercasolyl effects lymphocytes synthesizing autoantibodies to the thyroid gland. PMID- 2711650 TI - [The Soviet information flow of secondary documents on cardiovascular diseases]. PMID- 2711651 TI - [Various problems of organizing outpatient medical services]. PMID- 2711652 TI - [Work capacity evaluation of patients with chronic lympholeukosis]. PMID- 2711653 TI - [Public health education as a means of decreasing viral hepatitis morbidity]. PMID- 2711654 TI - [Compensatory-adaptive and alternative processes in periodontal tissues in hypothyroidism]. PMID- 2711655 TI - [The effect of norkolut on immune system status in patients with dyshormonal myocardial dystrophy and hyperplastic processes of the uterus]. AB - Use of norkolut in 34 patients with dyshormonal myocardiodystrophy per 10 mg from the 16-th through 25-th days of the menstrual cycle for 6 months favoured improvement of clinical, ECG-data, normalization of values of the immune system. Three months after discontinuation of norkolut restoration occurred of T gamma, A RFC at the I phase of menstrual cycle while the content of B-lymphocytes remains reduced. At the II phase of the menstrual cycle one observed a reduction of the absolute content of T gamma-cells, A-RFC. PMID- 2711656 TI - [Disorders of hypothalamico-pituitary regulation of adrenal and ovarian function in women suffering from Itsenko-Cushing disease]. AB - Data are reported of the functional state of the hypothalamoadrenal system in 119 women with Itsenko-Cushing disease in the active stage, stage of stable clinical remission and after total adrenalectomy. It was established that the most pronounced changes of the relationship of pituitary, adrenal, uterine hormones were found in the active stage of the disease. This leads to disorders of the menstrual cycle according to the type of hypomenstrual syndrome, polycystic degeneration of the ovaries and infertility. In the state of stable remission after treatment and after adrenalectomy, hypothalamo-pituitary-adrenal relationships were found to be within normal limits; this resulted in restoration of the menstrual cycle and fertility. PMID- 2711657 TI - [Non-drug treatment of ulcers]. AB - On the basis of treatment of 131 patients with ulcer disease the efficacy was shown of the employment of electromagnetic radiation in the millimeter range and lasers. Using these non-drug methods it proved possible to reduce scarring time of duodenal ulcers to 13.3-16 days and gastric ulcers to 16-24.5 days, to increase significantly remission time and reduce the number of recurrences. PMID- 2711658 TI - [Early diagnosis of postoperative intestinal obstruction]. AB - Forty-three patients were reoperated in the early postoperative period. In 27 of them the cause of early relaparotomy was postoperative intestinal obstruction. In 20 of these 27 patients the cause of postoperative obstruction were adhesive lesions. Of the 43 reoperated patients 31 showed distinct clinical signs and symptoms of postoperative obstruction. In 12 patients early diagnostic laparoscopy was performed due to unclear symptomatology. This allowed to obtain detailed information and to reduce the period of dynamic observation, to lessen postoperative risk, to avoid unnecessary relaparotomy. PMID- 2711659 TI - [Significance of biochemical examination of the bile in the early diagnosis of chronic diseases of the biliary tract]. AB - Three groups of subjects were examined without complaints characteristic of involvement of the hepatobiliary system. In 11% of healthy persons disorders of the biochemical composition of bile were revealed, namely reduction of the level of bile acids and phospholipids, 23% changes in the ratio of bile acids and phospholipid fractions. PMID- 2711660 TI - [Concentration of sex hormones in chronic bronchitis in men]. AB - Thirty-five males (age: 18-45 years) suffering of chronic bronchitis were examined. The patients showed a reduced level of blood serum testosterone, increased level of luteinizing hormone in males with chronic obstructive bronchitis. The level of luteinizing hormone in males with atrophic bronchitis does not exceed the value in the control group. PMID- 2711661 TI - [Dynamics of the antiprotease system and ventilation indicators during treatment of chronic bronchitis]. AB - The relationship between the antitryptic activity of the blood serum, bronchoalveolar secretion and ventilatory indices of the external respiration function in 85 patients with chronic bronchitis in the process of treatment is described. The above findings allow to recommend antibiotics for wide use only in exacerbations of purulent bronchitis while in other clinical variants reduction of drug loads result in increased therapeutic efficiency. PMID- 2711662 TI - [Use of lasers and cryocoagulation in the complex therapy of scleroma of the trachea]. PMID- 2711663 TI - [Diagnostic errors in detecting open forms of pulmonary tuberculosis]. AB - A study of 206 patients with open forms of pulmonary tuberculosis indicates that in 25.2% of them tuberculosis was initially diagnosed as pneumonia, bronchitis or tumour of the lungs. The main causes of diagnostic errors were inadequate knowledge of general practitioner of tuberculosis problems, neglect in examination of the sputum for MBT, incomplete scope and incorrect interpretation of roentgenological data. PMID- 2711664 TI - [Clinico-morphologic changes of the respiratory passages in cases of burns of them]. AB - The authors examined the functional state of the respiratory apparatus in 343 patients with burns of the respiratory ways (BRW). The defensive, respiratory, conditioning and olfactory functions were investigated. It was established that lesions of the respiratory tract mucosa in BRW causes primarily severe disorders of the transport and secretory functions that further the development of bronchial obstruction and deteriorate pulmonary ventilation. Lesions of the respiratory tract mucosa in BRW are deep and should be equated with III AB grade burns. The course of he burn process in the respiratory ways plays a significant part in the pathogenesis of burn disease pneumonia. This should be considered in planning treatment of patients with BRW. PMID- 2711665 TI - [Myocardial infarction of the right ventricle with pulmonary bleeding]. PMID- 2711666 TI - [Prophylactic medical examination of patients with chronic pulmonary heart]. AB - Results are analysed of the efficiency of complex treatment of patients with chronic cor pulmonale including cardiac glycosides, agents stimulating metabolism processes in the myocardium, immunoactive drugs and antiaggregants. The efficacy was evaluated of cardiotonic therapy with different glycosides in hospital and outpatient treatment. The necessity is substantiated of including into complex treatment drugs of metabolic action, immunoactive and antiaggregant agents with the purpose of reducing the threshold of sensitivity of the myocardium to the toxic effect of cardiac glycosides. PMID- 2711667 TI - [Diagnostic significance of protein complexes in ischemic and noncoronagenic damage of the myocardium]. AB - A study of the structural aspects of blood serum albumin in patients with different forms of IHD and non-coronarogenous diseases of the myocardium revealed a reduction of spiralization of the albumin molecule, formation of modified form of protein and albumin-carbohydrate complexes. It is recommended to use these biochemical parameters in the complex diagnosis of different forms of cardiac pathology. PMID- 2711668 TI - [Myocardial blood flow and changes in the electrocardiogram during veloergometry in patients with ischemic heart disease]. AB - The authors studied in 64 patients with ischemic heart disease and 14 control persons the myocardial blood flow and its relationship with depolarization and repolarization indices and depression of the ST segment at threshold loads. The myocardial blood flow in IHD patients with stenosing atherosclerosis of two and three coronary arteries was reduced by 50% and the tolerance to physical load was low. PMID- 2711669 TI - [Veloergometric indicators in patients with ischemic heart disease depending on collateral circulation]. AB - The dynamics was studied of tolerance to physical load in the course of three year prophylactic medical care of 60 male with ischemic heart disease (functional class II-III) against the background of antianginal therapy related to presence or absence of collateral blood flow as evidenced by coronaroangiography. The presence of collateral blood flow in patients with ischemic heart disease is considered as a sign of marked hemodynamic disorder in the system of the stenosed blood vessel leading to myocardial ischemia, reduction of the contractile function and a more severe clinical course of ischemic heart disease with a possible development of reinfarctions of the myocardium and advancing reduction of tolerance to physical load. PMID- 2711670 TI - [Difficulties in diagnosing mitral valve prolapse]. PMID- 2711671 TI - [A case of rheumatic pneumonia]. PMID- 2711672 TI - [Development of a blast crisis in a patient with chronic myeloleukosis]. PMID- 2711673 TI - [Immune response of donors during immunization with staphylococcus anatoxin]. AB - The content of antistaphylococcal antitoxins--antialphastaphylolysins was examined in the blood serum of three groups of blood donor volunteers. It is shown that volunteer blood donors immunized according to two schemes with prophylactic purposes may be a source of antistaphylococcal plasma. Additionally antistaphylococcal plasma may be obtained from non-immune donors showing high titers of antialphastaphylolysins revealed by the screening method. PMID- 2711674 TI - [Lymphoid tissue during phylo- and ontogenesis]. AB - In the process of evolution lymphoid tissue is isolated from the single hemolymphatic system as central and peripheral organs of the immune system. However there remains a close relationship between the lymphoid and myeloid tissues in the forms of perivascular lymphoid accumulations in organs both in the phylo- and ontogenesis. In mammals and man the diffusely disseminated within the body perivascular lymphoid tissue if differentiated in organoid-perivascular lymphoid follicles which are regularly located along the course of links of the hemo- and lymphocirculatory bed. PMID- 2711675 TI - [The role of fat-soluble vitamins in the development of psoriasis]. PMID- 2711676 TI - [Features of regional peripheral hemodynamics in radicular syndromes of the sacro lumbar region]. AB - Different causes leading to lesions of the peripheral nerve trunk result in instability of the state of regional hemodynamics values. Vegetative-vascular disorders determining the characteristic aspects of the peripheral hemodynamics may result in the development of intratruncal edematous compression of the nerve trunks. PMID- 2711677 TI - [Composition of intestinal microflora in various kidney diseases]. AB - The effect of intestinal microflora on the abdominal clinical signs was studied in patients with chronic diseases of the kidneys. Renal diseases are accompanied by morphological changes of digestive tract and by dysbacteriosis which may lead the clinical picture. The importance of these findings for the treatment of patients with renal diseases is emphasized. PMID- 2711678 TI - [Features of mild repeated cranio-cerebral injuries]. AB - An analysis of 97 cases indicates that the clinical manifestations of mild repeated head injuries do not reflect the real severity of the traumatic brain disease which determines the necessity of complex clinico-instrumental examination of these patients. Objective clinical and instrumental methods suggest that complete cure does not occur in mild repeated head injury in patients of all age groups. PMID- 2711679 TI - [Rehabilitation of patients suffering from closed spinal trauma with damage to the spinal cord]. AB - Results of complex rehabilitative treatment of 652 patients with above kind of pathology are examined. Outcomes of motor mobility depending on the level and severity of the injury are shown. In spine-spinal cord injury 77.3% of patients could walk using supplementing devices. The percent of I group invalidity depending on the level of spinal cord injury varies from 74.6-92.7%, II group invalidity--0.8-7.5%, III group invalidity--0.8-3.5%. PMID- 2711680 TI - [Psychotherapy of post-traumatic borderline neuropsychiatric disorders]. AB - A study of borderline neuro-psychic disorders observed in he restorative period of head injuries revealed their polymorphous character and the necessity of psychotherapy. The author carried out a psychotherapeutic program (rational psychotherapy, prolonged sleep-hypnosis, hypnosuggestion, psychotherapeutic passes) that essentially increased the efficiency of treatment of borderline neuro-psychic disorders in the restorative period of head injuries. PMID- 2711681 TI - [Lateral signs in adolescents suffering from enuresis]. AB - The authors carried out a neuropsychological investigation of the characteristic aspects of functional asymmetry of the brain (FAB) in 72 adolescents (24 girls, 48 boys; age: 9-14 years) suffering of enuresis in comparison with a control choice of healthy adolescents (n-92). It was found that the patients showed a tendency to an accumulation of subjects with the left leading eye and revealed distinct differences in the distribution of ambidexters. These data may indicate immaturity and delay in FAB formation in the clinical choice and suggest the presence of mild exogenous-organic disorders of the central nervous system characterized by minimal brain dysfunction. Psychological control of the efficiency of treatment was realized. PMID- 2711682 TI - [Physiologo-hygienic features of workers engaged in welding cast-iron items with preliminary heating]. AB - It was established that in welding of cast-iron wares with their preliminary heating, the thermal factor occupies the leading place in overstrain of the physiological reactions of the worker's body. The workers showed an increase of the average values of most indices of the thermal state and cardio-vascular system. Hygienic measures directed to prevent conveying heat to the working zone of the welder are described. PMID- 2711683 TI - [Immunologic indicators of adaptation to high temperature]. AB - It is shown that immunological adaptation of the worker's body to heating industrial microclimate is not perfect. In the genesis of immunological disorders a certain role is played by disturbances of protein metabolism and interaction of biologically active substances: histamine, heparin, hyaluronidase. Perspectives of further studies of the immune status due to effect of high temperatures of the human body are outlined. PMID- 2711684 TI - [Status of the respiratory organs in workers of cotton-processing enterprises according to epidemiologic data]. AB - Reported epidemiological findings of the state of blonchopulmonary apparatus using a questionnaire, physical and functional examination of workers allowed to reveal chronic bronchitis, mainly of stage I and initial signs of byssinosis in those working at enterprises on processing of low-quality cotton growth. Results of hygienic evaluation of the dust factor dictate the necessity of extending the existing method during examination of enterprises engaged in processing of fibrous vegetal dusts. The necessity is also substantiated of perfecting medical screening of this category of workers. PMID- 2711685 TI - [Psychiatric and parasitologic aspects of dermatozoon delusion]. AB - Patients suffering from delusional parasitosis are not only seen by psychiatrists, but more often by dermatologists and parasitologists. Previous results published by researchers of differing specialities led to somewhat contradictory opinions concerning these patients. The main goals of the present study were, on the one hand, to examine the various and partly controversial hypotheses, which were mostly based on single case observations in a substantial sample of 107 patients with delusional parasitosis and, on the other hand, to investigate possible differences between patients who consulted the parasitologist initially and those who saw the dermatologist first and were subsequently treated by a psychiatrist. Hence, 34 patients treated by one of the authors (M.M.) at a special outpatient clinic for patients with delusional parasitosis of the Second Dermatological University Department, Vienna, have been compared with 73 patients who consulted the other author (E.K.) at the Institute of Parasitology of the University of Veterinary Medicine, Vienna. Some similarities, but also marked differences were found between the two groups: the sex ratio was similar in both groups but they differed with regard to age, social background (size of household) localisation of "parasites" and the mode of "infection". The results demonstrate the necessity of developing differentiated medical care programmes which take into account these differences. PMID- 2711686 TI - [Prognostic factors for long-term mortality and risk of stroke in patients with transient ischemic attacks]. AB - The aim of the present study was to evaluate the natural course of patients with transient ischaemic attacks and to determine prognostic factors concerning long term mortality and the incidence of stroke. 159 patients, who were hospitalized after transient ischaemic attacks at the Neurological University Department Vienna during the years 1976 to 1985, were asked about the further course of their illness using questionnaires. 22 patients had moved to unknown addresses and the return rate of the remaining questionnaires was 73.0%. Thus, the results of 100 patients were included in the present study. The follow-up period was 71 +/- 32 months (x +/- s; range: 19-135 months). During the follow-up period, 11 patients had died and 25 had eventually incurred full-blown cerebral infarction. The following variables were analyzed for their prognostic relevance with respect to long-term mortality and stroke occurrence: sex, age, vessel territority involved clinically, number of vessel territories involved clinically, number of strokes, and severity of clinical symptoms. The clinical symptoms (motor deficits, sensory deficits, speech disorders, visual field defects and organic mental syndrome) were graded semiquantitatively and added up to a "total score". Age had a significant influence on survival, but not on stroke occurrence. All other variables had no significant impact on long-term mortality and stroke occurrence. It is concluded that transient ischaemic attacks are warning symptoms of an impending stroke. However, prognostic assumptions cannot be made of the basis of clinical features in this subacute stage. Thus, all patients suffering from transient ischaemic attacks should have a comprehensive and thorough vascular investigation as soon as possible. PMID- 2711687 TI - [Nyctometry and flicker discrimination in diabetic retinopathy]. AB - 98 diabetics and 34 healthy probands were recruited for ophthalmoscopic evaluation of the retina with a fundus camera, and for functional tests of the retina using a flicker frequency analyzer and a nyctometer. One year later, funduscopic evaluation of the ocular fundal state was carried out, and the results compared with the original baseline set of functional parameters. In the control group of healthy probands, a result only partially duplicated in the group of diabetics. An age-corrected comparison of the two groups revealed no difference between the diabetics and the healthy probands. Attempts were made to identify groups displaying significant differences in retinal performance as evaluated by the procedures mentioned above, but neither taking duration of diabetes as a criterion, nor selecting for differences in the course of diabetic retinopathy enabled the identification of such groups. A decrease in retinal performance was seen in very severe stages of diabetic retinopathy. These functional tests are not suitable in the early stages of diabetic retinopathy for defining that group of high-risk patients in which rapid progression of diabetic retinopathy is to be expected. PMID- 2711688 TI - ["Body packing" in Austria. Clinical and diagnostic aspects of gastrointestinal smuggling of intoxicating drugs based on 2 cases]. AB - The alimentary tract is frequently used as a hiding place for the transportation of drugs. We report on the cases of two smugglers with drug packages ("body packing") in the gastrointestinal tract. Radiological techniques provide the best method of diagnosis. The clinical problems and symptoms of acute drug intoxication are presented. PMID- 2711689 TI - [Survey of elective education in crisis intervention and suicide prevention (attempt at an evaluation) at the Institute of Medical Psychology]. PMID- 2711690 TI - [Demarcation of diseases]. AB - Feinstein's opinion that diseases overlap does not stand up to professional criticism. Different diseases can certainly present very similarly, but they cannot overlap, in the same way as specialties cannot overlap. The specialties are separated from each other according to their different connections with the diseases. Diseases are separated from each other by their relations to the symptoms and clinical signs on the one hand and the results of medical consultation on the other hand. These considerations emphasize the fact that doctors should not make a diagnosis too hastily if a typical symptomatology is present. That, however, has nothing to do with overlapping of diseases, but with the temptation in the presence of a typical clinical picture to jump to a diagnosis without first having scrupulously clarified the possibility that the classical symptomatology was not, in fact, really due to the atypical manifestations of a totally different disease. PMID- 2711691 TI - [Transvenous high frequency current ablation of atrioventricular conduction in therapy refractory tachycardic atrial fibrillation]. AB - We present a case of radiofrequency ablation of the atrioventricular conduction system by means of intravenous catheter technique in a patient with drug refractory paroxysmal atrial fibrillation. Total AV block was produced. Since the ablation and implantation of a pacemaker this female has had no recurrences. The advantages of this method compared with electrical fulguration are better control of delivered energy and reduction of complications (catheter perforation, thromboembolism). The disadvantage of radiofrequency ablation is the difficulty in positioning the catheter so as to give the most precise contact with the tissue, which is a very time-consuming procedure. PMID- 2711692 TI - [Redilatation with the trefoil balloon catheter in 2 patients with a high degree of aortic stenosis]. AB - Percutaneous transluminal balloon valvuloplasty (PTBV) is successfully applied in the treatment of calcified aortic stenosis. However, results following redilatation have not yet been dealt with in the literature. This method was successfully used in two patients (62a m/70a f) suffering from severe sclerotic aortic stenoses. Redilatation was undertaken in the first case after one month and after four in the second. A second redilatation by balloon catheter was done upon request of the patients after a further nine months. Following this third dilatation both patients suffered from femoral thrombosis which was treated surgically in the second case, while in the first local thrombolysis was done. In the management of the first patient valve replacement had to be performed four months after the last dilatation due to renewed complaints, while the second patient showed no evidence of recurrence within three months after the last dilatation. PMID- 2711693 TI - [Obstructive sleep apnea--a risk factor for arterial hypertension]. AB - Obstructive sleep apnea is frequently found in middle-aged men. Usually, these patients are obese and therefore predisposed to hypertension. This study aimed to elucidate the relationships between hypertension, obesity and obstructive sleep apnea in 48 men suffering from sleep apnea. Hypertension was found in 39 of them (= 81%), 27 patients (= 56%) were morbidly obese (Broca index above 125%), 17 patients (= 36%) were moderately obese (Broca index between 100 and 125%) and 4 patients (= 8%) showed normal weight (Broca index below 100%). Severity of sleep apnea did not correlate with obesity or hypertension. Patients with sleep apnea who were hypertensive were significantly (p less than 0.025) more obese than those with normal blood pressure. Compared with an unselected population showing a similar degree of obesity, patients with obstructive sleep apnea showed a higher prevalence of hypertension and this is independent of age. These findings establish sleep apnea as a risk factor for hypertension. PMID- 2711694 TI - [The value of Doppler echocardiography findings in selecting patients with aortic stenosis for surgical intervention]. AB - Doppler echocardiographic and catheter measurements of pressure gradients were compared in 29 patients (61 +/- 11 a) with isolated aortic stenosis. In addition we retrospectively evaluated which easily obtained Doppler echocardiographic parameters might indicate severe aortic stenosis requiring surgery. Catheter derived peak to peak and mean gradients correlated well with maximum systolic Doppler gradient (r = 0.78, p less than 0.01) and mean Doppler gradient (r = 0.73, p less than 0.01). Using the continuity equation, the aortic valve area was assessed in 14 patients by Doppler echocardiography. A good correlation was found with catheter-determined aortic valve area (r = 0.83, p less than 0.01). Surgical intervention was recommended in 19 patients after left heart catheterisation. Doppler determined maximum transvalvular flow velocity (Vmax.) was greater than 4.5 m/s in 10 patients, all ultimately considered to be surgical candidates. None of the 7 patients with Vmax. less than 3.8 m/s proved to have critical aortic stenosis. In 12 patients Vmax. was between 3.8 and 4.5 m/s. In this group aortic valve replacement was advised in 9 patients after catheterisation. In 5 surgical candidates echocardiography showed reduced left ventricular function (systolic shortening fraction less than 0.27). Hence, the Doppler derived peak flow velocity greater than 4.5 m/s or peak flow greater than 3.8 m/s in the presence of reduced left ventricular function indicate severe aortic stenosis requiring surgery. PMID- 2711695 TI - [Pathogens of urinary tract infections in ambulatory care--resistance status and pathogen spectrum]. AB - 320 bacterial strains, isolated in January 1988 in the course of routine diagnostic investigations from patients with urinary tract infections, were compared with 594 strains isolated in 1983. Samples originated from outpatients in Tyrol and Vorarlberg. Most of the strains examined proved to be sensitive to oral chemotherapeutics. No increase in resistance to standard agents was observed from 1983 to 1988; the most frequently isolated organisms are still E. coli and enterococci. In contrast to the situation in hospitals, bacteriological investigation of urinary samples is not mandatory for outpatients with acute urinary tract infection. PMID- 2711696 TI - [Antibiotic therapy in hip endoprosthesis surgery]. AB - A 5-point programme preventing deep infection following total hip replacement is presented. All of the single-stage procedures (3948) were subjected to analysis. An infection rate after total hip replacement of 0.07% in the first half year and long-term follow-up results of 1.29% were found using a laminar air flow system without prophylactic antibiotics. One-stage reimplantation was performed in combination with local administration of antibiotics, followed by a postoperative regimen of alternating administration of 2 antimicrobial drugs for the treatment of deep periprosthetic infection. Over a follow-up period of one to 9 years there was no evidence of recurrence of infection in 80% of cases. PMID- 2711697 TI - [High-dose short-term antibiotic therapy in bacteremia and infection in severely burned patients]. AB - 60 to 70% of all late deaths in patients with severe burns are due to sepsis. Thus, treatment with antibiotics is essential in the overall management of such patients, which in our hospital is carried out according to the following principles: 1. No prophylactic antibiotic treatment. 2. Careful evaluation of the bacterial spectrum of the burns, nasopharyngeal area, anal region, sputum and blood cultures. 3. In case of bacteriaemia we start high-dose combination therapy with two different, specific chemotherapeutic agents, given alternately every 4 to 6 hours. 4. In concordance with the clinical picture antibiotic therapy is discontinued as soon as three subsequent blood cultures remain sterile. Since 1980, 58 patients with severe burns (extent: 20 to 90% of body surface) have been treated according to these principles. Mortality due to sepsis was low, namely 9.5% (2 out of 21 patients presenting with bacteriaemia), so that our method of treatment has proven to be effective. PMID- 2711698 TI - [Epidemiology of autopsy verified infection]. AB - In a retrospective study of 35,220 autopsies performed from 1950 to 1984 in our department, septicaemia was found in 707 cases (2% of all autopsies). The incidence of pyaemia decreased after 1960, whereas that of septicaemia increased significantly. This increase was observed in surgical and medical departments due to patients suffering from neoplastic disease who died of septicaemia (40% of our cases). In the paediatric departments, however, mortality from septicaemia decreased slowly, but continuously. Age distribution revealed two peaks, one in infancy and one in patients older than 60 years. Over the past decade the mean age increased significantly (15 years on average). In blood cultures gram negative bacteria were found more often than gram positive strains. PMID- 2711699 TI - [Vitamin C]. PMID- 2711700 TI - The assessment of preventable infant and child deaths in developing countries: some applications of a new index. AB - This article briefly reviews epidemiological and demographic measures used to assess preventable deaths in developing country situations. Problems with the use of the infant mortality rate (IMR) as a health-policy indicator are illustrated. The Matlab experience of rural Bangladesh is used to develop a new index for preventable infant and child deaths. This index, based on a statistical transformation of usual demographic measures, links mortality levels and cause-of death structure. The use of this index is illustrated with applications to Asia and Africa. It is claimed that the index exhibits more clearly the difficulty involved in the control of particular causes of death, thus providing important information for health policy makers. PMID- 2711701 TI - [Preventable deaths: general view]. PMID- 2711702 TI - Excess mortality ratio with reference to the lowest age-sex-specific death rates among countries. AB - Indicators based on mortality data have long been used to measure the level of health status and to monitor and evaluate the progress and achievements of health programmes. Their usefulness is particularly obvious when dealing with preventable deaths. This article proposes the use of the lowest death rate recorded among industrialized countries for each age/sex group as an achievable target and as a reference for assessing the amount of excess mortality. The resulting indicator, excess mortality ratio (EMR), reveals some features of the mortality pattern which may not be easily noticed by means of other mortality indicators. Two sets of the lowest age-sex-specific death rates are considered, namely one comprising the lowest rates recorded in each calendar year (the current minimum) and the other comprising the lowest rates ever recorded since 1950 (the historical minimum). The former may be used for monitoring whether a country is moving ahead in mortality reduction in pace with low mortality countries, while the latter may be considered as a realistic goal for a country's mortality reduction. In computing the EMR, the lowest death rates are first applied to the age-sex composition of the population of a given country for a given calendar year to obtain the number of deaths which would have been expected under the lowest mortality pattern; the expected number is then subtracted from the actual number of deaths recorded in the country during the calendar year to yield the "excess". The indicator is finally calculated by taking the ratio of the excess to the expected minimum. The historical minimum death rates found from the records maintained in WHO's mortality data base are shown in Table 2 (for country codes used, see Table 1). The minimum rates have themselves declined with time as seen in Table 4, especially in young age groups, and the declining trend has been more marked in females. These trends are seen also in individual countries' data (Table 3). A comparison of the cause-of-death pattern of a country with that of the world's lowest death rate will reveal the causes to which the country's excess mortality is attributable, as seen in Table 5. At the same time, the table also shows that even the lowest rates are made up of causes which are largely preventable. The world's lowest rate therefore may be regarded as conservative targets for mortality reduction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2711703 TI - Preventable mortality: indicator or target? Applications in developing countries. AB - Preventable mortality, empirically defined, is analysed using the standardized mortality ratio for all ages (SMR), the SMR for deaths occurring before age 65, and the ratio of observed and expected years of potential life lost (RYPLL). Mortality data from Argentina and Mexico are used for illustration. To assess progress made, expected deaths are computed using data from the country's own past; to show challenges still ahead, expected deaths are computed using the rates of the United States of America. Comparisons with the past are made for mortality from all causes only; to assess what lies ahead, cause-specific mortality is also looked at. It is shown that for the data at hand the RYPLL is the indicator most sensitive to discrepancies between number of deaths observed and those expected, and that it provides information on inequalities beyond and in addition to that obtained from analysing crude and age-adjusted mortality rates and cause-specific proportional mortality. It is hoped that countries and areas will use these procedures for their own benefit to assess their current health situation against their own past and also against a suitable future reference, to assist them in priority setting and surveillance and evaluation of their health-services system. PMID- 2711704 TI - [Geographical variations in mortality due to diseases amenable to medical intervention in Europe--Commission of European Communities: atlas of avoidable deaths]. AB - The urgent need to develop measures of the outcome of health-care services has led to the collaboration of 10 countries of the European Community in the production of the European Community atlas of avoidable death (1974-1978). Seventeen disease groups were chosen for which it was considered that death within specified age groups should be either wholly or substantially avoidable when appropriate medical care is sought and provided in good time. Mortality from these causes was compared across 360 health-service administrative areas in the participating countries. For all diseases there was considerable variation in mortality both within and between the countries of the European Community and it is suggested that high levels of mortality from these causes should be viewed by health authorities as warning signals of potential failures of health-care services. Work is in progress on a further edition of the Atlas for the years 1980-1984. Changes in avoidable mortality over time could indicate which health authorities have persistent problems and which authorities are succeeding in reducing avoidable mortality. PMID- 2711705 TI - Years of potential life lost: application of an indicator for assessing premature mortality in Spain and Portugal. AB - In this article, the authors present an analysis of causes of death in Spain and Portugal in 1984 based on a calculation of the "years of potential life lost" (YPLL) between the first and the 70th birthdays, the latter age corresponding approximately to the average life expectancy in both countries. This analysis of the YPLL led to a substantially different ranking of the main causes of death, based on what might be termed "premature mortality" compared with that obtained from more conventional mortality indices. According to this criterion, which is especially appropriate for the planning and evaluation of health interventions, the main causes of premature death (1-69 years) in the two countries of the Iberian peninsula are malignant tumours and, particularly in Portugal, violent deaths (especially motor-vehicle accidents, but also suicides). This is in contrast to the predominance of cardiovascular diseases indicated by other weightings of age-specific mortality rates. Portugal shows significantly worse YPLL rates than Spain not only for general mortality (45% higher than in Spain), but also for several major groups of causes. In Spain only malignant neoplasms, diabetes and chronic rheumatic heart diseases show higher specific mortality rates than in Portugal, based on traditional mortality indicators.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711706 TI - [Increasing mental performance by multistep oxygen therapy. Computer-assisted measurements of information processing capacity, intelligence, short-term memory and further parameters of cerebral performance]. AB - Several basic characteristics of mental capacity were measured on 59 patients by means of computer-based-methods before and after oxygen multistep therapy (O2-MT) and compared with the results obtained from 14 volunteers serving as controls. Before and without O2-MT, an appreciable, age-dependent decline of the short-term memory capacity (general fluid intelligence) was found. O2-MT, completed by brain jogging, effected a significant increase in the presence duration by 0.4-0.7 secs, in the information flow by 1.4-1.9 bit/sec, resulting in an increase in the short-term memory capacity by 19-23% (in two experimental groups). The short-term memory itself was, however, not improved as compared to the controls. Moreover, the times needed for the accomplishment of perception, interference and reaction tests became significantly shorter by 12-18%. By using the screening test for cerebral insufficiency (CI), which is based on these parameters, the suspicion of CI could be excluded in 18 of 59 patients. PMID- 2711707 TI - [Effect of social factors on the oral health status and utilization of stomatologic care by elderly citizens]. AB - Different social items (marital status, social contacts, indigence, level of education) and in addition the social area have consequences to the dental health behaviour and the health consciousness until old age, and influence the success of dental care for the prosthesis wearer. PMID- 2711708 TI - [Research and practice requirements in gerontology--results of a pilot study]. AB - This report includes empirical findings of a questionnaire-based pilot study. A group of physicians in geriatric practice has been asked with respect to research requirements in social gerontology. The findings presents evidence for need for increase in scientific founded knowledge in specific spheres of perception. According to the recommendations of the explored subjects such themes as housing/relocation to old-age institutions, family, preparation for old age, activating/rehabilitation and so on should be taken up in research work. Our purpose is to stimulate both the discussion between different branches of knowledge on further development of gerontological investigation and the adequate realization of proportion of research to practice in GDR. PMID- 2711709 TI - [Practical and education-oriented aspects of surgical health care in advanced age]. AB - Besides the advances of physiology, pathophysiology, biochemistry, immunology, pharmacology, operative technique affect above all a well balanced nursing in the unit of care, mobilization and prophylaxis positive on the prognosis after surgical operations in the higher age. The demographic development clearly demonstrate the increasing of geriatric surgery in the following years. These pieces of work represent relevant aspects of the surgical care by elderly people; the medical practice and education must take into consideration in these aspects. PMID- 2711710 TI - [Complications of temporary transvenous endocardial pacemaker therapy]. AB - The prospective analysis of the results of the temporary transvenous-endocardial pacemaker therapy in 591 cases of treatment resulted in a total rate of complications of 37.1%. Hereby the main part of complications were disturbances of the function of electrodes (28.3%). The greatest numbers of complications showed infiltrable electrode catheters which were applied at bedside with a dislocation rate of 17.2% and a rate of not achieved stable stimulation positions of 13.7%. The smallest numbers of complications were to be observed in semiflexible stimulation catheters, which were positioned under X-ray control (dislocations in 4.1%, no achievement of a stable stimulation position in 3.3%). For the practice of the temporary pacemaker therapy from this analysis result particularly consequences in the choice of a suitable stimulation catheter and the methodical approach in positioning of this catheter. PMID- 2711711 TI - [Dose-reduced antihypertensive agents--use in complex nonmedicamentous therapy of hypertension]. AB - In order to estimate the influence of a non-medicamentous therapy (CNT) on the consumption of medicaments and coronary risk in high blood pressure 73 hypertensives of a medicamentously stabilized CNT-group were examined in comparison to a group of the same size of patients with hypertension who were managed exclusively medicamentously for behaviour of blood pressure, need of antihypertensive drugs and changes of hypertension-associated risk factors. After an exactly controlled 6-month treatment hypertensives with additionally recommended far-reaching CNT showed an economization of medicaments by scarcely the half in comparison to the reference group. By means of suitable control methods a causal non-medicamentously conditioned decrease of blood pressure could be excluded. A different need of antihypertensive drugs was simulated by the exacter intake of medicaments in the index-patients. Notwithstanding the metabolic effects of the additional therapy have induced a positive change of atherogenic lipids. The examinations indicate in general the difficulty of the judgement of efficacy of non-medicamentous therapeutic measures in connection with a rational dose-reduced long-term therapy with antihypertensive drugs. PMID- 2711712 TI - [Secondary L-carnitine deficiency in chronic hemodialysis patients]. AB - L-carnitine is an essential substance for the decomposition of long-chain fatty acids and thus for the obtaining of energy in the mitochondria. The L-carnitine fractions in the serum were analysed in 10 patients undergoing haemodialysis before and after the dialysis treatment. 4 patients received a substitution of L carnitine by oral application of 3.0 and 1.0 g, respectively, after every dialysis or as addition to the dialysate (ca. 62 mumol/l) for in each case 4 weeks. In patients undergoing dialysis the serum carnitine fractions were in many cases already clearly diminished before the dialysis. During the treatment the total L-carnitine levels decreased by ca. 50%, the free L-carnitine values by ca. 70%. Particularly distinct carnitine depletions were found in patients with catabolic metabolic condition, incompatibility of dialysis and post-dialysis syndrome. All forms of application and dosages chosen led to a good correction of the serum carnitine concentrations. 2 patients with oral L-carnitine substitution of 3.0 g and resulting from this serum carnitine levels highly significantly lying above the normal region mentioned ameliorations of the subjective lipid parameters cholesterol, HDL-cholesterol and triglycerides could not be changed in the short period of observation by substitution of L-carnitine. PMID- 2711713 TI - [Results of treatment of endocrine orbitopathy]. AB - We registered 101 patients from the ambulatory endocrinological dispensary with an endocrine orbitopathy stage II to VI. The peak of age at the time of the disease was in the fifth decennium of age. Females are four times more, frequently affected than males. Only one third of the patients could be registered and treated at the early stage of the endocrine orbitopathy within the first six months after appearance of the symptoms. The metabolic condition of the thyroid gland was hyperthyroid in 70.3% of the cases. 82.2% of all patients showed a struma. By a thyrostatic treatment of hyperthyroid persons in 14.1% a decrease of Hertel's values and in 31.0% a reduction of the subjective eye complaints was obtained. The parabulbar dexamethasone therapy in each case in circa half the patients resulted in an improvement of Hertel's values as well as of the subjective symptoms. A comparison of the oral dexamethasone and prednisolone showed a more favourable effect, when Hertel's values were measured. It is to be stated that there is not therapeutic remedy of choice of the endocrine orbitopathy, but the combination of several forms of treatment is necessary. PMID- 2711714 TI - [Achalasia and mycosis]. AB - Report on a massive candidosis of the oesophagus in a 73-year-old woman with achalasia. Discussion of the possible causes and the differential diagnosis of the achalasia. Reference to the mycotic oesophagitis as one complication, apart from many others, of the lesion of the oesophagus. PMID- 2711715 TI - [A contribution to Mirizzi syndrome]. AB - The Mirizzi-syndrome is an up to now little described, but apparently not in the least infrequent complication of the cholecystolithiasis with compression of the common hepatic duct by a concrement of the cystic duct with accompanying cholecystitis/pericholecystitis. The diagnosis is made by sonography, above all, however, by endoscopic-retrograde cholangiography (ERC) and percutaneous transhepatic cholangiography (PTC). The difficulties of the demarcation to the tumour-caused obstruction of the bile duct and their importance for therapy and prognosis are described on the basis of a casuistics. PMID- 2711716 TI - [Experimental animal studies of the healing of burn wounds with the use of local antimicrobials and hyperbaric O2 therapy]. AB - Standardized burns without experimental infection and such with infection by a constant number of bacteria of a fixed Pseudomonas-aeruginosa-strain were treated differently. Silver sulfadiazine- and Cefsulodin-cream, Polyvidon-iodine-ointment (PVP-Jod), and hyperbaric oxygen (OHP) were used to them. The courses of healing were checked by determination of the wound area daily. The best results showed the experimental uninfected untreated wounds. Wounds infected by Pseudomonas were healing most quickly by immediate and continuous application of hyperbaric oxygen. By silver sulfadiazine- and Cefsulodin-cream treated burns showed statistical significant better results than the control group. The courses of healing were significantly poorer in delayed application of OHP (only from the 8th day after the burn) or in case of therapy with PVP-iodine alone. PMID- 2711717 TI - [Endotoxin in experimental mesenteric infarction]. AB - After ligation of the mesenteric arteries an intestinal ischaemia was obtained. Endotoxin was measured from the peritoneal cavity, the portal und the peripheral blood. The limulus test for Endotoxin was used after phenol-water-extraction of the plasma. Microbiological investigations were done simultaneously. The endotoxin concentrations correlated to the clinical state of gram negative sepsis. PMID- 2711718 TI - [Changes in passive electric tissue properties of experimental tumors during carcinogenesis]. AB - The DS-carcinosarcoma of rats changes its passive electrical properties during the development time. Using a pulse measurement method the pulse parameters h beta and h1 of cancer tissue from 10 rats were measured in vivo during a period of 13 days after the beginning of the tumour growth. These parameters depend on the intra- and extracellular conductivity, on the membrane capacity, and on the volume fraction of the structures surrounded by a membrane. The values of h beta and h1 decrease during the first 4 days of the cancerogenesis by more than 50%. These findings agree with measurements carried out in portiocarcinomas. PMID- 2711719 TI - [Experimental animal studies of the effect of selective proximal vagotomy on the prostaglandin content of the gastric mucosa in the Shay ulcer model]. AB - Mucosa damage, these appear in the Shay ulcer model before the macroscopic ulceration, can be prevented by the selective proximal vagotomy. Changes of the potential difference and the prostaglandin content were discovered after pylorus ligation, and Thromboxane was increased, PGF2 alpha and TXB2 were nearly constant, whereas 6-keto-PGF1 alpha increased clearly in the rumen. The 6-keto PGF1 alpha and the PGF2 alpha content and Thromboxane remained unchanged and the potential difference was normalized in case of selective proximal vagotomy and pylorus ligation. The SPV is significant as you know for the secretion of H+ion and bicarbonate, but also for the normalization of increased TXB2 on the basis of our investigation results. PMID- 2711720 TI - Comparison of respiratory and cardiovascular effects of halothane, isoflurane, and enflurane delivered via the Jackson-Rees breathing system in rats. New anaesthesia model for small animal surgery. AB - We studied the respiratory (R) and cardiovascular (CV) effects of 1.25 MAC halothane (H), isoflurane (I) and enflurane (E) in oxygen, delivered by the Jackson-Rees breathing system in 5 normothermic rats. Mean arterial pressure (MAP), heart rate (HR) were depressed after 30 minutes than stabilized after 2 hours anaesthesia regardless of the inhalational agent. Respiratory rate (RR) slowed down markedly unter I and E anaesthesia. Significant R depression was developed (PCO2 53.5 +/- 2.44 Torr) under E. Stabil metabolic condition was maintained. The R and CV changes caused by H and I were far less than changes produced by E. H or I is preferable to E for small animal anaesthesia with spontaneous breathing. Maintenance of constant temperature minimizes the CV and R disturbances. PMID- 2711721 TI - [The technic of implanting peripheral nerves in the cerebral hemispheres of rabbits for experimental purposes]. AB - An implantation method of the tibial nerve into the cerebral hemispheres of rabbits is reported. The operations were carried out in 10 adult animals of both sexes of the chinchilla race. All operations were got over well and without any complication within 12 to 14 weeks. 2 female rabbits had brought forth and up healthy animals. PMID- 2711722 TI - [A model of a rat cage for the collection of urine free of fecal matter]. AB - A cage for total separation of feces and urine in the awake rat is presented. Construction and function are described in detail. Two important indications (investigation of the urinary enzyme activity, and determination of the endogenous creatinine clearance) are denominated. PMID- 2711723 TI - [The effect of hydrocortisone and dopamine on the activity of some lysosomal liver enzymes in experimental endotoxic shock]. AB - The influence of hydrocortisone and dopamine to the course of the organic functional changes and the activity of same lysosomal hepatic enzymes were tested in 30 dogs in endotoxic shock. A continuous lowering of the blood pressure and the central venous pressure were observed in the non-treated group. The hemodynamic impairments turned out in the treated groups in a less acute course. The coupled treatment with hydrocortisone and dopamine in the experimental endotoxic shock seems to reduce the activity of the lysosomal enzymes in the liver and in the peripheral blood. PMID- 2711724 TI - [Premature rupture of fetal membranes near term: wait it out or intervene?]. AB - In the here presented study we investigated whether it is preferable to wait or to intervene after premature rupture of membranes (PROM) near term (greater than or equal to 36 weeks). In our first approach to answer this question we compared two time periods retrospectively in which we had managed PROM in alternate ways: In 1984 we waited 12 hours for spontaneous start of labor. After 12 hours we induced labor by Oxytocin infusion. In 1986 and 1987 we applicated 0.4 mg Prostaglandin E2 (PGE2) intracervically instead of iv Oxytocin. 67 patients received PGE2 within 6 hours, 63 patients within 7-12 hours after PROM. In total we included 416 patients into this study. We were able to show that intracervical PGE2 gel gave unambiguously better results both for primiparae and multiparae. We observed the least complications with early (less than or equal to 6 h after PROM) application of PGE2 gel. The following parameters favoured early PGE2 application significantly (p less than 0.01): interval PROM - delivery, duration of labor, incidence of cesarean sections, morbidity rate of mother and child. In our second approach we were able to confirm our results in a randomised prospective study, in which we looked at 57 women with PROM in early 1988. Additionally a direct correlation of time between PROM and birth and rate of maternal or neonatal infection emerged: We saw the best results, if labor started within 6 hours after PROM. The rate of cesarean sections and newborns that had to be transferred to pediatrics had doubled within 7-12 hours and more than quadrupled after 12 hours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711725 TI - [Laser spectroscopy in the newborn infant--initial experiences]. AB - Equipment for near-infrared laserspectroscopy for clinical application is newly available. By this technique noninvasive monitoring of biochemical parameters is achievable. We report on our first experience with a Radiometer prototype for such NIR laserspectroscopy during measurements in 5 neonates. Laserdiodes provide emission at a wavelength of 775, 805, 845 and 904 nm. The registered signals are computerized aiming at a calculation of relative changes of saturated and unsaturated hemoglobine, changes in blood volume and cytochrome aa-3. In this article graphical display of the parameters give insights in the redoxstate and the hemodynamics of the biological sample. The near-infrared laserspectroscopy has the potential of becoming an instrument for the study of biophysical and biochemical alterations in the newborn. PMID- 2711727 TI - [Echocardiography determination of the diameter of the heart and great vessels near the heart and their quotients in the newborn infant and infant]. AB - 110 infants aged from one to 384 days without cardiovascular diseases were examined by two-dimensional echocardiography. Their body weights were 2.4 to 10 kg. Using mechanical, angular scanheads of 7.5 and 5.0 MHz, the parasternal long and short axes views, the apical long axis view, the suprasternal long and short axes views and the subxiphoidal position was searched. Long axis and short axis of the left ventricle were measured at end-diastole and at end-systole. Aorta, pulmonary artery trunk, left and right pulmonary arteries and the roots of both coronary arteries were measured off-line at end-diastole. To confirm the measurements a) vertical and horizontal diameters of orthogonal transected vessels were measured, b) some vessel diameters were measured in different views and c) 10 infants were examined by two independent observers. The result of this inter-observer examination had an agreement of 77% in the 370 measurements and an inter-observer variability of 2.4%. The measured diameters were linearily related to body weight and BSA in this age group. Also, the calculated areas and volumes of the left ventricle related linearily to body weight and BSA. To simplify the estimation of left ventricular volume a formula was derived id est: Volume of left ventricle = 9.15 x greatest short axis x greatest long axis -20. The following quotients are independent from age, body weight, height, and BSA: Pulmonary artery root/aortic root, pulmonary artery bifurcation/aortic root, pulmonary artery bifurcation/-root, left atrium/aortic root.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711726 TI - [Tocolytic treatment with fenoterol. I. Prospective study of the effect of tocolysis on the condition of the newborn infant and early childhood development up to 4 years of age]. AB - From 1976 to 1979 a prospective study was run at the Women's Hospital of Heidelberg in which every women was registered who attended the hospital before the 20th week of pregnancy. After delivery the infants' development was followed up to four years. During this time 404 women received fenoterol and 74 of them had premature deliveries. While 20% of the women were primarily treated with fenoterol before the 20th week of pregnancy (threatened abortion, cerclage), 80% received the drug in the 2nd and 3rd trimester (premature contractions, abnormal fetal heart rate pattern, premature opening of the external os etc.). Risk factors and early childhood development were compared with 465 women seen in the same time who had never needed fenoterol. The data of the patients' history, the course of pregnancy, and the state of the newborn, revealed that the risk of premature delivery in spite of tocolytic treatment was highest in young women, women with low bodyweight, women with a history of miscarriages, women with threatened abortion and women with anaemia during pregnancy. In correspondence with prematurity, the development of these children was delayed. The same factors of risk were demonstrated in women with successful tocolytic treatment and delivery after the 37th week of pregnancy, although their neonates were in a markedly better state. Early childhood development in this group did not differ from that in the group of women with deliveries after the 37th week and without tocolytic treatment. PMID- 2711728 TI - [Detection and localization of the ventricular septum defect using color Doppler echocardiography. Sensitivity, specificity, limitations]. AB - In part 1 of this study 50 healthy children and 56 patients with known VSD were examined by color-Doppler-echocardiography to derive criteria for the diagnosis of a VSD by this technique. Using a defined Nyquist velocity the healthy children showed a monochrome ventricular bloodflow pattern. In patients with VSD and an interventricular pressure gradient greater than 15 mm Hg a turquois-yellow jet could be seen additionally in the ventricle with the lower pressure. The same pattern could be observed within the defect itself, except for four patients, in whom the VSD could not be visualized by two-dimensional echocardiography. In these patients, however, the VSD could be localized by tracing the jet to the septal endocardium. In patients with equal left and right ventricular pressures a monochrome transseptal bloodflow could be seen. Its color pattern was not significantly different from the normal bloodflow pattern. In these cases it was difficult to diagnose a small VSD, if the defect itself could not be visualized. Thus, the following criteria for the diagnosis of a VSD by color-Doppler echocardiography were derived depending on the interventricular pressure gradient: 1) Interventricular pressure gradient greater than 15 mm Hg: visualization of the VSD-jet including its origin at the septal endocardium. 2) Equal left and right ventricular pressures: visualization of the VSD as echo drop out as well as a transseptal bloodflow. Using these criteria, sensitivity and specificity of color-Doppler-echocardiography in the detection of VSD were evaluated in part II; 234 consecutive patients, of which 119 had a VSD, were examined. All had undergone cardiac catheterisation. A high sensitivity of 98.3% and a specificity of 99.1% were found. Diagnostic problems remain in patients with a small VSD and also in patients with equal left and right ventricular pressures. In particular, multiple VSD with equal left and right ventricular pressures are difficult to visualize completely, as compared to cases with significant interventricular pressure gradients. PMID- 2711729 TI - [The determination of creatine kinase isoenzyme subunits CK-M and CK-B with the help of precipitating antibodies]. AB - Isoenzymes of creatine kinase (CK-MM and CK-BB) of samples of tissues from human skeletal muscle and human brain tissues were highly purified. Anti-CK-M and anti CK-B were prepared by immunization of goats. The obtained antibodies were used in a modified immunoprecipitation method for measuring the creatine kinase subunits of CK-M and CK-B in serum. PMID- 2711730 TI - [Triglyceride determination with the Sumal system in routine operations]. AB - A micromethod for determination of serum triglyceride concentrations using the Sumal-system and the sampler Sumal PVS 100 will be described. The results show that the qualitative, technical and economic parameters of the method (coefficient of variation 5%, 500 specimens per day and examiner, cost of reagents 0.50 M per test) correspond to the requirements of standard techniques and methods used in prevention trials. The method is suitable for use in routine clinical laboratory. PMID- 2711731 TI - [The effect of oral contraceptives on the intraindividual variation of clinico biochemical parameters]. AB - The effects of oral contraceptives on the average biological intra-individual variation of 22 clinical-biochemical analytes were investigated. There was no effect for sodium, chloride, potassium, calcium, urea, creatinine, uric acid, HDL cholesterol, triglycerides, thyroxin, triiodothyronine, ASAT, ALAT, gamma-GT, AAP, ChE in serum. Whereas the average biological intra-individual variation of total protein, albumin, cholesterol, hemoglobin and amylase were significantly higher in the group of women taking oral contraceptives. For these analytes the use of oral contraceptives must be considered in establishing decision making criteria for longitudinal monitoring. PMID- 2711732 TI - [Laboratory parameters for the estimation of the oxygen supply of the organism]. AB - The parameters oxygen partial pressure and oxygen saturation have been reviewed briefly with respect to their methodical problems and indications, finally in the same way the P50 as a summarizing value for the position of the oxygen dissociation curve and its significance for the estimation of hypoxic situations. PMID- 2711733 TI - [The effect of high glucose concentrations on the osmotic and mechanical resistance of human erythrocytes]. AB - Incubation of citrated or heparinized blood samples with 25 or 50 mmoles/l glucose for 1 hour at 37 degrees C results in a decrease in the osmotic and mechanical resistance of red blood cells as well as in an increase in the red blood cell volume measured as increase in haematocrit. Fructose, but not sorbitol or saccharose has effects on red blood cells that are similar to those of glucose. It is discussed that an uptake of glucose into red blood cells with subsequent water influx results in swelling and decreased stability of the cells. PMID- 2711734 TI - [Counting and differentiation of blood corpuscles with a simple flow cytometer]. AB - The performance of a simple flow cytometer for counting of blood cells was checked. The counting of erythrocytes, platelets as well as the differential counting of lymphocytes, monocytes and granulocytes was obtained by means of simple sample preparation. PMID- 2711736 TI - [The determination of the activity of cholinesterase in serum as a single test]. PMID- 2711737 TI - [An apparatus for the cleaning of microtiter plates]. PMID- 2711735 TI - [The behavior of selected parameters of sulcus fluids in inflammatory periodontal diseases]. PMID- 2711738 TI - [Laboratory centralization and the development of pathological and clinical biochemistry at the Charite hospital]. AB - The development of the discipline "Pathological and Clinical Biochemistry" at the Charite hospital from 1963-1983 was described. In the beginning of the sixties new structures for the clinical chemistry were necessary. The role of biochemical diagnostics increased due to the rapid development of the mechanization and automation of clinical chemical analysis. The centralization period of the laboratories of the clinics of the university hospital Charite included two phases: 1963 - foundation of the department of clinical biochemistry of the clinic of internal medicine and 1971 - foundation of the department of clinical biochemistry of the Charite. The main stimulus for the centralization of the laboratories and the foundation of the department of Clinical Biochemistry of the Charite hospital was the increased requests for medical care of the patients. With the new building and the reconstruction of the Charite hospital (1979-1983) the prerequisite were given to establish the discipline as Pathological and Clinical Biochemistry and in form of an institute (1983). The main stimuli for this development were demands to meet all requirements of research, teaching, biochemical diagnostics and pathobiochemical interpretation of biochemical findings of patients. PMID- 2711739 TI - [The importance of the determination of intraerythrocytic sodium for the differential diagnosis and the control of the progression of essential hypertension]. AB - Intraerythrocytic sodium concentration in 432 patients with essential hypertension under antihypertensive therapy with various drugs was determined. Aim of this investigation was to detect the importance of such finding for diagnosis and control of essential hypertension. According results presented intraerythrocytic sodium should be investigated in beginning of each antihypertensive therapy and later in intervals of 6-8 months to control effectiveness of therapy. PMID- 2711740 TI - [The binding of blood plasma proteins and salivary proteins to hydroxyapatite columns and its effect on demineralization in an in vitro system]. AB - Demineralization of hydroxyapatite (HAP) columns by acidic acetate buffer proceeds in two phases. In an initial phase which is characterized by the formation of pH gradient within the HAP sediment, calcium but no phosphate ions are eluted from the column. In the second phase when a low pH value has been established in the pellet calcium and phosphate are eluted in a ratio identical to that of the original HAP. The binding of human blood plasma proteins and saliva proteins to the HAP as well as the effect of the protein binding on HAP demineralization was investigated. The maximum binding capacity of HAP for the proteins of unstimulated mixed saliva is about four times lower than the binding of human serum albumin or blood plasma proteins. However, saliva proteins affect HAP demineralization more markedly than the other proteins. Whereas the pretreatment of HAP with human serum albumin does not alter the the demineralization process. binding of blood plasma proteins inhibits the initial phase of demineralization. Both phases of HAP demineralization are strongly inhibited when saliva proteins are bound to HAP. It is also shown that demineralization modifies the protein binding to HAP. PMID- 2711741 TI - [The problem of the influences of brain cholinergic mechanisms on lipoprotein metabolism in disorders of heat exchange and in emotional stress]. AB - The contribution of central cholinoreactive systems to the control of plasma lipoprotein metabolism was studied in white rats exposed to cold, overheating and immobilization stress. Possible mechanisms of shifts in fatty-acid composition, as well as high-density lipoprotein cholesterol and total very low and low density lipoproteins, associated with hypothermia, hypertermia and emotional stress under conditions of excitement and blockade of cerebral m- and n cholinoreceptors, are discussed. Changes in hypothalamic acetylcholin metabolism in stress-exposed animals are demonstrated. It is suggested that central cholinoreactive systems may play an important role in the control of adaptive metabolic reactions involving composite lipids under exposure to low and high environmental temperatures and emotion factors. PMID- 2711742 TI - [The mechanism coupling adrenergic and cholinergic influences on the smooth musculature of the small intestine]. AB - Experimental results, substantiating the idea of a specific mechanism for the activation of small-intestinal smooth muscle by the adrenergic system are summarized. This mechanism is realized via catecholamines affecting excitatory beta-adrenoreceptors located on cholinergic interneurones of the myenteric plexus. The excitatory beta-adrenoreceptors are shown to contribute to the realization of small-intestinal motor responses to acetylcholine, vagal stimulation and 5-hydroxytryptamine, histamine, bradykinin. The data obtained are an evidence of physiological significance of this specific adrenosensitive input of small-intestinal cholinergic neurones. The cholinergic neurones are shown to participate in producing small-intestinal responses to 5-hydroxytryptamine, histamine, bradykinin, the responses being, for this reason, dependent on the level of catecholamines, stimulating excitatory beta-adrenoreceptors. It is suggested that cholinergic neurones of the enteric nervous system are under double adrenergic control: a stimulating effect of catecholamines mediated by excitatory beta-adrenoreceptors is counteracted by an inhibitory effect of alpha adrenoreceptor activation by sympathetic neuromediator noradrenaline. PMID- 2711743 TI - [Characteristics of the gastric secretory function of dogs at different age periods]. AB - The study of various indices of the secretory function of the stomach in antenatal and postnatal period made it possible to establish the dynamics of the process. The presence of the lactic acid in the gastric juice and the absence of hydrochloric acid (15-25 days before birth)--are characteristic features of the process. The significance of the obtained material for pediatrics is shown. PMID- 2711744 TI - [Characteristics of the adaptive restructurings of the digestive system during exposure to the factors of space flight]. AB - The article presents an evaluation of the state of the digestive system in astronauts during short-term and long-term space flights. After short-term (7- or 8-day) flights, there was a transitory activation of gastrointestinal enzyme systems. After prolonged space flights, there was an increase in gastric acidity and pepsin excretion, as well as pancreatic and intestinal malfunctions. In summary, there is a transition of the digestive system to a new level of functioning. PMID- 2711745 TI - [Characteristics of temporary organization of the bronchopulmonary pattern in healthy persons and in patients with bronchial asthma]. AB - It has been shown by periodographic computer analysis that ultradian rhythms of all examined parameters (bronchial resistance, inhalation, exhalation and breathing cycle duration, inspiration activity index, pneumographic amplitude, inhalation rate) of bronchopulmonary pattern in asthmatics and normal subjects exhibit latent periodicity, with prevailing oscillations of about 60 sec. during spontaneous breathing or under exposures. changing bronchial potency. Slow-wave components form very complex poly-harmonical temporal structure with specific organization during air breathing and response to challenge tests. Bronchospasm provoked by inhalation of acetylcholine produced an abrupt decrease of the number of periodical ultradian components (or even total disappearance of oscillations) and the development of a rigid hypersynchronic temporal structure on the basis of the hypersynchronized ultradien fluctiations. The principal factors of this new system may be changes of airway resistance. Analysis of our data suggests that the phenomenon of bronchial hyper-reactivity may be associated with a disturbance in temporal organization of the cardiobronchopulmonary pattern. Development of temporal disorganization may have some pathogenetic stages such as hypersynchronization, disrhythmy, appearance of a rigid temporal structure and bronchospasm as a clinical result. PMID- 2711746 TI - [Systematic approach to the evaluation of the role of neuro-psychological factors in the development and course of bronchial asthma]. AB - The role of personality and socio-psychological factors in the initiation and course of bronchial asthma are analyzed from a systemic psychogenic-existential point of view. In this context, the meaning of personality subsystems (perception, individual psychological defences, cognition, emotional reactivity, behavior) and peculiarities of microsocial environment (group/family myths, structural and functional group characteristics) are discussed. High effectiveness of Family Psychotherapy and Gestalt Therapy in the treatment of patients with bronchial asthma is pointed out. PMID- 2711747 TI - [Current views on the role of disorders of hormonal regulation in the development of altered sensitivity and reactivity of the bronchi]. AB - Altered bronchial sensitivity and reactivity are the basis of different variations of bronchospasm. In addition to exogenous agents, endogenous regulation factors such as adrenal and ovarian hormones are believed to make an important contribution to their development. Asthmatics showed the lowest sensitivity and the highest hyperreactivity to acetylcholine as compared to patients with preasthmatic conditions or chronic bronchitis and healthy consanguins of asthmatic patients. Disturbances of glucocorticoid homeostasis, related to various (adrenal, extra-adrenal (transcortin) and cellular) mechanisms of corticosteroid insufficiency, occurred in the majority of asthmatics and asthmatic bronchitis patients. Identification of various mechanisms of glucocorticoid insufficiency opens up actual approaches to increasing the efficiency of an individual therapy. PMID- 2711748 TI - [Various aspects of the interrelations between blood phospholipids, blood coagulation and microcirculation in chronic bronchitis]. AB - Studies of conjunctival microcirculation, thromboelastographic coagulation (as assessed by 8 parameters) and plasma phospholipid spectrum (with 8 fractions obtained), carried out in 136 patients with acute phases of chronic bronchitis, have demonstrated considerable disorders of microcirculation, hypercoagulation and shifts of blood phospholipid spectrum. Marked perivascular disorders were matched by increased levels of plasma lysophosphatidylcholines, which promote increased capillary permeability. Intravascular changes (erythrocyte aggregation and sludging, intermittent flow and stasis of blood) were accompanied by established hypercoagulation and increased phosphatidylethanolamines, producing a coagulating effect. A drop in plasma phosphatidylcholines is a symptom of disrupted synthesis of this phospholipid class in the lungs, and a disorder of pulmonary surfactant structure and function. The level of phosphatidylserins, conducive to histamine release by mast cells, rose in patients with the bronchospastic syndrome. Shifts in other phospholipid fractions, typical for different types and stages of chronic bronchitis, have also been demonstrated. Basically, the magnitude of shifts was greater prior to treatment in the majority of parameters. PMID- 2711749 TI - [Pathogenesis of protracted pneumonia]. PMID- 2711750 TI - [The main trends and prospects of using electronic-computer technology and mathematical methods in clinical roentgenology]. PMID- 2711751 TI - Size distribution and general structural features of N-linked oligosaccharides from the methylotrophic yeast, Pichia pastoris. AB - The secreted glycoproteins of Pichia pastoris contain more than 35% of their N linked oligosaccharides as structures smaller than Man14GlcNAc2 (Man = mannose; GlcNAc = N-acetylglucosamine). On heterologous invertase produced in P. pastoris, approximately 85% of the oligosaccharides are in the size range Man8-14GlcNAc2. The structures appear to contain alpha-linked mannose. In addition, one-third of the structures contain net negative charge and can be radio-labelled in vivo with 32P. The largest oligosaccharides isolated from P. pastoris are significantly shorter than the hypermannosylated structures typical of S. cerevisiae, indicating that the factors which influence the processing of N-linked oligosaccharides in P. pastoris are different from those which influence processing in S. cerevisiae. The smaller N-linked oligosaccharides synthesized by P. pastoris resemble high-mannose oligosaccharides synthesized by animal cells, and this finding increases the utility of P. pastoris as a host for the production of heterologous glycoproteins. PMID- 2711752 TI - RAG1 and RAG2: nuclear genes involved in the dependence/independence on mitochondrial respiratory function for growth on sugars. AB - The analysis of five independent isolates of Kluyveromyces lactis shows that CBS 2359, CBS 683 and CBS 4574 could grow in the presence of mitochondrial inhibitors (antimycin A, oligomycin or erythromycin) and that CBS 2360 and CBS 141 were unable to grow in the presence of drugs. The resistant growth was observed only on glucose and not on other fermentable carbon sources (galactose, lactose). The phenotype 'growth on glucose in the presence of mitochondrial inhibitors' was called Rag+. This phenotype was found to be controlled by two unlinked nuclear genes: RAG1 and RAG2. Either of their recessive alleles, rag1 and rag2, led to the Rag- phenotype (i.e. the failure of growth on glucose in the presence of antimitochondrial drugs). Rag- strains represent the case in which fermentative growth becomes absolutely dependent on the functioning of the normal respiratory chain. PMID- 2711753 TI - [The determination of the herbicide glyphosate and its chief metabolite aminomethylphosphonic acid (AMPA) in drinking water with the aid of HPLC]. AB - A method for the determination of glyphosate and its major metabolite aminomethylphosphonic acid (AMPA) is described. With a detection limit of 0.02 microgram/l, the method suitably fulfills the requirements of the Swiss legislation (tolerance value of 0.1 micrograms/l water). The compounds are derivatized directly in the original water sample with 9-fluorenylmethyl chloroformate (FMOCC1) in order to obtain extractable and fluorescent derivatives. These are extracted with organic solvents and determined by HPLC using a fluorescence detector. Neither of the compounds could be detected in 151 tap water samples from the Canton of Berne. PMID- 2711754 TI - The levels of zinc, copper, manganese, selenium, chromium, nickel, cobalt, and aluminium in the meat, liver and kidney of swedish pigs and cattle. AB - The levels of zinc, copper, manganese, selenium, chromium, nickel, cobalt, and aluminium were determined in samples of meat, liver and kidney from pigs and cattle from Swedish slaughterhouses. The results have been compared with those reported from other investigations carried out in recent years. For zinc, copper, manganese and selenium, the mean levels found in the different tissues were very similar to those reported in previous studies. The mean levels of chromium and nickel were found to be in the range less than 0.010-0.015 mg/kg, regardless of the type of tissue. Cobalt levels ranged from 0.001 to 0.043 mg/kg, the highest levels being in the liver samples. The mean levels of aluminium were between 0.024 and 0.068 mg/kg. Tissues from cattle contained approximately twice as much aluminium as tissues from pigs. Analytical quality assurance was carried out by analysing standard reference materials. A great effort was made to minimize and check contamination. This may partly explain the fact that the levels of chromium, nickel, and aluminium found in the present study are among the lowest reported. PMID- 2711755 TI - Determination of residual tetrachloroethylene in olive oil by headspace-gas chromatography. AB - This study describes a method for the quantitative determination of residual tetrachloroethylene or perchloroethylene (PCE) in olive oil by headspace-gas chromatography. The analysis of the chlorinated product is performed by electron capture gas chromatography, using a fused silica capillary column, CP Sil 8 CB. The absolute detection limit for PCE was 1 pg. Forty samples of olive oil and 5 other commodities have been analysed. Only one sample exceeded the proposed maximum level of 1 mg/kg. PMID- 2711756 TI - A rapid fluorimetric screening method for chlortetracycline, oxytetracycline and tetracycline in pig meat and kidney tissues. AB - A rapid fluorimetric screening method for chlortetracycline, oxytetracycline and tetracycline in pig meat and kidney tissues is described. After sonication-aided extraction with ethyl acetate, the extract is cleaned and concentrated by means of solid-phase extraction using an aromatic sulphonic acid cation-exchange column. Subsequent screening is carried out by fluorimetry. The detection level is estimated to be about 0.05 mg kg-1 for oxytetracycline, 0.1 mg kg-1 for chlortetracycline and 0.2 mg kg-1 for tetracycline. PMID- 2711757 TI - Keeping quality of vacuum-packed smoked sardine fillets: microbiological aspects. AB - The effect of mixed smoking (2 h at 30 degrees C and 45 min at 75 degrees C was studied on the keeping quality of lean and fatty sardine fillets from fish caught in the Mediterranean Sea in March and June, respectively. Raw material for smoking included both fresh and frozen sardine fillets. Microbiological and sensory analyses were performed over the storage period, which lasted for 120 days at 0 +/- 1 degrees C. Smoking reduced the viable microbial flora values from 3-5 x 10(4) cfu/g to 2 x 10(2) cfu/g. The antimicrobial action of smoking, combined with that of vacuum packaging, had the effect of producing a gram positive flora made up mainly of lactic acid bacteria. A practical consequence of this was to extend the shelf life of the smoked sardines for a period of 4 months. Frozen storage of samples at -18 degrees C for 6 months prior to smoking affected the behaviour of the microbial flora during cold storage at 0 degrees C, but did not affect the behaviour of the flora over a period of 3 months frozen storage, since the initial numbers of bacteria decreased and microbial growth was retarded. Furthermore, at the end of the storage period, the number of bacteria in the samples of frozen fatty sardines were higher than in the samples of frozen lean sardine. Physical conditions, therefore appear to exert an influence on bacterial growth. Sulphite-reducing Clostridia were not detected during the storage period. PMID- 2711758 TI - Awareness and treatment of hypercholesterolemia: results of the first survey of the MONICA Project Augsburg. AB - In the first survey of the MONICA project Augsburg (1984/1985), awareness and treatment of hypercholesterolemia was determined on a two-stage cluster sample of 5069 25-64 year old citizens (participation 79.6%). Hypercholesterolemia was defined according to the Conference of the European Atherosclerosis Society (EAS) and of the National Cholesterol Education Program (NCEP). Awareness (elevated lipid levels found during the last 12 months), and drug and dietary treatment were determined by an interview. The awareness was low and varied between 4 and 24% in the different age-sex groups with no significant differences between sexes, with one exception: The awareness in women aged 55-64 years with cholesterol levels greater than or equal to 300 mg/dl was 38% and differed significantly from that found in men in the same age group (21%). Older participants showed a higher degree of awareness than younger; in men the awareness was independent from the cholesterol level, in women those with higher levels showed a better awareness than those with lower levels (results from a logistic regression analysis for cholesterol levels greater than or equal to 240 mg/dl). The use of lipid-lowering drugs was low in the study population (2% in men, 1% in women). The drug treatment of hypercholesterolemia was low and in no age-sex group higher than 7%, despite the definition of hypercholesterolemia; the dietary treatment was not higher than 20%. In conclusion it is shown, that there is a great need for the identification and management of hypercholesterolemia in the examined population in Southern Germany. PMID- 2711759 TI - Worksite-screenings for hypertension with follow-up: experiences from the Munich Blood Pressure Program. AB - In 1983/84, the Munich Blood Pressure Program (MBP) performed worksite screenings for arterial hypertension at 18 Munich companies. A participation of 51% (n = 7310) was achieved. After duplicate measurements of casual blood pressure 1084 participants were suspected of having actual hypertension. All suspected cases were invited for a reexamination to reduce the number of false-positive hypertensives. Individuals with persisting hypertension after this two-step screening were predominantly male, on the average younger than 50 years and showed a low level of antihypertensive drug treatment. About 75% of all detected hypertensives saw a family physician subsequent to the screenings for further management. Referrals and patient compliance were frequently reinforced by a computer based reminder system. A follow-up examination was performed among the MBP participants after two years. It showed that in 417 confirmed hypertensives of the primary screenings a marked increase in the proportion of treated and controlled hypertensives had occurred. This was true for younger and older hypertensives. PMID- 2711760 TI - Prevention of tobacco use among adolescents in public schools in San Diego County, U.S.A. AB - Project S.H.O.U.T. (which stands for "Students Helping Others Understand Tobacco") is a tobacco-use prevention project funded by the United States National Cancer Institute for preventing the use of cigarettes and smokeless tobacco (snuff and chewing tobacco) in public schools in San Diego County, California. Based on principles of behavior modification, Project S.H.O.U.T. teaches students how to anticipate and overcome negative peer pressure to use tobacco and reinforces them for having done so. Preliminary results indicate that the prevalence of tobacco use among students receiving peer pressure resistance skills training was somewhat but not statistically significantly lower than the control group after one year of intervention. In addition, students in a third lottery condition, who were reinforced for simply not using tobacco, showed lower prevalence rates compared to controls. Additional support for the efficacy of the intervention program was provided by the refusal skills assessment test, which indicated that students exposed to the intervention were able to refuse tobacco offers more effectively than the control students. Our results indicate that tobacco use prevention experts should do more than provide decision-making and behavioral skills for resisting tobacco use, but should also reinforce the non use of tobacco. PMID- 2711761 TI - [Physical occupational activity and colonic carcinoma mortality in Swiss men 1979 1982]. AB - Colorectal cancers are the second most frequent cause of cancer death among men. To our knowledge, approximately six studies have been able to show an inverse relationship between occupational physical activity and colon cancer mortality. Information drawn from the mortality statistics for the years 1979-1982 was used to study this hypothetical association among Swiss men aged 15-79. At-risk populations were calculated based on 1980 national census data on occupation of all Swiss men. Estimates of occupational physical activity (OPA) were based on job titles of death certificates and were "blindly" classified into three groups of low, moderate and high OPA by three independent experts. Among the cohort of 1.86 million men, 1995 deaths of colon cancer and 1066 deaths of rectal cancer occurred during the four study years. The standardized mortality ratio showed a significant, graded and inverse relationship between OPA and mortality from colon cancer but not from rectal cancer. The estimated relative risk for colon cancer of the physically inactive, as compared to those active, was 1.3 to 1.4, slightly influenced by minor differences in the way of classification of OPA. For several reasons this estimate of excess risk is probably on the low side. The subgroup of men with jobs with very high OPA showed no further reduction in risk of colon cancer, which suggests that other etiologic factors, such as diet, may play an important role. As sedentary lifestyle and colon cancer are both frequent in central Europe the hypothesized protective effect of habitual physical activity against colon cancer would seem important, especially from the public health point of view. PMID- 2711762 TI - Cardiovascular mortality in the Federal Republic of Germany, 1970-79, and the evaluation of the German Cardiovascular Prevention Study: results from a geographic mortality study. AB - The primary endpoint of the German Cardiovascular Prevention Study (GCP), cardiovascular mortality, has to be based on the official mortality statistics. In the scope of a geographic mortality study trends and regional variations of ischemic heart disease (ICD-9, 410-414) and cerebrovascular disease (ICD-9, 430 438) mortality were investigated. During the study period from 1970 to 1979 a relevant decline of cerebrovascular diseases in men and women was observed, whereas ischemic heart disease mortality figures remained relatively stable. Over time the importance of ischemic heart disease mortality has increased. The geographic analysis points to relevant problems concerning the validity of mortality data due to the particularities of the German mortality statistics (separately signed in the 11 statistical offices of the 11 federal states). The mortality rates of the four intervention regions of the "Kooperative Pravention" (corresponding data of "Kommunale Pravention" not available) indicate that the intervention regions are at a considerably lower level than the FRG, the mortality patterns, however, paralleling those of the FRG. As far as mortality structures are concerned, ischemic heart diseases are more important in the intervention regions than in the FRG as a whole. PMID- 2711763 TI - [Traumatic, ischemic and toxic rhabdomyolysis]. AB - Rhabdomyolysis with myoglobinuria and acute renal failure can develop from a variety of traumatic and nontraumatic reasons and the clinical as well as forensic significance of it may vary from an epiphenomenon with an excellent prognosis to the cause of death. We present altogether four autopsy cases in two of which the rhabdomyolysis was associated with an acute intoxication with alcohol (male, 41 years of age) or amitriptyline in combination with chlordiazepoxide (male, 52 years of age). In both these subjects the myoglobinuria was a secondary finding and not the cause of death. In the other two subjects the outcome of rhabdomyolysis associated myoglobinuria was lethal. In the first one (female, 18 years of age) the muscle injury was traumatic, caused by long-lasting compression and ischaemia of the lower limbs (classical crush-syndrome), the outcome of which in spite of the adequate therapy was lethal. In the other one (male, 20 years of age) the rhabdomyolytic myoglobinuria and subsequent acute renal failure occurred postoperatively after reconstructive surgery of one hand and the interruption of blood circulation to the corresponding arm for the time of a nerve reconstruction. The recovery of the patient was complicated by continuing electrolyte disturbances associated with metastatic tissue calcification, especially of the lungs, leading to progressive respiratory insufficiency and eventually to death. PMID- 2711764 TI - [The dynamics of injuries caused by thrown, razor-sharp shurikens]. AB - In 10 tests, the linear velocity and rotation frequency of a thrown, pointed, razor-sharp shuriken were investigated using a high-speed camera. The linear velocity (5.1-9.87 m/s) and rotation frequency (0-4.46 m/s) determine the impact (0.91-3.6 nm) of this Asiatic weapon. An impact of 3.6 Nm is sufficient to cause a penetration depth of more than 3.5 cm within the regio ossis temporalis, the regio collis lateralis and the regio intercostalis. Legally, the use of this new generation of pointed, razor-sharp shurikens should be prohibited as "sports" apparatus. PMID- 2711765 TI - [The informative aspects of the wound surface for determining vitality and wound age in skin cuts]. AB - A histological study was carried out on skin cut wounds of guinea pigs at various time intervals during the first day after infliction of the cut. At the same time intervals, blood cells were obtained from the wound surface prints and analyzed cytologically and cytochemically. Histological examination showed that a central and peripheral zone formed in the wound area, demonstrating that necrobiotic and inflammatory processes were even occurring in the early hours after injury. However, changes in the quantitative relationships between individual kinds of cells were much more differentiated cytologically and reflected much more precisely. Functional and structural macrophage and lymphocyte changes in the wound region during inflammation were also revealed. In correlation, cytochemical analysis confirmed the concept concerning the development of the inflammatory process in the wound area, as enzyme-activity changes clearly detectable, which reflected the rapid, energetic, plastic cellular processes on the wound surface. Our combined results suggest that the wound surface is a zone of vital processes, but that it is not a "dead," "necrobiotic" area. The dynamics of the cellular alterations in the wound surface, reflecting the vital processes developing there, can be successfully used when the problem of vitality, especially the time lapse after the skin injury, is to be resolved. PMID- 2711766 TI - [Spontaneous degeneration of the posticus muscle]. AB - The intrinsic muscles of the larynx were prepared in 265 forensic postmortems (death by strangulation: 73; other violent deaths: 93, natural death: 79, others: 20) for a histological examination. Muscle-fiber alterations were found in the (macroscopically normal) PCA muscle in most cases where the persons were of middle age or older. There were abnormalities such as rows or clumps of nuclei (also inside muscle fibers), the accumulation of lipofuscin pigment, focal or total necrosis of muscle fibers with or without predominant histiocytic infiltration, atrophic muscle cells, and fibrosis. The changes were mostly mild (normal muscle cells predominated) but clearly visible. If there had been acute damage to the larynx (for instance, death some time after attempted strangulation), these preexistent alterations must be taken into consideration when interpreting the microscopical findings. PMID- 2711767 TI - Orosomucoid (ORM) typing by isoelectric focusing: description of two new alleles in a German population and thermostability in bloodstains. AB - The genetic polymorphism of serum orosomucoid (ORM) was studied in 168 unrelated German individuals using isoelectric focusing followed by immunoprinting. Two new alleles, tentatively designated ORM1*14 and ORM2*13, were identified. The method was successfully applied to demonstrate ORM1 types in dried bloodstains. Each type of ORM1 was also correctly determined in bloodstains heated at 130 degrees C for 30 min. The results indicated that ORM1 is a new powerful genetic marker system for the grouping of bloodstains. PMID- 2711768 TI - Determination of calcium and magnesium in postmortem human vitreous humor as a test to ascertain the cause and time of death. AB - The concentrations of magnesium and total calcium human vitreous humors obtained postmortem was tested. In the groups of heart disease and asphyxia a correlation between the postmortem interval and calcium or magnesium concentrations was found. There was no correlation between postmortem interval and calcium respectively magnesium in the other causes of death. It seems possible that the analysis of vitreous humor may be useful in both diagnosis and determination of postmortem interval in the cases of heart death and asphyxia. PMID- 2711769 TI - Identification by MRI. AB - A semi-skeletted water-lodged corpse was supposed to be an 82-year-old missed man. Fifteen years ago this person underwent an operation of a trimalleolar fracture of the left ankle joint. Conventional X-ray photograms of the left ankle joint of the water-lodged corpse showed no evidence of an operation. A T-1 weighted spin-echo sequence revealed the entire aspect of the osteosynthesis as documented in the previously performed post-operative X-ray photograms. PMID- 2711770 TI - [Extra- and intracranial injuries of the cerebral arteries as a sequela of assault]. AB - The case of an 47-year-old man is reported, who was injured in a fight while under the influence of alcohol. The culprit knocked him down and stamped several times on the left side of his head. The victim became unconscious. At the hospital, subarachnoid hemorrhage and massive ventricular bleeding was diagnosed via CT. Despite the implantation of a ventricular shunt, there was repeated massive cerebral pressure and arterial bleeding. Brain death occurred after 8 days. The main finding at autopsy was nearly complete disruption of the left inferior posterior cerebellar artery as the source of the lethal bleeding. The histological examination showed some additional, incomplete ruptures of this vessel and of the left intracranial vertebral artery. This is a typical result of "minor head injuries" sustained in fights: arterial rupture (ipsilateral) as a result of overstretching. Fracture of the left zygomatic arch and maxilla; no skull fracture; no primary traumatic brain damage. The extracranial carotid arteries were intact. When the vertebral arteries were examined (in the undamaged cervical spine), there was a surprising finding: distant dissection of the right vertebral artery between C1 and C2, which perhaps occurred as a result of compression (contralateral to the impact) of this region. PMID- 2711771 TI - [Hepatitis in drug poisonings]. AB - In the period between 1983 and 1987 autopsies were carried out on 120 drug victims at the Institute for Forensic Medicine in Hamburg, and 93 cases were serologically tested for hepatitis B. It was found that 50 cases (54%) were positive for anti-HBc, 39 (42%) for anti-HBs, and 5 cases (5%) for HBsAg. The prevalence of hepatitis-B-virus markers was dependent upon the age of the victims. In 81% inflammatory alterations of the liver (including unspecific reactive hepatitis) were diagnosed histologically. The pathogenesis of these serological and pathomorphological findings is discussed. Drug addicts are a group at risk for hepatitis B, and it can spread on account of the epidemiological connection with other risk groups, e.g., prostitutes and homosexuals. Postmortem serological investigations for hepatitis markers proved to be a well-established and reproducible means of differentiating histopathological liver alterations. PMID- 2711772 TI - [Roentgen identification of unknown cadavers with advanced postmortem changes]. AB - The postmortem changes in the bodies of two individuals were so advanced that the usual identification methods could not be applied; one had drowned and the other died by burning. Antemortem roentgenograms--up to 10 years old--and postmortem X ray plates were compared and the bodies thus identified. This was possible because the skeleton shows individual, highly specific markers that do not change during life or after death. PMID- 2711773 TI - Sudden death due to congenital malformation of coronary arteries. AB - A case of sudden death of a 12-year-old girl after jogging, due to congenital malformation of coronary arteries, is presented. PMID- 2711774 TI - Forensic usefulness of the silicone rubber cast of the cardiac vessels. AB - Adequate examination of the coronary arteries at forensic autopsy is often difficult. No matter whether the arteries are opened longitudinally or transversely, each method has its disadvantages. A technique making silicone rubber casts of the cardiac vessels providing simultaneous angiography is described. The method allows the three-dimensional precise assessment of stenotic lesions of the coronary arteries. It is concluded that the method examined could be useful for the forensic problems. PMID- 2711775 TI - [Script crossing in scanning electron microscopy]. AB - A case of mixed script in which ball point-pen ink was contaminated with typewriting prompted a survey of the literature and a systematic SEM study of mixed script with various writing instruments or inks. Mixed scripts produced with the following instruments or inks were investigated: pencil, ink/India ink, ball-pint pen, felt-tip pen, copied script and typewriter. This investigation showed SEM to be the method of choice for visualizing overlying scripts produced by different writing instruments or inks. PMID- 2711776 TI - [The pathomorphology of chronic alcohol-associated myocardial changes]. AB - Forensic cases of sudden cardiac death were reviewed from the point of view of a history of alcohol consumption. A group of known cases of chronic alcoholism and another group of cases known to have been normal social drinkers without evidence of chronic alcoholism were selected. Cases with evidence of hypertension, ischemic or coronary heart disease, as well as cases with positive toxicological findings, were excluded. Applying the same criteria, cases of sudden death from other causes without a known history of alcohol consumption were selected to form a control group. With particular reference to histological myocardial changes, which are often documented in association with alcohol consumption, no noteworthy differences were found between the two major groups despite the significantly much lower frequency in the control group. PMID- 2711777 TI - [Assessment of disputed identity of blood alcohol samples using DNA fingerprinting]. AB - DNA fingerprinting is a perfect tool for investigating the identity of disputed blood by alcohol samples extracted. However, blood samples stored at an ambient temperature for longer periods can show considerable degradation of high molecular DNA, diminishing the value of fingerprint investigation because of loss of the less frequent bands formed by the longer DNA fragments. Addition of the complexing agent EDTA can retard this degradation. Determination of the sex with DNA probes in the blood alcohol sample increases confidence in the investigation. PMID- 2711778 TI - The effect of allopurinol on lysosomal enzyme release. AB - Values of released enzymes from PMNL under resting conditions and after phagocytic stimulation in non-treated patients with gout were increased in comparison with healthy controls and hyperuricemic patients without joint involvement. Allopurinol, given to gout-patients for 3 weeks, had an inhibitory effect on PMNL lysosomal enzyme release from which was also observable after stimulation by opsonized zymosan. Similar results were obtained in experiments in vitro. The 1 hr preincubation of isolated polymorphonuclear leukocytes with allopurinol in concentrations from 0.01 mM-1 mM resulted in a dose-dependent decrease of enzymes released into extracellular space. PMID- 2711779 TI - [Ultrastructure of reparation collagen and its relations to residual hyaline joint cartilage in inflammatory cartilage destruction]. AB - The development of collagenous fibrils in reparative tissues replacing hyaline cartilage in arthritic joints was investigated by electron microscopy: granulation tissue consists of a loose network of collagenous fibrils, scar tissue is characterized by dense bundles of parallel arranged collagenous fibrils, chondroid tissue that may develop under certain instances is characterized by a network of random orientated fibrils that differ from those of the normal hyaline cartilage by their uniformity. The fibrils of the reparative tissues often exhibited an intense contact with those of the original hyaline cartilage. PMID- 2711780 TI - [Surgical therapy of impotence with implantation of a penile prosthesis. The psychological status of the impotent male]. AB - The results of a psychological examination of 22 male patients which requested a penile prosthesis implantation are reported. The mean age was 47 years and the intelligence score of the patients was higher than the normal value. In a personal self-judgement they described oneself as stable, minimally neurotic and rather introverted personality. The test results were complicated by a high lie score. A great difference between the self-judgement and the ideal was established. The sexual anamnesis of the most patients was not striking out of the erectile dysfunction. PMID- 2711781 TI - Identification and clinical examination of jaundiced rats. AB - Rats with or without spontaneously occurring jaundice were clinically examined. Jaundiced rats had five-fold higher serum bilirubin concentrations than control animals. About 90% of serum bilirubin in the jaundiced animals was in conjugated form. Control and jaundiced rats did not differ with respect to clinical signs such as alertness, stance, hair coat, position of eyes, discharge from eyes and nose, and cleanliness of anal orifice. While examined individually, jaundiced rats could not be identified readily on the basis of a yellow colour of sole of feet, nose, ears and tail. When kept together with control rats, jaundiced rats could be selected reasonably well. Urines of jaundiced rats had a more intense yellow colour than urines of control animals. Rats with jaundice were significantly more active in a small open field test than control rats. PMID- 2711783 TI - [Temperature determination of the skin surface for the estimation of blood supply disorders in myocutaneous island flaps of rats]. AB - In rectus abdominis myocutaneous island flaps (3.0 x 1.5 cm) of rats (Uje:WIST) skin surface temperature was measured by an infrared pyrometer for monitoring flap viability following experimentally induced blood flow insufficiency. The insufficiency was caused by ligation of the pedicle vessels (epigastric superior artery and vein) on the 3rd, 4th, 5th and 7th d after flap replantation, and by occlusion of these vessels with microclips for 2 h. Only the temperature differences between the intact and the operated skin surface were used to estimate blood flow efficiency not, the absolute values. These differences were statistically insignificant between the intact right and left abdominal skin areas and between the intact skin and the vital flap surfaces. In these cases the maximal temperature differences were 0.52 degree C. Only during the early postoperative period (3-days ligation group) a correlation between blood flow insufficiency and flap viability is expressed by temperature differences (2.14 degrees C). Later on (7-days ligation group) a temperature difference of 1.87 degrees C was no evidence of disturbed wound healing. Thus in advanced stages in myocutaneous flaps differences of blood flow and neovascularization respectively cannot be estimated reliably by measurements of skin surface temperature. However, temperature differences greater than 2 degrees C signal impaired flap viability. PMID- 2711782 TI - [The use of modern scintigraphic methods for the control of thyroid gland function in small laboratory animals]. AB - In the present investigation modern scintigraphic methods like scanner- and gamma camera-techniques have been used for the first time to diagnose the thyroid function of small laboratory animals. Both methods have been tested on completely or partially iodine-resected rats. Because the results concerning the gamma camera could be quantified they could be compared to those of the gamma counter as a reference method. Assuming a linear relationship between both methods a correlation coefficient of r = 0.97 (n = 32) could be calculated. The capacity of both the scanner and the gamma camera was high enough to show even small amounts of residual thyroid tissue. Therefore both methods are extremely suitable for the diagnosis of the thyroid function. Using them as a control of the iodine resection of the thyroidea a control group of animals is not necessary and, therefore, less animals are required. With regard to the narcosis of heavily hypothyroid animals it must be noted that the usually pentobarbital dosage must at least be reduced by one third. PMID- 2711784 TI - [Radioiodine administration for the production of an athyreotic animal model]. AB - The resection of thyroid gland with radioiodine is a painless method to eliminate the Gl. thyroidea. By the present investigation it could be demonstrated that the thyroid gland of Wistar rats with a body mass between 100 and 500 g can be safely eliminated by administering them 2 doses of 18.5 MBq (0.5 mCi) 131I with a waiting period of 7 d in between. Application of 37.0 MBq (1.0 mCi) 131I once is, with regard to the radio-hygiene, to prefer, since the rats were contaminated on the surface when administering them iodine for the second time. The success of the experiment has been controlled in vitro and in vivo. Measuring the extirpated larynx region in the borehole of a gamma counter after a diagnostic labelling has been found to be an useful control method in vitro. Histological investigation of the larynx is extremely time-consuming. Besides it was not always possible to distinguish the single radio-iodine treated groups with this method. Since there were some animals showing residual thyroid tissue, the control by means of the development of the body masses cannot be recommended. Apart from this the development of the body masses depended very much on the surrounding temperature in which the animals were kept. The rectal temperature of the rats also depended on various external disturbances, so that this parameter failed to control the function of the thyroid gland. PMID- 2711785 TI - [Long-term results following femoro-popliteal vascular reconstruction]. AB - All in all, 330 thromboendarterectomies (TEA) and 354 venous bypass operations (VBP) were performed on 550 patients. In 11.01 per cent of all cases in which VBP had been planned, veins were not in optimum condition. Repetitive interventions had to be applied to 111 patients. Successful reoperations could be performed on six cases with immediate TEA-closures (1.8 per cent) and another two after immediate VBP-closures (0.56 per cent). Postoperative lethality figures were 0.6 per cent after TEA and 0.28 per cent following VBP. Twenty-nine early TEA closures (8.9 per cent) were corrected by secondary VBP in 16 cases (4.8 per cent). Three were corrected by femoral ablation and two by toe amputation in the border zone (1.7 per cent). Thirty-nine early VBP-closures (11.0 per cent) required repetitive VBP in two cases (0.5 per cent) and toe amputation in the border zone in another three instances (0.84 per cent). Eight patients each died within the first postoperative year from TEA (2.4 per cent) and after VBP (2.2 per cent). The following cumulative patency rates were recorded according to the life table method: after one year (TEA: 90.9 per cent, VBP: 88.9 per cent), after five years (TEA: 73.4 per cent, VBP: 84.6 per cent), after ten years (TEA: 38.2 per cent, VBP: 73.7 per cent), after 15 years (TEA: 9.8 per cent, VBP: 24.2 per cent). These differences were significant as early as five years from surgery. Late amputation rates were 2.1 per cent for TEA and 2.9 per cent for VBP. Late lethality rates were 28.8 per cent for TEA and 7.6 per cent for VBP. PMID- 2711786 TI - [Postoperative complications following alloplastic aortic valve replacement in bacterial endocarditis of the aortic valve in established aortic coarctation--a case report]. PMID- 2711787 TI - [Surgical treatment of extracranial occlusive processes of the vertebral artery by construction of a subclavio-vertebral bypass]. AB - An account is given of causes and clinical patterns of vertebro-basilar insufficiency, before reference is made to patients treated at the Surgical Department of Charite to describe indications for surgery, diagnostic approach, and various surgical techniques. A particular role is played, in this context, by stenoses and occlusions of the vertebral artery in the bone canal of the cervicovertebral column. Subclavio-vertebral bypass is a new surgical technique recommended for surgical treatment of that kind of vascular processes. PMID- 2711788 TI - Demonstration of capsules in Clostridium difficile. AB - In four strains of Clostridium difficile the formation of capsules was demonstrated by light and electron microscopy. PMID- 2711789 TI - Immunodiagnosis of human anisakiasis by use of larval excretory-secretory antigen. AB - L3 larvae of Anisakis simplex, isolated from freshly caught herrings were cultured in Medium 199 at different temperatures to obtain excretory-secretory (ES) antigen. Larvae have been cultured in vitro for a period of 11 months. A crude extract of A. simplex larvae was compared with ES antigen obtained under 4 different culture conditions for the determination of IgG and IgE antibodies by ELISA and a modified RAST, respectively. 1 serum from a patient with histopathologically proved anisakiasis and 4 samples from persons with presumptive clinical disease were positive in the ELISA. Two sera were positive in the RAST. A combination of both tests is suggested for the serodiagnosis of human anisakiasis. PMID- 2711790 TI - [Prostaglandins and cyclic nucleotides in the dynamic development of an experimental poisoning syndrome caused by Yersinia pestis lipopolysaccharide]. AB - This work deals with the influence of Y. pestis lipopolysaccharide (LPS), introduced intraperitoneally in a dose of 2 LD50, on the content of prostaglandins (PG), such as PGE, PGF2 alpha and 6-keto-PGF1 alpha, thromboxane, cAMP and cGMP in the liver, lungs and blood plasma of guinea pigs in the process of the development of experimental intoxication. The content of thromboxane in blood plasma increased 2.4-fold in 2 hours after intoxication and remained elevated for as long as 5 hours. Other parameters of blood plasma remained unchanged. The data obtained in this investigation indicate that thromboxane, known as a regulator of thrombogenesis, may induce early disturbances in microcirculation. A change in the content of PG was shown to occur in pulmonary tissue 2 and 5 hours after the beginning of intoxication. The content of PG in liver tissue was found to occur at a later period of the toxic action. The concentration of cyclic nucleotides (CN) in the tissues under study sharply increased even at the initial stage of the development of shock in guinea pigs. The effect of LPS on the metabolism of PG and CN, revealed in this investigation, resembles the effect produced by the thermostable fraction of "mouse" toxin. PMID- 2711791 TI - [The risk of infecting premature newborn infants with the HB virus in transfusions with plasma HBsAg-negative by counterimmunoelectrophoresis]. AB - The prospective dynamic study of 229 premature infants with the use of highly sensitive methods, such as the passive hemagglutination test and the enzyme immunoassay, for the detection of HBsAg and anti-HBs antibodies. Of these, 182 infants received plasma (blood) transfusions in the first days of their life. Plasma (blood) used for transfusions was known to contain no HBsAg in accordance with the results of countercurrent immunoelectrophoresis. 47 infants had no plasma (blood) transfusions. In the group of 182 plasma recipients the presence of hepatitis B virus infection was detected in 17.0% of infants, the ratio of icteric, nonicteric and inapparent forms being 1:4.2:2. In the group of 47 infants no case of hepatitis B virus infection was observed. PMID- 2711792 TI - [The role of the bone marrow in forming an immunological memory to Staphylococcus]. AB - The dynamic study of antibody formation in the bone marrow tissue of mice immunized with corpuscular staphylococcal antigen was made. A single intravenous injection of this antigen to the animals produced no essential changes in the number of antibody-forming cells in the bone marrow, their repeated immunization led to the involvement of the bone marrow in the anamnetic reaction, which was manifested by the accumulation of a great number of plasmocytes synthesizing antibodies to staphylococci in bone marrow tissue. The relative contribution of the bone marrow to systemic antibody formation essentially increased at later stages of secondary immune response. The possible biological significance of the regularities and the practical importance of the data revealed in this investigation are discussed. PMID- 2711793 TI - [The social ecology concept of the epidemic process of B. L. Cherkaskii]. PMID- 2711794 TI - Alterations of atrial repolarization after tricyclic antidepressant drugs absorption. AB - We describe a case of voluntary intoxication with tricyclic antidepressant drugs: initial electrocardiogram showed alterations of atrial repolarization (Ta segment) which were more pronounced than usual ST-T alterations. Evolution was uneventful (and repolarization normalized). Tricyclic antidepressant drugs absorption can lead to Ta segment alterations, which may be a useful clue in the differential diagnosis of drugs intoxication. PMID- 2711795 TI - Primary pulmonary hypertension in infancy: report of two autopsy cases. AB - Two cases of unexplained plexogenic pulmonary arteriopathy in infancy were studied by patho-anatomical approach. The patients were boys, age 7 months and 2 years 2 months. Pulmonary arteries revealed Grade 3 and Grade 4 hypertensive changes, respectively, after Heath and Edwards' criteria. The configuration of the media of the pulmonary trunk suggested that though these cases were very young, pulmonary arterial pressure had been elevated since some time after birth. PMID- 2711797 TI - Belgian Society of Cardiology, 8th annual scientific meeting. Brussels, 3-4 February 1989. Abstracts. PMID- 2711796 TI - Echocardiography and magnetic resonance imaging in cardiac amyloidosis. AB - Cardiac amyloidosis is an uncommon cause of heart failure. Based on an observation of immunocytic cardiac amyloidosis with a fatal course, the diagnostic modalities are reviewed with special emphasis on echocardiographic findings. The possible role of magnetic resonance imaging is discussed. PMID- 2711798 TI - Sinus node electrogram study on sinus pacemaker shifts. AB - The aim of this study was to investigate the sinus pacemaker shifts and its clinical significance. Spontaneous sinus pacemaker shifts and shifts after overdrive atrial pacing were assessed. A total of 43 cases, in whom stable sinus node electrograms (SNE) were obtained, were selected for the study, eight of the 43 cases had sick sinus syndrome (SSS group), the other 35 cases had no sinus node dysfunction (normal group). Sinus pacemaker shifts occurred spontaneously in 11.4% of the normal group and 12.5% of the SSS group respectively (P greater than 0.05); sinus pacemaker shifts were induced after overdrive atrial pacing in 25.7% of the normal group and 62.5% of the SSS group respectively (P less than 0.05). Sinus pacemaker shifts were characterized by loss or inversion of the primary positivity, with or without changes of P wave morphology on ECG, in association with significant prolongation of direct sinoatrial conduction time (SACTd) and sinus cycle length (SCL). The paper concludes: 1) the human sinus node has dominant and subsidiary foci; 2) after overdrive atrial pacing, sinus pacemaker shifts occur more frequently in patients with SSS than that in patients without SSS, which may be useful in evaluation of sinus node function. PMID- 2711799 TI - [Massive pulmonary thromboembolism--case report]. AB - This paper presents a case with massive pulmonary embolism which has been successfully treated at the V.M.A. Belgrade. The diagnosis of massive pulmonary thromboembolism by right heart catheterization was confirmed and urgent surgery was performed. The pulmonary embolus was surgically removed under extra corporeal circulation, given successful reanimation and anesthesia. Postoperatively was treated by mechanical ventilation, inotropic drugs and anticoagulant therapy. The presentation of this case is justified because in well organized cardiosurgical units, the urgent surgery gives most satisfactory results. PMID- 2711800 TI - [Advantages of emergency percutaneous transcondylar osteosynthesis of supracondylar fractures of the humerus in children]. AB - Based on our experience and on the experience of others in the treatment of such fractures, we have realized that every poorly executed manual reposition, inadequate and too long an immobilization, untimely and delayed operation, leaves serious consequences not only on physical activity but also on the psychologic development. Only a timely and correct indication for a surgical procedure along with saving as much of the tissue of the elbow joint as possible, optimal immobilization as well as the timely removal of the Kirschner-wires, represent conditions needed for the following successful treatment, rehabilitation and complete sanitation of the above fracture. The 2 cases described can serve as modest contributions and a stimulus for the further use of this method, which is closest to the declared demand for the resolution of the supracondylar fractures in children, with dislocation to the humerus. PMID- 2711801 TI - [Rupture of the supraspinal tendon]. AB - The function of the musculus supraspinatus and the functional deficiency after its rupture is described in the article. The reasons for unrecognized supraspinatus tendon ruptures and their consequences are mentioned. The emphasis is on the diagnostics and the operation for the supraspinatus rupture. Five patients, operated on for musculus supraspinatus rupture in the years 1980-1986 at the surgical department of the General Hospital at Novo Mesto, are presented. Despite the small number of patients the results are similar to those in bigger series. PMID- 2711802 TI - [The free TRAM (transverse rectus abdominis myocutaneous) flap--a new possibility in breast reconstruction]. AB - Free TRAM slap transfer for breast reconstruction following mastectomy is a functional operation requiring knowledge of aesthetic surgery and mastering of microsurgical techniques. It overcomes the shortcomings of the pedicled TRAM (transverse rectus abdominis myocutaneous flap. By taking advantage of the dominant vascular pedicle (deep inferior epigastric artery and vein) it provides a better vascularization even in zones 3 and 4 and allows a greater freedom in tailoring of the flap. The vascular pedicle is anastomosed to the vessels in axilla providing high filling pressure. Both facts allow the use of free TRAM flap even after irradiation or radical mastectomy. A secondary operation, the "mammilla-areola complex" reconstruction and contralateral breast surgery to achieve symmetry, follow after 3-4 months. Clinical application in 6 post mastectomy patients is discussed as well as the operative technique of free TRAM flap. PMID- 2711803 TI - [Diagnosis and therapy of pyeloureteral stenoses in infancy]. AB - Described are 8 cases with stenosis of the pyeloureteral segment in newborns, 12 of whom were operated upon. They insist on an early detection and a timely surgical intervention during which the Hynes-Anderson resection method without intubation is performed, as the procedure of choice. PMID- 2711804 TI - [Determination of the necessary time for prevention of thromboembolism using heparin/dihydroergotamine during implantation of partial hip joint endoprostheses]. AB - The paper presents investigation of efficiency of thromboembolic prophylaxis heparin/dihydroergotamine in patients with femur cervix fracture undergoing standard operational treatment with insertion of partial femur endoprosthesis. Various thrombo-prophylaxis durations have been considered, after the patients have been divided into a control group (without thrombo-prophylaxis) and the group of patients which were subjected to thrombo-prophylaxis for period of up to one week and two, three and four weeks. The investigations have encompassed a rather large group of 162 patients operatively treated within a 12 year period (1974-85) at Orthopaedic Clinic in Biograd o/s. Based on the analysis of general characteristics of standard cases, where thrombo-prophylaxis duration has been examined by statistical methods applied to observed material, and on the basis of comparison with previously published experiences, optimum duration of thromboembolic prophylaxis is proposed. PMID- 2711805 TI - [Evaluation of the use of the CO2 laser in 134 patients with expansive processes in the central nervous system]. AB - The laser began to be used in neurosurgery towards the end of the 60s. The early experience of their clinical use did not promise much; but from the first half of the 70s with the improvement of the laser and the accumulation of laboratory and clinical experiences, the new technology began irrepressibly to spread throughout the world. Three lasers are in use today: CO2, ND.YAG and Argon laser. Each one of them, due to their different wave length and electromagnetic radiation, gave separate characteristics of employment, i.e., the interaction between the biologic tissues and the radiation is different. Depending upon the type of intraoperative needs we will choose one of the lasers. Presently the CO2-laser is the most used in neurosurgery due to its characteristics of low penetration into the tissue and the vaporization of the tissue which is exposed to the radiation. That is why such a laser (Sharplan 1060) has been acquired by our clinic. During one year we performed 134 operations due to expansive processes in the CNS with a partial or complete use of the laser during every phase of the operation. The accumulated experiences showed that the laser is a fairly useful new tool during the various surgical situations with a wide use of the everyday work of the neurosurgeon; with its implementation we have significantly improved the surgical technique in the tumors of the CNS, both in terms of radicality as well as in sparing the healthy tissue. We believe that the laser has an absolute indication in all the glioma tumors regardless of the localization, thereafter in all remaining tumors which are not extremely supplied by blood, while at the same time reducing the time needed for the surgical procedure. In time we spread the use of the laser on arteriovenous malformations as well, which, until now, has not been suggested in literature. Our results on 4 smaller superficial angiomas fully justified the use of a laser in such cases. But it also showed us that generally the laser is still a fairly unresearched surgical innovation, and that in the future wil bring about the wider implementation of this technology in the neurosurgical operating rooms. The final results of our operations and the experiences the other neurosurgical centers in the world that use the laser, regardless of which kind have justified investment of this new surgical technology. PMID- 2711806 TI - [Carcinoma of the stomach in the light of epidemiologic, clinical and pathologic research (definition of etiologic and pathogenic phenomena in our data and the literature)]. AB - The malignant diseases are ever more frequent; the carcinoma of the stomach occupies a significant position here with approximately 20% of all cases of malignant diseases and therefore represents a fairly serious health problem, even more so since the only, somewhat successful, therapy is surgical treatment. Yet, even when it is performed on time (partial resection) the results are not particularly good, similarly to the unperspective life following a total amputation of the stomach. Only the disease which we recognize well in etiologic, epidemiologic, and pathogenetic terms can successfully be treated. This paper is concerned with these three elements, that are described in regards to our epidemiological, etiological and clinical research. Presently, in sciences three phenomena are thought of as being important in malignant diseases: the immunologic condition of the organism, the role of the virus as an etiologic factor, and the intracellular derangements. These first two problems have been considered in a somewhat original manner, while the third problem has been considered through the literature and our experience, which compromise the theoretical basis of our paper. PMID- 2711807 TI - [Splenectomy in the treatment of idiopathic thrombocytopenic purpura]. AB - During the period from 1985 till 1988, 48 patients with this disease were treated; in 28 patients (58%) conservatively treated with pronisone, immunated with thrombocytes that possessed onkovin, a remission had been achieved. In 20 patients (41%), following an unsuccessful conservative treatment, splenectomy was performed; of whom 14 were female (70%) and 6 were male (30%), with an average age of 36 years (between 20-52 years). Prior to that they were conservatively treated from 1-15 years (on the average 4.7 years). Despite the failure of the conservative treatment, an indication for splenectomy was the high doses of corticosteroids needed, as well as the appearance of serious unwanted effects of this therapy (ulcer, steroid diabetes, hypertension, osteoporosis), also the unsuccessful treatment with thrombocytes which carried onkovin. There was no surgical lethality; 2 female patients developed deep ileofemoral thrombophlebitis of the left leg, one 7 days, and the other 1 1/2 months following the surgery, and after an adnexoparametritis of the left side. Following intensive anticoagulant and fibrinolytic therapy, a complete recanalization of the vein was achieved in both female patients, without any signs of a postphlebitis syndrome. One patient who had previously been treated for 15 years with high doses of pronisone and persistently refused surgery during this period, followed splenectomy developed miliary tuberculosis which ended lethally 2 months following the splenectomy. In 14 patients (73.6%) a complete remission was attained. In 2 patients (10.5%) the number of thrombocytes was not necessary.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711808 TI - Experimentally induced chronic pancreatitis in dogs by ligation of pancreatic lobes. AB - We have noticed chronic changes in the ligated lobes of 5 of our experimental animals, but in the middle lobe no changes occurred. These morphological changes were proved by histological examination. These changes were of different severity according to the duration of pancreatic outflow disturbance, the longer the duration of the disturbance, the more severe were the changes, the duration of the disturbance, the more severe were the changes. The main cause of chronic pancreatitis, and the other causes such as alcohol, biliary tract diseases, hyperparathyroidism, hyperlipaemia, etc., are only secondary to that. And only if we eliminate the cause of disturbance of pancreatic outflow can we prevent the progress of the disease and improve the function of the gland. PMID- 2711809 TI - [Injuries of the pelvis associated with injuries to other organs]. AB - In polytraumatized patients with fracture of the pelvis and injury to the other organs, the clinical picture is dominated by a hypovolemic shock, which is difficult to control. Surgical intervention must be quick in cases of external or internal bleeding. The importance of reaching a quick diagnosis cannot be emphasized enough, upon which the life of the patient is greatly dependent. During the seven year period 23 patients with injury to the pelvis were treated. 10 had injuries to the surrounding organs (brain commotion, injury to the urethra and vagina, as well as the lower extremities). The causes were: automobile accidents (8), falling during play (6), from height (5), during sports (4). Two injured girls are individually described (2 1/2 and 8 years old), who were surgically treated successfully. There was no mortality. PMID- 2711810 TI - Influence of anesthetic procedures on surgical sequelae. An update. Holland, September 7-9, 1987. PMID- 2711811 TI - Combined epidural and general anesthesia versus general anesthesia in patients having colon and rectal anastomoses. AB - Three retrospective studies were conducted at St. Vincent's Hospital to compare the outcomes of colorectal anastomoses, with and without resections, with respect to anesthetic technique. Operations were performed upon patients anesthetized with either combined regional (epidural) and general anesthesia (CRAG) or general anesthesia alone (GA). Postoperative pain relief was achieved with either continuous epidural analgesia (CEA) in the CRAG group or with postoperative narcotics in the GA groups (GA/PN). In one group, a different regimen was introduced: combined epidural and general anesthesia with postoperative epidural morphine (CRAG/EDM). Overall, anastomotic leak rates and death rates were lower in the CRAG group, and the lowest incidence of anastomotic leak was reported in the patients receiving CEA. Thus the reduced leak rate was associated more with the postoperative analgesia regimen than with the anesthetic technique. An increased incidence of wound dehiscence occurred with postoperative epidural morphine analgesia. PMID- 2711812 TI - Postoperative analgesia. AB - In recent years hospitals have begun to institute special postoperative pain services staffed by anesthesia department personnel. The charter for such services is to provide the best and most appropriate postoperative analgesia for surgical patients, in particular for the increasing numbers of patients who, released from hospital soon after surgery, still require pain relief on an outpatient basis. This review focuses on the relative benefits and risks of the currently available options for postoperative pain relief: intramuscular (i.m.) and intravenous (i.v.) administration of narcotics; epidural or subarachnoid administration of narcotics and/or local anesthetics; and peripheral nerve blocks with local anesthetics. In terms of efficacy, cost, risk, and personnel requirements, the particular advantages of continuous analgesia techniques- including patient-controlled analgesia--are discussed. PMID- 2711813 TI - Failure of peripheral arterial reconstruction. AB - Infrainguinal arterial reconstruction utilizing autogenous vein grafts provides acceptable results in most cases, yet 15-25% of such grafts fail during the first 5 years. Secondary reconstruction, especially when vein graft failure is identified prior to total thrombosis, frequently restores significant patency although multiple attempts may be required. While the reasons for initial graft failure are understood in many cases, a significant number of early failures occur within 30 days without a specific cause being determined. While the in situ technique combined with completion angiography has reduced the incidence of these early failures, in order to effect further reductions, surgical and anesthetic management must address such diverse entities as vasospasm, hypercoagulopathy, embolization, and systemic hypotension. PMID- 2711814 TI - Beneficial effects on intraoperative and postoperative blood loss in total hip replacement when performed under lumbar epidural anesthesia. An explanatory study. AB - The effects of continuous lumbar epidural anesthesia and two types of general anesthesia on blood loss and hemodynamics during and after total hip replacement were compared in three groups of patients. Fourteen patients received local anesthetics via continuous lumbar epidural administration; 10 patients received inhalational anesthetics and breathed spontaneously after endotracheal intubation; and 14 received artificial ventilation after intubation and intermittent intravenous (i.v.) injections of pancuronium and fentanyl. The results documented that both intraoperative and postoperative blood losses were significantly reduced in patients subjected to total hip replacement under lumbar epidural anesthesia as compared with the patients receiving the two general anesthetic techniques. Hemodynamic differences explained the differences in blood loss. The epidural anesthesia induced hypotension on the arterial and venous sides as compared with the two general anesthetic techniques. Inhalational anesthesia also induced hypotension on the arterial and venous sides intraoperatively as compared with general anesthesia with artificial ventilation. Postoperatively, the hemodynamics of the general anesthesia groups were similar, and no differences in blood loss occurred. Continuous' epidural anesthesia can be viewed as a tool to achieve hypotensive anesthesia--notably on the venous side- for the purpose of minimizing blood loss. The reduction in blood loss associated with lumbar epidural anesthesia is beneficial in decreasing the hazard and cost of blood transfusion. PMID- 2711815 TI - [The inadequate status of information of interested lay persons about the educational campaign regarding risk factors for cardiovascular diseases]. AB - 181 interested individuals (75 males, 106 females; range 16 to 84 years) responded to a questionnaire issued by the Styrian Cardiovascular Lay Society. The main topic of the questionnaire concerned information gained via media, about the possible risk factors related to cardiovascular diseases and about any changes in life style consequent to this information. The results show that the general knowledge in this field especially in younger subjects is disappointing and that there is need for further intensive information and education. PMID- 2711816 TI - [Immunohistology and prognosis in thyroid cancer. Determination of the malignancy potential of papillary and medullary neoplasms by the detection of S-100 protein and Leu-M1 antigen]. AB - 170 thyroid carcinomas were investigated for the presence of S-100-protein positive Langerhans cells (LC) and the expression of Leu-M1-antigen. Dense LC infiltrates were found only in papillary tumours and were shown to be significantly related to prognosis. Irrespective of any other feature, no single instance of death resulting from cancer occurred among 23 tumours (including 6 cases of stage pT4) with dense infiltrates (greater than 20 LC/unit field) while 9/53 (17%) of the remaining patients died from carcinoma (p less than 0.01). The degree of epithelial Leu-M1 expression was significantly related to the biological behaviour of papillary and medullary neoplasms. Death resulting from cancer occurred 17 times more frequently among papillary tumours with marked positivity (greater than 15%) as compared to cases with slight or absent immunoreactivity (8/24 vs. 1/52; p less than 0.00005). Among medullary carcinomas, local recurrences occurred 2.9 times (14/16 vs. 7/23; p less than 0.005) and death resulting from tumour occurred 4.3 times (9/16 vs. 3/23; p less than 0.03) more frequently for intensely stained as compared to slightly immunoreactive and unstained neoplasms. PMID- 2711817 TI - Visual and brain stem auditory evoked responses in Wilson's disease. AB - Sensory evoked potentials were studied in 15 patients with Wilson's disease. Thirteen patients were investigated with pattern reversal visual stimulation. A prolonged P 100 latency of the VEP was present in 7 patients. Brain stem auditory responses were evoked in 12 patients. Prolongation of III-V and I-V interpeak latency was found in 8 patients. The evoked potential studies demonstrated subclinical disturbances in optic and caudal brainstem auditory pathways. Further studies are in progress to evaluate the role of these techniques in monitoring the therapy of newly diagnosed cases. PMID- 2711818 TI - Orthostatic tremor: report of two cases and an electrophysiological study. AB - Two patients with legs tremor present on standing, but none on walking or sitting, are reported. Tremor was not exclusive or orthostatism and was also evoked by strong tonic contraction of leg muscles. Synchronous EMG bursts were recorded in antagonistic muscle groups at 8-10 Hz in the first patient and at 16 Hz in the second. EMG activity was synchronous in corresponding muscles of both legs. The occurrence of EMG activity was not influenced by stimulation of nerve afferent fibers. We suggest that this movement disorder may be an exaggeration of physiological tremor due to synchronization of motor units by spontaneous oscillations in central structures. PMID- 2711819 TI - Leptomeningeal gliomatosis with spinal cord or cauda equina compression: a complication of supratentorial gliomas in adults. AB - Seven patients with supratentorial gliomas developed leptomeningeal gliomatosis (LMG) without symptomatic recurrence at the primary tumor site. In all, severe back and radicular pain, often simulating disc disease, preceded the development of spinal cord or cauda equina dysfunction. In 4 instances, intracranial hypertension due to hydrocephalus developed prior to spinal involvement. Cytological examination of the CSF revealed malignant cells in only 2/7 but a myelogram was diagnostic in all 7. All patients received spinal irradiation (RT) and 5 received chemotherapy. Two patients with low-grade gliomas improved transiently; 5 with malignant gliomas responded poorly, became paraplegic over 4 months and eventually died of LMG. When fatal LMG occurs in young adults suffering from supratentorial glioma, the primary tumor is often quiescent. Hydrocephalus is often the first manifestation of LMG and, when it is detected, a myelogram and CSF cytology study should be performed in the hope that diagnosis and treatment of spinal cord lesion at a very early stage will prove beneficial. Irradiation of the entire spinal canal is probably required as there is a high risk of rapid development of new lesions in non irradiated segments of the spinal canal. PMID- 2711820 TI - Otoneurological abnormalities in asymptomatic HIV-seropositive patients. AB - Twenty-four male patients, all homosexual except one, with asymptomatic HIV infection were studied. The patients had no signs of opportunistic CNS-infections but 6 had been treated for syphilis. The patients were tested with auditory brainstem response (ABR) audiometry and with oculomotor tests (saccades and smooth pursuit eye movements). The ABR-recordings were pathological in 38% of the cases and the oculomotor tests in 50% of the cases. Abnormality of either one or of both methods were seen in 67% of the patients tested. The duration of the HIV infection had no influence on the test results. The abnormal otoneurological tests indicate that occult CNS-dysfunction is a frequent finding in asymptomatic HIV-positive patients. PMID- 2711821 TI - Sleep disturbances in torture survivors. AB - One of the main complaints in torture survivors is sleep disturbance with nightmares, too little sleep and daytime fatigue. Seven subjects, who had been exposed to torture from 6 months to seven years previously, were examined by polysomnography. All had abnormal sleep patterns compared with normal age- and sex-matched controls. The subjects woke frequently from REM sleep, had reduced REM sleep duration, absent Stage 4 sleep, short total sleep time and low sleep efficiency. This study revealed that previously healthy young persons subjected to extreme stress may develop an abnormal sleep pattern. PMID- 2711822 TI - The effect of hemiplegia on bone mass and soft tissue body composition. AB - The content of bone mineral (BMC), lean tissue, and fat tissue were measured by single and dual photon absorptiometry in both the paretic and the non-paretic limbs of 15 patients, hemiplegic due to cerebrovascular accident 23-38 weeks earlier. Compared with the non-paretic arm, the paretic arm had approximately 10% lower (P less than 0.01) BMC. This difference was largest at the measuring site with the highest ratio of trabecular to compact bone. The paretic leg had a 4% (P less than 0.001) lower BMC than the non-paretic leg. For both the arms and the legs, the lean content was lower (P less than 0.05) and the fat content higher (P less than 0.01) in the paretic than in the non-paretic. This was relatively more pronounced in the arms than in the legs. We conclude that partial immobilization, owing to paresis after a cerebrovascular accident, results in characteristic changes in the affected limbs, with a marked decrease in the content of bone and lean tissue and a pronounced increase in fatty tissue. PMID- 2711823 TI - CSF choline levels in neurologically disturbed children. AB - Choline levels in cerebrospinal fluid (CSF) were measured in a large group of neurologically disturbed children (n = 114) and in a control group (n = 15). Only 5 children showed CSF choline levels that differed more than 2 standard deviations from the mean of the total investigated group, suggesting that CSF choline levels are extremely stable. Of the 5 children showing extreme values, 3 suffered primarily from psychomotor retardation. Further analysis showed that the CSF choline levels in the medication-free patient group suffering from psychomotor retardation (n = 18) were significantly elevated in comparison with the control group. CSF choline levels of children were found to fit excellently in the regression line showing the increase of CSF choline levels with age as calculated earlier for adults. Therefore, CSF choline levels appear to increase linearly with age during the whole life span. From direct measurements and from measurements in consecutive fractions of lumbar CSF it is concluded that choline levels in intracranial CSF are 2-3 fold as high as those in lumbar CSF. PMID- 2711824 TI - Inhibitory effect of calcium channel blockers on proliferation of human glioma cells in vitro. AB - The effects of 2 specific calcium channel blockers, verapamil and nimodipine, on the proliferation of human glioma tumour cells were investigated in vitro. Tumour tissues for primary cell cultures were obtained bioptically from 3 patients with the histopathological diagnosis of glioblastoma. The [3H]-thymidine incorporation into glioma tumour cells DNA was used as a sensitive index of the cell proliferation. It was found that verapamil (10(-4)-10(-5) M) and nimodipine (10( 4)-10(-6) M) significantly inhibited the [3H]-thymidine uptake in a dose-related manner. The inhibitory effect of both calcium channel antagonists was reversed by simultaneous addition of calcium chloride (5 x 10(-3) M). These results indicate that verapamil and nimodipine may exert an antiproliferative effect on glioma cells growth acting through a blockade of specific voltage-dependent calcium channels. PMID- 2711825 TI - Parkinson's disease and autoimmunity. AB - Sera from 22 patients with Parkinson's disease were tested for autoantibodies in 11 different assays, including a test for autoantibodies directed against determinants in the pituitary gland. All patients were tested twice with a 12 month interval between tests. No pituitary autoantibodies were detected. The other autoantibodies investigated were found in low frequencies and in low titers. Our data supports the view that the pathogenesis of Parkinson's disease is not autoimmune. PMID- 2711826 TI - Electrophoretic immunoblotting analysis of anti-thymus microsome antibodies in patients with myasthenia gravis. AB - Anti-thymus microsome antibodies and anti-skeletal muscle microsome antibodies in sera from patients with myasthenia gravis (MG) were analyzed by means of immunoblotting, which was performed after SDS polyacrylamide gel electrophoresis of antigens to clarify the pathogenic role of the thymus in MG. Anti-thymus microsome antibodies were detected in 15 of the 20 cases of MG examined. The detection frequency (75%) was significantly higher than the corresponding frequency determined for anti-muscle microsome antibodies (35%) in the same group of patients. Thymic antigens with a molecular weight of 38 kilodaltons (KD), 60 KD and 220 KD were often recognized by antibodies in sera from MG patients studied here. The anti-thymus microsome antibodies were not cross-reactive with either thymic acetylcholine receptors or lymphocyte surfaces. These findings indicated that the specific antibodies were produced to the thymic microsomal fraction, and its frequency was higher than has been suspected in MG patients. PMID- 2711827 TI - Impairment after severe blunt head injury: the results from a consecutive series of 100 patients. AB - Three scales, assessing the degree of brain impairment after severe blunt head injury in neurophysical and neuropsychological functions as well as overall organic functioning, are described. A consecutive series of 100 severe blunt head injured patients was followed up 6 years post-trauma and the scales were used to measure the residual impairments and determine the level of recovery for 82 subjects in the series. No subject made a complete neurophysical and neuropsychological recovery, 92% of the series was classified as suffering clinically significant impairments and in half the series the moderate or severe impairments were consistent with a poor level of recovery. The impairments of a large proportion (42%) of the series, however, were classified as mild. Although most subjects demonstrated impairments in both neurophysical and neuropsychological functions, 43% of the series suffered isolated impairments in either the neurophysical or neuropsychological areas. There was strong agreement between the overall organic impairment profile and the subjects' classifications on the Glasgow Outcome Scale. PMID- 2711828 TI - Evidence for sequential degeneration of the neurons in the intermediate zone of the spinal cord in amyotrophic lateral sclerosis: a topographic and quantitative investigation. AB - To elucidate the degenerating mechanism of the neurons in the intermediate zone of the spinal cord in classical amyotrophic lateral sclerosis (ALS), the spinal neurons in a patient with ALS, whose muscular strength was fairly well preserved up to death, were examined quantitatively and topographically, and compared with the data of advanced ALS patients and age-matched control subjects reported previously. In advanced ALS patients, anterior horn cells completely disappeared and the medium-sized (nuclear area; 71-150 microns 2) and large (nuclear area; greater than 151 microns 2) neurons in the intermediate zone were severely reduced. In the present case, however, the loss of anterior horn cells was severe but the degree was not equal to that of advanced ALS patients, and the neurons in the intermediate zone were quite well preserved. The finding indicates that the primary degeneration may occur in the anterior horn cells and the neurons in the intermediate zone degenerate sequentially in the spinal gray matter in ALS. PMID- 2711829 TI - Cerebral endothelial regeneration following experimental brain injury. Variation in the regeneration process according to the severity of injury. AB - It is still unknown when and in which area endothelial regeneration occurs after brain injury, and to what extent such changes depend on the severity of the injury. We have, therefore, studied bromodeoxyuridine (BrdU) uptake by regenerating endothelial cells in two different groups of rats given cold lesions using immunohistochemistry employing anti-BrdU monoclonal antibody, anti-factor VIII-related antigen antibody and anti-glial fibrillary acidic protein antibody. The earliest evidence for the presence of BrdU-positive endothelial cells (BrdU + end) was observed at 2 days after injury, the injured endothelial cells regenerating from the edge toward the center of the lesion in both groups. We considered that edema fluid could act as an important factor, since at 2 days post-injury BrdU + end were not in contact with macrophages and were always found in Evans blue-stained areas. Study of endothelial cell kinetics also confirmed that the repair of injured endothelial cells was intimately involved in the reconstruction of the blood-brain barrier, since the time of disappearance of BrdU + end coincided with the disappearance of Evans blue-stained areas. The difference in the process of endothelial regeneration was first apparent on the 3rd day, there being no difference at 2 days. PMID- 2711830 TI - Senile plaque neurites fail to demonstrate anti-paired helical filament and anti microtubule-associated protein-tau immunoreactive proteins in the absence of neurofibrillary tangles in the neocortex. AB - Although much work has been directed recently towards unravelling the protein chemistry of neurofibrillary tangle (NFT) and senile plaque (SP) components in Alzheimer's disease, the pathogeneses of these lesions remains largely unknown and the problem of their relationship is unresolved. In particular, although paired helical filaments (PHF) have long been documented in SP neurites, we do not know if they are of pathogenetic relevance for the formation of the SP. To investigate the relationship between NFT and SP, we examined antigenic properties of proteins in SP neurites in neocortical tissues of patients with senile dementia of Alzheimer type, in the presence or absence of NFT in the same cortical area. We used two polyclonal antibodies directed against PHF and microtubule-associated protein (MAP)-tau and three monoclonal antibodies (MAbs) (RT97, BF10, 147) to phosphorylated epitopes of human neurofilament polypeptides, as well as the Gallyas silver impregnation method which specifically stains PHF in NFT and neurites. The main finding of our investigations consists in a differential pattern of immunoreactivity of SP neurites depending on the presence or absence of NFT in the neocortex. In the presence of NFT, there were numerous neuropil threads and SP neurites containing Gallyas-positive, as well as anti-PHF and anti-tau-labelled material. In the absence of NFT in the neocortex there was a striking absence of any Gallyas-positive or PHF- and tau-immunoreactive structure in the cortical neuropil and in SP neurites, irrespective of the maturation stage of the SP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711831 TI - Chronic relapsing demyelinating encephalomyelitis associated with persistent spontaneous canine distemper virus infection. AB - This is the first report of spontaneous canine distemper virus (CDV) infection in a dog associated with chronic progressive multiphasic neurological disease. Initial neurological deficits in the pelvic limbs progressed rapidly to paraplegia with almost complete remission after 9 weeks. Then another acute episode occurred with severe thoracic limb deficits and cerebellar dysfunction and progressive neurological deterioration over 3 months with rising serum neutralizing (SN) anti-CDV titers in the serum and cerebrospinal fluid (CSF). Three neuropathologically distinct lesions of spinal cystic necrosis, chronic demyelinating foci in the cerebellum and acute demyelinating encephalitis in the pons were identified. Persistent CDV antigen was demonstrated immunocytochemically only in acute lesions and atypically restricted to neurons. However, the immunological mechanism associated with the distinct remissions and exacerbations and CDV antigen clearance from chronic demyelinating lesions but persistence in acute lesions, despite a vigorous anti-CDV serologic response, was not defined. PMID- 2711832 TI - Brachial plexus meningioma, report of a case with immunohistochemical and ultrastructural examination. AB - Peripheral nerve meningiomas are exceedingly rare neoplasms of controversial origin; only four cases have been reported. Proposed origins of ectopic meningiomas include extradural trapping of arachnoid cells during embryogenesis, ectopic migration of arachnoid cell nests with the developing peripheral nerve, and metaplasia of mature peripheral nerve sheath cells or a common progenitor cell. In this report of a meningioma of the brachial plexus, immunohistochemical and ultrastructural examinations of the tumor matched all the criteria of a traditional meningioma but failed to clarify the origins of such neoplasms. PMID- 2711833 TI - Analysis of the claims submitted to the patient insurance (PI) scheme in Sweden during 1975-1979 in obstetrical and gynaecological cases. AB - The Patient Insurance (PI) scheme in Sweden was instituted on 1 January 1975. From the PI it is possible for a patient to obtain acknowledgement of an injury sustained in connection with medical treatment or operation--and receive financial compensation therefore--without having to prove that the injury was the result of fault or neglect. Special conditions of undertaking are laid down for the guidance of PI assessors which, if fulfilled, will entitle the patient to indemnity from the respective county council (via the PI) for injury sustained in connection with medical care received from county institutions or staff. As the Swedish PI scheme was the first of its kind in the world, an evaluation of its application during the first 5 years seemed justified. The present work constitutes the obstetrical-gynaecological part of that project. The objectives of the study were: to analyse and group according to injury all claims concerning obstetrical or gynaecological intervention submitted to the PI during 1975-79; to evaluate available literature on such injuries in relation to the present findings; to make recommendations for changes in the treatment routines of frequently occurring or serious injuries; and to study the working procedures of the PI, especially regarding its assessment of patient claims. Chapter I sets out the historical background of the PI. The extent of a patient's right to indemnity from the PI is discussed, covering the conditions of undertaking that must be fulfilled on the patient's part, and the PI's obligations. The Patient Injuries Committee is presented, to which injured parties can appeal against decisions of the PI. Chapters II--X. During the period studied, altogether 275 claims concerning obstetrical and gynaecological treatment were submitted to the PI, i.e. 2.5% of all claims received by the PI during that period. Most of the injuries resulted from surgical intervention. The claims have been grouped into six gynaecological and three obstetrical chapters. The reporting frequency to the PI was low during this period and therefore no statistical information can be derived from the analysis. A review of the current literature revealed a similar pattern of severe complications as that found among claims to the PI. In one respect, however, the present study is unique, since complications resulting from certain types of intervention, though performed under so varying circumstances, have never before been compiled and evaluated. The reported injuries were fairly evenly distributed among the 26 counties and the three different sizes of hospital.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2711834 TI - Bladder cancers. Their process of development and its modification. AB - Much information on the development of bladder cancers and its modification has accumulated. It is generally considered that the presence of chemicals in the environment including carcinogens and modifiers (promoters, inhibitors, anti promoters, etc.) is responsible for the geographical variation in human neoplasia including urinary bladder cancer development. A diagrammatic representation of the possible interactions between environmental factors and tumor development in man is shown in Fig. 6. Thus if potent carcinogens or promoters are present, neoplasia results, with tumor death occurring within an individual's normal lifetime. However, lack of such substances or the existence of powerful inhibitory factors is presumed to slow down the process, so that the normal life span is not affected. It is therefore of prime importance for thorough awareness of the factors involved to be generated. PMID- 2711835 TI - Increased serum type IV collagen peptide in carbon tetrachloride-treated rats. AB - We developed a competitive enzyme-immunoassay for serum type IV collagen peptide as a marker of fibrogenesis, and examined the relationship between serum type IV collagen peptide and hepatic disorder in CCl4-treated rats. The rats were treated for 8 weeks and signs of liver damage began to appear from about week 2. With the progression of these signs to liver fibrosis, type IV collagen increased in the fibrous septa and especially in the perisinusoidal walls, where the increase was manifested as development of a real basement membrane beneath the sinusoidal endothelial cells. In CCl4-treated rats, serum type IV collagen peptide significantly increased with the progression of liver fibrosis. When CCl4 administration was stopped, the collagen peptide rapidly decreased without any rebound rise. An intimate relationship was found between the production of serum type IV collagen peptide and liver prolyl hydroxylase activity and the amount of collagen deposited in the liver. These results suggest that serum type IV collagen peptide will be a useful biochemical marker for the early detection of fibrogenesis in the liver. PMID- 2711837 TI - [Formulation of effervescent tablets containing acetylsalicylic acid. III. Investigation of the stability of the active principles of tablets]. AB - Parameters influencing the stability of active principles of effervescent tablets containing acetylsalicylic acid were investigated. On the basis of factorial experiment project the effects of contents of citric acid: sodium hydrogen carbonate, polyvinylpyrrolidone and those of storing temperature of tablets and humidity of atmosphere on decomposition of active principle were studied. High performance liquid chromatographic method has been developed for simultaneous determination of acetylsalicylic acid and salicylic acid. It has been established that first of all storing circumstances effect the stability of preparation and composition of tablets also significantly influences the decomposition of acetylsalicylic acid. PMID- 2711836 TI - Mixed medullary-follicular carcinoma of the thyroid. Immunohistochemical and electron microscopic studies. AB - A case of mixed medullary-follicular carcinoma of the thyroid is reported. Grossly, the tumor was a solid, grayish-white, well circumscribed mass without lymph node metastasis. Microscopically, the tumor showed both medullary and follicular areas. The follicular areas occupied discrete portions of the tumor, and were considered to be neoplastic. Tumor cells in the medullary area were polyhedral or spindle-shaped. There was no amyloid deposition within the tumor. Immunohistochemically, tumor cells in the medullary area were positive for calcitonin and negative for thyroglobulin. Some cells lining the follicles were positive for thyroglobulin. By electron microscopy, two types of tumor cell were observed. One type contained numerous cytoplasmic secretory granules, whereas the other type had few granules and showed a prominent rough endoplasmic reticulum. These findings suggested that this mixed medullary-follicular carcinoma of the thyroid presented neoplastic changes within a common cell lineage. PMID- 2711838 TI - [Preparation and in vitro study of suppositories containing No-Spa. I. Significance of choosing the basic substance. Determination of physical parameters of suppositories]. PMID- 2711839 TI - [Preparation and in vitro study of suppositories containing No-Spa. II. Determination of release of the active principle by membrane diffusion methods]. AB - The authors have made proposal of pharmaceutical technology of a well storable, excellent drug release No-Spa./suppository besides No-Spa./tablets and injection have been in circulation in this country. Without Estaram 299 of small hydroxyl value or combined with 10% ESTASAN oil it suits to therapeutical expectations in every respect. Physical parameters of suppositories and chemical stability of drotaverinium chloride have been excellent on the basis of one year storing. On the ground of in vitro investigations the suppository has been proposed to be introduced to human therapy as antispasmodic preparation. PMID- 2711840 TI - [Instrumentation and evaluation of the pharmacopoeia test of color]. AB - Instrumental investigation of colorimetric matching fluids of the Hungarian Pharmacopoeia has been carried out. It has been established that by means of the internationally accepted CIELAB parameters the samples can be well characterized and comparative tests can be precisely accomplished. PMID- 2711841 TI - A new theory of infarction-genesis in cats. AB - It can be shown that a number of substances that are derived from incubation have a good blocking capacity in myocardial infarction. There exists also a natural substance (intrinsic factor, i.f.) which can also block infarction. The same substances also inhibit arrhythmias of ischaemic origin. Thus a common root for myocardial infarction and arrhythmias could be inferred. A new dynamic method (T/2 velocity) was elaborated for evaluating anti-infarction drugs instead of using static T/2 values. Oxidation of i.f. in vitro and in vivo enhances the blocking capacity of artificial drugs reagented previously each other. The natural substance (i.f.) lost its blocking capacity after oxygenation, thus may be unable to compete with the above mentioned artificial substances. Ligation of the coronaries i.e. its myocardial infarction producing effect can also be inhibited by the same substances. No matter how infarction is produced, the same substances can block it. Since after cutting the vagi KCl elicits the same phenomena their reflex origin can be excluded. PMID- 2711842 TI - Frequency-dependent and independent effects of tetrodotoxin on Vmax in cardiac fibers. AB - Superfusion with 3 microM tetrodotoxin (TTX) induced both a use-dependent and a frequency-independent depression of the rate rise of the action potential (Vmax) in dog Purkinje and guinea pig ventricular muscle fibers. The recovery from block was fast and exponential with a time constant of 225.4 +/- 7.1 ms in dog Purkinje fibers (n = 6). The onset kinetics of the frequency-dependent Vmax block was rapid, i.e. reached steady state after 3.0 +/- 0.3 beats in guinea pig ventricular muscle (n = 6). The rapid use-dependent interactions with sodium channel make TTX similar to antiarrhythmic drugs with fast kinetics i.e. lidocaine, mexiletine, and tocainide, but unlike antiarrhythmic drugs, TTX induces a large frequency-independent Vmax block at the same concentrations. PMID- 2711843 TI - Intraventricular administration of neurohypophyseal hormones interferes with the development of tolerance to ethanol. AB - The effects of intracerebroventricularly (icv.) administered oxytocin (OXT) and lysine-8-vasopressin (LVP) on the development of hypothermic tolerance to ethanol were investigated. Mice equipped with an icv cannula were pretreated with graded doses of OXT or LVP (3 ng, 300 pg, 30 pg or 3 pg/animal) before the daily intraperitoneal ethanol (4 g/kg) injection. Two doses of OXT or LVP (3 ng or 300 pg/animal) blocked the development of hypothermic tolerance to ethanol. Smaller doses of the peptides were ineffective in inhibiting the gradual decrease in hypothermia upon repeated ethanol administration, which effect was observed in the control group. The data presented show that the central administration of these neurohypophyseal peptides blocks the development of tolerance to ethanol. PMID- 2711844 TI - Recent trends in methods of suicide. AB - Trends in completed suicide by method were analysed for Belgium between 1968-1972 and 1978-1981, using the information reported on death certificates. Around 1980, hanging was the most preferred method of suicide in both sexes, followed by firearms in males and poisoning by solid and liquid substances in females. Between 1970 and 1980, rates for all but one method (domestic gas) increased. The largest changes among men were seen for firearms and for poisoning, accounting respectively for 43% and 33% of the overall increase. For women, 48% of the rise was attributable to poisoning and 24% to drowning. The choice of method was seen to be influenced by age: hanging and drowning were the preferred methods for older people, whereas poisoning was the most popular among younger adults. The male-female ratio decreased for firearms and was reversed for poisoning and drowning. These findings are compared with trends in other industrialized countries, and the possibilities for suicide prevention by reducing the firearms and poisoning rates are discussed. PMID- 2711845 TI - Suicide in England and Wales 1946-1985: an age-period-cohort analysis. AB - Four decades of suicide mortality data for England and Wales were analysed within an age-period-cohort framework. Marked differences in results were found by sex. The analysis of the male data showed that the risk of suicide increased with age until men were in their mid-fifties (after allowing for period and cohort effects), and that suicide risk declined for males born from 1876 to 1915, but had increased over 4-fold for certain later-born cohorts. Female suicide risk was found to decline with later nativity (after adjusting for age and period effects). The identification of period effects in terms of known changes in the carbon monoxide (CO) content of domestic gas successfully accounted for temporal variation in male suicide risk, but fitted less well to the data for females. PMID- 2711846 TI - Suicide among soldiers and young men in the Nordic countries 1977-1984. AB - A comparison of suicide rates among soldiers and civilians in the Nordic countries during the 8-year period 1977-1984 revealed that suicides among soldiers were more frequent in Norway than in Sweden and Finland. An in-depth study of the suicides of Norwegian soldiers during the same time period points to selection procedures and distance from home to the soldier's duty camp as possible causal factors. The suicides were frequently precipitated by an acute crisis. Preventive measures are discussed. PMID- 2711847 TI - Completed suicide in psychiatric inpatients and former inpatients. A comparative study. AB - A total of 49 psychiatric inpatient suicides were compared with 53 former psychiatric inpatients who had committed suicide within one year after their discharge. Significant differences were found in the diagnostic distribution of both groups, especially the predominance of schizophrenics among inpatient suicides, and of alcoholics and drug abusers among suicides of former inpatients. Furthermore, some other important differences between the groups emerged that bore practical implications. In different diagnostic groups suicide occurs for different reasons and based on different psychosocial backgrounds. In the investigation of suicide in psychiatric patients, homogeneity of the population studied in terms of patient status should be strived for. PMID- 2711848 TI - Personal violence (suicide and homicide) in South Africa. AB - An examination of recent suicide and homicide rates in the United States and South Africa showed quite similar patterns, with whites having higher rates of suicide and nonwhites having higher rates of homicide. In recent years, suicide rates for white males have risen in South Africa while remaining stable in the United States. In contrast, homicide rates have risen for nonwhites in South Africa. PMID- 2711849 TI - Suicide in Jordan 1980-1985. AB - In a study of suicide from 1980 through 1985 in Jordan, there were 219 suicides with an annual suicide rate of 2.1 per 100,000. The peak suicide rate was found to be among the age group 15-34 years. Nearly two-thirds of males that committed suicide were single, which was not the case with suicides among females. Over half of males that committed suicide were either unemployed and/or unskilled manual workers and over two-thirds of females that committed suicide were either housewives and/or students. Nearly two-thirds of the total population that committed suicide had previous psychiatric treatment. Violent methods of suicide were most frequently used. Some of the results were observed for the first time and the role of sociocultural factors is discussed. Suggestions are made to explore the role of religion in combatting suicide. PMID- 2711850 TI - Language of publication of journal articles on suicide and mental disorders. AB - English as the language of publication for articles on suicide in the medical literature increased from 58% of articles in 1966 to 79% in 1986. This increase occurred at the expense of all languages. These changes parallel those for the language of publication of articles on mental disorders and all medical subjects. PMID- 2711851 TI - Mortality among psychiatric patients--the groups at risk. AB - This study examined standardized mortality ratios (SMR) among the patients who had undergone psychiatric hospitalization in Israel in 1978. The size of the sample (83,175 person-years) allowed us to calculate simultaneously SMR by age, sex, diagnosis and cause of death. The global SMR was 2.3 and decreased with age. Excess mortality was found in patients from all diagnostic groups for death from both natural and unnatural causes. Excess mortality from cancer was found only among patients aged under 40. The SMR for death by suicide was lower than that reported in the literature. The highest excess mortality was due to respiratory and infectious diseases in all groups and especially among young alcoholics and drug addicts (SMR = 273). This points to the importance of an ongoing follow-up of the physical health of psychiatric patients. PMID- 2711852 TI - Mortality in psychiatric inpatients. AB - The number of persons taken into psychiatric hospital care during 1982 in France was estimated using data on length of stay and analysing these by the person-year method. The number of observed deaths was compared by sex and age group with the number of deaths expected if the mortality in the general French population in 1982 were applied to the numbers of inpatients of the same sex and age group. The result of this comparison was that the mortality in mentally ill inpatients was found to be 3 times higher than that in the general population. This higher rate is further accentuated in younger age groups, especially women. This excess mortality has been observed with respect to natural causes of death as well as to unnatural causes, i.e. injury and suicide. Deaths from diseases of the circulatory system are overrepresented. As is true in the general population, these diseases account for the greatest number of deaths. Excess mortality is also high from diseases of the respiratory system. There is a high excess mortality due to signs, symptoms and ill-defined conditions, especially among women. Only in the case of neoplasms is there no excess mortality. Finally, excess mortality is found for deaths by injury and poisoning, especially for women, and suicides, particularly among men. Nevertheless, up to the age of 34, the female suicide rate is higher than that of men. PMID- 2711853 TI - Repeat self-harm: an 18-month follow-up. AB - An 18-month follow-up of cases of deliberate self-harm (DSH) revealed that 30% had repeated the act. Of a large number of items recorded at index DSH only one, a past history of self-harm, was associated with repetition. It is suggested that some factors not predictive of longer term repeat DSH may be important in the assessment of risk for immediate further self-harm. PMID- 2711854 TI - Suicide and attempted suicide in general practice, 1979-1986. AB - Using data from the Continuous Morbidity Registration Sentinel Stations over the period 1979-1986, the authors tried to determine the incidence and the characteristics of patients in general practice who attempted or committed suicide. Almost half of the suicide attempts and suicides had contacted their general practitioner (GP) shortly before the suicidal act. A minority of these cases were recognized by the GP as having a high suicide risk. In almost 70% of the suicides and 58% of the suicide attempters the GPs reported the existence, currently or previously, of a depressive episode. About half of both the suicides and the suicide attempters had been treated or seen by mental health professionals or social workers. Given the fact that suicide and suicide attempt are relatively rare events in general practice, and given the fact that for the patients who contact their GP shortly before the suicidal act, it is not at all certain whether they present clearly recognizable signs of suicide risk at that time, the authors conclude that GPs cannot play an important role in the prevention of suicidal behaviour. PMID- 2711855 TI - The dexamethasone suppression test and suicide attempts. AB - We examined covariations between results of the dexamethasone suppression test (DST) and suicidal behaviour for 44 patients who had attempted suicide at least once; the suicide methods, diagnoses and time factors were controlled for. The control groups comprised 82 psychiatric patients and a sample of 69 patients with endogenous depression. In spite of hypotheses suggesting the contrary, there was no significant relationship between DST results and acute suicide attempts. Although patients who had used "soft" methods were often suppressors, chi-square tests using the suicide classification of the ICD-9 as well as tests employing more precise subcategories failed to reveal any significant covariation. In groups of patients with an identical diagnosis of endogenous depression, the sensitivity of the DST with regard to suicide attempts was 52%. The difference between suppressors and nonsuppressors in previous suicide attempts was insignificant. Further, the Hamilton Rating Scale for Depression profiles of DST suppressors and nonsuppressors showed no significant differences with regard to either different symptoms or the evaluation of acute suicide risk. PMID- 2711856 TI - Female habitual self-mutilators. AB - Data are presented on 240 female habitual self-mutilators. The typical subject is a 28-year-old Caucasian who first deliberately harmed herself at age 14. Skin cutting is her usual practice, but she has used other methods such as skin burning and self-hitting, and she has injured herself on at least 50 occasions. Her decision to self-mutilate is impulsive and results in temporary relief from symptoms such as racing thoughts, depersonalization, and marked anxiety. She now has or has had an eating disorder, and may be concerned about her drinking. She has been a heavy utilizer of medical and mental health services, although treatment generally has been unsatisfactory. In desperation over her inability to control her self-mutilative behavior this typical subject has attempted suicide by a drug overdose. PMID- 2711857 TI - Personality disorder and suicide intent. AB - Studies of suicide intent have found a link between seriousness of the attempt and personality. Following a parasuicide, 60 patients were assessed using measures of depression, suicide intent and personality. Personality disorder was found to be present in over 65% of these and was mainly of explosive type. It was significantly more common in men than women and the dimension measuring sociopathy was equivocally linked to male gender. There were no other associations between gender and the other dimensions measured. Using a categorical approach to personality, suicide intent was not significantly different between the categories of personality; there was no correlation between dimensional or categorical measures of personality and suicide intent, when the severity of depression was controlled. By itself personality did not contribute significantly in determining variance in intent but it did interact significantly with age. PMID- 2711859 TI - [Cellular immunity in patients with psoriasis]. AB - The angiotensin converting enzyme activity was determined in a dog's plasma in the course of an irreversible hemorrhagic shock development. A statistically significant increase of the angiotensin converting enzyme activity in the plasma was found after one hour and two hours' duration of posthemorrhagic hypotension. After one hour and two hours' duration of posthemorrhagic hypotension the plasma angiotensin converting activity was higher by 29% and 33%, respectively, compared with the control levels determined in the normotensive period. After three hours' duration of posthemorrhagic hypotension the plasma activity of the angiotension converting activity was even more evident. In these conditions the plasma enzyme activity was increased by 71% compared to the control levels. The results obtained indicate the possibility that certain changes occur at the endothelial level of pulmonary blood vessels during the hemorrhagic shock development. These changes suggest an intense angiotensin converting enzyme release into the systemic circulation. The results of this investigation are a contribution to a better understanding of the renin-angiotensin system in shock conditions. PMID- 2711858 TI - Early separation and suicidal behaviour in the parental homes of 40 consecutive suicide attempters. AB - Forty suicide-attempt patients who were consecutively admitted to an intensive care unit, their significant others and treatment personnel were investigated by semistructured interviews. The patients were divided into neurosis (n = 14), abuse (n = 19) and psychosis (n = 7) groups. Twenty-one of the patients (52%) had lost contact with one or both parents before the age of 18, in 25% of cases owing to death and in 27% because of the parents' divorce or separation. Parents and/or siblings of 19 patients (47%) had shown suicidal behaviour in the form of attempted suicide and/or suicide. Differences between the groups were not significant. Alcohol abuse in the parental home was overrepresented in the abuse group compared with the other groups. The role of identification with the dead and suicidal parent in prompting suicidal actions in adulthood is discussed, as well as that of the impeded evolution of stable external object relations owing to parental losses. PMID- 2711860 TI - [Early detection of colorectal carcinoma using the Hemdetect Test]. AB - Cellular immunity was examined by two methods in vitro: absolute number T and B lymphocytes (E.T. and E.A.C. rosettes) and by the lymphocyte transformation test, in 280 patients with psoriasis (83.5% with psoriasis vulgaris and 16.5% with other forms of psoriasis). No statistically significant changes were found in comparison with the control group. PMID- 2711861 TI - [Primary brain sarcomas]. AB - The authors report on 79 cases of primary brain sarcomas, correlating clinical and pathoanatomical data. In the material analyzed the group of gliosarcomas prevailed, while the smallest group were rhabdomyosarcomas. In some groups the topic predilection did not show any specific characteristics, except that there were more gliosarcomas occurring in the parietal lobe. The symptoms lasted 1-3 months before operation. PMID- 2711862 TI - Cytostatic treatment of metastatic cervical carcinoma. AB - The activity of cytostatics in cervical cancer has not as yet been sufficiently investigated. This is especially true for combined cytostatic treatments. The only two cytostatics that have been adequately examined in clinical trials in a larger number of patients are 5-fluorouracil and cis-dichlorodiamineplatinum. The paper presents the results of treatment with single cytostatic agents and the combinations of different cytostatics, emphasizing the role of combined treatment using irradiation and cytostatics. It also describes the preliminary results of a Phase II trial going on at the Central Institute for Tumors in Zagreb, using a combination of cis-DDP, 5-fluorouracil and vincristine. So far the results of 11 out of 14 patients included in the trial have been evaluated. Objective remission (CR + PR) was achieved in 4 patients (33%). Toxic side-effects were mild and tolerable for the patients. In conclusion, the reasons are given why chemotherapy has not as yet gained a more important place in the treatment of advanced forms of cervical cancer. PMID- 2711863 TI - Acute myelomonoblastic leukemia in a patient with multiple myeloma. AB - A 40-year-old man who developed acute myelomonoblastic leukemia (M4) after 7 years of treatment for multiple myeloma with the alkylating agent melphalan and steroids is presented. Leukemia was treated with courses of adriblastin, cytosine arabinoside, and thioguanin (DAT protocol), with a 8 months' survival. PMID- 2711864 TI - In vitro experiments on neuronal and glial cell lineages among the ventricular cells of the mouse neural plate. AB - The proliferative ventricular cells of the early neural plate of the mouse are generally assumed to be pluripotent and equivalent to one another in their developmental capability. Ventricular cells from the rostral parts of the neural plates of mice (Theiler stages 11 and 12, embryonic days 71/2 and 8) were studied in tissue culture with respect to their potential to give rise to neurons or glial cells, or both. Autoradiographic and immunohistochemical analyses showed that ventricular cells developing into neuronal phenotypes stopped proliferating immediately upon transfer to cell culture. Using polyclonal anti-GFAP antibodies, a small proportion of immunoreactive cells could be detected after 4 days of culture. These cells retained their proliferative activity, displayed morphological characteristics of radial glial cells, and may have either developed from specific glial progenitor cells or have been induced to proceed along the glial differentiation pathway at the beginning of culture. Therefore, two distinct types of progenitor cells, committed either to neuronal or glial lineages, appear to co-exist among the cultured neural plate ventricular cells. PMID- 2711865 TI - Development of homospecific activity of GABA-transaminase in the mouse cerebral cortex and cerebellum and in neurons cultured from these brain areas. AB - The homospecific activity of GABA-transaminase (EC 2.6.1.19; GABA-T) in brain or neurons was determined as a function of development in vivo or in culture by measuring the enzyme activity together with the relative amount of GABA-T apoenzyme by the aid of a monospecific anti-GABA-T antibody. It was observed that both in cerebral cortex and cerebellum in vivo and in neurons cultured from these brain regions the homospecific activity of GABA-T changed during development. By incubation of tissue extracts with similar extracts in which GABA-T activity had been selectively and irreversibly destroyed with gamma-vinyl GABA (Vigabatrin) it was established that this change in homospecific activity was at least partly due to the presence of an endogenous activator of GABA-T. The results point towards a rather complex endogenous regulation of GABA-T during development in vivo and in vitro. PMID- 2711866 TI - Correlated ultrastructural damage between cerebellum cells after early anticonvulsant treatment in mice. AB - The anticonvulsants phenobarbital and diphenylhydantoin administered early in life to mice resulted in significant and long-lasting ultrastructural damage, including abnormalities of mitochondria, myelin sheaths, and lamellar inclusion bodies inside identified cells throughout the cortical layers of the cerebellum in treated vs control mice. The magnitude, distribution and duration of damage was age and treatment specific. No differences were detected in density of parallel fiber processes nor in synapse density within the molecular layer. Neuron profiles containing damaged organelles were not homogeneously distributed but made up only a small fraction of the total cell population examined. In our experiments, there was an overall within-animal correlation explaining 45% of the magnitude of damage in different cerebellar regions, but between synaptically connected cells, specifically mossy fiber axon varicosities and granule cell dendrite profiles, the subset population ratio of damaged-to-total mitochondria was highly significantly correlated (70-90%; P less than 0.001). We hypothesized that some correlated transneuronal degeneration and death in the central nervous system may have a transynaptically regulated component that first appears as correlated damage between synaptically connected cells, perhaps regardless of the degree of toxicity. The orderly cytoarchitecture and cell connections of the cerebellar cortex can be used to study these patterns of degeneration. PMID- 2711867 TI - Development and distribution of serotonin in the central nervous system of Manduca sexta during embryogenesis. I. The brain and frontal ganglion. AB - Development of the serotonergic system in the brain and frontal ganglion of the Manduca embryo between 35 and 100% of development was studied immunocytochemically with an antiserum to serotonin (5-HT). Serotonin immunoreactivity was initially detectable at 40-45% development in short fibers in the head region, prior to differentiation of the brain. Immunoreactive cell bodies were first seen in the brain at 60% development, located in the protocerebrum and tritocerebrum. Thick fiber tracts crossing the midline (commissures) could also be observed at this early stage. As development of the embryo progressed, eight immunoreactive cell groups, containing a total of about 38-40 cells, and four commissures with terminal arborizations appeared successively in the brain. From 75 to 100% development, no obvious changes occurred in the number or distribution of cells, and the brain exhibited the same pattern of 5-HT immunoreactive cells, fiber tracts and arborizations as in last instar larvae of Manduca. However, an increase in the size of the cells in both the brain and frontal ganglion was noted between 75 and 80% development, followed by a decrease by 100% development. The frontal ganglion was found to contain three 5-HT immunoreactive cells, which appeared to send bilateral projections into the frontal connectives and the recurrent nerve. During embryonic development, the dendritic arborizations of these frontal ganglion cells increased, while the amount of 5-HT immunoreactivity in the cell bodies decreased. Thus, the serotonergic system first appears in the Manduca embryo at an early stage of development, similar to the situation in other insects as well as vertebrates. By the end of the embryonic period, the same number of serotonergic neurons are present in the brain as in larval and adult Manduca, suggesting that once formed, these cells persist through postembryonic development and metamorphosis. PMID- 2711868 TI - Development and distribution of serotonin in the central nervous system of Manduca sexta during embryogenesis. II. The ventral ganglia. AB - The distribution of serotonin (5-HT) immunoreactive cells and their projections was mapped in the ganglia of the ventral nerve cord of the tobacco hornworm, Manduca sexta, during embryonic development, using an antiserum to 5-HT. Immunoreactive cells were first seen at 60% development. By 75% of embryonic development, a total of 94 immunoreactive cells were found in the ventral ganglia, including the suboesophageal ganglion. This number decreased to 80 neurons by 100% of development. About 50% of these cells were arranged in the abdominal ganglia and the rest were located in both the suboesophageal and thoracic ganglia. The suboesophageal ganglion exhibited immunoreactive segmental interneurons in areas corresponding to the mandibular, maxillary and labial neuromeres. Two pairs of immunoreactive interneurons were also observed to occur bilaterally in each of the thoracic and abdominal ganglia, with the exception of the prothoracic ganglion. This ganglion contained three pairs of bilaterally arranged immunoreactive neurons as early as 60% of embryonic development. Serotonin immunoreactivity was also found in a number of efferent neurons in the mandibular and labial neuromeres of the suboesophageal ganglion and in the prothoracic, mesothoracic and posterior abdominal ganglia. The occurrence of 5-HT in these efferent neurons suggests an involvement of serotonin in fore- and hindgut function via its effect on the visceral muscles. Immunoreactive lateral longitudinal fibers extended along the entire length of the ventral nerve cord together with dense segmental arborizations. The latter had regressed by the time the embryo was fully developed. This regression of the arborizations in the ganglia at the end of embryonic development indicates that a reorganization of 5 HT innervation occurs to support new larval functions. The time of appearance of 5-HT immunoreactive cells and fibers suggests that serotonin may play a role in the development of the ventral nerve cord. PMID- 2711869 TI - Serotonin-immunoreactive neurons in the brain of Manduca sexta during larval development and larval-pupal metamorphosis. AB - The developing serotonergic system of the tobacco hornworm, Manduca sexta, has been studied immunocytochemically in whole mount preparations of brain retrocerebral complexes. The distribution of serotonin-immunoreactive cell bodies, fibers and terminal fields has been analysed during larval and larval pupal development using a specific rabbit antiserum against serotonin-hemocyanin conjugates. The serotonergic system was conserved from the fourth to the fifth larval stadium, with minimal changes occurring until the onset of pupal development. At this time, alterations in the distribution of serotonin immunoreactive cells and processes were observed, including the apparent disappearance of some cell bodies and terminals. Nevertheless, the overall appearance of this system in the pupal brain was not significantly different from that in the larva. The larval pattern was characterized by eight bilateral groups of cell bodies which sent thick bridges of fibers across the midline, a feature strikingly similar to the serotonergic system in vertebrate embryos. In addition, three bilateral immunoreactive fields of arborization were observed around and ventral to these cell groups, together with regions of serotonin immunoreactivity in the medial and lateral protocerebral lobes. The central body, larval antennal centers, larval accessory lobes, and the tritocerebrum were also immunoreactive. Fibrous networks of serotonergic processes were usually observed around nerves emanating from the brain, including the connectives from the brain to the corpus cardiacum and corpus allatum. Smaller varicosities were observed in the interior of these neurohemal and glandular organs, and a network of 5-HT fibers was occasionally found around the corpus cardiacum and corpus allatum. The possible relationship of serotonin to cerebral neuroendocrine functions during the postembryonic development of M. sexta is discussed. PMID- 2711870 TI - Ontogeny of the metencephalic, mesencephalic and diencephalic content of catecholamines as measured by high performance liquid chromatography with electrochemical detection. AB - Developmental changes in norepinephrine (NE), dopamine (DA) and epinephrine (E) contents of the rat metencephalon, mesencephalon and diencephalon, have been measured by high performance liquid chromatography with electrochemical detection, from fetal stages (E15 or E17 to E21) to postnatal days (P0 to P30) and compared to the adult levels. The data show a biphasic pattern in NE changes of the three brain areas, with a first increase in the late prenatal period, followed by a further development from P0 to P18, thus reaching the adult levels. A similar pattern of development is found for the mesencephalic and diencephalic DA contents. The E levels of the diencephalon are very low in comparison to the NE and DA concentrations, but present a gradual increase from E17 to P18. The results correlate with the development of catecholamine systems in brain area as measured by other methodological approaches. PMID- 2711871 TI - Commissural size in neonatal rats: effects of sex and prenatal alcohol exposure. AB - Sex differences have been reported in the size of the adult corpus callosum in both humans and rodents. This experiment investigated whether sex and/or different prenatal treatment conditions would influence commissural size at birth. Male and female 3-day-old Long Evans rats were selected from one of three prenatal treatment histories: prenatal alcohol-exposed (35% ethanol-derived calories, 35% EDC), nutritional control (0% ethanol-derived calories, 0% EDC) or standard control (lab chow). Midline sagittal areas of the corpus callosum and the anterior commissure were determined for these subjects. Male control subjects had significantly larger callosal areas than females. Prenatal alcohol exposure significantly abolished this sexual dimorphism, with 35% EDC males having a significantly smaller callosal area than males from both control groups. This effect was independent of prenatal treatment differences in body or brain size. There were no significant sex differences in the midline sagittal area of the anterior commissure, nor were there any apparent effects of prenatal treatment on this measure. These results indicate that sex differences in the size of the corpus callosum are present at birth. Since a difference in myelination cannot account for this difference in area, there may be a sex difference in the number of fibers or in the average fiber size. Additionally, the effects of prenatal alcohol exposure on male, but not female, offspring suggest that this alcohol related birth defect is hormonally mediated. PMID- 2711872 TI - Non-selective afferent innervation develops in embryonic mouse spinal cord-dorsal root ganglia explants chronically exposed to GM1 ganglioside. AB - Projection patterns of dorsal root ganglion afferents within organotypic explants of fetal mouse spinal cord were examined histologically using a horseradish peroxidase staining method. All explants were also examined electrophysiologically and showed spontaneous and evoked bioelectric discharges, which were evenly distributed across the cord explants. Explants chronically grown in a serum-free medium containing the monosialoganglioside GM1 failed to develop dorsal cord selectivity as was previously observed when a mixture of gangliosides was used. It therefore appears that not all gangliosides can induce selectivity in this model. PMID- 2711873 TI - Gangliosides of the mouse spinal cord: a comparison in in vivo and in vitro tissues. AB - Ganglioside profiles in spinal cord from 13-day mouse fetuses, 21-day postnatal and adult mice were compared with those harvested from organotypic cross-sections of fetal mouse spinal cord grown for 28 days in vitro in a serum-free medium. All the major species of gangliosides reported for brain were present both in the in vivo tissue and cultured spinal cord, though not necessarily at each developmental stage examined. Fresh tissues showed increases and decreases in various gangliosides as have been reported for higher brain centers at similar stages of development in mammals and birds. However, qualitative and quantitative differences exist between fresh spinal cord and cultured cord explants as well as between galactose-grown and galactose-free cultures. Spinal cord explants grown in the presence of galactose showed measurable amounts of GM2 and GM3 which were not detected in the control-defined medium-grown cultures. The differences between the two culture groups may be related to interneuronal connectivity patterns. PMID- 2711874 TI - Effects of glycosaminoglycans and proteinase inhibitors on astroglia-induced detachment of cultured rat cerebellar neurons. AB - Neurons in mixed primary embryonic CNS cultures degenerate secondary to their detachment from the substratum. The present study demonstrates that in primary cultures of postnatal cerebellum, detachment of neurons can be prevented by antiproliferative drugs which inhibit the growth of astroglia. Several types of proteinase inhibitors did not affect the process of detachment. However, among several types of glycosaminoglycans, heparan sulfate and to a lesser degree heparin, could reversibly inhibit neuron detachment without causing morphological changes of astroglia. The enzymes heparitinase and heparinase caused neuron detachment but only within the first 24-48 hr after plating and not in older cultures. We conclude: (1) cerebellar interneurons in culture are not dependent on astroglia for their survival; (2) astroglia are most probably responsible for neuron detachment via a membrane associated activity and (3) heparan sulfate-like glycosaminoglycans are important in neuron-substratum attachment. PMID- 2711875 TI - Malic enzyme activity in the developing rat brain in relation to thyroid status. AB - Malic enzyme activity in the soluble fraction of neonate brains from mothers fed with propylthiouracil (0.015% w/v) in drinking water from day 12 of the gestation period was significantly lowered (P less than 0.01) as compared to the offspring of normal mothers. Supplementation of triiodothyronine to the neonates from experimental mothers restored the malic enzyme activity to normal levels. However, administration of triiodothyronine to adult control rats did not influence malic enzyme activity in the brains of these animals. Our data suggest that during the initial critical period of brain maturation, malic enzyme is under the control of thyroid hormones. The response of malic enzyme towards thyroid hormones is lost once the brain has matured. PMID- 2711876 TI - Soluble neural cell adhesion molecule in brain, cerebrospinal fluid and plasma in the developing rat. AB - Neural cell adhesion molecule (NCAM) is a glycoprotein found in neurons, glial cells and muscle cells. In this report we describe the polypeptide composition and amount of soluble NCAM in brain, cerebrospinal fluid (CSF) and plasma in rats of various ages. One-two percent of total NCAM in rat brain was shown to be buffer-soluble. Soluble NCAM in brain, extracted at pH 7.2, constituted an increasing relative proportion of total NCAM during development, whereas the concentration of soluble NCAM in both CSF and plasma decreased in the same period. By radioiodination of brain extracts, CSF, and plasma, soluble NCAM was found to be composed of up to five polypeptides with molecular weights (Mr) of 200,000, 170,000, 150,000, 115,000 and 80,000. The relative composition did not vary significantly with age. The major forms in brain were the polypeptides with Mr of 200,000 and 115,000, whereas in CSF all forms seemed to appear in equal amounts. In plasma the 200,000 and the 170,000 Mr polypeptides were not observed and here the major forms were the 150,000 and 115,000 Mr polypeptides. PMID- 2711877 TI - Laminin and other basal lamina proteins with neurite promoting activity in medium conditioned by C6 glioma cells. AB - Neurite promoting activities (NPFs) are essential factors in neuronal differentiation. Some of them are associated with proteins of the extracellular matrix (ECM). C6 cells, a rat glioma cell line, release NPF activities into the cell culture medium. We used antibodies against ECM-proteins for enrichment and partial characterization of these activities. Results show that, (1) C6 cells express and release laminin; (2) the C6-laminin consists of 260 kD chains only and is therefore different from typical basal lamina laminin (220 and 440 kD chains), but comparable to other laminins of glial origin (chains in the 200 kD range only); (3) C6-laminin partially purified by affinity chromatography shows NPF-activity; (4) laminin concentration in C6 cell-conditioned medium is not sufficient to account for the total neurite promoting activity of the medium, and (5) in addition to laminin C6 cells express and release fibronectin and possibly type IV collagen. PMID- 2711878 TI - Sensitive sigmoidoscopy: a straight sigmoid technique. AB - Colorectal cancer prevention requires screening more sensitive than standard colonoscopy in cost, convenience, comfort, and safety, and it requires screening more sensitive epidemiologically than occult blood, radiography, or standard sigmoidoscopy to detect small polyps throughout the colon. Using a 65-cm videosigmoidoscope and no sedation, this family doctor reached the ascending colon (95 percent of polyps) in 81 percent of 78 private practice patients not having prior intraperitoneal surgery (compared with 57 percent of 35 patients with abdominal surgery), mostly by gentle scope rotation for many minutes at 12 20 cm insertion to gather folds and keep the sigmoid colon straight. PMID- 2711880 TI - Transient vitamin B12 malabsorption in a patient with mixed nutritional anemia. AB - A 47-year-old nonvegan woman presented to my rural family practice with an anemia and was found to be deficient in iron, folate, and vitamin B12. Initial vitamin B12 malabsorption was documented by Schilling test and was reversed by nutritional repletion alone. This case illustrates that simple lack of intrinsic factor is not the only cause of vitamin B12 malabsorption in primary care patients and that inadequate diets may cause significant pathological consequences in ambulatory patients. PMID- 2711879 TI - Chlamydia and incidental carcinoid tumor in spontaneous abortion. AB - Maternal Chlamydia trachomatis infections have been associated with premature rupture of the membranes, preterm labor, premature birth, and fetal wastage. Women with acute infection may be at particular risk. We report the case of an unexplained second trimester spontaneous abortion with serologic evidence of recent infection with C. trachomatis. Serum IgG antibody titer ultimately exceeded 1:10,240. This patient also had an incidental finding of appendiceal carcinoid tumor. While treatment of asymptomatic chlamydial infections in early pregnancy is controversial, we suggest that delaying treatment may result in fetal loss. PMID- 2711882 TI - Epidural anesthesia. PMID- 2711883 TI - Medical ethics. PMID- 2711881 TI - When the part becomes more than the whole: what I learned from earlobes. PMID- 2711884 TI - Intrathecal morphine in OB. PMID- 2711885 TI - Rural obstetric care. PMID- 2711886 TI - Decubitus ulcers. PMID- 2711887 TI - A case for refereed journals. PMID- 2711888 TI - Perinatal outcomes in obstetric and family medicine services in a county hospital. AB - The relations between perinatal outcomes and physician specialty were examined in a retrospective study. Data pertaining to demographics, labor and delivery events, and maternal and neonatal outcomes were examined for 125 family medicine and 125 obstetric patients. Bivariate analyses showed no differences between the groups for demographics. Significant differences were found for two of 13 labor and delivery events: episiotomy and degree of lacerations. However, when multivariate analyses were conducted to control for possible confounding effects, differences between the groups for episiotomy or degree of lacerations were no longer significant. The only significant difference between the groups on perinatal outcomes was that family medicine newborns had a significantly higher mean birth weight (3364.9 grams) than obstetric newborns (3147.1 grams). Stepwise multiple regression analysis showed that smoking and specialty account for approximately 10 percent of the variance in birth weight. Overall, the results suggest that, regardless of physician specialty, obstetric and family medicine patients had similar outcomes. PMID- 2711889 TI - Patient satisfaction and selected physician behaviors: does the type of practice make a difference? AB - This study was designed to show what specific physician characteristics lead to patient satisfaction and to compare satisfaction of patients using either prepaid or fee-for-service modes of payment within the same settings. We surveyed 1142 patients in five family practice clinics in rural and suburban areas of the North Central United States. Regression analysis of a seven-item satisfaction scale showed four significant factors that accounted for variance: sensitivity, is on time for appointments, follows up promptly, and provides personalized medical care. No meaningful differences were found between health-maintenance organization and fee-for-service patients on these satisfactions. This study expands findings from previous research and raises more questions about reliable rating scales for complex physician/patient relations. Our methods can be used to investigate the effects of newer types of prepaid plans (including individual practice associations and preferred provider organizations) on patient satisfaction. The challenge for future investigations is to test and build reliable predictive models showing how physician characteristics, patient satisfaction, and quality of medical care affect each other in these more complex models of practice and reimbursement. PMID- 2711890 TI - Enhanced chemiluminescence in the peroxidase-luminol-H2O2 system: anomalous reactivity of enhancer phenols with enzyme intermediates. AB - Phenols which markedly enhance chemiluminescence in the horseradish peroxidase catalysed oxidation of luminol by hydrogen peroxide show anomalously high reactivity (by factors of approximately 10(2) compared with published Hammett correlations) in the reduction of the enzyme intermediates, Compound I and Compound II. The results support the hypothesis that efficient production of phenoxy radicals from phenols is a necessary criterion for chemiluminescence enhancer action. PMID- 2711891 TI - Continuous-flow bioluminescent determination of ATP in platelets using firefly luciferase immobilized on epoxy methacrylate. AB - Firefly luciferase was immobilized on epoxy methacrylate beads and used for a continuous-flow assay of ATP extracted from platelets. The immobilized luciferase had a half-life of 3 days at 25 degrees C; there was a 25% recovery of luciferase activity upon immobilization, and ca 50 reactors were made from 1 mg of commercial enzyme. The sensitivity of the assay was 0.3 pmol of ATP, and the response was linear between 1 and 500 pmol of ATP. The ATP content of platelets obtained with the present method correlated well with those obtained using soluble luciferase. PMID- 2711892 TI - Does acute hyperventilation provoke cerebral oligaemia in comatose patients after acute head injury? AB - In 27 comatose patients with acute head injury, 45 paired studies of regional cerebral blood flow (rCBF) were performed before and after hyperventilation. In total 676 regions were studied, and rCBF was calculated as initial slope index using the intracarotid washout technique of 133 Xe. The tests were applied from one day to three weeks after the acute trauma. In total hyperventilation from PaCO2 averaging 4.8 to 3.5 kPa increased the frequency of regions with oligaemia defined CBF less than 20 ml/100 g/min from 5 to 16%. Before hyperventilation oligaemia was observed in 11 of 45 studies (9 of 27 patients); after hyperventilation the frequency increased to 21 studies (15 patients). The frequency of severe oligaemia (CBF less than 15 ml) increased from 0.1 to 3% of all regions, or from 2 to 8 of all studies (from 2 to 9 patients). The increased frequency of oligaemia after hyperventilation was correlated to a poor outcome (dementia, vegetative survival or death), where it was observed in 21% of all regions, in 16 of 26 studies and 11 of 15 patients, whereas the frequency in patients with a good recovery was found to be 7% of all regions and observed in 5 of 19 studies (4 of 12 patients). The high frequency of oligaemia after hyperventilation was associated to a low hemispheric CBF before hyperventilation, but not to the level of PaCO2, the level of intracranial pressure, cerebral perfusion pressure or CSF-pH or lactate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711894 TI - Non-traumatic cerebrospinal fluid rhinorrhea: the "normal pressure leaks". AB - Non-traumatic cerebrospinal fluid (CSF) rhinorrhea is an uncommon condition. 15 patients with non-traumatic CSF rhinorrhea having "normal pressure leaks" are presented. Metrizamide CT cisternography failed to reveal the site of the fistula in 3 patients. 11 of the 15 patients underwent surgery for closure of the fistulous communication. In 8 of them the fistula was in the anterior fossa, in one it was in the sellar floor and in two the fistula site was not seen either radiologically or at surgery. In all except the one patient with sellar floor defect an intracranial approach was used. 12 patients have been followed up for 6 months to 9 years and 10 (83%) have been cured of their rhinorrhea. The intracranial approach is preferred to an extracranial approach in the repair of anterior fossa fistulae. Conservative treatment may be effective in selected patients. PMID- 2711893 TI - Rhinorrhea following dopamine agonist therapy of invasive macroprolactinoma. AB - We report on the occurrence of CSF rhinorrhea in a group of 17 patients harbouring macroprolactinomas who were treated with a dopamine agonist (DA, bromocriptine) alone or the combination of DA and transcranial operation. In 2 out of 17 cases shrinkage of tumour remnants during therapy with the oral or injectable form of bromocriptine was responsible for delayed occurrence of rhinorrhea. Operative procedures for successful closure of the fistulae were mandatory in both cases. PMID- 2711895 TI - Perioperative external ventricular drainage in obstructive hydrocephalus secondary to infratentorial brain tumours. AB - Of 148 patients with infratentorial brain tumours which were operated upon during a 5 year period, 59 patients had associated obstructive hydrocephalus, as evidenced by preoperative CT scan. External ventricular drainage was performed in these cases at time of surgery. CSF drainage was continued in the postoperative period for a mean of 2.3 (+/- 1.6) days. Only 6 of these 59 patients (10%) required a subsequent indwelling shunt. The infection rate was 10% and the total mortality was 8%. Perioperative ventricular drainage during and following the removal of posterior fossa tumours causing hydrocephalus provides an effective alternative to the preoperative placement of an indwelling shunt. Problems of shunt dysfunction, tumour seeding and upward herniation are thereby avoided. Postoperative ICP monitoring and drainage of blood and debris laden CSF is performed, increasing the safety of the postoperative period and possibly reducing the incidence of aseptic meningitis and postoperative shunt requirement. PMID- 2711896 TI - Nasal complication after transsphenoidal surgery for pituitary pathologies. AB - A retrospective study was performed to investigate the frequency of nasal complications following sublabial transseptal transsphenoidal surgery for pituitary pathologies. 42 patients were examined. It was noted that more than 50% developed iatrogenic sequelae. It was concluded that a team of neurosurgeons and rhinologists should be established, combining their skills and techniques, to reduce the incidence of iatrogenic sequelae. PMID- 2711897 TI - Experimental radiofrequency (RF) coagulation with computer-based on line monitoring of temperature and power. AB - The safety and reliability of radiofrequency coagulative techniques are questioned after each coagulation, especially in functional neurosurgery. In spite of the high level of technical development of modern surgical RF generators there is still uncertainty about the character of the coagulative lesion. For the present study, a 500 kHz RF generator was connected through a module for analog/digital conversion and for regulation to a personal computer provided with a software programme for the graphic display in real time of the RF power and of the temperature/time curves. The effects of thermocoagulation were studied in fresh egg white, and monopolar lesions were made in the subcortical white matter of rabbits with a probe with a 0.5 mm diameter and a bare tip of 3 mm in length. The regularity of thermocoagulation depends on the accurate temperature reading at the tip of the electrode. The ideal course of the temperature is a smoothly ascending curve from the level of 37 degrees C to the level present for coagulation, followed by a straight horizontal line. With too slow a response of the probe to temperature changes there is an inherent danger of overheating in the initial phase of the procedure. Additionally the power level has to be adjusted for each probe. On line monitoring with graphic display of the physical parameters provides a direct control of the course of the coagulation. Regular curves of the physical parameters without temperature overshoot correspond to reproducible lesions in vitro and in vivo. PMID- 2711898 TI - Establishment of the experimental conditions for inducing saccular cerebral aneurysms in primates with special reference to hypertension. AB - To find out the optimum experimental conditions for the induction of saccular cerebral aneurysms in primates, various procedures for inducing renal hypertension were used in cynomolgus monkeys treated with ligation of unilateral carotid artery and beta-amino-propionitrile feeding. Animals were divided into four groups. In the first group, both kidneys were simultaneously compressed with a figure-eight ligation. In the second group, the kidneys were ligated at an interval of one week. In the third and fourth groups, posterior branches of both renal arteries were ligated at the same time, or at an interval of one week, respectively. Hypertension about 200 mmHg was produced only in the last group and aneurysms were noted in more than half of these hypertensive animals. The best procedure for renal hypertension to induce cerebral aneurysms was proved to be ligation of the posterior branches of both renal arteries at an interval of one week. We can conclude that lasting severe hypertension is essential for inducing cerebral aneurysms in monkeys. PMID- 2711899 TI - Mechanical properties of brain tissue related to oedema development in rabbits. AB - We studied the mechanical properties of the brain in anaesthetized rabbits by application of a standard external load to the exposed cerebral surface. The experimental model used allows one to eliminate potential circulatory factors. Brain oedema was produced by repeated episodes of ischaemia secondary to a decrease of the arterial blood pressure to zero. The development of brain oedema was assessed by an increase of the cerebral water content. In the course brain oedema development brain fluidity was found to steadily rise, while the brain compliance and the index of hysteresis decreased from the control value found at the onset of the experiment. Most important both, brain compliance and the index of hysteresis were already markedly elevated prior to the manifestation of brain oedema. PMID- 2711900 TI - Effect of dexamethasone on various stages of experimental brain abscess. AB - Rats were inoculated with staphylococcus aureus to produce cerebral abscesses and treated with either antibiotic or dexamethasone and with antibiotic plus dexamethasone at sequential stages of abscess formation. Antibiotic alone shortened the cerebritis stage, accelerated the encapsulation and affected the bacterial clearance in the abscess centre when it was started early in the course of cerebritis. Dexamethasone impaired the lymphocytic and fibroblastic responses and delayed the collagen deposition as well as suppressed the efficacy of antibiotic. However, it did not halt entirely the encapsulation and did reduce the associated cerebral oedema. PMID- 2711901 TI - Cystic arteriovenous malformation. A case report. AB - The authors report on a rare case of arteriovenous malformation (AVM) associated with cyst formation. Only five similar cases have been reported. CT findings of the cyst are divided into two types: 1) slit-like low density and 2) round one. Three patients showing slit-like cysts had experienced sudden severe headaches, probably due to haemorrhage. In contrast, two patients showing round cystic lesions had not experienced such sudden headaches and they revealed a nodule in the cyst at surgery. These facts suggest that there may be two different mechanisms for cyst formation in AVM's: haemorrhage and exudation. Slit-like cysts may result from old haemorrhage from the AVM nidus. Round cystic lesions may be due to exudation from the AVM nidus. PMID- 2711902 TI - Parkinsonism in the presence of intracranial extracerebral haematomas. AB - Bilateral Parkinsonism has been observed in a 60-year-old female with a chronic subdural intracranial haematoma. Scattered, poorly marginated, hypodense areas within the ipsilateral pallidus and putamen were evident on the preoperative CT scans. The rapid neurological improvement following the surgical drainage of the subdural clot and the evolution of the densitometric features of the nuclear lesions, which became clear-cut, though smaller, in the following months, suggest a cause-and-effect relation between the haematoma and the clinical symptomatology. To the best of our knowledge this is the first case in which anatomical lesions within the basal ganglia could be detected neuroradiologically. PMID- 2711903 TI - Magnetic resonance imaging of jugular foramen neurinomas. AB - Four cases of jugular foramen neurinoma, extending from the posterior fossa into the temporal bone through the jugular foramen, are reported. The information provided by magnetic resonance imaging was compared with that by computed tomography. Due to the excellent sensitivity, the absence of bone artifacts, and the ease of imaging in any plane, magnetic resonance imaging gave better information particularly about the location of the tumour than X-CT scan did. It included the dumb-bell shaped tumour through the jugular foramen, the extra-axial nature of the tumour, and the precise anatomical relationships between the tumour and the facial and acoustic nerves or the internal carotid artery. Sagittal and coronal views clearly demonstrated the superior and inferior margins of the tumour. The information is very useful not only for preoperative diagnosis but also for planning the surgical approaches and postoperative follow-up. PMID- 2711904 TI - Discectomies of the lower cervical spine using interbody biopolymer (B.O.P.) implants. Advantages in the treatment of complicated cervical arthrosis. A review of 150 cases. AB - The authors report their experience with 150 cases of discectomies performed with interbody grafts using a copolymer (Biocompatible Orthopedic Polymer or BOP). Made of N-Vinylpyrrolidone-Methylmethacrylate monomers, polyamide fibres and calcium gluconate. BOP is a biocompatible, biodegradable, osteoconductive matrix, easy to use and quite safe. These properties are quite well appreciated for cervical interbody grafting. After discectomy, stabilization of the spine is immediate, and fusion slowly occurs around and through the biopolymer within one year. The biomaterial avoids morbidity inherent in the harvesting of an autograft, as well as any limitations resulting from the use of allografts. PMID- 2711905 TI - A two-year prospective follow-up study of the outcome after surgery in patients with slipped lumbar disk operated upon for the first time. AB - 57 patients who were operated upon for the first time for slipped lumbar disk have been investigated in a prospective blind follow-up design. In both the preoperative and postoperative evaluation objective as well as subjective conditions have been considered, and the surgeons have not re-examined the patients. There is a 100% follow-up of the patients. We found that the following preoperative conditions are associated with surgical outcome, 6 and 24 months postoperatively: Medical parameters like statement of pain and surgical findings; social parameters such as being employed, duration of education, and whether you get sufficient social support from family and friends; duration of sick-leave, actions for damages, and number of life events. Psychological parameters such as pain drawing and the MMPI-scales: F, K, Hs, D, Hy, Pa, Pt, Sc, Ma, and Ad. In the statistical analysis multiple linear regression analysis is used, which allows evaluation of the different parameters compared with each other. It is found that conditions such as being employed, increase of the MMPI-scale Ad, alone could explain the 42% difference in surgical outcome. Good outcome is correctly predicted in 88% of the cases with observed good outcome. Poor outcome is correctly predicted in 54% of the cases with observed poor outcome. PMID- 2711906 TI - [Intraoperative radiotherapy in locally advanced carcinoma of the kidney: initial experience]. AB - Intraoperative radiotherapy (IORT) is a rather interesting therapeutic modality in multidisciplinary oncology. Its greatest advantages reside in the approach of deeply seeded abdomino-pelvic tumors. Its inclusion in the therapeutic approach of renal carcinoma with a high local relapse rate has been analyzed in this study in relation to its technical aspects and preliminary clinical results. 11 stage III or IV patients or with local relapse in lumbar fossa were treated with nephrectomy or exeresis surgery and OIRT (10-20 Gy). Surgical exposure of the lumbar fossa and nodal drainage areas was appropriate in dal cases. No toxic signs or sequellae relating to OIRT were observed. Local tumor controls at 8 months of follow-up on the average (range from 2 to 33 months), was 82%. The data obtained in this series suggest the viability of the combined approach nephrectomy or rescue surgery and IORT. The initial clinical results suggest HIGH local tumor control without an increase in the toxicity rate or complications. PMID- 2711907 TI - [Renopleural fistula secondary to xanthogranulomatous pyelonephritis]. AB - A case is presented of renopleural fistula secondary to xantogranulomatous pyelonephritis in an 18-year-old female patient. Although the renopleural communication was not observed radiologically, concomitant clinical signs, bacteriological isolation of E. coli in renal and pleural content and surgical findings, confirmed the existence of such fistula. PMID- 2711908 TI - [Double-J catheter: spontaneous rupture]. AB - A case is presented of spontaneous rupture of a double-J catheter in a 61-year old patient suffering from carcinoma of the prostate gland with urethral entrapment. The patient did not attend visits for periodical catheter changes, suffering the rupture of the catheter in two occasions remaining under those conditions for 20 and 18 months respectively. Removal of the fragments and placing of a new double Pit-Tail, required in both occasions a combination of cystoscopic and percutaneous maneuvers. PMID- 2711909 TI - [Unilateral absence of excretion in urography after external injury]. AB - We communicate a case of unilateral renal non visualization in the pyelogram after an external trauma, due to traumatic occlusion of the main renal artery. The etiology and pathogenesis are reviewed and the frequent associated injuries of other abdominal organs are emphasized. The Pyelogram, used as a screening technique, is useful, though in these situations, CT-scan and rarely angiography are the methods of choice in the evaluation of parenchymal and vascular injures of the kidneys, as well as in evaluating other abdominal organs. El surgical treatment is not necessary early, nephrectomy of the ischemic kidney may be postponed depending on the evolution of the patient. PMID- 2711910 TI - [Melanoma of female distal urethra: apropos of a case]. AB - A case is presented of melanoma located at the distal urethra in a 74-year-old patient who underwent local surgery. At present the survival rate is 5 years and local relapse and metastases of one inguinal ganglion has been observed. The different clinical, diagnostic and therapeutic aspects of this neoplasia are discussed. PMID- 2711911 TI - [Urologic symptoms as first clinical manifestation of tumors of the nervous system. Apropos of 2 cases]. AB - Neurological tumor processes when involving urinary bladder organs or innervation, may give rise to urological symptoms. Depending on the organ or nerve tract affected, and whether such involvement leads to disturbances in the storing or emptying capacity of the bladder, the clinical signs manifested may be extremely varied, simulating different pathological entities that may lead to unnecessary treatment. Two such cases are presented. The symptoms produced and the difficulty in pinning down their origin are discussed. The relevance of urodynamic tests and a permanent attitude of suspicion are highlighted as a key approach to correct diagnosis. PMID- 2711912 TI - [Genito-urinary tuberculosis in acquired immunodeficiency syndrome]. AB - Tuberculosis is being described as a highly associated entity with the acquired immunodeficiency syndrome (AIDS) in countries or geographical areas where this entity is endemic, even becoming its first clinical manifestation. Two cases of prostatic abscess are presented in patients with anti-HIV antibodies, who are parenteral drug users. In one of them, his genitourinary tuberculous infection was the first sign of AIDS. In the other, a previous association with tuberculous meningitis was found. The evolution and pathogenicity of tuberculous genitourinary in AIDS patients is discussed. PMID- 2711913 TI - The relative influence of selected social factors on Korean drinking behavior in Los Angeles. AB - The purpose of this study was twofold: to identify characteristics distinguishing Korean-American drinkers from abstainers and to clarify differences between those who drink smaller versus larger amounts of alcohol. A random sample of 280 Korean adults was interviewed using a schedule based on Cahalan's national study of drinking behavior and attitudes. Approximately 58% of the sample were abstainers while only about 14% were heavy drinkers. Logistic regression was used to determine the relative influence of various social factors on drinking behavior. The logistic model identified five characteristics which differentiated abstainers from drinkers: gender (male), college education, parental opposition, playing indoor games (e.g., cards) and going to bars, and/or nightclubs. A second logistic model clarified the influence of similar characteristics on the level of drinking. Males and those who went to bars and/or nightclubs were most apt to be heavy drinkers whereas participants in sports and Protestants were aligned with more moderate drinking. PMID- 2711914 TI - New mandatory course in alcohol and drug dependence for medical students at the Karolinska Institute. AB - Traditionally, instruction concerning alcohol and drug dependence has been insignificant in medical schools. The Karolinska Institute in Stockholm, Sweden, decided to introduce a special course starting in the academic year of 1983-84. It is given 4 times a year and is of a comprehensive nature. It comprises 2 weeks, 1 week of lectures and 1 week of clinical training and is followed by a separate examination. The first 7 courses from the fall of 1983 to the spring of 1985 are described and evaluated here. Evidently, the new course is much appreciated by the students and there is also a marked shift in opinion towards a more positive attitude in coping with these problems. PMID- 2711915 TI - Self-reinforcement scores of alcoholics. AB - The mean self-reinforcement score of 62 chronic alcoholics was significantly lower than the mean score of 18 age- and sex-matched normal controls. However, both groups scored higher than the mean score of 300 normal undergraduates in a study by Heiby: low self-reinforcement scores do not seem to be unique to alcoholics. In alcoholics, the self-reinforcement scores were significantly correlated with the majority of the MMPI clinical scales: the highest coefficients were with the Social Introversion, Depression, Psychasthenia, and Schizophrenia--lower self-reinforcement level was associated with more psychopathology. PMID- 2711916 TI - Distance from mother and father among alcoholics. AB - The relationship of parental closeness to current behavior and related psychopathological indices is studied among alcoholics. Seventy alcoholics from an inpatient treatment unit and thirty medical inpatients were given a battery of alcohol related measures. These measures included a scale assessing the psychological distance from mother and father, a social closeness measure, an index of anger, a locus of control measure, along with basic alcohol-related information. In addition, the alcoholic sample was given psychometric measures of depression and cognition. Results show that perceived distance from parents is greater among alcoholics than medical patients. Comparison analyses of mother and father distance scores on the study variables of alcohol-related and psychometric measures yielded only a few differences. Correlational analyses showed, however, that distance from mother and father is related to parental alcohol abuse and parents not being at home but not to current behavior (except anger). PMID- 2711917 TI - Monitoring recovery from substance abuse: rationales, methods and challenges. PMID- 2711918 TI - The prevalence and aetiology of long-term L-dopa side-effects in elderly parkinsonian patients. AB - Fifty-one elderly parkinsonian patients (mean age 80 years) on long-term (greater than 5 years) L-dopa therapy were identified from the patients within the three geriatric units in Edinburgh. Side-effects were identified in 57% of patients and tended to be mild in severity. Mean duration of disease was 10.2 years in those with side-effects and 6.7 years in those without (p less than 0.01). Past and present L-dopa side-effects are more likely to be caused by disease progression than by L-dopa therapy. It is therefore recommended that L-dopa should be prescribed at disease onset to elderly Parkinsonian patients. PMID- 2711920 TI - Risk of imbalance in elderly people with impaired hearing or vision. AB - We evaluated the effect of impaired hearing and vision on balance in a sample of 977 elderly people residing in the community. Of the sample, 21% reported balance problems, 27% vision problems, and 30% hearing problems. The increased relative risk for balance problems was 1.7 for each 10-year age increment. Women were 1.7 times more likely to report balance problems than were men. The relative risk of imbalance with impaired vision decreased with age from 2.8 in those aged 65-69 years to 1.0 in those over 85 years. There was no age-hearing interaction, the relative risk for impaired hearing is 1.6. It appears that impaired vision and hearing are important risk factors for imbalance and perhaps falls and injury. PMID- 2711919 TI - Effect of naproxen on renal haemodynamics in elderly patients with arthritis. AB - The effects of naproxen on renal haemodynamics were observed in ten elderly arthritic patients who were otherwise healthy and without clinical evidence of renal disease. Glomerular filtration rate (GFR,51Cr-EDTA clearance) and effective renal plasma flow (ERPF, 125I-iodohippurate clearance) were measured after 2 weeks' treatment with naproxen 500 mg twice daily and again after 2 weeks off the drug, in random order. Baseline values for GFR and ERPF were within normal limits (mean 72 ml/min/1.73 m2, 110% predicted and 326 ml/min/1.73 m2, 111% predicted, respectively). On naproxen, ERPF and renal blood flow decreased by 10% and 9%, respectively (-32 ml/min/1.73 m2; p = 0.05 and -49 ml/min/1.73 m2; p less than 0.01). These events produced no untoward clinical effects. Nevertheless, this response might impair the kidney's ability to preserve GFR if a further stress were to supervene. Consequently, temporary withdrawal of non-steroidal anti inflammatory drugs from elderly patients should be considered in response to intercurrent illness or drug therapy likely to compromise renal blood flow. PMID- 2711921 TI - Mechanisms of vitamin B12 deficiency in elderly inpatients. AB - A protein-bound Schilling test incorporating chick serum was used to study 16 elderly vitamin B12-deficient inpatients. Thirteen of these also underwent standard Schilling tests. They were compared with an age-matched control group of non-deficient inpatients. The lower limit of normal for assimilation of protein bound vitamin B12 was 0.7%. Fourteen out of 16 deficient patients assimilated protein-bound vitamin B12 subnormally. Twelve of these were fully Schilling tested. Five assimilated free B12 normally, and five responded to intrinsic factor. One patient did not respond to intrinsic factor and had jejunal diverticulosis and one could not be categorized. One of two patients with normal assimilation had a borderline vitamin B12 intake. No subjects had neurological sequelae and only three were anaemic. In this population, B12 deficiency is usually asymptomatic but nearly always results from impaired assimilation possibly justifying replacement therapy. Schilling testing only affects treatment if there is other evidence of small-bowel dysfunction. PMID- 2711922 TI - The need for a more rational approach to drug prescribing for elderly people in nursing homes. AB - In order to establish the pattern of drug use in Irish nursing homes and to compare prescribing rates with those in other countries, drugs prescribed during a 1-week period for 301 residents in 11 nursing homes were recorded. A mean of four drugs (range 0-14) was prescribed per patient and 41% of patients were taking five drugs or more. Forty-two per cent of patients were prescribed potentially interacting combinations and in particular the use of drugs with additive sedative or anticholinergic effects was common. The mean number of drugs prescribed ranged from 2.3 to 5.6 in the different nursing homes, the most notable differences being in the use of digoxin, vitamins, hypnotics and psychotropic drugs. Prescribing rates were similar to those reported from the United Kingdom but very different from data for the United States where prescribing rates for laxatives, neuroleptics and analgesics are higher. Marked variation in prescribing both between institutions and between countries as well as the quantity and pattern of prescribing led to the conclusion that prescribing is less than optimal in this clinical setting. However, additional studies linking diagnosis and prescribing are required to test this hypothesis. PMID- 2711923 TI - A survey of private nursing home residents in Weston Super Mare. AB - A representative sample of 351 patients in Private Nursing Homes in Weston Super Mare was surveyed with regard to their origins, admission assessment and continuing care, with particular reference to the nature of medical review during their residency. The results suggest inadequate medical care especially for 'imported' patients and those admitted for psychiatric reasons. PMID- 2711924 TI - Hypothesis: old people would benefit from a patient-held standardized primary health care record. AB - While many advances have been made in primary health care, for old people it has lagged behind other areas. The case is made for the adoption of a standard primary-care record for people aged over 70 years to be retained by the patient and attached behind the front door, where it would be available to ambulance crews, deputizing doctors and other community health workers. It would also be of value to the elderly patient when travelling or registering with a new doctor. Such a focus on information would facilitate communication between professional workers and increase productivity. PMID- 2711925 TI - Inhaler technique and elderly patients. PMID- 2711926 TI - Regulation of mediator release and function. 10th European Workshop on Inflammation. Rotterdam, The Netherlands. April 17-19, 1988. Proceedings. PMID- 2711927 TI - Modulation of PAF biosynthesis in human polymorphonuclear leukocytes. The role of phorbol esters and protein kinases. PMID- 2711928 TI - The effects of PAF-acether and FMLP on eicosanoid production in guinea pig alveolar macrophages. PMID- 2711929 TI - Role of platelet activating factor in the endotoxin induced tracheal hyperreactivity to histamine in the guinea pig. PMID- 2711930 TI - Effect of PAF acether on oriented egg phosphatidylcholine multibilayers; interaction with cholesterol; comparison to lyso-PC and lyso-PAF. PMID- 2711931 TI - Effects of topically applied glucocorticosteroids on patch test responses and recruitment of inflammatory cells in allergic contact dermatitis. AB - The effects of repeated topical application of a strong glucocorticosteroid (GCS) on patch test responses and the inflammatory infiltrate were studied in twenty nickel allergic patients. Patch test responses were strongly inhibited in 18 out of 20 patients. Immunohistochemical analysis revealed marked reductions in CD1+(T6+) Langerhans cells, activated inflammatory T cells and of mast cells in the skin. It is concluded that GCS suppress contact allergic responses by reduction, or functional inhibition of antigen presenting cells. The reduced number of mast cells release less vasoactive mediators, inhibiting recruitment of inflammatory cells. PMID- 2711932 TI - Glucocorticoid receptors in alveolar macrophages: methodological aspects of the determination of the number of glucocorticoid receptors per cell. AB - Among patients with asthma or chronic obstructive pulmonary diseases the response to glucocorticoids varies considerably. To investigate the possible relationship between clinical response and number of glucocorticoid receptors in alveolar macrophages or their KD value a micro receptor assay was developed. Assay conditions were adjusted because of receptor occupancy by endogenous or therapeutically used glucocorticoids and high aspecific binding. PMID- 2711933 TI - Treatment of colon cancer in rats with rMuTNF and the interferon-inducer bropirimine. AB - It is well documented that the antitumor activity of tumor necrosis factor (TNF) is improved by interferons (IFN's). Bropirimine (BP) is an immune response modifier which induces IFN. Both TNF and BP have the capacity to inhibit the growth of a transplantable colon tumor (CC531) in inbred WAG rats. In the present study their combined use was investigated in a one-week assay, with the tumor implanted under the renal capsule. The results indicate that BP, given on days 0 and 1, and 1 microgram TNF on days 0, 2 and 4 act additively, leading to an almost complete inhibition of tumor growth. PMID- 2711934 TI - Regulation of eicosanoid synthesis in mouse peritoneal macrophages by protein kinase C. PMID- 2711935 TI - Chondrocyte unresponsiveness to insulin-like growth factor-1. A novel pathogenetic mechanisms for cartilage destruction in experimental arthritis. PMID- 2711936 TI - Defective intracellular killing of micro-organisms by murine alveolar macrophages. AB - Peritoneal and alveolar macrophages differ in phenotype, endocytic activities, and oxidative metabolism. PMID- 2711937 TI - A new model for inflammatory colonic disease induced by capsaicin in rats. PMID- 2711938 TI - Directional cellular movement of cell populations: its description by chemotactic assays. AB - Chemotaxis (CT) of cells is an important factor in the defense of organisms. For the study of this process several assays are available using the Boyden chamber. Its popularity, however, has led to a use of the system of which the basic qualities are not always known and so may lead to erroneous interpretation of results. Experiments were performed with the purpose of elucidating the significance of parameters regularly used in CT: 1. the cell count at the bottom of the permeable filter, 2. a chemotactic index, and 3. the leading front method. Neutrophils and eosinophils were stimulated with FMLP (10(-13)-10(-3) M). It appeared that: 1. the parameters are indicative only for (small) parts of the cell population, 2. for the comparison of effects of compounds complete concentration-effect relationships are needed, 3. to avoid cell to cell interactions a maximal cell purity is desired, and 4. if possible, no combinations of chemotactic agents should be tested. PMID- 2711939 TI - Repeated application of arachidonic acid to the ear of mice: a model of chronic skin inflammation? PMID- 2711940 TI - Topical anti-inflammatory activity of a new acylated flavonoid. PMID- 2711941 TI - Neurogenic inflammation: axon reflex in pigs. PMID- 2711942 TI - Hydrogen peroxide production by inflammatory cells ex vivo: alteration by dexamethasone and diclofenac. PMID- 2711943 TI - Antagonism by D-penicillamine of the suppression of PWM-stimulated mononuclear cells by chloroquine. PMID- 2711945 TI - The effect of adrenalectomy on eicosanoid formation in blood platelets after aggregation and in the thymus of the rat. PMID- 2711944 TI - Endotoxin protection against pulmonary oxygen toxicity and its reversal by acetyl salicylic acid: role of eicosanoid production by broncho-alveolar lavage cells. AB - Small doses of endotoxin markedly increase the survival rate of adult rats exposed to 98% oxygen for periods that are normally lethal. The lysine salt of acetyl salicylic acid (L-ASA) partially reverses this protective effect of endotoxin. In this pilot study we investigated the level of eicosanoid production by broncho-alveolar lavage (BAL) cells and found that BAL cells of endotoxin protected rats, present in abundance, have an equal or increased capacity of HHT, 15-HETE, 12-HETE, LTB4 and 5-HETE production. These data suggest that production of the lipoxygenase products by BAL cells does not seem to play an important role in the pathogenesis of pulmonary oxygen toxicity. We did not find any indication for the occurrence of shunting of arachidonic acid metabolism to the lipoxygenase pathway as an explanation for the reversal of endotoxin's protective action by L ASA. PMID- 2711946 TI - Enhancement of the phospholipase A2 activity in fMLP-treated guinea-pig alveolar macrophages. PMID- 2711947 TI - Histamine determination in the blood during the immediate asthmatic response (IAR). PMID- 2711948 TI - Prostaglandin modulation of mast cell-dependent inflammation. PMID- 2711949 TI - Patients with chronic bronchitis differ in their mast cell subtypes as compared with normal subjects. AB - Mast cells were isolated by enzymatic digestion from lung tissue obtained from patients with chronic obstructive lung disease and from normal subjects. Two mast cell subtypes could be demonstrated in human lung tissue. Mast cell subtypes were differentiated in formalin-sensitive and formalin-insensitive mast cells. It appeared that compared with normal individuals, patients suffering from chronic bronchitis had increased numbers of mast cells of the formalin-sensitive type, whereas patients with emphysema had reduced numbers, but the same ratio, of both mast cell subtypes. PMID- 2711950 TI - Respiratory airway hyperreactivity coincides with decreased epithelium-derived PGE2. PMID- 2711951 TI - Electrically stimulated Krebs-Henseleit buffer does not relax precontracted human bronchi in vitro. AB - Electric field stimulation (EFS) causes a non-adrenergic relaxation of precontracted human airways. Only 10-20% of this response can be blocked with the nervous conductance blocker tetrodotoxin (TTX). Therefore, 80-90% of the non adrenergic relaxation is not neurally mediated. The mechanism of this non-neural component is unclear. We examined whether EFS induces the generation of muscle relaxing substances in oxygenated Krebs-Henseleit buffer. Strips of central airways of 6 patients were precontracted with methacholine (10(-5) M) and exposed to Krebs buffer that had previously been stimulated with EFS (50 V, 0.3 ms, 30 s, 1-50 Hz). Results were compared to those obtained with unstimulated buffer. The contractile state of the airways did not change significantly with either EFS stimulated or unstimulated buffer. We conclude that in oxygenated Krebs buffer EFS does not cause generation of substances that change the contractile state of prestimulated human airways. PMID- 2711952 TI - In vivo anaphylaxis in the rat: effects of phosphodiesterase inhibitors. AB - On the basis of their inhibitory capacities on the phosphodiesterase enzyme system, we studied the anti-anaphylactic effect of milrinone and sulmazole in comparison with theophylline. For this purpose anaphylactic shock was induced in actively sensitised, spontaneously breathing rats. Milrinone, sulmazole and theophylline reduced anaphylactic bronchoconstriction without affecting the antigen induced fall in blood pressure. Surprisingly, sulmazole reduced mortality significantly. PMID- 2711953 TI - Lipoxin A4 causes generation of thromboxane A2 in the guinea-pig lung. PMID- 2711954 TI - Pharmacodynamics of lipoxin A4 in airway smooth muscle. PMID- 2711955 TI - Helicopter transport of ruptured abdominal aortic aneurysms. PMID- 2711956 TI - An education in college financing. By AMA Advisers, Inc. PMID- 2711957 TI - A rare cause of stump pain--herniated lumbar disc. A case report. PMID- 2711959 TI - State licensure under fire: a reply. PMID- 2711958 TI - Quantifying the unquantifiable. PMID- 2711960 TI - The case of Dr. Y. PMID- 2711961 TI - Critical pulmonary valve stenosis in patients less than 1 year of age: treatment with percutaneous gradational balloon pulmonary valvuloplasty. AB - A new technique of percutaneous gradational balloon pulmonary valvuloplasty was used successfully in 17 infants less than 1 year of age, including four neonates, with critical congenital pulmonary valve stenosis, who would otherwise have required surgical intervention. This technique uses a sequential series of balloon catheters of gradually increasing size as a means of eventually crossing the very small valve orifice with a balloon catheter of adequate size to achieve successful pulmonary valvuloplasty. The initial dilatations were achieved with balloon catheters 2, 3, or 4 mm in diameter. Immediately after successful balloon valvuloplasty, the mean pulmonary systolic pressure gradient was reduced from 105 +/- 11 to 20 +/- 5 mm Hg. Percutaneous balloon pulmonary valvuloplasty can be performed safely with good results despite critical congenital pulmonary valve obstruction in severely ill infants. PMID- 2711962 TI - Presence of angina pectoris before acute myocardial infarction and degree of residual stenosis after coronary thrombolysis. AB - This study tested the hypothesis that the degree of residual stenosis after coronary thrombolysis reflected that of original stenosis presented by symptom of angina before acute myocardial infarction (AMI). The relation between the presence of angina before AMI and the degree of residual stenosis after coronary thrombolysis was observed in 57 patients with successful coronary thrombolysis for AMI. Patients with significant coronary artery stenoses other than the artery responsible for AMI were excluded from this study. In 22 patients with chronic angina for 2 weeks or longer before AMI, 14 patients had a residual stenosis of 75% or more and 8 patients had a residual stenosis of less than 75%. In 35 patients with angina for less than 2 weeks or not at all before AMI, 9 patients had a residual stenosis of 75% or more, and 26 patients had a residual stenosis of less than 75% (p less than 0.01). In the course of progression of coronary artery disease, some patients had AMI without severe underlying stenosis and others with severe underlying stenosis. Patients with chronic angina before AMI might tend to have AMI with acute occlusion superimposed on the severe organic stenosis. Patients without chronic angina before AMI would be more at risk for AMI caused by acute occlusion without underlying severe stenosis. PMID- 2711963 TI - Emergency room infusion of intravenous streptokinase in acute myocardial infarction: feasibility, safety, and hemodynamic consequences. AB - Between September 1, 1986, and December 31, 1987, sixty-four consecutive patients younger than 70 years, with early (less than 4 hours) symptoms and signs of myocardial infarction, were treated with 1.5 million units streptokinase intravenously in the emergency room (ER group) before admission to the coronary care unit. Data from these patients were compared in retrospect to those of 66 consecutive patients with myocardial infarction who were treated with intravenous streptokinase in the coronary care unit (CCU group) before September 1, 1986. Time between first symptoms and initiation of fibrinolytic therapy was significantly shorter in the ER group: 114 +/- 53 minutes vs 150 +/- 56 minutes in the CCU group (p less than 0.001). The incidence of in-hospital complications was similar in both groups. However, left ventricular stroke work index during the stay in the coronary care unit was 50 +/- 19 gm/m2 in the ER group vs 42 +/- 14 in the CCU group (p = 0.02). Also the echocardiographic left ventricular wall motion score at 48 hours after admission tended to be better in the ER group: 6.7 +/- 4.0 compared to that in the CCU group (7.6 +/- 4.5; p = 0.29). In conclusion, infusion of intravenous streptokinase in the emergency room is feasible and safe and results in a significant time gain leading to a better hemodynamic profile. Within the hospital the emergency room is the ideal place for intravenous fibrinolytic therapy in eligible patients with acute myocardial infarction. PMID- 2711964 TI - Predictors of sustained ventricular tachycardia inducibility in patients with nonsustained ventricular tachycardia and chronic coronary artery disease. AB - To assess the likelihood of inducing sustained ventricular tachycardia, we analyzed a cohort of 58 retrospective and 18 prospective patients with chronic coronary artery disease who underwent electrophysiologic study because of spontaneous nonsustained ventricular tachycardia (three or more beats, lasting less than 30 seconds, at a rate greater than 100/min). In 24 of the 58 retrospective patients (41%) sustained ventricular tachycardia was inducible. Stepwise logistic regression identified two "major" variables--left ventricular aneurysm/dyskinesis/akinesis (p = 0.0001; relative risk = 11.88) and ejection fraction less than 40% (p = 0.0002; relative risk = 9.69)--and one "minor" variable--nonsustained ventricular tachycardia longer than 10 beats (p = 0.0151; relative risk = 4.21)--as significant predictors of inducibility. Nineteen patients with both major variables had a high probability of inducibility (greater than 90%). Nineteen patients with neither major variable had a low probability of inducibility (less than 5%). The remaining 20 patients with only one of the major variables had an intermediate probability of inducibility (14% to 75%). The significance of the third minor factor, nonsustained ventricular tachycardia longer than 10 beats, was confined to this intermediate group, in which it could be used to segregate relatively high (65% to 75%) and relatively low (14% to 20%) probability of inducibility. Prospective application of the predictor function stratified 18 additional patients into three groups with high (six patients), intermediate (seven patients), and low (five patients) probability of inducibility. The observed rate of inducibility in each group was 5 of 6 (83%), 2 of 7 (29%), and 0 of 5 (0%), respectively. These data suggest that patients with nonsustained ventricular tachycardia and chronic coronary artery disease can be stratified into subgroups with high, intermediate, and low probability of inducibility of sustained ventricular tachycardia on the basis of ejection fraction and regional ventricular wall motion defects alone. PMID- 2711965 TI - Therapeutic serum lidocaine and metabolite concentrations in patients undergoing electrophysiologic study after discontinuation of intravenous lidocaine infusion. AB - Serum concentrations of lidocaine and its metabolites monoethylglycinexylidide (MEGX) and glycinexylidide (GX) were measured in seven patients after discontinuation of intravenous lidocaine necessary for control of spontaneous arrhythmias prior to electrophysiologic study. Standard loading doses of lidocaine were given intravenously followed by 2 mg/min infusions for 79.5 +/- 6.5 hours. Electrophysiologic studies all started more than 5 half-lives or 7.5 hours after discontinuation of intravenous lidocaine. Local anesthesia with subcutaneous lidocaine (mean 162 +/- 96 mg) was administered in six patients. Plasma concentrations of lidocaine and its metabolites were determined at the termination of the infusion, 2 and 4 hours afterwards, at the start of the electrophysiologic study prior to local anesthesia, and at the end of the study. Levels were also determined at 12 and 24 hours after discontinuation of the infusion. Mean plasma concentrations of lidocaine, MEGX, and GX at the start of the study were 1.02, 0.86, and 0.62 micrograms/ml, respectively. These had increased to 2.78, 0.92, and 0.68 by the end of the electrophysiologic study. One patient with coronary artery disease and prior out-of-hospital ventricular fibrillation had a therapeutic lidocaine level and no inducible arrhythmia at the time of the initial study. At a subsequent electrophysiologic study, no lidocaine or metabolites were detected in the serum and ventricular fibrillation was induced. Thus using the reported half-life of 90 minutes and discontinuing lidocaine 5 half-lives prior to electrophysiologic evaluation does not ensure lack of electrophysiologic effects of the parent compound or its metabolites. Lidocaine given for local anesthesia further increases lidocaine and metabolite levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711966 TI - The effect of an unsuccessful subthreshold shock on the energy requirement for the subsequent defibrillation. AB - The effect of an unsuccessful subthreshold shock on the energy requirement for the subsequent defibrillation was studied in 10 anesthetized dogs. Defibrillation was achieved with a spring catheter electrode in the superior vena cava and a patch electrode on the anteroapical ventricular wall. Success rates of defibrillation 20 seconds from the onset of ventricular fibrillation were determined at three energy levels with and without a preceding subthreshold shock. Altogether, 637 episodes of fibrillation-defibrillation were performed (63.7 +/- 6.7 per dog). Predicted energy levels for defibrillation success rates of 50% and 80% (E50 and E80) acquired from a logistic regression curve were 0.0303 +/- 0.0064 and 0.0367 +/- 0.0069 joule/gm, respectively, without subthreshold shocks. E50 and E80 with an unsuccessful subthreshold shock resulted in comparable values (E50: 0.0325 +/- 0.0041 joule/gm; E80: 0.0.380 +/- 0.0100 joule/gm). Our results suggest that an unsuccessful low-energy shock does not alter the energy requirement for subsequent defibrillation with an implantable defibrillator. PMID- 2711967 TI - Exercise-related changes in serum catecholamines and potassium: effect of sustained exercise above and below lactate threshold. AB - Plasma potassium and catecholamines exhibit rapid shifts during exercise testing, particularly when exercise intensity exceeds lactate threshold. To assess changes that may occur during sustained exercise, we studied 10 healthy men to determine the effect of 20 minutes of exercise at 25 W above lactate threshold (ALT) and 20 minutes of exercise at 25 W below lactate threshold (BLT). Both conditions showed elevation of catecholamines at end exercise compared to baseline, but catecholamine levels ALT were significantly higher than the levels BLT (2270 +/- 190 versus 900 +/- 230 pg/ml norepinephrine, p less than 0.001; 509 +/- 69 versus 150 +/- 18 pg/ml epinephrine, p less than 0.001). This difference persisted at 2 minutes of recovery (1620 +/- 130 versus 590 +/- 60 pg/ml norepinephrine, p less than 0.001; 216 +/- 31 versus 98 +/- 16 pg/ml epinephrine, p less than 0.001). Both conditions resulted in a significant elevation in potassium at end exercise compared to baseline, but the potassium levels ALT were significantly higher than the levels BLT (1.1 +/- 0.1 mEq/L versus 0.5 +/- 0.1 mEq/L, p less than 0.001. The fall in potassium in the immediate post-exercise period was significantly greater following exercise ALT (-0.8 +/- 0.1 mEq/L versus -0.2 +/- 0.1 mEq/L, p less than 0.001). Thus sustained exercise slightly ALT resulted in a significant potassium flux and very elevated catecholamine levels. Avoiding these metabolic stresses by exercising BLT may decrease chances for exercise-related arrhythmia or other cardiac dysfunction in susceptible patients. PMID- 2711968 TI - Clinical value of serum digoxin assays in outpatients: improvement by the standardization of blood sampling. AB - Everyday physical activity previously has been shown to affect serum digoxin concentrations. Standardized rest in the supine position increases outpatient serum digoxin levels 0% to 75%. The present study comprising 56 outpatients treated with digoxin was undertaken to elucidate the clinical importance of a standardized period of rest before collection of the blood sample. Blood samples were taken about 24 hours after the latest dose, before and after 2 hours of rest in the supine position. A careful clinical examination, including electrocardiogram (ECG) findings, systolic time intervals, and chest x-ray studies, was performed to identify adverse effects/intoxication or failure of digitalis treatment. Signs of failure of digitalis treatment occurred in 12% of the patients, with a serum digoxin concentration of 0.68 +/- 0.15 (mean +/- SD) nmol/L before rest and 0.85 +/- 0.22 nmol/L after rest. Eleven percent showed signs of adverse effects/intoxication, with serum digoxin concentrations of 1.70 +/- 0.70 nmol/L before rest and 2.08 +/- 0.80 nmol/L after rest. The serum digoxin concentrations of the adequately treated patients (77%) were 1.02 +/- 0.35 nmol/L before rest and 1.28 +/- 0.41 nmol/L after rest. The importance of standardized rest before blood sampling is illustrated by the fact that only one third of the patients without signs of adverse effects/intoxication or failure of digitalis treatment had serum digoxin concentrations within the therapeutic range most commonly used (1.2 to 2.6 nmol/L) without supine rest. If allowed to rest in the supine position before blood sampling, approximately 60% of the adequately treated patients had serum digoxin concentrations within this range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711969 TI - Life-threatening hyperkalemia in severe heart failure. AB - The therapeutic course of patients with severe heart failure can be complicated by disturbances in potassium homeostasis. Although hypokalemia in more prevalent, hyperkalemia may occur. Among 730 consecutive patients admitted to the hospital because of heart failure, nine episodes of acute, life-threatening hyperkalemia (mean serum potassium level: 7.2 +/- 0.5 mEq/L) were diagnosed in six patients (0.8%) with severe chronic heart failure during maintenance oral potassium therapy and exacerbation of heart failure and/or after additional oral doses had been administered for correction of hypokalemia. Of nine hyperkalemic episodes observed, one was fatal, seven episodes were successfully treated, and one resolved spontaneously. Only one patient was receiving an angiotensin-converting enzyme inhibitor. An awareness of this complication and the clinical setting in which it is likely to occur could lead to earlier recognition and successful management. PMID- 2711970 TI - Value of color Doppler estimation of regurgitant volume in patients with chronic aortic insufficiency. AB - We studied 16 patients with chronic aortic insufficiency to compare a method for measuring regurgitant volume with color Doppler flow mapping to stroke count ratio determined by radionuclide ventriculography and to ventricular volumes assessed by two-dimensional echocardiography. A real-time color flow map of the left ventricular was obtained from an apical two- and five-chamber view and the maximal mosaic pattern of diastolic turbulent flow was planimetered as a reflection of the maximal regurgitant volume using biplane Simpson's rule. The maximal Doppler regurgitant volume evaluated by color Doppler flow mapping correlated with the stroke count ratio measured by scintigraphy (r = 0.86, SEE = 11 cc). There were significant relationships between maximal regurgitant volume measured by color Doppler and echocardiographic left ventricular end-diastolic volume (r = 0.88), left ventricular end-systolic volume (r = 0.77), and left ventricular mass (r = 0.71). Patients with larger regurgitant volumes tended to have a larger left ventricular end-diastolic volume-to-mass ratio (r = 0.56). Thus maximal aortic regurgitant volume can be estimated noninvasively with color Doppler flow mapping. The measurement appears to relate to left ventricular morphologic changes occurring in this condition and it may prove to be useful in assessing patients with chronic aortic insufficiency and in determining their long-term management. PMID- 2711971 TI - Diastolic mitral regurgitation in acute but not chronic aortic regurgitation: implications regarding the mechanism of mitral closure. AB - In acute aortic regurgitation, left ventricular pressure rises rapidly during diastole, which produces presystolic mitral valve closure. This does not occur in chronic aortic regurgitation. Since normal, nonregurgitant mitral valve closure may depend on properly coordinated atrial and ventricular contractions, we hypothesized that abnormal mitral valve closure occurring before systole in acute aortic regurgitation may produce diastolic mitral regurgitation detectable by Doppler echocardiography. Accordingly, we performed ultrasonic Doppler examination of seven patients with acute aortic regurgitation and 12 patients with chronic aortic regurgitation. Regurgitant aortic flow was severe in all cases. Doppler sampling within the left atrium demonstrated regurgitant mitral flow in late diastole in all patients with acute aortic regurgitation. The onset of diastolic mitral regurgitation coincided with mitral valve preclosure in patients with acute aortic regurgitation and occurred regardless of the position of the mitral leaflets at the initiation of closure. In contrast, none of the 12 patients with chronic aortic regurgitation had mitral valve preclosure or diastolic mitral regurgitation (p less than 0.05 versus acute aortic regurgitation). We conclude that diastolic mitral regurgitation accompanies mitral valve preclosure, which occurs in acute but not chronic aortic regurgitation. Thus diastolic mitral regurgitation may be a Doppler sign of acute aortic regurgitation, in the absence of a markedly prolonged PR interval. Furthermore, this observation suggests that normal, nonregurgitant mitral closure requires more than an increase in left ventricular pressure above left atrial pressure, regardless of the position of the mitral leaflets before closure. PMID- 2711972 TI - Noninvasive evaluation of mitral regurgitation by analysis of left atrial signal loss in cine magnetic resonance. AB - Magnetic resonance imaging that uses shallow flip angles, short repetition times, and gradient refocused echoes results in multiple images throughout the cardiac cycle in which the blood pool has high signal intensity. In cine magnetic resonance images, disturbed (high velocity) blood flow produces a loss of signal intensity within the intracavitary blood pool, which makes this technique potentially useful for evaluating valvular disease. Multilevel cine magnetic resonance imaging was performed in 26 patients with mitral regurgitation (MR) documented and graded for severity by Doppler echocardiography or contrast ventriculography. Intracavitary left atrial signal intensity was analyzed in order to derive parameters that reflect the severity of the lesion. Seven normal volunteers were studied for comparison. All regurgitant lesions were visualized in cine magnetic resonance images as discrete regions of systolic signal loss extending from the mitral valve into the left atrium. The extent and degree of signal loss correlated well with severity. In patients with mild MR, signal loss was seen in 3.3 +/- 1.2 (+/- SD) anatomic levels compared to 4.9 +/- 1.4 levels in patients with moderate MR (p = NS), and in 7.0 +/- 1.4 levels in patients with severe MR (p less than 0.001 versus mild MR). The total area of maximal systolic left atrial signal loss seen in all levels was 10 +/- 6 cm2 in mild versus 31 +/- 17 cm2 in moderate (p less than 0.001) and 96 +/- 30 cm2 in severe MR (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711973 TI - Doppler color flow mapping studies of jet formation and spatial orientation in obstructive hypertrophic cardiomyopathy. AB - To help clarify the mechanism of outflow tract obstruction and systolic anterior motion of the anterior leaflet of the mitral valve and their relation to the geometry of the left ventricle, we studied left ventricular outflow tract flow in 20 patients with hypertrophic cardiomyopathy (HCM) using two-dimensional Doppler flow mapping. We compared our results with outflow tract flow in 10 patients with isolated valvular aortic stenosis, (AS) and with those in 10 healthy volunteers. In HCM, a 94- to 145-degree angle (mean 111.4 +/- 11.9 degrees) developed between the direction of left ventricular outflow tract flow acceleration and aortic valve outflow, resulting in posterolaterally directed left ventricular outflow jets. The angle of the outflow jet and the peak velocity of the jet measured with continuous wave Doppler (as an indicator of the severity of obstruction) correlated well (r = -0.81, SEE = 7.8 degrees). Jet narrowing during ejection measured just proximal to the point of systolic anterior motion was 42 +/- 11% in HCM and was weakly correlated with peak jet velocity (r = 0.61, SEE = 8.9 degrees). Aliasing of left ventricular outflow occurred proximal to systolic anterior motion of the mitral valve, and color M-mode demonstrated temporal and spatial flow acceleration proximal to systolic anterior motion, providing evidence for obstruction at that site. In AS, left ventricular outflow tract jets were more parallel to the axis of aortic outflow (129 to 153 degree, 138.4 +/- 8.1 degrees). Jet narrowing was only 8 +/- 5% compared to HCM (both p less than 0.05), and flow acceleration occurred proximal to the stenotic valve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711974 TI - The aortic root in subaortic stenosis. AB - This study investigated the size of the aortic root (AoR) and its effect on surgical outcome in patients with fixed subaortic stenosis. The diameter of the AoR was measured in two groups by means of two-dimensional echocardiography. Group A consisted of 138 normal subjects, aged 3 weeks to 20 years (mean 7.5 years). Group B consisted of 28 patients with fixed subaortic stenosis, aged 1.5 to 18 years (mean 9.5 years), 21 of whom had undergone surgical resection of the stenosis. Normal values and growth curves for AoR diameter were obtained from patients in group A. There was marked retardation of growth of the AoR among patients in group B, with seven patients having a small AoR diameter (less than 2 standard deviations). Postoperative gradients had a high correlation with the small size of diameter of the AoR (r = -0.84). In fixed subaortic stenosis the AoR may be small (25%). The presence of a small AoR has a marked effect on the optimal relief of fixed subaortic stenosis. The diameter of the AoR should be measured preoperatively, inasmuch as special surgical techniques may be required. PMID- 2711975 TI - Tuberculous pericarditis: long-term outcome in patients who received medical therapy alone. AB - A conservative approach to operative intervention in the treatment of active tuberculous pericarditis was adopted and only 4 of 16 consecutive patients underwent pericardiectomy, all within 2 months of diagnosis. One patient died of constrictive pericarditis despite pericardiectomy, and one died of acute bronchopneumonia after 8 months of otherwise successful medical management. All 14 long-term survivors were reevaluated to exclude chronic constrictive pericarditis and other potential sequelae of tuberculous pericarditis. Reevaluation included physical examination, chest radiograph, electrocardiogram, M-mode and two-dimensional echocardiogram, computed tomography (CT) scan, and in patients less than or equal to 75 years of age, incremental cycle exercise to maximum oxygen consumption. None were found to have chronic constrictive pericarditis or convincing evidence of other recognized complications of tuberculous pericarditis. Our results suggest that when pericardiectomy is not required for the relief of cardiac compression during the acute phase of tuberculous pericarditis and patients are treated with medical therapy alone, an excellent long-term outcome may be anticipated. PMID- 2711976 TI - Percutaneous coronary angioscopy by means of a fiberscope with a steerable guide wire. PMID- 2711977 TI - Low-energy electrical catheter ablation of sustained ventricular tachycardia originating from the right ventricle. PMID- 2711978 TI - Extraluminal contrast pooling on coronary angiography as an expression of ruptured atheromatous plaque. PMID- 2711979 TI - The hemodynamics of left ventricular pseudoaneurysm: color Doppler echocardiographic study. PMID- 2711980 TI - Pacemaker lead-induced tricuspid stenosis: diagnosis by Doppler echocardiography. PMID- 2711981 TI - Mitral and pulmonary vein blood flow patterns in cor triatriatum. PMID- 2711983 TI - Medicare catastrophic drug benefit: APhA's role. PMID- 2711982 TI - Severe hemolytic anemia following mitral valve repair. PMID- 2711984 TI - Slow-release theophylline: do not substitute. PMID- 2711985 TI - Slow-release theophylline: substitute only AB-rated products. PMID- 2711986 TI - New drugs of 1988. PMID- 2711987 TI - Establishing a market niche: meeting the competitive challenge. PMID- 2711988 TI - Safety and characteristics of exercise testing early after acute myocardial infarction. AB - Five hundred and seventy physicians, researchers and clinicians (42% response) responded to a mailed questionnaire about the safety and nature of exercise testing conducted less than or equal to 4 weeks after acute myocardial infarction (AMI). Of 570 institutions, 193 reported that they routinely performed testing early after AMI and data were provided on 151,949 tests. A majority (111 or 58%) used a low-level testing protocol, 50 (26%) used symptom-limited testing and 32 (16%) used both types. Testing was routinely conducted less than or equal to 14 days after AMI by 147 (76%) respondents, whereas 46 (24%) tested 15 to 28 days after AMI. Thirty-three (17%) respondents used a standardized research protocol and 160 (83%) did not. There were 41 (0.03%) fatal, 141 (0.09%) major nonfatal and 2,124 (1.4%) other cardiac complications reported during testing. No difference in incidence of major complications was observed at centers using a clinical versus research protocol. Compared with clinic-based testing, hospital based testing had an increased risk for all major (2.1) and nonfatal major complications (2.1). Although a symptom-limited protocol increased the overall risk for major cardiac complications by 1.9 times compared with a low-level protocol, the incidence of fatal complications during symptom-limited testing (0.03%) was quite low and this greater risk is of dubious clinical importance. PMID- 2711989 TI - Comparison of coronary vasomotor responses to nifedipine in syndrome X and in Prinzmetal's angina pectoris. AB - To test whether calcium channel blockade plays a similar role in the coronary vasomotion of patients with syndrome X (n = 29) and patients with Prinzmetal's angina pectoris (n = 12), quantitative angiography was used to evaluate the effect of nifedipine (10 mg, sublingually) on the lumen diameter of proximal, mid and distal thirds of normal epicardial branches. The main differences in the coronary vasomotor reaction were uniform vasodilatation in Prinzmetal's angina and a variable response to syndrome X, and a greater increase in the coronary lumen in patients with Prinzmetal's angina as compared with those with syndrome X who showed vasodilatation. The variable response in syndrome X was not related to changes in diastolic pressure and cardiac output. Patients showing coronary constriction were those who responded to nifedipine with a higher degree of tachycardia, which might suggest a neural participation in the paradoxic reaction to this drug. In the Prinzmetal group, on the contrary, at a similar heart rate increase the pattern was invariably vasodilatation. Thus, calcium ions appear to have a different role in the coronary smooth muscle contractility of the 2 series of patients; in fact, in Prinzmetal's angina nifedipine relaxed the coronary arteries to a greater degree and made them unresponsive to stimuli that were still able to cause vasoconstriction in patients with syndrome X. PMID- 2711990 TI - Usefulness of nicardipine as monotherapy for chronic, stable angina. AB - Using a double-blind, Latin square protocol designed to detect dose response, nicardipine hydrochloride, a new calcium antagonist, was studied as monotherapy for stable exertional angina. Eighty-one patients were enrolled in the trial and 62 patients were included in greater than or equal to 1 primary efficacy analyses. Patients received 1 to 2 weeks of placebo run-in, then 5 weeks of treatment with placebo and with 10, 20 and 30 mg of nicardipine given 3 times daily. Patients completed symptom diaries, were monitored with 24-hour electrocardiographic Holter monitors and underwent serial exercise treadmill tests. By 1 hour, 10, 20 and 30 mg of nicardipine administered 3 times daily produced statistically significant, dose-related improvements in all key exercise parameters, which persisted at the 4-hour evaluation. The systolic blood pressure at rest and during exercise decreased, but the pulse slightly increased. The peak rate-pressure product was unchanged. The side effects were not severe. Nicardipine hydrochloride is an effective, well-tolerated medication for the treatment of stable exertional angina, and is a good alternative to currently available calcium antagonists. PMID- 2711991 TI - Influence of plasma triglycerides on lipoprotein patterns in normal subjects and in patients with coronary artery disease. AB - This study examined the correlation of plasma triglyceride levels with concentrations of intermediate, low and high density lipoproteins (IDL, LDL, and HDL, respectively) and to particle sizes of LDL in 93 normal men and 106 men with coronary artery disease. Plasma triglyceride concentrations were in the normal range for all persons in both groups. Analysis of lipoproteins of density less than 1.063 g/ml was carried out by analytical ultracentrifugation. The analytical pattern gave the peak Sf for LDL as well as an indication of heterogeneity of particle sizes in the density range of LDL. In both normal subjects and patients with coronary artery disease, a positive correlation was found between peak Sf for LDL and concentrations of plasma triglycerides. Plasma triglyceride levels also were correlated positively with concentrations of Sf 20 to 60 lipoproteins and total IDL mass, and inversely with HDL cholesterol levels. Furthermore, the value for peak Sf for LDL correlated inversely with the IDL mass concentration and IDL/LDL mass ratio, and positively with the HDL cholesterol levels. The results indicate that the lipoprotein pattern, including lipoprotein concentrations and particle sizes, is sensitive to concentrations of plasma triglycerides even when the latter are within the normal range. PMID- 2711992 TI - Antihypertensive effect of diltiazem in a slow-release formulation for mild to moderate essential hypertension. AB - The antihypertensive efficacy and frequency of adverse reactions following administration of diltiazem in a new slow-release formulation were compared with placebo in 34 patients with mild to moderate essential hypertension in a randomized, double-blind, crossover study. After 6 weeks of treatment with diltiazem (240 or 360 mg/day), average supine blood pressure (BP) decreased from 165 +/- 21/101 +/- 5 mm Hg at baseline to 152 +/- 16/93 +/- 4 mm Hg compared with 160 +/- 19/100 +/- 7 mm Hg with placebo (p less than 0.01/p less than 0.001). Standing BP decreased from 162 +/- 20/107 +/- 6 mm Hg at baseline to 150 +/- 14/101 +/- 5 mm Hg compared to 159 +/- 18/107 +/- 8 mm Hg with placebo (p less than 0.01/p less than 0.001). The supine heart rate after diltiazem was 65 +/- 7 beats/min and after placebo 69 +/- 9 beats/min (p less than 0.01). There were no hematologic side effects. Only minor differences between diltiazem and placebo were observed in some of the biochemical laboratory values. Four patients were withdrawn due to side effects during treatment with diltiazem and 2 with placebo. Diltiazem in a slow-release formulation given twice a day lowered blood pressure significantly as monotherapy in patients with mild to moderate hypertension and was well tolerated. PMID- 2711993 TI - Cardiovascular responsiveness to norepinephrine in mild essential hypertension. AB - The responses of blood pressure, heart rate and forearm vascular resistance to exogenous norepinephrine (NE) were measured in 40 normotensive and 65 mildly hypertensive subjects (mean blood pressure 117/72 and 146/92 mm Hg, respectively). Both groups received low incremental doses of NE: 15, 30 and 60 ng/kg/min for 8 minutes each. In contrast to previous studies that compared the dose-response curves in normo- and hypertensive subjects, this study corrected the cardiovascular responses for the increment of plasma NE to account for differences in metabolic clearance of NE. Although age and sex appeared to play a role, the corrected cardiovascular responses did not differ significantly between normo- and hypertensive subjects. Thus, an increased cardiovascular sensitivity to exogenous NE was not demonstrated in mildly hypertensive subjects. This finding confirms some but not all previous studies of the dose-response relation. PMID- 2711994 TI - Effects of a single dose of isosorbide-5-mononitrate on the left ventricular diastolic function in systemic hypertension. AB - The effect of a single dose of isosorbide-5-mononitrate on left ventricular (LV) diastolic function was assessed by radionuclide ventriculography in 18 hypertensive patients. The effect of the mononitrate on atrial filling also was assessed. As expected, there was a significant decrease in mean blood pressure (120 +/- 17 to 102 +/- 18 mm Hg, p less than 0.005). Global LV ejection fraction did not show a significant change, increasing slightly from 64 +/- 9 to 68 +/- 8% (difference not significant). The mononitrate prolonged the time to peak filling rate from 176 +/- 36 to 195 +/- 29 ms (p less than 0.0001). The percentage of time to peak filling rate from diastole also increased, from 46 to 53% (p less than 0.05), whereas the normalized peak filling rate did not change (2.36 +/- 0.6 to 2.31 +/- 0.6 end-diastolic volumes/s, difference not significant). This effect on LV diastolic function was closely related to a certain reduction in preload, as suggested by the reduction in mean left atrial filling (45 +/- 12 to 40 +/- 13 counts/s, p less than 0.005) and LV diastolic counts, suggesting that the "impairment" of diastolic function induced by nitrates is secondary to the reduction in venous return to the left atrium. The mononitrate did not affect the mean right atrial filling rate (50 +/- 12 to 52 +/- 13 counts/s) and the right ventricular end-diastolic counts, suggesting a primary vasodilatory effect of nitrates on the pulmonary vascular bed. PMID- 2711995 TI - Infective endocarditis in opiate addicts: analysis of 80 cases studied at necropsy. AB - Eighty opiate addicts were studied at necropsy. Fifty-nine patients had anatomic evidence of active infective endocarditis (IE); 11 had healed IE; and 10 had both. Of the 80 patients, the first episode of IE involved a single right-sided cardiac valve in 24 patients (30%); both a right- and a left-sided valve in 13 patients (16%); a single left-sided valve in 33 patients (41%); and both left sided valves in 10 patients (13%). Of the 320 cardiac valves in the 80 patients, 103 were sites of vegetations, an average of 1.3 of the 4 valves. Of the 80 patients, the tricuspid valve was infected in 35 (44%), mitral in 34 (43%), aortic in 32 (40%) and pulmonic in 2 (3%). Of the 103 infected cardiac valves, the infection caused sufficient damage to cause dysfunction in 70 (68%): in 28 (88%) of 32 infected aortic valves; in 22 (63%) of 35 infected tricuspid valves; in 19 (56%) of the 34 infected mitral valves; and in 1 of the 2 infected pulmonic valves. Of the 80 patients, 57 (71%) had sufficient valvular damage to cause valvular dysfunction. Of the 80 patients, gross examination of the valves at necropsy indicated that the infected valve almost certainly had been anatomically normal in 65 patients (81%) and abnormal in 15 patients (19%) before the onset of IE. Of the 65 patients with previously anatomically normal valves, 86 (33%) of their 260 cardiac valves were sites of infection (average 1.3 valves/patient); of the 15 patients with infection superimposed on a previously abnormal valve, the infection in each involved previously abnormal valves (21 in the 15 patients) or 17 (28%) of their 60 cardiac valves were sites of infection (average 1.1 valve/patient). Of the 15 patients with abnormal cardiac valves before the infection, 7 had congenitally bicuspid aortic valves and 8 had diffuse fibrous thickening of the mitral valve typical of rheumatic heart disease with (6 patients) or without (2 patients) diffuse fibrous thickening of tricuspid aortic valves. Of the 80 patients, 42 (53%) died during their first episode of active IE, 17 (21%) underwent operative excision with or without valve replacement during the active IE, and in 21 patients (26%) the first episode of active IE healed. In 10 of the latter 21 patients, active IE recurred and was fatal. A total of 19 patients had cardiac valve excision with or without replacement, 17 during active IE and 2 after healing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2711996 TI - A simple method of monitoring antiarrhythmic drugs during short- and long-term therapy. PMID- 2711997 TI - Efficacy of intravenous propafenone for the acute management of atrial fibrillation. PMID- 2711998 TI - Doppler echocardiographic findings of mitral and aortic valvular regurgitation in children manifesting only rheumatic arthritis. PMID- 2711999 TI - Effectiveness of operative and nonoperative therapy in endomyocardial fibrosis. PMID- 2712000 TI - Transesophageal Doppler echocardiographic demonstration of pulmonary venous flow velocity in restrictive cardiomyopathy and constrictive pericarditis. PMID- 2712001 TI - Giant right atrial LeVeen shunt pseudocyst. PMID- 2712002 TI - Normal stages of cardiac organogenesis in the mouse: I. Development of the external shape of the heart. AB - Normal development of the mouse embryonic heart was studied at the organ level using microdissection and scanning electron microscopy (SEM). Altogether 225 embryos, sampled at 8-hour intervals between 11ed (ed = embryonic day; day of vaginal plug = 1ed) and 15ed were collected. Their hearts were fixed by high flow low pressure perfusion, microdissected, and observed in SEM. Standardized frontal, right profile, and left profile SEM micrographs were obtained and analyzed. The main purpose of this study was to create a series of normal stages of mouse cardiac development as a reference for ongoing studies in experimental cardiac teratology (e.g., in fetal mouse trisomies). Comparisons with chick, human, and dog embryonic hearts, prepared using the same technique, show that the mouse embryonic heart is characterized by a relatively deep interventricular sulcus. The absence of a conoventricular sulcus in the mouse results in poor definition of the boundary between the conus and the right ventricle. The external separation of the aorta and the pulmonary artery is evident from 13ed onward. The respective positions of the great arteries (aorta dextroposterior, pulmonary artery sinistroanterior) does not change until the end of cardiac organogenesis (15ed in the mouse). PMID- 2712003 TI - Normal stages of cardiac organogenesis in the mouse: II. Development of the internal relief of the heart. AB - Normal stages of intracardiac development of the mouse heart are illustrated by a collection and analysis of two complementary SEM views, the septal and parietal halves of the right ventricle and conotruncus. These views are particularly suitable for understanding the septation of the outflow tract of the heart. They represent references for the studies of the pathogenesis of conotruncal malformations. The analysis is based on 90 hearts between 11ed and 15ed at intervals of 8 hours with an additional stage at 16ed. They were prepared by perfusion fixation, microdissection, and critical point drying and were examined in SEM. The following main features of the intracardiac morphogenesis were observed: 1) the presence of two spirally positioned conotruncal ridges, their disto-proximal fusion, and the formation of the semilunar valves at their distal part; 2) the trabecular transformation of the conotruncal wall; and 3) the presence of two different interventricular foramina (FIV II and FIV III), with the final closure of FIV III at 14ed16h-15ed. As a result of these observations, our description of the outflow tract septation and its interpretation are different from other conceptions based on mechanisms such as bulbar shift, bulbar absorption, torsions, or transfer of the aorta into the left ventricle. PMID- 2712004 TI - Epicardial formation in embryonic chick heart: computer-aided reconstruction, scanning, and transmission electron microscopic studies. AB - Epicardial formation in the embryonic chick heart from initial to final stages was revealed by means of computer-aided reconstructions based on serial resin sections for light microscopy, with further detailed observations using scanning and transmission electron microscopy. The origin of the epicardium was recognized as protrusions of mesothelial cell clusters on the right side of the external surface of the sinus venosus at 23 somites (stage 14+). These protrusions elongated to give rise to several villous processes, the tips of which eventually touched the dorsal wall of the embryonic heart at 30 somites (stage 17). Originating from these adhesion sites, mesothelial cells spread gradually onto myocardial cells in all directions to form a monolayered sheetlike cover. Thus, by stage 23, the ventricle was completely overlaid with epicardium, and blood island-like structures appeared within the subepicardial layer. The atrium was not enveloped by epicardium until stage 25, and the extreme distal end of the bulbus cordis was reached by the advancing epicardium at stage 27. A chronological table of epicardial formation in the chick heart is presented. PMID- 2712005 TI - Lymphocyte subpopulations in high endothelial venules and lymphatic capillaries of bronchus-associated lymphoid tissue (BALT) in the rat. AB - The subpopulations of lymphocytes and non-lymphoid cells in high endothelial venules (HEV) and in lymphatic capillaries surrounding lymphoid follicles in bronchus-associated lymphoid tissue (BALT) were examined by electron microscopy after preembedding the tissue and staining with an immunoperoxidase technique. The results were compared with those obtained in gut-associated lymphoid tissue (GALT) reported previously. Monoclonal mouse-anti-rat T cell, IgG, IgM, IgA, and Ia antisera were used. Plasma cells that were reactive to anti-IgG, anti-IgM, and anti-IgA were detected as cells in which the 3',3'-diaminobenzidine tetrahydroxychloride reaction product was localized in rough endoplasmic reticulum and perinuclear spaces but not on plasma membranes. These plasma cells did not occur in either lymphatic capillaries or HEV in BALT as they did in GALT. Cells with surface Ig (sIg cells), T-cell antigen (T cells), and Ia antigen (Ia cells) were present in BALT. T cells were located predominantly in the follicular area opposite the bronchial epithelium; IgM- and IgG-reactive cells were found in the follicular area adjacent to the bronchial epithelium; and IgA-positive cells were found in the lateral part of the area where the T cells were localized (T cell area). Ia cells were abundant throughout BALT and in moderate numbers in the epithelium. A striking observation was the presence of "nurse-cell"-like structures in the periphery of BALT. The percentages of T, sIgG, sIgM, and sIgA cells in the HEV were 54.7%, 2.4%, 28.9%, and 27.3%, respectively, and in the lymphatic capillaries, 41.2%, 3.8%, 38.2%, and 21.2%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712006 TI - Changes with senescence in the fine structure of the granular convoluted tubule of the submandibular gland of the mouse. AB - Cells of the granular convoluted tubules (GCTs) of the submandibular gland of senescent male mice show structural changes indicative of functional decline. In order to define the nature of these age-related changes more clearly, the fine structure of GCT cells of 12- and 28-month-old males was compared. In old mice, there was cell-to-cell variation in the extent of these changes, with some cells of senescent males appearing no different from those of young adults. In affected cells the most striking alterations were seen in secretion granules and lysosomal elements. Secretion granules varied greatly in size, with some GCT cells having only very fine apical granules. Secondary lysosomes and large lipofuscin granules were frequent in the basal cytoplasm. Very large dense bodies (3-5 micron) occurred in many cells. These possibly represent intracellular pools of released secretory materials, as they were occasionally seen in continuity with the luminal contents. Structures whose appearance was intermediate between the very large dense bodies and lipofuscin granules were common, suggesting crinophagic activity. There was an apparent decrease in numbers of polysomes and in the extent of the Golgi apparatus. These fine structural changes are consistent with impairments with advanced age in synthesis and posttranslational processing of secretory products by affected GCT cells. In addition to cell-to-cell variation in any one male, there was also interanimal variation in the degree and extent of these senescent changes. PMID- 2712007 TI - Ontogeny of Langerhans cells in human embryonic and fetal skin: cell densities and phenotypic expression relative to epidermal growth. AB - Langerhans cells (LCs) positive for HLA-DR antigens were present in developing human epidermis by at least 7 weeks estimated gestational age (EGA). Most were negative for CD1 (T6) until 12-13 weeks EGA when they underwent a dramatic increase in CD1 reactivity. To gain insight into the density of LCs during ontogeny and to assess whether their distribution was coordinated with epidermal growth, the number of cells positive for both HLA-DR and CD1 antigens was determined relative to surface area and to volume of developing, interfollicular epidermis. LCs differed in their phenotype, distribution (follicular vs. interfollicular), size, and shape between 7 and 21 weeks EGA; however, during this period they maintained a statistically equivalent (P greater than .25) density (65 cells/mm2 and 1,750/mm3) even though the epidermis increased in thickness and the fetus rapidly expanded its surface area. While LCs were evenly distributed within the epidermal sheets at all gestational ages, those in embryonic skin were much smaller and less dendritic than the older cells. The density, size, and shape of LCs in developing skin seemed to be independent of epidermal status (e.g., thickness of keratinization, and number of cell layers) but rather were correlated with gestational age. The number of fetal LCs, through at least 23 weeks EGA, was only 10-20% of the adult LC density. Thus, we can conclude that the increase in LC density to adult levels must occur either during the third trimester or after birth. PMID- 2712008 TI - Anatomy of the cruciate ligaments and their function in extension and flexion of the human knee joint. AB - The areas of the femoral origin of the cruciate ligaments have approximately the shape of sectors of ellipses, the one for the anterior ligament on the lateral condyle posteroproximally and the one for the posterior ligament on the medial condyle distally. By means of a new technique of dissection, combined with the use of X-rays, the change in distance between the origin and insertion and so the change of tension of single bundles of the ligaments could be analyzed. Only a rather thin bundle in each cruciate ligament is in constant tension: "guiding bundles." The maximal diminution of distance between the origin and insertion for some bundles is 65%. In the anterior cruciate ligament the majority of fibres are taut in extreme extension: "limiting bundles." The same is true in the posterior cruciate ligament in extreme flexion. There are also some fibres, especially in the posterior cruciate ligament, that are taut only in an intermediate position. The geometric analysis of the function of different groups of fibers was performed by a modification of Menschik's concept of a four-bar link. PMID- 2712009 TI - Hypnotizability does not predict outcome of behavioral treatment in pediatric headache. AB - Several adult studies suggest that recurrent headache patients who are highly hypnotizable benefit most from behavioral treatment. We examined the relationship between intrinsic patient factors and clinical outcome in 100 children and adolescents with recurrent headache who were enrolled in our behavioral treatment program. We found no correlation between age, sex, headache type, hypnotizability, and clinical outcome. PMID- 2712010 TI - What do clients think about the metaphors they receive? An initial inquiry. AB - Research on Ericksonian techniques and claims of effectiveness has been very sparse. Most of the focus on Ericksonian approaches has been on the development of techniques by the clinicians, seemingly independent of the meaning to the client. One of these interventions is the multiple embedded metaphor (MEM), a series of stories within stories. The underlying assumption is that in order to be effective the metaphor(s) needs to be processed outside of conscious awareness. Six clients participated and were given eight session of psychotherapy, three sessions of which involved the use of MEM. A week after each MEM session, clients reviewed that session on videotape with the therapist. Only one of the six clients reported amnesia for the experience. Four of the five nonamnestic clients had changes in their presenting problems and felt the process to be helpful. The limitations and implications for clinicians are discussed. PMID- 2712011 TI - Utilization approaches and psychodynamic psychotherapy in a case of hospital phobia: an integrated approach. AB - Milton Erickson's approaches, including utilization techniques, were integrated with psychodynamically oriented psychotherapy in the treatment of a woman with a hospital phobia. The patient was a 28-year-old married woman who met the criteria for both Somatoform Disorder and Dependent Personality Disorder, and who had a variety of obsessive and compulsive personality traits. In trance the patient was given permission to replace many aspects of the hospital setting (e.g., driving to the hospital, checking in, talking with nurses, etc.) with interactions with certain emotionally meaningful people from her past. The outcome was that the hospital experience was quite pleasurable, as have been subsequent hospitalizations. Two years later, the patient discussed her hypnotic experience and reported an increase in positive transference and also an increase in her ability to cope with other difficult aspects of her life. PMID- 2712012 TI - And so to sleep: hypnotherapy for lagophthalmos. AB - We used hypnosis to facilitate eye closure during sleep for a 44-year-old woman whose nocturnal lagophthalmos prevented use of a contact lens following cataract surgery and could have resulted in severe corneal damage. On three separate occasions the symptoms remitted following a very brief course of treatment. We discuss the results in terms of alternate theories of hypnotic performance. PMID- 2712013 TI - Temporomandibular joint disease treated with hypnosis. AB - A 17-year-old girl with temporomandibular joint disease who had been treated with the usual types of treatment for 8 1/2 years by multiple clinicians was treated using hypnosis as an adjunct. The treatment, which is described in detail, was successful for 6 months until the patient transferred to an urban college where additional academic and personal pressures caused her bruxism symptoms to reappear. Probable causes of the relapse are discussed. PMID- 2712014 TI - The return to community. PMID- 2712015 TI - Community psychology in Thailand. AB - In a developing country such as Thailand, where many pressing problems must be dealt with promptly, quick solutions, though often short-lived, are usually preferred over long-term preventive measures. This paper attempts to describe the Thai community psychology movement and its struggles to overcome momentous obstacles, along with innovations that serve as a foundation for future work. PMID- 2712016 TI - Toward a synergism of rural development and community psychology. AB - It is a common experience that all social intervention programs planned and executed for social amelioration have not met with success. The major thesis of this article is that parallel growth of two subfields: rural development and community psychology, may not be coincidental, and the recent trends in Indian psychology readily lead themselves to a union between the two. The attempts to intervene in two different communities (heterogeneous and homogeneous) have proved an eye-opener for future interventions. PMID- 2712017 TI - Ethnic populations: community mental health services ten years later. AB - In a replication of a series of studies conducted by Sue and colleagues in the mid-1970s, demographic and service data were retrieved for the Seattle-King County area from the Washington Mental Health Information System. Caucasian clients were compared against Asian, black, Hispanic, and Native American client groups, and, where possible, against the findings reported earlier by Sue. These clients were compared in terms of basic demographic characteristics, characteristics of staff providing the services, dropout rates, and average number of services received. The most notable findings are (a) that failure-to return rates are dramatically lower for the current sample than for Sue's and not greatly different for minorities than for Caucasians, (b) that variability in failure-to-return rates is most strongly related to level of functioning and not related to minority status, and (c) that although Asian Americans still average fewer services than Caucasians (other minorities do not differ significantly), the mean number of services had increased substantially for all groups but more for minorities than for Caucasians. PMID- 2712019 TI - Community psychology in Hong Kong: past, present, and future. AB - The expansion of mental health services during the 1960s from a single remote mental hospital to centers and clinics in mainstream communities fostered the development of community psychology in Hong Kong. Few psychologists were initially involved in the local community mental health movement, but its momentum resulted in increasing numbers of practitioner psychologists working in community-based service settings. Community psychology in Hong Kong today consists primarily of service delivery, but also includes applied research, community organization/consultation, and community education. Despite having many parallels with the American situation, key concepts underpinning the practice of community psychology in the Territory possess their own character as a reflection of nuances in the local scene. Prospects for the continued development of community psychology in Hong Kong appear favorable. Of special relevance is the field's potential contribution to a better understanding of the psychological phenomena associated with the Territory's sociopolitical transformation in 1997. PMID- 2712018 TI - The problem of confounding social support and depressive symptoms: a brief report on a college sample. AB - The problem of confounding social support and depressive symptoms was addressed by examining the convergent and discriminant validity of interview and questionnaire measures of social support and depression using the multitrait multimethod matrix approach. Participants were 40 late-adolescent college students with half the sample selected on the basis of mild to moderate scores on self-reported depressive symptoms. Measures of depression displayed excellent convergent and discriminant validity, and measures of objective features of social networks were found to have moderate convergent and discriminant validity. However, the subjective measures of satisfaction with social support used were found to have neither adequate convergent nor discriminant validity. Implications for the conceptualization and assessment of social support are highlighted. PMID- 2712020 TI - Stability of galactose in aqueous solutions. AB - The stability of 5%-30% w/v galactose in sterile water for injection and acetate and phosphate buffers was studied. The concentration of galactose was determined after each sample was diluted to a nominal concentration of 0.5% (w/v); for purposes of data analysis, the concentration as measured in the diluted sample was multiplied by a dilution factor to obtain the true concentration in the sample. The concentrations were determined from the regression line obtained by plotting the peak-height ratios (for various concentrations of galactose and the internal standard cellobiose) versus the galactose concentrations. Triplicate samples were quantitatively analyzed for galactose content by high-performance liquid chromatography. The stability of the samples was then studied in relation to buffer concentration; pH; storage at 25, 45, and 65 degrees C for six weeks, and autoclaving at 121 degrees C for 30 minutes. Galactose degradation increased in relation to its concentration, increasing temperature, and buffer concentration. Galactose solutions in water and phosphate incurred less than 5% degradation on autoclaving; however, the 30% solutions in acetate buffers lost up to 21% of initial content. Yellow discoloration of solutions was associated with autoclaving and prolonged exposure at 65 degrees C and appeared in some solutions that did not exceed the USP XXI limit of 5-hydroxymethylfurfural and related compounds in dextrose injection. The estimated room temperature shelf-life of galactose in sterile water for injection sterilized by 0.45-micron-porosity membrane filtration is four and one-half months. Solutions may also be sterilized by autoclaving at 121 degrees C for 30 minutes; galactose solutions containing pH buffers should not be sterilized by autoclaving. PMID- 2712021 TI - Hospital pharmacy: what is ethical? AB - Characteristics of ethical evaluations as they apply to the dilemmas faced by the pharmacist in the workplace are described, and the general principles and theories of Western normative ethics are discussed. Because ethical dilemmas are commonplace in pharmacy practice, pharmacists must develop a working knowledge of formal and systematic ethical analysis, as well as learn to distinguish ethical issues from social, psychological, political, and legal issues. Ethical evaluations are distinguished by three characteristics: They are ultimate, they possess universality, and they treat the good of everyone alike. Ethical analyses can be thought of as having four different and successive stages. The first stage is ensuring that all parties understand the facts of the specific case. If controversy remains after the facts are clear, parties to the dispute can proceed through three successive stages of general moral reflection: (1) the level of moral rules, (2) the level of ethical principles, and (3) the level of ethical theories. Specific moral rules cover groups of cases, and they generally are regarded as being derived from a shorter list of abstract moral principles. An ethical theory is a systematic position about which principles are morally significant, how the principles relate to each other, and how they should be tested. Pursuit of ethical dilemmas through the full hierarchy of levels of analysis exposes simplistic or irrational moral decisions and clarifies the nature of disputes. PMID- 2712022 TI - Maintaining patient confidentiality in a case of potential substance abuse. PMID- 2712023 TI - Legal issues associated with pharmacokinetic software. AB - Legal issues associated with the use of pharmacokinetic computer software are discussed. One issue involves the physician's reliance on the pharmacist, as a drug therapy expert, to provide consultation on drug dosages. Another issue is the problem of liability associated with the software and how this relates to the physician, the pharmacist, and those who designed, manufactured, and sold the software. The legal concept of negligence as it relates to medical computer software is discussed. Although the programmer and the manufacturer are responsible for verifying that the program does what it purports to do, the user must exercise due care in identifying any program limitations that might influence the accuracy of a consultation. Clinical perspective, effective validation techniques, and critical selection will help to ensure that pharmacokinetic computer software is developed, purchased, and used safely and effectively. PMID- 2712024 TI - Politics in the drug-development process: the case of mifepristone. PMID- 2712025 TI - Evaluating the use of participative decision making in hospital pharmacy practice. PMID- 2712026 TI - Hospital staff reductions. PMID- 2712027 TI - Program to correct inappropriate prescribing. PMID- 2712028 TI - Drug information cards for cancer patients. PMID- 2712029 TI - Pharmacist has responsibility to warn patients of drug interactions. PMID- 2712030 TI - Human-accuracy factors can influence pharmacokinetic variables. PMID- 2712031 TI - Ethics. PMID- 2712032 TI - Use of a path model to analyze factors that influence hospital pharmacists' salaries. AB - The direct and indirect effects of eight factors on Texas hospital pharmacists' salaries are described. Data for a path analysis (a method of examining relationships among specific variables while controlling for the effects of other variables) were collected by mail survey during the fall of 1985 from randomly selected hospital pharmacists residing in Texas. A path model was constructed to examine the effects of the following variables on the annual salary earned by full-time pharmacists: position, gender, seniority, academic degree, age, number of hours worked per week, size of hospital, and location of hospital. The relationships among the variables were evaluated using linear regression analysis. Of 1500 questionnaires mailed, 502 usable responses from full-time pharmacists were received. Six factors--gender, position, seniority, size of hospital, academic degree, and number of hours worked per week--had significant direct impact on financial compensation. Pharmacists' position also had an indirect effect on salary through the number of hours worked per week, with managers working more hours than nonmanagers. Position was influenced by seniority, gender, size of hospital, and academic degree. Male pharmacists earned more than their female counterparts. Age and hospital location had no significant influence on annual salary, position, or the number of hours worked per week. Overall, path analysis showed only 11 of 21 relationships among the nine variables to be significant. Seniority, gender, size of hospital, academic degree, position, and number of hours worked per week all had a significant effect on salary. PMID- 2712033 TI - Facilitating drug-use evaluation with spreadsheet software. AB - The use of a personal computer spreadsheet program, Lotus 1-2-3, as an aid in drug-use evaluation is described. Dipyridamole was chosen for review because the drug is widely prescribed and often given for questionable indications. Developing criteria that could be translated into conditional logic statements made possible the use of the spreadsheet program for determining appropriateness of drug use. As data are entered into spreadsheet cells, the program simultaneously determines if the criteria for appropriate drug use are met. The program is not particularly difficult to apply to drug-use evaluation and is faster, more accurate, and more consistent than manual processing of data. In addition, the program allows the user to extract subsets of data for more detailed examination of drug-use patterns. Because decisions by the operator are unnecessary during data entry, this step can be performed by secretarial or technical personnel rather than pharmacists. A commercially available spreadsheet software program was faster and more accurate than a manual system for determining appropriate drug use. PMID- 2712034 TI - Inline fluid dynamics in piggyback and manifold drug delivery systems. AB - Inline mixing characteristics of primary and secondary i.v. solutions were evaluated for the piggyback and manifold systems. Dextrose (5%) and sodium chloride (0.9%) were used as markers for the primary and secondary solutions, respectively. With a 120-mL/hr flow rate, samples (up to 180) were collected over 36 minutes to quantify the change in concentration of each marker when the primary solution was changed to the secondary solution (phase 1) and when the secondary solution was changed to the primary solution (phase 2). The relative concentration data for each marker were fitted to a Weibull mathematical model to describe the disappearance and appearance of the two solutions over time. These data were then used to calculate the volume of secondary solution that was mixed with the primary solution in phases 1 and 2. With the piggyback system, the total mixing volume was 13.5 mL, with 11.1 mL contributed by the secondary solution (phase 1). In phase 2, the total mixing volume decreased to 6.6 mL, with 2.0 mL contributed by the secondary solution. The mixing volumes for the manifold system were markedly reduced; 5.8 mL of the secondary solution became mixed with 1.9 mL of the primary solution. The total mixing volume during phase 1 was reduced from 13.5 to 5.6 mL. The mixing volumes for the primary, secondary, and total solutions in phase 2 were comparable to those with the piggyback system. The use of manual clamps or automated line closures as part of a manifold system can substantially reduce the mixing of solutions inline, compared with a piggyback system. PMID- 2712035 TI - Compatibility of aminophylline and verapamil in intravenous admixtures. AB - The chemical and visual compatibility of aminophylline and verapamil hydrochloride in intravenous admixtures was evaluated. Verapamil hydrochloride injection was added to a solution of aminophylline 1.0 mg/mL in 5% dextrose injection (D5W) to yield final verapamil hydrochloride concentrations of 0.1 and 0.4 mg/mL. Each solution type was prepared in triplicate. An aliquot from each of these solutions was assayed in duplicate for theophylline and verapamil by high performance liquid chromatography at 0, 4, 8, 12, and 24 hours after mixing. All aliquots were filtered with a 0.22-micron filter immediately before assay. At each time interval, samples were assessed for pH and inspected visually and microscopically for evidence of incompatibility. Theophylline concentrations showed less than 10% change over 24 hours in the two-drug admixtures. Less than 1% of the original verapamil concentrations remained immediately after mixing with aminophylline injection in D5W. Turbidity was readily apparent in the admixture containing verapamil hydrochloride 0.4 mg/mL; however, microscopic evaluation revealed precipitate in both solutions. Solution pH was determined to be a primary cause of precipitation. The mean pH values for the verapamil hydrochloride 0.1 and 0.4 mg/mL control solutions were 4.09 and 4.36, respectively. The mean pH of the aminophylline 1.0 mg/mL control solution was 8.35. The mean pH of the aminophylline-verapamil admixtures at verapamil hydrochloride concentrations of 0.1 and 0.4 mg/mL was 8.14 and 8.06, respectively. Verapamil hydrochloride injection in final concentrations of 0.1 and 0.4 mg/mL is incompatible with aminophylline 1.0 mg/mL in D5W. PMID- 2712036 TI - Personal intervention for nonformulary drug orders. PMID- 2712037 TI - Stability of cefuroxime axetil in beverages. PMID- 2712038 TI - Attitudes of pharmacists and nurses toward their responsibilities in the drug treatment process. PMID- 2712039 TI - Updating the costs of preparing small-volume injections. PMID- 2712041 TI - Interchangeability of cefotetan and cefoxitin. PMID- 2712040 TI - Caveats with respect to storage of cisplatin and fluorouracil admixtures. PMID- 2712042 TI - Alteplase dosages adjusted for patient weight. PMID- 2712043 TI - Standardized concentrations for dobutamine hydrochloride admixtures. PMID- 2712044 TI - Beyond isolation. PMID- 2712045 TI - Factors affecting outcomes of medication-history interviewing by pharmacy students. AB - Factors affecting outcomes of medication-history interviewing by pharmacy students were studied. Data were obtained from fourth-year pharmacy students enrolled in a required course in fall 1984. Each student conducted a medication history interview with one of two simulated patients who presented a predetermined history; interviews were videotaped from behind a one-way mirror. Students also completed an interviewing-orientation survey and a personal report of communication apprehension (PRCA). Trained raters evaluated the videotaped interviews using measures of interview skill and interview completeness. The simulated patients completed a patient-satisfaction form after each interview. Two path models were developed that were identical except that one had completeness and one had patient satisfaction as the dependent variable. Interview skill was the final factor in each model, preceded by variables representing the student's background and orientation factors, PRCA, and simulated-patient gender. Of 112 students conducting the interview, 107 (95.5%) and 95 (84.8%) completed the PRCA and orientation surveys, respectively. The models explained 36% and 27% of the variance in patient satisfaction and completeness, respectively. Shown in parentheses are the significant direct predictors of variables in the model of patient satisfaction: satisfaction (skill, prepharmacy grade point average [preGPA], people and health-care [PHC] orientation); skill (interviewing orientation, preGPA); interviewing orientation PHC orientation, preGPA, PRCA); and (PHC orientation (student gender). All effects were positive except for PRCA on interviewing orientation. For the model of completeness, direct predictors were as follows: completeness (skill, PHC orientation, student gender, simulated-patient gender); skill (interviewing orientation, preGPA); interviewing orientation (PRCA, preGPA, PHC orientation); and PHC orientation (student gender). All effects were positive except for PRCA on interviewing orientation and PHC orientation on completeness. Results suggest that one path model reflects the patient's assessment of interviewer competence in terms of satisfaction, and the other reflects the clinician-rater's assessment of interviewer competence in terms of interview completeness. The interviewing process positively influences both patient satisfaction and interview completeness. PMID- 2712046 TI - Bar-code technology for documenting administration of large-volume intravenous solutions. AB - The failure to properly document dispensing, administration, charging, and crediting of large-volume plain i.v. solutions in a hospital, along with the potential for using bar-code technology to reduce documentation discrepancies, was investigated. Portable bar-code scanners and preprinted bar-code labels were employed to identify large-volume plain i.v. solutions administered on two selected nursing units of a 1000-bed, private, not-for-profit hospital. Inservice training sessions were conducted to instruct hospital personnel in the use of the scanning equipment. Comparisons of patient statements and medication administration records for large-volume plain i.v. solutions established the level of documentation errors in the study hospital. The causes of these errors were traced to three primary sources: (1) failure to document administration of a solution to a patient (38%), (2) failure to credit patients for i.v. solutions returned to the pharmacy (37%), and (3) administration of a solution to a patient other than the patient for whom the solution was dispensed (25%). Accountability for large-volume plain i.v. solution charges to patients was improved by 19% using bar-code technology. The pharmacy manager desiring to employ bar-code technology should determine convenient methods for applying bar-code labels to solutions and for scanning the bar codes, as well as provide programming that can compensate for erroneous scans. PMID- 2712047 TI - Pharmacy-initiated introduction of patient-controlled analgesia to a 400-bed community hospital. AB - The pharmacist's role in the implementation of patient-controlled analgesia (PCA) in a 400-bed community hospital is described. PCA for postoperative patients was introduced on the recommendation of the pharmacy and therapeutics committee. A subcommittee selected a PCA pump, developed a physician order form and patient monitoring sheet, and in March 1987 initiated a two-month pilot study of PCA therapy in orthopedic-surgery patients. An orthopedic-service pharmacist developed an inservice-education program for the physicians, anesthesiologists, and nurses involved in the care of these patients. Because of the support of anesthesiologists for this program, PCA use during the two-month period rapidly expanded beyond orthopedics to include general and genitourinary-gynecologic patients. Nursing staff demand for PCA inservice education became so great that all staff pharmacists participated in the teaching. Pharmacists in the decentralized areas also provided one-on-one instruction to physicians, nurses, and patients. Positive evaluations of PCA therapy by patients and nurses and favorable patient pain assessment scores, in addition to the hospital-wide acceptance and use of PCA by medical staff, indicated that the program was a success. Active pharmacist participation was a major factor in PCA being well accepted by physicians, nurses, and patients as an effective alternative method of narcotic administration. PMID- 2712048 TI - Criteria for staff pharmacist selection in Ohio. AB - Criteria that pharmacy managers think are currently being used and criteria that they think should be used in the selection of staff pharmacists were identified. A questionnaire was mailed to pharmacy directors in 232 Ohio hospitals. Respondents were asked to indicate how frequently they think that pharmacy managers consider each of 63 criteria when choosing a staff pharmacist and whether each criterion should be considered in an ideal selection process. Respondents also assessed the effect that each of 17 of these criteria would have on their own hiring decisions, all other factors being equal. A total of 116 usable questionnaires were returned, for a 50% response rate. Respondents indicated that they believed that many managers consider the following when choosing a staff pharmacist: licensure status, salary requirements, date of availability, interest in the position, ability to relocate, willingness to work unexpected hours, appearance, honesty, friendliness, police record, previous illicit drug use, previous absenteeism record, and the reason for leaving the last job. Respondents also thought that the equal employment opportunity traits, with the exceptions of handicaps and the applicant's age, were considered by few or some managers. However, 17% of the respondents indicated that they would discriminate in favor of a married applicant, 14% indicated that they would discriminate against an applicant born outside of the United States, 22% indicated that they would discriminate against an applicant whose age was in the fifties, and 24% indicated that they would discriminate against an applicant with a handicap that could reasonably be accommodated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712049 TI - Stability of a nonaqueous trimethoprim preparation. AB - A nonaqueous formulation of trimethoprim for injection was prepared, and the stability of the undiluted solution (50 mg/mL) was studied. Six nonaqueous injectable solvents were used in an attempt to attain a trimethoprim concentration of 50 mg/mL; N,N-dimethylacetamide was found suitable, and a cosolvent system containing 52% N,N-dimethylacetamide and 48% propylene glycol was developed. The stability of trimethoprim 50 mg/mL in this solution after storage at temperatures of 80 degrees C, 90 degrees C, and 140 degrees C was studied using high-performance liquid chromatography. Samples were also examined visually for signs of color change or precipitation. More than 90% of the initial concentration remained after storage at 80 degrees C for 45 days. Examination of the stability data suggested that trimethoprim degradation was a zero-order process, although a first-order process could not be excluded. Extrapolation of data from an Arrhenius plot yielded a zero-order trimethoprim degradation rate constant at 25 degrees C of 0.0113% day-1. The time for 10% trimethoprim degradation at 25 degrees C would be 885 days. No precipitation was observed, but the initially colorless solution turned yellow or brown during storage. The extent of color change was associated with the degree of trimethoprim degradation. Trimethoprim, when prepared in the nonaqueous solution described, is stable at 25 degrees C. The preparation may be suitable for intravenous use. PMID- 2712050 TI - Concentration uniformity of extemporaneously prepared ranitidine suspension. AB - The concentration uniformity of an extemporaneously prepared ranitidine suspension was studied. To prepare the ranitidine suspension, 36 150-mg tablets were pulverized and suspended in 180 mL of distilled water. This mixture was diluted with simple syrup to a total volume of 360 mL, resulting in a final ranitidine concentration of 150 mg/10 mL. Samples from each of three bottles that had been filled with 60 mL of the suspension were assayed for ranitidine content by high-performance liquid chromatography. The sedimentation of suspended ranitidine tablet particles was studied by visual observation of the setting process in 10-mL samples from the same batch. The overall mean concentrations (in milligrams per milliliter) of ranitidine were 14.53, 15.25, 13.92, 12.67, and 12.72 at 0, 3, 7, 14, and 21 days, respectively. Compared with baseline, the difference in the ranitidine concentration was not significant over days 0-7. The ranitidine concentration was significantly reduced during the following time intervals: days 0-14, days 0-21, and days 7-21. In the settling experiments, the mean time (+/- S.D.) for sediment to first appear on the test tube bottom was 14.67 +/- 5.35 seconds. Approximately 40-50% (mean level = 3.2 mm) of the total sedimentation level (mean level = 7.3 mm) was observed one minute after shaking. The uniformity of ranitidine suspensions compounded according to procedures described in this report possibly could be improved with sonication. The ranitidine suspension should be well shaken, the dosage should be measured immediately after shaking, and the suspension should be used within seven days of compounding. PMID- 2712051 TI - Process-oriented measurement of clinical pharmacy activities in a large Army medical center. PMID- 2712052 TI - Effect of automated prescription transmittal on number of unclaimed prescriptions. PMID- 2712053 TI - Technician intervention in use of nonformulary antimicrobial agents in the surgical suite. PMID- 2712054 TI - Restructuring nursing unit inspections as a quality assurance activity. PMID- 2712055 TI - Experience with 211 courses of home intravenous antimicrobial therapy. PMID- 2712056 TI - Experience with electronic bulletin boards. PMID- 2712057 TI - Manufacturers' recommendations for handling spilled antineoplastic agents. PMID- 2712058 TI - Chlamydia trachomatis cervical infection in women seeking routine gynecologic care: criteria for selective testing. AB - PURPOSE: Chlamydia trachomatis infection is one of the most common sexually transmitted diseases. Developing methods to identify patients who are at higher risk would enable clinicians to perform selective testing for C. trachomatis infection, which may reduce morbidity, sequelae, and overall costs. Risk factors for C. trachomatis infection of the cervix in women seen for routine gynecologic care were therefore analyzed. PATIENTS AND METHODS: Extensive clinical data and cervical cultures were obtained from 1,141 women between the ages of 18 and 50. Multivariate techniques were used to develop and prospectively test a model to predict infection. RESULTS: In the model development series of 530 patients seen in a hospital-based practice, 24 (4.5%) had a positive culture result. In the validation series of 611 patients seen in private practice, 17 (2.8%) had positive culture results. The majority of infected patients (61%) were asymptomatic. For sexually active women 18 to 35 years of age, the optimal predictive model was based on three factors: level of education (high school or less), a sex partner with other partners during the prior three months, and endocervical bleeding induced by the initial swab. In the validation series, the prevalence of infection for women with one or more of these factors was 5.8% (95% confidence interval, 4.0 to 8.6) compared with 0.9% in patients without these factors (p = 0.005). CONCLUSION: Clinical information can be used in a low prevalence population to predict a patient's risk for C. trachomatis infection and to select patients for testing. PMID- 2712059 TI - Evaluation of the policy of empiric treatment of suspected Toxoplasma encephalitis in patients with the acquired immunodeficiency syndrome. AB - PURPOSE: This study was designed to measure response rates and survival in patients with acquired immunodeficiency syndrome (AIDS) and suspected Toxoplasma encephalitis treated empirically and in AIDS patients treated for biopsy-proven toxoplasmosis. PATIENTS AND METHODS: AIDS patients identified at Bellevue Hospital between August 1985 and May 1986, who had abnormal computed tomographic scans of the brain and who received empiric treatment for toxoplasmosis, constitute the empirically treated cohort. A cohort with biopsy-proven toxoplasmosis was identified from Bellevue Hospital neuropathology records spanning 1981 through 1986. Patient records were reviewed with a standardized data form, and tomograms were evaluated by neuroradiologists unaware of the identity of the scans. Survival analysis was performed by the product limit method. RESULTS: Of 38 empirically treated patients, 26 responded clinically and radiographically within four weeks of initiation of therapy. Four of nine patients who underwent biopsy responded to treatment. There was no difference in these response rates (68% versus 44%, p = 0.24). The median survival of the empirically treated responders, from first diagnosis of AIDS to last follow-up, was 422 days. Among the 30 responders, five patients discontinued therapy and four of them had relapses. No relapses occurred in the 25 patients who continued full-dose therapy indefinitely (p = 0.0004). Sixteen of 30 patients (53%) receiving continuous therapy developed toxicity, which required a change in medication. There was no difference in the survival of patients who continued to receive sulfadiazine and pyrimethamine compared with those in whom clindamycin was substituted for sulfadiazine (median, 311 days versus 422 days, p = 0.25). CONCLUSION: A policy of empiric treatment of suspected Toxoplasma encephalitis is satisfactory, and patients who respond to such therapy and continue to take full therapeutic doses of anti-Toxoplasma drugs have relatively long survivals. PMID- 2712060 TI - Cerebral infarctions and transient neurologic deficits associated with acquired immunodeficiency syndrome. AB - PURPOSE: Little information is available concerning the clinical importance of cerebral infarction in patients with acquired immunodeficiency syndrome (AIDS). The purpose of this retrospective study was two-fold: (1) to determine the frequency and clinical characteristics of cerebral infarction and transient neurologic deficits (TNDs) among patients with AIDS; and (2) to identify specific patient subgroups at risk for such complications and whether there were underlying associated diseases requiring specific therapy. PATIENTS AND METHODS: Neurology inpatient and consult service records, neuropathology reports, and the University of California, San Francisco, AIDS computerized registry were used in identifying study cases. Information on demographic background, associated clinical diagnoses, presenting neurologic symptoms and signs, laboratory results, pathologic findings, and clinical follow-up was obtained from each patient's medical record. RESULTS: Twenty-five patients with AIDS (mean age, 38) having clinical or pathologic findings suggestive of focal cerebral ischemia or infarction were identified. Ten patients had non-hemorrhagic cerebral infarctions, 13 had acute TNDs, and two had both. Cerebral infarction was associated with central nervous system (CNS) infections (cryptococcus, four; tuberculosis, one; zoster vasculitis, one) and cardiogenic embolism (one). TNDs were associated with toxoplasmosis (four), cerebral infarction (two), cryptococcal meningitis (one), vasculitis (one), and CNS Kaposi's sarcoma (one). A presumptive cause was absent in five cases of cerebral infarction and eight of TND. All five patients with pathologically proven macroscopic cerebral infarcts were diagnosed clinically before death. CONCLUSIONS: We conclude the following: (1) AIDS patients, especially given their young age, appear to be increased risk for cerebral infarction and TND. (2) Cerebral infarction and TND may be the initial presentation of AIDS. (3) TND and cerebral infarction often signify treatable CNS infection among AIDS patients. (4) The causes of AIDS-related cerebral infarction and TND are unknown in many cases. PMID- 2712061 TI - Acquired immunodeficiency syndrome cholangiopathy: spectrum of disease. AB - PURPOSE: Reports of biliary tract abnormalities in patients with acquired immunodeficiency syndrome (AIDS) are infrequent. Nine patients with features of papillary stenosis and sclerosing cholangitis and one patient with primary bile duct lymphoma were previously described. Since those reports, an additional 16 AIDS patients with clinical and laboratory features suggestive of biliary tract disease have been evaluated. The findings in these 26 patients form the basis of this study. PATIENTS AND METHODS: The patients, 25 men and one woman, with right upper quadrant abdominal pain, fevers, or elevated serum alkaline phosphatase levels, or any combination of the three symptoms, underwent endoscopic retrograde cholangiopancreatography and ampullary biopsy. RESULTS: Twenty of these 26 (77%) patients were found to have markedly abnormal cholangiograms. Four patterns of cholangiographic abnormalities were identified: sclerosing cholangitis and papillary stenosis (10 patients), papillary stenosis alone (three patients), sclerosing cholangitis alone (four patients), and long extrahepatic bile duct strictures (three patients). An AIDS-associated pathogen or malignancy was identified in 11 patients (55%), with cytomegalovirus being the most common (five patients). Demographic, clinical, and laboratory features were not significantly different between AIDS patients with cholangiopathy and those without cholangiopathy. However, 15 of 20 patients with cholangiographic abnormalities (versus only one of six patients without such abnormalities) had ductal dilation on ultrasound or computed tomography, or both. CONCLUSION: Clinicians should be aware that profound biliary tract abnormalities may develop in a large number of human immunodeficiency virus-infected patients. Confirmation of the anatomic abnormalities, determination of correct etiology, and effective therapy may depend upon early endoscopic cholangiography. PMID- 2712062 TI - Cocaine-induced rhabdomyolysis masquerading as myocardial ischemia. AB - PURPOSE: Cocaine abuse has recently emerged as a major problem among young adults, and is increasingly associated with a variety of medical complications. In view of recent reports demonstrating that illicit cocaine use may cause rhabdomyolysis, we reviewed the collective experience of a university-affiliated medical center to identify patients with cocaine-induced rhabdomyolysis. PATIENTS AND METHODS: Among hospital admissions due to acute cocaine abuse during the period June 1987 through June 1988, we identified seven patients who exhibited biochemical evidence of skeletal muscle injury. Six of these patients presented within one hour of free-basing cocaine with complaints of thoracic skeletal muscle pain. Hospital admission was prompted by the suspicion of myocardial ischemia or infarction. The remaining patient was incidentally found to have an elevated serum level of creatine phosphokinase (CPK) after abusing cocaine and was hospitalized to exclude a cardiac origin. RESULTS: Serum CPK levels in the seven patients rose to a mean peak value of 16.1 +/- 3.6 mu kat/L, and returned toward normal within 72 hours. A cardiac origin for the elevated CPK values was excluded by negative results of determinations of CPK-MB fractions. CONCLUSION: Rhabdomyolysis must be added to the every-growing list of medical complications associated with the illicit use of cocaine. Skeletal muscle injury may be a more common complication of cocaine abuse than has previously been appreciated, escaping medical attention when the clinical manifestations are relatively mild. The importance of recognizing this clinical entity lies in the potential confusion with myocardial ischemia. This point is illustrated by the fact that each of our patients was hospitalized to exclude the possibility of cocaine induced myocardial infarction. Cardiac ischemia could not be differentiated from skeletal muscle injury solely on the basis of clinical assessment. PMID- 2712063 TI - Recombinant interferon-alpha therapy of Philadelphia chromosome-negative myeloproliferative disorders with thrombocytosis. AB - PURPOSE: The clinical course of patients with myeloproliferative disorders and excessive thrombocytosis may be complicated by serious hemorrhagic or thrombotic events. We have previously reported that interferon-alpha can control severe refractory thrombocytosis in patients with advanced chronic myelogenous leukemia. Therefore, we treated a group of thrombocythemic patients with Ph-negative myeloproliferative disorders, including polycythemia vera and essential thrombocythemia, with recombinant interferon-alpha (rIFN-alpha 2a). PATIENTS AND METHODS: Eight patients with profound elevations in platelet counts received a median induction dose of 5.4 X 10(6) U/day (range, 5.0 to 10.0 X 10(6) U/day) of rIFN-alpha 2a administered intramuscularly or subcutaneously. RESULTS: We observed a significant decline in platelet counts from a median baseline value of 1,929 X 10(9)/L (range, 960 to 2,960 X 10(9)/L) to a median posttreatment value of 431 X 10(9)/L (range, 71 to 1,150 X 10(9)/L) (p less than 0.01). Concomitantly, white blood cell counts declined from a median baseline value of 20.8 X 10(9)/L (range, 10.5 to 40.8 X 10(9)/L) to a median posttreatment value of 6.1 X 10(9)/L (range, 2.9 to 29.0 X 10(9)/L) (p less than 0.02). Correction of thrombocytosis was rapid, with a median of only eight days from the start of therapy to the achievement of a platelet count less than 1,000 X 10(9)/L. Six of eight patients have shown an ongoing response with a median follow-up period of 11 months (range, one to 30 months). There have been no bleeding or thrombotic events during the study. Side effects of rIFN-alpha 2a therapy consisted of fever and flu-like symptoms, with tachyphylaxis developing after one to two weeks of therapy. CONCLUSION: Our observations suggest that alpha interferon may be a promising therapeutic agent for myeloproliferative disorders characterized by thrombocytosis. PMID- 2712064 TI - Needlestick injuries and needle disposal in Minnesota physicians' offices. AB - Because little is known about needlestick injury and needle disposal in non hospital settings, we surveyed physicians' offices in Minnesota. Recapping of needles was frequent (51.1%, 72 of 141) and injuries had occurred during the past year in 44.0% of offices. When of known cause, needlesticks were most common during blood drawing and recapping (52.0%, 13 of 25). Small offices more often recapped needles, but only metropolitan small offices reported more frequent injuries. Only 37.6% of offices used a protocol for management of injuries, and in less than half (45.4%) was physician evaluation routine. Although most offices used plastic containers and a majority (73.0%) incinerated or autoclaved needles prior to disposal, small offices more often disposed of sharps in their routine solid waste. Larger metropolitan offices more consistently followed current recommendations for handling and disposing of needles. There is a need for education efforts to address these issues for physicians and their office staff. PMID- 2712065 TI - Building cathedrals: one physician's perspective. PMID- 2712066 TI - Ode to my first patient. PMID- 2712067 TI - Subcutaneous masses and adenopathy in a 77-year-old man with Sjogren's syndrome and amyloidosis. PMID- 2712068 TI - Immunologic studies in two patients with antitubular basement membrane nephritis. PMID- 2712069 TI - Nephrotic syndrome, hematuria, and hypocomplementemia in a case of mesangial lupus nephritis evolving later to a membranous lesion. PMID- 2712070 TI - Production of a novel anticoagulant by neoplastic plasma cells: report of a case and review of the literature. PMID- 2712071 TI - Diethylstilbestrol-associated hemolytic anemia with a positive direct antiglobulin test result. PMID- 2712072 TI - Cholestatic jaundice in hyperthyroidism. PMID- 2712073 TI - Diaphragmatic paralysis. PMID- 2712074 TI - Inadvertent administration of 480 mg/m2 of cisplatin. PMID- 2712075 TI - Magnetic resonance imaging versus computed tomographic scanning in neuropsychiatric systemic lupus erythematosus. PMID- 2712076 TI - Cardiac tamponade as the presenting manifestation of systemic lupus erythematosus. PMID- 2712077 TI - Idiopathic hyperammonemia after high-dose chemotherapy. PMID- 2712078 TI - Lack of evidence for reduction of theophylline clearance by ranitidine. PMID- 2712079 TI - Cocaine-associated myoglobinuric renal failure. PMID- 2712080 TI - Protracted elimination of cocaine metabolites. PMID- 2712081 TI - Syndrome of inappropriate secretion of antidiuretic hormone and temporal arteritis. PMID- 2712082 TI - Antiphospholipid antibodies, valvular heart disease and systemic lupus erythematosus. PMID- 2712084 TI - Fatal disease in a bird fancier. PMID- 2712083 TI - Treatment of proteinuric idiopathic glomerulonephritides in adults. PMID- 2712086 TI - Lives that sing. PMID- 2712085 TI - 'Ondine's curse': side effect of acetazolamide? PMID- 2712087 TI - HIV-infected kids in NYC: an invisible emergency. PMID- 2712088 TI - How can a hospital ethics committee help? PMID- 2712089 TI - How to use intermittent abdominal compressions. PMID- 2712090 TI - Skin to skin: Kangaroo Care in western Europe. PMID- 2712091 TI - Last hope for a failing heart. PMID- 2712092 TI - Why I'm an agency nurse. PMID- 2712093 TI - Near-drowning. PMID- 2712094 TI - A smart way to secure an i.v. PMID- 2712095 TI - Taking the bite out of TMJ syndrome. PMID- 2712096 TI - How well do CCU patient-nurse contracts work? PMID- 2712097 TI - Southeast jobfocus. Heading south by southeast. PMID- 2712098 TI - Georgia jobfocus. Georgia on your mind. PMID- 2712099 TI - How to discharge a patient in the AM. PMID- 2712100 TI - Florida jobfocus. Florida boom times and beaches. PMID- 2712101 TI - Asthenia in breast cancer. PMID- 2712102 TI - Can nurses care too much? PMID- 2712103 TI - Sinai's Davis sees mission as advocacy for patients with AIDS. PMID- 2712104 TI - Flashbacks: the character of pain. PMID- 2712105 TI - Relationship between fetal heart rate and umbilical blood flow velocity in term human fetuses during labor. AB - Fourteen pregnant women between 37 and 41 weeks' gestational age, who subsequently were delivered of healthy newborn infants, were studied to examine the effects of spontaneous changes in fetal heart rate on the flow-velocity waveforms in the umbilical artery. The women were in active labor and under epidural anesthesia at the time Doppler measurements were made. There was a significant positive relationship between end-diastolic flow velocity and fetal heart rate. The umbilical artery peak-systolic/end-diastolic ratio was best correlated with the negative reciprocal transformation of the instantaneous fetal heart rate value and end-diastolic flow velocity. No significant correlation was found between fetal heart rate, umbilical artery peak-systolic/end-diastolic ratio, and peak-systolic flow velocity. An upper limit of 3.0 for a normal umbilical artery peak-systolic/end-diastolic ratio was acceptable only if the instantaneous fetal heart rate was greater than or equal to 130 beats/min. PMID- 2712106 TI - Effects of calcium antagonists during pregnancy. PMID- 2712107 TI - Digoxin-like immunosubstance in pregnancy and preeclampsia. PMID- 2712108 TI - Elevated fibronectin levels and preeclampsia. PMID- 2712109 TI - Vaginal mucus? PMID- 2712110 TI - Changing trends in the cesarean section rates for stillbirths. PMID- 2712111 TI - Need for differentiation of small-for-gestational-age infants and those with intrauterine growth retardation. PMID- 2712112 TI - The development of alpha-emitting radionuclide lead 212 for the potential treatment of ovarian carcinoma. AB - alpha-Emitting radionuclides may be an effective alternative treatment against ovarian carcinoma because they have short half-lives and are densely ionizing, with high linear energy transfer to a depth of several cell diameters without requiring cellular oxygenation. One radionuclide that has been generated and tested in our laboratory in vitro and in vivo is lead 212 (212Pb). Intraperitoneal instillation of 212Pb prolonged survival and totally eradicated tumor in 24% of mice inoculated with the extremely virulent Ehrlich ascites producing tumor. In vitro 212Pb was two to four times more effective in killing human ovarian cancer cells than x-rays. Irradiation with 212Pb increased the radiosensitivity and chromosomal aberrations of cells. In dogs, intraperitoneal instillation of 2.6 mCi of ferrous hydroxide tagged with 212Pb caused no significant toxicity. It appears that alpha-emitting radionucides such as 212Pb have the potential to be a new and potent treatment of ovarian carcinoma and could be effective in cases that are resistant to conventional chemotherapy or x ray therapy. PMID- 2712113 TI - Studies of human germinal mutations by deoxyribonucleic acid hybridization. AB - Spontaneous mutations that occur in human germ cells contribute significantly to clinical disorders and result in premature mortality, incurable morbidity, mental handicap, and infertility. We have used molecular analysis of deoxyribonucleic acid to study the occurrence of spontaneous human germinal mutations. We examined 458 offspring and parents in 60 multigeneration human families. Probes for hypervariable loci were dispersed throughout all chromosomes to note the occurrence of new mutations. We found that both point mutations and insertion deletion mutations occur frequently enough to be directly quantitated. The rates of occurrence detected at the molecular level are much greater than the rates detected with other modalities. The mutational rates at some loci approach 1% in live-born children. Such mutations appear to be sequence specific and related to the processes of meiosis or mitosis as they occur in the production of human gametes. PMID- 2712114 TI - A phase I/II study of intraperitoneally administered doxorubicin entrapped in cardiolipin liposomes in patients with ovarian cancer. AB - A phase I and II clinical trial of intraperitoneally administered liposome encapsulated doxorubicin in patients with advanced ovarian cancer is being evaluated. Doxyrubicin liposomes were prepared with cardiolipin, phosphatidyl choline, cholesterol, and sterarylamine and sized by flow cytometry before administration. Fifteen patients have been treated with 42 cycles of intraperitoneal liposome-encapsulated doxrubicin. Liposome-encapsulated doxorubicin in 2 L of normal saline solution was infused over 1 hour through an infusaport into the peritoneal cavity with a dwell time of 4 hours every 21 days. Liposome-encapsulated doxorubicin has been administered at escalating doses up to 100 mg/2 L and has been well tolerated. Increased bowel motility with mild-to moderate abdominal distress has been encountered during the first 24 hours after administration. There has been one patient with presumed chemically induced peritonitis after a temperature elevation to 39.5 degrees C. There has been no myelosuppression, abnormalities of liver function tests, or alopecia. Nausea and vomiting were minimal. Liposome-encapsulated doxorubicin was extravasated in two patients without sequelae. Drug levels were measured after completion of infusion. At a dose of 70 mg, the peak intraperitoneal concentration was 28.6 micrograms/microliter, which was reduced to 23.6 micrograms/microliter by 2 hours. Concurrent plasma levels were in the range of 0.2 to 0.5 micrograms/microliter. A similar pattern was observed at other doses. The maximum tolerable dose has not yet been obtained. There were three responders in the 10 evaluable patients. The preliminary experience with intraperitoneal liposome encapsulated doxorubicin is encouraging. PMID- 2712115 TI - Effects of reductions in hemoglobin-oxygen affinity and hematocrit level on oxygen consumption and acid-base state in fetal lambs. AB - To determine whether the high oxygen affinity of fetal blood, compared with that of the adult, is advantageous to the fetus during fetal anemia we studied 16 chronically catheterized fetal lambs. Half of the lambs had hemoglobin-oxygen affinity reduced acutely by isovolemic exchange transfusion with fresh adult whole blood; the other half served as controls. In both groups of fetuses, we measured fetal oxygen delivery, oxygen consumption, and acid-base state at normal fetal hematocrit levels and during reductions in the hematocrit level of 30% (moderate anemia) and 60% (severe anemia) produced by isovolemic exchange transfusions with plasma. At normal fetal hematocrit levels, reductions in hemoglobin-oxygen affinity had no effect on fetal oxygen consumption or acid-base state. During moderate anemia, fetal oxygen delivery decreased in both series of fetuses, but oxygen consumption and base excess fell only in those fetuses whose circulations contained adult hemoglobin. During severe anemia, oxygen consumption and base excess decreased in both groups of fetuses, although these changes were more pronounced in fetuses with adult hemoglobin than in those with fetal hemoglobin. Our data indicate that, even though a high hemoglobin-oxygen affinity may not be essential to a healthy fetus, it is critical for normal metabolism in a fetus subjected to a hypoxic stress such as anemia. PMID- 2712116 TI - Evaluation of risk scoring in a preterm birth prevention study of indigent patients. AB - A total of 4591 indigent patients were scored for risk of preterm labor and birth by the Creasy et al. scoring system and delivered at greater than or equal to 20 weeks' gestation. Of 462 preterm deliveries (less than 37 weeks), only 39.6% were contributed by the 18.1% of patients who scored at high risk (score greater than or equal to 10). Of the 44 risk factors in the scoring system, 25 were not statistically significant by univariate chi 2 analysis. The spontaneous preterm birth rate was 8.0%. The positive predictive value of the Creasy et al. system was 18.3%. With multiple logistic analyses we excluded infrequent risk factors and identified five factors that remained significant (prepregnancy weight less than 45.5 kg, black race, single marital status, one preterm labor and delivery, preterm labor, and delivery greater than or equal to 2). With these five risk factors we created an equation that allowed identification of 12% of patients at high risk of preterm delivery with a positive predictive value of 21.9%. Because of the importance of previous preterm delivery, risk scoring of primigravid patients is of limited value. PMID- 2712117 TI - Construction of a neovagina for patients with a flat perineum. AB - Vaginal dilatation affords an acceptable functional success rate for women with vaginal agenesis, provided there is an introitus with a pouch or dimple. In contrast, women with a flat perineum who lack labia majora, labia minora, and vaginal introitus have no alternative to development of a vagina-like orifice other than surgical vaginoplasty. This study addresses the anatomic and functional success rate of these women after undergoing modified McIndoe technique. Thirty-four patients with microphallus were assigned the female gender as the sex of rearing at the Johns Hopkins Hospital between 1951 and 1987. A majority of patients underwent surgical revision of the external genitalia and gonadectomy before 2 years of age. Family counseling was begun at birth. Of these patients, 15 (17 to 25 years old) who requested the ability to have sexual relations underwent modified McIndoe vaginoplasty. All 15 of these women have experienced satisfactory coitus. All but one patient have an adequate size vagina. Results of this group indicate that patients with ambiguous genitalia as a result of male hermaphroditism or microphallus can achieve functional success after vaginal creation with a modified McIndoe technique despite the presence of a flat perineum. PMID- 2712118 TI - The T-ACE questions: practical prenatal detection of risk-drinking. AB - Heavy maternal alcohol intake is a major perinatal risk but, unfortunately, is difficult for obstetricians and gynecologists to detect. To develop a brief questionnaire appropriate for office detection of "risk-drinking," that is, alcohol intake potentially sufficient to damage the fetus, defined here as greater than or equal to 1 ounce of absolute alcohol per day, we obtained a quantitative drinking history at the first prenatal visit from 971 consecutive gravid women who admitted ever having drunk alcohol. In addition, we administered the 25-question Michigan Alcoholism Screening Test and the four CAGE questions (C = cut down, A = annoyed, G = guilt, E = eye opener), a screening test previously unstudied in pregnancy, and sought evidence of tolerance to the inebriating effect of alcohol, a question which does not appear to trigger psychologic denial. The patient was considered tolerant if it took greater than 2 drinks to make her feel "high." Among 42 (4.3%) risk-drinkers and 929 women who did not report drinking at risk levels, four questions were found to contribute to reliably differentiating risk-drinkers from non-risk-drinkers (R2 = 14.6%, p less than 0.0001). The probability of risk-drinking increased from 1.5% for those responding negatively to 62.7% for those responding positively to all four questions (T = tolerance, A = annoyed, C = cut down, E = eye-opener; odds ratio = 109X). A simple scoring scheme (2 points for T and 1 each for A, C, or E, with a total score of greater than or equal to 2 considered positive) correctly identified 69% of the risk-drinkers (sensitivity) with a positive predictive value of 23%). The T-ACE questions take about 1 minute to ask and represent the first validated sensitive screen for risk-drinking appropriate for routine use in obstetric-gynecologic practice. If validated in further samples, broad application might contribute to better risk identification, secondary prevention efforts, and improved pregnancy outcomes for offspring at risk from heavy prenatal alcohol exposure. PMID- 2712119 TI - Transabdominal chorionic villus sampling for first-trimester prenatal diagnosis. AB - We report here our technique and initial experience with transabdominal chorionic villus sampling for first-trimester prenatal diagnosis at the University of Tennessee, Memphis. Eighty-seven patients underwent transabdominal chorionic villus sampling between 9 and 12 menstrual weeks of pregnancy. Sufficient chorionic villi (greater than or equal to 5 mg) were obtained from 83 of the 87 patients (95.4%); in 73 (88%) of the 83 successful samplings only a single needle passage was required. In one case a 47,XX, +21 complement was diagnosed; the patient elected to terminate the pregnancy and the diagnosis was confirmed in the abortus. In a second case a 46,XX,rcp(15;21)(p11;q21) woman had a fetus who also had the same balanced translocation. In a third case nonmosaic 47,XX, +16 was detected in both direct preparations of cytotrophoblast cells and cultured mesenchymal core cells. Amniocentesis performed at 15 weeks showed a normal 46,XX complement. The pregnancy continued, and the patient was delivered at term of a healthy female infant. Two spontaneous fetal losses occurred in this series, and one woman underwent an elective abortion after receiving the results of a 46,XX complement. To date, 39 of the women have been delivered and all infants are doing well; the remaining 44 pregnancies are continuing uneventfully. We conclude that transabdominal chorionic villus sampling can be a useful alternative to transcervical chorionic villus sampling, particularly when transcervical sampling is contraindicated (e.g., active genital herpes) or where the transcervical approach would be technically difficult. PMID- 2712120 TI - Transactions of the forty-fourth annual meeting of the Society of Obstetricians and Gynaecologists of Canada. Vancouver, British Columbia, Canada, June 21-25, 1988. PMID- 2712122 TI - Maternal weight loss associated with hyperemesis gravidarum: a predictor of fetal outcome. AB - Over a 5-year period in our center 64 patients were hospitalized with a diagnosis of hyperemesis gravidarum. Patients were classified into two groups to determine whether weight loss was an objective predictor of pregnancy outcome. Patients whose weight loss was greater than 5% of their prepregnancy weight were classified as group A (n = 30). Patients with nausea and vomiting of pregnancy but with maintenance of at least 95% of prepregnancy body weight were in group B (n = 34). Infants in group A were significantly smaller with respect to average birth weight expressed as a percentile for gestational age: 38.11 percentile, versus 72.00 percentile for group B (p less than 0.025). Macrosomia (greater than or equal to 4000 gm) was significantly associated with group B (18% versus group A, 0%; p less than 0.025). Growth retardation (less than or equal to 10th percentile weight at birth) was significantly associated with group A (30% versus group B, 6%; p less than 0.01). Three integumentary system abnormalities (3 of 30 cases) occurred in group A compared with none in group B. Although hyperemesis gravidarum has been viewed as a positive predictor, those patients who also demonstrate weight loss and electrolyte disturbance may be a distinct entity and at greater risk for growth retardation and fetal anomalies. PMID- 2712121 TI - Transcervical sterilization with use of methyl 2-cyanoacrylate and a newer delivery system (the FEMCEPT device). AB - The increasing use of sterilization as a means of permanent contraception prompts the search for simpler, safer methods. Methyl 2-cyanoacrylate 0.6 ml was administered to the uterocornual tubal junction with the use of the FEMCEPT transcervical delivery system in 35 healthy parous women aged 30 to 44 years. Hysterosalpingography 4 months after the procedure showed bilateral tubal occlusion in 88.2% of the study participants. There were no complications in the study group, and there were no pregnancies among those who demonstrated bilateral tubal occlusion. The technique, which is safe, effective, and simple, could consideraly reduce anesthetic and operative risk in sterilization. PMID- 2712123 TI - Late maternal age and postdate pregnancy. AB - Charts of 443 postdate pregnancies were reviewed to determine the effect of late maternal age on pregnancy outcome. There were significantly more low 1-minute Apgar scores, intrapartum decelerations, and cesarean sections in the group of women greater than 35 years old. Use of oxytocin percentages and the results were similar with regard to both groups. Five-minute Apgar scores also were similar. Women greater than 35 years of age are less able to be delivered of postdate infants with optimal outcomes, but it is still safe to allow them to exceed 42 weeks' gestation. PMID- 2712124 TI - Regional blood flow change in the lamb during the perinatal period. AB - Regional blood flow distribution was studied with a radioactive-labeled microsphere technique in 11 unanesthetized fetal sheep (139 to 143 days' gestation). After cesarean delivery each neonatal lamb was studied at 2 and 24 hours of age. Blood flow to the cerebral hemispheres and adrenal glands decreased progressively after birth and correlated inversely with the postnatal rise in arterial oxygen content (r = -0.77, p less than 0.001 and r = -0.52, p less than 0.01, respectively). Blood flow to the gastrointestinal tract and kidneys changed little despite the known increase in blood flow from the late fetal to the early neonatal period. Skeletal muscle and brown fat blood flow were both increased when measured at 2 hours after birth, with an even greater increase in their respective oxygen deliveries presumably reflecting their increased metabolic activity with thermogenesis at this time. Variable blood flow changes are thus evident over the immediate perinatal period. In some cases these changes reflect birth-related changes in either blood gases or functional activity whereas in others the changes simply reflect a continuum from the late fetal to the early neonatal period. PMID- 2712125 TI - Purified human early pregnancy factor from preimplantation embryo possesses immunosuppresive properties. AB - This study was undertaken to determine whether early pregnancy factor secreted by preimplantation embryos has immunosuppressive properties. Human early pregnancy factor was purified from embryo growth media of in vitro fertilized ova with ion exchange and gel filtration chromatography. During each step of purification the fractions were tested for (1) early pregnancy factor activity with the rosette inhibition assay, (2) immunosuppressive properties with a concanavalin A stimulated lymphocyte proliferation assay, and (3) purity by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Results indicate that (1) human early pregnancy factor has a basic molecular weight of 14 kd, (2) early pregnancy factor has immunosuppressive activity, (3) polymers of early pregnancy factor also appear to be present in the embryo growth media, and (4) immunosuppressive factors other than early pregnancy factor are also secreted by preimplantation human embryos. Early pregnancy factor and other factor(s) produced by the preimplantation embryo may play a role in suppressing maternal cellular immune responses, thereby preventing maternal rejection of the embryo. PMID- 2712126 TI - Umbilical cord is the major source of prostaglandin E2 in the gestational sac during term labor. AB - The umbilical cord is an amniotic structure histologically resembling amnion lining the basal plate and reflected chorion. Prostaglandin E2 is secreted by amnion and is present in amniotic fluid. This study measured prostaglandin E2 production by amnion from all three locations to determine the relative contributions of prostaglandin E2 to amniotic fluid at term. Total surface areas and weights of umbilical cord, basal placental plate, and reflected chorionic amnion were measured in afterbirths from 20 normal patients delivered at term by elective repeat cesarean section before the onset of labor or vaginally after spontaneous onset of labor. Subsequently, 2 cm lengths of umbilical cord and 8 cm2 disks of basal placental plate and reflected chorionic amnion were incubated in perfusion chambers, and prostaglandin E2 production was measured by radioimmunoassay. Umbilical cord accounted for the least surface area (16% to 17%) but greatest tissue mass (75% to 76%). Both basal placental plate and reflected chorionic amnion increased prostaglandin E2 production 2.3-fold and 4.1 fold, respectively, after labor versus before labor, whereas umbilical cord prostaglandin E2 output was unchanged. However, umbilical cord accounted for 66% and 44% of the total prostaglandin E2 output before labor (697 +/- 169 ng/hr) versus (1201 +/- 380 ng/hr) after labor. Thus, of the three amniotic locations, umbilical cord represents the principal site of prostaglandin E2 production within the gestational sac. PMID- 2712127 TI - The influence of spontaneous accelerations of fetal heart rate on umbilical artery velocity waveforms. AB - For clinical interpretation of Doppler waveforms, it is important to establish the extent to which fetal heart rate changes affect the umbilical artery velocity waveform. Umbilical artery waveforms were measured with continuous wave ultrasonography during spontaneous accelerations of the fetal heart rate in 20 uncomplicated, near-term pregnancies. On average, an acceleration of 20 beats/min of fetal heart rate within an individual was associated with a reduction in the systolic/diastolic velocity ratio of 0.25. There was, however, considerable variability in the response, and in six patients the systolic/diastolic ratio actually increased with heart rate. We conclude that fetal heart accelerations within the normal range cause only small and variable changes in the systolic/diastolic ratio. PMID- 2712128 TI - Inflammatory bowel disease: a controlled study of late pregnancy outcome. AB - A retrospective controlled study of 98 pregnancies complicated by inflammatory bowel disease was conducted with control pregnancies matched for parity, sex of offspring, year of delivery, and maternal age. Two control pregnancies were paired with each study case. There was no significant difference in weight gain or hemoglobin levels between the two groups. However, patients with inflammatory bowel disease had a statistically significantly higher preterm delivery rate (p less than 0.01) than the rate of the control group. The risk of these two disorders was further increased when exacerbation of the bowel disease occurred during pregnancy. PMID- 2712129 TI - Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. AB - We measured the number and size of retinal ganglion cells from six human eyes with glaucoma. In each, the histologic findings were correlated with visual field results. Five age-matched normal eyes were studied for comparison. In general, there were fewer remaining large ganglion cells in retinal areas with atrophy. In the perifoveal area, however, no consistent pattern of cell loss by size was found. Our estimates suggest that visual field sensitivity in automated testing begins to decline soon after the initial loss of ganglion cells. Throughout the central 30 degrees of the retina, 20% of the normal number of cells were gone in locations with a 5-dB sensitivity loss, and 40% cell loss corresponded to a 10-dB decrease. There were some remaining ganglion cells in areas that had 0-dB sensitivity in the field test. PMID- 2712130 TI - The time-course of intraocular pressure in timolol-treated and untreated glaucoma suspects. AB - We studied the behavior of intraocular pressure in glaucoma suspects randomly selected to receive either topical timolol or no treatment over the course of a long-term prospective follow-up study. All patients who after six years of follow up showed no localized field defects or disk changes, or whose pressures were not dangerously increased (24 treated and 22 untreated patients), were included in the present study. Overall, the two groups showed an increase in pressure followed by a gentle leveling off and a decrease toward the end of the follow-up period. The pressure-time curves of the two groups were parallel and vertically separated by 4.94 mm Hg. When pressure-time relationships were determined in individual patients, the categorical group differences were not statistically significant. Our results suggest that most glaucoma suspects did not exhibit a random time-course of intraocular pressure and that the effect of treatment was simply to lower the pressure-time curve of the treated group by a fixed level throughout the six-year follow-up period. PMID- 2712131 TI - Reversible optic disk cupping and visual field improvement in adults with glaucoma. AB - To assess change over time in the optic disk and the associated change in visual field, we retrospectively reviewed perimetry results and optic disk photographs of adult patients treated for glaucoma. Three glaucoma specialists masked to the clinical course independently reviewed optic disk stereophotographs and visual fields taken before and after treatment. Each member of each pair of stereophotographs or perimetry results, which were presented in a random sequence, were graded as better, worse, or unchanged. Of the 75 eyes, 16 (21%) showed a reversal of optic disk cupping; 20 of the 63 visual fields (31%) were classified as improved. In six of 17 eyes (35%) with a change in the disk (better or worse), a corresponding change was also noted in the visual field. The frequency of improvement in optic disk and visual field appearance was significantly (P less than .05) associated with the degree of intraocular pressure reduction. PMID- 2712132 TI - Threshold equivalence between perimeters. AB - To determine equivalence between perimeters, 49 eyes of 35 subjects underwent static threshold testing of the central 30 degrees twice on each of three automated perimeters and twice by manual kinetic threshold testing with the Goldmann perimeter. The Octopus-Humphrey difference was 3.3 dB (2.3 dB in the upper two rows for programs 32 and 30-2). The Dicon-Octopus difference was 3.5 dB and the Dicon-Humphrey, 6.5 dB. The I4e stimulus of the Goldmann perimeter was equivalent to 17.1 dB, 13.6 dB, and 10.8 dB on the Humphrey, Octopus, and Dicon perimeters, respectively. The III4e stimulus of the Goldmann perimeter, used for visual impairment determination, was roughly equivalent to 7 to 10 dB, 4 to 7 dB, and 0 to 6 dB on the Humphrey, Octopus, and Dicon perimeters, respectively. The prediction when converting from one instrument to another was only 10% less reliable than the ability of a perimeter to predict the values on a second examination with the same perimeter. Validity of the conversion formulas was confirmed by the age-corrected normal values available for the Octopus, Humphrey, and Goldmann perimeters. PMID- 2712133 TI - Kestenbaum's number as an indicator of pupillomotor input asymmetry. AB - We compared the direct light response of both eyes in 90 patients who had anterior visual pathway disease using two different testing methods. We measured Kestenbaum's number in millimeters of pupillary diameter. Kestenbaum's number (K) is the difference in the pupil size attained in each eye under direct illumination while the other eye is occluded. We then measured the relative afferent pupillary defect (RAPD) in log units using neutral density filters. The two tests gave similar results (K = 0.88 x RAPD). Kestenbaum's number is the less precise measure, but it can be quickly and cheaply estimated even in dark brown eyes. The filter test requires a set of filters and at least one well-innervated iris sphincter. Kestenbaum's number can be measured without filters, but the iris sphincter and dilator muscles in both eyes must be normally innervated. PMID- 2712134 TI - Retinal detachment after neodymium:YAG laser posterior capsulotomy. AB - We reviewed the records of 397 patients who had undergone Nd:YAG laser posterior capsulotomy between July 1983 and August 1988. Of the 366 eyes that had been followed up for three months or more, 13 (3.6%) developed a retinal detachment after capsulotomy; of these 13 detachments, 11 (84.6%) occurred within the first year. The combination of male gender with axial myopia (greater than or equal to 25.00 mm), a history of lattice degeneration, or a history of retinal detachment in the fellow eye was a significant risk factor for the development of retinal detachment after YAG capsulotomy. PMID- 2712135 TI - Silicone oil injection after failed primary vitreous surgery in severe ocular trauma. AB - In 42 cases of complicated retinal detachment following trauma after failed primary vitrectomy, at six months follow-up anatomic retinal reattachment posterior to the scleral buckle was achieved in 20 of 40 eyes (50%). Of the 40 eyes, 11 (28%) had a visual acuity of 5/200 or better. Of the eyes that were completely attached posterior to the buckle at six months, 13 of the 20 (65%) remained attached at the last follow-up examination. Many patients who had visual acuities of 5/200 or better at six months experienced a progressive decrease in visual acuity over three years, primarily because of recurrent retinal detachments and corneal edema. A final visual acuity of 5/200 or better was obtained in only five of the 42 eyes (12%) at the last follow-up examination. PMID- 2712136 TI - Organizing to prevent Third World blindness. PMID- 2712137 TI - Idiopathic inflammatory orbital pseudotumor and low-dose cyclosporine. PMID- 2712138 TI - Pseudomonas corneal ulcers after artificial fingernail injuries. PMID- 2712139 TI - Sinus histiocytosis with massive lymphadenopathy. PMID- 2712140 TI - Conjunctival squamous cell carcinoma in a patient with human immunodeficiency virus infection. PMID- 2712141 TI - Retained glass foreign body in the eyelid. PMID- 2712142 TI - Calcific eyelid margin lesions in chronic renal failure. PMID- 2712143 TI - Mycobacterium chelonae scleral abscess after removal of a scleral buckle. PMID- 2712144 TI - Early diagnosis of tyrosinemia type II. PMID- 2712145 TI - Branch retinal vein occlusion in sarcoidosis. PMID- 2712146 TI - Systemic absorption of ophthalmic cyclopentolate. PMID- 2712147 TI - Mean visual acuity. PMID- 2712148 TI - Visual results with low-vision aids in age-related macular degeneration. PMID- 2712149 TI - Nd:YAG laser photodisruption of hemorrhagic detachment of the internal limiting membrane. PMID- 2712150 TI - Intraocular pressure increase associated with traumatic epsilon-aminocaproic acid therapy for traumatic hyphema. PMID- 2712151 TI - Severity of depression and developmental levels of psychological functioning in 8 16-year-old girls. AB - Clinical knowledge of subjective experience is considered essential for formulation of appropriate treatment expectations and goals. This study examined the relationship between self-reported depression and affective and cognitive correlates. Results indicated that girls reporting more depression had significantly earlier developmental levels of object relations and cognition than girls reporting less depression, regardless of chronological ages. PMID- 2712152 TI - Causes of elder abuse: caregiver stress versus problem relatives. AB - Elderly abuse victims and a nonabused control group were compared to test the widely accepted proposition that such abuse results from the burden and stress placed on those caring for infirm and dependent elderly people. The study found substantially more support for the idea that abuse is associated with personality problems of the caregiver. PMID- 2712153 TI - Age at first hospitalization and premorbid social competence in schizophrenia and affective disorder. AB - Paranoid schizophrenics were found to be more similar to affective disordered patients than to other types of schizophrenics on age at first hospitalization and premorbid social competence. These findings support an earlier formulation of paranoid schizophrenia as a reflection of underlying affective disorder rather than as a subtype of schizophrenia. In addition, in all the diagnostic groups, women were found to be older than men at first hospitalization. PMID- 2712154 TI - Maternal support following disclosure of incest. AB - The level of maternal support to incest victims following disclosure was found to be more closely related to perpetrator than to child characteristics. Lack of maternal support was significantly associated with foster placement and higher psychopathology scores in a clinical interview. Evidence is presented challenging the validity of maternal behavioral reports in assessments of incest victims. PMID- 2712155 TI - Changing patterns among homeless and runaway youth. AB - In recent years, the population of runaway and homeless youth has changed. In a study of 536 homeless and runaway youth who were clients of service agencies in New Jersey, homeless youth predominated. Only one-third of the sample were able to return home after service and this particular focus of service is seen as feasible only for a minority of such youth. PMID- 2712156 TI - Treating the sibling subsystem: an adjunct of divorce therapy. AB - Sibling therapy, frequently overlooked as a method of treatment, is particularly appropriate in situations that require a deliberate focus on the "unit of continuity," or the subsystem that remains intact during a process of family reorganization. For this and other reasons it can be an effective tool in treating children of divorce. A case illustrating this use of sibling therapy is presented. PMID- 2712157 TI - Sexualized attention: normal interaction or precursor to sexual abuse? AB - Sexualized attention is defined as a behavioral interaction between a caregiver and a preverbal child in which the adult appears to be sexually stimulated or involves the child in sexually stimulating games. Four cases involving parents whose infants had already exhibited physical signs of abuse or neglect are presented. Research and practice implications of this exploratory concept are discussed, and caution is urged with regard to its diagnostic application. PMID- 2712158 TI - Psychotherapy and mandated reporting of child abuse. AB - Seventy-six percent of 65 psychotherapy cases seen in a child guidance clinic either did not change or improved following a mandated report of suspected child abuse. In a significant minority of cases, the therapy relationship deteriorated when the report was made about a client in treatment, and improved when the report was made about a third party not in treatment. PMID- 2712159 TI - The role of self-understanding in resilient individuals: the development of a perspective. AB - Three studies are reviewed in which an in-depth life-history approach was used, and in which a strong connection was demonstrated between self-understanding and resilience. Subjects were civil rights workers in the South, survivors of childhood cancer, and adolescents whose parents had serious affective disorders. Dimensions of the concept of self-understanding which are evident in all three investigations are explored, and the study of resilience as part of an integrative approach to the understanding of human behavior is outlined. PMID- 2712160 TI - Epidemiology and child psychiatry: entering the second phase. AB - Recent progress in epidemiological studies describing the prevalence, distribution, and possible determinants of psychiatric disorders in children have pointed the way toward a new, experimental phase for research. Such investigations would be formal in design, use principles of a preventive trial, and exploit all current knowledge about the role of risk factors and causal mechanisms. This paper proposes the prevention of conduct disorder as the most productive starting point for this new phase. PMID- 2712161 TI - Disabling practitioners: hazards of learning to be a doctor in American medical education. AB - Ongoing work with first and second-year medical students suggests that American medical culture is characterized by a juxtaposition of notions of "competence" and "caring," and that the training of students to be competent physicians requires a reconstruction of "common sense" views of the patient, of sickness, and of the personal boundaries of the medical student. Contradictions that arise from efforts to maintain qualities of caring while undergoing these changes are highlighted. PMID- 2712162 TI - Child abuse allegations. PMID- 2712163 TI - Nutritional status of Efe pygmies and Lese horticulturists. AB - We assessed the nutritional status of 90 pygmies (Efe) and 211 members of a neighboring horticultural Lese in the Ituri forest in northeast Zaire. Clinical signs of iron and iodine deficiency were highly prevalent, but the frequency of these and other clinical signs of nutritional deficiency did not differ between the two groups. Infectious diseases such as yaws, cellulitis, and filiariasis were common. Absolute heights and weights of both Efe males and females aged 2-18 years were less than the 5th percentile of the National Center for Health Statistics standards. Weights for height of both groups were within the normal range. Weights and heights, expressed as percentages of the 50th percentile for age and sex, were significantly lower (P less than .001) in Efe males and females than among Lese males and females, but weights for height did not differ significantly. Z-Scores of height and weight were also significantly lower in Efe males and females than among their Lese counterparts. The differences in weight and height, expressed either as a percentage of the 50th percentile or as Z scores, were most apparent in older adolescents and persisted among adults. The normal weight for height among both populations indicated that acute undernutrition did not exist at the time of the survey. Despite comparable levels of adult fatness, measured by triceps skinfold thickness, heights of Efe males and females were lower than those of the Lese. These observations support the hypothesis that genetic differences account for the short stature of the Ituri pygmy. However, because the environments shared by the two groups are not identical and because other practices differ, nutritional effects cannot be excluded. PMID- 2712164 TI - Ecology and ovarian function among Lese women of the Ituri Forest, Zaire. AB - Ovarian function is examined in 35 Lese women inhabiting the Ituri Forest of northeastern Zaire over a period of 4 months through measurements of progesterone in saliva samples collected twice weekly. Ovulatory frequency is found to be only 56% on average, with a pattern of age variation similar to that observed in western women, though lower in level at each age. Average luteal progesterone levels of the Lese women are lower than those of Boston controls even if only ovulatory cycles are considered. Women with the poorest nutritional status, inferred from longitudinal weight changes and weight for height, show the greatest compromise of ovarian function, and the average ovulatory frequency of the whole sample declines in parallel with a period of weight loss over four months. It is suggested that low ovulatory frequency and luteal insufficiency contribute to the low fecundity of the Lese population and that nutritional status is likely to be one of the ecological factors modulating this effect. PMID- 2712165 TI - Ecology and affective behavior: selected results from a quantitative study among Efe foragers of northeast Zaire. AB - This paper reports selected results of a quantitative study of the affective behavior of the Efe, exchange-dependent hunter-gatherers of the Ituri forest in northeastern Zaire. Measures of the amount and kind of affective display were based on systematic, direct observation of the routine behavior of three Efe bands in residential settings (camps), using a new technique to characterize affect-laden behavior according to nonlinguistic information conveyed in the voice. Resulting data provide a direct measure of the affective milieu of a foraging people, providing an objective indicator of the subjective impact of social and ecological conditions, which are thought to affect quality of life. In this paper, measures of "camp mood" are used to explore the psychosocial impact of a 3-month period of acute food shortage that occurred in the Ituri Project study area in 1983. Contrary to expectation, rates of behaviors conveying pleasure did not exhibit significant change, whereas a 44% increase in expressions of displeasure and a 17% drop in use of complaint tones were observed during the period of hunger. This and other findings support the view that systematic, direct observation in natural habitats can increase our understanding, both of the functions of affective behavior, and of the affective dimension of quality of life. PMID- 2712166 TI - Stratigraphic context of fossil hominids from the Omo group deposits: northern Turkana Basin, Kenya and Ethiopia. AB - The chronometric framework developed for Plio-Pleistocene deposits of the northern Turkana Basin is reviewed in light of recent advances in lithostratigraphy, geochemical correlation, paleomagnetic stratigraphy, and isotopic dating. The sequence is tightly controlled by 20 precise ages on volcanic materials. These ages are internally consistent but are at variance with estimates for the boundaries of the magnetic polarity time scale by about 0.07 my. This discrepancy can be only partially resolved at present. Based on the established chronometric framework and stratigraphic sequences, depositional ages can be estimated for significant marker beds. These ages can in turn be used to constrain the 449 hominid specimens thus far reported from the basin. Ages for most hominid specimens can be estimated with a precision of +/- 0.05 my. In addition, the chronometric framework will be applicable to other paleontological collections, archeological excavations, and future discoveries in the basin. PMID- 2712167 TI - Recent life events and panic disorder. AB - The authors assessed life events during the 12 months before the onset of panic disorder in 64 patients. Compared with a control group of 78 healthy subjects, patients with panic disorder had higher scores however life events were assessed, i.e., number of events, weighted normative scores, contextual scores, and number of subjects with major events. Independent life events (those beyond the subject's control) were also more numerous and more severe among the patients. The larger number of events experienced by the patients was due to the more frequent occurrence of life stress in the month before the onset of panic disorder. Loss events had the strongest relationship to panic disorder. PMID- 2712168 TI - Lateralization of dementia of depression in stroke patients. AB - In a group of stroke patients with left-hemisphere lesions, those with major depression performed significantly below nondepressed patients on four of nine cognitive domains examined with a neuropsychological test battery. Among patients with right-hemisphere stroke, those with major depression did not perform below nondepressed patients on any of the nine cognitive domains. The differential effect of depression on cognitive performance between left- and right-hemisphere lesion groups could not be accounted for by demographic variables, neurological symptoms, lesion location, or lesion size. Poststroke major depression appeared to produce a decline in cognitive performance or dementia of depression that depended on the laterality of the lesion. PMID- 2712169 TI - Influence of nondepressive psychiatric symptoms on whether patients tell a doctor about depression. AB - The authors studied the other recent psychiatric symptoms of 218 subjects who reported having had depressive episodes within the past year to determine the influence of the nondepressive symptoms on whether the subjects discussed the depressive episodes with a doctor. Symptoms of panic and obsessive-compulsive disorders encouraged discussion of a depressive episode, but symptoms of drug abuse/dependence inhibited such discussion. The findings illustrate the bias in studying only patients who seek treatment, point to groups of persons who may need psychiatric help, and provide insight into the complex process of help seeking. PMID- 2712170 TI - Murder and assault arrests of White House cases: clinical and demographic correlates of violence subsequent to civil commitment. AB - The authors studied arrest records and clinical data on 217 persons formerly hospitalized as "White House Cases" because they were psychotically preoccupied with prominent political figures. Prior arrest for violent crime was the variable most strongly associated with arrest for violent crime after hospital discharge. Male gender and a history of weapons possession were also correlated with future violence. For those with prior violent crime arrests, hospital incidents requiring seclusion were also associated with later violence. For those without prior arrests, subsequent violence was associated with threats, living outside Washington, and command hallucinations. For those previously arrested for nonviolent crimes, only persecutory delusions were associated with later violence. PMID- 2712171 TI - Growth rate in adolescents with obsessive-compulsive disorder. AB - In an epidemiological study of 5,596 high school students, the authors identified 20 adolescents with obsessive-compulsive disorder and compared their physical size to that of adolescents of the same sex with no obsessive-compulsive symptoms. The obsessive-compulsive boys (N = 11) were shorter and weighed less than the other boys (N = 2,479) and were shorter than a subsample of normal boys (N = 33) and boys with other psychiatric diagnoses (N = 16). Regression analysis showed a flatter growth pattern through adolescence for the obsessive-compulsive boys (although within the 95% confidence limits for the other boys), suggesting a subtle neuroendocrine dysfunction in obsessive-compulsive disorder. PMID- 2712172 TI - Patterns of contagion in self-mutilation epidemics. AB - Contagion of self-mutilation was studied in a treatment program for disturbed adolescents. Statistical analyses and a sociogram revealed that 1) episodes of contagion were significantly associated with specific pairs of subjects, and 2) a few subjects were identified as being at the center of most of the contagion activity. PMID- 2712173 TI - Psychopathology in patients with Wilson's disease. AB - The authors used the MMPI to assess psychopathology in neurologically impaired and neurologically asymptomatic patients with Wilson's disease. Neurologically impaired patients showed more psychopathology on the schizophrenia and depression scales and had a significantly higher rate of severe depression. PMID- 2712174 TI - Posttraumatic stress disorder: a descriptive study supporting DSM-III-R criteria. AB - Posttraumatic stress disorder, as defined by DSM-III, remains a controversial diagnostic entity. This descriptive study, which was carried out by the author in a war zone, supports the changes made in the criteria in DSM-III-R. PMID- 2712175 TI - Violent crime possibly associated with anabolic steroid use. PMID- 2712176 TI - Arm cutting and glucose level in depression. PMID- 2712177 TI - Menstrual cycle phase-related appetite dysregulation. PMID- 2712178 TI - Correlates of duration of panic and/or phobic avoidance. PMID- 2712179 TI - Asking patients about symptoms of multiple personality disorder. PMID- 2712180 TI - Antidepressant action of crisis seeking and crisis making. PMID- 2712181 TI - Interview as part of medical treatment. PMID- 2712182 TI - Diagnosis of posttraumatic stress disorder. PMID- 2712183 TI - DSM-III versus DSM-III-R criteria for schizophrenia. PMID- 2712184 TI - Minimal cultural experiences in psychiatric training. PMID- 2712185 TI - Trends in the treatment of depression. PMID- 2712186 TI - Palisaded myofibroblastoma. A benign mesenchymal tumor of lymph node. AB - We report 22 examples of an unusual and distinctive benign mesenchymal tumor arising exclusively from lymph nodes of the groin. The tumor, which presents clinically as a swelling, is composed of spindled cells arranged in solid sheets or short, vaguely palisaded fascicles similar to a neurilemoma. The spindled cells blend gradually with large mats of eosinophilic material that appear as thick bands, ellipses, or circular profiles, depending on the plane of section. These eosinophilic structures, which represent a highly characteristic feature of the tumor, contain deeply eosinophilic, collagen-rich cores surrounded by a weakly eosinophilic, actin-rich cuff. The actin within these eosinophilic structures is derived by coalescence of intracellular actin globules extruded from neighboring cells. In all cases, a thin, compressed rim of normal lymph node was identified. Immunohistochemical analysis indicates that the cells express actin but lack S-100 protein, synaptophysin, desmin, keratin, and epithelial membrane antigen. Delicate, linear striations were identified in only two cases by conventional histochemical techniques. The foregoing features suggest that the tumor is related to a myofibroblast or a specialized smooth-muscle cell. These tumors, therefore, probably arise from smooth-muscle-like cells, which are normally present in some lymph node capsules or stroma. Follow-up information on 17 patients indicated that all are alive and well without any evidence of recurrence or metastasis. PMID- 2712187 TI - Intranodal hemorrhagic spindle-cell tumor with "amianthoid" fibers. Report of six cases of a distinctive mesenchymal neoplasm of the inguinal region that simulates Kaposi's sarcoma. AB - We describe six cases of a distinctive spindle-cell neoplasm apparently arising from inguinal lymph nodes in adult patients. The lesions were characterized histologically by highly vascularized, interlacing fascicles of spindle cells circumscribed by an irregular band of sclerosis and hemorrhage, and surrounded by a compressed rim of lymph node remnant. A striking feature observed in all cases was the presence of stellate-shaped areas containing thick collagen fibers (so called amianthoid fibers). Immunohistochemically, the tumor cells were positive for actin, muscle myosin, and vimentin. Electron-microscopic examination demonstrated features indicative of myofibroblastic and smooth-muscle differentiation. Follow-up has shown no evidence of recurrence or metastases. The lesions appear to represent an intranodal neoplastic proliferation of mesenchymal cells exhibiting benign biologic behavior. The inguinal location, presence of amianthoid fibers, and the striking rim of hemorrhage surrounding the spindle cell proliferation set this tumor apart from other lesions. It is important to distinguish this entity from nodal involvement by Kaposi's sarcoma, a lesion it may closely resemble. PMID- 2712188 TI - Desmoplastic malignant melanoma and its variants. A study of 45 cases. AB - Forty-five tumors exhibiting the histological features of desmoplastic malignant melanoma or its variant, neurotropic melanoma, were found among approximately 4,500 soft-tissue tumors referred in consultation from Australia and New Zealand. All patients were Caucasians. Tumors fell into three groups: (a) desmoplastic melanoma with an atypical intra-epidermal melanocytic component (classical desmoplastic melanoma) (12 cases); (b) desmoplastic melanoma without an atypical intra-epidermal melanocytic component (de novo desmoplastic melanoma) (21 cases); (c) predominantly nerve-centered superficial malignant tumors with or without an atypical intra-epidermal melanocytic component (12 cases). Three of the nerve centered tumors were associated with pigmentary abnormalities in the overlying skin. The patients' ages ranged from 42 to 91 years, with a peak in the seventh decade; 31 patients were male and 14 were female. Lesions were located in the head and neck (35 cases), shoulder and arm (four), back and chest (three), abdomen (one), thigh (one), and leg (one). Three tumors arose in irradiated areas, and one occurred on the face of a radiotherapist. Melanin was found in only four tumors, but the S-100 protein stain was positive in 19 tumors and negative in three. Follow-up details of 42 patients were available. In follow-up times from 4 months to 15 years (mean, 4.6 years), 15 patients (36%) had died of the disease or were terminally ill; 24 (57%) were alive with no apparent residual tumor; and three (7%) had died of other causes. Twenty-three patients (55%) developed one or more local recurrences; 17 (40%) developed distant spread, including extension into the cranial cavity along nerves; and 14 (33%) had both local recurrence and distal spread. Nine (82%) of 11 patients with nerve-centered tumors died or were terminally ill. The usual treatment was surgical. Most uncontrolled recurrences were resistant to chemotherapy and radiotherapy; however, two patients responded well, one to chemotherapy and one to radiotherapy. Our observation support Reed and Leonard's metaplastic explanation for the varied differentiation seen in desmoplastic melanomas. PMID- 2712189 TI - Carcinomas of the urinary bladder with deceptively benign-appearing foci. A report of three cases. AB - Three men, aged 53 to 77 years, had carcinomas of the urinary bladder characterized by foci with a deceptively benign histological appearance. In two cases, this feature led to a significant delay in establishing the correct diagnosis. The diagnostic difficulty in these cases resulted from the resemblance of foci of infiltrating carcinoma to von Brunn's nests, cystitis glandularis, cystitis cystica, and nephrogenic adenoma, alone or in combination. Features that helped distinguish these foci from benign processes were an irregular distribution, the presence of large numbers of closely packed epithelial aggregates, focal mild to moderate cytologic atypia, and transitions to unequivocal carcinoma. In a third case, the superficial component of a carcinoma closely resembled an inverted papilloma. PMID- 2712190 TI - Hypocellular paratrabecular foci of treated small cleaved cell lymphoma in bone marrow biopsies. AB - Because of the new drug combinations being used to treat follicular lymphomas, the small cleaved cell lymphomatous foci in bone marrow biopsies appear to be altered. They become progressively hypocellular and contain a few and sometimes no small cleaved cells within oligocellular paratrabecular fibrous foci. These hypocellular paratrabecular foci (HPF) (a) are a clue that deeper sectioning is necessary to determine whether there are diagnostic foci of residual involvement by small cleaved cell lymphoma, (b) may indicate that other portions of the patient's bone marrow still contain viable foci of small cleaved cell lymphoma, and further, (c) should alert the clinician to the possibility of recurrence of small cleaved cell lymphoma in subsequent bone marrow biopsies. A comparison of patients who developed HPF in one or more of their bone marrow biopsy specimens with those who did not indicates that the changes are related to combinations of chemotherapy other than CHOP-Bleo (cyclophosphamide, adriamycin, vincristine, prednisone, bleomycin). Eighty-one percent of patients who developed HPF had received additional chemotherapeutic regimens, whereas 75% of patients whose bone marrows did not contain HPF had received only CHOP-B. The older age of the HPF negative patients (median age 64 versus median age 43 for HPF-positive cases) may reflect more aggressive chemotherapy in the younger age group. While HPF appear to reflect some increased chemotherapeutic cytotoxicity affecting the lymphomatous foci in bone marrow, they do not appear to predict for a longer survival or cure. PMID- 2712191 TI - Squamous cell carcinoma arising in mature cystic teratoma of the ovary. Clinicopathologic and topographic analysis. AB - Clinical and pathologic features of 28 patients with squamous cell carcinoma (SCC) arising in mature cystic teratoma (MCT) of the ovary were analyzed. The overall 5-year survival rate of these patients was 52%. Clinical staging (Stage I versus Stages II or more), histologic differentiation (well versus moderately or poorly differentiated SCC), and the presence of vascular invasion were factors affecting the prognosis of these patients. In 11 tumors, including 2 of the 4 examined in stepwise serial sections, the SCC was considered to have originated from a columnar epithelium (ciliated or nonciliated) or from a metaplastic squamous epithelium. On the other hand, no SCC was a direct transition from the ordinary epidermis of the teratomatous skin tissue. These results strongly support the proposal that SCC arising in MCT derives from the columnar epithelium. PMID- 2712192 TI - Meningeal nodules with features of extranodal sinus histiocytosis with massive lymphadenopathy. AB - We present an unusual case of multiple intracranial meningeal nodules in a 30 year-old man. Histologically, the nodules consisted predominantly of plasma cells, histiocytes, and lymphoid cells with Russell bodies and emperipolesis. Emperipolesis may be a clue to understanding the pathogenesis of the process that has features consistent with so-called sinus histiocytosis with massive lymphadenopathy in the extranodal location. PMID- 2712193 TI - Composite adenoma-small-cell undifferentiated carcinoma of the colon. PMID- 2712194 TI - Occult tumor cells in lymph nodes. PMID- 2712195 TI - Trial of deltamethrin impregnated bed nets for the control of malaria transmitted by Anopheles sinensis and Anopheles anthropophagus. AB - In 1985-1987, a field trial of malaria control using deltamethrin impregnated mosquito nets was carried out with 4,450 people in the Buji district, Bao'an County, Guangdong Province, China. The vectors were exophilic Anopheles sinensis (80%) and the endophilic and anthropophilic An. anthropophagus (20%). The first impregnation of the nets was in June 1985 and the second in April 1986. About 87% of the population slept under treated nets. The indoor vector density decreased by 93% and remained at the same level during the second year. During the second year the average monthly malaria incidence was 1.3% for January-June, a decrease of 74.6% as compared with pretreatment data, and 0.85% from July to December, a decrease of 92.7%. In April 1986 and April 1987, the treatment was extended to the whole Buji District, which has a total population of approximately 40,000. The average monthly malaria incidence (April-December 1986 and 1987) was 0.54% and 0.17%, a decrease of 64.7% and 89% respectively as compared with the same period for the previous year. PMID- 2712196 TI - A specific diagnostic antigen of Echinococcus granulosus with an apparent molecular weight of 8 kDA. AB - An echinococcus antigen with an apparent molecular weight of 8 kDa was identified as diagnostically important. An immunoblot assay using this antigen was 91% sensitive for surgically confirmed Echinococcus granulosus hydatid disease of the liver. Specificity was 100% for echinococcosis. Marked cross-reactivity was observed with serum specimens from patients with E. multilocularis and E. vogeli infections. The 8 kDa component was not related to the widely recognized echinococcus antigen 5. PMID- 2712197 TI - Isolation of Fusobacterium nucleatum and electron microscopic observations of spirochetes from tropical skin ulcers in Papua New Guinea. AB - Tropical ulcer is a disabling condition of the lower leg affecting mainly young adults and older children. Microscopic observations of lesion material have shown fusiform bacilli and spirochetes. We used anaerobic culture techniques to isolate and identify these fusiform bacilli. Electron microscopic (EM) studies were performed to characterize the spirochetes. Material collected on swabs was used to inoculate pre-reduced media and to prepare smears for gram staining; the swabs were placed in fixative for EM study. After incubation, colonies containing fusiform bacilli were subcultured. The anaerobic gram-negative fusiform isolates were identified as Fusobacterium nucleatum using biochemical reactions, hemagglutination testing, and reaction of antigen preparations of the isolates and ATCC strains in serological tests with rabbit antisera. EM observations of negatively stained spirochetes revealed an 8-16-8 periplasmic flagellar arrangement. F. nucleatum and spirochetes may participate in the pathogenesis of this polymicrobic infection. PMID- 2712198 TI - Fatal infection of silvered leaf monkeys with a virus-like infectious agent (VLIA) derived from a patient with AIDS. AB - Four silvered leaf monkeys, inoculated with a virus-like infectious agent (VLIA) derived from transformed NIH/3T3 cells (sb51) transfected with Kaposi's sarcoma DNA of an AIDS patient, showed wasting syndromes and died in 7-9 months. Two monkeys had a transient lymphadenopathy in earlier stages. Two moribund animals showed lymphopenia. Although 3 of the VLIA inoculated monkeys had persistent low grade fever early in the infection, the animals became afebrile in the later stages. One VLIA inoculated animal had a prominent antibody response, which occurred 7 months after VLIA inoculation. The other 3 monkeys had a transient or poor antibody response in the later stages. These 3 animals revealed periodic VLIA antigenemia during the course of the experiment. A control monkey was killed 8 months after the last VLIA inoculated monkey succumbed and showed neither an antibody response nor evidence of antigenemia. VLIA-specific DNA could be directly detected in necropsy tissues of all 4 monkeys inoculated with VLIA using the polymerase chain reaction method. VLIA infection was identified in all 4 spleens, 2 of 4 livers, 1 of 2 kidneys, and all 3 brains tested from these 4 animals, but not in the tissues from the control monkey. The necropsy examination of the 4 VLIA inoculated animals revealed no opportunistic infections, acute inflammatory lesions, malignancy or cause of death other than VLIA infection. We believe that the VLIA caused a fatal systemic infection in these monkeys. PMID- 2712199 TI - Antibody-dependent enhancement of dengue virus growth in human monocytes as a risk factor for dengue hemorrhagic fever. AB - Serum specimens collected during a prospective study of dengue infections among schoolchildren in Bangkok were tested for their ability to enhance dengue 2 (DEN 2) virus growth in human monocytes in vitro. Two groups of dengue-immune sera were compared: 32 dengue antibody positive serum specimens from children who subsequently developed asymptomatic secondary dengue infections; and 9 dengue antibody positive serum specimens from children who subsequently developed severe symptomatic secondary dengue infections, 8 of which were clinically diagnosed as dengue hemorrhagic fever. Antibody-dependent enhancement of virus growth was quantitated by measurement of virus yields in supernatant fluids of normal human monocyte cultures that were infected with DEN-2 virus in the presence of undiluted test serum. Only 4 of 32 (12%) preinfection sera from asymptomatic children, but 6 of 9 (67%) preinfection sera from symptomatic children, had significant enhancing activity (P less than 0.001). High serum DEN-2 antibody dependent enhancing activity is a significant (relative risk = 6.2) risk factor for severe illness among children in a dengue hemorrhagic fever endemic region. Dengue antibodies can be neutralizing and therefore protective, or they can be enhancing and increase the risk of dengue hemorrhagic fever. PMID- 2712200 TI - Thoughts while scrubbing. PMID- 2712201 TI - Abdominal injuries associated with the use of seatbelts. AB - The mandatory use of seatbelts has become commonplace in Canada, and such legislation was adopted by the province of British Columbia in 1977. This has provided us with an opportunity to study the effects of seatbelt restraints on accident victims, particularly concerning abdominal injuries. Five hundred sixty two patient charts were reviewed during a 3-year period. Documented use of seatbelts was found in 126 cases. Thirty-six of these patients underwent laparotomy and form the basis of this study. Compared with previously reported figures for blunt abdominal trauma, there was a high incidence of gastrointestinal injuries (67 percent). In addition, associated lumbar spine injuries were found in a large proportion of patients (19 percent, p less than 0.005). We found an increased risk of spinal injury in patients wearing a lap versus a three-point belt. PMID- 2712202 TI - Rural trauma management. AB - Rural trauma is a major problem in the United States. Up to 70 percent of trauma fatalities occur in rural areas, even though 70 percent of the population live in urban areas. Over the past 3 decades, numerous studies have defined the concept of preventable trauma death in both rural and urban populations. With the development of a regional trauma care system in Oregon, preventable trauma mortality should decrease. An effort was made to improve the quality of trauma care in Clatsop County, Oregon, a community of 30,000 people with 2 small rural hospitals. To obtain this goal, four steps were taken: (1) physician and nurse education was improved, (2) trauma protocols promoting prompt resuscitation and stabilization of patients were established, (3) regular trauma case reviews were conducted, and (4) emergency medical technician and prehospital management were coordinated. This study reviews the trail from sporadic, uncoordinated rural trauma care to the designation process. PMID- 2712203 TI - Liver resection without blood transfusion. AB - A personal series of 58 liver resections was reviewed to identify technical factors minimizing blood transfusions. We identified a concept of vascular isolation prior to parenchymal division (VIP) which used singularly or in combination the following methods of vascular control: parenchymal compression, Pringle maneuver, hepatic venous tourniquet, hilar division, hepatic vein division, and Heaney maneuver. VIP significantly decreased the need for transfusion; of 34 patients with VIP only 2 (6 percent) required transfusion, whereas of 24 patients without VIP, 18 (75 percent) required transfusion (p less than 0.001). PMID- 2712204 TI - A twelve-year survey of cervicothoracic vascular injuries. AB - This study of a large series of victims of trauma to the cervicothoracic great vessels confirms the lethal potential of these injuries: more than half of victims of such injuries died. The optimal management of patients potentially harboring such vascular damage appears to include skilled prehospital resuscitation and rapid transport to a trauma center, a high index of diagnostic suspicion, a low threshold for the performance of contrast arteriography, aggressive surveillance for associated neurologic and aerodigestive tract injuries, and timely technical repair, including liberal indications for sternotomy or thoracotomy to assure vascular control. PMID- 2712205 TI - Staged repair of interrupted aortic arch with ventricular septal defect compared with primary repair in infancy. AB - Interrupted aortic arch is a poor prognosis cardiac anomaly with nearly 100 percent mortality if not recognized and treated early. The associated intracardiac lesions often lead to death if only the arch defect is repaired. Several recent reports have described patients with interrupted aortic arch who were treated as infants by primary repair of the arch defect with simultaneous repair of the intracardiac lesions. The improved survival data from these series have been attributed to the simultaneous repair of both lesions. We report herein on nine patients with both interrupted aortic arch and ventricular septal defect seen at Children's Hospital and Medical Center in Seattle from 1979 to 1987. Three patients had partial expression of DiGeorge's syndrome. All patients underwent primary repair of the interrupted aortic arch with concomitant pulmonary artery banding during infancy (mean age 18 days, range 2 days to 4 months). Operative mortality was 11 percent (1 of 9 patients). Eight patients had eventual repair of the ventricular septal defect (mean age 18 months, range 6 to 29 months) with one death occurring at 5 months postoperatively (12 percent mortality). The overall mortality of these nine patients was 22 percent. Staged repair of interrupted aortic arch with associated ventricular septal defect can be performed with results comparable to simultaneous primary repair in infancy. The improved survival from either approach is more likely to be attributable to improved perioperative stabilization, particularly the use of prostaglandin E. PMID- 2712206 TI - Empyema thoracis in patients undergoing emergent closed tube thoracostomy for thoracic trauma. AB - The vast majority of thoracic trauma victims require only observation or tube thoracostomy for definitive treatment of their thoracic injury. Although tube thoracostomy is generally considered a limited intervention, 2 to 25 percent of patients who undergo this procedure develop infectious complications. To determine the incidence and risk factors for the development of empyema thoracis after tube thoracostomy, a retrospective study was undertaken. We found that the development of empyema thoracis was increased in patients whose pleural space was incompletely drained and whose thoracic catheters were in place for a prolonged period. PMID- 2712207 TI - Endarterectomy as the procedure of choice for atherosclerotic occlusive lesions of the common femoral artery. AB - Isolated atherosclerotic lesions of the common femoral artery, though uncommon, are frequently associated with disabling peripheral ischemic symptoms when compared with similar lesions in the superficial femoral artery since claudication involves the thigh and calf and usually limits walking distance to less than one block. From 1969 to 1987, 29 patients underwent common femoral endarterectomy with vein patch angioplasty for symptoms of disabling claudication in 17, rest pain in 6 and ischemic ulceration in 6 patients. Endarterectomy was confined to the common femoral artery in 10 patients whereas endarterectomy was carried into either or both the deep or superficial femoral arteries in 19 patients. There was one immediate failure, secondary to residual disease in the outflow tract. All patients were discharged with patent reconstructions. Amputations were avoided in the 12 patients with advanced ischemic symptoms. Patients were followed long-term. Three patients were lost to follow-up with patent repairs to that time. There was one late occlusion. The cumulative patency rate 5 years postoperatively was 94 percent. The only complication was aneurysmal dilatation of the end-arterectomy site in one patient. PMID- 2712208 TI - Factors affecting the incidence of lymph node metastases in small cancers of the breast. AB - Six hundred twenty-six cases of breast cancer treated at the Mason Clinic during the period from January 1, 1977 to December 31, 1987 were retrospectively reviewed. The review included only tumors 2 cm or less in maximal diameter and sought to determine the degree of correlation between axillary lymph node metastases in each of the following: patient age, estrogen receptor status, tumor location, degree of histologic differentiation, and tumor size. Only tumor size correlated significantly with the incidence of axillary lymph node metastases (p = 0.000001). The degree of differentiation appeared to correlate with the incidence of lymph node involvement but was not statistically significant (p = 0.17). No other subset of the above factors could be identified in association with axillary lymph node metastases. Forty-five noninvasive tumors were encountered in this series; none were associated with axillary lymph node metastases. The findings of this review lend support to the importance of screening mammography in the detection of breast cancer. PMID- 2712209 TI - Squamous cell carcinoma radioimmunoassay in squamous cell carcinoma of the head and neck. AB - Tumor-associated antigen has shown promise as a clinical aid in the detection and monitoring of uterine cervical squamous cell carcinoma. Antigen levels have been shown to reflect the extent of disease and response to treatment. These findings have suggested that measurements of tumor-associated antigen may be useful in monitoring other squamous cell carcinomas. To test this hypothesis, we measured tumor-associated antigen using the squamous cell carcinoma radioimmunoassay in 103 patients with previously treated squamous cell head and neck tumors and 28 patients with known squamous cell carcinoma of the head and neck. Increased squamous cell carcinoma antigen levels were found in 39 percent of patients with known tumors and in 19 percent of the patients with previous curative resection. The sensitivity of the assay limited its usefulness in predicting the presence of new and recurrent tumors. PMID- 2712210 TI - The sensitivity of vital signs in identifying major thoracoabdominal hemorrhage. AB - Prehospital and emergency room recordings of hemodynamic vital signs frequently play a major role in the evaluation and treatment of trauma victims. Guidelines for resuscitation and treatment are affected by absolute cutoffs in hemodynamic parameters. To determine the sensitivity of various strata of systolic blood pressure and heart rate in identifying patients with major thoracoabdominal hemorrhage, a 1-year retrospective review was conducted. A third of all patients presented to the emergency department with a normal blood pressure and over three quarters attained a normal blood pressure during the emergency department evaluation. Although the sensitivity of vital signs in identifying this group of patients improved as the variance from normal increased, standard cutoffs were relatively insensitive. We conclude that normal postinjury vital signs do not predict the absence of potentially life-threatening hemorrhage and abnormal vital signs at any point after injury require investigation to rule out significant blood loss. PMID- 2712211 TI - Early experience with the automatic implantable cardioverter defibrillator in sudden death survivors. AB - Medical management of life-threatening ventricular arrhythmias is difficult because of the toxicity and limited efficacy of antiarrhythmic drugs. The automatic implantable cardioverter defibrillator (AICD) offers protection against malignant ventricular arrhythmias and allows some patients to be managed without antiarrhythmic drugs. We reviewed our experience with the AICD to determine its safety and efficacy. Since June 1987, 24 patients (mean age 63 years) who survived out-of-hospital ventricular fibrillation or hemodynamically unstable ventricular tachycardia not associated with acute myocardial infarction had implantation of an AICD. None had inducible monomorphic ventricular tachycardia associated with ventricular aneurysm. Twenty-three had abnormal left ventricular function (mean ejection fraction 0.32). There were no operative deaths and three complications. At last follow-up (mean 8.9 months) 23 patients were alive. Eight patients had one or more AICD discharges associated with symptomatic or monitored cardiac arrest. AICD implantation can be performed with low risk and appears to be an effective alternative to antiarrhythmic therapy with toxic drugs. PMID- 2712212 TI - Management of cavernous hemangioma of the liver. AB - Cavernous hemangioma of the liver was diagnosed in 12 of 60 patients (20 percent) evaluated for surgery of neoplastic liver disease. All were female, from 29 to 77 years old. Six patients presented with abdominal pain and seven had taken estrogens. Indications for surgery included uncertain diagnosis, symptoms, large lesion greater than or equal to 6 cm, and hypoproliferative anemia. Three right lobectomies, one left lateral segmentectomy, one open biopsy, and one right trisegmentectomy were performed. There were no deaths, one subphrenic abscess, and one bile leak. The remaining seven patients were observed and at 2 to 6 years post operatively had followed a benign course. Resectional therapy may be considered for superficial large or symptomatic lesions in the appropriate patient, but most hepatic hemangiomas follow a benign course. PMID- 2712214 TI - Treatment of giant ulcer. PMID- 2712213 TI - The role of the specialist in undergraduate surgical education. PMID- 2712215 TI - [Clinical and morphological aspects of abruptio placentae with hemorrhagic shock]. AB - Seven histories of deliveries, complicated with abruptio placentae with hemorrhagic shock, and fetal autopsy protocols were examined, while the placentas and the uteri, removed at surgery were studied morphologically. Pregnancy had been complicated by gestosis in all patients. Placental abruption developed by 35 37 weeks of pregnancy in 5 patients, and near term in 2. All patients underwent urgent cesarean section followed by supravaginal amputation and extirpation of the uterus. Uterine, placental and fetal morphologic changes were qualified as shock-related. It is concluded that progressive abruptio placentae is an indication for abdominal delivery. PMID- 2712216 TI - [Cortisol contents in maternal and umbilical artery blood during delivery of low birth weight fetuses]. AB - Cortisol was measured in 50 parturients with low birthweight (LBW) fetuses in the course of vaginal delivery (n-18) and cesarean section (n-32). Twenty normal parturients whose pregnancy and labor were uncomplicated were taken as controls. In the main group, low birthweights corresponded to gestational age in 30 parturients, and fetal growth retardation (FGR) was diagnosed in 20. In the course of vaginal delivery, maternal cortisol level increased significantly, the rise being higher in parturients with the FGR syndrome. In both groups, blood cortisol levels were higher in the umbilical artery as compared to umbilical vein; in FGR cases, umbilical-artery cortisol level approached the respective values in control newborns. Following cesarean section, LBW fetuses showed considerably lower umbilical cortisol levels. Separate examination of cortisol fractions has demonstrated that free cortisol goes up in the maternal blood both at vaginal and abdominal delivery. The effect of corticosteroids, used to prevent respiratory distress syndrome, on maternal adrenal activity and LBW fetuses has been evaluated. PMID- 2712217 TI - [All-Union Congress of Physicians]. PMID- 2712218 TI - [Monitoring of platelet activity as a basis for the use of antiaggregants in placental insufficiency]. AB - Platelet hemostatic component was studied in 20 pregnant patients with placental insufficiency. Schedules of antiaggregant treatment have been proposed with respect to the magnitude of abnormal platelet activation. It is concluded that platelet monitoring is essential for the choice of an optimum treatment regimen. PMID- 2712219 TI - [Physico-chemical characteristics of the plasma membrane of the human placenta in placental insufficiency]. AB - Lipid peroxidation, microviscosity, lipid fraction ratios and glycoprotein carbohydrate metabolism were investigated in syncytiotrophoblastic plasmatic membranes of patients with placental insufficiency. Changes are demonstrated in the above parameters, as compared to normal values, indicative of profound structural transformations of placental membranes. Hyperbaric oxygenation is shown to have a favorable effect on structure and properties of placental membranes. PMID- 2712220 TI - [Relations between indicators of the activity of several blood enzymes and the state of the utero-placental blood flow in pregnant women at high risk of perinatal pathology]. AB - Studies of the uteroplacental blood flow and of some peripheral blood enzymes activities in 117 pregnant women have revealed that deterioration of the uteroplacental blood flow is associated with an increase of the activities of hydroxybutyrate and lactate dehydrogenases, creatine phosphokinase, and alkaline phosphatase. Exhaustion of the compensatory adaptive mechanisms, that manifests itself by a marked reduction of the blood flow in the intervillous space and by an intrauterine fetal distress is paralleled by a reduction of these enzymes activities. PMID- 2712221 TI - [Coagulative activity of the amniotic fluid]. AB - An ultracentrifugation study has shown thromboplastin to be the only blood coagulating agent, present in the amniotic fluid (AF). Its AF level shows no correlation to the rate of intrapartum or early postpartum thrombohemorrhagic complications, which may rather be related to the AF volume penetrating into the bloodstream. AF thromboplastin has also been shown to have an antiheparin activity. PMID- 2712222 TI - [Effects of intrauterine alcohol intoxication on the function of the central nervous system in the progeny]. AB - Behavior of mature rats, who had been exposed antenatally to intrauterine alcoholic intoxication, was studied in the open field settings, unavoidable swimming and Simonov's emotional resonance situations; their conditioned reflexes of passive and active avoidance were trained, arterial blood pressure was measured, and sleeping patterns examined. It was demonstrated that animals' orientation/exploration activity was reduced, while passive behavior and fear associated emotions became more prominent, conditioned reflexes were more difficult to form, vegetative autoregulation was disturbed, and insomniac disturbances were in evidence as a result of intrauterine alcoholic intoxication. It is suggested that the above-listed disorders are rooted in hypoxic cerebral changes, induced by pathogenic effects of alcohol on the embryonal and fetal central nervous system. PMID- 2712223 TI - [Treatment and prevention of conjugation jaundice in newborn infants]. AB - Risk factors of conjugation jaundice, developing in full-term newborns are listed. They should be taken into account at first neonatal examination of the infant in order to timely prevent marked hyperbilirubinemia. Treatment for conjugation jaundice should be combined and aim to improve hepatic activity and bilirubin lysis and withdrawal from the body. PMID- 2712224 TI - [Prenatal diagnosis of several hereditary skin diseases]. AB - Twenty-two control women and 5 women at risk for delivering a baby with Brocq's ichthyosiform erythroderma or fatal epidermolysis bullosa were investigated in order to make prenatal diagnosis of inherited fetal skin diseases. Fetal skin abnormalities were detected in 3 of the 5 high-risk patients, and their pregnancies were terminated. There was a spontaneous abortion with a normal fetus in 1 case. In one woman, pregnancy progressed to term delivery of a normal girl. Methodologic aspects of obtaining fetal skin samples and the results of their morphologic studies are discussed. PMID- 2712225 TI - [Epidemiological study of conditions causing miscarriage]. AB - The results of a population survey of the causes of spontaneous abortion are reported. A total of 328 female residents of the Cheremushki district in Moscow were investigated, using a retrospective epidemiologic method and 2 kinds of specifically-elaborated questionnaires. Mathematical analysis of the data has identified meaningful risk factors of spontaneous abortion. PMID- 2712226 TI - [Levels of 17 alpha-hydroxyprogesterone and cortisol in the amniotic fluid in pregnancy with normal fetus and in fetal diseases]. PMID- 2712227 TI - [Changes in lipid composition of maternal and fetal blood and placental tissues in intrauterine growth retardation]. PMID- 2712228 TI - [Proteoglycan synthesis in fibroblast cell lines obtained from human aborted fetuses with triploid chromosomes]. PMID- 2712229 TI - [Pathogenesis of obstetric paralysis of the arm in children]. PMID- 2712230 TI - [Significance of early diagnosis and therapy in gestoses]. PMID- 2712231 TI - [Phenomenon of physiological hypobiosis in the fetus and newborn]. AB - Within the first 2 weeks of postnatal life, neonatal response to stress (hypoxia, pain, etc.) is shown to de related to inhibition of vital processes rather than their activation as seen in the adults. In full-term fetuses and newborns, the pituitary, the adrenal cortex, the thyroid, the immune system, the heat controlling system, etc. have been found to have a well-developed biosynthetic structure, capable of producing and secreting hormones, as early as the antenatal and early postnatal periods. There is a potential capacity for homeostatic reactions. The absence of active protective reactions in fetuses and newborns, while their realization is actually possible, might be explained through the assumption that the lack of engagement, avoidance of conflict, stowed-down vital processes in response to aggression may be a biologically-expedient form of protection; the same as it is in hibernating animals. PMID- 2712232 TI - Neurophysiological findings in the Rett syndrome, I: EMG, conduction velocity, EEG and somatosensory-evoked potential studies. AB - Nine girls, aged 10 to 22 years, with confirmed Rett syndrome--eight as stage IV and one at stage III--were investigated neurophysiologically. EMG and neurography studies were performed, and somatosensory-evoked responses (SER) were recorded as well as EEG with topographic mapping. Even in advanced clinical stages, no major motor root involvement or demyelinating motor peripheral neuropathy was detected on EMG or neurography, but an axonopathy, possibly of secondary origin, was observed. EEG showed slowing and dominance of low frequency activity of subcortical origin, with or without epileptic discharges. SER findings suggested involvement of the spinal cord and the spinothalamic system. Neurophysiological investigations can be used by the clinician in the differential diagnosis of the Rett syndrome. PMID- 2712233 TI - Neurophysiological findings in the Rett syndrome, II: Visual and auditory brainstem, middle and late evoked responses. AB - Nine girls with the Rett syndrome (RS) were investigated neurophysiologically using evoked potentials techniques. Visual- (VER) and auditory-evoked responses, including the early (ABR), middle (MLR) and late components (ACR), were recorded. There was evidence of variable, multilevel impairment of the nervous system. While ABR and MLR indicated lesions at the brainstem and midbrain levels, the late responses and VER pointed to an intra-cerebral/cortical defect. It is suggested that the perceptual mechanisms still functioned and some discrimination properties remained. PMID- 2712234 TI - The EEG evolution and neurological prognosis of neonates with perinatal hypoxia [corrected]. AB - One hundred and seventy-three full-term newborns with hypoxic encephalopathy were subjected to polygraphic recordings (EEG, EOG, ECG and respiration) of 2.5-3.5 hr duration in the first 3 weeks in the period from 1970 to 1986. Their conceptional age ranged from 38 w to 42 w and birth weight from 1,750 g to 4,860 g. Their clinical outcome was evaluated in relation to the degree of depression of background EEG classified at each postnatal age. Cases with normal background before the 7th day, minimal or less depression before the 4th day and mild or less depression on the first day developed normally. Cases with marked or maximal depression at any day, moderate or more depression after the 7th day and mild or more depression after the 12th day developed neurological handicaps. The prognosis of others were not certain. Prognostic value of the neonatal EEG depended on the day of recording. Serial EEG recording was useful to prognosticate the clinical outcome. PMID- 2712235 TI - Relationship between periventricular hemorrhage, leukomalacia and brainstem lesions in prematurely born infants. AB - The brain pathology in very prematurely born infants with intraventricular hemorrhage (IVH) was studied particularly as to the severity and site of the complicated brain lesions responsible for the prognosis. A high frequency of leukomalacia, pontosubicular necrosis and/or olivocerebellar neuronal loss was found in the cases of IVH, and these non-hemorrhagic brain lesions showed an increasing frequency with the grade of IVH. However, there was marked reduction of IVH, periventricular leukomalacia and, in particular, brainstem lesions in prematurely born cases of sudden infant death. These IVH and associated conditions have different pathogenesis, but factors responsible for their occurrence may be present together in each case. PMID- 2712236 TI - Treatment of t(4;11) acute leukemia with aggressive multiagent chemotherapy. Preliminary results. AB - Acute leukemia patients with a 4;11 translocation have had a poor prognosis in the past, averaging 9 months survival from diagnosis. Three patients from The Children's Hospital of Denver were reported in 1982--all died. This report describes five additional patients who fared better. Aggressive treatment during induction and maintenance with intensive alternating non-cross-resistant chemotherapeutic agents may have contributed to the improved survival. PMID- 2712237 TI - Lineage switch and translocation t(9;11) in acute leukemia. AB - A boy with acute lymphoblastic leukemia (ALL) who underwent lineage switch at relapse is reported. The second leukemia was myeloid in nature (acute myeloid leukemia, AML), characterized by predominantly My 9 positive blasts at first and at second relapse. Cytogenetic studies at second relapse revealed the translocation (9;11) (p21;q23) in all examined blasts. This is typical for myelomonocytic leukemia. The nature of the relapse and the occurrence of t(9;11) translocations in acute leukemia are discussed. PMID- 2712238 TI - Transient dyserythropoiesis occurring during the involutionary phase of stage IV S neuroblastoma. AB - An acutely ill 6-month-old female infant presented with massive hepatomegaly, accompanied by severe anemia with peripheral normoblastemia and thrombocytopenia. Bone marrow examination revealed erythroid hyperplasia with gross erythroid dysplasia, reduced granulocytic precursors, and virtually absent megakaryocytes. The bone marrow also contained completely necrotic cells occurring in clumps as well as singly. The appearances suggested bone marrow involvement by neuroblastoma. Accordingly, combination chemotherapy was instituted and laparotomy was performed as soon as her clinical condition had improved. Left adrenalectomy was carried out, because a small adrenal nodule of ganglioneuroma was present. Liver biopsy showed expansion of portal tracts by loose fibrous connective tissue containing hemosiderin deposits and some degenerate cellular debris, consistent with areas of involuted metastatic neuroblastoma. Complete recovery followed, and subsequent bone marrow examination was entirely normal. It is thought that the dyserythropoiesis probably resulted from the release of toxic metabolites from regressing neuroblastoma. PMID- 2712239 TI - Idiopathic Heinz body hemolytic anemia in newborn infants. AB - Heinz body hemolytic anemia developed in six full-term infants while at home during the first 2 weeks of life. The disorder first manifested as hyperbilirubinemia. However, in all cases, severe anemia (hemoglobin concentration 49-73 g/L) developed during the 4-12 days of hospitalization. The infants had not been exposed to known oxidants, and their erythrocytes were not glucose-6-phosphate dehydrogenase (G6PD) deficient and contained no unstable hemoglobin. It is hypothesized that in these newborn infants, Heinz body hemolytic anemia developed as a result of ingestion of an oxidant contained in feedings. The nature of this agent is as yet unknown. PMID- 2712240 TI - Endodermal sinus (yolk sac) tumor in infants and children. A clinical and pathologic study: an 11 year review. AB - We reviewed the clinical features, treatment, and results of children with gonadal and extragonadal yolk sac (endodermal sinus) tumors seen in the King Faisal Specialist Hospital and Research Centre between 1976 and 1987. There were nine children (seven girls and two boys) with ages ranging from 7 months to 12 years (median of 3.5 years). Sites of origin included the vagina (two cases), face (two cases), sacrum (two cases), mediastinum (one case), ovary (one case), and testicle (1 case). All children had elevated alpha-fetoprotein (AFP) at diagnosis. One girl had complete surgical excision of an ovarian tumor at the time of diagnosis, and one boy had surgical excision of the testis. In the remaining seven children, the tumor was unresectable. Surgery was limited to a biopsy in six children. All patients received different combinations of chemotherapy, including vincristine (VCR), actinomycin D (Act-D), cyclophosphamide (Cyclo), adriamycin (Adria), bleomycin (Bleo), cis-platinum (CDDP), vinblastine (VBL), and VP-16. Of the nine patients, one was lost to follow-up while in remission, five died, one was lost to follow-up, and three are alive and disease-free at 15, 55, and 67 months from diagnosis. This review demonstrates an unusual preponderance of the extragonadal form of endodermal sinus tumor among our patients. PMID- 2712241 TI - Idiopathic cyclic thrombocytopenia of childhood. AB - Two children were found to have cyclic thrombocytopenia, recurring at regular intervals. Coagulation studies as well as immunologic evaluation did not reveal any abnormality. One of the patients continued to demonstrate the cyclic fluctuation in platelet counts despite corticosteroid therapy and showed no response to fresh frozen plasma infusion. One patient had been previously misdiagnosed as having idiopathic thrombocytopenic purpura (ITP), which might have caused problems if other therapies had been tried. The diagnosis of cyclic thrombocytopenia led to appropriate counseling and activity regulation. PMID- 2712242 TI - Chemotherapy-induced painful acral erythema in childhood: Burgdorf's reaction. AB - Painful acral erythema as a reaction to intensive chemotherapy has been increasingly recognized since 1982. It has not been reported in the pediatric literature. We report its occurrence in a 3-year-old boy who had received intensive chemotherapy for acute lymphoblastic leukemia. PMID- 2712243 TI - Hodgkin's disease complicating neuronal ceroid-lipofuscinosis. AB - This article reports the previously undescribed occurrence of Hodgkin's disease in a child with neuronal ceroid-lipofuscinosis. PMID- 2712244 TI - Meningeal leukemia: current concepts in biology and treatment. Introduction. PMID- 2712245 TI - Biology and pathogenesis of CNS leukemia. AB - Despite routine preventive central-nervous-system (CNS) therapy, 5-10% of children with acute lymphoblastic leukemia continue to suffer CNS relapse. In a majority of these patients, bone marrow relapse ensues and is usually fatal. A better understanding of the biology and pathogenesis of CNS leukemia is needed to develop more effective methods of prevention and treatment of this adverse complication of acute leukemia. Concepts of the origin and proliferation of leukemic cells in the CNS are reviewed, as well postulated mechanisms of their ingress into and egress out of the CNS. PMID- 2712246 TI - Malignant melanoma in situ on the sole of the foot. Its clinical and histopathologic characteristics. AB - This clinical and histologic study of 122 macular melanocytic lesions on the soles of the feet of Japanese subjects revealed ten in situ malignant melanomas. Clinically, the lesions were broad pigmented macules or patches with asymmetric, angular, irregular shapes, and notched borders. The lesions appeared brownish black, and most were variegated from tan to black. The largest diameters were greater than or equal to 9 mm. The demargination of most lesions was not even; that is, one part of the lesion border was vague while another part was sharp. Histologically, an increased number of atypical melanocytes, mainly arranged as solitary units, were observed within the epidermis. Intraepidermal nests of melanocytes were found in five cases. The great majority of malignant melanomas in non-Caucasians affect acral regions--especially the sole of the foot--so, to improve their prognosis, the characteristics of malignant melanoma in situ on the sole must be elucidated. PMID- 2712247 TI - A comparative histopathologic study of generalized and localized granuloma annulare. AB - We have reviewed the morphologic findings in 41 histologic slides of granuloma annulare (GA), 15 from localized (LGA) and 26 from generalized granuloma annulare (GGA). The most common pattern was the histiocytic infiltrative type, more so in cases with LGA than with GGA. The palisading granuloma pattern was present in 21.9% of patients and its prevalence was almost equal in both clinical types. The least prevalent histologic type in all patients taken together was the epithelioid nodule type. However, the prevalence of this type in LGA was equal to that of the palisading type, in contrast to that in GGA where it accounted for only 11.5%. In addition, a mixed histologic pattern was found in greater than 25% of sections from GGA and in only one section from LGA. Periodic acid-Schiff stain revealed hyalinized capillary basement membrane in most of GGA and only in approximately 50% of LGA sections. The variation in prevalence of the different histologic patterns between sections from LGA and GGA, and the difference between our findings and those observed in other series, are discussed. PMID- 2712248 TI - Ichthyosis with laminated membrane structures. AB - Clinical, light-microscopic, and electron-microscopic features of a new type of ichthyosis are presented. The ichthyotic disease of a 75-year-old woman appeared in early childhood as dry and scaly skin. It slowly progressed to thickened and folded hyperkeratosis on her neck and axillae. The skin on the other parts of her body was shiny, red and hard. Her physical development was normal. Light microscopy showed acanthosis and papillomatosis with hyperkeratosis. The granular cells were vacuolated. Electron microscopy revealed diagnostic changes, i.e., concentric or parallel lamellar membrane structures and amorphous material in upper epidermal cells. Corresponding lamellar material was also seen in the cornified cells. The keratinosomes were abnormal and a hypothesis is presented indicating that a defect in keratinosome formation results in vacuolization and abnormal desquamation in this disease. According to the current classification, the present type of ichthyosis is one subgroup of lamellar ichthyosis. We have called it ichthyosis with laminated membrane structures, because they are electron-microscopically diagnostic. The mode of inheritance is unknown. PMID- 2712249 TI - Embolic and metastatic cardiac myxoma. AB - This paper presents a case of a cardiac myxoma with cutaneous emboli. The diagnosis of a cardiac lesion was anticipated after the histologic examination of a skin lesion. The first clue to the existence of a cardiac myxoma was a distinctive intravascular lesion of a dermal vessel. The clinical and pathologic features of cardiac myxoma are discussed. In addition, new evidence regarding the nature of a previously reported case of metastasizing cardiac myxoma is also presented. PMID- 2712250 TI - Regressing ulcerative histiocytosis. AB - A 15-year-old girl presented with many round to oval erythematous indurated plaques on the trunk, scalp, and proximal portion of the extremities. The individual lesions showed ulceration within a short period but spontaneously healed after 2 or 3 months. The main histological feature was dermal proliferation of rather mature histiocytes that were regarded as neither inflammatory nor neoplastic, with subsequent destruction of normal dermal tissue architectures. Lymph nodes, bone marrow, and internal organs were not involved. The lesions were improved neither by potassium iodide therapy nor by combined therapy of corticosteroid and cyclophosphamide, but the patient recovered by clofazimine after a 2-year course. We considered this case to be an unusual form of cutaneous histiocytic proliferation, which we tentatively termed "regressing ulcerative histiocytosis." PMID- 2712251 TI - AIDS-related angiomatosis. AB - We report multifocal cutaneous and mucosal vascular proliferations with the clinical and histological features of lobular capillary hemangioma and histiocytoid hemangioma in a 32-year-old acquired immunodeficiency syndrome patient. The lesions resolved subsequent to erythromycin therapy. PMID- 2712252 TI - What's so scary about talking ethics? A case for renewed public ethical debate. PMID- 2712253 TI - Langerhans cells and epidermal microenvironment. PMID- 2712254 TI - Pseudocarcinomatous or infundibular hyperplasia. PMID- 2712255 TI - Respiratory symptoms in damp homes. A pilot study. AB - The association between living in damp homes and the prevalence of health symptoms was investigated in a population of 519 occupants (adults and children) of 185 homes. Positive associations were found between the reporting of respiratory and some other health symptoms and living in a damp home. The concentration of variable mould spores in indoor air was measured, using modified Andersen samplers, in the living rooms of a sample of 36 homes. The results were compared with the occurrence of dampness characteristics in their homes as reported by the occupants. Homes with at least two dampness characteristics showed higher average spore counts and higher prevalence of respiratory symptoms. PMID- 2712257 TI - A new formulation of flunisolide for intranasal application reduces side effects. PMID- 2712256 TI - Comparative evaluation of RAST and FAST for 11 allergens in 288 patients. AB - The specific IgE levels for 11 allergens were compared in 288 patients by means of the Phadebas RAST and the IgE-FAST. Agreement (less than 1 class difference) was observed in 78.7% of the cases. The best agreement was observed with Phleum pratense, egg white, corn, Betula verrucosa and cat epithelium. In 91 cases the results were retrospectively compared with clinical data and skin tests. When RAST and FAST differed (n = 31) 93.5% and 51.6% of the respective results were in agreement with the skin test. When RAST and FAST were similar (n = 60) 81.7% and 80.0% of the respective results were in agreement with the skin test. It was concluded that the RAST and the FAST gave similar results in most cases but that the RAST was more sensitive than the FAST, especially when the results obtained with both methods differed. PMID- 2712258 TI - [Noninvasive, apparatus-assisted patient monitoring: a help or a burden for the anesthesiologist?]. PMID- 2712259 TI - [The use of pulse oximetry in detecting disorders of the arterial oxygen status in the immediate postoperative phase exemplified by combination anesthesia with isoflurane]. AB - Adequate respiratory monitoring should immediately indicate deteriorations of arterial oxygen status, e.g. hypoxia (paO2-decrease [mmHg]), hypoxaemia (caO2 decrease [ml/dl]) and hypoxygenation (saO2-decrease [%]). These alterations have been detected in the early postanaesthetic period only by the classical clinical criterias cyanosis and tachycardia. Therefore, O2-application often is recommended for the first 10 min postoperatively. Nevertheless oxygen therapy as well as discharge from the recovery room both are dependent on the anaesthetist's judgement. It was the aim of this study to evaluate incidence and criterias of postanaesthetic hypoxygenation following balanced anaesthesia with isoflurane and to estimate both the actually most valid parameter (psO2) and the monitoring of choice (pulse oximetry). Postoperative hypoxygenation (psO2 less than 90%) occurred in 36% within the total of 50 patients. A correlation between hypoxygenation and sex, age, smoking habits and ASA-classification (groups I and II) could not be detected. In conclusion postanaesthetic hypoxygenation must be considered as being influenced by a widespread number of different factors. It's occurrence therefore, seems to be unpredictable. Hypoxygenation can easily be avoided by application of O2 (31/min) over at least 40 min. Cyanosis and tachycardia are not suitable for recognition of hypoxaemia caused by periodically occurring hypoxygenations. With respect to the limitations of the method (measurement of arterial O2-saturation in peripheral circulation using pulse wave as an inflow indicator of arterial blood into the capillary bed; increased Hb derivative concentrations, e.g. COHb), pulse oximetry for estimation of partial O2-saturation (psO2) seems to be the respiratory monitoring of choice in the early postoperative period. In that sense it is superior to pO2 but inferior to saO2 and caO2. PMID- 2712260 TI - [Postoperative arterial oxygen saturation in children]. AB - In 46 pediatric patients (ASA-group I + II) the arterial saturation of oxygen was monitored perioperatively by the Nellcor N-100 and N-200, respectively. During postoperative transportation a statistically significant desaturation could be detected. But the saturation remained within a clinically acceptable range after a trial period of breathing various fractions of oxygen spontaneously before transfer. Motion artifacts occurred to a far lesser extent using the ECG triggered Nellcor N-200 as compared to the N-100. As there was no significant difference between the lateral and supine position as far as arterial saturation is concerned, the lateral position is still highly recommended for postoperative transportation. PMID- 2712261 TI - Report from the Australian Patient Safety Foundation: Australasian Incident Monitoring Study. PMID- 2712262 TI - Maximum transfusion rate through 24G cannulae. PMID- 2712263 TI - ACE inhibitors. PMID- 2712264 TI - Tubeless anaesthesia for microlaryngoscopy. PMID- 2712265 TI - Point of view--day stay surgery. PMID- 2712266 TI - Day surgery: a contrary view. PMID- 2712268 TI - When in doubt, leave it in. PMID- 2712267 TI - Disconnection and the Campbell ventilator. PMID- 2712269 TI - Pulse oximetry for localisation of the dorsalis pedis artery. PMID- 2712270 TI - Blind nasal intubation. PMID- 2712271 TI - Bilateral abnormal branch of radial artery. PMID- 2712272 TI - Attenuation of electroconvulsive therapy induced hypertension with sublingual nifedipine. AB - Five patients known to be previously hypertensive but not currently receiving anti-hypertensive medications were studied for a total of twenty-six administrations of electroconvulsive therapy. Patients randomly received sublingual nifedipine 10 mg, 20 minutes prior to half of their treatments, and for the remaining treatments acted as their own controls. The use of nifedipine resulted in significant attenuation of the blood pressure response to therapy. Systolic pressure increase was 24 mmHg (SD 14) versus 62 mmHg (SD 24) (P less than 0.01). There was no difference in heart rate between the two groups. It is concluded that nifedipine reduces the pressor response to electroconvulsive therapy in individuals with a history of hypertension. PMID- 2712273 TI - Dorsal nerve of penis block--anatomical and radiological studies. AB - Dorsal nerve of penis block is becoming more widely used for circumcision in infants and children. Various techniques have been described. This paper presents a detailed study of the anatomy involved based on anatomical dissections and radiological studies. Complications and their possible causes are discussed. PMID- 2712274 TI - A simple technique for diagnosing oesophageal intubation. AB - Undiagnosed oesophageal intubation during anaesthesia is a major cause of anaesthetic-related morbidity and mortality. A test was devised and evaluated to distinguish between placing an endotracheal tube in the trachea and in the oesophagus. The test involves threading a lubricated nasogastric tube through the endotracheal tube, applying continuous suction to the nasogastric tube and then attempting to withdraw the nasogastric tube. Four aspects distinguish an endotracheal tube in the trachea from one in the oesophagus: 1. the length of nasogastric tube inserted and the feel of the final obstruction to further insertion. 2. the ability to maintain unobstructed suction through the nasogastric tube, 3. the ease of withdrawal of the nasogastric tube during continuous suction, 4. the nature of any aspirate (i.e. mucus or gastric contents). An evaluation was performed on twenty patients in whom both the trachea and oesophagus were intubated simultaneously. In all twenty cases, each of the two endotracheal tubes was correctly identified as being either tracheal or oesophageal. The ability to maintain suction and the ease of withdrawal most clearly distinguished between the two positions. PMID- 2712275 TI - Cardiovascular responses to tracheal intubation: a comparison of direct laryngoscopy and fibreoptic intubation. AB - The cardiovascular responses to tracheal intubation using a fibreoptic bronchoscope or Macintosh laryngoscope were compared in twenty in-patients and twenty day-stay patients. Within these groups patients were randomly allocated to direct laryngoscopic or fibreoptic bronchoscopic intubation. Arterial blood pressure, heart rate and arterial oxygen saturation were recorded before induction and at one-minute intervals until four minutes after intubation. In both groups both laryngoscopic and bronchoscopic intubation resulted in a significant rise in blood pressure and heart rate. At no stage was there a significant difference in mean blood pressure in either group, or in heart rate in the day-stay patients, between the different methods of intubation. In the in patients mean heart rate was significantly higher in those patients intubated with the bronchoscope at three and four minutes after intubation. Time taken for intubation was significantly longer in those patients intubated with the bronchoscope. In no patient did the arterial oxygen saturation fall below 98%. PMID- 2712276 TI - Anaesthesia and anaesthetic training in the Pacific Islands. AB - These are thoughts and impressions on the practice of anaesthesia, the management of operating theatres, and a plan for the training of anaesthetists for the Pacific island nations. They are based on accumulated experience and personal observations gained over ten years of working and travelling throughout the Pacific region. The concepts and ideas expressed are a correlation and condensation of many conversations with local anaesthetists and people involved with managing hospitals and administering the health services of many of the countries in the Pacific. PMID- 2712277 TI - Two worlds of anaesthesia. PMID- 2712278 TI - A comparison of fifteen pulse oximeters. Part I: A clinical comparison; Part II: A test of performance under conditions of poor perfusion. AB - Fifteen pulse oximeters were compared. Their physical characteristics, price, warranty, information handling and displays were catalogued. Times for changes in data display and susceptibility to interference were assessed. A model for comparison of oximeters under conditions of poor perfusion was developed using a tourniquet to progressively diminish limb perfusion pressure (systolic minus tourniquet pressure). The oximeters evidenced a wide variety of features and performance in poor perfusion states. Instruments lacking a beep varying in pitch with saturation or a waveform/pulse bar display of plethysmograph signal were considered less satisfactory. The majority of instruments, with some notable exceptions, performed remarkably well in a state of diminished perfusion. The study demonstrates that purchasers of pulse oximeters need to exercise care in assessing the suitability of particular instruments to their specific requirements. PMID- 2712279 TI - Constancy of air-oxygen mixtures in intensive care. AB - The performance of ten high-flow Bird blenders (3M Company) was assessed to ascertain the stability of the oxygen delivery both over time and within a single respiratory cycle. Blended oxygen concentrations were assessed for both continuous low flow and for intermittent flow with variable tidal volumes as is seen with mechanical ventilation. Studies were repeated after the addition of a high flow bleed from the blender via a T-piece. We observed clinically significant variations in the oxygen concentrations delivered by several blenders when the relationship between air and oxygen supply pressures varied. This variability was greatest when the air and oxygen pressures were nearly equal. When the line pressures were stable, mixed oxygen concentrations were constant but variations in oxygen delivery were found within individual breath cycles. This could be explained by postulating that at the initiation of flow from the blender a small pocket of unblended gas (pure air or pure oxygen) was issued by the blender before the balancing mechanism stabilised to deliver the desired oxygen concentration. This variability of oxygen delivery may have considerable impact on the measurement of oxygen consumption using the open circuit technique. The addition of a high flow bleed completely ablated this blender-derived variation in oxygen delivery. PMID- 2712280 TI - Atmospheric concentrations of nitrous oxide in ambulances during Entonox administration. PMID- 2712281 TI - Phaeochromocytoma with asthma. PMID- 2712282 TI - Anaesthesia in the management of congenital tracheal stenosis. PMID- 2712283 TI - Australian Society of Anaesthetists, annual general meeting. Ballarat, Victoria, October 1988. Scientific abstracts. PMID- 2712284 TI - A direct high-performance liquid chromatography assay of the enzymatic activity of enterokinase (enteropeptidase). AB - Bovine enterokinase (enteropeptidase) activates trypsinogen to trypsin at pH 8.0. In the presence of chicken ovomucoid, a stable complex of ovomucoid-trypsin is produced, inactivating trypsin and eliminating autoactivation of trypsinogen. The molecular size of trypsin (24,000 Da) is increased twofold on forming the ovomucoid-trypsin complex (52,000 Da). Size-exclusion chromatography on a Toya Soda TSK G2000SW column in an HPLC system and with computer-assisted analyses gives a direct quantitative determination of the amount of substrate (trypsinogen) and product (ovomucoid-trypsin). The rate of disappearance of substrate is equal to the rate of formation of product in agreement with kinetic theory. The simultaneous determination of both rates increases the reliability of the assay. The HPLC assay has an extended linear range for the velocity of the activation process as a function of enzyme concentration. The assay is reliable and accurate for highly purified preparations, samples at different steps in the purification scheme, and for a direct assay of the intestinal contents. The assay should be useful in clinical analyses. PMID- 2712285 TI - An inexpensive small volume equilibrium dialysis system for protein-ligand binding assays. AB - A simple and inexpensive system for equilibrium dialysis-based binding assays has been developed employing 1.5-ml microtubes. The main advantages are small volume of test buffers, no time-consuming assembly of the test vials, and inexpensive test cells. A comparison of the results derived from this equilibrium dialysis system with those of polyethylenimine-filtration assay and those of a commercially available equilibrium dialysis test system (Diachema from Dianorm) shows good agreement. PMID- 2712286 TI - Evaluation of uncertainties for parameters in binding studies: the sum-of-squares profile and Monte Carlo estimation. AB - Methods for characterization and evaluation of uncertainties in the parameter values for binding experiments are presented. A sum-of-squares profile is defined and illustrated. Sum-of-squares profiles give a qualitative description of both the uncertainties and correlation of parameters. The Monte Carlo method is developed as an accurate means of evaluating uncertainties in parameter values for nonlinear models. Examples are given for both actual and synthetic data. PMID- 2712287 TI - Continuous spectrophotometric assay of phospholipase A2 activity hydrolyzing plasmalogens using coupling enzymes. AB - We developed a continuous spectrophotometric assay of the phospholipase A2 activity specific for choline plasmalogen using rat liver lysoplasmalogenase and horse liver alcohol dehydrogenase as coupling enzymes and Naja naja venom phospholipase A2 as a source of the phospholipase A2 activity. In these coupling reactions, choline lysoplasmalogen is hydrolyzed by lysoplasmalogenase to glycerophosphocholine and free aldehyde. The free aldehyde is quantitatively converted to alcohol by alcohol dehydrogenase with the oxidation of NADH. The disappearance of NADH is measured spectrophotometrically at 340 nm. The assay is sensitive to about 0.2 nmol aldehyde produced/ml/min and also is rapid, convenient, and continuous. PMID- 2712288 TI - Stopped-flow front-face fluorometer: a prototype design to measure hemoglobin R-- -T transition kinetics. AB - Stopped-flow techniques are successfully used to study the kinetics of the R----T transition of hemoglobin (Hb). We have previously used front-face fluorometry to demonstrate that (i) the intrinsic fluorescence of Hb primarily originates from beta 37 Trp; (ii) the intrinsic fluorescence is sensitive to the R----T transition; and (iii) the emission of the fluorescent probes bound to specific sites on the Hb molecule (beta 93 Cys) is sensitive to the R----T transition. These findings suggested that a stopped-flow front-face fluorometer could probe R ---T transitions at specific sites, such as the aromatic amino acids and sites selectively binding extrinsic fluorophores. We have developed a prototype instrument using as the core a Gibson-Durrum stopped-flow apparatus on line with a digital data analysis system using a modified Marquardt algorithm. Excitation (470 nm) and emission light (520 nm) were selected by narrow band pass filters. To study the R----T transition, a solution of purified oxy Hb A covalently bound to the fluorescent probe 5-iodoacetamidofluorescein (Hb A-AF) (1.0 g%) was mixed rapidly with deoxygenated buffer (pH 7.35, 0.05 M potassium phosphate) containing 2 mg/ml of sodium dithionite. The hemoglobin, at a final concentration of 0.5 g% after mixing, is essentially completely tetrameric. A first-order reaction was observed with a rate constant near 8 s-1, similar to the oxygen dissociation rate reported for oxy Hb A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712289 TI - Immobilized artificial membrane chromatography: supports composed of membrane lipids. AB - Cell membranes provide an environment for several types of molecular processes and we are attempting to mimic the cell membranes' environment on a chromatography solid support. Chromatography solid supports utilizing lecithin as the bonded phase were synthesized and the HPLC behavior of hydrophilic peptides evaluated. A diC14 lecithin containing a terminal carboxy group on the C2 fatty acid chain was amidated with the surface amines of Nucleosil-300 (7NH2) silica particles. Based on elemental analysis, lecithin was coupled to Nucleosil-300 (7NH2) at a surface density near that of lecithin found in biological membranes and this novel chromatographic support material is denoted as Nucleosil-lecithin, the prototype immobilized artificial membrane. Infrared difference spectra of Nucleosil-lecithin minus Nucleosil-300 (7NH2) clearly showed amide I (1653.1 cm 1) and amide II (1550.9 cm-1) bands, giving direct spectroscopic evidence for the amide linkage. Spectral deconvolution resolved two peaks for the amide I band, and three peaks for the amide II band. This demonstrates lecithin interchain amide hydrogen bonding and/or hydrogen bonds between the lecithin amide link and unreacted silica surface amines. Nucleosil-lecithin as a solid phase mimics membranes and can be used to study the interactions of biomolecules with membranes. Our primary objective is to develop HPLC methods for studying the interaction between cell membranes and peptide sequences found near the interfaces of cell membranes. A frequency distribution of amino acids bracketing approximately 400 transmembrane peptide sequences showed Cys to be the least frequently occurring amino acid at this putative interfacial membrane region. Hydrophilic peptide analogs bearing Cys were used as model compounds to test Nucleosil-lecithin solid supports. Small peptides, six to eight amino acids in length, containing Cys bind approximately 2X tighter to Nucleosil-lecithin compared to identical peptides without the Cys residue. Thus, Cys at the interface of cells may stabilize protein-lipid interactions. PMID- 2712290 TI - A human liver alcohol dehydrogenase enzyme-linked immunosorbent assay method specific for class I, II, and III isozymes. AB - A sensitive and convenient method for the quantitative measurement of human alcohol dehydrogenase (ADH) isozymes based on enzyme-linked immunosorbent assay has been devised. The procedure was optimized with respect to antigen coating density, antiserum dilution, and incubation times with rabbit antisera raised against beta 1 beta 1-ADH to achieve a limit of sensitivity of 1 ng/ml for this isozyme when purified. Using the optimal conditions established, quantitative measurement of alpha beta 1, alpha gamma 1, beta 1 gamma 1, pi, and chi-ADH were obtained with antisera raised in rabbits toward these individual isozymes. The incorporation into the procedure of thimerosal (ethyl(4-mercaptobenzoato S)mercury) or other sulfhydryl specific reagents improved the soluble phase antiserum avidity for all ADH isozymes, thereby increasing the sensitivity. Thimerosal is an absolute requirement for chi-ADH antigen-antibody binding. The polyclonal rabbit antisera elicited by the individual isozymes of the three classes of ADH exhibit a high degree of isozyme class specificity. Cross reactivity of the antibodies with the beta 1 beta 1, alpha gamma 1, alpha gamma 2, alpha beta 1, beta 1 gamma 1, beta 1 gamma 2, pi and chi isozymes were evaluated. Antisera against the class I isozymes beta 1 beta 1 and beta 1 gamma 1 cross-react with all class I isozymes and with pi-ADH. Antibodies against pi and chi-ADH are selective and specific only for their respective antigens. Neither one cross-reacts with any class I isozyme. Conformational effects resulting from subunit interactions likely account for differences in cross-immunoreactivity between the closely homologous class I isozymes. PMID- 2712291 TI - Automated analysis of 2,3-diamino-2,3-dideoxy-D-glucuronic acid by cation exchange chromatography with fluorometric postcolumn derivatization. AB - 2,3-Diamino-2,3-dideoxy-D-glucuronic acid (diaminoglucuronic acid) occurs as its di-N-acetyl derivative as a unique constituent of some bacterial cell walls. A sensitive chromatographic method for its determination is described. Diaminoglucuronic acid was well separated from glucosamine and galactosamine in about 80 min on a Dionex DC-6A cation exchange column (0.9 x 18 cm, 50 degrees C) with a sodium citrate buffer (pH 5.28) containing boric acid (0.2 M). The amino sugars in the eluate were monitored fluorometrically by postcolumn derivatization with orthophthalaldehyde detection reagent. This method allowed the automated determination of 50-100 pmol of glucosamine, galactosamine, and diaminoglucuronic acid and was applied successfully to the analysis of diaminoglucuronic acid in Propionibacterium acnes cells. PMID- 2712292 TI - Simultaneous determination of reducing monosaccharides by capillary zone electrophoresis as the borate complexes of N-2-pyridylglycamines. AB - Reducing monosaccharides were derivatized to N-2-pyridylglycamines and separated as their borate complexes by capillary zone electrophoresis, using a capillary tube (50 microns i.d., 65 cm) of fused silica containing 200 mM borate buffer (pH 10.5) as carrier. The derivatives of 12 saccharides were completely separated in ca. 25 min, with high resolution, at an applied potential of 15 kV. On-column uv monitoring allowed detection of these derivatives at the 10-pmol level, and quantification by the relative peak area method allowed reproducible determination of these saccharides at least in the concentration range of 10-100 mM in reaction solutions. This method was applied to the determination of the monosaccharide compositions of various carbohydrate materials to demonstrate its usefulness. PMID- 2712293 TI - Thermostable reduced nicotinamide adenine dinucleotide oxidase: application to amperometric enzyme assay. AB - The use in amperometric enzyme assays of a highly stable, pH insensitive flavoenzyme, reduced nicotinamide adenine dinucleotide oxidase (NADH oxidase), from the thermophilic organism Thermus aquaticus is described. The enzyme catalyses the oxidation of reduced nicotinamide adenine dinucleotide with concomitant two-electron reduction of dioxygen to hydrogen peroxide. In addition the enzyme used a substituted ferrocene as an alternative mediator of electron transfer. Hydrogen peroxide was detected at +650 mV vs Ag/AgCl at a platinum electrode. The current produced by oxidation of hydrogen peroxide was directly proportional to NADH concentration. The enzyme was used in solution to reoxidize enzymatically generated NADH and served as a basis for amperometric enzyme amplification systems for immunoassay as well as for the detection of substrate concentration for oxidoreductase enzymes. In the presence of alcohol dehydrogenase a rapid production of current occurred upon addition of ethanol over a clinically significant range. Thermus aquaticus NADH oxidase appears to be ideally suited for future exploitation in amperometric sensors for oxidoreductase substrates, offering a number of advantages over previously reported methods. PMID- 2712294 TI - Multiple fluorescence labeling with europium chelators. Application to time resolved fluoroimmunoassays. AB - Multiple fluorescence labeling with conventional probes like fluorescein, to improve the detection limit of labeled reactants, is not usually successful because of fluorescence quenching. In contrast, we found that the europium chelator 4,7-bis(chlorosulfophenyl)-1,10-phenanthroline-2,9-dicarboxylic acid (BCPDA) can be incorporated into proteins at very high molar ratios. Working with thyroglobulin as a model protein, we found that when 160 BCPDA molecules are incorporated into one thyroglobulin molecule, the fluorescence emitted by the labeled protein in the presence of excess Eu3+, is equivalent to that emitted by approximately 900 molecules of unconjugated BCPDA:Eu3+ complexes. We took advantage of the lack of any quenching effects and of the enhancement observed with the multiply labeled protein, to develop a universal reagent system consisting of (a) streptavidin covalently coupled to BCPDA labeled thyroglobulin and (b) excess Eu3+. With this approach, streptavidin is heavily labeled through thyroglobulin and retains its full biotin binding activity. We used the reagent to develop a highly sensitive time-resolved heterogeneous immunofluorometric assay of alpha-fetoprotein (AFP) in serum, using monoclonal antibodies. One antibody is immobilized in white microtitration wells (solid-phase) and the other is biotinylated. We demonstrate that this assay, using the newly developed reagent, is 25-fold more sensitive than the one using directly BCPDA labeled antibody and 5-fold more sensitive than an assay that uses BCPDA-labeled streptavidin. The detection limit of the assay with the new reagent was down to 60 amol of AFP per well. We conclude that multiple fluorescence labeling with europium chelators is an effective method of extending the sensitivity of currently used fluorescence immunoassay procedures. PMID- 2712295 TI - High-resolution ion partitioning technique by phase-specific ion excitation for Fourier transform ion cyclotron resonance. PMID- 2712296 TI - Indium-alkene complex ions as reagents for selective chemical ionization. PMID- 2712297 TI - D-alanine as a chemical marker for the determination of streptococcal cell wall levels in mammalian tissues by gas chromatography/negative ion chemical ionization mass spectrometry. AB - A gas chromatography/mass spectrometry method using selected ion monitoring with negative ion detection and methane chemical ionization was employed to quantitate a marker for bacterial peptidoglycan, D-alanine, in mammalian tissues. D-Alanine originating from bacterial peptidoglycan was obscured by substantial amounts of D alanine generated by racemization from L-alanine present in tissue protein. To overcome this problem, samples were enzymatically treated and hydrolyzed in deuterated hydrochloric acid. Newly formed D-alanine derived from protein was labeled with deuterium and bacterial D-alanine remained unlabeled, enabling differentiation by the molecular weight increase. Butyl heptafluorobutyryl derivatives of the D- and L-amino acids were separated on a fused silica capillary column coated with Chirasil-val. The amounts of bacterial D-alanine found in livers of arthritic rats were consistent with previously reported levels of other carbohydrate-derived markers for bacterial peptidoglycan-polysaccharide complexes. PMID- 2712298 TI - Capillary electrophoresis. PMID- 2712299 TI - Signal-to-noise ratio in microelectrode-array-based electrochemical detectors. AB - The signal-to-noise ratio at an electrode array depends on the electrode area, the perimeter-to-area ratio of the electroactive portion of the surface, the mass transfer coefficient of the analyte-electrode combination, the measurement bandwidth, and the sources and magnitudes of the noises. Simple models for chronoamperometry with an array in quiescent solution and for hydrodynamic current at an array in one wall of a rectangular conduit through which analyte containing solution is following are given. Noises from seven sources, including environmental noises, are considered in a noise model. The signal and noise models are combined to yield a model for signal-to-noise ratio at array-based electrochemical detectors. There exists an optimum array density for a given area that depends on the noise power, noise resistance, the current density at a sparse array, and the current density at a solid electrode of the same area. Approximations that lead to simple expressions for the optimum electroactive area fraction and noise resistance lead to results that are in good agreement with more complex and less approximate calculations. Electrodes of millimeter dimensions consisting of about 1% active surface with electroactive "pieces" of micrometer dimensions are anticipated to yield detection limits of about 1 fmol injected into a typical packed-column liquid chromatograph. This corresponds to about 10(-10) M analyte in the detector and about an order of magnitude improvement over solid electrodes. PMID- 2712300 TI - Control of molecular weight selectivity in electrode modifications based on phase inversion cellulose acetate membranes. AB - Modified electrodes with size selectivity are required for electrochemical blosensors and for analysis of biological samples. The phase-inversion process for making reverse osmosis membranes is used to make modified electrodes with the goals of decreasing thickness, improving response time, and understanding the influence of both casting solution composition and casting conditions on the resultant membrane's porosity. Poly(ethylene glycol) esters of ferrocene carboxylic acid are used for the determination of the membrane's response time, selectivity, and structure. It is shown that there is an optimum composition range of greater than 95% acetone, less than 2% cellulose acetate, and less than 5% aqueous Mg(CIO4)2. This composition range gives the minimum response time (greater than 90% of maximum signal is obtained in less than 7 min), maximum reproducibility (less than 20% relative error), and best size selectivity in the few thousand daltons range. PMID- 2712301 TI - Multifrequency phase fluorescence study of hapten-antibody complexation. AB - The rotational dynamics of a phenytoin fluoroimmunoassay system is investigated by using multifrequency phase and modulation fluorescence spectroscopy. Results indicated that the fluorescein label on this relatively small hapten undergoes significant (greater than 45%) local motion even when bound to the phenytoin antibody. We attribute this local motion to unhindered rotation of the fluorescein moiety around the bond attaching it to phenytoin. This local motion affects the sensitivity of a steady-state polarization immunoassay dramatically. PMID- 2712302 TI - Computer simulation and experimental validation of the electrophoretic behavior of proteins. AB - A mathematical model of the electrophoretic behavior of proteins is presented. The Debye-Huckel-Henry theory is used for the description of protein mobility, which has the important result of making net mobility a function of ionic strength. A net charge vs pH relationship and a diffusion coefficient are required to describe a specific protein. The model is employed for the computer simulation of three distinct electrophoretic modes: isoelectric focusing, isotachophoresis, and zone electrophoresis. The validity of the model is tested by comparing simulation with experimental data. Excellent qualitative agreement was found. PMID- 2712303 TI - Influence of sample concentration and adsorption time on the yield of biomolecule ions in plasma desorption mass spectrometry. AB - The yield of intact ions formed in 252Cf plasma desorption mass spectrometry has been investigated by analyzing melittin and bovine trypsin at different concentrations on a nitrocellulose surface. The yield of trypsin ions is shown to vary with the protein concentration and adsorption time. The singly charged ion of trypsin is observed when concentrated solution (10 microM to 1 mM) of bovine trypsin are applied for sufficient time. PMID- 2712304 TI - Simultaneous spectrophotometric determination of mefenamic acid and paracetamol in pharmaceutical preparations. AB - A spectrophotometric procedure for the simultaneous determination of mefenamic acid and paracetamol in a mixture is described. Using 0.01 M methanolic hydrochloric acid as solvent, the absorbance of the mixture is measured at 248, 279 and 351 nm. The concentration of each component can be calculated by solving two equations using two wavelengths, either 248 and 279 nm or 248 and 351 nm. PMID- 2712305 TI - Potentiometric determination of cephalothin. AB - The composition of a pseudo-liquid potential-determining phase for the cephalothin-selective electrode has been determined and the following basic electrode parameters were examined: measurement range, slope, limit of detection, selectivity and lifetime. This paper discusses the effect of side-chain substituents on the electrode properties, the electrode having been used for cephalothin determination in the range 43-436.5 mg l-1 (standard deviation, 0.64 4.5 mg l-1). PMID- 2712306 TI - Selective electrochemical biosensors from state-switching of bilayer and monolayer lipid membranes by lectin-polysaccharide complexes. AB - Interaction of the lectin concanavalin A with the polysaccharide glycogen can provide rapid spontaneous transients of the surface potential at bilayer and monolayer lipid membranes. The selective binding process can cause large, rapid potassium ion current fluctuations across bilayer membranes in a manner that is periodic and reproducible. The frequency of these transient ion current signals was shown to be related to sub-nanomolar concentrations of the reactive agents in aqueous solution. The physical mechanism responsible for ion current modulation was investigated by fluorescence methods using lipid vesicles, by the thermal dependence of the potassium ion current across planar bilayers and by pressure area and dipolar potential measurements of lipid monolayers at an air-water interface. The mechanism is primarily associated with physical perturbations of lipid membranes by lectin-polysaccharide aggregates, resulting in the formation of localised domains of variable electrostatic potential and conductivity. PMID- 2712307 TI - Development and optimisation of a high-performance liquid chromatographic assay for tioconazole and its potential impurities. Part II. Selection of detection conditions for potential impurities. AB - An optimised high-performance liquid chromatographic separation developed for the assay of tioconazole and its potential impurities has been applied to real-world samples where tioconazole is in excess. As severe peak tailing interferes with the assay of two of the impurity peaks, changes in detection wavelength have been examined as a means to discriminate between this interference. The resulting enhancement of resolution has been exploited in the optimisation of analysis time. PMID- 2712308 TI - Indirect determination of tungstate in rat tissues by atomic absorption spectrometry. AB - An indirect method is described for the determination of tungsten as tungstate in tissue samples by atomic absorption spectrometry (AAS). Tungstate forms a stable ion-association complex [Fe(dipy)3]2+WO4(2-) (dipy = 2,2'-dipyridyl) in acidic solution, which can be extracted into chloroform with an efficiency of higher than 98%. The extract can be analysed for iron (and hence indirectly for WO4(2-] by flame AAS after stripping back into 60% perchloric acid. The calibration graph is linear up to 19 p.p.m. of WO4(2-) and the limit of detection is 0.17 p.p.m. Many foreign ions do not interfere and the method has been applied successfully to the determination of tungstate in rattus norvegicus tissue samples. PMID- 2712309 TI - Artifactual chemiluminescence in the determination of nitrogen monoxide in the vapour phase of mainstream cigarette smoke. AB - Evidence is presented for the artifactual chemiluminescence from olefins in the determination of nitrogen monoxide in the vapour phase of mainstream cigarette smoke. The interference may be quantified by measuring the residual chemiluminescence remaining in the vapour phase of mainstream cigarette smoke after 24 h. For the nitrogen monoxide analyser used, corrections to the yield of most cigarette brands retailed in the UK were found to be about 1.5 micrograms of nitrogen monoxide per puff, each machine puff being defined by international standards. PMID- 2712310 TI - Micellar enhancement of benzodiazepine fluorescence. AB - The interactions that exist between benzodiazepines and surfactants provide micellar enhancement factors for their fluorimetric determination in the range 1.2-6.5, depending on the nature of both the benzodiazepine and the surfactant. A series of benzodiazepines and anionic surfactants were treated topologically to determine the influence of each benzodiazepine substituent on the basic benzodiazepine structure and the influence of both the hydrophobic moiety of the surfactant and its counter ion on the sensitisation process. Sensitisation parameters were used to quantify the effect of the chemical structures of both surfactants and drugs on their interaction. PMID- 2712311 TI - Applications of a simultaneous assay of ascorbic acid, dehydroascorbic acid and ascorbic sulphate in biological materials. AB - A modified spectrophotometric assay for ascorbic acid and its derivatives based on their reaction with 2,4-dinitrophenylhydrazine (DNPH) is described. Using standard ascorbic acid or ascorbic sulphate solutions, together with animal tissue or compound diet extracts, the conditions for ascorbic acid degradation were determined. For the differential measurement of reduced ascorbic acid (AA), dehydroascorbic acid (dAA) and ascorbic sulphate (AS), five series of simultaneous determinations were performed. These included the use of (1) KBrO3 for the hydrolysis of AS, (2) 2,6-dichlorophenolindophenol as an oxidant, (3) DNPH to form a hydrazone derivative with dAA and (4 and 5) two blanks (where ascorbate was degraded) to correct for interfering substances. A variety of vertebrate and invertebrate tissues were examined for their ascorbate content, and the advantages of the modified procedure over currently available assays are discussed. The results suggest that the Artemia cyst is a unique material in which ascorbic sulphate is present in large amounts whereas fish tissues do not contain this form of vitamin C. PMID- 2712312 TI - Stopped-flow determination of iodide in pharmaceutical and food samples. AB - The iodide-catalysed reaction between cerium(IV) and arsenic(III) has been studied using a modular stopped-flow system. The features of both the stopped flow and conventional kinetic methods have been compared by using the same instrument. The stopped-flow method has a wider linear range and is faster than the conventional kinetic method and has been applied satisfactorily to the photometric determination of iodide in pharmaceutical preparations, table salt and cow's milk. The results obtained show that the stopped-flow method is simple, inexpensive and rapid and requires no sophisticated equipment. In addition, its high sampling rate makes it particularly suitable for the routine determination of iodide. PMID- 2712313 TI - Determination of iron species in wine by ion-exchange chromatography--flame atomic absorption spectrometry. AB - The direct coupling of ion-exchange chromatography to flame atomic absorption spectrometry (AAS) has been achieved by employing a Babington type nebuliser. The system enables all the processes on the column to be followed directly at flow rates of between 1 and 5 ml min-1. The potential of the system was investigated for the determination of various iron species in synthetic samples containing iron(II) and iron(III) in ionic or chelated form by employing various ion exchange (Dowex 50-X8, Dowex 1-X8) and sorptive (Amberlite XAD-2) resins, respectively. In some instances where direct coupling was impossible, owing to the physical properties of the effluent or eluent, conventional analyses of chromatographically separated iron species were performed by flame AAS. The optimum concentration range, limit of detection and reproducibility of measurement were also determined for a particular column capacity. When direct coupling was employed, the detection limit for the separated iron species was 15 micrograms with a relative standard deviation (RSD) of +/- 3% and, using the conventional method of analysis, 2-5 micrograms with an RSD of +/- 1%. On the basis of these results the system was applied to the determination of the ratio of iron(II) to iron(III) in wines. PMID- 2712314 TI - Direct determination of iron in urine and serum using graphite furnace atomic absorption spectrometry. AB - A simple, rapid and low-cost method for the routine determination of iron in urine and serum using graphite furnace atomic absorption spectrometry is described which may provide an alternative to the more widespread automated spectrophotometric methods. The urine and serum samples were simply diluted with water prior to analysis. Matrix modification was found to be redundant. The standard additions technique or the use of matrix matched standards (addition calibration) was found to be unnecessary and, therefore, the calibration was performed using aqueous standards. For serum analysis the degree of dilution could be reduced by using the less sensitive 302.0-nm resonance line, yielding more precise determinations, and for urine analysis, interferences were eliminated by means of a L'vov platform. The interferences that exist in the presence of nitric acid are also discussed. Finally, the presence of background absorption was investigated by means of Zeeman effect atomic absorption. PMID- 2712315 TI - Photolytic interface for high-performance liquid chromatography- chemiluminescence detection of non-volatile N-nitroso compounds. AB - A photolytic interface between high-performance liquid chromatography (HPLC) and a chemiluminescence detector has been developed for the trace detection of non volatile N-nitroso compounds in biological matrices. A chromatographic effluent containing separated N-nitrosoamino acids and N-nitrosamides is introduced into a glass coil with a purge stream of He and irradiated with ultraviolet light. Nitrogen oxide, cleaved by photolysis, is separated rapidly from the solvent through a series of cold traps and carried by the He into the reaction chamber of a chemiluminescence detector. The method is compatible with most types of HPLC, especially reversed-phase, and yields low-nanogram sensitivity for underivatised N-nitrosoamino acids and N-nitrosamides. The detection of a model N-nitrosamide, trimethylnitrosourea, in spiked porcine gastric fluid (42 micrograms l-1), and of N-nitrosoproline and N-nitroso-1,3-thiazolidine-4-carboxylic acid, in spiked human urine (7-8 micrograms l-1), is demonstrated. PMID- 2712316 TI - Liquid chromatographic and fluorescent derivative aerobic degradation studies of dehydroascorbic acid in aqueous solution at elevated temperatures. AB - The aqueous degradation of dehydroascorbic acid (DHA) has been studied in the temperature range 52-90 degrees C. The DHA was determined by reversed-phase liquid chromatography and by derivatisation of DHA with o-phenylenediamine to form the fluorescent quinoxaline. The pseudo-first-order degradation of DHA has been verified and rate constants for the process are presented. The role of DHA in the degradation of ascorbic acid and previous DHA solution stability studies are discussed. PMID- 2712317 TI - Investigation of the mechanism of the electrochemical oxidation of bamipine hydrochloride by voltammetry. AB - The electrochemical oxidation of bamipine hydrochloride in sulphuric acid and phosphate buffer solutions was examined using a platinum electrode. Two different reaction mechanisms for two different potential regions are proposed. It was shown that the determination of the drug by this method is feasible. PMID- 2712318 TI - Polycyclic aromatic hydrocarbon solute probes. Part II. Effect of solvent polarity on the fluorescence emission fine structures of coronene derivatives. AB - The fluorescence properties of coronene (Co), benzo[a]coronene (BCo), naphtho[2,3 a]coronene (NCo), dibenzo[a,j]coronene (DCo), naphtho[1,2,3,4-ghi]perylene, benzo[pqr]naphtho[8,1,2-bcd]perylene and dibenzo[cd,lm]perylene dissolved in solvents of varying polarity are reported. Measurements indicated that the emission intensities of the four coronene derivatives depended on solvent polarity. The Co, BCo and NCo scales have been defined as the ratio of the fluorescence intensities of bands I and III of the vibronic spectra. Band III of dibenzo[a,j]coronene was not clearly identifiable in all the solvents studied, and the DCo scale was therefore defined as the intensity ratio of band I and IV. Emission intensity ratios of the three perylene derivatives remained nearly constant, irrespective of solvent polarity. PMID- 2712319 TI - Stopped-flow--photometric and kinetic--fluorimetric methods for the determination of thyroid hormones in tablets. AB - The catalytic effect of thyroxine and triiodothyronine on the reaction between cerium(IV) and arsenic(III) was studied by using photometric and fluorimetric measurements. The kinetic - photometric studies were based on measurement of the decrease in absorbance of cerium(IV), whereas the rate of formation of fluorescent cerium(III) was measured in the kinetic - fluorimetric studies. A modular stopped-flow system was coupled to a spectrophotometer in order to develop stopped-flow methods for the determination of thyroxine and triiodothyronine. The proposed methods were compared and applied to the determination of these hormones in pharmaceutical preparations. PMID- 2712320 TI - Spectrophotometric method for the determination of sorbic acid in various food samples with iron(III) and 2-thiobarbituric acid as reagents. AB - A simple, rapid and accurate spectrophotometric method has been developed for the determination of sorbic acid in various food samples based on the oxidation of sorbic acid by iron(III) at 100 degrees C to malonaldehyde, which then reacts with 2-thiobarbituric acid to form a reddish brown product. The optimum experimental conditions for colour development have been assessed. Absorbance measurements were made at 529 nm in the presence of 0.4% m/V citric acid. The calibration graph was linear for 0-6 micrograms ml-1 of sorbic acid with a slope of 0.131 A micrograms-1 ml. The recoveries of sorbic acid at concentrations of 164-557 micrograms ml-1 ranged from 96 to 103%. The relative standard deviations of ten replicate determinations of sorbic acid in a synthetic cream soda sample spiked with 573 micrograms ml-1 of sorbic acid and in an onion juice sample containing 82 micrograms ml-1 of sorbic acid were 1.6 and 1.9%, respectively. Interferences from several common food additives can be minimised by extracting sorbic acid with diethyl ether and then back-extracting the acid with sodium hydrogen carbonate. The method has been applied successfully to the determination of sorbic acid in a wide range of food samples including beverages, cake, cake mate, garlic bread sprinkle, onion juice, oyster flavoured sauce and grenadine syrup. PMID- 2712321 TI - Spectrophotometric determination of certain cephalosporins using molybdophosphoric acid. Part II. Determination of cefadroxil, cefapirin, ceforanide and cefuroxime. AB - The use of molybdophosphoric acid as an oxidising agent for the spectrophotometric determination of four cephalosporin derivatives, viz., cefadroxil monohydrate (I), cefapirin sodium (II), ceforanide L-lysine (III) and cefuroxime sodium (IV), either in the pure form or in pharmaceutical formulations is described. Beer's law is obeyed up to 100 micrograms ml-1 for I, up to 60 micrograms ml-1 for II and IV and up to 80 micrograms ml-1 for III. The molar absorptivities were 4.58 X 10(3), 11.3 X 10(3), 9.8 X 10(3) and 10.9 X 10(3) l mol-1 cm-1 and the Sandell sensitivities were 83.3, 39.3, 53.0 and 41.0 ng cm-2 for I, II, III and IV, respectively. The slopes and intercepts of the equations of the regression line were calculated for each of these drugs with the following correlation coefficients: I, 0.9993; II, 0.9999; III, 1.000; and IV, 0.9999. These antibiotics were determined successfully both in the pure form and in pharmaceutical preparations. The results demonstrated that the proposed procedure is at least as accurate, precise and reproducible as the official methods, while being simpler and less time consuming. A statistical analysis indicated that there was no significant difference between the results obtained by the proposed procedure and those of the official methods. PMID- 2712322 TI - Determination of chlorpheniramine maleate in tablets by second-derivative absorption spectrophotometry. AB - A rapid method for the determination of chlorpheniramine maleate in tablets using second-derivative absorption spectrophotometry is described. The method has the advantage of requiring simple sample preparation and having accuracy comparable to the official acid-alkaline solvent extraction procedure. Results of recovery tests were close to 100%. PMID- 2712323 TI - Influence of nicotine and caffeine on skeletal development in the rat. AB - The effects of nicotine and caffeine at dose levels approximating human consumption on skeletal development was investigated in Sprague-Dawley rats. One group of animals received nicotine administered subcutaneously by an Alzet miniosmotic pump from gestational d 6 through 12 (25 mg over 7 d; rate 149 micrograms/h). Control animals received physiological saline in a similar manner. A2. group received a single intravenous injection of caffeine (25 mg/kg) on gestational d 6. Control animals were treated with physiological saline. A further group received both nicotine and caffeine on gestational d 6 as described for the 2 previous groups. Evaluation of the fetal skeletal system on gestational d 20 revealed a significant decrease in the number of complete sternal ossification centers, as well as delays in the ossification of the skull and face, following combined nicotine and caffeine treatment. Other skeletal anomalies and variations were frequently observed, but their incidences were not significantly increased in any of the treatment groups, compared to the corresponding controls. A coteratogenic effect is evident between nicotine and caffeine on account of the increased incidence of delayed and abnormal skeletal development. PMID- 2712324 TI - Organization of collagen and other extracellular material in anterior capsular cataract. AB - Capsular cataract takes the form of a white-grey opacity appearing under the anterior lens capsule (anterior subcapsular cataract). The capsule is wrinkled through the action of myofibroblast-like cells developed from the anterior lenticular epithelium. The myofibroblast-like cells also produce collagen that takes on a dysplastic appearance. Collagenous microfibrils accumulate to form fibre-like aggregations. These aggregations represent an abnormal collagen density (collagen condensation or attraction) in comparison to normal collagenous fibrils and fibres. Within the anterior capsular cataract 4 topological regions may be distinguished: Cell regions (1), stratification regions (2), aggregation regions (3), and intermediate regions (4). It is postulated that these regions represent different stages in the maturation and degradation of collagen, in the absence of phagocytic elements. PMID- 2712325 TI - Carapace growth of the turtle Chrysemys scripta: a longitudinal study of shape using Fourier analysis. AB - Because the majority of morphological structures encountered in Biology are irregular in form, conventional metrics composed of distances, angles and ratios, are inefficient shape descriptors. To circumvent this drawback in the application of morphometrics to describe 2 dimensional shapes, an alternative procedure based on Fourier analysis was developed and applied to the turtle carapace. Once size differences were controlled for, the presence of shape changes with age could be demonstrated. This study showed that small systematic differences in the phase angle are associated with increase in carapace asymmetry. The differences were not visually apparent in the original data. These results reinforce the need for precise shape descriptors that are capable of measuring a large percentage of the informational content that is present in all biological forms. PMID- 2712326 TI - Hypoplasia of the proximal segment of the anterior cerebral artery. AB - Hypoplasia of the proximal (A1) segment of the anterior cerebral artery (ACA) has been examined in 50 human brains and on 8 selected carotid arteriograms. Hypoplasia has been found in 22% of the cases. Two types of this phenomenon exist, namely the mild and extreme hypoplasia. Mild hypoplasia has been noticed in 14% of the specimens. The hypoplastic vessel has ranged from 1.3 to 1.9 mm in diameter (average 1.6 mm) and it was from 0.6 to 0.9 mm smaller than the opposite A1 portion. Extremely hypoplastic proximal segment has been present in 8% of the cases. It has varied from 0.3 to 1.1 mm in size (average 0.9 mm) and has been more than 1 mm smaller than the opposite proximal segment. Both mild and extreme hypoplasia have been associated in 81.8% of the cases with the corresponding variations or malformations of the anterior cerebral, posterior cerebral, posterior communicating and basilar arteries. PMID- 2712327 TI - Innervation of the scapular muscles and its morphological significance in man. AB - The origin, course and distribution of the nerves supplying the supraspinatus, infraspinatus, subscapularis, teres minor, deltoid, teres major and latissimus dorsi were examined in 40 human body-halves. All the nerves supplying these 7 muscles derive from the brachial plexus between the upper trunk and the posterior cord. Within the plexus the nerves originate in the following order: the suprascapular nerve in the most cranial and ventral position followed caudally and dorsally the superior subscapular nerve, the axillary nerve, the inferior subscapular nerve and the thoracodorsal nerve. The superior subscapular nerve tends to innervate the upper and middle (thoracic) portions of the subscapularis. Both the axillary and inferior subscapular nerves tend to innervate the lower (axillary) portion of the subscapularis as well as the teres minor and deltoid, and the teres major, respectively. The subscapularis can be regarded as the compound muscle deriving from the components supplied by these nerves, 4 segmental nerves from C5 to C8 innervate the 7 muscles: C5, and (C6) innervate the supraspinatus; C5, and C6 the infraspinatus, the thoracic portion of the subscapularis, and the teres minor; C5, C6, and (C7) the deltoid; (C5), C6, and (C7) the axillary portion of the subscapularis; (C5), C6, and C7 the teres major; and (C6), C7, and C8 the latissimus dorsi. The relationships between the nerves and muscles suggest that these 7 muscles morphologically belong to the same group, the second group of the dorsal musculature attached to the shoulder girdle and limb. The probable process of formation of these muscles from the cervical myotoms is proposed. PMID- 2712328 TI - Morphological study of M. anococcygeus in male and female rats. AB - In the rat, m. anococcygeus appears as a paired smooth muscle. In the males the muscle divides into a dorsal and ventral part. The ventral parts from both sides embrace the rectum ventrocaudally, they join in front of the rectum and proceed in the septum scroti in a fan-like manner. The dorsal part of the muscle in males and the whole muscle in the females proceed caudally along the lateral gut circumference, gradually developing a fibromuscular plate, a cord adjoining the rectal wall. Caudally from the junction of MA, the longitudinal gut musculature is more abundant in the plate area, appearing as if extracted in the form of a longitudinal column. Directed towards the anus, a frontally oriented septum is formed from connective tissue emerging from the columns. The morphology of the muscle as described here permits to assume that MA in the females and its dorsal part in the males operates as a levator ani, the ventral part of the muscle in males operating as a levator - retractor scroti. PMID- 2712329 TI - Musculus sphincter ani externus in the rat. AB - M. sphincter ani externus (MSAE) in the rat appears as a circular ring 1-1.25 mm in height and 250-350 microns thick, completed by a plate composed of longitudinal musculature in its posterior third. The main structures serving for the structural arrangement of MSAE are columns composed of longitudinal smooth musculature of the gut lining the posterior third of the anal circumference. Ventrally to the columns there are several structures in the MSAE showing fluent mutal transitions, namely the horshoe-like pars profunda, the ring-shaped pars superficialis and the pars subcutanea. The ends of the fibres of the horshoe shaped pars profunda join with the columns and pass along longitudinally to gradually replace the smooth musculature. The extension of the longitudinal muscle fibres of the columns upon the dorsal circumference leads to the development of the dorsal plate of MSAE. Some of the fibres of MSAE cross each other ventrally in the pars profunda and pars subcutanea, as well as dorsally in the pars subcutanea and in the area of longitudinally oriented fibres. Some fibres of MSAE are also fixed to the surrounding structures. PMID- 2712330 TI - Dermal-epidermal relationships in the skin of the bottlenose dolphin (Tursiops truncatus). AB - Using a variety of methods the outer surface of the dolphin dermis presents as a rather regularly arranged series of mainly longitudinal and approximately parallel ridges which are surmounted by laterally flattened, regularly distributed dermal papillae. At variable intervals groups of dermal ridges are supported by shallow elevations referred to here as basal dermal elevations. These tend to contain vessels and/or nerves for distribution to two or more dermal ridges. The opposing epidermal surface reveals an irregularly edged series of nearly parallel epidermal ridges alternating with the grooves which in the living state contain the dermal ridges. In the depths of these grooves are the crypts which in the intact skin contain the dermal papillae. Nothing is observable which could correspond to the epidermal pegs referred to in the literature. Small irregular epidermal projections (knobs) appear along the free edge of the epidermal ridge. Topographical variations in density and height of dermal ridges, height of basal dermal elevation plus dermal ridge and papillae as well as total epidermal thickness are illustrated by means of skin maps. Inconsistencies in the literature on Cetacean skin are discussed. PMID- 2712331 TI - The M. soleus in the domestic dog (Canis familiaris). AB - In six among a series of forty hind limbs of the domestic dog, the M. flexor digit. superficialis revealed an additional head, which otherwise manifests itself as a tendonless muscular slip, fused with the superficial digital flexor. The comparative anatomy of the M. soleus in various terrestrial carnivores leads to the conclusion that this additional head and the homologue muscular slip represent the M. soleus. PMID- 2712332 TI - [Differentiation of the crystalline lens in explants of the chicken embryo in the absence of the hypoblast and optical vesicle]. AB - In vitro studies of lens formation in chick embryo have suggested the action of two factors leading the lens induction in the cephalic ectoderm in the absence of optic vesicle: preliminary instructive specific stimulus (homotypic endo mesoderm) and permissive unspecific stimulus (heterotypic mesenchymes). In order to detect the true capacities of tissues that exert this influence in the cultural condition, series of in vitro experiments were planned. Exclusion experiments: explants including presumptive lens ectoderm were cultured previous to a progressive exclusion of adjacent tissues to trigger lens formation (endoderm, mesoderm and neural tissue), from stage 1 to 7 of HAMBURGER/HAMILTON. Recombinant experiments: Recombinations of caudal epiblast with cephalic hypoblast from blastoderms stages 3, 4 and 5; and recombinations of cardiac mesoderm stage 7 with trunk ectoderm stage 11, were cultured in close association. Lens and lentoids were formed in the presumptive lens ectoderm, even when endoderm, neural tissue and optic vesicle were excluded, but always in presence of subjacent mesoderm. Observation of cephalic epiblast after to be separated mechanically from the underlying tissues showed that the presumptive cardiac mesoderm remains in contact with the epiblast. Beside the cardiac area was capable of forming lens bodies in contact with the trunk ectoderm. It was concluded that the cardiac mesoderm is able to exert a instructive specific stimulus and a permissive unspecific stimulus during in vitro lens formation. PMID- 2712333 TI - Myocardial bridges in animals. AB - Myocardial bridges in a number of different species is described and classified. In formulation of the classification special attention was given to the location, width, thickness of the muscular layer of the bridge and the number of commitant veins of the overbridged artery. Four types of myocardial bridges were recognized. PMID- 2712334 TI - Muscle fibre composition of the bovine tail: a pilot study. AB - A bovine tail was cross-sectioned at four vertebrae, to expose its muscles - dorsal extensors, ventral flexors and the lateral flexors that pass between the transverse processes. Muscle cross-sectional areas were measured at these faces and muscle sections were stained to distinguish slow and fast fibre types. From the muscle and fibre area data and fibre type occurrences, preliminary conclusions are drawn about the role of different muscles. The tail as a model for muscle studies is briefly discussed. PMID- 2712335 TI - Anatomical and radiological observations of the sesamoid bone of the popliteus muscle in the adult dog and cat. AB - In a random selection of 50 adult dogs (25 males and 25 females) and 50 adult cats (25 males and 25 females), the incidence of ossification of the sesamoid structure of the popliteus muscle was characterized through anatomical dissection and radiographic techniques. The incidence of ossification was 84% in the dogs and 100% in the cats. In both anatomical and radiologic studies, it was demonstrated that when the knee was fully extended, the sesamoid bone was adjacent to the caudodistal part of the articular surface of the lateral tibial condyle in both dogs and cats. When the knee was flexed, the sesamoid bone articulated progressively with the more craniodorsal part of the tibial articular surface and when full flexion is obtained, it articulated with the articular part of the lateral surface of the lateral meniscus. The probable functions of the sesamoid bone are discussed. PMID- 2712336 TI - The vascularization of the Bursa cloacalis (of Fabricius) in the duck. AB - The morphological and structural features of the vascular component of the bursa of Fabricius in the duck are described. By means of an intravasal perfusion of suitably colored neoprene Latex or Microscopaque, or a perfusion of Indian ink, it was possible to follow visually the routes of arteries, veins and the microcirculation; this last represents a major characteristic of the bursal follicle in the duck. The microcirculation has its origins in several roots arising from the follicular arterioles, which in the region of the cortex constitute an open vascular layer. From these pre-capillary arterioles, adjacent to the limiting layer between cortex and medulla, a dense capillary network is formed. With the aid of an electron microscope the presence of a cortico medullary barrier of an epithelio-reticular nature was revealed; close to it there are the terminal branches of the intrafollicular network. The barrier appears to be structurally more compact than that of the cortical capillaries of the mammalian thymus. PMID- 2712337 TI - [The vascularization of the intervertebral disks of the adult dog]. AB - The (mainly lumbar) intervertebral discs of 21 recently euthanatized dogs (aged 3 days to 14 years) were examined grossly, under the dissection microscope and by light microscopy. The findings of the adult animals and the salient differences from the younger ones are reported. A few capillaries were observed in the outer 2-4 layers of the anulus fibrosus; these arose from segmental arteries that lay directly on the intervertebral discs. The principal supply of all intervertebral discs occurs by diffusion emanating from capillary loops. These are visible at 10 30 times enlargement in both unstained and benzidine stained preparations. They pass through the end plate of the vertebral body to where the bone gives way to the softer tissue of the disc. The capillary loops have wider lumina and are more numerous opposite the nucleus pulposus and in the adjacent perinuclear zone than more peripherally where the annular fibers attach to the bone. PMID- 2712339 TI - Distribution of 35S-sulfate within the transseptal ligament of the mouse. AB - The distribution of 35S-sulfate-labeled macromolecules was examined within three regions of the transseptal ligament: the 1) mesial, 2) middle and 3) distal thirds. Swiss mice, 6 weeks of age, were injected with 35S-sulfate and killed after 1, 6, and 12 hours and 1, 2, 3, 4, 5, and 7 days. Silver grains and cell nuclei were counted on autoradiographs which had been counterstained by the Van Gieson method, and mean counts were analyzed statistically. Analysis of variance revealed no significant differences in mean number of cell nuclei between regions throughout the course of the experiment. 35S-sulfate was rapidly incorporated into the transseptal ligament macromolecules. Grain counts were highest 6 hours after injections: counts were highest over the middle and lowest over the mesial thirds of the ligament. The rate of grain removal was significantly higher in the middle third compared to the mesial or distal thirds (P less than 0.001) and was significantly lower in the mesial third compared to the middle or distal thirds (P less than 0.001). The half-life of labeled macromolecules was significantly greater in the mesial and distal thirds than in the middle third (P less than 0.005). The data demonstrate significantly higher rates of turnover of 35S sulfate-labeled macromolecules in the middle region of the transseptal ligament. Since cellular density was similar throughout the transseptal ligament, higher turnover rates of 35S-sulfate-labeled macromolecules probably indicate higher rates of cellular activity in this region, possibly a result of tissue remodeling coincident to stresses generated by occlusal forces and physiologic drift of the adjacent teeth. PMID- 2712338 TI - Tissue-specific granularity of gap junction cytoplasmic surfaces revealed by rapid-freeze, deep-etch replicas. AB - Previous rapid-freeze, deep-etch replica studies have revealed the differences between heart and liver gap junctions; cytoplasmic surfaces of in situ and phenylmethylsulfonyl fluoride (PMSF)-unproteolyzed isolated cardiac gap junctions (MW 47 kD) have a particulate substructure, which is absent both in the proteolyzed heart junctions (MW 29 kD) and in the liver junctions isolated with PMSF (MW 28 kD). The present deep-etch replica studies of gap junction cytoplasmic surface (CS) membranes in several tissues of rats and mice were performed to examine whether or not this difference between liver and heart is typical of variations in gap junction proteins from tissue to tissue. In surface mucous cells of the stomach, intestinal epithelial cells, and kidney tubule cells, these epithelial gap junctions always showed smooth cytoplasmic surfaces, similar to the liver gap junctions. In contrast, in the atrial myocardium, aortic endothelium, and the ciliary process, cytoplasmic surface membranes of the gap junctions consistently revealed particulate patterns. Close examinations disclosed that those granular structures were not merely attached to the memvrane surface, but they also protruded from the membrane interior as an integral component of gap junction particles. Furthermore, in the pregnant rat uterus at term, cytoplasmic surface membranes of myometrial smooth muscle gap junctions were particulate, but those of endometrial epithelium were smooth. The present observation suggest that tissue specificity exists in cytoplasmic surface structures of gap junctions between the "true" epithelial and the nonepithelial tissues: the nonepithelial gap junctions contain the additional cytoplasmic surface domain that is absent in the gap junctions of "true" epithelial origin. PMID- 2712340 TI - Granule formation and polarity of the Golgi apparatus in neutrophil granulocytes of the rat. AB - The formation of granules in neutrophil (heterophil) progenitor cells was examined with the electron microscope in sections of rat bone marrow fixed in 2% glutaraldehyde and postfixed with reduced osmium (Karnovsky: Proceedings of the 11th Meeting, American Society of Cell Biologists, Abstr. 284, p. 146, 1971). The cells were also osmicated in 2% osmium tetroxide for 36 hours at 37 degrees C to outline the osmiophilic element usually observed on the cis-face of the stacks of saccules of the Golgi apparatus of various cell types. In myeloblasts, which do not produce granules, the cis-osmiophilic element (CE) was found on the concave face of the C-shaped Golgi stacks. In promyelocytes the CE was present on the convex aspect of the C-shaped stacks, while the primary (azurophilic) granules formed in relation to elements on the concave aspects of the stacks. In myelocytes, the situation was reversed: the CE was found on the concave face of the Golgi stacks, while the secondary (specific) granules were seen forming in relation to elements on the convex aspect of the stacks. Finally, in metamyelocytes and mature neutrophils in which no granule formation took place, the appearance on Golgi stacks varied: they were either flat or C-shaped. The CE was indiscriminately found on one face or the other of the flat Golgi stacks of metamyetocytes and on the convex or concave faces of the C-shaped Golgi stacks of mature neutrophils. Using the cis-osmiophilic-element as a marker of the cis-face of the stacked Golgi elements, it thus appeared that despite marked changes in the configuration and orientation of the stacks of the cis-trans polarity of the stacked elements was maintained throughout granulopoiesis. In addition the primary and secondary granules that appeared sequentially in promyelocytes and myelocytes were both seen to form in relation to trans-elements of the Golgi apparatus. PMID- 2712341 TI - An electron microscopic study of cells with steroid-secreting morphology in the paraaortic lymph node of the hamster. AB - Clustered cells with steroid-secreting morphology (SH), located within the paraaortic lymph node (PLN) capsules of normal and pregnant female golden hamsters, were examined by light and electron microscopy. Hydroxysteroid dehydrogenase (HD) activity of the SH cell cluster also was examined by histochemical techniques. The cluster was composed of mostly packed SH cells and surrounding mesenchymal cells. Individual SH cells possessed prominent smooth endoplasmic reticulum, well-developed Golgi complexes, some lipid droplets, and numerous mitochondria containing tubulovesicular cristae common to mammalian SH cells. Intermediate-type junctions were often observed between SH cells. The same SH cells were rarely detected in the subcapsular sinus and in the cortical parenchyma of the PLN. Early oophorectomy of the hamster resulted in cytoplasmic degeneration of the SH cell at day 5 after the operation. On the other hand, normal adult male hamsters possessed similar PLNs, but no SH cells were recognized in the nodes. The present histochemical preparation of normal female PLNs revealed moderate-to-strong HD activity, probably associated with SH cell clusters, in the limited regions of the capsules. Based on the present ultrastructural and histochemical findings, it is proposed that the SH cell cluster consists of steroid hormone producing cells. PMID- 2712342 TI - Primary in situ immune response in popliteal lymph nodes and spleen of mice after subcutaneous immunization with thymus-dependent or thymus-independent (type 1 and 2) antigens. AB - Mice were immunized subcutaneously with thymus-independent (TI)-type 1 antigen trinitrophenylated lipopolysaccharide (TNP-LPS), TI-type 2 antigen TNP-Ficoll or thymus-dependent (TD) antigen TNP-keyhole limpet haemocyanin (TNP-KLH) in order to study the primary in situ immune response in popliteal lymph nodes (PLN) and spleen. The spleen responded more rapidly in developing specific antibody-forming cells (AFC) than the lymph nodes did, in spite of the fact that antigens reach the spleen only after passing several lymph node stations. This difference between lymph nodes and spleen in developing AFC was particularly significant with respect to the responses to TI (both type 1 and type 2) antigens. No differences in the distribution of specific AFC in PLN and spleen were observed after immunization with TI and TD antigens. Results are discussed with respect to the relative contributions of lymph nodes and spleen to immune responses to antigens injected subcutaneously. PMID- 2712343 TI - Differentiation of interstitial cells and stromal proteins in the secondary septum of early postnatal rat: effect of maternal chronic exposure to whole cigarette smoke. AB - The intention of this investigation was to ascertain the effect of maternal exposure to cigarette smoke on the early postnatal morphogenesis of pulmonary interstitium in offspring. Female rats were chronically exposed to whole cigarette smoke. Offspring of these and control animals were sacrificed at postnatal day 15, and their tissues were prepared for quantitative and qualitative analyses. Results indicate a diminished quantitative representation of parenchymal tissue (P less than 0.01) and a slower pace of secondary septal growth (P less than 0.07) in the experimental lung. Furthermore, a greater cellular volume density (P less than 0.0002) and, inversely, a lesser quantitative representation of extracellular matrix (P less than 0.0002) was ascertained for the experimental septal interstitium. There was proportionately less of elastin substances (P less than 0.009), collagen together with basal laminae (P less than 0.0008), and nonfibrillar, amorphous matrix (P less than 0.02) in the experimental extracellular stroma. Fibrillar collagen and nonfibrillar matrix were represented quantitatively 6.3 times more in the experimental extracellular interstitium than elastin, whereas that ratio for the control tissue was only 4.2. Most experimental interstitial cells (80%) contained numerous lipid globules, which, in contrast, were only occasionally present in control cells (7.3%). Experimental cells, consequently, possessed a larger cross sectional diameter and a smaller nucleus-to-cytoplasm volume ratio than control cells. These divergent developmental patterns are possibly suggestive of a delayed differentiation of interstitial cells and a modified production to degradation balance of stromal proteins in offspring of animals chronically exposed to whole cigarette smoke. PMID- 2712344 TI - Perisynaptic satellite cells in human external intercostal muscle: a quantitative and qualitative study. AB - It is not known whether or not satellite cell nuclei are more common in the vicinity of motor endplates than in extrasynaptic regions of human muscle, as in animals. If so, perisynaptic satellite cells may have a role in preserving neuromuscular function. We compared the frequencies of satellite cell nuclei and of myonuclei in perisynaptic and extrasynaptic regions of human external intercostal muscle, and found an absolute as well as a relative increase of perisynaptic satellite cells. The mean frequency of satellite cell nuclei per sarcomere was 0.016 in perisynaptic and 0.00003 in extrasynaptic regions. The mean frequency of myonuclei per sarcomere was 0.098 in perisynaptic and 0.014 in extrasynaptic regions. We could not demonstrate any influence of aging on satellite cell distribution. Perisynaptic satellite cells had many processes, and some features suggested a more active state. These cells might add to the pool of junctional myonuclei for synthesis of acetylcholine-receptor molecules or help in the repair of the postsynaptic membrane. Alternatively, they may synthesize basal lamina substances that are specific for the endplate. PMID- 2712345 TI - Neurulation in the mouse: manner and timing of neural tube closure. AB - The manner and timing of neural fold fusion in primary neurulation were studied in 1,575 normal ICR mouse embryos by using binocular dissecting, light, and scanning electron microscopy. The initial fusion of apposing neural folds occurred at the level of the intermediate point between the third and fourth somites (i.e., in the caudal myelencephalon) and proceeded both rostrally and caudally. A second fusion occurred at what was originally the rostral end of the neural plate and proceeded rostrodorsally. A third fusion occurred in the caudal diencephalon and proceeded both rostrally and caudally. This was followed by complete closure of the telencephalic neuropore at the midpoint of the telencephalic roof and then complete closure of the metencephalic neuropore at the rostral part of the metencephalic roof. A fourth fusion occurred at what was originally the caudal end of the neural plate and proceeded rostrally. Finally, the caudal neuropore completely closed at the level of the caudal end of the future 33rd somite. PMID- 2712346 TI - Cell proliferation in chick oral membrane lags behind that of adjacent epithelia at the time of rupture. AB - Radioautographic analysis showed that ectoderm and endoderm cells in chick oral membrane continued to label with tritiated thymidine through the period of rupture, but their frequency of labeling was significantly lower than those of adjacent epithelia. Frequency of labeling increased in adjacent ectoderm and endoderm, while oral membrane rates remained relatively low, suggesting that growth in the membrane lags relative to adjacent epithelia. Relatively greater proliferation in adjacent epithelia could generate tension and pull apart the thinned oral membrane. Differentials in rates of cell proliferation, when considered along with knowledge of cellular rearrangements following changes in basal lamina and matrical components, suggest that differential growth is an important force in rupture of the avian oral membrane. PMID- 2712347 TI - Radioautographic study of [3H]mannose utilization during cementoblast differentiation, formation of acellular cementum, and development of periodontal ligament principal fibers. AB - The formation of acellular cementum and the deposition of [3H]mannose-labeled extracellular matrix were studied in 14-day-old Sprague-Dawley rats. The sequential events of cementogenesis and periodontal ligament formation observed by light and electron microscopy were described from the stage of an intact root sheath to postcementogenesis. Ultrastructural examination of cementoblasts and periodontal ligament fibroblasts revealed [3H]mannose labeling of the Golgi apparatus at 10 minutes, collagen secretion granules at 30 minutes, and the extracellular matrix beginning at 30 minutes. The extracellular matrix between cementoblasts and dentin was heavily labeled at 1 and 4 hours. Newly formed principal fibers of the periodontal ligament were also heavily labeled at 4 hours. Fully differentiated cementoblasts exhibited the largest sectional profiles and the highest number of silver grains per unit area of cytoplasm. The morphologic and radioautographic data suggest that during the formation of acellular cementum, the cementoblast phenotype is expressed for a short period of time, after which cementoblasts appear to mix with the fibroblasts of the periodontal ligament. PMID- 2712348 TI - Mammalian frontal diploic vein and the human foramen caecum. AB - The course of the frontal diploic vein in the mole Talpa and the tree shrew Tupaia is described and compared to the frontal diploic vein of other mammals. The frontal diploic vein in Talpa and Tupaia connects the dorsal sagittal sinus to the veins of the orbit and has an emissary function. In certain other mammals it has a diploic function and may drain towards the orbit (e.g., Orycteropus) or towards the dorsal sagittal sinus (e.g., Didelphis). The frontal diploic vein of these mammals is not homologous to the vein of the human foramen caecum, but to the human frontal diploic vein. The vein of the foramen caecum is a problematic structure: its incidence in embryos and children is not clear. PMID- 2712349 TI - Glyoxylate cycle in the epiphyseal growth plate: isocitrate lyase and malate synthase identified in mammalian cartilage. AB - Peroxisomes were identified in chondrocytes from all zones of the mammalian epiphyseal growth plate by using light microscopic techniques for the cytochemical demonstration of catalase, the marker enzyme for these organelles. Additional cytochemistry showed the presence of malate-synthase-positive structures within the chondrocytes. The latter enzyme, also associated with peroxisomes, is unique to the glyoxylate shunt, a metabolic pathway thought to be absent in vertebrate tissues. The glyoxylate cycle allows the net conversion of lipid to carbohydrate, i.e., gluconeogenesis. Biochemical studies on growth plate cartilage indicate that this tissue has the capacity to carry out cyanide insensitive B-oxidation of fatty acids. The latter takes place in a nonmitochondrial compartment, most likely the peroxisomal compartment. Additionally, both of the unique enzymes associated with the glyoxylate cycle, i.e., isocitrate lyase and malate synthase, were also identified in a cell-free homogenate of this cartilage. These studies indicate that cartilage, a poorly vascularized tissue characterized by its low oxygen tension and anaerobic glycolysis, may have the capacity to convert lipid to carbohydrate, i.e., gluconeogenesis via the glyoxylate pathway. In this way, cartilage may be unique among mammalian tissues. PMID- 2712350 TI - Coordinated regulation of endothelial and fibroblast cell proliferation and matrix synthesis in periodontal ligament adjacent to appositional and resorptive bone surfaces. AB - Little is known about the remodeling of blood vessels and soft connective tissue or the proliferation of endothelial cells in the periodontal ligament (PL) of teeth undergoing physiological drift. To determine whether there is evidence for coordinated regulation of endothelial cell and fibroblast proliferation and matrix synthesis in sites within the PL adjacent to bone-appositional (A) and bone-resorptive (R) surfaces, the PL in mouse mandibular molar was subdivided into A and R sectors on the basis of 3H-proline incorporation into alveolar bone. Computer-assisted morphometry of radioautographs showed that the number and area of blood vessels were similar in A and R sectors. Proliferation of endothelial cells and fibroblasts was assessed from radioautographs prepared from mice continuously labeled with 3H-thymidine at times between 2 and 60 days. Significantly more labeled endothelial cells (P less than .001) and fibroblasts (P less than .05) were seen in the A sector. The percent of labeled endothelial cells and the percent of labeled fibroblasts increased linearly to 25 days and then formed a plateau. The rate of increase of labeled fibroblasts was higher in the A sector than in the R sector (P less than .025). In addition, 3H-proline grain counts over extracellular matrix were significantly higher in the appositional sector than in the resorptive sector (P less than .025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712351 TI - Ultrastructure of a model basement membrane lacking type IV collagen. AB - Basement membranes (BMs) are specialized extracellular matrices which have important roles in cell attachment, migration, growth, and differentiation. The major components of these matrices include type IV collagen, laminin, entactin, and heparan sulfate proteoglycan. The framework or scaffold of BMs has been proposed to be type IV collagen (Yurchenco et al., 1986, J. Histochem. Cytochem., 34:93-102). However, a murine teratocarcinoma cell-line, M1536-B3, has been described which produces an extracellular matrix (ECM) composed of some of the known components of BM, e.g., laminin, entactin, and sulfated proteoglycan, but lacking type IV collagen (Chung et al., 1979, Cell, 16:277-287). With the use of morphological techniques, we have found that the ECM assembled by these cells is composed of multiple layers of electron-dense cords arranged in an interweaving meshwork with short 2-4 nm-diameter cylindrical rods embedded throughout. This organization closely resembles that reported for naturally occurring BMs, e.g., Reichert's membrane (Inoue et al., 1983, J. Cell Biol., 97: 1524-1537). The previous identification of known in vivo BM components in M1536-B3 ECM and the correspondence in morphological appearance of M1536-B3 ECM with that present in naturally occurring BMs suggests that a BM-type of ECM can be assembled without a type IV collagen framework, thus indicating that other components of BMs have a critical role in BM organization and assembly. PMID- 2712352 TI - S-100 protein-immunoreactive cells in the bovine ovary. AB - The present study deals with an immunohistochemical localization of S-100 protein in the bovine ovary. Immunoreactivity for S-100 was observed in various types of cells, as well as in cells of the nervous system. The endothelial cells of arterial vessels, blood capillaries, and lymph vessels; the epithelial cells of ovarian cysts; and the oocytes of normal and atretic follicles showed an S-100 protein positivity. The immunoreactivity also was found in the epithelial cells of the rete ovarii. No cells other than these showed immunoreactivity to the anti S-100 serum. S-100 protein can be a useful marker for providing information on ovarian function. PMID- 2712353 TI - Scanning and transmission electron microscopic study of the tracheal air sac system in a grasshopper Chrotogonus senegalensis (Kraus)--Orthoptera: Acrididae: Pyrgomorphinae. AB - The morphology of the trachea-air sac system in a species of grasshopper Chrotogonus senegalensis has been studied by using scanning and transmission electron microscopes. Capacious air sacs were formed as dilatations along the primary tracheal trunks. Narrower secondary trachea arose either directly from the primary trachea that bypassed the air sacs or from the air sacs themselves. At or close to the organ or tissue supplied with air, the secondary trachea gave rise to the notably smaller tertiary trachea that penetrated the tissue, giving rise terminally to the extremely small tracheoles that indent some cells. The trachea and the air sacs were basically made up of an inner cuticular lining, helical taenidial rings, and an overlying epithelial cell cover. The air sacs may be important in efficient ventilation of the respiratory system. The supply of air directly to the tissue cells was viewed as an exemplary efficient design when compared to that prevailing in the nontracheate air-breathing animals, where the vascular system is interposed between the respiratory organ and the target tissue cells. A similarity in the general morphological design of the insect and avian respiratory systems has been observed, mainly in respect to the presence of the air sacs and that of the respiratory shunts. This, together with the reported functional features like the unidirectional mode of ventilation, has been interpreted as a classic case of structural and functional convergent evolution leading to the evolution of similar and comparably efficient respiratory systems capable of providing the large amount of oxygen demanded by flight. PMID- 2712354 TI - Pathways between lymph vessels and sinuses in lymph nodes: a study in horses. AB - The pathways through which lymph flows from terminal afferent lymphatics to the lymph sinuses, and from the sinuses to initial efferent lymphatics, were studied in horse lymph nodes by using Microfil casts and electron microscopy. Terminal afferent lymphatics are continuous with the subcapsular sinus through oval holes, about 3 microns wide, along their length, and through larger openings near their end. Other terminal afferents penetrate into the node within trabeculae and are supported by processes across the lumen. They connect with trabecular and medullary sinuses through oval or round holes, generally 20-30 microns across. Some of these have processes, similar to the luminal strands of the adjacent sinuses, extending across them, apparently providing reinforcement. Initial efferent lymphatics receive lymph from medullary sinuses through holes which are similar to those in afferent lymphatics, though more common, especially near the origin of the vessel. Initial efferents within the medulla appear to be supported by the luminal strands of the surrounding medullary sinuses. It seems likely that these strands, like the trabeculae which surround the penetrating afferent lymphatics, may help to keep the lymphatic vessels open as the node swells while draining an area of infection. PMID- 2712355 TI - Epidermis, basement membrane, and connective-tissue healing after amputation of mouse digits: implications for mammalian appendage regeneration. AB - Soft tissues from amputation sites of mice were examined at both light and electron microscope levels to determine whether features of growth buds (blastemas), which are necessary for amphibian limb regeneration, exist in nonregenerating mice. Several such features were found. A small area of the wound bed was covered by wound epithelium which, as in regenerating newt limbs, initially lacked an underlying basement membrane. Serially sectioned digits revealed blastemalike growth in the subdermal layer surrounding periosteal chondrogenic cells. Mesenchymelike cells were seen among the fibroblasts and leucocytes within the proliferating tissues. However, no evidence of dedifferentiation was seen in the dermis, which persisted as an apparent intact obstruction to growth bud formation. Existence of the essential ingredients of growth buds and soft-tissue proliferation adjacent to chondrogenic cells proximally suggest that the tissues of mammalian healing may differ quantitatively rather than qualitatively from tissues of appendage regeneration. This premise is encouraging for efforts at growth enhancement in mammals. PMID- 2712356 TI - Membrane relationships in murine Meissner corpuscles: cytology of freeze substituted tissue. AB - Mechanoreceptive sensory corpuscles (murine Meissner corpuscles) in the toe pad skin of mice, consisting of axon terminals and lamellar cells, were studied following freeze-substitution in order to clarify the plasma membrane relationships between axon terminals and lamellar cells. Tissue preservation of corpuscles was excellent when the corpuscle was located within 10 microns from the contact surface with the precooled metal block. The axolemmata appeared more electron-opaque than did plasma membranes of lamellar cells. The inner leaflet of the unit membranes was thicker than the outer leaflet in the axolemma, and the contour of cell plasma membranes was relatively smooth and straight. Characteristic focal or regional approximations of plasma membranes were noted between the axon and abutting lamellae. Such membrane appositions resembled gap junctions, although no gap junctions were found between the axon and lamellae in chemically fixed materials. Similar gap junction-like close appositions of plasma membranes also were found between neighboring lamellae. These approximations occurred more frequently than typical gap junctions seen in chemically fixed materials. These findings indicate that there may be a relationship of the plasma membranes in the axon terminals and in abutting lamellae as well as between neighboring lamellae that have not been identified as yet in conventional chemically fixed material. Another striking finding was that basal laminae on lamellar cells exhibited the same electron opacity as the surrounding connective tissue matrix and thus the two are indistinguishable from one another. Furthermore, the lamina lucida was not evident, and basal lamina material was directly contiguous with the plasma membrane.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712357 TI - Oviductal, not oviducal. AB - Both etymologically and in literal meaning the term "oviductal" is overwhelmingly preferable to "oviducal." PMID- 2712358 TI - Clinical features of patients with detached ciliary tufts in semen. AB - Cilia in the male genital tract are found on the epithelium of the ductuli efferentes, epididymis and vas deferens. Detached ciliary tufts (DCTs) were observed in semen of 13 men and this paper deals with the clinical features of these patients. There was a high incidence of smoking (73%), diminished testicular volume in 64%, a high number with previous urological surgery and trauma and an increased percentage of cytoplasmic droplets. It is postulated that DCTs originate from the epididymal ephithelium. DCTs are possibly shedded as part of epididymal involvement which occurs as a result of testicular pathology caused by several agents. PMID- 2712359 TI - Pulse pattern of luteinizing hormone (LH) in patients with varicocele: a preliminary report. AB - Serum concentrations of LH were measured every 20 minutes for 6 hours in 4 varicocele patients and 4 control subjects. In both groups, a pulsatile pattern of LH secretion was observed. Also in the two groups, LH pulse rate (2-5/6 hour) and amplitude (23.5-61%) were identical. These findings suggest that Gonadotrophin releasing hormone (Gn RH) and LH secretions have no role in the deranged sperm parameters often found in infertile men with varicocele. PMID- 2712360 TI - Serum prolactin concentration in impotent African males. AB - Serum prolactin concentration, measured by radioimmunoassay, was significantly higher (p less than 0.005) in 49 patients with impotence than in a control population of 16 normal subjects. 26.5% of the impotent patients had hyperprolactinemia. Their serum testosterone was also significantly lower (p less than 0.05). Bromocriptine suppressed the raised prolactin, normalised testosterone in seven treated hyperprolactinemic patients, and restored potency in five of them. These results suggest a possible role for hyperprolactinemia in a substantial proportion of African patients with impotence. Further studies in more affected patients are in order. PMID- 2712361 TI - Effect of lipid peroxidation upon human spermatic adenosinetriphosphate (ATP). Relationship with motility, velocity and linearity of the spermatozoa. AB - The aim of the present paper was to study the effect of forced lipid peroxidation upon human spermatozoa and its relation with motility, velocity, linearity and ATP content. Forty-three pools of semen samples were studied one hour after liquefaction. After washing, normal and pathological spermatozoa presented no variations in motility, velocity or linearity with respect to basal values. Forced peroxidation produced a significant decrease of motility, velocity and linearity (p less than 0.02) with respect to control. Spermatic ATP was not significantly different in control vs forced peroxidation groups in normozoospermic samples. In contrast, a significant decrease of ATP between control and peroxidation groups was observed in asthenozoospermia at 120 minutes of incubation (p less than 0.02). In the asthenozoospermic group, a significant LPO-p increase was observed in comparison with the normal group. PMID- 2712362 TI - [Monoclonal antibodies Ki-Sp II-13 and VI-2 react with surface membrane of human spermatozoa]. AB - Immunizing Balb-c mice with washed motile human spermatozoa enabled the production of 2 monoclonal spermatozoal antibodies designated Ki-Sp II-13 and Ki Sp VI-2. Immunohistochemically Ki-Sp VI-2 reacts only with mature spermatozoa. The monoclonal antibody Ki-Sp II-13 recognizes besides spermatozoa also T- and B lymphocytes. Electronmicroscopically both antibodies react with the surface membrane of spermatozoa in the area of the head, the neck and the proximal part of the tail. Functional tests show a high sperm-agglutinating and sperm immobilizing activity, using different test systems for Ki-Sp II-13. Both antibodies proved to be IgG. On immunoprecipitation Ki-Sp II-13 was identified as IgG-2a and Ki-Sp VI-2 as IgG1. Immunoprecipitates of SDS-electrophoretically separated and radiolabeled sperm surface antigens revealed a molecular weight of 18 KD for Ki-Sp II-13 and of 24 KD for Ki-Sp VI-2. PMID- 2712363 TI - Ureaplasma urealyticum and male infertility: an animal model: II. Morphologic changes of testicular tissue at light microscopic level and electron microscopic findings. AB - Testicular biopsies were obtained from Wistar rats that had been infected artificially with Ureaplasma urealyticum, serotype 3. Approximately 50% of the biopsy specimens obtained 3 and 6 months after infection showed degeneration of the germinal epithelium, giant cell formation and Leydig cell hyperplasia. Electron microscopic studies revealed striking alterations of Sertoli cells, germ cells, and Leydig cells as well as ureaplasma organisms inside the seminiferous tubules. The changes noted in the ertoli cells were apparent as early as one week after infection. PMID- 2712364 TI - [The alteration of the motility rate of human spermatozoa and relationship to morphological quality]. AB - On the ejaculate of 715 patients with fertility disorders (one spermatogram) as well as on 90 patients (two spermatograms) the alteration of the motility rate comparing the morphological quality of the spermatozoa has been carried out. In some norm orientated subgroups a statistical evaluation (correlation analysis, covariance selection) were determined. We found a positive correlation between increased percentage of pathological spermatozoa and increased motility rate. A special graphic allows more information about the correlative structure of the correlation matrix: this confirms the results of the correlation analysis. On the different malformations of the spermatozoa the intraindividual fluctuation was in the least, but very high on the sperm density. The fluctuation of the fructose content (detailed observed) was very little. PMID- 2712365 TI - The effect of semen processing on sperm morphology. AB - Semen samples were obtained from 28 infertile men referred for AIH. The percentage morphologically normal sperm was assessed on Papanicolaou stained smears before and after semen processing. The percentage of normal sperm increased significantly (p less than 0.005). It would seem that the semen processing procedure increased the number of morphologically normal sperm, which could theoretically improve the results of AIH. PMID- 2712366 TI - Some variability factors in the cytomorphological analysis of frozen bull semen. AB - Frozen bull semen was analyzed after fixation with glutaraldehyde (0.2% sol. in PBS) by clear field microscopy (after staining with Rose Bengal and Victoria blue B), phase contrast microscopy and differential-interference-contrast microscopy performed by two observers who analysed sets of 100 and 200 spermatozoa. The results obtained with phase-contrast microscopy did not differ significantly from those obtained using interference contrast microscopy, performed by two observers on sets on 100 and 200 spermatozoa, concerning the following sperm abnormalities: abnormal detached heads, acrosome ruptures, tail abnormalities and total abnormalities. In view of the importance of extending the evaluation of sperm cytomorphology among artificial insemination centres, and the fact the phase contrast microscopy system is less expensive than a differential-interference contrast system and easier to operate, the authors recommend the use of phase contrast microscopy for the routine study of sperm cytomorphology. PMID- 2712367 TI - Sperm adenylyl cyclase in young and middle-aged men. AB - The present report is an extension of a previous study of the accessory sex gland function in normal young (20-25 years) and middle-aged (50-55 years) men. In the same individuals, the basal and in vitro stimulated activities of the sperm adenylyl cyclase were determined. A high degree of individual variation existed in both basal and Gpp(NH)p-, forskolin- and acetate-stimulated sperm adenylyl cyclase, and no significant difference could be demonstrated between the means of the age groups. Furthermore, no significant correlation existed between the concentrations of the glandular secretory products (prostatic acid phosphatase, citric acid, zinc, spermine, spermidine, putrescine, fructose and prostaglandin E) in the ejaculate and the activity of the sperm adenylyl cyclase. Furthermore, the number of morphologically abnormal sperm cells in the ejaculate did not influence the activity of the enzyme. No inverse correlation existed between the magnitude of basal activity and the relative response to Gpp(NH)p, forskolin or acetate suggesting that the variation in the enzyme could not be explained by its partial desensitization by seminal plasma constituents during the liquefaction period. A lack of correlation between the response of the enzyme to Gpp(NH) p and forskolin on the one hand and acetate on the other, implied that these drugs activate the enzyme through different mechanisms. PMID- 2712368 TI - Human seminal plasma cadmium: comparison with fertility and smoking habits. AB - Cadmium, selenium and zinc were determined in seminal plasma and serum of 64 men by atomic absorption spectrometry (AAS). The mean (+/- SD) cadmium concentrations in seminal plasma and serum were 0.22 +/- 0.22 micrograms and 0.28 +/- 0.10 micrograms, respectively, but they did not correlate with each other. Smokers (n = 31) had significantly (p less than 0.01) higher serum cadmium concentrations than non-smokers (n = 31). Also seminal plasma cadmium in smokers was elevated, but a significant difference to non-smokers was only found if more than 20 cigarettes were consumed daily. No differences were found in semen quality and fertility between smokers and non-smokers. The seminal plasma cadmium had no correlation to selenium or zinc which, however, displayed a positive correlation (r = 0.852, p less than 0.001) to each other. It is concluded that smoking increases the exposure to cadmium. Although no obvious reproductive suppression was observed, heavy smoking may possibly enhance toxic effects in men under other detrimental exposures. PMID- 2712369 TI - Relationship of sperm acrosin activity to semen and clinical parameters in infertile patients. AB - Acrosin activity (aa) was routinely measured in 189 infertile men who attended the hospital between March 1984 and January 1985. The evaluation of the male included semen analysis, microbial screening, postcoital testing (PCT), in vitro sperm penetration test (SPMT), and screening for anti-sperm antibodies in serum. The strongest positive correlations of aa were found for sperm motility, count, morphology, vitality and volume. In presence of a poor PCT result, aa was significantly reduced, even in patients with good motility in native semen. A similar result was obtained with the SPMT: reduced sperm density and poor sperm motility in the capillary after 2 hours were significantly correlated to reduced aa. Smokers exhibited lower aa in presence of normal sperm count and motility. In the infertile group aa was significantly lower than in the group of men whose spouses conceived. On the basis of our results, the routine determination of aa is not necessary, but it provides additional prognostic information in couples with unexplained infertility. PMID- 2712370 TI - The evaluation of free-L-carnitine, zinc and fructose in the seminal plasma of patients with varicocele and normozoospermia. AB - The function of the epididymis and of the sex accessory glands have been investigated in a selected group of varicocele patients with normal sperm count. In the seminal plasma of these patients free-L-carnitine, fructose and zinc levels were determined as functional markers respectively of epididymis, seminal vesicles and prostate. Despite the unvaried free-L-carnitine and fructose levels, zinc levels were significantly lower (p less than 0.001) than in the control group. The Zn/F ratio, an index of the ratio between the prostatic and vesicular secretions, resulted also lower (p less than 0.01) with respect to the controls. The authors suggest that the impaired prostatic function could arise from the decreased venous drainage in the vesico-prostatic plexus. In the same patients sperm motility resulted significantly lower than in the controls, and was positively related to zinc levels (r = 0.44, p less than 0.01) and, to a higher degree, to the Zn/F ratio (r = 0.62, p less than 0.001). Our data show that in this selected group of varicocele patients with a not yet altered tubular epididymal unit, sex accessory gland secretions can influence, per se, the motility of the ejaculated spermatozoa. PMID- 2712371 TI - Mecobalamin promotes mouse sperm maturation. AB - The effect of Mecobalamin (alpha-(5,6-dimethyl benzimidazolyl)-Co-methyl cobamide: Me-B 12) on sperm production in the oligozoospermic mice experimentally induced by the treatment with adriamycin (0.3 mg/kg, three times a week for 5 weeks) was evaluated quantitatively by means of equilibrium sedimentation in Percoll. After centrifugation, the distribution profile of the sperm showed two peaks, i.e. the first peak near the bottom consisting of mature sperm with good motility and the second peak containing immature and/or immotile sperm. By oral administration of Me B 12 (1.0 mg/kg/day) to the oligozoospermic mice for 10 weeks, the sperm count, sperm motility, motile sperm count, diameter of seminiferous tubules and the percentage of good motile sperm with higher apparent density were increased as compared with those of the control. These results suggest that Me-B 12 enhanced the testicular function, resulting in an increased output of mature sperm. PMID- 2712373 TI - [Inderal as a means of preventing damage to vitally important organs in the case of mechanical asphyxiation, accompanied by clinical death]. AB - The effect of mechanical asphyxia and the following resuscitation on the metabolism of the vital organs (brain, heart, liver, and lungs) has been experimentally studied in male rats. It has been shown that excessive activation of lipid peroxidation leading to the damage of membrane structures is one of the key factors causing bioenergetic disturbances. In clinical conditions it is manifested in hyperenzymemia, while in isolated isovolumetrically contracting heart it is manifested in massive enzyme outflow from cardiomyocytes into the coronary duct and reduction of glucose uptake per unit of cardiac work performed. These changes closely correlate with contractility function disturbances both in normal and accelerated heart rate. Preadministration of 0.2 mg/kg propranolol increased survival in the early postasphyxia period, decreased considerably metabolic disturbances in vital organs and improved myocardial contractility. PMID- 2712372 TI - The effect of vasectomy on serum lipids. AB - The effects of vasectomy on serum lipids and free fatty acids were followed. The concentration of serum cholesterol was lower one year after vasectomy than one week after and immediately before vasectomy (p less than 0.01). The LDL cholesterol concentration decreases by 16 per cent (p less than 0.01) within one year after vasectomy. The concentration of serum free fatty acids was significantly higher (p less than 0.001) before vasectomy than after it. PMID- 2712374 TI - [Changes in the oxygen transport function in patients with chronic kidney failure during hemodialysis]. AB - Some parameters of oxygen transport blood function have been studied prior to hemodialysis treatment and following 5, 25, 50 and 100 hemodialysis procedures. It has been established that programmed hemodialysis decreases O2 transport and reserve. These changes may be associated with an unfavourable effect of the procedure itself on the body, accompanied by anemia, microthromboembolisms in lung vessels, hypercapnia and arteriovenous blood shunt. Partial compensation of O2 transport decrease is achieved due to cardiac output increase and O2 tissue excretion. These compensatory mechanisms cannot ensure normal values of O2 reserve and transport and are fairly quickly depleted in the course of hemodialysis. PMID- 2712375 TI - [Choice of antibacterial therapy with the use of a computerized consultation system]. AB - The principle for a consulting system ensuring selection of a "theoretically optimal" antibiotic or antibacterial drug combination for the treatment of severe pyo-septic conditions in critically ill patients is described. The system is an addition to an automated case history, which ensures its efficacy. The algorithms are based on the analysis of the literary data and the results of many years of studying microorganisms in infectious foci. PMID- 2712376 TI - [Pathogenesis of intra-operative disruption of hemodynamics during hemodialysis of patients poisoned by phosphorganic insecticides, complicated by the development of exotoxic shock]. AB - The results of central hemodynamic and myocardial contractility studies during hemodialysis in 62 patients with severe fluoroorganic insecticide poisoning complicated by exotoxic shock are reviewed. It has been established that hemodynamic disturbances are manifested in progressing fall of venous pressure, stroke volume and cardiac output accompanied by the onset of phase myocardial hypodynamia syndrome. The leading role of hypovolemia resulting from ultrafiltration in the pathogenesis of the above hemodynamic disturbances has been revealed. The results obtained make it possible to outline approaches aimed at correction of intraoperative hemodynamic disturbances and to increase safety of extracorporeal hemodialysis. PMID- 2712377 TI - [Noninvasive methods of determining the minute volume of the heart in young children in the early postoperative period]. PMID- 2712379 TI - [Pharmacologic stimulation of acupuncture points for postoperative analgesia]. AB - A method for postoperative analgesia is described on 200 patients operated on abdominal organs and anterior abdominal wall. The technique of pharmacological stimulation of acupuncture points was used. Placental suspension was used as a stimulator. The method is highly effective, simple in use and cheap. The use of reflex therapy technique ensures early postoperative activation of patients. The method does not affect adversely the functions of the patients' organs and systems and makes it possible to detect early signs of postoperative complications and identify and eliminate cases of addiction to narcotic analgesics, as it is possible to restrain from their use in the postoperative period. PMID- 2712378 TI - [The effect of anesthesia on the immunoglobulin level of the blood]. AB - The effect of halothane anesthesia, neuroleptanalgesia and ketamine anesthesia on immunoglobulin (Ig) blood level has been studied in 67 patients with gastric and duodenal ulcers subject to selective proximal vagotomy. The results obtained indicate possible reduction in humoral immunity under the influence of anesthesia and surgery. In patients operated on under halothane anesthesia there was a decrease in IgM, IgG and IgA levels. Neuroleptanalgesia produced a drop in IgA level, while ketamine anesthesia caused no significant changes in IgG blood level. PMID- 2712380 TI - [Magnesium levels in the blood of patients during surgery using cardiopulmonary bypass]. AB - The use of gelatinol as a basic diluent for perfusion caused hypermagniemia (an increase in total magnesium plasma level-MgT-to 1.72 and in its ionized fraction Mg2+- to 0.93 mmol/l) which persisted in the early postoperative period. Normal or elevated MgT plasma level does not exclude possible lowering in Mg2+ level. PMID- 2712381 TI - [A method and the clinical effect of quantum ultraviolet autohemotherapy in resuscitation of children]. AB - Using the technique developed by the authors, 279 sessions of ultraviolet autoblood irradiation were performed in 93 patients with complicated infectious pathology. 90 patients with the same pathology constituted the control group. All the patients were treated pathogenetically and etiotropically for toxicoseptic pathology, using current schemes based on correction of clinical-biochemical alterations. In the test group one session of ultraviolet autoblood irradiation was performed once daily for 3 days. The data obtained show positive dynamics of the disease in patients after quantum ultraviolet autohemotherapy and a considerable decrease in lethality and the time of the patient's stay in intensive care unit. PMID- 2712382 TI - [Changes in the kallikrein-kinin system as a result of electrical-medicinal anesthesia]. AB - The results of kallikrein-kinin system studies are analysed in 105 urological patients at different stages of surgical treatment. It has been established that changes in kallikrein-kinin system during combined electrical and drug anesthesia as well as during ataralgesia are unidirectional and reside in moderate system activation of compensatory nature. It is concluded that combined electrical and drug anesthesia is an adequate anesthetic technique to be used during urological surgery. PMID- 2712383 TI - [Changes in the natural killer activity of lymphocytes in peripheral blood of patients with purulent-septic diseases under the effect of extracorporeal perfusion of pig spleen sections]. AB - 23 patients with pyo-septic diseases resistant to conservative therapy were treated by extracorporeal perfusion of xenospleen (EPXS). In 17 patients on EPXS a persistent detoxicating effect was achieved. 6 patients died. EPXS procedure was accompanied by a drop in medium-molecular lipid blood level and normalization of natural killer activity that was decreased considerably prior to EPXS. It is concluded that EPXS has a normalizing effect on the natural killer activity, which may be essential for resistance to infectious complications. PMID- 2712384 TI - [Removal of steroid hormones with the carbon sorbent SKN-1K]. AB - Hemosorption, using CKH-1K sorbent, leads to an acute drop in cortisol and progestagen levels. To avoid complications it is recommended to determine steroid hormone level prior to hemosorption procedure. PMID- 2712385 TI - [A method of replacing blood in severe exotoxic shock]. AB - Extracorporeal perfusion blood oxygenation makes it possible to stabilize blood flow, improve gas exchange in severe exotoxic shock, perform blood replacement, using a small volume of donor blood, and continue etipathogenetic therapy of patients with severe vinegar essence poisoning. PMID- 2712386 TI - [Clinical use of long-term nasotracheal intubation]. AB - Clinical data are presented on prolonged (3 to 63 days) nasotracheal intubation in 159 patients performed for controlled lung ventilation and for maintenance of upper respiratory ways patency in spontaneous respiration. The advantages and disadvantages of nasotracheal intubation as compared to tracheostomy and orotracheal intubation are analysed. The indications for delayed tracheostomy, ways of prevention of complications of prolonged nasotracheal intubation and a method for maintenance of intubation tube patency are suggested. PMID- 2712387 TI - [Nasotracheal intubation with the use of fibroscopes]. AB - The technique of nasotracheal intubation with a fibroscope in 139 patients is described. The advantages and disadvantages of the fibroscopes used, difficulties and complications associated with the technique and their reasons have been reviewed. It has been concluded that endoscopic intubation is an effective non traumatic method and can be performed in complex cases by an experienced physician. The authors prefer the technique described to other methods suggested by foreign authors. PMID- 2712388 TI - [The securing of perfusion nozzles for hemosorption in flasks with various capacities]. AB - A device for the fastening of a standard perfusion nozzle on flasks with thread free necks for hemosorption is described. The device enables to perform hemosorption procedures when it is not appropriate to use standard 400-ml flasks. PMID- 2712389 TI - [A method of decreasing accidental positive exhalation pressure upon high frequency artificial respiration of newborn infants]. AB - A simple method has been suggested for the reduction of excessive positive end expiratory pressure (EPEEP) occurring during high-frequency ventilation with positive pressure in the newborn. The method employs a special conntecor with an inner diameter decreasing towards the end of the tube included into the inspiration line. The use of a connector during high-frequency jet ventilation of lung models from newborn with hyaline membrane disease and meconial aspiration reduced effectively EPEEP in the proximal end of the intubation tube. However, the same efficacy of EPEEP reduction in the lungs has been observed only on the model of hyaline membranes. On the models of lungs from newborn with meconial aspiration EPEEP reduced insignificantly. With the increase in gas mixture flow, the efficacy of the device enhanced. PMID- 2712390 TI - [A method of fixation of an aspirator mouthpiece]. PMID- 2712391 TI - [Anesthesiology in urgent operations in treating heart wounds]. AB - Experience of treating 11 patients with knife wounds of the heart in a central district hospital is reviewed. Limited preoperative period, intensive therapy of hemorrhagic shock, readiness of a surgical and anesthesiological teams to perform a wide range of resuscitation procedures in the course of the operation, prophylaxis, timely and adequate therapy of complications arising in the postoperative period--all help to obtain good results. PMID- 2712392 TI - [Bleeding as a complication of resuscitation in a case of thromboembolism of the pulmonary artery]. AB - Massive blood shed (1700 ml) from the punction wound in the left ventricle was observed in a patient on 65,000 U heparin. Comatose condition was accompanied by a pronounced lactacidemia of liquor (10 mmol/l) developed due to adrenaline administration with an extremely high glucose level (33 mmol/l--in blood; 11 mmol/l--in liquor). High efficacy of hyperbaric oxygenation in hypoxemic coma has been established. PMID- 2712393 TI - [A clinical case of botulism]. AB - A patient with botulism (type E) has been subject to complex therapy, which involved specific serotherapy, infusion therapy, and controlled lung ventilation with the following assisted lung ventilation. PMID- 2712394 TI - [Diagnostic value of laboratory indicators in various states of oxygen transport function of the blood in patients, operated on under conditions of cardiopulmonary bypass]. AB - Changes in oxygen and acid-base balance have been studied in 86 patients with different oxygen transport function after cardiopulmonary bypass surgery. It has been shown that diagnostic value of such indexes as SO2 and pO2 in mixed venous blood, O2 consumption and transport, blood and erythrocyte acid-base balance, lactate concentration depends on the cardiac pump function, microcirculatory patterns, pulmonary oxygenation and cell metabolism. In case of acute circulatory disturbances in the early postoperative period the prognostic value of each laboratory finding is in close correlation with the degree of circulatory failure. The observation of changes in oxygen and acid-base balance in the first hours after the operation enables a more accurate diagnosis of disturbances in the inner body medium and a choice of pathogenetically verified methods of their correction in patients after cardiopulmonary bypass surgery to be made. PMID- 2712396 TI - [Lymphedema and lymphonodovenous anastomosis. Preoposal of a technical modification]. AB - After some considerations about lymphedema and the progresses in its study, the surgical procedures to its treatment are exposed, considering this treatment technically and also orientate to lymphedema etiology. Afterwards, a clinical case, its treatment, and its discussion are exposed. PMID- 2712395 TI - [Non-invasive monitoring of cardiac output with Doppler in aortoiliac surgery. Preliminary study]. AB - The experience about 18 patients subjected to aortoiliac surgery is exposed. The cardiac flow was bloodless monitorized by means of an apparatus, based in Doppler effect, which proved its accuracy and usefulness. Authors considers necessary to monitorize the cardiac flow in this sort of surgery, and this bloodless method has showed its validity and simplicity. PMID- 2712397 TI - [Hemodynamic evaluation of extra-anatomic revascularization of the aorto-iliac sector]. AB - Arterial flow pressure were recorded from 24 extraanatomic bypass (5 axillo femoral, 8 bifemoral and 11 femoro femoral). A significant flow increase was found in the donor's limbs. On the contrary it returned to basal levels when they were temporary occluded. These results confirm the positive outcome of these operations and the inexistance of "steal syndrome" in patients without stenosis in the donor arteries. Hemodymanic studies referring to blood velocity as an important antithrombogenic factor have been taken into consideration. PMID- 2712398 TI - [Assay of fructosamine. Value and limits in diabetology]. AB - Fructosamine test using a Nitroblue Tetrazolium (NBT) method offers many advantages: quickness, reproducibility, easy automation and unexpansiveness, but a standardization of the different methods is needed. The results can be expressed in absolute value of equivalent DMF per liter, except in pregnancy where mumol per g of protein is used. The interpretation of the results can be difficult in case of quantitative and/or qualitative proteins abnormalities: icterus and severe chronic renal insufficiency. Fructosamine is significantly higher in diabetic patients. It gives a good correlation with glycated haemoglobin but the provided information is different, concerning a shorter period of 2 to 3 weeks and perhaps more sensitive to recent glycaemic variations. Fructosamine test does not seem to be a good screening test for diabetes and impaired glucose tolerance. The test indications of the assay could be: situations where the dosage of glycated haemoglobin is not interpretable, diabetic pregnancy follow-up and short term evaluation of a therapeutic change on glycaemic control. However, the individual significance of fructosamine concentration remains to be assessed and seems to be less accurate than glycated albumin. PMID- 2712399 TI - High performance liquid chromatographic method for routine monitoring of amiodarone and desethylamiodarone plasma levels. AB - The authors describe a normal phase liquid-chromatographic assay suitable for therapeutic monitoring of amiodarone and desethylamiodarone in human plasma. The compounds were extracted at pH 3.8 into methyl tert-butyl ether containing [2 ethyl-3-3.5-dibromo-4-dipropylaminoproxybenzoyl)benzothiophe ne] as internal standard. The separation was obtained by using a mobile phase of methanol-methyl tert butyl ether-sulfuric acid (60-40-0.015; v/v/v). The absorbance of the compounds was monitored at 254 nm with a sensitivity limit of 0.05 mg/l for amiodarone and 0.02 mg/l for desethylamiodarone. The mean overall recovery from plasma samples was greater than 90 p. cent for both compounds. This method was applied to therapeutic and pharmacokinetic studies. PMID- 2712400 TI - [Usual values of selenium and glutathione peroxidase in a Belgian population]. AB - Several biological parameters for assessing selenium status have been determined in years 1985-1986 in a large Belgian population group, males and females 0 to 92 years old, representative from Brussels and surroundings. In 145 people, 20 to 79 years old, mean concentrations were: 1.06 +/- 0.15 mumol Se/l plasma, 5.0 +/- 1.1 nmol Se/g Hb in erythrocytes and 7.4 +/- 2.0 mu/g Hb for the selenodependent glutathione peroxidase activity measured in erythrocytes (mean +/- standard deviation). Values for urine selenium have a disymmetric distribution and range from 0.05 to 0.65 mumol Se/g creatinine. No difference was evidenced in this group according to sex and age. Children below 20 years and elderly above 80 years have decreased plasma and erythrocyte selenium concentrations but glutathione peroxidase is not modified. These blood selenium concentrations are lower than those determined in a similar population group in years 1980-1981, suggesting a progressive decrease in selenium intake. The concentrations of the biological parameters are not correlated together except in selenium deficient patients having plasma selenium less than 0.75 mumol/l: a significant correlation is observed between plasma selenium and erythrocyte glutathione peroxidase activity, that becomes more intense with decreasing plasma selenium. Finally, two recent investigations are described where a significant response in platelet glutathione peroxidase was obtained during a 60 days selenium supplementation with 100 to 200 micrograms selenium per day, suggesting that usual selenium intake in Belgium (50 micrograms per day) is marginally deficient. PMID- 2712401 TI - [Blood ethanol assay by gas chromatography]. AB - Blood ethanol measurement can be performed by gas chromatography if the samples are diluted before tungstate-sulfuric acid deproteinization. A good knowledge of linearity area is needed for to obtain with this method the same results than with the oxydimetric method. PMID- 2712402 TI - [Hydrogen peroxide assay by chemoluminescence]. PMID- 2712403 TI - [Oral administration of sodium citrate before general anesthesia in elective cesarean section. Effect on pH and gastric volume]. AB - A study was carried out to assess the effects of oral sodium citrate on the pH and volume of gastric content in 52 unpremedicated women undergoing elective Caesarean section under general anaesthesia. The patients were randomly assigned to two groups: group T (n = 26) without antacids and group C (n = 26) receiving orally 30 ml of 0.3 M sodium citrate solution 5 min before induction of anaesthesia. After tracheal intubation, a size 18 double lumen naso-gastric tube was introduced. The gastric content was sampled 10 min (n = 52), 50 min (n = 52) and 80 min (n = 24) later. Before extubation, the stomach was completely emptied and the naso-gastric tube removed. On each sampling time, the pH was measured with a digital pHmeter; a search for biliary salts (pyloric reflux) was carried out with thin layer chromatography; the volume of the gastric content was measured using the phenol red dilution method. At 10 min, none patient in group C had a gastric pH less than 2.5, in the opposite to 92% of patients in the control group T. The alkalinizing effect of the citrate lasted throughout the evaluation time. The mean pH was respectively 5.3 +/- 1.07, 5.23 +/- 1.2 and 5.53 +/- 1.3 at 10, 50 and 80 min in group C (controls: 1.9 +/- 0.7; 2.49 +/- 1.3; 2.40 +/- 0.61). However, the citrate solution increased significantly the volume of the gastric content. It was respectively 51.1 +/- 29.9 ml, 79.15 +/- 70.9 ml and 32.9 +/- 22.1 ml; 29.6 +/- 28.5 ml; 26.6 +/- 10.9 ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712404 TI - [Use of norepinephrine in the treatment of septic shock]. AB - The effects of noradrenaline were studied in 16 patients, with either a hyperkinetic septic shock syndrome or a septic shock resistant to dobutamine treatment. The study aimed to restore normal tissue perfusion pressure, assessed by a return to normal of urine output or blood pressure. An optimal left ventricular filling pressure, estimated by the pulmonary capillary wedge pressure, was obtained for each patient using a Swan-Ganz catheter. The administration of 10.6 +/- 0.5 micrograms.kg-1.min-1 dobutamine (starting dose: 6 micrograms.kg-1.min-1) was started when the cardiac index (CI) was less than 3.3 l.min-1.m-2 after vascular filling with plasma expanders. Patients became eligible for noradrenaline treatment when they fulfilled the following conditions: arterial systolic pressure (Pasys) less than or equal to 90 mmHg; systemic vascular resistances less than or equal to 600 dyn.s.cm-5; CI greater than 3.5 l.min-1.m-2; persistent oliguria (less than 30 ml.h-1). This drug was given at a constant rate with a starting dose of 0.5 micrograms.kg-1.min-1, increased every 10 min by 0.3 to 0.6 micrograms.kg-1.min-1 according to the effects on Pasys and hourly urine output. Eight patients received noradrenaline alone; the efficient dose was 0.9 +/- 0.2 micrograms.kg-1.min-1, and it was used for a mean 5.1 +/- 1 days. CI increased in those patients who were given both noradrenaline and dobutamine. Thirteen out of the 16 patients had a dramatic increase in urine output; only three patients remained oliguric. There were no effects on serum creatinine concentration, anion gap, intrapulmonary shunt and oxygen consumption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712405 TI - [Use of erythrocytapheresis in a pregnant woman with sickle cell anemia]. AB - A case is reported of a 23 yr old pregnant woman from Zaire in whom homozygous sickle-cell disease was discovered at her first obstetrical visit at 25 week amenorrhea. She had had two previous pregnancies: the first one had been voluntarily interrupted; the second one went to term, but the child, born in a state of apparent death, died on the third day. Despite severe normocytic anaemia (5 mmol.l-1 haemoglobin, 2.9 T.l-1 erythrocytes, 0.25 haematocrit, 93 fl mean globular volume), she was symptomless. The diagnosis was confirmed by haemoglobin electrophoresis: 0 haemoglobin A (HbA) and 0.854 haemoglobin S (HbS). Because foetal growth and maturation appeared satisfactory, no procedure to increase the HbA/HbS ratio was used before the 37th week of amenorrhea. At that time, erythrocytapheresis was carried out using a discontinuous flow cell separator. Eight phenotyped red cell packs without leukocytes (removed by filtration) were transfused; at the end of the procedure, there was 0.67 HbA and 0.25 HbS. At 39 week amenorrhea, haemoglobin electrophoresis gave 0.43 HbA and 0.47 HbS. No further treatment was therefore given. At the 40th week, she gave birth to a healthy girl, Apgar score 10 at 1 min. She was given two further red cell packs at start of labour, because her haemoglobin level had fallen to 6.4 mmol.l-1. In the immediate postpartum, her HbS level was 0.38. The aims, advantages and disadvantages of the different techniques available for the treatment of homozygous sickle-cell anaemia in pregnancy are discussed. PMID- 2712406 TI - [Prolonged apnea after suxamethonium related to congenital abnormality of plasma pseudocholinesterase]. PMID- 2712407 TI - [Activity indicators for an anesthesiology department]. PMID- 2712408 TI - [Value of a cumulated prognostic index in the development of severe peritonitis with adult respiratory distress syndrome]. PMID- 2712409 TI - [Tracheal rupture after intubation in surgical procedures using general anesthesia]. PMID- 2712410 TI - [Lack of clinical impact of biological disorders in the surgery of thoraco abdominal aneurysms?]. PMID- 2712412 TI - In vitro function of bovine neutrophils against Actinomyces pyogenes. AB - Factors that influenced the in vitro bactericidal activity of bovine neutrophils against Actinomyces pyogenes were investigated. Neutrophils and serum from 2 clinically normal donor cows were incubated with bacteria for 2 hours. To determine bactericidal activity, colony-forming units were counted after a 48 hour incubation on blood agar plates. Microscopic examination indicated that in the presence of serum, bacteria were cell associated after incubation, whereas when serum was replaced by medium, bacteria were not cell associated. Bactericidal activity of neutrophils was similar whether the sera were heat treated at 56 C for 30 minutes or were not heated. Heating the serum at 65 C for 30 minutes significantly (P less than 0.001) reduced bactericidal activity. Bactericidal activity decreased (P less than 0.001) as serum concentration (less than 10%) decreased. More than 80% of the bacteria were killed within the 40 minutes of incubation. The opsonizing capacity of serum varied significantly (P less than 0.01) among 12 cows. Similarly, neutrophil bactericidal activity (by cow) was affected significantly (P less than 0.001). Preincubation of serum with A pyogenes significantly (P less than 0.001) reduced the opsonizing ability of the serum. Culture filtrate of A pyogenes was not chemotactic for neutrophils in vitro. PMID- 2712411 TI - Antibodies to Pasteurella haemolytica somatic antigens in two models of the bovine respiratory disease complex. AB - Serum samples obtained from feeder calves before and after entry into the market system (days 0 to 7) were assayed for antibodies to Pasteurella hamolytica biotype A, serotype 1 capsular polysaccharide (CPS) and lipopolysaccharide/outer membrane protein (LPSp) by isotype in a kinetic-augmented, antigen-capture ELISA. These test results, plus indirect hemagglutination (IHA) antibody titers, and hemolysin-in-gel test (HIGT) findings were compared with clinical performance data during the initial 4 weeks in the feedlot (receiving period). High concentrations of HIGT antibody, at the point of initial assembly of feeder calves at weaning and during the subsequent 7-day marketing period, were associated with freedom from bovine respiratory disease (BRD) during the receiving period. High or rapidly increasing concentrations of anti-CPS IgG1 during the marketing period were also associated with less BRD. However, high concentrations of anti-LPSp IgG1 during the marketing period were associated with increased BRD during the receiving period. There was no correlation between the concentrations of antibody determined by IHA tests early in the marketing period and freedom from BRD during the receiving period. High concentrations of antibody determined by this test at entry into the feedlot (day 7) were associated with a high incidence of BRD. Calves vaccinated with a P haemolytica bacterin had significantly (P less than 0.05) higher HIGT values and concentrations of anti LPSp IgG1 and IHA antibody than did nonvaccinated calves on entry into the feedlot (day 7). Vaccination appeared to have little effect on the amount of anti CPS IgG1. Of all the tests used to quantitate antibody, the HIGT correlated best with clinical performance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712413 TI - Colostral volume and immunoglobulin G and M determinations in mares. AB - Colostral volume and IgG and IgM concentrations were determined in 6 multiparous mares at foaling and them every 2 hours from 16 to 20 hours after parturition. Serum IgG and IgM concentrations at foaling also were determined in each mare. The rate of mammary secretion was 292 +/- 26 ml/h (range, 202 to 389 ml/h), and the colostral volume was 5.1 +/- 0.5 L (range, 3.2 to 7.0 L). The colostral IgG and IgM contents were 440 +/- 106 g (range, 199 to 855 g) and 3.1 +/- 0.9 g (range, 0.7 g to 7.1 g), respectively. There was no significant correlation between serum and initial colostral IgG and IgM concentration or between serum and total colostral IgG or IgM values. The colostral IgG and IgM concentrations at foaling correlated well with the total colostral IgG and IgM contents, respectively. The initial 250 ml of colostrum contained 10 +/- 1.4% (range, 6.0 to 13.9%) and 6 +/- 1.0% (range, 2.4 to 8.5%) of the total IgG and IgM contents, respectively, and the initial 500 ml of colostrum contained 20 +/- 2.7% (range 12.0 to 27.1%) and 14 +/- 1.2% (8.2 to 17%) of the total colostral IgG and IgM contents, respectively. PMID- 2712414 TI - Natural killer cell activity in untreated and treated dogs with lymphoma. AB - Natural killer (NK) cell activity and function were determined for 11 untreated and treated dogs with lymphoma. Concurrent chromium release and single cell binding assays, methods used to measure overall cytotoxic activity and that from individual cells, respectively, were performed at effector-to-target cell ratios of 50:1 and 100:1, with incubation periods of 12 and 16 hours. Significant reduction was achieved in overall activity for untreated dogs, using a 16-hour incubation period and an effector-to-target ratio of 100:1 (P less than 0.05). Decreased activity (P less than 0.025) was also achieved for those dogs that were administered combination chemotherapy, consisting of such drugs as cyclophosphamide, vincristine, prednisone, and doxorubicin. There was no significant difference in binding or cytotoxic activity by individual cells in the untreated or treated dogs, compared with the healthy controls. Short- or long term treatment with glucocorticoids did not influence overall NK cll activity or individual cell cytotoxicity. The overall cytotoxic activity in untreated dogs was reduced, but these dogs had relatively normal numbers of NK cells compared with paracontrols. This suggests that a defect in recycling or the ability to kill targets repetitively, may be involved. A similar defect was found in NK cells of dogs treated aggressively with combination chemotherapy. PMID- 2712416 TI - Pharmacokinetic properties of theophylline given intravenously and orally to ruminating calves. AB - The disposition of theophylline in healthy ruminating calves was best described by a first-order 2-compartment open pharmacokinetic model. The drug had a mean elimination half-life of 6.4 hours and a mean distribution half-life of 22 minutes. Total body clearance averaged 91 ml/kg/h. The mean values for the pharmacokinetic volume of the central compartment, pharmacokinetic volume of distribution during the terminal phase, and volume of distribution at steady state were 0.502, 0.870, and 0.815 L/kg, respectively. Theophylline was readily absorbed after oral administration to the ruminating calf, with a mean fraction of 0.93 absorbed. The plasma concentrations after oral dosing peaked in approximately 5 to 6 hours, with a mean absorption half-life of 3.7 hours. A flip flop model (rate constant of input is much smaller than the rate constant of output) of drug absorption was not found because the elimination process roughly paralleled that of the study concerning IV administration. In a multiple-dose trial that used a dosage regimen based on single-dose pharmacokinetic values, clinically normal calves responded as predicted. However, diseased calves had higher than expected plasma concentrations after being given multiple oral doses of theophylline at 28 mg/kg once daily. Overt signs of toxicosis were not seen, but this aspect of the drug was not formally investigated. Theophylline can be used as an ancillary therapeutic agent to treat bovine respiratory disease, but not without risk. The suggested oral dose of theophylline at 28 mg/kg of body weight once daily should be tailored to each case.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712415 TI - In vitro immune monitoring of antibody response in dogs given chemoimmunotherapy for lymphoma. AB - Clinical remission in 30 dogs with lymphoma was induced with a combination of vincristine, L-asparaginase, cyclophosphamide, and doxorubicin HCl, administered sequentially, and then an autochthonous tumor cell vaccine, given intralymphatically, as maintenance therapy. Humoral antibody amounts were monitored in 11 dogs, using a solid-phase bead-type radioimmunoassay. The median survival of the 30 dogs was 13 months from the start of chemotherapy (range, 7 to 25 months; mean, 13.8). The median remission duration was 16 weeks (range, 9 to 98 weeks; mean, 26.8). Correlation between increase in amount of humoral antibody was significant (P = 0.0001 to 0.012), before and after chemoimmunotherapy, in dogs responding to therapy, compared with that in dogs not responding to therapy. PMID- 2712417 TI - In vitro reactivity of digital arteries and veins to vasoconstrictive mediators in healthy horses and in horses with early laminitis. AB - The in vitro reactivity of vasoconstrictive mediators that are implicated in acute laminitis was determined in palmar and plantar digital arteries and veins obtained from healthy horses and in palmar digital vessels of horses with early laminitis (Obel grade I). To obtain baseline reactivity data, 3 experiments were conducted, using healthy horses: (1) the reactivity of palmar and plantar digital arteries and veins to angiotensin II, norepinephrine, and 5-hydroxytryptamine (serotonin) were compared; (2) the direct effects of bacterial endotoxin on vascular reactivity were assessed; and (3) the reactivity of palmar digital arteries and veins to angiotensin II, norepinephrine, prostaglandin F2 alpha (PGF2 alpha), serotonin, and a thromboxane-endoperoxide analog (U46619) were determined. The vascular reactivity of these same 5 vasoconstrictors then was determined in horses with early laminitis and was compared with data from healthy (control) horses. Obel grade-I laminitis was experimentally induced in horses, using carbohydrate overload. Dose responses were conducted for each agent at concentrations between 10(-8)M and 10(-4)M. The potency of a drug was defined as the mean effective concentration necessary to induce 50% of maximal contraction (EC50). There were no differences in EC50 concentrations and in maximal contractions between forelimb and hind limb arteries and veins for angiotensin II, norepinephrine, and serotonin. Incubation with endotoxin had no effect on the reactivity of arteries and veins to angiotensin II, norepinephrine, and serotonin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712418 TI - Bioavailability, pharmacokinetics, and plasma concentration of tetracycline hydrochloride fed to swine. AB - A 2 X 2 crossover design trial was conducted in gilts to determine the bioavailability and pharmacokinetics of tetracycline hydrochloride. The bioavailability of tetracycline hydrochloride administered orally to fasted gilts was approximately 23%. After intravascular administration, the disposition kinetics of tetracycline in plasma were best described by a triexponential equation. The drug had a rapid distribution phase followed by a relatively slow elimination phase, with half-life of 16 hours. Its large volume of distribution (4.5 +/- 1.06 L/kg) suggested that tetracycline is distributed widely in swine tissues. Total body clearance was 0.185 +/- 0.24 L/kg/h. Other pharmacokinetic variables were estimated. In a second trial, 3 gilts were fed a ration containing 0.55 g of tetracycline hydrochloride/kg of feed. Resulting plasma concentration of tetracycline was determined at selected times during 96 hours after exposure to the medicated feed. Plasma drug concentration peaked (0.6 micrograms/ml) at 72 hours after access to the medicated feed. PMID- 2712419 TI - Pharmacokinetics of oxytetracycline in the turkey: evaluation of biliary and urinary excretion. AB - Oxytetracycline (OTC) pharmacokinetic values in plasma and bile were ascertained after IV administration of the drug. At 6 hours after administration of 1 mg of OTC/kg of body weight, 2.15% of the dose was found in the bile and 37.6% was found in the urine. At 2 hours after administration, the peak bile-to-plasma OTC concentration ratio was 60:1. Bioavailability of OTC was 47.6% when it was administered orally to fasted turkeys and was 9.4% when administered to fed turkeys. PMID- 2712420 TI - Somatosensory-evoked and spinal cord-evoked potentials in response to pudendal and tibial nerve stimulation in cats. AB - Somatosensory-evoked potentials (SEP) and spinal cord-evoked potentials (SCEP) were recorded in clinically normal adult cats in response to electrical stimulation of pudendal and tibial nerves to provide normative data that can be used in a clinical evaluation of pudendal nerve function in cats after sacral or sacrococcygeal luxations or fractures. Responses to tibial nerve stimulation were included in the study as an internal control because it is usually not involved in these types of injuries and because its SEP and SCEP are easily recorded. Evoked potentials were characterized by the latencies (ms) of positive (P or p) and negative (N or n) peaks. The SEP resulting from percutaneous pudendal nerve stimulation consisted of a prominent P-N-P potential in the 30- to 80-ms range. The pudendal SCEP was not successfully recorded because of large muscle artifacts evoked from the sacral area. The tibial SEP was similar to the pudendal SEP, except that the prominent P-N-P series in the 35- to 81-ms range was preceded by a smaller p-n-p-n sequence in the 7- to 23-ms range. The tibial SCEP consisted of a P-N-P series in the 2- to 4-ms range. PMID- 2712421 TI - Determination of brodifacoum and bromadiolone residues in rodent and canine liver. AB - A method to determine residue concentrations of anti-coagulant rodenticides, brodifacoum (BF) and bromadiolone (BD) in liver was developed, using gas chromatography/mass spectrometry. Nine dogs were given 1.1 mg of BF/kg of body weight, PO, in polyethylene glycol 400, one time. Rats were fed BF or BD (via commercial baits) in amounts from 0.28 to 11.25 mg/kg over 1- to 4-day periods. Fresh liver samples were collected at necropsy from all rats and 3 dogs, ground with Na2SO4, and extracted with CHCl3:MeOH (9:1). After evaporation and silica cartridge purification were performed, residues were oxidized with a 0.16M chromic acid solution, and an oxidation product (4-bromobenzoic acid) was partitioned into CHCl3. The methylated derivative (port derivatization with trimethylanilinium hydroxide) was assayed, using gas chromatography/mass spectrometry. Bromadiolone was detected in livers from rats given greater than 6 mg of BD/kg of body weight, but not in livers of rats given 1.25 mg of BD/kg. In contrast, BF was detected (with one exception) in livers from dogs (given 1.1 mg of BF/kg) and from rats given high (11.25 mg of BF/kg) and low (0.28 mg of BF/kg) doses. This protocol, which does not differentiate between BF and BD because of the formation of a common product after chromic acid oxidation, was used to diagnose anticoagulant toxicosis in 3 dogs, 1 human being and 1 llama naturally poisoned. PMID- 2712422 TI - Effect of Pasteurella haemolytica (A1) capsular polysaccharide on sheep lung in vivo and on pulmonary surfactant in vitro. AB - Capsular polysaccharide (CP) of Pasteurella haemolytica (type A1) was first deposited by fiberoptic bronchoscopy into the lungs of sheep to examine lesions and changes in bronchoalveolar lavage cell populations and, later, was mixed with pulmonary surfactant to investigate alterations in physical properties or surface tension. At 22 hours after deposition, minimal lesions were seen in the lungs only at and contiguous to the site of CP deposition in 2 of 4 sheep. Microscopically, alveoli and interlobular septa were filled with edema fluid. Terminal airways and alveoli contained a moderate amount of neutrophils that varied between sheep. Significant differences in number or type of bronchoalveolar lavage cells were not observed in the weekly lavages between each group or among sheep within each group, either before or after deposition of CP or physiologic saline solution. After 6 hours of incubation at 37 C, CP surfactant mixtures were examined with a surface tensiometer and centrifuged in sucrose gradients. The CP bound to surfactant, resulting in formation of a precipitate with a surface tension of 31.6 +/- 0.1 dynes/cm and a density of 1.07 to 1.08 g/ml. Lipopolysaccharide of P haemolytica, used as a control, also bound to surfactant, resulting in a complex with a surface tension of 57.7 +/- 0.4 dynes/cm and a density of 1.06 to 1.10 g/ml. Surfactant alone had a surface tension of 32.6 +/- 0.2 dynes/cm and density of 1.05 to 1.06 g/ml. The CP appears by itself not to be a direct major factor in the lung damage that develops in cases of pneumonic pasteurellosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712423 TI - Efficacy of long-acting oxytetracycline alone or in combination with streptomycin for treatment of Brucella ovis infection of rams. AB - Twenty-four rams inoculated with Brucella ovis by conjunctival and preputial routes were treated with a long-acting oxytetracycline alone or in combination with dihydrostreptomycin sulfate. The combined treatment eliminated Brucella ovis from 11 of 12 (91.6%) treated rams. Only 4 of 12 (33.3%) rams treated with oxytetracycline alone were bacteriologically negative. Neither treatment resolved clinical epididymitis in 2 rams affected before treatment. Many rams had pathologic lesions in the epididymis and ampullae, which limited the efficacy of antibiotic treatment. PMID- 2712424 TI - Distribution of bovine cysticercosis in Washington. AB - Data from slaughter plants (n = 3) and feedlots (n = 18) in eastern Washington were analyzed to characterize occurrence patterns of cysticercosis in Washington during 1984. Three concurrent peaks in cysticercosis rates (0.6/1,000 to 5/1,000 slaughtered cattle) were detected at 3 slaughter plants. Peaks were observed at 8 feedlots from December 1983 to March 1984, at 6 feedlots from April to July 1984, at 2 feedlots from August to October 1984, and at 3 feedlots from November 1984 to February 1985. Affected feedlots were not closely associated geographically and were feeding cattle from many, predominantly northwestern, origins. For 3 feedlots for which time in the feedlot was available for each slaughter shipment, an increase in cysticercosis rate with increasing time in the feedlot was noticed. Within these 3 feedlots, cases of cysticercosis were widely scattered spatially. The pattern of cysticercosis indicated human fecal contamination of a regionally available feed source. Of feedstuffs in use, potato waste, a byproduct of the processed potato industry, appeared to be the most likely source of Taenia saginata ova. PMID- 2712425 TI - Prevalence of Cryptosporidium sp in equids in Louisiana. AB - In 1985, 22 pony foals reared in a helminth-free environment were tested daily for oocysts of Cryptosporidium sp by use of fecal flotation. Oocysts were found in all foals. Oocysts were first observed in feces collected from foals 9 to 28 days after birth. The mean period of oocyst shedding was 10 days and ranged from 2 to 18 days in individual foals. Diarrhea was observed in 14 of 22 (64%) foals and began before the period of oocyst shedding. Fecal samples also were examined for other infective agents. Salmonella poona was isolated from 1 foal that did not have diarrhea, and coronavirus particles were observed in the feces of 2 foals with diarrhea. Cryptosporidium sp oocysts also were observed in feces of 2 of 17 Thoroughbred foals, 3 of 14 Quarter Horse foals, and 3 of 26 pony foals reared on pastures with their dams. Samples from pasture-reared foals were collected at irregular intervals. Of the 11 Cryptosporidium-positive fecal samples collected from pastured foals, 2 were from foals with diarrhea. A similar survey was conducted during the 1986 foaling season, using the same procedures. Examination of 300 samples from 58 Quarter Horse, Arabian, and pony foals did not detect oocysts. Daily examination of feces from 10 pony foals reared under helminth-free conditions for 30 days also failed to detect Cryptosporidium oocysts. PMID- 2712426 TI - Basal and bile salt-stimulated bile flow and biliary lipid excretion in ponies. AB - The role of bile salt in biliary lipid excretion was studied in 3 healthy ponies with chronic external biliary fistulas. After endogenous bile salt pool depletion, micelle-forming taurocholate or taurochenodeoxycholate was infused to replace excreted bile salt. Enterohepatic circulations were held open (total biliary diversion) throughout each study. Results indicated that biliary lipid excretion in ponies (113 +/- 21 nmol/min/kg of body weight) is approximately 10 times less than that reported in rodents. Although the lipid composition (4.4% cholesterol, 5.6% phospholipid, and 90% bile salt) was within the predicted range for a single phase of micellar (or vesicular) liquid in solution, it was supersaturated with cholesterol because of low absolute concentrations of bile salt and phospholipid. Ponies, like guinea pigs, were determined to have a high bile salt-independent secretion of biliary lipid with little (or no) coupling to endogenous bile salt output. However, bile salt excretion induced by higher taurocholate infusion rates (ie, those greater than the physiologic range of 61 to 125 nmol/min/kg) was positively correlated with an increase in biliary phospholipid excretion, but not cholesterol excretion, thus indicating that a threshold intracellular bile salt concentration may be associated with enhanced biliary phospholipid excretion in ponies. The apparent cholerectic effects of endogenous bile salts, taurocholate, and taurochenodeoxycholate (that is, the increment in bile flow per increment in bile salt recovered) were greater in ponies than reported for any other mammal. PMID- 2712427 TI - Hematologic, biochemical, blood-gas, and acid-base values in greyhounds before and after exercise. AB - After racing 722 m, 16 Greyhounds were evaluated to determine changes in hematologic, biochemical, blood-gas, and acid-base values following exercise. Values were determined before racing (T0), immediately after racing (T1), and 3 hours after racing (T2). Significant changes detected immediately after racing included increased heart rate, respiratory rate, and rectal temperature. Significant changes in hematologic values included increases in PCV, total plasma protein, hemoglobin, RBC, WBC, neutrophils, and lymphocytes. Change was not detected in values for monocytes, eosinophils, and neutrophil/lymphocyte ratio. Other increases included those for plasma concentrations of sodium, chloride, calcium, lactic acid, aspartate transaminase, alanine transaminase, alkaline phosphatase, creatine kinase, lactate dehydrogenase, and glucose. Concentrations of potassium and urea did not change. Measurement of blood-gas and acid-base status revealed significant increases in PaO2 and base deficit, whereas PaCO2, pH, and bicarbonate decreased. Three hours after exercise, all vital signs and blood-gas and acid-base values, except for PaCO2, which was still slightly low, had returned to baseline (T0) values. Most biochemical values had also returned to baseline, although sodium, chloride, aspartate transaminase, and creatine kinase were still high, and urea was low. Many hematologic values were still different from baseline values, with high values for WBC, neutrophils and neutrophil/lymphocyte ratio, and low values for PCV, total plasma protein, hemoglobin, RBC, and lymphocytes. PMID- 2712428 TI - Cell proliferation of epidermis, hair follicles, and sebaceous glands of beagles and cocker spaniels with healthy skin. AB - Cell proliferation kinetic values were established for the epidermis, hair follicle epithelium, and sebaceous glands of 10 Beagles and 4 Cocker Spaniels with healthy skin and coats. Values were established by intradermal pulse labeling injections of [3H]thymidine, examination of cutaneous biopsied tissues, and autoradiography. The epidermal basal cell-labeling index was 1.41 +/- 0.46% for Beagles and 1.71 +/- 0.56% for Cocker Spaniels. The hair follicle basal cell labeling index was 1.46 +/- 0.78 and 1.07 +/- 0.42%, respectively. Calculated epidermal cell-renewal time for viable layers of the epidermis was 23.38 +/- 5.93 days for Beagles and 20.97 +/- 4.92 days for Cocker Spaniels. Differences between cell kinetic data for the 2 breeds were not significant (P greater than 0.05). The basal cell-labeling index for the sebaceous gland was significantly (P = 0.009) lower for Cocker Spaniels (0.40 +/- 0.18%) than for Beagles (1.81 +/- 1.08%). Seemingly, epidermal and follicular cell proliferation kinetics in healthy dogs was similar between the 2 breeds, whereas sebaceous gland basal cells were less proliferative in healthy Cocker Spaniels than in healthy Beagles. PMID- 2712429 TI - Overriding vertebral spinous processes in the extinct horse, Equus occidentalis. AB - Lumbar and thoracic vertebrae of the extinct horse, Equus occidentalis, were examined for gross and radiographic evidence of overriding spinous processes. Of 2,661 vertebrae examined, 580 had intact spinous processes. Thirty-six intact spinous processes, which appeared grossly similar to overriding spinous processes in the modern domestic horse, E caballus caballus, were radiographed. Of these 36 vertebrae, 2 had radiographic signs compatible with a radiographic diagnosis of overriding spinous processes, ie, radiographically observed lysis and/or sclerosis. Seemingly, weight bearing or other stresses imposed by human beings may not have induced the signs of overriding spinous processes. PMID- 2712430 TI - Pathogenesis of psoroptic scabies in Hereford heifer calves. AB - Hereford heifer calves were experimentally infested with Psoroptes ovis. Histologic examination of skin specimens was conducted at weekly intervals before and after treatment with ivermectin on postinfestation week 7. Electron microscopy revealed numerous degranulating mast cells in the skin of infested but not in control calves. many active, as well as degenerate, neutrophils were in the scab on infested calves. Microscopic epidermal ulcers developed on infested calves when live mites were present but not after treatment. Numbers of dermal neutrophils and plasma cells decreased and numbers of circulating neutrophils increased 1 week after treatment. Numbers of dermal eosinophils and mast cells in calves with eosinophilia increased for several weeks after treatment. Statistical analysis indicated significant correlations (P less than 0.05) among numbers of dermal inflammatory cells, hemogram values, and changes in dermal thickness. Seemingly, mite-induced epidermal damage was the key pathogenic event in psoroptic scabies in calves. Mast cell degranulation contributed to the pathogenesis of the dermatitis, and neutropenia was caused by sustained, poorly compensated efflux of neutrophils into the scab through mite-induced breaks in the epidermis. PMID- 2712432 TI - Children and their development: knowledge base, research agenda, and social policy application. PMID- 2712431 TI - Effects of aflatoxin, deoxynivalenol, and their combinations in the diets of growing pigs. AB - In 2 studies, the effects of dietary aflatoxin (AF) and deoxynivalenol (DON) were evaluated in growing crossbred barrows. The first study consisted of 4 treatments of 5 barrows each (6 weeks old) at dosages of 0 mg of DON and AF (control), 2.5 mg of DON/kg of feed, 0.75 mg of AF/kg of feed, and 2.5 mg of DON + 0.75 mg of AF/kg of feed. Pigs were fed their respective diets for 21 days. Treatment with DON caused decreases in weight gains, but no other treatment-related differences could be attributed to diets. In a second study, the experimental design consisted of 4 treatments of 5 barrows each (6 weeks old) at dosages of 0 mg of DON and AF (control), 3 mg of DON/kg of feed, 3 mg of AF/kg of feed, and 3 mg of DON + 3 mg of AF/kg of feed fed ad libitum for 28 days. The pigs were observed twice daily for clinical signs, hematologic and serum biochemical measurements were made weekly, and body weights and feed consumption were determined weekly. Body weight gains were significantly depressed by the AF and the AF + DON treatments for days 7, 14, 21, and 28. Body weights and body weight gains were only slightly reduced in the DON treatment. Changes in serum enzymatic activities of alkaline phosphatase, aspartate transaminase, creatine kinase, and gamma glutamyl transferase were noticed in pigs given treatments with AF alone and those given AF + DON.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712433 TI - Nitrogen dioxide and respiratory infection. PMID- 2712434 TI - Effect of nitrogen dioxide exposure on susceptibility to influenza A virus infection in healthy adults. AB - The effect of NO2 exposure and human susceptibility to respiratory virus infection was investigated in a placebo-controlled, randomized, double-blind trial conducted in an environmentally controlled research chamber over 3 yr. Healthy, nonsmoking, young adult volunteers who were seronegative to influenza A/Korea/82 (H3N2) virus were randomly assigned to breathe either filtered clean air (control group) or NO2 for 2 h/day for 3 consecutive days. The NO2 concentrations were 2 ppm (Year 1), 3 ppm (Year 2), and 1 or 2 ppm (Year 3). Live, attenuated cold-adapted (ca) influenza A/Korea/82 reassortant virus was administered intranasally to all subjects immediately after the second exposure. Only one of the 152 volunteers had any symptoms; this person had a low grade fever. Pulmonary function measurements and nonspecific airway reactivity to methacholine were unchanged after NO2 exposure, virus infection, or both. Infection was determined by virus recovery, a fourfold or greater increase in serum or nasal wash influenza-specific antibody titers, or both. The infection rates of the groups were 12/21 (2 ppm NO2) versus 15/23 (clean air) in Year 1, 17/22 (3 ppm NO2) versus 15/21 (clean air) in Year 2, and 20/22 (2 ppm) and 20/22 (1 ppm) versus 15/21 (clean air) in Year 3. Each group exposed to 1 or 2 ppm NO2 in the last year became infected more often (91%) than did the control group (71%), but the differences were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712435 TI - Pulmonary tuberculosis in South African gold miners. AB - In 1977, a comprehensive tuberculosis management program was introduced at a medical facility which then served approximately 65,000 black gold miners. The effectiveness of this program was evaluated from the relapse rate after treatment in 2,776 men. Post-treatment follow-up averaged 23.5 months. Limited information on potential determinants of relapse was available for all subjects and more detailed information for subsets. The drug regimen was the major determinant of relapse. Age was not a determinant of relapse nor was primary resistance of Mycobacterium tuberculosis to antituberculosis drugs, which was infrequent. The initial extent and severity of disease had a direct relation with the risk of relapse. The risk of relapse was greatest during the first 3 yr after treatment but persisted for the duration of the observation period. Neither continued exposure to mine dust nor the presence of pre-existing silicosis were shown to be determinants of relapse. A 4.5-month, four-drug weekday regimen was identified as being particularly effective in this working population and may be suitable for use in other working populations in the developing world. PMID- 2712436 TI - The combined toxicity of azidothymidine and antimycobacterial agents. A retrospective study. AB - Eight patients being treated for tuberculosis prior to starting azidothymidine therapy (study group) were compared with 56 patients who were treated with azidothymidine but not with antimycobacterial agents (control group). Toxicity was assessed 12 wk after the initiation of treatment with azidothymidine. Study group patients were more likely than control subjects to be either black or Hispanic (75% versus 30%, p = 0.02). There were no other statistically significant demographic differences. Seven study patients, and 20 control subjects experienced a fall in leukocyte count greater than 10% (88% versus 36%, p = 0.01). Within each group, patients with acquired immune deficiency syndrome (AIDS) were more likely to experience this degree of hematologic toxicity than were patients with AIDS-related complex (p = 0.03). However, analysis of covariance showed no significant differences between the groups after 12 wk of azidothymidine with regard to mean leukocyte or platelet counts, hemoglobin levels, or values for tests of liver function. The groups were similar in transfusion requirements and frequency of changes in azidothymidine dosage. Although this study was limited in power by the number of patients and the nonrandomized, retrospective design, the data suggest that patients can tolerate concurrent therapy with azidothymidine and antimycobacterial agents without unacceptable toxicity. PMID- 2712437 TI - Susceptibility of beige mice to Mycobacterium avium complex infections by different routes of challenge. AB - We have studied the susceptibility of beige (C57Bl/6/bgJ/bgJ) mice to a virulent strain of Mycobacterium avium complex (MAC) (101) by intravenous, intraperitoneal, intranasal, oral, and intrarectal routes. Consistent with our earlier findings, intravenous challenge resulted in high mortality and colony forming unit (CFU) counts of recoverable organisms from spleens, lungs, livers, and lymph nodes, plus high levels of mortality. Intraperitoneal challenge resulted in high organ CFU counts but no mortality. Of relevance to the sexual practice of certain homosexual patients with AIDS is the intrarectal route of inoculation, which resulted in extensive involvement of the visceral organs with MAC disease. Multiple challenges by intravenous, oral, or rectal routes resulted in higher CFU counts than did single exposures. PMID- 2712438 TI - Malotilate prevents accumulation of type III pN-collagen, type IV collagen, and laminin in carbon tetrachloride-induced pulmonary fibrosis in rats. AB - Orally administered malotilate was studied as a protective antifibrotic agent with respect to experimentally induced pulmonary fibrosis in rats using immunohistochemical methods. Specific antibodies raised in rabbits against the aminoterminal propeptide of human type III procollagen and against two basement membrane proteins, the 7S domain of human type IV collagen and the P1 fragment of human laminin, were used for the immunohistochemical analysis, and the result was confirmed by morphometry. Intraperitoneally injected carbon tetrachloride significantly increased the volume densities of reticulin fibers, type III pN collagen, type IV collagen, and laminin, whereas treatment with malotilate completely normalized these. Binding of the antibodies to rat antigens was also demonstrated by immunoelectron microscopy in which the collagen fibers with a typical periodic pattern were labeled positively with rabbit antitype III procollagen, whereas the amorphous basement membrane material reacted positively with rabbit antitype IV collagen and antilaminin, indicating good, specific cross reactivity between these antibodies and the rat antigens. It is concluded that malotilate prevents the accumulation of type III pN-collagen and two basement membrane proteins, type IV collagen and laminin, in experimental pulmonary fibrosis, and can potentially be developed to provide a useful drug for preventing pulmonary fibrosis in humans. PMID- 2712439 TI - Cigarette smoking-induced changes in the number and differentiated state of pulmonary dendritic cells/Langerhans cells. AB - To evaluate the effect of cigarette smoking on the number, distribution, and differentiated state of dendritic cells (DC) and Langerhans cells (LC) in the human lung, we have quantitated the number of these cells present in the bronchioles and alveolar parenchyma of lung tissue from nonsmokers and cigarette smokers using anti-CD1 monoclonal antibodies which react preferentially with DC (M241) and LC (T6). M241+ DC were found in the bronchiolar submucosa and alveolar parenchyma of nonsmokers; T6+ LC were present within the bronchiolar epithelium. Cigarette smoking was associated with a twofold increase in the total number of cells of DC/LC lineage and a 30-fold increase in the number of T6+ cells, many of which contained Birbeck granules (LC), present in the alveolar parenchyma. Most LC found in the parenchyma of smokers were observed in close association with areas of alveolar type II pneumocyte hyperplasia. Cigarette smoking did not change the number of differentiated state of cells of DC/LC lineage within the bronchioles. Both DC and LC are present in the human lung. Cigarette smoking has an important effect on the number, distribution, and differentiated state of these cells, which may explain why most adult patients who develop Langerhans cell granulomatosis are smokers. PMID- 2712440 TI - Endothelial cell inhibition of hypoxia-induced stimulation of serotonin uptake by vascular smooth muscle cells. AB - Exposure of bovine pulmonary artery smooth muscle cells (SMC) to anoxia for 24 h resulted in an approximate twofold stimulation of serotonin (5-HT) uptake compared with SMC exposed to 20% O2. The stimulation of 5-HT uptake by exposure to anoxia was eliminated when bovine pulmonary artery endothelial cells (EC) were cocultured with SMC. Incubation with EC-conditioned medium produced similar inhibitory effects on 5-HT uptake of SMC exposed to anoxia, a result not seen with SMC-conditioned medium. The inhibitory effect of EC-conditioned medium on the anoxia-stimulated 5-HT uptake was concentration dependent and absent at a dilution of 1:16. The production of the inhibitor was time-dependent. The EC derived inhibitory factor was heat-stable at 100 degrees C for as long as 10 min and was stable in a pH range from 5.0 to 10.0. Significant losses of inhibitory activity of EC-conditioned medium were observed after treatment with trypsin, pronase E, and proteinase K. The molecular weight on the inhibitory factor from EC-conditioned medium was estimated to be approximately 66,000 by size-exclusion chromatography. The data show that stimulated uptake of 5-HT by SMC under anoxic conditions is under regulation by a protein (or polypeptide) produced by EC. PMID- 2712441 TI - Mechanisms of hypoxemia in chronic thromboembolic pulmonary hypertension. AB - Chronic thromboembolic pulmonary hypertension is characterized by widespread central obstruction of the pulmonary arteries with organized thrombus and thereby differs substantially from other forms of pulmonary hypertension. We studied 25 patients using the multiple inert gas elimination technique to identify and quantitate the physiologic mechanisms of hypoxemia in this disorder. All patients had chronic obstruction of the central pulmonary arteries, which was demonstrated angiographically and later surgically confirmed. All patients but one were hypoxemic (PaO2 = 65 +/- 11 mm Hg, PaCO2 = 32 +/- 4 mm Hg, AaPO2 = 45 +/- 14 mm Hg), and all patients had pulmonary hypertension (mean Ppa = 45 +/- 11 mm Hg) with an elevated pulmonary vascular resistance (mean PVR = 1,000 +/- 791 dyne/s/cm5, normal less than 300). The cardiac index was reduced (1.7 +/- 0.6 L/min/m2), as was the P-vO2 (31 +/- 5 mm Hg). Inert gas studies revealed widened unimodal Va/Q distributions in 20 of 25 subjects, with a log standard deviation of 1.01 +/- 0.32 (upper limit of normal, 0.6; ages 20 to 40), shunt = 0.03 +/- 0.05 of cardiac output, and dead space of 3.4 +/- 1.1 ml/kg (upper limit of normal, 2.9). The VD/VT ratio was 0.51 +/- 0.10. No low (VA/Q less than 0.1) or high (VA/Q greater than 10.0) regions were present, and no evidence for diffusion limitation of O2 transfer at rest was found. The low cardiac output and resulting low P-VO2 were responsible for approximately 33% of the increased AaPO2. The magnitude of the VA/Q abnormality correlated poorly with the PVR, the mean Ppa, or the magnitude of vascular obstruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712442 TI - Patterns of pulmonary perfusion scans in normal subjects. IV. The prevalence of abnormal scans in smokers 30 to 49 years of age. AB - The usefulness of ventilation-perfusion scans in the diagnosis of pulmonary embolism is limited by the wide range of pulmonary diseases that are associated with abnormal scans, and by the largely undetermined prevalence of abnormal scans in persons without cardiopulmonary disease. In prior studies, we found perfusion defects to be rarely present in young persons and in older nonsmokers. To determine if normal older smokers have a higher prevalence of abnormal ventilation and perfusion scans, we performed six-view 99mTc perfusion (Q) scans and 133Xe ventilation (V) scans in 40 subjects 30 to 49 yr of age who had no known cardiopulmonary disease. Each subject had undergone a history, physical examination, electrocardiogram, spirometry, and posteroanterior chest roentgenogram prior to scanning. All V and Q scans were interpreted blindly and independently by two experienced readers. No subject demonstrated a lobar or segmental defect on two views. One subject had a matched subsegmental defect, and one subject had delayed washout from a subsegmental area of the right upper lobe during V scanning, with a normal Q scan. We conclude that abnormal V and Q scans are uncommon among normal smokers 30 to 49 yr of age. PMID- 2712443 TI - Impairment after adult respiratory distress syndrome. An evaluation based on American Thoracic Society recommendations. AB - To test the hypothesis that impairment after the adult respiratory distress syndrome (ARDS) is uncommon, we evaluated 41 ARDS survivors using ATS standards for determination of impairment. A total of 101 trials of pulmonary function tests were obtained between 1 and 388 wk after the onset of ARDS. It was possible to evaluate impairment at 1 yr or more after ARDS in 27 subjects. Eighteen of the 27 were impaired. The percentage of ARDS survivors who were impaired on the basis of FVC, FEV1, FEV1/FVC, and DLCOsb was 50.0, 61.1, 33.3, and 82.4%, respectively. Impairment was mild in 13 (72.2%), moderate in four (22.2%), and severe in one (5.6%). Smoking status had no predictive value in determining impairment. Physiologic indices of ARDS severity (maximal pulmonary artery pressure, lowest static thoracic compliance, and maximal level of PEEP) were found to be significantly different when those impaired 1 yr or more after ARDS were compared with those not impaired. Symptoms were found to have no association with impairment. We conclude that, using ATS criteria, impairment 1 yr or more after ARDS onset is common. Patient characteristics and symptoms after ARDS have no association with impairment 1 yr or more after ARDS onset, whereas physiologic indices of severity during ARDS do. PMID- 2712444 TI - Clinical determinants of abnormalities in pulmonary functions in survivors of the adult respiratory distress syndrome. AB - Pulmonary function tests (PFTs) were performed in 39 survivors of the adult respiratory distress syndrome (ARDS) in whom clinical data had been prospectively collected during the acute episode. PFTs stabilized within 6 months of the episode and had returned to normal in most survivors. Persistent abnormalities were found after 6 months in diffusing capacity (14 of 23 patients, 61%), vital capacity (10 of 23 patients, 43%), and total lung capacity (five of 24 patients, 21%). To clarify the mechanisms underlying these persistent abnormalities, we attempted to correlate long-term PFT outcomes with estimates of the severity of initial lung injury as assessed from clinical data and with other features of the patient's course. The severity of lung function impairment during the first 3 days of ARDS was not related to long-term PFT values. However, a lower DLCO was related to a higher AaDO2, higher pulmonary artery pressure, and worse radiographic appearance on Days 4 through 7 and to the occurrence of sepsis. A lower FVC was related to higher pulmonary vascular resistance in Days 4 through 7 of ARDS. Long-term values for FVC and TLC were directly related to increasing levels of PEEP applied from Days 4 through 7 of ARDS in patients with peak airway pressures less than 50 cm H2O. Long-term abnormalities of pulmonary function of survivors of ARDS were not related to initial lung impairment but were directly related to persistence of impaired lung function during the acute episode. Recovery of lung function may also have been directly related to therapeutic modalities such as PEEP and impaired by the occurrence of sepsis. PMID- 2712445 TI - Sensory receptors and reflex pathways of nonadrenergic inhibitory nervous system in feline airways. AB - The sensory receptors and reflex pathways of the nonadrenergic inhibitory nervous system (NAINS) were examined, using separately ventilated left and right lungs in cats. During bronchoconstriction induced by 5-hydroxytryptamine (5-HT) (50 to 250 micrograms/kg/min, i.v.) infusion after atropine (3 mg/kg, i.v.) and propranolol (2 mg/kg, i.v.), one lung was challenged with (1) citric acid aerosol or (2) capsaicin aerosol or (3) lung volume change (lung inflation). Citric acid or capsaicin inhalation to one lung produced significant bronchodilatation in not only the stimulated lung (SL) but also in the opposite lung (OL). The 5-HT induced change in pulmonary resistance (RL) was reduced 66.5 +/- 3.3% (mean +/- 1 SE) (SL) and 53.0 +/- 8.1% (OL) by citric acid (20%) and 40.5 +/- 8.9% (SL) and 44.0 +/- 9.9% (OL) by capsaicin (0.1%) inhalation, respectively. These bronchodilatations were abolished by bilateral vagotomy. Inflation of one side of the lung did not reduce the 5-HT-induced change in RL in the OL. These findings indicate that (1) C-fiber and irritant receptors are the possible sensory receptors of the NAINS reflex pathway, and (2) afferent nerve stimulation of NAINS in one lung can produce reflex bronchodilatation in both lungs. PMID- 2712446 TI - Comparison of single breath carbon monoxide diffusing capacity and pressure volume curves in detecting emphysema. AB - To evaluate the sensitivity of diffusing capacity (DLCO) and pressure-volume (P V) curves in the detection of emphysema, these tests were compared with pathologic assessment of emphysema in patients undergoing lung resection for a localized tumor, and with the overall extent of emphysema as assessed by computed tomography (CT). The resected lung specimens were fixed in the inflated state and cut at 1-cm intervals in the horizontal plane. The pathologic extent of emphysema was quantitated by comparison with a standard reference panel of emphysema grading. The overall extent of emphysema on CT was assessed by a visual scoring system in a total of 55 patients, 19 undergoing lung resection and 36 not undergoing lung resection. Analysis of 37 patients by pathology scores revealed 18 with no or trivial emphysema (emphysema grades less than or equal to 5; mean grade, 2.2 +/- SD 2.6) and 19 with emphysema (grades greater than or equal to 10; mean grade, 33.2 +/- SD 24.2). Diffusing capacity, the ratio of DLCO to alveolar volume (DLCO/VA), maximal lung elastic recoil (PLmax), and lung elastic recoil at 90% of total lung capacity (PL90) were significantly different between the two groups, whereas K (the exponential constant describing the shape of the P-V curve) was not. The pathology grade of emphysema showed a significant correlation with (DLCO) (r = -0.53) and DLCO/VA (r = -0.55), which was greater than the correlation with PLmax (r = -0.42) and PL90 (r = -0.43).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712447 TI - Action of the inspiratory muscles of the rib cage during breathing in newborns. AB - To determine whether the rib cage muscles actively contribute to tidal volume change in infancy, we measured tidal volume (VT), using a pneumotachograph, respiratory gastric pressure swings (Pga), using a liquid-filled gastric catheter, and rib cage and abdominal volume, using respiratory inductive plethysmography in 15 newborns, both before and during 2% CO2-induced hyperventilation. Active rib cage expansion produced by phasic contraction of the inspiratory muscles of the rib cage should reduce respiratory abdominal pressure fluctuations by moving the anterior abdominal wall outward and cephalad, thereby having an expanding influence on the abdominal cavity. During quiet sleep (n = 13), CO2-induced hyperventilation was associated with significant increases in VT, Pga, rib cage volume (Vrc), and abdominal volume (Vab). Increments in Pga were small relative to VT, as shown by an increase in the slope of the VT versus Pga respiratory loop (VT/Pga) in all subjects (p less than 0.001, paired t test). CO2 breathing was associated with an increase in the contribution of the rib cage compartment to total volume change (Vrc/Vrc + Vab) in all infants studied (p less than 0.001, paired t test), and the total volume response to hyperventilation was more strongly related to changes in rib cage volume (slope = 0.62, r = 0.90) than to abdominal volume (slope = 0.31, r = 0.60). During REM sleep (n = 6), mean VT/Pga did not change significantly, and the rib cage contribution to tidal breathing decreased in three of six infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712448 TI - Maximal relaxation rates of esophageal, nose, and mouth pressures during a sniff reflect inspiratory muscle fatigue. AB - Maximal relaxation rate (MRR, % pressure fall/10 msec) of the inspiratory muscles is reduced with fatigue. We have investigated whether MRR of esophageal pressure (Pes) generated by voluntary sniffs is decreased by fatigue, and whether sniff nasopharyngeal (Pnp) and mouth (Pmo) MRR reflect these changes. In 10 normal subjects, control MRR of sniff Pes correlated closely to Pnp MRR (r = 0.977, p less than 0.001) and Pmo MRR (r = 0.947, p less than 0.001). To produce inspiratory muscle fatigue, four highly motivated subjects breathed to exhaustion (3 to 6 min) through a high inspiratory resistance. MRR was determined from 10 sniffs for Pes, Pnp, and Pmo before fatigue, and at intervals up to 10 min after fatigue. The subjects showed a mean decrease in sniff Pes MRR of 33% (range, 20 to 42) immediately after fatigue, which returned exponentially to control values within 3 to 4 min. The mean changes in Pes MRR were reflected by similar changes in Pnp MRR, 32% (range, 18 to 43) and Pmo MRR, 33% (range, 21 to 42). Studies were repeated in the four subjects with closely similar results. We conclude that fatigue of the inspiratory muscles reduces MRR of sniff Pes, and that this is reflected in Pnp and Pmo. Sniff Pes, Pnp, and Pmo MRR measurements may provide a useful method for detecting and monitoring fatigue; Pnp and Pmo have the advantage of being less invasive. PMID- 2712449 TI - The effect of pectoralis muscle training in tetraplegic subjects. AB - We have previously shown that subjects with traumatic tetraplegia use the clavicular portion of the pectoralis major to expire actively. To determine if we could improve the expiratory function of these subjects, we studied six patients in whom the pectoralis major was trained by repetitive, strenuous, isometric contractions for 6 wk. Six patients receiving conventional respiratory rehabilitation served as control subjects. Training of the pectoralis major produced marked increases in the maximal isometric muscle strength (mean +/- SE: 54.6 +/- 5.8%; p less than 0.005) and in expiratory reserve volume (46.6 +/- 9.9%; p less than 0.005). Functional residual capacity did not change, such that residual volume decreased by 14.1 +/- 2.9% (p less than 0.005). In contrast, the control patients did not develop any significant alterations. We conclude that unlike conventional rehabilitation, training the pectoralis major for strength improves expiratory function in tetraplegic subjects. Therefore, training of this muscle should increase the effectiveness of coughing and might reduce the prevalence of bronchopulmonary infections in such subjects. PMID- 2712450 TI - Effects of high-frequency chest wall oscillation on respiratory control in humans. AB - We studied the spontaneous breathing patterns of 10 normal adult volunteers during high-frequency chest wall oscillation (HFCWO), accomplished by inflating and deflating a vest worn around each subject's thorax at 2.5 Hz. Tidal volumes generated by HFCWO averaged 100 ml. Mean vest pressure was maintained at approximately 35 cm H2O throughout each experiment, even when HFCWO was not applied. During HFCWO, subjects were instructed occasionally to exhale deeply to obtain end-tidal samples representative of PACO2. HFCWO increased the breath-to breath variability of spontaneous respiration in all subjects, prolonging expiratory pauses and producing short apneas in some cases. PACO2 decreased significantly (p less than 0.05). The effects on minute ventilation, tidal volume, and inspiratory and expiratory durations remained variable across subjects, even when differences in PACO2 between control and HFCWO states were reduced through inhalation of a low CO2 mixture. None of the changes were statistically significant, although average expiratory duration increased by 29%. Ventilatory responses to CO2 with and without HFCWO were also measured. Normocapnic (PACO2 = 40 mm Hg) ventilatory drive increased significantly (p less than 0.05) in six subjects (Type 1 response) and decreased substantially in the others (Type 2 response); with hypercapnia, the changes in drive were attenuated in both groups. Consequently, CO2 sensitivity decreased in Type 1 subjects and increased in Type 2 subjects. A simple analysis based on this result shows that with HFCWO, Type 2 subjects breathing air will tend to have a lower spontaneous minute ventilation and become hypercapnic. Type 1 subjects will become hypocapnic, but minute ventilation may be higher or lower than control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712451 TI - Antileukoprotease-containing bronchiolar cells. Relationship with morphologic disease of small airways and parenchyma. AB - Twenty-seven surgically removed lungs and lobes were studied to assess the relation between the abundance of bronchiolar epithelial cells containing antileukoprotease (ALP) (ALP-pos/mm) and the degree of small airways disease (SADscore) and emphysema (destructive index = DI, and number of normal alveolar attachments on membranous bronchioles = normal AA/min). Between subjects, ALPpos/mm correlated with SADscore in membranous bronchioles (rs = 0.75; p less than 0.001) and with normal AA/mm (rs = -0.38; p = 0.05). Evaluation within each subject revealed significant correlations of ALPpos/mm with SADscore in membranous as well as in respiratory bronchioles (p less than 0.001), and also with normal AA/mm (p = 0.005). In membranous and in respiratory bronchioles, ALPpos/mm correlated significantly with the ALP concentration in homogenized tissue, as measured by ELISA (rs = 0.55 and 0.57, respectively; p less than 0.01). It is concluded that disease in small airways and destruction of their alveolar attachments are associated with a rise of the number of ALP-containing epithelial cells. We hypothesize that this cellular increase is part of the general defense against inflammatory and destructive processes in distal human airways, leading to higher levels of proteinase inhibitor in order to minimize tissue damage. PMID- 2712452 TI - Elastin degradation by human alveolar macrophages. A prominent role of metalloproteinase activity. AB - Macrophages are thought to play an important role in the turnover of extracellular matrix, but the capacity of human macrophages to degrade elastin, and the elastolytic mechanisms of these cells, have been controversial. Particular difficulty has been encountered in efforts to establish whether human macrophages secrete a metalloelastase that is analogous to the enzyme secreted by rodent macrophages. We studied elastin degradation by human alveolar macrophages cultured directly in contact with radiolabeled elastin using media containing 10% fetal bovine serum, and for comparison performed parallel studies of P388D1 murine macrophagelike cells that are known to secrete metalloelastase. With both cell types, we observed elastin degradation and the following: (1) direct contact between the cells and elastin substrate was required for elastin degradation; (2) elastin degradation was inhibited by the tissue inhibitor of metalloproteinases, but minimally or not at all by inhibitors of cysteine proteinases (E-64, CBZ-phe phe-CHN2, CBZ-phe-ala-CHN2, and cystatin C), or by the serine proteinase inhibitor eglin-c; (3) elastin degradation increased sharply after the cells were in contact with elastin for 24 h, and required new protein synthesis as indicated by sensitivity to cycloheximide; (4) inclusion of dexamethasone (10(-6) to 10(-8) M) in the cultures led to decreased elastin degradation. Also, with both cell types, elastin degradation occurred despite the finding that cell-conditioned media did not contain elastase activity and could inhibit P388D1-derived metalloproteinase elastase. These results indicate a prominent role for metalloproteinase activity in elastin degradation by both human and murine macrophages and support the concept that events at the cell-substrate interface are critically important to macrophage-mediated elastin degradation. PMID- 2712454 TI - Perestroika, fashion, and the universal glue. PMID- 2712453 TI - Open lung biopsy in patients with Hodgkin's disease and pulmonary infiltrates. AB - Although open lung biopsy (OLB) is frequently employed for diagnosis of pulmonary lesions in patients with Hodgkin's disease, the actual efficacy of the procedure in establishing a diagnosis in these patients, and its effect on their treatment and clinical outcome, have not been evaluated. We reviewed the results of OLB in 41 patients with previously diagnosed Hodgkin's disease (17 with stage II disease, 10 with stage III, and 14 with stage IV) who had pulmonary opacification on chest roentgenogram. Nineteen (46%) diagnoses were specific and 22 nonspecific. The most common specific diagnosis was Hodgkin's disease (12 patients); the others were Pneumocystis carinii pneumonia (3), solitary fungal granuloma (2), cytomegalovirus pneumonia (1), and primary lung adenocarcinoma (1). Specific diagnoses were made in 11 (69%) of 16 patients with discrete nodules or masses but in only eight (32%) of the 25 patients with non-nodular radiographic opacification. Eleven (58%) of 19 patients who were asymptomatic or had had symptoms for longer than 4 wk had specific diagnoses, compared to one of six patients (17%) symptomatic for 1 wk or less. Survival of hospitalization correlated more with stage of Hodgkin's disease than with specific diagnosis. However, treatment was changed after biopsy in 22 (54%) of the patients. The results suggest that OLB can be helpful in the management of patients with Hodgkin's disease and pulmonary infiltrates, both in establishing a diagnosis and in assisting the patients' management. OLB appears to be more helpful in patients with Hodgkin's disease than in patients with acute nonlymphocytic leukemia or the acquired immunodeficiency syndrome and pulmonary infiltrates. PMID- 2712455 TI - Changes in bronchial reactivity and respiratory symptoms. PMID- 2712456 TI - Detection of nosocomial lung infection in ventilated patients. PMID- 2712457 TI - Identification of an effective vaccine against tuberculosis. PMID- 2712458 TI - Medical residencies: quantity or quality? PMID- 2712459 TI - Percutaneous aortic balloon valvuloplasty in octogenarians: morbidity and mortality. AB - STUDY OBJECTIVE: To examine the morbidity, mortality, and hospital course of an elderly patient sample (mean age, 86 years; 95% CI, 84 to 87) having percutaneous aortic balloon valvuloplasty. DESIGN: Retrospective consecutive case series before and after balloon valvuloplasty. SETTING: Tertiary care referral hospital. PATIENTS: Consecutive sample of 26 patients aged 80 years or older with symptomatic aortic stenosis referred for balloon valvuloplasty from July 1987 to July 1988. MEASUREMENTS AND MAIN RESULTS: Percutaneous aortic balloon valvuloplasty reduced the transvalvular gradient from 59 (95% CI, 51 to 67) to 31 mm Hg (95% CI, 26 to 35; P less than 0.0001) and increased aortic valve area from 0.45 (95% CI, 0.38 to 0.51) to 0.67 cm2 (95% CI, 0.58 to 0.76; P less than 0.0001). The mean length of hospital stay for the entire study population was 11.2 days (95% CI, 7.3 to 15.2) at a total hospital charge per patient of $29,600 (95% CI, 21,050 to 38,150). For patients having procedural complications (11 complications in 8 patients), surgical procedures, or cardiogenic shock, the mean hospital stay increased to 16.2 days (95% CI, 6.2 to 26.2; P less than 0.05) and the hospital charge increased to $44,400 (95% CI, 24,280 to 64,520; P less than 0.01). Two patients who presented with cardiogenic shock died, and 1 patient had an aortic valve replacement before discharge. Four patients were recently discharged (less than 1 month) and follow-up was obtained in the remaining 19 patients at 6.1 months (95% CI, 4.1 to 8.1). Five more patients, including the remaining patient who presented with cardiogenic shock, died after discharge for an overall mortality of 32%. Twelve of the remaining fourteen patients had fewer symptoms and improved an average of 1.1 New York Heart Association classes (95% CI, 0.7 to 1.4; P less than 0.0001). CONCLUSIONS: Percutaneous aortic balloon valvuloplasty in patients 80 years and older improves hemodynamics and symptoms of heart failure during short-term follow-up in most patients, but overall mortality is high in this elderly patient population. Hospital charges and length of stay were much higher in patients with complications or coexisting medical illnesses. Valvuloplasty is a reasonable alternative treatment for patients with aortic stenosis who require palliative treatment of symptoms and have high surgical risk. PMID- 2712460 TI - Asthma in respiratory therapists. AB - STUDY OBJECTIVE: To test the hypothesis that work as a respiratory therapist is associated with an increased risk of developing asthma. DESIGN: Cross-sectional questionnaire study comparing respiratory therapists with controls (physical therapists and radiologic technologists). Subsequent validation of reported asthma with methacholine challenge studies. SUBJECTS: All respiratory therapists and physical therapists and a random 50% sample of radiologic technologists working in the state of Rhode Island as of June 1986. METHODS: All subjects received a mail questionnaire with questions about the presence or absence of asthma, time of onset, and important covariates. Responses were analyzed for all subjects, and again after excluding those subjects with pre-existing asthma. Subjects who reported physician-diagnosed asthma were asked to have methacholine challenge testing. RESULTS: Respondents included 194 respiratory therapists (response rate, 69.5%) and 517 controls (response rate, 75.3%). After excluding respiratory therapists from the hospital at which the hypothesis was generated, there were 34 respiratory therapists (18.7%) and 30 controls (5.8%) reporting physician-diagnosed asthma. After controlling for age, smoking status, family history, atopic history, and other covariates using logistic regression, respiratory therapy carried an odds ratio of 3.2 (95% CI, 1.9 to 5.5). With analysis restricted to those who developed asthma after entering their profession, the odds ratio for respiratory therapy was 4.6 (95% CI, 2.0 to 10.4). In the validation study, 10 of 14 respiratory therapists (71%) and 6 of 10 controls (60%) had evidence of bronchial hyperreactivity. CONCLUSIONS: These results suggest a previously unrecognized excess of asthma in respiratory therapists. The excess develops after entry into the profession, and does not appear to be explained by confounding, information bias, or selection bias. PMID- 2712461 TI - Hepatitis D virus infection in Illinois state facilities for the developmentally disabled. Epidemiology and clinical manifestations. AB - OBJECTIVE: To define the epidemiology and clinical manifestations of hepatitis D virus infection in an institutionalized population. DESIGN: A case-control study of hepatitis B carriers with and without serologic evidence of hepatitis D virus infection. Demographic, institutional, and medical data were obtained through questionnaires and chart review. Clinical status was assessed by liver function assays. SETTING: Thirteen Illinois state facilities for the developmentally disabled. PARTICIPANTS: Clients (238) who were hepatitis B carriers. RESULTS: Antibody to hepatitis D virus (anti-HDV) was detected in 71 of 238 (30%) hepatitis B carriers. Nine of thirteen facilities housed positive clients. Previous residence at one facility, designated B, was the strongest correlate of anti-HDV positivity; 85% of positive persons had lived there compared with 16% of negative controls (odds ratio 28.3 [95% CI, 13.2 to 60.7], P less than 0.001). Past hepatitis episodes were more common among anti-HDV-positive clients (37% compared with 7%) (odds ratio, 7.5 [95% CI, 3.0 to 19.1], P less than 0.001) and occurred mainly at facility B from 1950 to 1975. Liver function tests were infrequently abnormal among anti-HDV-positive clients. CONCLUSIONS: Results show widespread hepatitis D virus infection in our institutionalized population and suggest that transmission occurred mainly in the past at the overcrowded facility B. The low prevalence of laboratory evidence of chronic liver disease in the anti HDV-positive clients may be explained by increased mortality among those originally infected from 1950 to 1975. PMID- 2712463 TI - Fulminant hepatitis A in intravenous drug users with chronic liver disease. PMID- 2712462 TI - High prevalence of antibodies to intestinal epithelial antigens in patients with inflammatory bowel disease and their relatives. AB - STUDY OBJECTIVE: To assess whether healthy members of families of patients with inflammatory bowel disease share an immune reactivity to gut epithelial cell antigens. DESIGN: Assessment of immune reactivity against epithelial-cell associated components (ECAC). METHODS: Detection of specific anti-ECAC serum antibodies by antibody-dependent cellular cytotoxicity (percent specific lysis) and by immunoblotting (Western blots). PATIENTS: Index cases (131) and first degree relatives in 17 families with 2 or more affected members, and 13 with only 1 member affected. MAIN RESULTS: Compared with a gastrointestinal disease control group (0.5% +/- 0.8%), specific lysis against ECAC-C (colon-derived) among patients with inflammatory bowel disease was significantly greater in both multiply affected (8.4% +/- 8.2%; P less than 0.01) and singly affected (5.2% +/- 5.4%; P less than 0.05) families. In contrast, specific lysis by patients with other inflammatory processes of the small and large bowel (1.1% +/- 1.4%) or autoimmune disease (0.7% +/- 1.0%) did not differ from that of the gastrointestinal disease control group. Among relatives of patients with inflammatory bowel disease (index cases), specific lysis was also significantly higher than in the control group (4.8% +/- 5.5% for multiply affected, P less than 0.01, and 4.3% +/- 5.5% for singly affected, P less than 0.05). Relatives of patients with chronic inflammatory liver disease had a level of lysis (0.6% +/- 0.9%) similar to that of controls. The prevalence of antibodies to ECAC-C was 69.7% among patients with chronic inflammatory bowel disease, and 55.7% among relatives; both prevalences were significantly higher than that of the control group (8.0%, P less than 0.001). Using small-bowel-derived ECAC, the prevalence of antibodies among patients with inflammatory bowel disease and relatives was also significantly higher than that of controls. Reactivity of sera was directed to a 160- and a 137-kilodalton macromolecule. CONCLUSIONS: Immune sensitization to intestinal epithelial antigens is common in families with chronic inflammatory bowel disease; its high frequency among asymptomatic relatives suggests it may represent a primary phenomenon, perhaps predisposing individuals to gut tissue injury. PMID- 2712464 TI - Intravenous amiodarone during prolonged resuscitation from cardiac arrest. PMID- 2712465 TI - Cocaine, pulmonary edema, and propranolol. PMID- 2712466 TI - Indocyanine-green: infusion rate and reactions. PMID- 2712467 TI - Methotrexate and inflammatory bowel disease. PMID- 2712468 TI - Fulminant hepatitis A in intravenous-drug users. PMID- 2712469 TI - Frequency of hemolytic transfusion reactions. PMID- 2712470 TI - Normal ranges and "errors". PMID- 2712472 TI - The physician and the family. PMID- 2712471 TI - Methotrexate in corticosteroid-resistant urticaria. PMID- 2712473 TI - Late development of chorioretinal lesions in birdshot retinochoroidopathy. AB - The clinical manifestations of diffuse retinochoroidopathy after recurrent episodes of vitriitis led to the diagnosis of birdshot retinochoroidopathy in two patients in whom the initial lesions were cystoid macular edema and papillophlebitis. Although the onset and clinical characteristics of the early lesions varied, both patients had manifestations of chronic retinal vasculitis. We observed the late appearance and evolution of the characteristic cream-colored depigmented spots which were not present in the early stages of the disease. In addition the second case also developed choroidal neovascularization. Serial electroretinographic examinations showed that this disorder has a progressive course from focal lesions to widespread diffuse changes. PMID- 2712474 TI - A bidirectional, turbulent, delaying, centripetal, suction filter. AB - The physiologic functions of the outer retina and the pathophysiology of drusen related macular failure are best explained by attributing the properties of a bidirectional, turbulent, delaying, centripetal, suction filter to Bruch's membrane. PMID- 2712475 TI - Sinus histiocytosis with massive lymphadenopathy: bilateral orbital involvement spanning 17 years. AB - We report a case of sinus histiocytosis with massive lymphadenopathy (SHML) with a right inferior orbital mass. The mass was excised and, on histopathologic examination, was believed to be a "lipogranuloma." Thirteen years later, the patient was seen at our institution for what appeared to be a recurrent orbital mass. Orbital tumors were removed from the right superior and inferior orbit and from the left superior orbit. Histopathologic examination of these tumors at this institution and at the Armed Forces Institute of Pathology showed them to be SHML. The original biopsy tissue obtained in 1969 was reexamined and found also to be SHML. The clinical and histopathologic features of this disease are discussed. PMID- 2712477 TI - Posterior synechiae after laser iridectomy. AB - Eighty-six eyes of 46 patients were studied retrospectively to determine the incidence of posterior synechiae after laser iridectomy. All eyes were dilated and studied with a slit lamp. The incidence of permanent posterior synechiae in the eyes in this study (37%) is much higher than that previously reported. There was a strong positive correlation between the use of miotic agents postoperatively and the finding of posterior synechiae. The probable pathogenesis of this complication is discussed, and methods to decrease the incidence of this complication are given. PMID- 2712476 TI - Enlarging fundal hemorrhage in Terson's syndrome. AB - Serial photographs of an enlarging fundal hemorrhage were taken in a 44-year-old man with a subarachnoid hemorrhage. Although clipping surgery was done successfully 17 hours after onset, the patient developed impaired vision on the third postoperative day. Funduscopic examination can document the exact moment when enlarging subhyaloid hemorrhage extends into the vitreous cavity. PMID- 2712478 TI - Threshold sensitivity tests in various ocular diseases. AB - The threshold sensitivity visual-field test is one of the most accurate ways to detect ocular disorders. The indications for utilization of this device in the detection and follow-up of many diseases other than glaucoma and neuro ophthalmologic disorders can be expanded. PMID- 2712479 TI - Retinal periphlebitis after hormonal treatment. AB - Two cases, those of a man and a woman, developed retinal periphlebitis after hormonal treatment for infertility and contraceptives, respectively. Both had a unilateral severe decrease in visual acuity, and a central scotoma and defect in color vision were also present. The fundus had retinal edema, especially of the macula, a hyperemic disc with blurred margins, normal arteries, congested veins, and marked sheathing along the main veins, with retinal hemorrhages in the inferior half of the retina. Fluorescein angiography showed a delayed filling of the veins in the affected retina and late staining of these veins. Since there was severe visual impairment in each case, systemic adrenocorticosteroids were administered, and a rapid improvement in visual acuity occurred. In one patient, a trace Marcus-Gunn sign, a few small paracentral scotomas, and a defect in color vision were permanent sequelae. PMID- 2712480 TI - [Confluent and reticulated papillomatosis of Gougerot and Carteaud. Treatment by minocycline]. PMID- 2712481 TI - [Generalized acute pustular drug dermatitis. Apropos of a case induced by josamycin]. PMID- 2712482 TI - [Hypertrophy of the salivary glands and Hashimoto thyroiditis. Regression under substitutive opotherapy]. PMID- 2712483 TI - [Cost of prescriptions in hospital consultation in dermatology. Role of the parapharmacy and the amount of reimbursement]. PMID- 2712484 TI - [What is your diagnosis? Frictional longitudinal melanonychia]. PMID- 2712485 TI - [What is your diagnosis? Neonatal cytosteatonecrosis]. PMID- 2712486 TI - [Pruritus ani: a new approach]. PMID- 2712487 TI - [Solaria]. PMID- 2712488 TI - [Practical use of antiseptics in dermatology]. PMID- 2712489 TI - Council discussion topic--surgical examinations. PMID- 2712490 TI - Out-patient session case times. PMID- 2712491 TI - [Primary failure of pericardial valvular heterografts]. AB - From July 1981 to October 1984, 79 Hancock pericardial valves were implanted in 74 patients surviving the hospital period and with a mean age of 64.2 years. Fifty-two patients underwent aortic valve replacement, 16 had mitral valve replacement, 5 bad a double replacement and 19 associated procedures were performed. The mean survival is 48 months. Until 1st June 1987, 11 primary failures have required reoperation (14.9%), 4 in the mitral position (4.6% patient-years), 7 in the aortic position (3.01% patient-years). The time to reoperation was 48.4 months for the aortic orifice and 36.5 months for the mitral orifice. The lesions most frequently encountered were tears (7 cases), calcifications (5 cases) and stretching of valvular tissue (2 cases); two patients died during the postoperative phase of this operation. Despite the small number of patients followed, this series demonstrates of high incidence of dysfunction due to primary tissue degeneration as, after the 5th year, the actuarial rate of absence of primary lesion is 85.3 +/- 8% with no significant difference between the aortic and the mitral orifices, although dysfunction appears to occur more rapidly in mitral prostheses. These results are much less favourable than those obtained with Ionescu bioprostheses in the aortic position of those obtained with porcine bioprostheses in either position. This justifies very regular clinical and echocardiographic follow-up of patients with Hancock pericardial valvular heterografts. PMID- 2712492 TI - [Intra-aortic balloon counterpulsation. Percutaneous insertion at surgical units. Apropos of 170 cases]. AB - From 1st January 1985 to 31st December 1987, an intra-aortic balloon counterpulsation device (IABCP) was inserted in 170 patients: 166 balloons were inserted percutaneously and 4 surgically after failure of the percutaneous route. The indications for insertion of IABCP are classified into 3 categories. Category 1 (N = 28) consists of non-operated patients, category 2 (N = 60) consists of patients in whom IABCP balloons were inserted by necessity before, during of after a surgical operation under cardiopulmonary bypass (CPB) and category 1 (N = 82) consists of patients in whom the IABCP balloons were inserted prophylactically prior to an operation under CPB in patients at high risk. Sixteen patients with a percutaneous IABCP balloon developed a major complication related to the balloon (9.6 +/- 2.3%). The early mortality for the entire population was 49.4 +/- 3.8% (84/170). The mortality was 89 +/- 6% (25/28), 65 +/ 6% (39/60) and 24 +/- 5% (20/80) respectively in categories 1, 2 and 3. In category 3, 56 IABCP balloons (68.3%) were retrospectively considered to be necessary (group A). Nineteen patients in group A died (34 +/- 6%). The mortality observed in the 30 patients in category 2 in whom an IABCP balloon was required during the intra- or post-operative period (group B) was 76.6 +/- 7.7% (23/30). It was significantly higher than that observed in group A (p less than 0.001). However, the retrospective nature of this study prevented any formal conclusions concerning the benefit provided by prophylactic IABCP. PMID- 2712493 TI - [Cardiac wounds. Experience from 10 years of war. Apropos of 32 cases treated surgically]. AB - Thirty-two patients with cardiac wounds from high velocity firearms (bullets or shrapnel) were operated. Seven of these patients who had no cardiac activity on arrival underwent emergency thoracotomy with a mortality of 85%. The other twenty five patients underwent planned sternotomy with a mortality of 12%. The authors analyse these case with emphasis on the diagnostic and therapeutic management. PMID- 2712494 TI - [Analysis of 64 second primary cancers of the bronchi]. AB - Sixty-four primary lung carcinomas were observed among 1,039 patients operated for bronchial carcinoma between 1975 and 1984. (Statement: July 1987). The second tumor tended to develop at a distance from the first resection performed for a lesion with good prognostic factors. Their site and histology present no unusual features. 64% appeared in the contralateral lung; 78% had the same histological type as the first cancer. Among 28 patients treated by surgery, 26 had a second resection: there were two peri-operative deaths and 4 major complications. Among the 36 patients rejected for surgery, 21 had excessively altered lung function tests. 30 patients were treated with radiotherapy, 7 with chemotherapy first; one had no treatment. The survival rate for the whole group was quite good: 26% at three years; it was significantly better after a second resection: 41% at three years. Overall survival seems comparable with that of the patients operated upon for a single carcinoma. PMID- 2712495 TI - [The association of lung cancer and atheromatous arterial disease]. AB - This work is based on the retrospective study of the case history of 26 patients who were treated between September 1979 and January 1987 in the department of thoracic and vascular surgery at the Avicenne Hospital--and who were all suffering from both lung cancer and atheromatous arterial disease. It is now well established by all the epidemiologic research that the link between lung cancer and atheromatous arterial disease is smoking tobacco. The risks involved in the misunderstanding of such an association are not without danger for the patient, particularly the risk of severe complication of possible coronary or carotid lesions, threatening survival; from this derives the necessity to decide automatically for a minimum of pre-surgery vascular investigations in the case of patients suffering from lung cancer. The therapeutic strategy in this association must be thorough, considering that there are three priorities in the vascular field which must absolutely be treated before the lung itself: --the coronary and carotid lesions which are likely to be complicated cancer after surgery and any state of emergency in the other vascular territories. The fight against tobacco smoking must also be considered as a priority aim. PMID- 2712496 TI - [Giant tumoral hemangioma of the mediastinum. Apropos of a case]. AB - The originality of this case report of malformed tumoral hemangioma of the mediastinum apart from its rarity (105 cases reported in the literature), concerns the patient's age (76 years old), when these tumors are predominantly observed in children and babies. The huge tumor size (800 gr), authorized the designation of giant tumor. The posterior mediastinal localization, when the usual site is in the anterior mediastinum. As in the majority of cases reported in the literature, total excision was possible. The tumor always has a benign character in the case of pure hemangioma, therefore the results are generally satisfactory. PMID- 2712497 TI - [Value and current role of anterior mediastinotomy in the diagnosis of mediastinal diseases. Apropos of a series of 100 cases]. AB - One hundred anterior mediastinotomies performed between 1981 and 1987 resulted in the diagnosis of 90 malignant mediastino-hilar or anterior mediastinal tumours, 4 benign lymph node diseases and 6 non-specific lesions. This easy to perform biopsy technique was followed by low morbidity (7%) and one death after 48 hours due to major mediastinal compression. Its sensitivity and specificity make it a valuable alternative and, according to the authors, preferable to mediastinoscopy in the diagnosis of tumours of lymph node diseases in the anterior, pulmonary hila, especially on the left side, and anterior mediastinal lymph node chains. PMID- 2712498 TI - [A case of vascular tumor of the thoracic wall surgically treated. Role of embolization in this type of tumor]. AB - The authors report a case of arteriovenous aneurysm of the chest wall in a 23 year old woman treated by ligation of the vessels and excision. They discuss the obliteration of vessel by embolization or by a surgical approach. They stress the importance of excision to prevent recurrence. PMID- 2712499 TI - [Value of prolonged epidural analgesia in thoracic surgery]. AB - The use of high thoracic epidurals for post-thoracotomy pain relief in 156 patients is reviewed. Analgesia was maintained with a continuous infusion of a local anaesthetic, bupivacaine 0.5% 40 ml, mixed with a narcotic, fentanyl 10 ml (perfusion rate between 3 and 7 ml/h). There was successful analgesia in 92%, with efficient ventilation, effective cough, no respiratory distress and only 8 cases of fibroaspiration. Only two significant respiratory complications occurred, due to incorrect management of the peridural route: the analgesic mixture was too concentrated and was injected by bolus instead of by continuous infusion. Other complications occurred, 8 cases of nausea or pruritus, 4 hallucinations, 10 cases of urinary retention lasting more than 24 h, 14 superior limb palsies and 22 Horner's oculopapillary syndrome. All of these complications were minor, easy to manage, and resolved after stopping peridural infusion. In conclusion, peridural analgesia is highly effective and improves the atmosphere in post-thoracotomy wards. PMID- 2712500 TI - [Long-term results (6 to 17 years) of 372 mitral valve replacements using the Bjork-Shiley prosthesis]. AB - From November 1970 to December 1981, an isolated mitral valve replacement was performed in 372 patients (166 males - 206 females), ranging in age from 2 months to 76 years (mean age 49 years). Eighty-nine patients (24%) had previously undergone one or two cardiac operations. Only one of the 24 hospital deaths (6.4%) was related to the prosthesis (early thrombosis). Three hundred and fourty eight patients were discharged from the hospital, 35 were lost to follow-up, and 313 were observed with a mean follow-up of 8 years 8 months (ranging from 5 years 2 months to 16 years 3 months). Ninety-two patients (29.4%) died from 2 months to 16 years post-operatively. Thirteen late deaths were from extra cardiac causes. Cardiac failure and thromboembolic or haemorrhagic complications represent the main causes of late mortality, respectively 10 and 6.7%. Twenty-one deaths were related to the prosthesis (10 thrombo-embolic accidents, 7 haemorrhagic complications and prosthesis could be discussed in 11 cases of sudden deaths and in 12 cases of death of undetermined causes. Among the 34 thrombo-embolic complications and the 13 perivalvular leakages (6 of them related to infection), 23 patients required reoperation, for valve thrombosis (14 cases with 2 deaths) or perivalvular leakage (9 cases with 2 deaths). Four other cases of valve thrombosis were treated with fibrinolytic agents with 1 death. The actuarial survival rate, hospital mortality excluded, is 69% at 10 years and 55% at 15 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712501 TI - [Abnormalities of the aortic arch in adults. A rare cause of tracheo-oesophageal compression. Apropos of 2 cases]. AB - Two cases of symptomatic aortic arch anomalies in adults are reported: a case of Neuhauser's ligamentum arteriosum with compressive retro-oesophageal diverticulum, and a case of double aortic arch revealed by postoperative tracheal compression. In both cases, surgical correction was made very difficult by the aneurysmal progression of the compressive vascular anomalies and resection of the thoracic aorta under cardiopulmonary by-pass was necessary. These therapeutic difficulties therefore highlight the differences between aortic arch anomalies in adults and those in infants which can be simply and effectively treated with no mortality in our experience. These observations argue in favour of systematic surgical correction of any aortic arch anomalies in infants, even when they are responsible for few symptoms. PMID- 2712502 TI - Biliary tract cancer--treatment options. AB - Cancers of the extrahepatic biliary tract are rare, but they pose great problems from diagnostic and therapeutic points of view. Surgical resection offers the only prospect of cure for patients with this type of cancer. The resectability rates vary from 50% for tumours in the lower common bile duct to only 10% for tumours in the upper third. For the first group of patients there is a 5-year survival rate of 20-30% in several reports and for the other 10-15%. The operative mortality is acceptable low. For tumours in the liver hilum a liver resection is recommended. Most patients can only be helped by a by-pass procedure. The operative by-pass procedure carries a significant morbidity and mortality and most patients should be drained by PTC or preferably endoscopically. The effects of radiotherapy and chemotherapy have so far been insignificant. The combined use of intraarterial chemotherapy combined with radiotherapy seems to offer some advantage and this treatment modality must undergo further trials. PMID- 2712503 TI - [Long-term results of the Harrington operation. Apropos of a series of 200 cases (1964-1986)]. AB - The authors present a series of 200 patients who underwent vertebral arthrodesis with Harrington's distraction rods for idiopathic scoliosis reviewed after a mean follow-up of 7.5 years (maximum: 24 years). The surgical procedure consisted of either simple distraction or distraction associated with convex compression or a transverse traction device or insertion of double rods according to Armstrong's technique. The operative gain was 44%, the angular loss was 12% and the definitive gain was 32%. The results were better in girls and in juvenile scoliosis type III and adolescent scoliosis. The best long-term correction was obtained in cases of lumbar scoliosis. The best operative reduction was obtained in thoracic and thoracolumbar scoliosis and the greatest angular loss was observed with major double scolioses. The most favourable results were obtained in cases of scoliosis were severe angulation. The best system was Armstrong's followed by Dollar's and the least effective was simple distraction. Heavy pre- and intra-operative vertebral traction improved the angular score. Rupture of the rod, when it occurred late, was not equivalent to pseudarthrosis. Angular deterioration over time was essentially observed over the first 10 years but led to disappointing results. PMID- 2712504 TI - [Antibiotic prevention with a single dose of metronidazole in appendectomy in children]. AB - One hundred children were prophylactically treated with 15 mg/kg-1 of metronidazole immediately before appendicectomy and retrospectively compared with 100 other patients without any antibioprophylaxis. No statistically significant difference was found between the two groups as regards age, weight, sex and macroscopic appearance of the appendix. The overall incidence of complications was 1% in the antibioprophylactic group and 9% in the control group. Furthermore, a single pre-operative intravenous dose of metronidazole was as effective as conventional antibioprophylaxis. PMID- 2712505 TI - [Anterior decompression and spinal stabilization in the treatment of dorsolumbar metastatic compression]. AB - The authors report their experience of the postero-lateral approach for the treatment of thoraco-lumbar spinal metastasis with anterior decompression and osteosynthesis. They stress the progress in the surgical technique which is designed to have a direct effect on osseous posterior wall compression with a more effective osteosynthesis to allow an immediate mobilization. PMID- 2712506 TI - [Leptospirosis caused by Leptospira icterohaemorrhagiae of the pseudo-surgical type: a case]. AB - The authors report a case of fatal leptospirosis due to Leptospira icterohaemorrhagiae revealed by typical signs of acute cholecystitis and associated with pancreatitis in a 73 year old patient presenting with gallstones. The initial clinical findings were highly suggestive of severe but typical cholecystitis and the final diagnosis was only considered when the patient's condition worsened despite surgery, with increasing obstructive jaundice and multiple organ failure. Pancreatitis was an autopsy finding. Misleading, especially gastrointestinal symptoms are frequent in leptospirosis. Hence an early diagnosis is an essential condition for a successful antibiotic management in severe cases of leptospirosis. This possibility should be considered whenever a patient presents with infectious obstructive jaundice. The patient has to be questioned concerning possible contact with contaminated animals and, when in doubt, the presence of specific antibodies should be investigated. PMID- 2712507 TI - [A new type of small calibre carbon fiber arterial prosthesis]. AB - A new type of vascular prosthesis, made of pyrolytic carbon fibres, was tested on growing pigs. Fourteen grafts (4 x 33 mm) were implanted on the infrarenal aorta and removed 15 s, 60 m and 7, 15, 30, 60 and 120 days after surgery. Specimens were examined by light and scanning electron microscopy. As controls ten pigs underwent excision and re-implantation of a 30 mm segment of infrarenal aorta. Autografts were removed 7 to 120 days after surgery. All but one carbon grafts, as well as all autografts were patent at the time of removal. Basic characteristics of carbon grafts, as shown by the present study, may be summarized as follows: 1) thromboresistance of the inner surface, at the time of implantation, 2) development of a thin neo-intima, 3) rapid and complete endothelialization of the flow surface, 4) good viability of the inner layers and 5) solid anchorage to peri-graft tissues. PMID- 2712508 TI - [Last recourse reconstruction of the cervicothoracic esophagus: the free jejunal transplant]. AB - Free intestinal autograft has been recommended for oesophageal reconstruction following total circular pharyngolaryngectomy for cancer. Coloplasty or gastroplasty are commonly used for reconstruction of cervical and thoracic oesophagus. Necrosis of the plasty or anastomotic leakage can occur and may require the resection or reintegration of the pedicled graft into the abdominal cavity. For later reconstruction another pedicled graft may not be feasible and interposition of a free intestinal autograft can be a helpful method. The authors report a case of successful reconstruction of the cervical and thoracic oesophagus by a free ileal autograft, after the initial failure of a right coloplasty in a patient with previous gastrectomy. The free ileal autograft was interposed between the cervical oesophagus and the previous coloplasty repositioned in the lower part of the anterior mediastinum. The vessels of the graft were implanted onto the left common carotid artery and the innominate venous confluent. PMID- 2712510 TI - [Esophageal stenosis caused by carcinomatous mediastinitis secondary to epidermoid carcinoma of the anal canal]. AB - A case of oesophageal stenosis due to mediastinal carcinosis from squamous carcinoma of the anus, treated five years before by radiotherapy, is reported. Radiosensitivity of the tumor ensured a good results with complete resolution. PMID- 2712509 TI - [Anastomoses of the small intestine in a septic environment protected by polyglactin 910-collagen mesh. Experimental study in rats]. AB - An experimental study was carried out in rats to evaluate the outcome of small bowel anastomoses in the presence of peritonitis with and without protection by a polyglactin 910 mesh. One hundred and thirty rats were operated. 1) Thirty small bowel anastomoses were performed in a sterile environment to evaluate the morbidity and mortality due to the surgical procedure itself. All these animals had an uneventful course. 2) Forty anastomoses were performed in a septic environment without protection. Twelve rats died immediately after the procedure. Six rats developed an anastomotic fistula and 22 had an uneventful course. 3) Sixty anastomoses were performed in a septic environment and protected by a polyglactin 910 mesh. Seventeen rats died immediately after the procedure. There were no anastomotic disruptions. Seventeen rats had an uneventful course, and 28 (65%) developed stenosis of the anastomosis. Protection of small bowel anastomoses by a polyglactin 910 mesh appears to effectively prevent disruptions (no anastomotic fistulae or locoregional infections were recorded). However, the mesh is responsible for an intense inflammatory reaction, that often results in intestinal obstruction. PMID- 2712511 TI - [Chronic segmental pancreatitis and the annular pancreas: apropos of a case]. AB - In a young patient, stenosis due to annular pancreas was revealed by an attack of pancreatitis. The patient already had segmental chronic pancreatitis. Etiological considerations are proposed, based on an embryological approach with special attention to duct anomalies. PMID- 2712512 TI - [Synovial osteochondromatosis of the elbow in a 60-year-old woman]. AB - The authors report the case of a 60 year old woman with synovial osteochondromatosis of the elbow treated by total synovectomy. The result was good for all symptoms. They discuss the etiology, pathogenesis, diagnosis and treatment. PMID- 2712513 TI - The Ninth Gordon Ransome oration--some medico-legal aspects of AIDS. PMID- 2712514 TI - Kawasaki disease--the Singapore experience. AB - 50 children with Kawasaki disease were seen between September 1983 to March 1988. Their ages ranged from 3 months to 10 years with a mean age of 25 months. Male to Female ratio was 2.3 to 1. The diagnosis of Kawasaki disease was made between the fourth to fifteenth day of illness. Marked thrombocytosis, raised erythrocyte sedimentation rate, leucocytosis, mild anemia and sterile pyuria were common features. All patients had a normal ECG and chest X-ray. 2D echocardiogram was done in the sub-acute phase of the illness in every patient. Sixteen patients (32%) had coronary artery dilatation. Thirteen of these had serial 2D echocardiograms done over a period of more than one year. Twelve had echocardiographic resolution of the coronary lesion within 18 months of follow up. Patients with coronary artery dilatation were significantly younger. All had full clinical recovery with aspirin therapy. Kawasaki disease afflicts mostly young children and can present as a diagnostic problem. Coronary artery involvement is common, and except for age, it is not predictable by any clinical or laboratory parameter. Serial echocardiographic examinations are necessary in the management of these patients. PMID- 2712515 TI - Attitudes and experience of Singapore doctors and dental surgeons regarding acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) positive patients. AB - A survey conducted in September 1987 among medical doctors and dental surgeons in Singapore found that most respondents expressed personal reservations and inadequacies in dealing with AIDS/HIV-positive patients and homosexuals. They were also concerned about exposure of their staff to AIDS patients and their likely reactions towards treating these patients. The risk of contagion with AIDS was a major deterrent expressed. The majority of the health professionals had no experience in the management of AIDS related conditions. Although many indicated interest in training, only less than half were willing to undergo what they perceived as the more effective clinically based training themselves. PMID- 2712516 TI - Pattern of glomerulonephritis in Singapore children--a renal biopsy perspective. AB - This study was aimed at determining the pattern of glomerulonephritis (GN) in Singapore children from a histopathological perspective. Fifty-seven consecutive children, aged between 10 weeks to 16 years, who underwent a renal biopsy at the Departments of Paediatrics, National University of Singapore and Singapore General Hospital over an 8 year period were studied. The main indications for biopsy were nephrotic syndrome (67%), recurrent gross haematuria (16%), nephritic syndrome (7%), and renal failure (10%). Primary GN occurred in 81%, while secondary GN was seen in 19%, the most common being lupus nephritis. Of the primary GN, minor abnormalities was the most common (22%), followed by focal global sclerosis (20%), focal segmental glomerulosclerosis (17%), diffuse mesangial proliferative GN (11%), focal mesangial proliferative GN (9%), membranous GN (7%), diffuse endocapillary GN (4%), diffuse sclerosing GN (4%), diffuse mesangial sclerosis (4%), and diffuse crescentic GN (2%). Immunofluorescent examination was performed in 50 children. IgA nephropathy was diagnosed in 17% of the patients with primary GN. Of the children with primary nephrotic syndrome due to minimal change disease or focal global sclerosis, about half had IgM mesangial deposits. Of 47 patients who were followed up, 9 developed chronic renal failure, of which 7 reached end-stage disease (4 have died, while 3 are on chronic dialysis). Three other patients died of other complications. The histopathological findings influenced the therapeutic decision in 49% of our patients. In summary, the pattern of GN in our cohort of patients tended to reflect more severe glomerular lesions, mainly due to our criteria of selection for renal biopsy. PMID- 2712517 TI - Clinical experience with phototherapy. AB - Clinical experience with phototherapy in 3,999 infants with non-haemolytic hyperbilirubinaemia and 427 infants with hyperbilirubinaemia associated with G6PD deficiency is presented. For non-haemolytic hyperbilirubinaemia, phototherapy was extremely effective in extremely preterm infants with very low birth weight (gestation less than or equal to 32 weeks, birth weight less than or equal to 1,500 gm) and least effective in full term infants with very low birth weight (gestation greater than 37 weeks, birth weight less than or equal to 1,500 gm) and large preterm infants (gestation less than 37 weeks, birth weight greater than 2,270 gm). The failure rate of phototherapy for non-haemolytic hyperbilirubinemia was only 2.00/1,000 infants. The bilirubin rebound was usually mild; repeat phototherapy was required in only 30 infants (7.50/1,000) with the response to the second exposure comparable to that of the first. No infant required a third exposure. Phototherapy was effective in reducing bilirubin levels in hyperbilirubinaemia associated with G6PD deficiency, the effectiveness being, however, less than in babies with non-haemolytic hyperbilirubinaemia (G6PD normal status). There was no failure in this group of babies. Only a small proportion of infants required a second exposure (4.68/1,000). All the infants tolerated phototherapy well with none developing any illness that could be attributed to the exposure. This clinical experience demonstrates that phototherapy is effective and safe for the treatment of non-haemolytic hyperbilirubinaemia or hyperbilirubinaemia associated with G6PD deficiency. PMID- 2712518 TI - Long-term sequelae of epilepsy. AB - The long-term prognosis for epileptics vary from an entirely normal life to early death or complete incapacity. Studies to date have not provided clear answers on the long-term sequelae of epilepsy. This is because there are many epileptic syndromes with different outcomes. Most studies include a heterogeneous group of patients who may not be representative of all the epileptics in the community. The prognosis for permanent remission of seizure varies with the seizure type. In childhood epilepsies, overall there is at least 50% chance of permanent remission. The more seizures the patient has had before anticonvulsants were started, the more difficult it is to control the seizures, the poorer the prospects for remission. Other unfavourable signs include partial seizures, multiple seizure types, mental retardation, neurological deficits and underlying brain lesion. The effect of seizures on intellectual development is controversial. Actual regression in children with epilepsy is rare except where the seizures are caused by a progressive pathology. However, in a significant proportion of children, intellectual development slows down after the onset of seizures. This is more likely to occur in children with severe seizures, and those on multiple anticonvulsants and with frequent toxic levels. Children with epilepsy have an increased likelihood of developing behavioural, emotional and psychiatric problems. The underlying neurological dysfunction, anxiety about losing control of oneself at any time, reaction of parents, friends and teachers to the condition and side effects of anticonvulsants all contribute to the psychopathology. In conclusion, the long-term sequelae of epilepsy are multiple and serious. Some of the causal factors are known and preventable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712519 TI - Rapid karyotyping of spontaneous abortions with trophoblastic villi. AB - 24-hour short term culture of trophoblastic villi provided rapid and accurate karyotypes in spontaneous first trimester abortions. Good quality metaphases were obtained in 60.0% of villous cultures if these were set up within 8 hours of uterine evacuation, in contrast to the 10.3% success rate with intervals longer than 8 hours. 21% (4 of 19) of first trimester pregnancy losses were chromosomally abnormal, 3 of which were examples of autosomal trisomy; in 2 cases, the mothers were more than 37 years of age. The results of successful karyotyping reported here compare well with previous reports of long term culture of minced fetal material. Further, the risks of infected cultures, maternal contamination and pseudomosaicism are minimal with the short-term culture technique described here. Chorionic villi isolated from spontaneously aborted material are a simple and practicable source of fetal material for rapid and accurate cytogenic diagnosis in early spontaneous abortions. PMID- 2712520 TI - Antegrade ureteroscopy and ultrasonic lithotripsy in the treatment of difficult upper and middle ureteric stones. AB - 34 patients with difficult upper and middle ureteric stones were treated by antegrade ureteroscopy with ultrasonic lithotripsy over a 2-year period. 14 patients (41 percent) had failed extracorporeal wave lithotripsy and another 20 patients (59 percent) were considered unsuitable for extracorporeal shock wave lithotripsy due either to obstruction associated with urosepsis or renal failure. Thirty patients (88 percent) had large stones with a transverse diameter from 10 to 20mm in size. Thirty-three of the 34 patients (97 percent) were successfully treated by this method with minimal morbidity. Of the 7 patients with residual stones, only one needed transurethral ureteroscopic removal and another by piezoelectric extracorporeal shock wave lithotripsy. This technique is a safe and effective method in removing impacted upper and middle ureteric stones for patients who have failed or are unsuitable for extra-corporeal shock wave lithotripsy treatment. PMID- 2712521 TI - Early gastric cancer in Singapore. AB - A study was carried out on 41 cases of early gastric cancer over a five year period (1983-1987) based on resected stomach specimens. Males (29) outnumbered females (12) by 2.4:1. Mean age was 63 years (Range 30-80 years), and there was an overwhelming Chinese preponderance (40, 97.6%). The indications for endoscopy were: dyspepsia (24, 58.5%), gastro-intestinal bleeding (14, 34.1%) and follow up of megaloblastic anaemia (3, 7.4%). The diagnosis of malignancy was unsuspected at endoscopy in 38 patients and the commonest finding was a chronic ulcer (35, 85.4%). Most of the lesions were located in the body (24, 58.5%) and along the lesser curvature (36, 87.8%). Depressed lesions (Type III and combined IIc + III) were the commonest macroscopic lesions. Intestinal type carcinoma was the commonest microscopic type (34, 82.9%). Submucosal infiltration was present in 19 (47.3%) and lymph node metastases in 4 (9.8%). There was only one death from carcinoma of the stomach (mortality 2.4%). PMID- 2712522 TI - Outcome of failure in clearing the oesophageal margin in total gastrectomy for adenocarcinoma. AB - Failure to clear the oesophageal margin in total gastrectomy for adenocarcinoma is believed to be a major cause of mortality and morbidity. The incidence of histologically positive margin could range from 7.3 to 74%. Forty nine cases of total gastrectomy for adenocarcinoma were reviewed and nine (18%) had a positive oesophageal margin. One of the nine patients died on the second postoperative day from technical difficulty: the rest did not have anastomotic leaks. They all eventually died of metastatic disease in 3-20 months. Two had mild dysphagic symptoms which did not require active intervention. It is concluded that a histologically positive oesophageal margin in total gastrectomy does not preclude good anastomotic healing. Sound surgical judgement is required to balance the risk of leaving a positive margin and the risk of an extended operative procedure particularly when majority of the total gastrectomies are palliative rather than curative. PMID- 2712523 TI - Surgery of hepatic metastases. AB - 5-year survival after liver resection for colorectal liver metastases is 20-30%. Several factors contribute to a short survival: 4 or more liver tumours, a tumour free margin less than 10 mm and the occurrence of extrahepatic metastases. The prognosis is not significantly less in bilateral as compared in unilateral disease provided that 3 or less tumours, no extrahepatic spread at the tumour free margin more than 10 mm can be achieved. No prognostic difference is seen between synchronous and metachronous metastases. PMID- 2712524 TI - Gynaecological cancer screening. AB - One hundred years ago cervical cancer was rapidly fatal, regardless of therapy rendered. Today with cytological screening, early diagnosis is possible and ablative therapy can be instituted in appropriate cases. The advent of coloscopy has helped reduce unnecessary cone biopsy for diagnosis. However, the same cannot be said of the use of cytology for screening endometrial cancer, and often endometrial tissue biopsy is necessary. Ovarian cancer is notoriously silent in its early stages and symptoms if present are generally non-specific. To date there is no other useful and reliable method for its early detection than routine pelvic examination. An annual cytological screening test for cervical cancer will give an opportunity for examination of the breasts, abdomen and pelvis. Screening techniques for female genital tract malignancies are discussed. PMID- 2712525 TI - Screening for NPC. AB - This paper discusses the criteria of cancer screening in general and of nasopharyngeal carcinoma in particular. It also discusses the screening results in China and the strategy for screening of this cancer in Singapore. PMID- 2712526 TI - A case for colorectal cancer screening in Singapore. AB - Colorectal cancer is the second most common cancer in Singapore: it forms 11.9% of all cancers registered by the Singapore Cancer Registry compared with 18.4%, 10.4% and 8% for lung, stomach and liver respectively. Despite recent advances in surgery, radiotherapy and chemotherapy, more than half of those afflicted will die from their cancer. Arguments are presented for a colorectal cancer screening programme. To succeed it is necessary to appreciate the short-comings of testing for faecal occult blood, to evaluate and adopt new screening tests and to establish a well organised programme. PMID- 2712527 TI - The Runme Shaw memorial lecture. Amyloidoses of brain: transmissible and non transmissible dementias. PMID- 2712529 TI - [A mysterious enlarged liver (or, when the inferior vena cava strikes back...)]. PMID- 2712528 TI - [Efficacy of endoscopic pneumatic dilatation in achalasia. Medium-term results]. AB - During a seven-year period, thirty patients with achalasia of the esophagus were treated by pneumatic dilatation without complications. Only twenty patients could be followed with a mean follow of 32 +/- 23 months after their initial dilatation. Excellent to good results were obtained in more than 75 p. cent of the group. Most patients have not required a further dilatation. This study suggest to propose a regular supervision of these patients by clinical examination, esophageal manometry and endoscopy. PMID- 2712530 TI - [Ischemic colitis as a manifestation of Moschkowitz's syndrome]. PMID- 2712531 TI - Development of dementing illnesses in an 80-year-old volunteer cohort. AB - We have prospectively followed over a 5-year period 434 volunteers who were at intake ambulatory, functional, presumably nondemented, and between 75 and 85 years of age. Fifty-six (an incidence of 3.53 per 100 person-years at risk) developed a progressive dementia: 32 met diagnostic criteria for Alzheimer's disease (AD) (an incidence of 2.0 per 100 person-years at risk), 15 had vascular or mixed dementia, and 9 had other disorders or remain undiagnosed. New cases of dementia were as common as myocardial infarction and twice as common as stroke. Risk factors for both dementia and AD were age (over 80) and gender (female); other reported risk factors such as family history, prior head injury, thyroid disease, maternal age, and smoking were not risk factors for AD in this elderly cohort. Prior stroke was the major risk factor for vascular or mixed dementia; diabetes and left ventricular hypertrophy but not a history of hypertension per se were also risk factors for vascular dementia. The major predictor of the development of AD was the mental status score on entry. The 58.5% of the cohort who made zero to two errors on a 33-item mental status test had a less than 0.6% per year chance of developing AD, whereas the 16% of the cohort with five to eight errors on this test developed AD at a rate of over 12% per year. Thus, it is possible to identify a large cohort of 80-year-olds who are at low risk for AD and a smaller cohort at very high risk. PMID- 2712532 TI - Neocortical propagation in temporal lobe spike foci on magnetoencephalography and electroencephalography. AB - Propagation of the neuronal population of the interictal epileptic spike was quantified in 5 patients with complex partial epilepsy arising from temporal lobe using electroencephalography and magnetoencephalography. During the spike complex in each patient there was a spike at the deep sphenoidal electrode and a spike at the superficial scalp electrode on spontaneous electroencephalography. In each patient the sphenoidal spike had a different peak latency than the scalp spike, consistent with spike propagation. Electroencephalography was used to trigger two magnetoencephalographic averages of stereotyped spikes during the sphenoidal peak and the scalp peak. Magnetoencephalography discriminated the centers of two cortical spike populations at different latencies, showing deeper localization with sphenoidal trigger and more superficial localization with scalp trigger in each patient (p less than 0.05). Latency differences and propagation distances of spikes were consistent with the conduction velocity of corticocortical fibers. Noninvasive estimates of the cortical surface area of the spikes agreed with estimates obtained by electrocorticography over temporal neocortex. These findings indicate propagation of neuronal populations active during human interictal spikes between deep and superficial cortex of temporal lobe, likely by monosynaptic or oligosynaptic pathways. This interictal system appears to be partly independent of the hippocampal interictal system in complex partial epilepsy. PMID- 2712533 TI - Infarcts of undetermined cause: the NINCDS Stroke Data Bank. AB - In a prospective study of 1,805 hospitalized patients in the Stroke Data Bank of the National Institute of Neurological and Communicative Disorders and Stroke, the 1,273 with infarction were classified into diagnostic subtypes. Diagnosis was based on the clinical history, examination, and laboratory tests including computed tomography, noninvasive vascular imaging, and where safe and relevant, angiography. Five hundred and eight cases (fully 40%) were labeled as infarcts of undetermined cause (IUC), of which 138 (27%) were evaluated with both computed tomography and angiography. The clinical syndrome and computed tomographic and angiographic findings in 91 (65.9%) of these 138 IUC cases were clearly not attributable to large-artery thrombosis and could permit reclassification of the infarct as due to some form of embolism. Failure to define a source of embolus kept them in the category of IUC. Thirty-one cases (22.5%) could be reclassified as due to stenosis or thrombosis of a large artery, and 16 (11.6%) as lacunar infarction. To determine if those selected for angiography among the IUC patients differed from those with other final diagnoses, a stepwise multiple logistic model was used. The most important characteristics were young age, presence of a superficial infarct, prior transient ischemic attack, low weakness score, and presentation with a nonlacunar syndrome. The results of the model suggest that angiography use was determined by clinical characteristics uniformly across centers and not by final diagnosis. Continued use of the category IUC may help clarify risk factors and stroke subtypes, allow new mechanisms of ischemic stroke to be uncovered, and prevent classification categories of stroke used in clinical trials from becoming too broad. PMID- 2712534 TI - Progressive aphasia without dementia: further documentation. AB - Two patients with progressive aphasia without dementia had magnetic resonance imaging findings of focal left temporal lobe abnormality. Unlike most of the other documented cases of progressive aphasia, onset was not presenile, occurring at ages 68 and 69. PMID- 2712535 TI - Gaze distractibility in Wilson's disease. AB - We describe the case of a patient with Wilson's disease who was first seen with distractibility of gaze fixation. Clinical and magnetic resonance imaging studies suggest that the disorder was probably due to frontal lobe involvement. PMID- 2712536 TI - Neurosyphilis presenting with Raeder's syndrome. PMID- 2712537 TI - Adrenomedullary hypofunction and diabetic neuropathy. PMID- 2712538 TI - Human T-lymphotropic virus type I-associated myelopathy presenting as spinocerebellar syndrome. PMID- 2712539 TI - Shy-Drager syndrome and human T-lymphotropic virus type I infection. PMID- 2712540 TI - Optical approaches to neuron function. PMID- 2712541 TI - Susceptibilities of genital mycoplasmas to the newer quinolones as determined by the agar dilution method. AB - The increasing resistance of genital mycoplasmas to tetracycline poses a problem because tetracycline is one of the few antimicrobial agents active against Mycoplasma hominis, Ureaplasma urealyticum, chlamydiae, gonococci, and other agents of genitourinary-tract disease. Since the quinolones are a promising group of antimicrobial agents, the susceptibilities of M. hominis and U. urealyticum to the newer 6-fluoroquinolones were determined by the agar dilution method. Ciprofloxacin, difloxacin, and ofloxacin had good activity against M. hominis, with the MIC for 50% of isolates tested (MIC50) being 1 microgram/ml. Fleroxacin, lomefloxacin, pefloxacin, and rosoxacin had MIC50s of 2 micrograms/ml. Enoxacin, norfloxacin, and amifloxacin had MIC50s of 8 to 16 micrograms/ml, and cinoxacin and nalidixic acid were inactive (MIC50, greater than or equal to 256 micrograms/ml). Overall, the activities of 6-fluoroquinolones for ureaplasmas were similar to those for M. hominis, with MICs being the same or twofold greater. The most active 6-fluoroquinolones against ureaplasmas were difloxacin, ofloxacin, and pefloxacin, with MIC50s of 1 to 2 micrograms/ml. Ciprofloxacin was unusual in that the MIC50 for M. hominis was 1 microgram/ml, whereas the MIC50 for ureaplasmas was 8 micrograms/ml. Since the MIC50s for the most active quinolones approximate achievable concentrations in blood and urine, quinolones have promise in treating mycoplasmal infections. PMID- 2712542 TI - Comparative in vitro activities of six new fluoroquinolones and other oral antimicrobial agents against Campylobacter pylori. AB - The in vitro susceptibilities of 56 clinical isolates of Campylobacter pylori to six new fluoroquinolones and other oral antimicrobial agents were determined by an agar dilution technique. Ciprofloxacin was the most active of the fluoroquinolones (MIC for 90% of strains tested [MIC90], 0.05 microgram/ml). Other fluoroquinolones had variable activities, although most isolates were moderately susceptible to fleroxacin (MIC90, 4 micrograms/ml) and lomefloxacin (MIC90, 4 micrograms/ml). PMID- 2712543 TI - In vitro activities of temafloxacin (A-62254) and four other antibiotics against Chlamydia trachomatis. AB - The in vitro activity of temafloxacin (A-62254), a new quinolone antibiotic, against 13 strains of Chlamydia trachomatis was determined and compared with those of doxycycline, norfloxacin, ciprofloxacin, and difloxacin. Temafloxacin and difloxacin were the most active quinolones tested, with bactericidal activity comparable to that of doxycycline. PMID- 2712544 TI - Interaction of FCE 22101 with penicillin-binding proteins of Staphylococcus aureus. AB - FCE 22101 is a new penem characterized by a broad spectrum of activity which includes activity against methicillin-resistant strains of Staphylococcus aureus. The interaction of FCE 22101 with penicillin-binding protein 2a of a methicillin resistant S. aureus strain has been investigated in the present study. In competition experiments, the penem showed a very low affinity for this protein, and a concentration more than 4 times the MIC was required for penicillin-binding protein 2a saturation. When the classical competitive procedure was modified by increasing the time of incubation of either membranes or growing cells with FCE 22101, the antibiotic showed a much higher affinity for penicillin-binding protein 2a and saturated the protein at a concentration close to the MIC, with slow kinetics. PMID- 2712545 TI - Influence of two quinolones, ofloxacin and pefloxacin, on human myelopoiesis in vitro. AB - The influence of ofloxacin and pefloxacin on human myelopoiesis in vitro was investigated. Drug concentrations varied from 0.5 to 50 micrograms/ml, and the effect on granulomonocyte precursors was evaluated on cell cultures in agar. Our results indicate that ofloxacin and pefloxacin do not induce inhibition of myelopoiesis. PMID- 2712546 TI - Ciprofloxacin for methicillin-resistant Staphylococcus aureus infections. AB - Thirty-seven patients with methicillin-resistant Staphylococcus aureus infections and/or colonization were treated with oral ciprofloxacin (750 mg twice a day). Clinical cure or improvement of infections occurred in 91% of the patients, and bacteriologic cure occurred in 60%. Ciprofloxacin therapy suppressed methicillin resistant S. aureus colonization in 55% of the patients. Ciprofloxacin-resistant strains emerged in 6 of the 37 patients. PMID- 2712547 TI - Zidovudine antagonizes the action of pyrimethamine in experimental infection with Toxoplasma gondii. AB - The effect of zidovudine (azidothymidine; AZT) on the action of pyrimethamine against Toxoplasma gondii was investigated. Zidovudine was found to antagonize the toxoplasmacidal effect of low concentrations of pyrimethamine in vitro, and in vitro synergism of pyrimethamine and sulfadiazine against T. gondii was reversed by zidovudine. Zidovudine also antagonized the therapeutic effect of pyrimethamine in mice acutely infected with T. gondii. PMID- 2712549 TI - Efficacy and safety of low dosage amantadine hydrochloride as prophylaxis for influenza A. AB - The efficacy and safety of prophylactic low dose amantadine hydrochloride was assessed in two double-blind, placebo-controlled, randomized studies. In a study of 476 subjects aged 18 to 55 years, adverse reactions were not significantly different between the group receiving 100 mg/day amantadine and the placebo group but significantly greater in the group given 200 mg/day (P less than 0.009). The influenza attack rate in this study was too low to assess efficacy. In an experimental challenge study of influenza A/Beth/1/85 in 78 subjects of similar age the prophylactic administration of 50 mg, 100 mg or 200 mg/day doses of amantadine were more effective than placebo in preventing influenza illness (P less than 0.02, 66, 74 and 82% protection, respectively), and in suppressing viral replication (P = 0.02). There was no significant difference between amantadine groups in influenza illness or viral shedding. Compared with the placebo group the 100 and 200 mg amantadine groups showed a significant decrease in infection rate (100 mg: 40% protection: P = 0.012; 200 mg: 32% protection: P = 0.045) whereas the 50 mg group did not (20% protection: P = 0.187). These results suggest that 100 mg/day of amantadine will reduce toxicity but maintain the prophylactic efficacy seen with 200 mg/day. PMID- 2712548 TI - Sucralfate reduces the gastrointestinal absorption of norfloxacin. AB - The effect of sucralfate on the bioavailability of norfloxacin after single 400 mg doses of norfloxacin was evaluated in eight healthy males. Subjects received each of the following treatments in random sequence: (i), norfloxacin, 400 mg alone; (ii) sucralfate, 1 g, concurrently with norfloxacin, 400 mg; and (iii) sucralfate, 1 g, followed by norfloxacin, 400 mg, 2 h later. One day before administration of treatments 2 and 3, 1 g of sucralfate was given at 7 a.m., 11 a.m., 5 p.m., and 10 p.m. Blood samples were collected immediately before the norfloxacin dose and at 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, and 24 h postdose. Urine was collected in divided intervals: from 0 to 12, from 12 to 24, and from 24 to 48 h. Norfloxacin concentrations in plasma and urine were determined by high-performance liquid chromatography. Mean area under the plasma concentration-versus-time curve extrapolated to infinity decreased significantly (P less than 0.001) after norfloxacin was given with and 2 h after sucralfate. The relative bioavailabilities were 1.8% when norfloxacin was taken with sucralfate and 56.6% when it was taken 2 h after sucralfate. After norfloxacin was given alone, the mean norfloxacin concentrations in urine collected during intervals of 0 to 12, 12 to 24, and 24 to 28 h were 118.9 +/- 72.3, 18.8 +/- 12.5, and 2.4 +/- 2.2 micrograms/ml, respectively. After norfloxacin was given with sucralfate, however, the mean norfloxacin concentrations in urine collected during the same time intervals were 6.8 +/- 4.7, 1.8 +/- 1.4, and 0 +/- 0 microgram/ml, respectively. Because of low pH and relatively high magnesium concentration in urine, susceptibilities of bacteria in urine are 8- to 32-fold lower than in broth. This fact, in combination with the reduced bioavailability of norfloxacin in the presence of sucralfate or antacids, is likely to result in treatment failure. The effect of sucralfate given after norfloxacin was not examined, nor was the effect of sucralfate given more than 2 h before norfloxacin. Administration or norfloxacin with sucralfate should therefore by avoided. PMID- 2712550 TI - Antiviral activity of tiazofurine against barley stripe mosaic virus. AB - Tiazofurine (2-beta-D-ribofuranosylthiazole-4-carboxamide) was found to inhibit replication of barley stripe mosaic virus (BSMV) in barley and wheat plants. Treatment with this nucleoside analogue delayed and inhibited symptom development and suppressed virus multiplication. The most effective concentration applied twice as a foliar spray 3 h and one day after inoculation, was 10(-3) M. Decreased virus multiplication was obtained without marked phytotoxicity. Three weeks after treatment the antiviral effect declined. PMID- 2712551 TI - Spinal fixation. Using the Steffee pedicle screw and plate system. PMID- 2712552 TI - Microvascular tissue transfer. Perioperative nursing considerations. AB - Microvascular tissue transfer is a growing subspecialty in reconstructive surgery. Its use is increasing, and it has been used to solve difficult wound problems. The use of microvascular surgery has placed new demands on the perioperative nurse to remain current on perioperative implications of this type of surgery. Operating room nurses must continue to expand their knowledge of this area through ongoing education from journal review, specialty seminars, and increased operative experiences. PMID- 2712553 TI - Fire safety training. A program for the operating room. PMID- 2712554 TI - Perioperative nursing in the college curriculum. A custom fit. AB - Although this course is in its infancy, it has become popular among baccalaureate students. Incoming junior students are enthusiastic about an elective course that provides them an opportunity to focus on an aspect of nursing that is no longer available to them in most nursing programs. The morale of the operating room nursing staff, particularly among the preceptors, has increased tenfold. In an era of nursing shortages, creative and innovative methods of recruiting students and retaining experienced nurses in all fields are vital. This unique course may be one of those methods. It is widely known that high morale yields a more productive work environment, lower turnover, and a cohesive work force that provides high quality nursing care in a most cost-effective manner. PMID- 2712555 TI - OR scheduling. A study of actual versus projected time. PMID- 2712556 TI - Practicing in a university hospital. Perioperative nurses focus on patient care in a teaching setting. AB - The contributions to this article show that the perioperative nurse has become a knowledgeable highly skilled practitioner. Nurses with different backgrounds, nationalities, educational preparation, and professional experience show that the outcome--excellent patient care--is more important than the process. Since the individual perioperative practitioner has implemented the nursing process, perioperative nursing care of patients has improved. The primary lesson that the UCIMC administrators learned was that there are many ways to accomplish goals. Administrators commended the perioperative nurses for their knowledge, risk taking, input and assessments related to problems and decisions, and for accepting challenges with enthusiasm and vigor. The administrators also learned that they need to be facilitating supporters more than supervisors in the OR. This creates an appropriate environment for effective practice. In this manner, the perioperative nurse can achieve both personal and professional satisfaction. PMID- 2712557 TI - Recommended practices. Product evaluation and selection for perioperative patient care. PMID- 2712558 TI - The definition and purpose of professional licensure. PMID- 2712559 TI - Tips for a freestanding center to survive a Joint Commission survey. AB - Achieving accreditation for a freestanding facility is no different from achieving accreditation for a hospital. "Our standards do not drop because we work in a freestanding facility," Phillips said. PMID- 2712560 TI - Flash sterilization of anesthesia bellows reduces postoperative infection rate. PMID- 2712561 TI - AIDS patients often cannot obtain insurance. PMID- 2712562 TI - Take time to study something besides nursing. PMID- 2712563 TI - Racist remark deplored. PMID- 2712564 TI - Shoulder arthroscopy does not improve understanding of disease. PMID- 2712565 TI - Transposition of the great arteries. The Jatene procedure. PMID- 2712566 TI - Electrolyte imbalances. Intraoperative risk factors. PMID- 2712567 TI - Control of hepatic gluconeogenesis: role of fatty acid oxidation. AB - Octanoate has been found to activate the gluconeogenic pathway in perfused isolated rat liver. Whether a net increase in the production of glucose is observed is a function of the relative concentrations of the glucose precursor and the fatty acid. The kinetics of octanoate interaction with the gluconeogenic pathway are influenced by the rate changes induced by decreases in pyruvate concentration as a result of the increased NAD redox potential produced by the oxidation of fatty acid. Taking this into account, two distinct effects of octanoate were identified. The first is an increase in the Vmax even at the lowest (25 microM) concentration of the fatty acid tested. The second is a progressive decrease in [pyruvate]0.5 as a function of octanoate concentration. The latter occurs at low (less than 0.1 mM), presumably physiological, pyruvate concentrations, when its mitochondrial transport is limiting, indicating that this process must have been activated. The former is observable even at high (greater than 0.5 mM), supraphysiological, concentrations of pyruvate, when its mitochondrial transport is not limiting, indicating that a distal step, presumably pyruvate carboxylation, is activated. The action of octanoate in increasing gluconeogenesis has been found not to be related to a decreased flux through pyruvate dehydrogenase, neither to changes in the NAD redox potential nor to its ability to increase energy production. Actually, the oxygen uptake induced by octanoate was largely accounted for by the production of ketone body and the latter process was found to be independent of variations in energy demand. PMID- 2712568 TI - Specificity of S-adenosyl-L-methionine in the inactivation and the labeling of 1 aminocyclopropane-1-carboxylate synthase isolated from tomato fruits. AB - 1-Aminocyclopropane-1-carboxylate (ACC) synthase, which catalyzes the conversion of S-adenosyl-L-methionine (AdoMet) to ACC, is irreversibly inactivated by its substrate AdoMet. AdoMet has two diastereomers with respect to its sulfonium center, (-)-AdoMet and (+)-AdoMet. We prepared (+)- and (-)-AdoMet from a commercial source, and compared their activities as a substrate and as an inactivator of ACC synthase isolated from tomato (Lycopersicon esculentum Mill). fruits. Only (-)-AdoMet produced ACC, whereas both (-)- and (+)-AdoMet inactivated ACC synthase; (+)-AdoMet inactivated the enzyme three times faster than (-)-AdoMet. We have previously shown that ACC synthase was specifically radiolabeled when the enzyme was incubated with S-adenosyl-L-[3,4-14C]methionine. The present results further indicate that S-adenosyl-L-[carboxyl-14C]methionine, but not S-adenosyl-L-[methyl-14C]methionine, radiolabeled the enzyme. These data suggest that the 2-aminobutyric acid portion of AdoMet is linked to ACC synthase during the autoinactivation process. A possible mechanism for ACC synthase inactivation by AdoMet is discussed. PMID- 2712569 TI - Studies of ascorbate-dependent, iron-catalyzed lipid peroxidation. AB - We have previously observed that both Fe(II) and Fe(III) are required for lipid peroxidation to occur, with maximal rates of lipid peroxidation observed when the ratio of Fe(II) to Fe(III) is approximately one (J. R. Bucher et al. (1983) Biochem. Biophys. Res. Commun. 111, 777-784; G. Minotti and S. D. Aust (1987) J. Biol. Chem. 262, 1098-1104). Consistent with the requirement for both Fe(II) and Fe(III), ascorbate, by reducing Fe(III) to Fe(II), stimulated iron-catalyzed lipid peroxidation but when the ascorbate concentration was sufficient to reduce all of the Fe(III) to Fe(II), ascorbate inhibited lipid peroxidation. The rates of lipid peroxidation were unaffected by the addition of catalase, superoxide dismutase, or hydroxyl radical scavengers. Exogenously added H2O2 also either stimulated or inhibited ascorbate-dependent, iron-catalyzed lipid peroxidation apparently by altering the ratio of Fe(II) to Fe(III). Thus, it appears that the prooxidant effect of ascorbate is related to the ability of ascorbate to promote the formation of a proposed Fe(II):Fe(III) complex and not due to oxygen radical production. The antioxidant effect of ascorbate on iron-catalyzed lipid peroxidation may be due to complete reduction of iron. PMID- 2712570 TI - Effect of glycerol and dihydroxyacetone on hepatic lipogenesis. AB - Glycerol is a dietary component which is metabolized primarily by the liver and kidney where it is used mainly for glucose synthesis. The metabolism of glycerol is very similar to that of dihydroxyacetone which can be considered its more oxidized counterpart. The effects of these substrates on hepatic lipogenesis and gluconeogenesis were examined. In isolated hepatocytes, 10 mM dihydroxyacetone caused a large increase in glucose output and stimulated lipogenesis without affecting the lactate/pyruvate ratio or the total ATP content of the cells. (As compared to dihydroxyacetone, 10 mM glycerol was less effective as a gluconeogenic substrate, increased the lactate/pyruvate ratio, caused a slight decrease in the total ATP content, and inhibited lipogenesis by at least 40% depending on the type of diet fed to the rats.) The fall in ATP levels was very small and did not correlate with the changes in fatty acid synthesis. The immediate cause of the inhibition of lipogenesis, brought about by glycerol in hepatocytes from sucrose fed rats, seemed to be a large decrease in pyruvate levels. This did not result from impairment of glycolysis but from a rise in the cytosolic NADH/NAD ratio. PMID- 2712571 TI - Mouse liver P450Coh: genetic regulation of the pyrazole-inducible enzyme and comparison with other P450 isoenzymes. AB - Genetic experiments with two inbred strains of mice, AKR/J and DBA/2N, show a single major gene inheritance of additive mode for pyrazole-inducible coumarin 7 hydroxylase. Intragroup variation in the enzyme activity further suggests the contribution of minor modifying genes to the final enzyme activity. Western blot analysis with a polyclonal antibody raised against the purified isozyme P450Coh (highly active in the 7-hydroxylation of coumarin) showed that a difference in the amounts of P450Coh protein between the D2 and AKR mice is the reason for the differences in the enzyme activity between the two mouse strains. Accordingly, changes at the regulatory level rather than at the structural gene would explain the genetic difference in the activity of coumarin 7-hydroxylase. This hypothesis is further supported by the identical Km values of the basal and induced enzyme. The inducibility of coumarin 7-hydroxylase by phenobarbital (PB) and its genetic regulation have been previously studied by A. W. Wood and colleagues ((1974) Science 185, 612-614; (1979); J. Biol. Chem. 254, 5641-5646 and 5647-5651). Our present experiments show that the regulation is the same for the pyrazole inducible enzyme. Furthermore the experiments with anti-P450Coh antibody show that the PB- and pyrazole-inducible proteins have the same molecular weight and are immunologically indistinguishable. This suggests that PB and pyrazole may induce the same enzyme. Immunoinhibition of microsomal coumarin 7-hydroxylase is practically 100% for control animals and after pretreatment with pyrazole or PB. This suggests that in each case the same or immunologically closely related proteins are metabolizing coumarin and that the P450Coh may be the only P450 isoenzyme in mouse liver microsomes catalyzing the 7-hydroxylation of coumarin. The N-terminal amino acid sequence of P450Coh was found to be identical with those from Type I and Type II genes of the mouse P45015 alpha family for the first 21 amino acids. With rat PB-inducible P450b the homology is only 33%. Also the immunological properties of P450Coh are different from those of P450b. This may suggest that P450Coh has a closer association to the steroid 15 alpha hydroxylase gene family than to the P450IIB subfamily of phenobarbital-inducible isoenzymes. PMID- 2712572 TI - Fluorescent derivative of cysteine-10 reveals thyroxine-dependent conformational modifications in human serum prealbumin. AB - Fluorescence studies on the N-(iodoacetyl)-N'-(5-sulfo-1-naphthyl)ethylenediamine labeled cysteine-10 residue of human prealbumin were carried out to detect conformational changes induced by the binding of the ligand thyroxine to the two structurally identical binding sites. A red shift of the spectrum was observed and the total change was confined to the first ligand. This was interpreted as resulting from a conformational change which increases the exposure of the fluorescent probe moiety. Thyroxine also alters the effect of the collisional quencher, acrylamide, confirming the greater exposure of the probe. This modification in structure is associated with changes in relaxation time which indicate that when thyroxine is bound there is an increase in the rotational freedom of the segment or domain of prealbumin which contains the fluorescent probe. PMID- 2712573 TI - NAD-linked, GSH- and factor-independent aldehyde dehydrogenase of the methylotrophic bacterium, Hyphomicrobium X. AB - Cell-free extracts of Hyphomicrobium X showed NAD-dependent aldehyde dehydrogenase activity, provided that NAD addition preceded that of aldehyde. Activity was lost rather rapidly, especially during purification attempts, but this could be partially masked by including a time-dependent restoration step with thiol compounds in the protocol. The nature of the assay buffer appeared to be critical and stimulation occurred on incorporation of K+ ions in the mixture. An even higher specific activity could be achieved by 1,4-dithiothreitol (DTT) treatment of the preparation, followed by removal of DTT, and assaying in the absence of thiol compounds under anaerobic conditions. Exposure of such a preparation to O2 led to a significant decrease in activity within a couple of hours. Immediate inactivation occurred on addition of H2O2, but this could be prevented completely by prior addition of NAD. Since GSH does not participate in the reaction and no stimulating factor was detected, the role of thiol compounds is most probably confined to restoration or prevention of damage to an O2 sensitive, necessary thiol group. Since the same features were found for cell free extract as for the partially purified enzyme, only one enzyme type seems to be present. Although the enzyme is a general aldehyde dehydrogenase, the kinetic parameters and the specific activity of the cell-free extract for formaldehyde indicate that it may play a role in formaldehyde dissimilation by Hyphomicrobium X. The NAD-linked, GSH- and factor-independent aldehyde dehydrogenase described here appears to be different in several respects from the formaldehyde dehydrogenase of Pseudomonas putida (EC 1.2.1.46) (despite showing similar behavior toward coenzymes and factors) but resembles the aldehyde dehydrogenase from baker's yeast (EC 1.2.1.5). PMID- 2712574 TI - The microsomal ethanol oxidizing system mediates metabolic tolerance to ethanol in deermice lacking alcohol dehydrogenase. AB - Metabolic tolerance to ethanol has been attributed to enhanced mitochondrial reoxidation of reducing equivalents produced in the alcohol dehydrogenase (ADH) pathway or to non-ADH mechanisms. To resolve this issue, deermice lacking low Km hepatic ADH were fed for 2 weeks a liquid diet containing ethanol or isocaloric carbohydrate and hepatocytes were isolated. Ethanol (50 mM) oxidation increased (9.8 vs 4.5 nmol/min/10(6) cells in controls). To differentiate which of two non ADH pathways (the microsomal ethanol oxidizing system (MEOS) or catalase) was responsible for the induction, four approaches were used. First, MEOS was assayed in hepatic microsomes and found to be increased (24.4 vs 6.8 nmol/min/mg protein in controls). Second, hepatocyte ethanol metabolism was measured after addition of the catalase inhibitor azide (0.1 mM) and found to be unchanged. By contrast, the competitive MEOS inhibitor, 1-butanol, depressed metabolism in a concentration-dependent manner. A third approach relied on measurement of isotope effects known to be different for MEOS and catalase. From the isotope effect values, MEOS was calculated to contribute 85% or more of total ethanol oxidation by cells from both ethanol-fed and control animals. A fourth approach involved in vivo pretreatment with pyrazole (300 mg/kg/day for 2 days), which reduced peroxidation by catalase to 13% of control values in liver homogenates while inducing MEOS activity to 152% of controls. Hepatocytes from pyrazole-treated deermice showed a 47% increase in ethanol metabolism, paralleling the MEOS induction and contrasting with the catalase suppression. These results indicate that since metabolic tolerance occurs in the absence of ADH, it is not necessarily ADH mediated, and further, that MEOS rather than catalase accounts for basal ethanol metabolism and its increase after chronic ethanol treatment. PMID- 2712575 TI - Betaine aldehyde dehydrogenase from spinach leaves: purification, in vitro translation of the mRNA, and regulation by salinity. AB - Spinach (Spinacia oleracea L.) leaves contain a nuclear-encoded chloroplastic betaine aldehyde dehydrogenase (EC 1.2.1.8) which is induced several-fold by salinization. Betaine aldehyde dehydrogenase was purified 2400-fold to homogeneity with an overall yield of 14%. The procedure included fractional precipitation with ammonium sulfate, followed by ion-exchange, hydrophobic interaction, and hydroxyapatite chromatography in open columns, and ion-exchange and hydrophobic interaction chromatography in a fast-protein liquid chromatography system. The betaine aldehyde dehydrogenase had a pI of 5.65, and a broad pH optimum between 7.5 and 9.5. The Km values for NAD+ and NADP+ were 20 and 320 microM, respectively; the Vmax of the reaction with NADP+ was 75% of that with NAD+. The native enzyme is a dimer with subunits of Mr 63,000. Highly specific antiserum was raised against the native enzyme, and was used in conjunction with cell-free translation of leaf poly(A)+ RNA to show (a) that betaine aldehyde dehydrogenase is synthesized as a precursor of Mr 1200 higher than the mature polypeptide, and (b) that both chronic salt stress and salt shock provoke a several-fold increase in the level of translatable message for the enzyme. PMID- 2712576 TI - A kinetic study of the effects of phosphate and organic phosphates on the activity of phosphoenolpyruvate carboxylase from Crassula argentea. AB - The effects of phosphate and several phosphate-containing compounds on the activity of purified phosphoenolpyruvate carboxylase (PEPC) from the crassulacean acid metabolism plant, Crassula argentea, were investigated. When assayed at subsaturating phosphoenolpyruvate (PEP) concentrations, low concentrations of most of the compounds tested were found to stimulate PEPC activity. This activation, variable in extent, was found in all cases to be competitive with glucose 6-phosphate (Glc-6-P) stimulation, suggesting that these effectors bind to the Glc-6-P site. At higher concentrations, depending upon the effector molecule studied, deactivation, inhibition, or no response was observed. More detailed studies were performed with Glc-6-P, AMP, phosphoglycolate, and phosphate. AMP had previously been shown to be a specific ligand for the Glc-6-P site. The main effect of Glc-6-P and AMP on the kinetic parameters was to decrease the apparent Km and increase Vmax/Km. AMP also caused a decrease in the Vmax of the reaction. In contrast, phosphoglycolate acted essentially as a competitive inhibitor increasing the apparent Km for PEP and decreasing Vmax/Km. Inorganic phosphate had a biphasic effect on the kinetic parameters, resulting in a transient decrease in Km followed by an increase of the apparent Km for PEP with increasing concentration of phosphate. The Vmax also was decreased with increasing phosphate concentrations. Further, the enzyme appeared to respond to the complex of phosphate with magnesium. In the presence of a saturating concentration of AMP, no activation but rather inhibition was observed with increasing phosphate concentration. This is consistent with the binding of phosphate to two separate sites--the Glc-6-P activation site and an inhibitory site, a phenomenon that may be occurring with other phosphate containing compounds. High concentrations of phosphate with magnesium were found to protect enzyme activity when PEPC, previously shown to contain an essential arginine at the active site, was incubated with the specific arginyl reagent 2,3-butanedione, consistent with the binding of phosphate at the active site. Data were successfully fitted to a rapid equilibrium model allowing for binding of the phosphate-magnesium complex to both the activation site and the active site which accounts for the activation/deactivation observed at low substrate concentrations. Effects on the Vmax of the reaction are also addressed. Factors controlling the differential affinity of various effectors to the active site or activation site appear to include charge distribution, size, and other steric factors. PMID- 2712577 TI - [Experimental study of normal liver regeneration in hepatic arterial infusion with degradable starch microspheres (DSM)]. AB - Influence of hepatic arterial infusion with degradable starch microspheres (DSM) or with anti-cancer drug or with both for normal liver regeneration in rat was determined by histological and microautoradiographical examination and liquid scintilation before or after 70% hepatectomy. DSM was seen in interlobular artery in early phase after hepatic arterial infusion, but disappeared into the central vein by degrees for 2 hours later. Adriamycin (ADM) in serum was detected for a long time after hepatic arterial infusion with DSM + ADM. In the heart muscle, a significantly lower concentration of ADM was seen in the DSM + ADM group than in the ADM only group. In the case of hepatic arterial infusion with DSM only after hepatectomy, there was no influence on normal liver regeneration. No significant difference was seen between hepatic arterial infusion and intravenous infusion with ADM only. However, in the case of hepatic arterial infusion with DSM + ADM after hepatectomy, a significant difference was seen in the inhibition of liver regeneration from any other groups. PMID- 2712578 TI - [Antiemetic efficacy of betamethasone versus betamethasone combined with metoclopramide in cisplatin-treated cancer patients]. AB - This study was designed to compare the antiemetic effect of betamethasone alone with that of betamethasone combined with metoclopramide. Forty-seven patients on chemotherapeutic regimens including cisplatin were entered into this study. Betamethasone was given in 4 doses of 20 mg/body at 30 minutes before and at 2.5 and 8 hours after cisplatin. Metoclopramide was given in 4 doses of 1mg/kg on the same schedule. Within 24 hours after the administration of cisplatin, no vomiting was observed in 42.9% of the patients treated with betamethasone alone and in 76.9% with betamethasone and metoclopramide. Betamethasone combined with metoclopramide was superior to betamethasone alone for the antiemetic effect in cisplatin-treated patients. PMID- 2712579 TI - [Combination chemotherapy of CPM-MTX-5-FU in non-resectable and recurrent cancer patients]. AB - Fifty-two non-resectable and recurrent cancer patients with prior treatment, were entered in this study; 1 esophageal, 33 gastric, 1 duodenal, 4 colorectal, 2 pancreatic, 2 bile duct, and 9 breast cancer. The protocol of this therapy was as follows: On day 1, 500 mg/body cyclophosphamide (CPM) was administered by drip infusion, and on day 2, 200 mg/m2 methotrexate (MTX) was infused intravenously for 30 min; immediately after, 500 mg/body 5-fluorouracil (5-FU) was injected by bolus infusion for 5-10 min. On day 3, 24 hours after MTX administration, leucovorin rescue was added. This combination chemotherapy was repeated every two weeks. As a result, 35 of 52 patients were evaluable and the response rate (CR + PR) was investigated; 2/21 (9.5%) for gastric, 2/7 (28.6%) for breast, and 0% for miscellaneous. As complications for side effect, general fatigue, anorexia, nausea, vomiting and stomatitis were observed symptomatically, and leukopenia and thrombocytopenia were recognized in laboratory data as dose limiting factors. PMID- 2712580 TI - [Amelioration of cisplatin-induced vomiting and anorexia by methylprednisolone]. AB - Amelioration of cisplatin (CDDP)-induced vomiting and anorexia by methylprednisolone (MP) was studied using conscious dogs. The incidence of vomiting was 88.9% and the mean number of emetic episodes was 8.22 +/- 1.25/dog during 5 hours after i.v. administration of 1.5 mg/kg CDDP in 9 dogs. In control dogs, food intake on the day after administration of CDDP was markedly reduced to 60 +/- 22.4 g/day from 461 +/- 23 g. Continuous high-dose infusion of MP (10 mg/kg, 10 min before the start of CDDP infusion and 50 mg/kg/h for 5 h) markedly reduced the incidence (33%) and mean number of vomiting episodes (2.00 +/- 1.51/dog) and also mitigated the reduction of food intake (350 +/- 30.6 g/day). However, continuous low-dose infusion of MP (5 mg/kg, 10 min before CDDP infusion and 16.6 mg/kg/h for 5 h) showed a little effect on CDDP-induced vomiting. Plasma MP levels after the high-dose and the low-dose regimens were 6.20 +/- 0.628 micrograms/ml and 4.66 +/- 1.72 micrograms/ml, respectively, 30 min after CDDP infusion. In both cases, MP levels gradually increased and reached to those more than twice 5 hours after CDDP infusion. Bolus administrations of MP (30 mg/kg, each time) 2 hr and 30 min before CDDP infusion also significantly reduced the mean number of emetic episodes (3.22 +/- 1.33/dog) and mitigated the reduction of food intake (325 +/- 37.3 g/day). No significant changes in catecholamines, prostaglandins, vasopressin, plasma renin activity, Na+, K+, Mg++ and osmolality in peripheral blood were noted after administration of CDDP and/or MP. The results suggest that administration of MP was effective against CDDP-induced vomiting and anorexia in dogs. PMID- 2712581 TI - [Endocrine therapy of lung cancer]. PMID- 2712582 TI - [Technics in molecular biology in cancer research. DNA transfection in mammalian cells]. PMID- 2712583 TI - Pruritic skin lesions. A common initial presentation of acquired immunodeficiency syndrome. AB - During July 1983 to December 1984, we observed that 62 (46%) of 134 Haitian patients with acquired immunodeficiency syndrome had intensely pruritic eruptions for which neither specific causative nor categoric diagnoses could be established. These lesions were a presenting manifestation of acquired immunodeficiency syndrome in 79% of the patients and appeared a mean of 8 months before the diagnosis of either Kaposi's sarcoma or opportunistic infection. Lesions included erythematous round macules, papules, or nodules that first appeared on the extensor surface of the arms, but subsequently involved the legs, trunk, and face. Histologically, the lesions were characterized by varying degrees of mixed (predominantly eosinophilic) perivascular and perifollicular inflammatory cell infiltrates of the dermis. The lesions did not respond to any therapeutic regimens used and usually persisted throughout the acquired immunodeficiency syndrome illness. Demographic and laboratory data did not distinguish these patients from those without pruritic skin lesions. PMID- 2712584 TI - The relationship between postnatal skin maturation and electrical skin impedance. AB - Electrical impedance, which is the resistance to an alternating current, is a parameter that is used to determine the condition of the electrode-skin interface before evoked potentials are recorded. High electrical impedance can result in inaccurate interpretation of evoked potentials due to excessive artifacts. This study investigated the electrical skin impedance in 36 full-term infants who ranged from 0 to 1 year of age to delineate the temporal relationship between skin maturation and skin impedance. Correlation and regression analyses demonstrated a statistically significant inverse relationship between electrical skin impedance and age during the first year of life. This drop in skin impedance during the first few postnatal months was attributed to an increase in skin hydration as a result of the greater functional maturity of eccrine sweat glands. PMID- 2712585 TI - Leg ulcers following subcutaneous injection of a liquid silicone preparation. AB - We present an unusual case of leg ulcers occurring 23 years after the patient had received large-volume subcutaneous injections of a liquid silicone preparation into her legs for cosmetic reasons. Light microscopy of a biopsy specimen from the edge of the ulcer showed optically clear vacuoles in the dermis, together with a mixed cellular infiltrate. Scanning electron microscopic studies revealed amorphous spherules within the vacuoles, and energy-dispersive spectroscopy established the presence of silicon in these spherules. Nearby tissue not containing spherules did not show a silicon peak. This case adds to the growing documentation of morbidity associated with injections of silicone of uncertain purity. PMID- 2712586 TI - Fever and hyperpigmented papules in an intravenous drug abuser. Disseminated histoplasmosis in acquired immunodeficiency syndrome (AIDS). PMID- 2712587 TI - The Wolff-Chaikoff effect: hypothyroidism due to iodine application. PMID- 2712588 TI - Complete skin examinations. PMID- 2712589 TI - Acquired immunodeficiency syndrome-related bacillary vascular proliferation (epithelioid angiomatosis): rapid response to erythromycin therapy. PMID- 2712590 TI - Conceptual analysis of agitation in the confused elderly. AB - Agitation is a significant behavior problem for many elderly nursing-home residents with dementia. Lack of conceptual clarity constrains effective management of agitated behaviors. This conceptual analysis examines the meaning of agitation and attempts to disentangle its antecedents, critical attributes, and consequences. Measurement and management implications are examined. PMID- 2712592 TI - The three Cs and the chronically mentally ill. PMID- 2712591 TI - Nursing therapeutics in a group encounter. AB - This report explores a successful clinical group encounter in a community setting with an aging client population. The clinical example presented is discussed from the perspective of Martha Rogers' Science of Unitary Human Beings. The authors seek to explicate the integration of intuitive understanding and empirical knowledge in the nursing process using Rogerian theory as a framework. PMID- 2712593 TI - Issues in psychiatric caregiving. AB - This report presents descriptive data from a pilot investigation of 20 family caregivers to the psychiatrically disabled. Data were obtained through focused interviews with caregivers recruited from community organizations and clinical services. The model subject was a middle-aged mother caring for an adult child with schizophrenia. Qualitative analysis of interview data identified major concerns and support needs of individuals who assume this stressful role. Mental health nurses may assist caregivers to obtain support, reduce risks to their own well-being, and to promote well-being of the mentally ill. PMID- 2712594 TI - Adopted children in psychotherapy. AB - Research shows that a larger than expected proportion of children in psychiatric treatment are adopted. When these children present with more pressing symptomatology, it is often difficult to determine how and when to address the adoption issue. This report provides a brief analysis of adoption from the perspective of attachment theory and family of origin theory. Case examples illustrate typical themes and dilemmas that arise in therapy. The authors conclude the report with an analysis of factors to consider in clinical decision making and guidelines for intervention. PMID- 2712595 TI - Loneliness and disturbed grief: a comparison of parents who lost a child to suicide or accidental death. AB - Grief reactions of two types of sudden untimely deaths were compared: the loss of a child by accidental death and the loss of a child by suicidal death. Three hypotheses were tested. The degree of disturbed grief and the degree of loneliness in parents who lost a child to suicidal death were compared to those reactions in parents who lost a child to accidental death. The relationship between the degree of disturbed grief and the degree of loneliness was assessed. For suicide survivors, grief and loneliness tended to rise over time, whereas grief and loneliness decreased over time for accidental death survivors. The findings from this study indicate that the loss of a child from an accidental death places a parent at high risk for disturbed grief and loneliness, and at even higher risk when the loss is a result of suicidal death. PMID- 2712596 TI - CA 125 in normal tissues and carcinomas of the uterine cervix, endometrium and fallopian tube. I. Immunohistochemical detection. AB - The distribution of cancer antigen 125 (CA 125) has been investigated in normal tissues and carcinomas of the Mullerian duct by immunohistochemical methods using the monoclonal antibody OC 125. Detection of CA 125 was most intense in cryostat sections and decreased in formalin fixed and paraffin embedded tissues according to the duration of fixation. Enzymatic digestion with neuraminidase or alkaline hydrolysis abolished specific staining suggesting the antigen is a sialylsaccharide bound to protein by alkali-labile linkage. Immunohistochemical staining demonstrated the presence of CA 125 in all normal glandular epithelia of the endocervix, endometrium and fallopian tube in different distribution patterns. In normal endometrium the cellular distribution pattern was related to the menstrual cycle. In endocervical, endometrial and tubal adenocarcinomas CA 125 was found in 73% of cases. In glandular structures the antigen was concentrated at the luminal surface of the tumour cells, in solid tumour areas it was spread throughout the cytoplasm or concentrated in large cytoplasmic vacuoles. The expression of CA 125 was considerably lower in solid tumour areas. These data show that CA 125 is not a true "tumour marker", but a product of female genital mucosae and of their cancerous derivates provided their synthesizing ability is not lost in the course of pathologic differentiation. PMID- 2712597 TI - CA 125 in normal tissues and carcinomas of the uterine cervix, endometrium and Fallopian tube. II. Immunoradiometric determination in secretions, tissue extracts and serum. AB - The study deals with the occurrence of cancer antigen 125 (CA 125) in the normal and neoplastic uterine cervix, endometrium and fallopian tube and its applicability as a tumour marker. CA 125 concentrations were measured in 52 secretion specimens, in cytosol fractions of 97 tissue biopsies and in serum from 47 women with nonmalignant disorders and from 334 patients with carcinomas. High quantities of CA 125 (780-454860 U/ml) were detected in cervical mucus, intra uterine and tubal fluid, exceeding those in the corresponding serum samples by factors of up to 2000. CA 125 concentrations were 9-53 fold higher in cytosol fractions of normal and neoplastic glandular epithelia of the endocervix and endometrium than in those of cervical squamous epithelia and the cervical wall. Despite similarly high antigen concentrations in normal glandular epithelia and adenocarcinomas serum levels elevated to above 65 U/ml were only found in patients with malignant tumours. The positivity rates in serum increased with tumour extent and were 0-43% for primary and 63-79% for recurrent cervical, endometrial and tubal adenocarcinomas. During long-term follow-up, CA 125 serum concentrations were concordant with the clinical course in 10 out of 11 patients with progressive carcinomas. According to these results, the release of CA 125 into the peripheral blood is apparently dependent on the infiltrative growth and the mass of the tumour rather than on the local tissue concentrations. The clinical use of CA 125 is limited to the detection of advanced adenocarcinomas of the Mullerian duct. PMID- 2712598 TI - Intrauterine treatment of a fetal pulmonary cyst by chorioamniotic shunt. AB - This is a report of a prenatal diagnosis and successful intrauterine drainage of a pulmonary cyst by placement of a thoracoamniotic shunt at 36 weeks gestation. At the time of delivery the newborn had no signs of pulmonary hypoplasia or respiratory insufficiency. PMID- 2712599 TI - Bacteriological findings after premature rupture of the membranes. AB - Of 243 children born after premature rupture of the membranes (PROM) 61 (26%) had the same bacteria in placental arterial blood, in ear swabs (taken deep from the external auditory canal) and in meconium. The predominant organisms were E. coli, Bacteroides fragilis, Streptococcus faecalis (enterococci) and Streptococcus agalactiae (group B streptococci). The infection rate was only 10% if the membranes had ruptured within 24 h of the onset of labour and 30% if the interval was longer than 24 h. Of 131 children born without premature rupture of the membranes but with risk factors for sepsis 9 (7%) had a positive blood culture with the same organism in the ear swabs and in meconium. The organisms were Streptococcus agalactiae (6 cases) and E. coli, Streptococcus faecalis and Klebsiella pneumoniae (one case each). Contamination of placental blood cultures was rare. PMID- 2712600 TI - A study of the effect of mifepristone (antiprogesterone) followed by prostaglandin on uterine activity and fetal heart rate in patients having a termination of pregnancy. AB - In the 72 h after a single oral dose of 400 mg of the antiprogesterone mifepristone, 12 out of 14 first and one second trimester fetuses had a slight increase in heart rate; 2 fetuses died and one aborted. During the same 72 h, uterine activity increased moderately, and was physiological with no increase in resting pressure. The treatment sensitized the uterus to prostaglandin (PG) about ten-fold. A low, 0.05 mg IM, dose of sulprostone caused the demise of 5 more fetuses and caused the onset of clinical abortion in less than 2 h. After a relatively short hypertonic phase uterine resting pressure fell to normal levels and active contractions occurred leading to expulsion of uterine contents. The plasma level of progesterone (P) remained unaltered after mifepristone treatment, but the levels of estradiol 17b (E2) and cortisol increased. The plasma level of mifepristone was 1640 +/- 424 ng. ml -1 at 72 h, and the substance was still detectable after one week. PMID- 2712601 TI - The value of second-look operation in patients with advanced epithelial ovarian carcinoma. AB - A second-look operation was performed on 151 patients with stage III and IV epithelial ovarian carcinoma who had responded to primary surgery and chemotherapy. 19% of the 79 patients who appeared clinically to be free of disease had microscopic recurrences and 23% had macroscopic residual disease at a second-look operation. The 5-year survival rate for patients with no histological and for those with microscopic secondaries at second-look operation were 55% and 35% respectively (P = 0.45). Only patients with well or moderately well differentiated tumors and a small residual tumor mass at first operation had a good prognosis after a second-look operation even without further chemotherapy. Median survival after secondary debulking was 15 to 17 months and was independent in the radicality of the second-look procedure. Outside of clinical trials second look laparotomy should therefore only be performed as a diagnostic procedure in patients with well or moderately well differentiated tumors who are left with a small residual tumor mass at the time of the first operation. Because this is a group of patients in whom chemotherapy can be discontinued after a negative second-look operation. PMID- 2712602 TI - Placental biopsy for rapid fetal karyotyping in the second and third trimesters of pregnancy. AB - Rapid chromosomal analysis in the 2nd and 3rd trimester of gestation is desirable in cases of suspected or proven fetal malformation. The presence of any chromosomal aberration of the fetus influences the further prenatal and perinatal management of the pregnancy. Placental biopsy and preparation of trophoblast tissue after short term culture offers the possibility of getting satisfactory results within 2 to 3 days of biopsy. Fifty-seven patients underwent placental biopsy between the 16th and 36th weeks of gestation because of sonographically suspected or proven fetal malformation. In 51 of 57 cases fetal karyotyping was successful and no severe complications after biopsy were seen. Eight pathologic karyotypes were found. In 3 cases the chromosomal analysis yielded unsatisfactory results because of the inadequate quality of metaphases. In another 3 cases not enough chorionic tissue was aspirated in 2 biopsy attempts. In all other cases normal fetal karyotypes were found. Sonographically guided placental biopsy represents a simple method for fetal karyotyping and is a useful tool for the management of pregnancies with suspected or proven fetal malformation in the 2nd and 3rd trimester. PMID- 2712603 TI - [Intraperitoneal hemorrhage after labor as manifestation of renal angiomyolipoma]. AB - We report a case of renal angiomyolipoma in a patient who, following normal delivery, presented with abdominal pain and acute abdomen with severe hemodynamic compromise that led to hypovolemic shock. Following diagnosis by emergency exploratory laparotomy, a left nephrectomy was performed. We underscore the difficulty involved in the diagnosis of acute abdomen from hemoperitoneum resulting from a ruptured angiomyolipoma, and highlight the rarity of this condition. Our patient was submitted to radical surgery because of vessel (hilum) invasion. The tumor was benign and no complications were observed. Patient work up eight years postoperatively revealed no local or systemic evidence of disease. PMID- 2712604 TI - [Verrucous carcinoma of the penis: apropos of 2 cases]. AB - Verrucous carcinoma accounts for approximately 5% of penile carcinomas. Verrucous carcinoma is a variety of squamous cell carcinoma with peculiar histologic features and a benign nature. We report two cases of this disease entity diagnosed in two patients aged 57 and 73 years, with a follow up of 2 and 3 years, who had been submitted to partial resection of the penis. PMID- 2712605 TI - [Ureterorenoscopy combined with extracorporeal shockwave lithotripsy]. AB - In May 1986, extracorporeal shock wave lithotripsy and endourologic procedures became available in the treatment of lithiasis at the "Hermanos Ameijeiras" Hospital. The present study describes our experience and the results achieved during a 12-month period using endourologic procedures. During this period 65 URS procedures were performed to treat post-ESWL ureteral obstruction, and 22 to push the stone up to the kidney for subsequent ESWL treatment. PMID- 2712606 TI - [Endoscopic resection of tumor of the kidney pelvis]. AB - We report on a 70-year-old patient diagnosed as having urothelial carcinoma (T1, G1) localized in the anterior aspect of the right renal pelvis. Following preoperative assessment, the patient underwent percutaneous endoscopic resection of the tumor. The procedure was performed utilizing an irrigation-suction resectoscope passed through an Amplatz sheath. The patient was placed in the supine decubitus position and received local anesthesia. The procedure was successful and the patient's postoperative course was unremarkable. Patient examination at 3 and 6 months postoperatively yielded no tumor recurrence or metastasis. The advantages of endourology in the treatment of this tumor type and the new possibilities afforded by laser are discussed. PMID- 2712607 TI - [Bladder leiomyosarcoma: presentation of 2 cases]. AB - We report two cases of bladder leiomyosarcoma diagnosed by histology. Total segmental cystectomy was performed in both cases because of the scant progressive nature of the disease. A follow up of 11 and 6 years, respectively, revealed no tumor recurrence or metastasis. The choice of performing a conservative or radical surgical procedure in the treatment of this tumor type should depend on the endoscopic findings as well as tumor grade and stage. PMID- 2712608 TI - [Parafunicular hemangiopericytoma]. AB - We report a case of right-sided parafunicular hemangiopericytoma in a 72-year-old patient with unilateral cryptorchidism. We describe the outstanding histologic features of this uncommon tumor which permit making a differential diagnosis from other neoplasms. PMID- 2712609 TI - Quality of life in patients with advanced bladder cancer treated by tumorectomy and systemic adjuvant polychemotherapy (M-VAC). Our experience in 14 cases. AB - Fourteen patients with advanced bladder cancer T3 to T4, N1 to N2 positive, were treated with reductive surgery (tumorectomy) and systemic adjuvant polychemotherapy (M-VAC: methotrexate 30 mg/m2, vinblastine 3 mg/m2, adriamycin 30 mg/m2 and cis-platin 70 mg/m2) in the period from December 1985 to December 1987. The aim of this combination was to preserve detrusor function in order to give tha patients a better "quality of life". After a follow-up varying from 12 24 months, complete clinical remission for 18 months was observed in 2 patients, the remainder showed an improvement of the performance status compared with those treated by conventional therapy (radical cystectomy and/or radiotherapy) but no changes in overall survival was achieved. PMID- 2712610 TI - Epidemiology of osteoarthritis: Zoetermeer survey. Comparison of radiological osteoarthritis in a Dutch population with that in 10 other populations. AB - The prevalence of mild and severe radiological osteoarthritis was investigated in a random sample of 6585 inhabitants of a Dutch village. Radiographs were graded 0 4 according to the criteria described by Kellgren and Lawrence. The prevalence of radiological osteoarthritis increased strongly with age and was highest for cervical spine (peak: men 84.8%, women 84.3%), lumbar spine (peak: 71.9%, women 67.3%), and distal interphalangeal joints of the hands (peak: men 64.4%, women 76%). Prevalence did not exceed 10% in sacroiliac joints, lateral carpometacarpal joints, and tarsometatarsal joints. Severe radiological osteoarthritis (grade 3 or grade 4) was uncommon under age 45; in elderly persons the prevalence of severe radiological osteoarthritis did not exceed 20% except for the cervical and lumbar spine, distal interphalangeal joints of the hands and, in women only, metacarpophalangeal joints, first carpometacarpal joints, first metatarsophalangeal joints, and knees. Overall, differences between men and women were small except for hips and knees; however, severe radiological osteoarthritis was found in a higher proportion in most of the joints in women. Our data were compared with data from similar population surveys. The slope between joint involvement and age was strikingly constant for most of the joints. Differences between populations were mainly differences in level. These differences of prevalence of radiological osteoarthritis may be attributed to interobserver differences--that is, different criteria used to establish radiological osteoarthritis, in addition to genetic or environmental factors, or both. PMID- 2712611 TI - A study of headaches and migraine in Sjogren's syndrome and other rheumatic disorders. AB - Migraine occurs with increased frequency in patients with systemic lupus erythematosus and in subjects suffering from Raynaud's phenomenon without any underlying connective tissue disorders. A possible link between migraine and Raynaud's phenomenon has been suggested. Two rheumatic conditions where Raynaud's phenomenon occurs very commonly are scleroderma and primary Sjogren's syndrome. It is possible that migraine is also common in these disorders but has been unrecognised. Therefore, the prevalence of migraine was assessed by a questionnaire in 191 subjects suffering from various connective tissue disorders and control subjects. Migraine was diagnosed in 16/35 (46%) patients with primary Sjogren's syndrome, 31/97 (32%) patients with scleroderma, 4/33 (12%) patients with rheumatoid arthritis/Sjogren's syndrome compared with 3/26 (11%) control subjects. A family history of headaches was more common in the patient groups than controls. There was a significant association between occurrence of Raynaud's phenomenon and migraine. Small vessel pathology may underlie both migraine and Raynaud's phenomenon in these connective tissue disorders--as has been suggested in systemic lupus erythematosus. The findings stress the need to ask specifically about complaints of headaches/migraines in patients with scleroderma and primary Sjogren's syndrome for the appropriate total management of these patients. PMID- 2712612 TI - Factors associated with severity of symptoms in patients with chronic unexplained muscular aching. AB - Subjects with chronic, diffuse, unexplained muscular aching were recruited--21 from a primary care practice, nine from a rheumatology practice, and two from a pain clinic. No additional criteria were used to select subjects. Subjects with mild or moderate symptoms differed from those with severe symptoms with respect to the following characteristics: the presence of fatigue on awakening, the number of tender points, difficulty in sleeping, and the degree of tenderness in typical fibromyalgia areas as measured by a dolorimeter. These findings suggest that muscular aching is likely to be of greater severity if other symptoms or signs of fibromyalgia are also present. PMID- 2712613 TI - Injections and physiotherapy for the painful stiff shoulder. AB - Cost effective treatment is needed for common self limiting rheumatological conditions. Periarthritis of the shoulder is an example. There is no consensus for one type of treatment, though local steroids or physiotherapy are conventionally used. Their cost and efficacy were compared in a prospective randomised observer-blind trial--in essence a medical audit of the treatment of a common rheumatological problem. Sixty two consecutive patients presenting with a painful stiff shoulder were studied. Patients with coexistent diseases like cervical spondylosis or a stroke were excluded. They were randomly allocated to receive local steroids, six weeks' physiotherapy, or both. The three groups were of similar age, sex, and disease severity. Assessments of pain and shoulder movement were made initially, at six weeks, and at six months by a 'blinded' observer. Physiotherapy was given by one therapist and injections by one physician. All three groups showed significant improvements by six weeks, with further improvement at six months. Improvements were identical in all three groups. No treatment gave complications. The costs of treatment varied: an injection of triamcinolone cost 2.10 pounds; a six week course of physiotherapy cost 48.50 pounds; combination treatment cost 50.60 pounds. Patients expect treatment for a painful stiff shoulder. The results show that local steroid injections are as effective as physiotherapy alone or a combination. They provide rapid treatment and are less expensive. In the uncomplicated case a local steroid injection is the most cost effective treatment. PMID- 2712614 TI - Multicentric Castleman's disease associated with rheumatoid arthritis: a possible role of hepatitis B antigen. AB - A patient with seropositive rheumatoid arthritis and a carrier of hepatitis B surface antigen developed angiofollicular hyperplasia (multicentric Castleman's disease). The hepatitis B virus and the rheumatoid factor may have had a role in the aetiology of this lymphatic disorder. The development of Castleman's disease in association with these factors may provide another clue supporting the reactive nature of this disease. PMID- 2712615 TI - Overwhelming pneumococcal bacteraemia in systemic lupus erythematosus. AB - An 18 year old woman presented with fulminant pneumococcal bacteraemia and subsequently died with multisystem organ failure. A search for diseases predisposing to overwhelming encapsulated bacterial infections was negative except for previously undiagnosed systemic lupus erythematosus (SLE). This case emphasises the severity of immune system dysfunction in some patients with SLE, regardless of immunosuppressive treatment. The possible relation between Fc receptor dysfunction and pneumococcal bacteraemia in SLE is discussed. PMID- 2712616 TI - Atypical mycobacterial infection of the lung in rheumatoid arthritis. AB - Mycobacterium kansasii was isolated from a cavitating pneumonia found in a 51 year old man with seropositive rheumatoid arthritis, and treatment was complicated by drug induced neuropathy. PMID- 2712617 TI - Reflex sympathetic dystrophy associated with squamous cell carcinoma of the lung. AB - Reflex sympathetic dystrophy was the presenting feature in an otherwise occult case of non-metastatic squamous cell carcinoma of the lung which improved on surgical removal of the primary tumour. Reflex sympathetic dystrophy, therefore, should be considered an occasional manifestation of a paraneoplastic syndrome warranting a thorough search for underlying malignancy. PMID- 2712618 TI - Azathioprine induced hepatic veno-occlusive disease in rheumatoid arthritis. AB - A patient with rheumatoid arthritis developed hepatic veno-occlusive disease following the use of azathioprine. Although azathioprine induced veno-occlusive disease is suspected to occur more frequently in patients with autoimmune dysfunction, it has not previously been reported as a complication of treatment in rheumatoid arthritis. The mechanism responsible for this condition remains unknown. PMID- 2712619 TI - Laterality and incidence of adhesive capsulitis of the shoulder and plantar fasciitis among rural Saudis in the Jeddah zone. PMID- 2712620 TI - Low incidence of osteoarthrosis of the hips in contrast with osteoarthrosis of the knees among rural Saudis: why? PMID- 2712621 TI - Corticosteroid dosage for temporal arteritis. PMID- 2712622 TI - Truncus arteriosus. PMID- 2712623 TI - Repair of truncus arteriosus in the neonate and young infant. AB - Infants with truncus arteriosus present a difficult management issue. Because of the high operative mortality, repair is often delayed beyond the first 3 to 6 months of age. We reviewed our experience with 11 neonates and young infants with truncus arteriosus undergoing repair (median age, 21 days). Five patients also had major truncal valve insufficiency, and 2 required valve replacement. Right ventricle-pulmonary artery continuity was established with a porcine valved conduit in 3 patients and an aortic or pulmonary homograft in 8. There was 1 operative death (9%; 70% confidence limits, 3%-22%) and 1 late death over a mean follow-up of 21 months (range, 4 to 32 months). Eight of the 9 late survivors are growing normally. Echocardiographic examination revealed normal ventricular function in all patients (mean shortening fraction, 39%). Doppler assessment demonstrated trivial prosthetic or homograft valve regurgitation in 7 patients and mild to moderate obstruction in 5 patients. This recent experience with repair of truncus arteriosus indicates that the operative risk is low even in the neonate. Repair in the first month of life should be recommended before the development of critical congestive heart failure or irreversible pulmonary vascular disease. PMID- 2712624 TI - Late reoperation for systemic atrioventricular valve regurgitation after repair of congenital heart defects. AB - Since 1979, 17 infants and children have undergone reoperation for systemic atrioventricular (AV) valve regurgitation 6 weeks to 7 years after repair of congenital heart defects. Prior operations were repair of incomplete or complete AV canal (14 patients), Mustard repair of complex transposition of the great arteries including ventricular septal defect closure (2 patients), or first-stage operation for hypoplastic left heart (1 patient). Age ranged from 6 months to 11 years. In 12 of the 17 patients (10, AV canal; 1, transposition; 1, hypoplastic left heart), valve reconstruction was possible. Operative techniques included a combination of septal cleft approximation, leaflet resection, commissural annuloplasty, or ring annuloplasty. There were no operative deaths, and there were no reoperations in the repair group. The condition of these patients has improved. Follow-up ranges from 1 month to 9 years (mean follow-up, 4.1 years). Five of the 17 patients (4, AV canal; 1, transposition) underwent valve replacement. There were no operative deaths. Follow-up ranges from 3 to 8 years. Three patients later underwent re-replacement of the prosthetic valve; there was 1 late death. The condition of all 4 survivors is improved. Substantial AV valve regurgitation can occur months or years after repair of congenital heart defects. A combination of reconstructive techniques may be useful in preserving native valve function and avoiding systemic AV valve replacement. PMID- 2712625 TI - Mitral valve annuloplasty: the effect of the type on left ventricular function. AB - This study was undertaken to determine whether rigid-ring annuloplasty and flexible-ring annuloplasty have the same effect on left ventricular function in patients with chronic mitral regurgitation secondary to degenerative disease of the mitral valve. Twenty-five patients who underwent isolated mitral valve repair and required annuloplasty were randomized into two groups: rigid-ring and flexible-ring annuloplasty. Left ventricular function was assessed by echocardiography and radionuclide angiography on the day before operation and 2 to 3 months later. Preoperative left ventricular function was similar in the two groups of patients. Postoperatively, left ventricular end-diastolic diameter and volume decreased significantly in both groups. The left ventricular end-systolic diameter and volume decreased significantly only in patients with a flexible annuloplasty ring. Left ventricular systolic function as assessed by pressure volume relationships was significantly better in patients with a flexible ring (p less than 0.02 by analysis of covariance), and left ventricular performance measured by stroke volume-end-diastolic volume relationships was also better in these patients (p less than 0.05 by analysis of covariance). These data indicate that patients with a flexible annuloplasty ring have better left ventricular systolic function than patients with a rigid annuloplasty ring 2 to 3 months after mitral valve reconstruction for chronic mitral regurgitation secondary to degenerative disease of the mitral valve. PMID- 2712626 TI - Predonated autologous blood use in elective cardiac surgery. AB - The risks of homologous blood transfusion are well documented and recently increased with the emergence of acquired immunodeficiency syndrome. Preoperative autologous donation has been suggested to reduce these risks. This is a report concerning 104 consecutive adult autologous donors (group 1) who had an elective cardiac operation. A similar group of 111 patients operated on during the same period but without autologous blood donation was used for comparison (group 2). Both groups contained similar numbers of patients with coronary artery disease, valvular disease, and mixed lesions, and both had several patients with atrial septal defects. Group 2 patients (mean age, 67.8 years) were significantly older than group 1 patients (mean age, 58.9 years) (p less than 0.05). The mean donation in group 1 was 4.1 units, but 12 (11.5%) had to discontinue donations. Increasing angina in 10 (12.2%) of the 82 patients with coronary artery disease was the most common complication, and necessitated hospitalization in two instances. In 77 (75.5%) of the 102 group 1 patients who had operation and 23 (21%) of the 110 group 2 patients, no homologous blood products were required. Group 1 patients used significantly less homologous fresh frozen plasma (0.1 unit versus 0.97 unit; p less than 0.005) and packed red blood cells (0.6 unit versus 2.1 units; p less than 0.001) than group 2 patients. Group 1 patients received 3.3 and 3.1 units of autologous packed cells and plasma, respectively. No complications of autologous transfusion were seen. Predonation of autologous blood is an effective, safe method of reducing homologous blood requirements in elective cardiac operations, but it does carry some risk, especially in patients with coronary artery disease. PMID- 2712627 TI - When should the hypoplastic right ventricle be used in a Fontan operation? An experimental and clinical correlation. AB - Eight anesthetized dogs underwent closure of the tricuspid valve and a Fontan procedure, and the right ventricular cavity was reduced in stepwise fashion. There was an increase in right atrial pressure from 9.3 +/- 2.2 to 14.1 +/- 2.4 mm Hg (p less than 0.001), a decrease in pulmonary artery pulse pressure from 10.8 +/- 2.2 to 6.8 +/- 2.2 mm Hg (p less than 0.01), and a decrease in cardiac index from 2.7 +/- 0.3 to 2.2 +/- 0.2 L/min/m2 (p less than 0.001) when the ventricular size was dropped from 50% to 25% of normal. The difference between mean pulmonary artery pressure and mean right atrial pressure, which reflects the positive stroke work index of the ventricle, disappeared once the right ventricular cavity was reduced to 25% of normal (15.0 +/- 6.1 versus 14.1 +/- 2.4 mm Hg; p = not significant). Experimental results were correlated with postoperative catheterization data from 19 patients with tricuspid atresia who had the Fontan operation. Mean right atrial pressure was 18 +/- 4.6 mm Hg and cardiac index was 2.35 +/- 0.65 L/min/m2 in patients with a direct atrium pulmonary artery anastomosis or an atrioventricular anastomosis with a right ventricular cavity less than 30% of normal versus 13 +/- 3.2 mm Hg and 3.42 +/- 0.46 L/min/m2 for those with an atrioventricular connection and a right ventricular cavity greater than 30% of normal (p less than 0.05 and p less than 0.02, respectively). The right ventricle enlarged from 27% +/- 6% of normal preoperatively to 35% +/- 10% of normal on follow-up (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712628 TI - Right atrial approach for surgical correction of tetralogy of Fallot. AB - Total correction of tetralogy of Fallot was performed without a ventriculotomy in 39 patients aged 8 months to 39 years (mean age, 9.1 years) between May 1984 and July 1988. A transatrial approach was used to resect the obstructed infundibulum and to close the ventricular septal defect. In 14 patients, the pulmonary annulus was not enlarged (group 1). Twenty-five patients required a transannular patch (group 2), placed by extending the pulmonary artery incision 1 cm into the right ventricular infundibulum. Eleven patients had repair of pulmonary artery branch stenosis, and associated intracardiac anomalies were simultaneously corrected in 10 patients. After repair, the right ventricular to left ventricular systolic pressure ratios ranged from 0.36 to 0.59 (mean ratio, 0.45) in group 1 and 0.33 to 0.70 (mean ratio, 0.51) in group 2. There were no hospital or late deaths in group 1. Two patients in group 2 with a small left ventricle died shortly after operation. The 37 survivors were followed for 2 to 51 months. Postoperative catheterization in 7 patients detected no residual ventricular septal defects, mild pulmonary regurgitation in 2 patients (group 2), and right ventricular to left ventricular pressure ratios ranging from 0.25 to 0.42 (mean ratio, 0.34). Only 1 patient with a previous total repair by ventriculotomy is symptomatic and requires antiarrhythmic agents and diuretics. The other 36 patients are asymptomatic. In conclusion, tetralogy of Fallot can be safely repaired at any age without a ventriculotomy. The results indicate a minimal incidence of postoperative arrhythmias and pulmonary regurgitation, as well as improved right ventricular function. PMID- 2712629 TI - Myocardial salvage with trolox and ascorbic acid for an acute evolving infarction. AB - Both Trolox (a water-soluble analogue of alpha-tocopherol) and ascorbic acid were more effective than superoxide dismutase or catalase in protecting myocyte cell cultures from free radical attack (induced by hypoxanthine and xanthine oxidase). In a canine model of two hours of left anterior descending coronary artery occlusion followed by four hours of reperfusion, Trolox and ascorbic acid reduced the area of infarction within the area at risk. The Trolox group received 500 mL of deoxygenated saline solution containing 2.0 g of Trolox, 3.0 g of ascorbic acid, and 18 mg of EDTA (ethylenediaminetetraacetic acid) infused into the ascending aorta 30 seconds before and four minutes after reperfusion. Saline controls received 500 mL of deoxygenated saline solution containing 18 mg of EDTA. The angioplasty group had unmodified reperfusion by simple release of the occlusion. The area at risk and the area infarcted were estimated with Evans blue and triphenyl tetrazolium hydrochloride stains, respectively. The ratio of the area infarcted to the area at risk was significantly lower with Trolox (angioplasty, 30.4% +/- 5.1%; saline, 20.8% +/- 2.9%; and Trolox, 8.7% +/- 4.0%; p less than 0.01). In summary, the antioxidants Trolox and ascorbic acid effectively reduced myocardial necrosis after ischemia. PMID- 2712630 TI - Cryoablation of septal pathways in patients with supraventricular tachyarrhythmias. AB - Eighteen patients with supraventricular tachycardia refractory to medical therapy underwent preoperative electrophysiological study and subsequent operation. There were 6 female and 12 male patients ranging in age from 1.5 to 31.6 years (mean age, 11.9 +/- 7.8 years). Eleven had classic Wolff-Parkinson-White syndrome with intermittent tachycardia, and 7 had a form of permanent junctional reciprocating tachycardia. Five had impaired left ventricular function preoperatively. The location of the accessory conduction pathway was anteroseptal in 3, posteroseptal in 12, and both anteroseptal and posteroseptal in 3 patients. Pathway location was confirmed by intraoperative mapping in all patients. The pathways were ablated utilizing a cryoprobe at -70 degrees C. All patients survived the operation, had immediate abolishment of delta waves and tachycardia, and were considered cured at the time of hospital discharge. Sixteen (89%) remain cured at a mean follow-up of 16.9 months. One patient with a posteroseptal pathway no longer has a delta wave but has had poorly documented episodes of tachycardia and is taking medication. One other patient with both anteroseptal and posteroseptal pathways had a recurrent delta wave 6 months postoperatively but has had no tachycardia and is asymptomatic without medication. No patient experienced heart block. Ventricular function has returned to normal in all 5 patients with impaired function preoperatively. Cryoablation is an effective method of abolishing accessory conduction pathways located in the anteroseptal or posteroseptal region. The method is easy, and results are comparable with those of other techniques previously described. PMID- 2712631 TI - Deleterious effects of shock in internal mammary artery anastomoses. AB - Internal mammary arteries (IMAs) are increasingly used for coronary artery revascularization. However, spastic reactions after IMA-coronary artery anastomoses have been reported. Internal mammary artery flow and the effects of sudden hypovolemia, gradual hypovolemia, papaverine hydrochloride, nitrates, and epinephrine were evaluated in a canine model (n = 10) (body weight, 19 +/- 5 kg) without interference from coronary artery resistance by dissecting the IMA as a pedicle, calibrating the flowmeter during free IMA flow, and anastomosing the IMA to the right atrium. Sudden hypovolemia (withdrawal of 20% of circulating blood volume over 90 seconds) caused significant modifications (p less than 0.01) of the following hemodynamic variables: heart rate (+12%), right atrial pressure ( 17%), pulmonary artery pressure (-20%), wedge pressure (-30%), aortic pressure ( 49%), cardiac output (-33%), distal IMA pressure (-54%), and IMA flow (-85%). During hypovolemia, IMA flow could not be increased with topical application of papaverine, but baseline values were achieved after retransfusion of the withdrawn blood volume. Gradual hypovolemia and application of large doses of nitrates showed less dramatic effects, and injection of an epinephrine bolus under normovolemic conditions increased aortic pressure and IMA flow. Under sever hypovolemia, however, administration of an epinephrine bolus provoked only a minimal increase in aortic pressure and a contrasting decrease in IMA flow. We conclude that sudden, severe hypovolemia can lead to disproportionate IMA flow reduction and that pharmacological interventions are delicate under these circumstances. PMID- 2712632 TI - Anticoagulant therapy in children with prosthetic valves. AB - The purpose of this study was to evaluate the effectiveness and complications of several types of anticoagulant therapy in children with prosthetic valves. During a 7-year period ending April 1985, 130 children aged 1 to 19 years underwent left sided valve replacement. Operative mortality was 3%, 5%, and 9%, respectively, for aortic, mitral, and aortic and mitral valve replacement. Among the 123 survivors, 32 (26%) had had aortic, 71 (58%) had had mitral, and 20 (16%) had had aortic and mitral valve replacement. Follow-up ranged from 2 months to 8.2 years, a total of 544 patient-years. The survivors were divided into three groups based on anticoagulant treatment: warfarin sodium, aspirin plus dipyridamole, and no anticoagulants. Among the patients who had aortic valve replacement, thromboembolic complications developed in 2.5% (2.5/100 patient-years) of the aspirin plus dipyridamole group and 5% of the group given no anticoagulants. Only the warfarin group (4%) experienced bleeding complications. Among the patients having mitral valve replacement, thromboembolic complications developed in 4% of the warfarin group, 3% of the aspirin plus dipyridamole group, and 11% of the no anticoagulant group. In addition, 2% of patients in the warfarin group experienced severe bleeding. Two fatal cerebrovascular accidents occurred, both in the aspirin plus dipyridamole group. Patients who received a mitral heterograft were not prescribed any anticoagulant medications, and no thromboembolic complications developed. Among patients having double-valve replacement, complications developed in 5% of the warfarin group and 27% of the group given no anticoagulants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712633 TI - Repair of large muscular ventricular septal defects in infants employing left ventriculotomy. AB - The approach to muscular ventricular septal defect has been controversial. Traditional approaches have included pulmonary artery banding or right ventriculotomy. Left ventriculotomy has been employed in older children because of the ease of exposure in the absence of trabeculations, but concern has been raised regarding potential loss of left ventricular function. Four infants less than 4 months of age underwent repair of a large muscular ventricular septal defect by left ventriculotomy. One infant had no associated defects; 2 had undergone previous coarctation repair (1 with pulmonary artery banding); and 1 had a large secundum atrial septal defect. All had congestive heart failure refractory to maximal medical management. All patients survived, and there was no myocardial dysfunction. Echocardiographic indices of ventricular function 3 to 24 months postoperatively were normal (mean shortening fraction, 32.5%). Left ventriculotomy with patch closure of the ventricular septal defect provides a simple approach to a large muscular ventricular septal defect in infants with heart failure. PMID- 2712634 TI - Latissimus dorsi dynamic cardiomyoplasty. AB - Cardiomyoplasty is a new surgical technique that uses an electrostimulated skeletal muscle to reinforce or partially replace the heart muscle. Since the first clinical case performed in 1985, long-term beneficial cardiac effects of latissimus dorsi cardiomyoplasty have been documented in patients with various myocardial diseases (ischemic, neoplastic, dilated cardiomyopathy). In this article we describe the surgical technique that we have developed to biomechanically assist severe and irreversible ventricular failure. PMID- 2712635 TI - Percutaneous cardiopulmonary bypass for the treatment of hypothermic circulatory collapse. AB - Environmentally induced hypothermia has a very high mortality. Cardiopulmonary bypass affords the best chance of survival from hypothermia but can be time consuming to institute. We have utilized percutaneous cardiopulmonary bypass with recently developed bypass catheters to resuscitate a patient with profound hypothermia complicated by circulatory collapse. Percutaneous cardiopulmonary bypass appears to be the treatment of choice for profound hypothermia. PMID- 2712636 TI - Traumatic rupture of the pulmonary artery. AB - Traumatic rupture of the main pulmonary artery in a surviving patient is very rare. The case history of a 37-year-old man who sustained blunt chest trauma in a motor vehicle accident is presented. A persistent, bloody right pleural effusion led to the diagnosis of a ruptured right main pulmonary artery, which was surgically repaired using cardiopulmonary bypass. Points of diagnostic interest and therapeutic decision making are discussed. PMID- 2712637 TI - Localized pericardial flap to prevent tension on left internal mammary artery grafts. AB - Tension on a left internal mammary artery graft may be caused by the medial edge of the left lung. A localized pericardial flap may be used to prevent this problem while still allowing adequate pulmonary expansion. PMID- 2712638 TI - Assessment of exercise oxygen consumption: reply. PMID- 2712639 TI - Bovine cervical mucus penetration by human spermatozoa: lack of association with conception. AB - Penetration of bovine cervical mucus (BCMP) by human spermatozoa has been reported to be a test that may aid in assessment of male fertility. We determined the predictive value of BCMP for conception in 127 infertile couples. Fresh semen and swim-up specimens were tested with the Penetrak assay. Out of 127 patients 16 (13%) achieved pregnancy with 6 months to 2 years of follow-up. In the 62 men with sperm counts of greater than 20 million/ml and motility of greater than 60%, 55 (89%) had adequate BCMP while adequate penetration was found in only eight of 24 (33%) with both sperm count and motility below these values (p less than 0.001). A normal BCMP did not predict pregnancy, and a reduced BCMP had no prognostic value in designating couples not likely to conceive. The comparison of penetration values for semen following swim-up suggests that this preparation may improve the correlation of BCMP with fertility. These results indicate that the semen parameters of sperm density and percent motility predicted spermatozoal performance in the BCMP assay, and that the assessment of BCMP did not predict the likelihood of pregnancy. PMID- 2712640 TI - Absence of development of late steroidogenic lesions in rat testis during the end of fetal life. AB - In the rat during the last 4 days of fetal life, the production of testosterone by the testis does not increase, whereas the plasma level of biological LH-like activity rises sharply. The present study was designed to test whether this phenomenon is attributed to the development of defects in the activity of the enzyme 17 alpha-hydroxylase and C17,20-lyase (called late steroidogenic lesions) during the end of fetal life. As this occurrence would lead to an age-related decrease in the ratio testosterone/progesterone, the testicular productions of these two steroids were evaluated on 18.5, 20.5, and 21.5 days postconception. Three different measurements were performed: (a) the in vivo testicular contents; (b) the in vitro secretions during a 120-min incubation in the presence or in the absence of 100 ng/ml ovine LH; (c) the testicular contents after these incubations. These measurements never revealed a decrease in the ratio testosterone/progesterone as a function of fetal age. It would appear that late steroidogenic lesions do not develop during the end of fetal life in the rat. PMID- 2712641 TI - Lipid composition of human seminal plasma. AB - This study aims at determining the amounts of cholesterol, triglycerides, phospholipids, and nonesterified fatty acids in man's seminal liquid and determining their possible variations linked with the ways of taking and congealing samples. It concludes the determinations of lipids in human seminal liquid are reproducible; the way of taking samples has no real influence; however, it seems best to centrifuge sperm immediately after liquefaction to avoid use of triglycerides and NEFA by the spermatozoa. PMID- 2712642 TI - Effect of sperm washing and swim-up on antibodies bound to sperm membrane: use of immunobead/sperm cervical mucus contact tests. AB - The direct immunobead test (IBT) and the sperm cervical mucus contact (SCMC) test were used to evaluate the effect of sperm washes and swim-up on antibodies bound to the sperm membrane in 11 patients with autosperm antibodies (30-100% IgA and 30-100% IgG) but otherwise normal semen measurements. The tests were performed on semen samples before and after a wash/swim-up procedure in Ham F10 + 10% human blood serum. Sperm-bound antibodies in washed spermatozoa that were able to swim into a layer of medium did not differ from those in unwashed samples. The IBT and the SCMC test on unwashed and washed spermatozoa were also not significantly different. However, all other washed semen parameters were improved. Correct washing of semen samples is important when performing the IBT to prevent false negative results. Eight of the 11 partners (73%) of the patients tested became pregnant after treatment with washed sperm. The ongoing pregnancy rate was 64%. PMID- 2712643 TI - Sperm antibodies, semen quality, and male infertility. AB - Twelve couples who underwent infertility investigations at the Universitas Hospital in Bloemfontein were examined using several tests: postcoital (PCT), sperm-cervical-mucus-contact (SCMC-T), indirect immunobead (IBT), tray agglutination (TAT), and sperm-immobilization procedures (SIT). Two factors played a role during the immunologic evaluation of a couple: semen quality and the intensity of the antibody in the cervical mucus or seminal plasma. PMID- 2712644 TI - Blood serotonin levels and male infertility. AB - Seventy men, aged 20-40 years, who were attending an infertility clinic were studied to evaluate associations between seminal quality, whole blood serotonin, and serum testosterone levels. Men with blood serotonin levels greater than 100 ng/ml showed lower sperm counts and sperm motility than those with normal levels of blood serotonin (less than 90 ng/ml). Seminal volume, pH, sperm morphology, fructose, citric acid, and serum testosterone values were similar between groups of patients with different levels of blood serotonin. The levels of blood serotonin correlated best with sperm motility when using a cubic regression analysis. When blood serotonin increased from 50 to 90 ng/ml (normal range), there was an increase in the percentage of spermatozoa with excellent motility. However, when serotonin was above 90 ng/ml the percentage of sperm with excellent motility decreased. An inverse exponential relationship was observed between blood serotonin and sperm count. The sperm count reached values of oligozoospermia when blood serotonin was over 100 ng/ml. It would appear that blood serotonin in the normal range is important for sperm motility. Values of serotonin above the normal range could affect negatively both sperm count and motility. These effects were observed in the absence of changes in serum testosterone levels. PMID- 2712645 TI - Transient acrosomal hypoplasia of spermatozoa and male fertility. AB - Successful pregnancy was established despite previous demonstration of acrosomal hypoplasia. Although initial studies of sperm function and electron microscopic evaluation of the semen documented the presence of severe structural abnormalities, the condition proved to be transient in nature. PMID- 2712646 TI - Effect of methylene blue and cobaltous chloride on the alloxan-induced changes in collagen characteristics in the skin of garden lizard Calotes versicolor. AB - In the present study the effect of two chemicals such as methylene blue and CoCl2 on the accelerated ageing of collagen in alloxan-diabetic lizards has been tested. Both methylene blue and CoCl2 have been found to accelerate the ageing of collagen in normal lizards. While methylene blue enhanced the effects of alloxan in alloxanized lizards, CoCl2 tended to reverse it. It appears that methylene blue acts as a potentiator of alloxan; CoCl2, on the contrary, showed clear anti ageing effects. PMID- 2712647 TI - The basal nucleus of Meynert revised: the nerve cell number decreases with age. AB - There is an age-dependent nerve cell loss in some areas of the brain, while other brain regions are stable with aging. The nucleus basalis of Meynert (NbM) is believed to be the source of cholinergic innervation of the cerebral cortex, and loss of its neurons seems to be followed by cognitive deficits. The normal age kinetics of the NbM are, therefore, of considerable importance. Sixteen autoptic human brains were examined, ages ranging from 35th week of gestation to 90 years of age. Blocks containing the NbM in its entirety were cut into 20-mu thick serial sections; every 25th section was cresyl-violet stained and underwent morphometric analysis. Nerve cell counts were slightly but significantly higher in the right hemisphere. The total number of neurons in the 9th decade was 23% below that in newborns. This decrease was statistically significant. We hypothesize that there is a threshold number of nerve cells below which cognitive failure is highly probable. PMID- 2712648 TI - A new psychometric test of attention-related behavior in rats; its validity in the aging process. AB - The ability to distinguish relevance from irrelevance has been attributed to an attention-related mechanism and may be supposed to be disturbed in aging. The reaction to low electrical stimuli which causes neither pain nor escape behavior was investigated by means of a newly developed test in adult and aged rats. The animals' reaction was classified into two different responses depending on the intensity of the electrical stimuli. The first reaction related to sensitivity, the second reaction contained two components, an orienting response and a cognition-controlled type of discriminative behavior. There was no significant difference between the amperage values of the two reactions in adult rats. With respect to aged rats, the amperage values of both reactions are significantly increased as compared with the adult rats. The sensitivity reaction and the attention-related behaviors diverged considerably. These findings show very precisely that certain behavioral reactions may decline differently or even independently with age indicating different age-related changes in the underlying neuroanatomical systems of attention. The results demonstrate the sensitivity of the test used as a model for studying some types of attention-related mechanisms in the aging process. The use of a relatively simple test of animals' reactivity to sensory stimuli may reveal changes that are critical to understanding not only of the aging brain, but of different types of brain lesions and disorders, as well as of drug treatments. PMID- 2712649 TI - Postlabeling analysis of indigenous aromatic DNA adducts in mouse myocardium during aging. AB - The possible presence of aromatic chemicals covalently linked to DNA (aromatic adducts) was investigated in heart cells during aging of the C57BL/6Nia mouse. Heart DNAs were isolated from untreated mice of different ages and analyzed by 32P-postlabeling assays. To determine low levels of adducts, assays were carried out in which aromatic adducts were first isolated by phase transfer to 1-butanol, then labeled with excess, carrier-free [gamma-32P]ATP. This analysis showed that the number and frequency of aromatic adducts varied between DNA samples. Several adducts were present in all mouse DNA preparations and were more abundant in 32P maps of senescent heart DNA. The results suggest that genomes of myocytes have a higher steady-state level of DNA damage in old animals which could adversely affect cell function. PMID- 2712650 TI - Age-related changes of the mossy fibre system in rat hippocampus: effect of long term acetyl-L-carnitine treatment. AB - Age-related changes of the hippocampal mossy fibre system were studied in rats of different ages (4, 12, and 24 months) using the Timm's histochemical technique for the detection of tissue stores of zinc and heavy transitional metals. Quantitative image analysis and microdensitometry techniques were applied for the evaluation of the changes themselves. The area occupied by mossy fibres and the intensity of Timm's staining in field CA3 of hippocampus were greater in adult rats than in young and old animals. These findings are consistent with previous behavioural data indicating that young and old rats exhibited a reduced passive avoidance learning with respect to adult animals. The above techniques were also used in a second session of this study designed to investigate the effect of a 6 months treatment with acetyl-L-carnitine (ALC) on the hippocampal mossy fibre system. ALC was found to increase significantly the area occupied by mossy fibres and the intensity of Timm's staining in the hippocampus of old rats. These findings are in agreement with and support from an anatomical point of view, the data indicating that long-term treatment with ALC improves passive avoidance performance. PMID- 2712651 TI - Pharmacokinetics of triamterene in geriatric patients--influence of piretanide and hydrochlorothiazide. AB - Pharmacokinetics of triamterene (single oral dose of 50 mg) and its pharmacologically active metabolite (OH-TA-ester) were determined in 20 geriatric patients with multiple diseases. Mean peak concentration of triamterene was increased in the elderly patients compared with the data of young healthy volunteers. Coadministration of piretanide seems to lower the mean plasma concentration (AUC) and the mean concentration after 24 h of triamterene as compared with the coadministration of hydrochlorothiazide. PMID- 2712652 TI - Measuring outcome after discharge from hospital for the elderly--a conceptual and empirical investigation. AB - Despite the fact that the elderly are a major client group of the hospital service, there has been comparatively little investigation of outcome for this client group after discharge. In this paper the difficulties in recording outcome for the elderly are discussed, using the example of a survey based in Wales. A 4% random sample of patients aged 65 years and over discharged from NHS non psychiatric hospitals in Wales during 1981 were sent a postal questionnaire 3 months after discharge. Response rates of over 80% were achieved. Outcome after discharge was measured by 3 indices: mortality, physical disability, and patients' own assessments of their health status and rehabilitation. Of survivors, 35% were more disabled than before admission, and 43% did not feel that they were fully rehabilitated. All measures of outcome were strongly inter correlated and demonstrate a clear trend to deteriorate with increased time after discharge. Interpretation of these results remains difficult until measures of cost and benefit are developed. Without these it is not possible to determine if the results reported are better (or worse) than would be expected given the level of resources involved. PMID- 2712653 TI - [The extremely premature infant: what is the future, at what price?]. PMID- 2712654 TI - [Is the dilution of milk necessary in benign acute diarrhea in eutrophic infants?]. AB - Early feeding is generally recommended for children with acute diarrhea. The concentration at which the milk should be given to children weaned at an early age remains a matter of debate. The aim of the study was therefore to evaluate the role of milk dilution in the first 24 hours on the outcome of diarrhea. Sixty nine well nourished and weaned children, aged 1 to 9 months and with moderate watery acute diarrhea were included after oral rehydration therapy (ORT) in a randomised controlled study to receive either half-strength (diluted group) or full strength (undiluted group) milk. Both groups displayed the same clinical characteristics except for the weight. The outcome of the diarrhea until cessation was the same in the 2 groups. No failure requiring a specific treatment was observed. The duration of diarrhea and the total stool output were not statistically different in the 2 groups, i.e. 39 +/- 7 hrs in diluted vs 47 +/- 8 in undiluted, and 883 +/- 205 g in diluted vs 924 +/- 161 g in undiluted. These results are strengthened by the lack of significant differences in the weight gain, the number and volume of vomiting, the volume of ORT and milk intake. However, the energy intake was significantly higher in the group receiving full strength milk. These results suggest that there is no immediate clinical advantage to dilute the milk in the first 24 hours of feeding well nourished children with moderate acute watery diarrhea, if early feeding is associated with the ORT recommended by the WHO. PMID- 2712655 TI - [Severe Epstein-Barr virus infection in an infant]. AB - A 11 month-old boy, without any informative familial pedigree, was admitted for peritonitis after intestinal perforation, associated with signs of pseudolymphoma and histiocytic activation. He developed later unexplained gastrointestinal bleeding and interstitial pneumonitis, which spontaneously improved. All infectious and immunologic studies were negative. Epstein-Barr Virus was found in throat, lungs and blood, whereas the specific antibodies production was delayed. No abnormality was detected 18 months later, except for a disappearance of vaccinal antibodies. PMID- 2712656 TI - [Portal system obstruction of delayed onset following neonatal Staphylococcus aureus infection]. AB - Two neonates underwent staphylococcal septicemia with multiple intrahepatic abscesses, following umbilical catheterization in one case and due to superinfected heel puncture in the other case. At the first examination, liver ultrasonography showed multiple hypoechogenic areas and assessed patency of the portal vein flow. In spite of clinical, biological and sonographic recovery within the following weeks, portal hypertension due to seemingly late portal vein thrombosis occurred. These clinical reports indicate the need for a protracted echosonographic supervision of neonatal intrahepatic abscesses and portal vein patency before asserting complete recovery. PMID- 2712657 TI - [Dyslexia and karyotype]. PMID- 2712658 TI - [Viral serologies in rheumatoid purpura]. PMID- 2712659 TI - [The ear, predicate of rhombencephalon? An undemonstrated hypothesis]. PMID- 2712660 TI - The cholinergic rapid eye movement sleep induction test with RS-86. State or trait marker of depression? AB - Rapid eye movement (REM) sleep disinhibition at the beginning of the night is one of the most frequently described biologic abnormalities in depression. As REM sleep in animals and humans seems to be facilitated by cholinergic neuronal activity, it has been postulated that REM sleep disinhibition in depression is a consequence of cholinergic neuronal overactivity. The current study with the newly available cholinergic agonist RS-86, which is orally active, has a half life of six to eight hours, and exhibits only minor peripheral side effects, supports this assumption. The application of this compound before sleep led to a significantly faster induction of REM sleep at the beginning of the night in patients with major depressive disorders compared with healthy subjects and patients with other nondepressive psychiatric diseases, such as eating disorders. Whereas 14 of 16 depressed patients displayed sleep-onset REM periods after the administration of RS-86, this happened only in three of the 16 healthy controls and in one of the 20 patients with other diagnoses. The increased susceptibility of REM sleep to cholinergic stimulation was limited to the state of depression and was not observed in a group of remitted depressed patients. PMID- 2712661 TI - Possible subtypes of affective disorder suggested by differences in cerebral laterality and testosterone. A preliminary report. AB - Two language-related dichotic listening tests of cerebral laterality were used to divide a group of 18 hospitalized patients with affective disorder into two subgroups of nine. The groups proved to differ in serum testosterone levels at the time of admission and in mean serum testosterone levels throughout hospitalization. Moreover, there was a positive correlation between testosterone level and symptom severity in one of the laterality-defined subgroups and a negative correlation in the other. These data (1) provide new evidence of pathophysiological heterogeneity within a single general diagnostic group; (2) suggest that noninvasive, inexpensive, and easily administered dichotic listening tests may be able to define pathophysiologically meaningful subgroups; and (3) suggest a role for testosterone-related alterations in left hemisphere function in the pathogeneses of some affective disorders. PMID- 2712662 TI - Recall and dating of psychiatric symptoms. Test-retest reliability of time related symptom questions in a standardized psychiatric interview. AB - The advent of more explicit diagnostic criteria and the growing interest in "lifetime" rates of mental disorders has made imperative an accurate determination of time-related diagnostic criteria. We used data from two independent test-retest studies of the Diagnostic Interview Schedule (DIS) and the Composite International Diagnostic Interview (CIDI) to study the reliability of different time-related questions in these fully standardized diagnostic interviews. With two exceptions (anxiety disorders and alcohol-related questions), the test-retest reliability of most time-related questions in both interviews was judged to be satisfactorily high. Furthermore, the validity of time-related questions in the DIS (age at symptom onset, duration and frequency of illness episodes) was examined by comparing them with detailed "consensus" ratings done independently by different clinicians for 207 former psychiatric inpatients. A surprisingly high concordance was found for former psychotic patients except for those still severely disturbed at the follow-up investigation. Some severe restrictions were also found for nonpsychotic disorders with regard to judgment of the age at onset of phobias, panic attacks, and depression. For a more valid assessment of time-related symptom information, the use of specific memory aids is suggested. PMID- 2712663 TI - An empirical study of defense mechanisms. I. Clinical interview and life vignette ratings. AB - The Defense Mechanism Rating Scales (DMRS) measure the use of defense mechanisms based on clinical interview or life vignette data. Using nonprofessional raters observing videotaped psychodynamic interviews of individuals with personality and affective disorders, the median intraclass interrater reliability (IR) of the defense scales was .36 but was .57 for group consensus ratings and .74 when related defenses were grouped into defense summary scales. When follow-up data on life vignettes were rated, the median interrater IR was .55 for those defenses occurring at least 5% of the time and .66 for the defense summary scales. In relation to follow-up data, so-called immature defenses (denial, projection, acting out, hypochondriasis, passive-aggression) were associated with higher levels of symptoms, poorer global functioning, and higher proportion of time impaired in psychosocial role functioning. Borderline defenses (splitting, projective identification) displayed a similar pattern. Among narcissistic and neurotic defenses, only devaluation was associated with poorer functioning, whereas intellectualization was associated with higher functioning. Finally, action and borderline defenses demonstrated significant correlations across methods and across time (video vs life vignettes), whereas obsessional, disavowal, and narcissistic defenses showed nonsignificant trends. Overall, these results support the model of a hierarchy of defenses. PMID- 2712664 TI - Limitations of the ratio of concordance rates in monozygotic and dizygotic twins. PMID- 2712665 TI - A single dominant gene still cannot account for the transmission of schizophrenia. PMID- 2712666 TI - High rates of chronicity and rapidity of relapse in patients with bulimia nervosa and depression. PMID- 2712667 TI - Rating weight loss on the Hamilton Depression Rating Scale. PMID- 2712668 TI - Epithelioid germinal centers. PMID- 2712669 TI - Histologic manifestations of perinatal genital mycoplasmal infection. AB - Genital mycoplasmas are controversial gynecologic and obstetric pathogens; their role in perinatal morbidity and mortality is ill defined. This retrospective study was conducted to identify autopsy manifestations of perinatal genital mycoplasmal infection. Bacterial and mycoplasmal cultures were obtained from multiple organ sites, along with detailed clinical, autopsy, and histologic information. All materials were screened by two pathologists. Twenty-nine cases were included in the study. In 17 only a genital mycoplasma was isolated, and in 12 cases a genital mycoplasma plus another bacterial pathogen were identified. Significant histologic findings included subpericardial and pleural hemorrhages, polymorphonuclear leukocytes in alveolar spaces, hemorrhage, and tubulocytic changes in the adrenal glands. The placentas revealed villous edema, deciduitis, and funicitis. The changes identified as significant suggest that mycoplasmas either cause hypoxia or promote histologic changes that mimick hypoxia. PMID- 2712670 TI - Absence of Campylobacter-like organisms in Barrett's esophagus. AB - Barrett's esophagus is a chronic condition in which the normal squamous mucosal lining is replaced by columnar mucosa. Campylobacter-like organism (CLOs) are implicated in the pathogenesis of gastritis and peptic ulcer disease and have been identified in Barrett's esophagus. The purpose of this study was to examine the incidence of CLOs in Barrett's esophagus and to consider their role, if any, in the pathogenesis of the disease. None of the bacteria were identified in 38 specimens obtained from 34 patients with Barrett's esophagus. It is concluded that the incidence of CLOs in Barrett's esophagus must be low and that CLOs do not contribute to the natural history of the disease. PMID- 2712671 TI - Organ-specific variation in the morphology of the fungomas (fungus balls) of Pseudallescheria boydii. Development within necrotic host tissue. AB - Pseudallescheria boydii is an increasingly important cause of infection in debilitated and immunocompromised persons. It is frequently found within pulmonary cavities, where it forms matted collections of fungal hyphae, variously termed fungus balls, fungomas, or pseudallescheriomas. This report describes the unusual occurrence of pseudallescheriomas in the lungs, brain, and kidney. The morphological features of the fungomas varied between involved organs, with those in the lung showing well-defined layers of peripheral mycelial hypocellularity and hypercellularity consisting of anneloconidiophores and conidia. The fungomas in all organs were derived from necrotic host tissue, which resulted from nodular infarction due to fungal invasion and thrombosis of blood vessels. I believe that some previous cases of Pseudallescheria pulmonary fungomas that were ascribed to passive colonization of preformed lung cavitations may have been due to frankly invasive mycotic disease. PMID- 2712672 TI - Fat embolism in acute pancreatitis. AB - A patient who developed progressive hypoxemia and multiple system failure during the course of acute pancreatitis is described. Autopsy showed fat emboli to the lungs, kidneys, and heart, as well as multiple petechial hemorrhages in the brain. We conclude that fat embolism should be considered in the differential diagnosis of progressive hypoxemia in patients with acute pancreatitis. PMID- 2712673 TI - Tubulovenous communication in myeloma kidney. Tubular prolapse and tubular transformation of renal vein. AB - We studied renal histopathologic findings of 20 autopsy cases with multiple myeloma with particular attention to structural tubulovenous relationship. Urinary deposition in renal vein or lymphatics, which has been previously noted in pyelonephritis, obstructive uropathy, or vesicoureteral reflux was found in 14 cases. Four of 14 cases had unique tubulovenous communications designated as tubular prolase and tubular transformation of vein. Such communications were most frequently seen at the architectural weak point where the thin-walled interlobar vein and their tributaries adjoin the renal pyramid. Simultaneously, Tamm Horsfall protein used as a marker for the location of urine was detected in renal vein. These changes had no significant correlation to morphologic severity of myeloma kidney or clinical manifestations of renal failure. Thus, tubulovenous communication producing backflow of urine into the circulation is frequently observed among myeloma kidney as well as other tubulointerstitial nephritis, but its clinical significance is unclear. PMID- 2712674 TI - Simultaneous acute thrombosis of two major coronary arteries following intravenous cocaine use. AB - Myocardial infarction is now a well-recognized complication of cocaine abuse. This report describes a 38-year-old man who sustained simultaneous acute thrombosis of two major epicardial coronary arteries shortly after intravenous cocaine use. The finding of layers of mural thrombus of varying age, from acute to two to three days, in both coronary arteries represents a previously unreported finding (to our knowledge) in cocaine-associated cardiac death. Potential mechanisms for the association between cocaine use and infarction and the cardiac pathologic findings in cocaine-associated death are discussed. PMID- 2712675 TI - Value of assessment of ploidy in rectal cancers. AB - Flow cytometry was performed on available archival material from 232 patients with rectal cancer enrolled in the National Surgical Adjuvant Breast and Bowel Project protocol R-01. Tumor ploidy was not found to be significantly related to such pathologic and clinical parameters as Dukes' stage; nodal status; nuclear or histologic grades; patient's age, sex, or overall survival rate with an average study time of 79 months. A trend was evident that patients with poor histologic grade, or those with Dukes' B and C tumors that were aneuploid fared worse than those with diploid cancers. However, measurements of survival were found to be more strongly and consistently related to such conventional prognostic parameters as tumor differentiation, Dukes' stage, and nodal status. Further, numbers of nodes with metastases (ie, 1 to 4 or 5+) more significantly discriminated Dukes' C cases than estimation of tumor ploidy. Although tumor ploidy may reflect some features of rectal cancers, their natural history and prognosis are explained better by assessment of conventional parameters used for these purposes. PMID- 2712676 TI - Passively acquired antibody to hepatitis B surface antigen. Pitfall in evaluating immunity to hepatitis B viral infections. AB - Antibody to hepatitis B surface antigen (anti-HBs) has been used clinically to indicate an immune response to hepatitis B virus (HBV) and a protection against reinfection with the virus. We describe a child with hemophilia who had high titer IgG anti-HBs in his serum and who subsequently developed viral B hepatitis. The child had received a unit of fresh frozen plasma 17 days prior to the determination of anti-HBs. The fresh frozen plasma donor was later found to be anti-HBs positive. The patient's anti-HBs was most likely passively acquired and therefore did not signify immunity to HBV. Various tests, including hepatitis B surface antigen group-specific and subtype determinants, ratio units of anti-HBs, and antibody class, have been used to determine whether or not anti-HBs will confer immunity. Although these tests have been thought to accurately predict immune status against infection with HBV, our case shows this may not be true, especially in patients who have been recently transfused. Anti-HBs testing may be predictive of immunity to HBV in the absence of a source of passively acquired anti-HBs. PMID- 2712677 TI - Human immunodeficiency virus-associated large-cell immunoblastic lymphoma presenting as a perianal abscess. AB - We report a case of perianal non-Hodgkin's lymphoma that presented as a perianal abscess in an otherwise asymptomatic intravenous drug abuser who tested positively for human immunodeficiency virus infection. Extranodal lymphoma of the anal canal is a very rare event, which has recently been described in homosexual men with the acquired immunodeficiency syndrome. This is the first report, to our knowledge, of perianal lymphoma occurring in a nonhomosexual patient with the acquired immunodeficiency syndrome. PMID- 2712678 TI - Complete heart block in the 18p--syndrome. Congenital calcification of the atrioventricular node. AB - Complete heart block exists when the atria and ventricles beat completely independently of each other. It is heterogeneous with respect to pathogenesis. Occasionally, complete heart block may be symptomatic in infancy. Rarely, it is associated with genetic syndromes. Cardiac abnormalities are unusual in the 18p syndrome. We describe a female stillborn infant who had 18p-syndrome with hydrops fetalis and complete heart block secondary to atrioventricular node calcification. PMID- 2712679 TI - Amyloid goiter with hypothyroidism. AB - Whereas the microscopic infiltration of the thyroid by amyloid is a common phenomenon, significant enlargement of the gland due to the deposition of amyloid is infrequent. Amyloid goiter usually occurs as one of the unusual manifestations of systemic amyloidosis. The rapid growth associated with local pressure symptoms often suggests malignancy. In spite of the extensive infiltration of the gland by amyloid, thyroid function usually remains euthyroid. We have recently observed an unusual case of multicentric giant lymph node hyperplasia in a patient who developed amyloid goiter with hypothyroidism. The amyloid material was of AA type. PMID- 2712680 TI - Solitary spindle cell tumor with myoid differentiation of the lymph node. AB - Spindle cell tumors arising in the lymph nodes are very rare. We report the light microscopic, histochemical, immunohistochemical, and ultrastructural findings of an unusual solitary spindle cell tumor in a peripheral lymph node of a 45-year old woman. Microscopically, the tumor was characterized by interlacing fascicles of uniform spindle cells with nuclear palisading and formation of Verocay bodies. Numerous erythrocytes were found interstitially. There were no mitotic figures or significant nuclear atypia. The ultrastructural findings of abundant myofilaments with dense bodies indicated myoid differentiation. The clinical and pathologic findings favored this being a benign tumor and could represent a unique example of "intranodal myofibroblastoma." The differential diagnosis includes neurilemoma, leiomyoma, and, more importantly, leiomyosarcoma, Kaposi's sarcoma, and other metastatic spindle cell tumors. PMID- 2712681 TI - Penile and finger sensory thresholds in young, aging, and diabetic males. AB - To investigate the possible role of sensory function in conditions affecting sexual function, sensory thresholds were compared between young healthy men (n = 14, means age = 29.8), aging men (n = 15, means age = 67.3), and men suffering from diabetic impotence (n = 15, means age = 45.0). Using the psychophysical method of forced choice, vibrotactile and electrical stimulation thresholds were deterlmined in two separate sessions at two body sites: the fingertip and the ventral surface of the penis, just proximal to the glans. Vibrotactile penile thresholds (VTP) were lowest for young (Y) subjects and much higher for both aging (A) and diabetic (D) subjects. Electrical stimulation of the penis (ESP) showed the same trends, although the differences only approached significance (p = 0.06). The vibrotactile finger threshold (VTF) was significantly higher for A subjects as compared with Y and D subjects, but there was no difference between the Y and D groups. Diabetic patients had significantly higher thresholds for electrical stimulation of the finger (ESF), in contrast to the VTF finding. Finger thresholds were significantly lower than penile thresholds for all groups, and the change in threshold from finger to penis was greater in both aging and diabetic than in young subjects. Age was positively correlated with thresholds for ESF, ESP, VTF, and marginally for VTP when all three groups were analyzed together. However, in general the results of threshold determinations could not be attributed merely to age. Based on a detailed questionnaire of sexuality, VTP was negatively correlated with sexual activity and both ESP and VTP were negatively correlated with erectile capacity. The data are consistent with a genital sensory role for age-related and diabetic changes in sexual function. PMID- 2712682 TI - The socialization of homosexuality and heterosexuality in a non-Western society. AB - Data on the Sambia--a tribe living in Papua New Guinea--are presented to demonstrate how Sambia males develop a homosexual orientation in boyhood and adolescence, then switch to become heterosexuals in adulthood. Social learning theory is used to explain how sexual orientation in the Sambia change from homo- to heterosexual during the transition to adulthood. Whereas most learning analyses of sexual orientation are based on data from Western cultures, this manuscript extends that literature to deal with a non-Western culture. While including Pavlovian and operant conditioning, which is stressed in many learning analyses of sexual learning, the present analysis also includes detail on the social and cognitive learning principles that are important in understanding the learning of sexual orientation and behavior. PMID- 2712683 TI - Commentary to "The socialization of homosexuality and heterosexuality in a non Western society. PMID- 2712684 TI - Power in college students' contraceptive decisions. AB - Excluding Hollerbach (1980), previous fertility researchers have paid little attention to contraceptive power bases, relationships that become the source of changes in birth control values and behavior. Eight contraceptive power bases, each evaluated as a direct or obvious strategy, were identified in a pilot study involving 25 college students as participants and 10 undergraduate raters. Two hundred college students completed a questionnaire which included the Bem Sex Role Inventory, inquired into their sexual and contraceptive behavior, and asked about contraceptive power bases. There were highly significant main effects for both students' personal experiences with contraceptive power bases and for their opinions about the comfort and effectiveness of same. Coercion was the most popular and legitimate power was the least popular power base. Women were more likely than men to be the targets of contraceptive power bases, the majority of which were stereotyped as feminine by women in particular. Sex role identification was unrelated to students' experiences with contraceptive power bases. The implications of these findings for family-planning researchers and practioners are addressed. PMID- 2712685 TI - Sexual satisfaction in marriage as a function of life meaning. AB - Previous research has demonstrated that male and female who are self-actualized and have a purpose in life tend to have satisfying sex lives. However, some research has suggested that self-actualized male partners tend to have dissatisfied female partners due to high levels of egocentricity in self actualized males. Two alternative approaches to assessing meaning in life were utilized to further test this hypothesis. Forty-eight married couples were administered the Purpose in Life Test (PIL), Personal Orientation Inventory (POI), Selfism Scale, Sexual Interaction Inventory (SII), and Crowne-Marlowe Social Desirability Scale. The findings show that persons high on PIL and POI scores reported higher levels of sexual enjoyment. Egocentricity was positively correlated with dissatisfaction, however this result was significant for females but not males. Although no relationship was found between personality factors in the female spouse and male enjoyment, male self-actualization, but not egocentricity, was indicative of female dissatisfaction. These results are discussed in light of existing theory and research. PMID- 2712686 TI - Transvestites' women revisited: a nonpatient sample. AB - Data obtained from seven female partners of nonpatient transvestites are presented. None were receiving psychiatric treatment. The group was self assembled and affiliated with a cross-dressing social organization. The sample was divided into Acceptors and Rejectors based on the degree of acceptance of their mate's cross-dressing activities. Mean relationship duration was 9.9 years. None were traumatized by accidental discovery of their mate's transvestism. Childhood loss of parent(s), substance abuse, and divorce were rare. None had had homosexual experiences. Four of seven transvestite mates were reported by their partners to have gender dysphoric symptoms at some point in their lives. All of the couples' children (two male, three female) knew of their father's transvestism by direct observation at young ages; sons from two different families were noted to cross-dress spontaneously. PMID- 2712687 TI - The effect of chronological and theoretical birth order on sexual attitudes and behaviors. AB - A survey designed to evaluate the impact that both chronological and theoretical birth order may have on sexual attitudes and behaviors was completed by 441 respondents (221 male, 220 female). The attitudes and behaviors investigated were aggressive sexual behavior, social relationship attitudes, emotional relationship attitudes, total heterosexual behavior, and total orgasmic behavior. The data revealed no difference between male and female in terms of total sexual behavior. However, males had significantly higher sexual aggression, social attitudes, emotional attitudes, and total orgasm scores. These results suggest that while there may be equity between the sexes in terms of heterosexual behavior, there are still significant differences between the sexes in terms of specific behaviors and attitudes. No differences were found on any of the scales based on either chronological or theoretical birth order. These results suggest that sexual behavior and attitudes may be influenced to a greater degree by biological and cohort factors than by sibling position. PMID- 2712689 TI - Sexual language usage in different interpersonal contexts: a comparison of gender and sexual orientation. AB - Previous investigators have demonstrated that gender differences exist in the use of sexual language in various interpersonal contexts. However, sexual orientation has not been addressed in any study regarding sexual language usage. This investigation examined the use of sexual language for female and male in different interpersonal contexts based upon sexual orientation. Respondents were 440 university students: 202 heterosexual female, 30 lesbian, 173 heterosexual male, and 35 gay male. Findings indicate that differences in sexual language usage in interpersonal contexts is significant for gender as well as for sexual orientation. Conjecture is made for the implications this may have on intimate relationships. PMID- 2712688 TI - An evaluation of the Minnesota Multiphasic Personality Inventory as a discriminator of primary organic and primary psychogenic impotence in diabetic males. AB - The ability of the MMPI to discriminate between primary psychogenic impotence and primary organic impotence in males with diabetes mellitus was assessed. In order to provide the MMPI with the optimal situation to discriminate between the two groups, we attempted to form a homogeneous sample in terms of physical conditions. Thirty impotent diabetic males were classified as primary organic or primary psychogenic based on nocturnal penile tumescence data. Beutler et al.'s MMPI decision rules yielded a 63% misclassification of the two groups. Possible explanations for the lack of discriminative power of the MMPI with this sample of diabetic males were discussed in relation to previous findings. The power of nocturnal penile tumescence to classify men as having primary organic or primary psychogenic impotence was examined with reference to other vascular and endocrine variables. PMID- 2712690 TI - Effects of adequacy of gender reassignment surgery on psychological adjustment: a follow-up of fourteen male-to-female patients. AB - The relationship between the adequacy of surgical result and postoperative psychopathology was examined in 14 male-to-female transsexuals selected for the absence of preoperative psychopathology. Data indicated that the best predictors of postoperative psychopathology as rated on Hunt and Hampson's (1980) Standardized Rating Format were breast scarring, erectile urethral meatus, current social supports, family reaction, urinary incontinence, and need for extra surgery. Together, these accounted for 98% of the variance in postoperative psychopathology. These data suggest that factors which make it difficult for postoperative transsexuals to "pass" or which continue to remind them of their gender-reassigned status are associated with adjustment difficulties. Surgical results may be a major determinant of postoperative psychopathology. PMID- 2712691 TI - Homosexuality in families of boys with early effeminate behavior: an epidemiological study. AB - In the course of a long-term study of 55 boys with early effeminate (cross gender) behavior an effort was also made to ascertain the presence of sexual deviance in their parents, siblings, uncles, and aunts. For most of these groups of relatives, only one to three members in each group were found to be homosexual, equaling 4% male and 1% female for the total test population. Compared to similar studies, the results were not too different except in the case of the siblings of one study where the incidence was much higher. Some evidence is considered for the speculation of a nongenetic, congenital cause of homosexuality. PMID- 2712692 TI - The preparedness of freshman medical students for taking sexual histories. AB - With recent epidemics of sexually transmitted diseases, it is increasingly important for medical students to be well prepared to take sexual histories. The authors studied this issue through a self-administered questionnaire completed by first-year medical students at two western U.S. medical schools (response rate 87%). Students who were better prepared (i.e., more knowledgeable, more comfortable, more appropriate attitudes) had more personal sexual experience and were more likely to have spoken with either a physician or a patient about a personal sexual concern. Different student characteristics were associated with different domains of preparation for taking a sexual history (e.g., knowledge v.s. attitudes). The educational implications of these findings are discussed. PMID- 2712693 TI - Vaginal sensitivity to electric stimuli: theoretical and practical implications. AB - Vaginal sensitivity was investigated in a group of 60 volunteers by means of an electric stimulus and under nonerotic conditions. In comparison to the dorsum of the hand, the genital area has a low sensitivity for electric stimuli (p less than 0.001). Of the genital area, the vaginal wall measured 2 to 4 cm from the vaginal introitus was found to be very insensitive (p less than 0.05). Within the vaginal wall a relatively sensitive position to electric stimuli could be detected at the "12-hr position" (the anterior vaginal wall) (p less than 0.001). The study provides data underscoring previous anatomical and clinical research findings regarding the sensitivity of the anterior vaginal wall. The inefficiency of coitus for inducing female orgasm is discussed. PMID- 2712694 TI - Resistance to treatment of adolescent sex offenders. AB - Little information is available concerning adolescent sexual offenders and their response to treatment. Of 45 sex offenders treated in two studies, 6 were adolescents and 21 of the 39 adults reported that their deviant behavior had commenced before or during adolescence. All 6 adolescents presented for treatment only following detection of their offenses, which in 3 led to legal charges. Of the 39 adults, 12 sought treatment voluntarily. Subjects were randomly allocated to receive covert sensitization, imaginal desensitization, medroxyprogesterone, or imaginal desensitization plus medroxyprogesterone. The response of the adults was equivalent to the best reported in the literature. Seven of the 39 required additional treatment, 3 being charged for further sexual offenses. Four of the 6 adolescents required additional treatment, 3 being charged with further sexual offenses. These differences were statistically significant. Adolescent sexual offenders may be more resistant to treatment because their sexual urges are under more direct hormonal control whereas in adults sexual urges are in part under the control of behavior completion mechanisms. Sexual offenses in adolescence need to be considered as at least as significant as those of adults, and more intensive follow-up treatment appears indicated in their management. PMID- 2712695 TI - Papers read before the 69th annual meeting of the New England Surgical Society. Montreal, Canada, Sept 15 to Sept 17, 1988. PMID- 2712696 TI - Tamoxifen as an alternative to surgical resection for selected geriatric patients with primary breast cancer. AB - Thirty elderly patients with primary operable breast cancer were treated initially, because of refusal of surgery or because of infirmity, only with the antiestrogen tamoxifen citrate. Nineteen patients had regression of the primary tumor (complete in five and partial in 14). Eight patients were stable with no change, and three had measurable increases in the size of their primary tumors. Nine of the 30 eventually required locoregional treatment with surgery or radiotherapy for progression or recrudescence of their tumors after initial regression. No patient developed uncontrollable locoregional disease. For selected geriatric patients, treatment with tamoxifen alone permits a delay of surgery, which for some exceeds life expectancy. PMID- 2712697 TI - Liver abscess. The need for complete gastrointestinal evaluation. AB - The cause of liver abscess is frequently obscure at initial presentation. We reviewed the medical records of 20 patients with pyogenic liver abscess over a 6 year period from 1981 to 1987. Liver abscess was suspected in only 3 patients on admission; the most common initial diagnosis was fever of unknown origin. Subsequently, the origin of the abscess was found to be intestinal in 7 patients, pancreatobiliary in 11 patients, and cryptogenic in 2 patients. Eleven patients underwent percutaneous transhepatic drainage of the abscess as the initial treatment, while open operation was the initial treatment in 9 patients. Percutaneous transhepatic drainage was ultimately successful in only 4 patients (36%). In the absence of an obvious pathologic condition of the biliary tract, all patients should undergo full gastrointestinal evaluation. PMID- 2712698 TI - Intrapleural regional analgesia for pain management in cholecystectomy. AB - Fifty patients undergoing cholecystectomy either electively or urgently were treated in the postoperative period with the intrapleural injection of 30 mL of 0.75% bupivacaine hydrochloride with epinephrine (1:200,000). The frequency of narcotic administration and the postoperative stay were compared with those of 50 historical controls. The group receiving intrapleural regional analgesia had significant, prolonged pain relief requiring minimal narcotic analgesics in the first 24 hours postoperatively and had a significantly shortened hospital stay. There were no complications related to catheter insertion or bupivacaine toxic effects. This technique is safe and effective in controlling perioperative pain. PMID- 2712699 TI - Management of pancreatic fistulas. AB - Conservative management of pancreatic fistulas resulting from trauma, operation for tumor, or operation for pancreatitis has met with variable success. To assess optimal management strategies and outcome, we reviewed the records of 35 patients with external pancreatic fistulas (26 patients), pancreatic ascites (6 patients), or pancreatic pleural effusion (3 patients). Treatment included no operation in 5 patients, oversewing of the fistula in 7 patients, internal drainage in 11 patients, and resection in 12 patients. One (3%) postoperative death occurred. The overall rate of operative success was 83% (25 patients). The incidence of recurrent fistulas was about the same regardless of the procedure. Patients treated successfully without operation did not have pancreatitis as an underlying disease. Patient selection is of great importance in the decision to resect or to drain and is based in part on imaging the pancreatic duct and fistula. PMID- 2712700 TI - Selective nonoperative management of blunt splenic trauma in adults. AB - The use of selective nonoperative management of blunt splenic trauma in adults is based on the undeniable benefits of this approach in children. Proper patient selection requires hemodynamic stability, lack of generalized peritoneal irritation, and minimal blood transfusion needs. Computed tomography is now used to make the diagnosis, but the decision for laparotomy is based on clinical grounds. Forty-one (87%) of 47 patients selected for nonoperative management were treated successfully without laparotomy, while the remaining 6 patients underwent delayed operations for persistent splenic bleeding. Blood transfusion requirements were significantly less in the observed group than in the operative group for patients with isolated trauma and for patients with polytrauma. There were no known missed intra-abdominal injuries and no deaths with the nonoperative approach. Analysis of our results has confirmed that nonoperative management is a safe and effective alternative to immediate laparotomy in properly selected patients and it can result in splenic salvage without the need for an operation. PMID- 2712701 TI - Progress in experimental porcine small-bowel transplantation. AB - Studies in large animals are needed to overcome technical complications, allograft rejection, and graft-vs-host disease, which are major problems that prevent clinical application of small-bowel transplantation. The small bowel was allografted heterotopically or orthotopically into 30 pigs with the use of cyclosporine, prednisone, and azathioprine. When cyclosporine was given orally to heterotopically transplantation recipients, rejection was frequent, and graft-vs host disease caused one death. After 30 days of intravenous cyclosporine followed by oral administration, no rejection occurred. Graft-vs-host disease was mild or absent, and there were some long-term survivors. Technical failures were relatively infrequent, but death from sepsis, eg, intra-abdominal abscess, occurred in 17% (5/30). Anastomoses of donor superior mesenteric vein to recipient portal vein offered no advantages over systemic venous drainage. Although the high cyclosporine levels used would be intolerable in humans, these results indicate that successful small-bowel transplantation can be achieved with adequate immunosuppression in a large animal. PMID- 2712702 TI - Routine intraoperative angioscopy in lower extremity revascularization. AB - The inability to see through blood remains the main obstacle to the widespread and routine use of angioscopy. Local irrigation with a balanced salt solution is presently the most widely used method to clear the blood. By applying basic principles of irrigation and using a unique, dedicated, irrigation pump, we found that routine angioscopy during lower extremity revascularization that yields consistent high-quality studies is feasible, clinically useful, and safe. Between May 1, 1987, and July 31, 1988, 136 intraoperative angioscopies were performed during 112 peripheral bypass procedures, 15 thrombectomies, 2 embolectomies, and 7 miscellaneous revascularization procedures. Mean total irrigation fluid used in the peripheral bypasses was 398 mL (range, 0 to 1400 mL). Good visual quality was obtained in more than 80% of angioscopies and the failure rate was only 1.8%. On the basis of the findings in 71 of the 136 angioscopies, 78 clinical or surgical decisions were made. No complications were directly attributable to the insertion of the angioscope or use of the pump. PMID- 2712703 TI - Limb salvage despite extensive tissue loss. Free tissue transfer combined with distal revascularization. AB - Extensive lower-extremity tissue loss may preclude limb salvage despite successful arterial reconstruction. We attempted to avoid limb loss in such patients by combining arterial bypass with microvascular free tissue transfer. Fourteen patient (12 diabetic), 33 to 74 years of age, presented with extensive tissue loss in 15 lower extremities, exposing bone or tendon on the heel, ankle, lower part of the leg, or hindfoot. Mean ulcer size was 5 X 8 cm. Four patients had had previous contralateral below-knee amputations. Femorodistal (seven), popliteal-distal (three), or femoropopliteal (four) bypass, or tibial angioplasty (one), was performed to provide sufficient inflow for free tissue transfer. Serratus anterior, scapular, latissimus dorsi, rectus abdominis, gracilis, ulnar, or temporalis free flaps were used. One free flap failed due to venous thrombosis and was corrected with a second flap. Limb salvage was achieved in 14 (93%) of 15 limbs during a mean follow-up of 24 months. The single amputation occurred due to severe foot ischemia in a patient whose femorodistal bypass remained patent only to the viable free flap. The remaining 13 patients (14 limbs) became ambulatory, including those with free flaps to weight-bearing regions. PMID- 2712704 TI - Recent experience with thoracoabdominal aneurysm repair. AB - Thoracoabdominal aneurysm repair was carried out in 55 patients during the period from January 1978 to June 1988. Considering the volume of experience and application of a routine for preoperative and intraoperative management, the experience was divided as follows: group 1 1978 to 1985 (26 patients) and group 2 1985 to 1988 (29 patients). Clinical features of the two groups differed only in the incidence of emergency operations (group 1 [6/18, 30%] vs group 2 [2/29, 8%]). Operative mortality in elective operations improved substantially in recent experience (group 1 [50%] vs group 2 [7.4%]). Significant reductions in total operative time, operative blood loss, and total aortic cross-clamping times paralleled and, in part, explained the improvement in overall surgical results seen in group 2 patients. Spinal cord injury occurred in 7.2% of the entire cohort. Nonfatal but major complications occurred in 25% of group 2 patients, with the most common being prolonged ventilatory assistance (12%). Current results with thoracoabdominal aneurysm repair both establish its safety and help to provide guidelines in selecting patients for elective repair. PMID- 2712705 TI - Gallstone disease. The clinical manifestations of infectious stones. AB - Gallstones from 82 patients were examined under a scanning electron microscope for evidence of bacteria, and the findings were compared with the clinical manifestations of the disease. Bacteria were present in 68% of pigment stones and the pigment portions of 80% of composite stones. These gallstones were referred to as infectious stones. No bacteria were found in cholesterol gallstones. Acute cholangitis was diagnosed in 52% of patients with infectious stones and in 18% of patients with noninfectious stones. Over half of the patients with noninfectious stones presented with mild symptoms. Infectious stones were more often associated with a previous common duct exploration, an urgent operation, infected bile, a common duct procedure, and complications. These data show that gallstone disease is more virulent in patients whose gallstones contain bacteria. PMID- 2712706 TI - Massive upper-extremity edema following forearm fistula: cause and treatment with salvage of the fistula. PMID- 2712707 TI - Sclerosing cholangitis associated with hydatid liver disease. PMID- 2712708 TI - Comparison of experimental hypercholesterolemia and atherosclerosis in male and female mini-pigs of the Gottingen strain. AB - The susceptibilities of male and female mini-pigs of the Gottingen strain to experimental hyperlipoproteinemia and atherosclerosis were studied and compared. Hyperlipoproteinemia was induced in groups of pigs of each sex by adding 11.2% egg yolk and 0.5% cholesterol to the diet. The initial increase in the plasma cholesterol concentration was significantly greater in the female animals than in the male ones. In both sexes most of the increase in plasma cholesterol was referable to the low-density lipoprotein fraction. As the experiment proceeded, the difference in the plasma cholesterol level between the sexes became less pronounced. After 18 months on the lipid-rich diet the animals were slaughtered and examined for atherosclerotic lesions. Specimens from the coronary arteries and the thoracic and abdominal aorta were taken for lipid analyses. From colour photographs of the intimal surface of the aorta, the percentage area of visible atherosclerosis in the abdominal part was calculated. Atherosclerotic lesions were present in the coronary arteries and in the abdominal aorta in both sexes. In the abdominal aorta, the results of the lipid analyses, and the calculated percentage area of atherosclerosis, indicated that the degree of atherosclerosis was similar in male and female pigs. In the coronary arteries, the atherosclerosis was more pronounced in the female pigs, as judged from the accumulation of cholesterol. PMID- 2712709 TI - Cultured bovine aortic endothelial cells secrete factor(s) chemotactic for aortic smooth muscle cells. AB - Interactions of vascular endothelial cells (ECs) and smooth muscle cells (SMCs) were studied by testing the ability of cultured bovine aortic ECs to secrete factors influencing the migration of cultured aortic SMCs from the same species. Migration of SMCs was examined in blind-well chambers using gelatin-coated polycarbonate filters. Conditioned culture medium obtained by incubating confluent monolayers of ECs in serum-free RPMI-1640 medium for 48 hours caused a 2.4-fold increase in the migration of SMCs as compared with nonconditioned medium (p less than 0.001). The effect was dependent on the length of conditioning with the ECs and was chemotactic in nature as judged on the basis of checkerboard analysis. Preliminary characterization of the migration stimulating activity indicates that it is sensitive to trypsin, nondialyzable, and stable at 56 degrees C for 30 min. The activity was abolished by heating to 100 degrees C for 20 min but was not significantly inhibited by protamine sulphate, which suggests that most of the activity was not due to platelet-derived growth factor (PDGF) like proteins. Our results thus show that ECs secrete polypeptide(s) chemotactic for vascular SMCs. Such interactions between ECs and SMCs in vivo might contribute to the migration of medial SMCs into the intima during atherogenesis. PMID- 2712710 TI - Factors regulating plasma cholesterol concentration. AB - Plasma cholesterol concentration in humans and animals is held at remarkably constant level under constant dietary condition. Critical reevaluation of our studies indicated that cholesterol absorption and fecal excretion rather than cholesterol synthesis play major role in regulating plasma cholesterol concentration in high- and low-responding rhesus monkeys. The high-responding monkeys are those who respond with mild increase in plasma cholesterol when fed high cholesterol diet while the low-responding monkeys are those who respond with mild increase in plasma cholesterol when fed an identical high cholesterol diet. Humans also respond differently when fed high cholesterol diet, i.e., there are high- and low-responding humans. I suggest that in humans also cholesterol absorption and fecal excretion rather than cholesterol synthesis play greater roles in the regulation of plasma cholesterol concentration. PMID- 2712711 TI - Hypolipemic activity of K12.148 in rats, marmosets and pigs. AB - The hypolipemic effect of K12.148, a new hypolipemic compound, was examined in normolipemic rats, marmosets and pigs. It could be demonstrated that this compound reduced serum lipids, and in particular serum cholesterol, very effectively in all tested animal species. The analysis of the lipids of the pig give evidence that the hypocholesterolemic effect is due to a reduction of LDL only. In vitro experiments with rat liver homogenates suggest that the hypocholesterolemic effect is brought about by the inhibition of hepatic cholesterol synthesis. PMID- 2712712 TI - [Changes in the sensomotor cortex of offspring after chronic intoxication with tobacco smoke through the mother-fetus system]. AB - The state of the sensomotor cortex in the offspring of white non-inbred rats, "passively" smoking before mating, during mating and throughout pregnancy time has been investigated. The investigation performed in 14 age groups from the period of birth up to a relative morphological stability (age of 3 months), control and experimental rats (as a whole 281 animals) makes it possible to conclude that certain components of the tobacco smoke are accumulated in the offspring blood and continue to exercise a destructive influence on the neocortex during 2 weeks after birth. The consequence of chronic intoxication of the tobacco smoke through the system mother--fetus is expressed as diffuse and focal decrease of neurons nearly by 1/3 in the sensomotor cortex, especially in the V cytoarchitectonic layer. PMID- 2712713 TI - [Changes in the neurite-glial interrelations under the influence of antiserum against galactocerebrosides (a vital tissue culture study)]. AB - Two--five-day-old culture of 10-11-day-old chick embryos has been used. Antiserum against galactocerebrosides (anti-GalC) is added to the nutrition medium before cultuvation. In the presence of anti-GalC the growth and gliocyte migration zone decreases, the area index becomes essentially small (3.5 +/- 0.7 in the control, 1.5 +/- 0.5 in the experiment). This is connected with inhibition of migration and proliferation of gliocytes during first 48 h of cultivation, while intensity of neuron regeneration remains unchanged. Alterations of the neurit-glial relations are investigated by means of the vital phase-contrast microscopy. Effect of anti-GalC to peripheral gliocytes is accompanied with a decreasing adhesive ability of their plasmolemma. This makes difficult their flattening on the neurit membrane, formation of contact membranous neurit-glial relations and formation of glial membranes. On the 3d day formation of nervous fasciculi is retarded, as well as their fusion into trunks and plexuses. On the 5th day, unlike the control, a continuous "epineural" covering of neuritic plexuses does not form. Round retractile and defective (with protrusions) forms of gliocytes predominate. These data demonstrate inhibitory effect of anti-GalC on the structural-functional maturation of the glia and on formation of neurit-glial relations in the culture of the sensitive ganglion. PMID- 2712714 TI - [Morphologic mechanisms of blood flow regulation in the hemomicrocirculatory system of the human heart during ontogenesis]. AB - Hearts of 220 human corpses, who had not any cardiovascular system disease during their life, have been distributed into age groups, beginning from fetuses up to old age. By means of injection, silver nitrate impregnation and scanning electron microscopy methods, applied to corrosive preparations, morphological mechanisms of the blood stream regulation in the hemomicrocirculatory bed of the human heart have been revealed in ontogenesis. The first group of the regulation mechanisms includes proper mechanisms inherent in the links of the microbed: spatial orientation of microvessels, precapillary sphincters, anastomoses between these vessels, sequence in arrangement of the endothelial cell nuclei, length, diameter and number of links in the microcirculatory bed. The second group embraces those mechanisms, that depend on structure of the myocardial wall, influencing the microcirculatory bed. PMID- 2712715 TI - [Cardiac vessels of human fetuses and newborn infants]. AB - The anatomy of the cardiac arteries has been studied in 78 and that of the veins- in 74 total preparations of human fetal hearts 3--10-lunar month-old and in newborns. The cardiac vessels are injected with contrast masses, erythrocytes are stained with benzidine, histotopograms are made. In the fetuses all branches of the 1st-3d order of the coronary arteries and cardiac veins have been formed. Topography and main dimentions of large cardiac vessels are defined. During the prenatal period ramification zones of the coronary arteries do not change. In different age groups of the fetuses and newborns right coronary type of the cardiac blood supply predominates considerably (58-60%), in 27-32%--equal, and in 8-13%--left coronary type is observed. A great variability of the venous cardiac bed, vast intervenous anastomoses and a special importance of the cardiac middle vein in blood outflow are noted. PMID- 2712716 TI - [Ultrastructure of the pulmonary trunk wall during the prenatal period of ontogenesis]. AB - By means of transmissive electron microscopy stages of morphogenesis have been studied in the pulmonary trunk wall of 12 healthy human embryos and fetuses of 5 24-week-old. There is a close dependence in development of the smooth muscle component of the middle tunic, elastic and collagenous fibers of the pulmonary trunk wall. In the early prenatal morphogenesis of the pulmonary trunk fibrillogenesis develops intensively, overtakes the differentiation time of myocytes from mesenchymal cells, the collagenous fibers appearing earlier than the elastic ones. The structures, that ensure solidity of the vascular wall (collagenous fibers), appear in embryogenesis earlier that those, ensuring its elasticity (ability to reversible deformity). PMID- 2712717 TI - [Ultrastructural features of hormone-producing cardiomyocytes under certain experimental and clinical conditions]. AB - Ultrastructural peculiarities of the cardiac hormone secretion (atrial natriiuretic factor) have been studied under certain experimental and clinical conditions. In atrial myocytes of intact dogs degree of the Golgi complex development, where the hormone is formed, amount of endocrinic granules and their qualitative composition vary considerably even in neighbouring cells. These structures reach a very great development in myocytes of the left atrium in persons with mitral stenosis, where certain anomaleously large secretory granules, resembling lyosomes are formed. When the organism is cooled up to 27-28 degrees C and the blood stream is interrupted in the experiment and along the course of a defect correction, amount of the secretory granules in cardiomyocytes decline significantly. The Golgi complex decreases, its cysterns become fragmented, their content is cleared. After warming up to the normal temperature there is no complete restoration of these structures. On the 3d day after the experiment in some cases signs of hypertrophy and elevated functional activity of the secretory structures appear. The ways of synthesis, accumulation and degradation of secretory granules in cardiomyocytes are followed, a classification of their ultrastructural varieties is suggested: forming, young, mature and dissolving forms. Together with the analysis of the Golgi complex, it helps to judge the endocrinic activity of cardiomyocytes. PMID- 2712718 TI - [Anthropometric characteristics of people 21 to 35 years of age from Moscow and the Moscow region who participate in physical culture and popular sports on a regular basis]. AB - By means of certain anthropometrical methods, in accordance with 56 initial data, 262 men and 274 women, Russian nationality, students of Institute of Physical Culture at the age of 21-35 years have been examined. They all are third-grade and second-grade athletes in popular sport games and regularly go in for physical culture. Morphofunctional characteristics, including 74 parameters, that are summarized in three tables (absolute anthropometrical, body proportions and morphofunctional) are presented. The total dimensions of the body (mass--69 +/- 7 kg in the men and 61 +/- 7 kg in the women and body length--174 +/- 7 and 163 +/- 6 sm, respectively) and its parts changed but little during last 20 years, nevertheless, are noticably higher than the standards accepted in the 50s. A slight variability is revealed (in the women a little greater) in most of the anthropometrical parameters, body proportions are near the classical forms. The results of the work reflect favourable role of regular physical exercises for formation of optimal morphofunctional human status, interrelations of muscular, fatty and osseous body components. The low variability of the characteristics obtained demonstrates their typicalness; therefore, it is possible to recommend them as standards for estimation physical development and body built of persons in the given age group. PMID- 2712719 TI - [Emperipolesis and interrelations of megakaryocytes and neutrophilic granulocytes in the bone marrow of healthy dogs]. AB - Emperipolesis is an ability of one cell to penetrate into cytoplasm of another cell and to stay there for some time, or to pass through it. Unlike a common phagocytosis, not a cell interacting is damaged. Penetration of neutrophilic granulocytes into cytoplasm of megakaryocytes is also considered as emperipolesis, that is revealed in the bone marrow of healthy persons. Its occurrence becomes greater at various pathological states of tumorous and non tumorous etiology. Histological investigation of the bone marrow of the rib, breast bone, vertebral body and iliac bone crest, performed in 10 healthy dogs makes it possible to state, that there are possible specific interrelations between megakaryocytes and neutrophilic granulocytes, that terminate in death of the former. Therefore, the phenomenon observed cannot be identified with emperipolesis. In this case we, evidently, deal with a morphological demonstration of cell cytotoxicity, when neutrophils, being killers, act as effector-cells, and megakaryocytes - as target-cells. Cell cytotoxicity is a natural phenomenon, that under certain physiological conditions is evidently connected with thrombocytopoiesis. PMID- 2712720 TI - [Transformation of erythrocytes and their ultrastructure with respect to aging]. AB - Transformation and ultrastructure of erythrocytes have been investigated in 58 white non-inbred rats on the 1st, 2nd, 3d days after birth and at the age of 1.5, 3, 8, 20 months. The transformation index of the erythrocytes drops by the 8th month of life and further it rises in old animals. In newborn rats echino poikiloid forms predominate; they are mainly presented as reticulocytes with remnants of nuclei, mitochondria and other organells. During first three days of life cells of the erythroid line actively free themselves from the nucleus by means of its pyknosis and chromatinolysis. In newborn rats erythrocytes have folds of plasmolemma of linear and spotted form on their surface; their number sharply decreases in mature animals. The least changes in form and ultrastructure of erythrocytes are noticed in 3-8-month-old animals. PMID- 2712721 TI - [A device for studying large, flat macro-microscopic preparations]. PMID- 2712722 TI - [Experience in the formation of a deductive theory of specialization and integration of cells in phylo-, onto- and pathogenesis]. PMID- 2712723 TI - [New approaches to optimizing students' work in a histology course]. PMID- 2712724 TI - [Histology at the medical institute]. PMID- 2712725 TI - [Structuro-functional characteristics of the human coronary arteries in atherosclerosis]. AB - Structural features of the endothelium interaction with the blood cellular elements during atherosclerotic processes of varying severity in the coronary arteries have been analyzed from the data of early sections and coronary artery biopsy specimens. The status of the endothelium has been uniform in macroscopically unchanged sites irrespective of the coronary atherosclerosis severity. A stable characteristic symptom of the initial stages of atherogenesis is the formation of crater-like defects and monocyte adhesion. Scanning electron microscopy has shown for the first time the presence of echinocytes in the blood of coronary patients and adhesion of these cells at the site of the endothelial monolayer destruction. The formation of microthrombi at the site of endothelial destruction is not a stable symptom of the initial stages of atherogenesis. Endothelial destruction and regeneration, aided by the platelets, can be observed at all stages of atherogenesis. PMID- 2712726 TI - [Neuromorphologic studies in pathologic anatomy]. AB - In the USSR, pathological neuromorphology that developed at the borderline of pathological anatomy, clinical neuropathology and psychiatry was represented by historically established research schools noted for great achievements. During the past two decades, the number of those skilled in this area has been, however, drastically reduced for a variety of reasons, adversely affecting both the research designs and the pathoanatomic care itself. The paper analyses the present-day pathomorphology of the nervous system in the USSR and provides the possible ways of eliminating the lag existing in the science and the perspectives of its development. PMID- 2712727 TI - [Morphobiophysical features of the duodenal mucosa in patients with duodenal ulcers]. AB - Chronic duodenitis in patients with duodenal ulcer is characterized by substantial morphofunctional changes in the mucosa, decreased transmural potential difference and definite patterns of carbohydrate-containing biopolymer production, the initial changes being manifested as neutral glycoprotein hypersecretion with their subsequent diminished synthesis rates, followed by a more pronounced drop of sialo- and sulfoglycoprotein levels. A correlation was found between the severity of duodenitis, morphometric and histochemical parameters, and gastric pepsin secretion rates (hypersecretion). It is suggested that these changes are etiopathogenetically common. PMID- 2712728 TI - [Pathomorphologic changes of the solar plexus ganglia in burn disease]. AB - Solar ganglia taken from 64 subjects who died in different periods of burn disease: (shock, toxemia septico toxemia, and burn exhaustion) were pathomorphologically examined. The specific time course of changes in solar ganglia was established in various periods of the disease. Dystrophic changes, necrosis of individual neuron groups, and varices of myelinated fibers were detected during burn shock, hypertrophic neurons with thick processes interwoven in between as "felt" predominanted in toxemia whereas in septicotoxemia and burn exhaustion, necrotic changes in neurons and degeneration of nerve fibrous bundle. PMID- 2712729 TI - [Morphology of the palatine tonsil lymphocytes in chronic tonsillitis using data of electron microscopic radioautography]. AB - Electron-microscopic and electron-radioautographic examinations of the palatine tonsil lymphocytes in 20 patients with chronic decompensated tonsillitis, aged 21 50, have revealed the proliferation of poorly differentiated T- and B-lymphocyte pools in the lymphoid tissue of the tonsils; these processes manifest by an intensive 3H-thymidine incorporation into the minor lymphocytes of different types. A high level of the RNA radioactive precursor incorporation in B lymphocytes indicates a constant differentiation of this lymphocyte population. The biological essence of intensive incorporation of protein radioactive precursors in B-lymphocytes appears to consist in the maximal production of active protein substrates mediating the humoral immunity in chronic tonsillitis. PMID- 2712730 TI - [Intracranial oncogenic aneurysm]. AB - The paper deals with a death from cerebrosubarachnoidal hemorrhage in a 22-year old male. Autopsy revealed fusiform aneurysm at the junction of right posterior connective and cerebral arteries whose wall was histologically examined. The examination indicated that the wall was invaded by tumor cells from the endothelium, the internal elastic membrane and vascular muscle layer being destructed. The primary cause of the tumor was a testis removed 40 days before the death and diagnosed as having chorionepithelioma. PMID- 2712731 TI - [Histologic diagnosis of African histoplasmosis (the first case of the disease in the USSR)]. AB - The findings obtained from histological examination of a biopsy specimen enabled a case of African histoplasmosis to be first recorded in the USSR. The disease was detected in an African student who had had a long-term latent period. The diagnosis was culturally and clinically verified. The problems of the histological differential diagnosis of African histoplasmosis are also discussed. PMID- 2712732 TI - [Methods of rapid anterior vertebral canal dissection using a Gigli wire saw]. AB - The author has developed two procedures for immediate sparing dissection of the vertebral canal in 50 cadavers by employing wire saws introduced into the canal followed by its cutting inside. They make it possible to dissect, by spending minimal time and making less efforts, the vertebral canal both within several vertebrae and its nearly full length, providing a wide view of the spinal cord, rootlets, and intervertebral ganglia. PMID- 2712733 TI - [Ultrastructure of cardiomyocytes during mitral valve replacement in non perfusion hypothermia]. AB - The ultrastructure of biopsy specimens obtained from the left ventricle was examined at varying stages of mitral valve replacement under non-perfusion hypothermal protection (at 27-28 degrees C). In patients with clinical stage IV mitral incompetence, cardiomyocytes were shown to combine signs of marked hypertrophy and decompensation. Despite the initial plastic muscular cell incompetence, there are only small changes in their ultrastructure and myofibril contracture in the pre-occlusion period, which subside by the end of long-term (up to 37 min) occlusions. For the myocardium, reperfusion is the most damaging, but the damages, though widely diverse, are regarded mainly as moderate and reversible. Over again the electron microscopic finding provide good evidence for the feasibility of performing complicated cardiac surgeries with prolonged reversible exclusion of blood circulation under non-perfusion hypothermia. PMID- 2712734 TI - The impact of erythropoietin on hemodialyzer design and performance. AB - The present study investigated theoretically and experimentally the effects of increases in hematocrit on the clearance of urea by the Baxter ST15 hollow fiber dialyzer. In a theoretical model that incorporates the three component resistances for the overall mass transfer rate, namely, the resistance of the blood (Rb)-, membrane (Rm)-, and dialysate side (Rd), it was predicted that a change in hematocrit would alter only the blood side resistance. The overall impact of this alteration is expected to be determined by the relative contribution of Rb to the overall resistance (RO). The modest contribution of Rb to RO implies that a major change in Rb (50%) would have only a minor effect on RO (11%) and consequently on urea clearance (5%). These theoretical conclusions were tested experimentally and the results confirmed the theoretical predictions. Indeed, there was little change in urea clearance in the clinically relevant range of variations in hematocrit (19-39%). Possible ways of compensation by minor changes in the hollow fiber geometry are discussed as well as the more complex relationships with larger solutes (creatinine) or unequally distributed solutes (potassium, phosphate). PMID- 2712735 TI - The physics of continuous flow centrifugal cell separation. AB - The governing equations defining the separation of blood in continuous flow centrifuges are derived using an empirical model for the viscosity of blood. The effects of fluid shear on the separation process are addressed and further models are developed to permit estimations of shear rate during centrifugation. Simplified predictive equations for species specific separations are developed. Contributions due to shear enhanced diffusion are addressed and found to be negligible at the discontinuous interface between cells and plasma. Experimental results from an investigational centrifuge are presented and compared with theoretical predictions. The role of rouleaux formation in conventional centrifuges is discussed and known centrifugal separation characteristics are explained. The viscosity of blood is related to that for suspensions of rigid particles and an equation for the hydraulic permeability of red blood cell suspensions is derived. PMID- 2712736 TI - Plasma filtration in Couette flow membrane devices. AB - This report investigates the effects of transmembrane pressure (ptm), rotation speed, and membrane characteristics on the performance of a rotating membrane device for separating plasma from whole blood. This device consists of 58 cm2 polymeric membrane rotating at high speed (3,000-4,000 r/min) inside a concentric cylinder and produces a Couette type flow in a gap 0.9 mm thick. Blood enters tangentially at the top, exits tangentially at bottom, and plasma is collected by an axial duct. It is found that this device yields maximum filtration velocities (plasma filtration flux per unit area) in the range of 0.5-0.8 cm/min, which are 10-20 times larger than those obtained by using hollow fiber plasma filters. This high performance is not due to the effect of centrifugal forces on red blood cells but rather to the very high shear rates, on the order of 20,000 sec-1, generated in the gap by toroidal flow instabilities (Taylor vortices). When a 0.8 micron pore size Nuclepore (polycarbonate) membrane is used, the filtration velocity presents a narrow peak of 0.6 cm/min at ptm = 10 mm Hg at 3,000 r/min and decreases to 0.35 cm/min at larger ptm. With a 0.5-micron pore nylon membrane the filtration speed increases continuously with ptm and reaches a plateau of 0.5 cm/min. PMID- 2712737 TI - Surface area effects on efficiency and biocompatibility in experimental membrane plasmapheresis. AB - The effect of different surface areas on cellular, humoral, and hemodynamic changes and on plasma separation performance were investigated. Membrane plasmapheresis, consisting of plasma separation and on-line reinfusion, was carried out on dogs for 3 h with 0.6 and 0.3-m2 polyethylene (PE) and polyvinyl alcohol (PVA) modules. The plasma separation and sieving performance was comparable in both the 0.6 and 0.3-m2 modules. The initial white blood count (WBC) reductions were independent of the surface area difference, but the rebound was greater in the smaller modules. The platelet (PLT) reductions were less with the 0.3-m2 PE module in comparison to those with the larger PE module, but no differences existed between both of the PVA modules. The smaller PVA module showed less complement activation compared to the 0.6-m2 module, whereas both of the PE modules showed comparable changes. Hemodynamic responses, especially the changes in pulmonary vascular resistance, were less with the smaller modules compared to the 0.6-m2 modules. The PE modules themselves showed less blood cellular, humoral, and hemodynamic changes compared to the PVA modules. The smaller modules showed greater rebound of WBC counts, however, PLT reductions, complement activation, and changes in hemodynamic parameters were less in the smaller modules. PMID- 2712738 TI - Agenesis of the corpus callosum in Apert syndrome? PMID- 2712739 TI - Epidemiologic aspects of epilepsy. PMID- 2712740 TI - Prosody, socioeconomic level, and the right hemisphere. PMID- 2712741 TI - High-resolution magnetic resonance imaging findings in juvenile-onset myotonic dystrophy. PMID- 2712742 TI - Pathogenesis of reflex sympathetic dystrophy. PMID- 2712743 TI - Muscular dystrophy in the chicken. PMID- 2712744 TI - Adrenal medullary transplantation to the caudate nucleus in Parkinson's disease. Initial clinical results in 18 patients. AB - Results from a pilot study of adrenal medullary autotransplantation for Parkinson's disease are presented. Eighteen patients were studied; 12 were followed up for 1 year, and 6 were followed up for 6 months. Four of 12 patients showed distinct improvement in the signs and symptoms of their disease, as assessed using the Columbia Rating Scale, at 1 year; none showed distinct deterioration. The 6 patients who were followed up for only 6 months were an average of 20 years older and generally more severely affected. None distinctly improved. Morbidity was considered to be minor and transient among the first 12 patients, while 4 of the last 6 patients experienced alteration in mental status lasting as long as several months. This problem has led us to conclude that older patients with preexisting cognitive impairment should not be included in future studies until the benefits are more clearly established. However, we believe that the distinct and persistent improvement seen in some of the younger patients warrants the initiation of a well-designed, randomized, and controlled trial of adrenal medullary autotransplantation for the purpose of confirming these results and assessing the effect of the procedure on the natural progression of Parkinson's disease. PMID- 2712745 TI - Falling and postural deficits due to acute unilateral basal ganglia lesions. AB - Nine patients presented with sudden falling events to one side while sitting, standing, or walking. All were initially unaware of their severe postural deficit, and five were obfuscated. The observed falls were a distinctly slow, tilting motion in a stereotypic lateral or diagonal trajectory, literally "like a falling log." The events occurred with eyes opened and were exacerbated with eye closure, but no patient had evidence of cerebellar, vestibular, or posterior column dysfunction or significant motor weakness. Unilateral basal ganglia hemorrhages or lacunar infarcts contralateral to the side of the fall were demonstrated by computed tomographic scans. The overall prognosis was favorable; eight of nine patients regained independent ambulation within 3 to 6 weeks. Our findings indicate that a distinct loss of postural balance arises contralaterally to unilateral pallidal-putaminal lesions. PMID- 2712747 TI - Long-term follow-up of biochemical and cognitive functioning in patients with mannosidosis. AB - Longitudinal assessments of three brothers with alpha-mannosidosis were performed biochemically by determining levels of leukocyte enzyme activity, and neurodevelopmentally by testing of general intelligence, language, visual spatial skills, and overall adaptive abilities. During the follow-up examination, enzyme activity was assessed in fibroblasts to evaluate the uniformity of biochemical deficits. The biochemical findings demonstrated profound deficits of leukocyte alpha-mannosidase that remained remarkably stable over time and were very similar to levels of the same enzyme activity in fibroblasts. The cognitive findings showed that the patients manifested mild cognitive deficits. Cognitive deficits were generally uniform with no signs of progressive deterioration, except receptive language abilities. Suggestions are made for careful follow-up of auditory abilities in patients with mannosidosis. PMID- 2712746 TI - Postpolio muscular atrophy. Diagnostic utility of macroelectromyography. AB - Muscles recovered from previous poliomyelitis may exhibit new weakness and wasting years after the original infection (postpolio muscular atrophy). Routine electrophysiological and morphological techniques may not differentiate weakening muscles from previously affected but stable muscles. We used quantitative motor unit potential analysis, single-fiber electromyography, and macroelectromyography (macro-EMG) to determine if these techniques could identify weakening muscles. We classified 18 previously affected muscles according to strength from 12 patients who had had poliomyelitis 18 to 50 years earlier. Muscles of normal strength had large-amplitude macro-EMG signals (1000 to 4110 microV; normal level, less than 390 microV). Muscles with new weakness and atrophy had smaller than expected macro-EMG amplitude (130 to 450 microV). Two muscles with weakness and atrophy unchanged since the original childhood infection had markedly increased macro-EMG amplitude (1710 and 1860 microV), suggesting the increased macro-EMG amplitude is due to stable reinnervation not strength. Mean motor unit potential duration and amplitude were lower in newly weakened muscles, but jitter, fiber density, and blocking were similar in all muscles regardless of strength. We conclude that low amplitude macro-EMG signals may be useful in the identification of muscles weakened by postpolio muscular atrophy. PMID- 2712748 TI - Electroencephalographic abnormalities in human T-cell lymphotropic virus type I associated myelopathy. AB - Thirty-six patients with human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy were studied by electroencephalogram. Twenty-two of 36 patients showed mild to moderate electroencephalographic abnormalities, ranging from poor organization or slowing of the background activity to theta bursts and/or spikes. None of these abnormalities were considered specific for HTLV-I associated myelopathy. These electroencephalographic abnormalities had no apparent relationship to duration or severity of illness, nor to HTLV-I antibody titers in the cerebrospinal fluid. We document electroencephalographic changes in HTLV-I-associated myelopathy. Our data are consistent with previous reports describing the fact that involvement of regions above the spinal cord may exist in HTLV-I-associated myelopathy. PMID- 2712749 TI - Somatosensory evoked potentials in cerebral palsy after partial dorsal root rhizotomy. AB - Somatosensory evoked potentials (SEPs) were studied in 20 children with cerebral palsy and severe lower extremity spasticity before and after selective partial dorsal root rhizotomy of the lumbosacral cord. The potentials from stimulating nerves in the lower extremity were abnormal in two thirds of the children before the operation, whereas the potentials were generally normal from upper extremity nerves. Dorsal root rhizotomies caused an attenuation of nerve root entry volleys recorded over the lumbar cord but did not change SEPs recorded over the cortex. The exception to this was that the incidence of abnormal sural nerve SEPs decreased postoperatively. Lumbar cord functions measured by H-reflexes or by tendon jerks were depressed following the operation. These results indicate a significant degree of abnormality of somatosensory transmission from the lower extremity in a group of cerebral palsied children with severe spasticity. Moreover, selective sectioning of approximately 50% of the dorsal root fibers in the lumbosacral cord had little influence on cortical evoked potentials. PMID- 2712750 TI - Brain-stem tuberculoma. An analysis of 11 patients. AB - The clinical and radiologic findings in 11 patients with brain-stem tuberculoma were reviewed. Clinical manifestations included various combinations of focal signs and symptoms of subacute onset, similar to those produced by other space occupying lesions of the brain stem. Evidence of systemic tuberculosis was found in six cases (55%). Computed tomography (CT) usually showed an isodense or hyperdense brain-stem mass with abnormal contrast enhancement; associated supratentorial granulomas were found in four cases, and hydrocephalus was found in two cases. Magnetic resonance imaging showed irregular brain-stem lesions with long T1 and short T2 relaxation times. Cerebrospinal fluid findings were also nonspecific, as smears for acid-fast bacilli were most often negative. An incorrect diagnosis of pontine glioma was made in one patient. In contrast, proper integration of data from CT and magnetic resonance imaging findings, cerebrospinal fluid analysis, and x-ray films of the chest permitted an accurate diagnosis in ten cases. Prompt therapy with antituberculous drugs resulted in clinical improvement, documented by CT, in most patients. Brain-stem tuberculoma should be suspected in patients with space-occupying lesions of the brain stem who live in geographic areas where tuberculosis is endemic. Early diagnosis and prompt medical therapy are important in preventing mortality and reducing morbidity. PMID- 2712751 TI - Neurologic complications in long-standing nephropathic cystinosis. AB - The central nervous system has been considered to be uninvolved in nephropathic cystinosis. Survival into adulthood, following renal dialysis and transplantation, has brought attention to the sequelae of long-standing cystinosis. We examined 14 patients with cystinosis, 12 of whom had undergone renal transplantation. Two patients had neurologic symptoms. One patient had progressive bradykinesia, dementia, and spasticity with computed tomographic scan evidence of cerebral atrophy and multifocal mineralization in bilateral internal capsules and periventricular white matter. One patient had behavioral and, to a lesser extent, cognitive disturbance and computed tomographic scan evidence of marked, progressive cerebral atrophy. Although the remaining patients had normal results of neurologic examinations, 11 had roentgenographic evidence of generalized cerebral atrophy; 2 of these had abnormal electroencephalograms, 1 had borderline-deficient intellectual function, and 2 had computed tomographic scan evidence of multifocal, intracerebral mineralization. The patients with nervous system abnormalities were not distinguished by patterns of medication use, demographic or laboratory features, or the relative severity of cystinosis. Although the neurologic involvement in these patients suggests that cystinosis may eventually involve the central nervous system, the differential diagnosis must include other complications from renal failure, dialysis, and immunosuppression. PMID- 2712752 TI - Lacunar infarct of the tegmentum of the lower lateral pons. AB - A stroke with a somewhat unusual neurologic formula was correlated with a small linear high-intensity T2 focus in the lateral tegmentum of the lower third of the pons. The clinical features included dysarthria, staggering gait, incoordination of handwriting, right facial weakness, nystagmus, ocular overshoot, right appendicular ataxia, and left-sided dissociated sensory loss for pain and temperature. Lacunar lesions of the tegmentum in the region of the pontomedullary junction, while not uncommon, have not been studied pathologically and have not been reported in the magnetic resonance imaging literature, to my knowledge. PMID- 2712753 TI - Loss of spontaneous blinking in a patient with Balint's syndrome. AB - A patient with Balint's syndrome caused by bilateral parieto-occipital lesions lost spontaneous blinking, suggesting that humans, like nonhuman primates, have parietal lobe neurons that are important for blinking. Although the functions of spontaneous blinking are not known, they may help initiate some saccades and, like saccades, be involved in the cancellation of thalamic inhibitory postsynaptic potentials, thereby facilitating processing of new foveal targets. Spontaneous blinking may also facilitate sensory relay during sustained attention and, therefore, help prevent fading of a retinal image. PMID- 2712754 TI - Neuropsychological deficits in choreoacanthocytosis. AB - Little is known about the cognitive deficits associated with choreoacanthocytosis. This case report focuses on the neuropsychological deficits of a woman diagnosed with choreoacanthocytosis. The similarity between her cognitive deficits and those of patients with Huntington's disease is consistent with the neuropathology of the two disorders. The findings of this study suggest that careful neuropsychological assessment of patients with choreoacanthocytosis is warranted, since cognitive impairment may well be a clinical feature of the disorder. PMID- 2712755 TI - Chronic myopathy with a partial deficiency of the carnitine palmityltransferase enzyme. AB - To date, chronic myopathy has not been reported (to our knowledge) to occur in carnitine palmityltransferase (CPT) deficiency, a disorder of muscle lipid metabolism. We describe two patients with CPT deficiency: a mother, who had a partial CPT deficiency associated with fixed proximal weakness but without rhabdomyolysis, and her son, who had a complete CPT deficiency (95% reduction in enzyme activity) and who suffered from classic attacks of exercise-induced rhabdomyolysis but had normal strength on recovery. Careful examination of family members of patients with complete CPT deficiency is suggested in order to identify clinically affected heterozygotes. PMID- 2712756 TI - AIDS. RAH experience (Royal Adelaide Hospital). PMID- 2712757 TI - AIDS hurts. PMID- 2712758 TI - Feeling OK about AIDS. PMID- 2712759 TI - AIDS. Blood transfusions: reducing the risk. PMID- 2712760 TI - AIDS: facts about acquired immune deficiency syndrome. PMID- 2712761 TI - Living with AIDS. PMID- 2712762 TI - Zidovudine--AZT. PMID- 2712763 TI - AIDS experience. PMID- 2712764 TI - AIDS. Nursing care. AB - Nursing personnel, as front-line health care providers working directly with individuals infected with HIV, their families, and their community, are presented with a challenge that requires unprecedented creativity, energy and resources. The extent to which nursing personnel are willing and able to meet this challenge may well have a profound impact on the future course of the epidemic. PMID- 2712765 TI - Causes of death in sheep exported live by sea. AB - Post-mortem examinations were conducted on 950 dead and terminally ill sheep during assembly for export and during transport by sea from Fremantle, Western Australia to various Middle East ports. Causes of death were grouped into 5 major categories; inanition (deaths associated with reduced feed intake, including hypocalcaemia and hypomagnesaemia), salmonellosis (enteric and septicaemic), trauma, diseases associated with excessive feed intake (lactic acidosis and enterotoxaemia) and miscellaneous diseases (mostly of farm origin). During assembly the causes of death were salmonellosis 53.4%, miscellaneous diseases 23.8%, trauma 12.6%, inanition 10.2%, acidosis 3.9%, enterotoxaemia 3.4% and no diagnosis was made in 3.4%. During shipping the causes of death in defined populations of sheep in 5 voyages were; inanition 43.4%, salmonellosis 20.2%, trauma 10.6%, miscellaneous diseases 5.9%, enterotoxaemia 1.0% and no diagnosis was made in 19.0%. The range of mortality rates per 10,000 sheep at risk for the first 11 days at sea in 5 voyages were inanition 52.6 to 76.7, salmonellosis 7.8 to 109.8, trauma 2.1 to 17.1, miscellaneous diseases 5.9 to 17.1 and enterotoxaemia nil to 10.3. PMID- 2712766 TI - The effects of duration and concentration of plasma progesterone on the fertility of post-partum cows treated with pregnant mare serum gonadotrophin and intravaginal progesterone. AB - The effects of duration of insertion of progesterone releasing devices (PRIDs) on the concentrations of plasma progesterone (plasma P4) and the relationship of these with fertility were examined respectively in ovariectomised and intact Bos taurus cattle. In experiment 1, ovariectomised cows (n = 14) were treated with PRIDs to produce high and low plasma P4 for 7 or 14 days giving 4 treatment groups designated H7, H14, L7 or L14. Mean plasma P4 in the H14 and L14 groups were 6.6 and 6.0 ng/ml respectively, during the first week and 5.4 and 3.8 ng/ml respectively, during the second. Mean plasma P4 of 6.3 and 4.2 ng/ml were observed in H7 and L7. In experiment 2, suckled cows (n = 171) received the same PRID treatments as cows in experiment 1, plus either 375 or 750 iu pregnant mare serum gonadotrophin, and subsequent calving rates were recorded. These were significantly lower after L7 than the other treatments (12% v 38%, P less than 0.025). These results showed that fertility after oestrus was closely related to plasma P4 observed before oestrus and indicated that treatment with progesterone for as little as 1 week can produce normal fertility providing plasma P4 attain a critical threshold during treatment. PMID- 2712767 TI - Maple syrup urine disease in calves: a clinical, pathological and biochemical study. AB - The clinical, pathological and biochemical findings of a study of 30 Poll Hereford, Hereford, Poll Hereford cross or Hereford cross calves affected with branched chain ketoacid dehydrogenase (BCKAD) complex deficiency or maple syrup urine disease (MSUD) are presented. In breeding studies, 6 of 21 calves from obligate heterozygote matings were affected with MSUD, suggesting the disease is inherited in an autosomal recessive manner. Calves were clinically affected from birth, but there were variations in the subsequent course of progressive deterioration of central nervous system function. Concentrations of the branched chain amino acids and keto acids were elevated in pre-suckle plasma and cerebellar water content was higher in affected calves. Activity of BCKAD complex was minimal in fibroblasts cultured from an affected calf. Spongiform encephalopathy and elevated ratios of the branched to straight chain amino acids in formalin fixed cerebral tissue were found in a stillborn foetus and a 3-month old Hereford calf. These findings suggest the disease occurs prenatally and that a delayed form may exist. PMID- 2712769 TI - Evaluation of strategies for control of sheep lice (Damalinia ovis) with an epidemiological model. AB - A model was constructed to integrate the epidemiology and economics of control of sheep lice in Victoria and provide an objective basis for comparing lice control strategies. The strategies evaluated included different allocations of Department of Agriculture and Rural Affairs (DARA) resources for detection and supervision of infected flocks and for extension to enhance owner detection rates, change treatment practices or promote the adoption of disease prevention measures. Changes in prevalence and the net present cost of sheep lice to the industry were calculated over a 10-year period. The model predicted that the most profitable lice control strategy was to discourage routine annual treatment, promote treatment on detection, and encourage the adoption of lice prevention measures. The number of infested flocks undertaking eradication programs under DARA supervision had little effect on the prevalence or net cost of lice to Victoria. PMID- 2712768 TI - Sequential bacteriological observations in relation to cell-mediated and humoral antibody responses of cattle infected with Mycobacterium paratuberculosis and maintained on normal or high iron intake. AB - Twenty calves were orally infected with Mycobacterium paratuberculosis before weaning. Ten of these plus 4 non-infected controls were maintained on elevated dietary iron intake from 6 to 33 months of age. During this time, in which the majority of animals were bred, the influence of increased dietary iron upon tests of cellular and humoral immune responsiveness to antigens of the organism were monitored. Results were examined in relation to the organism's capacity to multiply and infect up to 7 portions of the intestinal tract. No significant differences were detected in the degree of intestinal disease or pattern of faecal excretion of M. paratuberculosis in iron supplemented and non-supplemented cattle. Cutaneous delayed-type hypersensitivity (DTH) to johnin PPD developed at 1 month and in-vitro lymphocyte and immunostimulatory activity (LS) to this antigen at 2 months after infection. LS indices were significantly reduced in magnitude in iron-supplemented cattle (p less than 0.01). Most ELISA antibody responses were positive 10 to 17 months after infection and preceded the fewer number of CF responses by several months. Neither of the antibody tests was affected by elevated iron intake. Generally, complete or partial resistance to paratuberculosis was associated with sustained positive monthly LS tests (index greater than or equal to 2.0), whereas antibody levels tended to be sustained only in the more severely affected cattle. Although neither test system was affected by pregnancy the ELISA failed to detect a significant proportion of cattle chronically shedding M. paratuberculosis in faeces. PMID- 2712770 TI - The epidemiology of fasciolosis in Papua New Guinea. AB - Fasciola hepatica metacercariae were present on pasture throughout the year at the trial site. The highest infection rate in trial sheep occurred in the first year after the beginning of the wet season, in December/January, when contamination of the pasture was maintained by other sheep. Variation in rates of infection in consecutive years was linked to differences in grazing pressure and to a change from sheep to cattle as accompanying grazing stock. A minimum precipitation of 125 mm over 4 consecutive weeks appears to be necessary for infected snails to move from their normal habitats and to contaminate wet pasture with cercariae. Infection of sheep can occur during a dry season if pasture has permanent seepage sites or swampy areas where infected snails can remain active and continue to liberate cercariae. PMID- 2712772 TI - Bovine spongiform encephalopathy (BSE)--a new disease. PMID- 2712771 TI - Indices of renal function: reference values in normal horses. AB - Urine and blood samples were taken at the same time from normal adult horses presented for routine investigations to establish reference values for a variety of parameters reported to be useful in the clinical evaluation of renal function. Blood biochemical values were consistent with previous studies and had well defined normal ranges. Parameters representing urine concentration and electrolyte excretion however, varied widely reflecting the ability of the healthy kidney to change the composition of urine in response to differences in environment and management. Percent creatinine clearance ratios for potassium in particular were lower than those reported in normal horses in previous studies. Rational interpretation of these latter measurements should accept a wide range of normal values and management conditions must be considered in this interpretation. PMID- 2712773 TI - Virulence and transmissibility of Mycoplasma gallisepticum. AB - The virulence of 4 low passage strains of Mycoplasma gallisepticum obtained from different sources within Australia was studied by experimental infection of chickens. Strain Ap3AS, originally isolated from the air sac of a broiler chicken, produced severe air sac lesions following injection into the abdominal air sacs of 2-week or 3-week-old chickens, and adult hens. Strain 80083 which was isolated from a clinically normal broiler breeder hen was also capable of producing gross air sac lesions following intra-abdominal (IA) injection, although it did so less consistently than strain Ap3AS. Strain 82078 isolated from a layer hen and strain QXO which was isolated from a turkey were also moderately pathogenic in terms of the incidence and severity of lesions elicited following IA injection. Strains Ap3AS and 80083 both caused a substantial loss of egg production over a 5 week period after IA infection of 27-week-old hens. Neither strain Ap3AS nor 80083 caused gross lesions or loss of egg production when administered alone into the upper respiratory tract. However, when inoculated into the conjunctival sac in combination with the Vic S strain of infectious bronchitis virus (IBV) strains Ap3AS and 80083 produced identical clinical signs of conjunctivitis. The mean numbers of M. gallisepticum in tracheal washings were significantly higher 2 weeks after infection in the group receiving strain 80083 in combination with IBV than in the group infected with strain Ap3AS and IBV (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712775 TI - Lesions of presumed congenital origin in the accessory sex glands of bulls. AB - A detailed description of lesions of presumed congenital origin involving the accessory sex glands of 11 bulls is given. All of these lesions would have been detectable by careful clinical examination during bull evaluation. Evidence presented here supports the view that congenital abnormalities such as bilateral ampulla-seminal vesicle fusion, ampulla cysts associated with luminal constriction, cysts of urogenital sinus origin, prostatic appendage, and persistent remnant of the urachus could sometimes be responsible for development of inflammatory conditions in the accessory sex glands. Anomalies such as segmental aplasia or hypoplasia of mesonephric duct derivations, or single ampulla-seminal vesicle fusion in which the ducts opened freely in the colliculus seminalis were not seen to be associated with inflammation in the accessory sex glands. The significance of these findings is considered. PMID- 2712774 TI - An evaluation of three serological tests for antibody to Brucella suis in pigs. AB - The Rose Bengal Plate Agglutination test (RBT), the complement fixation text (CFT) and the tube agglutination test (TAT) were applied to serums from 345 feral and 80 domestic pigs sampled at slaughter. At least 2 of the 3 serological tests were applied to each serum. Tissues from all pigs were cultured for Brucella suis and the degree of culture effort was categorised from 1 to 4 in decreasing order. Fifty-eight feral and 35 domestic pigs were culture-positive. A greater proportion of culture-positive pigs was obtained for category 1 and 2 culture effort. Tissues yielding B. suis most often were mandibular, gastrohepatic and external iliac lymph nodes, spleen and various abdominal organs. Infection in domestic pigs was associated with exposure to feral pigs. The sensitivity (Se) in culture-positive pigs of the RBT (79.1%) was significantly greater than that of either the CFT (49.1%) or TAT (51.1%). The specificities (Sp) in culture-negative pigs were 81.2% for the RBT, 90.8% for the CFT and 81.0% for the TAT. A more realistic estimate of Sp for the RBT was considered to be 97.6%, based on serological results from 31,326 domestic pigs routinely tested for regulatory purposes. The RBT was clearly superior to the other 2 tests in this study. However, a more sensitive screening test would be preferable for use in a test and slaughter eradication program. The RBT would be a suitable confirmatory test. PMID- 2712776 TI - Campylobacter associated intestinal pathology in pigs. PMID- 2712777 TI - Acute oxalate toxicity of sheep associated with slender iceplant (Mesembryanthemum nodiflorum). PMID- 2712778 TI - Cerebral coenuriasis in a domestic cat. PMID- 2712779 TI - Treatment of lantana poisoning in cattle. PMID- 2712780 TI - Occurrence of the Old World screw-worm fly Chrysomya bezziana on livestock vessels and commercial aircraft. PMID- 2712781 TI - Modified "Tores" biopsy needle for use in C.T. guided mediastinal and paraspinal biopsy. PMID- 2712782 TI - Egg whisk stone removal basket. PMID- 2712783 TI - Caecal herniation through the foramen of Winslow. AB - Caecal herniation through the foramen of Winslow is a rare cause of intestinal obstruction and the preoperative diagnosis is rarely made. A patient with caecal herniation through the foramen of Winslow is presented and differentiation from caecal volvulus is stressed. In caecal herniation through the foramen of Winslow the "hilum" of the kidney shaped loop of bowel points towards the foramen of Winslow rather than the right iliac fossa. PMID- 2712784 TI - Adult onset medulloblastoma cerebelli with leptomeningeal dissemination and coincidental primary hyperparathyroidism. PMID- 2712785 TI - Ewing's tumour of rib presenting as chest mass. AB - A case of Ewing's tumour of rib presenting as chest mass is reported. The role of computed tomography and chest ultrasound in evaluating such patients is discussed along with a brief review of literature. PMID- 2712786 TI - Box diagram to express tumour extent: basis of a new staging system in carcinoma of the cervix? AB - The FIGO classification for the clinical staging of carcinoma of the cervix does not adequately express primary tumour extent or volume, and contains anomalies which probably lead to a wide variation in therapeutic results between centres (particularly in Stages II and III). A box diagram method of recording primary tumour extent is proposed and was applied to a retrospective study of 191 women aged 35 years and under with invasive carcinoma of the cervix. Patients who scored one or two boxes (Stages IB, IIA and IIB with unilateral parametrial infiltration) have a similar actuarial 5 years survival rate: 70% and 69% respectively. Those with 3 boxes (Stage IIA and B, bilateral Stage IIB and unilateral IIIB) and 4 boxes or more (Stages IIA and B, bilateral IIIB) involved had a substantially worse survival: 44% and 22% respectively. No patient, with more than five boxes involved was cured. The further study of this system, its potential in clinical research, and as part of a possible revised staging system are discussed. PMID- 2712787 TI - Magnetic resonance imaging. Physics and technical aspects. PMID- 2712788 TI - Therapeutic decision-making in clinical oncology: a matter of perspective. PMID- 2712789 TI - Magnetic resonance imaging: project planning and management of a superconductive M.R.I. installation. AB - The planning and installation of a Superconductive Magnetic Resonance Imaging (M.R.I.) installation is described at the Royal Adelaide Hospital, Adelaide, South Australia. Tender specification, assessment of offers via criteria weighted analysis of technical and economic factors and the final recommendation for a 1.0 Tesla unit are discussed. Building and installation considerations are noted including fringe field effects, magnetic shielding, radiofrequency shielding, cryogens, metallic screening and specific considerations in the Magnet room. PMID- 2712790 TI - Volume related configurational changes in the aetiology of pelvi-ureteric junction obstruction. AB - The aetiology of pelivi-ureteric junction (PUJ) obstruction is controversial. We present four patients who had normal or equivocal intravenous pyelograms and non obstructive Whitaker tests in whom complete pelvi-ureteric obstruction was precipitated by more rapid distension of the renal pelvis. We speculate that in vivo physiological urine flow rates and temporary kinking of PUJ produces a critical increase in pelvic volume and subsequent valvular kinking of the upper ureter, which cannot be usually achieved by maximal urine flow rates alone. Co existence of vesico-ureteric reflux (VUR) may be a contributory factor to critical pelvic distension and tortuous PUJ. Volume related configurational changes of this type are probably a more frequent cause of PUJ obstruction than is generally recognised. PMID- 2712791 TI - Urolithiasis in the aboriginal--a comment. PMID- 2712792 TI - Coronary artery calcification identified by CT in patients over forty years of age. AB - In a study of 100 unselected patients forty years of age or older, routine CT of the thorax demonstrated coronary artery calcification in 41%. Calcification of the left anterior descending was most common, occurring in 34%. For patients 60 years of age and over, clinical evidence of coronary artery disease was 1.7 times more common in those with calcification compared to those without; however, for patients under 60, coronary artery disease was 5.5 times more common in those with calcification than those without. Because of the strong relationship that is known to exist between coronary artery calcification and coronary arteriosclerosis, we believe that the incidental discovery of coronary artery calcification on routine CT of the thorax has significance. All patients under 60 with coronary artery calcification discovered on CT should be investigated for hyperlipidemia if this has not been done, and, if they are not known to have a history of coronary artery disease, they should have a stress test and, if positive, arteriography may be warranted. PMID- 2712793 TI - Dominant craniometaphyseal dysplasia--a family study over five generations. AB - A two month old male infant being investigated for nasal obstruction was noted to have the typical facies and radiological changes of craniometaphyseal dysplasia. Investigation of the family detected 9 individuals in 4 generations with radiological evidence of craniometaphyseal dysplasia. Their ages ranged from 2 months to 70 years. Three presented with nasal obstruction, one with facial nerve dysfunction and three had developed deafness in or before their third decade. Two were asymptomatic. One family member, now dead, was known to have had early onset of deafness but had not been examined or X-rayed. All of the affected individuals were noted to have had the typical facies in childhood. Characteristic radiological findings in the cranium and long bones were present to a varying degree and were most prominent in those presenting in infancy. PMID- 2712794 TI - Erosive spondylo-arthropathy and tertiary hyperparathyroidism. AB - A patient on long term haemodialysis for analgesic nephropathy, with known teriary hyperparathyroidism developed a rapidly evolving, erosive, non-infective spondylo-arthropathy at two vertebral levels. In addition, erosions were noted adjacent to the right sacroiliac joint. Subsequent postmortem material from the affected vertebral levels demonstrated changes consistent with hyperparathyroidism alone and this is suggested as the possible aetiology underlying this recently recognised destructive spondyloarthropathy. PMID- 2712795 TI - Ipsilateral craniofacial uptake of Tc-99m MDP in nasopharyngeal carcinoma: incidence and implication. AB - A five year review of 224 Tc-99m methylene diphosphonate (MDP) scintiscans of 194 patients with proven nasopharyngeal carcinoma revealed evidence of craniofacial asymmetry in 73.7 per cent. In virtually all instances tracer accumulation corresponded to the side of the primary lesion, cervical node enlargement and or cranial nerve dysfunction. It was concluded that the high frequency of asymmetric ipsilateral MDP accumulation about the face may be attributed to one or all of the following; tumour extension into contiguous structures, localised inflammatory or necrotic changes or even tracer uptake by the tumour itself. PMID- 2712796 TI - Mammographic hook wire localization--a step by step guide. AB - A practical approach to hook wire localization of impalpable mammographic lesions is described, together with hints and potential pitfalls. A standard set of five radiographic projections is outlined. This consists of: 1. The "Right Angle" View 2. The "Needle Placement" View 3. The "Depth Adjustment" View 4. & 5. The "Hook Check" Views Modifications of the technique for more experienced operators are also described. The technique is simple and accurate in many circumstances. PMID- 2712797 TI - Detectability of emergency lights for underwater escape. AB - The time to detect each of three underwater lights by six subjects was measured in clear and turbid (attenuation coefficient = 4.2.m-1) water, at distances of 1.54 m and 3.1 m, from two viewing angles, straight ahead (0 degrees) or 65 degrees to one side, and under three levels of ambient illumination. The lights were viewed either through a window, to simulate the use of a face mask, or with the subjects immersed. All lights were detected rapidly (less than 1 s) when viewed through the window in clear water. In turbid conditions, none of the lights was seen at 3.1 m by any subject. At a 1.54 m viewing distance, reliable detection by immersed subjects was found only in the clear water under the two darker ambient illuminations. In turbid water, detection was unreliable. We conclude that the design of underwater escape lighting should not rely on visibility over distances greater than 1.5 m, and that an illuminated guide-bar might provide valuable assistance in directing escape from aircraft. PMID- 2712798 TI - Thresholds for the perception of whole body angular movement about a vertical axis. AB - Thresholds for the detection (at p = 0.75 correct) of the direction of discrete angular movements about a vertical Z axis, having a cosine bell velocity trajectory and a duration of 3.3 s, were determined using an adaptive psychophysical procedure. In 30 subjects the mean threshold for the detection of Z axis stimuli was 1.5 deg.s-1. X and Y axis thresholds of 20 subjects had mean values of 2.04 and 2.07 deg.5(-1), respectively, and were significantly higher than Z axis thresholds. The mean Z axis threshold of 6 subjects, who viewed a visual target fixed to the turntable, was reduced by 8.6 dB over that obtained in darkness. Z axis thresholds were found to increase at 5.9 dB/decade as a function of stimulus duration over the range 0.9 to 20 s. The possible implication of this finding in relation to the dynamics of the sensory system mediating the perception of whole-body angular movement is discussed. PMID- 2712799 TI - Electrogastrograms during motion sickness in fasted and fed subjects. AB - Seven human volunteers were subjected to stressful Coriolis stimulation (rotating chair) either during the fasted state or following the ingestion of yogurt (6 oz). Subjects tested after yogurt reached a Malaise-III (M-III) endpoint of motion sickness after significantly (p less than 0.01) fewer head movements than subjects tested in the fasted state. Surface electrogastrogram (EGG) recordings at M-III were similar for both dietary states and consisted of a brief period of tachygastria, followed by a period of low amplitude EGG waves. Ingestion of yogurt enhanced susceptibility to motion sickness but did not affect the associated pattern of EGG. PMID- 2712800 TI - Effects of dipyridamole on the cardiovascular response to +Gz stress in miniature swine. AB - Eight conscious female miniature swine experienced acceleration levels of 3, 5, and 7 +Gz before and after infusion of dipyridamole (1-2 mg.kg-1). Each animal was instrumented to measure ECG, heart level arterial pressure (AP), eye level arterial pressure (ELBP), left arterial pressure (LAP), heart rate (HR), and regional tissue blood flows. Each was also fitted with an abdominal anti-G suit which automatically inflated. Dipyridamole infusion had no direct effect on HR or LAP but AP was significantly reduced. All cardiovascular responses to +Gz were qualitatively similar before and after dipyridamole. Tachycardia always occurred. AP and CNS blood flow were maintained better prior to dipyridamole and AP always fell in proportion to acceleration intensity. +Gz was generally associated with increased blood flow to respiratory muscles and heart, decreased blood flow throughout the viscera and to the eyes. ELBP paralleled AP, but was always lower in direct proportion to the +Gz level. We conclude that dipyridamole reduces arterial pressure thus compromising the ability of the animal to sustain cerebral perfusion pressure (ELBP) during +Gz. PMID- 2712802 TI - Erythrocyte agglutination in microgravity. AB - This experiment tested a self-contained blood grouping device under microgravity as well as the possibility that gravity could affect the blood grouping reaction. The experiment tested Rh, ABO, and Coombs-sensitized human erythrocytes against their appropriate antisera and diluents. A self-contained device was built which accomplished the agglutination and collected the agglutinates on filter paper. This was flown on the Columbia Space Shuttle on Jan. 12, 1986. The device produced blood agglutinates to several blood groups and the agglutinates were held on filter paper until returned to us by NASA as soon as practical after landing. Both the Rh test and Rh control systems failed because of crystallization within the tubing. The remaining three systems functioned as expected. After comparing these results to similar experiments conducted under full gravity, we conclude that ABO and Coombs-sensitized blood grouping tests do occur under micro-gravity, although the agglutinates formed may be smaller. The use of a closed system for clinical laboratory examination in space is demonstrated. PMID- 2712801 TI - Exercise effects on the size and metabolic properties of soleus fibers in hindlimb-suspended rats. AB - The soleus atrophies rapidly when a rat is subjected to hindlimb suspension (HS), probably as a result of a decrease in the force encountered by the muscle. To test this premise, adult female rats were HS and half the rats were exercised (HS EX) on a treadmill for 1.5 h.d-1 at 20 m.min-1 and a 30% grade. After 4 weeks, the midbelly of the soleus was prepared for histochemical analysis. Fibers were typed as dark or light staining for myosin ATPase, alkaline preincubation. Fiber size and quantitative histochemical enzyme activities of succinate dehydrogenase (SDH) were determined using a computer enhanced image processing system. In comparison to age-matched controls, the soleus wet weight was 69 and 30% smaller in HS and HS-EX rats. The mean cross sectional area of the dark ATPase fibers was reduced by 46 and 18% and light ATPase fibers by 69 and 48% in the HS and HS-EX, respectively. The percent dark ATPase fibers increased from 10% in the control rats to 19 and 17% in the HS and HS-EX. In both suspended groups, SDH activities in light ATPase fibers were 40% higher than control. The SDH activity of the dark ATPase fibers of HS-EX was 20% higher than control, while the dark ATPase fibers of HS were similar to control. To determine the degree to which these increases in SDH could be related to reductions in fiber size rather than increases in the actual amount of protein, integrated activity (activity/min x area) was calculated per fiber.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712803 TI - Modulation of human plasma fibronectin levels following exercise. AB - Elevated reticuloendothelial function and plasma fibronectin (PF) level correlate with reduced rat heat shock mortality. Procedures that enhance human PF level may offer some advantage in dealing with the adverse effects of environmental stress. Both short- (STE) and long- (LTE) term exercise programs were evaluated for their ability to increase male human PF. STE (1 week; N = 14) consisted of treadmill running (0% grade) in a hot environment (41 degrees C, 39% relative humidity). The LTE (12 weeks) program was studied in two parts (LTE-1, N = 10; LTE-2, N = 19), with each part divided into four subject groups. Two groups performed the same running program combined with either full-body or upper-body weight training. The other two groups participated in only the running or full-body weight training. STE and LTE-2 had a significantly (p less than 0.05) higher mean initial PF level than LTE-1. STE (337.1 +/- 22.8 vs. 372.5 +/- 17.0 micrograms.ml 1). LTE-1 (266.0 +/- 13.0 vs. 348.0 +/- 18.8 micrograms.ml-1), and LTE-2 (370.9 +/- 13.8 vs. 413.6 +/- 12.5 micrograms.ml-1) all resulted in significant (p less than 0.05) increases in PF after program completion. Therefore, with diverse exercise training programs, PF elevations were attained even when initial concentration was high or the program was of short or long duration. However, PF level was suppressed in LTE-2 at 4 (323.2 +/- 10.8 micrograms.ml(-1)) and 8 (339.6 +/- 15.0 micrograms.ml(-1)) weeks before elevations occurred at 12 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712804 TI - Aircraft noise-induced temporary threshold shift. AB - Audiograms were taken on 20 young men before and immediately after exposure to Fighter-6 ground running-up noise, and their course of recovery was followed. The sound levels at the engine hatch were 117-128 dB(A). The noise-induced temporary threshold shift was more than 13 dB. The maximum threshold shift occurred at 4 kHz. The shift in the low and speech frequencies recovers more rapidly and is completed in 30 min, whereas that in the high-frequency range recovers much more slowly, not returning to normal until 24 h later. High-frequency hearing loss is at risk in groundcrew. In order to prevent hearing damage, they ought to wear ear protectors. We discovered that the V-shaped depression was not at 4 kHz but at 6 kHz. The former view concerning the pathogenesis of "4 kHz depression", therefore, is open to question. This interesting subject warrants further study. PMID- 2712806 TI - Federal Air Regulations and the Medical Certification of civilian airmen. PMID- 2712805 TI - Cases from the aerospace medicine residents' teaching file, case #30. A difficult differentiation between idiopathic perilymph fistula and psychosomatic dizziness and unsteadiness. PMID- 2712807 TI - Do the planes in Spain fall mainly on the grain? PMID- 2712808 TI - Genetic analysis of twin and family data: structural modeling using LISREL. Papers delivered at the International Workshop on Twin Methodology. Leuven, Belgium, August 24-29, 1987. PMID- 2712809 TI - The effects of social homogamy and cultural inheritance on the covariances of twins and their parents: a LISREL model. AB - In general, models involving parent-offspring transmission are not possible to specify in LISREL due to the complex constraints implied by assortative mating and genotype-environmental correlation. In this short note we describe one simple model of resemblance among twins and their parents which can be accommodated in the LISREL specification due to the strong assumption of social homogamy. The specification is described fully and checked for identification, and its power to resolve different parameters is briefly examined. PMID- 2712810 TI - Resemblances of parents and twins in sports participation and heart rate. AB - A model to analyze resemblances of twins and parents using LISREL is outlined and applied to sports participation and heart-rate data. Sports participation and heart rate were measured in 44 monozygotic and 46 dizygotic adolescent twin pairs and in their parents. Genetic factors influence variation in both sports behavior and heart rate, while there is no evidence for transmission from parental environment to offspring environment. For sports participation the data support a model in which there is a high positive correlation between environments of spouses and between environments of female twins. This correlation is absent for male twins and negative for opposite sex twins. For heart rate, a positive correlation between environmental influences was observed for all twins; there is no evidence for assortative mating. The proposed model can also handle data sets where parents and twins have been measured on more than one variable. This is illustrated by an application to the observed association of sports participation and heart rate. PMID- 2712811 TI - Genetic and environmental variation in the birth weight of twins. AB - Two novel approaches to the analysis of twin data are illustrated with data from birth weight in twins. First, two possible covariates of birth weight are fitted to the data simultaneously, allowing for linear effects of these variables, and their correlation. Second, information on chorionicity is used to estimate the effects of chorion type on birth weight. The data were collected from a large sample of twins born in East Flanders, Belgium. Variation and covariation in twins were considered as a function of sex, chorionicity, maternal age, gestational age, and genotype. No evidence for sex differences in causes of variation was found. As expected, the largest source of variation in bith weight was associated with gestational age. Other common environmental influences were non-significant. Heritability was significant, constituting approximately 40% of variation not associated with maternal and gestational age. A small but significant effect of chorionicity was found, such that dichorionic twins show a greater similarity than monochorionic. PMID- 2712812 TI - Fitting genetic models with LISREL: hypothesis testing. AB - A brief introduction to the mathematical theory involved in model fitting is provided. The properties of maximum-likelihood estimates are described, and their advantages in fitting structural models are given. Identification of models is considered. Standard errors of parameter estimates are compared with the use of likelihood-ratio (L-R) statistics. For structural modeling, L-R tests are invariant to parameter transformation and give robust tests of significance. Some guidelines for fitting models to data collected from twins are given, with discussion of the relative merits of parsimony and data description. PMID- 2712813 TI - LISREL analysis of twin data with structured means. AB - A method is introduced to test the hypothesis that both the phenotypic means and the phenotypic covariances can be modeled with the same common genetic and environmental factors. LISREL can be used to implement the method. An illustration is given with simulated twin data. PMID- 2712814 TI - The effects of age, sex, and genotype on self-report drunkenness following a challenge dose of alcohol. AB - Age is a potential source of variation that contributes to differences between, but not within, twin pairs. In most genetic analyses of twin data, linear and other functions of age are usually removed prior to model fitting. This correction is typically applied only within twin groups of the same sex and zygosity, and no heterogeneity test of age regressions is performed. Here we include age as a variable in the model-fitting procedure and allow for tests of heterogeneity of age regressions across sex and zygosity groups. The LISREL formulation of the approach is illustrated with data collected from Australian twins on subjective impressions of drunkenness following alcohol consumption. The results indicate significant negative covariation of impressions of drunkenness with age. The data support a simple model of additive genetic and unique environmental variation. No evidence was found for sex differences in genetic or environmental components of variation. PMID- 2712815 TI - Factor and simplex models for repeated measures: application to two psychomotor measures of alcohol sensitivity in twins. AB - As part of a larger study, data on arithmetic computation and motor coordination were obtained from 206 twin pairs. The twins were measured once before and three times after ingesting a standard dose of alcohol. Previous analyses ignored the time-series structure of these data. Here we illustrate the application of simplex models for the genetic analysis of covariance structures in a repeated measures design and compare the results with factor models for the two psychomotor measures. We then present a bivariate analysis incorporating simplex processes common and specific to the two measures. Our analyses confirm the notion that there is genetic variation affecting psychomotor performance which is "switched on" in the presence of alcohol. We compare the merits of analysis of mean products versus covariance matrices and confront some practical problems that may arise in situations where the number of subjects is relatively small and where the causal structure among the latent variables places a heavy demand on the data. PMID- 2712816 TI - Testing structural equation models for twin data using LISREL. AB - Simple genetic models can be fitted to twin data using software packages such as LISREL (Joreskog and Sorbom, 1986a). After discussion of data preparation and routine checks on possible violation of assumptions of the twin method, we illustrate univariate, bivariate, and multivariate genetic models which can be tested in cross-sectional twin data using LISREL. These include models for cohort or cohabitation effects, genotype x sex interaction, and certain types of genotype x environment interaction and genotype-environment correlation. PMID- 2712817 TI - Willingness to drive when drunk and personality: a twin study. AB - In a laboratory study of psychomotor sensitivity to alcohol, twins were asked "Would you drive a car now?" at 1, 2, and 3 h after drinking a standard dose of ethanol (0.75 g/kg). Correlations among these binary items, the Eysenck personality scales, and age were investigated using PRELIS and LISREL. Willingness to drive and Extraversion correlate at all three times in both males and females. In males, willingness to drive also correlates with Psychoticism, and in females it correlates negatively with the Lie (or Social Desirability) scale. Most correlations between cotwins in willingness to drive were significant in both monozygotic (MZ) and dizygotic (DZ) male twins but correlations were lower in female twins. Factor and Markovian models were fitted. In males there seem to be both genetic and cultural influences on willingness to drive when drunk. About half the genetic variance seems to be the pleiotropic effects of genes influencing Extraversion. The correlations with Psychoticism, on the other hand, seem to be largely environmental in origin. The small sample size and lack of proper significance tests mean that these results must be interpreted with caution. PMID- 2712818 TI - Paradoxical punishment as it relates to the battered woman syndrome. AB - The main goal of this article is to suggest some processes by which the behavioral interactions of an abusive couple can be developed and maintained. A summary of these processes as they have been adapted from the animal analog and human research follows. First, the pairing of abuse (punishment) with love and affection (reinforcement) could indicate that the battered woman responds to the reinforcement that follows an abusive incident. Second, the battered woman may seek to escape the fear of the tension-building phase but during the escape behavior she is punished (physical abuse), which fortifies and strengthens her initial fear. However, after the abusive incident, there is an absence of tension and fear (negative reinforcement) compounded by the positive reinforcement of the contrition phase. Thus, a cyclical pattern of behavior evolves and sustains itself. Possibly augmenting the vicious cycle is habituation or negative adaptation to the physical abuse, as well as the lack of opportunities to learn adaptive behavioral responses that may break the cycle of violence. Finally, the need for primary reinforcement (i.e., love and affection) may be so powerful that it somewhat mitigates the abuse endured to obtain it. PMID- 2712819 TI - Multidimensional behavioral treatment for child stutterers. PMID- 2712820 TI - Sequential assessment of staff administration of contingency management procedures on a child psychiatric unit. PMID- 2712821 TI - The acceptability of electric shock programs. PMID- 2712822 TI - The N haplotype of the murine beta-glucuronidase gene is altered in both its systemic regulation and its response to androgen induction. AB - A new haplotype of the beta-glucuronidase gene complex, [Gus]N, has been characterized following its transfer from the PAC/Cr strain to the standard strain C57BL/6J. The N haplotype contains a novel structural gene allele which encodes an allozyme differing from all previously characterized allozymes in both size and charge. Altered systemic regulation is exhibited by the [Gus]N haplotype. Multiple tissues contain levels of GUS protein that are 60 +/- 15% those found in the standard B haplotype. The regulatory mechanism for reduction is complex, involving tissue-specific changes in both enzyme synthesis and enzyme turnover. The changes in GUS protein synthesis do not result from changes in GUS mRNA levels. Instead, the amount of mature enzyme formed per mRNA molecule, or translational yield, is altered. These regulatory changes parallel those seen in other systemic regulatory variants of GUS which are also altered in translational yield. A commonality of mechanism among systemic regulatory variants of this gene is suggested. The N haplotype is also exceptional in the nature of its response to androgenic induction in kidney proximal tubule epithelial cells. The time course for GUS induction consists of a lag period followed by a progressive increase in mRNA, rate of enzyme synthesis, and enzyme activity. For the [Gus]N haplotype the lag is of an exceptionally short duration and the plateau is of a greater magnitude than for any haplotype previously described. PMID- 2712823 TI - Organic aciduria and butyryl CoA dehydrogenase deficiency in BALB/cByJ mice. AB - A metabolic screening program of inbred strains of mice has detected a marked organic aciduria in the BALB/cByJ strain. Gas chromatographic and mass spectrometric analysis identified large quantities of n-butyrylglycine plus lesser quantities of ethylmalonic acid. Crosses with the nonexcreting C57BL/6J strain indicate that this condition is inherited as an autosomal recessive trait. Independently from this screening a variant with no detectable enzyme activity of butyryl CoA dehydrogenase (BCD) in liver and kidney of the BALB/cByJ strain but not other BALB/c sublines was discovered. Data from a three-point cross indicated that the null variant maps to the structural locus for the enzyme, Bcd-1, on chromosome 5. The findings indicate that a mutation at or near Bcd-1 in the BALB/cByJ strain resulted in a biochemical abnormality manifest as the BCD deficiency. It is concluded that accumulation of butyryl CoA due to a block in the oxidation of short-chain fatty acids results in an overproduction of organic metabolites leading to the observed organic aciduria. The fact that other BALB/c substrains do not exhibit this abnormality further suggests that this disorder reflects subline divergence within the BALB/c family. PMID- 2712824 TI - Aspartate aminotransferase isozymes in the genus Capsella (Brassicaceae): subcellular location, gene duplication, and polymorphism. AB - The subcellular location of aspartate aminotransferase isozymes (EC 2.6.1.1) in the genus Capsella (Brassicaceae) was studied. The diploid species C. grandiflora and C. rubella have three AAT isozymes, including one located in the plastids. Each locus is duplicated in the tetraploid Capsella bursa-pastoris. Variation at the plastid-coding locus exceeded that at the other loci. C. bursa-pastoris had some unique alleles not detected in the diploid species. Segregation in open pollinated families revealed that Capsella grandiflora was outcrossing, whereas C. rubella was highly inbred, with most populations homozygous or uniform at all three loci. Inheritance in the tetraploid colonizer C. bursa-pastoris is disomic. This species was also predominantly selfing with outcrossing rates between 2% and 10%. PMID- 2712825 TI - Differences in the number of embryonic and pseudo-beta-globin genes between HbA and HbB sheep. AB - DNA samples obtained from 8 goats, 1 moufflon, and 84 sheep with HbA, HbAB, and HbB belonging to different breeds were digested with BamHI, EcoRI, HindIII and PstI and probed with the 5' end of the goat epsilon IV- and psi beta Z-globin genes. Sheep homozygous for HbA show a different restriction pattern than sheep homozygous fo HbB with each of these endonucleases. The main difference is that HbB sheep lack the epsilon II and psi beta X genes. These results, in addition to those previously obtained using a probe specific for beta-globin genes, suggest that HbB sheep probably lack the preadult four-gene set. The DNAs from moufflon and sheep homozygous for HbA show indistinguishable restriction patterns. Furthermore, a number of restriction fragment length polymorphisms (RFLPs) are detected in the epsilon IV and psi beta Z DNA regions, and one HindIII RFLP in the epsilon VI DNA region. PMID- 2712826 TI - Does early replication control transcription of genes? PMID- 2712827 TI - Nascent very low density lipoproteins from rat hepatocytic Golgi fractions are enriched in phosphatidylethanolamine. AB - The phospholipid composition of nascent very low density lipoproteins (VLDL) of rat hepatocytic Golgi fractions differs greatly from that of plasma VLDL. The phospholipids of nascent VLDL contain about four times more phosphatidylethanolamine (PE) than plasma VLDL, whereas plasma VLDL contain considerably more sphingomyelin. Thus, the ratio of PE to sphingomyelin differs by a factor of about 12 between nascent Golgi VLDL and circulating plasma VLDL. It is evident from these data that the PE/sphingomyelin ratio of VLDL can be used to estimate endosomal contamination of hepatocytic Golgi fractions. PMID- 2712828 TI - Caldesmon: anomalous electrophoretic behaviour in polyacrylamide gel. AB - In SDS gels caldesmon (Mr = 140 kDa) and myosin light chain kinase (Mr = 130 kDa) migrate as a closely separated doublet. When glycerol is added to the gel caldesmon is characterized by an anomalous migration. In fact under this latter condition, the distance between caldesmon and myosin light chain kinase is enhanced by two-three times. The nature of putative caldesmon and myosin light chain kinase was confirmed by physicochemical, enzymatic and immunological methods. PMID- 2712829 TI - Receptor-mediated actin assembly in electropermeabilized neutrophils: role of intracellular pH. AB - Neutrophil activation by a variety of stimuli is accompanied by an intracellular acidification, which has been postulated to mediate actin polymerization (Yuli and Oplatka, Science 1987, 235, 340). This hypothesis was tested using 7 nitrobenz-2-oxa-1,3-diazole (NBD)-phallacidin staining and flow cytometry, or right angle light scattering to study actin assembly in intact and electrically permeabilized human neutrophils. Intracellular pH was measured fluorimetrically using a pH sensitive dye. In cells stimulated with N-formyl-methionyl-leucyl phenylalanine (fMLP) at 21 degrees C, actin assembly clearly preceded the intracellular acidification in response to fMLP. Moreover, actin polymerization persisted in cells where intracellular pH was clamped near the resting (unstimulated) level using nigericin/K+. Finally, fMLP induced a significant increase in F-actin content in electropermeabilized neutrophils equilibrated with an extracellular medium containing up to 50 mM HEPES. These observations indicate that fMLP-stimulated F-actin assembly is not mediated by a decrease in intracellular pH and suggest that changes in transmembrane potential and ionic gradients are unlikely to mediate actin polymerization. PMID- 2712830 TI - Modulation of an RGDS binding site on the platelet membrane glycoprotein IIb-IIIa complex. AB - Fibronectin, von Willebrand factor, and fibrinogen each bind to the glycoprotein IIb-IIIa complex on activated platelets via an arg-gly-asp-ser (RGDS) sequence present within the adhesive proteins. Both the IIb and IIIa polypeptides of the IIb-IIIa complex on thrombin activated platelets are specifically and extensively labeled by a radiolabeled, photoactivatable arylazide derivative of the RGDS sequence when the labeling is performed in the presence of concentrations of Ca++ or Mg++ approaching 0.5 mM. In contrast, labeling of unactivated platelets, ADP activated platelets, or thrombin activated platelets in the presence of low concentrations of divalent cations resulted in restriction of labeling to the IIb polypeptide of the complex. PMID- 2712831 TI - The 5'-region of the P450XIA1 (P450scc) gene contains a basal promoter and an adrenal-specific activating domain. AB - The first step to the synthesis of all steroids is catalyzed by P450scc. We constructed nine deletion mutants of the 5'-region of the P450scc gene and connected them to a CAT reporter gene to assay transcriptional activity of the P450scc promoter. A short 145 bp fragment stimulated transcription by two fold. This DNA was active in all cells tested irrespective of their tissue origin and steroidogenic activity. DNA at -145/-573 of the upstream region did not increase transcription any further. DNA including 2500 bp of the upstream region stimulated transcription by 10 fold only in adrenal Y-1 cells. Hence in the -145 region contains a low level P450scc promoter and the 2500 bp DNA possesses an adrenal specific enhancing element. PMID- 2712832 TI - Kinetics of the glycation of bovine serum albumin by mannose and fucose in vitro. AB - Glycation of bovine serum albumin was measured for mannose and fucose at 37 degrees C. Mannose as well as fucose demonstrated an initial rapid increase in rate of formation of total adducts followed by a slower secondary reaction. The equilibrium constant for Schiff base formation was almost two times larger for mannose than fucose, although the Schiff base formed by fucose rearranged 1.5 times faster than that for mannose. Both sugars showed parallel lines for the formation of total and acid stable products after three hours. Discussion integrates new mechanistic data with previously suggested mechanisms. PMID- 2712833 TI - Cyclosporin A inhibits protein kinase C activity: a contributing mechanism in the development of nephrotoxicity? AB - Cyclosporin A modifies many intracellular functions in a variety of different cells. This study investigated the potential interaction between cyclosporin A and protein kinase C, as a possible mechanism for the development of nephrotoxicity. The activity of protein kinase C, in the cytosol of renal epithelial cells, was shown to be significantly inhibited in a dose-dependent manner by CSA. Activation of protein kinase C by 12-O-tetradecanoylphorbol-13 acetate (phorbol ester) in rat mesangial cells in culture leads to an increase in PGE2 release. Phorbol ester stimulated PGE2 release was significantly inhibited by cyclosporin A. These results would suggest that intracellular site of action of cyclosporin A, in producing alterations in intracellular function and toxicity, may be at the level of protein kinase C. PMID- 2712835 TI - Laboratory investigations of the electrical characteristics of honey bees and their exposure to intense electric fields. AB - Bees exposed to 60-Hz electric (E) fields greater than 150 kV/m show field induced vibrations of wings, antennae, and body hairs. They also show altered behavior if exposed while in contact with a conductive substrate. Measurements indicate that approximately 240 nA is coupled to a bee standing on a conductive substrate in a 100-kV/m E field. In lab experiments, bee disturbance and sting result from exposure to E field greater than 200 kV/m (bee current greater than 480 nA) and reduced voluntary movements at greater than 300 kV/m (greater than 720 nA bee current) only if the bee is on a conductive substrate. It is hypothesized that in the latter situation coupled bee current drains through the lower thorax and legs to the conductive substrate, and that the resulting enhanced current density in these regions is the cause of observed responses. The observation that bees exposed to intense E fields on an insulator show vibration of body parts but no behavioral response suggests that vibration contributes little to the disturbance of bees in intense E fields. Lab measurements of bee impedance from front-to-rear leg pairs were made on wet and dry conductors. Measurements validate the selection of 1 M omega as a middle value for bee impedance used in the design of devices used to generate step-potential-induced currents in bees. PMID- 2712834 TI - Human prostatic acid phosphatase: cDNA cloning, gene mapping and protein sequence homology with lysosomal acid phosphatase. AB - The cDNAs encoding human prostatic acid phosphatase were cloned and characterized. The mRNAs contain 3' noncoding regions of heterogeneous sizes 646, 1887 or 1913 nucleotides. A dimer and a monomer of the conserved Alu-repeats are present in the longer 3' noncoding sequences. The complete sequence of 354 amino acids for the mature enzyme was determined by sequencing both cDNA and protein. Human prostatic and lysosomal acid phosphatases exhibit 50% sequence homology, including five Cys residues and two putative N-linked glycosylation sites. The Acp-3 gene coding for human prostatic acid phosphatase was mapped onto chromosome 3 in this investigation. The Acp-2 gene coding for lysosomal acid phosphatase has previously been located on chromosome 11, while the Acp-1 gene coding for red blood cell acid phosphatase is on chromosome 2. PMID- 2712836 TI - Intensity threshold for 60-Hz magnetically induced behavioral changes in rats. AB - Experiments were conducted to further investigate the effect of 60-Hz cyclotron resonance exposures on rats performing on a multiple FR-DRL schedule. The previously reported temporary loss of DRL baseline response, when measured as a function of A.C. magnetic intensity, was found to have a threshold. Utilizing the component of A.C. magnetic intensity parallel to the D.C. field, we report this threshold as (0.27 +/- 0.10) x 10(-4) Trms. PMID- 2712837 TI - Use of wiring configuration and wiring codes for estimating externally generated electric and magnetic fields. AB - The relative locations and characteristics of the distribution lines feeding 434 residences in the Denver metropolitan area were recorded and classified according to the Wertheimer-Leeper code (WL code) as a part of an epidemiological study of the incidence of childhood cancer. The WL code was found to place the mean values of the fields in rank order. However, the standard deviations were approximately the same size as the means. Theoretical calculations indicate that a significant fraction of the low-power magnetic fields can be generated by the distribution lines, especially in the cases where the distribution lines are within 50 feet of the residence. Thus, the wiring code was shown to be a useful method for making a first-order approximation to predict long-term, low-level magnetic fields in residences. PMID- 2712838 TI - Statistical approach to combining the results of similar experiments, with application to the hematologic effects of extremely-low-frequency electric field exposures. AB - A large proportion of scientific effort in investigating the possible biological effects of exposure to extremely-low-frequency (ELF) fields consists of laboratory studies on experimental animals. Most experiments in which hematologic properties are measured show no statistically significant effect due to exposure. However, some studies show significant effects which, in general, are not clearly reproducible. A difficult question must then be addressed: Are these relatively few indications of ELF effects statistical artifacts due to the increased risk of a type I error in multiple studies, or is there a real biological effect that is undetected in most studies due to the relatively small sample sizes commonly used? A statistical approach for examining the accumulated results of multiple experiments which results in a single test for treatment effect is presented. The technique requires very mild assumptions, and is valid for experiments that vary widely in specific characteristics such as exposure level, duration, and laboratory. The method is applied to the results of a collection of hematologic and serum chemistry experiments, and the combined results indicate the existence of experimental effects on some end points. PMID- 2712839 TI - Electromagnetic pulse propagation in dispersive planar dielectrics. AB - The responses of a plane-wave pulse train irradiating a lossy dispersive dielectric half-space are investigated. The incident pulse train is expressed as a Fourier series with summing done by the inverse fast Fourier transform. The Fourier series technique is adopted to avoid the many difficulties often encountered in finding the inverse Fourier transform when transform analyses are used. Calculations are made for propagation in pure water, and typical waveforms inside the dielectric half-space are presented. Higher harmonics are strongly attenuated, resulting in a single continuous sinusoidal waveform at the frequency of the fundamental depth in the material. The time-averaged specific absorption rate (SAR) for pulse-train propagation is shown to be the sum of the time averaged SARs of the individual harmonic components of the pulse train. For the same average power, calculated SARs reveal that pulse trains generally penetrate deeper than carrier-frequency continuous waves but not deeper than continuous waves at frequencies approaching the fundamental of the pulse train. The effects of rise time on the propagating pulse train in the dielectrics are shown and explained. Since most practical pulsed systems are very limited in bandwidth, no pronounced differences between their response and continuous wave (CW) response would be expected. Typical results for pulse-train propagation in arrays of dispersive planar dielectric slabs are presented. Expressing the pulse train as a Fourier series provides a practical way of interpreting the dispersion characteristics from the spectral point of view. PMID- 2712840 TI - ELF electromagnetic environment in power substations. AB - This paper presents a theoretical analysis of electromagnetic environments in power substations in service. A new analytical method is developed and applied to magnetic field calculations in 187-kV and 66-kV substations. Experimental results verify that the method offers a good prediction of the magnetic field profiles in the substations except for the areas where localized field sources exist. The analytical results show that the magnetic field strength depends to a great extent on how the load powers distribute on individual lines and buses, that the magnetic fields in substations have a three-dimensional characteristic, and that the predominant field component depends on the position of interest. Moreover, it is suggested that objects placed in substations are exposed not only to magnetic fields of high strength in comparison to those in houses or near the distribution networks but also to fields with several percent of harmonic distortion. PMID- 2712841 TI - Lack of behavioral effects in the rhesus monkey: high peak microwave pulses at 1.3 GHz. AB - The current safety standards for radiofrequency and microwave exposure do not limit the peak power of microwave pulses for general or occupational exposures. While some biological effects, primarily the auditory effect, depend on pulsed microwaves, hazards associated with very high peak-power microwave pulses in the absence of whole-body heating are unknown. Five rhesus monkeys, Macaca mulatta, were exposed to peak-power densities of 131.8 W/cm2 (RMS) while performing a time related behavioral task. The task was composed of a multiple schedule of reinforcement consisting of three distinct behavioral components: inter-response time, time discrimination, and fixed interval. Trained monkeys performed the multiple schedule during exposure to 1.3-GHz pulses at low pulse-repetition rates (2-32 Hz). No significant change was observed in any behavior during irradiation as compared to sham-irradiation sessions. Generalization of these findings to experimental results with higher peak-power densities, other pulse rates, different carrier frequencies, or other behaviors is limited. PMID- 2712843 TI - Addition of magnetic field capability to existing extremely-low-frequency electric field exposure systems. AB - Magnetic field systems were added to existing electric field exposure apparatuses for exposing cell suspensions in vitro and small animals in vivo. Two horizontally oriented, rectangular coils, stacked one directly above the other, have opposite electric currents. This configuration minimizes leakage fields and allows sham- and field-exposure systems to be placed in the same room or incubator. For the in vitro system, copper plates formed the loop-pair, with up to 900 A supplied by a 180:1 transformer. Electric fields were supplied via electrodes at the ends of cell-culture tubes, eight of which can be accommodated by each exposure system. Two complete systems are situated in an incubator to allow simultaneous sham and field exposure up to 1 mT. For the in vivo system, four pairs of 0.8 x 2.7-m coils made of copper bus bar are employed. This arrangement is energized from the power grid via a 30:1 transformer; horizontal magnetic flux densities up to 1 mT can be generated. Pairs of electrode plates spaced 30.5 cm apart provide electric field exposure of up to 130 kV/m. Four systems with a capacity of 48 rats each are located in one room. For both the in vitro and in vivo systems, magnetic exposure fields are uniform to within +/- 2.5%, and sham levels are at least 2,500-fold lower than exposure levels. Potential confounding factors, such as heating and vibration, were examined and found to be minimal. PMID- 2712842 TI - Relationship between local temperature and heat transfer through the hand and wrist. AB - The heat uptake that resulted from immersing the hand and wrist into a water filled calorimeter maintained at temperatures between 37-40 degrees C was measured under standard conditions in a group of eight subjects of either sex. The rate of heat transfer (W) increased exponentially with temperature and was a function of hand or body size and age, but not sex. The heat transfer rate normalized to hand mass (W.kg-1) was determined by temperature and age: best-fit mean values (and 95% confidence limits of the population) were 6.0 W.kg-1 (3.2 11.2 W.kg-1) at an immersion temperature of 37 degrees C and 25.4 W.kg-1 (13.7 47.0 W.kg-1) at 40 degrees C. The application of these results to limits on specific energy absorption rate induced in the hands and wrists by radiofrequency dielectric heat sealer welders is discussed. PMID- 2712844 TI - Comparison of 60-Hz electric fields and incandescent light as aversive stimuli controlling the behavior of rats. AB - Rats were exposed to two procedures which enabled them to press a lever to turn off a 90 or 100 kV/m 60-Hz electric field or, later in the study, illumination from an incandescent lamp. Under one procedure, a response turned off the stimulus for a fixed duration, after which the stimulus was turned on again. A response during the off-period restarted the fixed duration. None of the rats turned the field off reliably. Next, under an alternative procedure, pressing one lever turned the field off; pressing the other lever turned it back on; responding under those conditions differed little from that seen at 0 kV/m. Under both procedures, when illumination from an incandescent lamp served as the stimulus, each rat did turn the stimulus off, and performances varied with stimulus intensity. The results show that a 100 kV/m 60-Hz electric field is not sufficient to function as an aversive stimulus under two procedures where illumination from a lamp does function as an aversive stimulus. PMID- 2712845 TI - Search for cyclotron resonance in cells in vitro. AB - There are a number of reports of the plasma membrane transport of Ca2+ in biological systems being enhanced by low frequency electromagnetic fields (EMF), including reports that the enhancement involves a resonance-type response at the cyclotron frequency for Ca2+ ions for geomagnetic values of the magnetic field. Using the fluorescent probe fura2, we find no evidence for changes in cytosolic calcium concentration in BALB/c3T3, L929, V-79, and ROS, a rat osteosarcoma cell line, at the application of both resonant and nonresonant EMF. PMID- 2712846 TI - Thresholds of cat cochlear nucleus neurons to microwave pulses. AB - Action potentials of neurons in cat dorsal and posteroventral cochlear nuclei were recorded extracellularly with glass microelectrodes while the head of the cat was exposed to microwave pulses at 915 MHz using a diathermy applicator. Response thresholds to acoustic tones, acoustic clicks, and microwave pulses were determined for auditory units with characteristic frequencies (CFs) from 278 Hz to 39.2 kHz. Tests with pulsatile stimuli were performed for durations of 20-700 mus, principally 20, 70, and 200 mus. Brainstem midline specific absorption rate (SAR) threshold was as small as 11.1 mW/g per pulse, and specific absorption (SA) threshold was a small as 0.6 muJ/g per pulse. Microwave thresholds were generally lower for CF less than 9 kHz, as were most acoustic thresholds. However, microwave threshold was only weakly related to click threshold and CF-tone threshold of each unit. PMID- 2712847 TI - Specific absorption rate (SAR) in models of the human head exposed to hand-held UHF portable radios. AB - Specific absorption rate (SAR) was measured in models of the human head exposed to hand-held portable radios ("transceivers") transmitting at frequencies in the 800-MHz band. An isotropic implantable electric-field probe was used to measure internal fields induced in the head models, and SARs were determined by calculation. As well as determining representative values and distributions for SARs under various conditions, it was shown that antenna type and orientation with respect to the head are important factors affecting energy absorption. PMID- 2712848 TI - Ambient 60-Hz magnetic flux density in an urban neighborhood. AB - A residential neighborhood in Buffalo, NY, was surveyed with a magnetic field meter to evaluate whether or not spot measurements are reliable predictors of the 60-Hz fields at street corners and residences. The results of repeated measurements over 7 days at 33 street corners in this neighborhood indicate that day-to-day variation in power line magnetic fields is negligible (intraclass correlation coefficient = 0.94). Multivariate linear regression analysis of the data indicates that transmission lines and thick, three-phase primary wires near the field measurement site are strong predictors and account for the majority of the ambient magnetic field variance between locations (multiple correlation coefficient squared = 0.60; F ratio = 22.2, P less than .001). Magnetic fields measured at the front sidewalk were highly correlated with fields at the front doorsteps of 45 homes in this neighborhood (gamma = 0.81). These results suggest that ambient power line magnetic field levels at urban residences can be reliably characterized on a one-time site inspection using a hand-held magnetic field meter and a simple wiring classification system. PMID- 2712849 TI - Low-level microwave irradiation and central cholinergic activity: a dose-response study. AB - Rats were irradiated with circularly polarized, 2,450-MHz pulsed microwaves (2 microseconds pulses, 500 pulses per second [pps]) for 45 min in the cylindrical waveguide system of Guy et al:(Radio Sci 14:63-74, 1979). Immediately after exposure, sodium-dependent high-affinity choline uptake, an indicator of cholinergic activity in neural tissue, was measured in the striatum, frontal cortex, hippocampus, and hypothalamus. The power density was set to give average whole-body specific absorption rates (SAR) of 0.3, 0.45, 0.6, 0.75, 0.9, or 1.2 W/kg to study the dose-response relationship between the rate of microwave energy absorption and cholinergic activity in the different areas of the brain. Decrease in choline uptake was observed in the striatum at a SAR of 0.75 W/kg and above, whereas for the frontal cortex and hippocampus, decreases in choline uptake were observed at a SAR of 0.45 W/kg and above. No significant effect was observed in the hypothalamus at the irradiation power densities studied. The probit analysis was used to determine the SAR50 in each brain area, i.e., the SAR at which 50% of maximum response was elicited. SAR50 values for the striatum, frontal cortex, and hippocampus were 0.65, 0.38, and 0.44 W/kg, respectively. PMID- 2712850 TI - Simple nonperturbing temperature probe for microwave/radio frequency dosimetry. AB - We present a simple readout device that fills the void produced by the gradual disappearance of the Vitck model 101 Electrothermia Monitor. The new device uses commercially available probes that are similar to Bowman's (IEEE Trans Microwave Theory Tech MTT-24:43-45, 1976) original design. As described, the device covers the range of 7 degrees to 45 degrees C with an accuracy and resolution of better than 0.1 degree C throughout. The digital readout (3 1/2 digits) is proportional to the thermistor resistance in the tip of the probe; it is converted to temperature through a formula or printed table. Outdoor dosimetric comparisons between the new and Vitek devices were conducted. Results showed no significant difference in the calculated specific absorption rates (SARs); moreover, variance was lower in the data collected from the new device. PMID- 2712851 TI - Issues in learning disabilities: assessment and diagnosis. PMID- 2712852 TI - Issues in determining eligibility for language intervention. PMID- 2712853 TI - Deinstitutionalization: its effect on the delivery of speech-language-hearing services for persons with mental retardation and developmental disabilities. PMID- 2712854 TI - Audiologic screening of newborn infants who are at risk for hearing impairment. AB - The importance of early identification of hearing impairment is well documented. The Joint Committee on Infant Hearing 1982 Position Statement established the goal of identification and habilitation of hearing-impaired infants by age 6 months but did not specify the procedure for initial audiologic screening. In these guidelines, ASHA specifies the recommended procedure for audiologic screening of infants at risk for hearing impairment that includes a) parent/caregiver education; b) audiologic screening by ABR; and c) referral to a comprehensive evaluation, follow-up, and management system for those infants who fail initial ABR screening. The procedures recommended in these guidelines are complex and require substantial involvement of a qualified audiologist. Identification programs should be instituted only when all components are available to provide appropriate services to the infant and his/her family. It is hoped that these guidelines will encourage implementation of programs for early identification of hearing impairment in at-risk infants. PMID- 2712855 TI - Effect of dietary vitamin E on plasma lipids and atherogenesis in restricted ovulator chickens. AB - Restricted ovulator hens, which develop hyperlipidemia, were fed 1000 IU vitamin E per k of diet. These hens maintained their hyperlipidemia but plasma peroxide levels were reduced to those of laying hens. The intimal thickness of the aorta was measured by light microscopy. Hyperlipidemic hens which had high plasma peroxide levels had an increased intimal thickness as compared to laying hens. Hyperlipidemic hens which had their plasma peroxide levels reduced by dietary vitamin E had intimal thicknesses the same as laying hens. It is suggested that hyperlipidemia without lipid peroxidation either does not promote atherogenesis or does so at a reduced rate. PMID- 2712856 TI - Anthropometric and lifestyle correlates of serum lipoprotein and apolipoprotein levels among normal non-smoking men and women. AB - The relationship between serologic predictors of coronary risk and anthropometric as well as lifestyle characteristics was investigated in 61 men (37.5 +/- 8.5 yrs) and 33 women (40.1 +/- 9.0 yrs). All subjects were healthy non-smokers, mostly middle-class bank employees. In bivariate analysis, among both genders the ratio of waist-to-hip circumference (WHR) was the single best predictor of levels of serum LDL-cholesterol, apolipoprotein B, VLDL-cholesterol and triglycerides (positive association) as well as HDL-cholesterol and apolipoprotein A-I (inverse association). In men, body fat as estimated from bioelectrical impedance measurement was the second best predictor of lipoprotein and apoprotein concentrations, whereas in women it was the body mass index (BMI). The additional independent predictive power of WHR and body fat for the lipid profile was tested in multivariate analysis by adding WHR and body fat sequentially to regression models containing already BMI, endurance capacity, exercise, alcohol consumption and age. For example, explained variance of triglyceride distribution rose from 26.3 to 35.1% (P = 0.01 for increase) when body fat was entered into the regression equation, or inclusion of WHR into a model already containing age, the behavioral variables, BMI, and body fat increased the explained variance of LDL/HDL-cholesterol ratio from 20.9 to 27.6% (P = 0.04 for increase). In women, the same regression models were even slightly more predictive for the serum lipid profile. Endurance capacity was related to a low atherogenic risk lipid profile in bivariate analysis but lost much of its predictive power in multivariate analysis, which confirms that the effect of fitness on lipid levels is probably mediated in part by a low body fat content. It is concluded from this cross sectional investigation that studies which focus on associations between lifestyle and serologic predictors of atherogenic risk should possibly include the WHR and a measure of body fat, since the latter two appear to be closer correlates of serum lipoprotein and apolipoprotein levels than BMI or single behavioral factors, at least among male non-smokers. PMID- 2712857 TI - Experimental atherosclerosis in rabbits fed cholesterol-free diets. 13. Interaction of proteins and fat. AB - The atherogenic and cholesterolemic effects of animal protein vis-a-vis plant protein are well documented. Virtually all the studies were carried out using diets high in saturated fat, such as coconut oil. In order to determine if the same effects were seen with less saturated fat, we have compared atherogenic effects of an animal protein (casein) with those of a plant protein (soybean protein isolate) fed with partially hydrogenated soybean oil (PHS) (iodine value 72) or soybean oil (iodine value 134) as part of a cholesterol-free semipurified diet. After 6 months only rabbits fed casein-PHS exhibited elevated levels of plasma and liver cholesterol and triglycerides and atherosclerosis. Rabbits fed soy protein-PHS had slightly higher plasma cholesterol and triglycerides than did those fed soy protein and soybean oil, but values in both groups were in the normal range. The different effects of animal and plant protein on lipidemia and atherosclerosis can be influenced by dietary fat and appear to be dependent on fat saturation. PMID- 2712858 TI - Interrelationship of plasma triglyceride and coagulant factor VII levels in normotriglyceridemic hypercholesterolemia. AB - We have evaluated the potential relationships between plasma levels of certain coagulation factors, i.e. factor VII antigen (F VIIag) and factor VII coagulant activity (F VIIc), and parameters of lipid transport in a group of 90 normotriglyceridemic patients displaying hypercholesterolemia (Fredrickson's type IIa hyperlipoproteinemia). Levels of factor VIIc were significantly elevated (P less than 0.01) in this patient group as compared to a group of healthy normolipidemic subjects. By contrast, levels of factor VIIag were also increased, but such differences were not significant in relation to those of controls. Furthermore, concentrations of F VIIc and F VIIag in hypercholesterolemic males and females resembled each other. Similar observations were made when patients were divided into those either presenting or lacking symptoms of vascular disease. However, plasma levels of both F VIIc and F VIIag were positively correlated with circulating triglyceride concentrations in the hypercholesterolemic group, but not with other parameters of lipid transport such as serum cholesterol, HDL-cholesterol, and apolipoprotein B. When patients were treated with a lipid-lowering agent (cholestyramine), lower levels of both F VIIc and F VIIag were found concomitantly with a decrease of similar order in triglyceride concentrations. We conclude that serum triglyceride levels, even within the normal range, may be associated with elevation in the activity of factor VII in hypercholesterolemic patients, thereby increasing their risk of thrombosis. PMID- 2712859 TI - Densitometric measurement of increased endothelial permeability in arteriosclerotic plaques and inhibition of permeability under the influence of two calcium antagonists. AB - A densitometric technique was established to investigate quantitative changes in endothelial permeability for horseradish peroxidase (HRP), mol. wt. 40,000 daltons, in rabbit carotid artery. Repeated weak electrical stimulations of rabbit carotid arterial walls with implanted electrodes lead to fibromuscular plaques mainly beneath the anode. It could be demonstrated that there exists a typical growth curve of the plaques dependent on the number of days of electrostimulation, with a fast proliferation rate of smooth muscle cells in the first 2 weeks of electrostimulation, and an increasing retardation of proliferation during the next 4 weeks. Endothelial permeability for HRP increases in close relation to the plaque development. Intravenous applications of single doses of the calcium entry blockers flunarizine or nimodipine are able to inhibit the increased permeability of the endothelial lining covering arteriosclerotic plaques. The intensity of the inhibitory action of these calcium antagonists correlates with the size of the arteriosclerotic plaques in inverse proportion, but nevertheless in large plaques an inhibitory effect is seen. PMID- 2712860 TI - Lack of effect of probucol on atheroma formation in cholesterol-fed rabbits kept at comparable plasma cholesterol levels. AB - Rabbits were fed cholesterol for 14 weeks to study the effect of probucol on atheroma formation. Three groups of animals were investigated: group CHOL was fed 1% cholesterol and served as control for group P + CHOL. fed 1% cholesterol and 1% probucol from the onset till the end of the experiment: group CHOL + P received 1% cholesterol throughout the experiment and 1% probucol during the last 4 weeks only. Plasma cholesterol concentrations were monitored at frequent intervals and were modulated by dietary perturbations so that the areas under the curve expressing plasma cholesterol changes with time, were similar in probucol and non-treated rabbits. The efficacy of long-term probucol treatment was evidenced by a significant reduction in plasma apolipoprotein A-I throughout the experiment and lower plasma TBARs during the first 6 weeks, when the hypocholesterolemic effect of probucol was also seen. Two weeks prior to the termination of the experiment, the rabbits were injected with rabbit plasma labeled with [3H]cholesteryl linoleyl ether [( 3H]CLE). Aortic atheromatosis was quantified by determination of total and cholesteryl ester (CE). The aortic cholesterol content was related to the arch, thoracic and abdominal segments, to the surface area of each segment or its dry defatted weight. Total and esterified cholesterol were highest in the aortic arch in all 3 groups when related to any of the above mentioned parameters. No statistically significant difference in aortic total cholesterol and CE content was seen among the three groups studied. The [3H]CLE recovered in the aortic segment correlated with the CE content and the [3H]CLE (dpm)/mg CE in all segments was similar. No statistically significant difference in the [3H]CLE recovered in the aortic segments among the 3 groups was seen. We conclude that in cholesterol-fed rabbits, in which the plasma cholesterol levels were maintained at comparable levels, probucol treatment did not affect plasma CE influx into the aorta and did not attenuate development of aortic atherosclerosis. PMID- 2712861 TI - Habitual fish consumption, fatty acids of serum phospholipids and platelet function. AB - To clarify whether the inverse relation between habitual fish consumption and cardiovascular mortality in the Dutch town of Zutphen could be explained by changes in platelet function or fibrinolysis, 40 healthy elderly men were selected from the Zutphen study population on the basis of their fish consumption over the last 26 years. In the high-fish group (n = 25) fish consumption was on average 33 g per person per day; in the low-fish group (n = 15) it was on average 2 g per person per day. This difference was reflected by significant differences in the concentrations of timnodonic acid (20:5n - 3) and cervonic acid (22:6n - 3) in the serum phospholipids of the participants. Between both groups no significant differences were observed in cutaneous bleeding time, platelet number, and collagen-induced platelet aggregation and ATP-release in whole blood. The same holds for the actual as well as the potential thromboxane B2 formation of activated platelets and for the activity of the plasminogen activator inhibitor. For most of the platelet-related variables a trend was found for a lower activity in the high-fish group. Therefore changes in platelet function might not explain, but may have slightly contributed to the inverse relationship between coronary heart disease and fish consumption, as observed in Zutphen. PMID- 2712862 TI - Apolipoprotein E polymorphism and lipoproteins in insulin-treated diabetes mellitus. AB - Apolipoprotein E (apo E), a component of VLDL, HDL and chylomicron remnants, is inherited at a single genetic locus with 3 common alleles (epsilon 2, epsilon 3 and epsilon 4). epsilon 2 homozygosity is found in 0-2% of healthy populations, but in 75-100% of subjects with type III hyperlipoproteinaemia, in whom an increased prevalence of glucose intolerance has previously been reported. The lipoprotein abnormality associated with diabetes mellitus has features in common with type III hyperlipoproteinaemia and both conditions lead to accelerated atherogenesis with a similar anatomical distribution. We have therefore examined the frequency of apo E genotypes in 120 subjects with insulin-treated diabetes mellitus (ITDM) and 107 healthy controls, and examined the effect of apo E polymorphism on lipoproteins in the diabetic group. As in the general population, the apo E phenotype in ITDM was a significant determinant of the total serum and LDL cholesterol concentrations which were lowest in patients possessing the epsilon 2 allele, intermediate in those homozygous for epsilon 3 and highest in those with an epsilon 4 allele. The observed gene frequencies of epsilon 2 (0.091), epsilon 3 (0.780) and epsilon 4 (0.130) were similar to those of the healthy control group and those in the general population. However, there was an unexpected increase (P less than 0.0002) in epsilon 2 homozygosity of 6.7% compared to a prevalence of 0.8% predicted both from the Hardy-Weinberg equilibrium and the 0.9% prevalence observed in the healthy control group. This suggests either that epsilon 2 homozygosity increases susceptibility to the development of ITDM or that the two conditions are genetically linked.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712863 TI - High density lipoprotein concentrations after cessation of smoking: the importance of alterations in diet. AB - Cessation of smoking is followed by a rapid rise in plasma HDL concentrations. An earlier study has demonstrated a significant relationship between the increase in HDL concentrations and spontaneous changes in food intake, specifically an increased fat intake. In this investigation we have dissociated the effects of cessation of smoking as such from those of dietary alterations by monitoring plasma lipid and lipoprotein concentrations after cessation of smoking in 12 subjects whose diet was kept constant during an initial 2-week control period and during 2 weeks following cessation of smoking. Under these conditions plasma HDL cholesterol levels did not increase significantly (1.01 +/- 0.26 mmol/l (mean +/- SD) before and 1.04 +/- 0.27 mmol/l after cessation of smoking). Similarly, no significant alterations were recorded for other plasma lipid or lipoprotein concentrations. Activities of lipoprotein lipase and hepatic lipase were unchanged throughout the study. These results suggest that the marked rise in HDL concentrations after stopping smoking is largely related to spontaneous changes in dietary habits which occur upon cessation of smoking. PMID- 2712864 TI - Transport pathways of beta-VLDL by aortic endothelium of normal and hypercholesterolemic rabbits. AB - The uptake and transport of beta-VLDL by the aortic endothelium was investigated in normal and hyperlipidemic rabbits fed a cholesterol-enriched diet for 1 week to 5 months. Weekly (in the first month) or every other week afterwards, animals were given one of the following probes: (a) [125I]-beta-VLDL injected in vivo and after 24 h the whole aorta or its intima and media were separately collected and examined by spectrometry and autoradiography; (b) [125I]-beta-VLDL coupled to the fluorescent probe 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate perfused in situ for 1-2 h and aorta examined by radioassay and fluorescence microscopy; (c) beta-VLDL-gold complex perfused in situ for 10-15 min and aortic fragments examined by electron microscopy. In addition, cryosections of aortic wall were processed for the immunocytochemical detection of apolipoprotein B and apolipoprotein E. The results showed that both in normal and hyperlipidemic rabbits, the aortic endothelium transports plasma beta-VLDL by a dual pathway: (i) endocytosis involving coated pits and vesicles, endosomes, multivesicular bodies and lysosomes, and (ii) transcytosis, the predominant process, carried out by plasmalemmal vesicles. Both processes, and especially transcytosis, are markedly increased in hyperlipidemia leading to progressive accumulation of beta-VLDL or/and its components in the subendothelial extracellular matrix. In prelesional stages of atherogenesis, beta-VLDL-gold complexes or deposits of apo B and apo E were detected in close association with extracellular liposomes. With the appearance of intimal macrophage-derived foam cells, the immunoperoxidase reaction product, revealing the presence of the two apolipoproteins, could also be seen in intracellular lipid inclusions. PMID- 2712865 TI - Risk factors and the anatomic distribution of coronary artery disease. AB - Differences in the importance of risk factors according to the anatomic location of coronary artery disease (CAD) were assessed in 4722 men and 1069 women who underwent arteriography. Examined characteristics included total and high-density lipoprotein (HDL)-cholesterol, triglycerides, obesity, smoking, alcohol consumption, diabetes, and hypertension. Of these risk factors, the ratio of total to HDL-cholesterol showed the highest correlation with the overall severity of CAD (r = 0.24, men; r = 0.38, women); in contrast, its relation to left main (LM) disease was much lower (r = 0.10, men; r = 0.08 women) than were correlations with stenotic disease in the left anterior descending, circumflex, and right coronary arteries. Other risk factors also showed weaker associations with LM disease than with stenoses in other vessels, and none was related to increased LM disease after controlling for disease in other vessels. For example, as compared with men who had no significant CAD, those with 1-, 2-, and 3-vessel disease had mean increases in total cholesterol of 12, 18, and 19 mg/dl, respectively. In contrast, after adjusting for disease in other vessels, LM disease (present in 293 men) was associated with only a 4 mg/dl increase in mean cholesterol levels (P = 0.20). These results indicate that the relation of risk factors to CAD differs according to the location of the stenotic disease, and that LM disease is poorly predicted by the standard risk factors. PMID- 2712866 TI - Plasma lipids in beta-thalassemia minor. AB - Because total cholesterol levels have been found to be lower in patients affected by thalassemia major and intermedia, we examined the plasma lipid pattern of 628 beta-thalassemia trait carriers and 4552 controls in order to evaluate whether the plasma lipid impairment is also present in the heterozygous state. Total cholesterol and low density lipoprotein (LDL)-cholesterol levels were significantly lower in beta-thalassemia trait carriers when compared to controls, whereas plasma triglycerides and high density lipoprotein (HDL)-cholesterol levels did not differ between the two groups. We suggest that accelerated erythropoiesis and increased uptake of LDL by macrophages and histiocytes of the reticuloendothelial system are the main determinants of low plasma cholesterol levels in heterozygous thalassemia. PMID- 2712868 TI - ["Mixed' (follicular and parafollicular) carcinomas of the thyroid. Histological and immunocytological study of 5 cases]. AB - We studied five cases of poorly differentiated follicular or papillary thyroid carcinomas. Immunohistochemical study revealed numerous ACE positive cells, also positive for calcitonin, ACTH, somatostatin or several of these peptides. These tumors containing both vesicular component and parafollicular cells are endocrine tumors of "mixed" or "intermediate" type. The diagnosis must be confirmed by immunohistochemistry but can be suggested by histological findings: abundant fibrous stroma, trabeculovesicular pattern, and swelled moderately acidophilic cells neighbouring vesicular cells. These facts argue in favor of a common embryological origin of vesicular and parafollicular cells from ultimobranchial undifferentiated cells. Nevertheless such tumors must take place in thyroid neoplasia's classifications and an appropriate terminology remains to be precised. PMID- 2712867 TI - [Transient ischemic colitis. Diagnostic value of patchy epithelial atrophy]. AB - Microscopic findings, observed in 58 colonic biopsies, have been described by the authors during transient ischemic colitis. One of these lesions, closely associated with the diagnosis and named patchy tubular atrophy, was considered as a marker for ischemia. Patchy tubular atrophy was observed at the beginning of the disease, and was regularly associated with normal and necrotic areas. Three morphological aspects characterized this condition: --non secretory glandular crypts covered with rudimentary basophilic epithelium, --crypts regularly distributed in a geometrical pattern with intact connective spaces, --absence of interstitial inflammatory infiltrate, and presence of fibrinous thrombosis with extravasation of erythrocytes. This morphologic pattern was specific enough to rule ou the other inflammatory or trophic bowel diseases. Therefore patchy tubular atrophy, observed during transient ischemic colitis, was considered by authors as a distinct entity. PMID- 2712869 TI - [Giant leiomyoma of the inferior vena cava]. AB - The authors report an uncommon case of giant leiomyoma of the inferior vena cava with intracardiac extension and arising from the external iliac vena. This case report illustrates the diagnostical problems usually encountered with this type of tumour. Indeed, despite ultrasound and transverse CT scan, the diagnosis was only assessed by histopathological analysis following a successful surgical removal of the leiomyoma. Only 7 cases of leiomyoma of the inferior vena cava are already reported in the literature. Relationship with intravenous leiomyomatosis of the uterus is also discussed. PMID- 2712870 TI - [Giant cell tumors developing in Paget's disease. Presentation of 2 cases with an ultrastructural study]. AB - We report two cases of giant cell tumor of bone (osteoclastoma) associated with Paget's disease. One appeared on the left cubitus in a 68-year-old male patient while the second involved the right maxillary sinus in a 79-year-old woman. Histopathological study was completed by ultrastructural and immunocytological studies. They were demonstrated to contain intranuclear virus-like filamentous inclusions in the osteoclasts. However, we cannot obtain positive response with antisera against measles virus and respiratory syncitial virus. These data are confronted to the hypothesis for a viral aetiology of Paget's disease and giant cell tumor of bone, associated or not to Paget's disease. PMID- 2712871 TI - [Involvement of the basal ganglia and brain stem in infection by Listeria monocytogenes. Anatomo-clinical study]. AB - A case of a patient with haematogeneous infection by listeria monocytogenes, involving the basal and brainstem is reported. Clinically the disease manifested by fever and brainstem syndrome of acute onset. The microscopic examination revealed foci of suppurative encephalitis in the brainstem and basal ganglia. The possible pathogenic mechanisms are discussed. It is emphasized that the association of a febrile syndrome with brainstem dysfunction should raise the possibility of infection of the nervous system by listeria monocytogenes. PMID- 2712872 TI - [Primary malignant melanoma of the esophagus arising in melanosis. Histological, immunohistochemical and ultrastructural study of a case]. AB - The authors report a case of a primary melanoma of the esophagus, which is a rare neoplasm with poor prognosis. The diagnosis of malignant melanoma was suggested, on endoscopic biopsies, because of the presence of large malignant cells with abundant cytoplasm containing melanin pigment positive in the Fontana-Masson's reaction. These cells were immunoreactive for S100 protein while they did not show staining for antiepithelial membrane antigen and anti-keratin antibodies. Moreover ultrastructural study of the tumor cells revealed cytoplasmic aberrant premelanosomas. An important histological feature of the present case, which confirmed the primary oesophageal nature of the tumor was the presence of foci of melanosis (benign melanocytes) within the oesophageal epithelium which was adjacent to the melanoma. The variation in the histology of malignant melanoma may provide difficulties in diagnosis especially if one is limited to study a small biopsy specimen. In such cases other diagnoses including epidermoid carcinoma with prominent spindle-cell features and sarcomas should be eliminated by means of immunohistochemical and ultrastructural studies. The particular feature of our case, which apparently has not been reported previously, is the identification of the melanosis two years prior to the diagnosis of the malignant melanoma. The present study indicates that the identification of this lesion is of important diagnostic interest and might lead to the follow-up surveillance of the melanosis by multiple biopsies. PMID- 2712873 TI - [Statistical use of a database (Bull-SOPRA-ADICAP system). Application in the study of cancers in women]. AB - The author analyses the frequency of cancer among women for 2 years at pathological department of Bichat's hospital. He presents a method about how to use the computer systeme Bull-SOPRA of "Assistance Publique de Paris". Among 13,778 women, he counts 750 primary invasive malignant tumors which 3/4 are grouped among fifties to eighties. The author notes cancers frequency doubles nearly every 10 years and notes an often late appearance of breast cancers which are known to reach women between 60 to 90. PMID- 2712874 TI - [A simple system for semi-automatic image analysis]. AB - A device using a Macintosh microcomputer and a light microscope equipped with a drawing tube is described. The mirror of the drawing tube is turned to the screen of the microcomputer. An example of its use in morphometry of peripheral nerves is given. At a 1000X magnification, the resolution of the system is 10 pixels per 2.6-microns. The coefficient of variation between 20 measurements of diameter of thin (3 microns in diameter) and large (12 microns in diameter) myelinated fibers was 8% and 2% respectively. This precise and inexpensive system could be easily run in laboratories of morphology. PMID- 2712875 TI - [Updating of the Kiel classification of malignant non-Hodgkin lymphomas]. PMID- 2712876 TI - [Cutaneous papular cryptococcosis in AIDS]. PMID- 2712877 TI - [Myxoid leiomyosarcoma: immunohistochemical study of a case]. PMID- 2712878 TI - Breast cancer prevention and management. PMID- 2712879 TI - Facilitating adherence to ACS and NCI guidelines for breast cancer screening. AB - 1. Measures are needed to increase awareness of the incidence of breast cancer, and perhaps to increase the perception of susceptibility to breast cancer among all women. 2. Common reasons for noncompliance with the established guidelines include: fear of the carcinogenic effect of radiation, unfamiliarity with the guidelines, belief that mammography is ineffective, or fear that detection will necessitate mastectomy. 3. While cost, accessibility, and availability are critically important in enhancing public compliance, professional health care providers have a tremendous burden to obtain current information regarding the breast screening guidelines, and communicate the information to the public. 4. By helping to establish accessible and affordable breast screening programs, nurses have an excellent opportunity to play a role in the reduction of morbidity and mortality associated with breast cancer. PMID- 2712880 TI - Employee counseling with respect to lifestyles, life events, and breast cancer risks. AB - 1. All women should be considered at risk for breast cancer, because about 75% of the cases occur in women who are not considered high risk, or in whom no cause is identified. 2. Risk is a function of unalterable genetic and constitutional factors that are modified by lifestyle, life events, and environmental factors. 3. Knowledge about factors that influence employee behaviors regarding their risks is useful for planning strategies to encourage health-promoting behaviors. 4. The future goal of education and counseling will be primary prevention as well as early detection of breast cancer. PMID- 2712881 TI - Implementing the American Cancer Society breast cancer awareness program in the workplace. AB - 1. The goal of the American Cancer Society and of the National Cancer Institute is to increase the survival of women with breast cancer through early detection. 2. The key ingredients in promoting any program are enthusiasm and a rationale that identifies need, cost-containment, and program responsibility. 3. Utilizing nursing skills that allay fears but encourage thorough evaluation, engenders confidence in the department and the program. 4. Employees have more confidence in a program when results are communicated, and administrative support is more likely when justification is documented. PMID- 2712882 TI - Reintegration and maintenance of employees with breast cancer in the workplace. AB - For many persons with cancer, return to work serves as a measure of recovery from the treatment aspect of the illness as well as a positive step toward the future. Problems related to insurance coverage exist for cancer survivors due to the lack of legal requirement that an insurance company insure any applicant. The occupational health nurse brings knowledge of cancer, cancer therapy, and rehabilitation to the employer and the employee and serves as a liaison between the needs of the organization and the employee with respect to return to work. Information sharing, values clarification, role playing, and legal and ethical consultation may be effective in helping the employer as well as the co-workers meet identified goals. PMID- 2712883 TI - Expanding the nurse's role to diagnosis and treatment: understanding the legal significance. PMID- 2712884 TI - The influence of gender and use of barium enema on morbidity in acute appendicitis. AB - The records of 166 patients with appendicitis were analyzed by sex for time from presentation in the emergency department to surgery. Additionally, the effects of barium enema examinations on these times were noted. Our findings indicate that there was no significant delay in surgery based on gender (P = .42). However, those patients who had barium enema as part of their workup had significantly longer delays from presentation to surgery (P = .00005). These results support the notion that the most appropriate treatment for acute appendicitis is early diagnosis, a short preoperative resuscitation, and early surgical intervention. Barium enema is indicated only when the diagnosis is highly suspect and only if it can be carried out in a timely manner. PMID- 2712885 TI - Serum osmolality in alcohol ingestions: differences in availability among laboratories of teaching hospital, nonteaching hospital, and commercial facilities. AB - Freezing point depression osmometry is preferred over vapor pressure with ingestions of volatile substances. Sixty-six laboratories nationwide (23 teaching hospital, 22 nonteaching hospital, and 21 commercial facilities) were surveyed to determine the availability and use of these techniques. Overall, 80% conducted serum osmometry (teaching, 100%; nonteaching, 82%; commercial, 57%). Freezing point depression was the most common method used by all laboratories; however, 33% of commercial laboratories and 11% of nonteaching laboratories used vapor pressure exclusively. One half of all laboratory supervisors did not identify why one method was preferred. Only 3% identified vapor pressure as a possible source of error in ingestions of volatile substances. Most laboratories estimated that they were aware of the patient diagnosis less than 50% of the time. Because vapor pressure osmometry is a potential source of false negative results when estimating serum concentrations of volatile substances, clinicians treating patients who have ingested ethanol, ethylene glycol, isopropanol, or methanol need to be aware of the methodology used in their reference laboratories. PMID- 2712886 TI - Radial artery cannulation guided by Doppler ultrasound. AB - A technique to enhance difficult percutaneous radial artery cannulations using Doppler ultrasound is described. A series of 12 patients (nine hypotensive and three normotensive patients with poorly palpable or absent radial pulses) was assembled and the radial arteries were cannulated using standard intravenous catheters and a hand-held Doppler ultrasound device. Localization and cannulation of the arteries was facilitated by noting the characteristic sounds using the Doppler. Eleven of the 12 patients had successful cannulation of the radial artery. In one case the artery was localized but the catheter could not be advanced. No complications were encountered. It was concluded that the use of a common Doppler ultrasound on selected patients with poor peripheral pulses may facilitate percutaneous radial artery cannulations and minimize the number of catheter punctures before successful placement. PMID- 2712887 TI - Rapid venous access using saphenous vein cutdown at the ankle. AB - Injured adults can usually be treated adequately with peripheral intravenous lines. However, in hypotensive patients, alternative techniques such as venous cutdown may be necessary. There are no adult studies that document the success rate or time required to complete this procedure in the emergent situation. During a 1-year period, 73 cutdowns were attempted on 56 patients. Sixty-two of these attempts resulted in venous cannulation with a free flow of fluid (84.9%). The average time required for placement was 4.9 minutes. First-year residents had a significantly lower success rate (70%) than emergency department staff (89%) or second- through fifth-year surgical residents (94%). One patient who lived developed a local cellulitis. There were no other complications. In the hands of an experienced operator, saphenous vein cutdown at the ankle is a reliable method of rapidly gaining venous access in the adult patient. There are few immediate or late complications if the catheter is removed within 24 hours. PMID- 2712888 TI - New Mexico safety restraint law: changing patterns of motor vehicle injury, severity, and cost. AB - The impact of the New Mexico safety belt law on patterns of injury, severity, and cost was evaluated (using an emergency department data base). Data collected from November 1985 through February 1986 compared the 2 months before the January 1986 law with 2 months after. Before the law, 22.2% of the 379 injuries included abrasions, contusions, and lacerations to face, neck, and head. Following the law, this category constituted only 13.8% of 356 injuries, representing a reduction of 38% (P less than .05). Cost and injury severity scores (ISS) for 436 injured patients covered by the law were not significantly different between the pre- and post-seatbelt law periods. However, significant cost and severity differences were observed after the law between belted and nonbelted occupants: +2,569 compared with +662; ISS of 3.6 compared with 2.0 (P less than .05). Methodologic problems of an emergency department-based study and the need for E coding (external causes of injury) are discussed. PMID- 2712889 TI - The effect of norepinephrine versus epinephrine on regional cerebral blood flow during cardiopulmonary resuscitation. AB - alpha-Adrenergic drugs improve cerebral blood flow (CBF) during cardiopulmonary resuscitation (CPR), in part, by reversing carotid artery collapse and by shunting blood from extracerebral to intracerebral vascular structures. Adrenergic drugs with beta 2-agonist properties may cause peripheral vasodilation, and thus may be less beneficial in this setting. The purpose of this study was to compare epinephrine (E), an alpha 1,2, beta 1,2-agonist, with norepinephrine (NE), an alpha 1,2, beta 1-agonist, on CBF during CPR. Twenty swine each weighing greater than 15 kg were instrumented for regional CBF measurements using tracer microspheres. Regional CBF was measured during normal sinus rhythm (NSR). Animals were then placed into ventricular fibrillation (VF). After ten minutes of VF, the animals received closed-chest CPR using a mechanical thumper. Regional CBF was measured during CPR. After three minutes of CPR, the animals were allocated to receive either E, 0.20 mg/kg (N = 5); NE, 0.08 mg/kg (N = 5); NE, 0.12 mg/kg (N = 5); or NE, 0.16 mg/kg (N = 5). Regional blood flows were again measured following drug administration. CBFs following drug administration were compared using an analysis of covariance adjusting for baseline differences during CPR. A Newman-Keuls multiple comparison was used to follow-up significant (P less than or equal to .05) differences. Statistical significance was considered at P less than or equal to .05. There was a clinically significant improvement in cerebral cortical flow with NE, 0.12 mg/kg, and NE, 0.16 mg/kg, compared with NE, 0.08 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712890 TI - Survival of a child despite unusually high blood ethanol levels. AB - A 30-month-old, 13-kg child reportedly ingested up to 16 ounces of a wine containing 20% ethanol. The child was brought into the emergency department by paramedics, and upon arrival was found to be comatose and unresponsive to deep stimuli but breathing spontaneously. The patient remained unconscious and unresponsive for three hours after admission. Despite an initial blood ethanol level of 98.78 mmol/L (455 mg/dL), recovery was complete without sequelae. Treatment consisted of prompt gastric decontamination and maintenance of adequate hydration and euglycemia. Elimination of ethanol was rapid in this child and appeared to follow first-order kinetics instead of the zero-order kinetics usually observed. To our knowledge, this is the highest initial blood ethanol level reported in a child with survival. Additionally, no significant metabolic or cardiorespiratory derangement occurred. Ethanol toxicity, elimination kinetics, and treatment are discussed. PMID- 2712891 TI - Formic acid poisoning: case report and in vitro study of the hemolytic activity. AB - A case of fatal oral poisoning with formic acid resulting in shock, metabolic acidosis, and hemolysis is reported. The formic acid concentration on admission was 348 micrograms/mL, which, together with an increase in lactic acid, contributed to the metabolic acidosis. Because it has been suggested in the literature that formic acid might induce hemolysis via a direct cytotoxic action on the RBCs, an in vitro study was performed using human RBCs in saline, phosphate buffered saline, and plasma in order to define the mechanism of the hemolysis. These experiments indicate that the hemolysis is not a cytotoxic effect of formic acid but is related to the degree of acidity in itself. PMID- 2712892 TI - Chronic beta-blocker therapy complicating the presentation of cardiac tamponade of malignancy. AB - A case report is related of an elderly patient with metastatic carcinoma who presented to the emergency department with mental status change and ultimately proved to have cardiac tamponade. All of the classic cardiovascular signs of this condition were obscured by chronic beta-blocker therapy and concurrent hypovolemia. A discussion of pertinent pathophysiology and review of the literature is included. PMID- 2712893 TI - Emergency laser vaporization and helium-oxygen administration for acute malignant tracheobronchial obstruction. AB - Two patients with malignant airway obstruction and acute respiratory insufficiency were given emergency treatment with yttrium aluminum garnet (YAG) laser tissue vaporization under local anesthesia only. A mixture of oxygen and helium was administered to reduce the respiratory distress. This case emphasizes the rapidity and effectiveness of YAG laser treatment via fiberoptic bronchoscopy under local anesthesia in the management of acute malignant airway obstructions. PMID- 2712894 TI - Isopropanol ingestion: case report with pharmacokinetic analysis. AB - An unusual case of acute isopropanol overdose which occurred within the confines of the emergency department is reported. Serial serum concentrations of isopropanol and its metabolite acetone were followed for 43 hours. Pharmacokinetic analysis is presented, as well as a brief literature review of diagnosis and management. CNS toxicity was related mainly to isopropanol concentrations. The calculated half-life of isopropanol was 7.3 hours. Because of the pharmacokinetic profile of isopropanol, management decisions regarding the use of hemodialysis should be made within one to two hours of patient presentation. PMID- 2712895 TI - Fatal motorcyclist injury from a hinged and rounded rearview mirror. AB - Rigidly mounted sharp projections from automobile exteriors have been replaced by flexibly mounted rounded structures believed to be less hazardous to unprotected road users. The present report of a fatality from an external rearview mirror indicates the continued potential for harm from a projecting structure in spite of a hinged mounting and rounded shape. PMID- 2712896 TI - Bilateral hypothenar hammer syndrome: an unusual and preventable cause of digital ischemia. AB - Unilateral ischemia of hand digits is usually caused by thoracic outlet obstruction, arterial emboli from a cardiac source, or atherosclerosis. The case of a metal press worker with unilateral ischemia due to hypothenar hammer syndrome, a condition caused by the repetitive use of the hypothenar eminence as a hammer with resultant damage to the ulnar artery, is described. Most such patients present with unilateral ischemia in the ulnar artery distribution of the dominant hand. This patient had used both hands repeatedly to pound the edges of large steel plates and presented with nondominant-hand ischemia, but was found to have the syndrome bilaterally by angiography. The distinctive features of this syndrome, a preventable and treatable cause of digital ischemia, are emphasized. PMID- 2712897 TI - Topical ophthalmic exposure to rattlesnake venom. AB - An 18-year-old woman was struck in the eye from a distance of about 1 m by a stream of venom projected by a western diamond-back rattlesnake. She experienced an immediate burning sensation in the eye. The eye was irrigated first with tap water and later with a commercial eye wash solution. The patient's symptoms abated and no further eye injury was noted. Topical ophthalmic exposures to North American snake venom usually produce only transient symptoms, but the venom from tropical snakes has produced significant eye injury. PMID- 2712898 TI - Brown recluse spider bites: a common cause of necrotic arachnidism. PMID- 2712899 TI - Thallium myocardial scanning in the emergency department evaluation of chest pain. AB - Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a "classic" history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive. PMID- 2712900 TI - Pulmonary edema in the renal failure patient. AB - A patient with chronic renal failure presenting to the emergency department with acute pulmonary edema has a true life-threatening emergency. Whereas conventional treatment modalities may prove useful, more unusual therapeutic measures may be necessary. A case is presented followed by useful recommendations for the emergency physician faced with such a patient. PMID- 2712902 TI - Nonconvulsive status epilepticus in adults. PMID- 2712901 TI - Clonidine poisoning treated with naloxone. PMID- 2712903 TI - Penicillin anaphylaxis. PMID- 2712904 TI - Sudden cardiac arrest in Israel. PMID- 2712905 TI - Antiarrhythmic efficacy of magnesium in the setting of life-threatening digoxin toxicity. PMID- 2712906 TI - Emergency physicians and critical care. PMID- 2712907 TI - Prostaglandin injection for termination of tubal pregnancy: preliminary results. AB - A variety of conservative surgical techniques is available for the termination of ectopic pregnancy with preservation of the tube. We report on a new treatment by means of intratubal prostaglandin F2 alpha application followed by intramuscular administration of a prostaglandin E2 derivative (sulprostone) for 3 days. Only 5 of the 30 patients enrolled had to undergo laparotomy later. The results were compared with those obtained by different surgical procedures during the 2 preceding years. Hysterosalpingography was performed in 12 patients of the prostaglandin treated group and 14 of the surgically treated group. Tubal patency was demonstrated in 11 patients of the PG group but only in two patients of the surgically treated group. PMID- 2712908 TI - Expectant management of abruptio placentae before 35 weeks gestation. AB - Forty-three patients with abruptio placentae before 35 weeks of pregnancy were managed expectantly with observation or with tocolytic therapy when contractions were present. Mean time to delivery was 12.4 days. Twenty-three patients were delivered within 1 week of admission. In the remaining 20 patients, the mean time to delivery was 26.8 days. There were no intrauterine deaths. In properly selected patients with preterm gestation and low-grade abruptio it is reasonable to defer delivery. These patients must be followed closely with antepartum fetal heart rate monitoring, serial hematologic and coagulation profiles, and serial sonograms when indicated. PMID- 2712909 TI - Single cause for initiation of labor and toxemia: a hypothesis. AB - A hypothesis is presented that states that the decline in oxygen tension (PO2) in the intervillous space causes both toxemia (preeclampsia-eclampsia) and the initiation of labor. The trophoblast is identified as the monitor of the fetal PO2 and as the source of substances that are released into the maternal circulation stimulating the myometrium, the heart, the vascular smooth muscle, and, perhaps, the brain. In the presence of normal trophoblast the release takes place only when the PO2 in the intervillous space decreases to a level at which the fetus should be expelled from the uterus to avoid intrapartum hypoxia. Near term, the myometrium is the most responsive site to the released substances, and stimulation of the heart and systemic vasculature is observed only infrequently. With release of these substances, intrapartum toxemia results. Toxemia before onset of labor is created by hypoxia of the trophoblast in the presence of a nonresponsive myometrium to materials released. A small placenta, compression of the intervillous space by villous edema, and avulsion of spiral arterioles are the main causes of the premature decline of intervillous space PO2, leading to toxemia. Postpartum toxemia is produced by the retained (extraplacental) trophoblast, perhaps facilitated by the rapid clearance of progesterone. PMID- 2712910 TI - Vitamin D3 metabolites stimulate prostaglandin production by human fetal membranes and placenta in vitro. AB - In the present study we examined whether the vitamin D3 metabolites, 25 hydroxyvitamin D and 1-25-dihydroxycholecalciferol affected the production of the prostaglandins PGE2 and PGF2 alpha in human fetal membranes and placenta in vitro. Human amnion, chorion, decidual, and placental cells were maintained in primary monolayer culture. Treatment with the vitamin D3 metabolites resulted in an increase in PGE2 and PGF2 alpha production by amnion, decidua, and placental cells; however, these effects varied with time and were different between tissues. Although there was no significant increase in the production of PGE2 and PGF2 alpha by chorion cells in vitro, there was a significant increase in the production of prostaglandin F metabolites after treatment with the vitamin D3 metabolites. The data suggest that the vitamin D3 metabolites may increase free calcium availability and the conversion of arachidonic acid to the prostaglandins. The data do not, however, exclude the possibility that the vitamin D3 metabolites act at other points of arachidonic acid metabolism. These findings raise the possibility of a paracrine role for the vitamin D3 metabolites in the modulation of prostaglandin production within the human fetal membranes and placenta. PMID- 2712911 TI - Prostaglandins E and F in cervical mucus of pregnant women. AB - Cervical mucus concentrations of prostaglandins E (PGE) and F (PGF) were measured by radioimmunoassay in samples collected from 30 pregnant women. The amount of mucus that could be aspirated did not vary significantly at various stages of gestation and was 67 mg on the average. Concentrations of both prostaglandins were lowest in the first trimester and increased significantly during the second trimester. No significant further increase was observed during the third trimester. Serial samples taken from five women at approximately weekly intervals from the 35th to the 36th week onward did not show any significant increase toward term, although several individual samples had very high concentrations, suggesting that the prostaglandins were secreted into the cervical lumen in pulses. During the first and second trimester, the concentrations of PGE and PGF were similar, but during the third trimester PGF levels were significantly higher. The mean concentrations of PGE and PGF in cervical mucus during the second half of gestation were 10 to 20 times higher than their reported levels in amniotic fluid at the same stage, and in the range reported by others to be effective in modulating cervical tissue responses in vitro. Two to 4 hours after intercourse, prostaglandin concentrations in the cervical mucus were found to be about 10- to 50-fold higher than normal. The prostaglandins in cervical mucus may well participate in the gradual changes in the extracellular matrix of the cervix that result in the extensive remodeling of the cervix during pregnancy. PMID- 2712912 TI - Pulsatile administration enhances the effect and reduces the dose of oxytocin required for induction of labor. AB - Pulsatile administration of oxytocin was compared with continuous infusion of oxytocin for induction of labor in pregnant rats. The dosages consisted of intravenous injections of 0, 2.5, and 5 mU oxytocin every 10 minutes and intravenous infusion of 1 mU/minute of oxytocin in 0.9% sodium chloride. These doses are within the range of endogenously secreted pulses. All treatments began on day 22 at 2 p.m. and continued for 8 hours. Pulsatile administration resulted in a marked reduction in the dose of oxytocin required to induce labor. Using 5 mU pulses, birth was induced with 18.4%, and using 2.5 mU pulses, with 24% of the dose needed using continuous infusion. Parturition was advanced by 12 hours on the average by oxytocin treatment, but no significant differences were observed between the various oxytocin dosage regimens in this regard or in regard to gestation length, induction-delivery interval, duration of delivery, or the proportion of living or dead pups. Significantly more uterine activity was induced with each mU of oxytocin using pulsatile administration than using continuous infusion. There was no evidence for down-regulation of oxytocin receptors during a continuous infusion of oxytocin. We postulate that the greater efficacy of oxytocin pulses to induce uterine activity and delivery in comparison to continuous infusions is due to a more effective stimulation of prostaglandin F2 alpha release from the decidua. The amount of oxytocin needed for induction of labor with 2.5 mU pulses was similar to the decrease in neurohypophyseal oxytocin content during the first stage of spontaneous labor, and uterine activity elicited was also similar to that observed during spontaneous labor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712913 TI - Influence of premature rupture of membranes on induction of labor and plasma 13,14-dihydro-15-keto-prostaglandin F2 alpha and oxytocin levels in patients with unripe cervix. AB - Rupture of membranes at term, whether spontaneous or artificial, causes rapid and sustained increase in prostaglandin F2 alpha (PGF2 alpha) metabolite (PGFM) levels and is associated with augmentation of uterine contractions. To investigate why premature rupture of membranes (PROM) often fails to initiate uterine contractions, we measured plasma concentrations of PGFM and oxytocin (OT) in patients with PROM near term. Serial blood samples were taken before and after PROM as well as before and after local PGE2 gel application for cervical ripening. For comparison, patients with similar criteria with intact membranes were also studied, as were patients in spontaneous labor at term with and without spontaneous rupture of membranes. PROM was always associated with an initial, marked increase in plasma PGFM. Whether or not this increased PGF2 alpha production was maintained was related to the cervical status at the time of PROM. In patients with unripe cervix PGFM levels returned to initial levels within 2 hours and no contractions were elicited; when the cervix was 3 cm or more dilated, PGFM levels remained high and contractions began within 1 to 3 hours. PROM had no significant effect on plasma OT levels. When PGE2 gel was applied to ripen the cervix, PGFM levels increased moderately within 30 minutes in all patients regardless of the status of the membranes. In patients with intact membranes the concentration of PGFM in plasma declined to initial levels within 4 hours, whereas in patients with PROM, PGFM levels remained increased throughout the study period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2712914 TI - Premature rupture of membranes near term: induction of labor with endocervical prostaglandin E2 gel or intravenous oxytocin. AB - We have studied the influence of endocervical application of 0.4 mg prostaglandin E2 (PGE2) in gel on the clinical outcome of pregnancies of at least 36 weeks' duration complicated with premature rupture of the membranes (PROM) and unripe cervix, (modified Bishop score of 7 or less). There were 579 women in the study. The PGE2 gel was applied within the first 12 hours after PROM. The first 60 women were randomly divided into controls given oxytocin infusions and experimental subjects given PGE2 gel. All others were given PGE2 gel, and the results were compared with those obtained in patients with similar criteria who were treated with oxytocin infusions during the preceding year. The clinical outcome was significantly better in the PGE2-treated patients than oxytocin-infused patients. PROM to delivery interval and the incidence of operative deliveries were significantly reduced. No adverse effects on the neonates were observed and the incidence of neonatal infection declined. It is concluded that cervical ripening with PGE2 gel in patients with PROM and unripe cervix near term significantly improves the outcome for both mother and child. PMID- 2712915 TI - Cervical change and uterine activity as predictors of preterm delivery. AB - Premature uterine activity and early cervical change have both been shown to be useful in predicting preterm delivery. Prospective studies evaluating weekly uterine activity and cervical change were performed in 20 women, 17 of whom were at risk for preterm delivery, starting at 20 to 25 weeks' gestation. Patients were followed weekly until either 36 weeks' gestation or until the onset of premature labor or delivery. Seven women delivered before 37 weeks' gestation (preterm group). Thirteen women did not require tocolysis and delivered after 37 weeks' gestation (term group). A Bishop score was assessed weekly and the score added to the prior values in order to obtain a cumulative cervical score. A similar process was used to assess uterine activity. The cumulative values of Bishop score and uterine activity were plotted against gestational age in both groups. There was no observed increase in cumulative uterine activity in the preterm group before delivery. However, there was a progressive increase in cumulative cervical change weeks before delivery in the preterm group (p less than 0.05). Despite the small sample size, we conclude that progressive cervical change precedes the onset of labor and may be a better predictor of preterm delivery than is weekly monitoring of uterine activity. PMID- 2712916 TI - Low-dose ethanol for inhibition of preterm uterine activity. AB - Inhibition of preterm labor by tocolytic agents reduces the incidence of preterm birth. Betamimetic drugs are the most widely used tocolytic. However, they are from time to time contraindicated, their administration involves potential risks for mother and fetus, and their tocolytic effect is sometimes insufficient. Ethanol infused in intoxicating doses was the first clinically useful tocolytic agent, but because of its potential risks to the fetus, its use is now infrequent. We have examined the efficacy of ethanol infused at much lower rates, alone or in combination with ritodrine, to inhibit preterm uterine contractions. Fifty-four women between 20 and 36 weeks of gestation participated in the study. In 14, betamimetics were contraindicated and they were given ethanol alone. In 38, ritodrine infusions (0.2 gm/min) had failed to arrest preterm labor and they were then given ethanol with ritodrine (0.2 gm/min) The dose of ethanol was 0.11 gm/kg/hour on the average, which is approximately equivalent to the metabolic rate. Altogether, 64 treatments were given, 14 with ethanol alone and 50 combined with 0.2 gm/min ritodrine. In 81% of the treatments, contractions were suppressed within 15.3 hours on the average. Preterm birth (infant less than 2500 gm) was prevented in 70% of the patients. No adverse effects attributable to ethanol were observed. Treatment with low-dose intravenous infusion of ethanol is a cheap, efficacious, and low-risk method to stop preterm uterine activity and is clinically useful for prevention of preterm birth. Possible mechanism of this effect is discussed. PMID- 2712917 TI - Profile of an oxytocin antagonist, RWJ 22164 for treatment of preterm labor in laboratory models of uterine contractility. AB - An oxytocin antagonist, 1-deamino-[D-TYR(Oethyl)2,THR4,ORN8]oxytocin (RWJ 22164; dTVT), has recently been characterized in models of uterine contractility. Studies were undertaken to characterize the action of dTVT further on both oxytocin- and vasopressin-induced increases in uterine contractility both in vitro and in situ models and in a model of preterm labor. In these studies, dTVT was found to be a specific competitive inhibitor of both oxytocin- and vasopressin-induced contractions of both pregnant and nonpregnant guinea pig uterus in vitro. In situ, the intravenous administration of dTVT induced a dose dependent inhibition of oxytocin- and vasopressin-induced contractions in a guinea pig model which measures uterine activity as changes in uterine perfusion pressure. Further studies demonstrated that the intravenous infusion of dTVT delays ongoing labor. PMID- 2712918 TI - Pharmacokinetic studies on fenoterol in maternal and cord blood. AB - Fenoterol plasma concentrations were measured by radioimmunoassay in 38 pregnant women at different stages of preterm labor and in cord blood. Eight women were treated intravenously until delivery with 1.0 to 4 micrograms/min of fenoterol for periods ranging from 27 hours to 27 days; blood samples were taken at the same time as cord blood. In these women the fenoterol concentrations in cord blood ranged from 18 to 53% of the maternal concentrations. In eight women treated intravenously with 1.2 to 4.0 micrograms/min for 2 to 15 days, the infusion was stopped 1.3 to 38 hours before delivery. In these instances the concentrations in cord blood reached as much as 90% of the maternal, meaning that the rate of elimination from fetal plasma is lower than that from maternal plasma. Five women were treated daily with 20 to 30 mg per os for 3 to 17 days (three of these women had also had intravenous treatment before). The ratio of cord to maternal blood concentrations was higher than in women receiving the drug intravenously, the relative times of sampling being the same. The findings suggest that: (1) the placental transfer of fenoterol is higher than that found in previous studies in humans and animals with tritium-labeled substances; (2) the rate of fenoterol elimination from fetal plasma after intravenous and oral long-term therapy is lower than that from maternal plasma; (3) after oral administration, the ratios of fetal to maternal fenoterol concentrations are higher than after intravenous infusion. PMID- 2712919 TI - Effectiveness of patient education to reduce preterm delivery among ordinary risk patients. AB - Patient education is an important component of all preterm birth prevention programs, but studies of these programs have not examined the independent contribution of patient education to preterm birth prevention. The Program to Reduce Obstetrical Problems and Prematurity in the Bronx, New York, is a multifaceted preterm birth prevention program that includes a half hour combined videotape and nurse discussion session, which was offered to all patients. In evaluating the outcome of pregnancies in patients not at high risk for preterm delivery (ordinary risk patients) we found that patients who received instruction to recognize early signs of preterm labor had babies with a higher birthweight (3255 +/- 548 gm) than patients who were not so instructed (3200 +/- 599 gm, p = 0.03). Average length of gestation in the instructed and noninstructed patients was 276 +/- 15 days and 275 +/- 18 days (p = 0.12), respectively. The preterm delivery rate among patients receiving the instruction was 9.5% compared with 11.5% among those who did not receive it. We conclude that specific prenatal education about early warning signs of preterm labor is an important component of preterm birth prevention programs that can be demonstrated to have an independent contribution to prenatal care. PMID- 2712920 TI - Effective prenatal care decreases the incidence of low birthweight. AB - In Finland a nationwide free prenatal care system was mandated by law in 1944. At present, 99.9% of Finland's pregnant women use it. The primary aim is to provide advice and care to all women in local centers and to identify pregnant women exhibiting risk factors and refer them to specialized prenatal units located in 21 central hospital districts. This screening has succeeded well since the late 1970s, as judged by the low frequency of stillborn and low birthweight children born outside central hospitals. The rate of preterm birth has decreased by 1% during the latter half of the 1970s and is now 5.8%. This decrease occurred concomitantly with an overall decrease of 55% in the use of betamimetic drugs, which suggests that the use of betamimetic agents has had minor or no significant impact on the reduction of the incidence of prematurity. In order to improve the identification of mothers at high risk for preterm delivery, a mathematical model was constructed that included 13 risk factors. This model successfully identified a class made up of 22% of all women in whom 65% of preterm deliveries occurred, but 35% of mothers delivering prematurely still remained unidentified. Efficient screening of genital tract infections, relieving mothers of heavy work, and developing new oxytocin analogues may further reduce prematurity in the future. PMID- 2712921 TI - Infection and premature labor. AB - The possibility that infection can cause premature labor is appealing. If true, antibiotics treat the cause, in contrast to tocolytic agents, which treat symptoms. There is strong evidence that infection is a factor in premature labor. Historical data from the preantibiotic era in patients with pyelonephritis and pneumonia support this. Vaginal bacterial colonization studies and amniotic fluid studies indicate that a portion of women with preterm labor have an identifiable microbiologic profile. Preliminary reports on antibiotic intervention in asymptomatic women and women in premature labor are encouraging. This may be the dawn of a new era in the diagnosis and treatment of preterm labor. PMID- 2712922 TI - First trimester growth delay in trisomy 18. AB - Neonates with trisomy 18 are usually growth retarded at birth, and delayed growth has been ultrasonigraphically detected antenatally during the second and third trimesters in fetuses with this aneuploidy. We examined the growth patterns of five fetuses with trisomy 18 during the first trimester and compared them with a group of 16 normal control subjects. The crown-rump length of all trisomy 18 fetuses was at least 5 days smaller than expected (mean, 8.2 days; range 5 to 11 days), whereas only two controls had a similar delay (p less than 0.005). We conclude that in patients in whom gestational age is certain by other parameters, significant growth delay detected during the first trimester may be a useful marker for trisomy 18. PMID- 2712923 TI - Drug ingestion during pregnancy: infrequent exposure in a contemporary United States sample. National Institute of Child Health and Human Development Diabetes in Early Pregnancy Study Group. AB - Drug ingestion in a cohort of United States women proved consistently lower than in prior United States populations. Participating were 342 insulin-dependent diabetic and 387 control subjects who were enrolled before conception (76%) or no later than 21 days after conception (24%). Drug exposures were then recorded at entry and periodically throughout organogenesis (gestational weeks 6, 8, 10). During gestational weeks 1 to 10, approximately two thirds of the subjects were exposed to no agent other than oral iron, oral vitamins, or insulin (diabetic subjects). The mean exposures in gestational weeks 1 to 10 were 0.72 +/- 1.05 (SD) for diabetic women and 0.54 +/- 0.96 for control subjects; throughout pregnancy, the mean exposures were 1.26 +/- 1.66 and 1.58 +/- 1.78, respectively. The low exposure frequency in this contemporary United States population is highly encouraging. However, it follows that collaborative cohort efforts may be necessary in order to assess teratogenicity of drugs because relatively few women are now exposed. PMID- 2712924 TI - The wider perinatal significance of the Australian in vitro fertilization data collection program. AB - The most recent report (1986) from the Australian Register of In Vitro Fertilization pregnancies comprises 2242 in vitro fertilization (IVF) pregnancies and 261 gamete intrafallopian transfer (GIFT) pregnancies. A review of this data base indicated that this population had a relatively high incidence of both obstetric and perinatal morbidity and perinatal mortality. About 58% of the IVF pregnancies resulted in live births and 36.4% of the infants weighted less than 2500 gm at birth. These high rates could be partially accounted for by maternal prepregnancy risk factors, such as age, and by risk factors associated with the infertility management, such as multiple pregnancy (22% of all pregnancies more than 20 weeks), which accounted for approximately 50% of the preterm births (less than 37 weeks). Singleton pregnancies also had a higher incidence of preterm birth (17.8% at gestational age 24 to 36 weeks), low-birthweight babies (15.9% less than 2500 g) and perinatal mortality rates (35.4% per 1000 live births) than the Australian population at large. This warrants these patients being regarded as high risk. It is reassuring that the incidence of major malformations in IVF births (2.2%) is similar to that in the general population (1.4%). PMID- 2712925 TI - Antenatal and perinatal conditions correlated to handicap among 4-year-old children. AB - The purpose of this study was to investigate the impact of maternal prepregnancy and pregnancy-related risk factors, complicated delivery, and perinatal morbidity on subsequent handicaps in children. We surveyed a birth cohort of 4102 mothers and 4138 children in Frederiksborg County, Denmark. Maternal risk factors were defined according to guidelines published by the Danish National Board of Health, and perinatal morbidity and handicaps according to World Health Organization guidelines. The incidence of handicaps: (cerebral palsy, mental retardation [mild and severe], epilepsy, severe defects of vision and hearing); was 44 of 4038 children (twins and neonatal deaths were excluded). A combination of three or more maternal risk factors was found to be a predictor of risk for children with later handicaps; the incidence of handicaps was 11 times higher than in mothers with no risk factors. Eleven percent of all mothers had three or more risk factors and they had 43% of the handicapped children. Multiparity increased the risk in all risk categories. Of complications at delivery, intrapartum asphyxia, as evident from Apgar scores of less than 7 at 1 minute and less than 10 at 10 minutes in particular, was a strong predictor of a later handicap. Premature rupture of membranes for more than 24 hours was also significantly associated with later handicaps. Perinatal morbidity was correlated with a later handicap. The perinatal complication most strongly associated with later handicaps was low birthweight. Forty-eight percent of the affected children had a birthweight of less than 2500 gm and were small for gestational age. We conclude that the incidence of handicaps could possibly be reduced if the causes of the following maternal risk factors were identified and, if possible, eliminated: previous delivery of a child with a birthweight less than 2500 gm, previous delivery of a stillborn child, repeated abortions, severe infection during pregnancy, intrauterine growth retardation, and preterm delivery. Improved intrapartum diagnosis and prevention of asphyxia and treatment of children born with low Apgar scores would reduce the incidence of handicaps, as would intervention to prevent premature rupture of the membranes of more than 24 hour's duration. PMID- 2712926 TI - Planning a maternal-fetal medicine program. The subspecialist's perspective. PMID- 2712927 TI - Planning a maternal-fetal medicine program. Relationship to obstetricians. AB - The success of a consultation program is dependent on the ready availability of skilled subspecialty advice that is nonthreatening and sensitive to the needs of the referring obstetrician. PMID- 2712928 TI - Planning a maternal-fetal medicine program. The private practice model. PMID- 2712929 TI - Planning a maternal-fetal medicine program. The hospital employee model. AB - Communities requiring the services of a maternal-fetal medicine person will need to provide an environment in which the subspecialist is seen as an adjunctive help and improvement to that community. The perception of competitiveness among the obstetric and gynecologic community will need to be avoided and careful consideration given to the type of practice that the perinatologist will develop and the inability of some subspecialists in this field to derive a proportion of their income from the more elective aspects of obstetrics and gynecology normally opened to physicians practicing general obstetrics and gynecology. PMID- 2712930 TI - Planning a maternal-fetal medicine program. Joint university and private hospital models. PMID- 2712931 TI - Planning a maternal-fetal medicine program. Contracts. PMID- 2712932 TI - Planning a maternal-fetal medicine program. The hospital's perspective. PMID- 2712933 TI - Morphometry of blood vessels in the cortex and germinal plate of premature neonates. AB - Germinal plate hemorrhage with intraventricular rupture has been a leading cause of morbidity and mortality among premature neonates. Because germinal plate hemorrhage decreases with increasing gestational age, germinal plate vessel size and/or structure may be an important etiologic factor. Electron micrographs of the cortical and germinal plate blood vessels from 13 premature infants ranging in age from 19-37 weeks gestation were studied; vessel, lumena, and endothelial areas were measured using a digitizing tablet. In infants between 25-32 weeks gestation, the germinal plate vessel and lumenal areas were significantly greater than the areas of cortical vessel and lumena. This finding suggests that one of the factors involved in germinal plate hemorrhage is described by LaPlace's law which states that the larger the vessel diameter, the greater the pressure on the vessel wall. PMID- 2712934 TI - EEG diagnoses of neonatal seizures: clinical correlations and outcome. AB - Electroencephalographic seizures were evaluated in 112 neonates. The first portion of the study involved 80 neonates with clinically identified abnormal movements, 8 of whom (10%) had electroencephalographic evidence of seizures coincident with this activity. Patients with abnormal movements (90%) had no concurrent electrical seizures. In the second part of the study, 40 infants who had electrical seizures were investigated. Eight of these infants had been identified during the first part of the study. Two-thirds of the patients (25) were premature. Sixteen patients (40%) died; 90% had brain lesions documented by computed tomography and/or postmortem study. Cerebral infarction and intraventricular hemorrhage were the most common lesions. One-third of the survivors (8 of 24 patients) were normal at a mean age of 3 years, while two thirds had significant neurologic and developmental abnormalities. Neonatal seizures often are subtle, not associated with observable clinical expression, and associated with adverse development. Electroencephalographic confirmation is important in the evaluation of neonatal seizures. PMID- 2712935 TI - Nemaline myopathy: comparative muscle histochemistry in the severe neonatal, moderate congenital, and adult-onset forms. AB - A histochemical study of biopsied muscle specimens from patients with the 3 forms of nemaline myopathy (i.e., severe neonatal, moderate congenital, and adult onset), classified on the basis of clinical symptoms, was conducted. A close relationship could not be found between the number of rods and the severity of weakness in any form. Type 1 fiber atrophy and predominance or type 2B fiber deficiency was the usual finding in all forms. In the moderate congenital form, type 1 fiber atrophy and predominance became more apparent in patients with a protracted course, suggesting that the histochemical abnormalities are progressive. The abnormal fiber type distribution is assumed to be related to the pathogenetic mechanism of nemaline myopathy in all forms. Because acid phosphatase activity was increased in muscle fibers of patients with rapid progression, an autodegenerative process inducing lysosomal enzyme activation may be responsible for the acute clinical progression and muscle fiber loss in this disorder. PMID- 2712936 TI - Mental status examination of children with learning problems. AB - Questionnaires were submitted to 163 board-certified/eligible child neurologists to determine whether they employed a consistent approach to the mental status examination of children with learning problems and whether this approach appropriately emphasized the assessment of higher and related cortical functions. The responders' frequency of testing in 6 major categories of mental status function was independent of their age, sex, board-certified/eligible status, type of practice, and years elapsed since completion of training. The results of the entire study group and comparisons among demographic subgroups demonstrated a progressive decline in testing frequency with increasing complexity of mental status function. Child neurologists' approach to the mental status examination was remarkably uniform across a wide range of demographic variables. Higher and related cortical functions are tested significantly less often in children with learning problems than are other more elementary categories of mental status function; therefore, the importance of the mental status examination in this context must be questioned. It is likely that the diagnosis ascribed to a child with learning problems is based on findings other than those provided by the mental status examination. PMID- 2712937 TI - Inappropriate antidiuretic hormone in children with viral meningitis. AB - Urinary excretion rates of antidiuretic hormone were determined by radioimmunoassay in children with bacterial (6) and viral (11) meningitis, and in children with other febrile illnesses (7). These values were compared to normal data obtained from 50 healthy, normally hydrated children ranging in age from 1 week to 9 years. Plasma sodium concentrations were measured in the sick children; urine osmolality and creatinine concentrations were measured in all children. Upon admission, all children with bacterial meningitis and 64% of those with viral meningitis had urinary antidiuretic hormone excretion rates greater than 2 S.D. above values obtained from age-matched controls. Fifty-seven percent of children with other febrile illnesses had similarly elevated antidiuretic hormone values; however, only in the bacterial and viral meningitis groups were antidiuretic hormone excretion rates inappropriate because they occurred when serum sodium concentrations were found to be normal or low normal (i.e., 136 +/- 2 mEq/L and 137 +/- 1 mEq/L, respectively). The average serum sodium in the group with other febrile illnesses was higher (146 +/- 5 mEq/L; p less than 0.05) and could represent an appropriate stimulus for antidiuretic hormone release. In spite of high levels of antidiuretic hormone, most viral meningitis patients did not concentrate their urine, probably because all except 2 were younger than 2 months of age. We conclude that viral meningitis, like bacterial meningitis, frequently is associated with inappropriate antidiuretic hormone secretion; however, most children with viral meningitis may be protected from developing hyponatremia because of their inability to concentrate their urine. PMID- 2712938 TI - Development of behavioral and emotional problems in Tourette syndrome. AB - Tourette syndrome is a movement disorder with multiple neuropsychiatric features. Using the parent form of the Child Behavior Checklist by Achenbach and Edelbrock, we identified behavioral and emotional difficulties in 78 males, 6-16 years of age, with Tourette syndrome. Symptoms most often identified included obsessive compulsive behavior, aggressiveness, hyperactivity, immaturity, withdrawal, and somatic complaints. Abnormal checklist scores were most prevalent in adolescents with Tourette syndrome. Tic severity was not a statistically significant predictor of behavioral disturbance, although a suggestive relationship between tic severity and behavioral disturbance was observed in the 12- to 16-year-old group. Dividing Tourette syndrome patients into those with or without hyperactivity failed to identify whether hyperactivity had a major impact on abnormal behaviors. Our results illustrate the relative frequency of psychopathology in Tourette syndrome and emphasize the need for a comprehensive approach to this syndrome. PMID- 2712939 TI - Nontraumatic spinal intramedullary hemorrhage in an infant. AB - After an uncomplicated pregnancy and delivery, this female child suddenly became quadriplegic on the fifth day of life. She gradually regained movement in her upper extremities. At 2 months of age, she exhibited paraplegia with exaggerated deep tendon reflexes in the lower extremities. Babinski reflex was present bilaterally and sensory disturbances below the trunk were suspected. Somatosensory evoked potentials after median and ulnar nerve stimulation revealed preserved conduction from the upper extremities through the cervical spinal cord to the cortex. Somatosensory evoked potentials after posterior tibial nerve stimulation suggested disturbed conduction in the upper thoracic spinal cord. Magnetic resonance imaging disclosed a hypodense area in the thoracic cord between T1 and T4 on both the T1-weighted and gradient echo images consonant with an old hematoma cavity. Digital subtraction angiography failed to demonstrate any vascular malformation. PMID- 2712940 TI - Multiple ischemic infarcts in a child with AIDS, varicella zoster infection, and cerebral vasculitis. AB - A 4 1/2-year-old girl with acquired immunodeficiency syndrome and prolonged varicella zoster virus skin infection developed multiple ischemic strokes and radiologic and histopathologic evidence of central nervous system vasculitis. Typical features of acquired immunodeficiency syndrome encephalitis were not present and there was no evidence of vasculitis outside the nervous system. Central nervous system vasculitis probably resulted from varicella zoster virus infection that persisted because of immunodeficiency. This acquired immunodeficiency syndrome complication has only rarely been described in adults and to our knowledge has not been described in children. PMID- 2712941 TI - Results of computed tomography in "neurologically normal" children after initial onset of seizures. AB - A combined retrospective and prospective study assessed the results of computed tomographic (CT) scans in infants and children without neurologic deficit who presented with initial onset of seizures. Of 101 pediatric patients, 81 had afebrile seizures and 20 had complicated febrile seizures (i.e., focal, multiple, or prolonged). Seven children (7%), 6 with afebrile and 1 with a febrile seizure, had CT abnormalities. Four patients (4%) required further diagnostic workup including angiography and/or surgery. Children with afebrile focal seizures were more likely to have an abnormality than those with afebrile generalized seizures without focal components (13% and 4.9%, respectively). This study demonstrated a lower percentage of overall CT abnormalities, yet a similar percentage of "therapeutically important" abnormalities, in neurologically normal children with new onset of seizures when compared to previous reports of children with chronic seizures. Although an abnormal CT was more likely to be associated with an abnormal electroencephalogram, a normal result did not eliminate the possibility of an abnormal CT. PMID- 2712942 TI - Pressure-related torticollis: an unusual manifestation of pseudotumor cerebri. AB - A 9-year-old boy with pseudotumor cerebri who presented with neck pain and an accompanying torticollis is described. The patient exhibited bony abnormalities of the upper cervical spine and facial asymmetry that suggested a congenital torticollis. Reduction of the increased cerebrospinal fluid pressure by lumbar puncture resulted in a prompt and dramatic resolution of the cervical symptoms and signs. Increased cerebrospinal fluid pressure should be added to the list of those disorders that may give rise to reversible torticollis. PMID- 2712943 TI - Hypernatremic dehydration with hemorrhage into the choroid plexus. AB - A 2 1/2-month-old patient is reported with computed tomographic evidence of bilateral choroid plexus hemorrhage associated with hypernatremic dehydration. Choroid plexus hemorrhage may have caused increased cerebrospinal fluid protein observed in hypernatremic dehydration, as well as intraventricular hemorrhage. PMID- 2712944 TI - Intermittent dystonia in Hartnup disease. AB - A 6-month-old girl developed intermittent dystonic posture of the legs and eczematous dermatitis without ataxia. Qualitative and quantitative urine amino acid testing confirmed the diagnosis of Hartnup disease. Cranial computed tomography, electroencephalogram, electromyogram/nerve conduction study, posterior tibial somatosensory evoked potentials, 24-hour electroencephalographic telemetry, and metrizamide myelogram were normal. Spinal fluid hydroxy indoleacetic acid concentration was less than or equal to 2 S.D. of normal; oral tryptophan loading (70 mg/kg) resulted in a two-fold rise in cerebrospinal fluid 5-hydroxy-indoleacetic acid concentration. Tryptophan administered alone or with nicotinic acid failed to improve the dystonia; however, trihexyphenidyl (1-2 mg/kg/day) dramatically improved it. Hartnup disease should be considered in children with unexplained dystonia. PMID- 2712945 TI - Use of botulinum toxin to treat blepharospasm in a 16-year-old with a dystonic syndrome. AB - A 16-year-old boy with generalized dystonia had continuous, severe blepharospasm and facial grimacing. Local intradermal injections of botulinum A toxin greatly reduced the spasms and improved function. No side effects were observed. Local botulinum A toxin injections may be useful in the treatment of eyelid and facial spasms in patients with generalized dystonias. PMID- 2712946 TI - Bathing-induced seizures. AB - Two unusual patients with sensory-induced seizures are presented. The clinical approach and evolution of seizures induced by bathing in patients with and without accompanying epilepsy are discussed. PMID- 2712947 TI - Oculomotor apraxia: the presenting sign of Gaucher disease. AB - Oculomotor apraxia may be idiopathic or a symptom of a variety of diseases. In Gaucher disease, oculomotor deficit is characterized by a failure of volitional horizontal gaze with preservation of vertical movements. We present 2 sisters, 6 1/2 and 5 1/2 years of age, in whom the presenting sign was oculomotor apraxia. Oculomotor apraxia has not been previously reported as the presenting manifestation of Gaucher disease. PMID- 2712948 TI - Electroencephalographic abnormalities in infants with hypoplastic left heart syndrome. AB - Electroencephalography (EEG) was performed on 16 neonates between 38-45 weeks conceptional age with hypoplastic left heart syndrome (HLHS). The findings were compared blindly with EEGs recorded from 16 infants with other congenital heart defects and 15 infants referred for EEGs with noncardiac diagnoses or problems. EEGs from HLHS infants demonstrated significantly decreased quiet sleep and increased indeterminate sleep, an abnormally discontinuous tracing in active and indeterminate sleep, and lack of response to stimulation. No significant differences were present in the amount of active sleep, sharp waves, focal slowing, or rhythmic theta activity. The distinctive abnormalities were unrelated to arterial blood gases or treatment with prostaglandin E at recording. Four HLHS infants had repeat recordings performed; there were serial increases in quiet sleep, decreases in indeterminate sleep, and improved continuity in all patients. Certain EEG abnormalities occur more frequently in infants with HLHS than in patients with other cardiac defects or noncardiac problems. These findings may result from the early onset of heart failure and abnormal cerebral perfusion due to hypoplasia of the ascending aorta and great arteries, conditions commonly associated with HLHS. PMID- 2712949 TI - Friction in femoral prosthesis and photoelastic model cone taper joints. AB - Static axial push-on and lift-off, and push-on and twist-off experiments were designed and performed to measure the effective, room-temperature coefficient of friction mu for different design femoral prosthesis cone taper joints comprising a universal head on a stem spigot. Alumina and metal heads were tested on metal spigots using either distilled water, Ringer's solution, blood or no lubricant. Complementary push-on and lift-off friction tests of Araldite model joints for subsequent frozen-stress, photoelastic stress analysis were performed at 130 degrees C. It was found that lubricant caused little decrease in the values of the coefficient of friction in prosthesis tapers. The values measured were typically mu = 0.2 for an alumina head on a Co-Cr-Mo or Ti-6Al-4V spigot, mu = 0.15 for a Co-Cr-Mo head on a Co-Cr-Mo or Ti-6Al-4V spigot and mu = 0.13 for a stainless steel head on a stainless steel spigot. For Araldite photoelastic models of an alumina head on a Vitallium spigot, as-cast taper surfaces lubricated with silicone grease gave consistent friction of typically mu = 0.14. The axial displacement of model heads on their spigots were compared with predicted values and previously measured values for prosthesis heads. PMID- 2712950 TI - A study of stresses in alumina universal heads of femoral prostheses. AB - Three-dimensional, frozen-stress photoelasticity was used to study the best shape for a proposed alumina universal head loaded on to a Vitallium cone taper spigot with a 30 degrees inclined force, as in vivo. Typical cone taper friction values were reproduced in the photoelastic models. The location of the highest tensile stresses in the Mark I shape with a flat crown was found to be on the inner surface of the crown. Changing to a torispherical surface in the Mark II shape reduced this magnitude. However, the Mark III shape with a hemispherical inner crown surface gave even lower stress there, equal to the maximum value of the hoop stress at the taper, which was measured to be fairly uniform both around and along the taper except at the ends where contact pressure concentrations were found to occur and it became reduced. Lame axisymmetric cylinder stress predictions were found to be useful approximations to measured values and were generally overestimates of the tensile hoop stress at the head taper surface. PMID- 2712951 TI - An experimental technique for the investigation of three-dimensional stress in bone cement underlying a tibial plateau. AB - The technique of experimental model testing was applied to the analysis of stress at selected sites in bone cement underlying a tibial plateau. The investigation utilized a large model knee fabricated from materials which had mechanical properties similar to the actual tibial plateau and acrylic cement but which did not duplicate adequately the complexity of bone. A porous interface was created in the model between the materials representing the bone and cement. Three dimensional strain rosettes were embedded into the cement and the model was loaded in a varus or valgus mode. Overloading resulted in breakdown of the modelled anterior and part of the posterior cement-bone interfaces, producing non linear and in some cases erratic strains in the anterior section but repeatable linear results in the posterior section. The investigation highlighted the necessity for three-dimensional strain gauge investigations as opposed to two dimensional studies. It is suggested that the approach could provide comparative information about different products and form the basis for a valuable design tool. PMID- 2712952 TI - A microcomputer-based respiratory heat exchange facility for use in the diagnosis of thermally induced asthma. AB - Exercise-induced asthma is prevalent in many asthmatics and during the winter months can be exacerbated by cold air inhalation. A laboratory facility was required to permit early diagnosis of cold air sensitivity in these patients. This paper describes the development of a modular air conditioning system to produce a range of inhalative thermal burdens and the microcomputer interfacing to measure the rate of airway heat loss imposed. A single-stage refrigerator was built capable of cooling 150 l/min air to -25 degrees C. This was also used to generate dry ambient temperature air by rewarming the chilled air supply. An air humidifier was developed based upon natural convection and evaporation. It was capable of raising 150 l/min ambient air to 37 degrees C, 100 per cent relative humidity. In two pilot studies of 18 asthmatics it was found that the rate of respiratory heat exchange could be correlated with the magnitude of post exertional bronchoconstriction (lung dysfunction) and that exercise-induced asthma could be minimized by attenuating the rate of airway heat loss. PMID- 2712953 TI - Reinforcement of bone cement using metal meshes. AB - Following on from previous work reported in this journal, a practical system has been developed for in situ fibre reinforcement of bone cement in the hip joint prosthesis. A fibre preform is inserted during the operation, surrounding the metal stem of the prosthesis, forming a composite with the cement. Tests performed on full-scale models of the joint show improvements in fatigue life by more than an order of magnitude when a preform of metal fibres is used; this significantly delays the onset of cement cracking and stem loosening. Initial results reported previously suggest that other fibre materials such as carbon may give even greater improvements. Clinical trials have begun, using a form of the metal mesh. PMID- 2712954 TI - A new stretcher design for easy manoeuvreability on narrow staircases and rough ground for developing countries. AB - Rough terrains with obstacles, narrow staircases and inadequate space to position the ambulance conveniently in relation to the exit door of houses, often encountered in developing countries like India, make it difficult if not impossible to carry patients using conventional stretchers. A novel two-wheeled stretcher to overcome the limitations has been designed, fabricated and tested for a decade. The special features allow even one stretcher operator to transport a patient over all types of ground, down staircases with landings so small as not to provide space for a regular stretcher to turn into and out from the ambulance. This wide range of facilities has been obtained by incorporating very simple and low-cost devices such as a metal guard over two wheels, friction belts and an ergonomically designed tie bar system. Usage in handling various medical and surgical emergency cases has proven the efficacy and acceptability of the design. PMID- 2712955 TI - In-service education for home health aides by home health aides. AB - Gerontological nursing as an emerging specialty is now recognized by all professional nurses as a legitimate professional entity capable of governing the care of older adults through implementation of standards of care. The historical upgrading of care is now reaching its culmination in the newly revised document titled Scope and Standards of Gerontological Nursing as published in 1988 by the Council of Gerontological Nursing of the American Nurses Association. The utilization of these standards should continue to assist nurses in whatever facility they may practice to upgrade the care delivered through partnership with the older adult and their family to a high degree of satisfaction for the consumer and the gerontological nurse practitioner. Expanded knowledge, expertise in skill and care measured by the standards of care are key components in achieving success as a professional nurse and bring pride to the profession of nursing. PMID- 2712956 TI - Aging: a disease or an evolution? PMID- 2712957 TI - Anxiety, depression and hostility in cancer patients: differences based on age. PMID- 2712958 TI - Determinants of mortality in patients with the syndrome of persistent pulmonary hypertension of the newborn. PMID- 2712959 TI - Splenic cyst: a case report. AB - The following presentation deals with a case report of a large true splenic cyst. After a thorough research of the available medical literature this appears to be the largest reported specimen of this entity. PMID- 2712960 TI - [Osseous metastasis of an intracranial angioblastic meningioma: report of a case]. AB - A case of multiple bone metastases from an angioblastic meningioma (intracranial hemangiopericytoma) is reported. From the clinical and pathologic point of view, it is essential to be aware that the hemangiopericytic variant of meningioma (angioblastic meningioma) displays a significantly higher rate of recurrence and extracranial metastasis than other forms of meningioma. PMID- 2712961 TI - Medical education in Puerto Rico: proposals in search of a sponsor. PMID- 2712962 TI - Bezafibrate in the treatment of hyperlipidemia. PMID- 2712963 TI - [The physician-patient relationship: power, confidence and sexuality]. PMID- 2712965 TI - [Observations on the commentary of the Cardiovascular Center of Puerto Rico and the Caribbean]. PMID- 2712964 TI - National nutrition objectives for the years 1990 and 2000. AB - Development of nutrition objectives for the years 1990 and 2000 forms an important part of a national strategy to reduce preventable health risks. These initiatives present an opportunity for nutrition professionals to define priorities for nutrition in preventive health care and to establish the nation's nutrition policy agenda for the next decade. PMID- 2712966 TI - Ethics and bioethics. AB - The Biomedical Ethics Advisory Committee is not concerned with infractions of the hospital's by-laws or the personal, professional code of ethics of the physician. It answers consultations relative to moral issues involved in possible infractions of patients' rights. As much, after studying the moral issues involved, the committee presents the referring physician with advice that will enable him to render a valid decision in accord with preservation of the patient's rights and avoidance of possible future legal involvement. PMID- 2712967 TI - Metabolic control of food intake. AB - A specific biochemical mechanism for the metabolic control of food intake has not been identified. However, a theory based on a signal generated from the oxidation of metabolic fuels and detected in the liver offers a powerful, integrative framework that helps explain a number of phenomena related to feeding behavior. In addition to providing a metabolic basis for the formation of conditioned food flavor preferences, a control of food intake by fuel oxidation provides a mechanism for overeating in the dynamic phase of obesity and hyperphagia produced by high-fat diets. PMID- 2712968 TI - AIDS incidence, latency same for homosexual, hemophilic men: study. PMID- 2712969 TI - What is your diagnosis? Dermatomyositis. PMID- 2712970 TI - Stomach cancer in a native and migrant population in Puerto Rico and New York City, 1975 to 1979. AB - This study compares age-adjusted stomach cancer incidence and mortality rates, by sex, among Puerto Rican-born residents of New York City (NYC/PR) and Puerto Rico (PR/PR) for the time period 1975 through 1979. One, three, and five year observed survival for cases diagnosed between 1975 and 1977 were compared. The results indicate that age-adjusted stomach cancer incidence rates per 100,000 among NYC/PR males (58.94) and females (27.58) were slightly higher compared to rates among PR/PR males (54.48) and females (25.73), while age-adjusted mortality rates were substantially higher among PR/PR males (46.38 vs. 37.29) and females (22.76 vs. 17.84), although these differences were not statistically significant. Differentials in observed survival consistently favored NYC/PR after one (43% vs. 35%), three (20% vs. 14%), and five years (11% vs. 9%) of follow-up. PMID- 2712971 TI - Acute histoplasmosis: a modern appraisal. AB - Acute histoplasmosis is an infrequently recognized pulmonary disease endemic in Puerto Rico. Two cases of acute histoplasmosis which followed an exposure to bat guano in a tunnel are presented. Negative cultures of bronchial washings and negative transbronchial biopsies illustrate the usual difficulty in establishing a definitive diagnosis. Serial serum complement fixation titers suggested a recent infection. The illness was quickly and effectively controlled with oral ketoconazole. When symptoms of acute histoplasmosis persist beyond two weeks treatment with ketoconazole for at least two months should be considered. PMID- 2712972 TI - [Idiopathic facial paralysis: long-term catamnestic study of prognosis and the significance of electrodiagnostic findings]. AB - 550 patients suffering from Bell's palsy and examined by electromyography (EMG) as well as electroneurography (ENG) were interviewed in respect of treatment and remission. In more than 80% of the cases it was possible to register volitional activity by EMG as well as to elicit an electroneurographic response. We found a high correlation between electrodiagnostical deficit and degree of recovery. EMG and ENG were equally suitable to assess the severity of damage. The overall prognosis of Bell's palsy was favorable in cases of incomplete lesions. The recovery was probably improved by administration of steroids in the examined group, especially in cases with temporary loss of electroneurographic response. PMID- 2712973 TI - [Therapy of facial paralysis in herpes zoster oticus with acyclovir]. AB - In the present study patients suffering from facial nerve palsy caused by a herpes zoster oticus were treated with aciclovir. After therapy all patients could be controlled via clinical grading system and electromyographic observations. Aciclovir therapy did not yield any results superior to those obtained with other forms of therapy presented in the literature. PMID- 2712974 TI - [Intratemporal facial neurinoma]. AB - Two patients with intratemporally localised facial nerve schwannomas developed conductive hearing loss beside persisting facial nerve palsy. Tympanotomy revealed a tumour of the facial nerve that was totally removed. In one case reconstruction was performed with great auricular nerve interposition. The long term follow-up (12 years) showed a good functional result. Facial nerve schwannomas present problems in detection, and reconstruction methods are not safe with regard to long-term prognosis. PMID- 2712975 TI - [The functional significance of the suspending ligaments of the ear ossicle chain]. AB - The contraction of the tensor tympani muscle has not enough force to stabilise the drum membrane-malleus complex against a negative pressure in the external ear nor against a hyperpressure in the middle-ear, as in sneezing, Valsalva's manoeuvre, etc. The ossicular ligaments must therefore perform this task. It was shown in experiments with fresh temporal bone preparations that the superior malleolar ligament diminishes the pressure-induced displacements of the malleus. This proves that this often neglected ligament has true functional significance. The most important ligament, which retains the malleus against an outward displacement, however, is the sturdy connective tissue between the cochleariform process and the malleus' handle, enveloping the tendon of the tensor tympani muscle and crossing the middle-ear cleft together with the tendon. These connective tissue strands are much too strong for a simple sheath of tendon, as can be seen histologically. In consideration of the fact that the functional significance surpasses the function of a pure tendon sheath, this ligamentous structure can be called the malleo-cochleariform ligament. PMID- 2712976 TI - [Chlamydia trachomatis, a pathogen in infections of the upper respiratory tract?]. AB - In neonates and in older children C. trachomatis can cause otitis media in rare cases. This fact has to be taken into account in diagnosis. The detection of C. trachomatis in the pharynx after orogenital sexual practice seems to be rather due to colonization than to an infection. According to existing studies C. trachomatis does not play a causative role in the pathogenesis of pharyngitis in adults. PMID- 2712977 TI - [Radiocephalometric findings and duration of snoring in habitual snoring and obstructive apnea syndrome]. AB - In 11 patients with chronic snoring and 12 subjects with obstructive apnoea syndrome the percentage of snoring duration above a preset sound pressure level during one night's sleep was correlated with the radiocephalometric data. Cephalometric distances PAS, PM-Pg, MP-H and angles SNA and SNB representing measures for posterior airway space, size of soft palate, relative position of hyoid bone and relative position of maxilla and mandibula were evaluated. Each patient showed pathological deviations from normal values in at least one of the cephalometric parameters. A significant correlation between snoring duration and a single cephalometric distance could not be found. However, an index combining pathological deviations from all three cephalometric distances showed a highly significant correlation with snoring duration (p less than 0.01 - Fig. 11), as did deviations from normal values of angle SNB (p less than 0.03 - Fig. 10). Our findings indicate that snoring and obstructive apnoea syndrome are not only caused by neurologic dysregulation, and that in addition specific craniofacial anomalies are prerequisites for the development of the disease. For the first time it is demonstrated that these anomalies exist in chronic snorers as well as in apnoeic patients. Our findings support Lugaresi's hypothesis that heavy snoring and obstructive apnoea syndrome are based on the same defect and differ in severity only. PMID- 2712978 TI - [High-frequency jet ventilation in emergency tracheal puncture]. AB - A case of obstruction of the upper respiratory tract is reported, in which an intubation or insufflation by rigid tracheobronchoscopes was not possible. Due to the anatomical situation after multiple operations and irradiation, coniotomy could not be performed. Blind puncture of the trachea with subsequent High Frequency Jet Ventilation has proved successful as an emergency approach to maintain respiratory function. PMID- 2712979 TI - [Hemostasis screening before ENT operations]. PMID- 2712980 TI - [Which analgesics do you recommend following tonsillectomy?]. PMID- 2712981 TI - Clinical benefits of early cold therapy in accident and emergency following ankle sprain. AB - One hundred and forty-three patients presenting with ankle sprains within 24 h of injury were entered into a double blind study. Treatment consisted of a standardized regime of high dose non-steroidal anti-inflammatory medication and an elastic support for all patients, who were then randomly allocated to two groups. One group received immediate cold therapy, the other received simulated therapy. Assessments made at 7 days showed a trend in favour of the group receiving cold therapy, although this did not reach significance. It is concluded that cold therapy together with compression may have a beneficial effect but that a single application in the accident and emergency department is not justified when a background therapy of non-steroidal anti-inflammatory medication is given. PMID- 2712982 TI - Fish bones in the throat. AB - Patients presenting with sharp pain in their throat after eating fish were studied to determine the site and frequency of impacted fish bones. In 79% no fish bone was demonstrated despite careful follow up. In those proven to have a fish bone 93% were in the oropharynx. The role of X-rays and the indications for referral for endoscopy are discussed. PMID- 2712983 TI - Do head-restraints protect the neck from whiplash injuries? AB - Over an 11-month period a study was made of all patients presenting to an accident and emergency department who had sustained whiplash as a result of rear bumper impacts. The patients were analysed with respect to the presence of head restraints in their vehicles. A significant increase in the incidence of whiplash was found in patients whose vehicles did not have head-restraints fitted. Legislation requiring all passenger cars to have head-restraints fitted as standard would have a major impact in reducing the number of whiplash injuries sustained in rear bumper impacts. PMID- 2712984 TI - Serum potassium responses to nebulized salbutamol administered during an acute asthmatic attack. AB - A prospective study of 20 patients presenting to an accident and emergency department with an exacerbation of pre-existing reversible airways disease was undertaken in order to determine whether such patients incurred any changes in their serum potassium following administration of 5 mg of nebulized salbutamol. Electrolytes were estimated before and 30 min after administration of nebulized salbutamol. No other drug was administered during this period. Results indicate that nebulized salbutamol can cause a significant hypokalaemic response in such situations. Eight out of the 20 patients studied demonstrated falls in serum potassium of more than 0.3 mmol/l. Most of the falls in serum potassium occurred in patients with low pre-treatment PCO2 values; a group of patients with less severe respiratory distress. This preliminary study indicates that a further study aimed at elucidating the clinical significance of nebulized salbutamol induced hypokalaemia is required. PMID- 2712985 TI - The role of physiotherapy in the management of acute neck sprains following road traffic accidents. AB - In acute whiplash injuries, early physiotherapy has been shown to reduce pain and increase cervical movement, but the cost-effectiveness of this treatment has been questioned. It is unclear whether the benefits result from manipulative physiotherapy or from the patient's ability to perform the accompanying home exercise programme when instructed about its importance. In a single blind prospective randomized trial 71 patients who received out-patient physiotherapy were shown to have significant improvement in severity of neck pain (P less than 0.01) and cervical movement (P less than 0.01) at 1 and 2 months post-injury when compared with 33 patients who received analgesia and a cervical collar. Sixty-six patients who were offered comprehensive advice for home mobilization by a physiotherapist showed a similar improvement. There appears to be no difference in effectiveness between outpatient physiotherapy and home mobilization. PMID- 2712987 TI - Children's car-restraints: use and parental attitudes. AB - An analysis of the attitudes of 600 parents towards children's car-restraints together with their use is presented. Only 47% of infants under 9 months of age and 26% of children under 15 years of age were always appropriately restrained. Children under 4 were more likely to be restrained than older children and previous involvement in a road-traffic accident led to increased use of restraint. PMID- 2712986 TI - Use of a questionnaire to obtain an alcohol history from those attending an inner city accident and emergency department. AB - A screening questionnaire designed to take an alcohol history was used on 996 patients attending the London Hospital Accident and Emergency Department. Questions concerned with 'binge' drinking detected many problem drinkers who were not identified by questions on weekly alcohol intake or 'CAGE' questions. The relative increase in detection was particularly marked in women. PMID- 2712988 TI - Scaphoid tubercle tenderness: a better indicator of scaphoid fractures? AB - Tenderness in the anatomical snuff box (ASB) has long been accepted as an indicator of a possible scaphoid fracture. The longitudinal axis of the scaphoid lies in an anteroposterior plane, perpendicular to the remainder of the carpal bones, in the radially deviated wrist. The scaphoid tubercle can therefore be easily and accurately palpated on the palmar aspect of the radially deviated wrist. This study was devised to determine if tenderness over the scaphoid tubercle (ST) was superior to ASB tenderness in identifying definite fractures. Over a 10-month period 246 patients were seen who were suspected of having a scaphoid injury. Thirty (12%) were eventually proven to have definite fracture. Tenderness in the ASB had a sensitivity rate of 90% (95% confidence limits 80 100%) and specificity of 40% (33-47%) as an indicator of a definite fracture. ST tenderness had a sensitivity of 87% (75-99%) and specificity of 57% (50-64%). There is therefore no significant difference in the sensitivity between ASB and ST tenderness but ST tenderness is significantly more specific. However, the presence of either ASB or ST tenderness should be used in order to identify all fractures. Patients with neither ASB nor ST tenderness require symptomatic treatment only. PMID- 2712989 TI - A study of the knowledge of radiological anatomy of senior house officers in accident and emergency medicine. AB - Senior house officers working in 10 major accident units were tested on their ability to name normal anatomical features seen on radiographs of commonly X rayed areas. The results show that, overall, those tested could only identify 77% of the areas correctly. The discussion considers these results and also considers whether it is important to be able to identify the anatomical features presented. PMID- 2712990 TI - Ankle swelling is not always 'medical'. PMID- 2712992 TI - An unusual case of fracture of the radius. PMID- 2712991 TI - Beware the patient with a headache in the accident and emergency department. AB - We have reviewed the 130 patients presenting to an accident and emergency (A & E) department with a headache, followed up for 2 years. These are infrequent attenders but we have found that there is a high incidence of serious neurological pathology (16%) in this group of patients. We suggest that patients presenting to the A & E department with headache should be thoroughly examined and investigated and in the absence of a definite benign diagnosis should at least be admitted for a period of observation. PMID- 2712993 TI - SHOs' performance of diagnosing X-ray abnormalities. PMID- 2712994 TI - Computer-unaided diagnosis of acute abdominal pain in an accident and emergency department. PMID- 2712995 TI - The use of breath alcohol analysers for diagnosis in the accident and emergency department. PMID- 2712996 TI - Biosynthesis of cytochalasans. XI. New results on the incorporation of phenylalanine into cytochalasin D by Zygosporium masonii [1]. AB - Incorporation of L-[2-2H]phenyl-[2-2H]alanine and L-phenyl-[2-13C, 15N]alanine into cytochalasin D by Zygosporium masonii involved the complete loss of both the alpha-2H- and the alpha-15N-atom. Incorporation of a mixture of L-phenyl [15N]alanine and L-[U-14C]phenylalanine into cytochalasin D and protein amino acids (phenylalanine, leucine, isoleucine) was accompanied by a substantial loss of 15N with respect to 14C. These effects are attributed to rapid exchange reactions taking place while L-phenylalanine is part of the intracellular pool of amino acids. In addition, the medium- and concentration-dependent incorporation of the carbon skeleton of exogeneous D-phenylalanine into cytochalasin D is reported. In a peptone-based complex medium, D-phenyl-alanine is poorly incorporated. Throughout the whole concentration range (0-250 mg/l), the incorporation rates are less than 10% of those of L-phenylalanine. In a minimal medium containing NH4NO3 as nitrogen source however, D-phenylalanine is preferred over the natural enantiomer by a factor of 1.28 up to 6.78, depending on the concentrations of exogeneous D- and L-phenylalanine. These effects are attributed to the medium-dependent activities of different amino acid transport systems responsible for the uptake of D- and L-phenylalanine in Z. masonii. PMID- 2712998 TI - Science and public policy. AB - Politicians generally do not look to scientists to help them get votes. But issues of science policy become extremely important when politicians and scientists, together, grasp the degree to which science and technology are transforming the business of the president and Congress. The author discusses the uneasy relationship of two institutions--political governance and the progress of science--that, while possibly irreconcilable, have an ongoing alliance of convenience. The author indicates issues confronting the Bush presidency in which scientific and technical factors are crucial, raises questions about the future relationship of science and government, defines the political framework for this relationship, and documents the encouraging and significant science-policy commitments made by president-elect Bush. PMID- 2712997 TI - Hyperthermia induced polyphosphate changes in Propionibacterium acnes as studied by 31P NMR. AB - The polyphosphate component in 31P NMR spectra of the Gram-positive Propionibacterium acnes increased after hyperthermia treatment. The cells were exposed to temperatures in the interval from 15 degrees C to 45 degrees C. The amount of polyphosphate increased with increasing temperature. There were no temperature induced changes in the other phosphorous components seen in the spectra with exception of a decrease in ATP for higher temperatures. The increase in polyphosphates was less than that obtained from cells irradiated by near ultra violet light. PMID- 2712999 TI - The Duke University program for integrating ethics and human values into medical education. AB - In its second year of development, this program blends cognitive and affective approaches to integrating ethics and human values into medical education. The core of this effort is the establishment of direct and continuing relationships between the four advisory deans and their medical student advisees through small groups that continue throughout the four years of medical school. Clinical correlation seminars, lecture/discussions, the humanities, clinical clerkships, and electives are components of this integration process. Both basic science and clinical faculty members have observed positive changes in the degree and depth of participation, discussion, and interest, as well as in the general attitudes of the students. PMID- 2713000 TI - Projections of physician supply and demand: a summary of HRSA and AMA studies. AB - There is concern that the United States may have a surplus of physicians soon. In a continuation of a movement started around 1980 by the Graduate Medical Education National Advisory Committee (GMENAC) to quantify and project supply and demand for physicians, the American Medical Association (AMA) and the Health Resources and Services Administration (HRSA) have recently produced their latest studies on this subject. The HRSA conclusion, published in its 1988 report to the President and Congress on the status of health personnel in the United States, is that a surplus may come as early as 1990 and will probably worsen by the year 2000. The AMA study, also published in 1988, agrees with the HRSA and the GMENAC that supply will probably grow faster than demand, but it disclaims the notion of a surplus or shortage because that would imply judgments about the adequacy of current utilization rates by all segments of the population. The HRSA report cites a 1986 finding by the Robert Wood Johnson Foundation that access to medical care deteriorated between 1982 and 1986 for minorities and lower-income groups. On the supply side, the HRSA's estimates are somewhat higher than the AMA's, mainly because the former assumes faster growth in foreign medical graduates. Both studies use a demand-based approach to projecting the number of physicians required, but there are considerable differences in the assumptions made about future utilization rates. PMID- 2713001 TI - Unchanging dilemmas in American medical education. AB - The author reviews "the lietmotiv of unresolved dilemmas" in American medical education: the problems of determining the premedical and medical school curricula and of selecting medical students. She offers suggestions for each area, but cautions that there are no simple answers. PMID- 2713002 TI - The Robert Wood Johnson Foundation. PMID- 2713003 TI - Preventing default: the care for HEAL. PMID- 2713004 TI - Improving trauma care. PMID- 2713005 TI - Physician dropout. PMID- 2713006 TI - Ethics teaching. PMID- 2713007 TI - Use of animals. PMID- 2713008 TI - Teaching medical ethics during residency. AB - Because practicing physicians are poorly prepared to resolve many ethical issues that arise in patient care, this article proposes that residencies include practical training in medical ethics. Training in medical ethics helps physicians recognize ethical issues in patient care and resolve those issues wisely. Furthermore, such training has its maximum impact during the professionally formative years of residency. The article specifies key ethical concepts residents should know, including knowing how to obtain informed consent, knowing what to do about incompetent patients, knowing when to withhold or disclose clinical information, and knowing how to use resources properly. The article also points out that the success of residency training in ethics depends on strong commitments from the department: endorsement by the chairman and the residency program director; recruitment of several dedicated faculty; support for adequate ethics training for these faculty; dedication of conferences, rounds, and consultations to teaching ethics; and allocation of sufficient funds. PMID- 2713009 TI - A medical ethics project for third-year medical students. AB - During the 1987-1988 academic year, each of the third-year students at Virginia Commonwealth University Medical College of Virginia were asked to prepare a case study that involved ethical issues, drawn from a clinical experience. Instructions for the studies included a brief description of ethical principles and a format for including needed information about the patient, the family, and the caregivers. A study was made of the quality of these case studies, the types of ethical issues raised, and some attitudes expressed in them. Follow-up discussion groups with faculty leaders, using these case studies, are described. PMID- 2713010 TI - Academic promotion and tenure in U.S. family medicine units. AB - The authors interviewed by telephone the heads (or their representatives) of 101 of the 120 family practice units in U.S. medical schools in 1987. Each respondent was asked for his or her personal perceptions of the relative importances of research, teaching, patient care, and administrative activities in the academic promotion process. Respondents were also asked for their views of their units' and institutions' perceptions of the importances of the same four activities in the promotion process, as well as other related questions about promotion and tenure. The findings indicate that there is still a significant incongruence between the value structure of most family practice units and that of their institutions but that many family practice units are beginning to achieve parity of promotion and tenure with other departments in their institutions. PMID- 2713011 TI - Assessing the value of student case write-ups and write-up evaluations. AB - To investigate the attitudes of medical students concerning the educational value of case write-ups and write-up evaluations and the usefulness of write-up evaluations in assessing clinical skills, the author surveyed 140 students at McGill University after they had completed a 10-week clinical course in internal medicine. He also surveyed internal medicine course directors at the 16 Canadian medical schools to determine their assessments of write-up evaluation practices in their departments. There was broad agreement among the students and directors that case write-ups and their evaluations are useful for learning, but there were major concerns about the variability of the criteria and standards for evaluation. Recommendations are presented. PMID- 2713012 TI - A four-year program to train residents in emergency medical services. AB - There is general agreement that residents in the field of emergency medicine require extensive training in emergency medical services (EMS). This paper outlines a comprehensive four-year training program in EMS that has been integrated into the emergency medicine residency curriculum of the University of Cincinnati since 1985. The EMS program is comprehensive and makes it possible for the level and type of EMS activities that are provided to match the evolving expertise of the resident. The program provides a significant amount of practical training in ground and aeromedical transport, in disaster work, in telemetry communications, and in other areas. Evaluation of the program is at an early stage but informal reports are strongly positive. PMID- 2713013 TI - Evaluating the interview performance of internal medicine interns. AB - Limited primary data are available to indicate in which areas physicians' interview performances are deficient. Videotaped recordings of 48 house officers performing a complete medical history were evaluated using a checklist to assess content, questioning technique, and interview style. Frequent deficiencies included inadequate social, psychiatric, and drug reaction histories. Several house officers demonstrated a marked tendency toward an overly directed interview style. The use of a detailed checklist during the observation of a complete medical history facilitates both accurate evaluation and specific detailed feedback to house officers. PMID- 2713014 TI - A comparison of the spectra of diseases seen by students on a medical clerkship in 1977 and in 1987. PMID- 2713015 TI - A two-year self-assessment evaluation by students in a family medicine clerkship. PMID- 2713016 TI - A workshop to foster medical humanism in residents. PMID- 2713017 TI - The National Sexually Transmitted Diseases Prevention/Training Clinic Program and the training of health care providers about AIDS. PMID- 2713018 TI - Strategies for developing innovative programs in international medical education. Proceedings of the 1988 international invitational conference. New York, New York, July 14-15, 1988. PMID- 2713019 TI - Resources and limitations of medical centers in the United States. AB - A profile is provided of the range of opportunities and limitations for foreign nationals who seek access to the U.S. health care education and training system. The system is complicated, and entry depends on numerous variables. Facility in the English language is considered a prerequisite. Among opportunities, clinical training is probably most sought in the form of either residencies or clinical fellowships. Many major medical centers are eager to host earnest students and trainees from abroad. Yet such opportunities are limited, since most programs are unable to accept additional trainees once the first year of the program has been filled. Additional residency positions are not likely to be created and funded. In general, the larger academic medical centers tend to be the first to introduce new technologies and newer diagnostic and therapeutic modalities. Other settings may offer better, or at least equally good, environments for other kinds of post M.D.-degree training. U.S. educational opportunities also exist in health policy and health systems education, nursing education, allied health and non-physician education, and research. All those seeking to study in the United States are urged to consult one of the several agencies that are knowledgeable about the opportunities and requirements for entering the programs offered. PMID- 2713020 TI - Strategies for developing innovative programs in international medical education. A viewpoint from Latin America. AB - Problems affecting the quality of medical education and health services in Latin America include variable standards of medical education, geographic maldistribution of physicians, a shortage of nurses and allied health workers, overtraining of physicians in high technology, government control of health and education systems, and economic problems. The Panamerican Federation of Associations of Medical Schools (PAFAMS) was founded for the purpose of addressing such problems in Latin American medical education. PAFAMS has promoted the exchange of ideas and experience among its member associations and schools by establishing a data base of information on medical education and developing mechanisms to disseminate such information. Other PAFAMS initiatives include a program to integrate professional health education and health care services within individual communities, and the linkage of medical education programs with health care institutions as a means of improving the quality of health care. A crucial next step in Latin America is the development of a leadership program to identify and nurture leaders in individual countries who will be instrumental in developing community-based health services by means of medical education oriented to such purpose. Thus, the key issue is to develop healthcare-oriented medical education. PMID- 2713021 TI - Asian medical education. AB - In order to address issues relating to medical education in Asia, consideration must be given to the many differences among Asian countries, including variations in sizes, populations, social and cultural backgrounds, histories, political systems, and stages of economic development. In most Asian countries, poverty is pervasive, and it is usually national in scope. This is often coupled with lack of government commitment to provide health facilities and health care for the entire population. Systems of medical education differ widely and are based mainly on those of the country of colonial domination; hence, the systems may reflect predominantly British, American, Japanese, or Dutch influence, among others. Although most medical schools in Asia have academic disciplines and admission standards similar to those of Western schools, there are sharp differences among countries in faculty salaries, faculty competence, academic standards, adequacy of staffing, and number of medical schools. Underlying conditions and influences that have contributed to the current status of medical education systems in Asia are discussed. PMID- 2713022 TI - Strategies for developing innovative programs in international medical education. A viewpoint from Africa. AB - Postgraduate medical education is an important factor in Africa's present emphasis on health care as a basis for socioeconomic development. Such education must be relevant to the realities of health problems in Africa. The priority of most African governments is training in traditional health care management and in fields related to community- and problem-based medicine. Presently, opportunities for such training exist in only seven centers throughout Africa. A model health care system, offered by most national governments, is described. This system, which includes district, provincial, and central levels of care, delivers over 80% of health services, and it is within such a system that nationals returning from postgraduate medical education abroad will function. Problems currently associated with these systems are the shortages of expertise in the areas of management, logistics, informatics, and resources mobilization, as well as the generally low literacy of the community. Africa also needs more teachers in the basic sciences, further development of biomedical research, courses in continuing education, particularly for field workers in isolated areas, short courses on investigative techniques, and goal-oriented research aimed at solving public health problems in the student's country. PMID- 2713023 TI - The roles and responsibilities of United States medical schools in international medical education. AB - Once dependent on the educational and professional resources of other countries, by the end of World War II the United States was recognized as one of the preeminent centers of the world for medical science and teaching. A period of nearly open access to the American medical education system between 1962 and 1975 was followed, however, by a period of stricture. Reasons are cited in favor of a more active international role by the United States in medical education. Some of the contributions that the United States can make are summarized, and seven areas are identified in which the United States stands to make substantial gains through a more active role in international medical education. The authors conclude that it is the spirit of science, rather than diplomatic advantage, that should guide United States efforts in international medical education. A proposed role for the Association of American Medical Colleges as both a facilitator and a national policy advocate in the area of international medical education and health is outlined. PMID- 2713024 TI - Strategies for developing innovative programs in international medical education. World health perspective. AB - While physicians have always been considered the leaders of the health team, widespread discussions have been held for at least two decades on the reorientation of medical education to ensure that physicians will not only possess adequate scientific and clinical knowledge but also have other equally important qualities to foster worldwide health. For example, physicians should be socially responsible, have a broad viewpoint of the relationship of people to their environment, be trained in the proper mix of preventive and curative disciplines, and have practical skills as social scientists, leaders, and agents of change. While many innovative answers have been found concerning these and other complex educational issues, in developing countries, little change has occurred in the overall direction of medical education: doctors remain the last converts to the cause of primary health care, and time is running out for medical education reforms. In addition, in developing countries, the importance of the medical team leader is lessening as the importance of other members of the team, who are willing to work in the villages away from the great medical schools and hospital complexes, is growing. However, there are innovative programs that show how this unacceptable state of affairs can be changed. The author makes a plea for the planning and programs to make the necessary reforms. PMID- 2713025 TI - Report on the survey of international activities of U.S. health professions schools. AB - The Educational Commission for Foreign Medical Graduates recently undertook a survey of all accredited U.S. schools of medicine, dentistry, pharmacy, and public health to determine each school's domestic and foreign participation in international education, research, administration, and health care. The response rate was good, especially for schools of medicine, with 125 (98%) of 127 schools providing information. The resulting directory, published in July 1988, lists 494 programs involving 84 countries: 319 in medicine, 44 in dentistry, 30 in pharmacy, and 101 in public health. Directors, titles and objectives of programs are listed, along with descriptions of areas of emphasis, types of affiliation, personnel involved, and sources of funding. International involvement of the schools was unevenly distributed: about 16% of the medical and public health schools and 6% of the dental and pharmacy schools accounted for half of the international programs in each of these four disciplines. Schools of public health had the largest mean number of international programs per school, followed by schools of medicine. The majority of programs emphasized education and research; lesser numbers were in administration and health care. The majority of programs were in developing countries, the People's Republic of China, and Mexico, together accounting for 19% of the programs listed. In addition to providing needed aggregate and individual information on programs in international health, the directory may serve as a basis for planning by students, scholars, and institutions. PMID- 2713026 TI - The International Medical Scholars Program: purpose and potential. AB - Among medical leaders in other countries, there is a general perception that it is difficult at present for their citizens to get graduate medical education in the United States. In response to concern that current U.S. policies may be negatively affecting opportunities for international medical education, a task force recommendation of the Accreditation Council for Graduate Medical Education led to the founding of a managing structure through which to develop the International Medical Scholars Program (IMSP). IMSP is described as an organization that will be able to provide tailored opportunities for high-quality education, centralized matching, planning, and evaluation; certificates for recognition of program completion; mechanisms to ensure the return of participants to their home countries; and a system to record the careers of IMSP graduates in their home countries. Proposed eligibility requirements for foreign medical graduates and selection criteria for U.S. institutions are discussed, along with obligations and requirements of program participants, program content, and the recognition for completion of IMSP programs. Administrative considerations also are presented, including IMSP financing and evaluation plans. PMID- 2713027 TI - Strategies for developing innovative programs in international medical education. Identification of educational needs. AB - A U.S. medical educator noted that the needs of developing countries are not necessarily addressed by traditional methods of medical education in the United States, involving high-technology education, technology transfer, development of academic personnel, and the like. In many developing nations, where there may be a surplus of doctors and many unemployed doctors, there is also a vast population of underserved people. Many of the physicians may have been trained inappropriately, or they were not comfortable in certain environments. In order to have an impact on the vast population, that kind of anachronism must be addressed. He inquired whether there is a role for the United States in addressing the health of communities rather than the sickness of individuals. It was observed that the health needs of developing countries are often thought to relate to the issues of hygiene, sanitation, and prevention and that these needs are homogeneous. The needs for interventional technology and preventive primary care should be differentiated, and the requirements at both levels of assistance should be heeded, be it at a primary and preventive level or at the level of specialist-oriented technological intervention. There was discussion about the dichotomy that exists between schools of public health in the United States and the medical schools with which they are associated. They were referred to as "two separate cultures." Thus, some suggested that U.S. physicians involved in curative medicine need to be exposed to community-based medicine in other countries, and many questioned whether other countries should seek to model their systems after those in the United States.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713028 TI - Strategies for developing innovative programs in international medical education. Selection of scholarship candidates. PMID- 2713029 TI - Recognition for completing the International Medical Scholars Program. PMID- 2713030 TI - Assurance that foreign scholars return to their home countries. PMID- 2713031 TI - Implementation of the International Medical Scholars Program. PMID- 2713032 TI - Strategies for developing innovative programs in international medical education. Suggestions for future planning. PMID- 2713033 TI - Defining global medical education needs. AB - The graduates of medical education institutions should be, both in their numbers and in their acquired skills, appropriate to improving the health of the particular society they are intended to serve. Medical education should be tailored to deal with the diseases the physician is most apt to see--or at least apt to see in an academic medical center. Such logic does not prevail, however, in terms of either the numbers of physicians trained or the content of the medical curriculum. The Western model of a medical school curriculum has been adopted--but little adapted--for use by much of the Third World. Relevant subjects such as epidemiology, social sciences, and management are often either ineptly taught or omitted. A shift in attention from patient to community is recommended, accompanied by deliberate programs of education and health care to measure and improve the health of the community. Significant improvements in health in much of the world can be made only through community-based programs such as improved nutrition, education, sanitation, prevention of infectious diseases, and family planning. Two types of U.S. participation in international medical education are recommended: (1) specialty training of physicians from countries whose access to instrumentation and medical care support structures are similar to those in the United States, and (2) strengthening of institutions in developing countries in the areas of education, research, and practice appropriate to the particular needs of each of these countries. PMID- 2713034 TI - Injury patterns for occupants of small trucks. AB - A limited number of studies have been completed on the factors contributing to accident-related injuries sustained by occupants of pickup trucks. The increasing number and changing pattern of use of light trucks necessitates the need to critically review this vehicle type with respect to contributing accident factors and associated injuries. This paper investigates the injury mechanisms of occupants of pickup trucks and the surfaces that the occupants contact in roadway accidents. Selection of cases from the Canadian vehicle database was based on the location of the vehicles' most severe impact deformation. The overall occupant injury severity was examined with respect to impact location, impact speed, and magnitude of occupant compartment intrusion. The results of the investigation illustrate the benefits of seat belt restraint use. In addition, identification of frequent injury contact surfaces establishes a reference for improved vehicle design initiatives and standards. PMID- 2713035 TI - Filtering effects in reporting work injuries. AB - Research efforts in the field of occupational injuries have been hampered by difficulties in ascertaining true prevalence rates. Lack of accuracy in reporting and documentation of work injuries leads to loss of information and lack of comparability of work injury statistics. The paper explores some of the factors related to loss of information about work injuries and proposes a descriptive model of the information processing system. The Filter Model describes the way in which information about a given injury proceeds through a series of levels, from true prevalence of injuries in the workplace, to prevalence as indicated by national aggregate statistics. Between each level is a "filter" or barrier that is selectively permeable, ensuring that information about some, but not all, injuries will pass through to the next level. Consequently, the type of work injury data collected at each level will differ. The Filter Model can aid in choice of appropriate level of data for research purposes, and provides a framework for investigation into the nature and extent of filtering processes within work injury reporting systems. PMID- 2713036 TI - Assessing one's own and others' driving ability: influences of sex, age, and experience. AB - Observational studies of drivers' involvements in dangerous situations suggest that young males drive differently from other road users. Studies of drivers' assessments of their own ability appear to show that they believe they drive better than their peers and that, while young males equate their ability with that of older male drivers, the latter group see themselves as superior to their younger counterparts but of equivalent ability to peers. It is unclear from previous studies what the influence of driving experience is on such assessments and, indeed, what female drivers feel about their ability. The present studies suggest that the widely reported tendency for people to overestimate their ability may be largely artifactual, that males and females describe their performance similarly, and that previously reported age differences disappear when driving experience is controlled. Among the differences that remain is the reported greater "recklessness" and comparative lack of "smoothness" of young males' driving. The implications of these findings for our understanding of risk assessment and acceptance are discussed. PMID- 2713037 TI - Potential fatality reductions through eliminating occupant ejection from cars. AB - The percent of occupant fatalities preventable by eliminating ejection is calculated using Fatal Accident Reporting System (FARS) data for 1975 through 1986. The calculation requires estimates of two quantities. First, the fraction of all fatally injured occupants who were ejected; this is obtained directly from the FARS data. Second, the probability that an ejected occupant was killed compared to the probability that the occupant would have been killed in a similar crash in the absence of ejection; this quantity is estimated using the double pair comparison method, and its dependence on occupant age and sex and on car mass and model year is examined. High precision estimates of the reduction in fatalities that would result from eliminating ejection as functions of these same variables are thereby obtained. These estimates depend on assuming that whatever method is used to prevent ejection would cause the formerly ejected occupant to acquire the same fatality risk as a nonejected occupant in a similar crash; the study does not address how to prevent ejection. It is concluded that ejection elimination would decrease fatalities to unrestrained car occupants by 18 +/- 1%. The fatality reductions are independent of car seating position (19%, 19%, 17%, 16%, 19%, and 18% for drivers, middle front, right front, left rear, middle rear, and right rear passengers, respectively); they decrease with driver age, from 25% at age 18 years to 7% at 70 years; they decrease with increasing mass, but remained relatively independent of car model year since the early 1970s, being somewhat higher for earlier model years. PMID- 2713038 TI - Regional variation in motor vehicle accident reporting: findings from Massachusetts. AB - Differences in motor vehicle crash reporting may affect geographic comparisons of motor vehicle crash rates. Substantial differences have been reported between nations and, within the United States, between states, but little is known about more localized differences. Data from Massachusetts' 45 largest municipalities indicate substantial local variation in the percentage of reported injury producing crashes for which a police report is available, from fewer than 20% in the lowest decile to more than 85% in the highest. For a given municipality, the percentage of crashes with police reports in 1979 was highly predictive of the percentage with police reports in 1983. PMID- 2713039 TI - [Severe forms of effort-induced asthma]. AB - Severe reactions in exercise-induced asthma (EIA) seem to be underestimated in the published literature. We report two cases of near-miss death from EIA that occurred after a short run. We review 364 exercise tests that were performed between September 1987 and October 1988 by a standardised protocol on a treadmill, on patients with possible EIA. A positive test, defined by a fall of FEV1 of at least 20% was found in 173 patients. From 21 patients with a fall of greater than 50%, 4 presented severe signs of: Cyanosis. Intense dyspnea with impediment of speech. General malaise with hypertension. These 4 patients were not greatly different from patients of the 50% fall group when compared for FEV1 before the test and for heart-rate during the test. They differed in the duration of the asthma attack, which was more protracted, despite the use of beta-2 agonists. The onset of severe reactions is 2.3% of positive tests and seems to be unpredictable. PMID- 2713040 TI - [False intrinsic asthma of infancy]. AB - A case of asthma in an infant child from a family already showed inability to tolerate cow milk and which only responded when such food was discontinued. The study concerns: a. The diagnostic methods of the disease; b. The relationship between the IPLV and hypotrophy that was perceptible in the infant child, a hypotrophy that was revealed in the course of the evolution of the disease. Finally, a study of the documents on the pathogenic processes enabled us to locate the observation involved to half-way between IgE dependent cases and those other cases that produce delayed hypersensitivity. PMID- 2713041 TI - [Rescue from sudden death syndrome and allergy to milk proteins (apropos of a case)]. AB - Allergy to milk proteins may be responsible for the syndrome of unexplained, sudden death of infants, but well-documented cases are rare. The authors report an observation where clinical history and complementary investigations support the incrimination of this factor. PMID- 2713042 TI - [Epidemiologic study of adult bronchial asthma in a Benin hospital environment]. AB - This work is a contribution to the epidemiological study of bronchial asthma in adults in a hospital environment at Cotonou. It is a question of the necessity of admission to hospital of clinical cases. The study has emphasized the following points: Separation according to age has shown that 52% of patients are less than 35 years old, young subjects are in this group. The two sexes are equally involved, with a sex ratio of 1. The different socio-professional groups involved have shown a predominance of those without profession. The main allergic factors identified by questioning are dominated by housedust, which suggests, failing allergological tests, that the role of mites is probably preponderant. There does not seem to be any particular influence of meteorological factors (rain or dryness) on the frequency of crises. Finally, it should be emphasized that technical difficulties make it very difficult to study asthma in Benin. PMID- 2713043 TI - [Effect of a visit in an eradication environment on reactivity to mites in the respiratory mucus]. AB - 33 asthmatic children, stabilised and allergic to mites on a long-term stay at Font-Romeu, were included in a protocol that was intended to show the effect of stay in an environment of natural eradication on the reactivity of the nasal mucosae. 3 groups were formed: A. To receive every day several microgrammes of mites on the nasal mucosae, lasting one month P. Physiological saline T. Left untreated. The reactivity was measured before the test, after one month, then after about another month during which each group was left untreated. The reactivity remained stable in A and T, and reduced in P. The indications were: 1. That the mites (the stay in the infested environment) augmented the reactivity. 2. In the eradication environment it decreased then stabilised itself at a basal level. 3. It then decreased again, due to the effect of the saline. PMID- 2713044 TI - [Anaphylactic accidents. Etiologic and clinical study of 143 cases outside the hospital setting]. AB - From 01/01/1981 to 31/12/1986 inclusive, the S.A.M.U. of Lyon investigated 143 anaphylactic accidents in an extra-hospital environment. The allergological study has shown that 36.3% of the patients are already the victims of a similar incident (in 9.8% of cases, with the same product). The main causative products are the analgesics and non-steroid anti-inflammatory compounds, hymenoptera venoms and antibiotics. In about 1 in 4 cases the enquiry gave negative results. In 1 case in 2 there was a cardiovascular collapse; however it was not possible to establish the relationship between the severity of the clinical picture and the different classes of products. There were no deaths. In comparison with preceding studies there were no developments in the place occupied by the causative products. PMID- 2713045 TI - [Epidemiologic study of allergy in the school environment]. AB - A school environmental study of about 20,000 children from the French department of MAINE and LOIRE (1/100 of French territory and 1/100 of the total population) was made during the summer of 1987 in all the schools of the region. The replies allowed evaluation of: -- The elements of the environment; . urban or rural . type of building . soils . domestic animals (types, lifestyle, large or small, relationship with the children). -- The proportion of allergic children per classroom, types of sickness, suggestions made by parents, eventual allergic accidents during class hours. In addition, school teachers were asked to comment on the subject. Their answers showed extreme variety of attitude towards allergy, there were those who refuted it, some fully accepted and others who asked for more information so that they could be more help to their students. A prime interest of the study lies in the dialogue between parents, teachers and physicians as the children spent most of the daytime at school and therefore the quality of the environment is a major factor in infantile allergy. PMID- 2713046 TI - [Spontaneous intestinal perforation in newborn infants. A form of necrotizing enterocolitis]. AB - The present study comprised twelve premature infants with "spontaneous" gastrointestinal perforations studied retrospectively during a period of three years. This problem was found to be more frequent in extremely premature babies affected with respiratory distress syndrome and patent ductus arteriosus and accompanied with very high mortality. A clinical-pathological correlation was done with the intestinal biopsy or postmortem studies and according to these findings, it is suggested that "spontaneous" intestinal perforations probably represent a form of necrotizing enterocolitis. PMID- 2713048 TI - [Hepatosplenomegaly of unknown etiology: clinical examination in making a diagnosis in 57 cases]. AB - Fifty-seven patients with the diagnosis of hepatosplenomegaly of unknown cause were studied. Most of the patients were infants and preschool age children. They were evenly distributed by sex. The patients were not undernourished nor did they have low height. However if such was the case, they were usually patients with a metabolic or neoplastic problem. Psychomotor retardation, paleness, jaundice and bleeding were the most common signs and symptoms. Hepatic function tests, complete blood count and urinalysis helped to establish the cause of hepatosplenomegaly in 19 of the 57 patients. Other studies only helped to establish the diagnosis of visceromegaly of unknown cause. Liver biopsy, bone marrow biopsy and a metabolic study were useful to establish the diagnosis in 34 cases. Infectious, metabolic and neoplastic problems were the usual cause for visceromegaly. PMID- 2713047 TI - [Acute appendicitis in children. Experience at a general hospital]. AB - In order to establish a guide for the diagnosis of acute appendicitis, we reviewed the charts of patients with appendectomy. In a 7-year period, 385 patients were studied. The age range was 3 to 15 years. In 53% there was an administration of medications prior to surgery. Perforated appendicitis was found in the majority (53%) of the cases. We could not find any association between age and perforation. Only localized, persistent abdominal pain, peritoneal irritation, anorexia, and vomiting were useful for differential diagnosis. In patients with acute appendicitis (p greater than 0.05), leukocytosis (greater than 10,000/mm3), neutrophilia (greater than 70%) and bands (greater than 3%) were observed in 80% of the cases. The frequency of complications was elevated (39.5%), and the mortality was five times higher than referred in other studies. We propose an algorithm for both opportune diagnosis and treatment of the disease. PMID- 2713049 TI - [Meningeal sarcoma in childhood. Experiences with 17 cases]. AB - A total of 17 patients with meningeal sarcoma were diagnosed and treated at the National Institute of Pediatrics in Mexico City in a period of 15 years. Among the diagnostic methodology used in this group we found that angiography is still the best to be used so far. On the other hand, the chemotherapy protocol employed did not improve the survival obtained with surgery and radiotherapy. Therefore we suggest that a new chemotherapy protocol has to be designed in order to obtain better results. Of particular interest, we found in this group of patients that the time elapsed between the first sign of disease to the moment of diagnosis varied from 2 months to 10 years without any prognostic significance. PMID- 2713050 TI - [Serology of typhoid fever in children. I. Capillary flocculation- agglutination. Its specificity in an asymptomatic population and its utility at a pediatric emergency service]. AB - Using a capillary flocculation technique we evaluated serum samples of asymptomatic children for typhoid fever serology. Thirty one (5.16%) of the 600 serum samples tested were positive for a specificity of 95%. To evaluate the sensitivity of the test, serum samples from 36 children with proven typhoid fever and a similar number of control patients were evaluated. The sensitivity of the capillary flocculation test in this group was 100%. The test compared favorably with the Ruiz Castaneda serologic test for typhoid fever. PMID- 2713051 TI - [Pulmonary aspergillosis]. AB - We report a 15-year-old male with bronchial asthma since five years old, unresponsive to treatment; at age 12 a diagnosis of pulmonary tuberculosis was made and treated with several drugs. He was referred to our hospital because of hemoptysis. A diagnosis of aspergillosis in the aspergilloma form was made; after, a left upper lobectomy showed the invasive form; later he presented recurrent obstructive respiratory problems, secondary to the allergic form. Serum IgE was elevated, lowering after treatment with corticoids; simultaneously he had clinical improvement. Treatment was discontinued when clinically asymptomatic and serum IgE was normal. Diagnostic route and treatment are discussed. PMID- 2713052 TI - [Instructions for authors of medical articles: third edition]. PMID- 2713053 TI - [Allagile's syndrome]. PMID- 2713054 TI - [Neonatal sepsis. Experience of the Pediatric Hospital of Mexico during 1980 1985]. PMID- 2713055 TI - [Hepatic markers (Ac-HVA-IgM and AcHBc-IgM) in cases of infectious hepatitis in Dominican children]. AB - The presence of IgM antibodies for the HVA and HBc antigens in 90 children of 15 or less years with acute hepatitis were investigated, finding that 62% (58) were positive for HVA, 8.9% (8) for HBc and 27.8% (25) did not show antibodies for HVA or HBc (non-A non-B hepatitis); comments are made on some clinical and epidemiological findings such as a higher frequency of blood transfusions in HNANB, more males in HB and HNANB, and more hepatomegaly and liver sensitivity in HNANB. PMID- 2713056 TI - [Some indicators of lineal and craniofacial proportionality in newborn infants]. AB - Looking for intersexual differences in size and lineal and craniofacial proportionality, assumed to be secondary to genetic induction, non-distorted by environmental factors, we studied 200 newborns from families who were residents in proletarian zones, parents with very similar education and employment (qualified workers). We chose 15 size measurements from which we derived 23 ratios and 15 craniofacial measurements with four key indices. Significant but discrete intersexual differences were found in height and in cranial circumference, and larger differences in leg, foot, forearm and arm length; there were no differences in the proportionality indices. In eight of the 10 craniofacial measurements there were intersexual differences, but not on the ratios derived from them. We conclude that as an expression of genetic induction (accepting "size" as a phenomenon of accumulated growth, and the "ratios" of development or differentiation) what we found confirms other studies that point out that when a boy is born, he is bigger in size but less developed than the girl. PMID- 2713057 TI - [Congenital cyst of the common bile duct. Surgical treatment with total excision of the cyst]. AB - Congenital choledochal cyst (CChC) has a very low frequency in our population; it is more frequent among females and its pattern of inheritance is multifactorial. The frequency of CChC in our population was 1 per 20,000 to 1 per 30,000 hospitalized patients in the pediatrics department of the Hospital Juarez and Hospital Infantil de Tacubaya, respectively. Four new cases of CChC are reported, two school children and two teenagers. Pre-operative diagnosis was accomplished clinically, which is the most precise non-invasive method. The most effective actual diagnostic methods include ultrasonography, CAT scan, and basic laboratory data, which can corroborate the clinical diagnosis of CChC with 100% certainty. The surgical treatment of CChC is controversial, but the surgical procedures of choice are choledochocystojejunostomy with total cyst removal, Roux's Y, and cholecystectomy. One case was treated with latero-terminal choledochocystojejunostomy and 3 cases with total removal of the cyst. The results were excellent. PMID- 2713058 TI - [Congenital contractural arachnodactyly. Report of 2 clinical cases]. AB - Two unrelated male children, aged 15 and 2 months, with congenital contractural arachnodactyly (CCA) are described. CCA is an autosomal dominant disorder of benign evolution, affects the connective tissue and its morphologic phenotype is similar to Marfan syndrome. Differential diagnosis and management are discussed. PMID- 2713059 TI - [What the pediatrician should know about introducing infants to solid foods]. AB - Since World War II, the introduction of solid foods to infants has been practiced at early ages. At the same time, knowledge about the physiology of the intestinal tract during the first year of life has been increasing: now the developmental immaturity of the intestine and the clinical consequences produced by the introduction of some foods at an early age are known. In this report this information is reviewed in order to rationalize the introduction of solid foods in babies. PMID- 2713060 TI - [Invasive amebiasis as a public health problem]. AB - Amebiasis, an infection of humans with the protozoan Entamoeba histolytica, has a wide distribution in Mexico. The lumenal, asymptomatic infection, as measured by the presence of cysts in stools has been recorded from 2.4% at Ometepec, Guerrero to over 55% at Mixquic, D.F., but only a small percentage of those having intestinal infection will develop invasive amebiasis, the main clinical forms being dysentery and liver abscess. In Mexico City, from 0.8 up to 14% of cases of acute diarrhoea in children requiring hospitalization were found to be associated with E. histolytica. Serological surveys for antibodies, suggest that approximately 5.98% of people had intestinal mucosal or liver invasion, but amebic dysentery may be five to 50 times more frequent than liver abscess, namely in children. Amebiasis may cause death when it manifests itself as fulminating colitis or liver abscess. Lethality in adults has been estimated to be around 0.2 to 2%, but in children with liver abscess it may be 1.1 to 26%. In addition to being a potentially lethal disease, it has important socioeconomic consequences, because incapacitating infections are rather frequent in wage-earning adult males requiring several weeks of hospitalization and from two to three months for full recovery. In Mexico, amebiasis has been more closely associated with poverty and low levels of sanitation than to climate, and in view of the high rates of morbidity and mortality caused by E. histolytica, more research into better and cheaper methods of diagnosis, treatment and prevention is clearly necessary plus a substantial improvement in control strategies. PMID- 2713062 TI - [Changes in the Boletin Medico del Hospital Infantil de Mexico]. PMID- 2713061 TI - [Is the anemic child studied adequately during hospitalization?]. PMID- 2713063 TI - [Role of social assistance agencies in reference to the malnourished child]. PMID- 2713064 TI - [Comparative serology in typhoid fever in children. II. Comparison of a microhemagglutination plate technic with Ruiz-Castaneda surface fixation]. AB - Two lipopolysaccharide antigens that differ by the technique of preparation from S. typhi, one named crude is easily extracted, the other one is water-phenol extracted. Both were adsorbed by papain and cysteine to lamb erythrocyte surfaces, fixed then by glutaraldehyde and used in a plate microhemagglutination test (MHA). The MHA test was done with 30 sera from children with S. typhi blood isolates. The same number of control sera were tested for comparison. The crude LPS antigen showed better sensitivity: 73% versus 53% of the water-phenol extracted one despite a high index correlation (r = 0.88). The latest one was evaluated in a prospective study, using it during a six-month period in an emergency room with S. typhi blood isolated sera. The MHA test was compared with the surface fixation test. Both assays showed similar sensitivity and a specificity of 91 and 100%, respectively. PMID- 2713065 TI - [Concepts of health personnel in relation to the management of acute diarrhea]. AB - With the objective of gaining more knowledge on the concepts of management of acute diarrhea in children from health personnel, a study was designed and carried out in two Central American countries. The sample was composed of pediatric residents, general practitioners, registered nurses and assistant nurses. A special form was designed and field workers were trained for this purpose. A total of 389 health personnel was interviewed. The results showed that there is a good knowledge on morbidity and mortality from diarrheal disease in children, less knowledge on the etiology of the disease and very little knowledge on the composition of oral rehydration solutions. Also there is no standard criterion on the use of drugs, being the general practitioners and nurses who have more wrong concepts. The factors most mentioned for non-acceptance of oral rehydration therapy (ORT) are little promotion of ORT, that the rehydration salts are not available in every place, that mothers do not accept ORT and that ORT seems a non-scientific therapy. PMID- 2713066 TI - [Etiology of growth retardation (failure to thrive)]. PMID- 2713067 TI - [Etiology of growth retardation (failure to thrive)]. AB - To determinate the different characteristics of growth and development that could categorize the etiology of failure to thrive (FTT), we analyzed 174 patients hospitalized because of FTT. Forty-eight percent had "organic and psychosocial" causes, and fifty-two percent had "non- organic" causes. The predominant organic factors were intrauterine retardation (41%) and gastrointestinal pathology (24%). Children with genetic and neurologic diseases were significantly more stunted and wasted than those of the "non-organic category (p less than 0.05). At discharge, the anthropometric data of the patients with genetic pathology remained with lower values than the ones observed in the other categories (p less than 0.05). The genetic and neurologic categories had the higher percentages of psychomotor retardation, and this impairment didn't improve after treatment. In all the categories, the motor areas were most retarded at the time of admission; nevertheless, they showed the higher percentage of recovery. PMID- 2713068 TI - [Resistance of enterobacteria and Pseudomonas to old and new antimicrobial agents]. AB - Antibiotic sensitivity to eight common use antibiotics for 9,538 enterobacteria and Pseudomonas strains isolated from hospitalized children was studied using the serial dilution plate technique. Minimum inhibitory concentration to seven new antibiotics for 310 strains was also determined. Enterobacteria showed high resistance (50-80%) to ampicillin, carbenicillin, sulbenicillin, chloramphenicol and trimethoprim/sulfamethoxazole; resistance to piperacillin, gentamicin, tobramycin, and netilmicin was moderate (15-45%), and resistance to amikacin, cefotaxime, moxalactam and aztreonam was low (2-10%). Pseudomonas strains showed less than 20% resistance to carbenicillin, piperacillin, amikacin and aztreonam. Enterobacteria isolated from urine samples showed low resistance to nitrofurantoin and nalidixic acid (15%). Therapeutic recommendation for most frequent infections caused by these etiologic agents based on the resistance values found were elaborated. PMID- 2713069 TI - [Acute infantile diarrhea caused by rotavirus in a pediatric population of Merida, Yucatan, Mexico]. AB - The frequency and clinical characteristics of rotavirus infections were studied in 150 infants hospitalized in the General Hospital "Agustin O'Horan" SSA in Merida, Yucatan, Mexico, because of acute gastroenteritis during 1986. Rotavirus was detected in 32% of all subjects tested. Rotavirus was detected in all months studied. An age-related incidence peak was observed between 7 and 24 months and the infection proved to prevail within the rural area. The clinical pictures were analyzed. We consider it necessary to carry out many more studies in our country in order to obtain reliable knowledge of this problem. PMID- 2713070 TI - [Puberal gynecomastia]. AB - The clinical evaluation and the treatment of 46 patients that presented with puberal gynecomastia in a period of ten years to an Adolescent Medicine Department were assessed. The evolution period previous to the first appointment was less than six months in 47% of the cases; 59% were going through Tanner stages II and III; 26% presented emotional consequences. The result of the two year clinical follow-up was: remission in 43%; surgical treatment in 28% and loss from the study in 28%. Assessment of the evolution time, size of gynecomastia and emotional consequences is suggested in order to decide on the treatment. PMID- 2713071 TI - [Biochemical composition of oral rehydration solutions and their combinations suggested for use in Venezuela]. AB - We studied the electrolyte composition, pH and osmolality of six solutions for oral rehydration available in drug stores in Venezuela, and also their combinations with whole milk in a dilution of 6.6%. The solutions such as Pedialyte, Hidramilac and Hidramines showed an acid pH (4.30-5.10) in direct relationship to the concentration of carbohydrates (5% or more). Also, Pedialyte and Hidramilac had greater osmolalities (360-365 mOsm/kg) than plasma. Some of the levels of sodium and potassium in the solutions were found to be under the concentrations given by the producers. The combination of whole milk with oral solutions diminishes the concentrations of sodium and potassium in the mixture, changing the sodium-glucose relationship, pH and osmolality. The therapeutic implications for the use of oral rehydration solutions with low concentrations of sodium, acid pH, large content of glucose and elevated osmolality are discussed. It is concluded that the combination of whole milk with Sueroral (WHO) is not adequate for the optimum absorption of sodium and therefore to prevent dehydration. Therefore, except for the WHO solution and Oralite, other solutions are not adequate for the correction of the electrolytic and acid-base alterations present in infants with dehydration secondary to acute diarrhea. PMID- 2713072 TI - [Diagnostic problems in neonatal hypocalcemia]. AB - Fifteen newborns were studied in the neonatal ICU of the Infantile Hospital of Tamaulipas in whom ICH, neural infection, tetanus, HIE++ and electrolyte disturbances were ruled out, with clinical data highly suggestive of hypocalcemia. Determination of both QTc and QoTc intervals by ECG and measurement of levels of total serum calcium and calcium in CSF and calculation of ionic calcium by means of the McLean Hastings nomogram were made in each patient. Calcium gluconate was administered IV as a therapeutic test. Presence and disappearance of clinical manifestations were correlated with laboratory tests during the suspicious period, 8 and 24 hours after treatment was begun. There was no correlation between clinical features and QTc or QoTc, nor between total serum, CSF or ionic calculated calcium. We conclude that the diagnosis of hypocalcemia in centers that do not have the specific electrode for direct Ca +/- measurement, should be sustained basically when after IV administration of Ca, symptomatology disappears and that the real usefulness of laboratory determination of total C, of ionic calcium, of QTc and QoTc is very limited. PMID- 2713073 TI - [Renal malacoplakia in childhood. Report of a case]. AB - Renal malacoplakia is a rare entity with less frequency in children. In the past 7 years it was the first case reported in a third level regional hospital. The present clinical case showed chronic urinary tract infection and IVP showed right renal exclusion. He was nephrectomized on the right side because of arterial hypertension which started in the third year of the illness. The diagnosis was made after the surgery by microscopic examination, with the characteristic Michaelis-Gutmann bodies being shown. PMID- 2713074 TI - [Embryologic and anatomic considerations on the normal and pathologic formation of the cardiac septum. I. Interauricular septum]. AB - A brief presentation of the normal embryological development of the human interatrial septum is made. The anatomical expression of each of its embryological components is described. Our classification of interatrial septal defect is enriched by their more precise anatomical description and by making a more correct morphogenetic interpretation, based on new information obtained by means of experimental embryology. Emphasis is made that absence of the interatrial septum does not preclude the diagnosis of viscero-atrial situs. PMID- 2713075 TI - [Intestinal perforation in typhoid fever]. PMID- 2713076 TI - The role of expression and identity in the face-selective responses of neurons in the temporal visual cortex of the monkey. AB - Neurophysiological studies have shown that some neurons in the cortex in the superior temporal sulcus and the inferior temporal gyrus of macaque monkeys respond to faces. To determine if facial factors such as expression and identity are encoded independently by face-responsive neurons, 45 neurons were tested on a stimulus set depicting 3 monkeys with 3 expressions each. As tested on a two-way ANOVA, 15 neurons showed response differences to different identities independently of expression, and 9 neurons showed responses to different expressions independently of identity. Three neurons showed significant effects of both factors. Six of the neurons with responses related to expression responded primarily to calm faces, while 2 responded primarily to threat faces. Of a further set of 31 neurons tested on pairs of different expressions, 6 showed strong responses to open-mouth fear or threat expressions, while 2 showed stronger responses to calm faces than threat expressions. Neurons responsive to expression were found primarily in the cortex in the superior temporal sulcus, while neurons responsive to identity were found primarily in the inferior temporal gyrus. The difference in anatomical distribution was statistically significant. This supports the possibility that specific impairments of the recognition of the identity of a face and of its expression in man are due to damage to or disconnection of separate neuronal substrates. PMID- 2713077 TI - Retention deficits produced in monkeys with reversible cold lesions in the prestriate cortex. AB - Cryodes were implanted over the prelunate and fusiform gyri in 4 monkeys. The intention was to block the prestriate projection to the inferotemporal cortex (IT). Cooling this cortex produced deficits that were completely reversed by removing the cold. The deficits appeared in the recall of visual discriminations that were learned prior to the application of the cold, but new discriminations were learned during cooling at the same rate as in control animals. This closely resembles the results of ablation experiments in this same cortex. There was no deficit when cooling this area on a delayed match-to-sample (DMS) task that required the animals to hold visual information over delays of 10 or 45 s. However, performance was close to chance during cooling when the delays were 6 min. With this long delay, when cooling was done separately at sample when the stimulus is received, or at match when the information is recalled, a significant deficit occurred only at match. The results are consistent with the suggestion that this area is involved in retrieval of visual information from long-term memory. PMID- 2713078 TI - Depth perception in cats after cerebral hemispherectomy: comparisons between neonatal- and adult-lesioned animals. AB - Depth perception was studied in adult cats following removal of the left cerebral hemisphere as a neonate or as an adult. Both monocular and binocular thresholds were determined using a visual cliff. Although both age-at-lesion groups showed depth perception deficits, the neonatal-lesioned animals performed much worse under binocular conditions on the visual cliff than either adult-lesioned or intact animals. This was primarily due to the lack of a binocular advantage in the neonatal-lesioned cats since their monocular thresholds were similar to that of adult-lesioned animals. Both lesioned groups showed higher monocular thresholds compared to intact animals but this effect reached significance only for the right eye. In addition, the neonatal-lesioned cats showed ocular misalignment which may have contributed to their lack of binocular depth perception. Regardless of these deficits neonatal-lesioned cats were more like intact controls regarding the types of errors made on the visual cliff. Neonatal lesioned animals and intact controls made random errors, whereas adult-lesioned animals made most of their errors when the shallow shelf was presented on the animals' right side. This may indicate that the adult-lesioned animals have greater motor and/or visual field biases than do neonatal-lesioned cats. PMID- 2713079 TI - Parasagittal thalamic knife-cuts and cardiac changes. AB - Rabbits received knife-cuts either medial or lateral to the mediodorsal nucleus of the thalamus (MD), and had stimulating electrodes implanted in MD. These animals were compared to animals with sham knife-cuts for (1) the cardiac component of the orienting reflex (OR) to novel tone stimuli; (2) differential pavlovian heart rate (HR) conditioning, utilizing tones of different frequencies as CSs and paraorbital shock as the US; and (3) heart rate, blood pressure, electromyographic activity, and respiration changes elicited by electrical stimulation in MD. Medial knife-cuts led to faster habituation of the OR, and to somewhat attenuated HR conditioning, but had no effect on stimulation-elicited changes. Lateral knife-cuts, on the other hand, enhanced the stimulation-elicited HR response, but had little effect on the HR OR. The HR CR was unaffected by lateral cuts during an initial conditioning session, but was attenuated in both knife-cut groups during a second session, compared to sham control animals. PMID- 2713080 TI - Cortical lesions interfere with behavioral recovery from unilateral substantia nigra lesions induced by brain grafts. AB - Effects of aspiration lesions of the cerebral cortex on the behavioral effects of intraventricular substantia nigra grafts were investigated. Apomorphine-induced rotational behavior consequent to unilateral lesions of the substantia nigra was used as a behavioral measure. Substantia nigra grafts reduced rotational behavior in animals with sham cortical lesions. Cortical lesions also decreased rotational behavior and, in these animals, no additional decrease in rotational behavior was induced by substantia nigra grafts. It is concluded that cortical lesions alter striatal circuitry so as to preclude a behavioral effect of substantia nigra grafts. PMID- 2713081 TI - Intervention of the lateral and central amygdala on the association of visual stimuli with different magnitudes of reinforcement. AB - Male rats received either kainic acid (KA) or sham lesions bilaterally into the lateral and central amygdala or were assigned to an unoperated control group. After the postoperation recovery period all lesioned and unoperated animals were tested for the ability to master a visual-stimulus/magnitude-of-reinforcement discrimination. Retention of the discrimination learning was evaluated 24 h later for the original and reversal problems. The lateral and central amygdala lesions differently affected the acquisition of a visual-stimulus/magnitude-of reinforcement discrimination and did not impair its retention. The lateral amygdala-lesioned group showed a significantly poorer performance in discrimination learning than all the other groups. Its performance was even poorer than that of the central amygdala-lesioned group. The contribution of lateral and central amygdala in the major components of a visual stimulus/magnitude-of-reinforcement discrimination is discussed. In order to know how the amygdala is involved in the association of sensorial stimuli with reinforcement, we suggest that the specific contribution of its individual nuclei in the detailed components of such an association be studied. PMID- 2713082 TI - Interocular transfer of preoperatively trained visual discriminations in goldfish (Carassius auratus) following selective commissure transections. AB - Goldfish were monocularly trained on either a red/green or circle/square discrimination task to show a differential classically conditioned cardiac deceleration. Combined section of the minor and horizontal commissure was then performed in animals trained on the colour problem, and transection of the posterior commissure in fish which had acquired the shape task. Both groups were then examined for retention and transfer. The results indicate that the engram for colour is fully represented bilaterally whilst that for shape is only established weakly in the naive side. PMID- 2713083 TI - Effects of acetaldehyde on the automaticity of the guinea pig sinus node. AB - The objective of this investigation was to characterize the effects of acetaldehyde (ACA) on sinus node automaticity (SNA). Guinea pig sinoatrial preparations superfused with Tyrode's solution at 37 degrees C were used. Intracellular microelectrodes were used to monitor SN rate (SNR). Acetaldehyde 3 X 10(-5) M had no effect on SNR, while 3 X 10(-3) M had a positive chronotropic action. The increase in SNR was associated with an increase in the slope of the slow diastolic depolarization (SDD) of subsidiary pacemaker fibers, with no change in the maximum diastolic potential (MDP). Acetaldehyde 3 X 10(-2) M exerted a biphasic effect: the SNR was enhanced and then depressed. Propranolol blocked the positive component of this chronotropic action. The negative component was not modified by propranolol, phentolamine, or atropine. It is concluded that ACA exerts both positive and negative chronotropic actions on the guinea pig sinus node. The positive component of this biphasic effect is mediated through a beta-adrenergic mechanism and it is associated with an increase in the SDD. The negative component is not due to alpha- or beta-adrenergic or muscarinic stimulation. PMID- 2713084 TI - Brain growth deficits following a single day of alcohol exposure in the neonatal rat. AB - Alcohol (7.5 g/kg) was administered to neonatal rats in a single day via artificial rearing procedures, being given in four consecutive feedings spaced two hours apart on either postnatal day 4, 5, or 6. These single days of alcohol exposure resulted in high peak blood alcohol concentrations (mean peak BACs of 380, 439 and 460 mg/dl, respectively) and significantly restricted brain weight when measured on postnatal day 10. The cerebellum was affected more than total brain, forebrain or brain stem. Additionally, growth of the cerebellum was more stunted by alcohol exposure on either day 4 or 5 than when the alcohol exposure occurred on day 6. Small but significant delays in body growth occurred 1-2 days after the alcohol exposure for each group. The interference with brain growth following high BACs for a short period of time has important clinical and experimental implications related to binge drinking and the mechanisms underlying alcohol-induced effects on the developing brain. PMID- 2713085 TI - Operant responding for oral ethanol in the alcohol-preferring P and alcohol nonpreferring NP lines of rats. AB - Rats of the P (n = 4) and NP (n = 5) lines were housed in operant chambers with food available ad lib, but all liquid was obtained by responding on either of two levers according to a FR5 schedule. Presses on one lever produced water from an automated dipper, while the other lever gave access to a dipper containing ethanol in concentrations ranging from 2 to 30% (v/v). P rats worked to obtain the ethanol at all concentrations offered and preferred the ethanol over water. The highest ethanol intake averaged 7.7 +/- 0.5 g/kg body weight/day at the 15% concentration and at least 5.8 +/- 0.9 g/kg/day for the 20-30% range. The NP rats responded more for the 2 and 5% concentrations of ethanol than for water, but responded predominantly for water when the ethanol concentrations were 10% and higher. In a second experiment, NP rats drank water rather than 10% ethanol by free-choice, even though the ethanol was mixed with a preferred flavor and the water with a nonpreferred flavor. The findings indicate that ethanol is rewarding to P rats in concentrations up to 30% (v/v) but is not rewarding to NP rats when the concentration is 10% and above. PMID- 2713086 TI - Interaction of tetrahydropapaveroline with inhibition of dopa-decarboxylase by Ro 4-4602 in brain: effects on alcohol drinking in the rat. AB - The effects of the 1-aromatic amino acid decarboxylase inhibitor, Ro 4-4602 (benserazide), was determined on alcohol drinking induced in the rat by tetrahydropapaveroline (THP) injected by the intracerebroventricular (ICV) route. After ICV guide cannulae were implanted stereotaxically in 19 Sprague-Dawley rats, an artificial CSF solution containing 5.0 ng/micrograms THP was infused twice daily for 3 days in a volume of 5.0 microliters. Following a standard self selection procedure, concentrations of alcohol which ranged from 3-30% were presented to the rats. A single maximally preferred solution, which in these rats ranged from 9-12% alcohol, was then offered in the presence of water. After a 4 day pretest in which alcohol intakes had stabilized, either 50 or 100 micrograms Ro 4-4602 plus THP were infused ICV to the animal during a 3-day period. Both doses of Ro 4-4602 significantly antagonized the g amount and proportional intakes of alcohol, but the higher dose was nearly twice as potent as the lower. During the 4-day postdrug test period, alcohol drinking continued to be suppressed. When THP was infused ICV over a 3-day period following the injections of Ro 4-4602, the predrug alcohol intake was partially reinstated, suggesting that this TIQ, when delivered directly into the brain, partly reversed the potent central action of Ro 4-4602. These results show that interference with the functional activity of central catecholamine pathways in the rat, by means of the inhibition of dopamine synthesis, serves to modify markedly the mechanisms underlying alcohol drinking in this species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713087 TI - Effects of chronic ethanol exposure on fatty acids of rat brain glycerophospholipids. AB - The lipid composition was analysed in forebrain subcellular fractions from rats treated with ethanol for three weeks and control rats. Increased proportions of oleic acid and a decrease in palmitic acid were consistently found in total glycerophospholipid fractions after ethanol exposure. The fatty acid compositions of individual phospholipids were also significantly changed. The proportion of docosahexaenoic acid was decreased in brain phosphatidylserine. In contrast to the decrease in the degree of unsaturation in phosphatidylserine, there was an opposite change in phosphatidylcholine wherein the degree of unsaturation was increased. No changes were produced in total cholesterol or phospholipid concentrations. These results point to a high degree of complexity of the mechanisms behind ethanol-induced changes in membrane lipid composition. The decrease in unsaturation in phosphatidylserine is probably an adaptive effect in order to counteract the fluidizing effect of ethanol. There are two possible explanations for the increase in unsaturation in brain phosphatidylcholine. The change may be due to adaptation to other biophysical effects, e.g., expansion of the membrane surface or be secondary to a change in liver lipid metabolism. PMID- 2713088 TI - Demonstration of lever pressing for oral ethanol by rats with no prior training or ethanol experience. AB - Male rats of the alcohol-preferring AA line were placed in an operant conditioning chamber with one lever delivering 10% alcohol solution and a second giving water. Free food and water were also continually available in the chamber so the animals should not have been motivated to obtain alcohol for reasons of hunger or thirst. The rats had never had alcohol previously. No shaping was used. The rats simply lived for the next 2 weeks in the operant chamber. All of them eventually learned to work for alcohol. Ethanol responding was significantly higher than pressing for water throughout the second week: on the last day, all rats pressed more than 300 times for alcohol and less than 40 times for water, took in a mean of 5.3 +/- 0.2 g/kg of ethanol, and obtained 72% of their total fluid as earned ethanol solution despite the presence of free water. Their acquisition was, however, much slower than that observed in male AA rats that had previously had prolonged access to drinking alcohol in their home cages. Living continually in the operant chamber is thought probably to have been an important factor in enabling the naive rats to learn to work for alcohol. PMID- 2713089 TI - Different effect of diltiazem and nifedipine on some central actions of ethanol in the rat. AB - The effect of two Ca2+ channel inhibitors (CCIs) on ethanol-induced hypothermia and hypnosis, on tolerance formation to both effects, and on audiogenic convulsions during ethanol withdrawal was studied in rats. Nifedipine, 2 and 5 mg/kg IP, significantly augmented the hypnotic action of ethanol without affecting hypothermia. Diltiazem failed to influence either effect of the toxin. Rectal temperature did not change in ethanol-naive rats after acute injection of diltiazem or nifedipine. Both drugs dose-dependently suppressed the development of tolerance to the hypothermic effect of ethanol without affecting the tolerance to the hypnotic action. Only nifedipine markedly suppressed the audiogenic seizure response in ethanol withdrawn animals. These data suggest that Ca2+ channels play a role in both acute and chronic effects of ethanol while pointing to certain differences in behavioral effects of various CCIs. PMID- 2713090 TI - Chronic alcohol intake modifies phorbol ester binding in selected rat brain areas. AB - 3H-Phorbol 12,13 dibutyrate binding to rat brain was modified by chronic ethanol treatment. Among the areas examined hippocampus and cortex showed a decrease in Bmax values of 32 and 24% respectively. No significant effect was observed in hypothalamus and cerebellum. In vitro ethanol did not modify the binding in all the areas except at molar concentrations. In hippocampus and cortex the direct measurement of protein kinase C activity indicated that the decrease in phorbol ester binding was accompanied with a concomitant decrease in kinase activity. The results indicate that chronic ethanol treatment leads to an inhibition of brain protein kinase C function. PMID- 2713091 TI - A histological study of the use of agar as a delivery vehicle for alcohol or iron to rats. AB - The supply of ethanol and other substances to the rat has necessitated the development of quite complex dietary preparation and feeding techniques. This study reports the use of ethanol/water solutions in conjunction with normal rat chow diet to provide up to 30 g/kg/day ethanol to study animals. By additionally supplying agar gels containing ethanol, voluntary intake of ethanol was raised to a possible maximum of 48 g/kg/day. Hepatic steatosis was produced in 7/18 rats supplied ethanol in this fashion. Agar gels were also used to provide carbonyl iron to rats and it produced grade 3 to 4 hepatocyte iron loading in all study animals. The study demonstrates a practical method for administering ethanol and iron to rats without altering normal dietary intake. Ethanol supplied in this way does produce hepatic injury in the rat. PMID- 2713092 TI - Effect of low alcohol dose on behavioral "despair" in rats neonatally treated with antidepressant drugs. AB - Rat pups were treated with monoamine uptake inhibiting antidepressant drugs, desipramine, imipramine or nomifensine (5 mg/kg) during the second and third postnatal weeks, and their later behavioral "despair," measured by Porsolt's swim test, was examined. At the age of two months, the desipramine-treated rats showed lengthened immobility in the swim test, and thus probably increased behavioral "despair." They also responded to 1 g/kg alcohol by shortening the immobility to the level of control rats. Neonatal treatment with either imipramine or nomifensine did not affect the swim test behavior. The results suggest that a low, stimulatory dose of alcohol was able to reverse the lengthened immobility in the swim test of rats treated with desipramine during the early postnatal period. PMID- 2713093 TI - An attempt to evaluate diagnostic and prognostic significance of blood endogenous ethanol in alcoholics and their relatives. AB - Endogenous ethanol in the blood of human subjects was measured by gas chromatography. In healthy males, 12-13-year-old boys (sons of alcoholic and nonalcoholic fathers), and alcoholic inpatients (after cessation of all drugs), the endogenous ethanol levels ranged from 0 to 4.3 mg/l. The results showed no significant differences between the groups. At the period of alcohol withdrawal reactions the concentrations of endogenous ethanol were minimal in patients with delirium tremens and maximal in patients with mild alcohol withdrawal syndrome, the dynamics of this parameter being dependent on the severity of the alcohol withdrawal syndrome and the nature of the drugs prescribed. PMID- 2713094 TI - Effect of Cu2+ and Zn2+ on the inhibition of human leucocyte elastase by 6-alkyl 3-(omega-carboxyalkyl)-2-pyrone, oleic acid and sulindac sulfide. AB - Inhibition of human leucocyte elastase by oleic acid and the structurally related 3-(1'-oxo-7'-carboxyheptyl)-4-hydroxy-6-octyl-2-pyrone is considerably enhanced by the addition of Cu2+, Zn2+ and, to a lesser extent, Co2+ and Ca2+. Sulindac sulfide and diflunisal also respond to changes in copper concentration, while Boc Ala-Pro-Val-NH[CH2]10CO2H does not. Binding of the -CO2H group in the vicinity of the S5 subsite is proposed for all but the last compound to account for this effect. Incubation experiments indicate that Cu2+ binds more rapidly to the enzyme than does the inhibitor. Local changes in conformation result in improved binding of the inhibitor, but do not affect the substrate (Km unchanged). Chelation by EDTA is time-dependent, indicating that the Cu2+ is shielded by the inhibitor. The results may partially explain the well-known anti-arthritic and anti-inflammatory properties of copper and zinc and their organic salts. PMID- 2713096 TI - Carnivora: the primary structure of the giant otter (Pteronura brasiliensis, Mustelidae) hemoglobin. AB - The hemoglobin of the Giant Otter (Pteronura brasiliensis, Carnivora) contains only one component. The complete primary structures of the alpha- and beta-chains are presented. The globin chains were separated by high-performance liquid chromatography and the sequences determined by automatic liquid- and gas-phase Edman degradation of the chains and their tryptic peptides. The alpha-chains show 18 and the beta-chains 12 exchanges compared with human alpha- and beta-chains, respectively. In the alpha-chains, two substitutions involve alpha 1/beta 1 contacts and one a heme-contact. In the beta-chains one alpha 1/beta 1-, one alpha 1/beta 2- and one heme-contact are exchanged. The alpha- and beta-chains of the Giant Otter are compared to those of the Common Otter and other Carnivora hemoglobins. PMID- 2713095 TI - Carnivora: the amino-acid sequence of the adult Sumatran tiger (Panthera tigris sumatrae) hemoglobins. AB - The complete amino-acid sequences of the hemoglobins from the adult Sumatran tiger (Panthera tigris sumatrae) have been determined on automatic liquid- and gas-phase sequenators. The globin chains were isolated by reverse phase HPLC on a column of Nucleosil-C4. N-Acetylserine was detected by FAB-mass spectroscopy as N terminal aminoacid residue of the beta I chain. Comparing the sequences of the globin chains of the tiger with that of human Hb-A, 23 substitutions were recognized in the alpha, 29 in beta I and 28 in the beta II chain. PMID- 2713097 TI - Purification and partial characterization of a transcription-inhibitory peptide from Tetrahymena. AB - The protozoa Tetrahymena excretes a small peptide complex with an Mr of about 5,000. The peptide inhibits transcription by reducing the activity of the RNA polymerase. We have purified and partially characterized the peptide complex. It contains two peptide chains of apparent Mr 2,300 and 2,600, respectively. Magnesium ions in connection with the SH groups of cysteine play a role in holding together the two chains of the intact complex. PMID- 2713098 TI - Amino-acid sequence of the hinge region in chicken myosin subfragment-2. AB - The CNBr fragments of the hinge region in the carboxyterminal portion of long subfragment-2 derived from adult chicken pectoralis muscle myosin were isolated and sequenced by conventional methods. The alignment of these fragments was deduced from the homology of their sequences with those of other myosins, so that the sequence of the hinge region consisting of 127 amino-acid residues was determined. A comparison of this sequence with that of chicken embryonic skeletal muscle, chicken gizzard muscle and rabbit cardiac muscle (alpha-myosin) shows degrees of 95%, 36% and 82% sequence identities, respectively. Furthermore, the frequency with which hydrophobic residues are present at position "a" in seven residues repeats of this region was significantly lower than the other portions of the rod. PMID- 2713099 TI - The influence of experimental conditions on the spectrin-hemoglobin interaction. AB - Human spectrin, when isolated, purified and stored in such conditions that preserve its tetrameric form, is able to associate with human hemoglobin as it is clearly shown by gel filtration. However, this hemoglobin-spectrin association does not seem to have a significant effect on hemoglobin oxygenation as indicated by equilibrium and rapid kinetics measurements. PMID- 2713100 TI - SS-B (La) nuclear antigen: fast and non-degradative procedure to prepare SS-B extracts free from other nuclear antigens. AB - A procedure is described allowing the easy and fast obtention of a cellular extract from calf thymus, enriched in the undegraded 52 kDa SS-B protein. As seen by western blot, the extract does not contain Sm and RNP antigens, allowing the use of such fraction for the detection of anti-SS-B antibodies without the interference of the anti-Sm and anti-RNP specificities. The enrichment avoids denaturing agents, making the fraction suitable for use in functional and structural studies. PMID- 2713101 TI - Isolation and characterization of a sialidase from the starfish Asterias rubens. AB - The starfish Asterias rubens contains a soluble sialidase (1.4 mU/mg homogenate protein), which was purified over 500-fold to apparent homogeneity by ammonium sulfate precipitation, gel filtration and affinity chromatography on immobilized 2-deoxy-2,3-didehydroneuraminic acid. The native sialidase has a molecular mass of 230 kDa (gel filtration) and consists of 4 subunits of each 63 kDa, as determined by SDS-gel electrophoresis. Its isoelectric point is at pH 4.9, the activity is optimum at pH 4.2 and 37 degrees C, and it hydrolyses preferably 4 methylumbelliferyl-alpha-N-acetyl-neuraminic acid, followed by sialyllactose and glycoproteins. The hydrolysis rate is decreased or stopped by the presence of O acetyl groups on the sialic-acid residue to be cleaved. N-Glycoloyl residues also retard enzyme action, as well as alpha(2-6) bonds when compared with alpha(2-3) linkages. This relatively stable enzyme is inhibited by mercury or copper ions, 2 deoxy-2,3-didehydro-N-acetylneuraminic acid and by the increase of ionic strength. The evolutionary significance of starfish sialidase is discussed. PMID- 2713102 TI - Isolation and structural characterization of twenty-one sialyloligosaccharides from galactosialidosis urine. An intact N,N'-diacetylchitobiose unit at the reducing end of a diantennary structure. AB - Galactosialidosis urine was fractionated by gel-permeation chromatography on Bio Gel P-6. The obtained sialic acid-containing carbohydrate fractions were purified by reversed-phase chromatography and separated according to charge by medium pressure anion-exchange chromatography on Mono Q. The Mono Q fractions, being mixtures of sialyloligosaccharides differing mainly in sialic acid-linkage type (alpha 2-3/alpha 2-6), were subfractionated by high-performance liquid chromatography on Lichrosorb-NH2. The purified compounds were analysed by 500-MHz 1H-NMR spectroscopy. Twenty-one fully and partially sialylated N acetyllactosamine-type compounds include mono-, di-, tri- and tetra-antennary structures. All structures have the sequence Man beta 1-4Glc-NAc at the reducing terminus in common, except one diantennary structure bearing an intact N,N' diacetylchitobiose unit at the reducing end, which is a new feature in human glycoproteinosis urine. PMID- 2713103 TI - Peptide analogues of the anaphylatoxin C3a; syntheses and properties. AB - The chemical syntheses of C-terminally shortened analogues of C3a, which is the best investigated anaphylatoxin and derives from the third component of complement system, is reported. The peptide assembly was performed with the solid phase technique using a polyamide support and an orthogonal protection strategy. The base-labile Fmoc group was chosen for N alpha protection in combination with acid-labile side-chain protection. Excellent acylation yields could be obtained using HBTU (O-benzotriazolyl-N,N,N',N'-tetramethyluronium hexafluorophosphate) as activating reagent. With this methodology we synthesized eighteen different peptides with the following modifications: Varying the peptide length by sequential addition of glycine or arginine residues, prolongating the N-terminus with the Fmoc- or Fmoc-aminohexanoyl residues and exchanging the glycine in position 74 for alanine or D-alanine. We obtained two C3a analogues, Fmoc YRAAALALAR and Fmoc-Ahx-YRRGRAAALGLAR, which were shown to be substantially more active than native C3a in the guinea-pig-platelet assay. PMID- 2713104 TI - The primary structure of the hemoglobin of the electric eel (Electrophorus electricus). AB - The blood of the Electric Eel contains only one hemoglobin component. The primary structures of the alpha- and beta-chains are presented. These were separated by high-performance liquid chromatography, using a new kind of buffer system. The alpha-chains are acetylated, and consist of 142 residues, while the beta-chains are not blocked, and consist of 147 residues. The phylogenetic distances between these and the alpha- and beta-chains of human hemoglobin are 48 and 50% amino acid exchanges, respectively. The relationship between primary structure and the Bohr effect and Root effect is discussed, especially the significance of the serine found in position F9 beta. PMID- 2713105 TI - [The primary structure of crystallizable monoclonal immunoglobulin IgG1 Kol. II. Amino acid sequence of the L-chain, gamma-type, subgroup I]. AB - The immunoglobulin Kol was the first intact antibody molecule which was characterized by high-resolution X-ray crystallography. Furthermore the complete amino-acid sequence of the heavy (H)-chain is known. Here we report the complete amino-acid sequence of the light (L)-chain of the monoclonal immunoglobulin Kol (IgG1). The polypeptide has an Mr of 22,781, consists of 216 amino acids and due to its structure is of the lambda-type. With the characteristic amino acids threonine, asparagine, threonine, glycine and lysine in positions 101, 114, 116, 154, and 165, respectively the Kol L-chain is of the Mcg isotype. With the proteins Mcg, Mot, Bur, Loc and Mem six myeloma-derived amino-acid sequences of the same isotype are known. The amino-acid sequence of the N-terminal variable part is characteristic of subgroup 1. This contribution completes the primary structure of IgG1 Kol. PMID- 2713107 TI - Mouth care for the dying. PMID- 2713106 TI - Hospice--is it effective? PMID- 2713108 TI - Responding to the needs of the terminally ill through laughter and play. AB - Care for the terminally ill has greatly expanded. Humor and play, however, remain largely unexplored, surrendered to the cultural expectation of dignity and respect for the dying. This paper suggests several uses of humor and play with the dying, and the benefits of these interventions with patients, families, and care givers. PMID- 2713109 TI - Dehydration in the terminal patient: perception of hospice nurses. AB - Recent discussion about the care of the terminally ill patient has focused on the appropriateness of withholding and withdrawing food and fluid and on the discomfort of the dehydrated state. Evidence is mounting that suggests that dehydration in this group of people is not painful, but rather may be more comfortable than hydration by means of IV fluids or enteral and parenteral feedings. This study examines the relationship between the experience of hospice nurses in observing terminal dehydration and their perception of this state. The scores for the degree of positive perception of dehydration are compared for the experienced and nonexperienced groups of nurses. This study suggests that those hospice nurses who have observed terminal dehydration have a more positive perception of this state than those who have not. PMID- 2713110 TI - Introducing hospice into allied health curricula: a challenge for educators. AB - Including hospice, as a concept of care, into existing allied health curricula is very important. Hospice should be integrated into the curricula of allied health programs. In addition to offering courses on hospice care, there are many novel ideas for exposing students to aspects of hospice care including grand rounds, self-instruction packets, journal clubs, honors program presentations, monthly forums, and clerkships. Federal funding is important to support and develop hospice training as well as other resources. PMID- 2713111 TI - Evaluating a hospice program: a practical approach. PMID- 2713112 TI - A special fundraising event: advantages and disadvantages for the hospice organization. PMID- 2713113 TI - Is this hospice? PMID- 2713114 TI - The management of malignant dysphagia. PMID- 2713115 TI - Interventional analgesia: epidural and subarachnoid therapy. PMID- 2713117 TI - The iatrogenic denial syndrome. PMID- 2713116 TI - Quality of care for dying patients. PMID- 2713118 TI - High risk grieving. PMID- 2713119 TI - Sobering lessons from a sad story. PMID- 2713120 TI - Echoes of silence: death and denial. PMID- 2713121 TI - Hospice day care standards development in Michigan. PMID- 2713122 TI - The death of a child: the use of group for conflict resolution. PMID- 2713124 TI - Fourth scientific meeting of the American Society of Hypertension. May 10-12, 1989, New York. Abstracts. PMID- 2713123 TI - Fundraising: a planning model for a capital campaign. PMID- 2713125 TI - Purification and characterization of activated human erythrocyte prolidase. AB - Prolidase (E.C. 3.4.13.9) has been purified 7500-fold to homogeneity from human erythrocytes in a Mn2+-activated form using conventional and fast protein liquid chromatography columns. The procedure includes a 1-h incubation of the crude hemolysate at 50 degrees C with 1 mM MnCl2. Following this novel step, prolidase retains full activity, obviating the requirement for preincubation of each enzyme fraction with Mn2+ prior to assay. Preincubation with MnCl2 does not change the isoelectric point of the enzyme. The molecular weight of the purified enzyme was 58,000 when measured by SDS-PAGE. Western blotting, using rabbit antibody raised to human kidney prolidase, with partially purified erythrocyte enzyme revealed a cross-reacting band at Mr 58,000. PMID- 2713126 TI - The glycosphingolipid composition and glycosyltransferase activities of the small intestinal mucosa of testosterone-treated rats. AB - Prior studies have demonstrated that sex hormones can influence the glycosphingolipid composition of different organs, including small intestine. However, to date, the effects of testosterone on glycosphingolipids of rat small intestinal mucosa have not been examined. Experiments were conducted to examine the effect of subcutaneous administration of synthetic testosterone (500 micrograms/100 g body wt.) on the gangliosides and neutral glycosphingolipids of rat small intestinal mucosa. Their results demonstrated that testosterone administrations: (i) increased the ganglioside content including hematoside (GM3); (ii) increased the total content of neutral glycosphingolipids, which was due to the increases in glucosylceramide and globotriaosylceramide; (iii) increased the activities of cytidine 5'-monophosphate-N-acetylneuraminic acid: lactosylceramide sialyltransferase, and UDPgalactose: lactosylceramide galactosyltransferase; (iv) increased the percentage of the long chain base phytosphingosine in hematoside, glucosyl-, and globotriaosylceramide; and (v) significantly altered the fatty acid composition of each of these glycosphingolipids. These results demonstrate that administration of testosterone induces alterations in glycosphingolipid composition and glycosyltransferases activities in rat small intestinal mucosa. PMID- 2713127 TI - Reversible ATP-dependent inactivation of glycerolphosphate acyltransferase from rat adipose tissue. AB - Microsomal glycerolphosphate acyltransferase from rat adipose tissue is shown to be inactivated with time upon incubation with ATP. The inactivation can be observed in postmitochondrial supernatant as well as in washed microsomes. However, the effect is more pronounced upon addition of the cytosolic fraction. This activity is specific for ATP, is dependent on the nucleotide concentration, and is prevented when ATP is substituted by beta,gamma-methylene-ATP. Some protection is provided by amiloride but not by EGTA or cAMP-protein kinase inhibitor. Also, the level of enzyme inactivation is not modified by addition of cAMP-dependent protein kinase and its substrates. Inactivated glycerol-phosphate acyltransferase from ATP-treated microsomes can be reactivated by incubation with partially purified protein phosphatase from rat liver. These results suggest the existence in adipose tissue of a protein kinase (cAMP independent) that may be involved in the regulation of glycerolphosphate acyltransferase. PMID- 2713128 TI - Rapid purification of ferritin from lysates of red blood cells using proteinase K. AB - A simple, rapid, and novel procedure for purifying ferritin from the postnuclear supernatant of red blood cell lysates is described. This report establishes the resistance of commercially available holo- and apo-ferritins to proteinase-K digestion, and documents how the use of this enzyme, in conjunction with the well documented resistance of ferritins to heat denaturation (75-80 degrees C for 10 min), makes it possible to obtain high yields (greater than 90%) of pure, undegraded ferritin from the postnuclear supernatant of hypotonically or Triton X 100 lysed red blood cells. The resultant purified ferritin contains the same amount of iron as ferritin not treated with proteinase-K and, as judged by one- and two-dimensional gel electrophoresis and electron microscopy, consists of intact ferritin with a subunit isoform composition identical in molecular mass and isoelectric points to that obtained from ferritin prepared in the absence of this enzyme. PMID- 2713129 TI - Dimethylmaleic anhydride, a specific reagent for protein amino groups. AB - The reagent dimethylmaleic anhydride does not cause a stable modification of thiol compounds under the conditions used for modification of protein amino groups, in contrast to maleic and monomethylmaleic anhydrides, which produce an irreversible modification of sulfhydryl groups. This behavior and the low reactivity toward hydroxyamino acid residues, shown in a previous work, make dimethylmaleic anhydride a specific reagent for protein amino groups. PMID- 2713130 TI - Purine metabolism in cultured aortic and coronary endothelial cells. AB - Purine salvage pathways in cultured endothelial cells of macrovascular (pig aorta) and microvascular (guinea pig coronary system) origin were investigated by measuring the incorporation of radioactive purine bases (adenine or hypoxanthine) or nucleosides (adenosine or inosine) into purine nucleotides. These precursors were used at initial extracellular concentrations of 0.1, 5, and 500 microM. In both types of endothelial cells, purine nucleotide synthesis occurred with all four substrates. Aortic endothelial cells salvaged adenine best among purines and nucleosides when applied at 0.1 microM. At 5 and 500 microM, adenosine was the best precursor. In contrast, microvascular endothelial cells from the coronary system used adenosine most efficiently at all concentrations studied. The synthetic capacity of salvage pathways was greater than that of the de novo pathway. As measured using radioactive formate or glycine, de novo synthesis of purine nucleotides was barely detectable in aortic endothelial cells, whereas it readily occurred in coronary endothelial cells. Purine de novo synthesis in coronary endothelial cells was inhibited by physiological concentrations of purine bases and nucleosides, and by ribose or isoproterenol. The isoproterenol induced inhibition was prevented by the beta-adrenergic receptor antagonist propranolol. The end product of purine catabolism in aortic endothelial cells was found to be hypoxanthine, whereas coronary endothelial cells degraded hypoxanthine further to xanthine and uric acid, a reaction catalyzed by the enzyme xanthine dehydrogenase. PMID- 2713131 TI - In vitro activity of dicloxacillin against methicillin-susceptible and methicillin-resistant Staphylococcus-aureus. AB - A total of 54 strains of Staphylococcus aureus, 37 methicillin-susceptible (MSSA) and 17 methicillin-resistant (MRSA), were investigated for their susceptibility to dicloxacillin as compared to methicillin and oxacillin by agar plate dilution at two different temperatures of incubation (30 degrees C and 37 degrees C). Against MSSA strains we found a slight but significant increase (0-2 dilution steps) in minimal inhibitor concentrations (MICs) for all three antibiotics with decrease in incubation temperature. Against MRSA strains methicillin and oxacillin showed a 3-6 fold increase in median MIC with decrease incubation temperature. For dicloxacillin, in contrast, there were no significant differences in median MICs (i.e. 0.4 mg/l) against MSSA strains at 30 degrees C or MRSA strains at either incubation temperature. Population-analysis of the MRSA strains revealed, however, that a highly dicloxacillin-resistant subpopulation appeared with a frequency of 10(-6) to 10(-7). Such heterogenous resistance of MRSA strains to dicloxacillin probably prohibits the use of dicloxacillin against serious infections caused by these pathogens. PMID- 2713132 TI - Interactions between three subpopulations of Ehrlich ascites tumor and a P388 murine leukemia in mixed solid tumors in immune competent mice. AB - Cellular interactions between three subpopulations of Ehrlich ascites tumor and between these and the P388 murine leukemia were studied during growth of solid tumors obtained by mixtures of the cells in immune competent N/D mice. An immunogenic Ehrlich cell line (E1.15) induced an immunologically based growth inhibition of the two other Ehrlich cell lines (E1.80 and E1.95) which themselves were non-immunogenic. E1.15 was, however, unable to induce an immunological response against the P388 cell line. It is therefore suggested that when in close contact, immunologically induced cellular responses imposed by an immunogenic cell line on other cell lines require genetic and thereby close immunogenic resemblance between the cell lines. Another type of interaction was found between the E1.95 cell line and the P388 line which showed nearly identical growth characteristics as determined by tumor weight day 14, tumor growth curves, cell cycle times (per cent labelled mitoses) and cell cycle distributions (flow cytometric DNA analysis). After 2 weeks of growth of mixed P388/E1.95 tumors, flow cytometric DNA analysis on fine-needle tumor aspirates showed nearly total dominance of P388. This type of interaction required close cellular contact of viable cells, and no cellular immune response was elicited by the host animals. A third finding was that a faster growing Ehrlich cell line E1.95 dominated the tumors when inoculated in mixture with a slower growing subpopulation E1.80. This could be explained on the basis of the cell kinetic differences between these two cell lines. PMID- 2713133 TI - Campylobacter strains from Swedish patients with diarrhoea. Distribution of serotypes over a five year period. AB - Serotyping, HS antigen and HL antigen, was performed on 105 Campylobacter jejuni/coli isolates from the same number of consequtive patients seeking medical attention for diarrhoea. The results were compared to a similar study performed five years earlier. It was found that there were only minor differences in frequency of the serotypes commonly isolated during the two different periods. PMID- 2713134 TI - Structural variations and growth potential of Yersinia enterocolitica under different culture conditions. AB - The growth potential and the polypeptide composition of Yersinia enterocolitica serotype 0:3 isolated from patients with uncomplicated diarrhoea, reactive arthritis or septicemia were evaluated under different culture conditions. The expression of polypeptides varied with presence of the virulence-associated 40-48 Mdal plasmid, growth medium, growth temperature and gas composition of the culture (air, carbon dioxide, oxygen). Also the initial growth medium at 26 degrees C, before temperature shift to 37 degrees C, influenced the subsequent growth potential and expression of polypeptides. The plasmid encoded at least 7 polypeptides. This plasmid also inhibited the multiplication of bacteria under defined culture conditions. The dominating plasmid-encoded polypeptides were optimally expressed in air or oxygen-supplemented growth medium. The majority of the chromosomally encoded polypeptides were expressed independently of presence of the plasmid, whereas the expression of at least 8 were repressed by the plasmid. Five chromosomally encoded polypeptides were expressed only in carbon dioxide and five only in oxygen environment. These results indicate that Y. enterocolitica may express different molecules in different environments in vivo. This may be of importance for host-parasite relationship and immune response. PMID- 2713135 TI - Rhabdomyosarcoma in middle-aged and elderly individuals. AB - In a review of a national series of malignant tumors in middle-aged and elderly individuals (over 40 years of age), in all 107 cases primarily diagnosed and reported to the Swedish Cancer Registry as rhabdomyosarcomas during the period 1972-1981, 4 cases were accepted as botryoid, embryonal or alveolar rhabdomyosarcoma, using light-microscopic criteria for the diagnosis. An electron microscopic and immunohistochemical analysis was performed on the 4 cases along with 7 cases of botryoid, embryonal and alveolar rhabdomyosarcoma in patients of over 40 years of age obtained from our own files. Rhabdomyoblastic differentiation was established ultrastructurally by the presence of myofilaments and Z-like densities in 10 of these 11 cases. There were tumor cells in the formaldehyde-fixed, paraffin-embedded material which were positively stained for desmin in all cases, for myoglobin in 7/11 cases, for vimentin in 5/11 cases and for actin in all cases, using monoclonal antibodies. The demonstration of desmin by the monoclonal antibody which was used on the formaldehyde-fixed, paraffin embedded material is of particular value in the diagnosis of rhabdomyosarcoma. Another tumor, located in the minor pelvis, lacked the light-microscopic features of botryoid, embryonal or alveolar rhabdomyosarcoma, but presented ultrastructural and immunohistochemical evidence of a rhabdomyoblastic differentiation. This tumor was epithelioid in appearance and shared features with alveolar soft part sarcoma. The label epithelioid rhabdomyosarcoma is proposed for this tumor. Nine pleomorphic sarcomas were selected from the national series as possible pleomorphic rhabdomyosarcomas because of the presence of ribbon-shaped tumor cells with an eosiniphilic cytoplasm. There was no electron-microscopic or immunohistochemical evidence of a myogenic differentiation in any of these 9 tumors. The present investigation indicates that a pleomorphic type of rhabdomyosarcoma, indistinguishable from embryonal, botryoid and alveolar rhabdomyosarcoma, is extremely rare or non-existent. PMID- 2713136 TI - Serological analysis of the heat-stable antigens involved in serotyping Campylobacter jejuni and Campylobacter coli. AB - Analysis with serotyping antisera showed that carbohydrate determinants were the dominant heat-stable antigens of Campylobacter jenuni/coli involved, whereas proteins did not contribute to the serological reactions. Lipopolysaccharide (LPS) along with a polysaccharide extract from whole bacteria (PS(WB] conferred strain serospecificity. In general, analysis with monoclonal antibodies in passive haemagglutination and co-agglutination tests showed the existence of similar antigenic determinants in LPS and PS(WB) of the same strain. However, in some strains determinants were detectable in LPS but not in PS(WB) using monoclonal antibodies, in other strains the situation was reversed. All of these monoclonal antibodies reacted with LPS in the more sensitive immunoblotting technique. The presence of 2-keto-3-deoxyoctonic acid in PS(WB) preparations, in the absence of endotoxin, supported the conclusion that PS(WB) was derived from LPS during extraction. The lack of detection of a reaction by monoclonal antibodies with LPS in passive haemagglutination, in contrast to immunoblotting, was suggested due to the presence of low concentrations of the relevant epitopes because of the procedure used to prepare the LPS tested. PMID- 2713137 TI - Radiography in post-mortem examinations of fetuses and neonates. Findings on plain films and at arteriography. AB - During the last decade there has been an increasing interest in radiological investigation of stillborns and neonates as a supplement to autopsy. A consecutive series of 137 fetuses and neonates is presented. Prior to autopsy plain X-ray films were taken, and in 50% arteriography was performed by injecting contrast medium into an umbilical or femoral artery. On the plain films only 41% were normal. The major part of the abnormal radiographs exhibited minor abnormalities such as transverse lines or "stress-lines" of the bones, cercival ribs or an abnormal numbers of ribs. Major abnormalities were seen in 9%. Most of these were abnormalities of the spine. The arteriographs were very detailed and were abnormal in 29% of the cases. The technique was not suitable for demonstration of heart malformations. It is concluded that plain film X-ray of soft tissues and bones is recommendable as a routine procedure, whereas arteriography should be limited to cases suspected of vascular malformations or if an autopsy cannot be performed. PMID- 2713138 TI - Serosurvey for antibodies to Borrelia burgdorferi in Danish dogs. AB - To estimate the regional presence of B. burgdorferi we performed a serosurvey for antibodies to B. burgdorferi in 205 healthy dogs from representative areas of Denmark. Blood samples were collected from November 1986 to March 1987. Twenty dogs bred for research purposes served as negative controls. IgG-antibodies to the B. burgdorferi strain DK-ECM 1 were measured by indirect immunofluorescens assay. Antibody titers ranged from nonreactive to 640. In 33 dogs (16.1%) titres were greater than or equal to 80, indicating exposure to B. burgdorferi. There were no significant differences in the prevalence rate of seropositive dogs due to place of residence, sex or age. The results indicate that dogs are exposed to tickborne B. burgdorferi in most areas of Denmark. PMID- 2713139 TI - Spatial performance and perceptual asymmetries in beginning readers: shift of hand advantage in dichhaptic tasks. AB - The stability of perceptual asymmetries was studied in two groups of 6-year-old, right-handed children (normal, NL, and poor, PL) learning reading, by means of two experiments occurring at a year's interval (Experiment I and Experiment II). A dichhaptic procedure derived from S. F. Witelson's method (1974, Cortex, 10, 3 17) was used. With group data, perceptual asymmetries were stable over time, whereas with individual data, perceptual asymmetries were highly variable. NL children demonstrated a left-hand advantage at the group level in both Experiment I and Experiment II, with relatively little individual evolution over time. No significant hand advantage was found in PL children in Experiment I, but dramatic alterations occurred in Experiment II where all PL children shifted to a left hand advantage. This shift was accompanied by an improvement in spatial performance. Such changes in perceptual asymmetry might be of an adaptive nature. Individual changes across time may be related to developmental plasticity (cerebral maturation) and/or neurocognitive flexibility (differential activation of cerebral subsystems). PMID- 2713140 TI - The nature of voluntary action. AB - This paper extends the microgenetic theory of action to the problem of volition and the nature of free will and responsibility. Volition is interpreted as an elaboration of the action structure without causal or agentive status in relation to the action. The implications of this approach for philosophy of mind are explored. PMID- 2713141 TI - Lateral asymmetry of the scalp distribution of somatosensory evoked potential amplitude. AB - Somatosensory potentials evoked by brief low-intensity electrical pulses delivered separately to the left and right index fingers were recorded from the scalp over the posterior half of the contralateral hemisphere in normal human subjects. In two experiments it was found that the scalp areas enclosed by 75 and 90% of maximum-amplitude isopotential contour lines of the early cortically generated complexes were more restricted over the left hemisphere. This asymmetrical evoked potential distribution supports the proposal by Semmes from her observations of brain-damaged patients that elementary somatosensory representation is focal in the left hemisphere and diffuse in the right. PMID- 2713142 TI - On the different roles of the cerebral hemispheres in mental imagery: the "o'Clock Test" in two clinical cases. AB - This paper develops the hypothesis of different roles of the two hemispheres in imaginal processes. A test designated the "o'Clock Test" is proposed, which contains closely confrontable perceptual and imaginal tasks. It enables examination of the abilities both to generate mental images and to explore them in their right and left halves (R + L Condition). This test was used to examine two patients, one severely affected by hemi-inattention resulting from a right posterior lesion, and the other with a selective deficit of imagery due to a left occipital lesion. The former demonstrated left neglect in both perceptive and imaginal capacities, while the latter was able to perform correctly only the perceptive tasks. These results suggest that the right hemisphere has functions of organization and spatial exploration at both perceptive and imaginal levels, and that the left hemisphere's role is to generate mental images. PMID- 2713143 TI - Regional cerebral blood flow characteristics and variations with age in resting normal subjects. AB - Regional cerebral blood flow (rCBF) was measured during resting in 97 normal subjects, 19-68 years old. The results showed that the mean CBF level decreased progressively with age. The decrease was more prominent in frontotemporal and inferior Rolandic areas bilaterally. Frontal areas showed the highest values in all age groups. This hyperfrontality weakened somewhat with age. Mean CBF in the right hemisphere was significantly higher than in the left, as was flow in superior frontal, inferior frontal, and parietal areas. These asymmetries were age invariant. The age-related decrease of rCBF is interpreted as reflecting aging of the brain per se, although the influence of asymptomatic brain disease can not be ruled out. The flow asymmetries are interpreted as being related to functional lateralization of some aspects of attentional activation. PMID- 2713144 TI - Hemispace and information control by the two cerebral hemispheres: which interaction? AB - Two experiments employing subjects with different experience in tactile discrimination (blind and seeing subjects) were carried out to investigate the effect of the space location of stimuli on the information processing activity of the two cerebral hemispheres. An angle discrimination task that yields a right hemisphere superiority was used. In Experiment 1, seeing subjects showed a general superiority of the left hand (right hemisphere) which was more pronounced in the left hemispace with respect to the central and the right hemispace performance. In Experiment 2, blind subjects showed a significant superiority of the left hand in the central and in the left hemispace and no difference between the two hands in the right hemispace. In both experiments hemispace differences were due only to the modification of the left hand (right hemisphere) performance. These results suggest that the hemispace control by the contralateral hemisphere interacts only with the activity of the hemisphere dominant in the information processing. PMID- 2713145 TI - Color and spatial error in block design in stone-age Auca Indians: ecological underuse of occipital-parietal system in men and of frontal lobes in women. AB - The entire healthy adult population of 19 nonmissionized nomadic Auca Indians of the Ecuadorian Amazon basin were given tests involving the four-colored Kohs Block Design, spatial-relational, lexical, and body and face shapes. The test results reveal a specific grouping of deficiencies in color naming (with preservation of color concept), block design especially related to representation, and construction of certain intrapattern spatial relations and graphic representational skills. This ecologically determined grouping of deficiencies suggests a homology to certain neuropsychological syndromes (E. Stengel, 1948, Journal of Mental Science, 94, 46-58; J. de Ajuriaguerra & H. Hecaen, 1960, Le cortex cerebrale; N. Geschwind & M. Fusillo, 1966, Archives of Neurology, 15, 137-146). Further, specifically deficient components of constructional praxis (A. R. Luria & L. S. Tsvetkova, 1964, Neuropsychologia, 2, 95-107) are proposed to reflect gender-related limitations of daily tasks, suggesting occipital-parietal underuse in Auca men and frontal system underuse in Auca women. PMID- 2713146 TI - Long-term follow-up of a childhood amnesic syndrome. AB - In attempting to explain observed dissociations between impaired and preserved memory functioning in amnesia, various dichotomous memory systems (e.g., procedural versus declarative, episodic versus semantic, working versus reference memory) have often been employed. In such cases, the assumption has been that memory subserved by one system is preserved, while that of the other system is impaired. Cohen and Squire have suggested that in amnesia, declarative memory is impaired, although procedural memory is preserved. Long-term follow-up of a densely amnesic patient refutes this view by demonstrating significant anterograde learning of school subjects including reading, vocabulary, spelling, and arithmetic, all of which include some component of declarative memory. It appears that the procedural/declarative dichotomy is not adequate to explain preserved memory in amnesia. PMID- 2713147 TI - Rate and variability of finger tapping as measures of lateralized concurrent task effects. AB - Using a sample of 48 normal right-handed adults, we assessed the effects of oral reading on concurrent unimanual finger tapping under all combinations of instructional set (speeded vs. consistent tapping), tapping movement (repetitive vs. alternating), task emphasis (reading emphasized vs. tapping emphasized), and tapping hand. Change in tapping rate and variability was measured relative to the corresponding single task control condition. Reading decreased the rate of speeded finger tapping but increased the rate of consistent tapping. In both instances, the right hand was affected more than the left hand. Asymmetries were comparable for repetitive and alternating tapping. When measured in terms of variability, however, effects were largely symmetric. The findings clarify the conditions under which lateralized concurrent task effects are most likely to occur and show that such effects are not statistical artifacts. It appears that subjects attempt to coordinate the timing of concurrent activities and that speech timing is more strongly linked to right-hand control than to left-hand control in right-handers. PMID- 2713148 TI - Characteristics of leukocyte and plasma methylumbelliferyl-alpha-L-iduronide iduronidase. AB - Some characteristics of the human leukocyte and plasma alpha-L-iduronidase are described. The enzyme from both sources is sufficiently stable and linear in time to allow accurate determinations. The leukocyte and plasma enzyme have a low acid pH optimum at 3.5 and 4, respectively, which is in agreement with the lysosomal origin of the enzyme in the cell. Both enzymes are inhibited by phenyl-alpha-L iduronide, heparin, and heparitin sulfate although other mucopolysaccharides also inhibit the leukocyte enzyme. When kept frozen at -20 degrees C, the leukocyte as well as the enzyme in acidified plasma are very stable. We studied the plasma enzyme in more detail. If the plasma is acidified, iduronidase is very stable between 0 and 37 degrees C. CuCl2 and Na2SO4 were very potent inhibitors at concentrations of 10 and 100 mM, respectively. The determination of iduronidase in leukocyte homogenates of patients suspected of Hurler disease together with plasma activities is useful for confirming or corroborating the diagnosis of genetic iduronidase deficiency. Further investigation is needed to determine if the plasma enzyme test would be useful in the biochemical diagnosis of Scheie disease and the Hurler-Scheie compound, two diseases which are also caused by a deficiency of alpha-L-iduronidase. PMID- 2713149 TI - Serum erythropoietic activity in acute anemia--an animal model. AB - Serum erythropoietic activity and reticulocyte response to anemia were investigated using a rabbit model. In hemolytic anemia, induced by injections of phenylhydrazine on Day 0 the hemoglobin reached a nadir (mean, 6.23 g/dl) on Day 4 when SEA was maximal (mean, 765 mU/ml). In animals venesected on Day 0 and Day 1 to produce anemia of equal severity, the SEA was maximal (mean 235 mU/ml) on Day 2. In both groups the reticulocyte response peaked on Day 7--at 34% for the hemolytic group and 21% for the venesected group. The 2,3-diphosphoglycerate, measured on Day 4, was significantly reduced in the PHZ-treated group. In the venesected group the 2,3-DPG increased between Day 0 and Day 4. There were no concurrent changes in acid-base balance. These results imply that the degree of anemia is only one of the factors which influence the level of circulating SEA. PMID- 2713150 TI - Suppression of macrophage lysosomal enzymes after Leishmania donovani infection. AB - In order to have an insight into the role of host lysosomal enzymes in the intracellular survival of Leishmania parasites, the activities of beta galactosidase, alpha-mannosidase, and N-acetyl-beta-D-glucosaminidase were studied in peritoneal macrophages of hamsters infected with L. donovani. There was a significant decrease of all three lysosomal enzymes after infection. Heat killed or formalin-treated parasites failed to inhibit the enzymes, instead a slight stimulation was observed. Purified excreted factor from promastigotes had no effect on the enzymes except beta-galactosidase which was inhibited up to 20%. Inhibition of enzymes was not due to increased secretion after infection. The absence of induction of any endogenous macrophage inhibitor was confirmed by mixed experiments. The levels of 5'-nucleotidase and lactate dehydrogenase remained unchanged after infection. Thus, the inhibition of lysosomal enzymes appears to be the effect of infection process and reflects to actua decrease rather than increased secretion or the action of any inhibitors present in Leishmania promastigotes. PMID- 2713151 TI - Failure of sodium benzoate to alleviate plasma and liver ammonia in rats. AB - The intraperitoneal administration of L-norvaline and L-methionine-SR-sulfoximine to rats caused an increase in the concentration of ammonia in plasma as well as in liver. These compounds interfere with urea and glutamine formation, respectively. Subsequent injection of sodium benzoate failed to alleviate ammonia levels, and on the contrary, caused a further increase. Sodium benzoate itself, when administered, resulted in higher levels of ammonia in plasma and liver of the rats. Administration of glycine to rats treated with benzoate did not lower ammonia levels indicating that other factors besides glycine may also be necessary for the removal of sodium benzoate. PMID- 2713152 TI - In vivo glycosylation of dermal and tendon type I collagen. AB - Recent studies show that native collagen fibers in the extracellular space can be subject to nonenzymatic glycosylation and that the extent of such glycosylation increases in clinical hyperglycemia and aging. In the present study, a comparison was made on the extent of glycosylation in rat tail tendon and in the soluble and insoluble fractions of collagen separated from rat skin after in vivo labeling with [14C]glucose. It was observed that nonenzymatic glycosylation occurred maximally in the salt-soluble fraction as measured by the level of ketoamine linked hexose. 14C radioactivity incorporation as well as the number of free amino groups was also increased in this fraction. However, the amounts of O glycosidically linked sugars did not show much variation between the soluble and insoluble fractions. These findings could be correlated to the enhanced metabolic turnover of newly synthesized collagen in diabetics. PMID- 2713153 TI - [Role of MRI in the pediatric central nervous system disorders]. AB - Recent rapid development of the MRI system has enabled us to diagnose precisely the disorders of the central nervous system (CNS) also in neonates and young children. Because of a long studying time, the use of oral chloral hydrate or other alternative drugs for sedation, such as secobarbital and meperidine, is necessary for young children under 6 years of age. The advantages of MRI are the optional plane imaging, a high contrast resolution, and the artifact-free imaging from the surrounding bones and air. MRI can detect myelination disorders and the lesions in the posterior fossa, the middle fossa, and the spinal canal. These abnormalities are difficult to depict with conventional X-ray CT scanning. MRI is useful also for the survey of various congenital anomalies of the brain and the spine. Furthermore, it is sensitive enough to detect the CNS blood flow and the cerebrospinal fluid (CSF) flow. Arteriovenous malformation, moyamoya disease, and sinus thrombosis are diagnosed by MRI without using contrast media, CSF flow void phenomena in the aqueduct and the Monro's foramina are indexes of the CSF pathway obstruction and of normal pressure hydrocephalus. PMID- 2713154 TI - [Visual evoked potential]. AB - Under the pathological conditions, the VEP may show changes in amplitude, latency, or waveform in one or more of its components. The major advantage of the pattern reversal VEP over the flash VEP lies in smaller variability in the waveform and latency of its components in the healthy population. The flash VEP is, however, particularly useful to infants and newborns. The variation in the waveform of the flash VEP was evaluated, and Type V was abnormal waveform. Subsequently, patients with various CNS diseases were examined. Acute hemiplegic patients showed high amplitude or increased latency patterns. In 45 percent of the West syndrome cases, VEP showed abnormal responses. The patients with asphyxia, respiratory distress syndrome and mental retardation showed increased latency. Latency was decreased in hypoglycemia and hypocalcemia of newborns, and it was increased or decreased in autism and epilepsy. In our study, it was concluded that the rhythmic after-discharge is a true response. This assumption is supported by the following observations: (1) the after-discharge of VEP appeared before the occurrence of the alpha-wave in EEG; (2) the frequency of the after-discharge was generally higher than that in EEG; and (3) the frequency of the after-discharge did not change between the conditions of the resting state and hyperventilation. There was no after-discharge in VEP in patients with a history of encephalitis even when their IQs were normal, and the latency was increased in pattern reversal VEP. PMID- 2713155 TI - [The auditory brainstem response]. AB - In 1967, Sohmer and Feinmesser recorded four negative peaks from extracochlear surface electrodes and they stated that the later components may be due to repetitive firing of auditory nerve fibers or may be due to the discharge of neurons in brain stem auditory nuclei. In 1970, Jewett, Romano and Williston presented the first full description of the scalp responses, postulated to be generated by brainstem nuclei. Since then, the auditory brainstem response (ABR) technique has attracted attention because it satisfied two previously unattainable needs; 1) a means of quantitative measurement of changes in auditory function in newborn babies or uncooperative patients, and 2) the detection of brainstem neurological abnormalities. Recording during wakefulness and in sleep or under drug intoxication has shown that ABRs are independent of the level of arousal or attention, and this feature is particularly useful for people unable to cooperate appropriately. Because of the close relationship to the anatomy of brainstem pathways, ABRs offer a neurophysiological index of neuronal function at the level of the brainstem. At present, these responses have become widely recognized as an important tool for the diagnosis of neurological diseases. One specific feature of the ABR is its dependence on maturation. The ABR appears at around 26 weeks of gestation and thereafter undergoes systematic changes in latency, amplitude and threshold. By using a supramaximal intensity of more than 60 dBHL, it is possible to evoke in all newborn babies with sufficient hearing ability, waves I, III and V.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713156 TI - [Short latency somatosensory evoked potentials following median nerve stimulation in children]. AB - We investigated short latency somatosensory evoked potentials (SSEP) to median nerve stimulation in normal children and children with neurological disorders. The waveform of SSEP in normal children was almost the same as that in adults. The peak latency and interpeak latency in normal children changed during their development. Moreover, after 3 years of age, each peak latency was positively correlated with the body length and arm length. Each peak latency per 1 m of body length decreased with age. We examined SSEP in children with various neurological disorders and found that SSEP was useful for evaluating sensory functions and somatosensory damages in children who were unable to cooperate in clinical examinations. Using SSEP, we could estimate the distal margin of the lesion in the somatosensory pathway, but it was difficult to determine the accurate range of the lesion. PMID- 2713157 TI - [Short latency somatosensory evoked potentials following the peripheral nerve stimulation of lower extremities in children]. AB - We have evaluated the short latency somatosensory evoked potentials (SSEPs) following peroneal and posterior tibial nerve stimulation in 27 normal children and adults, and then applied SSEPs examination following peroneal nerve stimulation to 6 children with neurological deficits. Features of the evoked potentials following peroneal nerve stimulation in normal children were almost similar to those in adults, but we found several points characteristic in children; a higher incidence of evoked potentials and a clearer appearance of "standing potential" at the lower thoracic vertebral level than in adults. Spinal afferent conduction velocity reached at a maximum at 3-4 years of age. The SSEPs following peripheral nerve stimulation in lower extremities are useful in pediatric neurology to determine the level of the spinal lesion, to reveal the distribution and pathophysiology of the spinal dysfunction, and to analyze the process of the disease progression. PMID- 2713158 TI - [Motor and cortical sensory evoked potentials by magnetic stimulation]. AB - Motor evoked potentials (MEP) by magnetic stimulation on the scalp and the spinous processes of the 7th cervical (C 7) and 5th lumbar (L 5) vertebrae were studied in 20 normal subjects and 10 patients with the pyramidal tract lesions. The magnetic stimulator composed of two flat helical coils with mean inner diameters of 12.0 and 2.2 cm. The evoked muscle action potentials were recorded from the thenar muscle in the hand and abductor hallucis muscle in the leg. The mean peak latencies of MEP recorded from the thenar muscle were 22.1 +/- 1.7 and 12.8 +/- 0.9 msec at the stimulations on the scalp and C 7, respectively. The central motor conduction time (CMCT) between the cortex and C 7 was 9.1 +/- 1.1 msec. On the other hand, the peak latencies of MEP were 41.0 +/- 3.2 and 21.6 +/- 2.3 msec at the stimulations on the scalp and L 5, respectively. CMCT between the cortex and L 5 was 19.3 +/- 2.3 msec. The patients with pyramidal tract involvements showed delayed peak latencies or absent MEP. The cortical somatosensory evoked potentials (SEP) by the noninvasive magnetic stimulation on the levels of Th 10, Th 12 and L 5 spines, gluteus and ankle were studied in 20 normal subjects and 7 patients with neurological diseases. Cortical components P 2 and N 2 were recorded clearly in all normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713159 TI - [Neuroendocrinologic studies on autism]. AB - The cause of autism is unknown. Recently, it has been suggested that it involves metabolic disorders of serotonin and/or dopamine. On the other hand, there is a close relationship between hormone secretion and monoamines. The aim of this study was to analyze the secretion of GH, PRL, TSH, cortisol, LH and FSH. The subjects were 30 children with autism, 25 males and 5 females, aged from 1 10/12 to 9 10/12 years. Their IQs (DQs) ranged from 34 to 123. Pituitary hormone secretion was measured during provocation with insulin (0.1 unit/kg), TRH (10 micrograms/kg) and/or LH-RH (100 micrograms/m2) in 26 of 30 cases. Control subjects included 16 age-matched children with attention deficit disorder (ADD) and 18 age-matched children with mental retardation (MR) without autistic and organic central nervous diseases. The 24-hour secretion rhythm of GH, PRL and cortisol for 14 cases with autism and of LH and FSH for 9 cases was also investigated. In insulin provocation test, the peak values of GH and delta GH (peak GH level minus baseline GH level) in ADD were significantly higher than those in MR (p less than 0.05). In TRH provocation test, the peak values of TSH and delta TSH in autism were significantly lower than those in MR. Five cases of autistic children revealed borderline responses for TSH, while the only one each of ADDs and MRs revealed borderline responses for TSH. In a study of the 24-hour hormone secretion rhythm, eleven of the 14 autistic children showed an abnormal secretion rhythm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713160 TI - [Neurophysiological study of autistic children]. AB - Two different hypotheses have been proposed on the pathophysiology of infantile autism; a caudally directed pathological influence originating in telencephalic structure, and a rostrally directed pathological influence originating in brainstem and diencephalic structure. This paper described results of neurophysiologic research of infantile autism: (1) cortical evoked potentials, (2) autoregressive spectral analysis of EEG, (3) brainstem lesions on ABR and vestibular study by Ornitz E M (1985) and (4) cognitive functioning by Novick (1980) and Niwa (1983). Those studies suggest that the brainstem, including the vestibular nuclei, and related nonspecific thalamic centers, can be the primary loci of the system dysfunction in autism. PMID- 2713161 TI - [Autism. Discussion: from the standpoint of pediatrics]. AB - Since Leo Kanner reported 11 cases of "early infantile autism" in 1943, various kinds of studies and researches have been made. At present, we generally understand the "autism" is a behavioral syndrome of multiple etiologies. I would like to stress that we pediatricians, meeting the patients first, must play the roles of the specialists in diagnosis, treatment, prophylaxis, and of the advisers in guiding mothers, teachers and the others. The purpose of medicine and education is to help the handicapped to draw as much satisfaction and enjoyment from life as possible. PMID- 2713162 TI - [30th annual meeting of the Japanese Society of Child Neurology. June 9-11, 1988, Tokushima. Proceedings]. PMID- 2713163 TI - Molecular characterization of HIV-1 isolated from a serum collected in 1976: nucleotide sequence comparison to recent isolates and generation of hybrid HIV. AB - Human immunodeficiency virus type 1 (Z321 designate, HIV-1Z321), the oldest known HIV, was isolated from a serum sample collected in Zaire in 1976 and was molecularly cloned. Restriction enzyme analysis of unintegrated viral DNA revealed the presence of conserved restriction enzyme cleavage sites in the long terminal repeat sequences. Nucleotide sequence analysis of the 3' end of the viral DNA revealed a pattern similar to other HIV-1 isolates described. However, some of the common restriction sites present in other isolates were absent in HIV 1Z321. The extent of differences between HIV-1Z321 and recent isolates from North America and Zaire was 17.86-18.36% on the nucleotide sequence level and 26.5 33.2% difference in the predicted amino acid sequence in the envelope gene. Differences were also noted in 3'-orf (nef: according to HIV gene nomenclature; see Ref. 42) gene and U3 region of the long terminal repeat sequences of HIV 1Z321 and other isolates. Nucleotide sequence of a HIV-1 isolate, 12 years apart from the present isolates, will provide an important time calibration point for the evolutionary divergence of HIV isolates. Hybrid HIV was also generated by transfecting HIV-1Z321 and HIV-1HTLV-III viral DNAs into cells. PMID- 2713164 TI - Augmentation of human immunodeficiency virus type 1 gene expression by tumor necrosis factor alpha. AB - It is now well established that cytokines are involved in the regulation of gene expression from HIV-1 LTR. The present study provides evidence that TNF-alpha stimulates HIV-1 gene expression and that the enhancer sequence within the HIV-1 LTR is involved in the stimulation. These results support the idea that immunologic stimulation and infection may trigger the development of clinical AIDS in individuals latently infected with HIV-1. PMID- 2713165 TI - HIV-1 core proteins expressed from recombinant vaccinia viruses. AB - The sequences encoding the core proteins p55, p25, and p18 of the human immunodeficiency virus (HIV-1) have been inserted into the vaccinia virus genome. Infection of cultured cells with the live recombinant viruses led to the expression of proteins that were recognized by sera from HIV-seropositive individuals. Immunization of mice with the recombinant virus expressing the HIV p25 protein and the p55 precursor yielded high levels of antibodies directed against the corresponding HIV antigens. The data obtained are discussed in terms of the possible use of these live recombinant viruses in the development of a strategy toward an AIDS vaccine. PMID- 2713166 TI - Large-scale production and purification of a vaccinia recombinant-derived HIV-1 gp160 and analysis of its immunogenicity. AB - The human immunodeficiency virus (HIV-1) envelope gene was expressed in large scale microcarrier cultures of Vero cells using a system involving coinfection with two recombinant vaccinia viruses. One recombinant contained the bacteriophage T7 RNA polymerase gene under control of a vaccinia virus promoter. The second contained the HIV-1 gp160 gene flanked by T7 promoter and termination sequences. The protein was expressed on the surface of infected cells, and it was shown to have a molecular weight of 160 kD and to react with gp41 and gp120 specific monoclonal antibodies. After purification by successive affinity and ion exchange chromatography, the protein was demonstrated to be present in a particulate form with a diameter in the range of 15-30 nm. When injected into goats a high-titer gp160 specific antibody response was elicited and group specific neutralizing activity could be demonstrated in vitro. The immunogenicity of the protein was also studied in conjunction with a number of adjuvant formulations, and the highest potency in mice was obtained using a preparation with 0.2% Al(OH)3 and 0.25% deoxycholate. PMID- 2713167 TI - Inhibitory effect of papaverine on HIV replication in vitro. AB - The ability of papaverine to inhibit human immunodeficiency virus (HIV) replication in H9 cell line and in peripheral blood mononuclear cell (PBMC) culture was examined. HIV-infected H9 cells were exposed to different concentrations of papaverine for 20 days. Reverse transcriptase (RT) activity and the presence of p24 in the supernatant were determined to assess the level of viral replication in treated and control cultures. The most effective concentration of papaverine in the culture medium was 10 micrograms/ml, a dose that did not significantly affect cell proliferation. At this drug concentration the treatment resulted in no RT activity or p24 expression in the supernatant and no virus antigen detection at the cellular level as demonstrated by Western blot (WB) analysis. The activity of the drug occurred in a short period of time (60 hours) as shown by radioimmunoprecipitation (RIP) assay and affected the synthesis of the env precursor protein gp160. The drug was also effective in inhibiting HIV replication in PBMC cultures and influenced specific viral markers, namely, RT and p24. Evidence of the efficacy of papaverine treatment was enforced by the finding in the treated PBMC cultures, compared with the untreated ones, of a reduced percentage of cells forming syncitia and of the inhibition of the virus-induced decrease in the number of cells. When an equal number of virus infected H9 cells exposed or unexposed to papaverine was analyzed for HIV specific proteins, a marked decrease in the expression of the viral proteins was observed in the treated cultures. At the same time, one cellular protein of molecular weight 69,000 was not inhibited by papaverine. This may indicate that, at least for one protein, synthesis may not be affected by the drug. Our data suggest that papaverine merits attention as a possible nontoxic candidate for the treatment of HIV infection. PMID- 2713168 TI - Long-term observation of baboons, rhesus monkeys, and chimpanzees inoculated with HIV and given periodic immunosuppressive treatment. AB - Baboons, rhesus monkeys, and chimpanzees were injected with the human immunodeficiency virus (HIV) and monitored for up to 4 years. Various immunosuppressive regimens were used during this time in attempts to induce development of the acquired immune deficiency syndrome (AIDS). No infectious virus was recovered or anti-HIV antibodies detected in the baboons and rhesus monkeys. Virus has been recovered from lymphocyte cultures of all five of the chimpanzees at intermittent periods following inoculation. The chimpanzees developed anti-HIV antibodies from 1 to 5 months after virus inoculation and had circulating antibodies that neutralized HIV. All the infected animals were capable of in vitro lymphocyte blastogenic responses to recombinant envelope and core HIV antigens. Despite immunosuppressive therapies and evidence of some immunologic abnormalities, none of the five chimpanzees has yet developed AIDS or a related disorder. PMID- 2713169 TI - The dependent professional. PMID- 2713170 TI - 'The great debate'. PMID- 2713171 TI - ALARA--unprofessional presentation. PMID- 2713173 TI - 'Getting back to dental practice'. PMID- 2713174 TI - 'Oral surgery: assessment and treatment'. PMID- 2713172 TI - The public image of cross-infection control. PMID- 2713175 TI - Oral surgery and orthodontic training. PMID- 2713176 TI - 'A double-blind cross-over trial of a mucin-containing artificial saliva'. PMID- 2713177 TI - 'Dentists and ethnic minority communities'. PMID- 2713178 TI - Use of a gum shield for Parkinson's disease patients. PMID- 2713179 TI - Economical fissure sealing. PMID- 2713180 TI - Off the record: a dentist's view of press exposure. PMID- 2713181 TI - An evaluation of the cariogenic potential of baby and infant fruit drinks. AB - The cariogenic potential of a range of fruit drinks was assessed on the basis of plaque pH by the plaque harvesting method. In addition, the inherent pH and titratable acidity of each drink was analysed. The effects of so-called 'no sugar added' and 'sugar-free' drinks were compared with a standard 10% sucrose drink for their effect on plaque pH in vitro, on a group of volunteers, using the Cariogenic Potential Index (CPI). All drinks had a low inherent pH and some a high titratable acidity. All the drinks also depressed the plaque pH below 5.5 within 5 minutes of drinking and had a CPI equal to or greater than a standard 10% sucrose solution. PMID- 2713182 TI - Ethnic indicators of dental health for young Asian schoolchildren resident in areas of multiple deprivation. AB - The aim of the study was to explore the use of two social indicators in a dental caries epidemiological study of 5-year-old Asian schoolchildren in an area of multiple deprivation. The two indicators selected were religious background and the mother's ability to speak English. Six hundred and forty-three 5-year-old schoolchildren from three schools were examined; the mean dmft was 2.84 (SD 3.63). Children were classified into three groups on broad ethnic/facial characteristics, and the mean dmft for Asians (3.64) differed statistically significantly from those of both Whites (1.83) and Afro-Caribbeans (1.87). When the Asian population was divided into four groups, to explore the effects of religion and the mother's ability to speak English, a statistically significant interaction was observed between religion and language for mean dmft and dental cleanliness. The Asian non-Muslim children whose mothers were English speaking (ES) compared well with the White and Afro-Caribbean group for mean dmft, percentage caries-free and oral cleanliness. When these variables were examined for the two Muslim groups and the non-Muslim group whose mothers were non-English speaking (NES), no statistically significant differences were observed. Oral health promotion should therefore consider that there are three distinct dental high-risk groups for young Asian children: Muslim ES and NES mothers and non Muslim NES mothers. Each group will require a different health promotion strategy. Non-English speaking mothers need adequate translation, whereas all Muslim mothers need help to find proper alternatives to baby-foods which, although common in the UK, are culturally inappropriate to Muslims. PMID- 2713183 TI - Myofascial pain dysfunction and viola playing. AB - Two cases are illustrated to demonstrate the importance of occupation, in the form of viola playing, in the aetiology of myofascial pain dysfunction. An understanding of the contribution of tension and playing style, together with physical limitations, is emphasised and, consequently, it is acknowledged that modification may be necessary to the formulation of a treatment plan. PMID- 2713184 TI - A cervicofacial infection due to Veillonella parvula in a patient with myxoedema. PMID- 2713185 TI - Comparison of several groups. AB - Techniques for the comparison of several samples are described. If the response is quantitative, comparison of the sample means is achieved by one-way analysis of variance. If the response is qualitative, comparison of several proportions is achieved by chi 2 tests. PMID- 2713186 TI - Dentistry in the People's Republic of China with particular reference to gerodontology. AB - The People's Republic of China is increasingly becoming open to the West, and a number of visits have recently been, and are about to be, made by British dentists. In November 1988, the authors of this report made a 2-week lecture tour, under the auspices of the Health Co-operation Agreement between the Department of Health (UK) and the Chinese Ministry of Public Health, organised by the British Council. The principal base for the visit was the Institute of Geriatrics at the Beijing Hospital, where seven lectures were given. Further lectures and seminars were given to staff and postgraduate students at the Fourth Military University in Xian. PMID- 2713187 TI - What becomes of the trainee hospital dental surgeon? A 10-year review of the Glasgow Rotation. AB - A survey of the career progress of participants in the Glasgow Rotational Training Programme is reported. Seventy per cent of trainees have now left the hospital service but the experience they gained was considered to be worth while. PMID- 2713188 TI - Impact of a policy of direct admission to a coronary care unit on use of thrombolytic treatment. AB - Because thrombolytic treatment is effective only if it is given within six hours of acute myocardial infarction it is vital to admit patients to the coronary care unit as soon as possible after the acute event. A policy of admitting patients to the coronary care unit at the request of the patient's general practitioner by a telephone line that is independent of the hospital switchboard significantly reduced the delay. Those admitted via the accident and emergency department at the same hospital reached the coronary care unit 1 h 32 min after being seen by the general practitioner whereas the patients admitted directly took only 43 minutes [corrected]. The policy of direct admission also significantly increased both the percentage of patients who received thrombolytic treatment and the percentage of patients admitted within three hours from the onset of symptoms. PMID- 2713189 TI - Half time of the diastolic aortoventricular pressure difference by continuous wave Doppler ultrasound: a measure of the severity of aortic regurgitation? AB - Thirty four patients with aortic regurgitation were studied by continuous wave Doppler ultrasound. In 30 of these the regurgitation was graded by cineangiography as mild, moderate, or severe and in four severe regurgitation was confirmed at operation. The half times of the aortoventricular pressure differences obtained with Doppler compared well with those obtained from pressure recordings at catheterisation. The relation between pressure half times and cineangiographic gradings of severity was not consistent. Similarly, a control group of patients without aortic regurgitation showed a wide range of the invasively recorded pressure half times which overlapped with those in patients with aortic regurgitation. This suggests that factors such as systemic vascular resistance, and aortic and left ventricular compliance can have an appreciable effect on the pressure half time. If these factors are not included the method will be of limited value, except in patients with pressure half times of less than 300 ms, when regurgitation invariably is severe. These results suggest that at present the method is of value only in recognising the patients with the most severe aortic regurgitation who need early operation. PMID- 2713190 TI - Isoprenaline as an aid to the induction of catecholamine dependent supraventricular tachycardias during programmed stimulation. AB - The effects of isoprenaline on the induction of supraventricular tachycardia by programmed stimulation were studied in 67 patients to see whether they correlated with spontaneous catecholamine mediated symptoms during exercise testing and Holter monitoring. Thirty seven control patients (group 1) did not have spontaneous arrhythmias either during exercise testing or Holter monitoring. Thirty patients (group 2) had documented exercise or stress related supraventricular tachycardias--that is paroxysmal junctional tachycardia (24) or atrial arrhythmia (6). Programmed electrical stimulation was performed before and during the infusion of isoprenaline. No group 1 patient developed sustained supraventricular tachycardia during isoprenaline infusion. In 21 patients with paroxysmal junctional tachycardia and all the patients with atrial arrhythmias electrical stimulation during isoprenaline infusion produced the same tachycardia that had been seen during exercise testing and Holter monitoring. Changes in electrophysiological variables and the concentrations of serum potassium were not associated with the induction of supraventricular tachycardia by isoprenaline. Infusion of isoprenaline safely facilitated the induction of supraventricular tachycardia by programmed stimulation in patients who had spontaneously occurring catecholamine mediated symptoms. PMID- 2713191 TI - Endocarditis in intravenous drug abusers with staphylococcal septicaemia. AB - The case reports of 186 intravenous drug abusers admitted over a three year period were studied. Nineteen had proven staphylococcal septicaemia. Echocardiography showed tricuspid vegetations in seven and aortic vegetations in two. Eighteen out of 19 had systolic murmurs, but only the two patients with aortic vegetations had diastolic murmurs. The chest x ray showed opacities in 10 patients (all those with tricuspid vegetations plus three with normal echocardiograms). Four patients died during follow up, including both those with aortic vegetations; both mitral and tricuspid vegetations were found at necropsy in the other two. All remaining patients were alive at one year. The presence of tricuspid vegetations in intravenous drug abusers is associated with opacities on chest x ray, but carries a good short term prognosis. But these results suggest a poor outcome when left sided endocarditis is present in intravenous drug abusers. PMID- 2713192 TI - Aortic valvotomy for critical aortic stenosis in neonates and infants aged less than one year. AB - Between April 1974 and December 1987, 20 infants (six under one month of age) (mean weight 4.9 kg) underwent surgical valvotomy for critical aortic stenosis. Three of the four patients treated before 1976 died. Since 1979, 16 infants (four neonates) have undergone valvotomy with no deaths. Mortality for the whole group was 15%; in the neonates it was 33%. There were no late deaths. The survivors were followed up for a mean of 3 years 9 months and two required re-operations. The considerable improvement in surgical results in the past decade should be taken into account when newer techniques such as balloon dilatation are evaluated. PMID- 2713194 TI - Perinatal management of critical aortic valve stenosis diagnosed by fetal echocardiography. AB - A case of critical aortic valve stenosis was diagnosed in utero by echocardiography and managed successfully by early elective caesarean section and aortic valvotomy. PMID- 2713193 TI - Diagonal earlobe creases and fatal cardiovascular disease: a necropsy study. AB - The association between diagonal earlobe creases and fatal cardiovascular disease was investigated in a consecutive series of 303 coroner's necropsies. Those studied all died outside hospital in the Brighton Health District. Data were analysed on the cause of death and on the type of earlobe, the presence or absence of diagonal creases, age, sex, height, and any previous history of cardiovascular disease or diabetes mellitus. The age of nine men and six women was not known. Cardiovascular causes of death included ischaemic and hypertensive disease, calcific valvar stenosis, ruptured dissecting aneurysm of the thoracic aorta, and ruptured atheromatous aneurysm of the abdominal aorta. The mean (SD) age at death was 72 (15) and the male to female ratio was 1.3:1. Diagonal creases were present in 123 (72%) of 171 men and 88 (67%) of 132 women. A previous history of cardiovascular disease was present in 90 (30%) of the total of 303 and 74 (35%) of the 211 with diagonal creases. A cardiovascular cause of death was present in 154 (73%) of 211 with and 41 (45%) of 92 without diagonal creases and was associated with an increased risk of a cardiovascular cause of death of 1.55 in men and 1.74 in non-diabetic women. PMID- 2713195 TI - Serial angiographic findings during the development of a saccular aneurysm of the coronary artery in association with unstable angina. AB - A 60 year old man presented with unstable angina and electrocardiographic features suggestive of disease of the left anterior descending coronary artery. Angiography showed slight proximal narrowing in this artery with reduced density of contrast that suggested an associated thrombus. Repeat angiography after 24 hours of heparin administration showed the development of a small saccular aneurysm. Three weeks later, after a further episode of unstable angina, angiography showed enlargement of the aneurysm. Although there were no further episodes of angina, repeat angiography three months after the initial event showed further slight enlargement of the aneurysm. It is suggested that the episodes of angina at rest were secondary to embolisation of thrombotic or atheromatous material or both. PMID- 2713196 TI - Unruptured aneurysm of the sinus of Valsalva presenting with isolated heart block: echocardiographic diagnosis and successful surgical repair. AB - A 31 year old man presented with intermittent dizziness and electrocardiographic evidence of a severe conduction disturbance, with asystolic pauses of up to six seconds, and was treated by implantation of a permanent pacemaker. Echocardiography showed an enlarging aneurysm of the right sinus of Valsalva extending into the interventricular septum. This was confirmed by aortography, and successful surgical repair was carried out. The characteristic diastolic expansion of the aneurysm and the demonstration of continuity between the septal extension and the related aortic sinus were useful diagnostic features. PMID- 2713197 TI - Propranolol induced bradycardia in tetralogy of Fallot. AB - When an 18 month old girl who had tetralogy of Fallot and episodes of severe cyanosis with loss of consciousness was treated with propranolol there was some improvement. But when the dose was increased she had further episodes of near syncope. Holter monitoring showed extreme intermittent bradycardia with pauses of up to 2.6 seconds. The episodes of near syncope and the bradycardia resolved after propranolol was stopped. Apparent failure of propranolol treatment may on rare occasions be related to drug induced bradycardia rather than to continued episodes of severe cyanosis. PMID- 2713200 TI - Challenges and solutions. PMID- 2713199 TI - Patient care provided by ADN students. PMID- 2713198 TI - Care techniques for elderly clients. PMID- 2713201 TI - ABC's of patient education. PMID- 2713202 TI - Clinical evaluations that work! PMID- 2713203 TI - Should I accept or reject my assignment? AB - This article examines the implications of one's decision to accept or reject a nursing assignment and presents alternatives to achieving equitable nursing assignments. PMID- 2713204 TI - Do you need a BSN? PMID- 2713205 TI - This drunk doesn't have to die! AB - Addiction treatment programs and after-care provide needed help to aid alcoholics in making fully recovery. They instruct, guide, and support the alcoholic back to a normal life. Ninety-three percent who abstain for five years remain sober. PMID- 2713206 TI - How to plan & implement change. PMID- 2713207 TI - Tetracyclines. PMID- 2713208 TI - Vietnamese refugees. PMID- 2713209 TI - Geriatric assessment (continuing education credit). AB - This article will increase the already knowledgeable nurse's awareness of subtle assessment differences for elderly clients. This increased awareness will help with early identification of deviations from health of the geriatric client, resulting in improved, holistic nursing care. PMID- 2713210 TI - Healthy volunteer studies in Great Britain: the results of a survey into 12 months activity in this field. AB - 1. A survey has been conducted amongst 459 members of the Clinical Section of the British Pharmacological Society to ascertain facts about the administration of drugs to healthy volunteers over the period October 1986 to September 1987. 2. A response rate of 87.1% was obtained with 114 individuals being involved in healthy volunteer studies. After exclusion of duplicate returns from the same unit 98 questionnaires were analysed. 3. Drugs were given in the year under review to 8163 healthy volunteers for research purposes. Minor adverse effects were reported in 565 (6.9%), moderately severe adverse effects in 45 (0.55%) and potentially life threatening adverse effects in 3 (0.04%). No lasting sequelae were reported. 4. Drugs were given to 7607 healthy student volunteers as part of class teaching practicals. Minor adverse effects were reported in 6.0% of student exposures but no moderately severe or life threatening adverse effects were reported. 5. The risk involved in healthy volunteer studies is very small indeed but some suggestions are made as a result of the questionnaire to improve further the safety of these studies. PMID- 2713211 TI - The effects of lisuride, terguride and bromocriptine on intraocular pressure (IOP). AB - 1. The effects of a single oral dose of the dopaminergic agonists lisuride (0.1 mg), terguride (0.25 mg) and bromocriptine (1.25 mg) on IOP were studied in eight normal volunteers using the non-contact tonometer. 2. Considering all post-dose measurements, compared with placebo, bromocriptine and lisuride but not terguride reduced IOP significantly in both eyes. 3. There was no significant difference between the ocular hypotensive effect of bromocriptine and lisuride. 4. Terguride reduced IOP significantly in the left eye at the 3 h time point after drug administration. 5. The result of this study confirms the reported ocular hypotensive effect of bromocriptine and showed that lisuride is as effective as bromocriptine in reducing IOP. 6. To evaluate the clinical importance of these drugs as ocular hypotensive agents other studies are needed using eye drops. PMID- 2713212 TI - Effect of infused adenosine on cardiac output and systemic resistance in normal subjects. AB - 1. The purine nucleoside adenosine relaxes smooth muscle in vitro and is a vasodilator in animals, but its effects on cardiac output and systemic vascular resistance have not been measured in normal conscious human subjects. 2. We have studied the effects of infused adenosine in doses of 0.005, 0.03 and 0.07 mg kg-1 min-1 on pulmonary blood flow and systemic vascular resistance in eight healthy volunteers, using a non-invasive, inert gas method and mass spectrometry. 3. At a dose of 0.07 mg kg-1 min-1, there was a rise in effective pulmonary blood flow (which is approximately equivalent to cardiac output) of 0.52 +/- 0.08 l min-1 m 2 (mean +/- s.e. mean) and a fall in estimated systemic vascular resistance of 357 +/- 44 dyn s cm-5. Despite this marked systemic vasodilation, there was no significant change in mean heart rate. 4. The effects of this dose of adenosine were maximal 2 min after starting the infusion, and had disappeared within 5 min of stopping it. 5. Adenosine may be therapeutically useful in the reduction of left ventricular afterload, where the absence of reflex tachycardia may be advantageous. We suggest that adenosine in doses of 0.03 mg kg-1 min-1 should be evaluated as a selective pulmonary vasodilator. PMID- 2713213 TI - Oral absorption profile of nitrendipine in healthy subjects: a kinetic and dynamic study. AB - 1. In nine healthy male subjects the kinetics of nitrendipine were assessed after i.v. administration and its absorption profile was studied when given by a tablet formulation and by an osmotic pumping device (Osmet) with a zero-order in vitro release of 2.62 +/- 0.19 mg h-1 for 13 h. 2. Plasma concentrations of nitrendipine and its pyridine metabolite, heart rate and blood pressure were determined at regular intervals after drug administration. 3. After i.v. nitrendipine, the plasma concentration declined triexponentially with a mean terminal elimination half-life of 11.7 +/- 5.4 h. The mean systemic plasma clearance was 1.47 +/- 0.22 l min-1. 4. Administration of the Osmet resulted in a relatively smooth plasma concentration-time profile in comparison with the tablet. The mean plateau concentration was 2.63 +/- 1.31 ng ml-1 and the duration of this plateau was 10.7 +/- 3.2 h. The intake of food gave rise to a transient increase of the plasma concentration of both nitrendipine and its pyridine metabolite. 5. The mean bioavailability of nitrendipine from the Osmet (8.2 +/- 1.6%) was lower than from the tablet (11.1 +/- 4.5%), which is probably due to release of nitrendipine in lower parts of the G.I. tract where absorption is not or less possible. 6. Intravenous administration caused a transient decrease in DBP of 26 +/- 4%, accompanied by a maximal reflex tachycardia of 46 +/- 17%. No clear haemodynamic effects were observed after oral administration. The Osmet produced less side-effects (headache) than the tablet. PMID- 2713214 TI - The pharmacokinetics of caffeine and its dimethylxanthine metabolites in patients with chronic liver disease. AB - 1. Serum and salivary concentrations of caffeine (1,3,7-trimethylxanthine) and its dimethylxanthine metabolites were measured in 10 healthy control subjects and in 19 patients with cirrhosis, for up to 96 h following a 400 mg oral caffeine load. 2. Serum and salivary caffeine concentrations correlated significantly (r = 0.954; P less than 0.001) and no significant differences were observed in the pharmacokinetic data derived from the respective concentration-time curves. 3. In the control subjects, basal salivary caffeine concentrations did not exceed 0.4 mg l-1. The median (range) basal salivary caffeine concentrations in patients with compensated cirrhosis (n = 10), 0.2 (0-0.7) mg l-1 and decompensated cirrhosis (n = 9), 0.7 (0-5.8) mg l-1, were not significantly different from control values, although three patients with decompensated cirrhosis had basal salivary caffeine values above 2.0 mg l-1. 4. In the patients with compensated cirrhosis, the median peak salivary caffeine concentration, 10.9 (8.2-16.5) mg l 1 was significantly greater than in controls, 7.1 (4.7-11.8) mg l-1 (P less than 0.01) and the median apparent volume of distribution was significantly reduced, 0.38 (0.19-0.49) vs 0.41 (0.23-0.63) l kg-1 (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713215 TI - Bayesian derived predictions for twice daily theophylline under outpatient conditions and an assessment of optimal sampling times. AB - 1. The accuracy of a computerised method of pharmacokinetic interpretation of a single serum theophylline concentration, employing the statistical technique of Bayesian analysis, has been evaluated for an oral slow release form of theophylline using twice daily dosing. 2. Twenty-four hour steady state serum theophylline concentration-time profiles of one Uniphyllin Continus 400 mg tablet (Napp Laboratories) every 12 h were measured in 15 patients. These profiles demonstrated a diurnal variation of theophylline absorption which was faster during the day. 3. Revised predictions of the profiles were generated by Bayesian analysis using a single serum theophylline concentration taken during a previous outpatient appointment. Comparing the predicted and measured profiles, the accuracy of the Bayesian method is considered more than adequate for clinical purposes. 4. The predictions produced by the revised estimates were statistically less biased and more precise than those derived by a theophylline algorithm using population data. 5. The mean prediction errors of the revised estimates of the day and night-peak drug concentrations were -0.55 mg l-1 and -0.21 mg l-1 whilst those of the evening and morning troughs were 1.17 mg l-1 and 0.41 mg l-1, respectively. 6. Analysis of the predictive and relative performance of the samples drawn during the profile revealed that the sample taken prior to a morning dose produced the most accurate predictions. 7. There was no statistical difference in the relative predictive performance of samples drawn up to 4 h before or 2 h after the morning dose. It is, therefore, recommended that all serum theophylline concentrations to be used in Bayesian analysis, should be drawn within this period. PMID- 2713216 TI - Dextromethorphan: polymorphic serum pattern of the O-demethylated and didemethylated metabolites in man. AB - 1. The interindividual differences in serum concentrations of dextromethorphan (DM) and its metabolites were studied in 29 healthy subjects given 120 mg orally. They were also phenotyped according to the urinary ratio of debrisoquine and 4 hydroxy-debrisoquine. 2. Four (14%) subjects were found to be poor metabolizers (PM) with a dextromethorphan/dextrorphan metabolite ratio in plasma of 3.6 or more compared with extensive metabolizers (EM) with a ratio of 0.11 or less. Significant levels of 3-hydroxymorphinan were measurable in all individuals except two, both of whom were PMs. This subdivision corresponded to the phenotype determined by the metabolic ratio of debrisoquine (r = 0.92). 3. Twelve of the 29 subjects reported adverse drug reactions after dextromethorphan administration compared with none after placebo. PMID- 2713217 TI - Binding of prazosin and propranolol at variable alpha 1-acid glycoprotein and albumin concentrations. AB - 1. The effect of variable alpha 1-acid glycoprotein (AAG) and albumin (HSA) concentrations on the binding of prazosin and propranolol was assessed in plasma after surgery and in mixtures of AAG/HSA with concentrations mimicking those found in vivo. 2. On the pre-operative day the binding of prazosin and propranolol was 94.8% and 89.0%, respectively and 97.3% and 93.2%, respectively, 5 days after surgery. 3. In solutions containing mixtures of highly purified AAG and HSA representing the pre-operative state, 88.6% and 83.9% binding of prazosin and propranolol was observed, whereas for solutions mimicking post-operative plasma, the equivalent values were 94.6% and 91.4%, respectively. 4. The ratios between bound and unbound concentrations of both drugs were closely correlated to the concentrations of AAG, but not to the concentrations of HSA. 5. The present study demonstrates that AAG is responsible for the binding variability of prazosin and propranolol in plasma from post-operative patients. PMID- 2713218 TI - Lack of effect of treatment with human recombinant-tumour necrosis factor (HrTNF) on the binding of quinidine to alpha 1-acid glycoprotein (AGP). AB - Tumour necrosis factor (TNF) is known to be a key mediator in the acute phase response and its administration has been shown to cause a five fold increase in serum alpha 1-acid glycoprotein (AGP) concentration in the rat. Since, in man, plasma AGP level determines the protein binding of many important drugs (e.g. narcotic analgesics, phenothiazines, antiarrhythmics, calcium channel blockers) likely to be given to patients who will be treated with TNF, it is important to determine if TNF treatment of humans causes a similar increase in AGP concentration and drug binding. Therefore, the plasma protein binding of quinidine and the serum level of AGP were studied over a 4 day period in each of five cancer patients who were treated with human recombinant-tumour necrosis factor (HrTNF) using a dosage schedule of 6-8 x 10(+5) units/m2 daily for 5 days. It was observed that the quinidine binding ratio (the quotient of bound and free concentration in plasma) was highly correlated with the plasma concentration of AGP (r = 0.818) and that the mean pretreatment AGP concentration in the patients was about three times that found in normal subjects. However, no effects of the TNF treatment regime used in the present study could be demonstrated on either plasma AGP concentration or quinidine free fraction. These observations allow the tentative conclusion that HrTNF does not cause a significant increase in serum AGP level in cancer patients whose baseline AGP concentration is high. However, further study of the relationship between TNF treatment and serum AGP level is needed. PMID- 2713219 TI - Lack of effect of paracetamol on the pharmacokinetics of chloramphenicol. AB - The effect of oral paracetamol (1 g) on the pharmacokinetics of oral chloramphenicol (500 mg) was examined in five adult male Zimbabwean patients with normal hepatic and renal function. No significant alteration of half-life, area under the concentration-time curve or peak concentration of chloramphenicol was observed. The previously reported, potentially serious interaction between chloramphenicol and paracetamol administered intravenously was not observed with the more commonly used oral preparations. PMID- 2713220 TI - Adenosine-induced respiratory and heart rate changes in young and elderly adults. AB - The effects of intravenous boluses of adenosine on respiration and heart rate were compared in young and elderly individuals. Respiratory stimulation and biphasic changes in heart rate were confirmed. The dose-response relationship for the effects of adenosine on respiration and heart-rate did not differ significantly between 10 young (mean age 25.2 +/- 4.9 years) and 10 elderly (mean age 66 +/- 3.1 years) drug-free individuals, indicating that age is unlikely to be a major determinant of adenosine responsiveness. PMID- 2713221 TI - Effects of atenolol vs diltiazem on the haemodynamic effects of an inhaled beta 2 adrenoceptor agonist. AB - To determine the effects of concurrent beta 1-adrenoceptor blocker or calcium channel antagonist administration on the haemodynamic sequelae of an inhaled beta 2-selective adrenoceptor agonist bronchodilator, we examined echocardiographically the effects of fenoterol (400 micrograms) by metered dose inhaler following oral pre-treatment with (a) placebo, (b) atenolol or (c) diltiazem. Following placebo, fenoterol produced significant decreases in diastolic blood pressure (14% +/- 6%), total peripheral vascular resistance (TPR) (31% +/- 9%) and end-systolic stress (ESS) (15% +/- 21%). Cardiac output rose significantly (42% +/- 23%) as did heart rate (25% +/- 13%). After atenolol, responses to fenoterol were significantly blunted. Post-fenoterol heart rate, systolic blood pressure, % fractional shortening, stroke volume, ejection fraction, cardiac output and pressure/volume ratio increased significantly less after atenolol pre-treatment as compared to placebo pretreatment. TPR decreased significantly less. After diltiazem pre-treatment, the response to inhaled fenoterol was not different from that following placebo pre-treatment. We conclude that atenolol blunts the haemodynamic changes induced by fenoterol inhalation whereas diltiazem has little effect. PMID- 2713222 TI - Substantial rise in sparteine metabolic ratio during haloperidol treatment. AB - A sparteine test was carried out in 14 patients suffering from acute schizophrenic psychoses before and 1-2 times during oral haloperidol treatment in doses of 10-40 mg day-1. In patients classified as extensive metabolisers (sparteine MR less than 20 before treatment), haloperidol treatment resulted in a rise in sparteine MR that correlated with the serum-haloperidol concentration both within and between patients. At the highest serum haloperidol concentrations (60-80 nM) an increase in sparteine MR by a factor 15-50 was seen, but no patients were transformed into phenotypically poor metabolisers. The steady state concentration of haloperidol on the initial standard dose of 10 mg day-1 was the same in one patient classified as a sparteine poor metaboliser (MR = 112) as in eleven patients classified as extensive metabolisers (MR:0.22-1.47). PMID- 2713223 TI - Seasonal variation in responsiveness of human eccrine sweat glands to phenylephrine. AB - The responses of eccrine sweat glands to intradermally injected phenylephrine were studied in six healthy male volunteers in two experiments carried out in February and June. Phenylephrine (10(-7)-10(-2) M, 50 microliters) had no consistent effect on sweat gland activity during February, but evoked dose related increases in sweat gland activity during June. Responsiveness to phenylephrine could be antagonized by prazosin (10(-5) and 10(-4) M) added to the injection solution. PMID- 2713224 TI - Once nightly sustained release theophylline in elderly subjects. PMID- 2713225 TI - Surgical approach to the treatment of popliteal aneurysm. AB - Seventeen popliteal artery aneurysms were repaired at the Santa Barbara Cottage Hospital from 1975 to 1987. Fourteen patients were involved, with three having bilateral lesions. All but one were men with an average age of 67 years. Four of the aneurysms (three patients) presented with asymptomatic masses while the others were associated with arterial or venous obstructive symptoms. The aneurysms were repaired and there was no mortality. One patient developed a transient foot-drop. All patients with symptoms caused by their aneurysm were improved or became asymptomatic, postoperatively. We are impressed that the posterior approach to an uncomplicated popliteal artery aneurysm has several advantages over the bypass technique. The distal anastomosis can frequently be kept proximal to the knee joint, and since exposure of the aneurysm is excellent, aneurysmectomy is often possible thus eliminating pressure symptoms as well as the possibility of late rupture. PMID- 2713226 TI - Limb salvage in the elderly. AB - Sixty-eight lower extremity bypass procedures for severe lower limb ischemia were undertaken on 53 patients of 75 years of age and over. The operative mortality was 4.4%. At two years cumulative limb salvage, patient survival, graft patency and survival with an intact limb were 77%, 72%, 44%, and 56%, respectively. Of all patients who died, 66% had an intact limb at the time of death. Based on these results we continue to offer reconstructive surgery to elderly patients. PMID- 2713227 TI - Surgery for radiation-induced symptomatic carotid atherosclerosis. AB - Carotid atherosclerosis occurring secondary to cervical irradiation is known to produce stroke. Transient neurologic symptoms have necessitated surgical intervention to prevent stroke despite concern over technical problems, wound healing, operative risks, and uncertain therapeutic outcome. With this report, 26 surgical procedures in 20 patients are now documented in the literature (12 men- 60%; eight women--40%). Mean age of these patients (56 years) was 10 years younger than carotid surgery patients with no prior radiation history. No relationship was noted between elevated serum cholesterol and the subsequent development of radiation-induced carotid atherosclerosis. Surgical procedures performed included carotid endarterectomy in 17 cases (65%) and arterial bypass in nine (35%). The combination of radiation therapy and previous neck surgery, including prior radical neck dissection, did not adversely influence operability. Surgical outcome was uniformly good with only one stroke (4%) documented in the perioperative period. Longer follow-up on our six cases (mean two years) disclosed neither new clinical symptoms nor the development of hemodynamically significant restenosis. PMID- 2713228 TI - The effect of postoperative smoking on femoropopliteal bypass grafts. AB - Effect of smoking habits on limb loss rates and cumulative patency rates of 136 arterial reconstructions performed for lower limb ischemia were analyzed in a five year follow-up retrospective study. Of 121 patients, 103 (85%) smoked before the operation and 43 of the smokers (42%) discontinued smoking postoperatively. Patients who continued to smoke more than 15 cigarettes per day (34 patients) increased the probability of losing their limb approximately five times at two years and three times at five years postoperatively, compared with nonsmokers and smokers of up to 15 cigarettes per day (87 patients) (p = 0.013). Cumulative patency rates of nonsmokers and smokers of up to five cigarettes per day (Group A, 66 patients) were not significantly influenced (p = 0.518) by preoperative symptoms (claudication versus limb salvage). However, for smokers of more than five cigarettes per day (Group B, 55 patients), at five years claudicants had a cumulative patency rate of 62.9% compared to 38.3% for limb salvage patients (p = 0.015). In group A at five years, autologous saphenous vein grafts had a cumulative patency rate of 74.2%, compared to 24% for prosthetic grafts (P = 0.013). In group B the CPR differences between autologous saphenous vein and prosthetic grafts were not significantly different (p = 0.394). Multiple interactions between smoking and variables like age, preoperative symptoms, and graft material demonstrate the complexity of the effects of smoking on cumulative patency rate and the need for sub-grouping and removal of confounding factors. In view of the adverse affects of continued smoking on postrevascularization prognosis, patients should be strongly advised to discontinue smoking. PMID- 2713229 TI - Distal anastomotic intimal hyperplasia: histopathologic character and biogenesis. AB - Although thrombogenicity of the prosthetic graft, progression of the atherosclerotic disease and distal anastomotic intimal hyperplasia are known etiologic factors of late graft failure, its occurrence is frequently encountered in the late graft occlusion. Forth-two canine PTFE iliofemoral grafts (all with end-to-side distal anastomosis) were studied. Computer digitization revealed that distal anastomotic intimal hyperplasia occurred exclusively at the heel and the toe of the graft and the floor of the host artery. The distal anastomotic intimal hyperplasia was 80-130 cells thick. Light microscopy and transmission electron microscopy revealed a similar architecture of interlamination of cellular elements and extracellular matrix in the hyperplastic cells. Transmission electron microscopy further defined a gradual cell transformation and orientation from the graft to the lumen. The cells near the graft were characterized by a gradual reduction of rough endoplasmic reticulum with a concomitant acquisition of myofilaments, transforming ovoid mesenchymoid cells to slender myofibroblasts. The orientation of cells in distal anastomotic intimal hyperplasia was embodied by random cell distribution at the periphery to a well-organized interlamination of myofibroblasts and extracellular matrix near the lumen. Distal anastomotic intimal hyperplasia is a biologic entity with active cellular and subcellular events. Its biogenesis appears to be influenced by the hemodynamics of blood flow at the distal anastomosis. PMID- 2713230 TI - Preoperative spinal cord arteriography in aneurysmal disease of the descending thoracic and thoracoabdominal aorta: preliminary results in 45 patients. AB - Between 1985 and 1988 45 patients with descending thoracic or thoracoabdominal aortic aneurysms underwent selective arteriography of the intercostal and lumbar arteries to delineate preoperatively the artery of Adamkiewicz and the thoracic radicular artery. Identification of these vessels failed in five patients (11%), was considered complete in 31 patients (69%) and incomplete in nine (20%). Selective arteriography classified these patients into four groups: groups A and B--the artery of Adamkiewicz arose respectively above and below the zone of operation; group C--the artery arose directly from the segment to be operated; and group D--origin could not be determined. All 30 patients in group C underwent a spinal cord revascularization procedure (complete in 20 cases, incomplete in 10). Spinal cord complications occurred in 9/45 patients (20%). No spinal cord complications occurred in groups A and B; their incidence was 5% in group C when revascularization was complete, and 50% when revascularization was incomplete; and 60% had complications in group D (p less than 0.01). Spinal cord complications were more frequent (p less than 0.05) when the artery of Adamkiewicz arose from an intercostal or lumbar artery obliterated at its aortic origin but filled through collaterals or when spinal cord circulation was interrupted for more than 45 minutes. This study confirms the importance of preserving arterial supply to the spinal cord during repair of descending thoracic and thoracoabdominal aneurysms. The information obtained from spinal cord arteriography allows the prediction of complications and informs the choice of the appropriate surgical technique. PMID- 2713231 TI - Blood flow in the perimalleolar skin in relation to posture in patients with venous hypertension. AB - The resting and standing perimalleolar skin blood flow and venoarteriolar response have been studied in 20 patients with postphlebitic limbs and 25 normal volunteers using laser-Doppler flowmetry. In postphlebitic limbs the venoarteriolar reflex was impaired and both the resting and standing skin blood flow were increased, suggesting the presence of local vasoparalysis similar to that previously observed in diabetics with peripheral neuropathy. PMID- 2713232 TI - Iatrogenic arterioportal fistulae: diagnosis and management. AB - Arterioportal fistulae can develop from a variety of causes, either congenital, iatrogenic, or acquired. They can have a varied clinical presentation including acute upper gastrointestinal bleeding, ischemic colitis, abdominal pain, ascites, and abdominal bruit. In the past the treatment has been ligation and surgical excision of the fistula with repair of the artery and vein or hepatic lobectomy. We report two patients with arterioportal fistulae between the hepatic artery and portal vein as a result of liver biopsy and transhepatic portography. Both patients were treated successfully by nonoperative radiologic intervention. PMID- 2713233 TI - Obturator bypass with nonreversed translocated saphenous vein. AB - Obturator bypasses with nonreversed translocated saphenous veins were performed in two patients with femoral graft infections. There were no deaths, limb loss, or graft occlusions at two and one-half years of follow-up in the first case and one and one-half years of follow-up in the second case. The nonreversed translocated saphenous vein is a versatile graft that allows for extraanatomic autogenous reconstruction in the face of infection. In both cases, small-caliber distal saphenous veins precluded performing reversed saphenous vein grafts. PMID- 2713234 TI - Venous insufficiency in a young man secondary to a traumatic arteriovenous fistula. AB - The medical history in a young man who developed varicose veins and venous insufficiency secondary to an acquired arteriovenous fistula in the thigh is presented. The radiological and clinical findings are discussed. The disease process in the development of varicose veins is not fully understood and cannot be satisfactorily explained as a consequence of arterial pressure within the venous system or a defect in the venous valves alone. The widespread ectatic changes seen within the venous system in our patient suggests the activation of an unknown, possibly humoral factor, resulting in morphological modifications in the vein wall. PMID- 2713235 TI - Retrosternal subclavian-femoral artery bypass. AB - In three cases we have used a retrosternal and extraperitoneal approach to revascularize the lower extremities with a subclavian-femoral artery bypass. This technique is as easy technically as the conventional subcutaneous axillofemoral bypass and has the advantage of avoiding extrinsic compression, thus improving long-term patency. PMID- 2713236 TI - Extended medial approach to the popliteal artery without muscular division. AB - This technique allows wide access to the entire popliteal artery by detaching the tendons of the pes anserinus and semimembranosus muscles, without any muscular division. The tendons are reinserted anatomically upon completion of the vascular procedure. This technique was used in 14 patients, without complication. This technique is of particular value when it is necessary to inspect the popliteal artery to determine the etiology of the occlusion in the young subject. It is invaluable when direct access to the midpopliteal artery is required. PMID- 2713237 TI - Plasma level of the creatine phosphokinase BB isoenzyme during experimental intestinal ischemia. AB - Changes in the serum of CPK-BB isoenzyme were investigated in dogs with intestinal ischemia in order to determine their use as an enzymatic diagnostic test for bowel infarction. The study consisted of 12 mongrel dogs. Group I (n = 6) was assigned as a control and was subjected to lumen obstruction of a jejunal segment 50-60 cm in length. Group II (n = 6) had an intestinal infarction created by ligation of the arteries of a jejunal segment 50-60 cm in length. A catheter was placed into the right atrium through the left jugular vein for blood sampling and monitoring. Blood samples were withdrawn every three hours for biochemical assays. CPK-BB measurements were performed by electrophoresis in agarose gel. CPK BB remained unchanged in Group I during the course of the study (median range 17 to 20 IU) showing no significant difference from normal levels. Significant elevation of CPK-BB occurred three hours after establishing the ischemia in Group II (median 50 IU) as compared to Group I (p less than 0.05). The highest levels were determined to be 96 and 80 IU at the sixth and ninth hour, respectively. From hour 15 until completion of the experiment, no significant difference was detected between Groups I and II. We conclude that CPK-BB elevation in serum signifies its release from the smooth muscles of the bowel due to ischemic cellular damage. PMID- 2713238 TI - The origin and nature of stromal osteoclast-like multinucleated giant cells in breast carcinoma: implications for tumour osteolysis and macrophage biology. AB - The origin and nature of osteoclast-like multinucleated giant cells (OMGCs), in extraskeletal neoplasms, is uncertain. The ultrastructure, antigenic phenotype and function of OMGCsm in a breast carcinoma were studied in order to clarify the relationship between OMGCs, osteoclasts and other cells of the mononuclear phagocyte system (MPS). OMGCs resorbed cortical bone in a manner similar to osteoclasts. However, unlike osteoclasts, OMGCs did not possess a ruffled border or clear zone, and expressed HLA-DR and Fc receptors and CD14, CD16, CD18 and CD11 (p150,95) antigens. In addition, OMGCs failed to respond morphologically to calcitonin and were directly stimulated by parathyroid hormone (PTH) to increase bone resorption. These findings suggest that OMGCs are a specific type of macrophage polykaryon distinct from both osteoclasts and other types of inflammatory polykaryon. Occasional smaller (20-25 microns) macrophage-like cells were also associated with resorption pits. Bone resorption by OMGCs isolated from the breast indicates that a cell of the MPS can be transplanted to a new tissue location and perform a highly specialised function appropriate to an MPS cell of that tissue (i.e. the osteoclast). PTH stimulation of bone resorption by OMGCs suggests that PTH or a PTH-like protein, may be involved in the bone resorption and consequent hypercalcaemia associated with metastatic breast cancer. PMID- 2713239 TI - Characterisation of a tamoxifen-resistant variant of the ZR-75-1 human breast cancer cell line (ZR-75-9a1) and ability of the resistant phenotype. AB - A 6-month exposure of ZR-75-1 human breast cancer cells to tamoxifen (1 microM rising to 2 microM). resulted in a fall in oestrogen receptor (ER) levels from 225 fmol mg protein-1 to 56 fmol mg protein-1 while progesterone receptor (PGR) concentration fell from 63 fmol mg protein-1 to undetectable levels. Sensitivity to the anti-proliferative effects of tamoxifen was unchanged. A further 6 months' exposure to 4 microM tamoxifen resulted in loss of detectable ER and PGR and development of resistance to tamoxifen. Resistant cells, designated ZR-75-9a1, displayed morphological changes consistent with the acquisition of a less well differentiated phenotype. Flow cytometric studies demonstrated that the cell cycle distribution pattern of the resistant variant growing in the presence of 8 microM tamoxifen was identical to that of the untreated parent line, which showed marked accumulation of cells in G0/G1 when exposed to 8 microM tamoxifen. The resistant phenotype was not stable if cells were transferred to complete drug free medium, but remained stable for at least 3 months in the presence of medium lacking oestrogenic activity. ZR-75-9a1 cells differ from previously reported tamoxifen-resistant variants of the MCF-7 line which retain ER and may prove a valuable model for the study of the development and stability of tamoxifen resistance in human breast cancer. PMID- 2713240 TI - Observations on the transcriptional activity of the glutathione S-transferase pi gene in human haematological malignancies and in the peripheral leucocytes of cancer patients under chemotherapy. PMID- 2713241 TI - Gastrin: growth enhancing effects on human gastric and colonic tumour cells. AB - Two colorectal (HT29, LoVo) and one gastric (MKN45) human tumour cell lines were examined for their in vitro trophic response to human gastrin-17. MKN45 and HT29 responded by increased 75Se selenomethionine uptake to exogenous gastrin (139 +/- 5.5% and 123 +/- 3% of control values respectively) whereas LoVo showed no significant response to this hormone. When these same cell lines were grown as xenografts in nude mice, similar responses were seen to exogenously administered human gastrin-17 (10 micrograms mouse-1 day-1, subcutaneous injection). MKN45 xenografts showed a greater response to continuously administered gastrin (osmotic mini-pumps, (10 micrograms mouse-1 day-1) when compared to the same dose given via a subcutaneous bolus injection. The hormone-treated xenografts had a two-fold increase in tumour cross-sectional area and growth rate when compared to saline-treated controls. Dose-response studies revealed that 0.4 micrograms gastrin mouse-1 day-1 appeared to be the minimally effective dose. As gastric and colorectal tumour cells show a trophic response to gastrin, antagonists of the gastrin receptor may prevent this effect causing tumour stasis. The gastric tumour cell line, MKN45, is gastrin-responsive and would be an ideal model for screening potent receptor antagonists. PMID- 2713242 TI - Gene amplification and overexpression of EGF receptor in squamous cell carcinomas of the head and neck. AB - Tumours of the head and neck were examined for gene amplification and expression of the epidermal growth factor (EGF) receptor by Southern blot and Western blot analyses. The EGF receptor gene was found to be amplified in four (19%) of 21 squamous cell carcinomas. The EGF receptor was overexpressed in eight (53%) of 15 squamous cell carcinomas examined, including all four tumours showing gene amplification. No amplification or overexpression of the EGF receptor gene was detected in any of nine malignant or eight benign tumours of other types of the head and neck. The tumours showing amplification and/or overexpression of the EGF receptor gene (8/15) were all identified histologically as well differentiated squamous cell carcinomas, whereas none of the histologically less differentiated squamous cell carcinomas (0/9) showed amplification and/or overexpression of the EGF receptor gene. Within our sample set, no correlation was evident between amplification and/or overexpression and the clinical stage or tumour site. Our results support the possible involvement of gene amplification and overexpression of the EGF receptor in a subclass of squamous cell carcinomas of the head and neck. PMID- 2713243 TI - Growth-promoting effect of oestriol in a lymphoma lacking oestrogen receptors. AB - Various doses (1 microgram to 10 mg) of oestriol (E3) were intraperitoneally injected into mice immediately after subcutaneous inoculation of an oestrogen receptor-negative lymphoma cell line (KE-5) established from a spontaneously developed AKR thymic lymphoma. The growth of KE-5 cells was markedly promoted by E3 at the early stage of tumour growth. At this stage, 1 microgram E3 enhanced tumour growth significantly and the maximum effect was obtained with 1 mg E3. Normal female mice showed a higher incidence and shorter latency than males. However, once tumours became palpable, the tumour growth rate appeared to be unaffected. Histological observations using Alcian blue and colloidal iron revealed a marked increase of hyaluronic acid in the subcutaneous connective tissue of the tumour-injection site within 3-5 days after intraperitoneal administration of 1 mg E3. Biochemical analyses showed a rapid and marked increase in skin hyaluronic acid content to over 3 times the control levels (0.25 +/- 0.10 mg g-1 skin) within 3 days of E3 administration. Subcutaneous inoculation of KE-5 cells together with hyaluronic acid (0.2 mg) resulted in markedly enhanced tumour growth, particularly at the early stage. These results suggest that an increase in stromal hyaluronic acid content is the most likely mechanism responsible for the promoting effect of E3 on KE-5 cells. PMID- 2713244 TI - Cervical intraepithelial neoplasia in lymphoma patients: a cytological and colposcopic study. AB - Twenty-seven patients with Hodgkin's (n = 19) and non-Hodgkin's (n = 8) lymphomas underwent cytological and colposcopic screening of the uterine cervix. Colposcopically directed cervical punch biopsies were taken from all patients in whom a colposcopic abnormality was detected. Lymphoma patients were compared with 79 controls with normal cervical cytology and no known haematological abnormality. Colposcopically directed punch biopsies were taken from the cervical transformation zone of all controls. Significantly more lymphoma patients (19%) than controls (3%) had CIN II or III (P less than 0.01) and cervical human papillomavirus infection, as judged by the presence of koilocytes (52% of lymphoma patients; 27% of controls; P less than 0.02). All six lymphoma patients with CIN had Hodgkin's disease (HD), and five had received combination chemotherapy. Half of the cases of CIN in lymphoma patients and all the cases of CIN in control patients were not detected by cervical cytology. This study suggests that female patients with HD are at increased risk of CIN, and that cervical cytology alone may be an inadequate form of screening for these patients. PMID- 2713245 TI - A comparative study of the relative sensitivity and specificity of radiolabelled monoclonal antibody and computerised tomography in the detection of sites of disease in human malignant melanoma. AB - A monoclonal antibody raised against the high molecular weight melanoma antigen was labelled with indium-111 and injected intravenously into 25 patients with malignant melanoma. The results obtained from images at 24 and 96 h post i.v. administration of the antibody were compared with results obtained from computerised tomography studies with regard to detection of previously unrecognised sites of metastatic disease and apparent false positive localisation. Detailed study of the patients' clinical condition and detection rates using the two methods suggest that both methods detect approximately 80% of clinically and pathologically confirmed metastases. Of 62 known metastases, the antibody detected 50 (81%), with 17 false positive results. False negatives were most common in the lung. In eight patients the two methods were considered of equal value, in 10 the monoclonal gave a greater amount of clinically relevant information, and in seven the CT was superior. In three patients clinically significant metastatic lesions were detected by the radiolabelled monoclonal and had not been previously recognised either by CT scanning or on clinical grounds. No patients had any adverse reaction to the antibody and in the course of our study the dose of antibody was reduced from 20 mg to 200 micrograms with no apparent loss of sensitivity. In at least two patients uptake of the labelled monoclonal into tumour sites would have been adequate for effective targeted radiotherapy. PMID- 2713246 TI - 'Debulking' surgery is unnecessary in advanced abdominal Burkitt lymphoma in Iraq. AB - In a previous study (Burkitt lymphoma study I, BL I) between 1982 and 1984, we used a multidrug rotating chemotherapy schedule, now known as 'GRAB', to treat 24 Iraqi children with non-localised BL (Murphy stages II, III and IV). At the time of reporting, actuarial survival was 50% (current actual survival 42%) and the major morbidity and mortality was not from resistant or relapsed lymphoma, but from complications of the tumour lysis syndrome, sepsis and early abdominal surgery. The study (BL II) reported here was carried out between 1984 and 1986; we used GRAB to treat 24 newly and consecutively diagnosed children with advanced Burkitt lymphoma but discouraged early 'debulking' surgery and paid special attention to supportive care during the first two weeks of treatment. As in BL I, no radiotherapy was used. Twenty patients (83.8%) attained complete remission: 17 (71%), including three of the seven stage IV patients, survive continuously disease-free at a median of 26 months (range 18-36 months) from diagnosis. We have previously pointed out that GRAB, without radiotherapy, may be especially suited for use in some developing countries. From this study we conclude that, with appropriate supportive care and minimal surgery, survival rates over 50% may be achieved. Our next studies are aimed at defining a 'good risk' group of patients, who may be curable without alkylating agents and a 'poor risk' group, who need more intensive therapy. PMID- 2713247 TI - Oral contraceptives and breast cancer: latest findings in a large cohort study. AB - During the interval 1968-74, 17,032 women aged 25-39 years were recruited to the Oxford-Family Planning Association contraceptive study, more than half of whom were using oral contraceptives. These women have been followed up over the years and breast cancer has been diagnosed in 189 of them. We have analysed the available data in two ways. First, we have calculated standardised breast cancer incidence rates in non-users and users of oral contraceptives according to total duration of use, interval since first use, interval since last use, duration of use before first term pregnancy and duration of use before age 25. Secondly, we have conducted case-control within cohort analyses to examine the possible effects of different types of pill and to search for evidence of a latent effect of oral contraceptive use before first term pregnancy on breast cancer risk. We have found no evidence of any adverse effect of oral contraceptive use on the risk of breast cancer in this study. There was, however, little exposure to the pill before first term pregnancy among the participants and virtually no such exposure at a very young age (i.e. below 20 years). Accordingly, the results of this study strengthen the evidence that oral contraceptive use by mature women does not increase breast cancer risk, but add little to the uncertainty about the effects of early use. PMID- 2713249 TI - Genetic and immunopathological findings in a lymphoma family. AB - We have studied a remarkable family with seven cases of malignant lymphoma extending through three generations wherein five sisters and their mother had histopathologically documented non-Hodgkin's lymphoma, while a granddaughter had Hodgkin's disease. An immunological study of three lymphoma survivors, nine of their first degree relatives, and four spouse controls was undertaken. Significant findings consisted of a depressed serum IgG3 level in four of the nine first-degree relatives; in two of these four, lymphocyte stimulation by both pokeweed mitogen and concanavalin A were significantly depressed. The subtle immunological abnormalities present in this kindred may be associated with the pathogenesis of the lymphomas. PMID- 2713248 TI - Oral contraceptives and breast cancer. AB - A population-based case-control study of oral contraceptive use and breast cancer was carried out among young women (less than 43 years of age) at Group Health Cooperative of Puget Sound, Seattle, Washington. Use of oral contraceptives before first pregnancy did not materially differ between cases or controls. The rate ratio estimate of breast cancer incidence in women who had used oral contraceptives before first pregnancy compared to those who had not was 0.9 (95% CI = 0.4, 2.1). There were no meaningful patterns of association between breast cancer and duration of use or formulation of oral contraceptive used before first pregnancy. PMID- 2713250 TI - Do multiple oestrogen receptor assays give significant additional information for the management of breast cancer? AB - In 101 breast cancer patients, measurement of oestrogen receptor status in multiple biopsies across a tumour reveals a highly significant difference in the proportion of patients remaining either disease-free (P less than 0.04) or alive (P less than 0.005), when those with uniformly receptor positive (++) primary tumours are matched with clinically comparable patients whose tumours were homogeneously receptor negative (--). Mean follow-up time was 85 months. The prognostic value of this discriminant is particularly striking in the 53 patients with involved nodes at presentation. Of these, 13 were (++) and seven remain alive of whom six are disease-free, whereas 24 of the 29 (--) patients are dead. These results further suggest that receptor assay on a single homogenate gives less clinical information than do assays on multiple biopsies across the tumour. For patients with involved nodes, clinical management may best be decided after determination of 'macroheterogeneity'. PMID- 2713251 TI - Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML). AB - This interview study included 136 Los Angeles County residents aged 20-69 with CML diagnosed from 1979 to 1985 (cases) and 136 neighbourhood controls. During the 3-20 years before diagnosis of the case, more cases than controls had radiographic examinations of the back, gastrointestinal (GI) tract and kidneys, and cases more often had GI and back radiography on multiple occasions (odds ratio (OR) for back X-rays on five or more occasions = 12.0; P less than 0.01). Published estimates were used to assign a minimum dose to the active bone marrow for various radiographic procedures. ORs were estimated for cumulative marrow doses for each of four time periods (3-5 years, 6-10 years, 11-20 years and 3-20 years before the diagnosis of the case). The ORs for exposure to 0.99, 100-999, 1000-1999 and greater than or equal to 2000 mrad in the 3-20 years before diagnosis were 1.0, 1.4, 1.6 and 2.4 (P for highest exposure category and P for trend both less than 0.05). The association was strongest for the period 6-10 years before diagnosis, and the effects of radiation exposure during this period remained significant after consideration of other risk factors in a logistic regression analysis. PMID- 2713252 TI - Influence of dose intensity and density on therapeutic and toxic effects in Hodgkin's disease. AB - From 1972 to 1976, 95 patients with clinical stages I-IIIA Hodgkin's disease were treated by chemotherapy with cyclophosphamide, vinblastine, procarbazine and prednisone (CVPP) before and after extended field radiotherapy. The CVPP schedule gave: (1) a constant drug dosage for each patient independent of body surface or weight; and (2) a total drug dosage dependent on haematological tolerance, since the treatment was given for 21 days or until the leukocyte count dropped to 2 x 10(9) l-1. The drug dosage per unit body surface (or 'dose density') significantly correlates with the drop in leukocyte count (P less than 0.001) and the tumour regression at the end of the induction course (P = 0.020). Disease free survival is significantly related to dose density (P = 0.050) but not to dose intensity calculated on the duration of treatment (P = 0.240). However, after exclusion of three marginal recurrences due to border-line radiotherapy, the dose intensity significantly correlates with the disease-free survival (P = 0.031) and with the duration of complete remission (r = 0.870). PMID- 2713253 TI - Response of patients in phase II studies of chemotherapy in ovarian cancer: implications for patient treatment and the design of phase II trials. AB - Results using the same drug in phase II studies of treatment in ovarian cancer vary widely. An analysis of five phase II studies with a total of 93 patients was carried out to determine whether factors other than the efficacy of the drug affect response. The drugs for the phase II studies were chosen on the basis of in vitro activity or previous activity in humans. Univariate analysis showed that several factors were of significance in predicting response. The most significant was interval from the end of previous treatment to entry into a phase II study. Others were the original presenting stage of the patient, the second line treatment given and the best previous response to therapy. In multivariate analysis, however, only two factors were shown to be of importance which were interval and the FIGO stage of the patient. Using these two variables the discriminant analysis predicted 89% of those who did not respond and 75% of those who did, with an overall correct prediction of 85%. The importance of interval is emphasised by the observation that the response rate for those patients who progressed on treatment or who relapsed within 3-6 months of primary therapy had a response rate of less than 10%. Future phase II studies should probably exclude patients in this category, since the chance of their responding is very low. PMID- 2713254 TI - Comparison of plasma and tissue thymidine kinase activities. PMID- 2713255 TI - Reduced density and morphologic alteration of Ia and ADPase positive Langerhans cells after low-protein diet. AB - This study examined the effects of low-protein diet on the population density, morphology and histochemical characteristics of Langerhans cells. Weaned at 18 days old, BALB/c mice were divided into two groups: one group received a high protein diet (20% casein) and the other was fed an isocaloric low-protein diet (caesin 4%). After 14 days, the mice were killed and the skin of the ears was removed for investigation. Langerhans cells were visualized using ADPase and anti Ia immunoperoxidase techniques. In protein malnourished mice, the density of ADPase and Ia-positive Langerhans cells was significantly reduced, while morphometric assessment of their cross-sectional area showed a significant reduction of total cell area, cell body area and degree of arborization. Quantitative cytophotometric analysis revealed a reduction of ADPase ectoenzyme activity and decreased concentration of membrane Ia antigen. We postulate that these changes affect Langerhans cell functions, and in turn influence the immune mechanisms in the skin. PMID- 2713256 TI - Identification of the origin of cells in human basal cell carcinoma xenografts in mice using in situ hybridization. AB - In an attempt to identify more clearly the origin of cells in human basal cell carcinoma xenografts in mice, paraffin and frozen sections were subjected to in situ DNA hybridization with biotin labelled human and murine DNA probes. Human skin and mouse skin sections were used as controls. As expected, the implanted epithelium reacted with the human DNA probe and the surface epithelium and most of the stromal cells reacted with the murine probe. However, the stroma immediately surrounding the implanted epithelium contained cells of human origin mixed with murine cells. Occasional murine cells (presumed inflammatory) were present in the human implanted epithelium. Assessment showed no correlation between the degree of differentiation of the implanted epithelium and the ratio of human/murine cells in the contiguous stroma. This technique provides a sensitive test for identifying human cells in xenografts and may be useful in assessing the role of stromal cells in the differentiation of a variety of carcinomas. PMID- 2713257 TI - Sex differences in susceptibility to development of contact hypersensitivity to dinitrochlorobenzene (DNCB). AB - We have investigated the differences between the sexes in the development of contact sensitivity induced by dinitrochlorobenzene (DNCB). Ten male and 12 female subjects were sensitized with DNCB (30 micrograms applied on a 1 cm patch test disc) and challenged 1 month later with doses of 8.8, 12.5, 17.7 and 25 micrograms. The responses were measured after 48 h as increase in skinfold thickness with Harpenden callipers. Females showed a larger response at all challenge doses studied, and the slope of the log-dose response curve was significantly steeper in females. We conclude that there are significant differences in delayed type hypersensitivity between males and females. PMID- 2713258 TI - The significance of the Darier-like solar keratosis and acantholytic change in preneoplastic lesions of the epidermis. AB - Fifty-two lesions of solar keratosis from 40 patients were studied prospectively for the presence of Darier-like changes and acantholysis. Twenty-seven per cent of specimens showed some degree of these changes. The affected lesions tended to be larger and were less common on the hands, but were otherwise clinically indistinguishable from other solar keratoses. Histologically, the specimens with Darier-like changes were significantly thicker and more dysplastic. The autoradiographic labelling index was not different for the lesions with these changes indicating similar cell kinetic characteristics. It is suggested that acantholytic separation of epidermal cells within a solar keratosis may signify that the lesion has a greater invasive potential than a solar keratosis not showing this change. PMID- 2713259 TI - Allergic and irritant contact dermatitis compared in the treatment of alopecia totalis and universalis. A comparison of the value of topical diphencyprone and tretinoin gel. AB - Diphencyprone is a potent topical sensitizer, but is non-mutagenic in the Ames test (unlike dinitroclorobenzene) and remains relatively stable in solution (unlike squaric acid dibutyl ester). Seventeen patients with total loss of scalp hair (eight alopecia totalis, nine alopecia universalis) were treated by maintaining on one side of the scalp an allergic contact dermatitis induced by 2,3 diphenylcyclopropenone-I ('diphencyprone'), and on the other side an irritant contact dermatitis using tretinoin gel (Retin A). After 20 weeks, treatment with tretinoin was stopped and diphencyprone was applied bilaterally for a further 10 weeks. Satisfactory regrowth of terminal hair on the scalp was achieved in only one patient. Eyebrow, eyelash and beard regrowth was achieved in one individual whilst in another, moderate, but not cosmetically satisfactory, scalp regrowth took place. In no patient did regrowth take place at tretinoin treated sites until after diphencyprone was substituted. PMID- 2713260 TI - Urticaria successfully treated by desensitization with grass pollen extract. AB - We report a case of severe incapacitating seasonal urticaria and angioedema in an 11-year-old boy due to grass pollen sensitivity, who responded well to desensitization therapy with Timothy grass pollen extract. PMID- 2713261 TI - Treatment of actinic prurigo with PUVA: mechanism of action. AB - Five patients with actinic prurigo were treated twice weekly with PUVA. One area on the back was shielded from UVA throughout the 15-week treatment period. Before PUVA, all patients had increased erythemal sensitivity to UVA and showed abnormal augmentation of UVB erythema by topical indomethacin. After PUVA, all patients were free of photosensitive symptoms and skin that had been exposed to UVA showed normal erythemal responses. By contrast, the areas of skin that had been protected from UVA showed erythemal responses that were unchanged from pre-PUVA values. Augmentation of UVB erythema by topical indomethacin persisted, both on UVA exposed and UVA protected skin. These results show that, although PUVA is an effective treatment in actinic prurigo, it does not alter the underlying mechanism of photosensitivity. The protective effect is local and is due presumably to an increase in melanin pigmentation and epidermal thickness. PMID- 2713262 TI - Erythema multiforme due to griseofulvin. AB - Three patients are reported who developed erythema multiforme during treatment with griseofulvin. To our knowledge there have been no previously documented reports of this drug causing erythema multiforme in either the English or American literature. PMID- 2713263 TI - An unusual case of trimethylaminuria. AB - A case is reported of trimethylaminuria that first developed in adulthood without any apparent cause. The patient developed a characteristic fish odour of his sweat, urine and to his breath after the consumption of choline-rich foods. Elevated levels of trimethylamine were present in the urine after dietary tests and identified by means of gas chromatography. PMID- 2713264 TI - A family with Dowling Degos disease showing features of Kitamura's reticulate acropigmentation. AB - We report a family showing a combination of features described in the two, rare genodermatoses, Dowling Degos disease and Kitamura's acropigmentatio reticularis. PMID- 2713265 TI - Discoid lupus erythematosus associated with the anticardiolipin syndrome. PMID- 2713266 TI - Rare-earth doped eyewear provide for safer laser surgery. PMID- 2713267 TI - Successful treatment of genital and oral ulceration in Behcet's disease with topical 5-aminosalicylic acid (5-ASA) PMID- 2713268 TI - Cataracts associated with long-term topical steroids. PMID- 2713269 TI - Effect of cell growth and cell differentiation on 1-beta-D arabinofuranosylcytosine metabolism in myeloid cells. AB - Resistance of leukaemic blasts to 1-beta-D-arabinofuranosylcytosine (ara-C) has been shown to be associated with changes in the metabolism of this drug. However, effects of cell growth and maturation stage on ara-C metabolizing enzymes have to be excluded as a possible cause of different enzyme activities in leukaemic blasts between nonresponders and patients achieving complete remission. We evaluated the effects of cell cycle phase and cell differentiation on the activity of cytidine deaminase, deoxycytidylate deaminase and deoxycytidine kinase in myeloid cell lines. Our data indicate that different enzyme profiles in nonresponders might not only be caused by the emergence of mutator phenotypes but may also reflect the growth and maturation stage of leukaemic blasts. PMID- 2713270 TI - Recombinant human erythropoietin has little influence on megakaryocytopoiesis in mice. AB - The availability of a preparation of recombinant human erythropoietin (rEp) prompted us to investigate the role of Ep in the regulation of megakaryocytopoiesis in mice, using experimental procedures by which the effects on the mitotic and post-mitotic compartment of megakaryocytes could be evaluated separately. In agar cultures of murine bone marrow cells, either serum-depleted or serum-supplemented, rEp (0.1-2 U/ml) did not stimulate megakaryocyte colony formation and when it was added to suboptimal amount of spleen cell-conditioned medium (SCM), it failed to show a significant synergistic activity. On the contrary, rEp increased the number of megakaryocytic colonies developed from splenic precursors in the presence of suboptimal amounts of SCM, although it was unable per se to stimulate colony formation. The effects of rEps on megakaryocyte maturation and platelet production were studied in vivo evaluating the incorporation of 75Se-selenomethionine into platelets, the platelet count and platelet size, and the number of megakaryocyte precursors (small acetylcholinesterase positive cells, sAchE) in the bone marrow of mice injected with 1-8 U of rEp. No modification of these parameters was found in comparison with control mice. On the other hand, rEp increased the number of recognizable splenic megakaryocytes in a dose-dependent fashion. These data suggest that rEp has little influence on megakaryocytopoiesis, at least at the doses we used and which are known to elicit a maximal response of erythropoiesis. However, a subset of megakaryocytes with particular kinetic properties, such as those in the spleen of mice, may be responsive to relatively high doses of rEp. The significance of this observation in the overall regulation of megakaryocytopoiesis remains to be determined. PMID- 2713271 TI - HRAS1 and INS genes are relocated but not structurally altered as a result of the t(7;11)(p15;p15) in a clone from a patient with acute myeloid leukaemia (M4). AB - A patient whose leukaemic cells carried the rare t(7;11)(p15;p15) was diagnosed as having acute myelomonocytic leukaemia (AML-M4), and supports the association of this specific translocation with forms of acute myeloid leukaemia showing differentiation. Blast phase chronic myeloid leukaemia was excluded by lack of involvement of the ABL and BCR genes. Chromosome in situ hybridization studies showed that both the HRAS1 and INS genes were present on the terminal part of chromosome 11p which was translocated to chromosome 7p. Neither HRAS1 nor INS were structurally rearranged. Field inversion gel electrophoresis showed that a 400 kb fragment encompassing HRAS1 was structurally entire in leukaemic DNA. Because the INS gene, which was also translocated, is probably located proximal to HRAS1 on chromosome 11p, it is unlikely that HRAS1 was near the chromosome 11 breakpoint or involved in this leukaemia. PMID- 2713272 TI - Menstrual cyclic thrombocytopenia. AB - We studied three patients with cyclic thrombocytopenia which occurred in phase with the menstrual cycle. The platelet count in each patient reached a nadir of 5 20 x 10(9)/l at the onset of menses. Thrombocytopenia was associated with bruising, epistaxis and menorrhagia and was followed 5-14 d later by normal or elevated platelet counts (up to 900 x 10(9)/l). Repeat bone marrow examinations performed at the time of reduced platelet counts showed megakaryocytic hyperplasia. 111In-platelet-disappearance from the circulation was measured in one patient; T50, time to half activity, was shortened to 0.7 d during the period of thrombocytopenia and was prolonged to 3.2 d when the platelet count increased (normal platelet T50 is about 4.8 d). In two of three patients platelet associated anti-glycoprotein Ib autoantibodies were present and remained elevated despite normalization of the platelet count. In both of two patients the decrease in platelet count at the onset of menses was associated with an increase in the expression of monocyte Fc gamma receptors. Based on the reported capacity of oestrogenic hormones to modulate macrophage Fc gamma receptor expression, we propose that hormonal changes during the menstrual cycle may alter the Fc gamma receptor-mediated clearance of antibody-coated platelets by macrophages, modulate platelet survival, and cause cyclic thrombocytopenia. PMID- 2713273 TI - Decreased frequency of bone marrow NK progenitors in aplastic anaemia. AB - Twelve patients with aplastic anaemia were studied with regard to the frequency of NK progenitors in the bone marrow (BM) to investigate the mechanism of depressed NK activity and low NK cell count in the peripheral blood. NK cell (CD16+ cell) count and NK (K562) activity were significantly decreased (P less than 0.02 and P less than 0.001, respectively) in the patients as compared to eight healthy control subjects. Nylon wool non-adherent (NW-NA) BM mononuclear cells (MNC) of each patient and control were prepared. Mature T and NK cells were extensively depleted by sheep red cell rosette formation followed by a centrifugation on Ficoll-Hypaque and monoclonal antibody mediated complement dependent cytolysis. Those selected BM cells were cultured in the presence of recombinant interleukin 2 (rIL2). Generation of NK activity was significantly decreased (P less than 0.01) in the patients with aplastic anaemia. Frequency of NK progenitors in the selected BM cells assayed by the limiting dilution method was significantly decreased in those patients (P less than 0.05). The frequency of BM NK progenitors relative to NW-NA BM cells were related to NK cell count (P less than 0.01). Those results indicate that depressed NK activity in aplastic anaemia is closely related to decreased NK cell count which is probably due to decreased production of NK cells in the BM. PMID- 2713274 TI - Gastric recurrence of acute lymphoblastic leukaemia mimicking graft-versus-host disease. PMID- 2713275 TI - Deletion of the short arm of chromosome 7 in chronic monocytic leukaemia undergoing blast cell transformation. PMID- 2713276 TI - Variant (3;21) translocation and megakaryocytic involvement in blastic crisis of Philadelphia positive chronic myeloid leukaemia. PMID- 2713278 TI - Abstracts of papers, combined scientific meeting of the British Society for Haematology and The Netherland Society for Haematology. Canterbury, 5-7 April 1989. PMID- 2713277 TI - Histology of neuroblastoma involving bone marrow. PMID- 2713279 TI - Organic dust toxic syndrome among farmers. AB - Clinical symptoms and exposure conditions were investigated in 80 farmers with organic dust toxic syndrome, defined as the occurrence of febrile reactions after exposure to organic dust in subjects with no evidence of allergic alveolitis. The material was compiled from a field study of febrile reactions in the farming community and the diagnosis was based on interviews performed by physicians. Of the 75 men (mean age 44) and five women (mean age 39), only 13% of the men and none of the women were current smokers. One attack had been experienced by 44% and the remaining subjects had had two or more attacks, often several years apart. The duration of symptoms was 24 hours or less in 46% of the farmers and in 95% of the cases the symptoms lasted less than one week. The attacks were most common in the autumn and were usually provoked by handling grain (80% of the farmers with organic dust toxic syndrome). Other causes were hay, straw, wood chips, and silocapping material. The material was usually described as extremely mouldy and the episodes were usually provoked by unusual work tasks such as cleaning grain bins or removing mouldy feed. Twenty three farmers had consulted physicians: five of nine examined during symptoms had slightly abnormal chest radiographs and two of four examined had decreased arterial oxygen tension. Spirometry performed during a symptom free interval was normal. PMID- 2713280 TI - Potential of physiologically based pharmacokinetics to amalgamate kinetic data of trichloroethylene and tetrachloroethylene obtained in rats and man. AB - A physiologically based pharmacokinetic model was used to amalgamate information obtained in rats and man by various routes of exposure to trichloroethylene (TRI) and tetrachloroethylene (TETRA). Since there have been no pharmacokinetic data on drinking water exposure, drinking water exposure to TRI was conducted in rats using 14C-TRI. Several partition coefficients of TRI and TETRA were also determined in the present study. Simulations of the kinetics of TRI and TETRA were made with the unified physiologically based pharmacokinetic model to determine whether reported pharmacokinetic data from different routes of exposure to TRI and TETRA (inhalation, intravenous, drinking water in rats, and inhalation in man) could be simulated. The results indicated that the unified model used in this study successfully simulates the pharmacokinetics of TRI and TETRA irrespective of the routes and exposure intensities. Subsequently, sensitivity analyses were performed. Since both TRI and TETRA require bioactivation to produce their toxicity, the amounts metabolised in the body were used as indicators of toxicity. Vmax (maximum velocity of metabolism in the liver), alveolar ventilation, and the blood/air partition coefficient had a more profound effect than other factors on the amounts of these chemicals metabolised when parameter values were altered. The model was applied to simulate the biologically permissible values of exhaled air concentration and blood concentration of these compounds for monitoring exposure intensities in occupational settings. The simulated maximum permissible values showed good agreement with those obtained by field studies. Finally, the model was applied to the risk assessment of drinking water exposures to TRI and TETRA, assuming that a man weighing 70 kg drinks 2 l of the most contaminated drinking water ever reported in the US; 32 ppb for TRI and 5 ppb for TETRA. The simulated metabolised amounts of TRI and TETRA under steady state condition in man were a fifth of an order of magnitude lower than non-cancer causing metabolised amounts of TRI and TETRA in rats through inhalation. PMID- 2713281 TI - A method for the retrospective estimation of the individual respiratory intake of a highly and a poorly metabolising solvent during rest and physical exercise. AB - A method for the retrospective estimation of the individual respiratory intake was tested. The method is based on system dynamics. Subjects were exposed simultaneously to the poorly metabolising solvent tetrachloroethene (PER, perchloroethylene) and the highly metabolising trichloroethene (TRI) at rest, 30, and 65 watt physical exercise. The time courses of the alveolar concentration (Calv) of both PER and TRI were measured. A retrospective estimation of the individual intake of PER could be carried out up to 400 hours after exposure with 10-20% accuracy, irrespective of the level of exercise. The estimates of the intake of TRI are less accurate. The Calv in the 1-15 hours postexposure permits the estimation of the intake of TRI within a mean error of 25% for most subjects. For men the method may be applied up to 48 hours after exposure within 20% error. For women the intake estimates showed a poor accuracy with the use of Calv beyond the day of exposure. PMID- 2713282 TI - China clay workers in the south west of England: analysis of chest radiograph readings, ventilatory capacity, and respiratory symptoms in relation to type and duration of occupation. AB - In 1985, employees in the china clay industry were offered chest x ray examinations and 4478 (52.6% of the total workforce) accepted. Of these, 4167 workers and pensioners of the largest single employer also completed occupational histories, respiratory symptom questionnaires, and underwent ventilatory capacity tests. The x ray readings (read to the 1980 ILO classification) of the 4167 workers and pensioners were analysed to seek relations between the indices of pulmonary health and occupational exposure. The information available, particularly on occupational history, was more detailed than in previous studies of 1961, 1977, and 1981. Analyses show that in the improved operating conditions of recent years the average worker exposed to dust only after 1971 would not expect to develop category 1 pneumoconiosis through a full working life in any of the industry's occupations. For those with exposure before 1971 the category reached will depend on the amount of early exposure, but the rate of development of pneumoconiosis since 1971 is about half that before 1971. The milling of china stone, a practice that ceased over 15 years ago in the china clay industry, had by far the largest effect on x ray category, whereas of the current occupations, employment in china clay attritor mills has the greatest effect. Ventilatory capacity is related to x ray category as well as age, and results for loss of ventilatory capacity in relation to age, x ray category, and smoking habits were similar to the results in previous studies. Respiratory symptoms are associated with smoking class and a loss in ventilatory capacity (FVC or FEV1), FEV1 being the most dominant. Allowing for this, there was no further effect for years of exposure, x ray category, or age. PMID- 2713283 TI - Medical planning for toxic releases into the community: the example of chlorine gas. AB - Emergency planning for a major accidental release of chlorine gas from industrial installations into the community is outlined for emergency services and hospitals. Realistic planning has been made possible with the advent of computer models for gas dispersion which may be used to estimate the numbers of deaths and casualties, according to their severity. For most purposes sufficient accuracy may be obtained by using a small number of computer analyses for the most serious reasonably foreseeable events under typical day and night weather conditions, and allowing for the emergency response to be scaled up or down according to the size of an actual release. In highly populated areas triage should be preplanned to deal with a large number of victims; field stations will be needed for the treatment and observation of minor casualties. The management and treatment of casualties is summarised. The best protection against a gas cloud is afforded by buildings whose windows, doors, and ventilation systems have been closed. Hospitals in the vicinity of an installation should draw up plans to protect patients and staff. Coordination in a disaster will require toxicological and epidemiological expertise and hospital plans should allow for this. PMID- 2713284 TI - What is measured by the alcian blue binding to red blood cells? PMID- 2713285 TI - High urinary cadmium concentration in a case of gastric cancer. PMID- 2713286 TI - Can social support influence pregnancy outcome? PMID- 2713287 TI - A prospective longitudinal study of social, psychological and obstetric factors in pregnancy: response rates and demographic characteristics of the 8556 respondents. AB - This paper introduces the Mater Misericordiae Mothers' Hospital-University of Queensland Study of Pregnancy, a prospective study of 8556 pregnant women interviewed at their first clinic visit, and subsequently interviewed some days after the birth of the baby and again 6 months later. Additional data were derived from the medical record of the pregnancy and delivery. The study was designed to assess the impact of social, psychological and obstetric factors on pregnancy outcome. We present here details of the study design, sampling, response rates and demographic characteristics of the sample. PMID- 2713288 TI - Socio-economic status and pregnancy outcome. An Australian study. AB - A prospective cohort of 8556 pregnant women attending the Mater Misericordiae Mothers' Hospital in Brisbane was examined to consider the impact of socio economic status on pregnancy outcome. The indicators of socio-economic status selected were family income, maternal education and paternal occupational status. Pregnancy outcomes considered were preterm delivery, low birthweight, low birthweight for gestational age, and perinatal death. Subsidiary analyses were also undertaken for Apgar scores, time to establish respiration, need for mechanical respiration and admission to intensive care. Before adjustment, the main consistent association was between the occupational status of the father and three measures of perinatal morbidity. Initial adjustment for the mother's socio demographic background and weight/height ratio reduced the strength and statistical significance of the above associations, while further adjustment for lifestyle variations between the three status groups further reduced the above associations to marginal statistical significance. The findings suggest that observed class differences in pregnancy outcome are attributable to the mother's personal characteristics (height/weight, parity) and her lifestyle. PMID- 2713289 TI - Unemployment and reproductive outcome. An Australian study. AB - The Mater-University of Queensland Study involves the follow-up of 8556 pregnant women who were enrolled at their first clinic visit. This analysis compares four groups of women categorized according to their own and their partners' employment status. Group 1 comprised women unemployed, partners not unemployed. Group 2 comprised women not unemployed with unemployed partners. Group 3 comprised women and partners who were both unemployed. In group 4 neither partner was unemployed. Initial analysis showed that there was a significant association between birthweight and birthweight for gestational age, and unemployment as reported by mothers. After adjustment for lifestyle variables (principally smoking) there were no remaining statistically significant associations. PMID- 2713290 TI - C-reactive protein in preterm labour: association with outcome of tocolysis and placental histology. AB - Tocolytics were administered in 66 consecutive women in uncomplicated preterm labour with intact fetal membranes (53 singleton and 13 twin pregnancies). C reactive protein (CRP), a marker of infection, was determined daily and used retrospectively to investigate the role of subclinical infection in preterm labour and to predict the efficacy of tocolysis and the development of a clinical perinatal infection. CRP was also determined in 66 women in uncomplicated labour at term (53 singleton and 13 twin pregnancies). The placenta was examined for histological evidence of infection in all patients who were delivered before 36 weeks (n = 21) and in all women in the control group (n = 66). Elevated CRP levels were more often found in patients who were refractory to tocolysis, suggesting an underlying infectious morbidity. Placental infection was found in 62% of the preterm delivery group and in 12% of the control group. There was an association between elevated CRP levels and histological evidence of placental infection. However, confounding factors such as urinary tract infections limit the usefulness of the CRP test. Because CRP cannot predict clinical perinatal infection accurately, its clinical relevance is very limited. PMID- 2713291 TI - Placental hormones and maternal glucose metabolism. A study of fetal growth in normal pregnancy. AB - The interrelations between three placental hormones (oestradiol, progesterone and hPL), maternal glucose metabolism, maternal anthropometry and fetal growth were studied in a sample of 52 carefully selected pregnant women. A relation was found between infant birthweight and both fasting blood glucose and t1/2 of glucose of an intravenous glucose tolerance test at week 37 of pregnancy. The serum concentrations of the placental hormones were not significantly related to the glucose variables. The correlation between birthweight and the maternal levels of hPL in late pregnancy (r = 0.60) persisted when fasting blood glucose and t1/2 of glucose were taken into account. Maternal fat mass was found to explain more of the variation in basal insulin levels around week 37 than did the placental hormones. PMID- 2713292 TI - Induction of abortion in early first trimester human pregnancy using epostane. AB - The role of epostane (Sterling Winthrop, Guildford, UK), a competitive inhibitor of the 3 beta hydroxysteroid dehydrogenase enzyme system (3 beta-HSD), as an abortifacient agent in early human pregnancy has been studied in 54 women. All were less than 49 days from their last menstrual period. Thirty were treated with 200 mg of epostane every 8 h for 7 days and 24 were given 200 mg every 6 h for 7 days. This caused a sustained reduction in circulating progesterone concentrations, a smaller fall in 17 beta-oestradiol and no effect on serum cortisol. Abortion occurred in 21 women (70%) in the lower dosage group and in 20 women (87%) in the higher dosage group. Abortion was incomplete in 6 of these 41 women. A worsening of pregnancy nausea and vomiting was noted by 66% of women in the first group and 84% in the second. There was no delay in the resumption of normal menstruation following abortion. This study confirms the potential of epostane as an effective inhibitor of ovarian and placental steroidogenesis and as a potent abortifacient agent in early human pregnancy. PMID- 2713293 TI - Absorption of irrigating fluid during laser photocoagulation of the endometrium in the treatment of menorrhagia. AB - Twelve women undergoing laser ablation of the uterus for menorrhagia were studied by haemodynamic, biochemical and haematological indices including radioisotope dilution studies of plasma volume to assess the degree of fluid absorption into the circulation during laser surgery. There was a significant rise in central venous pressure and serum chloride and a significant decrease in plasma protein, albumin and haematocrit. Absorption of the irrigating fluid used was demonstrated and in one woman whose case history is illustrated this was excessive. PMID- 2713294 TI - The role of postoperative alkylating agent therapy in early-stage epithelial ovarian cancer. AB - Forty-six patients with early (Stage I and II) ovarian cancer referred as free of residual disease after primary surgery, selected for high-risk features, were treated with adjuvant single-agent alkylating therapy comprising either intravenous cyclophosphamide (1 g/m2) in 36 patients, or oral melphalan (0.2 mg/kg daily for 5 days) in eight. Cyclophosphamide was repeated every 3 weeks for 10 cycles and melphalan every 6 weeks for 12 cycles. With a median follow-up of 36+ months, 18 patients have relapsed. The actuarial 5-year relapse-free survival was 48% and the overall 5-year survival was 54%; median survival was 84 months. Pretreatment FIGO stage was the single most important predictor of relapse-free and overall survival duration. For patients with Stage IA and IB tumours the 5 year actuarial relapse-free survival was 89%; for patients with stage IC and II (all substages), the 5-year relapse-free survival was 24% (P = 0.001). For this latter group adjuvant single alkylating agent therapy was not adequate and alternative therapeutic regimens are required. The problem of suboptimal primary surgical staging is also addressed. PMID- 2713295 TI - Lipoprotein and apolipoprotein levels in postmenopausal women on continuous oestrogen/progestogen therapy. AB - Levels of serum lipoproteins and apolipoproteins were monitored for 48 weeks in two groups of women taking part in a double-blind trial of continuous oestrogen/progestogen with and without oestriol. There were no differences between the effects of the two treatments on the substances measured. Triglycerides did not change and there was a transient fall in very low density lipoprotein cholesterol. Low density lipoprotein cholesterol fell over the first 24 weeks but rose thereafter to pretreatment levels. There was a decrease in high density lipoprotein (HDL) cholesterol due to a transient fall in HDL2 cholesterol and a gradual decrease in HDL3 cholesterol. Consequently, the only change in lipid levels present after 48 weeks was a decrease in HDL3 cholesterol, the clinical significance of which is uncertain. There was, however, an increase in apoprotein B levels and decreases in apoprotein AI and AII levels. These alterations in apoprotein levels may be unfavourable, since apoprotein B levels have been positively correlated and apoprotein AI and AII levels negatively correlated with coronary heart disease. PMID- 2713296 TI - Genetic control of susceptibility to eclampsia and miscarriage. PMID- 2713297 TI - Umbilical artery flow velocity waveforms in fetuses dying with congenital anomalies. PMID- 2713298 TI - Serial oxytocin levels in amniotic fluid and maternal plasma during normal and induced labour. PMID- 2713299 TI - Classical versus low-segment transverse incision for preterm caesarean section: maternal complications and outcome of subsequent pregnancies. PMID- 2713300 TI - Changes in colour contrast sensitivity associated with operating argon lasers. AB - A new test of colour vision using computer graphics has been used to obtain quantitative estimates of colour contrast sensitivity in ophthalmologists before and after they have treated patients by argon laser retinal photocoagulation. The colour vision of all subjects is normal when tested with the 100-hue test and HRR (Hardy, Rittler, Rand) plates, but colour contrast sensitivity measured along a tritan colour confusion line is selectively impaired after a treatment session. No such change occurs after a medical session spent examining patients with a fundus camera. In younger ophthalmologists the sensitivity recovers several hours after the treatment session ends, but in some persons there is a prolonged and possibly permanent elevation of threshold. PMID- 2713301 TI - Non-contact tonometry in the postoperative eye. AB - The Keeler Pulsair non-contact tonometer was compared with the Goldmann applanation tonometer in a series of 48 eyes after operation. A correlation coefficient of 0.92 (p less than 0.001) was found between the two instruments, with the Pulsair having a statistically significant tendency to overread the Goldmann slightly in this situation. The Pulsair was, however, shown to be effective in the identification of postoperative ocular hypertension with a high degree of sensitivity and specificity and good patient compliance, while reducing the risk of cross infection. PMID- 2713302 TI - Leber's congenital amaurosis--a new syndrome with a cardiomyopathy. AB - Seven members of four families had nystagmus noted by 4 months of age, poor vision, photophobia, and a markedly reduced or absent electroretinogram. Six of these patients had a life threatening episode of cardiac failure in infancy. There were also two neonatal deaths, and one of the affected children died at 2 years and one at 19 years. The five surviving children are well, remain with nystagmus, and have visual acuities of less than 6/60, with the eldest two having lost perception of light. They have a short obese habitus distinct from that of their unaffected siblings and parents. PMID- 2713303 TI - The EEC syndrome and its ocular manifestations. AB - The EEC syndrome (ectrodactyly or lobster-claw deformity, ectodermal dysplasia, and cleft lip and palate) is a rare disorder with autosomal dominant inheritance, variable expression, and in some families lack of penetrance. We present the findings in five cases with emphasis on the ocular findings. Lacrimal surgery was performed on three patients with good results in each case. We also report the occurrence of spontaneous corneal perforation in two cases, a complication not previously recognised. The ophthalmic care of these patients must be pursued long term, as progressive visual impairment may be the most disabling feature of the syndrome. PMID- 2713304 TI - Visual evoked potentials in dissociated vertical deviation: a reappraisal. AB - Pattern reversal and flash evoked potentials were recorded in 13 children with dissociated vertical deviation (DVD). No electrophysiological evidence was found to support the notion that patients with DVD have an anomalous (albinoid) projection of visual fibres originating from the temporal retina of each eye. However, DVD patients had significantly smaller monocular and binocular pattern evoked responses than age matched controls. Explanations are given for this finding and for the occipital VEP asymmetries reported by other workers. PMID- 2713305 TI - Immunopathology of trachomatous conjunctivitis. AB - Upper palpebral conjunctival biopsy specimens obtained from eight patients with active trachoma were examined by routine histological and immunohistochemical methods. The epithelium expressed class I major histocompatibility complex (MHC) products throughout and class II MHC products in the superficial layers. The epithelial inflammatory infiltrate consisted of polymorphonuclear leucocytes, macrophages, T lymphocytes, and dendritic cells. In the underlying stroma the inflammatory infiltrate was organised as B lymphoid follicles, and there was also a diffuse infiltrate consisting of plasma cells and scattered B lymphoid cells, dendritic cells, T cells, macrophages, and polymorphonuclear leucocytes. Each type of cell has its special location in the tissue. Plasma cells were located on a subepithelial band and as a dense infiltrate round the acini of accessory lacrimal glands. IgA+ plasma cells outnumbered IgG+ cells, whereas IgM+ and IgE+ cells were few. Our data provide good evidence for the presence of both humoral and cell mediated immune responses and a possible role for autoimmune mechanisms in the conjunctival tissues of trachoma patients. PMID- 2713306 TI - Ptosis following cataract and trabeculectomy surgery. AB - A prospective study was carried out to estimate the incidence and severity of ptosis following cataract extraction and trabeculectomy. A postoperative ptosis of 2 mm or more was found in 6.2% of all cases. In this series the incidence of ptosis following surgery under local anaesthesia was greater than that under general anaesthesia. The aetiology and management of this complication are discussed. PMID- 2713307 TI - Visual toxicity of synthetic retinoids. AB - Twelve patients treated with isotretinoin, a synthetic vitamin A analogue, were assessed before, during, and after therapy. Significant falls occurred in the amplitude of the a waves of the scotopic electroretinogram. PMID- 2713308 TI - Familial iris melanosis--a misnomer? AB - Iris melanosis is an unusual condition characterised by the presence of minute, discrete, pigmented elevations arising from the anterior surface of the iris. We encountered two unrelated Mexican families in which all children, but no parent, had varying degrees of the condition bilaterally. Some family members also gave findings suggestive of ocular hypertension. No family member had any other ocular or cutaneous pigmentary changes with the exception of a hairy naevus on the thigh of one member. To our knowledge these are the first families reported with more than one member having isolated iris melanosis. This is also the first report of a possible relationship with ocular hypertension. Finally we suggest that the term 'melanosis' may be a misnomer, since the condition is characterised not by abnormal iris hyperpigmentation but by discrete, round elevations on the anterior iris surface. PMID- 2713309 TI - Atypical band keratopathy following long-term pilocarpine treatment. AB - Two patients with an atypical form of band keratopathy following long-term pilocarpine treatment are described. The keratopathy is thought to have resulted from the presence of the preservative phenylmercuric nitrate in the pilocarpine drops. Symptoms of reduced acuity, visual haloes, and recurrent epithelial erosions were relieved by removal of the opacities. PMID- 2713310 TI - Fundus changes in (type II) mesangiocapillary glomerulonephritis simulating drusen: a histopathological report. AB - We report for the first time to our knowledge the histopathological findings in the eye of a patient with type II mesangiocapillary glomerulonephritis (dense deposit disease) in which a deposit of material morphologically very similar to that which is pathognomonic for the disease in the kidney was demonstrated in Bruch's membrane. The nature of the deposit in the renal lesion is unknown but is considered to represent a structural alteration secondary to a reaction with anticomplement antibody. Clinically the fundus appearance resembled that seen in drusen. PMID- 2713311 TI - Vitrectomy in aphakia: a simplified technique for fundus visualisation. AB - By using a small air bubble that fills about two thirds of the anterior chamber the erect image of the fundus of the aphakic human eye can be visualised clearly during vitrectomy, enabling the surgeon to operate without the need for vitrectomy lenses. The refractive power of the human aphakic eye is calculated here and the image site and size are presented. PMID- 2713312 TI - Leber's hereditary optic atrophy: further evidence for a defect of cyanide metabolism? AB - We studied one patient with Leber's optic atrophy (LOA) in the acute stage and 12 at the chronic stage of the disease, and measured the activity of rhodanese in white blood cells and the level of cyanide in whole blood. In the patient with acute disease the blood cyanide level was significantly increased at first. Treatment of this patient with cyanide antagonists reduced his cyanide level, but this was not accompanied by improvement in visual function. Rhodanese activity was normal in all patients, as were the blood cyanide levels in each of the 12 patients at the chronic stage of the disease. These findings suggest a temporary disturbance of cyanide metabolism during the acute phase of the disease in this family. The abnormal metabolic mechanism was not identified. PMID- 2713313 TI - Ocular horn. AB - The case of a horn-like hyperplasia of the caruncle of the left eye in a 3-month old child is reported. An atavistic origin of this growth as a vestigial upper incisor is suggested from the anatomical location of the horn. PMID- 2713314 TI - Unfixed reference, monocular occlusion, and developmental dyslexia--a critique. PMID- 2713315 TI - Oral Crohn's disease revisited--a 10-year-review. AB - The clinical presentation of seven patients with oral lesions of Crohn's disease, but with no evidence of other gastrointestinal involvement was described by Tyldesley in 1979. The clinical progress of five of these patients available for review is reported after a minimum period of 10 years. The gross oedema of the lips and painful buccal lesions present in all five patients have shown gradual resolution from the time of initial diagnosis. The nomenclature for oral Crohn's disease and related conditions is discussed with specific reference to the term 'orofacial granulomatosis'. PMID- 2713316 TI - The marginal mandibulectomy for the treatment of mandibular tumours. AB - With the knowledge and techniques gained from orthognathic surgery and more precise imaging techniques, it has become more practical to carry out rim or marginal resections for some malignant tumours of the alveolus to preserve mandibular continuity and yet have adequate tumour margins. This is of great functional and cosmetic importance to the patient. A study of 11 patients is presented to analyse criteria for carrying out this procedure. PMID- 2713317 TI - Parapharyngeal neurilemmomas. AB - Parapharyngeal neurilemmomas are uncommon benign tumours. Two patients are reported with one tumour arising from the vagus and the other from the hypoglossal nerve. Access to the vagal tumour was accomplished with the aid of an osteotomy at the angle of the mandible. Theoretically these lesions can be enucleated with preservation of the nerve or resected and repaired with a nerve graft. However, these alternative procedures were impractical in both these patients and the explanations for this are discussed. PMID- 2713318 TI - The radiographic and surgical evaluation of meniscal dysfunction of the temporomandibular joint. AB - A retrospective study of 106 patients who underwent temporomandibular joint surgery for meniscal dysfunction was conducted. The patients were evaluated by tomography and arthrography of the temporomandibular joint and abnormalities of the hard and soft tissue structures were determined by these investigations and compared directly with the findings at surgical examination. Tomography had a high degree of correlation with bony pathology as did arthrography with meniscal displacement. The arthrogram also frequently revealed the presence of meniscal scarring associated with the head of condyle in long-standing cases, but gave an incidence of 3% false/positive findings of a perforation of the meniscus. PMID- 2713319 TI - Experimental fractures of the mandibular body of sheep and dogs. A new technique. AB - In order to create artificial fractures in animals resembling those which occur naturally, a new technique for fracture production was developed. Using a specially designed clamp, artificial fractures were produced in the mandibular body of seven sheep and 12 dogs. Radiographical analysis of the effects of the clamp on the mandibular body showed simple, single vertical fractures in the buccal cortex, inferior border and the alveolar process comparable to those which occur naturally. Using the technique described it was possible, in all cases, to carry out treatment with the use of 4-hole poly(L-lactide) plates and screws. PMID- 2713320 TI - Ameloblastic carcinoma. PMID- 2713321 TI - The shortage of consultant posts. PMID- 2713322 TI - Shrinkage of muscle flaps. PMID- 2713323 TI - A comparison of the use of external pin and transnasal Kirschner wire fixation for the unstable tripod malar fracture: a prospective trial. AB - A prospective study involving 54 patients was undertaken to compare external pin and transnasal Kirschner wire (K-wire) fixation of the unstable, non-comminuted, tripod malar fracture. The features assessed were: (1) The aesthetic result. (2) The ease and speed of both procedures. (3) Per-operative complications. (4) Post operative complications. (5) Patient tolerance of the procedure. PMID- 2713324 TI - Nitrite, a new substrate for nitrogenase. AB - We have examined the reactivity of the purified component proteins of Azotobacter vinelandii nitrogenase (Av1 and Av2) toward nitrate and nitrite. Nitrate has no effect on H2 evolution or C2H2 reduction by nitrogenase and thus is neither a substrate nor an inhibitor. Nitrite dramatically inhibits H2 evolution. This inhibition has two components, one irreversible and one reversible upon addition of CO. The irreversible inhibition is due to nitrite inactivation of the Fe protein. The rate of this inactivation is greatly enhanced by addition of MgATP, suggesting the [4Fe-4S] cluster is the site of nitrite attack. The reversible inhibition does not represent an inhibition of electron flow but rather a diversion of electrons away from H2 evolution and into the six-electron reduction of nitrite to ammonia. Thus, nitrogenase functions as a nitrite reductase. PMID- 2713325 TI - Purification and characterization of an isoform of protein kinase C from bovine neutrophils. AB - Protein kinase C (PKC) from bovine neutrophils was purified 1420-fold. Subcellular fractionation analysis of bovine neutrophil homogenate in the presence of EGTA indicated that more than 95% of the PKC activity was present in the soluble fraction. The purification procedure from cytosol involved sequential chromatographic steps on DE-52 cellulose, Mono Q, and phenyl-Sepharose. Whereas bovine brain PKC could be resolved into four isoenzymatic forms by chromatography on a hydroxylapatite column, bovine neutrophil PKC was eluted in a single peak, suggesting that it corresponded to a single isoform. The apparent molecular weight of bovine neutrophil PKC was 82,000, as judged by sodium dodecyl sulfate polyacrylamide gel electrophoresis. By filtration on Sephadex G-150, a molecular weight of 85,000 was calculated, indicating that bovine neutrophil PKC in solution is monomeric. Its isoelectric point was 5.9 +/- 0.1. Bovine neutrophil PKC was autophosphorylated in the presence of [gamma-32P]ATP, provided that the medium was supplemented with Mg2+, Ca2+, phosphatidylserine, and diacylglycerol; phorbol myristate acetate could substitute for diacylglycerol. Autophosphorylated PKC could be cleaved by trypsin to generate two radiolabeled peptides of Mr 48,000 and 39,000. The labeled amino acids were serine and threonine. During the course of the purification procedure of bovine neutrophil PKC, a protein of Mr 23,000, which was abundant in the cytosolic fraction of the homogenate, was found to exhibit a strong propensity to PKC-dependent phosphorylation in the presence of [gamma-32P]ATP, Mg2+, Ca2+, phosphatidylserine, and diacylglycerol. This protein was recovered together with PKC in one of the two active peaks eluted from the Mono Q column at the second step of PKC purification.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713326 TI - Effects of conversion of an invariant tryptophan residue to phenylalanine on the function of human dihydrofolate reductase. AB - The binding site residue Trp-24 is conserved in all vertebrate and bacterial dihydrofolate reductases of known sequence. To determine its effects on enzyme properties, a Trp-24 to Phe-24 mutant (W-24-F) of human dihydrofolate reductase has been constructed by oligodeoxynucleotide site-directed mutagenesis. The W-24 F mutant enzyme appears to have a more open or flexible conformation as compared to the wild-type human dihydrofolate reductase on the basis of results of a number of studies. These studies include competitive ELISA using peptide-specific antibodies against human dihydrofolate reductase, thermal stability, and protease susceptibility studies of both mutant W-24-F and wild-type enzymes. It is concluded that Trp-24 is important for maintaining the structural integrity of the native enzymes. Changes in relative fluorescence quantum yield indicate that Trp-24 is buried and its fluorescence quenched relative to the other two tryptophan residues in the wild-type human reductase. Kinetic studies indicate that kcat values for W-24-F are increased in the pH range of 4.5-8.5 with a 5 fold increase at pH 7.5 as compared to the wild-type enzyme. However, the catalytic efficiency of W-24-F decreases rapidly as the pH is increased from 7.5 to 9.5. The Km values for dihydrofolate are also increased for W-24-F in the pH range of 4.5-9.5 with a 30-fold increase at pH 7.5, while the Km value for NADPH increases only ca. 1.4-fold at pH 7.5 as compared to the wild type.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713327 TI - Activity and spectroscopic properties of bacterial D-amino acid transaminase after multiple site-directed mutagenesis of a single tryptophan residue. AB - One of the three tryptophan residues per subunit of thermostable D-amino acid transaminase, Trp-139, is close to the active-site Lys-145 in the sequence of the protein. This tryptophan has been changed to several other types of residues by site-directed mutagenesis. The only mutant protein that was sufficiently active and stable for study had Phe substituted for Trp (W139F). The spectroscopic properties of this mutant enzyme differed from those of the wild-type transaminase. For example, denatured W139F showed the expected decrease in fluorescence emission intensity at 350 nm due to the deletion of one Trp residue, but the fluorescence emission of the wild-type and W139F enzymes in the native state did not differ in intensity. This result suggests that the fluorescence of Trp-139 in the native, wild-type enzyme is not manifested perhaps due to its proximity to the coenzyme, pyridoxal phosphate. Results of energy-transfer studies at several wavelengths could also be interpreted as due to the proximity of Trp-139 and the coenzyme. Circular dichroism studies indicated that the negative Cotton effect at 420 nm due to the coenzyme was still present in W139F. However, the 280-nm optically active band present in the wild-type enzyme was greatly diminished in W139F. The mutant protein with Asp at position 139 (W139D) could not be isolated presumably because it was degraded. The other mutant enzymes, W139P, W139A, and W139H, were isolated with partial activities (15-35%) that were slowly lost upon storage at 4 degrees C. Overall, these results indicate the importance of Trp-139 in the thermostable D-amino acid transaminase. PMID- 2713328 TI - Binary mixtures of saturated and unsaturated mixed-chain phosphatidylcholine. A differential scanning calorimetry study. AB - High-resolution differential scanning calorimetry (DSC) has been used to study the aqueous dispersions of mixed-chain phosphatidylcholines prepared from colyophilized mixtures of C(18):C(11:1 delta 10) PC/C(18):C(10)PC and C(18):C(11:1 delta 10) PC/C(18):C(11)PC of various molar ratios. These mixed chain phospholipids are characterized by a marked disparity in their acyl-chain lengths; however, the sn-1 acyl chain in the fully extended conformation is about twice as long as the sn-2 acyl chain. Their thermotropic behavior was determined, and the phase diagrams of these two mixtures were constructed from the calorimetric data. Results indicate that C(18):C(11:1 delta 10)PC/C(18):C(10)PC and C(18):C-(11:1 delta 10)PC/C(18):C(11)PC are miscible in all proportions with a near-ideal behavior of mixing in the gel and liquid-crystalline phases. Equimolar mixtures of diC(14)PC/C(18):C(11:1 delta 10)PC, diC(14)PC/C(18):C(10)PC, and diC(14)PC/C(18):C(11)PC have also been studied by DSC. These phosphatidylcholines in the 1:1 mixture differ in Tm by less than 11 degrees C; however, they exhibit gel-phase immiscibility in the plane of the bilayer. Taken together, these studies suggest that C(18):C(11)PC and C(18):C(11:1 delta 10)PC are packed similarly to C(18):C(10)PC in excess water as mixed interdigitated bilayers, at T less than Tm, which transform into partially interdigitated bilayers when heated above Tm. PMID- 2713329 TI - Energetics of diphtheria toxin membrane insertion and translocation: calorimetric characterization of the acid pH induced transition. AB - The pH and temperature stabilities of diphtheria toxin and its fragments have been studied by high-sensitivity differential scanning calorimetry. These studies demonstrate that the pH-induced conformational transition associated with the mechanism of membrane insertion and translocation of the toxin involves a massive unfolding of the toxin molecule. At physiological temperatures (37 degrees C), this process is centered at pH 4.7 at low ionic strength and at pH 5.4 in the presence of 0.2 M NaCl. At pH 8, the thermal unfolding of the nucleotide-bound toxin is centered at 58.2 degrees C whereas that of the nucleotide-free toxin is centered at 51.8 degrees C, indicating that nucleotide binding (ApUp) stabilizes the native conformation of the toxin. The unfolding profile of the toxin is consistent with two transitions most likely corresponding to the A fragment (Tm = 54.5 degrees C) and the B fragment (Tm = 58.4 degrees C), as inferred from experiments using the isolated A fragment. These two transitions are not independent, judging from the fact that the isolated A fragment unfolds at much lower temperatures (Tm = 44.2 degrees C) and that the B fragment is insoluble in aqueous solutions when separated from the A fragment. Interfragment association contributes an extra -2.6 kcal/mol to the free energy of stabilization of the A fragment. Whereas the unfolding of the entire toxin is irreversible, the unfolding of the A fragment is a reversible process. These findings provide a thermodynamic basis for the refolding of the A fragment after reexposure to neutral pH immediately following translocation across the lysosomal membrane. PMID- 2713330 TI - Assembly of complement components C5b-8 and C5b-9 on lipid bilayer membranes: visualization by freeze-etch electron microscopy. AB - We have visualized by freeze-etch electron microscopy the macromolecular complexes of complement, C5b-8 and C5b-9, respectively, assembled on synthetic phospholipid bilayers. These complexes were formed sequentially by using purified human complement components C5b-6 followed by C7, C8, and C9. Complexes of C5b-8 were observed on the external surface (ES) of vesicles as 12-nm particles that tended to form polydisperse aggregates. The aggregates were sometimes of a regular chainlike structure containing varying numbers of paired subunits. Etching of vesicles containing C5b-9 complexes revealed on the ES large rings of approximately 27-nm outer diameter. One or two knobs usually were attached to the perimeter of the rings. Splitting of the membrane resulted in partitioning of the C5b-9 with the outer leaflet. Thus, round holes of approximately 17-nm diameter were present in the protoplasmic face (PF), and raised circular stumps of a matching size were present on the exoplasmic face (EF) of C5b-9 vesicles. C5b-9 complexes were frequently localized in regions of the lowest lipid order. That is, in micrographs of the EF and ES, single C5b-9 complexes were located where the ripples of the P beta' phase bend or reach a dead end, and linear arrays of C5b-9 complexes outlined disclination-like structures in the lattice; the holes in the PF mirrored this distribution. The membrane immediately surrounding C5b-9 rings was often sunk inwardly over an area much larger than that of the ring itself.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713331 TI - Effect of fatty acyl chain length and structure on the lamellar gel to liquid crystalline and lamellar to reversed hexagonal phase transitions of aqueous phosphatidylethanolamine dispersions. AB - The lamellar gel/liquid-crystalline and the lamellar liquid-crystalline/reversed hexagonal phase transitions of aqueous dispersions of a number of synthetic phosphatidylethanolamines containing linear saturated, branched chain, and alicyclic fatty acyl chains of varying length were studied by differential scanning calorimetry, 31P nuclear magnetic resonance spectroscopy, and X-ray diffraction. For any given homologous series of phosphatidylethanolamines containing a single chemical class of fatty acids, the lamellar gel/liquid crystalline phase transition temperature increases and the lamellar liquid crystalline/reversed hexagonal phase transition temperature decreases with increases in hydrocarbon chain length. For a series of phosphatidylethanolamines of the same hydrocarbon chain length but with different chemical structures, both the lamellar gel/liquid-crystalline and the lamellar liquid-crystalline/reversed hexagonal phase transition temperatures vary markedly and in the same direction. In particular, at comparable effective hydrocarbon chain lengths, both the lamellar gel/liquid-crystalline and the lamellar liquid-crystalline/reversed hexagonal phase transition temperatures vary in parallel, such that the temperature difference between these two phase transitions is nearly constant. Moreover, at comparable effective acyl chain lengths, the d spacings of the lamellar liquid-crystalline phases and of the inverted hexagonal phases are all similar, implying that the thickness of the phosphatidylethanolamine bilayers at the onset of the lamellar liquid-crystalline/reversed hexagonal phase transition and the diameter of the water-filled cylinders formed at the completion of this phase transition are comparable and independent of the chemical structure of the acyl chain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713332 TI - Metabolic behavior of cell surface biotinylated proteins. AB - The turnover of proteins on the surface of cultured mammalian cells was measured by a new approach. Reactive free amino or sulfhydryl groups on surface-accessible proteins were derivatized with biotinyl reagents and the proteins solubilized from culture dishes with detergent. Solubilized, biotinylated proteins were then adsorbed onto streptavidin-agarose, released with sodium dodecyl sulfate and mercaptoethanol, and separated on polyacrylamide gels. Biotin-epsilon aminocaproic acid N-hydroxysuccinimide ester (BNHS) or N-biotinoyl-N' (maleimidohexanoyl)hydrazine (BM) were the derivatizing agents. Only 10-12 bands were adsorbed onto streptavidin-agarose from undervatized cells or from derivatized cells treated with free avidin at 4 degrees C. Two-dimensional isoelectric focusing-sodium dodecyl sulfate gel electrophoresis resolved greater than 100 BNHS-derivatized proteins and greater than 40 BM-derivatized proteins. There appeared to be little overlap between the two groups of derivatized proteins. Short-term pulse-chase studies showed an accumulation of label into both groups of biotinylated proteins up until 1-2 h of chase and a rapid decrease over the next 1-5 h. Delayed appearance of labeled protein at the cell surface was attributed to transit time from site of synthesis. The unexpected and unexplained rapid disappearance of pulse-labeled proteins from the cell surface was invariant for all two-dimensionally resolved proteins and was sensitive to temperature reduction to 18 degrees C. Long-term pulse-chase experiments beginning 4-8 h after the initiation of chase showed the disappearance of derivatized proteins to be a simple first-order process having a half-life of 115 h in the case of BNHS-derivatized proteins and 30 h in the case of BM-derivatized proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713333 TI - 1H NMR assignment and secondary structural elements of human transforming growth factor alpha. AB - The 1H NMR spectrum of human transforming growth factor alpha (hTGF-alpha) has been completely assigned, and secondary structural elements have been identified as a preliminary step in determining the structure of this protein by distance geometry methods. Many of these structural elements closely correspond to those previously found in a truncated human EGF [Cooke et al. (1987) Nature (London) 327, 339-341] and murine EGF [Montelione et al. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 5226-5230]. These include the presence of an antiparallel beta-sheet between residues G19 and C34 with a type I beta-turn at V25-D28, a type II beta turn at H35-Y38, and another short beta-sheet between residues Y38-V39 and H45 A46. PMID- 2713334 TI - A cytoplasmic thyroid hormone binding protein: characterization using monoclonal antibodies. AB - We have previously purified a cellular thyroid hormone binding protein (p58) from a human carcinoma cell line [Kitagawa, S., Obata, T., Hasumura, S., Pastan, I., & Cheng, S.-y. (1987) J. Biol. Chem. 262, 3903-3908]. In the present study, the binding characteristics, the molecular properties, and subcellular localization of p58 were further characterized. Binding of the purified p58 to thyroid hormones was examined. Analysis of binding data indicates that p58 binds to 3,3',5-triiodo-L-thyronine (T3) with a Kd of 24.3 +/- 0.3 nM and n = 0.71. p58 binds to L-thyroxine similarly as to T3. However, D-T3 and reverse-T3 bind to p58 with an affinity 4- and 20-fold less than that of T3, respectively. By use of the purified p58 as an immunogen, two hybridomas, J11 and J12, secreting monoclonal antibodies to p58 were isolated; both antibodies belong to the IgG1K subclass. J12 recognizes p58 from human, monkey, dog, hamster, and rat, but not mouse. J11 exhibits a similar species specificity except that it does not react with p58 from hamster. With these antibodies, p58 was found to be not posttranslationally modified by glycosylation, sulfation, or phosphorylation. It has a cellular degradation rate t1/2 congruent to 2.1 h. Immunocytochemical studies indicate that p58 is located in the nonmembranous cytoplasm (cytosol). These results are consistent with subcellular fractionation studies which show that greater than 95% of J11 and J12 reactivity and T3 binding activity can be found in the 110,000g supernatant. PMID- 2713335 TI - Kinetics and in vitro origin of the temperature-dependent transition of the estrogen receptor monomer. AB - Partitioning of estrogen receptors in aqueous two-phase polymer systems has provided the basis for a detailed kinetic analysis of the effects of temperature on estrogen receptor (ER) structure in vitro. Exposure to temperatures of 0-30 degrees C increased the rate of change in ER partition coefficients by up to 100 fold but did not affect the final extent of the process. The temperature dependent change in ER partition coefficients was characterized by a linear Arrhenius plot and an activation energy of 25 kcal/mol. The rate of the temperature-dependent ER transition (28 degrees C) was found to be unaffected by greater than 50-fold changes in receptor concentration, which indicates that the temperature-dependent change in partition coefficients reflects a first-order process. The partition coefficients of heated ER were unaffected by subsequent 18 h incubations at 0 degree C, indicating that the temperature-dependent ER transition is irreversible in vitro. Direct heating of the unoccupied ER resulted in both a change in ER partition coefficients and a loss of ER binding sites. The temperature-dependent change in unoccupied ER partition coefficients was complete within 30 min at 28 degrees C and yielded a first-order rate constant that was the same as that obtained for heating the receptor-estradiol complex at 28 degrees C. In contrast, the loss of unoccupied ER binding sites that occurred during 28 degrees C incubations did not reach completion after 150 min of heating and was found to behave as a second-order process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713336 TI - Secondary structure prediction of 52 membrane-bound cytochromes P450 shows a strong structural similarity to P450cam. AB - The secondary structure of 52 aligned cytochrome P450 sequences, all of which are membrane bound, is predicted and collectively compared with the crystal structure of the soluble cytochrome P450cam. Ten of 13 helical regions, 6 of 7 beta-pair regions, and beta-structure corresponding to a known beta-bulge near the active site of P450cam are predicted to exist in the membrane-bound P450s. Three turns associated with beta-structure in the soluble enzyme are also predicted for the membrane-bound forms. A strong structural similarity is evident between membrane P450s and the soluble P450cam. Consequently, a multitransmembrane structure involving much of P450 seems highly unlikely. A structure with two N-terminal transmembrane segments is compatible with these observations. PMID- 2713337 TI - NMR studies of the influence of dodecyl sulfate on the amide hydrogen exchange kinetics of a micelle-solubilized hydrophobic tripeptide. AB - Backbone amide hydrogen exchange measurements are an important source of information about the internal dynamics of proteins. Before such measurements can be interpreted unambiguously, contributions to hydrogen exchange rates from the chemical and physical environment of the amides must be taken into account. Membrane proteins are often solubilized in detergents, yet there have not been any systematic investigations of the possible effects detergents may have on the amide hydrogen exchange rates of proteins. To address this question, we have measured individual backbone and carboxyl-terminal amide exchange rates for the amphipathic tripeptide Leu-Val-Ile-amide dissolved in water and dodecyl sulfate micelles. 1H NMR spectroscopy was used to measure exchange using the direct exchange-out into D2O technique at 5 degrees C and using an indirect steady-state saturation-transfer technique at 25 degrees C. The broadening effect of micelle incorporated spin-labeled fatty acid (12-doxylstearate) on the 1H NMR spectra of both the detergent and the peptide resonances was used to demonstrate that the tripeptide is intimately associated with the micelle. The resonance from formate ion, which is excluded from the micelle, was unperturbed by the spin label. The detergent did not retard the exchange rates of either the primary (terminal) or secondary (backbone) amides of the tripeptide. This suggests that the micelle/peptide interaction does not restrict access of charged catalysts and water to these amides and shows that the peptide amides are not hydrogen bonded. However, the pH for the exchange minima of these amides in detergent was increased between 1.2 and 1.7 units compared to exchange in water.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713338 TI - Photoaffinity labeling of terminal deoxynucleotidyl transferase. 1. Active site directed interactions with 8-azido-2'-deoxyadenosine 5'-triphosphate. AB - A photoaffinity analogue of dATP, 8-azido-2'-deoxyadenosine 5'-triphosphate (8 azido-dATP), was used to probe the nucleotide binding site of the non-template directed DNA polymerase terminal deoxynucleotidyl transferase (EC 2.7.7.31). The Mg2+ form of 8-azido-dATP was shown to be an efficient enzyme substrate with a Km of 53 microM. Loss of enzyme activity occurred during UV photolysis only in the presence of 8-azido-dATP. At saturation (120 microM 8-azido-dATP), 54% of the protein molecules were modified as determined by inhibition of enzyme activity. Kinetic analysis of enzyme inhibition induced by photoincorporation of 8-azido dATP indicated an apparent Kd of approximately 38 microM. Addition of 2 mM dATP to 120 microM 8-azido-dATP resulted in greater than 90% protection from photoinduced loss of enzyme activity. In contrast, no protection was observed with the addition of 2 mM dAMP. Enzyme inactivation was directly correlated with incorporation of radiolabeled 8-azido-dATP into the protein and UV-induced destruction of the azido group. Photoincorporation of 8-azido-dATP into terminal transferase was reduced by all purine and pyrimidine deoxynucleoside triphosphates of which dGTP was the most effective. The alpha and beta polypeptides of calf terminal transferase were specifically photolabeled by [gamma-32P]-8-azido-dATP, and both polypeptides were equally protected by all four deoxynucleoside triphosphates. This suggests that the nucleotide binding domain involves components from both polypeptides. PMID- 2713339 TI - Photoaffinity labeling of terminal deoxynucleotidyl transferase. 2. Identification of peptides in the nucleotide binding domain. AB - Terminal deoxynucleotidyl transferase (terminal transferase) was specifically modified in the nucleotide binding site by the substrate photoaffinity analogue [gamma-32P]-8-azido-dATP. The alpha and beta polypeptides of photolabeled terminal transferase were resolved by high-performance liquid chromatography. The beta polypeptide was digested with trypsin and fractionated by reverse-phase chromatography. Two 32P-containing fractions were isolated and subjected to amino acid sequence analysis. Peptides were identified as Ile209-Lys232 (B26) and Val233-Lys239 (B27). Peptide B26 was further resolved into two overlapping species; one contained an additional lysine residue at the N-terminus which resulted from tryptic cleavage between Lys207 and Lys208. In order to ensure that the sequenced peptides corresponded to the photolabeled species, we devised an anion-exchange procedure to isolate photolabeled peptides from the mixture. Analysis of photolabeled peptides from terminal transferase alpha beta using DEAE cellulose chromatography followed by reverse-phase HPLC confirmed that the photolabeled species were peptides B26 and B27. Peptide B26, the major photolabeled species, contained a conserved octapeptide region found in several eucaryotic DNA polymerases. In addition, peptide B27 was flanked by a sequence that has been implicated in triphosphate binding in other proteins. Structure predictions, based on sequence data, place the two peptides identified by photolabeling in spatial proximity consistent with the participation of both in the nucleotide binding domain. PMID- 2713340 TI - Temperature-dependent CD and NMR studies on a synthetic oligonucleotide containing a B-Z junction at high salt. AB - It is now accepted that two or more conformations may exist within the same DNA molecule, thereby generating conformational junctions. The presence of B-Z junctions between right- and left-handed DNA conformations has been detected in plasmids by a number of techniques. Preliminary characterization of the first example of a B-Z junction is a short DNA oligonucleotide has recently been reported [Sheardy, R. D. (1988) Nucleic Acids Res. 16, 1153-1167]. We report additional CD and NMR data that support the existence of the junction in this model oligomer. These studies indicate that only three base pairs are involved in the junction and only one of these is dramatically distorted. Furthermore, the NMR saturation-transfer experiments suggest the junction's internal motion is temperature dependent. PMID- 2713341 TI - Solution structure of the chromomycin-DNA complex. AB - The structure of the chromomycin-DNA complex at the deoxyoctanucleotide duplex level has been determined from one- and two-dimensional proton NMR studies in Mg containing aqueous solution. The NMR results demonstrate that the antitumor agent binds as a symmetrical dimer to the self-complementary d[T-T-G-G-C-C-A-A] duplex with retention of the 2-fold symmetry in the complex. A set of intermolecular nuclear Overhauser enhancements (NOEs) establishes that two chromomycin molecules in the dimer share the minor groove at the G-G-C-C.G-G-C-C segment in such a way that each hydrophilic edge of the chromophore is located next to the G-G.C-C half site and each C-D-E trisaccharide chain extends toward the 3'-direction of the octanucleotide duplex. In addition, the A-B disaccharide segment and the hydrophilic side chain of the antitumor agent are directed toward the phosphate backbone. The observed changes in nucleic acid NOEs and coupling patterns on complex formation establish a transition to a wider and shallower minor groove at the central G-G-C-C.G-G-C-C segment required for accommodating the chromomycin dimer. The present demonstration that chromomycin binds as a dimer and switches the conformation of the DNA at its G.C-rich minor groove binding site provides new insights into antitumor agent design and the sequence specificity of antitumor agent-DNA recognition. PMID- 2713342 TI - Characterization of primary transcripts and identification of transcription initiation sites on the heavy and light strands of mouse mitochondrial DNA. AB - Total RNA from Ehrlich ascites mitochondria pretreated with RNase-free DNase was capped in vitro with [alpha-32P]GTP and guanylyl transferase. The cappable RNAs representing the primary transcripts show a heterogeneous size distribution with four major species of 46, 63, 94, and 152 nucleotides and four minor species of 19, 24, 104, and 790 nucleotides in size. Hybridization with the D-loop DNA probes shows that the 19-nucleotide-long capped RNA is coded by the H-strand of mitochondrial DNA while the rest are coded by the L-strand. S1 nuclease mapping and primer extension analyses suggest the occurrence of a transcription initiation of H-strand at about 19 nucleotides upstream from the start of the tRNA(Phe) gene. All of the L-strand cappable RNAs have a common 5' end mapping to nucleotide 16,183 +/- 5 of the genome. The 3' ends of four major cappable RNA species line up to the conserved sequence boxes, putative start sites of DH-DNA; and in fact about 2% of these cappable species are found to exist as DNA-linked RNA under steady-state conditions. The 3' end of the 790-nucleotide cappable RNA lies close to the start of the tRNA(Pro) gene, suggesting that it may be the true precursor of L-strand transcript endonucleolytically processed at the 3' end. The level of L-strand-coded cappable RNAs varies markedly under different growth conditions. Treatment with cycloheximide results in a reduction while chloramphenicol caused over 3-fold induction, suggesting that these "primer" RNAs may have an additional regulatory function. PMID- 2713343 TI - Properties of the telomeric DNA-binding protein from Oxytricha nova. AB - Telomeres of Oxytricha macronuclear DNA exist as discrete DNA-protein complexes. Different regions of each complex display characteristic DNA-protein interactions. In the most terminal region, binding of a 43- and a 55-kDa protein to the telomeric DNA appears to account for all the DNA-protein interactions that can be detected by chemical and nuclease footprinting. We have used gradient sedimentation and protein-protein cross-linking to establish that the 43- and 55 kDa proteins are subunits of a heterodimer. Both subunits are very basic, which is unexpected considering the resistance of the DNA-protein interaction to high concentrations of salt. It is extremely difficult to dissociate the two subunits either from telomeric DNA or from each other. Even after extensive treatment of protein preparations with nuclease, a fragment of the 3' tail from macronuclear DNA remains bound to the protein. A wide range of conditions was screened for dissociation of the subunits from the DNA and/or from each other. Dissociation was only obtained by using conditions that caused some inactivation of the DNA binding capacity of the protein. The use of reagents that covalently modify sulfydryl groups during the purification procedure facilitates preparation of telomere protein with full DNA-binding activity. PMID- 2713344 TI - Template length, sequence context, and 3'-5' exonuclease activity modulate replicative bypass of thymine glycol lesions in vitro. AB - cis-Thymine glycol, a product of ionizing radiation damage to DNA, has been introduced quantitatively at a single site into oligonucleotide templates. The ability of DNA polymerases to replicate templates containing thymine glycol was studied by a primer extension assay, and three factors that influence replicative bypass of this lesion in vitro have been identified. These factors include template length, sequence context, and 3'-5' exonuclease activity. Synthesis by the large fragment of DNA polymerase I (Klenow fragment) terminates quantitatively opposite thymine glycol when the template strand extends only two nucleotides beyond the lesion. Significant bypass is observed when the length of the template beyond the lesion is increased to six nucleotides. On the longer templates, the frequency of bypass of the Klenow fragment depends upon the identity of the base immediately 5' to thymine glycol. The extent of bypass is greatest with cytosine and least with adenine at this position. Bypass of thymine glycol lesions by DNA polymerase alpha 2 from HeLa cells shows a qualitatively similar dependence upon local sequence context. In contrast, synthesis by T4 DNA polymerase is quantitatively blocked opposite the lesion regardless of template length or DNA sequence context. Synthesis by a mutant Klenow fragment that is deficient in 3'-5' exonuclease activity, or by AMV reverse transcriptase, results in a significant increase in the frequency of bypass. Thus, increased nucleotide turnover at, or beyond, the site of the lesion is likely to contribute significantly to the arrest of synthesis provoked by cis-thymine glycol in vitro. PMID- 2713345 TI - Purification and determination of the NH2-terminal amino acid sequence of uracil DNA glycosylase from human placenta. AB - Uracil-DNA glycosylase has been purified approximately 130,000-fold from extracts of human placenta. Although all of the uracil-DNA glycosylase activity coeluted through six chromatographic steps, at least four distinct peaks of activity were resolved in the final purification on a Mono S column. Each of the peaks containing uracil-DNA glycosylase activity contained two peptides of Mr = 29,000 and Mr = 26,500, respectively, as analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Experimental evidence indicated that the Mr = 29,000 peptide was the uracil-DNA glycosylase enzyme. The amino-terminal sequence of each peptide was determined after blotting of the peptides from the gel onto Polybrene GF/C paper. The sequences were not related to each other, and neither was any significant homology to other proteins found. Uracil-DNA glycosylase had a molecular turnover number of approximately 600/min and apparent Km value of 2 microM. The enzyme is a basic protein and was stimulated about 10-fold by 60-70 mM NaCl whereas higher concentrations were inhibitory. PMID- 2713346 TI - Characterization of the ethenoadenosine diphosphate binding site of myosin subfragment 1. Energetics of the equilibrium between two states of nucleotide.S1 and vanadate-induced global conformation changes detected by energy transfer. AB - The fluorescence decay of 1,N6-ethenoadenosine diphosphate (epsilon ADP) bound to myosin subfragment 1 (S1) was studied as a function of temperature. The decay was biexponential, and the two lifetimes were quenched relative to the single lifetime of free epsilon ADP. The temperature dependence of the fractional intensities of the decay components showed two states of the S1.epsilon ADP complex. At pH 7.5 in 30 mM TES, 60 mM KCl, and 3 mM MgCl2, the equilibrium constant for the conversion of the low-temperature state (S1L.epsilon ADP) to the high-temperature state (S1H.epsilon ADP) was 40 at physiological temperatures, and delta H degrees = 13 kcal.mol-1 and delta S degrees = 49 cal.deg-1.mol-1. At 10 degrees C the equilibrium constant of S1 for epsilon ADP was 5, indicating that S1H.epsilon ADP was the dominant state, and that for the vanadate complex epsilon ADP.Vi was 0.7, suggesting that in S1.epsilon ADP.Vi the dominant state of the S1-nucleotide complex was converted from S1H.epsilon ADP to S1L.epsilon ADP. The single rotational correlation time of bound epsilon ADP at 10 degrees C decreased from 107 ns in S1.epsilon ADP to 74 ns in S1+.epsilon ADP.Vi. Conversion of the binary complex to the ternary vanadate complex resulted in a 3 A decrease in the energy transfer distance between bound epsilon ADP and N-[4 (dimethylamino)-3,5-dinitrophenyl]maleimide attached to SH1 and a decrease of the average distance between bound epsilon ADP and bound Co2+ from 12.6 to 8.3 A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713347 TI - Effect of nucleotide structure on cardiac myosin subfragment 1 transient kinetics. AB - Transient kinetic data of the hydrolysis of several nucleotides (TTP, CTP, UTP, GTP) by cardiac myosin subfragment 1 (S1) were analyzed to obtain values for the equilibrium constant for nucleotide binding and rate constants for the S1 nucleotide isomerization and the subsequent nucleotide hydrolysis as well as the magnitudes of the relative fluorescence enhancements of the myosin that occur upon isomerization and hydrolysis. These data are compared with data from a previous study with ATP. Nucleotide binding is found to be relatively insensitive to nucleotide ring structure, being affected most by the group at position C6. Isomerization and hydrolysis are more sensitive to nucleotide structure, being inhibited by the presence of a bulky group at position C2. Kinetic parameters decrease as follows: for binding, GTP greater than UTP approximately TTP greater than ATP greater than CTP; for isomerization, ATP greater than UTP approximately TTP approximately CTP greater than GTP; for hydrolysis, ATP greater than TTP greater than CTP approximately UTP greater than GTP. Fluorescence enhancements appear to be most dependent upon the relative values of the individual rate constants. PMID- 2713348 TI - Activation of Chlamydomonas rhodopsin in vivo does not require isomerization of retinal. AB - The unicellular eukaryote Chlamydomonas reinhardtii is a phototactic alga that swims toward or away from light, using rhodopsin as the photopigment. The activity of retinal analogues was tested in the mutant FN68, which has high phototactic sensitivity only after incubation with retinal or analogues of retinal. Analogues prevented from isomerizing about the 7-ene, 9-ene, 11-ene, 13 ene, or 15-ene (C = N+H) bonds retained full activity. Also, bleaching, protonation of the N, and a stable geometrically altered chromophore are not required for full activity. An attractive hypothesis is that charge redistribution in the excited state of retinal directly triggers the activity of rhodopsin. PMID- 2713349 TI - Retinal isomer ratio in dark-adapted purple membrane and bacteriorhodopsin monomers. AB - On the basis of data obtained by spectroscopic analysis and chromatography of retinal extracts, a consensus has been adopted that dark-adapted purple membrane (pm) contains 13-cis- and all-trans-retinal in equal amounts, whereas the light adapted membrane contains all-trans-retinal only. We have developed an improved extraction technique which extracts up to 70% of the retinal in pm within 4 min. In the extracts from dark-adapted pm at room temperature, we consistently find 66 67% 13-cis-retinal and 33-34% all-trans-retinal, and more than 98.5% all-trans isomer in light-adapted samples. The spectrum obtained by reconstitution of bacterioopsin with 13-cis-retinal at 2 degrees C (to minimize isomerization) shows an absorbance maximum at 554 nm and agrees well with the spectrum for the 13-cis component calculated from the dark-adapted and light-adapted bR spectra with our extraction data. The ratio of 13-cis:all-trans isomer in dark-adapted pm is 2:1 and nearly constant between 0 and 38 degrees C but begins to decrease distinctly above 40 degrees C, and more rapidly near 70 degrees C, reaching 0.75 at 90 degrees C. The van't Hoff plot of the isomer ratio shows a nonlinear temperature dependence above 40 degrees C, indicating a more complex system than a simple thermal 13-cis/all-trans isomer equilibrium. We attribute the broadening, absorbance decrease, and blut shift of the visible absorption band with increasing temperature to the appearance of at least one and possibly two or three new chromophores which contain, mainly or exclusively, the all-trans isomer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713350 TI - Monoclonal antibody to microtubule-associated STOP protein: affinity purification of neuronal STOP activity and comparison of antigen with activity in neuronal and nonneuronal cell extracts. AB - Microtubules, ordinarily cold-labile structures, are made entirely resistant to cold temperature by the presence of substoichiometric amounts of STOP (stable tubule only polypeptide), a microtubule-associated protein. We have produced a monoclonal antibody which specifically recognizes a 145-kDa protein previously implicated in STOP activity in rat brain extracts. An antibody affinity column removes both the 145-kDa protein and STOP activity from solution. A urea eluate from the affinity column contains the 145-kDa protein and exhibits substantial STOP activity. We conclude the 145-kDa protein accounts for all measurable STOP activity in rat neuronal extracts. For this work, we have developed an assay of microtubule cold stability which is generally applicable to the detection of STOP activity in various tissues. Using this assay, we show STOP activity is most abundant in neuronal tissue but is detectable in all tissues tested, with the exception of heart muscle. In all tissues that we have examined, STOP activity elutes as a single peak from heparin affinity columns, and in common with brain STOP, all activity is Ca2+-calmodulin sensitive. The monoclonal antibody recognizes the 145-kDa STOP in rat neuronal extracts but reacts with no protein in active fractions from other tissue. A similar, but not identical, analogue of brain STOP thus appears to be widespread in mammalian tissues. PMID- 2713351 TI - Reversible unfolding of the gelatin-binding domain of fibronectin: structural stability in relation to function. AB - Fibronectin, a large multidomain glycoprotein, binds denatured collagen (gelatin) and mediates cell attachment and spreading on collagen-coated surfaces. Despite the high affinity, binding to gelatin is disrupted by relatively mild conditions. We have examined the effects of denaturants on the structure and function of a 42 kDa gelatin-binding fragment (GBF) isolated from chymotryptic and thermolytic digests of the parent protein. Application of linear gradients to GBF-loaded gelatin-agarose columns resulted in peak elution of the fragment at pH 5.2 or 10.2, at 0.4 M dimethylformamide, 0.9 M GdmCl, or 2.0 M urea, conditions far short of those required to induce structural changes detectable by fluorescence or circular dichroism. Solvent perturbation, fluorescence quenching, and chemical modification experiments indicate that about half of the 8 tryptophans, one-third of the 21 tyrosines, and all of the 9 lysine residues are solvent-exposed in the native protein and that 1 or more of the latter are directly involved in binding to gelatin, most likely through a hydrogen-bonding mechanism. Titration with GdmCl produced a single unfolding transition centered near 2.5 M GdmCl as monitored by changes in fluorescence and circular dichroism. This transition was fully reversible with complete recovery of structural parameters and gelatin binding. Treatment with disulfide reducing agents caused rapid irreversible changes in structure similar to those produced by GdmCl with concomitant loss of gelatin binding. Thus, tertiary and secondary structures are important for binding, but binding can be disrupted without perturbing those structures. PMID- 2713352 TI - Phospholipase-induced modulation of dolichyl-phosphomannose synthase activity. AB - Rat liver dolichyl-phosphomannose synthase is optimally active when the enzyme is reconstituted with lipids that prefer a nonlamellar macroscopic organization in isolation, such as phosphatidylethanolamine (PE), but the enzyme is only negligibly active in the presence of lipids that normally form stable bilayers, such as phosphatidylcholine (PC) [Jensen, J.W., & Schutzbach, J.S. (1985) Eur. J. Biochem. 153, 41-48]. We now report that the activity of the synthase can be modulated by incorporating diacylglycerol and lysophosphatidylcholine into the lipid matrix. Enzyme activity in PC bilayers was stimulated by the presence of diacylglycerol, a lipid that has a conical dynamic molecular shape and disrupts bilayer stability. In PC/diacylglycerol mixtures the apparent Km for dolichyl-P was 30-fold lower than the apparent Km for the polyprenol acceptor in PC membranes. Enzyme activity was also stimulated when diacylglycerol was generated in situ by incubation of PC vesicles with phospholipase C. In contrast, the activity of enzyme reconstituted in PE dispersions, or in PE/PC bilayers, was markedly inhibited by the presence of lysophospholipids. Enzyme activity was also reduced by the in situ generation of lysophospholipids in PE/PC vesicles by incubation with phospholipase A2. Since lysophospholipids and diacylglycerols arise in vivo as products of phospholipid metabolism, modulation of enzyme activity by these compounds may represent a potential regulatory mechanism for the synthesis of oligosaccharide lipids. PMID- 2713353 TI - Partitioning of exchangeable fluorescent phospholipids and sphingolipids between different lipid bilayer environments. AB - Exchangeable phospho- and sphingolipid probes (phosphatidylcholine, ethanolamine, -serine, and -glycerol, phosphatidic acid, sphingomyelin, cerebroside, and sulfatide) have been synthesized in which one acyl chain is substituted with a fluorescent bimanyl, 7-(dimethylamino)coumarin-3-yl, or diphenyl-hexatrienyl group. The distribution of these probes between two different populations of lipid vesicles can be readily monitored by fluorescence intensity measurements, as described by Nichols and Pagano [Nichols, J. W., & Pagano, R. E. (1982) Biochemistry 21, 1720-1726], when one of the vesicle populations contains a low mole fraction of a nonexchangeable quencher, (12-DABS) 18-PC. The probes examined in this study exchange between phospholipid vesicles on a time scale of minutes, with kinetics indicating that the transfer process takes place by diffusion of probe monomers through the aqueous phase. As expected, lipid probes with different charges differ markedly in their equilibrium distributions between neutral and charged lipid vesicles. However, probes with different polar headgroups differ only modestly in their relative affinities for vesicles composed of "hydrogen-bonding" lipids (PE and PS) vs "non hydrogen-bonding" lipids (PC and PG or O-methyl-PA). Probes with different headgroups also show modest, albeit reproducible, differences in their relative affinities for cholesterol-containing vs cholesterol-free PC/PG vesicles. Our results suggest that lipids with different headgroup structures may mix more nearly ideally in liquid-crystalline lipid bilayers than would be predicted from previous analyses of the phase diagrams for binary lipid mixtures. PMID- 2713354 TI - The structural basis for substrate-induced changes in redox potential and spin equilibrium in cytochrome P-450CAM. AB - The crystal structures of cytochrome P-450CAM complexed with the alternative substrates norcamphor and adamantanone have been refined at 2.0-A resolution and compared with the native, camphor-bound form of the enzyme. Norcamphor lacks the 8-, 9-, and 10-methyl groups of camphor. Thus, specific interactions between these groups and phenylalanine 87 and valines 247 and 295 are missing in the norcamphor complex. As a result, norcamphor binds about 0.9 A further from the oxygen-binding site than does camphor, which allows sufficient room for a water molecule or hydroxide ion to remain coordinated with the heme iron atom. The larger adamantanone occupies a position closer to that of camphor and, as in the camphor-bound enzyme, the heme iron remains pentacoordinate with no solvent molecule coordinated as a sixth ligand. A comparison of crystallographic temperature factors indicates that norcamphor is more "loosely" bound than are either camphor or adamantanone, as might be expected from the relative sizes of the different substrates. The looser fit of norcamphor in the active-site pocket results in a less specific pattern of hydroxylation. The presence of an aqua ligand is the likely structural basis for the norcamphor-P-450CAM complex having both a lower redox potential and higher percentage of low-spin heme than do either the camphor-P-450CAM or adamantanone-P-450CAM complexes. PMID- 2713355 TI - Characterization of the cDNA encoding human nucleophosmin and studies of its role in normal and abnormal growth. AB - A cDNA encoding human nucleophosmin (protein B23) was obtained by screening a human placental cDNA library in lambda gtll first with monoclonal antibody to rat nucleophosmin and then with confirmed partial cDNA of human nucleophosmin as probes. The cDNA had 1311 bp with a coding sequence encoding a protein of 294 amino acids. The identity of the cDNA was confirmed by the presence of encoded amino acid sequences identical with those determined by sequencing pure rat nucleophosmin (a total of 138 amino acids). The most striking feature of the sequence is an acidic cluster located in the middle of the molecule. The cluster consists of 26 Asp/Glu and 1 Phe and Ala. Comparison of human nucleophosmin and Xenopus nucleolar protein NO38 shows 64.3% sequence identity. The N-terminal 130 amino acids of human nucleophosmin also bear 50% identity with that of Xenopus nucleoplasmin. Northern blot analysis of rat liver total RNA with a partial nucleophosmin cDNA as probe demonstrated a homogeneous mRNA band of about 1.6 kb. Similar observations were made in hypertrophic rat liver and Novikoff hepatoma. However, the quantity of nucleophosmin mRNA is 50- and 5-fold higher in Novikoff hepatoma and hypertrophic rat liver, respectively, when compared with normal rat liver. Dot blot analysis also showed a nucleophosmin mRNA ratio of 64:5:1 in the three types of rat liver. When the protein levels were compared with Western blot immunoassays, Novikoff hepatoma showed 20 times more nucleophosmin, while only about 5 times more nucleophosmin was observed in hypertrophic rat liver than in unstimulated normal liver. PMID- 2713356 TI - Effect of ionic strength on the hybridization of oligodeoxynucleotides with reduced charge due to methylphosphonate linkages to unmodified oligodeoxynucleotides containing the complementary sequence. AB - A 12-mer oligodeoxynucleotide containing 10 methylphosphonate bonds and 1 phosphodiester bond was shown to bind specifically to the restriction endonuclease fragment containing complementary DNA in a Southern blot. This 12 mer as well as 14-mer oligodeoxynucleotides containing 3 methylphosphonate and 10 phosphodiester bonds was used to examine the effect of reduced charge on the thermodynamics of binding to complementary DNA or complementary oligodeoxynucleotides with additional nucleotides overlapping both the 3' and 5' ends. The 14-mer oligodeoxynucleotides were synthesized with one methylphosphonamidite (A, C, G, or T). Melting profiles were examined by spectrophotometry for the 14-mers and by a gel-shift assay for the 12-mer. Nearest-neighbor free energy values were compiled for predicting concentration dependent melting temperatures for all oligodeoxynucleotide hybridizations, including those involving adjacent dG residues. The free energy contribution to duplex formation from the dangling ends was about 1 kcal/mol. The free energy decrement due to introduction of each methylphosphonate linkage was -0.75 kcal/mol in high salt independent of the methylphosphonamidite used for synthesis of the oligodeoxynucleotide. However, the change in charge per nearest-neighbor base pair decreased from 0.26 to 0.0 when the nearest-neighbor base pair contained one methylphosphonate. Thus at very low salt, methylphosphonate substituted oligodeoxynucleotides form more stable hybrids than analogous phosphodiester sequences. The 12-mer with 10 methylphosphonate bonds outcompetes the analogous phosphodiester 12-mer below 0.01 M NaCl. The temperature of 50% dissociation of bound oligodeoxynucleotide after being washed for 30 min was measured with a dot-blot assay. These results, together with the thermodynamic results, indicate that the substitution of methylphosphonate linkages at high salt only affects the reverse rate constant. PMID- 2713358 TI - Kinetics of trypsin inhibition by its specific inhibitors. AB - The kinetics of inhibition of trypsin by its specific inhibitors, pancreatic trypsin inhibitor, ovomucoid trypsin inhibitor, and soybean trypsin inhibitor, has been studied by following the hydrolysis of benzoylarginine ethyl ester in the presence of the inhibitor, and the results have been analyzed with the method described previously [Tian & Tsou (1982) Biochemistry 21, 1028]. The results obtained are consistent with the following: (a) The enzyme binds with the pancreatic inhibitor irreversibly to form an inactive complex. (b) The binding with the ovomucoid inhibitor to form the inactive complex is reversible. (c) An intermediate is formed before the relatively stable inactive complex with the soybean inhibitor, and both steps are reversible. The respective microscopic rate constants are determined by suitable plots of the apparent rate constants under different substrate and inhibitor concentrations. The second-order rate constants for the initial binding step thus obtained are in accord with the apparent inactivation rate constants determined by measuring the activity remaining with a stopped-flow apparatus equipped with a multimixing system after the enzyme inhibitor mixture has been incubated for different time intervals. PMID- 2713357 TI - Solution conformation of a synthetic fragment of human pituitary growth hormone. Two-dimensional NMR of an alpha-helical dimer. AB - Circular dichroism and two-dimensional NMR spectra indicate that a peptide fragment consisting of the first 28 residues from the N-terminus of human growth hormone (hGH 1-28) has considerable alpha-helical structure. The peptide, (1) H Phe-Pro-Thr-Ile-Pro-Leu-Ser-Arg-Leu-Phe-Asp-Asn-Ala-Met-Leu-Arg-Ala-Hi s-Arg- Leu His-Gln-Leu-Ala-Phe-Asp-Thr-Tyr-OH (28), was synthesized on an automated peptide synthesizer using the Merrifield solid-phase method. The peptide can be modeled as an amphiphilic helix, and the unusual stability of the alpha-helix in aqueous solution is suggested to be attributable to formation of a dimer of alpha helices. Most of the 1H NMR signals were assigned through pure absorption phase COSY/NOESY and single- and double-relay COSY 2D NMR spectra by using the sequential assignment methodology. The NOEs were large and negative, suggesting that the peptide was not a random coil and that it existed in solution primarily as a large, fairly rigid macromolecule, consistent with the dimer structure. A network of N alpha Hi-N alpha Hi+1 NOESY crosspeaks is observed from residues 13 to 18 as are several other crosspeaks which indicate that the peptide has considerable alpha-helical structure between residues 8 and 24. In addition, gel filtration of the peptide is consistent with a dimer structure, presumably involving packing of the two hydrophobic faces of the amphiphilic alpha-helices. PMID- 2713359 TI - Inducible (class 3) aldehyde dehydrogenase from rat hepatocellular carcinoma and 2,3,7,8-tetrachlorodibenzo-p-dioxin-treated liver: distant relationship to the class 1 and 2 enzymes from mammalian liver cytosol/mitochondria. AB - Peptides from rat liver aldehyde dehydrogenase (AIDH) induced by 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) treatment match the AIDH structure from HTC rat hepatoma cells (HTC-AIDH) at all positions examined, indicating induction of the same gene product by two independent routes. This 452 amino acid residue, class 3 AIDH structure differs substantially from the 500-residue AIDH structures isolated from normal liver cytosol (class 1) and mitochondria (class 2). Despite a 29.8% identity in 429 overlapping amino acids vs the human class 1 enzyme (27.7% vs class 2), neither the N- nor C-termini coincide, and gaps are introduced to optimize the alignment. Two residues placed in the active site of human liver AIDH by chemical modification, Cys-302 and Glu-268, are conserved in class 3 AIDH as Cys-243 and Glu-209. Cys-243/302 is the only cysteine residue conserved in all known AIDH structures. Gly-245 and Gly-250 of class 1/2 AIDHs, fitting the patterns of glycine residues in coenzyme binding fold of other dehydrogenases, are also conserved. Otherwise, Cys-49, Cys-162, and Glu-487, to which functional importance has also been ascribed, are not retained in the class 3 structure. Overall, a high conservation of Gly, Pro, and Trp and similar patterns of predicted secondary structure indicate general conservation of tertiary structure, as noted with other distantly related proteins. Three exon boundaries from the human liver mitochondria AIDH gene directly correspond to the N-terminus of the rat class 3 protein and to two of the gaps in the alignment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713360 TI - Binding of heparin to human high molecular weight kininogen. AB - The binding of heparin to high molecular weight kininogen (H-kininogen) was analyzed by the effect of kininogen in decreasing the heparin-induced enhancement of the rate of inactivation of thrombin by antithrombin. The conditions were arranged so that the heparin-catalyzed antithrombin-thrombin reaction, monitored in the presence of the reversible thrombin inhibitor p-aminobenzamidine, followed pseudo-first-order kinetics and the observed rate constant (kappa obsd) varied linearly with the heparin concentration. In the absence of metal ions, H kininogen minimally affected kappa obsd, measured at a constant concentration of heparin with high affinity for antithrombin (30 nM), at I = 0.15, pH 7.4 and 25 degrees C. However, at a saturating concentration of Zn2+ (10 microM), kappa obsd was reduced to 50% at approximately 20 nM H-kininogen and to that of the uncatalyzed reaction at greater than or equal to approximately 0.2 microM H kininogen. Conversely, at a saturating concentration of H-kininogen (0.5 microM), kappa obsd was decreased to 50% at approximately 0.6 microM Zn2+ and to the kappa obsd of the uncatalyzed reaction at greater than or equal to 10 microM Zn2+. Other metal ions were effective in the order Zn2+ approximately Ni2+ greater than Cu2+ approximately Co2+ approximately Cd2+. The single-chain and two-chain forms of H-kininogen and the H-kininogen light chain reduced the heparin enhancement in the presence of Zn2+ to the same extent, whereas low molecular weight kininogen had no influence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713361 TI - Transition-state stabilization by adenosine deaminase: 1,6-addition of water to purine ribonucleoside, the enzyme's affinity for 6-hydroxy-1,6-dihydropurine ribonucleoside, and the effective concentration of substrate water at the active site. AB - Positions of equilibria of highly unfavorable addition reactions, whose products are present at concentrations below the limits of detection, can be determined from equilibria of combination of anionic nucleophiles with quaternized enamines. Applied to the newly prepared 1-methylpurinium ribonucleoside cation, this method yields approximate equilibrium constants of 2 X 10(-9) M-1 for addition of water and 4 X 10(-5) M-1 for addition of N-acetylcysteine to neutral purine ribonucleoside, in dilute aqueous solution. Positions of 13C magnetic resonances and UV absorption maxima of the above complexes and comparison with those of adenosine deaminase complexes strongly suggest that purine ribonucleoside is bound by adenosine deaminase as the 1,6 covalent hydrate, not as a covalently bonded complex formed by addition of a thiol group at the active site. The favorable position of equilibrium of the hydration reaction on the enzyme, together with its extremely unfavorable position in free solution, indicates that the effective activity of substrate water at the active site is in the neighborhood of 10(10) M. The Ki value of the active diastereomer of 6-hydroxy 1,6-dihydropurine ribonucleoside is estimated as 1.6 X 10(-13) M, more than 8 orders of magnitude lower than the apparent dissociation constants of enzyme complexes with the substrate adenosine or the product inosine. The enzyme's remarkable affinity for this hydrated species, which is vanishingly rare in free solution, seems understandable in terms of the hydrate's close resemblance to a hydrated intermediate approaching the transition state in direct water attack on adenosine. PMID- 2713362 TI - Conformational differences between aged and nonaged pyrenebutyl-containing organophosphoryl conjugates of chymotrypsin as detected by optical spectroscopy. AB - Homologous aged and nonaged fluorescent organophosphorus conjugates of alpha chymotrypsin (Cht) were used in a comparative spectroscopic study of the conformation of their active sites, employing the pyrene group as the fluorescent probe. Steady-state fluorescence measurements showed that the quantum yield of the pyrene probe which is stoichiometrically attached to the active site is ca. 20% lower in the aged conjugate, pyrenebutyl-O-P(O)(O-)-Cht (PBP-Cht), than in the nonaged conjugate, pyrenebutyl-O-P-(O)(OC2H5)-Cht (PBEP-Cht). Furthermore, fluorescence decay data indicate that quenching is dynamic and is not caused by oxygen. These data, together with collisional quenching data, imply that quenching originates in an internal interaction of the fluorophore with a group within the protein. Thus, interaction of the pyrene moiety with the polypeptide chain is significantly stronger in the aged than in the nonaged conjugate, implying a different orientation of the fluorophore with respect to the protein. Circular dichroism measurements, which reflect the asymmetry of the bound pyrene in the ground state, as well as circularly polarized luminescence studies, which reflect its asymmetry in the excited state, also show that the relative configuration of the pyrene moiety and the polypeptide chain is significantly altered upon aging. Aged conjugates obtained by use of various fluorescenct organophosphates [pyrenebutyl-O-P(O)Cl2, pyrenebutyl-O-P(O)(p-nitrophenoxy)Cl, pyrenebutyl-O-P(O)(p-nitrophenoxy)2] exhibit similar spectroscopic features, thus substantiating the hypothesis that instantaneous aging, by use of pyrenebutyl-O P(O)Cl2, and dynamic aging, by gradual removal of an aryloxy group, yield a similar product. This finding provides strong support for the formation of a P-O- moiety in the aged conjugates, since the only expected common product of the two processes is PB-O-P(O)(O-)-Cht. Formation of excimers of the pyrene-containing organophosphorylchymotrypsin conjugates at concentrations above 3 X 10(-6) M is also reported. PMID- 2713363 TI - Isotopic labeling affects 1,25-dihydroxyvitamin D metabolism. AB - Isotope substitution can change the biochemical properties of vitamin D. To determine the effect of substituting 3H for 1H on the metabolism of 1,25(OH)2D3, we measured the metabolic clearance rate and renal metabolism of unlabeled and 3H labeled 1,25(OH)2D3. Substitution of 3H for 1H on carbons 26 and 27 [1,25(OH)2[26,27(n)-3H]D3] or on carbons 23 and 24 [1,25(OH)2[23,24(n)-3H]D3] reduced the in vivo metabolic clearance rate of 1,25(OH)2D3 by 36% and 37%, respectively, and reduced the in vitro renal catabolism of 1,25(OH)2D3 by 11% and 54%, respectively. Substitutions of 3H for 1H on carbons 23 and 24 as opposed to carbons 26 and 27 reduced conversion of [3H]1,25(OH)2D3 to [3H]1,24,25(OH)2D3 by 25% and to putative 24-oxo-1,23,25-dihydroxyvitamin D3 by 1600%. These results indicate that substitution of 3H for 1H on carbons 26 and 27 or on carbons 23 and 24 can reduce the metabolic clearance rate and in vitro metabolism of 1,25(OH)2D3 and quantitatively alter the pattern of metabolic products produced. PMID- 2713364 TI - In-register homodimers of smooth muscle tropomyosin. AB - Gizzard smooth muscle tropomyosin dimer molecules were dissociated by guanidinium chloride and reassociated by dialysis against 1 M NaCl. Several properties of the protein were changed by this treatment. There was a large decrease in tropomyosin's low-salt viscosity, owing to reduced end-to-end polymerization, the helix unfolding profile changed from a one-step to a two-step process, and the ability to form intramolecular, interchain, disulfide-cross-linked homodimers increased dramatically. Thus, the native molecule, though to exist predominantly as by the beta gamma heterodimer which cannot form disulfide cross-links [Sanders, C., Burtnick, L.D., & Smillie, L. B. (1986) J. Biol. Chem. 261, 12774 12778], reassembles, after dissociation, to form predominantly parallel, in register beta beta and gamma gamma homodimers able to form disulfide cross-links. This suggests that the physical properties, including the end-to-end interaction, of gizzard tropomyosin homodimers differ considerably from those of the heterodimer. This is a first step toward a molecular understanding of the end-to end interaction of smooth muscle tropomyosin. PMID- 2713365 TI - Calmodulin and troponin C structures studied by Fourier transform infrared spectroscopy: effects of Ca2+ and Mg2+ binding. AB - Fourier transform infrared (FTIR) spectroscopy has been used to examine the conformationally sensitive amide I' bands of calmodulin and troponin C. These are observed to undergo a sequence of spectroscopic changes which reflect conformational rearrangements that take place when Ca2+ is bound. Calmodulin and troponin C show similar though not identical changes on Ca2+ binding, and the effect of Mg2+ on troponin C is quite different from that of Ca2+. Both proteins show absorption maxima in the amide I' region at 1644 cm-1 which is significantly lower in frequency than has been generally observed for proteins that contain a high percentage of alpha-helix. It is proposed that an unusually high proportion of the helices in the structures of these proteins are distorted from the normal alpha-helical configuration such that the carbonyl stretching frequencies are lowered. It is further proposed that the shift to lower frequency is due to backbone carbonyl groups in the distorted helices that form strong hydrogen bonds with solvent molecules. A decrease in intensity at 1654 cm-1, the normal frequency assignment for alpha-helical structure, is observed as Ca2+ binds to calmodulin and troponin C. This suggests that Ca2+ binding results in a net decrease in "normal" alpha-helix conformation. There is a corresponding increase in intensity of the band at 1644 cm-1, possibly due to an increase in distorted helix content, allowing for a net increase in helix consistent with circular dichroism estimates of the Ca2+-dependent changes in helix content in calmodulin. PMID- 2713366 TI - Reversed hexagonal phase formation in lecithin-alkane-water systems with different acyl chain unsaturation and alkane length. AB - Investigations of lipid-alkane systems are important for an understanding of the interactions between lipids and hydrophobic/amphiphilic peptides or other hydrophobic biological molecules. A study of the formation of nonlamellar phases in several phosphatidylcholine (PC)-alkane-2H2O systems has been performed. The PC molecules chosen in this work are dipalmitoyl-PC (DPPC), 1-palmitoyl-2-oleoyl PC (POPC), dioleoyl-PC (DOPC), and dilinoleoyl-PC (DLiPC), lipids that in excess water form just a lamellar liquid-crystalline phase up to at least 90 degrees C. The addition of n-alkanes (C8-C20) to these PC-2H2O systems induces the formation of reversed hexagonal (HII) and isotropic phases. The water and dodecane concentrations required to form these phases depend on the degree of acyl chain unsaturation of the PC molecules and increase in the order DLiPC approximately DOPC less than POPC less than DPPC. The most likely explanation to this result is that the diameter of the lipid-water cylinders in the HII phase grows gradually larger with increased acyl chain saturation and more water and dodecane are consequently needed to fill the water cylinders and the void volumes between the cylinders, respectively. The ability of the alkanes to promote the formation of an HII phase is strongly chain length dependent. Although the number of alkane carbon atoms added per DOPC molecule in the DOPC-n-alkane-2H2O mixtures was kept constant, this ability decreased on going from octane to eicosane. The thermal history of a DPPC-n-dodecane-2H2O sample was important for its phase behavior.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713367 TI - Crystal structure of a papain-E-64 complex. AB - E-64 [1-[N-[(L-3-trans-carboxyoxirane-2-carbonyl)-L-leucyl] amino]-4 guanidinobutane] is an irreversible inhibitor of many cysteine proteases. A papain-E-64 complex was crystallized at pH 6.3 by using the hanging drop method. Three different crystal forms grew in 3-7 days; the form chosen for structure analysis has space group P212121, with a = 42.91(4) A, b = 102.02(6) A, c = 49.73(2) A, and Z = 4. Diffraction data were measured to 2.4-A resolution, giving 9367 unique reflections. The papain structure was solved by use of the molecular replacement method, and then the inhibitor was located from a difference electron density map and fitted with the aid of a PS330 computer graphics system. The structure of the complex was refined to R = 23.3%. Our analysis shows that a covalent link is formed between the sulfur of the active-site cysteine 25 and the C-2 atom of the inhibitor. Contrary to earlier predictions, the E-64 inhibitor clearly interacts with the S subsites on the enzyme rather than the S' subsites, and papain's histidine 159 imidazole group plays a binding rather than a catalytic role in the inactivation process. PMID- 2713368 TI - Crystallization of isoelectrically homogeneous cholera toxin. AB - Past difficulty in growing good crystals of cholera toxin has prevented the study of the crystal structure of this important protein. We have determined that failure of cholera toxin to crystallize well has been due to its heterogeneity. We have now succeeded in overcoming the problem by isolating a single isoelectric variant of this oligomeric protein (one A subunit and five B subunits). Cholera toxin purified by our procedure readily forms large single crystals. The crystal form (space group P2(1), a = 73.0 A, b = 92.2 A, c = 60.6 A, beta = 106.4 degrees, one molecule in the asymmetric unit) has been described previously [Sigler et al. (1977) Science (Washington, D.C.) 197, 1277-1278]. We have recorded data from native crystals of cholera toxin to 3.0-A resolution with our electronic area detectors. With these data, we have found the orientation of a 5 fold symmetry axis within these crystals, perpendicular to the screw dyad of the crystal. We are now determining the crystal structure of cholera toxin by a combination of multiple heavy-atom isomorphous replacement and density modification techniques, making use of rotational 5-fold averaging of the B subunits. PMID- 2713369 TI - Protein dynamics from chemical shift and dipolar rotational spin-echo 15N NMR. AB - The partial collapse of dipolar and chemical shift tensors for peptide NH and for the amide NH at cross-link sites in cell wall peptidoglycan, of intact lyophilized cells of Aerococcus viridans, indicates NH vector root-mean-square fluctuations of 23 degrees. This result is consistent with the local mobility calculated in typical picosecond regime computer simulations of protein dynamics in the solid state. The experimental root-mean-square angular fluctuations for both types of NH vectors increase to 37 degrees for viable wet cells at 10 degrees C. The similarity in mobilities for both general protein and cell wall peptidoglycan suggests that one additional motion in wet cells involves cooperative fluctuations of segments of cell walls, attached proteins, and associated cytoplasmic proteins. PMID- 2713370 TI - Clonal analysis of the glycosylation of immunoglobulin G secreted by murine hybridomas. AB - A panel of 10 hybridomas was assembled to assess the influence of various genetic and biological factors upon glycosylation of secreted monoclonal IgG. After exhaustive Pronase digestion of IgG, glycopeptides were characterized chromatographically by apparent size, charge, and concanavalin A (Con A) Sepharose and Lens culinaris (LcH)-agarose affinity. Six glycosylation phenotypes were found to be common among all clones studied. Despite this phenotypic heterogeneity in glycosylation of IgG, considerable similarity exists between different clones. In particular, virtually all IgG glycopeptides bear a core fucose residue. Second, the majority of the glycosylation repertoire is comprised of two phenotypes, characterized by glycopeptides which differ in affinity for Con A-Sepharose. Of these, the predominantly expressed phenotype is the same for all clones. The carbohydrate structure derived from this phenotype, elucidated by 500-MHz 1H NMR spectroscopy, is (Formula: see text). Significant variability between different hybridomas exists in the relative expression of the two major phenotypes. Other differences between clones may reflect the expression of an additional site which is glycosylated differently. However, there is no apparent correlation of phenotype with either the hybridoma's parentage or the serologically defined polypeptide structure of the IgG which it secretes. In addition to clonal variability, other sources of variability in phenotypic expression were identified. A generational variability is apparent upon continuous culturing of the same hybridoma. Also, differences in culture medium pH or proliferative state of the cells may have a modest influence upon the glycosylation phenotype. PMID- 2713371 TI - Effect of homo poly(L-amino acids) on fibrin assembly: role of charge and molecular weight. AB - Positively charged molecules such as protamine, leukocyte cationic protein, and the carboxyl terminus of platelet factor 4 have been shown to increase fibrin fiber thickness. Synthetic homo poly(L-amino acids) were used to explore the role of charge and molecular weight of cationic molecules on fibrin assembly. The effects of poly(L-lysine) (PLL), poly(L-glutamic acid) (PLG), poly(L-aspartic acid) (PLA), poly(L-histidine) (PLH), and poly(L-arginine) (PLArg) on the assembly and structure of fibrin gels were studied by using light-scattering techniques. At a PLG (Mr 60,000) concentration of 80 micrograms/mL and a PLA (Mr 20,000) concentration of 64 microgram/mL, neither of these negatively charged polymers produced a detectable change in either fibrin assembly kinetics or final structure. Positively charged PLArg (16 micrograms/mL) caused a 30% increase in fibrin fiber mass/length ratio without calcium. In contrast, PLH (16 micrograms/mL), also positively charged, had no effect in the absence of CaCl2 but produced a 40% increase in fiber mass/length ratio with 5 mM CaCl2. At concentrations as low as 1 microgram/mL, positively charged PLL increased the initial fibrin assembly kinetics and led to larger fiber mass/length ratio. The impact on fibrin mass/length ratio was equivalent for three different molecular weight preparations of PLL (Mr 25,000, 90,000, and 240,000). The lack of a molecular weight effect on fiber thickness and the low polymer concentrations required to produce the perturbation argue against an excluded volume effect as the mechanism by which lateral fiber growth is augmented. Mechanisms by which poly(L-amino acids) may perturb fibrin assembly are discussed. PMID- 2713372 TI - Assembly of pure tubulin in the absence of free GTP: effect of magnesium, glycerol, ATP, and the nonhydrolyzable GTP analogues. AB - We describe in vitro microtubule assembly that exhibits, in bulk solution, behavior consistent with the GTP cap model of dynamic instability. Microtubules assembled from pure tubulin in the absence of free nucleotides could undergo one cycle of assembly, but could not sustain an assembly plateau. After the initial peak of assembly was reached and bound E-site GTP hydrolyzed to GDP, the microtubules gradually disassembled. We studied buffer conditions that maximized this disassembly while still allowing robust assembly to take place. While both glycerol and glutamate increased the rate of initial assembly and then slowed disassembly, magnesium promoted initial assembly and, surprisingly, enhanced disassembly. After cooling, a second cycle of assembly was unsuccessful unless GTP or the hydrolyzable GTP analogue GMPCPOP was readded. The nonhydrolyzable GTP analogues GMPPNP and GMPPCP could not support the second assembly cycle in the absence of E-site GTP. Analysis using HPLC found no evidence that GMPPNP, GMPPCP, or ATP could bind to free tubulin, and these nucleotides did not compete with GTP for the E-site. We have, however, demonstrated that the nonhydrolyzable GTP analogues and ATP do have an important effect on microtubule assembly. GMPPNP, GMPPCP, and ATP could each enhance the rate of assembly and stabilize the plateau of assembled microtubules against disassembly, while not binding appreciably to free tubulin. We conclude that these nucleotides, as well as GTP itself, enhance assembly by binding to a site on microtubules that is not present on free, unpolymerized tubulin. We estimate the affinity (KD) of the polymeric site for nucleotide triphosphates to be approximately 10(-4)M. PMID- 2713373 TI - Patterns of alternative splicing of fibronectin pre-mRNA in human adult and fetal tissues. AB - Alternative splicing of fibronectin pre-mRNA at two distinct regions, termed ED-A and IIICS, was investigated with human adult and fetal tissues by the nuclease S1 protection assay. A clear tissue specificity was observed in the splicing pattern at the ED-A region. More ED-A+ than ED-A- mRNAs were identified in lung, whereas ED-A- mRNAs were predominantly expressed in liver. Endometrium contained nearly equal amounts of ED-A+ and ED-A- mRNAs. The splicing pattern at the ED-A region was also different between adult and fetal liver but not between adult and fetal lung. Tissue type specific splicing was also observed at the IIICS region. Although the mRNA species containing the complete IIICS sequence comprised 40-65% of the total fibronectin mRNAs irrespective of tissue types, expression of the mRNA species lacking a part or all of the IIICS sequence was more pronounced in adult liver than in other tissues including fetal liver. These results strongly suggest that the alternative splicing of fibronectin pre-mRNA in vivo is regulated in a tissue type specific manner at both the ED-A and IIICS regions and that it is developmentally regulated in liver but not in lung. On the basis of these and other observations reported previously, a possibility that a part of the fibronectins synthesized and secreted by hepatocytes is deposited in the tissue matrix is discussed. PMID- 2713374 TI - Structure of cytochrome b5 in solution by Fourier-transform infrared spectroscopy. AB - Fourier-transform infrared spectroscopy was used to examine the secondary structure of rabbit liver cytochrome b5 and the polar and nonpolar domains of the protein. The data for both the polar and nonpolar domains agree well with those previously obtained by other physical techniques. In particular it was found that the nonpolar membrane-binding domain was predominantly alpha helix and that the polar domain was also highly helical, but not all alpha helix. The independence of the two domains in the whole molecule was, in general, confirmed by the additivity of the spectra of the two domains. The small differences that were seen indicate that there is a loss of alpha helix when the protein is cut into the two domains. In addition, there appeared to be a slight difference in the exposure to solvent of the amide NH groups in the alpha-helical portion of the nonpolar domain when it was examined in isolation. PMID- 2713375 TI - Ubiquitinated histone H2B is preferentially located in transcriptionally active chromatin. AB - Using an anti-ubiquitin antibody in Western blotting experiments, we detected polyubiquitinated species of histones H2A, H2A.Z, and H2B in histone preparations of bovine thymus, chicken erythrocyte, and Tetrahymena macro- and micronuclei. Histone H2A had the greatest level of polyubiquitinated species, with tetra- to hexaubiquitinated forms of this histone being observed. The fraction of bovine thymus and chicken erythrocyte chromatin enriched in transcriptionally active gene sequences was enriched in mono- and polyubiquitinated species of histones H2A, H2B, and H2A.Z, especially in the ubiquitinated forms of histone H2B. Histones H2A and H2B were ubiquitinated in the transcriptionally active Tetrahymena macronucleus, with monoubiquitinated (u) H2B being the predominant ubiquitinated histone species. Ubiquitinated forms of histones H2A and H2B were found in transcriptionally inert micronuclei, but at lower levels than seen in macronuclear histones. Also, the level of micronuclear uH2A was greater than that of uH2B which may be from macronuclei that contaminate the preparation. These results indicate that the mono- and polyubiquitinated species of histone H2B are preferentially located in transcriptionally active chromatin regions. Ubiquitinated histone H2A is located in both expressed and repressed chromatin domains, but expressed chromatin is enriched in mono- and polyubiquitinated forms of this histone. These observations are consistent with the hypothesis that ubiquitinated histones have a role maintaining the structure of transcriptionally active chromatin. PMID- 2713376 TI - Nucleosome reconstitution of core-length poly(dG).poly(dC) and poly(rG dC).poly(rG-dC). AB - The double-stranded polypurine.polypyrimidines poly(dG).poly(dC) and poly[d(A G)].poly[d(T-C)] and the mixed ribose-deoxyribose polynucleotide poly(rG dC).poly(rG-dC) have been successfully reconstituted into nucleosomes. The radioactively labeled particles comigrate in gel electrophoresis and sucrose density gradient experiments with authentic nucleosomes derived from chicken erythrocyte chromatin. These results show that nucleosomes are able to accommodate a wider variety of polynucleotides than was previously believed. PMID- 2713377 TI - Exonucleolytic proofreading by a mammalian DNA polymerase. AB - Porcine liver DNA polymerase gamma contains exonuclease activity capable of digesting DNA in the 3'----5' direction, releasing deoxyribonucleoside 5' monophosphates. The exonuclease activity excises 3'-terminal bases from both matched and mismatched primer termini, with a preference for mismatched bases. Under polymerization conditions, mismatch excision by the exonuclease occurs prior to polymerization by polymerase gamma, and this excision can be inhibited by adding to the reaction a high concentration of dNTP substrates and/or nucleoside 5'-monophosphates. In an M13mp2-based reversion assay for detecting single-base substitution errors, porcine liver polymerase gamma is highly accurate; the estimated base substitution error rate is less than one error for each 500,000 bases polymerized. Lower fidelity is observed using reaction conditions that inhibit the exonuclease activity, strongly suggesting that the exonuclease proofreads errors during polymerization. However, in a forward mutation assay capable of detecting all 12 mispairs at a variety of template positions, certain base substitution errors are readily detected even using unperturbed polymerization conditions. Thus, for some errors, polymerase gamma is not highly accurate, suggesting that proofreading is not equally active against all mispairs. To examine if the polymerase and exonuclease activities are physically as well as functionally associated, both activities were monitored during purification by four procedures, each based on a different separation principle. The two activities copurify during chromatography using phosphocellulose, heparin-agarose, or double-strand DNA-cellulose, and during velocity sedimentation in a glycerol gradient containing 0.5 M KCl. These results suggest that the polymerase and exonuclease activities are physically associated. It remains to be determined if they reside in the same subunit. PMID- 2713378 TI - Novel isoglobo-neolacto-series hybrid glycolipid detected by a monoclonal antibody is a rat colon tumor-associated antigen. AB - Isoglobotetraosylceramide (GalNAc(beta 1-3)Gal(alpha 1-3)Gal(beta 1-4)Glc (beta 1 1)Cer), the major glycolipid species in dimethylhydrazine-induced rat tumors of colorectal origin, was not detected in epithelial cells of normal colon but was present in the non-epithelial stroma and could be extracted from each of nine tumors studied. Monoclonal antibodies produced against isoglobotetraosylceramide detected this and another novel rat tumor-associated glycolipid not present in epithelial cells nor in non-epithelial stroma of normal rat colon (Brodin, T., Thurin, J., Stromberg, N., Karlsson, K.-A. and Sjogren, H.O. (1985) Eur. J. Immunol. 16, 951-956). This novel glycolipid was present in 8/9 of the studied tumors and was also present in two in vitro cell clones. These were originally obtained from a W49/T4 colon tumor isograft. The novel glycolipid was characterized by mass spectrometry, 1H-NMR, and methylation analysis as a hybrid between the isoglobo- and neolacto-series, with the structure GalNAc(beta 1 3)Gal(alpha 1-3)Gal(beta 1-4)GlcNA(beta 1-3)Gal (beta 1-4)Glc(beta 1-1)Cer. PMID- 2713379 TI - Extracellular Ca2+ influences 1,2-diacylglycerol and inositol monophosphate formation in renal cortical slices stimulated with plasma obtained from uninephrectomized rats. AB - Formation of 1,2-diacylglycerol (DAG) and inositol phosphates was investigated in renal cortical slices after addition of plasma obtained 30 min after either uninephrectomy or sham operation. Plasma from uninephrectomized rats increased DAG concentration about 100% above control value during 5 min of incubation, but when extracellular Ca2+ had been chelated with 4 mM EGTA, the increase of DAG was only about 50% and the duration of the effect was 2 min only. Furthermore, chelation of extracellular Ca2+ did not affect the formation of InsP3 and InsP2 during 20 min of incubation, while the formation of InsP was significantly reduced. Results indicate that extracellular Ca2+ is needed for sustained increase in DAG concentration and increase in InsP radioactivity, suggesting phosphatidylinositol as their probable source. PMID- 2713380 TI - The species of acyl-CoA in subcellular fractions of type II cells isolated from adult rat lung and their incorporation into phosphatidic acid. AB - Microsomes and cytosol were prepared from type II cells isolated from adult rat lung. Upon determination of the acyl-CoA composition in the microsomes, we found 49% palmitoyl-CoA, 2% myristoyl-CoA, 21% stearoyl-CoA, 5% palmitoleoyl-CoA, 16% oleoyl-CoA, 5% linoleoyl-CoA and 2% arachidonoyl-CoA. The acyl-CoA composition of the cytosol was very similar. Upon incubation of type II cell microsomes with [U 14C]glycerol 3-phosphate and with acyl-CoA species mixed in the proportions in which they were found in this cell fraction, approx. 40% of the synthesized phosphatidic acid was disaturated. Of the two quantitatively most important acyl CoA species, the palmitoyl species was incorporated 4-times faster into total and disaturated phosphatidic acid than the stearoyl species. These two species were distributed very similarly among the phosphatidic acid species synthesized de novo. In newly formed disaturated phosphatidic acid, the palmitoyl groups were distributed approximately equally between the 1- and the 2-position. From these data, it can be estimated that of the phosphatidic acid molecules synthesized by type II cell microsomes, approx. 26% contain two palmitoyl moieties. Assuming that both phosphatidic acid phosphatase and cholinephosphotransferase are non selective with regard to the substrate species that they convert, this would mean that 26% of the phosphatidylcholine molecules synthesized de novo would be dipalmitoylphosphatidylcholine. As in surfactant, approx. 60% of the phosphatidylcholine is constituted by the dipalmitoyl species, this would mean that approx. 45% of the surfactant dipalmitoylphosphatidylcholine would be made via de novo synthesis. PMID- 2713381 TI - Lipid and lipoprotein synthesis in isolated and cultured hepatocytes from lean and obese Zucker rats. AB - Hepatocytes were isolated by EDTA perfusion of livers from lean (Fa/-) and obese (fa/fa) Zucker rats. Triacylglycerol (TG) and sn-glycerol 3-phosphate were increased in fa/fa hepatocytes, but free fatty acids, cholesterol and phospholipid concentrations were similar in both groups. In spite of an identical fatty acid uptake rate, glycerolipid synthesis was higher in obese compared to lean rat hepatocytes, and this difference remained for at least 2-3 days of culture. Triacylglycerol mass secretion was 2-fold higher in obese than in lean rat hepatocytes. This was confirmed by the higher incorporation of labeled glycerol and oleic acid into the medium TG fraction floating at density 1.006 g/ml. Density gradient ultracentrifugation of [14C]oleate-labeled lipoproteins showed that fa/fa hepatocytes secreted more TG-rich lipoproteins, and that 87% of the label was in the VLDL fraction compared with 67% in the medium of Fa/- hepatocytes. Decreased utilisation of leucine for protein synthesis in obese rat compared to lean rat hepatocytes was associated with enhanced leucine oxidation to CO2. [35S]Methionine incorporation showed an identical cell protein synthesis rate. Autoradiography after PAGE separation of secreted apolipoproteins (apoBh, Bl, apoA-VI, apoE, apoA-I, apoC) showed an identical pattern in both cell types. PMID- 2713382 TI - Effect of dietary fats on linoleic acid metabolism. A radiolabel study in rats. AB - Effects on the linoleic acid metabolism in vivo of three dietary fats, rich in either oleic acid, trans fatty acids or alpha-linolenic acid, and all with the same linoleic acid content, were investigated in male Wistar rats. After 6 weeks of feeding, the rats were intubated with [1-14C]linoleic acid and [3H]oleic acid. The incorporation of these radiolabels into liver, heart and serum was investigated 2, 4, 8, 24 and 48 h after intubation. The amount of 14C-labelled arachidonic acid incorporated into the liver phospholipid of the group fed the oleic acid-rich diet was significantly higher than that of the other groups. However, compared to the trans fatty acids-containing diet, the oleic acid-rich diet induced only a slightly higher arachidonic acid level in the phospholipid fraction of the tissues as determined by GLC. Dietary alpha-linolenic acid more than halved the arachidonic acid levels. Our results do not support the hypothesis that the delta 6-desaturase system actually determines the polyunsaturated fatty acid levels in tissue lipids by regulating the amount of polyunsaturated fatty acids (e.g., arachidonic acid) synthesized. The biosynthesis of polyunsaturated fatty acids only is not sufficient to explain the complicated changes in fatty acid compositions as observed after feeding different dietary fats. PMID- 2713383 TI - Impaired triacylglycerol catabolism in hypertriglyceridemia of the diabetic, cholesterol-fed rabbit: a possible mechanism for protection from atherosclerosis. AB - The etiology of the hypertriglyceridemia in alloxan-diabetic rabbits was studied by two independent methods. Production and removal rates of VLDL triacylglycerol were measured in diabetic rabbits by injection of [3H]palmitate-labelled VLDL. Similarly, triacylglycerol total removal rates were determined in non-diabetic rabbits which were infused with Intralipid to mimic the plasma triacylglycerol concentrations of diabetic rabbits. Compared to nondiabetic rabbits, triacylglycerol removal rats were decreased in diabetic rabbits, particularly at higher levels of plasma triacylglycerol. During cholesterol and triacylglycerol supplementation of the diet, post-heparin plasma lipoprotein lipase activity of diabetic rabbits with severe hypertriglyceridemia averaged 36% of that of nondiabetics, suggesting an impaired triacylglycerol removal capacity. Furthermore, plasma triacylglycerol was inversely related to post-heparin plasma lipoprotein lipase activity among diabetic rabbits. VLDL triacylglycerol production increased with increasing plasma triacylglycerol concentration among diabetic cholesterol-fed rabbits with moderately severe hypertriglyceridemia, but reached an apparent plateau among rabbits with plasma triacylglycerol concentrations from approx. 2000-9000 mg/dl. Thus, severe hypertriglyceridemia in this model of insulin deficiency can be attributed only partially to VLDL hypersecretion, whereas a removal defect, resulting in saturation of the triacylglycerol removal mechanism, appears to be largely responsible. The impaired removal of plasma triacylglycerol is also related to the presence of cholesterol predominantly in lipoproteins of increased size. The data support the hypothesis that protection against atherosclerosis in cholesterol-fed diabetic rabbits results from exclusion of very large cholesterol-containing lipoproteins from the arterial wall. PMID- 2713384 TI - Effects of heparin-induced lipolytic activity on the structure of rat high density lipoprotein. AB - Following its secretion into the plasma compartment, the high-density lipoprotein (HDL) is presumed to be acted upon by both soluble enzymes, such as lecithin:cholesterol acyltransferase (LCAT), and membrane-associated enzymes, such as lipoprotein lipase and hepatic lipase. Rats were injected intravenously with heparin to release membrane-associated lipolytic activities into the circulation and the collected plasma was incubated overnight at 37 degrees C in the presence or absence of an LCAT inhibitor or an inhibitor of lipoprotein lipase (1 M NaCl). It was observed that lipoprotein lipase accounted for most of the triglyceride hydrolase activity in the heparin-treated plasma, and that the heparin-releasable activities caused an increase in HDL density but no measurable change in particle size when LCAT was inhibited. Heparin treatment caused about a 60% decrease in plasma triacylglycerol during the interval between injection of heparin and blood collection. Although this caused marked compositional changes in the d less than 1.063 g/ml lipoproteins, no changes were observed in the lipid composition or apoprotein distribution in the HDL. Subsequent incubation for 18 h at 37 degrees C produced marked increases in the apoE content of HDL from heparin treated plasma even when LCAT was inhibited. Time-course studies showed that in the presence of an LCAT inhibitor there was considerable conversion of phosphatidylcholine to lysophosphatidylcholine in heparin-treated plasma, and that this activity was diminished by 1 M NaCl, but that no phospholipolysis was observed in control plasma. By contrast, both heparin-treated and control plasma possessed substantial triglyceride hydrolase activity. The concurrent action of lipases and LCAT was observed to reduce the maximum level of cholesterol esterification which could be achieved in the absence of lipase activity. It is concluded that changes in HDL particle size are mainly attributable to LCAT, but that lipase activities, which are either free in rat plasma or releasable by heparin, play a role in restructuring the phospholipid moiety and altering the protein composition of the HDL, especially with respect to apoE, a potential ligand to cellular receptors. PMID- 2713385 TI - Effect of surfactant-associated protein-A (SP-A) on the activity of lipid extract surfactant. AB - The properties of natural bovine surfactant and its lipid extract have been examined with a pulsating bubble surfactometer which assesses the ability of surfactant lipids to adsorb to the air/liquid interface and reduce the surface tension to near 0 dynes/cm during dynamic compression. Studies conducted at 1 mg/ml phospholipid revealed that the surface activity (i.e., the ability to produce low surface tensions) of lipid extracts could be enhanced by incubating the sample at 37 degrees C for 120 min or by addition of CaCl2. In contrast, incubation at 37 degrees C only slightly improved the biophysical activity of natural surfactant and the addition of CaCl2 had a more modest effect than with lipid extracts. With 20 mM CaCl2, the surfactant activity of lipid extract surfactant was similar to that of natural surfactant. Incubation with EDTA reduced the biophysical activity of natural surfactant. Experiments in which increasing amounts of lipid extract were replaced by natural surfactant revealed that small amounts of natural surfactant enhanced the surfactant activity of lipid extract. The biophysical activity of lipid extract surfactant was also increased by the addition of soluble surfactant-associated protein-A (SP-A) (28 36 kDa) purified from natural bovine surfactant. These results indicate that SP-A (28-36 kDa) improves the surfactant activity of lipid extracts by enhancing the rate of adsorption and/or spreading of phospholipid at the air/liquid interface resulting in the formation of a stable lipid monolayer at lower bulk concentrations of either phospholipid or calcium. PMID- 2713386 TI - The effect of added monoacylglycerols on the removal from plasma of chylomicron like emulsions injected intravenously in rats. AB - Lipid emulsions were prepared with compositions similar to the triacylglycerol rich plasma lipoproteins, but also incorporating added small amounts of monoacylglycerols. Control emulsions without monoacylglycerol were metabolized similarly to natural chylomicrons or very-low-density lipoproteins when injected intravenously in rats. The emulsion triacylglycerols and cholesteryl esters were both removed rapidly from the bloodstream, with the removal rates of triacylglycerols faster than those of cholesteryl esters. Much of the removed cholesteryl ester was found in the liver, but only a small fraction of the triacylglycerol, consistent with hepatic uptake of the triacylglycerol-depleted remnants of the injected emulsion. Emulsions incorporating added monooleoylglycerol or stearic acid were metabolized similarly. Added 1- or 2 monostearoylglycerol had no effect on triacylglycerol removal from plasma, but the removal rate of cholesteryl esters was decreased and less cholesteryl ester was found in the liver. These effects are similar to those recently described when emulsions and chylomicrons contained triacylglycerols with a saturated acyl chain at the glycerol 2-position, suggesting that saturated monoacylglycerol produced by the action of lipoprotein lipase may cause triacylglycerol-depleted remnant particles to remain in the plasma instead of being rapidly taken up by the liver. PMID- 2713387 TI - A plasma membrane pool of cholesteryl esters that may mediate the selective uptake of cholesteryl esters from high-density lipoproteins. AB - Selective uptake of high-density lipoprotein (HDL) cholesteryl esters without parallel uptake of HDL particles occurs by a nonendocytotic pathway that requires no specific apolipoprotein and results in the net delivery of cholesteryl esters to cells. Here we examine a reversibly cell-associated pool of cholesteryl ester tracer and its relationship to selective uptake. A fraction of cholesteryl ester tracer selectively taken up from HDL by rat primary or mouse Y1-BS1 adrenocortical cells was chased from the cells by subsequent incubation with unlabeled HDL. This pool of cholesteryl ester tracer was distinct from that irreversibly internalized, and in excess of that accounted for by dissociation of labeled HDL particles bound to the cell surface. In response to various metabolic effectors, cholesteryl ester tracer in this reversibly cell-associated pool of Y1 BS1 cells correlated linearly with irreversible selective uptake. Both reversibly and irreversibly cell-associated pools of cholesteryl ester tracer displayed similar saturation kinetics for uptake from HDL, and both pools correlated inversely with cell-free cholesterol levels. Cholesteryl ester tracer in the reversible pool was shown to serve as a precursor for irreversible selective uptake. A pool with properties similar to the reversibly cell-associated pool was identified in plasma membrane fractions; enough tracer was incorporated into this pool to account for the reversibly cell-associated pool of intact cells. The data suggest that a pool of cholesteryl esters in the plasma membrane is involved in selective uptake at a step prior to irreversible internalization. PMID- 2713388 TI - Purification of pancreatic phospholipase A2 from human duodenal juice. AB - Phospholipase A2 (EC 3.1.1.4) was purified from delipidated human duodenal juice by hydrophobic and cation exchange chromatography, followed by molecular sieving on an HPLC column. The resulting enzyme preparation of phospholipase A2 had a molecular weight of 14 kDa, a specific activity of 2000 U/mg protein, and an N terminal amino acid sequence which was characteristic for human pancreatic phospholipase A2. PMID- 2713389 TI - Effects of 6,6-difluorocholestanol and 7,7-difluorocholestanol on hepatic enzymes of cholesterol metabolism. AB - The effects of 6,6-difluorocholestanol and 7,7-difluorocholestanol on enzymes of hepatic liver cholesterol were examined. Neither compound affected the activity of 3-hydroxy-3-methylglutaryl-CoA reductase. 7,7-Diffluorocholestanol had no effect on the activity of acyl-CoA: cholesterol acyltransferase or cholesterol 7 alpha-hydroxylase. However, 6,6-difluorocholestanol was a competitive substrate for cholesterol in the esterification of cholesterol catalysed by the acyltransferase. 6,6-Difluorocholestanol also inhibited hydroxylation of cholesterol by cholesterol 7 alpha-hydroxylase but was not itself a substrate for this enzyme. These results show that substitutents in ring B of the sterol can have a significant effect on the binding of the sterol to enzymes and to the catalytic mechanism if the substituent is close to the groups in the molecule that participate. PMID- 2713390 TI - Ethanol increases the sensitivity of carnitine palmitoyltransferase I to inhibition by malonyl-CoA in short-term hepatocyte incubations. AB - The sensitivity of carnitine palmitoyltransferase I to inhibition by malonyl-CoA was increased in mitochondria isolated from rat hepatocytes incubated with ethanol. This effect was mimicked by incubation of hepatocytes with acetaldehyde or by preincubation of isolated mitochondria with malonyl-CoA. Both ethanol and acetaldehyde increased the intracellular concentration of malonyl-CoA. Results suggest that the ethanol-induced elevation of intracellular malonyl-CoA levels may be responsible for the enhanced sensitivity of carnitine palmitoyltransferase I to inhibition by malonyl-CoA. PMID- 2713391 TI - Effect of catalytic hydrogenation of Tetrahymena ciliary phospholipid fatty acids on ciliary phospholipase A activity. AB - Detached Tetrahymena cilia were treated for increasing periods of time with the homogeneous hydrogenation catalyst palladium di(sodium alizarine monosulphonate). This caused a 4-70% reduction in the number of double bonds in phospholipid-bound fatty acids and a concurrent decrease in membrane fluidity as detected by ESR measurements. Ciliary phospholipase A activity was markedly inhibited when as little as 13% of the fatty acid double bonds had been hydrogenated, suggesting that the enzyme activity is very sensitive to changes in membrane fluidity. PMID- 2713392 TI - Effects of blocking plasma lipid transfer protein activity in the rabbit. AB - Plasma lipid transfer protein activity was completely blocked in rabbits for up to 48 h by infusion with goat antibody to rabbit lipid transfer protein. Lipid transfer protein activity in plasma of control animals, infused with antibody from a non-immune goat, decreased during the experiment but was never less than 50% of pre-infusion levels. During the period that lipid transfer protein activity was completely blocked, there were changes in high-density lipoprotein composition (expressed as % by weight) with a reduction in triacylglycerol from 8.4 +/- 2.4% to 1.0 +/- 0.2% (P less than 0.05) and an increase in esterified cholesterol from 10.7 +/- 1.7% to 14.5 +/- 0.3% (P less than 0.1). In conjunction with the observed changes in high-density lipoprotein composition, there was an increase in high-density lipoprotein particle size from a mean radius of 4.7 to 5.4 nm. The change in composition and particle size was not observed in high density lipoproteins from control animals. There was a change in the distribution of plasma cholesterol in control animals, with a fall in the proportion of cholesterol in high-density lipoproteins (P less than 0.02) and consequently an increase in the proportion of cholesterol in low-density lipoproteins (P less than 0.02). However, the distribution of plasma cholesterol in animals in which lipid transfer protein activity was inhibited was maintained at original levels during the period of inhibition. Consequently, in these animals, there was a less atherogenic distribution of cholesterol during the period of lipid transfer protein inhibition when compared with control animals. The changes observed in lipoproteins, in the absence of lipid transfer protein activity, demonstrate that lipid transfer protein modifies lipoproteins in vivo and appears to contribute to a more atherogenic lipid profile. PMID- 2713393 TI - Identification of a novel 7-cis-11-trans-lipoxin A4 generated by human neutrophils: total synthesis, spasmogenic activities and comparison with other geometric isomers of lipoxins A4 and B4. AB - Addition of (15S)-hydroxy-5,8,11-cis-13-trans-eicosatetraenoic acid (15-HETE) and the ionophore A23187 (2.5 microM) to human neutrophils led to the formation of both lipoxin A4 and lipoxin B4 as well as a novel 5,6,15 trihydroxyeicosatetraenoic acid. The new compound was identified using an improved isolation and detection system and its basic structure was determined by physical methods. On the basis of biosynthetic considerations, geometric isomers of lipoxin A4 and lipoxin B4 were prepared by total synthesis. Comparison of these synthetic materials with the neutrophil-derived product showed that the new compound is (5S,6R,15S)-trihydroxy-9,11,13-trans-7-cis-eicosatetraenoic acid or the 7-cis-11-trans-isomer of LXA4 (7-cis-11-trans-LXA4). LXA4, 11-trans-LXA4, 7 cis-LXA4 and 7-cis-11-trans-LXA4 all evoked dose-dependent (0.1-10 microM) contractions of the guinea pig lung strip, whereas 6-cis-LXB4 and 6-cis-8-trans LXB4 relaxed this preparation. LXA4 and 7-cis-LXA4 were approx. 10-times more potent than the compounds with 11-trans geometry. However, all four double-bond isomers of LXA4 caused contractions which, based upon pharmacological evidence, appeared to involve specific activation of the same site as cysteinyl-containing leukotrienes. In conclusion, 7-cis-11-trans-LXA4 was isolated and identified as a novel biologically active eicosanoid formed by human neutrophils. PMID- 2713394 TI - Covalent coupling of sugars to liposomes. AB - A procedure is described for the covalent coupling of p-aminophenyl-alpha-D mannopyranoside, in the presence of carbodiimide, to a derivative of phosphatidylethanolamine (N-glutarylphosphatidylethanolamine) incorporated into the bilayers of multilamellar liposomes prepared by the dehydration-rehydration method. It appears that much of the phospholipid derivative exposed on the surface of the outer liposomal bilayer interacts with the aminosugar. The procedure is simple, does not destabilize liposomes and could be applied to other receptor-specific aminosugars. PMID- 2713395 TI - Dehydration-rehydration vesicle methodology facilitates a novel approach to antibody binding to liposomes. AB - Mouse monoclonal IgG1 specific for hepatitis B surface antigen and ovine polyclonal antibody raised against digoxin were covalently coupled by a diazotisation method to small unilamellar vesicles (SUV) composed of equimolar phospholipid and cholesterol supplemented with 6 mol% aminophenylstearylamine (APSA). Up to 33% of the antibody used was associated with vesicles, depending on the phospholipid and the antibody type used. Antibody-coated SUV were mixed with carboxyfluorescein (CF) or beta-galactosidase to generate multilamellar dehydration-rehydration vesicles (DRV) containing CF or active enzyme. In contrast, coupling of antibodies directly to beta-galactosidase-containing DRV resulted in total inactivation of the enzyme. About 85% of the SUV-bound antibody was recovered in DRV and of this, 78-82% was exposed on the liposomal surface, possibly because of reorientation of the APSA-antibody complex during DRV formation. Antibody-coated DRV remained stable in the presence of plasma at 37 degrees C and also under storage at 4 degrees C. Further, antibody coupled to such liposomes was capable of efficient interaction with the respective antigen. The present method allows the attachment of antibodies to the liposomal surface independently of entrapment of solutes, the activity of which is thus preserved, and could be adapted to alternative coupling procedures or ligands. PMID- 2713396 TI - Prostaglandin E2 in the lung lavage fluid of premature newborns before and after surgical or medical closure of a patent ductus arteriosus. AB - To analyze the role of prostaglandin E2 in maintaining ductal patency in premature newborns, we measured the PGE2 concentration in the lung lavage fluid of nine patients within 24 h before and 4-8 h after surgical ligation of a patent ductus arteriosus and in two patients before and after closure of the ductus following intravenous indomethacin. The concentration of PGE2 ranged from 240 to 3770 pg/ml (mean 1666 +/- 1256 pg/ml) before operative intervention and show a significant decrease to 0-300 pg/ml (mean 93 +/- 106 pg/ml, P less than 0.001, Student's two-tailed t-test) within a few hours after ligation of the ductus arteriosus. The same significant decrease could be seen in two patients with successful indomethacin therapy (0.25 mg/kg in three doses/day) with concomitant ductus closure. In contrast, when indomethacin was given in a reduced dose (0.1 mg/kg in three doses/day), only a slight effect on PGE2 synthesis could be seen without closure of ductus arteriosus. We suggest that the fall of PGE2 levels in lung lavage fluid reflects the local synthesis in the ductus arteriosus itself and is responsible for the decrease induced by surgical ligation or pharmacological inhibition by indomethacin. PMID- 2713397 TI - Induction of peroxisomal beta-oxidation in 7800 C1 Morris hepatoma cells in steady state by fatty acids and fatty acid analogues. AB - (1) The activities of peroxisomal beta-oxidation and palmitoyl-CoA hydrolase in Morris hepatoma 7800 C1 cells were studied. The cells were grown until they reached steady state (constant DNA content per dish) and then were cultured in the presence of fatty acids or alkylthioacetic acids, i.e., S-substituted fatty acid analogues. (2) The fatty acid analogues increased the activity of the cyanide-insensitive palmitoyl-CoA oxidase several-fold. The effect was dose dependent; 5 microM tetradecylthioacetic acid (TTA) was sufficient to give a significant induction. With 20 microM TTA, the increase in enzyme activity was discernable after 3 h and reached a maximum after 3 days. The inducing effect of the alkylthioacetic acids increased with the length of the hydrophobic alkyl end of the analogue. The inducing ability disappeared when the fatty acid analogue was omega-oxidized to the corresponding dicarboxylic acid. Oxidation of the sulfur atom resulted in inhibited cellular uptake and abolished enzyme induction. (3) At higher concentrations (0.5-1 mM), normal fatty acids also induced cyanide insensitive palmitoyl-CoA oxidation. Myristic acid was the most potent inducer, whereas fatty acids with shorter as well as longer carbon chains were less efficient. The inducing effect increased with the number of double bounds in the fatty acid. (4) The normal fatty acids as well as the fatty acid analogues also induced palmitoyl-CoA hydrolase, but the relative changes were much less pronounced than with the palmitoyl-CoA oxidase. PMID- 2713398 TI - Substrate specificity for interfacial catalysis by phospholipase A2 in the scooting mode. AB - Action of pig pancreatic phospholipase A2 on vesicles and micelles of homologous anionic phospholipids is examined in the absence of additives. As shown elsewhere (Jain et al. (1986) Biochim. Biophys. Acta 860, 435-447), hydrolysis of anionic vesicles occurs by interfacial catalysis in the scooting mode, i.e., the catalytic turnover is fast relative to the off-rate of the enzyme from the interface. When the rate of intervesicle exchange of the enzyme is negligibly slow, it hydrolyses only the substrate molecules in the outer monolayer of the vesicle to which it is bound. Interfacial catalysis in the scooting mode with a high processivity occurs on vesicles of anionic phospholipids, and under these conditions the dynamics and order of the substrate in the interface influences the catalytic turnover only moderately, i.e., about 2- to 10-fold. Similarly, anomalous kinetic effects of the thermotropic gel-fluid phase transition or of a change in the general disorder of the bilayer organization (fluidity) has a minor effect on the kinetics of hydrolysis in the scooting mode. Similarly, higher unsaturation and shorter acyl chains in the substrate modestly increase the rate of catalytic turnover by the low-calcium form of the enzyme without noticeably influencing the affinity of the enzyme for the interface. On the other hand, perturbation of the charge distribution in the substrate interface can shift the proportion of the bound enzyme by several orders of magnitude. For example, the membrane perturbing amphiphiles (e.g., mepacrine, indomethacin, compound 48/80, aristolochic acid, local anesthetics, and the products of hydrolysis) do not influence the catalytic turnover of the bound enzyme but the proportion of the bound enzyme. Short-chain anionic phospholipids are readily hydrolyzed by phospholipase A2. Now no anomalous increase in the rate of hydrolysis is observed at the critical micelle as is the case with the zwitterionic analogs. This is because with anionic (but not with zwitterionic) substrates the enzyme forms an aggregated complex below the cmc of the monomer. The stability of these micellar complexes does not appear to change noticeably with the acyl chain length of the monomers. These observations show that the factors regulating the quality of interface substantially influence the binding of the enzyme, but not the catalytic turnover in the interface. PMID- 2713399 TI - Biosynthesis of high molecular weight polylactosamine-type glycopeptides in rat Zajdela hepatoma ascites cells. AB - The first steps of the biosynthetic pathway of high molecular weight polylactosamine-type glycopeptides from rat Zajdela hepatoma cells were studied by pulse-chase experiments, biochemical analysis and by inhibition of N glycosylation. It is clear that this process involves firstly the transfer of a lipid-linked high-mannose oligosaccharide precursor to a protein moiety in a similar way to that of N-linked glycopeptides of a more common size range according to the classical 'cycle of dolichol'. In the presence of enzymes which are inhibitors of the processing of high-mannose oligosaccharide chains, this class of oligosaccharides was considerably increased, whereas polylactosamine chains and lower complex N-linked glycopeptides were concomitantly decreased in the same kinetics and the same ratio. As expected in the presence of N methyldeoxynojirimycin, which is an alpha-glucosidase inhibitor, high-mannose oligosaccharides remained glycosylated and are mostly of the Glc1-3Man9GlcNAc type. In the presence of swainsonine, which is an alpha-mannosidase (EC 3.2.1.24) inhibitor, these chains were devoid of glucose residues. In addition, some chains displayed hybrid structures. It appears, therefore, that the first steps of the biosynthesis of polylactosamine-type and N-linked oligosaccharides of a more common size range proceed similarly and that differences between their biosynthetic pathways occur during the elongation phase, which leads to their final respective structures. Glycopeptides prepared from the cell surface by mild trypsin treatment as well as from entire cells, previously treated or not by processing inhibitors, display the same gel filtration patterns indicating that modifications in protein glycosylation do not prevent glycoprotein insertion into the cell membrane. PMID- 2713400 TI - In vitro translation, post-translational processing and secretion of pulmonary surfactant protein B precursors. AB - Surfactant proteolipid SP-B is a hydrophobic protein of Mr = 8000 identified in organic solvent extracts of pulmonary surfactant. Analysis of the human SP-B RNA predicts that the active surfactant peptide is derived by proteolysis of an Mr = 40,000 precursor. In the present work, characteristics of synthesis, secretion and processing of SP-B were demonstrated in a pulmonary adenocarcinoma cell line by immunoprecipitation of radiolabelled precursors. Treatment of cells with tunicamycin resulted in synthesis and secretion of unglycosylated proSP-B of Mr = 39,000. Immunoprecipitation of protein produced by in vitro translation of human lung poly(A)+ RNA detected an Mr = 40,000 protein; the size discrepancy is likely related to cleavage of a leader signal sequence. Endoglycosidase-H-sensitive precursors of Mr = 41,000-43,000, pI = 5.1-5.4 were the first isoforms detected within the cells and were processed to endoglycosidase-H-resistant isoforms and secreted. Neuraminidase and endoglycosidase-F-sensitive forms of proSP-B were first detected in the media at 60 min as Mr = 42-46,000 isoforms with pI = 4.6 5.1. Proteolytically processed isoforms of proSP-B were detected primarily in the media and were generated by cleavage of an amino-terminal Mr = 16,000 peptide resulting in Mr = 27,000-33,000 isoforms (pH = 5.6-6.8). The Mr = 27,000-33,000 isoforms were sensitive to neuraminidase, resulting in isoforms with pH = 6.0 6.8. Digestion of the Mr = 27,000-33,000 peptide with endoglycosidase-F resulted in isoforms of Mr = 23,000, pH = 6.0-6.8. The endoglycosidase-F-resistant peptide of Mr = 16,000, pI = 4.2-4.4 was identified with an antiserum generated against synthetic peptides derived from the amino-terminal domain, as deduced from the SP B DNA sequence. Further proteolytic processing of the Mr = 27,000-33,000 isoforms to the Mr = 8000 peptide detected in surfactant was not observed in this cell line. Thus, in the H441-4 cells (a cell line with morphologic features of Clara cells), SP-B is synthesized as a preproprotein which undergoes cleavage of a signal sequence and addition of asparagine-linked carbohydrate; proSP-B is secreted by processes which are independent of glycosylation. SP-B peptides of Mr = 27,000-33,000 and Mr = 16,000, representing carboxy and amino-terminal domains, accumulate in the media. PMID- 2713401 TI - Cholesterogenesis and cell division in phytohemagglutinin-stimulated human lymphocytes: a comparative study with several inhibitors. AB - It has been shown that when lymphocytes are stimulated by phytohemagglutinin the expected stimulation of DNA synthesis is preceded by stimulation of cholesterol synthesis. This confirms the existence of a relation between cell division and cholesterol synthesis. We studied the effect on cell division of six inhibitors of cholesterol biosynthesis, previously shown to interfere with different steps of the process: 7 beta-hydroxycholesterol, 25-hydroxycholesterol, lanost-7-en-3 beta, 32-diol, mevinolin, propiconazole, dodecylimidazole. Since experiments were performed in the presence of a high percentage of human serum, which provided cells with exogenous cholesterol via the LDL-receptor pathway, our investigation was focused on the role of newly synthesized cholesterol. The biosynthesis was evaluated by labeling cells with [14C]sodium acetate; to take into account variations of cell permeability to sodium acetate, the results were expressed as the percentage of total cellularly incorporated radioactivity transformed into cholesterol, after separation from all other labeled metabolites. These data were compared with the percentage of transformation into nonsaponifiable lipids, which varied in parallel with HMG-CoA reductase activity, as confirmed by direct enzymatic measurement. Cell division was assessed by simultaneous measurements of three parameters: thymidine incorporation into DNA, cell proliferation and cellular protein content. All the effectors strongly inhibited the conversion of labeled acetate into cholesterol, but cell division was not inhibited by two of them: propiconazole and 7 beta-hydroxycholesterol. These compounds only slightly inhibited the synthesis of nonsaponifiable lipids, which mainly consisted of methylsterols resulting from a blockage of lanosterol demethylation. Thus, it can be concluded that the nonsaponifiable metabolite essential for cell growth is not newly synthesized cholesterol. It was also found that inhibitors affected cell division only when they were added to the culture medium before the decline of cholesterol synthesis stimulation. PMID- 2713402 TI - Binding characteristics of progesterone and antiprogestin ZK 98.299 in human endometrial and myometrial cytosol. AB - The binding of ZK 98.299, a synthetic progesterone antagonist, with human endometrium and myometrium cytosol was studied and compared with that of progesterone. Progesterone showed specific saturable binding to its receptors in both endometrium and myometrium. ZK 98.299 and progesterone were mutually competitive for binding to progesterone receptors; however, the relative binding affinity of ZK 98.299 was 16% that of progesterone. ZK 98.299 exchanged the progesterone-labelled receptor sites. [3H]ZK 98.299 showed specific binding which was linearly related to the cytosol protein concentration. The binding was not saturable at 15 nM of ligand. The binding capacity and binding affinity of ZK 98.299 receptor was less than that of progesterone. Progesterone also partially displaced the binding of [3H]ZK 98.299. This study suggest that ZK 98.299 and progesterone both bind to the same protein. However, whether ZK 98.299 binds to progesterone receptors alone or even to other functionally related sites is not known. It appears that ZK 98.299 when present in higher concentration than progesterone would be an effective receptor ligand. PMID- 2713403 TI - Particulate untransformed glucocorticoid-receptor complexes from HeLa cells crosslinked in vivo. AB - When control HeLa cells were incubated at 2 degrees C in the presence of tritiated dexamethasone, most glucocorticoid-receptor complexes were found in cytosolic extracts as untransformed forms. Chemical crosslinking of intact HeLa cells resulted in the immobilization of 50% of the total cellular glucocorticoid receptor complexes in the nuclear fraction. Under these conditions the redistribution of total protein, RNA and lactate dehydrogenase activity between cytosol and nuclei was negligible, indicating that glucocorticoid binding in the nuclear fraction was not due to a methodological artifact. High levels of glucocorticoid receptor were also found in the nuclear fraction of crosslinked cells which were not exposed to glucocorticoids. Nuclear receptor complexes could be released in soluble forms by DNase I and sonication. Evaluations of DNA binding and ionic properties of glucocorticoid receptors prepared from control and crosslinked cells maintained at 2 degrees C revealed that most of the hormone receptor complex in cytosols and nuclear extracts behaved as untransformed forms. As opposed to glucocorticoid receptors prepared from control cells, heat treatment of extracts obtained from crosslinked cells did not result in increased DNA binding and changes in ionic properties of receptor complexes. I conclude that untransformed glucocorticoid receptors are present in both cytosol and nuclei of intact cells. PMID- 2713404 TI - Gadolinium chloride-induced shifts in intrahepatic distributions of liposomes. AB - Intravenously administered gadolinium chloride caused only a slight decrease in the rate of elimination of small unilamellar liposomes from the blood and had no influence on the total hepatic uptake of these vesicles, but did alter their intrahepatic distribution substantially. Uptake by the non-parenchymal cells was substantially decreased, whereas uptake by the parenchymal cells showed a concomitant increase. Our earlier observations (Roerdink et al. (1981) Biochim. Biophys. Acta 677, 79-89) on the effect of lanthanides on the in vivo distribution of multilamellar liposomes have been extended, in that we demonstrate, in addition to the drop in elimination rate from the blood and in the over-all hepatic uptake, a shift of liposome distribution within the Kupffer cell population. While the larger Kupffer cells, which normally take up a major fraction of an injected liposome dose, were strongly inhibited in liposome uptake, the more numerous small macrophages showed a 3-4-fold increase in uptake. PMID- 2713405 TI - Spectroscopic analysis of chlorophyll model complexes: methyl ester ClFe(III)pheophorbides. AB - As models for chlorophyll a (Chl a), methyl ester ClFe(III)pheophorbides (1, pheophorbide a; 2, mesopheophorbide a; and 3, mesopyropheophorbide a) were examined by Fourier transform infrared (FTIR) absorption and resonance Raman (RR) spectroscopy. The infrared (IR) chlorin band above 1600 cm-1, assigned as a Ca-Cm mode (Andersson et al. (1987) J. Am. Chem. Soc. 109, 2908-2916) is shown to be metal-sensitive and responsive to spin state and coordination number for dihydroporphyrins, as well as being diagnostic for the chlorin vs. porphyrin or bacteriochlorin macrocycle. Frequency variations for this metallochlorin IR band thus parallel those of the v10 RR mode of porphyrins in their predictive utility. Qy excitation SERRS spectra of Chl a were compared with Qy excitation RR spectra of 1 and methyl Ni(II)pyropheophorbide a. The data demonstrate that 5-coordinate ClFe(III)pheophorbides are better models for chlorophylls than are ruffled 4 coordinate Ni(II)pheophorbides. Major spectral differences between the three chlorophyll models are associated with the C-9 keto and/or C-10 carbomethoxy vibrational modes. The approx. 1700 cm-1 IR band was formerly assigned solely to v(C = O) of the C-9 keto group. However, this IR feature shifts down to approx. 1685 cm-1 and nearly doubles in intensity when the C-10 carbomethoxy is removed, as for 3. Similar frequency downshifts coupled with intensity increases in the IR are found in the literature on chlorophylls. RR spectra of pheophorbides having the C-10 carbomethoxy group (1 and 2) have bands at both approx. 1700 and approx. 1735 cm-1. However, the C-9 keto v(C = O) mode of pyrophorbins also downshifts to approx. 1685 cm-1, as in the IR spectra. The approx. 1735 cm-1 ester RR mode disappears in the case of pyrophorbins, and is never RR active for nonconjugated esters of porphyrins or chlorins. These data demonstrate an interaction between the C-10 and C-9 carbonyls of phorbins. They also indicate that phorbins tend toward conjugation of the C-10 ester. Biological examples of such conjugation effects have recently been reported, e.g., for the Chl a pi-cation radical (Heald et al. (1988) J. Phys. Chem. 92, 4820-4824). Because the phorbin E ring is the major structural feature distinguishing chlorophylls from non-photosynthetic systems, the participation of the C-10 ester in ring conjugation is suggestive of its biological importance. PMID- 2713406 TI - Characterization of sarcoplasmic reticulum in skinned muscle cultures. AB - The plasma membranes of chick or rat skeletal muscles, grown in cell culture, were made permeable with saponin in a solution lacking calcium. The cells were then supplied with a medium resembling the cytosol and the ATP-dependent Ca2+ sequestration was performed. Based on the low concentration of free Ca2+ in the medium (below 5 microM), the presence of mitochondrial inhibitors and the effect of drugs that interfere with sarcoplasmic reticulum (SR) function, we assume that the measured Ca2+ accumulation expresses SR function on the saponin-treated myotubes. The development of the SR in muscle cultures is augmented as myogenesis proceeds and depends on its occurrence. Whereas creatine kinase activity is elevated immediately following cell fusion, there is a delay of at least 1 day between myoblast fusion and the increase in Ca2+ accumulation in the SR. Thyroxine or triiodothyronine caused an inhibition of Ca2+ accumulation in rat or chick muscle cultures. This inhibition could explain some of the muscle abnormalities caused by excess of thyroid hormones. A comparison was made between a white-type (fast) and heterogeneous muscle, differentiated in cell culture. There was no significant difference in SR function, indicating the important role of innervation in specifying the properties of muscle fiber types. PMID- 2713407 TI - Major proteolytic fragments of the murine band 3 protein as obtained after in situ proteolysis. AB - Proteolytic fragments of murine band 3 were produced by exposure to extracellular chymotrypsin and intracellular trypsin. The ensuing proteolytic fragments were isolated, their N-terminal sequences were determined and their locations in the known amino acid sequence of murine band 3 established. Equivalents of the human 60, 35 and 17 kDa fragments were obtained through the cleavage sites were situated at locations that are not strictly homologous to the corresponding cleavage sites in human band 3, although all of them were near such sites. Exposure of the intact murine red cell to chymotrypsin leads to the formation of two fragments of 67 kDa and 41 kDa, which are equivalent to the 60 kDa and the 35 kDa fragments of the human band 3. Internal trypsin cleaves the chymotryptic 67 kDa fragment while the 41 kDa fragment appears essentially unaffected. The 67 kDa fragment is first degraded to 64 kDa, then further to 22 kDa and finally to 19 kDa. The anion transport inhibitor H2DIDS (4,4'-diisothiocyanodihydrostilbene 2,2'-disulfonate) combines with murine band 3 protein as it does with human band 3. Anion transport is maximally inhibited when 5.10(5) H2DIDS molecules per cell are bound to band 3. As in the human red cell, after exposure to high pH (9.0 9.5) of the H2DIDS-labeled, chymotryptically cleaved band 3 intramolecular cross linking takes place. This joins the 67 and 41 kDa chymotryptic pieces together to form a peptide of the original molecular mass of band 3 of 108 kDa. If cross linking is performed after additional tryptic cleavage, the 19 and 22 kDa pieces join together with 41 kDa pieces to form overlapping bands that cover the molecular weight range from 60 to 63 kDa. PMID- 2713408 TI - Identification of receptors in the liver that mediate endocytosis of circulating tissue kallikreins. AB - The liver plays an important role in the clearance, by receptor-mediated endocytosis, of circulating glycoproteins. It has been demonstrated that tissue kallikreins, which are acid glycoproteins, circulate in plasma, where they are poorly inhibited by plasma proteins. We have shown that the liver is the main organ that clears tissue kallikreins from the circulation. We now report the identification of receptors involved in this clearance. Using a perfused rat liver system, and as models, pig pancreatic (PPK) and horse urinary (HoUK) kallikreins, we have found that: (a) the binding of PPK to the perfused liver was inhibited by 50 mM methyl alpha-D-mannoside and 20 microM mannan, was partially inhibited by 50 mM mannose and was unaffected by 1.5 microM asialofetuin; (b) binding of HoUK to the perfused liver was inhibited by 1.5 microM asialofetuin, 50 mM galactose and 50 mM lactose and was unaffected by 50 mM mannose; (c) the clearance rate of both kallikreins followed the equation y = a.xb; (d) their binding was Ca2+-dependent and their clearance was inhibited by 3 mM chloroquine and 10 mM methylamine. Using isolated liver cells and tritiated HoUK, we calculated that 500,000 receptors/cell were present and the Scatchard plot showed that there were two apparent affinity constants: 0.24.10(9) l/M) (high-affinity) and 0.3.10(8) l/M (low-affinity). These results show that PPK is recognized by a liver mannose receptor and HoUK by the galactose receptor. The liver uptake of native and circulating tissue kallikreins thus emerges as a mechanism by which their levels in plasma are regulated. PMID- 2713409 TI - Intermixing of dipalmitoylphosphatidylcholine with phospho- and sphingolipids bearing highly asymmetric hydrocarbon chains. AB - We have used high-sensitivity differential scanning calorimetry to investigate the mixing of dipalmitoylphosphatidylcholine (DPPC) with N lignoceroylgalactocerebroside, N-lignoceroylsulfogalactocerebroside and 1-lauroyl 2-lignoceroylphosphatidylcholine. These three lignoceroyl species, whose two hydrocarbon chains are quite discrepant in length, are completely miscible with DPPC in the liquid-crystalline state. Mixtures of all three lignoceroyl lipids with DPPC show phase separation in the gel state, which is observed over a limited range of compositions (from less than 10 mol% to just over 40 mol% sulfatide) in the case of N-lignoceroylsulfatide and over a wide range of compositions in the cases of N-lignoceroylcerebroside (less than 10 mol% to greater than 90 mol% cerebroside) and 1-lauroyl-2-lignoceroyl-PC (roughly 10 mol% to 90 mol% lauroyl/lignoceroyl PC). The extensive solid-solid phase separation observed in mixtures of DPPC and 1-lauroyl-2-lignoceroyl-PC, which show eutectic behavior, is somewhat unexpected given the similar transition temperatures of the two components but appears to reflect the ability of the lignoceroyl species to form an interdigitated gel phase. However, we find no evidence that the N lignoceroylsphingolipids are markedly more prone to segregate laterally in PC rich bilayers than are previously studied sphingolipid species with shorter N acyl chains. We suggest on the basis of these results that the primary biological importance of the very long N-acyl chains found in many sphingolipids may lie in some function other than the promotion of lateral segregation of sphingolipid enriched domains in biological membranes. PMID- 2713410 TI - Differences between individuals in high-molecular weight glycoproteins from mammary epithelia of several species. AB - Milk fat globules are secreted by envelopment in plasma membrane of the lactating cell. SDS-gel electrophoresis of proteins from this membrane has revealed differences between milk donors in two mucin-like glycoproteins. One of these glycoproteins resolves in 3% acrylamide stacking gel and the other in 4% running gel. The proteins vary in number of bands (one or two) and band mobilities. This polymorphism arises, at least in part, from expression of hypervariable genes. In this study, gel electrophoretic evidence of similar polymorphism in glycoproteins from cow, chimpanzee, horse and human milks is presented. In distinction to the other species, the cow expressed only one of these proteins which was detected in the running gel at Mr 180,000 to 200,000. The electrophoresis pattern for this protein from six cows was highly varied with respect to number (one or two) and position of bands. Peanut agglutinin, wheat germ agglutinin and concanavalin A all were bound specifically by bands of the bovine glycoprotein. Binding of concanavalin A distinguishes the bovine protein from the two human glycoproteins. Further studies of species differences should help shed light on the evolution of these unique glycoproteins and their possible functions in mother and young. PMID- 2713411 TI - Interaction of bovine skeletal muscle lactate dehydrogenase with liposomes. Comparison with the data for the heart enzyme. AB - The effects of pH, salt concentration and the presence of oxidized and reduced forms of coenzyme on the interaction of skeletal muscle lactate dehydrogenase with the liposomes derived from the total fraction of bovine erythrocyte lipids were investigated by ultracentrifugation and were compared with those results obtained using the heart-rate isoenzyme which we have previously studied. Liposomes are good adsorptive systems for both types of isoenzyme. In the presence of erythrocyte lipid liposomes, bovine muscle and heart lactate dehydrogenases form two kinds of complex: lactate dehydrogenase adsorbed to liposomes and soluble lactate dehydrogenase-phospholipid complexes. Soluble protein-phospholipid complexes reveal different dependences of their stabilities on pH values and it seems that the nature of the binding site in either isozyme is different. In addition, absorption of the isoenzymes on the liposomes also reveals in difference in the effects of NAD and NADH. While the presence of NAD dissociates LDH-H4 from the liposomes and NADH does not influence its adsorption, NAD promotes the binding of LDH-M4, and NADH favors the dissociation. PMID- 2713412 TI - Binding of plasma membrane glycoproteins to the cytoskeleton during patching and capping is consistent with an entropy-enhancement model. AB - Concentrations of concanavalin A that induced patching and capping of cell surface receptors on Dictyostelium discoideum also induce binding of the receptors to the cortical cytoskeleton, which was isolated by density-gradient centrifugation. The receptors were solubilized by deoxycholate, purified by affinity chromatography, and used to determine whether the receptors bound directly to the cytoskeletal protein, actin. As the concentration of actin was increased, many of the receptors became bound to purified filamentous rabbit muscle actin, even in the absence of concanavalin A. As in the ligation-induced binding of receptors to the cortical cytoskeleton in cells, concanavalin A induced much stronger binding of the purified receptors to filamentous actin. The results were consistent with a previously stated hypothesis that induction of receptor binding to the cytoskeleton during their patching and capping is driven by clustering the receptors, which reduces their translational entropy and by doing so enhances their avidity for the cytoskeleton. PMID- 2713413 TI - Effect of acyl chain composition on salt-induced lamellar to inverted hexagonal phase transitions in cardiolipin. AB - Salt-induced fluid lamellar (L alpha) to inverted hexagonal (HII) phase transitions have been studied in diphosphatidylglycerols (cardiolipins) with different acyl chain compositions, using 31P nuclear magnetic resonance (NMR) spectroscopy. Cardiolipins with four myristoyl chains, tetramyristoyl cardiolipin (TMCL), and with four oleoyl chains, tetraoleoyl cardiolipin (TOCL), were synthesized chemically. TMCL was found to undergo a thermotropic lamellar gel to lamellar liquid-crystalline phase transition at 33-35 degrees C. This lipid exhibited an axially symmetric 31P-NMR spectrum corresponding to a lamellar phase at all NaCl concentrations between 0 and 6 M. In the case of TOCL, formation of an HII phase was induced by salt concentrations of 3.5 M NaCl or greater. These observations, taken together with earlier findings that bovine heart cardiolipin aqueous dispersions adopt an HII phase at salt concentrations of 1.5 M NaCl or greater, indicate that increasing unsaturation and length of the acyl chains favour formation of the HII phase in diphosphatidylglycerols. PMID- 2713414 TI - Purification and characterization of an anti-sticking factor from goat epididymal plasma that inhibits sperm--glass and sperm--sperm adhesions. AB - An anti-sticking factor (ASF-I) that showed high affinity for inhibiting adhesion of spermatozoa to glass was isolated from goat epididymal plasma and characterized. The factor was purified approx. 5600-fold and showed a single protein band when examined by non-denaturation and SDS-polyacrylamide gel electrophoresis. The molecular mass and S20w value of ASF-I were approx. 47 kDa and 4.25 S. ASF-I at a concentration of 1 nM showed nearly maximal anti-sticking activity when approx. 60% of the intact spermatozoa were prevented from adhesion to glass and it showed a high degree of protein specificity. Studies with trypsin and glycosidases demonstrated that both the sugar and protein parts of the molecule are essential for its anti-sticking activity. Evidence has been presented to support the view that the outer surface of sperm possesses specific ASF-I receptors that bind to 125I-labelled ASF and mediate cell adhesion to glass. ASF-I also showed high affinity for inhibiting agglutination of corpus epididymal spermatozoa. The ASF activity was found to be distributed in all the tissues tested and its specific activity was markedly higher in blood plasma than in the tissues. The results suggest that ASF may play an important biological role by serving as a specific inhibitor of cell-substratum and cell-cell adhesions. PMID- 2713415 TI - Isoelectric focusing studies of bacteriorhodopsin. AB - Purified bacteriorhodopsin (BR) samples show a minimum of four isoelectric forms in immobilized pH gradient isoelectric focusing gels. The bands occur as doublets with isoelectric points (pI) centered at 5.20 (principal species) and 5.60. In typical preparations additional bands may be observed at 4.90, 5.07 and 5.50. Purple membrane (PM) was proteolyzed with papain to calibrate the pI shift produced by changing the number of charges on the protein. Asp-242 is removed during the first cleavage between residues 239 and 240 resulting in the loss of a single negative charge and a shift of the principal doublet by +0.35 pH units to pI 5.55. The second papain cleavage occurs between residues 231 and 232 which removes Glu-232, -234 and -237 and shifts the pI by +0.60 pH units to pI 6.10. The +0.60 pH shift upon the second papain cleavage is consistent with the loss of two negative charges and is supported by prior evidence that at least one of the three glutamate residues lost during the second proteolysis step is protonated and neutral in the intact protein. The native and proteolyzed products of BR retain the characteristic 550 nm absorption maxima for solubilized BR. A model for the structural origin of the pI heterogeneity of BR species in proteolyzed PM is presented. PMID- 2713416 TI - Conditions controlling tumor cytotoxicity of rat liver macrophages mediated by liposomal muramyl dipeptide. AB - Activation of rat liver macrophages with free and liposome-encapsulated muramyl dipeptide (MDP) to a tumorcytotoxic state was characterized by employing various experimental conditions. Macrophage-mediated tumor cytotoxicity was determined using two standard assay systems: a [methyl-3H]thymidine release assay to measure the extent of tumor cell lysis and a [methyl-3H]thymidine incorporation assay to measure the combined effects of tumor cell lysis and stasis. The extent of cell lysis was not affected by the ratio of macrophages to tumor cells within the ratio range of 30:1 to 5:1, provided that the macrophages form a confluent monolayer. Tumor cell lysis, however, was significantly influenced by macrophage density; a low macrophage density for example resulted in a low percentage of tumor cell lysis. Tumor target cells used in this study, i.e., C26 adenocarcinoma, B16 melanoma and P815 mastocytoma, differed in their susceptibility towards macrophage-mediated cell lysis, whereas no differences were observed with respect to tumor cell stasis. Non-tumorigenic cell lines such as human fibroblastic cells and LLC monkey kidney cells were not lysed by activated macrophages, although proliferation of these cells was markedly inhibited. Additionally, the effects of liposomal lipid composition on macrophage activation were studied. With a basic composition of phospholipid/cholesterol/dicetylphosphate, we used either egg-yolk, dipalmitoyl-, distearoyl- or dihexadecylphosphatidylcholine as the bulk phospholipid constituent. Although these liposomes display a widely different susceptibility to lysosomal phospholipase activities, we could not detect any significant difference in either the extent or the duration of the tumoricidal activity induced by MDP encapsulated in these different types of liposomes. PMID- 2713417 TI - Use of the glucose oxidase/peroxidase method for glucose assay leads to overestimation of the inhibition of gluconeogenesis by aminopyrine. AB - 4-Aminoantipyrine strongly inhibits glucose determination by the glucose oxidase/peroxidase/dianisidine assay but does not interfere in the assay using glucose-6-phosphate dehydrogenase, hexokinase and ATP. As a result, the inhibition of gluconeogenesis by aminopyrine reported to be 50-90% (Banhegyi, G., Mandl, J., Antoni, F. and Garzo, T. (1987) Biochim. Biophys. Acta 927, 406-416) is strongly overestimated and amounts to only 10-30%. PMID- 2713418 TI - Purification and characterization of carboxypeptidase from terminally differentiated rat epidermal cells. AB - A tissue carboxypeptidase-A-like enzyme was purified to apparent homogeneity from terminally differentiated epidermal cells of 2-day-old rats by potato inhibitor affinity chromatography followed by FPLC Mono Q column chromatography. The enzyme has an Mr of 35,000 as determined by SDS-polyacrylamide gel electrophoresis and HPLC gel filtration. It has a pH optimum of 8.5 for hydrolysis of benzyloxycarbonyl-Phe-Leu (Km = 0.22 mM, kcat = 57.9 s-1). The enzyme does not hydrolyze substrates with Arg, Lys and Pro at the C-terminal and Pro at the penultimate position. Angiotensin I was effectively hydrolyzed (Km = 0.06 mM, kcat = 6.48 s-1) and produced both des-Leu10-angiotensin I and angiotensin II. The enzyme activity, relatively stable at 4 degrees C and pH 8.0-10.5, was inactivated at pH values higher than 12.0 and lower than 5.0 or at 65 degrees C for 10 min. Inhibitor profiles of the epidermal enzyme also differed slightly from those of tissue carboxypeptidase A of pancreatic or mast cell origin. PMID- 2713419 TI - A highly efficient chemical isolation procedure for the rat placental transferrin receptor. AB - A chemical method for the purification of rat placental transferrin receptor is described. After initial solubilization and concentration by ammonium sulfate precipitation, radioiron-tagged diferric transferrin was added to the dialyzed receptor fraction and subjected to anion-exchange chromatography on DEAE Sephacel. Elution with a Tris-HCl buffer gradient yields a single fraction of radioactivity containing both free transferrin and the receptor-transferrin as a complex. Further separation of the receptor-transferrin complex from the free transferrin is achieved by gel chromatography on a AcA34-Sepharose 6B separation system. Final purification is obtained by preparative gel electrophoresis in 5% polyacrylamide gels. The receptor was shown to be pure by various methods including HPLC chromatography. The average yield was 20-30 mg receptor transferrin complex/100 g placental tissue. Because of the purely chemical approach, this method is universally applicable for the isolation of transferrin receptors from various tissues. PMID- 2713420 TI - Effects of brefeldin A on the synthesis and secretion of egg white proteins in primary cultured oviduct cells of laying Japanese quail (Coturnix coturnix japonica). AB - We investigated the effect of brefeldin A (BFA) and monensin on the secretion of egg white proteins in primary cultured oviduct cells. Monensin inhibited the secretion of egg white proteins, but this drug also caused morphological changes of the cells and inhibited their protein synthesis. BFA inhibited protein secretion without any remarkable morphological changes of the cells and without significant inhibition of protein synthesis. In the presence of BFA at 1 microgram/ml, only 10% of synthesized ovalbumin was secreted into the medium even after 6 h. A similar effect of BFA was shown in the case of conalbumin. When the cells were cultured in the presence of BFA, precursors of mature ovalbumin accumulated which were not secreted. Their affinity for lectin binding affinity columns (Con-A Sepharose and WGA-agarose) suggested that they contained immature high-mannose-type chains. The above results suggest that the conversion of high mannose-type oligosaccharides to hybrid-type ones, which is not usually observed in mammalian species but only in avian oviduct tissues, proceeds between the Golgi complex and the endoplasmic reticulum. PMID- 2713421 TI - Purification and characterization of antizyme inhibitor of ornithine decarboxylase from rat liver. AB - A protein inhibiting a protein inhibitor (antizyme) to ornithine decarboxylase (L ornithine carboxy-lyase, EC 4.1.1.17) (ODC), antizyme inhibitor, was purified from the liver cytosol of thioacetamide-treated rats by procedures including antizyme affinity chromatography. Overall purification was roughly estimated to be about 17,000,000-fold and recovery was about 2.4%. The purified preparation showed one major protein band and a faint band corresponding in mobility to molecular weights of 51,000 and 53,500, respectively, on sodium dodecyl sulfate polyacrylamide gel electrophoresis. Judging from the ornithine decarboxylase activity of the final preparation, the faint band may be ornithine decarboxylase. The apparent molecular weight of antizyme inhibitor estimated by gel filtration on Sephacryl S-200 was approx. 62,000, indicating that antizyme inhibitor may be composed of a single polypeptide chain. In order to examine the question of whether antizyme inhibitor is a protein derived from ornithine decarboxylase, an inactive ornithine decarboxylase, in an immunotitration study and analysis of the binding to antizyme were investigated. The results indicate that antizyme inhibitor may be a protein distinct from ornithine decarboxylase. PMID- 2713422 TI - Specific purification of glyceraldehyde-3-phosphate dehydrogenase by hydrophobic chromatography on immobilized colchicine. AB - Hydrophobic column chromatography of bovine brain extracts (40-80% ammonium sulfate fraction) on immobilized colchicine resulted in the selective elution of one major protein with decreasing ionic strength of medium. This protein was identified as glyceraldehyde-3-phosphate dehydrogenase (GAPDH; EC 1.2.1.1) on the basis of its biochemical properties, N-terminal amino-acid sequence and enzymatic activity. The present method enabled GAPDH to be isolated with a high recovery (80%; 184 mg/kg brain) and could be of potential use for the purification of GAPDH from various tissues. PMID- 2713423 TI - Regulation of the biosynthetic pathway of aromatic amino acids in Nocardia mediterranei. AB - The regulation of enzymes in the biosynthetic pathway of aromatic amino acids in Norcardia mediterranei was studied. Anthranilate synthase was sensitive to feedback inhibition by very low concentrations of LTrp, and kinetic analysis showed that LTrp was competitive with respect to chorismate; the five enzymes in LTrp biosynthesis pathway, anthranilate synthase (AS), anthranilate phosphoribosylpyrophosphate phosphoribosyltransferase (PRT), N-5' phosphoribosylanthranilate isomerase (PRAI), indole-3-glycerol phosphate synthetase (InGPS) and tryptophan synthase (TS), were all repressed by LTrp; LTyr and LPhe inhibited chorismate mutase. Prephenate dehydratase activity was greatly inhibited by LPhe and activated by LTyr, nearly 60% of its activity was inhibited by 5 microM of LPhe, and 20 microM of LTyr increased the activity approx. 3-fold. In addition, the effects of LPhe and LTyr on prephenate dehydratase were highly specific. The regulatory circuit of the biosynthetic pathway of aromatic amino acids in N. mediterranei is presented. PMID- 2713424 TI - Distribution of xanthine dehydrogenase and oxidase activities in human and rabbit tissues. AB - The activity of xanthine dehydrogenase in human postmortem tissues is surprisingly high in brain and heart; activity was found in most tissue samples, whereas many samples contained little or no oxidase activity. We have confirmed the high level of oxidase activity in liver in which tissue conversion of dehydrogenase to oxidase appears complete. We have also confirmed the virtual absence of either activity in fresh human placenta. Fresh rabbit tissues similarly show considerable dehydrogenase activity in brain and heart. In view of the stability and generalised distribution of dehydrogenase activity, our results suggest that some modification of existing ideas on the physiological and pathological roles of the enzyme may be needed. PMID- 2713425 TI - The effects of dose of elemental mercury and first-pass circulation time on exhalation and organ distribution of inorganic mercury in rats. AB - The lung plays a major role in the removal of dissolved elemental mercury (Hg0) from the bloodstream. During the first passage through the lung after an intravenous dose of Hg0 dissolved in aqueous buffer, from 10 to 17% was exhaled depending on the dose (0.11 or 1.1 micrograms Hg/rat) and the injection site (jugular versus tail vein). Furthermore, evidence is presented that subsequent exhalation over the next 50 s, before the rats were killed and the mercury determined in the lung at that time, was largely Hg0-extracted during the first pass. The total mercury extracted during the 60 s period was in the range of 40 49% of the dose. The oxidation of Hg0 to Hg2+ in red cells is important in limiting the availability of Hg0 to certain tissues. Thus, after a short residence time in blood (0.6 s after jugular vein injection), 12.9-17% is exhaled in the first pass as compared to 10.4-12.2% with a longer residence time (1.8 s after tail vein injection). Furthermore, there was a general tendency, even at 60 s after dosing, for certain tissues - lung, brain, and heart - to have higher values after dosing from the jugular vein. It was estimated that the half-time for oxidation was 3.3 s. Our results confirm previous observations that the form of inorganic mercury greatly influences the short-term deposition in certain tissues. Thus as compared to Hg2+, administration of Hg0 increases lung levels 5 10-fold; brain, 4-fold; and heart, 3-fold. Blood levels are lower after Hg0, particularly after the higher dose. Such findings are consistent with a model wherein Hg0 is in part oxidized by red blood cells, the remainder rapidly diffusing in tissues where it is also oxidized to Hg2+. PMID- 2713426 TI - [The importance of antioxidative enzymes in regulating lipid peroxidation in human erythrocyte membranes]. PMID- 2713427 TI - [Nuclear matrix proteins of the rat liver at various levels of body thyroid status]. PMID- 2713428 TI - Activity toward thrombin-antithrombin of heparin immobilized on two hydrogels. AB - Commercially obtained (Diosynth) heparin was covalently bonded to poly (vinyl alcohol) (PVA) hydrogels and to polyethylene oxide (PEO) hydrogels activated by tresyl chloride. We found that as tresyl chloride activation of PVA increased, the specific activity of the bound heparin toward thrombin and antithrombin decreased by nearly a factor of 10 and that commercial heparin bound to PEO had nearly ten-fold greater activity than when bound to PVA at comparable concentrations. These findings suggest that the long 'leash' provided by PEO hydrogels may give the heparin more access to the thrombin-antithrombin pair than the tight bond to PVA, and that crowding of heparin units on a surface limits access of the thrombin-antithrombin pair. PMID- 2713429 TI - In vivo release of cisplatin from a needle-type copolymer formulation implanted in rat kidney. AB - Cisplatin, cis-dichlorodiamine platinum (II), was incorporated in a needle-type copolymer formulation (0.8 mm diameter, 6 mm long) by radiation-induced polymerization. The copolymer used was copoly(diethylene glycol dimethacrylate/polyethylene glycol #600 dimethacrylate, 80/20 vol%). This copolymer, containing 6 mg of cisplatin, was implanted into the kidney of adult male Wistar rats (420 +/- 20 g). A total of 70 d was required for 100% release of cisplatin in vivo. The kidney tissue surrounding the formulation was strongly necrotized by the action of cisplatin. Two layers of necrosis could be distinguished: necrotic tissue surrounding the formulation and necrobiotic tissue surrounding the necrotic tissue. The amount of necrotic tissue changed markedly over time, but no change was apparent in the amount of necrobiotic tissue. The maximal amounts of necrotized tissue were observed 14 d after implantation: 3100 microns and 600 microns thick for the necrotic and necrobiotic tissues, respectively. PMID- 2713430 TI - Bulk, surface and blood-contacting properties of polyether polyurethanes modified with polydimethylsiloxane macroglycols. AB - The bulk, surface and blood-contacting properties of a series of polyether polyurethanes, modified with three different polydimethylsiloxane (PDMS) macroglycol segments, were evaluated. The PDMS oligomers were terminated with hydroxy-tipped end groups of varying polarity. The effect of substituting the polytetramethylene oxide (PTMO) soft segment of a base polyurethane with 5 and 15 wt% of these PDMS-containing polyols was investigated. The ultimate tensile strength and elongation at break appeared to be the bulk properties most significantly affected by the addition of the PDMS-containing polyols. Underwater contact angle data indicate that the block copolymer surface became more hydrophilic with increasing PDMS content. In a vacuum, as determined from the ESCA data, the relatively non-polar PDMS soft segments preferentially oriented at the surface with increasing PDMS incorporation. Despite the variation in the surface properties, the blood compatibility of these polymers was not significantly affected by the addition of the PDMS-containing polyols. PMID- 2713431 TI - Ageing of radiation-sterilized polypropylene: changes in semicrystallinity. AB - Studies on radiation sterilization of isotactic polypropylene intended for biomedical applications were carried out for uncovered and covered samples. The effect of ageing on these samples was studied by determining the changes in relative crystallinity. The semicrystalline nature of the polymer is responsible for the changes in crystallinity. The transitions between short- and long-range order and short- and long-duration stiffness in both covered and uncovered samples, reflected in changes in relative crystallinity, were highly affected by the formation of branches in the backbone of the polymer. The high degree of branching in covered samples resulted in greater long-duration stiffness in the transition between short- and long-duration stiffness. The high degree of branching in covered samples was attributed to the high diffusion of energized oxygen into the polymer matrix compared with uncovered samples. The changes in relative crystallinity were rapid in uncovered samples (70% max; 34% min) but rather slow in covered samples (87% max; 43% min). PMID- 2713432 TI - Mechanical properties of collagen fibres: a comparison of reconstituted and rat tail tendon fibres. AB - This study involves comparison of the mechanical properties of reconstituted collagen fibres with those of collagen fibres obtained from rat tail tendons. Reconstituted collagen fibres were cross-linked in the presence of glutaraldehyde vapour for 2 and 4 d or using a combination of severe dehydration and carbodiimide treatment. Ultimate tensile strengths for reconstituted fibres cross linked with glutaraldehyde ranged from 50 to 66 MPa while those cross-linked by severe dehydration and carbodiimide treatment had ultimate tensile strengths between 24 and 31 MPa. Rat tail tendon fibres had tensile strengths that ranged from 33 to 39 MPa. These results indicate that high-strength collagen fibres can be reconstituted in vitro and that these fibres may be useful in repair of dermal, dental, cardiovascular and orthopaedic defects. PMID- 2713433 TI - Kinetics of cell spreading on protein precoated substrata: a study of interfacial aspects. AB - In this paper, interfacial aspects of spreading and adhesion of human skin fibroblasts on solid substrata after protein precoating have been studied. Three solid substrata were used with different surface free energy (gamma s): Tissue Culture Polystyrene (TCPS) with gamma s = 70 erg.cm-2, Polyvinylfluoride (PVF) with gamma s = 56 erg.cm-2 and Fluoroethylenepropylene (FEP) copolymer with gamma s = 18 erg.cm-2. The substrata were precoated with fetal calf serum, bovine fibronectin or bovine serum albumin. Cell spreading was evaluated by means of light microscopy and scanning electron microscopy (SEM). Adhesion sites were studied by transmission electron microscopy (TEM). In general, spreading was lowest on FEP and highest on TCPS. Although protein precoating markedly increased cell spreading, the relative order in which the cells spread on the protein precoated substrata remained identical to that on the bare substrata. Analysis of the kinetics of spreading demonstrated that spreading was fastest on the high energy substratum and slowest on the low-energy substratum. In the presence of all three types of protein precoating, the average distance between a cell and a substratum after spreading was smaller (20-50 nm) than without a coating (greater than 100 nm). PMID- 2713434 TI - Nuclear magnetic resonance spectroscopic studies of the interaction of methyl methacrylate and ethylene dimethacrylate with phosphatidylcholine liposomes as a model for biomembranes. AB - The interaction of methyl methacrylate (MMA) and ethylene dimethacrylate (EDMA) with dipalmitoyl phosphatidylcholine (DPPC) liposomes was studied by 1H and 13C nuclear magnetic resonance spectroscopy (NMR). It was found that the changes in the 1H chemical shift of EDMA were larger than those of MMA when comparing membrane-bound state with free state and that the amount of EDMA incorporated into DPPC liposomes was approximately 74%, whilst MMA was approximately 41%. The major changes in chemical shifts of EDMA appeared to be due to its interaction with the acyl chains of DPPC liposomes. PMID- 2713435 TI - Acuity of biopsy needles. AB - The acuities of the conventional biopsy device and of a new design of biopsy needle holder were determined in an in vitro study using fresh pork kidney. A second study, using fresh beef kidney, evaluated the effect of different surface treatments on the acuity of biopsy needles. Only minor clinical differences were found in the acuities of the two types of biopsy needle. It was established, however, that silicone surface treatment and cryogenic treatment of biopsy needles significantly increases their acuity. PMID- 2713436 TI - Two-site exchange revisited: a new method for extracting exchange parameters in biological systems. AB - A new analysis is presented which links real volume fractions, relaxation rates, and intracompartmental exchange rates directly with apparent volume fractions and relaxation rates obtained from biexponential fits of transverse magnetization decay curves. The analysis differs from previous methods in that measurements from two paramagnetic doping levels are used to close the two-site exchange equations. Both the new method and one previously described by Herbst and Goldstein (HG) have been applied to paramagnetically doped whole-blood data sets. Significant differences in the calculated exchange parameters are found between the two methods. A small dependence of the intracellular relaxation rate on extracellular paramagnetic agent concentration, assumed nonexistent with the HG method, is inferred from the new analysis. The analysis was also applied to published data on perfused rat hearts, and we obtained a limited assessment of two-site exchange in this system. PMID- 2713437 TI - Photolysis intermediates of the artificial visual pigment cis-5,6-dihydro isorhodopsin. AB - The photolysis intermediates of an artificial bovine rhodopsin pigment, cis-5,6 dihydro-isorhodopsin (cis-5,6,-diH-ISORHO, lambda max 461 nm), which contains a cis-5,6-dihydro-9-cis-retinal chromophore, are investigated by room temperature, nanosecond laser photolysis, and low temperature irradiation studies. The observations are discussed both in terms of low temperature experiments of Yoshizawa and co-workers on trans-5,6-diH-ISORHO (Yoshizawa, T., Y. Shichida, and S. Matuoka. 1984. Vision Res. 24: 1455-1463), and in relation to the photolysis intermediates of native bovine rhodopsin (RHO). It is suggested that in 5,6-diH ISORHO, a primary bathorhodopsin intermediate analogous to the bathorhodopsin intermediate (BATHO) of the native pigment, rapidly converts to a blue-shifted intermediate (BSI, lambda max 430 nm) which is not observed after photolysis of native rhodopsin. The analogs from lumirhodopsin (LUMI) to meta-II rhodopsin (META-II) are generated subsequent to BSI, similar to their generation from BATHO in the native pigment. It is proposed that the retinal chromophore in the bathorhodopsin stage of 5,6-diH-ISORHO is relieved of strain induced by the primary cis to trans isomerization by undergoing a geometrical rearrangement of the retinal. Such a rearrangement, which leads to BSI, would not take place so rapidly in the native pigment due to ring-protein interactions. In the native pigment, the strain in BATHO would be relieved only on a longer time scale, via a process with a rate determined by protein relaxation. PMID- 2713439 TI - Picosecond time-resolved fluorescence spectroscopy of K-590 in the bacteriorhodopsin photocycle. AB - The fluorescence spectrum of a distinct isometric and conformational intermediate formed on the 10(-11) s time scale during the bacteriorhodopsin (BR) photocycle is observed at room temperature using a two laser, pump-probe technique with picosecond time resolution. The BR photocycle is initiated by pulsed (8 ps) excitation at 565 nm, whereas the fluorescence is generated by 4-ps laser pulses at 590 nm. The unstructured fluorescence extends from 650 to 880 nm and appears in the same general spectral region as the fluorescence spectrum assigned to BR 570. The transient fluorescence spectrum can be distinguished from that assigned to BR-570 by a larger emission quantum yield (approximately twice that of BR-570) and by a maximum intensity near 731 nm (shifted 17 nm to higher energy from the maximum of the BR-570 fluorescence spectrum). The fluorescence spectrum of BR-570 only is measured with low energy, picosecond pulsed excitation at 590 nm and is in good agreement with recent data in the literature. The assignment of the transient fluorescence spectrum to the K-590 intermediate is based on its appearance at time delays longer than 40 ps. The K-590 fluorescence spectrum remains unchanged over the entire 40-100-ps interval. The relevance of these fluorescence data with respect to the molecular mechanism used to model the primary processes in the BR photocycle also is discussed. PMID- 2713438 TI - Elasticity of the human red cell membrane skeleton. Effects of temperature and denaturants. AB - The molecular basis for the elasticity of the human erythrocyte membrane was explored. Skeletons were released from ghosts in Triton X-100 and their dimensions followed by dark-field microscopy and packed volume. The rest size of skeletons was assumed to reflect the balance point between expansion (deformation) driven by electrostatic repulsions among the excess of fixed negative charges on the proteins and contraction (recovery) driven by their elasticity. The size of skeletons decreased with increasing temperature. This finding suggests that entropy drives elasticity. The requisite entropy change could be associated with either the configurational freedom of flexible protein chains or with the solvation of side chains exposed during protein dissociation (hydrophobic effects). To distinguish between these two alternatives, we tested the impact of two weak denaturants, 10% ethanol and 20 nM lithium 3,5 diiodosalicylate. Both agents reversibly promoted the expansion of skeletons, presumably by reducing their elasticity. Since the conformation of random coils and globular proteins should not be significantly altered by these mild treatments, this finding strongly suggests a role for weak interdomain and/or interprotein associations. We conclude that the elasticity of the red cell membrane skeleton may not derive from the configurational entropy of flexible coils. Rather, the elastic energy may arise from reversible dissociations of weak but specific intramolecular and/or intermolecular contacts, presumably within deformed spectrin filaments. PMID- 2713440 TI - An analytic solution to the Monod-Wyman-Changeux model and all parameters in this model. AB - Starting from the Monod-Wyman-Changeux (MWC) model (Monod, J., J. Wyman, and J. P. Changeux. 1965. J. Mol. Biol. 12:88-118), we obtain an analytical expression for the slope of the Hill plot at any ligand concentration. Furthermore, we derive an equation satisfied by the ligand concentration at the position of maximum slope. From these results, we derive a set of formulas which allow determination of the parameters of the MWC model (kR, C, and L) from the value of the Hill coefficient, nH, the ligand concentration at the position of maximum slope [( A]0), and the value of nu/(n-nu) at this point. We then outline procedures for utilizing these equations to provide a "best fit" of the MWC model to the experimental data, and to obtain a refined set of the parameters. Finally, we demonstrate the applicability of the technique by analysis of oxygen binding data for Octopus hemocyanin. PMID- 2713441 TI - Effect of chain unsaturation on the structure and thermotropic properties of galactocerebrosides. AB - Differential scanning calorimetry (DSC) and x-ray diffraction have been used to study the effect of increasing chain-unsaturation on the structure and properties of the hydrated cerebrosides N-stearoyl, -oleoyl, and -linoleoyl galactosylsphingosine (NSGS, NOGS, and NLnGS, respectively). DSC of hydrated (70 wt% water) NSGS shows an endothermic transition at 85 degrees C (delta H = 18.0 kcal/mol NSGS) and a broad exothermic transition at 40-60 degrees C, the latter being dependent upon the previous cooling rate. X-Ray diffraction patterns recorded at 21, 61, and 86 degrees C provide evidence for interconversions between metastable and stable crystalline NSGS bilayer phases. The properties of the unsaturated-chain cerebrosides are more complex. Hydrated NOGS shows a single endothermic transition at 44.8 degrees C (delta H = 11.5 kcal/mol NOGS). However, incubation of NOGS at 49 degrees C for 24 h results in a second transition at 55.5 degrees C. By cycling NOGS between 0 and 49 degrees C complete conversion into this higher melting phase (delta H = 12.1 kcal/mol NOGS) is achieved. X-ray diffraction confirms a bilayer phase at all temperatures and delineates the conversions between a crystalline phase at 21 degrees C (bilayer period d = 56.5A), a second crystalline phase at 47 degrees C (d = 69.9A), and a liquid crystalline phase at 59 degrees C (d = 52.0A). The more unsaturated NLnGS shows two transitions, a sharp transition at 28 degrees C (delta H = 8.0 kcal/mol NLGS) and a broad, low-enthalpy transition at 42 degrees C (delta H = 0.4 kcal/mol NLGS). Again, incubation between the two transitions leads to a single transition at 44 degrees C (delta H = 9.3 kcal/mol NLGS). X-ray diffraction demonstrates conversions between two crystalline bilayer phases (d = 55.2A and d = 68.4A), and a liquid crystalline bilayer phase (d = 51.8A). Thus, increased unsaturation in the amide-linked fatty acyl chain of cerebrosides results in decreased chain melting temperatures (NSGS greater than NOGS greater than NLnGS) and has marked effects on their structural properties. PMID- 2713442 TI - pH dependence of actin self-assembly. AB - Fluorescence enhancement and fluorescence photobleaching recovery have been utilized to examine actin self-assembly over the pH range 6.6-8.0. The kinetics of assembly are faster and the critical concentrations are lower at lower pH. Filament diffusion coefficients are not a function of pH, indicating that average filament lengths are not pH dependent. Although critical actin concentrations are a sensitive function of the concentrations of various cations in the medium, the relative pH dependences of critical concentrations are similar for all combinations of cations employed. The pH dependence of actin self-assembly is sufficiently great that it should be taken into account when comparing data from different reports and when relating in vitro measurements to cytoplasmic mechanisms. PMID- 2713443 TI - Measurement of nonuniform current densities and current kinetics in Aplysia neurons using a large patch method. AB - A large patch electrode was used to measure local currents from the cell bodies of Aplysia neurons that were voltage-clamped by a two-microelectrode method. Patch currents recorded at the soma cap, antipodal to the origin of the axon, and whole-cell currents were recorded simultaneously and normalized to membrane capacitance. The patch electrode could be reused and moved to different locations which allowed currents from adjacent patches on a single cell to be compared. The results show that the current density at the soma cap is smaller than the average current density in the cell body for three components of membrane current: the inward Na current (INa), the delayed outward current (Iout), and the transient outward current (IA). Of these three classes of ionic currents, IA is found to reach the highest relative density at the soma cap. Current density varies between adjacent patches on the same cell, suggesting that ion channels occur in clusters. The kinetics of Iout, and on rare occasions IA, were also found to vary between patches. Possible sources of error inherent to this combination of voltage clamp techniques were identified and the maximum amplitudes of the errors estimated. Procedures necessary to reduce errors to acceptable levels are described in an appendix. PMID- 2713444 TI - Relations for lipid bilayers. Connection of electron density profiles to other structural quantities. AB - Three relations are derived that connect low angle diffraction/scattering results obtained from lipid bilayers to other structural quantities of interest. The first relates the area along the surface of the bilayer, the measured specific volume, and the zeroth order structure factor, F(0). The second relates the size of the trough in the center of the electron density profile, the volume of the terminal methyl groups, and the volume of the methylene groups in the fatty acid chains. The third relates the size of the headgroup electron density peak, the volume of the headgroup, and the volumes of water and hydrocarbon in the headgroup region. These relations, which are easily modified for neutron diffraction, are useful for obtaining structural quantities from electron density profiles obtained by fitting model profiles to measured low angle x-ray intensities. PMID- 2713445 TI - Structure of the fully hydrated gel phase of dipalmitoylphosphatidylcholine. AB - X-ray diffraction intensities for lamellar repeats, h = 1 to 7, and wide-angle x ray scattering were measured for the gel phase of fully hydrated dipalmitoylphosphatidylcholine. A hybrid model, which represents the electron density along the lamellar repeat direction as a continuous function composed of constant strips and superimposed Gaussians, is defined. The data were used to determine the best parameters in hybrid models and also in the older strip models. The most successful results were obtained when the density of the methylene region was constrained to the value obtained from the wide-angle scattering. Further analysis utilized the lipid volume obtained from absolute specific volume measurements. Together with the fundamental relations derived in the previous paper, the electron density modeling yielded the headgroup volume (340 +/- 10 A3) and the methylene volume (25.3 +/- 0.2A3). The results were in agreement whether the hybrid model or the strip model was used and whether our data or the data of Torbet and Wilkins were used. Additional structural results, such as the area (45.9 +/- 2.0 A2) and the number of waters of hydration per lipid (10.6 +/- 2.0), required one additional piece of information, which we took to be the tilt angle theta, which is 30 +/- 3 degrees from other experiments in the literature. Absolute electron density profiles, which clearly indicate two features in the headgroup region, are presented. The analysis yielded an accurate value of F(0), which contributes to the continuous scattering transform F(X), which is also given. PMID- 2713446 TI - Dielectric properties of Artemia cysts at low water contents. Evidence for a percolative transition. AB - Cellular cysts of the crustacean Artemia provide a useful model for studies on water-dependent mechanisms in cellular function because they can undergo reversible cycles of dehydration-rehydration. We explored their dielectric behavior over the frequency range of 10 kHz to 1 MHz, at water contents between near zero and 0.5 g H2O/g dry weight (g/g). The dc conductivity and static dielectric permittivity were evaluated from electrostatic analysis of data obtained with a three-layered capacitor. Below cyst hydrations of 0.05 g/g, negligible dielectric response was observed at all frequencies. Between 0.05 and 0.25 g/g the permittivity increased sharply then reached a near plateau up to cyst hydrations close to 0.35 g/g, above which a second abrupt increase occurred. Values for the dielectric loss (tan delta) exhibited frequency-dependent peaks over the hydration range of 0.05-0.3 g/g, followed by an abrupt increase near 0.35 g/g, an hydration at which metabolism is first initiated in this system. These hydration-dependent dielectric changes are compared with previous studies on the biology and physics of this system, and evaluated by a model involving percolative ionic (likely protonic) conduction. Percolative behavior is characterized by a sharp increase in conductivity at a critical threshold of hydration (hc) according to a power law in which the exponent, t, equals 1.65 for a three-dimensional infinite lattice. For the Artemia cyst, t = 1.64 above hc = 0.35 g/g, which is in excellent agreement with theory. These results are compared to similar studies on lysozyme which also exhibits percolative behavior connected with the onset of biological function. PMID- 2713447 TI - Calculation of intermolecular interaction strengths in the P beta' phase in lipid bilayers. Implications for theoretical models. AB - The existence of the P beta' phase in certain lipid bilayers is evidence that molecular interactions between lipids are capable of producing unusual large scale structures at or near biological conditions. The problem of identifying the specific intermolecular interactions responsible for the structures requires construction of theoretical models capable of clear predictions of the observable consequences of postulated intermolecular interactions. To this end we have carried out a twofold modeling effort aimed at understanding the ripple phase. First, we have performed detailed numerical calculations of potential energies of interaction between pairs and triplets of lipid molecules having different chain tilt angles and relative vertical alignments. The calculations support the notion that chain tilting in the gel phase is a result of successive 3-5-A displacements of neighboring molecules perpendicular to the bilayer plane rather than long range cooperative chain tilting. Secondly, we have used these results as a guide to formulate a new lattice model for lipid bilayer condensed phases. The new model is less complex than our earlier model and it includes interactions which are, based on the energy calculations, more likely to be responsible for the ripple phase. In a certain limit the model maps onto the chiral clock model, a model of much interest in condensed matter theory. In this limit the model exhibits a chain-tilted ordered phase followed by (as temperature increases) a modulated phase followed by a disordered phase. Within this limit we discuss the properties of the model and compare structures of the modulated phase exhibited by the model with experimental data for the P beta' phase in lipid bilayers. PMID- 2713448 TI - Two-dimensional 1H/13C heteronuclear chemical shift correlation spectroscopy of lipid bilayers. AB - Using solid-state magic angle spinning nuclear magnetic resonance (NMR) techniques, we have obtained two-dimensional (2D), 1H/13C chemical shift correlated spectra of liquid crystalline 1,2-dimyristoyl-sn-glycero-3 phosphatidylcholine (DMPC) bilayers in 30 wt% PO4/D2O buffer. Linewidths in both the 13C and the 1H dimensions were less than 0.3 ppm wide. The 2D spectrum consists of chemical shift correlations between all resolvable, directly bonded 13C-1H pairs and exhibits considerably greater spectral dispersion than either ID 1H or 13C MAS spectra. This approach promises to be an important tool in structural studies of biological membranes. PMID- 2713450 TI - Model selection: reliability and bias. PMID- 2713449 TI - Streaming potential measurements in Ca2+-activated K+ channels from skeletal and smooth muscle. Coupling of ion and water fluxes. AB - Streaming potentials arising across large-conductance Ca2+-activated K+ channels incorporated into planar lipid bilayers were measured. Ca2+-activated channels obtained either from skeletal muscle or from smooth muscle membranes were used. Streaming potentials were extracted from the current-voltage relationship for the open channel obtained in the presence of an osmotic gradient. The osmotic gradient was established by adding glucose to one side of the membrane. At 300 mM KCl, the average streaming potential was 0.72 mV/osmol per kg for t-tubule channels and 0.83 mV/osmol per kg for smooth muscle channels. Streaming potential values depend on KCl concentration, they decrease as KCl concentration increases, and the value obtained by extrapolation to zero KCl concentration is 0.85 mV/osmol per kg. Assuming that water and ions cannot pass each other, at least in a region of the channel, the streaming potential values obtained indicate that this region contains a minimum of two and a maximum of four water molecules. It is concluded that the channel has a narrow region with a length of 0.6-1.2 nm. PMID- 2713451 TI - Molecular mechanics studies on poly(purine).poly(pyrimidine) sequences in DNA: polymorphism and local variability. AB - Energy minimization has been carried out on three poly(purine).poly(pyrimidine) sequences--d(G)10.d(C)10, d(A)10.d(T)10, and d(AG)5.d(CT)5--using the molecular mechanics program AMBER (Assisted Model Building and Energy Refinement). In order to extensively scan the conformational space available, five different helical models were studied, three of them being right-handed helices while the other two were left helical. For all three sequences the right-handed A- and B-type helices are energetically slightly preferred over the left helices, but the energy difference between the various right-handed helices is only marginal. A detailed analysis has been carried out to characterize the local structural variability in the refined structures, both in terms of torsion angles as well as other parameters such as base-pair tilt, wedge roll, and wedge tilt, etc. All three sequences exhibit similar structural features for a particular form, but both the forms A and B show significant deviations from fiber models. In particular, the A form structures have higher unit rise (2.7 A), and lower unit twist (31 degrees) and base-pair tilt (12 degrees), compared to the fiber model, which has corresponding values of 2.56 A, 32.7 degrees, and 20 degrees, respectively. All these changes indicate that the refined models are closer to the A-form structure observed in crystals of oligonucleotides. In the refined B-for models, the helical parameters are close to the fiber B-form, although the torsion angles show considerable variations. None of the three sequences examined, including the d(A)n.d(T)n sequence, show any pronounced curvature for the B-form structure. PMID- 2713452 TI - Base and conformational specificity of an amine modification of DNA. AB - We have investigated the site and conformational preference of the reaction of a formaldehyde/amine reagent with DNA. Previous investigations of this laboratory have established that this reagent will react with native DNA, placing a positively charged amine moiety on the duplex that will survive exhaustive dialysis. The resulting adduct is duplex and base stacked in character, possessing B backbone geometry with a higher average winding angle and exhibiting remarkable stability with respect to the A-form, Z-form, or the single-strand denaturated species. In this current investigation, we have found that the stability of the adduct is dramatically reduced if the DNA is converted to mononucleotides, thus obviating the usual approach of nuclease digestion and chromatography for the identification of the modified nucleotides. Using indirect approaches, we have established that the reactive site that survives removal of the equilibrium concentrations of CH2O and amine is the exocyclic amino group of the guanine bases. This conclusion is based on (1) the positive correlation between GC content and the extent of adduct formation under standard reaction conditions (27 degrees C, 0.63M CH2O, 0.007M n-butylamine, pH 7); (2) decreases in the level of substitution of amine in DNA, which has this site blocked by trinitrobenzene modification; and (3) failure of poly(dI-dC) to retain amine upon dialysis. Raman spectra of the derivatized poly(dG-dC) show enhanced 2'-endo B character, with no marked shifts in the position of any of the lines, indicating the absence of any ring structures involving the N7 and the 06 of G. In standard reaction mixtures, other sites may react but this phenomenon appears to be minimal under conditions that do not favor fluctuational opening of base pairs. In the latter case, excess loading of amine on high GC content polymers produces a CD spectrum that is similar to one produced by poly(dA-dT) in the "X"-form [M. Vorlickova, E. Minyat, and J. Kypr (1984) Biopolymers 23, 1-4]. This conformation is lost, however, upon removal of excess reagents by dialysis and cannot be reestablished, in the absence of unbound amine and formaldehyde. The reaction is specific for the B-form of polynucleotides as demonstrated by the failure of poly(dG-m5dC) in the stable Z-form to exhibit substantial reaction. The B-form of this polymer will react readily with the retention of 0.23 moles amine/mole nucleotide under our standard reaction conditions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2713453 TI - Conformational analysis of cyclolinopeptide A, a cyclic nonapeptide: nuclear Overhauser effect and energy minimization studies. AB - The conformation of cyclolinopeptide A [cyclo(Pro-Pro-Phe-Phe-Leu-Ile-Ile-Leu Val)], a naturally occurring cyclic nonapeptide has been investigated in dimethylsulfoxide solution by 270 MHz 1H-nmr. A complete assignment of all C alpha H and NH resonances has been accomplished using two-dimensional correlated spectroscopy and nuclear Overhauser effects (NOEs). Analysis of interresidue NOEs and JHNC alpha H values permit construction of a molecular model for the cyclic peptide backbone. The crude model derived from nmr has been used as a starting point for energy minimization, which yields a refined structure largely compatible with nmr observations. The major features of the conformation of cyclolinopeptide A are a Type VI beta-turn centered at Pro(1)-Pro(2), with a cis peptide bond between these residues and a gamma-turn (C7 structure) centered at Ile(6). Two intramolecular hydrogen bonds Val(9) CO--Phe(3)NH (4----1) and Leu(5) CO--Ile(7)NH (3----1) are observed in the low-energy conformation. The limited solvent accessibility observed for the Val(9) and Leu(5) NH groups in the nmr studies are rationalized in terms of steric shielding. PMID- 2713454 TI - C-H ... O hydrogen bonding in solutions of methylated nucleic acid base analogs as revealed by NMR. AB - Formation and thermodynamic characteristics of C-H ... O hydrogen bonding of methylated uracils and caffeine have been studied by nmr along two lines. 1. The concentration and temperature dependencies of the PMR spectra of 1,3 dimethyluracil (m2 1,3Ura), 1,3-dimethylthymine (m2 1,3Thy), and 1,3,6 trimethyluracil (m3 1,3,6Ura) in chloroform at high concentrations of base analogs indicated the self-association of m2 1,3Ura and m2 1,3Thy via C(6)H ... O hydrogen bonding and the competitive formation of C-H ... O bonds between carbonyl oxygens and chloroform. The intermolecular interaction energy and the arrangement of molecules in the local minima of various m2 1,3Ura dimers were calculated by the method of atom-atom potentials. The deepest minimum for the m2 1,3Ura coplanar dimer corresponds to a C(6)-H ... O hydrogen-bond formation. 2. At low concentration of m2 1,3Ura and caffeine in CCl4, C(6)-H ... O bonding for m2 1,3Ura and C(8)-H ... O bonding for caffeine with oxygens of dimethyl sulfoxide (DMSO) and acetone were observed. The association constants of these complexes were obtained at different temperatures. The enthalpies delta H, of the m2 1,3Ura-DMSO, m2 1,3Ura-accetone, caffeine-DMSO, and caffeine-acetone complexes were -2 +/- 0.1 kcal/mol. The calculations showed that the deepest minimum of the caffeine-acetone coplanar complex corresponds to C(8)-H ... O bonding with energy of -3.5 kcal/mol and that of the m2 1,3Ura-acetone complexes corresponds to C(6) H ... O bonding with energy of -3.4 kcal/mol. The approximate correction for the solvent effect provides good agreement of the experimental data with the calculations. PMID- 2713455 TI - CD spectra of isoionic DNA solutions. AB - The ion-exchange transition of Na-DNA----H-DNA in concentrated salt-free solutions is accompanied by strong variations in CD spectra. The rotational force of the negative band magnitude of delta epsilon 249 decreases when going to H-DNA by about 4 times, and the value of delta epsilon 279, by 1.2 times. These changes are irreversible to a considerable extent, which is evident because the spectra of Na-DNA obtained by neutralizing isoionic H-DNA solutions with NaOH or by the ion-exchange method significantly differ from those of Na-DNA taken by dissolving solid Na-DNA in deionized water. It has been shown that additions of NaCl to an isoionic solution of DNA leads to variations of spectra, typical for deprotonation processes as well as for an increase in DNA hydration. PMID- 2713456 TI - Dynamic light scattering measurements of the diffusion of probes in filamentous actin solutions. AB - The diffusion coefficients of monodisperse polystyrene latex spheres in solutions of polymerized actin were measured using dynamic light scattering. Four different probes with radii R, ranging from 50 to 500 nm, were separately used in actin solutions with concentrations c, ranging from 1.5 to 21 microM, which had been polymerized with either 1 mM MgCl2, 1 mM CaCl2, or 100 mM KCl. Under all conditions, and at four different scattering angles in the range of 30 degrees-90 degrees, the measured average diffusion coefficients D of the probes were systematically smaller for samples of increased actin concentration or of increased probe radius. Control experiments indicated that the probes did not bind to the actin. These data for Mg2+- and Ca2+-polymerized actin agree and were found to be quite well summarized by the scaling relation D/D0 = exp[-alpha R delta c nu], where D0 is the measured diffusion coefficient of the probes in water (and, as also measured, in the starting actin solutions prior to polymerization with added salt), with values of delta = 0.73 +/- 0.05, nu = 1.08 +/- 0.09, and alpha = (1.1 +/- 0.6) x 10(-3) (with c in microM and R in nm). Data for KCl-polymerized actin show much more restricted diffusivities of the probes at comparable actin concentrations. Inhomogeneities in the solution are reflected in the "effective polydispersity" of the probe diffusion coefficients, which depend on local microviscosity differences. PMID- 2713457 TI - Low-frequency dynamics and Raman scattering of crystals, of B-, A-, and Z-DNA, and fibers of C-DNA. AB - Normal modes of vibration of DNA in the low-frequency region (10-300 cm-1 interval) have been identified from Raman spectra of crystals of B-DNA [d(CGCAAATTTGCG)], A-DNA [r(GCG)d(CGC) and d(CCCCGGGG)], and Z-DNA [d(CGCGCG) and d(CGCGTG)]. The lowest vibrational frequencies detected in the canonical DNA structures--at 18 +/- 2 cm-1 in the B-DNA crystal, near 24 +/- 2 cm-1 in A-DNA crystals, and near 30 +/- 2 cm-1 in Z-DNA crystals--are shown to correlate well with the degree of DNA hydration in the crystal structures, as well as with the level of hydration in calf thymus DNA fibers. These findings support the assignment [H. Urabe et al. (1985) J. Chem. Phys. 82, 531-535; C. Demarco et al. (1985) Biopolymers 24, 2035-2040] of the lowest frequency Raman band of each DNA to a helix mode, which is dependent primarily upon the degree of helix hydration, rather than upon the intrahelical conformation. The present results show also that B-, A-, C-, and Z-DNA structures can be distinguished from one another on the basis of their characteristic Raman intensity profiles in the region of 40 140 cm-1, even though all structures display two rather similar and complex bands centered within the intervals of 66-72 and 90-120 cm-1. The similarity of Raman frequencies for B-, A-, C-, and Z-DNA suggests that these modes originate from concerted motions of the bases (librations), which are not strongly dependent upon helix backbone geometry or handedness. Correlation of the Raman frequencies and intensities with the DNA base compositions suggests that the complex band near 90-120 cm-1 in all double-helix structures is due to in-plane librational motions of the bases, which involve stretching of the purine-pyrimidine hydrogen bonds. This would explain the centering of the band at higher frequencies in structures containing G.C pairs (greater than 100 cm-1) than in structures containing A.T pairs (less than 100 cm-1), consistent with the strengths of G.C and A.T hydrogen bonding. PMID- 2713458 TI - [Effect of taktivin on diuresis and tubular cardiotrast secretion in the kidney]. AB - The effect of a new immunomodulator taktivin (7-20 micrograms/kg subcutaneously, for 6 days) on the diuresis and tubular transport of cardiotrast (diodrast) was studied on rats. taktivin was shown to increase the tubular transport of the xenobiotic without significant changes in glomerular filtration and renal excretion of water, sodium, potassium, uric acid and creatinine. Possible mechanism of taktivin's action on the tubular transport of xenobiotics is discussed. PMID- 2713459 TI - [Kindling of the limbic structures with a shortened interstimulus interval]. AB - We investigated the possibility to produce hippocampal or amygdala kindling syndrome in rabbits which had been electrically stimulated at a fixed interval between stimuli at 5 min. Animals were prepared with chronically implanted electrodes (neocortex, hippocampus, amygdala, nucleus caudatus). The initial stimuli produced only localized effect, but repeated applications of the stimuli progressively increased the seizure activity resulting in generalized kindled convulsions after 2-4 h period. At the first stage generalized seizures were followed by long lasting refractory period, but at the end of the procedure almost all stimuli evoke major motor seizures and recurrent widely spread electrographic epileptic changes. The most noteworthy findings emerging from this study is the inhibition of postictal seizure inhibition period. This effect was independent of whether stimulated the electrode was positioned in the hippocampus or amygdala, but the hippocampal formation occupied the central position for the once and propagation of the seizure activity in all cases. When established this syndrome persisted without any attenuation for some weeks. It was concluded that this model of rapid development of kindling syndrome is useful for investigation of the nature of epilepsy and postictal seizure inhibition. PMID- 2713461 TI - [Effect of brain extracts from rats subjected to korazol kindling on generalized epileptic activity]. AB - The pharmacological kindling was induced in rats by corazol repeated injections in subthreshold doses. The peptide-containing fraction was emitted from animal brains by the help of hot acetic acid on the stage of generalized clonic-tonic seizures development. Intraperitoneal injection of brain extracts of kindled rats significantly increased corazol and picrotoxin induced seizure severity in mice. The effect was removed by preliminary injection of naloxone or by preventive incubation of extracts with pronase. Intraventricular injection of extracts to intact rats increased the seizure severity which was provoked by corazol and in high doses induced in rats generalized seizure reactions. PMID- 2713460 TI - [The structural specificity of factors in the chemical regulation of muscle tonus at the spinal cord level]. AB - The chemical factors of the postural asymmetry (FPA) were studied on the recipients without hemispheres. The structural specificity of the fore and hind limb spinal centers regulation in normal and damaged CNS was observed. In the normal CNS this structural specificity was displayed in the selective activation of the cross-situated hemicenters in the cervical and lumbal regions (for example in the left part of the cervical and in the right part of the lumbal region). In the case of the unilateral lesion of the central motor systems the normal pattern of chemical structural specificity was modified by activation of FPA selectively acting on the partly denervated regions of the spinal cord. PMID- 2713462 TI - [Characteristics of the normal gluconeogenesis effect of prostaglandin F2 alpha and in myocardial infarct]. AB - The effect of PGF2 alpha on glucose synthesis de novo in a healthy rat organism and those with coronary occlusion-myocardial infarction was studied. There was observed prostaglandin's metabolic action simultaneously at one direction: there was increased the concentration of non-nitric precursors of gluconeogenesis in blood of animals of both groups, final disintegration product of tissue proteins, the gluconeogenic activity of key enzymes and therefore the concentration of newly formed glucose went up as so as glycogen in liver, cardiac and skeletal muscle. Seemingly, PGF2 alpha stimulates the intensity not only of gluco-, but glyconeogenesis having cardioprotective action. At the same time metabolic effect of PGF2 alpha is strongly marked in coronary occlusion rat with myocardial infarction. PMID- 2713463 TI - [Use of hyperbaric oxygenation in the therapy of experimental hypothyroidism]. AB - In animal experiments on rabbits the effect of hyperbaric oxygen was studied on the functional state of the myocardium, the cardiac resistance to induced peroxide lipid oxidation, the structural and functional changes in the thyroid gland and the state of microcirculation in the conditions of experimentally induced hypothyrosis. It was demonstrated that hyperbaric oxygen has a favourable effect on the state of myocardium and microcirculation. PMID- 2713464 TI - [Tetraphenylporphyrin-Sn4+ induction of cytochrome P-450]. AB - TPP-Sn4+ was administered intraperitoneally (25 mg/kg body weight). The study was performed for 1-30 days. A day after administration the increase in the hemoprotein level 1.4 times was observed, as well as an increase in the level of p-hydroxylation of aniline. On 7-14 days the greatest increase in cytochrome P 450 content was observed. To clarity the mechanism of TPP-Sn4+ effect on cytochrome P-450, we studied its effect on the activity of heme oxygenase and LP rate. This compound is an inhibitor of heme oxygenase activity and reduces the rate of LP in the microsomes which regulates porphyrin metabolism in the organism. PMID- 2713465 TI - [Modification of blood plasma lipoproteins by a lipid peroxidation product- hexanal]. AB - HDL treated with hexanal is shown to lose the ability for the cholesterol absorption. In the case of LDL at low concentration of the modifying agent the rate of their elimination from the blood stream of the rabbit decrease, but their uptake by the rat macrophages do not differ from the uptake of native lipoproteins. At high concentration of hexanal the rate of the elimination of LDL from the blood stream increases considerably and is close to that of acetylated LDL. Thus, the modification of plasma lipoproteins with monoaldehydes occurring in the aorta wall leads to the loss of the functional properties of the lipoprotein particles. PMID- 2713466 TI - [Lipid peroxidation and the endogenous DNA polymerase activity of fractions of isolated liver chromatin in rats]. AB - Lipids which enter the composition of actively transcribed and repressed chromatin fractions are found to undergo a peroxidation. The peroxidation induction results in a depression of the endogenous DNA polymerase activity of these fractions. Tetrachloromethane increases the intensity of lipid peroxidation processes and induces a more marked depression of the DNA polymerase activity in all repressed chromatin fractions. It is assumed that selective action of tetrachloromethane on the studied indices of this chromatin fraction may be related to the differences of lipid composition of actively transcribed and repressed chromatin. PMID- 2713467 TI - [Dynamic changes in the indices of lipid metabolism in erythrocyte membranes at different times of the development of alloxan diabetes]. AB - The changes in the content of phospholipids (PL), cholesterol (cr) and its fractions were studied in the processes of lipid peroxidation. At the different periods of alloxan diabetes development the CS/LP ratio coefficient was determined (7, 14, 21 days). The results of our investigations we explain by erythrocyte membranes destruction in the molecular mechanism of which the significant role has played the activation of free radical lipid oxidation processes. PMID- 2713468 TI - [Lipid peroxidation in the synaptosomal and mitochondrial fractions of separate brain structures in hypoxia]. AB - The paper studies intensification of lipid peroxide oxidation in separate brain structures (the medulla oblongata, cerebellum, visual and sensomotor cortex), synaptosomal and mitochondrial fractions under hypoxia. It has been established that acute hypoxia increases accumulation of lipid peroxidation (LPO) products, hydroperoxide and malonyl dialdehyde. Intensification of LPO in synaptosomes and mitochondria is more pronounced as compared to the whole structures. Preliminary treatment with antioxidants (vitamin E and ionol) considerably suppressed LPO intensity under both hypoxia and hypoxia with reoxygenation. Intensification of LPO in synaptosomes and mitochondria is suggested to be the key point in structural-functional disturbances of the nervous system under hypoxia and ischemia. PMID- 2713470 TI - [Effect of a 3-hydroxypyridine-class antioxidant on an ethanol-induced learning disorder in mice and the accumulation of lipofuscin]. AB - Molecular processes of biological aging could interact with molecular effects of ethanol, potentiating each other and culminating in accelerated aging process. According to this premise effect of antioxidant of 3-hydroxypyridine class (3-HP) on behaviour of 3-month-old mice after chronic alcoholisation was investigated. 5 month alcoholisation induced impairment of the process of learning in mice and accelerated accumulation of lipofuscin (age pigment) in the brain. 3-HP consumption (20-25 mg/kg/day in drinking water) during alcoholisation contributed to preservation of learning ability in mice and decreased lipofuscin accumulation in the brain in comparison with alcohol-treated mice. Effect of 3-HP may be due to its antioxidant properties and its ability to increase animals resistance to the extreme factors. PMID- 2713469 TI - [Effect of ethanol and probenecid on the excretory function of the cerebral choroid plexus in rats]. AB - Probenecid at a dose 100 and 200 mg/kg, i.v. has been found to decrease in a dose dependent manner the level of radioactivity of cerebrospinal fluid (CSF) measured at 1, 15, 30 and 60 min. after the intravenous injection of 14C-tyrosine, 14C tryptophan and 14C-DOPA. Ethanol at a dose 2 and 4 g/kg, i. p. has not changed the level of radioactivity of the CSF. It is suggested that mentioned in the literature an increased accumulation of the labeled tyrosine, tryptophan and DOPA in the brain structures after their intravenous injection is not related to the inhibitory effect of ethanol on the excretory function of the choroid plexus of the brain. On the other hand, it is concluded that probenecid is able to inhibit the excretion from the brain of some acid compounds including tyrosine, tryptophan and DOPA. PMID- 2713471 TI - [A decrease in the acute toxicity of ethanol produced by zinc sulfate]. AB - It was shown that zinc sulphate injection during the acute alcohol intoxication resulted in the decrease of anaesthetic and toxic effects of ethanol. The most effective dose was 15 mkg/kg i.p. The possible mechanisms are discussed. PMID- 2713473 TI - [Isolation of a cytotoxic factor from the blood serum of athymic rats]. PMID- 2713472 TI - [Antibody formation to autologous erythrocytes following the immunization with rat erythrocytes of normal animals and mice tolerant to the immunizing antigen]. AB - (CBA X C57B1/6)F1 mice immunized three times with rat erythrocytes produced antibodies both to this antigen and to autologous erythrocytes. Most of the antibodies to rat erythrocytes belonged to IgM isotype while antibodies to autologous red cells were of IgG isotype. Combined injection of thymectomized (CBA X C57B1/6)F1 mice with a massive dose of rat spleen cells and cyclophosphamide induced in animals stable tolerance to rat cells. Inducibility of antibodies to autologous red cells in tolerant mice injected 3-5 times with rat erythrocytes was drastically reduced. Nonspecific suppression (thymectomy and cyclophosphamide) did not prevent production of autoantibodies. PMID- 2713474 TI - [Enhanced inhibition of splenic lymphocyte proliferation by 2,3,7,8 tetrachlorodibenzo-p-dioxin in C57B1/10 (Ah+Ah+) mice compared to DBA/2 (AhAh) mice]. AB - In concanavalin A-treated cultures TCDD (10(-8)M) inhibited proliferation of mouse spleen lymphocytes in cells of C57B1/10/mice by 65% and in cells of DBA/2 mice--by 42%. In phytohaemagglutinin-treated cultures of spleen lymphocytes of both strains TCDD produced no significant decrease in incorporation of 3H thymidine into DNA. These observations indicate that effects of TCDD on lymphocyte proliferation are mediated by pleiotropic activity of Ah gene. PMID- 2713475 TI - [Cytostatic action of the peritoneal cells of Syrian hamsters on transformed cells]. AB - The cytostatic effect (CSE) of intact Syrian hamster peritoneal cells (PC) was determined by their capability to inhibit 3H-thymidine incorporation in target cells of HETR, which were placed in 1 X 10(4) or 4 X 10(4) cells per well together with 4 tenfold differing concentrations of PC (10(2)-10(5]. The optimum of CSE was seen with the use of maximal doses of PC and HETR in reaction. Maximal level of CSE with all effector-target cell rations was observed between 23-28 hours of contact. These data permit to suggest the role of HETR cells in activation of PC, as well as the transfer of cytostatic state in dense cell shift mediated by cell-cell contacts. The role of humoral cytostatic factor is also not excluded. PMID- 2713476 TI - [Oxidoreductase activity of an unusual liver estrogen-binding protein in rats]. AB - The possibility that an unusual estrogen-binding protein (UEBP) of rat liver possess the oxidoreductase activity (ORA) has been explored. Estrane, androstane, and pregnane steroid derivates (all together 31) were used as a potential substrates. The expression of ORA was referred to as changes in fluorescence of NAD(P)H, which appearance or disappearance follows the steroid oxidation or reduction in a presence of cofactors and highly purified UEBP preparation. In the set conditions the protein didn't show the ORA. The results achieved confirm the conception on the steromodulin function of UEBP which is realized by reversible interaction of the protein with it's steroidal ligands. PMID- 2713477 TI - [Effect of helium-neon laser rays on the processes of postradiation recovery in the skeletal muscles of old rats]. AB - The present experiments were conducted to determine the stimulant effect of helium-neon laser on the postradiation recovery in irradiated uninjured skeletal muscle of rats aged 2-2.5. This was indicated by a restored ability of the muscle for posttraumatic regeneration. The both hind rat legs were exposed to local irradiation of 20 Gy and following laser therapy (8-9 procedures at 3 min each, impulsive or continuous one). Then both musculus gastrocnemius were cut across 30 days after irradiation. It was shown that laser therapy employed before injury of the irradiated muscle accelerated fibrin resorption and improved connective tissue, but slightly stimulated muscular tissue. Impulse laser therapy was more favourable for state of skin and healing of the skin wound after irradiation. PMID- 2713478 TI - [Biochemical and morphological changes in the neuroglia in experimental herpetic encephalitis]. AB - The complex virological, biochemical and morphological study permitted to obtain various characteristics of mice herpes encephalitis. The reaction of astrocyte glia at different stages of herpes encephalitis was revealed and analyzed in detail. New data on the dynamics of desoxyribonuclease activity changes in neuroglia and the glial complex formation were obtained. It was shown that the increased DNA-ase activity in neuroglia and the astrocyte activation which morphological manifestation was the formation of glial complexes, may be referred to as processes dealing with barrier and elimination neuroglia functions in herpes encephalitis. The results presented allows to suppose that the severity of the development and outcome of herpes encephalitis mainly depends on the astrocyte glia condition, its potential abilities in appearing of barrier and eliminative functions. PMID- 2713479 TI - [Characteristics of the recovery processes in the resected thyroid of adult rats after sympathectomy]. AB - The investigation was carried out on 65 adult white male rats (12-month-old) after normal development or chemical sympathectomy by guanethidine and subtotal thyroidectomy. By means of electronic microscopic, autoradiographic and radioimmunological methods the increased functional activity in thyroid gland of chemically sympathectomized rats was found. This is mainly due to thyrotropin hyperproduction and intensification of proliferative potential of the organ. Partial resection of sympathectomized rats thyroid gland leads to exhaustion of adenohypophysis compensatory potential manifested in disjunction of integrative connections in hypothalamus-hypophysis-thyroid gland system and delay of thyroid status normalization. PMID- 2713480 TI - [Morphological characteristics of the healing of burn wounds covered by an activated-charcoal tissue dressing]. AB - Activated-charcoal cloth and dressings product based upon this material were applied for covering burn wounds. As a control served a gauze dressings with greases and solution topical drugs. The healing of deep thermal burns of 3rd degree on rabbits studied by a histological method was differed by a rapid decreasing of inflammation reaction, active epithelialization and soft scar formation. A clinical use in 15 burned patients was shown that in combination with enzymatic and antimicrobial drug solutions these materials accelerate healing and epithelialization of superficial burn wounds and improve treatment of deep burn wounds before autodermoplasty. PMID- 2713481 TI - [The origin of lipofuscin granules in a hybridoma cell culture]. AB - The ultrastructure of lipofuscin granules (LG) in hybridoma cells is described. Based on the electron microscopic evidence and literature data the possibility of generation of LG from cell endoplasmic reticulum (ER) is discussed. It is proposed that the production of LG is connected with disturbances in glycosylation of proteins and lipids on the ER membranes. PMID- 2713482 TI - [Morphometric research on the experimental performance of the erythrocyte filterability test]. PMID- 2713483 TI - [Ultrastructural bases of intravascular thrombosis in the liver in mechanical jaundice]. AB - Electron microscopic studies of a rat liver blood circulatory bed at the experimentally induced 20-day cholestasis demonstrated that the biliary cirrhosis was accompanied by the development of intravascular thrombosis in the liver in a number of cases. Appearance of "pure" thrombocytic thrombi in the lumen of interlobular veins having continuous intact vascular walls was the morphologic feature of the thrombosis. These thrombi are characterized by absence of fibrin fibres. Presence of the intravascular thrombi indicated the higher aggregative ability of thrombocytes which in complex with haemostasis disorders, was one of the causes of hypertension and hemorrhage at the liver pathology. PMID- 2713484 TI - [Morphological validation of the use of polyhydroxyethyl methacrylate-based x-ray contrast emboli for vascular occlusion]. AB - In the experiments on rabbits histological specimens with embolus radiopaque by iodides, bromides of silver and by (3-amino-2,4,6-triiodobenzyl) oil acid have been investigated 7 days after implantation. Optimum emboli were used in clinical practice during preoperative procedure for endovascular occlusion of liver and kidney arteries. PMID- 2713485 TI - Absence of both the 91kD and 22kD subunits of human neutrophil cytochrome b in two genetic forms of chronic granulomatous disease. AB - Chronic granulomatous disease (CGD) is a group of inherited disorders in which phagocytic cells fail to generate antimicrobial oxidants. The various forms of CGD can be classified in terms of the mode of inheritance (either X-linked or autosomal recessive), and whether the neutrophils display the absorbance spectrum of a unique b-type cytochrome important for the function of the respiratory burst oxidase. The finding that purified neutrophil cytochrome b is a heterodimer consisting of a 91kD glycosylated and a 22kD nonglycosylated polypeptide has raised the question of which subunits are absent (or defective) in the various types of CGD. To address this question we have studied the expression of the cytochrome b subunits in three genetically distinct forms of CGD: X linked/cytochrome b-negative (X-), autosomal recessive/cytochrome b-negative (A ), and autosomal recessive/cytochrome b-positive (A+). Using polyclonal antibodies to each of the two subunits, we prepared Western blots of lysates of intact neutrophils from ten CGD patients. In the controls and three patients with A+ CGD, both cytochrome subunits were easily detected. Consistent with the previously reported finding in five X- patients, neither subunit could be identified in neutrophils from three additional X- patients. Both subunits were also undetectable in four patients with A- CGD (three females, one male). This latter group of patients most likely bears a normal 91kD gene, since the patients are genetically distinct from the 91kD-defective X- group. The mutation in A- CGD, therefore, probably involves the 22kD gene and the eventual expression of the 22kD subunit. Furthermore, the expression of the 91kD subunit in this group of patients appears to be prevented due to the 22kD mutation in a manner converse to that seen in the X- CGD patients. Based on these studies, we hypothesize that the stable of expression of either of the two cytochrome subunits is dependent upon the other. PMID- 2713486 TI - Favorable response of early stage B CLL patients to treatment with IFN-alpha 2. AB - Since interferon (IFN-alpha) treatment has proven effective in hairy cell leukemia, its evaluation in chronic lymphocytic leukemia (CLL), a cytologically related disease, appeared reasonable. In our study, we have focused on previously untreated, early stage patients who are less than 60 years of age. All patients had less than 50,000 lymphocytes/microL and immunologic analysis revealed a CD20+, IgM+, IgD- phenotype for leukemic B cells in eight of nine patients. Recombinant interferon alpha 2b (IFN-alpha 2) at 5 x 10(6) U was given subcutaneously three times per week for 8 to 16 months. Consistent with earlier reports, side effects were minor with this low-dose protocol. All patients responded with a decrease of WBC count and lymphocyte count; in one patient, splenomegaly resolved such that he moved from Rai stage II to Rai stage I. On the average CD20+ B cells decreased from 14,312 to 3,995 cells/microL, indicating that no complete eradication of the leukemic cells was possible. A partial response, based on a greater than 50% reduction of CD20+ B cells was obtained in five of seven patients analyzed. The increased numbers of CD2+ T lymphocytes decreased in response to interferon treatment in six of seven patients. Furthermore, in a portion of the patients class II antigen expression was enhanced on LeuM3+ monocytes suggesting an in vivo activation of the monocytes by IFN-alpha 2. Immunoglobulin levels were substantially improved in that serum IgG increased by more than 3 g/L in three of seven patients. In one patient, lymphocyte counts increased in spite of continued therapy, whereas all others exhibited no increase of lymphocyte numbers while on therapy. Our study clearly demonstrates effects of IFN-alpha 2 treatment on both the leukemic cells and on the nonleukemic components of the immune system in peripheral blood. Whether IFN alpha treatment will result in long-term beneficial effects in early stage CLL needs to be evaluated in a larger study. PMID- 2713487 TI - Effects of CAMPATH-1 antibodies in vivo in patients with lymphoid malignancies: influence of antibody isotype. AB - The CAMPATH-1 family of antibodies recognize an abundant glycoprotein expressed on virtually all human lymphocytes. All rat IgM and IgG antibodies of this specificity are lytic with human complement, but only IgG2b is active in antibody dependent cell-mediated cytotoxicity (ADCC). We compared the ability of IgM, IgG2a, and IgG2b to deplete lymphocytes in vivo in two patients with prolymphocytic transformation of B-cell chronic lymphocytic leukemia (CLL). The IgM (CAMPATH-1M) produced transient depletion of blood lymphocytes with consumption of complement but had no effect on solid masses or bone marrow. Similar transient depletion of blood lymphocytes was noted with the IgG2a (YTH34.5). In contrast, the IgG2b (CAMPATH-1G) produced long-lasting depletion of lymphocytes from blood and marrow and improvement in splenomegaly but no detectable changes in complement levels. These differences probably reflect the importance of Fc receptor binding for effective clearance of target cells in vivo. We treated 16 more patients with a variety of lymphoid malignancies and noted consistent effects on blood lymphocytes, marrow infiltration, and splenomegaly. At this dose level, there was comparatively little improvement in affected lymph nodes or extranodal masses. Nevertheless, the in vivo lympholytic ability of CAMPATH-1G is very potent as compared with other monoclonal antibodies (MoAbs) and may have applications in therapy of lymphoid malignancies and as an immunosuppressive agent. PMID- 2713488 TI - Very low dose alpha-2b interferon for the treatment of hairy cell leukemia. AB - Alpha-2b interferon (alpha-2b IFN), administered at 2 x 10(6) U/m2 three times per week is highly effective in the treatment of progressive hairy cell leukemia (HCL) and in the retreatment of patients who have relapsed after previous IFN therapy. To determine if a lower interferon dose would induce a comparable antileukemic effect with less toxicity, a-2b IFN was administered at 2 x 10(5) U/m2 subcutaneously three times per week to 17 patients with progressive HCL. Thirteen patients had HCL in relapse after a previous response to alpha-2b IFN; four patients were previously untreated. The median duration of treatment was 9 months. Toxicity consisted only of transient, mild flu-like symptoms in two patients. Of the 13 previously IFN-treated patients, four had a minimal response, one had no response, and eight had progressive disease. Of four previously untreated patients, one had a partial response, two had a minimal response, and one had no response. In seven of eight patients whose disease progressed on low dose IFN, the dose was escalated to 2 x 10(6) U/m2 three times per week, and all seven patients demonstrated hematologic response within 3 months to the dose escalation. We conclude that alpha-2b IFN at 2 x 10(5) U/m2 three times per week is relatively ineffective for the treatment of relapse after previous IFN therapy. PMID- 2713489 TI - Cloning of cDNA coding for connective tissue activating peptide III from a human platelet-derived lambda gt11 expression library. AB - We report here the cloning of the cDNA coding for platelet connective tissue activating peptide-III (CTAP-III) from a lambda gt11 expression library prepared using messenger RNA (mRNA) isolated from human platelets. The open reading frame of the clone coded for a protein with 128 amino acid residues. Since the precursor of CTAP-III, platelet basic protein (PBP is 94 amino acids long, the 5' translated region of the cDNA codes for a leader sequence 34 amino acids long. This leader sequence, like the sequence of mature CTAP-III, shows significant homology to the sequence of platelet factor 4 (PF4), the only other platelet specific alpha-granule protein cloned until now, from a human erythroleukemic (HEL) cell line-derived cDNA library. These leader sequences are probably critical for targeting such proteins to the alpha-granule. Northern blot hybridization with platelet and megakaryocyte mRNA shows a single species mRNA of approximately 0.8 kb, suggesting that the corresponding cDNA is full length. The cloning of platelet specific CTAP-III provides additional evidence for the platelet specificity of the cDNA library used. PMID- 2713490 TI - Platelet membrane glycoprotein IIb heavy chain forms a complex with glycoprotein IIIa that binds Arg-Gly-Asp peptides. AB - Platelet membrane GPIIb is comprised of a disulfide-linked heavy chain (GPIIb(H)) and light chain (GPIIb(L)). We have examined the role of the two chains of GPIIb in the maintenance of the GPIIb-IIIa heterodimer and Arg-Gly-Asp (RGD) peptide binding function. Lysates of surface radioiodinated platelets were treated with 1% 2-mercaptoethanol for 18 hours at 4 degrees C. Reduction of the interchain disulfide in GPIIb was followed by immunoprecipitation with antipeptide antibodies specific for GPIIb(H) or GPIIb(L). In addition to the GPIIb-IIIa complex, a polypeptide of 120 Kd was precipitated by anti-GPIIb(H) and a polypeptide of 23 Kd was precipitated by anti-GPIIb(L) from reduced platelet lysates. To determine whether GPIIb(H) or GPIIb(L) remained complexed with GPIIIa, reduced platelet lysates were immunoprecipitated with AP3, a monoclonal anti-GPIIIa antibody, resulting in the coimmunoprecipitation of GPIIb(H) but not GPIIb(L). Conversely, the monoclonal anti-GPIIb(H) antibody PMI-1 immunoprecipitated GPIIIa with GPIIb(H). Thus GPIIb(H) maintains its association with GPIIIa. Furthermore, the GPIIb(H)-IIIa complex retains its reactivity with AP2, a monoclonal antibody (MoAb) specific for the nondissociated GPIIb-IIIa complex. Affinity chromatography of reduced platelet lysates on immobilized KYGRGDS resulted in binding and specific elution of the GPIIb(H)-IIIa complex. These findings indicate that GPIIb(H) contains sufficient information for maintenance of a complex with GPIIIa and support of the binding of the heterodimer to RGD peptides. PMID- 2713491 TI - The activation of the contact phase of coagulation by physiologic surfaces in plasma: the effect of large negatively charged liposomal vesicles. AB - The endogenous, negatively charged surface that induces activation of the contact coagulation factors was investigated in plasmas taken from women in late pregnancy and control subjects of child-bearing age. The plasmas from the two groups of subjects were incubated at 4 degrees C for 24 hours either in plastic or in glass tubes and the factor VII coagulant activity (VIIc) was assayed in the treated plasmas. The activation of factor VII under these conditions involves the generation of enzymes derived from factor XII (XIIa). The contact surface is rate limiting for the activation of factor VII in the plasmas in both groups of subjects and can be supplemented by large multilamellar liposomal vesicles carrying the appropriate density of negative charge. The size of these vesicles is within the range of sizes of the large lipoprotein particles (chylomicrons, very low and intermediate-density lipoproteins). The relationship between the density of negative charge on the liposomal vesicles and VIIc was similar in the late pregnancy and the control plasmas incubated in plastic tubes. At a saturating density of negative charge the observed relative VIIc was similar in both sets of plasmas. The incubation of late pregnancy or control plasma in plastic tubes in the presence of sodium stearate caused VIIc to increase with increasing concentration of the added fatty acid. These results suggest that large lipoprotein particles carrying the appropriate free fatty acid at a sufficient density of negative charge could provide the contact surface that induces the generation of factor XIIa and the subsequent activation of factor VII. Moreover, plasmas from women in late pregnancy have a higher concentration of potential surface and a higher density of negative charge than the plasmas from nonpregnant women. PMID- 2713492 TI - Interaction of platelet factor four with cultured vascular endothelial cells. AB - Platelets secrete a low-molecular-weight protein, platelet factor four (PF-4), which binds to and neutralizes heparin and related sulfated glycosaminoglycans (GAGs). To examine the interactions of PF-4 with the GAGs present on endothelial cell surfaces, we incubated 125I-PF-4 with cell suspensions derived from confluent monolayers of cultured bovine aortic endothelium. Binding of 125I-PF-4 was inhibited by a 100-fold excess of nonradioactive PF-4 and varied with duration and temperature of incubation. At 4 degrees C, binding reached equilibrium at 20 minutes with kd = 2.87 mumol/L and Bmax of 63.83 pmol/10(5) cells. Binding capacity was reduced 83.4% by brief incubation of endothelial cells with trypsin and 46.67% by incubation with Flavobacterium heparinase, but was unchanged by chondroitin-ABCase treatment. At 37 degrees C, PF-4 was internalized by confluent monolayer of bovine aortic endothelial cells primarily through low-affinity adsorptive endocytosis. The internalized PF-4 was degraded to amino acids and small peptides with 50% conversion after 18-hour incubation. These studies demonstrate that a secreted platelet protein can bind to and enter endothelial cells. Binding may explain the rapid clearance of released PF-4 from plasma and could have important local effects on endothelial structure and function. PMID- 2713493 TI - Functional consequences of an arginine180 to glutamine mutation in factor IX Hilo. AB - Factor IX Hilo is a variant factor IX molecule that has no detectable coagulant activity. The defect in factor IX Hilo arises from a point mutation in the gene such that in the protein Arg180 is converted to a Gln. Activation of factor IX Hilo by factor Xla was monitored using the fluorescent active site probe p aminobenzamidine. Normal factor IX showed complete activation in one hour as determined by measuring the increase in fluorescence when p-aminobenzamidine bound to activated factor IX. Factor IX Hilo showed no increase in fluorescence even after 24 hours, indicating that the active site was not exposed. Polyacrylamide gel electrophoresis showed that factor IX Hilo was cleaved to a light chain plus a larger peptide with a molecular weight equivalent to a heavy chain covalently linked to an activation peptide. Amino terminal amino acid sequencing of factor IX Hilo cleaved by factor Xla showed cleavage only at Arg145 Ala146, indicating that the Gln180-Val181 bond was not cleaved and that the active site was thus not exposed. The presence of factor IX Hilo in patient plasma was responsible for the patient having a very long ox brain prothrombin time characteristic of severe hemophilia Bm. Patient plasma had an ox brain prothrombin time of 100 seconds using a Thrombotest kit, significantly prolonged over the normal control value of 45 seconds. When factor IX Hilo was depleted from patient plasma using an immunoaffinity column, the ox brain prothrombin time decreased to 41 seconds. When factor IX Hilo was added back to depleted patient plasma, to normal plasma depleted of factor IX by the same affinity column, or to plasma from a CRM- hemophilia B patient, the ox brain prothrombin time was significantly prolonged. We conclude that the Arg180 to Gln mutation in factor IX Hilo results in a molecule that cannot be activated by factor Xla. Further, our data suggest that the mutation results in a molecule that interacts with components of the extrinsic pathway to give a prolonged ox brain prothrombin time. PMID- 2713494 TI - Cyclic thrombocytopenia of apparent autoimmune etiology. AB - Serial studies were performed in two patients with cyclic thrombocytopenia to investigate the pathogenesis of this disorder. Mean life span of autologous platelets when platelet levels were declining was subnormal (2.4 and 0.8 days), and megakaryocytes were abundant in the bone marrow during thrombocytopenia. Megakaryocyte colony-stimulating activity could not be detected in the serum of either patient at any point of their cycles. In each patient, total platelet associated IgG varied inversely with platelet levels. Surface platelet-associated IgG was measured only in patient 2 and was significantly elevated (greater than 1,280 IgG molecules per platelet) at all stages of the cycle, even during thrombocytosis. However, the highest values were observed during thrombocytopenia. Platelet-bindable IgG in plasma declined to normal immediately before platelet levels began to rise. IgG eluted from the platelets of this patient reacted strongly with autologous and homologous platelets in contrast to a "mock eluate" prepared from platelets of a normal subject. The eluate from the patient's platelets reacted strongly with immobilized autologous and homologous glycoprotein IIb/IIIa complex and weakly with GPIb but not with isolated GPIIIa alone. In each patient the decline in platelet levels was significantly delayed following administration of intravenous gamma globulin 0.4 g/kg body weight for five days. These findings suggest that platelet-reactive autoantibodies are of pathogenic significance in some patients with cyclic thrombocytopenia. PMID- 2713495 TI - Micropipette aspiration of guinea pig megakaryocytes: absence of fragmentation and dependence on maturation stage. AB - Platelet release has been alternatively viewed as a fragmentation of platelet territories demarcated within the cytoplasm of mature megakaryocytes or as a later event involving segmentation of proplatelet pseudopodia extended from the cell. The mechanical constraints on platelet release were evaluated by measuring the resistance of guinea pig megakaryocytes to aspiration into micropipettes of similar diameter to the width of naturally forming proplatelet projections. Application of increasing negative pressure to the surface of the cells resulted in progressively longer extensions being drawn into the pipette until maximal extension lengths were reached. None of the passively aspirated cytoplasmic extensions fragmented off the cells even at the highest aspiration pressure under physiologic study conditions. The longest extensions were aspirated from megakaryocytes of the most advanced maturation stage, and a proportion of the mature cells yielded very long extensions over 50 mu and up to 150 mu in length. Surprisingly, the ease of aspiration did not correlate to cell size during any stage of maturation. The mechanical behavior of guinea pig megakaryocytes indicates a large availability of surface for extension in mature cells ideal for active proplatelet projection. The lack of mechanical fragility suggests that platelet release is a very late maturational event not yet initiated in the "mature" megakaryocytes available for study from marrow harvests. PMID- 2713496 TI - Heparin-induced thrombocytopenia: studies with a new low molecular weight heparinoid, Org 10172. AB - Studies were performed to determine the cross-reaction rate of the heparin dependent antibody with Org 10172, a new low molecular weight heparinoid, and to investigate the effect of Org 10172 on platelet activation induced by the antibody. The plasmas of 17 patients with thrombocytopenia induced by standard heparin were shown, by platelet aggregation studies, to contain the heparin dependent antibody. Of these 17 patient plasmas, only three cross-reacted with the heparinoid, producing a cross-reaction rate of 18%. When Org 10172 was added to a reaction mixture containing normal platelet-rich plasma, patient plasma, and standard heparin with non-cross-reacting plasmas, it inhibited platelet aggregation and thromboxane B2 production induced by the antibody, provided that the ratio of Org 10172 concentration (anti-Xa U/mL) to standard heparin concentration (IU/mL) exceeded 2.5 to 5.0. This inhibitory effect was observed only with platelet activation mediated by the antibody, but not by collagen (2 micrograms/mL) or ADP (5.0 mumol/L). Additionally, three of 17 patients with serious thrombosis, whose plasma showed no cross-reaction with the heparinoid, received Org 10172 treatment with a good response in each case. These findings suggest that Org 10172 may be a useful drug for the treatment of heparin-induced thrombocytopenia. PMID- 2713497 TI - Characterization of the blood group Kell (K1) antigen with a human monoclonal antibody. AB - A human monoclonal anti-Kell (K1) antibody secreted by an Epstein-Barr virus (EBV)-transformed B-cell line was used for binding studies and immunopurification of the K1 blood group antigen. The 125I-labeled antibody bound to 4 to 5 x 10(3) and 2.5 to 3 x 10(3) antigenic sites on K1K1 and K1K2 erythrocytes, respectively, with an affinity constant of 5 x 10(8) mol/L-1. Immunoprecipitation analysis showed that the K1 antigen is carried by a 93 Kd glycoprotein containing several cysteine residues, and approximately six N-glycosidically linked sugar chains but no detectable O-linked sugar. A minor labeled component of 32 Kd was also immunoprecipitated from K1K1 RBCs but the 93- and 32-Kd components were absent from K2K2 and Kell null erythrocytes. Under nonreducing conditions, three bands were detected at 200 (weak), 120, and 93 Kd. We suggest that the 120-Kd component represents a heterodimer of the 93- and 32-Kd proteins covalently linked by disulfide bridge(s). The 93-Kd glycoprotein is a transmembrane component which interacts with the membrane skeleton but is distinct from band 3 as shown by one dimensional peptide mapping. The site density of K1 antigen blood group on Gerbich-negative RBCs (Ge:-2,-3) was threefold lower than on K1K1 erythrocytes, but the qualitative properties of the 93-Kd component were not modified. PMID- 2713498 TI - Two karyotypically independent leukemic clones with the t(8;21) and 11q23 translocation in acute myeloblastic leukemia at relapse. AB - Leukemic blast cells are thought to arise from clonal expansion of a single transformed hematopoietic cell. This generality is supported by the rarity of convincing reports on acute myeloblastic leukemia (AML) with two karyotypically independent clones. Relying on sequential cytogenetic analyses, we identified such clones in two children with relapsed AML. The first case, classified as M2 leukemia in the French-American-British (FAB) classification system, had a t(8;21) (q22;q22) at diagnosis; 16 months later, at relapse, the leukemic cells had uniform morphologic features similar to those observed at diagnosis, except that two independent clones were present: one with the original t(8;21) and the other with t(11;22)(q23;q13) [corrected]). The second case was initially classified as FAB M1 leukemia with a t(8;21) (q22;q22). At relapse, 16 months later, the blast cells appeared morphologically uniform and similar to the diagnostic specimen; however, in addition to the original t(8;21) clone, there was a t(1;11) (p32;q23) [corrected]. These findings suggest that separate leukemogenic events affecting different progenitor cells can occur in rare cases of AML. The presence of two karyotypically independent clones could also be explained by multistep leukemogenesis; that is, more than one cell from a common pool of preleukemic cells could be affected by the transforming event, resulting in two independent clones. Alternatively, in light of recent reports of therapy related leukemias with an 11q23 translocation, the new independent clone in these two patients could represent a therapy-related secondary malignancy. Thus, 11q23 translocations may occur preferentially in stem cells that are more susceptible to treatment-induced malignant transformation. PMID- 2713499 TI - Profiles of expression of activated cell antigens on peripheral blood and lymph node cells from different clinical stages of adult T-cell leukemia. AB - The expression of activated cell antigens (Ags) on adult T cell leukemia (ATL) cells at different clinical stages (acute, chronic, and smoldering), and ATL cells from enlarged lymph nodes were studied using monoclonal antibodies (MoAbs). The expressions of CD25 (Tac), CD28, T9 (transferrin receptor), and Ki-67 (proliferating cell nuclear antigen) Ags were high, and that of CD7 Ag was low in both acute and chronic ATL cells compared with that in normal T cells. The expressions of T9 and Ki-67 Ags were higher in acute ATL cells than in chronic ATL cells. The expression of CD38 Ag was higher in acute ATL cells but not in chronic ATL cells compared with normal T cells. On the contrary, the expression of HLA-DR Ag on the cell surface and the transcript of the HLA-DR Ag gene were high in chronic ATL cells, but not in acute ATL cells. A high percentage of lymph node ATL cells expressed T9, CD38, and Ki-67 Ags, although the peripheral blood ATL cells of the same patients showed significantly lower levels of expression of the same Ags. Interestingly, CD7 and HLA-DR Ags were detected on the majority of lymph node ATL cells. Moderately high percentage of smoldering ATL cells expressed CD25, CD28, and HLA-DR Ags, though a few numbers of leukemic cells were present in the samples. These findings confirm that the modes of activation of ATL cells in different clinical stages differ, and suggest that the differences might be reflected in the clinical features. The low expression of HLA-DR Ag in acute ATL cells, despite high expression of the Ag in chronic ATL cells, suggests that successive events that suppress HLA-DR Ag expression are necessary for the transformation of chronic ATL cells into acute ATL cells. Moreover, the high expressions of T9, CD38, Ki-67, CD7, and HLA-DR Ags on lymph node ATL cells indicate that ATL cells preferentially proliferate in lymph nodes. PMID- 2713500 TI - Hematopoietic bone marrow recovery after radiation therapy: MRI evaluation. AB - Magnetic resonance imaging (MRI) is able to detect the increase of adipocytes in the hematopoietic bone marrow that occurs as a consequence of radiotherapy and is indicative of the loss of myeloid tissue. By monitoring this process, it is also possible to determine the recovery of the bone marrow. The amount of viable hematopoietic tissue plays a fundamental role in determining whether the patient is able to undergo further antineoplastic therapy, particularly chemotherapy. We examined 35 patients who had been treated with radiotherapy for Hodgkin's lymphoma (12), uterine cervix carcinoma (nine), ovarian dysgerminoma (six), testicular seminoma (four), and non-Hodgkin's lymphoma (four). We observed that radiation-induced modifications of the MRI pattern in the bone marrow are tightly linked to two parameters; the administered radiation dose and the length of time passed after the treatment. Bone marrow recovery was observed only when patients were treated with doses lower than 50 Gy. The earlier radiation-induced modifications of the bone marrow MRI pattern occurred 6 to 12 months after irradiation, and they were most evident 5 to 6 years after the treatment. From 2 to 9 years after radiotherapy, we observed partial recovery. Complete recovery, when it occurred, was observed only 10 to 23 years after the treatment. Our results indicate that MRI studies are likely to be useful in the assessment of radiation-induced injuries. PMID- 2713501 TI - Heparin cofactor II-proteinase reaction products exhibit neutrophil chemoattractant activity. AB - The physiologic function of the plasma glycoprotein heparin cofactor II (HCII) is not well understood. An in vivo role for thrombin (IIa) inhibition by HCII in the presence of certain glycosaminoglycans (dermatan sulfate and heparin) can be proposed. Many proteins, such as complement components, can be proteolyzed to generate secondary bioactive molecules. HCII is a substrate for the human neutrophil (PMN) proteinases cathepsin G (CG) and elastase (LE). We found that degradation of HCII by CG or LE generated products with potent PMN chemotactic activity, which did not stimulate the PMN oxidative burst. Our results suggest that HCII may be a physiologic regulator of the acute inflammatory response. PMID- 2713502 TI - A beta-thalassemia gene caused by a 290-base pair deletion: analysis by direct sequencing of enzymatically amplified DNA. AB - The base composition around a recently detected deletion in the human beta-globin gene was determined by direct DNA sequencing of an enzymatically amplified DNA segment. The deletion removes 290 base pairs (bp), including the entire exon 1 and the mRNA cap site. In the vicinity of the deletion endpoints, the normal beta globin gene contains direct and inverted repeats which may have taken part in generation of this deletion. PMID- 2713504 TI - HTLV-1 infection in Brazil. PMID- 2713503 TI - A C----T substitution at nt--101 in a conserved DNA sequence of the promotor region of the beta-globin gene is associated with "silent" beta-thalassemia. AB - Sequence analyses and dot-blot analyses with synthetic oligonucleotide probes have identified eight individuals in three Turkish families and one Bulgarian family with one chromosome having a C----T mutation at nucleotide position--101 relative to the Cap site of the beta-globin gene. This nucleotide is part of one of the conserved blocks of nucleotides within the promoter region; in vitro expression analyses with the chloramphenicol acetyltransferase system showed that this substitution will decrease the effectiveness of transcription. Five subjects had a thalassemia intermedia due to the additional presence of a known classical high hemoglobin (Hb) A2 beta-thalassemia mutation on the second chromosome; their hematologic condition was relatively mild. The three persons with a heterozygosity for the--101 C----T mutation had normal hematologic data without microcytosis but with high-normal levels of Hb A2 and a mild imbalance in chain synthesis. The newly discovered mutation is considered one of the silent types of beta-thalassemia. It is relatively rare because it was absent among several hundred normal and beta-thalassemia chromosomes. PMID- 2713505 TI - Detection of chromosomal translocation t(14;18) within the minor cluster region of bcl-2 by polymerase chain reaction and direct genomic sequencing of the enzymatically amplified DNA in follicular lymphomas. AB - A majority of t(14;18) translocations have been shown to cluster at one of two sites on chromosome 18, called the major breakpoint region (mbr) or the minor cluster region, (mcr), which map within or flanking the bcl-2 proto-oncogene, respectively. We have determined the nucleotide sequence for a portion of the mcr, and constructed oligonucleotides that were used to perform the polymerase chain reaction (PCR) in conjunction with universal immunoglobulin primers to specifically amplify t(14;18) breakpoints in DNA obtained from follicular lymphomas. Eight of ten breakpoints that were detectable on Southern blots using DNA probes for the mcr could be detected due to specific amplification by the PCR technique using an mcr-specific primer. Direct nucleotide sequencing of the enzymatically amplified DNAs showed that the breakpoints clustered within a 500 nucleotide region, and five occurred within three nucleotides of each other. These data show a remarkable clustering of some t(14;18) breakpoints at a site on chromosome 18, at least a 30-kb distance from the bcl-2 gene. Our findings also indicate that mcr-specific primers may be used in conjunction with previously described mbr-specific primers in a highly sensitive DNA amplification technique to detect a large fraction of t(14;18) breakpoints. PMID- 2713506 TI - Characterization of guinea pig megakaryocyte subpopulations at different phases of maturation prepared with a Celsep separation system. AB - We introduce a new method for preparing subpopulations of guinea pig megakaryocytes (MK). MK, partially purified by a density gradient, were separated according to size by sedimentation, starting as a monolayer, in an albumin gradient at unit gravity. Twenty-two fractions were collected. Cells were cytocentrifuged, ploidy was assessed by microdensitometry, and small MK were identified with anti-von Willebrand factor (vWF) immunoglobulin. Immaturity was assessed by uptake of 3H thymidine and synthesis of proteoglycans from 35S sulfate. About 88% of cells in fractions 2 through 18 were MK, of which 90% were viable. Fractions containing the largest cells were composed of 98% stage III and IV MK; fractions with the smallest cells contained up to 80% stage I and II MK. Six MK classes were isolated: immature cells, both stage I and II cells, at either the 8N, 16N or 32N ploidy class; mature cells, both stage III and IV cells, at either the 8N, 16N or 32N ploidy class. The fractions were pooled into three groups: (a) 8% of MK in group 1, fractions 2 through 11, were immature, and group 1 was composed of 92% of 16N and 32N mature classes; (b) 29% of MK in group 2, fractions 12 through 15, were immature, and group 2 was composed of 52% 16N mature, 24% 16N immature, and 13% 8N mature classes; 67% of MK in group 3, fractions 16 through 18, were immature, and group 3 contained 51% 8N immature, 14% 16N immature, and 18% mature 16N classes. The mean protein content of the three groups was 1.251, 0.624, and 0.284 mg/10(6) MK, respectively. Nine percent of cells in group 3 but no cells in group 1 took up large amounts of 3H thymidine. The synthesis of high-molecular-weight (high-mol-wt) proteoglycans in group 3 and synthesis of lower mol wt proteoglycans in groups 1 and 2 provided further evidence for differences in MK maturity. Thus, the method can isolate MK subpopulations that are viable and can be used to investigate the biochemical characteristics of MK at different phases of maturation. PMID- 2713507 TI - The mechanism of plasminogen activation and fibrin dissolution by single chain urokinase-type plasminogen activator in a plasma milieu in vitro. AB - The relative contribution of several mechanisms to plasminogen activation and fibrin dissolution by urokinase-type plasminogen activator (u-PA) in vitro was quantitated. The activation of plasminogen by recombinant single chain u-PA (rscu PA), by its two chain derivative (rtcu-PA) and by a plasmin-resistant mutant, rscu-PA-Glu158, obeys Michaelis-Menten kinetics with catalytic efficiencies of 0.00064, 0.046, and 0.00005 L/mumol.s for native plasminogen (Glu-plasminogen) and of 0.0061, 1.21, and 0.0004 L/mumol.s for partially degraded plasminogen (Lys plasminogen). In a purified system consisting of a fibrin clot submerged in a plasminogen solution, the equi-effective doses (50% lysis in one hour) for rscu PA, rtcu-PA, and rscu-PA-Glu158 were 16, 6.5, and 32,000 ng/mL for Glu plasminogen and two- to fourfold lower for Lys-plasminogen. In a plasma milieu, 50% lysis in two hours was obtained for a plasma clot with 2.1 micrograms/mL rscu PA, 0.5 micrograms/mL rtcu-PA, and greater than 200 micrograms/mL rscu-PA-Glu158 and for a purified fibrin clot with 1.3 micrograms/mL rscu-PA and 0.27 microgram/mL rtcu-PA. After predigestion of a purified fibrin clot with plasmin, the apparent potency of rscu-PA and rtcu-PA increased by 40% and 20%, respectively. In conclusion, rscu-PA has an intrinsic plasminogen activating potential that is only about 1% of that of rtcu-PA and that is 13 times higher than that of rscu-PA-Glu158. Conformational transition of Glu-plasminogen to Lys plasminogen enhances its sensitivity to activation by all u-PA moieties ten- to 20-fold. Predigestion of fibrin clots with associated increased binding of plasminogen results in a minor apparent increase of the fibrinolytic potency of rscu-PA and rtcu-PA. The relative fibrinolytic potency of rtcu-PA is two to three orders of magnitude higher than that of rscu-PA-Glu158 but only two- to five-fold higher than that of rscu-PA, both in purified systems and in a plasma milieu. These results indicate that conversion of rscu-PA to rtcu-PA constitutes the primary mechanism of fibrin dissolution. PMID- 2713508 TI - Response patterns of purified myeloma cells to hematopoietic growth factors. AB - Tumor cells were isolated from the bone marrow of seven patients with multiple myeloma and from the peripheral blood of three patients with plasma cell leukemia using Ficoll-Hypaque (FH) density sedimentation followed by immune rosette depletion of T, myeloid, monocytoid, and natural killer (NK) cells. Enrichment to greater than or equal to 93% plasma cells was confirmed with Wright's-Giemsa staining, with intracytoplasmic immunoglobulin staining, and with staining using monoclonal antibodies (MoAbs) directed at B, T, myeloid, monocytoid, and myeloma antigens in indirect immunofluorescence assays. Myeloma cells neither proliferated nor secreted Ig in response to G/M-CSF, G-CSF, M-CSF, interleukin-1 alpha (IL-1 alpha), interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), or interleukin-4 (IL-4). Significant proliferation (SI greater than or equal to 3.0) was induced by interleukin-6 (IL-6) in six of ten patients (SI of 31 and 43 in two cases); and to interleukin-3 (IL-3) and interleukin-5 (IL-5), independently, in two patients each. Peak proliferation to IL-5 or IL-6 and to IL-3 occurred in cells pulsed with 3[H] thymidine at 24 and 48 hours, respectively; and proliferation to combinations of factors did not exceed that noted to IL-6 alone; Ig secretion was not documented under any culture conditions. Three myeloma derived cell lines similarly studied demonstrated variable responses. The heterogeneity in the in vitro responses of myeloma cells and derived cell lines to exogenous growth factors enhances our understanding of abnormal plasma cell growth and may yield insight into the pathophysiology of plasma cell dyscrasias. PMID- 2713509 TI - Immunocytochemical identification of meningeal leukemia and lymphoma: poly-L lysine-coated slides permit multimarker analysis even with minute cerebrospinal fluid cell specimens. AB - Use of immunocytology for accurate identification of malignant cells in cerebrospinal fluid (CSF) has so far been hampered by high cell requirements of the immunologic methods hitherto used. In an attempt to minimize cell loss in cytopreparation, electrostatic binding of cells to poly-L-lysine (PLL)-coated multispot slides, followed by immunocytochemistry, was investigated. Using optimized conditions of cell attachment and fixation and performing all washing procedures on the slide made multimarker analysis possible even in paucicellular specimens, while preserving excellent cell morphology and yielding high sensitivity in the detection of antigens. In a study of 26 CSF specimens with inconclusive cytomorphology, comprising 335 single marker determinations, we were able to discriminate reliably between resting or activated benign cells and a wide range of types of malignant lymphoid cell. A definitive diagnosis was reached in all cases by one tap only. Malignant meningitis was ruled out in ten specimens and proved in 16, including five in which the type of malignancy could only be determined by immunophenotyping. We conclude that immunocytochemistry on PLL-coated slides constitutes the method of choice for immunologic cell differentiation in CSF, which allows equivocal morphologic findings to be clarified. PMID- 2713510 TI - Prognostic importance of structural chromosomal abnormalities in children with hyperdiploid (greater than 50 chromosomes) acute lymphoblastic leukemia. AB - Approximately one fourth of children with newly diagnosed acute lymphoblastic leukemia (ALL) have hyperdiploid (greater than 50 chromosomes) blasts and a relatively favorable prognosis. Nonetheless, a substantial proportion of these patients fail therapy. We studied 138 children (70 male, 68 female) with hyperdiploid greater than 50 ALL to assess initial clinical and cytogenetic features that might predict treatment failure. In 85 of these cases (62%), structural chromosomal abnormalities were also present; clinical and laboratory features in this group did not differ from those of the 53 cases with only numeric abnormalities. However, of the 28 failures seen at a median follow-up of 4 years, 22 occurred in cases with structural chromosomal abnormalities (P = .03 by Breslow test). In a multivariate analysis, only the presence of structural chromosomal abnormalities and male gender were independently associated with treatment failure. Structural chromosomal abnormalities in cases of ALL with greater than 50 chromosomes may define a biologically different form of leukemia characterized by increased likelihood of drug resistance. PMID- 2713511 TI - Selective enzymatic amplification of alpha 2-globin DNA for detection of the hemoglobin Constant Spring mutation. AB - Hemoglobin Constant Spring is an elongation mutation of the alpha 2-globin locus that results in a thalassemic phenotype. It has a high prevalence in Asian populations. When inherited with other alpha-thalassemia determinants, the Constant Spring gene has the potential to cause severe forms of alpha thalassemia. Accurate diagnosis of the condition with standard hemoglobin electrophoresis is unreliable due to the small to undetectable amounts of the mutant hemoglobin present. Because of the extensive sequence homology of the alpha 1 and alpha 2 loci, allele-specific hybridization to total genomic DNA containing the Constant Spring gene would not distinguish between heterozygous and homozygous hemoglobin Constant Spring. Selective enzymatic amplification of alpha 2-globin DNA sequences, however, allows unambiguous diagnoses to be made using allele-specific hybridization. This method is useful for providing accurate genetic counseling and prenatal diagnosis in populations and specific families in which precise diagnosis is important. PMID- 2713512 TI - Measurement of arteriole diameter changes by analysis of television images. PMID- 2713513 TI - [Cancers of the breast at metastatic high-risk: prediction of survival by steroidal receptors]. AB - From 1982 to 1985, 279 patients with locally advanced breast cancer have been treated with induction chemotherapy, adjusted loco-regional treatment (surgery and/or radiotherapy) and adjuvant chemotherapy with or without immunostimulation. Overall and relapse free survivals are better for tumors with estrogen and progesterone receptors (EPR). For these patients, we may hope that tumoral reduction with hormonotherapy would get the same overall and relapse-free survivals as induction chemotherapy. PMID- 2713514 TI - The role of antioxidant enzymes in benzo(a)pyrene-induced carcinogenesis. AB - Chick embryo hepatocytes were cultured in the presence of benzo(a)pyrene in order to study the effects of this carcinogen on catalase, glutathione peroxidase and superoxide dismutase activity. The results demonstrate that benzo(a)pyrene is incapable of modifying the activity of these enzymes, even though it is taken up by cultured cells to form benzo(a)pyrene-DNA adducts. The effect of culturing, however, caused a marked reduction in the activity of these enzymes. The significance of these activity variations in benzo(a)pyrene in vitro carcinogenesis is discussed. PMID- 2713515 TI - [What are the prognostic factors in operable breast cancer without histologic axillary lymph node invasiveness. Results of an uni- and multifactorial analysis]. AB - Between October 1977 and December 1983, 379 consecutive patients have been treated for unilateral, non metastatic breast cancer, either with conservative (n = 205) or radical surgery (n = 174), with axillary dissection in all the cases. None of them had histologically proved lymph node involvement. Adjuvant radiotherapy was given in 268 cases. Estrogen receptor (ER) and progesterone receptor (PR) levels were measured on each tumor. Levels greater than 5 fmoles/mg cytosolic protein were considered as positive for both ER and PR. At 5 years, overall survival (OS) and disease-free survival (DFS) are respectively 88% and 79%. Unifactorial analysis using KAPLAN and MEIER estimates and Logrank test revealed that OS was significantly related to age, tumor size, histopathological grading, ER and PR. DFS was significantly related to the same factors. Menopausal status, number of intra mammary tumor foci, previous familial history of breast cancer were not significant. Multifactorial analysis revealed that DFS was significantly related to age (bad prognosis [bp]: less than or equal to 37 years old), tumor size, histopathological grading (bp: SBR = 3) and that OS was significantly related to tumor size and PR (bp: PR less than or equal to 5 fmoles/mg protein). A prognostic score was obtained which sampled our patients into 3 significantly different (P less than 0.0001) groups with high, intermediate and low risk of relapse. These results suggest that tumor size, histopathological grading and PR have their own prognostic weight in histologically node negative breast cancer. Grouping these factors together allows to define a high risk relapse group that could benefit from adjuvant treatment. PMID- 2713516 TI - [Medical treatment of advanced cancers of the breast (metastatic and at metastatic high-risk)]. PMID- 2713517 TI - [Current status of hormonotherapy of metastatic cancer of the breast]. AB - Hormonotherapy of metastatic breast cancer was begun in 1896. The first trials were based on surgery (ovariectomy, adrenalectomy, hypophysectomy). Medical hormone therapy began with the administration of estrogens to postmenopausal women, and was then extended to include androgens. The use of tamoxifen, medroxyprogesterone acetate or aminoglutethimide combined with hydrocortisone progressively enlarged therapeutic applications. Comparison of the results obtained with these various substances reveals that they are all of equal therapeutic value, but that tamoxifen is the best tolerated hormonotherapy. No two-drug association has yet been found better that any one product used alone. By contrast, successive administration of 2 drugs has resulted in longer maintenance of benefits. Clinical and especially biological criteria (hormone receptor assays) allow identification of the population that has the most chance of responding to this type of treatment. PMID- 2713518 TI - [Treatment of inflammatory cancer of the breast. Combined chemotherapy and radiotherapy. Apropos of 270 women treated at the Institut Gustave-Roussy]. AB - From January 1976 to January 1985, 210 patients (less than 70 years old) with unilateral inflammatory breast carcinoma M0 were treated, under protocol way, by chemotherapy, hormonotherapy and radiotherapy association. Results of these protocols are compared to those of an historical control group T (60 patients treated from 1973 to 1975 by radiotherapy alone, with castration for pre menopausal women). From 1976 to 1980, 91 patients (group A) were treated by induction chemotherapy first with adriamycin, vincristine and methotrexate (AVM), loco-regional radiotherapy and maintenance chemotherapy with vincristine, cyclophosphamide and 5 fluorouracil (VCF). From 1980 to 1982, 79 patients (group B) were treated under a similar protocol, but the 3 first sequences were reinforced with the association of five drugs: adriamycin, vincristine, cyclophosphamide, methotrexate, 5 FU (AVCMF). From 1983 to 1985, 40 patients (group C) were treated under the same schedule AVCMF, AVM, VCF, but radiotherapy was delivered on a different schedule to shorten the intervals between the 3, 4, 5 and 6th chemotherapy sequences. All patients form the groups A, B and C had received hormonotherapy: castration for premenopausal patients or on-going menopause, or tamoxifen for post-menopausal patients. Disease-free survival rates at 30 months are respectively 19, 37, 61 and 64% for groups T, A, B and C and for groups T, A and B: 8, 22 and 40% at 5 years, and total survival rates at 5 years: 28, 40 and 55% for these groups. The benefit of chemotherapy in addition to radiotherapy is highly statistically significant. The improvement of these results seems partially linked to the increasing dosage of the induction chemotherapy. PMID- 2713519 TI - [New agents in chemotherapy and new methods of their administration in the treatment of metastatic cancer of the breast]. AB - Chemotherapy of metastatic breast cancer induces temporary tumor responses, without any incidence on vital prognosis. New drugs are sometimes less toxic than previous but are not more efficient. Such findings are observed with other schedules of chemotherapy. It is necessary to adapt treatment to expected goal: optimal efficacy or minimal toxicity. PMID- 2713520 TI - Chronic dose effects of methyl parathion on nuthatches: cholinesterase and ptilochronology. PMID- 2713521 TI - Delta aminolevulinic acid dehydratase and ferrochelatase activities during chronic lead exposure in mice. PMID- 2713522 TI - Decrease of inhaled toluene, ethyl benzene, m-xylene, or mesitylene in rat blood after combined exposure to ethyl acetate. PMID- 2713523 TI - Body size and organ accumulation of mercury and selenium in young harbor seals (Phoca vitulina). PMID- 2713524 TI - Treatment of landfill leachate by spray irrigation--an overview of research results from Ontario, Canada. I. Site hydrology. PMID- 2713525 TI - Treatment of landfill leachate by spray irrigation--an overview of research results from Ontario, Canada. II. Soil quality for leachate disposal. PMID- 2713526 TI - Fate of organic contaminants during sewage sludge composting. PMID- 2713527 TI - Element composition of municipal refuse ashes and their aqueous extracts from 18 incinerators. PMID- 2713528 TI - Compressive strength of cement containing ash from municipal refuse or sewage sludge incinerators. PMID- 2713529 TI - Fate of 14C nitrofen in rice paddy ecosystem. PMID- 2713530 TI - Cyanide content of cassava mash and gari flour and influence of water activity (aw) during storage. PMID- 2713531 TI - Toxic and potentially toxic constituents of gari and beef marketed in Nigerian traditional markets. PMID- 2713532 TI - Temperature and humidity dependence of formaldehyde release from selected building materials. PMID- 2713533 TI - Evaporative dissipation of methyl parathion from laundered protective apparel fabrics. PMID- 2713534 TI - Comparative analysis of lead in Maine urban soils. PMID- 2713535 TI - Water contamination by heavy metals (Hg, Cd, Pb, Cu and Zn) in Donana National Park (Spain). PMID- 2713536 TI - Levels of chlordane in water and sediment of rivers around Saga City, Japan. PMID- 2713537 TI - Pesticide residues in drinking water in the North Coast region of New South Wales, Australia, 1986-87. PMID- 2713538 TI - Organochlorine pesticide residues in grain storages of New South Wales. PMID- 2713539 TI - Effect of selenium on reproductive behavior and fry of fathead minnows. PMID- 2713540 TI - Effects of phenol exposure on the thermal tolerance ability of the central stoneroller minnow. PMID- 2713541 TI - Inhibition of sodium-dependent taurine transport in red blood cells from the marine polychaete, Glycera dibranchiata, after exposure to mercury. PMID- 2713542 TI - Chemical and biological impact of effluent from edible bamboo shoot canning factory on a stream. PMID- 2713543 TI - Heavy metals in bivalve molluscs in the Huelva estuary. PMID- 2713544 TI - Metabolic studies of explosives 6. Electron impact and chemical ionization mass spectrometry of metabolites of 2,4-dinitrotoluene. AB - A series of metabolites of 2,4-dinitrotoluene have been synthesized and analysed by electron impact and chemical ionization mass spectrometry. Identification characteristics of these metabolites by their mass spectra have been determined. Differentiation of isomers is made possible by electron impact ions which are characteristic to the position of the methyl group with regard to the nitro group and to the position of the carboxylic acid group with regard to the nitro group. Metabolites containing an acetyl amino group are characterized by an [M - COCH2]+. electron impact ion. PMID- 2713545 TI - Peptide sequencing by partial methanolysis and fast atom bombardment mass spectrometry. AB - The possibility of obtaining sequence information on peptides by partial methanolysis with 5 N HCl in dry methanol and subsequent fast atom bombardment (FAB) of the resulting mixture was investigated. This procedure was tested using four peptides of different size and amino acid composition. The results obtained demonstrate that this approach is effective in producing FAB spectra containing more sequence information than the spectra of the untreated peptides. For the compounds investigated the spectra contain enough information to unequivocally reassemble the original sequence. PMID- 2713546 TI - Measurement of mevalonate in human plasma and urine by multiple selected ion monitoring. AB - Plasma levels and urinary excretion of mevalonate were reported to be correlated with cholesterol biosynthesis. Evaluation of mevalonate concentration in plasma and urine represents therefore a non-invasive method for studying the modifications of cholesterol synthesis. A method is described here by which mevalonate in plasma and urine is determined by the selected ion monitoring technique after extraction as mevalonolactone and conversion into the trimethylsilyl ether. Linear responses were obtained in the evaluation of mevalonate added to plasma in the 10-100 ng/ml (r greater than 0.995) and to urine in the 50-1000 ng/ml concentration ranges, respectively. Identity of mevalonate in plasma and urine was confirmed by high-resolution mass spectrometry. PMID- 2713547 TI - Mass spectrometric analysis of cardiac glycosides by the desorption/ionization technique potassium ion ionization of desorbed species. AB - The analysis of cardiac glycosides by the desorption/ionization (D/I) mass spectrometric technique potassium ion ionization of desorbed species (K+IDS) is presented. K+IDS mass spectra of digitonin, digoxin, digoxigenin, digitoxin and ouabain are discussed to demonstrate the capabilities of this D/I method. The K+IDS analysis consists of two steps: thermal desorption of neutral molecules representative of the analyte, followed by gas-phase addition of K+ ions to these species. Structural and molecular weight information of the cardiac glycosides is obtained with the K+IDS technique. The most intense peak in the K+IDS mass spectrum of an analyte, M, is frequently the [M]K+ ion. Interpretation of the K+IDS mass spectra is simple, since one thermal degradation mechanism dominates. This mechanism is a 1,2-elimination process. A variation of the original K+IDS technique, performed by changing the ionizing metal from K+ to Na+ (i.e. Na+IDS), is presented for the analysis of digoxin. The Na+IDS mass spectrum of digoxin contains more structural information than the K+IDS mass spectrum of that compound. This may lead to a means of controlling the types of information obtainable with this D/I technique by varying the cation that is thermionically generated. K+IDS analyses can be performed rapidly, no sample derivatization is necessary, no matrix is required and little instrument modification is necessary. PMID- 2713548 TI - High-performance liquid chromatographic/mass spectrometric and high-performance liquid chromatographic/tandem mass spectrometric analysis of carbamate pesticides. AB - The thermospray ionization mass spectra of selected carbamate pesticides were obtained using both single-stage and triple-stage quadrupole mass spectrometry in conjunction with high-performance liquid chromatography. With the use of the single-quadrupole mass spectrometer and ammonium acetate as the mobile phase, enhanced sensitivity for the analytes of interest was obtained by monitoring the relatively intact [M + 1]+ or [M + 18]+ adduct ions. Further structural characterization of the carbamates was not readily obtainable owing to the lack of diagnostic bond cleavages. The single-stage quadrupole analyses were therefore complemented by triple-stage quadrupole analyses. Here, collisionally activated daughter ion spectra exhibited structure-specific fragmentations. In addition, the enhanced selectivity and specificity provided by tandem mass spectrometry allowed use of the technique as a rapid screening tool for carbamates without the need for the chromatographic separation step. PMID- 2713549 TI - Electron impact mass spectrometry of BHT and its alteration products. AB - The electron impact (EI) mass spectra of 2,6-di-tert-butyl-4-methylphenol (BHT) and certain of its alteration products are described in detail. Accurate mass measurements confirm the elemental compositions of important fragment ions in the EI spectra. Collisionally activated mass spectra are also used to study fragmentation and suggest common ion structures. The reference spectra provide the basis for identifying various alteration products of BHT by capillary gas chromatography/mass spectrometry (GC/MS) without the necessity of isolating individual components. Application of GC/MS is made to three studies: (i) pyrolysis of hydroperoxy-BHT as a potential pathway to alteration products in food; (ii) GC/MS pyrolysis of hydroperoxy-BHT as a model study; and (iii) alteration of BHT in ethanol/water as a food-simulating solvent. PMID- 2713550 TI - Plant biotechnology. PMID- 2713551 TI - Proceedings of Leukaemia 1988. Recent progress in biology and clinical research. First advanced international course. 5-8 November 1988, Genoa, Italy. PMID- 2713552 TI - Central nervous system (CNS) leukemia: the role of high dose cytarabine (HDAra C). AB - Knowing the good penetration of systemic HDara-C into the CNS, we treated with this approach overt meningeal leukemia, either isolated or with bone marrow (BM) disease, in 31 adults: 18 ALL, 4 ANLL, 1 lymphoid blast crisis of CGL (LBC-CGL), and 8 non-Hodgkin's lymphoma (NHL). Treatment consisted of Ara-C, 3 g/m2 i.v. q 12 h, by 3 h infusion for 8 doses, followed by 4 doses at day 21. Complete remitters received consolidation with four monthly 4-dose courses of HDara-C. Additional multidrug consolidation and direct CNS therapy with intrathecal (i.t.) methotrexate (MTX) or Ara-C +/- cranial RT was administered to the 11 remitters last treated. Twenty of 31 patients (64%) achieved CR: 10/10 with isolated meningeal leukemia and 10/21 with concurrent CNS and BM disease. Of the remaining 11 patients, 8 had cerebrospinal fluid (CSF) clearing with persistent BM disease. In all cases but one CNS symptoms resolved promptly. CR median duration was 6 months (range 2 to 20). The main toxicity was myelosuppression requiring intensive support. There was no neurologic toxicity. These results show that systemic HDara-C is highly effective in acute leukemias and NHL with CNS involvement, and suggest the utility of this regimen for sanctuary chemoprophylaxis in patients at high risk for CNS disease. PMID- 2713553 TI - The prognosis of chronic myeloid leukemia. PMID- 2713554 TI - Cell kinetics and therapy in multiple myeloma: an update of the M83 protocol. PMID- 2713555 TI - Monoclonal antibodies and complement purged autograft in Burkitt lymphoma and lymphoblastic leukemia. PMID- 2713556 TI - Microgranular acute promyelocytic leukaemia (M3 variant). A study of 16 patients. PMID- 2713557 TI - Cell cycle characteristics in myeloid leukemias. PMID- 2713558 TI - Low dose cytosine arabinoside in adult acute non-lymphoid leukemia. PMID- 2713559 TI - New cytarabine analogs. PMID- 2713560 TI - The role of alkylating agents in acute and chronic leukemia. PMID- 2713561 TI - Idarubicin in acute leukemia: results of US trials. PMID- 2713562 TI - Idarubicin in combination with etoposide and cytarabine in adult acute non lymphoblastic leukaemia (ANLL). PMID- 2713563 TI - Vinca alkaloids. PMID- 2713564 TI - Acute mixed lineage leukemias. PMID- 2713565 TI - On the heterogeneity of minimal residual disease in acute leukemia. PMID- 2713567 TI - A log book for preregistration house officers. PMID- 2713566 TI - Prognostic factors in adult acute lymphoblastic leukemia (ALL). PMID- 2713568 TI - Screening for HIV. PMID- 2713569 TI - What sort of letters do GPs want to receive from hospital specialists? PMID- 2713570 TI - Idiopathic hypoparathyroidism presenting as the neuroleptic malignant syndrome. PMID- 2713571 TI - Upper airway obstruction misdiagnosed as asthma. PMID- 2713572 TI - Pensions: spoilt for choice? PMID- 2713574 TI - Are we achieving a balance? PMID- 2713573 TI - The hours doctors work. PMID- 2713575 TI - Psychophysiology and clinical psychiatry. PMID- 2713576 TI - Motor neurone disease. AB - Motor neurone disease is one of the incurable diseases; it is a tragic and distressing condition, leading from full health through paralysis to death within a few years. Although powerless to prevent or arrest the disease, doctors and all who work with those affected and their families can do much to ameliorate and bring comfort and understanding to sufferers of this disease. PMID- 2713577 TI - Chloroquine and onchocerciasis. AB - My original elective proposal was to study the prevalence and nature of onchocerciasis or 'river blindness' along the Canande River in Esmeraldas province of Ecuador (Cooper, 1986). However, unknown to me, this study was completed and published before I arrived (Guderian et al, 1987). Fortunately, on arrival I was able to join the same group on a study of the efficacy of chloroquine in the control of onchocerciasis. PMID- 2713578 TI - Solitary caecal diverticular presenting with right iliac fossa pain. PMID- 2713579 TI - White paper on NHS. PMID- 2713580 TI - National ethics committee. PMID- 2713581 TI - In support of hypnotherapy. PMID- 2713582 TI - Carbon monoxide inhalation with the engine switched off. PMID- 2713583 TI - Should the royal colleges be the employers' watchdogs? PMID- 2713584 TI - A well-known 'phallacy' resurrected. PMID- 2713585 TI - Automatic implantable defibrillators--lost opportunities. PMID- 2713586 TI - Heat loss during abdominal surgery. PMID- 2713587 TI - Plasma potassium in phaeochromocytoma. PMID- 2713588 TI - The relation of radionuclide uptake by bone to the rate of calcium mineralization. I: Experimental studies using 45Ca, 32P and 99Tcm-MDP. AB - The study of the uptake of radionuclides by bone has been undertaken in a mouse tail graft model using 45Ca, 32P and a routine bone scanning agent 99Tcm-MDP, together with serial calcium determinations. The model provided an experimental system in which the calcium mineral content and the rate of mineralization both changed progressively throughout its development. A significant linear correlation was found between 45Ca and 32P uptake and the rate of calcium mineralization, which held for all stages of the graft's growth. Both radiotracers therefore accurately reflected the calcium mineral deposition. In the case of 99Tcm-MDP, the correlation with mineralization rate only applied for the most active growth period of the graft when the rate was increasing. For all radiotracers, the peak in bone uptake corresponded to the maximum in mineralization rate. PMID- 2713589 TI - The relation of radionuclide uptake by bone to the rate of calcium mineralization. II: Patient studies using 99Tcm-MDP. AB - The relation of radionuclide uptake by bone and rate of calcification has been studied in normal vertebrae and in vertebral metastases from cancer of the prostate. Specifically, the determination of 99Tcm-MDP uptake by radionuclide scanning and the estimation of calcium concentration of trabecular bone by dual energy computed tomography have provided the means of obtaining a relation between these parameters which was similar to that found in an animal model, in which the dependence of radionuclide uptake on the rate of mineralization was established. This relationship has enabled the experimental findings to be extrapolated to those in patient studies and has shown that in sclerotic bone lesions, the increase in 99Tcm-MDP uptake accompanying the progression of the metastases was proportional to the rate of calcification. PMID- 2713590 TI - Phalangeal osteoid osteoma. AB - Although the typical features of osteoid osteomas are well known, those arising in phalanges are frequently misdiagnosed. This is partly because of their rarity (9% of osteoid osteomas in the Bristol Bone Tumour Registry occur in phalanges), and also because of atypical radiological features. The most common appearance is of an eccentric lesion with soft-tissue swelling and a relative absence of sclerosis, suggesting osteomyelitis. PMID- 2713591 TI - Radiation-induced cell death by chromatin loss. A model to explain the shape of low-linear-energy-transfer cell survival curves. AB - A model is proposed which relates reproductive death of cells caused by radiation to loss of chromatin at cell division. This loss of chromatin can occur through chromosomal deletions or through the formation of asymmetrical chromosomal exchanges. It is proposed that smaller doses of radiation produce fewer chromatin breaks, which are more likely to be accurately repaired, compared with larger doses. Consequently, smaller doses of radiation are less efficient in causing cell death, leading to a shoulder on the cell survival curve. Experimental evidence supports this model, and the fit between the derived formula and experimental cell survival curves is good. The derived formula approximates to the linear-quadratic equation at low doses of radiation. PMID- 2713592 TI - Changes in biological effectiveness of the neutron beam at Clatterbridge (62 MeV p on Be) measured with cells in vitro. AB - Chinese hamster V79 cells have been used to assess changes in RBE of the p(62)Be neutron beam at the Clatterbridge Hospital with depth in a phantom and with use of a hydrogenous filter. The cells were exposed at depths of 2 and 12 cm and at a depth of 2 cm with a hydrogenous filter. Two groups of experimenters each conducted two experiments. The ratios of relative biological effectiveness (RBE) at a depth of 12 cm to that at 2 cm were found by the two groups to be 0.99 +/- 0.04 and 0.96 +/- 0.02 (standard errors). The effect of a polythene filter 4.5 cm thick was measured at a depth of 2 cm and the ratio of RBE with and without the filter was found by both groups to be 0.99 +/- 0.02. All the experiments suggest that there may be small effects of beam hardening by depth and filtration but these results are in marked contrast with those obtained using an in vivo system. PMID- 2713593 TI - Treatment of persistent and recurrent nasopharyngeal carcinoma by brachytherapy. AB - The early results of brachytherapy for persistent and recurrent nasopharyngeal carcinoma in 30 patients is presented. Fifteen patients were treated by intracavitary caesium, 12 patients were treated by interstitial gold grain implant using the split-palate approach and three patients were treated by both intracavitary caesium and interstitial gold grain implant for the first and second relapse in the nasopharynx, respectively. The overall tumour control rate for intracavitary caesium was 5/18 (28%) with median follow-up of 25.2 months, and for interstitial gold grain implant it was 9/14 (64%) with median follow-up of 16.5 months. Interstitial gold grain implantation appears to be effective in the treatment of persistent and recurrent nasopharyngeal carcinoma. PMID- 2713594 TI - The ICRU recommendations for reporting intracavitary therapy in gynaecology and the Manchester method of treating cancer of the cervix uteri. AB - The recommendations of the International Commission on Radiation Units and Measurements for reporting intracavitary therapy have been considered with particular regard to the Manchester method of treating cancer of the cervix uteri. The total reference air kerma is calculated and tabulated as a function of prescription for the standard Manchester applicator arrangements. Furthermore, it is shown that the volume contained within a particular isodose surface may be determined, with very acceptable accuracy, from the total reference air kerma by the use of a simple empirical expression. PMID- 2713595 TI - Radiotherapy simulators and independent field wire movement. PMID- 2713596 TI - Magnetic resonance imaging of the infant heart at 1.5 T. PMID- 2713597 TI - Balloon embolization of a congenital arterio-venous fistula between the internal mammary artery and a portal vein radicle. PMID- 2713598 TI - Magnetic resonance imaging of ruptured aneurysm of the ascending aorta. PMID- 2713599 TI - Haemoptysis in a laundry worker. PMID- 2713600 TI - Tetrachlorodecaoxygen anion complex treatment after localized X irradiation of the rat colon. PMID- 2713601 TI - Iotrolan in selective bronchography via the fibreoptic bronchoscope. PMID- 2713602 TI - Stem-cell depletion and grid therapy. PMID- 2713603 TI - Secretion of radioactivity in breast milk following administration of 123I hippuran. PMID- 2713604 TI - The influence of type of tube and experience of the operator on performance of small bowel enema. AB - Seventy patients underwent small bowel enema (SBE) to assess the influence of experience of the radiologist on the ease of jejunal intubation and the adequacy of SBE using two types of tubes. Comparing intubation time, intubation screening time, total screening time and total room time, we conclude that jejunal intubation is achieved easily, in a reasonable time with both types of tube, by all grades of radiologist, although the experienced operator using the Silk tube achieved intubation in a significantly shorter time. Overall patient acceptability was satisfactory (75%) but was better using the Silk tube, with which entero-gastric reflux and vomiting were less. PMID- 2713605 TI - In vivo viability of 111In-labelled granulocytes demonstrated in a sham-dialysis model. AB - In seven febrile patients undergoing regular dialysis treatment, sham-dialysis with a dialyzer equipped with a cuprophane membrane was performed during a routine 111In-oxine white blood cell scan with "pure" granulocytes isolated on a discontinuous gradient (Percoll/plasma: n = 5; Metrizamide/plasma: n = 2). The patients were in contact with the cuprophane membrane over 45 or 90 min. Twenty five (+/- 5) minutes after the start of the dialysis, the peripheral leucocyte count (59 +/- 22%) and the 111In activity in the peripheral blood decreased to a minimum of their initial range (64 +/- 21%) because of leucocyte activation. The activity over both lungs increased symmetrically (29 +/- 15%), the spleen activity decreased (14.8 +/- 8%) and the liver activity remained constant. At the end of the dialysis (45-90 min post-injection), the number of circulating neutrophils, peripheral 111In activity and activity distribution in the organs regained their initial level. In conclusion, these data confirm previously described data concerning the sequestration of neutrophils into the lung during dialysis treatment. The data demonstrate the origin of the activated neutrophils in the circulation and the spleen. The identical behaviour of 111In-oxine labelled and unlabelled granulocytes is demonstrated. Additionally, the accumulation of activity in the spleen is due not to opsonized cells but to sequestrated neutrophils, which are able to migrate from the spleen after adequate activation. The migration of activated cells into the lung explains the diagnostic difficulties posed by diffuse lung uptake in leucocyte scans in patients with leucocyte-activating diseases. PMID- 2713606 TI - Radiation toxicity of indium-111-2-mercaptopyridine-N-oxide on HeLa S-3 cells. AB - As one of a series of systematic studies to determine the cytotoxicity of radiopharmaceuticals, indium-111-2-mercaptopyridine-N-oxide (111In-merc) was studied using a monolayer of HeLa S-3 cells. Exponentially growing cells were incubated with up to 2.96 MBq/ml (80 microCi/ml) of 111In-merc (molecular ratio of In/Cd to merc was 1:1000) in phosphate buffered saline for up to 240 min at room temperature. Surviving fractions were assayed by the colony-forming method. The cell uptake curve was upward concave with increasing activity and was saturated after an incubation time of 60 min. A clonogenic assay resulted in an exponential dose-survival curve with a shoulder (D0 of 0.44 MBq/ml (12 microCi/ml); n = 5), and an upward concave time-survival relationship. Merc alone and decayed In-merc were non-toxic at the equivalent range, substantiating radiation-induced cytotoxicity of 111In-merc. PMID- 2713607 TI - Memorandum from the British Committee on Radiation Units and Measurements. Quantities for environmental monitoring. PMID- 2713608 TI - An alignment test jig for measuring the effective focal-spot size of mammographic X-ray tubes. PMID- 2713609 TI - The warm and tender hip. PMID- 2713610 TI - Splenic accumulation of 99Tcm-methylene diphosphonate. PMID- 2713611 TI - A pressure valve for pneumatic reduction of intussusception. PMID- 2713612 TI - Pediatric nuclear medicine. Proceedings of the British Institute of Radiology. London, November 23, 1988. Abstracts. PMID- 2713613 TI - Presentation of arms to the Urological Society of Australasia. PMID- 2713614 TI - Effect of animal and vegetable protein intake on oxalate excretion in idiopathic calcium stone disease. AB - Oxalate excretion was measured in healthy subjects and idiopathic calcium stone formers on dietary regimens which differed in the type and amount of protein allowed; 24-h urine collections were obtained from 41 practising vegetarians and 40 normal persons on a free, mixed, "mediterranean" diet. Twenty idiopathic calcium stone-formers were also studied while on two low calcium, low oxalate diets which differed in that animal protein was high in one and restricted in the other. Vegetarians had higher urinary oxalate levels than controls and although the calcium levels were markedly lower, urinary saturation with calcium/oxalate was significantly higher. This mild hypercalciuria was interpreted as being secondary to both a higher intake and increased fractional intestinal absorption of oxalate. Changing calcium stone-formers from a high to a low animal protein intake produced a significant decrease in calcium excretion but there was no variation in urinary oxalate. As a result, the decrease in calcium oxalate saturation was only marginal and not significant. It was concluded that dietary animal protein has a minimal effect on oxalate excretion. Mild hyperoxaluria of idiopathic calcium stone disease is likely to be intestinal in origin. Calcium stone-formers should be advised to avoid an excess of animal protein but the risks of a vegetable-rich diet should also be borne in mind. PMID- 2713615 TI - Assessment of the safety of regular DDAVP therapy in primary nocturnal enuresis. AB - A group of 7 patients with refractory primary nocturnal enuresis on long-term DDAVP therapy (mean 13 months) were submitted to a standard water deprivation test in conjunction with a hormone profile and routine haematological and biochemical investigations. No abnormalities were demonstrated, which suggests that the drug is safe in this clinical situation. PMID- 2713617 TI - The "plain film" bladder shadow in outflow obstruction: as accurate a discriminant of residual urine as ultrasound. AB - The height, width and area of the bladder shadow on post-micturition plain abdominal radiography was compared with the residual urine obtained at endoscopy from 58 men presenting with pure bladder outflow obstruction. Each parameter of the bladder shadow correlated significantly with the residual urine in patients in whom this shadow was visible. Post-micturition plain abdominal radiography is considerably cheaper than ultrasound and appears to be equally effective in the determination of residual urine. Its use as the sole imaging technique in the routine management of bladder outflow obstruction is recommended. PMID- 2713616 TI - Histological changes in the urinary bladder secondary to urethral catheterisation. AB - The macroscopic and microscopic features of the urothelial response of the human urinary bladder to urethral catherisation are described. The catheter reaction is characterised by a predominantly eosinophilic inflammatory response producing, macroscopically, a papillary mucosal appearance termed polypoid cystitis. The severity of the epithelial inflammatory response correlates significantly with the duration of catheterisation. Urothelial dysplasia confined to the catheter reaction site was noted in 6% of cases. The possible implications of these findings are discussed. PMID- 2713618 TI - Biocompatibility of urinary catheters. Effect on complement activation. AB - The ability of 2 brands of urinary catheters to activate the complement system in vitro as a marker of biocompatibility was investigated. Pieces of a silicone/latex catheter and an all-silicone catheter were incubated in human serum. Complement activation was tested in 2 enzyme immunoassays, one evaluating C3 activation and the other the terminal complement complex (TCC) formation. The silicone/latex catheter caused considerably more complement activation in both assays than did the all-silicone one. The findings are in agreement with previous results of tissue toxicity tests. The methods presented may prove valuable for the practical purpose of testing the biocompatibility of urinary catheters. PMID- 2713619 TI - The dissolution of urinary mucus after cystoplasty. AB - Three agents have been tested for mucolytic activity to prevent or treat difficulties in bladder emptying following augmentation and substitution cystoplasty, particularly in patients emptying by intermittent self catheterisation. Carbocysteine produced precipitation of mucus, which was found not to be helpful. N-acetylcysteine and urea both dissolved mucus, but urea proved to be more effective. PMID- 2713620 TI - Effect of suprapubic operation on urethral closure. Evaluation by single cough urethrocystometry. AB - To evaluate urodynamic effects of modified Burch colposuspension, 24 patients with stress urinary incontinence were investigated before and 6 to 9 months after the operation. A new method of urodynamic evaluation was performed using a multitransducer-catheter, 5 microtransducers inside the urethra and 1 in the bladder, connected to a computer and graphic plotter. Single coughs were analysed with the catheter in a fixed position and the patient in the standing position. The operation, which was successful, in all but 1 patient, did not alter urethral pressure at rest, but urethral closure pressure at stress after the operation (mean 45.0 cm H2O (SD 21.6) was significantly higher (P less than 0.005) than the -3.6 cm H2O (SD 10.2) recorded before the operation. The pressure transmission ratio was less than 100% in 22 patients before the operation and more than 100% in 18 patients afterwards, the pre- and post-operative mean values being 78.9% (SD 11.9) and 109.5% (SD 17.2) respectively (P less than 0.0005). Burch colposuspension markedly improves urethral closure function as evaluated by this method, which analyses the pressure data at different points of the urethra and bladder during one single cough. PMID- 2713621 TI - A new stent for the treatment of urethral strictures. Preliminary report. AB - We describe a new urethral stent which was implanted into 12 patients with urethral strictures. The stent is woven in the form of a tubular mesh from fine stainless steel wire and is self-expanding when released from its small diameter delivery catheter. All patients have been treated successfully, with a good calibre urethra visible on urethrography and direct endoscopy and with improved urine flow rates. The mean follow-up of these patients was 7 months (range 2-13). Urethroscopy demonstrated complete epithelial covering of the implant in 4 to 6 months. Although the follow-up period was short, it seems that this simple technique may offer a lasting treatment for many urethral strictures. A longer follow-up will be necessary to exclude late complications. PMID- 2713622 TI - Urethral strictures following transurethral resection of the prostate. The role of the catheter. AB - Urethral stricture is the most common late complication of transurethral prostatectomy (TURP). The cause is unknown. A prospective, randomised study was undertaken to investigate the role of the transurethral catheter in stricture formation. A total of 205 patients subjected to TURP were studied. Following resection, they were randomly divided into 2 groups: those drained by a transurethral siliconised latex catheter and those drained by a suprapubic siliconised latex catheter. At follow-up, 6 to 24 months later, 17% of the patients in the transurethral group had developed urethral stricture; the corresponding figure in the suprapubic group was 4%. As a consequence of the higher incidence of stricture in the transurethrally drained group, more patients in that group were dissatisfied with the results of the operation. It was concluded that the post-operative transurethral catheter was an important factor in stricture formation following TURP and that transurethral drainage with a siliconised latex catheter resulted in a higher incidence of stricture. This led to a greater number of patients being dissatisfied with the results of the operation, but the catheter did not affect the results in any other way. PMID- 2713623 TI - One-stage repair of hypospadias using split preputial flaps (Harris). The first 100 patients treated. AB - An analysis is presented of the outcome in the first 100 patients treated by a new technique for the repair of hypospadias and congenital short urethra associated with chordee. Further reconstructive surgery was required in 24 patients. The effect of the position of the meatus, the length of the reconstructed urethra and the method of urinary drainage are analysed. Minor complications are described. A significantly higher complication rate was associated with a perurethral than with a suprapubic catheter; 5 of the 38 patients in whom a suprapubic catheter was used developed complications requiring reconstructive surgery. Possible causes of the complications are discussed and the results compared with those of other methods. It was concluded that this is a satisfactory method of repair for hypospadias associated with chordee. PMID- 2713624 TI - Responses of erectile tissue from impotent men to pharmacological agents. AB - Erectile tissue was removed from the corpora cavernosa of 25 impotent men undergoing surgery for insertion of penile prostheses. Strips, set up in an organ bath, were contracted by the alpha-adrenergic agonist phenylephrine. There was no significant difference between tissue taken from men with diabetes, alcoholism, Peyronie's disease or men with no obvious condition causing the impotence. The sensitivity of tissues from hypertensive patients was significantly reduced but this was probably due to drugs being taken for hypertension. Precontracted tissues could be relaxed by acetylcholine or isoprenaline. The responses, however, were inconsistent, so that no difference between the different groups of patients was apparent. PMID- 2713625 TI - Acute scrotum due to tick bite. PMID- 2713626 TI - Near-fatal urinary peritonitis secondary to ureteric calculus. PMID- 2713627 TI - Primary Hodgkin's disease of the urinary bladder. PMID- 2713628 TI - Piroxicam-induced renal failure following relief of chronic retention. PMID- 2713629 TI - An unusual case of rectovesical fistula. PMID- 2713630 TI - Angiosarcoma of the penis. PMID- 2713631 TI - Reversal of duodenal obstruction due to metastatic teratoma by combination chemotherapy. PMID- 2713632 TI - Suprapubic catheterisation. PMID- 2713633 TI - Re: One-stage pedicle scrotal flap urethroplasty. PMID- 2713634 TI - Low phosphorus intakes by beef suckler cows in late pregnancy and early lactation. AB - Two groups each of 10 suckler cows were given a basal diet of oat straw and pressed unmolassed sugar beet pulp for the last 19 weeks of pregnancy and the first 6 weeks of lactation. One group received 0.88 kg extracted soya bean meal (SBM) in pregnancy and 1.03 kg in lactation. The other was given 0.27 kg of a liquid supplement (LS) (containing inter alia urea and phosphoric acid) in pregnancy increasing to 0.33 kg in lactation. Both diets provided about the same amounts of digestible crude protein and about 10 g phosphorus (P) per day in pregnancy and 12 g P per day in lactation. Cows given SBM consumed marginally more straw but there were no differences in total diet digestibility. Cows given LS lost significantly more liveweight but their calves grew equally well. There were indications that cows given LS had slightly higher mean blood inorganic P and lower mean blood calcium (Ca) concentrations. Mean blood inorganic P concentrations were not below 1.4 mmol/l in pregnancy or 1.2 in lactation. There were no signs of reduction in voluntary straw intake or depraved appetite. When transferred to grass with a bull at the end of the experiment all cows were served within 24 days. It is concluded that these amounts of dietary P were adequate over the 25 weeks. PMID- 2713635 TI - Infection following challenge of the lactating and dry udder of dairy cows with Actinomyces pyogenes and Peptostreptococcus indolicus. AB - Challenge of 12 mammary glands of cows in mid-lactation with 10(7) colony forming units (cfu) of Peptostreptococcus indolicus on two occasions led to clinical mastitis in only four quarters. The bacteria were rarely recovered and disappeared from the secretion within 14 days. In challenges 7 days prior to drying off eight of 12 quarters became infected and at drying off all quarters challenged became infected. The infections established at drying off persisted well into the dry period. P. indolicus infection was also established in all of 12 dry glands challenged, but usually eliminated at calving or early in the next lactation. Isolation of P. indolicus was accompanied in about one-third of cases by changes in the appearance of the secretion. Intramammary challenge with Actinomyces (formally Corynebacterium) pyogenes led to clinical and subclinical infections in nine of 12 lactating glands and in all of six dry glands. Dry period infections with A. pyogenes were more severe and rarely eliminated even by antibiotic therapy. Infections during lactation were often eliminated either naturally or by antibiotic therapy. Intermittent recovery of A. pyogenes from the lactating mammary gland, without clinical signs of infection, was possible for up to 90 days after challenge. Combined infections with A. pyogenes and P. indolicus were clinically more severe with a higher frequency of systemic involvement. It was shown that in the non-lactating gland an acute mastitis, similar to 'summer mastitis' could be established either by simultaneous inoculation with A. pyogenes and P. indolicus or by subsequent inoculation of quarters excreting P. indolicus with A. pyogenes. PMID- 2713636 TI - Effect of electrical stunning on somatosensory evoked potentials in chickens. AB - The spontaneous EEG and somatosensory evoked potentials (SEPs) were examined in chickens before and after electrical stunning using a waterbath stunner. Fifty four per cent of the birds became epileptic and lost their SEPs, and 17% were non epileptic and appeared to retain their SEPs. It was concluded that there was a reasonably close association between the presence of epileptiform activity in the EEG and the absence of SEPs following electrical stunning, but that the absence of SEPs could be preferred as an indicator of an effective stun on conceptual grounds. PMID- 2713637 TI - Effect of antibiotic treatment of young calves on glucose absorption and some plasma components. AB - Oral treatment of 10-15 day-old calves with either chloramphenicol (55 mg/kg body wt) or tetracycline (11 mg/kg body wt) did not induce diarrhoea. Treatment caused significant elevation of plasma Na+, K+ and total protein. Calves treated with chloramphenicol showed retarded glucose absorption from the gut. PMID- 2713638 TI - Prevalence of salmonellae, shigellae and Plesiomonas shigelloides in dogs in Zaria, Nigeria. AB - The prevalence of salmonellae, shigellae and Plesiomonas shigelloides among 303 dogs in Zaria was determined. Salmonella serotypes including S. kofandoka, a new serotype, were recovered from three dogs giving a proportion of 1.0%. None of the dogs from which salmonellae were isolated was showing evidence of gastroenteritis at the time of presentation. Neither Shigella nor Plesiomonas shigelloides was isolated from any of the dogs. PMID- 2713639 TI - Non-clinical intramammary infection in lactating ewes and its association with clinical mastitis. AB - A bacteriological survey for the study of non-clinical intramammary infection in the sheep udder was carried out in 88 Assaf ewes. A mean infection prevalence in the first few weeks of lactation was 55%. The most common bacterial isolates were Micrococcus spp. followed by coagulase negative staphylococcus, together accounting for 93% of the total number of isolates. An infection prevalence of 54% was found in ewelambs 2 days after their first lambing, indicating a marked new infection rate around lambing. Generally, the course of lactation was characterized by dynamic changes of new infection and spontaneous resolution. About 5% of half udders examined developed clinical mastitis. The comparison of bacteriological data from mastitic milk samples and from samples taken from the same half udders before the appearance of the clinical disease could not support the theory that in sheep, mastitis is a clinical exacerbation of a non-clinical intramammary infection. PMID- 2713640 TI - Occurrence of 14 cases of bovine spongiform encephalopathy in a closed dairy herd. AB - Fourteen cases of bovine spongiform encephalopathy (BSE) were diagnosed on the basis of clinical examination in a closed herd of British Friesian cows during a 9-month period from October 1987 until June 1988. The diagnosis was confirmed on histopathological examination of brain tissue from five of the six samples submitted. The main presenting clinical signs were of altered behaviour: apprehension, anxiety and hyperaesthesia. One cow was euthanized after a short period of recumbency; the remaining 13 cows were slaughtered on humane or economic grounds. No protein of animal origin had been fed to either heifers or cows in this herd during the past 5 years and there had been no direct contact with sheep. The epidemiology of BSE in this report suggests that, if the postulate of Morgan (1988) is correct, infection is ingested within the first 6 months of life and there then follows a 4-5-year period before clinical signs appear. PMID- 2713641 TI - Antibiotic susceptibility of Fusobacterium necrophorum from bovine hepatic abscesses. PMID- 2713642 TI - Veterinary pharmaceutics in Australia. PMID- 2713643 TI - Immunohistochemical evidence of the presence of estrogen and progesterone receptors in the same neurons of the guinea pig hypothalamus and preoptic area. AB - Estrogen and progesterone interact in the regulation of various brain functions including mechanisms controlling gonadotropin secretion and female sexual behavior. Various methods have been used to map the regions where these hormones act and where specific receptors can be detected. However, it remains unknown if both steroids act on the same neuron or if there are neural populations responding to either one or the other of these hormones To answer this question, we used various immunocytochemical procedures to detect estrogen and progesterone receptors (ER-IR and PR-IR) on the same histological section, taking advantage of the fact that anti-ER monoclonal antibodies were raised from rats whereas anti-PR monoclonal antibodies were raised from mice. Initial experiments showed that the number of cells displaying ER and PR immunoreactivity changed with hormonal treatment. Prolonged treatment of ovariectomized guinea pigs with high doses of estradiol benzoate (EB) (10 or 15 micrograms/day for 4 or 6 days) increased the number of PR-positive cells in the preoptic area and the hypothalamus. Inversely, with this estrogen priming regimen the number of ER-positive cells decreased, as did the immunostaining intensity in their nuclei. With a lower dose of estrogen administered for a shorter period (2-microgram dose of EB for 2 days) the two receptor populations could be easily observed. Under these hormonal conditions, the sequential procedure revealed that the vast majority of cells containing ER IR in the preoptic area (nucleus preopticus periventricularis, medialis) and the mediobasal hypothalamus (nucleus periventricularis, arcuatus, ventrolateral part of nucleus ventromedialis and premamillaris) showed PR immunoreactivity. This was true regardless of the order in which dual immunocytochemical staining was performed. There were, however, a few ER-positive/PR-negative cells in these regions. However, only ER-positive neurons were found in the n. interstitialis stria terminalis, the n. amygdaloideus medialis and the n. supraopticus. Thus, in guinea pigs receiving moderate doses of estrogen, all PR-positive cells contain ER-IR whereas there is a population of ER-positive cells which are devoid of PR IR. PMID- 2713644 TI - Cholecystokinin-octapeptide antagonizes morphine analgesia in periaqueductal gray of the rat. AB - The analgesic effect of systemic morphine (5 mg/kg, s.c.) was dose-dependently antagonized by CCK-8 administered to the periaqueductal gray (PAG) of the rat. This effect could be reversed by proglumide, a CCK-receptor antagonist. The effect of morphine analgesia was potentiated by proglumide administered to PAG. These results are compatible with the notion that PAG is a strategic site where CCK-8 exerts an antiopioid activity. PMID- 2713645 TI - An HRP study of the central projections from primary sensory neurons innervating the rat masseter muscle. AB - Retrograde and transganglionic transport of horseradish peroxidase has been used to study the cell bodies of origin and the central projections of neurons innervating the rat masseter muscle. Labeled cell bodies were observed both in the trigeminal ganglion and in the mesencephalic trigeminal nucleus. Major central projections from mesencephalic trigeminal neurons were traced to the supratrigeminal nucleus and to the brainstem reticular formation. Smaller projections from these neurons could be followed to the borders of the solitary tract and hypoglossal nuclei as well as to lamina V of nucleus caudalis and corresponding areas in the dorsal horn at C1-C2 spinal cord segments. Labeling from trigeminal ganglion neurons was observed close to the trigeminal tract in all subdivisions of the trigeminal sensory nuclear complex and in the dorsal horn lamina I at C1 and C2 levels. PMID- 2713646 TI - Accumulation of estrogen in a vocal control brain region of a duetting song bird. AB - Tritiated estradiol (E) was injected into bay wrens (Thryothorus nigricapillus), a tropical species in which females sing complex vocal duets with males. Autoradiographic analysis revealed that males and females have equal proportions of cells labeled by estradiol or its metabolites (E target cells) in a telencephalic region involved in song: the caudal nucleus of the ventral hyperstriatum (HVc). Other forebrain song regions failed to show labeling by E. E or its metabolites were accumulated, however, by cells in the midbrain song region ICo (the intercollicular nucleus) and in hypothalamic regions. This pattern of accumulation in the song system differs from that observed in a previous study in which bay wrens were injected with tritiated testosterone (T); T or its metabolites were accumulated by cells in HVc, RA (robust nucleus of the archistriatum), MAN (magnocellular nucleus of the neostriatum), ICo, and nXII (hypoglossal (nucleus). Such comparison suggests that cells in HVc have different steroid accumulation properties from those in other song regions. Bay wrens differ from zebra finches (Poephilia guttata), in which HVc contains very few E target cells. The wrens are more similar to canaries (Serinus canarius), because both species have E target cells in HVc, and females of both species are able to sing. The interspecies comparison raises the question of whether the ability of HVc cells to accumulate E or its metabolites in both species constitutes a precondition for the bisexual potential for song production. PMID- 2713647 TI - Uptake of leucine and alanine by cultured cerebral capillary endothelial cells. AB - Pure cultures of rat cerebral capillary endothelium have been used to study the A and L-systems of amino acid transport. Leucine is taken up by a non concentrative mechanism that can be saturated, and competitively inhibited by phenylalanine. Uptake is rapid, with equilibration apparent after 3-5 min (all experiments performed at 37 degrees C). The Km for transport was 83 microM +/- 26 (mean +/- S.E.M., n = 3) which is in good agreement with recent in vivo reports using unanaesthetised rats. Alanine was transported by a saturable, concentrative mechanism. Dependence on Na+-ions was demonstrated by lack of specific uptake in Na+-free buffer and reduced uptake after preincubation in ouabain--a Na+,K+ ATPase inhibitor. The Km for transport was 325 microM +/- 88 (mean +/- S.E.M., n = 3). The finding of an active A-system transporter in vitro suggests that the cells may have lost the polarity they demonstrate in vivo. The relevance of these findings to transport of nutrients and drugs across the blood-brain barrier is discussed. PMID- 2713648 TI - Responses of neurons in the lamb nucleus tractus solitarius to stimulation of the caudal oral cavity and epiglottis with different stimulus modalities. AB - Receptors located in the posterior oral cavity and on the epiglottis play an important role in the initiation of upper airway reflexes such as swallowing, gagging, coughing and apnea. Peripheral nerves which innervate these receptor areas terminate in the nucleus tractus solitarius (NTS). We have recorded the responses of 61 neurons in the lamb NTS to stimulation of the caudal tongue, palate and epiglottis with mechanical, chemical and thermal stimuli and mapped receptive field location. Although there was some overlap in the areas of the NTS from which neurons with oral cavity and epiglottal receptive fields could be recorded, a significant difference was observed in the mean recording sites of the two groups of neurons. Neurons with oral cavity receptive fields were located more rostral, lateral and ventral in the NTS than neurons with receptive fields on the epiglottis. Little convergence of sensory input onto single cells in the NTS was observed between the oral cavity and the epiglottis. Only one NTS neuron had a receptive field in both of these receptor areas. In contrast, a large number of neurons with oral cavity receptive fields received input from two receptor areas. These neurons had a receptive field on the tongue which was located directly beneath the receptive field on the palate. Mechanical stimuli were the most effective for neurons with either oral cavity or epiglottal receptive fields and thermal stimuli were the least effective. Neurons which responded to mechanical stimuli responded better to a moving stimulus than to a punctate one, and large increases in the strength of a punctate stimulus were required to elicit significant increases in response frequency. Most NTS neurons responded to more than one of the stimulus modalities. However, a significant difference in the mean number of stimulus modalities which elicited responses was observed between neurons with oral cavity and epiglottal receptive fields. The number of multimodal neurons with epiglottal receptive fields was higher than those with oral cavity receptive fields. The multimodal nature of neurons which responded to epiglottal or oral cavity stimulation combined with their location in reflexogenic areas of the NTS suggests that these neurons could be important in the integration of afferent input from the oral cavity and upper airway. If these NTS neurons are involved in the control of oral and upper airway reflexes it would be important for them to respond to as many of the stimulus cues as possible and the majority of these neurons do just that. PMID- 2713649 TI - Perinatal administration of nicotine alters subsequent sexual behavior and testosterone levels of male rats. AB - The effect of pre- and/or postnatal administration of nicotine (0.25 mg/kg) on sexual behavior and testosterone levels in adult male rats was examined. Prenatal nicotine decreases male sexual behavior as measured by the number of males that mounted, intromitted or ejaculated. The males that did mount and/or ejaculate exhibited an increase in mount latency and number of mounts and a decrease in efficiency. This decrease was correlated with a decrease in plasma testosterone levels. Postnatal nicotine treatment improved the sexual performance of sexually naive males as measured by an increase in the number of males that completed 2 ejaculatory series and by a decrease in mount latency. This effect is transient, subsequent testing of the nicotine males eliminated this difference in sexual performance. Pre- and postnatal nicotine treatment did not affect the overall sexual performance of the male rats, although the number of mounts and intromissions during a second series decreased. Eye opening of male and female pups was accelerated with pre/postnatal nicotine administration. Birth weight, testis and levator ani weights, sex ratio and number of pups per litter were not affected. We suggest that nicotine may act as a neuromodulator during sexual differentiation of the brain, demasculinizing the male progeny in rats. This effect is correlated with decreased testosterone levels during adulthood. PMID- 2713650 TI - Effects of short- and long-term haloperidol administration and withdrawal on regional brain cholecystokinin and neurotensin concentrations in the rat. AB - The effects of oral administration of the neuroleptic, haloperidol, on regional brain concentrations of cholecystokinin (CCK) and neurotensin were examined in the rat. Both short-term (3 weeks) and long-term (8 months) haloperidol administration increased the concentration of CCK in the substantia nigra. While short-term administration significantly increased the concentration of CCK in the ventral tegmental area and decreased the concentration of CCK in the cortex, including the medial prefrontal cortex, these effects were not observed following long-term drug administration. In contrast, long-term, but not short-term, haloperidol administration decreased the concentration of CCK in the olfactory tubercle. Withdrawal from long-term haloperidol did not alter CCK concentrations in any of the brain regions examined. Short-term haloperidol administration significantly increased the concentration of neurotensin in the caudate-putamen. Both short- and long-term administration increased the concentration of neurotensin in the nucleus accumbens, but only the increased following long-term administration reached statistical significance. Withdrawal from long-term haloperidol administration slightly decreased the concentrations of neurotensin in the caudate-putamen and nucleus accumbens. These results indicate that dopamine receptor blockade can affect both CCK- and neurotensin-containing neural systems. Furthermore, these two neuropeptides are affected differently depending upon the duration of haloperidol administration and withdrawal from this drug. The results raise the possibility that chronic administration of haloperidol may be toxic to some neurotensin-containing neurons in the basal ganglia. PMID- 2713651 TI - Auditory cortex lesions prevent the extinction of Pavlovian differential heart rate conditioning to tonal stimuli in rabbits. AB - The present study examined the role of the auditory cortex in the extinction of differentially conditioned heart rate (HR) responses in rabbits. Lesions were placed bilaterally in either the auditory cortex or the visual cortex. Three days after recovery from surgery, the auditory cortex lesion group and the visual cortex lesion control group were habituated to the tonal conditioned stimuli (CSs), and then given 2 days of Pavlovian differential conditioning (60 trials per day) in which one tone (CS+) was always paired with the unconditioned stimulus and another tone (CS-) was never paired with the unconditioned stimulus. Animals that had demonstrated reliable differential conditioning (CS+ response at least 5 beats greater than the CS- response) were placed on an extinction schedule for 7 days. The extinction schedule was identical to the differential conditioning schedule with the exception that shock never followed the CS+. The results of the study indicate that auditory cortex lesions prevent the extinction of differential bradycardia conditioned responses (CRs) to tonal CSs. Whereas the bradycardia responses to the CS+ quickly extinguished in the group that had control lesions in the visual cortex, the auditory cortex lesion group continued to exhibit significantly larger bradycardiac HR CRs to the CS+ relative to the CS during all 7 days of extinction. These results suggest that the animals in the auditory cortex lesioned group did not inhibit responses to a previously reinforced stimulus (i.e., CS+) as well as animals with control lesions in the visual cortex. PMID- 2713652 TI - Interaction between nerve growth factor and GM1 monosialoganglioside in preventing cortical choline acetyltransferase and high affinity choline uptake decrease after lesion of the nucleus basalis. AB - Monosialoganglioside GM1 and nerve growth factor (NGF) were administered alone or concomitantly to adult male rats with a unilateral ibotenic acid lesion of the nucleus basalis magnocellularis (NBM). High-affinity choline uptake (HACU) rate and choline acetyltransferase (ChAT) activity were measured, 4 and 21 days after surgery, respectively, in the frontal and parietal cortices of both hemispheres. A 33-34% decrease in HACU rate and a 43-39% decrease in ChAT activity was found in the ipsilateral cortices 4 and 21 days, respectively, after the lesion. If the lesioned rats received NGF (10 micrograms i.c.v.) twice a week or daily administrations of GM1 (30 mg/kg, i.p.), beginning immediately after surgery the decrease in HACU rate and ChAT activity was smaller. If NGF and GM1 were given concomitantly no decrease in HACU rate and ChAT activity was detected in the lesioned hemisphere and a slight increase occurred in the contralateral hemisphere. However, after the concurrent administration of NGF (10 micrograms i.c.v.) and the inactive dose of GM1 10 mg/kg i.p. no decrease in HACU and ChAT activity was also found in the lesioned rats. The latter finding indicates a potentiation by GM1 of NGF effects on the cholinergic neurons of the NBM. The two drugs may either antagonize the neurotoxic effects of ibotenic acid or stimulate a compensatory activity in the remaining neurons. PMID- 2713653 TI - Functional damage of dopamine nerve terminals following intrastriatal kainic acid injection. AB - The release of [3H]dopamine ([3H]DA) previously taken up into rat striatal slices was studied one week after a monolateral intrastriatal injection of kainic acid (KA). Different releasing stimuli (electrical pulses, veratrine, high-K+) were applied. The electrically evoked release in the KA-lesioned striata was drastically reduced with respect to the unlesioned contralateral striata. In contrast, KA had no effect on the release of [3H]DA evoked by veratrine or high K+. In unlesioned striatal slices, depolarized with 15 mM KCl, apomorphine reduced and (-)sulpiride increased the release of [3H]DA. The effect of apomorphine was antagonized by (-)sulpiride indicating the presence of an autoreceptor system similar to that seen in unlesioned striata stimulated electrically. However, the effects of apomorphine and of (-)sulpiride were dramatically reduced in K+-depolarized slices prepared from KA-lesioned striata. The results suggest that the axon terminals in KA-treated areas remain intact in several of their properties but may be damaged in some critical processes. PMID- 2713654 TI - Kynurenic acid antagonizes the excitatory postsynaptic potential elicited in neostriatal neurons in the in vitro slice of the rat. AB - Stimulation of corpus callosum in rat brain slices evoked an excitatory postsynaptic potential (EPSP) in neostriatal neurons. This EPSP is greatly reduced by exposing the slice to kynurenic acid (KY). The action of KY is reversed when the preparation is bathed in normal Ringer's solution. KY reduces the EPSP amplitude in a dose-dependent fashion, with 1 mM KY attenuating the potential by 86%. The effect is not due to a conductance change, since KY treatment does not alter the neuron's input resistance. PMID- 2713655 TI - Excessive intra- and supragranular mossy fibers in the dentate gyrus of tottering (tg/tg) mice. AB - In Timm's sulfide silver preparations, intragranular and supragranular mossy fiber staining is found to be much more prevalent in the temporal dentate gyrus of the spontaneous epileptic mouse, tottering, than at matching levels in unaffected littermate controls. This aberrant distribution of mossy fibers may be due to the spontaneous seizures affecting this mutant. PMID- 2713656 TI - Polymer electret guidance channels enhance peripheral nerve regeneration in mice. AB - Polytetrafluoroethylene (PTFE) tubes were prepared as electrets displaying a quasi-permanent surface charge due to the presence of trapped monopolar charge carriers. PTFE tubes containing either positive or negative charges and electrically neutral PTFE tubes were used as nerve guidance channels for the repair of a 4 mm nerve gap in the sciatic nerve of mice. After 4 weeks of implantation, positively and negatively charged PTFE electrets contained regenerated nerves with significantly more myelinated axons than nerves regenerated in uncharged PTFE tubes. This observation suggests that peripheral nerve regeneration can be enhanced by electrically charged nerve guidance channels. PMID- 2713657 TI - Translocation of zinc may contribute to seizure-induced death of neurons. AB - Rats were subjected to seizures induced by kainic acid, and the resulting changes in CNS zinc staining were studied with the toluene sulfonamide quinoline fluorescence method. Seizures caused a loss of zinc staining from presynaptic boutons in many limbic and cerebrocortical regions. Simultaneously, the postsynaptic neurons that were degenerating (acidophilic) in those regions as a result of the seizure developed intense fluorescence for zinc. A possible role for zinc in the death of the postsynaptic neurons is suggested. PMID- 2713658 TI - Glucocorticoids potentiate kainic acid-induced seizures and wet dog shakes. AB - Glucocorticoid effects on kainic acid-induced motor seizures and wet dog shakes in rats were investigated by adrenalectomy and dexamethasone treatment. One-day adrenalectomy attenuated kainic acid-induced wet dog shakes and seizure activity. These effects were restored by dexamethasone. Administration of dexamethasone to non-adrenalectomized rats potentiated kainic acid-induced wet dog shakes and severity of seizure activity. These results suggest that glucocorticoids may play an important role in modulating the severity of kainic acid-induced seizures and wet dog shakes. PMID- 2713659 TI - Perforated synapses on double-headed dendritic spines: a possible structural substrate of synaptic plasticity. AB - Examination of axospinous synapses in serial sections obtained from the middle molecular layer of the rat dentate gyrus has revealed that some of them involve double-headed dendritic spines. Each spine head is apposed by a separate axon terminal with which it always forms a perforated synaptic contact distinguished by a discontinuous postsynaptic density. The number of perforated synapses on double-headed spines was estimated as a synapse-to-neuron ratio with the aid of the disector technique and found to be significantly increased in rats kindled via medial perforant path stimulation. These results support the notion that perforated synapses involving double-headed dendritic spines represent a structural modification related to enhanced synaptic efficacy. PMID- 2713660 TI - Is the androgen-dependent increase in preoptic estradiol-17 beta formation due to aromatase induction? AB - Aromatization of testosterone in the preoptic area of the male ring dove is required for the expression of specific estrogen-sensitive sexual behavior. Estradiol metabolism and/or binding of the aromatization product(s) to the preoptic estrogen receptors (ER) could interfere with the apparent increase in estradiol formation that occurs after androgen administration to castrated males. Therefore, we have re-examined the induction mechanism using a direct in vitro assay of aromatase activity. Since levels of aromatase activity and enzyme kinetics were similar irrespective of the assay used, we can conclude that increased estradiol formation after androgen stimulation is mainly due to enzyme induction and that estrogen binding and/or metabolism do not interfere significantly with the induction process. PMID- 2713661 TI - Compartmental distribution of endogenous amino acids in the substantia nigra of the rat. AB - Using a push-pull cannula we have monitored the spontaneous efflux of 8 endogenous amino acids into perfusates of the substantia nigra of the rat. The extracellular concentrations of the amino acids were estimated and compared to their respective tissue levels. High intra-/extracellular concentration ratios were found for gamma-aminobutyric acid (GABA), aspartate, glutamate and taurine. Much lower values were found for glycine, alanine, serine and glutamine. These results provide evidence for possible neurotransmitter roles for aspartate, glutamate and taurine in the substantia nigra in addition to that, long recognized, for GABA. PMID- 2713662 TI - Respiratory effects of 5'-ethylcarboxamidoadenosine, an analog of adenosine, following microinjections into the nucleus tractus solitarius of rats. AB - Microinjections of 5'-ethylcarboxamidoadenosine (NECA), an adenosine analog, were made into respiratory-related regions of the nucleus tractus solitarius (NTS) of spontaneously breathing rats and cardiorespiratory parameters were recorded during a 60-min test period. Microinjections of NECA, in the dose range of 0.35 350 picomol per rat, produced significant dose-related reductions in respiratory rate which were accompanied by correlative increases in tidal volume. At the end of the 60-min test period following the administration of NECA, the respiratory rate remained profoundly depressed, whereas blood pressure and heart rate were not significantly affected compared to preinjection control values. The data from this study suggest that adenosine may exert modulatory influences in brainstem respiratory control regions. PMID- 2713663 TI - Acetylcholine produces stimulus-specific receptive field alterations in cat auditory cortex. AB - Frequency receptive fields (RFs) were determined before and after pairing iontophoretic administration of acetylcholine (ACh) with a repeated single frequency stimulus in the auditory cortex of barbiturate-anesthetized cats. In 58% of the cells, the paired ACh + tone treatment produced subsequent alterations of frequency RFs. In half of these cases, the RF modifications were highly specific to the frequency that had been paired with ACh. Atropine antagonized the frequency-specific effects of ACh, suggesting that they were mediated via muscarinic cholinergic receptors. PMID- 2713664 TI - The role of the nigrotegmental GABAergic pathway in the propagation of pentylenetetrazol-induced seizures. AB - Recent evidence suggests that the substantia nigra (SN) may be involved in the modification of various experimental epilepsy models. We determined the role of gamma-aminobutyric acid (GABA)ergic activity of the SN and the target sites of SN efferents, the pedunculopontine nucleus (PPN) and superior colliculus (SC), in pentylenetetrazol-induced seizures in rats. Bilateral administration of a GABA agonist (muscimol) into the SN significantly reduced seizure severity; its administration into the PPN significantly augmented seizure severity; administration into the SC did not alter the seizure severity. On the other hand, infusion of a GABA antagonist (bicuculline) into the PPN revealed a protective effect against seizures. Our findings indicate that the nigral GABAergic projections to the PPN play an important role in seizure propagation. Thus, PPN neurons may be a possible target site of nigral output modulating seizure propagation. PMID- 2713665 TI - Activation of supraoptic magnocellular neurons by gamma 2-melanocyte stimulating hormone (gamma 2-MSH). AB - The effects of intracarotid infusions of the peptide gamma 2-melanocyte stimulating hormone (gamma 2-MSH) on electrophysiologically and immunohistochemically identified supraoptic nucleus (SON) units were investigated. Over a wide dose range this agent always excited SON units, while control infusions of vehicle had no effect. Because neural responses invariably preceded blood pressure elevation, it appears that gamma 2-MSH excitation of the magnocellular system was due to a direct effect on the central nervous system and was not a result of systemic cardiovascular responses. These results suggest a forebrain gamma 2-MSH sensitive site in the activation of SON magnocellular neurons. PMID- 2713666 TI - Reflections of low calcium epileptiform activity from area CA1 into dentate gyrus in the rat hippocampal slice. AB - Lowering of [Ca2+]o induces epileptiform activity in hippocampal area CA1, characterized by slow negative field potentials with superimposed trains of population spikes and by rises in [K+]o. In dentate gyrus slow positive field potentials occur simultaneously with the activity in area CA1. The accompanying small rises in [K+]o may stem from spatial K+ redistribution through glial cells from area CA1. PMID- 2713667 TI - Lymphokines facilitate maturation of oligodendrocytes in vitro. AB - As oligodendrocytes develop in vitro, A2B5+ progenitor cells acquire the oligodendrocyte-specific marker, galactocerebroside (GalC), to become A2B5+ GalC+ cells. They then gradually lose reactivity to A2B5, to become A2B5- GalC+ mature oligodendrocytes. By examining this developmental surface antigen expression with and without lymphokine stimuli we found that crude lymphokines, but not interleukin-2 or gamma-interferon, facilitate this maturation process. Thus, lymphokines may have a role in differentiation of oligodendrocytes. The same lymphokine stimuli, however, did not enhance the proliferation of oligodendrocytes. PMID- 2713668 TI - Unlike hypoxia, hypoglycemia does not preferentially destroy GABAergic neurons in developing rat neocortex explants in culture. AB - We tested whether hypoglycemia, like hypoxia, would preferentially destroy GABAergic nerve cells in the neocortex. To this end, rat neocortex explants dissected from 6-day-old rat pups and cultured up to a developmental stage approximately comparable to that of the newborn human neocortex, were exposed to hypoglycemia for different periods. Quantitative light microscopic and immunocytochemical evaluation of the cultures demonstrated that hypoglycemia does not preferentially destroy GABAergic but rather non-GABAergic neurons, a finding quite opposite to what was found after hypoxia. Recent biochemical data from other laboratories which seem to support this difference in neuronal vulnerability are discussed. It is concluded that perinatal hypoglycemia may not form such a serious threat with respect to the genesis of epilepsy as does hypoxia. PMID- 2713669 TI - An aminopyridine-sensitive, early outward current recorded in vivo in neurons of the precruciate cortex of cats using single-electrode voltage-clamp techniques. AB - Studies were performed in cortical neurons to determine if voltage- and time dependent membrane currents could be recognized and characterized in the dynamic, in vivo state. Intracellular measurements made in neurons of the precruciate cortex of awake cats with single-electrode voltage-clamp (SEVC) techniques disclosed an early outward current to depolarizing command steps in 124 of 137 cells studied. The voltage-dependent properties of the early outward current closely resembled those of A-currents studied in vitro in vertebrate and invertebrate neurons. The current was activated rapidly at onset latencies of less than two ms, fell to flat plateau levels within 60-120 ms during sustained depolarization, and was reduced or eliminated in 22 of 23 cells following intracellular administration of 3- or 4-aminopyridine. The magnitude of outward current in response to depolarizing commands was increased by preceding steady hyperpolarization and reduced by preceding steady depolarization. (The steady potentials were of 9.8 s duration and +/- 40 mV apart from the holding potentials.) Since return to the holding potentials occurred 80 ms before the onset of the command steps, the changes in membrane properties that were induced lasted beyond cessation of the steady polarizing stimuli themselves. Spiking did not prevent recognition of the early outward current as judged from its appearance before and after intracellular application of QX-314 to reduce spike activity. Apart from fast inward currents associated with spike potentials, the early outward current was the most conspicuous and characteristic membrane current noted in these recordings. An additional current component that was noted but not characterized in these studies was a slow, depolarization-induced inward current that could be reduced by intracellular injection of QX-314. PMID- 2713670 TI - Involvement of spinal noradrenergic system in the mechanism of an antinociceptive effect of delta-sleep-inducing peptide (DSIP). AB - We studied whether the antinociceptive effect produced by intracerebroventricular injection of delta-sleep-inducing peptide (DSIP) to mice involved the monoaminergic pathways that descended from brainstem to spinal cord (the descending inhibitory systems). In the tail-pinch test, the antinociceptive effect of DSIP was significantly reduced by the pretreatment with reserpine (3 mg/kg i.p.) which depleted endogenous monoamines. Moreover, the intrathecal injections of monoamine antagonists were performed to evaluate the roles of the spinal noradrenergic and/or serotonergic systems in the production of the DSIP antinociception. In both tail-pinch and hot plate tests, the antinociceptive effect of DSIP was significantly antagonized by the previous intrathecal administration of phentolamine (an alpha-adrenergic blocker) or yohimbine (an alpha 2-adrenergic blocker), but was unaffected by the pretreatment with methysergide (a serotonin antagonist). These results demonstrate that the activation of the descending inhibitory systems, mainly spinal noradrenergic systems, is involved in the elicitation of DSIP antinociception. PMID- 2713671 TI - DNA synthesis by young adult human-derived astrocytes in vitro. AB - We have assessed whether adult human non-neoplastic astrocytes exhibit DNA synthesis in vitro, as measured using a double immunofluorescence technique to detect incorporation of 5-bromodeoxyuridine (BrdU) by nuclei of glial fibrillary acidic protein (GFAP)-containing cells. Dissociated cell cultures containing GFAP+ cells were established from surgically resected temporal lobe tissue from 3 young adult individuals operated upon to remove epileptogenic foci. In 5-18-day old cultures from each of the 3 individuals, we observed GFAP+ cells whose nuclei had incorporated BrdU. BrdU nuclear staining was found in GFAP+ cells with either flat or process-bearing morphologies. The mean mitotic index for the GFAP+ cells was 6% (range 2-12%) as compared to a mean mitotic index of 29% for the GMK-7 glioma cell line. Our results do indicate that astrocytes derived from young adult donors, unlike such cells derived at autopsy from elderly adults, are capable of DNA synthesis in vitro, albeit to a markedly lesser extent than reported for fetal human astrocytes. PMID- 2713672 TI - Neurophysiological characterization of commissurally projecting dentate neurons in the rat. AB - Commissural neurons in the dentate hilus and in the deep dentate granule cell layer were recorded intracellularly in vivo, in conjunction with combined injection of the anterograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L) at sites of electrical stimulation. Two hilar neurons responded with short latency antidromic spikes to stimulation of the contralateral dentate infrapyramidal molecular layer, but did not show any synaptic potentials, suggesting that these neurons do not receive commissural hilar input, either directly or indirectly, from the stimulating sites. On the other hand, 3 dentate-hilar border neurons responded to the contralateral hilar stimulation with antidromic spikes, excitatory postsynaptic potentials (EPSPs), orthodromic spikes, and inhibitory PSPs (IPSPs), suggesting a rich synaptic interaction both commissurally and locally in this region. No direct commissural inhibition was observed in any of the cells. PHA-L injection at the stimulation site indicated that commissural hilar axon terminals project to a limited region of the contralateral molecular layer in a lamellar fashion, and have only a sparse distribution in the contralateral hilus. The results indicate that rapidly conducting commissural neurons in the dentate gyrus are themselves inhibited in an indirect manner by commissural fibers. PMID- 2713673 TI - Quantitative autoradiography of angiotensin II receptors in the rat solitary vagal area: effects of nodose ganglionectomy or sinoaortic denervation. AB - The experiments reported here were designed to examine whether angiotensin II (AII) receptors in the rat solitary-vagal area (SVA) are associated with the neuronal components of the baroreceptor reflex. AII receptors were characterized both in membrane preparations from the rat brainstem and by in vitro autoradiography using the radiolabeled AII antagonist [125I]Sar1,Ile8-AII([ 125I]SI-AII). Saturation analysis of [125I]SI-AII binding to membrane preparations from rat brainstem indicated binding to two high affinity sites (Kd1 0.32 nM and Bmax1 5.10 fmol/mg protein, Kd2 0.99 nM and Bmax2 7.94 fmol/mg protein). The rank order competition by unlabeled angiotensin peptides (SI-AII greater than AII greater than AIII greater than AI) in both membrane preparations and by quantitative autoradiography was consistent with the labeling of the brain AII receptor. Autoradiography of the [125I]SI-AII binding in sections through the SVA revealed that the nucleus tractus solitarius (NTS) and the dorsal motor nucleus of the vagus (DMV) were heavily labeled. Bilateral sinoartic denervation, which disrupts primary baroreceptor afferents, resulted in a small decrease in [125I]SI-AII binding in the rostral and intermediate NTS and DMV. Unilateral nodose ganglionectomy, which disrupts completely the vagal afferent input to the NTS and produces retrograde degeneration of the vagal efferent neurons in the DMV, resulted in a marked decrease in [125I]SI-AII binding at all levels of the ipsilateral NTS and 56% decrease within the ipsilateral DMV. These results indicate that AII receptors within the SVA are distributed heterogeneously, with a large portion associated with vagal afferent fibers in the NTS and vagal efferent neurons of the DMV, and a small but significant portion associated with baroreceptor afferents. The majority of AII receptors in the NTS, however, were not affected by these surgical interventions and therefore appear to be located on intrinsic interneurons or non-vagal afferents in the NTS. PMID- 2713674 TI - Convulsant gamma-butyrolactones block GABA currents in cultured chick spinal cord neurons. AB - The gamma-aminobutyric acid (GABA) inhibiting properties of the beta-substituted gamma-butyrolactone convulsant, beta-isopropyl-gamma-butyrolactone (beta IPGBL), were studied using gigaseal recording techniques in cultured chick spinal cord neurons. beta IPGBL produced a dose-dependent inhibition of GABA currents with half maximal effect at 92 microM. The effects of beta IPGBL were immediate and completely reversible within minutes after exposure. The inhibition by beta IPGBL showed mixed competitive and non-competitive features with little voltage dependence. beta IPGBL did not alter the GABA reversal potential nor the degree of GABA desensitization. At a single-channel level, beta IPGBL markedly diminished the opening of GABA channels and decreased the mean channel open time by 30-40% without affecting the amplitude of the single-channel current. PMID- 2713675 TI - Autoradiographic characterization of high-affinity adenosine A2 receptors in the rat brain. AB - Binding of the non-selective adenosine receptor agonist, [3H]NECA (5'-N ethylcarboxamidoadenosine) was evaluated in sections of rat brain using quantitative receptor autoradiography. [3H]NECA bound specifically to a variety of different brain regions including striatum, cerebellum and thalamus. In the presence of the selective adenosine A1 receptor agonist, cyclopentyladenosine (CPA: 50 nM), [3H]NECA binding was exclusively localized to the striatum and olfactory tubercle. Binding in rat striatum occurred at a single site (Kd = 9 nM) with limited capacity (apparent Bmax = 230 fmol/mg tissue). Competition experiments in both striatum and olfactory tubercle with various adenosine agonists and antagonists indicated that the sites labeled by [3H]NECA in the presence of 50 nM CPA were A2 in nature, the rank order of activity for agonists being NECA greater than 2-chloroadenosine (2-CADO), greater than R-N6 phenylisopropyladenosine (R-PIA) greater than CPA greater than S-N6 phenylisopropyladenosine (S-PIA). For xanthine antagonists the order was greater than 1,3-dipropyl-8(2-amino-4-chloro)phenylxanthine (PACPX) greater than xanthine amino acid congener (XAC) greater than xanthine carboxylic acid congener (XCC) greater than 1,3-diethyl-8-phenylxanthine (DPX). The localization of A2 receptors to discrete regions of rat brain indicates that the purine may have a selective role in modulating basal ganglia function. PMID- 2713676 TI - Compensatory eye movements during head and body rotation in infants. AB - Eye movements were measured in 2- and 4-month-old infants during rotation in the light and in the dark using a specially constructed infant seat that was rotated sinusoidally at 0.1, 0.25 and 0.5 Hz. As in adults, the phase of the vestibulo ocular reflex (VOR) was nearly compensatory with respect to head position, and the gain values were generally in the range between 0.4 and 1.4. There were two types of phases for the cervico-ocular (COR) responses: compensatory and anticompensatory. The gain of the COR was 4-6 times larger than that reported for adults. In addition, it was both frequency- and age-dependent. These characteristics of the COR may reflect developmental processes in the infant nervous system. The interaction of the two reflexes (VOR + COR) gave responses similar to when the VOR was elicited alone. The subjects' use of a fixation light raised the gain of the VOR and VOR + COR to about 1.67 and 1.44, respectively. These values were higher than most gains reported for adults. However, they were close to what was predicted (1.53) for the experimental conditions wherein fixation was on a target 25 cm in front of the eyes. PMID- 2713677 TI - Laminar cortical interactions during epileptic spikes studied with principal component analysis and physiological modeling. AB - The direct cortical responses (DCR) to electrical stimulation and electrically evoked interictal penicillin spikes (EIIS) were studied in the same rats using current source-density (CSD) analysis to directly compare regions of neuronal depolarization and hyperpolarization in neocortex. Principal component analysis (PCA) was further used to evaluate patterns of covariance in the CSD that were characteristic of interactions between pyramidal cell populations with spatially and temporally distinct transmembrane currents. A physical model was applied to the physiological interpretation of PCA results and the optimal model parameters used to estimate neuronal generators of recorded laminar field potentials. The data suggested that the DCR and EIIS were produced by the same neuronal circuit which could be represented by two anatomically distinct populations of pyramidal cells. The first of these populations was situated in the upper and middle layers (supragranular pyramidal neurons) and formed a dipolar CSD pattern that reversed polarity in layers II and III. The second deeper population (infragranular pyramidal neurons) extended throughout most of the cortical thickness and formed a dipolar CSD pattern that reversed polarity in layer V. We propose that excitatory intracortical connections of supragranular pyramidal cells may pathologically synchronize depolarization within the epileptic focus. In this way, supragranular pyramidal cells may provide a trigger mechanism for interictal spikes in neocortex. PMID- 2713678 TI - Experimental studies on the olfactory marker protein. V. Olfactory marker protein in the olfactory neurons transplanted within the olfactory bulb. AB - The olfactory mucosa of neonatal rats was transplanted within the olfactory bulb of littermates to investigate whether the olfactory bulb would have played a role in the differentiation of the olfactory neurons and whether the olfactory axons, growing out from the transplant, would have interacted with the olfactory glomeruli of the host. The observations were conducted on sections stained with Gill's hematoxylin, Loots' silver method, and the immunohistochemical technique for the demonstration of the olfactory marker protein (OMP). The olfactory neurons of the transplant (those localized in the neuroepithelium and those migrating from it into the bulbar parenchyma) could become fully differentiated but only few of them were OMP positive. Numerous sensory axons originated from the transplanted olfactory mucosa, however, they did not form ectopic glomeruli nor did they interact with the glomeruli of the host. These results indicate that the olfactory bulb, in vivo, does not affect the number of olfactory neurons expressing OMP and that the ectopically located neurons lack the cues to recognize the host glomeruli. PMID- 2713680 TI - Properties of single potassium channels in cultured primary astrocytes. AB - The patch-clamp technique was used to characterize the single channel ion currents in primary cultures of rat astrocytes. The most dominant channel type, which was found in over half of the inside-out membrane patches, was a potassium channel. The measured reversal potential was -67 mV, which is close to the calculated Nernst potential for potassium ions (-80 mV). These potassium channels activated with bursts of very brief openings. Once activated the channels did not inactivate. The measured probabilities of the channels to be closed showed at least 3 different modes of channel behaviour: one voltage-independent and two voltage-dependent modes. During each activity-mode a 'main' conductance level plus two other conductance levels were observed. In some recordings a pronounced outward rectification could also be seen. PMID- 2713679 TI - Development of progesterone-facilitated lordosis in female guinea pigs: relationship to neural estrogen and progestin receptors. AB - Ovariectomized (OVX), 20-day-old female guinea pigs did not exhibit lordosis following treatment with estradiol benzoate (EB) and progesterone. Behavioral responsiveness to EB and progesterone developed abruptly; by 30 days of age, responses typical of adult females (greater than 9 weeks of age) were observed. In vitro assays of neural steroid receptors were performed to test the hypothesis that a deficiency in the concentration of hypothalamic and/or preoptic area estrogen and/or progestin receptors contributes to the lack of progesterone facilitated lordosis in juvenile (20-day-old) females. Assay of cytosol progestin receptors in the mediobasal hypothalamus (MBH) and preoptic area (POA) of immature and adult females 40 h after injection of EB confirmed a previous report that the concentration of estradiol-induced cytosol progestin receptors in the MBH of juvenile females was slightly lower than that observed in adults. Furthermore, MBH cell nuclear accumulation of progestin receptors after progesterone injection was markedly lower (i.e. 42%) in immature, as compared to adult females. The concentrations of cytosol estrogen receptors in the MBH and POA did not differ between immature and adult OVX guinea pigs. Also, cell nuclear estrogen receptor accumulation in the MBH after estradiol injection was comparable in immature and adult females. These data suggest that a deficiency in cell nuclear progestin receptor accumulation in the MBH may contribute to the absence of progesterone-facilitated lordosis in estradiol-primed, immature female guinea pigs. This age-related difference in cell nuclear progestin receptor accumulation may be due, in part, to reduced concentrations of estradiol-induced cytosol progestin receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713681 TI - Phasic modulation of reticulospinal neurones during fictive locomotion and other types of spinal motor activity in lamprey. AB - The intracellular activity of different types of reticulospinal neurones was studied during fictive locomotion and other types of spinal motor activity in an in vitro preparation of the lamprey brainstem-spinal cord. The examined neurones included large Muller cells of the rhombencephalic and mesencephalic reticular formation, the Mauthner cell, and neurones in the posterior rhombencephalic reticular nucleus with different sizes and conduction velocities. During bouts of fictive swimming initiated spontaneously or by stimulation of the trigeminal nerve or spinal cord, the Muller cells were depolarized and fired action potentials. Bulbar Muller cells in addition showed a phasic modulation of membrane potential with excitation in phase with ipsilateral motoneurones of the rostral spinal cord. The Mauthner cell was depolarized in phase with contralateral motoneurones. Many neurones in the posterior rhombencephalic reticular nucleus showed modulation in phase with ipsilateral motoneurones during fictive swimming. Such oscillations were observed in both fast-conducting neurones, located mainly in the medial part of the nucleus, and slower conducting cells with a more lateral distribution. All examined reticulospinal neurones showed a strong coupling also with other types of spinal motor activity, such as slow alternating bursting and synchronous bilateral ventral root bursts, but the reticulospinal activity had no correlation with respiratory activity recorded from the Xth nerve. The consequences of a phasic reticulospinal activity during locomotion are discussed. PMID- 2713682 TI - Choline increases acetylcholine release and protects against the stimulation induced decrease in phosphatide levels within membranes of rat corpus striatum. AB - This study examined the possibility that membrane phospholipids might be a source of choline used for acetylcholine (ACh) synthesis. Slices of rat striatum or cerebellum were superfused with a choline-free or choline-containing (10, 20 or 40 microM) physiological solution with eserine, for alternating 20 min periods of rest or electrical stimulation. Superfusion media were assayed for choline and ACh, and slice samples taken before and after stimulation were assayed for choline, ACh, various phospholipids, protein and DNA. The striatal slices were able to sustain the stimulation-induced release of ACh, releasing a total of about 3 times their initial ACh contents during the 8 periods of stimulation and rest. During these 8 cycles, 885 pmol/micrograms DNA free choline was released from the slices into the medium, an amount about 45-fold higher than the initial or final free choline levels in the slices. Although repeated stimulation of the striatal slices failed to affect tissue levels of free choline or of ACh, this treatment did cause significant, dose-related (i.e., number of stimulation periods) stoichiometric decreases in tissue levels of phosphatidylcholine (PC) and of the other major phospholipids; tissue protein levels also declined significantly. Addition of exogenous choline to the superfusion medium produced dose-related increases in resting and evoked ACh release. The choline also fully protected the striatal slices from phospholipid depletion for as many as 6 stimulation periods. Cerebellar slices liberated large amounts of free choline into the medium but did not release measurable quantities of ACh; their phospholipid and protein levels did not decline with electrical stimulation. These data show that membrane phospholipids constitute a reservoir of free choline that can be used for ACh synthesis. When free choline is in short supply, ACh synthesis and release are sustained at the expense of this reservoir. The consequent reduction in membrane PC apparently is associated with a depletion of cellular membrane. The use of free choline by cholinergic neurons for two purposes, the syntheses of both ACh and membrane phospholipids, may thus impart vulnerability to them in situations where the supply of free choline is less than that needed for acetylation. PMID- 2713683 TI - Postischemic changes of calcium and endogenous antagonist in the rat hippocampus studied by proton-induced X-ray emission analysis. AB - Proton-induced X-ray emission analysis (PIXE) was applied to determine ischemia induced changes in the content of calcium, iron, nickel and zinc in the rat hippocampus. After 30 min or 2 h reperfusion following 20 min of ischemia, the nickel content decreased and the zinc content increased. The calcium content was increased 50% after 30 min but was normal after 2 h reperfusion. PMID- 2713684 TI - Histamine-immunoreactive nerve fibers in the mammalian spinal cord. AB - New sensitive antisera against histamine were used to study the distribution of histamine-immunoreactive nerve fibers in the spinal cord of several mammalian species. Tissues were fixed with carbodiimide by transcardiac perfusion or immersion. A few immunoreactive nerve fibers were found in the cervical spinal cord of the rat in the superficial laminae of the dorsal horn, around the central canal and scattered in the anterior horn. The density of immunoreactive fibers in the cervical spinal cord of the guinea pig and tree shrew was higher, but still low. The densest networks of histamine-immunoreactive fibers were seen in the cervical spinal cord of the pig. The laminar distribution of histamine immunoreactive fibers was similar in all species. Histamine-immunoreactive fibers were densest in lamina X, followed by laminae I-II. Scattered fibers were also seen in the white matter in the lateral and posterior funiculus in the pig. In the rat and the guinea pig, no histamine-immunoreactive cell bodies were seen in the spinal sensory ganglia. The results suggest that the histamine-immunoreactive nerve fibers in the spinal cord may originate from the brain, probably from the posterior hypothalamus, and the fiber projection is more extensive in higher mammalian species. The role of histamine in the spinal cord is not known, but it may be involved in, e.g., pain sensation. PMID- 2713685 TI - Degeneration patterns in the chicken central nervous system induced by ingestion of the organophosphorus delayed neurotoxin tri-ortho-tolyl phosphate. A silver impregnation study. AB - Exposure to certain organophosphorus compounds results in a neurological condition known as organophosphorus-induced delayed neurotoxicity (OPIDN). OPIDN is characterized clinically by an initial post-exposure delay period of 8-14 days after which signs of progressively developing ataxia and paralysis of the hindlimbs are observed. Although several studies have reported the presence of degeneration induced by organophosphorus delayed neurotoxins in specific central nervous system (CNS) structures, none have systematically examined CNS changes seen in the most frequently studied animal model for OPIDN--the domestic fowl. In the present study, we assessed the location and extent of anterograde degeneration in the chicken CNS following exposure to tri-o-tolyl phosphate (TOTP). All birds were dosed with 500 mg TOTP/kg body weight and killed after post-exposure periods of 1, 2, 3, or 4 weeks. The brains and spinal cords were processed with Fink-Heimer and Nissl stains. In the spinal cord, axon degeneration was noted in the fasciculus gracilis at cervical levels two weeks after exposure to TOTP. At 3 weeks, degeneration was also present in the cervical part of the dorsal spinocerebellar tract, in the lumbar part of the medial pontine-spinal tract, and in lamina VII in the lumbar ventral horn. In the medulla, moderate amounts of terminal and preterminal degeneration appeared at two weeks in the lateral vestibular, gracile, external cuneate, and lateral cervical nuclei. Lesser amounts of degeneration were noted in the solitary, inferior olivary, and raphae nuclei, in the medial, descending and lateral vestibular nuclei, and in the lateral paragigantocellular, gigantocellular, and lateral reticular nuclei. Fiber degeneration was also present in the medullary portions of the dorsal and ventral spinocerebellar tracts and spinal lemniscus. In the cerebellum, moderate amounts of terminal degeneration appeared in the deep cerebellar nuclei at one week while moderate mossy fiber degeneration was first noted in the granular layers of cerebellar folia I-V at 3 weeks. These results indicate (1) that, in the CNS, axonal and terminal degeneration resulting from TOTP intoxication appears to be confined to the spinal cord, medulla and cerebellum, (2) that the time of onset of degeneration in different fiber tracts and nuclei ranges from one to three weeks post-exposure, and (3) that the delay in the appearance of clinical signs of OPIDN is consistent with the delayed onset of degeneration in many of the affected CNS fiber systems. PMID- 2713686 TI - Survival of adult 5-HT neurons following intraocular transplantation. AB - The present study was undertaken to provide an improved environment in which to examine the capacity of more mature CNS tissue to survive following transplantation. Tissue containing serotonin (5-HT) neurons from nucleus raphe dorsalis of 4- and 8-week-old rats was transplanted to the anterior chamber of the eye. Baseline conditions were improved by minimizing the time of the grafting procedure and enhancing the nutrition and oxygenation of the grafting medium. Additional treatment of the grafts during the 4 weeks of in oculo development included either: (1) intermittent hyperbaric oxygen (HBO), (2) continuous hyperoxia, or (3) control. In vivo measurement revealed that all grafts decreased significantly in size, a majority of which still demonstrated a small degree of vascularization. Microscopically, a significant percentage of the grafts demonstrated 5-HT-immunoreactive (5-HT-ir) fiber outgrowth into the host irides, although 5-HT-ir cell bodies could not always be discerned. In terms of percentage of grafts with surviving 5-HT-ir fibers, the best results were seen with the grafts treated with continuous hyperoxia (3 out of 4), as compared to HBO-treated grafts (4/18) and the control group (3/24). For both the HBO-treated and control groups, slightly better results were seen with 4-week-old vs 8-week old donor tissue. The density and the surface area covered by the 5-HT-ir fibers was not correlated with either treatment or donor age. Thus, while continuous hyperoxia or HBO treatment may have a positive effect, the enhanced baseline conditions appear to provide an environment in which to demonstrate that 5-HT neurons from 4- and 8-week-old rats possess the capacity to survive transplantation. PMID- 2713687 TI - The actions of two monoamines on spinal motoneurons from stimulation of the locus coeruleus in the cat. AB - The present study investigates the role of the two putative amine transmitters (norepinephrine and serotonin) in mediating the facilitatory action following locus coeruleus (LC) stimulation on hindlimb flexor and extensor monosynaptic reflexes (MSRs) in unanesthetized, decerebrate cats. When administered sequentially, in either order, methysergide (a serotonergic blocker) and prazosin (an alpha 1-adrenergic blocker) were observed to cause subtotal, decremental changes in the potentiation of gastrocnemius-soleus and common peroneal MSRs by stimuli applied in the LC. These changes were determined to be independent of the blood pressure changes induced by the aminergic blockers. These results support the hypothesis that the facilitation of the group Ia reflex transmission in cat spinal cord by stimulation of LC is mediated in part by alpha 1-noradrenergic and serotonergic mechanisms. PMID- 2713688 TI - Suppression of spontaneous LH surges in estrogen-treated ovariectomized rats by microimplants of antiestrogens into the preoptic brain. AB - Studies by others have shown that parenteral administration of antiestrogens blocks the positive feedback effect of estrogen on the luteinizing hormone (LH) surge mechanism. Since all estrogen-accumulating cells could be affected by this treatment, it is difficult to identify the site(s) at which this steroid acts to affect LH surges. In the present study we attempted to deprive specific hypothalamic neurons of estrogen by stereotaxically implanting antiestrogen containing microcannulae into the brains of ovariectomized (OVX) rats which, otherwise, were completely estrogenized. The animal model used in these studies was the 14-day OVX rat into which 2 estradiol-containing Silastic capsules were inserted s.c. on day 14 (day 0). Microcannulae were placed into either the medial or lateral preoptic nuclei (MPN, LPN) on day 0 and the effects on LH release were examined 2 days later (day 2). When empty cannulae were placed into the MPN or LPN, 6 of 7 and 8 of 8 rats, respectively, had normal spontaneous LH surges. In contrast, when cannulae containing either CI-628, LY 10074 or Keoxifene were implanted into MPN only 33.3, 0, and 14.3% of the rats, respectively, had LH surges by 16.00 h on day 2 (time of LH peak). When antiestrogen-containing cannulae were placed into the LPN, all rats displayed normal LH patterns of release and concentrations. The antiestrogens did not prevent estrogen from suppressing elevated high post-ovariectomy plasma LH concentrations (negative feedback). To evaluate whether Keoxifene affected releasable luteinizing hormone releasing hormone (LH-RH), we examined the effects of MPN-Keoxifene implants on LH secretion evoked by electrochemical stimulation (ECS) of the MPN or the medial basal hypothalamus (MBH). In ketamine-anesthetized rats with empty cannulae, plasma LH increased significantly to reach peak concentrations 30-45 min after ECS. Similar LH concentrations and release patterns occurred in rats with the antiestrogen implant. Other studies examined the effects of MPN-Keoxifene implants on norepinephrine (NE) concentrations and rate constants following administration of alpha-methyl-p-tyrosine. NE concentrations and rate constants in the MPN and median eminence did not differ significantly in rats which had received empty versus Keoxifene-containing microcannulae. In the final series of studies we examined the response of LH-RH neurons to an intracerebroventricular (i.c.v.) infusion of norepinephrine (20 micrograms). Plasma LH peaked within 10 min after i.c.v. NE and, thereafter, declined towards baseline. Keoxifene did not affect LH-RH neuronal responsiveness to i.c.v. NE.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2713689 TI - Sensitivity of magnocellular oxytocin neurones to opioid antagonists in rats treated chronically with intracerebroventricular (i.c.v.) morphine. AB - The identity of the subtype of opioid receptor mediating morphine dependence in relation to oxytocin neurones was investigated. Virgin female rats were implanted with a subcutaneous osmotic minipump to infuse morphine continuously (up to 50 micrograms/h) into a lateral cerebral ventricle. After 5 days of morphine infusion, rats were anesthetized with urethane, and the electrical activity of electrophysiologically identified supraoptic neurones was recorded extracellularly while opioid antagonists were injected i.v. Putative oxytocin cells were excited following low doses of naloxone HCl: 4/7 cells were excited by 1 microgram/kg, 6/7 cells by 2.5 micrograms/kg, and 11/13 cells by doses of 5-50 micrograms/kg. MR2266 ((-)-5,9 alpha-diethyl-2-(3-furylmethyl)-2'-hydroxy-6,7 benzomorphan: an antagonist with much greater affinity for kappa-subtype opioid receptors than naloxone) excited oxytocin cells less potently: none of 9 cells was excited by 10 micrograms/kg MR2266, 2/4 cells were by 25-50 micrograms/kg, 3/9 cells by 100 micrograms/kg and only 4/8 by 200-500 micrograms/kg. At low concentrations naloxone is selective for mu-subtype opioid receptors, hence the morphine dependence of oxytocin neurones is probably via mu-receptors. Naloxone methylbromide (MRZ), a quaternary ammonium derivative of naloxone, excited oxytocin cells in morphine-treated rats, but was at least 10 times less potent than naloxone. Thus part of the morphine-withdrawal excitation of oxytocin neurones may be mediated by mu-receptors outside the blood-brain barrier. PMID- 2713690 TI - Nociceptive responses of trigeminal neurons in SII-7b cortex of awake monkeys. AB - A cluster of trigeminal nociceptive neurons was located in the lateral sulcus on the upper bank of the frontoparietal operculum in a region bordering between cortical areas SII and 7b. These neurons were isolated in cortical cell layers IV and V-VI. All nociceptive neurons responded exclusively to noxious mechanical stimulation of cutaneous receptive fields on the face/head or intraoral tissue. Sustained noxious mechanical stimulation elicited slowly adapting responses that accurately encoded the duration of the stimulation. Prolonged discharges following removal of noxious stimulation were not observed. These nociceptive specific neurons poorly encoded graded noxious stimuli. Trigeminal somatosensory neurons within and surrounding the SII-7b cluster were not topographically organized according to divisions of the trigeminal nerve, laterality of receptive fields, or division of face/head and intraoral receptive fields. The thalamocortical, corticocortical and indirect corticolimbic connectivities of SII and area 7b and the possible role of SII-7b nociceptive neurons in learning, memory and avoidance behaviors are discussed. PMID- 2713691 TI - Effects of LTP-inducing tetanic stimulations of the perforant path on the commissural inhibition and facilitation of dentate granule cell discharge. AB - Effects of diazepam (1 mg/kg, i.p.) on the commissural influences on granule cells were first examined to further assess its GABAergic inhibitory mechanism. Whereas the commissural inhibition at an interval of 5-8 ms of the contralateral dentate-perforant path (CP) combined stimulus was not enhanced by diazepam, the commissural facilitation at a CP interval of 11-20 ms was reduced, suggesting that the GABAergic inhibition is involved in rather a part of the commissural facilitation at a CP interval of 11-20 msec than a part of the 'commissural' inhibition at a shorter CP interval. Based on the results of diazepam, effects of high-frequency stimulations of the perforant path on the commissural inhibition of dentate granule cells were then examined, in relation to their effects on the dentate paired-pulse depression. These stimulations produced the long-term potentiation of the perforant path-dentate excitatory synapse and significant reduction of the paired-pulse depression. The commissural inhibition at a CP interval of 5-8 ms remained unchanged following tetanization. The commissural facilitation at a CP interval of 11-20 ms was, however, slightly enhanced by tetanic stimulations and a statistical significance was obtained at a CP interval of 19 ms. These results imply that tetanic stimulations of the perforant path selectively reduce the GABAergic component of the commissural inhibition, as well as that of the paired-pulse depression. PMID- 2713692 TI - Classical conditioning leads to changes in extracellular concentrations of ependymin in goldfish brain. AB - ELISA measurements showed that brain extracellular fluid (ECF) levels of ependymin decreased for animals that learned to associate a paired presentation of a light stimulus (CS) with the onset of an electric shock (US), whereas no changes were obtained for control goldfish that received the same number of stimuli delivered in a random unpaired order. Studies of the time course of the changes showed an immediate decrease (19%) after training followed by an increase (20%) above baseline by 5 h and a final return to baseline by 25 h. These data extend the findings of previous experiments, which demonstrated a role for ependymin in two training procedures that involved motor learning, to classical conditioning where no motor learning occurs. Thus it appears that ependymin may have a functional role in molecular mechanisms of learning and memory in general. PMID- 2713693 TI - Neuronal-glial and synaptic plasticity in the adult rat paraventricular nucleus. AB - Using quantitative ultrastructural analysis on cells identified by immunogold postembedding immunocytochemistry, we show that magnocellular oxytocinergic neurons in the adult rat paraventricular nucleus (PVN) undergo significant neuronal-glial and synaptic changes upon stimulation. Thus, during lactation, the surface membranes of most PVN oxytocinergic somata and dendrites were directly juxtaposed; many were also contacted synaptically by the same axonal terminal ('shared' synapses). Non-oxytocinergic profiles showed few plasmalemma juxtapositions and 'shared' synapses. These ultrastructural changes are similar to those that modify oxytocin neurons in the supraoptic nucleus under the same conditions, and indicate that the whole oxytocinergic system in the hypothalamus is capable of neuronal-glial and synaptic plasticity when stimulated to release its neurohormone. PMID- 2713694 TI - Does the pulvinar-LP complex contribute to motor programming? AB - Extracellular unit recording studies in the pulvinar lateral posterior complex (Pul-LP) of behaving monkeys have shown a response property not previously reported. In monkeys performing aimed arm reaching movements towards frontally located targets some cells showed a change in activity beginning 495 +/- 84 ms before the onset of the reaching movement. This change in frequency precedes that observed in primary motor and parietal posterior cortex for reaching movements. These findings seem to indicate the involvement of the Pul-LP in motor functions and suggest its possible contribution to motor programming. PMID- 2713695 TI - De novo formation of axon-like processes from axotomized retinal ganglion cells which exhibit long distance growth in a peripheral nerve graft in adult hamsters. AB - Damaged axons in the central nervous system of the adult mammal can be stimulated to regenerate extensively into a peripheral nerve graft. It was generally believed that the new axonal sprouts which extend into the graft arose from the injured proximal axonal stumps. However, when retinal ganglion cells of the adult hamster were axotomized by crushing the optic nerve and the proximal axonal stump was not in direct apposition to the graft, a new axon-like process could be seen to be emitted from either the cell soma or dendrite and extended in the graft for at least 1-2 cm. This axon-like process was distinct from the original injured axon which could still be seen to course towards the optic disc in the retina. Evidently, even a fully differentiated central nervous system neuron of the adult mammal retains a great degree of morphological plasticity so that if the original axon is discouraged to regrow after injury, other parts of the neurons can act as favourable sites for the sprouting of a new axon-like process. PMID- 2713696 TI - Progressive changes in somatosensory cortical maps in 6-week-old kittens cord transected at T12. AB - Maps of primary somatosensory cortex were obtained using multiunit recordings immediately, and 3, 6, 9 and 12 weeks following cord-transection (T12) performed on 6-week-old kittens. Results suggest that cortex responds to the injury in two stages: (1) after 3 weeks, all deprived cortex can be excited by the remaining afferent input with little somatotopic organization: and (2) by 12 weeks, the area of drivable cortex has decreased, but somatotopic organization is present within this region. PMID- 2713697 TI - Evidence for central phenomena participating in the changes of responses of ventrobasal thalamic neurons in arthritic rats. AB - In this study performed in the Freund's adjuvant-induced arthritic rat, a local injection of lidocaine in one hind paw strongly depressed the ventrobasal thalamic neuronal responses to mild stimulation of both ankles. In parallel, a behavioral study provided evidence for a bilateral hypoalgesia, tested by the vocalization threshold to paw pressure, after a unilateral anesthetic block. The involvement of central phenomena in the changes of neuronal responsivity described in this model of experimental pain is therefore suggested. PMID- 2713698 TI - Repeated haloperidol administration changes basal release of striatal dopamine and subsequent response to haloperidol challenge. AB - The effects of acute or repeated administration of haloperidol on release of dopamine (DA) and homovanillic acid (HVA) from striata of awake rats were studied using a microdialysis probe. A single injection of haloperidol (1 mg/kg, i.p.) produced a time-dependent increase in DA and HVA in the perfusate. Comparative studies in rats anesthetized with 300 mg/kg of chloral hydrate given i.p. found that anesthesia decreased the basal release of DA, but not HVA, and significantly blocked haloperidol-induced increases in DA, while haloperidol-induced increases in HVA were not affected. Studies done in awake rats found that 21 repeated daily injections of haloperidol increased the basal release of DA, but not HVA. Subsequent challenge with haloperidol indicated a significant decrease in responsiveness to haloperidol-induced release of DA, but not HVA, in chronically dosed rats. These data suggest that repeated exposure to haloperidol causes a compensatory increase in extracellular DA release. That these compensatory changes may be associated with the increased therapeutic efficacy or extrapyramidal side effects of neuroleptics following repeated dosing warrants further study. PMID- 2713699 TI - Monosynaptic connections between serotonin-containing neurones labelled by 5,6 dihydroxytryptamine-induced pigmentation in the snail Helix pomatia L. AB - Microelectrophysiological experiments were carried out on in vivo 5,6 dihydroxytryptamine-induced pigment-labelled serotonin-containing neurones of Helix pomatia. Excitatory chemical monosynaptic connections were found between the giant pedal LP3 neurone and several follower cells in the visceral and right parietal ganglia. These neurones have previously been described to be involved in regulation of visceral functions. Monitoring changes in identified monosynaptic connections between pairs of serotonin-containing neurones aids the cellular analysis of behavioural plasticity. PMID- 2713700 TI - Changes in premovement activity in primary somatosensory cortex differ when monkeys make hand movements in response to visual vs vibratory cues. AB - Rhesus monkeys were taught to make identical wrist flexion and extension movements in response to either a visual cue or to vibratory cues. Changes in firing rates that were not stimulus-associated but preceded the movements were measured for each primary somatosensory cortical neuron recorded under the two stimulus cued conditions. The onset of the premovement activity changes and the magnitude of these changes differed when visually cued trials were compared with vibratory cued trials that resulted in the same behavioral response. In general, the magnitudes of premovement activity changes were less and the onset of these changes occurred earlier for vibratory cued trials than for the corresponding trials triggered by the visual stimulus. These findings support the hypothesis that centrally generated modulatory influences arriving at primary somatosensory cortical neurons prior to movement onset may differ, depending upon the modality of the stimulus which signals that a movement may be initiated. PMID- 2713701 TI - Involvement of nigrotecto-reticulospinal pathways in the iminodipropionitrile (IDPN) model of spasmodic dyskinesias: a 2-deoxy-D-[1-14C]glucose study in the rat. AB - Chronic administration of iminodipropionitrile (IDPN) to rats causes a persistent behavioral syndrome characterized by lateral and vertical head twitches, random circling, and increased tactile and acoustic startle responses. In order to identify brain areas which are affected in rats manifesting this syndrome, we used the autoradiographic 2-deoxy-D-[1-14C]glucose ([14C]DG) method to map cerebral glucose utilization in IDPN-treated rats. One day after the development of the dyskinetic syndrome, there were significant decreases in local glucose utilization in the substantia nigra pars reticulata (SNr) and compacta (SNc), the dorsal raphe, the superficial and deep layers of the superior colliculus, the inferior colliculi, the interpeduncular nucleus, the medial and dorsolateral geniculate nuclei, and the superior and lateral vestibular nuclei. There were also significant decreases in layer 2 of the cingulate cortex and in the temporal and occipital cortices. In contrast, there were no changes in the motor cortex, the caudate-putamen, the nucleus accumbens, or the median raphe. These findings suggest that deleterious effects of IDPN on the nigrotectal pathways which affect head and neck movements and circling behaviors via the brainstem reticulospinal tracts may play an important role in the IDPN-induced persistent spasmodic dyskinetic syndrome in rats. PMID- 2713702 TI - Uptake and concentrations of calcium in rat choroid plexus during chronic hypo- and hypercalcemia. AB - The choroid plexus has been implicated in the regulation of cerebrospinal fluid (CSF) [Ca], but little information is available concerning Ca transport by this epithelium. We determined the transfer coefficients for 45Ca uptake into choroid plexus from blood, as well as tissue [Ca], in weanling Fischer-344 rats fed low, normal, or high Ca diets for 8 weeks. Plasma [Ca] decreased by 45% with low Ca diet and increased by 25% with high Ca diet. Choroid plexus 45Ca uptake varied inversely with plasma [Ca]. This relation was due largely to changes in extracellular Ca binding rather than to entry from blood, as the transfer coefficient was independent of plasma [Ca]. The extracellular Ca distribution in choroid plexus, the intercept of a plot of tissue 45Ca distribution against time, was reciprocally related to plasma [Ca]. Changes in total cell [Ca] during hypercalcemia were equivalent to those in plasma, and in hypocalcemia were 70% of those in plasma. These findings indicate that regulation of CSF [Ca] does not involve saturable transport of Ca into the choroid epithelium from blood, and that the apical membrane of the choroid epithelium is involved in homeostasis of CSF [Ca]. PMID- 2713703 TI - Segmental release of Met-enkephalin-like material from the spinal cord of rats, elicited by noxious thermal stimuli. AB - In order to investigate possible changes induced by noxious thermal stimuli in the activity of enkephalinergic neurones at various levels of the spinal cord, either the whole cord, the cervicotrigeminal area or the lumbar area were perifused with artificial CSF at a rate of 0.1 ml/min in halothane anaesthetized rats, and Met-enkephalin-like material (MELM) was measured in 0.5 ml fractions collected from the perifusates. Immersing the muzzle of intact rats in water at 52 degrees C produced a significant enhancement of MELM content in perifusates from both the whole spinal cord and the cervicotrigeminal area but not from the lumbar area. Heating the tail resulted in an increase in MELM release from the whole spinal cord of intact as well as of cervically transected rats. It is concluded that noxious thermal stimuli can induce a segmental release of MELM, i.e., only within spinal zones receiving the nociceptive inputs. PMID- 2713704 TI - Role of pontomedullary reticular formation neurons in horizontal head movements: an ibotenic acid lesion study in the cat. AB - Single-cell recording, electrolytic lesion and electrical stimulation studies have indicated that the pontomedullary reticular formation (PMRF) plays a role in head movement (HM) control. However, recent studies utilizing excitotoxin lesions of the PMRF have reported no effect on HM. In the present study, we have examined the acute and chronic motor effects of injecting ibotenic acid (IBO) into the nucleus reticularis pontis oralis, nucleus reticularis pontis caudalis and rostral medullary nucleus gigantocellularis of the feline PMRF. IBO injections in all of these regions induced tonic flexion of the head toward the ipsilateral side. This effect lasted 4-16 h. It was followed by a second phase in which head flexion and whole body circling were directed toward the contralateral side. Although this forced contralateral head turning disappeared within two days, the tendency to turn contralaterally and the impaired ability to make rapid ipsilateral HMs were present throughout survival periods lasting more than 4 months. Unilateral IBO PMRF lesions reduced the amplitude of vestibular induced quick phase (anti-compensatory) HMs toward the ipsilateral side and resulted in abnormally large and persistent slow compensatory HMs toward the contralateral side. Following IBO injections, the threshold intensity for HMs evoked by electrical stimulation at the injection site was elevated, and the amplitude and velocity of evoked HMs reduced. Histological data indicated that the reticular area involved in HM control was relatively large and probably extended beyond the PMRF region examined here. However, lesions including the nucleus reticularis pontis caudalis (NRPC) produced more severe and persistent HM deficits than those including the nucleus reticularis gigantocellularis. These data together with available anatomical and electrophysiological evidence indicate that PMRF neurons play a critical role in the generation of fast horizontal HMs toward the ipsilateral side. PMID- 2713705 TI - Absence of long-term potentiation in the subcortically deafferented dentate gyrus. AB - All subcortical afferents to the dorsal hippocampus, running in the fimbria fornix and supracallosal path, were removed by aspiration. Three to 5 months later the rats were implanted with chronic recording electrodes in the dentate gyrus and CA1 region, and stimulating electrodes in the angular bundle. In non lesioned rats, high-frequency trains delivered to the angular bundle gave rise to a sustained increase of the evoked population spike in the dentate gyrus. In lesioned animals, high-frequency stimulation resulted in only short-lasting changes, and by 15 min after the conditioning trains the amplitude of both the population spike and field postsynaptic potentials returned to baseline. In lesioned rats large amplitude interictal spikes (less than 40 ms, 3-8 mV) occurred spontaneously. These findings suggest that either (1) coactivation of entorhinal and subcortical inputs is essential for the induction of long-lasting plastic changes in the dentate gyrus, or (2) the long-term potentiation mechanism is saturated by the chronically occurring interictal discharges in the subcortically denervated dentate gyrus. PMID- 2713706 TI - Spinal cord--recent work on trauma and recovery. Papers from a meeting. Paris, France, September 15-17, 1987. PMID- 2713707 TI - Spinal cord--recent work on trauma and recovery: introductory comments. PMID- 2713708 TI - Formation of functional endplates by spinal axons regenerating through a peripheral nerve graft. A study in the adult rat. AB - Peripheral nerve (PN) autografts were used in the adult rat to join the midcervical spinal cord to a nearby denervated skeletal muscle. Retrograde tracing, morphological and electrophysiological studies indicated the following: 1) a great number of neurons, located bilaterally, between C3 and C7 in most laminae of the grey matter, extended axons into the PN grafts, 2) a lesser number of neurons regenerated up to the reconnected muscle, but most of them were typical motoneurons, 3) neuromuscular junctions were formed in ectopic locations, around the tip of the grafted nerve, and at the sites of original endplates, 4) these junctions were functional and formed by axons that had regenerated into the PN bridges, as muscle contraction was obtained by electrical stimulation of the grafted nerves, 5) they were proved to be cholinergic since endplate potentials, evoked by stimulating the PN graft, were suppressed by curare. These results strongly suggest that spinal neurons, and especially motoneurons, are involved in the formation, through PN bridges, of new functional cholinergic connections with denervated skeletal muscles. PMID- 2713709 TI - Locomotion in rats transplanted with noradrenergic neurons. AB - It is known that catecholaminergic drugs can induce both locomotion and a late flexion reflex in spinalized animals. We studied spinal reflexes and locomotor activity in five adult spinal rats which had received a suspension of fetal noradrenergic (NA) neurons below the transection and in three control spinal rats. A rhythmical activity similar to the one of locomotion was regularly observed in three of the grafted rats held above a moving belt. In two of them, the step frequency was increased when the velocity of the moving belt was increased. This was not observed in control rats. A late flexion reflex was obtained in grafted rats that displayed locomotor activity, as well as in two controls. In the two rats which exhibited locomotor activity, analysis showed numerous immunoreactivite (against NA) cells and processes with terminals concentrated around the perikarya of motoneurones. PMID- 2713710 TI - Intraspinal transplants of serotonergic neurons in the adult rat. AB - Adult male Sprague-Dawley rats were made paraplegic by a complete transection of the spinal cord at lower thoracic level. One week later they were transplanted, below the level of the section, with a cell suspension prepared from the raphe region of 14-day embryos. After survival periods of 10 days to 1 year, the animals were sacrificed and the spinal cord processed for the immunocytochemical detection of 5-HT. Axons from grafted cells grew extensively into the grey matter of the host, and established axosomatic and axodendritic synapses in the anterior horn and intermediolateral column, similar to those of the intact animal. In addition, a group of transplanted animals was tested for sexual reflexes which are under the control of serotonin. It was found that ejaculation reflexes, which are absent in paraplegic rats, are restored in transplanted animals. PMID- 2713711 TI - Structural and functional analysis of raphe neurone implants into denervated rat spinal cord. AB - The ability of grafts of embryonic raphe cells to the adult rat spinal cord to reverse the morphological, neurochemical and functional deficits caused by ablation of the serotoninergic afferents has been studied. After grafting, extensive reinnervation was observed by 5HT-immunoreactive fibres, many of which appeared to make contacts with host motoneurones. The neurotransmitter complement was apparently normal. There was also a reinstatement of 5HT levels in the denervated cord after transplantation, amounting to some 40% of normal at the level of the graft. Similarly, Na+-dependent uptake of [3H]-5HT into P3 fractions was over 40% of that recorded in unlesioned animals. Antidromic stimulation of the ventral roots of the spinal cord was used to assess the degree of motoneurone excitability. The field potential in the ventral horn of grafted animals was increased by electrical stimulation of discrete regions along the cord, probably corresponding to the graft loci. It is concluded that serotoninergic neurones transplanted to the denervated spinal cord survive and develop normally, reinnervating the host tissue extensively. Furthermore, the graft/host connections appear to be functionally viable. PMID- 2713712 TI - Graft derived reafferentation of host spinal cord is not necessary for amelioration of lesion-induced deficits: possible role of migrating grafted astrocytes. AB - The present study explores the ability of fetal spinal cord homografts into lesioned host C3 fasiculus gracilis to influence the expected deterioration of hindlimb performance following this lesion. Rats were trained to traverse a narrow platform for a water reward. Animals were ranked for hindlimb performance utilizing slips, recovery and manner of traversing the platform. After training the animals, numbers were recorded, laminectomy performed at C3 and subject fasiculus gracilis (FG) bilaterally aspirated. Half the subjects were randomly selected for implantation of two, one mm segments of 14 day gestation cervical spinal cord. Recorded lesion-only and lesion-transplanted animals were tested 21, 30, 45, 60 and 90 days later. C3 fetal transplants significantly decreased the severity of hindlimb deficit at 21 and 90 days postlesion (p less than 0.05). The C1-FG of both groups contained no nerve fibers. However, the host nucleus gracilis of lesion-transplant animals contained normal sizes and numbers of neurons whereas the lesion-only group did not. This neuronal maintenance may have been due to factor(s) secreted by transplant derived astrocytes which migrated at 0.72-0.76 mm/day and reside in the host nucleus gracilis. PMID- 2713713 TI - Molecular genetic approach to the study of mammalian choline acetyltransferase. AB - The enzyme choline acetyltransferase catalyses the biosynthesis of the neurotransmitter acetylcholine and constitutes a specific marker of cholinergic system. To date, there is very limited information about the structure of the mammalian enzyme. More detailed understanding of this enzyme is particularly desirable because of the importance of the cholinergic system in neurotransmission, as well as the possible involvement of this system in certain neurological disorders. In this article, recent studies concerning the isolation of a cDNA encoding the complete sequence of the porcine enzyme are reported and the potential applications of this probe are discussed. PMID- 2713714 TI - Spinal traumas: some postoperative complications in experimental animals. AB - Animals with severe spinal traumas show paraplegic syndrome and various somatic and autonomic dysfunctions. Of the various dysfunctions those related to hypothermia, bladder problems, and autophagia are of serious nature. The condition of animals with these complications deteriorates rapidly, and the animals are sacrificed for histological and pathological analyses. The findings show that the postoperative complications are related to the degree of severity of the trauma, and that 50-80% animals are lost due to these complications. Most of these animals are lost during the first two weeks after surgery, and the remaining at later stages. Transplantation of neural tissue at the site of lesion does not ameliorate these postoperative complications and improve the survival rate of the animals. PMID- 2713715 TI - Transsynaptic degeneration of motoneurones caudal to spinal cord lesions. AB - We studied the effects of complete transversal section of the spinal cord, at T8 10, in adult rats, upon the number and morphology of identified motoneurones in lumbar segments L4 and L5. In observations by light and electron microscopy many lumbar motoneurones had structural abnormalities when the interval between surgery and perfusion ranged between a few hours and one week. We found also that as many as 25% of the motoneurones distal to a cord transection disappeared as a consequence of the lesions. We did not find comparable changes in the spinal cord at C6 after transection at T8-10. Complete removal of the cerebellum did not reduce the lumbar motoneurone counts. Bilateral ablation of the "motor" cortex did cause a reduction of motoneurone counts at L4-5; these animals showed normal or near normal spontaneous locomotor activity beginning a few days after the lesion was placed. Motoneurone counts were significantly reduced after partial cord lesions that spared the dorsal funiculi (where the corticospinal tract travels in the rat), but in this case the rats were paraplegic as a result of the lesion. Cord transection at 7 days of postnatal age resulted in reduced motoneurone counts when the rats reached adulthood. Intraspinal or subarachnoid administration of colchicine led to reduced motoneurone counts. Prolonged infusion of a GABA agonist, muscimol, into the lumbar CSF did not prevent the loss of motoneurones produced by cord transection. Pretreatment of animals with a Ca2+ channel blocker (nimodipine) did not prevent the effects of cord transection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713717 TI - Glial activity during axonal regrowth following cryogenic injury of rat spinal cord. AB - The cryogenic model of spinal cord injury is associated with regrowth of axons through a zone of injury which is composed of a complex matrix of intact blood vessels, cells and extracellular materials. We have used this, therefore, as a means for studying the relationship between these cellular components, particularly the astrocytes, and the regrowing axons. For the time period of 60 days following injury we have found that, from an undifferentiated group of cells which appears early, there develops a population of astrocytes which is associated with the restoration of neural structure, including the return of axons, to the damaged area. We interpret these associations to be supportive through direct axonal interactions and indirect environmental contributions. PMID- 2713716 TI - Characterization of dissociated monolayer cultures of human spinal cord. AB - Embryonic human spinal cord cells have been grown in dissociated monolayer cultures for 1 to 7 weeks. Using cell type specific markers, it was possible to show that the cultures contain neurons, astrocytes and fibroblasts. Electrical membrane properties were studied with patch electrodes using the whole cell recording technique. Neurons had short duration action potentials that could be blocked by tetrodotoxin. The membrane currents in these neurons were studied in voltage clamp experiments. Three types of voltage-dependent currents were observed: a sodium current; a potassium current made up of two components, IA and IK; and a calcium current. Both cholinergic and GABAergic neurons are present in the cultures. There is more choline acetyltransferase activity in cultures prepared from the anterior as compared to the posterior part of the spinal cord, suggesting that the cultures contain motoneurons. This tissue culture preparation was developed for the study of amyotrophic lateral sclerosis; we have been unable to detect the presence of any toxic agent from the serum of these patients on the cultured cells. Experiments are in progress to purify the motoneurons using Percoll gradients. PMID- 2713718 TI - Reactive astrocytes in lesioned rat spinal cord: effect of neural transplants. AB - The astroglial reaction following a laceration-type surgical lesion of rat spinal cord is recognized by hypertrophy of astrocytes. This phenomenon can be readily demonstrated by enhanced immunoreactivity for glial fibrillary acidic protein (GFAP) and a recently discovered 30 kD protein (J1-31 antigen). The results reported in this article lead to the conclusion that the astroglial reaction is not influenced significantly by the transplantation of embryonic neocortical tissue to the cavity of a laceration-type lesion. These observations could be relevant to the assessment of strategies for treatment of spinal cord injury. PMID- 2713719 TI - Prospects for axonal regrowth in spinal cord injury. AB - Some of the evidence relating to the possible cellular relationships in regenerating mammalian central nervous tissue is reviewed. From this review it is suggested that data do exist which reveal a potential for regeneration based upon the basic properties and behavior of axons and glial cells. Models of tissue injury which optimize these intrinsic capabilities may generate significant information about the regenerative possibilities of central nervous tissue. PMID- 2713720 TI - Nerve fibre regeneration across the PNS-CNS interface at the root-spinal cord junction. AB - Root-spinal cord regeneration was investigated in immature and adult rats. The elongation in the dorsal root of regrowing dorsal root axons, rerouted ventral root nerve fibres (cholinergic neurons) or hypogastric nerve fibres (catecholaminergic neurons) is impeded as they meet the astrocyte dominated CNS tissue of the root. The establishment of synaptoid nerve terminals as the regrowing axons encounter astrocytes indicates a mechanism for growth inhibition other than a physical impediment in the CNS environment. The glial cells of the CNS segment in the root are influenced by the type of regenerating nerve fibres in terms of maintenance, multiplication and phenotypic expression. After a dorsal root lesion in the neonatal rat several root axons may reinnervate the spinal cord. In these rats, the normal establishment of a CNS root segment has been disrupted and the PNS-CNS border is situated central to the root-spinal cord junction. Implantation of cut dorsal roots into the spinal cord of adult rats results in the extension of processes from intrinsic spinal cord neurons out into the root. After implantation of avulsed ventral roots into the ventro-lateral aspect of the cord, axonal regrowth and functional restitution of alpha motoneurons could be demonstrated by intracellular recordings and injections with horseradish peroxidase. These results show that regeneration can occur across a PNS-CNS interface that has been established secondary to a trauma in the mature animal and in the immature animal before the astrocyte-rich CNS root segment has been developed. PMID- 2713721 TI - Brainstem location of serotonin neurons projecting to the caudal neurosecretory complex. AB - Serotonergic fibers in the caudal neurosecretory complex (CNc) of poeciliids originate from neurons within, and extrinsic to this spinal cord nucleus. In the present study, retrograde tracing and immunofluorescence techniques were combined to localize extrinsic serotonergic projection neurons. The entire spinal cord and brain were sectioned after Fast Blue (FB) or horseradish peroxidase (HRP) was implanted in the CNc. No HRP or FB filled neurons were found in the spinal cord. Retrogradely filled neurons were found bilaterally in dorsolateral and ventromedial reticular nuclei, and the dorsal midbrain tegmentum. Fusiform cells in the medullary fasciculus longitudinalis medialis filled with FB but not HRP. Serotonin immunopositive neurons were found surrounding the third ventricle, in the raphe and in medullary reticular nuclei. Double labelled neurons in the medial reticular nucleus were determined to be the source of serotonergic projections to the CNc. Reticular projection nuclei are strategically situated to receive visceral sensory input from rhombencephalic cranial nerves. These putative pathways may provide an anatomical substrate by which visceral sensory information is transmitted to the CNc. PMID- 2713722 TI - Cortical projection of giant neostriatal neurons in the cat. Light and electron microscopic horseradish peroxidase study. AB - Following voluminous injections of horseradish peroxidase (HRP) in various neocortical fields, a small number of labeled large neurons are observed ipsilaterally in the putamen, striatal ponticuli, caudate nucleus, and nucleus accumbens septi. The bulk of the corticopetal cells are found in the putamen and in the striatal ponticuli. A more significant number of labeled neurons is encountered following injections in auditory and sensorimotor cortex, followed by the prefrontal and premotor cortex; very few cells project to the visual cortex. Ultrastructurally, the large HRP-labeled neurons display an eccentrically located, indented nucleus, abundant granular endoplasmic reticulum forming Nissl bodies, well developed Golgi zones, and numerous dense bodies. The simultaneous demonstration of retrogradely transported HRP and acetylcholinesterase (AChE) suggest that the large neurons are presumably cholinergic. These results provide evidence that at least some of the giant striatal neurons are efferent cells. The coincidence of cytological, histochemical, and hodological criteria invite the speculation that the giant corticopetal neostriatal neurons might be related to the magnocellular cholinergic groups of the basal forebrain (especially the Ch4 group). PMID- 2713723 TI - Mesocortical dopaminergic neurons. 1. Electrophysiological properties and evidence for soma-dendritic autoreceptors. AB - Mesencephalic dopaminergic neurons were electrophysiologically identified by a variety of criteria, including antidromic activation from prefrontal or cingulate cortex, neostriatum, or nucleus accumbens in urethane-anesthetized rats. The mean firing rate of 98 mesocortical dopaminergic neurons was 2.9 +/- 0.3 spikes/sec and did not differ from the mean firing rate found for nigrostriatal or nucleus accumbens dopaminergic neurons. Spontaneously active mesocortical dopaminergic neurons were inhibited by intravenous administration of either apomorphine (6 micrograms/kg) or amphetamine (0.25 mg/kg). Whereas most antidromic responses of nigrostriatal and mesoaccumbens neurons consisted of the initial segment spike only, cortically-elicited antidromic responses typically consisted of a full initial segment-soma-dendritic spike. These findings are discussed with regard to the presence of soma-dendritic autoreceptors on mesocortical dopaminergic neurons. PMID- 2713724 TI - Mesocortical dopaminergic neurons. 2. Electrophysiological consequences of terminal autoreceptor activation. AB - Measurement of drug- and stimulation-induced changes in the electrical excitability of dopaminergic terminals was employed to assess the effects of stimulation of dopamine terminal autoreceptors in the prefrontal cortex in urethane-anesthetized rats. Systemic or local administration of amphetamine decreased, whereas systemic administration of haloperidol increased the excitability of prefrontal cortical dopaminergic terminals of ventral tegmental area dopaminergic neurons. Mesoprefrontal dopaminergic terminal excitability was also responsive to spontaneous and stimulation-induced alterations in the rate of impulses reaching the terminal fields. These results are comparable to those previously reported for nigrostriatal and mesoaccumbens dopaminergic neurons, and are discussed with regard to the operational characteristics of autoinhibition in the mesocortical dopaminergic system. PMID- 2713725 TI - Effects of food intake and body weight on a serotonergic turnover index in rat hypothalamus. AB - Absolute levels and ratio of serotonergic compounds in food-related hypothalamic nuclei were determined with a chromatographic method comparing for control (C) versus lean (L) versus obese (O) rats. In all three groups, a second parameter, i.e., fasting (F) versus satiation (S) was superimposed on the body weight factor. Indoleamine levels failed to show statistical differences depending on the body weight and/or the nutritional status. A significant negative correlation between an index of the serotonin turnover, the 5-HIAA/5-HT ratio, and body weight was found for the paraventricular (PVN) nucleus in the C and L groups as well as for the lateral (LH) nucleus for the C and O groups. A positive correlation was found for the ventromedian (VMH) nucleus in the O group. These data suggest that the body weight factor is implicated in the central serotonergic regulation more than the feeding parameter. PMID- 2713726 TI - Microdialysis measurement of monoamine and amino acid release from the medial preoptic region of the sheep in response to heat exposure. AB - Concentrations of monoamines and metabolites and amino acids were measured in microdialysis samples taken from the medial preoptic area of 5 conscious sheep before, during and after exposure to an ambient temperature of 45 degrees C. Concentrations of dopamine, noradrenaline and aspartate significantly increased, and those of the serotonin metabolite, 5-hydroxyindole-3-acetic acid (5-HIAA), significantly decreased during heat exposure and although panting was induced, body temperature did not change. Concentrations of noradrenaline and aspartate declined and 5-HIAA increased to preheat exposure levels during the 60 min after the ambient temperature was reduced but levels of dopamine and its metabolite, homovanillic acid, remained elevated. Dopamine, noradrenaline, 5-HIAA and aspartate concentrations were not significantly altered by isolation stress and did not show significant changes in the cortex following heat exposure. These experiments provide further support for the proposed roles of dopamine, noradrenaline, serotonin and aspartate in the neural control of autonomic thermoregulatory responses. PMID- 2713727 TI - Norepinephrine content of discrete brain nuclei in acutely and chronically stressed borderline hypertensive rats. AB - Forty-three male borderline hypertensive rats were subjected to either 3 days, or 4, 10, or 16 weeks of daily stress. An additional 43 animals served as unstressed, age-matched controls. At the end of study, animals were sacrificed, brains were removed, and cardiovascularly-important nuclei in the brainstem and hypothalamus were removed by micropunch. Assays revealed that norepinephrine (NE) levels were initially elevated in the brainstem in animals stressed for 3 days. As stress continued, NE levels were significantly lower in the brainstem, and eventually in the hypothalamus, of stressed animals. The relationship of these observations to environmentally-induced hypertension is discussed. PMID- 2713728 TI - Activity of hypothalamic neurons in conscious rats decreased by hyperbaric environment. AB - Single-unit activity of neurons in rat hypothalamus, prefrontal cortex (PFC) and central medial thalamus (CM) was recorded through chronically implanted electrodes. Upon being subjected to 7 atmospheres absolute (ATA) hyperbaric air (709 kPa) environment, about two-thirds of the hypothalamic neurons tested reversibly decreased their firing rate to 71 +/- 12% (mean +/- SD, n = 25) compared to the precompression control activity, and the remaining one-third did not change their firing rate (100 +/- 6%, n = 13). It is suggested that the decrease in firing rate was attributable to increased partial pressure of both oxygen and nitrogen. In contrast to the hypothalamus, the firing rates of most neurons in the PFC and CM did not decrease (99 +/- 9% for PFC, 107 +/- 12% for CM). In separate acute experiments, 3 out of 5 hypothalamic neurons tested in the isolated forebrain also decreased their firing rates in hyperbaric environment. The results suggest that the hyperbaric air acted directly on the forebrain and depressed more than half of the hypothalamic neurons. PMID- 2713729 TI - In vitro electrophysiology of neurons in the lateral dorsal tegmental nucleus. AB - The lateral dorsal tegmental nucleus (LDT) provides ascending cholinergic projections to forebrain structures such as prefrontal cortex, septum, habenula, and thalamus, but relatively little is known of the physiology of LDT neurons. Intracellular recordings from LDT neurons in guinea pig brain slices found that most neurons fired action potentials either tonically or in bursts. The voltage dependent characteristics of the neurons suggest that a prolonged afterhyperpolarization due to an outward potassium current and a low-threshold calcium conductance contributed to these two modes of firing. Intracellular injections of Lucifer Yellow and subsequent staining for NADPH-diaphorase activity permitted positive identification of cholinergic neurons. PMID- 2713730 TI - A procedure for chronic recording of diaphragmatic electromyographic activity. AB - A simple procedure for recording of diaphragmatic electromyographic activity in awake, freely behaving animals is described. This procedure produces highly stable recording of muscle activity for very long periods. Because of its ease of use, the procedure has become the technique of choice for acute recording in our laboratories as well. The present procedure can also be adapted for chronic recording of electromyographic activities from nonrespiratory muscles. This option thus offers a variety of applications to those involved in investigations into the central neuromotor control of movement, pattern generation and autonomic functions. PMID- 2713731 TI - Central dopamine-synthesis regulation by the calcium-calmodulin-dependent system. AB - The effects of the intraventricular (IVT) administration of calcium on the amount of dopamine (DA) in various regions of the mouse brain were analyzed immunohistochemically by using a microphotometry system. The DA levels in the nucleus accumbens and the lateral part of the neostriatum were increased by approximately 45% (p less than 0.01) and 25-35% (p less than 0.01), respectively, by the IVT administration of CaCl2 (10 mumol/kg). It was also found that this effect was abolished by the calmodulin antagonist, W-7 (4.2 micrograms/mouse, IVT). The brain regions in which the amount of DA was increased by calcium were areas where high levels of calmodulin and tyrosine hydroxylase are distributed. These findings suggest that the synthesis of central DA is regulated by calcium through a calmodulin-dependent system. PMID- 2713732 TI - Age-dependent expression of microtubule-associated protein 2 in the ventromedial nucleus of the hypothalamus. AB - A distinctive developmental pattern of microtubule-associated protein 2 (MAP2) was detected in the ventromedial hypothalamus of rats. A region of more intense MAP2 immunoreactivity in this nucleus was present at birth, became prominent in a ringed appearance by postnatal day 4 and disappeared in the third postnatal week. This period of selective MAP2 expression in particular subcortical regions may signify important functions of MAP2 in the stabilization of developing dendritic structure. PMID- 2713734 TI - Mental illness in Ireland. PMID- 2713733 TI - An integrating averager of microspectrofluorometric signals. AB - Optical signals are used to measure a variety of cell events; in particular, ratiometric fluorescent dyes offer diverse applications, but bring with them the difficult analytical problem of obtaining optical signals at rapidly alternating wavelengths. An improved method for using a computer to record these optical signals is described, and an example record of a Ca+2 transient given. A second technical problem is that ultraviolet (UV) light is required to excite many fluorescent dyes; many common lenses cannot transmit UV light. This article describes the tests needed to measure and optimize the optical path taken by light through a microscope and provides examples with sample lenses. PMID- 2713735 TI - Cancer--the big 'C'. What the doctor says. PMID- 2713736 TI - Food allergy symptoms. PMID- 2713737 TI - Kangaroo babies. PMID- 2713738 TI - Proportion-altering factor (PAF) stimulates nerve cell formation in Hydractinia echinata. AB - The low-molecular weight proportion altering factor (PAF) from colonial hydroids has general animalizing effects on morphogenesis in hydroid development. On the cellular level, the factor stimulates the formation of nerve cells in several developmental stages of Hydractinia echinata. Treatment during metamorphosis yielded a fivefold increase in the number of nerve cells with FMRF-amide-like immunoreactivity. In non-metamorphosing planula larvae, PAF triggered the differentiation of nerve cells that normally develop only upon initiation of metamorphosis and that occur in the polyp stage. After post-metamorphic treatment of young primary polyps, nerve cell numbers increased to 2.5 times the normal value. PMID- 2713739 TI - The exogastrula-inducing peptides in embryos of the sea urchin, Anthocidaris crassispina--isolation and determination of the primary structure. AB - Four exogastrula-inducing peptides, A, B, C, and D have been isolated from the homogenates of embryos of the sea urchin, Anthocidaris crassispina, with successive chromatographic fractionations. The complete amino acid sequences of the peptides A and D were determined by analysis of the peptides generated by their digestion with lysyl endopeptidase. They were composed of 52 and 53 amino acid residues, and their molecular weights were calculated to be 5754 and 5737, respectively. The sequences of peptides A and D were DSVYQCNRDTNSCDGFGKCEKSTFGRTTGQYICNCDDGYRNNAYGGCSPRTE, and DTVARCERDTKNCDGHGTCQLSTFGRRTGQYICFCDAGYRKPNSYGGCSPSSA, respectively. The biological significance of the exogastrula-inducing peptides was discussed. PMID- 2713740 TI - Evidence of a precursor-product relationship between vitellogenin and toposome, a glycoprotein complex mediating cell adhesion. AB - Toposome, a large and oligomeric glycoprotein complex isolated from mesenchyme blastula embryos, was defined as a cell-adhesion molecule expressing positional information specificities during sea urchin embryogenesis. This report describes the biochemical and functional characterization of the toposome precursor from sea urchin coelomic fluids of both male and female organisms. The molecule is isolated in the form of a 22S particle which has an apparent molecular mass of 200 kDa. An intermediate form is present in yolk granules of unfertilized eggs with a molecular mass of 180 kDa. The 200 kDa and 180 kDa polypeptides are defined as toposome precursors by Western blot and immunoprecipitation analyses using polyclonal and monoclonal toposome-specific antibodies. Comparison of the 200 kDa polypeptide and mesenchyme-blastula toposome by partial-proteolysis peptide-mapping shows that they are related in a precursor-product relationship. A morphogenetic cell-aggregation assay shows that toposome precursors promote cell adhesion of dissociated blastula cells, suggesting that processing is not required for the cell-adhesion function. The studies reported here present the first evidence that cell adhesion molecules first appear in the form of a 200 kDa polypeptide, previously named vitellogenin, and to which only a function as major yolk-protein precursor has been ascribed. PMID- 2713741 TI - Eosinophils: receptors and mediators in hypersensitivity. AB - The presence of receptors for IgE on eosinophils has drawn attention to their direct participation in IgE-dependent hypersensitivity reactions. Surface IgE antibodies were detected on eosinophils from parasite-infected or allergic patients. The addition of the specific antigen or anti-IgE antibodies to such purified eosinophils induced the release of eosinophil peroxidase (EPO) and major basic protein (MBP), but not of eosinophil cationic protein (ECP). In contrast, ECP was detected after the addition of anti-IgG antibodies. Moreover, PAF-acether was only produced after IgE-dependent activation of hypodense eosinophils but not after IgG triggering. These results suggest a selectivity in the mediators (pre formed and newly formed) released in response to IgE- or IgG-dependent activation of human hypodense eosinophils. Associated with preliminary findings obtained by using electron microscopy and immunogold staining, they bring new information concerning the mechanisms of release of eosinophil mediators. Finally, they underline the essential role of eosinophils in hypersensitivity reactions. PMID- 2713742 TI - Regulatory mechanisms of the contractile responses of rat airways to immunological stimulation. AB - Pulmonary anaphylaxis induced by antigen inhalation includes a primary release of mediators from IgE-stimulated cells together with the activation of secondary pathways. The results presented here summarize the role of cells and mediators in the immediate response of rat tracheal anaphylaxis in vitro. Modulation of rat tracheal smooth muscle response to antigen is played by sensory and cholinergic innervation and by epithelium. The epithelial modulation seems to be partly due to its innervation, mainly C-fibre endings, releasing neuropeptides at the vicinity of epithelial cells. Epithelium is playing some role in the uptake and release of serotonin, and is acting on airway smooth muscle and on the inflammatory phase by releasing secondary factors such as arachidonic acid derivatives. The implication of non-IgE-binding cells for mediator release is now proving to be of greater importance in the understanding of allergic disease. PMID- 2713743 TI - Sources of protein-induced endogenous acid production and excretion by human adults. AB - The origin of the increase in endogenous acid production and excretion associated with the calciuretic action of high protein intakes was investigated in human adults. Eight subjects, 4 males and 4 females, aged 25-36 years, were fed a low protein diet (50 g/day) and a high protein diet (120 g/day in males and 106 g/day in females) for 7 days each. The high protein diet was formulated by supplementing the low protein diet with a mixture of four purified proteins. Increased protein intake was associated with increases in urinary Ca, sulfate, titratable acidity (acid phosphates) and ammonium, and decreases in urinary pH and bicarbonate. There was no increase in organic anion excretion. The increases in endogenous acid production (EAP) and net acid excretion (NAE) were entirely attributable to the oxidation of excess sulfur amino acids (SAA), which yields 2 moles of hydrogen ions per mole of amino acid catabolized. The results differ in this respect from those reported for studies on the effect of SAA loading, which indicate that non-SAA make a major contribution to the increase in EAP seen under these conditions. PMID- 2713744 TI - The chaplain as a resource to families of patients in I.C.U. AB - A trained chaplain can be a major resource to families of patients in the I.C.U. The classical perceptions of a clergy person as God's representative, as an intermediator, as the repository of ethical standards and as the ritual leader at the time of death all work to help support families in crisis. Properly understood a chaplain can use these archetypical projections to help families deal with their stress. This in conjunction with the rest of the treatment team, can aid families to better cope with anxiety. PMID- 2713745 TI - Demystifying general anaesthesia. PMID- 2713747 TI - Transfer of functions and the law. PMID- 2713746 TI - Ethics and an ethical dilemma: to resuscitate or not. PMID- 2713748 TI - The need for humaneness. PMID- 2713749 TI - The changing role of the I.C.U. nurse in medical rounds. PMID- 2713750 TI - Meconium aspiration syndrome. PMID- 2713751 TI - Effect of pre-enucleation radiotherapy on the viability of human choroidal melanoma cells. AB - Using standard tissue culture techniques we cultured cells from 12 large choroidal melanomas to assess the capacity of pre-enucleation radiotherapy to decrease the viability of melanoma cells. Specimens from the six melanomas that received 40 Gy given in 20 daily fractions did not grow in tissue culture. Specimens from the six nonirradiated tumours did grow, with a mean in-vitro doubling time of 39.6 hours. The results show that the applied regimen of pre enucleation radiotherapy decreased the viability of choroidal melanoma cells. Further study is needed to determine the correlation between the in-vitro characteristics of irradiated and nonirradiated choroidal melanomas. PMID- 2713752 TI - Bilateral congenital third cranial nerve palsy. AB - We describe a patient in whom bilateral congenital third cranial nerve palsy was diagnosed at 2 weeks of age. The ptosis was treated at 3 weeks with bilateral eyelid suspension surgery, and surgical repair of the exotropia was done at 4 months. To our knowledge this is the fourth reported case of this condition. It was probably caused by a single lesion involving the oculomotor and possibly the trochlear nuclei in the brain stem. Magnetic resonance imaging scans supported this hypothesis and suggested other central nervous system anomalies. PMID- 2713753 TI - Specialist societies and Royal College tackle thorny problem of competence. PMID- 2713754 TI - Comparison of the Pulsair noncontact tonometer and the Goldmann applanation tonometer. AB - We measured the intraocular pressure (IOP) in 100 consecutive new patients (200 eyes) with the Pulsair noncontact tonometer and with the Goldmann applanation tonometer. The correlation coefficient between the two instruments was 0.76 for the first eye tested and 0.90 for the second eye tested. The Pulsair noncontact tonometer may be useful for screening patients presumed to have normal IOP if an appropriately low IOP value is used to indicate the need for further assessment. The calibration of the instrument could be improved. PMID- 2713755 TI - Uncoupling protein and its mRNA in brown adipose tissue of newborn rabbits. AB - Guanosine diphosphate binding to the uncoupling protein of isolated mitochondria of brown adipose tissue in newborn rabbits was measured as an index of thermogenic activity. The binding was 0.281 +/- 0.022 nmol GDP/mg mitochondrial protein at 1 day of age, 0.214 +/- 0.017 at 3 days, 0.428 +/- 0.038 at 5 days, and 0.208 +/- 0.016 at 7 days. The increase in binding between 3 and 7 days of age suggests that the brown fat has an increased thermogenic capacity at that age. In addition, the potential for synthesis of the uncoupling protein was investigated in 1- to 5-day-old newborn rabbits by probing the total cellular ribonucleic acid for the messenger that codes for uncoupling protein. The amount of uncoupling protein messenger was highest at 1 day of age and declined at least until 5 days of age. Because the amount of uncoupling protein messenger decreased as the GDP binding increased, the results suggest that either the initially translated uncoupling protein was unmasked at about 5 days of age or there was a delay in the incorporation of uncoupling protein into the mitochondrial inner membrane, or both. PMID- 2713756 TI - A superfusion bioassay for platelet-activating factor. AB - A superfusion bioassay for platelet-activating factor is described using various types of tissues. By washing the tissue with 0.1-0.5% bovine serum albumin for 2 3 min after each addition of platelet-activating factor, desensitization did not develop in most tissues studied. Because of the ability to apply a sample directly onto an assay tissue with negligible dilution, this bioassay can detect smaller amounts of platelet-activating factor than those previously reported in which an organ bath was utilized. The ascending colon of the rat and dog appeared to be the most sensitive of the tissues tested, with a limited of detectability in the range of 100-500 fg. Repeated additions of platelet-activating factor could be made for up to 4 h without desensitization. Release of platelet activating factor from samples of rat stomach was measured using the superfusion bioassay and a platelet aggregation bioassay. There was a significant correlation (r = 0.96; p less than 0.01) between the values obtained using the two assay systems. Thus, the sensitivity, the reproducibility, and the inexpensive nature of this bioassay make it an attractive alternative to existing bioassays for platelet-activating factor. PMID- 2713757 TI - Changes in the regional brain histamine and histidine levels in postmortem brains of Alzheimer patients. AB - In postmortem brains of Alzheimer patients, statistically significant decreases in histamine levels were observed in the frontal (45%), temporal (20%), and occipital cortices (38%) and in the caudate nucleus (25%). Histidine levels were decreased in the frontal (15%), temporal (21%), and occipital cortices (30%) and in the caudate nucleus (25%); the decrease was statistically significant in the last two brain regions. Histamine was determined by the double isotope technique, and histidine was determined fluorometrically by a fluorescamine method. The data indicate that brain histamine regulation is altered in Alzheimer's disease. PMID- 2713758 TI - Noradrenaline turnover in brown adipose tissue and the heart of fed and fasted golden hamsters. AB - The effect of fasting on sympathetic activity in tissues of the golden hamster has been investigated using measurements of noradrenaline turnover. Fasting for 60 h did not have a significant effect on noradrenaline turnover, both fractional and total, in brown adipose tissue or the heart. Fasting did, however, result in a functional atrophy of brown adipose tissue; tissue weight, protein content, and cytochrome oxidase activity were each reduced after a 60-h fast. These results suggest that the atrophy of brown adipose tissue induced by fasting in the golden hamster does not relate to a major decrease in sympathetic activity. The findings add further support for the view that the thermogenic capacity of brown adipose tissue is not primarily dependent on sympathetic activity in the golden hamster. PMID- 2713759 TI - The effects of propranolol, phentolamine, and atropine on canine coronary vascular gradients. AB - The objective of this study was to measure pressure gradients in the coronary circulation following the administration of three receptor-blocking drugs, propranolol, phentolamine, and atropine when administered singly and in sequence. As well, we examined the responses of these gradients to eight interventions: left stellate ganglion or left vagosympathetic trunk stimulation, administration of isoproterenol, acetylcholine, noradrenaline, adenosine, phenylephrine, or adrenaline. Using a multiple linear regression model we examined the actions and interactions of the receptor-blocking agents on hemodynamic variables and vascular gradients. Propranolol reduced heart rate as expected and blocked the responses to isoproterenol administration. As well, it abolished the epicardial coronary artery diastolic gradient. The gradient was restored when propranolol was the second receptor blocker administered but was abolished when it was the third. Phentolamine induced vasodilation with a decrease in coronary small vessel gradients. This effect persisted without regard to the sequence of administration. When it was the second or third agent it decreased the microcirculation and small vein gradients, an action it did not manifest when given singly. Atropine singly did not alter pressures or gradients; but as the second agent it altered the transmural, outflow tract, epicardial diastolic, and microcirculation and small vein diastolic gradients; and as the third agent the changes were in the transmural, epicardial systolic and diastolic, and small artery systolic and diastolic gradients. The pattern of responses was not predictable and that indicates that unique changes occur in the responses of the coronary circulation when multiple receptor-blocking agents are employed. Adrenergic control tends to dominate in the coronary arterial circulation, and muscarinic control in the coronary microcirculation and veins with considerable overlap. PMID- 2713760 TI - Activation by curare of acetylcholine receptor channels in a murine skeletal muscle cell line. AB - Curare action on nicotinic acetylcholine receptors has a number of facets, of which the best known is competitive antagonism. Here we describe the weak agonist action of 10(-5) M curare on the murine skeletal muscle cell line, G8. Although curare induces no depolarization in G8 cells, single-channel recordings reveal short-lived curare-induced currents. A feature of these brief events is the multiplicity of conductance levels (of the four levels with conductances of 48, 37, 14, and 6 pS, none had a lifetime greater than 1.5 ms). Most well-resolved events (about 17% of which are to a subconductance) last less than 0.5 ms, with activation occurring predominantly as isolated events rather than in bursts. Agonism is not, however, a high probability action for curare: calculations based on the frequency of events at half-saturating conditions suggest that curare induced channel openings occur during less than 1% of acetylcholine receptor curare binding episodes. The outcome is (a) an agonist action too feeble to perturb the membrane voltage and (b) a powerful competitive antagonist action. PMID- 2713761 TI - Persistence of central respiratory rhythmogenesis after maximal acetylcholinesterase inhibition in unanaesthetized cats. AB - Cats were given systemically the anticholinesterase paraoxon at a dosage (3 mg/kg i.v.) that produced a maximal (over 90%) inhibition of brainstem acetylcholinesterase. All paralyzed and artificially ventilated animals were either unanaesthetized (decerebrated or ventilated with 70% nitrous oxide and 30% oxygen) or anaesthetized (with pentobarbital, alpha-chloralose, or halothane). In unanaesthetized cats, paraoxon produced an immediate rise in arterial blood pressure and did not suppress phrenic nerve respiratory discharges, while in anaesthetized animals it produced an immediate and long-lasting hypotension and a complete arrest of central respiratory activity. It is concluded that acetylcholine accumulation may not suppress respiratory rhythmogenesis and that most anaesthetics may considerably alter the response of cardiorespiratory cholinergic mechanisms to anticholinesterase administration. PMID- 2713762 TI - Synaptic restructuring during long-term facilitation at the crayfish neuromuscular junction. AB - Long-term facilitation was induced by 20-Hz stimulation of the motor axon innervating the opener muscle of the crayfish, Procambarus clarkii. Excitatory postsynaptic potentials remained potentiated for several hours after stimulation. Structural correlates of potentiation were sought. Nerve terminals of the motor axon were fixed for electron microscopy in unstimulated preparations (controls), and during and after 20-Hz stimulation. Synapses were reconstructed from micrographs obtained from serial sections. Synaptic contact area and the number of vesicles at the presynaptic membrane did not change after 20-Hz stimulation, but the latter decreased during stimulation. Presynaptic dense bars ("active zones") decreased in number during and increased after stimulation, while perforated synapses increased after stimulation. Modification of presynaptic structures occurs rapidly and may be linked to long-lasting changes in quantal content of transmission. PMID- 2713763 TI - Rx for noncompliance. PMID- 2713764 TI - New directions. PMID- 2713765 TI - Peritoneal carcinomatosis: the role of debulking procedures. PMID- 2713766 TI - Primary omental torsion. PMID- 2713767 TI - Treatment of genital herpes: an option. PMID- 2713768 TI - Meatal-based tubularized skin flap for distal hypospadias repair. PMID- 2713769 TI - Carotid body tumours: the University of Alberta Hospital experience. AB - At the University of Alberta Hospital between 1950 and 1988, 17 patients who had a diagnosis of carotid body tumour were seen; 15 of them were followed up for an average of 8 years (range from 1 to 38 years). In 14 patients the tumour was removed surgically. There were no operative deaths and no strokes occurred. The most frequent complication was cranial nerve deficit. Of the 15 patients followed up, 10 (67%) manifested a deficit of the facial, vagus or hypoglossal nerve. The primary tumour was diagnosed histologically as a benign neoplasm in all 14 patients operated on, but in 3 distant metastases developed or there was invasive local recurrence. Patients with malignant tumour were significantly (p less than or equal to 0.01) younger than those with a benign tumour. Carotid body tumours can be managed safely with respect to stroke complications, but cranial nerve injuries continue to be a problem. Malignant tumours are difficult to distinguish from benign tumours except that they tend to occur in younger patients. Prompt surgery and close follow-up is particularly important in patients with carotid body tumour. PMID- 2713770 TI - Surgical treatment of peritoneal carcinomatosis: 1988 Du Pont lecture. AB - Tumour spread onto peritoneal surfaces is frequent in patients who have recurrent gastrointestinal cancer. In this study the author describes (a) a cytoreductive surgical technique of ball-tipped electrocautery dissection, which can rapidly and definitively remove large volumes of intra-abdominal tumour, (b) a procedure for immediate postoperative lavage of the abdominal cavity to remove blood and tissue debris, and (c) a regimen of early and delayed intraperitoneal chemotherapy to destroy small quantities of residual cancer cells on intra abdominal surfaces. Forty-seven patients underwent cytoreductive surgery to remove large volumes of adenocarcinoma widely disseminated through the abdomen. Most patients had intraperitoneal chemotherapy to destroy small volumes of cancer remaining within the abdomen. In the absence of previous radiotherapy, one patient died and the morbidity was acceptable. In eight patients who received radiotherapy, seven had bowel perforation and one died. Surprisingly, the majority of patients who had cytoreductive surgery plus intraperitoneal chemotherapy had disease-free long-term survival. In patients with peritoneal carcinomatosis, long-term disease-free survival correlated with low tumour aggressiveness, adequate cytoreductive surgery and the use of intraperitoneal chemotherapy. PMID- 2713771 TI - Periosteal neochondrogenesis for biologically resurfacing joints: its cellular origin. AB - The purpose of this study was to determine if the hyaline-like cartilage produced in major full-thickness defects of a joint surface, treated by a free periosteal graft and subjected to continuous passive motion (CPM), originated exclusively from the progenitor cells of the cambium of the graft. Free periosteal grafts were raised from the tibia of both hind legs of eight male New Zealand rabbits and transplanted into full-thickness defects across the entire width of the patellar groove of 15 female rabbits. Postoperatively, CPM was instituted and the animals were sacrificed after 3 weeks. Cells from the regenerated tissue were grown from tissue explants and their karyotypes determined. In 33% of the rabbits, all cells contained a Y (male) chromosome, indicating that regenerated tissue originated exclusively from the progenitor cell of the periosteal graft. Karyotypes of the cells from the other 67% were mosaics (both female and male); thus, their cellular origin was from both the periosteal allograft and the pluripotential mesenchymal cells in the subchondral tissues. PMID- 2713772 TI - Comparison of processed bovine internal mammary arteries and autologous veins as arterial femoral substitutes in dogs: blood compatibility and pathological characteristics. AB - This study was undertaken to compare the chemically processed internal mammary artery (BIMA) and the autologous femoral vein as arterial grafts. The BIMA prosthesis was implanted as a left femoral artery bypass and the femoral vein as a right femoral artery bypass graft in 27 dogs. In groups of three dogs the grafts were implanted for predetermined durations: 4, 24 and 48 hours (short term), 1, 2 and 4 weeks (medium term) and 3, 6 and 9 months (long term). All autologous veins were patent when the dogs were killed. The patency rates of the BIMA grafts were 100% in the short-term group, 67% in the medium-term group and 29% in the long-term group. The deposition of labelled fibrinogen and platelets on flow surfaces, the structural preservation of the wall of the BIMA prosthesis and accumulation of thrombi during the period of implantation were studied. PMID- 2713773 TI - Nonoperative management of complications of percutaneous renal nephrostomy. AB - Between 1984 and 1986 at the Wellesley Hospital in Toronto, 210 percutaneous renal nephrostomies were performed for drainage and 140 were done to provide access for nephrolithotomy. Less than 2% of the patients experienced complications requiring intervention and less than 0.5% required an open surgical approach for the management of procedure-related problems. Complications that were managed conservatively included splenic puncture, false aneurysm, laceration of the renal artery, arteriovenous fistula, hemorrhage requiring transfusion, pneumothorax-empyema, urinoma, septic shock and the hemolysis-hyponatremia-renal shutdown syndrome. PMID- 2713774 TI - Ketoconazole in the treatment of osteomyelitis due to Candida albicans. AB - Osteomyelitis caused by Candida albicans is a rare condition. The authors report its occurrence as an infective complication in the fractured phalanx of a 3-year old boy. The infection was first thought to be due to Staphylococcus aureus, but a course of cloxacillin was unsuccessful, and when cultures of the injured finger grew C. albicans, a 3-month course of ketoconazole orally was begun. Ketoconazole was prescribed because, unlike amphotericin B, the antibiotic usually used in such cases, it is not nephrotoxic, it can be taken orally and it has proved successful in other reported cases of osteomyelitis due to C. albicans. The boy's infection resolved and fracture healing was confirmed radiologically. PMID- 2713775 TI - Studies of DNA content in cervical intraepithelial neoplasia by cytologic and histologic flow cytometry. AB - Flow cytometry was done on 82 specimens of cervical cytologic scrapings and biopsies from patients with cervical intraepithelial neoplasia or condyloma. This study yielded significant results when compared with standard cytologic (p less than 0.01) and histopathologic studies (p less than 0.05). Histologic evaluation by flow cytometry required more examinations and did not give significant results. The authors conclude that cytologic flow cytometry, though not a replacement for standard cytologic examination, may be of help in establishing therapeutic strategies and follow-up protocols for patients with cervical precancerous conditions. PMID- 2713776 TI - Spontaneous rupture of the diaphragm in labour: a case report. AB - Spontaneous rupture of the diaphragm during normal labour is extremely rare. It requires emergency surgical correction. The authors report what they believe is only the second reported case. Eleven hours after delivery of a male infant, a 27 year-old woman experienced severe epigastric pain, vomiting and dyspnea, followed by cardiopulmonary arrest. Although the ruptured diaphragm was diagnosed and repaired, she suffered severe anoxic encephalopathy and died 3 weeks after operation without regaining consciousness. Clinicians must be aware of the existence of this rare condition because failure to diagnose and treat the ruptured diaphragm will almost certainly lead to the patient's death. PMID- 2713777 TI - Undiversion in patients with meningomyelocele. AB - Since 1981, 12 patients with neurogenic bladder due to meningomyelocele who had had previous ileal conduit urinary diversions underwent assessment for undiversion. Two important criteria for undiversion were motivation and a reconstructable bladder. Four patients either did not fulfil these criteria or refused surgery. Eight patients (six females and two males) underwent undiversions. Uretero-ureteral anastomosis was achieved in 13 ureters and ureteroneocystostomy in 2; transureteroureterostomy was necessary in 1 ureter. Augmentation cystoplasty and vesicourethropexy were important in establishing continence postoperatively; these procedures were not performed in two patients whose undiversion failed early in the series. The evolution of an investigation protocol, surgical technique and final approach to this complex problem are discussed. PMID- 2713778 TI - An evaluation of the multiple-breath nitrogen washout as a pulmonary function test in dairy cattle. AB - Multiple-breath nitrogen washouts (MBNW) were performed with 21 adult dairy cows (seven normal cows tested on two days each, four clinically normal cows tested on six days, and ten cows with respiratory disease tested on one day each). The functional residual capacity (FRC), lung clearance index (LCI), Becklake index (BI), mixing ratio (MR), pulmonary N2 clearance delay (PCD), index of distribution of inspiration (IDI) and ventilatory efficiency (EFF) were calculated for each MBNW. The LCI, MR, PCD, IDI and EFF were calculated at an end tidal N2 concentration of 3% (FETN2,3%) and the end-tidal N2 concentration of the final breath of the MBNW (FETN2,fb), while BI was calculated and EFF was also calculated at FETN2 = 8% (i.e. after washout of 90% of the N2 in the lung). All of the MBNW were irregular due to breath-to-breath variability in the breathing pattern of cows and variability in FRC. The within day coefficients of variation for FRC, LCI, MR, IDI, EFF3% and EFFfb were less than 10%, but in the four cows tested on six days there was significant day-to-day variability for individuals for FRC, LCI, BI, MR, PCD and IDI. The shape of the MBNW curves differed between the normal cows and those with respiratory disease. The FRC, EFF3% and EFFfb were the most sensitive indices in detecting the cows with respiratory disease, and when EFF3%, EFFfb or FETN2fb, was used in conjunction with FRC it was possible to detect all of the cows with respiratory disease. PMID- 2713779 TI - Simple nonrebreathing valves for use with large mammals. AB - Two simple nonrebreathing valves suitable for use with large mammals are described. These valves can be constructed in a reasonably well equipped workshop using materials that are readily available. The resistive pressure of both valves is less than 0.1 kPa at flow rates up to 15 L.s-1. Their main limitation is a relatively large dead space, although the dead space of valve B (290 mL) is less than the dead space of some commercially available valves. Healthy adult horses and cows compensate for the increased dead space by an increase in tidal volume. PMID- 2713780 TI - Urinary excretion of pentoxifylline and its metabolites by standardbred mares. AB - The urinary excretion of a sustained-release formulation of pentoxifylline was studied in the horse after the oral administration of 4.0 grams of Trental tablets. Urine samples were collected for 24 hours after dosing and analyzed for pentoxifylline and its metabolites using high-performance liquid chromatography coupled with an ultraviolet detector. Six metabolites of pentoxifylline were identified in horse urine in addition to less than 0.2% of unchanged drug. Concomitant use of gas chromatography/mass spectrometry allowed for the elucidation of the chemical structures of the metabolites. Metabolism of pentoxifylline yields one demethylated derivative, four hydroxylated metabolites and a conjugate of one of the hydroxymetabolites as urine products. The demethylated derivative, 3-methyl-1-(5-oxohexyl)-xanthine, was found to be the predominant metabolite in the urine. PMID- 2713781 TI - 2'-5' oligo-A-synthetase activity in bovine peripheral blood leukocytes and alveolar macrophages exposed to recombinant interferons and tumor necrosis factor alpha. AB - In vitro treatment of bovine peripheral blood mononuclear leukocytes, polymorphonuclear neutrophilic granulocytes and alveolar macrophages with recombinant bovine interferons -alpha 1 1, -beta 2 or -gamma induced an immediate increase in the intracellular level of 2'-5' oligoadenylate synthetase activity. The induction was dose-dependent, with interferon -alpha 1 1 and -beta 2 being more potent than interferon-gamma. Maximal levels were reached within 10-12 h with IFN-alpha 1 1, which corresponded well with findings in vivo. In contrast to what has been found in nonlymphoid bovine cells, tumour necrosis factor-alpha did not potentiate the induction of 2-5A synthetase by interferons, neither did it by itself induce the enzyme. PMID- 2713782 TI - Relationship between test-day measures of somatic cell count and milk production in California dairy cows. AB - The relationship between test-day measures of milk somatic cell count and milk yield was evaluated using the November 1985 test data from 8352 Holstein cattle (2923 primiparous and 5429 multiparous cows) located in ten Tulare County, California dairies. Following correction for herd and stage of lactation effects, design variable regression was used to create separate models for primiparous and multiparous cows predicting the changes in milk production associated with milk somatic cell count class. Cell counts were stratified by 1/2 loge cell count (x1000 cells/mL) units, permitting comparisons with previous studies. Cell counts less than 148,000/mL were not found to be associated with significant reductions in milk yield when compared to the reference class (cell counts less than 20,000/mL). Consistent incremental decreases in milk production were not noted with increasing cell count strata, even following the natural log transformation. The most dramatic production losses were noted in the range of 148,000 to 665,000 cells/mL. Primiparous cattle in the 403,000 to 665,000 cell count strata experienced a 5.22 kg (19.72%) decrease in test-day milk yield. Multiparous cattle in the same class experienced 3.01 kg (7.82%) reductions in milk production. Primiparous and multiparous cows had similar production losses. The study population differed from previous studies on the basis of herd size, milk production and the level of udder health, measured by milk somatic cell count. These differences and the choice of experimental design may in part explain differences in study results and conclusions. PMID- 2713783 TI - The associations between milk production, milk composition and Salmonella in the bulk milk supplies of dairy farms in Ontario. AB - The purpose of this study was to assess changes in dairy herd milk production and milk composition associated with changes in Salmonella contamination of bulk milk on dairy farms in southwestern Ontario. Twenty-three dairy farms that had submitted milk filters for culture from which Salmonella were isolated (cases) and 23 farms that submitted Salmonella-negative milk filters (controls) were included in the study. The rolling herd averages for milk and fat of case and control farms for the months of December 1985, December 1986 and April 1987 were compared and no significant differences were detected. Case and control farms were divided into three groups (A,B,C) on the basis of Salmonella culture results of milk filters submitted at various time periods throughout the study. Daily and monthly changes in milk production and composition parameters that reflected the time periods of milk filter culture were compared. The following unconditional associations between a changing Salmonella infection status on dairy farms and changes in milk production or composition variables were significant (p less than or equal to 0.05): group A: case farms had higher plate loop counts than control farms; group B: case farms had younger cows than control farms; group C: case farms had cows with longer average days in lactation than control farms. After analytical control of confounding variables, the disappearance of Salmonella from bulk milk supplies of dairy farms was associated with a decrease in percent fat and in somatic cell count. PMID- 2713784 TI - Clinical and pathological effects of flunixin meglumine administration to neonatal foals. AB - The effects of daily intravenous administration of flunixin meglumine at dosages of 0.55, 1.1, 2.2 and 6.6 mg/kg for five days were examined in neonatal foals. Six two day old foals were used to evaluate the effect of each dosage. Foals were examined every day and blood samples collected on days 1, 3 and 6. All foals were euthanized after six days, necropsied and examined for lesions. The major clinical abnormality was diarrhea, but the incidence was not related to the dosage of flunixin meglumine administered. The foals receiving 6.6 mg/kg of flunixin meglumine had significantly more gastrointestinal ulceration and greater cecal pathology and cecal petechiation scores than those foals treated with saline. The foals in the 6.6 mg/kg treatment group had a greater loss of total protein during the study, but the difference was not significant. There were no statistically significant blood cellular or biochemical alterations associated with the administration of flunixin meglumine. There were no significant clinicopathological differences between healthy foals treated with the recommended dosage of flunixin meglumine and those treated with physiological saline. PMID- 2713785 TI - Attempts to restore abduction of the paralyzed equine arytenoid cartilage. I. Nerve-muscle pedicle transplants. AB - The purpose of this project was to adapt a surgical technique from humans and dogs to horses in which a portion of an accessory muscle of respiration and its nerve supply is transplanted to a denervated dorsal cricoarytenoid muscle. Anatomical dissections in seven horses revealed two possible donor nerve-pedicle grafts: the omohyoid and the sternothyrohyoid, both innervated by a branch of the first and second cervical nerves. Histochemical evaluations in two ponies of the dorsal cricoarytenoid, omohyoid and sternothyrohyoid muscles revealed similar proportions of fiber types 1 and 2 in all three muscles. Electromyographic studies in these two ponies revealed that the omohyoid and sternothyrohyoid muscles contract synchronously with respirations during forced inspiration under general anesthesia. Based on surgical ease of access, a 1 cm2 portion of the omohyoid muscle at the point of penetration of the second cervical nerve was used as a nerve-muscle pedicle graft in an attempt to reinnervate the left dorsal cricoarytenoid muscle in four ponies. These four ponies (as well as three others which served as controls) had previously undergone left recurrent laryngeal nerve transection. All seven ponies endoscopically showed signs of complete left laryngeal hemiplegia immediately postoperatively. Animals were monitored endoscopically for 30 weeks after surgery. The three control ponies showed no abduction of the arytenoid cartilage. In addition, in these three ponies, histological and histochemical expected changes of muscle fiber atrophy and fibrosis were present in the dorsal cricoarytenoid muscle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713786 TI - Attempts to restore abduction of the paralyzed equine arytenoid cartilage. II. Nerve implantation (pilot study). AB - The purpose of this project was to attempt restoration of abduction of a recently experimentally denervated left dorsal cricoarytenoid muscle by implanting a transected nerve-end into the paralyzed muscle. In six ponies the cut end of the second cervical nerve was implanted into a slit made in the left dorsal cricoarytenoid muscle. The nerve end was secured in place with one 5-0 polypropylene suture connecting the epineurium to the epimysium. The left recurrent laryngeal nerve was transected during this procedure. All six ponies showed signs of complete left laryngeal hemiplegia immediately after surgery. Postoperatively all ponies were evaluated qualitatively on a monthly basis by subjective examination for evidence of abduction of the arytenoid cartilages on endoscopy and quantitatively by measurement of the cross sectional area of the left and right half of the rima glottidis. Subjective endoscopic evidence of partial abduction was seen in four of the six ponies six months postoperatively. Measurement of the cross sectional area of the rima glottidis revealed a total loss of 38% of the area immediately postoperatively. There were no significant changes in cross sectional areas of the rima glottidis between the immediate postoperative evaluation to the six months postoperative evaluation. Gross postmortem examination revealed partial dorsal cricoarytenoid muscle atrophy as evidenced by a 24-55% decrease in muscle mass compared to the right dorsal cricoarytenoid muscle. Histopathological studies revealed regions with clusters of large muscle fibers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713787 TI - Attempts to restore abduction of the paralyzed equine arytenoid cartilage. III. Nerve anastomosis. AB - The purpose of this project was to attempt restoration of abduction of a recently denervated left dorsal cricoarytenoid muscle in the horse by anastomosing the first cervical nerve to the abductor branch of the left recurrent laryngeal nerve. Ten horses were used in the study. In six horses the left recurrent laryngeal nerve was transected and ligated while the ventral branch of the left first cervical nerve was anastomosed to the abductor branch of the left recurrent laryngeal nerve. The remaining four horses also had the left recurrent laryngeal nerve transected and ligated but had no nerve anastomosis performed. Each horse was evaluated preoperatively, and at one week, three and six months after surgery, by endoscopy and determination of upper airway resistance. The endoscopy was performed with the horses breathing room air and while breathing 10% carbon dioxide. All ten horses showed endoscopic signs of complete laryngeal hemiplegia immediately postoperatively. Starting at three months postoperatively clonic movements of the left arytenoid cartilage were observed in four of the six reinnervated horses but not in the sham operated horses. At the sixth postoperative month five reinnervated horses had clonic movements of the left arytenoid cartilage. The comparison of upper airway resistance measurements before surgery and at one week, three and six months after surgery showed no significant differences in either control or experimental horses. Following euthanasia at six months postoperatively, the left and right dorsal crioarytenoid muscles were compared for evidence of reinnervation. No significant difference in weight was noted in the reinnervated horses but the left dorsal cricoarytenoid muscle weighed less than the control horses. PMID- 2713788 TI - The protective effects of sucralfate and ranitidine in foals experimentally intoxicated with phenylbutazone. AB - The effects of sucralfate and ranitidine on the gastrointestinal manifestations of phenylbutazone (PBZ) toxicity in horse foals were determined by complete blood count, serum chemistry profile, and gross and histological necropsy examinations. Twenty-eight, three to four month old Belgian-cross foals were randomly assigned to one of four groups. Phenylbutazone was administered at a dosage of 10 mg/kg of bodyweight (BW) per day, intravenously (IV), in equally divided doses to three of the groups. In addition to PBZ, ranitidine was administered at 2 mg/kg BW, IV, twice daily, to one group of seven foals (PBZ/ranitidine group), and sucralfate was administered at 4 g, orally, twice daily to another group of seven foals (PBZ/sucralfate group). A fourth group received normal saline IV and corn syrup orally, twice daily, as placebos (control group). Treatments were administered for ten days. Clinical signs included oral ulceration (in all PBZ-treated foals) and diarrhea (5/7 and 2/7 foals from the PBZ and PBZ/ranitidine groups, respectively). A reduction in total protein and albumin was greatest in the PBZ group and least in the PBZ/ranitidine and PBZ/sucralfate groups when compared to the control group. The PBZ group lost weight during the treatment period. At necropsy, the PBZ group had the greatest area of oral ulceration compared to the other treatment groups. All foals treated with PBZ had gastric ulcers; however, the PBZ group had the most severe gastric epithelial necrosis compared to the other three treatment groups. Duodenal villous atrophy, epithelial necrosis and mucosal inflammation, and a reduction in epithelial mitotic figures were seen in all PBZ-treated foals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713789 TI - Esophageal acid clearance test in healthy dogs. AB - Esophageal acid clearance in healthy dogs was evaluated by placing a pH probe in the distal esophagus and determining the number of swallows and time required for esophageal pH to reach 4.0 after injection of a 10 mL bolus of 0.1 N hydrochloric acid. The increase in pH occurred in a stepwise fashion and was associated with esophageal peristalsis as determined by esophageal manometry. The number of swallows required for acid clearance varied from four to 12 with a mean of 8 +/- 1.8. The time required for acid clearance varied from 150 to 480 s with a mean of 285 +/- 75. No significant difference was noted after 0.16 mg/kg of lenperone hydrochloride was given intramuscularly. The esophageal acid clearance test in dogs appears similar to that reported in humans. PMID- 2713790 TI - Identification of the heat-labile hemolysin of Actinobacillus pleuropneumoniae serotype 1. AB - The heat-labile hemolysin of Actinobacillus pleuropneumoniae serotype 1 strain CM 5 was partially purified using ammonium sulfate precipitation and gel permeation chromatography. This partially purified material was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and blotted onto nylon filters. The filters were treated with convalescent pig serum and subsequently with CM-5 culture supernatant containing active hemolysin. A 104 kd peptide was identified as the hemolysin because it bound antibodies in convalescent pig serum which cross-linked active hemolysin. The same 104 kd protein when injected into a rabbit produced neutralizing antibodies to the CM-5 hemolysin in culture supernatant. PMID- 2713792 TI - Care in the air. PMID- 2713791 TI - Do you love this planet? PMID- 2713793 TI - Induced abortion. PMID- 2713794 TI - Getting help for depressed colleagues. PMID- 2713795 TI - Laboratory reports of chlamydial infections in Canada in 1987. PMID- 2713796 TI - Management of acute asthma. PMID- 2713797 TI - Recognizing your limitations. PMID- 2713798 TI - Blood pressure in the left lateral position. PMID- 2713799 TI - Treating enteritis in Indonesia. PMID- 2713800 TI - Sexual abuse of children and sexually transmitted diseases: implications for physicians. PMID- 2713801 TI - Incidence and duration of lactation and lactational performance among mothers of low-birth-weight and term infants. AB - The lactation experience of 55 mothers of 62 infants of low birth weight (2500 g or less) was prospectively compared with that of 55 mothers of 55 control infants (38 weeks' gestation or more, birth weight more than 2500 g) born at the same institution. The incidence rates of lactation at delivery were 73% for the control group and 58% for the low-birth-weight group; 11% of the infants of low birth weight fed breast milk were never put to the breast. The mean age at first suckling was 277.3 hours in the low-birth-weight group, compared with 3.3 hours in the control group (p less than 0.0005). At first suckling 81% of the low-birth weight infants and 25% of the control infants sucked poorly or refused the breast (p less than 0.001). At discharge 65% of the breast-milk-fed control infants were exclusively breast-fed, compared with 3% of the low-birth-weight infants fed breast milk (p less than 0.001). The incidence rates of lactation over time were similar in the control and low-birth-weight groups (51% v. 44% at 1 month, 29% v. 13% at 3 months, 13% v. 4% at 6 months and 4% v. 2% at 12 months). The mean duration of lactation was 3.2 months for the control group and 2.5 months for the low-birth-weight group. In the long term 37% of the low-birth-weight infants fed breast milk failed to breast-feed, compared with 2% of the control infants, and only 31% were exclusively breast-fed, compared with 85% of the control infants (p less than 0.001). However, the degree of satisfaction with the lactation experience was similar in the two groups. We conclude that mothers of low-birth weight infants have good potential for lactation. PMID- 2713802 TI - Birth prevalence of cleft lip and palate in British Columbia between 1952 and 1986: stability of rates. AB - We examined the birth prevalence of cleft lip with or without cleft palate and of isolated cleft palate in British Columbia between 1952 and 1986 using the data of the BC Health Surveillance Registry. The rates fluctuated over the study period, but linear trend analysis showed no increase or decrease for cleft lip with or without cleft palate; however, there was a significant increase for isolated cleft palate, attributed to improved ascertainment around 1963-66. Given the possible effects of newer agents used in both silviculture and agriculture, as well as the general concern over drugs and other environmental agents, such a long-term monitoring program is important. Furthermore, if significant clustering occurs, good background data are essential for comparison. The general public's perception is that the rates of birth defects are increasing. Our findings should give some reassurance with respect to orofacial clefts. PMID- 2713803 TI - Epidemiologic data on serum lipids and lipoproteins: clinical implications. PMID- 2713804 TI - CMA booklet to help doctors, health care workers deal with AIDS. PMID- 2713805 TI - Hallux valgus and allied deformities. PMID- 2713806 TI - Cytogenetic and molecular studies in primary myelofibrosis. AB - Cytogenetic and molecular data of three patients affected by primary myelofibrosis with myeloid metaplasia (PMMM) evolving to blastic crisis are reported. The cytogenetic findings were uncommon. The first patient (female) showed an idic(X)(q13) as the sole alteration in chronic phase, with an additional r(7) in 67% of the cells of the blast crisis; the other two patients showed, in blast crisis, a partial trisomy of the long arm of chromosome 1, without translocation, as a unique structural abnormality. These findings confirm the presence of nonrandom, although nonspecific, alterations in PMMM that, in our cases, seem to be related to the multistep progression of the neoplastic process. Molecular investigations have been applied to study the genomic organization and the level of expression of genes such as bcr and calcyclin and c-fms protooncogene possibly involved in the molecular mechanisms underlying cell proliferation in hematopoietic cells. The data obtained are discussed with respect to the myeloproliferative disorder. PMID- 2713807 TI - Two new chromosomal abnormalities in chronic myelogenous leukemia 46,XY,t(9;15;22)(q34;q22;q11) and 46,XY,t(6;9;12;22)(p21;q34;q24;q11). AB - Two new variant cases of chronic myelogenous leukemia (CML) are presented. The first case is a 19-year-old male with a 46,XY,t(9;15;22)(q34;q22;q11) karyotype. The second case is a 75-year-old man with a 46,XY,t(6;9;12;22)(p21;q34;q24;q11) karyotype. In both cases, the prognosis was no different from those cases of CML with the standard t(9;22) as the only abnormality. We recommend that all unusual translocations be reported. PMID- 2713808 TI - Chromosome 21q22 deletion. A specific chromosome change in a new bladder cancer subgroup. PMID- 2713809 TI - Sequential cytogenetic studies in an ovarian cancer cell line. AB - Cytogenetic analysis of a human ovarian carcinoma cell line JoN was performed at passages 6, 43, and 89. At passage 6 there were pseudodiploid and pseudotetraploid cells containing up to 22 markers. Pseudodiploid cells predominated. Significant differences were seen in the later analyses. At passages 43 and 89, cells had a modal number of 44 and 88 chromosomes with four new reciprocal translocations and loss of all unidentified markers. There was retention of one identified marker throughout plus one that gradually disappeared. Karyotypes at passages 43 and 89 were identical, suggesting stability of rearrangements. These changes indicate continuing chromosomal rearrangements in culture, not necessarily creating more complexity. PMID- 2713810 TI - Translocation t(2;8) in AIDS-associated Burkitt leukemia. PMID- 2713811 TI - Involvement of chromosomes 1, 3, and i(8q) in lung adenocarcinoma. PMID- 2713812 TI - Different homing pattern of isolated mouse lymphoma cells correlates with a different chromosomal pattern. AB - After 5-20 weeks of in vitro culture of mouse lymphoma cells, a characteristic and reproducible change in cell morphology, clonogenic ability, and homing pattern after intraperitoneal or intravenous injection was observed. Cytogenetic comparison of the two cell populations present before and after the "switch" revealed that the phenotypic changes cannot be due to in vitro karyotype evolution because their chromosomal pattern differed in such a way that it is impossible that they can evolve from each other. It was concluded that two different cell populations are present in the lymphoma and their growth and behavior are influenced by certain circumstances and/or interactions. Apparently one population predominates in the peripheral blood circulation, whereas the other will predominate after prolonged in vitro culturing. PMID- 2713813 TI - Involvement of chromosome 22 in a Merkel cell carcinoma in a patient with a previous meningioma. AB - The relatively simple cytogenetic findings in an aggressive metastatic Merkel cell carcinoma are reported. Deletion 2p was found in 100% of the cells. Nevertheless, this was considered a secondary (metastatic?) change because the same aberration has been found in several other kinds of malignancy. The involvement of chromosome 22 [del(22q) and -22] in 85% of the cells seemed more intriguing, considering the fact that the Merkel cell carcinoma followed a previous meningioma. PMID- 2713814 TI - Translocation 1;7 in four cases of myeloid disorders. AB - A der(1)t(1;7)(p11;p11) was observed in bone marrow chromosome analyses of four patients with myeloproliferative disorders. Three patients had developed secondary leukemias or preleukemias following chemotherapeutic exposure, and one patient was diagnosed with M4 de novo. PMID- 2713815 TI - Chromosomal in situ hybridization and Southern blot analyses using c-abl, c-sis, or bcr probe in chronic myelogenous leukemia cells with variant Philadelphia translocations. AB - The Philadelphia (Ph) chromosome is a cytogenetic hallmark of chronic myelogenous leukemia (CML). Whereas the majority of Ph-positive CML patients show the standard Ph translocation involving chromosomes 9 and 22, t(9;22)(q34;q11), the minority of cases exhibit a variant type of Ph translocation involving these two and other chromosomes (complex type) or those involving #22 and chromosomes other than #9 (simple type). To get an insight into the nature of variant Ph translocations and the process of their formation, we examined the localization of the c-abl and c-sis oncogenes and the breakpoint cluster region (bcr) gene by chromosomal in situ hybridization in ten variant Ph translocations of CML including five simple and five complex ones as initially interpreted. In situ hybridization showed that c-abl localized to band 9q34 and c-sis localized to band 22q12-q13 were translocated on the Ph and on one of the rearranged chromosomes other than #9, respectively, in all the variant translocations examined. On the other hand, bcr localized to band 22q11 was translocated on various chromosomes but mostly on chromosome 9. Parallel Southern blot analyses on DNA from leukemic cells of five patients including two with simple translocations and three with complex ones revealed rearrangements of bcr with breakpoints occurring mostly in a 5' portion of 5.8-kb BamHI/BglII sequences, which are quite similar to those detected so far in CML cases with the standard Ph translocation. The present findings strongly suggest that variant Ph translocations of CML are all complex, and some of them are formed stepwisely from the standard translocation. PMID- 2713816 TI - Protooncogene structure in the cancer family syndrome. AB - Protooncogene loci in constitutional DNA from affected members of a kindred with the cancer family syndrome were studied by Southern blot hybridization analysis. No structural rearrangements or amplification of 16 protooncogenes were detected. These studies demonstrated that gross structural alteration of the tested protoocongenes is not responsible for cancer susceptibility in this syndrome. PMID- 2713817 TI - Translocations involving chromosomes 2 and 13 in benign and malignant cartilaginous neoplasms. AB - Cytogenetic analysis of a chrondromyxoid fibroma of bone and an extraskeletal myxoid chondrosarcoma revealed clonal chromosomal rearrangements involving chromosomes 2 and 13. The significance of these findings in these neoplasms of cartilaginous origin, one benign and one malignant, is discussed. PMID- 2713819 TI - A dysmorphic child with myelodysplasia characterized by a duplication of 1q and multiple duplications of 3q. AB - Multiple inserted duplications of bands 3q21 through 3q27 and a duplication of the chromosome 1 long arm are reported in a karyotypically altered clone from a dysmorphic child with myelodysplasia. PMID- 2713818 TI - Complex karyotypes in a series of pediatric osteosarcomas. AB - Cytogenetic analysis was performed on eight osteosarcomas, including six primary untreated biopsies, one second primary in a patient with a history of undifferentiated sarcoma, and one recurrent lung metastasis. Two primary tumors and the peripheral blood lymphocytes from all eight patients had normal karyotypes. Six of the tumors demonstrated extremely complex karyotypes, with modal numbers in the hypodiploid, triploid, and hypertetraploid ranges. The predominant types of structural abnormalities observed were nonreciprocal translocations and deletions, which differed between cases. A consistent loss of normal chromosome 13 homologs was evident in the six cases with abnormal tumor karyotypes; however, chromosomal loss was not restricted to #13. Molecular studies of osteosarcoma, especially with regard to the retinoblastoma locus on chromosome 13, should take into consideration the complex cytogenetic changes seen in this tumor. PMID- 2713820 TI - The glycosylation state of the precursors of the cathepsin B-like proteinase from human malignant ascitic fluid: possible implication in the secretory pathway of these proenzymes. AB - We have investigated the structure of the carbohydrate moiety of the precursors of the cathepsin B-like proteinase (PCBt). The largest precursor has an apparent molecular size (Mr) of 45-47 Kd and it contains 3 N-linked oligosaccharide chains which were Endo beta N acetylglucosaminidase H (Endo H)-resistant forms. On the other hand, these chains were sequentially removed by Endo beta N acetylglucosaminidase F (Endo F). Both results indicate a complex type structure for these oligosaccharides. As usual in these cases, sialic acids were also found. In the deglycosylated state, PCBt has a Mr value of 36 Kd closely related to the 35.9 Kd Mr for human Pro CB, deduced from the cDNa sequence. These findings may explain the extracellular location of PCBt in malignancy: complex oligosaccharides are in most cases associated with secretory or membrane bound glycoproteins. On the contrary, mannose-rich types are involved in the lysosomal routage. PMID- 2713821 TI - A mitogenic factor from rat muscle. AB - A growth-promoting polypeptide has been purified about 1950-fold from rat abdominal muscle by gel chromatography, isoelectric-focusing (IEF) and reverse phase high pressure liquid chromatographic (RP-HPLC) techniques. This factor is an acidic protein with an isoelectric point (pI) of 3.4 and a mol. wt of 12 kDa when run on SDS-polyacrylamide gels under reducing conditions. It is acid and heat-stable but is sensitive to reducing agent and protease action. It stimulates [3H]thymidine incorporation in NRK-49F and NIH 3T3 cells and induces soft agar colony formation of NIH 3T3 cells. The muscle-derived mitogen appears to differ from other known growth factors (GFs) in its physico-chemical properties. PMID- 2713822 TI - Comparative carcinogenicity of N-nitrosobis(2-oxopropyl)-amine and N nitrosomethyl(2-oxopropyl)amine following subcutaneous or oral administration to rats. AB - The carcinogenicity of N-nitrosomethyl(2-oxopropyl)amine (MOP), a postulated proximate carcinogen of N-nitrosobis(2-oxopropyl)-amine (BOP), was tested after either a single subcutaneous (s.c.) injection or weekly intragastric (i.g.) administration in Wistar-derived MRC rats and was compared with the effect of BOP, given similarly and at equitoxic doses. Following i.g. administration, MOP induced a high incidence of neoplasms in the pharynx and esophagus which, however, were not affected by BOP; on the other hand, tumors of the thyroid, lungs, colon and urethra occurred in a greater incidence following BOP than after MOP, and renal neoplasms were found only following MOP, given s.c. Moreover, there were remarkable sex differences in the responses of the rats' respiratory and urothelial tissues to these two carcinogens: nasal cavity carcinomas, pulmonary adenomas, urinary and urethra papillomas were induced primarily or exclusively in male rats treated with BOP, either s.c. or i.g., whereas such sex differences were not found following either route of MOP administration. There were also differences in the spectrum of the neoplasms induced by BOP or MOP depending upon the route of their administration. For example, MOP was more effective in inducing nasal, esophageal and hepatic tumors when given orally, compared to its effect following the s.c. route, and thyroid and renal tumors were induced only after its s.c. injection. The results point to a complexity of nitrosamine carcinogenesis and also indicate that in some tissues activation of BOP, but not of MOP, depends on sex hormones. PMID- 2713823 TI - Reproducibility studies and effects of bowel preparations on measurements of rectal epithelial proliferation. AB - Measurements of rectal epithelial proliferation (REP), using tritiated labelled thymidine, correlate with colonic epithelial proliferation, risk for cancer and response to therapies. There have been criticisms regarding its reproducibility and the possible deleterious effects of bowel preparations on this biomarker. We studied paired observations on 7 patients repeated without bowel preparation, 11 repeated after tap-water enema, and 8 repeated after PEG-electrolyte solution or extract of senna purgative and found no significant differences between paired observations. In addition, in a high-risk group for colorectal cancer, 31 persons received PEG or senna preparation and their REP was not significantly different from that of 23 examined without these preparations. Thus, REP is a reproducible biomarker and not affected by several commonly used bowel preparations. PMID- 2713824 TI - Effects of urinary transferrin and ornithine decarboxylase-inducing fraction on rat bladder carcinogenesis. AB - Using heterotopically transplanted rat urinary bladder (HTB) system, we previously have shown that contact with urine enhanced bladder carcinogenesis initiated by carcinogen. In order to screen urine for promoter substances, several short term in vitro assays were developed and their results were correlated with the in vivo assay results. Chromatographically separated urine fractions were examined for the inability to induce ornithine decarboxylase (ODC), to enhance incorporation of [3H]thymidine in a bladder carcinoma cell line (804G) and to form colonies in soft agar by NRK-49F. Data from the ODC assay and soft agar colony formation correlated well with the results derived from chronic animal studies. Thus then two assays appear useful in further screening urine for promoter substance. Data furthermore indicate that ODC-inducing urine component(s) may play a primary role in the steps following initiation whereas transferrin, a mitogenic urine component, may play a secondary role. PMID- 2713826 TI - Acquired immunodeficiency syndrome. The impact on professional nursing practice. AB - The epidemic of human immunodeficiency virus (HIV) infection and all of its consequences has had a significant impact on our society and on the delivery of health care. This article explores the impact that HIV infection and AIDS has had on professional nursing practice. The risk of occupational exposure, the question of obligation to care, the need for reexamination of values, philosophy of nursing, and some of the ethical issues, the need for learning and relearning, and the need for supporting each other as individuals, co-workers, and co professionals are discussed. PMID- 2713825 TI - Promoting activity of betel quid ingredients and their inhibition by retinol. AB - Ingredients of betel quids, which have been linked to the high incidence of precancerous oral lesions and oral cancers, were examined for their promoting activity. Aqueous extracts were tested using the bovine papillomavirus (BPV) DNA transformation assay, which consists of cultured C3H/10T1/2 cells transfected with the plasmid pdPBV-1 as targets, and the frequency of transformed foci as endpoints. Areca nut extracts enhanced the formation of BPV DNA-induced transformed foci approximately tenfold. No promoting activity was detected in two samples of chewing tobacco examined. The addition of retinol to the areca nut extract inhibited its tumour promoting effect in a dose-dependent manner, completely abolishing the promoting activity at a dose of 10(-6) M. The experimental results are compared with epidemiological data on oral cancer incidences among chewers of different areca nut/tobacco mixtures and with the chemopreventive effect of vitamin A administered to betel quid chewers. PMID- 2713827 TI - Sexual rehabilitation of the cancer patient. AB - Sexual rehabilitation has been identified by the Oncology Nurses Society, the American Nurses Association, and various other health care organizations as an expected aspect of care for patients. Addressed in this article are the following questions: who involved in the patient's care should be participating in sexual rehabilitation, what are barriers to this involvement, and how might they be overcome? PMID- 2713828 TI - Ethnic variations in the prevalence of smoking among registered nurses. AB - A survey of smoking behavior was conducted on 1,569 registered nurses in six unrelated acute care hospitals in Los Angeles in 1984-1985. Smoking prevalence, higher than for other health professionals but lower than for women in the United States or in other recently surveyed samples of nurses, was closely linked to the ethnicity and the age distribution of the nurses surveyed. Patterns for black and white nurses, who account for the majority of nurses nationally, were similar to those found in other recent studies of registered nurses. Among Asian nurses, however, prevalence was lower, age of initiation was higher, and the mean number of cigarettes smoked daily was lower than for other nurses. Smoking prevalence for younger nurses was lower than for other nurses, and these nurses were more likely to report themselves as never having smoked. Smoking patterns among nurses remain a significant public health concern. PMID- 2713829 TI - Predictors of self-care in cancer patients receiving radiotherapy. AB - The purpose of this study was to examine, within a theoretical framework derived from Orem's conceptual model of nursing, whether self-care can be predicted jointly by social support and the selected basic conditioning factors of age, marital and socioeconomic status, living arrangements, and stage and site of cancer. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinics in three hospitals located in Bangkok, Thailand. Multiple regression was used to analyze the data. Socioeconomic status and social support were significant predictors of self-care, whereas stage and site of cancer seemed to predict self-care indirectly through social support. The findings are discussed in terms of the validity of Orem's self-care model. Implications for practice and further study are explored. PMID- 2713830 TI - Living with cancer. Family experiences. AB - The focus of this paper is to describe what it is like to live with cancer from the perspective of families. Recent studies indicate that family members' concerns vary with their roles as family members and patient/nonpatient status. Moreover, concerns vary with stage of illness and time since diagnosis. Not all concerns are shared among all family members. Families influence the adjustment of the person with cancer. Family members cope in different ways, and coping patterns vary with status of the disease and the person's role in the family. Nevertheless, families coping in different ways can achieve similar outcomes. PMID- 2713831 TI - The suffering associated with lung cancer. AB - The purpose of this study was to investigate the physical, psychological, and interactional aspects of lung cancer associated with suffering. A sample of 30 adults with primary pulmonary malignancies was obtained from an oncology clinic and from the practice of a thoracic surgeon. The subjects had been treated with chemotherapy, surgery, and/or radiation. A structured interview was conducted with each subject to determine the incidence of suffering associated with lung cancer. A five-point Likert-type scale was used to quantify the subjects' responses. The highest level on the scale, "Very Much" suffering, was reported to be associated with lung cancer by 50% of the sample. Ten percent of the sample reported no suffering. The following were reported to be the sources of greatest suffering: disability, pain, anxiety, changed daily activities, and weakness/fatigue. There were no statistically significant differences beyond the 0.05 level in reported suffering among groups treated with surgery, chemotherapy, or radiation. There was a statistically significant difference (p = 0.028) between groups with known metastatic disease and no known metastatic disease in the amount of suffering associated with the psychological aspects. PMID- 2713832 TI - Factors involved in nurses' teaching breast self-examination. AB - It has been demonstrated that breast self-examination (BSE) is a reliable method for early detection of breast abnormalities when practiced regularly and correctly. In addition, it has been found that a woman is likely to be more proficient if she has been taught BSE by a physician or nurse. In a hospital based study, nurses were surveyed regarding both their personal practice and their teaching of BSE to patients. Although the nurses revealed themselves to be highly compliant in terms of performing the procedure themselves, only 40% included BSE in their patient teaching. The nurses' teaching of BSE was found to be unrelated to their age, BSE practice, or personal risk for breast cancer. Nurses agreed that BSE was a valuable tool in the prevention of deaths from breast cancer. They also believed themselves to be susceptible to breast cancer despite good health and low-to-medium risk sources. We suggest that nurses' ambivalent attitudes towards breast cancer and BSE may influence their teaching behavior. PMID- 2713833 TI - Myths of antiemetic administration. AB - Chemotherapy as a treatment modality for cancer has dramatically improved outcomes for patients. However, to attain therapeutic benefit, side effects and toxicities must be endured. Among the most frequent and distressing side effects are nausea and vomiting. The experience of nausea and vomiting may become so devastating that patients will discontinue curative treatment modalities. The major responsibility of the nurse caring for a patient receiving chemotherapy treatment is to prevent or treat nausea and vomiting effectively. To accomplish this, the nurse needs to understand how nausea and vomiting occur, the action of antiemetics, and how to administer them. There are myths, beliefs, and/or practice behaviors that influence interventions for antiemetic administration. Successful nursing interventions to control nausea and vomiting may be less than optimal when myths instead of correct facts affect the interventions. PMID- 2713834 TI - Increasing severity of illness among patients undergoing phase 1 trials. Implications for nursing resources. AB - To determine whether the severity of illness of hospitalized patients participating in Phase 1 trials has changed, a modified APACHE II (MA II) index was used to evaluate retrospectively each Phase 1 patient admitted during September through December 1983 and the same 4-month span in 1987. During the 1983 period, 28 patients were enrolled in 13 Phase 1 protocols. Their average length of stay (LOS) was 12.6 days (+/- 12.3 SD) with a mean MA II of 3.44 (+/- 2.69 SD). During the same 4 months in 1987, there were 37 patients enrolled in 18 Phase 1 trials with a mean LOS of 13.5 days (+/- 13.4 SD) and a mean MA II of 6.08 (+/- 3.33). As indicated by MA II scores, 1987 hospitalized patients enrolled in Phase 1 trials had a higher severity of illness than did 1983 Phase 1 patients (p = 0.01). The implications of an oncology patient population with an increasing severity of illness are examined in relation to nursing staff forecasting, resource allocation, and productivity. PMID- 2713835 TI - Personal control and the needs for hope and information among adults diagnosed with cancer. AB - Cancer patients inevitably experience situations in which their sense of personal control is diminished. Identifying the strategies used by these individuals to maintain or regain control can be an important component in the planning of care. This study examined the relationship between levels of perceived personal control and the needs for hope and information among 56 adult cancer patients. Subjects responded to the Needs Assessment Inventory and the Spheres of Control Scales. Data were analyzed using responses from the total group (n = 56), male subjects (n = 23), and female subjects (n = 33). Significant correlations were found between perceived level of control and eight issues related to hope and information-seeking. PMID- 2713836 TI - Caring for the revolution. PMID- 2713837 TI - Safe handling of antineoplastic agents. Self-learning module. PMID- 2713838 TI - The epidemiology and primary prevention of gastric and esophageal cancer. A worldwide perspective. AB - This article examines the epidemiology and primary prevention of gastric and esophageal cancer throughout the world. Although both of these cancers have low incidence rates in many Westernized countries, they rank as foremost among all cancers in a number of developing countries. Risk factors, early signs and symptoms, and early detection procedures are discussed. Primary prevention of both stomach and esophageal cancer involves changing selected lifestyle variables: decreased alcohol intake, cessation of smoking, and decreased intake of dried, smoked, and salted foods. The nursing role in the primary prevention of stomach and esophageal cancer involves (a) familiarity with the known and hypothesized risk factors, (b) developing community-based patient education programs that are culturally relevant, simple, practical, and cost-effective, (c) working with other disciplines in prevention and early detection programs, and (d) lobbying governmental agencies to encourage their involvement in primary prevention of these cancers. PMID- 2713839 TI - Humor. A therapeutic approach in oncology nursing. AB - Humor theory has evolved from various disciplines. Numerous professionals have published literature and research studies that examine the historical perspective of humor and the current practice of humor in health care. Historically, researchers have found humor to be an unconscious activity developed from childhood to adulthood. They describe humor as spontaneous and incongruent, involving a changing state of mind. Currently, health care professionals and patients are utilizing humor as a coping mechanism, as a communication skill, and as a tool to promote the psychological and physiological healing process. This article describes how humor theory has evolved, the use of humor in health care, and humor as an adjunct therapy in oncology. Oncology nurses can utilize humor as a part of the nursing process in the care provided to patients and families. PMID- 2713840 TI - Perceived home care needs of cancer patients and their caregivers. AB - The purpose of this study was to identify perceived home care needs of outpatients receiving treatment for cancer and their caregivers. The purposive subsample consisted of 16 subjects, 8 patients receiving treatment as outpatients and their 8 caregivers. Two interview guides, one for the patients and the other for their caregivers, were based on the Neuman Systems Model to assess patient and caregiver stressors The data were analyzed in relation to intrapersonal stressors (within the individual), interpersonal stressors (between the individual and others), and extrapersonal stressors (between the individual and the environment) Several stressors within each category were identified by both the patients and caregivers. Intrapersonal stressors included treatment uncertainty and role change, the interpersonal stressor of lack of social support, and the extrapersonal stressors of lack of transportation and limited finances. In addition, patients identified specific intrapersonal stressors in relation to their situation. These included assistance in coping with physical restrictions resulting in subsequent anger and depression. On the other hand, intrapersonal stressors identified by the caregivers included support in coping with the added responsibilities in relation to patient care, the fear of being alone, guilt, and the interpersonal stressor of limited knowledge regarding the patient situation. The stressors identified by both the patients and caregivers can serve as a beginning means to explore the needs encountered by this population group. PMID- 2713841 TI - Adolescents with cancer. Sexual and reproductive issues. AB - Adolescents with cancer are confronted with sexual and reproductive issues at diagnosis, during the entire treatment period, and as long-term survivors. To help the patient cope effectively with his/her concerns, the nurse must understand normal sexual growth and development, current trends in adolescent sexuality, and specific problems arising from diagnosis and treatment. This article discusses an overview of sexuality in the well adolescent, using research findings and anecdotal accounts. The impact of the diagnosis on the adolescent's emerging sexual identity is explored in depth. Information is given on the impact of long-term effects on both sexuality and reproduction. Finally, nursing interventions for helping adolescent cancer patients cope with both the impact of diagnosis and late effects are given. These interventions include collaboration with parents, relationship building, assessment, anticipatory guidance, education, and counseling. PMID- 2713842 TI - Persistence of the hypertriglyceridemic effect of tumor necrosis factor despite development of tachyphylaxis to its anorectic/cachectic effects in rats. AB - The administration of a single injection of tumor necrosis factor (TNF) produces a variety of acute and sustained biological effects, including hyperlipidemia, stimulation of hepatic lipogenesis, decreases in adipose tissue lipoprotein lipase activity, and anorexia with weight loss. Chronic administration of a fixed dose of TNF produces tachyphylaxis to the anorectic/cachectic effects of TNF. We now report that the hyperlipidemic effect of TNF persists during chronic TNF administration in the absence of any cachectic effect of TNF. Sprague-Dawley rats injected with TNF (250 micrograms/kg) show a significant decrease in weight over the next 24 h which can be accounted for by decreases in food and water intake accompanied by an increase in urine output. With subsequent daily injections of TNF, treated rats begin eating and rapidly regain weight. Hypertriglyceridemia persists for up to 10 days of daily injections of TNF. After three daily injections of TNF, no decreases were seen in lipoprotein lipase activity in a wide variety of tissues. De novo hepatic lipogenesis remained increased in TNF treated animals after four daily injections, but by the fifth day hepatic lipogenesis returned to normal. After 5 days of TNF treatment the acute incorporation of labeled glycerol into serum triglycerides remained elevated. These data indicate that hyperlipidemia persists during multiple daily injections of TNF and that TNF induced hypertriglyceridemia is not inevitably linked to the syndrome of cachexia. PMID- 2713843 TI - Intratumoral aromatase as a prognostic factor in human breast carcinoma. AB - Intratumoral aromatase activity (AA) was measured in 145 samples of human primary breast carcinoma using the tritiated water release assay which quantifies the tritium lost to water during the aromatization of 1 beta-[3H]androstenedione to estrone. Significant AA was detected in 91/145 (63%) tumors. The possibility of a relationship between AA and a variety of clinical prognostic factors such as estrogen receptors, menopausal status, site, size, and histological grade of tumor was investigated. Possible relationship with time to relapse, overall survival, and survival of patients after relapse were also studied to determine whether intratumoral AA itself was of any prognostic value. There was no relationship between AA and tumor size, site, nodal status, menopausal status or estrogen receptors. However there was a significant correlation between AA and histological grade with an excess of AA-positive tumors having high grade (P = 0.03). There was no significant relationship between AA and overall survival (P greater than 0.1), but there was a marginal inverse correlation between AA and time to relapse (P less than 0.1). A statistically significant correlation was found between AA and survival of patients after relapse (P less than 0.05). PMID- 2713844 TI - Formation of 8-hydroxydeoxyguanosine in liver DNA of rats following long-term exposure to a peroxisome proliferator. AB - The mechanism by which nongenotoxic peroxisome proliferators induce hepatocellular carcinomas in rats and mice remains intriguing. The available experimental evidence suggests that the proliferation of peroxisomes and induction of peroxisome-associated enzymes results in oxidative stress which then leads to tumorigenesis. However, so far no direct evidence for oxidative DNA damage in livers of peroxisome proliferator-treated animals has been established. In the present study we have examined the DNA obtained from the livers of rats treated with ciprofibrate, a potent peroxisome proliferator, for variable periods of time for 8-hydroxydeoxyguanosine (8-OH-dG), an adduct that results from the damage of DNA caused by hydroxyl radical. Administration of ciprofibrate in diet at a concentration of 0.025% for 16, 28, 36, or 40 weeks resulted in progressive increases in the levels of 8-OH-dG. At 16, 28, and 40 weeks of ciprofibrate treatment, the 8-OH-dG in the liver DNA was significantly increased as compared to controls. This increase in 8-OH-dG levels is attributed to persistent peroxisome proliferation resulting from chronic ciprofibrate treatment as no increase in 8-OH-dG was found in liver DNA of rats that received a single large dose of ciprofibrate. The results of this study clearly demonstrate, for the first time, that persistent proliferation of peroxisomes leads to specific oxidative DNA damage. PMID- 2713845 TI - Ligand-induced phosphorylation of a murine tumor surface protein (TSP-180) associated with metastatic phenotype. AB - A tumor surface protein (TSP-180) has been identified on murine lung carcinomas using two monoclonal antibodies (MoAbs) (135-13C and 346-11A). Quantitative analysis of TSP-180 on 3LL variants maintained either in vitro or in vivo indicates that TSP-180 is highly expressed in highly malignant metastatic cells. In reducing conditions, sodium dodecyl sulfate-polyacrylamide gel electrophoresis banding patterns of TSP-180 obtained with MoAb 135-13C from cell lysates of 3LL metastatic cells show three proteins migrating to Mr 204,000, 134,000, and 116,000. In the same experimental conditions MoAb 135-13C precipitates from low metastasizing ones only one band, corresponding to the lower molecular weight (Mr 116,000). All bands of TSP-180 observed in 3LL variants are labeled by lactoperoxidase-catalyzed radioiodination of viable cells, incorporate 32PO4, and contain carbohydrates, as judged by binding to wheat germ agglutinin. These results indicate that all proteins have external exposure on the cell surface and that at least some of TSP-180 proteins could be differentially regulated in different tumor cells (highly metastatic versus low metastatic). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis banding patterns and immunoblots obtained from cell lysates of 3LL variants by using a monoclonal antibody to phosphotyrosine (IG-2) indicate that this MoAb recognizes proteins migrating with molecular weights identical to those reported for TSP-180. Moreover, the immunoblots of solubilized immunocomplex, obtained from cell lysates of 3LL variants by using MoAb 135-13C, demonstrate that MoAb IG-2 specifically reacts with TSP-180 proteins. Experiments undertaken in order to assess if some or all of TSP-180 proteins have tyrosine kinase activity demonstrate that MoAb 135-13C binding to the cell surface induces specific phosphorylation of the Mr 204,000 protein of TSP-180. Phosphoaminoacid analysis of the ligand-induced phosphorylated protein (pp204) demonstrates that this protein is phosphorylated at serine and tyrosine. Results reported lead us to hypothesize that TSP-180 is involved in growth-regulation mechanisms and that its high expression on cells with more malignant phenotype could be responsible for a proliferative advantage of such tumor clones. PMID- 2713846 TI - Denitrosation of 1,3-bis(2-chloroethyl)-1-nitrosourea by class mu glutathione transferases and its role in cellular resistance in rat brain tumor cells. AB - 1,3-Bis(2-chloroethyl)-1-nitrosourea (BCNU) is known to be detoxified by a denitrosation reaction catalyzed by glutathione-dependent enzymes in rat liver cytosol (R. E. Talcott and V. A. Levin, Drug Metab. Dispos., 11:175-176, 1983). Using a modification of their procedure, we have measured the ability of different purified rat glutathione transferase isoenzymes to denitrosate BCNU. The catalytic efficiencies of the isoenzymes for the denitrosation reaction expressed as the ratio of Vmax to Km were as follows (isoenzyme, Vmax/Km): 1-2, 2.3; 3-3, 12.2; 3-4, 29.2; and 4-4, 26.1. Thus, the class mu isoenzymes containing subunit 4 are by far the best catalysts of the BCNU denitrosation reaction. The class pi transferase 7-7 and class alpha transferases 1-1 and 1-2 demonstrated very weak catalytic activity with BCNU. Determination of the glutathione transferase isoenzyme profiles of 9L rat brain tumor cells and the BCNU-resistant 9L-2 subline by immunoblotting revealed that although the resistant 9L-2 cells contain lower total glutathione transferase activity than 9L cells, they have elevated levels of the class mu transferases. Also, the class pi transferases were found to be down-regulated in 9L-2 as compared with 9L cells. Thus, the increased resistance of 9L-2 cells to BCNU may, in part, be explained by up-regulation of class mu transferase expression with consequent increased capacity for BCNU detoxication. Further support for this hypothesis comes from the fact that pretreatment of 9L-2 cells with the glutathione transferase inhibitors ethacrynic acid or triphenyltin chloride enhanced the cytotoxic effects of BCNU. These results suggest that the class mu transferases play a role in the resistance of brain tumor cells to BCNU. PMID- 2713847 TI - Effects of route of administration on tissue distribution of DNA adducts in mice: comparison of 7H-dibenzo(c,g)carbazole, benzo(a)pyrene, and 2 acetylaminofluorene. AB - The environmental pollutant 7H-dibenzo(c,g)carbazole (DBC) has been shown to be a potent carcinogen in various mouse tissues, but displays an unusual degree of hepatocarcinogenicity. We have previously reported that in accord with this activity, mouse liver is the target organ for DBC-DNA binding, with total levels being up to 2700 times greater than in extrahepatic tissues after s.c. administration. To elaborate on this finding, we have directly compared the tissue distribution of DNA damage by three diverse aromatic carcinogens, DBC, benzo(a)pyrene (BP), and 2-acetylaminofluorene (AAF). Following a single topical, p.o., or s.c. administration of 80 mumol/kg of test compound to male BALB/c mice, a 32P-postlabeling assay showed the total number of DBC adducts in liver DNA to be 11-138 times that in kidney, lung, or skin DNA. The degree of hepatic adduction varied as a function of the route of administration, with the highest occurring after topical application and the lowest after s.c. injection. The tissue preference for AAF and BP adducts varied with the route of administration and was much less than for DBC adducts, except that topical application of BP gave DNA adduct levels in skin that were 91-218 times greater than in other tissues. For a given tissue and route of administration, DNA adduction by DBC was 1.7- to 950-fold greater than that by BP and AAF, except in skin where the level of DNA adducts from BP was 3 to 4 times that from DBC. We conclude that (a) DBC exhibits an exceptional and unique preference for liver DNA adduction after different routes of administration; (b) DBC is more potent overall than BP or AAF in causing tissue DNA damage; and (c) for each of the three carcinogens, the route of exposure is a much less important factor than the nature of the carcinogen in determining the tissue distribution of covalent DNA damage. PMID- 2713848 TI - Dual effects of pyrazofurin and 3-deazauridine upon pyrimidine and purine biosynthesis in mouse L1210 leukemia. AB - Pyrazofurin (NSC 143095) as the monophosphate derivative is a potent inhibitor of orotidine 5'-monophosphate (OMP) decarboxylase of the pyrimidine pathway and has been proposed to inhibit 5-aminoimidazole-4-carboxamide ribotide (AICAR) transformylase (EC 2.1.2.3) of the purine pathway (J. F. Worzalla, and M. J. Sweeney, Pyrazofurin inhibition of purine biosynthesis via 5-aminoimidazole-4 carboxamide-1-beta-D-ribofuranosyl 5'-monophosphate formyltransferase. Cancer Res., 40: 1482-1485, 1980). Measurement of levels of pyrimidine and purine intermediates in cultured mouse L1210 leukemia cells has shown that 25 microM pyrazofurin induces an 8-fold accumulation of OMP and large accumulations of intermediates proximal to the blockade with abrupt decreases in uridine and cytidine nucleotides. Considerable increases in the cellular concentrations of N succino-AICAR (SAICAR), AICAR, 5-formamidoimidazole-4-carboxamide ribotide (FAICAR), IMP, XMP, and GMP at later times indicate that AICAR transformylase is not significantly inhibited in cultured cells; rather the purine pathway and the GMP branch are stimulated. However, addition of 25 microM 3-deazauridine (NSC 126849) to leukemia cells did result in inhibition of AICAR transformylase: AICAR and SAICAR accumulated, IMP disappeared and there was a large accumulation of guanosine nucleotides. Blockade of pyrimidine biosynthesis by derivatives of pyrazofurin or 3-deazauridine spares 5-phosphoribosyl-1-pyrophosphate and L glutamine, elevated concentrations of which may stimulate initial reactions of purine biosynthesis and the reaction XMP----GMP. PMID- 2713849 TI - Augmentation of 1-beta-D-arabinofuranosylcytosine cytotoxicity in human tumor cells by inhibiting drug efflux. AB - Dipyridamole is a potent inhibitor of membrane nucleoside transport into mammalian cells. Since the membrane transporter mediates both the influx and the efflux of nucleosides, dipyridamole should be able to block nucleoside efflux from cells as well. In human ovarian carcinoma cells (2008) and promyelocytic leukemia cells (HL60), we observed that sequential treatment with 20 microM dipyridamole 2 h after their initial exposure to varying concentrations of 1-beta D-arabinofuranosylcytosine (ara-C) increased the cytotoxicity of this nucleoside analogue by 100 to 300% at all drug concentrations tested. In washout experiments in which cells were exposed to radiolabeled ara-C for 2 h and reincubated in fresh medium, the presence of 20 microM dipyridamole in the reincubation medium resulted in significantly elevated levels of intracellular radioactivity at the end of a 24-h period. High performance liquid chromatography analyses of cellular nucleotide pools during this 24-h period revealed that cells treated with the sequential ara-C/dipyridamole regimen have 2-to 3-fold higher levels of ara-CTP at all time points studied. Using alkaline elution assays, we measured a 30% increase in DNA strand breaks in cells treated with ara-C followed by dipyridamole when compared to cells treated with ara-C alone, while dipyridamole alone did not produce DNA lesions. ara-C resistance in tumor cells is associated with either the natural substrates competing with ara-C for phosphorylation and incorporation into macromolecules or increased catabolism of the parent drug. Sequential exposure regimens may overcome such tumor resistance by increasing the cellular pools of ara-C and its metabolites. A second advantage to the sequential regimen is that the prolonged retention of ara-C in non-S-phase cells may improve its efficacy. The applicability of such regimens in treating human cancer awaits the results from preclinical efficacy and toxicity trials. PMID- 2713850 TI - Modulation of doxorubicin resistance by valinomycin (NSC 122023) and liposomal valinomycin in Chinese hamster ovary cells. AB - Recently, we have reported that the toxicity of the membrane-active agent valinomycin (VM) can be reduced with maintenance and/or enhancement of its antitumor activity by incorporation in liposomes (S. S. Daoud and Juliano, Cancer Res., 46:5518-5525, 1986). Since the underlying defect(s) in multidrug resistance reside mainly in the cell membrane, it seems reasonable to attempt to overcome multidrug resistance with membrane-active drugs. Here, we report on the in vitro restoration of Adriamycin (ADR) sensitivity in a resistant Chinese hamster ovary cell line (CHRC5) by treatment with nontoxic doses of valinomycin or of liposomal valinomycin. During a 1-h drug exposure, the sensitivity of CHRC5 to ADR was enhanced 21- to 28-fold when 20 or 40 nM VM was present, doses which are not toxic to CHRC5 cells. At the same time, modest synergistic toxicity could be seen in the parent drug-sensitive cell line (AUX B1). At 100 nM VM, the sensitivity of CHRC5 to ADR was restored to almost that of the sensitive AUX B1 cells. The effects of liposomal VM on ADR sensitivity were similar to the effects produced by free VM. At nontoxic doses and with continuous exposure of the drug, valinomycin was highly active in restoring ADR sensitivity in CHRC5 cells. In cells treated for 72 h, valinomycin enhanced the sensitivity to ADR 208- to 250 fold in CHRC5 and 3- to 5-fold in AUX B1 cells. Measurements of ADR uptake and efflux indicate that, unlike other multidrug resistance modifiers, valinomycin exerts its actions in modulating ADR resistance by mechanism(s) other than increasing intracellular accumulation of Adriamycin. The possible mechanisms of the restoration of ADR sensitivity by valinomycin are discussed. PMID- 2713851 TI - Characterization of a cisplatin-resistant subline of murine RIF-1 cells and reversal of drug resistance by hyperthermia. AB - The development of tumor cell drug resistance is a major obstacle which often leads to failure of cancer chemotherapy. Therefore, reversing the cell drug resistance would have important implications in cancer treatment. We have developed a cisplatin-resistant mouse tumor cell line from the radiation induced fibrosarcoma (RIF-1) parental line; this line is named RIF/ptr1 versus the parental line RIF/pts1. It is shown that the formation of cisplatin-DNA interstrand cross-links is the same for both cell lines although the intracellular cisplatin concentrations of resistant line is significantly lower. The cytosolic activities of glutathione reductase, glutathione peroxidase, and DT diaphorase were the same in two cell lines. However, the concentration of glutathione was significantly higher in the resistant line. The resistant line was shown to be more sensitive to the cytotoxicity of heat (43 degrees C) but the combination of heat and drug had the same tumoricidal effect for both cell lines. The addition of verapamil also had a similar effect on both cell lines. We conclude that the major difference between these two lines was the glutathione related detoxification of platinum. Regardless of drug resistance, the combination of drug and heat can effectively kill both cell lines. Elevated glutathione in RIF/ptr1 cells may be associated both with enhanced heat sensitivity and drug resistance such that combined treatments with drug and heat were equally effective in killing cells of either line. PMID- 2713852 TI - Stimulation of growth in human and murine cells by adriamycin. AB - Adriamycin causes a variety of biological actions and is an effective cytotoxic agent against proliferating cells. In this paper we show that the drug is not limited in its action solely to cytotoxicity, but can also stimulate cell growth under the appropriate conditions. Using the survival assay of cloning in soft agar, we present data showing that the conditions for Adriamycin-induced growth stimulation are that the drug be in a subtoxic concentration range of 10(-10)-10( 9) M (greater than 10(-8) M causes cytotoxicity) and that the growth medium be suboptimal. This latter condition is satisfied by either growing cells for an extended period in order to exhaust the growth supporting capacity of the medium, or by growing the cells at low (less than 10%) serum concentrations. Several active anthracycline congeners also have the ability to stimulate growth. The results indicate that the cytotoxic anticancer agent Adriamycin can stimulate the proliferation of some cells. PMID- 2713853 TI - Inhibition of N-nitrosodiethylamine carcinogenesis in mice by naturally occurring organosulfur compounds and monoterpenes. AB - Naturally occurring compounds belonging to two chemical groups were studied for their capacities to inhibit N-nitrosodiethylamine (NDEA)-induced carcinogenesis in female A/J mice. One group consists of organosulfur compounds found in Allium species, including garlic, onions, leeks, and shallots, and the other, two monoterpenes, i.e., D-limonene and D-carvone. In an initial experiment, in which organosulfur compounds were investigated, diallyl disulfide, allyl mercaptan, and allyl methyl disulfide were found to produce a marked inhibition of NDEA-induced neoplasia of the forestomach when the test compounds were administered p.o. 96 and 48 h prior to NDEA. The most potent was diallyl disulfide which reduced forestomach tumor formation by more than 90%. Pulmonary adenoma formation also was inhibited but to a considerably lesser extent, i.e., about 30%. In three additional experiments, test compounds were given p.o. either 15 min or 1 h prior to NDEA. Under these conditions diallyl disulfide and allyl mercaptan again inhibited forestomach tumor formation substantially, i.e., greater than 75%, and pulmonary adenoma formation marginally, i.e., less than 20%. In these experiments D-limonene and D-carvone were tested and reduced forestomach tumor formation by slightly over 60% and pulmonary adenoma formation by about 35%. The results of these studies provide evidence of an increasing diversity of naturally occurring compounds having the capacity to inhibit nitrosamine carcinogenesis. PMID- 2713854 TI - Optimization of perfluorochemical levels with radiation therapy in mice. AB - We have examined the effects of a wide range of levels of Therox, a perfluorochemical emulsion containing bis-perfluorobutyl ethylene (F44E) with carbogen breathing on the tumor growth delay of the Lewis lung carcinoma produced by single dose radiation and fractionated radiation. The enhancement in tumor growth delay with single dose radiation therapy increased as the dose of F44E was increased from 1.2 g/kg (0.03 ml) to 4 g/kg (0.1 ml). As the dose was increased further from 6 g/kg (0.15 ml) to 8 g/kg (0.2 ml) and then to 12 g/kg (0.3 ml), there was a progressive decrease in the tumor growth delay observed. The dose of 4 g/kg was the optimal F44E level with single dose radiation therapy, giving a dose modifying factor of 2.4 +/- 0.2. This was true whether administered as a 48% (v/v) emulsion in 0.1 ml or as a 16% (v/v) emulsion in 0.3 ml. When the injection volume was varied from 0.1 ml to 0.4 ml at the 4 g/kg or 6 g/kg dose, thereby varying the emulsion concentration from 48% (v/v) to 12% (v/v) or 18% (v/v), the results tended to indicate that the volume of injection may be more important than the emulsion concentration, i.e., an injection volume of 0.2 ml produced the greatest tumor growth delay for both doses, and the emulsion concentration of 0.2 ml and 4 g/kg of F44E is 24% (v/v) whereas the emulsion concentration of 0.2 ml and 6 g/kg of F44E is 36% (v/v). Administering any dose of the emulsion with carbogen for 1 h prior to and during the radiation fraction on Day 1 only of a daily fractionated radiation protocol (3 Gy/fraction x 5 days) had very little effect on tumor growth delay compared to radiation and daily carbogen breathing. When F44E was administered on treatment Days 1, 3, and 5 with carbogen breathing, there was an increased effect on tumor growth delay which reached a maximum at 4 g/kg (0.1 ml) of 10.0 +/- 1.2 days compared with 6.7 +/- 1.0 days for radiation with daily carbogen breathing. However, when the F44E emulsion was administered every day with fractionated radiation and carbogen breathing, there was a marked enhancement in tumor growth delay observed across the entire dosage range, from 1.2 g/kg to 12 g/kg.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2713855 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin enhancement of N-methyl-N'-nitro-N nitrosoguanidine-induced transformation of rat tracheal epithelial cells in culture. AB - The abilities of various dioxins to induce toxicity or transformation of rat tracheal epithelial cells in culture were examined. 2,3,7,8-Tetrachlorodibenzo-p dioxin (TCDD) was not cytotoxic and did not induce transformation as measured by the induction of growth-altered, preneoplastic cells (termed enhanced growth variants). However, TCDD enhanced the transformation of N-methyl-N'-nitro-N nitrosoguanidine (MNNG)-initiated rat tracheal epithelial cells. Other dioxin congeners with 0 to 3 chloro substitutions were inactive in enhancing MNNG transformation. TCDD was most effective at a concentration of 0.3 nM and when treatment was administered immediately after MNNG exposure. The dose-response curves for enhancement of MNNG-induced transformation and induction of aryl hydrocarbon hydroxylase activity by TCDD were similar. These results are consistent with the hypothesis that the enhancement of cell transformation by TCDD is mediated through the TCDD receptor. TCDD also enhanced transformation when the cells were treated before MNNG treatment. The ability of 12-O tetradecanoylphorbol-13-acetate (TPA) to enhance MNNG-induced rat tracheal epithelial transformation was also examined. In contrast to the findings with TCDD, the number of transformed colonies was increased only by pretreatment with TPA followed by MNNG. TPA-pretreatment enhanced equally the number of normal cells forming colonies and the total number of transformed colonies after selection; therefore, the transformation frequency (transformants per total surviving colonies) was unchanged by TPA. In contrast, TCDD treatment enhanced the transformation frequency in MNNG-exposed cultures since the number of transformed colonies increased while the number of total colonies remained constant. Thus, TCDD appears to act by a different mechanism than TPA. TCDD enhancement of MNNG-induced transformation may be attributed to a promotional effect, a comutagenic action, or a modulation of cell proliferation and/or differentiation mediated through the TCDD receptor. PMID- 2713856 TI - Association of lysosomal activity with sensitivity and resistance to tumor necrosis factor in murine L929 cells. AB - The cytotoxic mechanism of action of tumor necrosis factor (TNF) was examined using murine L929 fibrosarcoma cells in vitro. Two cell lines were evaluated: parental TNF sensitive (L929S) (50% cytotoxic concentration, 2-6 ng/ml); and TNF resistant (L929R) (50% cytotoxic concentration, greater than 10,000 ng/ml). The latter resistant cell line was developed by serial passage in increasing concentrations of recombinant human TNF. Sensitive cells demonstrated cytolytic and cytostatic effects at TNF concentrations between 2 and 6 ng/ml, respectively. However, TNF failed to show any selective depression of RNA, DNA, or protein synthesis or ATP content in these cells until general cell death was apparent, as defined by the cell rounding and lifting off the plastic surface. The cytokine also failed to cause DNA single-strand breaks, as detected by alkaline elution techniques. TNF was also found to be no more active in glutathione-depleted cells than in target cells containing normal glutathione levels. In contrast, various nonspecific lysosomotropic agents such as ammonium chloride and D-saccharic acid lactone led to a marked inhibition of the cytotoxic action of TNF in vitro. Furthermore, significant differences in lysosomal enzyme activity were noted between L929S and L929R cells. The changes in L929R cells involved a 50% reduction in total lysosomal protein levels and a marked depression of beta glucuronidase activity. In contrast, L929R lysosomal hexosaminidase activity was significantly elevated over the L929S cells. From these studies it is concluded that the antitumor activity of TNF does not involve specific inhibition of macromolecular synthesis, ATP production, or the level of reduced thiols. Instead, TNF cytotoxicity appears to require functional lysosomes, which are altered when TNF resistance develops in vitro. PMID- 2713857 TI - Correlation between the induction of heat shock protein 70 and enhanced viral reactivation in mammalian cells treated with ultraviolet light and heat shock. AB - Enhanced viral reactivation (EVR) is considered to be one manifestation of an inducible response to DNA damage in mammalian cells analogous to the SOS response in Escherichia coli. EVR is characterized by the increased survival of ultraviolet (UV)-irradiated virus in cells which have been pretreated with DNA damaging agents or by another type of cellular stress, heat shock (HS). In this study, we have analyzed the induction of nuclear proteins from Vero cells treated with either UV or HS, with the goal of identifying the protein(s) which mediate the EVR response. Results of 2-dimensional protein gel electrophoresis and fluorographic analysis of [35S]methionine-labeled nuclear proteins showed that UV irradiation caused the increased synthesis of five proteins at 4-9 h after treatment. At 19-24 h, one of these proteins was still being synthesized at a higher level in UV-irradiated cells, and there were nine additional proteins whose syntheses were enhanced over control levels. In contrast, HS induced only one Mr 72,000 nuclear protein whose synthesis was maximal during the 4-9-h labeling period and corresponded to one of the proteins induced by UV at 19-24 h. Subsequent Western and Northern blot analyses have confirmed that this protein is a member of the heat shock protein (hsp) 70 family. Elevated nuclear levels of this protein correlated temporally with the maximum EVR response induced by each treatment (4 h after HS and 24 h after UV). Since the kinetics of EVR is different following UV and HS and parallels the difference in the induction of nuclear levels of hsp70 following each treatment, the results suggest that hsp70 may be involved in mediating the EVR response. In addition, this protein may also play a role in the recovery of DNA synthesis in UV-irradiated cells. PMID- 2713858 TI - Mesenchymal-epithelial interactions between normal and transformed human bladder cells. AB - Epithelial cells obtained from normal human urothelium, a cell line derived from a papillary bladder carcinoma, and cells derived from an invasive carcinoma were grown in a serum-free fully defined medium. The interaction between these cell types and normal bladder stromal cells obtained by explant culture in serum were investigated in mixed cultures. These studies showed that normal urothelium was not responsive to the growth factors produced by cultured bladder fibroblasts and the cells did not grow at increased rates in association with living fibroblast layers. Cells derived from a papillary human bladder carcinoma cell line also did not associate well with fibroblast layers or show marked stimulation of growth by preformed layers of fibroblast cells. On the other hand, cells of the EJ carcinoma line, originally derived from a patient with highly invasive disease, easily infiltrated fibroblast layers and were strongly stimulated to grow by the presence of the stromal cells. This model system might therefore be used to determine key elements associated with malignant progression in human bladder carcinoma. PMID- 2713859 TI - Aberrant postendocytotic fate of a 34-kDa molecular mass growth factor from human trophoblasts. AB - A 34-kDa growth factor expressed by trophoblasts and certain carcinomas binds to target fibroblastic cells through specific high-affinity receptors. Here we report studies on the cellular routing behavior of the receptor-bound 34-kDa protein. Internalization was visualized by using lissamine rhodamine-conjugated 34-kDa protein and was quantified by analyzing the acid dissociability of cell bound radioiodinated protein after incubation at 37 degrees C. The protein was found to be rapidly internalized in a temperature-sensitive manner. However, in contrast with other protein ligands, the 34-kDa protein was not rapidly degraded. The extent of ligand degradation was small as quantified by gel filtration analysis. Studies on the receptor showed that there was an atypical up regulation, i.e., increase in surface receptors in response to ligand binding at 37 degrees C. The up-regulation was partially blocked by cycloheximide, an inhibitor of protein biosynthesis, but not by known inhibitors of receptor recycling such as monensin, chloroquine, and methylamine, suggesting that enhanced receptor biosynthesis may be responsible for the process. These studies indicate that the cellular routing and receptor regulatory characteristics of the internalized 34-kDa growth factor are different from those of most growth factor ligands and imply the involvement of receptor up-regulation in signal transduction. PMID- 2713861 TI - Hyperthermia, tissue microcirculation, and temporarily increased thermosensitivity in VX2 carcinoma in rabbit liver. AB - The role of microcirculatory factors within and around liver tumors after heat treatment was investigated in a rabbit model of liver cancer (VX2 carcinoma). As a physiological factor of the microenvironment, regional blood flow (RBF) was measured by the hydrogen clearance method, and a histopathological study was done. Local hyperthermia was administered directly to the liver tumor via a 915 MHz microwave. Hyperthermia produced a temporary reduction of RBF in both the tumor and the surrounding normal liver tissues, and the histopathology revealed congestion, petechiae, and thrombosis. After hyperthermia at 43.0 degrees C for 20 min, RBF in the tumor rapidly decreased to a minimum of 40% of the control level during 0-12 h after the treatment and increased gradually to the pretreatment level at 2 days. RBF in the normal liver also decreased rapidly after hyperthermia, to a minimum of 30% of the pretreatment level, 1-12 h after treatment. In the case of treatment at 42.5 degrees C for 20 min, RBF in the tumor also rapidly decreased to a minimum of 40% of the control level, at 4 h after the treatment, and recovery was within 2 days. However, RBF in the surrounding normal liver decreased to 80% of the control level, at 2 h after the treatment, and then increased more rapidly to reach levels seen in the controls. Thus, the latter condition of heat treatment was considered to be favorable for therapeutic gain. Based on the results of these sequential microcirculatory changes, the effects of continuous and intermittent hyperthermia were studied in groups given various treatments. In a group treated with intermittent hyperthermia at 4-h intervals, the antitumor effects determined by tumor growth retardation were significantly greater, as compared with findings in the group given treatment without an interval and that given at a 24-h interval (P less than 0.001). In the tumor at 4 h after hyperthermia, the increased thermosensitivity was considered to surpass the developing thermotolerance. Thus, the antitumor effect of hyperthermia in vivo greatly depends on the microcirculation. The most efficacious mode for application of hyperthermia must be vigorously examined if a clinical relevance is to be gained. PMID- 2713860 TI - Murine monoclonal IgG3 antibodies to human colorectal tumor-associated antigens: production and characterization of antibodies active in both antibody-dependent cellular cytotoxicity and complement-mediated cytolysis. AB - Murine monoclonal antibodies have been developed against human colorectal tumors using immunogens consisting of extracts from xenografted human colon carcinoma bound to lectin-conjugated agarose beads. Antibodies of the IgG3 isotype were selected from the resulting fusions, since we and other investigators have reported that this class of antibody can mediate antibody-dependent cellular cytotoxicity (ADCC). They were characterized with respect to specificity, ADCC activity, and complement-mediated cytolytic activity. One antibody, NR-Co-01, was produced using wheat germ agglutinin-agarose, whereas NR-Co-03, NR-Co-04, and NR Co-05 were independently derived after immunization with a Dolichos biflorus lectin-agarose carrier. All four antibodies reacted intensely with the cytoplasm and cell surface of colonic adenocarcinomas and showed a restricted normal tissue reactivity. Recognition of epithelial cells in some normal adult tissues was revealed by immunoperoxidase staining of frozen tissues. No binding was found to normal lymphocytes, monocytes, granulocytes, and erythrocytes by immunofluorescence flow cytometry. All four of the antibodies were reactive with neutral glycolipids partitioned by Folch extraction of human colon carcinoma cell lines and also with a glycoprotein extracted from ovarian cyst mucin, suggesting that they may recognize one or more carbohydrate structures. The NR-Co-01, NR-Co 03, NR-Co-04, and NR-Co-05 are potent inducers of ADCC with human peripheral blood mononuclear effector cells and of complement-mediated cytolysis with human complement. However, they exhibited no ADCC activity with nude or normal mouse peripheral blood mononuclear cells at target:effector ratios ranging from 40:1 to 160:1. Their tumor reactivity, restricted normal tissue distribution, and ability to direct ADCC and complement-mediated cytolysis make these antibodies promising candidates for cancer therapy. PMID- 2713862 TI - Local distribution and concentration of intravenously injected 131I-9.2.27 monoclonal antibody in human malignant melanoma. AB - Regional measurements of 131I-9.2.27 distribution in human melanoma tumors were obtained using quantitative autoradiography. Tumors were removed from patients 72 96 h after they had received an i.v. injection of 9.15 mCi (100 mg) of 131I 9.2.27. The autoradiographic images showed that the radioactivity reaching the tumor was heterogeneously distributed. Areas of relative high and low uptake were selected in each tumor. Regions of high activity contained from 51 to 1371 nCi/g, while areas with low uptake had radioactivity ranging from 12 to 487 nCi/g. The reliability of the autoradiographic measurements was demonstrated by the strong positive correlation with direct tissue sample counting (r = 0.994 P less than 0.001). Since comparative immunocytochemistry showed a homogeneous and diffuse staining of target antigen on viable tumor cells, variability of monoclonal antibody uptake within individual tumors was not primarily due to heterogeneity of antigen expression in these cases. However, antigen levels accounted for some of the variation from tumor to tumor. When immunoperoxidase staining was repeated on adjacent sections without the addition of 9.2.27, it confirmed the nonuniform distribution of monoclonal antibody found at autoradiography. Thus, quantitative autoradiography gives information about the distribution and the local concentration of radioactive antibody in tumors allowing calculation of the radiation dose delivered to small regions within tumors. PMID- 2713863 TI - Risk factors for oral cancer in women. AB - Interviews were obtained from 125 women with oral cavity cancer and 107 female controls to assess the role of mouthwash use as a risk factor for oral cancer in women. In addition to detailed information on mouthwash use throughout adult life, information was obtained regarding smoking, alcohol consumption, general oral hygiene practices, and occurrence of nonmalignant conditions of the oral cavity. Mouthwash use was not associated with increased oral cancer risk in terms of frequency, duration of use, dilution, or rinsing practices. Among mouthwash users, cases reported taking more mouthfuls of mouthwash at each use compared with controls. Again among mouthwash users, cases were significantly more likely than controls to give as a reason for using mouthwash "to disguise the smell of tobacco" and "to disguise the smell of alcohol," whereas similar proportions of cases and controls reported using mouthwash to "disguise the smell of onions, garlic, etc." and "to disguise breath odors due to mouth infections or dental problems." These first two reasons for using mouthwash were strongly associated with smoking and drinking, respectively, and appear to be proxies for these exposures. Smoking, drinking, having 10 or more missing teeth, and religious background (non-Jewish versus Jewish) were significantly associated with oral cancer. PMID- 2713864 TI - Motor response following repeated apomorphine administration is reduced in Parkinson's disease. AB - Ten patients with Parkinson's disease (PD) with motor fluctuations under levodopa treatment were given repeated equal subcutaneous injections of apomorphine [minimal effective dose (MED)] in 1 day. The MED was defined as the dose of apomorphine necessary to induce at least 60% reduction of motor disability for a minimum period of 10 min. MED was found for each patient in previous study days. In eight a subcutaneous infusion of apomorphine was performed on a different day. Four patients with simple fluctuations ("wearing off") showed a progressive reduction of the motor response to apomorphine injections, but three of the four had a stable response (continuous "on") to apomorphine infusion. Six patients with complicated fluctuations also exhibited a decreasing response to successive apomorphine injections and often completely failed to respond to some of the boluses. The response to a subcutaneous infusion of apomorphine was unstable in three of four cases. These findings indicate that a reduction of striatal dopaminergic receptor sensitivity is associated with repeated "pulsatile" apomorphine administration in parkinsonian patients with oscillations of motor performance. It is suggested that altered regulation of dopaminergic receptor sensitivity following pulsatile stimulation with levodopa may be a relevant phenomenon in the pathogenesis of motor fluctuations in PD. PMID- 2713865 TI - Piribedil therapy in Parkinson's disease. Use of the drug in the retard form. AB - We conducted a 20-week nonblind study to evaluate the efficacy of piribedil in 30 patients with idiopathic Parkinson's disease (PD). Prior to the study 17 of these patients were under L-Dopa treatment alone or in combination with anticholinergics and/or amantadine, while 13 patients who had never taken L-Dopa were treated only with anticholinergics and/or amantadine, or were without any medication. Piribedil (in the retard form) was administered orally at a gradually increasing dose up to 200 mg daily, while previous antiparkinsonian medication remained unchanged. Twenty-five patients showed statistically significant improvement. Among the cardinal symptoms of parkinsonism, tremor responded the best. Depression also appeared to respond favorably. Our results indicate that piribedil may be a useful adjuvant in the treatment of PD. PMID- 2713866 TI - Nocturnal gamma-hydroxybutyrate. Effect on periodic leg movements and sleep organization of narcoleptic patients. AB - Periodic leg movements during sleep (PMS) is a disorder frequently encountered in narcolepsy. In the present study, 12 narcoleptic patients (six with PMS and six without) were recorded in a sleep laboratory for 2 consecutive nights before and after treatment with gamma-hydroxybutyrate (GHB) taken at bedtime for 1 month. Treatment resulted in decreased rapid eye movement (REM) sleep latency and increased REM efficiency without change in the total duration of REM sleep. GHB was associated with the appearance of pathological levels of PMS in patients who were unaffected before treatment. These results are discussed in relation to the role of dopamine in the physiopathology of narcolepsy and PMS. PMID- 2713867 TI - Levodopa and 3-O-methyldopa plasma levels in parkinsonian patients with stable and fluctuating motor response. AB - Many parkinsonian patients with motor fluctuations in response to levodopa show a good response to initial morning doses but fail to respond in the afternoon and evening. We have studied levodopa and 3-O-methyldopa (3-OM-dopa) plasma profiles in 21 patients with fluctuations and eight patients with stable motor function throughout the day. Levodopa plasma peaks and valleys were similar for both group of patients. No significant difference for levodopa absorption index [defined as levodopa plasma levels after each dose divided by the quantity (mg) of ingested levodopa] was found between the first and the second levodopa-carbidopa dose in either group of patients. Even in patients who failed to improve after the second levodopa-carbidopa tablet (p.o.) on the day of the study, no significant variation in levodopa absorption index was observed. 3-OM-dopa values depended mainly upon levodopa consumption and were not different for patients with fluctuating or stable motor response. These findings provide further evidence of the prime role of central pharmacokinetic and pharmacodynamic factors in the pathogenesis of motor fluctuations in Parkinson's disease. PMID- 2713868 TI - Increased dosage of carbidopa in parkinsonian patients on low carbidopa-levodopa regimen. Effect on levodopa bioavailability. AB - The effect of a 2.5-fold increase in daily carbidopa intake on the bioavailability of levodopa was studied in six patients with Parkinson's disease on a low chronic regimen of carbidopa-levodopa (Sinemet) at the fixed ratio of 1:10. The extent of levodopa absorption, expressed as the area under the 11-h plasma levodopa concentration-time curve (AUC0-11 h), was not enhanced by the higher carbidopa dose. A significant increase in the AUC was found for the levodopa metabolite 3-O-methyldopa at the higher carbidopa intake. Clinical performances of individual patients were identical with both carbidopa-levodopa ratios. From these data, an adequate inhibition of peripheral decarboxylation and hence a good bioavailability of levodopa may be expected in patients taking low doses of carbidopa-levodopa, using currently available commercial preparations. PMID- 2713869 TI - Complete 1H- and 13C-n.m.r. assignments for two sulphated oligosaccharide alditols of hen ovomucin. AB - The complete 1H- and 13C-n.m.r. assignments for beta-D-Galp-(1----4)-beta-D GlcpNAc-6-SO3H-(1----6)-[beta-D-Galp-(1----3 )]- D-GalNAcol and alpha-NeuAcp-(2-- -3)-beta-D-Galp-(1----3)-[beta-D-Galp-(1----4)-b eta-D- GlcpNAc-6-SO3H-(1----6)] D-GalNAcol were made by a combination of 2-D correlation experiments (Relayed Cosy; and 13C,1H Correlation-shift n.m.r. spectroscopy), and 1-D n.m.r. spectroscopy. The results illustrate the ability of these methods to locate sulphate and NeuAc groups in anionic mucinous glycoproteins. PMID- 2713871 TI - Synthesis of the 3"-sulfate ester of beta-D-GalpNAc-(1----4)-beta-D-GlcpNAc-(1--- 2)-alpha-D-Manp. PMID- 2713870 TI - Aleuria aurantia agglutinin. A new isolation procedure and further study of its specificity towards various glycopeptides and oligosaccharides. AB - A new procedure for isolating a L-fucose-specific lectin from the mushroom Aleuria aurantia is described. The fine specificity of the purified lectin was determined by inhibition of agglutination of human red blood cells by various glycopeptides and oligosaccharides, and by studying the affinity of the immobilized lectin towards glycopeptides and oligosaccharides. Results of inhibition of hemagglutination showed that the lectin presents the highest affinity towards alpha-(1----6)-linked L-fucosyl groups. Immobilized Aleuria aurantia agglutinin interacts strongly with all N-glycosylpeptides or related glycans possessing an alpha-L-fucopyranosyl group linked to O-6 of the 2 acetamido-2-deoxy-beta-D-glucopyranosyl residue involved in the glycosylamine linkage. In addition, presence of alpha-(1----3)-linked L-fucosyl groups greatly enhances the affinity of the lectin for the alpha-(1----6)-L-fucosylated glycans. The immobilized Aleuria lectin is a powerful tool for the resolution of the microheterogeneity of L-fucosylated glycopeptides and glycans of the N-acetyl lactosamine type. PMID- 2713872 TI - X-ray structural and n.m.r.-spectral studies of methyl alpha-L-evalopyranoside: reassignment of anomeric configuration for the methanolysis product of methyl 6 deoxy-3-C-methyl-alpha-L-mannofuranoside. AB - The methanolysis product of methyl 6-deoxy-3-C-methyl-alpha-L-mannofuranoside has been reassigned as methyl 6-deoxy-3-C-methyl-alpha-L-mannopyranoside by X-ray crystallographic and n.m.r.-spectral analyses. The crystals of methyl alpha-L evalopyranoside are monoclinic, space group C2, with cell dimensions: a = 12.913(2), b = 8.052(1), c = 9.766(2) A, B = 105.13(2) degrees. The pyranoside ring exists in the 1C4 conformation, with the methoxyl and 3-C-methyl groups axial. Nuclear Overhauser effects were measured for selected proton resonances in the 1H-n.m.r. spectrum. Irradiation of the 3-C-methyl and 5-C-methyl group proton signals resulted in enhancements for H-2, H-4, H-5, and the methoxyl group hydrogen atoms, but not for H-1. PMID- 2713873 TI - Examination, by 1H-n.m.r. spectroscopy, of the binding of a synthetic, high affinity heparin pentasaccharide to human antithrombin III. AB - Binding of a synthetic, high-affinity heparin pentasaccharide and of intact heparin to both native and elastase-modified human antithrombin III have been examined by 1H-n.m.r. spectroscopy. The pentasaccharide perturbs many protein resonances in the same way as does intact heparin. There are, however, differences that seem to arise both from fewer contacts in the heparin binding site when the pentasaccharide binds and from dissimilar conformational changes in the protein. The resonance of the H-2 atom of the histidine, considered to be the N-terminal residue and to be located in the heparin binding-site, is strongly perturbed by heparin binding both to native and modified antithrombin. The pentasaccharide has little effect on this histidine in either protein. Resonances from two of the remaining four histidine units are sensitive to longer-range conformational changes, and show differences between binding of the two heparin species both in native and modified ATIII. It is concluded that the pentasaccharide only partly fills the heparin binding-site and does not produce a conformational change identical to that caused by intact heparin. This is particularly significant as regards the mechanism of action of heparin, because the synthetic pentasaccharide activates ATIII towards Factor Xa, but not towards thrombin. PMID- 2713874 TI - 3rd International Symposium on Immunobiology in Clinical Oncology. Symposium on Cancer in Patients with AIDS. 7th International Symposium on Prevention and Detection of Cancer. Program and abstracts. Nice, Cote D'Azur, April 9-15, 1989. PMID- 2713875 TI - The biochemical pharmacology of fenofibrate. AB - Fenofibrate is metabolized in several stages. First, the carboxyl ester moiety is cleaved by hydrolysis, resulting in fenofibric acid, the main pharmacologically active compound. Fenofibric acid, in turn, undergoes carbonyl reduction, resulting in a pharmacologically active metabolite referred to as reduced fenofibric acid. Both fenofibric acid and reduced fenofibric acid may be conjugated to form glucuronides. There are important species differences in the metabolism and elimination patterns of fenofibrate. In the rat and dog, fenofibric acid and reduced fenofibric acid are the principal metabolites. In humans, the glucuronide of fenofibric acid is predominant. In the rat and dog, approximately 70-80% of fenofibrate and its metabolites are recovered in the feces, whereas in humans approximately 65% of the dose is excreted in the urine. Several mechanisms contribute to fenofibrate's hypolipidemic action, including inhibition of fatty acid synthesis, stimulation of fatty acid beta-oxidation, inhibition of triglyceride synthesis, and enhancement of lipoprotein lipase activity. Fenofibrate's hypocholesterolemic action is a result of both decreased biosynthesis of cholesterol through inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and increased low-density lipoprotein (LDL) clearance via modulation of hepatic LDL receptors. Fenofibrate also has three other actions that may result in the prevention or at least slowing of atherogenesis, namely inhibition of cholesterol esterification, platelet aggregation, and platelet-derived growth factor. The native acyl glucuronide of fenofibric acid is very stable, and is unlikely to have any toxic potential. Although the elimination half-life of fenofibrate is prolonged in the elderly and in patients with impaired hepatic function, the area under the curve and its clearance are not altered because of compensatory changes in the volume of distribution. PMID- 2713877 TI - Acute myocardial infarction. PMID- 2713876 TI - Mechanism of action of bile acid sequestrants and other lipid-lowering drugs. AB - Although the primary and direct action of the bile acid sequestrants is to bind bile acids in the gut, their interruption of the enterohepatic recirculation of bile acids has important effects on hepatic lipoprotein metabolism. Three key enzyme systems are affected: phosphatidic acid phosphatase, cholesterol 7 alpha hydroxylase, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase. Activation of phosphatidic acid phosphatase promotes hepatic triglyceride (TG) synthesis, induces secretion of TG-rich, very low density lipoprotein particles, and consequently, increases plasma TG levels. The activation of hepatic cholesterol 7 alpha-hydroxylase promotes the conversion of intracellular cholesterol to bile acids. The decrease in intracellular cholesterol stores, in turn, increases low-density lipoprotein (LDL) receptor expression on hepatocyte surface membranes and, consequently, receptor-mediated fractional catabolism of LDL. Reduction of intracellular cholesterol may also increase the synthesis of cholesterol through activation of HMG CoA reductase. The potential loss of the sequestrant's cholesterol-lowering efficacy can be overcome by adding a drug to the regimen that inhibits HMG CoA reductase. Finally, bile acid sequestrants promote apoprotein AI synthesis by an unknown mechanism and tend to raise high density lipoprotein (HDL) cholesterol levels, primarily by increasing plasma HDL 2 concentrations. PMID- 2713878 TI - Dietary fat influences electric membrane properties of neurons in cell culture. AB - 1. SJL/J mice were maintained on semipurified diets which differed in the ratio of polyunsaturated/saturated fatty acid content (P/S). Exposure was from conception and was maintained for periods ranging from 6 to 34 weeks. 2. Neural cell cultures were prepared from dorsal root ganglia (DRG). After 6 and 20 days of culture, neuronal electric membrane properties were determined quantitatively by intracellular recording. 3. A number of significant differences were observed for the two dietary conditions. DRG from mice on the low-P/s diet had an increase in the rate of fall of both phases of repolarization which, in conjunction with the reduced action potential overshoot, led to a reduced action potential duration. This shift to shorter-duration action potentials was accompanied by a shift to more monophasic falling phases. The low-P/S neurons also exhibited a decreased afterhyperpolarization, decreased specific membrane resistance, and decreased membrane electrical time constant compared to high-P/S neurons. 4. It was concluded that the P/S ratio in the diet can have a significant effect on the electric properties of neurons. The high-P/S neurons tended to have action potentials with biphasic repolarizations and longer durations. In contrast, the low-P/S neurons tended to have action potentials with monophasic repolarizations and shorter durations. Moreover, the known ionic dependence of these two types of action potentials suggested that the low-P/S diet resulted in action potentials with a more exclusive Na dependence, while the high-P/S diet resulted in action potentials with both Na and Ca dependence. PMID- 2713879 TI - Repeated (isolation) stress increases tribulin-like activity in the rat. AB - 1. The effect of repeated isolation stress on MAO inhibitory activity (tribulin) in rat tissues as well as on plasma catecholamine levels was investigated. 2. Animals were subjected to a daily period of isolation (9 min) and sacrificed on days 1, 2, 4, and 5. 3. In brain and cerebellum the levels of both inhibitory activities were found to be significantly higher in animals sacrificed on days 1 2 than in either controls or animals sacrificed on days 4-5. 4. In heart and kidney the highest levels of both activities were found in animals sacrificed on days 4-5. 5. Plasma levels of dopamine on day 4 were significantly higher than those in controls or in any of the experimental groups. Plasma levels of epinephrine showed step-by-step increments from day 1 up to day 5, reaching statistical significance only on day 5. Plasma levels of norepinephrine were significantly increased on days 2, 4, and 5. 6. Under the experimental conditions of this study, we have shown a rapid and short-lasting increment of tribulin in the central nervous system. Its disappearance on days 4-5 could be related to adaptation to the novel situation. Changes in the peripheral tissues appeared later, and a similar adaptation was absent during the period of observation. 7. Tribulin would be related to the stressful situation not only as an anxiety promoting agent but also in contributing to the maintenance of high levels of circulating catecholamines. PMID- 2713881 TI - [Do we know how to value our health?]. PMID- 2713880 TI - Neuronal membrane depolarization and the control of cholinergic muscarinic receptors: selective effect on different neuronal cell types. AB - 1. The possibility that a long-lasting neuronal activation regulates the expression of muscarinic cholinergic receptors was studied with three cultured neuronal cell lines. 2. Continuous depolarization of a subclone of the neuroblastoma-glioma NG108-15 hybrid cells with potassium chloride increased by 45-75% the number of cholinergic muscarinic receptors, monitored with 3H-QNB, whereas a short incubation with KCl for 10 min or 6 hr had no effect. 3. The calcium channel blocker verapamil increased the effect of KCl. 4. Two cell lines, named SC9 and WC5, that originate from the rat brain, also bind 3H-QNB. They were therefore used to test whether the effect of chronic depolarization is universal. Depolarized SC9 and WC5 cells, in the presence or absence of verapamil, did not show an increased 3H-QNB binding. 5. Muscarinic receptors of both SC9 and WC5 cells have a higher affinity to pirenzepine than the M-3 receptor subtype of the neuroblastoma-glioma cells, suggesting therefore that the two rat brain cell lines possess M-1 or M-2 receptors. 6. The physiological significance of this differential role of depolarization on the expression of different muscarinic receptors is discussed in the context of their postreceptor second messengers. PMID- 2713882 TI - [Psychological subdeprivation]. AB - The term psychic subdeprivation is explained on the basis of findings assembled in a series of research investigations the object of which were relatively large samples of children growing up in families under less favourable emotional circumstances - children born from unwanted pregnancies, children from families of alcoholics, children of illegitimate birth, children followed up after the parents' divorce. The research used a uniform methodology. The findings remind in many respects of less favourable developmental trends recorded in classical studies of psychic deprivation of children living permanently in childrens homes. Their clinical picture is, however, less marked. Nevertheless they represent the danger of a less favourable psychosocial development in a not negligible part of the child population, the potential source of more serious social pathology and the danger of transmission to the next generation. PMID- 2713883 TI - [Accumulation of aluminum in the dialyzed patient: incidence, causes and possibilities of prevention]. AB - In a group of 60 patients dialyzed for more than three years laboratory signs of aluminum accumulation were found in 30%. Serum Al values correlated with the increment in the desferal test. Orally administered aluminium hydroxide is a significant source of Al accumulation, as has been demonstrated by the decline of the blood aluminium level after its discontinuation and a negative desferal test in patients to whom it was not prescribed. The passage of Al across the dialyzation membrane depends on the difference between the ultrafiltrable ratio of the blood value and the Al concentration in the dialyzate. Therefore even a concentration of 10 micrograms/l Al in the dilyzate, so far recommended as "safe", can lead to a rise of the Al blood level during haemodialysis and to Al accumulation in tissues. Effective removal of Al from the organism is possible only during haemodialysis after previous administration of Desferal. Unless an adequate substitute of aluminium hydroxide will be available and a completely aluminium free dialyzate, Al accumulation can be prevented by preventive administration of Desferal. PMID- 2713884 TI - [Dual-photon densitometry of the lumbar spine. Basic experience and results]. AB - The principle of assessment of absorption of gamma radiation (single photon radiation, i.e. with one radiation energy) was first applied to assess the content of mineral substances in peripheral bones. Earlier and more marked affection of the spine in osteoporosis led to the development of dual-photon densitometry, i.e. differential assessment of the absorption of gamma radiation with two energies, which makes it possible to eliminate the ratio of soft tissues in absorption of the radiation (the source of radiation is gadolinium 153Gd). The equipment is more complicated and more expensive, the operation more time consuming and more pretentious. Various circumstances - most frequently changes of the spine with foci of increased density - make it difficult or impossible to evaluate and use the results in one third of patients with disorders of the bones (most frequently osteoporosis), incl. 1/2 of the patients above 60 years of age. Short-term reproducibility of the estimations is satisfactory - variation coefficients of repeated measurements in g.cm-1 and in g.cm-2 are less than 2%. Examination of 183 controls (83 men, 100 women) indicates a drop of the mineral content in L2 to L4 with age in women from 25 to 30 years to old age with a slight acceleration during the menopause, in men a decline only after the age of 60 years. In younger age groups the scatter of our normal values in men is greater than in women. The bone density in g, g.cm-1 as well as in 9.cm-2 rises significantly in the order L2 less than L3 less than L4. Except for the limited applicability of results the basic experience is on the whole favourable. From the clinical aspects the evaluation of pathological findings, to which a separate paper will be devoted, is of decisive importance. PMID- 2713885 TI - [Endocrinology: lessons from the past, hopes for the future]. AB - The social importance of endocrinology is apparent from an analysis of the prevalence of endocrinopathies in the CSSR. They affect (incl. diabetes and eufunctional goitre) some 10% of the population. The author submits a brief account of the development of knowledge of hormones and of Nobel prizes awarded for hormone research. On some examples he demonstrates the importance of endocrinology for other medical disciplines: the interrelationship of stress and infectious reactions via interleukin 1, the discovery of a series of new growth and immune factors; the participation TNF (cachectin, tumour necrosis factor) in pathological processes (tumours, atherosclerosis); vasoactive peptides EDRF (endothelium derived relaxation factor), endothelin (vasoconstriction), GM-CSF (granulocyte-macrophage colony stimulating factor) in treatment of radiation sickness and adjuvans in chemotherapy; interleukins. These new peptide hormones are words in the complex cellular signal alphabet the importance of which in the control of cellular activities we are beginning to understand. PMID- 2713886 TI - Distribution of neurons in the major pelvic ganglion of the rat which supply the bladder, colon or penis. AB - In male rats a large number of the postganglionic neurons which innervate the pelvic organs are located in the major pelvic ganglion. In the present study we have identified the location within this ganglion of neurons which project to either of three pelvic organs, the penis, colon or urinary bladder. Two fluorescent retrogradely-transported dyes, Fast Blue and Fluoro-Gold, were used. For most animals one dye was injected into the cavernous space of the penis, the wall of the distal colon or the wall of the urinary bladder. In a small number of animals two organs were injected, each with a different dye. One to six weeks after injection the major pelvic ganglia were fixed in buffered formaldehyde. The distribution of fluorescent dye-labelled cells was observed in whole mounts of complete ganglia and, in most cases, also in small accessory ganglia located between the ureter and the prostate. The studies showed a unique pattern of distribution for each organ-specific group of neurons. Most of the colon neurons are located in the major pelvic ganglion near the entrance of the pelvic nerve, whereas almost all of the penis neurons are near or within the penile nerve. Bladder neurons are relatively evenly distributed throughout the ganglion. These results demonstrate a distinct topographical organization of organ-specific neurons of the major pelvic ganglion of the male rat, a phenomenon which has also been observed in other peripheral ganglia. PMID- 2713887 TI - Adrenergic nerves and 5-hydroxytryptamine-containing cells in the pulmonary vasculature of the aquatic file snake Acrochordus granulatus. AB - The adrenergic innervation of the pulmonary vasculature of the file snake Acrochordus granulatus was examined by use of glyoxylic acid-induced fluorescence. Perivascular plexuses of blue-green fluorescent nerves are observed around the common pulmonary artery, the anterior and posterior pulmonary arteries, the arterioles leading to the gas exchange capillaries of the lung, the venules draining the lung, and the anterior and posterior pulmonary veins. Adrenergic nerves are also associated with the visceral smooth muscle of the lung septa and other tissues. Thus, adrenergic control of pulmonary blood flow may occur either at the common pulmonary artery or more regionally within the lung. Regional control of blood flow in the elongate lung of this snake may be important in matching pulmonary perfusion with the distribution of respiratory gas. Glyoxylic acid-histochemistry and immunohistochemistry revealed that populations of cells located in the common pulmonary artery contain the indoleamine 5-hydroxytryptamine. Many of the cells are intimately associated with varicose blue-green fluorescent nerves. It is proposed that the 5 hydroxytryptamine-containing cells may be involved in intravascular chemoreception. PMID- 2713888 TI - Stimulation-induced changes at crayfish (Procambarus clarkii) neuromuscular terminals. AB - The fine structure of neuromuscular terminals of the single excitor axon was examined in the limb stretcher muscle of the crayfish Procambarus clarkii. A morphometric comparison of the neuromuscular terminals of the left and right limbs of a control crayfish showed them to be similiar in qualitative as well as quantitative features. The excitor axon to the stretcher muscle of the right side was stimulated, by backfiring its branches in the adjacent opener muscle, at 20 Hz for 4-5 h per day over 4-5 days. The stretcher muscle on the left side was not stimulated and served as a control. Morphometric analysis of stimulated terminals revealed an increase in the number of dense bars and synaptic vesicles compared to their non-stimulated, contralateral counterparts. Since dense bars are regarded as active sites of transmitter release, changes in their number provide a morphological basis for synaptic plasticity. PMID- 2713889 TI - Vasoactive intestinal polypeptide-like immunoreactivity in the bovine heart: high degree of coexistence with neuropeptide Y-like immunoreactivity. AB - It is not known whether VIP coexists with other neuropeptides or neurotransmitters in the heart. In the present study, the distribution of nerve fibers showing VIP-like immunoreactivity (VIP-LI) in various parts of the bovine heart was compared with that of fibers possessing neuropeptide Y (NPY)- and dopamine-beta-hydroxylase (DBH)-LI. It was found that fibers showing VIP-LI most regularly occurred in the regions of sinuatrial and atrioventricular nodes and intracardiac ganglia, the nerve fibers being associated with nodal and ganglionic cells and arterial walls. Furthermore, it was observed that almost all fibers showing VIP-LI also exhibited NPY-LI. The fibers displaying VIP-LI occurred close to fibers endowed with DBH-LI, and on some occasions it appeared that varicosities showing immunolabeling for VIP also displayed DBH-LI. VIP- and NPY LI, but not DBH-LI, was detected in some of the intracardiac ganglionic cells. The observations are discussed in relation to the previously known distribution and function of VIP in the heart and other organs. Further studies examining the effects of VIP and NPY in the heart should take into account possible interactions between these two peptides. PMID- 2713890 TI - Effects of dexamethasone on expression and maintenance of cartilage in serum containing cultures of calvaria cells. AB - The effects of dexamethasone on the ability of cells enzymatically isolated from 21-day fetal rat calvaria to produce cartilage in vitro has been investigated. Primary cultures of single-cell suspensions of rat calvaria were grown for up to 28 days in vitro in alpha-minimal essential medium containing 15% fetal bovine serum, 50 micrograms/ml ascorbic acid, 10 mM Na beta-glycerophosphate and dexamethasone at concentrations of 1 microM to 1 nM. Two types of nodules were present in dexamethasone-containing cultures. One has been characterized previously as bone (Bellows et al. 1986). The second morphologically resembled hyaline cartilage, possessed a strong Alcian blue-positive matrix and contained type-II, but not type-I, collagen. Both bone and cartilaginous nodules were spatially distinct and developed in isolation from each other. Cartilaginous nodules were found in the highest number at a dexamethasone concentration of 100 nM. Time-course experiments revealed that while the number of bone nodules increased continuously at least to day 28, the number of cartilaginous nodules remained constant after cultures had reached confluency. When cells were isolated separately from frontal and parietal bones and sutural regions, the greatest number of cartilaginous nodules developed from parietal bones. Since 21-day fetal rat calvaria contains 2 distinct patches of cartilage at the periphery of the parietal bones, it seems likely that this cartilaginous tissue is the origin of the cartilage cells. The results demonstrate that cultures of rat calvaria cells contain chondrocytes and possibly chondroprogenitor cells that are distinct from osteoprogenitors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713891 TI - Photoperiodic influence on the innervation of the ductus epididymidis and ductus deferens of the Djungarian hamster, Phodopus sungorus: electron-microscopic and biochemical results. AB - The influence of long (light:dark 16:8) and short (light:dark 8:16) photoperiods on the autonomic innervation of the ductus epididymidis and the ductus deferens of Phodopus sungorus was studied using electron microscopy with morphometric analyses, and biochemical methods. At short photoperiods, only the large smooth muscle cells in the ductus deferens became atrophic, the number of mainly adrenergic varicosities in the smooth muscle layer decreased, and the mean distance between varicosity and smooth muscle cells increased. The content of noradrenaline was determined by high-performance liquid chromatography with electrochemical detection. For the ductus deferens, the noradrenaline content was reduced at LD 8:16 to less than 10% of the initial value. Short photoperiods are proposed to influence only the adrenergic innervation of the large smooth muscle cells of the ductus deferens. These cells are believed to exert a trophic influence on their nerves. PMID- 2713892 TI - Pattern of compartmentation in human seminiferous tubules showing dislocation of spermatogonia. AB - The pattern of compartmentation of the seminiferous epithelium was investigated, using a lanthanum tracer technique, in human testicular biopsies of adult infertile men (age 27 to 44 years), where dislocation of spermatogonia from the basal lamina occurred. Spermatogonia type A and B were found in a two- or three layered arrangement, in aberrant locations throughout the seminiferous epithelium, and in intratubular positions associated with fragments of Sertoli cell cytoplasm. Tracer impregnation was found around spermatogonia in a multilayered arrangement, indicating the extension of the basal compartment in a luminal direction. Single spermatogonia within the second or third layer of the seminiferous epithelium were regularly found to be surrounded by tracer. The junctional complex between the lateral membranes of adjacent Sertoli cells was devoid of tight junctions. Tracer penetration around spermatogonia in a more luminal position was prevented by intact Sertoli cell junctional complexes; tracer was also absent from intraluminal located spermatogonia associated with cytoplasmic fragments of Sertoli cells. The luminal extension of the basal compartment associated with the dislocation of spermatogonia clearly differs from the pattern of compartmentation during the movement of primary spermatocytes within undisturbed epithelium. There is a strong incidence of elevated serum levels of follicle-stimulating hormone (greater than 7 U/l), indicating a suppression of Sertoli cell function; this may be the cause for the dislocation of spermatogonia and the changes of compartmentation. PMID- 2713893 TI - Ultrastructural changes in the thymus of the turtle Mauremys caspica in relation to the seasonal cycle. AB - Changes in the ultrastructure of the thymus of the turtle Mauremys caspica, with special reference to its non-lymphoid components, were studied in relation to the seasonal cycle. The thymic cortex contains framework-forming epithelial-reticular cells and free macrophages, while the medulla includes, in addition, mature and presumptive pro-interdigitating cells. The ultrastructural features of these cells are generally similar to those described for non-lymphoid components of the mammalian thymus. The turtle thymus undergoes cortical involution in spring, with recovery periods in May-June and during autumn. A moderate involution occurs in winter. At the beginning of spring, cortical (but not medullary) epithelial reticular cells show degenerative changes, probably related to high levels of circulating testosterone. In spring and autumn, mature interdigitating cells are absent, but macrophages, monocytes, and pro-interdigitating cells are found. During May-June, the cortical epithelial-reticular population recovers and macrophages, monocytes, and interdigitating cells are actively phagocytic. In summer, the epithelial-reticular cells in both cortex and medulla display normal ultrastructural features; mature and immature interdigitating cells are absent and some macrophages are detected occasionally. The results suggest that non lymphoid components of the reptilian thymus can play a role in governing T lymphocyte differentiation, and that the thymic cortex and medulla exhibit different cycles of seasonal activity. PMID- 2713894 TI - Phenotypic heterogeneity of vascular endothelial cells in the human kidney. AB - To clarify the structural base of immune response occurring in the kidney, we investigated the antigenic and functional properties of vascular endothelial cells. Peritubular capillary endothelial cells exhibited the same immunohistochemical characteristics (OKM5-positive, HLA-DR-positive, Factor VIII/von Willebrand factor antigen-negative, Interleukin 1-positive) as a peripheral blood macrophage subset capable of presenting soluble antigens and triggering the autologous mixed lymphocyte reaction. On the other hand, endothelial cells of glomerular capillary loops, considered to be involved in blood coagulation, were OKM5-negative, HLA-DR-positive, Factor VIII/von Willebrand factor antigen-positive, Interleukin 1-positive. Thus the results of this study suggest that vascular endothelial cells in different anatomic compartments of the kidney express surface antigens heterogenously and may play different roles in the immune reaction. PMID- 2713895 TI - Suramin inhibits binding and degradation of platelet-derived growth factor in arterial smooth muscle cells but does not interfere with autocrine stimulation of DNA synthesis. AB - During in vitro culture arterial smooth muscle cells of adult rats are able to produce a platelet-derived growth factor (PDGF)-like protein and to promote their own growth in an autocrine manner. Here, this process has been studied using suramin, a polyanionic drug that has been reported to interfere with the cellular binding of several growth factors. Our results indicate that suramin speeds up the transition of the cells from a contractile to a synthetic phenotype early in primary culture. It inhibits the binding of PDGF to the cells, displaces PDGF bound to the cell surface, and slows down the degradation of PDGF internalized by the cells. It reduces the specific activities of the lysosomal enzymes acid phosphatase, beta-N-acetylglucosaminidase and beta-glucuronidase, and gives rise to an accumulation of lysosomes with myelin-like inclusions. It blocks PDGF- and serum-induced DNA synthesis and cellular proliferation in secondary cultures, but lacks a distinct inhibitory effect on DNA synthesis in primary cultures under serum-free conditions. The results suggest that the PDGF-like protein produced by the smooth muscle cells under the latter conditions may bind to its receptor and exert its autocrine effect intracellularly, without prior release into the pericellular space. PMID- 2713896 TI - Patchy basement membrane of rat Leydig cells shown by ultrastructural immunolabeling. AB - Rat testes were examined by conventional and immunolabeling transmission electron microscopy. Ultrastructurally identifiable continuous basement membranes were found around seminiferous tubules and the interstitial capillaries. Patches of basement membrane were, additionally, found on free surfaces of Leydig cells, between two Leydig cells, and in macrophage-Leydig cell contact sites. The ultrastructural findings were confirmed by immunocytochemical localization of laminin and collagen type IV in the same areas. A close association between the capillary basement membranes and the surfaces of perivascular Leydig cells was also observed. The possible basement membrane-mediated interactions of Leydig cells with other testicular structures, together with the novel bioactive products and regulators of Leydig cells, support the role of these cells as exceptionally complex regulatory centers of testicular functions. PMID- 2713897 TI - Substructure of cisternal organelles of neuronal perikarya in immature rat brains revealed by quick-freeze and deep-etch techniques. AB - Membrane-bounded organelles possessing cisternae, i.e., rough endoplasmic reticulum and Golgi apparatus, in immature rat central neurons were examined by quick-freeze and deep-etch techniques to see how their intracisternal structures are organized and how ribosomes are associated with the membrane of the endoplasmic reticulum. Cisternae of endoplasmic reticulum, 60-100 nm wide, were bridged with randomly-distributed strands (trabecular strands, 12.5 nm in mean diameter). Luminal surfaces of cisternae of the endoplasmic reticulum were decorated with various-sized globular particles, some as small as intramembrane particles, and others as large as granules formed by soluble proteins seen in the cytoplasm. A closer examination revealed much thinner strands (3.3 nm in mean diameter). Such thin strands were short, usually winding toward the luminal surface, and sometimes touching the luminal surface with one end. Ribosomes appeared to be embedded into the entire thickness of cross-fractured membranes of endoplasmic reticulum, that is, their internal portions appeared to be situated at almost the same level as the cisternal luminal surface. From the internal portion of ribosomes, single thin strands occasionally protruded into the lumen, suggesting that these thin strands were newly synthesized polypeptides. A horizontal separation within ribosomes appeared to occur at the same level as the hydrophobic middle of the membrane of the endoplasmic reticulum. Interiors of the Golgi apparatus cisternae, which were much narrower than cisternae of endoplasmic reticulum, were similarly bridged with trabecular strands, but the Golgi trabecular strands were thinner and more frequent. Their cisternal lumina were also dotted with globular particles. No identifiable profiles corresponding to the thin strands in the endoplasmic reticulum were observed. Golgi cisternae showed a heterogeneous distribution of membrane granularity; the membrane in narrow cisternal space was granule-rich, while that in expanded space was granule poor, suggesting a functional compartmentalization of the Golgi cisternae. PMID- 2713898 TI - Neuron-specific enolase and S-100 protein immunohistochemistry for defining the structure and topographical relationship of the different enteric nerve plexuses in the small intestine of the pig. AB - The morphological and topographical features of the intramural enteric nervous system in the small intestine of the pig has been studied on whole mounts by means of neuron-specific enolase (NSE) and S-100 protein immunohistochemistry. A clear visualization of the myenteric plexus allows the recognition of its characteristic morphology, including the thin tertiary plexus coursing within the smooth muscle layers. In the tela submucosa two ganglionated plexuses, each with its own specific characteristics, can clearly be demonstrated: (1) the plexus submucosus externus (Schabadasch) located near the inner surface of the circular muscle layer at the abluminal side of the submucosal vascular arcades, and (2) the plexus submucosus internus (Meissner) close to the outer surface of the lamina muscularis mucosae at the luminal side of the submucosal vascular arcades. Due to the possibility to trace clearly the perivascular plexuses of these vascular arcades by use of immunohistochemical techniques with antibodies to NSE and S-100 protein, the two submucosal nerve plexuses can be demonstrated with exceptional clarity. This is the first report of an investigation of the intramural nerve plexuses of the small intestine of the pig using the NSE and S 100 immunostaining methods, which is sufficiently detailed to substantiate the characteristic topography and structure of the two submucosal plexuses and their relation to the smooth muscle layers and perivascular plexuses. The level of NSE immunoreactivity for enteric neurons displays great variation, a substantial proportion of the type-II neurons appearing strongly stained. Although little is known of the specific function of these enzymes, proposals are discussed. PMID- 2713899 TI - Calmodulin is associated with microtubules forming in PTK1 cells upon release from nocodazole treatment. AB - To investigate the association of calmodulin (CaM) with microtubules (MTs) in the mitotic apparatus (MA), the distributions of CaM and tubulin were examined in cells in which the normal spindle organization had been altered. A fluorescent CaM conjugate with tetramethylrhodamine isothiocyanate (CaM-TRITC) and a dichlorotriazinyl aminofluorescein conjugate with tubulin (tubulin-DTAF) were injected into cells that had been treated with the MT inhibitor nocodazole. With moderate nocodazole concentration (0.3 micrograms/ml, 37 degrees C, 4 h) in live cells, CaM-TRITC and tubulin-DTAF concentrated identically on or near the centrosomes and kinetochores. In serial sections of these cells, small MT segments were observed by transmission electron microscopy (TEM) in the regions where fluorescent protein had concentrated. When a higher drug concentration was used (3.0 micrograms/ml, 37 degrees C, 4 h), no regions of CaM-TRITC or tubulin DTAF localization were observed, and no MTs were observed when serial sections were examined by TEM. However, following release from the high-concentration nocodazole block, CaM-TRITC colocalized with newly formed MTs at the kinetochores and centrosomes. Later in the recovery period, when chromosome-to-pole fibers had formed, CaM association with kinetochores diminished, ultimately attaining its normal pole-proximal association with kinetochore MTs in cells that progressed through mitosis. We interpret these observations as supporting the hypothesis that in the MA, CaM attains a physical association with kinetochore MTs and suggest that CaM-associated MTs may be inherently more stable. PMID- 2713901 TI - [Serologic detection of sexually transmitted diseases caused by Chlamydia trachomatis]. AB - 163 patients were examined for the presence of C. trachomatis by cultivation and concurrently sera were examined by the ELISA method for the presence of antibodies against C. trachomatis. Significant titres of antibodies were detected in less than half the patients with infection proved by cultivation. Antibodies were found more frequently in patients with a complicated course of the disease. In approximately 3% of the patients, where the agent was not detected by cultivation, antibodies were found in high titres. The author evaluated also the possibility to use the complement fixation reaction with ornithose antigen for the diagnosis of sexually transmitted infections caused by C. trachomatis. According to the author's results this method cannot be used. Serological evidence of Chlamydia infection is not a method of first choice for the diagnosis of sexually transmitted infections caused by C. trachomatis, but is an important supplementary method for the diagnosis, mainly of complicated infections. PMID- 2713900 TI - Actomyosin organization during cytokinesis: reversible translocation and differential redistribution in Dictyostelium. AB - Synchronized cultures of Dictyostelium discoideum were used to study organizational changes of the cytoskeleton during mitotic cell division. The agar overlay technique (Yumura et al.: J. Cell Biol. 99:894-899, 1984) was employed for immunofluorescence localization and video microscopic observation of living mitotic cells. The mitotic phase was defined by changes in chromosome configuration by using a double stain with the fluorescent dye DAPI. This study showed that the actin- and myosin-containing cytoskeleton was reversibly redistributed between the cortical ectoplasm and the endoplasm during prophase and telophase. Both actin and myosin filaments were dissociated from the cell cortex in prophase. Most of the actin and myosin was filamentous and remained in the endoplasm until telophase. Saltatory movements of organelles stopped suddenly, coincident with the breakdown of the cytoplasmic microtubule network. This change in the microtubule system was temporally coupled with the disappearance of actomyosin from the cortex. At the same time, the local vibrating movement of particles almost stopped, suggesting that the viscoelastic nature of the endoplasm was altered. In the late anaphase, actin and myosin relocalized to the cortical ectoplasm. Early in this phase, myosin filaments were localized specifically at the anticipated cleavage furrow region of the cleavage furrow, whereas actin filaments were redistributed more uniformly in the cell cortex, with an extremely large accumulation in the polar pseudopods. Subsequently the actin formed an orderly parallel array of cables along with myosin filaments in the contractile ring. The spatial segregation of actin and myosin in late anaphase was clearly demonstrated by multipolar cell division of artificially induced giant cells. Actin was relocalized in both the polar and the proximal constricting regions whereas myosin was only localized in the center of each pair of daughter microtubule networks where the cleavage furrow was formed. This study demonstrates that actin and myosin are reorganized by a temporally coordinated but spatially different mechanism during cytokinesis of Dictyostelium. PMID- 2713902 TI - [Comparison of the incidence of enterobacterial R plasmids in hospitals and ambulatory care facilities]. AB - Bacteriological examination of patients in hospital and ambulatory facilities revealed that in hospitals the investigated diseases of patients are twice as frequently caused by pathogenic enterobacteria which contain R plasmids than pathogenic bacteria detected in subjects who had ambulatory treatment. Comparison of the number of isolated autonomously transmissible R plasmids revealed an even greater disproportion because some bacterial strains, in particular in hospitals, contained several compatible R plasmids. The author assumes that the almost treble number of R plasmids in strains from hospitals is due to a greater opportunity of plasmid transmission in hospitalized patients, and repeatedly hospitalized patients, and is enhanced by the permanent selective pressure of antibiotics. PMID- 2713903 TI - [Simultaneous toxoplasmosis and larval toxocariasis infection in the Czechoslovak population]. AB - The authors discuss the coexistence of infection with toxoplasmosis and larval toxocariasis in man. Both these zoonoses are the most widespread and most serious of all tissue parasitoses on the territory of the CSSR. Knowledge of the incidence and frequency of concurrent infections is important for the differential diagnosis and therapy. In the introduction the authors mention briefly the incidence of toxoplasmosis and toxocariasis in animal hosts on the territory of the CSSR, deals with the developmental stages of the two parasites, Toxoplasma gondii and Toxocara canis and Toxocara cati which are infectious also for man, and with the transmission of infection. In the world literature there are so far only two papers dealing with the parallel course of these two zoonoses and they present only one confirmed case of concurrent disease in man. In the diagnostic group investigated by the authors during examination of tissue helminthoses among almost 9000 examinations larval toxocarosis was diagnosed 798 times. These patients were examined repeatedly to investigate the dynamics of toxocaral antibodies and concurrently possible toxoplasmatic antibodies. In 45 instances concurrent toxoplasmosis was revealed. In the discussion the author deals with possibilities and interrelations of infection with the two parasitoses. PMID- 2713904 TI - [Results of a 30-year study of shigellae in a reference laboratory]. AB - In Czechoslovakia in addition to the most frequent species of the genus shigella, S. sonnei, and in addition to serovars of S. flexneri which during the years of investigation accounted for 4-40% of all Shigellae a small number of serovars of sub-groups A (S. dysenteriae) and C (S. boydii) were isolated. The European endemities of S. dysenteriae 2, S. boydii 1 and S. boydii 4 occur regularly and are mostly of local origin, while in Europe uncommon serovars 3, 4, 7, 12 of S. dysenteriae and serovars 2, 3, 5, 7, 9, 10, 14, 16 and provisional E 1655/79 of S. boydii were mostly of foreign origin. Of these uncommon serovars only S. boydii 13 was isolated in Kosice in 1986 and is the only one where a foreign origin was proved. In Czechoslovakia all serovars of subgroup B of S. flexneri were isolated, incl. the newly suggested sub-serovars and biochemically aberrant strains of sub-groups B, C and D. An epidemic in a nursery caused by serovar S. flexneri, 4b, where the source of infection was a monkey, was remarkable. As to aberrant strains, the indole-positive variant of S. boydii 1, is remarkable being the first finding in the world. PMID- 2713905 TI - [Standardization of plates used in the ELISA reaction]. AB - The results of ELISA reactions made on the entire area of the plates, in the same way in all wells revealed that it is essential to eliminate the marginal rows. Even then there are in some instances deviations from the mean. These deviations frequently follow a loop-sided or dish-like pattern with the minimum in the centre of the plate. The deviations equalled in different wells on average 5-10% (or 20%) of the optic density. Between individual rows there may be a 0.100 difference in optic density, in rare instances as much as 0.300. These differences may influence the results during dilution of sera in a series more detailed than 4n and also when examining a single dilution of sera repeated in an inadequate number of wells. PMID- 2713906 TI - [The occupation of the pregnant woman in relation to the course and outcome of pregnancy]. AB - Some occupations are associated with an extra risk during pregnancy. Intensive action is not involved (the relative risk does not exceed the value of 2,000) but with regard to the number of women in these categories it is a significant extensive factor. Based on the results of an analysis of a group of all naturally terminated pregnancies in the district of Gottwaldov in 1981-1983 (6166 pregnancies), as compared with the mean an increased ratio of reproductive losses was recorded in charwomen, hairdressers, teachers, engineers with university education. Prematurity was recorded in particular in waitresses, shop-assistants, nurses, other health workers and women doctors. Workers on the whole have relatively favourable results, however, the risk in these occupation more frequently develops into actual failure of pregnancy (haemorrhage in the 1st trimester, imminent premature child birth). These workers are also more protected by legal leave after a previous childbirth, as compared with other occupations. PMID- 2713907 TI - [Clinical manifestations of hyperandrogenism in infertile women]. AB - The authors investigated clinical manifestations of hyperandrogenism in infertile women with hirsutism. Assessment of accurate quantitative indicators (hirsutic number, clitoral index, body mass growth coefficient and morphogram) made it possible to characterize the manifestations of hyperandrogenism in infertile women (n = 112). Correlation analysis revealed that the state of hirsutism and the body mass growth relations are the most sensitive indicators of the action of androgens (testosterone) in fertile age. PMID- 2713908 TI - [Conization of the uterine cervix, our technic and the results of a 5-year period]. PMID- 2713909 TI - [Analgesia-sedation using ketamine and benzodiazepines in mini-abortion]. PMID- 2713910 TI - [Hormonal therapy of breast carcinoma (in pre-, peri- and postmenopausal women)]. PMID- 2713911 TI - [The oncology patient from the viewpoint of the psychologist]. PMID- 2713912 TI - [Proceedings of the all-state conference of the Czech Gynecologic and Obstetrical Society, the Czech Sexology Society and the Section for Planned Parenthood and Parenthood Training. Podolanky, 16-17 October 1987]. PMID- 2713913 TI - [Involuntary urinary incontinence in association with pregnancy and childbirth]. AB - The authors examined the incidence of stress incontinence of urine during pregnancy and the early post-partum period. Pregnancy is with increasing frequency mentioned in the literature as a key period for development of this disorder. A detailed questionnaire was completed by all patients who were delivered of babies at the obstetric clinic after January 1, 1987. From the total number escape of urine was reported by 23.5%, incl. 41.2% primiparae. Among primiparae who reported stress incontinence during pregnancy only 7.6% had similar problems before pregnancy. Authors abroad agree that stress incontinence persists in cca 10% women who had childbirth by the vaginal route and where this disorder was manifested in conjunction with pregnancy and childbirth. It is thus necessary to focus attention on prevention and early treatment of women at risk and affected women. PMID- 2713914 TI - [Partial trabeculoplasty using the argon laser in the microsurgery of glaucoma]. AB - Authors refer one-year-results of their original modification of the partial trabeculoplasty using the argon laser Britt 152 in the treatment of the primary open-angle glaucoma. In 48 eyes of 35 patients the laser trabeculoplasty (ALT) was performed, using parameters 50 microns, 750-100 mW, 0.1 sec, 120 degrees of circumference of the anterior chamber angle. Influence of ALT on the compensation of the intraocular pressure and visual functions were followed in week intervals (1.5, 6-15, 16-25, 25-35, 36-45, 46-55, 56-70) after the performed ALT. The mean decrease of the intraocular pressure was 8.4 mmHg (1.12 kPa), the mean success was in 87%. PMID- 2713915 TI - [Argon laser trabeculoplasty in the treatment of secondary glaucoma]. AB - Author refers a group of 17 eyes with secondary glaucomas with oper irido-corneal angle and treated by argon laser trabeculoplasty. The mean time of observation was 11.1 +/- 4.2 months after the operation. The intraocular pressure was compensated in 82.4% of eyes. The best results were achieved in the group of the exfoliative glaucomas and glaucomas present after the previous antiglaucomatic operations. The worst complication which occurred was the sympathetic ophthalmia. PMID- 2713916 TI - [Complications of argon laser trabeculoplasty]. AB - Authors evaluated in the group of 90 eys occurrence and importance of one hundred spots ALT (360 degrees ALT) and of the 180 degrees ALT. Results confirmed that the complications of ALT (iritis, corneal opacities, transitory hypertension, anterior peripheral synechiae) were less frequent and more moderate after the use of 180 degrees ALT, but this fact was not proved to be significantly different. Transitory hypertension was the worst complication which was followed seven days after the performance ALT, occurring after the performed ALT in 360 degrees ALT in 53.3% and in 180 degrees ALT in 36.6% of treated eyes. PMID- 2713917 TI - [Statistical evaluation of visual acuity]. AB - The statistical evaluation of the visual acuity has to be based on the non parametric test as the decimal scale of the visual acuity forms a serial scale and not the intervallic one. From the theoretic point of view, the most advantageous approach uses the paremetric statistical tests. Visual acuity is measured on optotypic tables with log gradiation of the optotype size. At present time optotypes of this kind are not available in Czechoslovakia. PMID- 2713918 TI - [Working ability of patients with various forms and stages of glaucoma]. AB - Authors evaluated the questionnaries filled by patients with glaucoma of different type treated on the Prague Second Eye Clinic. These were completed by clinical data as state of visual functions and modes and course of the treatment. Different types of glaucoma were present: open-angle glaucoma (74), angular glaucoma (34), pigmentary glaucoma (12), exfoliative glaucoma (4), congenital glaucoma (13). Operations were performed in 26.5% of eyes, laser trabeculoplasty 18.8% and laser irodotomy 15.7%, and pharmacotherapy was applied in remaining patients. Ocular disease was the cause of the change of employment in 11.6%, the total disability pension and the partial one, were acknowledged in 3.6% and, 6.6%, resp. On contrary to the previous data, the number of patients with working disability was significantly decreased in comparison with the previous data. This fact could be explained by the use of the non-miotic antiglaucomatics, laser surgery, microsurgical operations and more precise diagnostics of the earlier stages of glaucoma. PMID- 2713919 TI - [Indications for pars plana vitrectomy]. AB - The main indications of pars plana vitrectomy are opacities of the vitreous without tendency to be absorbed, proliferating retinopathies, complicated retina detachment, heavy ocular injuries and states after the injuries, infective endopthalmitis and epimacular membranes. There is paid attention also to the indication for the inner tamponade using gases and silicone oil. Author emphasizes the cooperation between the all ophthalmologists with specialized vitreoretinal surgical units, because this is extremely needed for the repair of the urgent cases where early performance of PPV is operation of choice. PMID- 2713920 TI - [Problems in pars plana vitrectomy in complicated diabetic retinopathy]. AB - Introduction summarizes basal indications for pars plana vitrectomy (PPV) in complicated diabetic retinopathy (DR) and indications for urgently performed PPV are accentuated. Further there are explained various peculiarities of PPV in DR, various components forming the solution for infusion, advantages of the cerclage, some problems with surgery of the complicated cataracts, contribution and indications of the use of the silicone oil for the inner tamponade. Special attention was paid to the postoperative complications affecting the cornea, rubeosis iridis, iatrogenic tears of the retina and recurring intravitreal hemorrhages. Thereafter author concludes this review evaluating prognosis and long-term results of PPV and DR. He emphasizes the technical difficulties of this operation and recommends to concentrate the performance of this operation into the centres specialized for vitreoretinal surgery. PMID- 2713921 TI - [Is the prognosis of pars plana vitrectomy in diabetic retinopathy dependent on the general status of the diabetic?]. AB - Results of pars plana vitrectomy (PPV) were compared in two groups of patients. The first group was formed from 105 eyes of 87 diabetics without clinical signs of the diabetic nephropathy or nephropathy without decrease of renal functions. The other group was formed from 64 eyes of 50 diabetics suffering from diabetic nephropathy in the stage of the renal insufficiency. In the first group PPV was successful during the mean observatory period of 26 months, in 59 from 105 eyes (56%) and the mean visual acuity was 0.12. In the second group PPV was successful, during the mean observatory period of 18 months, in 34 from 64 eyes (53%) and the mean visual acuity was 0.09. Number of the successfully treated PPV was steadily decreasing according to the prolonged period of the further observations, in both mentioned groups: from 85 (81%) after 3 months on 62 (41%) after the interval of 3 years. The mean visual acuity in both followed groups was, with respect to the length of observation, moderately increased. Diabetic nephropathy in the stage of the renal insufficiency was without negative effect on the prognosis of PPV in complicated diabetic retinopathy. The more advanced organ complications of diabetes were not evaluated as contraindications of PPV and the operation may significantly improve the quality of the life of an otherwise heavily ill diabetic patient. PMID- 2713922 TI - [Combination therapy of the retina in diabetic retinopathy]. AB - Authors refer experiences with the complex therapy of diabetic retinopathy combining laser photocoagulation with cryocoagulation. Various indications and techniques of treatment were described. Equatorial cryocoagulation is advantageous with respect for its rapid performance without excessive loading of the patient and has similar effects as photocoagulation. Cryocoagulation is recommended as the operation of first choice in cases of the partial intravitreal hemorrhage. Cryocoagulation was performed in 51 eyes, 43 of them was followed for the mean period 7.2 months, with additional photocoagulation. After the cryocoagulation, which was preceeded or followed by photocoagulation, the visual acuity was measured one month after the operation and in 18 patients (42%) was improved, in 6 patients (14%) worsened. After one year in 12 followed patients 3 of them were improved, 7 patients worsened. Partial intravitreal hemorrhage with vision 6/60 and better was during one month sufficiently absorbed as to perform the further photocoagulation. PMID- 2713923 TI - [Monitoring and therapy of patients with diabetic retinopathy at the Eye Clinic in Brno]. AB - Authors refer the control and therapy of patients with diabetic retinopathy followed on the Brno Eye Clinic. The laser therapy was on the first place and was successfully used in 160 patients. Conservative therapy using some drugs is considered as an auxiliary one. Vitrectomies were not performed for the lack of the needed instrumental equipment. PMID- 2713924 TI - [Laser microsurgery after ineffective anti-glaucoma surgery]. AB - Authors suggest possibilities to use the laser microsurgery for improvement of the intraocular pressure in the eyes previously operated by means of different antiglaucomatic operations. Argon and YAG lasers were used for indicated microsurgical operations affecting the anterior chamber angle or the iris when the previous operation was not followed by adequate decrease of the intraocular pressure. PMID- 2713925 TI - [Reinnervation of the larynx in an experiment]. AB - In an experiment on five dogs the authors investigated the topographic anatomical relations of the laryngeal recurrent nerve, the vagus, the phrenic nerve and ansa cervicalis. They elaborated a surgical approach to the above nerves. In nine dogs the authors dissected the n. laryngeus recurrens and made anastomoses: an end-to end anastomosis in three dogs, a bypass anastomosis of the distal stump of the recurrent laryngeal nerve with a separated portion of the trunk of the vagus in two dogs, an end-to-end anastomosis of the distal stump of the recurrent laryngeal nerve with the dissected central portion of the phrenic nerve in four dogs (in one also interposition of the nerve trunk from a small branch of the ansa cervicalis was made). Reaxonization was investigated by histological examination. Satisfactory functional results were achieved after anastomosis of the recurrent laryngeal nerve and the phrenic nerve. Less satisfactory results were obtained when a portion of the vagus was used and subsequent anastomosis of the distal stump of the recurrent laryngeal nerve nad finally after end-to-end anastomosis of the previously dissected recurrent laryngeal nerve. PMID- 2713926 TI - [The effect of relaxation, the quality and strength of signals on the latency of brain stem evoked response audiometry]. AB - The paper deals with one of the pitfalls in examinations of acoustic evoked potentials - the problem of complete relaxation of the patient. The possibility of adequate gain of signals and the optimal record of latency is closely associated with this question. Sixty-two results of BERA examinations revealed that in 22 instances the findings of the latency of the V wave were beyond the wider range. There was, however, no marked interaural asymmetry suggesting a retrocochlear lesion. It may be concluded that protraction of the latency was associated with a low grade of relaxation. This is apparent from repeated examinations where a greater motor inhibition was achieved. To attain complete rest it is advisable to administer as premedication a psychopharmaceutical preparation and the neuroleptic preparation Haloperidol in adequate doses. PMID- 2713927 TI - [The development of occupational perceptual deafness in blacksmiths]. AB - Analysis of hearing of 140 blacksmiths from three workships (280 ears) revealed considerable differences in the development of occupational perception deafness between different individuals and also as regard the affection of the right and left ear. The author worked out the decibel increment and average audiogram after 40 years exposure to noise after dividing the aers into five groups with regard to the affection on the main four frequencies. In the majority of ears the audiometric curve is not higher than 60 dB which is due to the numerical atrophy of the external ciliated cells. A drop of the audiometric curve below 60 dB was recorded in 13 ears (4.6%); in the group during the subsequent development of deafness a decline of the audiometric curve was recorded also at lower frequencies which suggests affection of the inner ciliated cells in the course of development of progressive necrosis. For investigation of hearing during preventive examinations ensues that occupational deafness develops after a prolonged period of exposure to noise typically at a frequency of 4 kHz to 60 dB on the audiogram. A drop of the audiometric curve below 60 dB in the area of a frequency of 4 kHz and concurrently below 20 dB at lower frequencies means that the hearing of the person is threatened due to overexposure. PMID- 2713928 TI - [The relation between the auditory threshold and the threshold of middle ear reflexes induced by ipsilateral stimulation in occupational deafness]. AB - The author examined and evaluated middle ear reflexes obtained by ipsilateral stimulation in a group of 115 men, mean age 52.5 years (s = 9 years) who worked exposed to noise in uranium mines on average for 16.5 years (s = 4.6 years). Their total percentage auditory loss calculated according to Fowler is 49.7% (s = 15.1%). The arithmetic mean of differences of the auditory threshold and the threshold of middle ear reflexes in 214 ears examined at a frequency of 1000 Hz is 45.5 dB (s = 16.3 dB, min. 0 dB, max. 80 dB), in 208 ears at a frequency of 2000 Hz 30.4 dB (s = 13.5 dB, min. 0 dB, max. 75 dB), in 196 ears at frequency 3000 Hz 23.2 dB (s = 12.6 dB, min. 0 dB, max. 85 dB). The relation--ship between the auditory threshold and middle ear reflexes obtained by ipsilateral stimulation corresponds to the following equations Y1000Hz = 105.86--9.73 square root chi i Y2000Hz = 119.21--11.61 square root chi i Y3000Hz = 108.62--10.59 square root chi i Individual forecasts of the auditory threshold for pure tones only from values of the threshold of middle ear reflexes in occupational deafness are of restricted value due to the great scatter of values. PMID- 2713929 TI - [Vasovagal arrest in microlaryngoscopy]. AB - The author analyzes the causes of vasovagal arrest of cardiac activity during microlaryngoscopy when the cardio pulmonary finding is normal. After 1220 microsurgical operations the authors observed in the course of 15 years 86 local lesions of the mucosa incl. transient pareses of the lingual nerve, the glossopharyngeal and hypoglossus nerve (7%). Sudden death occurred only in one patient (0.08%). PMID- 2713930 TI - [Relation between deviation of the nasal septum and diseases of the paranasal sinuses]. AB - In a group of 50 patients the author evaluates the relationship between deviation of the nasal septum and diseases of the paranasal sinuses. He confirmed a 3-4 times more frequent incidence of deviations of the nasal septum in men. The most frequent indication for resection of the nasal septum was difficult nasal breathing (90%). A pathological X-ray finding in the paranasal sinuses was most frequently homolateral with degenerated mucosa. Eleven patients with chronic sinusitis (X-ray finding) did not have operation a cyst in the maxillary sinus was detected twice and three times a polypously surgical treatment of the paranasal sinuses and 1 to 3 years after resection of the nasal septum X-ray examination in 8 patients a negative finding and only in 3 a positive fin deviation of the nasal septum. A positive X-ray finding was recorded in 18 patients, on ding on X-ray of the paranasal sinuses persisted. PMID- 2713932 TI - [Personal experience with the use of auditory ossicle transplantation in tympanoplasty]. AB - For improvement of the mechanism of transmission of sound we use in tympanoplasty transplants of ossicles obtained from subjects who died accidentally. For preservation we use a 0.5% formaldehyde solution. In 68 patients with chronic suppurative epytympanic inflammation of the middle ear tympanoplasty was performed with transplantation of the complex of auditory ossicles: articulated incus and stapes. Positive functional results were achieved in 59 patients. Transplantation of the ossicles thus may become the method of choice; it must be, however, further improved. PMID- 2713931 TI - [Preauricular fistulae]. AB - Preauricular fistulae and their relapses are not exceptional in ENT practice. Simple topographic and anatomical relations in this area tempt us to underrate the surgical risk which is mainly the danger of incomplete removal and subsequent relapses. The elimination of nonidentifiable remnants of branchiomas in the granulation and scar tissue calls for resection extending to sound neighbouring structures which require more pretentious knowledge of clinical and anatomical conditions in this region. The authors operated successfully during the past 10 years 10 preauricular fistulae (primary operations) and two relapses. They outline the principles of surgery which were formulated with regard to their own experience, data in the literature and based on the most recent embryological findings; they emphasize preventive aspects of surgical treatment of preauricular fistulae. PMID- 2713934 TI - [Immunohistochemical classification of hypophyseal adenomas]. AB - Immunohistochemical analysis showed production of hormones in more than half of 88 pituitary adenomas that were classified mostly as chromophobe in basic staining during 3 years. Prolactin was the most often detected. A combined production of hormones especially of prolactin and growth hormone was not exceptional. Using a sensitive double indirect immunoperoxidase technique enables economy in spending primary antibodies. Evaluation of hormonal production is important for selection of therapy, as well as for settlement of prognosis. PMID- 2713933 TI - [Ultrastructural evaluation of pulmonary adenocarcinoma. I. Cytologically homogeneous phenotypes]. AB - A group of 102 lung carcinomas with an ultrastructural evidence of exocrine features comprised 88 adenocarcinomas and 2 adenosquamous carcinomas classified correctly according to the WHO histological typing as well as 12 other carcinomas which had to be re-classified after electron microscopy. Microvilli and secretory granules served as exocrine markers. The microvilli were more specific than granules because of being missing in 15 less differentiated tumours and granules in 45 cases. Microvilli were oriented into intercellular lumina in 65 tumours as well as into intracellular secretion slots in 16 cases, nonpolarized microvilli encirced the circumference of less differentiated cells in 22 tumours. Glycocalyceal bodies were identified not rarely and that was why they did not prove useful in distinguishing primary and secondary lung adenocarcinomas. Electron microscopical classification of adenocarcinomas, more reliable than the light microscopical one, was based on a phenotypical expression of various secretion granules in tumour cells. Phenotypical homogeneity characterized only 56 percent of tumours (57). The two most frequent phenotypes were together mucous cells (5) and dense granule microvillous elements (9) representing serous cells of bronchial glands; cells with apical dense granules but without microvilli (7) represented Clara cells in peripheral carcinomas; type II pneumocytes oftener were normal cells included in tumours (8) than proper tumour cells (2). PMID- 2713936 TI - [Stationary trichogenic tumors (trichohamartomas, benign trichoepitheliomas and trichogenic cystic pseudotumors]. AB - Trichohamartomas, benign trichoepiteliomas and cystic pseudotumours could be well distinguished in a group of 194 tumours. A possibility of common hamartoblastic features and transient forms does always exist. Diagnostic difficulties resulted mainly from a big number of specified units. An auxiliary separation into three subgroups is recommendable from didactic as well as practical reasons. The first subgroup comprises evident hamartoblastomas mimicking all the hair complex by their structure (hair follicle naevus, comedonic naevus, trichofolliculoma). The second subgroup comprises benign trichoepitheliomas with hamartoblastic features mimicking external hair sheath in cystology and histology (Wiener's porus pilar acanthoma, follicular poroma, tricholemmoma, folicular infundibulum tumour). Analogical cysts are in the third subgroup (epidermoid, tricholemmal, steatocystoma multiplex). PMID- 2713935 TI - [Epithelioid hemangioendothelioma of the liver]. AB - Epitheloid hemangioendothelioma of the liver was found at autopsy of two women and one man (at the age of 67, 74 and 68). It occurred in multinodular form or as a huge tumours infiltration. In one case secondaries were noticed in a portal lymphnode and in the lung. Histology was characterized by epitheloid and elongated cells with irregular nuclei and sparse cytoplasmic vacuoles. A massive growth of tumour into sinusoid, central and portal veins resulted in a progressive liver atrophy or destruction. Differential diagnosis comprised epithelial tumours, especially cholangiocellular carcinoma, angiosarcoma and non neoplastic processes (liver fibrosis and venoocclusive disease. PMID- 2713937 TI - [Histopathology of gonads in syndromes of abnormal sexual differentiation]. AB - Gonads were studied from 11 phenotypical women with syndromes of abnormal sexual differentiation. The group comprised 4 cases of complete and 3 cases of uncomplete testicular feminization one masculine pseudohermaphrodite with mosaic 45,XO/46,XY and 3 cases of Swyer syndrome. Sertoli-cells-only tubules with some nodes of so called "tubular adenomas" were the prevailing finding. One classical seminoma and two carcinomas in situ were registered in dysgenetic gonads. PMID- 2713938 TI - [Principles of handling frozen material in biopsy pathology]. PMID- 2713939 TI - [Ultrastructural evaluation of pulmonary adenocarcinoma. II. Phenotype heterogeneity and classification]. AB - A phenotypical heterogeneity was observed in 45 tumours (45 per cent) from a group of 102 carcinomas with ultrastructural features of exocrine differentiation. Double heterogeneity was found in 36 tumours and a triple one in 8 tumours; a case with quadruple heterogeneity was presented analogy of which has been lacking in literature. A combination of different exocrine phenotypes occurred in 12 tumours, exocrine and endocrine phenotypes combined in 18 tumours, exocrine cells and keratinocytes were found in 21 tumours. The exocrine phenotype was characterized usually (38 times) by secretion granules mostly of a serous type (19 times), cells with microvillous specialization without granules represented (15 times) a lower level of the exocrine phenotypical differentiation. A ciliary phenotype which could not produce homogenous population of dividing cells yet occurred (4 times) as a rudimentary accompaniment of an endocrine phenotype. The case of quadruple heterogeneity combined ciliary, serous, endocrine and keratinocytic phenotypes. The WHO histological typing scheme does not offer a proper category for heterogenous adenocarcinomas with one prevailing exocrine phenotype when compared with an analogous group of "combined" small cell carcinomas. Histological typing of such heterogenous adenocarcinomas is to be completed at least by an electron microscopical prevailing cytological characteristic in the same way as in phenotypically homogenous carcinomas. Heterogenous tumours without any phenotypical prevalence may form a group of mixed carcinomas which has been represented so far only by the histological types of adenosquamous and mucoepidermoid carcinoma. PMID- 2713940 TI - [Tasks of the Czechoslovak health care system]. PMID- 2713941 TI - [Reflex responses in the trapezius muscle after percussion of various parts of the body]. AB - In a Group of 20 healthy subjects and 16 patients with different central motor disorders a reflexological investigation was made in the upper part of the trapezius muscle. The reflex responses were produced by percussion with a reflex hammer on several sites on the head, trunk and upper extremities and identified as excitatory and inhibitory modulations of recorded EMG activity resulting from the stimulus, after averaging of 50 responses. In the group of healthy subjects after percussion of the chin, upper lip, cheek, mastoid process, back of the skull, the processus spinosus of vertebras C7 and Th12 and both sides of the volar area of the wrist, reflex responses with a short and long latency were recorded. In the group of patients with central motor disorders the reflexological finding was different, depending on the type of central disorder. On the side of spastic hemiparesis after a hemispheric ischaemic cerebrovascular lesion only responses with a short latency were recorded. In patients with parkinsonism mostly only reflex responses with a long latency were elicited. In patients with the dystonic form of torticollis spastica a side asymmetry was found. The results of the investigation provided evidence of reflex connections of remote parts of the body with trapezius muscle in healthy subjects and of the incidence of specific deviations of reflex responses in this muscle in patients with various central lesions. This is important in the differential diagnosis of central motor disorders. PMID- 2713942 TI - [Administration of high doses of B6 in age-related epileptic encephalopathies]. AB - The authors present an account on 14 patients with markedly pharmaco-resistant age-conditioned epileptic encephalopathies (4 x West's syndrome, 5 x Lennox Gastaut's syndrome and 5 x an intermediate stage of the two), treated with large doses of vitamin B6 (Pyridoxin Spofa). The mean age at the onset of therapy was 2.5 years (0.5-6 years). In addition to hitherto unsuccessful medication, the patients were given at first five-day treatment of vitamin B6 50-100 mg/day by the i.m. route, and then 200-300 mg/day orally. A marked clinical effect was recorded in five children, in another five it was less marked and usually only transient. Only in four patients the seizures were not affected, incl. three times in Lennox-Gastaut's syndrome. The EEG changes correlated with the clinical course. The authors recommend to attempt early administration of large doses of vitamin B6 in refractory age-conditioned epilepsies in the first three years of life. PMID- 2713943 TI - [Therapeutic effect of dopaminergic substances in drug-resistant Lennox-Gastaut syndrome]. AB - The authors administered to 18 children with an expressed pharmaco-resistant Lennox-Gastaut syndrome as adjuvant treatment medium doses of amantadine (Viregyt K, Egyt), 8 mg/kg/day divided into 1-2 portions or L-DOPA (Nakom, Lek) 22 mg/kg/day in 3-4 portions. The mean age at the time of administration of the agonist or dopamine precursor was 5 years (1-12.5 years). A very favourable clinical effect was recorded in eight children, in another five the positive effect was less obvious and was transient. Only in five instances the paroxysmal manifestations were not affected. Reduction of the EEG pathology corresponded to the clinical improvement. In 11 children the psychic make-up was favourably influenced and only once polymorphous hyperkinesias developed after Nakom administration. The authors assume that dopaminergic substances may play a part in the pathogenesis of some epileptic syndromes, in particular in the period of early ontogenesis of the brain. PMID- 2713944 TI - [Postoperative spondylodiscitis]. PMID- 2713945 TI - [Neurosurgery in Japan]. PMID- 2713947 TI - Influenza activity in Canada. PMID- 2713946 TI - Meningococcal disease in Ontario during the winter of 1988-1989. PMID- 2713948 TI - Influenza activity in Canada, 1988-1989. PMID- 2713949 TI - Reporting of influenza outbreaks in long-term care facilities. PMID- 2713950 TI - [The "envelope" versus the biomechanical function of the spine]. AB - As a continuation of argumentation presented in a number of previous communications, the author advocates the view according to which the developing spine and its neural content ["spinal cord-nerve roots complex"] are linked by an equally intimate morphogenetic relation like that existing between the brain and its skeletogenic envelope. A specific feature of the neurovertebral developmental relation consists in the fact that the elongated spinal cord-nerve roots complex is enveloped by its skeletogenic case both in the transversal and in the longitudinal direction. The matter is further complicated by lagging of the spinal neural growth behind that of the vertebral column. The development of the basic anatomical features of the individual vertebrae such as their length and width, the girth of the vertebral body as well as the shape of the intervertebral foramina cannot be understood without taking into account the gross developmental dynamics of the two main components of the axial organ, viz., of the spinal cord nerve roots complex and of the vertebral column. PMID- 2713951 TI - [Extramedullary Ewing's sarcoma]. AB - The authors refer to six observations of periostal Ewing's sarcoma and describe its X-ray symptomatology. It differs considerably from the commonly known picture of centrally, intramedullar-originated Ewing sarcomas and tumours, diagnosed at considerable advanced stage. The possibility of periosteal origin of Ewing's sarcoma must be considered in differential diagnosis of periostoses and the patients must be examined in a complex way, particularly by computer tomography (and in the future also by MR tomography) in order to demonstrate that the medullar space of the bone is not affected by the tumour. This enables a more considerate resection during the operation. Histological verification of the nature of the tumour and excluding presence of the tumour cells in bone marrow dissection material is necessary. It may be expected that prognosis of this form of Ewing's sarcoma while treated in a modern combined way is more favourable than in the central forms. PMID- 2713952 TI - [Spinal stenosis]. AB - Space conditions in the spine canal play the decisive role in the origin of neurological difficulties connected with pressure on the spinal cord and its radices. For the diagnosis of spinal stenosis the dimensions of the spine canal are of importance: sagital, interpedicular, interarticular and the width of lateral recessus of the spine canal. The diagnostics of spinal stenosis is based on the anterior-posterior and lateral picture of the spine, CT examination and contrast examination of the spine canal--myeloradiculography. CT is included in the diagnostic algorhythm on the 2nd place after picture of the spine in classical projections. The anvantage of CT in its non-invasiveness, illustration without projection distortion and high sensitivity and specificity of the examination. Myeloradiculography is indicated for cases of uncertain findings with CT or discrepancy of the CT picture and clinical condition. It may be presumed that in the near future the CT examination will be required in the diagnosis of spine stenosis more frequently by the physicians. PMID- 2713953 TI - [Differential diagnosis of herniation of the disks of the lumbar spine using computer tomography]. AB - In a native examination of lumbar region by computer tomography, hernia or a sequester of the disc may be imitated, in addition to cicatricing postoperation conditions, also by a convolute of varicose extended epidural veins. An unambiguous confirmation that the tissue in frontal epidural space is based on such pathological anatomical condition is possible if a repeated tomogram is made immediately after the administration of a contrast medium into a femoral vein while inferior vena cava has been compressed. PMID- 2713954 TI - [Dilatation technic in esophageal stenoses using a balloon catheter]. AB - In dilating oesophageal stenoses by balloon catheters it becomes necessary to adapt the technique of the intervention to the type and degree of stenosis and condition of the patient. The dilatation may be successfully performed even in very narrow postinflammation, postoperation and postcorrosion stenoses. The dilatation is usually performed for the period of 30 minutes, the shortest period between interventions being twice in a week, being followed by weekly or several weeks intervals. In a careful application of the balloon catheters transnasally or transorally it becomes possible to decrease the unpleasant feelings of the patient and possible complications to a minimum. PMID- 2713955 TI - CGP 6809--a new nitrosoureido-sugar derivative with activity in human tumor xenografts. AB - CGP 6809 [ethyl-6-deoxy-3,5-di-O-methyl-6-(3-methyl-3-nitrosoureido)-alpha-D- glucofuranoside] is a new methylnitrosoureido-sugar derivative that has been shown to be active against a broad spectrum of transplantable tumours in mice and rats. We investigated the anti-tumour effect of CGP 6809 in ten selected, human tumour xenograft lines growing s.c. in nude mice. The p.o. administration of 125 mg/kg per day for 10-15 days was less toxic (lethality 12% in tumour-bearing nude mice) than the i.p. injection of 62.5 mg/kg per day (lethality 22%). The anti tumour effect was similar for both application routes; two large bowel cancers responded to treatment with CGP 6809, rectal cancer CXF 158 showed a remission, and the rapidly growing, undifferentiated colonic cancer CXF 280 exhibited a transient no-change. Furthermore, remissions were observed in the epidermoid lung cancer LXF 322 and in thyroid cancer 117. Tumour progression was found in another epidermoid lung cancer and in three stomach cancers, one melanoma, and one soft tissue sarcoma. CGP 6809 is a promising new agent for clinical trials, especially for large bowel and epidermoid lung cancer. PMID- 2713956 TI - CGP 6809, a sugar-containing nitrosourea derivative: pharmacological and physicochemical properties. AB - CGP 6809 is a water-soluble nitrosourea derivative with quite distinct chemical and biological properties as compared with the well-known representatives of this class of compounds. It is related to the antibiotic streptozotocin, from which it is distinguished in the structure of the sugar moiety and the position of the methylnitrosourea residue. CGP 6809 possesses practically the same alkylating potential as streptozotocin; however, its carbamoylating activity is comparable with that of CCNU. In contrast to other nitrosourea derivatives, CGP 6809 showed relatively little activity in murine leukemias but was markedly active in solid transplantable melanomas (Harding-Passay, B16), in the 11095 prostate carcinoma, and in a substrain of Yoshida hepatoma (AH 7974) resistant to BCNU and CCNU. In the Ehrlich and Yoshida ascitic tumors complete responses were seen with no toxic death. Dose-dependent activity was found in the human lung carcinoma MBA 9812 and almost complete growth inhibition was achieved in the human melanoma WM 47 by both the oral and parenteral routes of administration. However, mammary tumor lines (Ca 755, 2661/61, R-3230AC), the Guerin-T8 uterus epithelioma, and the Rous sarcoma/S-R proved to be relatively refractory to this drug. This was also the case for the Lewis lung carcinoma implanted i.m. or s.c. However, development of lung metastases was markedly inhibited. Combination therapy using CGP 6809 with cyclophosphamide, 5-fluorouracil, or chlorambucil in the same model led to partial responses of the primary tumor as well as almost total eradication of lung metastases. PMID- 2713957 TI - Phase I study of methylacetylenic putrescine, an inhibitor of polyamine biosynthesis. AB - In a phase I clinical trial, nine patients with advanced malignancies not amenable to alternative therapy received alpha-methyl-delta-acetylenic putrescine (MAP), an enzyme-activated, irreversible inhibitor of ornithine decarboxylase (ODC). MAP was given orally in increasing doses to successive groups of three patients as follows: 375 mg, 750 mg and 1500 mg/day, given as three equally divided doses for 4 weeks. Doses of 375 and 750 mg/day were well tolerated, with no detectable toxicity. Of three patients receiving 1500 mg/day, two experienced moderate to severe myelosuppression; one of these also became anuric, requiring the discontinuation of therapy after 9 days. Both effects were reversible after treatment was stopped. No objective responses were observed, with five patients having stable disease and four, progressive disease during the study period. In the seven patients in whom it could be calculated, the plasma elimination half life t1/2 of MAP measured on the last day of treatment was between 3.9 and 9.2 h in six patients (mean, 5.6 h) and 26.1 h in the seventh. Mean steady-state trough concentrations of MAP were 2.3 mumol after the 375 mg/day dose, 7.1 mumol after 750 mg/day and 16.6 mumol after dosing with 1500 mg/day for 4 weeks, the levels after each treatment schedule being sufficient to inhibit ODC as demonstrated by increases in the urinary excretion of decarboxylated S-adenosylmethionine (dc SAM). MAP treatment was associated with mean maximal increases in the urinary excretion of dc-SAM of 2.6-, 9.3- and 17.9-fold after 375, 750 and 1500 mg/day for 4 weeks, respectively, but no consistent changes in the urinary excretion of the polyamines, putrescine, spermidine or spermine were observed. Thus, the 24-h urinary excretion of dc-SAM may be used as a conveniently accessible marker of ODC inhibition in cancer patients. PMID- 2713958 TI - A comparison of regional versus systemic drug injection. Adriamycin concentration in peripheral blood and gastric stump (post-Billroth II gastrectomy) in the dog. AB - Gastric stump cancer has a low resection rate and poor response to systemic chemotherapy. This study attempted to achieve higher drug concentrations in target tissues by way of regional arterial injection instead of systemic venous administration. A total of 12 male mongrel dogs that had undergone post-Billroth II gastrectomies were randomly divided into two groups: in group A, 1.27 mg/kg adriamycin (ADM) was injected through the left gastric artery; in group B, the same dose of ADM was injected into a vein in the left front leg. Blood samples were taken at various time intervals, and the dogs were sacrificed 2 h after drug administration. Tissues were removed from various parts of the gastric stump for measurement of the ADM concentration. The ADM content in the jejunum, heart, liver, spleen, and pancreas was also determined. The results were as follows: (1) the ADM concentration in the gastric stump near its lesser curvature and stomal mucosa was significantly higher in group A than in group B (P less than 0.05). (2) The ADM concentrations in the adjacent organs (heart, liver, and pancreas) were also significantly higher in group A than in group B (P less than 0.05). (3) The ADM levels in the venous blood were significantly higher in group B than in group A (P less than 0.05). These results indicate that a chemotherapeutic drug given through the left gastric artery provides a higher drug concentration in the area where gastric stump cancer frequently occurs and that a lower systemic blood level may cause fewer adverse drug effects. The high concentration of ADM in the heart may not be a good indication, but it may serve as an important signal either to select a less cardiotoxic drug or to monitor heart function cautiously during drug therapy. PMID- 2713959 TI - Treatment of adult acute lymphoblastic leukaemia using an intensive chemotherapy protocol. AB - A total of 25 evaluable adult patients with acute lymphoblastic leukaemia (ALL) were treated with an intensive chemotherapy regime modified from the L17/L17M protocol of the Sloan-Kettering Hospital. There were 18 men and 7 women; their median age was 36 years (range, 13-78). Seven cases had L1 morphology and 18, L2. The immunophenotype was common-ALL in 10, null-ALL in 9, T-ALL in 4 and B-ALL in 1. Of the 25 patients, 14 (56%) achieved a complete remission (CR). The causes of induction failure were partial remission (PR) only in 7 (28%) and hypoplastic death in 4 (16%). Of the 14 CR patients, 11 (78.6%) relapsed. Five patients developed CNS disease. The median disease-free survival and overall survival were only 9 and 13 months, respectively. As the follow-up periods of the surviving patients were short, late relapses may still occur and the overall treatment result is likely to be worse on longer follow-up. The possible causes of this disappointing result are discussed. PMID- 2713960 TI - Pharmacokinetics of prednisolone in children with acute lymphoblastic leukaemia. AB - The pharmacokinetics of soluble oral prednisolone were studied during induction therapy in six children with acute lymphoblastic leukaemia. There was a three- to four-fold variation in the pharmacokinetics of total and free prednisolone. For total prednisolone, the mean elimination half-life was relatively short (1.37 h) and the total clearance, relatively high (15.1 ml min-1 kg-1). The mean free fraction was high (0.37). PMID- 2713961 TI - Effect of cancer chemotherapy on dapsone N-acetylation in man. AB - The effect of cancer chemotherapy on dapsone (DDS) N-acetylation was explored in 28 patients with various malignancies. There was a significant (P = 0.01) increase in plasma monoacetydapsone/dapsone (MADDS/DDS) ratios within 24 h of the start of chemotherapy (CT), indicating an acceleration of N-acetylation. PMID- 2713962 TI - Could interspecies differences in the protein binding of flavone acetic acid contribute to the failure to predict lack of efficacy in patients? AB - We investigated the differences in plasma protein binding of flavone acetic acid (FAA) in mice and men in an attempt to explain the inter-species differences in response. In vitro data indicate both qualitative and quantitative differences in FAA protein binding: approximately 80% is bound in humans, with two different types of binding site identified; in mice, 70% is bound and only one binding site could be described. Protein binding is dose-dependent in both species. Plasma samples from 20 patients receiving FAA showed that most achieved levels that would be active in mice. We conclude that these differences in protein binding are insufficient to explain totally the observed differences in response. PMID- 2713963 TI - Fractionated anthracycline therapy in acute myeloblastic leukaemia in adults. AB - A total of nine adults with newly diagnosed acute myeloblastic leukaemia (AML) and seven with relapsed disease were treated with fractionated daunorubicin in combination with cytosine arabinoside and 6-thioguanine. Remissions were seen in 89% and 57%, respectively. The side effects associated with bolus injections of daunorubicin were much less severe with fractionated treatment, and there was no significant cardiotoxicity despite total doses of up to 1363 mg/m2 daunorubicin. These results show that fractionated anthracyclines are effective in the treatment of AML and that this mode of administration may permit an upward revision of the accepted dose limits for anthracyclines. PMID- 2713964 TI - Impact of gestational age on preterm motor development at 4 months chronological and adjusted ages. AB - A cohort of 62 low-risk preterm infants was identified and followed prospectively through the first 4 months of life to assess whether motor development is determined by biological maturity or the duration of the extrauterine experience. After identification, the cohort was subdivided into two groups according to gestational age at birth: less than 32 weeks gestation (n = 23) and greater than or equal to 32 weeks gestation (n = 39). Neuromotor assessments were performed on every infant at both 4 months chronological and 4 months adjusted ages. Analyses revealed that (1) the two groups of infants differed significantly at 4 months chronological age in terms of tone, primitive reflexes and volitional movement, but not in automatic reactions, and (2) the two groups of infants differed significantly at 4 months adjusted age in terms of primitive reflexes, but not in tone, automatic reactions or volitional movement. These findings suggest that the development of volitional movement and tone appear to evolve according to biological maturity alone. In contrast, primitive reflexes and automatic reactions in the preterm infant may be influenced by both biological maturation and environmental experience. PMID- 2713965 TI - Evaluation of a staffed ordinary house for children with severe learning difficulties. AB - The concept of living in an ordinary house in an ordinary street is becoming well accepted by those providing services to people with mental handicaps. Numerous examples have been described, but little in the way of service evaluation has been done. It is important to demonstrate that the quality of life is better in 'smaller units' and that institutional patterns of care are not being reproduced in the community. An observational study of small homely units for adults with mental handicaps has been carried out and has shown that the quality of life is better. This paper reports an observational study of the quality of care in a small staffed house for children with severe learning difficulties. The rate and content of naturally occurring interaction patterns were observed. The Child Management Practices Questionnaire was also administered. The results show that these children are enjoying a better standard of care than that found in hospital studies. However, some management practices were found to be institutionally orientated. For example, there was restricted access to some areas of the house, a lack of personal possessions and staff served and supervised meals rather than eating with the children. The implications of the findings are discussed in relation to recent policy trends and alternative forms of care in the community. PMID- 2713966 TI - Early infant feeding practice: socioeconomic factors and health visiting support. AB - A survey of health visitor and child health clinic records revealed an association between place of residence and socioeconomic factors and early infant feeding practice. Bottle feeding was associated with poor social circumstance while breast feeding was associated with higher social classes and their socioeconomic attributes. Health visiting home support was limited in its extent and there was no statistical evidence of positive discrimination towards bottle- or breast-feeding families. However, breast-feeding parents made significantly greater use of the child health clinics and so sought more health professional support in the early months of their infants' lives. PMID- 2713967 TI - Developmental outcome of high-risk neonates in North Staffordshire. AB - The findings of the developmental outcome of a 2-year follow-up study (1982-1983) on 92 2 1/2-year-old children born in North Staffordshire District are reported. They were assessed by the Griffiths Mental Developmental Scales and all came from a defined geographical area. The babies were all cared for in the Neonatal Unit at the North Staffordshire Maternity Hospital. The group comprised infants weighing less than 1500 g and those of more than 1500 g who required ventilatory support for more than 48 hours. Nine (9.8%) children had major disabilities, including two with severe hearing impairment and two with visual impairment. Disabilities were not attributable to a congenital abnormality or illness acquired after discharge from the neonatal unit. PMID- 2713968 TI - Childhood dysgraphia. Part 1. An illustrated clinical classification. AB - In this paper we propose a clinical neurological classification of childhood dysgraphia (medical model). The subject is introduced by briefly considering the childhood learning disorders as a whole, and subsequently dysgraphia will be considered in particular with description and illustration of the different types. In our second paper we report a detailed neuropsychological study which we made of 66 children with dysgraphia. In view of the differing definitions used between professionals, this first paper is an attempt to define the terms used in our classification so that subsequent statistical analysis of individual factors in aetiology and neurology can be interpreted. PMID- 2713969 TI - Physical exercise conditioning in the absence of weight loss reduces fasting and postprandial triglyceride-rich lipoprotein levels. AB - The effect of physical exercise conditioning on fasting and postprandial lipoprotein levels was studied in six normolipidemic subjects. The study consisted of two phases: a baseline stabilization phase in which subjects maintained their regular physical activity and an exercise conditioning phase in which subjects had 29 exercise sessions during a 7-week period. Each of these sessions consisted of jogging on a treadmill for 30 minutes. The subjects averaged 15.2 miles/wk. To control for possible confounding factors, such as changes in diet composition and weight loss, we placed the subjects on a metabolic diet and increased their daily caloric intake during the exercise phase. At the end of each phase of the study, a vitamin A-fat loading test was done to specifically label and follow postprandial lipoprotein levels, and a maximum oxygen consumption test was done to evaluate the subjects' physical fitness. The exercise conditioning phase significantly increased the subjects' aerobic capacity and postheparin lipoprotein lipase activity, and the phase decreased fasting triglyceride levels. Physical exercise also significantly decreased chylomicron (Sf greater than 1,000) levels by 37%. In summary, this study suggests that physical exercise conditioning reduces fasting and postprandial lipoprotein levels by increasing the catabolism of triglyceride-rich particles. Because these particles may have a role in atherogenesis, this could be a major mechanism by which exercise prevents coronary heart disease. PMID- 2713970 TI - Exercise-induced myocardial ischemia in a cold environment. Effect of antianginal medications. AB - The influence of cold on the threshold for myocardial ischemia and the efficacy of antianginal drugs in a cold environment were assessed in 24 patients with stable angina and exercise-induced ST depression. Treadmill exercise tests were done according to a randomized double-blind protocol 90 minutes after administration of placebo, 80 mg propranolol, or 120 mg diltiazem, each at both 8 degrees and 20 degrees C. Eight of the patients were classified by history as cold-sensitive before the study. For the entire group, none of the exercise end points differed significantly between cold and normal temperatures with placebo. However, cold-sensitive patients developed 1 mm ST depression 30% sooner (169 +/- 41 versus 244 +/- 38 seconds, p less than 0.01) at -8 degrees C compared with 20 degrees C. At the onset of ischemia, rate-pressure product was lower in the cold (19.8 +/- 1.0 versus 22.0 +/- 1.6 x 10(-3), p less than 0.05). Both propranolol and diltiazem prolonged time to onset of 1 mm ST depression at both temperatures. The magnitude of improvement at -8 degrees C was equal to that at 20 degrees C, and differences between the two drugs were not statistically significant. Only diltiazem prolonged total exercise duration. Thus, as assessed by exercise testing, cold does not worsen ischemic threshold in most stable angina patients. However, in a subgroup identifiable by history, ischemic threshold is lower in the cold. Propranolol and diltiazem are as effective for exercise-induced ischemia in a cold environment as at normal temperatures. PMID- 2713971 TI - Sympathetic vasoconstriction during exercise in ambulatory patients with left ventricular failure. AB - In patients with heart failure, exercise is thought to increase sympathetic vasoconstrictor tone. To investigate the extent of this sympathetic activation, we studied the effect of maximal exercise on nonexercising vascular beds in 35 patients with left ventricular failure (ejection fraction, 21 +/- 8%; peak exercise oxygen uptake (VO2), 12.3 +/- 3.5 ml/min/kg). In 28 patients, cardiac output and leg blood flow were measured during maximal upright bicycle exercise. Total flow to nonexercising tissue was then calculated as cardiac output--(2 x leg flow). In seven patients and six normal subjects, forearm blood flow was measured during supine bicycle exercise before and after alpha-adrenergic blockade with intravenous phentolamine. Maximal upright exercise increased the vascular resistance of nonexercising tissue from 34 +/- 16 units at upright rest to 45 +/- 25 units (p less than 0.02) but did not affect total flow to nonexercising tissue (rest, 2.9 +/- 1.0; maximal exercise, 2.8 +/- 1.4 l/min; p = NS). Supine exercise had no significant effect on forearm blood flow or vascular resistance in the normal subjects. In the patients with heart failure, supine exercise increased forearm vascular resistance from 45 +/- 17 to 58 +/- 25 mm Hg/ml/min/100 ml (p less than 0.02), again with no change in tissue flow (rest, 2.4 +/- 0.1; maximal exercise, 2.4 +/- 0.9 ml/min/100 ml; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713972 TI - Progressive improvement in pulmonary vascular resistance after percutaneous mitral valvuloplasty. AB - Percutaneous mitral valvuloplasty has been proposed as a nonsurgical technique for treating high-risk patients with mitral stenosis who are deferred from mitral valve replacement. The effect of this technique on patients with pulmonary hypertension, however, has not been fully evaluated. Accordingly, serial assessment of pulmonary vascular resistance was made in 14 patients with critical mitral stenosis and pulmonary hypertension (pulmonary vascular resistance greater than 250 dynes.sec/cm5 or mean pulmonary artery pressure greater than 40 mm Hg or both) who underwent percutaneous balloon dilatation of the mitral valve. Balloon valvuloplasty was performed with either one (n = 10) or two (n = 4) balloons through the transseptal approach, and it resulted in significant improvement in mean mitral gradient (from 18 +/- 4 to 9 +/- 4 mm Hg, p less than 0.001), systemic blood flow (from 3.7 +/- 1.2 to 5.0 +/- 2.2 l/min, p less than 0.001), and calculated mitral valve area (from 0.7 +/- 0.2 to 1.6 +/- 0.7 cm2, p less than 0.001). Immediately after balloon mitral valvuloplasty, pulmonary vascular resistance fell from 630 +/- 570 to 447 +/- 324 dynes.sec/cm5. Repeat catheterization 7 +/- 4 months after valvuloplasty showed further improvement of pulmonary hypertension in 12 of the 14 patients, with a mean pulmonary vascular resistance for the group as a whole of 280 +/- 183 dynes.sec/cm5, p less than 0.005. In two patients, mitral valve restenosis to a mitral valve area less than 1.0 cm2 was associated with a return of pulmonary hypertension to predilatation values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713973 TI - Stereoselective disposition and pharmacologic activity of propafenone enantiomers. AB - Propafenone is an antiarrhythmic drug that produces a variable degree of beta blockade in humans and is administered as a racemate. To examine the relative contribution of the individual enantiomers to pharmacologic effects seen during treatment with propafenone, we assessed the steady-state plasma concentrations of (+)-S-propafenone and (-)-R-propafenone in seven patients who were on long-term oral therapy, and we evaluated the electrophysiologic and beta-blocking properties of both enantiomers in vitro. The metabolism of propafenone is known to be polymorphic and to cosegregate with that of debrisoquine-4-hydroxylation. Among five patients with the extensive metabolizer phenotype (EM), the ratio of the area under the plasma concentration-time curve of (+)-S-propafenone to (-)-R propafenone was 1.73 +/- 0.15 (mean +/- SD). In the other two patients, who had the poor metabolizer phenotype (PM), the concentrations of both enantiomers were elevated but the S/R ratios were similar to those seen in patients with EM. In canine cardiac Purkinje fibers, both enantiomers produced similar frequency dependent depression of maximum upstroke of phase 0. In contrast, the affinity of the human lymphocyte beta 2-adrenoceptor was approximately 100-fold greater for (+)-S-propafenone (Ki, 7.2 +/- 2.9 nM) than for the (-)-R-enantiomer (Ki, 571 +/- 141 nM). We conclude that during long-term oral therapy, propafenone undergoes stereoselective disposition in patients with either EM or PM. beta-Blockade during propafenone therapy is likely related to accumulation of (+)-S propafenone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2713974 TI - Sources of variability in normal body surface potential maps. AB - Within-group variability of body surface potential maps was assessed on data from 685 carefully validated normal subjects (348 men and 337 women). Sources of within-group variability were evaluated by subgrouping maps by patient sex, age, height, and weight. Contribution of reproducibility error to total variance was assessed in a separate group of 52 normal subjects in whom multiple maps were recorded. Total variance was significantly lower in women than in men. Total variance tended to decrease with age, and the greatest decrease occurred in men during the 3rd decade. The ratio of total variance to mean signal energy showed a slow decrease with age for each group. Results suggest that the dominant source of within-group variability arises from variability of cardiac electric sources while the influence of volume conductor variability is significantly less. Variability due to measurement reproducibility was approximately half of the total variance. PMID- 2713975 TI - Transcatheter closure of atrial septal defects. Experimental studies. AB - Recent experience with the spring-loaded patent ductus arteriosus (PDA) occluder has demonstrated several advantages of this device in the closure of intracardiac defects compared with previously described techniques. Pathologic and animal model studies were performed to identify which atrial septal defects (ASDs) might be suitable for device closure and to test a new septal closure double umbrella. Fifty specimens from the Cardiac Registry with unrepaired ASD secunda (2 degrees) were analyzed. Mean ASD size was 8 x 10 mm (range, 3 x 4 to 30 x 30 mm); 80% (n = 40) of ASDs were judged closable with the new device. ASD closure was attempted in four lambs with the Rashkind (hooked single umbrella) ASD occluder. One of four umbrellas was correctly positioned; no ASDs were closed. A new double-hinged ("clamshell") umbrella device was designed: eight ASD closures were attempted with this device (defects ranged from 8 to 20 mm in diameter). Six of eight umbrellas were correctly positioned; four of four animals observed more than 1 day appeared to have complete closure on postmortem examination with endothelialization of the device. We conclude that 1) most ASD 2 degrees are far enough from vital structures to permit closure, 2) initial placement of hooked umbrellas is often incorrect and cannot be altered, 3) clamshell double umbrellas were successfully placed in six of eight attempts, and 4) endothelialization of closed ASDs appears complete within weeks of implantation. These preliminary studies appear promising and support testing the clamshell ASD device in clinical trials. PMID- 2713976 TI - Modulation of the Purkinje-ventricular muscle junctional conduction by elevated potassium and hypoxia. AB - Action potential transmission in the canine ventricle normally occurs from the Purkinje (P) system into the ventricular muscle (VM) at specific P-VM junction sites. Transitional (T) cells are located between the Purkinje and the ventricular (V) cells at these P-VM junction sites. It has been shown that exposure to elevated [K+]0 in combination with hypoxia produces an increase in the P-VM conduction time. To examine this increase in P-VM conduction time, simultaneous measurements of the action potential upstrokes of T cells and the activation times of the local P and V cells at P-VM junctional sites were obtained from in vitro canine papillary muscles. The effects of elevated [K+]0 and hypoxia on conduction from P cells to T cells was then compared with the conduction from T cells to V cells to assess the relative contribution of each to the increase in the P-VM conduction time. We found that this intervention has approximately equal effects on the two sequential steps involved in P-VM conduction. We then analyzed the increased delay from T cells and V cells on the basis of three hypothetical mechanisms: 1) increased coupling resistance, 2) decreased V cell excitability, and 3) decreased cellular responsiveness of the T cells. Our results show that the effects of elevated [K+]0 and hypoxia on T-VM delay can be accounted for by a decreased responsiveness of the T cells without any significant electrical uncoupling between T and V cells or decrease in VM excitability. PMID- 2713977 TI - Exercise, lipoproteins, and coronary artery disease. PMID- 2713978 TI - Nonischemic ventricular tachycardia. Clinical course and long-term follow-up in patients without clinically overt heart disease. AB - This report describes the clinical, laboratory, and electrophysiologic features of 52 patients with ventricular tachycardia (VT) who had no clinical evidence of heart disease. The mean age of patients was 36 years, cardiovascular collapse occurred in 18 patients (35%), and exercise-related symptoms were present in 24 of 49 patients (49%). There were 20 patients with sustained monomorphic VT, 11 with incessant VT, and 21 with nonsustained VT. Abnormalities were present in 14 of 38 patients (37%) during echocardiography and in 21 of 47 patients (45%) who underwent cardiac catheterization. During baseline evaluation while patients were not receiving antiarrhythmic drugs, ambulatory monitoring and exercise testing showed an 88% and 57% incidence, respectively, of nonsustained or sustained monomorphic VT, whereas 31 of 50 patients (62%) had inducible VT (requiring an infusion of isoproterenol in 11 patients) during programmed electrical stimulation. The clinical VT (when a 12-lead electrocardiogram was available for analysis) had a left bundle branch block (LBBB) configuration in 20 of 33 patients (61%) and a right axis deviation in 17 of 33 patients (51%). The VT occurring during exercise testing and programmed electrical stimulation had the same configuration as the clinical VT in 22 of 22 patients. Three patients have received an antitachycardia pacemaker, and one patient underwent endocardial resection. Forty-eight patients (92%) were treated medically. One patient died of cancer; the remaining 47 patients were alive at a mean follow-up of 96 months after initial symptoms and 46 months after programmed electrical stimulation. We conclude that in patients without clinical evidence of heart disease, VT may be incessant, sustained, or nonsustained and that VT originates from the right ventricular outflow tract in more than 50% of patients. Although cardiac abnormalities may be found in more than 30% of patients, the exact significance of these abnormalities is unclear because of the absence of progressive changes and the excellent prognosis of this group of patients. PMID- 2713979 TI - Protease inhibitors influence the direction of neurite outgrowth. AB - Addition of protease inhibitors to the culture medium has been shown to enhance neurite outgrowth by cultured mouse dorsal root ganglia (DRG). Those results are now extended to show that a diffusible source of soybean trypsin inhibitor (STI) or zones of immobilized STI can orient the direction of outgrowth towards the region of STI. However, a high concentration of diffusible STI promotes outgrowth in the opposite direction from the STI source. Immobilized leupeptin, L-lysine, or D-Phe-Pro-Arg-chloromethyl ketone can also direct outgrowth towards their immobilized areas, as do zones of laminin or fibronectin. However, derivatized zones containing urokinase or thrombin preferentially direct outgrowth away from those zones. These data support the hypothesis that a balance between extracellular protease and inhibitor is important in mediating interactions between neurite growth cone and extracellular matrix. PMID- 2713980 TI - Evidence for an enhanced role of GABA inhibition in visual cortical ocular dominance of cats reared with abnormal monocular experience. AB - The effects of microiontophoretic bicuculline, a gamma-aminobutyric acid (GABA) antagonist, on the ocular dominance of visual cortical neurons were compared in normal cats and cats reared with abnormal monocular visual experience (monocular deprivation, surgical strabismus, and monocular deprivation after dark rearing). Cells that were monocular prior to drug application showed disinhibitory effects on ocular dominance far more frequently than originally binocular cells in all rearing conditions. When the total population of neurons was considered there were marked differences among rearing conditions: only 17% of cells showed change in ocular dominance in normal cats whereas over 50% showed changes in cats reared with abnormal monocular visual experience. These results indicate that GABA inhibition plays an enhanced role in cats with abnormal cortical ocular dominance. The results are interpreted in the context that the GABA system is passively biased by alterations in the pattern of excitatory input to contribute to abnormal patterns of ocular dominance. PMID- 2713981 TI - Postnatal redistribution of pericruciate motor cortical projections within the kitten spinal cord. AB - The anatomical distribution of pericruciate cortical axons in the spinal cord was examined using anterograde transport of WGA-HRP from multiple unilateral injections into defined regions of the pericruciate cortex (PC) in 20 time-mated kittens and 3 adult cats. The gray matter and descending white matter tract distributions of WGA-HRP-labelled densities were analyzed using computerized morphometry and 3-dimensional reconstruction. In kittens older than 16 days postnatal (dPN), PC axon densities were found in dorsolateral column tracts corresponding to those of the adult, indicating that the white matter projections from the PC were largely established by this age. However, in kittens less than 38-44 dPN (about 105-109 days gestation), the spinal gray matter PC axon densities were distributed widely (so as to involve dorsal, intermediate and ventral laminae, e.g., I to IX) and bilaterally at all levels of the spinal cord. This contrasted sharply with the adult spinal cord in which the majority of densities was localized to laminae IV-VII on the contralateral side. The proportion of PC densities counted in the ipsilateral grey matter of neonates was found to average 23% of the total gray matter projection, while in adults this value was 9%. In all animals, by about 44 dPN, the terminal fields became effectively restricted to the adult distribution, that is, focused predominantly in the medial portions of laminae IV-VII in the gray matter contralateral to the cortical injection site. PMID- 2713982 TI - Pattern formation in the striatum: developmental changes in the distribution of striatonigral projections. AB - The mammalian striatum (the major subcortical structure in the telencephalon) can be divided into two compartments, the patch and the matrix, on the basis of various neurochemical and hodological markers expressed in the adult. The primary efferent target of striatal neurons is the substantia nigra. We have previously shown that the patch compartment sends projections to the substantia nigra embryonically; whereas the matrix does not form a similar projection until the early postnatal period (Fishell and van der Kooy, J. Neurosci., 7 (1987) 1969 1978). The projection of patch neurons to the substantia nigra is the earliest developmental marker for the patch compartment. Here we ask about the early distribution of patch projections and their possible relation to striatal compartmentalization. Embryonic anterograde axonal tracing of the striatonigral pathway can take advantage of the temporal separation of patch versus matrix projections to reveal the terminal distribution of patch striatonigral neurons independent of the nigral terminal distribution from the striatal matrix. The anterograde tracer rhodamine isothiocyanate was shown in a model system to persist in labeled neurons for more than a week, but to be available for uptake into these neurons for a few days after injection at the most. These properties of rhodamine isothiocyanate were combined experimentally with short and long term survival periods. This allowed assessment of the changing developmental distribution of nigral fibers from specifically the striatal patch compartment. In all experimental cases the anterogradely labeled sections of the substantia nigra were also stained with antibodies to tyrosine hydroxylase, which permitted differentiation of the dopamine cell rich pars compacta from the dopamine cell poor pars reticulata. The results show that in the adult the majority of patch and matrix striatonigral projections are confined to the substantia nigra pars reticulata. Furthermore, their fiber distribution within the pars reticulata is overlapping rather than complementary. Most interestingly, in the late embryonic period (most noticeably at embryonic day 19) there is a marked overlap between patch striatonigral fibers and nigral dopamine perikarya. By early postnatal times, when the matrix compartment begins to form its striatonigral projection, the overlap of patch striatonigral fibers and dopamine cells has largely disappeared. The results suggest that a transient interaction between patch striatonigral fibers and dopamine neurons (which is concomitant with the formation of striatal compartments), may be an important developmental event in the phenotypic maturation of striatal pa PMID- 2713983 TI - 5-HT2 receptor binding and 5-HT uptake in mouse brain: developmental changes and the relationship to audiogenic seizure susceptibility in DBA/2J mice. AB - Abnormal function of serotonergic neurones may be involved in the age-related susceptibility of DBA/2J mice to generalised convulsions induced by auditory stimulation. We have measured 5-HT2 receptor binding sites and synaptosomal 5-HT uptake in 5 brain regions of DBA/2J mice at ages before, during and after their maximal susceptibility to audiogenic seizures and in age-matched C57 B1/6 mice, a strain resistant to audiogenic seizures at all ages. The number of 5-HT2 binding sites was 20% higher in the cerebral cortex of DBA/2J than C57 B1/6 mice at the time of maximal susceptibility of DBA/2J mice to audiogenic seizures but did not differ at other ages. The number of 5-HT2 binding sites did not differ between the two strains at the ages studied in forebrain, mid-brain, hippocampus and pons medulla. A marked reduction in the number of 5-HT2 binding sites was apparent in the mid-brain, hippocampus and pons-medulla of both strains of mice between 13-15 days of age and 21-23 days of age. Synaptosomal 5-HT uptake did not differ significantly between DBA/2J and C57 B1/6 in any of the brain regions at the ages studied. The higher density of cortical 5-HT2 binding sites in DBA/2J mice may contribute to their susceptibility to sound-induced seizures. PMID- 2713984 TI - Phospholipids can influence the interconversion of flat epithelial-like and stellate process-bearing astroglial cells in culture: relationships between molecular structure and biological activity. AB - Secondary cultures of neonatal rat astroglial cells, maintained in a serum-free, chemically defined medium were treated with several agents known to elevate intracellular cyclic AMP levels in these cells. Earlier studies had shown such drugs to induce a process-bearing (stellate) morphology in the astroglial cells, a response that is antagonized or reversed by the presence of exogenously added gangliosides. As a next step in understanding the basis for such an influence on cell morphologics, we have examined in more detail the molecular specificity of this response. In particular, a variety of phospholipids have been used in substitution of GM1 ganglioside. Natural phosphatidic acid (PA), which physicochemically displays lipophilic and hydrophilic bipolarity as does GM1, was fully active in mimicking the effects of GM1. The ED50 for the morphologic effect of PA was 10 microM, similar to that of GM1. Synthetic PAs (oleic, stearic, palmitic, myristic) had no effect up to 50 microM. Relatively long fatty acid chains were thus required for a PA effect. Other phospholipids including phosphatidylserine could not replace PA. Exposure of the cells to phospholipase D to generate endogenous PA from other phospholipids elicited the morphological response as well. These results indicate that the ability of exogenously supplied lipid molecules to modulate astroglial cell behaviors can be assigned, in functional terms, to a class of molecules having the appropriate balance (which includes PA and GM1) between their hydrophobic and hydrophilic domains. PMID- 2713985 TI - Nerve growth factor promotes survival of retrogradely labeled hippocampus projecting neurons in the rat basal forebrain in vitro. AB - The effect of nerve growth factor (NGF) on the survival of neurons projecting to the hippocampus from developing medial septum and vertical limb of the diagonal band was studied in vitro. The neurons had previously been labeled retrogradely in vivo with fluorescent latex microspheres. The microspheres were injected bilaterally into the hippocampus of 5-day-old rats. Twenty to 24 h after the injection, cells from the basal forebrain were dissociated with papain and cultured for 3-5 days. The number of microsphere-labeled neurons in the culture with supplementation of NGF was much greater than that without NGF. The result clearly indicates a survival-promoting effect of NGF on these projection neurons. PMID- 2713986 TI - Formation and growth of the cerebral convolutions. II. Cell death in the gyrus suprasylvius and adjoining sulci in the cat. AB - Cell death, calculated by counting pyknotic nuclei to assess the number of dying cells, in the gyrus suprasylvius (GS-Syl) and adjoining sulci sulcus lateralis (SL) and sulcus suprasylvius (SS-Syl) was studied in cats aged 5, 15, 25 days and 6 months. Three patterns of cell death were characterized: (1) an ascending gradient from the inner to the upper cortical layers; (2) a lateromedial gradient from the SS-Syl towards the SL; and (3) a predominance of cell death in the sulcal zones. These patterns are in accordance with the sequence of cortical neurogenesis, the lateromedial pattern of the whole formation and growth of the GS-Syl and adjoining sulci, and the differences in the cortical thickness between the sulci and the gyral crown. PMID- 2713987 TI - An anterograde tracer study on the development of corticospinal projections from the medial prefrontal cortex in the rat. AB - The aim of the present study is to investigate, both qualitatively and quantitatively, the development of corticospinal (CS) projections from the medial prefrontal cortex of the rat. This study was carried out with the use of anterogradely transported wheat germ agglutinin-conjugated horseradish peroxidase (WGA-HRP) after iontophoretic injections in the medial prefrontal cortex. For comparison similar injections are made in the sensorimotor cortex. The CS axons of neurons situated in the medial prefrontal cortex have reached the first thoracic segment (T1) at postnatal day 3 (P3) and reach their most caudal extension in the spinal cord sixth thoracic segment (T6) at postnatal day 7 (P7) and then gradually disappear during the second postnatal week. Quantitative results revealed that after labelling of the medial prefrontal cortex no peaks in labelling density, neither at the cervical nor at the lumbar intumescence, were present. Furthermore, the CS axons of medial prefrontal neurons never showed any outgrowth into the spinal grey matter at any age studied. Concludingly, the extension and subsequent elimination of CS axons originating in the medial prefrontal cortex follow a similar time course as those from the occipital cortex (Dev. Brain Res., 36 (1987) 121-130). PMID- 2713988 TI - Successful vaginal delivery after caesarean scar rupture: a case report. AB - A case of successful vaginal delivery following a previous lower segment caesarean scar rupture is presented. PMID- 2713989 TI - 5-(2-bromoethyl)-2'-deoxyuridine: a selective inhibitor of herpes simplex viruses in vitro. AB - A new pyrimidine analog, 5-(2-bromoethyl)-2'-deoxyuridine (BEUdR), was tested in vitro for antiviral activity on Herpes simplex virus types 1 and 2. As reference compounds, ACG, BVUdR and PAA were used. Compared to ACG and BVUdR, BEUdR resulted less potent on both HSV-1 and HSV-2. However, a 50% inhibition of the multiplication of uninfected cells could be obtained only at very high BEUdR concentration (ID50 = 8500 microM). This makes BEUdR the least toxic analog known and gives it a selective index comparable to, if not better, than of ACG and BVUdR. PMID- 2713990 TI - Changes in the Bishop score induced by manual nipple stimulation. A cross-over randomized study. AB - Bishop score changes, by a cross-over, randomized study, were evaluated in 60 primigravidas at term, not yet in labour, who performed nipple stimulation for 45 minutes three times a day for three days. Results showed that changes of Bishop score in the treated groups were statistically highly significant, in comparison to control groups. A greater frequency in the onset of labour was also remarked. PMID- 2713991 TI - A case of struma ovarii in a 92-year-old woman. AB - A case of struma ovarii in a 92-year-old patient with altered thyroid function is reported. PMID- 2713992 TI - Vulvo-vaginal condylomatosis and relapse: combined treatment with electrocauterization and beta-interferon. AB - The therapeutical effectiveness of beta-interferon and the possibility of reducing the incidence of relapses were evaluated by selecting three groups of patients affected with three forms of condylomatosis and submitting then to various treatments. In the first group of sixty patients treated with beta interferon, we obtained the best results in micro-condylomatosis (a 100% response), while florid condylomatosis responded less well to the treatment (72% with no response). In the second group of ten patients, electrocoagulation of florid condylomata determined a complete response (CR) in seven cases (70%). Moreover, immunoperoxidase identified three case of sub-clinical infection, two of which relapsed. In the third group of ten patients, we combined electrocoagulation with beta-interferon. This combination showed the effectiveness of beta-interferon in decreasing relapses. This result is evident if we consider that only one out of four patients with immunoperoxidase-positive biopsy relapsed. PMID- 2713993 TI - The rationale for treatment of cervical lesions (HPV +/- CIN). AB - In the laser surgery service of the 2nd Department of the Obstetric and Gynecologic Clinic of the University of Rome "La Sapienza", from October 1984 to March 1987, we have treated with CO2 laser surgery (vaporization and conization) 228 patients affected with cervical lesions (HPV +/- CIN). The choice of the treatment must be based on two parameters: site and extension of the lesion. The results we have obtained with CO2 laser vaporization (201 cases) are most satisfactory (92%); patients have been followed-up from two to twenty-six months. As far as the CO2 laser conization is concerned (27 cases), patients were followed-up from two to twenty-two months and the percentage of success was 96.1%. The Authors evaluated also the side effects of the CO2 laser surgery. PMID- 2713994 TI - Mode of delivery and level of passive immunity against herpes simplex virus. AB - The level of passive neonate protection against HSV depends on the transplacentally acquired neutralized HSV antibodies' titer. In this study we investigated the anti HSV antibodies' transplacental passage in a group of women who delivered vaginally and pregnant women who had cesarean section, with the aim of examining the influence of the mode of delivery on the level of passive immunity to HSV. Serologic examination was performed in a group of 102 women who delivered vaginally and 80 pregnant women who had cesarean section, using the test of microneutralization. The titer of anti HSV type 1 and anti HSV type 2 antibodies in the mothers' and cord blood was determined and compared. The cord serum neutralizing HSV type 1 antibodies' titer, was twice higher as compared to those in mothers blood in 60.7% of paired sera in the group of women who delivered vaginally. The cord serum anti HSV type 1 titers were twice as high as compared to those in mothers' blood only in 15.5% of paired sera in group of pregnant women who had cesarean section. In the cases when cesarean section was performed, our results showed the lack of anti HSV type 2 antibodies in 15% of cord sera, even though the mothers' sera were anti HSV type 2 positive. The results of this study point to the possibility that antibody transfer through the placenta is an active and selective process that depends also on the mode of delivery: there are lower levels of HSV neutralizing antibodies in the cord sera of infants whose mothers had cesarean section compared to those who delivered vaginally. PMID- 2713995 TI - Estrogen replacement therapy (ERT) by a special regimen in the years following menopause. AB - A group of 16 post-menopausal women, mean age 56.6 years, with typical and non typical climacteric symptoms, were treated by a combination of estrogen (Premarin 0.625) followed by clomiphene citrate. Beside an improvement in musculo-skeletal pain and a marked improvement of their sense of well-being there was an increase in Hdl cholesterol, the protecting factor against M.I., while weight and blood pressure remained stable. The link between mood, sleep and libido improvement and catecholamine raise, is discussed, and so are the effects on blood pressure, in long lasting ERT. PMID- 2713996 TI - Improved competitive enzyme-linked immunoassay (ELISA) for albuminuria. AB - Microalbuminuria has been established as a marker strongly predictive of diabetic nephropathy. The appearance of microalbuminuria (30-150 micrograms/min) is considered to herald incipient nephropathy, and the progression to clinical proteinuria (greater than 200 mg/24 h) is believed to reflect a shift from reversible to irreversible renal damage in diabetic patients. Periodic monitoring of albumin excretion could thus detect diabetic renal disease at an early, potentially reversible stage. However, this is not routinely done, largely due to cumbersome collection and methodologic constraints. We therefore have developed a simplified competitive immunoassay (ELISA) that is sensitive to 10 ng and reproducibly quantifies urinary albumin levels between 0.1-10 micrograms/ml, a range appropriate to that demarcating normal from microalbuminuric patients. Examination of results obtained with aliquots of 24 h and fractional urine collections, without and with correction for creatinine (albumin: creatine ratio), in basal and post-exercise states indicates that (a) this assay can effectively measure urine albumin concentration in single void specimens, and albumin excretion rates in fractional collections, and (b) conversion to albumin:creatinine ratio is not necessary to discriminate normal from microalbuminuric states. PMID- 2713997 TI - Fibrinogen Sevilla, a congenital dysfibrinogenemia characterized by an abnormal monomer aggregation and a defective plasmin lysis. AB - A dysfibrinogenemia (fibrinogen Sevilla) was detected in a 64-yr-old woman with no previous history of hemorrhagic diathesis or thrombosis. Thrombin and reptilase times were prolonged. The aggregation of fibrin monomers showed a prolonged latency time with a defective slope although fibrinopeptide release and clot stabilization were found to be normal. Plasmin proteolysis was abnormal with a much slower plasmic degradation in patient's purified fibrinogen. By chromatofocussing the patient's fibrinogen showed an abnormality in pattern elution with a second peak eluting at a pH slightly more basic than the normal one (pH 5.5). Likewise, the isoelectrofocussing of purified non-reduced patient's fibrinogen in agarose gel showed an abnormal distribution in its focussed bands, especially in a group which focussed in a pI-interval between 5.20-5.85. By two dimensional electrophoresis we did not find any abnormality in the fibrinogen reduced chains. These results could indicate that the abnormal monomer aggregation, as well as the defective plasmin lysis, could be due to conformational aspects of fibrinogen rather than to structural defects. PMID- 2713999 TI - Application of solid-phase antibodies to radioimmunoassay. Improved performance of Dynospheres following affinity purification of antisera. AB - Affinity purification of antibody before covalent binding to pre-activated micro particles (Dynospheres) was necessary to overcome the reduced coupling capacity evident with low titre antisera, particularly antihapten sera. Optimally prepared Dynospheres anti-thyroxine provided a radioimmunoassay with good performance and economical usage of microparticles. Assay sensitivity was less than 10 nmol/l while precision across the clinically relevant dose range (50-150 nmol/l) was 3% CV using 125 micrograms particles per assay tube. PMID- 2713998 TI - Assessment of antithyroglobulin and antimicrosomal autoantibodies in patients with autoimmune thyroid disease: comparison of haemagglutination assay, enzyme linked immunoassay and radioligand assay. AB - Four different assay systems for detection of antithyroglobulin (T-Ab) and thyroid antimicrosomal autoantibodies (M-Ab) were evaluated: two passive haemagglutination assays (PHA), an enzyme-linked immunoassay (ELISA) and a radioligand assay (RLA). Antibody levels measured with these methods correlated well (T-Ab: r = 0.72 to 0.88; M-Ab: r = 0.63 to 0.84; p less than 0.0001). However, when the results of the measured samples were classified as normal, slightly elevated and pathological, only 40-50% of the samples showed congruous results in all tests; 60-70% agreed in PHA and ELISA, whereas 80 to 90% corresponded in the two PHAs. RLA and ELISA gave more frequently positive results for T-Ab and negative results for M-Ab than the PHAs. Despite the lower sensitivity of the quantitative methods for M-Ab detection, they depicted more readily small changes after thyroxine treatment than the PHAs. We suggest that differences in autoantibody levels found with different methods may be due to autoantibody heterogeneity. PMID- 2714000 TI - Relationship between hair, serum and bone aluminium in hemodialyzed patients. AB - To establish the predictive value in osteodystrophy of hair aluminium content in patients on hemodialysis, we compared the aluminium levels in serum, cortical and trabecular bone and hair of 40 such patients with the levels in 23 healthy controls. In the patients, mean hair aluminium content was significantly higher than the controls (0.226 mumol/g, range: 0.09-0.500 mumol/g, n = 39 versus 0.126 mumol/g, range: 0.020-0.330 mumol/g, n = 49) but there was a large overlap between the two groups. The patients exhibited a significant correlation between serum and cortical bone aluminium measured by atomic absorption spectrometry (rs = 0.67, n = 37, p less than 0.05), but no correlation between aluminium in hair and in serum or bone, whether cortical or trabecular. Bone histomorphometric studies also indicated that unlike aluminium levels in cortical or trabecular bone, its levels in hair are not predictive of aluminium-induced osteomalacia. Consequently, hair aluminium cannot suitably replace bone and serum aluminium as a criterion of osteodystrophy in hemodialyzed patients. PMID- 2714001 TI - The subunit composition of factor XIII proteins in normal and factor XIII deficient plasma and serum analysed by line immunoelectrophoresis. AB - Line immunoelectrophoresis was used for the characterization of human coagulation factor XIII in normal and factor XIII-deficient plasma and serum. In normal plasma, two immunoreactive factor XIII proteins termed XIII-p (Mr 330,000 Da) and XIII-s (Mr 170,000 Da) were identified within the beta-globulin fraction. Their reactions with monospecific antisera against known factor XIII subunits, suggests that the factor XIII-p and -s proteins recognized represent the factor XIII a2b2 tetramer and -b2 dimer, respectively. The concentration of the XIII-p protein was, in normal plasma, approximately 6 mg/l, in plasma from a case of congenital factor XIII, approximately 1 mg/l and in normal serum approximately 3 mg/l. The concentration of the XIII-s protein (approximately 18 mg/l) was unaffected by the coagulation process and normal in plasma and serum from the case of congenital factor XIII deficiency. Thus, the present investigation indicates the presence of an excess of the anticatalytic, DNA-binding factor XIII carrier protein in normal as well as in factor XIII-deficient plasma and serum. PMID- 2714002 TI - Erythrocyte and plasma cholesterol exchange in sickle cell anemia. AB - The effects of sickling on cholesterol exchange between red cell membranes and serum lipoproteins were studied by following the movement of tritiated cholesterol incorporated into erythrocytes. The initial rate of this exchange was greater in sickled cells than in normal cells. One quarter of the cholesterol in the sickled cells is quickly exchanged with plasma lipoproteins. After 15 minutes, the rate becomes identical for these two types of cells, reaching similar equilibrium at end. The sickling of red cells would explain the observed differences, although conditions of hypoxia and the saturation of the incubation medium with oxygen tend respectively to accentuate and to cancel this phenomenon. PMID- 2714003 TI - Microbial influences on urinary polyamine excretion. AB - We determined diamines, polyamines, their monoacetylated conjugates and some of their catabolites in urines of healthy persons during decontamination of the gastrointestinal tract and patients with urinary tract infections. The compounds were also measured after in vitro incubation of urines from healthy persons and patients. During decontamination the urinary excretion of total putrescine decreased by a small amount. This fall was for the greater part accountable to monoacetylated putrescine. Free putrescine levels were increased in urines of patients with urinary tract infections, decreased after therapy, and increased after incubation of the pretherapeutical samples. Total cadaverine decreased during decontamination and increased during recontamination. The changes were partly accountable to monoacetylated cadaverine. Free cadaverine levels of patients with urinary tract infections were normal and did not change after therapy. These data show that, under normal conditions, a small part of monoacetylated putrescine and a considerable part of monoacetylated cadaverine originate from the gastrointestinal tract, and that urinary tract infections lead to an increase of free putrescine. The microbial synthesis of putrescine in the gastrointestinal- and urinary tracts, should therefore be taken into account for the interpretation of urinary putrescine levels as a parameter for body cell turnover. PMID- 2714004 TI - Procollagen III peptide and fibronectin in alcohol-related chronic liver disease: correlations with morphological features and biochemical tests. AB - In order to clarify the significance of procollagen III peptide (PIIIP) and fibronectin (FN) blood concentration in alcohol related chronic liver disease (ALD), we have investigated their relationships with histological liver features and biochemical liver tests in 44 ALD patients. PIIIP was measured in serum by radioimmunoassay whereas FN was determined in plasma using an immunonephelometric method. In each liver biopsy, steatosis, portal infiltrate, lobular necro inflammation, portal fibrosis and lobular fibrosis were semiquantitatively assessed by scoring from 0 to 3. A close correlation of PIIIP was found with morphological features of fibrosis (both of lobular and portal type), but not with necro-inflammation or steatosis. PIIIP was also positively correlated with ALP and GGT and exhibited a good diagnostic value in liver fibrosis. On the contrary, FN did not distinguish between normals and patients and was not correlated with any morphological liver feature or biochemical liver test. We also conclude that serum NP3P effectively reflects liver fibrosis, whereas plasma FN seems not related to any of the main histological aspects of liver damage in ALD. PMID- 2714005 TI - Kinetics of serum glutamate dehydrogenase during short-term alcohol withdrawal. AB - The behavior of serum glutamate dehydrogenase after alcohol withdrawal was studied in 64 alcoholics admitted to a detoxification center. The enzyme activity decreased in 57 patients by a median of -35.8 percent in 24 h. Thus, the decrease of serum glutamate dehydrogenase after 24 h of ethanol abstinence can serve as a test of alcohol abuse. PMID- 2714006 TI - The lysosomal beta-D-N-acetylglucosaminidase isozymes in human plasma during pregnancy: separation and quantification by a simple automated procedure. AB - beta-D-N-Acetylglucosaminidase isozymes were separated and assayed in the plasma of control healthy individuals and pregnant women by an automated method consisting in chromatofocusing on polybuffer exchanger PBE-94 column, flow through fluorimetric determination of activity and computer assisted quantification. Under the established optimal conditions the method fractionated beta-D-N-acetylglucosaminidase into four isozymes. A, I2, I1 and B, with the analytical coefficients of variation of 1.8, 2.2, 6.4 and 4.1%, respectively. Duration of a single analysis was 25 min including washing, and 10-15 successive runs could be performed on the same column with good reproducibility. A linear activity response was observed from 1-5 microliters of plasma (depending on the individual isozyme) to 50 microliters, and the detection limit was 0.016 mUnits. Isozyme A was heat labile. Upon sialidase treatment, isozymes A, I2 and I1 released sialic acid and were eluted from the column at less acidic pHs. In healthy individuals isozymes A, I2, I1 and B covered about 62.8, 6.9, 15.0 and 15.1% of the total beta-D-N-acetyl-glucosaminidase activity, respectively. During pregnancy the plasma concentration of all isozymes increased. Isozyme I2 showed the highest enhancement (30-fold), followed by I1 (8-fold), B (5.6-fold) and A (3 fold). Interruption of pregnancy by either physiological delivery or ambulatory abortion was followed by a sharp fall of the concentration of all isozymes reaching, in a few days, the control levels. PMID- 2714007 TI - Retention of antimony in hair during leishmaniasis treatment. PMID- 2714008 TI - Failure to determine heparin concentrations in plasma containing Fluosol-DA using an analytical kit. PMID- 2714009 TI - Levels of immunoreactive angiotensin II in microdissected nuclei from adult WKY and SH rat brain. AB - Levels of immunoreactive angiotensin II (ANG II) were measured by radioimmunoassay in microdissected nuclei from the brain of the spontaneously hypertensive rat (SHR) and its normotensive control, the Wistar Kyoto rat (WKY). The nuclei assayed included the paraventricular nucleus of the hypothalamus (PVH), locus coeruleus (LC), nucleus of the solitary tract (NTS), dorsal motor nucleus of the vagus nerve (DMN of X) and the A1 region of the medulla. Sections of cerebral and cerebellar cortex were used as controls. Levels of immunoreactive ANG II ranged from 0.24 nmoles/g protein to 0.93 nmoles/g protein, with SHR brain containing significantly higher levels than WKY brain in the PVH and NTS. Although LC and DMN of X in the SHR brain contained higher levels of immunoreactive ANG II than WKY brain, the difference was not significant. No significant difference was found in the A1 region between the two species, and no detectable ANG II immunoreactivity was found in cerebral or cerebellar cortex. Since each of the nuclei studied has been implicated in the neural control of cardiovascular function, the increased levels of immunoreactive ANG II in the SH rat brain nuclei indicates a possible role for ANG II in the pathophysiology of hypertension in the SHR model. PMID- 2714010 TI - Effect of bunazosin on cardiac sympathetic nerve activity in anesthetized rats. AB - The present study was undertaken to elucidate the effect of selective alpha-1 adrenoceptor antagonist, bunazosin, on sympathetic nerve activity in anesthetized rats. Intravenous administration of bunazosin (10 micrograms/kg) produced a reduction of mean arterial pressure with a significant decrease in heart rate. Accompanied with its hypotension and bradycardia, bunazosin caused a decrease in inferior cardiac nerve activity. On the other hand, renal nerve activity, which reflects vasoconstriction, was not significantly decreased by bunazosin. These findings suggest that bunazosin may possess an anti-tachycardic action resulting from the reduction of cardiac sympathetic nerve activity and that the sympathoinhibitory action of bunazosin may not contribute to its hypotensive action. PMID- 2714011 TI - Further evidence for genetic independence of blood pressure and salt appetite in spontaneously hypertensive and Wistar-Kyoto rats. AB - We previously reported that blood pressure and volitional consumption of salt were under independent genetic regulation in the F2 population of crosses between Spontaneously Hypertensive (SHR) and Wistar-Kyoto (WKY) rats. However, the use of 1.5% NaCl as the test solution in that study might have resulted in a limit on the range of variability in saline consumption that could possibly have obscured a correlation between these traits, if one existed. In the present study, volitional consumption of normal (.9%) saline and blood pressure were measured in a sample of 61 adult male F2 (SHR x WKY) rats. There was considerable inter individual variance in saline consumption (2 to 100 ml/day), indicating that the range of intake was not truncated in this experiment. However, there was no correlation between blood pressure and any measure of saline consumption in the F2 sample, again indicating that ad libitum salt appetite and blood pressure are genetically independent in the SHR and WKY strains of rats. PMID- 2714012 TI - Non-mosaic trisomy 20 in amniotic fluid cultures with minor anomalies in the fetus. AB - A non-mosaic trisomy 20 was discovered in all cells in two separate cultures from an age-related genetic amniocentesis. Karyotypes of cells obtained via amniocentesis at the time of termination and of cells cultured from the placenta gave the same unambiguous results. However, the fetus, under macro- and microscopic analysis, showed only two minor anomalies: left simian crease and low set ears. These findings are more suggestive of a normal or at most mosaic trisomy 20 state. The significance of this finding for prenatal diagnosis is discussed. PMID- 2714013 TI - Brachydactyly type A-7 (Smorgasbord): a new entity. AB - We report a family with a form of brachydactyly that involves characteristic features of types A2 and D brachydactyly plus features found in other types of brachydactyly and also features not previously noted. This set of findings represents a new syndrome, which we have termed brachydactyly type A7 (Smorgasbord). PMID- 2714014 TI - Sjogren-Larsson syndrome in Sweden: distribution of the gene. AB - The distribution of carriers of the gene for Sjogren-Larsson syndrome in Sweden suggests a center of dispersion in the county of Vasterbotten in Northern Sweden. The origin of the spread of the gene can be traced back at least 700 years. PMID- 2714015 TI - Trisomy 5 mosaicism in amniotic fluid with normal outcome. AB - A case of prenatally diagnosed true mosaicism for trisomy 5 with a clinically normal outcome is presented. Trisomy 5 was detected in 23% of cells obtained by amniocentesis, but it was not detected from cells obtained by fetal blood sampling. While in this case the finding at amniocentesis did not reflect the status of the fetus, care must be exercised in reaching this conclusion in all cases. PMID- 2714016 TI - A 45,X/69,XXY fetus. AB - Post-mortem examination of a 20-week fetus showed incompletely masculinised external genitalia, hypoplastic adrenal glands and minor physical stigmata suggestive of a chromosome abnormality. Gonad and skin were karyotyped and both were found to contain two cell lines, 45,X and 69,XXY. It appears this fetus is a true 45,X/69,XXY mosaic. PMID- 2714017 TI - Dermatoglyphic features of a male with diploid/tetraploid mosaicism. PMID- 2714018 TI - Nonsyndromal microphthalmia. PMID- 2714019 TI - Plasma, cardiac tissue and brain morphine concentrations in acute and chronic morphine-treated rats. AB - 1. The plasma, cardiac tissues and brain morphine concentrations in rats after acute or chronic morphine treatment were measured by high-performance liquid chromatography. 2. Morphine concentrations in plasma and cardiac tissues were found to be significantly higher than those in brain after acute morphine injection. However, after chronic oral administration, morphine concentrations in plasma, cardiac tissues and brain were similar. 3. Brain concentrations of morphine following chronic administration were higher than those obtained after acute administration although concentrations in plasma and cardiac tissues were lower. PMID- 2714020 TI - Micropuncture comparison of nephron function during acute and chronic ADH excess in the rat. AB - 1. The aim of this study was to compare the effect of acute versus chronic ADH administration on the handling of sodium, potassium and water by the nephron. Simultaneous clearance and free-flow micropuncture experiments were performed on rats, infused with hypotonic Ringer solution, following either 1-3 h ('acute') or 10-12 days ('chronic') of continuous treatment with arginine vasopressin, 50 mU/h. A third group of animals receiving no exogenous ADH acted as controls. 2. Chronic ADH treatment led to more profound concentration of the urine and antidiuresis than acute treatment, due to enhanced extraction of water in the renal medulla. 3. Fractional sodium excretion during this protocol was increased after 'acute' but not 'chronic' ADH treatment. The acute natriuretic response was brought about principally along the length of the proximal tubule, probably due to volume expansion and increased arterial blood pressure. 4. Fractional excretion of potassium was also increased by 'acute' ADH, but this response was due to stimulation of potassium secretion in the late distal tubule. 5. It is concluded that acute and chronic exposure to ADH have different effects on nephron function, as a result of both direct and indirect actions. PMID- 2714021 TI - Use of methionine-enkephalin sulfoxide and leucine-enkephalin radio-immunoassays for the measurement of enkephalins in the rat brain. AB - 1. A radio-immunoassay (RIA) for methionine-enkephalin sulfoxide was developed and was used to measure methionine-enkephalin, after oxidation, in the rat brain. 2. The RIA was performed together with assays that use commercially available met and leu-enkephalin antisera. 3. Evidence is presented here indicating that antisera raised against the native met-enkephalin peptide underestimate met enkephalin content due to loss of immunoreactivity after oxidation of peptide. 4. These results show that a more accurate measurement of met-enkephalin may be obtained by using the met-enkephalin sulfoxide RIA. The cross-reactivity of met enkephalin with the leu-enkephalin RIA was diminished following oxidation of peptide. PMID- 2714022 TI - Prevention and treatment of aluminum overload in uremic patients: long-term results. AB - The authors evaluate the efficacy of a protocol of prevention and treatment of aluminum (Al) overload in RDT patients during a 7-year period (from 1981, 164 patients, to 1987, 161 patients). Al in dialysate solutions was always less than 25 micrograms/l. Baseline Al levels greater than 100 micrograms/l were found in 22% of patients in 1981 but in none in 1987, while the percentage of values less than 60 micrograms/l increased from 55 to 91%. DFO tests were positive in 54% and 7% of cases in 1981 and 1987, respectively. A clinical diagnosis of Al intoxication was performed in 6 patients in 1981, and no further cases were diagnosed later. DFO treatment (50 mg/kg once a week) was employed preventively in 31 patients owing to positive DFO-tests, and in the 6 Al-intoxicated patients therapeutically. In the former patients none developed clinical intoxication. In the latter group clinical improvement was only temporary in the three parathyroidectomized patients. Al hydroxide [Al(OH)3] as a phosphate binder was tapered off in 1981 and substituted by Al-free chelants. In 1987, 66% of patients were given CaCO3 or Mg (OH)2 alone or in association, while 34% still needed Al(OH)3, although at low dosages (less than 2 g/day). The conclusion is that such a protocol is able to prevent and to treat cases of Al intoxication, albeit only partially. PMID- 2714023 TI - Long-term treatment and prognosis of rapidly progressive glomerulonephritis. AB - Short-term prognosis of rapidly progressive glomerulonephritis (RPGN) has improved since immunosuppressive therapy was introduced. The long-term course of the disease was investigated in 46 consecutive and unselected patients over a period of 15 years (1970-1986) with a mean observation time of five years (+/- 45 months). Most of the 46 patients had idiopathic RPGN (61%). Initially, hemodialysis needed 25 of the 46 patients (54%). Immunosuppressive therapy (plasma exchange, methylprednisolone pulses, steroids, cyclophosphamide, azathioprine) was administered in 36 of the 46 patients (78%). A remission was achieved in only 19 of the 36 patients who received immunosuppression (53%) and no spontaneous improvement was seen. Factors indicating poor prognosis were initial high serum creatinine, high percentage of crescents in glomeruli, glomerular sclerosis, and immunohistologic staining of the IgG at the tubuli. In 11 patients with remission, immunosuppression was discontinued and 6 had a relapse. Long-term immunosuppression was given to 8 patients with remission. Their renal function was not normal (creatinine 240 +/- 77 mumol/l), but none had a relapse (p = 0.01). It is concluded that the treatment of RPGN requires long term attendance and repeated immunosuppression comparable to a systemic immune disease. PMID- 2714024 TI - Increase in Hb-O2-affinity at moderate altitude (2000 m) in patients on maintenance hemodialysis. AB - Oxygen transport by erythrocytes was studied in eight patients on maintenance hemodialysis before, during and after a 2-week stay at an altitude of 2000 m. Dialysis was continued at that altitude. In all tests, blood samples were collected one or two days following hemodialysis. Pre-altitude tests: The patients exhibited anemia (hemoglobin concentration, Hb = 97.4 +/- 17 g/l). Due to an elevated red cell 2,3-diphosphoglycerate concentration (2,3-DPG) and mild metabolic acidosis, elevated standard and in vivo P50 values (pO2 at 50% oxygen saturation of hemoglobin, sO2) were measured. Altitude: Upon ascent, arterial pO2 decreased from 82 +/- 4 torr to about 60 torr, sO2 was lowered by 5%. After 2 weeks sojourn, pO2 and sO2 increased towards normal values. In contrast to healthy subjects, dialysis patients developed respiratory alkalosis (blood pH: +0.074) upon ascent. This caused a significant shift to the left of the oxygen dissociation curve (ODC), indicated by lowered in vivo P50-values (P50,vv,-2 torr). Red cell 2,3-DPG, P50,st (P50 at a blood pH = 7.4 and pCO2 = 40 torr), hemoglobin concentration and hematocrit showed a high day-to-day variability and did not change because of the altitude exposure. We interpret the increase of the oxygen affinity of hemoglobin in patients with renal anemia as beneficial, as it favors oxygen loading of hemoglobin in the lung during exposure to a hypoxic environment. PMID- 2714025 TI - IgG subclasses of PEG precipitable IgG in systemic lupus erythematosus sera. AB - Polyethylene glycol (PEG, 4%)-precipitated macromolecular IgG isolated from the sera of 20 patients with systemic lupus erythematosus (SLE) and 15 control subjects was analyzed for its IgG isotype concentration by single radial immunodiffusion. PEG precipitates from SLE sera had higher mean levels of IgG1, IgG2 and IgG3 and lower IgG4 than PEG precipitates isolated from normal sera although only the IgG2 levels were significantly different. Using an anti complementary assay there was a significant correlation between the ability of parent sera to fix complement and the absolute levels of PEG precipitable IgG1, IgG2 and IgG3. These data suggest that the ability of immune complexes in the sera of patients with SLE to fix complement is dependent on their IgG subclass composition. PMID- 2714026 TI - Crescentic glomerulonephritis in Behcet's syndrome--results of therapy and review of the literature. AB - The syndrome initially described by Behcet in 1937 comprised the triad of ocular inflammation, oral and genital ulcers. The described manifestations have gradually expanded to include most tissues; renal involvement has been described but is usually mild. Although crescentic glomerulonephritis (GN) has been reported, it is extremely rare. We report two patients presenting with Behcet's syndrome complicated by an active crescentic GN. Their course, following the initiation of therapy with prednisone and cyclophosphamide is described. Both patients evolved to a sclerosed glomerulopathy documented by follow-up renal biopsy in spite of a dramatic clinical improvement in one patient and a stabilization of renal function in the other. Both developed nephrotic range proteinuria without amyloidosis. PMID- 2714027 TI - Renal failure caused by long-term use of a germanium preparation as an elixir. AB - Two Japanese women and one Japanese man, who had been taking the same germanium preparation, mainly containing inorganic germanium, as an elixir for health almost every day at 90 mg of germanium per day for 6 to 20 months, suffered from chronic renal failure. Histological examination of the kidney in one patient showed marked interstitial changes with vacuolar degeneration of the renal tubules. High germanium concentrations were found in hair and nails of the three patients, but no germanium was detected in hair or nails of normal persons. These results suggest that long-term use of a germanium preparation at high dosage can cause serious renal tubular damage and renal failure due to germanium toxicity. PMID- 2714028 TI - Left ventricular tamponade: echocardiographic and hemodynamic manifestations. AB - A patient with progressive systemic sclerosis was evaluated for dyspnea. Echocardiography revealed enlarged right heart chambers, a moderate pericardial effusion, and diastolic collapse of the left ventricle. Hemodynamic studies before and after removal of pericardial fluid were consistent with compromise of left, but not right, heart filling by the pericardial fluid. PMID- 2714029 TI - Right ventricular pacing wire thrombus presenting as pyrexia of unknown origin. AB - Pacing wire thrombosis may be invisible echocardiographically while producing severe symptoms. We report a patient whose pacing wire thrombosis presented as a pyrexial illness 5 months after its insertion. Treatment with tissue plasminogen activator provoked cardiovascular collapse; therefore, we recommend that such thrombosis be treated surgically. PMID- 2714030 TI - Release of adenosine and lactate from human hearts during atrial pacing in patients with ischemic heart disease. AB - Thirty-eight patients treated by atrial pacing were divided into three groups (Group I, patients with neither coronary stenosis nor anginal pain during pacing; Group II, patients with no coronary stenosis but having anginal pain during pacing; Group III, patients with coronary stenosis). The concentrations of adenosine and lactate were measured in the coronary sinus blood and in the arterial blood before, during, and after atrial pacing. During atrial pacing, significant levels of adenosine were released from the heart of patients in Group III, whereas significant lactate release was observed in Groups II and III. In Group II, the concentration of adenosine in coronary sinus blood appeared to increase during pacing, but not significantly. There was no significant correlation between the release of adenosine and that of lactate. A significant release of adenosine due to atrial pacing may be observed only in patients with coronary artery disease. PMID- 2714031 TI - Atrial pacing and thallium-201 scintigraphy in patients with chest pain: correlation with coronary anatomy. AB - Atrial pacing and thallium-201 scintigraphy were performed in 72 patients referred for evaluation of chest pain. Coronary artery disease (CAD) was present in 63 patients, as documented by cardiac catheterization performed at the same time or within 2 months of atrial pacing. Nine patients had no or insignificant (less than 50% stenosis) CAD. The sensitivity of pacing-induced angina for CAD was 51%, and was 49% for ST depression. Specificities were 89% and 78%, respectively. A reversible perfusion defect was seen in 54% of patients with CAD (specificity 89%), and a fixed defect in 29% (specificity 100%). The sensitivity of an abnormal thallium-201 scan (one or more reversible or fixed defects) was 79% (p less than 0.05 compared to angina or ST depression). Combined sensitivity of ST depression and/or an abnormal thallium-201 scan was 87%. There were no significant changes in any of these sensitivities as the number of vessels with CAD increased. Thallium-201 scintigraphy correctly identified 11 of 19 (58%) patients with single-vessel disease as having CAD in only one vessel, but underestimated the extent of disease in all but a few patients with multivessel disease. The sensitivity of perfusion imaging to identify lesions in specific vessels ranged from 27% (circumflex) to 57% (right coronary artery). Specificities were 100% for circumflex, 78% for anterior descending, and 83% for right coronary artery lesions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714032 TI - Sudden cardiac death after aortic valve surgery: incidence and concomitant factors. AB - A retrospective analysis of 599 consecutive patients after aortic valve surgery aged 7-82 years (mean 56) was performed. During a follow-up of 1-14 years (mean 4.7 years) a 4-week perioperative mortality of 6.9% and a late annual mortality of 3.6% were observed. Sudden cardiac death was the most frequent single cause of death, accounting for 24% of all deaths. Patients dying suddenly were younger than patients dying from other causes (51 +/- 17 vs. 59 +/- 14 years, p less than 0.05) and showed more left ventricular hypertrophy by electrocardiographic criteria when compared with matched survivors (mean Estes score 5.2 +/- 2.4 vs. 2.8 +/- 1.9; p less than 0.01) and with patients dying nonsuddenly (mean Estes score 5.2 +/- 2.4 vs. 1.8 +/- 1.8; p less than 0.01). Ventricular premature beats in the resting electrocardiogram were more prevalent in patients dying suddenly than in matched survivors (55 vs. 20%; p less than 0.025) as well as in patients dying from other causes (55 vs. 25%; p less than 0.05). In addition, there were more intracardiac conduction disturbances and more ungrafted coronary vessels with insignificant stenoses at the time of surgery in sudden death patients. Our findings suggest that after aortic valve replacement patients with left ventricular hypertrophy, bundle-branch block, and ventricular premature beats in the resting electrocardiogram are at increased risk for sudden cardiac death. A possible etiological role of concomitant coronary artery disease must be considered. PMID- 2714033 TI - Exercise-induced pulmonary blood volume changes and diastolic dysfunction of the aged heart. AB - Impaired diastolic function has been described in healthy elderly subjects. Pulmonary blood volume (PBV) changes with exercise have been associated with left ventricular dysfunction, but not directly related to diastolic abnormalities. Exercise-induced relative changes in PBV were measured using gated blood pool imaging with count density comparisons over the lung in 20 healthy volunteers: 13 elderly, age 76 +/- 5 years and seven young, age 27 +/- 4 years. Serial (first exercise stage, peak exercise, and post exercise) PBV ratios were measured and correlated to peak early filling rate, peak late filling rate, and percent atrial filling obtained from the resting left ventricular time-activity curve analysis. PBV ratios tended to be higher in elderly subjects, but reached significance only at the first stage of exercise (1.04 +/- 0.07 vs. 0.93 +/- 0.10, p less than 0.01). Significant correlations were found between PBV ratios at first exercise stage and peak early filling rate (r = -0.64), peak late filling rate (r = 0.47), and percent atrial filling (r = 0.48). A significant correlation was found between PBV changes at peak exercise and resting diastolic parameters. Exercise induced PBV changes are associated with left ventricular diastolic dysfunction at rest. Diastolic abnormalities of the aged heart may explain the differential PBV response early into exercise between young and elderly healthy subjects. PMID- 2714034 TI - Long QT syndrome associated with inflammatory degeneration of the stellate ganglia. AB - A well-studied case of intermittent long QT syndrome in a 21-year-old female is presented. Electrophysiologic investigation repeated three times revealed changing sinoatrial and atrioventricular dysfunction and nonsustained ventricular tachycardia. The patient died 29 months after first hospitalization in a stage of electromechanical dissociation after runs of torsade de pointes although she had been treated with repeated anti-inflammatory therapy as well as high doses of propranolol. Postmortem examination demonstrated active inflammation of stellate ganglia. Myocardium appeared normal. PMID- 2714036 TI - Radionuclide therapy of pheochromocytomas and neuroblastomas using iodine-131 metaiodobenzylguanidine (MIBG). PMID- 2714035 TI - Radioiodine uptake following iodine-131 therapy for Graves' disease: an early indicator of need for retreatment. AB - Forty-five patients with Graves' disease were studied prospectively to determine if 24-hour I-131 uptake measurements alone or in combination with serum thyroid hormone levels at six weeks would determine the necessity for retreatment of the thyrotoxicosis. All patients with an I-131 uptake greater than 30% at six weeks required retreatment. No patient with an I-131 uptake of less than 15% required retreatment. Patients with uptakes between 15% and 30% were variable. An elevated free thyroxin index at 6 weeks is not helpful to determine which patients will remain thyrotoxic. Patients with a free thyroxin index within the normal range at six weeks can be predicted to be euthyroid by 12 weeks if their 24-hour I-131 uptake is between 15% and 30% and to be hypothyroid if their 24-hour I-131 uptake is below 15%. There was no difference between patient groups treated initially with antithyroid medication and those who were not. PMID- 2714037 TI - Scintigraphic findings in congenital lipodystrophy. AB - The scintigraphic findings of a patient with characteristic clinical, laboratory, and radiographic features of congenital lipodystrophy were studied. Bone scan showed uniform increased bone uptake of Tc-99m MDP with markedly enhanced peri articular activity and very prominent renal activity. Liver-spleen scan showed marked hepatosplenomegaly. This combination of scintigraphic abnormalities is unique in congenital lipodystrophy and constitutes a very interesting constellation of findings. Observed scintigraphic findings are compatible with previously described radiographic findings. PMID- 2714038 TI - Scintigraphic evaluation of regional migratory osteoporosis. AB - Three patients with regional migratory osteoporosis (RMO) of the lower extremity were observed over a period of time with clinical and scintigraphic follow-up. The diagnosis of RMO is clinically and radiographically difficult, but a three phase bone image is very helpful in diagnosing patients with RMO. PMID- 2714039 TI - Scintigraphic evaluation of gastric emptying: are radiolabeled solids necessary? AB - A standard, dual-isotope meal (Tc-99m-egg sandwich and In-111 DTPA in water) was administered to 14 normal volunteers and 37 patients, who had not undergone gastric surgery, to determine if the emptying characteristics of the liquid phase alone could accurately predict delayed solid emptying. Delayed gastric emptying was defined clinically as a solid half-emptying time more than two standard deviations greater than the mean for normal volunteers. Linear regression analysis was performed on the natural logarithm of liquid fractional retention at each time interval to yield a slope and y-intercept for each subject. There was no significant difference (0.6 less than P less than 0.8) between volunteers and patients with normal solid emptying for the liquid slope. In patients who exhibited delayed gastric emptying for solids, the liquid slopes were significantly different from the normal values (P less than .001). There was a high correlation of liquid slope to solid half-emptying time in all patients and volunteers (r = -0.80, P less than .001). Comparison of the liquid slope measurement to solid half-emptying time criteria revealed a sensitivity of 96%, a specificity of 100%, and a predictive value of 100% for the slope test. These results suggest that delayed gastric emptying can be accurately detected with a liquid-solid meal using only a single-liquid label. PMID- 2714040 TI - The evolving role of parathyroid scintigraphy. PMID- 2714041 TI - Technetium-99m uptake in neonatal breast. PMID- 2714042 TI - Resolution of metastatic calcification by bone imaging. PMID- 2714043 TI - False-positive indium-111 WBC image secondary to an unusual configuration of the right hepatic lobe. PMID- 2714044 TI - Unilateral gallium-67 uptake in submandibular salivary gland following sialography. PMID- 2714045 TI - Positive indium-111 leukocyte image following antigenic stimulation in a 15-month old female child. PMID- 2714046 TI - HLA A, B, and DR antigens and complotype in Tunisian patients with diabetes mellitus. AB - The frequency of HLA A, B, and DR antigens as well as the Bf and C4 allotypes have been investigated in insulin-dependent diabetes mellitus (IDDM) and compared to that of healthy controls in the Tunisian population. An increase of A30, DR3, DR4, BfF1, C4Ao, and C4Bo and decrease of B40, DR2, DR5, and DR6 were found in diabetics when compared to the value observed in controls. The strongest association was noticed with HLA DR3 and DR4. Heterozygotes DR3 DR4 were very frequent in diabetics: 24.2 per cent versus 3.6 per cent in controls (relative risk 7.72). The protective role of DR2 and DR5 antigens were also confirmed. No supratypes of HLA, Bf, and C4 alleles associated with IDDM have been observed among these Tunisian patients. PMID- 2714047 TI - Genetic studies of human apolipoproteins. VI. Common polymorphism of apolipoprotein E in blacks. AB - Human apolipoprotein E exhibits genetically determined polymorphism with three common alleles, and plays a pivotal role in lipoprotein metabolism. Except in Caucasians, variation at the apolipoprotein E locus has been studied poorly in world populations. Using isoelectric focusing and immunoblotting, we have determined apolipoprotein E phenotypes and gene frequencies in a large number of individuals of black ancestry from the U.S. and Nigeria. The common three allele polymorphism was observed in both populations, with a striking high frequency of the APO E*4 allele as compared to the reported values in other population groups. The frequencies of the three alleles, APO E*2, APO E*3, and APO E*4, respectively, are: 0.034, 0.706, 0.260 in U.S. Blacks and 0.028, 0.662, 0.310 in Nigerian Blacks. PMID- 2714048 TI - Studies on an isolated West Indies population. VII. Genetic linkage studies of hearing loss. AB - Linkage analysis was performed between the locus of sensorineural hearing loss and 14 polymorphic genetic markers on 108 informative families with a total of 721 individuals in the island of Saint-Barthelemy. No significant linkage was found, and only for Gm could tight linkage be excluded. PMID- 2714049 TI - Pharmacological modification of oxygen affinity improves deformability of deoxygenated sickle erythrocytes: a possible therapeutic approach to sickle cell disease. AB - 1. The formation of polymerized haemoglobin S in sickle cells is critically dependent on the concentration of deoxygenated haemoglobin so that compounds which increase the oxygen affinity of haemoglobin S are potential anti-sickling agents. 2. BW12C [5-(2-formyl-3-hydroxyphenoxy)pentanoic acid] and BWA589C [4-(2 formyl-3-hydroxyphenoxymethyl)benzoic acid] are aromatic benzaldehydes that cause a dose-dependent left-shift of the oxygen saturation curve of haemoglobin S by stabilization of its oxy-(R)-conformation. 3. A 5 micron pore filtration method, which is highly sensitive to polymerization of haemoglobin S, was used to demonstrate a significant improvement in the deformability of deoxygenated sickle erythrocytes at concentrations (0.75-1.5 mmol/l] of BW12C and BWA589C that are achievable in vivo. Both compounds may therefore be of value for the treatment of sickle cell disease. 4. Filtration of sickle cells through pores of 5 microns diameter is a sensitive technique for evaluating the rheological effects of potential anti-sickling compounds. PMID- 2714050 TI - Factors contributing to the accelerated clearance of theophylline and antipyrine in adults with exocrine pancreatic disease. AB - 1. Oxidative drug metabolizing capacity has been assessed by oral antipyrine and/or theophylline tests in consecutive patients with chronic pancreatitis (CP; alcoholic 24, idiopathic 47), acute pancreatitis (AP; 28) and pancreatic cancer (CA; 11). Most of the patients had drastically reduced their alcohol consumption and dietary fat intake for variable periods before the tests. Excellent bioavailability of theophylline was confirmed from paired oral and intravenous tests in seven subjects, including two with exocrine pancreatic failure. 2. The clearance of theophylline in the patients was faster than in 15 controls with a 'healthy lifestyle' [median 104 (range 18-320) ml h-1 kg-1 vs median 68 (range 50 97) ml h-1 kg-1, P less than 0.01]. The difference was especially apparent in the groups with alcoholic CP (P less than 0.001 and idiopathic CP (P less than 0.01), but not in the AP and CA group as a whole, although drug clearance in some 50% of those cases exceeded the reference range. 3. There was good correlation between theophylline and antipyrine clearance in a subset of 91 subjects who had both tests (15 controls, 76 patients), but antipyrine was much less sensitive as a marker of enzyme induction. This suggests that enzyme induction in pancreatic disease preferentially involves the polycyclic aromatic hydrocarbon-inducible subfamily of cytochrome P-450. 4. The lack of correlation between pancreatic secretory capacity in 56 cases, judged by a secretin-pancreozymin test, and theophylline clearance suggests that enzyme induction is not secondary to pancreatic dysfunction. 5. Multivariate regression analysis identified approximately 50% of variability in clearance of each probe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714051 TI - Intestinal glucose transport using perfused rat jejunum in vivo: model analysis and derivation of corrected kinetic constants. AB - 1. The transport model that best describes intestinal glucose transport in vivo remains unsettled. Three models have been proposed: (1) a single carrier, (2) a single carrier plus passive diffusion, and (3) a two-carrier system. The objectives of the current studies were to define the transport model that best fits experimental data and to devise methods to obtain the kinetic constants, corrected for diffusion barrier resistance, with this model. 2. Intestinal glucose uptake was measured during perfusion of rat jejunum in vivo over a wide range of perfusate concentrations and diffusion barrier resistance was determined under identical experimental conditions. The data were fitted to the transport equations that describe the three models with appropriate diffusion barrier corrections, and the kinetic constants were derived by non-linear regression techniques. The fit of each model to the data was assessed using six statistical tests, five of which favoured a model described by a single carrier and passive diffusion. 3. The main conclusions of these studies are: (1) kinetic constants uncorrected for diffusion barrier resistance are seriously in error; (2) values for the derived kinetic constants are strongly dependent on the transport model selected for the data analysis which underscores the need for rigorous model analysis; (3) corrected kinetic constants may be obtained by either non-linear regression or by a simpler graphical analysis once the correct transport model has been selected and diffusion barrier resistance determined; (4) only corrected kinetic constants should be used for inter-species comparisons or to study the effect of specific interventions on intestinal glucose transport. PMID- 2714052 TI - Brainstem auditory evoked responses in rats with experimental chronic renal failure. AB - 1. Chronic renal failure was induced in rats by five-sixths nephrectomy. Brainstem auditory evoked response (BAER) was recorded after 3 months. 2. In the uraemic rats latency of the first wave was delayed, while the interpeak I-V latency was similar to that of the controls. 3. These results suggest a delayed neural conduction along the acoustic nerve or cochlear changes in uraemic rats. PMID- 2714053 TI - Evidence that intravenous morphine stimulates central opiate receptors to increase sympatho-adrenal outflow and cause hypertension in conscious rabbits. AB - 1. In conscious rabbits, intravenous morphine caused hypertension, bradycardia, hyperglycaemia and increased plasma adrenaline and noradrenaline. These effects were prevented by ganglionic blockade with pentolinium. 2. The cardiovascular responses to morphine were not altered by pretreatment with a vasopressin V1 receptor antagonist. 3. After bilateral adrenalectomy morphine caused a similar rise in noradrenaline but no increase in adrenaline. The rise in blood pressure was attenuated and the hyperglycaemia was abolished. 4. Adrenaline infused intravenously to mimic the levels that occurred after morphine caused a similar degree of hyperglycaemia but only a small increase in blood pressure. 5. Pretreatment with intracerebroventricular naloxone prevented the morphine-induced hypertension, hyperglycaemia, increase in plasma catecholamines, respiratory depression and sedation. 6. These results demonstrate that, in conscious rabbits, intravenous morphine causes hypertension by increasing sympathetic vasoconstrictor nerve activity and elevating plasma adrenaline levels; the latter alone produces the hyperglycaemia. Vasopressin release is not involved in the hypertensive response to morphine. The effects of morphine appear to result from stimulation of central opiate receptors leading to enhanced sympathoadrenal outflow. PMID- 2714055 TI - Medical Research Society meeting. London, 5-6 January 1989. Abstracts. PMID- 2714054 TI - Increase in anterior tibialis muscle protein synthesis in healthy man during mixed amino acid infusion: studies of incorporation of [1-13C]leucine. AB - 1. Anterior tibial muscle protein synthesis in seven healthy postabsorptive men was determined from increases in muscle protein bound leucine enrichment during a primed continuous infusion of L-[1-13C]leucine. Biopsies were taken 30 min after the beginning of leucine infusion (when plasma 13C enrichment was steady), 240 min later during continued fasting and again after 240 min of infusion of a mixed amino acid solution which increased plasma total amino acid concentrations by 37%. The mean enrichment of 13C in plasma alpha-ketoisocaproate was used as an index of the enrichment of the precursor pool for leucine metabolism. 2. Anterior tibial muscle mixed protein synthetic rate during fasting was 0.055 (SD 0.008)%/h and this increased by an average of 35% during infusion of mixed amino acid to 0.074 (SD 0.021)%/h (P less than 0.05). 3. Whole-body protein breakdown (expressed as the rate of endogenous leucine appearance in plasma) was 121 (SD 8) mumol h-1 kg-1 during fasting and decreased (P less than 0.01) by an average of 12% during amino acid infusion. Leucine oxidation was 18 (SD 3) mumol h-1 kg-1 during fasting and increased (P less than 0.001) by 89% during amino acid infusion. Whole-body protein synthesis (non-oxidative leucine disappearance) was 104 (SD 6) mumol h-1 kg-1 during fasting and rose by 13% (P less than 0.001) during mixed amino acid infusion. 4. 13C enrichment of muscle free leucine was only 61 (SD 19)% of that in plasma alpha-ketoisocaproate and this increased to 74 (SD 16)% (P less than 0.02) during mixed amino acid infusion. 5. The results suggest that increased availability of amino acids reverses whole-body protein balance from negative to positive and a major component of this is the increase in muscle protein synthesis. PMID- 2714056 TI - Glucose enzyme electrode with percutaneous interface which operates independently of dissolved oxygen. AB - An enzyme glucose electrode that operates even when no oxygen is dissolved in the glucose solution has been developed and its in vitro performance evaluated. The electrode has been designed to be used with a percutaneous interface for future in vivo use. Oxygen is supplied to the electrode from the atmosphere. The electrode is based on the conventional H2O2 detecting enzyme electrode, in which an Ag cylinder 4.5 mm in diameter and 16 mm in length is used as a cathode. A Pt wire 0.5 mm in diameter is fixed in the centre for an anode, and 0.5 micrograms of albumin-linked glucose oxidase is immobilised at the tip of the anode. A recess of 3.6 mm diameter and 5 mm depth is made at the top of the electrode, and a breathing orifice 0.8 mm in diameter is drilled along the axis of the electrode to link the recess to the atmosphere. A thin oxygen permeable silicone layer fills the recess, allowing oxygen in the atmosphere to be supplied to the enzyme through the silicone layer. The electrode has a linear response to glucose concentration at an electrode output current ranging from 0 to 20 nA even when the oxygen concentration of the glucose solution is zero. The use of polyurethane as a diffusion barrier to glucose limits the electrode output current at a glucose concentration of 500 mg dl-1 (27.8 mmol 1-1] to 20 nA. Therefore, the electrode can measure glucose concentrations up to 500 mg dl-1 (27.8 mmol 1(-1] with no oxygen dissolved in the glucose solution. The electrode with the percutaneous interface seems suitable for implantation in sites of low oxygen concentration such as subcutaneous tissues. PMID- 2714057 TI - Experimental fluid dynamics of aortic stenosis in a model of the human aorta. AB - Aortic stenosis has been modelled in an in vitro, pulsatile mock circulatory system (MCS) using a porcine valvular prosthesis, and studied with a laser Doppler anemometer (LDA). The MCS incorporated an acrylic model of the human aorta made from a cadaveric casting in situ. A Carpentier-Edwards aortic valve prosthesis was placed in the MCS after being rendered stenotic by suturing of the valve cusps. Flow velocity profiles across the lumen of the aorta in the presence of aortic stenosis were determined using LDA at two preselected sites in the ascending aorta, and at one preselected site in the brachiocephalic artery. Results indicate that a strong systolic jet bordered by transient vortices with intensely reversed flows is produced distal to severely stenotic aortic valves, becoming less intense with a lesser degree of stenosis. Peak fluid velocities in the systolic jet were determined by LDA at distances of 2.6 and 5.6 cm from the valve inlet for a mean flow rate of 5.2 l min-1. Peak systolic pressure gradients and peak turbulent axial stresses were also determined and found to increase dramatically with stenosis. Furthermore, increasing degrees of stenosis also resulted in more severely disturbed flows in the brachiocephalic artery. Peak fluid velocities and their associated turbulent axial stresses in the systolic jets produced by aortic valvular stenosis are remarkably sensitive to even small changes in the calculated valve orifice areas, and can therefore be very useful in assessing the severity and progression of valvular disease. In addition, increasing degrees of aortic stenosis cause more turbulence to be transported into the brachiocephalic artery. PMID- 2714058 TI - Standing posture of craniocerebral injured patients: bi-lateral reactive force patterns. AB - Bi-lateral force measurements on the supporting limbs in postural sway while standing still were carried out to evaluate postural stability of craniocerebral injured (CCI) patients. Brain pathology of these patients was characterised by CT scans and MRI, as well as by their cognitive and behavioural disturbances. Normal subjects of the same age group were tested as controls. From the force tracings obtained, three oscillation frequencies were identified, with orders of magnitudes of 6, 1.5 and 0.1 Hz, respectively, of which the middle frequency, i.e. that corresponding to 1.5 Hz, was selected for subsequent processing and analysis, which included the determination of relative sequence of the force vectors on both feet and evaluation of timings and amplitudes of the waveforms. Weight-bearing imbalance was defined in the vertical direction to express the difference between the average forces supported by each of the legs. In the horizontal plane, two parameters were defined: Sway Total Activity (SA), to represent the vector summation of the absolute values of the horizontal force components acting on both legs; and Asymmetry (ASYM), to express the difference in activities between the two legs. The results presented disclose the reactive force patterns acting on each of the legs of CCI individuals, in comparison with normal individuals. Although the forces were shown to act synchronously on both legs, in most of the patients, they appeared to be asymmetrical in nature, with a typical vectorial pattern for every individual, which generally differed from that of normal subjects. Sway activity was found to be significantly higher in the CCI group as compared with that of the normal controls. These results justify the necessity to study the activity of each of the legs, rather than that corresponding to the resultant forces acting on the whole body, when treating the external forces involved in the stabilisation and regulation of the standing posture of these patients. An attempt to grade the patients according to ascending order of neurological deficits disclosed that their sway disturbances, as revealed by the magnitude of sway total activity and asymmetry, had a tendency to be related to the severity of neurobehavioural disturbances. PMID- 2714059 TI - Non-contact skin emissivity: measurement from reflectance using step change in ambient radiation temperature. AB - A method of estimating skin emissivity based on reflectance measurement upon transient stepwise change in the ambient radiation temperature was proposed. To effect this change, two shades at different temperatures were switched mechanically, and the change in radiation from the skin surface was recorded through an aperture for each shade by a high-resolution, fast-response radiometer having a sensitivity within the 8-14 microns range. Measurements were made on the forehead, forearm, palm and back of the hand in 10 male and 10 female subjects. No significant differences in emissivity were observed among sites and between sexes. The overall average of the skin emissivity obtained was 0.971 +/- 0.005 (SD). This result is inconsistent with most reported skin emissivity values. However, as the former studies had many inherent inadequacies, both theoretical and experimental, it is considered that most of these reported skin emissivities are unacceptable. The method proposed in this study has the following advantages: (1) relative calibration between instruments is unnecessary, (2) non-contact measurement can be achieved, and (3) each measurement can be made within one minute. PMID- 2714060 TI - A comparison of myocardial thallium-201 image quality after either dipyridamole or exercise stress. AB - Exercise and dipyridamole provide two mechanistically different stress techniques for thallium-201 imaging. To date, comparisons of the two have relied solely on assessments of clinical results. However, because diagnostic accuracy ultimately depends on image quality, this study was undertaken to compare the image quality obtained by both techniques. The left anterior oblique images of 30 patients, who had thallium imaging after intravenous dipyridamole (0.56 mg kg-1 over 4 min) were compared with those of 30 patients who were imaged after symptom limited, Bruce protocol, treadmill exercise in the same time period. Myocardial and lung background thallium uptake were compared after stress and on redistribution. The ratio of the best segmental myocardial thallium uptake (M) to that in a fixed lung-background region (B) was taken as an index (M/B) of image quality. Myocardial thallium uptake was significantly higher after dipyridamole than after exercise (P less than 0.001). Lung-background thallium uptake, however, was also higher (P less than 0.001) so that the resulting image quality indices (M/B) were similar (P = NS). The redistribution images gave the same results. In both techniques myocardial and lung-background thallium uptake counts dropped significantly from stress to redistribution images, but because they declined at similar rates, the resulting image quality index (M/B) remained unchanged. Adverse effects occurred less frequently in the dipyridamole stressed group. Thallium images performed after dipyridamole stress are at least equivalent in image quality to those after exercise stress. This technical study further strengthens the clinical case for the use of the dipyridamole stress technique in routine diagnostic imaging. PMID- 2714061 TI - Platelet thermophysiology: a new field of investigation dependent upon an improved sub-ambient platelet aggregometer. AB - Studies of platelet aggregation are normally performed at 37 degrees C. However, in hypothermia during certain surgical procedures (for example, cardiopulmonary bypass) efficient aggregation may be needed at temperatures below 37 degrees C: therefore, assessment of platelet aggregation at temperatures below 37 degrees C may be relevant. This paper describes a sub-ambient aggregometry system developed for this purpose. The effect of temperature (range of 4.5 degrees-37.0 degrees C) upon ADP-induced and spontaneous aggregation of platelets from normal subjects was studied. Platelet aggregation was found to be maximal at room temperature, and may represent 'pure' aggregation. At higher temperatures platelet disaggregation becomes measurable, and at lower temperatures, cold-induced platelet shape-change predominates. These parameters are briefly discussed in terms of their relevance to future research into the physiology of platelet storage and clinical haemostasis. PMID- 2714062 TI - Limb volume measurements in peripheral arterial disease. AB - A simple method for measuring limb volumes of patients with peripheral arterial disease undergoing limb blood flow measurement is described. The device uses the change in surface level of water in a cylindrical reservoir to generate a voltage which is amplified and converted to a volume. The plethysmograph is stable and accurate over a wide range of limb volumes. For patients with leg ulcers or gangrene, where water immersion is not possible, a geometrical model has been developed which allows the volume to be calculated from a series of six external measurements. Comparison with measured volumes in 46 patients has shown this model to be accurate with a mean error of 3.3%. It provides a convenient alternative to direct measurement in these patients. PMID- 2714063 TI - IPSM annual conference: selected abstracts. Institute of Physical Sciences in Medicine. Canterbury, 14th-16th September 1988. PMID- 2714064 TI - Cefamandole disposition in patients undergoing extracorporeal reinfusion of ascitic fluid. PMID- 2714065 TI - Selection of a gastric decontamination method for poisoning emergencies. PMID- 2714066 TI - Susceptibility of nosocomial isolates of Candida species to LY121019 and other antifungal agents. AB - LY121019 is a novel analog of the polypeptide antifungal antibiotic echinocandin B. We investigated the in vitro activity of LY121019, amphotericin B, ketoconazole and 5-fluorocytosine against 131 nosocomial isolates of Candida species: C. albicans (n = 50), C. tropicalis (n = 30), C. rugosa (n = 12), C. parapsilosis (n = 11), C. lusitaniae (n = 10), C. guillermondii (n = 9), and C. krusei (n = 9). In vitro susceptibility testing was performed using a broth microdilution method. The minimal inhibitory concentrations (MIC) of LY121019 were less than or equal to that of the other antifungal agents against C. albicans and C. tropicalis but were generally higher for the other species of Candida. Paradoxical growth at high concentrations, but not at low concentrations, of LY121019 was observed with isolates of C. albicans and C. tropicalis. PMID- 2714067 TI - Antibiotics for penetrating abdominal trauma: a prospective comparative trial of single agent cephalosporin therapy versus combination therapy. AB - In this prospective, comparative study, 129 patients who sustained penetrating abdominal trauma were randomized to receive preoperatively, and for 3-5 days postoperatively, one of three antibiotic regimens: Group I--cefotaxime (CTX) (2 Gm Q8H), Group II--cefoxitin (2 Gm Q6H), or Group III--clindamycin (900 mg Q8H) and gentamicin (3-5 mg/kg/day in divided doses Q8H). The three groups were similar in terms of the following: age, sex, severity of injury, number of organs injured, colon injuries, shock, blood transfusions, or positive intraoperative cultures. Septic complications occurred as follows: Group I--6.9%, Group II- 2.3%, and Group III--6.9%. The three regimens ranked as follows in terms of therapy costs: CTX less than cefoxitin less than clindamycin and gentamicin. It is concluded that single agent therapy with a cephalosporin is preferable to combination therapy on the basis of equivalent effectiveness, lower toxicity, and lower costs. PMID- 2714068 TI - Successful treatment of progressive disseminated histoplasmosis with amphotericin B methyl ester. AB - Amphotericin B methyl ester (AME) has been used to treat fungal infections, most often those caused by Coccidioides immitis. We describe the only patient with disseminated histoplasmosis who has been treated with AME. After having had alarming reactions to amphotericin B, the patient was treated and cured with AME without adverse drug effect or later relapse. PMID- 2714069 TI - Symposium: new findings on the antibacterial interactions between cefotaxime and desacetylcefotaxime. PMID- 2714070 TI - Comparative in vitro activity of cefoxitin, cefotaxime alone, and in combination with desacetylcefotaxime against the Bacteroides species. AB - The agar dilution method was used to determine the inhibitory activity of cefotaxime (CTX) alone, desacetylcefotaxime (dCTX) alone, CTX plus dCTX, and cefoxitin against 74 clinical isolates of the Bacteroides species recovered from diabetic patients with foot ulcers. The study concluded that the addition of dCTX to CTX increased the inhibitory activity from 45% to 73% for all strains tested and from 50% to 81% among the 32 strains of Bacteroides fragilis. This synergistic interaction against B. fragilis resulted in a four- to nine-fold reduction in the MIC of seven strains (64-128 micrograms/ml, resistant category MICs). While the lowest CTX MIC for B. fragilis was 2 micrograms/ml (four strains), the addition of dCTX also produced a remarkable reduction in susceptible range CTX MICs to 0.05-2 micrograms/ml in 16 strains (50%). The overall susceptibility to cefoxitin and CTX plus dCTX was as follows: 100% and 100% for Bacteroides vulgatus, 50% and 66% for Bacteroides thetaiotaomicron, 100% and 33% for Bacteroides ovatus, and 83% and 82% for Bacteroides species other than the B. fragilis group. PMID- 2714071 TI - Effectiveness of cefotaxime alone and in combination with desacetylcefotaxime against Bacteroides fragilis. AB - The synergistic activity of the combination cefotaxime-desacetylcefotaxime (CTX/dCTX) was compared to the effectiveness of seven other antimicrobial agents: cefoxitin (CFOX), cefotetan (CTAN), ceftizoxime (CTIZ), chloramphenicol (CLOR), clindamycin (CLIND), metronidazole (METR), and ampicillin-sulbactam (A/S) tested against 100 clinical isolates belonging to the Bacteroides fragilis group. All tests were performed using the NCCLS reference agar-dilution method. The overall susceptibility of these organisms to CTX/dCTX was 84% compared to CFOX at 78% or CTAN at 66%. The other antimicrobials inhibited greater than 90% of these isolates. There was no difference between the susceptibility rates of CTX/dCTX and CTX with the B fragilis (85%) or B. distasonis (75%) strains. Bacteroides thetaiotaomicron showed a 11% greater susceptibility to CTX/dCTX than to CTX. Of the 100 isolates tested, 40% showed either synergy or partial synergistic interactions between CTX and dCTX. Most of the isolates showed indifference (52%), while 8% demonstrated antagonism; a relatively unique finding to date. PMID- 2714072 TI - Comparison of the in vitro action and interaction of cefotaxime and desacetylcefotaxime against clinical isolates of Bacteroides spp. AB - Desacetylcefotaxime (dCTX), the in vivo metabolite of cefotaxime (CTX), possess significant in vitro antimicrobial activity similar to the parent compound against a variety of aerobic and anaerobic bacteria. In vitro susceptibility studies showed that CTX inhibited 86% of 473 strains of the Bacteroides fragilis at a concentration of 32 micrograms/ml while dCTX inhibited 91% of the test isolates at the same concentration. Strains of the B. fragilis species were significantly more susceptible to CTX than were the non-B. fragilis species. Susceptibility testing of CTX and dCTX in a 1:1 ratio produced significantly more inhibitory activity, especially against the non-B. fragilis strains. Synergy studies showed that the interaction of CTX and dCTX was either completely or partially synergistic against 85% of 92 test organisms. The presence of dCTX was also shown to lower the CTX MIC values four-fold or greater in 82% of the synergy studies. Synergy was noted against strains of the B. fragilis group, B. melaninogenicus group, B. bivius, B. disiens, and B. capillosus. Through the use of time-kill kinetics studies, the interaction of CTX and dCTX was shown to be additive at subinhibitory and inhibitory concentrations and suggestedly synergistic at suprainhibitory concentrations against strains of the B. fragilis group. These in vitro studies demonstrate that dCTX increases the inhibitory and bactericidal activity of CTX when tested in combination. PMID- 2714073 TI - Activity of cefotaxime/desacetylcefotaxime with two aminoglycosides against gram negative pathogens: an example of interactive synergy. AB - The susceptibility patterns of clinical Gram-negative isolates were determined to cefotaxime (CTX) and desacetylcefotaxime (dCTX) alone and in combination with gentamicin (GENT) or tobramycin (TOB) by an agar dilution technique. A constant ratio of 1:1 (CTX to dCTX) was tested throughout the study. Isolates were challenged with subinhibitory levels of TOB or GENT in combination with clinically achievable levels of CTX, dCTX and CTX/dCTX to examine the interactions of the agents. Results of this study demonstrate that CTX/dCTX interacts synergistically with aminoglycosides against many Gram-negative pathogens. Synergy (defined as a fourfold or greater decrease in minimum inhibitory concentration (MIC) when CTX/dCTX was compared to CTX/dCTX/TOB) was demonstrable for 55% of isolates tested. Similarly, 45% were synergistically inhibited by CTX/dCTX/GENT. Additivism (a 2-fold decrease in MIC with the same comparisons) was evident for an additional 18 isolates for CTX/dCTX/TOB and 19 with CTX/dCTX/GENT. When data for Pseudomonas spp. were excluded from the analysis, synergy or additivism was evident with CTX/dCTX/TOB for 88% of the organisms tested and 72% with CTX/dCTX/GENT. Synergistic synergy for CTX/dCTX/TOB (an 8- to greater than 16-fold decrease in MIC for CTX) was demonstrable for 35 and 32 of 82 nonspeudomonal isolates respectively with the TOB and GENT combinations. Ninety nine percent of the nonspeudomonal isolates were inhibited by less than 4 micrograms/ml of CTX, 4 micrograms/ml of dCTX and 0.12 micrograms/ml of TOB, or 0.25 micrograms/ml of GENT, respectively. PMID- 2714074 TI - Antibacterial activity of cefotaxime, desacetylcefotaxime, and the combination of the two. AB - Cefotaxime (CTX) is metabolized to desacetylcefotaxime (dCTX), which is antibacterially active. The combination of CTX and dCTX is synergistic in a 1:1 ratio, but in this study, a combination of CTX:dCTX in a fixed ratio of 5:1 was not found synergistic when tested on 120 recently isolated clinical strains. Zone diameters of disks containing pure CTX or dCTX 30 micrograms or the combination of CTX/dCTX in micrograms: 25/5, 20/10, 15/15, and 10/20, were compared. The correlation between the zone size of the pure CTX disk and the 25/5, 20/10, and 15/15 disks were high with correlation coefficients (r) 0.98 to 0.96. Regardless of the metabolism and the potential synergy, no differences were found in the zone sizes comparing the pure CTX disk with the combination with a ratio from 5:1 to 1:1. The clinical microbiological laboratory can go on using the pure 30 micrograms CTX disk for routine susceptibility testing. PMID- 2714075 TI - Evaluation of disk susceptibility testing of cefotaxime/desacetylcefotaxime. AB - The susceptibility of 453 clinical bacterial isolates was determined by broth microdilution and disk diffusion methods to cefotaxime (CTX), desacetylcefotaxime (dCTX), and various combinations of CTX plus dCTX. With a 1:1 ratio of CTX/dCTX, 97% of the minimal inhibitory concentrations were within one doubling dilution of those for CTX alone. With the disk diffusion test, the 30/30 micrograms disk of CTX/dCTX produced zone diameters very similar to those of the 30 micrograms CTX disk, averaging 0.4 mm larger than the latter. Regression analysis demonstrated that the 30 micrograms CTX disk was equally predictive for CTX and a 1:1 ratio of CTX/dCTX. PMID- 2714076 TI - A self-tuning Smith predictor applied to the control of blood pressure: simulation studies. AB - Significant time-delays occur in the response of blood pressure to drug therapy. The classical Smith predictor algorithm used to eliminate such delays is extended here to the principle of self-tuning under mis-match conditions. Two delay-free controller algorithms are investigated, being a self-tuning pole-placement and a self-tuning PID structure. Extensive simulation studies using the well-known Slate model have demonstrated the good transient performance obtained with this self-tuning Smith principle in various combinations, and under realistic variability of patient dynamics. PMID- 2714077 TI - A microcomputer-based sleep stage analyzer. AB - A microcomputer-based sleep stage analysis system for laboratory use is described. Rapid spectral analysis of the electroencephalogram (EEG) is achieved through hardware; subsequent analysis, including determination of the relative power in user-defined EEG frequency bands is provided through software. A decision matrix, based on standard sleep state analysis criteria, enables these spectral data, in conjunction with integrated electromyogram (EMG) power, to determine sleep stages. The system has been configured here to quantify standard sleep stages, but the algorithm can also identify, and provide information about, EEG states which are not easily classified according to earlier criteria used for visual classification of polygraphic records. This low-cost, user-friendly system thus achieves flexible, quantitative analysis of EEG and EMG signals. PMID- 2714078 TI - CONFREG: a BASIC program for calculating and plotting confidence regions based on correlational analyses. AB - Many observations encountered in biological and medical research are randomly distributed in bivariate scales, and thus not susceptible to simple regression analyses. Since such data are depicted by ellipses in scatter diagrams, a computer program to calculate the confidence regions for the means or the total data of bivariate samples was written in BASIC for correlational analyses. The program, based on the principal axes algorithm, plots the calculated confidence regions as an elliptic area, using the fitted equations for its major and minor axes. The program displays the sample parameters required to perform comparisons between different groups of experimental conditions. PMID- 2714079 TI - GENCOV: a Fortran program that generates randomly censored survival data with covariates. AB - We present a Fortran program for simulating censored survival data with covariates under the assumption of random censoring. The program generates times distributed according to the uniform distribution, the generalized Gamma distribution, the log-normal distribution and Pettitt's generalized logistic distribution with Box-Cox transformation of the time variable. Covariates can be introduced in the definition of the survival time, resulting in the generalized log-gamma, log-normal and Pettitt's regression models. Thereby the program provides the means for generating censored survival data according to parametric versions of three common regression models for censored survival data: the Accelerated Failure Time, the Proportional Hazards and the Proportional Odds models. PMID- 2714080 TI - A mathematical model and image analysis technique for calculating regional cerebral blood flow. AB - This paper discusses the theory and implementation of a modular data analysis system for the calculation and imaging of regional cerebral blood flow. The program may be generalized to any system requiring instantaneous and controllable visual data display, and we have set it up for compartmental analysis as described by the Fick equation with certain correction factors. We have included flow charts of the program source code and data paths for the various modules. We also describe the functional hardware components necessary for the execution of these algorithms. Finally, analyzed data are represented from a set of experiments employing differential visual stimulation. The results obtained using our methods are comparable to those in the existing literature; they are more accurately and easily obtained, and have the added power of manipulable digitization of the original image without loss of data. PMID- 2714081 TI - Program package for processing of autoradiography data. PMID- 2714082 TI - Legal aspects of employing "counselors" in a clinical practice. AB - With the increasing reliance of the medical profession upon nonlicensed counselors as employees or associates for facilitating psychosocial, rehabilitative, and various other services or guidance to patients, there is a parallel increase in liability exposure. Even if the counselor is not directly employed by the professional, so that the tort doctrine of respondeat superior would not pertain, other ties could cause either a direct agency or an ostensible agency doctrine to attach. This is so even if a referred patient merely had reasonable cause to (mis)understand an apparent agency relationship. Billing must be precisely worded and coded. There are ethical, medical, and legal responsibilities to screen applicants and to monitor, formally supervise, and record a counselor's work. Standards of care are unclear or untested. Referral of a troubled patient to an uncredentialed assistant may convey trivialization to the patient; however, beware misrepresentation of expertise. Failure to diagnose underlying disorder is a risk. Protocol agreement defining the scope of the relationship and the scope of practice may help limit liability. Any economic arrangement or prescription of a particular counselor's services can lead to the doctor's being joined in a suit, especially because of the "deep pocket" theory. Clarification of liability coverage is therefore prudent. PMID- 2714083 TI - Perspectives: Canada. Split vision: interpreting cross-border differences in health spending. PMID- 2714084 TI - Perspectives: United States. Learning from the Canadian experience. PMID- 2714085 TI - Residency requirements in medicine and the community hospital. PMID- 2714086 TI - In favor of Bill 413: helmet law. PMID- 2714087 TI - Latex condom deterioration accelerated by environmental factors: I. Ozone. AB - Commercial non-lubricated latex condoms were unpackaged and exposed in an environmental chamber to ozone levels (0.3 ppm) commonly present in urban smog conditions. Deterioration was observed by scanning electron microscopy after 18 hours exposure. Loss of mechanical strength was quantitated by measurement of the air pressures necessary to burst the condom and volumes at burst. After 24 hours exposure to ozone the latex surface was covered with craters and after 48 hours the pressure required to burst the condom was 44% that of control samples. Data suggest the need for study of the effectiveness of lubrication and packaging in protecting condoms from environmental factors which may accelerate deterioration. PMID- 2714088 TI - Magnesium sulphate and cervical ripening (a biomechanical double-blind, randomized comparison between a synthetic polyvinyl sponge with and without magnesium sulphate). AB - Lamicel is a commercially available synthetic polyvinyl sponge impregnated with magnesium sulphate (MgSO4), used to soften and dilate the cervix. To investigate whether magnesium sulphate contributes to the effect of Lamicel, forty-one pregnant nulliparous patients who underwent a first trimester abortion were allocated to three to four hours preoperative treatment with either Lamicel or the same type of tent without magnesium sulphate. The ripening effect on the cervix was measured biomechanically. Lamicel produced a cervical dilatation and ripeness equal to the syntetic tent without MgSO4. The two pretreated groups together showed a significantly (p less than 0.05) more favourable cervix compared to a control group of 40 patient. PMID- 2714089 TI - Anti-uterotrophic and folliculostatic activities of anordiol (2 alpha,17 alpha diethynyl-A-nor-5 alpha-androstane-2 beta,17 beta-diol). AB - The estrogenicity and antiestrogenicity of the biologically active metabolite of the contraceptive anordrin was investigated for its actions on both the uterus and ovary. Anordiol (30 micrograms), administered s.c. to ovariectomized mice did not significantly increase wet weight, soluble protein content, or DNA content of uteri 72 hours after a single dose. By comparison, 3 micrograms of estradiol-17 beta under the same conditions significantly increased all three parameters of uterine growth. The increments in uterine wet weight, soluble protein content, and DNA content that were induced by estradiol-17 beta were reduced by 50, 71, and 81%, respectively, when 30 micrograms of anordiol was administered with estradiol-17 beta. A 60 micrograms dose of anordiol did not decrease further any of the three parameters. In further evaluation of the uterine response to anordiol an increase in uterine wet weight and soluble protein was observed with both 30 and 90 micrograms doses of anordiol at 12, 24, 36, and 48 hours, but not at 6 or 72 hr after a single s.c. injection. No significant increase in uterine DNA content was observed with either dose at any time. We conclude that anordiol in this assay is an antiestrogen with weak estrogenic activity. Anordiol was further tested to determine its effect on the estrous cycle of the rat. When given on the afternoon of the first day of diestrus in a dose of 0.8 mg/kg body weight in rats with 5-day estrous cycles, it caused an average lengthening of the cycle to 9.1 +/- 2.1 (S.D.) days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714090 TI - Seminal fructose in normal and infertile men. AB - Fructose levels and fructolysis index in human semen were analysed to assess a correlation, if any, between the levels of this glycolysable sugar and sperm concentration. Semen was collected from normospermic men and men with azoospermia or oligospermia. Seminal fructose levels were elevated in men with obstructive azoospermia and in men who remained azoospermic following vasoepididy mostomy done to correct epididymal blockage. Men with sperm concentration of less than 20 million/ml pre-operatively or following vasoepididy mostomy, showed significantly high levels of fructose and lower fructolysis index. Fructose levels in normospermic infertile men, as well as in men with normal sperm counts (more than 20 million/ml), were similar to that in men of proven fertility. PMID- 2714091 TI - Antispermatogenic effect of embelin, a plant benzoquinone, on male albino rats in vivo and in vitro. AB - Embelin, the active principle of the seeds of Embelia ribes Burm, has been isolated and the purity established. Daily subcutaneous administration of the compound at a dose of 20 mg/kg body weight to male albino rats for 15 or 30 days revealed an inhibition of: a) epididymal motile sperm count, b) fertility parameters such as pregnancy attainment and litter size, and c) the activities of the enzymes of glycolysis and energy metabolism. These changes were reversible, as seen after 15 and 30 days of recovery. Addition of embelin to epididymal sperm suspensions caused a dose- and duration-dependent inhibition of spermatozoal motility and the activities of the enzymes of carbohydrate metabolism. Light and scanning electron microscopy showed that both in vivo and in vitro treatment with the drug causes profound morphological changes in spermatozoa such as: a) decapitation of the spermatozoal head, b) discontinuity of the outer membranous sheath in the mid-piece and the tail region, and c) alteration in the shape of the cytoplasmic droplet in the tail. PMID- 2714092 TI - In vitro spermicidal activity of parabens against human spermatozoa. AB - Potent in vitro spermicidal activity of parabens against human spermatozoa was demonstrated in this study. The "pass" point concentration of the four parabens- methylparaben, ethylparaben, propylparaben, and butylparaben, at which all spermatozoa were immobilized and no immobilized spermatozoon revived after 30 min incubation in phosphate buffered glucose solution, was 6, 8, 3, and 1 mg/ml, respectively, as tested by Harris' method. These parabens are used as food and pharmaceutic preservatives; less toxicity and side effects were expected for the development of parabens as vaginal contraceptive agents. PMID- 2714093 TI - Herpetic stromal keratitis in congenital dysgammaglobulinemia. Case report. AB - The clinical picture and laboratory findings of a case of secondary herpes simplex virus type 2 in a patient with congenital dysgammaglobulinemia who was followed for 26 months is described. Local combined therapy of acyclovir and Decadron (dexamethasone) 0.1% was given for management for 14 months. The clinical and immunopathologic findings of our patient match the results described by other investigators in experimental animals. PMID- 2714094 TI - Factors influencing predilection and outcome in bacterial keratitis. AB - Complete records from 175 patients with 176 episodes of culture-proven bacterial keratitis treated over a 4-year period at the Massachusetts Eye and Ear Infirmary in Boston were analyzed. Sixty-three percent of the infections involved gram positive organisms, and 40% involved gram-negative organisms; 15% were polymicrobial. There was a high incidence of infection with Staphylococcus aureus (28%), coagulase-negative staphylococci (14%), diphtheroids (14%), Pseudomonas aeruginosa (14%), and Streptococcus pneumoniae (12%). Gram stain correlation was achieved in 55%. Potential predisposing factors, usually multiple, were identified in 97% of the patients. Fifty percent of the ulcers were associated with such iatrogenic factors as prior topical corticosteroid therapy, penetrating keratoplasty, and contact lens use. Trauma occurred in only 16%. Several statistically significant associations of epidemiologic factors and outcome variables were revealed. Ninety-five percent of the ulcers resolved with therapy, but only 44% of the patients had visual acuity better than the level at admission, and 13% developed major complications. PMID- 2714095 TI - Corneal changes in the dislipoproteinaemias. AB - The corneal changes in the hyper- and hypoproteinaemias may affect vision and/or provide a diagnostic clue to a systemic disorder. This article describes the structure and function of the major lipoprotein classes and the means by which dietary lipid is absorbed and by which exogenous and endogenous lipid is distributed to and cleared from the tissues. In hyper-beta-lipoproteinaemia, lipid arcus formation may be related to the duration and height of the raised cholesterol levels. The peripheral location of the lipid deposit is presumed to be related to peripheral trapping of low-density lipoprotein (LDL) by glycosaminoglycan binding and tight stromal packing with maintained central clearing by high-density lipoprotein (HDL), whose smaller molecular diameter should allow freer stromal diffusion. In the hypolipoproteinaemias, e.g., Tangier disease, generalised (alpha and beta) lecithin cholesterol acyltransferase (LCAT) deficiency, and alpha-LCAT deficiency (fish-eye disease), the absence or abnormality of HDL may impair clearance of endogenous and possibly exogenous stromal lipid. The hyperlipoproteinaemia that sometimes accompanies Schnyder's crystalline corneal dystrophy is thought to modify the effects of a primary failure of corneal stromal lipid metabolism. PMID- 2714096 TI - Degradation of bovine corneal collagen by alkali. AB - This study was undertaken to demonstrate the effect of alkali on the molecular size of collagen. Type I and V collagen from bovine cornea were incubated with different concentrations of NaOH at room temperature and 37 degrees C for various times. The samples were then neutralized and analyzed by high-pressure liquid chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Degradation of collagen molecules to a heterogeneous mixture of peptides with molecular weights less than 20,000 daltons occurred at concentrations greater than 0.25N, and the effect of alkali was much faster at 37 degrees C than at room temperature. In contrast, the molecular size of collagen was not affected by similar concentrations of HCl under similar conditions of time and temperature. PMID- 2714097 TI - Guarded scalpel for corneal relaxing incision. PMID- 2714098 TI - Comparative studies of beta s-crystallins from human, bovine, rat and rabbit lenses. AB - Soluble extracts from young bovine, human, rat and rabbit lenses were fractionated by high resolution size-exclusion chromatography to demonstrate the existence of three discrete size-classes of monomeric crystallins in each species. These were identified by ion exchange chromatography, amino acid analysis, SDS electrophoresis and isoelectric focusing as the beta s-, gamma A- and gamma B-crystallins. Conventional SDS electrophoretic analysis of these proteins revealed apparent Mr values of about 23kD, 22kD and 19kD, respectively. Similar analysis in the presence of 6 M urea showed the proteins all co-migrated with an apparent Mr of about 20,500, which is far more consistent with the molecular weights calculated from beta s- and gamma-crystallin sequence data. Amino acid compositions of all the beta s samples indicate a high degree of homology to the bovine protein, whose sequence is known. The different species beta s-crystallins showed other general similarities in size, charge, thiol content and secondary structural properties. On the other hand, near UV CD and fluorescence emission and energy transfer measurements indicate that these proteins have subtle yet significant differences in their tertiary structures. Unlike the gamma-crystallins, the secondary structure of all of the beta s samples is completely denatured in the presence of 8 M urea at 20 degrees C. PMID- 2714099 TI - Differential synthesis and phosphorylation of the alpha-crystallin A and B chains during bovine lens fiber cell differentiation. AB - [14C]-amino acids and [32P]-orthophosphate incorporation experiments were carried out in bovine lenses in culture to study the synthesis and phosphorylation of alpha-crystallin A and B polypeptides during differentiation of the lens fiber cells. Following culture, the [14C] or [32P]-labelled alpha-crystallin was isolated by gel filtration chromatography from four regions of the lens corresponding to: A) quiescent epithelial cells, B) dividing epithelial cells and early stages of elongation, C) young elongating fibers, and D) mature fibers from the superficial cortex. The incorporation of label into the alpha-crystallin primary gene products alpha A2 and alpha B2 and their respective phosphorylated forms alpha A1 and alpha B1 was determined by isoelectric focusing and radioautography. Different synthesis and phosphorylation patterns were observed in alpha A and alpha B polypeptides. Synthesis and phosphorylation of the alpha B chain occurs most actively in the epithelial cells, both processes decrease during differentiation and there is no net accumulation of the phosphorylated form alpha B1 in the mature fiber cell. In contrast to the B chain, the A chain synthesis, minimal in the epithelial cell, increases with differentiation. Most striking, the A chain phosphorylation, not detectable in the epithelial cells, increases with differentiation. In the mature fiber cell, the phosphorylated form alpha A1 accounts for one third of the A chain. These observations indicate that the two chains may have different functions. the synthesis and phosphorylation patterns of alpha A suggest a lens-specific function of this polypeptide in the fiber cell and in the terminal differentiation process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714100 TI - Amacrine cells with a rectilinear dichotomy of dendrites in the chick retina. AB - With Golgi impregnation, a simple amacrine cell type is described in the chick retina. The most relevant morphological feature of these retinal neurons is a single straight, radial trunk which dichotomizes tangentially in a rectilinear expansion in the 5th stratum of the inner plexiform layer (IPL). PMID- 2714101 TI - Immunocytochemical localization of taurine in the mammalian retina. AB - This paper describes the first demonstration of taurine-like immunoreactivity in the mammalian retina using an antiserum raised in rabbits. In rat, cat and guinea pig retina a peroxidase-antiperoxidase immunocytochemical technique showed high levels of taurine immunostaining in photoreceptor inner segments and synaptic terminals, in subpopulations of amacrine and bipolar somata and their synaptic processes in the inner plexiform layer, including numerous large terminals near and on ganglion cell somata. Using the Protein A-gold technique for ultrastructural studies in the rat, the presence of synaptic ribbons confirmed that some of these taurine-containing terminals were from bipolar cells. Lower levels of immunostaining were seen in the pigment epithelium and distal parts of glial cells. PMID- 2714102 TI - Glutathione S-transferase of bovine iris and ciliary body: characterization of isoenzymes. AB - Five forms of glutathione (GSH) S-transferase (GST) having catalytic activities towards a variety of xenobiotics were present in bovine iris-ciliary body. In contrast to that in lens, cornea, and retina, GST isoenzymes belonging to all the three classes (alpha, mu and pi) were present in iris as well as in the ciliary body. GST isoenzymes of iris-ciliary body had pI values of 8.7, 7.4, 7.0, 6.6, and 6.0. GST 8.7 and GST 7.4 were apparent homodimers of 27,000 and 22,500 Mr subunits, respectively. GST 8.7 cross-reacted only with antibodies raised against the alpha class GST of human liver and GST 7.4 cross-reacted with the antibodies raised against GST pi of human placenta. GST 7.0 and 6.6 were heterodimers of Mr 26,500 and 25,000 subunits and both these subunits cross-reacted with the antibodies raised against the mu class human GST. Iris-ciliary body contained both, GSH peroxidase I and GSH peroxidase II activities and in this respect also, they differ from lens, cornea, and retina each of which have only one of these two activities. The presence of several GST isoenzymes belonging to all the three major classes and both GSH peroxidase I and II activities in iris-ciliary body may be important for the detoxification of oxidants and xenobiotics in order to prevent their infiltration in aqueous humor. PMID- 2714103 TI - The role of tears in preventing protein deposition on contact lenses. AB - Recently the presence of a coating inhibitory factor was described in human tears which can prevent the binding of proteins to a solid phase. In these earlier studies depositions of lactoferrin and IgG onto plastic was studied. In the study described here, peroxidase conjugated albumin was used as a model to investigate the effect of human tears on the binding of proteins to plastic surfaces. We investigated the question whether contact lens deposits are associated with decreased levels of this factor in the tearfilm of contact lens wearers. The mean value of the coating inhibiting activity in the tears of the controls did not differ significantly from contact lens wearers without deposits. The contact lens wearers with deposits on their lenses, had a lower mean coating inhibiting activity than the contact lens wearers without deposits. No significant difference was seen in coating inhibiting activity in tears obtained from individuals before and after they had worn lenses for three weeks. Also no difference was observed in the coating inhibiting activity on the eyes of persons who were wearing a lens in one eye only. The results of our study show that a too low activity of the coating inhibiting factor in tears is associated with deposits on contact lenses. PMID- 2714104 TI - Amyloid P protein in pseudoexfoliative fibrillopathy. AB - Amyloid P protein was demonstrated by immunostaining in all 14 samples of ocular and conjunctival pseudoexfoliative (PSX) material studied, although amyloid was not found by Congo red staining or ultrastructurally. Immunostaining of PSX aggregates for other common amyloid proteins, including amyloid A, prealbumin, and immunoglobulin light chains, was negative in most cases. In three eyes with advanced neovascular glaucoma there was irregular immunostaining of the PSX aggregates for 2-4 of these other amyloid proteins, besides diffuse staining of the iris and vitreous. Control cases of neovascular glaucoma without PSX disease showed minimal amyloid P, but similar tissue staining for prealbumin and immunoglobulin light chains, consistent with an origin from vascular leakage. The presence of amyloid P protein, a minor serum component, in PSX aggregates in all cases with or without evidence of vascular leakage, indicated a more specific association. Ultrastructural localization of the protein on the periphery of PSX fibers suggest it is not an intrinsic fiber component. Since PSX material has an immunological relation to elastic tissue, we propose that PSX fibers have peripheral binding sites for amyloid P protein, similar to those present on normal elastic fibers. PMID- 2714105 TI - Flow cytometry measurements of human chromosome kinetochore labeling. AB - A method for the preparation and measurement of immunofluorescent human chromosome centromeres in suspension is described using CREST antibodies, which bind to the centromeric region of chromosomes. Fluorescein isothiocyanate (FITC) conjugated antihuman antibodies provide the fluorescent label. Labeled chromosomes are examined on microscope slides and by flow cytometry. In both cases a dye which binds to DNA is added to provide identification of the chromosome groups. Sera from different CREST patients vary in their ability to bind to chromosome arms in addition to the centromeric region. Flow cytometry and microfluorimetry measurements have shown that with a given CREST serum the differences in kinetochore fluorescence between chromosomes are only minor. Flow cytometry experiments to relate the number of dicentric chromosomes, induced by in vitro radiation of peripheral blood cells to the slightly increased number of chromosomes with above-average kinetochore fluorescence did not produce decisive radiation dosimetry results. PMID- 2714106 TI - Vita Blue: a new 633-nm excitable fluorescent dye for cell analysis. AB - Several new derivatives of fluorescein were synthesized. The dyes were characterized by NMR; and the absorbance, excitation, and emission spectra were measured. The fluorescence quantum yields of the dyes were determined. The pKa3 values of the dyes were measured by fluorescence titration. The characteristics of the fluorescein and sulfonefluorescein derivatives were compared. The most promising dye for use in cell analysis appeared to be compound 9, which was given the name Vita Blue. The dibutyrate ester of Vita Blue was made and the compound was given the name Vita Blue dibutyrate (VBDB, 14). The Km of VBDB with pig liver esterase was measured and found to be 4 x 10(-5) M. The pKa3 of Vita Blue was 7.56 +/- 0.03; both acidic and basic forms were fluorescent (dual fluorescence). The use of VBDB as an intramolecular esterase substrate and its utility for the discrimination between live and dead cells by flow cytometry is described. PMID- 2714108 TI - 1,3'-Diethyl-4,2'-quinolylthiacyanine iodide as a "thiazole orange" analogue for nucleic acid staining. AB - Flow cytometric evaluation of reticulocytes has become a valuable and more precise alternative for the microscopically determined reticulocyte count. Until now, the most promising results are obtained with the "thiazole orange" (TO) nucleic acid dye. We report on the use of a "thiazole orange" analogue, 1,3' diethyl-4,2'-quinolylthiacyanine iodide (DEQTC), which gives comparable results and is commercially available at low cost. PMID- 2714107 TI - Improvement of flow-cytometric detection of multidrug-resistant cells by cell volume normalization of intracellular daunorubicin content. AB - To improve the ability of flow cytometry to detect multidrug-resistant cells, we studied the extent to which cell volume heterogeneity accounts for the variance of intracellular daunorubicin (DNR) content. For P388 murine or HL-60 human leukemia cells exposed to DNR (1 micrograms/ml, 60 min), log intracellular DNR content varied in direct proportion to log cell volume measured by flow cytometry, with a correlation coefficient of .9. This relationship was confirmed by cell sorting based on intracellular DNR content with subsequent volume determination of the sorted cells. Normalization of intracellular DNR content for cell volume (thus obtaining intracellular DNR concentration) was accomplished by subtracting log cell volume from log intracellular DNR content for each cell. This resulted in a 34% decrease (range 23-58%) in standard deviation compared to DNR content measurements without volume normalization for all cell types tested. Following exposure to DNR (as above), intracellular DNR content of drug-sensitive P388 or HL-60 cells measured by flow cytometry was 12- and 8-fold greater than that of the multidrug-resistant sublines P388/ADR and HL-60/AR, respectively. However, because of the variance of intracellular DNR content, the predictive value of flow-cytometric determination of intracellular DNR content as a discriminant assay for detecting the frequency of drug-resistant cells in a mixed population was acceptable only when the frequency of resistant cells in the population exceeded 10%. In contrast, volume normalization of intracellular DNR content enhanced the ability of the flow-cytometric assay to discriminate resistant cells by 10-fold for P388 cells and 100-fold for HL-60 cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714109 TI - On fully automatic feature measurement for banded chromosome classification. AB - Procedures for fully automatic location of chromosome axis and centromere in metaphase chromosomes are described for a practical interactive chromosome analysis system that omits the usual stages of interactive axis and centromere correction. Accuracy of centromere finding and consequential determination of a chromosome's polarity, i.e., which end is which, is measured experimentally. The saving in interaction by not correcting centromeres is compared to the increase in errors at the classification stage and the consequent increase in interaction needed to correct these errors. Some previously unreported features for banded chromosome classification are described, and in particular a set of global shape features is introduced. The discrimination capability of the feature measurements is evaluated by use of simple statistics and by reference to the performance of classifiers trained with various feature subsets. Class discrimination capability of the global shape feature set is shown to be comparable to that of centromere position, a widely used local shape feature. The variability of feature measurements that might occur in data from different laboratories on account of differing tissue, preparation methods, and digitiser hardware is assessed using three data bases of G-banded human metaphase cells. It is shown that the differences can be considerable and that appropriate feature selection and classifier training substantially improve classification performance. PMID- 2714110 TI - Cell-cycle studies by multiparametric automatic scanning of topographically preserved cells in culture. AB - The authors have developed a new methodology for characterizing in situ the cell cycle of human mammary epithelial cell lines. Using a SAMBA 200 cell image processor (scanning cytometry), 15 densitometric and textural parameters were computed on each Feulgen-stained nucleus. Parameters computed from the grey level cooccurrence and run-length section matrices allowed assessment of the chromatin pattern. Multiparametric analysis of data defined: 1) the relative position of each cell; 2) the relative positions of groups of cells, each group corresponding to a definite phase of the cell cycle; and 3) the function of these parameters best separating these phases. Files then were constructed for each phase: G0/G1, S, G2/ and M. Using these three files as a reference to classify cells, it was possible to ascertain the phase of the cell cycle for each cell of a population. The MDA AG human cell line synchronized by mitotic selection was used as a model to develop this method. The criteria used to assign cells to G0/G1, S, or G2 was DNA content. Classification in M phase was achieved by visual identification of mitotic cells. This method was checked on unsynchronized MDA AG and then applied to other human cell lines (MDA MB231, MCF-7, T47D C111). Comparison of results obtained by scanning cytometry and flow cytometry showed the proportion of cells assigned to G0/G1, S, and G2/M by the two methods to be similar. This new method removes some of the limitations of flow cytometry by 1) allowing visual verification of each cell analyzed; 2) lowering the number of cells required for study; 3) discriminating between G2 and M; and 4) preserving cell topography. PMID- 2714111 TI - A simple electronic volume cell sorter for clonogenicity assays. AB - A single-parameter electronic volume flow cell sorter that can be easily and inexpensively constructed using existing technology is described. The instrument is designed for ease and flexibility of operation, including such features as a large open area for recovering sorted cells into a variety of dishes or vessels; a remote, electrically activated fluidics system; a mechanism for heating or cooling samples during sorting; a simple arrangement for monitoring and adjusting the sorting control parameters; and an interface to a standard IBM personal computer for data acquisition, analysis, and control of the sorting windows. Several researchers in our laboratory now routinely use this sorter for plating precise numbers of cells directly into culture dishes in an aseptic manner for clonogenicity assays. The instrument can sort cells at rates of up to approximately 2,000 per second with greater than 80% sorting efficiency and no cytotoxicity. An advantage of this system is that the sorting windows can be set to exclude acellular debris and include either the entire cell volume distribution or a subset thereof. Applications of the instrument are detailed, including 1) precise cell plating for low-dose survival studies, 2) separation of cells into age compartments, and 3) rapid inoculation of single cells into multiwell dishes for cloning studies. Advantages of this technology for cell survival studies are detailed, along with some limitations to its applicability. PMID- 2714112 TI - Parallel processing data acquisition system for multilaser flow cytometry and cell sorting. AB - This report describes the data acquisition electronics for a flow cytometer. The design differs from most instruments in that the signals from a large number of detectors are processed in parallel. Each of the input channels is capable of autonomously measuring and digitizing the fluorescence signals. The digitized values that belong to one particle are collected by digital circuitry and are presented as a compact data package on a special bus. In addition to the pulse values, the data package contains a time marker, information needed for sort decisions, and an error detection code. Specially designed electronic modules that read the information from the bus can take complex multiparameter sort decisions at a very high speed. All events can also be recorded as data lists by a computer. The lists can be used to reconstruct a sort or analysis run. The raw data lists can also be reduced to kinetic curves and/or (gated) multivariate histograms. As a result of the applied scheme of parallel pulse processing, the dead time of the system is independent of the number of parameters measured and the number and time separation of the excitation beams. The instrument has a cycle time of 5 microseconds, which corresponds to a throughput rate of 2 x 10(5) events/s. At this rate, the incidence of correlation errors is well below 1 in 10(8) analyzed particles. The system has proved to be reliable and convenient to use in a variety of experiments. Its high speed and low error rate make it well suited for high-resolution measurements, rare-event analysis, kinetic measurements, and high-speed cell sorting. PMID- 2714113 TI - Model system evaluating fluorescein-labeled microbeads as internal standards to calibrate fluorescence intensity on flow cytometers. AB - Fluorescence intensity calibration was evaluated in a model system for flow cytometers using commercially available fluorescein-labeled microbeads as internal standards and stabilized fluoresceinated thymus cell nuclei (Fluorotrol) as surrogates for stained mononuclear cells. Spectrophotometrically determined calibration values for the microbeads were used to generate a standard curve that converted green fluorescence histogram channels into molecular equivalents of soluble fluorescein (MESF). In 19 analyses repeated during a single run, the coefficients of variation (CVs) for the derived MESF values on both dimly and brightly stained Fluorotrol populations were less than 2%. In 26 separate determinations over 14 weeks, the CVs of the derived MESF values were less than 3%. The MESF values of the dim and bright Fluorotrol populations derived from the microbead standard curves were both about 50% lower than those determined by direct spectrophotometric analysis of Fluorotrol. The analytical imprecision of fluorescence intensity measurements in this idealized model system has a CV less than 3%, and the analytical inaccuracy shows that calibration in MESF units remains uncertain over about a two-fold range. PMID- 2714114 TI - Flow cytometric studies of the nuclear matrix. AB - We have devised a method to measure the protein and nucleic acid content of the nuclear matrix using flow cytometry. Nuclear matrices were prepared from nuclei by DNase I digestion followed by 3 M NaCl extraction. The resulting particles were stained with fluorescein isothiocyanate (FITC) for protein and propidium iodide (PI) for double-stranded nucleic acids, and fluorescence as well as forward angle light scatter was detected. The matrices were also subjected to additional chemical or enzymatic perturbations, and changes in the above parameters were measured. Results showed that matrices from heat-shocked cells not only retained the majority of heat-induced excess nuclear protein, but also exhibited higher PI signals than controls after RNase A digestion. This observation did not hold if RNase A digestion preceded high-salt extraction, suggesting that a salt-extractable moiety had been replaced or altered by heat so that double-stranded RNA was protected from the nucleolytic attack. The residual PI fluorescence in matrices from heated cells bore a linear relationship to the increased protein content in those matrices, indicating that the excess protein sequesters matrix-associated RNA. Polyacrylamide gel electrophoresis of matrix polypeptides revealed increased amounts of many proteins as a result of heat as well as the appearance of several new proteins, one of which comigrates with the HSP72/73 heat-shock proteins. The results of these studies show that flow cytometry can be used to study the nuclear matrix and is capable of detecting changes that result from alterations in its protein composition. PMID- 2714115 TI - Intratumoral variations in DNA distribution patterns in mammary adenocarcinomas. AB - Correlated flow-cytometric (FCM) and microspectrophotometric (MSP) techniques were applied to investigating whether intratumoral variations in the DNA distribution patterns of 21 primary mammary adenocarcinomas can occur. Although neoplastic cell populations with both diploid and tetraploid (i.e., euploid) distribution patterns could be found in varying proportions in some of the tumors, there was no evidence in any tumor nodule for the presence of euploid populations in one part and aneuploid populations in another. This statement was based on the results of the MSP technique, where the assessments were made on cytodiagnostically identified neoplastic cells. Also, when applying the FCM technique the statement was found to be essentially valid; only one of the tumor nodules showed a DNA distribution pattern that, by means of the criteria used in this procedure, was defined as being both euploid and aneuploid. Here, however, the technique consists of assessments made on a great number of microscopically non-identified cells. It was concluded that when conflicting reports are given from different laboratories on the prognostic value of the cytochemically assessed DNA distribution patterns in breast carcinomas, they are not likely to be attributed to intratumoral DNA heterogeneity but, rather, to differences in the methods used and in the criteria applied for the so-called ploidy assessments. PMID- 2714116 TI - Cellular DNA content parameters in untreated and recurrent squamous cell cancers of the head and neck. AB - The presence and degree of DNA aneuploidy as measured by the DNA index (DI) and the S phase fraction (SPF) were determined by flow cytometry in 294 specimens from 237 patients with untreated and recurrent squamous cell carcinomas of the head and neck (SCCHN). A descriptive analysis was performed in which the specimen DNA parameters were correlated with stage, size of primary, degree of lymph node involvement, morphological grade, and treatment status of the corresponding patients. Approximately 70% of the previously untreated specimens contained DNA aneuploid populations (DI greater than 1.10) and three quarters had SPF that were above 15%. There was a strong, direct association between DI and SPF (P less than 0.001). There was no correlation of the presence or degree of DNA aneuploidy with the stage of the tumor or the size of the primary or conventional morphological grade of the tumor. Specimens from patients with recurrent tumors and untreated patients with N3 lymph nodes had significantly lower rates of DNA aneuploidy and mean DI. Serial determinations of DNA aneuploidy in patients with SCCHN undergoing cytotoxic therapy are ongoing and may prove useful in the identification and understanding of resistance and response in this tumor. PMID- 2714117 TI - Initial evaluation of a new epithelial antigen (T16) for bivariate flow cytometry of bladder irrigation specimens. AB - Bivariate flow cytometry (FCM) was used to study immunofluorescent T16 mouse monoclonal antibody (Mab) binding simultaneously with propidium iodide DNA measurements in bladder irrigation specimens from 30 patients with a history of bladder cancer. Aliquots of the same samples were stained with acridine orange (AO) and examined by conventional FCM. T16 Mab is believed to be specific for epithelial cells in this type of specimen and stained from 13% of the cells in a patient with cystitis to 95% of the cells in a patient with an atypical papilloma. In combination with DNA measurements, this antibody increased the sensitivity of FCM in patients with severe cystitis and relatively small numbers of tumor cells, but the diagnostic specificity may be decreased and the criteria established for interpreting univariate flow cytometry may have to be re evaluated and modified. PMID- 2714118 TI - DNA flow cytometry in sperm cells from unilaterally orchiectomized patients with testicular cancer before further treatment. AB - Light microscopic sperm cell analysis and DNA flow cytometry in the seminal fluid were done in 85 testicular cancer patients after orchiectomy before further treatment. The results were compared with those from 26 healthy age-matched males (control group). A computer-based method for analysis of the DNA histograms was developed for evaluation of the percentage of sperm cells within the sub-haploid, haploid (1c), and diploid (2c) and greater than 2c levels. Compared with the control group, testicular cancer patients had a reduced sperm cell density and sperm cell motility. The mobility grade was also significantly reduced as compared with healthy males. In addition, the number of condensed haploid sperm cells (within the subhaploid level) was decreased in testicular cancer patients, whereas the percentages of noncondensed haploid (1c), diploid, and greater than 2c cells were increased. Most of the DNA flow cytometric parameters were significantly correlated with sperm cell density. DNA flow cytometry in human seminal fluid offers a possible means of assessing spermatogenesis, thus providing an objective method for studying fertility disturbances, for example, in cancer patients before and after treatment. PMID- 2714119 TI - A spectrophotometric method for determining the stream sample core diameter of a flow cytometer. AB - A simple, rapid, and accurate method is described for the determination of flow cytometer stream sample core diameters. A precisely formulated solution of potassium dichromate is introduced as a sample, the stream is collected, and its absorbance is measured using a spectrophotometer. This permits the calculation of the factor by which the original solution was diluted and, given the stream diameter, the sample core diameter. PMID- 2714120 TI - Instar development and disengagement rate of engorged female winter ticks, Dermacentor albipictus (Acari:Ixodidae), following single- and trickle-exposure of moose (Alces alces). AB - Seven hand-reared moose (Alces alces) calves and one yearling were infested with 30,000 larvae each of the winter tick. Dermacentor albipictus, either by single- or trickle-exposure (1000/day). They were examined weekly for instar changes from September/October until late May. By 2 and 3 weeks post-exposure, most larvae on single- and trickle-infested moose, respectively, had fed and molted to nymphs. Thereafter, tick development was similar between both infestation techniques. Nymphs dominated the tick population from October to mid-February, and adults from mid-February to May. The peak of host disengagement by engorged females was late March in both years. Weights of engorged females from calf moose declined over time during the disengagement period. PMID- 2714121 TI - Effect of Dermacentor albipictus (Acari:Ixodidae) on blood composition, weight gain and hair coat of moose, Alces alces. AB - The physiological effects of the winter tick, Dermacentor albipictus, on moose, Alces alces, were investigated. Blood composition, weight gain, food intake and change in the hair coat of moose calves, four infested with D. albipictus larvae, and eight uninfested, were monitored. Infested moose groomed extensively, apparently in response to feeding nymphal and adult ticks, and developed alopecia. Other clinical signs included: chronic weight loss, anemia, hypoalbuminemia, hypophosphatemia, and transient decreases in serum aspartate transaminase and calcium during the period of nymphal and adult female tick engorgement. Infested animals did not become anorexic. Two moose with severe hair loss had increases in gamma globulin shortly after the onset of female tick engorgement. Results suggest that alopecia is associated with tick resistance. Animals that groom and develop hair loss likely carry fewer ticks and therefore suffer less severely from blood loss. PMID- 2714122 TI - Resistance in cattle against Rhipicephalus appendiculatus with an assessment of cross-resistance to R. pulchellus (Acari: Ixodidae). AB - A comparison of the yield of engorged nymphs of Rhipicephalus appendiculatus and R. pulchellus was carried out between cattle highly resistant to R. appendiculatus but susceptible to R. pulchellus, and cattle and rabbits susceptible to both species. Resistant cattle yielded fewer and smaller R. appendiculatus nymphs than either susceptible cattle or rabbits. More nymphs of both tick species dropped from susceptible cattle but no differences were detected in the mean weight of engorged R. pulchellus nymphs fed on R. appendiculatus-resistant and susceptible cattle, although resistant animals yielded more nymphs of R. pulchellus than of R. appendiculatus. An acute inflammatory reaction, accompanied by intense pruritus and grooming, was observed in the ears of the resistant cattle infested with R. appendiculatus, but no reaction was detected in the opposite ears where R. pulchellus was feeding. The low cross-resistance between these two closely related tick species suggests that different antigens may be involved in the development of resistance in cattle to different tick species. PMID- 2714123 TI - Sites of attachment and density assessment in Amblyomma americanum (Acari: Ixodidae) on nursing beef calves. AB - Primary attachment sites of male, female, and nymphal Amblyomma americanum (L.) on nursing beef calves were the axillary, inguinal and perianal areas of the body. About 50% of all larvae fed on the ears. A density assessment method which uses the number of A. americanum on less than or equal to 5 body areas to predict the total number of ticks (tick burden) on the left side of a calf is presented. Estimates of tick burden for male, female, nymphal and larval A. americanum each require examination of the axillary, inguinal, and perianal body areas. In addition, to estimate larval and male A. americanum, the neck, dewlap and brisket require examination as do the ears for estimates of nymphs and larvae. Mean tick burden in a herd of calves can be estimated by an examination of from 14 to 100% of all calves depending on the level of precision required for the estimate. PMID- 2714124 TI - Synchronous bowel anastomoses. AB - A retrospective review of patients who underwent double bowel resections and synchronous anastomoses without ileostomy or colostomy was undertaken. The study goal was to determine whether there was an increased incidence of complications attributable to the presence of a second anastomosis. A total of 66 patients who met the criteria were identified and divided into two groups. Group A consisted of 30 patients who had had two colonic resections and two colonic anastomoses. In Group B were 36 patients who had undergone separate colonic and small-bowel resections with two subsequent anastomoses. The indications for primary resection were: 1) adenocarcinoma, 54 percent; 2) Crohn's disease, 26 percent; 3) diverticulitis, 11 percent; 4) "other" indications, 9 percent. The indications for the second resection were: 1) metastatic adenocarcinoma, 30 percent; 2) Crohn's disease, 26 percent; 3) synchronous bowel lesions, 18 percent; 4) adhesions and enterotomies, 14 percent; 5) "other" indications, 12 percent. Overall, there were four major complications (6 percent), and 11 minor complications (17 percent). The sole anastomotic leak occurred in a patient who had undergone a double colonic resection (3%). The other major complications were one death, one ureteral complication that required reoperation, and one early small-bowel obstruction. Minor complications included two wound infections (3 percent), three seromas (5 percent), three prolonged ileus (5 percent), and three urinary infections (5 percent). These results are comparable to the best results reported for patients undergoing single colonic anastomoses. The conclusion is that it is safe to perform synchronous anastomoses without diversion provided the following conditions are present: well-prepared bowel with minimal fecal soilage, an adequate blood supply, technically good anastomoses, and lack of tension on the suture lines. PMID- 2714125 TI - Hemorrhoidal ligation. A review of efficacy. AB - Two hundred forty-one patients undergoing hemorrhoidal rubber band ligation over a five-year period were reviewed to focus on complications. Three patients (1.2 percent) were hospitalized. Two, on oral anticoagulants, recovered from bleeding complications. One patient developed a band-related abscess that resolved with drainage. Twenty patients (8.3 percent) reported pain associated with the procedure. Three patients went on to subsequent surgical hemorrhoidectomy. There were no deaths in the series. This report agrees with previously published series highlighting the efficacy and cost containment of hemorrhoidal ligation. Continued reliance on this approach to hemorrhoidal disease is justified. PMID- 2714126 TI - Rubber band ligation of hemorrhoids and rectal mucosal prolapse in constipated patients. AB - Rubber band ligation was used in 160 patients with internal hemorrhoids; 43 of them also had rectal anterior mucosal prolapse; 13 had prolapse alone. Two thirds of the patients underwent a single rubber band ligation and one third a double rubber band ligation in one session without anesthesia. Ninety-four required repeated ligations. A follow-up of 25 +/- 16 months (mean +/- SD) was carried out in 153 of them. Rubber band ligation was followed by prolonged bleeding in six patients and severe pain requiring removal of the rubber band in 12 patients. The complication rate decreased significantly (P less than .05) in the last 80 patients. Compared with multiple ligation, single rubber band ligation in one sitting was followed by a lower complication rate (P less than .01). Long-term results were good in 71 percent of the patients. (A formal hemorrhoidectomy was needed within two years in 6 percent.) A significantly lower recurrence rate of 9 percent was noted in those with normal bowel habits, when compared with constipated subjects whose symptoms recurred in 85 percent (P less than .001). Constipation seems to be a predictable factor in worsening the outcome of rubber band ligation. Rubber band ligation is followed by a lower complication rate when performed in a single ligation. PMID- 2714127 TI - Voluntary relaxation of the external anal sphincter. AB - In this study five volunteers with special training in anal sphincter exercise (Scandinavian Yoga School) managed voluntarily to reduce anal pressure. The mean reduction of anal pressure was 20 mm Hg. In one of the subjects, this was shown by manometry during low spinal anesthesia and electromyography to be caused by relaxation of the external anal sphincter. PMID- 2714128 TI - Vaginal fistulas in Crohn's disease. AB - Twenty-eight patients with vaginal fistulas complicating Crohn's disease, seen between 1970 and 1987, are described. Twelve required early operation; five of them had rectal excision. Conservative management was used in 16 patients but in none of these did the fistula close spontaneously. Subsequent proctocolectomy was required in seven patients though two patients with high vaginal fistulas were managed by total colectomy, end ileostomy, and oversewing of the rectal stump. Only two high fistulas resulting from ileal Crohn's disease resolved with resection and anastomosis of the diseased segment alone. Local repair was unsuccessful despite repeated operations in two of five patients. Two patients died of malignancy arising within a chronic vaginal fistula. Although some vaginal fistulas complicating Crohn's disease cause little disability and can be managed symptomatically, they do not heal by conservative therapy or by a proximal defunctioning stoma alone. In time, severe bowel symptoms develop in the majority of patients and necessitate proctectomy. PMID- 2714129 TI - The effect of pregnancy and delivery on the ileal pouch-anal anastomosis functions. AB - Since 1981, a total of 729 ileal pouch-anal anastomoses have been performed at the Mayo Clinic-affiliated hospitals. Three hundred fifty-four were in women. Twenty of these patients subsequently had at least one successful pregnancy and delivery. Eleven deliveries were vaginal with episiotomy, and nine were cesarean sections. No maternal deaths occurred. One child died of hyaline membrane disease. The frequency of nocturnal stooling increased in the ileal pouch-anal anastomosis patients during pregnancy (P less than .01), and the increase persisted for three months after delivery (P less than .05). In contrast, the frequency of daytime stools, the incidence of incontinence, the consistency of the stool, and the development of perineal seepage or skin irritation were not greatly altered by pregnancy or delivery. Moreover, postpartum pouch function was not influenced by the type of delivery (vaginal vs. cesarean section). In conclusion, pregnancy and delivery are safe in patients with the ileal pouch-anal anastomosis, but they lead to more frequent nocturnal stools. The type of delivery (vaginal vs. cesarean section) does not influence pouch functional outcome. PMID- 2714130 TI - Multivariate analysis of a tissue CEA, TPA, and CA 19.9 quantitative study in colorectal cancer patients. A preliminary finding. AB - Tissue CEA, TPA, and CA 19.9 concentrations from samples of surgical specimens were measured in 47 evaluable colorectal cancer patients (median follow-up, 20 months, 13 recurrences) and correlated with individual patient follow-up status. The quantitative method appeared to be sensitive, easily reproducible, and standardizable. The tissue marker concentration was analyzed by means of the multivariate discriminant analysis, to evaluate the risk of relapse in each patient; the tumor CEA (CEA T) showed the best discriminant capacity (P = .005). The relative Fisher function provided a reliable prognostic patient index, independently of other recognized prognostic factors (Dukes' stage and cellular differentiation grade). The Cox model showed a statistical significance analyzing the tumor (T) and healthy mucosa (M) CEA values (P = .001 and P = .006, respectively). The combination of these two variables allowed for identification of three classes of patients according to CEA T and M threshold values of 216 and 85 ng/mg of protein, respectively, and different disease-free curves were obtained for each group. The two-year disease-free rate was 81 percent for patients with low values of both CEA T and M, and 21.4 percent for the group with both values above these thresholds (P = .0008). In the third class (CEA T or M higher than the reported cut-off levels), the two-year disease-free rate was 65.9 percent. PMID- 2714131 TI - 5-Aminosalicylic acid suppositories in the management of ulcerative colitis. AB - 5-aminosalicylic acid (5-ASA) suppositories have been used in the author's out patient clinic in Bologna for the treatment of distal ulcerative colitis (UC). One hundred fifty-six patients with mild or moderate attacks of UC were treated using different protocols for controlling active disease. Improvement was observed in 88.5 percent of the therapeutic cycles after one month. A small preliminary maintenance study using only 400-mg suppositories of 5-ASA twice a day for 6 or 12 months showed a remission percentage similar to salicylazosulfapyridine (SASP). PMID- 2714132 TI - Current status of ileorectal anastomosis for inflammatory bowel disease. AB - Between September 1959 and December 1986, a total of 210 patients in a consecutive series were operated on for inflammatory bowel disease. One hundred ten (66 percent) had ileorectal anastomosis performed. There were no postoperative deaths. There were six failures in 53 ileorectal anastomoses for ulcerative colitis (11 percent), and five failures (8 percent) in 61 for Crohn's disease. The overall failure rate was 11 in 110 (10 percent). Ileorectal anastomosis, in suitable patients, is still a viable operation in the late 1980s. PMID- 2714133 TI - Fiberoptic sigmoidoscopy as the first screening procedure for colorectal neoplasms in an asymptomatic population. AB - As the first screening for colorectal neoplasms, a total of 2243 examinations by fiberoptic sigmoidoscopy (FS) were performed on 1573 asymptomatic patients. One hundred seventy neoplasms were found in 134 patients (6 percent of total examinations), including nine adenocarcinomas (0.4 percent). A flat, intramucosal cancer and a small, 5-mm cancer detected by FS could not be demonstrated by barium enema examination. On further investigation, additional adenomas were identified in the proximal colon in 22 percent of patients in whom neoplasms had first been detected by FS and in only 4.4 percent of those in whom FS findings were negative but other criteria were positive. It is concluded that FS is the procedure of choice for the first screening of asymptomatic patients, not only because it enables detection of flat and small lesions within its observation range, but also because it could lead to detection of proximal neoplasms. PMID- 2714134 TI - Anorectal abnormalities in progressive systemic sclerosis. AB - Seventeen patients with progressive systemic sclerosis (PSS) were evaluated with manometry for anorectal function, and an additional 36 age-matched normal subjects were collected as a control group. The study group had a significant decrement of maximum basal pressure (MBP), 42.6 +/- 27.0 mm Hg, in PSS as compared with the control group, 71.2 +/- 24.9 mm Hg (P = .0004). The difference in the functional length (FL) of the anal canal, PSS:control = 2.4 +/- 1.0 cm:3.7 +/- 0.5 cm (P = .0001); the volume of first defecating sensation, PSS:control = 66.3 +/- 35.2 ml:125.1 +/- 43.8 ml; the voluntary component, the difference between maximum squeeze pressure (MSP) and MBP, PSS:control = 116.6 +/- 73.6 mm Hg:61.8 +/- 35.9 mm Hg (P = .0087), were also found to be statistically significant. Nevertheless, the MSP and maximal tolerable capacity (Vmax) showed no difference in these two groups (MSP, PSS:control = 159.3 +/- 88.1 mm Hg:132.9 +/- 44.9 mm Hg, P = .259), (Vmax, PSS:control = 193.1 +/- 67.7 ml:230.0 +/- 60.9 ml, P = .0526). Twelve (71 percent) of 17 patients did not have rectoanal inhibitory reflex, and paradoxical contraction during rectal balloon inflation was noted in ten patients. Nine patients had different degrees of anal incontinence and abnormal anometric profiles were found in six of eight asymptomatic patients. Therefore, only two patients (12 percent) had neither symptoms nor anometric evidence of anorectal involvement in PSS. Two patients with long-standing disease received posterior anal repair for stool incontinence, the postoperative results were satisfactory both subjectively and objectively. The average MBP increased from 0 to 20 mm Hg, average FL from 0 to 1.5 cm. Patients complained less frequently about stool incontinence or soiling, and their daily life is now more comfortable. The analysis indicates that anorectal function in PSS is affected much more frequently and earlier than thought. Anorectal manometry can be used as an adjuvant in diagnosing controversial cases. Once anal incontinence occurs, posterior anal repair can achieve good results after six months of follow-up. PMID- 2714135 TI - Beware of hemolytic uremic syndrome presenting as colorectal disease in adults. Report of two cases. AB - Hemolytic uremic syndrome is seen occasionally by the surgeon in adult patients with colorectal manifestations. Two cases of hemolytic uremic syndrome are presented here, one misdiagnosed clinically as acute appendicitis and the other as acute ulcerative colitis. In each case the diagnosis was only established postoperatively and both patients died of this disease. These cases serve to remind colorectal surgeons that this potentially lethal disease may occur with symptoms and signs suggestive of more common colorectal pathology. PMID- 2714136 TI - Implantation of artificial sphincter for anal incontinence. Report of five cases. AB - The implantation of an artificial anal sphincter in five patients with anal incontinence of neuromuscular origin is described. The prosthesis, an AMS 800 artificial urinary sphincter (American Medical Systems), worked well with solid or semisolid stool, but less satisfactorily when diarrhea was present. Manometric and defecographic studies seem to indicate that the effect of the prosthesis may be ascribed partly to maintenance of an acute anorectal angle even during straining. PMID- 2714137 TI - Colonic perforation by amyloidosis. Report of a case. AB - One patient with a colonic perforation associated with secondary amyloidosis and ankylosing rheumatoid spondylitis was treated successfully. To our knowledge, this is the first case described of colonic perforation in amyloidosis. PMID- 2714138 TI - Are diverticula immune? PMID- 2714139 TI - Gastrin levels and colorectal cancer. PMID- 2714140 TI - Does the intraesophageal pH probe accurately detect acid reflux? Simultaneous recording with two pH probes in humans. AB - Little is known about the accuracy of intraesophageal pH monitoring, ie, do false negatives occur? This study was designed based on the assumption that if two pH probes are placed equidistant from a distal acid source, and the probes measure different values, then one probe might miss acid if it were there alone. We performed 24-hr intraesophageal pH monitoring in 10 patients with gastroesophageal reflux disease, simultaneously placing two pediatric pH probes (probes A and B) 5 cm proximal to the LES in such close proximity that one would expect only small differences in the acid exposure measured by the probes. However, the amount of acid exposure measured by probes A and B differed greatly in some instances. Individual probe performance does not alone account for these differences, since, when pH recordings were reviewed, one probe was as likely to miss acid exposure as the other. These differences would result in a change in the clinical diagnosis in two of 10 patients. Variability in the number of episodes was great and occurred even when there was concordance in percent acid exposure. These data raise questions about the absolute accuracy of the pH probe as the gold standard in the measurement of gastroesophageal reflux. PMID- 2714141 TI - Gastrointestinal transit and gastric acid secretion in patients with achalasia. AB - Previous studies suggest that patients with achalasia exhibit degenerative changes of extraesophageal nerve fibers. We investigated whether these morphological alterations are associated with functional abnormalities of the gastrointestinal tract. Patients with achalasia had a normal acid secretory response (5.5 +/- 1.5 mmol/hr) to vagal stimulation when compared to controls (6.0 +/- 5.3 mmol/hr). However, the half time of gastric emptying of liquids was significantly shorter in patients with achalasia (10.4 +/- 1.8 min) than in control subjects (19.3 +/- 11.3 min) (P less than 0.01). Although there was a tendency towards a more rapid gastrointestinal transit in patients with achalasia, these changes failed to reach statistical significance. It is concluded that patients with achalasia have a gastric emptying disorder that could either be explained by a selective defect of extraesophageal vagal inhibitory nerve fibers or as an epiphenomenon occurring as a consequence of impaired esophageal emptying. PMID- 2714142 TI - Upper esophageal sphincter tone and reactivity to stress in patients with a history of globus sensation. AB - Anxiety and abnormal upper esophageal sphincter function have been ascribed ill defined roles in the etiology of globus sensation. In this study, we examined the psychological profile and effect of acute mental stress (dichotic listening task) on UES tone in seven patients reporting to the clinic with globus sensation and 13 healthy controls. Alterations in heart rate, blood pressure, frontalis EMG, and skin conductance confirmed the effectiveness of the stress test in patients and controls. During resting conditions, UES pressure (mean +/- SE) in patients (40.4 +/- 4.6 mm Hg) did not differ significantly from controls (46.5 +/- 4.7 mm Hg). In response to stress, UES pressure rose by 31% in patients (P = 0.04) and by 25% in controls (P = 0.002). The stress-induced rise in UES pressure in patients (9.5 +/- 3.8 mm Hg) was not significantly different to that observed in controls (11.8 +/- 3.0 mm Hg). Psychological profiles of globus patients presenting to the clinic revealed them to be more introverted, anxious, neurotic, and depressed than normal controls. We conclude that in patients with a history of globus sensation, resting UES pressure and its response to stress is normal. Although individuals presenting to the clinic with globus sensation showed increased levels of psychoneurosis, acute, predictable stress is not a factor in the genesis of globus sensation. UES hyperresponsiveness to other stimuli or subjective intolerance to changes in UES pressure could account for symptoms of globus sensation. PMID- 2714143 TI - Effects of autonomic nervous system on gastric damage by ethanol in the rat. AB - To study whether or not the autonomic nervous system influences the defense mechanisms of the gastric mucosa, groups of Sprague-Dawley rats were given stimulants and inhibitors of the different components of the vagus and celiac nerves before administration of absolute or 70% w/v ethanol. The effects of vagotomy and sympathectomy on "adaptive cytoprotection" were studied, as were the effects of blocking the muscarinic receptors and stimulation of beta-adrenergic receptors. We found that: (1) cholinomimetic agents and norepinephrine make the damage caused by 70% ethanol worse; (2) atropine is the only agent that fully protects against absolute ethanol; (3) vagotomy and sympathectomy abolish the effects of atropine and adaptive cytoprotection; and (4) beta-adrenergic stimulation replaces conditions that allow adaptive cytoprotection and the protection by anticholinergics. These results suggest that two different reflexes are triggered by ethanol: when low concentrations are given, the beta-adrenergic mediated effect is prevalent, with protection of the mucosa; when high concentrations are given, the cholinergic-mediated effect is prevalent with damage of the mucosa. PMID- 2714144 TI - Role of prostaglandin deficiency in pathogenetic mechanism of gastric lesions induced by indomethacin in rats. AB - The present study was undertaken in rats using 2-deoxy-D-glucose (2DG) as a stimulator of gastric motility and a low dose of indomethacin as a prostaglandin (PG) synthesis inhibitor to investigate the roles of gastric motility and PG deficiency in the pathogenesis of indomethacin-induced gastric lesions. Subcutaneously administered indomethacin at 5 mg/kg did not induce any visible damage in the mucosa within 4 hr, but at 25 mg/kg produced linear hemorrhagic lesions along the long axis of the stomach. 2DG (100 mg/kg/hr), given intravenously, produced linear nonhemorrhagic lesions along the mucosal folds and, in the presence of 5 mg/kg of indomethacin, caused severe hemorrhagic lesions in the same areas of the stomach. Gastric motility was markedly enhanced by both indomethacin (25 mg/kg) and 2DG, while acid output and mucosal blood flow were increased only by the latter. Mucosal PGE2 levels were significantly reduced by indomethacin (25 mg/kg) but not by 2DG. Indomethacin at 5 mg/kg alone had no or little effect on any parameter except PG levels, which were reduced to similar degrees as caused by 25 mg/kg of the agent. Time-course development of the lesions was closely associated with those changes in gastric motility after administration of indomethacin (25 mg/kg) and 2DG. These results suggest that the enhanced gastric motility is, by itself, sufficient to induce damage (nonhemorrhagic) in the mucosa and that a PG deficiency alone does not induce any damage but is required for further extension to hemorrhagic lesions of nonhemorrhagic ones that are initially induced by enhanced gastric motility.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714145 TI - GLP-1 (glucagon-like peptide 1) and truncated GLP-1, fragments of human proglucagon, inhibit gastric acid secretion in humans. AB - Glucagon-like peptide 1 amide (GLP-1 amide), a predicted product of the glucagon gene (proglucagon 72-107-amide), and truncated GLP-1 (proglucagon 78-107-amide), recently isolated from porcine small intestine, were infused in doses of 100 and 400 ng/kg/hr and 12.5 and 50 ng/kg/hr, respectively, into eight volunteers to study pharmacokinetics and effects on pentagastrin-stimulated gastric acid secretion (plateau stimulation with pentagastrin at D50: 100 ng/kg/hr). The concentration of GLP-1 in plasma increased from 64 +/- 12 to 189 +/- 23 and 631 +/- 76 pmol/liter, respectively. The concentration of truncated GLP increased from approximately 7 pmol/liter to 28 +/- 3 pmol/liter during the high rate of infusion. A similar increase was seen in response to a mixed meal in eight normal volunteers. The metabolic clearance rate (MCR) of GLP-1 was 2.2 +/- 0.3 and 2.6 +/- 0.3 ml/kg/min, respectively, and the half-life in plasma was 17 +/- 2 min. The MCR of truncated GLP-1 was 13 +/- 2.8 ml/kg/min and the half-life 11.4 +/- 2.1 min. GLP-1 reduced the pentagastrin-stimulated acid secretion 16 +/- 9% during the low-rate infusion and 23 +/- 12% during the high rate (P less than 0.05). Truncated GLP-1 caused a 36 +/- 3% inhibition during the high infusion rate. Thus truncated GLP-1, a naturally occurring peptide, is a potent inhibitor of acid secretion in man and more so than GLP-1. PMID- 2714146 TI - Low serum cobalamin levels in a population study of 70- and 75-year-old subjects. Gastrointestinal causes and hematological effects. AB - We examined causes and hematological consequences of low serum cobalamin (vitamin B12) concentration in two representative population samples of 70-year-old (N = 293) and 75-year-old subjects (N = 486). Subjects with values below 130 pmol/liter (4.8% and 5.6%, respectively) were investigated with Schilling test, upper gastrointestinal endoscopy, determination of serum gastrin and group I pepsinogens, and bone marrow examination. Gastrointestinal abnormalities of etiologic significance were found in 26 of the 32 examined subjects: atrophy of the gastric body mucosa (N = 16, with pernicious anemia in six), partial gastrectomy (N = 6), and intestinal malabsorption (N = 4). Megaloblastic hematopoiesis was found in 10 individuals, four of whom had macrocytic anemia. Our results indicate that low serum cobalamin concentration in the elderly is usually a consequence of disease rather than of high age per se and that gastric mucosal atrophy is a major etiologic factor. PMID- 2714147 TI - Intestinal mucosal injury is associated with mast cell activation and leukotriene generation during Nippostrongylus-induced inflammation in the rat. AB - We examined mucosal injury in the jejunum of the rat during infection with the nematode parasite, Nippostrongylus brasiliensis (Nb). Injury was documented morphologically (increase in crypt length with or without villus atrophy) and biochemically (activities of digestive or proliferative enzymes) and related to mast cell activation and leukotriene generation. At day 4 crypt length and thymidine kinase activity were increased; no changes in villus parameters were recorded. No evidence of mast cell activation was found and leukotriene levels in the mucosa were normal. At day 7, the gut was acutely inflamed and edema was present at the tips of the villi. This progressed to enterocyte detachment, resulting in villus atrophy with decreased activities of brush border enzymes. At this stage mucosal histamine was decreased and rat mast cell protease II (RMCP II) was increased in serum, indicating mast cell activation. In addition, mucosal leukotrienes (LTB4, LTC4, LTE4) were present in significant quantities. Following worm expulsion, the villus abnormalities resolved and serum RMCP II returned to normal. However, the crypt hyperplasia persisted. Our results suggest that during Nb infection at least two components of injury can be identified. One component, epithelial injury at the villus tips, may be related to activation of mucosal mast cells. PMID- 2714148 TI - Rectal sensitivity in chronic constipation. AB - Rectal sensitivity is often reduced in patients affected by chronic constipation, but it is not known whether this alteration differs according to the severity and the site(s) of the slowing of gastrointestinal transit. Moreover, it is not known whether alteration precedes or follows bowel complaints. In this study, perception of intrarectal distension was evaluated in 28 healthy controls, in 20 patients complaining of constipation and with a normal gastrointestinal transit time (less than 96 hr), and in 44 patients complaining of constipation and with a prolonged gastrointestinal transit time (greater than 96 hr). Within the latter group, perception to intrarectal distension was analyzed in patients with slowing of transit in the rectum only, in the colon only, and in both the rectum and the colon. In a subgroup of 22 patients, rectal sensitivity was evaluated before and after treatment. Rectal sensitivity was found to be reduced significantly in constipated patients; it was more severely reduced in patients with objective evidence of prolonged gastrointestinal transit time and with slow transit in the rectum. Rectal sensitivity improved in patients who responded to treatment and did not vary significantly in nonresponders. PMID- 2714149 TI - Failure of 5-aminosalicylic acid enemas to improve chronic radiation proctitis. AB - Radiation proctitis is a well-known complication of abdominal and pelvic radiation. Conventional medical and surgical treatment often is disappointing. 5 Aminosalicylic acid (5-ASA) is the active component in sulfasalazine and is effective in the treatment of distal ulcerative colitis. Four patients with radiation proctitis were treated with 4 g 5-ASA by enema nightly for two to six months. Patients were seen monthly, interviewed, and a sigmoidoscopic exam performed. No change was seen in the degree of mucosal inflammation on follow-up sigmoidoscopic exams. Three patients noted no change in their symptoms of bleeding, pain, or tenesmus. One patient noted initial improvement, but this was not sustained. 5-ASA enemas do not appear to be effective in the treatment of radiation proctitis. PMID- 2714150 TI - The irritable bowel. A mechanism at last? PMID- 2714151 TI - Lymphatic and portal absorption of vitamin E in aging rats. AB - We studied the intestinal absorption and lymphatic versus portal distribution of vitamin E and its metabolites in vivo in young (4 month), "middle-aged" (14 month), and old (24 month) male Sprague-Dawley rats. Twenty-four hours after its surgical preparation, the rat's jejunum was infused with a physiological micellar solution containing 200 nM alpha-tocopherol. Its transport rate into lymph and bile as well as its accumulation in liver and intestinal tissues was measured. Lymphatic transport of vitamin E increased from 92 to 269 pmol/5 hr and bile appearance of vitamin E and its polar metabolites increased from 230 to 298 pmol/5 hr as rats aged. Tissue accumulation of the vitamin in the small intestine and liver increased significantly with aging (P less than 0.05). Total absorption of the vitamin and its intestinal metabolites increased from 5912 pmol/5 hr in young rats to 16,467 pmol/5 hr in old rats (P less than 0.01). Absorption expressed as a percentage of infused alpha-tocopherol increased from 19.7% at 4 months to 54.9% at 24 months. These studies demonstrate an aging-associated increase in the total amount of vitamin E absorbed and a shift from portal to lymphatic transport. These changes may represent a salutary adaptive increase in the systemic availability of vitamin E with aging. PMID- 2714152 TI - Intestinal infections in patients with acquired immunodeficiency syndrome. A prospective study in 132 patients. AB - We studied prospectively 132 patients with acquired immunodeficiency syndrome to define the spectrum of enteric pathogens during this disease, with special reference to the correlation between the lesions, the infections, and the symptoms. Forty-four percent of the patients harbored at least one enteric pathogen: the most frequently recovered were Cryptosporidium (28), cytomegalovirus (16), Entamoeba histolytica (13), Giardia lamblia (9), and Mycobacterium avium intracellulare (7). Patients harboring pathogens were more likely to be diarrheics (69%) than patients without a pathogen (38%; P = 0.01) and more likely to have endoscopic lesions (29%) than patients without a pathogen (4%; P less than 0.001). The most common pathogen associated with diarrhea was Cryptosporidium. Cytomegalovirus, Entamoeba histolytica, and Salmonella typhimurium were each significantly associated with endoscopic lesions. Patients with cytomegalovirus infection tended to have a greater incidence of ulcer than patients without cytomegalovirus infection. Stool analysis diagnosed 61% of the infections, while endoscopy diagnosed 44%. Seven percent were recognized by stool analysis and endoscopy. When considering the 24 patients in whom accurate diagnosis warranted endoscopic biopsies, stool examination alone would have given an incomplete diagnosis in 14 patients (due to the presence of polyinfection). The frequency of inaccurate diagnosis of infection by stool determination alone, plus the development of new antiviral agents that suppress cytomegalovirus, may favor the earlier application of endoscopic evaluation in these patients. PMID- 2714154 TI - Enemas for IBD maintenance therapy. PMID- 2714153 TI - Absorption of food protein antigen in infants with food protein-induced enterocolitis. AB - Increased gastrointestinal absorption of intact antigen with systemic immunization has been considered a major etiologic factor in the development of food sensitivity. We attempted to test this hypothesis in infants with suspected food protein-induced entercolitis by measuring serum ovalbumin (OVA) concentrations after ingestion of egg white (prior to the performance of good challenges to establish this diagnosis). We first noted significant underestimation of serum OVA concentrations in the presence of even low serum anti-OVA antibody concentrations (greater than 1:12). Next, using selected noninhibitory sera, we found that all infants studied absorbed some OVA, there was no correlation between serum OVA levels and age (3-11 months), and there was no significant difference between serum OVA concentrations in infants who subsequently had positive oral food challenge responses (120 +/- 67 ng/ml) and a matched group with negative challenges (102 +/- 80). These data do not support the hypothesis that "intestinal closure" (antigen exclusion) occurs in the neonatal period or the role of antigen absorption as the major etiological factor in the development of food sensitivity. Better methods of quantitating macromolecular absorption must be developed before the role of antigen absorption in food sensitivity can be assessed. Of note, urinary excretion of intact OVA also occurred. This varied greatly from one voiding to the next and continuing for at least 13 hr after ingestion. PMID- 2714155 TI - Nonsecretors and peptic ulceration. No link with Campylobacter pylori. PMID- 2714156 TI - Long-term follow-up of hepatic siderosis associated with spontaneous portosystemic shunting. PMID- 2714157 TI - Pulmonary oxygen toxicity in the guinea pig. Effect of indomethacin. AB - Deleterious pulmonary effects of hyperoxia are thought, in part, to be mediated by high-energy radicals and inflammatory reactions. It has been suggested that arachidonate metabolites, such as leukotrienes, may be responsible for the latter mechanism. We sought to demonstrate that concurrent exposure to hyperoxia and indomethacin, a potent inhibitor of cyclooxygenase, would increase pulmonary inflammation. A total of 50 female guinea pigs were treated as pairs with 95.6% oxygen or air and separately with 0.3 mg/kg of indomethacin or normal saline every 12 h for 3 days. A significant increase in leukocytes in bronchopulmonary lavage subsequent to combined oxygen and indomethacin treatment was observed when compared with either oxygen, indomethacin, or air treatments alone (p less than 0.05). Although oxygen treatment did alter pulmonary volume-pressure relations (p less than 0.05), hyperoxia alone or with concurrent indomethacin treatment did not alter elastance or histologic structures. These findings suggest that pulmonary inflammation in response to hyperoxia may be augmented by indomethacin. We speculate that increased lipoxygenase products of arachidonate metabolism may be partially responsible for these changes. PMID- 2714158 TI - Chloral hydrate sedation in neonates and infants--clinical and pharmacologic considerations. AB - Chloral hydrate has been used clinically for over 100 years. There is significant paucity of information regarding chloral hydrate metabolism in neonates and infants. Chloral hydrate and its various metabolites were quantitated in 12 neonates and 2 infants at prescribed time intervals. The analysis of the data indicates accumulation of trichloroacetic acid and trichloroethanol in tissue of compromised infants. There is indirect evidence of competition for hepatic glucuronidation for bilirubin with trichloroethanol in ill preterm infants. Multiple dosing of chloral hydrate in preterm infants should be used with caution and frequent monitoring of serum bilirubin concentrations is indicated in such cases. The mechanism of chloral hydrate metabolism is discussed in detail. PMID- 2714160 TI - Use of caffeine in the treatment of apnea associated with the Arnold-Chiari malformation. AB - The occurrence of significant apnea has been reported in infants with Arnold Chiari malformation (ACM). We report 1 infant with ACM and severe apnea treated with caffeine therapy. There was a marked decrease in apnea frequency, less variability in breathing patterns, and a shift to the left of the CO2 response curve with caffeine. Our findings in 1 infant suggest that caffeine may be an effective adjunct in the treatment of apnea associated with ACM. PMID- 2714159 TI - Caffeine pharmacokinetics in preterm infants older than 2 weeks. AB - We studied 17 preterm infants receiving caffeine, and measured their plasma levels of caffeine and the theophylline metabolite by high-pressure liquid chromatography. The half-life was calculated by computer analysis using the least square method. The mean gestational age of our patients was 29.7 +/- 1.9 weeks (mean +/- SD) and they were studied at 20.7 +/- 6.6 days (mean +/- SD) postnatal age. The caffeine half-life was 52.03 +/- 23.87 h (means +/- SD) and the theophylline half-life was 77.04 +/- 65.01 h (mean +/- SD). PMID- 2714161 TI - Role for opioid peptides in self-injurious behavior: dissociation from autonomic nervous system functioning. AB - The effects of acute, orally administered naltrexone (0.5, 1.0, 1.5 and 2.0 mg/kg), a potent opioid receptor antagonist, on self-injurious behavior (SIB), heart rate, and blood pressure in three males (one 10-year-old and two 17-year olds) were investigated. Subjects were evaluated in a structured test session for SIB. The frequency of the most predominant type of SIB (head and face hitting) was significantly reduced by naltrexone (maximum was 71% at the 1.5 mg/kg dose), while self-biting was not significantly decreased at any dose. In contrast, naltrexone had no significant effect on heart rate or blood pressure. Based upon these and other results it was concluded that naltrexone produced decreases in specific SIBs by blocking opioid receptors in brain, and that such opioid blockade had no effect on two measures of cardiovascular function. PMID- 2714162 TI - Perinatal cimetidine exposure has no apparent effect on hepatic drug oxidative or conjugative activity in adult male rat offspring. AB - Perinatal exposure of male rat pups to cimetidine has been reported to 'feminize' gonadal and sexual function and to reduce serum testosterone in adult male offspring. This study examined whether perinatal cimetidine exposure altered the androgen 'imprinting' of sex differences in mature male hepatic biotransformation capacities. During the perinatal period, dams were infused with cimetidine (18 mg/kg/day) through Alzet osmotic pumps placed subcutaneously beginning at 10 days of gestation. Pump function was confirmed by weekly high-performance liquid chromatographic analysis of maternal urine for unchanged cimetidine. Male pups were culled at birth with continued exposure to cimetidine in breast milk until weaning. At about 100 days of age, in vitro and in vivo drug oxidative and conjugative activities were measured in mature males. Early cimetidine exposure did not alter hepatic oxidative (cytochrome P-450 content or monooxygenase activity) or conjugative (UDP-glucuronosyltransferase activity towards testosterone, morphine, 1-naphthol, estrone, or sulfotransferase activity towards acetaminophen or glycolithocholate) capacities in mature males. Two sulfotransferase isoenzyme activities (acetaminophen sulfotransferase 2 and bile salt sulfotransferase I) previously shown to be regulated by gonadal hormones were also unchanged. Serum testosterone was unaffected by perinatal cimetidine exposure. Moreover, there were no effects of perinatal cimetidine exposure on in vivo pharmacokinetics or metabolic fate of acetaminophen. CONCLUSION: Perinatal exposure of male pups to doses of cimetidine similar to those used in humans did not appear to affect the imprinting of sex differences on in vitro hepatic drug metabolism or elimination kinetics of acetaminophen. PMID- 2714163 TI - Stress in parents of children with diabetes mellitus. AB - The level of stress experienced in the parenting role by mothers of 49 children with insulin-dependent diabetes mellitus (IDDM) and its relationship to glycemic control was examined with the parenting stress index (PSI). A subsample of the research group of 25 children with diabetes (less than or equal to 11 yr old) was compared with an age-matched control group (n = 21) drawn from the original study of the PSI on total stress, parent- and child-domain, and subdomain scale scores. The two groups differed on one child-domain subscale, whereby children with diabetes are perceived by their mothers as more demanding than healthy controls. Three parent-subscale differences existed between the two groups, with mothers of children with diabetes reporting less attachment to their children, less spousal support, and poorer health. Analysis of the diabetes sample demonstrated significant stress on several of the child- and parent-domain subscales in a large proportion of the sample. Stress, at levels greater than or equal to 70th percentile of the control group, existed on the child scales of acceptability, mood, demanding behavior, and reinforcement for 51% of children with diabetes. Elevations associated with stress in the parenting role were evident on the scales associated with parental attachment, depression, and competence for 33% of parents. No differences in the level of glycosylated hemoglobin (HbA1) existed between children whose mothers reported high levels of stress in themselves and their children and those whose mothers reported little stress. Hierarchal regression analysis demonstrated a significant relationship between the child stress scale of distractibility, the use of self-monitoring blood glucose assessment, and low levels of HbA1. PMID- 2714164 TI - Lower-extremity amputation in people with diabetes. Epidemiology and prevention. AB - The age-adjusted rate of lower-extremity amputation (LEA) in the diabetic population is approximately 15 times that of the nondiabetic population. Over 50,000 LEAs were performed on individuals with diabetes in the United States in 1985. Among individuals with diabetes, peripheral neuropathy and peripheral vascular disease (PVD) are major predisposing factors for LEA. Lack of adequate foot care and infection are additional risk factors. Several large clinical centers have experienced a 44-85% reduction in the rate of amputations among individuals with diabetes after the implementation of improved foot-care programs. Programs to reduce amputations among people with diabetes in primary care settings should identify those at high risk; clinically evaluate individuals to determine specific risk status; ensure appropriate preventive therapy, treatment for foot problems, and follow-up; provide patient education; and, when necessary, refer patients to specialists, including health-care professionals for diagnostic and therapeutic interventions and shoe fitters for proper footwear. Programs should monitor and evaluate their activities and outcomes. Many issues related to the etiology and prevention of LEAs require further research. PMID- 2714165 TI - Heparin addition to insulin in implantable pumps to prevent catheter obstruction. PMID- 2714166 TI - Role of protein in diabetes control. PMID- 2714167 TI - Office care of newly diagnosed IDDM. PMID- 2714168 TI - Effect of constant and variable heat on home glucose-testing reagent strips. PMID- 2714169 TI - Sensory thresholds. PMID- 2714171 TI - Sweeteners in diabetes. 20 March 1987, San Francisco, California. PMID- 2714170 TI - Gliclazide alcohol flush. PMID- 2714172 TI - Metabolism of cyclamate and its conversion to cyclohexylamine. AB - Since cyclamates were first introduced in the early 1950s, arguments have raged over the potential carcinogenicity of this artificial sweetener. Concern over the safety of cyclamates arises from observations that some individuals and experimental animals can metabolize cyclamate to cyclohexylamine and that cyclohexylamine has been shown to produce testicular atrophy in experimental animals. This study examines the absorption, excretion, and metabolism of cyclamate, particularly its conversion to cyclohexylamine. In addition, the potential toxicity and pharmacology of cyclohexylamine are discussed. PMID- 2714174 TI - Overcoming resistance to change in a long-term care facility: analysis of the team approach and consensus process. PMID- 2714173 TI - Just teach me how to teach. PMID- 2714175 TI - Understanding the management process and financial and managerial accounting. Part IV. Cash flow analysis and budgeting. PMID- 2714176 TI - Analysis and evaluation of patient teaching: selected segments from videotaped health professional-patient interactions. PMID- 2714177 TI - Patient-provider interactions and patient outcomes. AB - Research shows that a number of provider interactional skills are empirically related to patient adherence, making interaction skills a necessary and important part of clinical competence. These skills fall into three broad categories: techniques to elicit and modify patients' health and treatment beliefs, to aid recall of information, and to aid adherence. Specific skills in each category are discussed. Research further shows that health care providers can be taught effective communication skills, and that one of the most effective teaching techniques is audio or video feedback in which the provider's interaction with a patient is judged by tutor and peers using explicit, empirically based criteria. PMID- 2714178 TI - The influence of patient participation on satisfaction and compliance. AB - This investigation tested how patients' participation in the medical visit is related to their satisfaction and subsequent adherence. Thirty random samples of audiotaped dialogue were used to construct estimates of patient participation during the history, examination, and concluding segment of initial medical visits of 45 older male Veterans Administration patients. The data demonstrate that patients who offer information as well as answer physician questions are significantly more likely to comply with recommendations for new medication. The frequency with which patients interrupt physicians positively correlates with patient satisfaction, and the frequency with which physicians interrupt patients negatively correlates with patient satisfaction. The paper analyzes various examples of patient participation in visits with nationally recognized diabetes educators, and discusses an agenda for further research in the area. PMID- 2714179 TI - Qualitative analysis of the patient-provider interactions: the patient's perspective. AB - This qualitative analysis of videotaped patient-provider interviews focuses attention on the patient's experience of diabetes. Excerpts from the videotaped interviews are examined from the framework of a diabetes management trajectory identified from a qualitative research study of 19 insulin-managed adults. It is suggested that providers need to become sensitive to the experience of illness-as lived in order to more accurately assess patient responses to management and to promote sustained efforts toward diabetes self-care. PMID- 2714180 TI - Teaching skills of health professionals. AB - The purpose of this paper is to describe an analytic method that focuses on health professionals' teaching skills. The method involves comparing live or recorded teacher behaviors with operational definitions of 20 skills known to influence learning outcomes, and assigning numerical ratings on a four-point scale. The videotapes prepared for this symposium are rated and compared with other sessions recorded in health care settings. Virtually all patient educators could improve their teaching skills substantially. Although many questions about teaching skills and education process remain unanswered, available data clearly justify training to improve health professionals' teaching skills. PMID- 2714182 TI - Health education and perceived patient needs. PMID- 2714181 TI - Teacher as learner. PMID- 2714183 TI - Building the educational partnership. PMID- 2714184 TI - Discussion: the recent past, present, and foreseeable future of research on patient teaching. AB - Research on diabetes patient education over the last decade has flourished in a general climate of interest in the therapeutic value of tight metabolic control. That climate is changing. Whether patient education contributes to metabolic control may not be as much a research question in the future as what specific teaching protocols and/or communication strategies produce the highest levels of cognitive and behavioral outcomes. Quality control is a growing area of interest. This paper discusses how each of the symposium presenter's remarks might contribute to research on new teaching methods to increase the overall quality of diabetes patient education. PMID- 2714185 TI - Evaluation of diabetes education programs: getting the answers you need. AB - In the time that has passed since our evaluation, 14 of the 16 recommendations we made have been addressed by the education staff and incorporated into the program. Program monitoring methods have been implemented and patient follow-up has been improved. After the recommendations were incorporated into the program, a final but noteworthy outcome of the evaluation process was achieved. Formal recognition as a model diabetes patient education program was given by the state of Ohio Diabetes Control Program. Systematic evaluation of a patient education program may seem an overwhelming and impossible task to accomplish, but with some creative brainstorming with staff it can be done. And the payoffs are worth the effort. PMID- 2714186 TI - Disposal of medical wastes. PMID- 2714187 TI - Third-party reimbursement: what can we do? PMID- 2714188 TI - Marketing and diabetes education: "a harmonious chorus". PMID- 2714189 TI - The portion picture. PMID- 2714190 TI - Introduction to health insurance and reimbursement issues: options and resources. PMID- 2714191 TI - The value of a nurse-run diabetes foot clinic. PMID- 2714192 TI - Sugar-free preparations by therapeutic category. PMID- 2714193 TI - Implementation of low-protein diets for treatment of persons with early diabetic nephropathy. AB - Low-protein diets are being increasingly used as a treatment for early nephropathy associated with diabetes. Recent research studies have shown a decrease in proteinuria while serum albumin levels and weight have been maintained. A level of 0.6 g protein/kg ideal body weight has been suggested. In structuring these diets, fat should be restricted to approximately 30% of calories, with the remainder supplied as carbohydrate calories after the protein content has been calculated. In some persons, simple sugars need to be included to avoid excessive amounts of high-bulk, high-fiber carbohydrate foods. Insulin and oral agent dosages may need adjustment to compensate for increased glucose levels. Self-monitoring of glucose levels can provide valuable feedback for medication adjustment. Intensive dietary education is needed with these patients, as the diet is sometimes radically different from diets previously used. A hypothetical patient is described and diet calculations provided using the ADA Exchange Lists with accompanying menus. PMID- 2714194 TI - Evaluation of education program developments: illustration of the research and development cycle. AB - The Research and Development (R and D) cycle is a program development model used to translate research findings into educational programs or products ready for use in the field. The R and D cycle is illustrated by describing its application to Effective Patient Teaching, a course on teaching skills for health professionals. Evaluation is a continuing part of program development. Evaluation methods need not follow a rigid formula; methods will generally change with the stages of program development and the evaluation purposes. PMID- 2714195 TI - Establishing a new diabetes service on the basis of health services research. PMID- 2714196 TI - A Gompertz age-specific mortality rate model of aging, hormesis, and toxicity: dose-response studies. PMID- 2714197 TI - [The importance of the SCC antigen in the diagnosis and follow-up of cervix carcinoma. A cooperative study of the Gynecologic Tumor Marker Group (GTMG)]. AB - SCC (squamous cell carcinoma) antigen is a subfraction of tumour antigen TA-4 isolated from cervical squamous cell carcinomas. Serum concentrations of SCC antigen were measured by radioimmunoassay in 382 control subjects, 70 women with cervical intraepithelial neoplasia (CIN), 517 with cervical carcinoma and 203 with other gynaecological carcinomas. Elevated SCC antigen levels (greater than 2.5 ng/ml) were found in 4% of normal controls, in 7% of women with CIN I-III, in 2%-23% with various forms of genital adenocarcinomas, in 55% with primary and in 76% of those with recurrent cervical squamous cell carcinoma. The positivity rate of the antigen was correlated with tumour stage (FIGO) and lymph node involvement of primary cervical squamous cell carcinomas. During long-term follow-up serum levels of SCC antigen were found to be concordant with tumour activity in 74% of cases. Patients with still elevated marker levels after therapy had twice the recurrence rate of women with normal serum values. Routine determination of SCC antigen during follow-up of cervical cancer is recommended. PMID- 2714199 TI - [Thrombolysis in acute cardiac infarct]. PMID- 2714198 TI - [Ileus symptoms due to 3 distinctively differentiated small intestine carcinomas in nontropical sprue]. AB - Recently recurring abdominal pain, bouts of diarrhoea and weight-loss of 15 kg developed in a 50-year-old woman who had for 18 years been treated by diet for nontropical sprue. She was hospitalized for signs of mechanical ileus. Radiological examination revealed three stenosing small intestine tumours, one of them obstructing the lumen. After resection of the affected segments, with end-to end anastomosis, histological, histological examination of the surgical specimens demonstrated three small intestine carcinomas of different grades of differentiation. The largest tumour had already metastasized to four regional lymph nodes. This case illustrates the potentially precancerous nature of nontropical sprue which has been present for many years and thus requires careful follow-up. PMID- 2714200 TI - [The new ARA criteria: higher specificity--but with a delay before diagnostic classification. American Rheumatism Association]. PMID- 2714201 TI - [Extracorporeal shockwave lithotripsy of bile duct stones]. AB - Extracorporeal lithotripsy (EL) was undertaken in 50 patients (mean age 73.7 years; range 29-90 years) with extrahepatic and, in five, with intrahepatic gallstones, the usual endoscopic methods having been unsuccessful in removing the stones. Occasionally stone fragments were passed spontaneously, but in most they had to be removed endoscopically, in 48 (96%) with extrahepatic and in three (60%) with intrahepatic stones. Biliary tract or gallbladder infections occurred after the lithotripsy and associated local litholysis in seven of the 48 with extrahepatic (14%) and three of the five (60%) with intrahepatic stones. There was one hospital death. The results indicate that EL has definite advantages over surgical treatment in these patients, who are usually elderly and in whom surgical intervention is more risky. PMID- 2714202 TI - [Aortic aneurysm after dilatation of aortic isthmus stenosis]. AB - An aneurysm in the region of the dilatation occurred in two of 23 patients (a 17 year-old boy and a 29-year-old woman) three and one years, respectively, after balloon dilatation for coarctation of the (thoracic) aorta. The aneurysm in the boy was small (18 mm diameter) and he was symptom-free so that no operation is as yet indicated. But the woman had progressively increasing backache after physical exertion and the aneurysm was 4 cm in diameter. Therefore, the aneurysm and coarcted segment were resected and a Dacron prosthesis interposed. As the ultimate value and risk of balloon dilatation of coarctation of the aorta cannot as yet be definitively judged, all patients should be carefully and repeatedly examined over a longer period. PMID- 2714203 TI - [Remission of cold agglutinin disease following splenectomy]. AB - An anaemia (haemoglobin content 8.3 g/dl) of undetermined cause, accompanied by mild jaundice and nocturnal leg oedema, developed in a 68-year-old woman who also had an increased erythrocyte sedimentation rate (128/135 mm). Primary cold agglutinin anaemia was established as the cause. After administration of prednisone (2 mg/kg body-weight daily), cyclophosphamide (up to 150 mg daily) and plasmapheresis (twice weekly) had failed to bring about improvement, splenectomy achieved a clear reduction of haemolysis. At last examination the haemoglobin content had risen to 12 g/dl. This report demonstrates that in individual cases splenectomy may be useful, but it needs to be determined first by radioisotope study whether the spleen is in fact the main site of erythrocyte sequestration. PMID- 2714204 TI - [Blood pressure "normalization" in older people]. PMID- 2714205 TI - [Immunologic cancer treatment]. PMID- 2714206 TI - Toxicity of 8-methoxypsoralen in cynomolgous monkeys (Macaca fascicularis). AB - Male and female cynomolgous monkeys were administered 0, 2, 6 or 18 mg/kg 8 methoxypsoralen (8-MOP) 3 times a week orally for 26 consecutive weeks. Dose dependent emesis was the most sensitive indicator of 8-MOP toxicity. The lowest dose to elicit emesis was 3 x 6 mg/kg/week of 8-MOP. Among the histological findings proliferation of Kupffer cells was the only recurring observation. However, these finding as well as some hematological and serum electrolyte changes lacked a dose-response relationship. In the highest dosage group one female monkey was found in moribund condition on the 39th day of the study and was killed. Histopathological evidence indicated beginning shock as the cause of the rapidly deteriorating health of the monkey. Similar to effects in man and rats, 8-MOP displayed nonlinear pharmacokinetics in the cynomolgous monkey, saturation occurring between 3 x 2 and 3 x 6 mg/kg/week. Increased clearance of 8 MOP in the lowest dosage group after 26 test weeks was attributed to a combination of enzyme induction and saturable first pass effect. Since the plasma profile of 8-MOP at the lowest dose (3 x 2 mg/kg/week) in cynomolgous monkeys closely resembles that in humans after therapeutic doses (0.4-0.6 mg/kg) and because of other similarities (vomiting as earliest sign of toxicity, saturable first pass effect), it is reasonable to assume that chronic toxicity of 8-MOP as defined in this study is quite predictive for man. PMID- 2714207 TI - Two-week aerosol inhalation study on polyethylene glycol (PEG) 3350 in F-344 rats. AB - PEGs in the 3000 to 4000 MW range are used in many pharmaceutical and cosmetic applications; they produce little ocular or dermal irritation and have extremely low acute and subchronic toxicity by oral and dermal routes of administration. However, little information exists on the potential of aerosols of these materials to produce adverse health effects. F-344 rats were exposed to aerosols of PEG 3350 (20% w:w in water) at 0, 109, 567, or 1008 (highest attainable) mg/m3 for 6 hr/d, 5 d/wk for 2 wk. No exposure-related toxicity was found with regard to clinical signs, ophthalmology, serum chemistry, urinalysis, or gross pathology. Exposure-related effects included: a 50% increase in the neutrophil count (males only) at 1008 mg/m3; decreased body weight gain (16%) for both the 567 and 1008 mg/m3 groups (males only); absolute lung weights of both sexes were increased 10 and 18% for the 567 and 1008 mg/m3 groups, respectively. A slight increase in the number of macrophages in the alveoli was the only change observed histologically in all PEG 3350-exposed groups. Therefore, inhalation of aerosols of PEG 3350 at concentrations up to 1008 mg/m3 produced relatively little toxicity in rats, the lung was the target organ, and the no-observable-effect level was between 109 to 567 mg/m3. PMID- 2714208 TI - Disposition kinetics of cimetidine and ranitidine in endotoxin pretreated rats. AB - Cimetidine and ranitidine are used in patients with life-threatening gram negative infections, endotoxemia and acute stress erosions. Disposition kinetics of cimetidine and ranitidine in endotoxin pretreated rats was investigated. The H2-antagonists were administered intravenously 24 h after endotoxin (10 mg/kg) pretreatment. This endotoxin dosage resulted in 50% mortality in rats. Blood samples (0.25 ml) were collected at different timed intervals. No significant differences were observed in plasma clearance, half-life and volume of distribution between endotoxin pretreated and control rats. Cimetidine is eliminated extensively by the renal route in animals and man with metabolism being a minor process. Ranitidine is metabolized to a large extent (70%) in rats, while in humans this represents a minor process. No significant changes in cimetidine and ranitidine disposition parameters in endotoxin pretreated rats were observed. These results suggest that cimetidine and ranitidine may be used in normal dosages in endotoxemia patients since their pharmacokinetic parameters would not be affected under these circumstances. PMID- 2714209 TI - Developmental toxicity testing with FETAX: evaluation of five compounds. AB - The teratogenic potential of five compounds was evaluated with FETAX (Frog Embryo Teratogenesis Assay: Xenopus). Early embryos of Xenopus laevis were exposed for 96 h to 6-aminonicotinamide (6-AN), isoniazid (INH), urethane, nitrilotriacetate (NTA) or sodium cyclamate, in two separate static-renewal tests of each compound. Based on Teratogenic Index values, growth endpoints and the types and severity of the induced malformations, 6-AN, INH and urethane scored as having strong teratogenic potential. NTA and sodium cyclamate had little or no teratogenic potential. The results support continued evaluation of FETAX as a screening assay for chemical teratogens. PMID- 2714210 TI - The toxic effects of a chronic administration of the gut-stimulating principle in Croton penduliflorus hutch. seeds in mice. AB - Albino mice (8-10 wks) weighing between 14 and 25 g were divided into 2 groups and dosed orally once per week with 2 doses (7 mg/kg and 21 mg/kg) of the gut stimulating principle in Croton penduliflorus seeds (CP crystals) for 12 weeks. Some mice (3-4) from each group were killed at 10 days intervals for the first 6 wks of the experiment and at 20 days intervals for the last 6 weeks. Gross and histopathological changes in the brain, heart, liver, kidney, adrenal, spleen, testis, lung and various segments of the gastrointestinal tract including the stomach, duodenum, ileum and colon were observed. The relative weights of the visceral organs were also recorded. Significant weight change in the spleen was evident. The congestion of the lung was the most common gross pathological observation made. Other observations were splenomegaly, enlarged heart, swollen uterine horns, etc. Histopathological changes observed included haemorrhages in the lungs, myocardium, liver, kidney, testis, brain etc. Goblet cell hyperplasia with mucin present in the lumen were observed in the jejunum, ileum and colon. In conclusion, CP crystals produced severe lesions in the visceral organs and the brain after chronic oral administration at low and high dosage levels which should indicate caution in administering the extract to humans. PMID- 2714211 TI - Ethics committees for clinical research. Experience in the United Kingdom. PMID- 2714212 TI - Scanning electron microscopy of the development of layer I of the human visual cortex (area 17). AB - The development of layer I of the human visual cortex was studied. Tissues were obtained from 14 aborted and stillborn human fetuses, ranging in age from 13 to 32 fetal weeks. The middle third of the rostrocaudal area 17 above the left calcarine sulcus was selected for observation. The sections were cut perpendicular to the pial surface of the cortex. The specimens were processed for scanning electron microscopy. At 13-16 weeks the Cajal-Retzius neurons were the predominant neuronal elements of layer I, with a small amount of fibers present. In addition, it was found that at 13 weeks the folding plasma membranes of the glial cells formed primary myelin sheaths which wrapped around the nerve cell bodies and processes. Axosomatic and axodendritic contacts were present in the cortices of the fetuses. The nerve fibers of layer I increased progressively with age. However, at 17 weeks, some degenerating apical dendrites were occasionally found. These degenerating dendrites appeared fragmented and beaded. At 21-23 weeks, layer I was well developed with all its essential components present. However, the upper half of the cortical plate was still undifferentiated at this age. At 26-32 weeks, layer I had a prominent plexiform lamina. This lamina was poor in neurons and rich in fibers. In summary, during layer I ontogenesis, there were the following major changes: (1) a change from higher to lower neuronal density: (2) changes in morphology of neurons; (3) initial appearance of synapses early in development; (4) early onset of glial wrapping; (5) presence of degenerating fibers during ontogenesis, and (6) increase in fiber proportion as fetus aged. PMID- 2714213 TI - Neurite penetration into collagen gels requires Ca2+-dependent metalloproteinase activity. AB - Cultured sympathetic neurons from neonatal rats release a Ca2+-dependent metalloproteinase capable of degrading native and denatured type I collagen. A large fraction of the metalloproteinase activity is released from growth cones of growing neurites, which suggests that this proteinase may be involved in neurite penetration into collagen-rich extracellular matrices during development. In the present study, we investigated the possibility that neurite penetration into 3 dimensional collagen gels requires the Ca2+-dependent metalloproteinase. Sympathetic neurons were plated on top of collagen gels and the neuronal metalloproteinase activity was inhibited with the collagenase inhibitor HSCH2CH[CH2CH(CH3)2]-CO-Phe-Ala-NH2 (HS-LFA). HS-LFA inhibited the Ca2+-dependent metalloproteinase activity, penetration of neurites into collagen gels and release of 3H from 3H-collagen gels in a dose-dependent manner over very similar concentration ranges (EC50 = 150-200 nM). Highly significant correlations existed between neurite penetration into collagen gels and metalloproteinase activity (r = 0.99), and metalloproteinase activity and release of 3H from 3H-collagen gels (r = 0.99). Although HS-LFA inhibited the growth of neurites within collagen gels, it had no effect on neurite outgrowth on collagen films. Thus, the neuronal Ca2+-dependent metalloproteinase appears to be required for neurite penetration into and growth within 3-dimensional collagen matrices, but not for growth along a 2-dimensional collagen substrate. PMID- 2714214 TI - Peripheral nerve regeneration in quail-chick spinal cord chimeras treated with oral ciclosporin. AB - Regeneration of chimeric wing nerves in 2 quail-chick spinal cord chimeras is reported. The large DNA-containing quail nucleolar marker could not be distinguished in flattened cells, and in particular, in perineurial cell nuclei of chimeric nerves. With oral ciclosporin treatment, rejection of graft-derived nervous system tissues was acute and florid in one chimera, but followed a chronic, remitting course in the other. PMID- 2714215 TI - Study of possible teratogenic effects of the fungicide maneb on chick embryos. AB - The teratogenicity of the fungicide maneb (80% active ingredient and 20% inert ingredients) in chick embryos was evaluated. Eggs, before incubation, were dipped in 0.2% or 1.2% aqueous dispersions of maneb for 30 seconds. An untreated group, a water group and a formulation ingredient group, at the concentration present in the 1.2% maneb group, ensured control in the study. Eggs were incubated for 18 days then transferred to hatching racks and allowed to hatch normally. Viable chicks and chicks "dead in shell" were assessed for external deformities. There was no evidence that maneb or its formulation ingredients were teratogenic or embryotoxic to developing chick embryos. PMID- 2714216 TI - In vitro inhibition of goat brain acetylcholinesterase by pure and commercial anticholinesterase pesticides. AB - In vitro inhibition of goat cerebellar acetylcholinesterase by pure and commercial anticholinesterase pesticides clearly indicates a remarkably high inhibitory effect of commercial carbamate and organophosphate pesticides containing a lower percentage of the respective active ingredients comparable to that of the known anticholinesterase agents such as DFP and physostigmine. It may be presumed that injudicious use of commercial formulations conduce severe toxicity in the nontarget mammalian species, namely, goat, and this response of the brain acetylcholinesterase may be utilized as a reliable bioindicator of pesticidal contamination of the terrestrial environment. PMID- 2714217 TI - Hematotoxic effects in the rat of a toluene dinitro derivative after short-term exposure. AB - 3,5-Dinitro-4-chloro-alpha,alpha,alpha-trifluorotoluene (DNCTT) is an intermediate in the synthesis of dinitroaniline herbicides and was involved in an episode of ground water pollution in 1977. The compound presents a high environmental persistence, which may have possible implications concerning public health. In one experiment male Sprague-Dawley rats were administered DNCTT for 3 days at a dose level of 150 mg/kg body wt by oral gavage. Groups of rats were sacrificed up to 10 days after the end of the administration, at 2-day intervals. Methemoglobin was increased up to Day 7; white blood cells were also increased both in peripheral blood and in bone marrow smears. Spleen relative weights were observed to increase slightly at Days 7 and 10; microscopic examination revealed marked congestion with an increased density of the spleen's white pulp. In a similar scheduled experiment, but at a dose level of 300 mg/kg body wt, the bone marrow white cell series were not affected initially, but were affected after 3 days at the end of the administration. DNCTT has a definite effect on white cells. PMID- 2714218 TI - Teratological evaluation of the phenoxyacid herbicide MCPA in the regenerating forelimb of the adult newt. AB - The effects of a commercial formulation of the phenoxyacid herbicide 2-methyl-4 chlorophenoxyacetic acid sodium salt (MCPA) on the regenerating forelimb of the adult crested newt were studied. The animals were exposed percutaneously to 0, 200, 400, or 800 ppm of MCPA for 4 days a week throughout the regeneration period and were sacrificed 11 weeks after amputation. The concentrations tested did not cause histologically detectable toxic lesions of the examined organs. Exposure to MCPA resulted in a significant retardation of the morphogenetic process as evidenced by skeletal examination. At the highest concentration tested, a significant growth delay was also evident during the regeneration period. No significant differences in the frequency of skeletal malformations were observed between control and treated newts, although the frequency was higher in the latter. PMID- 2714219 TI - Effect of paraquat administered intraperitoneally on the nonpolar lipids of rabbits. AB - Rabbits were injected intraperitoneally with 3, 6, or 12 mg of paraquat/kg/day for a period of 3, 7, or 14 days. Rabbits receiving 3 or 6 mg of paraquat/kg/day showed a significant loss of body weight at 7 days of the treatment. Liver, kidney, heart, and lungs demonstrated a significant decrease in their weights in the first 3 days of paraquat treatment. A decrease in total lipids, total triglycerides, and total cholesterol of both liver and kidney was observed. This decrease was accompanied by a significant increase in plasma total triglycerides and total cholesterol at 7 days of paraquat treatment. The ratio of cholesterol to cholesterol esters in liver decreased after 3 days of paraquat treatment after which it showed a consistent increase until the 14th day of the paraquat treatment. In kidney, this ratio increased for up to 7 days of paraquat treatment followed by a decrease at the 14th day. These results indicate, contrary to earlier reports, that rabbits are susceptible to paraquat toxicity. PMID- 2714220 TI - Detergent-induced changes in the mapping of certain enzymes in various cell types of Rita rita. I. Opercular epidermis. AB - The different cell types in the opercular epidermis of Rita rita when exposed to a synthetic detergent, dodecylbenzene sodium sulfonate in the concentration of 6.9 mg liter-1 (96-hr LC50 of the detergent), had a gradual decrease in the activity of various enzymes responsible for different metabolic processes occurring inside the cell. After a certain period of detergent exposure, the activities of all the enzymes in these cells are completely inhibited. PMID- 2714221 TI - Detergent-induced changes in the mapping of certain enzymes in various cell types of Rita rita. II. Gill epithelium. AB - Rita rita were exposed to 6.9 mg/liter (96-hr LC50 of an anionic detergent, dodecylbenzene sodium sulfonate). Loss of activity of certain enzymes responsible for various metabolic processes in fish gill epithelium was observed using a battery of histochemical techniques. The information of this investigation may possibly add to an understanding of the as yet unknown mechanism of detergent action. PMID- 2714222 TI - The impact of temperature on the acute toxicity of arsenate and arsenite to rainbow trout (Salmo gairdneri). AB - This research investigated the influence of temperature (5 or 15 degrees C) on the acute toxicity of waterborne arsenite and arsenate to rainbow trout. Trout exposed to arsenate at 5 degrees C had a 144-hr LC50 (95% fiducial limits) of 114.1 (106.7 to 121.9) mg liter-1, twice the value of 58 (50.6 to 66.4) mg liter 1 evident in fish exposed at 15 degrees C. Temperature had no effect on the toxicity of arsenite; 144-hr LC50's at 5 and 15 degrees C were 17.7 (16.5 to 18.9) and 20.7 (19.9 to 21.5) mg liter-1, respectively. When fish were exposed to 70 mg liter-1 arsenate for 72 hr, those held at 15 degrees C had mean whole-body arsenic levels that were five times higher than the levels in fish held at 5 degrees C. There were, however, essentially no differences in the patterns of arsenic uptake between 5 and 15 degrees C when the fish were exposed to arsenate at 0.7 or 1.2 of the 144-hr LC50 at each temperature, a strategy which compensates for (eliminates) temperature as a modifier of toxicity. Fish which were held in arsenate-free water after the 72-hr arsenate exposure depurated significantly more arsenic at 15 degrees C than at 5 degrees C. Despite this, it is apparent that enhanced uptake at 15 degrees C was the overriding factor controlling the differences in the expression of arsenate toxicity at the two temperatures. PMID- 2714223 TI - Progesterone alone is responsible for stimulation of the growth of ducts and of mammary alveolar structures in mice. AB - The effect of estradiol valerate and progesterone on mammary growth of prepubertal (20, 25 and 30 days of age) female and prepubertal (15, 20 and 30 days of age) and adult male C3H/Di mice were studied. Estradiol treatment had no effect on mammary growth in 30 day old females, but mammary growth of 20 and 25 day old females showed clear inhibition. In contrast, treatment with progesterone alone stimulated both the growth of ducts and formation of alveolar buds. In males, the injection of estradiol valerate resulted in a stimulation of the growth of mammary rudiment. The treatment with progesterone alone stimulated the growth of mammary ducts and the formation of alveolar buds in males treated from day 15 and 20 of age, while mammary growth of those treated from day 30 of age was low and the growth of mammary rudiment of adult males was not stimulated at all. The mammogenic effect of progesterone was not affected by time of weaning of males but it was inhibited by simultaneous application of testosterone. An age dependent decrease of the mammogenic effect of progesterone in males is related to an increase in plasma concentration of testosterone. PMID- 2714224 TI - Effect of estradiol on the phosphorylation of rat liver ribosome proteins. AB - The effect of estradiol on phosphorylation with gamma-32P-ATP of ribosome proteins from polyribosome fraction, isolated from female rat liver is found out. Rats (180 g) used were: sham-operated, ovariectomized and treated after ovariectomy for 11 days with 20 micrograms 17 beta-estradiol-dipropionate per 100 g body weight. The estradiol deficiency after ovariectomy decreased phosphorylation, but the estrogenization of ovariectomized rats increases it twice. In vitro the hormone (1-2 mumol/l) [corrected] also stimulated ribosome protein phosphorylation. It is supposed that the hormone may take part in the regulation of protein synthesis in the translational region of the process. PMID- 2714225 TI - Acetylcholinesterase and choline acetyltransferase activity in some hypothalamic nuclei under immobilization stress in rats. AB - Rats were subjected to acute immobilization (IMO) for 1 or 2 h and killed by decapitation. The hypothalamic supraoptic and paraventricular nuclei were isolated by dissection technique and the activity of acetylcholinesterase (AChE) and choline acetyltransferase (ChAT) was assayed. A period of 1 or 2 h of IMO resulted in a significant increase of AChE activity only in the supraoptic nucleus, while no change of ChAT activity occurred. Acute IMO of 1 or 2 h duration resulted in an increase of AChE activity in supraoptic nucleus. PMID- 2714226 TI - Tritiation of [8-L-arginine, 9-desglycineamide] vasopressin. AB - Tritiated vasopressin analogue, [8-L-arginine, 9-desglycineamide]-vasopressin was prepared from its diiodo-derivative by means of catalytic reductive dehalogenation. The reaction products were purified by reversed-phase HPLC resulting in a labelled peptide with high specific radioactivity (629 TBq/mmol). PMID- 2714227 TI - Oophorectomy did not show any additional effect on bone density and mineral content in thyroxine treated mice. AB - Experimental hyperthyroidism (thyroxine administration for 21 days) caused a significant decrease in ash mass, bone density and mineral content in the femora of mice, the same degree of reduction in individual measures of bone mass being found in oophorectomized and intact mice treated with thyroxine. It may be suggested that estrogens did not protect the skeleton against the resorbing action of thyroxine or triiodothyronine. PMID- 2714229 TI - Adult respiratory emergencies. PMID- 2714228 TI - Histophysiological changes of sex organs in methylmercury intoxicated mice. AB - Methylmercury (MeHg) treatment intramuscularly at doses of 10 and 20 micrograms separately/day/mouse for 30 days affected the weight of body and organs like testes, vas deferens and seminal vesicles in mice. Diminution of testosterone in serum was also associated with an accumulation of cholesterol in testes and reduction in seminal vesicle fructose. Altered spermatogenesis and Leydig cell morphology in testes and the changes in histoarchitecture of seminal vesicle and vas deferens indicated androgen deficiency in treated mice. Thus, the data suggested that MeHg administration to mice induced androgen deprived effect to target organs probably by blocking Leydig cell function. PMID- 2714230 TI - A system for automated DNA electrophoresis, molecular hybridization and electronic detection: II. Electronic detection. AB - We have designed and constructed an automated, computer-controlled, nucleic acid hybridization analysis system (Electrophoresis 1987, 8, 255-261). The system performs 9 simultaneous experiments, beginning with submarine electrophoretic separation of the restriction fragments and including microwave fixation of the separated fragments, denaturation, neutralization, prehybridization, hybridization, washing and drying. The final step is electronic detection of the hybridization pattern. The detector system consists of 90 Geiger-Mueller detectors arranged to simultaneously sample the 9 hybridizations at 10 positions each. The hybridization matrix is moved across the detectors by a robot arm in increments preprogrammed by the operator and the entire length of the matrix can be counted. The results are printed out as a plot of radioactive counts vs. distance from the origin of electrophoresis. We describe here the characteristics of the detection system. PMID- 2714231 TI - A method for recovery of native, clonally-restricted immunoglobulins from agarose gels. AB - Multiple low level, clonally-restricted, immunoglobulins (Ig) are commonly encountered on routine serum protein electrophoresis by clinical laboratories using high resolution zone electrophoresis on agarose. We sought a method for recovering the clonally-restricted Ig, in native configuration, from clinical laboratory gels as a first step in the investigation of its clinical significance. We found that a two-stage electrophoretic procedure gave consistently good recoveries. After routine agarose gel electrophoresis, portions of the electropherogram, containing clonally-restricted Ig, were excised and subjected to flatbed isoelectric focusing in agarose to enhance separation of the individual antibody clonotypes. Multiple slabs, containing the same clonally restricted Ig, could be cut from adjacent tracks (i.e., tracks loaded with the same specimen) on the zone electropherogram and applied to a single track on the focusing gel to improve separation and increase yields. The focused gels were cut to isolate slabs containing individual clonotypes. These slabs were washed to remove carrier ampholytes and held at -20 degrees C overnight. Ig was extracted from the thawed gels, with 61-68% recovery, by ultracentrifugation following physical disruption of the gel. Antigen binding activity of the recovered Ig was verified by rate nephelometry. Clonally-restricted antibodies were successfully isolated from an immune animal serum by this procedure and biotinylated for use as probes on Western blots. PMID- 2714232 TI - The two radii of a charged particle. AB - The existence of two radii of each charged particle-a geometric and electrokinetic radii, is supposed. The mathematical relationship between them in the four possible combinations of an ion and its counterion is analyzed: (i) at equal geometric radii and, in absolute values, equal valencies; (ii) at equal geometric radii and, in absolute values, different valencies; (iii) at different geometric radii and, in absolute values, equal valencies; (iv) at different geometric radii and, in absolute values, different valencies. One of the equations worked out can be used to define the relationship between the geometric and electrokinetic radii of a polyion. All the equations are used in working out precise calculations. PMID- 2714233 TI - Determination of carboxymethyl-D-glucoses in the product of hydrolytic depolymerization of carboxymethylcellulose by isotachophoresis. AB - Optimal conditions for isotachophoretic separation of carboxymethyl-D-glucoses formed by acidic depolymerization of carboxymethylcellulose were found. 6-O carboxymethyl-D-glucose, 2-O-carboxymethyl-D-glucose and 3-O-carboxymethyl-D glucose were identified and determined in the reaction mixture after carboxymethylcellulose hydrolysis. Relative reactivity of hydroxy groups in the glucopyranose unit of cellulose decreased in the following order: O(6)H greater than O(2)H much greater than O(3)H. This was found to be in agreement with the data published by other authors. PMID- 2714234 TI - Fast and high resolution analysis of human serum transferrin by high performance isoelectric focusing in capillaries. AB - Human serum transferrin is a mixture of isoforms (isoproteins) having different amounts of carbohydrates. Each isoform may exist in iron-free and iron-complexed molecular form. The genetic variations in different populations increase the number of combinations of the different forms of transferrin. To resolve the many components in transferrin preparations, the new high performance capillary technique was employed for isoelectric focusing. Iron-free transferrin and transferrin samples of known iron content were examined. The above method gives an exceptionally rapid analysis (within 15-25 min) of small amounts of samples (less than 1 microgram protein) and as good as or better resolution than other isoelectric focusing techniques previously used for transferrin analysis. By monitoring the focused protein zones at both 280 and 460 nm the molecular forms of transferrin (iron-free, monoferric and differic complexes) can easily be identified. Both steps of isoelectric focusing in capillaries (i.e., prefocusing and mobilization) can be used for analysis. We observed that chelating agents (e.g., carrier ampholytes, nitrilotriacetate) may release iron from microsyringes having metal pistons causing the formation of iron-transferrin complexes. PMID- 2714235 TI - Improved separation of alpha chains of collagen type I, type III, and type V by noninterrupted electrophoresis using thioglycolic acid as a negatively charged reducer. AB - Improved separation of alpha chains of collagen type I (alpha 1 [I]2 alpha 2[I]), type III(alpha 1[III]3), and type V (alpha 1[V]alpha 3[V])was achieved by noninterrupted sodium dodecyl sulfate-polyacrylamide gel electrophoresis with a negatively charged reducer, thioglycolic acid. The thioglycolic acid, added to the running buffer of the cathodic reservoir, in the middle of electrophoresis quickly migrated in the gel anode, reducing interchain disulfide linkages in collagen type III and dissociating it into its alpha chain monomer, alpha 1[III], without an interruption of electrophoresis. The alpha chain, alpha 1[III], migrated more slowly than the alpha 1 [I] and alpha 2[I] chains of collagen type I, resulting in an excellent separation of alpha 1[III] from alpha 1[I]. The mobility of alpha 1[III] could be controlled by varying the time of thioglycolic acid addition to the running buffer. This enabled us not only to separate alpha 1[III] from alpha 1[I] and alpha 1[V], but also to precisely quantitate these alpha chains, even at low protein loading of mixed samples. PMID- 2714236 TI - Immunoblotting techniques with picogram sensitivity in cerebrospinal fluid protein detection. AB - Agarose isoelectric focusing followed by blotting with nitrocellulose, nylon or polyvinylidene difluoride membranes, and immunochemical detection of cerebrospinal fluid IgG with various combinations of antisera, was evaluated. Polyvinylidene difluoride proved to be an easy-to-handle and reliable membrane for protein blotting. Among immunochemical visualization reactions, the most sensitive employed biotinylated goat anti-human IgG followed by streptavidin colloidal gold conjugate and silver enhancement in 20% w/v urea, allowing a sensitivity of less then 1 picogram IgG/band. PMID- 2714237 TI - Application of an affinity electrophoretic and in situ oxidation method to the study of the equine protease inhibitory proteins. AB - An affinity method was developed to investigate the interaction between protease and protease inhibitor by incorporating a protease incubation step into a two dimensional electrophoretic separation of the plasma protease inhibitory proteins. This involved the application of the isoelectric focusing gel to filter paper saturated in the protease of choice before being placed on the second dimensional polyacrylamide electrophoresis gel. General protein staining or immunoblotting was used to detect the protein or ligand in the complex. An in situ oxidation method was developed using the reagent chloramine T to investigate the effect of this reagent on the complexing abilities and inhibitory activities of the protease inhibitory proteins. Oxidation was performed either after electrophoresis prior to staining for enzyme inhibition or during two-dimensional electrophoresis prior to the aforementioned protease incubation. The latter allowed the effect of oxidation on complex formation to be examined. Whole plasmas were utilized as the sources of protease inhibitory proteins with the human and mouse being used as models. The equine protease inhibitory system was examined by the two methods and shown to consist of three classes of inhibitory proteins based on their susceptibilities to oxidation and abilities to form complexes with various proteases. PMID- 2714238 TI - Identification of different classes of superoxide dismutase in carnation petals. AB - Isoelectric focusing and nondenaturing two-dimensional electrophoresis, followed by an enzymatic characterization involving use of specific inhibitors were applied to identify the different forms of the superoxide dismutase (SOD) extracted from petals of cut carnation. Electrophoresis was carried out either with the crude extract or with fractions obtained after ion exchange chromatography of the extract. Three forms of the SOD were identified (Cu,Zn-SOD, Fe-SOD and Mn-SOD). They have close pI's (4.7 to 4.9) and most of them are composed of several isoforms. PMID- 2714239 TI - Enzyme activity electrophoresis and rocket immunoelectrophoresis for the qualitative and quantitative analysis of Geotrichum candidum lipase activity. AB - The development and application of a rocket immunoelectrophoretic and an enzyme activity electrophoretic assay for the qualitative analysis of Geotrichum candidum lipase activity is presented. The sensitivities of the four assays were (in arbitrary units): enzyme activity electrophoresis, 1-0.5; rocket immunoelectrophoresis, 0.5-0.2; radial diffusion, 1; titrimetry, 1. The electrophoretic methods made it possible to distinguish between high and low molecular weight forms of the G. candidum lipases. The enzyme activity electrophoretic methods can be combined with other electrophoretic techniques, as demonstrated here with isoelectric focusing, and produce useful information on physico-chemical differences between different molecular forms of the lipase, e.g. forms with different pI. PMID- 2714240 TI - Genetic studies of low-abundance human plasma proteins. X. Coagulation factor XIIIB variants in blacks. AB - Human coagulation factor XIIIV (F XIIIB) demonstrates genetically determined structural variation with three common and several rare alleles. Population genetics studies reveal enormous intra and interracial group variation. In the present study, using isoelectric focusing and immunoblotting, we have determined for the first time the polymorphic occurrence of F XIIIB allelic forms in a native African population, namely Nigerian Blacks. In addition, F XIIIB data have been extended to various US Black populations. The characteristic feature of the black gene pool is the relative high frequency of the F XIIIB*2 allele, the highest being in Nigerians (0.723). The F XIIIB*6 allele is present at a polymorphic level in both the US and Nigerian Blacks and appears to be a unique black allele marker. The present technique has demonstrated several new alleles designated: F XIIIB*18, FXIIIB*22, F XIIIB*23 and F XIIIB*24. Among these new alleles the F XIIIB*23 exists at polymorphic level in both the US and Nigerian Blacks and is another unique Black allele marker of potential significance in population genetics studies. PMID- 2714241 TI - Multi-chamber apparatus for preparative isoelectric focusing. AB - A multi-chamber apparatus for preparative isoelectric focusing is described. The apparatus is constructed of 32 separation chambers and 2 electrode chambers, all separated by uncharged porous membranes. The total volume of the 32 separation chambers is 660 mL. A cooling system and a stirring system are built in. Human serum proteins were separated by isoelectric focusing in a natural pH gradient. The fractionation was monitored by fused rocket immunoelectrophoresis. The number of proteins in each fraction was monitored by crossed immunoelectrophoresis. The apparent pI values of IgG, transferrin and alpha-1-antitrypsin are as found in the literature. Orosomucoid (alpha-1-acid glycoprotein) (pI = 1.8) is concentrated at the acid end of the pH gradient. PMID- 2714242 TI - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis without a stacking gel: use for high sample throughput. AB - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis without a stacking gel minimizes lateral spreading of protein when samples are applied in agarose wells and allows high sample throughput (6 samples/cm gel width). The method is simple and convenient to use and gives comparable resolution to the standard method with 4-20% or 6-30% polyacrylamide gradient gels. Best results are obtained when the upper zone of the separating gel is of low polyacrylamide concentration. This indicates a need for the molten agarose to penetrate and anneal with the separating gel. PMID- 2714243 TI - Effect of electric field switching on the electrophoretic mobility of single stranded DNA molecules in polyacrylamide gels. AB - We have examined the effects of pulsed electric fields on the separation of single-stranded DNA molecules in polyacrylamide sequencing gels. Using different electric field pulsing regimens, the mobilities of single-stranded DNA molecules can be retarded or increased as compared to conventional electrophoresis. These results indicated that pulsed field techniques can be applied to gel electrophoresis of small single-stranded DNA molecules. PMID- 2714244 TI - Two-dimensional electrophoretic analysis of human milk proteins. AB - Identification of human milk proteins and formulation of a two-dimensional map is a first step in a project which intends to survey human milk proteins by two dimensional electrophoresis. Thirty-four proteins have been identified using the Iso-Dalt method of separation and Western blot with immunoprobes. Identification confirms that milk is species-specific, and, therefore, breast feeding confers a decided advantage for the infant. Using antisera for identification has revealed relationships between molecules which have not been previously noted. The antibody recognizes a common epitope between the IgA alpha chain and lactoferrin, and between the IgD d chain and beta casein. Milk protein concentrations vary longitudinally, diurnally, and individually. Identification of the proteins contributes meaning to the varying patterns. Knowledge of human milk proteins will help to elucidate human nutrition and health needs. PMID- 2714245 TI - The validity of the use of heart rate in estimating oxygen consumption in static and in combined static/dynamic exercise. AB - The accuracy of using the HR/VO2 relation determined in running to predict VO2 from HR in tasks involving static and combined static/dynamic exercise was examined in a group of 8 healthy subjects (age 20-27 years). The HR measured in weight-holding tasks (with static exercise) and weight-carrying tasks (with combined static/dynamic exercise) with weights varying from 4-12 kg was inserted into the linear relation between HR and VO2 in the running task (dynamic exercise). The predicted VO2 was compared with measured value. The conclusions were as follows. It is not accurate to use a simple dynamic task to predict VO2 from a measured HR in static work. The percentage differences vary between 78 and 186%. In combined static-dynamic work a simple dynamic task can be accurately used to predict VO2 from measured HR, while carrying small weights (4, 8 and 10 kg). However, more static work (12 kg) makes the estimations poorer with a significant percentage difference in VO2 of 38%. PMID- 2714246 TI - An endurance training programme for frequent manual carrying tasks. AB - This study was conducted with the aim of testing whether the endurance time of new employees engaged in frequent industrial carrying tasks can be significantly increased through a short training programme (2.5 weeks). Endurance time was here defined as the maximum length of time during which an individual can continuously carry a 20 kg load over a 4 m distance 8 times/min. The results showed that (1) endurance time increased by almost 100% over an 8-session training programme; (2) for a fixed workload, endurance time increased without changing job demand perception; and (3) overall body fatigue may be the limiting factor in frequent carrying tasks. PMID- 2714247 TI - Isoinertial tests to predict lifting performance. AB - Previous research has found isoinertial strength testing to be superior to isometric and isokinetic strength testing for prediction of task performance. The purpose of this study was to investigate tests on an isoinertial lifting machine (ILM) and their ability to predict performance on actual lifting tasks. Sixteen male subjects performed two lifting tasks: maximum box lift to truck-bed height of 1.35 m; and 'speed lifts' of 60 concrete blocks (each 22.7 kg) to the same height. These performance tests were compared to three ILM tests: a maximal lift to 1.83 m, a second maximal lift to 1.52 m, and an endurance test that entailed 60 timed ILM lifts of 22.7 kg to 1.83 m. Pearson product-moment correlations between ILM tests and performance tasks varied from r = 0.55 to 0.71. Therefore, the isoinertial test protocols employed in this study were able to account for only 30% to 50% of the variance in the performance of maximal lifting and endurance tasks. In was concluded that prediction of maximal lifting ability or endurance ability using an ILM might be enhanced by closer approximation of specific task variables, or by inclusion of dynamic parameters to measure technique. PMID- 2714248 TI - Shoulder posture and localized muscle fatigue and discomfort. AB - In many industries workers perform manual assembly tasks with hands postured above the shoulders. Awkward shoulder and arm postures are often viewed as acceptable given costs of workplace modification, postural exertions which are in compliance with current design recommendations, ready availability of strong workers, and numbers of electromyographic studies which fail to detect significant signs of localized muscle fatigue (LMF). An experiment was conducted to: (a) study the onset and severity of (LMF) in the shoulder when performing a stylus-to-hole Fitts reciprocal movement task under a range of postures, hand loads, ratios of work-to-rest, and task durations, and (b) to evaluate the efficacy of three techniques (i.e., changes in EMG behaviour, postural tremor, and cross-modal matching estimates) in detecting and monitoring posturally-based LMF and discomfort in the shoulder complex. Experimental findings showed that posturing hands above shoulder level significantly increased the risk of LMF and postural discomfort even in light-weight manual assembly environs where postural exertions are small, and that cross-modal matching estimates and postural tremor were more sensitive metrics of LMF in the shoulder complex than EMG RMS voltage and mean spectral power frequency metrics. The basis for experimental findings, as well as potential application of LMF metrics in future postural stress investigations, are discussed. Recommendations for workplace posture are provided for job designers facing work height decisions in manual assembly environs. PMID- 2714249 TI - Definitions and nomenclature of nucleic acid structure parameters. PMID- 2714250 TI - T antigen expression and tumorigenesis in transgenic mice containing a mouse major urinary protein/SV40 T antigen hybrid gene. AB - A hybrid mouse major urinary protein (MUP)/SV40 T antigen gene was microinjected into fertilized mouse embryos and the resulting transgenic mice analyzed for the regulated expression of the transgene. Available evidence indicates that the MUP gene used for the hybrid gene construct is expressed in both male and female liver and possibly mammary gland. Three different transgenic lines exhibited a consistent pattern of tissue specific expression of the transgene. As a consequence of transgene expression and T antigen synthesis in the liver, both male and female transgenic animals developed liver hyperplasia and tumors. Transgene expression and liver hyperplasia commenced at approximately 2-4 weeks of age, the same time that MUP gene expression is first detected in the liver. The expression of the transgene resulted in an immediate strong suppression of liver MUP mRNA levels but had relatively little effect on other liver specific mRNAs. From 4 to 8 weeks, the liver increased several fold in size, relative to non-transgenic littermates. Definitive tumor nodules were not apparent until 8-10 weeks. The transgene was also consistently found to be expressed in the skin sebaceous glands and the preputial gland, a modified sebaceous gland. The expression of the transgene in the skin sebaceous glands is consistent with the presence of MUP mRNA in the skin and a putative role for MUPs in the transport and excretion of small molecules. Occasional expression of the transgene in other tissues (kidney and mammary connective tissues) was also noted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714252 TI - Mapping the double-strand breaks at the mating-type locus in fission yeast by genomic sequencing. AB - In fission yeast mating-type switching is initiated by the formation of a double strand DNA break at the mating-type locus. A prerequisite for generation of the break is some 'imprinting' of the DNA in the previous cell cycle. We have used the technique of genomic sequencing to map the position of the break directly on chromosomal DNA cleaved in vivo. On one strand the break is situated very close to the right-hand border of the expressed mat1 cassette. Cells of opposite mating type, P and M, have their breaks at slightly different positions on this strand. On the other DNA strand of both alleles the ends are probably masked by tightly bound proteins and therefore the precise nature of the break could not be determined. Since the break is stable throughout the cell cycle, these proteins may function in vivo to confer structural stability on the chromosomes having the break. The implications of these findings for models of mating-type switching are discussed. PMID- 2714251 TI - Asymmetry and polarity of nucleosomes in chicken erythrocyte chromatin. AB - Nucleosome dimers containing, on average, a single molecule of histone H5 have been isolated from chicken erythrocyte nuclei and the associated DNA fragments cloned and sequenced. The average sequence organization of at least one of the two nucleosomes in the dimers is highly asymmetric and suggests that the torsional, as well as the axial, flexibility of DNA is a determinant of nucleosome positioning. On average the nucleosome dimer is a polar structure containing linker DNA of variable lengths. The sequences associated with H5 containing nucleosomes and core particles are sufficiently different to indicate that removal of histone H5 (or H1) from chromatin may result in the migration of the histone octamer and a consequent exposure of sites for regulatory proteins. PMID- 2714253 TI - In vitro synthesis of vertebrate U1 snRNA. AB - We have developed a DNA-dependent in vitro transcription system for vertebrate snRNA genes. By isolating the nuclei (germinal vesicles, GVs) of Xenopus laevis oocytes under oil to maintain the in vivo composition of their internal milieu, we are able to prepare nuclei that retain their ability to synthesize snRNAs efficiently. Homogenates of these GVs synthesize correctly initiated and terminated U1 snRNA using exogenous X.laevis U1 genes as templates. The templates may be either injected into the nucleus prior to its isolation or added to the nuclear homogenate. PMID- 2714254 TI - Non-enzymatic excision of pre-tRNA introns? AB - We used human tRNA(Tyr) precursor as a substrate to study self-excision of a pre tRNA intron. This RNA was synthesized in vitro in a HeLa cell extract. It contains a 5' leader, an intron of 20 nucleotides and a 3' trailer. Self-cleavage of pre-tRNA(Tyr) occurs in 100 mM NH4OAc at a pH ranging from 6 to 8.5 in the presence of spermine, MgCl2 and Triton X-100 under conditions very similar to enzymatic intron excision. The reaction is temperature-dependent, relatively fast as compared to the enzyme-catalysed reaction and leads to fragments which resist further degradation. The detailed structure of all major and minor cleavage products was established by fingerprint analyses. Non-enzymatic cleavage occurs predominantly at the 3' splice site and to a minor extent at the 5' splice site. Other minor cleavage sites are located within the intron and in the 3' trailer. Putative 5' and 3' tRNA halves resulting from pre-tRNA(Tyr) self-cleavage are substrates for wheat germ RNA ligase, suggesting that the cleavage reaction yields 2',3'-cyclic phosphate and 5'-hydroxyl termini. Pre-tRNA splicing endonuclease is believed to cleave both the 5' and the 3' splice site. However, on the basis of our results we propose that this enzyme may support the formation of a pre-tRNA tertiary structure favourable for autocatalytic intron excision and impair unspecific self-cleavage. PMID- 2714256 TI - Derivatives of ColE1 cer show altered topological specificity in site-specific recombination. AB - ColE1 contains a 250-bp sequence (cer) which is required in cis for the conversion of plasmid dimers to monomers. Recombination between cer and parB (a dimer resolution site from plasmid CloDF13) occurs in vivo at low frequency. The properties of the resulting hybrid sites have been studied. The type I hybrid closely resembles wild-type cer. It supports intramolecular recombination and requires the products of the chromosomal xerA, xerB and xerC genes together with the 250-bp site. In contrast, the type II hybrid (although differing from type I by only 2 bp) functions independently of the topological relationship of the participating sites, supporting both inter- and intramolecular recombination. Furthermore, recombination between type II sites is independent of the products of the xerA and xerB genes and requires a site of less than 50 bp. PMID- 2714255 TI - Ribosome inactivation by ricin A chain: a sensitive method to assess the activity of wild-type and mutant polypeptides. AB - When recombinant ricin A chain transcripts are translated in a rabbit reticulocyte lysate the ribosomes are rapidly inactivated as shown by their inability to support translation of yeast preproalpha factor or chicken lysozyme transcripts added subsequently. In contrast, ribosomes which have translated transcripts encoding non-toxic polypeptides such as ricin B chain, readily translate the second transcript under identical conditions. Ribosome inactivation is accompanied by a highly specific modification of 28S rRNA which occurs at the same position as the N-glycosidic cleavage of an adenine residue and which is thought to cause inactivation of the ribosomes. Protein synthesis by wheat germ ribosomes was not inhibited under the conditions which inhibit reticulocyte ribosomes confirming earlier observations that plant cytoplasmic ribosomes are much less sensitive to inhibition by ricin A chain than are mammalian ribosomes. Using the same assay we have shown that deleting an internal hexapeptide, which shares homology with hamster elongation factor-2, completely abolishes catalytic activity. Deleting a second pentapeptide conserved between ricin A chain and the ribosome-inactivating plant toxin trichosanthin, had no effect. Deleting the first nine residues from the N-terminus of A chain did not affect toxicity whereas deleting a further three residues inactivated the polypeptide. Point mutations which individually converted arginine 48 and arginine 56 of ricin A chain to alanine residues or which deleted arginine 56 were also without effect on the catalytic activity of the toxin. PMID- 2714259 TI - Abstracts of the Fifth International Conference on Environmental Mutagens. Cleveland, Ohio, July 10-15, 1989. PMID- 2714257 TI - The triose phosphate-3-phosphoglycerate-phosphate translocator from spinach chloroplasts: nucleotide sequence of a full-length cDNA clone and import of the in vitro synthesized precursor protein into chloroplasts. AB - The nucleotide sequence of several cDNA clones coding for the phosphate translocator from spinach chloroplasts has been determined. The cDNA clones were selected from a lambda gt10 library prepared from poly(A)+ mRNA of spinach leaves using oligonucleotide probes modeled from amino acid sequences of tryptic peptides prepared from the isolated translocator protein. A 1439 bp insert of one of the clones codes for the entire 404 amino acid residues of the precursor protein corresponding to a mol. wt of 44,234. The full-length clone includes 21 bp at the transcribed non-coding 5' region with the ribosome initiation sequence ACAATGG, a 1212 bp coding region and 199 bp at the non-coding 3' region excluding the poly(A) tail which starts 17 bp downstream from a putative polyadenylation signal, AATAAT. According to secondary structure predictions the mature part of the chloroplast phosphate translocator exhibits high hydrophobicity and consists of at least seven membrane-spanning segments. Using plasmid-programmed wheat germ lysate the precursor protein was synthesized in vitro and could be imported into spinach chloroplasts where it is inserted into the inner envelope membrane. PMID- 2714258 TI - Purification of axonin-1, a protein that is secreted from axons during neurogenesis. AB - Using selective metabolic labelling in a compartmental cell culture system two proteins, denoted axonin-1 and axonin-2, were found to be secreted by axons of dorsal root ganglia neurons from chicken embryos. Based on its characteristic coordinates and spot morphology in two-dimensional gel electrophoresis, axonin-1 was detected in the cerebrospinal fluid and the vitreous fluid, axonin-1 was purified 476-fold to homogeneity by a four-step chromatographic procedure. The identity of the purified protein as axonin-1 was confirmed by immunological methods. Axonin-1 is a glycoprotein that subdivides into at least 16 immunologically similar isoelectric variants; their molecular weight range extends from 132 to 140 kd and their pI range from 5.3 to 6.2. In the vitreous fluid of the embryo, axonin-1 could first be detected on the embryonic day 5 and highest concentrations were measured during the second half of embryonic life; in the vitreous fluid of the adult chicken, concentrations were approximately 20 times lower. The early onset of secretion and the time course of expression suggest a role for axonin-1 in the development of the nervous system. PMID- 2714260 TI - Myocardial infarction in the Tikur Anbessa Teaching Hospital. A five-year review. AB - During a five-year period between September 1981 and August 1986, 23 patients with acute myocardial infarction (17 Ethiopians, 4 foreigners and 2 half-blooded Ethiopians) were admitted to the Tikur Anbessa Hospital in Addis Ababa, giving an incidence for myocardial infarction among medical admissions of 3.5 per thousand. The age range for Ethiopians was 31 to 71 years. Of the 17 Ethiopians, seven were below the age of 50 years and five died giving a mortality rate of 29.4%. The only female patient was of Ethiopian-Greek origin with multiple coronary risk factors. Cigarette smoking, hypertension, diabetes mellitus, hypercholesterolemia and obesity were among the risk factors identified among Ethiopians suffering from myocardial infarction. The clinical features and complications seen in Ethiopians were similar to those seen in developed societies. It is concluded that myocardial infarction in Ethiopia may not be as rare as previous observations suggest. PMID- 2714261 TI - Idiopathic ulcerative colitis among Ethiopian patients with chronic diarrhoea. AB - Using both exclusion and inclusion criteria, a search for idiopathic ulcerative colitis was made among patients who presented with chronic diarrhoea over a period of 3 years. Five of 19 patients with chronic diarrhoea were clinically, histologically and radiologically compatible with idiopathic ulcerative colitis. Though rare, idiopathic ulcerative colitis does exist among this population and, therefore, should be looked for in patients presenting with chronic diarrhoea. PMID- 2714262 TI - Melkersson-Rosenthal syndrome. AB - A 65-year-old male patient who presented with recurrent facial swelling and episodic Bell's Palsy is reported. The clinical picture fits with an uncommon condition known as Melkersson-Rosenthal Syndrome. The clinical observations, pathologic data, and nerve conduction studies of the case are presented here. PMID- 2714263 TI - HIV seropositivity in a 40-day-old child in Addis Ababa. AB - In this communication Human Immunodeficiency Virus (HIV) seropositivity is described in a 40-day-old Ethiopian child born to parents infected with HIV-I. PMID- 2714264 TI - Subcutaneous nodules in rheumatic fever. AB - Acute rheumatic fever is described in a six year old Ethiopian male child who first presented with subcutaneous nodules and later developed carditis. PMID- 2714265 TI - Pharmacokinetics, metabolism, and renal excretion of articaine and its metabolite articainic acid in patients after epidural administration. AB - Articaine is metabolized into articainic acid. The half-lives of articaine are 0.54 +/- 0.05 and 2.44 +/- 0.30 h and that of its metabolite, 2.44 +/- 0.30 h. Of the administered dose approximately 2-5% is excreted unchanged, 40-70% is excreted as articainic acid, and 4-15% as articainic acid glucoronide. The percentage of the total dose recovered in the urine varies between 50% and 91%. Protein binding of articaine in patients varies between 50% and 70%, and that of articainic acid between 60% and 90%. Renal clearance of articaine varies between 12 and 28 ml min-1, while that of articainic acid is between 84 and 160 ml min-1. PMID- 2714266 TI - Proceedings of the European Academy of Anaesthesiology, 10th annual meeting. Rome, 8-10 September 1988. Abstracts. PMID- 2714267 TI - Nomenclature Committee of the International Union of Biochemistry (NC-IUB). Numbering of atoms in myo-inositol. Recommendations 1988. AB - A relaxation of previous recommendations on the numbering of the atoms of myo inositol is suggested: substituents need not necessarily be numbered so that the smallest possible locant is used. This allows an alternative designation to be used, when authors wish, to bring out structural relationships. PMID- 2714268 TI - Characterization of the lipid A component of genuine smooth-form lipopolysaccharide. AB - The smooth-form lipopolysaccharide of Salmonella abortus equi had earlier been separated into three distinct fractions, a long-chain fraction with an O chain containing 20-50 repeating units, a short-chain fraction consisting of an R lipopolysaccharide and another with 1-6 repeating units, and an R fraction identical to the lipopolysaccharide synthesized by Ra.b-mutant bacteria [Galanos et al. (1988) J. Chromatogr. 440, 397-404]. In this paper, the corresponding lipid A from each fraction was prepared by a newly elaborated procedure based on hydrolysis of the fractions in calcium acetate buffer (pH 3.5) followed by separation of the resulting free lipid A from the polysaccharide on a Sephadex G 100 column. Chemical analysis revealed that lipid A of the R fraction contained the expected spectrum and amounts of fatty acids and it proved to be structurally identical to lipid A of previously studied Salmonella R mutants. In contrast, the lipid A of the long-chain fraction contained only about 60% fatty acids compared to that of the R fraction. The lipid A of the short-chain fraction also expressed a reduced substitution pattern of acyl residues. PMID- 2714269 TI - Structural analysis of the nontoxic lipid A of Rhodobacter capsulatus 37b4. AB - Lipid A from Rhodobacter capsulatus 37b4 consists of a D-glucosaminyl-(beta 1-6) D-glucosamine disaccharide backbone, carrying diphosphorylethanolamine at C-1 of the reducing glucosamine and phosphorylethanolamine at C-4' of the nonreducing glucosamine. 1,4'-Bisphosphorylated lipid A, lacking the polar head groups, was also encountered and contributed to the observed microheterogeneity in the phosphate substitution. The amino functions of both glucosamines are substituted almost entirely by the rare 3-oxotetradecanoic acid, which is a characteristic constituent of lipid A in the genus Rhodobacter. 3-Hydroxydecanoic acid is ester bound at C-3 and C-3' of the glucosamine disaccharide and the one at the nonreducing glucosamine (C-3') is partially substituted by dodecenoic acid to form an ester-bound diester. In free lipid A, hydroxy groups at C-4 and C-6' of the glucosamine disaccharide are unsubstituted. C-6' being the putative attachment point of the lipopolysaccharide core. The nontoxic Rhodobacter capsulatus lipid A shows extensive serological cross-reaction with the toxic Salmonella lipid A. Structural similarities in the hydrophilic part of both types of lipid A, dissimilarities in the hydrophobic part and their impacts on serologic properties are discussed. PMID- 2714270 TI - On the role of the termination factor RF-2 and the 16S RNA in protein synthesis. AB - In the translational termination step of protein synthesis the three termination codons UAA, UAG or UGA are recognized by so-called release or termination factors. The release factor RF-1 interacts with UAG and UAA whereas RF-2 is specific for UGA and UAA. Two mechanisms concerning the termination event have been discussed so far: recognition of the termination codon by the protein in a tRNA-like manner or double-strand formation between the codon and the 3' end of the 16S rRNA which is stabilized by the termination factor. Using equilibrium dialysis we show that 40% of the ribosomes can bind UGAA in an RF-2-dependent manner. The stability with the correct combination RF-2-UGA is tenfold higher as compared to the wrong termination codon UAG. We confirm prior findings that the termination factor RF-2 is bound to the A-site of the ribosome. In addition to the ribosomal proteins L2, L10, L7/L12 and L20 of the large subunit and S6 and S18 of the small subunit, the 16S rRNA became labelled when radioactive UGA was crosslinked to the ribosome in the presence of RF-2. Our data support a mechanism of termination in which a double strand between the termination codon and the 3' end of the 16S rRNA is formed as the starting event. The resulting RNA-RNA double strand in turn may be recognized and stabilized by the termination factor. PMID- 2714271 TI - Reaction of bovine-liver copper-zinc superoxide dismutase with hydrogen peroxide. Evidence for reaction with H2O2 and HO2- leading to loss of copper. AB - The reaction of hydrogen peroxide with the copper-zinc bovine-liver superoxide dismutase at low molar ratios (0.2-20.0) of H2O2/active site between pH 7.3-10.0 leads to the loss of native enzyme as a distinct form monitored by electrophoresis. The pH dependence of the loss of native enzyme between 7.3 and 9.0 indicates the involvement of a conjugate base on the enzyme of pKa of 8.7 +/- 0.1. The rate of loss of the native enzyme is first order with respect to the concentration of both enzyme and hydrogen peroxide between pH 7.3 and 9.0 with no evidence for binding of peroxide. A second-order rate constant of 3.0 +/- 1.0 M-1 s-1 is obtained from these data. At pH 10.0 the reaction is first order with respect to enzyme concentration but saturable in H2O2. All data are consistent with the interpretation that H2O2 reacts with the enzyme at the lower pH where the reaction is dependent upon the conjugate base of a functional group on the enzyme. At the higher pH, the data are consistent with the reaction of HO2- and H2O2 with the dismutase. The dissociation constant for HO2- calculated from the kinetic data at pH 10.0 is between 25-50 microM and the rate constant for the breakdown of the HO2- dismutase complex is 1.10 + 0.05 x 10(-2) s-1. The change in the electrophoretic pattern at all pH values is accompanied by the loss of the ability of the enzyme to bind copper. Weakly bound or free copper can be detected using bathocuproine disulfonate. Furthermore copper-defficient forms of the enzyme can be detected by staining gels of the peroxide-treated dismutase with diethyldithiocarbamate. PMID- 2714272 TI - Isolation and molecular and functional properties of the amino-terminal domain of colicin A. AB - A plasmid was constructed which allowed easy and efficient production and purification of the NH2-terminal domain of colicin A. In only three steps, an homogenous 18-kDa polypeptide was obtained. The NH2- and COOH-terminal sequences of the protein were determined and showed that it corresponded to the NH2 terminal 171 amino acid residues of the 63-kDa colicin A. Although colicin A is a highly asymmetric protein, hydrodynamic studies indicated that the NH2-terminal domain (designated AT) has a globular structure. This fragment is not the receptor-binding domain of colicin A but is required for the transfer of colicin A across the outer membrane of sensitive cells. However, it has a low affinity for phospholipid films and this affinity is not pH-dependent, in contrast to that of colicin A. PMID- 2714273 TI - Myosin isoenzymes and their subunits in urodelan amphibian fast skeletal muscle. Coexistence of larval and adult heavy chains in neotenic individuals. AB - The distributions of native myosin isoforms were examined by electrophoresis under non-dissociating conditions, in the fast twitch dorsal skeletal muscle of young larvae, neotenic adults and metamorphosed adults of urodelan amphibians. Both heavy and light chains of myosin isoenzymes were analysed. In pyrophosphate acrylamide gel electrophoresis three isoenzymes were demonstrated in larval myosin; other isoforms of lower electrophoretic mobility were observed in metamorphosed adults myosin. Larval and adult isoenzymes were shown to coexist in myosin from neotenic adults. Analysis of heavy chains in denaturing conditions and proteolytic digestion revealed the sequential occurrence during development of two types of heavy chains, one larval and one adult, that coexist in the myosin of neotenic adults only. Analysis of light chain patterns under denaturing conditions revealed the existence of three fast light chains which displayed no modification during the course of development. The neotenic urodelan amphibian species model represents actually the only model in which the coexistence of larval (or neonatal) and adult heavy chains is maintained throughout life in adults. PMID- 2714274 TI - The G.C base-pair preference of 2-N-methyl 9-hydroxyellipticinium. AB - Among the DNA-intercalating drugs in the ellipticinium series, 9-hydroxy derivatives elicit the highest antitumoral properties. In water these drugs display a very low fluorescence quantum yield. Replacement of H2O by D2O partially restores the fluorescence of the ellipticinium chromophore. The possibility that such a proton-exchange mechanism could be involved in a base recognizing process at the DNA level (and therefore be responsible for some base preference) was examined by direct fluorescence titration in deuterated buffer and DNA/drug fluorescence energy transfer. These experimental approaches provide mutually consistent results showing that the 9-hydroxylated drug recognizes specific DNA sites that are not recognized by the non-hydroxylated drug. When compared to 2-N-methyl ellipticinium, the 2-N-methyl 9-hydroxyellipticinium presents: (1) higher binding constants for each DNA studied; (2) a base dependence of the fluorescence properties of the bound form (fluorescence increment upon DNA binding varying over 5-11); (3) a base dependence of its DNA affinity constants (1.1-3.3 x 10(6) M-1) and of its site size (exclusion parameters varying over 3.0-4.4); (4) a base dependence of its energy transfer from DNA bases. Analysis of the binding data suggests that the 9-hydroxyl group of 2-N-methyl ellipticinium is responsible for a G.C base-pair preference, the preferred binding site being a doublet sequence of two adjacent G.C which could be flanked either by a additional G.C base pair or by an A.T base pair. PMID- 2714275 TI - 2-(4'-chlorophenyl)benzothiazole is a potent inducer of cytochrome P450IA1 in a human and a mouse cell line. Anomalous correlation between protein and mRNA induction. AB - Two benzothiazole derivatives, 2-(4'-chlorophenyl)benzothiazole (CPBT) and 2-(4' formylphenyl)benzothiazole (FPBT) were studied for their ability to induce aryl hydrocarbon hydroxylase activity in a mouse and a human cell line. In both the mouse hepatoma cell line, Hepa-1, and the human choriocarcinoma cell line, JEG-3, a high aryl hydrocarbon hydroxylase activity was observed after treatment with CPBT. In contrast, FPBT had a very weak inducing capacity in both cell lines. The maximal induction by CPBT was several times (e.g. in Hepa-1 about fourfold on average) greater than that observed with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). A specific cDNA probe for mouse cytochrome P4501A1 gene was used to quantify mRNA levels in Hepa-1 cells. CPBT increased cytochrome P450IA1 mRNA to a level of 88% of that induced by TCDD. Immunoblot analysis with monoclonal antibody 1-7-1, directed against rat liver cytochrome P450IA1 and P450IA2, showed that the amount of P450IA1 is substantially increased in Hepa-1 cells after treatment with CPBT. The observation that CPBT competed TCDD off its specific cytosolic binding site suggests a receptor-mediated induction of cytochrome P450IA1 mRNA. An in vitro activation effect did not explain the exceptionally high hydroxylase activity. The results show that CPBT is a more efficient inducer of aryl hydrocarbon hydroxylase than TCDD in Hepa-1 and JEG-3 cells and that the induction is supported by P450IA1. The discordant effect of CPBT on mRNA and aryl hydrocarbon hydroxylase activity suggests that post-translational modifications of P450IA1 account for a major part of the increased enzyme activity. PMID- 2714276 TI - Covalent structure of collagen. Amino acid sequence of an arthritogenic cyanogen bromide peptide from type II collagen of bovine cartilage. AB - Bovine articular type II collagen was prepared by limited pepsin digestion, differential salt fractionation and carboxymethylcellulose chromatography. Cyanogen bromide digestion of purified type II collagen alpha chains yielded twelve distinct peptides designated CB1-12. The peptide alpha 1(II)-CB11 was isolated by carboxymethylcellulose chromatography and Sephadex G-75S gel filtration. Automated Edman degradation together with chymotrypsin, thermolysin and trypsin digestion enabled identification of its complete amino acid sequence. Compared with type I and type III collagen, the data show similarity with alpha 1(I)-CB8 and alpha 1(III)-CB6-1-8-10-2 peptides, respectively. The peptide is located within residues 124-402 of the alpha 1(II) collagen chain and with its identification, now extends the known amino acid sequence of bovine type II cartilage collagen to 660 amino acid residues including alpha 1(II)-CB1-2-6-12-11 8-10 (partial). This corresponds to alpha 1(I)-CB0-1-2-4-5-8-3-7 (partial; 1-660) and alpha 1(III)-CB3A-3B-3C-7-6-1-8-10-2-4-5 (partial; 1-660) of bovine alpha 1(I) and alpha 1(III) collagen chains. PMID- 2714277 TI - Isolation and characterization of the rainbow trout erythrocyte band-3 protein. AB - Rainbow trout (Salmo gairdneri) band-3 protein was isolated from trout erythrocyte plasma membranes by a combination of preparative SDS/PAGE and electroelution. High purity and recovery of the plasma membranes were achieved by a new method. This was demonstrated using 4,4'diiso-thiocyano[3H2]dihydro stilbene 2,2'disulfonic acid (3H2DIDS) which specifically labels band-3 protein. On SDS/PAGE, band-3 protein yields a similarly diffuse pattern, as does mammalian band-3 protein, with an apparent Mr of 116,000. In situ chymotryptic cleavage/cross-linking experiments with 3H2DIDS reveal that the fragments cross link as in human and mouse band-3 proteins but that there are minor differences. Treatment of trout erythrocytes with trypsin results in cleavage of the band-3 protein. Purified polyclonal antibodies raised against trout band-3 protein react with trout band-3 protein and do not crossreact with mouse or human band-3 protein. They react specifically with only one chymotryptic fragment of trout band-3 protein. PMID- 2714278 TI - Substrate-modulated reactions of putidamonooxin. The nature of the active oxygen species formed and its reaction mechanism. AB - 1. 4-Methoxybenzoate monooxygenase is fairly nonspecific. The enzyme system with putidamonooxin as its oxygen-activating component catalyses: (a) O-, S- and N demethylation; (b) the oxygenation of 4-methylbenzoate and 4 methylmercaptobenzoate, with formation of 4-carboxybenzyl alcohol and 4 carboxyphenylmethyl sulfoxide, respectively, and (c) attack of the aromatic ring of 4- and 3-hydroxybenzoate and 4-aminobenzoate, yielding 3,4-dihydroxybenzoate and 4-amino-3-hydroxybenzoate, respectively. 2. Compounds which are bound by the active sites of putidamonooxin have two essential features in common: a planar aromatic ring system, and a free carboxyl group attached to it. 3. By a substrate modulated reaction putidamonooxin can be induced to function not only as a monooxygenase but also as a peroxotransferase, i.e. it incorporates both atoms of the activated oxygen molecule into a substrate molecule. This finding supports the hypothesis that a mesomeric state of the iron.peroxo complex, [FeO2]+, is indeed the active oxygenating species of putidamonooxin. 4. The lifetime of the ternary complex consisting of enzyme.iron-peroxo-complex.substrate is significantly prolonged by uncoupling and partially uncoupling substrates, except when it is inactivated by protonation of the iron.peroxo complex by a proton transported into the active sites by a special kind of substrate (i.e. isomers of monoaminobenzoate), with the direct formation of H2O2. 5. The lifetime of the active oxygen species is determined by (a) the rate of the oxygenation reaction in the presence of tight-coupling substrates and (b) the rate of the oxygenation reaction as well as detoxification by the availability of a dissociable proton in the presence of partial uncoupling (and uncoupling) substrate analogues. 6. The rate of the oxygenation reaction depends on the lifetime of the active oxygen species, [FeO2]+, in the presence of partial uncoupling substrates. 7. The iron.peroxo complex attacks an aromatic ring system according to the empiric rules of electrophilic substitution, whereas the attack of aliphatic substituents at the aromatic ring is controlled by steric criteria. PMID- 2714279 TI - 4-Chloroacetylpyridine adenine dinucleotide. A highly reactive and chromophoric affinity label of glyceraldehyde-3-phosphate dehydrogenase from sturgeon. AB - The analogue of NAD+, 4-chloroacetylpyridine-adenine dinucleotide (clac4PdAD+), inactivated the glyceraldehyde-3-phosphate dehydrogenase from sturgeon at a high rate. An affinity labeling was shown to occur with clac4PdAD+. The mononucleotide 4-chloroacetylpyridine 1-beta-D-ribose 5'-phosphate (clac4PdMN+) reacted with the enzyme in a second-order reaction whose rate was much smaller than that calculated for clac4PdAD+ taken as a second-order rate reagent. The rate of the reaction of clac4PdAD+ with the enzyme was determined by stopped flow, using as a probe the long-wavelength absorption maximum (430 nm) formed concomitantly with inactivation of the enzyme. Computer-assisted graphic simulation showed that the clac4PdAD+ analogue could bind to the active site of the enzyme from Bacillus stearothermophilus in a similar manner to that of NAD+, and that the reactive carbon and the reactive thiolate of Cys-149 were within bonding distance. The absorption at 430 nm was linearly proportional to the substoichiometric concentration of clac4PdAD+/mole subunit. Thiol titration suggested the modification of one thiol residue per subunit. The modified thiol was identified by degradation as Cys-149. In contrast to the absorption band generated during the reaction of the 3-chloroacetylpyridine-adenine dinucleotide (clac3PdAD+) with the same enzyme [Eur. J. Biochem. (1982) 127, 519-524; 129, 437-446], enzyme inactivated with clac4PdAD+ and clac4PdMN+ exhibited an absorption maximum at long wavelength which was still present after denaturation. The chromophore is proposed to be the enol form of the alpha-thioether ketone produced by alkylation of the thiolate of Cys-149 by the chloroacetyl group. PMID- 2714280 TI - Ultraviolet and magnetic-circular-dichroic spectroscopic studies of Gd(III) complexed with diethylenetriaminepentaacetic acid. A contrast agent for NMR imaging. AB - Sensitive probes are required for studying the biochemistry of Gd(III) contrast agents used in magnetic resonance imaging. We show that complexation of Gd(III) by diethylenetriamine-N,N,N',N',N"-pentaacetic acid (DTPA) in aqueous solution can be readily determined from the sharp 4f-4f bands for free and bound Gd(III) in the range 270-282 nm, and, with greater sensitivity, from the associated magnetic-circular-dichroic spectra. PMID- 2714281 TI - The brain-specific gene for rat aldolase C possesses an unusual housekeeping-type promoter. AB - A DNA fragment encompassing the first exon and about 750 bp of the 5'-flanking sequence has been isolated and sequenced. The gene has multiple start sites of transcription which are dispersed over about 200 bp. The promoter lacks TATA and CAAT boxes and is very G + C-rich, with putative binding sites for the transcriptional factors Sp1 and AP2. Similar features are shared with two other brain-specific genes encoding thy-1 antigen and gamma-enolase. The existence of a conserved block of similarity upstream of the human and rat aldolase C genes suggests that this region could be involved in tissue-specific expression whose mechanism seem to be, at least in part, transcriptional. PMID- 2714282 TI - Isolation of heparin-binding growth factors from bovine, porcine and canine hearts. AB - Fresh bovine, porcine and canine hearts were homogenized and mitogens for mesoderm-derived cells were purified in three different steps. Extraction by two different ammonium sulfate precipitations was followed by cation-exchange chromatography and by heparin-Sepharose affinity chromatography. A heparin Sepharose fraction from heart (eluted at 1.1 M NaCl) increased mitotic activity in serum-deprived cultures of porcine aortic endothelial and smooth muscle cells, and in human fibroblasts. This mitogenic activity is potentiated by heparin and inhibited by gamma-interferon. The heart mitogenic fraction showed one double peak on HPLC at A215 and one polypeptide band on SDS/PAGE. These peaks and bands were identical to those obtained from bovine brain. The heart acidic fibroblast growth factor (aFGF) showed a positive signal in Western blots using antibodies raised against brain aFGF. Gas-phase amino acid sequencing established that the mitogens were identical to aFGF and the N-terminally truncated aFGF. Extraction in the presence of a protease inhibitor (pepstatin A) produced a higher-molecular mass form of aFGF with a blocked amino terminus. Another mitogen, eluted at 1.6 M NaCl from heparin-Sepharose, reacted with polyclonal antiserum against human recombinant basic fibroblast growth factor (bFGF) and showed a 66% (12 from 18 amino acids determined by gas-phase sequencing) similarity with bFGF. This polypeptide increased the mitotic activity of the same cell lines but was more potent than aFGF. PMID- 2714283 TI - The novel pituitary polypeptide 7B2 is a highly-conserved protein coexpressed with proopiomelanocortin. AB - In the amphibian intermediate pituitary gland the biosynthetic activity for production of the precursor protein proopiomelanocortin (POMC) can be physiologically manipulated; POMC synthesis is high in animals adapted to a black background and low in white-adapted animals. In order to study genes associated with POMC gene expression we applied a differential hybridization technique involving screening of a pituitary cDNA library with probes derived from RNA of inactive and physiologically activated intermediate pituitary cells of the amphibian Xenopus laevis. A differentially hybridizing Xenopus pituitary cDNA clone encoded the novel polypeptide 7B2. This Mr-21,000 secretory granule associated protein of unknown function is shown to be highly conserved between Xenopus and human (83% amino acid sequence similarity). Conserved segments within the 7B2 structure included the N-terminal portion, three pairs of basic amino acids which are potential recognition sites for proteolytic enzymes, and three regions sharing similarity with putative GTP-binding domains. Levels of 7B2 mRNA were about 3% of POMC mRNA levels in Xenopus pituitary glands. In the intermediate pituitary the amount of both POMC and 7B2 mRNA was much higher in black-adapted toads than in white-adapted animals. These physiologically-induced changes in POMC and 7B2 mRNA levels were not found in the anterior pituitary. We conclude that the POMC and 7B2 genes are coexpressed and that modulation of the activity of these genes is tissue-specific. PMID- 2714284 TI - 1H-NMR studies of high-potential iron-sulfur protein from the purple phototrophic bacterium, Rhodospirillum tenue. AB - The high-potential iron-sulfur protein (HiPIP) from Rhodospirillum tenue (strain 3761) shows only a weak (20-25%) sequence similarity to HiPIPs from Chromatium vinosum, Ectothiorhodospira halophila and Ectothiorhodospira vacuolata, including the strict conservation of only two of the twelve residues assumed to be in the 4Fe-4S cluster packing region [Tedro, S. M., Meyer, T. E. and Kamen, M. D. (1979) J. Biol. Chem. 254, 1495-1500]. In spite of these differences, the general range and distribution of hyperfine-shifted 1H-NMR peaks of oxidized and reduced R. tenue HiPIP resemble those of E. halophila HiPIP I [Krishnamoorthi, R., Markley, J. L., Cusanovich, M. A., Pryzycieki, C. T. and Meyer, T. E. (1986) Biochemistry 25, 60-67]. Temperature- and pH-dependence and longitudinal relaxation behavior were determined for hyperfine-shifted peaks of the oxidized protein. Tentative assignments of peaks to ligands and aromatic residues suggest the presence of common apoprotein-active-site interactions in these proteins. Differences occur in the pattern of paramagnetically shifted peaks attributed to hydrogens bonded to the 4Fe-4S cluster. Hyperfine-shifted peaks of R. tenue HiPIP are not perturbed by pH changes in the range 5-9. In contrast, those of the C. vinosum protein exhibit a pH-dependence of chemical shifts that has been attributed to the titration of His42 [Nettesheim, D. G., Meyer, T. E., Feinberg, B. A. and Otvos, J. D. (1983) J. Biol. Chem. 258, 8235-8239]. Since R. tenue HiPIP contains no histidine, the present observation confirms the above hypothesis. PMID- 2714285 TI - Identification of highly acidic peptides from processing of the skin prepropeptides of Xenopus laevis. AB - The skin secretion of the frog Xenopus laevis has been fractionated by reverse phase HPLC and the most polar components studied by fast-atom-bombardment mass spectrometry (FAB/MS). Esterification of the hydrophilic peptides with methanol and ethanol was employed to improve the sensitivity of the technique. A number of small, highly acidic peptides have been identified, and alcoholysis of the peptide bonds within a number of these permitted their sequencing by FAB/MS. The sequences confirmed that they originate from acidic spacer regions found in the precursors to peptide hormones, such as caerulein, which have already been found in the secretion. In addition, acidic peptides derived from the spaces of the precursor to the antimicrobial peptides, PGS (or the magainins) have been isolated. The release of these from the preprotein cannot be fully accounted for by documented processing mechanisms, suggesting that a novel type of cleavage site has been identified. PMID- 2714286 TI - Molecular structure of an A-DNA decamer d(ACCGGCCGGT). AB - The molecular structure of the DNA decamer d(ACCGGCCGGT) has been solved and refined by single-crystal X-ray-diffraction analysis at 0.20 nm to a final R factor of 18.0%. The decamer crystallizes as an A-DNA double helical fragment with unit-cell dimensions of a = b = 3.923 nm and c = 7.80 nm in the space group P6(1)22. The overall conformation of this A-DNA decamer is very similar to that of the fiber model for A-DNA which has a large average base-pair tilt and hence a wide and shallow minor groove. This structure is in contrast to that of several A DNA octamers in which the molecules all have low base-pair-tilt angles (8-12 degrees) resulting in an appearance intermediate between B-DNA and A-DNA. The average helical parameters of this decamer are typical of A-DNA with 10.9 base pairs/turn of helix, an average helical twist angle of 33.1 degrees, and a base pair-tilt angle of 18.2 degrees. However, the CpG step in this molecule has a low local-twist angle of 24.5 degrees, similar to that seen in other A-DNA oligomers, and therefore appears to be an intrinsic stacking pattern for this step. The molecules pack in the crystal using a recurring binding motif, namely, the terminal base pair of one helix abuts the surface of the shallow minor groove of another helix. In addition, the GC base pairs have large propeller-twist angles, unlike those found most other A-DNA structures. PMID- 2714287 TI - cDNA-directed expression of rat testosterone 7 alpha-hydroxylase using the modified vaccinia virus, T7-RNA-polymerase system and evidence for 6 alpha hydroxylation and delta 6-testosterone formation. AB - The modified vaccinia virus, T7-RNA-polymerase cDNA-expression system was used to express rat cytochrome P-450a. Various parameters such as host-cell type and density, and duration of infection were tested to optimize the level of expression of cytochrome P-450a enzyme activity. Cytochrome P-450a expressed from the cDNA sequence was exclusively incorporated into the membrane-containing portions of the cell lysates, as expected from its normal association in the liver endoplasmic reticulum. The enzyme displayed a carbon-monoxide-reduced cytochrome-P-450a difference spectrum with a Soret maximum of 450 nm. Activity measurements revealed that cytochrome P-450a produced three metabolites of testosterone; 7 alpha-hydroxytestosterone and 6 alpha-hydroxytestosterone and delta 6-testosterone at a ratio of about 38:1:1. Under the appropriate conditions, the vaccinia-virus, T7-RNA-polymerase system produces high levels of a single form of cytochrome P-450 in cells that are virtually devoid of endogenous cytochrome P-450. Analysis of the cytochrome P-450 in its natural membrane-bound state, as opposed to artificial-lipid reconstitution studies of purified enzymes, allows accurate and confident measurements of substrate specificities. PMID- 2714288 TI - A phosphodiester bridge between two arabinose residues as a structural element of an extracellular glycoprotein of Volvox carteri. AB - The sulphated glycoprotein SSG 185 is the monomeric precursor of a highly aggregated structural element in the extracellular matrix of the multicellular green alga Volvox carteri. A phosphodiester of arabinose was isolated from a saccharide fragment of SSG 185. The structure of this phosphodiester was investigated by methylation analysis, 13C-NMR, photometric methods and enzymatic assays and identified as D-Araiota-5-phospho-5-D-Araiota. The function of this phosphodiester bridge as a crosslink of different carbohydrate chains in SSG 185 is discussed. PMID- 2714289 TI - Basic proline-rich proteins of murine parotid glands. Induction of mRNA by isoprenaline and post-secretion processing. AB - Five major basic polypeptides with characteristics typical of proline-rich proteins, accumulated in parotid glands after long term isoprenaline treatment of Balb C mice. They were studied by two-dimensional gel electrophoresis and designated B1 degree, B2' degrees, B2 degrees, B3 degrees and B4 degrees on the basis of pI-dependent mobility. They were not observed in the glands of normal mice and were precipitated when glands were homogenized in 10% trichloroacetic acid unlike the three isoprenaline-induced proline-rich proteins of murine parotid glands reported previously. Isoprenaline induced six proline-rich in vitro translation products which were absent normally. Four of these species had pI-dependent mobilities almost identical to B1 degree, B2 degrees, B3 degrees and B4 degrees, indicating not only precursor/product relationships, but also that isoprenaline induced the accumulation of the proteins by regulating the mRNA. Identical salivary counterparts of the basic glandular proline-rich proteins were not detected whereas a series of smaller and more basic isoprenaline-induced polypeptides were observed in saliva (major speices B1s-B4s). The glandular proline-rich proteins were secreted from parotid tissue in vitro and the data indicate that proline-rich proteins are synthesised as precursors and processed into salivary form in the parotid glands after secretion. The relationships between the B-type in vitro translation products, parotid gland precursors and salivary proteins were also confirmed immunologically. PMID- 2714290 TI - Structure/activity relationships of scorpion alpha-toxins. Multiple residues contribute to the interaction with receptors. AB - Chemical modifications of tyrosine and tryptophan residues of scorpion alpha neurotoxins II and III from Androctonus australis Hector were performed as well as modification of the two arginines and the alpha-amino group of toxin I. The pharmacological potencies of each derivative were assessed in vivo by LD50 measurement and in vitro by competition experiments with 125I-toxin for synaptosomal receptors. Arginine residues in positions 2 and 60 and the alpha amino group of Androctonus toxin I were derivatized by p-hydroxyphenylglyoxal; the corresponding modified toxins exhibit low pharmacological potencies. Tryptophan 38 of toxin II and tryptophan 45 of toxin III were modified by nitrophenylsulfenyl chloride, leading respectively to a poorly and a fully active derivative. The tetranitromethane modification of tyrosine residues in positions 60, 5 and 14 of toxin III induced respectively 60%, 40% and 30% of loss of biological activity. Circular dichroic analysis indicated that for every derivative, except the nitrophenylsulfenyl derivative of Trp-45 of AaH III, the conformation of the toxin was not altered by derivatization. Conformational integrity was also confirmed by full activity of the derivatives in radioimmunoassays. Taken together, the results suggest that aromatic residues belonging to the conserved hydrophobic surface, to the C-terminal and to the loop region 37-44 are involved in the molecular mechanisms by which scorpion alpha toxins act. Charged residues in the N-terminal and C-terminal also contribute to the high efficacy of the binding process. It appears that all important residues are clustered on one face of the toxin, suggesting a multipoint interaction with the proteins of the sodium channel. PMID- 2714291 TI - Effect of the microenvironment on the tertiary structure of cytochrome P-450 LM2. AB - The relation between microenvironment and the tertiary structure of cytochrome P 450 LM2 has been investigated. No complete relaxation to the most active state of the native enzyme took place in the case of membrane-incorporated hemoprotein with three or four intramolecular cross-links. The spatial organization of the enzyme was predicted to determine the cross-link location on the hemoprotein surface and membrane-incorporated parts of the polypeptide chain. It was concluded on the basis of the predicted structure that hemoprotein has an amphipathic structure and, thus, the greater part of molecule is exposed to the water phase. Not more than one NH2-terminal alpha helix is able to incorporate into the membrane. The location of this region is believed to control the formation of the catalytically-active-conformational state of cytochrome P-450 LM2. PMID- 2714292 TI - Studies on the active site of rat glutathione S-transferase isoenzyme 4-4. Chemical modification by tetrachloro-1,4-benzoquinone and its glutathione conjugate. AB - The active site of glutathione S-transferase isoenzyme 4-4, purified from rat liver, was studied by chemical modification. Tetrachloro-1,4-benzoquinone, a compound previously shown to inactivate glutathione S-transferases very efficiently by covalent binding in or close to the active site, completely prevented the alkylation of the enzyme by iodoacetamide, indicating that the reaction had taken place with cysteine residues. Both from radioactive labeling and spectral quantification experiments, evidence was obtained for the covalent binding of three benzoquinone molecules per subunit, i.e. equivalent to the number of cysteine residues present. This threefold binding was achieved with a fourfold molar excess of the benzoquinone, illustrating the high reactivity of this compound. Comparison of the number of amino acid residues modified by tetrachloro-1,4-benzoquinone with the decrease of catalytic activity revealed an almost complete inhibition after modification of one cysteine residue. Chemical modification studies with diethylpyrocarbonate indicated that all four histidine residues of the subunit are ethoxyformylated in an at least partially sequential manner. Modification of the second histidine residue resulted in complete loss of catalytic activity. Preincubation of the transferase with the glutathione conjugate of tetrachloro-1,4-benzoquinone resulted in 78% protection against this modification. However, glutathione itself hardly protected against the reaction with diethylpyrocarbonate. The intrinsic fluorescence properties of the enzyme were affected by covalent binding of tetrachloro-1,4-benzoquinone. The concentration dependency of the fluorescence quenching is strongly correlated with the inactivation of the enzyme, indicating that covalent binding of the benzoquinone occurs in the vicinity of at least one tryptophan residue. Finally, the binding of bilirubin, as measured by means of circular dichroism, was inhibited by preincubation of the enzyme with tetrachloro-1,4-benzoquinone in a manner which strongly correlated with the loss of enzymatic activity, the protection against inactivation by diethylpyrocarbonate, and the fluorescence quenching. All processes showed a 70-80% decrease after incubation of the enzyme with an equimolar amount of the benzoquinone. Thus, evidence is presented for the presence of a cysteine, a histidine and a tryptophan residue in, or in the vicinity of, the active site of the glutathione S-transferase 4 subunit. PMID- 2714293 TI - Purification and properties of 5,6-dihydropyrimidine amidohydrolase from calf liver. AB - 5,6-Dihydropyrimidine amidohydrolase was isolated from an acetone powder of calf liver and purified to homogeneity. Purification made use of heat treatment, ammonium sulfate fractionation and chromatography on Chelating Sepharose and DEAE Sepharose with 44% recovery of total activity. The native enzyme has a molecular mass of 217 kDa consisting of four subunits with a molecular mass of 54 kDa each. The amidohydrolase is a metalloenzyme containing one zinc atom/subunit. The enzyme can slowly be inactivated by chelating agents. The kinetic parameters for substrates, 5,6-dihydrouracil, 5,6-dihydrothymine and glutarimide were determined. From log Vmax/KM data, a pKa of 7.6 could be calculated suggesting the formation of a zinc-bound hydroxyl ion which carries out the nucleophilic attack on the C-4 of dihydrouracil. PMID- 2714294 TI - Purification and characterization of an oxygen-stable carbon monoxide dehydrogenase of Methanothrix soehngenii. AB - Carbon monoxide dehydrogenase was purified to apparent homogeneity from Methanothrix soehngenii. In contrast with the carbon monoxide dehydrogenases from most other anaerobic bacteria, the purified enzyme of Methanothrix soehngenii was remarkably stable towards oxygen and it was only slightly inhibited by cyanide. The native molecular mass of the carbon monoxide dehydrogenase of Methanothrix soehngenii determined by gel filtration was 190 kDa. The enzyme is composed of subunits with molecular mass of 79.4 kDa and 19.4 kDa in an alpha 2 beta 2 oligomeric structure. The enzyme contains 1.9 +/- 0.2 (n = 3) mol Ni/mol and 19 +/- 3 (n = 3) mol Fe/mol and it constitutes 4% of the soluble cell protein. Analysis of enzyme kinetic properties revealed a Km of 0.7 mM for CO and of 65 microM for methyl viologen. At the optimum pH of 9.0 the Vmax was 140 mumol of CO oxidized min-1 mg protein-1. The enzyme showed a high degree of thermostability. PMID- 2714295 TI - Molecular and immunological characterization of plastid and cytosolic pyruvate kinase isozymes from castor-oil-plant endosperm and leaf. AB - 1. Monospecific antiserum was raised in rabbits to homogeneous cytosolic pyruvate kinase isolated from 5-day-old germinating endosperm of the castor oil plant, Ricinus communis. An earlier study demonstrated that the purified enzyme is putatively heterotetrameric, composed of two subunits which migrate as 57-kDa and 56-kDa proteins upon sodium dodecyl sulfate/polyacrylamide gel electrophoresis [Plaxton, W. C. (1988) Plant Physiol. (Bethesda) 86, 1065-1069]. Both proteins were detected on Western blots of extracts prepared under denaturing conditions from 4-8-day-old, but not 0-3-day-old, germinating-endosperm tissue. This suggests that both subunits exist in vivo, and that the large increase in pyruvate kinase activity which occurs around the fourth day of germination is due to an increase in pyruvate kinase concentration. 2. The cytosolic and plastidic pyruvate kinase isozymes (termed PKc and PKp, respectively) from castor-oil-plant developing endosperm and expanding leaf tissue were separated by anion-exchange chromatography on Q-Sepharose. The antigenic reaction of the partially purified enzyme preparations to rabbit polyclonal antibodies raised against homogeneous germinating-castor-bean PKc was tested by immunoprecipitation and Western blotting. Although developing-endosperm and leaf PKc appeared to be antigenically very similar to germinating-endosperm PKc, they differed from the heterotetrameric germinating-endosperm enzyme by being composed of a single type of subunit with a molecular mass of about 56 kDa. No cross-reactivity of the PKc antibodies was observed with either developing-endosperm or leaf PKp, nor with rabbit muscle or Bacillus stearothermophilus pyruvate kinase. Conversely, none of the castor-oil-plant pyruvate kinase preparations showed significant cross reactivity with antibodies raised against purified yeast or rabbit muscle pyruvate kinases. 3. To investigate the structural relationship between the two germinating-endosperm-PKc subunits, each polypeptide was characterized by amino acid composition analysis and peptide mapping by CNBr fragmentation. The amino acid compositions and CNBr cleavage patterns of the two subunits were similar, but not identical, suggesting that these polypeptides are related, but distinct, proteins. Mild tryptic attack of native enzyme led to an approximate 6-kDa reduction in the apparent molecular mass of both subunits, further indicating sequence similarity between the two polypeptides. 4. Native molecular masses of the various castor-oil-plant pyruvate kinases were estimated by Superose-6 gel filtration chromatography.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2714296 TI - Bioluminescence emission of bacterial luciferase with 1-deaza-FMN. Evidence for the noninvolvement of N(1)-protonated flavin species as emitters. AB - The reaction of reduced 1-d-FMN with oxygen and decanal results in bioluminescence with kinetic and spectral properties similar to those of the reaction with FMNH2, even though the spectral (absorbance, fluorescence) and chemical properties of the oxidized forms differ greatly. This emission, which is about 10-15% as efficient as with FMNH2, is postulated to involve the intermediacy of the corresponding 4a-hydroperoxide, the fluorescence of which occurred transiently. The N(1) protonated species had been proposed as the emitter in the reaction with FMNH2, but the 1-deaza analog cannot be protonated at the corresponding position, thus excluding this possibility. PMID- 2714297 TI - Mycolic acid metabolic filiation and location in Mycobacterium aurum and Mycobacterium phlei. AB - Synchronous cultures of Mycobacterium aurum were used to prove a close relationship between cellular division and active synthesis of mycolic acids (characteristic long-chain 3-hydroxyacids, branched at position 2), confirming previous proposals. Mycolic acid biosynthesis was studied in two species (Mycobacterium phlei and M. aurum) each producing three types of mycolic acids: di-unsatured mycolates, oxomycolates and wax-ester mycolates (ester of dicarboxymycolic acid and 2-icosanol or 2-octadecanol). It was shown that unsaturated mycolates and oxomycolic acids were not directly related, whereas a metabolic filiation was confirmed between oxomycolate and wax ester mycolate: the latter derived from the former by a Baeyer-Villiger oxidation step, as has been proposed on the basis of structural considerations. By observing the labelling of the different mycolate pools in the cell, i.e. the organic-solvent-extractable fraction (essentially containing esters of trehalose and of glycerol) and the cell residue (assumed to be the cell-wall polymers), it was clear that oxomycolates and unsaturated mycolates appeared first in the extractable lipids, then in the wall-linked mycolates while wax-ester mycolates appeared first as wall-linked derivatives. Thus, it is proposed that mycolates could follow separate routes involving differently located enzymes to reach their complex forms either in extractable lipids or in the wall-linked arabino-galactan. PMID- 2714298 TI - Solubilization and reconstitution of the sodium-and-chloride-coupled glycine transporter from rat spinal cord. AB - Synaptic membranes from rat spinal cord were solubilized in the presence of 2% sodium cholate, phospholipids and 15% ammonium sulphate. The soluble extract was incorporated into liposomes consisting of asolectin and crude rat brain lipids. Reconstitution of the functional transporter protein was achieved by removal of detergent by gel filtration. Several parameters proved to be important for optimal reconstitution efficiency: (a) the lipid composition of the liposomes, (b) the type of detergent, and (c) the phospholipid/protein and detergent/protein ratio during reconstitution. In the reconstituted system, the transport of glycine showed a specific activity about twice that of native vesicles. The ionic dependence of the transport, the inhibitory effect of nigericin in the presence of external sodium and the stimulatory effect of valinomycin in the presence of internal potassium on glycine transport were preserved and more clearly observed in the reconstituted system. These results indicate that, in this preparation, the glycine transporter protein retains the same features displayed in the synaptic plasma membrane vesicles, namely dependence on sodium and chloride, electrogenicity and inhibitor sensitivity. PMID- 2714299 TI - Left ventricular performance during psychological stress. AB - Left ventricular ejection fraction, systolic blood pressure and plasma norepinephrine were measured in six normotensive and six mildly hypertensive subjects during rest and psychological stress. Compared with rest, 8 of the 12 subjects developed significant (P less than 0.05) changes in ejection fraction (increase in 6, decrease in 2); 10 of 12 subjects developed significant elevations of plasma norepinephrine; and all developed significant increases in systolic blood pressure. When the stress effects were examined for the total group, as opposed to within subjects, there were significant increases in plasma norepinephrine (P less than 0.001) and systolic blood pressure (P less than 0.001) but, interestingly, mean ejection fraction and stroke volume remained unchanged, implying stress led to increased left ventricular contractility. PMID- 2714301 TI - Uptake of 99mTc-phytate in osteosarcoma cases. AB - During routine liver spleen scintigraphic studies using 99mTc-phytate in patients with proven osteosarcoma, an unusual uptake of this radiopharamaeutical at the primary site was observed. In all, five cases have been investigated and we have observed the uptake of 99mTc-phytate at the primary tumor site. Early and delayed imaging showed persistant concentration of the radiopharmaceutical. Studies with 99mTc-sulfur colloid in one of the patients did not show any uptake at the tumor site. PMID- 2714300 TI - The relationship between 67Ga accumulation and ATP metabolism in tumor cells in vitro. AB - Previously, we reported that the deposition of 67Ga into malignant tumors may be a sensitive index of proliferative activity in tumor cells. For the purpose of elucidation of this hypothesis, we investigated the relationship between the accumulation of 67Ga into malignant tumor cells and the intra cellular ATP metabolism in vitro. The uptake of 67Ga into tumor cells was inhibited by adding NaF which is an inhibitor of ATP production. Furthermore, the uptake of 67Ga into tumor cells was strongly inhibited by adding ouabain which is a specific inhibitor of Na+-K+-ATPase. From these in vitro results, it was concluded that there is a correlation between 67Ga uptake and intra cellular ATP metabolism in tumor cells. PMID- 2714302 TI - Quantitative aspects of factor analysis in nuclear cardiology. PMID- 2714303 TI - Comments to "Quantitative Lymphoscintigraphy". PMID- 2714304 TI - Reply to the letter of T. White and P. Wollmer. PMID- 2714305 TI - Second interim report of the nation-wide collaborative study on the long-term effects of bromocriptine in the treatment of parkinsonian patients. AB - The interim data obtained up to the end of the 2nd year of the nation-wide multicentric cooperative study on the long-term effects of bromocriptine in parkinsonian patients revealed the following results. Firstly, the bromocriptine monotherapy could be continued in about 40% of the patients at the mean maintenance dose of 10.8 mg daily. Secondly, the additional use of bromocriptine in parkinsonian patients already treated with levodopa had a favorable influence on late side effects of levodopa such as on-off phenomenon and dyskinesia. No significant difference has been found so far as to the management of the wearing off phenomenon between the patients with levodopa alone and those with levodopa and bromocriptine. PMID- 2714306 TI - Magnetic resonance imaging and extrapyramidal movement disorders. AB - High-field strength magnetic resonance imaging is an accurate clinical technique for detecting the relative distribution of ferritin in the brain. In normal adults, iron is found in highest concentrations in the globus pallidus, red nucleus, pars reticulata of the substantia nigra, and dentate nucleus of the cerebellum; its distribution is clearly mapped as signal hypointensity (darkness) on a T2-weighted image due to local-field heterogeneities produced by ferritin. Iron is absent at birth and increases in concentration in the putamen in the elderly. Poorly drug-responsive Parkinson's disease (multiple-system atrophy) is characterized by premature signal hypointensity in the putamen and caudate, while Hallervorden-Spatz disease exhibits abnormal hypointensity in the globus pallidus in children. Dyskinetic disorders often have abnormal signal hyperintensity (whiteness) in the putamen related to gliosis. PMID- 2714307 TI - Magnetic resonance imaging in detecting acute oedematous and haemorrhagic pancreatitis: an experimental study in pigs. AB - The present study was undertaken to evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of pancreatic inflammation. It was focused on the use of ultra-low- and low-field MRI imagers because of the good results achieved with them in detecting intracranial oedema and haemorrhage. In addition, there are 16 ultra-low-field MRI imagers in clinical use in the world. Nineteen piglets were examined by computed tomography (CT) and then by two MRI prototype imagers operating at 0.02 and 0.17 T. The level of the pancreas was selected on CT. Oedematous pancreatitis was induced in 9 animals by intraductal injection of autologous bile and haemorrhagic form in 7 animals by intraductal injection of 15% Na-taurocholate-trypsin with simultaneous intravenous secretin injection. After 6 or 24 h the animals were re-examined by both CT and MRI. The results show that haemorrhagic-necrotizing pancreatitis can well be differentiated from oedematous pancreatitis by CT. On MRI using an ultra-low or low magnetic field the pancreas was difficult to identify and the different forms of pancreatitis could not be differentiated. Thus, at present CT with or without contrast enhancement is superior to ultra-low-field MRI in detecting and estimating the severity of acute pancreatitis. Further progress in the MRI techniques probably improves the results in the future. PMID- 2714308 TI - Studies on the dose dependence of endotoxin-induced in vitro activation of the complement system. AB - The dose and time dependence of in vitro endotoxin-induced activation of complement was studied in citrated pool plasma at 37 degrees C. C3 activation fragments (C3act) and the fluid-phase terminal complement complex (TCC) were used as indicators of initial and terminal activation, respectively. At 1 h marked elevation of C3act and TCC were found in plasma tested with the highest doses of endotoxin (2.10(9) and 2.10(8) ng/l). In test plasmas with 2.10(7) and 2.10(6) ng/l of endotoxin, no sign of activation was seen during the first 4 h, whereas both C3act and TCC values were increased at 12 h. In thest plasma with 2.10(5) ng/l of endotoxin and in control plasma no elevation of TCC values were seen during the observation period (24 h), whereas C3act values increased slightly and to the same extent in both at 24 h. Parallel to the increases in C3act and TCC concentrations, the functional C1 inhibitor (C1INH) values decreased. Changes in C1INH values, however, occurred with a time lag of approximately 6 h compared to the increases in C3act and TCC. Our in vitro study showed a dose-dependent endotoxin-induced activation of both the initial and the terminal part of the complement cascade evaluated by C3act and TCC. PMID- 2714309 TI - Acute ischemic liver failure in the rat: a reproducible model not requiring portal decompression. AB - We report a model of acute ischemic liver failure which does not require temporary or permanent portal decompression. The model is induced by segmental ischemia of the median and left lateral lobes for 100 min by a vascular clamp applied on the afferent vessels. Declamping is followed by resection of the nonischemic right lateral and caudate lobes. No portal stasis occurs as blood flow to the right lateral and caudate lobes is maintained during the period of clamping. The 24-hour mortality is 76.5%. Evidence of severe liver damage is shown by histological and biochemical studies. PMID- 2714310 TI - Wolf Piezolith 2200 versus the modified Dornier HM3. Efficacy and range of indications. AB - From February to September 1987, a prospective study was performed at two clinics to compare the Piezolith and the Dornier HM3+ lithotripters. Based on the same clinical indications for extracorporeal shock wave lithotripsy, 334 patients were treated with the Dornier HM3+ and 378 patients with the Piezolith. Whereas stone size was similar in both groups, more ureteral calculi were treated with the Dornier HM3+ (31.1 versus 23%). The rate of successful disintegration and total number of auxiliary measures were similar in both groups. However, the mean number of impulses (HM3+ 1,997 versus Piezolith 2,855) and number of secondary ESWL treatments (HM3+ 15.5% versus Piezolith 45%) differed significantly. According to the locating systems, the success of in situ treatment was similar for renal calculi; however, fewer ureteric stones could be treated in situ at the Piezolith (HM3+ upper ureter 70.6%, middle ureter 82%, distal ureter 71.4% versus Piezolith upper ureter 37.5%, middle ureter 0%, distal ureter 62.8%). The stone free rate at discharge and after 3 months did not differ in both centers (HM3+ 75% versus Piezolith 72%). PMID- 2714311 TI - Painless extracorporeal shock wave lithotripsy for outpatients: a new option. AB - Extracorporeal shock wave lithotripsy is becoming the most common procedure for the treatment of renal and ureteral stones. The introduction of a new generator and a new hemi-ellipsoid for the Dornier HM-III lithotripter improves patient comfort and requires no general or peridural anesthesia, thus making it easier to perform this procedure on an outpatient basis. PMID- 2714312 TI - Urine from continent caecal reservoirs. Studies on chemical composition and bacterial growth. AB - The composition of urine from 11 patients with continent caecal reservoir was examined with regard to promotors and inhibitors of bacterial growth, and was compared with that of urine from individuals (controls) with intact urinary tracts. Reservoir urine was found to have a higher and less variable pH than control urine. The concentration of urea was lower in reservoir urine, probably due to the larger 24-hour urinary output, while the concentration of albumin was higher. Although these findings could suggest reservoir urine to be a more favourable medium for bacterial growth than normal urine, such a difference was not found in growth studies of common urinary pathogens. The increased prevalence of urinary tract infection in patients with caecal reservoir may be due to contamination on catheterization, residual urine and defective function of the reservoir outlet rather than differing qualities of the urine. PMID- 2714313 TI - Clinical observations on fertile males with varicocele. AB - During the clinical observation of 32 fertile cases with varicocele interesting findings were made. Normal semen, a sperm density above 40 million/ml and a motile sperm rate of over 60% were observed in 46.9% of the cases. Furthermore, a sperm density of more than 40 million/ml was found in 75% and a motile sperm rate of more than 50% was detected in 81.3%, indicating normal or adequate spermogram data. A difference in right-left testicular size was recognized in 35.5% (11 cases). Only 2 of the cases had oligospermia and 9 cases had normospermia. Two cases had low testosterone values and low motile sperm rates were also detected. Secondary infertility occurred in 33.3%. In 25% of the cases, scrotal scintigraphy revealed an accumulation of high radioactivity indicating venous blood pooling over the affected site in the early phase of dynamic images. In the other cases, different venous flow characteristics were detected visually. PMID- 2714314 TI - Immunoprophylaxis with Calmette-Guerin bacillus in recurrent superficial bladder tumors. AB - 26 patients with superficial bladder cancer underwent complete removal of tumors by transurethral resection and entered a prospective trial of immunoprophylaxis with Calmette-Guerin bacillus (BCG). The entire group had recurrent tumors that failed to respond to previous prophylaxis with thiotepa (13 patients) or other drugs (13 patients). Intravesical administration of BCG reduced the recurrence index and increased the disease-free interval. Side effects were mild and well tolerated. BCG seems to be effective in the prophylaxis of superficial bladder tumor recurrence after the failure of other drugs. PMID- 2714315 TI - Combined percutaneous and transurethral approach to stenoses of the ureteral meatus after transurethral resection for bladder tumor. AB - A stenosis of the ureteral meatus may result from transurethral resection (TUR) for bladder tumor. Open reconstructive surgery is not recommended because of possible tumor implantation. Preservation of the renal function is the main goal, particularly when chemotherapy with nephrotoxic drugs is planned. Moreover, the patency of the vesicoureteral junction has to be preserved to allow regular inspection of the upper urinary tract for urothelial tumor. The first measure is decompression by nephrostomy. After antegrade cannulation of the stenotic ureteral meatus, a ureteral stent is left for several weeks prior to transurethral meatotomy, which is also followed by stenting for 6 weeks. The retrograde approach will fail more frequently. Sixteen ureteral meatal stenoses were treated in 11 patients. The vesicoureteral junction was permanently restored in about 50%, even when it had not only been injured by one or several TURs, but also by the preceding radio- and chemotherapy. PMID- 2714316 TI - Relationship between the frequency of piezoelectric shock waves and the quality of renal stone fragmentation. In vitro study and clinical implications. AB - Nine renal stones were separated into 5 fragments of similar weight and size. One fragment was analyzed chemically and the other 4 fragments were submitted to treatment by piezoelectric shock waves according to the following modalities: 3,000 shock waves at firing frequencies of 1.25, 2.5, 5 and 10 shock waves/s. In the case of hard stones, better quality fragmentation was obtained with low frequencies than with high frequencies. With friable stones, using only 800 shock waves, the result was the same regardless of the frequency used. Treatment of hard stones by shock waves for 20 min at various frequencies revealed that a slightly better result was obtained with a frequency of 5 shock waves/s, although the result was not significantly better. In conclusion, slow frequencies of 1.25 or 2.5 shock waves/s allow better fragmentation of hard stones at the cost of a longer mean treatment than at high frequencies. High frequencies do not give significantly better results than low frequencies when the same firing time is used. In the clinical situation, it is therefore preferable to use low frequencies which allow treatment without anesthesia or analgesia and without admission to hospital. PMID- 2714317 TI - Comparative study of 24-hour urinary excretion of glycosaminoglycans by renal stone formers and healthy adults. AB - In order to find out the possible aetiological factors for urolithiasis in North Western India, an endemic region for urinary calculi, we studied the 24-hour urinary excretion of glycosaminoglycans (GAGs), inhibitors of calcium oxalate crystallisation and/or crystal aggregation, in 58 healthy adults and in 100 stone formers. GAGs were colorimetrically estimated in urine in terms of glucuronic acid content after precipitation of GAGs by cetyl pyridinium chloride. The 24 hour urinary excretion of GAGs was significantly less in stone formers as compared to healthy adults (15.32 +/- 6.94 vs. 22.44 +/- 5.54 mumol/day; p less than 0.001). There was no significant difference in the 24-hour urinary excretion of GAGs between male and female stone formers, or between male and female healthy adults. There was no correlation between age and 24-hour urinary excretion of GAGs in any of the groups. In conclusion, 24-hour urinary excretion of GAGs is significantly less both in male and in female stone formers. The 24-hour urinary excretion of GAGs is not related to age or sex in both healthy adults as well as in stone formers. PMID- 2714318 TI - Standardized estimate of the ion activity product of calcium oxalate in urine from renal stone formers. AB - An estimate of the ion activity product of calcium oxalate [AP(CaOx) index(s)] was calculated for a standardized 24-hour urine volume of 1,500 ml. AP(CaOx) index(s) was higher in stone formers than in normal subjects and higher in men than women. There was a good correlation between AP(CaOx) index(s) and our previously described CaOx risk index. AP(CaOx) index(s) might be particularly useful for comparison of different groups of patients as well as for comparison of men and women. It can be assumed that such an index will be very useful for evaluation of patients with short-term urine collections. PMID- 2714319 TI - In vitro chemosensitivity assay of human urologic malignancies. AB - An attempt was made to detect the chemosensitivity of fresh specimens of urologic malignancies using a liquid medium culture assay and an agar cloning assay. The sensitivity of cells to anticancer drugs was divided into five grades according to the ratio of cytotoxicity: 0 (0%); 1 (1-25%); 2 (26-50%); 3 (51-75%), and 4 (76-100%). Among the urothelial cancers (36 cases), the sensitivity grade was on the average 2.05 with cisplatin, 2.11 with doxorubicin, 1.49 with endoxan, 1.46 with methotrexate and 1.79 with thiotepa. Higher grade tumor specimens have higher sensitivity to anticancer drugs than lower grade tumor specimens, but there was no correlation between clinical stages and drug sensitivity. Three of 36 cases (8.3%) of transitional cell carcinoma showed complete drug resistance. Simultaneous agar culture clonogenic assays were performed in 7 cases, the results of which were similar to those of the liquid culture method. Three major drawbacks of clonogenic assay are that it is time-consuming, difficult to count, and easy to contaminate. Among 16 cases of kidney tumors, the highest response rate was to thiotepa (2.0) and lowest to endoxan (1.4). No correlation between clinical stage and drug sensitivity could be found. The other five miscellaneous cases all demonstrated moderate sensitivity to those anticancer drugs. PMID- 2714320 TI - New method of postprostatectomy bladder irrigation. AB - Bacterial filters have been used to sterilise the hospital water supply in order to provide irrigant for postprostatectomy irrigation. This method was compared retrospectively to bladder irrigation derived from a still on the ward. Postoperative bacteriuria was similar in both groups of 75 patients, occurring in 23.7% of patients irrigated from the still and in 20% of patients irrigated via the filters. The bacterial filter proved reliable and as safe as using water from the still. PMID- 2714321 TI - A safe surgical technique for the infradiaphragmatic removal of caval tumor thrombus complicating renal cell carcinoma. AB - The management of patients with renal cell cancer extending to the vena cava is controversial and challenging. Careful planning of the operative procedure, adequate exposure, complete mobilization of the retrohepatic vena cava and control of the hepatic venous effluence will allow patients with retrohepatic vena caval occlusions to be managed safely and successfully. The major advantage of this technique is the minimizing of both peroperative bleeding and circulatory and biochemical disturbances of the liver due to the interruption of the blood flow. PMID- 2714322 TI - Revascularization of the right ischemic kidney by gastroduodenal artery. AB - Hepatorenal bypass can successfully accomplish revascularization of the right renal artery when the aorta or the iliac vessels cannot be used for a standard renal bypass or renal autotransplantation. The use of the hepatic circulation can be increased by the gastroduodenal to renal artery bypass procedure. Herein we report a clinical case of severe hypertension in a patient with a solitary functional kidney and an extensive atheromatous alteration of the aortoiliac segment. It has been corrected by means of a gastroduodenal end-to-side renal saphenous vein bypass graft. PMID- 2714323 TI - Extracorporeal shock wave lithotripsy for urinary stone disease: clinical experience with the electromagnetic lithotriptor 'Lithostar'. AB - 400 urinary stone patients were treated with the electromagnetic lithotriptor Siemens 'Lithostar': 66.3% had renal stones and 33.7% had ureteral stones. Ninety percent of the treatments were performed under intravenous sedation only: 14.5% of the patients had more than one session. After 3 months more than 80% of the patients with a single stone smaller than 1.5 cm and 46% of the patients with stones larger than 2.5 cm were 'stone-free'. PMID- 2714324 TI - Primary testicular manifestation of systemic lupus erythematosus. AB - The case of a patient with a hitherto unknown primary testicular manifestation of systemic lupus erythematosus (SLE) is reported. Findings on scrotal palpation and sonography suggested the presence of a testicular tumor. Histological examination of the testicular biopsy and immune status did not confirm the clinical diagnosis but demonstrated SLE. PMID- 2714325 TI - Vaginal metastasis from renal cell carcinoma: the role of electron microscopy. AB - A case of vaginal metastasis from a renal cell carcinoma is reported. This rare localization is often the first clue leading to the diagnosis of an occult renal adenocarcinoma. The role of electron microscopy is emphasized, since the histologic aspect of the lesion is similar to that of a primary vaginal mesonephric adenocarcinoma. PMID- 2714326 TI - Oncocytoma and low-grade oncocytic carcinoma of the kidney. AB - Oncocytoma is a term generally used to describe a neoplasm of the renal parenchyma consisting of well-differentiated cells with prominently eosinophilic granular cytoplasm. We report our experience with such tumors and with 4 cases of granular cell carcinoma (grade 2). We present the histopathology, surgical staging studies, treatment, and clinical outcome. Of the 10 patients, 7 are alive without evidence of tumor at a mean follow-up of 5 years from the initial treatment. Three patients have died, 2 from nontumor-related causes while the cause of death of the third patient is uncertain, possibly due to the tumor. Although well-differentiated oncocytic renal tumors are usually considered as uncommon when the diagnosis is made, nonaggressive behavior is expected. However, careful radiographic and pathologic examination is required to avoid the pitfall of overlooking a higher-grade, more lethal neoplasm which may be mixed with the well-differentiated oncocytic neoplasm and form a minority component. A wide resection, which in most cases is nephrectomy, is apparently curative and assures that complete pathological examination of the specimen can be accomplished. In more than 90% of the cases, the tumor is solitary and unilateral. Cases in which there are multiple tumors are often bilateral, and this finding may create diagnostic confusion. PMID- 2714327 TI - Electrohydraulic lithotripsy for stones in Kock pouch. AB - During endoscopy of the Kock pouch, we found rather large stones in the pouches of 3 male patients 14-23 months after operation. The size of the stones varied from 1.5 to 3.5 cm. Because the stones in the pouch were too large to be extracted using forceps, for fear of damaging the efferent nipple valve, electrohydraulic lithotripsy (EHL) was applied and all stones could be broken down and removed easily. No complication occurred during or after EHL. Topical anesthesia was not necessary in all 3 patients. Usually the stones formed around staples. The major component of the stones was struvite. Urease-secreting bacteria as well as alkaline urine were found in all 3 patients. This result suggested that though EHL was used in an intestinal milieu (instead of urothelial bladder), it was an easy, safe and effective procedure for the removal of rather large stones (greater than 1.5 cm) from the Kock pouch. We suggest endoscopy of the Kock pouch at least once every 6 months or when stones have been demonstrated on plain X-ray of the abdomen. Stones in the pouch larger than 1.5 cm could be removed using EHL to avoid damaging the efferent nipple valve. PMID- 2714328 TI - Extent of surgery in rhabdomyosarcoma of urogenital structures. AB - After high inguinal semicastration in group-1 paratesticular rhabdomyosarcoma (RMS), the patient having undergone chemotherapy can be followed closely by CT scanning without retroperitoneal lymphadenectomy. In contrast, retroperitoneal RMS should be operated on as radically as possible after downstaging the tumor mass. In RMS of the female genitalia locally limited organ-preserving surgery is the method of choice. The prognosis is excellent with adjuvant chemotherapy. Only 20% of all bladder RMS arise from the bladder dome or the movable part of the bladder, where primary partial resection including a safety margin of 3 cm of healthy tissue is possible. The majority, however, arising from the submucous tissue of the bladder base, trigonal area and bladder neck, infiltrates the prostatic urethra and the surrounding pelvic fascia. Therefore differentiation between primary bladder or prostate RMS is often doubtful. The current strategy of downstaging by chemotherapy or chemo-radiotherapy followed either by limited organ-preserving surgery or by a wait-and-see policy includes the high risk of residual tumor or local tumor recurrence, which has proved to have the worst prognosis of all. As organ-preserving therapy was recommended as the method of choice, mainly to avoid anterior pelvic exenteration and urinary diversion, the question of advantages in comparison to the risk of tumor recurrence is still open. The routine use of chemoradiotherapy and increasing follow-up has called attention to a variety of chronic sequelae, such as contracted bladders with reduced capacity and upper urinary tract deterioration, which subsequently require secondary urinary diversion. Progress in continent urinary diversion may be an alternative procedure for better life quality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714329 TI - Autoinjection of corpus cavernosum with papaverine: a practical application device. AB - A new device for the autoinjection of papaverine into the corpus cavernosum for the treatment of impotence is described. Its use is much easier than conventional tuberculine syringes. PMID- 2714330 TI - Improved technique of tubeless cutaneous ureterostomy and results of permanent urinary diversion. AB - An improved technique of tubeless cutaneous ureterostomy through a single stoma was devised by modifing the traditional cutaneous ureterostomy. Using this method, urinary diversions were performed on 12 cases with malignancies: 6 had radical cystectomy and the other 6 had pelvic exenteration. Normal bilateral ureters were observed in 11 cases in preoperative intravenous pyelography. Stomal stenosis was found in 1 case (8.3%) requiring operative stomal revision. Generally satisfactory results were obtained. This method could lower the incidence of complications. A long-term follow-up is needed, but 2 cases who have survived for more than 4 years since the operation have shown excellent results. It was thought that it would be difficult to perform tubeless cutaneous ureterostomy on normal-sized ureters, but our clinical results indicate that this method may be able to provide permanent urinary diversion. PMID- 2714331 TI - Transplant of a pediculate segment of vas deferens. Experimental study. AB - A new surgical technique has been used on white New Zealand rabbits. A segment of vas deferens was transplanted to the contralateral deferens with the intention of improving treatment for certain cases of infertility caused by obstruction. Evaluation of the technique was carried out by repeated seminograms, deferentovesiculography and histological studies of the transplanted deferens segment and the corresponding testicle. The viability of this surgical technique has been shown using the rabbit as an experimental specimen. PMID- 2714332 TI - Stone formation and urine composition in calcium stone formers without medical treatment. AB - A retrospective estimate of the annual rate of stone formation (fSF) was obtained in only 154 (35%) of 438 patients without medical treatment at our out-patient stone clinic. Eighty-three of these patients had never been on any prophylactic treatment and were only given advice concerning drinking and dietary habits. There was a high calcium excretion in 46%, high oxalate in 17%, low citrate in 11%, low magnesium in 17%, and increased urate in 16% of the patients. As much as 25% had a 24-hour urine volume below 1,000 ml. There was a good correspondence between stone formation during the follow-up period (tT) and a period of the same length following diagnosis (tA). The mean (+/- SD) tT was 3.2 +/- 1.9 years, with an fSF of 0.19 +/- 0.43. During the tA period fSF was 0.13 +/- 0.31. The number of patients who formed new stones during these periods were 21 and 22, respectively. It is suggested that stone formation during tT and tA advantageously might be used for preliminary evaluation of the therapeutic response. The risk of forming a urine highly supersaturated with calcium oxalate was expressed in terms of a standardized AP(CaOx) index calculated for a 24-hour urine volume of 1,500 ml. There was no relationship between this AP(CaOx) index and fSF. When only those patients were considered who formed new stones during the first 10 years after diagnosis, slightly higher values of the standardized AP(CaOx) index were recorded than in the recurrence-free group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714333 TI - Urethral caruncle in an unusual location occurring in prepubertal girl. AB - Urethral caruncles are the most frequent benign tumors of the female urethra; the great majority occur after the menopause. Caruncles in prepubertal girls are quite rare and location other than the posterior lip of the urethra is quite rare too. In this paper we report a case with these rare properties. PMID- 2714334 TI - Bilateral traumatic renal artery rupture: emergency surgical repair and long-term evolution. AB - In one case of bilateral traumatic renal artery rupture, the role of clinical and radiographic explorations is discussed to reduce the duration of renal ischemia. The diagnosis of bilateral traumatic renal artery rupture requires the performance of pyelography if the patient is oliguric or exhibits microscopic hematuria, or of conventional aortography if there is no renal secretion. Renal artery repair must be done as soon as possible, but a review of the literature shows that delay in treatment is not rare. Everything must be done to reduce this delay in order to improve renal function after surgery. PMID- 2714335 TI - Inside-out kidney: unilateral herniation. Complication of cutaneous pyelostomy. AB - A case of unilateral kidney herniation through a cutaneous pyelostomy stoma is reported. Our purpose is to point out the likely causes of this complication and its correction. PMID- 2714336 TI - The significance of bladder quadrant biopsies in patients with primary superficial bladder carcinoma. AB - The prognostic significance of dysplasia (D I-III, Tis) based on bladder quadrant biopsies was established in 216 patients with primary urothelial carcinoma of the bladder (stage pTaGI-pTGIII). Collectively within the study, 51 of the 216 patients biopsied (24%) were found with abnormal urothelium. Twelve (6%) have coexistent Tis, and 30 (18%) were found with dysplastic changes D I-III. Further concerns included the incidence of dysplastic changes associated with tumor invasion, tumor dedifferentiation, and the presence of primary multifocal disease. The collective recurrence rate was 43%. However, with inclusion of quadrant biopsies, the predictability of positive biopsy results increased to 63% and the negative rate decreased to 37%. PMID- 2714337 TI - Single-stage salvage cystectomy: results and complications in 20 patients. AB - Twenty patients with bladder carcinoma underwent total cystectomy and one-stage urinary diversion after a definitive external radiotherapy. The indication for surgery was a persistent or locally recurrent tumor and/or intractable voiding symptoms. There was no operative mortality. Early or late complications occurred in 14 patients (70%) and in 7 of these cases a reoperation was necessary. The overall 5-year survival rate after the operation was 61%. The prognosis of the patients was dependent on the pathological stage of the tumor in cystectomy specimens. PMID- 2714338 TI - Characterization of cisplatin-resistant COLO 316 human ovarian carcinoma cells. AB - The biochemical changes responsible for acquired resistance to cisplatin (DDP) are not fully understood. We have developed DDP-resistant sublines of COLO 316 human ovarian carcinoma cells in vitro and characterized a number of biochemical features of these cells. Following selection with either continuous 50 nM DDP (COLO/DDP50 cells) or intermittent 1 microM DDP (COLO/B, COLO/C, or COLO/D cells) the onset of resistance was rapid. The resistance of the COLO/B cells gradually fell from 14-fold to 5-fold over 6 months in drug-free media. Both selection procedures produced cells exhibiting broad cross-resistance to other platinum analogs, natural products and alkylating agents. There was no significant change in the growth rate (doubling time = 36 h, cloning efficiency (28%), protein content (0.55 mg/10(6) cells), or morphology of these cells. Cell cycle distributions of log-phase cells were similar (60% G0/G1, 35% S, 5% G2/M) as determined by flow cytometry. Glutathione (GSH) levels, while not elevated in COLO-B cells at low levels of resistance (2-3-fold), were 30% elevated at higher levels of resistance (9-fold). However, GSH levels in COLO/DDP50 cells with 13 fold resistance were 2.3-fold elevated. The resistance of both cell types could be partially reversed by extended depletion of GSH with D,L-buthionine-S,R sulfoximine. COLO/D cells had a 48% decrease in DDP accumulation at 1 h while COLO/DDP50 cells had no change in DDP accumulation. The cross-resistance profiles, GSH biochemistry and DDP accumulation data indicate that acquired DDP resistance is a complex, multifactorial response in these cells. The specific combination of mechanisms expressed in these cells appears to depend upon the selection procedure. PMID- 2714339 TI - Phase I studies of rodorubicin single bolus and daily times five, once every three weeks in patients with advanced solid tumors. AB - Rodorubicin (Cytorhodin S, HLB 817) is a new tetraglycosidic anthracycline with interesting preclinical antitumor activity. We have performed two sequential phase I studies with the drug. In the first study Rodorubicin was administered as a single i.v. administration over 30-360 min, once every 3 weeks. The second study concerned a daily times five i.v. bolus schedule. Thirty patients entered these studies. Regardless of schedule, the dose limiting toxicity appeared to be proteinuria, which was reversible after discontinuation of the drug. Phlebitis was a cumbersome side-effect and it was initially considered to determine the MTD in the once every 3 weeks schedule, but finally it could be prevented by giving the drug as a bolus injection into a rapidly running infusion. Nausea and vomiting were infrequent and mild. Neither myelotoxicity nor alopecia were observed. However, even at low cumulative doses the drug was found to be cardiotoxic using both schedules of administration. Seven out of 12 patients developed grade 1-3 cardiotoxicity, most of them above a cumulative dose of more than 4000 micrograms/m2. These side-effects preclude a dose recommendation for phase II studies with these schedules. PMID- 2714340 TI - Doxorubicin-anti-carcinoembryonic antigen immunoconjugate activity in vitro. AB - An in vitro model consisting of a series of 11 human cancer cell lines with varying density of expression of membrane carcinoembryonic antigen (CEA) has been used to evaluate conjugates of doxorubicin (Adriamycin) covalently linked by a carbodiimide method to goat polyclonal antibodies and mouse monoclonal antibodies to CEA. Conjugates were produced which retained both antigen binding and drug cytotoxicity. IC50 values were determined for free drug, free drug mixed with unconjugated antibodies and for the immunoconjugates. Cell lines that were very sensitive to free drug (IC50 less than 100 ng/ml) were also found to be highly sensitive to conjugated drug and similarly cell lines resistant to drug (IC50 greater than 1,000 ng/ml) were also resistant to conjugated drug. Although there was no correlation between CEA expression and conjugates efficacy, competitive inhibition studies using autologous antibody to block conjugate binding to cells indicated immunoconjugates specificity for the CEA target. PMID- 2714341 TI - Immunocytochemical determination of the estrogen-regulated protein Mr 24,000 in primary breast cancer and response to endocrine therapy. AB - Monoclonal antibodies against an estrogen-regulated Mr 24,000 cytosol protein (p24) were used for immunocytochemical localization of p24 in formalin-fixed paraffin-embedded specimens from the primary tumor in 103 patients who received endocrine therapy for advanced breast cancer. Sixty-one per cent of the tumors showed p24-positive staining, and this correlated well with the presence of estrogen receptor (ER) (P = 0.00017, chi-square test). Response to endocrine therapy was obtained in 43% of the patients. A statistically significant association between p24 status and response could not be established, while response and ER status were highly correlated (P = 0.0000029, chi-square = 21.6). Discrimination between ER-positive responders and ER-positive non-responders was not possible using p24 staining. PMID- 2714342 TI - Phase II study of tauromustine in disseminated malignant melanoma. AB - Forty-seven patients with metastatic malignant melanoma took part in a phase II trial of tauromustine (TCNU), a new chlorethylnitrosourea based on the endogenous amino acid taurine. TCNU was given orally at a dosage of 130 mg/m2 every fifth week. No patient had previously received cytotoxic therapy. Among 37 evaluable patients, 26 patients experienced progressive disease including seven patients with early death, five showed no change, and six partial responses, yielding an objective response rate of 16%. Responses were limited to subcutaneous, lymph node, bone and lung metastases. Median time to progression was 26 weeks for responders. The treatment schedule was well tolerated with a median dose of 88% of the predicted dose given during all cycles. Dose-limiting toxicity was thrombocytopenia. It appears that TCNU is active in disseminated malignant melanoma with a response rate similar to other nitrosoureas. PMID- 2714343 TI - Ten-year nodular sclerosis Hodgkin's disease and second malignancies. AB - Hodgkin's disease is one of the most curable cancers thanks to progress in radiotherapy and multi-drug chemotherapy regimens such as mechloretamine vincristine-procarbazine-prednisone, best known as MOPP. However, long-term side effects and treatment-induced second malignancies are of great concern. In our institution, 69 patients with nodular sclerosis Hodgkin's disease were treated over 10 years. Twenty-two per cent were stage I, 49% stage II, 23% stage III and 6% stage IV. Actuarial 10-year survival was 83% and actuarial relapse-free survival 61%. Six patients developed a second malignancy with a 10-year actuarial risk of 18%. All six cases occurred in the group treated with MOPP and extensive radiotherapy. Acute non-lymphoblastic leukemia occurred in three patients, preleukemia in two and non Hodgkin's lymphoma in one. In all of these patients, the results were quite poor. Overall survival was equally affected by Hodgkin's disease and by second malignancies. Since new multiple-drug chemotherapy regimens such as adriamycin-bleomycin-vinblastine-dacarbazine, known as ABVD, are equally effective and seem less likely to induce second hematologic malignancies, we suggest that MOPP should no longer be used as a first choice for the treatment of Hodgkin's disease, especially when in combination with radiation therapy. PMID- 2714344 TI - Increasing therapeutic effect and reducing toxicity of doxorubicin by N-acyl dehydroalanines. AB - Doxorubicin toxicity is generally accepted to be free radical-mediated. N Substituted dehydroalanines (indexed as AD compounds) are capto-dative olefins which react and scavenge free radicals, especially the superoxide anion (O2-) and hydroxyl radical (HO). AD-20, an orthomethoxyphenylacetyl dehydroalanine derivative, decreases the mortality of mice when administered before an acute single dose or multiple non-toxic doses of doxorubicin. Doxorubicin administered to mice induces elevated serum transaminase levels, and the pretreatment of mice with AD-20 decreases significantly these serum enzymatic activities. Preliminary histological examinations suggest that these serum transaminase elevations reflect most likely liver injury. In addition to its cardiotoxicity, doxorubicin induces a severe bone marrow depletion. Although this initial decrease in the peripheral leukocytes induced by doxorubicin is not prevented by the administration of AD-20, it produces a fast recuperation in the white blood cells levels after 1 week, supporting a protective effect at this level. Moreover, the antitumor effect of doxorubicin in L1210 tumor-bearing mice was enhanced when AD 20 was injected before doxorubicin. We postulate that these effects may be related to the free radical scavenging ability of AD-20. PMID- 2714345 TI - The value of yearly chest X-ray in patients with stage I breast cancer. AB - In 263 patients with stage I breast cancer, i.e. tumour less than 5 cm in diameter, no invasion of skin and deep fascia, and no involvement of axillary lymph nodes, X-rays of the chest were performed at 6, 12 months and yearly thereafter to the 6th year or until recurrence, another cancer was detected, the patient refused further follow-up or died. Among 1599 examinations, in only 0.25% (four patients) were unsuspected malignant changes observed. Due to this low cost/benefit ratio a fixed routine schedule of repeated chest X-rays in stage I cancer patients, otherwise apparently free of disease, is not justified. PMID- 2714346 TI - Central nervous system involvement in non-Hodgkin's lymphoma. AB - Fifty-eight Hong Kong Chinese patients with CNS lymphoma were reviewed (primary seven, secondary 51). The incidence of secondary CNS lymphoma in patients with non-Hodgkin's lymphoma was estimated to be 9.4%. The Working Formulation separated subtypes which had a special propensity to involve the CNS. Significant proportions of our patients with secondary CNS lymphoma had other features which were known to be associated with a high risk of CNS disease including stage IV (48/51, 91.4%), bone marrow (26/51, 50.9%), peripheral blood (7.51, 13.7%), nasal (7/51, 13.7%), orbital (3/51, 5.9%), testicular (2/51, 3.9%) and bulky retroperitoneal (6/51, 11.8%) disease. 82% of patients with secondary CNS lymphoma had concurrent systemic disease and a further 12% had systemic relapse shortly afterward. CNS lymphoma is associated with poor prognosis and only 29% and 14% of the patients with primary and secondary CNS lymphoma respectively survived beyond 1 year. Patients responding to therapy had significantly better survival. 69.9% of the deaths were related to progressive systemic disease. PMID- 2714347 TI - A meta-analysis of prognostic factors in advanced ovarian cancer with median survival and overall survival (measured with the log (relative risk)) as main objectives. AB - We performed a meta-analysis of 38 articles containing 66 treatment groups and 3443 patients in order to evaluate prognostic factors in advanced epithelial ovarian cancer. To evaluate overall survival we designed a method to summarize the overall survival curve into one single figure: the log (relative risk) (LRR). This is the first meta-analysis using overall survival (measured with the LRR) as an objective. We found that the main prognostic factors predicting an improved survival (measured with the LRR) are: chemotherapy including cisplatin as initial treatment, a residual tumour mass of less than 2 cm prior to therapy, FIGO stage II/III and a good performance status. In a multivariate model, the use of cisplatin and the residual tumour were found to be the only factors of prognostic relevance. No relation between median survival and the overall clinical response rate of all patients entered in the denominator, could be demonstrated. Undifferentiated tumours and patients treated with cisplatin regimens had higher response rates to treatment but younger patients and those with endometrioid histology were less likely to respond. A surgical complete remission was encountered more frequently among studies that included a high number of patients with small tumour masses prior to treatment. Trials using cisplatin included more patients with small tumour nodules in their patient material compared to studies not using this drug. The data illustrate the danger of comparing studies with each other. In the trials with a high percentage of patients with small tumour residuals in the study population more toxic deaths were seen. This probably reflects the fact that they had received more intensive treatment. The LRR correlated strongly with the median survival, response and the percentage of surgical complete remissions. We concluded that the introduction of the LRR can be a meaningful addition to the evaluation of the influence of prognostic factors on overall survival. PMID- 2714348 TI - Unexpected synergy between N-phosphonacetyl-L-aspartate and cytidine against human tumor cells. AB - Cytidine, a non-toxic endogenous nucleoside, was found unexpectedly to augment the cytotoxicity of a pyrimidine antimetabolite N-phosphonacetyl-L-aspartate (PALA) in human ovarian carcinoma cells. The PALA/cytidine synergy is confirmed here in other human tumor cells (T242 melanoma, HL60 promyelocytic leukemia and SKOV3 ovarian carcinoma) in the cytidine concentration range of 1-10 micromolar. The synergy was not observed in Chinese hamster ovary (CHO) cells. Exogenous uridine (5-50 microM) completely reversed the PALA/cytidine cytotoxicity in a concentration-dependent manner. Measurements of cellular ribonucleotide levels revealed that the PALA treated cells had reduced UTP and CTP pools (10% and 40% of control respectively); and the PALA/cytidine treated cells had elevated CTP and GTP levels while their UTP levels remained at 10% of control. Deoxyribonucleotide levels were unremarkable except for a slight elevation of dCTP in the PALA/cytidine treated cells. Uridine competitively inhibited radioactive cytidine transport into 2008 cells, which may explain its ability to antagonize the PALA/cytidine synergy. These results suggest that the ribonucleotide biosynthetic mechanism is the primary cellular target for PALA/cytidine activity, and that the ratio of ribonucleotides to each other is an important determinant of tumor cell viability. The use of non-cytotoxic nucleosides to augment the activity of antimetabolites may have clinical relevance in cancer therapy. PMID- 2714349 TI - Acute non-lymphocytic leukemia is not a major type of childhood leukemia in Japan. AB - The distribution of acute leukemia according to type was examined in Japanese children by three surveys: (1) a review of bone marrow slides of 81 cases diagnosed as acute myelogenous leukemia between 1964 and 1976; (2) a prospective study of 97 cases observed since 1977, and (3) a study of 8108 cases registered with the Children's Cancer Registry of Japan from 1969 to 1984. The results indicate that the ratio of acute lymphocytic leukemia to non-lymphocytic leukemia in Japan is not different from that in other countries. PMID- 2714351 TI - Interferon administered intralesionally in skin and oral cavity lesions in heterosexual drug addicted patients with AIDS-related Kaposi's sarcoma. PMID- 2714350 TI - Randomized phase II trial of TCNU versus mitozolomide in malignant melanoma. EORTC Early Clinical Trials Group. PMID- 2714352 TI - Mitoxantrone-induced discoloration of the nails. PMID- 2714353 TI - Cancer in The Netherlands. From scenarios to health policy. AB - Future scenarios on cancer in The Netherlands were made with the help of existing trends, demographic changes and expected developments in cancer research, prevention, screening and treatment. Until the year 2000, cancer incidence will probably increase by 1.5% per year, by nearly 3% per year and the need for health care facilities accordingly. Upon the request of Parliament, the Dutch government used this information to formulate a long-term cancer control policy. Faced with a restricted budget and a growing demand for care, the government plans to increase its efforts in the areas of prevention and screening and to improve the efficiency of cancer care. More attention will be paid to the quality of life of those patients who cannot be cured. Support for cancer research will be maintained at its present level. PMID- 2714354 TI - Muscarinic receptors on cultured cells of rat hippocampus: cholinergic regulation and presence of subtypes. AB - Muscarinic acetylcholine receptors in intact, cultured explants of rat hippocampus were investigated in binding experiments with tritiated quinuclidinyl benzilate ([3H]QNB) as ligand. Dissociation constants (Kd) were determined to 320 575 pM and maximal binding capacity (Bmax) to 67-87 fmol/explant. The KdS obtained in kinetic experiments were very similar. Hippocampal explants cultured alone contained more muscarinic receptors than hippocampal explants reinnervated by cholinergic fibers from co-cultured septal explants. Pretreatment of hippocampal explants with carbachol resulted in a down-regulation of receptor number which was counteracted by the simultaneous addition of atropine. Atropine added alone had no effect on receptor number in hippocampal explants cultured alone whereas it occasionally caused an up-regulation in co-cultured hippocampus. Displacement experiments with scopolamine and oxotremorine as competitors, showed that hippocampal explants cultured alone contain multiple types of muscarinic receptors. With atropine, pirenzepine and AF-DX 116, only one class of receptors could be detected. PMID- 2714355 TI - Muscarinic stimulation of prostanoid synthesis by the isolated rat trachea: calcium dependency and effect of cortisol and cigarette smoke. AB - Tracheal prostanoid synthesis was stimulated by parasympathomimetics: arecoline greater than carbachol = methacholine greater than acetylcholine much greater than arecaidine. McNA343, dimethyl phenyl piperazinium (DMPP), nicotine, potassium and isoprenaline were without effect. Prostanoid synthesis was also stimulated by Ca2+ ionophore A23187 and arachidonic acid (AA). Carbachol stimulated prostanoid synthesis was inhibited by cholinergic antagonists (atropine greater than ipratropium bromide much greater than gallamine greater than pirenzepine); adrenaline and isoprenaline were without effect. Carbachol stimulated prostanoid synthesis was also inhibited by the Ca2+-channel blockers, nifedipine, diethylstilboestrol and TMB-8. Hydrocortisone and betamethasone inhibited carbachol- and A23187-stimulated, but not AA-stimulated, prostanoid synthesis following an 18 h tissue culture. Cigarette smoke extracts had a biphasic effect on carbachol-, A23187- and AA-stimulated prostanoid synthesis (potentiation at low concentrations, inhibition at high concentrations of extracts). These data demonstrate (1) that rat tracheal prostanoid synthesis is stimulable by activation of muscarine receptor-linked Ca2+ mobilisation, and (2) that tracheal prostanoid synthesis may be involved in secretion of mucus, the disruption of which by cigarette smoking may be related to the pathophysiology of airway disease. PMID- 2714356 TI - In vivo action of phosphatidylserine, amitriptyline and stress on the binding of [3H]imipramine to membranes of the rat cerebral cortex. AB - Liposomes of bovine brain phosphatidylserine and of phosphatidylcholine were prepared and injected i.p. into rats for 5 days. Another group received i.p. injections of amitriptyline in addition to phosphatidylserine. Subgroups of control and phosphatidylserine-injected rats were submitted to an acute swimming stress for 15 min. The number of [3H]imipramine binding sites in the phosphatidylserine-injected rats, decreased 23% whereas there was no change in the phosphatidylcholine-injected rats. The combination of amitriptyline and phosphatidylserine produced a more marked reduction in [3H]imipramine binding ( 47%). Control rats undergoing acute stress showed a 30% decrease in [3H]imipramine binding whereas the stress did not significantly change the control values of the phosphatidylserine-treated animals. These findings are discussed in relation to the known action of phosphatidylserine on several neurotransmitter systems and on the potentiation of antidepressant effects. PMID- 2714357 TI - Bretylium tosylate binds preferentially to muscarinic receptors labelled with [3H]oxotremorine M (SH or 'high affinity' receptors) in rat heart and brain cortex. AB - Bretylium tosylate is an antiarrhythmic agent. In guinea pig atria it showed the properties of a competitive muscarinic (cholinergic) antagonist and could distinguish between two muscarinic receptor classes or states in cardiac membranes. We decided to further investigate its binding properties at muscarinic cholinergic receptors of the rat heart and brain (cortex), keeping in mind the recently discovered heterogeneity of muscarinic receptor protein. Bretylium tosylate recognized two receptor classes or states in the heart with Ki values of 0.9 and 11 microM. All cardiac membrane receptors showed a homogeneous (11 microM) Ki value for the drug in the presence of GTP in the incubation medium, or after in vivo pretreatment with islet activating protein (IAP). Bretylium tosylate was able (but only at a high concentration, 1 mM) to slow the dissociation kinetics of the tracer, which suggests that it also bound to an allosteric site on the muscarinic receptor, or that it affected the receptor environment. In the brain cortex, as in the heart, bretylium tosylate displayed a high affinity for receptors labelled with the agonist [3H]oxotremorine M (Ki value: 0.8 microM for the SH-or cardiac-type high-affinity receptors), and a 8- to 10-fold lower affinity for cortex M and L receptors. These data suggest that the antagonist bretylium tosylate had binding properties in rat cardiac membranes analogous to those of the partial agonist pilocarpine and that it interacted with a single type of receptor. PMID- 2714358 TI - Effects of memantine on the twitch tension of mouse diaphragm. AB - The effects of memantine (50-175 microM) on the post-tetanic potentiation of the twitch tension were studied on the isolated mouse nerve diaphragm preparation. Memantine completely abolished the twitch tension elicited indirectly while it had no effect on the directly elicited twitch tension. Memantine also decreased the post-tetanic potentiation of amplitude of endplate potential and twitch tension. The duration of tetanic stimulation that induced a maximal decrease of twitch tension was 10-20 s. It is suggested that the effect of memantine on post tetanic potentiation may be due to its voltage- and time-dependent effect on the ion channel-acetylcholine receptor complex. PMID- 2714359 TI - Influences of nifedipine on vascular conductance of portally drained viscera, liver and kidney. AB - Nifedipine is a potent vasodilator, which induces various dose-related hemodynamic responses in the gastrointestinal tract, liver and kidney. Blood flow was assessed in anesthetized dogs with non-cannulating electromagnetic flow sensors. Nifedipine was injected into a brachial vein at intervals of 2 min in graded doses from 1-16 micrograms.kg-1. The pulsatile flow and pressure signals were analog-digital converted and processed by a computer program to obtain mean flow (ml.min-1) and mean pressure (mm Hg) values for every 3 s. The vascular data are presented as conductance. The arterial pressure decreased 45% while vascular conductance in vessels of the stomach, duodenum, small and large bowel increased between 75 and 128%. No response was observed in the splenic and common hepatic artery. An increase of resistance in the hepatic artery proper, while portal flow increased suggests that there were changes in liver metabolism. Although the literature indicates a decrease in renal vascular resistance, we encountered a decrease in flow but no change in resistance. Neither did we find an increase in heart rate. We propose that small intravenous doses of nifedipine reduce the afterload of the left ventricle. PMID- 2714360 TI - Theophylline affects the inotropic status of guinea-pig left atria by actions on the sarcolemma and sarcoplasmic reticulum. AB - Theophylline (0.1, 0.3 mM) produced a positive inotropism which was maximum by 15 min but was partially or completely absent by 45 min. The mechanism for this response was investigated using post-rest potentiation and positive staircase, phenomenon associated with the sarcoplasmic reticulum and sarcolemma, respectively. Staircase was enhanced at 15 min, but not after 45 min. Post-rest potentiation was attenuated by theophylline. The data suggest that theophylline's effect on cardiac contractility results from opposing actions on the sarcolemma and sarcoplasmic reticulum. PMID- 2714361 TI - Estrogen enhances a 5-HT1A response in hippocampal slices from female rats. PMID- 2714362 TI - Response by the neurotensin systems of the basal ganglia to cocaine treatment. AB - Multiple administrations of high doses of cocaine had profound effects on the neurotensin (NT) systems of the basal ganglia. Approximately 200-300% increases in striatal content of neurotensin-like immunoreactivity (NTLI) were observed 1-8 h following five doses of 30 mg/kg per dose of cocaine. The effect subsided by 48 h after treatment. Significant changes in striatal NTLI levels were not observed after a single dose of this stimulant. The nigral NT systems appeared to be even more sensitive to cocaine administration. Compared to striatal changes, increases in nigral NTLI content were greater (as much as 455% of control), required lower cocaine doses (20 mg/kg per dose), lasted longer (still elevated to 200% of control after 48 h) and were significant following a single cocaine exposure. The response of the striatal NT systems to cocaine appeared to be mediated principally by dopamine D-1 receptors, while both D-1 and D-2 receptors contributed to the response by the nigral NT projections. Specific dopamine, but not serotonin, uptake blockers caused increases in striatal and nigral NTLI concentrations similar to that seen with cocaine treatments, suggesting that interference with the dopamine uptake carrier complex by cocaine was responsible for its actions on extrapyramidal NT systems. PMID- 2714363 TI - Action of nicotine on accumbens dopamine and attenuation with repeated administration. AB - The behavioral and physiological effects of repeated nicotine administration are complex; sedation and hypothermia are present early but become attenuated while locomotor activity increases. Maximal blood levels and behavioral changes occur within 10 min of s.c. injection. We examined the effects of 10 nicotine injections (0.8 mg/kg) in 14 days on the levels of brain amines following challenge with either saline or nicotine on the 15th day. Dopamine, DOPAC, HVA, 3 methoxytyramine, norepinephrine, 5-hydroxytyramine, and 5-HIAA were measured in the frontal cortex, olfactory tubercle, nucleus accumbens, caudate-putamen, substantia nigra and ventral tegmental area. Ten minutes after nicotine was given to rats that had previously received only saline the levels of dopamine and its metabolite DOPAC indicated an increase in dopamine turnover in the nucleus accumbens. Of the areas examined the accumbens was the most sensitive to nicotine, with few significant amine changes in other regions. Twenty-four hours after the last nicotine injection the levels of dopamine and its metabolites indicated a sustained decrease in dopamine turnover in the accumbens induced by repeated administration. Following repeated nicotine a nicotine challenge still induced an acute increase in dopamine turnover in the accumbens, but the response was less than in animals not previously given nicotine. The results confirm earlier studies indicating that the accumbens is a major site of nicotine action. PMID- 2714364 TI - Effect of propranolol on accumulation of NEFA in the ischemic perfused rat heart. AB - The effect of propranolol on the accumulation of non-esterified fatty acids (NEFA) in the isolated, perfused working rat heart was investigated. Ischemia was induced by lowering the afterload pressure to 0 mm Hg for 20 min and for reperfusion, the pressure was raised to the pre-ischemic pressure (60 mm Hg) for 20 min. The heart was frozen for biochemical studies immediately after ischemia or reperfusion. Ischemia decreased mechanical function, increased the levels of palmitoleic, arachidonic and linoleic acids, left oleic, lauric, myristic, palmitic and stearic acids unchanged, decreased the levels of adenosine triphosphate (ATP), creatine phosphate (CrP) and the energy charge potential (ECP), and increased the level of lactate. Propranolol (10(-5) or 3 x 10(-5) M) restored mechanical function and inhibited the changes in NEFA, ATP and ECP caused by ischemia. It is suggested that propranolol inhibits the decrease in mechanical function and high energy phosphates caused by ischemia, and thereby inhibits the accumulation of NEFA, especially of the unsaturated fatty acids such as arachidonic acid, during ischemia. PMID- 2714365 TI - Calcium channel modulators: effects on gastric function. AB - Calcium is important in stimulus-secretion coupling in the gut. We therefore examined a dihydropyridine (nitrendipine), a phenylalkylamine (verapamil) and a benzothiazepine (diltiazem) calcium channel blocker as well as a calcium channel 'agonist', CGP 28392, in several models of gastric function. Nitrendipine significantly decreased stress-induced gastric lesions, but was far less efficacious against 100% ethanol-induced lesions. The anti-ulcer effects of nitrendipine were not reversible with indomethacin, sodium meclofenamate or N ethylmaleimide. Nitrendipine also significantly reduced basal gastric acid output. Verapamil significantly reduced stress lesions in an indomethacin and meclofenamate-reversible manner, but worsened ethanol ulcers. Verapamil also decreased basal acid secretion. Diltiazem decreased stress lesions (indomethacin- and meclofenamate-reversible), worsened ethanol lesions and slightly reduced acid secretion. CGP 28392 exerted a modest stress gastroprotective effect, decreased ethanol lesions and reduced slightly basal acid secretion. A possible clinical role for gastric calcium channel blockade is raised by these results. PMID- 2714366 TI - Effects of gallopamil, diltiazem and nifedipine on the loss of K+ from ischaemic pig hearts. AB - K+ release into the extracellular space was investigated during repeated 6-min coronary occlusions before and after the intravenous administration of cardiovascular active doses of gallopamil (0.02; 0.05 mg/kg), diltiazem (1.0; 2.0 mg/kg) or nifedipine (0.01; 0.05 mg/kg) to anaesthetized pigs. [K+]e was measured epicardially using silver valinomycin electrodes calibrated in vivo. During control occlusions [K+]e- rose steeply in all groups, from a pre-ischaemic baseline value of about 3.5 mmol/l reaching a plateau value within the ischaemic period. This response was reproducible in an untreated control group. Gallopamil reduced the ischaemic K+ efflux dose dependently and significantly 10 min after injection; the higher dose also did 60 min after injection. Diltiazem had less effect on K+ efflux 10 min after administration and an effect was no longer detectable after 60 min. Nifedipine did not significantly inhibit the ischaemic K+ loss. Besides these differences in the direct protection of the ischaemic myocardium, the Ca2+ antagonists also had the following effects on the haemodynamic profile. Diltiazem and gallopamil significantly prolonged PQ intervals whereas nifedipine caused a shortening accompanied by a significant increase in heart rate. Blood pressure and LV dP/dtmax were significantly reduced by all compounds, but to a different degree. Diltiazem reduced blood pressure to a greater extent than did nifedipine and gallopamil. LV dP/dtmax was comparably reduced by gallopamil and diltiazem, while nifedipine had less effect. Thus, gallopamil exerted pronounced protective effects on the ischaemic pig heart. PMID- 2714367 TI - Fluidization of brain membranes by A2C does not produce anesthesia and does not augment muscimol-stimulated 36Cl- influx. AB - Intravenous administration of 2-[2-methoxyethoxy]-ethyl 8-[cis-2-n octylcyclopropyl]-octanoate (A2C) was found to disorder brain membranes but did not produce intoxication or anesthesia in mice. The abilities of A2C and an anesthetic (benzyl alcohol) to inhibit [35S]t-butylbicyclophosphorothionate (TBPS) binding, and modify gamma-aminobutyric acid (GABA) receptor-mediated 36Cl- influx into brain vesicles were then compared. Both of the perturbants inhibited [35S]TBPS binding at the same concentrations at which they reduced membrane order; however, the anesthetic was nearly 4 times more effective in reducing [35S]TBPS binding than was A2C. Muscimol-stimulated 36Cl- uptake was enhanced by benzyl alcohol at a concentration which produced little or no change in membrane order. Concentrations of both A2C and benzyl alcohol which reduced membrane order inhibited muscimol-stimulated 36Cl- influx. Similarly, membrane order and muscimol-activated 36Cl- uptake were reduced in brain vesicles prepared from mice which had received A2C in vivo. The effects of anesthetics on the GABAA receptor chloride channel complex were analyzed by a two site model of action in which a 'perturbant' site is responsible for decreased 36Cl- uptake; but a distinct 'anesthetic' site is responsible for augmentation of chloride flux and anesthesia. PMID- 2714368 TI - Heterologous regulation of EGF receptor function in cultured aortic smooth muscle cells. AB - A10 cultured smooth muscle cells from rat embryonic thoracic aorta bound 125I labelled epidermal growth factor (125I-EGF), and responded to EGF by an increase in DNA synthesis. Scatchard analysis of binding data obtained at 4 degrees C showed curvilinearity consistent with there being two affinity classes of binding site. The amount of 125I-EGF that bound was decreased by treatment of the A10 cells at 37 degrees C with [Arg8]vasopressin or with 5-hydroxytryptamine (5-HT). Scatchard analysis of binding (at 4 degrees C after pretreatment at 37 degrees C) revealed this effect to be due to a loss of the high-affinity component of 125I EGF binding, with no change in total receptor number. The presence of vasopressin or 5-HT raised the concentration of EGF required for the stimulation of DNA synthesis. Cultured A10 aortic smooth muscle cells therefore have receptors for EGF that mediate an increase in cell proliferation. EGF receptor function is modified by vasopressin and 5-HT, probably as a consequence of their effects on EGF receptor affinity. PMID- 2714369 TI - Mapping the N6-region of the adenosine A1 receptor with computer graphics. AB - N6-substituted adenosine derivatives can be very potent and selective agonists at A1 receptors. The N6-region is usually described by a general model introduced by Kusachi et al. (J. Med. Chem. 1985, 28, 1636). Structure-activity relationships for this region have recently been reported from a detailed study by Daly et al. (Biochem. Pharmacol. 1986, 35, 2467). The N6-region of the A1 receptor was now investigated in further detail with the aid of computer graphics. A map of the N6 region was constructed on the basis of a selected set of data from Daly et al. This map allows Kusachi's model to be extended with two new subregions: a C subregion, accommodating cycloalkyl substituents and a B subregion, which is filled by bulky substituents, such as a norbornanyl moiety. Furthermore, three regions can be distinguished, where occupation leads to diminished receptor affinity, so-called forbidden areas. The extended model permits the contribution of each subregion to be determined quantitatively, allowing accurate prediction of affinities of compounds that were not used to construct the map. PMID- 2714370 TI - Allosteric interactions of three muscarine antagonists at bovine tracheal smooth muscle and cardiac M2 receptors. AB - The kinetics of [3H]dexetimide dissociation from muscarine receptors in bovine cardiac left ventricular and tracheal smooth muscle membranes were studied in the absence and presence of three muscarine antagonists. It was found that [3H]dexetimide dissociation from cardiac muscarine receptors was monophasic and very fast (half life less than 1 min) and was slowed by the cardioselective muscarine antagonists, gallamine, methoctramine and AF-DX 116, concentration dependently. [3H]Dexetimide dissociation from tracheal muscarine receptors was biphasic, with a fast phase (half-life less than 1 min) followed after 4-5 min by a slow phase (half-life = 38.5 min). The fast component, but not the slow component, was slowed by the muscarine antagonists with concentration dependencies very similar to those found in the heart. We conclude from these data that the major population of tracheal smooth muscle muscarine receptors resembles the cardiac M2 type not only with respect to equilibrium binding affinities but also with respect to the secondary, allosteric binding site on the muscarine receptor. The results also imply that the cardiac receptor subtype is much more sensitive to allosteric modulation than the glandular/smooth muscle receptor subtype. PMID- 2714372 TI - Fine structure of the mandibular gland in volcano rabbit. AB - The mandibular glands of 6 male and 6 female volcano rabbits were examined by means of light and transmission electron microscopy. The acinar cells of the glands were seromucous in nature, and contained faintly basophilic granules. The cells were classified into the light cells containing granules of low or moderate densities and the clear cells having polygonal granules of low density. The preacinar cells were occasionally observed at the site between acinus and intercalated duct. These cells had many weakly basophilic granules which contained fine granular materials of moderate density. The intercalated ducts were composed of light cells containing cored granules. The striated duct cells consisted of light cells and dark cells. Both of them contained a few vacuoles and vesicles, but no secretory granules. No sex-and age-related differences were observed in the mandibular gland of the volcano rabbit. The mandibular gland of the volcano rabbit was similar to the rabbit mandibular gland rather than the pika mandibular gland morphologically. PMID- 2714371 TI - Acute inactivation of tryptophan hydroxylase by amphetamine analogs involves the oxidation of sulfhydryl sites. AB - The activity of rat hippocampal tryptophan hydroxylase was reduced from 30-60% 3 h after the administration of a 10-15 mg/kg dose of either fenfluramine, methamphetamine or 3,4-methylenedioxymethamphetamine (MDMA). Tryptophan hydroxylase inactivated by these drug treatments could be reconstituted by a prolonged anaerobic incubation in the presence of 5 mM dithiothreitol and 50 microM Fe2+. Drug-inactivated enzyme obtained from rats killed 18 h after multiple doses of either D(+)- or L(-)-MDMA could not be similarly restored. These observations suggest that the rapid decrease in central tryptophan hydroxylase activity induced by amphetamine analogs results from the reversible oxidation of a sulfhydryl site(s) within the enzyme molecule, whereas the irreversible decrease in enzymatic activity measured 18 h after multiple-dose MDMA treatment may reflect serotonergic toxicity. PMID- 2714373 TI - [Individual differences in PCA response in the guinea pig]. AB - Experiments were carried out to determine the cause of individual differences in the passive cutaneous anaphylaxis (PCA) response in guinea pigs. The intensity of 4-h homologous PCA produced by anti-penicillin G serum was not markedly different among eight reactive sites on the back of a specified animal, whereas considerable individual differences were observed in the PCA response, even at a specified reactive site. PCA was significantly inhibited by an antihistaminic agent, promethazine, and the tissue histamine content was significantly reduced after PCA, suggesting histamine release as a mediator. The intensity of PCA in individual animals was highly correlated with that of the histamine-induced cutaneous reaction elicited at a site adjoining the PCA but was unrelated to skin histamine content. These results suggest that the difference in susceptibility to histamine has a considerable effect on individual differences in the PCA response in guinea pigs. PMID- 2714374 TI - [Study on the repeated oral administration method in infant rats]. AB - The purpose of this study was to establish a new technique for repeated oral administration to infant rats. To determine the maximum volume which could be administered to infant rats the following amounts of the Chinese ink were given by metal gastric zonde for mice: 0.01, 0.04 and 0.08ml/g B. W. General conditions and the arrival distance of the Chinese ink in the gastro-intestinal tract were also observed in infant rats. The best way of administration to infant rats was decided as follows: infant rats were isolated from the dums for one hour before administration and held tenderly by their neck to sustain their mouth upward, then a metal gastric zonde for mice 2 cm long was inserted to their mouth and drug solution was injected slowly. From the observation of general conditions and pathological examination, the maximum volumes for single or repeated administration were considered to be 0.04ml/g B. W. and 0.01 ml/g B. W. respectively. Daily oral administration of 0.1ml/g B. W. of distilled water, 1% CMC solution or 1% tragacantha gum suspension for 44 days caused no effects in infant rats when administration was begun 4 days after birth. These results show that the new method for administration to infant rats is useful to evaluate the toxicity or pharmacological activity of drugs. PMID- 2714375 TI - Initial lesions in the mouse brain induced by intraperitoneal injection of hypertonic saline. AB - A dose of 30 ml/kg of 8.5% solution of sodium chloride was intraperitoneally injected into ddY mice and time course observations were conducted. Colloidal carbon was infused 6 hr after injection and distribution of carbon in the brain was observed. A transient increase in hematocrit value, serum osmotic pressure and ascites was observed 1 hr arter injection. Distribution of colloidal carbon in the brain showed less penetration of the basal ganglia. Histopathological examination of the brain showed degeneration of pyramidal cells in hippocampus 6 hr after injection. Electron microscopical examination revealed intracytoplasmic microvacuoles, swollen mitochondria and dilated cisternae in rough-surfaced endoplasmic reticulum of pyramidal cells. It was suggested that serum viscosity was increased by rapid transport of water from blood into the peritoneal cavity or urine, due to the high osmotic pressure of hypertonic saline injected, resulting in a decrease in blood flow and ischemic changes in the brain. PMID- 2714376 TI - Re-examination on the sex-influenced esterase (ESSI) in rat serum. AB - The sex-limitation of sex-influenced esterase (ESSI) in serum of rats carrying Es Sia allele was re-examined. ESSI was detected in immature males and females, and orchiectomized rats as well as mature females whereas ESSI in normal males rapidly disappeared with puberty. The rats orchiectomized at weaning temporarily lost ESSI around the age of sexual maturation, thereafter, ESSI reappeared. When orchiectomized rats were administered testosterone, synthesis of ESSI was suppressed as in normal adult males. Effect of ovariectomy was not recognized. The exceptional strain named SI 3 of which normal mature males have a significant level of ESSI has been established, although the level in the males is lower than that in the females of the same strain. PMID- 2714377 TI - [Genetic parameters of body weight, muscle weight and skeletal characteristics in Japanese quail]. AB - Heritability, phenotypic and genetic correlations of body weight, muscle weight and skeletal characteristics of Japanese quail males at 8 weeks of age were investigated to obtain basal information on breeding and on genetic monitoring by morphometrical methods. For this study, 221 male progenies were used. Measurements were taken on body weight, muscle weight and four kind of skeletal characteristics (skeletal weight, skeletal length, skeletal width and skeletal height). Heritability estimates were 0.67 for body weight, 0.36 to 0.56 for muscle weight, 0.79 to 0.94 for skeletal weight, 0.35 to 0.77 for skeletal length, 0.17 to 0.32 for skeletal width and 0.41 to 0.84 for skeletal height, respectively. The phenotypic and genetic correlations were found to be highly positive between body weight, muscle weight and skeletal length. A high degree of genetic correlation was observed between femur length, ossa cruris length and ossa metatarsalia length. These results suggest that the body weight, muscle weight and skeletal characteristics can be improved by breeding and that these genetically determined skeletal characteristics might serve for strain identification and genetic monitoring in Japanese quail. PMID- 2714378 TI - Genetic parameters of egg characteristics in Japanese quail. AB - Heritability, phenotypic and genetic correlations of egg characteristics of Japanese quail were investigated to obtain basal information on breeding, strain identification and genetic monitoring. For this study, 3230 eggs produced from 323 female were used. Measurement were taken on egg weight, yolk weight, albumen weight, shell weight, egg shape index, albumen height, specific gravity, shell thickness, shell strength and yolk color. Heritability estimates of egg characteristics were high and ranged from 0.62 to 0.84. Diverse phenotypic and genetic correlations were observed among egg characteristics. These results indicate that individual selection should be the most efficient method of improving egg characteristics and that consideration should be given to the interrelationship of characteristics to accomplish genetic improvement. The possibility exists these assays of egg characteristics can be used for strain identification and genetic monitoring without killing an individual of quail. PMID- 2714379 TI - [Behavioral effects of ceruletide in Wriggle Mouse Sagami--in comparison with in Rolling Mouse Nagoya]. AB - The behavioral effects of ceruletide in Wriggle Mouse Sagami (WMS) and Rolling Mouse Nagoya (RMN) were observed in an open-field study. Ceruletide decreased the movements of both types of mice, improving the ataxic gait in WMS; however, no such improvement was observed in RMN. There may be different mechanisms underlying the ataxic manifestations in WMS and RMN. PMID- 2714380 TI - Laboratory rearing of the Amami rabbits (Pentalagus furnessi Stone, 1900) in captivity. AB - Five Amami rabbits in each sex were firstly introduced into the Central Institute for Experimental Animals. The authors intended to breed the Amami rabbits in the laboratory. During breeding, the Amami rabbits were nervous to external stimuli, easily frightened and always showed escaped behaviour. They were given pelleted foods for rabbits and pikas and also given apples and sweet potatoes as additional foods. The Amami rabbits were showed to practice coprophagy in the same way as laboratory rabbits. After introduction, they required 13 months to reach the maximum body weights which were 2.73 kg for females and 2.71 kg for males. Matings were attempted with one female and one male in newly deviced reproductive cages. By seventy-four matings, one pregnancy was produced and one child was delivered. This neonate (2 day old) had closed eyes and ears, incisors and brown short hair and weighed 100 g. Unfortunately, the pup died on the 4th day. The body length of this stage was 15 cm. PMID- 2714381 TI - [Food- and water- intake, urinary and fecal output, and urinalysis in the wild originated cynomolgus monkeys (Macaca fascicularis) under the indoor individually caged conditions]. AB - Daily food- and water- intake, and urinary and fecal output were determined with 253 wild-originated cynomolgus monkeys kept in individual cages. In addition, urinalysis was done for freshly collected urine. A statistically significant correlation was observed between total water intake and urinary output as well as between urinary output and urinary specific gravity (p less than 0.01). PMID- 2714382 TI - [Variation of glycosaminoglycan in the growth of transplantable tumors derived from a spontaneous ddY mouse mammary tumor]. AB - The components and variations of glycosaminoglycan (GAG) in the growth of transplantable tumors derived from a spontaneous mouse mammary tumor were investigated. A 45-week-old ddY female mouse, obtained from Shizuoka Laboratory Animal Center, was found to have a bean-sized mass at the third mammary gland of the left side. The tumor mass was surgically excised and used for transplantation in the present study. This mammary tumor was histologically found to be Type B adenocarcinoma. Transplantable mammary tumors consisted of the fibrous or edematous interstitium contained a large amount of GAG components, which was mainly hyaluronic acid (HA), dermatan sulfate (DS) and chondroitin sulfate A/C (ChS). In the analysis of GAG components, HA content was present in a large amount in logarithmic growth phase of transplanted mammary tumors, but it was markedly decreased in stationary phase. On the other hand, the contents of DS and ChS increased in stationary phase of the tumor growth, and these increases corresponded, histologically, with the propagation of the fibrous interstitial tissues. PMID- 2714383 TI - Effect of pregnant mare's serum gonadotropin on increased ovulation in guinea pigs with synchronized estrous cycle. AB - An ability of Pregnant Mare's Serum Gonadotropin (PMSG) to induce superovulation was investigated in guinea pigs with synchronized estrous cycle caused by the treatment for 21 days of progesterone tubing. On day 6 later following the removal of progesterone treatment, every animal given saline injection had synchronously ovulated. When compared with saline control, a significant increase of ova ovulated was induced by an injection of PMSG 8 hours before the removal of progesterone tubing, but not by the other PMSG treatment schedule. Present study indicates that PMSG injection given at a fixed stage of synchronized estrous cycle induced superovulation in guinea pigs treated with long-term implantation of progesterone tubing. PMID- 2714384 TI - Separation and quantification of serum alkaline phosphatase isozymes in the rat by affinity electrophoresis. AB - The purpose of this study was to examine the possibility of separation and quantification of serum alkaline phosphatase (ALP) isozymes in rats by wheatgerm lectin affinity electrophoresis. Cellulose acetate electrophoresis of the liver and bone ALPs without lectin results in overlapping bands, but in the presence of lectin, the mobility of the band of bone enzyme was retarded and well separated from the liver enzyme band. With this affinity electrophoretic method, we determined the serum ALP isozymes in fed and fasting rats grouped by age. As a result, the absolute activity of bone isozyme showed a downward trend with age in the fed and fasting rats. The serum ALP activity was steadily higher in fed rats than in fasting rats, and the increase was due to intestinal ALP isozyme. There was low activity bordering complete absence in liver isozyme under both nutritional conditions. The affinity electrophoretic method provided a rapid, reproducible, and relatively simple technique for further clinical characterization of ALP isozyme in the rat serum. PMID- 2714385 TI - [A computer program that draws pedigree charts for inbred strains of animals]. AB - We produced a computer program that draws pedigree charts for inbred strains of animals such as mice or rats. This program is composed of four subprograms, which are (1) inputting the data, (2) drawing pedigree charts, (3) listing the data which have been input, and (4) backup of the system and the data. Pedigree charts and lists of data can be displayed on a TV screen and printed out on the papers. Using this program, we drew the pedigree charts of the inbred strains of rats which we are maintaining by brother-sister inbreeding in our institute and found that there were three sublines in one of the strains, WKAH/Hkm, because of unsuitable maintenance. This program is very convenient to draw the pedigree charts and useful for checking the maintenance of inbred strains or the strains of animal models of human diseases. PMID- 2714386 TI - [A survey of the prevalence of Anatrichosoma sp. in nasal cavities of cynomolgus monkeys]. AB - Microscopic examination of 45 nasal swab samples of cynomolgus monkeys revealed that three of them were positive for Anatrichosoma sp. In the tissue sections of nasal mucosa collected from positive monkeys, female worms were consistently seen in the stratified squamous epithelial layer of the nasal mucosa. Epithelial layer thickening and parakeratosis were evident in nasal mucosa adjacent to female worms. Male worms were consistently seen in the submucosa and chronic inflammatory reactions was observed around them. PMID- 2714387 TI - Ileal papilloma in a rat. AB - Spontaneous Ileal papilloma was found in an 1-1/2 year old female Sprague-Dawley rat. The lesion was first recorded as a tiny bulge on the absorptive surface of the Ileum. Histologically, the outgrowth was recorded as papilloma showing hyperkeratosis, hyperplasia and acanthosis in the transformed epithelium. This appears to be the first report of its kind in the Ileum of rat in Bangladesh. PMID- 2714388 TI - The first cervical vertebra as an indicator of mandibular growth. AB - The association between the morphology of the first cervical vertebra, the atlas, and the direction of mandibular growth is studied by analysing two sets of lateral roentgenocephalograms--one comprising 18 non-treated children and another comprising 18 orthodontically treated subjects divided into three groups with regard to mandibular growth rotation. Among the non-treated cases there was a significant correlation between horizontal growth of the mandible during a two year period and the initial height of the atlas dorsal arch. The treated subjects with forward mandibular rotation during treatment, demonstrated a significantly higher pretreatment dorsal arch than the subjects with either no rotation or a backward mandibular rotation. PMID- 2714389 TI - Class II correction in Herbst and Bass therapy. AB - The purpose of this study was to make a quantitative evaluation on lateral cephalograms of skeletal and dental changes contributing to Class II correction in Herbst and Bass appliance therapy. From two male patient samples treated with either the Herbst appliance (n = 72) or the Bass appliance (n = 32) 18 pairs of subjects were selected. The subjects within each pair had to be in the same growth period at the time of therapy and to exhibit a similar pretreatment sagittal (ANB angle) and vertical (ML/NSL angle) jaw base relationship. Lateral cephalograms in centric occlusion taken before treatment and after 6 months were analysed according to the method of Pancherz (1982a). After six months of treatment the Bass appliance seemed to have a greater influence on mandibular jaw base position than the Herbst appliance, although no statistical significant differences existed between the treatment groups. The correction in overjet and sagittal molar relationships was more complete in the Herbst than in the Bass patients. This was due to greater dental changes (distal movement of the maxillary molars, proclination of the mandibular incisors) taking place in the Herbst subjects. PMID- 2714390 TI - Changes in head posture and nasopharyngeal airway following surgical correction of mandibular prognathism. AB - It was the aim of the present study to cast light on the role of the mandible in relation to head posture and airway space by evaluating patients before and after surgical correction of mandibular prognathism. The material comprised standardized profile cephalograms of 52 patients with mandibular prognathism. All patients had received orthodontic adjustments prior to mandibular osteotomy. Mean age of the patients was 24.3 years, and 12 males and 40 females participated in the study. The first profile radiograph of each patient was obtained the day before surgery in the natural head (mirror) position. All patients underwent mandibular surgery with a bilateral vertical ramus osteotomy. Approximately one year after surgery, the cephalometric investigation was repeated. Head posture was evaluated by the craniocervical angulation (NSL/CVT and NSL/OPT) and airway space as nasopharyngeal airway size (ad1 and ad2). Changes in posture and airway (ex.2-ex.1) were evaluated by paired t-tests. The results showed a mean increase in head posture of 2.7 degrees (p less than 0.001) and a mean reduction in airway space of 2.3 mm (p less than 0.001). PMID- 2714391 TI - Lack of correlation between mouth-breathing and bite force. AB - The correlation between mouth-breathing and bite force was studied in 81 children, 7 to 16 years old. Mouth-breathing was diagnosed on the basis of the subject history, the rhinomanometrically determined nasal airflow and the size of the airway measured on the profile cephalogram. The maximum bite force was measured at the first molars. In addition, the facial morphology was analysed on profile cephalograms. Both mouth-breathing and bite force were associated with the facial morphology but there was no association between mouth-breathing and bite force. It was concluded that the long-face morphology characteristic of mouth-breathing children is not due to weak masticatory muscles. PMID- 2714392 TI - The period between exfoliation of primary teeth and the emergence of permanent successors. AB - The dates of natural exfoliation of primary teeth and of clinical eruption of their successors were recorded in 141 children, a total of 660 teeth. The aim of this investigation was to study the length of the period between these two developmental events. In the mandible, the mean length of the toothless period for the central incisor was 2 weeks and that for the lateral incisors and canines 6 weeks. In the maxilla, the corresponding period was 6 weeks for the central incisor and over 4 months for the lateral incisor and the canine. The mean length of the toothless period was shortest, 0-6 days, between the primary molars and the succeeding premolars. Individual variation was great. No difference was detected between the sexes. In some cases the length of the toothless period for the maxillary lateral incisors and for the canines in both jaws exceeded one year. This was associated with crowding, which caused the premature loss of primary teeth. PMID- 2714393 TI - Effects of velar resistance on speech aerodynamics. AB - The level of intelligibility attained by speakers with cleft palate reflects not only the ability to achieve adequate velopharyngeal closure but other complex variables as well. When closure is inadequate, performance is influenced by compensatory responses of the tongue, vocal folds, respiratory muscles and nasal valve. The purpose of the present study was to determine how a loss of velar resistance associated with velopharyngeal inadequacy affects speech pressures and airflow. The pressure-flow technique (Warren, 1979) was used to assess mean airflow rate, mean intraoral and nasal pressures and velopharyngeal orifice areas in 211 subjects diagnosed as having cleft palate or velopharyngeal inadequacy. The data revealed that resistance fell as velopharyngeal orifice area increased. Intraoral pressures also fell as resistance dropped while nasal pressures and airflow rate increased. These findings suggest that individuals with velar inadequacy and associated low velar resistance compensate by increasing airflow rate in an attempt to maintain adequate pressures for consonant sound production. PMID- 2714394 TI - The effect of thyroxine on craniofacial morphology in the growing rat. Part I: A longitudinal cephalometric analysis. AB - The wide therapeutic use of hormones enhances the importance of detailed knowledge of the effects on skull growth. Thyroxine is known to regulate maturation of cell populations and long bone growth, but the influence on craniofacial bone remodelling is still obscure. One side effect of substitution therapy with thyroxine in children is premature closure of cranial sutures. The aim of the present study was to describe longitudinally the effect of different serum levels of thyroxine on craniofacial growth. In young rats injected with 20 micrograms/kg b.w. l-thyroxine for 28 days a change was found in craniofacial morphology measured by a cephalometric technique. A decrease in length of the viscerocranium was evident after 14 days, and occurred in connection with raised serum levels of thyroxine. In contrast, cranial base growth was increased between day 14 and 28 and also a catch-up growth in the viscerocranium was observed during this period. This observed change occurred after the induced peak in levels of thyroxine in serum had subsided. The inhibited forward directed growth of the viscerocranium was consistent with the fact that the skull in the thyroxine group developed a klinorhycial form in contrast to the normal orthocranialization. Thus, the craniofacial growth pattern was influenced by variations in the serum level of thyroxine. The effects of thyroxine on skull growth sites observed are consistent with reported effects of low dose of thyroxine on long bone growth. PMID- 2714395 TI - The relation between mandibular configuration and the shape of the glenoid fossa in the human. AB - In order to investigate the correlation between the shape of glenoid fossa and the morphology of the mandible, ten measurements were made on 37 pretreatment cephalograms of orthodontic patients aged from 8.1 to 12.3 years. The inclination of the articulating surface of the glenoid fossa when measured in relation to the clival plane, nasion-sella line or the nasal plane, correlated strongly with the configuration of the mandible. The results further support the hypothesis that the shape of the glenoid fossa affects the growth of the mandible. A vertically oriented articulating surface of the glenoid fossa, seems to direct condylar growth more vertically than does an articulating surface, which is oriented more horizontally. PMID- 2714396 TI - Sizes of dental arches and interdental space in 3-year-old children with and without cleft lip/palate. AB - The development of the dental arches in children with oral clefts differs from that in a normal population, due to the type and extension of the cleft, surgical procedure and timing, and decreased growth potential. The size of the maxillary and mandibular dental arches and the amount of interdental space in 3-year-old, cleft-affected and non-cleft children was investigated. Fifty non-cleft (NONC) and 104 cleft-affected subjects including different cleft groups were compared. On average, cleft lip was corrected at the age of 0.6 years and cleft palate at 1.8 years of age. The mean of all width and depth dimensions in the cleft lip group were close to the NONC controls, whereas the dimensions of the cleft palate group were 8-9 per cent smaller in the maxilla and 5-7 per cent smaller in the mandible than were those in the NONC group. In the unilateral complete cleft group, the maxillary dimensions were 11-19 per cent smaller, but in the mandible only 0-4 per cent smaller than in the NONC group. In the bilateral complete cleft group, the maxillary arch was only 6 per cent shorter but 30 per cent narrower at the canines than in the NONC group. In the mandible the corresponding differences were 2 per cent and 6 per cent. Forty per cent of the cleft palate subjects had a crowded maxillary arch compared with 6 per cent of the NONC controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714397 TI - Glucose deprivation results in the induction of glucose-regulated proteins and domes in MDCK monolayers in hormonally defined serum-free medium. AB - Madin-Darby canine kidney (MDCK) cells spontaneously form dome-like structures in vitro, a phenomenon which has been proposed to be indicative of cellular differentiation. This study indicates the existence of a correlation between the induction of domes and of glucose-regulated proteins during glucose starvation. When MDCK monolayers were glucose deprived, domes appeared very rapidly. After only 3 h of glucose deprivation domes appeared in 69% of the microscope fields. The level of expression of glucose-regulated proteins (grps) as well as domes was examined over a 6-h time interval of glucose deprivation. Both grp 76 and 97 were induced over this time interval, with grp 76 being the more readily detectable. The level of induction of grp 76 as a function of time was quantitated by means of densitometry measurements. The induction of domes was examined in parallel with the induction of grp 76. The results indicated that the induction of grp 76 and domes occurs with a similar time course. The effect of glucose deprivation on the initial rate of ouabain-sensitive Rb+ uptake was also examined. Within the first 4 h of glucose deprivation, the initial rate of ouabain-sensitive Rb+ uptake did not differ significantly in glucose-deprived and control MDCK monolayers. These observations indicate that unlike the case with other methods of dome induction (e.g., treatment with either prostaglandin E1 (PGE1) or hexamethylene bis-acetamide (HMBA] glucose deprivation does not affect the Na+K+ ATPase activity of MDCK monolayers. These observations suggest that PGE1, HMBA, and glucose deprivation affect dome formation in MDCK monolayers by means of distinct mechanisms. PMID- 2714398 TI - Purification and immunocytolocalization of protein phi 0 from sperm cells of the echinoderm Holothuria tubulosa. AB - Histones in chromatin from germ cells of the echinoderm Holothuria tubulosa are retained throughout spermatogenesis. However, some alterations occur in the histone complement of the mature sperm, including the presence of a germ-line specific H1 subcomponent unusually rich in arginine, and the appearance of a basic component termed phi 0. Histones from ripe sperm have been extracted in a preparative scale to allow for isolation and purification of protein phi 0. Polyclonal antibodies against phi 0 have been produced and purified by affinity chromatography. The specificity of the antibodies to phi 0 has been assessed by enzyme-linked immunosorbent assays, competition experiments, and Western immunoblotting analysis. No cross-reactivity of the antibodies with the remainder histone fractions has been observed. Immunocytolocalization of protein phi 0 by immunogold labeling has revealed that this protein is essentially confined to chromatin from ripe sperm, whereas it is wholly absent from less advanced germ cell types. From these observations, together with biochemical studies previously reported, it is inferred that protein phi 0 may well be instrumental in the known chromatin transitions occurring in this organism during germ cell development. PMID- 2714399 TI - Enhanced binding of fibronectin-coated latex beads to quiescent 3T3-L1 cells is correlated with escape from growth arrest. AB - The possible involvement of fibronectin receptors in growth stimulation was investigated by an analysis of fibronectin-coated latex bead binding to 3T3-L1 cells under various conditions. 3T3-L1 cells, growth-arrested in a medium with a low concentration of calf serum, bound few fibronectin-coated beads. After addition of serum at concentrations of 1.0% or higher, there was a rapid and transient increase in the number of cells with bound beads and a subsequent increase in the incorporation of bromodeoxyuridine (BrdU) into cell nuclei. Incorporation of BrdU was observed in about 60% of the cells with bound beads. Fibroblast growth factor and platelet-derived growth factor at concentrations of 5 ng/ml or higher also enhanced binding of fibronectin-coated beads to cells. Stimulation of bead binding by epidermal growth factor and insulin was weak. Fibroblast growth factor, but not epidermal growth factor, increased the incorporation of BrdU into nuclei. These results indicate a relationship between stimulation of cell proliferation in quiescent cells and increased binding by cells of fibronectin-coated latex beads. PMID- 2714400 TI - Strong association of bovine IgM with microvilli and their microfilament core from 13762 ascites tumor cells. AB - Microfilament cores, obtained by extracting 13762 mammary ascites tumor cell microvilli with Triton X-100, contain a major glycoprotein migrating at an apparent molecular weight of 80 kDa by dodecyl sulfate-polyacrylamide gel electrophoresis. The 80-kDa component is a disulfide-linked multimer, as demonstrated by velocity sedimentation and agarose-acrylamide gel electrophoresis analyses under nonreducing conditions. This 80-kDa species is not metabolically labeled, as is a minor 80-kDa glycoprotein found in the cores, membranes, and an isolated transmembrane complex with actin. Antibodies prepared against the 80-kDa glycoprotein react strongly with bovine IgM and more weakly with rat IgM. These antibodies were used to demonstrate that the 80-kDa component is present in microvilli, microvillar microfilament cores, and microvillar membranes only if the microvilli are prepared in the presence of calf serum. The 80-kDa component, purified by velocity sedimentation in dodecyl sulfate, reacts with anti-rat IgM by immunoblot analyses. Moreover, immunoprecipitation of detergent extracts of microvilli with anti-rat IgM specifically sediments the 80-kDa component. The 80 kDa glycoprotein fractionates with the actin-containing transmembrane complex prepared by gel filtration of Triton-solubilized microvillar membranes. These results indicate that the disulfide-linked, multi-meric 80-kDa component is bovine IgM, which binds strongly to a cell-surface component of the microvilli, and is indirectly associated with the microfilament cores. Thus, the IgM provides a marker by which the transmembrane complexes to the microfilaments can be identified. PMID- 2714401 TI - Type I collagen preparations inhibit DNA synthesis in glial cells of the peripheral nervous system. AB - The mechanisms underlying cessation of glial proliferation in the developing peripheral nervous system are obscure. One possibility, as yet little explored, is that mitotic inhibitory signals play a part in regulating glial cell numbers. In this study we demonstrate that type I collagen preparations from several different sources can inhibit the rate of DNA synthesis in purified populations of enteric glia and both short-term and long-term secondary Schwann cells in dissociated cell cultures. When these cells are grown on gelled or dried type I collagen substrata, they proliferate at substantially lower rates than on polylysine substrata. In contrast, type III or V collagen preparations do not inhibit glial DNA synthesis and laminin, fibronectin, type IV collagen, and secreted matrix from bovine corneal endothelial cells all stimulate thymidine incorporation. The inhibitory effect is not observed with heat denatured type I collagen preparations, but is seen equally in serum-containing medium, in medium containing fibronectin-free serum, or in serum-free medium, suggesting that the interaction of collagen with the cells requires structurally intact collagen molecules and does not occur via intermediary linkage to fibronectin. The inhibition on collagen is accompanied by a shape change from a more flattened morphology to a narrow spindle form. The labeling index of a rat Schwannoma cell line, 33B, is not inhibited on type I collagen substrata. These results demonstrate that type I collagen preparations inhibit the DNA synthesis levels of early postnatal peripheral glial cells in vitro. It remains to be determined whether this effect occurs via direct collagen-cell membrane interactions or whether it depends on accessory molecules, perhaps present in the collagen preparations themselves, since these are not purified to absolute homogeneity. PMID- 2714402 TI - Induction of the differentiation of synchronized HL-60 leukemia cells by tiazofurin. AB - Tiazofurin is an effective inducer of the maturation of HL-60 promyelocytic leukemia cells, as monitored by increased phagocytic ability and the capacity to reduce nitroblue tetrazolium (NBT). The antimetabolite acts as a potent inhibitor of IMP dehydrogenase, which results in a profound depression in the cellular levels of guanine nucleotides. Flow cytometric analysis of DNA histograms indicated that the commitment of HL-60 cells to differentiate when exposed to tiazofurin was preceded by a transient delay in the G1 phase of the cell cycle. HL-60 leukemia cells enriched in the various phases of the cell cycle by centrifugal elutriation were utilized to further characterize the relationship between the phase of the cell cycle and the commitment to enter a pathway of differentiation. Fractions composed mainly of G1 cells demonstrated an increased capacity to mature when exposed to tiazofurin, whereas fractions containing cells from the S and G2 + M phases of the cell cycle had a lower ability to enter a differentiation pathway. The findings suggest that the commitment of HL-60 cells to mature when exposed to tiazofurin is mediated during the G1 phase of the cell cycle. PMID- 2714403 TI - Developing Dictyostelium discoideum cells contain two distinct acid hydrolase containing vesicles. AB - Two distinct populations of acid hydrolase-containing vesicles have been found in developing Dictyostelium discoideum cells. Percoll gradient centrifugation revealed these vesicle populations have densities of 1.07 and 1.13 g/ml. The 1.13 g/ml vesicle populations arose during the aggregation stage of differentiation. Although both vesicle populations contained an array of acid hydrolases, they could be shown to differ by several criteria. Electron micrographs of prespore cells showed they contained two types of vesicles with distinct acid phosphatase staining patterns. One of these vesicle types appeared identical to the lysosomes found in vegetative cells. The second vesicle type had a morphology similar to that of a previously identified organelle, the prespore vesicle. The prespore vesicle is known to contain spore coat proteins which are exocytosed during the final stages of spore differentiation. The higher density acid hydrolase containing vesicle population was found to contain spore coat proteins. Electron micrographs of the higher density vesicle population showed the presence of acid phosphatase-staining vesicles with a morphology similar to that of prespore vesicles. These data suggest that the higher density acid hydrolase-containing vesicles represent a subpopulation of lysosomes which appear during development and which may be identical to prespore vesicles. PMID- 2714404 TI - Embryonal carcinoma cells adhere preferentially to fibronectin and laminin but their endodermal differentiation leads to a reduced adherence to laminin. AB - F9 and PC13 embryonal carcinoma (EC) cells adhered rapidly to growth substrata coated with fibronectin or laminin. When F9 cells were induced to differentiate into visceral or parietal endoderm-like cells, their ability to adhere to laminin diminished, but their adherence to fibronectin remained unchanged. Correspondingly, permanently differentiated teratocarcinoma-derived endoderm cells (PYS-2 and PSA-5e) adhered markedly less efficiently to laminin than to fibronectin. F9 cells adhered to proteolytic fibronectin fragments containing the cell-binding site but not to fragments containing gelatin- or heparin-binding sites. They also adhered slowly to gelatin, but this adhesion was completely blocked by cycloheximide. The results show that the teratocarcinoma stem cells may have specific mechanisms mediating adhesion to fibronectin and laminin and that endodermal differentiation leads to a reduction in their capacity to adhere to laminin but not to fibronectin. PMID- 2714405 TI - A new method to discriminate G1, S, G2, M, and G1 postmitotic cells. AB - A new flow cytometric method combining light scattering measurements, detection of bromodeoxyuridine (BrdU) incorporation via fluorescent antibody, and quantitation of cellular DNA content by propidium iodide (PI) allows identification of additional compartments in the cell cycle. Thus, while cell staining with BrdU-antibodies and PI reveals the G1, S, and G2 + M phases of the cell cycle, differences in light scattering allow separation of G2 phase cells from M phase cells and subdivision of G1 phase into two compartments, i.e., G1A representing postmitotic cells which mature to G1B cells ready to initiate DNA synthesis. The method involves fixation of cells in 70% ethanol, extraction of histones with HC1, and thermal denaturation of DNA. This treatment appears to enhance the differences in chromatin structure of cells in the various phases of the cell cycle to the extent that cells could be separated on the basis of the 90 degrees scatter. Mitotic cells show much lower scatter than G2 phase cells, and G1 postmitotic cells (G1A) show lower scatter than G1 cells about to enter the S phase (G1B). Light scattering is correlated with chromatin condensation, as judged by microscopic evaluation of cells sorted on the basis of light scatter. The method has the advantage over the parental BrdU/DNA bivariate analysis in allowing the G2 and M phases of the cell cycle to be separated and the G1 phase to be analyzed in more detail. The method may also allow separation of unlabeled S phase cells from mitotic cells and distinguish between labeled and unlabeled mitotic cells. PMID- 2714406 TI - A close relationship between microvilli and metabolic cooperation deficiency in embryonal carcinoma cells. AB - A revertant clone has been isolated from the metabolic cooperation-deficient embryonal carcinoma clone PT2md1. In PT2md1, its cooperation-competent parent, and its cooperation-competent revertant an inverse correlation has been demonstrated between cooperation competence and the incidence of microvilli. This demonstration, together with a similar correlation previously reported in an independently isolated series of cell lines, establishes a close causal relationship between the incidence of microvilli and communication deficiency. PMID- 2714407 TI - Commitment to division in Paramecium: effect of nutrient level on the macronuclear DNA increment. AB - In Paramecium, a fixed macronuclear DNA increment is associated with commitment to cell division. This study shows that this threshold DNA increment is about 70% of the final DNA increment in well-fed cells. The DNA increment is reduced when growth rate is decreased and decreases in parallel with growth rate to a minimum of 30% of the normal DNA increment. This minimum value is obtained when the growth rate is 20% of its normal level or lower. Further reduction in the growth rate produces no further reduction in the DNA increment. Following abrupt nutrient-level shifts, both the threshold DNA increment and the final DNA increment change progressively as the time of the shift is moved to later stages of the cell cycle. The threshold DNA increment is reset following nutrient-level shifts up to the point of commitment to division. These observations are consistent with the notion that the magnitude of the threshold DNA increment is strongly correlated with the rate of growth and is rapidly reset by factors which alter the growth rate. The implications of these observations for growth-driven regulation of the cell cycle are discussed. PMID- 2714408 TI - Recommendations for crystallin nomenclature. PMID- 2714409 TI - Time-resolved fluorescence properties of fluorescein and fluorescein glucuronide. AB - The use of fluorescein as a tracer in the study of the blood-ocular barriers is complicated by the metabolic production of fluorescein monoglucuronide, the excitation and fluorescence spectra of which overlap with those of fluorescein. Time-resolved fluorescence measurements provide a means of detecting the two substances in a mixture. Fluorescein and fluorescein glucuronide have different fluorescence lifetimes, 4.0 nsec and 2.3 nsec, at 37 degrees C and pH 7.35. Hence the two substances can be distinguished from the biexponential fluorescence decay in the mixture. The lifetimes are identical in buffered water, in hyaluronic acid and in human vitreous in vitro. The method is suggested for estimation of fluorescein and fluorescein glucuronide in the human vitreous in vivo. The time resolved and steady state fluorescence anisotropies, the fluorescence lifetimes and the quantum yields strongly suggest that binding of fluorescein or fluorescein glucuronide to hyaluronic acid or other macromolecules in the human vitreous is weak, if present at all, and that static quenching of fluorescence does not occur in the vitreous. PMID- 2714410 TI - Local variation in absolute water content of human and rabbit eye lenses measured by Raman microspectroscopy. AB - Raman spectra were obtained from fresh, fixed and sliced rabbit lenses and from human lens slices. For all lenses and lens slices the ratio R, defined as the Raman intensity at 3390 cm-1 divided by the Raman intensity at 2935 cm-1, was measured at different locations along the visual and equatorial axis. The ratios R were transformed to absolute water mass percentages by measuring solutions with known protein concentrations. It was shown that fixation and slicing have very little effect on the absolute water content of the lenses. The values obtained for the absolute water content are comparable to values given in literature. It was also shown that the water content in rabbit and human lenses rapidly decreases from the immediate anterior and posterior subsurface region to the deep superficial cortex and is relatively constant in the nucleus. Raman microspectroscopy appears to be a reliable method for the measurement of the absolute water content of small volumes on defined positions in the lens. This can be very useful when analyzing the possible relation between local variations in water content and the occurrence of opacities in the lens. PMID- 2714411 TI - Abnormal expression of the RI subunit of cyclic AMP-dependent protein kinase in Y 79 retinoblastoma cells. AB - The cyclic AMP-dependent protein kinases of Y-79 retinoblastoma cells were analyzed by DEAE Sephacel column chromatography, SDS-polyacrylamide gel electrophoresis, and immunoblotting. Both type I and type II protein kinases (characteristic of fetal and mature retina respectively) were observed. In addition, free RI (type I regulatory subunit) was present in Y-79 cells; three other retinoblastoma cell lines also showed evidence of free RI in immunoblot analysis. Northern blot analysis of poly A+-enriched RNA from Y-79 cells showed a 4.5 kb RI transcript and a 6.0 kb RII transcript. The single 4.5 kb RI message is typical of normal retina, in contrast to other tissues and cell lines in which a 2.0 kb message predominates. Since RI expression appears to be post transcriptionally inhibited in normal retina, it is suggested that free RI dimers in retinoblastoma is the result of loss of repression of translation of this transcript and that the free RI pool may contribute to the unregulated growth of these cells. PMID- 2714412 TI - Muscarinic receptors of the albino rabbit ciliary process. AB - Muscarinic receptor binding sites were identified in membranes prepared from albino rabbit ciliary processes, using the muscarinic antagonist [3H]L quinuclidinyl benzylate as the radioligand. Analysis of saturation binding experiments demonstrated that [3H]L-quinuclidinyl benzylate bound to an apparent homogeneous population of binding sites with a Kd value of 6.4 pm and a Bmax value of 155 fmol mg-1 protein. Seventy percent (70%) of binding sites showed high affinity for pirenzepine, i.e. belonged to the M1 subtype. In contrast, AF DX 116 was unable to discriminate between subtypes of muscarinic binding sites in this tissue. Carbachol caused a dose-dependent increase in phosphatidylinositol turnover (EC50 = 154 microM) in ciliary processes. A maximum stimulation of 652% of basal activity was obtained following a 45 min incubation with 10 mM carbachol. The potency of muscarinic antagonists to block the carbachol-induced response was comparable to that found for M1 receptors in other tissues. Oxotremorine and pilocarpine behaved like partial agonists in this assay. The carbachol-induced increase in phosphatidylinositol turnover was also observed in a suspension of epithelial cells from ciliary processes and it was blocked by atropine; thus, indicating the presence of muscarinic receptors functionally coupled to phosphatidylinositol turnover in these cells. PMID- 2714413 TI - Functional morphology of accommodation in the raccoon. AB - The raccoon (Procyon lotor) is a small carnivore which eats in the upright position, using hand- and finger-like front paws and digits to wash, hold and examine its food at close range. These anatomic and behavioral characteristics prompted structural and functional studies of the accommodative capability of this species. By light and electron microscopy, we observed a prominent ciliary smooth muscle and zonular apparatus. When stimulated by carbachol or pilocarpine, the muscle and zonular apparatus exhibited a shift from longitudinal to reticular or circular orientation of some ciliary muscle bundles, anterior movement of the muscle as a whole, and more oblique crossing of the zonular fiber bundles in the zonular plexus. Maximum carbachol-induced accommodative amplitude measured by coincidence refractometry ranged from 3 to 19 diopters in these 1 to 9 yr old animals, with no definite age-accommodation relationship. A-scan ultrasonographic biometry showed that during accommodation the lens thickened very little, if at all, but moved anteriorly, while the apparent cornea to retina distance increased slightly. The raccoon thus exhibits the greatest accommodative capability of any non-primate terrestrial mammal so far studied. PMID- 2714414 TI - Collagen-induced alterations in intercellular adhesion and antigen expression in retinoblastoma cells. AB - Y79 human retinoblastoma cells, which typically grow as suspension cultures in vitro, show increased intercellular and cell-substratum adhesion, and form compact cellular aggregates when cultured on a collagen substratum. Concomitant with collagen-induced formation of compact cellular aggregates, is an increase in the binding of peanut lectin, especially at points of intercellular apposition. In addition, increases in the binding of antibodies against neuron-specific enolase and the cone-specific monoclonal antibody CSA-1 are noted following attachment and growth on collagen. In contrast, a decrease in the binding of antibodies against the glial marker, glial fibrillary acidic protein, is observed in collagen-attached cells. Thus, both the adhesive properties and the biochemical composition of Y79 retinoblastoma cells are altered by their attachment to and growth upon a collagenous substratum. PMID- 2714415 TI - Hyaluronate in healing of corneal alkali wound in the rabbit. AB - The effect of topically applied 1% and 2% sodium hyaluronate was studied on the healing of a standardized rabbit corneal alkali wound. The healing of the epithelium, the stroma, and the endothelium was evaluated separately by applying quantitative methods. The healing was followed for 8 weeks. Both 1% and 2% sodium hyaluronate have a statistically significant positive influence on the epithelial re-surfacing, especially during the late healing phase. Furthermore, sodium hyaluronate has a positive healing influence on the stromal healing at a certain time interval during the observation period. This was reflected as a better maintained stromal dry mass level compared to control. The stromal healing was parallel to a faster re-surfacing of the endothelium. PMID- 2714416 TI - Laminin expressed by cultured Muller cells stimulates growth of retinal neurites. PMID- 2714417 TI - Red cell glutathione as a marker of tobacco smoke-induced optic neuropathy. PMID- 2714419 TI - Long-term proliferation of human leukemia cells induced by mouse stroma. AB - Acute lymphocytic leukemias (ALL) of infants and children were found to preferentially survive in coculture with a cloned cell line of endothelial adipose cells (14F1.1) from mouse bone marrow. One of these ALLs expressed a phenotype compatible with an early stage of differentiation (HLA-DR+, CD19+, and CD34+) and exhibited extensive growth in the presence of the mouse stromal cells during a period greater than 25 weeks following seeding. These ALL cells were strictly dependent upon the mouse stromal clone 14F1.1 and failed to proliferate in the absence of the endothelial adipocytes or with a variety of "feeder cells." Throughout the culture period the cells died if removed from the stroma. No similarly proliferative cell population with strict dependence upon stromal cells was found among a variety of other leukemias including hairy cell, acute myeloid, and chronic lymphocytic leukemia. The 14F1.1 clone has been previously found to promote the renewal of mouse and human stem cells. It is therefore possible that leukemias with a stem cell-like phenotype depend upon stromal cell factors similar to those affecting the growth of normal stem cells. These factors appear to operate across genetic barriers. PMID- 2714418 TI - A role for the macrophage in normal hemopoiesis: III. In vitro and in vivo erythropoietin gene expression in macrophages detected by in situ hybridization. AB - Macrophages derived from unstimulated and unseparated mouse bone marrow cells cultivated on hydrophobic foils can release hemopoietic regulator molecules into the surrounding medium. To prove that one of these regulators exists in macrophages in vitro, in situ hybridization using a 1.2-kb erythropoietin (Epo) gene probe was employed. The probe was biotinylated and the signal developed using a streptavidin-gold reagent. Observation was performed using reflection contrast microscopy. The results indicate that from a 98% pure population of macrophages, 34% F4/80 (mouse, macrophage-specific antigenic determinant) positive macrophages exhibited Epo gene expression. The technique was also applied to normal, steady-state mouse bone marrow in which approximately 10% of the cells are F4/80-positive and of which about 3% demonstrated simultaneous Epo gene expression. As positive control, kidneys from anemic mice were hybridized with the biotin-labeled Epo DNA. A second positive control utilized biotin labeled actin DNA hybridized to cultured macrophages and normal bone marrow cells. The accumulating information, demonstrating that the unstimulated kidney does not express the Epo gene, indicates that Epo is produced in other areas of the body under normal, steady-state conditions. The present results show that 1) macrophages can express the Epo gene, 2) this function is carried out by a subpopulation of macrophages, and 3) bone marrow macrophages in vivo may be responsible for the Epo production-target cell mechanism evoked by short-range and/or cell-to-cell interactions under normal, steady-state conditions. PMID- 2714420 TI - Long-term culture of canine bone marrow cells. AB - Conditions that allow the growth of canine marrow cells in long-term marrow culture are described. The quality of the culture conditions was evaluated based on the weekly number of granulocyte-macrophage colony-forming units (CFU-GM) in the nonadherent cell fraction. Using this parameter, the highest number of CFU-GM was obtained when marrow cells were incubated at 37 degrees C in RPMI-1640 or McCoy's 5A medium supplemented with 20% prescreened horse serum without addition of hydrocortisone. CFU-GM colonies could be regularly grown out of the nonadherent cell fraction for 20-31 weeks, after recharging the cultures with 1.5 X 10(7) mononuclear autologous marrow cells 1 week after establishing the stromal cell layer. PMID- 2714421 TI - Transferrin receptor-mediated suppression of in vitro hematopoiesis by transferrin-gallium. AB - The expression of transferrin receptors on cells is felt to reflect iron requirements for proliferation or for hemoglobin production. We have recently shown that transferrin-gallium (Tf-Ga) complexes bind to cellular transferrin receptors and inhibit cellular iron incorporation. In this study, Tf-Ga in a dose dependent manner inhibited the growth of erythroid (erythroid burst-forming units [BFU-E]-derived), granulocyte-macrophage (granulocyte-macrophage colony-forming units [CFU-GM]-derived) and mixed (mixed CFU [CFU-GEMM]-derived) hematopoietic colonies. Although major differences in the response of the different progenitor cells to Tf-Ga were not seen, CFU-GEMM-derived colonies appeared to be more sensitive to growth inhibition by Tf-Ga. The inhibitory effects on colony growth were reversible after 48 h of exposure of marrow cells to Tf-Ga, suggesting that the initial effects of Tf-Ga were mainly cytostatic and that continuous exposure of cells to Tf-Ga was required for maximal growth inhibition. Transferrin-iron (Tf-Fe) added to the Tf-Ga-containing cultures restored colony growth; however, this effect was best seen when Tf-Fe was added at day 0 of incubation. Tf-Fe added on days 3 or 7 failed to restore GEMM colonies and restored only a fraction of BFU-E and GM colonies. Tf-Ga appears to inhibit hematopoietic progenitor cell growth by interfering with cellular iron utilization during an early phase of progenitor cell proliferation. The use of Tf-Ga may allow further exploration of the role of iron and the Tf receptor in the regulation of hematopoietic progenitor cell growth. PMID- 2714422 TI - Tissue iron deposition in untransfused beta-thalassemic mice. AB - Homozygous beta-thalassemic mice show many of the features seen in human beta thalassemia, such as decreased hemoglobin, hematocrit, and red blood cell count as well as increased reticulocyte count. They also exhibit splenomegaly and a decrease in osmotic fragility of red cells. beta-thalassemic mice were examined for spontaneous iron overload at ages ranging from 20 to 595 days. Accumulation of iron was shown to occur in the spleen, liver, and kidneys but not in the heart. Sections of spleen, liver, kidney, and heart were stained for iron and subjectively scored. Image analysis microscopy was used to examine sections of spleen and liver. Nonheme iron in the four tissues was quantitated using the bathophenanthroline sulfonate colorimetric assay. An increase in tissue iron occurred primarily in the spleen, even before weaning, despite the low iron content of milk. Iron accumulation in the absence of blood transfusion is of interest because iron overload is the major cause of death in human beta thalassemia. PMID- 2714423 TI - In vivo effects of recombinant human erythropoietin on circulating human hemopoietic progenitor cells. AB - Recombinant human erythropoietin (rhEpo), now available, has become increasingly more important for clinical use, e.g., in the treatment of anemia of chronic renal failure, and has been shown to reverse anemia in these patients. When patients with anemia of chronic renal failure were treated with rhEpo at dosages between 40 and 120 U/kg three times per week, the numbers of circulating erythroid burst-forming units (BFU-E) and granulocyte-erythrocyte-macrophage megakaryocyte colony-forming units (CFU-GEMM) significantly increased during the first week of therapy. In contrast, the incidence of circulating granulocyte monocyte CFU (CFU-GM) was not significantly altered. PMID- 2714424 TI - Effect of alpha interferon on growth of leukemic and normal hematopoietic progenitors. Synergism with H2 histamine receptor antagonists. AB - We studied whether the histamine H2 receptor antagonist, cimetidine, potentiates antiproliferative effects of recombinant alpha interferon (IFN alpha) on in vitro clonal growth of certain normal and malignant hematopoietic cells. Cimetidine alone, at therapeutic serum concentrations, was not inhibitory to the cells studied. IFN alpha alone inhibited the growth of HL-60 leukemic cells only at concentrations greater than 1000 U/ml, whereas with cimetidine, inhibition was seen at greater than 1 U/ml of IFN alpha. The enhancing effect of cimetidine on IFN alpha inhibition of clonal growth was neutralized by histamine and was not seen with histamine H1 receptor antagonist. In HL-60 cells, cimetidine also increased the enzymatic activity of (2'-5')-oligoadenylate synthetase, induced by IFN alpha. The combination of cimetidine and IFN alpha had a synergistic inhibitory effect on the growth of leukemic granulocyte-macrophage colony-forming units (CFU-GM) from chronic myeloid leukemia patients, normal CFU-GM, and normal erythroid burst-forming unit (BFU-E) progenitors. These data suggest that cimetidine may play a role in overcoming resistance to IFN alpha therapy in leukemia, but may also increase IFN alpha hematopoietic toxicity. PMID- 2714425 TI - Sex education in the schools: policies and practice. PMID- 2714426 TI - Sex education and AIDS education in the schools: what states and large school districts are doing. AB - Four-fifths of the states either require or encourage the teaching of sex education in the public schools, and nearly nine in 10 large school districts across the United States support such instruction. All but four states and virtually every large school district support the provision of AIDS education, and backing for instruction about sexually transmitted diseases and about abstinence is nearly as widespread. Fewer states and districts (two-thirds and four-fifths, respectively) require or encourage the schools to teach about pregnancy prevention. Examination of state and district curricula indicates that large school districts tend to be bolder than the states in the range of sex related topics covered, especially in the area of pregnancy prevention. Districts also offer local educators more support (through curricula, training and other activities) than do the states. Finally, AIDS education appears to be receiving more attention and funding from both the states and the local school districts than is sex education. PMID- 2714427 TI - What public school teachers teach about preventing pregnancy, AIDS and sexually transmitted diseases. AB - Ninety-three percent of public school teachers in five specialties-biology, health education, home economics, physical education and school nursing--who teach grades 7-12 report that their schools offer sex education or AIDS education in some form. Almost all the teachers believe that a wide range of topics related to the prevention of pregnancy, AIDS and other sexually transmitted diseases (STDs) should be taught in the public schools, and most believe these topics should be covered by grades 7-8 at the latest. In practice, however, sex education tends not to occur until the ninth or 10th grades. Moreover, there is often a gap between what teachers think should be taught and what actually is taught. For example, virtually all the teachers say that school sex education should cover sexual decision-making, abstinence and birth control methods, but only 82-84 percent of the teachers are in schools that provide instruction in those topics. The largest gap occurs in connection with sources of birth control methods: Ninety-seven percent of teachers say that sex education classes should address where students can go to obtain a method, but only 48 percent are in schools where this is done. Forty-five percent of teachers in the five specialties currently provide sex education in some form. The messages they most want to give to their students are responsibility regarding sexual relationships and parenthood, the importance of abstinence and ways of resisting pressures to become sexually active, and information about AIDS and other STDs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714428 TI - Drawing women into prenatal care. AB - Participation in prenatal care services in the United States is low relative to that in many other developed countries, and rates of use are declining among some high risk groups. In 1986, 18 percent of all U.S. infants were born to women who delayed care until the second trimester of pregnancy; four percent, to women who initiated care in the third trimester; and about two percent, to women who obtained no prenatal care at all. Among the major barriers to prenatal care are inadequate insurance coverage, limitations in the Medicaid program, inadequate capacity in the maternity care system, lack of coordination between health and social services for low-income women and inhospitable conditions at some sites where prenatal care is delivered. The personal beliefs, knowledge, attitudes, fears and lifestyles of some pregnant women also constitute obstacles to care. For example, having an unwanted pregnancy, attaching little value to prenatal care and having a tenuous connection to the health care system in general are important predictors of insufficient care. Encouraging universal participation in prenatal care will require a major overhaul of the maternity care system. However, while consensus for fundamental reform builds, several immediate steps should be taken--such as reducing financial barriers to care; expanding the capacity of the maternity care system; improving the policies and practices that shape prenatal services at the site where they are delivered; and increasing public information. PMID- 2714429 TI - The geographic distribution of U.S. hospitals with abortion facilities. PMID- 2714430 TI - Teenage abortion, birth and pregnancy statistics: an update. PMID- 2714431 TI - Carboxypeptidase-B-like processing of the C-terminus of glucagon-like peptide-2 in pig and human small intestine. AB - We developed specific, C-terminal radioimmunoassays for three proglucagon (PG) fragments: PG 151-158, PG 151-160 and PG 126-159 (glucagon-like peptide-2 (GLP-2] in order to determine the exact C-terminal sequence of the newly isolated GLP-2 in man and pig. The antigens and the antisera showed no mutual cross-reactivity. By gel filtration of extracts of pig and human small intestine, the immunoreactivity eluting at the position of GLP-2 was identified by the radioimmunoassays for glucagon-like peptide-2 (PG 126-159) and for PG 151-158, whereas the assay for PG 151-160 was completely negative. We conclude that the C terminal amino acid residue of pig and human ileal GLP-2 is PG 158. Thus the basic residues, PG 159 and 160 are removed during its processing in the small intestine. PMID- 2714432 TI - Protein synthesis in rat cardiac myocytes is stimulated at the level of translation by phorbol esters. AB - 12-O-Tetradecanoylphorbol 13-acetate acutely stimulated the rate of protein synthesis maximally by about 43% in terminally differentiated myocytes freshly isolated from adult rat hearts. Stimulation was rapidly expressed (within 20 min). The relative effects of four phorbol esters on protein synthesis was consistent with a specific effect on protein kinase C. Inhibition of transcription with actinomycin D had no effect on the absolute stimulation of the protein synthesis rate by 12-O-tetradecanoylphorbol 13-acetate. We conclude that protein kinase C may be involved in the regulation of the translational process. PMID- 2714433 TI - The interaction of alkynyl carboxylates with serine enzymes. A potent new class of serine enzyme inhibitors. AB - The recently reported alkynyl esters, propynyl benzoate and propynyl p methoxybenzoate, were found to interact with a variety of serine enzymes. alpha Chymotrypsin was inhibited very rapidly by an equivalent amount of the esters. Trypsin, elastase and pronase were also inhibited by the esters. On the other hand, liver esterase started to hydrolyze the alkynyl esters rapidly, but the enzyme became inhibited during the course of reaction. The inhibited enzymes exhibited slow reactivation which could be considerably enhanced by hydroxylamine. PMID- 2714434 TI - Effects of mastoparan on catecholamine release from chromaffin cells. AB - Release of catecholamines from bovine adrenal chromaffin cells exposed to mastoparan, a wasp venom peptide which activates GTP-binding proteins and phospholipase A2, was evaluated. Release of catecholamines was dependent on mastoparan concentration and time of exposure. This release was, however, independent of extracellular calcium and accompanied by release of the cytoplasmic marker lactate dehydrogenase. Mastoparan also inhibited catecholamine secretion evoked by nicotine, but the peptide had little or no effect on release induced by other secretagogues. These findings suggest that in chromaffin cells mastoparan is not a secretagogue but rather causes cell lysis and blocks nicotinic receptor function. PMID- 2714435 TI - Determination of the functionally important heme peripheral vinyl group orientation in paramagnetic hemoprotein by 2D NMR. AB - 2D NMR spectroscopies have been successfully used to characterize the heme peripheral vinyl groups in paramagnetic hemoprotein in spite of the difficulties from the rapid paramagnetic relaxation and the low digital resolution of the 2D NMR map. The scalar coupling network system among the vinyl protons is clearly identified in the COSY spectra from its characteristic cross-peak pattern and the dipolar coupling connectivities of the vinyl proton resonances with other heme side-chain proton resonances not only provide the specific assignment of vinyl beta-proton resonances but also allow the determination of the vinyl group orientation with respect to the heme plane. PMID- 2714436 TI - Recombinant H-chain ferritins: effects of changes in the 3-fold channels. AB - Human H-chain ferritins bearing sequence changes in the 3-fold channels have been expressed in E. coli to investigate the role of these channels in iron-storage processes. The proteins assemble into shells resembling those of native ferritins. Iron uptake measurements indicate that residues in the 3-fold channels are involved neither in initial Fe(II)-oxidation nor in iron-core nucleation. PMID- 2714437 TI - Purification and partial amino acid sequence analysis of human erythrocyte acetylcholinesterase. AB - A single step immunoaffinity purification procedure for human erythrocyte acetylcholinesterase is described which permitted the isolation of milligram quantities of enzyme from 10 U of erythrocytes, with 113,000-fold purification and a yield of about 22%. In SDS-PAGE analysis, the enzyme corresponds to a disulfide linked dimer of 140 kDa which is converted to a 70 kDa monomer upon disulfide reduction. The tryptic peptides generated from purified enzyme were separated by reverse-phase HPLC. Five of these peptides were analysed to determine the amino acid sequences. The obtained sequences showed no homology to the already known amino acid sequences for human serum and brain butyrylcholinesterase and Torpedo californica acetylcholinesterase. PMID- 2714438 TI - Rat pineal S-antigen: sequence analysis reveals presence of alpha-transducin homologous sequence. AB - S-antigen (S-Ag) is a soluble, highly antigenic protein, the administration of which induces autoimmune uveitis. This protein is found in the retina and pineal. Retinal S-Ag from three species has been sequenced. In this study rat pineal S-Ag was sequenced. Clones were isolated from a rat pineal lambda gt11 cDNA library by probing with a 300 bp fragment of mouse retinal S-Ag cDNA containing the 5' coding region. The largest clone isolated (RPS-118; 1364 bp) contained the entire coding sequence. Comparison of the rat pineal and mouse retinal S-Ag nucleotide sequences indicated a high homology (95%). The deduced amino acid sequence was found to contain 403 residues (congruent to 44 992 Da). Comparison of the rat pineal and mouse retinal S-Ag amino acid sequences also revealed high homology (97%). The similarity of both the nucleotide and amino acid sequences of rat pineal and mouse retinal S-Ag indicates that expression of the S-Ag gene in both tissues is similar. Further analysis of the rat pineal S-Ag sequence indicated that it contained essentially the same major uveitopathogenic region of S-Ag present in bovine retina; minor uveitopathogenic sites were somewhat different. As is true of retinal S-Ag, rat pineal S-Ag contains the same consensus phosphoryl-binding site present in many GTP/GDP-binding proteins and a homologous sequence found in the C-terminus of alpha-transducin. These sequences may play a role in the action of pineal S-Ag in transmembrane signal transduction. PMID- 2714439 TI - Two structural types of mercury reductases and possible ways of their evolution. AB - Structural differences have been revealed among mercury reductases of immunologically unrelated types from Gram-positive bacteria: enzymes of one immunological type have a molecular mass of 62-69 kDa and seem to contain an N terminal extension of 5-15 kDa, which is easily cleaved by trypsin and chymotrypsin; enzymes of the other immunological type have a molecular mass of 52 57 kDa and are resistant to proteolysis. The existence of at least two different lines in the evolution of mercury reductases is surmised. PMID- 2714440 TI - Glycine and other amino compounds prevent chromatin precipitation at physiological ionic strength. AB - Glycine, proline and taurine, when present in the range 0.1-0.60 M, inhibit chromatin precipitation by sodium chloride. Histone gel electrophoresis revealed that the linker histones H1 and H5 were largely depleted from the supernatant chromatin fraction at 0.2 M NaCl, while this depletion was absent in the presence of glycine. These observations are discussed in relation with the various factors which may be involved in the precipitation process. PMID- 2714441 TI - Purification and characterization of Ca2+/calmodulin-dependent actin-binding proteins from squid retina. AB - Ca2+/calmodulin (CaM)-dependent actin-binding proteins (CABPs) of 92, 105, 120 and 135 kDa were purified from squid retina. These proteins were eluted from the CaM affinity column in a Ca2+-dependent manner, and binding of the CABPs to F actin was regulated by Ca2+/CaM. Electron microscopic observations employing the low-angle rotary shadowing technique showed the CABP molecules to have granular shapes similar to the granular proteins associated with actin filaments in squid rhabdomeral microvilli. We have previously reported that these actin filaments are fragmented upon exposure to light [(1988) J. Cell Biol. 106, 1151-1160]. Since the intracellular Ca2+ concentrations of the invertebrate retina are elevated during the light illumination, these results indicate that the CABPs are directly associated with the actin filament in the microvilli of the squid photoreceptors. We therefore suggest that the CABPs may regulate the light induced structural changes of the microvillar cytoskeleton. PMID- 2714442 TI - Chicken spermatogenesis is accompanied by a genomic-wide loss of DNA methylation. AB - Renaturation kinetics of DNA obtained from chicken testis cell nuclei separated by sedimentation at unit gravity showed that the undermethylation, previously observed in meiotic and postmeiotic cells, is not a peculiarity of repetitive sequences, but is also a feature of unique sequences. The large proportion of slowly renaturing, intermediately renaturing and rapidly renaturing DNAs contain 27, 32 and 31% less methylcytosines in meiotic and postmeiotic cells than the corresponding fractions of premeiotic cells. DNA methyltransferase activity is lower in meiotic cells containing undermethylated DNA than in immature testis, enriched in spermatogonia, with higher levels of DNA methylation. PMID- 2714443 TI - Stem bromelain: amino acid sequence and implications for weak binding of cystatin. AB - The amino acid sequence of stem bromelain, the major cysteine proteinase from pineapple stem is described. It shows that the enzyme is a member of the papain superfamily of cysteine proteinases, but is not very closely related to any other known member of this group. The sequence shows mutation or deletion of several residues that have been conserved in cysteine proteinases examined previously, including Asn-175 (papain). We suggest that some of these changes have the effect of altering the active-site geometry of stem bromelain, and that this accounts for the resistance of the enzyme to inhibition by cystatins and E-64[L-3-carboxy 2,3-trans-epoxypropionylleucylamido(4-guanidino)b utane]. PMID- 2714444 TI - Distribution of serotonin 5-HT1C receptor mRNA in adult rat brain. AB - Based on in situ hybridization histochemistry (ISHH), we describe the anatomical distribution of the serotonin 5-HT1C receptor mRNA. In addition to the very high levels in epithelial cells of the choroid plexus, 5-HT1C receptor mRNA is found throughout the limbic system, in catecholaminergic cells and in serotonergic neurons. Receptor transcripts are also present in the hypothalamus, numerous motor nuclei and the subthalamus. Our results correlate well with serotonin (5 HT) innervation and receptor binding. Receptor mRNA is present in many brain structures in addition to regions previously shown to have 5-HT1C receptor binding. The distribution of this receptor mRNA suggests that the 5-HT1C receptor may mediate a number of the central effects of 5-HT. PMID- 2714445 TI - Catecholamines increase nerve growth factor mRNA content in both mouse astroglial cells and fibroblast cells. AB - Previous studies have shown that catecholamines increase the nerve growth factor (NGF) content in medium conditioned by mouse L-M fibroblast cells and mouse astroglial cells. In this study, the NGF mRNA levels in these cells were measured by Northern blot analysis. In astroglial cells treated with epinephrine (EN), the cellular NGF mRNA level increased prior to accumulation of NGF in the culture medium. 3-Hydroxytyramine (DA) and norepinephrine (NE) also increased the cellular NGF mRNA content. An increased level of NGF mRNA elicited by EN was also observed in mouse L-M cells. These results indicate that catecholamines enhance NGF synthesis of L-M fibroblast cells and astroglial cells by increasing the cellular content of NGF mRNA. The present results also indicate that the effects of catecholamines are not mediated by adrenergic receptors. PMID- 2714446 TI - Chronic long-term electrostimulation creates a unique metabolic enzyme profile in rabbit fast-twitch muscle. AB - Long-term low-frequency stimulation (up to 120 days) of rabbit fast-twitch tibialis anterior muscle led, in a first-order-like time course, to changes in enzyme activities of energy metabolism which became stable with ongoing stimulation after 50 days. The glycolytic enzymes decreased to 30-40% of their normal values, but remained 2-3-fold higher than in heart or soleus muscle. The LDH isozyme pattern ultimately resembled that of the slow-twitch soleus muscle. Citrate synthase activity increased 3.7-fold which brought this enzyme to a value 45% above that of heart. These results indicate that chronic stimulation does not simply convert the fast-twitch muscle into a soleus-like slow-twitch muscle, but creates a tissue of unique metabolic properties. PMID- 2714448 TI - European vascular surgery 1988. Increasing needs in an era of constrained economical resources. PMID- 2714447 TI - Isozymic forms of protein kinase C in regenerating rat liver. AB - The expression of multiple forms of protein kinase C (PK-C) was studied in regenerating rat liver using hydroxyapatite column chromatography. Two forms of the enzyme were found in the cytosolic as well as membrane fraction of livers from partially hepatectomized rats. The kinetic variation in the activation of these two liver isozymes by fatty acids, phosphatidylserine and diacylglycerol was similar to that reported for the PK-C subspecies from rat brain, designated types II and III. Intracellular redistribution of PK-C caused by phorbol 12 myristate 13-acetate (PMA) was concentration-dependent and was due to translocation of isozyme III, because type II was insensitive to 5 x 10(-8) M PMA. The activity ratio of the two isozymes in either the particulate or cytosolic fraction was the same at 22 h as compared to 4 h after partial hepatectomy. PMID- 2714449 TI - Articles presented at the second meeting of the ESVS. European Society for Vascular Surgery. Rotterdam, September 1988. PMID- 2714450 TI - How fast do very small abdominal aortic aneurysms grow? AB - Fifty patients with abdominal aortic aneurysms from 2.5 to 5.0 cm in anteroposterior diameter (median 3.1 cm, mean +/- S.E. 3.3 +/- 0.1 cm) were initially offered non-operative treatment. Two patients have subsequently undergone successful elective aneurysm resection because of increase in aneurysm size, and a third has died. The median annual growth rate of the aneurysm has been 0.22 cm and 77.8% increased in size between 6 monthly ultrasound examination. For aneurysms less than 4.0 cm the maximum 6 monthly increment in diameter was 0.7 cm. Even the smallest abdominal aortic aneurysms usually progressively increase in size and 6 monthly ultrasound remeasurement of aneurysm diameter is an essential component of non-operative management. PMID- 2714451 TI - The influence of prostaglandin E1 on systemic and pulmonary haemodynamics after aortic surgery. AB - The influence of a peroperative prostaglandin E1 (PGE1) infusion on systemic and pulmonary haemodynamics in a porcine model of aortic surgery was studied. Twenty four pigs were randomised to PGE1 (100 ng/kg/min) or 0.9% Saline as placebo. Haemaccel was then infused to maintain a central venous pressure (CVP) of greater than 4 less than 6 mmHg and pulmonary artery wedge pressure (PAWP) of greater than 3 less than 5 mmHg. Standardised aortic surgery consisted of midline laparotomy, small bowel exteriorisation, 1.5 h aortic clamping and 1 h shock before resuscitation. Serial measurements of blood pressure (BP), cardiac output (CO), pulmonary vascular resistance (PVR), pulmonary shunt (A-V shunt), and arterial PO2 (PaO2) were recorded during and three days after surgery. Volume loading with Haemaccel prevented a significant fall in initial BP on PGE1 at 95.1 +/- 48 mmHg compared to 102 +/- 4.9 mmHg in control animals with similar CO in the two groups. Following release of the aortic clamp all animals became profoundly hypotensive with BP falling to 74.6 +/- 3.0 and 68.7 +/- 3.2 mmHg for PGE1 and placebo respectively, but CO was protected in those animals receiving PGE1 at 1.92 +/- 0.04 compared to 1.67 +/- 0.1 L/min/m2 on placebo and remained significantly higher following resuscitation and three days later (P less than 0.05). PGE1 also reduced the marked rise in pulmonary vascular resistance to 922 +/- 84 dynes-s/cm5/m2 during shock in control animals to only 555 +/- 30 (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714452 TI - Groin infections following vascular surgery: obturator bypass (BYP) versus "biologic coverage" (TRP)--a comparative analysis. AB - Deep infections in the groin complicating vascular surgical procedures pose a serious problem, in the treatment of which two alternative methods are available: (1) Removal of the graft and the construction of an extra anatomic bypass (obturator canal bypass, BYP), or (2) retaining the graft and achieving healing of the infected wound by various biological materials, such as omentum or an inferior rectus abdominis muscle flap (TRP). The probability of patient and limb survival was estimated by the Kaplan-Meier method and possible differences between both groups checked using Breslow's and Mantel's tests. No statistically significant differences were found and a variety of factors with potential influence on the outcome were considered equally balanced. However, as soon as the catastrophic event of infection plus haemorrhage enforced emergency surgery, the incidence of success differed markedly: in the BYP group 6 infections healed out of 8 and in the TRP group 1 out of 6. PMID- 2714453 TI - Defining parameters for peripheral laser angioplasty. AB - In vitro studies are reported using a Pulsed Dye laser at wavelengths of 440, 480, 504, 560 and 590 nm, to vaporise multiple samples of yellow, fibrous and calcified plaque. The threshold for crater production at 440 nm was 5 mJ/pulse and at 590 nm 65 mJ/pulse. Crater depth was significantly deeper at the short wavelengths (440, 480 and 504 nm) than at the longer (560 and 590 nm). Light microscopy confirmed the absence of thermal damage associated with continuous wave lasers. Electron microscopy revealed smooth-contoured craters and no disruption of subcellular elements at the crater margin. Samples of thrombus- and atheroma-occluded human femoral artery were successfully recanalised at the 480 nm wavelength with atraumatic spherical-tipped and modified spherical tipped optical fibres. The advantages of pulsed laser energy in peripheral vessel recanalisation are discussed. PMID- 2714454 TI - Laser Doppler flowmetry in evaluation of colonic blood flow during aortic reconstruction. AB - Intraoperative laser Doppler flowmetry (LDF) was used to measure blood perfusion in terminal ileum and sigmoid colon in eight patients operated on for aorto-iliac occlusive disease (AIO) and eight patients for abdominal aortic aneurysm (AAA). The aim of the study was to evaluate the influence of clamping the inferior mesenteric artery (IMA) on intestinal perfusion. LDF-measured sigmoid colon flow was also compared with the postoperative clinical course, to define a limit below which risk of ischaemic colitis is high and revascularisation should be considered. Neither clamping of the IMA nor aortic reconstruction affected perfusion in the terminal ileum in any group. Sigmoid colon perfusion in the AAA group showed a slight, not significant reduction after reconstruction (P = 0.09). AIO patients showed significant flow reduction in the sigmoid colon when the IMA was clamped (P less than 0.05), returning to the initial value after aortic reconstruction with end-to-side proximal anastomosis and preservation of IMA. AAA patients, operated with end-to-end proximal anastomosis and ligation of IMA, had significantly lower sigmoid colon perfusion after aortic reconstruction than AIO patients (P less than 0.05). Thirteen patients had sigmoid colon flux values greater than 5 RFU (Relative Flux Units) after reconstruction, and had no complications. Three aneurysm patients had flux values less than 3.3 RFU, and developed symptoms of ischaemic colitis. We conclude that LDF can be easily applied to the evaluation of colonic blood flow during aortic surgery. Flux values less than 4 RFU may indicate a risk of ischaemic colitis, and justify revascularisation of the colon. PMID- 2714455 TI - The non-reversed vein femoro-distal bypass graft: a modification of the standard in situ technique. AB - The results of 85 in situ vein femoro-distal bypass grafts using a modified technique where the vein was completely mobilised but left "non-reversed" have been reviewed with particular regard to risk factors and complications. The distal anastomosis was to the infrageniculate popliteal artery in 55% and to the tibioperoneal trunk or a single calf vessel in the rest. Arteriographic run-off was by a single vessel in 42%. The primary failure rate at 1 month was 20% and the secondary failure rate 9%; the majority of early failures being due to missed technical errors despite the use of a pulse volume recorder. The cumulative secondary patency rate at 1 and 2 years was 77% and 72%; limb salvage 85% and 77%; and patient survival 89% and 83% respectively. The only significant risk factors were the level of the distal anastomosis and the run-off (P = 0.002 and 0.03 respectively). Complete mobilisation of the vein allows a tension free proximal anastomosis to the common femoral artery and avoids the risk of arteriovenous fistulae. A high vein utilisation rate of 93% was achieved by using a small 2.5 mm Hall valvulotome. Although there was a trend towards lower patency rates in veins with a minimum diameter less than 4 mm the results are still superior to PTFE. Compared to reversed vein the in situ technique has a better utilisation rate and the long-term patency rates are at least as good if not better. Improved methods of haemodynamic assessment during reconstruction to reduce technical errors may be the key to better early patency rates. PMID- 2714456 TI - Applications and limitations of laser-assisted angioplasty. AB - Laser-assisted angioplasty is rapidly evolving into a promising adjunct to or replacement for standard vascular procedures. A protocol was devised to evaluate the technique in a non-selected, consecutive patient population to define the applications and limitations of the technique. In a 12-month period, 358 lower limb atherosclerotic lesions were treated with laser/balloon angioplasty [percutaneously (52%) or open (48%)] in 206 consecutive patients. Overall, the laser/balloon technique recanalised 234 lesions (65% laser success), judged clinically effective by a greater than 0.15 improvement in the ankle/brachial index and elimination of symptoms. Operative complications included: perforation (15, 4.2%); thrombosis (16, 4.5%); spasm (5, 1.4%); and false aneurysm at the puncture site (7, 2.0%). Of the 124 failures (35%) categorised for analysis, the most common cause was inability to cross the lesion in 20 cases. This experience has identified three significant clinical limitations to successful laser recanalisation: calcification, inadequate distal circulation, and inability to control restenosis/reocclusion (collapsible lesions and accelerated plaque deposition). Further research is needed to determine if thermal injury seriously compromises the safety and long-term outcome of laser-assisted angioplasty. PMID- 2714457 TI - Assessment of a new device for laser angioplasty. AB - Experimental work has shown that a transparent laser device delivering pulsed energy to an artery results in a smaller area of surrounding damage than does an opaque device with a continuous wave laser. The combination of a transparent ball tipped device with a pulsed Nd-YAG laser has been investigated. The system delivers pulses of 100 microseconds at a rate of 10 Hz and average energy of 0.5 J per pulse with an energy loss of 5-10% between the output at the laser rail and the fibre tip. The dose/response was measured and showed that on normal aorta under saline the device produces craters with a depth of 5 microns/J and 1.5 mm radius. There is a 100% increase in dose response with diseased aorta and a 50% increase when exposure is carried out under blood. The effect of a varying angle of incidence upon the arterial wall has been measured. Angulation of the device at 10 degrees from the perpendicular reduces the crater depth to 50%, as compared with a 50% reduction at 60 degrees using a bare fibre. As estimated with a thermal camera in air, the device heats up to a maximum of 50 degrees C during a 50 J exposure, compared to 110 degrees C after 5 J for the sapphire device. Artificial circulation experiments were carried out using diseased femoral vessels occluded by a ligature. The new system recanalised 100% of occlusion in straight vessels, and 40% of occlusions in curved vessels at a radius of 2.5 cm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714458 TI - Can thyroxine halt the progression of peripheral arterial disease? AB - Fifteen women with claudication and increased serum thyrotrophin (TSH) were treated with L-thyroxine (25-75 micrograms). These women were selected from a group of 80 consecutive women presenting with claudication, rest pain or gangrene. One year after their TSH was normal, their progress, serum lipids and lipoproteins were compared with the 58 women with normal levels of serum TSH; the remainder were already receiving thyroxine. Non-invasive assessment showed that three of the 15 (20%) women treated with thyroxine had progression of arterial disease, two in the legs and one in the legs and coronary arteries; two women showed improvement of ankle/brachial pressure indices. There was no accelerated angina, myocardial infarction, stroke or death in this group. Fifty-six of the 58 patients with normal levels of TSH were alive at follow-up and there was progression of distal disease in 24 (43%), coronary artery disease in 6 (11%), increasing carotid stenosis in four and two complained of transient ischaemic attacks. In this group, disease progression affected 32/56 (57%) of the women and this is significantly greater than in the thyroxine treated group chi 2 (P less than 0.05). Treatment with L-thyroxine caused a significant increase in HDL cholesterol from 1.29 +/- 0.34 to 1.45 +/- 0.49 mmol/L (P less than 0.05) and a significant decrease in cholesterol from 8.0 +/- 1.3 to 7.2 +/- 1.1 mmol/L (P less than 0.01) and apolipoprotein B from 1.23 +/- 0.20 to 1.04 +/- 0.16 g/l (P less than 0.001). Significant changes in apolipoprotein B were observed after 3 months of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714459 TI - The natural history of abdominal aortic aneurysm. AB - The outcome of 65 patients with unoperated abdominal aortic aneurysms (AAA) were reviewed in order to evaluate the natural history and "quality of life". An estimated cumulative life-table was constructed. Of the 65 patients admitted to the department (from 1972 to 1984), 52 were discharged from the hospital and not operated on because of concurrent medical disorders. These patients were divided into two groups: 34 with asymptomatic AAA on admission to the department and 18 with symptoms. During follow-up, 38 patients died, 71% in the asymptomatic and 78% in the symptomatic group. Less than 50% of all the patients died of concurrent disease. Of the patients in the asymptomatic group with a small aneurysm, 38% died of rupture of AAA. As AAA is a disease with a high mortality, the co-existent medical disorders must be very "serious" if the patient is not to be offered an operation. Even small, asymptomatic AAAs may rupture and should be operated on. No factor seemed to predict the natural history for the individual patient. A score system, for example, the "Boston score", is recommended. This would facilitate good objective assessment of the patients entering into future studies and the evaluation of "survival curves" will improve. PMID- 2714460 TI - Anticoagulation in abdominal aortic aneurysm surgery: the approach of vascular surgeons in Great Britain and Ireland. AB - A questionnaire was sent to 283 vascular surgeons in Great Britain and Ireland regarding their use of heparin in elective abdominal aortic aneurysm surgery. The answers form the basis of this study and show that there is great variation. The majority of surgeons routinely anticoagulate their patients peroperatively. Heparin is usually given intravenously--most giving the drug 2 to 3 min prior to cross clamping the aorta. Approximately half of the respondents use the same dose in all patients, whilst the remainder vary the dose, usually on the basis of weight or "size". Most surgeons use 5000 units but the range of dose varies from 400 to 20,000 units. Just under a quarter of surgeons continue to anticoagulate their patients postoperatively, almost all of these using subcutaneous heparin for prophylaxis against deep vein thrombosis. Only approximately 10% of surgeons routinely reverse the heparin with protamine. PMID- 2714461 TI - Plasma metabolic disturbances and reperfusion injury following partial limb ischaemia in man. AB - Despite efficient revascularisation procedures for vascular disease, the limb can occasionally be lost following reperfusion. One contributing factor might be the formation of oxygen free radicals. This study attempts to describe the conditions necessary for oxy-radical formation from adenine nucleotide breakdown products and the role of plasma creatine content as a marker of cellular injury. Twelve patients undergoing aortic reconstructive surgery were studied. Only partial ischaemia of the lower limbs was induced by the aortic clamping, since varying degrees of collateral circulation existed. Radial arterial and external iliac venous blood was obtained simultaneously before, during and after cross-clamping of the aorta, and plasma levels of ATP, ADP, hypoxanthine, phosphocreatine, creatine, creatinine and lactate measured using luminescence and spectrophotometry. Venous creatine content increased during ischaemia and was doubled 30 min after recirculation. This increase was possibly due to leakage following cellular injury agreeing with a previously observed decrease in muscle tissue creatine content. The iliac arterio-venous difference of hypoxanthine and lactate markedly increased immediately post-ischaemia, while the phosphocreatine difference decreased. Plasma hypoxanthine was abundant in the leg on reoxygenation. The existence of a xanthine oxidase system in skeletal muscle could produce favourable conditions for oxy-radical formation through hypoxanthine degradation, which may contribute to the known muscle tissue injury. PMID- 2714463 TI - Acute. PMID- 2714462 TI - Portal hypertension and chronic pancreatitis complicating an inflammatory aortic aneurysm. AB - A case of inflammatory abdominal aortic aneurysm (AAA) is described in which the inflammatory process extended to the porta hepatis leading to portal hypertension, and to the root of the small bowel mesentery with associated chronic pancreatitis. We have been unable to find a similar case recorded in the literature. PMID- 2714464 TI - Transposition of the Sartorius Muscle in the treatment of Infected Vascular Grafts in the Groin. PMID- 2714465 TI - [Digestive and transport enzymes of the small intestine under the action of low mineralized water "Naftusya" and its components]. AB - Mineral water Naftusya and its components: macrosalt analog and bitumen fraction have been studied in vitro for their effect on enzymes of the mucous small intestine membrane: M2+ and Na+, K+-ATPase, alpha-amylase, proteinase and leucine aminopeptidase. It is shown that certain components of mineral water are able to change activity of some enzymes. Transport Na+, K+-ATPase proved to be the most sensitive to the action of studied factors. Mineral water and bitumen fraction induced an increase of the enzyme activity by 23, 20 and 45%, respectively. Mineral water and its salt analog induced inhibition of leucine aminopeptidase: its activity decreased by 16 and 15%, respectively. Digestive enzymes: alpha amylase and proteinase are resistant to the action of mineral water and its components. PMID- 2714466 TI - [Role of the spleen in the regulation of the calcium content of the blood plasma in health and in stress]. AB - Splenectomy is found to be followed by an increase of the calcium level in blood. Administration of the spleen extract (splenin) decreases the calcium concentration in blood plasma of splenectomized animals. The normalizing splenin effect is observed in the presence of stress when the concentration of the studied trace element sharply increases as well. It is supposed that the humoral spleen factors participate in maintenance of the constant calcium level in blood preventing its elimination from tissues. PMID- 2714467 TI - [External respiration, gas exchange and blood acid-base status in dogs with hyperthermia]. AB - Experiments on dogs have shown that hyperthermia intensifies respiration, increases oxygen consumption, induces pronounced discrepancy of the alveolar ventilation to carbon dioxide elimination, severe hypocapnia and decompensated respiratory alkalosis. PMID- 2714468 TI - [Orthostatic reactions of blood circulation and autonomic regulation in healthy persons of various ages]. AB - The age-related changes in vegetative regulation of blood circulation during active orthostatic test (AOT) have been studied in 90 practically healthy people aged from 21 to 89. The stroke blood volume was determined using the tetrapolar thoracic rheography. The basic state of the vegetative heart regulation and its changes during AOT were studied by means of the spectral analysis of the stationary rhythmograms. It is shown that intensity of both primary and secondary compensatory circulatory responses during the AOT decreases with age. An age related impairment of the reflectory influences on heart and vessels is induced by a decreased overall vegetative tonus and insufficient activation of the sympathetic system in orthostasis. The orthostatic hypotension in elderly and old people is probably mediated by an inadequately small increment of peripheral vascular resistance and cardiac rhythm resulting from the age-related impairment of baroreceptor sympathetic control of the blood pressure. PMID- 2714470 TI - [Oxidative metabolism of the cerebral cortex in young animals]. AB - Intensity of glucose, leucine and palmitate oxidation in the cortex of pigs increases during the first days after their birth. Fasting of pigs during 24 hours after birth intensifies glucose catabolism in the cortex through the pentose phosphate way. Intensity of palmitate and leucine oxidation in the cortex of fasting pigs is at the low level. Ketonic bodies participate in the power supply of cortex functions of satisfied one-day pigs but their contribution to the nerve tissue power of fasting one-and five-day pigs is insignificant. PMID- 2714469 TI - [Effect of various types of sports on the pulmonary rheogram of young school age children]. AB - The pulmonary blood circulation of boys aged from 8 to 12 going in for swimming and wrestling has been studied by the rheographic method. It is found that the pulmonary rheogram of young sportsmen differs significantly from the one of non sportsmen of the same age. The basic wave amplitude is larger, its elevation and fall angle is smaller, presystolic, systolic and diastolic parts are longer, rheographic systolic and diastolic indices as well as vascular wall elasticity index are higher, peripheral resistance of arterioles and cappilaries are lower in trained children. These values demonstrate a decrease in the pulmonary blood flow rate and an increase in its volume as well as improvement of the elastic viscid properties of blood vessel walls. They also indicate the economy development of pulmonary circulation activity. The mentioned deviations are better expressed in young swimmers. PMID- 2714471 TI - [Dependence of lipid peroxidation on the typologic characteristics of the nervous system and their relation to the resistance of the body to exertion]. AB - Resistance of animals with different type of the nervous activity to physical exercises depends on the activity of lipid peroxidation processes in tissues. The highest degree of adaptation to prolonged running is observed in the inhibitory type rats as against the excitable and even-tempered ones. PMID- 2714472 TI - [Role of the hypophyseo-adrenal system in regulating the acid-secreting function of the kidneys]. AB - The experiments on male albino rats have shown that both stress and hydrocortisone elevate the urinary excretion of hydrogen ions in the form of titrated acids and ammonium ions. Desoxycorticosterone acetate (DOCSA) in intact rats, adrenal- and hypophysectomy lower ammonium ions excretion. Both stress and DOCSA increase the tubular sodium reabsorption, while hydrocortisone, adrenal- and hypophysectomy decrease it. A conclusion is made that both glucocorticoids and mineralocorticoids participate in the renal functional change under stress. It should be underlined that glucocorticoids stimulate the secretion while mineralocorticoids play the leading part in maintenance of sodium homeostasis. PMID- 2714473 TI - [Ontogenetic features of autonomic homeostasis in children according to the data of variation pulsometry]. AB - A method of variation pulsometry was used to determine the vegetative homeostasis state in 20 children aged from 4 to 14. Normotonic type of the cardiac rhythm regulation was observed in a group of children aged 4-5. In children aged 12-14 the effect of sympathetic area of the vegetative nervous system decreased while the effect of the parasympathetic one increased. The tension index, effect of the humoral regulation channel and the degree of cardiac rhythm control centralization decreased. PMID- 2714474 TI - [Status of the electrolyte balance of the gastric juice during stimulation of secretion by histamine]. AB - The content of electrolytes (Na+, K+, Ca2+) in human basal secrete has been determined before and after injection of histamine in gastric juice and insoluble mucus in healthy people. Electrolytes in the mucous membrane of the stomach, gastric juice and insoluble mucus have been determined in dogs with stomach fistula after Basow. Species peculiarities have been marked in electrolyte content change during gastric secretion. PMID- 2714475 TI - [Ontogenetic features of the accumulation and restoration of thiamine of the digestive system organs in white rats]. AB - Accumulation and renewal of thiamine in tissues of the uneven-aged rats have been investigated. The activity of thiamine-metabolizing and thiamine-retaining systems is shown to decrease in tissues of the digestive system with aging; the same refers to the intensity of enterohepatic recirculation of that vitamin. These phenomena underlie the revealed retardation of the thiamine renewal in organs of the digestive system. PMID- 2714476 TI - [Effect of emotional-algesic stress on the hormonal function of thyroid and parathyroid glands]. AB - Experiments on 215 Wistar rats have revealed that the state of the endured stress is an essential factor inducing disturbance in functioning of the hypothalamus adenohypophysis-thyroid gland system accompanied by disturbance in regulation of the thyrotropin and triiodothyronine formation under conditions of myocardium necrosis development. PMID- 2714477 TI - [Effect of triathlon competition on the content of various hormones and the energy substrate of the blood]. AB - The effect of triathlon (3.8 km swimming, 180 km biking, 42 km running) and of its short variant (1.5 km swimming, 42 km biking, 14 km running) was studied in 7 and 14 well-trained men, respectively. The level of plasma glucose, total cholesterol, HDL, LDL did not change significantly during the competition. FFA concentration increased significantly (by 439 and 61%, respectively). Triglycerides concentration decreased during the prolonged variant. Both variants of triathlon caused a pronounced rise in the cortisol level and moderate increase in somatotropin and progesterone levels. Testosterone concentration increased during a short variant and decreased during a prolonged one. Insulin and C peptide levels decreased. All those changes in hormones concentration are consistent with an increased lipolytic activity and, may be, with increased glycolytic activity (maintenance of the normal glucose concentration in blood). The rise in the aldosterone level reflects the homeostatic activity in maintaining electrolyte balance. PMID- 2714478 TI - [Effect of cortisol on estradiol secretion and its reception in the morning and evening hours in 30-day-old female rats]. AB - Cortisol administration (250 micrograms) to 5-day-old female rats was studied for its effect on the diurnal (morning-evening) rhythm of the estradiol secretion and reception on the 30th day of life. This stimulus had no influence on the estradiol level in the morning time. In the evening the estrogen concentration in the control group decreased while in the cortisol-treated group there were no changes. Disturbance of the circadian periodicity in the serum estradiol concentration in cortisol-treated animals was not induced by changes in the secretory ability of adrenals and ovaries, which was estimated by measurement of the estradiol production by glands in vitro. This disturbance was not a result of changes in hormone reception in uterine cytosol. The increased estradiol level in cortisol-treated rats in the evening is in good agreement with effects caused by neonatal glucocorticoid treatment in the reproductive system. PMID- 2714479 TI - [A micro-computer program for statistical analysis of data from twin studies]. AB - A program of statistical processing of data obtained while examining twins is described. Transformed algorithms, directions for programme use and a control model are presented. PMID- 2714481 TI - [A clearance method of measuring tissue blood flow using electrochemical generation of hydrogen]. AB - Practical approaches are elaborated as to application of the clearance method using electrochemical hydrogen generation to measure volume blood flow velocity in human and animal organs and tissues. Results from this elaboration and analysis of the obtained experimental data are presented. Some specific features of the method are described. PMID- 2714480 TI - [Correlation of the antioxidant and coagulating blood systems under physiologic conditions]. AB - Examinations carried out on intact animals and healthy people have revealed a paired and multiple correlation with exists between thromboplastic properties of erythrocytes, the level of malondialdehyde accumulation in their membranes and the superoxide dismutase activity. PMID- 2714482 TI - The amino-glycosides. AB - Nurses are in an excellent position to participate in the prevention of toxic reactions during aminoglycoside therapy. The nurse monitors important parameters and thus has the opportunity to promptly detect warning signs of toxic conditions. Awareness of the toxic potential of aminoglycosides as well as knowledge of the signs and potentiators of toxic reactions can make nurses a vital link in the safe administration of aminoglycosides. PMID- 2714483 TI - Acute crack cocaine intoxication: a case study. AB - The survival of a patient with acute crack intoxication requires the dynamic and ongoing collaboration of the nurse and physician to facilitate aggressive treatment. The prevention of ominous complications in the patient exhibiting multisystem failure requires advanced physical assessment skills. It is the integration of these physical findings along with the interpretation of laboratory data and invasive monitoring techniques that enables the critical care nurse to constantly evaluate the patient's response. This ongoing evaluation further directs care planning to potentiate optimum patient outcomes. PMID- 2714484 TI - Computerized patient records. Legal issues in nursing. PMID- 2714485 TI - Research priorities in critical care nursing. PMID- 2714486 TI - Measurement of pulsus paradoxus. AB - Pulsus paradoxus is a valuable clinical sign when there is a greater than 10 mm Hg drop in peak systolic blood pressure during normal inspiration. Although the exact mechanism is not known, tense fluid accumulation within the pericardial sac impairs left ventricular filling during inspiration when right ventricular filling is increased. This causes an exaggerated reduction in systolic blood pressure during inspiration. Critical care nurses need to become familiar with the three methods of measuring pulsus paradoxus: palpation, cuff sphygmomanometry, and arterial wave formation. Nurses should practice and become skilled at measuring a greater than 10 mm Hg change. PMID- 2714487 TI - Research: running with a winning team. PMID- 2714488 TI - Older adults need AIDS education. PMID- 2714489 TI - Redesign of the nursing delivery systems and positive public image campaign. PMID- 2714490 TI - How gerontological nursing views guardianship. PMID- 2714491 TI - Go for the gold. PMID- 2714493 TI - What gerontology means to me. PMID- 2714492 TI - Facts about GRTS--a residential treatment program. PMID- 2714494 TI - New class encourages care for the caregiver. PMID- 2714495 TI - S.E.C.U.R.E. helps respond to needs of older adults. PMID- 2714496 TI - Sleep in the elderly. PMID- 2714497 TI - Facts about cancer in women. PMID- 2714498 TI - Effects of two different hydrocortisone doses on human peripheral blood lymphocyte nucleologram. AB - The effect of 200 and 500 mg of hydrocortisone hemisuccinate given i.v. on the circulating lymphocyte nucleologram was studied in 12 healthy volunteers. Transient lymphopenia was observed in all treated subjects, with the nadir at 3 to 9 h after drug administration. An evaluation of the lymphocyte nucleologram, at this time, showed a statistically significant decrease in mono- and binucleolated lymphocytes. By 24-36 h, the number of total lymphocytes and the nucleologram had returned to baseline values. No differences were revealed among the two groups of subjects. The role of lymphocyte redistribution and of lymphocytolysis to explain the lymphocytopenia and the behaviour of lymphocyte nucleologram is discussed. PMID- 2714499 TI - [Recurrence and morphologic resistance phenomena of PUVA-treated lichen ruber planus cutaneous]. AB - 145 patients with lichen planus cutaneous were treated with PUVA. In a follow-up period of 1 to 4 years 6 of the patients (4.1%) showed a generalised recurrence and 32 patients (22%) a local recurrence. For the first time 3 morphological PUVA resistance phenomena were observed. Recurrence- and resistance correlation are discussed. PMID- 2714500 TI - [References for the operating behavior of ultraviolet fluorescence tubes in phototherapy equipment]. AB - The working behaviour of the UV-fluorescent tubes type UVS 20-2, UVS 40-2 and UVS 65-2 (Manufacturer: VEB NARVA "Rosa Luxemburg" Leuchten- und Leuchtstoff lampenwerk Brand-Erbisdorf) applicated in phototherapy equipments has been investigated in four commercially and two self-made devices. In the first 100 hours of the application of the fluorescent tubes an exponential decrease of the irradiation power reaching a value of 30 percent must be considered. After an exchange of old tubes (1,500 working hours) to new one a jump in the irradiation power with a factor 2.5 may be observed. The temperature of the fluorescent tube altering after the switch and daily instabilities in the supply power influence the irradiation power in a way that must not be neglected. The emission of equipments with good remove of the tube heat is constant after 5 minutes. In constructions causing and maintaining a high temperature of the tubes this time is about 20 minutes. PMID- 2714502 TI - [The skin health cure in the People's Republic of Albania]. PMID- 2714501 TI - [Disseminated superficial actinic porokeratosis. A case report]. AB - It is reported on a 72-year-old pensionary who developed one year ago a disseminated superficial actinic porokeratosis on the lower legs after chronic sun exposure during twenty summers. The diagnostic features and therapeutic schedules are summarized and the role as praecancerosis is emphasized. PMID- 2714503 TI - Lamicel does not promote induction of labour. A randomized controlled study. AB - Lamicel is a synthetic tent, which, when inserted in the cervical canal, dilates the cervix by osmosis. Lamicel as an adjunct to induction of labour with intravenous oxytocin or vaginal prostaglandin E2 has been examined in a randomized controlled trial. Ninety-one pregnant women with an unripe cervix participated in the study. No improvement in efficacy was observed in the Lamicel groups compared to the control groups, neither when induction of labour was performed with oxytocin nor with vaginal prostaglandin. PMID- 2714504 TI - An experiment of squatting birth. AB - Women throughout the ages have preferred to be delivered with their trunks vertical and most delivery positions illustrated in historical texts show birth in an upright posture with abducted thighs. A consumer attitude study in our hospital showed that patients have considerable interest in alternative birth positions. Squatting has been advocated to prevent caval compression, increase the diameter of the pelvic outlet and, perhaps with least justification, to enlist the force of gravity and thereby facilitate maternal expulsive effort. Despite the extensive literature advocating squatting birth, the suggested advantages of this method have not been examined in any formal, let alone unbiased study. We therefore conducted a randomised trial to examine the effect of squatting on the duration of second stage of labour, the duration of pushing, and several other variables. PMID- 2714505 TI - The effect of labour on prolactin and cortisol concentrations in the mother and the fetus. AB - Concentrations of prolactin and cortisol were determined in maternal and umbilical cord serum of women delivered by elective Caesarean section and by vaginal delivery. There was no difference in the concentration of prolactin in the two groups of women. Similarly, cord blood prolactin concentrations were not significantly different in the two groups. Cortisol concentrations in the women undergoing Caesarean section were similar to the vaginal delivery group before the onset of labour. However, there was a significant increase in cortisol concentration at delivery following labour. The cord blood cortisol concentration was significantly higher in the neonates delivered vaginally, and it correlated with the maternal cortisol concentration at delivery. The relevance of these findings is discussed. PMID- 2714506 TI - Fibrinopeptide A levels in maternal and newborn plasma. AB - Plasma fibrinopeptide A (FPA), a dynamic measure of intravascular coagulation, was determined in 70 healthy Chinese women during normal pregnancy, labour, delivery and the early puerperium and compared to a group of healthy non-pregnant adult controls. In the normal controls the plasma FPA level (mean +/- SD) was 1.43 +/- 0.46 ng/ml. During pregnancy and labour, the FPA levels were 3.05 +/- 0.98 ng/ml and 11.47 +/- 4.43 ng/ml, respectively, and it reached a peak of 32.95 +/- 11.66 ng/ml at parturition, then falling to 6.15 +/- 2.52 ng/ml in the early puerperium. All these levels were significantly higher (p less than 0.001) compared to controls. Fifteen of the 21 mothers with blood sampling during parturition also had umbilical cord blood taken for determination of FPA level. There was no significant difference between the maternal (34.07 +/- 10.12 ng/ml) and cord (31.06 +/- 12.67 ng/ml) plasma FPA levels. It is concluded that the hypercoagulable state in women during pregnancy and the puerperium is associated with increased intravascular coagulation activity, and that increased intravascular coagulation activity also occurs in the fetus during parturition. This observation may account for the increased risk of thrombotic disorders observed in pregnant and parturient women as well as in the newborn. PMID- 2714507 TI - Duration of the latency period in preterm premature rupture of the membranes. Maternal and neonatal consequences of expectant management. AB - 111 pregnancies complicated with premature rupture of the membranes (PROM) at a gestational age between 20 and 34 weeks, were observed prospectively with expectant management. Median duration of the latency period was 7 (0-109) days. The duration of the latency period was inversely related to the gestational age at PROM. Intra-uterine death ensued in 9.9% of the pregnancies. Clinical chorioamnionitis ensued in 12.6% of the pregnancies. Eight (7.6%) neonates developed sepsis. None of the babies died as a consequence of sepsis alone. Of the 43 (41.0%) neonates who developed idiopathic respiratory distress syndrome (IRDS), 8 (7.6%) babies died. The perinatal mortality rate was 18.6%. The study seems to justify the expectant management of PROM pregnancies of less than 34 weeks of gestation. PMID- 2714508 TI - The arterial blood supply of the parametrium. AB - The possible influence of tubal sterilization on the ovarian function is still debated. In this study, we have investigated the course of the main arteries in the parametrium. This study concludes that it is unlikely, from an anatomical point of view, that the ovarian function can be disturbed after tubal sterilization with bipolar cautery, silicone-rings or Filshieclips due to changes in the arterial blood supply. PMID- 2714509 TI - A simple rapid method for prolactin assay by reversed passive hemagglutination: evaluation of its clinical application. AB - Measurement of the serum prolactin (PRL) level is essential in diagnosis and treatment of infertile women. At present, the serum PRL level is generally measured routinely by a radioimmunoassay (RIA) technique, but this assay requires a qualified technician and special equipment. Here we report a semi-quantitative method for PRL assay (MS-8701 kit) by reversed passive hemagglutination (R-PHA) using monoclonal PRL antibody. This assay with the MS-8701 kit is specific, and its sensitivity is 1 ng/ml. The serum PRL levels determined with the MS-8701 kit were significantly correlated with those determined by RIA (correlation coefficient 0.932). Furthermore, the effect of bromocriptine on the serum PRL level in patients with prolactinoma, and the change in the serum PRL level after metoclopramide loading could be determined using this kit. These results suggest that the MS-8701 kit should be useful in an out-patient clinic to screen for hyperprolactinemia, to check the effect of bromocriptine, and to follow up patients after operation for prolactinoma. PMID- 2714510 TI - Smoking habits and spontaneous abortion. AB - Smoking habits have been compared in three samples of pregnancies: (1) spontaneous abortions (n = 610); (2) induced abortions (n = 800); and (3) deliveries (n = 1337). The variables studied were, besides smoking habits, day of LMP, outcome of earlier pregnancies, maternal age, and, for the delivery sample, also diagnoses of mother and child, gestational length, sex, and birthweight. A statistical analysis of the association between smoking and the risk of having a spontaneous abortion was made. The comparisons were made with all types of intra uterine pregnancies but spontaneous abortions, e.g., deliveries and induced abortions. The effects and consequences of that are discussed. The smoking rates according to pregnancy outcome differ among the samples. In the induced abortion sample 58% smoked compared with 50% in the spontaneous abortion sample and 44% in the delivery sample. The well-known effect of smoking on gestational length and birthweight was shown. No significant effect of smoking on the miscarriage risk was seen. The only trend was the opposite. Possible explanations for this are discussed. PMID- 2714511 TI - Post-surgical pyoderma gangrenosum of the vaginal vault associated with ulcerative colitis and Behcet's disease; a case report. AB - A case is described in which a patient with ulcerative colitis developed chronic vaginal ulceration around the incision lines after cone biopsy. The ulcers persisted at the vaginal vault after abdominal hysterectomy and removal of a cuff of vagina. Non-specific histological features compatible with pyoderma gangrenosum were found on biopsy. The auto-immune nature of this chronic ulcer is further supported by its rapid response to steroid therapy and the subsequent development of Behcet's syndrome. PMID- 2714512 TI - Role of cell surface glycoproteins in embryo cell adhesion to extracellular matrix. PMID- 2714513 TI - Asparagine-linked oligosaccharides in malignant tumour growth. AB - The expression of beta 1-6-branched complex-type oligosaccharides in several tumour cell models appears to be associated with enhanced metastatic potential. P2B, a major PHA-L-binding glycoprotein was isolated from metastatic MDAY-D2 cells and shown to bind to collagen, fibronectin and laminin with increased affinity after removal of N-linked sialic acid or polylactosamine. Sialylated polylactosamine-containing beta 1-6-branched oligosaccharides on proteins such as P2B and fibronectin may reduce cell adhesion and enhance tumour cell invasion. The loss of branched complex-type oligosaccharides in tumour cells due to somatic mutations or inhibition by swainsonine is also associated with decreased cell proliferation in tissue culture and slower rates of solid tumour growth in mice. PMID- 2714514 TI - The metabolism and functions of inositol pentakisphosphate and inositol hexakisphosphate. PMID- 2714516 TI - Alterations in the regulation of lipolysis in brown and white adipose tissue in the diabetic state. PMID- 2714515 TI - A hormone-regulated pro-cathepsin D secreted by human mammary cancer cells. PMID- 2714517 TI - Effect of diabetes on the metabolism of triacylglycerol-rich lipoproteins. PMID- 2714518 TI - Neuropathology of Alzheimer's disease: towards an understanding of the pathogenesis. PMID- 2714519 TI - Cross correlation of heart rate and respiration versus deep breathing. Assessment of new test of cardiac autonomic function in diabetes. AB - Cross correlation is a mathematical function whereby spectral analysis is used to describe the relationship between heart-rate fluctuations (256 R-R intervals) and respiration (simultaneously obtained by pneumotacograph). To assess its usefulness for testing autonomic integrity, cross correlation and deep breathing were compared in 141 diabetic subjects (aged 39 +/- 14 yr) and in 77 control subjects (aged 33 +/- 13 yr). To characterize patients, Valsalva maneuver, 30:15 ratio, tilt, and handgrip tests were performed in 96 of these patients; 23 had two or more abnormal tests (group A), 28 had one (group B), and 45 had none (group C). Sensitivity to parasympathetic withdrawal was compared in 9 control subjects (aged 26 +/- 4 yr) by four sequential 0.01-mg/kg i.v. atropine administrations. Reproducibility was compared in 11 control subjects (aged 25 +/- 2 yr) by repeating the tests four times for 2 consecutive days. Considering all 141 patients, cross correlation and deep breathing were less than 2SD of the mean of control subjects in 64 and 36 subjects, respectively. Considering patients who also performed other tests of autonomic function, cross correlation and deep breathing were less than 2SD of the mean of controls in 42 and 30 subjects, respectively (group A, 20 and 15; group B, 12 and 9; group C, 10 and 6). Cross correlation had better reproducibility than deep breathing (C.V. 10.3 vs. 30.6% at 6 breaths/min) and greater sensitivity to atropine (after the 1st injection, cross correlation and deep breathing decreased to 34.6 and 48.2% of baseline values, respectively; P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714520 TI - Epidemiology of IDDM in black and white children in Jefferson County, Alabama, 1979-1985. AB - For the period of 1 January 1979 through 31 December 1985, an average annual incidence rate (IR) of 12.1/100,000 (95% confidence interval [10.4/100,000, 14.0/100,000]) of insulin-dependent diabetes mellitus (IDDM) was observed in Jefferson County, Alabama, among people less than 20 yr old. Hospital medical record review was the primary source of case ascertainment. A large proportion of Black children in the county permitted race-specific analyses. The average annual IR among the Black children was less than half that observed in the White children (7.0/100,000 vs. 15.6/100,000, respectively). Nearly equal numbers of White boys and girls were diagnosed during this period; however, there were three times as many Black girls as Black boys diagnosed. Among the 134 Whites, age specific annual IRs were highest in the 5- to 9- and 10- to 14-yr age groups. Little variation was observed in age-specific rates among the 41 Black subjects. A seasonal trend was evident in both races, with the fewest cases of IDDM diagnosed in the months of April through June (P less than .001). No association between the incidence of diabetes and income level was found among White or Black children. Significant differences in the epidemiology of IDDM between White and Black children suggest an important avenue for studying the etiology of IDDM. PMID- 2714521 TI - In vivo pH of induced soft-tissue abscesses in diabetic and nondiabetic mice. AB - Infections in the diabetic host have been shown to persist longer than those in the nondiabetic host. To investigate whether intra-abscess milieu might be a contributing factor to this persistence, the in vivo intra-abscess pH was measured in induced soft-tissue abscesses in diabetic and nondiabetic mice. Two models (female genetically obese insulin-resistant and male streptozocin-induced diabetic mice) were used with appropriate controls. The bacteria injected to produce the soft-tissue abscesses were Bacteroides fragilis and Enterococcus (B + E), Staphylococcus epidermidis and Enterococcus (S + E), and S. aureus (SA). Intra-abscess pH measured on day 3 was consistently and significantly lower in all diabetic mice compared with their controls. In the diabetic mice, the pH of an abscess induced with B + E, S + E, and SA was 6.28 (n = 17), 6.79 (n = 10), and 6.52 (n = 10), respectively; the pH in the controls was 7.21 (n = 20), 7.30 (n = 10), and 7.17 (n = 10), respectively. Differences in all groups between diabetic and nondiabetic mice were significant. The blood glucose values of the diabetic mice averaged 722 mg/dl, and in the nondiabetic mice were 210 mg/dl. No animals were ketotic. There were no significant differences in total colony counts between any groups. In conclusion, there is a significantly lower pH in the abscess of the diabetic host compared with the nondiabetic host that is not related to the numbers or types of causative bacteria. PMID- 2714522 TI - A blind reanalysis of a random subset of NCI bioassay studies: do rats predict mice? PMID- 2714523 TI - Analysis of a random sample of 2-year carcinogen bioassays from the NCI data base. AB - We take as our primary goals the introduction of novel, methods of analysis that have the potential to control error rates and reconcile results of multiple studies of the same chemical. We develop a selection rule to pick, for each study, a tumor site/type combination for analysis, and then apply random effects models to these study-specific summaries. These models combine evidence over studies; producing a chemical-specific assessment of carcinogenicity. We declare 14 of the 25 chemicals "carcinogens," and find that female mice are the most sensitive sex/species combination. We discuss the benefits and drawbacks of our method and outline developments necessary for their incorporation into the risk assessment process. PMID- 2714524 TI - A blind reanalysis of a random subset of NCI bioassay studies: agreement between rats and mice. AB - There are many problems in the statistical analysis of long-term rodent studies. This paper discusses the alternative approaches to these problems suggested by the previous three papers and compares the results of the different analyses on 25 rat and mouse studies. It is concluded that many problems remain unresolved and that alternative, seemingly reasonable decision rules can give rise to dramatically different results. PMID- 2714525 TI - Hexachlorobenzene-induced hyperparathyroidism and osteosclerosis in rats. AB - Hexachlorobenzene (HCB) exposure has been shown to alter the normal concentrations of parathyroid hormone and 1,25-dihydroxyvitamin D3 in rats and to result in osteoporosis in humans. Experiments were undertaken to investigate the effects of HCB on the homeostatic mechanism of calcium metabolism and to determine its effect on bone in rats. Fischer 344 rats were dosed 5 days/week for 5, 10, or 15 weeks with 0, 0.1, 10.0, or 25.0 mg HCB/kg body wt. Body weight was not affected by any of the exposure conditions. Liver weight was significantly elevated above control values at the two higher dose levels at all three time periods. Kidney weight and kidney-to-body weight ratio were significantly elevated at the highest dose level after 10 weeks and at the two higher dose levels after 15 weeks of exposure. Serum alkaline phosphatase was significantly decreased at the two higher dose levels after both 10 and 15 weeks of exposure. 1,25-Dihydroxyvitamin D3 was measured in the 5-week exposure group only and was significantly elevated in the three higher dose levels. After 5 and 15 weeks of HCB exposure, parathyroid hormone concentration was significantly elevated at the two higher dose levels at both time periods. Wet femur density was significantly increased at the two higher dose levels of HCB after 10 weeks of exposure and the three higher dose levels after 15 weeks of exposure. Dry femur density was also increased in the cases where wet femur density was increased. However, femur weight was not affected at any dose level. The results from this study indicate that HCB induces hyperparathyroidism in rats, as demonstrated by increased serum parathyroid hormone levels and osteosclerosis of the femur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714526 TI - An objective procedure for quantitating eye irritation based upon changes of corneal thickness. AB - For four decades, the Draize test has remained the accepted method for evaluating eye irritation. Criticisms center around the inhumane treatment of animals and the irreproducibility of the subjective scoring procedure. The objective of this study was to determine if changes in corneal thickness obtained using a slit-lamp pachometer could be used to replace the Draize scoring procedure and provide a method for quantifying ocular irritation. Twenty-four chemicals (six surfactants, seven alcohols, four ketones, four acetates, and three aromatics) were instilled in the conjunctival sacs of rabbits and irritation monitored by Draize scoring and changes in corneal thickness. The Draize procedure was more adept at detecting minor conjunctival damage, but corneal thickness exhibited less variation and increased sensitivity for detection of healing reactions. A significant linear correlation (y = 1.736 chi + 92.883) was established between Draize score and corneal thickness changes with a correlation coefficient (r) of 0.86 and an F-value for regression of 261.3. Using these findings, an ocular irritation ranking system is proposed based upon the percentage of corneal swelling. Ocular irritation potential was ranked for the chemical groups tested (surfactants greater than alcohols greater than ketones or acetates greater than aromatics). Quantitation of ocular irritation from changes in corneal thickness provides objective, numerical data applicable to standard parametric statistical procedures. This should eliminate the subjective bias inherent to Draize scoring and decrease intra-and interlaboratory variability. PMID- 2714528 TI - A critical evaluation of predicting ocular irritancy potential from an in vitro cytotoxicity assay. AB - Numerous in vitro cytotoxicity assays have been proposed as potential alternatives to the Draize eye irritancy test. The results reported, based upon the rank correlation of ocular irritancy with cytotoxicity, have been encouraging. However, direct calibration of in vivo to in vitro data utilizing several categories of chemicals has not been reported. This study evaluated the use of in vitro cytotoxicity data for predicting the ocular irritancy potential of 24 chemicals (six surfactants, seven alcohols, four ketones, four acetates, and three aromatics). BALB/c 3T3 cells were grown overnight, then exposed for 30 min to at least four different concentrations of each chemical (expressed as volume percentage). Linear regression analysis of the log concentration versus percentage of control growth was used to calculate the concentration of toxicant that inhibited the normal growth rate by 50% (GI50). The rank ordering of cytotoxicity based upon the GI50s was surfactants greater than aromatics greater than alcohols greater than ketones or acetates. The larger molecular weight representative of each series (i.e., 2-ethyl-1-hexanol for alcohols) had lower GI50 values than those of the lower molecular weight substances. The GI50 values were then directly calibrated against in vivo ocular irritancy quantitated as percentage corneal swelling following exposure of rabbits to the same test chemicals. A significant linear correlation between cytotoxicity and ocular irritancy was established only for surfactants and alcohols. For acetates, ketones, and aromatics there was little correlation. The overall poor correlation between cytotoxicity and ocular irritancy was attributed to differences in mechanisms of irritancy. The lack of correlation illustrates that in vitro cytotoxicity data cannot be used to predict the ocular irritancy potential of a broad spectrum of chemicals. PMID- 2714527 TI - Evaluation of the developmental toxicity of ethylene glycol monohexyl ether vapor in Fischer 344 rats and New Zealand white rabbits. AB - Timed pregnant Fischer 344 rats and New Zealand White rabbits were exposed to vapor from ethylene glycol monohexyl ether (EGHE, CAS No. 112-25-4) for 6 hr/day on gestational days (gd) 6 through gd 15 (rats) or gd 6 through gd 18 (rabbits) at analytically measured concentrations (as means +/- SD) of 20.8 +/- 0.90, 41.1 +/- 1.77, or 79.2 +/- 10.8 ppm; control animals were exposed to air alone. Monitors for maternal toxicity were body weight, food and water consumption, clinical signs, and hematology. At sacrifice (gd 21 rats, gd 29 rabbits) maternal weight, liver weight, and gravid uterine weight were measured. Gestational parameters monitored were numbers of corpora lutea, preimplantation losses, viable implants, early and late resorptions, and dead fetuses. Live fetuses were sexed, weighed, and examined for external, visceral, and skeletal malformations and variations. Rabbit maternal toxicity occurred at 79.2 ppm as transient weight gain reduction during the exposure period. For maternal rats at 79.2 ppm, there were transient decrease in body weight and body weight gain during exposure, reduced food consumption, increased water consumption, and excess lacrimation. At 41.1 ppm, maternal body weight gain was reduced during the exposure period only. There were no treatment-related effects with respect to hematology, necropsy, or gestational parameters and no significant change in the incidence of malformations or variations (expressed as total, individual, external, visceral, or skeletal). Thus, exposure of rats and rabbits to EGHE vapor during the period of organogenesis produced maternal toxicity at near-saturation vapor concentrations (79.2 ppm), but no evidence for developmental toxicity or teratogenicity. The no-effect vapor concentrations for maternal toxicity were 41.1 ppm for rabbits and 20.8 ppm for rats. PMID- 2714529 TI - Optimal replication for histometric analyses of testicular function in rats or rabbits. AB - Quantitative evaluations of testicular histology can provide sensitive endpoints for determining toxicity of chemicals to the male reproductive system. But, the numbers of observations per testis or number of animals per treatment group often are selected by tradition or availability, rather than from a statistical basis. Therefore, we studied the number of observations per male (sampling intensity) and number of animals per treatment (replication) needed to detect treatment effects of given magnitude, with predictable error probabilities, using data from Sprague-Dawley rats and Dutch-belted rabbits that received 0.0, 0.94, 1.88, 3.75, 7.5, or 15.0 mg/kg body wt of 1,2-dibromo-3-chloropropane (DBCP). Data for one testis from 102 rats and 34 rabbits were available. For each testis, observations included measurement of the minor diameter of 50 seminiferous tubules, counts of the number of leptotene primary spermatocytes per 250 Sertoli cells, and counts of spherical spermatids within 20 seminiferous tubular cross sections. Tabular data are presented showing optimal numbers of observations per testis and animals per treatment group as a function of the difference to be detected and selected probabilities for Type I and II errors. In general, precise assessments required far fewer observations per testis than are used routinely. However, due to the inherent variability among animals, the number of animals required per treatment tended to be greater for experiments with the rabbit, and increased substantially for both species when detection of small differences had to be ensured. The data presented should enable investigators to design experiments of chosen sensitivity and precision while making cost-effective use of animals and labor. PMID- 2714531 TI - A subchronic toxicity study of octyl acetate in rats. AB - The subchronic toxicity of octyl acetate was assessed following its administration to rats via oral gavage, 5 days per week for 13 weeks. Treated rats received undiluted octyl acetate at doses of 0.1, 0.5, or 1.0 g/kg. Control rats received distilled water at a dose of 1.0 g/kg. An interim termination was made after 45 days of dosing at which time five animals per sex per group were terminated and necropsied. Blood samples were collected and liver tissues were prepared for histological examination. After 13 weeks of dosing all animals were terminated and necropsied. Blood samples were obtained and selected organs were weighed and prepared for subsequent histological examination. Several treatment related effects were observed in the high-dose group (1.0 g/kg) animals. These effects included slight reductions in body weight and food consumption, increased liver and kidney weights, and evidence of hydrocarbon nephropathy in high-dose males only. The significance of these observations is discussed in the report. With the exception of increased liver weights in the mid-dose group, no other significant treatment-related effects were observed in the mid- or low-dose groups of animals. It is believed that the increases in liver weight which were observed are a compensatory response to an increased metabolic load, and not a reflection of true hepatotoxicity. The results of this study indicated that octyl acetate possessed an overall low degree of systemic toxicity when administered orally to rats for 13 weeks. PMID- 2714530 TI - Immunotoxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin in a complex environmental mixture from the Love Canal. AB - The organic phase of the leachate (OPL) from the Love Canal chemical dump site contains more than 100 organic compounds including 2,3,7,8-tetrachlorodibenzo-p dioxin (TCDD). The immunotoxic potential of OPL was determined in two mouse strains which differ in their sensitivity to aromatic hydrocarbon (Ah) receptor mediated toxicity. OPL was administered in corn oil in a single oral gavage to male BALB/cByJ (Ahb/Ahb) mice (0.5, 0.8, or 1.1 g/kg) and DBA/2J (Ahd/Ahd) mice (0.6, 0.9, or 1.3 g/kg). TCDD was similarly administered at 0.25, 1.0, 4.0, or 16.0 micrograms/kg. Two days later all mice were immunized with sheep erythrocytes (SRBC). The antibody response (PFC) and organ weights were evaluated 4 days later. OPL produced thymic atrophy and hepatomegaly in both strains at all dose levels. The PFC/spleen in BALB/cByJ mice was significantly reduced at the three doses to 34, 13, and 15%, respectively, of the control response. Serum anti SRBC antibody levels and relative spleen weights were also reduced. The only immune effect in the DBA/2J mice was a decrease of the PFC/spleen to 58% of the control at the highest dose. TCDD decreased the relative thymus and spleen weights only in BALB/cByJ mice. However, TCDD produced hepatomegaly, a decrease in serum antibody, and a decrease in PFC/spleen in both BALB/cByJ and DBA/2J mice to 3 and 15%, respectively, at 16 micrograms/kg. Thus, the TCDD dose required to cause a 50% suppression (ED50) of PFC/spleen for the BALB/cByJ and DBA/2J strains was 1.84 and 3.89 micrograms/kg, respectively. The ED50 for OPL was 0.24 g/kg in BALB/cByJ mice. The TCDD concentration in the OPL was estimated to be 7.6 ppm, which agrees closely with the chemical analysis (3 ppm). The results suggest that the immunosuppression caused by OPL in BALB/cByJ mice was primarily due to TCDD, that the non-TCDD components of OPL diminished the TCDD immunotoxicity in the DBA/2J strain, and that the thymic atrophy and hepatomegaly were caused primarily by the non-TCDD components of the OPL. PMID- 2714532 TI - A 90-day inhalation toxicity study with benomyl in rats. AB - Benomyl [methyl 1-(butylcarbamoyl)-2-benzimidazolecarbamate, CAS Registry No. 17804-35-2] is a fungicide and the possibility for inhalation exposure exists for field workers. To assess the toxicity of benomyl, groups of 20 male and 20 female CD rats were exposed nose-only 6 hr a day, 5 days a week, to concentrations of 0, 10, 50 or 200 mg/m3 of a benomyl atmosphere. At the midpoint (approximately 45 days on test) and at the end of the exposure period, blood and urine samples for clinical evaluation were collected from 10 rats/group/sex, and these animals were sacrificed for pathological examination. Similar evaluations were performed on all remaining rats at the end of the 90-day test period. After approximately 45 days on test, compound-related degeneration of the olfactory epithelium was observed in all males and in 8 of 10 female rats exposed to 200 mg/m3 benomyl. Two male rats exposed to 50 mg/m3 had similar, although less severe, areas of olfactory epithelial degeneration. After approximately 90 days of exposure, the remaining 10 rats/group/sex were sacrificed and examined. Of these rats, all of the males and females exposed to 200 mg/m3 had olfactory degeneration, along with 3 males exposed to 50 mg/m3 of benomyl. No other observed lesions were interpreted to have been caused by the benomyl exposure. In addition, male rats exposed to 200 mg/m3 benomyl had depressed mean body weights compared to controls and this finding correlated with a reduction in food consumption. Based on pathological observations, 10 mg/m3 represents the no-observable-effect level (NOEL) for the male rats, and 50 mg/m3 is the NOEL for the female rats. PMID- 2714533 TI - The effect of lifetime sodium saccharin dosing on mice initiated with the carcinogen 2-acetylaminofluorene. AB - Sodium saccharin has been reported to promote the development of urinary bladder tumors in rats following low doses of several carcinogens. To evaluate the generality of this effect between species, an initiation-promotion study was conducted in mice. Weanling female BALB/c mice were initiated with 200 ppm dietary 2-acetylaminofluorene for 90 days. Following a 2-week period of control diet, saccharin was administered at 0, 0.1, 0.5, 1.0, and 5.0% in the diet for the remainder of the 132-week study. An elevated incidence of persistent bladder transitional cell hyperplasia and a low incidence of urothelial and hepatocellular tumors indicated that these organs achieved an adequate dose of the initiator. However, sodium saccharin dosing did not result in an increased incidence of tumors in either the bladder or liver and is therefore not considered to be a promoter of carcinogenesis at these sites in the mouse. Furthermore, sodium saccharin exhibited a modest inhibitory effect on the rate of development of lymphomas in both initiated and noninitiated animals. Interspecies differences in the bladder tumorigenic effect of sodium saccharin and their association with differences in urinary tract physiology are discussed. PMID- 2714534 TI - Developmental toxicity of 2,3,4,7,8-pentachlorodibenzofuran in the Fischer 344 rat. AB - Fischer 344 rats were exposed acutely to 2,3,4,7,8-pentachlorodibenzofuran (4 PeCDF) during the organogenic period to evaluate its potential as an inducer of teratogenic and embryolethal effects. All dams were treated by gavage with a single dose of 0, 30, 100, or 300 micrograms 4-PeCDF/kg body wt on gestation Day (gd) 8, 10, or 12. An additional treatment group was included on gd 12 and administered 10 micrograms 4-PeCDF/kg body wt po. All animals were killed on gd 20 and maternal and fetal toxicities were assessed. Determination of embryotoxicity involved both soft tissue and skeletal examinations. 4-PeCDF induced a dose-related decrease in corrected maternal weight gain following treatment on gd 8 and 10, as well as resulted in a concomitant increase in the liver/body weight ratios, first evident at 30 micrograms/kg for all 3 days of exposure. The maternal thymus weight decreased relative to body weight compared with those of controls. Embryo-fetal toxicity was evident from the high mortality (greater than 80%) observed at 300 micrograms/kg for all 3 days of exposure. Mean fetal weight, a sensitive indicator of fetal toxicity, decreased compared to that of controls at 30, 100, and 300 micrograms/kg following treatment on either gd 8, 10, or 12.4-PeCDF induced cleft palate in survivors at a dose of 300 micrograms/kg for all 3 days of exposure. In conclusion, 4-PeCDF is maternally and fetally toxic regardless of the gestation day of exposure, but induced terata only at doses where overt maternal and fetal toxicity were observed, in contrast to previously reported studies in the mice where teratogenic effects were observed at nonfetotoxic dose levels. Thus, the mouse may be a more sensitive model for evaluating specific toxic responses induced prenatally following exposure to the structurally related polyhalogenated aromatic hydrocarbons which include the dioxins, furans, biphenyls, and naphthalenes. PMID- 2714536 TI - Unemployment and ill-health: is the question going away? PMID- 2714535 TI - Peracute toxic effects of inhaled hydrogen sulfide and injected sodium hydrosulfide on the lungs of rats. AB - This study was designed to test whether intraperitoneally injected sodium hydrosulfide (NaHS) would mimic the pulmonary alterations induced by lethal peracute exposure to an atmosphere containing hydrogen sulfide. Groups of five Sprague-Dawley rats were exposed to an atmosphere of either 2317.6 +/- 547.3 mg m 3 H2S (H2S group) or no H2S (air group), or were injected intraperitoneally with a solution containing 30 mg kg-1 sodium hydrosulfide (NaHS group) or saline solution (vehicle control). Rats of the air and saline groups were killed by cervical dislocation. All rats exposed to H2S or injected with NaHS died within 3 min; however, only rats exposed to H2S showed severe respiratory distress in the agonic phase preceding death. In addition, rats in the H2S group had a notable discharge of serous fluid from the mouth and nostrils. At necropsy, all rats in the H2S group had gross and histologic evidence of pulmonary edema characterized by massive extravasation of eosinophilic fluid into the bronchoalveolar space. In contrast, the lungs of rats injected with NaHS or saline or exposed to air were unaffected. It was concluded that the edematogenic effect of H2S in the lungs cannot be reproduced by injection of NaHS. The severity of lung edema induced by a peracute exposure to H2S was extensive enough to account for death. PMID- 2714537 TI - Frequency of sexual dysfunctions among Roman Catholic women. AB - The frequency and type of sexual dysfunctions in healthy and sexually active Roman Catholic church-goers was compared with non-church-goers. All the women had had a steady psychosexual relationship with only one partner for at least one year. The sexual dysfunctions investigated were related only to vaginal intercourse. Although there is no significant difference in the frequency and type of sexual dysfunctions, the Roman Catholic church-goers more frequently complained of unsatisfying sexual relationships (P less than 0.05) or were requested by their partner on a change in their own sexual behaviour (P less than 0.05). The possible correlations between religiosity and sexual health are discussed. PMID- 2714538 TI - Differences in referral rates from general practice. AB - There are many unexplained differences in the rates at which general practitioners make referrals to other medical specialists. This study investigated 17,586 referrals from 141 general practitioners to specialists in seven specialties in Ringkjobing county in Denmark. As an expression of the referral rate, a referral index was estimated for every general practitioner. The referral index was the number of referrals to the specialist per 1000 patients per year, including children, standardized for age and sex to the average population in Ringkjobing county. The following six variables were evaluated in relation to the referral index: specialists in the local area, doctors per practice, consultations per general practitioner per year, patients registered, consultations per 1000 patients per year standardized for age and sex, and supplementary procedures per consultation. Stepwise multiple regression analysis was used. The study showed that the referral index rose both with a better access to specialist and with an increasing number of consultations per practitioner per year. The referral index fell with increased numbers of patients registered. No correlation was found between the referral index and number of supplementary procedures per consultation, number of doctors per practice and number of consultations per 1000 patients per year. PMID- 2714539 TI - Referrals and relationships in Sri Lankan general practice. AB - A detailed questionnaire was sent to the 347 members of the two professional bodies of general practitioners in Sri Lanka. A second questionnaire was sent to 123 of the responders two months later. The number of referrals to and from general practitioners are reported. No form of contact occurred for any of the referrals to general practitioners or for 20% of the referrals to secondary care services. The frequency and perceived value of contacts between general practitioners and others are reported. Factors which might lead to improving the referral pattern and relationships of general practitioners with their colleagues in Sri Lanka are discussed. PMID- 2714540 TI - Effects of a health activist course on knowledge and awareness of antibiotic use. AB - A cohort study investigated the specific outcomes of a health education coursed carried out by recently graduated physicians in an urban primary care setting in Israel. Questionnaires were used to study the effects of the programme on knowledge and awareness concerning antibiotic usage. The results showed a significant gain in knowledge about the causes of infectious disease, appropriate duration of antibiotic intake, side effects of antibiotics and the importance of compliance. In contrast with other studies, low income blue collar workers with less than high school education showed the most significant gains from the programme. Inexperienced physicians were able to implement a community health education programme with clearly defined goals. PMID- 2714542 TI - Reduction in antibiotic usage following an educational programme. AB - The past decade has seen a steady increase in the consumption of antibiotics in Sweden, most of which are prescribed for respiratory tract infections. Trends in the prescribing of antibiotics for respiratory tract infections at the community health centre in Hoor, southern Sweden, analysed before and after an educational programme, showed a significant reduction in the use of antibiotics, 67.6% of patients (n = 216) having been prescribed antibiotics before the programme in contrast to 43.9% (n = 212) afterwards. The reduction was particularly marked with regard to erythromycin and broad-spectrum antibiotics, and in cases of rhinitis/rhinopharyngitis, pharyngitis and bronchitis. On an annual basis, the reduction was equivalent to 2.5 defined daily doses per 1000 inhabitants per day. The study has shown that a reduction in antibiotic usage for respiratory tract infections can be achieved without changing the indications for antibiotic treatment. PMID- 2714541 TI - Comparison of the general health questionnaire and the Nottingham health profile in a study of unemployed and re-employed men. AB - Two measures of perceived health, the general health questionnaire and the Nottingham health profile were completed by middle and working class men who had been unemployed for between 18 and 24 months, or had been unemployed longer than six months before regaining employment. Clear differences were found between the perceived health status of the unemployed men and those who had become re employed. Virtually no association was found between social class and scores on the health measures, supporting earlier findings that unemployment leads to equally poor perceived health in middle class and working class males. High correlations were obtained between the 12-item general health questionnaire, the anxiety and the depression scales, with all three measures correlating quite highly with the emotional reactions, sleep and social isolation sections of the Nottingham health profile. However, the Nottingham health profile provided a broader assessment of perceived health, giving additional information on pain and physical mobility problems. PMID- 2714543 TI - The spectrum of farming accidents seen in Irish general practice: a one-year survey. AB - A one-year prospective survey of farming accidents in three Irish counties recruited 37 general practitioners in a wide geographical sample. The response rate to the survey was 84%. There were 319 accident cases seen by the general practitioners in the survey period, and 175 (55%) of these were farmers. Children accounted for 52 (16%) of all accident cases. The majority of cases (256, 80%) were treated by the general practitioner, and the spectrum of injuries treated was very broad. Many injuries required extensive suturing and follow-up of soft tissue injuries. General practitioner coroners were involved with five fatal farm accident cases. It is concluded that the Irish rural general practitioner is providing a significant trauma service to farm accident victims, and is a valuable source of information on these incidents. The general practitioner would be a local source of expertise in a health education campaign directed at increasing the awareness among the farming community on the extent of farm accident morbidity and mortality. Continuing education for rural general practitioners should be directed towards regular updates on trauma management. PMID- 2714544 TI - Medical advice by telephone at Swedish health centres: who calls and what are the problems? AB - Advice by telephone is an important activity at Swedish health centres and is mainly dealt with by nurses. This telephone counselling was studied during one week (Monday to Friday) at six Swedish health centres which were representative of rural as well as of urban populations. Based on the figures obtained from this study it could be calculated that about 20 million calls of this type are dealt with at Swedish health centres each year (population of Sweden about eight million). It was more common for women than for men to contact the health centre by telephone. About 70% of the calls were made by the patients themselves. Pain was the most common reason for contacting the health centre by telephone, followed by signs of infection. The majority of the telephone calls dealt with sick care, a minority were classified as administrative. About 40% of all calls were managed by the telephone adviser without involving the doctor at the health centre. Of all incoming calls, 44% resulted in an appointment time for a visit to a physician at the health centre, more than half of these being given for a visit during the same day. As the telephone counsel function is an important part of the activity at a Swedish health centre, it is important to evaluate its content and consequences. PMID- 2714545 TI - Life after divorce: a study of newly divorced middle-aged men in Sweden. AB - Thirty-two divorced men aged 30 to 44 years answered a questionnaire within seven months after the dissolution of their marriages. They were asked for life circumstances (housing and working conditions, economic situation) and perceived health and a personal interview was also performed with most of the men. Primary health care records during the year of divorce were analysed according to number of visits and reasons for encounter. A majority of the men perceived working conditions as satisfying while about half of the men had moved to less satisfying housing conditions. They recorded a high number of psychological symptoms (insomnia, fatigue, anxiety) but this was not recognizable in the primary health care records. Ten men had had more than one divorce and in this sub-group there were several alcohol abusers. The importance of primary health care in the early recognition of the complex situation of divorced men is stressed. PMID- 2714546 TI - [Working capacity under high altitude conditions in Antarctica in persons with various levels of hypoxic resistance]. PMID- 2714547 TI - [Effect of high temperature on several parameters of the functional state and working capacity]. PMID- 2714548 TI - [Thermoregulation in the nocturnal period under conditions of the arid zone]. PMID- 2714549 TI - [Analysis of temperature patterns in man]. PMID- 2714550 TI - [Regularities in the interactions of hormonal effects and characteristic activity of cells in the process of adaptation]. PMID- 2714551 TI - [Nervous mechanisms of disturbance of intellectual activity in pathologically excited personalities]. PMID- 2714552 TI - [Dynamics of biochemical parameters of the blood during the conduct of enterosorption]. PMID- 2714553 TI - [Age-related changes in the content of mineral substances in the bones of the lower extremities of the healthy human]. PMID- 2714554 TI - [Comparative study of the macro- and microelemental composition of the hair on the head in inhabitants of various regions]. PMID- 2714555 TI - [Specifically-dynamic action of raw vegetable products]. PMID- 2714556 TI - [Evaluation of parameters of psychophysiologic, biorhythmologic and hormonal metabolic status during adaptation of humans to operator work]. PMID- 2714557 TI - [Features of the correlation of EEG components in patients with psychoorganic syndrome of varying degrees of severity]. PMID- 2714558 TI - [Resonance phenomena in EEG during photostimulation with variable frequency bursts. I. Analysis of the effects of photostimulation]. PMID- 2714559 TI - [Physiologic bases of the effect of dilantin on psychoemotional and autonomic disorders in resistant pathologic states of the nervous system]. PMID- 2714560 TI - [Features of the main parameters of external respiration and hemodynamics in health and in hypertensive disease]. PMID- 2714561 TI - [A method for determining and characterizing manual asymmetry in ontogenesis]. PMID- 2714562 TI - [Changes in the cardiac rhythm in female athletes during urgent restoration of working capacity (artistic gymnastics)]. PMID- 2714563 TI - [Patterns of cardiac rhythm while shooting a bow]. PMID- 2714564 TI - [Relation of the frequency of cardiac contraction and subjectively perceptible tension in the body during muscular work]. PMID- 2714565 TI - [Central hemodynamics of the healthy human at the time of a monitored decrease in the volume of circulating blood]. PMID- 2714566 TI - [Psychophysiologic analysis of the achievement motivation and avoidance in work activity]. PMID- 2714567 TI - [Work intensity and fatigue]. PMID- 2714568 TI - The NIH training grant program. A program in trouble? PMID- 2714569 TI - This is FASEB. The Office of Public Affairs. PMID- 2714570 TI - Modulation of gastric acid secretion by hypnosis. AB - The ability of hypnosis to both stimulate and inhibit gastric acid secretion in highly hypnotizable healthy volunteers was examined in two studies. In the first, after basal acid secretion was measured, subjects were hypnotized and instructed to imagine all aspects of eating a series of delicious meals. Acid output rose from a basal mean of 3.60 +/- 0.48 to a mean of 6.80 +/- 0.02 mmol H+/h with hypnosis, an increase of 89% (p = 0.0007). In a second study, subjects underwent two sessions of gastric analysis in random order, once with no hypnosis and once under a hypnotic instruction to experience deep relaxation and remove their thoughts from hunger. When compared to the no-hypnosis session, with hypnosis there was a 39% reduction in basal acid output (4.29 +/- 0.93 vs. 2.60 +/- 0.44 mmol H+/h, p less than 0.05) and an 11% reduction in pentagastrin-stimulated peak acid output (28.69 +/- 2.34 vs. 25.43 +/- 2.98 mmol H+/h, p less than 0.05). We have shown that different cognitive states induced by hypnosis can promote or inhibit gastric acid production, processes clearly controlled by the central nervous system. Hypnosis offers promise as a safe and simple method for studying the mechanisms of such central control. PMID- 2714571 TI - Intrathecal injection of bombesin inhibits gastric acid secretion in the rat. AB - Bombesin (100-500 ng) injected intrathecally (T9-10) inhibited gastric acid secretion stimulated by pentagastrin and the GABAB agonist baclofen in urethane anesthetized rats and basal gastric acid secretion in conscious, pylorus-ligated rats. Peptide action was dose-related, occurred within 30 min, and lasted for greater than 1 h. Bombesin-induced inhibition of pentagastrin-stimulated gastric acid secretion was not altered by cervical cord transection. Intravenous infusion of the monoclonal bombesin antibody 2A11 abolished intravenous bombesin (10 micrograms/kg.h)-induced 33% inhibition of gastric response to pentagastrin but did not alter intrathecal bombesin (200 ng)-induced 38% inhibition of gastric response to pentagastrin. The inhibitory effect of bombesin (200 ng) on pentagastrin-stimulated gastric secretion was reversed by bilateral adrenalectomy or removal of celiac and mesenteric ganglia. Intrathecal injections of rat calcitonin gene-related peptide, neuromedin B, neuromedin U, and the stable substance P analogue (pGlu5, MePhe8, MeGly9)-substance P(5-11) did not alter pentagastrin-stimulated gastric acid secretion. These results demonstrate that bombesin injected into the subarachnoid space of the spinal cord inhibits vagally stimulated and pentagastrin-stimulated gastric secretion in rats. Bombesin action is peptide specific, exerted at a spinal site, and expressed through the sympathetic nervous system. PMID- 2714572 TI - Effect of barrier-breaking agents on intracellular pH and epithelial membrane resistances: studies in isolated Necturus antral mucosa exposed to luminal acid. AB - Features of "H+ back-diffusion" after disruption of the gastric mucosal barrier were investigated by assessing, with a microelectrode technique, the influence of three barrier-breaking agents, taurocholate (10 mM), ethanol (20% vol/vol), and acetylsalicylic acid (10 mM) on intracellular pH and epithelial membrane potentials and resistances in isolated Necturus antral mucosa exposed to luminal acid (pH 3). Exposure of the mucosa to each of the three agents induced intracellular acidification of surface epithelial cells, but the pattern of pHi behavior was different for each agent: taurocholate induced immediate acidification of pHi, ethanol acidified pHi after a delay of 4-6 min, whereas acetylsalicylic acid initially alkalinized pHi, whereafter a rapid acidification of pHi occurred. Assessment of intraepithelial membrane resistances indicated that taurocholate primarily increases cellular conductance, decreasing in particular Ra. In contrast, ethanol mainly increased paracellular conductance, but also decreased cellular resistance, in particular Ra. Acetylsalicylic acid initially increased cell membrane resistances and Ra/Rb, whereafter a rapid decrease of Ra/Rb and Rt occurred. In each instance, the decrease of Ra/Rb preceded acidification of pHi. The data suggest that all three agents induce intracellular acidification by increasing the conductance of the apical cell membrane to H+, but in ethanol-treated tissues paracellular conductance primarily contributes to H+ back-diffusion. PMID- 2714573 TI - Relative impact of smoking and reduced pulmonary function on peptic ulcer risk. A prospective study of Japanese men in Hawaii. AB - The aim of this study was to determine whether reduced pulmonary function is an independent risk factor for peptic ulcer. Among 5933 Japanese men studied in Hawaii, 243 developed gastric ulcers and 99 developed duodenal ulcers 20 yr after an examination completed in 1968. The examination included measurement of forced expiratory volume in 1 s and a detailed smoking history. The percent predicted forced expiratory volume was significantly and inversely related to ulcer incidence, but not after adjustment for smoking or among those who had never smoked. Cigarettes were associated with increased ulcer risk in both stomach and duodenum but showed a dose-response in pack years only for gastric ulcer. We conclude that the association of reduced pulmonary function with peptic ulcer in the Japanese in Hawaii is largely attributable to smoking and that smoking is more strongly related to gastric than duodenal ulcer. The especially strong link between cigarettes and gastric ulcer suggests that decreased smoking or synchronous decrease in cigarette tar content may have contributed to the recent unexplained decrease in male gastric ulcer. PMID- 2714574 TI - Serosal bicarbonate protects against acid injury to rabbit esophagus. AB - The role of serosal bicarbonate ions (HCO3-) in protection against acid injury was investigated in rabbit esophageal mucosa mounted in Ussing chambers. Luminal acidification reduced potential difference and resistance in tissues exposed serosally to HCO3- or (unbuffered) HCO3-free solution. Whereas resistance declined similarly in both groups, potential difference declined less in HCO3- solution. After washout, HCO3-bathed tissues also had a greater increase in resistance, lower permeability to mannitol, and less histologic damage. Furthermore, as protection by HCO3- was not blocked by pretreatment with either the anion exchange blocker, 4 acetamido-4'-isothiocyanatostilbene 2-2'-disulfonic acid, or the carbonic anhydrase inhibitor, acetazolamide, and replacement of HCO3 with N-2-hydroxyethylpiperazine-N'-2-ethane sulfonic acid, a buffer impermeant to cells, was protective, an extracellular site for protection by HCO3- was likely. Where in the extracellular space HCO3- buffers H+ is unclear, but the absence of change in luminal pH and the inability to prevent the acid-induced increase in permeability in HCO3-bathed tissues argue against a luminal (preepithelial) site. Also, rapid repair was not demonstrated, indicating that a luminal site for protection after surface cell damage was unlikely. We conclude that serosal HCO3- is important in esophageal protection against acid damage by buffering H+ within the intercellular compartment of the extracellular space. PMID- 2714575 TI - Fall in the number of myenteric neurons in aging guinea pigs. AB - The neurons of the myenteric plexus of the entire small intestine were stained in young adult (3-4 mo old) and aging guinea pigs (26-30 mo old). Total length and circumference of the intestine were measured in the same experiments. The small intestine of the aging guinea pigs was longer, and (in the conditions of distention used) had a total serosal surface approximately 70% greater than in young adult animals. The spatial density of myenteric neurons per unit of serosal surface fell dramatically in aging animals, and the total number of myenteric neurons in the small intestine ranged between 1.1 and 1.6 million, i.e., it was only 40%-60% of the value obtained in young adult guinea pigs (2.75 million). The light microscope appearance of the neurons of the two groups of animals was markedly different and the suggestion is put forward that in aging guinea pigs the substantial reduction in neuron number is accompanied by structural changes and reorganization of the neurons that are left. PMID- 2714576 TI - Major pathway for putrescine synthesis induced by 1 alpha,25-dihydroxyvitamin D3 in chick duodenum. AB - We have reported that a single injection of 1 alpha,25-dihydroxyvitamin D3 into vitamin D-deficient chicks produces a marked accumulation of putrescine in the duodenum by an interconversion pathway. In the present study, we examined the effect of N1,N2-bis(2,3-butadienyl)-1,4-butanediamine, a specific irreversible inhibitor of polyamine oxidase, on the duodenal putrescine synthesis induced by 1 alpha,25-dihydroxyvitamin D3. Addition of N1,N2-bis(2,3-butadienyl)-1,4 butanediamine to an assay mixture completely inhibited the activity of duodenal polyamine oxidase in vitro. Prior administration of N1,N2-bis(2,3-butadienyl)-1,4 butanediamine to chicks completely blocked the 1 alpha,25-dihydroxyvitamin D3 induced increase in duodenal accumulation of putrescine in vivo. The increase of the duodenal accumulation of putrescine by 1 alpha,25-dihydroxyvitamin D3 in vitamin D-deficient chicks coincided quantitatively with the amount of N1 acetylspermidine synthesized from spermidine after the injection of the vitamin into the chicks pretreated with the inhibitor of polyamine oxidase. These results clearly indicate that spermidine N1-acetyltransferase plays a preferential role in the increase in duodenal putrescine synthesis by 1 alpha,25-dihydroxyvitamin D3. The rapidly proliferating and maturing epithelium of small intestines will provide a good model for investigating the role of the interconversion of polyamine metabolism in cell growth and differentiation. PMID- 2714577 TI - Release of neurotensin by selective perfusion of the jejunum with oleic acid in dogs. AB - Plasma neurotensin concentrations are rapidly elevated after oral ingestion or intraduodenal infusion of fat, apparently before fat reaches the ileum where neurotensin is highly concentrated. The purpose of this study was to investigate the site of neurotensin release and to determine whether neurotensin is released by direct luminal stimulation by fat in conscious dogs. Dogs were prepared with isolated jejunal or ileal segments and portal vein catheters. Release of neurotensin into the portal venous blood was examined by selective perfusion of each intestinal segment with sodium oleate. The results of this study show that selective perfusion of the jejunum, but not the ileum, with sodium oleate, caused a significant release of neurotensin. We speculate that release of ileal neurotensin is not due to direct luminal stimulation, but is mediated by local neural or humoral intermediates. PMID- 2714578 TI - Effect of berberine on myoelectric activity and transit of the small intestine in rats. AB - The motility of the small intestine in unanesthetized rats receiving berberine sulfate (0.2, 2.0, and 20.0 mg/kg i.p.) was investigated. Motility was determined by two methods: myoelectric activity was monitored with indwelling bipolar electrodes, and intestinal transit was measured by the movement of radiochromium (Na51CrO4). The 20.0-mg/kg dose caused a marked inhibition of spike activity for 21.8 +/- 7.0 min and disrupted activity fronts of the migrating myoelectric complex for 212.3 min. Berberine, 2.0 mg/kg i.p., disrupted migrating myoelectric complexes for 64.6 min but spike inhibition was not observed. Transit of the small intestine was significantly (p less than 0.001) delayed at 15 and 100 min after the highest dose of berberine. Naloxone blocked the spike inhibition noted with 20.0 mg/kg of berberine but failed to improve transit. Phentolamine blocked spike inhibition and was associated with a significantly earlier return of activity fronts of the migrating myoelectric complex. Animals pretreated with this antagonist tended toward a higher geometric center in transit studies than those injected with berberine alone. Berberine was also administered by various routes (intraperitoneal injection, intravenous injection, orogastric gavage, and intraluminal injection). An intraperitoneal injection was 10-fold more potent than an intravenous injection. Orogastric gavage and intraluminal administration of berberine did not alter intestinal motility. In summary, berberine sulfate significantly inhibits myoelectric activity and transit of the small intestine. This appears to be partially mediated by opioid and alpha-adrenergic receptors. The antidiarrheal properties of berberine may be mediated, at least in part, by its ability to delay small intestinal transit. PMID- 2714579 TI - Biliary excretion of iron and ferritin in idiopathic hemochromatosis. AB - The role of biliary excretion of iron and ferritin in iron overload was studied and evaluated. Ten patients with idiopathic hemochromatosis and two groups of controls (14 gallstone patients and 16 healthy subjects) were included. Liver tissue (obtained by percutaneous or operative biopsy) was investigated with light microscopy and transmission electron microscopy in combination with x-ray microanalysis. Fasting bile samples were obtained through duodenal aspiration or at cholecystectomy. Iron was determined in liver tissue and bile using atomic absorption spectroscopy, and ferritin was determined in serum and bile with a radioimmunoassay technique. All patients with hemochromatosis had iron-positive staining as seen in light microscopy. Electron microscopy showed iron-containing proteins in the lysosomes and cytosol of liver parenchymal cells, and this observation was supported by x-ray microanalysis. Hepatic iron concentration was increased about eightfold in the patients with hemochromatosis (p less than 0.001). Biliary iron concentration, expressed per millimole of bile acid, was increased about twofold (p less than 0.05) and biliary ferritin concentration about fivefold (p less than 0.001) in hemochromatosis. Four of the patients with hemochromatosis were reexamined after completed treatment with venesection; this resulted in normalized biliary concentrations of iron and ferritin. We conclude that biliary secretion of ferritin occurs in humans and that both iron and ferritin excretion are enhanced in hepatic iron overload. The apparently limited capacity of biliary iron excretion may be of importance for the hepatic iron accumulation in hemochromatosis. PMID- 2714580 TI - Effect of age on tests of intestinal and hepatic function in healthy humans. AB - We studied intestinal function and hepatic microsomal phase I monooxygenase function in healthy, free-living subjects, aged 19-91 yr. In subjects (n = 114) given a diet including 100 g/day of fat, fecal fat in a 72-h collection did not increase with advancing age. D-Xylose excretion (n = 54) following a 25-g oral load significantly declined with increasing age, but a concomitant decline in creatinine clearance suggested a decrease in renal function rather than an absorptive defect. Furthermore, there was no evidence for an age-associated increase in bile salt deconjugation by intestinal bacteria as shown by the glycocholate breath test (n = 60). Finally, there was no evidence for a decrease in hepatic microsomal function with advancing age as measured by the aminopyrine breath test (n = 60). We conclude that digestive/absorptive and hepatic microsomal phase I monooxygenase function are well preserved in healthy humans throughout life. PMID- 2714581 TI - Preserved cytosolic and synthetic liver function in jaundice of severe extrahepatic infection. AB - We investigated prospectively 9 adult patients with the syndrome of jaundice complicating severe extrahepatic infection both clinically and by quantitative liver function tests. Five patients having severe extrahepatic infection without jaundice were used for comparison. Intraperitoneal infection was found to be a major risk factor for development of jaundice. Jaundice was mainly associated with gram-negative infection, but did not influence survival. Duration of jaundice was dependent on control of the underlying infection. Liver function tests showed a severely deranged organic anion transport, whereas synthetic, cytosolic, and microsomal functions remained preserved. Our study shows that (a) the syndrome of jaundice associated with extrahepatic infection is a functional disorder that is reversible upon control of infection, and that (b) cytosolic, synthetic, and microsomal function is preserved. This may have consequences for both assessing prognosis and clinical management. PMID- 2714583 TI - Papillary stenosis and sclerosing cholangitis in an immunodeficient child. AB - Sclerosing cholangitis, an inflammatory disease of the biliary tree that occurs infrequently in childhood, has been recognized in combination with papillary stenosis in adults with the acquired immunodeficiency syndrome. A 10-yr-old child with a familial immunodeficiency syndrome characterized by defective T-cell function and deficiencies of immunoglobulins A and G developed papillary stenosis and sclerosing cholangitis associated with cryptosporidium enteritis. The patient presented with fever, jaundice, right upper quadrant pain, and elevated serum concentrations of transaminases and alkaline phosphatase. The pain and jaundice resolved after endoscopic sphincterotomy, but the biochemical abnormalities persisted. This case demonstrates that the combination of papillary stenosis and sclerosing cholangitis can occur in children as well as adults and may be associated with immunodeficiency syndromes other than the acquired immunodeficiency syndrome. Endoscopic sphincterotomy can provide symptomatic treatment for papillary stenosis in children with this condition, although the effect of sphincterotomy on the natural history of the sclerosing cholangitis is uncertain. PMID- 2714582 TI - Intestinal lymphangiectasia markedly improved with antiplasmin therapy. AB - A 35-yr-old woman with intestinal lymphangiectasia was treated with trans-4 aminomethyl cyclohexane carboxylic acid. After 6 wk of antiplasmin therapy, her serum total protein increased to normal levels and 131I-polyvinyl pyrrolidone excretion was also normalized. With a daily administration of trans-4-aminomethyl cyclohexane carboxylic acid, the patient has manifested no symptoms for 8 yr up to the present. Throughout the clinical course, the values for euglobulin lysis time showed a close relationship to changes in serum total protein. It was then suggested that increased plasma fibrinolysis may enhance lymphatic permeability to plasma proteins. During this treatment, a decreased percentage of T lymphocytes became normalized together with serum immunoglobulin values. In addition, the therapy has resulted in the disappearance of duodenal lesions observed endoscopically. PMID- 2714584 TI - Pleural effusion coinciding with acute exacerbations in a patient with chronic hepatitis B. AB - A 28-yr-old man had pleural effusions coinciding with two separate episodes of acute exacerbation of chronic type B hepatitis. In both episodes, the pleural effusion was exudative with lymphocyte predominance, and there was no ascites. Hypocomplementemia was evident in the second episode when the complement level was determined, but immune complexes were not detected in the serum. The hepatitis itself was thought to be directly responsible for the pleural effusions because of meticulous exclusion of other causes and the fact that, without specific treatment, the effusions resolved completely as the hepatitis subsided. PMID- 2714585 TI - Reversible cholestatic hepatitis caused by acetohexamide. AB - We report a case of cholestatic hepatitis accompanied by peripheral and hepatic eosinophilia in a patient taking acetohexamide for a period of 1.5 yr. Jaundice developed acutely and was accompanied by fever. After discontinuation of the drug, there was no evidence of further damage, with prompt normalization of liver enzymes, bilirubin, and eosinophil count. PMID- 2714586 TI - Measurement of [14C]aminopyrine accumulation in isolated parietal cells. PMID- 2714587 TI - Pericarditis complicating esophageal sclerotherapy. PMID- 2714588 TI - Mucosal plaques seen at colonoscopy: chemical colitis or mucosal pseudolipomatosis? PMID- 2714589 TI - Prostaglandin inhibitors on porcine colon. PMID- 2714590 TI - Colchicine in primary biliary cirrhosis. PMID- 2714591 TI - External biliary duodenal drainage through a percutaneous endoscopic duodenostomy. PMID- 2714592 TI - A new technique using injectable collagen to promote sealing of an esophagorespiratory fistula. PMID- 2714593 TI - Management of a duodenal web by endoscopic laser therapy. PMID- 2714594 TI - The endoscopic diagnosis of colonic tuberculosis. PMID- 2714595 TI - Percutaneous endoscopic gastrostomy button malfunction with severe cough. PMID- 2714596 TI - Romancing the stones. PMID- 2714597 TI - Endocarditis prophylaxis and esophageal dilation. PMID- 2714598 TI - Treatment of solitary rectal ulcer syndrome with sucralfate enema. PMID- 2714599 TI - Pull caudad for the impacted stone. PMID- 2714600 TI - Complication of the Russell PEG method. PMID- 2714601 TI - The clinical value of endoscopic biopsy of duodenal ulcer. PMID- 2714602 TI - Laser ablation of symptomatic rectal pseudopolyps. PMID- 2714603 TI - Posttherapeutic foreign bodies in esophagus, stomach, and duodenum. PMID- 2714604 TI - Nd:YAG laser for diminutive polyps. PMID- 2714605 TI - Removal of colonic medium size sessile polyps without diathermy. PMID- 2714606 TI - Bacteremia following sclerotherapy in portal hypertension. PMID- 2714607 TI - Program abstracts. 1989 American Society for Gastrointestinal Endoscopy meeting. May 17, 1989, Washington, DC. PMID- 2714608 TI - Upper gastrointestinal endoscopy without sedation: a prospective study of 2000 examinations. AB - Various drugs are used for sedation prior to upper gastrointestinal endoscopy, some with undesirable side effects. In an attempt to avoid these side effects, 2000 upper diagnostic gastrointestinal endoscopies were performed in a period of 4 years between 1982 and 1986, without any sedation, using Olympus GIF-Q and GIF P3 gastroscopes. Anxiety, ease of introduction of gastroscope, tolerance of the procedure, and the overall success of the procedure were assessed. Most patients were calm (81.2%); 94.4% had an easy introduction of the gastroscope, 80.3% tolerated the procedure well; and 94.2% of the endoscopies were completely successful. There were no complications, and only four examinations failed (0.2%). Sedation had to be used (intravenous diazepam) in 32 patients due to excessive anxiety and an inability to introduce the gastroscope and in three children under 10 years (1.6%). The average time needed to complete an endoscopy without sedation was found to be 9.5 min, nearly half of the average time needed before this study when sedation was routinely given. It is concluded that upper gastrointestinal endoscopy without sedation can be a safe, quick, well-tolerated procedure. PMID- 2714609 TI - The significance of diminutive colonic polyps found at flexible sigmoidoscopy. AB - In order to determine the importance of identification and follow-up of diminutive colonic polyps (DCPs) (i.e., those less than or equal to 5 mm in diameter), we studied 3006 patients undergoing flexible sigmoidoscopy. DCPs were found in 315 patients (10.5%). Biopsy of these lesions showed them to be nonneoplastic in 187 patients (59.4%) and neoplastic in 128 (40.6%). Overall, 35% of all DCPs found were neoplastic. Gross appearance of the lesions was found to be an unreliable means of predicting their histologic makeup. Of the 128 patients with neoplastic DCPs, 73 underwent further examination with barium enema and colonoscopy. Synchronous lesions were found in 57.5%. In 10 patients, synchronous lesions were of significance, including carcinomas, adenomas greater than or equal to 8 mm in diameter, or severely dysplastic adenomas. We conclude that all DCPs discovered at sigmoidoscopy should be biopsied and in patients in whom DCPs are found to be neoplastic, colonoscopy should be undertaken to search for proximal synchronous lesions. PMID- 2714610 TI - Mucosal pseudolipomatosis: an air pressure-related colonoscopy complication. AB - Mucosal pseudolipomatosis is a recently described colonoscopic finding, most likely caused by intramucosal air. We describe four asymptomatic patients with this lesion which completely resolved 3 weeks later on repeat colonoscopy. This is a benign, transient lesion with distinct endoscopic and histologic findings. The similarity between mucosal pseudolipomatosis and pneumatosis cystoides intestinalis is supportive of the mechanical theory for pneumatosis cystoides intestinalis. PMID- 2714611 TI - Endoscopic biliary prostheses as treatment for benign postoperative bile duct strictures. AB - We evaluated the efficacy of endoscopically placed biliary stents as treatment for 32 benign postoperative biliary strictures in 29 patients. Five patients also had bile fistulas. Stents were inserted for a mean of 162 days and then removed. ERCPs were obtained before stent insertion and again after removal. Responses were followed and categorized as excellent, good, or poor. Stent insertion was successful in 25 patients (86%), 23 of which have a mean follow-up of 19 months (range, 2 to 42 months) after stent removal. Seventy-four percent had an excellent (48%) or good (26%) response. Early postoperative strictures and fistulas responded favorably. We conclude that benign postoperative biliary strictures can be treated successfully by endoscopic prostheses. PMID- 2714612 TI - A comparison of the effects of cyclosporine (CsA) on hepatic microsomal drug metabolism in three different strains of rat. AB - 1. Male albino Wistar (W), Sprague-Dawley (SD) and Fischer-344 (F344) rats, Rattus norvegicus, were dosed orally once daily with cyclosporine (CsA), 25 mg/kg/day, for 14 days. Control and treated rats were then sacrificed and selected assays were performed to measure differences in hepatic microsomal enzyme activity including: protein (PROT), cytochrome P-450 (CYT-P450) and cytochrome b5 (CYT-b5) levels, NADPH-cytochrome c reductase (CYT-c) activity, ethylmorphine N-demethylase (ETM) and aniline hydroxylase (ANL) activities. 2. Two-way analysis of variance (ANOVA) indicated that the effect of treatment alone showed significant strain-related differences in all parameters examined except CYT-b5 levels, while the effect of strain alone indicated significant differences in PROT, CYT-B5, CYT-c, and ANL. 3. The interaction component of the two-way ANOVA (treatment x strain) indicated strain-related differences in substrate metabolism only (ETM and ANL). 4. F344 rats were found to be significantly different from either Sprague-Dawley or Wistar rats in terms of the effect of CsA on ETM and ANL metabolism. PMID- 2714613 TI - A comparison of GABAergic influences on the analgesic responses to morphine and pentazocine. AB - 1. The interactions of three GABAergic compounds, gamma-acetylenic GABA, gamma vinyl GABA and ethylenediamine with the analgesic effects of morphine and pentazocine were examined in mice using the hot plate and tail immersion tests. 2. A significant increase in reaction time induced by morphine was noted in the tail immersion test after pretreatment with the drugs acting through GABA functions. 3. The inhibitors of GABA transaminase, gamma-acetylenic GABA and gamma-vinyl GABA, and the GABAmimetic ethylenediamine did not significantly change the analgesic action induced by pentazocine. 4. In the hot plate test the three GABAergic compounds antagonized the analgesic effects of pentazocine in contraposition with previous results indicating that morphine-induced analgesia is increased by pretreatment with those agents. 5. These findings suggest that GABAergic and opiopeptidergic systems are interconnected through mu receptors, whereas the kappa opiate systems seem to be unrelated to GABA functions. PMID- 2714614 TI - Effects of acute administration or chronic ethanol ingestion on sexual organs monoamine levels in male rats. AB - 1. Acute or chronic treatment with ethanol modify the monoamine levels in epididymis (body, tail) and prostate, without changes in head epididymis and seminal vesicle of male rats. 2. The prostate seems to be the most affected in acute treatment while the epididymis body is altered after prolonged exposure to ethanol. PMID- 2714615 TI - Therapeutic and prophylactic treatment of skin burns with several calmodulin antagonists. AB - 1. Several calmodulin antagonists abolished the decrease in ATP level and in the activities of 6-phosphogluconate dehydrogenase and mitochondrial and soluble hexokinase, induced by burns in the rat skin. 2. These antagonists had also a protective action on the blood capillaries and erythrocyte membrane, as judged by the electron microscopic appearance, as well as the abolishment of hemoglobin increase and burn edema. 3. Of all the compounds investigated here, the most effective were trifluoperazine and thioridazine, which are also known as the more potent calmodulin antagonists. 4. The present experiments suggest that calmodulin antagonists may be effective drugs in treatment of burns, having both therapeutic and prophylactic action. PMID- 2714616 TI - Methods for analyzing and interpreting cooperativity in dose-response curves--I. Antagonist effects on angiotensin receptors in smooth muscle. AB - 1. Dose-response curves for angiotensins II and III in the rat isolated uterus, portal vein and aorta, in the absence and presence of the antagonist [Sar1Ile8]ANG II, have been analyzed by methods which detect cooperativity. 2. Hanes-Woolf transformations of dose-response data were used to define phases of positive homotropic cooperativity, and this information was applied to the interpretation of Hill plots. 3. The level of positive cooperativity was found to be higher for ANG II (nH = 1.35-2.00) than ANG III (nH = 1.02-1.43) in the three tissues studied. 4. In the presence of the antagonist [Sar1Ile8]ANG II a decrease in the level of cooperativity produced by both agonists was observed, and high concentrations of the antagonist could induce negative cooperativity. 5. These findings have been interpreted on the basis of a 2-site agonist binding mechanism involving receptor dimers, in which angiotensin agonists induce an increase in their own receptor binding affinity, whereas the antagonist [Sar1Ile8]ANG II decreases the affinity of angiotensin receptors for ANG II and ANG III. PMID- 2714617 TI - Methods for analyzing and interpreting cooperativity in dose-response curves--II. Partial agonists acting on muscarinic receptors in smooth muscle. AB - 1. Dose-response curves for eight muscarinic agonists contracting guinea pig ileum were transformed into Hanes-Woolf plots and Hill plots respectively. 2. Hill plots for three full agonists were linear with slopes of 1.6, illustrating positive homotropic cooperativity involving two or more agonist binding sites. 3. Five partial agonists gave curved Hill plots with Hill coefficients of 1.2-1.7 at low agonist concentration and Hill coefficients of 0.3-0.5 at high agonist concentrations. 4. Hanes-Woolf transformations were used to delineate the transition from positive to negative cooperativity and to assist in the interpolation of Hill plots. 5. The results show that all of the agonists studied induce positive cooperativity, and that the difference between full agonists and partial agonists results from the ability of the latter to induce pronounced negative cooperativity at higher concentrations. PMID- 2714618 TI - Effects of the venom of the Brazilian scorpion Tityus serrulatus and two of its fractions on the isolated diaphragm of the rat. AB - 1. The effects of Tityus serrulatus venom and of two of its toxic fractions, toxin gamma (Tx gamma) and T2III1, on the rat isolated diaphragm were examined. 2. The crude venom (5 ng) facilitated the neuromuscular transmission and increased the twitch tension evoked by retrograde injection of Ach. 3. Tx gamma (25-100 ng) and fraction T2III1 (2.5 ng) also facilitated the neuromuscular transmission but only fraction T2III1 increased the twitch tension evoked by retrograde injection of Ach. 4. Tx gamma (50 ng) and fraction T2III1 (2.5 ng) produced a tetrodotoxin-sensitive increase in the frequency of miniature endplate potentials (m.e.p.p.) and a transitory reduction of the resting potential. The latter effect of the fractions was prevented by treating muscles with tetrodotoxin or D-tubocurarine. Fraction T2III1 also produced a tetrodotoxin resistance increase of m.e.p.p. amplitude. 5. These results suggest that Tx gamma enhances Ach output through the activation of Na+ channels in the motor nerve terminals. Fraction T2III1 produced effects similar to those induced by Tx gamma but also acted at postjunctional sites, probably by increasing subsynaptic membrane sensitivity to the neurotransmitter. PMID- 2714619 TI - Modulatory roles of GABAergic mechanisms in post-rotatory nystagmus in the rabbit. AB - 1. To determine how the GABAergic mechanism operates in the generation of post rotatory nystagmus, an experiment was performed with GABAergic drugs in rabbits. 2. Subconvulsive doses of picrotoxin (0.3-0.6 mg/kg, i.v.) and bicuculline (0.1 mg/kg, i.v.) decreased the number of post-rotatory nystagmus beats, whereas strychnine sulphate, at a subconvulsive dose (0.1 mg/kg i.v.), increased it. 3. Diazepam (1 mg/kg, i.v.) remarkably increased the number of post-rotatory nystagmus beats. Pretreatment with picrotoxin (0.45 mg/kg, i.v.), bicuculline (0.1 mg/kg, i.v.) or semicarbazide-HCl (180 mg/kg, i.v.) antagonized the effects of diazepam (1 mg/kg, i.v.). 4. GABAergic mechanisms may play a modulatory role in the production of nystagmus rhythm. Strychnine-sensitive neurons involved in the vestibular mechanism may behave in a different manner from picrotoxin sensitive neurons. PMID- 2714620 TI - The effects of imipramine, mianserin and trazodone on the chronotropic, inotropic and coronary vascular responses in the isolated perfused rat heart. AB - 1. The cardiovascular effects of the tricyclic antidepressant imipramine and two second generation antidepressants mianserin, a tetracyclic, and trazodone, a triazolopyridine derivative, were investigated in the isolated perfused rat heart. 2. Imipramine caused cardiac slowing and a negative inotropic effect at 2.5 microM after 30 min of perfusion. Conversely mianserin and trazodone had no effect on heart rate at 5 microM with inotropic state remaining above control values after 30 min of perfusion. 3. Varying effects on coronary flow, which appear to correlate well with the documented receptor actions of each drug, were demonstrated. Imipramine caused a decrease in coronary flow at 1.25 and 2.5 microM, followed by an increase at 10 microM. Mianserin decreased coronary flow at all concentrations between 1 and 20 microM. Trazodone elicited a marked elevation in coronary flow over the dose range of 2.5 to 250 microM. 4. The results in this model suggest that although the second generation agents appear to cause less cardiodepression all three agents elicit quantitatively different coronary vascular responses. PMID- 2714621 TI - Interference of pentobarbital and verapamil with the reactivity of middle cerebral artery of cat exposed to experimental subarachnoid hemorrhage. AB - 1. Pentobarbital and verapamil produced concentration-dependent vasodilation in segments of middle cerebral artery of either control or exposed to experimental subarachnoid hemorrhage (SAH) cats precontracted with 5-hydroxytryptamine (5-HT, 10(-5) M) or K+ (75 mM), the potency to evoke relaxation being greater for verapamil than pentobarbital. 2. Pentobarbital (10(-4) M and 10(-3) M) or verapamil (10(-6) M) inhibited the contractions induced by 10(-5) M 5-HT or 75 mM K+ in both kinds of vessels. 3. Pentobarbital (10(-3) M) and verapamil (10(-6) M) reduced the concentration-dependent contractions induced by Ca2+ addition in control and SAH arteries previously exposed to Ca2+-free medium containing K+ or 5-HT. 4. All these vasodepressor effects of pentobarbital and verapamil were similar in control and SAH vessels, suggesting that the sensitivity of them to these agents is unaffected by SAH. PMID- 2714622 TI - Effect of tetrahydroisoquinoline (TIQ), one of endogenous substances inducing parkinsonism, on isolated rat vas deferens. AB - 1. The effect of tetrahydroisoquinoline (TIQ) was examined on isolated rat vas deferens. 2. TIQ shifted the concentration-response curve for norepinephrine towards lower concentrations: the pD2-value of norepinephrine in the presence of TIQ was significantly greater than in its absence. 3. Tyramine-induced contraction in the presence of TIQ decreased by a significant 35% more than in the absence of TIQ. 4. These results indicate that the pharmacological effect of TIQ is due to the inhibition of the neuronal uptake of catecholamines. PMID- 2714623 TI - The study of insulin-like growth factors in Tilapia, Oreochromus mossambicus. AB - Whole and acid-separated serum samples from fed, starved, and refed Tilapia were analyzed for insulin-like growth factors 1 (IGF-1) and 2 (IGF-2) using human fetal brain radioreceptorassay (RRA-IGF-1), rat liver membrane radioreceptorassay (RRA-IGF-2), and radioimmunoassay (RIA-IGF-1). Triidothyronine (T3) and thyroxine (T4) levels were measured by commercial kits for RIA. For serum separation, acid Sephadex G-50 and G-100 and neutral Sephadex G-200 columns were used. Whole serum and separated serum cross-reacted in RRA-IGF-1, but only slightly in RRA-IGF-2. IGF activity eluted in two peaks after acid G-50 chromatography. Peak I eluted at the void volume, and peak II eluted with an apparent molecular weight of approximately 7 kDa. The 7 kDa activity did not cross-react in RIA-IGF-1 excluding identity with human intact or truncated IGF-1, but did suggest the presence of an IGF-1 variant form. Whole serum was separated over a neutral G-200 column, and all activity eluted at the void volume indicated an apparent molecular weight equal to or greater than 250 kDa. No IGF-binding activity was displayed by either whole serum or peak I after acid G-50 chromatography. Despite significant changes in body weight, an influence of starvation and refeeding on serum IGF activity could not be established. No correlation was seen between serum IGF and T3 and T4 levels. PMID- 2714624 TI - Detection of unconjugated and conjugated steroids in the ovary, eggs, and haemolymph of the decapod crustacean Nephrops norvegicus. AB - Gas chromatography/mass spectrometry with selected ion monitoring has been employed to examine extracts from the ovary, eggs, and haemolymph of the marine prawn, Nephrops norvegicus, to demonstrate the presence of steroids. Both free and conjugated steroids were isolated by solvent partitioning and chromatography (lipophilic Sephadex, reversed-phase Sep Pak, and normal phase medium-pressure liquid chromatography) and steroidal conjugates were cleaved enzymatically. Steroids were determined as their methyloxime derivatives, trimethylsilyl (TMS) ethers or methyloxime-TMS ethers. All assignments were based on the detection of characteristic ions and cochromatography with the authentic steroid derivatives. 5 alpha-Dihydrotestosterone, testosterone, pregnenolone, and 20 alpha hydroxypregn-4-en-3-one were detected in unconjugated form in the ovary. The eggs and haemolymph were found to contain unconjugated 17 beta-estradiol. Conjugated 5 alpha-dihydrotestosterone was detected in both the ovary and haemolymph, but no conjugated steroids were found in the eggs. PMID- 2714625 TI - Melanotropin structure-activity studies on melanocytes of the teleost fish, Synbranchus marmoratus. AB - The minimal sequence of alpha-MSH required for full agonism on fish (Synbranchus marmoratus) melanocytes was determined to be Ac-alpha-MSH5-10-NH2 since Ac-alpha MSH6-10-NH2 and Ac-alpha-MSH6-9-NH2 were inactive. The N-terminal tripeptide sequence, Ser-Tyr-Ser, lacked any contribution to potency since the 4-13 (Ac [Nle4]-alpha-MSH4-13-NH2) sequence was equipotent to alpha-MSH. The important potentiating amino acids were found to be Met at position 4 of the amino terminus and Val at position 13 of the carboxy terminus of the hormone, since Ac-alpha MSH4-10-NH2 was about 100 times more potent than the Ac-alpha-MSH5-10-NH2 sequence, and Ac-[Nle4]-alpha-MSH4-13-NH2 was about 10 times more active than Ac [Nle4]-alpha-MSH4-12-NH2. The minimal sequence for equipotency to alpha-MSH was demonstrated to be Ac-[Nle4]-alpha-MSH4-13-NH2. [Nle4, D-Phe7]-alpha-MSH was about 10 times more active than alpha-MSH. Unexpectingly, several conformationally restricted cyclic melanotropins were either partial agonists ([Cys4, Cys10]-alpha-MSH) or totally inactive (Ac[Cys4, Cys10]-alpha-MSH4-10-NH2) on fish melanocytes. These results point out some rather remarkable differences between S. marmoratus and tetrapod melanophores relative to structural requirements for MSH receptor recognition and signal transduction. PMID- 2714626 TI - Effect of ambient temperature on serotonin, norepinephrine, and epinephrine contents in the pineal-paraphyseal complex of the soft-shelled turtle (Lissemys punctata punctata). AB - The aim of the present investigation was to ascertain the influence of ambient temperature on serotonin, norepinephrine, and epinephrine contents in the pineal paraphyseal complex of soft-shelled turtles. Turtles were exposed to low (10 degrees) and high (32 degrees) temperatures for 7 days in an incubator with the same photoperiod (12L:12D). Control animals were also kept in the same incubator at 25 degrees for similar duration with the same photoperiod. The findings revealed that ambient temperatures significantly altered serotonin, norepinephrine, and epinephrine content in the pineal-paraphyseal complex of turtles. The results thus indicate that ambient temperature has some influence on pineal serotonin, norepinephrine, and epinephrine contents in soft-shelled turtles. PMID- 2714628 TI - Abstracts of papers presented at the Fourteenth Conference of European Comparative Endocrinologists. September 4-9, 1988, Salzburg, Austria. PMID- 2714627 TI - The measurement of melanin-concentrating hormone in trout blood. AB - Two methods are described for measuring the titres of melanin-concentrating hormone (MCH) in trout plasma. One involves the extraction of MCH from 1-ml plasma onto C18 Sep Pak cartridges, after which the eluted peptide is measured by conventional radioimmunoassay. In the alternative method, antibodies are bound onto immunobeads which are added to 0.5 ml plasma. After incubation for 24 hr, the beads are washed to remove the plasma and are incubated with 125I-labelled MCH; the following day, the labelled beads are separated by centrifugation, washed, and counted. The relative advantages of each method is discussed. Using these two methods, it is shown that the plasma concentration of the hormone is significantly higher in fish from white tanks (greater than 50 pmol/litre) than in fish from black tanks (approximately 10 pmol/litre) or those kept in the dark (approximately 5 pmol/litre). The plasma concentration of MCH changes rapidly when trout are moved from one coloured background to another, indicating its involvement in physiological colour change. PMID- 2714629 TI - A new bacterial alcohol dehydrogenase active on degraded lignin and several low molecular weight aromatic compounds. AB - A new intracellular bacterial dehydrogenase has been purified. It was active in the reversible reduction by NADH of conjugated carbonyl groups in partially degraded lignin. It was also active on various aromatic aldehydes such as vanillin, syringaldehyde and cinnamaldehyde, but had no effect on acetovanillone and lignin models carrying a conjugated ketone. It is proposed that this enzyme functions as a broadly specific lignin dehydrogenase at the level of aldehydic groups that are present in the lignin preparations. PMID- 2714630 TI - Nucleotide sequence of the gene coding for the elongation factor Tu from the extremely thermophilic eubacterium Thermotoga maritima. PMID- 2714631 TI - Cloning and characterization of the carbapenem biosynthetic genes from Streptomyces fulvoviridis. AB - Carbapenem non-producing mutants were isolated from Streptomyces fulvoviridis and divided into six cosynthesis groups. By using one of the mutants as the host and plasmid pIJ385 as the vector, we cloned carbapenem biosynthetic genes from the parental S. fulvoviridis strain. A cloned 6-kb DNA fragment complemented the defects of three mutants each of which had a mutation in different genes. Southern blot hybridization using the cloned 6-kb fragment as probe showed the presence of the nucleotide sequences homologous to the probe in other carbapenem producing Streptomyces spp. In addition, Streptomyces griseus, a carbapenem non producer, possessed the sequence homologous to the probe and showed co-synthesis phenomena with some of the carbapenem non-producing mutants of S. fulvoviridis. PMID- 2714632 TI - Initial characterization of a chlamydial receptor on mammalian cells. AB - We have examined characteristics of the binding of eukaryotic cells to chlamydial elementary body (EB)-specific proteins. A wide variety of eukaryotic cell lines bound to representatives of both Chlamydia trachomatis lymphogranuloma venereum (LGV) and trachoma biovars and a C. psittaci strain meningopneumonitis (Mn) suggesting the presence of a common host cell receptor. Neither tunicamycin nor neuraminidase treatment of HeLa cells impaired binding to C. trachomatis EB, implying that host cell N-linked carbohydrate domains and sialic acid moieties, respectively, are not involved in attachment. However, trypsinized HeLa cells do not bind to EB, suggestive of a proteinaceous host cell receptor. The trypsin sensitivity of two EB-specific binding proteins Mr = 18,000 and 31,000) was also examined, and the finding that 125I-labeled HeLa cells bind both the 18,000 and 31,000-dalton proteins after chlamydial trypsinization corroborates our earlier observation that these EB binding proteins mediate attachment. PMID- 2714633 TI - Glycylprolyl dipeptidase activity of Bacteroides gingivalis W50 and the avirulent variant W50/BEI. AB - Glycylprolyl dipeptidase activity was measured in cells, extracellular vesicles (ECV) and the soluble extracellular protein fraction (EP) of batch cultures of strains W50 and W50/BEI. Total culture enzyme activity of W50 dropped with age whilst that of W50/BEI remained constant. Activity was highest in the cellular fraction, greater for W50/BEI than W50 and rose with culture age. Both strains showed similar ECV activities but these declined with culture age. The EP glycylprolyl dipeptidase activity of W50/BEI in older cultures rose to a level 13 fold greater than W50. The majority of extracellular activity was represented by the ECV for strain W50 but by EP for W50/BEI. Variable but incomplete attenuation of activity was achieved by dithiothreitol. ECV and EP activities were associated with a high molecular mass fraction, but a smaller fraction (molecular mass 30,000) was detected in W50/BEI EP. PMID- 2714634 TI - Immunological detection of penicillin-binding protein 2' in clinical isolates of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. AB - The additional penicillin-binding protein (PBP 2') that is important in determining intrinsic resistance in methicillin-resistant strains of Staphylococcus aureus (MRSA) has been detected immunologically in strains from a variety of world-wide locations. This additional protein has also been definitively identified both immunologically and as a PBP in methicillin resistant strains of S. epidermidis (MRSE). The assay described is rapid, specific and sensitive and has been used to detect PBP 2' in S. haemolyticus but not in beta-lactam resistant Streptococci. PMID- 2714635 TI - Role of recBC function in formation of chromosomal rearrangements: a two-step model for recombination. AB - The role of recBC functions has been tested for three types of chromosomal recombination events: (1) recombination between direct repeats to generate a deletion, (2) recombination between a small circular fragment and the chromosome, and (3) recombination between inversely oriented repeats to form an inversion. Deletion formation by recombination between direct repeats, which does not require a fully reciprocal exchange, is independent of recBC function. Circle integration and inversion formation are both stimulated by the recBC function; these events require full reciprocality. The results suggest that half-reciprocal exchanges can occur without recBC, but recBC functions greatly stimulate completion of a fully reciprocal exchange. We propose that chromosomal recombination is a two-step process, and recBC functions are primarily required for the second step. PMID- 2714637 TI - The genetics of postzygotic isolation in the Drosophila virilis group. AB - In a genetic study of postzygotic reproductive isolation among species of the Drosophila virilis group, we find that the X chromosome has the largest effect on male and female hybrid sterility and inviability. The X alone has a discernible effect on postzygotic isolation between closely related species. Hybridizations involving more distantly related species also show large X-effects, although the autosomes may also play a role. In the only hybridization yet subjected to such analysis, we show that hybrid male and female sterility result from the action of different X-linked loci. Our results accord with genetic studies of other taxa, and support the view that both Haldane's rule (heterogametic F1 sterility or inviability) and the large effect of the X chromosome on reproductive isolation result from the accumulation by natural selection of partially recessive or underdominant mutations. We also describe a method that allows genetic analysis of reproductive isolation between species that produce completely sterile or inviable hybrids. Such species pairs, which represent the final stage of speciation, cannot be analyzed by traditional methods. The X chromosome also plays an important role in postzygotic isolation between these species. PMID- 2714636 TI - New mutants of Paramecium tetraurelia defective in a calcium control mechanism: genetic and behavioral characterizations. AB - The k-shy mutants of Paramecium tetraurelia are altered in several Ca2+-dependent functions which regulate ciliary motility. The isolation, genetics, and phenotypes of these mutants are described. Of six independent isolates, all contained recessive single-factor mutations and comprise two unlinked loci, ksA and ksB. All k-shy strains showed prolonged backward swimming responses to depolarizing stimuli, but gave infrequent responses to some stimuli. At least four k-shy strains displayed temperature sensitivity. Neither ksA nor ksB was allelic or linked to dancer, a mutation causing weak Ca2+ current inactivation and prolonged backward swimming. Analysis of ks+; Dn double mutants revealed synergism between the two mutations. The ksA mutant survived Ba2+ solutions longer than wild type, but was more sensitive to K+. Together with previous studies, these results are consistent with a defect in reducing intracellular Ca2+ causing both prolonged ciliary reversal and reduced Ca2+ channel activity due to more active Ca2+-dependent feedback mechanisms. The integration of the Ca2+-dependent stimulatory and inhibitory functions is therefore dependent on ks+ gene functions. The ksA mutant was rescued by microinjection of wild-type cytoplasm, suggesting a possible behavioral assay for factors related to the ksA+ gene product. PMID- 2714638 TI - Patterns of variation in the rDNA cistron within and among world populations of a mosquito, Aedes albopictus (Skuse). AB - A restriction map was constructed of the ribosomal cistron in a mosquito, Aedes albopictus (Skuse). The 18s, 28s and nontranscribed spacer (NTS) regions were subcloned and used to probe for intraspecific variation. Seventeen populations were examined throughout the world range of the species. No variation was detected in the coding regions but extensive and continuous variation existed in the NTS. The NTS consisted of two nonhomologous regions. The first region contained multiple 190-bp AluI repeats nested within larger XhoI repeats of various sizes. There was a large number of length variants in the AluI repeat region of the NTS. No repeats were found in the second region and it gave rise to relatively fewer variants. An analysis of NTS diversity in individual mosquitoes indicated that most of the diversity arose at the population level. Discriminant analysis was performed on spacer types in individual mosquitoes and demonstrated that individuals within a population carried a unique set of spacers. In contrast with studies of the NTS in Drosophila populations, there seems to be little conservation of spacers in a population. The importance of molecular drive relative to drift and selection in the generation of local population differentiation is discussed. PMID- 2714639 TI - Detecting small amounts of gene flow from phylogenies of alleles. AB - The method of coalescents is used to find the probability that none of the ancestors of alleles sampled from a population are immigrants. If that is the case for samples from two or more populations, then there would be concordance between the phylogenies of those alleles and the geographic locations from which they are drawn. This type of concordance has been found in several studies of mitochondrial DNA from natural populations. It is shown that if the number of sequences sampled from each population is reasonably large (10 or more), then this type of concordance suggests that the average number of individuals migrating between populations is likely to be relatively small (Nm less than 1) but the possibility of occasional migrants cannot be excluded. The method is applied to the data of E. Bermingham and J. C. Avise on mtDNA from the bowfin, Amia calva. PMID- 2714640 TI - Organelle gene diversity under migration, mutation, and drift: equilibrium expectations, approach to equilibrium, effects of heteroplasmic cells, and comparison to nuclear genes. AB - We developed stochastic population genetic theory for mitochondrial and chloroplast genes, using an infinite alleles model appropriate for molecular genetic data. We considered the effects of mutation, random drift, and migration in a finite island model on selectively neutral alleles. Recurrence equations were obtained for the expectation of gene diversities within zygotes, within colonies, and between colonies. The variables are number and sizes of colonies, migration rates, sex ratios, degree of paternal transmission, number of germ line cell divisions, effective number of segregating organelle genomes, and mutation rate. Computer solutions of the recurrence equations were used to study the approach to equilibrium. Gene diversities equilibrate slowly, while GST, used to measure population subdivision, equilibrates rapidly. Approximate equilibrium equations for gene diversities and GST can be obtained by substituting Neo and me, simple functions of the numbers of breeding or migrating males and females and of the degree of paternal transmission, for the effective numbers of genes and migration rates in the corresponding equations for nuclear genes. The approximate equations are not valid when the diversity within individuals is large compared to that between individuals, as is often true for the D-loop of animal mtDNA. We used the exact equations to verify that organelle genes often show more subdivision than nuclear genes; however, we also identified the range of breeding and migrating sex ratios for which population subdivision is greater for nuclear genes. Finally, we show that gene diversities are higher for nuclei than for organelles over a larger range of sex ratios in a subdivided population than in a panmictic population. PMID- 2714641 TI - Effect of Y chromosome and H-2 complex derived from Japanese wild mouse on sperm morphology. AB - Segregation of sperm abnormality level and H-2 haplotypes was investigated in F2 hybrid males obtained from reciprocal crosses involving two B10.congenic strains carrying H-2 and the Y chromosome of Japanese wild mice: B10.MOL-OHM (H-2wm4, 23.1% of sperm abnormalities) and B10.MOL-OKB (H-2wm8, 11.1% of sperm abnormalities). In both types of crosses mean levels of abnormal spermatozoa were significantly higher for males typed as H-2wm4/H-2wm4 than for heterozygous H 2wm4/H-2wm8 or homozygous H-2wm8/H-2wm8. These results suggest that the gene for high sperm abnormality is linked to H-2 complex of the B10.MOL-OHM strain. PMID- 2714642 TI - The in vivo and in vitro transmission frequencies of the tw5-haplotype in mice. AB - The recessive tw5-haplotype, a complete haplotype, is transmitted by heterozygous male mice at very high frequencies (greater than 0.90) in normal matings. The present studies were undertaken to determine the effects of delayed matings and in vitro fertilizations on this phenotypic expression. Males carrying the tw5 haplotype (+/tw5) were first tested for their frequencies of transmission of the mutant 17th chromosome in both normal and delayed matings. Spermatozoa obtained from these same males were then used to fertilize eggs in vitro. The in vivo and in vitro transmission frequencies were found to be statistically equivalent in all types of inseminations. An in vitro fertilization time course study showed that the same percentages of eggs are fertilized by tw5-bearing spermatozoa when the gametes are coincubated for either 2 or 6 h. The data lead to the conclusion that the transmission frequency of the tw5-haplotype is not affected either by the length of time elapsing between insemination and fertilization or by the environment in which fertilization occurs. PMID- 2714643 TI - The transmission ratio distortion of the th2-haplotype in vivo and in vitro. AB - The th2-haplotype is transmitted at low frequencies (less than 0.30) by +/th2 males in normal matings. In the studies described here, the transmission frequency of the th2-haplotype from Rb7/th2 males was determined for normal and delayed matings and in vitro inseminations. The data show the transmission frequency from the two in vivo inseminations to be less than 0.30 and to be statistically equivalent. However, the in vitro transmission frequency (0.80) is significantly greater than either of the in vivo frequencies. The results show that the environment in which fertilization occurs affects the transmission frequency of this specific t-haplotype significantly. PMID- 2714644 TI - Genic differentiation and origin of Robertsonian populations of the house mouse (Mus musculus domesticus Rutty). AB - This paper examines the relation between chromosomal and nuclear-gene divergence in 28 wild populations of the house mouse semi-species, Mus musculus domesticus, in Western Europe and North Africa. Besides describing the karyotypes of 15 of these populations and comparing them to those of 13 populations for which such information was already known, it reports the results of an electrophoretic survey of proteins encoded by 34 nuclear loci in all 28 populations. Karyotypic variation in this taxon involves only centric (or Robertsonian) fusions which often differ in arm combination and number between chromosomal races. The electrophoretic analysis showed that the amount of genic variation within Robertsonian (Rb) populations was similar to that for all-acrocentric populations, i.e. bearing the standard karyotype. Moreover, divergence between the two types of populations was extremely low. These results imply that centric fusions in mice have not modified either the level or the nature of genic variability. The genetic similarity between Rb and all-acrocentric populations is not attributed to the persistence of gene flow, since multiple fusions cause marked reproductive isolation. Rather, we attribute this extreme similarity to the very recent origin of chromosomal races in Europe. Furthermore, genic diversity measures suggest that geographically separated Rb populations have in situ and independent origins. Thus, Rb translocations are probably not unique events, but originated repeatedly. Two models are presented to explain how the rapid fixation of a series of chromosomal rearrangements can occur in a population without lowering variability in the nuclear genes. The first model assumes that chromosomal mutation rates are between 10(-3) and 10(-4) and that populations underwent a series of transient bottlenecks in which the effective population size did not fall below 35. In the second model, genic variability is restored following severe bottlenecks, through gene flow and recombination. PMID- 2714645 TI - Correlation between genetic distances based on single loci and on skeletal morphology in inbred mice. AB - Genetic and morphometric distances between 12 inbred strains of mice ranging from closely related substrains to a sub-species were estimated using published data on single locus polymorphisms, and on the basis of up to 44 measurements on seven different bones, respectively. Simulation was also used to investigate sampling effects for the single loci. There were strong and statistically highly significant correlations among all measures of genetic distance ranging from 0.58 for the comparison of single loci with the logarithm of the Mahalanobis distance based on 24 measurements on four bones, to 0.72 for estimates of genetic distance based on single loci and the morphology of the mandible. These findings are in sharp contrast with those of Wayne & O'Brien (1986) who claimed that 'structural gene and morphometric variation of mandible traits are uncoupled between mouse strains'. Their failure to find such a correlation is probably because their sample of inbred strains included only a single pair of closely related substrains, and no substrains separated for less than 40 years, and because they failed to correct for non-linearity between morphometric and single-locus measurement scales. Simulations and regression analysis suggested that genetic distances could be estimated with approximately equal precision using morphological data on bone measurements or about 10 cladistically informative single loci, which would usually involve sampling about 50 loci. Data based on single-gene markers is usually more informative than morphometric data for studying the similarity of independently-derived strains. However, similarities among closely related populations such as sublines of an inbred strain can usually be studied more efficiently using morphometry. PMID- 2714646 TI - Evidence of a unique developmental mechanism specifying both wool follicle density and fibre size in sheep selected for single skin and fleece characters. AB - Skin and fleece traits have been characterized in four lines of Merino sheep selected for high- and low-fibre diameter (D +/-) and staple length (L +/-) from a medium-woolled flock. Over a period of 20 years, each line responded in the desired direction, producing fleeces composed of thick or thin fibres and long or short wool staples. However, variations in the amounts of wool grown that might be expected from these procedures were compensated by changes in unselected characters. Thus a predicted difference in fleece weights between high and low staple length lines was reduced by an increase in fibre crimp frequency in L- sheep. Similarly, changes induced in fibre diameter in the D lines resulted in small effects on fleece weight in comparison to the large (and inverse) effects on follicle numbers. Towards the end of the selection regime, mean follicle density in D- sheep was twice that of D+ sheep. This intriguing response within the follicle population was examined further: an analysis of the relationship between follicle density and fibre diameter amongst the four lines revealed a highly significant, negative linear correlation. The implication of this statistical association is that the numbers of follicles initiated in skin during foetal life had a direct bearing on the sizes of wool fibres eventually produced. It was concluded that both features must be under the control of a single developmental mechanism. Since the expression of each of the characters is separated in time, the mechanism must be activated during the earlier event, i.e. at or before the phase of follicle initiation. PMID- 2714647 TI - Effects of identity disequilibrium and linkage on quantitative variation in finite populations. AB - Identity disequilibrium, ID, is the difference between joint identity by descent and the product of the separate probabilities of identity by descent for two loci. The effects of ID on the additive by additive (a*a) epistatic variance and joint dominance component between populations and in the additive, dominance and a*a variance within populations, including the effects on covariances of relatives within populations, were studied for finite monoecious populations. The effects are formulated in terms of three additive partitions, eta b, eta a and eta d, of the total ID, each of which increases from zero to a maximum at some generation dependent upon linkage and population size and decreases thereafter. eta d is about four times the magnitude of the other two but none is of any consequence except for tight linkage and very small populations. For single generation bottleneck populations only eta d is not zero. With random mating of expanded populations eta b remains constant and eta a and eta d go to zero at a rate dependent upon linkage, very fast with free recombination. The contributions of joint dominance to the genetic components of variance within and between populations are entirely a function of the eta's while those of a*a variance to the components are functions mainly of the coancestry coefficient and only modified by the eta's. The contributions of both to the covariances of half-sibs, full-sibs and parent-offspring follow the pattern expected from their contributions to the genetic components of variance within populations except for minor terms which most likely are of little importance. PMID- 2714648 TI - Genetic dissection of Drosophila myofibril formation: effects of actin and myosin heavy chain null alleles. AB - We used null mutations of Drosophila actin and myosin genes to investigate two aspects of myofibril assembly. First, we eliminated all actin or myosin in flight muscles to evaluate contributions of thick and thin filaments to sarcomere formation. Results demonstrate that thick and thin filament arrays can assemble independently but that both are essential for sarcomeric order and periodicity. Second, we examined how filament stoichiometry affects myofibril assembly. We find that heterozygotes for actin (Act88F) or myosin heavy chain (Mhc36B) null alleles have complex myofibrillar defects, whereas Mhc36B-/+; Act88F-/+ double heterozygotes have nearly normal myofibrils. These results imply that most defects observed in single heterozygotes are due to filament imbalances, not deficits, and suggest that thick and thin filament interactions regulate myofibrillar growth and alignment. PMID- 2714649 TI - The promoter-proximal rDNA terminator augments initiation by preventing disruption of the stable transcription complex caused by polymerase read-in. AB - We have examined the mechanism by which transcriptional initiation at the mouse rDNA promoter is augmented by the RNA polymerase I terminator element that resides just upstream of it. Using templates in which terminator elements are instead positioned at the opposite side of the plasmid rather than proximal to the promoter, or conditions where transcription is terminated elsewhere in the plasmid by UV-induced lesions, we show that the terminator's stimulatory effect is not position dependent. Mouse terminator elements therefore do not stimulate via the previously postulated 'read-through enhancement' model in which terminated polymerases are handed off to an adjacent promoter in a concerted reaction. The position independence and orientation dependence of the terminator also makes it unlikely that the terminator functions as a promoter element or as an enhancer. Instead, terminators serve to augment initiation by preventing polymerases from reading completely around the plasmid and through the promoter from upstream, an event which we show interferes with subsequent rounds of initiation. Notably, this transcriptional interference arises because polymerase passage across a promoter disrupts the otherwise stable transcription complex, specifically releasing the bound transcription factor D. These liberated D molecules can then bind to other templates and activate their expression. The rDNA transcriptional interference is not due to a steric impediment to the binding of new polymerase molecules, and it does not similarly liberate the initiation-competent polymerase (factor C). These studies have also convincingly demonstrated that multiple rounds of transcription are obtained from rDNA template molecules in vitro. PMID- 2714650 TI - 3'-end formation of mouse pre-rRNA involves both transcription termination and a specific processing reaction. AB - We have studied the sequence requirements for 3'-end formation of rDNA transcripts in a cell-free system and show that the generation of correct ends of mouse pre-rRNA is brought about by a two-step process that involves a bona fide termination reaction, followed by a specific trimming of the primary transcript by 10 nucleotides. We show that termination of mouse ribosomal gene transcription by RNA polymerase I (pol I) takes place in front of an 18-bp DNA sequence element (the 'Sal box'), which was previously shown to function as termination signal. Termination of pol I transcription occurs at a fixed distance (11 bp) upstream of the Sal box, independent of the sequence of adjacent gene regions. The processing reaction, however, is strongly influenced by sequences flanking the termination signal at the 5' site. Substitution of a cluster of T residues by guanines within the region of 3'-end formation abolishes the 3'-terminal trimming of the primary transcript. Interestingly, this 3'-terminal processing event, which can be uncoupled from the termination reaction, requires both a correct 3' end and specific sequences in the 3'-terminal region of the primary transcript. Read through transcripts generated in the extract system or by SP6 RNA polymerase are no substrate for the processing nuclease(s). Because the termination and processing activity can be separated chromatographically, the nucleolytic activity does not reside in TTF-I, the factor that binds to the Sal box and directs transcription termination. PMID- 2714651 TI - Sequence analysis of cloned dengue virus type 2 genome (New Guinea-C strain). AB - Sequences totalling 5472 nucleotides (nt) from four complementary DNA (cDNA) clones of the dengue virus type 2 (DEN-2) RNA (New Guinea strain, NGS-C) have been reported previously [Yaegashi et al., Gene 46 (1986) 257-267; Putnak et al., Virology 163 (1988) 93-103]. This report describes the complete nucleotide sequence, with the exception of about 7 nt at the 5'-noncoding region, of this RNA genome derived from several cDNA clones. It is 10,723 nt in length and contains a single long open reading frame of 10,173 nt, encoding a polyprotein of 3391 amino acids. The genomic organization is similar to that of other flaviviruses that have recently been reported. Among the three DEN-2 strains - the Jamaica genotype (DEN-2JAM), the DEN-2NGS-C, and the S1 candidate vaccine strain derived from Puerto Rico (PR)-159 isolate (DEN-2S1) - which have been sequenced to date, the amino acid sequences of the polyproteins bear 94%-99% similarity. When the amino acid sequences of DEN-2NGS-C are compared with those of the other two strains, the variations are greater in the DEN-2S1 than in the DEN-2JAM. When DEN-2 and DEN-4 are compared, the overall amino acid identities range from 30% to 80% in both the structural and nonstructural proteins; whereas between DEN-2 and DEN-1, they range from 68% to 79% in the region encoding the structural proteins and the nonstructural protein NS1. PMID- 2714652 TI - Mutational analysis of an ssi region carried by plasmid pACYC184. AB - To investigate the functional contribution of some structural components of the signal that directs single-stranded initiation of DNA replication (ssi signal) carried by a 119-nt segment of plasmid pACYC184 (Bahk et al., 1988), we constructed mutants carrying one-base substitutions and insertions using oligodeoxyribonucleotide (oligo) directed mutagenesis. Two one-base substitution mutants were obtained. The mutants, M13 delta lac 184/Sp and M13 delta lac 184/Ev, carried an SplI site and an EcoRV site, respectively, created by base substitution. Three kinds of synthetic oligos, that is, a 10-bp EcoRI linker, an 8-bp ScaI linker and an 8-bp SmaI linker, were inserted into the SplI site of M13 delta lac 184/Sp, and into the EcoRV site of M13 delta lac 184/Ev. The SSI activity of each mutant examined indicated that the one-base substitutions had different effects on the SSI functions of the altered ssi signals. This fact suggests that some structural components within the 119-bp region make distinct contributions to the SSI function. Moreover, when the three kinds of synthetic linkers were inserted into the mutants M13 delta lac 184/Sp and M13 delta lac 184/Ev, each of the insertion mutations affected the rate of conversion of ss DNA to RFI in vivo and the growth of the recombinant phages in a distinct manner. Judging from the above results, the base composition and the length of a certain specific site were crucial for maintenance of the SSI functional activity, and structural components of the ssi signal contributed distinctly to the SSI function. PMID- 2714653 TI - Stability of the pBR322 plasmid as affected by the promoter region of the tetracycline-resistance gene. AB - A region affecting the pBR322 plasmid maintenance has been located within the region of the TcR gene promoter. On the basis of stability analysis of pBR322 derivatives comprising the modified region of the TcR gene, we deduced that it is the nucleotide sequence localized in the region of the HindIII site that causes destabilization of the plasmid and not the TcR gene product or active transcription of this region. The destabilizing effect is manifested both in cis and in trans. PMID- 2714654 TI - [Questionnaire survey in the study of working conditions of machine operators in the agriculture]. AB - A questionnaire survey was undertaken among machine operators in order to determine unfavourable occupational factors, fatigue degree, burden and intensity of labour, capacity for work and their health state. It was established that working conditions had certain influence on operators' organism. The relationship of their body effect on anthropometric data, age and length of service was demonstrated. PMID- 2714655 TI - [Hygienic standardization of the intensity of heat emission in passenger compartments]. PMID- 2714656 TI - [Hygienic electrooculographic evaluation of working conditions of school children using a computer]. AB - The technique for the electrooculographic analysis of the visual system of schoolchildren working with computers is described. The strain of the oculomotor system and fatigue manifestation have been detected in children under unfavourable environmental conditions. It is recommended to use the derived indicators of evaluating electrooculograms when hygienically assessing the working conditions of schoolchildren using computers. PMID- 2714657 TI - [Current studies of energy expenditure and the quantitative and qualitative adequacy of nutrition of female textile workers]. AB - The study was designed to analyze nutrition and daily energy losses of textile workers. Energy intake constituted in general 2600 kcal for female weavers and 2300 kcal for spinning workers. Weavers' nutrition is redundant in caloric content but deficient in polyunsaturated fat acids, Vitamins A, B, C and calcium salts. PMID- 2714658 TI - [Rearrangement of bioelectric activity of the brain during adaptation to chronic hypokinesia]. AB - The study shows that chronic hypokinesia (7-8 months) in rats, analogous to that in humans, causes constant reduction in activation level and results in the development of rearrangements in brain slow bioelectric activity. The rearrangements initiate decrease of the general level of brain activity and compensatory rise of its response to environmental signals. A likely mechanism of the rearrangements of the first type can be characterized by amplification of recurrent stopping processes and that of the second type by raising efficacy of the synaptic system functioning. PMID- 2714659 TI - [Tactics in using aerosols for disinfection of therapeutic and prophylactic institutions]. AB - Two Soviet sprayers (ABD-2600H and EOC-5) are recommended for the disinfection of the surfaces and indoor air in the curative and prophylactic facilities. A special impetus has been given to the use of chloramine aerosols that ensure higher efficacy of disinfection, reduce the aerosol consumption and the period of the presence of active chlorine in the air of the treated place. PMID- 2714660 TI - [Health education of workers in food supply network and public nutrition in a rural area]. PMID- 2714661 TI - [Methodological aspects of hygienic standardization of pesticide level in food products]. AB - On the basis of a significant amount of experimental studies of toxic effect of pesticides attributed to different groups of chemical substances a rapid calculating and experimental technique for hygienic standardization of pesticide content in foodstuffs has been set forth. The proposed technique enables one to define quickly and safely the threshold and inert pesticide doses and to reduce general duration of toxicologic experiments by 35%. PMID- 2714662 TI - [Health-promoting life style and various aspects of anti-alcoholism propaganda]. PMID- 2714663 TI - [A method of elementary statistical analysis of distribution series of the data of medico-hygienic studies]. PMID- 2714664 TI - [Experimental study of the atherogenic effect of copper after its intake with drinking water]. PMID- 2714665 TI - [Ecological and hygienic classification of pesticides]. PMID- 2714666 TI - [Concerning the article by V.G. Khodzhaev "Effect of water boiling on the level of nitrates"]. PMID- 2714667 TI - [Equation of the dose-time-effect relations in cases of a single intake of xenobiotics]. AB - Proceeding from chemical and biologic kinetic characteristics an equation for dose/time/effect dependence was derived for the considered case. Effect dependence on the dose (as a difference logarythm of maximum and instantaneous effects) was described by a line and on time by a curve exponentially striving for limit. A dose/effect equation was given for the period of 2 weeks, thus the constant speed of interaction of xenobiotics and receptors was identified in a critical organ. PMID- 2714668 TI - [Current status of water fluoridation in the household and drinking water supply systems of the Ukraine and the ways of its further improvement]. PMID- 2714669 TI - [Evaluation of the degree of irradiation of accelerator operators by using EC 1033 computer]. PMID- 2714670 TI - [Establishing the maximum permissible level of methylnitrophos in atmospheric air]. PMID- 2714671 TI - [Hygienic significance of microelements in drinking water with low mineral level]. PMID- 2714672 TI - [Normal indicators of the cardiovascular system in laboratory animals (rats)]. PMID- 2714673 TI - [Status of thermoregulatory mechanisms in adolescents trained as radio assemblers at an industrial-training combine]. PMID- 2714674 TI - [Effect of chemical substances on the resistance of experimental animals to influenza virus]. AB - An experimental evaluation of the impact of a number of chemical compounds toxicologically attributed to different hazardous classes on animal resistibility to influenza virus showed that resistibility dependence on the dose and effect duration had a nonlinear character. There was no complete correlation of a hazardous class of chemical substances and their impact on body resistibility to respiratory infections. PMID- 2714675 TI - [Local and skin-resorptive effects of monochloracetic acid chloranhydride]. PMID- 2714676 TI - [Effect of voluntarily controlled respiration on the functional status of the cardiovascular system in adolescents and young adults]. PMID- 2714677 TI - Vitamin C in the human stomach: relation to gastric pH, gastroduodenal disease, and possible sources. AB - Fasting gastric juice pH and concentrations of vitamin C in gastric aspirate and plasma were measured in 73 patients undergoing endoscopy. Vitamin C concentrations were significantly lower in those with hypochlorhydria (pH greater than 4; n = 23) compared with those with pH less than or equal to 4 (p less than 0.005) and there was a significant correlation between gastric juice and plasma concentrations (p = 0.002). Patients with normal endoscopic findings had significantly higher intragastric concentrations of vitamin C than those with gastric cancer (p less than 0.001), pernicious anaemia (p less than 0.005), gastric ulcer (p less than 0.01), duodenal ulcer (p less than 0.05), or after gastric surgery (p less than 0.01). There was a strong trend (0.05 less than p less than 0.1) towards lower intragastric concentrations of vitamin C in patients with chronic atrophic gastritis. In vitro, vitamin C concentrations remained stable in acidic but fell significantly over 24 hours in alkaline gastric aspirate. Gastric secretory studies in five volunteers showed that vitamin C concentrations increased significantly after intramuscular pentagastrin. These findings suggest that the low fasting levels of vitamin C in hypochlorhydric gastric juice may be caused by chemical instability and that vitamin C may be secreted by the human stomach. PMID- 2714678 TI - Manometric evaluation of the interdigestive antroduodenal motility in subjects with fasting bile reflux, with and without antral gastritis. AB - The interdigestive antroduodenal motor activity was studied in 15 patients with bile reflux without gastritis (group A), 17 with bile reflux and chronic antral superficial gastritis (group B) and in nine healthy controls (group C), by manometric recording of phases of the interdigestive motility complex (IDMC) over 240 minutes, or until two consecutive migrating motor complexes (MMCs) had been recorded, whichever the shorter. In the patients with bile reflux the occurrence of MMCs was decreased and median duration of the IDMC was significantly prolonged (group A = 162.5 min; group B = 185.0 min), compared with controls (group C = 92.0 min; p less than 0.01 v groups A and B). There were no differences in motility pattern between patients with and without gastritis, suggesting that motor abnormalities are not caused by gastritis, but may precede its occurrence. Delayed occurrence of motor activity fronts increases duodenogastric reflux, but correlation with gastric mucosal lesions was not shown, suggesting that other mechanisms are involved. PMID- 2714679 TI - Stress effects on gastrointestinal transit in the rat. AB - Previous investigations of stress effects on gastric emptying, orocaecal, and colonic transit in rats have produced conflicting results. Here one type of stressor, a 'passive avoidance' situation, was used to investigate its effects on gastric emptying, orocaecal and colonic transit. After the rats had been trained to eat a standard amount of semisolid food, gastric emptying was determined (n = 12) by the food remaining in the stomach after various periods of rest, or stress exposure. Orocaecal transit (n = 14) was determined by breath hydrogen measurements after the food had been labelled with 1 g lactose. Colonic transit (n = 18) was measured as the arrival time of coloured faeces after infusion of a carmine red solution into the caecum through a chronically implanted catheter. The stressor had differential effects on transit through the stomach, small bowel and colon: gastric emptying was delayed (p less than 0.05) after stress (t1/2 = 2.66 h after stress, 1.97 h at rest). Orocaecal transit was accelerated (p less than 0.05) after stress; transit time decreased from 124.3 min at rest to 86.2 min after stress. Colonic transit was accelerated (p less than 0.01) under stress, from 15.5 h to 1.29 h. It is concluded that gastrointestinal transit in different parts of the gastrointestinal tract is differently affected by central nervous stimuli. PMID- 2714680 TI - Jejunal manometry in distal subacute mechanical obstruction: significance of prolonged simultaneous contractions. AB - The aim of this study is to assess the value of jejunal manometry in the diagnosis of subacute mechanical obstruction distal to the proximal small bowel. In a retrospective review of 850 manometric tracings carried out in patients with unexplained nausea, vomiting, abdominal pain or altered bowel movements, 16 tracings were identified with features suggestive of mechanical obstruction: prolonged simultaneous contractions (PC) and postprandial clustered contractions (CC). Three patients had CC lasting less than 20 minutes: none proved to have mechanical obstruction. Among seven patients with CC lasting more than 30 minutes, three had proven mechanical obstruction, one probable adhesion obstruction, and in three no obstruction was found. All three patients with PC and three with mixed PC and CC had mechanical obstruction. The obstructed intestine manifests a variety of pressure profiles in the proximal jejunum: PC, CC, or mixed patterns. Prolonged simultaneous contractions are suggestive of distal subacute bowel obstruction; CC lasting over 30 minutes are less specific, whereas CC lasting less than 20 minutes are not associated with obstruction. PMID- 2714681 TI - Dendritic cells and scavenger macrophages in chronic inflammatory bowel disease. AB - We used enzyme (acid phosphatase [AP]) and immunohistochemical techniques and a set of monoclonal antibodies (CD11, CD5, CD4, CD19, CD8, OKIa), including two recently developed antibodies--for example, HECA-452 (specific for an adhesion molecule on high endothelial venules) and RFD1 (specific for 'active' human dendritic cells) to analyse the composition of the gut wall infiltrate of 10 well defined cases of chronic inflammatory bowel disease (CIBD) (six Crohn's disease (CD), four ulcerative colitis (UC]. Two polar forms in a spectrum of gut mononuclear phagocyte types (CD11+) were identified: at the one extreme scavenger macrophages with blunted projections (AP+, Heca-452-, RFD1-) and at the other extreme, dendritic cells with long dendritic cytoplasmic projections (AP-, Heca 452+, RFD1+). Dendritic cells were mainly found in highly organised lymphoid tissue present at the deeper layers in the gut wall (normal gut: underneath the muscularis mucosae and T-cell areas of lymph follicles [25-30 per follicle]; surrounding the broad zone of scavenger macrophages at the bottom of ulcers (CIBD) and fissures (CD) and in the lymphoid aggregates [25-30 dendritic cells per aggregate] adjacent to granulomas (CD]. These observations can be taken as evidence that exaggerated antigen handling and presentation and stimulation of the immune response takes place at these foci. The observation that scavenger macrophages were localised more superficial, as band like zones (normal gut: subepithelial; mainly surrounding ulcers (CIBD) and fissures (CD] can be taken as evidence that at these spots the ingestion and degradation of foreign material takes place. PMID- 2714682 TI - Rectal reservoir and sensory function studied by graded isobaric distension in normal man. AB - The rectal expansion and concomitant sensory function on graded, isobaric, rectal distension within the interval 5-60 cm H2O was investigated in 36 healthy young volunteers. Anal pressure and electromyography (EMG) from the external anal sphincter were simultaneously recorded. Rectal distension caused an initial rapid expansion followed by transient, often repeated, reflex rectal contractions and a slow gradual increase of rectal volume. The maximal volume displaced by the first reflex rectal contraction was 18 (13) ml, which was less than 10% of the volume at 60 s. The pressure threshold for appreciation of rectal filling was 12 cm H2O (95% CL 5-15 cm H2O) and coincided with the threshold for rectoanal inhibition. Urge to defecate was experienced at 28 cm H2O (15-50 cm H2O) distension pressure, which was close to the threshold for maximal rectal contraction, also coinciding with the appearance of the external anal sphincter reflex. The interindividual variation of rectal volume on distension with defined pressures varied widely, indicating a considerable variation of rectal compliance in normal man. No correlation was found between rectal volume and sex or anthropometric variables. The relative variations in pressure thresholds for eliciting rectal sensation and rectoanal reflexes were less than the corresponding threshold volumes. It was concluded that the dynamic rectal response to distension reflects a well graded reflex adjustment ideal for a reservoir. PMID- 2714683 TI - Prevention of postischaemic lipid peroxidation and liver cell injury by iron chelation. AB - Liver ischaemia was induced by cross clamping the hilar pedicle for 30 minutes in groups of rats with or without treatment with the iron chelating agent desferrioxamine (deferoxamine, DFR). The groups included eight animals each and were divided into the following treatment categories: control; ischaemia alone; ischaemia with subsequent reperfusion; ischaemia preceded by DFR, 60 mg/kg body weight; and reperfusion preceded by 20, 40, or 60 mg/kg DFR. The drug was given intravenously five minutes before either ischaemia or reperfusion. Malondialdehyde (MDA), a product of lipid peroxidation, and histopathological changes of liver tissue samples were used as indicators of hepatocellular injury. Lipid peroxidation (MDA concentration in mumol/kg liver tissue) was highest (4.76 (1.19] after ischaemia without reperfusion and less pronounced (2.87 (0.34] after reperfusion. Both concentrations, however, were significantly (p less than 0.05) higher than basal (control) values (1.78 (0.27]. At 60 mg/kg body weight, DFR treatment reduced MDA to basal or even lower concentrations in both situations (1.98 (0.08) and 1.26 (0.06), respectively) with a corresponding improvement in liver histopathology. Lower DFR doses were less protective. The data suggest that liver ischaemia is associated with free radical initiated, and apparently iron catalysed lipid peroxidation, which can be significantly decreased by iron chelation. PMID- 2714684 TI - Immune mechanisms in tienilic acid associated hepatotoxicity. AB - In order to investigate the mechanisms underlying the hepatotoxicity associated with tienilic acid (Ticrynafen) ingestion we have looked for evidence of sensitisation to drug altered liver cell determinants using an indirect antibody dependent, cell mediated cytotoxicity assay (ADCC). As targets, hepatocytes were isolated from rabbits pretreated with either tienilic acid or its isomer with or without previous enzyme induction with either phenobarbitone or B-naphthoflavone (BNF). Sera from 16 of 36 patients with presumed tienilic acid hepatotoxicity induced significant cytotoxicity to hepatocytes isolated from rabbits pretreated with BNF and subsequently tienilic acid. Three of 10 sera from patients receiving tienilic acid but without overt liver damage also induced significant cytotoxicity to these hepatocytes, however, although none of 20 normal controls or of 16 patients with other liver diseases did so. Non-organ specific autoantibodies, classified as anti-LKM2, were also detectable. These were present in association with tienilic acid associated antibodies: of the 36 patients with presumed tienilic acid hepatotoxicity, 38% had both antibodies, 18% had only anti LKM2 antibodies and 9% only tienilic acid associated antibodies. These results suggest that this drug reaction is associated with sensitisation to drug altered liver cell antigens and autoantigens. If ticrynafen associated hepatotoxicity is immune mediated, then one possible mechanism is that the drug induced antigens break tolerance, leading to an immune attack on normal liver cell components. PMID- 2714685 TI - Hepatobiliary complications in chronic pancreatitis. AB - Thirty nine patients undergoing surgery for chronic pancreatitis were investigated for evidence of hepatobiliary disease. In addition to pre-operative assessment by liver function tests, ultrasound, ERCP (in 33) and percutaneous transhepatic cholangiography (in five), all had peroperative liver biopsy. Common bile duct stenosis was diagnosed in 16 (62%) of the 26 patients with successful cholangiography. Features of extrahepatic biliary obstruction were found on biopsy in 11 patients, three of whom showed features of secondary sclerosing cholangitis. No patients had secondary biliary cirrhosis. Three had parenchymal liver disease (cirrhosis, resolving hepatitis and alcoholic hepatitis respectively) and two others had features suggestive of previous alcohol-induced injury. Five (83%) of the patients with clinical jaundice had biopsy features of extrahepatic biliary obstruction, as did eight (67%) with alkaline phosphatase above twice normal and seven (44%) with radiological common bile duct stenosis. Neither alkaline phosphatase rise, nor common bile duct stenosis alone or in combination, were a reliable indication of the need for biliary enteric bypass surgery. Pre-operative liver biopsy may be a valuable adjunct in the assessment of such patients. PMID- 2714686 TI - Additional endoscopic procedures instead of urgent surgery for retained common bile duct stones. AB - One hundred and twenty seven patients were treated by nasobiliary drainage, or stenting, to prevent biliary obstruction after endoscopic failure to clear stones from the common bile duct. At presentation, 91 (72%) patients were jaundiced and 39 (31%) had cholangitis. Placement of either a nasobiliary drain or stent was successful in 124 (98%) patients. One hundred and twenty one (95%) patients were followed up. Clearance was ultimately achieved endoscopically in 52 and surgically in 25 patients after (mean) 2.4 months. Thirty day mortality was 3%. There were no complications of nasobiliary drainage, but two of 39 patients treated by temporary stents developed cholangitis, both successfully managed by endoscopic duct clearance. Forty two patients unfit for surgery or further endoscopic attempts at duct clearance were followed with stents in situ for a mean 15.9 months (range 2.5-37.5). Cholangitis developed in four patients and was successfully managed by stent change. These results indicate that longterm stenting can be useful for poor risk surgical patients and that nasobiliary drainage or temporary stenting permits further elective rather than urgent endoscopic or surgical treatment. PMID- 2714687 TI - Primary atypical mycobacteriosis of the intestine: a report of three cases. AB - Primary atypical mycobacteriosis of the lung is comparatively common but primary atypical mycobacteriosis of the intestine had not been described previously in the English literature. We have treated three such patients with antituberculous drugs and the clinicopathological findings and course are described. We suggest that these findings may belong to a new clinical entity. PMID- 2714688 TI - Staffing of a combined general medical service and gastroenterology unit in a district general hospital. A report prepared for the Royal College of Physicians (London). Gastroenterology Committee and the Clinical Services Committee of the British Society of Gastroenterology. PMID- 2714689 TI - Career prospects in medical gastroenterology in the United Kingdom. PMID- 2714690 TI - Family occurrence of achalasia. PMID- 2714691 TI - [Brain tumors in infants]. AB - In 76 of 575 children operated on for intracranial tumors during a 15 year period, symptoms had started during the first 2 years of life. Excision of the tumor was complete in 44, subtotal in 13, partial in 13, and in 6 only a biopsy was taken. Surgical mortality was 13% (10/76). 31 died later as their tumors progressed. The overall survival rate was 46% and 27 of the survivors are leading useful lives, with no signs of recurrence, 8 months to 14 years after operation. All of these had total or subtotal removal of the tumor. Only 3 required oncologic treatment. Despite radical surgery, the late neuropsychological results were good. However, 8 children who had had brain irradiation are severely handicapped. We conclude that in infancy functional recovery from a focal surgical lesion, even if extensive, is more complete than after diffuse damage to the immature central nervous system caused by irradiation. In this age group brain irradiation leads to severe handicapping in the great majority of cases. Radiotherapy should therefore be used only for highly malignant tumors, especially when surgical excision is incomplete. Radical surgery gives the best results in terms of survival and satisfactory neuropsychological state. PMID- 2714692 TI - [Can treatment be stopped when mild hypertension is controlled?]. AB - Antihypertensive medication was stopped in 20 patients with mild hypertension who had no signs of left ventricular hypertrophy and in whom fundoscopy was normal. At the end of 12 and 24 months, 60% and 34%, respectively, had remained normotensive. In 2 patients therapy had to be reinstituted after 1 year, and in 1 after 2 years. 8 had decided by themselves to restart treatment even though their blood pressures were in the normal range. 3 were uncooperative and dropped out of the study. These results show that a large proportion of mild hypertensives remain normotensive long after withdrawal of drug therapy. Since in our experience temporary withdrawal is beneficial, we suggest that therapy be stopped when mild hypertension has been controlled for at least 2 years. However, there must be careful followup and therapy should be reinstituted at once if hypertension recurs. PMID- 2714693 TI - [Thyroglossal duct cyst]. AB - Thyroglossal duct cysts are embryologic anomalies arising from epithelial remnants of the duct left after the descent of the developing thyroid. Clinical, operative and pathological findings in 124 patients operated on in the past 14 years were analyzed. There were 60 males and 64 females. 69 (56%) were under 10 years of age and the youngest was 6 months old. 26 (21%) were over the age of 30, and the oldest was 72 years old. All excisions were performed in accordance with the Sistrunk procedure, which includes removal of the body of the hyoid bone. Overall recurrence was 6.4%, but in infected cysts or cysts with a fistula to the skin, it was 3.5 times greater. In 20% the cyst was located off the midline. The lining of the cysts was cuboidal, columnar, pseudostratified or stratified squamous epithelium, and varied according to the location of the cyst. There were no malignant changes. PMID- 2714694 TI - [Recurrent unilateral pulmonary edema due to left heart failure]. AB - Unilateral pulmonary edema is uncommon and is usually associated with prolonged surgical procedures or rapid evacuation of a hydro- or pneumothorax. Unilateral pulmonary edema due to left heart failure in the absence of known lung disease is rare. It is therefore not readily recognized and is often confused with other unilateral alveolar or interstitial infiltrates. We describe 2 patients, a 69 year-old man and a 78-year-old woman, who had repeated episodes of unilateral pulmonary edema due to left heart failure. In both cases several other diagnoses were considered, but the cardiac origin of the infiltrates was supported by the rapid clearing of the lung after diuretic therapy. Awareness of this unusual clinical condition is important for the early institution of proper therapy. PMID- 2714695 TI - [Renal colic and renal calculus]. AB - A positive diagnosis of urinary stone was made in 183 of 407 patients (44.9%) with renal colic seen in the emergency room. 182 (44.7%) had normal intravenous pyelograms, 26 (6.4%) had evidence of dilatation of the urinary system, possibly due to the passage of a stone, and 16 (3.9%) had other pathological urinary conditions, such as double collecting system or cysts. Stones were located in the upper urinary tract in 28.4%, in the midureter in 21.9%, and in the lower ureter in 49.7%. There was a statistically significant correlation between recurrent episodes of left-sided renal colic, erythrocytes in the urine and the presence of a stone in the urinary tract. No ethnic differences were found, nor was there a difference in the rates of stones found in those who were hospitalized and in those who were not. PMID- 2714696 TI - [Nontropical pyomyositis]. AB - Pyomyositis of the pectoralis major was diagnosed in a 79-year-old man and Staphylococcus aureus was grown from pus drained from the infected muscle. Bacteremia and overwhelming sepsis accompanied the infection, and the patient died despite early diagnosis, combined chemotherapy and surgical drainage. The incidence of pyomyositis has been increasing lately in temperate climates. To our knowledge, this is the first report of nontropical pyomyositis in Israel. PMID- 2714698 TI - [Therapeutic approach to chemical drug addiction]. PMID- 2714699 TI - [High-density lipoprotein cholesterol--an epidemiologic reappraisal]. PMID- 2714697 TI - [Pneumovax vaccination in children]. PMID- 2714700 TI - [Somatostatin analogue (SMS 201-995)]. PMID- 2714701 TI - [Malignant melanoma of the face]. PMID- 2714702 TI - Health care needs of Hispanic Americans and the responsiveness of the health care system. AB - The Hispanic population in the United States is growing rapidly but this population has many health care needs that are not being met. The findings from recent research on the current health status of Hispanic people who live in the United States are presented. An assessment of how accessible and available medical care services are to Hispanic people is made. Serious gaps exist in the delivery of medical care services to this group. Human service providers, particularly social workers, can help make the current health care system more responsive to the needs of this group by helping Hispanic individuals who have no health insurance coverage to find employment that includes health insurance benefits or some other form of insurance, by establishing community-based health care centers in Hispanic communities, by developing counseling programs tailored to the alcohol and drug abuse problems of the Hispanic population, and by advocating for government agencies to improve existing sources of data on the health of this group. PMID- 2714703 TI - Social work and organ transplantation. AB - The nonsurgical aspects of organ transplantation are complex and beyond the expertise of professionals of any one discipline. This article addresses some of the issues involved in the organ donation, procurement, and transplantation process and suggests roles that social workers can play at the societal, institutional, and case levels in this new area of health care. Social workers can advocate against the commercialization of organ transplantation; help educate the public regarding organ donation; foster approaches to donor allocation that are free of social worth considerations; provide support to the families of organ donors before, during, and after the decision; and assist families to accept completely the death of their loved one. Through such services, social workers can free medical staff to focus on medical areas of organ transplantation and ensure that organ donation remains a humane and humanized gesture. PMID- 2714704 TI - Failure to thrive: knowledge for social workers. AB - Growth failure in young children no longer is classified simply as organic or nonorganic failure to thrive. The symptom of failure to thrive encompasses a variety of complex disorders, and each requires a specific treatment approach. Various forms of nonorganic growth failure and the social work role in intervention are reviewed. The diagnosis and treatment of attachment disorder, a potentially dangerous form of nonorganic failure to thrive that is considered child neglect, are discussed in detail. PMID- 2714705 TI - Previously infertile couples and the newborn intensive care unit. AB - Having a newborn child admitted to a newborn intensive care unit can be a traumatic experience for parents; however, parents who previously have been infertile face unique problems in coping with this situation. The authors discuss the difficulties parents must overcome in resolving their crises and in developing a good relationship with their child, or, in some cases, coming to terms with the child's death or ongoing disability. In addition, the authors offer suggestions for effective social work intervention. PMID- 2714706 TI - Establishing interfaces between community- and hospital-based service systems for the elderly. AB - The gerontological service delivery system often fails to integrate the different types of services needed at different times by older clients. Social workers need to address the urgent and increasing need for communication among acute care hospitals that are diversifying into areas previously the domain of community based providers of services for the aged. Coordinated care case management programs were developed in seven hospitals to determine whether hospitals could serve as a logical entry point of frail elderly persons into the system. Examination of the experiences of these hospitals illustrated the need for models of service integration and resulted in several approaches to comprehensive service delivery and coordination. Social work professionals in both acute and long-term care settings need to understand all aspects of the service delivery system to ensure that elderly clients receive appropriate levels and continuity of care in a complex and constantly changing system. PMID- 2714707 TI - Community-based mental health program. Outreach and rehabilitation center for homeless veterans. PMID- 2714708 TI - Classification and diagnosis in social work in health care. PMID- 2714709 TI - Prevention message for social workers. PMID- 2714710 TI - DSM-III-R: the conflict over new psychiatric diagnoses. AB - The inclusion of three new diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) has generated much controversy. Many women's groups and mental health organizations objected to paraphilac rapism, premenstrual dysphoric disorder, and masochistic personality disorder. Findings from a national survey of social workers' attitudes about DSM indicated that the majority of respondents did not support adoption of the proposed diagnoses, although many were undecided. The conflict has reopened the debate about the manual among mental health professionals. The opinions of social work practitioners potentially can influence whether these and other controversial diagnoses are included in the upcoming DSM-IV. PMID- 2714711 TI - [Proceedings of the 79th regional meeting (Kanto area) of the Japanese Pharmacological Society. October 15, 1988, Sagamihara, Japan. Abstracts]. PMID- 2714713 TI - [Proceedings of the 41st regional meeting (Seinan area) of the Japanese Pharmacological Society. November 6, 1988, Kumamoto, Japan. Abstracts]. PMID- 2714712 TI - [Abstracts of the 12th symposium of the National Committee for Pharmacology]. PMID- 2714714 TI - Metabolism of N-nitroso-1,3-thiazolidine in the rat. AB - [2-14C]N-nitroso-1,3-thiazolidine (125 mg/kg body weight) administered by gavage to rats was excreted mostly (81% of the dose) in the urine with a smaller amount (7%) in respired air. The major metabolite in the urine (77.2%) was 2-hydroxy-1,3 thiazolidine and minor quantities of the isomers 4- and 5-hydroxy-1,3 thiazolidine were also detected. The presence of hydroxy-1,3-thiazolidine, determined using mass spectrometry and high-performance liquid chromatography, indicated that alpha-hydroxylation and denitrosation are major metabolic pathways of N-nitroso-1,3-thiazolidine. Analysis of the non-acidic urine extract with gas chromatography-mass spectrometry (GC-MS) using untreated on-column injection and heated split injection gave differing results. Compounds detected using the latter technique may have been artefacts formed by pyrolysis in the heated injection port. Analysis of the metabolites by direct probe mass spectrometry (unheated) and Fourier transform infra-red spectroscopy supported the results seen with on-column GC-MS. PMID- 2714715 TI - Nitrite-cured meats as a source of endogenously and exogenously formed N nitrosoproline in the ferret. AB - Nitrite-cured meat containing 120 mg Na15NO2/kg was fed to male ferrets (Mustela putorius furo). During consumption of the meat, the animals were dosed orally with 0.87 mmol [2-2H]proline. All urine was collected throughout the study and analysed for total N-nitrosoproline (NPRO) and isotopic enrichment of NPRO by mass spectrometry. The cured-meat diet increased the urinary excretion of NPRO 14 fold. Isotope analyses indicated that approximately 70% of the NPRO came from the cured meat, the majority of which was analytically unavailable or 'bound' NPRO in the meat. A small portion of the excreted NPRO appeared to be formed in the stomach as a result of ingesting the cured meat. A minor amount of the excreted NPRO did not contain any isotopically labelled atoms. The administration of ascorbic acid did not significantly alter NPRO excretion. Animals dosed orally with 11.4 mumol of a peptide in which the N-terminal proline was nitrosated increased their excretion of NPRO by 385 nmol over the following 48 hr. These data indicate that nitrite-cured meat contains bound NPRO which contributes to the total amount of NPRO in the urine. PMID- 2714716 TI - Glutathione and cysteine enhance and diethylmaleate reduces thiabendazole teratogenicity in mice. AB - The effects of cysteine (CYS), glutathione (GSH) and diethylmaleate (DM) on the teratogenicity of thiabendazole (TBZ) were investigated. On day 9 of gestation mice were given ip a dose of 0, 50 or 100 mg CYS/kg body weight, or 0, 400 or 800 mg GSH/kg, or 0, 0.05, 0.10, 0.15 or 0.60 DM/kg. One hr later they were dosed orally with 0, 250, 500 or 1000 mg TBZ/kg. All foetuses were removed from the uterus on day 18 of gestation, and were examined for external and skeletal anomalies. The number of malformed foetuses was increased in mice pretreated with CYS or GSH and was decreased in those pretreated with DM, in comparison with numbers in the corresponding group treated with TBZ alone GSH pretreatment enlarged the area under the curve (AUC) of TBZ and 5-hydroxyTBZ, a representative metabolite, in foetal tissue. DM pretreatment reduced the AUC of TBZ and 5 hydroxyTBZ. PMID- 2714717 TI - Inhibition of spontaneous growth and induced differentiation of murine erythroleukaemia cells by paraquat and atrazine. AB - The effect of the herbicides paraquat and atrazine on erythroid differentiation has been studied in mouse erythroleukaemic cells. The addition of atrazine or paraquat was shown to inhibit both spontaneous growth and hexamethylene-bis acetamide (HMBA)-induced differentiation of undifferentiated erythroleukaemic cells. This effects was dose-dependent and occurred at concentrations of less than 10 ppm for both herbicides. Growth inhibition with atrazine (40-45%) was less pronounced than with paraquat (85-90%). Inhibition of differentiation paralleled growth inhibition. A synergistic effect was observed with HMBA, which per se reduced the growth rate of mouse erythroleukaemic cells, and either herbicide. Evaluation of cell viability under all the experimental conditions using either a trypan blue dye exclusion test or labelled chromium indicated that the effects observed were not related to a cytocidal action of atrazine or paraquat. PMID- 2714718 TI - Toxicity and carcinogenicity of nitrofurazone in F344/N rats and B6C3F1 mice. AB - Toxicology and carcinogenesis studies were conducted by feeding diets containing nitrofurazone (99% pure) to groups of F344/N rats and B6C3F1 mice for 14 days, 13 wk or 2 yr. In the 14-day studies, in which doses ranged from 630 to 10,000 ppm, nitrofurazone was more toxic to mice than to rats. Accordingly, in the 13-wk studies, doses for rats ranged from 150 to 2500 ppm and for mice from 70 to 1250 ppm. At the higher doses, convulsive seizures and gonadal hypoplasia were observed in both species. Evidence of toxicity in rats also included degenerative arthropathy. For the 2-yr studies, rats were exposed to 0, 310 or 620 ppm nitrofurazone and the survival of male rats given 620 ppm was lower than that of controls (33/50, 30/50 and 20/50 in the control, 310- and 620-ppm groups, respectively). Nitrofurazone administration increased the incidences of mammary gland fibroadenomas in female rats (8/49, 36/50 and 36/50 in the control, 310- and 620-ppm groups, respectively). In male rats it was associated with a marginal increase in sebaceous gland adenomas and trichoepitheliomas of the skin, mesotheliomas of the tunica vaginalis, and tumours of the perputial gland. Nitrofurazone caused testicular degeneration (atrophy of germinal epithelium and aspermatogenesis) in rats, and degeneration of vertebral and knee articular cartilage in rats of both sexes. In mice, dietary concentrations of nitrofurazone for the 2-yr studies were 0, 150 or 310 ppm. In mice of each sex, nitrofurazone administration induced stimulus-sensitive convulsive seizures, primarily during the first year of study. In male mice, there was no evidence of any chemically related carcinogenic effects, but there was a treatment-related decrease in survival (39/50, 31/50 and 27/50 in the control, 150- and 310-ppm groups, respectively). In female mice nitrofurazone induced ovarian lesions with increased incidences of benign mixed tumours (0/47, 17/50 and 20/50 in control, low- and high-dose groups, respectively) and granulosa cell tumours (1/47, 4/50 and 9/50 in control, low- and high-dose groups, respectively). PMID- 2714719 TI - Two-year drinking-water study of formaldehyde in rats. AB - Formaldehyde was administered in the drinking-water to groups of 70 male and 70 female Wistar rats for up to 24 months. Survivors of subgroups of ten rats/sex/group each were killed after 12 or 18 months. The mean formaldehyde doses administered were 0, 1.2, 15 or 82 mg/kg body weight/day for males, and 0, 1.8, 21 or 109 mg/kg/day for females. There were no adverse effects on general health, survival or haematological or clinical chemistry parameters. Body weight and food intake were decreased in the high-dose group. Liquid intake was decreased by 40% in the high-dose group in both sexes in comparison with the controls. There was a slight temporary increase in the density of urine, whereas there was a tendency towards lower urine production in the high-dose group. The relative kidney weights were increased in the high-dose females. Gross examination at autopsy revealed a raised and thickened limiting ridge of the forestomach in most high-dose rats. In addition, several rats in the high-dose group showed irregular mucosal thickenings in the fore- and/or glandular stomach. Treatment-related histopathological gastric changes seen in most of the animals of the high-dose group included papillary epithelial hyperplasia frequently accompanied by hyperkeratosis and focal ulceration in the forestomach and focal chronic atrophic gastritis, occasionally accompanied by ulceration and/or glandular hyperplasia, in the glandular stomach. A higher incidence and/or degree of renal papillary necrosis occurred in the high-dose rats. From this study it appeared that the 'no-observed-adverse-effect level' of formaldehyde was 15 and 21 mg/kg body weight/day for male and female rats, respectively. Oral administration of formaldehyde at doses of 82 and 109 mg/kg/day to male and female rats, respectively, caused severe damage to the gastric mucosa but did not result in gastric tumours or tumours at other sites. The study did not provide any evidence of carcinogenicity of formaldehyde after oral administration. PMID- 2714720 TI - Hepatotoxicity and renal toxicity in rats of corn samples associated with field cases of equine leukoencephalomalacia. AB - Currently there is no convenient bioassay to determine the potential toxicity of corn naturally contaminated with Fusarium moniliforme. A short-term bioassay would be useful for future investigations aimed at isolating as yet unidentified toxins produced by this fungus. Two groups of five male Sprague-Dawley rats were each fed one of two F. moniliforme contaminated corn samples, designated CS-1 and CS-2, that were associated with separate field cases of equine leukoencephalomalacia (ELEM). A control group, also consisting of five male rats, was fed uncontaminated seed corn. All animals survived to the end of the study and there were no apparent differences in appearance or behaviour among groups. Weight loss and irregular food consumption occurred in all groups and probably resulted from nutritional deficiencies inherent in the corn diets. Hepatocellular degeneration, necrosis and hyperplasia as well as biliary hyperplasia were found in the test groups only and were attributed to F. moniliforme. Serum transaminase and alkaline phosphatase activities in animals fed CS-1 and CS-2 for 4 wk were significantly increased compared with the controls, while serum bilirubin concentration was increased only in the CS-1 group. Tubular nephrosis was also present in the renal cortex of all animals fed CS-1 and CS-2. These effects may have been related to fumonisins B1 and B2, recently discovered metabolites of F. moniliforme, that were found in both CS-1 and CS-2. Short-term studies of this type may be useful in screening naturally-contaminated grains and other materials for hepatotoxic metabolites produced by F. moniliforme. PMID- 2714721 TI - Relation between dopaminergic control of pituitary lactotroph function and deceleration of age-related changes in serum prolactin of diet-restricted rats. AB - Pituitary lactotroph function has been examined in diet-restricted (6 hr/day) male and female rats and compared with that in animals fed ad lib. After 12 months the age-related increase in serum prolactin concentration was significantly attenuated in diet-restricted female rats. Similar effects were not observed in male rats. Isolated superfused anterior pituitary glands removed from rats on both feeding regimens at 12 or 18 months and challenged with dopamine in vitro (5 microM) did not show differential prolactin secretion. No significant differences were observed in serum prolactin secretion in vivo after administration of bromocriptine (3 mg/kg body weight, sc) or haloperidol (1.75 mg/kg body weight, ip). These results do not support an altered dopamine receptor function in the anterior pituitary lactotrophs. In contrast, central dopamine receptor function in rats 12 months of age was altered by dietary restriction, since the frequency of cataleptic responses to haloperidol injection (2 mg/kg body weight, ip) was significantly depressed in the test animals. PMID- 2714722 TI - [AIDS infection status of mothers. The blood of newborn infants as an indicator]. PMID- 2714723 TI - [More atherosclerosis prevention is necessary]. PMID- 2714724 TI - [The "upside-down stomach"--a diagnostic pitfall]. AB - Upside down stomach is an extreme variant of a paraesophageal hernia. The cardia and pylorus are located next to each other, while the rest of the stomach lies within the thorax. Radiology is mandatory for accurate anatomical documentation, while endoscopy is necessary to identify pathology, primarily bleeding sources. This is a rare condition found during endoscopy, with an incidence of 1.5%. Since there is a risk of volvulus, surgical correction is usually indicated. PMID- 2714725 TI - [Should chronic gastritis be redefined?]. PMID- 2714726 TI - [Suffering from stress or enjoying stress? Method and results of a clinically successful anti-stress triple strategy exemplified by asthma]. PMID- 2714727 TI - Algebraic potential of the Hill equation as an alternative tool for plotting dose (or time)/effects relationships in toxicology: a theoretical study. AB - Use of the Hill equation in plotting the results of toxicological experiments offers the following advantages: 1. In dose/effect relationships, the maximum response RM can be accurately determined by means of a described new noniterative algebraic method, from both hyperbolic and sigmoidal responses expressed in natural (nontransformed) units. The Hill coefficient (n) and the dose giving 50% (f50) or X% (fX) of RM, as well as their SD, are accurately deduced. 2. In time course experiments with sigmoidal shape, an additional set of parameters, readily available from the former basic 3, makes it possible to avoid arbitrary choices, such as the time at which a percentage or mortality is considered. The slopes of the tangents at the inflexion point (maximum rate of response) and at half maximum effect, then the coordinates of these points and the horizontal intercept of the tangent at inflexion point (as an index of initial lag-phase) will give increasing and decreasing functions of doses, respectively, depending on RM, f50, and (n). 3. The processes described first allow the classical parameters LD50 (or LDX) and LT50 (or LTX: X%--lethality time) to be calculated with high algebraic accuracy, in addition to RM and (n), both of which are of great interest in the general case of ligand-receptor interactions. Thus, the deduced set of additional indexes, not readily available from classical "Probits-type" transformations, eliminates the mortgage of subjective operations. PMID- 2714728 TI - Effect of renal failure on the pharmacokinetics of ethyl loflazepate (Victan) in man. AB - The kinetics of ethyl loflazepate were studied in patients with various degrees of renal failure. A strong correlation was noted between urinary excretion of metabolite loflazepate and creatinine clearance. In contrast, elimination half life and total plasma clearance of the sum of loflazepate + descarboxyloflazepate seemed to be independent of the degree of renal impairment. These results indicate the absence of a risk of accumulation of the 2 main and active metabolites of ethyl loflazepate in patients with renal failure. PMID- 2714729 TI - Single-dose pharmacokinetics of amineptine and of its main metabolite in healthy young adults. AB - The pharmacokinetics of the tricyclic antidepressant amineptine (Survector) and its main metabolite were studied in 12 young healthy adults (6 men, 6 women; mean age 35.8 yr). Plasma samples were taken over 24 h following a single oral dose of 100 mg amineptine chloryhdrate. Plasma levels of both compounds were determined by means of high performance liquid chromatography. Amineptine was rapidly absorbed. Mean peak plasma concentrations of amineptine and its metabolite occurred 1 h and 1.5 h, respectively, after product administration. The mean apparent volume of distribution was large: 2.4 l.kg-1. Elimination was rapid; the mean half-lives of the 2 compounds were short: 0.8 h for amineptine and 2.5 h for the metabolite. The mean apparent plasma clearance of amineptine was high (124.8 l.h-1). When the results were adjusted for body weight and surface area, no significant difference in pharmacokinetic parameters was found between men and women. Given its pharmacokinetic characteristics there is no risk of amineptine accumulation and thus it is a particularly easy drug to manage. A standard dosage of amineptine was defined for use in healthy young adults. PMID- 2714730 TI - Pharmacokinetics of dextromoramide in surgical patients. AB - The pharmacokinetics of the narcotic analgesic dextromoramide was investigated by means of a specific GC-MS method in 9 patients who were given a single oral dose of the drug (7.5 mg) together with an anticholinergic before undergoing minor orthopedic surgery. Dextromoramide was rapidly absorbed from the gastrointestinal tract, with peak plasma levels between 68 and 177 micrograms/L usually achieved within 0.5-4.0 h after dosing. In 5 patients, the decline of plasma concentrations after the peak followed a biphasic pattern, with half-lives of 0.4 1.6 h for the first phase and 6.3-21.8 h for the terminal phase. In the remaining patients, no clear-cut biphasic pattern was seen and half-lives calculated over the period between 4 h and 10 h after administration ranged from 1.5 to 4.7 h. Apparent clearance and volume of distribution values ranged from 0.06 to 0.36 1.h 1.kg-1 and from 0.6 to 2.4 l.kg-1, respectively. Less than 0.06% of the dose was excreted unchanged in urine within 8 h of administration. The concentration of the drug in a CSF sample collected 1 h after dosing was below the limit of detection (2 micrograms/L) in all subjects. PMID- 2714732 TI - Interaction between moclobemide and oral tyramine in depressed patients. AB - We investigated the pressor response to oral tyramine before and during treatment with moclobemide, a selective monoamine oxidase-A inhibitor, in 10 depressed patients. Before moclobemide therapy, tyramine was associated with a mean (SD) maximum rise in systolic blood pressure of 4.0 (5.2) mmHg, whereas during moclobemide treatment, tyramine was associated with an increase of 24.9 (14.2) mmHg. Only one subject failed to demonstrate an increased pressor response while taking moclobemide. Moclomebide potentiates the pressor response to oral tyramine, but is safer than older nonselective monoamine oxidase inhibitors. PMID- 2714731 TI - High affinity acceptor sites in guinea pig brain for [3H]52770 RP, a PAF antagonist. AB - [3H]52770 RP, a PAF antagonist, was found to bind with high affinity and in a reversible manner on specific and saturable binding sites in guinea pig cortical membranes. Scatchard analysis revealed the presence of one class of binding sites with an equilibrium dissociation constant of 0.38 nM and a Bmax of 1190 fmol/mg protein. However, these binding sites did not correspond to the PAF receptors described with this ligand in platelet plasma membranes; indeed, PAF and its analogs were unable to displace [3H]52770 RP binding in guinea pig brain. Therefore, one may conclude that [3H]52770 RP in guinea pig brain labels acceptor or recognition sites, rather than true receptor sites. PMID- 2714733 TI - Hemodynamic effects of blood volume restitution following a hemorrhage in rats with portal hypertension due to cirrhosis of the liver: influence of the extent of portal-systemic shunting. AB - The present study investigated whether, in rats with portal hypertension due to cirrhosis of the liver induced by carbon tetrachloride, blood volume restitution following a hemorrhage produces an increase of portal pressure beyond control values, as observed in rats with prehepatic portal hypertension. Since carbon tetrachloride-induced cirrhosis caused mild portal-systemic shunting, in some of the cirrhotic rats (12 of 29 rats) portal-systemic shunting was enhanced by a transient (4 days) partial constriction of the portal vein, which was removed 1 week prior to the study. After baseline measurements of portal pressure and arterial pressure, 15 ml per kg of blood were withdrawn at a rate of 0.3 ml per min and reinfused 15 min later. After blood reinfusion, portal pressure and arterial pressure were measured again, and cardiac output, regional blood flows and portal-systemic shunting were determined using radioactive microspheres. Portal-systemic shunting was 78 +/- 11% of total blood flow in the cirrhotic rats that had temporary portal vein constriction, but only 5 +/- 2% (p less than 0.001) in those that did not. Blood volume restitution in low-portal-systemic shunting rats did not produce any significant modification in splanchnic or systemic hemodynamics. However, in rats with high portal-systemic shunting, blood volume restitution produced a significant increase in portal pressure (from 9.9 +/- 0.9 to 13.5 +/- 0.9 mmHg, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714734 TI - Effect of vasodilators on hepatic microcirculation in cirrhosis: a study in the isolated perfused rat liver. AB - We studied the effects of a series of vasodilators on intrahepatic vascular resistance of isolated perfused cirrhotic rat livers in basal conditions and during norepinephrine-induced vasoconstriction. Cirrhosis was induced by repeated intraperitoneal injections of carbon tetrachloride. The vasodilators were a nonselective beta-adrenergic antagonist (propranolol), an alpha 1-adrenergic antagonist (prazosin), a nonselective beta-adrenergic agonist (isoproterenol), an alpha 2-agonist (clonidine), nitrovasodilators (nitroglycerin and nitroprusside), calcium channel blockers (verapamil, diltiazem, nifedipine), papaverine, diazoxide and pentoxifylline. In basal conditions, isoproterenol, nitroglycerin, papaverine, pentoxifylline and nitroprusside demonstrated significant vasodilatory activity. However, the response was weak and isoproterenol was the only drug active in the therapeutic range of concentrations. Propranolol, prazosin, verapamil, diltiazem, nifedipine and diazoxide were ineffective. Prazosin, papaverine and pentoxifylline reduced norepinephrine-induced vasoconstriction, whereas isoproterenol, clonidine and propranolol were ineffective. We conclude that several vasodilators can reduce resistance in the cirrhotic rat liver, but their potency is low and few are effective at therapeutic concentrations. Furthermore, their activity may be blunted when resistance is increased by norepinephrine. PMID- 2714735 TI - Bile acid metabolism in human hyperthyroidism. AB - Decreased levels of serum cholesterol are a well-recognized finding in hyperthyroidism. Since the conversion to bile acids is an important pathway for the elimination of cholesterol, we studied primary bile acid kinetics in seven hyperthyroid patients before and after medical treatment. Pool sizes, fractional turnover and synthesis rates of cholic acid and chenodeoxycholic acid were determined after oral administration of 50 mg [13C]cholic acid and 50 mg [13C]chenodeoxycholic acid. 13C/12C isotope ratios in serum were measured by capillary gas chromatography/electron impact mass spectrometry. Compared with the euthyroid state, serum cholesterol levels were distinctly lower in hyperthyroidism (150 +/- 33 vs. 261 +/- 51 mg per dl, p less than 0.01). Thyroid hormone excess caused a 34% reduction in cholic acid synthesis (5.8 +/- 2.8 vs. 7.9 +/- 4.2 mu moles per kg per day, p less than 0.02), which was associated with a 47% decrease in cholic acid pool size (11.7 +/- 3.4 vs. 22.0 +/- 5.2 mu moles per kg, p less than 0.01). Chenodeoxycholic acid kinetics exhibited no apparent changes. Thus, total primary bile acid synthesis was diminished by 20% in hyperthyroidism. After normalization of thyroid function, the ratio of cholic acid/chenodeoxycholic acid pool size increased in all patients. This was paralleled by a rise in the ratio of concentrations of cholic acid/chenodeoxycholic acid in serum. The depression of cholic acid synthesis in the presence of unaltered subjects is compatible with an inhibition of hepatic 12 alpha-hydroxylation by thyroid hormone. Furthermore, evidence is provided that, in man, the low serum cholesterol levels found during hyperthyroidism are not caused by an increased conversion of cholesterol to bile acid. PMID- 2714736 TI - Selective hepatobiliary transport of nordeoxycholate side chain conjugates in mutant rats with a canalicular transport defect. AB - Canalicular transport of bilirubin diglucuronide, dibromosulfophthalein and several glutathione conjugates is deficient in mutant TR- rats. In contrast, transport of cholyltaurine (taurocholate), a conjugated bile acid, is normal. Previous studies using normal rats have shown that C23 nor-dihydroxy bile acids are conjugated with sulfate or glucuronide during hepatic transport in contrast to the natural C24 bile acids, which are amidated with glycine or taurine. Studies were performed to test the hypothesis that (a) in the TR- rat, nordeoxycholate would be conjugated with glucuronate or sulfate just as in the normal rat, and (b) that such conjugates would have defective biliary secretion. [C23-14C]Nordeoxycholate was administered intravenously to bile fistula rats (TR- and normal), and the biliary recovery of metabolites was assessed by chromatography and mass spectrometry. In both groups of rats, the major biotransformation product of nordeoxycholate was the side chain (23-ester) glucuronide. Conjugation on the nucleus with sulfate and glucuronide at the 3 position (ethereal linkage) also occurred, as well as amidation at the C23 carboxylic acid group. In the mutant rats, biliary secretion of the 3-sulfate and 3-glucuronide conjugates was less than 10% and 1%, respectively, of that of normal rats, whereas biliary secretion of the 23-ester glucuronide and the 23 taurine amidate, as well as unchanged nordeoxycholate, was not decreased. Canalicular secretion of nor-bile acid 3-ether glucuronides and 3-sulfates appears to involve the "bilirubin transport system," which is deficient in mutant rats. Canalicular secretion of unconjugated, amidated or esterified nordeoxycholate is mediated via another pathway, probably the "bile acid transport system."(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714737 TI - Effect of molecular charge on para- and transcellular access of horseradish peroxidase into rat bile. AB - The permeability pathway into the biliary tree for small inert molecules exhibits a charge selectivity. Using a method which distinguishes trans- from paracellular access, we have examined the charge selectivity of biliary access pathways for the 40-kD protein horseradish peroxidase (pI 7.5), which was derivatized to strongly anionic (pI less than 3.5) and strongly cationic (pI greater than 9.5) isoenzymes. Each isoenzyme was injected as a bolus into the perfusate of an isolated rat liver perfused in situ with a nonrecirculating Krebs-Ringer buffer. Bile was collected at intervals and horseradish peroxidase activity was measured. Its appearance allowed differentiation of paracellular from transcellular access, and the amount entering via each pathway was quantified. The species of enzyme entering bile was the same as that injected as determined by cation-exchange high performance liquid chromatography of biliary horseradish peroxidase. Paracellular biliary access of anionic horseradish peroxidase was less than 50% that of neutral and cationic horseradish peroxidase both in the control state and when paracellular entry was augmented with 10(-10) M vasopressin. Transcellular access of anionic horseradish peroxidase was similarly restricted. To determine whether this restriction of anionic transcellular access was brought about by diminished hepatocellular uptake or augmented catabolism, we studied these parameters in 4 hr primary hepatocyte cultures. The uptake rates of all species were similar. Little or no degradation or efflux of any horseradish peroxidase species occurred over 30 min in the cultured cells. We conclude that access is charge selective for macromolecules and that this selectivity holds for trans- as well as for paracellular pathways.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714738 TI - Delta hepatitis in homosexual men in the United States. AB - To assess the incidence and prevalence of delta hepatitis in homosexual men, we tested serum specimens for delta markers in participants in two previous studies: a hepatitis B vaccine trial among homosexual men conducted in the early 1980's and the Centers for Disease Control sentinel counties hepatitis study for 1983 1984. In the vaccine trial, men found to be hepatitis B surface antigen positive at the time of enrollment and those men who had serologic evidence of new hepatitis B virus infection during follow-up were tested. In the sentinel counties study that determined risk factors for viral hepatitis in reported cases, all homosexual men with acute and chronic hepatitis B virus infections were tested for delta markers. Specimens were tested for delta antigen and IgM and total delta antibody. In seven different cities, among 321 men found to be HBsAg positive at the time of screening, eight (2%) were positive for any delta marker. Among 290 men with new hepatitis B virus infections during follow-up, three (two coinfections, one superinfection) had serologic evidence of delta hepatitis. In the sentinel counties study, 0/63 acute hepatitis B virus infections in homosexual men were associated with delta hepatitis. This study indicates that the delta agent is an infrequent cause of viral hepatitis in homosexual men in the United States. PMID- 2714739 TI - Pharmacokinetics of tin-mesoporphyrin in man and the effects of tin-chelated porphyrins on hyperexcretion of heme pathway precursors in patients with acute inducible porphyria. AB - Tin-mesoporphyrin shares many of the properties of its parent compound, tin protoporphyrin. These include competitive inhibition of heme oxygenase, amelioration of jaundice and suppression of chemically induced hepatic porphyria. Tin-mesoporphyrin is cleared from the plasma of normal subjects with dose dependent pharmacokinetics (T1/2 = 3.8 hr following i.v. administration of 1 mumole per kg body weight), and small amounts (less than 1% of administered dose) are excreted into the urine and feces. Intramuscular administration of tin mesoporphyrin resulted, within 2 hr, in plasma concentrations identical to those obtained following i.v. administration, but the compound was not absorbed orally. The only dose-limiting side effect was transient cutaneous photosensitivity. High doses (1 mumole per kg body weight) of tin-mesoporphyrin resulted in significant decreases in plasma bilirubin concentrations at 24 and 48 h after treatment of normal subjects. Administration of both tin-protoporphyrin and tin-mesoporphyrin resulted in decreases in the urinary excretion of heme pathway intermediates in stable hyperexcreters with acute hepatic porphyria. PMID- 2714740 TI - Immunization of newborns of HBsAg-positive mothers: a successful first step in control of hepatitis B virus in Taiwan. PMID- 2714741 TI - Protection against the transmission of hepatitis B virus in dental practitioners: better gloves, earlier vaccination, or both? PMID- 2714742 TI - Fat-storing cells and myofibroblasts: one cell or two? PMID- 2714743 TI - Animal models for alcoholic liver disease. PMID- 2714744 TI - Mental health research: the need for collaboration. PMID- 2714745 TI - Admitting children to psychiatric hospitals: a controversy revived. PMID- 2714746 TI - Screening tests for cognitive impairment. PMID- 2714747 TI - Emerging treatment guidelines for mentally ill chemical abusers. AB - Dr. Miller's Introduction: We are becoming more and more aware that many alcoholics and chemically dependent individuals also suffer from a psychiatric disorder. This reality emerges now after a period in which the possibility of coexisting mental and addictive disorders was often denied by the alcoholism and drug fields. Psychiatrists and other mental health professionals need to be alert to patients with these dual disorders so that relapses of both the dependency and the psychiatric disorder can be averted. This month's column presents useful guidelines to help professionals deal effectively with this difficult problem. PMID- 2714748 TI - Philadelphia's capitation plan for mental health services. AB - Dr. Sharfstein's Introduction: Prospective payment is the major economic change that is reshaping the delivery of medical care. Capitation financing for the chronic mentally ill is an innovative and promising alternative to underfunded and bureaucratically rigid public programs on the one hand and underfunded retrospective cost-based Medicaid programs on the other. This month's column describes one such capitation plan. Its impact on the target population as well as on the use of resources by persons with long-term and severe mental illnesses will require close evaluation. PMID- 2714749 TI - Clinical case management: definition, principles, components. AB - The burgeoning field of case management for long-term psychiatric patients has been handicapped by a lack of conceptual models that delineate the diverse activities of case managers. Based on the actual practice of case management, the author outlines a model of clinical case management that moves beyond the view of the case manager as a systems coordinator, service broker, or supportive companion. Using a contemporary biopsychosocial model of mental illness, the clinical case management model integrates the clinical acumen, personal involvement, and environmental interventions needed to address the overall maintenance of the patient's physical and social environment. Clinical case management involves 13 distinct activities, including engagement of the patient, assessment, planning, linkage with resources, consultation with families, collaboration with psychiatrists, patient psychoeducation, and crisis intervention. PMID- 2714750 TI - Outcomes of five years of continuous intensive case management. AB - Five years of intensive case management and specialized alternatives to hospitalization were provided to 72 young recidivistic, treatment-resistant, chronically thought-disordered patients. Compared with a two-year prestudy baseline, patients' days in the hospital during the five years were reduced by 75 percent, but this reduction was offset by a 193 percent increase in structured residential care days in the community. Patients' level of functioning as rated by the Global Assessment Scale and other measures remained essentially the same over the five years. However, use of emergency services and after-hours on-call services decreased steadily throughout the study. Comprehensive cost-analysis revealed that savings in hospital costs were offset by increased costs of community care. The authors conclude that this treatment approach effectively stabilized the treatment-resistant patients in the community but did not reduce net costs in constant dollars. PMID- 2714751 TI - Models of state funding for mental health research. AB - Twenty-eight of 49 states that responded to a survey supported mental health or substance abuse research through at least one of four funding mechanisms--the joint state-university research unit, research grants, state in-house research, and contracts. The authors illustrate the use of these mechanisms with examples from the states. The events leading to the establishment of the new Oklahoma Mental Health Research Institute are described. PMID- 2714752 TI - A national study of state-supported psychiatric research institutes. AB - States have funded psychiatric research through a variety of mechanisms, including psychiatric research institutes. The authors identified and surveyed 33 such institutes to obtain information on their organizational characteristics. Twenty-nine institutes responded; more than half were organizationally located within a university setting, and a similar number were involved in research, education, and direct services. Clinical research was the most prevalent type of research conducted, and annual state revenue appropriations were the major source of funding. Because budgetary problems have threatened their future funding in some states, the authors believe the institutes should increase efforts to demonstrate their relevance to state mental health needs. PMID- 2714753 TI - The nursing shortage and psychiatry. Interview by John A. Talbott. PMID- 2714754 TI - Sociodrama in the rehabilitation of chronic mentally ill patients. AB - Sociodrama, a synthesis of group psychotherapy and theatrical presentation, was used from 1978 to 1981 to promote rehabilitation of chronic mentally ill patients at Bellevue Mental Hospital in Jamaica. Staff and patients collectively analyzed their recollections of the hospital's history, then wrote and staged dramatic productions based on the insights derived from those analyses. Changes in the major themes that emerged from the process reflected improvement in therapeutic attitudes and practices and in patient-staff communication over the four-year period. Patients who participated in the sociodramas had greater decreases in medication dosage and psychosocial disability scores and higher rates of improvement and discharge than a matched group of patients who did not participate. PMID- 2714755 TI - A strategy for enhancing the clinical utility of the psychiatric record. PMID- 2714756 TI - The effect of a nurses' strike on the functioning of chronic patients. PMID- 2714757 TI - Social work students as case managers: a model of service delivery and training. PMID- 2714758 TI - Clinicians' effectiveness in detecting patients' requests during an initial screening. PMID- 2714759 TI - The role of the psychiatrist in board-and-care homes. PMID- 2714760 TI - Working with families. PMID- 2714762 TI - AIDS and CMHCs. PMID- 2714761 TI - The impact of outreach. PMID- 2714763 TI - Major teaching hospitals see profits decline. PMID- 2714764 TI - The future of the hospital association mission. PMID- 2714765 TI - Human error limits MRI's quality potential. PMID- 2714766 TI - Innovators and entrepreneurs: 1989. PMID- 2714767 TI - Hospitals maintain their 'beneficial' status. PMID- 2714768 TI - Facilities management. Energizing efficiency. PMID- 2714769 TI - Facilities management. Automated maintenance. PMID- 2714770 TI - Facilities management. Tossing the trash. PMID- 2714771 TI - Will employers accept a national health plan? PMID- 2714772 TI - Changing times restrict insurance coverage. PMID- 2714773 TI - Job hunting: how to negotiate the final offer. PMID- 2714774 TI - Management--not technology--will enhance IS (information systems). PMID- 2714775 TI - Genotype of alcohol dehydrogenase and aldehyde dehydrogenase loci in Japanese alcohol flushers and nonflushers. AB - A much higher incidence of alcohol flushing among Orientals in comparison to Caucasians, i.e., greater than 50% vs 5%-10%, has been attributed to racial differences in alcohol-metabolizing enzymes. A large majority of Orientals are "atypical" in alcohol dehydrogenase-2 locus (ADH2), and their livers exhibit significantly higher ADH activity than the livers of most Caucasians. Approximately 50% of Orientals lack the mitochondrial aldehyde dehydrogenase (ALDH2) activity, and elimination of acetaldehyde might be disturbed. We determined by means of hybridization of genomic DNA samples with allele specific oligonucleotide probes, genotypes of the ADH2 and ALDH2 loci in Japanese alcohol flushers and nonflushers. We found that all individuals with homozygous atypical ALDH2(2)/ALDH2(2) and most of those with heterozygous atypical ALDH1(2)/ALDH2(2) were alcohol flushers, while all subjects with homozygous usual ALDH1(2)/ALDH1(2) were nonflushers. Frequency of the atypical ADH2(2) was found to be higher in alcohol flushers than in nonflushers, but the statistical significance was not established in the sample size examined. PMID- 2714776 TI - Population cytogenetics of folate-sensitive fragile sites. II. Autosomal rare fragile sites. AB - The frequencies of folate-sensitive autosomal rare fragile sites (ARFS) were compared in populations of mentally retarded, mentally subnormal, and mentally normal children and of patients referred for diagnostic chromosome study. The frequencies did not differ significantly. Altogether, an autosomal rare fragile site was found in 16 of 1,445 individuals (1 in 90). Of six different folate sensitive ARFS detected, the most common one was FRA9A, with a frequency of 1 in 241 individuals. In addition, FRA17A, classified as a distamycin A-inducible fragile site, was found with a frequency of 1 in 206. It was regarded as a spontaneously expressive fragile site. In 19 families in which transmission of an autosomal rare fragile site was studied, the mother was the carrier in 16 families and the father, in one family. The mean percentage (+/- SD) of cells expressing ARFS in 55 individuals was 19% (+/- 11.4). The age did not affect the rate of expression. When the rate of expression was calculated separately in a group of mentally retarded (mean = 23.4%) and in a group of mentally normal individuals (mean = 16.0%), the difference was statistically significant. PMID- 2714777 TI - Cytogenetic and in situ DNA-hybridization studies in intracranial tumors of a patient with central neurofibromatosis. AB - We have studied a meningioma and an acoustic neurinoma of a patient with central neurofibromatosis. In the meningioma cells, one chromosome 22 was replaced by an almost metacentric, bisatellited marker chromosome that appeared monocentric after CBG-staining. In situ hybridization with a chromosome 22 centromere specific DNA probe (p22hom48.4) revealed specific signals in the pericentromeric region of the marker chromosome, indicating the presence of at least the short arm and the centromere of chromosome 22. The pericentromeric localization of the hybridization signals suggest the marker consists of an isoformation of the short arm of chromosome 22, resulting in a monosomy for the long arm of chromosome 22. In contrast to these findings in meningioma cells, no chromosomal abnormality could be detected in acoustic neurinoma cells. Our findings provide further evidence that loss of genetic material on the long arm of chromosome 22 is associated with the development of central neurofibromatosis. PMID- 2714778 TI - Differential associative behaviour of mitotic and meiotic acrocentric chromosomes. AB - A comparative study of the association of mitotic acrocentric chromosomes and acrocentric bivalents at the pachytene stage shows that at least two factors can act in the associative behaviour of these chromosomes: (1) Nor activity and (2) the presence of satellite DNA in the short arms of these chromosomes. These factors do not act with the same intensity in the two cell lines studied. In lymphocytes, Nor activity prevails, whereas satellite DNA plays the main role in the association of acrocentric chromosomes in germ cells at the pachytene stage. PMID- 2714779 TI - The absence of type II collagen and changes in proteoglycan structure of hyaline cartilage in a case of Langer-Saldino achondrogenesis. AB - Structural analysis of hyaline cartilage extracellular matrix components from the ribs and knee joint of a stillborn female with type II achondrogenesis was carried out. The absence of type II collagen, a decrease in the amount of proteoglycans (PG), and structural changes in PG, namely, increased electrophoretic mobility of PG, lower relative content of chondroitin 4-sulfate (Ch4-S), lower molecular weight and decreased total chondroitin sulfate (ChS) sulfation, were detected. Increased amounts of type I and type III collagens, atypical for hyaline cartilage, were revealed. Among the link proteins (LPs), a large protein with a mol. wt. of 48 kDa was predominant. Molecular and cellular mechanisms of the pathogenesis of achondrogenesis ("chondrogenesis imperfecta") are discussed. The data obtained suggest that the primary defect in type II achondrogenesis involves ChS or type II collagen synthesis. PMID- 2714780 TI - Non C-banding variants in some normal families might be homogeneously staining regions. AB - Three families are reported showing transmission of a previously described variant, which is not associated with any clinical abnormality. The variant involves additional material at the band 9p12, which shows homogeneous staining of intermediate density with GTL- and RBG-banding, and negative staining with CBG banding. The region stains positively with Feulgen stain. In situ hybridization with total genomic human DNA, cloned alpha satellite, satellite III, and ribosomal DNA all show no hybridization to the 9p12 variant. Two members of one of the families show the largest 9p12 variant yet reported; two other carriers in this family have inherited a variant of decreased size. It is suggested that the 9p12 variants are homogeneously staining regions. Using the ISCN three-letter convention, this variant could be described as hsr(9)(p12). PMID- 2714781 TI - Chromosomal localization of ARSB, the gene for human N-acetylgalactosamine-4 sulphatase. AB - A deficiency of N-acetylgalactosamine-4-sulphatase (G4S, gene symbol ARSB), results in the accumulation of undegraded substrate and the lysosomal storage disorder, Maroteaux-Lamy syndrome (mucopolysaccharidosis type VI). In situ hybridization using an 3H-labelled human G4S genomic DNA fragment to human metaphase chromosomes localized ARSB to chromosome 5q13-5q14. This location is consistent with, an refines, previous chromosomal assignments based on the expression of human G4S in somatic cell hybrids. PMID- 2714782 TI - The role of recombination in the evolvement of the fragile X mutation. AB - The frequency of recombination in the regions adjacent to the fragile X locus was studied in two groups of carriers: daughters of transmitting males and transmitters of maternally inherited fragile X chromosomes. Approximately one half of the offspring of the former and one quarter of the offspring of the latter are recombinant. Recombinants and parentals are equally distributed among affected and normal offspring in the two groups. These results indicate that crossing-over at or around the fragile X locus occurs in every meiosis in daughters of transmitting males, although the recombinant chromatids do not necessarily carry the fragile X mutation. Hence, crossing-over is unequivocally associated with, but is not the direct cause of, the transition from the primary genetic lesion to the final mutation. PMID- 2714783 TI - Localization of human platelet proteoglycan gene to chromosome 10, band q22.1, by in situ hybridization. AB - A cDNA probe of 527 base pairs coding for the human platelet proteoglycan (PPG) protein core demonstrated that the PPG gene lies on the long arm of chromosome 10, band q22.1. This result and other available data concerning proteoglycans containing serine-glycine repeats indicate that this gene is involved in the expression of a proteoglycan in various blood cell types. PMID- 2714784 TI - A hereditary double double-banded variation in the vitamin D-binding protein (GC) system analyzed by immunoblotting: duplication of the 1F and 1A2 genes? AB - A combination of immunoblotting and polyacrylamide gel isoelectric focusing (IEF PAGE) was used to define a new genetic variant in the (GC) group-specific component system. This appeared to be a GC 1-type variant, and was presumed to have arisen from duplication of the GC 1F and GC 1A2 genes. PMID- 2714785 TI - Haplotype analysis of familial amyloidotic polyneuropathy. Evidence for multiple origins of the Val----Met mutation most common to the disease. AB - Familial amyloidotic polyneuropathy (FAP) is an autosomal dominant genetic disease characterized by systemic accumulation of amyloid fibrils. A major component of FAP amyloid has been identified as variant transthyretin (TTR, also called prealbumin). In particular, a variant with the substitution 30Val----Met has been commonly found in FAP of various ethnic groups. To understand the origin and spread of the Val----Met mutation, we analyzed DNA polymorphisms associated with the TTR gene in six Japanese FAP families and several Portuguese FAP patients. Three distinct haplotypes associated with the Val----Met mutation were identified in Japanese FAP families, one of which was also found in Portuguese patients. On the other hand, it was found that the Val----Met mutation can be explained by a C-T transition at the CpG dinucleotide sequence of a mutation hot spot. Thus, our findings indicate that the Val----Met mutation has probably recurred in the human population, to generate FAP families of independent origin. PMID- 2714786 TI - Unbalanced translocation between chromosomes 2 and 7 with de novo deletion of band 35 on the long arm of chromosome 2. AB - Clinical and cytogenetical findings are described in an infant with a de novo deletion of the long arm of chromosome 2. The boy's karyotype is 46,XY, rec(2)delq,t(2;7) (2pter----2q34::7p21----7pter) (7qter----7p21::2q36----2qter). He showed developmental retardation, low-set ears, micrognathia, short, neck, abundant skin of the neck, tetralogy of Fallot, bipartite labialike scrotum, clitorislike penis, cryptorchism, and deformities of the hands and feet. PMID- 2714787 TI - PLG A91 and PLG M6: two new plasminogen allotypes in Japan. AB - In the Japanese two new inherited plasminogen allotypes were observed, PLG A91 and PLG M6, which migrated closely to PLG A and showed normal antigenic levels and functional activities. PMID- 2714788 TI - Response to Wiberg's remarks on our article: "H-Y Antigenicity of Human Fibroblasts". PMID- 2714789 TI - Nucleotide sequence comparison of five human pepsinogen A (PGA) genes: evolution of the PGA multigene family. AB - To unravel the genetic basis for the pepsinogen A (PGA) protein polymorphism, we have isolated and characterized a number of PGA genes, distinguishable by polymorphic EcoRI fragments of 12.0, 15.0, and 16.6 kb. Using a HindIII or AvaII polymorphism, we can discriminate between different 15.0 (15.0 and 15.0*) and 12.0 (12.0s and 12.0l) genes, respectively. The coding sequences of a 15.0 and a 16.6 gene were determined, together with considerable stretches of the 5'- and 3' flanking regions and introns. The genes were demonstrated to encode Pg5 and Pg4, respectively. Because substitutions in codons 43 and 207 appeared to be critical in the determination of the encoded proteins, we sequenced only these regions in the two 12.0 genes and the 15.0* gene. On the basis of these partial sequences, we assume that these genes encode Pg3. In the evolutionary model of the PGA gene cluster presented here, the 12.0 genes arose by an unequal, but homologous crossover. The results of sequence analysis of the second intron of the 12.0s, 12.0l, 15.0, and 16.6 genes suggest that the two 12.0 genes have arisen from two different crossover events. PMID- 2714790 TI - Chromosomal localization of human genes required for G1 progression in mammalian cells. AB - Specific probes derived from the human genes that complement the mutations of two independent temperature-sensitive (ts) mutants of the BHK-21 hamster cell line were used to determine the chromosomal locations of the loci in the human genome. The ts11 gene, which complements a mutation that blocks progression through the G1 phase of the cell cycle and which has now been identified as the structural gene for asparagine synthetase, is a member of a small gene/pseudogene family with four members. In a rodent-human somatic cell hybrid panel, the ts11 genomic locus from which the genomic probe derives segregates with human chromosome region 7cen----7q35, proximal to the TCR beta locus. In situ hybridization maps this locus more precisely to the q21-31 region of chromosome 7. Two other members of the gene family detected by the ts11 probe segregate concordantly with chromosome region 8pter----8q24 and chromosome region 21pter----21q22. Similar experiments using the same rodent-human hybrid panel conducted with a probe identifying the tsBN51 gene, which also encodes a function necessary for G1 progression, mapped this locus to human chromosome 8, proximal to the large amplification unit encompassing the c-myc gene of Colo320 cells. Chromosomal in situ hybridization of the tsBN51 probe confirmed the localization of this gene to chromosome 8, with the most likely location of the gene being 8q21. PMID- 2714791 TI - Mutations in the catalytic domain of human coagulation factor IX: rapid characterization by direct genomic sequencing of DNA fragments displaying an altered melting behavior. AB - Deficiency in coagulation factor IX, a plasma glycoprotein constituent of the clotting cascade, results in hemophilia B, an inherited recessive X-linked bleeding disorder. Some affected individuals, referred to as antigen positive or CRM+, express an inactive factor IX gene product at normal levels and are expected to have natural mutations altering domains of the molecule that are critical for its correct function. The serine protease catalytic domain of activated factor IX, encoded by exons VII and VIII of the gene, is a possible target for such mutations. We designed a strategy allowing rapid analysis of this region through enzymatic amplification of genomic DNA, analysis of the amplification products by denaturing gradient gel electrophoresis, and direct sequencing of the fragments displaying an altered melting behavior. This procedure permitted us to characterize two previously undescribed mutations. Factor IX Angers is a G-to-A substitution generating an Arg in place of a Gly at amino acid 396 of the mature factor IX protein. Factor IX Bordeaux is an A-to-T substitution introducing a nonsense codon in place of the normal codon for Lys at position 411. Moreover, the already described factor IX Vancouver defect was found in three apparently independent families. These results provide further insight into the molecular heterogeneity of hemophilia B. In addition, we demonstrate the usefulness of this rapid screening procedure, which has broad applications in human genetics and can be used as an alternative to RFLP analysis in carrier detection or prenatal diagnosis studies. PMID- 2714792 TI - The distribution of interspersed repetitive DNA sequences in the human genome. AB - The distribution of interspersed repetitive DNA sequences in the human genome has been investigated, using a combination of biochemical, cytological, computational, and recombinant DNA approaches. "Low-resolution" biochemical experiments indicate that the general distribution of repetitive sequences in human DNA can be adequately described by models that assume a random spacing, with an average distance of 3 kb. A detailed "high-resolution" map of the repetitive sequence organization along 400 kb of cloned human DNA, including 150 kb of DNA fragments isolated for this study, is consistent with this general distribution pattern. However, a higher frequency of spacing distances greater than 9.5 kb was observed in this genomic DNA sample. While the overall repetitive sequence distribution is best described by models that assume a random distribution, an analysis of the distribution of Alu repetitive sequences appearing in the GenBank sequence database indicates that there are local domains with varying Alu placement densities. In situ hybridization to human metaphase chromosomes indicates that local density domains for Alu placement can be observed cytologically. Centric heterochromatin regions, in particular, are at least 50-fold underrepresented in Alu sequences. The observed distribution for repetitive sequences in human DNA is the expected result for sequences that transpose throughout the genome, with local regions of "preference" or "exclusion" for integration. PMID- 2714793 TI - Assignment of the human intestinal Na+/glucose cotransporter gene (SGLT1) to the q11.2----qter region of chromosome 22. AB - The chromosomal location of the human intestinal Na+/glucose cotransporter gene (SGLT1) was determined using human cDNA and genomic probes for this transporter gene. Southern blot analysis of genomic DNA from 15 mouse-human somatic cell hybrids showed that the human gene for this transporter resides on chromosome 22. Analysis of hamster-human hybrids selectively retaining chromosome 22 or a portion of it allowed specific assignment of the locus to the q11.2----qter region of chromosome 22. A restriction fragment length polymorphism was identified with EcoRI. PMID- 2714794 TI - Analysis of somatic mutations at human minisatellite loci in tumors and cell lines. AB - Hypervariable human minisatellite loci show a substantial level of germline instability, and spontaneous mutation rates to new length alleles have been measured directly by pedigree analysis. We now show that mutation events altering the number of minisatellite repeat units are not restricted to the germline, but also arise in other tissues. Mutant alleles can be detected at a very low frequency in lymphoblastoid cell lines and at much higher frequencies in clonal tumor cell populations, most particularly in gastrointestinal adenocarcinomas. Mutant alleles in these tumors are usually present at a dosage equal to or greater than that of the progenitor allele, indicating that most or all of the tumor cells carry the same clonally derived mutant allele. As with germline mutation, the incidence of somatic mutations in tumors varies from locus to locus, with the same locus showing the highest level of germline and somatic instability. Most length changes, as those in the germline, are of only a few repeat units; however, very large changes are also observed, implying that such mutations can occur in the absence of meiosis. PMID- 2714795 TI - Mapping the short arm of human chromosome 16. AB - Physical mapping of 13 different breakpoints on the short arm of chromosome 16 using previously mapped probes and the subsequent mapping of additional probes enabled the division of this portion of the chromosome into six different intervals. D16S94 was mapped between HBA and D16S80 and is closer to PKD1 than either HBA or D16S80. A tight linkage group which includes FRA16A, D16S8, and D16S79 was identified. Seven breakpoints, including FRA16A, could not be separated by probe localizations. This study provides the basis for the development of detailed maps of the short arm of chromosome 16. PMID- 2714796 TI - Genomic organization of human 5 S rDNA and sequence of one tandem repeat. AB - An organization of human 5 S rDNA repeats is inferred from Southern analyses of restriction digests of genomic DNA fractionated by pulsed-field and conventional gel electrophoreses. A single unit of 2.2 kb is repeated approximately 90 times within a 200-kb fragment (defined by enzymes that do not cleave within individual units, i.e., EcoR1, BglII, HindIII, and PvuII); a comparable number of 5 S sequences are scattered elsewhere in the genome. A lambda clone containing six complete 5 S repeats was obtained from a human placental DNA library. One repeat contains 2231 bp and includes poly(dG-dT).(dC-dA), tracts of polypyrimidine, and an Alu sequence in the spacer region. Also, 5-S-hybridizing clones, containing DNA inserts with an average size of 250 kb, have been obtained as yeast artificial chromosomes. Thus far, four clones have been partially characterized and shown to be 5 S sequences from loci separate from the tandem repeat units. PMID- 2714797 TI - Definition of subchromosomal intervals around the myotonic dystrophy gene region at 19q. AB - The localization to 19q of the gene causing myotonic dystrophy (DM) has been defined more precisely by refinement of the physical location of several linked markers. A somatic cell hybrid mapping panel from cells with t(1;19), t(12;19), and t(X;19) translocation products was constructed to define five different intervals across 19q. In addition, we have derived a series of cell hybrids by irradiation of a der(19)-only hybrid to further subdivide the cen-q13.1 region. Using an array of 36 cloned genes, anonymous DNAs, and enzyme markers, we have tested the location of the panel breakpoints and refined the regional assignment of several of these markers. All markers tightly linked to DM are localized mainly within 19q13.2, thus suggesting that the DM gene is also close to this region. PMID- 2714798 TI - The gene for incontinentia pigmenti is assigned to Xq28. AB - A linkage study of eight families with incontinentia pigmenti (IP) has been performed, and linkage to site DXS52 has been established. We suggest that the IP locus lies in the Xq terminal region on the long arm of the X chromosome. PMID- 2714799 TI - Neuroblastoma double minutes isolated by pulsed-field gel electrophoresis without prior strand-cleaving treatments. AB - In a human neuroblastoma line, minute chromosomes were separable from the bulk of interphase nuclear DNA by contour-clamped homogeneous electric field (CHEF) gel electrophoresis. The minute chromosomes showed a homogeneous size of approximately 3 Mbp and contained amplified N-myc genes. Fractionation was accomplished without prior strand-cleaving treatment of the DNA, indicating that at least a portion of the minute chromosomes exist as free entities in the interphase nuclei. Human alphoid satellite DNA sequences were also detected in the 3-Mbp band. It is possible that alphoid sequences are contained in the constricted central region that joins these double minutes. PMID- 2714800 TI - Three-point linkage analysis using multiple DNA polymorphic markers in families with X-linked nephrogenic diabetes insipidus. AB - The gene for X-linked nephrogenic diabetes insipidus (NDI), a disorder which, if untreated, causes severe dehydration, mental retardation, and possibly death in affected males, has been mapped recently to the Xq28 band through demonstration of linkage to the DX552 locus and other DNA markers (N. Knoers et al., 1987, Cytogenet. Cell Genet. 46:640; M. Kambouris et al., 1987, Cytogenet. Cell Genet. 46:636). Linkage studies in 11 families with NDI have enabled us to map the NDI gene between closely linked flanking markers in the Xq28 region and to obtain the following gene order: centromere-F9-DXS98-F8/CBD,CBP-DXS52/NDI-DXS134- telomere. These results have implications for presymptomatic and prenatal diagnosis of NDI and should also improve the prospects for identifying the fundamental gene defect underlying this disorder. PMID- 2714801 TI - Organization of the exons coding for pro alpha 1(II) collagen N-propeptide confirms a distinct evolutionary history of this domain of the fibrillar collagen genes. AB - The organization of the exons coding for the N-terminal portion of human type II procollagen has been determined. Aside from inferring the previously unknown primary structure of type II N-propeptide, this study has revealed that this coding domain of the gene exhibits an organization uniquely distinct from those of type I and type III collagens. This finding substantiates the notion that the N-propeptide coding domains of the fibrillar collagen genes evolved under less stringent selection than those encoding the C-propeptide and triple helical regions. PMID- 2714802 TI - Assignment of the feline alpha-L-iduronidase gene to chromosome D4. AB - The structural gene encoding feline alpha-L-iduronidase has been assigned to chromosome D4 by electrophoretic analysis of feline-hamster somatic cell hybrids. Previously, the human alpha-L-iduronidase gene had been assigned to the chromosomal region 22pter-q11. alpha-L-Iduronidase is the first human gene on chromosome 22 to be comparatively mapped in cats and the localization of the feline gene should facilitate further genetic analysis of the feline MPS I animal model. PMID- 2714803 TI - A gene homologous to plasminogen located on human chromosome 2q11-p11. AB - A plasminogen probe encoding kringles 1-3 detects homologous loci on human chromosomes 6 and 2 by somatic cell hybrid analysis. Regional localization by in situ hybridization places the loci at 6q26-27 and 2p11-q11. Further analysis by varying washing stringencies of hybridization filters reveals a greater homology with the chromosome 6 locus than with the chromosome 2 locus. These results confirm localization of the plasminogen gene to human chromosome 6q26-27 and indicate that a homologous sequence of unknown identity resides on chromosome 2p11-q11. PMID- 2714804 TI - Toxicological evaluation of a poisoning attributed to ingestion of malathion insect spray and correlation with in vitro inhibition of cholinesterases. AB - A 24-year-old Caucasian male was found dead from unknown causes at his farm home. At the scene, partially filled bottles of ORTHO Malathion 50 Insect Spray and CLOROX bleach were found. At the time of autopsy, a strong odour of a petroleum based product was prominent in the small intestine and in the liquid stool. A similar odour was also present in the liquids of both bottles. Generalized visceral and vascular congestion with oedema in various tissues was markedly present. Toxicological analysis of the gastric contents, intestinal contents, bile and liquid samples from the malathion and bleach bottles revealed the presence of malathion in the concentrations of 2.1 g/kg, 98 g/kg, 570 mg/l, 54% and 11%, respectively. In the blood and urine, malathion was not detected. Xylenes and other common volatile components of the spray were detected in the liquids from the bottles and in the gastric and intestinal contents. The ability of the blood and bile samples to inhibit, in vitro, rat serum cholinesterase and electric eel acetylcholinesterase was consistent with their malathion concentrations as the bile inhibited both enzymes, while the blood did not. These findings conclude that the death was associated with the ingestion of a commercial malathion insect spray. PMID- 2714805 TI - Ranitidine fails to suppress the growth in vitro of haemopoietic progenitors from human peripheral blood or bone marrow. AB - Ranitidine was added in various concentrations (25-1600 ng/ml) to clonal assays of haemopoietic progenitors of normal human peripheral blood or bone marrow. Although a significant reduction in colonies forming from granulocyte-macrophage progenitors (CFU-GM) was demonstrated at the lowest drug concentration, no significant growth suppression was seen at higher concentrations. There was no evidence for growth inhibition of either erythroid progenitors (BFU-E) or pluripotent progenitors (CFU-mix) at any of the drug concentrations studied. A direct toxic effect of ranitidine on normal haemopoietic progenitors thus appears an unlikely cause of cytopenias observed during treatment. PMID- 2714806 TI - An evaluation of the safety of ranitidine during seven years daily oral administration to beagle dogs. AB - 1. Ranitidine hydrochloride was administered orally to Beagles at doses equivalent to 50 mg once daily, or 5 mg twice daily, of ranitidine base/kg for more than 7 years. 2. Apart from looseness of faeces, seen mainly after doses of 50 mg/kg and only rarely after the first year of such treatment, there were no adverse clinical effects. There were no deaths related to treatment. 3. Periodic gastroscopy revealed nothing abnormal. 4. Peak plasma levels of ranitidine occurred within 2 h of dosing; levels were proportional to the doses administered. 5. There were no major differences in fasting plasma gastrin levels between treated and untreated dogs; the expected increase occurred in response to the provision of food and, predictably, this was greater following a dose of ranitidine. 6. A normal histamine-induced gastric secretory response was demonstrated. 7. Necropsy revealed no lesions of toxicological significance. Macroscopically the stomachs appeared normal but microscopic examination showed some gastritis in both treated and control dogs. No changes in enterochromaffin like (ECL) cells were detected. Electron microscopy showed unimpaired secretory activity of parietal cells. 8. Thus, after more than 7 years administration to beagle dogs of doses in excess of the normal daily therapeutic dose, the stomachs showed no changes attributable to treatment and their secretory capacity was unimpaired. PMID- 2714807 TI - Environmental tobacco smoke in the context of indoor air quality. PMID- 2714808 TI - A new method for predicting the outcome and survival period in paraquat poisoning. AB - 1. To elucidate the importance of lung damage in the prognosis of paraquat poisoning, the respiratory index (RI: A-aDO2/PO2) was analysed in 51 patients with paraquat poisoning. 2. Progressive deterioration of the RI was observed in 43 non-survivors, but not in 8 survivors. In addition, the RI of non-survivors became greater than 1.5 in the course of their poisoning, while that of the survivors remained less than 1.5. 3. The level of the RI (i.e. whether it became greater than 1.5 or not) was found to be a good indicator for the prognosis for life. 4. The RI-time, defined as the time taken from ingestion for the RI to be greater than 1.5, was found to be a good indicator for predicting the survival period in fatal cases. 5. As a result, we conclude that it is important and useful to examine a series of RI and the RI-time in poisoned patients not only to provide proper respiratory care, but also to predict outcome and survival period. PMID- 2714809 TI - Metoprolol alpha-hydroxylation polymorphism in the San Bushmen of southern Africa. AB - 1. The metabolic oxidation of metoprolol has been studied in a group of 98 San Bushmen. 2. The amounts of metoprolol and alpha-hydroxy metoprolol excreted in 0 8 h urine collection, after dosing with 100 mg metoprolol, were measured and the metabolic ratio (% dose excreted as metoprolol/% dose excreted as alpha-hydroxy metoprolol) calculated. 3. Frequency distribution and probit plots of the metabolic rate data showed a bimodal distribution with 4.1% of the population exhibiting slow metabolism with an MR greater than 10. 4. These results are much less than found in Caucasians (8.4%) but very different from the unimodal distribution found for Nigerians. 5. A previous study in the same group of Bushmen had revealed that 18 of 96 subjects were poor or non-metabolizers of debrisoquine to 4-hydroxy debrisoquine, but only one of the poor metoprolol metabolizers was a poor metabolizer of debrisoquine. 6. On the basis of these results, the claim of debrisoquine type of polymorphism for beta-adrenoceptor antagonists found in Caucasians cannot be extrapolated to the San Bushmen, and one must query the use of debrisoquine as measure of oxidative status in any group other than Caucasians. PMID- 2714810 TI - Hyperaluminaemia associated with oral citrate and aluminium hydroxide. AB - 1. A hospitalized patient with renal failure receiving oral aluminium hydroxide was found to have a blood aluminium level of 3124 micrograms/l (116 mumol/l). 2. The extremely high aluminium concentration was attributed to the concurrent use of an oral citrate solution which converted the aluminium to a more soluble and absorbable form. 3. The combination of oral aluminium and citrate should be avoided in patients with poor renal function. PMID- 2714811 TI - The inhibitory effect of gossypol on human sperm motility: relationship with time, temperature and concentration. AB - The inhibitory effect of gossypol acetic acid on human sperm motility was studied with a transmembrane migration method. Gossypol decreased sperm motility after it had been incubated with semen for more than 15 min. However, when sperm motility was evaluated immediately after semen had been mixed with gossypol, no inhibitory effect could be found. We consider that the sperm immobilizing potency of gossypol is much less than our previously studied sperm immobilizing agents. It is unlikely that gossypol can be developed as a vaginal spermicide. The importance of time course in the pharmacological study of sperm motility is emphasized in this study. PMID- 2714812 TI - Chlortenoxicam and renal function of normal human volunteers. PMID- 2714813 TI - Monoclonal antibody MACG1 distinguishes between different molecular species of the ganglioside GM3. AB - The present study investigates the chemical structure of a ganglioside, detected by monoclonal antibody (MAb) MacG1, which reacts with intracytoplasmic granules of tumor-infiltrating macrophages. The results obtained by enzymatic hydrolysis and fast-atom bombardment-mass spectrometry reveal that MAb MacG1 reacts with a subcomponent of the ganglioside GM3 found in melanoma and bovine brain. MAb MacG1 might be a powerful tool to distinguish among GM3 species and could help to define their possibly different biological functions. PMID- 2714814 TI - Conserved antigen expression in epithelial tumors recognized by monoclonal antibody 4A9 generated against canine mammary carcinoma cells. AB - Hybridoma-derived murine monoclonal antibodies (MoAbs) were generated by fusing P3X63-Ag8.653 myeloma cells with splenic cells from BALB/c mouse which had been immunized with viable canine mammary adenocarcinoma cells, CMT-2. Fifteen MoAbs were shown to react with immunizing cells in indirect immunofluorescence (IFA) and enzyme-linked immunosorbent (ELISA) assays. The reactivity of one IgM MoAb, designated 4A9, was evaluated. The antigen recognized by 4A9 on CMT-2 cells appeared to be localized both in cell membrane and cytoplasm against fixed and unfixed preparations by IFA. The 4A9 MoAb was found to bind with four of five canine mammary carcinoma cell lines while no binding was detected with normal fibroblastic cell lines. In vivo tissue distribution of 4A9 antigen was evaluated by indirect immunoperoxidase (IP) assay against formalin-fixed, paraffin-embedded sections of normal and neoplastic tissues. 4A9 MoAb reacted strongly to moderately with 75% of mammary carcinomas, moderately to weakly with 57% of benign mammary tumors, and strongly with squamous cell and perianal gland carcinomas (100%), interstitial cell tumors (100%), transitional cell carcinomas (43%), lung adenocarcinomas (40%), colon carcinomas (33%), and pancreatic adenocarcinomas (20%). Moderate to weak staining was detected with granulosa cell tumors (25%) and apocrine gland adenocarcinomas (50%). Strong reactivity with perianal gland carcinomas contrasted to no reactivity with perianal gland adenomas. No immunostaining was detected with a large variety and number of normal adult and fetal tissues tested; negligible and very restricted staining was observed in a few adult and fetal tissues. Normal mammary gland was negative. Since the antigen is expressed on the cell surface and in the cytoplasm of most mammary carcinoma cells and a variety of other epithelial tumor cells, the 4A9 antibody may have potential application in diagnosis and management of canine mammary cancer and a variety of other epithelial tumors. PMID- 2714815 TI - Production of a monoclonal antibody to bovine kappa-casein. AB - Caseins (including alpha s1, alpha s2, beta, kappa and gamma casein), a family of phosphoproteins which binds to calcium, are the major proteins in mammalian milk. Kappa-casein, in addition to its calcium binding capacities has an important role in the stabilization of the micelle structure of milk. In the course of studies to investigate the immunologic effects of ingested bovine kappa-casein in IgA deficiency, a hybridoma has been produced that secretes a monoclonal antibody, (IgG1 kappa isotype), which is specific for bovine kappa -casein. The antibody has been characterized by ELISA and it has been shown to bind specifically to bovine kappa -casein. In a sandwich radioimmunoassay, as little as 0.3 x 10(-4) nM/ml of kappa-casein. could be detected. This antibody does not bind to other bovine milk proteins, nor to human casein. PMID- 2714816 TI - Production and isolation of large quantities of monoclonal antibody using serum free medium and fast protein liquid chromatography. AB - A method for the production and purification of monoclonal antibody on a large laboratory scale is described. It involves the growth of monoclonal antibodies in serum-free medium, ultrafiltration through an Amicon XM100A filter and fast protein liquid chromatography on a mono Q column with an ionic strength and pH elution gradient. Up to 30 mg of antibody per litre of cell culture supernatant was purified in one day. The procedure can be carried out at 4 degrees. PMID- 2714817 TI - Elimination of mycoplasmas from mouse myeloma cells by intraperitoneal passage in mice and by antibiotic treatment. AB - Intraperitoneal passage in mice and antibiotic treatment were evaluated alone and in combination for elimination of mycoplasma contamination of mouse myeloma cell cultures. Intentional infections were established by inoculating Mycoplasma arginini, M. fermentans, M. hyorhinis and M. orale into cell cultures. Successful elimination of mycoplasmas was achieved with all strains tested by intraperitoneal passage in mice, however, cells infected with M. hyorhinis did not survive the infection long enough to be tested. Clindamycin and lincomycin cured cells infected with M. arginini, M. hyorhinis, M. orale but not M. fermentans. M. fermentans were resistant to all antibiotics tested, but could be partially suppressed by clindamycin long enough to permit curing by in vivo passage. M. arginini was eliminated by all antibiotics tested. In vivo passage and treatment with antibiotics is an efficient combination of methods for mycoplasma elimination from cell cultures and has the advantage of being simple and inexpensive. PMID- 2714818 TI - Use of whole parasite for quick screening of hybridomas against Leishmania donovani. PMID- 2714819 TI - Estimating lung mechanics of dogs with unilateral lung injury. AB - Extended least-squares algorithms using transpulmonary pressure and airway flow data from ventilatory waveforms were studied for their ability to track parameters of one- and two-compartment models of lung mechanics. A recursive extended least-squares algorithm with discounted measures estimated parameters of discrete-time models during synchronized intermittent mandatory ventilation. In tests on seven dogs developing oleic acid-induced unilateral hemorrhagic pulmonary edema, the one-compartment estimator responded rapidly and appropriately to changes in mechanics: compliance fell to 0.55 +/- 0.15 of its initial value and resistance rose by a factor of 1.8 +/- 0.5 in 3 h following injection of oleic acid. One-compartment parameter estimates revealed a difference between the airway resistance of inspiration and expiration. Two compartment estimates were seldom physiologically plausible. The difference between inspiratory and expiratory resistance may have caused the two-compartment estimator to fail when applied to data from the entire respiratory cycle; when only expiratory data were used for estimation, the two-compartment estimates were meaningful. These estimates demonstrated increasing lung inhomogeneity after oleic acid was injected; at the end of 3 h, the ratio of the time constants of the two compartments ranged from 5 to 20 in six of the seven dogs. We conclude that the one- and two-compartment estimates may be combined to provide a meaningful assessment of lung mechanics. PMID- 2714820 TI - A model of the maturation of respiratory control in the newborn infant. AB - A model of automatic neonatal respiratory control has been constructed as an aid in the investigation of a possible maturation in respiratory control loops during the newborn period. The primary objective was to provide a framework for investigating this hypothesis without the need for external stimuli or invasive measurements. Spontaneous sighs provide a physiological disturbance to the respiratory system by transiently altering the levels of the blood gases. The dynamic ventilatory response following such a disturbance was modeled. A change from a highly damped to less damped pattern was found when model parameter values were varied to mimic maturation in the neonatal period. A perturbation model analysis demonstrated the dynamic ventilatory response is most sensitive to factors affecting the gain of the peripheral chemoreflex loop. It is concluded that the model provides valuable insight into the hypothesis that the peripheral chemoreflex matures during the neonatal period and provides a viable method for testing this in the human infant. PMID- 2714821 TI - Development and evaluation of spectral classification algorithms for fluorescence guided laser angioplasty. AB - Laser angioplasty, or the ablation of atherosclerotic plaque using laser energy, has tremendous potential to expand the scope of nonsurgical treatment of obstructive vascular disease. Clinical laser angioplasty, however, has been hindered by an unacceptable risk of vessel perforation. Laser-induced fluorescence spectroscopy can discriminate atherosclerotic from normal artery and may therefore be capable of guiding selective plaque ablation. To assess the feasibility of utilizing spectral information to discriminate arterial tissue type, several classification algorithms were developed and evaluated. Arterial fluorescence spectra from 350 to 700 nm were obtained from 100 human aortic specimens. Seven spectral classification algorithms were developed with the following techniques: multivariate linear regression, stepwise multivariate linear regression, principal components analysis, decision plane analysis, Bayes decision theory, principal peak ratio, and spectral width. The classification ability of each algorithm was evaluated by its application to the training set and to a validation set containing 82 additional spectra. All seven spectral classification algorithms prospectively classified atherosclerotic and normal aorta with an accuracy greater than 80 percent (range: 82-96 percent). Laser angioplasty systems incorporating spectral classification algorithms may therefore be capable of detection and selective ablation of atherosclerotic plaque. PMID- 2714822 TI - Induction of hyperthermia using an intracavitary multielement ultrasonic applicator. AB - In this paper, the possibility of inducing controlled hyperthermia in rectal or vaginal wall tumors using an intracavitary ultrasonic applicator was investigated. A computer model that took into account the thermal and ultrasonic properties of tissues and surface cooling was used to optimize the transducer parameters to obtain desirable temperature distributions for different perfusion situations in the tumor. Also, an applicator that consisted of a cylindrical array of five independently controllable ultrasonic transducers was developed. This array was then tested in degassed water to determine the functional characteristics. This same applicator, modified to include water cooling of the tissue surface, was tested in vivo in dogs. The temperature distributions were found to be promising and with modifications this approach will be used in clinical treatments of suitable tumors. PMID- 2714823 TI - An adaptive approach to spectral analysis of pattern-reversal visual evoked potentials. AB - A method for spectral analysis of pattern-reversal visual evoked potentials (PRVEP's) is presented that results in spectral peaks of uniform width in the frequency domain for signals with a wide range of time-domain duration. Uniformity of spectral peak width is necessary for accurate comparison of spectra. The desired frequency domain characteristics can be achieved through the application of "tunable" data windows prior to transformation. The Io-sinh (Kaiser), Gaussian, and cosine-taper (Tukey) windows were evaluated as to their ability to produce power spectra with uniform spectral peak width. Objective comparison of power spectra is based on the "spectral parameter," which is a numerical index of power distribution. Application of the method to PRVEP waveforms of normal subjects (N = 20) and to a population of Alzheimer's Disease patients (N = 15) showed the Io-sinh window to be the most effective method, yielding correct classification of all normal and abnormal subjects. The Gaussian window also performed well, with only two misclassifications. Use of the rectangular window resulted in seven misclassifications. The tapered-cosine window was very limited in its applicability, and was about equal in performance to the rectangular window. PMID- 2714824 TI - Adaptive Fourier estimation of time-varying evoked potentials. AB - An estimation procedure for dealing with time-varying evoked potentials is presented here. The evoked response is modeled as a dynamic Fourier series and the Fourier coefficients are estimated adaptively by the least mean square algorithm. Approximate expressions have been developed for the estimation error and time constant of adaptation. A procedure for optimizing the estimator performance is also presented. The effectiveness of the estimator in dealing with simulated as well as actual evoked responses is demonstrated. PMID- 2714825 TI - The combination method: a numerical technique for electrocardiographic calculations. AB - This paper presents a method for electrocardiographic and other bioelectric calculations combining the Green's function boundary integral technique with the finite element method. Both the boundary integral method and the finite element method have been used extensively in electrocardiography for calculating epicardial and torso potentials. The boundary integral method is well suited for finding potentials in regions of isotropic conductivity and is computationally efficient, requiring unknown potentials to be calculated on the bounding surfaces only. It also compares favorably in accuracy with the finite element method in those regions. The finite element method is used in solving for potentials in regions of anisotropic conductivity since no simplifying assumptions or transformations of anisotropic regions into isotropic regions before solution are required. Combining the two methods, using the boundary integral method in isotropic regions and the finite element method is anisotropic regions, allows the advantages of both methods to be exploited. PMID- 2714826 TI - Electrical analogs for monitoring vascular properties in artificial heart studies. AB - The problem of choosing parametric descriptions of the systemic vascular bed suitable for monitoring beat-to-beat changes in peripheral vascular properties is considered. Three simple models with two, three, and five elements are compared, essentially exploiting the Akaike information criterion combined with reasonable requirements for estimate accuracy. Analysis of pressure data, which are either simulated by the five-element model or measured on a mock circulatory system during abrupt changes in peripheral resistance, suggests guidelines for model selection. In particular, the five-element model exhibits very close adherence to physical reality by allowing for reflection, while the classical windkessel model provides the most reproducible estimates. PMID- 2714827 TI - A transducer for detection of fetal breathing movements. AB - The paper describes a new transducer for detection of fetal movements and sounds from the maternal abdominal wall. This transducer is based on an inductive principle. The compliance of the transducer should match the compliance of the maternal abdominal wall in order to detect the very weak acoustic signal caused by individual fetal breathing movements. The contact area of the transducer is supported on a membrane, the tension of which can be adjusted so as to match the compliances of tissue and transducer. The goal of this paper is to investigate detection of fetal movements in order to monitor fetal condition and motility. The more specialized field of investigating fetal heart rate variability by studying the relationship between fetal breathing movements and fetal heart rate may become of more interest in the future. The inductive phonometer (INPHO) shows a flat (+/- 1.5 dB) frequency response between 0.2 and 200 Hz which is not affected by the compliance adjustment. Some in vivo measurements have been performed. The transducer signal is stored on a 20MB hard disk of an Olivetti M24 Personal Computer (PC) simultaneously with a control signal indicating the presence of breathing movements. Ultrasound imaging is exclusively used for verification of breathing movements. The images are stored on videotape simultaneously with control signals from the PC for synchronization of data and image. Substantial digital filtering is necessary to discriminate between actual breathing movements and other fetal activities. It is shown that optimal adjustment of the transducer's compliance to that of the maternal abdominal wall is possible and that individual breathing movements can indeed be measured. PMID- 2714828 TI - Optimal insulin infusion resulting from a mathematical model of blood glucose dynamics. AB - Mathematical optimization techniques are applied to a simplified mathematical model of blood glucose dynamics to derive insulin infusion programs for the control of blood glucose levels in diabetic individuals. Two particular cases are discussed. First, the insulin infusion program which results in an initially high blood glucose level being reduced to acceptable levels. Second, the control of blood glucose levels following a meal, prior to which blood glucose and net blood glycemic hormone were at their fasting levels. PMID- 2714829 TI - Development of a three-channel, 24-h ambulatory esophageal pressure monitor. AB - We have developed a three-channel ambulatory esophageal pressure monitor and tested it with a series of 24-h studies. The monitor is a battery-operated, microprocessor-based device that measures pressures from three transducers positioned in the esophagus, stores the data in its memory, and transfers the data to an IBM PC computer system at the end of the recording period. Programs on the PC then analyze the data and identify contractile events, categorizing them according to specific parameters. Other programs display the pressure waveforms on the PC and allow visual inspection of the entire recordings or, alternatively, of particular events of interest. The system detects contractile abnormalities in patients with intermittent, noncardiac chest pains. We tested the system on ten normal subjects and found a relatively high incidence of what are usually considered "abnormal" contractions. PMID- 2714830 TI - An improved buffer for bioelectric signals. AB - We propose an ac-coupled amplifier that offers a high input impedance, thus making it suitable for bioelectric signal amplification. We also present the necessary formulas for calculating its input impedance and transfer function in order to facilitate its adaptation to different applications. PMID- 2714831 TI - Two-dimensional Fourier spectrum of QRST integral maps in classification of patients prone to ventricular arrhythmia. AB - Two-dimensional Fourier spectra of QRST integral maps, obtained by body surface potential mapping, were analyzed to identify subjects prone to ventricular arrhythmia, when they have not been identified by the extrema count method. The diagnostic performance (84.38 percent) of the peak value of the Fourier spectrum as a classifier for subjects prone to ventricular arrhythmia showed an improvement of 3.65 percent over the use of the extrema count method as a classifier. PMID- 2714832 TI - Bispectral analysis of the rat EEG during various vigilance states. AB - Bispectra were computed to detect phase coupling in the cortical and hippocampal EEG of the rat during various vigilance states. For EEG's recorded from the hippocampus, significant phase coupling was obtained during REM sleep between the frequency components (6-8 Hz) associated with theta rhythm. PMID- 2714833 TI - [Induction of remission in severe lupus erythematosus by intensified therapy]. AB - 11 patients with severe SLE were treated with plasmapheresis and subsequent pulse cyclophosphamide. In all patients rapid improvement was observed. After another 6 months of immunosuppression any treatment was withdrawn. The remissions remained stable in 6/8 patients during the follow-up period of 7-33 (mean: 21) months. PMID- 2714834 TI - [Immunoprint technic: a new method for planned production of allergen-specific monoclonal antibodies]. AB - Working on the isolation of allergens from crude pollen extracts we were looking for a simple method to produce monoclonal antibodies (mab) specific for a major allergen of cultivated rye (S. cereale) with an isoelectric point (pl) of 5.9. We used immunization with allergen isolated from nitrocellulose blots. Allergen was obtained by isoelectric focusing (IEF) of a rye pollen extract followed by immunoprint and detection of allergen bound to nitrocellulose by a monoclonal antibody (mab). Fusion with myeloma cell line P3X63Ag8.U1 led to production of 7 different mab specific for the protein with pl 5.9. The method seems to be a simple way to produce mab specific for a certain component of a crude protein mixture as a pollen extract. PMID- 2714835 TI - [An unusual slow course of systemic vasculitis with multiorgan involvement]. AB - This paper reports on an unusually slowly progressing course seen in systemic vasculitis of the median and smaller arteries and small veins associated with dermatomyositis, chronically active hepatitis, glomerulonephritis of the immune complex and restrictive cardiomyopathy in a 35-year-old patient. The authors discuss the difficulties in establishing the diagnosis and in finding the exact classification of this disease. PMID- 2714836 TI - [Farmer's lung: IgG-subclass reactivities against thermophilic actinomycetes]. AB - IgG subclass reactivities of patients suffering from farmer's lung, healthy family members and blood donors were tested for specific binding to Micropolyspora faeni extract by means of immunoblot techniques (IEF-Print, Western Blot). In patients' sera IgG1 and IgG2 had shown the strongest reactivities while IgG3- and IgG4-reactivities were not found in all cases. Strong IgG2-reactivities against acidic proteins (pl 3-5) of M. faeni seem to distinguish between patients and exposed or not exposed controls, respectively. PMID- 2714837 TI - [Heterogeneity of natural killer (NK) cells in the human spleen]. AB - Natural killer (NK) cells in the human spleen represent a population of 25% of splenic lymphocytes. They are mainly located in the red pulp. In this compartment they resemble blood NK-cells in function and phenotype. Within the lymph follicles only a small subset is detected, expressing a particular phenotype. PMID- 2714838 TI - Functional characteristics of veiled cells from canine prenodal lymph. AB - The surgical interruption of afferent lymphatics in the hind limb of dog leads to peripheral lymph stasis. The stagnated lymph contains large numbers of immunocompetent cells originating solely from the skin. This experimental model allows a study of the functions of the afferent skin-draining lymph cell population, the recovery and assessment of the lymphokines and other mediators liberated by these cells during the culture, and the production of anti-sera against different types of lymph cells. In the present study, we focused on the functional, morphological and cytochemical evaluation of the non-lymphoid cells, isolated from the whole lymph cell population by means of the gradient centrifugation technique. The non-lymphoid cells were large, with an irregularly shaped nucleus and numerous cytoplasmic projections, giving them a "veiled" cell (VC) appearance. All VC were strongly positive for DLA-class II antigens and membrane-associated ATP-ase, and 60% of them exhibited the activity of non specific esterase. In the functional assays, VC displayed the potent accessory cell activity in the mitogen-induced response of autologous blood- and lymph derived lymphocytes. In the mixed leukocyte cultures, VC acted as stimulators of the allogeneic and autologous lymphocyte proliferation. The high spontaneous and mitogen-induced responsiveness of the whole lymph cell population was found to be dependent on the presence of VC. The small number of VC (5% of cultured cells) was sufficient to produce the above-mentioned effects. These results indicate that VC is a cell responsible for the antigen presentation in the skin-associated immune reactions in dog, which is relevant to the observations on similar cells from the other species. PMID- 2714839 TI - Priming of systemic and local delayed-type hypersensitivity responses by feeding low doses of ovalbumin to mice. AB - We have examined the effects on both systemic and intestinal immunity of feeding different doses of ovalbumin (OVA) to mice. A single feed of doses of more than 1 mg OVA produced significant suppression of subsequent delayed-type hypersensitivity (DTH) and IgG antibody responses. Feeding 100 micrograms-1 mg OVA had no net effect on systemic immunity, but mice fed 10-50 micrograms OVA had consistently enhanced systemic DTH responses when immunized subsequently with OVA in adjuvant. Oral challenge of these mice with OVA produced alterations in mucosal architecture and in intra-epithelial lymphocyte counts, consistent with the presence of an intestinal DTH response. Similar changes were not found in mice fed tolerogenic doses of OVA. Although feeding low doses of OVA primed both systemic and intestinal DTH responses, this had no effect on serum IgG responses and very little systemic DTH could be revealed in OVA-fed mice without systemic challenge with OVA in adjuvant. We conclude that feeding certain low doses of protein antigens can induce priming of local and systemic DTH responses rather than the immune tolerance which is normally found. The development of clinical food hypersensitivities may be highly dependent on the dose of dietary antigen at the time of first encounter. PMID- 2714840 TI - Rapidly decreased serum IgG to Campylobacter pylori following elimination of Campylobacter in histological chronic biopsy Campylobacter-positive gastritis. AB - The anaerobic bacterium Campylobacter pylori (Cp) is thought to be associated with chronic gastritis. This paper presents clinical data underpinning this view. Five patients with histological chronic gastritis as determined by diagnostic endoscopy, which was associated with Cp as determined by positive biopsy cultures, all possessed statistically raised serum IgG ELISA titers to Cp during a longitudinal period of observation of 15 months. Treatment with the antibiotics amoxycillin (clamoxyl) or colloidal bismuth subcitrate (denol) eliminated Cp within one month. Associated with this, serum IgG ELISA titers were found to decrease sharply and rapidly. Tagamet and spiramycin had little effect. Although the data are preliminary, they support the assumed Cp involvement in chronic gastritis and suggest that specific serum IgG ELISA titers to Cp are useful parameters in monitoring disease status, exceeding bacteriological culture of biopsy specimens in speed and convenience. PMID- 2714841 TI - Low incidence of null alleles of the fourth component of complement (C4) in elderly people. AB - Allotype frequencies of three complement proteins (C2, factor B, and C4) encoded on the sixth chromosome were tested in 150 "young" (under 53 yrs) and 131 "old" (over 62 yrs) healthy Hungarian individuals. In women, we found significant differences in BF*F allotype frequencies between the two age groups. A marked decrease of null alleles for C4 was observed especially in men. In the "old" age group, the total frequency of the non-expressed, "null" (Q0) alleles of the C4 protein dropped to almost one third of the "young" ones. The decrease was even larger (a 5.5-fold decrease in the incidence) among men. The relative risk of those having C4B*Q0 allele not to survive a "critical age period" of 53-62 yrs for males and 58-62 yrs for females was calculated to be 12.4 and 2.85, respectively. Our data substantiate the view that the expected life time is genetically determined and it can be forecast partly by the analysis of the antigens encoded on the sixth chromosome. PMID- 2714842 TI - Localization of the cell activator lipopeptide in bone marrow-derived macrophages by electron energy loss spectroscopy (EELS). AB - Synthetic lipopeptide analogues of bacterial lipoprotein constitute potent polyclonal activators for monocytes/macrophages and B lymphocytes. However, the fate of the lipopeptides after their interaction with target cells is as yet unknown. In order to follow the routes and to determine the distribution of the lipopeptide within macrophages after stimulation, we investigated lipopeptide stimulated bone marrow-derived macrophages using the novel method of electron energy loss spectroscopy (EELS). Our results show that the lipopeptide was present in different compartments of the cell. The major amount of the activator was located within the cytoplasm and the plasma membrane, and minor quantities were detected within the nuclear membrane and the nucleus. The distribution of the lipopeptides varied depending on the duration of stimulation. Our results should help to elucidate the molecular mechanisms of macrophage stimulation by lipopeptides or other cell activators. PMID- 2714843 TI - Effects of a purified cecropin D from a Chinese silk moth on growth, function and differentiation of murine hemopoietic cells. AB - The effects of cecropin D, a small basic peptide isolated from a Chinese oak silk moth, on the functions or differentiation of mammalian hemopoietic cells are described in the present paper. This peptide suppressed lectin-induced DNA synthesis of murine splenocytes in a dose-dependent manner without any significant cytotoxic effects. It also exhibited inhibitory effects on antibody production in lipopolysaccharide-stimulated lymphocytes and on colony formation of hemopoietic progenitor cells in plasma clots culture. These results indicate that cecropin D can regulate growth, function and differentiation of murine hemopoietic cells. The biological significance of this finding is discussed from the comparative immunological point of view. PMID- 2714844 TI - The viability of mononuclear phagocytes in vitro is diminished by the interaction of cells with serum proteins bound to the culture substratum. AB - The long-term viability of bone marrow-derived mononuclear phagocytes in vitro was inversely correlated with the capacity of the cells to attach to the culture substratum. Mononuclear phagocytes suspended in medium containing 10% fetal bovine serum and subcultured on substrata coated with a 0.1% solution of poly(2 hydroxyethyl methacrylate) formed a population of non-adherent or loosely attached cells that remained viable for a 7 day incubation period. In contrast, cells subcultured under otherwise identical conditions on substrata optimal for cell attachment exhibited a 40-fold decline in cell number during the same period of time. The survival of mononuclear phagocytes subcultured under conditions which promoted cell attachment was increased by reducing the concentration of serum in the medium. Thus, cells subcultured 7 days in the complete absence of serum exhibited only a two-fold decline in cell number. However, mononuclear phagocytes subcultured in the absence of serum exhibited a ten-fold decline in cell number when cultured on substrata coated with serum proteins. This decline was reversed by the addition of the mononuclear phagocyte-specific growth factor, colony stimulating factor-1 (CSF-1) to the medium. These results indicate that serum proteins bound to the culture substratum exert a significant influence on the viability of adherent mononuclear phagocytes in vitro and on the requirement of cells for CSF-1 in order to survive. PMID- 2714845 TI - Cytotoxic endothelial cell antibodies in mixed connective tissue disease. AB - We examined the presence of anti-endothelial cell antibodies in the sera of 44 patients with mixed connective tissue disease (MCTD). Warm antibodies against endothelial cells were found in 45.4% of patients; the presence of these antibodies was positively correlated with anti-monocyte antibodies (P less than 0.01) but not with anti-lymphocytic antibodies. Strong correlations were found between the presence of these antibodies and abnormalities of pulmonary ventilatory capacity, neurophysiologic and myocardial function. Anti-endothelial antibodies were related to the high rate of spontaneous abortion noted in female MCTD patients. The identification of the antigen identified by MCTD sera in endothelial cells would help in understanding disease manifestations. PMID- 2714846 TI - Influence of factor D concentrations on fluid phase C3 activation, lysis of rabbit erythrocytes and solubilization of immune complexes. AB - Factor D depleted serum did not support hemolysis of rabbit erythrocytes and solubilization of performed immune complexes. Fluid phase C3 cleavage increased in a dose dependent manner when D protein was added to normal or to factor D depleted serum. During short incubation factor D concentrations were correlated with the capacity of serum to solubilize immune complexes and to lyse rabbit erythrocytes. With prolonged incubation, the hemolytic activity decreased in a factor D dose dependent manner. This was probably due to fluid phase breakdown of C3 and factor B in the presence of high factor D concentrations. Hypocomplementemic sera from patients with active systemic lupus erythematosus (SLE) did not support solubilization of bovine serum albumin (BSA) anti-BSA complexes when factor D was added in excess. Patients with polycystic kidney disease with reduced renal function and high factor D concentrations showed increased concentrations of circulating C3d/dg fragments. The possibility was considered that high factor D concentrations in uremia might promote fluid phase C3 degradation and thereby limit the in vivo efficiency of alternative pathway activation on target surfaces. PMID- 2714847 TI - Immunoadjuvant action of liposomes: comparison with other adjuvants. AB - Dehydration-rehydration vesicles (DRV liposomes) composed of equimolar phospholipid and cholesterol and containing bovine serum albumin (BSA) were used together with free BSA to immunize Balb/C mice. Primary and secondary immune responses (IgG1) to the liposomal antigen, as measured by ELISA in mouse sera, were similar for egg phosphatidylcholine (PC) and distearoyl phosphatidylcholine (DSPC) DRV, and much greater than those elicited by free BSA. The adjuvanticity of PC DRV was compared with that of aluminium salts (alum), complete Freund's adjuvant (CFA) and N-acetyl muramyl-L-threonyl-D-isoglutamine ([Thr1]MDP), the latter used as such or in a liposome form co-entrapped with the antigen. DRV (with or without co-entrapped [Thr1]MDP), and alum were equally strong in producing primary and secondary immune responses (IgG1) to BSA. Such responses were significantly higher than those achieved with CFA and [Thr1]MDP alone. The implications of these results for the potential role of liposomes as immunological adjuvants in vaccines are discussed. PMID- 2714848 TI - Cross-reactivity of mouse monoclonal antibodies produced by in vitro or in vivo immunization. AB - The effect of different immunization schemes on the resulting antibody specificity was investigated. The cross-reactivity of monoclonal antibodies produced by in vitro vs. in vivo immunization was tested, using a solid phase enzyme immunoassay. Ten different monoclonal antibodies were tested against 15 different antigens. There was no difference in cross-reactivity between the two types of antibodies when tested against antigens coated onto the plastic wells in a buffer solution. When the antigens were dried onto the plastic wells the IgM monoclonal antibodies produced by in vitro immunization exhibited a somewhat different reactivity pattern. However, the assay design was shown to be of more importance than the immunization procedure when determining antibody specificities. PMID- 2714849 TI - Human embryo associated immunosuppressor factor(s) from pre- and post implantation stages share some similarities. AB - The present study demonstrates that embryo associated immunosuppressive factor(s) (EASF) secreted by the human embryo at pre- and post-implantation stages share some similarities. Human EASF was partially purified from embryo growth media of in vitro fertilized ova and from first trimester pregnancy sera. Non-pregnancy sera were fractionated in parallel. During each step of purification the fractions were tested for immunosuppressive properties using concanavalin A stimulated lymphocyte proliferation assay. Analysis of EASF positive fractions on SDS-PAGE identified 14 kDa and 24 kDa molecules in embryo growth media and pregnancy sera. No such molecules were found in control sera, suggesting that these factors are embryo associated. The relationship of pre- and post implantation EASF was also analyzed by EASF binding assay using murine anti-EASF antibody, which was raised against EASF isolated from embryo growth media. Results show that murine antibody bound to EASF purified from pregnancy sera, but not to identical fractions from control sera, indicating that these post implantation EASF possess some similarity with pre-implantation EASF. Results also indicate that a species of suppressor factors present in embryo growth media and pregnancy sera were unique for their origin. Presence of these three EASFs at various stages of gestation may play a role in suppressing maternal cellular immune responses thereby preventing maternal rejection of the embryo. PMID- 2714850 TI - Cells carrying C5b-9 complement complexes in human atherosclerotic wall. AB - Fibrous plaques and intimal thickenings of 5 femoral and 5 iliac human arteries obtained at surgery were processed for indirect and double-labeling immunoelectron microscopy using an affinity purified rabbit IgG anti-C5b-9 neoantigen and the EBM 11 monoclonal antibody anti-human macrophages. The C5b-9 complexes were localized in intact cells, disintegrated cells and cell debris enmeshed in the connective tissue matrix. Some of the cell debris bearing C5b-9 deposits was found to be of macrophage origin. Endocyted or exocyted pieces of membrane with pore-forming C5b-9 complexes were also identified. Damage of cells by complement in atherosclerotic lesions may contribute to atherogenesis. PMID- 2714851 TI - Identification of a tumour factor inducing resistance to NK cell lysis. AB - The mechanisms involved in the resistance or susceptibility of tumour cells to NK cytotoxicity are poorly understood. The role of different molecules on the target cell surface which could act as recognition elements by NK effectors has been postulated. However, there are also some tumour cell lines which release factors capable of inhibiting NK cytotoxicity. This paper presents a new factor (NK-RIF), produced and released by different tumour cell lines, making K562 resistant to NK lysis without affecting the cytotoxic function of NK effector cells. This soluble factor is shown to be thermolabile, non-dialyzable and to have a molecular weight of 36,000 daltons. It does not block the binding capacity of the target and effector cells, nor does it affect target susceptibility to LAK or cytotoxic T cells. PMID- 2714852 TI - Allelic variation in HLA-B and HLA-C sequences and the evolution of the HLA-B alleles. AB - Several new HLA-B (B8, B51, Bw62)- and HLA-C (Cw6, Cw7)-specific genes were isolated either as genomic cosmid or cDNA clones to study the diversity of HLA antigens. The allele specificities were identified by sequence analysis in comparison with published HLA-B and -C sequences, by transfection experiments, and Southern and northern blot analysis using oligonucleotide probes. Comparison of the classical HLA-A, -B, and -C sequences reveals that allele-specific substitutions seem to be rare events. HLA-B51 codes only for one allele-specific residue: arginine at position 81 located on the alpha 1 helix, pointing toward the antigen binding site. HLA-B8 contains an acidic substitution in amino acid position 9 on the first central beta sheet which might affect antigen binding capacity, perhaps in combination with the rare replacement at position 67 (F) on the alpha 1 helix. HLA-B8 shows greatest homology to HLA-Bw42, -Bw41, -B7, and Bw60 antigens, all of which lack the conserved restriction sites Pst I at position 180 and Sac I at position 131. Both sites associated with amino acid replacements seem to be genetic markers of an evolutionary split of the HLA-B alleles, which is also observed in the leader sequences. HLA-Cw7 shows 98% sequence identity to the JY328 gene. In general, the HLA-C alleles display lower levels of variability in the highly polymorphic regions of the alpha 1 and alpha 2 domains, and have more distinct patterns of locus-specific residues in the transmembrane and cytoplasmic domains. Thus we propose a more recent origin for the HLA-C locus. PMID- 2714853 TI - Isolation and expression of a cDNA clone encoding HLA-Cw6: unique characteristics of HLA-C encoded gene products. AB - The HLA-C encoded gene products display several characteristics which distinguish them from HLA-A and -B. The HLA-C antigens are poorly expressed on the cell surface, they display multiple proteins with different isoelectric points, and alloimmunization to HLA-C antigens is less common. To investigate whether the multiple products result from differential splicing of HLA-C gene transcripts, we have isolated a full-length cDNA clone encoding the Cw6 antigen. Class I antigens produced by the cDNA clone in transfected cells were of the same relative mass as those observed in the parental cells when analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Isoelectric focusing (IEF) gel analysis of the cDNA translated products in transfectants revealed multiple IEF bands. All IEF bands detected in the transfectants were also found in the parental cells, indicating that the multiplicity of the C-locus products was not due to differential splicing of HLA-C gene transcripts, but was probably due to post translational modification. Comparison of the sequences of C-locus alleles with those of A and B alleles did not show any apparent sequences which would generate multiple IEF bands. Comparison of the coding regions for seven HLA-C alleles and one HLA-C-related class I gene with available data for 15 HLA-A and 20 HLA-B alleles demonstrated several unique features for the HLA-C locus. Six sites in the extra cellular domains, three in a1 and three in a3, were unique. While the cytoplasmic (CP) domain of HLA-A and -B are almost identical, the CP of HLA-C alleles is unique. Similar unique features of HLA-C are also observed in the transmembrane domain, resulting in locus-specific residues between positions 295 and 300. The present study has ruled out differential mRNA splicing as a mechanism for the multiplicity of Cw6 antigens and demonstrated unique HLA-C locus sequences. PMID- 2714854 TI - Trans-regulatory genes affect Slpa and Slpo expression and act in a tissue specific manner. AB - The plasma protein C4 and its androgen-dependent homologue Slp are encoded by genes located in the mouse major histocompatibility complex, H-2. The C4 and Slp protein levels and liver mRNA levels are influenced by non-H-2-linked regulatory genes. The allele-specific regulation of C4 expression and the androgen regulation of Slp expression are manifest only in some of the tissues where these genes are expressed. Therefore, we studied tissues in which the effects of the non-H-2 regulatory genes are apparent. We show that these genes only affect the Slp expression in tissues where it is androgen-dependent. This indicates that the non-H-2 regulatory genes most likely act through interaction with the androgen regulation of Slp expression. We also show that liver cells of mice with the Slpo allele, which do not produce Slp protein, do express Slp mRNA; this expression is also androgen-induced and regulated by non-H-2 genes. Thus, both the Slpa and Slpo alleles appear to be regulated in the same way. PMID- 2714855 TI - Sequence polymorphism of HLA-DP beta chains. PMID- 2714856 TI - Sequence analysis of the C3H H-2K1k gene: relationship to the H-2 loci. PMID- 2714857 TI - Etiology of acute hepatitis superimposed on hepatitis B surface antigen carriage. PMID- 2714858 TI - Nonvalue of antigen quantitation in diagnosis of Haemophilus meningitis. PMID- 2714859 TI - The use of ethylene oxide and low temperature steam/formaldehyde in hospitals. AB - Reprocessing of heat-labile medical equipment is a major problem in hospital practice. Requirements are either for sterilization, e.g. cardiac catheters, or disinfection, e.g. respiratory equipment. Methods of low temperature sterilization include ethylene oxide, low-temperature steam and formaldehyde (LTS/F) and immersion in 2% glutaraldehyde. Ethylene oxide is reliable, but potentially toxic. LTS/F machines operate at a high temperature, but treated equipment needs less aeration. The advantages of these processes and possible alternatives are discussed. PMID- 2714860 TI - Four-year experience with a recombinant hepatitis B vaccine. AB - Three hundred and forty-three healthy adults were vaccinated with five different lots of recombinant hepatitis B vaccine. Three hundred and forty (99.1%) individuals produced antibodies against hepatitis B surface antigen (anti-HBs). Peak anti-HBs concentrations were significantly higher in females and younger individuals. All anti-HBs positive individuals developed antibodies to the common determinant "a" of HBsAg. The vaccine was well tolerated, without severe side reactions. Persistence of anti-HBs was followed in 130 individuals for 3, and in 15 for 4 years after the first vaccination of these two groups. 21.7% and 32.3%, respectively, no longer had protective levels of anti-HBs after this time. The persistence of anti-HBs was dependent on peak anti-HBs levels, with consistent kinetics of anti-HBs decline. Revaccination of individuals whose specific antibody levels had fallen below 10 IU/l led to a prompt anti-HBs response. Comparison with individuals vaccinated with plasma-derived hepatitis B vaccine revealed no substantial differences between the two vaccines. PMID- 2714861 TI - The effects of an occlusive zinc medicated dressing on the bacterial flora in excised wounds in the rat. AB - The effects of three different dressings - two occlusive and one non-occlusive - on the bacterial flora of excised wounds in rats were studied. The number of colony forming units per gram of granulation tissue were significantly lower 4, 8 and 12 days postoperatively in wounds treated with a zinc medicated occlusive dressing compared with wounds treated with non-zinc medicated occlusive hydrocolloid dressing or wet-to-dry non-occlusive gauze dressing. The minimum inhibitory concentration (MIC) of zinc sulphate was determined on different strains of bacteria isolated from the wounds of rats and on strains isolated from humans. The most susceptible species isolated from both rat wounds and humans were Streptococcus sp., STaphylococcus aureus and Escherichia coli; whereas, Proteus and Enterococcus sp. had higher MIC-values. In vitro, the hydrocolloid dressing disclosed no antibacterial effects. If the practitioner prefers an occlusive dressing we believe, due to our animal and in vitro experiments, that the zinc medicated occlusive dressing will reduce the risk of wound infection in man. PMID- 2714862 TI - Clinical experience with pefloxacin in the therapy of typhoid fever. AB - Thirty hospitalized patients (22 men and eight women), aged between 15 and 41 years (mean = 25.4 years), with severe proven typhoid sepsis were treated with pefloxacin at daily dose of 1200 mg, divided in three doses, intravenously for the first five days and orally for the following ten days of treatment. All patients completely recovered from infection and pathogens were eradicated after 30 days of follow-up. In none of the patients was a relapse registered during the follow-up or enteric carrier state after disease. Pefloxacin therapy was well tolerated by all patients: in five patients a mild and transient epigastric pain and in one patient a mild and transient nausea were registered. Pefloxacin is a safe and effective agent for therapy of typhoid fever. PMID- 2714863 TI - Mycobacterium kansasii and Pneumocystis carinii pneumonia in a patient with the acquired immunodeficiency syndrome. AB - The case of a Swiss AIDS patient suffering from Mycobacterium kansasii lung disease is described. The course of the illness was complicated by Pneumocystis carinii pneumonia. Therapy with isoniazid, ethambutol, clofazimine, ciprofloxacin and, after the onset of P. carinii pneumonia, trimethoprim-sulfamethoxazole led to a rapid and sustained clinical recovery of the patient. PMID- 2714865 TI - [Anaphylactic shock following administration of an infusion solution containing fructose?]. AB - A sixty-seven year old female patient who received post-operatively an i.v. infusion of Sterofundin I, suffered an anaphylactic shock with cyanosis, dyspnoea and progressive hypotension. Over a period of 90 min there were ECG changes similar to acute posterior myocardial infarction and arrhythmias (total AV-block with high compensative rate). This could be due to circulatory shock but more probably to a transitory coronary spasm. Clinical signs and symptoms exclude a hereditary fructose intolerance because of case history and blood results as well as complications described in the literature due to low dosage of fructose. An intracutaneous test confirmed a hypersensitivity of fructose-containing i.v. infusion. PMID- 2714864 TI - Antimicrobial prophylaxis of experimental endocarditis caused by Staphylococcus epidermidis. AB - Using two different strains of Staphylococcus epidermidis in a rat model of experimental endocarditis, we examined the prophylactic efficacy of cefamandole (200 mg/kg/dose), cefazolin (200 mg/kg/dose), nafcillin (200 mg/kg/dose), and vancomycin (20 mg/kg/dose). In vitro susceptibility testing demonstrated that both test strains were resistant to methicillin and cefazolin and susceptible to cefamandole and vancomycin. A 10(6) cfu inoculum was used for both strains, an inoculum which produced endocardial infections in greater than 90% of rats. Initial doses of each antibiotic were given 45 min to 1 h prior to bacterial challenge and were followed by six additional doses of each antibiotic administered subcutaneously every 6 h. The efficacy rates of cefamandole (84.0%) and cefazolin (70.8%) were exactly the same for rats infected with either S. epidermidis strain. Similar efficacy rates were seen in rats infected with either strain and treated with vancomycin (94.4% and 86.7%). Unlike the other three drugs, the efficacy of nafcillin was quite different in rats challenged with the two strains (62.5% and 38.5%, p = 0.19). It appears that cefamandole and cefazolin may have considerable prophylactic efficacy against certain infecting strains of methicillin-resistant, coagulase-negative staphylococci when relatively large doses of cephalosporins are administered subcutaneously in this animal model. PMID- 2714866 TI - Changes in creativity with age: data, explanations, and further predictions. AB - Changes in creativity with age, it is argued, seem very probable. A variety of personal qualities usually found in creative people are examined. While conclusive evidence is sometimes lacking, it seems likely that most of these would change with age so as to affect creative productivity, usually adversely. Moreover, many theories of creativity representing a variety of intellectual traditions are discussed, and most of these predict aging decrements of some sort. However, it is also suggested that the creativity decline may vary, being more pronounced a) when the attribute of originality is predominant, b) in the sciences, as opposed to the arts and humanities, c) when certain motives, notably self-expression and sublimation of sexuality, are operative, and d) for male as compared to female creators. Finally, creativity may simply change rather than decline with age, with differing stylistic and thematic concerns gaining priority. PMID- 2714867 TI - Age differences in coping: does less mean worse. AB - Previous research suggests that elderly people utilize fewer coping strategies than younger people. Some researchers suggest that these quantitative changes reflect decreases in the use of maladaptive strategies; others contend that they reflect decreases in the use of adaptive strategies by older adults. The present article reports the findings of three studies of coping in older people, two addressing coping with health problems, and the other addressing coping with moving. In all three studies, the number of self-reported coping strategies decreases with age. Results do not support the idea that decreases in the number of strategies imply decrements in the quality of coping, however: in two studies, age was unrelated to the effectiveness of strategies, in the third, effectiveness ratings were higher for older subjects. The need for evaluation of specific outcomes of coping strategies is discussed, along with the need for task-specific measurement of coping. It is proposed that decreases in the number of coping strategies reflect improved coping efficiency, rather than a deterioration of adaptational skills. PMID- 2714868 TI - Rural versus urban differences in health dependence among the elderly population. AB - This article examines data on rural versus urban differences in health dependency for a random sample of 600 western New York elderly people residing in a range of community settings from farm areas to a metropolitan central city. Data were collected via personal interviews, and health dependency was operationalized as an index composed of nine criterion measures. The nonmetropolitan elderly population is found to be less health dependent as are elderly persons who are younger, white, married, and have higher incomes. However, the rural/urban variable is not a significant predictor of health dependency when included in a multiple-regression analysis. These findings do not support the rural elderly health disadvantage argument and serve to illustrate some of the shortcomings of existing research on this topic. PMID- 2714869 TI - A prognostic score for subfertile men based on anamnestic data and semen variables. AB - Over a 4-year period, 259 men were investigated for primary (86%) or secondary (14%) infertility. Some 3-5 years after the initial investigation, 200 of these men were followed up and the conception rate of their partners assessed. Their age at investigation, total testicular volume, sperm density, sperm motility, percentage morphologically normal sperm and the duration of infertility all gave information about the prospects of conception. A stepwise discriminant analysis showed that the age of the men at investigation, sperm density, sperm motility and the duration of infertility all had a strong discriminant bearing on future conception. A score based on these four variables for the estimation of prognosis in 'subfertile' men has been devised and would seem to be clinically useful. PMID- 2714870 TI - Correlates of human sperm motility assessed by laser Doppler spectroscopy. AB - The sperm motility characteristics of 140 men (percentage motile and average velocity of all sperm in motion; percentage progressive and the average velocity of sperm swimming more than 15 microns/sec) were determined using a laser-Doppler technique and correlated with other aspects of sperm quality, including the concentration and the proportion of abnormal and dead sperm in the ejaculate. In addition, the influence of the length of the period of abstinence, the viscosity of seminal plasma and the volume of the ejaculate were also assessed. The four motility characteristics were all highly correlated with each other. The magnitude of all four parameters increased in an exponential fashion with increasing sperm number up to 400 x 10(6) per ejaculate. At higher numbers, no further improvement in motility was observed. Moreover, increasing sperm number was associated with a decline in the proportion of sperm exhibiting abnormalities in morphology but with an increase in viable sperm 30 min after ejaculation. The relative viscosity of the ejaculates had generally no influence on sperm motility. In contrast, certain of the sperm motility characteristics, including the average velocity, were significantly negatively correlated with the length of the abstinence period. PMID- 2714871 TI - Anejaculation following spinal cord injury does not induce sperm-agglutinating antibodies. AB - Antisperm antibodies were tested for by the MAR-test and the tray agglutination test in 16 men with spinal cord injury. None of these men could ejaculate without artificial methods. Seven men ejaculated externally by vibrator stimulation or electroejaculation, while seven exhibited retrograde ejaculation; in two cases no semen was obtained. Sperm density in the external ejaculations was high (average = 405 x 10(6)/ml), with 10-45% motility. None of these 16 men had antisperm antibodies. This result indicates that anejaculation and sperm retention in men with spinal cord injury, even of 30 years duration, does not result in antisperm antibody formation. PMID- 2714872 TI - Evaluation of the effect of selective germ cell depletion on subsequent spermatogenesis and fertility in the rat. AB - Rats were treated with a single high dose of methoxy acetic acid (MAA; 650 mg/kg) specifically to deplete seminiferous tubules of pachytene and later spermatocytes. The impact of this selective depletion on subsequent spermatogenesis, sperm output and fertility was then evaluated at intervals ranging from 3 days to 10 weeks. Cauda epididymal sperm number was reduced progressively beyond 2 weeks post-treatment and reached a nadir at 5-6 weeks (28 34% of control values) before recovering progressively back to control levels at 10 weeks. Sperm motility was reduced significantly at 4-7 weeks post-treatment with a nadir at 6 weeks (35% of control values). Thus, at 5-6 weeks after MAA treatment, motile sperm output was reduced by 82-88%. Despite these changes, there was little evidence for infertility in the majority of treated males during a serial mating trial. Evaluation of seminiferous tubule morphology combined with germ cell counts at stage VII of the spermatogenic cycle confirmed that, initially, MAA induced the specific loss of pachytene and later spermatocytes at all stages other than early to mid stage VII. Maturation depletion of germ cells at later intervals was consistent with the initial effects of MAA, although at 21 days post-treatment a number of unpredicted (? secondary) changes in spermatogenesis were observed. These were (a) a reduction in number of pachytene spermatocytes at late stage VII/early stage VIII, (b) retention of sperm at stages IX-XIV, and (c) increased degeneration of pachytene spermatocytes and round spermatids at stage VII and of secondary spermatocytes at stages XIV-I. Whilst none of these changes was severe, together they probably accounted for the unexpectedly prolonged drop in sperm output. It is concluded that whilst deleterious changes in spermatogenesis may occur secondarily following MAA treatment, for the most part spermatogenesis proceeds normally and fertility is largely maintained despite a massive but transient decrease in sperm output. PMID- 2714873 TI - Determination of Sertoli cell numbers in the developing rat testis by stereological methods. AB - Stereological studies were performed to determine the number of Sertoli cells present during the postnatal development of the rat testes. Sprague-Dawley rats aged from 1 to 70 days were used in two experiments, and in each were fixed by vascular perfusion and embedded in Epon-Araldite, subsequent to which 1 micron sections stained with Toluidine blue were prepared. In the first experiment, rats aged from 1 to 20 days were used in groups of three, and number estimates were made using a direct counting method. In the second, which used groups of four rats aged from 20 to 70 days, a point sampled intercept was used to estimate nuclear volume and thence number. The results of the experiments indicate that the newborn rat testis contains 1.3 +/- 0.2 x 10(6) Sertoli cells and that this number increases to 38.4 +/- 2.7 x 10(6) at day 15. No further increase in Sertoli cell number occurred thereafter up to day 70 of age. PMID- 2714874 TI - Identification and characterization of arginine vasopressin receptors in the clonal murine Leydig-derived TM3 cell line. AB - Specific arginine vasopressin (AVP) binding sites were identified and characterized using Leydig cell membranes prepared from a clonal murine Leydig derived cell line, TM3. 3H-AVP binding data analyses demonstrated that the radioligand binds to a high affinity, low capacity, homogeneous class of sites with a dissociation constant of 0.5 nM. Characterization of these AVP binding sites included competition studies. Displacement of 3H-AVP binding with high affinity by unlabelled AVP, LVP and the V1 antagonist, d(CH2)5Tyr(Me)AVP, indicated that the Leydig cell AVP receptor is of the V1 type. Furthermore, AVP did not increase adenylate cyclase activity in TM3 membranes, a finding consistent with the V1 type of AVP receptor. No competition with 3H-AVP was found with the V2 agonist, dVDAVP, or the selective oxytocin agonist, [Thr4,Gly7]oxytocin. No specific binding for oxytocin was found in Leydig cell membranes. No specific binding for either 3H-AVP or 3H-oxytocin was observed in membranes prepared from the Sertoli cell line or peritubular cell line. These findings indicate that murine Leydig cells have specific AVP binding sites of the V1 type. These AVP sites are not coupled to the adenylate cyclase system. PMID- 2714875 TI - Enhanced conception by stored porcine sperm stimulated with chloroquine. AB - The effect of chloroquine stimulation on the motility of porcine sperm stored for 6 h and on the subsequent conception rate was assessed. There was a drastic decline in sperm motility after 6 h storage at 4 degrees and 25 degrees C, and a concomitant depression in their conception rate. However, chloroquine stimulation restored these functions towards normal, especially in sperm stored at 25 degrees C. These observations, coupled with the stability of the litter size, regardless of treatment, suggest that chloroquine can be used in an artificial insemination programme involving the utilization of semen several hours after collection and some distance away from the source of the ejaculate. PMID- 2714876 TI - A comparison between different models of the relation between recorded intradental nerve impulse activity and reported pain in man. AB - In this study three different models of the relation between intradental nerve impulse activity (INA) and pain report, expressed by finger-span (FS), in man were investigated. The techniques were (i) a previously described mathematical model, (ii) the relation between the Areas of INA and FS and (iii) the relation between the Peaks of INA and FS. Their usefulness in 533 clinical experiments on 15 subjects were evaluated by means of a statistical analysis of the variability and accuracy of the models. It was shown that the mathematical model was the most accurate and stable method of the three different methods investigated. This was indicated by, among other things, a significantly smaller variability for the mathematical model within experimental sessions than between sessions. The two other methods were found to be of less scientific value since they had an undesired high variability within sessions, and also showed contradicting results during control conditions. PMID- 2714877 TI - A least squares algorithm to determine the mechanical time constant distribution of the lung during forced expiration. AB - A method to determine the mechanical time-constant distribution of the lung during a forced expiration manoeuvre is proposed. The method is based on a least squares algorithm constrained to give reasonably smooth non-negative solutions. The smoothing constraint was imposed by minimizing the second derivative of the distribution function in accordance with the physiological meaning of the time constant distribution. Nevertheless, the obtained solution depends greatly on the relative weights of the two terms in the objective function to be minimized i.e., the error on the fit of the volume signal and the smoothness of the distribution function. To select the optimum smoothing weight, a criterion based on the stability of the reconstructed distribution shape was defined. The performance of the algorithm and that of the defined criterion were evaluated by using simulated signals of forced expired volume. The error of reconstructed distributions was quantified by means of the area enclosed between this distribution and the original one used to generate the simulated volume signal. The results obtained showed that for all the analyzed signals: (1) There is a value of the weight of the smoothing constraint which gives rise to a solution that is optimum in a least squares sense. (2) The proposed stabilization criterion enables us to approach this optimum solution from experimental signals. PMID- 2714878 TI - A simulation support system for solving large physiological models on microcomputers. AB - Although physiological modeling and computer simulation have become useful research tools to test new scientific theories and to design and analyze laboratory experiments, developing a new model can be a tedious process because the investigator must often write very complex and specific routines for data input and output. To facilitate the design of new models (as well as the use of existing models), we have developed MODSIM, a FORTRAN-based simulation support system for the IBM PC computer than can accommodate very large dynamic models having up to several thousand equations. It provides the investigator with utilities for continuous on-line graphical and/or tabular output, as well as facilities for dynamic interaction with the model. The user must only supply a model as a list of mathematical equations written in FORTRAN, along with the initial values of the model variables and parameters. The model is precompiled, compiled, and then linked to the MODSIM utilities. Without further programming, the user can then solve the model, select variables for graphical output, and stop the model at any time to analyze the data or to change a parameter before resuming the simulation. This simulation system makes it very easy to develop new models that actively interact with the experimental research of the investigator. PMID- 2714879 TI - A program for simulation of nerve equations with branching geometries. AB - A computer program has been developed for simulation of electrical activity in neurons with complex branching morphology, multiple channel types, and inhomogeneous channel distribution. The program is based around an interpreter and screen editor for flexible specification of nerve properties and analysis of simulation results. Efficient simulation of the nerve specification is accomplished with procedure calls to fast, compiled routines for integration of the nerve equations. PMID- 2714880 TI - A case-control study of cancer of the esophagus and gastric cardia in Linxian. AB - A case-control study involving interviews with 1,244 patients (758 males and 486 females) with cancer of the esophagus or gastric cardia and 1,314 population based controls (789 males, 525 females) was carried out in Linxian, a rural county in North Central China with one of the world's highest mortality rates for these tumors. Cancer risks tended to rise with increasing intake of wheat and corn, but no association was found with adult intake of pickled vegetables, the leading a priori suspect, and risks were not elevated among those consuming low quantities of fresh vegetables or fruits. Few differences in preparation or storage of food or water were detected, although cancer patients reported less fluid intake than controls. Few persons reported drinking alcoholic beverages. Smoking was reported by 61% of the male cases and was a mild risk factor, related more to cancer of the cardia than of the esophagus. The risk was increased by 70% among those whose parents had esophageal or stomach cancer, but only slightly among those whose spouses had such cancers, suggesting that exposure early in life and/or genetic effects may be involved. PMID- 2714881 TI - Risk factors for cancer of the cervix in a rural Chinese population. AB - A population-based case-control study of 109 women with invasive squamous-cell cervical cancer and 545 controls matched for age and area of residence was carried out in Jingan, China, to evaluate the importance of different risk factors and the effect of cervical cancer screening. After controlling for the protective effect of cervical cancer screening, several factors were found to make an independent contribution to risk. These included the number of sexual partners of the subjects and their husbands (OR: 3.9 for 2 or more sexual partners other than the current spouse, relative to none; 5.9 for 2 or more other partners of the husband relative to none), and poor genital hygiene (OR: 4.8 for absence of daily genital washing relative to washing every day; 0.3 for use of sanitary napkin), these are consistent with an infectious etiology. In addition, menstrual characteristics also had a strong relationship to the risk of cervical cancer (OR: 2.2 for 4 or more days' menstruation relative to shorter duration; 5.4 for irregular menstruation). PMID- 2714882 TI - Centchroman--a non-steroidal anti-cancer agent for advanced breast cancer: phase II study. AB - Treatment with Centchroman (3,4-trans-2,2-dimethyl-3-phenyl-4-p-(beta pyrrolidinoethoxy) phenyl-7-methoxy chroman) has been evaluated in 4 male and 75 female patients with advanced breast cancer. The overall response rate, including both male and female cases, was 40.5%. Among the female patients, the overall response rate was 38.7%. The median duration of response was 6 months. One of the 4 male patients showed a complete response and 2 showed partial responses. The responses were more marked for bone, pulmonary, soft tissue, skin and lymph-node metastases than for liver metastases. PMID- 2714883 TI - The role of alcohol in oesophageal cancer in non-smokers, and of tobacco in non drinkers. AB - Data from a hospital-based case-control study of oesophageal cancer conducted in Northern Italy were used to analyse the risk associated with alcohol in non smokers and with tobacco in non-drinkers. Out of a total of 250 cases (198 males, 52 females) and 1,089 controls (800 males, 289 females), there were 38 cases and 404 controls who described themselves as lifelong non-smokers. Among these persons, the relative risk was not different for teetotallers and moderate drinkers (less than 4 drinks per day), but increased markedly for higher levels of alcohol consumption. The point estimates were 2.1 for 4 to 8 and 3.6 for over 8 drinks per day, and the trend in risk was statistically significant. Likewise, among 30 cases and 189 controls who were non-drinkers, the point estimates were 2.0, 3.9 and 6.2 for smokers of less than 15, 15-24 and greater than or equal to 25 cigarettes per day, with, again, a statistically significant trend. This study supplies further evidence that both alcohol and tobacco are strongly related to the risk of oesophageal cancer, even in the absence of exposure to the other risk factor. This confirms previous indications from a study in Calvados, France and also provides statistically significant epidemiological evidence of an independent role of exposure to tobacco alone in the aetiology of oesophageal cancer. The relative risks associated with exposure to either of the 2 factors among subjects not exposed to the other were readily comparable to the estimates adjusted for the other factor in the overall data-set, thus further confirming the independent effect of alcohol and tobacco on oesophageal carcinogenesis. PMID- 2714884 TI - A case-control study of cancer of endometrium in Athens. AB - Eighty-three women with invasive adenocarcinoma of the endometrium and 164 control women hospitalized for various orthopedic conditions were interviewed regarding demographic, reproductive, socio-economic and biomedical characteristics, including their use of tobacco, drugs and exogenous estrogens. The data were analyzed by modelling rate ratio (r) through multiple logistic regression. The main results were as follows: women with invasive adenocarcinoma of the endometrium had earlier menarche (r = 0.82 for every additional year; one tailed p approx. 0.04), later menopause (r = 1.50 for a 5-year difference; one tailed p approx. 0.004), and fewer live-born children (r = 0.86 for every additional child; one-tailed p approx. 0.08); they were also taller (r = 1.33 for a 5-cm difference; one-tailed p approx 0.03), whereas weight, adjusted for height, was not a statistically significant risk indicator (one-tailed p approx. 0.38). Regular use of combination oral contraceptives was associated with a reduced risk of endometrial cancer (r = 0.56), whereas intake of menopausal estrogens for more than 6 months was associated with an increased risk (r = 2.04); however, because of the low frequency of use of exogenous estrogen preparations in Greece, neither of these 2 results was statistically significant. Tobacco smoking was associated with a significantly reduced risk of endometrial cancer; smoking 15-20 cigarettes per day for 20 years was associated with a rate ratio of 0.49 (one-tailed p approx. 0.03). The protective effect of tobacco smoking was evident only among post-menopausal women. These results indicate that the risk profile of endometrial cancer is similar in high-risk and low-risk countries, and underline the importance of unopposed estrogenic stimulation in the pathogenesis of this cancer. PMID- 2714885 TI - Multiple infections in cases of cervical cancer from a high-incidence area in tropical Africa. AB - The presence of several infections was determined in tissue and serum samples from 34 cases and 23 controls seen in 1984-85 at Mulago Hospital in Kampala, Uganda. When assessing single infections, association with cervical cancer could be shown for 5 agents, namely by Southern blot assay for human papillomavirus types 16 and 18 (HPV), and by serological tests at varying levels of antibody titres, for herpes simplex virus type I and/or 2 (HSV), cytomegalovirus (CMV), Epstein-Barr virus, viral capsid antigen (EBV-VCA), and Chlamydia trachomatis (CLT). Due to interaction, HSV and CMV were associated with cervical cancer only when infection by both of these agents was demonstrable. In the assessment of the simultaneous presence of these 5 infections, moderately high antibody titres were taken as the cut-off point for infection by HSV, CMV, EBV-VCA, and CLT. This showed that 3 and 4 infections at a time were seen in the majority of the cases in contrast to the controls with essentially no more than 2 such infections. A linear trend in the rise of risk for cervical cancer was noted with increasing number of infections. PMID- 2714886 TI - Systemic immunity against a murine colon tumor (CT-26) produced by immunization with syngeneic cells expressing a transfected viral gene product. AB - We have previously shown that CT-26 tumor cells expressing the transfected hemagglutination antigen of influenza virus elicit an immune response in syngeneic hosts that is cross-protective against an s.c. challenge with non transfected parental cells. Since CT-26 is a murine colorectal carcinoma we sought to determine whether the same immuno-protective effect could be achieved after a challenge with parent tumor cells injected into the usual sites of colon tumor growth and metastasis. We now show that the protection afforded by this immunization protocol is systemic and that animals can be protected against tumor growth in the cecum, lymphatics of the mesentery, liver and lung. PMID- 2714887 TI - Human lung cancer--a comparative study of the levels of circulating immune complexes in pulmonary blood draining the tumor area and peripheral venous blood. AB - Our objective was to investigate whether low levels of circulating immune complexes (cICs) in peripheral venous blood of cancer patients could be due to removal of cIC released at the tumor site during passage to the peripheral veins. In 54 patients with primary lung cancer, we therefore compared the cIC levels as detected by 3 different assays in paired samples from the pulmonary vein draining the tumor area and from a peripheral vein. Only 6 of the 54 patients had significantly increased pulmonary vein cIC levels as compared to the corresponding peripheral vein levels. The peripheral vein levels of these 6 patients were all within the normal range, and in none of these patients was the difference between the 2 sites of analysis--although significant--of such a magnitude that the pulmonary vein cIC level appeared higher than the normal range, i.e., "positive" for cIC. Positive cIC levels were only found in 11% of lung cancer patients (irrespective of the site of measurement). Thus, our present data, together with our previous findings indicating no significant difference between peripheral venous blood cIC levels in cancer patients and normal controls, contradict the theory of tumor cells expressing new antigens resulting in the formation of tumor-associated cICs. PMID- 2714888 TI - Differential response of adherent and unanchored melanoma cells to bromodeoxyuridine evidenced by specific lectin-binding protein changes. AB - The possible differential response of adherent and nonadherent cells of the same tumor type to pyrimidine analogues has been investigated. We show that bromodeoxyuridine (BUdR) increases interactions of attached cells with their substrate without markedly affecting the cell adhesion properties of the same cells when these are not anchored. However, evidence for an adhesion-independent response of both cell types to BUdR has been obtained with lectin binding assays using 125I-labelled Lens culinaris agglutinin (LCA). This revealed a greatly increased binding of LCA to a large glycoconjugate in all cultures exposed to the halogenated pyrimidine. Attachment-dependent effects of BUdR were manifested in flattened cells by a greater LCA-binding to a 240-kDa protein and by increased interaction of 125I-labelled wheat-germ agglutinin (WGA) with a 200-kDa protein and a large glycoconjugate sharply defined in electrophoresis. Although both tumor cell aggregates and anchored cells exhibit detectable responses to pyrimidine analogues such as BUdR, the corresponding effects are thus manifested unequally in cells with different adhesion properties. PMID- 2714889 TI - A derivative of staurosporine (CGP 41 251) shows selectivity for protein kinase C inhibition and in vitro anti-proliferative as well as in vivo anti-tumor activity. AB - Analogues of staurosporine were synthesized and their ability to inhibit protein kinases was examined. Staurosporine is a potent but non-selective inhibitor of in vitro protein kinase C(PKC) activity (IC50 6.0 nM). The derivative CGP 41 251 had reduced PKC activity with an IC50 of 50 nM but showed a high degree of selectivity when assayed for inhibition of cyclic AMP-dependent protein kinase (IC50 2.4 microM), S6 kinase (IC50 5.0 microM) and tyrosine-kinase-specific activity of epidermal growth factor receptor (IC50 3.0 microM). Staurosporine and CGP 41 251 exerted growth inhibition in the human bladder carcinoma line T-24, human promyelocytic leukemia line HL-60 and bovine corneal endothelial cells at concentrations which correlated well with in vitro PKC inhibition. In addition, both compounds inhibited the release of H2O2 from human monocytes pre-treated with 12-O-tetradecanoyl-phorbol-13-acetate at non-toxic concentrations. In vivo anti-tumor activity was examined in T-24 human bladder carcinoma xenografts in athymic nude mice. Tumor growth inhibition tests revealed significant anti-tumor activity (2p less than 0.001) at 1/10 of the maximum tolerated doses for both compounds. By contrast, a closely related derivative of staurosporine (CGP 42 700) was inactive at concentrations of over 100 microM in all in vitro enzyme and anti-proliferative assays as well as in animal tumor models. Our data suggest an association between PKC inhibition and anti-proliferative and anti-tumor activity. PMID- 2714890 TI - Ganglioside GM2 expression on human melanoma cells correlates with sensitivity to lymphokine-activated killer cells. AB - Ganglioside GM2 is expressed on cell surface membranes of a variety of human malignant cells and has been demonstrated to be immunogenic in humans. We have assessed the role of the antigen GM2 on melanoma cells as a recognition structure for lymphokine-activated killer (LAK) cells. LAK cells were generated by stimulation of non-adherent peripheral blood lymphocytes (PBL) from human donors with recombinant interleukin-2 (IL-2). The selection of target cells was based on GM2 content and included 11 human melanoma cell lines and 2 human leukemia lines. Using a single-cell binding assay, LAK cell binding to target lines expressing high levels of GM2 was significantly greater than to those expressing minimum GM2. This cell-binding was specifically inhibited by addition of purified GM2 but not by other gangliosides. LAK-melanoma cell-binding was also specifically inhibited by anti-GM2 monoclonal antibody (MAb). For further analysis LAK cell lysis of melanoma target cells expressing various amounts of GM2 was assessed. A significant correlation occurred with GM2 expression and LAK cell lysis (p less than 0.025; r = 0.623). Three other gangliosides commonly expressed on human melanoma, GM3, GD3 and GD2, had no correlation with LAK cell lysis. These studies suggest that GM2 on melanoma cells is a marker for LAK cell sensitivity, as well as indicate that GM2 is a potential target recognition structure for human LAK cells. PMID- 2714891 TI - Effect of retinyl acetate on cAMP-dependent protein kinase in transformed mouse 10T1/2 cells. AB - The effect of retinyl acetate (RAC) on the activity of cAMP-dependent protein kinase (PKA) was studied in mouse 10T1/2 cells. The studies revealed that normal 10T1/2 cells had about 13-fold more PKA activity than did methylcholanthrene transformed cells (MCA cells). The addition of RAC to MCA cells increased the activity of PKA about 3-fold as measured by the in vitro phosphorylation of a specific site in H1 histone (site A) or Kemptide. The increased PKA activity coincided with a reduction in the rate of cell replication of MCA cells, about 24 hr after exposure to the retinoid. Addition of forskolin to RAC-treated MCA cells resulted in a further reduction in the rate of cell replication, and this suggested that the enhanced PKA activity was also capable of action in vivo. To test this notion, MCA cells were grown with and without RAC, and the phosphorylation of the H1 histone at site A, a site known to be phosphorylated by PKA in cells treated with hormones or other agonists which activate PKA, was studied in vivo. RAC, by itself, was capable of causing an increase in the phosphorylation of the H1 histone at site A, demonstrating that the retinoid mediated increase in PKA activity was sufficient to cause the enhanced phosphorylation of a known substrate. PMID- 2714892 TI - Growth stimulation of human breast epithelial cells by basic fibroblast growth factor in serum-free medium. AB - Growth-stimulating activities of basic and acidic fibroblast growth factors (FGFs) toward human breast epithelial cells were examined and compared with the mitogenic activity of bovine pituitary extract (BPE) by the use of a serum-free medium which contained epidermal growth factor, insulin, transferrin, hydrocortisone, ethanolamine, phosphoethanolamine, prolactin and prostaglandin. Addition of 1 ng/ml of basic FGF (bFGF) to the serum-free medium significantly enhanced the growth potential of epithelial cells derived from human breast carcinoma, and the number of cells grown for 7 days with bFGF was more than 1 1/2 times higher than that in the serum-free medium containing BPE instead of prolactin and prostaglandin. Growth responsiveness toward bFGF of epithelial cells derived from histologically non-malignant breast tissues was lower than that of carcinoma-derived cells, and the growth-stimulating activity of bFGF was lower than that of BPE, which could significantly enhance the growth potential of the cells. Contrary to bFGF, acidic FGF at 1 ng/ml had no significant effect on the growth potential of breast epithelial cells which had grown out from either carcinoma or non-malignant tissues. The present results suggest that bFGF is a putative growth-stimulating factor for human breast epithelial cells, especially for carcinoma-derived cells, and can substitute at least in part for BPE in serum free monolayer culture of the cells. PMID- 2714893 TI - Effects of low- and high-density lipoproteins on the proliferation of human breast cancer cells in vitro: differences between hormone-dependent and hormone independent cell lines. AB - The influence of low- and high-density lipoproteins on the proliferation of human breast cancer cells in culture was studied. We compared total cell number after incubation for 48 hr in culture medium containing or lacking plasma lipoproteins. Marked differences were found between hormone-dependent (MCF-7, T-47-D, ZR-75) and hormone-independent (MDA-MB-231, HBL-100) mammary tumor cell lines. The cells also reacted differently on the different lipoproteins offered in the medium. Human low-density lipoproteins (LDL) exhibited a marked stimulation of the growth of hormone-independent cell lines but no or only toxic effects upon the hormone sensitive lines. Human high-density lipoproteins (HDL) stimulated the proliferation of all cell lines in a dose-dependent manner but hormone independent cells showed a higher response. These findings point towards different utilizations of nutrients in hormone-dependent and hormone-independent cells. PMID- 2714894 TI - Generation and partial characterization of melanoma sublines resistant to lymphokine activated killer (LAK) cells. Relevance to doxorubicin resistance. AB - To see whether a tumor cell population may contain cells resistant to lymphokine activated killer (LAK) lymphocytes, cells from a LAK-sensitive melanoma line (Me 665/2) were co-cultured with LAKs. Three sublines were obtained after 1, 2 or 3 immunoselection cycles. Immunoselected (IS) sublines show reduced proliferation, decreased reactivity to the monoclonal antibody (MAb) R24 and appeared morphologically more differentiated in comparison with the parental Me 665/2 line. A progressively reduced sensitivity to LAKs was observed in IS sublines with a more than 8-fold reduction in LAK susceptibility. A reduced complement (C) mediated lysis was also observed in IS sublines. Since we have previously shown that LAK sensitivity of melanoma cells may be associated with Doxorubicin (Dx) resistance, the sensitivity to Dx was tested in these lines. An augmented sensitivity to Dx was noted in IS sublines as compared with Me 665/2. The differences in LAK susceptibility between the IS sublines and the parental Me 665/2 line remained stable for 2 weeks but declined and disappeared thereafter. These results indicate that (1) a LAK-sensitive tumor line may contain a subpopulation of cells which are significantly less lysed by LAKs; (2) a correlation between LAK sensitivity and susceptibility to C-mediated lysis is also present; and (3) increased sensitivity to Dx is evident in the IS sublines. PMID- 2714895 TI - Correlations of dihydropyrimidine dehydrogenase, thymidine phosphorylase and thymidine kinase activities in strongly and weakly malignant cultured murine neuroblastoma cells. AB - The C-1300 neuroblastoma tumor which arises spontaneously in the A/J mouse has been maintained in this mouse strain. Two different cell populations have been recognized in cultured C-1300 mouse neuroblastoma (MNB): (1) round, "neuroblast like" cells, growing in suspension (poorly attached), that have a highly malignant behavior when injected into the A/J mouse (T1 cells); and (2) flat, "epithelioid" cells that attach well to surfaces and show low malignancy towards the inoculated animals (T2 cells). The specific activities of the pyrimidine metabolizing enzymes thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase (DPD) and thymidine kinase (TK) were examined in both MNB cell lines by a new radiochromatographic method. Enzymatic activities of TP and DPD in the cytosols of T2 (weakly malignant) cells were up to 15 times higher than those of T1 (strongly malignant) cells, whereas the mean TP/DPD activity ratio was 16 in either cell line. TP and DPD activity levels increased with time of growth in culture in T2 cells while no such increase was seen in the T1 cells. Maximal TK activity was similar in both cell lines but dropped more rapidly in the T2 cells as cell densities increased. The enzymatic activity levels of TP and DPD but not of TK correlated inversely with neoplastic expression of MNB cells. The observed patterns of pyrimidine metabolizing enzymes in MNB cells could result in an increased thymidine pool in T1 cells whenever TK activity is suppressed, whereas such conditions would favor the generation of thymine in the T2 cells. PMID- 2714896 TI - Anti-tumor effect of recombinant murine TNF-alpha (rMuTNFa) given by continuous i.v. infusion as compared to repeated i.v. injections in a rat liver metastasis model. AB - Anti-tumor effects of TNF in animal models are well documented. Therapeutic use of TNF, however, is hampered by its toxicity. In rats a single intravenous (i.v.) injection of 40 micrograms/kg is lethal. When given by continuous i.v. infusion, much higher doses are well tolerated. To compare the therapeutic efficacy of rMuTNF given either as repeated i.v. injections or as a continuous infusion, we have used a liver metastasis model (tumor CC531). The number of liver metastases at day 28 after tumor inoculation served as a parameter. The route of administration, administration schedule and dose, did, in general, not influence the effect produced by rMuTNFa. Only early continuous infusion had an effect on the number of liver metastases. A sublethal dose, given as a late continuous infusion, had no significant effect. It thus appears that rTNFa, even when administered at high doses, is not a very efficient anti-tumor agent. Attention should rather be focused on the use of rTNFa in combination with other substances, for example, interferons. PMID- 2714897 TI - A survey of in vivo growth characteristics and spontaneous metastasizing potentials of C3H mouse mammary tumors. AB - This investigation examined the relationship between spontaneous metastasizing potential, immunogenicity and growth rate in 34 C3H/He mammary carcinomas. The main purpose of our studies was to examine the hypothesis that a tumor's metastasizing potential is affected by its immunogenicity. The tumors were studied during serial intra-mammary transplantations, starting with tissue from autochthonous, spontaneous pulmonary metastases. The results show that there was no correlation between metastasizing potential and tumor immunogenicity, and no correlation between metastasizing potential and tumor growth rate. Moreover, metastasizing potential was not related to invasive behavior, because histological examination showed that all of the metastases grew extensively within pulmonary vessels and displayed no tendency to active extravasation. PMID- 2714898 TI - Stimulatory role of transforming growth factors in multistage skin carcinogenesis: possible explanation for the tumor-inducing effect of wounding in initiated NMRI mouse skin. AB - Mechanical wounding provides a convertogenic ("stage I tumor-promoting") stimulus in initiated NMRI mouse skin, indicating that this stage of carcinogenesis can be entirely controlled by endogenous factors. A search for such factors led to the finding that both platelet-derived Epstein-Barr-virus-inducing factor (EIF), alias human TGF beta 1 and porcine TGF beta, exhibited--upon intracutaneous injection--convertogenic efficacy in initiated NMRI-mouse skin in vivo provided that their injection was combined with a single topical application of the non convertogenic tumor promoter 12-O-retinolyphorbol-13-acetate (RPA). Since TGF beta inhibits epidermal cell proliferation, the RPA treatment is thought to provide a mitogenic stimulus required for conversion. The RPA treatment can be replaced by intracutaneous injection of transforming growth factor alpha (TGF alpha). These results indicate that the stage of conversion consists of two components, one of which is related to mitogenesis (RPA or TGF alpha), the other to a still unknown activity exhibited by TGF beta-like factors. Thus, endogenous factors with the quality of "wound hormones" may be involved in multistage skin carcinogenesis. This finding could explain the convertogenic effect of skin wounding. PMID- 2714899 TI - Cytogenetics of undifferentiated nasopharyngeal carcinoma xenografts from southern Chinese. AB - Three undifferentiated nasopharyngeal carcinoma (NPC) tumour lines were successfully established from fresh biopsy material injected s.c. into athymic mice and passaged for many generations. These xenografts were found to be free of infiltrating lymphoid cells and remained undifferentiated up to passage 30. They were designated NPC/HK2117 (Xeno-1), NPC/HK1915 (Xeno-2) and NPC/HK1530 (Xeno-3), respectively. Passage 16 from Xeno-1, passage 1 from Xeno-2 and passage 14 from Xeno-3 were studied cytogenetically using G-banding with the trypsin-Giemsa method. Two xenografts were hyperdiploid with chromosome modal numbers ranging from 49 to 76, and one was hypodiploid with modal numbers ranging from 28 to 38. Five marker chromosomes have been identified with involvement of chromosomes 1, 3, 11, 12 and 17. Marker chromosomes derived from chromosomes 12q, 1q and 3q were consistent in one of the 2 xenografts successfully G-banded, and chromosomes 12, 11 and 17 were consistent in another. Three out of the 6 markers involve 12q13--- qter. An abnormal chromosome 3 with most of the p arm deleted was also observed. PMID- 2714900 TI - Variations in serum alkaline DNase activity in rats during growth and treatment of tumors sensitive or resistant to therapy. AB - Serum alkaline DNase activity (SADA) was investigated in rats receiving s.c. transplants of tumor cells sensitive or resistant to chemotherapy. Serum samples from each animal were collected before transplantation, during the development of tumors and after therapy. Within a few days after transplantation of both tumor lines (sensitive or resistant), SADA levels decreased progressively to 52% of the normal pre-transplantation level (p less than 0.01). This decrease in SADA preceded by 4 to 5 days the appearance of any palpable tumor mass. In all untreated animals as well as in treated rats bearing resistant tumors, SADA remained at a low level until death. In rats bearing tumors sensitive to therapy a progressive increase in SADA was observed after treatment, paralleling tumor regression. When tumor regression was complete, SADA resumed the levels of activity measured prior to transplantation. PMID- 2714901 TI - Multiple pulmonary arteriovenous fistulas in childhood. AB - Three cases of multiple pulmonary arteriovenous fistulas are described in children who presented at five months, two and nine years of age. Mass spectrometry was used to measure pulmonary blood flow and, in two cases, the intrapulmonary right-to-left shunt. The shunt fractions were 51% and 35%, with no significant change on breathing 100% oxygen. In one case, effective pulmonary blood flow was measured during cardiac catheterisation by the argon-freon rebreathing method and agreed closely with that found from the Fick, principle with measured oxygen consumption. Treatment consisted of surgical ligation of a lower lobe pulmonary artery in the youngest child, balloon embolisation in the second, and initial surgical oversewing of a single large fistula followed twenty months later by steel coil embolisation in the third. The last and oldest child is well and no longer cyanosed. The first two children died seven months after treatment with evidence of progression of their pulmonary arteriovenous fistulas. The first of these, who also had an atrial septal defect and discordant thoraco abdominal arrangement, died of heart failure. Autopsies on both children confirmed extensive involvement of both lungs by arteriovenous fistulas. In one case who had a diffuse, telangiectatic form of pulmonary arteriovenous fistulas, microscopic serial reconstructions of lung tissue revealed that anastomoses occurred between arteries accompanying terminal bronchioles and intra-acinar arteries and adjacent veins. Occlusion of the pulmonary arteries supplying the fistulas led to extensive fibrosis within them, and was associated with enlargement of the corresponding bronchial arterial circulation. PMID- 2714902 TI - A communication from the left ventricle to the right atrium: a defect in the central fibrous body. AB - An isolated defect in the membranous atrioventricular septum was found in a five year-old girl who presented with a cystic lesion in the right atrium. This type of left ventricular-right atrial communication could result from a structural abnormality of the central fibrous body in combination with arrested maturation of the membranous ventricular septum. PMID- 2714903 TI - Intermittent superior caval venous syndrome due to permanent transvenous electrode. AB - A 75-year-old man began suffering from intermittent episodes of superior caval venous syndrome, seven years after implantation of an endocardial pacemaker via the right cephalic vein. The obstruction of the superior caval vein was confirmed by venography and computed tomography of the chest. Changes of the intrathoracic pressure were considered to be the mechanism responsible for the intermittence of the syndrome. PMID- 2714904 TI - Fixed subaortic stenosis with congenital aneurysm of sinus of Valsalva--cross sectional and Doppler echocardiographic diagnosis of a rare association. AB - A 13-year-old girl was diagnosed by cross-sectional and Doppler echocardiography to have the rare combination of congenital aneurysm of the right sinus of Valsalva rupturing into the right ventricular outflow tract and a discrete subaortic fibrous shelf with severe subvalvar stenosis, moderate aortic regurgitation and left ventricular dysfunction. The findings were confirmed at cardiac catheterisation and surgery. PMID- 2714905 TI - Congestive heart failure associated with diabetes mellitus. AB - A case of typical congestive heart failure associated with diabetes mellitus is reported. The case was diagnosed on the basis of biopsy findings such as basal laminar thickness and of angiographically normal coronary arteries. The therapy, including insulin, resulted in normalization of electrocardiographic abnormalities and improvement of myocardial contractility. PMID- 2714906 TI - Digital subtraction venography for assessment of deep venous thrombosis in the arms following pacemaker implantation. AB - We recently performed digital subtraction venography and detected axillary venous thrombosis in a 56-year-old female with nonspecific symptoms related to the right arm following a permanent transvenous endocardial pacemaker implantation two years ago. In view of its cost-effectiveness and less invasive approach, digital venography appears ideally suited for evaluation of the frequently occurring subclinical deep venous thrombosis in these patients. PMID- 2714907 TI - Platelet aggregation and arrhythmias after myocardial infarction. AB - We investigated the relationship between platelet aggregability and occurrence of complex arrhythmias in 72 males in the third or fourth week after the onset of myocardial infarction. The patients who displayed complex arrhythmias (n = 31), as opposed to those with stable rhythm (n = 41) showed higher platelet aggregability (48 +/- 27% vs 37 +/- 22%, mean +/- standard deviation, respectively, P less than 0.01). No differences were found with respect to plasma free fatty acids and excretion of catecholamines. It is suggested that, after myocardial infarction, increased platelet aggregability may contribute to the development of complex arrhythmias. PMID- 2714908 TI - Patient with a cyanotic atrial septal defect without pulmonary hypertension. PMID- 2714909 TI - Arrhythmia occurring in hypertrophic cardiomyopathy. PMID- 2714910 TI - Surgical experience with diseases of the tricuspid valve. Cross-sectional and Doppler echocardiographic evaluation following DeVega's repair. AB - Seventy-eight patients undergoing mitral valve surgery with or without replacement of the aortic valve also underwent procedures on the tricuspid valve over a period of 10 years. All patients were in functional class III or IV preoperatively. The procedures were performed in all patients with organic disease of the tricuspid valve (N = 44) and in those with moderate or severe functional tricuspid valvar regurgitation (N = 34). Seventy-one patients underwent DeVega's annuloplasty with or without commissurotomy. The overall mortality was 11.5%. 65 long-term survivors were followed up for a period of 6 months to 10 years (mean 5.3 years). Sixty-three patients were in functional class I or II at the last follow-up. Six patients had clinical evidence of mild to moderate tricuspid regurgitation. Regression of cardiomegaly (as judged by the chest radiograph and right ventricular hypertrophy seen in the electrocardiogram) was evident in most cases. Fifty-one of 54 patients evaluated by cross-sectional echocardiography were reported to have a functionally normal tricuspid valve. Doppler echocardiography in 28 patients showed no significant tricuspid regurgitation or stenosis in 26 patients. Eleven consecutive patients undergoing DeVega's annuloplasty were studied prospectively with pre- and postoperative Doppler echocardiography. Good correlation existed between right ventricular systolic pressures predicted by Doppler with those obtained preoperatively at cardiac catheterization. Postoperative Doppler echocardiography in these 11 patients showed complete restoration of competence of the tricuspid valve as well as normalisation of the right ventricular systolic pressure in 10 patients. PMID- 2714911 TI - Angiographic findings in patients exhibiting ischemia after oral dipyridamole. AB - We have assessed the angiographic features of a group of 37 patients given oral dipyridamole and 37 patients given matching placebo. Both groups represented severe coronary arterial disease and were studied prior to bypass surgery. Six patients (16%) had angina and 13 patients (35%) had electrocardiographic changes after dipyridamole. All the patients in the control group were nonresponders. In the group given dipyridamole the patients responding with angina had significantly more compromised collaterals than the patients without chest pain (P = 0.021). The same applied to the patients with electrocardiographic changes versus those with no electrocardiographic changes (P = 0.034). No differences between responders and nonresponders could be found in terms of the severity of coronary arterial disease, severity of anginal symptoms, exercise tolerance, antianginal medication, number of past myocardial infarctions, and left ventricular ejection fraction. In conclusion, the data strongly suggest that ischaemic responses to dipyridamole originate from myocardial steal accentuated by compromised flow in collateral vessels. PMID- 2714912 TI - Failure of oral atenolol and verapamil to increase the capacity and duration of exercise in patients in sinus rhythm with mitral stenosis. AB - The efficacy of oral atenolol in increasing the capacity and duration of exercise in 43 patients in sinus rhythm with mitral stenosis was evaluated and compared with that of oral verapamil in an open-label cross-over design. It was observed that although oral atenolol (100 mg per day) caused significant reductions in heart rate while resting and during exercise (P less than 0.001), the increases in capacity and duration of exercise were not significant. Oral verapamil (80 mg three times per day) also caused significant reductions in the heart rates at rest and during exercise (P less than 0.05) but the increases observed, although greater than that with atenolol, failed to reach the level of statistical significance. Occasional side effects occurred with both the drugs. Subjective symptoms of dyspnoea at rest and on exertion were relieved with both the drugs. We conclude that, although both drugs reduce the symptoms of dyspnoea, they cause only minor increases in the objective parameters. They do not, therefore, provide an alternative to surgery and have only a temporary place in the management of patients in sinus rhythm with mitral stenosis who are awaiting surgery. PMID- 2714913 TI - Myocardial metabolism of glutamate and left ventricular function in patients with coronary arterial disease. AB - Fractional myocardial extraction of glutamate, glutamine, ammonia, glucose and lactate was studied in 35 male patients during rest and atrial pacing. Fourteen patients had no coronary arterial disease. In 21 patients with coronary arterial disease and left ventricular dysfunction the increased myocardial extraction of glutamate at rest positively correlated with increased extraction of glucose, lactate and glutamine release, while it was inversely related to ammonia release. In 9 of these 21 patients pacing did not affect either left ventricular contractile function or myocardial metabolism of all studied compounds. In the other 12 patients pacing caused a decrease in left ventricular ejection fraction, velocity of circumferential fiber shortening and new regional wall motion abnormalities. A more pronounced pacing-induced left ventricular dysfunction was accompanied by myocardial lactate production and 2-fold decrease in myocardial glutamate extraction which was associated with the reduction of glutamine release and increased myocardial ammonia production. Possible relationships between alterations in myocardial glutamate metabolism and diminished ventricular performance have been reviewed. The results suggest the importance of myocardial glutamate extraction for the contractile function of human ischemic heart. PMID- 2714914 TI - High dose nalbuphine in early acute myocardial infarction. AB - Twenty patients with moderate or severe pain of suspected myocardial infarction received nalbuphine 50 mg intravenously as analgesia in 2 divided doses of 30 mg and 20 mg with 10 mg metoclopramide and were observed for 2 hours. Eighteen patients received nalbuphine outside hospital. The median time from onset of pain to treatment was 73 minutes. Within 30 minutes of the drug's administration 90% of all patients reported satisfactory pain relief (grade 0 or 1). For those with definite myocardial infarction 83% reported satisfactory pain relief at 30 minutes. There were no significant adverse cardiorespiratory effects observed or serious side-effects reported. Nalbuphine is effective and safe when used in this higher dose, although no additional analgesic effect was demonstrated when compared with lower established doses used early in acute myocardial infarction. PMID- 2714915 TI - First passage radionuclide cardiography for determination of cardiac output: evaluation of an improved method. AB - A noninvasive method for determination of cardiac output by aid of first passage radionuclide cardiography is presented. As opposed to most other scintigraphic methods, a forward blood flow is measured, even in patients with valvar incompetence. In addition, the technique allows measurement of cardiac output in the presence of cardiac arrhythmias. No geometrical assumptions, corrections for radiation attenuation, loss of tracer, or empirical correction factors due to extracardiac radioactivity are required. We have evaluated the method in 19 patients with various heart diseases by comparison of the radionuclide cardiac outputs with those derived from the thermodilution technique performed simultaneously. Eight patients had valvar incompetence and 2 had cardiac arrhythmias. The mean radionuclide and thermodilution cardiac output values were 5.03 l/min (SD 1.21) and 5.18 l/min (SD 1.09), respectively. The 95% confidence interval for the bias was -0.40 to 0.10 l/min, and correlation analysis demonstrated an excellent correlation between results obtained with the two methods, r = 0.91 (P less than 0.001). This study shows that the improved gamma camera method represents a valid noninvasive technique for determination of cardiac output. PMID- 2714916 TI - Investigations on the dose-dependent pharmacokinetics of adriamycin and its metabolites. AB - Four tumor patients with a normal liver function were each given twice 30 mg/m2 adriamycin (ADR) and then once 70 mg/m2 ADR in the form of 3-min intravenous bolus injections at three-week intervals. In addition to the first and third ADR administrations, the patients were each given p.o. 875 mg of antipyrine. During the six-week study period, the kinetics of antipyrine displayed a high degree of intra-individual constancy. Its CL varied between 75 and 119 percent intra individually. The kinetic parameters of CL, AUC/dose, VDss, MRT and t1/2 gamma of ADR did not differ between dosages of 30 and 70 mg/m2. The ADR-dose-standardized AUC10-40 min of adriamycinol (ADR-OH), its concentration time product at the times of its highest concentration in plasma, did not display any dependence upon the ADR dose. The AUCADR-OH/dose quotient, however, was found to be significantly higher (p less than 0.05) at 70 mg/m2 than at 30 mg/m2. The MTR and the t1/2z of ADR-OH showed a trend towards prolongation at 70 mg/m2. The ADR-dose-standardized AUC of the aglycones showed no dependence upon the ADR dose while the ADR-dose standardized AUC10-40 min of the aglycones was significantly lower at a high ADR dose (p less than 0.05) than at a small ADR dose. The results suggest that in the ADR dose range studied the ADR pharmacokinetics is dose-independent and linear, and the rate at which ADR-OH, its main metabolite is formed, is also dose independent. In contrast, the elimination of ADR-OH seems to be capacity limited.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2714918 TI - Phenytoin Michaelis-Menten pharmacokinetics in Saudi patients. AB - The Michaelis-Menten pharmacokinetic parameters Vmax and Km were calculated for 17 epileptic Saudi patients receiving phenytoin. Their ages ranged from 2.5 to 47 years (mean 21 years) and their weight ranged from 9.5 to 80 kg (mean 53 kg). Eight were females and 9 were males. Phenytoin serum concentrations at steady state were measured using the fluorescence polarization immunoassay. The mean (+/ s.e.m) for Vmax and Km were, respectively, 10.93 +/- 0.78 mg.kg-1.day-1 and 7.75 +/- 0.66 mg.l-1 for children and 6.91 +/- 0.4 mg.kg-1.day-1 and 6.44 +/- 1.01 mg.l-1 for adults. The derived values of Vmax and Km were used to predict the steady-state serum phenytoin concentrations following a change in dose for 7 adult patients. There was a highly significant correlation between observed and predicted steady-state concentrations (r = 0.968, p less than 0.001). Linear regression analysis of Vmax vs age revealed a significant decline in Vmax with age (r = 0.877, p less than 0.01). There is a significant increase in Vmax with weight (r = 0.816, p less than 0.01). A plot of Km vs age and weight showed a poor correlation (r = 0.302, r = 0.218, respectively) and a large amount of variability. Based on this data, the daily phenytoin doses for children and adults are 7.21 mg.kg-1 and 4.83 mg.kg-1, respectively, in order to achieve and maintain a steady-state phenytoin concentration of 15 mg.l-1. PMID- 2714917 TI - Kinetics of antipyrine and sulfamethazine in patients recovered from dihydralazine-hepatitis. AB - Pharmacokinetic studies with sulfamethazine (500 mg) and antipyrine (15 mg/kg) were performed in 27 hypertonic patients (16 females, 11 males, 37-78 years) who had recovered from a dihydralazine-induced hepatitis, and 21 patients with essential hypertension (13 females, 8 males, 18-74 years) treated with antihypertonics excluding dihydralazine. 20 patients of the hepatitis group (74%) and 12 patients of the control group (57%) were slow acetylators. With regard to the pharmacokinetic parameters no differences were found in both slow and rapid acetylators between the sulfamethazine group and the antipyrine group. PMID- 2714919 TI - The biology of panic-genetic evidence. AB - Family aggregations for panic disorder as defined by the American Psychiatric Association's DSM-III classification were examined at the Austin Hospital in Victoria, Australia, covering 636 individuals. The results were consistent with the common genetic relatedness of parents to offspring and of sibling pairs, but also consistent with other factors common to the family. The family data alone were not sufficient to draw conclusions about the cause of aggregation. PMID- 2714920 TI - Plasma melatonin levels in affective states. AB - Melatonin is a major endocrine product of the pineal gland. It is produced at night when noradrenaline acts on beta-adrenergic receptors to stimulate enzymes which catalyse the formation of melatonin from serotonin. It is believed by some that nocturnal melatonin levels reflect beta-receptor function. The melatonin rhythm is also thought to be an indication of circadian rhythmicity. The nocturnal production of melatonin was studied in patients with depression and panic disorder and in control subjects. Midnight concentrations of melatonin in eleven depressed patients were significantly lower than 18 control subjects (27.1 +/- 5.1 pg/ml compared with 51.6 +/- 4.1 pg/ml; p less than 0.02, t-test). These data support previous reports of reduced melatonin synthesis in depressive illness. In the first report of patients with panic disorders, significantly lower midnight levels of melatonin were found compared with controls (28.4 +/- 6.4 pg/ml versus 51.6 +/- 4.1 pg/ml, p less than 0.02, t-test). In subsequent investigations this finding was confirmed, measuring melatonin levels over the initial phase of synthesis (i.e. 20h00 to 24h00). In these samples the melatonin rhythm also seemed to be delayed. These findings are discussed in terms of beta receptor function and circadian rhythm alterations in affective disorders. PMID- 2714921 TI - The politics of welfare privatization: the British experience. AB - The 1980s Conservative government in Britain is committed to policies of welfare privatization for practical and ideological reasons--to facilitate tax cuts and to roll back the state. One problem this policy faces is that the most expensive and interventionist services are highly popular with voters from all parties. In this article, the author examines the extent to which recent privatization policies in welfare are influenced by conflict between the goals of achieving tax cuts and of maintaining electoral support, so that the outcome is a change in the form of state interventionism, rather than a rolling back of the welfare state. It also considers the impact of new policies designed to undermine the consensus across social groups and political parties of support for big-spending state services, which may facilitate reductions in the overall scope of welfare provision in future years. PMID- 2714922 TI - Better health--but not for all: the Swedish Public Health Report, 1987. AB - This article is a summary of the Public Health Report submitted to the Swedish Parliament in 1987. Health development, especially that of underprivileged groups, is regarded as an indicator of the quality of social and economic development of the country. Sweden is a very egalitarian country, but in spite of decreasing inequalities in living standards, the Report shows increasing inequalities in health. At the same time, the state has put restraints on health care spending, and the shift in the health care budget toward more primary care has stopped. This development seriously impairs the ability of the health and medical services to cope with inequities described in this Report. PMID- 2714923 TI - When violence has a benevolent face: the paradox of hunger in the world's wealthiest democracy. AB - During the last two decades, Americans initially discovered that millions of fellow-citizens were going hungry, then acted to virtually eliminate the problem, and, in the 1980s, learned that hunger has reappeared in epidemic proportions. Hunger, particularly in a wealthy democracy, is most appropriately seen as a form of institutionalized violence, the product of ideologies that fail to distribute national abundance in a manner that achieves the possible goal of preventing hunger. The return of hunger to the United States is associated with economic and tax policies that have reallocated income distribution from poor and middle income groups to the wealthy, and with a concomitant reluctance to utilize the federal government to protect needy citizens from undernutrition associated with growing economic deprivation. PMID- 2714924 TI - The psychology of Colombian street children. AB - This article calls into question the diverse perceptions of the street children in Colombia. Through the use of participant observations and the administration of the Bender-Gestalt, Kohs Block Designs, and Human Figure Drawing tests, the author explains the psychology of the street children. Their behavior on the streets is explained as being rational and appropriate to their circumstances. Since most of the children are not actively rejected by their families, and because they receive support among their peers and from private benefactors in the society, their mental health is not as bad as popularly believed. The misperceptions of them and of the way they are treated by the society are explained in the context of the family and class structure in Colombia. The dominant society consists of patrifocal families that raise children to be submissive to their fathers, whereas the lower social classes raise their children in matrifocal families, which do not have men in them, and which encourage their children to be independent at an early age. The children in their early public display of liberty symbolically threaten the man's dominance in the patrifocal family system. As a result the children's skills are devalued. PMID- 2714925 TI - Race or class, or race and class. AB - In 1987, The Milbank Quarterly published two special supplements on the health status of blacks in the United States. Dr. Vicente Navarro wrote a letter concerning the issues raised in these publications to the editor of The Milbank Quarterly, but the decision was made not to print it. Because of the importance of the subject involved, the letter is published here, with the hope of opening a debate on the issues discussed in The Milbank Quarterly's supplements and in Navarro's letter. Professor Miller, a major contributor to the supplements, will reply to Navarro's comments in an upcoming issue of this journal. PMID- 2714926 TI - Organizational change and work reforms at the levels of society, trade union, work group, and task. AB - This article introduces the third series of articles in the Special Section on work organization and health. The authors follow up on themes addressed in earlier articles, among them the interrelations between work organization and health, organizational obstacles to democratization at the work place, and the need for employee involvement in attaining and developing democratic forms of work organization. PMID- 2714927 TI - Organizational change and health at work. AB - The focus of this article is the link between organizational change and individual working conditions. In some organizational development projects health aspects may be left to chance, in others they may be to some extent respected, and in still others they are the main theme of the process and direction of change. Along this line, the author presents and discusses a number of Swedish cases. The analysis aims at emphasizing a necessary characteristic of occupational health experts, namely, to be sensitive to the differences between the goals of various projects in organizational development. Preventive work must be based on a careful identification of the sort of health aspects that are overlooked in every effort at organizational change. PMID- 2714928 TI - Job demands and stress reactions in repetitive and uneventful monotony at work. AB - Monotonous work has been analyzed from sociological and social psychological perspectives in terms of consequences for job satisfaction, life satisfaction, leisure activities, and health. In this article, a distinction is made between repetitive and uneventful monotony. Psychobiological reactions to these tasks are analyzed and related to possible long-term consequences for health. Strategies for work reform required for the two types of monotony are discussed. PMID- 2714929 TI - Immunohistochemistry in the differential diagnosis in the second-look operation for ovarian carcinomas. AB - The second-look laparotomy is the procedure of choice to obtain peritoneal and nodal biopsies from patients who have received a full course of chemotherapy for an ovarian malignancy. If there is pathologic evidence of persistent tumor, chemotherapy is continued. In most cases, the histopathologic interpretation is straightforward in terms of positive or negative results. However, atypical mesothelial reactions or glandular inclusions, or both, in lymph nodes are potential and real difficulties in differential diagnosis. This study evaluated a panel of immunohistochemical markers, namely carcinoembryonic antigen (CEA), Leu M1, human milk fat globule protein, cytokeratin, epithelial membrane antigen, and LN2 antibody for their usefulness in differentiating benign epithelium and mesothelium from carcinoma. Only CEA and Leu M1 were specific and sensitive, respectively, for malignant tumors in this study. PMID- 2714930 TI - Endometrial polyps in postmenopausal patients receiving tamoxifen. AB - The histologic features of an endometrial polyp include irregular, often dilated glands, thick-walled blood vessels, and a fibrotic stroma. Such polyps may be responsive to some chemotherapeutic drugs that can exert hormonal effects. We report on endometrial polyps detected in three postmenopausal patients who were receiving tamoxifen for treatment of metastatic breast carcinoma. The clinical presentation in all cases was vaginal bleeding and all had documented uterine enlargement suggestive of an intrauterine malignancy. The polyps were large, measuring up to 9 cm in largest diameter. On histologic examination each polyp had extensive cystic glandular hyperplasia. In one case foci of atypical epithelial proliferation and predecidualization were noted. The atypical proliferation suggested a borderline neoplastic process and was strongly positive for carcinoembryonic antigen. These findings underscore the marked proliferative changes that can be induced in endometrial polyps in postmenopausal women receiving hormonally active chemotherapeutic agents. PMID- 2714931 TI - Endometrioid and clear cell carcinoma of the ovary. Factors affecting survival. AB - Eighty-five patients, 52 with endometrioid carcinoma (EC), nine with mixed endometrioid and clear cell carcinoma (MC), and 24 with clear cell carcinoma (CC), were studied to determine if prognosis was affected by (a) mixed tumor histology, (b) grade of the endometrioid component in ECs, and MCs, (c) presence of benign or malignant squamous differentiation in ECs, (d) solid versus tubular histology in CCs, (e) endometriosis in the same ovary as the tumor or elsewhere in the pelvis, (f) tumor stage, (g) patient age, or (h) presence of a coexisting carcinoma of the endometrium. The 5 year survivals for the ECs, MCs, and CCs were 52%, 22%, and 69%, respectively, for all stages. The 5 year survivals for Stage I ECs and CCs were 82% and 93%, respectively. None of these differences were statistically significant. Higher stages of disease for all three tumor types and higher grades of the endometrioid component of the ECs and the MCs were associated with significantly decreased survival. Patients with CCs had a significantly increased incidence of pelvic endometriosis (67%) versus patients with ECs (17%) or MCs (22%) (p less than 0.001). Survival was not significantly affected by benign or malignant squamous differentiation in ECs, tubular differentiation in CCs, patient age, the presence of endometriosis, or a coexisting carcinoma of the endometrium. PMID- 2714932 TI - A new histologic grading index in ovarian carcinoma. AB - It is generally believed that the degree of differentiation or tumor grade is of prognostic value in human ovarian carcinoma, but the methods of evaluation are subject to considerable variation. The present work investigates the prognostic value of a new Histologic Grading Index (HGI), containing most of the known systems and taking into account both the usual histologic and cytologic features (tumor structure, nuclear polymorphism, nucleolar features, nuclear-cytoplasmic ratio, frequency of mitosis) and the probably more independent parameters (mode of invasion, capsular penetration, and vascular invasion). This study shows that the index correlates significantly with both presence of tumor at second-look operations and survival. PMID- 2714933 TI - Comparison between tissue and serum content of CA 125, CA 19-9, and carcinoembryonic antigen in ovarian tumors. AB - Tumor markers CA 125, CA 19-9, and carcinoembryonic antigen (CEA) were detected by immunohistochemistry in paraffin embedded tissue samples obtained from two different locations in 35 ovarian tumors. In addition, serum concentrations of these tumor markers were measured before cytoreductive surgery. The staining reaction was heterogeneous in different parts of the tumor as well as within the parenchyma. Of the marker positive tumors, a staining reaction was observed in both tissue samples in only 10 of 22 cases for CA 125, in eight of 13 cases for CEA, and in three of eight cases for CA 19-9. Eighty-one percent of the patients whose tumor was positive for CA 125 also showed elevated serum levels of this marker. A poor correlation was found between tissue and circulating CA 19-9 levels. CEA was detected in 28% of the tumors and seemed to be valuable only for monitoring in rare cases of ovarian cancer. For purposes of selecting a marker for monitoring of patients with ovarian carcinoma, immunohistochemistry has a predictive value for CA 125 only. In order to better define the marker expressed in a tumor, it is necessary to examine at least two samples of different parts of the malignant tissue. PMID- 2714934 TI - Multiple continuous-flow solid-phase peptide synthesis. Synthesis of an HIV antigenic peptide and its omission analogues. AB - Multiple continuous-flow solid-phase peptide synthesis was performed on a standard polystyrene-based resin under low-pressure conditions using a simple manually operated synthesizer. Stable-flow resin-packed columns were prepared in small polypropylene flow reactors, adjustable for volume. The concurrent synthesis of 10 peptides was carried out in flow reactors concatenated together; solvents and reactants were passed through this set of columns using moderate overpressure. One decapeptide, H-Val-Tyr-Tyr-Arg-Asp-Ser-Arg-Asn-Pro-Leu-NH2, containing an antigenic determinant of the p31 protein product of the pol gene of the human immunodeficiency virus, and its nine omission analogues were synthesized. PMID- 2714935 TI - Neuropsychological factors associated with perceptual biases for emotional chimeric faces. AB - Mechanisms underlying hemispace biases for free-field judgments of emotional intensity in chimeric faces were explored. The Levy et al. chimeric faces task (1983b) was examined in relationship to relevant neuropsychological measures (emotional, imaginal, ocular). Forty-four normal adults were administered a test battery including measures of chimeric face perception, lateral eye movements to nonemotional and emotional instructions, image generation, and ocular dominance ("eyedness"). Overall, subjects showed a significant left-sided bias for judging chimeric faces and for producing lateral eye movements to emotional instructions. Asymmetries for chimeric face perception were significantly correlated with asymmetries for the location of self-generated images in space. When task modalities were examined, there was a specific relationship between chimeric face perception and tactile processing on the other neuropsychological measures. PMID- 2714936 TI - Disruption of neocortical lamina V neuronal bursts by serotonin in urethane anaesthetized rats. AB - Time-shared high speed cyclic voltametry using carbon fibre multibarrelled microelectrodes was used to monitor the concentration of 5-Hydroxytryptamine administered by iontophoresis to locations in lamina V of Sm l neocortex and to record spontaneous neuronal spike activity. In the absence of 5-Hydroxytryptamine at any one recording location the firing of two or more individual units was seen to be synchronized so that the pattern of multi-unit activity consisted of synchronized clusters of spike activity interspersed with period of neuronal silence. The repetition rate of such clusters of neuronal activity was seen to be between 0.5 and 4Hz. Maximum concentrations of 2.7 x 10(-7) M 5-Hydroxytryptamine produced by iontophoresis disrupted synchronized neuronal cluster activity. 5 Hydroxytryptamine at a concentration of 6.2 x 10(-8) M resulted in a greater than 50% inhibition of activity for 47 single units but a change in firing pattern from cluster restricted high frequency activity to a continuous mode of firing for a separate population of 11 units. Intraperitoneal administration of P Chloroamphetamine produced similar changes of neuronal firing and hence loss of synchrony. PMID- 2714937 TI - Estrogens and the pathophysiology of Parkinson's disease. AB - Two postmenopausal female Parkinsonian patients experienced exacerbation of symptoms including levodopa-induced "On-Off" following withdrawal or reduction of conjugated estrogen therapy. This report supports animal data implicating female sexual hormones in the pathophysiology of Parkinson's disease and levodopa induced dyskinesias. PMID- 2714938 TI - Effects of tone stimulus frequency on late positive component activity (P3) among normal elderly subjects. AB - The effects of tone stimulus frequency on the auditory P3 of normal younger (n = 16) and elderly (n = 23) subjects were assessed using latency and amplitude measures. Because presbycusis is prevalent among the elderly, it was hypothesized that P3s of elderly subjects elicited by a 2000 Hz target tone would show longer latencies and smaller amplitudes than those elicited by a 500 Hz target tone. As hypothesized, the results indicated that elderly subjects showed prolonged P3 latencies under a 2000 Hz, as compared to 500 Hz target tone condition, whereas younger subjects did not show such latency differences. The P3 amplitudes of the younger and elderly groups were not, however, affected by target tone frequency. The implications of these findings in clinical geriatric ERP research are discussed. PMID- 2714939 TI - Correlation between EEG and cognitive abilities: sex differences. AB - EEG activity was recorded during rest in 9 male and 9 female volunteers, aged 23 and 27, from C3, C4, T3, T4, P3, P4, O1 and O2, referenced to the ipsilateral earlobe. In a separate session verbal, spatial and abstract reasoning subtests of the Differential Aptitude Test were administered. Samples of EEG activity of 20.48 s were analysed and the interhemispheric correlation was obtained. Interhemispheric correlation in the alpha band was significantly higher in women than in men at central, parietal and occipital derivations. Significant correlations were found between D.A.T. scores and interhemispheric correlation, positive for women with abstract and spatial aptitudes in the central cortex, and negative for men with spatial, abstract and verbal scores in most derivations recorded. The opposite sign of men and women's correlations suggests the existence of a different cerebral functional organization, women showing lower hemispheric differentiation than men. PMID- 2714940 TI - Somatosensory evoked potential changes during muscle testing. AB - Fifteen naive subjects with no known neurological problems were tested by means of manual muscle testing to determine two "strong" and one "weak" muscle on a limb contralateral to the stimulated side. Somatosensory evoked potentials (SEP) were then recorded from contralateral median nerve stimulation while a naive tester tested the three previously identified muscles. In all subjects the baseline (no muscle test) and control "strong" muscle test recordings were comparable while the recording from the "weak" muscle test showed increased amplitudes in contralateral layer components. These findings suggest a neurologic basis for manual muscle testing. PMID- 2714941 TI - The neuropsychological significance of a verbal-performance discrepancy with the Wechsler Intelligence Scale for Children-Revised. AB - This study examined the neuropsychological significance of the Wechsler Intelligence Scale for Children-Revised (Wechsler, 1974) Verbal-Performance discrepancy using a large learning-disabled sample taken from a school population. A simple index was formed to allow the Verbal-Performance discrepancy to be considered as a continuous variable. In an attempt to consider the neuropsychological significance of the Verbal-Performance discrepancy, measures of the Halstead-Reitan Neuropsychological Battery for older children (HRNB) (Reitan, 1969) were regressed against the index. Some 9% of the variance in Verbal-Performance differences was explained by five neuropsychological measures of the HRNB. The practical significance of this relationship was questioned. It was concluded that the Verbal-Performance discrepancy is a poor general indicator of neuropsychological functioning in learning-disabled students in the school setting. PMID- 2714943 TI - Alcoholism and attention deficit disorder: MMPI correlates. AB - Previous research suggests that the alcoholic population can be meaningfully divided into subtypes, one of which is attention deficit disorder, residual type (ADDRT). The purpose of this study was to identify differences in personality profiles, as measured by the Minnesota Multiphasic Personality Inventory (MMPI), between ADDRT alcoholics and other alcoholics. Groups of 50 male ADDRT alcoholics and 50 male nonADDRT alcoholics were administered the MMPI. Statistically significant differences were found for the D, PD, Pa, Pt. Sc. MA, Si, F and K scales: the ADDRT alcoholics scored significantly higher than the nonADDRT alcoholics on most of the scales, but significantly lower on the K scale. PMID- 2714942 TI - The variety of relations between spatial frequency and reaction time. AB - While stimuli of lower spatial frequency often result in faster responses, this is not invariably the case. Some individuals respond faster to high frequency stimuli on tasks for which most others respond faster to low frequency stimuli. Past experience can also determine the degree to which a low frequency stimulus will mask a high frequency stimulus. These observations suggest that the effects of spatial frequency on visual information processing are under the control of higher level cognitive operations. PMID- 2714944 TI - Contralateral and ipsilateral tactile extinction in patients with right and left focal brain damage. AB - Heilman has suggested that right hemisphere lesions produce neglect both in the spaces contralateral and ipsilateral to the damaged hemisphere. To test this hypothesis, we studied the incidence of contralateral and ipsilateral tactile extinctions in 44 right and 59 left brain-damaged patients, by means of a standard test of a double tactile simultaneous stimulation of symmetrical and asymmetrical parts of the two sides of the body and of ipsilateral body parts. Results did not confirm Heilman's hypothesis; while contralateral tactile extinction was more frequent and severe in right than in left brain-damaged patients, no hemispheric difference was found when the number of ipsilateral extinctions was taken into account. Furthermore, ipsilateral tactile extinction was significantly related to aspecific factors (such as age, severity of sensorimotor impairment and widespread mental deterioration), irrespective of the hemispheric side of lesion. PMID- 2714945 TI - Psychological stress and administered oxytocin during pregnancy: effect corticosterone and prolactin response in lactating rats. AB - Recent evidence suggests that oxytocin modulates both ACTH and prolactin secretion. The present study was designed to investigate the possible role of oxytocin in the corticosterone and prolactin response to predictable and unpredictable novelty stress. These responses were examined in lactating females (Day 6 and Day 21 postpartum) which had received stress and oxytocin treatment during pregnancy. The results demonstrated that exposure to the novelty stressors during pregnancy resulted in a significant elevation in corticosterone levels of lactating females on Day 6 postpartum. A similar elevation was also observed on Day 21 postpartum for the unpredictable condition. Oxytocin treatment did not, however, significantly affect the corticosterone response to the psychological stressor. Furthermore, prolactin levels were not significantly affected on either Day 6 or Day 21 postpartum by either novelty stress or oxytocin treatment administered during pregnancy. It was suggested that the sustained elevation in corticosterone levels obtained following unpredictable exposure to the stressor had important implications for the lactation process. PMID- 2714946 TI - Effect of papaverine on solute transport in peritoneal dialysis. AB - Since vasodilators enhance the peritoneal solute transport, the influence of intraperitoneal papaverine was studied. To verify the action of papaverine on peritoneal transport we selected 33 patients on acute peritoneal dialysis and performed two 2-hour cycles with 2000 cc of a 1.5% solution, adding 40 mg of papaverine to the fourth cycle. At the end of the third and fourth cycles blood and dialysate were drawn for urea, creatinine, glucose and protein levels, using peritoneal clearances of urea and creatinine, glucose absorption and net protein loss to compare the two cycles. We found no significant change in solute transport (urea clearance p greater than 0.0.5; creatinine clearance, protein loss and glucose absorption p greater than 0.1). PMID- 2714947 TI - Pattern of urolithiasis in a general hospital. A prospective study. AB - Judging from the abundance of papers published in the medical journals there appears to be a global increase in the incidence of urolithiasis. Urinary excretion of various stone-forming salts in a 24-hour urine specimen is the mainstay of the metabolic workup done in stone-formers. According to the findings patients have been classified into neat categories depending on whether they were hypercalciuric, hyperuricosuric, etc. As a group their excretion of calcium, oxalate, and urate was not different from the controls. However, they excreted significantly more phosphate and had lower 24-hour urine volumes than the controls. PMID- 2714948 TI - Bilateral renal malacoplakia in systemic lupus erythematosus and adrenogenital syndrome. AB - We report a case of an 8-year-old girl with adrenogenital syndrome secondary to adrenocortical hyperplasia. Thirteen years later systemic lupus erythematosus developed with lupus nephritis. In spite of complex continuous immunosuppressive therapy, she died from terminal renal failure. At autopsy, extensive bilateral renal malacoplakia was discovered. The role of recurrent urinary tract infections and of immunological disturbances in the pathogenesis of malacoplakia is discussed. PMID- 2714949 TI - Transurethral resection of the prostate. A review of 1111 cases. AB - A review of 1111 transurethral resections of the prostate (TURP) revealed a mortality of 0.5% (6 patients). A stricture frequency of 3% was observed as a complication after the operation. A supplementary resection was done within one year in 9%. Transurethral resection syndrome of the prostate (TURP syndrome) occurred in two patients. Cancer incidence was 18%. Blood transfusions were given to 20% of the patients. The weight of resected prostatic tissue ranged from 4 to 115 g (mean 25 g), and was less than 20 g in 60%. Peroperative bleeding amounting to over 1800 ml occurred in 3.3% (37 patients). PMID- 2714950 TI - Aspects concerning posterior urethral valves. AB - Twenty-six boys were evaluated and treated for posterior urethral valves. At the time the valves were diagnosed unilateral or bilateral vesicoureteral reflux was present in 58% of the ureters and 69% of the children, while dilatation of the upper urinary tract was present in 88% and 92%, respectively. There was a variety of symptoms and signs, but the most prominent in neonates and infants were vesical urine retention, palpable kidneys and failure to thrive, whereas in the older children voiding dysfunction, incontinence and urinary infection were the most common. Twenty-four out of 26 boys were managed by primary valve ablation and in 62.5% of them this type of treatment was adequate in resolving or sufficiently improving clinical manifestations and roentgenologic findings, requiring no further management. Urinary diversion in the form of vesicostomy and cutaneous ureterostomy was preserved for those patients who did not improve with valve ablation alone. The current aspects concerning posterior urethral valves are also discussed. PMID- 2714951 TI - The influence of various aetiopathogenetic factors on testicular function. AB - Three hundred and seventy-one patients with azoospermia were examined by means of testicular biopsy. The patients were assigned to seven histological groups according to the degree of damage found in their germinative epithelium. The degree of damage to the germinative epithelium was correlated with the aetiopathogenetic factors. PMID- 2714952 TI - Vasography: experimental study. AB - Vasography may cause stricture of the vas deferens. The probable causes of this obstruction are traumatic lesion at the puncture site and the radiological contrast material used. Because of this problem we performed an experimental study using Wistar rats, which were divided into four groups: Group A - Control, Group B - injection of a saline solution, Group C - hypaque injection, Group D - hypaque plus saline solution. According to the results obtained it was concluded that the needle puncture is not responsible for stricture of the vas deferens. Hypaque is responsible for 5% of strictures and the use of a saline solution to wash the vas did not show any benefit. PMID- 2714953 TI - Amino acids in urine and plasma of urolithiasis patients. AB - Urine and plasma amino acids in healthy males and patients with calcium stones, were analyzed for thirty-four amino acids. There was no difference in urinary excretion of thirty-two amino acids between the two groups. Plasma values of taurine, aspartic acid, hydroxyproline, glutamic acid, glycine, alanine, cystathionine, ornithine and lysine were significantly higher in controls than in stone formers. Of these amino acids, aspartic acid, glutamic acid, glycine, alanine and lysine are the main amino acids of matrix protein in renal stones. The levels of aspartic acid, glutamic acid, glycine, alanine and lysine in the serum of normal individuals were higher than those in plasma. On the basis of the findings, these amino acids may form soluble complexes with calcium and heparin in stone formers. It is also possible that some amino acids act as promoters or inhibitors in the pathogenesis of calcium oxalate stones. PMID- 2714954 TI - Mercy, murder, & morality: perspectives on euthanasia. The California Humane and Dignified Death Initiative. PMID- 2714956 TI - Mercy, murder, & morality: perspectives on euthanasia. The challenge of definition. PMID- 2714955 TI - Mercy, murder, & morality: perspectives on euthanasia. Holding the line on euthanasia. PMID- 2714957 TI - Mercy, murder, & morality: perspectives on euthanasia. A case against Dutch euthanasia. PMID- 2714958 TI - Mercy, murder, & morality: perspectives on euthanasia. Euthanasia in The Netherlands: distinguishing facts from fiction. PMID- 2714959 TI - Mercy, murder, & morality: perspectives on euthanasia. Can we return death to disease? PMID- 2714960 TI - Mercy, murder, & morality: perspectives on euthanasia. Fashioning an ethic for life and death on a post-modern society. PMID- 2714961 TI - Cost containment, DRGs, and the ethics of health care. A physician's reflections. PMID- 2714962 TI - Ethics committees. The limits of moral objectivity. PMID- 2714963 TI - Ethics committees. Advice and consent. PMID- 2714964 TI - Ethics committees. Why cases sometimes go wrong. PMID- 2714965 TI - Hospital ethics committees required by law in Maryland. PMID- 2714967 TI - The technology fallacy. PMID- 2714966 TI - HIV-infected physicians and the practice of seriously invasive procedures. AB - The practice of HIV-infected physicians who perform seriously invasive procedures calls for professional guidance to protect patient safety and the privacy of infected physicians. PMID- 2714968 TI - Doctor bashing? PMID- 2714969 TI - Letting go of the "brain dead". PMID- 2714970 TI - Language, thought, and reality. PMID- 2714971 TI - AIDS--missing the date. PMID- 2714972 TI - Headaches in hospitalized cocaine users. AB - We reviewed the medical records of 283 cocaine users consecutively admitted to a municipal hospital and identified 37 patients (13.1%) complaining of headaches. These patients were divided into three groups. Three patients had migraine-like headaches and transient hemiparesis associated with cocaine use. Five patients had headaches associated with cocaine withdrawal. In 29 patients headaches were not clearly associated with cocaine. Twenty-two of the 29 had chronic daily headaches; nine of these patients were depressed. Three had focal brain lesions with chronic daily headache or acute onset global headache. The four remaining patients had other headaches. Based on these findings, we conclude that: (1) Headache is a common complaint in hospitalized cocaine users; (2) Cocaine may occasionally trigger a syndrome which resembles hemiplegic migraine. The potential mechanisms of this syndrome will be discussed; (3) Hospitalized cocaine users who present with headaches most frequently have depression with suicidal ideation, often associated with cocaine withdrawal; and (4) Structural brain disease in these patients may result from a variety of causes. PMID- 2714973 TI - Facial pain, headache, and temporomandibular joint inflammation. AB - We studied one hundred patients with suspected temporomandibular joint (TMJ) arthropathy in whom 64 also complained of headache and/or facial pain, using high field surface coil magnetic resonance (MR) imaging, and found that headache and facial pain are commonly observed in association with inflammatory arthropathy of the TMJ. Each patient complained of pain and/or tenderness localized to the immediate vicinity of at least one TMJ. Pathologic joint effusion was demonstrated by MR in 88 of the painful joints studied. Significant meniscus displacement, with or without meniscus deformity and alteration of intrinsic signal intensity was present in 94 of the 100 painful joints examined. Fascial inflammation and atrophy of the ipsilateral muscles of mastication were observed occasionally with painful joints. There were no mechanical TMJ symptoms, such as joint clicking, crepitus or locking in 14 internally deranged and painful joints, 12 of which exhibited joint effusion and local inflammation. At least 80 patients described occlusal changes within 12 months of imaging. 28 of the pathologic joints in the series underwent subsequent meniscectomy, including routine histologic evaluation of surgical material. We conclude that internal derangement and inflammation of the TMJ should be considered in patients with unexplained headache and/or facial pain, even if mechanical TMJ symptoms are absent. PMID- 2714974 TI - Relevance of prostaglandins in true menstrual migraine. AB - Eighteen patients suffering from true menstrual migraine and 12 control subjects were studied. We evaluated in different phases of the menstrual cycle and during the migraine crisis the peripheral plasma concentrations of 6-keto-PGF1 alpha (the stable metabolite of PGI2), thromboxane B2 (the stable metabolite of thromboxane A2), PGF2 alpha and PGE2. The mean values of 6-keto-PGF1 alpha in menstrual migraine sufferers are lower than in normal women throughout the whole cycle. The difference between the trends observed in the two groups is statistically significant (p less than 0.05). The plasma levels of TXB2 and of PGF2 alpha are similar in the two groups investigated, both in basal conditions and during the attack. The plasma concentrations of PGE2 are slightly lower in migraineurs in basal conditions than in normals. However, during the crisis they increase significantly (p less than 0.05). In conclusion, among all the parameters considered, PGE2 seems to play the most important role during the pain phase of the attack. The results of the present study suggest that a deficit of PGI2, one of the most important protecting agents against ischemia, might be a typical feature of menstrual migraine and might cause in these patients a vascular hypersensitivity to different ischemic stimuli. PMID- 2714975 TI - Long-latency auditory event related potentials in migraine. AB - The pathophysiology of migraine and its associated perceptual symptoms remains controversial. We recorded long-latency auditory event related potentials (AEPs) in 30 unmedicated patients with common migraine, and compared them to 20 controls. 1,000 and 3,000 Hz tones were presented in an 80:20 ratio at 75 dB SL. 200 responses were recorded and replicated from Cz-A1 + A2, with filter band-pass of 1-100 Hz, analysis time of 1,000 ms., and interstimulus interval of 1.1 second. N100, P200, and N200 ERP components did not differ in latency or amplitude between migraine patients and controls. P300 was longer in latency among those with common migraine, and P300 amplitude was significantly reduced (P greater than 0.05). These findings suggest that migraine may have a central mechanism, and that migraineurs may have a difference in task involvement or perception which may influence their clinical course and response to therapy. PMID- 2714976 TI - Nocturnal plasma melatonin levels in migraine: a preliminary report. AB - We determined by radioimmunoassay plasma melatonin levels on blood samples drawn at 11 p.m. in migraine patients and control subjects. Ninety-three cephalalgic outpatients (75 females, 18 males) were compared to a control group (24 females, 22 males) matched according to age. Patients were divided into subgroups presenting common migraine (n = 38); ophthalmic migraine (n = 12); and tension headache associated with ophthalmic or common migraine (n = 24), and associated depressive status (n = 19). Statistical analysis revealed a decrease in plasma melatonin levels for the entire migraine population, compared to the control one, and a heterogeneity in both controls and patients; this heterogeneity was found mainly in the depressive and tension headache subgroups. When the migraine population--from which the depressive patients were excluded--was divided into male and female subgroups, a decrease in plasma melatonin levels was observed only for the female subgroups. Results are discussed with reference to the role of the pineal gland in the synchronization of the organism with the environmental conditions. PMID- 2714977 TI - Legal inhibitions. PMID- 2714978 TI - The migraine aura as a cause of avoidance behavior. AB - Two patients are reported in whom the occurrence of migraine aura led to the development of avoidance behavior. In both patients the migraine aura was given a significance of doom by a previous experience. The avoidance behavior represented an attempt of the patients to deal with the visual disturbance. PMID- 2714979 TI - A medically oriented eclectic psychoanalytic psychiatrist. PMID- 2714980 TI - Hospital wellness centers: strategic implementation, marketing, and management. AB - Fitness and wellness programs can be a strategic extension of a hospital's services, assist in attracting totally new patients to a facility, and help improve a hospital's image. PMID- 2714981 TI - Future role of academic medical centers. AB - Academic medical centers face many future challenges; success will not come as easily as it has in the past. Building on strengths of the past, as well as reorganizing to address emerging issues, will be the keys to success. PMID- 2714982 TI - Public relations marketing: applying public relations techniques to the marketing mix. AB - Public relations plays an important role in the marketing mix. To use public relations effectively, marketers should become more familiar with its function and techniques. PMID- 2714983 TI - Health care quality: the new marketing challenge. AB - More and more buyers of health care are evaluating the quality of care as well as the cost. To stay competitive, providers must now learn how to sell quality. PMID- 2714984 TI - [Detection of a mitogenic serum factor in psoriasis]. AB - Using human fibroblast cultures in vitro, a study was carried out on the effect of sera from patients with psoriasis and from healthy volunteers on DNA and protein synthesis. Thymidine incorporation was enhanced under the influence of psoriatic sera whereas there was no difference in amino acid incorporation in the control sera. Based on these results, we conclude that systemic psoriasis may be under humoral control. PMID- 2714985 TI - [Apocrine chromhidrosis]. AB - Apocrine chromhidrosis is an extremely rare and impressive skin disorder. Primarily after emotional stress patients complain of coloured sweat secretion (black, green, blue or yellow). The deposition of lipofuscin in the apocrine glands may be the cause of this disease, the different colours of sweat being due to various oxidation stages of lipofuscin. We report two patients, one with blue and one with green axillae; the clinical features, histopathology, differential diagnosis, and pathogenesis of apocrine chromhidrosis are discussed. PMID- 2714986 TI - [Post-zoster granuloma anulare]. AB - Five weeks after a herpes zoster infection of the right 6th thoracic segment, a 57-year-old male patient developed papular skin lesions in the same area. Histological examination allowed a diagnosis of granuloma anulare. PMID- 2714987 TI - [Growth inhibition of melanoma cells by interferons in vitro. Similar antiproliferative effects of 100-1000 times lower concentrations of nIFN-beta in comparison with rIFN-alpha-2a]. AB - The type I interferons (IFNs) rIFN-alpha 2a and nIFN-beta showed a significant dose-dependent antiproliferative effect on melanoma cell monolayer cultures in vitro compared with untreated controls (P less than 0.01 at 10 IU/ml; P less than 0.01 and P less than 0.001 at 1,000 IU/ml). The antiproliferative effect of a single IFN dose lasted for a maximum of 4 days, after which uninhibited proliferation of melanoma cells was again observed. In all experiments nIFN-beta showed a similar antiproliferative effect to rIFN-alpha 2a on the two melanoma cell lines (StML-11, SKMel-28) tested, when used in concentrations 100-1,000 times lower. At concentrations of 10,000 IU/ml rIFN-alpha 2a and 100-1,000 IU/ml hIFN-beta cytotoxic effects were observed. PMID- 2714988 TI - [Staphylococcal scalded skin syndrome in 2 adults with acute kidney failure]. AB - We report on two cases of staphylococcal scalded skin syndrome (SSSS) in adults. In contrast to the previously reported cases our patients were neither immunosuppressed nor haemodialysed, nor did they have cancer. In both cases, acute renal failure in the presence of a rather banal staphylococcal infection preceded the SSSS. The pathogenic role of acute renal failure in the development of SSSS is discussed. PMID- 2714989 TI - [Adenoid basalioma of the axilla]. AB - Basal cell carcinoma is the most common malignant skin tumor in the elderly. It occurs predominantly in the head and neck region. As is well known, skin exposed to sunlight is the most frequent location, but basal cell carcinoma can arise elsewhere. This report describes a 81-year old woman who developed a basal cell carcinoma of the adenoid subtype in the axilla. Before surgical excision, the lesion was diagnosed cytologically. This diagnosis was confirmed by histology. Cytologic examination of skin lesions whose size and location allow this procedure appears to be the sole conservative means of achieving a presurgical diagnosis. The technique is simple. The morphologic differential diagnosis of basal cell carcinoma is discussed. PMID- 2714990 TI - [Clofazimine--therapeutic alternative in necrobiosis lipoidica and granuloma anulare]. AB - Twenty patients, ten suffering from disseminated granuloma anulare and ten from necrobiosis lipoidica, were treated with clofazimine 200 mg p.o. daily. Six patients in each group (60%) responded to this regimen, and three of the responders in each group achieved complete remission of the dermatosis. In eight patients (40%) no improvement at all was observed. All the patients treated had reddening of the skin, but this was reversible after the end of therapy, as were the other side-effects, i.e. diarrhoea and dryness of the skin, which were not experienced by all patients. PMID- 2714991 TI - [Scleroderma and HLA antigens]. AB - A possible HLA disease association was investigated in 40 patients (38 female, 2 male) with progressive systemic scleroderma (PSS), and 42 patients (32 female, 10 male) with morphea. HLA ABCDR/DQ, glyoxalase and properdin factor B (GLO and BF) phenotypes of patients were compared with 193 healthy controls. Four PSS family studies were performed. The following relative risk (rR) values were determined in PSS: A1 (1.38), A2 (1.39), B8 (1.67), B15 (3.22) and in morphea: A3 (1.43), B7 (1.39), B40 (1.81), BW60 (2.49), DR2 (2.38) and DRW8 (2.55), indicating a relatively weak, HLA-linked genetic predisposition for the manifestation of these dermatological disorders. The HLA "risk" antigens for the two clinically different subtypes of the disease are also different: raised A1/B8 frequencies such as those in our PSS group are related to high (or pathologic) immune response (autoimmune disorders). In contrast, A3 B7 DR2 elevations such as those recorded in our morphea group correlate with low immune response. Following exposition to certain suspected environmental factors (quartz, chemical solvents, drugs, viral fragments), the HLA phenotype may thus predipose some individuals- predominantly women--to different clinical patterns of the disease. HLA typing may thus be useful in clinical differential diagnosis (recent subtyping protocols) and possibly also for determination of the prognosis, i.e. HLA-B8 seems to be related to an acute, inflammatory course of PSS, and HLA-B7/DR2, to rather mild morphea patterns. PMID- 2714992 TI - [Neurodermatitis in primates: a case description of a female gorilla]. AB - Neurodermatitis or atopic dermatitis appears to be more widespread among animals than has been assumed hitherto. We report on a female gorilla in Saarbrucken Zoo; after years of captivity the animal developed recurrent eczema in the crooks of the elbows and knees. An interesting aspect of this case is that apparently psychological factors stemming from a partner conflict led to manifestation of the disease. We discuss the feasibility of determining the presence of IgE. PMID- 2714994 TI - Determining provider choice for the treatment of mental disorder: the role of health and mental health status. AB - This article specifies and estimates a model of provider choice for mental health services. Three types of providers are identified: specialty mental health providers, general medical providers, and informal providers. Specific attention is paid to the role of health and mental health status in determining provider choice. The model is estimated using a multinomial logit approach applied to a sample of 2,800 respondents to the Baltimore Epidemiological Catchment Area Survey. The results are largely consistent with the previous work of Wells et al. (1982), suggesting that health and mental health status play an important role in the decision to seek care but have little effect on the type of provider chosen. The results also reveal that 22 percent of individuals obtaining mental health care did so through the informal care sector. One exemplary benefit design simulation is performed using the estimation results. PMID- 2714993 TI - Patterns of surgical and nonsurgical hospital use in Michigan communities from 1980 through 1984. AB - Hospital discharge rates vary substantially among 60 communities in Michigan. (R2 = 90 percent and R2 = 85 percent of the systematic variance is explained by community effects for nonsurgical and surgical discharges, respectively.) The ranking of communities by discharge rates is stable over a five-year period (Spearman rho = 0.78 for nonsurgical discharges and 0.72 for surgical discharges). Surgical discharge rates decreased substantially (4 percent per year) over this time period, while nonsurgical rates showed no consistent pattern. Communities with exceptional discharge rates showed no substantial or significant regression toward the mean through the five-year study. PMID- 2714995 TI - A new method for protein labeling with 99mTc. AB - A method is described for labeling proteins with 99mTc, the radionuclide of choice in diagnostic nuclear medicine. Labeling efficiency, stability of label attachment and retained biological behaviour, e.g. immunoreactivity of monoclonal antibodies after radiolabeling are demonstrated. An application of a 99mTc labeled anti-fibrin monoclonal antibody in radioimmunoimaging of thrombi is presented. PMID- 2714996 TI - Comparative studies of radiotracer citrates in oncological models--2. 153Sm citrate and 67Ga-citrate. AB - 153Sm-citrate solutions were prepared from enriched 152Sm2O3 which had been irradiated at 10(12)n cm-2 s-1 in the University of Alberta Slowpoke reactor. 153Sm was rapidly bound (93% in 2 h) by Melanoma 2AB cells in tissue culture upon incubation in the presence of 153Sm-citrate (1.9 nmol 10(6) cells). In vitro ultracentrifugation studies of 153Sm-citrate solutions showed that colloid formation under incubation conditions could have been responsible in part for the uptake by cultured cells. Low uptakes (less than 1% in 2h) of 67Ga-citrate were seen under similar conditions. 153Sm-citrate injected into BDF1 mice (Lewis lung carcinoma) and Copenhagen x Fisher rats (Dunning R3327-H prostatic tumors) was concentrated mainly in the liver, with some tumor and bone uptake. The percent of injected dose per organ for 153Sm and 67Ga in the murine and rat models respectively, 24 h after i.v. dosing, was 17.2 +/- 4.7 and 2.0 +/- 0.6 (tumor), 63.9 +/- 7.9 and 14.4 +/- 1.4 (liver) and 0.6 +/- 0.1 and 1.3 +/- 0.1 (blood); % injected dose g-1 femur was 6.2 +/- 2.7 and 12.9 +/- 2.7, respectively. Scintigrams of rats showed qualitative biodistributions similar to the quantitative mouse data obtained by dissection studies. The high hepatic uptake detracted from the otherwise superior tumor localization of 153Sm-citrate when compared to 67Ga-citrate in these models. The murine Lewis lung tumor index (% injected dose g-1 tumor x tumor: blood) was 303.6 for 153Sm-citrate and 48.9 for 67Ga-citrate, 24 h after injection. PMID- 2714997 TI - Differentiation in vivo of the sequential blood cell invasion following ureter obstruction of the rabbit kidney. AB - Inflammatory cellular changes occurring during renal injury as a consequence of unilateral ureter obstruction were studied in vivo using 111In-labeled leukocytes and 111In-labeled platelets. The radiolabeled cells were administered at various times after induction of hydronephrosis by unilateral ureter ligation in New Zealand rabbits. The contralateral kidney (CLK) served as the control. The migration and accumulation of the radiolabeled cells was monitored by dual isotope scintigraphic imaging (i.e. 99mTc-labeled red blood cell subtraction) and confirmed by direct analysis of removed epsilateral hydronephrotic kidney (HNK) and CLK at the time of sacrifice. When 111In platelets were administered, significantly greater uptake in the hydronephrotic kidney was observed within 15 min of ureter ligation. Furthermore, the HNK accumulated twice the amount of 111In radioactivity than the CLK, when either the polymorphonuclear neutrophils (PMN) or monocytes were injected at the time of ureter obstruction. The differences between HNK and CLK were scintigraphically detectable between 6 and 12 h after hydronephrosis respectively; and 111In-labeled monocytes selectively accumulated in HNK if administered during the first 48 h after ureter ligation. These data suggest that inflammatory cells sequentially accumulate following ureter obstruction and are derived from circulating white blood cells. PMID- 2714998 TI - Synthesis and evaluation of (17 alpha,20E)21-[125I]iodo-11-substituted-19 norpregna-1,3,5(10), 20-tetraene-3,17 beta-diols: the influence of 11 stereochemistry on tissue distribution of radioiodinated estrogens. AB - The 21-tri-n-butylstannyl derivatives of (17 alpha,20E)-11 alpha and beta-methoxy 19-norpregna-1,3,5(10),20-tetraene-3,17 beta-diol were synthesized and characterized. These compounds, as well as the 11-unsubstituted compound were converted via electrophilic ipso radioiododestannylation to the corresponding 21[125I]iodo analogs at the no-carrier-added level in 73-90% isolated radiochemical yields. The radiochemical 4c [IV alpha ME2, (17,20E)-21[125I]iodo 11 alpha-methoxy-19-norpregna-1,3, 5(10),20-tetraene-3,17 beta-diol] was evaluated in immature female rats and the results compared to those previously reported for 4a (IVE2) and 4b (IV beta ME2) to determine the influence of 11 substitution on the ability of the compounds to function as estrogen receptor seeking agents in vivo. The results indicated that the uptake of 11 alpha-methoxy derivative in the target organ was substantially lower, of shorter duration, with a much smaller specific receptor binding component than the other two radioligands. The distribution profile of the three 17 alpha-iodovinyl estrogens paralleled that previously reported for the corresponding 17 alpha-ethynyl estrogens and this study suggests that the in vivo pharmacological results reported for the 17 alpha-ethynyl estrogens may be used to predict the in vivo behavior of the corresponding 17 alpha-iodovinyl analogs. PMID- 2714999 TI - Compartmental biodistribution of a monoclonal antibody against human lung adenocarcinoma grown in athymic mice. AB - The biodistribution of the radioiodinated monoclonal antibody KS1/4 and of its F(ab) and F(ab')2 fragments were studied in tumor-bearing nude mice. Intravenous administration of the intact antibody resulted in the highest tumor retention and tumor/blood ratios. No metabolites or antigen-antibody conjugates were detectable, in serum, by HPLC analyses. Reasonable correlations were obtained between the estimated time-course of KS1/4 and experimental biodistribution data using an eight-compartment linear radiopharmacokinetic model, suggesting that such models may be useful in predicting the biodistribution and effective targeting of this monoclonal antibody. PMID- 2715000 TI - Biodistribution of two 99mTc-cardiac glycosides with end glucose unit: effect of lipophilicity on their relative myocardial accumulation. AB - In biodistribution experiments with tritium labelled cardiac glycoside it was observed that compounds of low lipophilicity showed a considerably higher affinity towards myocardium with respect to other tissues and organs. A similar trend was also observed with 99mTc-cardiac glycosides except for one compound with glucose residue, which in spite of its lower lipophilicity exhibited an unexpectedly low heart to non-target concentration ratio, thereby indicating a possible influence of carbohydrate residue on biodistribution. To confirm this, in this article we radiolabelled two glucose containing cardiac glycosides (K strophanthin-beta and K-strophanthoside) with 99mTc and, in biodistribution experiments, less lipophilic 99mTc-K-strophanthoside showed a much better heart to non-target ratio over 99mTc-K-strophanthin-beta. It is thus concluded that, in addition to lipophilicity, the affinity of the carbohydrate residue for non target organs is also an important consideration in determining the structure distribution relationship of 99mTc-cardiac glycosides. PMID- 2715001 TI - Relation between the location of elements in the periodic table and various organ uptake rates. AB - Fifty four elements and 65 radioactive compounds were examined to determine the organ uptake rates for rats 3, 24 and 48 h after i.v. injection of these compounds. They were prepared as carrier free nuclides, or containing a small amount of stable nuclide. Generally speaking, behaviors of K, Rb, Cs and Tl in all the organs were very similar to one another, but they differed from that of Na. Bivalent hard acids were avidly taken up into bone; therefore, uptake rates in soft tissues were very small. Hard acids of tri-, quadri- and pentavalence which were taken up into the soft tissue organs decreased more slowly from these organs than other ions. Soft acids such as Hg2+ were bound very firmly to the component in the kidney. Anions (with few exceptions), GeCl4 and SbCl3 were rapidly excreted in urine, so that the uptake rates in organs were low. PMID- 2715003 TI - In vivo diagnosis and therapy of human tumors with monoclonal antibodies. Part I. Proceedings of a symposium. Naples, Italy, 16-19 March 1988. PMID- 2715002 TI - Ocular blood flow in dogs using radiolabelled microspheres. AB - We used radioactive microspheres of different sizes to determine the rate of blood flow through the various parts of the eye in dogs. The use of either 15 +/- 5 microns or 25 +/- 5 microns microspheres gave reproducible measurements of total ocular and uveal blood flows. Using these sphere sizes, retinal flow was found to be close to 1% of the total ocular blood flow and showed poor reproducibility due in part to the small number of spheres trapped in the retinal vessels. PMID- 2715004 TI - Detection of colon cancer with radiolabelled monoclonal antibodies. PMID- 2715005 TI - Anti-murine antibody response to mouse monoclonal antibodies: clinical findings and implications. AB - Many patients given murine monoclonal antibody become immune to these proteins. Important factors in the development of immunity are (1) the patient's ability to become immune and (2) whether whole immunoglobulin or Fab fragment was used. Circulating anti-murine antibodies increase the murine antibody plasma clearance and the liver or spleen uptake while reducing tumor targeting. Clearance rates and radioassay measured levels of anti-murine antibodies are related to serum murine/anti-murine antibody complexes. Unlabeled murine antibody displaces radiolabeled antibody from these complexes. PMID- 2715006 TI - Diagnosis of ovarian cancer with radiolabelled monoclonal antibodies: our experience using 131I-B72.3. AB - Radioimmunoscintigraphy (RIS) using 131I-labelled B72.3, a monoclonal antibody (MoAb) reacting against a tumor associated antigen (TAA) called TAG-72, has been performed in 36 patients with epithelial ovarian cancer. The patients were divided in three groups as follows: 17 patients with primary cancer before any therapy (Group 1); 10 patients studied after a partial therapeutic approach, having either bulky or minimal disease (Group 2); 9 patients with microscopic disease or in clinical remission at the moment of the study (Group 3). All the most important epithelial histotypes, including mucinous, were present. Results were confirmed at surgery and/or by other diagnostic procedures. Immunocytochemical (ICC) and immunocytofluorimetric (ICF) studies on ascitic collections were performed in order to demonstrate specificity of B72.3 and TAG 72 distribution on neoplastic cells. Immunohistochemistry (IHC) on tissue sections was also obtained. No cross reactions between B72.3 and mesothelial cells in the presence of specific uptake by neoplastic cells was found. Moreover, a non-homogeneous distribution of TAG-72 in the neoplastic population was demonstrated by ICF. RIS proved the intraperitoneal presence of disease in 15 out of 17 and in 5 out of 10 patients in Groups 1 and 2, respectively. One out of four (Group 1) and two out of four (Group 2) extraperitoneal metastases were also seen. False negative results were explained by lack of expression of the antigen, size and location of the lesion, and patho-physiological conditions. One false positive due to an aspecific uptake by a post-surgical active scar was also observed in a disease-free patient. PMID- 2715007 TI - Determination of antigen concentration and distribution in human tumors: the quantitative autoradiographic approach. PMID- 2715008 TI - Monoclonal antibody internalization by tumor cells: an experimental model for potential radioimmunotherapy applications. AB - The monoclonal IgM 3G5, which reacts with the surface membranes of rat insulinoma cells RINm5F, was purified by HPLC and labeled with 125I using Protag-125; bovine IgG (bIgG) was similarly radiolabeled, and used as a control. 125I-3G5 was incubated with RINm5F cells either at 4 degrees C or at 37 degrees C. 125I-3G5 bound onto RINm5F cells growing in Petri dishes remained approx. constant over 44 h when incubated at 4 degrees C, whereas at 37 degrees C radioactivity was released back in the medium starting at 3 h (plateau at approx. 20 h). At the end of incubation at 37 degrees C, activity in the medium included a high percentage of free 125I (15.69 vs 2.62% for bIgG, and 1% for 3G5 at 4 degrees C). In a cell suspension experiment, cell-bound 125I-3G5 also remained constant over a 24 h incubation at 4 degrees C, whereas at 37 degrees C it decreased to 37.5% of its initial value (64.1% at 4 h). Concomitant microautoradiography showed diffuse radioactive deposits within the RINm5F cells following incubation with 125I-3G5 (but not 125I-bIgG) at 37 degrees C. These results indicate that 3G5-IgM reacts with a surface antigen on the RINm5F cells, but is rapidly internalized by the cells: within the cells, this antibody undergoes some metabolic processing which results in the release of free 125I outside the cells. PMID- 2715009 TI - Role of 131I-labelled anti-CEA/CA 19-9 monoclonal antibodies in the diagnosis and follow-up of gastrointestinal tumors. PMID- 2715010 TI - Comparison of bone marrow dosimetry and toxic effect of high dose 131I-labeled monoclonal antibodies administered to man. AB - 131I-labeled monoclonal antibodies were used in therapeutic trials in two potentially useful clinical situations: disseminated melanoma (intravenously administered Fab fragments; 21 patients) and disseminated peritoneal adenocarcinomatosis (intraperitoneal injection of IgG; 5 patients). Acute toxicity observed is consistent with mild bone marrow suppression of acute radiation syndrome and the observed toxicity is dose related in a manner that conforms to the expected human response to total body irradiation. For single doses of both i.p. administered and intravenously administered 131I-labeled anti tumor antibodies, 100 rad to red marrow, calculated by the absorbed dose fraction method (MIRD), appeared to be a threshold below which significant acute toxicity was unlikely. PMID- 2715011 TI - A simple qualitative determination of human antibodies to murine immunoglobulins (HAMA) in serum samples. PMID- 2715012 TI - HPLC as the archetypical animal. PMID- 2715013 TI - The biodistribution of [75Se]bis-[beta-(N,N,N-trimethylamino)ethyl]selenide diiodide in adult guinea pigs. AB - The biodistribution of [75Se]BISTAES was studied in guinea pigs. A higher concentration of radioactivity was observed in articular cartilage than in other tissues or organs. A minimal amount of radioactivity was found in the blood, muscle and bone. The compound was excreted rapidly in urine. The target to background ratios were encouraging. [75Se]BISTAES has potential as an articular cartilage imaging agent and further studies in osteoarthritic animals are merited. PMID- 2715014 TI - Radiopharmacological profiles of tracers under pathophysiological conditions. Bone uptake of 99mTc-phytate in vitamin D deficient rats. AB - The radiopharmaceutical 99mTc-phytate, formed by reacting the phosphatic ligand, myo-inositol hexakisphosphate with a reduced form of 99mTcO4-, is widely employed in diagnostic nuclear medicine for scinti-imaging the RE system. Despite it being a compound derived from a ligand containing phosphatic functional moieties it does not concentrate to a significant extent in the osseous tissue following i.v. injection into animals or humans. Neither has there been any clinical report citing its localization in the skeletal tissue consequent to its i.v. injection into patients with different types of pathophysiological conditions/metabolic bone disorders. In the course of our study of the homing characteristics of radiopharmaceuticals into specific organ systems or secondary target sites we found that 99mTc-phytate could be directed to some extent into the skeletal tissues of experimental rats by altering its physiological milieu--viz. by decreasing blood calcium levels and increasing bone resorption. Such an altered physiologic condition is obtained by experimentally inducing vitamin D deficiency in animals. Our results show that 8-10% of the administered dose could be redirected to the bone matrix but at the expense of the liver. The study also indicates that many so-called organ specific 99mTc-radiopharmaceuticals could have more than one target tissue/organ system for accumulation consequent to being introduced into the systemic circulation. In a number of instances the secondary target may be masked and may be elicited only under certain specific pathophysiologic conditions. PMID- 2715015 TI - Synthesis and biological properties of the lipophilic technetium-99m complex 99mTc(acac)3. AB - In the development of technetium-99m radiopharmaceuticals for the evaluation of regional cerebral perfusion, one series of complexes that has remained unexplored is the neutral lipophilic tris complexes formed with beta-diketonato ligands. The prototype complex of this series, tris(2,4-pentanedionato) technetium(III), has been prepared via a new synthetic route and chemically characterized using 99Tc and the biodistribution of the no-carrier-added 99mTc complex has been determined. The 99mTc complex was found to be distributed throughout the body with persistent high blood levels indicative of a high degree of protein binding. The primary route of excretion was the hepatobiliary system as indicated by the appearance of 99mTc in the gut and feces at longer sample times post-injection. Although this complex was not retained by the brain, it does provide a starting point from which a more effective agent might be developed. PMID- 2715016 TI - Technetium-99m complexes of dimethylaminomethylene diphosphonate (DMAD)--I. Anion exchange HPLC characterization of 99mTc(NaBH4)-DMAD mixtures. AB - Radiopharmaceutical analogs prepared by sodium borohydride reduction of 99mTcO4- in the presence of DMAD have been characterized by anion exchange HPLC (high performance liquid chromatography) separation of the resulting mixture into component 99mTc-DMAD complexes. The distribution of complexes within a radiopharmaceutical formulation can be manipulated by controlling technetium concentration, pH, presence or absence of air, and time post reaction. PMID- 2715017 TI - [Swiss Society of Surgery, 75th annual meeting. 23-25 June 1988, Montreux. Held jointly with the 11th annual meeting of the Swiss Society of Senology. Proceedings]. PMID- 2715018 TI - [How great is the risk of cancer and recurrence following benign breast biopsy?]. AB - Four hundred and thirty-eight patients with biopsy-proven benign breast disease were followed annually in a prospective manner for 4-17 years, to analyze breast cancer risk, correlations with cancer development and recurrence during follow up. Twelve breast cancers developed in 12 patients during follow-up, giving a 2.6 fold increased cancer risk over the reference population. No association was found between patients who developed cancer and those who did not with respect to the initial histologic feature (p = 0.9), the age at entry by decades (p = 0.4) and relative to menopause (p = 0.3), the presence of cysts (p = 0.5) or calcification (p = 0.2) in the biopsy specimen, a family history of breast cancer (p = 0.7) or the follow-up time (p = 0.9). Benign breast disease does not inevitably lead to recurrence. Moreover, 47% of the 438 patients never had any recurrence and were free of symptoms during follow-up, and 84% never required a further operation. We conclude that an aggressive approach to benign breast disease is not justified, for any type of lesion as defined in this report. PMID- 2715019 TI - [Paralyses of the recurrent laryngeal nerve following strumectomy in late follow up]. AB - Over a period of 5 years, 323 patients underwent an operation on a goiter. A postoperative paralysis of the recurrent laryngeal nerve occurred in 31 patients, most in malignancies and recurrent goiters. 26 patients were controlled at least 1 year after operation. 65% of the patients have a fully recovered voice and normal vocal cord function. Another 14% showed a normal voice for daily use by functional compensation of the paralysis. Only in 4 patients (16%) the operation resulted in a permanent modest or severe hoarseness as consequence of a thyroidectomy in cancer. PMID- 2715020 TI - [The value of thymectomy in myasthenia gravis]. AB - In the management of Myastenia gravis thymectomy has gained an important position. Still in discussion is whether a transsternal approach gives a superior result to a collar approach. Between 1970 and 1986 35 patients with Myasthenia gravis underwent thymectomy, in 12 by a collar approach, in 19 by sternotomy and 4 by thoracotomy. Results were equivalent independent of the approach but only after transsternal incision complications occurred in 3 patients. At 6 months after operation 18 of 35 patients were classified in a lower category following Ossermann's classification, an other 12 were stable and in 5 the information unobtainable. At the end of follow-up between 1 and 17 years, 19 out of 29 were improved; 4 unchanged and 5 demonstrated progressive disease, 1 patient died due to the disease. Almost 70% of patients judged the operation as helpful. We conclude that the collar approach is safe and effective in patient without thymoma and that in our department thymectomy has an important place in the treatment of Myasthenia gravis. PMID- 2715021 TI - [Can recurrent reflux disease following fundoplication be prevented by adding a vagotomy?]. AB - Recurrent reflux disease is one of the main problems after fundoplication. Reducing gastric acid secretion by adding a vagotomy could theoretically be of beneficial value in controlling reflux. The clinical results of 109 patients were assessed 10 to 20 years after combined fundoplication and vagotomy for primary reflux disease. Indication for an additional vagotomy was severe reflux disease or increased gastric acid output in 56 and coexistent ulcer disease in 53 patients. Data from 64 patients (59.6%) were analyzed. Results were as follows: 17.2% had persistent or recurrent reflux disease, 9.5% needing medical treatment. The results were similar with different types of vagotomy: 18.5% and 14.8%, respectively for truncular vagotomy and pyloroplasty (27 pts.) 17.9% and 7.4%, respectively for selective gastric vagotomy and pyloroplasty (28 pts.), and 11.1% and 0%, respectively for proximal gastric vagotomy (9 pts.). Compared with the results after fundoplication alone, an additional vagotomy does not seem to prevent recurrent reflux disease. PMID- 2715022 TI - [Can truncal vagotomy still be justified?]. AB - The aim of the study was to determine the severeness of the postvagotomy side effects in patients who underwent truncal vagotomy and pyloroplasty in emergency situations because of perforation or haemorrhage of a gastro-duodenal ulcer. Fullness (21%) and diarrhoea (17%) were found to be the most important side effects. Although there were 31% of Visick Grades 3 and 4.86% of the patients were content with their general condition after the operation. None were disabled in their social or working life. It is concluded that because of the well tolerated side-effects truncal vagotomy and pyloroplasty may still be performed in case of emergency-complications of the gastro-duodenal ulcer. PMID- 2715023 TI - [Surgical intraoperative complications in simple cholecystectomy]. AB - In a retrospective analysis of all simple cholecystectomies performed between 1970 and 1987, we were particularly interested in the incidence of intraoperative surgical complications and their long-term follow-up. We analyzed 2441 consecutive simple cholecystectomies and found 60 major intraoperative complications with 55 patients (2.25%): there were 31 vascular lesions (1.27%) and 26 lesions of the biliary tract (1.06%). Amongst the patients with biliary tract lesion but one had to be reoperated one year later due to a stricture which occurred as a consequence of an end-to-end-hepatico-choledochostomy over a T tube. Intraoperative technical complications may happen. Their early recognition and treatment are of utmost importance. PMID- 2715024 TI - [A combined surgical and interventional-radiologic procedure in bile duct obstructions]. AB - Surgery for biliary obstruction may be complicated by the presence of intrahepatic stones and, in difficult anastomoses, by the possibility of recurrent stricture formation. In order to decrease the need for further operation, the first surgical repair in selected cases should allow access for later radiological intervention. Primary operation consists of biliary digestive anastomosis using established techniques with a Roux-en-Y-loop. A limb of the Roux-loop may be brought to the abdominal wall and secured to the anterior parietal peritoneum to allow access for later radiological intervention either by utilizing an established tubal tract into the Roux-loop or by later puncture of the loop under ultrasound guidance. Since October 1986 we have treated 11 patients utilizing this technique. Six patients had complex strictures following cholecystectomy and two patients had obstructions secondary to alveolar or cystic Echinococcosis. One stricture was due to a previous liver resection, one followed previous operation for congenital atresia of the biliary tract and one consisted of multiple strictures and stones associated with oriental recurrent pyogenic cholangitis. In all 11 patients, postoperative radiological imaging was possible. In 6 patients, 14 radiological manoeuvers were carried out for dilatation or for removal of stones and debris. There were no complications. During a median follow up of 11 months no patient needed further surgical intervention. The indications and techniques are outlined. PMID- 2715025 TI - [Therapy and prognosis in 102 liver injuries]. AB - Case histories of 102 patients with liver trauma were analyzed. 88% sustained blunt and 12% penetrating liver injury. 71% of all patients had a polytrauma. The liver injuries were classified in 4 types. With 25 patients primary resuscitation was unsuccessful, in 12 of these cases even though immediate laparotomy and aortic clamping was performed in the emergency room. In 62 of the remaining 77 patients haemostasis was accomplished with minor surgical procedures (lethality 16%), in 13 cases major surgery had to be performed (lethality 62%). Packing was used in one patient only. Prognosis of liver trauma depends mainly on associated injuries and on severity of liver trauma. PMID- 2715026 TI - [Diagnosis and therapy of liver injuries in the polytraumatized patient]. AB - We examined 120 patients with liver trauma, 100 retrospectively (1973-1986 group I) and 20 prospectively (1986-1987 group II). The severity of the liver injury was categorized in 5 grades (modified after Moore) and the degree of multiple trauma was assessed by the injury severity score (ISS). Patients in the liver injury groups were equally distributed among grades I to IV; there was one patient with a grade V injury in both the retrospective and prospective group. The overall mortality was 14%, 15% for the retrospective and 10% for the prospective group. Mortality was mainly due to concomitant injuries (head injuries, ARDS, multiple organ failure, pneumonia) and only 3 patients in the whole group died as a result of continuous bleeding or because of prolonged hemorrhagic shock due to the liver injury. The defined protocol for the prospective group included early efficient resuscitation and blood/fresh frozen plasma transfusion, systematic and rapid assessment of injuries and determination of priorities of treatment. Immediate ultrasonography or peritoneal lavage was used for assessment and diagnosis of a liver injury and early selection of treatment according to the grade of the liver injury: Conservative management for stable cases consisted of close supervision and repeated investigations (CT, angiography). Immediate operation was undertaken for continuing hemorrhage. Postoperative care in an intensive care unit with a low threshold for reoperation in cases of suspected sepsis, ongoing hemorrhage or necrosis of liver tissue was an important part of the treatment. Our results suggest that death in multiple trauma patients should almost never be due to liver injury alone. Conservative treatment may be justified in some patients, but early resuscitation and operation directed at definitive or provisional control of hemorrhage with removal of all devitalized tissue and liberal use of early reoperation are essential in the management of severe liver injury. PMID- 2715027 TI - [Surgical tactics in complicated sigmoid diverticulitis]. AB - Between January 1972 and February 1988 139 admissions (136 patients) for diverticulitis were registered. Treatment remained conservative in 47 cases. 23 cases underwent elective surgery. In 69 patients emergency-laparotomy had to be done. In 41 cases (3 deaths) the abdomen was washed out and drained, followed by a proximal colostomy. In 23 of these patients a free perforation had to be oversewn. 6 patients were treated by Hartmann resection (1 death). Primary resection, anastomosis and proximal colostomy were performed in 15 cases. 3 patients underwent exterritorization and resection. 4 patients with colonic ileus were initially treated by colostomy alone. There were 2 late deaths both from pulmonary embolism. Of the 63 patients who had a colostomy constructed 4 (6.3%) never had the stoma closed. There were 2 persistent stomas in the 41 patients who had a preliminary colostomy alone (4.9%) and the incidence of persistent stoma in 5 patients who had a Hartmann resection was 40% (2 cases). -The three-stage resection makes good results, provided that a free perforation is solidly oversewn to prevent further fecal contamination. Primary resection with anastomosis and proximal colostomy, which is more and more used in suitable cases, considerably shortens duration of treatment. Hartmann resection remains second choice because of the known high incidence of persistent stoma. It is submitted to surgeon's experience to choose at any situation the best procedure regarding age and general state, local findings and extent of peritonitis. With this tactic hospital lethality of emergency operation was 4 of 69 patients (5.8%), overall lethality 6 (8.7%). Intestinal continuity was restored in 94% of surviving patients. PMID- 2715029 TI - [Status of resection-anastomosis in emergency left-sided colon surgery]. AB - Resection and primary anastomosis (RPA) in emergency left-side colon surgery is not universally performed because of anastomotic healing difficulties of unprepared, dilated, or inflamed colons. Ninety-three patients underwent emergency surgery for left-side colon disease. Sixty-three primary anastomoses were performed with a 16% mortality rate and a 6% incidence of anastomotic leakage. These results are similar to those reported in the literature, depending upon the pathology involved, and appear to justify resection and primary anastomosis in case of hemorrhage, trauma, and left-colonic obstruction. As for diverticular perforation with localized peritonitis, RPA can be attempted in some instances, if a protective stoma is added. Finally, in case of diffuse peritonitis, the Hartmann procedure still remains the safest method. PMID- 2715028 TI - [Experiences with 169 mechanical colorectal anastomoses (1981-1984)]. AB - An account is given of 169 rectal anastomosis performed with the EEA-stapler between 1981 and 1984 in the Municipal Hospital Waid of Zurich. The average age of the patients was 63.8 years. 71.6% of the operations have been performed because of a rectosigmoidal carcinoma (50.4% of them with lymph node metastasis) and 28.4% because of a benign rectal disease. 44.4% of the anastomosis were localized at 3.5 to 7 centimeter, 34.9% between 7.5-11 and 20.7% higher than 11 centimeter above the anus. We used the biggest loading unit of 31 millimeter diameter in 89% of all cases. A primary anastomotic insufficiency was discovered intraoperatively in 6.5% (anastomosis sutured or redone). 3.1% of the patients had a temporary colostomy. We found a 4.3% rate of secondary anastomotic insufficiency. All those colo-cutaneous fistula healed spontaneously. Non specific complications as thromboembolism, urinary or wound infection and others were detected in 31.3% of the cases. We found a perioperative mortality rate of 2.5% with no intraoperative deaths. 91.4% of the patients had a follow-up over 2 5 years. There was a need of dilatation of anastomotic stenosis in 2.5% of the cases within the first 4-8 postoperative months. 40.2% of the cancer patients died during their follow-up, two thirds of them within the first two years. The local recurrence rate after 2-5 years of the cancer patients who were operated curatively was 22.3% and 10.7% for distant metastasis. 60.2% were disease free. 54.5% of the recurrent disease was found in patients with primary tumors stage Dukes C2 and D.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715030 TI - [Improvement of perineal wound healing following rectum amputation by omentum flap]. AB - The aim of the presented study was to find whether significant improvement in perineal woundhealing could be achieved by placing pedunculate parts of greater omentum in the sacral cavity after rectal amputation. 70 patients undergoing rectal amputation were evaluated, in 34 patients pedunculate parts of the greater omentum were positioned in the presacral cavity. Results show that an omentum flap improves primary perineal woundhealing and reduces per secundam woundhealing time (p less than 0.025). Since regular placement of pedunculate parts all wounds were closed after 3 months. Sinus formation is reduced (p less than 0.05). Suction drainage must be removed early, otherwise infections aggravate woundhealing going up the tube (p less than 0.001). We conclude from our results that the placement of pedunculate parts of the greater omentum in the sacral cavity after rectal amputation is a useful method to improve perineal woundhealing and should be done as routine procedure. PMID- 2715031 TI - [Prognostic value of DNA ploidy of colorectal tumor cells]. AB - The analysis of ploidy provides valuable information allowing a more precise diagnosis, a more dependable prognostic and the choice of appropriate therapy. With ploidy analysis one can assess the aggressiveness of a given tumor. Aneuploidy of tumors clearly indicates a significantly lower patient survival index. Ploidy analysis of tissue sections yields a clear overall indication of the proportion of cells exhibiting hyperploidy within the tumor mass. The application of this approach is amenable to diverse types of tumors including colo-rectal neoplasias. Additionally, it provides a correlation with the histological presentation of each tumor. The study includes DNA ploidy analysis of 212 patients with primary adenocarcinoma. Sixty-four of the cases examined had follow-ups of a least 2 years. Eighteen of this group had diploid non proliferating tumors, of which 2 (11%) subsequently died. Nineteen of the 64 had proliferating diploid tumors, 11 (58%) of whom died within the follow-up periods. Twenty-seven patients had tumors which were clearly aneuploid, 12 (45%) of whom later died. Our study demonstrates the prognostic value of ploidy analysis. The preliminary results indicate that mortality of patients with proliferating tumors is approximately 50% after 2 years. This prognostic is independent of other more classical criteria of tumor staging, namely Dukes' classification, histological differentiation and size of tumor. In the near future, ploidy analysis should be introduced as a standard part of tumor assessment. It clearly provides a valuable prognostic allowing the selection of patients requiring a careful follow-up. PMID- 2715032 TI - [Effect of blood transfusions on the survival of patients with colorectal cancers]. AB - Blood transfusion is reported to cause immunosuppression. An adverse relationship between perioperative blood transfusions and the risk of subsequent recurrence of cancer was reported recently. We reviewed the records of 282 patients and analyzed the interaction between blood tranfusion and the outcome of Dukes stages A, B and C colorectal cancers treated by radical resection during the years 1978 1985. 53 of these patients did not receive any blood transfusions. The actuarial survival analysis (Cutler and Ederer) showed no significant difference for the overall and recurrence-free survival. This study did not support the hypothesis that blood transfusions had an adverse effect on survival of patients with colorectal cancer. PMID- 2715033 TI - [Esophageal perforation: prognostic factors]. AB - Esophageal ruptures are amongst the severest of the digestive tract. We report a retrospective study of 30 cases (15 men and 15 women) aged 17 to 85, collected between 1976 and 1987. The group of risk is constituted by patients aged 60 and up, presenting an underlying esophageal illness. The endoscopic etiology of the perforation is as severe as the one of surgical or spontaneous origins. Medical treatment is considered only if the perforation is inferior to 2 cm, extra thoracic, without an associated pleural effusion and without an associated esophageal illness. When surgical treatment of a primary suture is done, it is the most important factor to protect the suture by a patch. PMID- 2715034 TI - [Surgical treatment of Barrett esophagus. Apropos of 110 cases]. AB - One hundred and ten patients with Barrett's esophagus were operated on between 1963 and 1986. Preoperative endoscopy showed active peptic disease in 94% of the cases and a stenosis or ulcer in 61%. An anti-reflux operation was performed in 102 cases and a resection in 8 cases. Operative mortality was 3.6% and the morbidity was 9%. After an average follow-up of 6.9 years, 83% of the patients were satisfied with their operation. Postoperative endoscopy was performed in 39 patients after an average of 5.4 years. No progression or regression of the columnar epithelium was found. Two patients developed an adenocarcinoma in spite of adequate reflux control. PMID- 2715035 TI - [Adenocarcinoma of the cardia]. AB - The extensed total gastrectomy of principle represents a new hope in the surgical treatment of the cardial adenocarcinoma. On the basis of a retrospective study of 38 patients (30 men and 8 women) we think that for patients in good general condition and for stades I and II, the enlarged total gastrectomy represents the only treatment with curative aiming. As for stade III and a fortiori stade IV, there is no advantage to use the enlarged total gastrectomy. For stade III, survival is inferior to 10 months, whatever the type of operation used, and for stade IV survival is inferior to 3 months, whatever the treatment. PMID- 2715036 TI - [Is in esophago-intestinal anastomosis the use of mechanical staplers an advantage?]. AB - Sixty-seven consecutive esophageal anastomoses were performed in a period from 1984 to 1987. 35 esophagoenterostomies performed in manual single layer suturing were compared with 32 esophagoenterostomies using mechanical stapling. After manual suturing there was a leak in 8.6%. After mechanical suturing anastomotic failure was seen in 6.2%. The analysis of mortality and morbidity indicate the use of mechanical staplers as a favorable alternative. PMID- 2715037 TI - [Surgical treatment of the unstable thorax in respiratory insufficiency]. AB - Sixteen patients with traumatic flail chest underwent surgical stabilization using procedures introduced by Rehbein, Judet and Vecsei. Compared with sixteen patients treated by internal stabilization with intermittent positive pressure respiration, there are some advantages: time of artificial respiration is shortened, early mobilization is possible, nursing is easier, the costs are lower. The procedure is indicated in those patients, in whom long-term artificial respiration is not necessary for other reasons. PMID- 2715038 TI - [Surgical therapy of pleural empyema]. AB - In the period from January 1976 to December 1986, 31 (56.3%) out of 55 patients with pleural empyema were treated, after failure of conservative treatment with antibiotic drugs, pleural puncture and tube drainage. Twenty-two patients were submitted to a posterolateral thoracotomy with debridement in the early stage or decortication in the later stage of empyema thoracis. There was no relapse of empyema in this group, but 7 patients suffered from air leakage for 7 to 19 days (mean 12 days). One patient needed rethoracotomy after debridement for continuous bleeding. Nine patients were treated in a first step with limited thoracotomy in local anaesthesia with or without costotomy. There were 5 relapses of empyema in this group. The average time of hospitalization was for the debrided cases 13.6 days and for the decortication group 19.6 days. The conservatively treated group remained during 39.5 days in the hospital. PMID- 2715039 TI - [Exploratory thoracotomies for unresectable lung cancer]. AB - We analysed 55 exploratory thoracotomies undertaken in the Thoracic Surgery Service of the Geneva University Hospital between 1977 and 1987, to determine the preoperative examinations to prevent exploratory thoracotomy, a gesture that brings no benefits at all for the patients. We concluded that the most helpful preoperative examination is the CT-scan. PMID- 2715040 TI - [Pancoast's tumor: multi-disciplinary treatment and combined cervico-thoracic approach]. AB - Five patients were treated from May 1987 to April 1988 in CHUV, Lausanne, for a superior sulcus tumor (3 epidermoid, 2 undifferentiated carcinomas). Treatment consisted of preoperative radiotherapy (3000 cGy)-surgery-postoperative radiotherapy (1500-2500 cGy). Two patients died from metastases. Only one patient presented with a local recurrence. Surgical resection was carried out by combined cervical and thoracic exposure. The cervical approach allows separation of the tumor from the subclavian artery, brachial plexus and vertebrae. Then, by thoracotomy, the superior lobe with tumor and thoracic wall is removed. Technical aspects of the procedure are described. PMID- 2715041 TI - [Experiences with the "epigastric pain syndrome"]. AB - The report concerns 162 patients suffering from severe upper abdominal pain without organic findings on routine GI-exploration. Palpation of the abdominal wall revealed well localised pain maxima which appeared to correlate with the distribution of intercostal nerve endings. Exploratory local anaesthesia was able to relieve these symptoms whereby - much to our surprise - the therapeutic effect very often outlasted by months and even years the pharmacological effect attributable to the anaesthetic agent. 129 of the 162 patients treated could be significantly improved or even freed of their painful symptoms. Out of the 33 patients with recurring symptoms, three quarters could be cured or significantly improved by separating the subcutaneous fat from the epigastric fascia, thus destroying the cutaneous branches of the intercostal nerves. It seems legitimate to consider the pathogenesis of these symptoms as being due to entrapments of the intercostal nerve endings in the abdominal fascia and it may thus be considered as an organic entity. Diagnosis is relatively easy and without risk for the patient: exploratory local anaesthesia loco dolenti, which in fact may have a long lasting therapeutic effect. PMID- 2715042 TI - Immunohistochemical study of ontogeny and phylogeny of a terminal N acetylglucosamine cluster antigen. AB - In this work an immunohistochemical method was used to study the ontogeny and phylogeny of a terminal N-acetylglucosamine (GlcNAc) cluster antigen which is an epitope(s) of highly branched N-linked oligosaccharides terminating in GlcNAc residues. The ontogenic studies demonstrated that expression of the antigen is developmentally regulated in lymphocytes, epithelial cells of endodermal origin and kidney mesangial cells of the chicken. The antigen was found in several other avian species studied, namely, the Japanese quail, duck, goose and turkey. Furthermore, the distribution of the antigen in all these species was similar. In adult animals, it was found in bursal and thymic lymphocytes, macrophages, spleen reticulum cells, epithelial cells of the intestine and bronchioles and capillary endothelial cells. The antigen was also detected in epithelial cells of the gastrointestinal tract of several lower vertebrates studied: the amphibian (frog), reptile (chameleon) and fish (rainbow trout). It was undetectable in various organs of the human, African green monkey, calf, pig, rat and guinea-pig, but was found in the intestinal epithelial cells of ten mouse strains. It is likely that biosynthetic processing leading to the formation of highly branched N linked glycans terminating in GlcNAc residues is conserved during evolution in birds and other lower vertebrates. PMID- 2715043 TI - Localization of thyroid hormone in subpopulations of rat alveolar macrophages. AB - Radioimmunoassay and immunocytochemical staining methods were used to study the distribution of thyroid hormone in rat alveolar macrophages. The cells were fractionated into six subpopulations by Percoll density gradient. Positive immunoreactive tri-iodothyronine (T3) was observed in all subpopulations of macrophages, especially in low-density (1.040 and 1.050 g cm-3) groups, by avidin biotin-peroxidase immunostaining techniques. The macrophages also showed various patterns of cellular T3 stainability. Results from radioimmunoassay of macrophage extracts also demonstrated that macrophages of low density had a higher level of total T3 than those of higher densities (greater than or equal to 1.060 g cm-3). PMID- 2715044 TI - Morphometric cytochemistry of diminution of catalase-containing peroxisomes in copper-loaded liver. AB - The density of hepatocellular catalase-containing peroxisomes was quantified, utilizing a computer-aided image analysing technique, on 1-micron thick diaminobenzidine-stained sections. Hepatic copper accumulation following intraperitoneal injection of cupric chloride resulted in a dose-dependent reduction in the density of catalase-containing peroxisomes. A significant correlation between the density of peroxisomes and the activity of hepatic catalase indicated that computer-aided image analysis of peroxisomes stained by the diaminobenzidine technique provided a useful estimate of catalase activity in liver injured by copper. Slight treatment-related differences in the mean diameter of peroxisomes were detected in high-dose but not low-dose rats. PMID- 2715045 TI - Enzymatic degradation and quantitative lectin labeling for characterizing glycoconjugates which act as lectin acceptors in cat submandibular gland. AB - Sites of binding of eight different lectins (LTA, UEA I, WGA, SBA, DBA, CON A, PNA, RCA I) to cat submandibular gland were studied after exposure of tissue sections to sialidase, alpha-fucosidase, beta-galactosidase, alpha-mannosidase, beta-N-acetylglucosaminidase. All lectins were affected by enzymatic predigestion and the labeling of individual lectins was highly dependent upon the glycosidase used to pretreat the sections. Glycoconjugates of demilunar, acinar and ductal cells exhibited a different composition of terminal sequences. For example, fucose proved to form the disaccharide fucose-galactose in demilunar and acinar cells, whereas it was present with the sequence fucose-N-acetyl-D-glucosamine in striated duct cells. Sialic acid participated both to the terminal sequence sialic acid-galactose and sialic acid-N-acetyl-D-galactosamine either in demilunar or in ductal cells. Lectin labeling combined with glycosidase digestion was also helpful in verifying the influence of neighbouring oligosaccharides on the affinity of lectins for the respective sugars. PMID- 2715046 TI - Ultrastructural cytochemistry of hepatic lysosomes and their protein components is selectively revealed by the ninhydrin-dimethyl sulfoxide-thiocarbohydrazide silver proteinate reaction. AB - Proteins in lysosomal membranes, lysosomes and within the transtubular network are readily accessible for electron microscopic analysis by a new three-step method. Oxidative deamination of tissue-bound amino acids by ninhydrin in aqueous dimethyl sulfoxide and the concomitant formation of corresponding carbonyl groups comprise the first step. The addition reaction of thiocarbohydrazide to tissue bound carbonyl groups comprises the second step, while the reduction of silver proteinate by tissue-bound thiocarbohydrazones is the final step of this sequential method. Glutaraldehyde-fixed and osmified ultrathin sections of rat liver embedded in LR White were oxidatively deaminated for 24 h by 1% w/v ninhydrin in aqueous 75% v/v dimethyl sulfoxide (DMSO). They were then incubated for 40 min in aqueous 1% w/v thiocarbohydrazide (TCH) and stained for 30 min at 50 degrees C with silver proteinate (SP). The ninhydrin-dimethyl sulfoxide thiocarbohydrazide-silver proteinate (N-DMSO-TCH-SP) reaction proved to be chemically specific and highly selective for ultrastructural resolution of the internal structure of lysosomes and their protein components. We conclude that the N-DMSO-TCH-SP reaction is the method of choice for cytochemical elucidation of the protein ultrastructure of lysosomes and their enzymatic aggregates. PMID- 2715047 TI - Quantitative immunohistochemistry of metallothionein in rat placenta. AB - The presence of metallothionein (MT) was demonstrated in placentae from cadmium exposed and control rats by an immunohistochemical technique, using peroxidase as label and the diaminobenzidine procedure for the staining reaction. The protein was found in different regions of the placenta, i.e. in trophoblastic labyrinth, in spongiotrophoblast and in visceral yolk sac. Cytophotometric analysis of the final reaction product revealed that the amount of MT was increased in the placental labyrinth of cadmium-exposed rats. Increases were found in both nuclei and cytoplasm of trophoblast cells in the labyrinth region. Possible roles of MT in the transport of zinc and in the carbohydrate metabolism are discussed. PMID- 2715048 TI - Immunohistochemical localization of desmin in the quail ovary. Demonstration of a suspensory apparatus. AB - We have localized desmin in the quail ovary, by the unlabelled antibody peroxidase-antiperoxidase technique, using two monoclonal and one polyclonal antisera. Special attention has been paid to the influence of fixation and of proteolytic pretreatment of sections. It appeared that the immunostaining of desmin largely depends on the nature of the fixative. Carnoy fluid, Bouin's fixative, and a paraformaldehyde-acetic acid fixative preserved the histological structure very efficiently. However, trypsin pretreatment proved to be necessary to unmask the antigenic sites in the ovaries fixed in Bouin's fixative and the paraformaldehyde-acetic acid fixative. Desmin immunoreactivity was detected in the tunica albuginea and the chordae, a number of which surrounding the blood vessels, from the hilus to the thecal surface of the follicles. Small branches of chordae connected them with the tunica albuginea, forming a suspensory apparatus. Desmin was also localized in the smooth-muscle cells of the blood vessels. In the theca, immunoreactivity was detected in the wall of arterioles, of venules, and of capillaries. Further experimental and immunohistochemical research have to be performed to establish if the suspensory apparatus is a myoid tissue. PMID- 2715049 TI - Lectin histochemistry of mammalian Brunner's glands. AB - Lectin histochemical study was performed on twenty-eight specimens of formalin fixed paraffin embedded tissues of proximal duodenum from human, cat, dog and Rhesus (macaque) monkey to demonstrate the pattern of carbohydrate residues in submucosal glands of Brunner as compared to that of the duodenal absorptive and goblet cells. Ten different biotinylated lectins were used as probes, and avidin biotin-peroxidase (ABC) or avidin-gold-silver (AGS) complexes were used as "visualants". Brunner's gland cells of the four species studied exhibited a similar lectin-binding pattern which differ from other duodenal cells. The epithelium of Brunner's gland stained intensely with Ricinus communis agglutinin I (RCA-I), succinylated-WGA (S-WGA) and wheat-germ agglutinin (WGA), moderately with Bandeirea simplicifolia agglutinin-I (BS-I), Concanavalia ensiformis agglutinin (Con A) peanut agglutinin (PNA) and Ulex europaeus agglutinin-I (UEA I) and occasionally with Dolichos biflorus agglutinin (DBA), Lens culinaris agglutinin (LCA) and soybean agglutinin (SBA). Desialylation with neuraminidase resulted in only a slight elevation in binding intensities of PNA, DBA and SBA, indicating that glycoconjugates of the Brunner's gland cells are rich in asialo oligosaccharides, which differs from duodenal epithelial cells. In addition, these histochemical reagents were useful in localizing Brunner's gland elements in the duodenal mucosa. PMID- 2715050 TI - Lectin binding sites in normal and phenobarbitale/halothane treated rat liver. A histochemical study. AB - The content of carbohydrate residues of both normal and phenobarbitale-halothane hypoxia exposed rat liver has been examined by means of lectin histochemistry. Eight biotinylated lectins specific to galactose, N-acetyl-galactosamine, N acetyl-glucosamine, fucose and mannose were applied to paraffin sections of rat liver at light microscopic level. The most distinct binding was observed at the structures of the "perisinusoidal functional unit": Kupffer cells are bound by S WGA, SBA and PNA. Bile canaliculi display binding sites for RCA I and WGA. Cytoplasm of hepatocytes appears lectin-negative, except for PSA. The enhanced reaction of S-WGA, PNA and SBA after the preincubation of the sections with neuraminidase indicates the occurrence of sialic acid in Kupffer cells. The phenobarbitale-halothane-hypoxia exposed rat liver shows centrolobular degeneration of hepatocytes with a diminished amount of hepatocyte and Kupffer cells as well. The lectin binding pattern of sinusoidal walls, membranes of hepatocytes and bile canaliculi remains the same compared to that of normal rat liver. This finding suggests that at least the carbohydrate content of membranes in the liver resists severe destruction under phenobarbitale-halothane-hypoxia. It is assumed that there exists a connection between intact carbohydrate residues and the regeneration of liver parenchyma. PMID- 2715051 TI - Lectin-gold cytochemistry of the Golgi apparatus in rabbit luteal cells, with special emphasis on the formation of a lysosomal-type membrane. AB - In rabbit luteal cells embedded in glycolmethacrylate and stained with PTA at low pH highly glycosylated membrane patches can be observed after vesiculation of the trans-Golgi network. As these membranes could be prelysosomal, their sialic acid content was investigated by post-embedding labeling with Limax flavus agglutinin (LFA)/fetuin-Au. Additional labeling of the Golgi apparatus was performed with Wheat germ agglutinin (WGA)/ovomucoid Au, Ricinus communis agglutininI (RCAI)/Au and Helix pomatia agglutinin (HPA)/Au. The sections were then counterstained with PTA at low pH, which allows a clear distinction between the elements of the trans Golgi network (G2-G1) and the saccules of the stack (g). With WGA, LFA and RCAI the trans-Golgi network was observed to be clearly more reactive than the stack. After vesiculation most intense labeling was found over the highly glycosylated vacuolar membranes derived from the G2-element. The limiting membrane of lysosomes, the MvB's and the plasma membrane also reacted strongly. Colloidal gold particles were also found over the membranes of the vacuoles derived from G1. The Golgi stack showed a lower reactivity and label for all three lectins could be found over three to four saccules of the stack (g3-g4). The matrix of the lysosomes was slightly labeled. Labeling with HPA was absent from the trans saccules and was consistently found in the cis and cis-most (g4-g5) saccules of the stack. Some cytoplasmic vesicles near the cell border were also labeled. With our procedure the Golgi apparatus can easily be detected and it is apparent that in rabbit luteal cells the highest lectin reactivity is found in the trans-Golgi network.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715052 TI - Polarization of plasma membrane glycoconjugates in amphibian epidermis during metamorphosis. AB - Wheat germ agglutinin (WGA) binding sites have been examined in tadpole epidermal cells at the level of both light and electron microscopy using the WGA-ovomucoid gold technique. In premetamorphic tadpoles the reaction was observed on the plasma membranes of epithelial cells showing a gradient from inner to outer membranes. These glycoconjugates were polarized during development, and at the end of metamorphic climax they were only located in plasma membranes of stratum corneum. The existence of an apical cell surface coat is needed to facilitate the absorption of water through the adult epidermis. The possible implications of this polarization process are discussed. PMID- 2715053 TI - Optimization of the histochemical demonstration of DNA using 3-hydroxy-2 naphthoic acid hydrazide and fast blue B. AB - Previous methods for the histochemical demonstration of DNA were optimized. p Toluene sulfonic acid as catalyst for hydrazone formation between the aldehydes generated after Feulgen hydrolysis and 3-hydroxy-2-naphthoic acid hydrazide (NAH) was used instead of acetic acid. Modifications of the conditions of the coupling reaction with Fast Blue B reduced the background staining. The optimized histochemical staining method for DNA (NAH-FB-DNA staining) can be performed easily and reproducibly. Without prior Feulgen hydrolysis the optimized method can also be used for the histochemical demonstration of reactive carbonyls undissolved under the given histochemical conditions. PMID- 2715054 TI - The distribution of GAWK-like immunoreactivity in neuroendocrine cells of the human gut, pancreas, adrenal and pituitary glands and its co-localisation with chromogranin B. AB - GAWK is a recently discovered peptide isolated from extracts of human pituitary gland and subsequently shown to be identical to sequence 420-493 of human chromogranin B. The distribution of this peptide was studied in human gut, pancreas, adrenal and pituitary glands using antisera to two portions of the 74 amino acid peptide (sequences 1-17 and 20-38). In addition, the co-existence of GAWK immunoreactivity with other peptides and chromogranin B was investigated using comparative immunocytochemistry. In the gut, GAWK was localised mainly to serotonin-containing cells of the mucosal epithelium, where electron microscopy showed it to be stored in typical electron-dense (250 nm diameter) granules, and to a moderate population of nerve fibres in the gut wall. Considerable quantities of GAWK-like immunoreactivity were measured in the gut, up to 36.3 +/- 18 pmol GAWK 1-17/g wet weight of tissue (mean +/- SEM) and 12.4 +/- 2.9 pmol GAWK 20 38/g. Chromatography of gut extracts revealed several GAWK-like immunoreactive peaks. GAWK-like immunoreactivity was also detected in endocrine cells of pancreas, pituitary gland and adrenal medulla, where the highest concentrations of GAWK-like immunoreactivity were measured (GAWK 1-17 2071.8 +/- 873.2 and GAWK 20-38 1292.7 +/- 542.7 pmol/g). Endocrine cells containing GAWK-like immunoreactivity were found also to be immunoreactive for chromogranin B. Our results define a discrete distribution of GAWK immunoreactivity in human endocrine cells and nerves and provide morphological support for the postulated precursor-product relationship between chromogranin B and GAWK. Details of the functions of this peptide are awaited. PMID- 2715055 TI - Enhancement of gentamicin-induced nephrotoxicity by Mg deficiency in non-pregnant rats. Morphological, enzyme histochemical and immunohistochemical studies. AB - Non-pregnant rats fed an Mg-deficient diet showed some degenerated and calcified proximal tubules in the inner region of the medullary rays accompanied by reduced or absent enzyme activities. After gentamicin treatment some damaged convoluted proximal tubules occurred. Enzyme histochemistry revealed decreased activities for brush border and lysosomal hydrolases; using immunohistochemistry lesions were detectable for the cytoskeletal proteins keratin and vimentin. Administration of gentamicin to Mg-deficient rats led to a further decrease of hydrolase activities in obviously intact proximal tubules and drastic structural and enzymatic defects as well as alterations of the cytoskeletal proteins in the convoluted and straight segments of other proximal tubules and to a lesser degree also in glomeruli and further portions of the tubular apparatus including the collecting ducts. PMID- 2715056 TI - Human immune responsiveness to Lolium perenne pollen allergen Lol p III (rye III) is associated with HLA-DR3 and DR5. AB - A well-characterized allergen of Lolium perenne (perennial rye grass) pollen, Lol p III, has been used as a model antigen to study the genetic control of the human immune response. Associations between HLA type and IgE or IgG antibody (Ab) responsiveness to Lol p III were studied in two groups of skin-test-positive Caucasoid adults (N = 135 and 67). We found by nonparametric and parametric analyses that immune responsiveness to Lol p III was significantly associated with HLA-DR3 and DR5. No association was found between any DQ type and immune responsiveness to Lol p III. Geometric mean IgE or IgG Ab levels to Lol p III were not different between B8+, DR3+ subjects and B8-, DR3+ subjects, showing that HLA-B8 had no influence on the association. Lol p III IgG Ab data obtained on subjects after grass antigen immunotherapy showed that 100% of DR3 subjects and 100% of DR5 subjects were Ab+. A comparison of all the available protein sequences of DRB gene products showed that the first hypervariable region of DR3 and DR5 (and DRw6), and no other region, contains the sequence Glu9-Tyr-Ser-Thr Ser13. Our observations are consistent with the possibility that immune responsiveness to the allergen Lol p III is associated with this amino acid sequence in the first hypervariable region of the DR beta 1 polypeptide chain. PMID- 2715057 TI - Chemical modifiers of cancer treatment. Part 2. Paris, France, 21-25 March 1988. Proceedings of the 6th international congress. PMID- 2715058 TI - Potentiation of the tumor cytotoxicity of melphalan by vasodilating drugs. AB - Previous studies have shown that several vasoactive drugs can selectively reduce blood flow and increase hypoxia in experimental tumor systems. Our studies with one such agent, the vasodilator hydralazine, have clearly demonstrated that it can increase the tumor cytotoxicity of drugs which are known to be more toxic under hypoxic conditions. We have now extended our investigations to determine whether such selective reductions in tumor blood flow induced by hydralazine can increase the tumor cytotoxicity of other classes of cancer chemotherapeutic drugs. Our initial studies have involved the alkylating agent melphalan. Administration of hydralazine (5 mg/kg IP) at various times before or after melphalan results in increased tumor cytotoxicity in the Lewis lung carcinoma. An enhancement factor of between 2 and 3 was obtained in this tumor system. Similar results are observed if the vasodilator cadralazine is used. In contrast to the enhancement of the tumor cytotoxicity of melphalan by hydralazine, systemic toxicity is only increased by a factor of 1.2. Therefore, therapeutic gain may accrue from the use of vasodilating agents in combination with melphalan. Studies using spheroids to establish the mechanism responsible for the enhanced tumor cytotoxicity indicate that both hypoxia and pH can influence melphalan toxicity. PMID- 2715059 TI - Enhancement of the anti-tumor effect of melphalan in experimental mice by some vaso-active agents. AB - A comparison is made between the vaso-active agents hydralazine, nifedipine, and verapamil for their ability to increase the anti-tumor effectiveness of melphalan. Treatment of mice with hydralazine (5 mg/kg) 15 mins after melphalan increases by a factor of approximately 2.5 melphalan-induced delay in growth of either the RIF-1 or KHT tumors. Similar enhancements are obtained when measurement is made of the surviving fraction of tumor cells in vitro following treatment in vivo with hydralazine and melphalan. Further, tumor cell kill is also increased when nifedipine is administered with melphalan compared with the effect of melphalan alone. These enhanced effects are observed if the vaso-active agents are given before or after melphalan. Hydralazine (5 mg/kg) induces close to 100% radiobiological hypoxia in the RIF-1 and KHT tumors. In contrast, Nifedipine has no effect on tumor hypoxic fraction at a dose of 10 mg/kg although the anti-tumor effectiveness of melphalan is substantially increased. However, a higher dose of 50 mg/kg nifedipine causes a large increase in tumor hypoxic fraction, an effect that persists for several hours. Verapamil causes no change in the fraction of hypoxic cells in the KHT tumor and increases, only slightly, the anti-tumor effect of melphalan. PMID- 2715060 TI - Calcium antagonists as radiation modifiers: site specificity in relation to tumor response. AB - The calcium antagonists, verapamil, nifedipine, and flunarizine, were studied for their effects on blood flow and radiation response in SCCVII/St intradermal back tumors, over a dose range of 0.05-50 mg/kg. Verapamil, at low doses, increased tumor blood flow, as measured by relative fluorescence intensity of Ho33342 stain, and increased tumor radiosensitivity. However, at doses of 20 mg/kg and above, verapamil reduced Ho33342 fluorescence intensity, and increased tumor radioresistance. Nifedipine reduced tumor radiosensitivity and Ho33342 fluroscence intensity at doses above 1 mg/kg, but below this dose increased Ho33342 intensity was observed and a small radiosensitization was apparent. Flunarizine sensitized tumors to X rays at all doses tested, although increased Ho33342 intensity was seen only at 5 mg/kg. The relative affinities of these compounds for different sites within the host may explain the variations in blood flow and radiation sensitivity in this tumor system. PMID- 2715061 TI - Effects of hydralazine on in vivo tumor energy metabolism, hematopoietic radiation sensitivity, and cardiovascular parameters. AB - Energy metabolism of murine FSaII foot tumors was studied by in vivo 31P-MRS in C3Hf/Sed mice. Spectroscopy was performed following exposure to escalating doses of hydralazine (HYD) ip. At 0.25 mg/kg, HYD caused a 20% increase in PCr/Pi and had no significant effect on mean arterial blood pressure. HYD doses greater than or equal to 2 mg/kg lead to hypotension which was associated with a decrease in PCr, NTP, pH, and an increase in Pi (p less than 0.01 for control vs 10 mg/kg HYD). When mice were given ip injections of HYD (0.25, 1, 2 and 10 mg/kg) 10 min prior to whole body irradiation, spleen stem cell survival after 6 Gy was increased (2.19 colonies in control animals vs 6.74 colonies per spleen in animals treated with greater than or equal to 2 mg/kg HYD), as was the LD50/30 dose (6.49 Gy [control] vs 9.00 Gy [10 mg/kg HYD]). The data provide evidence that PCr/Pi is a useful indicator of perfusion efficiency (and indirectly of hypoxic cell fraction) in FSaII tumors. These observations suggest that HYD may be a useful adjuvant for hyperthermic treatment of tumors and for potentiation of agents specifically toxic to hypoxic or nutrient-deprived cancer cells. HYD should be used with care in patients receiving radiation treatments or other therapies for which hypoxia can unfavorably affect treatment outcome. PMID- 2715062 TI - New high O2 carrying perfluorochemical emulsions: toxicity, radiosensitivity of GM-CFC and development of metastases in mice. AB - The effects of two new concentrated perfluorochemical emulsions based on F-66E and PFOB, which carry significantly more oxygen than Fluosol-DA 20%, were tested on normal tissues (toxicity and radiation response) and on the development of metastases from Lewis Lung Carcinoma (3LL) in female C57 BL/6 mice. Twenty one days after injection of F-66E or PFOB emulsions (15 ml/kg body weight), the spleen and liver weights were significantly increased but had returned to normal after 2-3 months. Splenomegaly already observed in 3LL bearing mice was significantly increased by F-66E emulsion injection. The radiosensitivity of GM CFC was not altered when unanesthetized GM-CFC was not altered when unanesthetized mice were pretreated with F-66E emulsions and/or carbogen 1 hr prior to and during irradiation. The rate of tumor take and the period before detection of tumors were not modified when an emulsion of F-66E was injected simultaneously or 10 days after 3LL cells. Mean survival of mice, and the number of metastases on lung surfaces were similar in F-66E injected mice and control mice. PMID- 2715063 TI - Variation of vascular density within and between tumors of the uterine cervix and its predictive value for radiotherapy. AB - Vascular density in different regions of a number of uterine cervix carcinomas was determined by morphometric analysis of stained histologic sections. Variance analysis indicated a larger inter- than intra-tumoral inhomogeneity of the vasculature, suggesting a certain individual vascularization pattern in these tumors. As indicated by a retrospective study of archival biopsies, this pattern has a predictive value in regard to the efficacy of radiotherapy. PMID- 2715064 TI - Radioprotection of normal tissues of the mouse by hypoxic breathing. AB - Hypoxic breathing during irradiation has been advocated as a therapeutic modality, to increase the efficacy of radiotherapy. In this form of treatment, the total and daily X-ray dose is increased by a factor of 1.25, on the assumption that all normal tissues in the beam will be protected to a similar extent by breathing gas containing a reduced oxygen concentration (usually 10%). To test this concept, we have determined the effect of varying the inspired oxygen tension on the radiosensitivity of 3 normal tissues in the mouse (kidney, jejunum and skin), and have compared these results with data from the literature for mouse lung. Reduction of the inspired oxygen tension from 21% (air) to 7-8% led to much greater radioprotection of skin (protection factor 1.37) than of lung (1.09). Protection factors for jejunum and kidney were 1.16 and 1.36 respectively. The results show that the extent of radioprotection afforded by hypoxic breathing is tissue dependent, and that great care must be taken clinically in choosing the increased radiation dose to be used in conjunction with hypoxic breathing. PMID- 2715065 TI - Manipulations in the oxygen transport capacity of blood as a means of sensitizing tumors to radiation therapy. AB - Tumor response to radiation is dependent not only on the quantity of hemoglobin (Hb) available for oxygen (O2) transport but also on the position of the Hb-O2 dissociation curve (Hb affinity). Previous studies have shown that administering agents which shift the Hb-O2 dissociation curve to the right (decrease Hb affinity) sensitize tumors to radiation by reducing the fraction of radiobiologically hypoxic cells. However, there may be toxicity limitations when agents aimed at altering Hb affinity are administered directly to the host. The present studies evaluated the therapeutic benefit of shifting the Hb-O2 dissociation curve in vitro prior to the transfusion of the biochemically modified RBCs into recipient hosts. Mice were given a hemolysis agent (phenylhydrazine hydrochloride, PH) prior to transfusing RBCs with normal or altered Hb affinity. A 100 mg/kg dose of PH reduced the hematocrit to approximately 60% of control 24 hr after treatment. Tumors irradiated at this time demonstrated an increased fraction of hypoxic cells. If the hematocrit was returned to normal by transfusing mice prior to irradiation, a significant but transient reduction in the hypoxic fraction was seen. Tumor response was reduced if RBCs with elevated Hb affinity, obtained by storing the erythrocytes at 4 degrees C, were used. Alternatively, tumor sensitization was noted when animals were transfused with RBCs having decreased Hb affinities. The latter was achieved by incubating the RBCs in the presence of either clofibrate or the precursors of 2,3 diphosphoglycerate (2,3 DPG). These findings further support the notion that the Hb affinity is an important parameter in determining tumor response to radiation and suggest that this factor ought to be considered when RBCs are used to transfuse anemic patients undergoing radiotherapy. PMID- 2715066 TI - The influence of initial hemoglobin and blood pressure levels on results of radiation therapy for carcinoma of the prostate. AB - A group of 914 patients with carcinoma of the prostate treated by definitive radiotherapy at Stanford between 1956 and 1985 was studied. Of these, the initial hemoglobin level was recorded in 656 cases and the initial blood pressure in 760 cases. End-points studied in actuarial analyses were survival, disease-specific survival, local control, freedom from distant relapse, and occurrence of late intestinal complications. Although the anemic group (Hb less than 13.5 g/dl) was correlated negatively with survival (p = 0.02), there was no correlation with disease-specific survival or local control. The conclusion was that anemia per se did not affect the outcome of radiation therapy. A pulse pressure greater than or equal to 60 mm Hg was significantly correlated with worse survival (p = 0.01) and local control (p = 0.04), but no correlation was found between systolic and diastolic blood pressure and the end-points measured. Neither anemia nor hypertension were significantly correlated with late intestinal complications. PMID- 2715067 TI - Induction of severe tumor hypoxia by modifiers of the oxygen affinity of hemoglobin. AB - Methods have been compared for inducing severe hypoxia in experimental tumors. Hypoxic fractions in the tumors were obtained from measurements of the displacement of cellular survival plots in vitro following tumor irradiation in vivo. Two compounds that displace to the left, oxygen-hemoglobin association curves greatly increase the hypoxic fractions in the tumors. The compound BW12C increases the hypoxic fractions in the KHT and Lewis-Lung tumors from about 10% to between 50-100%. The longer acting analogue BW589C increases hypoxic fraction in the KHT tumor to the same level achievable by treatment with the vaso-active drug hydralazine. The effect is also observed in the RIF-1 tumor even though the hypoxic fraction in this tumor is normally only about 1-3%. The kinetics for hypoxia induction by BW589C and its subsequent return to normal levels are comparable to those for the left-shifting of the oxy-hemoglobin association curve observable up to about 2 days post treatment. PMID- 2715068 TI - Chlorophenoxy acetic acid derivatives as hemoglobin modifiers and tumor radiosensitizers. AB - We have studied the influence of the antilipidemia drug, clofibrate, and several structurally related analogs on the binding affinity of hemoglobin for oxygen and the radiation sensitivity of the SCCVII/St carcinoma in the mouse. Several compounds in this class reduced hemoglobin affinity in vivo; and two of these, ML1024 (etophyline clofibrate) and ML1037, were at least as effective as clofibrate at reducing hemoglobin affinity and much less toxic. When given orally at a dose of 4.1 m mole/Kg, 1/2-2 hrs before 20 Gy X rays, clofibrate gave radiosensitization in the SCCVII/St tumor equivalent to a 40-fold reduction in hypoxic fraction. ML1024 and ML1037 at a dose (3.0 m mole/Kg), which had a similar effect on hemoglobin, gave much less sensitization of the tumor. Only ML1024 produced a statistically significant effect, equivalent to a four-fold reduction in hypoxic fraction. We conclude that there are several clofibrate analogs which in relation to their toxicity are much better hemoglobin modifiers than the parent compound. They do not, however, show the same radiosensitizing effects, leading us to believe that mechanisms other than changes in hemoglobin/oxygen binding must also be involved. PMID- 2715069 TI - Effect of the manipulation of oxyhemoglobin status by BW12C on tumor thermosensitivity and on blood flow in tumor and normal tissues in mice. AB - The effect of 70 mgkg-1 BW12C 30 min before heating on the thermosensitivity of RIF-1 leg tumors was studied. This schedule is known to increase the hypoxic fraction by a factor of 5. Heating, using a combined radio-frequency and saline bath technique, was for 30 min at 43, 43.5, and 44 degrees C and response was assayed by clonogenic cell survival immediately and 24 hr after treatment. BW12C did not alter RIF-1 thermosensitivity. The effects of heat up to 44 degrees C on the oxygen saturation curves of normal and BW12C-modified blood were compared and P50s were shown to rise from 36 to 52 mm Hg and 6.5 to 8.0 mm Hg respectively, showing the latter to be relatively resistant to right-shifting by heat. 86Rb extraction studies on BW12C-treated unheated animals showed that blood flow in leg and flank tumours 60 min after BW12C was reduced to 64% and 34% of control values respectively, indicating a further mechanism for induction of tumour hypoxia by BW12C. Blood flow in leg muscle, liver, and spleen was unchanged but in kidney and lung was increased to 127% and 119% of control respectively 60 min after BW12C. PMID- 2715070 TI - Modification of the radiation response of pig skin by manipulation of tissue oxygen tension using anesthetics and administration of BW12C. AB - The importance of tissue oxygen tension on radiosensitivity was studied by examining modifications in the incidence of moist desquamation in pig skin after irradiation with strontium-90 plaques. The effects were analyzed using quantal dose-response data and comparisons were made using ED50 values for moist desquamation. Under standard anesthetic conditions of 2% halothane, approximately 70% oxygen, and approximately 30% nitrous oxide, the ED50 value (+/- SE) for moist desquamation was 27.32 +/- 0.52 Gy with no significant variation in radiosensitivity between dorsal, lateral, and ventral skin sites on the flank. Irradiation with 2% halothane and air increased the ED50 to 31.25 +/- 0.94 Gy, primarily due to an increased radioresistance of the dorsal sites. When combined with BW12C, a drug which binds oxygen selectively to hemoglobin and hence reduced the oxygen availability to tissues, a further increase in the ED50 values was observed. This was approximately 39 Gy with BW12C concentrations of 30 mg/kg and 50 mg/kg b.w. of BW12C, indicating a dose modification factor (DMF) of approximately 1.26. However, when animals were breathing the standard gas mixture, this DMF was reduced to 1.15 for 30 mg/kg of BW12C, indicating that a higher level of oxygen partly counteracted the effects of the drug in these studies with BW12C. The greatest variability in radiosensitivity was seen in the dorsal fields. This suggested complex physiological adaptation, a phenomenon that might also explain the absence of any modification of the radiation response when 100 mg/kg of BW12C was used. PMID- 2715071 TI - Protection of cultured Chinese hamster ovary cells by the aminothiol WR-255591 from the lethal and DNA-damaging effects of fast neutrons. AB - We examined the radioprotective effect of the aminothiol WR-255591 on cultured aerated Chinese hamster ovary cells irradiated with cyclotron-generated fast neutrons. The effects of a 30 min pretreatment with 6 mM WR-255591 on the induction of DNA single-strand breaks (SSBs) and double-strand breaks (DSBs) were measured using alkaline (pH 12.1) and neutral (pH 7.0) filter elution, respectively. Molecular protection factors (PFs) calculated from these data were compared with the PF measured using the biological endpoint of cell survival. WR 255591 afforded significant protection against cell killing by neutrons (PF = 1.36) although protection was less efficient than against cell killing by gamma rays (PF = 2.30). Whereas for gamma-rays, the PFs were in the order survival greater than or equal to DSB induction much greater than SSB induction, the magnitude of the modification of the induction of both SSBs (PF = 1.38) and DSBs (PF = 1.38) after neutron irradiation was the same as that of cell killing. PMID- 2715072 TI - Role of glutathione peroxidase in the radiation response of mouse kidney. AB - Glutathione peroxidase (GSH-Px) has been implicated in mediating the radioprotective effects of glutathione (GSH). This hypothesis was tested in vivo by determining the effect of GSH-Px depletion on the radiation response of murine kidneys. Renal GSH-Px levels were depleted to 17% of control values by feeding animals a selenium deficient diet for 6 weeks; this had no significant effect on renal levels of GSH or GSH-S-transferase (GST). However, we also tested the effect of direct depletion of GSH to 3-4% of control values, using a combination of DL-buthionine sulphoximine (BSO) and diethyl maleate (DEM). Kidneys with normal or depleted levels of GSH-Px and/or GSH were irradiated with 240kVp X rays (2 fractions, 7 days apart to minimize intestinal injury). Mice breathed 7% oxygen during irradiation. Renal damage was assessed at 20, 25, and 32 weeks after the first fraction of X rays, in terms of reduced hematocrit and renal clearance of 51Cr-EDTA. Depletion of GSH-Px levels to 17% of control did not alter renal radiosensitivity, but depletion of GSH to 3-4% of control values radiosensitized the kidney by a factor of 1.4. Depletion of both GSH and GSH-Px together did not radiosensitize the kidney any more than was achieved by GSH depletion alone. PMID- 2715073 TI - Effect of varying the concentration of damage restituting species in the radical repair model. AB - From analytical expressions derived for the radical-repair (competition) model describing the relationship between cellular radiosensitivity and oxygen concentration, "K-curve" behavior has been quantified as a function of the concentration of the species S which restitutes the radiation-induced radicals to their original molecular configuration. If these species are identified with thiols, K-curves modified by fractionally depleting [S] through calculation can be compared with experimental data where cells have their thiols depleted using various means, for example, by chemical agents or by the use of cells with decreased thiols because of genetic deficiency. Families of curves have been calculated related both to the S-depleted and the non-S-depleted hypoxic control, the latter of which is used to calculate enhancement ratios. Comparison of the model with experimental data is made. PMID- 2715074 TI - Selective radiosensitization and cytotoxicity of human melanoma cells using halogenated deoxycytidines and tetrahydrouridine. AB - The halogenated pyrimidines 5-chloro-2'-deoxycytidine (CldCyd) and 5-bromo-2' deoxycytidine (BrdCyd) can act as radiosensitizers and cytotoxic agents. It was hypothesized that tumor cells and normal cells might use different metabolic pathways to incorporate these halogenated deoxycytidines into DNA. This difference could potentially be exploited to produce selective radiosensitization and cytotoxicity of human tumor cells compared to normal human fibroblasts. This hypothesis was tested using two human melanoma cell lines and two normal fibroblast cell lines. Either CldCyd or BrdCyd alone caused both cytotoxicity and radiosensitization of tumor and normal cells. The addition of the cytidine deaminase inhibitor tetrahydrouridine (H4U) significantly protected the normal cells but had relatively little effect on the tumor cells. These data indicate that it may be possible to exploit differences between the pyrimidine metabolism of normal cells and melanoma cells to improve the therapeutic index of halogenated pyrimidines both as radiosensitizers and as cytotoxic agents. PMID- 2715075 TI - Iododeoxyuridine (IdUrd) incorporation into DNA of human hematopoietic cells, normal liver and hepatic metastases in man: as a radiosensitizer and as a marker for cell kinetic studies. AB - Iododeoxyuridine (IdUrd) was administered as a continuous infusion for 14 days to patients with glioblastoma and sarcoma, and for 3 days to patients with metastatic colorectal carcinoma. In the first group, the maximum incorporation of IdUrd into DNA was determined, taking granulocytes as parameter. In the second group, selective incorporation into DNA of normal liver and hepatic metastases of colorectal cancer was investigated. The highest dose of 675 mg/sq.m./day for 14 days produced IdUrd plasma concentrations of 1.8 +/- 0.3 microM, and a substitution of dThd by IdUrd in the range of 7.1-11.7%. Coadministration of fluorodeoxyuridine did not show significant enhancement of IdUrd-incorporation in granulocytes. Three-day intravenous infusions of IdUrd 1000 mg/sq.m./day produced 1.7-4.5% IdUrd-incorporation in hepatic metastases. Three-day intraarterial infusions (hepatic artery) produced 3.8-10.5% dThd-replacement, whereas, in 9/10 patients this was less than 1% in normal liver. In tumor tissue there was a trend towards FdUrd-modulated enhancement of IdUrd-incorporation, although there was considerable scatter. Cell kinetic studies revealed that IdUrd-incorporation in monocytes and granulocytes was very similar. In lymphocytes, a much lower fraction incorporated IdUrd. Liver tumor contained a considerably higher fraction of IdUrd-labeled cells, compared with normal liver. Potential doubling times for the tumors were estimated to be 10 days. PMID- 2715076 TI - Correlation of exposure time, concentration and incorporation of IdUrd in V-79 cells with radiation response. AB - These experiments were designed to find the minimum concentration at which incorporation of and sensitization by IdUrd (Iododeoxyuridine) would occur and the effect of concentrations from .1 to 100 microM for exposures of 8 to 96 hr in cultured V-79 cells exposed to 137Cs gamma rays at 2 Gy per minute. At 0.1 microM thymidine replacement averaged 1% and the SER ranged from 1.1 to 1.28, significant at the 95% level. The maximum thymidine replacement was 49% after 48 hr exposure to 30 microM yielding an SER of 2.7. SER generally peaked after 72 hr of exposure. This cell line has an 8 hr cycle time in our hands and thus optimal sensitization would occur after 9 cell cycles. These ranges need testing in human cells in culture and in Phase I clinical trials. PMID- 2715077 TI - The effect of the oxic cell sensitizer, beta-ara A on human fibroblasts in plateau and in exponential growth phases. AB - Before an oxic cell sensitizer such as beta-ara A (a DNA-dependent DNA polymerase inhibitor) can be used in cancer treatment, it is essential to know both the influence of this type of drug on certain critical normal tissues and the role of proliferation kinetics in the radiosensitizing capacity. The biological system chosen for this in vitro study was the human fibroblast cell line HF19. Cells were studied in plateau phase and in the exponential growth phase. Cells were incubated with beta-ara A for 7 hr (1 hr before and 6 hr after irradiation). beta ara A was extremely toxic to growing cells (concentrations ranging from 200 to 1000 microM), but no detectable effect was found on plateau-phase cells (up to 4000 microM). However, for a given drug concentration, the radiosensitizing effect (Sensitizing Enhancement Ratio SER) was very similar for growing and plateau phase cells (SER measured with Ds ratio was about 1.7 for a concentration of 500 microM). The enhancement ratio depended on the radiation dose; it was relatively higher for low doses. This can be explained by a differential effect of the drug on the alpha and beta components of the survival curve. Only the alpha component was increased. PMID- 2715078 TI - The initial slope of human tumor cell survival curves: its modification by the oxic cell sensitizer beta-arabinofuranosyladenine. AB - The initial slope of the survival curve, which is a characteristic of each tumor cell line, varies with the histological group of the tumor. It is one of the factors on which clinical radioresponsiveness depends. The DNA dependant DNA polymerase inhibitor beta-ara A acts as an oxic cell sensitizer. This study was carried out on human tumor cell lines to look for a correlation between the degree of radiosensitization induced by beta-ara A and the radiosensitivity of a given cell line. Six human tumor cell lines with different radiosensitivities were used (the survival rate at 2 Gy and D ranged from 20 to 73% and from 1.2 to 3.2 Gy, respectively). beta-ara A had a major toxic effect on all cell lines but this varied greatly from one cell line to another and was concentration dependant; this toxic effect was taken into account when calculating the surviving fractions. For all cell lines, beta-ara A acted as an oxic radiosensitizer and the radiosensitization was concentration dependant. Analysis of the survival curves of the 6 cell lines using the linear quadratic model showed that concentrations of beta-ara A between 200 and 1000 microM induced an increase in the linear component while the quadratic component underwent no systematic change. The sensitizing enhancement ratio (SER) measured from the Ds ratios, varied greatly from one line to another. For example, at a concentration of 500 microM, the extreme values of Ds ratios were 1.5 and 2.6. The radiosensitization is greater, the higher the radiosensitivity of the cell line studied during exponential growth. The results do not favor the use of beta-ara A in the treatment of intrinsically radioresistant human tumors. PMID- 2715079 TI - Potentiation of radiation effects on multicellular tumor spheroids (MTS) of HeLa cells by lonidamine. AB - Lonidamine is a potent inhibitor of spermatogenesis and a hyperthermic sensitizer. The previous study of lonidamine and radiation using two murine tumors demonstrated that tumor cure rates were significantly increased by radiation and concomitant lonidamine. In an effort to determine the radiobiologic factors involved with the potentiating effect of radiation by lonidamine, a series of cell culture studies were carried out using multicellular tumor spheroids (MTS) of HeLa Cells. When the MTS were treated with lonidamine in combination with fractionated irradiation, remarkable enhancement of growth inhibition was observed at the drug concentration of 10 micrograms/ml. On the other hand, there was no demonstrable enhancement of growth inhibition induced by a single dose of irradiation. Although the present findings would be consistent with the inhibitory action of potentially lethal damage repair of radiation by the drug, an alternative possibility is that the cells that have received the combined treatment have undergone a metabolic change, which has altered their sensitivity to the growth inhibitory effects of lonidamine. Based on the studies reported here and in mice, it is suggested that continued drug exposure over a prolonged period may provide an enhanced therapeutic effect, even in tumor varieties where the drug has no apparent antitumor activity on nonirradiated cells. PMID- 2715080 TI - The interaction of trans-DDP [PtCl2(NH3)2] with low doses of radiation in mammalian cells. AB - Trans-DDP, a less toxic isomer of cisplatin, was examined for its radiosensitizing activity at high and low doses of ionizing radiation. Cells were exposed to the drug to produce low toxicity before exposure to X rays. A sensitive assay using the DMIPS Cell Analyzer was employed to measure cell survival response in low dose region (0-4 Gy) and conventional assay was used for high doses (4-25 Gy). The results show that trans-DDP is a much more effective radiosensitizer at low doses than at high doses, whether or not cytotoxicity was pronounced. This is in contrast to any other sensitizer studied to date, including oxygen, misonidazole, SR-2508 and Ro-03-8799, regardless of prior incubation and/or cytotoxicity. PMID- 2715081 TI - Modification of radiosensitivity and recovery from X ray damage in vitro by retinoic acid. AB - We studied the effects of all-trans retinoic acid (RA) combined with X irradiation on confluent cultures of human breast cancer (MCF-7) and melanoma (C 143) cell lines, as well as in a normal human diploid fibroblast strain (AG 1522). RA in non-cytotoxic concentrations was a potent inhibitor of confluent holding recovery of potentially lethal damage (PLD repair) for all three cell types. A complete inhibition of recovery was observed at lower RA concentrations in the tumor lines than in the fibroblast strain. Exposure to RA prior to and during irradiation resulted in a radiosensitizing effect that was similar in MCF 7 and AG 1522 cells. The implications of these findings are discussed in terms of the potential value of retinoids as biological response modifiers for the clinical radiotherapy of cancer. PMID- 2715082 TI - The effect of alpha-tocopherol and alpha-tocopheryl quinone on the radiosensitivity of thiol-depleted mammalian cells. AB - The effect of hypoxic cell radiosensitizers is increased when mammalian cells are depleted of endogenous glutathione by buthionine sulphoximine pre-treatment in vitro; a similar gain has not been observed in tumors in vivo despite evidence of glutathione depletion in vivo following buthionine sulphoximine treatment. However, concentrations of biological reducing agents other than glutathione were not measured in the in vivo experiments. Other reducing agents found in tumors include alpha-tocopherol, which reduces the sensitizing efficiency of nitro aromatic sensitizers in thiol-depleted mammalian cells. These data suggest that the failure to observe large gains in misonidazole sensitizing efficiency in thiol-depleted tumors in vivo may be due, in part, to the presence of biological reducing agents such as alpha-tocopherol. PMID- 2715083 TI - The relationship between radiation response of human squamous carcinoma cells and specific metabolic changes induced by chronic hypoxia. AB - Chronic hypoxia can cause a range of metabolic changes within cells, such as increasing the synthesis rate of a group of proteins, oxygen regulated proteins (ORPs) and reducing glutathione (GSH) content. We are currently interested in the radiation responses of cells during recovery after chronic hypoxia in relation to these metabolic changes. Experiments have therefore been carried out on the influence of hypoxic pretreatment to gamma rays of two human squamous carcinoma cell lines, A431 (vulva) and CaSki (cervix), in exponential and plateau growth phases. In both cell lines, the synthesis rate of ORPs reached to a maximum level after 12 hr of hypoxia and during the same time, the cellular GSH content reduced by about 50%, but both returned to the control levels by 12 hr of reoxygenation. After 12 hr of hypoxic incubation at 37 degrees C, cells were allowed to reoxygenate in air for 10 min (on ice) or 12 hr at 37 degrees C before irradiation. Clonogenic assays were performed immediately after irradiation. Compared to the aerobic control, the radiosensitivity of both cell lines reoxygenated for 10 min after hypoxia increased significantly and later returned to the aerobic control level by 12 hr of reoxygenation. Since aerobic A431 cells treated with 10 mM buthionine sulfoximine for 12 hr did not increase the radiosensitivity, the enhanced aerobic radiosensitivity observed after chronic hypoxia was unlikely to be directly related to decreased GSH content. Further investigations of ORPs and other associated metabolic changes caused by chronic hypoxia have been in progress to determine their possible role in this enhanced radiation sensitivity. PMID- 2715084 TI - Role of glutathione in the aerobic radiation response. AB - We will review the relationships between glutathione (GSH), protein thiols, and cellular responses to radiation, peroxides, and peroxide-producing drugs. Our primary interest involves the behavior of sulfhydryls as electron and hydrogen carriers, and their capacity to protect various target molecules against radiation and peroxidative damage. We used reagents such as L-buthionine sulfoximine (LBSO), alone and in combination with N-ethyl maleimide (NEM), diamide, and dimethylfumarate, to decrease GSH so that it could no longer participate in the electron transfer reactions. Our results indicate that aerobic sensitization produced by GSH depletion can be further enhanced if electron accepting agents, such as tertiary butyl hydroperoxide (t-BOOH), are present during irradiation. Hydroperoxide is a substrate for glutathione peroxidase and diverts electrons and hydrogen away from target molecules during its reduction. Sensitivity to radiation seems to be due to the inhibition of the mitochondria's capacity to reduce hydroperoxide. We will also report the mitochondria's ability to reduce the oxygen radicals produced by radiation and drugs. Data also indicate that t-BOOH oxidizes protein thiols which are enzymatically involved in repair of DNA damage. PMID- 2715086 TI - Use of monochlorobimane for glutathione measurements in hamster and human tumor cell lines. AB - The use of monochlorobimane (MCIB) as a fluorescence label for glutathione (GSH) quantitation was investigated in human tumor cell lines. When MCIB was used with a hamster fibroblast cell line under conditions where GSH was either depleted or elevated, an excellent correlation between bimane-GSH fluorescence and the standard cyclic GSH reductase assay (Tietze's) was accomplished. When the MCIB technique was applied to a human lung adenocarcinoma cell line, little or no GSH labeling was noted even at MCIB levels 10X higher than that used for the hamster line. HPLC analysis suggested that the source of the problem may be the affinity for MCIB to glutathione S-transferase. By using higher dye concentrations and longer staining times, adequate staining was possible. While the MCIB technique may have problems quantitating GSH levels between cell types, the possibility of examining GSH heterogeneity in solid tumor biopsies remains feasible. PMID- 2715085 TI - Isolation by flow cytometry of a human ovarian tumor cell subpopulation exhibiting a high glutathione content phenotype and increased resistance to adriamycin. AB - We have used monochlorobimane as a quantitative marker by which cells of naturally high or low GSH contents were purified by fluorescence-activated cell sorting (FACS). The cell line chosen for this purpose, MLS, was a human ovarian tumor cell line established from a patient who had received extensive chemotherapy and showed evidence of 'multidrug' resistance. Cells of a specified volume were sorted into subpopulations containing the 1% most dim (low GSH) and 1% most bright (high GSH) cells. With an increasing number of sortings, cell subpopulations emerged with progressively lower (dim) and higher (bright) GSH content as compared to the parent population. After 4 sortings, GSH contents were 10.6 +/- 0.8, 5.1 +/- 0.4, and 7.2 +/- 0.7 X 10(-18) moles/micron3 for MLS/bright, MLS/dim and MLS/parent respectively. The high and low GSH phenotypes were of limited stability reverting to the parent phenotype by the sixth week following the last FACS. Cells with high GSH content were more resistant to adriamycin than cells with low GSH content, for example, at 1 log cell kill MLS/bright was 1.6 fold more resistant than MLS/dim. An ADR resistant variant of the MLS line, designated MLS/ADRR/2, established by twice treating MLS cells with 1 microgram/ml ADR for 2 hr, also showed increased GSH content (1.3-fold) and ADR resistance as compared with the parent line. These results illustrate the possible importance of tumor cell GSH status in determining the response to chemotherapy of a heterogenous population of tumor cells with diverse GSH contents. PMID- 2715087 TI - Radiosensitization by misonidazole during recovery of cellular thiols following depletion by BSO or DEM. AB - V79 cells have been depleted of their endogenous thiols by treatment with 100 microM BSO for 16-18 hr, or 0.5 mM DEM for 1 hr. The recovery of cellular thiols after removal of the drugs was determined by h.p.l.c. or flow cytometry and the sensitizer enhancement ratio for 100 microM misonidazole was measured as a function of time after removal of the drugs. The SER of 1.2 for control (hypoxic) cells increased to 1.8 for BSO treated (hypoxic) cells and 2.2 for DEM treated ones, when thiol levels were below 10% of controls. The SER and thiol levels returned to control values within 5 hr of removing DEM. After BSO there was little change during the first 5 hr and then a gradual return to normal values by 24 hrs. The major fall in the SER after removal of the drugs occurred as the cellular thiols increased to 60% of control values. PMID- 2715088 TI - Effect of thiol manipulation on chemopotentiation by nitroimidazoles. AB - Highly electron affinic compounds such as the nitroimidazole misonidazole (MISO) have been shown both in vitro and in vivo to be effective potentiators of certain conventional chemotherapeutic agents. Mechanistically, the observation that nitroheterocyclics reduce intra-cellular thiols by enhancing the oxidation of glutathione (GSH), has suggested that thiol depletion by MISO may be a key factor in this enhancement. The present investigations were undertaken to determine whether the use of buthionine sulfoximine (BSO) to affect GSH metabolism may lead to more effective potentiation of chemotherapeutic agents by sensitizers. KHT/iv cells were treated in exponential phase under hypoxic conditions with variable doses of the activated form of cyclophosphamide (4-hydroxy-cyclo-phosphamide, 4OH CY) administered concomitantly with or without MISO (2.5 mM) for an exposure time of 4 hr. Inclusion of the sensitizer in the treatment protocol resulted in a dose modifying factor of approximately 2.4. Exposing cells to 1.0 mM BSO for 2 hr prior to treatment reduced intracellular GSH levels to 70-80% of control and increased the efficacy of 40H-CY approximately 1.2-fold. If BSO was administered prior to the 4OH-CY + MISO combination, severe tumor cell toxicity resulted. For example, when combined with 4OH-CY, similar cell kill could be achieved with 5 to 6-fold lower MISO doses in the presence of BSO as in the absence of BSO. Ultrastructural evaluations revealed that in the three agent combination, membrane damage, as reflected by the formation of surface blebs, may play a key role in the mechanism of the observed enhanced cytotoxicity. PMID- 2715089 TI - Effects of methylphenidate on cardiovascular responses in attention deficit hyperactivity disordered adolescents. AB - The short-term dose effects of methylphenidate were examined on cardiovascular measures in 11 black male adolescents diagnosed as having attention deficit hyperactivity disorder (ADHD). In a double-blind, cross-over design with randomized order, the subjects received placebo and each of three methylphenidate doses (0.15, 0.3, and 0.5 mg/kg) for a period of 2 weeks per medication dosage. Significant main effects were found for diastolic and systolic blood pressure; however, pairwise comparisons revealed a significant linear increase in diastolic blood pressure only. Because of the unexpected increase in diastolic blood pressure, careful monitoring of black adolescents who are receiving methylphenidate is recommended. PMID- 2715090 TI - The importance of recognizing a history of sexual abuse in female adolescents. AB - We have become increasingly aware of sexual abuse in our society, and yet the majority of teens who were sexually abused as children enter adolescence carrying the secret of their abuse. Such hidden abuse may have devastating effects on the development of personal identity, self-esteem, attitudes, behaviors, and interpersonal relationships that may persist and set a pattern for a troubled adulthood. This article details how children cope with a sexually abusive situation, the long-term effects of unresolved sexual abuse, and diagnostic criteria to differentiate a hidden history of sexual abuse from other trauma and conditions. Focus is on recognizing and assessing "legitimate" symptoms that may be conscious or unconscious cries for help by victims of previous sexual abuse. Correct diagnosis is essential to appropriate intervention to lessen possible further psychologic damage during adolescence. PMID- 2715091 TI - A follow-up study of adiposity and growth of Jerusalem schoolchildren from age 6 to 14 years. AB - This study evaluated growth and change in adiposity from childhood to early adolescence in 587 Jerusalem schoolchildren examined in both the first and eighth grades. Mean body mass index, height, and weight were determined according to demographic variables and menstrual status and were compared to international reference populations. Menstruating females were taller and heavier than nonmenstruating females at both ages and were more overweight at age 14 years. Height and weight were positively correlated with social class for boys, and few differences were found among ethnic groups. Study subjects were shorter than reference subjects, and study girls were more overweight than reference girls at age 14 years. Our findings suggest that previously demonstrated ethnic differences in growth and adiposity among Israeli children are disappearing. Adolescent girls appear to be at greatest risk for developing obesity. The relationship of pubertal status to body size and obesity at and between the two ages is discussed. PMID- 2715092 TI - Nutrition beliefs, practices, and perceptions of young dancers. AB - Forty-nine dancers from 21 states and Mexico ages 13-20 years participated in a study designed to further explore nutrition beliefs and dietary practices of young dancers. Subjects completed a previously used questionnaire that identifies nutrition beliefs and practices. The correlation between actual height and weight and subjects' perceived height and weight was significantly different (p = less than or equal to 0.5). Subjects requested that additional nutrition education be included in their training programs. PMID- 2715093 TI - Attitudes versus performance in providing gynecologic care to adolescents by pediatricians. AB - This study ascertained current pediatric attitudes verses performance in caring for adolescent females in private practices in a suburban area. Sixty-seven randomly selected pediatricians were given a confidential questionnaire; 90% responded. Areas assessed were attitudes and practice about sexual history, breast examination, teaching self-breast examination, and vaginal examination. Comparisons were made between the different age groups and between male and female pediatricians. Ninety-two percent of pediatricians felt it was important to take a sexual history by age 16 years, while only 73% actually did. More female than male pediatricians thought it was important to take a sexual history and actually did so. Seventy-five percent stated that a breast examination should be routine, and most performed the examination. However only 60% taught self breast examination despite the fact that 93% believed it was important. An internal vaginal examination as part of a routine physical was performed by only 7%. For specific gynecologic problems most asked to see the patient but most did not do an internal examination. The most likely indication for a pelvic examination was a vaginal discharge, but only 28% of the pediatricians would examine their patient for this complaint. Of the pediatricians who do the examination, 41% were not sure they had received the proper training. These data suggest that despite the American Academy of Pediatrics' recommendations that pediatricians continue the care of patients until age 21 years, there does not appear to be optimal care provided to female adolescent patients. PMID- 2715094 TI - Preexisting musculoskeletal conditions presenting as school sports injuries. AB - One hundred thousand insurance claims for secondary school injuries sustained between 1974 and 1986 were analyzed to determine the incidence of diagnosis and misdiagnosis of preexisting musculoskeletal conditions. Seventy-five percent of accident reports described acute injury to normal bones, joints, and soft tissues. Twenty percent were reinjuries or other sequelae of past trauma. Infection, congenital or developmental anomalies, or other nontraumatic conditions were found in 5% of the injuries reported. Patients with preexisting diseases had a higher morbidity than those with an acute primary injury. The majority of preexisting conditions were correctly described and documented by the attending physician. However, for 268 patients with a previous accident residual and 465 patients suffering from infection, pathologic fracture, congenital/developmental disorder, neoplasia, or other diseases, the potential role of the underlying condition was not correctly stated. Correct preexisting diagnoses need to be recognized if treatment is to be optimal. PMID- 2715095 TI - Vaginal douching in teenagers attending a family planning clinic. AB - This study assessed the knowledge and usage patterns of vaginal douching in sexually active teenagers attending a family planning clinic. A questionnaire was administered consecutively to 94 black, 36 Hispanic, and 12 Anglo females ranging in age from 13 to 19 years. The survey showed that vaginal douching is a common practice, with almost two thirds learning about douching from their mother. The technique is primarily used for hygienic reasons with few using it to prevent pregnancy or infection. Age of first douche correlated with age of first intercourse (p less than 0.001). Almost 23% had douched within 2 days of the clinic visit, and 56% reported douching one or more times a week. PMID- 2715097 TI - The High-Risk Young People's Program. A summing up. AB - For over five years, 21 teaching hospitals and 54 community cosponsors provided health services to young people at risk for sociomedical problems, i.e., to young people living in communities characterized by high rates of teen pregnancy, sexually transmitted disease, drug abuse, alcohol abuse, accidents, homicide, suicide, and mental illness. With support from The Robert Wood Johnson Foundation, the 20 grantees of the High-Risk Young People's Program developed projects whose collective goal was to expand services to high-risk youth and improve their health. This goal was to be achieved by a direct provision of medical services, training health providers in the care of high-risk youth, consolidating categorical youth services into single, comprehensive care sites, and securing long-term support for these new services and training activities. During the grant period, 114 fellows, 974 residents, 453 medical students, and 126 graduate nurses trained at project sites. Patient visits, which totaled 47,203 the first year, reached 84,754 the second year, and were reported at 89,024 in the fourth year. Sixteen of the 20 projects secured 117 grants worth nearly $7 million. We conclude that the projects were successful in training health care providers and in securing additional support for Program purposes, but were less successful in expanding services beyond the initial pilot for clinical care. PMID- 2715096 TI - Attitudes of adolescents and parents of adolescents concerning condom advertisements on television. AB - The major television networks have considered airing condom advertisements. A Louis-Harris poll entitled "Attitudes About Television, Sex and Contraceptive Advertising" conducted in early 1987 concluded that at least 60% of adult Americans were in favor of such advertisements. To better understand the attitudes of adolescents and parents of adolescents in a private practice setting toward contraceptive advertisement on television, the present study was performed. Between March and June 1987, 108 parents of adolescents, 100 adolescent females, and 90 adolescent males filled out a questionnaire asking their opinions of such advertisements. Eighty-three percent of the parents, 89% of adolescent females, and 92% of adolescent males approved of such advertisements. The data suggest that a majority of adults and adolescents approve of condom advertisements on television. The use of the media to take advantage of the present opportunity to educate and promote birth control and disease prevention to our adolescent population may be beneficial. PMID- 2715098 TI - Teenage pregnancy in Sweden and Finland. Implications for the United States. AB - Fertility and the rates of pregnancy, live births, and abortion in teenagers in the United States are considerably higher than in most other developed countries of northern and western Europe. Fertility rates in teenagers in Sweden have declined significantly. The teaching of family life education is universal in Sweden and almost universal in Finland. Sex is openly discussed within society in both countries. Family planning and abortion services are geographically very available in both countries and both services and supplies are free. The educational level of both males and females is high in both countries. The United States has the opportunity to reduce teenage pregnancy by applying the experience of Sweden and Finland in the fields of family life education and family planning services. PMID- 2715099 TI - Does mild mean minor? Recovery after closed head injury. AB - The sequelae of severe closed head injury has received much attention in the literature, but the effects of mild closed head injury are less well established. The course of an 18-year-old female who sustained a mild closed head injury is presented. Substantial gains in intellectual function were observed over the year postinjury, with the most dramatic improvement coming in the first 6 months after the accident. Psychologic adjustment did not mirror the cognitive recovery. The implications of these findings are discussed. PMID- 2715100 TI - Microrecanalization after vasectomy in man. AB - Previously spermatozoa in the semen of vasectomized men were reported in 62 of 63 specimens from 24 men 2 to 31 years postvasectomy (Freund and Couture, 1982). A morphologic basis and term, "microrecanalization," was proposed for this observation. Serial sections (5 mu at 200-mu intervals) of 40 specimens removed at vasovasostomy from 20 men (2 to 14 years postvasectomy) were examined and microcanals (small epithelial-lined channels) were demonstrated in 27 specimens from 18 men. In nine of the 27 specimens, spermatozoa or sperm heads were found within the microcanals. Microcanals occurred in smooth muscle, connective tissue and scar tissue, in each segment, testicular, central and abdominal, in the presence or absence of the vas deferens. Microcanal continuity was traced for 200 to 1140 microns by computerized image analysis. Microrecanalization is characterized by the absence of inflammation or sperm extravasation and is histologically distinct from vasitis nodes or sperm granuloma. Microrecanalization provides morphologic and physiologic bases for the protection of the testis and maintenance of spermatogenesis in man after vasectomy. PMID- 2715101 TI - Evaluation of computerized analysis of sperm movement characteristics and differential sperm tail swelling patterns in predicting human sperm in vitro fertilizing capacity. AB - Multivariate discriminant analysis was used to evaluate the usefulness of computer image analysis of sperm movement characteristics and differential patterns of sperm tail swelling after hypoosmotic treatment for predicting the human sperm in vitro fertilizing capacity assessed by the zona-free hamster egg penetration assay. Fifty-five semen samples, mostly normospermic, from untreated infertility clinic patients were analyzed. The % normal sperm morphology, linearity of seminal sperm movement, seminal sperm head beat frequency, mean and maximum amplitudes of lateral head displacement, and hypoosmotic sperm tail swelling patterns c, d and f were selected by multivariate discriminant analysis to be capable of discriminating the samples exhibiting the presence or the absence of sperm in vitro fertilizing capacity. The % total sperm tail swelling did not give additional information about in vitro fertilizing capacity. These preliminary data suggest that computer image analysis of sperm movement characteristics and differential evaluation of hypoosmotic sperm tail swelling might be useful for the prediction of human sperm fertility. Further prospective studies are necessary to validate their predictive functions. PMID- 2715102 TI - Relationship between the results of sperm analysis and GIFT. AB - In vitro fertilization (IVF) and GIFT have been proposed as therapeutic approaches in infertile couples where a significant male factor is present. To date, few published data are available relating the success rate of GIFT to the severity of the male factor. In this report the results of the first 172 GIFT cases were analyzed. The overall pregnancy rate was 18.0%. The relationship between the occurrence of pregnancy and sperm count (millions/ml), total sperm count (millions/ejaculate), % motility, motile sperm count (millions/ml) and total motile sperm count (millions/ejaculate) were examined. Significant direct correlations were observed between the clinical pregnancy rate and sperm count, total sperm count, motile sperm count and total motile sperm count. Motile sperm count and total motile sperm count had the best correlations with clinical pregnancy rates, which were over 24.0% in groups with motile sperm counts exceeding 40 X 10(6) cells/ml or total motile sperm counts greater than 100 X 10(6)/ejaculate. The clinical pregnancy rates were 12.5% and 7.7%, respectively, for groups with motile sperm counts under 10 X 10(6)/ml and total motile sperm counts below 25 X 10(6)/ejaculate. No correlation was found between percent motile cells and pregnancy rate. Results of the sperm penetration assay using zona-free hamster eggs were available in a subpopulation of 27 patients. No significant correlation between this sperm penetration assay and pregnancy rate could be demonstrated. The incidence of chemical pregnancy showed a significant negative correlation with the total motile sperm count, indicating a higher incidence of early pregnancy wastage in cases of oligozoospermia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715103 TI - Polyamine profiles in rat testis, germ cells and Sertoli cells during testicular maturation. AB - Polyamine cellular concentrations (putrescine, spermidine and spermine) in the rat testis and testicular cell types were determined by fluorescence spectroscopy of their dansyl derivatives. A method is described to separate dansylated polyamines by high performance liquid chromatography in less than 12 minutes. In rat Sertoli cells, polyamine concentrations (per mg DNA) were greater than those in germ cells and the testis. The concentrations of all three polyamines increased with age. Concentrations of spermidine and spermine in germ cells also increased with age and leveled off after 27 to 35 days. On the other hand, higher putrescine levels were found in the testis of young rats (13 to 22 days) while the greatest spermidine and spermine contents were observed in the testis from rats of 31 to 35 days old. Of great interest, Sertoli cells from all age groups studied released a relatively large quantity of putrescine and a smaller amount of spermidine, but no spermine, into culture media. The amount of polyamine released by Sertoli cells varied with the age of the animal. Sertoli cells from 27-day-old rats released the greatest quantity of putrescine on a per mg DNA basis. The release of putrescine increased after hypotonic treatment that removed contaminating germ cells from the remaining Sertoli cells. It is concluded that cellular polyamine levels in the rat testis, germ cells and cultured Sertoli cells and the amount of polyamines released by Sertoli cells were age-dependent during the first wave of spermatogenesis. PMID- 2715104 TI - The changing profiles of L-ornithine decarboxylase and S-adenosyl-L-methionine decarboxylase activities in testicular cell types during sexual maturation of male rats. AB - To understand the involvement of polyamines in testicular maturation and spermatogenesis, the activity of two enzymes involved in the polyamine synthetic pathway, L-ornithine decarboxylase (ODC) and S-adenosyl-L-methionine decarboxylase (AdoMetDC) were determined in whole testis and isolated testicular cell types during the sexual maturation of male rats. ODC activities per mg protein in whole testis and cultured Sertoli cells from 12- to 14-day-old rats were very high but declined as the age of the animals increased. ODC activities in both germ cells and interstitial cells increased as the age of the rats increased, reached a maximum at 22 days and then declined rapidly. On the other hand, AdoMetDC activity in whole testis, Sertoli cells, germ cells and interstitial cells was highest from 27 to 35 days, 18 to 22 days, 22 to 27 or 35 days, and 27 days of age, respectively, then decreased and remained at a constant lower level after 45 days. After 35 or 45 days of age, cellular AdoMetDC activities were relatively higher than ODC activities in the whole testis and germ cells, while the activity of both enzymes was comparable in the Sertoli cells. Correlation of these data with the development of germ cells during rat testicular maturation suggests that the high ODC activity in both Sertoli and germ cells is associated mainly with cell proliferation while the increase in AdoMetDC activity is most likely associated with the maturation of Sertoli cells and the meiosis of germ cells, particularly the formation of pachytene spermatocytes and the meiotic cell division of spermatocytes into spermatids. PMID- 2715105 TI - Leydig cells do not have Fc receptors. AB - It has been reported that Leydig cells have Fc receptors, which traditionally have been considered markers specific for macrophages and polymorphonuclear leukocytes. The purpose of this investigation was to study further this phenomenon and also to determine if Leydig cells and macrophages could be separated from each other either by density gradient centrifugation using Percoll or by differential detachment with trypsin treatment of cultures of crude interstitial preparations. Interstitial cells were obtained by collagenase digestion of rat testis and established in culture. These cultures were reacted for 3 beta-steroid dehydrogenase and Fc receptor and viewed with phase contrast microscopy. No individual cells were positive for both steroid dehydrogenase activity and Fc receptors. The order in which the cells were stained for these two markers did not influence the results. Trypsin treatment of these crude interstitial cultures removed over 90% of the Leydig cells and approximately 20% of the macrophages. Macrophages were located in the same portion of Percoll gradients as the less dense (Population I) Leydig cells, while Leydig cells found in the dense area of the gradient (Population II) were not contaminated with macrophages. These studies indicate that Leydig cells do not have Fc receptors and that a subpopulation of Leydig cells can be isolated free of macrophages using density gradient centrifugation. PMID- 2715106 TI - Can the fertility potential of a seminal sample be predicted accurately? AB - This paper highlights the most critical aspects of the problem of predicting fertility. To determine if a laboratory test(s) is highly correlated with fertility it is essential to have: a) specific, precise and accurate laboratory tests, and b) precise and accurate fertility data. Acquisition of precise and accurate data for laboratory tests and fertility of spermatozoa in the same sample is not easy. Data derived from in vitro fertilization are not tests of fertility, because only a subset of the attributes important for fertilization in vivo are tested. Because of deficiencies in fertility data, there probably is no valid report for human spermatozoa correlating results of laboratory tests and fertility, and very few valid studies for laboratory or domesticated animals. There is little doubt that objective measures of sperm motion, acrosomal status, or other characteristics are significantly correlated with fertility. However, establishment of the correlations between a group of attributes and fertility is not the question of interest. The goal is prediction of fertility. There has been no recent effort to develop a prediction of fertility or fecundity based on sperm characteristics, and achievement of this goal may be elusive. PMID- 2715107 TI - Possible role of histamine in the regulation of secretion of luteinizing hormone in the ewe. AB - Concentrations of histamine were quantified by an enzymatic isotopic assay in different regions of the brain and pituitary gland of gonadal-intact and chronically ovariectomized ewes during the anestrous season. Sera concentrations of LH were confirmed to be elevated in ovariectomized compared with intact animals immediately before tissues were obtained. Areas of the brain that were examined included cerebral cortex, thalamus, pineal gland, hypothalamus (rostral, medial basal, median eminence), midbrain, cerebellum and brain stem. Concentrations of histamine were greatest within the thalamus, pineal gland, medial basal hypothalamus and median eminence. Histamine within the medial basal hypothalamus was greater (P less than .05) in ovariectomized than in ovarian intact animals. Further experiments were designed to determine the effect of antihistaminic drugs on secretion of LH. Ovariectomized ewes were treated every 6 h (i.m.) for 24 h with diphenhydramine (an antagonist of the H1-receptor for histamine), cimetidine (an H2-receptor antagonist), a combination of the drugs, or vehicle. Twelve hours after initiation of treatments, animals were injected with estradiol. Diphenhydramine depressed (P less than .01) basal serum concentrations of LH and the positive feedback effect of estradiol on serum concentrations of LH. Cimetidine did not influence the pattern of secretion of LH. Diphenhydramine did not alter LHRH-induced release of LH in ovariectomized ewes or basal serum concentrations of LH in ovarian-intact anestrous ewes. We suggest that histamine acts at the level of the central nervous system through an H1-receptor mechanism to control secretion of LH in female sheep. PMID- 2715108 TI - Influence of level and source of dietary fat on its comparative feeding value in finishing diets for steers: feedlot cattle growth and performance. AB - Two hundred twenty-eight crossbred steers (304 kg) were used in a 125-d comparative slaughter trial to evaluate the influence of level and source of supplemental fats on their feeding value for feedlot cattle. Dietary treatments consisted of a steam-rolled, barley-based finishing diet containing 1) no supplemental fat; 2) 4% yellow grease (YG); 3) 4% blended animal-vegetable fat (BVF); 4) 8% YG; 5) 8% BVF or 6) 6% BVF and 2% crude soybean lecithin. Increasing level of supplemental fat in the diet resulted in linear improvements (P less than .01) in weight gain, feed conversion and NE value of the diet. Estimated NE values of YG and BVF were similar and did not appear to be influenced by level of supplementation, averaging 5.78 and 4.61 Mcal/kg for maintenance and gain, respectively. Fat supplementation resulted in linear increases in empty body fat (P less than .01), kidney, pelvic and heart fat (P less than .01) and marbling score (P less than .05). Partially replacing BVF with lecithin did not influence (P greater than .10) steer performance, carcass merit or estimated NE value of the diet. The comparative feeding value (in terms of both diet acceptability and NE value) of the supplemental fats tested was similar and was apparently not influenced by level of supplementation up to 8% of diet DM. PMID- 2715109 TI - Influence of level and source of dietary fat on its comparative feeding value in finishing diets for feedlot steers: metabolism. AB - Six crossbred steers (315 kg) with cannulas in the rumen, proximal duodenum and distal ileum were used to study the influence of level and source of dietary fat on characteristics of digestion. Dietary treatments consisted of a steam-rolled barley-based finishing diet containing 1) no supplemental fat; 2) 4% yellow grease (YG); 3) 4% blended animal-vegetable fat (BVF); 4)8% YG; 5) 8% BVF or 6) 6% BVF and 2% crude lecithin. Increasing level of fat supplementation resulted in linear decreases (P less than .01) in ruminal and total tract digestion of OM and ADF and intestinal digestion of fat (P less than .05). At the 4 and 8% levels of supplementation, intestinal true digestibility of fat averaged 80.1 and 69.3%, respectively. Ruminal molar proportions of acetate decreased, and propionate molar proportion, as well as DE and ME values of the diet, increased linearly (P less than .01) with level of fat supplementation. The DE and ME values for fat were 8.17 and 9.76 at the 4% level and 7.35 and 8.72 Mcal/kg at the 8% level of supplementation, respectively. Yellow grease supplementation resulted in greater (P less than .05) ruminal fiber digestion and greater ruminal molar proportions of propionate than BVF. Intestinal fat digestion was similar (P greater than .10) for YG and BVF. Adding 25% lecithin to BVF resulted in greater ruminal fiber digestion and greater ruminal molar proportions of acetate; however, lecithin tended (P less than .10) to have a lower ME value than BVF. PMID- 2715110 TI - Effects of thermal stress and level of feed intake on portal plasma flow and net fluxes of metabolites in lactating Holstein cows. AB - Six Holstein cows (averaging 475 kg body weight, 2.3 parities and 96 d in lactation) fitted with catheters in the hepatic portal vein, mesenteric vein and intercostalis posterior artery were exposed to treatments of thermal comfort environments with libitum or restricted (75% of ad libitum) DM intake and a thermal stress environment with ad libitum intake in two balanced 3 x 3 latin squares to evaluate effects of thermal stress on portal plasma flow and net fluxes of metabolites. Portal plasma flow was measured by administering a primed, continuous infusion of para-aminohippurate into a mesenteric vein and determining its concentration and dilution in portal vein plasma. Thermal stress treatment increased rectal temperatures and respiration rates. Dry matter intake decreased from thermal comfort ad libitum level (15.1 kg/d) to lower levels in thermal comfort restricted (11.5 kg/d) and thermal stress (11.1 kg/d) treatments. Portal plasma flow was related directly to level of DM intake, declining about 14% with thermal comfort restricted intake and thermal stress environment treatments compared with the thermal comfort restricted intake and thermal stress environment treatments compared with the thermal comfort ad libitum intake treatment. Net flux of alpha-amino N was reduced 20 and 35% by thermal comfort restricted intake and thermal stress treatments compared with the thermal comfort ad libitum intake treatment. Net fluxes of urea N, ammonia N and glucose were not affected by experimental treatments. A portion of the negative effects of thermal stress on milk production can be explained by decreased nutrient intake and decreased nutrient uptake by the portal-drained viscera of the cow. PMID- 2715111 TI - Occurrence of 2-aminoethylphosphonic acid in feeds, ruminal bacteria and duodenal digesta from defaunated sheep. AB - A quantitative method of analysis for 2-aminoethylphosphonic acid (AEP) was developed using reverse-phase HPLC. The detection limit for AEP was 15 nM, and the detector response (peak area) was linear from AEP levels up to 100 microM (R = .99). Mean recovery of AEP added to strained ruminal fluid from faunated sheep was 98.2%. When AEP was added to a fermentation mixture at a concentration of 22.6 micrograms/ml, 78% disappeared during a 24-h incubation. 2 Aminoethylphosphonic acid was readily detected in preparations of mixed ruminal ciliate protozoa as well as in mixed and pure strains of ruminal bacteria, feedstuffs, and ruminal fluid and duodenal digesta from defaunated sheep. The occurrence of AEP in feed and bacterial hydrolysates was confirmed by organic phosphorus analyses. The concentration of AEP in mixed ruminal protozoa was three times greater than its concentration in mixed ruminal bacteria (4,304 vs 1,383 micrograms/g DM, respectively). The AEP values for pure ruminal bacterial cultures ranged from 733 micrograms/g DM in Bacteroides succinogenes B21a to 1,166 micrograms/g DM in Butyrivibrio fibrisolvens H17c. Ruminal fluid and duodenal digesta from defaunated sheep contained AEP concentrations of 30 micrograms/ml and 90 micrograms/g DM, respectively. The concentration of AEP in feedstuffs ranged from 25 micrograms/g DM in wheat straw to 263 micrograms/g DM in oats. Because AEP occurrence is not limited to ruminal ciliate protozoa, it is of little value as a marker for protozoal presence in or passage out of the rumen. PMID- 2715112 TI - Physiological effects of feeding high levels of magnesium to sheep. AB - The effects of feeding high levels of Mg to sheep on animal health, nutrient digestibility, metabolism of macro-minerals, blood and tissue mineral concentrations and hematological and histological tissue changes were evaluated. Six lambs were allotted to each of four diets supplemented with MgO to attain .2, .6, 1.2 or 2.4% Mg. Total fecal and urinary collections were made for the initial 20 d and last 10 d of a 50 d study. Diarrhea was noted in lambs fed the two highest Mg levels. Apparent digestibility of DM, ADF and CP decreased linearly (P less than .01) with increasing Mg levels. Dietary Mg levels did not affect (P greater than .05) rectal temperature, respiration rate or pulse rate. Apparent absorption and retention of Mg (g/d) were lowest in lambs fed 2.4% Mg until 15 d on trial, after which values increased linearly (P less than .01) with dietary Mg. Phosphorus absorption and retention decreased linearly (P less than .01) with increasing Mg levels. Increasing dietary Mg resulted in a linear increase (P less than .01) in serum Mg and variable increases (P less than .05) in erythrocyte Mg. Serum Ca was decreased linearly (P less than .05) and quadratically (P less than .05) by added Mg during the d 1 to 30 and 40 to 50 periods, respectively. Serum inorganic P was elevated consistently in lambs fed 2.4% Mg. A linear response to increasing dietary Mg (P less than .05) occurred in the Mg content of liver, kidney, rib bone and femur bone. Dietary Mg did not alter (P greater than .05) other criteria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715113 TI - Isolation and characterization of recombinant cDNA clones corresponding to developmentally regulated genes in pig liver. AB - To identify clones that corresponded to developmentally regulated genes in pig liver, recombinant cDNA libraries were constructed from early fetal (d 40), late fetal (d 110) and adult liver mRNA. Each library was screened by probing with total cDNA prepared from mRNA at different stages of development. Nine clones that gave distinct developmental patterns when hybridized to liver RNA isolated from various stages of development were subsequently isolated and partially sequenced. The cognate proteins for seven of these clones were identified by searching a national DNA sequence resource (Bionet) for similar sequences. Clones hybridizing to mRNA that was most abundant early in development were alpha fetoprotein, alpha 1 antiprotease, alpha globin and an unidentified clone. The mRNA for beta and gamma fibrinogen were most abundant perinatally. The abundance of mRNA for albumin, haptoglobin and a second unidentified clone was low in fetal liver, but increased to adult levels between birth and 3 d of age. These clones provide probes to study the relationship between factors affecting fetal growth and expression of specific genes throughout the development. PMID- 2715114 TI - Effect of altering nutrient density (concentrate to roughage ratio) and restricting energy intake on rate, efficiency and composition of growing lambs. AB - Two hundred ninety-eight Rambouillet ewe and wether lambs approximately 9 mo old from Texas were allotted to pens (29 to 30 lambs/pen). Two replicate pens were fed each of five diets. Two methods of restricting energy intake were evaluated: altering nutrient density (55% vs 72.5% vs 90% concentrate levels) and restricting intake of the 90% concentrate pelleted diet (92.5% or 85% ad libitum intake). Daily gains were highest with the 72.5% concentrate level and feed efficiency was poorest with the 55% concentrate diet fed ad libitum. Altering nutrient density did not reduce energy intake because lambs compensated by increasing feed intake at the lower nutrient densities. Actual feed intake was 89.5% of ad libitum for the 92.5% of ad libitum intake level and 84% of ad libitum at the 85% of ad libitum intake level due to refusal to consume some fines from the 90% concentrate diet. Feed refusal was greatest for lambs with ad libitum access to feed. Average daily gain was depressed by 8% at the 85% intake level. However, feed efficiency was improved (P less than .01) by 20% when intake was restricted to 92.5% of the ad libitum intake level. Differences in carcass traits were small, but consistent; carcass fat content was reduced slightly by restricting feed intake at constant slaughter weight. PMID- 2715115 TI - Cytoplasmic genetic effects and growth of hybrid mice. AB - Variation in cellular biochemical functions controlled by cytoplasmic genes was studied in relation to phenotypic differences between progeny of reciprocal hybrid female mice. Least squares procedures were used to test for differences in mitochondrial respiratory metabolism and in capacity for ATP synthesis, and differences in growth of progeny of hybrid dams. Under identical nuclear influences, mitochondria of A/J and C57BL/6J cytoplasms differed (P less than .10 to P less than .01) from those of BALB/cJ cytoplasm in energy conservation. No differences were detected in mitochondrial efficiency between BALB/cJ cytoplasm evaluated in different nuclear environments. Three-way cross progeny of C57BL/6J x BALB/cJ reciprocal hybrid females mated to DBA/2J males differed (P less than .05) in litter weight at weaning and 1 wk and 2 wk postweaning. The F2 progeny of reciprocal C57BL/6J x BALB/cJ dams and F2 and three-way cross progeny of reciprocal A/J x BALB/cJ dams did not differ in weight at any age measured. Across all genotypes of dam, rank correlations of mitochondrial traits with F2 litter weights were nonsignificant. Observed variation in mitochondrial functions partially controlled by cytoplasmic genes did not limit mouse growth under these experimental conditions. PMID- 2715116 TI - Effects of inbreeding and heterosis in Hereford females on fertility, calf survival and preweaning growth. AB - Effects of inbreeding and heterosis and the difference between them were estimated by comparing linecross (L), topcross (T), inbred (I) and control line (C) Hereford females for reproductive and preweaning growth traits of their progeny. Inbred females (average inbreeding coefficient = 26.5%) originated from four single-sire inbred lines. Control females (average inbreeding coefficient = 6.9%) were produced by a four-sire, 60-cow line. Linecross females were produced from all possible reciprocal crosses of the I lines. Topcross females were produced by mating I bulls to C cows. Differences in pregnancy rate among these lines were not detected. Effects of maternal heterosis were positive for both prenatal and postnatal survival. The weaning rate by L females exceeded the weaning rate by I females as a result. Prenatal survival was reduced in calves from I females relative to those from C females, resulting in corresponding differences in birth and weaning rates. Differences in the magnitudes of maternal heterosis and inbreeding effects were not detected, except for birth weight. For birth weight the effect of maternal inbreeding was of greater magnitude than the effect of maternal heterosis. Within the I and C lines regressions of pregnancy rate, prenatal survival, birth rate, postnatal survival, weaning rate, weaning weight/cow exposed, birth weight and weaning weight on the inbreeding coefficients of the cows indicated significant inbreeding depression on all traits except pregnancy rate and postnatal survival. PMID- 2715117 TI - Heterosis, maternal and direct effects in double-muscled and normal cattle: I. Reproduction and growth traits. AB - Data from a two-breed group diallel experiment involving double-muscled (DM) and normal (N) cattle were analyzed to evaluate the importance of heterosis, maternal and direct effects for reproduction and growth traits. The DM cattle were from a composite of primarily Angus, Charolais, Galloway and Hereford breeds, and N cattle were crossbred cattle with at least 50% Hereford breeding. The data comprised a total of 491 matings and 389 calvings in four breeding seasons. Records on calving performance, calving date, calf crop born and weaned, sex ratio of progeny and weight of calves were analyzed using least squares procedures. Significant heterosis of 5 to 12% was observed for all the calf crop and growth traits, except for birth weight. Heterosis resulted in 24% reduction in the incidence of dystocia and perinatal calf mortality (P less than .05). The significant heterosis was due mainly to poor production in DM X DM crosses. The DM cows were superior (P less than .05) to N cows in reciprocal crossing (maternal effect) for all the calf crop traits, but had higher incidence of calving difficulty and a higher proportion of male progeny. Significant direct effect was observed for all the traits except calving date and sex ratio among progeny. The N sires were superior for all the calf crop traits and caused less incidence of dystocia and perinatal mortality compared with the DM sires. Significant differences were obtained between the straightbreds for all the traits except calving date. The N straightbreds were superior to the DM straightbreds for all the significant traits. PMID- 2715118 TI - Heterosis, maternal and direct effects in double-muscled and normal cattle: II. Carcass traits of young bulls. AB - Data on 135 young bulls from a two-breed group diallel experiment involving double-muscled (DM) and normal (N) cattle were analyzed to obtain estimates of heterosis, maternal and direct effects for carcass traits. When carcass traits were adjusted to a constant age at slaughter (398.5 d), significant positive heterosis was observed for slaughter and carcass weights, carcass length and s.c. fat thickness. Maternal effect was relatively unimportant for the traits studied. The progeny of N sires and DM straightbreds were heavier at slaughter and had higher carcass weight, s.c. fat thickness and carcass length (P less than .01), whereas DM-sired progeny and DM straightbreds had higher dressing percentage (P less than .05) and cutability (P less than .01). Heterosis was significant for all the 10-11-12th rib joint dissection traits except for percentage of muscle. Although there was negative heterosis for percentage of bone, there was positive heterosis for rib joint weight, fat weight and percentage, muscle weight and muscle:fat and muscle:bone ratios. For direct effect and straightbred differences, N-sired progeny and N straightbreds, respectively, had significantly larger values for rib joint weight, fat weight and percentage and bone weight. The DM-sired progeny and DM straightbreds had larger values for percentage of muscle, muscle:fat and muscle:bone ratios. When the carcass and dissection traits were adjusted to a constant carcass (303.7 kg) and rib joint (4,812 g) weight, respectively, the results were similar to those observed on age constant basis except for rib eye area, for which DM-sired progeny and DM straightbreds had larger values. PMID- 2715119 TI - Relationship between body fat and postweaning interval to estrus in primiparous sows. AB - Twenty-two primiparous Yorkshire sows were used to determine whether a minimal threshold of body fat exists below which the return to estrus is delayed. A second objective was to examine the relationship between body fat and interval from weaning to estrus in restricted-fed sows. During lactation (28 d), sows received 7, 9, 11 or 13 Mcal of ME daily to produce a range of sow body fatness at weaning. Intake of all dietary essentials except ME was similar for all sows. Litter size was adjusted to 10 pigs for all sows by d 3 postpartum. Each day from weaning to estrus, sows received 110 kcal ME per kg metabolic body weight plus 1,359 kcal ME per sow. Body fat was estimated at weaning and at first postweaning estrus by deuterium oxide dilution. Last rib backfat depth was determined ultrasonically 24 h postpartum and at weaning. Irrespective of dietary ME intake, percentage body fat at weaning (R2 = .24; P less than .05) and first postweaning estrus (R2 = .03; P greater than .50) accounted for only a small portion of variation in interval from weaning to estrus. Likewise, loss of backfat depth during lactation was not an accurate predictor of interval from weaning to estrus (R2 = .24; P less than .05). The low coefficients of determination (less than .25) suggest that body fat is a minor controller of postweaning interval to estrus. In contrast, dietary ME intake during lactation accounted for the largest portion of the variation (R2; = .48; P less than .01) in postweaning interval to estrus. We conclude that timing of postweaning estrus in primiparous sows is not dependent on a minimal threshold of body fat. Furthermore, effects of lactational ME intake on the postweaning interval to estrus are more pronounced than the effects of body fat. PMID- 2715120 TI - Effects of dietary energy and phosphorus content on blood chemistry and development of growing horses. AB - Growth and clinical biochemistry were examined over 30 wk in 42 light horse weanlings fed high-forage diets (73 to 77% alfalfa) or high-concentrate diets (63 to 65% grain and grain by-products) that were either low (.24 to .35%), normal (.68%) or high (.95 to 1.06%) in P. Body weights and blood samples were taken every 2 wk. Forage and concentrate diets contained 2.65 and 3.09 Mcal digestible energy/kg DM, respectively. Calcium and P digestibilities were highest (P less than .01) in those horses fed the low P diets, but only horses fed forage-low P diets may have absorbed insufficient P. Serum alkaline phosphatase activity, serum Ca, serum Mg and plasma Cu concentrations were unaffected by diet but varied (P less than .01) among sampling periods. The concentrations of serum Ca and P of all groups fluctuated to wk 10 before being stabilized at means of 2.77 and 2.03 mmol/liter, respectively. Plasma Zn concentrations increased quadratically with age and were 3.8% greater (P less than .05) for concentrate fed horses than for forage-fed horses. Mild to moderate physitis and flexure limb deformities occurred in 88% of the weanlings principally between wk 6 and 8 of the study. Limb deformities had largely resolved by wk 12. Marginally deficient P intakes did not alter productivity, feed intake, blood mineral concentration in the final 20 wk or the occurrence of musculoskeletal abnormalities in weanling horses. PMID- 2715121 TI - Amelioration of selenium toxicity by arsenicals and cysteine. AB - Young chicks exhibited a 61% reduction in weight gain when a corn-soybean meal diet was supplemented with 15 mg/kg Se provided as Na selenite. The same level of Se provided as selenomethionine depressed weight gain by 32%. Supplementing the high selenite diet with isoarsenous (14 mg/kg As) additions of As2O5, As2O3, phenylarsonic acid, phenylarsine oxide and roxarsone ameliorated the Se-induced growth depression: As2O5 almost totally restored growth rate; As2O3, phenylarsonic acid and phenylarsine oxide gave intermediate responses; and roxarsone gave only a small ameliorative growth response. Arsanilic acid was without effect in stimulating growth rate of selenite-intoxicated chicks. Dietary addition of .4% L-cysteine produced a growth response in selenite intoxicated chicks that was somewhat greater than that obtained with roxarsone; administering both roxarsone and cysteine corrected growth better than either compound given singly. Both roxarsone and As2O5 also effectively ameliorated the Se-toxicity growth depression caused by selenomethionine (15 mg Se/kg) supplementation, but cysteine showed no efficacy against morbidity caused by this form of Se. Liver Se concentration was elevated 10-fold by selenite and 25-fold by selenomethionine supplementation. The arsenic compounds had varying effects on liver Se, whereas cysteine tended to increase Se concentration. These findings suggest that both inorganic and organic arsenicals as well as cysteine ameliorate selenium toxicity by different mechanisms. PMID- 2715122 TI - Effect of postnatal nutritional status on subsequent growth and reproductive performance of gilts. AB - Two trials involving 128 gilts were conducted to determine the effect of nutritional status during the first 28 d postnatally on subsequent growth and reproductive performance. Nutritional status was altered by adjusting litter size at birth to either 6 or 12 pigs and maintaining a lactation length of either 13 or 28 d. Pigs weaned at d 13 were fed on an ad libitum basis or at 50% of ad libitum through d 28. After d 28, all pigs were fed the same diets through the first parity. By market weight (d 154) pigs recovered differences in body weight imposed during the early postnatal period. Postnatal nutritional status did not alter age at puberty. Gilts weaned at d 28 from litter size 6 produced 2.4 more (P less than .05) ova than gilts from litter size 12; however, when weaned at d 13, gilts from litter size 6 produced 2.3 fewer ova than gilts from litter size 12. Feed restriction for 15 d postweaning did not depress ovulation rate in gilts. Subsequent litter size was not affected by postnatal litter size, lactation length or feed restriction, even though growth rate and ovulation rate had been altered by treatments imposed during the first 28 d postnatally. Assuming no difference in fertilization, these data suggest that prenatal mortality was altered by the early postnatal treatments and was the limiting factor for litter size. Until factors that influence prenatal losses are characterized and controlled, the alteration of nutritional status by changes in postnatal litter size, lactation length or feeding level will not detrimentally affect subsequent litter size in gilts. PMID- 2715123 TI - Effect of colostrum or medium-chain triglyceride supplementation on the pattern of plasma glucose, non-esterified fatty acids and survival of neonatal pigs. AB - A total of 48 neonatal pigs were used to determine whether intubation with colostrum or medium-chain triglyceride (MCT) would enhance glucose homeostasis and survival. Pigs were removed from the sow prior to nursing and alloted to three treatment groups. Fasted pigs received only water for 30 h, whereas those allotted to supplemented groups received either 30 ml of colostrum or 15 ml of MCT at 6 and 16 h after birth (t6 and t16). Supplementation with MCT (t6) resulted in a 2.4-fold elevation in plasma non-esterified fatty acid (NEFA) concentration compared with fasted pigs (260 vs 109 microEq/liter at t8; P less than .05). This difference increased following the second MCT dose (436 vs 117 microEq/liter at t18; P less than .05). Colostrum supplementation also elevated plasma NEFA (201 and 259 microEq/liter at t8 and t18, respectively); however, less triglyceride fatty acid was presented via colostrum compared with MCT. Supplementation with MCT resulted in a greater increase in plasma glucose concentration, relative to fasting levels (75 vs 56 mg/ml at t8; 76 vs 62 mg/ml at t18), than was obtained with colostrum (68 and 65 mg/ml at t8 and t18, respectively). Residual effects of supplementation to t30 were evident for both MCT and colostrum pigs in NEFA levels, but only the MCT group had a greater (P less than .05) concentration of plasma glucose at t30 compared with the fasted group (63 vs 49; P less than .05). This regimen of MCT supplementation was employed in an experiment with nursing pigs to determine whether MCT would improve glucose status and survival of less-competitive pigs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715124 TI - Embryonic migration relative to maternal recognition of pregnancy in sheep. AB - Twenty-five crossbred ewes were utilized to examine the timing of embryonic migration relative to maternal recognition of pregnancy. These ewes also were utilized to examine whether ovine embryos synthesized estradiol-17 beta in association with embryonic elongation and intrauterine migration. Embryos were flushed on d 11 through 15 from hemiovariectomized ewes. Recovery of embryos from the uterine horn contralateral to the remaining ovary indicated that migration had occurred. Ewes subsequently were returned with rams to determine their interestrous interval. Recovered embryos were classified morphologically, their length determined and individually incubated. Changes in estradiol within the medium were determined after a 6-h incubation. Embryo migration began on d 14 (P less than .05); on consecutive days from 11 through 15, 0, 0, 0, 60 and 100% of ewes examined, respectively, had an embryo in the contralateral horn. Extended estrous cycles (greater than 20 d) were observed in 0, 0, 40, 80 and 100% of ewes examined (P less than .05) following removal of embryos on d 11 through 15 of the cycle. Ovine embryos were longer (P less than .05) on d 14 (4.8 +/- 1.1 cm length, mean +/- SE) compared with d 13 (.2 +/- .1 cm) and increased further (P less than .05) on d 15 (7.8 +/- 1.1 cm). Incidence of intrauterine migration was correlated with embryonic length (r = .83; P less than .01) and estradiol synthesis (r = .77; P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715125 TI - AIDS and AIDS-related infections: current strategies for prevention and therapy. Based on a meeting of the British Society for Antimicrobial Chemotherapy. Stratford-on-Avon, 21-22 April 1988. PMID- 2715126 TI - Diagnosis and treatment of Kaposi's sarcoma. AB - Kaposi's sarcoma occurs in the non-classical form in immunosuppressed patients in non-HIV patients in Africa and in patients infected with HIV. The latter group are now the most common. The treatment of Kaposi's sarcoma in AIDS patients must be seen in the context of their general condition. Symptomatic treatment by radiotherapy and low dose chemotherapy is often all that is appropriate. Immunotherapy has a small treatment role at present. PMID- 2715127 TI - Endothelial injury assessed by isotope release: 3H-adenine compared with 51Cr. PMID- 2715128 TI - Synthetic hydrogel microspheres as substrata for cell adhesion and growth. AB - Cross-linked poly(methyl methacrylate) (PMMA) microspheres were subjected to alkaline hydrolysis to obtain hydrophilic microspheres having carboxyl residues distributed throughout the matrix. These microspheres were found to support the growth of human skin fibroblasts and human heart and lung cells. Further, fibroblasts grown on them were found to be comparable with those grown on the commercial tissue culture plate with respect to [14C]amino acid uptake and incorporation into proteins. The hydrolyzed PMMA microspheres may find application as a microcarrier for cell culture. PMID- 2715129 TI - Influence of branched-chain amino acid composition of culture media on the synthesis of plasma proteins by serum-free cultured rat hepatocytes. AB - Supplementation of Ham's F12 culture medium with essential amino acids (EAA) up to the rat plasma levels increased the rates of synthesis of albumin and transferrin by cultured rat hepatocytes by 1.3 and 1.7, respectively. Fifty percent of this increase could be attributed to three of the EAA: the branched chain amino acids (BCAA: Leu Ile and Val). Non-branched-chain essential amino acids (non-BC-EAA) stimulated only 25% of the increase produced by the whole EAA mixture. When each EAA was tested individually, none of them caused an appreciable increase in albumin and transferrin in culture medium. When the concentrations of all EAA were raised to rat postprandial portal levels, albumin and transferrin synthesis rates reached a maximum, increasing by 3.2 and 3.5, respectively. Supplementation with BCAA at postprandial portal concentrations increased albumin and transferrin synthesis rates by 2.2 and 2.0, respectively, and had no noteworthy effect on the synthesis of cellular proteins. Non-BC-EAA at their postprandial portal concentrations increased albumin and transferrin synthesis rates by 1.7 and 1.9, respectively. Supplementation with alanine to reach a nitrogen content equal to that of the modified EAA-enriched medium had no stimulatory effect. Our results show that EAA have a specific effect on the synthesis of plasma proteins by cultured hepatocytes, and that BCAA at physiologic concentrations account for the major part of this stimulatory effect. Consequently, EAA and particularly BCAA concentration should be elevated in serum free nutrient media to sustain maximum plasma protein synthesis. PMID- 2715131 TI - Radionuclides in domestic and imported foods in the United States, 1983-1986. AB - Findings in the Food and Drug Administration's Radionuclides in Foods program are summarized for samples collected between October 1, 1982, and September 30, 1986. All radionuclide findings for Total Diet and reactor samples were either in Action Range I or low in Range II of the surveillance and control recommendations given by the Federal Radiation Council. The only long-range trend noted was a continuation of the general decline in dietary intake of 90Sr since 1961. Imported food samples were analyzed for contamination after the Chernobyl nuclear accident. The findings for imported foods indicate that the surveillance efforts successfully targeted contaminated foods, and that contamination levels were below levels of concern for all but one oregano and 3 cheese samples. PMID- 2715130 TI - Stimulating effects of bovine small intestine mucosal factors on rat hepatocyte development. AB - A mass of pure adult rat parenchymal hepatocytes, obtained by a newly devised isolation technique, developed into organized micro-liverlike layered multicellular colonies in long-term primary cultures grown in the presence of bovine small intestine mucosal factors (SIMFs). These factors stimulated proliferation, aggregation, and orderly arrangement of the hepatocytes, and differentiation into partially functional micro-livers in vitro. SIMFs derived from other mammalian species affected rat hepatocytes in the same manner. Studies of the effects of mammalian SIMFs on hepatocytes may provide new insights into the kinetics and mechanisms of liver regeneration. PMID- 2715132 TI - Investigations on N-nitrosopyrrolidine in dry-cured bacon. AB - Dry-cured or "country-style" bacon is a low volume specialty product typically made by small producers whose production practices vary widely. These practices include the direct application of dry-cure formulations containing varying concentrations of salt, sugar, flavoring agents, sodium nitrite, and sometimes sodium nitrate, and the use of lengthy curing and processing times. Because of the possibility of generating higher levels of N-nitrosopyrrolidine (NPYR) after frying in this product type compared with pump-cured bacon, an investigation was carried out on dry-cured bacon obtained from cooperating state or federally inspected establishments. Three different samples from each of the 16 plants were analyzed. Only one sample from each of 2 different producers exceeded the Food Safety and Inspection Service (FSIS) action level of 17 ppb NPYR, indicating that the majority of samples tested were in compliance. A significant correlation (P less than 0.01) was found between residual NaNO2 prior to frying and NPYR after frying. The elimination of added nitrate in the dry-cure formulations is recommended. PMID- 2715133 TI - Determination of polysorbates in foods by colorimetry with confirmation by infrared spectrophotometry, thin-layer chromatography, and gas chromatography. AB - A method is presented for the detection of polysorbates (PSs) in 8 kinds of processed foods by colorimetric and thin-layer chromatographic (TLC) techniques. The PSs are extracted from processed foods with a mixture of methylene chloride and ethanol by using an Extrelut column. The extract is further purified by using a silica gel column. The PS extract is complexed with cobalt-thiocyanate (Cothiocyanate) reagent and is determined spectrophotometrically at 620 nm. The recoveries and coefficients of variation for 8 kinds of processed foods fortified with 0.1% PS 80 were 67.9-94.6% and 4.0-11.3%, respectively. The detection limit of TLC corresponded to 50 mg PS 80/kg. PS identity was confirmed by infrared spectrophotometry of PS extract, and gas chromatography of fatty acids and thin layer chromatography of POE-sorbitan residues after saponification. PMID- 2715134 TI - Limited survey of deoxynivalenol in wheat and corn in the United States. AB - A limited survey was conducted over a 2-year period to determine the incidence and levels of deoxynivalenol (DON) in corn and wheat grown in selected areas of the United States. Samples of corn (198) and wheat (247) were collected and analyzed by a gas chromatographic method. Sixty-six percent of the corn samples collected in 1984 and 30% of the corn samples collected in 1985 contained DON. The average concentration of DON in corn, by state, ranged from 0.11 to 1.20 micrograms/g; the maximum concentration was 2.47 micrograms/g. Only 2 of the 247 samples of wheat contained DON at a concentration greater than 2 micrograms/g, which is the level of concern suggested by the Food and Drug Administration for wheat entering the milling process for human consumption. PMID- 2715135 TI - Class definition and mixture class definition by means of construction of convex hull boundaries: application to analysis for animal fat adulteration. AB - A visual classification technique based on the construction of convex hull boundaries in combination with a principal component analysis is described. This combined technique was evaluated in the situation in which a distinction has to be made between 2 pure animal fat classes and the corresponding mixture class. In the first instance, a principal component analysis is carried out to ensure the 2 dimensional and thus visual aspect of the technique. Convex hulls are then constructed in the 2-dimensional principal component plane to delimit the boundaries of the different classes to be defined. The effectiveness of the constructed hull boundaries in the definition of class-membership was investigated by means of the classification of different simulated test samples. The results show that, at least for the tested applications, the technique is valid, although some false positive classifications occur. The detection of outliers especially seemed to pose problems. Therefore, some propositions are made of how to refine the developed hull technique to enhance the classification results. PMID- 2715136 TI - Analysis of natural coloring matters in food. III. Application of methylation with diazomethane for the detection of lac color. AB - A new method has been proposed for detection of lac color in food. Lac color is a natural color additive derived from a secretion of the insect Coccus Laccae (Laccifer lacca Kerr). It is extracted from food with methanolic oxalic acid and eluted from a column of Amberlite XAD-2 with the same solvent. The fraction containing the lac color is treated with diazomethane to produce 2 reddish-orange markers. The marker species in the reaction mixture are detected by both thin layer chromatography and reverse-phase liquid chromatography. PMID- 2715138 TI - Association of Official Analytical Chemists. General referee reports. PMID- 2715137 TI - Liquid chromatographic determination of ivermectin in bovine serum. AB - A rapid, sensitive method is described for the determination of ivermectin concentrations in bovine serum. Ivermectin is extracted by passing a sample through a reverse-phase C18 cartridge. A silica-packed cartridge is used to purify the extract further. Ivermectin is quantitated by liquid chromatography with detection at 245 nm. Recoveries were 95 +/- 4% for samples fortified with 20 ppb ivermectin. Concentrations as low as 2 ppb can be detected in 5 g samples. PMID- 2715139 TI - Problems with tricyclic antidepressant use in patients with panic disorder or agoraphobia: results of a naturalistic follow-up study. AB - The authors followed up 107 patients with panic disorder or agoraphobia with panic attacks who had been placed on a regimen of tricyclic antidepressant treatment 1 to 4 years earlier. Sixty-three percent reported at least moderate improvement during treatment; however, side effects were often difficult to tolerate, and 35% discontinued tricyclic treatment on this account. Overstimulation, which occurred in 20%, was the most frequent reason for early termination, and weight gain, which occurred in 34%, was the most common reason for stopping the drug later on. Seizures occurred in 2 patients. Even though they were encouraged to discontinue drug use, most of the patients who had responded were still taking their drugs at follow-up. More than half of those who had responded before stopping drug treatment subsequently relapsed. The findings highlight problems with safety, side effects, and patient acceptance resulting from the use of tricyclic antidepressants in patients with anxiety disorders. PMID- 2715140 TI - Hospitalized schizophrenic patient views about seclusion. AB - Twenty-six of 100 consecutively admitted schizophrenic or schizoaffective patients required seclusion during their hospital stays. Seclusion episodes usually involved involuntarily committed, severely ill patients and occurred early in their hospitalizations. The recollections of the personal seclusion experiences of 17 patients were generally factually accurate, except for a tendency to play down disruptive aggressive behavior on their part. Patients described seclusion as a painful experience associated with feelings of helplessness, fear, sadness, and anger. However, patients also stated that seclusion rooms were necessary on inpatient psychiatric units and that the rooms were used for the control of disruptive aggressive patient behaviors. This study highlights not only the need for staff to clarify for patients what behavior has led to seclusion and what behavior will lead to release, but also the need for staff to acknowledge patients' distress at the experience. PMID- 2715141 TI - A case of koro in a refugee family: association with depression and folie a deux. AB - Koro, a folk syndrome involving fear of genital retraction, is known to occur in epidemic fashion and is usually associated with anxiety symptoms. The author describes a sporadic case of koro accompanied by psychotic depression in a refugee. The refugee's wife, who was also suffering a major depression, also believed that the patient was undergoing genital retraction with a potentially fatal outcome. The cultural, familial, and acculturative stresses associated with the syndrome are described. Resolution of the koro syndrome and its associated psychopathology required interventions on biomedical, psychological, familial, and sociocultural levels. PMID- 2715142 TI - Gastric outlet obstruction masquerading as anorexia nervosa. AB - A 30-year-old Chinese housewife presenting with what appeared to be late-onset anorexia nervosa was subsequently found to have peptic ulcer disease complicated by gastric outlet obstruction. Surgical treatment led to rapid improvement of body weight but not immature personality. Extra caution should be exercised in the diagnosis of anorexia nervosa presenting with atypical features in a community in which that condition is rare. PMID- 2715143 TI - Euphorigenic properties of anticholinergics. PMID- 2715144 TI - Psychotic and nonpsychotic depression: comparison of response to ECT. PMID- 2715145 TI - Neurotoxicity resulting from a combination of lithium and loxapine. PMID- 2715146 TI - Coexisting panic disorder and alcoholism. PMID- 2715147 TI - Interrelations between depression, the immune system, and the endocrine system. Charleston, South Carolina, October 22, 1988. Proceedings. PMID- 2715148 TI - Overview: depression in health and illness. PMID- 2715149 TI - The production and assessment of a plastic rod for the Chinese Reference Preparation for Opacity. AB - A reference preparation for opacity consisting of a plastic rod was introduced by Perkins et al. in 1973. It was adopted as the International Reference Preparation for Opacity in 1975. This plastic rod opacity reference preparation has been used to standardize the Chinese National Bacterial Opacity Standard. The material was prepared from plastic sheet by a water-bath method and by a dry-heat method; the sheet was then machined into the plastic rods. We have studied the technical processes and set up methods for the examination of the sheets and rods. The water-bath method was found to be better than the dry-heat method in our tests. Collaborative assays in research institutes of biological products have shown that the plastic rod can replace the glass-powder suspension. The duration of validity of the plastic rod opacity reference preparation and that of the glass powder suspension used for the Chinese National Bacterial Opacity Standard were studied and found to be similar. For this reason the plastic rod opacity reference preparation has not been widely used in China. PMID- 2715150 TI - The detection of Clostridium perfringens epsilon antitoxin in rabbit serum by monoclonal antibody based competition ELISA. AB - A competitive enzyme-linked immunosorbent assay (CELISA) has been developed, standardized and compared with the toxin neutralization (TN) test performed in mice for the measurement of antibody responses in rabbits vaccinated with clostridial vaccines. In CELISA, sera were tested at a single dilution for their ability to compete with the reaction between a monoclonal antibody, which neutralizes epsilon toxin, and epsilon toxoid coated on to a solid phase. The results of the two tests correlated well. CELISA was specific, rapid, reproducible and simple to perform and offered an alternative to the TN test that reduced the requirement for experimental animals in the potency testing of clostridial vaccines. PMID- 2715151 TI - The International Standard for Endotoxin: evaluation in an international collaborative study. AB - An ampouled preparation of bacterial endotoxin, coded 84/650, was evaluated in 35 laboratories in 12 countries for its suitability to serve as the International Standard for Endotoxin. The ampouled preparation was calibrated in terms of the USA National Standard, EC5, in Limulus Amoebocyte Lysate gelation, turbidimetric and chromogenic tests and in rabbit pyrogen tests. On the basis of the results reported here, with the agreement of the participants in the study, and with the authorization of the Expert Committee on Biological Standardization of the World Health Organization, the preparation coded 84/650 was established in 1986 as the International Standard for Endotoxin for Limulus Gelation Tests with an assigned unitage of 14,000 IU of endotoxin per ampoule. PMID- 2715152 TI - Assessment of the biological stability of human thyroid stimulating hormone prepared by immunoaffinity chromatography. AB - This paper reports a comprehensive study of the biological stability of an immunoaffinity purified preparation of human thyroid stimulating hormone (TSH) and provides a reference against which future natural or synthetic preparations may be compared. The stability of the hormone preparation was investigated using the accelerated degradation method. The bioassay of the TSH was carried out in mice using a modified McKenzie method. Analysis of the results showed that the preparation was as stable as other TSH preparations purified by conventional methods. PMID- 2715153 TI - Combined estimation of tetanus and diphtheria antitoxin in human sera by the in vitro Toxin-Binding Inhibition (ToBI) test. AB - The use of the principle of inhibition of toxin binding to an antitoxin coated immunoassay plate as described in a previous paper for tetanus antitoxin titration, was adapted for the estimation of diphtheria antitoxin in human sera. With a few modifications, a Toxin-Binding Inhibition (ToBI) test was developed which could be used for a combined estimation of both tetanus and diphtheria antitoxin levels. The application of streptavidin-biotinylated peroxidase complex when using small serum samples (less than 50 microliters) is discussed. Antitoxin titres (both diphtheria and tetanus) of 0.002 IU ml-1 were detectable by the ToBI test, this being far below the level considered to be protective in man. Sera from 140 adults with different vaccination histories were titrated for both tetanus and diphtheria antitoxin. Good correlations were found between the estimates obtained by the ToBI test and those obtained by the toxin neutralization (TN) test in mice (tetanus antitoxin) and those obtained in the in vitro neutralization test in VERO cells (diphtheria antitoxin). It is concluded that the ToBI test is a simple and reliable alternative to the functional models currently in use for the estimation of diphtheria and tetanus antitoxin levels. In addition, the ToBI test eliminates the need for laboratory-animal or cell culture facilities and can be performed with small quantities of serum as required in field trials. PMID- 2715154 TI - Angiotensin II stimulates human gastric smooth muscle in vitro. AB - 1. For a precise analysis of angiotensin II (ANG) effects on human gastric muscle, we dissected longitudinal (lo) and circular (ci) strips from fundus (Fu), corpus (Co) and antrum (An), and circular muscle from the inner and outer part of the pyloric sphincter (Py-inn and Py-out) and from duodenum. The mechanical activity of these muscle strips was recorded simultaneously under auxotonic conditions. Preparations were taken from a total of 10 stomachs (from organ donors or gastrectomy preparations). 2. Excitatory effect after application of ANG (10(-9) to 10(-6) mol l-1) were regularly observed in all types of preparation (threshold: 10(-9) mol/l). 3. The quality of the responses depended on the general characteristics of the type of preparation. Tonic types of muscle showed predominantly tonic responses to ANG (Fu-lo, Fu-ci, Co-lo). Purely phasic muscles (An-ci) showed increases of the phasic activity (amplitude up to 33% delta 1). Intermediate types of muscle exhibited combined phasic/tonic responses (Co-ci, An-lo). Phasic responses were also seen in Py-out. Inner pyloric muscle (Py-inn) responded only to a small extent to ANG. Phasic/tonic activations were observed in the duodenal preparations, accompanied by slight increases in frequency. 4. The intensity of the ANG-induced responses often exceeded the maximum acetylcholine-induced activation. The qualitative pattern of ANG responses was similar to that of bombesin-induced activation. PMID- 2715155 TI - Enhanced patency of small-diameter tubings after surface immobilization of heparin fragments. A study in the dog. AB - The luminal surfaces of polyethylene and polyurethane tubings of 1 mm inner diameter and 1 m in length were coated with heparin by end point attachment and thereafter sterilized in ethylene oxide. The tubings were inserted as arterio venous shunts from the aorta to the superior caval vein via a carotid artery and a jugular vein. Patency was assessed with an ultrasound doppler flow meter and flow measurements. All nonheparinized shunts occluded within 10 days with a mean elapsed time from the insertion of the tubing is the last positive doppler registration being 3.5 days. The corresponding patency time for heparinized shunts was 25.9 days. The occlusion of the heparinized tubings was due to the incorporation of the ends of the tubings in the walls of aorta and caval vein, whereas the nonheparinized tubings occluded as a result of clot formation. It is concluded that surface immobilization of heparin with sequences capable of activating antithrombin may be beneficial in the development of small-diameter vascular protheses. PMID- 2715156 TI - Oligomers with pendant isocyanate groups as tissue adhesives. I. Synthesis and characterization. AB - A series of methacrylate oligomers containing pendant isocyanate groups were synthesized by reacting 2-isocyanatoethyl methacrylate (IEM) and/or m-isopropenyl alpha, alpha-dimethylbenzyl isocyanate (TMI) in ethoxyethyl acetate with methacrylates ranging from methyl to stearyl methacrylate or allyl-, cyclohexyl-, glycidyl-, i-bornyl-, or dicyclopentenyloxyethyl methacrylate. The oligomers which are stable at room temperature were characterized by IR for NCO, ester, and C = C groups and by their refractive indices. They have a small number of residual double bonds and a molecular weight low enough so that the compounds are liquids at room temperature and dissolve readily in esters and chlorinated hydrocarbons. HPLC showed no residual monomer. GPC and intrinsic viscosity of selected oligomers indicated a molecular weight range from 1400 to 2600. Isocyanate groups were determined titrimetrically and ranged from 15.9% to 5.1%. Concurrent studies have demonstrated that these oligomers bond strongly to hard and soft tissues. Thus, subject to their biocompatibility they could find many applications as tissue adhesives. PMID- 2715157 TI - Properties and biological interactions of polyurethane anionomers: effect of sulfonate incorporation. AB - In order to investigate the factors affecting the interaction of polyurethanes and blood, a series of poly(tetramethylene oxide)-based polyurethane block copolymers was synthesized with systematically varying levels of ion incorporation in the hard segment block. A bimolecular nucleophilic substitution reaction was used to replace up to 20% of the urethane hydrogens with propyl sulfonate groups. Bulk and surface characterization was performed, and a canine ex vivo arteriovenous shunt was used to monitor initial platelet and fibrinogen deposition on these surfaces. The microphase separation and bulk physical properties were found to vary with ionic content. Surface analysis using both in vacuo (ESCA) and water-equilibrated (contact angle) methods indicated that these polymers, and especially the highly sulfonated materials, could rearrange to minimize their interfacial tension, depending on the contacting environment. Platelet deposition onto these materials decreased as the level of sulfonation increased, with the highly sulfonated polymer showing substantially less platelet spreading and activation than previously seen in the same experiment with other polymers. PMID- 2715158 TI - The spatial resolution of protein adsorption on surfaces of heterogeneous metallic biomaterials. AB - This study was designed to examine the heterogeneity of the adsorption of proteins onto metallic materials. The materials studied included pure Ag, Au, and Ti and sintered Ag 10% Ti and Ag 10% Ta. The distribution of the protein adsorption was studied using I-125 labeled albumin detected by microautoradiography. The surface morphology of the specimens was examined in the scanning electron microscope prior to exposure to the protein solution. A heterogeneous distribution in albumin adsorption was observed over the Ag surface. Similar regions were observed over parts of the mixed metal specimens, but superimposed on this pattern were distinct regions of very low protein adsorption which appeared to correlate closely with the regions of Ti or Ta observed in the scanning electron microscope. A uniform distribution of adsorbed albumin was observed on the Au and Ti, with Au giving a much denser microautoradiograph than Ti. This work demonstrates that variations in the protein adsorption to heterogeneous materials can be observed on a microscopic scale. PMID- 2715159 TI - Protein-resistant surfaces prepared by PEO-containing block copolymer surfactants. AB - Polyethylene oxide(PEO)-containing nonionic polymeric surfactants were studied as a possible means to produce PEO-rich surfaces by a simple coating treatment of a common hydrophobic medical material--polyethylene. Surface tension and adsorption properties of PEO/polypropylene oxide(PPO) and PEO/polybutylene oxide(PBO) block copolymer surfactants on a hydrophobic surface (low density polyethylene, LDPE) were investigated, using the Wilhelmy plate surface tension technique and x-ray photoelectron spectroscopy(XPS). The protein resistance of the surfactant-treated surfaces was evaluated by XPS and 125I-labeled proteins. The data presented indicate that adsorption of the surfactants on LDPE is dependent on the molecular geometry of the surfactants. Adsorption of human albumin was significantly decreased on the surfactant-treated LDPE surfaces, as compared with the untreated surface. Surfactants suitable for the preparation of PEO-rich surfaces and possible mechanisms for their protein resistance are discussed. PMID- 2715160 TI - The bovine pericardial xenograft: I. Effect of fixation in aldehydes without constraint on the tensile viscoelastic properties of bovine pericardium. AB - Tensile testing of tissue strips has been used to examine the effect of simple fixation in glutaraldehyde and formaldehyde on the viscoelastic properties of bovine pericardium. To assess tissue anisotropy, tissue strips were cut at 0 degree, 30 degrees, 60 degrees, and 90 degrees relative to the base-to-apex direction. Fresh anterior pericardium was modestly anisotropic, being least extensible in the base-to-apex direction; however, fixation removed this anisotropy. Fixation also produced a marked change in the response of the material to initial cyclic loading during preconditioning. Overall extensibility of the fixed material was significantly greater than that for the fresh tissue, consistent with a 10.7% shrinkage in aldehydes calculated from strain at fracture data. Reductions in stress relaxation and creep after fixation were noted as well, consistent with intrafibrillar crosslinking. Cyclic hysteresis and ultimate tensile strength were unaffected. Since the observed changes in the stress-strain response were largely attributable to shrinkage, control of shrinkage by physical means would allow for engineering modification of bovine pericardial mechanics for controlled anisotropy. PMID- 2715161 TI - The bovine pericardial xenograft: II. Effect of tethering or pressurization during fixation on the tensile viscoelastic properties of bovine pericardium. AB - Our previous article suggested that control of the extensibility of aldehyde fixed pericardium could be achieved by controlling shrinkage during fixation. Therefore, to prevent shrinkage, we have used sandpaper-lined plexiglass plates to clamp circular samples of bovine pericardium during fixation in glutaraldehyde, tethering them at their original dimensions. As well, we have applied transmural pressures of 50 or 100 mm Hg during fixation using a hydraulic column of glutaraldehyde solution. Strips cut at 0 degree, 30 degrees, 60 degrees, and 90 degrees to the base-to-apex cardiac direction have been examined for cyclic stress-strain response, stress relaxation, plastic deformation, and fracture behavior. Under physiological stresses, tethered and pressure-fixed materials were both nearly isotropic. Tethering during fixation produced a material with extensibility nearly identical to that of fresh tissue. Plastic deformation during cyclic loading was reduced below that seen in simple fixation while stress relaxation was unchanged. Pressure-fixation produced reduced extensibility similar to that produced in porcine aortic valve leaflets. Plastic deformation and stress relaxation were both markedly reduced. Pressure-fixation reduced the strain at fracture, but fracture behavior was otherwise unaffected. Tethering and pressure-fixation offer attractive means to control the mechanical behavior of bovine xenograft materials. PMID- 2715162 TI - The bovine pericardial xenograft: III. Effect of uniaxial and sequential biaxial stress during fixation on the tensile viscoelastic properties of bovine pericardium. AB - Our previous two articles have shown that glutaraldehyde-fixed bovine pericardium is nearly isotropic, whether fixed without constraints, with tethering, or with pressure. In this study, we have used uniaxial stress during fixation to produce bovine pericardial material with marked tensile anisotropy. Rectangular and cruciate pericardial samples have been mechanically examined after one of four treatments: (i) fixation under 88-kPa uniaxial stress, (ii) fixation under 176 kPa uniaxial stress, (iii) 3 h of 176-kPa uniaxial stress in saline followed by 24-h fixation under the same stress, (iv) fixation under 176-kPa uniaxial stress followed by a second fixation under 176-kPa stress in a direction normal to the first. Strips of material were cut at 0 degree, 30 degrees, 60 degrees, and 90 degrees to direction of the initial stress, and tested for response to cyclic loading, stress relaxation, plastic deformation, and fracture properties. Fixation under uniaxial stress produced anistropy similar to that seen in porcine aortic valve leaflets; however, the overall extensibility of the material depended on the applied stress and the aspect ratio of the stressed sample. While loading in saline produced no change, the sequential biaxial stressing produced a reduction in anisotropy, suggesting exposure of additional crosslinking sites. Uniaxial stress during fixation may be a useful method for construction of anisotropic heart valve leaflets. PMID- 2715163 TI - Fracture behavior of urinary stones under compression. AB - The fracture behavior of two types of urinary stones, namely struvite and calcium oxalate, during compression testing was studied. Scanning electron microscopy (SEM) was used to characterize the fracture surfaces. Both types of stone showed pseudo-plastic behavior as indicated by their load-displacement curve. The onset of nonlinear behavior was found to correspond to development of microcracks in the specimens. The compressive strength was defined as the stress calculated at the maximum load. In struvite samples, the maximum load corresponded with the development of large cracks parallel to the compressive axis. For oxalate stones a separation of the outer layer (crust) from the inner layer (core) marked the point of maximum load. The compressive strength of the struvite samples was found to depend on the orientation of lamellae relative to the loading axis. Struvite stones, when loaded parallel to the lamination direction showed a higher compressive strength than oxalate stones did. The fracture behavior and compressive strength of a model material (z-brick) were also characterized and compared to those of the urinary stones. PMID- 2715164 TI - Raman spectroscopy for the study of porous composite alumina coating. AB - A new acetabular cup prosthesis made of alumina and bioactive glass was studied and evaluated using nondestructive and noninvasive Raman laser spectroscopy. The prosthesis consists of an alumina socket coated with a double layer of alumina beads bonded to the prosthesis with a layer of glass. Raman spectroscopy showed that both the socket and the beads are composed of alpha-Al2O3 (corundum), while the bioactive glass (alkaline and alkaline earth alumosilicate with a small quantity of zirconium oxide) showed this to have an intermediate structure between that of vitreous silica and that of the alkaline and alkaline earth disilicate glasses. The Raman spectra of the contact surfaces between the bioactive glass and the alumina of the assembled prosthesis and of an alumina disk coated with the same glass showed the presence of new bands which may be correlated with a chemical interaction between the components of the prosthesis. PMID- 2715165 TI - Esophageal cancer in Kashmir--an assessment. PMID- 2715166 TI - Induction of Epstein-Barr virus early antigens by tumor promoters of the diterpene ester type in Raji cells and specific (receptor) binding as compared to irritant and promoting activities. AB - Sixteen new diterpene esters (DTE) of the tigliane, ingenane, daphnane, and 1 alpha-alkyldaphnane types were investigated in two in vitro assays: as inhibitors of specific binding of 3H-labeled 12-O-tetradecanoylphorbol 13-acetate (TPA) to protein kinase C in a receptor preparation from mouse brain, and as inducers of Epstein-Barr virus (EBV) early antigens in Raji cells. Inhibition of binding of [3H]TPA to the receptor preparation by tigliane and ingenane DTE correlates with irritant activity in vivo, while some daphnane and 1 alpha-alkyldaphnane DTE inhibit binding of [3H]TPA in a less pronounced manner but still are very irritant. Tumor-promoting activity does not correlate consistently with the receptor-binding data. To test the hypothesis that early antigen induction in Raji cells by DTE is coupled to functional DTE receptors (protein kinase C), the latter were searched on these Raji cells by a 'cold acetone-filter assay' and shown to be present. The dependence of the early antigen induction rate on the concentration of the DTE tested was demonstrated. At a given concentration of DTE, differences in the induction rate between various DTE are seen. However, a clear quantitative correlation either between early antigen induction and receptor binding data in vitro, or early-antigen-inducing activity in vitro versus irritancy and tumor-promoting activity in vivo was not observed. PMID- 2715167 TI - Ester derivatives of the mammary-tumor-inhibiting antiestrogen 2,3-bis(2-fluoro-4 hydroxyphenyl)-2,3-dimethylbutane. AB - The synthesis of the bisacetate (8), the bisdichloroacetate (9), the biscarbamate (10) and the bisphosphate (11) of the "partial" antiestrogen 2,3-bis(2-fluoro-4 hydroxyphenyl)-2,3-dimethylbutane (7) is described. In the case of 8-10 the introduction of ester functions slightly reduces the estrogen receptor affinity of 7. However, it was strongly diminished in 11. Compared with 7 the estrogenic potency of 8-11 is moderately increased. Compounds 8-11 cause a strong inhibition of the hormone-dependent MXT M3.2 mouse mammary tumor. Only 9 containing cytotoxic dichloroacetate groups shows a significantly better antitumor effect than 7. PMID- 2715168 TI - Determination of the proliferative potential of human brain tumors using the monoclonal antibody Ki-67. AB - The proliferative activity of 133 human tumors of the nervous system was investigated by means of immunohistochemistry using the monoclonal antibody Ki-67 in order to evaluate the usefulness of this method for histopathological tumor grading. Ki-67 recognizes a proliferation-associated nuclear antigen present in human cells during all active phases of the cell cycle but absent in the G0 phase [Gerdes J, Schwab U, Lemke H, Stein H (1983) Int J Cancer 31:13-20]. In 28 WHO grade I and II gliomas of all major types Ki-67 indices were generally low with mean values ranging from less than 1% in pilocytic astrocytomas to 4.2% in grade II oligodendrogliomas. Individual cases of grade II astrocytomas and oligodendrogliomas had, however, values up to 8.5%. In 13 primary anaplastic gliomas of WHO grade III consistently higher statistical means were obtained with values ranging from 8.6% for anaplastic astrocytomas to 14.2% for anaplastic mixed gliomas. Interestingly, 18 WHO grade IV glioblastomas demonstrated a mean value of only 7%, which is probably due to the pronounced phenothypic heterogeneity in this tumor group. This heterogeneity results in enormous intra- and intertumor variability in Ki-67 indices (range less than 1%-22.1%). Investigation of 17 recurrent gliomas revealed mean values for Ki-67 ranging from 1.7% for three WHO grade II astrocytomas up to 48.5% obtained in two highly anaplastic recurrent astrocytomas corresponding to WHO grade IV. Other tumors of the nervous system evaluated included 9 medulloblastomas (mean 17.9%, range 5.0% 42.0%), 17 benign meningiomas (mean 1.1%, range 0%-5%), 15 metastatic carcinomas (mean 16.5%, range less than 1%-46.0%), and individual tumors of various types. Our results indicate that Ki-67 immunohistochemistry can add useful additional information for histopathological grading which, by supplementing and refining the traditional WHO grading system, might lead to a better assessment of the biological behaviour of human tumors of the nervous system. PMID- 2715169 TI - Adjuvant chemotherapy after resection of adenocarcinoma of the periampullary region and the head of the pancreas. A non-randomized pilot study. AB - From 1980 till 1984 16 patients were entered into a non-randomized pilot study, to investigate the feasibility of five courses of adjuvant 5-fluorouracil, Adriamycin and mitomycin C (FAM) after a curative resection of pancreatic or periampullary cancer. The survival of this group of patients was compared with that of 36 patients who underwent a curative resection alone between 1977 and 1984. Four patients received less than 20%, 4 patients 50%-60% and 7 patients greater than or equal to 80% of the calculated dose of adjuvant chemotherapy. The chemotherapy was badly tolerated. Only 1 patient resumed some of his normal activity during chemotherapy. The 3-year actuarial survival after curative resection with and without FAM was similar, i.e. 24% and 28% respectively. These data suggest that adjuvant FAM after a Whipple's operation or total pancreatectomy is not feasible because of additive postoperative and chemotherapy induced morbidity. PMID- 2715170 TI - Different effects of cyclophosphamide in vivo and phosphamide mustard in vitro on two cell clones of chemically induced mammary carcinoma of the rat. AB - Two cell clones of a methylnitrosourea-induced rat mammary carcinoma, a hyperdiploid (44 chromosomes, clone A) and a hypertetraploid clone (88 chromosomes, clone B) were cultured and transplanted subcutaneously into three groups of eight rats. Group 1 was treated with 62.6 mg cyclophosphamide/kg, group 2 with 41.8 mg/kg once weekly for 3 weeks. The volume of tumors derived from clone B cells was diminished by the administration of the agent, whereas clone A cell tumors did not respond. Incubation of cells of both clones with phosphamide mustard in vitro showed that cells of clone B are much more sensitive to the activated cyclophosphamide, especially after incubation in low concentrations of 40 microM and 20 microM, than those of clone A. It is concluded that the initial success of cyclophosphamide therapy on chemically induced tumors is due to the different sensitivities of the tumor cell populations. PMID- 2715171 TI - Scientific proceedings. Fifth symposium of the Section of Experimental Cancer Research (SEK) of the German Cancer Society. Heidelberg, 10-12 April, 1989. Abstracts. PMID- 2715172 TI - The intracellular transport of low density lipoprotein-derived cholesterol is defective in Niemann-Pick type C fibroblasts. AB - Niemann-Pick disease type C (NPC) is characterized by substantial intracellular accumulation of unesterified cholesterol. The accumulation of unesterified cholesterol in NPC fibroblasts cultured with low density lipoprotein (LDL) appears to result from the inability of LDL to stimulate cholesterol esterification in addition to impaired LDL-mediated downregulation of LDL receptor activity and cellular cholesterol synthesis. Although a defect in cholesterol transport in NPC cells has been inferred from previous studies, no experiments have been reported that measure the intracellular movement of LDL cholesterol specifically. We have used four approaches to assess intracellular cholesterol transport in normal and NPC cells and have determined the following: (a) mevinolin-inhibited NPC cells are defective in using LDL-cholesterol for growth. However, exogenously added mevalonate restores cell growth equally in normal and NPC cells; (b) the transport of LDL-derived [3H]cholesterol to the plasma membrane is slower in NPC cells, while the rate of appearance of [3H]acetate-derived, endogenously synthesized [3H]cholesterol at the plasma membrane is the same for normal and NPC cells; (c) in NPC cells, LDL-derived [3H]cholesterol accumulates in lysosomes to higher levels than normal, resulting in defective movement to other cell membranes; and (d) incubation of cells with LDL causes an increase in cholesterol content of NPC lysosomes that is threefold greater than that observed in normal lysosomes. Our results indicate that a cholesterol transport defect exists in NPC that is specific for LDL-derived cholesterol. PMID- 2715173 TI - Developmental regulation of cryptdin, a corticostatin/defensin precursor mRNA in mouse small intestinal crypt epithelium. AB - Cryptdin mRNA codes for the apparent precursor to a corticostatin/defensin related peptide that accumulates to high levels in mouse intestinal crypt epithelium during postnatal development. The primary structure, intestinal cell distribution, and developmental appearance of cryptdin mRNA have been determined. Cryptdin mRNA is 450-480 nucleotides long. Translation of the partial cryptdin cDNA sequence reveals a 70-amino acid open reading frame that includes 32 carboxy terminal residues that align with those in the consensus sequence, C.CR...C....ER..G.C....CCR, which is a common feature of leukocyte defensins and lung corticostatins (Selsted, M. E., D. M. Brown, R. J. DeLange, S. S. L. Harwig, and R. I. Lehrer. 1985. J. Biol. Chem. 260:4579-4584; Zhu, Q., J. Hu, S. Mulay, F. Esch, S. Shimasaki, and S. Solomon. 1988. Proc. Natl. Acad. Sci. USA. 85:592 596). In situ hybridization of cryptdin cDNA to paraformaldehyde-fixed, frozen sections of adult jejunum and ileum showed intense and specific labeling of epithelial cells in the base of all crypts. Analysis of sections from suckling mice showed that cryptdin mRNA is detectable in 10-20% of crypts in 10-d-old mice, in approximately 80% of crypts in 16-d-old mice, and in all crypts of mice 20 d and older. During the fourth week, the sequence accumulates in crypts to the maximal adult level. Cryptdin mRNA content in adult small intestine is independent both of T cell involvement and luminal bacteria. The role of cryptdin in small bowel physiology remains to be determined: cryptdin may inhibit bacterial translocation, modulate intestinal hormone synthesis, influence hormonal sensitivity of the intestinal epithelium, or exhibit a multiplicity of related activities. PMID- 2715174 TI - Flexural rigidity of marginal bands isolated from erythrocytes of the newt. AB - The marginal band is a bundle of microtubules residing at the periphery of nucleated erythrocytes of nonmammalian vertebrates and some invertebrates. Marginal bands from erythrocytes of the newt (Notopthalmus viridescens) were isolated from the cells as intact structures by treatment with detergent and either mild protease or high salt. Isolated bands were subjected to mechanical testing by stretching the band between a glass microhook and a calibrated glass fiber. The deflection of the fiber provided a measure of the force on the band. The flexural rigidity of the band was determined from measurements of the band deformation as a function of applied force. Bands isolated with either of two proteases (pepsin or elastase) or with high salt exhibited elastic behavior with a flexural rigidity of approximately 9.0 X 10(-12) dyn.cm2. Treatment of bands with chymopapain caused an increase in band rigidity and inelastic behavior. Estimates of the contribution of the band to cellular rigidity are made based on the measurements of the structural properties of the isolated band. The band provides the cell with a large resistance to indentations at the rim and to large extensions, while maintaining a high degree of flexibility in small extensions or flexure. PMID- 2715175 TI - Evidence for active interactions between microfilaments and microtubules in myxomycete flagellates. AB - We have previously observed the apparent displacement of microfilaments over microtubules in the backbone structure of permeabilized flagellates of Physarum polycephalum upon addition of ATP (Uyeda, T. Q. P., and M. Furuya. 1987. Protoplasma. 140:190-192). We now report that disrupting the microtubular cytoskeleton by treatment with 0.2 mM Ca2+ for 3-30 s inhibits the movement of the microfilaments induced by subsequent treatment with 1 mM Mg-ATP and 10 mM EGTA. Stabilization of microtubules by pretreatment with 50 microM taxol retarded both the disintegrative effect of Ca2+ on the microtubules and the inhibitory effect of Ca2+ on the subsequent, ATP-induced movement of the microfilaments. These results suggest that the movement of the microfilaments depends on the integrity of the microtubular cytoskeleton. EM observation showed that the backbone structure in control permeabilized flagellates consists of two arrays of microtubules closely aligned with bundles of microfilaments of uniform polarity. The microtubular arrays after ATP treatment were no longer associated with microfilaments, yet their alignment was not affected by the ATP treatment. These results imply that the ATP treatment induces reciprocal sliding between the microfilaments and the microtubules, rather than between the microfilaments themselves or between the microtubules themselves. While sliding was best stimulated by ATP, the movement was partially induced by GTP or ATP gamma S, but not by ADP or adenylyl-imidodiphosphate (AMP-PNP). AMP-PNP added in excess to ATP, 50 microM vanadate, or 2 mM erythro-9-[3-(2-hydroxynonyl)]adenine (EHNA) inhibited the sliding. Thus, the pharmacological characteristics of this motility were partly similar to, although not the same as, those of the known microtubule dependent motilities. PMID- 2715176 TI - Three-dimensional reconstruction of the Z disk of sectioned bee flight muscle. AB - The three-dimensional structure of the central region of the Z disk of honeybee flight muscle has been determined to a resolution of 70 A by three-dimensional reconstruction from electron micrographs of tilted thin sections. The reconstructions show a complex assembly in which actin filaments terminate and are cross-linked together; a number of structural domains of this network are resolved in quantitative three-dimensional detail. The central region of the Z disk contains two sets of overlapping actin filaments of opposite polarity, which originate in the sarcomeres adjacent to the Z disk, and connections between these filaments. The filaments are deflected by the attachment of cross-links; spacing between filaments change by greater than 100 A during their passage through the Z disk. Each actin filament is linked by connecting structures to four filaments of opposite polarity and two filaments are of the same polarity. Four types of connecting density domain are observed in association with pairs of filaments of opposite polarity: C1, C2, C3, and C5. Two of these, C3 and C5, are associated with the ends of actin filaments. Another connection, C4, is associated with three filaments of the same polarity; C4 is threefold symmetric. PMID- 2715177 TI - Arrangement of filaments and cross-links in the bee flight muscle Z disk by image analysis of oblique sections. AB - Information from oblique thin sections and from three-dimensional reconstructions of tilted, transverse thin sections (Cheng, N., and J. F. Deatherage. 1989. J. Cell Biol. 108:1761-1774) has been combined to determine the three-dimensional structure of the honeybee flight muscle Z disk at 70-A resolution. The overall symmetry and structure of the Z disk and its relationship to the rest of the myofibril have been determined by tracing filaments and connecting elements on electron images of oblique sections which have been enhanced by a local crystallographic averaging technique. In the three-dimensional structure, the connecting density between actin filaments can be described as five compact, crystallographically nonequivalent domains. Features C1 and C2 are located on the transverse twofold rotation axes in the central plane of the Z disk. They are associated with the sides of actin filaments of opposite polarity. Features C3, C4, and C5 are present in two symmetry-related sets which are located on opposite sides of the central plane. C3 and C5 are each associated with two filaments of opposite polarity, interacting with the side of one filament and the end of the other filament. C3 and C5 may be involved in stabilizing actin filament ends inside the Z disk. The location of the threefold symmetric connection C4, relative to the thick filament of the adjacent sarcomere, is determined and its possible relationship to the C filament is considered. PMID- 2715178 TI - Location of the head-tail junction of myosin. AB - The tails of double-headed myosin molecules consist of an alpha-helical/coiled coil structure composed of two identical polypeptides with a heptad repeat of hydrophobic amino acids that starts immediately after a conserved proline near position 847. Both muscle and nonmuscle myosins have this heptad repeat and it has been assumed that proline 847 is physically located at the head-tail junction. We present two lines of evidence that this assumption is incorrect. First, we localized the binding sites of several monoclonal antibodies on Acanthamoeba myosin-II both physically, by electron microscopy, and chemically, with a series of truncated myosin-II peptides produced in bacteria. These data indicate that the head-tail junction is located near residue 900. Second, we compared the lengths of two truncated recombinant myosin-II tails with native myosin-II. The distances from the NH2 termini to the tips of these short tails confirms the rise per residue (0.148 nm/residue) and establishes that the 86-nm tail of myosin-II must start near residue 900. We propose that the first 53 residues of heptad repeat of Acanthamoeba myosin-II and other myosins are located in the heads and the proteolytic separation of S-1 from rod occurs within the heads. PMID- 2715179 TI - Molecular genetic characterization of a developmentally regulated human perinatal myosin heavy chain. AB - We have isolated a human cDNA which corresponds to a developmentally regulated sarcomeric myosin heavy chain. RNA hybridization and DNA sequence analysis indicate that this cDNA, called SMHCP, encodes a perinatal myosin heavy chain isoform. The nucleotide and deduced amino acid sequences of the 3.4-kb cDNA insert show strong homology with other sarcomeric myosin heavy chains. The strongest homology is to a previously described 970-bp cDNA encoding a rat perinatal isoform (Periasamy, M., D. F. Wieczorek, and B. Nadal-Ginard. 1984. J. Biol. Chem. 259:13573-13578). The homology between the analogous human and rat perinatal myosin heavy chain cDNAs is maintained through the highly isoform specific final 20 carboxyl-terminal amino acids, as well as the 3' untranslated region. Ribonuclease protection studies show that the mRNA encoding this isoform is expressed at high levels in 21-wk fetal skeletal tissue and not in fetal cardiac muscle. In contrast to the rat perinatal isoform, which was not found to be expressed in adult hind-leg tissue, the gene encoding SMHCP continues to be expressed in adult human skeletal tissue, but at lower levels relative to fetal skeletal tissue. PMID- 2715180 TI - The expression of sarcomeric muscle-specific contractile protein genes in BC3H1 cells: BC3H1 cells resemble skeletal myoblasts that are defective for commitment to terminal differentiation. AB - The BC3H1 cell line has been used widely as a model for studying regulation of muscle-related proteins, such as the acetylcholine receptor, myokinase, creatine kinase, and actin. These cells, derived from a nitrosourea-induced mouse brain neoplasm, have some of the morphological characteristics of smooth muscle and have been shown to express the vascular smooth muscle isoform of alpha-actin. To provide further information about the contractile protein phenotype of BC3H1 and to gain additional insights into the possible tissue of origin of these cells, we have examined the expression of a battery of contractile protein genes. During rapid growth, subconfluent BC3H1 cells express the nonmuscle isoform of alpha tropomyosin (alpha-Tm) and the nonsarcomeric isoforms of myosin heavy and light chains (MHCs and MLCs, respectively), but do not express troponin T(TnT). However, when BC3H1 cells differentiate in response to incubation in serum deprived medium or upon approaching confluence, they express TnT as well as sarcomeric muscle isoforms of MHC, MLC 2 and 3, alpha-Tm, and alpha-actin. These results suggest that BC3H1 is a skeletal muscle cell line of ectodermal origin that is defective for commitment to terminal differentiation. PMID- 2715181 TI - Acetylcholine receptor alpha-subunit mRNA is increased by ascorbic acid in cloned L5 muscle cells: Northern blot analysis and in situ hybridization. AB - Ascorbic acid is the major factor in brain extract responsible for increasing the average acetylcholine receptor (AChR) site density on the cloned muscle cell line L5. In the present study, we show that this effect of ascorbic acid requires mRNA synthesis, and that the mRNA level for the AChR alpha-subunit is increased to about the same level as are the surface receptors. We have found no increase in the mRNA levels of the beta-, gamma-, and delta-subunits, or in the mRNAs of other muscle-specific proteins, such as that of light chain myosin 2, alpha actin, and creatine kinase. By in situ hybridization, we further show that the increase in alpha-mRNA in response to ascorbic acid is exclusively in myotubes and is located near clusters of nuclei. mRNA levels for the alpha-subunit in mononucleated cells are very low and do not significantly increase in response to ascorbic acid. The mononucleated cells are thus excluded as a possible source for the increase in alpha-subunit mRNA detected by Northern blot analysis. Our results indicate that there is a very specific action of ascorbic acid on the regulation of AChR alpha-mRNA in the L5 muscle cells, and that the expression of surface receptors in these cells is limited by the amount of AChR alpha-subunit mRNA. PMID- 2715182 TI - Neural cell adhesion molecule expression is regulated by Schwann cell-neuron interactions in culture. AB - To investigate the cellular and molecular signals underlying regulation of cell adhesion molecule expression, the influence of interactions between dorsal root ganglion neurons and Schwann cells on their expression of L1 and N-CAM was quantitated by immunogold electronmicroscopy. The numbers of antibody binding sites on cell surfaces of neurons and glia were compared between pure populations and co-cultures. After 3 d of co-culture, expression of L1 was reduced by 91% on Schwann cells and 36% on neurons, with expression in pure cultures being taken as 100%. N-CAM expression was unchanged on neurons and reduced by 43% on Schwann cells. Within 3 d after removal of neurons from Schwann cell-neuron co-cultures by immunocytolysis, expression of L1 and N-CAM on Schwann cell surfaces increased by 69 and 84%, respectively. Cell surface antigens recognized by an antibody to mouse liver membranes were unchanged in co-cultures. Furthermore, in co-cultures of neurons and sciatic nerve fibroblasts neither of the three antibodies detected any changes in expression of antigens when pure and co-cultures were compared. These observations suggest that adhesion molecules are not only involved in neuron-Schwann cell recognition and neurite outgrowth on Schwann cells (Seilheimer, B., and M. Schachner. 1988. J. Cell Biol. 107: 341-351), but that cell interactions, in turn, modulate the extent of adhesion molecule expression. PMID- 2715183 TI - The membrane glycoprotein Ia-IIa (VLA-2) complex mediates the Mg++-dependent adhesion of platelets to collagen. AB - We have purified the platelet membrane glycoprotein Ia-IIa complex by detergent solubilization and sequential affinity chromatography on Concanavalin A-Sepharose and collagen-Sepharose. The complex, which is identical to the VLA-2 complex of lymphocytes and other cells and contains subunits of 160 and 130 kD on SDS-PAGE, was labeled with 125I and incorporated into phosphatidyl choline liposomes. The liposomes, like intact platelets, adhered to collagenous substrates in an Mg++ dependent manner with a K'a(Mg++) of 3.5 mM. Little adhesion of the liposomes to collagen occurred when Mg++ was replaced by Ca++ or EDTA. Calcium ions inhibited the Mg++-dependent adhesion with a K'i(Ca++) of 5.5 mM. Liposomes containing the Ia-IIa complex adhered to substrates composed of types I, II, III, and IV collagen, but did not effectively adhere to substrates composed of type V collagen or gelatin. Adhesion to collagen was specific. The liposomes did not adhere to fibronectin, vitronectin, laminin, thrombospondin, fibrinogen, or von Willebrand factor substrates. The monoclonal antibody P1H5, which specifically immunoprecipitated the Ia-IIa complex, also specifically inhibited the Mg++ dependent adhesion of both platelets and Ia-IIa-containing liposomes to collagen substrates. These findings provide additional evidence that the platelet membrane Ia-IIa complex is the mediator of Mg++-dependent platelet adhesion to collagen and suggest that the VLA-2 complex may also function as an Mg++-dependent collagen receptor in other cells. PMID- 2715184 TI - RGD-dependent linkage between plant cell wall and plasma membrane: consequences for growth. AB - Soybean (Glycine max [L.] Merr. cv. Mandarin) root cells (SB-1 cell line) grown in suspension culture containing Glycyl-Arginyl-Glycyl-Aspartyl-Seryl-Proline (GRGDSP) (0.25 mg/ml), a synthetic peptide containing the RGD sequence found in many extracellular matrix adhesive proteins, demonstrated (a) significantly enhanced growth rate, and (b) aberrant cell wall/plasma membrane interactions and organization. Substitution of the Asp (D) by a Glu (E) amino acid in the hexapeptide, or inversion of the RGD sequence to GDR, abolished the morphological and growth effects observed for GRGDSP in plant cells. Immunoblots, which were prepared from beta-octylglucoside extracts of whole soybean cells and protoplasts, probed with polyclonal antibodies raised against human vitronectin receptor (hVNR) complex, demonstrated a single band with an apparent molecular mass of 70-72 kD. Chromatography of beta-octylglucoside extracts of SB-1 cells on a Gly-Arg-Gly-Asp-Ser-Pro-Lys-Sepharose affinity column demonstrated the retention of a single 70-72 kD polypeptide that reacted specifically with anti hVNR antiserum. In contradistinction, no cross-reactivity was observed with antifibronectin receptor antiserum. Epifluorescence microscopy of whole soybean cells, after moderate treatment with pectinase, demonstrated punctate fluorescent patches at the cell membrane/wall boundary when probed with anti-hVNR and rhodamine-derivatized secondary antibodies. We propose that coordination and control of plant cell division and proper cell wall biosynthesis may be mediated by an RGD-dependent recognition system in which RGD binding protein(s) promote cell membrane-cell wall attachment. PMID- 2715185 TI - Insulin receptor and altered glucose transport in a monensin-resistant mutant of Chinese hamster ovary cell. AB - A monensin-resistant mutant Monr-31, derived from Chinese hamster ovary (CHO) cell line, has been shown to have a reduced number of insulin receptors and a reduction in glucose uptake in response to insulin. We have further investigated the possibility that altered glucose uptake in Monr-31 cells is related to an alteration in the activity of the insulin receptor. Uptake of glucosamine, 2 deoxy-D-glucose, and 3-O-methyl-D-glucose in Monr-31 cells was one-half to one third that of CHO cells. The cellular content of the glucose transporter in Monr 31 was reduced to about one-third that of CHO as assayed by use of an antiglucose transporter antibody. After transfection with the human insulin receptor cDNA, we obtained clones CIR-0 from CHO, and MIR-2 and MIR-15 from Monr-31; CIR-0 expressed a tenfold higher level of the insulin-binding activity than did CHO, and MIR-2 and MIR-15 expressed a 20-fold higher level than did Monr-31. Glucose uptake in both CHO and CIR-0 was significantly enhanced by exogenous insulin, but not in Monr-31, MIR-2, and MIR-15. The beta-subunits of insulin receptor in CHO, CIR-0, Monr-31, and MIR-2 were similarly phosphorylated. The decreased glucose transport activity in Monr-31 cells is discussed in relation to the absence or presence of insulin receptor expression. PMID- 2715186 TI - Interaction of platelet-activating factor with endothelial and vascular smooth muscle cells in coculture. AB - Platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine [PAF]) is a vasoactive ether lipid produced by activated blood cells. To examine the molecular traffic and sites of metabolism of PAF released in the vascular wall, we used a coculture system in which endothelial cells are grown on micropore filters suspended over confluent cultures of vascular smooth muscle cells. The endothelial cells took up PAF 5-7 times more readily from the apical than from the basolateral surface, converting it to 1-O-alkyl-2-acyl-sn-glycero-3 phosphocholine (2-acyl-PAF) and other minor metabolites. Intact endothelial monolayers effectively shielded the underlying smooth muscle cells from PAF present in the apical fluid; after a 30-min incubation with [3H]-PAF, only 1% of the radioactivity was transferred to the interstitial fluid. By contrast, PAF readily entered the interstitial fluid when the endothelial monolayers were injured by exposure to xanthine and xanthine oxidase. PAF did not significantly increase the permeability of endothelial monolayers to albumin. Smooth muscle cells took up and metabolized interstitial PAF more quickly and more completely than did endothelial cells; 65% was converted to 2-acyl-PAF in 15 min by the smooth muscle cells. PAF enhanced the proliferative effect of PDGF on smooth muscle cells, as assessed by [3H]-thymidine incorporation. These findings suggest that endothelial cells form a barrier to PAF released at the luminal surface, but PAF released in the vascular intima interacts primarily with smooth muscle cells, possibly stimulating proliferation in these cells. PMID- 2715187 TI - Inhibition of DNA synthesis and cell division by a cell surface sialoglycopeptide. AB - We have isolated and purified a cell surface sialoglycopeptide (SGP) from bovine cerebral cortex cells that previously was shown to be a potent inhibitor of cellular protein synthesis. The following studies were carried out to characterize the potential ability of the SGP to inhibit DNA synthesis and to arrest cell division. Treatment of exponentially proliferating Swiss 3T3 cells with the SGP inhibitor resulted in a marked inhibition of thymidine incorporation within 24 h. When the SGP was removed from inhibited cultures, a sharp rise in 3H thymidine incorporation followed within 3-4 h that peaked well above that measured in exponentially growing cultures, suggesting that the inhibitory action of the SGP was reversible and that a significant proportion of the arrested cells was synchronized in the mitotic cycle. In addition to DNA synthesis, the inhibitory action of the SGP was monitored by direct measurement of cell number. Consistent with the thymidine incorporation data, the SGP completely inhibited 3T3 cell division 20 h after its addition to exponentially growing cultures. Upon reversal there was a delay of 15 h before cell division resumed, when the arrested cells quickly doubled. Most, if not all, of the growth-arrested cells appeared to have been synchronized by the SGP. The SGP inhibited DNA synthesis in a surprisingly wide variety of target cells, and the relative degree of their sensitivity to the inhibitor was remarkably similar. Cells sensitive to the SGP ranged from vertebrate to invertebrate cells, fibroblast and epitheliallike cells, primary cells and established cell cultures, as well as a wide range of transformed cell lines. PMID- 2715188 TI - Control of cell division in hepatoma cells by exogenous heparan sulfate proteoglycan. AB - The effects of cell surface heparan sulfate proteoglycan (HSPG) prepared from log and confluent monolayers of a rat hepatoma cell line on hepatoma cell growth were studied. When HSPG isolated from confluent cells was added exogenously to log phase cells, it was internalized and free heparan sulfate (HS) chains appeared transiently in the nucleus. Concurrently, the growth of the treated cells was inhibited, but the cells resumed logarithmic growth as the level of nuclear HS fell, and the cells grew to confluence and became contact inhibited. When HSPG prepared from log-phase hepatoma cells was added exogenously to log phase cells, it was internalized but very little of the internalized HS appeared in the nucleus, and there was no change in the rate of cell growth. However, when the rate of cell growth was reduced by culture of the cells in serum- and insulin deficient medium, HSPG prepared from log-phase cells stimulated the growth rate of these slow-growing cells. The cell cycle dependency of HSPG uptake and growth inhibition was studied in cultures synchronized by a thymidine/aphidicolin double block. When [35SO4]HSPG from confluent cells was added to synchronized cells just as they were released from the second block, a portion of the [35SO4]HSPG was internalized and [35SO4]HS appeared in the nucleus. However, at mitosis the [35SO4]HS disappeared almost completely from all of the cellular pools, and after mitosis, more of the [35SO4]HSPG was taken up and [35SO4]HS reappeared in the nucleus and remained in the nucleus until the cells divided again. When cultures were released from the aphidicolin block, both control and HSPG-treated cells progressed through the S, the G2, and the M phases of the cell cycle. However, the length of the G1 phase of the cycle was increased in the HSPG-treated cells. The treated cultures then progressed through the second S, G2, and M phases. Thus, the inhibition of cell division occurred in the G1 phase of the cell cycle, prior to the G1/S boundary. Addition of the HSPG to the synchronized cultures just after the first mitosis resulted in an immediate arrest of the cell cycle in G1.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2715189 TI - Effects of fluorescent derivatives of TPA on HL60 cells: dissociation between the differentiation-induced and protein kinase C activity. AB - The four fluorescent derivatives of TPA--dansylaza-TPA, NBDaza-TPA, and (N)- and (P)-dansylamino-TPA--were synthesized and examined for their ability to induce differentiation in human promyelocytic leukemic HL60 cells. At a concentration of 20 nM, all the derivatives inhibited proliferation and induced 60-80% of the cells to differentiate into macrophage-like cells. Removal of dansylaza-TPA from the medium after 5 h did not arrest adherence or the expression of nonspecific esterase activity. However, upon removal of any of the other three compounds after 5 h, HL60 cells became nonadherent and expressed low nonspecific esterase activity after additional culture. To investigate the relationship between protein kinase C (PKC) activation and cell maturation, PKC activity and translocation were measured after 0.5, 5, 24, and 48 h of treatment with each compound. Cells induced to differentiate by dansylaza-TPA or (N)- or (P) dansylamino-TPA exhibited enhanced PKC activity, 50-80% of which was located in the particulate fraction. In cells that differentiated with NBDaza-TPA, 65-70% of PKC activity remained in the cytosol. After removal of the TPA derivatives, all cells exhibited PKC activity in the cytosol. These results indicate that the fluorescent derivatives are as potent as TPA in inducing HL60 cell differentiation. However, in the case of NBDaza-TPA and (N)- or (P)-dansylamino TPA, their continuous presence in the culture medium was required for the recruitment of cells to differentiate. Consequently, it is suggested that activation and translocation of PKC are among the early biochemical events that trigger HL60 cell differentiation. Nevertheless, these two events alone are not sufficient to induce differentiation. PMID- 2715190 TI - Specific interactions of histone H1 and a 45 kilodalton nuclear protein with a putative matrix attachment site in the distal promoter region of a cell cycle regulated human histone gene. AB - Protein-DNA interactions within the promoter of a cell cycle-regulated human H4 histone gene were examined by binding of 5'-end-labeled DNA segments to Western blots of nuclear protein fractions. Specific protein interactions were observed with DNA segments located between -500 bp and -1,070 bp upstream of the ATG initiation codon and included a histone H1 binding segment flanked on both sides by binding sites for a 45 kD nuclear protein. This region of the gene contains a DNase I-sensitive site in the center (-720 to -820 bp), and sequence analysis revealed the presence of scaffold attachment sequences in the two flanking segments. Topoisomerase II consensus sequences and in vitro topoisomerase II cleavage sites were also detected in the two flanking segments. Our results suggest that the 45 kd nuclear protein may preferentially interact with these two segments of the H4 histone gene to mediate association with the nuclear matrix. The presence of negative regulatory elements in this putative matrix attachment region provides a basis for the speculation that such nuclear proteins are associated with alterations in gene-matrix interaction that are functionally related to gene expression. PMID- 2715191 TI - Control of DNA polymerase-alpha activity in regenerating rat liver by calcium and 1 alpha,25(OH)2D3. AB - The late G1 surge of DNA polymerase-alpha activity and the initiation of DNA replication in the hepatocytes of partial hepatectomy-induced regenerating liver were severely reduced when the mitogenic partial hepatectomy was carried out in the hypocalcemic and 1,25(OH)2D3 (1 alpha,25-dihydroxycholecalciferol)-deficient environment of parathyroidectomized (PTX) or thyroparathyroidectomized (TPTX) rats. These inhibitions were prevented in TPTX rats by a postpartial hepatectomy injection of 1,25(OH)2D3, which also restored blood calcium to normocalcemic levels. Inhibition of active DNA polymerase-alpha accumulation and initiation of DNA synthesis in TPTX rats were also completely prevented by prefeeding the rats a low phosphorus diet, which stopped the lowering of the blood levels of calcium and 1,25(OH)2D3 following parathyroid removal. These studies indicate that the rise of DNA polymerase-alpha activity and the initiation of DNA replication in regenerating liver are controlled by cellular processes that rely on normal blood levels of calcium and 1,25(OH)2D3. Because DNA polymerase-alpha is the third DNA replication enzyme (the others are ribonucleotide reductase and thymidylate synthase) that has been shown to depend on parathyroid hormone and/or the circulating levels of calcium and 1,25(OH)2D3 that it controls, the authors concluded that the processes dependent on calcium and 1,25(OH)2D3 are parts of a mechanism that coordinately activates the DNA-replicating enzymes. The possibility that cyclic adenosine monophosphate (cAMP)-dependent protein kinases are involved in this replication mechanism is considered. PMID- 2715192 TI - Superoxide dismutase induces differentiation of Friend erythroleukemia cells. AB - Friend erythroleukemia cells (FELC) served as a model system for cell differentiation because these cells can be triggered to differentiate by a variety of chemical agents. Treatment with the classical inducer of differentiation, hexamethylene bisacetamide (HMBA), stimulated superoxide dismutase (SOD) activity, which increased in parallel with HMBA-induced differentiation. Furthermore, FELC were shown to differentiate in response to the addition of liposomes containing SOD. Oxidative treatment with liposomes containing D-amino acid oxidase or xanthine oxidase, cumene peroxide, or potassium superoxide also induced differentiation, whereas antioxidants such as alpha-tocopherol, butylated hydroxytoluene, or beta-carotene did not induce differentiation. Also, HMBA induction of differentiation was suppressed by treatment with antioxidants. PMID- 2715193 TI - Cytochalasin D-mediated hyperinduction of the substrate-associated 52-kilodalton protein p52 in rat kidney fibroblasts. AB - Regulation of certain differentiated and housekeeping functions in cultured mammalian cells is significantly influenced by cell shape. The shape-modulating agent cytochalasin D (CD) was used, therefore, to elucidate potential cytoarchitectural influences affecting synthesis of a major 52 kDa secreted/substrate-associated protein (p52) of normal rat kidney (NRK) fibroblasts. Biosynthetic labeling experiments indicated that treatment of NRK cells with CD increased, by 10-18-fold, the medium content of an Mr 52,000 protein. Two-dimensional gel electrophoresis and peptide fragment mapping confirmed that the 52 kDa protein produced in abundance as a consequence of CD treatment was identical to p52 constitutively expressed by NRK cells. A lower mw protein (p50; Mr 50,000) was also resolved which, based on pl microheterogeneity, protease fragmentation profile, and sensitivity to tunicamycin, could be identified as a less-glycosylated form of p52. p50 and p52 were both detected in the matrix and medium compartments of NRK and NRK/CD cells. The matrix p52 content of CD-induced and uninduced cells, however, was significantly greater (by 200-500-fold) than the corresponding medium levels. This differential compartmentalization, the time course of p52 accumulation in the matrix of NRK/CD cells compared to its appearance in the medium, and the kinetics of p52 pulse chase from the matrix collectively indicated that the matrix is the initial site of p52 deposition. Low levels of CD (1 microM) produced extensive disruptions of cellular microfilaments but did not result in an overall cell shape change nor a hyperinduction of p52. Morphologic rounding (seen in 10-100 microM CD) coincided with augmented p52 production. Transition from a flat to a round phenotype in NRK cells, or at least the generation of sufficient microfilament fragmentation to compromise cell-substrate adhesivity, appears to be an essential aspect of CD mediated p52 hyperinduction. PMID- 2715194 TI - Serum stimulation of quiescent human fibroblasts induces the synthesis of tissue factor mRNA followed by the appearance of tissue factor antigen and procoagulant activity. AB - Expression of the gene for tissue factor, the cell-surface initiator of blood coagulation, was examined by stimulating growth-arrested human fibroblasts with serum and measuring changes in the cellular content of tissue factor mRNA, antigen, and activity. Maximum tissue factor mRNA levels were reached within 1 h following serum induction and slowly declined to basal levels from 24 to 48 h after stimulation. The appearance of the tissue factor mRNA was followed by an increase in tissue factor antigen and activity. The parallel rise in antigenically positive protein and procoagulant activity was first observed about 2 h after serum stimulation with a peak at 12 h followed by a slow decline during the next 36 h. The serum-induced synthesis of the tissue factor mRNA was independent of de novo protein synthesis as demonstrated by the increased tissue factor mRNA levels generated in the presence of cycloheximide. The results of this study suggest that the synthesis of tissue factor in human fibroblasts is regulated principally at the level of transcription. In one strain of fibroblasts the activity/antigen ratio, during the period of maximum synthesis, was indistinguishable from that of tissue factor which had been immunoaffinity purified from human brain and reconstituted into phospholipid vesicles. However, during serum starvation the activity/antigen ratio in these cells was significantly reduced. Western blot analysis revealed that in serum-starved cells there was an accumulation of truncated forms of the tissue factor antigen while in the serum-stimulated cells only the full-length antigen was observed. PMID- 2715195 TI - Binding of cytochalasin B to platelets. AB - The binding of cytochalasin B (CB) to human platelets and to isolated platelet cytosol and membranes has been analyzed with [3H]CB. High- and low affinity classes of saturable binding sites were associated with intact platelets. Binding at very low concentrations of CB (i.e., high-affinity binding) was partially prevented by 100 mM D-galactose or D-glucose and to a much lesser extent by L glucose. Binding to platelet cytosol also involved two classes of sites with affinities and capacities similar to those observed with the whole cells. None of this binding, however, was affected by 100 mM D-galactose. Saturable binding to platelet membranes occurred at sites with a uniform binding affinity. Approximately 52% of this binding was prevented by 1 M D-galactose and another 15% by cytochalasin E (CE). We hypothesize that binding in the cytosol is to monomeric (low-affinity) and polymerized (high-affinity) actin, whereas membrane binding (high-affinity only) occurs primarily at sites involved with galactose transport. PMID- 2715196 TI - Augmented nuclease activity during cellular senescence in vitro. AB - The molecular correlates of the limited proliferative potential of normal human diploid fibroblasts and extensive single-strand breaks in the genomic DNA of these cells were examined by transfection analyses in which DNA replication could be uncoupled from DNA damage and repair. Both supercoiled (fmI), and restriction endonuclease-cleaved, linear (fmIII) molecules of a well-defined bacterial plasmid DNA, pBR322, were transfected into, and subsequently recovered from, early and late passage fibroblasts. Southern blot analysis revealed that fmI DNA was converted by random nicks into fmII DNA slightly more rapidly in late passage cells compared with cells at early passage. Similarly, fmII and fmIII DNAs also sustained multiple random nicks and no appreciable net religation of free ends of fmIII DNA could be detected at either passage. In addition, the efficiency of in vitro ligation of fmIII DNA recovered from late passage cells was also reduced, compared with that from early passage cells, as determined by Southern blotting. These data suggest that in the absence of DNA replication, a putative nuclease activity may contribute to DNA damage observed in senescent cells, which, in turn, may be causally related to their limited replicative potential. PMID- 2715197 TI - Transforming growth factor-beta 1 enhances the suppression of human hematopoiesis by tumor necrosis factor-alpha or recombinant interferon-alpha. AB - The effects of transforming growth factor-beta 1 (TGF-beta 1) on human hematopoiesis were evaluated in combination with two other regulatory cytokines, namely, recombinant human tumor necrosis factor-alpha (TNF-alpha) and recombinant human interferon-alpha (rIFN-alpha). Combinations of TNF-alpha and TGF-beta 1 resulted in a synergistic suppression of colony formation by erythroid progenitor cells (BFU-E) and an additive suppression of granulocyte-macrophage (CFU-GM) and multipotential (CFU-GEMM) progenitor cells. In addition, TGF-beta 1 synergized with rIFN-alpha to suppress CFU-GM formation, while the combined suppressive effects of both cytokines on CFU-GEMM and BFU-E were additive. When TGF-beta 1 was tested with TNF-alpha or IFN-alpha on granulocyte/macrophage colony stimulating factor (GM-CSF)-stimulated bone marrow cells in a 5-day proliferation assay, the antiproliferative effects of TGF-beta 1 and TNF-alpha were additive, while those with TGF-beta 1 and rIFN-alpha were synergistic. A similar pattern was seen in the suppression of the myeloblastic cell line KG-1 where TGF-beta 1 in combination with TNF-alpha resulted in an additive suppression while inhibition by TGF-beta 1 and IFN-alpha was synergistic. These results demonstrate for the first time the cooperative effects between TGF-beta and TNF-alpha and IFN alpha in the suppression of hematopoietic cell growth, raising the possibility that TGF-beta might be used in concert with TNF-alpha or IFN-alpha in the treatment of various myeloproliferative disorders. PMID- 2715198 TI - Effects of platelet-derived growth factor and fibroblast growth factor on free intracellular calcium and mitogenesis. AB - Although increased free intracellular calcium (Cai) may be one of the main regulators of cell growth and differentiation, studies in cell populations have implied that not all growth factors produce Cai increases. In order to examine in more detail whether Cai increases were related to mitogenesis, we used digital image analysis of intracellular Fura-2 fluorescence to measure Cai in individual BALB/c 3T3 cells stimulated with either platelet-derived growth factor (PDGF) or fibroblast growth factor (FGF). We found that PDGF induced larger and more prolonged Cai increases than FGF did, but that both growth factors induced an initial rapid increase in Cai (less than 2 min) followed by a later sustained increase (greater than 20 min). Only the prolonged Cai increase required extracellular calcium. Following PDGF treatment (1-8 units/ml), the percentage of cells with a large peak Cai increase (greater than twofold) correlated with the percentage of cells made competent (subsequent growth in 1% platelet-poor plasma). In contrast, purified bovine basic FGF (200-800 pg/ml) and recombinant human acidic FGF (10-300 ng/ml) produced peak Cai increases that were not directly correlated with mitogenesis. In addition, concentrations of intracellular Quin 2 that inhibited Cai transients also inhibited PDGF stimulation but not FGF stimulation of mitogenesis. Thus, Cai increases are necessary for mitogenesis in BALB/c 3T3 cells stimulated by PDGF, but not that stimulated by FGF. PMID- 2715199 TI - Comparative study of nuclear and cytoplasmic glycogen isolated from mutant HD33 ascites cells. AB - Mutant cells of the HD33 subline of the Ehrlich-Lettre ascites tumor synthesize and store glycogen mainly intranuclearly, when growing in vivo, and exclusively in the cytoplasm, when permanently cultivated as a suspension cell strain. To investigate whether there exist differences between glycogen of nuclear and cytoplasmic origin, the ultrastructure and the biophysical and biochemical properties of glycogen from in vivo and in vitro grown HD33 ascites cells were compared. Pronounced heterogeneity and differences in glycogen particle ultrastructure were evident in situ and after isolation of the native, high molecular polysaccharide. Nuclear glycogen contains a fraction of heavier molecules (up to 2 X 10(9)) and larger particles (up to 340 nm) which could not be found in the cytoplasmic preparations, which contained only particles smaller than 140 nm. The subparticles of beta-type are similar in both nuclear and cytoplasmic glycogen. The absorption spectra and glucose analysis after degradation with phosphorylase and debranching enzyme indicate that nuclear glycogen has a higher degree of branching, associated with a decrease in the average chain length between the branching points, and shorter external polyglucosidic chains than cytoplasmic glycogen. This is the first report about the analysis and properties of isolated nuclear glycogen. PMID- 2715200 TI - Effects of electrical stimulation of the dorsal raphe nucleus on local cerebral blood flow in the rat. AB - We have studied the effects of electrical stimulation of the dorsal raphe nucleus on local cerebral blood flow (LCBF), as assessed by the quantitative [14C] iodoantipyrine autoradiographic technique. Stimulation of the dorsal raphe nucleus in the alpha-chloralose anesthetized rat caused a significant decrease in LCBF, ranging from -13 to -26% in 24 brain structures out of 33 investigated. The most pronounced decreases (-23 to -26%) were observed in the accumbens, amygdaloid, interpeduncular nuclei and in the median raphe nucleus, limbic system relays. The decreases also concerned cortical regions and the extrapyramidal system. These results indicate that activation of ascending serotonergic system produces a vasoconstriction and that the dorsal raphe nucleus has a widespread modulatory influence on the cerebral circulation. PMID- 2715201 TI - Effects of dopamine on pial arteriolar diameter and CSF prostanoid levels in piglets. AB - We examined effects of topically applied dopamine on pial arteriolar diameter and CSF prostanoid levels in newborn pigs. Vascular responses were determined using the closed cranial window technique and intravital microscopy, and prostanoids were determined by radioimmunoassay. Topical application of dopamine did not change arteriolar diameter at 10(-7)-10(-5) M, but constricted arterioles at 10( 4) (16%) and 10(-3) M (30%). Intravenous administration of indomethacin (5 mg/kg) did not alter this constriction. In addition, CSF prostanoid levels did not increase in response to application of dopamine except for a modest increase of prostaglandin E2 at 10(-3) M. We conclude that dopamine is a constrictor at high doses of piglet pial arterioles and that this response is not modified by endogenous prostanoids. PMID- 2715202 TI - Direct chemical measurement of the lambda of the lumped constant of the [14C]deoxyglucose method in rat brain: effects of arterial plasma glucose level on the distribution spaces of [14C]deoxyglucose and glucose and on lambda. AB - The lumped constant in the operational equation of the 2-[14C]deoxyglucose (DG) method contains the factor lambda that represents the ratio of the steady-state tissue distribution spaces for [14C]DG and glucose. The lumped constant has been shown to vary with arterial plasma glucose concentration. Predictions based mainly on theoretical grounds have suggested that disproportionate changes in the distribution spaces for [14C]DG and glucose and in the value of lambda are responsible for these variations in the lumped constant. The influence of arterial plasma glucose concentration on the distribution spaces for DG and glucose and on lambda were, therefore, determined in the present studies by direct chemical measurements. The brain was maintained in steady states of delivery and metabolism of DG and glucose by programmed intravenous infusions of both hexoses designed to produce and maintain constant arterial concentrations. Hexose concentrations were assayed in acid extracts of arterial plasma and freeze blown brain. Graded hyperglycemia up to 28 mM produced progressive decreases in the distribution spaces of both hexoses from their normoglycemic values (e.g., approximately -20% for glucose and -50% for DG at 28 mM). In contrast, graded hypoglycemia progressively reduced the distribution space for glucose and increased the space for [14C]DG. The values for lambda were comparatively stable in normoglycemic and hyperglycemic conditions but rose sharply (e.g., as much as 9-10-fold at 2 mM) in severe hypoglycemia. PMID- 2715203 TI - Deoxyglucose kinetics in a rat brain tumor. AB - Accurate quantitation of local glucose metabolic rates (LMRglc) of abnormal tissues such as brain tumors with the 2-deoxyglucose (DG) method requires knowledge of the tissue rate constants and lumped constant. The deoxyglucose rate constants were measured in an experimental intracerebral glioma in 24 awake rats with a dual tracer [(3H)-DG and (14C)-DG] method. Tissue time points were obtained at 2, 5, 10, 18, 30, 60, 90, and 180 min after injection by decapitation and liquid scintillation counting. Blood samples were obtained at 1 min intervals initially and at longer intervals later. The rate constants were estimated with parameter estimation. LMRglc was calculated from the rate constants, assuming a lumped constant of 0.5. K1 for normal cerebrum was found to be 0.258 ml/g/min, and k2-k4 were 0.406, 0.075, and 0.0103 min-1; LMRglc = 65.1 mumol/100 g/min. The corresponding values for the glioma were 0.108, 0.126, 0.040, and 0.0019 with LMRglc = 41.7. The considerably lower k4 in the glioma was reflected in persistent higher activity in the glioma at longer times. Thus, tissue activity alone cannot be used to assess relative glucose metabolic rates in abnormal tissues such as gliomas, particularly at late times after injection. PMID- 2715204 TI - The role of cerebral metabolism in determining the local cerebral blood flow effects of volatile anesthetics: evidence for persistent flow-metabolism coupling. AB - The effects of equipotent doses of halothane (1.05%) versus isoflurane (1.38%) anesthesia on CMRglc were determined autoradiographically using the 2 [14C]deoxyglucose technique in the rat. Eight anatomically standardized coronal sections were selected and digitized from the autoradiographs. Mean CMRglc was determined for hemispheric, neocortical, and subcortical regions at each anatomic level, and a neocortical/subcortical CMRglc ratio was calculated. In addition, the current CMRglc autoradiographs, as well as previous CBF autoradiographs obtained under identical experimental conditions were examined to characterize and compare flow/metabolism relationships for the two anesthetics. For this analysis, CBF was determined in 80 selected anatomic areas, and the values from each area were plotted against CMRglc values obtained from identical areas. In all major regions, mean CMRglc was greater with halothane than with isoflurane. The neocortical/subcortical ratio, reflecting the pattern of CMRglc distribution, was also greater during halothane anesthesia. This suggests that isoflurane has a disproportionate effect on neocortical metabolism resembling patterns previously seen for CBF. Analysis of CBF versus CMRglc plots for each anesthetic group showed two parallel lines with nearly identical slopes, but different Y intercepts. We conclude that the distribution of CMRglc observed during 1 MAC (minimum alveolar concentration) halothane and isoflurane anesthesia parallels the distribution of CBF. This finding supports the conclusion that flow metabolism coupling is intact during halothane and isoflurane anesthesia, and that drug induced changes in cerebral metabolism may play an important role in determining the CBF response to that drug. Furthermore, there is evidence that, at a given level of CMRglc, isoflurane may have greater vasodilating capabilities than halothane. PMID- 2715205 TI - Acute thrombotic infarction suppresses metabolic activation of ipsilateral somatosensory cortex: evidence for functional diaschisis. AB - To study the effects of focal infarction on the capacity for functional activation of an ipsilateral somatosensory system remote from the lesion, we produced a small thrombotic infarct in the left frontal pole of male Wistar rats by a photochemical method. Five days later, the awake, restrained rats received tactile stimulation of the large whiskers (vibrissae) of the right side of the face, while a double-label 14C-autoradiographic study of local CMRglc (lCMRglc) and local CBF (lCBF) was performed. Unlesioned and unstimulated animals served as controls. In rats without frontal infarct, vibrissae stimulation led to activation of lCMRglc in the three synaptic relay stations of the barrel-field pathway (ipsilateral trigeminal medullary nucleus, contralateral ventrobasal thalamus, and contralateral barrel-field cortex). The mean increment in lCMRglc was 42% in lamina IV of barrel-field cortex and 49% in ventrobasal thalamus. Normalized lCBF tended to increase in superficial cortical laminae. In unstimulated animals with frontal infarct, lCMRglc was reduced by 20-30% throughout the ipsilateral barrel-field cortex as well as other ipsilateral cortical regions, but not in ventrobasal thalamus or other subcortical areas. In animals with frontal infarct subjected to contralateral vibrissae stimulation, a remarkable suppression of activation was observed throughout the barrel-field cortex so that left-less-than-right hemispheral lCMRglc asymmetry persisted despite stimulation. The ventrobasal thalamus, similarly, failed to increment its lCMRglc with vibrissae stimulation, whereas activation of the trigeminal nucleus was not suppressed. Similar trends were observed in the normalized lCBF data. These observations, which establish that a small frontal infarct is capable of suppressing normal physiological activation in remote ipsilateral brain structures, may have important implications with respect to suppression and recovery of function in human ischemic stroke. PMID- 2715206 TI - Effects of moderate hypoxemia and unilateral carotid ligation on cerebral glucose metabolism and acid-base balance in the rat. AB - We used our recently developed method for the simultaneous measurement of the local CMRglc (LCMRglc) and composite tissue pH to evaluate the response to unilateral carotid ligation and moderate hypoxia [40.1 +/- 4.8 (SD) mm Hg]. The LCMRglc and tissue pH were measured simultaneously in brain slices using [14C]2 deoxy-D-glucose and [14C]5,5-dimethyl-2,4-oxazolidinedione. The ipsilateral LCMRglc was increased significantly in the caudate-putamen and medical thalamus and was surrounded by a much more extensive zone of acidosis, as shown by significant reductions in the tissue pH, which was affected in parietal cortex, caudate-putamen, lateral septal nucleus, medial geniculate, Ammon's horn, and nucleus reticularis of substantia nigra. In regions with an elevated LCMRglc and acidosis, anaerobic glycolysis combined with ATP hydrolysis are likely to co exist. In regions characterized by normal glucose metabolism and acidosis, we hypothesize that a direct effect of hypoxia on the sodium/hydrogen ion antiporter may lead to secondary acidosis. Disturbed acid-base balance during hypoxia may have an adverse effect on cerebral function and cause clinical symptoms. PMID- 2715207 TI - Pyruvate dehydrogenase activity in the rat cerebral cortex following cerebral ischemia. AB - The effect of cerebral ischemia on the activity of pyruvate dehydrogenase (PDH) enzyme complex (PDHC) was investigated in homogenates of frozen rat cerebral cortex following 15 min of bilateral common carotid occlusion ischemia and following 15 min, 60 min, and 6 h of recirculation after 15 min of ischemia. In frozen cortical tissue from the same animals, the levels of labile phosphate compounds, glucose, glycogen, lactate, and pyruvate was determined. In cortex from control animals, the rate of [1(-14)C]pyruvate decarboxylation was 9.6 +/- 0.5 nmol CO2/(min-mg protein) or 40% of the total PDHC activity. This fraction increased to 89% at the end of 15 min of ischemia. At 15 min of recirculation following 15 min of ischemia, the PDHC activity decreased to 50% of control levels and was depressed for up to 6 h post ischemia. This decrease in activity was not due to a decrease in total PDHC activity. Apart from a reduction in ATP levels, the acute changes in the levels of energy metabolites were essentially normalized at 6 h of recovery. Dichloroacetate (DCA), an inhibitor of PDH kinase, given to rats at 250 mg/kg i.p. four times over 2 h, significantly decreased blood glucose levels from 7.4 +/- 0.6 to 5.1 +/- 0.3 mmol/L and fully activated PDHC. In animals in which the plasma glucose level was maintained at control levels of 8.3 +/- 0.5 mumol/g by intravenous infusion of glucose, the active portion of PDHC increased to 95 +/- 4%. In contrast, the depressed PDHC activity at 15 min following ischemia was not affected by the DCA treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715208 TI - Relative cerebral ischemia in SHR due to hypotensive hemorrhage: cerebral function, blood flow and extracellular levels of lactate and purine catabolites. AB - Cerebral blood flow (CBF, by laser Doppler flowmetry) and extracellular cortical concentrations (by microdialysis) of adenosine, inosine, xanthine, hypoxanthine, and lactate were measured together with somatosensory evoked potentials (SEP) in chloralose-anaesthetized spontaneously hypertensive rats (SHR) during relative cerebral ischemia induced by hypotensive hemorrhage. Reduction of mean arterial blood pressure (MABP) to 40-50 mm Hg, which decreased SEP to about 50% of prebleeding control level, decreased CBF only to about 75% of control due to cerebrovascular "autoregulation." A secondary, marked rise in cerebrovascular resistance (CVR) occurred after about 15 min in parallel with a striking increase in heart rate (after initial bradycardia). This late rise in heart rate is probably elicited by relative ischemia in medullary centers. The increase in CVR might indicate increased sympathetic nerve activity to the circle of Willis and large cerebral arteries. Cortical lactate increased initially but started to decline after about 30 min, and after 2 h it was not significantly higher than control. Cortical adenosine, inosine, hypoxanthine, and xanthine increased slowly and were significantly elevated after 50 min of hemorrhage. After 80 min, adenosine and inosine had returned to initial levels, while hypoxanthine and xanthine were further elevated. Despite the apparent partial recovery of metabolic disturbances during late hemorrhage, and with a blood flow maintained at 75% of resting control, SEP did not improve. It is suggested that the depression of SEP is not primarily caused by circulatory-metabolic derangements, but instead by activation of specific inhibitory systems. PMID- 2715209 TI - Cerebral enzyme antioxidant system. Influence of aging and phosphatidylcholine. AB - To obtain a comprehensive profile of the age-related changes of the antioxidant enzyme system in discrete brain regions (cortex, caudate-putamen, substantia nigra, thalamus), the present study involved practically the total life span of male Wistar rats (from 5 to 35 months of age). The activities of both glucose-6 phosphate dehydrogenase and 6-phosphogluconate dehydrogenase increase from 5 to 25 months of life and remain relatively constant or decrease scantily thereafter. In thalamus, the activity of total superoxide dismutase (SOD) increases from 5 to 20 months of rat life and decreases thereafter. Conversely, in both substantia nigra and caudate-putamen, enzyme activity declines steadily with age, while in parietotemporal cortex enzyme activity deteriorates from the 25th month onward. In both caudate-putamen and parietotemporal cortex, the activity of glutathione peroxidase increases from 5 to 20 months of life and remains relatively constant thereafter, while in substantia nigra the enzyme activity is practically unmodified during the life span. Furthermore, the activity of glutathione reductase in parietotemporal cortex declines from the 20th month onward, while in caudate-putamen and thalamus, enzyme activity deteriorates after an increase from 5 to 20 months of life. The interference of phosphatidylcholine and/or its metabolite(s) with the cerebral enzyme antioxidant system shows a characteristic specificity as regards both the time of onset and the enzyme activities involved, namely, SOD and glutathione reductase. The interference with SOD is related to the cytosolic form of the enzyme and affects the cortex only of 5-month-old animals and also extends to the thalamus of 15-month-old rats and all regions in 25-month-old ones.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715210 TI - Regional cerebral blood flow and anxiety: a correlation study in neurologically normal patients. AB - Regional CBF (rCBF) was evaluated by the 133Xe inhalation method in 60 neurologically normal patients (30 men and 30 women) and hemispheric and regional values were correlated with anxiety measurements collected by a self-rating questionnaire before and after the examination. Statistically significant negative correlations between rCBF and anxiety measures were found. rCBF reduction for high anxiety levels is in line with results previously reported by others and could be related to lower performance levels for moderately high anxiety scores as those reported in the present population. This could perhaps be explained by rearrangement of flow from cortical zones to deeper areas of the brain, classically known to be implicated in the control of emotions. However, these results should be interpreted cautiously, since they were obtained in patients and not in normal subjects. PMID- 2715211 TI - Neuronal pH regulation: constant normal intracellular pH is maintained in brain during low extracellular pH induced by acetazolamide--31P NMR study. AB - The intracellular pH in the brain was studied in six healthy volunteers before and immediately after the administration of 2 g of acetazolamide. Phosphorus-31 nuclear magnetic resonance spectroscopy by a 1.5 tesla whole-body scanner was used. The chemical shift between the inorganic phosphate and the phosphocreatine resonance frequencies was used for indirect assessment of the intracellular pH. The mean baseline intracellular pH was 7.05 +/- 0.04 (SD). The mean pH changes obtained at 15-min intervals within the first hour of acetazolamide administration were -0.03 +/- 0.04 (SD), -0.02 +/- 0.03 (SD), and 0.00 +/- 0.04 (SD), i.e., no statistically significant pH decrease was observed during the period where extracellular pH is known to drop markedly. Although several factors contribute to the lack of change of the intraneuronal pH, we will discuss that this observation in addition might suggest a direct intracerebral effect of acetazolamide. PMID- 2715212 TI - Cerebral blood flow before and after cardioversion of atrial fibrillation. AB - In nine patients with atrial fibrillation (AF) of less than 3 months' duration, CBF was measured the day before and after and again 30 days after electrical cardioversion therapy to sinus rhythm. The day before cardioversion therapy, median CBF (expressed as initial slope index 1, ml/100 g.min-1) was 35.8 and the day after it was 37.1. After 30 days in sinus rhythm, CBF was 39.4 (NS), although the end-tidal PCO2 values were lower than the pretreatment values. After correction for changes in end-tidal PCO2, the median CBF had increased significantly from 35.8 to 40.3 on day 1 and to 46.7 on day 30. The reduced CBF during AF could be a contributing factor in the development of cerebrovascular complications in patients with AF. PMID- 2715213 TI - Brain autoradiographic images from rats injected with both [18F] fluorodeoxyglucose (FDG) and [14C]-glucose. PMID- 2715214 TI - Home care: the new frontier. PMID- 2715215 TI - Home care nursing practice: the new frontier. AB - Home care is an integral part of the health care delivery system. Although home care has been discussed as a less costly alternative to hospital care, it is quite reasonable to consider the home the primary site for the delivery of health care, with the institution the alternative site. Thus, home care nursing, as the new frontier of health care, does and will continue to involve an array of nursing responsibilities from high-technology skills to case management of the chronically ill patient's multiple needs. There are specific areas that need to be addressed in home care, three of which were included in this discussion. These include the changing practice of the home care nurse, the lack of preventive and supportive services, and home care financing. Home care nursing has changed since the first sick poor people were visited in their homes by nurses in 1877. It would behoove nurses to try creative ways to reconstruct Wald's model of home care in today's home care system. Nurses in home care must be actively involved in practice (including care of the sick, chronically ill, and those at risk for potential health problems), continuing education, research, and political action. Home care nursing is more than caring for an individual or family at home; it is being aware of and involved in changing the home care climate for a holistic nursing practice. PMID- 2715216 TI - A concept of nursing discharge. AB - The timing is opportune for this expansion of hospital nurses' practice into the home. First, more home health agencies are aligning themselves with hospitals, making cooperative arrangements easier. Second, in response to the nursing shortage crisis, institutions are developing share governance models that offer nurses more autonomy and control over their schedules, affording them the opportunities to accommodate home visits into their day. If these visits are reimbursable through a third party payer, the nurse and the home health agency could receive payment if the hospital nurse either had a direct contract with the agency or belonged to a temporary staffing agency (registry) from which the home health agency could request services. If, however, the hospital nurse is unable to follow the patient into the home, that nurse could make a referral to a home health agency. For example, the hospital nurse would communicate the patient's treatment plan to the home health agency, request any necessary ancillary services (e.g., physical therapy or home health aides), and provide any education and training necessary for the community health nurse to provide hands-on care to patients with complex or high-technology needs. The home health agency could also employ special high-technology nurses for these types of cases. The use of this alternative, however, reduces the continuity of care aspect of the nursing discharge concept. The concept of nursing discharge solves several problems. It facilitates continuity of care and provides a definition for home health care that identifies the need both to service acutely ill patients and facilitate basic community health concepts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715217 TI - Maternal-child preventive health home visiting. PMID- 2715218 TI - Home care and the older adult: illness care versus wellness care. AB - If older citizens are to maximize their potential for optimal functioning and independence, there will surely be a greater need for holistic nursing care. How can nurses fulfill this need in view of existing barriers? What can they do to ensure that home- and community-based holistic nursing care will be available to elderly citizens for whom the quality of life is at risk? Although there are no easy answers, there are several strategies that nurses might find useful in this current predicament. These strategies fall into four categories: Documentation. When restrictions are imposed, nurses must be prepared to challenge fiscal intermediaries. To do this, they must have strong documentation of the rationale for service. Every effort must be made to document those services that are reasonable and necessary for the treatment of a client's illness or injury. Client advocacy. Because of the restrictions on service that are imposed by the principal sources of public funding, nurses must seek wide support from other community sources. Gaining such support requires a knowledge of community structure, the display of activism and leadership, and a willingness to engage in the political process. Lobbying. As an extension of client advocacy, nurses must create an effective lobbying force to educate public policy makers and legislators. Nurses must persuade elected representatives that there is a need to develop a broader interpretation of what constitutes a "skilled nursing service." Research. Nursing research, sweeping but creative, must become part of every professional nurse's responsibility. Ways to measure the outcomes of holistic nursing must be found.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715219 TI - AIDS caregiving crisis: a proactive approach. AB - Within the next few years, it is very likely that AIDS will personally affect almost everyone in the United States in some manner. A relative, neighbor, friend, acquaintance, or coworker may develop AIDS. It is estimated that 1 to 1.5 million people in the United States are presently infected with the human immunodeficiency virus and may develop AIDS. AIDS is, indeed, a major public health problem. With the high cost of hospital care, home care is an effective health care alternative for people with AIDS. Obviously, people feel more comfortable in their own homes. Professional home care services are available for many people with AIDS but cannot always meet their needs 24 hours a day. The Home Nursing Course for Caregivers of Persons With AIDS is an example of an effective way to begin to deal with the present and future caregiving crisis. Nurses serve as both teachers and role models while presenting the course. This type of course presents a challenge for nurses to use their knowledge, experiences, and creativity to continue to address AIDS and other health care crises in similar ways. PMID- 2715220 TI - Compliance redefined and implications for home care. AB - In home care, clients' behaviors are of primary concern. Behavioral change toward health maintenance and health promotion is influenced by the role of the nurse and the client in the process of change. The proposed definition of compliance is consistent with the philosophy of nursing and, in particular, with that of home care. The theoretical definitions reviewed were inconsistent in defining the health care provider's and the client's roles in compliance. The proposed definition of compliance clarified these roles. The operational definitions, although suggesting client behavior, do not explicate client participation in the therapeutic regimen. The definitions imply that clients could be labeled noncompliant if they did not follow exact protocols or were uncooperative with treatment. The validity of operational definitions and measurement techniques has been questioned. Perhaps if the instruments measured factors affecting health related behavior from the client's perspective, nurses could target interventions more effectively. Several implications of the proposed definition for home care nursing were described to clarify the need for comprehensive assessment and intervention targeted at the cause of client compliance issues. Analysis of the definitions of compliance assists home care nurses to clarify the meaning of compliance in their practice. The time has come to end the ongoing debate about the words used, recognize the richness of the compliance literature, and come to a consensus on the meaning of this concept. PMID- 2715221 TI - Hospice: a design for home care for the terminally ill. AB - Hospice may appropriately be understood as a model of holistic care. As a model of holistic care, hospice provides numerous insights suitable for adoption in other health care settings. In addition, hospice provides a preeminent opportunity for nurses to practice within a nursing model; at the present time, nursing goals may be pursued more freely within hospice than in any other setting. PMID- 2715222 TI - Baccalaureate nursing education: the framework for holistic home health nursing practice. AB - The concept of home care has been an intricate domain of professional nursing practice for over 100 years. Home health care as the new frontier in health care delivery, although not new to professional nursing, is an exciting challenge for professional nursing practice. The health care delivery system in the United States has, for the first time, been confronted with the issue of cost containment. Professional nursing has the opportunity to demonstrate to society not only the cost effectiveness of professional nursing services but also the comprehensive scope of professional nursing practice. To meet this challenge, home health nursing care must be delivered by practitioners who are highly skilled and qualified for their positions. Baccalaureate nursing education incorporates public and community health nursing content into the curriculum. Therefore, the baccalaureate degree in nursing should be a prerequisite for practitioners in home, public, and community health settings. PMID- 2715223 TI - [Hemihepatectomy]. AB - Controlled right hemi-hepatectomy is a major operation reserved for primary or secondary malignant tumours, a few very large benign tumour and, more rarely, rupture of the right lobe of the liver. The surgical technique of hemi hepatectomy respects several general rules concerning positioning of the patient, the surgical incision, haemostasis of the various pedicles, biliary stasis and drainage. Six technical variants are discussed together with their advantages and disadvantages and respective indications according to the size, nature and situation of the lesion in relation to the glissonian and hepato-caval pedicles. On the basis of this very detailed basic technique, tactical modalities according to the features of the lesion are proposed: extra or intra-hepatic control of the pedicles, initial or terminal opening of the median fissure, initial or terminal mobilisation of the right hemi-liver, total vascular exclusion. Controlled left hemi-hepatectomy is a less complicated technique which can be performed according to tactical variant identical to those described for right hemi-hepatectomy, but total vascular exclusion is rarely essential. PMID- 2715224 TI - [Vaginal hysterectomy of the non-prolapsed uterus. Rehabilitating a technic]. AB - The main steps to be carried out in the operation of vaginal hysterectomy when the uterus is not prolapsed are overall the same as when vaginal hysterectomy is carried out for prolapse: separation of the bladder from the uterus, opening of the Pouch of Douglas, dividing the utero-sacral ligaments, opening the vesico uterine pouch, dividing the cardinal ligaments, delivering the fundus of the uterus, freeing the uterine cornua and reperitonealisation. All the same, for each step there are numerous different details to be carried out. Careful attention to all these modifications make it easier to remove a non mobile uterus or one that is markedly enlarged. When the definite advantages of this technique, which is unfortunately insufficiently practised in France, are understood it is the operation of choice rather than the abdominal approach whenever a vaginal approach is possible, which it is in the large majority of cases. PMID- 2715225 TI - [Apropos of a rare localization of Buschke Lowenstein tumor]. PMID- 2715227 TI - [Free total skin graft in loss of cutaneous substance of the hand. Apropos of 60 cases]. AB - We report 60 cases of free total skin graft--taken from the corresponding forearm -in loss of cutaneous substances of the hand, following hand injury seen in the emergency room, or after removal of a massive skin tumor. The results were interesting. PMID- 2715226 TI - [Angiomyolipoma of the kidney. Apropos of a case]. PMID- 2715228 TI - [Intestinal intussusception in adults. Apropos of 8 cases]. AB - Traditionally considered the revealing sign of an organic lesion in adults, intestinal intussusception has been reported to be generally idiopathic in African series. The authors analyze 8 cases in adults, of which 6 were idiopathic. Intestinal resection was required in 7 of 8 cases. Mortality was 25%, and linked to intestinal necrosis. PMID- 2715229 TI - [Prognostic factors of surgically-treated cancers of the right colon. Multifactorial analysis of a series of 50 curative excisions]. AB - Between 1970 and 1986, 502 colorectal cancers were operated in our department. In 82 cases, it was located on the right, including 50 patients who underwent curative right hemicolectomy. Overall, at 5 years, 23 patients are alive with no recurrence (46%), 17 died from their cancer (34%) and 10 patients died of intercurrent causes (20%). Among the 13 prognostic factors analyzed, only the pathologic stage of the tumor (extend of dissemination to the abdominal wall and lymph nodes) and preoperative fever had a statistically significant effect on 5 year survival (p = 0.001 for fever and p = 0.01 for Duke's stage). The multifactor analysis clearly delineates a group with a poor prognosis (group with lymph node involvement and fever) in which the median of survival was 30 months. PMID- 2715230 TI - [Cystic dilatation of the common bile duct initially treated by cystojejunostomy and reoperation 25 years later because of infectious and lithiasic complications]. AB - A case of cystic dilatation of the common bile duct is reported. Initially treated by Roux-Y cystojejunostomy, twenty five years after, the patient presented a cholecystitis. This patient was treated by cholecystectomy and a few months after by excision of the cyst with Roux-Y hepato-jejunostomy. This attitude is proposed to avoid the complications of the cystic dilatation of the common bile duct: secondary biliary cirrhosis, angiocholitis, and malignant degeneration. PMID- 2715231 TI - Selective, stability-indicating assay of the major ipecacuanha alkaloids, emetine and cephaeline, in pharmaceutical preparations by high-performance liquid chromatography using spectrofluorimetric detection. AB - A selective high-performance liquid chromatographic procedure has been developed for the determination of the major Ipecacuanha alkaloids, emetine and cephaeline, in a number of linctus and pastille preparations. The reversed-phase chromatographic procedure uses an octadecyl-bonded column with a mobile phase of aqueous methanol containing an ion-pairing reagent. A spectrofluorimetric detector is used for increased sensitivity and selectivity. Sample preparation is simple, involving either straight dilution for linctus formulations or simple dissolutions for pastilles. The procedure has been shown to be stability indicating. Validation studies, to show that the method is precise, accurate and rectilinear, have been carried out on four linctus formulations and two pastille formulations. The method has been used to determine both emetine and cephaeline at levels as low as 5 micrograms/g in formulations. PMID- 2715232 TI - [Maillard reaction of bovine serum albumin with glucose. Determination of 2 formyl-5-(hydroxymethyl)pyrrole-1-norleucine by high-performance liquid chromatography after alkaline hydrolysis]. AB - Reactions between glucose and bovine serum albumin proceed predominantly at the side chain amino groups of lysine residues. Among other products, protein-bound 2 formyl-5-(hydroxymethyl)pyrrole-1-norleucine is formed. After alkaline hydrolysis and fractionation of the protein hydrolysate on RP-18 material this substance can be separated by high-performance liquid chromatography. The identity of the norleucine derivative with a synthesized compound can be determined with fast atom bombardment-mass spectrometry spectral data. A colour reaction with thiobarbituric acid is also suitable for detection. PMID- 2715233 TI - Determination of selenium in drugs by oxygen flask combustion and ion chromatography. AB - A method is described for the determination of trace selenium (impurities in medicinal organic compounds) by ion chromatography (IC) after oxygen flask combustion. All selenium compounds formed by oxygen flask combustion are converted to selenate ion by heating with nitric acid and potassium permanganate. The selenate ion is then determined by IC, using a simple recycle system to eliminate interfering ions. The detection limit of selenium is 0.4 nmol in 50 mg of sample. The recoveries of selenium added to seven drugs are ca. 95-103% with relative standard deviations of 1-6%. PMID- 2715234 TI - A post-column immobilized leucine dehydrogenase reactor for determination of branched chain amino acids by high-performance liquid chromatography with fluorescence detection. PMID- 2715235 TI - A post-column co-immobilized galactose oxidase/peroxidase reactor for fluorometric detection of saccharides in a liquid chromatographic system. PMID- 2715236 TI - Analysis of benzalkonium chlorides by gas chromatography. PMID- 2715237 TI - Determination of volatile amines in air by on-line solid-phase derivatization and high-performance liquid chromatography with ultraviolet and fluorescence detection. PMID- 2715238 TI - Separation and assay of N-nitroso compounds by high-performance liquid chromatography with chemiluminescence detection. PMID- 2715239 TI - Analysis of B6 vitamers in foods using a modified high-performance liquid chromatographic method. PMID- 2715240 TI - Determination of residual dimethyl sulphate in a lipophilic bulk drug by wide bore capillary gas chromatography. PMID- 2715241 TI - Determination of the ophthalmic drug guaiazulene by high-performance liquid chromatography. PMID- 2715242 TI - Spectrometric and thin-layer chromatographic quantification of sulfathiazole residues in honey. PMID- 2715243 TI - Thermospray high-performance liquid chromatographic-mass spectrometric characterization of biological macromolecules. I. Analysis of acid hydrolysate of peptides. AB - A method for the routine analysis of phenylthiocarbamyl (PTC) amino acids by thermospray high-performance liquid chromatography-mass spectrometry (TSP LC-MS) is described. Data were acquired on a small dedicated TSP LC-MS system in which the temperature of the vaporizer and ion source block were optimized. PTC-amino acids exhibited unique TSP mass spectra containing sufficient fragment ions to determine structural data. Therefore, using this method the amino acids contained in the acid hydrolysates of unique and modified peptides were able to be positively identified. Additionally, the amino acid composition of peptides as determined by TSP LC-MS in the selected ion monitoring mode corresponded well with the theoretical value. The detection limits for the PTC-amino acids were at the low picomole level. PMID- 2715244 TI - Separation of basic drugs by high-performance liquid chromatography on a silica column using a methanol-ethylenediamine buffer. AB - The application of methanol-aqueous ethylenediamine-ammonium nitrate eluents has been investigated for the high-performance liquid chromatographic separation of basic drugs on silica stationary phases. These eluents were shown to be more reproducible than previously studied systems based on methanol-aqueous ammonia ammonium nitrate eluents. The effects of different eluent pH and buffer concentrations have been examined. PMID- 2715245 TI - Use of cyclodextrins in isotachophoresis. VII. Resolution of structurally related and chiral phenothiazines. AB - Commercially available phenothiazine derivatives were used for the study of cyclodextrin complex formation by cationic isotachophoresis with alpha-, beta- and gamma-cyclodextrin and methylated analogues of beta-cyclodextrin as leading electrolyte additives. The relationships between the type of solute substituent in the 10- and/or 2-position and the stability of the created cyclodextrin complex were studied and the results were utilized for the optimization of isotachophoretic conditions suitable for the resolution of the studied phenothiazine derivatives. Successful resolution of three racemic solutes was achieved. PMID- 2715246 TI - Determination of residues of carazolol and a number of tranquilizers in swine kidney by high-performance liquid chromatography with ultraviolet and fluorescence detection. AB - A rapid and sensitive method has been set up for the determination of the beta receptor blocker carazolol and the tranquillizers acepromazine, azaperone, chlorpromazine, haloperidol, propionylpromazine and xylazine in swine kidneys. The procedure involves extraction with acetonitrile, rapid sample clean-up with a Sep-Pak C18 cartridge and high-performance liquid chromatography with ultraviolet and fluorescence detection. The mean recoveries range from 93 to 101%, with the exception of xylazine (52%), and the coefficients of variation from 5.3 to 18.9% at a fortification level of 20 micrograms/kg. The limits of determination range from 0.3 micrograms/kg for carazolol to 1-10 micrograms/kg for the other drugs. The method has been tested in routine monitoring programmes. PMID- 2715247 TI - Limitations of 2-diphenylacetyl-1,3-indandione-1-hydrazone as a precolumn fluorescence derivatization reagent. PMID- 2715248 TI - Separation of natural product sweetening agents using overpressured layer chromatography. PMID- 2715249 TI - Development and optimisation of a high-performance liquid chromatographic assay for tioconazole and its potential impurities. I. Selection of separation conditions. AB - Statistical mixture design techniques have been utilized to develop an isocratic high-performance liquid chromatographic separation of 1-(2- [(2-chloro-3-thienyl) methoxy]-2-(2,4-dichlorophenyl)ethyl)- 1H-imidazole (tioconazole) and its potential impurities. By using suitable quality criteria such as reduced plate height, peak asymmetry and selectivity for the interrogation of chromatograms the variables producing best column efficiency and greatest selectivity have been identified. The optimum separation for these variables has been located by the sequential simplex approach and confirmed by response surface mapping. PMID- 2715250 TI - Use of the surfactant 3-(3-cholamidopropyl)-dimethyl-ammoniopropane sulfonate in hydrophobic interaction chromatography of proteins. AB - Isocratic hydrophobic interaction chromatography of five proteins has been carried out using mobile phases containing the surfactant 3-(3-cholamidopropyl) dimethylammoniopropane sulfonate (CHAPS). Linear relationships were found between log k' and ammonium sulfate concentrations for all the proteins with CHAPS in the submicellar concentration range. The slope of such a plot decreases monotonically as CHAPS concentration is increased. To a first approximation, the effect of CHAPS on protein retention can be explained in terms of a competitive binding model. However, CHAPS does show differential effects on the elution of proteins, substantially altering selectivity. The use of a normalized capacity factor, k'/k'o, proves useful for comparing retention times of different proteins as a function of CHAPS concentration. The magnitudes of k'/k'o were found to be inversely correlated with the slopes of plots of log k' vs. ammonium sulfate concentration in the absence of CHAPS. Adsorption isotherms for CHAPS were determined over the working range of ammonium sulfate. The binding of CHAPS to the SynChropak Propyl stationary phase and its effects on retention were found to be readily reversible. For each protein, plots of k'/k'o vs. surface concentration of CHAPS were superposable for data obtained at different salt concentrations. These findings support a competitive binding model. A simple geometric argument for stationary phase occupancy provides a qualitative explanation for the observed surfactant selectivity. PMID- 2715251 TI - Effect of the structure and density of chemically bonded C18 phase on the recovery of tryptophan and its metabolites from human urine. AB - A series of materials with chemically bonded C18 phase for use as the packings in clean-up columns for solid-phase extraction were prepared. The effects of the monomeric and/or polymeric structure of the chemically bonded phase and of the porous structure of the silica gel support on the recovery of tryptophan and two of its metabolites used as test substances were considered. It appeared that the best recoveries of at least 60% of the three test substances were obtained on material of the "monomer" type containing chemically bonded C18 phase characterized by a high coverage density of alpha RP approximately 3.8 mumol/m2. The use of a silica gel support with a larger pore size and volume permits not only the effective isolation of individual substances, e.g., from urine, but also their 5-fold concentration. PMID- 2715252 TI - Microbore liquid chromatography and refractive index gradient detection of low nanogram and low-ppm quantities of carbohydrates. AB - A refractive index gradient detector is presented as a universal detector in the microbore high-performance liquid chromatography analysis of carbohydrates. Simultaneously, low-ng and low-ppm injected quantities of carbohydrates were detected at the 3 x root-mean-square baseline noise level. A typical microbore high-performance liquid chromatography chromatogram separating fructose from sucrose followed by refractive index gradient (RIG) detection is reported. Use of a position sensitive detector (PSD) in the RIG detector design is reported and experimental considerations discussed. Optimization of the PSD-based RIG detector is addressed. Potential for the device in industrial and clinical applications is considered. PMID- 2715253 TI - Simple and rapid reversed-phase high-performance liquid chromatographic determination of baclofen in human plasma with ultraviolet detection. Application to a pharmacokinetic study. AB - A sensitive, selective, and rapid reversed-phase high-performance liquid chromatographic method for separation and quantitation of intact racemic baclofen in human plasma has been described. Baclofen is very soluble in water and cannot be extracted efficiently by an organic solvent. Therefore, baclofen was isolated from plasma endogenous materials by adding 0.50 ml of acetonitrile and 50 mg of zinc sulfate to 1.0 ml of plasma. A 15 cm X 4.6 mm, 10-microns octyl (C8) column was slurry packed and used throughout the study. An isocratic mobile phase containing 0.01 M monobasic potassium phosphate (pH congruent to 3.5) acetonitrile (80:20, v/v) was delivered at a flow-rate of 1.0 ml/min through the chromatographic system. Baclofen was detected with an ultraviolet-visible variable-wavelength detector at 220 nm and 0.50-0.005 a.u.f.s. The time needed to complete the analysis of one sample was approximately 15 min. The limit of detection for the assay of racemic baclofen was 35 ng/ml. After an oral dose of 20 mg of baclofen, blood samples were collected at several time points and plasma was analyzed using the method developed in this study. Various pharmacokinetics parameters were determined from the plasma concentration versus time profile of baclofen. PMID- 2715254 TI - High-performance liquid chromatographic assay of nesosteine in human plasma and urine. AB - A high-performance liquid chromatographic method for the quantitation of the mucoactive drug sodium 2-(3-thiazolidinylcarbonyl)benzoate in plasma and urine was developed, involving liquid-liquid extraction under acidic conditions and reversed-phase chromatography using ultraviolet detection at 210 or 235 nm. The extraction efficiency, linearity, limit of detection, precision and accuracy were determined. Products of the main biotransformation of the drug, involving hydrolysis of the amidic bond, do not interfere. The method is selective, precise, reproducible and applicable to studies of the pharmacokinetic behaviour of the drug in humans. Pharmacokinetic parameters derived from six healthy subjects following acute intravenous administration of the drug (150 mg) are presented. PMID- 2715255 TI - Determination of enantiomeric purity of the new D-2 dopamine agonist 2-(N-propyl N-2-thienylethylamino)-5-hydroxytetralin (N-0437) by reversed-phase high performance liquid chromatography after pre-column derivatization with D(+) glucuronic acid. AB - This paper describes an enzymic derivatization procedure that allows accurate determination of very small amounts of enantiomeric impurities in the D-2 dopamine agonist 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin (N-0437). After pre-column glucuronidation of the individual enantiomers, two diastereoisomers were formed which were separated by reversed-phase high performance liquid chromatography. An enantiomeric purity of 99.84% was calculated for the (-)-enantiomer, against 99.89% for the (+)-enantiomer. The assay was validated by spiking 1% of the (-)-enantiomer in the (+)-enantiomer. A high accuracy (error 4.5%) and precision (coefficient of variation 2.9%, n = 5) of the method were established. PMID- 2715256 TI - Body fluid analysis of a phosphonic acid angiotensin-converting enzyme inhibitor using high-performance liquid chromatography and post-column derivatization with o-phthalaldehyde. AB - A method is described for the extraction of a phosphonic acid angiotensin converting enzyme inhibitor from either urine or plasma, and subsequent quantitation using high-performance liquid chromatographic (HPLC) analysis and post-column o-phthalaldehyde reagent derivatization. The compound cannot be quantitatively extracted from the body fluids, but use of a fluorinated internal standard allowed for the computation of accurate results. With the use of an internal standard, excellent precision, linearity, and recovery were obtained for analyte response in both urine and plasma. In urine a working range of 0.2-10 micrograms/ml was found, with a limit of detection of 0.1 micrograms/ml. For plasma the working range was found to be 2-500 ng/ml, and the limit of detection was established as 1 ng/ml. Due to the non-polar character of the analyte at low pH values, it was possible to use novel extraction (solid-phase C8 column) and HPLC [poly(styrenedivinyl benzene) HPLC column] conditions to separate and quantitate the compound from plasma and urine. PMID- 2715257 TI - High-performance liquid chromatographic method for the rapid profiling of plasma and urinary organic acids. PMID- 2715258 TI - Purification of human apolipoprotein A-IV by fast protein liquid chromatography. PMID- 2715259 TI - Isocratic separation of phenylthiohydantoin-amino acids by reversed-phase high performance liquid chromatography. PMID- 2715260 TI - gamma-Aminobutyric acid, glutamate, glycine and taurine analysis using reversed phase high-performance liquid chromatography and ultraviolet detection of dansyl chloride derivatives. PMID- 2715261 TI - Determination of catecholamines in human plasma by high-performance liquid chromatography: comparison between a new method with fluorescence detection and an established method with electrochemical detection. AB - We report a sensitive fluorimetric method, in which catecholamines are concentrated from plasma by liquid-liquid extraction and derivatized with the selective fluorescent agent 1,2-diphenylethyl-enediamine prior to chromatography. Optimal conditions for extraction, derivatization and chromatography were investigated. With alpha-methylnorepinephrine as internal standard, the chromatographic separations are complete within 6 min. Limits of detection are 0.3 pg for norepinephrine and epinephrine and 0.5 pg for dopamine. Coefficients of variation are low (3-7%). Comparison of plasma catecholamine values determined with this method and with an established method with electrochemical detection (n = 135) shows good correlation (r = 0.94-1.00), and regression lines are close to lines of identity. PMID- 2715262 TI - Separation of vitamin K-dependent coagulation factors on sulphated cellulose. PMID- 2715263 TI - Determination of m-iodobenzylguanidine in serum and urine by high-performance liquid chromatography. PMID- 2715264 TI - Rapid and sensitive method for the determination of 5-fluorocytosine in human plasma by ion-pair high-performance liquid chromatography. PMID- 2715265 TI - Identification and determination of a carboxylic acid metabolite of chloroquine in human urine by high-performance liquid chromatography. PMID- 2715266 TI - Resolution of antihypertensive aryloxypropanolamine enantiomers by reversed-phase chromatography of (-)-menthyl chloroformate derivatives. PMID- 2715267 TI - Measurement of thiamylal in human plasma using reversed-phase high-performance liquid chromatography. PMID- 2715268 TI - Analysis of the dopamine agonist N-0437 in rat serum using reversed-phase high performance liquid chromatography with electrochemical detection. PMID- 2715269 TI - [Serum level of perphenazine determines by liquid chromatography]. PMID- 2715270 TI - High-performance liquid chromatographic assay of benzalkonium in plasma. PMID- 2715271 TI - Simplified gas chromatographic analysis of ethanol in blood and tissue. PMID- 2715272 TI - Rapid analysis of piroxicam in dog, rat and human plasma by high-performance liquid chromatography. PMID- 2715273 TI - Analysis of the O-methylated metabolites of isoprenaline, adrenaline and noradrenaline in physiological salt solutions by high-performance liquid chromatography with electrochemical detection. AB - This study provides the first report of a sensitive, simple and rapid high performance liquid chromatographic (HPLC) assay for the simultaneous analysis of isoprenaline and its metabolite, 3-O-methylisoprenaline, in samples of physiological salt solutions. The assay does not require time-consuming sample clean-up or extraction procedures and uses a Nova-Pak C18 column, an isocratic mobile phase and an amperometric detector. In addition, small modifications to the composition of the mobile phase have also provided sensitive assays for noradrenaline and adrenaline and their O-methylated or O-methylated deaminated metabolites (normetanephrine, metanephrine, 3-methoxy-4-hydroxyphenylethylene glycol and 3-methoxy-4-hydroxymandelic acid). These HPLC assays are sufficiently sensitive and rapid to replace the use of [3H]amines and column chromatographic separation of the metabolites for most in vitro studies on the uptake and subsequent metabolism of catecholamines by monoamine oxidase and/or catechol-O methyltransferase in tissues. PMID- 2715274 TI - Reversed-phase liquid chromatography of elastin peptides. AB - Soluble fragments of elastin are frequently present in biological tissue in small amounts. Because of their hydrophobic character, these peptides are not well resolved by a number of conventional techniques. However, their separation should be possible by reversed-phase chromatography. A wide range of columns, gradients and solvents were evaluated. Two systems are described. One was a C18 liganded silica column eluted isocratically by gravity flow. Some degree of size fractionation was achieved with larger peptides being eluted with methanol and smaller ones with isopropanol. The second system uses a pressurized elution from another C18 ligand column. A concave gradient of trifluoroacetic acid acetonitrile with a decreasing acetonitrile concentration was optimal. Similar resolution of peptides produced by a variety of digestion methods was obtained with the lower-molecular-mass peptides eluting in the middle of the gradient. PMID- 2715275 TI - Enantioselective gas chromatographic assays with electron-capture detection for methoxyphenamine and its three primary metabolites in human urine. AB - Sensitive and enantioselective gas chromatographic assays have been developed and applied to the quantitation in human urine of the enantiomers of methoxyphenamine and its three primary oxidative metabolites, namely, N-desmethylmethoxyphenamine, O-desmethylmethoxyphenamine and 5-hydroxymethoxyphenamine. The separation of the various analytes was achieved through the combined use of high-resolution gas chromatography coupled with electron-capture detection and employing a capillary OV-225 column. The formation of diastereometric derivatives involved the chiral acylating reagent N-heptafluorobutyryl-L-prolyl chloride. The assays for methoxyphenamine and O-desmethylmethoxyphenamine were linear over the range 0.25 2.0 micrograms/ml for each analytes' enantiomers, while in the case of the enantiomers for N-desmethylmethoxyphenamine and 5-hydroxymethoxyphenamine linearity was shown over the ranges 0.094-0.75 and 0.188-1.5 micrograms/ml, respectively. The mean coefficients of variation in all cases were less than 4%. PMID- 2715276 TI - Gas chromatographic determination of gallopamil and norgallopamil in human plasma. AB - A highly sensitive gas chromatographic assay is described for the simultaneous determination of gallopamil, a calcium channel blocking agent, and its major metabolite, norgallopamil. A multi-step extraction procedure is employed followed by on-column capillary gas chromatographic analysis using nitrogen-selective detection. Acetylation of norgallopamil is performed to enable accurate quantification of the metabolite. Linearity was achieved over the range 1-50 ng/ml for both analytes. Assay specificity, precision and accuracy were investigated. PMID- 2715277 TI - Determination of xylometazoline in plasma and urine by gas chromatography using a fused-silica capillary column and an electron-capture detector. AB - A sensitive method is described for the determination of unchanged xylometazoline in plasma and urine at concentrations down to 35 nmol/l. After addition of naphazoline as an internal standard, both compounds are extracted with dichloromethane-diethyl ether (20:80) at pH 10, back-extracted with an acidic solution and re-extracted from a sodium hydroxide solution with dichloromethane diethyl ether (20:80). The compounds are then derivatized with heptafluorobutyric anhydride in the presence of pyridine. The derivatives are determined by capillary gas chromatography using electron-capture detection. PMID- 2715278 TI - Gas chromatographic-mass spectrometric analysis of plasma oxybutynin using a deuterated internal standard. AB - A gas chromatographic-mass spectrometric method is described for the quantitative analysis of plasma oxybutynin. Deuterated oxybutynin served as the internal standard and its synthesis is described. Chromatographic separation on a methylsilicone capillary column avoided the thermal decomposition observed using a packed column. Electron-impact ionization and selected-ion monitoring of the alpha-cleavage fragments of drug and internal standard permitted quantitation of oxybutynin down to 0.25 ng/ml of plasma. At the 2 ng/ml level the accuracy and precision are 4 and 10%, respectively, and improved at higher drug concentrations. Application of the method to the pharmacokinetics of oral oxybutynin in man demonstrated rapid absorption and elimination of the drug. PMID- 2715280 TI - Profiling cells and body fluids--chromatography and two-dimensional electrophoresis as complementary techniques. AB - Recent results on the use of gas chromatography-mass spectrometry, high performance liquid chromatography with diode array detector, amino acid analysis and high-resolution two-dimensional (2-D) electrophoresis to study body fluids and cells in health and disease are surveyed. The chromatography profiling techniques are particularly suitable for the diagnosis of inborn errors of metabolism, with DNA technology as a complementary tool for prenatal diagnosis. Both chromatography and electrophoresis were utilized to study pre-diagnostic sera from the JANUS serum bank and to classify certain bacteria. Protein profiling by 2-D electrophoresis was employed to identify marker proteins associated with the metastatic properties of cloned cancer cells. The electrophoretic technique is also appropriate as a preparative tool for isolating sufficient amounts of marker proteins for microsequencing of amino acids. Chromatography and protein profiling were complementary tools for evaluating the toxicity and mutagenicity of environmental samples in a new test utilizing living human leukocytes and fibroblasts. PMID- 2715279 TI - Determination of hydroxypropyl-beta-cyclodextrin in plasma and urine by size exclusion chromatography with post-column complexation. AB - The analytical method described here provides the appropriate sensitivity and selectivity for the determination of unlabelled hydroxypropyl-beta-cyclodextrin as a parenteral carrier in pharmaceutical formulations. The method may also be used in clinical trials evaluating the fate and pharmacokinetic profile of this compound, which was isolated from the biological matrix by solid-phase extraction with Bond Elut C18 cartridges. The lack of uniformity of the product was circumvented by the use of a size-exclusion chromatographic column. An indirect colorimetric complexation method was used for detection. The detection limit was 0.1 micrograms per 2 ml of biological fluid and the extraction recovery was sufficient (78%). PMID- 2715281 TI - Bioaffinity chromatography: synergy between interactive chromatography and molecular recognition for the separation and analysis of macromolecules. AB - Affinity chromatography, commonly regarded as an integral tool in macromolecular separation sciences, also provides an analytical method to study structure function relationships of macromolecular interaction processes and to design recognition molecules. The latter, as found recently for the case of antisense peptides, may be useful as affinity agents in immobilized forms to effect new types of biomolecular separation. PMID- 2715282 TI - High-performance liquid chromatography of sialooligosaccharides and gangliosides. AB - Glycans were cleaved from gangliosides and separated by high-performance liquid chromatography (HPLC). The columns were packed with bonded stationary phases made of microparticulate, macroporous silica with serotonin, phenylpropanolamine or tryptamine as the biogenic amine ligate. The ganglioside oligosaccharides were eluted in the order of increasing number of sialic acid residues in the molecule and their retention decreased with the ionic strength of the mobile phase. Best selectivity was obtained in the pH range from 3.0 to 4.0. The two major sialic acids, N-acetylneuraminic and N-glycolylneuraminic acids, were separated by lectin affinity chromatography using an HPLC column packed with silica-bound wheat germ agglutinin and 10 mM phosphate buffer, pH 4.0, as the eluent. Throughout this study, isocratic elution was used and the column effluent was monitored at 195 nm. PMID- 2715283 TI - Gas chromatographic-mass spectrometric study of deacetylation and oxidation of 2 acetylaminofluorene by rat liver epithelial cell lines upon cocarcinogen induction. AB - Cell line cultures from postnatal and adult rats were incubated with 5-100 mumol/l [9-14C]-2-acetylaminofluorene. On incubation of 10 mumol/l, ring hydroxylated metabolites, expressed as nmol hydroxy-2-acetylaminofluorene (OH-2 AAF)/mg cell protein/24 h, were 9-OH- 1.28 +/- 0.37, 7-OH- 1.08 +/- 0.28 and 5-OH 0.30 +/- 0.08, and deacetylated 2-AAF (2-AF) 1.20 +/- 0.18. For 5, 10, 50 and 100 mumol/l 2-AAF, the total production of OH-2-AAF (same units) and 2-AF (%) were, respectively, 0.86 (0%), 3.86 (35%), 17.8 (60%) and 35.03 (89%). On preincubation with phenobarbital (BP) or 3-methylcholanthrene (3-MC) and then incubation of 10 mumol/l 2-AAF, the total synthesis of OH-2-AAF increased 1.9 fold (PB) and 2.5-fold (3-MC). In addition, four other OH-2-AAF (1-OH-, 3-OH- and two unknown OH-2-AAF) were produced and glucuronidation of all metabolites was induced and amounted to 57% of the total after PB and 75% after 3-MC preincubation. Metyrapone or alpha-naphthoflavone inhibition of BP or 3-MC, respectively, markedly affected the production of free and conjugated metabolites and, almost completely, the deacetylation of 2-AAF. PMID- 2715284 TI - Gas chromatography-mass spectrometry of perindopril and its active free metabolite, an angiotensin convertase inhibitor: choice of derivatives and ionization modes. AB - Perindopril, a perhydroindole compound and a novel class of angiotensin convertase inhibitor, after oral administration leads to an active metabolite by de-esterification of an ethyl ester. Routine biological measurements are currently done using a radioimmunological assay, but a mass fragmentographic method was developed using plasma spiked with the drugs, which were then derivatized to the isobutyl ester heptofluorobutyramide and assayed using ammonia negative chemical ionization. Levels of 100 pg/ml were assayed. However, isobutanol derivatization provoked partial transesterification of the ethyl ester of the parent drug into the diisobutyl ester derivative, which corresponds to the active metabolite. A second method of derivatization to stable trimethylsilyl esters preserved the original ethyl ester of the parent drug. Despite the lower ionization yields, the mass fragmentographic method was sensitive and accurate enough to work satisfactorily at the 2 ng/ml level in spiked plasma, which is the level found currently in patients. PMID- 2715285 TI - Determination of radiolabelled proline and hydroxyproline in collagen hydrolysates by high-performance liquid chromatography with on-line radiometric detection. AB - Radiolabelled proline and hydroxyproline were separated on a C8 column (10 cm X 4.6 mm I.D.) with 10.4 mM sodium dodecyl sulphate in water-n-propanol (88:12, v/v) (pH 2.6) as the mobile phase at a flow-rate of 0.6 ml/min. The retention times of hydroxyproline and proline were 5 and 8 min, respectively. On-line radiometric detection was performed either in a homogeneous mode (liquid scintillator was added to the column effluent in the ratio 3.33:1) or in a heterogeneous mode (the detection cell was packed with a solid scintillator and 0.1 M ammonia was mixed with the column effluent in the ratio 1:6 in order to prevent adsorption of amino acids on the cell packing). Detection limits were in the range 100-900 dpm for individual isotopes and detection modes and the reproducibilities were better than 10%. The application of the method to a collagen synthesis study is reported. PMID- 2715286 TI - Determination of the new monoamine oxidase inhibitor brofaromine and its major metabolite in biological material by gas chromatography with electron-capture detection. AB - A sensitive gas chromatographic assay for the simultaneous determination of brofaromine [4-(7-bromo-5-methoxy-2-benzofuranyl)piperidine hydrochloride], a new monoamine oxidase-A inhibitor, and its major metabolite was developed and validated. After addition of 4-(5-bromo-2-benzofuranyl)piperidine as internal standard, the compounds were isolated from biological fluids by liquid-liquid extraction at basic pH. After derivatization with heptafluorobutyric anhydride the compounds were chromatographed using a packed column (OV-17) and an electron capture detector. The limit of quantitation was ca. 0.03 nmol per sample (10 ng) for both compounds. analysis of spiked samples demonstrated the good accuracy and precision of the method, which is suitable for use in pharmacokinetic and bioavailability studies. The method was applied to samples from an experiment in a healthy volunteer treated with a single oral dose of 75 mg of brofaromine hydrochloride. Plasma profiles before and after enzymic hydrolysis showed that about one-third of the total brofaromine in plasma and practically all of the major metabolite (O-desmethylbrofaromine) were present in the conjugated form. PMID- 2715287 TI - Therapeutic monitoring of metipamide during antihypertensive therapy. AB - The aim of our study was to monitor metipamide during a two-month period of treatment and to determine whether the whole-blood levels estimated by high performance liquid chromatography provide a relevant indicator of possible accumulation of the drug. We also analysed antihypertensive activity and biochemical changes in the blood of twenty hypertonic patients. The results of our clinical trial showed that metipamide is an effective first-line antihypertensive agent, in that it combines satisfactory reduction of blood pressure with a low frequency of side-effects and a simple once-daily dosage regime. PMID- 2715288 TI - Strain differentiation of barley yellow dwarf virus isolates using specific monoclonal antibodies in immunosorbent electron microscopy. AB - Three strain-specific monoclonal antibodies, MAC. 91, MAC. 92 and MAb. MAFF2, were compared with two polyclonal antisera for the diagnosis of barley yellow dwarf virus (BYDV) strains in immunosorbent electron microscopy (ISEM). Used at 1 micrograms ml-1, the three monoclonal antibodies specifically trapped the Rothamsted PAV, RPV and MAV-like type isolates respectively, unlike the polyclonal antisera, which showed considerable heterologous reaction. The efficiency of the monoclonal and polyclonal antibodies in trapping and detecting these isolates of BYDV were compared quantitatively using ISEM and enzyme-linked immunosorbent assay (ELISA) techniques. The test provides a simple and sensitive diagnostic method for BYDV, suitable for small numbers of samples and is useful in confirming doubtful ELISA results. PMID- 2715289 TI - Longitudinal study of progestins, mineralocorticoids, and glucocorticoids throughout human pregnancy. AB - The maternal adrenal cortex seems to be involved in the adaptation to pregnancy. To study in detail adrenocortical secretion during pregnancy, we measured plasma aldosterone, corticosterone, 11-deoxycorticosterone, progesterone, 17 hydroxyprogesterone, 11-deoxycortisol, cortisol, and cortisone simultaneously by RIA after extraction and automated Sephadex LH-20 chromatography of 10 normal pregnant women longitudinally throughout pregnancy at weeks 8-10, 14-17, 21-24, 28-32, and 38 as well as at the time of admission to the delivery room. The mean plasma progesterone and 17-hydroxy-progesterone concentrations increased from 37.2 +/- 6.5 (+/- SE) and 8.2 +/- 1.0 nmol/L, respectively, in early gestation to maximum levels of 138.0 +/- 25.7 and 22.8 +/- 2.2 nmol/L at week 38 (P less than 0.01). Plasma glucocorticoid levels rose 2- to 3-fold (P less than 0.01) from weeks 8-10 (corticosterone, 18.5 +/- 5.4; 11-deoxycortisol, 1.9 +/- 0.2; cortisone, 24.2 +/- 4.2; cortisol, 195.5 +/- 37.6 nmol/L) to week 38 (corticosterone, 42.9 +/- 11.2; 11-deoxycortisol, 4.6 +/- 0.5; cortisone, 71.5 +/ 13.6; cortisol, 420 +/- 63 nmol/L). Similarly, plasma mineralocorticoid levels increased 5- to 7-fold (P less than 0.01) from weeks 8-10 (11 deoxycorticosterone, 0.69 +/- 0.12; aldosterone, 0.41 +/- 0.08 nmol/L) to maximum levels at week 38 (5.3 +/- 0.9 and 2.1 +/- 0.3 nmol/L, respectively). At the time of admission to the delivery room, plasma 11-deoxycortisol, corticosterone, and cortisol concentrations were higher (P less than 0.02) than at 38 weeks, but plasma progestin and mineralocorticoid concentrations were not. We conclude that the source of the elevated maternal corticosteroid levels in pregnancy in addition to the estrogen-mediated rise in corticosteroid-binding globulin is the maternal adrenal cortex itself. The peak glucocorticoid levels at admission to the delivery room reflect increased maternal and fetal stress with the onset of labor. PMID- 2715290 TI - Human pituitary tumors secrete chromogranin-A. AB - Chromogranin-A (CgA) has emerged as a serum and tissue marker for a number of endocrine tumors. We studied 15 patients with pituitary tumors to evaluate the clinical value of CgA as a serum and tissue marker for such tumors. One third of the patients had elevated serum CgA levels; 2 of these patients had nonsecreting pituitary tumors, and the other 3 had corticotroph adenomas. CgA-positive cells were detected in 9 of the 11 anterior pituitary tumors that were immunostained; in these 9 tumors at least half of the cells were CgA positive. We conclude that CgA production is common in pituitary tumors and that immunohistochemical studies for CgA may aid in their classification. In addition, serum CgA measurements may help to identify patients with pituitary tumors, especially those that do not secrete a known pituitary peptide. PMID- 2715291 TI - Epidermal growth factor receptors in plasma membranes of normal and diseased human thyroid glands. AB - We studied the characteristics of epidermal growth factor (EGF) receptors in plasma membrane fractions derived from normal and diseased human thyroid tissues. The mean maximal specific binding of EGF to membrane fractions of normal thyroid tissue (n = 25) was 1.46 +/- 0.47 (+/- SD) fmol/mg protein. The maximal specific binding was higher than the upper limit of the normal range (2.40) in 12 of the 39 (31%) differentiated carcinomas, 2 of the 3 (67%) undifferentiated carcinomas, and 1 squamous cell thyroid carcinoma. In contrast, the maximal specific binding in samples derived from adenomas (1.13 +/- 0.91), adenomatous goiters (0.92 +/- 0.56), and hyperplastic (Graves') thyroids (1.57 +/- 0.61) was not different from that in normal thyroid tissue. Scatchard plot analysis revealed that all thyroid membrane fractions had two classes of specific receptors for EGF. The mean association constant for the high affinity EGF receptors in normal thyroid tissue was 7.9 +/- 2.9 (+/- SD) X 10(9) mol/L-1, and the capacity was 22.9 +/- 7.0 fmol/mg protein. The capacity of the high affinity receptors was higher (P less than 0.05) in differentiated carcinoma (37.2 +/- 25.5) and undifferentiated carcinoma (32.7 +/- 11.6) than in normal thyroid tissue. In one squamous cell carcinoma, the capacities for the two classes of binding sites were about 15-fold greater than in normal thyroid tissue. In contrast, the association constants of the high affinity receptors from carcinomas (differentiated, 6.9 +/- 2.8; undifferentiated, 11.8 +/- 4.1; squamous cell, 8.2) were similar to that of normal thyroid tissue. In the thyroid tissues from eight patients with Graves' disease the capacity of the high affinity binding sites (37.5 +/- 12.3 fmol/mg protein) was higher than that in normal tissue, but the affinity (4.4 +/- 1.6 X 10(9) mol/L-1) was less, and the maximal specific binding was similar in the two types of tissue. These results suggest that a significant increase in the number of high affinity EGF receptors may play a role in the pathogenesis of human thyroid carcinoma. PMID- 2715292 TI - Human serum does not contain a high affinity estrogen-binding glycoprotein different from sex hormone-binding globulin. AB - The mannoglycoprotein fraction obtained by Concanavalin-A chromatography of human serum binds both androgens and estrogens with high affinity. Sex hormone-binding globulin (SHBG) is a component of this fraction that binds both steroids, but the fraction may contain another component that binds only estrogen. We used several chromatographic methods to ascertain whether the estradiol-binding properties of the mannoglycoprotein fraction could be attributed to SHBG or to SHBG and the putative estrogen-binding protein. DEAE-trisacryl, chromatofocusing, and anti SHBG-immunoglobulin Sepharose chromatography resulted in coelution of the androgen- and estrogen-binding activities. SHBG purified by ligand affinity chromatography as well as immunoaffinity-purified SHBG had estradiol-binding properties similar to those of the crude mannoglycoprotein preparation. These data strongly suggest that 1) SHBG is the only estradiol-binding protein in the mannoglycoprotein fraction obtained by Concanavalin-A chromatography of human serum, and 2) the putative estradiol-binding protein of serum is most likely SHBG. PMID- 2715293 TI - Circadian variation of basal plasma prolactin, prolactin response to suckling, and length of amenorrhea in nursing women. AB - The circadian pattern of plasma PRL levels and the PRL response to suckling were examined at various times during the first postpartum year and related to the length of lactational amenorrhea. Ten healthy women whose infants were breast-fed exclusively and who were amenorrheic 3 months postpartum were studied 3, 6, and 9 11 months postpartum. The women and their babies were admitted to a metabolic unit for 48 h. On the second day, blood samples were drawn at 2-h intervals for 26 h starting at 0800 h and also 10 and 30 min after the initiation of six of the nursing episodes. During the three postpartum periods, there was a circadian rhythm of basal plasma PRL concentrations; the peak concentrations occurred between 2400-0600 h. Suckling induced a significant rise in plasma PRL levels at all hours except 0800 h. There was a positive correlation between the duration of the nursing episode and the suckling-induced PRL increase at 30 min. Both the basal plasma PRL levels and the PRL responses to suckling diminished with time after delivery. This trend was less evident at 0400 h and was not fully explained by changes in the nursing pattern. The five women in whom menstrual cycles resumed before day 180 postpartum had lower basal and suckling-induced plasma PRL levels than the women who had amenorrhea for a longer period. This difference was present in the third month, when all women were amenorrheic and fully nursing and when the frequency and duration of nursing episodes and infant growth rates were similar. The results indicate that comparable nursing patterns may be associated with different plasma PRL levels, which are associated with different lengths of lactational amenorrhea. An early difference in the sensitivity of the breast hypothalamus-pituitary system to suckling may explain the differences in the duration of lactational amenorrhea, which are not dependant on the breastfeeding pattern. The magnitude of the PRL response to suckling may predict the likelihood of recovering ovarian function during lactation. PMID- 2715294 TI - Spironolactone is an effective and well tolerated systemic antiandrogen therapy for Hirsute women. AB - We treated 22 hirsute women with spironolactone in an open trial to determine whether it caused objective changes in hair growth. Among them, 18 women completed 12 months therapy with 200 mg spironolactone daily. During this period, the mean daily linear growth rates of hair on the face, abdomen, and thigh were reduced to 66% (P less than 0.001), 75% (P less than 0.01), and 72% (P less than 0.001) of their pretreatment values. The mean hair shaft diameters were reduced to 83% (P less than 0.01) on the face, 88% (P less than 0.001) on the arm, 74% (P less than 0.01) on the abdomen, and 80% (P less than 0.001) on the thigh. Daily hair volume production was calculated from the diameter and daily growth rate; it was reduced to 60% (P less than 0.01) on the face, 52% (P less than 0.01) on the arm, 34% (P less than 0.001) on the abdomen, and 48% (P less than 0.001) on the thigh. Six of the 18 women who completed the study developed midcycle vaginal bleeding, and 3 women had previously irregular menstrual cycles regulated. We conclude that spironolactone is effective and well tolerated for hirsute women. PMID- 2715295 TI - Heterogeneity of serum prolactin throughout the menstrual cycle and pregnancy in hyperprolactinemic women with normal ovarian function. AB - We have demonstrated the selective secretion of high mol wt PRL series (big big PRL) in women with hyperprolactinemia and normal ovarian function. This observation suggests that big big PRL is immunologically similar, but biologically less active, than monomeric or little PRL. In this study we determined the molecular size heterogeneity of immunoreactive PRL in the serum from two ovulatory hyperprolactinemic women (subjects A and B) who had large amounts of serum big big PRL during a menstrual cycle and/or gestation. Serum samples obtained throughout the menstrual cycle (days 6, 10, 14, 17, 23, and 28, taking as day 1 the first day of bleeding) and pregnancy (weeks 7, 9, 11, 15, 20, 25, 30, 34, and 38) were fractionated by gel filtration chromatography. PRL was identified in column eluates by specific RIA. Two additional pregnant women, one with a bromocriptine-treated PRL-secreting adenoma (subject C), and a normal woman (subject D) were studied. Big big PRL was the predominant species throughout the different phases of the menstrual cycle in subject B, comprising 70-80% of the total immunoreactive PRL. Most of the remainder was big PRL, and little PRL was present in only small amounts (6-12%) during the luteal phase. During their pregnancies, the serum PRL in subjects A and B initially was mostly big big PRL, but later in gestation the PRL composition shifted from the high mol wt variants to little PRL. The infant's cord (subject A) and peripheral (subject B) serum at birth contained appreciable quantities of big big and big PRL, respectively. These results indicate that structural changes in PRL occur during pregnancy and the menstrual cycle which are probably influenced by the hormonal environment. In addition, the occurrence of larger mol wt PRL species in the serum of the infant of a hyperprolactinemic mother suggests that the presence of high proportions of big big PRL in the serum is genetically determined. PMID- 2715296 TI - Distribution and effect on the endometrium of progesterone released from a progestasert device. AB - Progestasert devices releasing 65 micrograms of [14C]progesterone daily were inserted in 10 women 3 months prior to elective hysterectomy. Following surgery, specimens were examined by light and electron microscopy and by autoradiography. In three uteri, removed during the early follicular phase, there was a clear contrast between the appearance of the superficial portion of the endometrium in the zone immediately adjacent to the device, when compared to areas away from the progestasert. This difference became more pronounced in four specimens obtained at mid-cycle and tended to diminish during the luteal phase: the number of glands was still lower than normal, but stromal decidual reaction was apparent throughout the functional layer of endometrium; in addition, in portions away from the device, glands showed the characteristics of a secretory phase. Progesterone and/or its metabolites were abundant in the superficial epithelium and in the portion of the glands adjacent to the surface; and also well distributed in the stroma and in the capillary walls. Historadiography however, clearly showed that progesterone barely penetrated the deeper portion of the endometrium. This picture does not substantially change during the entire cycle. PMID- 2715297 TI - Culture of epithelial cells derived from the oviduct of different species. AB - This study proposes a procedure for the isolation and culture of oviduct epithelial cells of several species. In-vitro culture on such a feeder seems to allow full embryonic development and viability. The inner linings of Fallopian tubes from mouse, rabbit, cow and human were trypsinized and the epithelial cells were enriched with Percoll gradient. Isolated cells, obtained in high yield with good viability, were maintained in monolayer culture in B2-Menezo medium supplemented with serum, which also supports early embryonic development in vitro. The plated primary cultures reached confluence within 8 days, producing a monolayer of cohesive polygonal cells. Associated with this large epithelial cell population, ciliated cells as well as polykaryotic cells and few fibroblastic nests were observed. After the first sub-culture, the ciliated cells disappeared and the epithelial cell monolayer grew rapidly to confluence within 3 days and displayed contact inhibition. No epithelial cell growth could be obtained in culture in the absence of serum. The addition of oestrogens had no effect on any of the cultured oviductal epithelial cells. A spontaneous alteration was observed in morphology and growth after several passages, the number of which depends mainly upon the species. PMID- 2715298 TI - Effects of progesterone and oestradiol-17 beta on 17 beta-ol-dehydrogenase activity in stromal cells of human endometrium under in-vitro conditions. AB - A 17 beta-ol-dehydrogenase activity could be demonstrated in fibroblast monolayer cell cultures of proliferative human endometrium. After 24 h incubation 100 nCi [6,7-3H]oestradiol-17 beta was completely oxidized to oestrone. Progesterone was not able to enhance the metabolizing velocity. In contrast, progesterone incubation revealed a decreasing oxidation rate with increasing molarity. Histological changes after transformation of the endometrium are discussed to explain in-vivo results showing an increased 17 beta-ol-dehydrogenase activity in the secretory phase of the cycle. PMID- 2715299 TI - In-vitro fertilization: how many attempts before success? AB - Repeated attempts increase the overall rate of success of sterility therapy by in vitro fertilization. The present study, using data collected between 1983 and 1987 in a Belgian hospital, attempts to investigate the expected number of treatment cycles before success is achieved. The answer requires some knowledge about the degree of independence between success probability and treatment duration. Using mathematical models of implantation, it can be shown that success probability actually decreases during treatment. A method for updating individual probabilities is suggested; it could be used as a prognostic estimation for women undergoing this kind of therapy. PMID- 2715300 TI - Biochemical exploration of azoospermia: interest of the seminal transferrin assay. AB - Seminal transferrin is considered a good index of Sertoli cell function. In this study, including 19 control subjects, four vasectomized subjects and 65 non vasectomized subjects with azoospermia, transferrin was measured concomitantly with other classical biochemical seminal markers such as L-carnitine, fructose and zinc. This parameter should provide additional information for differentiation between obstructive and non-obstructive azoospermia. A threshold value of 85 micrograms/ejaculate for transferrin was defined in the control and the vasectomized groups. The 65 subjects with azoospermia were divided into five groups according to L-carnitine and transferrin threshold values; the nature of azoospermia (obstructive or non-obstructive) was considered in each group. In the biological investigation of sterility, the measurement of transferrin provided information as to the aetiology of azoospermia. However, the determination of L carnitine and fructose remains important in the localization of any obstruction. PMID- 2715301 TI - A program of oocyte donation and gamete intra-fallopian transfer. AB - The outcome of a series of 19 patients with premature ovarian failure (POF) undergoing gamete intra-Fallopian transfer (GIFT), utilizing donated oocytes, is described. The steroid replacement protocol consisted of the administration of increasing dosages of 17 beta-oestradiol (E2) and progesterone (P4). Hormonal replacement was maintained until day 100 of gestation. All patients underwent an evaluation cycle in which serum levels of E2 and P4 were monitored and an endometrial biopsy was performed either 7 or 11 days after initiation of progesterone administration. All cases of GIFT were performed between days 12 and 15 of the induced menstrual cycle. Of the 19 patients treated, 11 became pregnant, giving a clinical pregnancy rate of 58% (visualization of gestational sac by ultrasound). Two patients aborted between the 4th and 5th weeks of gestation. No ectopic pregnancies occurred. Three of the seven deliveries involved multiple births. Details of the circulating hormone levels and endometrial response are discussed. PMID- 2715302 TI - Tubal infertility and silent chlamydial salpingitis. AB - Antibodies to Chlamydia trachomatis (serum IgG antibodies with a titre of at least 32) were detected in 141 (86.0%) of 164 infertile women with tubal infertility (TF group) and in 20 (28.6%) in 70 infertile women with normal tubes (NTF group). The difference was highly significant (P less than 0.001), as was the difference in geometric mean titre of antibody-positive cases, 181 and 87, respectively. Pregnant, age-matched women were used as controls. Significantly fewer of these women (P less than 0.001) had antibodies, when compared with the TF group, 60 (36.6%) of 164, but not when the comparison was made with the NTF group, 31 (44.3%) of 70. There was a history of salpingitis in 64 (39.0%) of the 164 infertile women with damaged tubes. Neither the frequency nor the geometric mean titre of chlamydial antibodies differed between tubal factor infertility patients with and without a history of salpingitis. Previous chlamydial infection, reflected by serological markers, is strongly associated with tubal damage leading to tubal infertility. A large proportion of these cases run a silent course, since a majority of the antibody-positive patients with tubal infertility have never had salpingitis. PMID- 2715303 TI - Presence of sperm antibodies and association with viscosity of semen. AB - Semen characteristics were studied in 96 men from an in-vitro fertilization and embryo transfer programme. Along with the routine semen analysis, the presence of sperm antibodies in seminal plasma was measured by an ELISA technique. Antibodies to spermatozoa (IgA and/or IgG) were present in 19 cases and 15 of these (78.95%) had abnormally high viscosity, often associated with a high percentage of particulate debris and an increased number of morphologically abnormal spermatozoa. PMID- 2715304 TI - The value of sperm swimming speed measurements in assessing the fertility of human frozen semen. AB - The purpose of this study was to evaluate relationships between measured sperm velocity and in-vivo fertility, using donor semen samples from an artificial insemination (AID) programme. Seventy-one frozen semen samples were examined; measurements of sperm velocity were made immediately after thawing, upon a motile 'swim-up' fraction, and finally after 3.5 h incubation at 37 degrees C in the freezing mixture. Zona-free hamster egg penetration assays were performed upon all samples. Two groups of samples were identified; seven donors (11 samples) had failed to produce any pregnancies through AID from a range of 3 to 14 cycles tested, whilst the remaining samples (from 25 donors) had achieved at least one pregnancy each. The mean sperm velocity (+/- SEM) for the latter 'fertile' group was significantly higher than the corresponding value for the 'infertile' group; (i) after thawing, 65.9 +/- 1.8 versus 50.4 +/- 3.2 microns/s (P less than 0.001) and (ii) after 3.5 h incubation, 42.1 +/- 2.1 versus 24.7 +/- 5.7 microns/s (P less than 0.002). Using the maintenance of sperm velocity during incubation as an indicator of survival, life-table analyses were used to calculate monthly conception rates on various sub-groups of the semen samples. Poor survival (greater than 40% decline in velocity over 3.5 h) was associated with a monthly pregnancy rate of only 11.58% (362 cycles), whilst better survival (less than 40% decline) was associated with the significantly higher (P = 0.024) pregnancy rate of 16.87% (480 cycles). PMID- 2715305 TI - Results of microsurgical vasoepididymostomy: role of epididymis in sperm maturation. AB - One-hundred-and-ninety patients with obstructive azoospermia caused by bilateral epididymal blockage have been followed for greater than or equal to 4 years after undergoing 'specific tubule' vasoepididymostomy. When anastomosis was required in the corpus epididymidis, the 'patency' rate was 78% and the overall pregnancy rate was 56%. The pregnancy rate for 'patent' cases was 72%, indicating that a high fertility rate can be obtained with spermatozoa that have not passed through the full length of corpus epididymidis. By contrast, with vasoepididymostomy to the caput epididymidis there was a 73% 'patency' rate, but the overall pregnancy rate was only 31%. The pregnancy rate for 'patent' cases was 43%. Spermatozoa from the corpus epididymidis have a higher rate of fertility than spermatozoa from the caput epididymidis, but spermatozoa from proximal areas of the corpus have no less fertility than spermatozoa from the distal corpus epididymidis. The most remarkable observation is that in almost half the cases, spermatozoa which have never journeyed beyond the caput epididymidis seem to be capable of causing pregnancy. PMID- 2715306 TI - Semen selenium content and sperm mitochondrial volume in human and some animal species. AB - Selenium (Se) and glutathione peroxidase (GSH-Px) were determined from the seminal plasma samples and spermatozoa of human and four different animal species. The human sperm Se concentration was 1.8 +/- 0.8 micrograms/g dry weight, which was about half of that in the bull. Abnormal sperm morphology and motility correlated with low sperm Se content. The volume of sperm mitochondrial sheath in human, bull and stallion was measured using transmission electron microscopy. In these species the sperm Se content was highly correlated with the volume of mitochondria. Among the five species studied, the seminal plasma level of Se was lowest in human male and stallion, while the highest levels were encountered in the bull. No correlation was obtained between human semen quality and seminal plasma Se concentration. The seminal plasma GSH-Px activity was low in man and ram, absent in boar and stallion but very high in the bull. The amount of structural sperm Se as well as seminal plasma Se and GSH-Px activity appears to be highly variable in different species. PMID- 2715307 TI - The human embryo produces basement membrane collagen (type IV collagen)-degrading protease activity. AB - The biochemical basis and mechanism of embryo implantation is poorly understood. The human embryo has to penetrate the endometrial basement membrane and the thick decidual wall during implantation, a process which resembles the active spreading of invasive tumour cells where the degradation of type IV collagen (basement membrane collagen) plays an important role. This study reports that human embryos produce type IV collagen-degrading enzyme activity and the secretion of this enzyme increases with time in culture. The type IV collagen-degrading enzyme activity might facilitate the penetration of the embryo through the decidua, thus emphasizing an active role of the embryo in implantation. On the other hand, unfertilized oocytes secrete low, stable amounts of type IV collagen-degrading enzyme activity in vitro. It was also found that follicular granulosa cells secrete high amounts of type IV collagenolytic activity in culture. It has been previously shown that there is a pre-ovulatory peak in type IV collagenolytic activity in follicular fluid, and it can be assumed that the appearance of this enzyme in the follicular fluid is probably connected to follicular rupture and that it is produced by granulosa cells. PMID- 2715308 TI - Cryopreservation of human and rabbit oocytes and one-cell embryos: a comparison of DMSO and propanediol. AB - The aim of this study was to improve the cryopreservation of human oocytes and pronuclear embryos. One-step and multiple-step addition of dimethyl sulphoxide (DMSO) and 1,2-propanediol (PROH) and three different freezing protocols with intermediate temperatures of -35, -70 and -110 degrees C were investigated. This work was performed using rabbit oocytes as well as human oocytes and one-cell embryos from the routine IVF programme. Also, human polyploid pronucleate oocytes were used in controlled prospective studies of morphological intactness and development in vitro. Rabbit oocytes survived best (113/126) when PROH was added in one step and controlled freezing stopped at -110 degrees C. But the development was better (141/187) if DMSO was added in multiple steps and the oocytes were cooled to -70 degrees C before being plunged into liquid nitrogen. The mode of addition of the cryoprotectant influenced development only if slow freezing was stopped at -35 degrees C (51 versus 34%). Using PROH, the development after thawing was also better if cooling was stopped at -35 degrees C (51 versus 37%) and DMSO was superior to PROH when the oocytes were cooled slowly to -110 degrees C (66 versus 37%). In the human, significantly more pronucleated than unfertilized oocytes developed after freezing (92 versus 50%). The best results were achieved with pronuclear embryos using 1.5 M PROH and cooling to 110 degrees C, when 91.7% of the surviving oocytes developed further. This is a marked improvement of the development rate and comparable to embryo freezing. PMID- 2715309 TI - Pregnancy after vasovasostomy for vasectomy reversal: a study of factors affecting long-term return of fertility in 282 patients followed for 10 years. AB - The aim of this study was to determine the eventual fertility of those patients following vasectomy reversal who have no pressure-induced secondary epididymal blockage. These patients underwent simple vasovasostomy because at the time of the reversal surgery there were sperm present in large numbers in the vas fluid. It was possible to obtain long-term follow-up on 326 early patients who underwent vasectomy reversal 8-10 years ago. Two hundred and eighty-two of those patients had sperm in the vas fluid. These patients were studied for pregnancy rate and post-operative semen parameters in relation to presence or absence of sperm in the vas fluid at the time of vasectomy reversal, duration of time since vasectomy, pre-operative serum antisperm antibody titers, the influence of varicocoele and quantitative evaluation of testicular biopsy. All of the 44 patients with no sperm in the vas fluid remained azoospermic following vasovasostomy. Of the 282 patients with sperm in the vas fluid, 228 (81%) eventually impregnated their wives. Twenty-four patients with sperm in the vas fluid (9%) were azoospermic and did not impregnate their wives. Of the 258 patients who had sperm patency, the pregnancy rate was 88%. The number of mature spermatids per tubule in the testis correlated closely with the post-operative sperm count in patent cases. Quantitative evaluation of the testicular biopsy revealed normal spermatogenesis, even in patients with azoospermia or severe oligospermia post-operatively. Technical failures were due to blockage either at the vasovasostomy site, or epididymal blockage unrecognized at the time of vasovasostomy.2+perm count had a minimal impact on the PMID- 2715310 TI - Platelet aggregating activity in human embryo culture media free of PAF-acether. AB - A factor activating human platelets and liberated by the embryo was sought in the culture media of human embryos using two bioassays. The first bioassay demonstrated the existence of a thrombocytopaenic factor after the i.p. injection of culture media into splenectomized mice. This factor was found more frequently in media which contained an embryo compared to those which contained a non fertilized oocyte. PAF-acether (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine) was searched for with a specific bioassay, using washed rabbit platelets. This remained negative for all the media studied, including those which had contained an embryo giving rise to a pregnancy. In these experiments it was not possible to relate embryo-derived platelet activating factor (EDPAF) to PAF-acether. Neither were we able to use the detection of EDPAF to test embryonic viability, or attempt to identify those embryos which were susceptible to lead to a pregnancy after intrauterine transfer from among all the embryos transferred. PMID- 2715311 TI - Circulating levels of placental protein 12 and chorionic gonadotrophin following RU 38486 and gemeprost for termination of first trimester pregnancy. AB - First trimester termination of pregnancy was successfully induced in ten patients with RU 38486 followed 2 days later by a prostaglandin (Gemeprost) pessary. Human chorionic gonadotrophin (HCG) values remained unaltered until after the abortion. The levels of placental protein 12 (PP12) showed an immediate and significant fall following RU 38486, then rose to values substantially higher than those at the initial visit after 2 days. These findings show that RU 38486 has a direct inhibitory effect on tissues producing PP12 and confirm the progesterone dependency of this protein. PMID- 2715312 TI - The surrogate triplets of Perth, Western Australia. PMID- 2715313 TI - D-lactic acid measurements in the diagnosis of bacterial infections. AB - Body fluids suspected of bacterial infection were cultured and examined for the presence of D-lactic acid, a specific bacterial metabolite. We examined 206 patients and 264 specimens. D-Lactic acid was found in concentrations of greater than or equal to 0.15 mM in 11 of 11 infected and 6 of 40 noninfected ascitic fluids, 6 of 6 infected and 4 of 33 noninfected pleural fluids, 4 of 4 infected and 0 of 13 noninfected synovial fluids, and 26 of 27 infected and 2 of 130 noninfected cerebrospinal fluids. The overall sensitivity was 79.7%, and the specificity was 99.5% when the D-lactic acid concentration was at least 0.15 mM. The most important clinical utility of the D-lactic acid measurement appears to be for patients with bacterial infection in various body compartments and in patients who have already received antimicrobial therapy. An elevation in D lactic acid may indicate the presence of bacterial infection even when cultures are negative. PMID- 2715314 TI - Genetic and antigenic characterization of Borrelia coriaceae, putative agent of epizootic bovine abortion. AB - Borrelia coriaceae was characterized genetically and antigenically by utilizing the following techniques: restriction endonuclease analysis, Southern blotting and genomic hybridization, pulsed-field electrophoresis, sodium dodecyl sulfate polyacrylamide gel electrophoresis, and immunoblotting. The B. coriaceae genome revealed unique and characteristic banding patterns both by agarose gel electrophoresis and by hybridization when compared with several Borrelia burgdorferi isolates. Pulsed-field gel electrophoresis demonstrated several linear plasmids ranging from 65 to 30 kilobase pairs. Cross-reaction with B. burgdorferi antigens ranging from 21 to 26 kilodaltons were demonstrated by immunoblotting with rabbit anti-B. coriaceae antiserum. However, most B. coriaceae antigens were quite distinct when compared with B. burgdorferi and Leptospira interrogans antigens. PMID- 2715315 TI - Phialophora repens, an emerging agent of subcutaneous phaeohyphomycosis in humans. AB - A 63-year-old Japanese man had phaeohyphomycosis that occurred as a solitary subcutaneous nodule on the dorsal aspect of his left hand. In the nodule there were foci of mixed granulomatous and suppurative infiltrations circumscribed by thick fibrous tissue reaction. The foci contained short septate hyphae and occasionally small rounded aggregates of irregularly branched septate hyphae, both of which were nonpigmented or rarely weakly pale brown. Fungal culture from the nodule was positive for a dematiaceous mold. The mycologic features of the mold were typical of Phialophora repens. The infection was successfully treated by excision of the nodule. This is the second reported case of infection due to P. repens. PMID- 2715317 TI - Use of an enzyme-linked immunosorbent assay for detection of Treponema hyodysenteriae infection in swine. AB - Discriminate analysis was used to evaluate the enzyme-linked immunosorbent assay (ELISA) for the detection of anti-Treponema hyodysenteriae antibodies in experimentally and naturally infected swine. In trial 1, 26 pigs were randomly divided into three groups (naturally infected, n = 8; experimentally infected, n = 11; and noninfected, n = 7), and samples were collected for 10 weeks. For trial 2, 31 pigs were randomly divided into two groups (naturally infected, n = 22; and noninfected, n = 7), and samples were collected for 20 weeks. Rectal swabs for T. hyodysenteriae isolation were collected daily, and fecal samples for isolation of Salmonella spp. were collected weekly. Serum samples for ELISA evaluation were collected biweekly (trial 1) or weekly (trial 2). Results of discriminate analysis indicated that the ELISA correctly identified 90% or more of the individually infected pigs at prior probabilities of infection ranging from 60 to 90%. The test correctly identified noninfected pigs at a lower rate (61 to 92% range). The mean ELISA titers of naturally infected pigs without clinical signs were not significantly different (P less than 0.05) from the titers of both groups of experimentally infected pigs. Mean ELISA titers of naturally infected pigs without clinical signs were significantly greater than the mean titers of naturally infected pigs with clinical signs. Naturally infected pigs with clinical signs had a mean ELISA titer that was significantly greater than that of noninfected pigs and significantly less than the mean titers of the experimentally infected pigs without clinical signs and the naturally infected pigs without clinical signs. PMID- 2715316 TI - Variation in penicillin-binding protein patterns of penicillin-resistant clinical isolates of pneumococci. AB - A large number of pneumococcal isolates (over 80 strains) from a variety of geographic locales and representing a spectrum of resistance levels from a penicillin MIC of 0.003 microgram/ml up to an MIC of 16 micrograms/ml were analyzed for their penicillin-binding protein (PBP) patterns. With a few exceptions, the great majority of strains with penicillin MICs up to about 0.05 microgram/ml contained the same set of five PBPs with molecular sizes typical of those of susceptible pneumococci. In strains with penicillin MICs of about 0.1 microgram/ml and up, virtually all isolates showed two common features: (i) all isolates showed loss of PBP 1A (98 kilodaltons) with or without a parallel appearance of a "new" PBP that ranged in molecular size between 96 and 97 kilodaltons; and (ii) in strains with penicillin MICs of 0.5 microgram/ml or more, PBP 2B could not be detected on the fluorograms even with very high concentrations of radioactive penicillin. Beyond these two common features, resistant strains with similar penicillin MICs showed a surprising variety of PBP profiles (i.e., in the number and molecular sizes of PBPs), each characteristic of a given isolate. We suggest that in pneumococci remodeling of critical PBPs in more than one way may result in comparable levels of penicillin resistance. PMID- 2715318 TI - Diagnosis of Giardia lamblia infections by detection of parasite-specific antigens. AB - Antigen detection methods may facilitate diagnosis of Giardia lamblia in stool specimens. As determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis and immunoblotting, G. lamblia cysts and trophozoites share several antigens, especially in the 65-kilodalton and 30- to 34-kilodalton regions. By using blind methods, we compared results obtained by counterimmunoelectrophoresis using cyst-immune rabbit serum and by enzyme-linked immunosorbent assay (ELISA) using trophozoite-immune rabbit serum with results obtained by microscopic examination of a preserved, concentrated, and permanently stained stool specimen. Results were similar when these three methods were used to examine 118 stool specimens from clinical microbiology laboratories (53 specimens with G. lamblia) and specimens from 239 day-care-center toddlers (39 specimens with G. lamblia). Compared with microscopy, we found, for counterimmunoelectrophoresis and ELISA, respectively: sensitivity, 88 versus 94%; specificity, 97 versus 95%; positive predictive value, 86 versus 76%; negative predictive value, 98 versus 97%; and concordance, 89%. The false-positive rate by ELISA was 24% (10 of 42) in day-care-center toddlers but only 3% (1 of 32) in healthy adults (P less than 0.04) as corroborated by microscopy. This discrepancy suggests that the ELISA may be more sensitive than microscopy, which is considered the reference standard, and that results may be dependent, in part, on the epidemiology of the infection in the study subjects. PMID- 2715319 TI - Ultrastructure and chemical analysis of Campylobacter pylori flagella. AB - Flagella of Campylobacter pylori were analyzed by electron microscopy and purified, and the molecular weight of the flagellin was determined. Isolation of flagella was performed by mechanical shearing from the cell surface, sucrose density gradient centrifugation, and Sepharose CL-4B gel chromatography. The flagella of C. pylori differ from those of other Campylobacter species and of most other bacteria by the presence of a flagellar sheath. The sheath narrows at the end and is linked to a club-shaped terminal structure. The molecular weight of C. pylori flagellin was 51,000. PMID- 2715320 TI - Cellular fatty acid compositions and isoprenoid quinone contents of 23 Legionella species. AB - The cellular fatty acid compositions and ubiquinone contents of 182 Legionella strains representing 23 species were determined by capillary gas-liquid chromatography and reverse-phase high-performance liquid chromatography, respectively. Except for the type strain of Legionella erythra (ATCC 35303T), all Legionella species contained large (40 to 90%) amounts of branched-chain fatty acids and only trace to small (less than 0.5 to 5%) amounts of ester-linked hydroxy acids. The 23 species were placed in three major fatty acid groups on the basis of differences in the relative amounts of 14-methylpentadecanoic (Ci16:0), hexadecanoic (C16:1), and 12-methyltetradecanoic (Ca15:0) acids. All Legionella species contained ubiquinones with 9 to 14 isoprene units in the side chains and were divided into five different ubiquinone groups. The species were further differentiated into 16 groups on the basis of qualitative and quantitative differences in their fatty acid compositions and ubiquinone contents. Both of these chemical characteristics can be used to distinguish Legionella species from other gram-negative bacteria and rapidly and accurately identify suspected isolates before serologic and other tests are done. PMID- 2715321 TI - Microbial burdens in disposable and nondisposable ventilator circuits used for 24 and 48 h in intensive care units. AB - One hospital sought to study the differences in using resterilizable permanent versus disposable ventilator circuits and changing the circuits on a 24-h versus a 48-h basis. Over a period of 13 months 656 condensate samples from 92 permanent and 72 disposable circuits were collected and plated by a loop dilution technique. Two samples were collected from the inspiratory limb (humidifier; tubing or nebulizer), and two were collected from the expiratory limb (tubing and trap) of each circuit. Contamination rates were higher for disposable circuits than for permanent circuits and for 48-h changes than for 24-h changes. Results of chi 2 testing by site indicated there was more contamination on the inspiratory and expiratory limbs each with use of disposable circuits than with the use of permanent circuits. The total results (chi 2 analysis) showed significantly greater microbial growth with the use of disposable circuits (permanent versus disposable, P less than 0.001) and extension of time to 48-h changes (24 h versus 48 h, P less than 0.05). In the experience of this hospital permanent circuits proved more advantageous from the standpoint of contamination risk and cost. PMID- 2715322 TI - Synthetic exfoliative toxin A and B DNA probes for detection of toxigenic Staphylococcus aureus strains. AB - Two methods for the detection of exfoliative toxin (ET) from Staphylococcus aureus were compared: (i) a phenotypic assay, electrosyneresis, and (ii) a genotypic assay, staphylococcal DNA hybridization with oligodeoxynucleotide probes. The probes were chosen from the previously determined sequences of serotype A and B of ET, one probe for serotype A and another for serotype B. Strains exhibiting ET production in electrosyneresis always possessed the ET gene(s). Conversely, some strains not exhibiting ET production in electrosyneresis harbored the ET gene(s). The latter strains produced levels of ET. ET-negative phage group 2 strains of S. aureus as well as tested coagulase negative staphylococci did not possess the ET gene(s). The sensitivity of the DNA hybridization technique was 10(6) bacteria or 100 ng of genomic DNA. PMID- 2715323 TI - Comparative virulence of human isolates of coagulase-negative staphylococci tested in an infant mouse weight retardation model. AB - Human infections caused by coagulase-negative staphylococci have steadily increased in numbers and severity. Causes may be the use of artificial prostheses, immunocompromising chemotherapy and radiation therapy, and sophisticated surgical techniques, to name a few. Although the infectivity of coagulase-negative staphylococci as a group has been well documented for humans, attempts to study the pathogenesis of infections caused by individual species of coagulase-negative staphylococci have been hampered by the lack of an animal model that is not refractory to infection by these organisms. In the study reported here, a 2-day-old-mouse weight retardation test was used to assay the virulence of 60 clinical and reference strains of coagulase-negative staphylococci. These strains represented eight species of coagulase-negative staphylococci. The most virulent strains were demonstrated to be of the species Staphylococcus haemolyticus, S. saprophyticus, and S. epidermidis. The data further suggest that production of slime is a marker of virulence in S. epidermidis and that intraspecies differences in virulence occur. PMID- 2715324 TI - Improved colorimetric assay for detecting influenza B virus neutralizing antibody responses to vaccination and infection. AB - An automated neutralization test for influenza B virus is described in which antibody titers are determined according to the release of neutral red from infected or uninfected cells of the Madin-Darby canine kidney line. Endpoints are determined in a standard enzyme-linked immunosorbent assay reader. The test requires no expensive immunologic reagents and was used to evaluate responses to both vaccination and natural infection against influenza B virus. Overall responses to vaccination were comparable with those obtained by hemagglutination inhibition, using Tween-ether-split influenza B/Ann Arbor/1/86 virus as the antigen (the HI-TE test). The sensitivities of neutralization responses compared with those obtained by the HI-TE test for two vaccines were 88 and 89%; the specificities were lower at 61 and 60%, respectively. Responses to vaccination, measured by hemagglutination inhibition, were significantly higher with split virus compared with whole virus. However, seroconversion by both the HI-TE and neutralization tests was observed in 5 of 10 individuals from whom virus was detected by either culture of nasal or throat washings or the presence of antigen from immunofluorescence in cells from nasal washings. PMID- 2715325 TI - Serodiagnosis of erythema migrans and acrodermatitis chronica atrophicans by the Borrelia burgdorferi flagellum enzyme-linked immunosorbent assay. AB - The diagnostic performance of an enzyme-linked immunosorbent assay (ELISA) using purified Borrelia burgdorferi flagella as test antigen was compared with that of a B. burgdorferi sonic extract ELISA. We tested sera from 200 healthy controls, 107 patients with erythema migrans (EM), 50 patients with acrodermatitis chronica atrophicans (ACA), and 98 patients with various dermatological disorders without clinical evidence of active Lyme borreliosis. The flagellum ELISA was significantly more sensitive than the sonic extract ELISA. With sera from patients with EM, the diagnostic sensitivity for immunoglobulin G (IgG) antibody detection increased from 11.2 to 35.5% (P less than 0.001) and for IgM antibody detection it increased from 16.6 to 44.8% (P less than 0.001). In the flagellum ELISA, the number of positive tests increased significantly (P less than 0.005) when the duration of EM exceeded 1 month, but still only about 50% of patients with longstanding (1 to 12 months) untreated EM were IgG seropositive. Concomitant general symptoms did not affect the antibody level, whereas patients with multiple erythema were more frequently seropositive. All sera from patients with EM which were positive in the sonic extract ELISA were also positive in the flagellum ELISA. Not only did the overall number of positive tests increase, but the flagellum ELISA yielded a significantly better quantitative discrimination between seropositive patients and controls (P less than 0.002). IgG antibodies to the B. burgdorferi flagellum were found in all sera from patients with ACA, indicating persistence of an antiflagellum immune response in late stages of Lyme borreliosis. IgM reactivity in sera from patients with ACA was shown to be unspecific and the result IgM rheumatoid factor. A rheumatoid factor was detected in sera from 32% of patients with ACA, compared with 7.5% of patients with EM. The improved diagnostic performance, the ease of standardization of the flagellum antigen, and the lack of strain variation make the B. burgdorferi flagellum a needed reference antigen for growing routine serology in Lyme borreliosis. PMID- 2715326 TI - Epidemiological typing of Enterobacter aerogenes. AB - The applicability of Enterobacter cloacae and Klebsiella typing reagents for classifying clinical strains of Enterobacter aerogenes was evaluated. Of 75 strains, none were agglutinated by E. cloacae O antisera or were sensitive to E. cloacae bacteriophages. In contrast, 70 strains reacted with Klebsiella capsular antisera. Two-thirds of the strains were lysed by Klebsiella typing phages. A set of five E. aerogenes bacteriocin producers classified 92% of strains into 15 sensitivity types. In conclusion, E. aerogenes may be typed with Klebsiella reagents, and the simple bacteriocin test provides further discrimination between strains. The limited number of capsular antigens in the species and their apparent similarity to Klebsiella capsular antigens warrant further investigation. PMID- 2715327 TI - Synthesis and secretion of phospholipase C by oral spirochetes. AB - Four strains of oral treponemes and Treponema phagedenis Reiter synthesize and secrete phospholipase C (PLC), which was detected by the hydrolysis of p nitrophenylphosphorylcholine. PLC was detected in gingival crevicular fluid from diseased but not from healthy sulci. The initiation and progression of periodontal lesions may begin with the hydrolysis of membrane phospholipids by PLC. PMID- 2715328 TI - Catheter-related bacteremia caused by Oerskovia turbata. AB - A case of Broviac catheter-related bacteremia in a 3-year-old boy infected with Oerskovia turbata is discussed. The blood cultures of the patient remained positive despite antibiotic therapy, and only with catheter removal was his blood sterilized. The microbiology and antimicrobial susceptibilities of this organism are described. PMID- 2715329 TI - Equine zygomycosis caused by Conidiobolus lamprauges. AB - A 15-year-old Arabian mare from southern Louisiana with a 2-month history of periodic epistaxis and severe weight loss had a large, fibrosing, granulomatous mass containing numerous nodules ("kunkers") projecting dorsally into the nasopharynx, and was euthanized at the owner's request. In addition to these kunkers, the mass contained a single trematode tentatively identified as Fasciola hepatica. Several kunkers were removed, washed thoroughly in sterile water and embedded in nutrient agars; the fungus that grew out of them was identified as Conidiobolus lamprauges Drechsler (Entomophthorales: Ancylistaceae). This is the first report of C. lamprauges from any vertebrate mycosis, and only the third Conidiobolus species reported from vertebrates. Unlike many other entomophthoraleans, the fungus isolated from this mycosis grew well at 37 degrees C. The possible means by which Conidiobolus species may infect vertebrates is discussed. These mycoses probably result most often from chronic exposure during sleep to conidia discharged from fungal growth on decaying plant material in the bedding. PMID- 2715330 TI - Comparison of bacteria with and without plasmid-encoded proteins as antigens for measurement of immunoglobulin M, G, and A antibodies to Yersinia enterocolitica by enzyme-linked immunosorbent assay. AB - Yersinia enterocolitica serovar O:3 bacteria with and without plasmid-encoded proteins were compared as antigens in an enzyme-linked immunosorbent assay. Good correlations between the two antigen preparations were obtained for immunoglobulin M (IgM), IgG, and IgA antibodies of patients with yersiniosis. For routine diagnostic purposes, these antigens are considered equal. PMID- 2715332 TI - Diagnosis of rotavirus infection. PMID- 2715331 TI - Serum immunoglobulin G antibody subclass response to respiratory syncytial virus F and G glycoproteins after first, second, and third infections. AB - Serum samples from 31 children who experienced two or three infections with respiratory syncytial virus (RSV) in the first four years of life were tested in an enzyme-linked immunosorbent assay to examine the immunoglobulin G (IgG) subclass responses to the RSV F and G surface glycoproteins associated with primary infection and reinfection. We sought to determine whether the greater degree of glycosylation of the G glycoprotein was reflected in an IgG subclass immune response more like that to a polysaccharide antigen than to a protein antigen. We found that the IgG1/IgG2 ratio of postinfection antibody titers to F was fourfold higher than that to the G glycoprotein after RSV infections 1, 2, and 3. The IgG2 response to the heavily glycosylated G glycoprotein differed from that to a polysaccharide antigen in that the IgG1/IgG2 ratio remained constant with age, whereas the response to a polysaccharide antigen decreased as the IgG2 response increased with age. We also noted that antibody responses to both surface glycoproteins in the IgG1 and IgG2 subclasses reached their maximum levels after RSV infection 2. PMID- 2715333 TI - Reagents for diagnosis of Chlamydia trachomatis infections. PMID- 2715334 TI - Towards public sector goals: New Zealand's recent experience in health services reorganization. PMID- 2715335 TI - Government procurement leverage. PMID- 2715336 TI - The Future of Public Health: the Institute of Medicine's 1988 report. AB - A long list of enduring and emerging public health issues have raised questions about the capacity of the public health service system to address these concerns. A two-year Institute of Medicine study revealed a system in disarray. It is inappropriately politicized, and public health responsibilities have become so fragmented that deliberate action is often difficult. The Institute of Medicine's committee emphasized that these issues are complex and affect our society broadly. It called for comprehensive action to bring about necessary changes including a clear delineation of the mission of the public health service system and improvement in technical, political, managerial and programmatic skills of public health practitioners. PMID- 2715337 TI - The cigarette advertising broadcast ban and magazine coverage of smoking and health. AB - At the time of the cigarette broadcast advertising ban, which took effect in 1971, cigarette manufacturers rapidly shifted advertising expenditures from the broadcast media to the print media. In the last year of broadcast advertising and the first year of the ban, cigarette ad expenditures in a sample of major national magazines increased by 49 and then 131 percent in constant dollars. From an 11-year period preceding the ban to an 11-year period following it, these magazines decreased their coverage of smoking and health by 65 percent, an amount that is statistically significantly greater than decreases found in magazines that did not carry cigarette ads and in two major newspapers. This finding adds to evidence that media dependent on cigarette advertising have restricted their coverage of smoking and health. This may have significant implications for public health, as well as raising obvious concerns about the integrity of the profession of journalism. PMID- 2715338 TI - Development of behaviorally-based policy guidelines for the promotion of exercise. AB - We describe the results of a project to develop policy guidelines to promote increased levels of participation in regular physical activity in Australia. Theories of behavior change, and research findings concerning factors influencing the adoption and maintenance of exercising, were used as an information base for policy development. This information was presented and organized in the form of eleven behaviorally-based principles designed to be of use to practitioners, administrators and policy makers. Nine policy recommendations were developed from these principles, and from the contributions of people with practical administrative and political expertise in the field. Specific, focused campaigns, the provision of pleasant and convenient facilities, and an awareness of the process of behavior change and of the limitations imposed by environmental and social factors were emphases of the final recommendations. These may have relevance for similar work in North America and other developed countries. Some comments on the process involved in moving from an interpretation of behavior change theories and basic research to the development of usable recommendations are offered. The project illustrates an approach to using a behavioral-science knowledge base for the development of public health principles and policies which have the potential to be of practical use. PMID- 2715339 TI - National health systems as market interventions. AB - National health systems have developed in all countries; their features have been shaped largely by organized interventions in the free market of health service. Any health system can be characterized through analysis of five major components: (1) its production of resources, (2) organization of programs (including a residual private market), (3) sources of economic support, (4) modes of management, and (5) patterns of providing services. The diverse types of health systems in the world may be categorized in a matrix derived from two dimensions: (a) the economic level (four steps), and (b) the political ideology of the health system, scaled (also four steps) from highly entrepreneurial (minor market intervention) to socialist (nearly complete market intervention). Every national health system would fit into one of the 16 cells of this matrix, although positions change as a result of economic and political dynamics. PMID- 2715340 TI - An agenda for public health. PMID- 2715341 TI - The health status of Cuba: recommendations for epidemiologic investigation and public health policy. AB - The health status of Cuba is described in comparison with Costa Rica and, in some instances, the United States. Recommendations are made for epidemiologic studies and for specific health policies to lower death rates from diarrhea and enteritis, cardiovascular disease, cancer, and injuries. Rapid expansion of training and research in epidemiology and biostatistics is emphasized, and specific goals for health outcomes for the year 2000 are suggested. PMID- 2715342 TI - Comments on the Institute of Medicine's report: The Future of Public Health. United States Conference of Local Health Officers. PMID- 2715343 TI - NACHO's response to the IOM report: The Future of Public Health. National Association of County Health Officials. PMID- 2715344 TI - Health care in rural America: the crisis unfolds. Joint Task Force of the National Association of Community Health Centers and the National Rural Health Association. PMID- 2715345 TI - Development and characterization of monoclonal antibodies reactive with paraquat. AB - A set of three anti-paraquat monoclonal antibodies(MoAbs), named APM-1, APM-2 and APM-3, has been isolated. In order to evaluate the ability of these MoAbs to recognize various kinds of bipyridyl herbicides and similar congeners of paraquat, a competition enzyme-linked immunosorbent assay (ELISA) using avidin biotin complex (ABC) was developed. All three antibodies strongly recognized paraquat and slightly did the other analogs. These three MoAbs are therefore advantageous to a toxicological study of paraquat and of its localization in tissues. PMID- 2715346 TI - Preparation of 125I-labeled human growth hormone of high quality binding properties endowed with long-term stability. AB - 125I-labeled human growth hormone (125I-labeled.hGH) was prepared by using two variants of the chloramine T labelling procedure and purified by polyacrylamide gel electrophoresis (PAGE) of the reaction mixture. Variant A produced a tracer with high specific activity (100 +/- 10 microCi/microgram), high maximal binding capacity to antibodies (93%) and long-term stability (at least 150 days at -20 degrees C). No diiodinated tyrosil residues could be detected in this tracer. Variant B was devised to obtain higher yields of labeled hormone. The electrophoresis of the iodination mixture revealed two radioactive components with Rm values of 0.49 and 0.55 which result from the iodination of hGH variants preexisting in the starting material. Both tracers had similar specific activities (70 +/- 10 microCi/microgram), high maximal binding capacity to antibodies or receptors (80-100%, after 80 days of their obtention) and high stability (at least 100 days at -20 degrees C). It is concluded that the iododerivatives of hGH obtained by either method are adequate to perform radioimmunoassay and receptor studies and have long-term stability. PMID- 2715347 TI - The production and characterisation of monoclonal antibodies against human prolactin and the development of a two-site immunoradiometric assay. AB - Monoclonal antibodies against human prolactin (PRL) have been produced and characterised and used to develop a sensitive two-site immunoradiometric assay (IRMA). Nine anti-PRL monoclonal antibodies were assessed for reactivity in immunoblotting experiments with PRL, hPL, hGH and pituitary gland extract. There was no detectable crossreactivity with hPL or hGH. In liquid phase radioimmunoassay (RIA) studies using three of the antibodies there was no detectable crossreaction from hPL or hGH. Five antibodies were positive in immunocytochemical studies using sections of human pituitary gland. Using FPLC purified monoclonal antibodies, a two-site IRMA was developed that could assay PRL over the range 17.5-3500 mIU per litre and was readily adapted to assaying serum samples from patients. The two-site IRMA could be performed within one day without loss of sensitivity and has potential as a rapid and simple method for screening clinical samples. PMID- 2715348 TI - Gastric metaplasia and Campylobacter pylori infection of duodenum in patients with chronic renal failure. AB - Duodenal biopsy specimens from 80 patients with chronic renal failure, who were undergoing haemodialysis, were examined by light microscopy for evidence of inflammation, gastric metaplasia, and Campylobacter pylori infection. Chronic duodenitis was present in 47 (59%) of patients, of whom only seven (9%) showed evidence of active inflammation. Gastric metaplasia was present in 50 (62.5%) of patients, yet Campylobacter pylori was identified in only two patients (2.5%). It is suggested that the duodenal environment of patients with chronic renal failure remains hostile to the growth of these organisms in spite of the presence of gastric metaplasia. PMID- 2715349 TI - Ultrastructural study of two subtypes of gastric adenoma. AB - An ultrastructural study was performed to identify any differences in fine detail between type III and IV gastric polyps, which seem to differ from each other because they have different histological features and malignant potential. Clear ultrastructural differences were found, implicating microvilli, mucous granules, interdigitations, ribosomes, mitochondria and nuclei. Although these two subtypes have often been grouped together as borderline lesions or adenomas, the findings imply that they should be treated as essentially different. PMID- 2715350 TI - Mucosal argyrophil endocrine cells in pernicious anaemia and upper gastrointestinal carcinoid tumours. AB - The number and density of argyrophil endocrine cells were morphometrically calculated in gastric fundal mucosal biopsy specimens taken from 64 patients with pernicious anaemia (five with gastric carcinoids, 15 with nodular argyrophil cell hyperplasia, 44 with diffuse argyrophil cell hyperplasia) and from 14 healthy controls. Similar calculations were also made on the ileal mucosa away from the tumour of 10 patients with ileal carcinoids and 10 controls. In the stomach, the argyrophil cell counts were twice as high in the patients with pernicious anaemia than in controls and the densities in the whole mucosa or in the epithelial structures were similarly three to five times higher. The cell counts in the patients showed positive correlation with the serum gastrin concentration. The patients with nodular argyrophil cell hyperplasia and gastric carcinoids formed a uniform group with the highest cell counts and serum gastrin concentrations; the difference between the groups was in the longer duration of pernicious anaemia in the patients with carcinoid tumours. On the other hand, no endocrine cell hyperplasia was seen in those with ileal carcinoids. It is concluded that fundal mucosal endocrine cells show an increase in patients with pernicious anaemia that is related to the gastrin concentration. This phenomenon may favour the development of hyperplastic endocrine cell nodules and, eventually, carcinoid tumours. PMID- 2715351 TI - Histopathological assessment of bleeding from polyps of the colon and rectum. AB - One hundred and twenty seven colorectal polyps were examined to assess histopathological evidence of recent and old haemorrhage to test the usefulness of faecal occult blood tests in detecting colorectal neoplasia, in particular premalignant adenomas. Evidence of haemorrhage was consistently found in adenomas but was rare in non-neoplastic polyps. Haemorrhage within adenomas was predominantly stromal and associated with dilated, congested vessels. Factors associated with more severe haemorrhage were size, pedunculation, and villous growth; the degree of epithelial dysplasia and the age and sex of the patient were not associated factors. Proximal polyps showed more old haemorrhage than rectal polyps, but there was no such difference for recent haemorrhage. PMID- 2715352 TI - Bone histology in young adult osteoporosis. AB - Bone histology was quantitated in 10 osteoporotic patients aged between 17 and 51 years and in six healthy subjects aged between 23 and 43 years. The osteoporosis was of varying aetiology and was clinically stable. All patients were given tetracycline before biopsy and double tetracycline labelling was used in seven patients. Bone forming and resorbing surfaces were defined by the presence of osteoblasts and osteoclasts, respectively, which were identified by histochemical techniques. The associations between bone forming and resorbing surfaces were similar in patients and controls, though the range of values was wider in the patients than in the controls. Mineral apposition rate was normal in the osteoporotic patients, but there was a reduction in mineralising (tetracycline) surface, whether related to osteoid surface or to osteoblast surface. This did not indicate osteomalacia as the directly and indirectly measured mineralisation lag times were normal. The osteoid seams were thinner in osteoporotic patients than in controls. The data suggest that osteoclast and osteoblast numbers were normal in this group of osteoporotic patients but that the metabolic activity of osteoblasts was impaired. PMID- 2715353 TI - New direct method for measuring red cell lithium. AB - A new direct method for the measurement of red cell lithium was compared with the indirect method. Good correlation (r = 0.97) was found and the coefficients of variation of the direct and indirect methods were 3.9% and 5.5%, respectively. In the direct method red cells suspended in choline chloride were centrifuged through dibutyl phthalate, which removes plasma adherent to the cells. A haemolysate is made of the sedimented red cells. The lithium concentration of this was measured by atomic absorption spectrophotometry. There are many conflicting reports about the value of red cell lithium, and methodological problems have been proposed as a reason for this. It is suggested that the simpler, more precise direct method described here should be used in future. PMID- 2715354 TI - Is thrombocytopenia seen in patients with leptospirosis immunologically mediated? PMID- 2715355 TI - Non-Hodgkin's lymphoma and Hodgkin's lymphoma in the same patient. PMID- 2715356 TI - Nucleolar organiser regions and proliferative index in glandular and squamous carcinomas of the cervix. PMID- 2715357 TI - Granulomas of the kidney induced by Bacillus Calmette Guerin (BCG) PMID- 2715358 TI - Slide coagulase positive, tube coagulase negative Staphylococcus aureus. PMID- 2715359 TI - Hair "follicle" in tonsil. PMID- 2715360 TI - Quantification of periodontal attachment at single-rooted teeth. AB - The measurement process of attachment loss has been criticized in recent years. Problems with clinical interpretation, precision of the measurement, and statistical manipulation of the obtained data, are some of the problems associated with the present methodology. The purpose of the present study was to propose an alternative measurement process which addresses some of the existing problems by estimating the lost attachment surface area (LAS) and the remaining attachment surface area (RAS) from a combination of clinical measurements. The results show that a linear combination of several sources of clinical information can be used to predict RAS and LAS. A diagnostic model for LAS (R2 = 81.5%) predicts the square root of LAS with information obtained from bucco-lingual attachment level measurements, the radiographic lost attachment area, the gingivitis index and the radiographic tooth length. This model increases the precision of the estimate of LAS by a factor of 1.86 when compared to the estimate of LAS using only attachment level measurements. A diagnostic model for RAS (R2 = 75.5%) predicts the square root of RAS with the information obtained from the remaining radiographic attachment area, the gingivitis index and the mobility index. Both linear inference models are constructed with measurements of anatomical landmarks to avoid the discrepancy between anatomical and clinical measurements in the produced estimates. It is concluded that modeling of periodontal data provides a simple, inexpensive, and precise diagnostic tool for predicting the lost and the remaining periodontal attachment of single-rooted teeth. Measurement processes of this type could provide a convincing basis for the evaluation of clinical decisions and research questions. PMID- 2715361 TI - Scanning electron microscopic examination of pocket wall epithelium and associated plaque in localized juvenile periodontitis. AB - The purpose of this investigation was to describe the morphologic characteristics of epithelial-associated plaque in periodontal pockets of patients with localized juvenile periodontitis (LJP). 25 tissue specimens obtained from 10 adolescent patients were examined by scanning electron microscopy. Specimens were evaluated to determine the following specific features: (1) distribution of microbial colonies on the epithelial surface; (2) topographic features of pocket epithelium associated with microbial colonies; and (3) the predominante microbial morphologic types comprising the colonies. Observations made during this investigation revealed the following. (1) The surface epithelium in the coronal one-third of the pocket wall was essentially healthy in appearance and exhibited no distinct microbial colonies or unusual topographic features. (2) The surface epithelium in the middle one-third area featured randomly-dispersed microbial colonies consisting of 3 major morphotypes: cocci, bacilli and coccobacilli. Also in this zone, there was morphologic evidence of microbial penetration of the epithelial barrier along intercellular spaces. (4) The apical one-third zone was characterized by lymphocytic infiltration, epithelial cavitation and ulcerations, and singular organisms entrapped in fibrin meshworks. There were no distinct microbial colonies in this zone, although individual spirochetes, fusiforms, filamentous organisms, and short and long rods were observed. PMID- 2715362 TI - Neutrophil chemotactic behaviour in patients with early-onset forms of periodontitis (I). Leading front analysis in Boyden chambers. AB - Despite some reports to the contrary, it is generally assumed that early-onset forms of periodontal disease (including both juvenile and rapidly progressive periodontitis) are associated with a defect in neutrophil (PMN) chemotactic behaviour. Using the Boyden chamber technique and N-formyl-methionyl leucylphenylalanine (FMLP) to assess locomotion by the leading front method, we have failed to show any evidence for such depressed PMN locomotion. Indeed, when PMN chemotaxis and chemokinesis are considered in response to a range of chemoattractant doses our results indicate significant enhancement of all but random locomotion. When taken together with other studies, our results suggest that PMNs from patients with early-onset periodontitis may show abnormal locomotory behaviour which can either be enhanced or reduced in nature. The extent to which these results reflect in vitro methodology in uncertain and, furthermore, their in vivo significance is unclear. PMID- 2715363 TI - Neutrophil chemotactic behaviour in patients with early-onset forms of periodontitis (II). Assessment using the under agarose technique. AB - The locomotory behaviour of peripheral blood neutrophils (PMNs) from patients with juvenile (JP) and rapidly progressive (RPP) forms of early-onset periodontal disease was studied using the under agarose technique and n-formyl-methionyl leucyl-phenylalanine (FMLP) as the chemotractant. PMNs from experimental patients showed normal random, chemotactic and chemokinetic locomotory behaviour when compared with control subjects. Further investigation of single-cell movements using time-lapse video analysis also failed to show any significant differences in locomotory behaviour between the PMNs of experimental and control individuals. We conclude that differences in technique may account for much of the variation which exists in the literature with respect to PMN locomotion in periodontal disease. In the final analysis, it is difficult to dispute direct observation of moving cells, and using this approach, we have been unable to confirm the presence of any PMN locomotory defect in our series of patients with early-onset periodontal disease. PMID- 2715364 TI - The in vitro effects of chlorhexidine on subgingival plaque bacteria. AB - The purpose of this study was to determine the susceptibility to chlorhexidine of a range of bacteria which may be isolated from subgingival plaque. In addition, the effect of chlorhexidine on the survival of bacteria in subgingival plaque samples from patients with chronic inflammatory periodontal disease was investigated. The minimum inhibitory concentration (MIC) of chlorhexidine for 52 strains of bacteria ranged from 8 to 500 micrograms/ml. The modal value of the MIC was found to be 62 micrograms/ml, 64% of the strains tested being inhibited at this concentration. A concentration of 250 micrograms/ml of chlorhexidine inhibited the growth of all bacteria in the 25 subgingival plaque samples investigated. The MIC of chlorhexidine for the samples ranged from 31 to 250 micrograms/ml, the modal value being 125 micrograms/ml. PMID- 2715365 TI - Early plaque colonization on human cementum. AB - We have described the morphology of developing plaque on cementum in an in vivo human model. Slabs of cementum obtained from sound teeth, rendered anorganic with 5% sodium hypochlorite, were glued to orthodontic brackets and positioned on the upper canines, premolars and molars in 8 volunteers. The brackets were removed after 2, 4, 8, 24 h and processed for scanning electron microscopy (SEM). Within 2 h, a thin pellicle covered the cementum surface, with few micro-organisms detectable. At 4 and 8 h, coccoid plaques were present. Filaments inserted perpendicularly to the plaque surface were seen at 24 h. The results indicate that early bacterial colonization of human cementum is a selective process, mediated by an organic pellicle and mainly involves cocci. PMID- 2715366 TI - An interindividual variability in the sensitivity of atrioventricular node to diltiazem in patients with paroxysmal supraventricular tachycardia. AB - To study the sensitivity of atrioventricular (AV) node to diltiazem in seven patients with paroxysmal supraventricular tachycardia (PSVT), we analyzed the plasma concentration-response relationship of this Ca-antagonist using AH interval as an index for assessing its Ca channel blocking effect on the AV node after an IV infusion (0.4 mg/kg). The postdose AH intervals were prolonged compared with the baseline, and their percentage changes correlated significantly (P less than 0.01) with log-diltiazem concentrations in all patients. However, drug concentrations associated with a 20% prolongation of AH interval differed considerably among the patients (range; 65 to 260 ng/ml), indicating a large interindividual variability in the sensitivity of AV node to diltiazem. These results suggest that the interindividual difference in the responsiveness of AV node to diltiazem-induced Ca channel blocking effect may be one of the possible explanations for the therapeutic failure of this Ca-antagonist for terminating PSVT or preventing its recurrences in certain patients. PMID- 2715367 TI - Propafenone disposition in renal insufficiency and renal failure. AB - The pharmacokinetics of a single intravenous dose of propafenone were studied in subjects with normal renal function (n = 5), renal insufficiency (n = 5), and renal failure (n = 3). No difference in central volume of distribution, total ischemic clearance or terminal half-life existed. None of the pharmacokinetic parameters examined correlated to creatinine clearance. Within the confines of the small number of patients studied, there does not appear to be any effect of renal insufficiency or failure on single-dose propafenone disposition. PMID- 2715368 TI - Disposition of guanadrel in subjects with normal and impaired renal function. AB - The disposition of a single 25 mg oral dose of guanadrel was evaluated in 22 subjects with various degrees of renal function. The terminal elimination half life was significantly prolonged in subjects with a creatinine clearance (ClCr) less than 30 mL/min/1.73 m2 (19.2 +/- 16.8 h) compared to 3.7 +/- 1.9 h in subjects with a ClCr greater than 80 mL/min/1.73 m2. Apparent total body clearance (Clp/F) was also progressively lower in the patients with decreased renal function and the decline was significantly correlated with ClCr (Clp/F = 0.0294 + 0.0236 Clcr, r = 0.74, P = 0.002). Renal clearance and apparent nonrenal clearance also declined as creatinine clearance decreased, and both were significantly correlated with the observed ClCr. Apparent volume of distribution averaged 11.5 +/- 8.9 L/kg and did not differ in patients with decreased renal function compared to those with normal renal function. Thus, the disposition of guanadrel is significantly altered in the presence of renal insufficiency and dosage adjustments may be necessary, especially in patients with ClCr less than 50 ml/min. PMID- 2715369 TI - Transdermal clonidine compared with hydrochlorothiazide as monotherapy in elderly hypertensive males. AB - Sixteen of 22 elderly male patients (aged 60-74 years) who had previously taken only hydrochlorothiazide 50 mg completed a study evaluating the safety, efficacy, and tolerability of 12-20 weeks of transdermal clonidine (Catapres TTS) as monotherapy for mild hypertension. Thirteen of the sixteen patients (81%) responded to transdermal clonidine which was begun after 28 days of placebo. Five patients discontinued transdermal clonidine therapy because of intolerable skin irritation, and one because of daytime fatigue. Clonidine caused none of the metabolic effects we observed with hydrochlorothiazide: no change in serum potassium, uric acid, cholesterol, or triglyceride. Eleven of the 22 patients (50%) who began the study experienced a skin reaction under the transdermal clonidine patch. The incidence of dry mouth and fatigue in patients using transdermal clonidine was dose-related and similar to reports of dry mouth and fatigue in patients taking oral clonidine tablets. Rebound hypertension occurred in one patient upon withdrawal of transdermal clonidine. There was no effect of transdermal clonidine or hydrochlorothiazide on cognitive function or emotional state tested with three questionnaires. Overall, transdermal clonidine, in various doses, was as effective as hydrochlorothiazide in elderly male hypertensive patients. The effectiveness of both was inversely proportional to the level of untreated blood pressure. The high incidence of skin reactions limited prolonged use of transdermal clonidine in our patients. PMID- 2715370 TI - Dosing regimen of gentamicin during intermittent peritoneal dialysis. AB - The peritoneal clearance of gentamicin was studied in 11 chronic uremic patients who undergoing intermittent peritoneal dialysis. Gentamicin was significantly removed by peritoneal dialysis with a clearance value of 9.75 +/- 3.78 ml/min. The serum half life was 14.08 +/- 3.57 hr, a value significantly less than that of non dialysed end stage renal disease patients. The mean apparent volume of distribution of the drug in these patients was about 27% of body weight. The derived value for gentamicin peritoneal clearance and volume of distribution can be used to calculate maintenance dose during intermittent peritoneal dialysis. In order to achieve the peak level of 8 micrograms/ml, supplementary dose compensated for the loss during peritoneal dialysis is approximately 40% of loading dose 0.8 mg/kg every 12 hours. PMID- 2715371 TI - Phase I study of E1040, a new parenteral cephem antibiotic. AB - The safety and pharmacokinetics of E1040, a new injectable cephem antibiotic, were evaluated in healthy volunteers. In single-dose studies, 125, 250, 500, 1000 and 2000 mg of E1040 were administered by I.V. infusion over 1 hour. Results of 5 minutes I.V. infusions of 500, 1000 and 2000 mg of the drug were also studied. Plasma concentration-time profiles were well suited to a two-compartment open model. The half-life of elimination from plasma was 1.85 +/- 0.16 hours, and the Cmax and AUC paralleled the doses given. The mean urinary recovery within the first 24 hours was 85.7 +/- 6.43% of the dose. In a multiple-dose study, 2000 mg of E1040 (I.V. over 1 hour) was administered every 12 hours (total 9 times) and no abnormal accumulation of the drug in plasma was observed. There were no significant differences in plasma levels or in urinary recoveries between single- and multiple-dose regimens. There were no subjective or objective abnormal findings definitely attributable to the drug except that one subject given 250 mg over 1 hour reported diarrhea, and another complained of nausea during the infusion of 2000 mg over 5 minutes. From these results E1040 was concluded to be safe and well tolerated. PMID- 2715372 TI - Absolute bioavailability and noncompartmental analysis of intravenous and intramuscular Cefotan (cefotetan) in normal volunteers. AB - Cefotetan (1 g) was administered to 12 normal volunteers as a 30 minute intravenous infusion and as an intramuscular injection. The pharmacokinetic parameters were estimated using noncompartmental analysis. The mean +/- SD maximum plasma concentration, terminal half-life, and systemic clearance after intravenous infusion were 158 +/- 21 micrograms/mL, 4.54 +/- 1.05 hours, and 29.1 +/- 3.8 mL/min/1.73 m2, respectively. Renal clearance and nonrenal clearance accounted for 63.1% and 36.9% of the systemic clearance, respectively. The mean +/- SD maximum plasma concentration, time to maximum concentration, terminal half life, and absolute bioavailability after intramuscular injection were 75.5 +/- 8.7 micrograms/mL, 1.33 +/- 0.48 hours, 4.32 +/- 0.77 hours, and 0.931 +/- 0.193, respectively. Moment analysis gave average +/- SD mean residence times (MRT) of 4.98 +/- 0.75 and 5.86 +/- 0.77 hours after intravenous and intramuscular administration, respectively. The average +/- SD mean absorption time (MAT) after intramuscular injection was 1.11 +/- 0.57 hours. The mean +/- SD steady-state volume of distribution after intravenous infusion was 0.129 +/- 0.024 L/kg. The mean +/- SD cumulative percentage of the dose excreted in the urine in 24 hours were 61.1 +/- 11.4% and 50.4 +/- 13.5% after intravenous and intramuscular dosing, respectively. The maximum urinary cefotetan concentrations occurred during the first 2 hours after dosing by both routes of administration. Cefotetan tautomer was detected in the plasma and urine of all subjects after both routes of administration, but the mean concentrations were only minimal compared to those for cefotetan. In conclusion, intramuscular cefotetan (1 g) is rapidly and almost completely absorbed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715373 TI - The pharmacokinetics of 2.5- to 10-mg oral doses of minoxidil in healthy volunteers. AB - The dose proportionality of minoxidil was investigated by studying its pharmacokinetics after administration of single, oral doses of 2.5, 5.0, and 10.0 mg. The study, which was a Latin square cross-over design, was performed in 30 young, nonobese, normal subjects. Treatments were separated by a 4-day washout period. Serum and urine levels of minoxidil were determined by high-performance liquid chromatography (HPLC) and radioimmunoassay (RIA). Supine blood pressure and pulse were monitored during each study phase. Minoxidil concentrations determined by RIA were highly correlated with concentrations determined by HPLC; only the HPLC data was used in the pharmacokinetic analyses. No significant effects were observed for dose normalized Cmax, tmax, volume of distribution, minoxidil renal clearance, or the percentage of the dose excreted as either minoxidil or minoxidil glucuronide. Significant differences in apparent oral clearance, dose normalized AUC, and terminal elimination rate constant (beta) were observed between the 2.5-mg dose and the higher doses, but no differences in these parameters between the 5.0- and 10.0-mg doses were apparent. Thus, the available data support dose-independent pharmacokinetics for minoxidil over this range of doses. Repeated measures analysis of variance detected significant time and treatment effects on supine blood pressure and pulse rate, but the effects were generally small and of little clinical significance. The results support the hypothesis that minoxidil has little effect on blood pressure in normotensive subjects. PMID- 2715374 TI - Pharmacokinetic equivalence of 5(ethyl(2H)5)- and unlabelled phenobarbitone. AB - The present study shows the absence of in vivo pharmacokinetic isotope effect on phenobarbitone (PB) C5-ethyl deuteration (PBd5) following oral administration to man of equimolar PB/PBd5 mixtures (0.40 mmol each). Plasma PB and PBd5 (17 days) and urine PB, PBd5 and parahydroxy-metabolites (PBOH, PBHOd5) levels were determined by GC-MS. Isotope effect research includes comparison of pharmacokinetic parameters, study of time-dependence of isotope ratios (IRs) in plasma and urine (linearity test), comparison of IRs between samples and administered mixtures (Mann Whitney's test) and comparison of PBOH/PBOHd5 ratios before and after urine enzymatic hydrolysis (Student's two tailed t-test). No significant isotope effect was observed on pharmacokinetic parameters, PB hydroxylation or PBOH conjugation (x less than or equal to 5%); which the absence of pentadeuteration-induced alteration in PB's HSA binding parameters (binding mode, Ka, N) corroborates (x less than or equal to 5%). These results establish bioequivalence of PB and PBd5; the latter can be used with benefit in stable isotope clinical pharmacology (steady state pharmacokinetics, drug interactions...) investigations as well as bioavailability studies of PB preparations. PMID- 2715375 TI - Flurbiprofen in post-partum women: plasma and breast milk disposition. AB - The plasma and milk disposition of flurbiprofen (FB) was assessed in healthy women during the early post-partum period after multiple doses of FB. The results confirmed that a pragmatic study design is an attainable requirement for definitive statements about the excretion of FB in transitional milk. Nine doses of FB (50 mg per dose) were administered during three days. Paired milk and plasma samples were obtained during this period of dosing as well as after the last dose. The plasma data were used to derive an equation, which was then used to simulate cumulative plasma profiles for multiple doses given at unequal time intervals. The observed data corresponded to the simulated cumulative profiles of FB in plasma. The plasma elimination half-life of FB during early lactation was slightly prolonged (mean 4.8 hrs) as compared to reported values for normal adult men. The peak plasma concentrations of FB were comparable to those reported for healthy volunteers. In 10 of 12 women (3-5 days post-partum) the FB concentration in breast milk was less than 0.050 micrograms/ml. In two women the milk concentrations of FB were 0.06, 0.07 and 0.07 micrograms/ml as found in only three samples. We conclude that, on the basis of dose found in milk, FB is safe for women breast feeding their infants in the early post-partum period. PMID- 2715376 TI - A study of correlates of speech production performance--an ecological approach. AB - The purpose of the present study was to identify and analyze predictors of speech production performance of hearing-impaired children. Teachers' ratings of 327 elementary school hearing-impaired students were studied in relation to demographic characteristics of the students, parental demographic characteristics, and educational treatment parameters. Better performance was found to be associated with better hearing, higher socioeconomic status of the family, consistent use of amplification, and later commencing of preschool training. These findings held when other variables were statistically controlled. The implications of these findings are discussed and suggestions for further research are made. PMID- 2715377 TI - How do aphasic and normal speaking subjects restate a message in response to feedback? AB - Seven aphasic and seven normal subjects (Ss) viewed and described 25 cartoon drawings. While Ss described individual pictures the experimenter provided one of three types of feedback: explicit feedback, for example, "Can you tell me anything else about it?"; false feedback, for example, asking a question about another picture; or implicit feedback, for example, "I can't find it." five types of responses (recodings) were tallied. These included deletion, expansion, repetition, revision, and "other communicative behaviors." It was found that (1) the normal Ss used significantly more expansion and deletion than the aphasics; (2) there were no significant differences between the groups for repetition, revision, and "other communicative behaviors"; and (3) the Ss' recodings varied depending on the type of feedback presented. PMID- 2715378 TI - VOT and dysarthria: a descriptive study. AB - The purpose of this paper was to investigate whether voice onset time differences occurred among speakers exhibiting four different types of dysarthria. Twenty dysarthric speakers were used as subjects: five spastic, five flaccid, five ataxic, and five hypokinetic. Repeated utterance tasks using /p lambda/, /t lambda/ and /k lambda/ were analyzed using spectrography. All the speakers exhibited phonetic errors in their voice onset time productions, with voice onset times occurring in the range of values between voiced and voiceless stops. The spastic speakers exhibited shortest voice onset times while the flaccid and ataxic speakers exhibited significantly more voice onset time variability than the spastic and hypokinetic speakers. The short voice onset times exhibited by these speakers were related to the physiologic demands of voiceless stop productions. PMID- 2715379 TI - Speech acceptability and olfaction in laryngectomees. AB - A number of hypotheses concerning the causal relationships and interrelationships between esophageal speech acceptability, olfactory abilities, and airflow volume in laryngectomees were tested. To assess the hypotheses, data were collected from 25 laryngectomees and comprised the following: (1) A measure of speech acceptability using a standard passage of prose; (2) odor identification test results in which 14 common odorants were used; (3) odor threshold test results in which an 11-step aqueous dilution series of l-butanol was used and: (4) a measure of nasal airflow volume in liters per minute. The null hypotheses linking speech acceptability, olfaction, and airflow volume were all tested and none of the path coefficients was significant. The results are discussed in relation to observations made by Gilchrist [Acta Otolaryngol. (Stockh.) 75:511-518 (1973)], who noted that those esophageal speakers who attained good speech maintained a greater sensitivity to smell. The findings in the present study do not support Gilchrist's observations. PMID- 2715380 TI - Types of repairs used by normally developing and language-impaired preschool children in response to clarification requests. AB - Competent communicators learn to regulate and modify speech within a conversational dyad. Speech modifications may entail selecting appropriate words, reducing the complexity of utterances, or elaborating for clarification [Leonard Top. Lang. Disord. 4:28-37 (1983)]. This study was designed to examine how 4- to 5 1/2-year-old language-impaired children respond to clarification requests; how their repairs differ from two groups of matched controls; and how type of request affects the repair. Fifteen boys served as subjects, five with language impairments and 10 controls with normal language, half matched for age and cognition and half matched for verbal competence. Three types of requests were used: requests for confirmation, neutral requests, and requests for specific constituent repetition. All three groups of children in this study overwhelmingly used revisions to repair their original utterances. The repair strategies used by the language-impaired children did not differ from the controls. The clinical implications of the findings are discussed. PMID- 2715381 TI - Repeated readings using audiotaped material enhances oral reading in children with reading difficulties. AB - The method of repeated readings using audiotaped material was implemented in the present study by having poor readers aged 9-13 years listen to and read audiotaped stories until the passages could be read fluently without the tape. A same-age control group with similar reading difficulties was given an alternative reading program that was similar to that received by the experimental group (with respect to creative writing, spelling, phonics, and vocabulary development), but which differed in terms of passage reading exercises (controls read from basal readers, whereas the experimental group did repeated readings of audiotaped material). Only students in the repeated readings of audiotaped material group showed a significant effect of treatment on oral reading, whereas controls showed significantly larger gains in word attack skills. There were no between-group differences in silent reading, a close comprehension test, or isolated word recognition. The pattern of findings suggested that repeated readings of audiotaped material enhances oral reading ability of students with reading difficulties, but the effects of treatment do not generalize to a wide range of reading measures. PMID- 2715382 TI - Health care needs for children of the recently homeless. AB - Thirty families were surveyed at a shelter for the homeless in San Diego, California concerning the health care status and needs of their children. 56.7% of the families had no regular source of health care and 46.6% were not covered by any form of health coverage. Children whose families had a regular source of health care were more likely to have reported better health and more frequent checkups. Also, increased duration of homelessness was predictably correlated with poorer reported health of the children. Though the families sampled were representative of those recently made homeless i.e. less than six months, needs were identified that would be applicable to all homeless families. The most frequent needs the families expressed for their children were: general nonemergency clinics (76.7%), emergency services (66.7%), and dental services (66.7%). Nutritional and dietary counseling were chosen by 43.3% and only 6.7% of the parents rated social and psychological services as needed. PMID- 2715383 TI - An extramural dental education program in a rural setting in Florida. AB - An extramural dental education experience which is a required component of the University of Florida College of Dentistry is described. The program, established in 1977, is conducted on a contractual basis between the college and the Lafayette-Suwannee Rural Health Corporation, Inc., the governing body of the Dental Center clinic located in the town of Mayo, Florida, which is 65 miles from the dental school. The program has brought high quality comprehensive dental care to a previously underserved population. Dental students are provided with experiences that enhance social sensitization, and that are perceived by them as a help in bridging the gap between dental school and dental practice after graduation. The program has made valued contributions to the education, research, and service components of the dental school's mission. PMID- 2715384 TI - Ethical issues in primary health care: a survey of practitioners' perceptions. AB - While most health care is provided at the primary care level, little research has been done to document the ethical issues of such care. A stratified random sample of 702 physicians, nurses, physical therapist, and physician assistants within one southeastern state was surveyed to determine the frequency of ethical issues in primary care. The most frequently occurring issue concerned moral decisions about the amount of time to spend with each patient. A comparison of physician and nonphysician professional groups revealed significant differences in frequencies of the issues. Age had a slight impact on the responses, while gender, religion, and region of practice had none. The study showed that the most frequently occurring issues are pragmatic, not dramatic, and center on patient self-determination, adequacy of care and professional responsibility, and distribution of resources. PMID- 2715385 TI - Noradrenergic innervation of monkey prefrontal cortex: a dopamine-beta hydroxylase immunohistochemical study. AB - Norepinephrine has been implicated in the regulation of a number of cortical functions, yet relatively little is known about the anatomical organization of noradrenergic axons in the expanded and highly differentiated prefrontal cortex of primates. In this study, the distribution of fibers containing dopamine-beta hydroxylase (DBH), the enzyme that converts dopamine to norepinephrine, was characterized immunohistochemically in the prefrontal cortical regions of Old World cynomolgus monkeys (Macaca fascicularis) and New World squirrel monkeys (Saimiri sciureus). In both species, differences in the density of DBH-labeled fibers were detected both across and within many prefrontal cytoarchitectonic regions. In cynomolgus monkeys, area 8B had the greatest density of DBH immunoreactive fibers; within this region, the medial surface had a greater density of labeled processes than the dorsal surface. Areas 9 and 24 also had a high density of DBH-labeled fibers, areas 11, 12, 13 and 25 were of intermediate density, and portions of areas 10 and 46 had the lowest density of immunoreactive fibers. Regional differences in the density of DBH-immunoreactive fibers were also present in squirrel monkey prefrontal cortex. Despite the regional variations in the density of DBH-immunoreactive fibers, the laminar distribution of these fibers was very similar across cytoarchitectonic areas of cynomolgus prefrontal cortex. Layer I contained a low density of labeled fibers which were primarily tangential in orientation. The predominantly radially oriented fibers in layers II-IV were slightly higher in density. The density of both radially and tangentially oriented immunoreactive fibers increased substantially in layer V. Fiber density decreased in layer VI; a band of tangentially oriented fibers was present in the deep portion of this layer. With a few exceptions, the laminar distribution of DBH-immunoreactive fibers in the prefrontal regions of squirrel monkey cortex was similar to that of cynomolgus monkey. Since other data suggest that anti-DBH selectively labels noradrenergic axons in monkey neocortex, the distinctive innervation patterns exhibited by DBH-immunoreactive fibers reveal the regions and layers that may be the principal sites of action of norepinephrine in exerting its effects on prefrontal cortical function. PMID- 2715386 TI - Subcortical projections to the pontine nuclei in the cat. AB - In a systematic attempt to trace all projections from the brainstem and diencephalon to the pontine nuclei of the cat, implantations and injections of horseradish peroxidase-wheat germ agglutinin (HRP-WGA) or Fluoro-Gold were placed in the pontine nuclei of 21 cats. In most of the cases there was no evidence of spread of tracer outside the pontine nuclei. Retrogradely labeled cells in the brainstem and diencephalon were carefully mapped and counted. The number labeled cells in the brainstem and diencephalon ranged from 24 in cases with very small implantations to 3,490 in cases with large injections in the pontine nuclei (counts from every fifth section). The labeled cells are located bilaterally with an ipsilateral preponderance. After large injections, 25-38% of the labeled cells were located in the brainstem reticular formation, 10-16% in the pretectal nuclei, 10-15% in the hypothalamus, 7-9% in the zona incerta, 3-9% in the fields of Forel, 4-5% in the nucleus locus coeruleus, 3-5% in the ventral lateral geniculate body, 2-4% in the superior colliculus, 3% in the periaqueductal gray, and 14-15% in other parts of the brainstem. Judging from cases with small tracer deposits entirely confined to the pontine nuclei, there appear to be two types of subcortical inputs: Projections from the reticular formation, the nucleus locus coeruleus, the periaqueductal gray, and the raphe nuclei are widespread, presumably reaching all parts of the pontine nuclei, while projections from a diversity of other sources are localized, reaching limited parts of the pontine nuclei only or predominantly. PMID- 2715387 TI - Extension of the critical period for developmental plasticity of the corticospinal pathway. AB - The corticospinal tract (CST) of the rat undergoes a prolonged period of postnatal development. Lesions of the presumptive CST pathway at birth are followed by the aberrant rerouting of the developing corticospinal axons around the lesion site through adjacent undamaged CNS tissue. This developmental plasticity becomes severely restricted by 5-6 days of age, so the axons are no longer capable of growth around the site of injury. The aim of the current study was to determine whether altering the environment at the site of injury by filling the lesion with transplanted fetal spinal cord tissue could prolong the critical period for developmental plasticity of the corticospinal pathway. The spinal cord was damaged (overhemisection) at three stages in the development of the corticospinal (CS) pathway: 1) prior to the arrival of CS axons, 2) after the axons elongated through the cord but prior to synaptogenesis, and 3) after both axonal elongation and synaptogenesis were completed. One to 9 months later, anterograde neuronal tracing with horseradish peroxidase was used to assess the growth of the corticospinal pathway with or without a fetal transplant at the site of injury, and the pattern of labeling was compared with that observed in adult nonlesioned control animals. Our results indicate that the presence of a transplant prolongs the critical period for developmental plasticity of the CST. Transplants elicited growth of CST axons throughout the postnatal period examined. CST axons damaged prior to synaptogenesis exhibited more robust growth than those lesioned after synaptogenesis had been completed. These results suggest that both environmental and neuronal factors interact to regulate the response of immature CS neurons to injury. PMID- 2715388 TI - Effects of intraocular tetrodotoxin on the development of the retinocollicular pathway in the Syrian hamster. AB - The developing uncrossed retinocollicular projection in the Syrian hamster undergoes a characteristic set of changes during the first 2 postnatal weeks. The retinal fibres, which initially project across the whole superior colliculus, withdraw from the caudal part and their terminals become clustered into deep, discrete clumps rostrally. Coincident with these afferent changes, there is substantial retinal ganglion cell death. To examine whether neuronal activity plays a role in these changes, we made daily injections of the sodium channel blocker tetrodotoxin (TTX) into one or both eyes from postnatal day 2 or 4 up to day 12. Following TTX treatment, the uncrossed terminals retracted on schedule from the caudal and superficial parts of the superior colliculus and came to lie, as normal, in the deep layers rostrally. Within the rostral superior colliculus, however, the uncrossed terminals from TTX-injected eyes lost their characteristic patchy distribution and were arranged diffusely. When only one eye received TTX injections, this inhibiting effect on terminal segregation was seen only in the projections from the TTX-treated eye. The effect of TTX treatment on terminal segregation was much less severe than that of unilateral enucleation, after which uncrossed terminals persis throughout the entire superior colliculus. TTX injections appeared to have little effect on overall ganglion cell death since the total number of ganglion cells in the crossed projection from TTX-treated eyes was similar to that in normal eyes. However, the relative distribution of uncrossed cells in temporal and nasal retina was altered. In eyes that received TTX injections, the proportion of uncrossed cells in nasal retina was about 1.6 times that in normal animals and was close to the proportion seen in unilaterally enucleated animals. This increase in the treated eye occurred whether one or both eyes were injected with TTX. We conclude that neuronal activity plays a role in the segregation of uncrossed terminals into discrete clumps in rostral colliculus and in the preferential elimination of uncrossed cells from the nasal retina. The inactive uncrossed projections from TTX-treated eyes showed the greatest degree of disruption. The extent of the disruption was similar whether the crossed input from the other eye was active or inactive. This suggests that the activity-drive interactions between ganglion cells within one eye are more significant than those between the two eyes in shaping the final form of the uncrossed retinocollicular projection. PMID- 2715389 TI - Physiological, morphological, and cytochemical characteristics of a layer 1 neuron in cat striate cortex. AB - We have recorded from a small neuron in layer 1 of the striate visual cortex in a 34-day-old kitten. It had a simple, orientation-selective receptive field that was nondirectional and showed length summation. The neuron was injected intracellularly with horseradish peroxidase. Computer-aided reconstruction revealed that it had a dense axonal plexus confined to layer 1, elongated in the anteroposterior dimension. By means of an antibody directed against a GABA-like antigen, and postembedding immunocytohemistry, the neuron was found to be strongly immunoreactive. The main input to soma and dendrites of the neuron was from synapses that were not GABA-L-immunoreactive, and probably originated from pyramidal cells. The axon of the cell formed synapses on dendritic shafts and spines, whose most likely sources were the apical tufts of pyramidal cell dendrites. These data suggest that such neurons may be involved in local circuits that contribute to the formation of pyramidal cell receptive fields. PMID- 2715390 TI - Cytoarchitectural characteristic of the frontal eye fields in macaque monkeys. AB - The cytoarchitecture of the prearcuate gyrus, including the region of the physiologically defined frontal eye fields (FEF), was studied in four macaque monkeys (Macaca fascicularis, M. mulatta) to determine if the FEF could be anatomically identified. Brain sections were stained with standard Nissl and, in some cases, myelin stains. Two nonstandard planes of section were used: one tangential to the prearcuate gyrus and the second normal to the most posterior bend of the prearcuate gyrus. The first plane of section was advantageous for studying the location of the FEF with reference to the entire medial-lateral extent of the gyrus and the second allowed good comparisons of the FEF to adjacent anterior and posterior cortical areas. Frontal plane sections through the prearcuate gyrus were also examined in 15 macaque monkeys for comparison with sections cut normal to the posterior bend of the gyrus and tangential to the gyrus. Intracortical microstimulation was performed in three monkeys. The FEF was defined as the area from which low-threshold (less than or equal to 50 microA) saccades could be evoked. The area extended about 10 mm along the anterior bank of the arcuate sulcus. Within the area, saccade amplitudes were represented in a mediolateral, large-to-small topography. No topography of saccade direction was noted within FEF but reversals of saccade direction for any given electrode pass were found. These results confirm the results from our earlier mapping study of FEF (Bruce et al.: J. Neurophysiol. 54:714-734, '85). Cell bodies of large pyramidal cells in layers III and V of the prearcuate gyri from three hemispheres were measured with the aid of an image-combining computer microscope. The distribution of cells of greater than 22 microns diameter or cross-sectional areas of greater than 500 microns 2 were plotted. In one monkey, marker lesions made at microstimulation sites within the FEF or in adjacent non-FEF areas were also plotted. The location of the FEF appeared to coincide with the concentration of large layer V pyramidal cells in the prearcuate gyrus rather than with any previously mapped cytoarchitectonic area. The numbers of large pyramids in layer V were noticeably reduced along the lip of the prearcuate gyrus and at dorsomedial and ventrolateral locations which were outside the physiologically defined FEF. PMID- 2715391 TI - Laminar and areal differences in the origin of the subcortical projection neurons of the rat somatosensory cortex. AB - Fluorescent retrograde tracing techniques were employed in a double-labelling paradigm to determine the distribution of corticospinal, corticotectal, and corticotrigeminal projection neurons in layer Vb of the adult and neonatal rat somatosensory cortex. The double-labelling paradigm allowed a direct comparison of the cortical distribution of neurons projecting to each target and identification of neurons projecting to more than one target. In the adult rat, each population of projection neurons was found to have a unique laminar and/or areal distribution. Corticospinal projection neurons were located throughout the width of layer Vb in the medial granular portion of somatosensory cortex, while corticotrigeminal projection neurons were distributed throughout the width of layer Vb in the more laterally located dysgranular portion of somatosensory cortex. Corticotectal projection neurons were located more superficially in layer Vb than either corticospinal or corticotrigeminal projection neurons and found scattered throughout both dysgranular and granular somatosensory cortex. Each combination of subcortical injections also resulted in double labelling a small percentage of uniquely distributed neurons. These distribution differences coupled with measurements of cell size allowed us to identify the parent population of the dual projection neurons. Subpopulations of corticotectal neurons also project to the brainstem trigeminal complex and to the spinal cord. Subpopulations of corticotrigeminal neurons also project to the spinal cord, and a proportion of corticotrigeminal neurons projects to at least two targets within the brainstem trigeminal complex (nucleus principalis and subnucleus interpolaris). In the adult rat, corticospinal neurons (as defined by either laminar position or somal size) did not appear to give off collaterals to either the superior colliculus or brainstem trigeminal complex. In the neonatal rat, double-labelled neurons which project to both the spinal cord and the tectum are distributed throughout the full width of layer Vb, rather than restricted to the superficial portion of the layer as in the adult rat. Further, it appears as if the ontogenetic change in the laminar distribution of corticospinal and tectal projection neurons is achieved by mechanisms of selective process elimination rather than cell death. These results are discussed in terms of both the developmental factor which may contribute to the discrete distribution of cortical projection neurons found in the adult and the functional significance of bifurcating projection neurons. PMID- 2715392 TI - Morphology of single, physiologically identified retinogeniculate Y-cell axons in the cat following damage to visual cortex at birth. AB - It has been reported previously that neurons in the dorsal lateral geniculate nucleus (LGN) of cats with neonatal damage to visual cortex (KVC cats) have receptive fields that are abnormally large and that the receptive fields of these neurons sometimes do not appear to conform to the normal retinotopic order in the LGN. A primary aim of this study was to determine if these physiological abnormalities are related to inappropriate patterns of retinogeniculate connections. We therefore have analyzed the terminal arbors of retinogeniculate axons in adult cats that had received a lesion of visual cortex (areas 17, 18, and 19) on the day of birth. Single retinogeniculate axons were characterized physiologically and injected intracellularly with horseradish peroxidase. Consistent with earlier reports that neonatal removal of visual cortex results in a retrograde loss of retinal X-cells, all of the retinogeniculate axons that we recorded were from Y-cells. While the visual responses of these Y-cell axons were normal, the morphology of their terminal arbors in the LGN was abnormal. Retinal Y-cell axons in KVC cats have terminal fields in the A laminae of the LGN that are as large or larger than those of normal Y-cells. However, since the LGN in KVC cats is severely degenerated, single Y-cell arbors occupy a proportional volume of the LGN that is 12 times greater than normal. Thus an early lesion of visual cortex produces a severe mismatch between retinogeniculate axon arbor size and target size. Also, despite the normal size of retinogeniculate axon arbors in KVC cats, the number and density of terminal boutons are greatly decreased. Thus our morphological results suggest that the unusually large receptive fields of LGN cells in KVC cats and the relative lack of retinotopic precision in the LGN are due, at least in part, to anomalies in the relative size and distribution of retinogeniculate axon arbors that develop after neonatal removal of visual cortex. PMID- 2715393 TI - Plasticity of frequency organization in auditory cortex of guinea pigs with partial unilateral deafness. AB - We have examined the effect of restricted unilateral cochlear lesions on the orderly topographic mapping of sound frequency in the auditory cortex of adult guinea pigs. These lesions, although restricted in spatial extent, resulted in a variety of patterns of histological damage to receptor cells and nerve fibres within the cochlea. Nevertheless, all lesions resulted in permanent losses of sensitivity of the cochlear neural output across a limited frequency range. Thirty-five to 81 days after such damage to the organ of Corti, the area of contralateral auditory cortex in which the lesioned frequency range would normally have been represented was partly occupied by an expanded representation of sound frequencies adjacent to the frequency range damaged by the lesion. The thresholds at their new characteristic frequencies (CFs) of clusters of cortical neurones in these regions were close to normal thresholds at those frequencies (mean difference across all animals was 3.8 dB). In a second series of experiments, the responses of neurone clusters were examined within hours of making similar cochlear lesions. It was found that shifts in CF toward frequencies spared by the lesions could occur, but thresholds were greatly elevated compared to normal (mean difference was 31.7 dB in five animals). The emergence of sensitive drive in such regions after prolonged recovery periods in lesioned animals thus suggests that the auditory cortical frequency map undergoes reorganization in cases of partial deafness. Some features of this reorganization are similar to changes reported in somatosensory cortex after peripheral nerve injury, and this form of plasticity may therefore be a feature of all adult sensory systems. PMID- 2715394 TI - Response to anaemia in experimental Trypanosoma vivax infection of sheep. AB - Trypanosoma vivax produced a progressive macrocytic normochromic anaemia in sheep during the acute phase of infection. Reticulocytes were absent from the blood of healthy sheep and of sheep with T. vivax-induced anaemia. However, anaemia induced artificially (AHA) in sheep by in vitro heat treatment of red cells, which was comparable in classification and degree to the anaemia of T. vivax infection, produced a reticulocytosis of 1.5 +/- 1.0 per cent. When plasma from the anaemic blood of sheep infected with T. vivax for two and four weeks was inoculated subcutaneously into mice, the reticulocyte response was similar to that of mice that received no sheep plasma and inferior to that elicited by normal sheep plasma. The anaemic plasma from sheep infected with T. vivax for three weeks induced a moderate reticulocyte response in mice which was, however, less intense than that induced by plasma from sheep with artificially induced anaemia of comparable intensity. These results indicate that, although the macrocytosis suggests that T. vivax-induced anaemia in sheep is slightly responsive, this response is suboptimal since reticulocytes were lacking in the blood of the sheep and their plasma was weakly erythrogenic in mice. This contrasts with the mild reticulocytosis in sheep with AHA of the same intensity and classification, whose plasma also stimulated considerable erythropoiesis in mice. The poor stimulation by plasma from T. vivax-infected sheep at two and four weeks post-infection suggests subnormal erythropoietin at these periods of infection. PMID- 2715395 TI - Immunohistochemical localization of immunoglobulins in bovine granulomatous lesions. AB - The immunohistochemical distribution of IgG, IgA and IgM in granulomatous lesions caused by Actinomyces bovis, Actinobacillus lignieresi, Actinomyces (Corynebacterium) pyogenes, Pseudomonas aeruginosa, Staphylococcus aureus and Mycobacterium bovis was studied. Numerous IgG-containing cells (plasma cells) were distributed in the peripheral connective tissue layers, but not in the epithelioid cell layer. A few scattered IgA- and IgM-containing cells were found in all the lesions examined. Mycobacterial granulomas contained fewer IgG-cells than did non-mycobacterial granulomas. Eosinophilic club-shaped bodies were found in A. bovis, A. lignieresi, P. aeruginosa and S. aureus, but they were generally negative for IgG, IgA and IgM. PMID- 2715396 TI - The epithelial pathology of bovine genital tuberculosis. AB - The histopathology of the uterine and salpingeal epithelium of five cows affected with genital tuberculosis was studied. Both optical and scanning electron microscopy were used and the results were compared. Various forms and degrees of cellular lesions are described, including hypertrophy, flattening, detachment, nuclear protrusions and alterations of the cilia. In the different sites considered (uterus: intercaruncular and caruncular areas; salpinges: isthmus and ampulla) various characteristic lesions were observed. PMID- 2715397 TI - Infection of pigs with the Cameroon isolate (Cam/82) of African swine fever virus. AB - African swine fever (ASF) was produced in eight pigs by exposure to donors infected with the Cameroon/82 isolate of African swine fever virus. The primary clinical sign was pyrexia of more than 40 degrees C first observed 10 to 13 days post-exposure (dpe) in all pigs; other clinical signs were rarely observed. The most frequent post-mortem lesion was haemorrhage in the visceral lymph nodes. Other lesions included excess fluid in the abdominal cavity and petechial haemorrhages in the kidneys. Viraemia was first observed 1 to 2 days before the onset of pyrexia and maximal titres of more than 10(7.5) HAD50 per ml occurred 11 to 14 dpe. Virus excretion by the pharyngeal route was observed at 2 to 4 days before the onset of pyrexia and continued throughout the course of infection. Susceptible pigs, mixed directly with infected ones, contracted infection within 2 h; transmission time increased to 2 to 6 h when recipient pigs were separated by wire mesh from the infected pigs. The comparatively low mortality, ill-defined clinical signs and clinical recovery of many of the infected pigs show that the Cam/82 ASF virus is of relatively low virulence and thereby resembles recent European, South American and Caribbean isolates. PMID- 2715398 TI - Further analysis of lethal factors in cycloheximide-treated mice given low doses of bacterial lipopolysaccharide. AB - Endotoxin challenge (0.2 micrograms per mouse) 6 h after a standard dose of cycloheximide was compared with the previously-reported effects of simultaneous injection of cycloheximide and endotoxin. With the submicrogram dose of endotoxin given 6 h after cycloheximide, fatalities occurred without evidence of thrombogenic bilateral renal cortical necrosis which characterized mice dying after the two agents were given together. Anticoagulation with heparin or with ancrod is life-saving, indicating that cycloheximide-treated mice were fatally susceptible to fibrinogen-to-fibrin conversion, and that, in contrast to the situation where cycloheximide and endotoxin are given simultaneously, there was no essential demand for supplementary glycocorticosteroid. A dose of 5.0 micrograms of endotoxin given 6 h after cycloheximide was fatal; again no renal cortical necrosis occurred, but both ancrod and hydrocortisone were essential to ensure survival. PMID- 2715399 TI - A quantitative morphological study of the bovine vaginal epithelium during the oestrous cycle. AB - Samples were collected post mortem from 28 cycling parous cows. At all stages of the oestrous cycle, the cranial vaginal epithelium was thinner (P less than 0.001), had fewer cell layers (P less than 0.001) and proportionally more superficial columnar cells (P less than 0.001) than more caudal regions. At all stages of the cycle there were more intraepithelial lymphocytes caudally than in more cranial regions (P less than 0.001). At oestrus the proportion of superficial columnar cells was maximal, having increased from the late dioestrus proportions of 1, 29 and 40 per cent of all superficial cells to 15, 54 and 83 per cent in caudal, middle and cranial regions, respectively (P less than 0.02). However, the epithelial thickness in all regions of the vagina was greatest at metoestrus (P less than 0.02). At this stage, the number of cell layers was greater than at any other stage (P less than 0.05). PMID- 2715400 TI - Osteocartilaginous metaplasia of the right atrium in male domestic sheep. AB - Among 53 clinically healthy male sheep with epididymitis, nine had minimal to severe firm nodular thickening of the right atrial wall at necropsy. The two most severely affected atria were about three times normal size. Histologically, the atrial masses consisted of partly mineralized cartilage nodules with lipid-filled cavities and basophilic to eosinophilic trabeculae. Further investigation failed to reveal clues as to etiopathogenesis of these lesions. PMID- 2715401 TI - Siliceous pneumoconiosis in two dogs. AB - A siliceous pneumoconiosis was detected in two dogs by light microscopical, transmission electron microscopical and elemental analysis methods. Aluminium and silicon were the predominant elements and were present in macrophages associated with airways and vessels. The significance and origin of the deposits are discussed. PMID- 2715402 TI - Hodgkin's disease in a killer whale (Orcinus orca). AB - Hodgkin's disease (HD) is reported in a killer whale (Orcinus orca). Generalized lymphadenopathy and splenomegaly were noted at necropsy and histopathological examination revealed diffuse proliferation of atypical large cells with huge eosinophilic nucleoli. They were often multinucleated, and binucleated forms characteristic of Sternberg-Reed cells of human HD were occasionally present. There was no cytological atypia in the background lymphocytes. Thus, the lesion was identified as analogous to HD in man. To our knowledge, this is the first recorded case of HD in the killer whale. PMID- 2715403 TI - Penile melanosis. AB - Five patients with penile melanosis are described. The lesions consisted of macular hyperpigmentation of the penile shaft and/or glans. Histologically only hyperpigmentation of the basal cell layer was observed with no melanocytic hyperplasia. Patients had follow-up for 3 to 13 years; enlargement of some lesions was observed, but the condition remained benign. The main differential diagnostic problem was with acral lentiginous melanoma. Penile melanosis shares clinical and microscopic features with Laugier-Hunziker syndrome of the buccal mucosa and vulvovaginal melanosis. We suggest that the three disorders be grouped as essential melanotic hyperpigmentation of mucosa. PMID- 2715404 TI - Cutaneous diseases preceding diagnoses of lymphoreticular malignancies. AB - Dermatology visits during a 5-year period before the diagnosis of lymphoreticular malignancy in 258 subjects were reviewed and compared with visits made by 258 randomly selected, age- and sex-matched control subjects in the same period. Six of the 96 patients with leukemia and none of their matched controls (p less than 0.05) had cutaneous malignancies 20 to 60 months before the diagnosis of leukemia. There was no increase in cutaneous malignancies preceding lymphoma. A common factor predisposing to both cutaneous malignancy and leukemia, such as a defect in immunosurveillance, is suggested. PMID- 2715405 TI - Malignant melanoma associated with human immunodeficiency virus infection in three homosexual men. AB - This report concerns three patients with human immunodeficiency virus (HIV) infection in whom malignant melanoma developed. One patient had metastatic malignant melanoma, one had iris melanoma, and one had a single skin melanoma. All three had lower absolute numbers of CD4+ cells than a control group, and the severity of their disease was inversely proportional to the absolute number of CD4+ cells. This report suggests an association between the immunodeficiency resulting from HIV infection and the development of malignant melanoma. PMID- 2715406 TI - Circadian rhythm of natural killer cell activity in vitiligo. AB - Ten patients with vitiligo, either in the active (six cases) or static (four cases) phase, and twelve healthy control subjects were studied with a standard cytotoxicity assay to evaluate the circadian rhythm of natural killer cell activity from peripheral blood mononuclear cells. The natural killer cell activity was measured at the zero, sixth, twelfth, and eighteenth hours of the day. The results demonstrated that patients with vitiligo had significantly higher natural killer cell activity compared with normal controls. When patients with static and active vitiligo were compared, those with the static form had increased natural killer cell activity at all times except noon, whereas those with active form had increased natural killer cell activity only at 0600 and 1800. These changes shifted the acrophase of the circadian rhythm of each group. Indeed, by cosinor analysis, both patients with vitiligo and normal controls had similar circadian rhythms, but the acrophase was shifted from 0602 in control subjects to 0435 in the ten patients with vitiligo. The acrophase in the six patients with active vitiligo was found to be closest to that of normal controls (0508). These findings indicate that natural killer cell activity abnormalities are more marked in the static rather than in the active form of vitiligo. PMID- 2715407 TI - Annular erythema: a possible association with primary Sjogren's syndrome. AB - In four patients with primary Sjogren's syndrome a distinct annular erythema developed, which was characterized by a wide, elevated border (which can be likened to a doughnut ring) and central pallor. Histologically, there was a coat sleeve-like infiltration of lymphocytes around blood vessels and nuclear debris in the connective tissue. Vasculitis or epidermal changes suggestive of lupus erythematosus were not observed, and there was no immunoglobulin deposition along the basement membrane zone. This annular erythema may be a cutaneous manifestation of Sjogren's syndrome. PMID- 2715408 TI - Skin cancer in patients with chronic radiation dermatitis. AB - The cases of 76 patients with chronic radiation dermatitis resulting from low dose ionizing radiation for benign disease were reviewed retrospectively for risk factors leading to the development of neoplasia. The patients were studied with respect to original hair color, eye color, sun reactive skin type, benign disease treated, area treated, age at treatment, and age at development of first skin cancer. Analysis of data showed 37% of patients had sun-reactive skin type I, 27% had type II, and 36% had type III. Types IV through VI were not represented. There appeared to be an overrepresentation of types I and II. Increased melanin pigmentation may therefore be either directly or indirectly protective against the development of skin cancers in patients who have received low-dose superficial ionizing radiation for benign disease. The sun-reactive skin type of patients with chronic radiation dermatitis may be used as a predictor of skin cancer risk when the total dose of ionizing radiation is not known. PMID- 2715409 TI - Cutaneous changes of dermatomyositis precede muscle weakness. AB - A retrospective review of 50 patients with dermatomyositis was performed to determine the temporal relationship between onset of muscle weakness and skin involvement. We found that cutaneous changes sometimes preceded muscle weakness more than a year before the onset of muscle weakness. These findings suggest that the characteristic dermatomyositis eruption without muscle weakness should not preclude a diagnosis of dermatomyositis, and these cases should be carefully followed. PMID- 2715410 TI - Linear focal elastosis (elastotic striae). AB - Three patients are described who had a distinctive clinical and histologic presentation of dermal elastosis. Sunlight apparently played little role in the development of this elastotic change. To the best of our knowledge, this is the first report of this form of elastosis. PMID- 2715411 TI - Disseminated ecthymatous herpes varicella-zoster virus infection in patients with acquired immunodeficiency syndrome. AB - Herpesvirus infections are among the most common and debilitating opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS), and they may have atypical clinical features. We describe the cases of three patients with AIDS in whom atypical persistent ulcerative skin lesions developed as a result of varicella-zoster virus infection. Two patients had disseminated infection without a vesicular stage; one patient had underlying asteatotic eczema. All responded well to acyclovir. One patient was treated with azidothymidine, and typical dermatomal herpes zoster subsequently developed. The profound loss of helper T cell function in AIDS may lead to multiple abnormalities in local immune response to cutaneous herpesvirus infections and may be responsible for the atypical morphology and a prolonged course. PMID- 2715412 TI - Interpretation of Mohs micrographic frozen sections: a peer review comparison study. AB - The ability of the Mohs surgeon to interpret frozen sections generated during Mohs surgery has been questioned recently. In this study 1000 Mohs micrographic slides were interpreted by a Mohs surgeon and subsequently by a general pathologist. The disputed slides were then reviewed independently by two Mohs surgeons, two pathologists, and a dermatopathologist. Overall, there was a 98.9% agreement in interpretation among the Mohs surgeons, the pathologists, and the dermatopathologist. Results would indicate that a well-trained and experienced Mohs surgeon is competent to interpret slides prepared under his or her supervision during Mohs surgery. PMID- 2715413 TI - The enigma of fogo selvagem. PMID- 2715414 TI - White blood cells as mediators of hyperviscosity-induced tissue damage in neutrophilic vascular reactions: therapy with pentoxifylline. PMID- 2715415 TI - Untreated relapsing secondary syphilis with meningitis. PMID- 2715416 TI - Coexistence of pemphigus foliaceus and Sheehan's syndrome: a case report. PMID- 2715417 TI - Felted hair untangled. PMID- 2715418 TI - Laryngeal involvement in dermatitis herpetiformis: case report. PMID- 2715419 TI - An immunohistologic study on eccrine gland carcinoma. PMID- 2715420 TI - Localized trichorrhexis nodosa. PMID- 2715421 TI - Chemical removal of splinters without epidermal toxic effects. PMID- 2715422 TI - Guttate psoriasis and vitiligo: anatomic cohabitation. PMID- 2715423 TI - "Skin is in". PMID- 2715424 TI - The misspelling of pruritus. PMID- 2715425 TI - Colposcopic examination of men. PMID- 2715426 TI - Misuse of the term colposcopy. PMID- 2715427 TI - Do it yourself--how to produce a disposable electrosurgery electrode. PMID- 2715428 TI - Ultraviolet A sunscreen evaluations in normal subjects. AB - We have used a specially modified xenon arc solar simulator to examine ultraviolet A (UVA) protection of a research sunscreen formulation. UVA doses were given to sunscreen-protected and unprotected skin with the use of irradiance values of 50 mW/cm2 and 100 mW/cm2. Erythemal responses were evaluated 5.2 +/- 0.9 hours later and again 24.4 +/- 1.8 hours later. The overall mean unprotected UVA minimal erythema dose (MED) was 23.6 joules/cm2 (SD = 4.8) and the mean UVA protection factor (APF) was 3.2 (SD = 0.78). Neither irradiance nor evaluation time significantly affected MED or APF. These preliminary findings indicate that the modified solar simulator permits convenient determination of sunscreen APF. The APF of a sunscreen is analogous to SPF: APF refers to UVA protection, while SPF refers to protection from the entire solar spectrum, predominantly from the effects of UVB. PMID- 2715429 TI - Effects of occlusive and semiocclusive dressings on the return of barrier function to transepidermal water loss in standardized human wounds. AB - Clinical observation and histologic examination of excised wounds have confirmed that occlusive dressings promote rapid wound reepithelialization. However, normalization of barrier function has not been routinely assessed in studies of occlusive dressing effects on wound healing. We examined the effects of occlusive dressings on the reestablishment of the cutaneous barrier to transepidermal water loss (TEWL) after standardized skin wounds were produced in human subjects. We confirmed previous observations that occlusive dressings augment reepithelialization. No significant improvement in the rate of reestablishment of the barrier to TEWL was measured between the covered test or uncovered control sites in each subject, however. TEWL declined in an exponential fashion after wounding. Measurements of TEWL were over twice that of adjacent normal skin when epithelialization was judged to be overtly complete and did not return to normal until 4 weeks after wounds were produced. PMID- 2715430 TI - Bioequivalence (bioavailability) of generic topical corticosteroids. AB - A new, quantitative modification of the vasoconstrictor assay was used to measure bioavailability of generic topical corticosteroid products in two categories: betamethasone valerate 0.1% cream and triamcinolone 0.1% cream. Betamethasone valerate products could be separated into two distinct categories, and triamcinolone acetonide products could be grouped into three categories of activity. A survey of local pharmacies showed that generic substitution would be made for the prescribed brand of betamethasone valerate in 58% of cases and for the prescribed triamcinolone acetonide 75% of the time. Because of the prevalence of generic substitution of products that may not have equivalent bioavailability, some standardization of the bioavailability of topical products is needed. PMID- 2715431 TI - Basic principles of dermatologic surgery. PMID- 2715432 TI - It's time to change: the academy needs an assembly of state representatives. PMID- 2715433 TI - Lichenoid photoreactive epidermal necrosis with diflunisal. PMID- 2715434 TI - "Pastoral" purpura. PMID- 2715435 TI - Papular pearly penile pearls. PMID- 2715436 TI - Treatment of lymphedema with a multicompartmental pneumatic compression device. PMID- 2715437 TI - Localized trichorrhexis nodosa. PMID- 2715439 TI - Irritant contact dermatitis caused by povidone-iodine. PMID- 2715438 TI - Disseminated paracoccidioidomycosis with skin lesions in a patient with acquired immunodeficiency syndrome. PMID- 2715440 TI - Naltrexone for neurotic excoriations. PMID- 2715441 TI - Adverse reactions to tretinoin and collagen injections. PMID- 2715442 TI - Cytophagic histiocytic panniculitis. Case report with resolution after treatment. AB - This report describes a patient with cytophagic histiocytic panniculitis in which early diagnosis and therapy resulted in complete clinical remission of the disease. PMID- 2715443 TI - Aluminum-induced granulomas in a tattoo. AB - A patient who developed localized, granulomatous reactions in a tattoo is described. With the use of scanning electron microscopy and energy dispersive x ray microanalysis, both aluminum and titanium particles were found in the involved skin sections. Intradermal provocation testing with separate suspensions of aluminum and titanium induced a positive response only in the case of aluminum. Examination by scanning electron microscopy and energy dispersive x-ray microanalysis of the provoked response established aluminum as the only nonorganic element present in the test site tissue. This is the first report of confirmed aluminum-induced, delayed-hypersensitivity granulomas in a tattoo. PMID- 2715444 TI - Disseminated Mycobacterium chelonae ssp. abscessus in an immunocompetent host and with a known portal of entry. AB - A unique case is presented in which disseminated Mycobacterium chelonae ssp. abscessus was found in a normal immunocompetent host after a traumatic injury. Although disseminated disease is known to occur in immunocompromised and postsurgical patients, this case is unusual in that it occurred in a patient with no evidence of immunodeficiency and with a known portal of entry. PMID- 2715445 TI - Lichenoid epidermal nevus: "linear lichen planus". AB - A 3-year-old girl had an eruption that showed clinical and histologic evidence of both a verrucous epidermal nevus and a lichenoid tissue reaction. Linear plaques had been present on her right lower limb for 2 years. Microscopic features included hyperkeratosis, papillomatosis, acanthosis, a bandlike lymphohistiocytic infiltrate that obscured the dermoepidermal junction, Civatte bodies, and melanophages. Lichenoid epidermal nevus is a new variant of linear verrucous epidermal nevus. At least some of the cases previously diagnosed as linear lichen planus probably represent lichenoid epidermal nevus. There is a parallel between lichenoid epidermal nevus and the entity described as inflammatory linear verrucous epidermal nevus, which frequently was misinterpreted as linear psoriasis before it was recognized as a linear verrucous epidermal nevus with psoriasiform features. PMID- 2715446 TI - Railway track-like dermatitis: an atypical Mondor's disease? AB - The cases of two patients with linear, cordlike lesions on the anterolateral chest wall are reported. Both cases suggested a clinical diagnosis of Mondor's disease (i.e., sclerosing periphlebitis of the chest wall) with atypical aspects. The histologic picture showed a diffuse dermal infiltrate, predominantly of eosinophils mixed with lymphocytes and histiocytes, with some evidence of collagen degeneration. No flame figures were seen. Problems of differential diagnosis are discussed. PMID- 2715447 TI - Porokeratotic eccrine ostial and dermal duct nevus. Report of a case of adult onset. AB - We describe the case of a 38-year-old woman with adult-onset porokeratotic eccrine ostial and dermal duct nevus. The patient had a 9-year history of multiple keratotic papules and comedo-like pits on the medial border of the left foot. Light- and electron microscopic studies showed multiple cornoid lamella like parakeratotic columns, which invariably were associated with hyperplastic eccrine ostia and distal sweat ducts. It is concluded that this entity, the first reported case of adult-onset porokeratotic eccrine ostial and dermal duct nevus, is a variant of the congenital form described previously by Abell and Read and by Aloi and Pippione. PMID- 2715448 TI - Staphylococcus aureus induction of inflammatory plaques of nipples and areolae. AB - A 30-year-old atopic lactating woman developed a peculiar plaquelike dermatitis of nipples and areolae after infection with Staphylococcus aureus. Histologic examination showed an eosinophilic and plasma cellular edematous psoriasiform dermatitis. This constellation of findings seems distinct from other clinicopathologic states induced by staphylococci. PMID- 2715449 TI - Incontinentia pigmenti in a male infant with Klinefelter syndrome. AB - Incontinentia pigmenti is a familial disorder affecting tissues derived from neuroectoderm. Statistical analysis of reported pedigrees is consistent with transmission of incontinentia pigmenti by an X-linked dominant gene with male hemizygote lethality. This report describes a male infant with the classic clinical features of this condition and a 47,XXY chromosomal constitution. These findings support the concept that incontinentia pigmenti is an X-linked dominant disorder. This case illustrates the importance of a full genetic investigation in all males with physical findings suggestive of an X-linked dominant disorder lethal in males. PMID- 2715450 TI - Fulminant transfusion-associated graft-versus-host disease in a premature infant. AB - A fatal case of transfusion-associated graft-versus-host disease developed in a premature infant after receiving several blood products, including nonirradiated white blood cells. Transfusion-associated graft-versus-host disease can be prevented. Irradiation of blood products is the least controversial and most effective method. Treatment was unsuccessful in most reported cases of transfusion-associated graft-versus-host disease. Therefore irradiation of blood products before transfusing to patients susceptible to transfusion-associated graft-versus-host disease is strongly recommended. PMID- 2715451 TI - Possible ultraviolet A-induced lentigines: a side effect of chronic tanning salon usage. AB - A patient who developed lentigines after prolonged ultraviolet A (UVA) exposure in a tanning booth is described. The patient had no exposure to psoralens or furocoumarins. Histologic examination of a representative lentigo revealed melanocytic hyperplasia and cytologic atypia. Increased nevocytic activity with histologic dysplasia was present in several junctional nevi excised during the period of UVA exposure. Several studies have revealed significant effects of UVA on melanocytes. Patients should be cautioned to avoid tanning bed use in view of these potentially deleterious effects. PMID- 2715452 TI - Sporotrichosis in a father and son. AB - A 41-year-old man developed classic lymphocutaneous sporotrichosis on the left arm; his 2-year-old son developed a single lesion of the "fixed" type on the right leg. Both patients responded rapidly to therapy with oral potassium iodide. Seven previous reports of familial sporotrichosis are listed, and therapy is reviewed briefly. PMID- 2715453 TI - Unilateral linear basal cell nevus associated with diffuse osteoma cutis, unilateral anodontia, and abnormal bone mineralization. AB - A case of unilateral linear basal cell nevus, diffuse osteoma cutis, unilateral anodontia, and abnormal bone mineralization is reported. Unlike the anodontia, the unilateral linear basal cell nevus and osteoma cutis began to appear in adulthood. A hamartomatous process is suggested to explain these conditions. This complex syndrome has not been reported in the literature. PMID- 2715454 TI - Control of renal and extrarenal salt and water excretion by plasma angiotensin II in the kelp gull (Larus dominicanus). AB - The osmoregulatory effects of intravenously (i.v.) administered angiotensin II (AII) at dose rates of 5, 15 and 45 ng.kg-1.min-1 were examined in kelp gulls utilizing salt gland and/or kidneys as excretory organs. In birds given i.v. infusion of 1200 mOsmolal NaCl at 0.3 ml.min-1 and utilizing only the salt glands to excrete the load, infusion of AII for 30 min consistently inhibited salt gland function in a dose-dependent manner. In birds given i.v. infusion of 500 mOsmolal NaCl at 0.72 ml.min-1 and utilizing both salt glands and kidneys to excrete the load, each dose of AII given for 2 h inhibited salt gland function but stimulated the kidney, so that the overall outputs of salt and water were enhanced and showed significant (2P less than 0.01) positive correlations with plasma AII. In birds given i.v. infusion of 200 mOsmolal glucose at 0.5 ml.min-1 and utilizing only the kidneys to excrete the load, low doses of AII (5 and 15 ng.kg-1.min-1) caused renal salt and water retention, whereas a high dose (45 ng.kg-1.min-1) stimulated salt and water output. The actions of plasma AII in kelp gulls support the concept that this hormone plays a vital role in avian osmoregulation, having effects on both salt gland and kidney function. Elevation of plasma AII consistently inhibits actively secreting salt glands, but its effects upon renal excretion depend primarily on the osmotic status as well as on the plasma AII concentration. In conditions of salt and volume loading doses of AII stimulate sodium and water excretion. With salt and volume depletion, the action of AII is bi-phasic with low doses promoting renal sodium and water retention but high circulating levels causing natriuresis and diuresis. PMID- 2715455 TI - Cold-induced mitochondrial degradation and cryoprotectant synthesis in freeze tolerant arctic caterpillars. AB - The larvae of Gynaephora groenlandica, a long-lived moth endemic to the high arctic, are perennially freeze-tolerant and able to increase their freeze tolerance by synthesizing glycerol. Cold-induced mitochondrial changes were correlated (using electron microscopy, DNA staining, cytochrome c assay, and oxygen uptake) with glycerol production (using NMR spectroscopy) in larvae under different acclimations and in the field. Hypometabolism in summer- or warm acclimated larvae led to glycerol accumulation. Extended exposure to near-zero or freezing temperatures caused mitochondrial degradation and glycerol accumulation. Rapid freezing of warm-acclimated larvae did not result in mitochondrial breakdown. Mitochondrial reconstitution upon warm-acclimation occurred much more rapidly (less than 1 week) than did degradation (greater than 2 months). Concomitant with mitochondrial breakdown was reduced oxidative metabolism, but the cytochrome c concentration remained independent of acclimation temperature. The adaptive response to cold by mitochondrial degradation and glycerol accumulation by G. groenlandica may be linked to diapause in other species of ectotherms. PMID- 2715456 TI - Interaction of harderian glands, illumination, and temperature on thyroid hormones in golden hamsters. AB - In this study, Harderianectomy (Hdx) has been shown to differentially modify circulating levels of the thyroid hormones, T4 and T3, in male and female golden hamsters exposed to low photic intensities or to moderately low temperatures. Specifically, low photic intensities depress circulating levels of T4 in both control and Harderianectomized (Hdx) male and female hamsters. In addition, T3 is decreased in both control and Hdx males but not in females, as a consequence of reduced levels of illumination. Moderately low temperatures (10 degrees C) depress T4 in both control and Hdx males but not in females, while T3 is increased in both control male and female hamsters, and in Hdx males, but not Hdx females. The data suggest that the Harderian gland of males enhances the sensitivity of the TSH-thyroid axis to photic intensity and to lower temperatures, and further, that there is a considerable sexual difference in the role the Harderian glands may play in response to these two environmental factors. PMID- 2715457 TI - Central effects of angiotensin II in conscious hamsters: drinking, pressor response, and release of vasopressin. AB - The effects of intracerebroventricular (icv) injections of angiotensin II (ANG II) on water intake, blood pressure, heart rate, and plasma arginine-vasopressin (AVP) concentration were studied in chronically instrumented adult male Syrian golden hamsters (Mesocricetus auratus). Furthermore, the effects of pharmacological ganglionic blockade, and of vascular AVP receptor blockade, on central ANG II-induced cardiovascular responses were investigated. ANG II (1, 10, and 100 ng, icv) elicited dose-dependent increases in water intake and arterial blood pressure. Heart rate showed a biphasic response with a short initial non dose-dependent tachycardic and a subsequent longer lasting bradycardic phase. Plasma AVP concentration was increased two and a half fold with 100 ng ANG II icv. Both ganglionic blockade and vascular AVP receptor blockade significantly attenuated the central ANG II-induced pressor response. The tachycardic phase of the heart rate response was abolished by ganglionic blockade and the bradycardic phase was significantly diminished by AVP receptor blockade. The results support the hypothesis that brain ANG II may participate in the central control of body fluid volume and in central cardiovascular regulation in conscious hamsters. PMID- 2715458 TI - Microinjection and expression of a mouse metallothionein human growth hormone fusion gene in fertilized salmonid eggs. AB - Using a microinjection method (Rokkones et al. 1985) deoxyribonucleic acid was introduced into fertilized salmonid eggs. The survival rate after a 28 day period was 91% for injected eggs in comparison to non-injected controls. A gene construct containing the mouse metallothionein promoter fused to the human growth hormone structural gene was microinjected either as a supercoiled plasmid or as a linear sequence. In Southern blot analysis of both 5 and 73 day old dissected rainbow trout embryos, as well as in 1 year old Atlantic salmon, the mouse metallothionein human growth hormone gene sequence was detected together with the chromosomal DNA when micro-injected as plasmid or as linear DNA. After digestion with Bam HI restriction endonuclease, the human growth hormone gene was excised from the high molecular weight DNA fraction. Transcription into human growth hormone specific RNA, as well as translation and release of human growth hormone immunoreactive protein, could be demonstrated in early embryonic stages. PMID- 2715459 TI - Characteristics of cardiac action potentials in marsupials. AB - Standard microelectrode techniques were used to record action potentials from single atrial, ventricular and Purkinje fibers of hearts taken from three species of marsupial (Macropus rufus, Macropus robustus and Macropus eugenii) and from dogs, sheep and guinea-pigs. The major electrophysiological parameters of marsupial potentials were qualitatively similar to the values for placental mammals. The grouped data for ventricular action potentials from studies on 6 adult male red kangaroos (Macropus rufus) were (mean +/- SD): Resting potential 69.5 +/- 5.0 mV; action potential amplitude 92.7 +/- 5.7 mV; action potential duration (to 90% repolarization): 182.5 +/- 17.5 ms; maximum rate of depolarization: 196.5 +/- 80.1 V/s. The major point of difference was the short duration of the red kangaroo ventricular action potential compared to those of the placental mammals, and compared to atrial cells from the kangaroos. It is suggested that this explains the short QT interval reported by others for kangaroo electrocardiograms, and that it may also be implicated in the high frequency of sudden death previously noted in these animals. PMID- 2715460 TI - Long-term evaluation of a prolonged-release formulation of N-methionyl bovine somatotropin in lactating dairy cows. AB - Eighty Holstein cows (first, second, or third lactation) were used to evaluate the efficacy of a prolonged-release formulation for sometribove (n-methionyl bovine somatotropin). Cows were fed ad libitum a complete mixed diet and milked twice daily. Cows were allocated randomly by parity to two treatment groups receiving 500 mg sometribove in a prolonged release formulation or excipient at 14-d intervals starting at 60 +/- 3 d postpartum and continuing for 36 wk. Treatment with sometribove increased FCM yield to a similar extent (11.4%, +3.1 kg/d) in primiparous and multiparous animals. Milk content of lactose, fat, ash, and Ca was not affected, but protein and phosphorous were slightly greater (less than 5%) in milk from sometribove-treated cows. Within a 14-d injection interval, animals treated with sometribove displayed a cyclic pattern in milk yield, but a similar pattern was not evident in feed intake. PMID- 2715461 TI - Genetic parameters of estimated net energy efficiencies for milk production, maintenance, and body weight change in dairy cows. AB - Net efficiencies of converting intake energy into energy for maintenance, milk production, and body weight change in a lactation were estimated for each of 79 Holstein cows by a two-stage multiple regression model. Cows were from 16 paternal half-sib families, which each had members in at least two of the six herds. Each cow was recorded for milk yield, net energy intake, and three efficiency traits. These were analyzed in a multitrait model containing the same 14 fixed subclasses of herd by season by parity and a random factor of sires for each of the five traits. Restricted maximum likelihood estimates of sire and residual (co)variance components were obtained by an expectation maximization algorithm with canonical transformations. Between milk yield and net energy intake, net energy efficiencies for milk yield, maintenance, and body weight change, the estimated phenotypic correlations were .36, -.02, .08, and -.06, while the genetic correlations were .92, .56, .02, and -.32, respectively. Both genetic and phenotypic correlations were zero between net energy efficiency of maintenance and that of milk yield and .17 between net energy efficiency of body weight change and that of milk yield. The estimated genetic correlation between net efficiency for lactation and milk yield is approximately 60% of that between gross efficiency and milk yield. With a heritability of .32 equivalent.49, net energy efficiency for milk yield may be worth consideration for genetic selection in certain dairy cattle populations. PMID- 2715462 TI - Estimates of genetic and environmental (co)variances for first lactation on milk yield, survival, and calving interval. AB - Variance and covariance components for milk yield, survival to second freshening, calving interval in first lactation were estimated by REML with the expectation and maximization algorithm for an animal model which included herd-year-season effects. Cows without calving interval but with milk yield were included. Each of the four data sets of 15 herds included about 3000 Holstein cows. Relationships across herds were ignored to enable inversion of the coefficient matrix of mixed model equations. Quadratics and their expectations were accumulated herd by herd. Heritability of milk yield (.32) agrees with reports by same methods. Heritabilities of survival (.11) and calving interval(.15) are slightly larger and genetic correlations smaller than results from different methods of estimation. Genetic correlation between milk yield and calving interval (.09) indicates genetic ability to produce more milk is lightly associated with decreased fertility. PMID- 2715463 TI - Electrical conductivity of reproductive tissue for detection of estrus in dairy cows. AB - The pattern of temporal measurements of electrical conductivity obtained from electrodes that had been surgically implanted in the mucosa of the vagina or in the submucosa of the vulva in each of five dairy cows was evaluated for changes associated with the occurrence of estrus. Tissue conductivity was monitored at 6 h intervals during and around estrus by hard-ware devices operating at either 16 or 100 kHz. Blood samples were taken at time of conductivity measurement for progesterone determination and at 2-h intervals during estrus for LH determination. Vaginal and vulvar biopsies were performed during diestrus and estrus to measure tissue hydration. Conductivity increased significantly at estrus relative to a nonestrus base period in both vaginal and vulvar tissue. Both electrical frequencies were found to be satisfactory for characterizing changes in tissue conductivity associated with estrus. Peak concentrations of luteinizing hormone, increases in tissue hydration, and patterns of blood progesterone were consistent with the occurrence of estrus during the time of elevated tissue conductivity. PMID- 2715464 TI - Soluble complex formation of bovine immunoglobulin G2 with staphylococcal protein A studied by gel filtration chromatography. AB - The binding property of bovine IgG2 to staphylococcal Protein A was investigated by the methods of gel filtration chromatography and affinity chromatography. High performance gel filtration chromatography was carried out using TSK gel G3000SW and G2000SW columns, and immobilized Protein A column was used for affinity chromatography. Although bovine IgG2 did not form any precipitin lines with Protein A by double diffusion method on agar gel, IgG2 could bind to immobilized Protein A column. Moreover, by gel filtration chromatography, peaks of the complex between bovine IgG2 and Protein A were observed in addition to the IgG2 monomer peak. Thus, it is concluded that bovine IgG2 interacts with staphylococcal Protein A and forms "soluble complexes". Carbethoxylated IgG2 lost its affinity to Protein A indicating that histidyl residues in IgG2 is essential for the binding to Protein A. PMID- 2715465 TI - Uridine monophosphate synthase of Jersey bulls. AB - Fifteen Jersey sires, with significant impact on the breed in the United States, were assayed for activity of uridine monophosphate (UMP) synthase. Six of these bulls were the highest ranking Jersey bulls, as July 1987, with cheese yield dollars averaging $165. These 15 bulls sired over one-third of all Jersey sons registered in 1986 and 1987 and have registered approximately 14,000 of the 37,000 lactating daughters contributing to active AI sire evaluations in 1988. These bulls represent a cross-section of the Jersey breed as they have 11 different sires; 7 different, additional maternal grandsires; and their five generation inbreeding coefficients average 1.5%. Activity of UMP synthase was 3.14 plus or minus .24 units/ml with a range from 2.74 to 3.58 units/ml. The coefficient of variation of 7.7% was slightly less than previously reported coefficients of variation for Holsteins. All these Jersey sires had activities within normal expectations, above delimiter of two thirds of average, and none should be considered heterozygous for UMP synthase. Although this is insufficient proof of absence of the undesirable UMP synthase allele among Jerseys, it is reassuring that no heterozygotes were found among these popular Jersey sires. PMID- 2715466 TI - Economics of using bovine somatotropin in dairy cows and potential impact on the US dairy industry. AB - Budgets with a microcomputer spreadsheet were developed to evaluate the economics of bovine somatotropin use and to estimate the impact on US dairy cow numbers. Income over feed and variable costs increased with somatotropin use and low feed prices. With high feed prices, income responses were less favorable, and when combined with low milk prices, somatotropin use resulted in less income than from control cows. Price of somatotropin did not have a major effect on production costs. The number of cows needed to meet US milk requirements is primarily influenced by per capita consumption and production per cow. With continuing yearly increases in per capita consumption of 2 kg of milk equivalent and cow milk yields of 114 kg, the number of milk cows needed through 1992 remains at the 1987 figure of approximately 10.3 million. In the scenario of a 15% increase in milk yield due to somatotropin, 20% of cows receiving the hormone, and cows receiving the hormone being 10% above the national average of all cows; the number needed in 1992 is 9.77 million, or a drop of 5.4% from 1987. Somatotropin use will have a less drastic effect on cow numbers than originally predicted. PMID- 2715467 TI - Interactions of nutrition and reproduction. AB - As dairy cattle achieve higher milk production, we are becoming aware of closer relationships between nutrition and fertility. An increasing body of evidence indicates that excessive protein intake in early lactation may be detrimental to postpartum fertility. In addition, protein solubility and degradability are important. Energy restriction in high producing cows may be detrimental to fertility through its effect on hypothalamic and ovarian function. Dairy producers are susceptible to advertisements advocating the addition of specific vitamins and minerals to the rations of high producing cows since inadequate or excessive quantities may be detrimental to fertility. This is particularly true for minerals. However, high producing cows do not usually receive grossly inadequate or excessive dietary sources of vitamins and minerals. Rather, they may be presented with a borderline intake of several vitamins and minerals, which together may be detrimental to fertility. Finally, new methods must be developed to provide a more sensitive indication of fertility. These are some of the research and educational needs of the dairy industry if it is to continue successfully increased milk production. Predictions of herd averages of 16,000 kg milk and individual records exceeding 30,000 kg have been made for the yr 2000. PMID- 2715468 TI - Prevalence of and factors associated with root decay in older adults in Canada. AB - We collected data on the oral health status and treatment needs of a random sample of persons aged 50 years and over. Data on root decay were obtained from the 183 subjects who were dentate. All remaining teeth were examined for root decay and restorations, whether root surfaces were affected by recession or not. Analysis was undertaken by case and root surface, with separate analyses of decayed (DS), and decayed and filled (DFS) root surfaces. One or more root surfaces with untreated decay were found in 37.2% of subjects, while one or more decayed or filled root surfaces were found in 56.8%. The mean number of decayed surfaces was 1.3 per person, and the mean number of decayed and filled root surfaces was 2.6. Multiple and logistic regression analyses showed that oral health variables were more important predictors of the presence and severity of root decay than demographic, general health, or dental care factors. PMID- 2715469 TI - Dental plaque and caries on occlusal surfaces of first permanent molars in relation to stage of eruption. AB - The occlusal surfaces of partly and fully erupted first right permanent molars were examined with respect to the occurrence and distribution of plaque and dental caries in a group of 57 six- to eight-year-old children. The children were classified into four groups ranging from one tooth partially erupted to full occlusion. Occlusal plaque was recorded at two levels of examination: (1) visible plaque and (2) detailed mapping by means of a plaque detector system. Dental caries was recorded after professional cleaning. The recording of plaque was repeated after 48 hr without oral hygiene. The findings showed a significant reduction in the easily detectable plaque in fully erupted teeth, compared with the three groups representing partly erupted teeth. The detailed mapping of plaque showed a clear pattern of preferential locations related to the macromorphology of the occlusal surfaces, and revealed reduction in the frequency of thick plaque accumulation in the fully erupted teeth. The proportion of active lesions was reduced in fully erupted teeth, and arrested lesions were mainly observed in the same group. This indicated that erupting teeth are more likely to develop dental caries, due to favorable conditions for plaque accumulation. Functional usage of teeth in addition to improved access for toothbrushing promoted arrestment of lesions initiated during eruption. PMID- 2715470 TI - The contribution of dental amalgam to mercury in blood. AB - We determined the exposure to mercury from dental amalgam by comparison of blood levels of mercury before and after removal of all amalgams from ten subjects. Baseline concentrations of mercury in whole blood were measured weekly for four to 18 weeks (median = 6.6 weeks) prior to removal. All amalgams were removed in a single appointment. The subjects had an average of 14 surfaces of amalgam, seven of which were occlusal surfaces. Weekly blood sampling was continued for five to 18 weeks (median = 7.6 weeks) after the amalgams were removed. The mean baseline concentration of total mercury in whole blood of the ten subjects was 2.18 (SD = 0.90) ng Hg/mL before the amalgams were removed. The baseline mercury levels were related to the number of amalgam surfaces. The linear correlation coefficient was 0.724 with number of occlusal surfaces, and 0.433 with total number of surfaces. After removal of the amalgams, nine of the ten subjects exhibited a statistically significant decrease in blood mercury at the 95% level of confidence. The mean decrease in mercury was 1.13 (SD = 0.60) ng Hg/mL. The half-time for elimination of mercury from blood after amalgam removal was 30.2 (SD = 5.8) days. Removal of the amalgams provided an additional exposure of 1.46 (SD = 1.17) ng Hg/mL that was rapidly cleared from the blood with a half-time of 2.9 days. The daily intake of mercury from amalgam in the subjects was estimated to be at least 1.3 micrograms. PMID- 2715471 TI - The effect of daily gum-chewing on salivary flow rates in man. AB - Following reports of increased salivary gland size and increased function, induced by increased mastication in animals, the effects of long-term, frequent gum-chewing on resting and stimulated flow rates were studied in human volunteers in separate experiments in Newcastle upon Tyne and in Toronto. In both experiments, unstimulated and stimulated saliva flow rates were measured in student volunteers at intervals of one or two weeks over a baseline period. Approximately half of the subjects were then given sugarless gum to be chewed (four pieces per day) over the experimental period; controls refrained from vigorous mastication. During (and, in Newcastle, after) the experimental period, salivary flow rates were measured at intervals, as before. In Newcastle unstimulated, but not stimulated, flow rates increased in the gum-chewing group and were still elevated (compared with controls) eight weeks following the experiment. In Toronto, the mean results showed no effect of gum-chewing, but the seven gum-chewers among the 11 subjects with low baseline flow rates (less than 0.3 mL/min) showed a 43% rise in unstimulated flow rate (p approximately 0.05). The results suggest that increased mastication, in the form of gum-chewing, can increase unstimulated flow rates, especially in those with low salivary function. In addition to short-term beneficial effects of sugarless gum, these long-term effects indicate the possibility of a beneficial effect in caries prevention. PMID- 2715473 TI - EMG power spectrum patterns of anterior temporal and masseter muscles in children and adults. AB - The power spectrum of electromyograms (EMG) has been demonstrated to vary with muscles having different muscle fiber type compositions. This study investigated the variations in EMG power spectrum patterns of the masticatory muscles with age and gender by comparison of the mean power frequency (MPF) of the anterior temporal and masseter muscles in children and adults. Surface EMG signals were sampled bilaterally from the muscles when the subjects were performing maximum voluntary isometric clenches at maximal intercuspal position. The results indicated that MPF values were age-dependent (p less than 0.001), and sexual dimorphism was evident (p less than 0.001), with lower MPF values in male and adult muscles. While male adults had the lowest and female children had the highest MPF values, female adults had MPF values closer to values obtained from male children. These differences or similarities could be attributed to the degree of differentiation of the muscles during growth and development of the craniofacial morphology. PMID- 2715472 TI - The influence of surface free-energy on planimetric plaque growth in man. AB - The purpose of this study was to examine the change in plaque area over nine days in vivo on four materials with different surface free-energies (s.f.e.). Twelve healthy dental students participated in a cross-over, split-mouth, double-blind study. Supragingival plaque formation was recorded over a nine-day period, on four different materials: fluorethylenepropylene (Teflon) (FEP), parafilm (PAR), cellulose acetate (CA), and enamel (E) with s.f.e. of 20, 26, 57, and 88 erg/cm2, respectively. Strips made from the first three materials were stuck to the buccal surface of an upper incisor. The remaining incisor was carefully polished and served as an enamel surface. The increase in plaque was evaluated after three, six, and nine days. A planimetrical analysis was used so that the plaque area could be expressed as a percentage of the total buccal tooth surface. This procedure was repeated on each subject, so that at the end, each pair of central or lateral incisors received the four tested materials. The results indicated that the adherence of micro-organisms on pellicle-coated substrata was influenced by the material's s.f.e.; there was an association between the s.f.e. of the substrata and the supragingival plaque extension in vivo. High surface free energy substrata in the oral cavity attracted more micro-organisms than did low energetic materials. Additionally, the bacterial adhesion seemed very weak on surfaces with a low s.f.e. PMID- 2715474 TI - Relationship between jaw muscle volume and craniofacial form. AB - To study the relationship between craniofacial form and jaw muscle function, we evaluated 25 adult male subjects with Obstructive Sleep Apnea (age, 30-61 years; weight, 58-122 kg) on the basis of CT scans obtained for routine diagnostic purposes. All scans were obtained with the Frankfort horizontal plane at right angles to the floor; each CT slice was 8 mm thick. Masseter and medial pterygoid muscle outlines were traced, digitized, and stored, and three-dimensional reconstructions were made for calculation of muscle volume. Lateral cephalometric radiographs were analyzed for quantification of selected craniofacial variables. Significant correlations could not be identified between physiological apnea variables and jaw muscle volume. An intersubject variability in masseter muscle volume was identified (range, 22.4-38.1 cm3). Medial pterygoid muscle volume revealed more variability (range, 7.4-15.2 cm3). Masseter muscle volume had a negative correlation with mandibular plane and gonial angle, and a positive correlation with posterior face height, ramus height, posterior face length, condylar center to first molar point length, gonion to pterygomaxillary fissure length, and the ramus height/anterior face height ratio. Medial pterygoid muscle volume showed a positive correlation with posterior face height, ramus height, posterior face length, and the lengths between condylar center to first molar contact point, gonion to pterygomaxillary fissure, and antegonion to key ridge. Subjects with large masseter and medial pterygoid muscle volumes had flat mandibular and occlusal planes, and small gonial angles. PMID- 2715475 TI - Efficacy of panoramic radiography in dental diagnosis and treatment planning. AB - We compared treatment decisions based on a clinical examination alone with decisions based on an examination plus a panoramic radiograph to determine whether the panoramic radiograph increased the diagnostic yield and consequently affected treatment. Provisional treatment plans, based on a screening clinical examination alone (n = 33), or on a screening clinical examination plus panoramic radiograph (n = 43), were compared with final treatment plans based on a complete diagnostic assessment (including all necessary radiographs). For this analysis, the final treatment plan was considered correct and used as the gold standard. The two groups used in the comparison were equivalent in age, gender, and final treatment plan needs. The availability of a panoramic radiograph did not improve the accuracy with which provisional treatment plans predicted the number of teeth requiring composites, amalgams, crowns, or extraction, nor did it improve the accuracy of the assessment of the periodontal status (Wilcoxon rank sum, alpha = 0.05). The proportion of patients who had an intra-oral full-mouth series as part of the complete diagnostic work-up was essentially the same for both groups (58% and 60%, respectively); the availability of the panoramic film did not reduce the need for full-mouth series radiographs for the development of the final treatment plans. PMID- 2715476 TI - Assessment of appearance match by visual observation and clinical colorimetry. AB - Judgments of appearance matching by means of the visual criteria established by the United States Public Health Service (USPHS) and by means of an extended visual rating scale were determined for composite resin veneer restorations and their comparison teeth. Using a colorimeter of 45 degrees/0 degrees geometry and the CIELAB color order system we used the color of the restorations and comparison teeth to calculate a color difference for every visual rating. Statistically significant relationships were found between each of the two visual rating systems and the color differences. The average CIELAB color difference of those ratings judged a match by the USPHS criteria was found to be 3.7. However, the overlap in ranges of the color differences for those comparisons rated matches and mismatches indicates the importance of other factors in appearance matching, such as translucency and the effects of other surrounding visual stimuli. The extended visual rating scale offers no advantages to the more broadly defined criteria established by the USPHS. PMID- 2715477 TI - Clinical vs. arthrographic diagnosis of TMJ internal derangement. AB - Internal derangements of the temporomandibular joint (TMJ) have gained increased recognition as a potential source of pain and dysfunction of the masticatory system. The objective of this study was to evaluate the reliability of clinicians in predicting an arthrographic diagnosis of articular disc position in a typical patient population presenting for TMJ arthrographic evaluation. Two clinicians utilized a brief history, clinical examination (including evaluation of mandibular movement and TMJ auscultation), and tomographic TMJ imaging in evaluating 60 patients. The radiologist subsequently performed the arthrographic procedures on 102 TMJs (18 unilateral and 42 bilateral). Diagnostic agreement was determined for all possible diagnostic categories including: normal disc position, TMJ internal derangement with reduction, TMJ internal derangement without reduction/acute, TMJ internal derangement without reduction/chronic, and osteoarthrosis. The significance of the diagnostic agreement between the clinicians and arthrography was evaluated with a Kappa Statistical Test, which showed good reliability. For epidemiological studies, it was concluded that clinical and tomographic evaluation would provide sufficient reliability for determination of the presence and stage of TMJ internal derangement. However, in a specific clinical situation, a difficult diagnostic problem may require the use of arthrography, depending on the impact of the diagnosis on subsequent treatment decisions. PMID- 2715478 TI - The modified model cavity method for assessing antibacterial properties of dental restorative materials. AB - A new in vitro method for assessing the antibacterial properties of dental restorative materials is described with ratios of test material/culture medium volume aiming to simulate conditions around a restoration in vivo. Antibacterial activity is determined by the reduction in optical density of the test culture relative to controls. The method was used for assessment of the antibacterial activity of five dental materials of different composition against five oral bacteria. Release of zinc and fluoride from these materials was also measured and correlated with antibacterial activity. There was a general trend toward greater antibacterial activity with increased zinc release, while fluoride release had a significant effect on only one organism. While all the materials, when freshly mixed, were strongly toxic to three out of the five bacteria studied, much of this activity was lost after the materials had set. PMID- 2715480 TI - A polemic on behalf of a poor cousin. PMID- 2715479 TI - The concentration of dietary casein required for normal mandibular growth in the rat. AB - To determine a suitable casein concentration for normal, undeformed mandibular growth, we placed weanling male rats on diets containing graded levels of casein between 0% and 30% for 19 days. Some weanlings were killed so that initial values could be established. Ten linear dimensions corresponding to the six skeletal units of the mandible were evaluated so that their growth rates at the end of the experimental period could be established. Other dimensions were also evaluated for study of the growth rate of the bone as a whole. The macroscopic growth of the mandible showed a sigmoidal relationship with dietary casein concentration, most of the measurements reaching a plateau at 20% casein. Within the skeletal units, four dimensions corresponding to the alveolar and symphyseal regions did not change with age and were not affected by the casein content of the diet. The remaining six dimensions-corresponding to condylar, coronoid, angular, and basal regions of the mandible-increased with age and were related positively to dietary casein concentration. Their growth patterns were not uniform, although all of them reached maximal values when the diet contained 20% casein. Therefore, deformation of the mandible appears to occur in rats fed diets with a casein concentration lower than 20%. It appears that a dietary casein concentration of 20% is required for normal, undeformed mandibular growth. PMID- 2715481 TI - Abstracts of papers, 67th general session, International Association for Dental Research; 6th meeting, IADR Irish Division; 72nd annual meeting, Scandinavian Association for Dental Research; 26th annual meeting, Continental European Division of the IADR. June 28-July 1, 1989, Dublin, Ireland. PMID- 2715482 TI - Sclerotherapy--translucidation of the skin prior to injection. AB - A useful technique for enhancing the visualization of microvaricosities of the legs is presented. This allows for easy, rapid, and accurate treatment of even the minutest vessels. PMID- 2715483 TI - A simple method of tissue embedding for Mohs micrographic surgery. AB - A simple and reliable method for tissue embedding for Mohs micrographic surgery is described. This technique reduces the number of frozen sections necessary to evaluate a complete margin and can easily be adapted to the office setting without the need of special equipment. PMID- 2715484 TI - Facial nerve palsy as a result of squamous cell carcinoma of the skin. AB - Perineural invasion is increasingly recognized as a significant mode of tumor spread in squamous cell carcinoma (SCC) of the skin. Clinically, it is very difficult to diagnose perineural involvement in the majority of patients due to the lack of symptoms. The occasional propensity for perineural invasion from SCCs of the skin of the head and neck region is well documented and, although SCCs arising from actinically damaged skin reportedly have a low incidence of metastasis or deep invasion, failure to recognize this potential mode of spread could result in fatal consequences. PMID- 2715485 TI - Frigipoint: a new cryosurgical instrument. AB - Frigipoint, a new handheld dipstick cryoprobe, will be introduced. This apparatus has three components: (1) a thermal conductive housing chamber (reservoir) tapered to tips with diameters of 2-10 mm (applicator); (2) a cryogen absorbent member within the housing chamber; and (3) a low-thermal conductivity handle, which is threaded onto the housing chamber. Laboratory experiments employing a gelatin medium showed that the delivery of the cryogen is uniform over the area of application, producing a flat-bottom ice ball. In animal studies, liquid nitrogen spray produced greater depth of destruction and inflammation than Frigipoint. In preliminary clinical studies, 68 lesions, including actinic keratosis, molluscum contagiosum, verruca plana, solar lentigo, seborrheic keratosis, and verruca vulgaris, were treated in 16 patients. All but one resolved after cryosurgery with Frigipoint. Frigipoint is an effective, safe, and easily portable cryosurgical instrument that has a wide spectrum of dermatologic applications. It provides efficient, well-controlled focal cryosurgical treatment of multiple lesions with one immersion of the probe in liquid nitrogen. In addition, its simple operation is met with high patient and physician acceptance. PMID- 2715486 TI - Micro and mini hair grafting using the standard hair implantation procedure. AB - The method described here for micro and mini hair grafting is simpler, faster, and as reliable as the standard implantation procedures that are currently employed. PMID- 2715487 TI - The treatment of multiple lipomas by liposuction surgery. AB - When lipomas reach 4 cm or more in size or are multiple, liposuction becomes an excellent alternative to excisional surgery, which is the treatment of choice for small lipomas. Two cases of multiple lipomas treated by liposuction surgery are presented. PMID- 2715489 TI - Extensive scalp-lifting. PMID- 2715488 TI - Pseudoepitheliomatous hyperplasia following Mohs micrographic surgery. AB - Pseudoepitheliomatous hyperplasia may arise secondarily in a number of cutaneous disorders. Herein we discuss this entity and describe its occurrence in a post Mohs micrographic surgery wound. We will also relate the subsequent histopathologic confusion engendered by its presence. PMID- 2715490 TI - [The regular alternation of exo- and endotrophy in the cell cycle of yeasts]. AB - The data supporting the hypothesis of a succession of endo- and exotrophic phases in cell cycle of proliferating cells have been obtained. The succession is expressed in the changes in rate of endogenous respiration, sensitivity of the cells to rotenone, and the rate of substrate absorption. PMID- 2715491 TI - [Antibacterial activity of coumarin derivatives]. AB - Preliminary tests of antibacterial activity of several coumarin derivatives, substituted at the positions of 3 or 4 of the pyrone cycle. Halogen-containing coumarins do not exhibit antibacterial properties. A sodium salt of 4 mercaptocoumarin is the most active bacteriostatic compounds among sulfur containing derivatives. PMID- 2715492 TI - [Phase correlation of cupular and otolithic reactions and their interrelation with the development of motion sickness]. PMID- 2715493 TI - [Principles of the design of an automated system for the quantitative analysis of the action of environmental factors on the body of laboratory animals]. AB - Complicated ecological conditions, caused by wide and active application of artificial chemicals, makes it necessary to reveal their effect on human and animal organism and take measures for protecting health. The possibility to use advanced computing and information devices in combination with specialized methodical approaches allowed to elaborate and build a model of a system for revealing fine and multi-aspect influence of various factors on organisms of experimental animals. The results obtained allow to consider creation of similar systems a necessary and feasible task. PMID- 2715494 TI - [Biological trials of chemical compounds: the strategy of the initial search]. AB - Some aspects of the strategy of initial search of biologically active compounds at mass tests of chemical compounds have been discussed. Different approaches to pre-experimental estimation of biological activity using mathematical statistics and computer analysis have been analysed. PMID- 2715495 TI - [Regulation of the RNAse activity of the saliva in healthy subjects and in stomach cancer]. AB - Acidic and alkaline RNase activity from healthy humans and gastric cancer patients has been studied. A decrease in daily saliva production and an increase in RNase activity was detected saliva of cancer patients. This suggests the existence of RNase inhibitors in healthy humans. This supposition is further confirmed by comparative analysis of total, joint fractional and reconstituted RNase activity. A considerable increase in acidic RNase inhibitors and disappearance of alkaline RNase inhibitor was observed in cancer patients. The specificity, mechanisms and clinical significance of this phenomena has been discussed. PMID- 2715497 TI - [The nitrosophenol system of iron metabolism regulation in actinomycetes]. AB - Iron-containing o-nitrosophenol compounds have been isolated from 64 strains of microorganisms of 18 species. The analysis of author's and published data allowed to divide iron-containing microbial compounds into two physiological groups: ferri-ionophores, i. e. compounds participating in active iron transfer, and those immobilizing iron at increase in its content in medium up to 10(-4)-10(-2) M. O-nitrosophenol pigments were found to belong to the latter group. A scheme of participation of o-nitrosophenol compounds in regulation of iron metabolism in actinomycetes has been proposed. PMID- 2715496 TI - [L-DOPA interaction with the brain tissue DNA of rats]. AB - The possibility of direct interaction of L-DOPA with DNA isolated from rat brain tissue has been considered. The spectral and viscosity data suggest conformational changes in L-DOPA-treated DNA in conditions excluding the accumulation of L-DOPA oxidation products. PMID- 2715498 TI - Impaired venous return causes circulatory failure in experimental pancreatitic shock in dogs. AB - The haemodynamic effects in the early phase of canine acute experimental pancreatitis (AP) were studied using a cardiac catheterization technique. AP was induced in anaesthetized dogs with an infusion of trypsin-sodium-taurocholate into the pancreatic duct. The initial haemodynamic measurements were performed after the preparation of the animal and 5 min after the induction of AP. Thereafter, pressure and volume parameters were measured at 10 min intervals. AP induced significant increases in heart rate, dP/dtmax and mean arterial pressure, but a decrease in Vmax 5 min after the induction of AP. After the initial phase, the heart rate remained significantly increased, while constant and significant decreases of stroke volume, cardiac output, end-diastolic volume and end diastolic pressure developed. The parameters of the contractility of the left ventricle were not affected to the same extent. It is suggested that the circulatory failure observed in AP, characterised by a prompt reduction of cardiac output, was primarily due to a heavy reduction in preload. This supports the theory that cardiac output is primarily affected by impaired venous return with consequently decreased preload rather than by a loss of ventricular contractility. Hence, the existence of a myocardial depressant factor in the early phase of experimental AP does not gain support from the present results. PMID- 2715499 TI - In vitro colloid osmotic pressure of commonly used plasma expanders and substitutes: a study of the diffusibility of colloid molecules. AB - The rational choice of a plasma substitute for states of hypovolaemia depends partly on its colloid osmotic pressure (COP). We have measured the COP of 108 samples of plasma substitute across selectively permeable membranes which retain molecules greater than 10,000 dalton (COP10) and 50,000 dalton (COP50) the ratio COP50/COP10 providing a potential index of diffusibility of the smaller molecules across capillary membranes. 6% Hespan solution showed a particularly favourable COP50/COP10 ratio at 0.58 indicating a potential for good retention in the circulation whilst 3.5% Haemaccel showed a COP50/COP10 ratio of 0.18 indicating a potential for marked transcapillary diffusion, especially in states of capillary leak. In patients with normal capillary permeability both Gelofusine and Dextran 110 are likely to show adequate retention in the circulation with a COP50/COP10 ratio of 0.37 and 0.39 respectively. These are comparable to the retention of 4.5% human albumin (0.36) but all of the plasma substitutes tested, with the exception of Haemaccel, provided a higher COP across both membranes than 4.5% human albumin solution. An in vivo comparison of these plasma substitutes is required to confirm the advantages of macromolecular colloids in states of capillary leak. PMID- 2715500 TI - Fatal right-sided nonbacterial endocarditis associated with pulmonary artery catheterization. AB - Pulmonary artery (PA) catheterization is now a routine procedure in the care of critically ill patients. We report a case in which a pulmonary artery catheter was a major factor in the demise of a patient who developed adult respiratory distress syndrome following a septic abortion. PMID- 2715501 TI - Rapid diagnosis of amniotic fluid embolism causing severe pulmonary failure. AB - We report an amniotic fluid embolism in a 28-year-old woman developing 8 h after elective cesarean section. She presented with severe respiratory distress syndrome. Amniotic cells were demonstrated in central venous blood and in the endotracheal aspirate. PMID- 2715502 TI - Isolated phrenic nerve injury after apparently atraumatic puncture of the internal jugular vein. AB - Vascular lesions due to subclavian and internal jugular vein puncture may result in hematomas, which are usually clinically evident. While mostly benign, some of these hematomas can cause compression of the surrounding structures. When the hematoma is obvious, straightforward correlation can be made between the symptoms, for instance nerve compression, and the clinical signs. We present a case where we missed the diagnosis of phrenic nerve paralysis, which occurred after an unsuccessful, but apparently atraumatic attempt to puncture the internal jugular vein, prior to cardiac surgery. At the time the diagnosis was made (8 days post-op), the radiographic appearance of the neck was normal, and further investigation (i.e., CT-scan) had become pointless. A retrospective study of serial chest X-rays disclosed a space occupying lesion in the right lateral neck that displaced the nasogastric tube. This abnormality could only be seen on the first film and disappeared on the following. Since phrenic nerve paralysis is extremely rare in our institution, even after cardiac surgery, and as there was no clinical evidence of hematoma, our attention was not been drawn to the only definite sign that could have led to an early diagnosis. PMID- 2715503 TI - Cardiac arrest due to aberrant left coronary artery originating from the right sinus of Valsalva in a young girl. AB - We report a 14-year-old girl who sustained a syncope followed by cardiac arrest. She was kept alive for three days by full cardiocirculatory support using left and right ventricular assist devices, but subsequently died in multiple organ failure. Autopsy revealed an anomalous origin of the left coronary artery (LCA) from the right sinus of Valsalva (RSV) and a major left anterior wall infarction. A cyclo-ergometric stress test performed two years before having been negative, we discuss its value in preventing sudden death due to coronary anomalies. PMID- 2715504 TI - Decreased reflection coefficient as a possible cause of low blood pressure in severe septicaemia. AB - A 44-year-old woman developed a septicaemia with low intra-arterially recorded blood pressure values despite vasoactive medication and optimal support. Sphygmomanometer cuff measurements showed higher values than intra-arterial blood pressure records. We suggest a low reflection coefficient of the capillary bed as the cause of this phenomenon. The constant pressure of the sphygmomanometer cuff on the venous tract appeared to create an increase of the reflection coefficient in our patient, thus causing higher blood pressure readings with the sphygmomanometer cuff measurements than expected. PMID- 2715505 TI - A complication of cricothyroid "minitracheostomy"--oesophageal perforation. AB - Two patients suffered perforation of the oesophagus during attempted placement of a cricothyroid minitracheostomy. We discuss the probable mechanisms and means of preventing such a recurrence. PMID- 2715506 TI - When and why do people die? PMID- 2715507 TI - Reliability of cardiac output estimation by thermodilution. PMID- 2715508 TI - Effect of a 2 g cimetidine infusion on 24-h intragastric pH in critically ill patients. PMID- 2715509 TI - Use of albumin in intensive care medicine. PMID- 2715510 TI - Fulminant fat embolism and neurological impairment. PMID- 2715511 TI - Evaluation of pediatric intensive care scoring systems. AB - There is no report analysing pediatric severity scoring systems in British Intensive Therapy Units (ICUs). Two previously reported pediatric severity scoring systems, the Admission Physiologic Stability Index (APSI) and the Organ System Failure (OSF) score were evaluated for 151 patients. The APSI was higher for children who died than for those who lived (p less than 0.001). This difference reflected the sharp distinction between the APSI for children who left intensive care within 24 h and those remaining in ICU longer than 24 h (p less than 0.001). For children remaining in ICU longer than 24 h, there was a large overlap of APSI scores, and the APSI did not discriminate between children in the overlap region who lived and those who died (p = 0.054). There was underscoring of neurological patients; the APSI did not differentiate neurological patients whole lived and those who died (p greater than 0.10). The OSF also underscored neurological patients. Increasing number of organ systems failed was associated with increasing mortality. In contrast to previous reports, however, the mortality rate was unaffected by whether the total number of systems failed simultaneously or non-simultaneously. There is still a need for a comprehensive yet simple pediatric scoring system for comparing the efficacy and outcome of pediatric intensive care in different ICUs in different countries. PMID- 2715512 TI - Differences in tocopherol-lipid ratios in ARDS and non-ARDS patients. AB - Plasma tocopherol, plasma total lipid levels and tocopherol-lipid ratio were measured every 6 h during 48 h in 12 critically ill patients and compared with those of a control group. The patients were divided into two groups. Group I comprised 6 critically ill patients with ARDS and group II comprised 6 severely ill patients without ARDS. The means for all observations of plasma tocopherol, total lipid levels and tocopherol-lipid ratio in groups I and II were significantly depressed relative to a control group (p less than 0.0001). The difference in the average tocopherol-lipid ratio between the three groups (p less than 0.0001) and between the groups I and II was statistically significant (p less than 0.0001). Our results indicated: (1) a decrease of vitamin E concentrations in the critically ill patients, particularly in ARDS patients; (2) the importance of the relationship between plasma tocopherol and plasma lipids levels in evaluating the deficiency in vitamin E which was evident in ARDS patients. PMID- 2715513 TI - Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for the bacteriologic diagnosis of pulmonary infections in mechanically ventilated patients. AB - We compared nonbronchoscopic bronchoalveolar lavage (NB-BAL) with open lung biopsy to determine the etiological diagnosis of lung infiltrates in patients requiring mechanical ventilation. NB-BAL was performed via a cuffed reusable 7F catheter generally used for right heart catheterization (BAL-C). In 13 patients, BAL-C and open lung biopsy were performed in the same lobe immediately after death when the ventilator was still functioning. No organism was cultured from BAL-C cultures when histopathologic examination of the lung showed no pneumonia and lung culture isolated no organism. Among the 10 positive BAL-C cultures, lung biopsy showed histologic pneumonia in 9 cases. Among these 9 pneumonia cases, 14 organisms were isolated in lung cultures and BAL-C correctly identified the causative agent in 13 cases. BAL-C appears to be an effective and safe procedure in the diagnosis of pulmonary infections in patients under mechanical ventilation who have previously received antibiotic therapy. PMID- 2715515 TI - 117th meeting of the Acoustical Society of America. Syracuse, New York, 22-26 May 1989. Abstracts. PMID- 2715514 TI - Contact phase of blood coagulation in cardiogenic pulmonary oedema (CPO) and adult respiratory distress syndrome (ARDS). AB - In order to assess the role of the kallikreinkinin (k-k) system in the pathogenesis of pulmonary oedema, we studied the contact phase factors of blood coagulation, as well as the haemodynamics and blood gas changes in 34 patients with pulmonary oedema, 23 of them with Adult Respiratory Distress Syndrome (ARDS) and 11 with cardiogenic pulmonary oedema (CPO). We have verified significant differences in the haemodynamic pattern and blood gases between the two groups of patients, which corroborate the previously established differences between both types of pulmonary oedema. Our results reveal k-k system activation in ARDS patients, with a significant fall in factor XII (p less than 0.05), prekallikrein (p less than 0.01), alpha-2-macroglobulin (p less than 0.01) and high molecular - weight kininogens (p less than 0.005), with a rise in C1-esterase inhibitor (p less than 0.001) in comparison with patients with CPO. All of the CPO patients had normal prekallikrein levels, whereas 15 out 23 ARDS cases (65%) had decreased prekallikrein values. Our results suggest that the k-k system activation could play a role in the pathogenesis of ARDS. Estimation of prekallikrein levels may be helpful in the differential diagnosis of ARDS. PMID- 2715516 TI - Welcome innovations in education for cancer nurses in the United Kingdom. PMID- 2715517 TI - Living with a history of a heart attack: a human science investigation. AB - The intent of this study was to gain insights into and a deeper understanding of what it means to live with a history of a heart attack for males at least 2 years after the event. The descriptive/interpretive work of the study is based on conversations with seven men who had heart attacks, all of whom subsequently returned to work. The insights emerge from the descriptions which focused respectively on the experiences of the body, other, time, and space. Pseudonyms are used instead of the participants' names. This has been necessary to maintain anonymity of the persons concerned. PMID- 2715518 TI - The functioning of nursing routines in the management of a transient workforce. AB - Project 2000 recommends supernumerary status for learner nurses. This recommendation is derived, in part, from research into the educational effects of the current organization of nurse training. However, little research appears to have been undertaken into how the current training programme influences the organization and implementation of patient care. The research from which this paper is taken, addresses this question. It demonstrates that the allocation of learners to wards gives rise to an unstable and transient workforce. Currently, ward sisters and charge nurses are expected to plan and be accountability for care given. This research suggests that nursing routines provide qualified nurses with a method for maintaining control, stability and accountability for the care given by an unqualified and everchanging workforce. It is suggested, therefore, that the promotion of individualized care in nursing requires a reduction in dependence on the transient workforce which results from including learners in the staffing establishment of hospital wards. PMID- 2715519 TI - Semantic differentials and the process of developing one to measure maternal role competence. AB - The semantic differential (SD) technique is seen increasingly in studies by nurse investigators. A better understanding of this technique will assist in the appraisal of findings based on SD data. In taking a semantic differential the respondent describes the meaning of a given concept or stimulus by marking a series of bipolar adjective pair scales. Scoring and analysis can proceed in various ways but should not violate the semantic differential's multidimensional nature. The evaluative, potency, and activity dimensions commonly seen in the technique are described. How to construct an SD is explained. The ease with which an SD can be completed makes this technique suitable for clinical populations. The process of developing an SD to measure maternal role competence provides an example of using the technique in a new area of investigation. Factor analysis of the SD to measure the concept myself as a mother revealed that the adjective pairs did not cluster according to the typical SD dimensions. Alternative dimensions are described. These new dimensions gain support from their correlation with other measures of maternal role. The SD provides a promising technique for the measurement of maternal role competence. PMID- 2715520 TI - Postoperative temperature and infection in patients undergoing general surgery. AB - During a study concerned with postoperative hypothermia, Closs (1985) noted an association between patients' core temperatures in the immediate postoperative period and respiratory infection. In this paper, a small follow-up study is reported in which the relationship between postoperative temperature and the development of infection (respiratory, wound or urinary tract) was investigated in 41 patients who underwent general surgery. Aural and oral core temperatures were monitored at 270, 300 and 330 minutes following return to the ward postoperatively. In the week following surgery, patients were monitored daily for any sign or symptom of infection. Reference was made to the patient, nursing notes, medical notes and physiotherapist (when available). Seven of the 16 patients (44%) exhibiting an aural core temperature of greater than or equal to 37.8 degrees C between 270 and 330 minutes post-return to ward developed infection while five of the 25 patients (20%) exhibiting an aural core temperature of less than 37.8 degrees C developed infection. Oral temperature measurements (using ward mercury-in-glass thermometers) showed a very similar pattern. Overall, infection was detected in 12 of the 41 patients (29%) in the 6 days following surgery, 11 having a respiratory infection and one a wound infection. PMID- 2715521 TI - Study of information given by nurses for catheter care to patients and their carers. AB - Patients who are to use a long-term indwelling urethral catheter, and their informal carers, require knowledge and information for its successful management. Education of both patients and carers regarding catheter care has been recommended but not always carried out in practice. This study has investigated the information given by 106 hospital and district nurses to patients who are to use an indwelling urethral catheter in the community, and their carers. It was concluded that the information given for catheter care was not comprehensive nor consistent and differed according to the nurse's location of work. The implications this has for nursing practice are a need for further education of nurses regarding catheter care and improved teaching of patients who are to use a long-term indwelling urethral catheter, and their carers. PMID- 2715522 TI - The concept of family nursing. AB - A system-based conceptualization of family nursing is suggested, with family nursing practised on three system levels. The level of individual family members views the family as the context of the individuals. The interpersonal level addresses dyads and larger units and the family system level includes the structural and functional system components interacting with the environment. Intervention on a higher system level includes the lower levels. While family nursing falls within the practice scope of all nurses, intervention aimed at system change requires holistic understanding of the intricate relationships between family system components and the skills of clinical specialists. PMID- 2715523 TI - Bacteriuria and urinary incontinence in aged female nursing home residents. AB - Although urinary incontinence (UI) is identified as a symptom of urinary tract infection (UTI), the incontinent elderly frequently are not treated for UTI unless clinically significant manifestations are present. The purpose of this research was to identify variables that may be associated with bacteriuria in the female person who is already known to be incontinent. A sample of 65 incontinent female nursing home residents was divided into three groups: (1) those with negative urine screens; (2) those with a bacterial count of over 100,000 per ml of urine; and (3) those with a bacterial count of below 100,000 per ml urine. Variables examined were: (1) physical symptoms; (2) physical examination findings; (3) mental status; and (4) functional abilities. Significant group differences were found regarding awareness of the urge to void and ability to hold urine. A near significance finding suggested that the higher the level of cognitive function the less likely the presence of UTI. There was some evidence to suggest the higher the level of independence the less likely the presence of UTI. Recommendations for nursing practice and future nursing research are made. PMID- 2715524 TI - Nursing knowledge: women's knowledge. A sociological perspective. AB - As nurses approach the 21st century questions are being raised regarding the direction in which the profession is moving. The majority of leaders and educators in the field of nursing have, to this point, stressed the importance of defining nursing as a science and of developing a scientific knowledge base. Recently, however, there has been a move among some researchers and theorists in the field of nursing to question the ability of science and the scientific method to deal with nursing concerns. Using a variety of perspectives, including feminist theory, they are critiquing many of the basic assumptions about science, scientific method and scientific knowledge. This paper uses sociological and feminist theory to support the idea that nursing, as a discipline, has a distinct knowledge base which is not grounded in empirico-analytic science and its methodology but which stems from the lived experiences of nurses as women and as nurses involved in caring relationships with their clients. PMID- 2715525 TI - Management behaviour of one community health nurse supervisor. AB - Mintzberg's theoretical framework of management, which examines the roles and functions of a manager in relation to effective communication, is used to analyse observational data of managerial conflict within a community health setting. In this setting the manager failed to establish sound interpersonal relations with her peers or with the clinic nurses. This led to a poor information base from which she could make decisions. The result was that the group became stressed and developed signs of disintegration. PMID- 2715526 TI - The nursing management of pain in the community: a theoretical framework. AB - This paper is based upon a research project designed to investigate the nursing management of pain in the community. A theoretical framework is described which has been designed to encompass the complexities of different types of pain, individual differences in reaction to pain, and to identify key differences between patients who cope with pain and those who do not. The framework is based on a model of stress, the concept of controllability, and contemporary learning theory. It identifies a unique role for the nurse in pain management and will be used to direct a study into strategies which nurses can use to enhance the coping abilities and resources of elderly patients in the community with pain. PMID- 2715527 TI - Anticipating 2000 AD. PMID- 2715528 TI - A study of values of baccalaureate nursing students and graduate nurses from a secular and a nonsecular program. AB - This study examined the relationship between professional values of senior baccalaureate nursing students and graduate nurses compared to the values reflected in the Code for Nurses. A questionnaire was completed by 199 students and graduates of a secular and a nonsecular university. Data were analyzed using content analysis, frequency distributions, and multivariate procedures. Findings indicated that values identified most frequently by all respondents related to patient care issues rather than social issues of the profession. Analyses showed no significant difference in value identification between respondents from the secular and the nonsecular institutions. Implications for nursing education, nursing service, and future research are also discussed. PMID- 2715529 TI - Endowed chairs in nursing: a 1988 update. PMID- 2715530 TI - Prospective payment and baccalaureate nursing education: projections for the future. AB - The implementation of a prospective payment system has had a profound effect on health care delivery in the United States. Providing realistic nursing experiences for baccalaureate students has become a challenge in the new arena of increased patient acuity, decreased length of patient stay in acute care settings, and increased use of home care services. The purpose of this study was to describe changes in the health care system and projected changes in baccalaureate nursing education associated with prospective payment. The descriptive survey design used a mail questionnaire to which deans or their designees from 186 National League for Nursing (NLN) accredited baccalaureate nursing programs responded. Outcomes of the study indicated specific health care delivery changes in all geographic areas and all types of institutions. Projected changes in nursing education included curriculum, teaching methods, and clinical learning experiences. PMID- 2715531 TI - Can you see me? PMID- 2715532 TI - Concept analysis: an approach to teaching physiologic variables. AB - Establishment of a knowledge base for nursing practice has been an ongoing goal of nurse professionals for the past decade. Because nurses are especially concerned with management of the body's potential or actual response to illness, the development and use of materials that reflect these body responses seems appropriate. This article is an effort to promote the use of concepts as a basis for nursing practice. A concept analysis approach for didactic instruction, currently being used for organizing and synthesizing pathophysiologic data present in literature, is presented. The process is exemplified by excerpts from the concept "inflammation." Advantages and disadvantages identified by graduate students for the use of concepts and the analysis process as a teaching/learning strategy are included. PMID- 2715533 TI - Academic tenure in schools of nursing. AB - The purpose of this research study was to examine factors involved in tenure decisions in schools of nursing. Of 139 deans of nursing surveyed, from schools having both National League for Nursing (NLN) accredited BSN and graduate programs, 135 provided a profile of tenure practices; however, 133 schools were used in the data analysis because two of the programs did not offer tenure. The majority of deans selected academic activities related to teaching performance as more important than research and service activities for tenure decisions. When deans were asked to rank the three broad areas of tenure criteria, 60 deans (55 per cent) ranked teaching as most important, as compared with 49 deans (45 per cent) who ranked research most important. Service was ranked least important by 98 deans (89 per cent). However, deans from the 41 doctoral programs ranked research more important than teaching, but still ranked service the least important. In examining faculty performance of those who were reviewed for tenure in the past 3 years, faculty members who were viewed by deans as providing a high standard of teaching, research, and service were more likely to have been awarded tenure. Quality of teaching, quality of research, and quality of service, in rank order of predictive power, were found to be predictors for attainment of tenure. PMID- 2715534 TI - Catastrophic health care and public law 100-360. PMID- 2715536 TI - Curriculum revolution: defining the components. PMID- 2715535 TI - The nursing shortage and research opportunities. PMID- 2715537 TI - Fogarty International Center: a resource for international nursing. PMID- 2715538 TI - Protecting your license. PMID- 2715539 TI - The richness of diverse perspectives. PMID- 2715540 TI - Infection control and barrier techniques. PMID- 2715541 TI - Stannous fluoride. PMID- 2715542 TI - New dentists' problems. PMID- 2715543 TI - Dental esthetic satisfaction in adults. AB - This study determined the influence of teeth, mouth, and face on self-image and personal esthetic satisfaction in adults. A random sample of 125 patients completed a five-item questionnaire about personal esthetic satisfaction and oral self-image. As a group, general dental variables were stronger predictors of esthetic satisfaction than orthodontic variables (P less than .01). Discrepancies between clinical findings and patterns of self-perception and satisfaction suggest the dentist and patient should plan together for esthetic dental treatment. PMID- 2715544 TI - Calcium hydroxide in the treatment of external root resorption. AB - A case is presented in which calcium hydroxide was used in endodontic treatment of external root resorption in a tooth with a necrotic pulp, during active orthodontic movement. A calcified deposit formed, filling a defect, and the tooth was subsequently obturated with gutta-percha. Thus, both types of therapy- endodontic and orthodontic--were performed simultaneously. PMID- 2715545 TI - Pain referred to teeth as the sole discomfort in undiagnosed mediastinal lymphoma: report of case. AB - The role of routine medical examination in dental diagnosis is described in a report of case involving a young, seemingly healthy patient whose only symptom, pain in the mandibular left molars, proved a manifestation of a malignant mediastinal lymphoma. PMID- 2715546 TI - Relative microhardness of glass ionomer restorative materials as an indicator of finishing time. AB - Microhardness was evaluated as an indicator of appropriate finishing intervals for glass ionomer restorative materials. The hardness of several materials was determined after the first hour of mixing. A material clinically documented to be satisfactorily finished after a delay of 15 minutes attained 29% of its 24-hour hardness during that interval. Samples of the other materials finished on reaching this relative hardness, which differed from the manufacturers' suggested finishing delays, showed no differences in surface characteristics, appearance, or surface roughness compared with specimens finished at the recommended times. PMID- 2715547 TI - Rare earth filters for intraoral radiography: exposure reduction as a function of kV(p) with comparisons of image quality. AB - Radiographs of phantoms were produced using E-speed film and various rare earth X ray beam filters. The rare earth filters considerably reduced the amount of radiation needed to produce diagnostic quality images and, in many cases, improved image quality. These filters can be implemented easily and inexpensively in a clinical setting, resulting in radiation exposure reductions of up to 71%. PMID- 2715548 TI - Epidemiology of acute asthma: IgE antibodies to common inhalant allergens as a risk factor for emergency room visits. AB - In recent years the morbidity and mortality of asthma has increased, although the etiology is still poorly understood. Most patients with asthma suffer acute attacks that are commonly treated in hospital emergency rooms (ER). In the present study, asthma in adults was studied with acute attacks as a marker for the disease; 102 patients first observed at a university hospital ER with acute airway obstruction were compared to 118 patients observed at the same ER with any diagnosis other than shortness of breath to evaluate allergy as a risk factor for asthma in adults. Sera were assayed for IgE antibody (Ab) to dust mites, cockroach, cat dander, and grass and ragweed pollen. The results demonstrate that in adults younger than 50 years of age, the prevalence of IgE Abs was fourfold greater among subjects with asthma than among control subjects (46/67 versus 12/81; odds ratio, 10.1; 95% confidence interval, 4.9 to 20.7). The population attributable risk for the presence of IgE Ab to one of the five allergens was greater than 50%. Among individuals older than 50 years of age, the prevalence of serum IgE Abs was not significantly increased among patients with acute airway obstruction. In the whole group, the prevalence of IgE Abs to different allergens demonstrated significant seasonal and socioeconomic differences, suggesting that the associated risk is related to exposure to those allergens. The results establish that, with acute attacks of asthma as a marker for adult asthma, the presence of serum IgE Abs to common inhalant allergens is a major risk factor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715549 TI - The natural history of peanut allergy. AB - Between 1973 and 1985, 114 children, aged 2 to 14 years, underwent double-blind, placebo-controlled, food challenge (DBPCFC) to peanut. Thirty-two of 46 children with symptoms produced by DBPCFC to peanut were included in this longitudinal evaluation. Contact was made with the 32 subjects 2 to 14 years after their positive DBPCFC to peanut. All 32 subjects had exhibited a positive puncture skin test to peanut at the time of the original evaluation. Sixteen subjects had experienced symptoms caused by accidental peanut ingestion in the year before contact. Eight subjects had reacted to accidental ingestion in more than 1 year but less than 5 years before contact. Eight subjects had completely avoided peanut since the original evaluation and positive DBPCFC. No subjects could be demonstrated to have "outgrown" their peanut reactivity. All subjects tested continued to have skin reactivity to a puncture skin test with peanut extract. It appears uncommon for peanut-sensitive patients to lose their clinical reactivity, even after many years have elapsed. In addition, data were collected concerning reactions to other legumes and other (nonlegume) nuts. Only two patients with DBPCFC to peanut reacted on DBPCFC to soy or pea (one each). None of the subjects with a positive DBPCFC to peanut reacted to nonlegume nuts. PMID- 2715550 TI - Effect of indomethacin on adenosine-induced bronchoconstriction. AB - The exact mechanism of adenosine-induced bronchoconstriction in patients with asthma is unknown. Adenosine contraction of guinea pig trachea was antagonized by inhibitors of cyclooxygenase. The aim of this study was to investigate the effect of indomethacin (100 mg/day) on adenosine-induced bronchoconstriction in 14 asymptomatic patients with asthma. Airway response was evaluated as FEV1, and adenosine was administered as an aerosol diluted in 0.9% saline to produce a concentration range of 0.125 to 4 mg/ml. The dose of adenosine producing a 20% change in FEV1 (PD20) was calculated from the individual semilogarithmic dose response curve; the results of PD20 were converted to log values for statistical analysis (Student's paired t test). The study was performed on 3 separate days. On the first day, the adenosine challenge was performed, and on subsequent days patients were pretreated with either placebo or indomethacin in a randomized, double-blind manner. Inhaled adenosine caused bronchoconstriction with a geometric mean PD20 of 0.71 mg (95% confidence limits, 0.44 to 1.16). After placebo, a geometric mean PD20 of 0.91 mg (95% confidence limits, 0.53 to 1.58) was obtained. Indomethacin pretreatment decreased adenosine hyperresponsiveness and shifted the dose-response curves of adenosine challenge to the right with a geometric mean PD20 of 1.28 mg (95% confidence limits, 0.64 to 2.56). The effect of indomethacin on adenosine bronchoconstriction (p less than 0.01 versus baseline; p less than 0.05 versus placebo) suggests an indirect mechanism of adenosine on inducing release of arachidonic acid derivatives. Inflammatory mediators inhibited by indomethacin may be involved in adenosine bronchoconstriction, even if this mechanism is not relevant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715551 TI - Guanine content and Dermatophagoides pteronyssinus allergens in house dust samples. AB - The study of the relationship between the guanine content and Dermatophagoides pteronyssinus (Dp) allergens in house dust samples is reported. Mattress and carpet dust of bedrooms from 22 different homes constituted the house dust samples. The guanine content was determined by quantitative measurements and the mite allergenicity by two immunochemical assays with a partially purified extract of Dp as internal reference: RAST inhibition and crossed and rocket line immunoelectrophoresis. A large scale range of guanine content was obtained among the 22 house dust samples studied (0.01 to 1.78 mg/0.1 gm of dust). Data of RAST inhibition, analyzed according to parallel line bioassay, demonstrated no significant difference between the slopes of the reference and the house dust sample lines, but a 100-fold variation in the relative Dp potencies was observed. By crossed and rocket line immunoelectrophoresis technique, the presence and the amounts of major Dp allergens (Der p I and Dp 4) were established in most house dust extracts. A significant correlation was found between the guanine content of the house dust samples and their relative Dp potencies (r = 0.86) on the one hand, and with their relative content of Der p I and Dp 4, two major Dp allergens (r = 0.75 and r = 0.74, respectively) on the other hand; in each case, a quantitative relationship was established. These results suggest that the guanine determination could assess mite allergens in house dust and may be a useful tool in large-scale investigations of house dust. PMID- 2715553 TI - Nasal histamine challenges in symptomatic allergic rhinitis. AB - Twenty subjects (seven with perennial allergic rhinitis, seven with symptomatic seasonal allergic rhinitis, and six normal control subjects) underwent assessment of nasal sensitivity to histamine. Nasal resistance was measured by posterior rhinometry under control conditions and after log incremental doses of histamine solution pipetted into the nose (0.5 to 5000 micrograms). Allergic subjects exhibited a twofold rise of nasal resistance with doses of 0.5, 5, or 50 micrograms of histamine, whereas the nasal resistance in normal subjects remained unchanged until 500 or 5000 micrograms of histamine had been administered. Nasal reactivity to histamine was not correlated with symptoms on the day of testing but was correlated with the number of positive wheals to skin prick testing. It was concluded that nasal resistance is more sensitive to histamine in subjects with allergic rhinitis than in normal control subjects and that this difference may be used as the basis of a diagnostic test. PMID- 2715552 TI - Effect of the oral leukotriene D4 antagonist LY171883 on inhaled and intradermal challenge with antigen and leukotriene D4 in atopic subjects. AB - Sulfidopeptide leukotrienes have been suggested as potential mediators of the bronchoconstriction of asthma. The effect of the orally active leukotriene D4 (LTD4) antagonist LY171883 (LY) (400 mg) on antigen or LTD4-induced bronchoconstriction and wheal-and-flare responses was studied in atopic subjects on six occasions (three groups of 2 consecutive days). On the first 2 study days, subjects were screened for their response to inhaled LTD4 and antigen. On the second and third groups of 2 study days, subjects received LY, 400 mg, or placebo 2 hours before inhaled leukotriene LTD4 or antigen challenge. After antigen challenge, the lung function was measured for 6 hours. After the inhaled challenge, intradermal LTD4 and antigen challenges were performed. LY had no effect on baseline lung function. Geometric mean (95% confidence intervals) for the provocative dose of LTD4 causing a 40% fall in forced expiratory flow at 40% vital capacity from a forced expiratory flow maneuver was 1.8 (0.5 to 5.6) nmol after placebo and 5.6 (2.0 to 15.7) nmol after LY. This difference was not significant. The mean maximum change during the early phase of antigen-induced bronchoconstriction was reduced, being 54.7 (26.9% to 82.4%) after placebo and 35.8 (2.3% to 69.3%) after LY (p less than 0.05). There was, however, no difference in the maximum response observed during the late phase. There was also a significant reduction in the area under the curve of the early but not late phase response to antigen. LY significantly shifted the intradermal LTD4 dose response curve for both wheal and flare to the right (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715554 TI - Evaluation of nasal patency by fiberoptic rhinoscopy. AB - A novel method of assessing anterior nasal patency by flexible fiberoptic rhinoscopy was evaluated in two centers by comparison with active anterior rhinomanometry. Rhinoscopy and rhinomanometry were performed 20 times on each of 14 subjects during 14 to 26 minutes. The procedure was videotaped, and nasal airway area was measured from a video monitor. The mean coefficients of variation for rhinoscopy and rhinomanometry were 14% and 19%, respectively. Another investigator examined five subjects by rhinoscopy 30 times in 15 minutes; the mean coefficient of variation was 9%. These means were not significantly different. Rhinoscopy and rhinomanometry were performed at 30-minute intervals for a 6-hour period in 13 subjects. Three investigators independently evaluated results for changes in nasal function characteristic of the nasal cycle. Rhinoscopy detected the nasal cycle in an average of 72% of subjects and rhinomanometry in 49%. Both methods detected the response to topically applied oxymetazoline and methacholine. Results indicate that, whereas the two procedures evaluate different aspects of nasal function, their precision is similar. Rhinoscopy additionally permits evaluation of nasal mucosal changes occurring from disease or treatment. PMID- 2715555 TI - Impaired vision and hip fracture. The Framingham Study. AB - Falls affect a large proportion of the elderly and can result in a variety of injuries, including hip fractures. Several studies have suggested that visual impairment contributes to falls, but studies have not used standardized definitions of visual impairment and have not examined injurious falls or fractures. We looked at the risk of hip fracture associated with visual impairment in those members of the Framingham Study Cohort who took part in the Framingham Eye Study in 1973-75. Of 2,633 subjects followed for 10 years after the eye exam, 110 sustained hip fractures. The fracture rates in those with moderately impaired (20/30 to 20/80) vision (8.5%) and poor (20/100 or worse) vision (11.3%) were higher than in those with good (20/25 or better) vision (3.0%). After adjustment for age, sex, weight, alcohol consumption, and (in women) estrogen use, the relative risk of fracture in those with moderate impairment was 1.54 (95% CI = 0.95-2.49), while for those with poor vision, the relative risk was 2.17 (95% CI = 1.24-3.80). Of note, those with moderately impaired vision in one eye and good vision in the other had a higher risk of fracture (relative risk = 1.94) than those with a similar degree of binocular impairment (relative risk = 1.11). Poor vision in one or both eyes was linked to an elevated fracture risk. This suggests that good stereoscopic vision may be necessary to prevent falls. The risk of fracture with poor and moderately impaired vision combined was increased in women (relative risk = 1.96, 95% CI = 1.23-3.11) but not in men (relative risk = 0.79, 95% CI = 0.23-2.72).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715556 TI - 41-month follow-up of risk factors correlated with new coronary events in 708 elderly patients. AB - A prospective study correlated coronary risk factors with new coronary events in 192 elderly men and 516 elderly women, mean age 82 +/- 8 years. Follow-up was 41 +/- 6 months (range 24-44). Coronary events (myocardial infarction, primary ventricular fibrillation, and sudden cardiac death) occurred in 64 of 192 men (33%) and in 149 of 516 women (29%), P not significant. Using univariate analysis, significant risk factors for coronary events were antecedent coronary artery disease, cigarette smoking, hypertension, diabetes mellitus, serum total cholesterol (TC) greater than or equal to 200 mg/dL and greater than or equal to 250 mg/dL, serum high-density lipoprotein cholesterol (HDL-C) less than 35 mg/dL, and serum TC/HDL-C greater than or equal to 6.5 in men and women, and obesity in women. Using multivariate analysis, significant risk factors for coronary events were age, antecedent coronary artery disease, cigarette smoking, hypertension, diabetes mellitus, and serum TC in men and women and serum HDL-C and serum triglycerides in women. Using univariate analysis, significant risk factors for coronary events in men and women with antecedent coronary artery disease were cigarette smoking, diabetes mellitus, serum TC greater than or equal to 250 mg/dL, and serum TC/HDL-C greater than or equal to 6.5. Using multivariate analysis, significant risk factors for coronary events in men and women with antecedent coronary artery disease were age, cigarette smoking, diabetes mellitus, serum TC, serum HDL-C, and serum triglycerides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715557 TI - Hypochondriasis in the elderly depressed. AB - The significance of hypochondriacal complaints in elderly depressives was explored. Sixty percent of patients had such symptoms on admission. Twelve percent were delusional. At discharge, hypochondriasis was present in 40% of the sample, with 0% delusional. Hypochondriasis was associated with anxiety (P less than .05) and somatic concerns (P less than .001), but not with complaints of depressed mood, suicidality, or short-term outcome. In dependent physical illness ratings did not correlate with hypochondriasis, however nonpsychotropic medication use did (P less than .01). Improvement in hypochondriacal complaints with treatment, yet persistence of less intense hypochondriacal concerns after remission suggests that these features may represent an admixture of state and trait phenomena in elderly depressives. PMID- 2715558 TI - Rate of progression of Alzheimer's disease. AB - We determined rate of cognitive decline in 54 patients with a clinical diagnosis of Alzheimer's disease. Cognitive ability was assessed by score on the Blessed test of orientation, memory, and concentration. Rate of progression was defined as the change in score on the Blessed test per year and was computed using a linear regression analysis. Only patients who had been followed for at least one year and who had at least three separate evaluations were included in the study. The overall rate of progression was 4.1 Blessed points per year. Age of onset, duration of illness, and family history of dementia had no significant influence on rate of progression. PMID- 2715559 TI - The safety and lack of efficacy of vinpocetine in Alzheimer's disease. AB - Fifteen Alzheimer patients were treated with increasing doses of vinpocetine (30, 45, and 60 mg per day) in an open-label pilot trial during a one-year period. Patients were assessed seven times both on and off drug with: the Buschke Selective Reminding Task, a letter fluency test, a category fluency test, the Boston Naming Test, a cognitive capacity screening examination, and a clinical global impression. Vinpocetine failed to improve cognition on psychometric testing or overall functioning, as measured by the clinical global impression, at any dose tested. Patients showed significant decline in most measures during the course of the study, at the same rate as a matched control group, consistent with progressive dementia. There were no significant side effects from drug therapy. We conclude that vinpocetine is ineffective in improving cognitive deficits and does not slow the rate of decline in individuals with Alzheimer's disease. PMID- 2715560 TI - The influence of age and blood pressure on the hemodynamic and humoral response to head-up tilt. AB - It has been reported that postural hypotension in the elderly is common. However, these studies included institutionalized and more or less disabled persons. Furthermore, postural hypotension may be related to baseline blood pressure. In this study, the influence of age and blood pressure on the hemodynamic and plasma catecholamine responses to orthostatic stress was investigated in young and old normotensive and hypertensive healthy subjects. In normotensive and hypertensive elderly persons, the percentage blood pressure responses during tilt were not significantly different from that seen in young normotensives. We measured a slight decrease of systolic blood pressure and a slight increase of diastolic blood pressure. The hypertensive young patients showed an enhanced diastolic blood pressure response with no fall in systolic blood pressure, in contrast to the normotensive young subjects. Both elderly groups had a lower increase of heart rate than the young subjects. The percentage increase in norepinephrine after tilting was significantly lower in elderly hypertensives than in elderly normotensives and young hypertensives. The presence of hypertension was associated with a decrease in blood pressure, but age had no influence on the change in blood pressure during tilt. In this group of healthy elderly subjects, there was no significant orthostatic hypotension when the blood pressure course of the entire tilt test was taken into account. PMID- 2715561 TI - Utility of fever, white blood cells, and differential count in predicting bacterial infections in the elderly. AB - A total of 221 elderly patients between the ages of 70 to 99 years who presented to a community-based teaching hospital emergency room were prospectively evaluated by assessing for fever (greater than or equal to 37.5 degrees C), leukocytosis (greater than or equal to 14,000/mm3) and bandemia (greater than 6%) as a screening method for predicting the presence of bacterial infection. Thirty three patients had documented bacterial infections. Although with increasing body temperature the percent of patients who were infected increased, 48% of the infected elderly patients had no fever. In patients with fever, 39% had a bacterial infection compared to only 9% in the afebrile group. In patients with fever, leukocytosis, and bandemia, all patients were infected. Conversely, in the absence of fever, leukocytosis, and bandemia, only 6% had bacterial infection. All elderly patients who present with an acute or subacute change in health status or functional capabilities associated with fever, leukocytosis, or bandemia should be carefully assessed for the high probability of a bacterial infection. PMID- 2715562 TI - Implementing a "Do-Not-Resuscitate" (DNR) policy in a nursing home. AB - During implementation of a new Do-Not-Resuscitate (DNR) policy in New York State, decisions by 233 nursing home patients of their surrogates were evaluated. Eighteen patients with capacity (mean age +/- SD = 76.4 +/- 12.1 years) chose DNR; 30 patients with capacity (mean age +/- SD = 76.2 +/- 10.7 years) chose to be resuscitated (CODE); 54 patients without capacity, (mean age +/- SD = 86.1 +/- 9.1 years) had surrogates who chose DNR; and 131 patients without capacity and with surrogates (mean age +/- SD = 81.9 +/- 9.8 years) remained CODE. Most patients with capacity who chose DNR had multiple sclerosis, while most choosing CODE had strokes. Most patients who lacked capacity had dementia. Forty-five percent of surrogates did not respond regarding CODE status during the three month study interval, and 10% wanted additional time to decide. Patient age appeared to be a factor in surrogate choice for DNR but not in patients with capacity making their own decision. Reasons for patients with capacity choosing DNR are discussed; perceived quality of life and premorbid feelings by patients help in the decision-making process. PMID- 2715563 TI - Chronic salicylate intoxication. A common cause of morbidity in the elderly. AB - We reviewed the clinical profile of adults with chronic salicylate intoxication by evaluating the experience of our community teaching hospital between 1977 and 1987. Data on similar patients reported was obtained from an English-language literature search using MEDLINE (1966-88) and bibliographic reviews of textbooks and review articles. We also examined the impact of education and incentive on increasing the awareness and ability of physicians to diagnose the disorder. Chronic salicylate intoxication was defined by 1) a compatible clinical syndrome; 2) a serum level in the toxic range; and 3) improvement with withdrawal of the drug. Patients with chronic salicylism represent a cross-section of an elderly population. Our review suggests that diminished body mass, concurrent administration of drugs and conditions which exacerbate renal insufficiency may predispose to salicylate intoxication; however, few specific precipitants of chronic salicylism were recognized. Salicylate intoxication should be considered in all elderly patients with delirium and/or dementia. PMID- 2715564 TI - Aspirin and MID. Notes of caution. PMID- 2715565 TI - Effect of iron overload on spontaneous and xenobiotic-induced lipid peroxidation in vivo. AB - To study the effect of iron-overload on hepatic lipid peroxidation, two rat models of haemochromatosis were employed: in the first model resembling secondary haemochromatosis, repeated i.p. injections with Fe-dextran led to an accumulation of Fe in Kupffer cells, while in the second model resembling hereditary haemochromatosis, iron was located mainly in periportal hepatocytes after feeding on a diet containing 3.5% Fe-fumarate for 3 weeks. In both models, total hepatic iron content was elevated four- to fivefold over controls. In vivo lipid peroxidation (ethane exhalation) was enhanced only in the second model, indicating that the hepatocytes are the main targets of Fe-induced lipid peroxidation. Low hepatotoxicity was observed in the second model. Additional treatment of the rats with hepatotoxic agents led to different results: with ethanol and bromobenzene, lipid peroxidation was only evident in both models of iron-overload, while paracetamol-induced lipid peroxidation was seen only in Fe fumarate-fed rats. CCl4-induced lipid peroxidation was strongly enhanced in both models of haemochromatosis. Hepatotoxicity was enhanced by iron overload only in the case of CCl4-treated, Fe-fumarate-fed rats. The activities of phase I and phase II enzymes of xenobiotic metabolism were not markedly altered in livers of iron-overloaded rats. This implies that neither the bioactivation nor the detoxification of the agents studied were affected in experimental haemochromatosis. PMID- 2715566 TI - Toxicity of aromatic thiols in the human red blood cell. AB - Thiophenol and 4-aminothiophenol were used to study levels of toxicity in human red blood cells. Thiophenols caused conversion of oxyhemoglobin to methemoglobin. Reduction of corresponding disulfides by intracellular glutathione caused cyclic reduction/oxidation reactions, resulting in increased oxidative flux. Three levels of oxidative stress were observed in these experiments: the lowest level resulted from incubation with 0.25 mM thiophenol; the intermediate level with 0.50 mM thiophenol or 0.25 mM 4-aminothiophenol; the highest levels with 0.50 mM 4-aminothiophenol. Methemoglobin formation increased with increasing level of oxidative stress. Glycolysis and the hexose monophosphate shunt were inhibited at the intermediate and highest levels of stress, respectively. Above the highest level of stress non-intact hemoglobin was formed and cell lysis occurred. These metabolic responses were reflected in cellular levels of NADH, NADPH and reduced glutathione. At the lowest level of oxidative stress, both glycolysis and hexose monophosphate shunt were increased such that near-normal levels of NADH, NADPH and reduced glutathione were maintained and methemoglobin formation was kept to a minimum. The response of red cells to 0.25 mM thiophenol appears to represent a level of oxidative stress to which the cell is capable of adaptive metabolic response. Glycolysis contributes approximately one-quarter of the total reducing equivalents from glucose metabolism in response to the oxidative challenge by thiophenol. The results suggest that the metabolic response to autoxidation of endogenous thiols is thiol exchange with glutathione and reduction of resulting glutathione disulfide by the hexose monophosphate shunt. PMID- 2715567 TI - Cadmium toxicity and bioantioxidants: status of vitamin E and ascorbic acid of selected organs in rat. AB - Effects of i.p. administered cadmium acetate (Cd, 0.4 mg/kg) was studied on the levels of vitamin E and ascorbic acid in different brain regions, liver, kidney, testis, RBC and plasma at 15, 30 and 60 days intervals in male albino rats (45 +/ 5 g). Exposure to Cd for 15 days decreased the levels of vitamin E significantly in the liver and testis only, while 30 days of treatment resulted in a significant decline in cerebellum, cerebral cortex, corpus striatum, mid-brain + hypothalamus, and plasma. Cadmium administration for 60 days caused a decrease in vitamin E in all tissues. Furthermore, a duration-dependent decrease in hepatic ascorbic acid levels was noticed. The implications of these results are discussed. PMID- 2715568 TI - Specific determination of bromobenzene metabolites by high-performance liquid chromatography. AB - A chromatographic method for the quantitative and simultaneous determination of phenolic and mercapturic acid type metabolites of bromobenzene is presented. Acid hydrolysis (1.5 N HCl, 100 degrees C, 10 min) yielded unconjugated bromophenols. After extraction (ethyl acetate, pH 2), evaporation to dryness and dissolution in methanol, samples were analysed by high-performance liquid chromatography (HPLC) with a c18 reverse-phase column and a phosphate buffer (0.1 M,pH 9 + 5 mM tetrabutylammonium dihydrogen phosphate) - acetonitrile gradient with ultraviolet detection (225 nm). Benzylmercapturic acid and o-chlorophenol were used as internal standards. Using this method, it was possible to determine simultaneously o, m- and p-bromophenols together with o-, m- and p bromophenylmercapturic acids. Additional validation data were obtained by analysis of urine samples from rats treated with bromobenzene. This new method was compared to existing procedures. PMID- 2715570 TI - Evidence that phomopsins A and B are not the only toxic metabolites produced by Phomopsis leptostromiformis. AB - The toxicities of up to four different toxic preparations containing metabolites of Phomopsis leptostromiformis were examined in two experiments with sheep and one with rats. It was shown that the different toxic preparations containing similar amounts of phomopsin A varied substantially in toxicity. Crystalline phomopsin A was the least toxic. It is suggested that the increased toxicity of the other three preparations was due to the presence of toxic metabolites additional to phomopsins A and B. Evidence to support this suggestion is presented. PMID- 2715569 TI - Effect of cimetidine on hepatic biochemical changes, liver toxicity and major urinary metabolite excretion of trichloroethylene in rats. AB - The effects of cimetidine (CIM) (an inhibitor of the hepatic microsomal monooxygenase system) on the metabolism and hepatotoxicity of trichloroethylene (TRI) were studied in male Sprague-Dawley rats. Rats were given three doses of 120 mg/kg i.p. (low-dose regimen) of CIM at 0, 6 and 11 h for 1 day, or ten doses of 200 mg/kg (high-dose regimen) at 8, 11, 14 and 17 h for 2 days and 8 and 11 h on 3rd day. Trichloroethylene (0.5 or 0.65 ml/kg) was administered i.p. 1 h after 2nd dose (low-dose regimen) or 9th dose (high-dose regimen) of CIM. In the low dose regimen study, the activity of hepatic microsomal aminopyrine N-demethylase was decreased 1 and 5 h after the second dose and 7 h after the third dose of CIM, but became normal 20 h after the last dose. The cytochrome P-450 content and the activities of aniline hydroxylase and epoxide hydratase remained unchanged. Trichloroethylene at both dose levels produced liver toxicity, as verified by increase in activities of SDH and SGPT as well as by liver histology. Cimetidine alone had no such effect. An apparent reduction in TRI toxicity by CIM (at both dose regimens) could be observed histologically. The biochemical tests (SDH and SGPT) corroborated the histological changes only when TRI was given at a dose of 0.5 ml/kg combined with a high-dose regimen of CIM. Cimetidine at both dose regimens had a tendency to decrease the in vivo metabolism of TRI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715571 TI - Toxicokinetics of ochratoxin A in several species and its plasma-binding properties. AB - The toxicokinetic profile of ochratoxin A was studied after the oral or intravenous administration of 50 ng/g b.w. to fish, quail, mouse, rat and monkey. The elimination half-life varied from 0.68 h after oral administration to fish, up to 840 h after intravenous administration to monkey. The distribution volume ranged from 57 ml/kg in fish to 1500 ml/kg in quail. The plasma clearance was most rapid in quail and fish, 72 and 58 ml/kg.h, respectively, while it was only 0.17 ml/kg.h in monkey. The bioavailability was as low as 1.6% in fish but as high as 97% in mouse. The binding abilities of ochratoxin A to plasma proteins were also studied. From these data we calculated the free fraction of toxin in plasma, which we found to be less than 0.2% in all species investigated (including man) except fish. A similar but smaller investigation on the toxicokinetics and binding properties of ochratoxin B was also performed. Ochratoxin B was more readily eliminated and had a lower affinity for plasma proteins, which partly may explain its lower toxicity. PMID- 2715572 TI - Dislocation of the tarsometatarsal joint. PMID- 2715573 TI - Motion of the first metatarsophalangeal joint. AB - The analysis of motion of the first metatarsophalangeal joint in this study demonstrates the character of motion about this joint. Four instantaneous centers of rotation were calculated in the first metatarsal head that formed an arc encircling an area of increased stress patterns. The joint motion is made up of rolling, sliding, and compression. The fact that there is more than one center of motion contradicts the theory of a simple hinge joint. The joint is a dynamic acetabulum or "hammock," as described by Kelikian. That is, the first metatarsal head moves within a stable support comprised of the base of the proximal phalanx, the sesamoids, soft tissue, and muscle tendons. The nature of first metatarsophalangeal joint motion must be considered when contemplating surgical procedures of the first metatarsophalangeal joint. PMID- 2715574 TI - Osteoid osteoma: two unusual case reports. AB - Osteoid osteoma is a relatively common bone tumor that is diagnosed easily but requires a high index of suspicion. The increasing percentage of sports-related injuries in podiatrists' offices, including stress fractures, may cause a doctor to overlook the less frequent pathologic fracture. Two case reports of runners with osteoid osteoma in anatomic areas of classic overuse syndrome are described. A review of the diagnosis and treatment follows in an effort to increase awareness that runners do suffer nonmechanical foot disorders. PMID- 2715575 TI - Variation in practitioner-measured x-ray angles in hallux abducto valgus evaluation. AB - Angular measurements taken on preoperative hallux abducto valgus x-rays have been relied upon heavily by surgeons in helping to determine the nature and extent of the deformity, as well as a guide for selecting the most appropriate surgical procedure for correction. The reliability of measuring these angles among different physicians has never been tested, to these authors' knowledge. Therefore, this study is designed to measure the variation in values for the five basic angles among a group of podiatrists with varying capabilities, training, and experiences, and demonstrates that preoperative radiographic measurements may not be an accurate reflection of the general degree of pathology about the first metatarsophalangeal joint. PMID- 2715576 TI - Antibiotic-impregnated bone cement: an in vitro comparative analysis. AB - This manuscript examines the in vitro antibacterial activity of eight different antibiotics when mixed with polymethyl methacrylate. Two different parameters are presented as being important considerations in the choice of antibiotic. One parameter is the bacterial inhibition created by the direct contact of the antibiotic-impregnated bone cement. The second parameter is the bacterial inhibition produced by diffusion of antibiotic from the bone cement into the surrounding liquid medium. These two experimental models were created to establish the contiguous and remote antimicrobial effects of antibiotic impregnated bone cement. PMID- 2715577 TI - Plantar approach for excision of bilateral soft tissue masses in a child. AB - A painful soft tissue mass of the plantar aspect of both feet, in a 5-year-old child, is presented. Plantar incisions are ideal in specific cases as long as the surgeon adheres to certain principles, as outlined in this manuscript. A discussion of lipomas is also presented. Optimum exposure is the key to total eradication of soft tissue lesions and to proper maintenance of wound healing. Location of the lesion presented warranted use of the plantar approach. Minimal hypertrophy of the plantar scar was achieved, as well as few symptoms by the patient. PMID- 2715578 TI - Akin osteotomy using the 3M Shapiro Staplizer. AB - Internal fixation of the Akin osteotomy has taken many forms. With the advent of the 3M Power Metaphyseal Staplizer, fixation of this osteotomy has been improved. This staple provides ease of use, light compression, maintenance of position, and speed. PMID- 2715579 TI - Muscle transposition in the management of chronic osteomyelitis and ulceration of the heel. AB - Transposition of intrinsic muscles of the foot may be beneficial for coverage of local full-thickness defects. A case representing this situation is presented. The authors report successful resolution of the procedure 28 months postoperatively. PMID- 2715580 TI - Bleeding complications in the uremic patient. AB - Many patients seen in podiatric medicine may have some degree of renal disease. An often neglected and unrecognized complication of renal disease may be abnormal bleeding. Presented in this paper is a review of the etiologies and treatment of uremia-induced bleeding complications. Included is a case presentation in which the authors discuss a patient in acute renal failure who developed postoperative bleeding following an incision and drainage for a diabetic foot infection. PMID- 2715581 TI - Chondroblastoma of the foot. PMID- 2715582 TI - Magnetic resonance images. Interdigital or Morton's neuroma. PMID- 2715583 TI - The decidual cell response in aging C57BL/6J mice is potentiated by long-term ovariectomy and chronic food restriction. AB - The effects of long-term ovariectomy (LOVX) and chronic food restriction on the decidual cell response were examined in aging mice. At 2 mos of age, mice were either ovariectomized, started on a regimen of food restriction (70% of ad lib intake), or left untreated. At 10 mos, the decidual cell response (DCR) was induced in all groups and measured by uterine weight gain, alkaline phosphatase activity, and DNA content. The DCR was also examined in young (4.5 mos) mice. LOVX and, to a lesser extent, food restriction (FR) potentiated the DCR, as indicated by 20-75% greater alkaline phosphatase activity and uterine weight relative to age-matched controls. In contrast to previous reports, however, there was no age-related reduction of the DCR. These results show that both LOVX and FR can enhance uterine function in middle-aged mice and indicate that, under some experimental conditions, there is no age-related impairment in the DCR. PMID- 2715584 TI - A description of agitation in a nursing home. AB - Agitation is a significant problem for elderly persons, their families, and their caregivers. This study describes the agitated behaviors of 408 nursing home residents. Nurses who were familiar with the residents used a 7-point scale to rate how often each resident manifested 29 agitated behaviors. Each resident was rated independently by three nurses, one from each of the three nursing shifts. Results showed that agitated behaviors occurred most often during the day shift (i.e., when residents were most active), and least often during the night shift. The most frequently exhibited agitated behaviors were general restlessness, pacing, repetitious sentences, requests for attention, complaining, negativism, and cursing. Most agitated behaviors correlated significantly across shifts, suggesting that such behaviors occur and reoccur throughout the 24-hour day. Factor analysis yielded three syndromes of agitation: aggressive behavior, physically nonaggressive behavior, and verbally agitated behavior. These results provide a foundation for further studies of agitation in elderly persons. PMID- 2715585 TI - Language deficits in depression: comparisons with SDAT and normal aging. AB - In order to contribute to the definition of the structure of cognitive deficits in major depression/unipolar, language processing was studied in 20 elderly persons with major depression/unipolar, 23 elderly with SDAT, and 20 normal elderly. Measures administered included the Western Aphasia Battery, Test for Syntactic Complexity, and Chomsky Test of Syntax. Results indicate that depressed elderly performance on structural language variables of repetition, naming, auditory verbal comprehension, syntax, and reading is significantly better than performance of the SDAT sample. In contrast, results suggest that in comparing normal and depressed elderly, the normal elderly have the edge. On three measures of eleven, there are significant differences between depressed and normal elderly language processing. In analyzing the measures of significant difference, it is determined that complexity is an intervening variable. It is concluded that although the reason for language deficits in major depression/unipolar is as yet unknown, it is not justifiable at present to rule out an organic hypothesis. PMID- 2715586 TI - Aging of diabetic and nondiabetic skin fibroblasts in vitro: life span and sequential growth curves. AB - Skin fibroblasts from age-matched normal and juvenile diabetic (IDDM) subjects were studied throughout their life span in vitro. The number of mean population doublings (MPD) attained at senescence was determined. Sequential 5-day growth curves were constructed. Normal cells were compared to cells from diabetics with recent onset of disease, 1-5 years, 6-10 years, and greater than 10 years of insulin therapy. A trend of decreasing MPD in vitro with increasing duration of diabetes in vivo was found. The growth potential of all cells (sequential growth curves) decreased with increasing time in vitro. The confluent density (Day 5) of diabetic (10 years' duration) cells was significantly lower than that for normal cells at Stage 2 of growth (passage 6-10). The in vitro aging of cells from diabetics (recent onset) was essentially the same as that of normal cells. PMID- 2715587 TI - Measuring caregiving appraisal. AB - Caregivers of disabled older people were studied in terms of their appraisal of the caregiving process. A conceptual approach based on stress theory suggested that such appraisal was broader than the traditional term, "caregiving burden." An item pool was constructed using traditional and new items to represent dimensions of subjective caregiving burden, caregiving satisfaction, caregiving impact, caregiving mastery, and traditional caregiving ideology. Component analysis of responses of 632 caregivers in a respite research project yielded factors that corresponded with those hypothesized; the content of similar factored responses from 239 caregivers in another study was quite similar. A series of exploratory and confirmatory factor analyses resulted in acceptance of the subjective burden, caregiving satisfaction, and caregiving impact factors. Used as composite item scores, evidence of their psychometric quality is presented. PMID- 2715588 TI - The prediction of mortality in elderly institution residents. AB - The relationship between activity and mortality has been examined mainly in middle-aged and elderly community residents. This study investigated the prediction of five-year mortality in 156 institution residents, including a subsample (n = 121) retested one year after the initial assessment. The measures included demographic variables, three health indexes, happiness, quality of life ratings, personality and life stress indexes, cognitive function, and activity level. The strongest predictors of survival beyond five years from initial testing were a younger age and a high activity level. The relationships of age and activity to survival were mutually independent and were not secondary to the effects of any other variable. Health was not related to activity level and did not emerge as a strong predictor of survival. After a consideration of methodological issues, the findings were interpreted as providing support for an activity theory formulation of mortality prediction. PMID- 2715589 TI - Age differences in heart rate patterns during concentration in a precision sport: implications for attentional functioning. AB - Highly skilled young (M = 29.5 years) and older (M = 50.0 years) miniature golf players were observed in relaxed training and high-arousal competition rounds. Motor performance (number of shots), subjective ratings of anxiety, and heart rate were registered. Results showed a similar increase of arousal from training to competition for both age groups. However, the older group deteriorated in motor performance from training to competition, whereas the younger group played equally well on both occasions. Results from continuous measurement of heart rate indicated a deceleration during the concentration phases among the younger players, and the magnitude of deceleration increased from training to competition. In contrast, heart rate accelerated during training among the older players, the magnitude of the heart rate change decreasing from training to competition. This evidence suggests that the deterioration in motor performance observed in older players in stressful competitive activity may be due to age related changes in attentional functioning. PMID- 2715590 TI - Age and semantic inhibition in word retrieval. AB - An experiment to identify the source of age-related inhibition by semantically related primes in a word-retrieval paradigm is reported. Stimuli were definitions of target words, and responses were names of the target words that were defined. It has been shown previously that in this paradigm older adults are differentially inhibited by semantically related primes (Bowles & Poon, 1985a). The present experiment was designed to test the hypothesis that the additional inhibition by semantically related primes resulted from a decision strategy adopted by older adults when the primes themselves were sometimes correct target words. When the correct prime condition was eliminated in the present experiment, response times were statistically the same for semantically related and unrelated conditions for both older and younger adults. This suggests that the inhibition was due to additional decision processing performed by older adults rather than to longer retrieval processing in the presence of semantically related primes. PMID- 2715591 TI - The memory advantages of the generation effect: age and process differences. AB - This study examined the impact of age on the generation effect using measures of study time, recognition (d prime), cautiousness (beta), and judgment reaction time. Thirty-six younger and 36 older adults studied antonym pairs, half of which were intact and half of which were missing two adjacent interior letters requiring active encoding (generation) to complete the word. In general, older adults studied items longer; both younger and older adults studied items requiring generation longer than intact items. Subsequent recognition testing also revealed age-related memory differences and generation effect-related memory improvements, but no age by task interaction. Cautiousness data showed only differences due to encoding task with no age-related differences to indicate older adults were more cautious than younger adults. Response time data also revealed expected effects due to age-related slowing and generation (not previously demonstrated in the literature). PMID- 2715592 TI - Generational differences in the structure of the CES-D scale in Mexican Americans. AB - This study examines differences in the structure of the Center for Epidemiologic Studies Depression (CES-D) scale across three generations of Mexican Americans. The covariance structure of the items was viewed as a function of several parameter matrices. Factorial invariance was evaluated by testing a series of hypotheses involving equivalence constraints on one or more parameter matrices. The findings revealed that the proposed 12-item model fits the data within each of the three generations adequately. Although no generational differences in factor loadings were revealed, structural variations of the CES-D in measurement error variances were found. Measurement error variances associated with certain items in the older generation are significantly greater than those in the middle aged and young generations. In addition, socioeconomic characteristics, acculturation, and health status fail to explain the observed differences in the structure of the CES-D among the three generations. PMID- 2715593 TI - Life-cycle models of saving and the effect of the timing of divorce on retirement economic well-being. AB - The long-term effect of the current high rate of divorce upon the future economic status of individuals has not been thoroughly analyzed. This study reviews the retirement, precautionary, and bequest motives for saving, then evaluates how marriage dissolution may (a) decrease the family's savings rate, (b) cause shifts in the family's portfolio to assets with lower rates of return, and (c) destroy or deplete existing family assets. Whether divorce interrupts the savings process or destroys assets, it is unlikely that most individuals will be able to save enough in later life to overcome the loss. The long-term effect may well be that, in future years, we will recognize a new category of elderly poor, those who have experienced the dissolution of their marriage. PMID- 2715594 TI - Cognitive impairment among elderly adults in Shanghai, China. AB - This study reports the methods and initial findings of the first longitudinal study of Alzheimer's disease and dementia in China. A probability sample of 5,055 noninstitutionalized elderly persons in Shanghai was tested directly during the first phase of the study using a Chinese version of the Mini-Mental State Examination (MMSE). Details of sampling design and data collection procedures are described. Overall, some 4.1 percent of adults 55 years or older may be classified as having severe cognitive impairment, and 14.4 percent are mild cases. The rates for females are higher than for males by a ratio of 3.75 in the severe category, and 2.6 in the mild group. Within each age group, cognitive impairment rates vary by education. Multiple logistic regression was used to examine, within each age group, the nature of the association between the presence of a cognitive impairment and educational level controlling for sex. The results showed that educational attainment has a highly significant inverse relationship with prevalence of cognitive impairments (severe vs others). On the other hand, when educational attainment was controlled for in the logistic regression model, sex was significantly associated with prevalence of cognitive disorders for the age groups 65-74 and 75 years or older, but not for the group 55-64 years. These findings suggest the impact that basic educational deficits have on human cognitive functioning as measured through tests like the MMSE. Cross-tabulations of impairment rates according to marital status, economic status, and health-related problems are also presented. PMID- 2715595 TI - [Rapid determination of plasma progesterone. Its value in ovarian stimulation for in vitro fertilization]. AB - Plasma Progesterone levels show definite variations during the periovulatory period of the superovulated cycle similar to those of the physiological cycle. The question arises whether the pattern of these variations is of significance with regard to the success rate of the IVF cycle. This prospective study was conducted with a rapid and highly sensitive radioimmunoassay of plasma progesterone labelled with Iodine 125. A total of 452 cycles were initiated in 328 patients (280 cycles using a clomiphene citrate-HMG regimen, 272 cycles using an association of LHRH analogues with HMG according to three different protocols). Ovarian response was monitored with sonography and rapid plasma radioimmunoassays of 17 beta-estradiol, progesterone and LH (in non-analogue cycles). Plasma progesterone in particular was assayed 17 hours before, at the time, and 7 hours after the administration of HCG. 10,000 UI IM for triggering ovulation. During the Clomiphene-HMG therapy when LH levels are instable, the plasma progesterone assay is highly discriminant between the beginning of a true LH peak (with concomitant rise of progesterone greater than 1 ng/ml, 15.7% of the cycles) and hectic variations of LH (no concomitant rise of progesterone, 4.3% of the cycles); the progesterone assay was also able to detect the occurrence of ovulation in 3 cycles without sensible variation of plasma LH (1.1% of the cycles). Pre- and post-ovulatory levels of plasma progesterone also demonstrate a prognosis significance with regard to the chances of success of the cycle, with all the different types of ovarian stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715596 TI - [Paracervical block. A valuable alternative for ambulatory surgery]. AB - The technique, indications for and the complications of paracervical block analgesia are reviewed in a series of 30 patients. The authors consider that this technique can be used for some gynaecological procedures, and that the patients are comfortable with it. The technique makes it possible to have complete analgesia but with small doses of drugs. In each case the stay in hospital was short and it is therefore a technique that can be used for day surgery. There is no need to explain how economically useful this is. PMID- 2715597 TI - [Leukocyte immunization and early spontaneous abortions]. AB - Forty patients who had had at least two early spontaneous abortions, i.e. before the 12th week of pregnancy without known aetiology factors (anatomical, chromosomal, infectious or hormonal) were immunised with their husband's leucocytes. These immunisations were carried out by repeated intravenous injections of leucocytes taken from the husband's peripheral blood. In 24 patients the search for anti-HLA antibodies was shown to be positive after a varying number of injections (2 to 10). Twelve patients are still being treated, 4 did not make antibodies. Eighteen pregnancies have been observed, of whom 11 have so far come to term, 4 are following a normal course and 3 pregnancies were interrupted late of different reasons. The success rate, by which is meant pregnancies without early abortion, was 17/21, i.e. 81%. A comparison of the number of HLA A, B or DR antigens found to be shared between the couple in 40 couples studied, when compared with a series of 64 fertile couples (who had had at least 2 children without any abortions) shows no differences. These couples as compared with fertile couples do not show either differences in the frequency of HLA antigens. After leucocyte immunisation an inhibition in the mixed lymphocyte culture is found between the patient's lymphocytes and her husband's in the wife's serum if this has made anti-HLA antibodies. PMID- 2715598 TI - [Congenital malformations and socio-occupational status]. AB - A case-control study was conducted in a maternity hospital, in order to look for the relationships between the occurrence of birthdefects and the socio occupational status of the parents. Cases were 189 new-born children with one or several congenital malformations diagnosed at birth or within the first 8 days of the life. Birthdefects were listed according to the British Paediatric Association classification of diseases. Controls were 5,896 new-born children without any congenital malformation detected within the first 8 days of life. Cases and controls were all children born in the same maternity hospital, between 1980 and 1983. The socio-occupational status (INSEE classification) of the parents of cases and controls was ascertained within the first trimester of the pregnancy, before a possible congenital malformation was known. In order to look for the relationships between the socio-occupational status of the parents and the occurrence of birthdefects, we compared the proportions, in each of the socio occupational classes, of the fathers and of the mothers of cases and controls. These comparisons (for all birthdefects together and for the most frequent ones) were tested using the chi-square test, when the expected number was greater than 5, and the Fischer's test, when it was equal to, or lower than 5. The incidence rate of birthdefects in this sample was 3,1%. Their distribution according to the types of malformations did not differ from that observed in 1982 among the new borns in Paris. There was no significant difference between the parents of cases and controls, for: age, degree of instruction, ethnic origin, marital status.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715599 TI - [Evolution of salivary estradiol levels during the spontaneous menstrual cycle. Correlation between saliva and plasma]. AB - The measurement of steroid concentrations is recommended in the exploration of the different endocrine functions. The salivary concentrations are the reflect of the free biologically active fraction in the plasma. In this study we have used a sensitive and specific method that can be routinely applied in salivary extradiol (SE2) RIA, using a 3 CMO 125I histamine derivative as a tracer. This study related to 12 normal spontaneous menstrual cycles and two abnormal spontaneous cycles. Saliva samples were collected daily throughout the menstrual cycle. Plasma samples were collected simultaneously to compare the salivary and plasma patterns. In the follicular phase SE2 was low: M +/- SD = 9.4 +/- 2.4 pmol/l. During the periovulatory period, the mean level of SE2 the day of the preovulatory peak was 27.6 +/- 8.6 pmol/l. In the luteal phase the SE2 levels fluctuated in a serrated manner with a mean of 11.7 +/- 3.4 pmol/l. The difference between the different phases is significant at the probability threshold 0.01. We have compared the salivary and plasma patterns during the different phases. At the beginning the salivary/plasma ratio was 3.4 +/- 0.9%. During the periovulatory period this ratio was only 2.5 +/- 0.6% and the end of the cycle 2.8 +/- 1%. The statistic study showed that these differences were significant at the probability threshold 0.01. PMID- 2715600 TI - [Advanced cancer of the ovary and pregnancy. Apropos of 2 cases]. AB - Cancer of the ovary together with pregnancy is rare. The authors report two new case histories which are of particular interest because of advanced cancer of the ovary and a continuing pregnancy, and also because of the anatomophathological type of the malignant tumour, which was an immature (malignant) teratoma of the ovary. Looking at these cases carefully makes it possible to describe the characteristics of this very serious combination and to describe the principles for deciding on the method of treatment. PMID- 2715601 TI - [Polyuria and polydipsia in acute fatty liver of pregnancy. Discussion based on a case]. AB - We report the case of a 25-year-old nullipara in whom polyuria and polydipsia occurred 8 weeks before the first symptoms of acute fatty liver of pregnancy and disappeared a few days after delivery. This time course suggests that polyuria and polydipsia were closely related to acute fatty liver of pregnancy. Thus, this diagnosis should be envisaged in any woman with normal blood levels of glucose and calcium, and complaining of polyuria and polydipsia in the third trimester of pregnancy. PMID- 2715602 TI - [Pre-eclampsia and the nephrotic syndrome. Prognosis and management; apropos of a series of 23 cases]. AB - In pregnancy pre-eclampsia can be complicated by the nephrotic syndrome. We report on the clinical findings in 23 patients who had the nephrotic syndrome in pregnancy with hypertension. None of these patients had any previous sign of nephropathy. In most patients clinical signs first showed up in the 3rd trimester. The prognosis for the fetus was poor. This was because of the degree of proteinuria and of uraemia (5 fetuses died). After delivery all signs cleared up, as they would have done in moderately severe pre-eclampsia. All patients were considered to be cured by six months. In spite of this the longterm prognosis is difficult to assess. It is necessary to find out whether the nephrotic syndrome was evidence of an underlying nephropathy or just was due to the pre-eclampsia. Treatment consists mainly of rest, control of hypertension, correction of low blood volume and delivery of the fetus with regard to the degree of maturity and the viability of the fetus. PMID- 2715603 TI - [Graduated ruler for making a transverse suprapubic incision]. AB - The transverse suprapubic incision is the most usual approach to laparotomy in obstetrics and gynaecology. It has many advantages both from the aesthetic as well as the functional points of view. The low transverse scar is hidden in the region of the pubis. Post-operative breakdowns (such as hernia and eventertion) that occur with longitudinal incisions have almost disappeared. The site, the length and the height of the incision vary according to the surgeon's ideas and his experience. The result cosmetically therefore varies and the optimum benefit is not always achieved. We describe a graduated ruler specially designed for the transverse suprapubic incision. It was worked out in 1984. It makes it easier to standardise the technique of suprapubic incision, but one that can be changed according to variations in body contours. The ruler can be sterilised. It is available in two models: one, a flexible one which is ideal for caesarean sections and laparotomies in fat women or where the abdominal wall is distorted by tumours under it; the second model is rigid and should be able to be used on the normal flat abdomen. One and a half years experience shows that the ruler can be used to standardise the technique of transverse suprapubic incision. It also helps to teach this method of laparotomy; and the cosmetic results have become better. PMID- 2715604 TI - Childhood developmental changes in the auditory P300. AB - In this study we investigated developmental changes in the auditory P3 latency from childhood to adolescence. Event-related potentials evoked by improbable auditory stimuli were recorded from 35 normal children between the ages of 5 and 13 years. Regression analyses showed significant age trends in the auditory P3 latency. Latencies decreased at a rapid rate (Cz: 20.34 msec/yr; Pz: 19.27 msec/yr) from childhood to adolescence, suggesting an increased efficiency in processing information as children mature. This rate was linear or constant in nature as evidenced by the failure of the quadratic and cubic components to significantly increase predictability of the regression equation. The slope of the P3 latency/age regression line was also shown to be influenced by the interactive effects of task difficulty and maturation. It was hypothesized that neuro-developmental processes (increased myelination and dendritic arborization) may underlie the maturational changes observed in the P3 latency during childhood. PMID- 2715605 TI - Neurological complications of hemolytic-uremic syndrome. AB - Of 78 children identified with hemolytic-uremic syndrome at the Children's Hospital, Boston, from 1976 to 1986, 16 patients (20.5%) had neurological manifestations during their hospitalization. The most common manifestations were significant alterations in consciousness (coma, stupor) in 12 patients, and either generalized or partial seizures in ten patients. Others included hemiplegia (4 patients), decerebrate posturing (3), cortical blindness (2), hallucinations (1), and dystonic posturing (1). Cranial computed tomographic scans were abnormal in eight of 11 patients scanned. The abnormalities included diffuse cerebral edema (4 patients), large vessel infarctions (3), diffuse multiple small infarcts (4), and multiple hemorrhages (1). Five patients died as a result of their central nervous system complications, and six had neurological sequelae at discharge. Five patients recovered and at discharge had no evidence of neurological dysfunction. PMID- 2715606 TI - Hydranencephaly and maximal hydrocephalus: usefulness of electrophysiological studies for their differentiation. AB - The EEG was evaluated in three cases of hydranencephaly and two cases of maximal hydrocephalus, and the visual evoked potential was studied in one case each of hydranencephaly and maximal hydrocephalus. The EEG tracing of hydranencephaly typically showed a flat pattern in most bipolar derivations because of the differential amplification of the same activity from remote generators. However, the EEG of maximal hydrocephalus did not demonstrate a flat pattern in bipolar as well as referential derivation, and the activities were different from various electrodes in referential derivation. The visual evoked potential of maximal hydrocephalus showed a normal pattern, while that of hydranencephaly showed no response. Electrophysiological examinations (such as EEG and visual evoked potential) are useful for differentiation of hydranencephaly and maximal hydrocephalus in cases whose computed tomographic scans do not provide clear differentiation. PMID- 2715607 TI - Placental examination in perinatal asphyxia. PMID- 2715608 TI - Home use of rectal diazepam to prevent status epilepticus in children with convulsive disorders. AB - Thirty families were taught to administer rectal liquid diazepam to their children to stop a seizure at home. Twelve children had previous prolonged afebrile seizures, and 18 had either prolonged or repeated febrile seizures. During follow-up, 17 of the 30 families administered the rectal diazepam an average of three times per child with no complications. Fifteen of 17 families reported prompt cessation of the seizure, while in two the rectal diazepam was unsuccessful and hospital treatment was needed. We conclude that rectal diazepam is a useful adjunctive home treatment for children at risk for prolonged seizures. Hospitalization is decreased and parental confidence increased. Without our knowledge, twelve families taught others how to give the rectal diazepam, a practice that might be hazardous and should be anticipated. PMID- 2715609 TI - Congenital choroid plexus papilloma of the fourth ventricle. AB - A newborn infant with marked hydrocephalus had a large papilloma of the choroid plexus originating in the fourth ventricle and infiltrating the brain stem. The computed tomographic (CT) scan appearance was distinctive, showing vascularity and marked enhancement with contrast medium. Histological confirmation was made from several surgical sites. Total removal of the tumor was not possible. Review of congenital choroid plexus brain tumors reveals the location of this child's tumor in the fourth ventricle to be uncommon. PMID- 2715610 TI - Acute pseudobulbar palsy due to bilateral focal cortical damage: the opercular syndrome of Foix-Chavany-Marie. AB - Two children are described who suddenly developed an encephalitic illness with intractable bilateral facial seizures. The seizures subsided over several days, but the children were left with the signs of pseudobulbar palsy and are unable to speak or swallow effectively. Bilateral destructive lesions in the opercular regions evolved on computed tomographic scans. Both children were treated with acyclovir relatively early in the illness, and cerebrospinal fluid and serum antibodies support the diagnosis of herpes simplex virus encephalitis. PMID- 2715611 TI - Meconium-induced vasocontraction: a potential cause of cerebral and other fetal hypoperfusion and of poor pregnancy outcome. AB - Chronically meconium-stained fetuses may ultimately suffer cerebral palsy and other devastation. The mechanism is unknown. Innocuous pregnancy complications may cause some fetuses to discharge meconium, which may become hazardous, independently of aspiration. We herein report previously undescribed, meconium induced umbilical and placental vascular necrosis. To investigate whether meconium causes vasocontraction, we tested umbilical vein tissue with an isometric transducer connected to a polygraph. The specimens were suspended in a 30-mL organ bath with Krebs solution (pH, 7.4; temperature, 37 degrees C; under aeration with 95% O2 and 5% CO2). We exposed the tissue to meconium and compared meconium-induced vasocontraction with that induced by Krebs solution and 10(-5) molar serotonin. Meconium maximally produced 62.9% of serotonin-induced vasocontraction. Krebs solution and boiled meconium did not produce vasocontraction. We hypothesize that meconium may cause placental and umbilical cord vasocontraction, cerebral and other fetal hypoperfusion, and major poor outcome. PMID- 2715612 TI - Intracranial arterial aneurysms complicating Behcet's disease. PMID- 2715613 TI - Type 2 GM2 gangliosidosis (Sandhoff's disease) in Saudi Arabia. PMID- 2715614 TI - Multiple sclerosis from late exposure to childhood infections: is the Alvord hypothesis correct? PMID- 2715615 TI - Residency training programs in child neurology and their accreditation. PMID- 2715617 TI - Organ transplantation. Papers from the symposium "Organ transplantation policy: issues and prospects". 26-28 June 1988, Vanderbilt. PMID- 2715616 TI - Recurrent myoglobinuria in a child with mental retardation: phosphoglycerate kinase deficiency. AB - We report the case of an 11-year-old mentally retarded boy with recurrent myoglobinuria precipitated after a generalized tonic-clonic convulsion. No hemolysis was noted. Ischemic forearm test revealed no rise of venous lactate, suggesting a metabolic defect in an anaerobic glycolytic pathway. Histochemistry studies of the quadriceps muscle showed a normal appearance, but electron microscopy confirmed a moderate increase of the glycogen content in muscle. Direct measurement of glycolytic enzymes demonstrated a marked decrease of phosphoglycerate kinase (PGK) activity in muscle (4.4% of control mean) and hemolysate (8% of control mean). Enzyme characteristics of PGK from our patient (PGK Hamamatsu) using hemolysate demonstrated that it had normal Michaelis constants (Km), normal thermal stability, and a normal pH curve. The reason that hemolytic anemia was absent is uncertain. We concluded that a systematic enzyme analysis of the glycolytic pathway, especially of PGK, should be performed on myoglobinuric patients who are males, or who have an X-linked inheritance as suggested by the family history. PMID- 2715618 TI - Changes in liver and spleen volumes in alcoholic liver disease. AB - Liver and spleen volumes were determined using computed tomography in 57 subjects with alcoholic liver disease and 76 subjects with nonalcoholic liver disease, in order to clarify the clinical characteristics and pathogenetic mechanisms of portal hypertension in alcoholic liver disease. The liver volumes in alcoholic liver disease were significantly larger than those in nonalcoholic liver disease, except in cases of decompensated liver cirrhosis. The increase in liver volume in alcoholic liver disease showed a significant correlation with the degree of hepatocytic ballooning. Overlapping of values for liver volume between alcoholic and nonalcoholic liver disease was quite small, suggesting that determination of liver volumes could be helpful for making etiological diagnoses in chronic liver disease. Spleen volumes were increased in the advanced cases of both alcoholic and nonalcoholic liver disease. The correlations between liver and spleen volumes were quite different between alcoholic and nonalcoholic liver disease. In nonalcoholic liver disease, a negative correlation was obtained, while, on the other hand, it was significantly positive in alcoholic liver disease. This appears to suggest that the pathogenetic mechanism of portal hypertension may differ between the diseases. After abstinence from alcohol, the decrease in liver and spleen volumes showed a statistically significant correlation, suggesting that ballooning of the hepatocytes may play a role in the augmentation of portal hypertension in alcoholic liver disease. PMID- 2715619 TI - Genetically determined oxidation polymorphism and drug hepatotoxicity. Study of 51 patients. AB - The influence of genetically determined oxidation polymorphism on drug hepatotoxicity has been poorly investigated and results are controversial. We studied drug oxidation capacity in 51 patients with hepatitis caused mainly by drugs undergoing oxidative metabolism, using dextromethorphan, a test compound recently proposed as a substitute for debrisoquine. Phenotyping was performed using the metabolic ratio (MR) calculated as MR = 0-10 h urinary output of dextromethorphan/0-10 h urinary output of dextrorphan (the main oxidative metabolite), after oral administration of 40 mg dextromethorphan hydrobromide. Dextromethorphan oxidation capacity was similar in patients and in 103 control subjects as judged by: (a) the prevalence of each phenotype (5.9% versus 3.9% for the poor metabolizer phenotype and 94.1% versus 96.1% for the extensive metabolizer phenotype; (b) the frequency distribution histograms of log metabolic ratio; (c) the mean values of dextromethorphan and dextrorphan urinary outputs and of log metabolic ratio for each phenotype. These results show that hepatotoxicity of several drugs, including amineptine, amodiaquine and Plethoryl, is related neither to an impairment in dextromethorphan oxidation capacity nor to an unusually high capacity to oxidize this drug. PMID- 2715620 TI - Kupffer cell number is normal, but their lysozyme content is reduced in alcoholic liver disease. AB - A quantitative immunohistochemical study of Kupffer cells in liver biopsies from alcoholics was carried out. Two markers were compared, lysozyme and an antimacrophage monoclonal antibody EMB/11. The results showed that there is no significant reduction in Kupffer cell numbers in acute and chronic alcoholic liver disease but that there is a reduction in the number of Kupffer cells staining positively for lysozyme. Thus, those clinical phenomena such as endotoxaemia in alcoholic liver disease are not due to reduction in Kupffer cell number but perhaps to a functional deficit in these cells. PMID- 2715621 TI - The histoautoradiographic localization of taurocholate in rat liver after bile duct ligation. Evidence for ongoing secretion and reabsorption processes. AB - To determine whether in complete obstructive cholestasis taurocholate is taken up by hepatocytes and if so whether it is secreted into bile, tritium-labelled taurocholate was localized by histoautoradiography on cryoslices from normal rat livers and from those after bile duct ligation. In non-cholestatic livers the hepatocytes of acinar zones 1 as well as the lumina and the epithelia of bile ductules and ducts became intensely labelled directly after injection of [3H]taurocholate into a mesenterial vein. Four hours and 4 days after bile duct ligation, hepatocytes of all three acinar zones became labelled, but in contrast to the normal state, pericanalicular concentration of silver grains was not observed, not even within 5 min. Fifteen days after bile duct obstruction, cryoslices taken 2 min after injection of [3H]taurocholate exhibited an intense silver grain labelling of all acinar zones, with the highest density at bile canalicular areas of the liver cell plates as well as the proliferated bile ductules and bile ducts. The biliary epithelium of small bile ductules and ducts of non-cholestatic and of bile duct-obstructed livers were also covered with silver grains; the epithelium of larger ducts exhibited significant labelling predominantly at the lateral sites of the cells. The biliary epithelium of the common bile duct was not significantly labelled. The results indicate that in complete obstructive cholestasis (a) taurocholate continues to be taken up from blood by hepatocytes and secreted into bile, but in terms of varying duration of obstruction, (b) all acinar zones are involved in bile salt transport, (c) in the initial phase (4 h and 4 days respectively after bile duct obstruction) hepatocytes fail to concentrate taurocholate at the canalicular site, (d) in a consecutive phase, in which bile ductules and ducts proliferate (demonstrated for a 15-day cholestasis), the taurocholate concentration at the canalicular site of hepatocytes is re-established and biliary secretion seems to be enhanced, (e) the biliary epithelium of bile ductules and ducts may play a significant role in the reabsorption and/or regurgitation of bile salts from bile to blood. Reabsorption/regurgitation of biliary constituents may also be operative in the non-cholestatic state but may become significantly enhanced with bile ductular proliferation. PMID- 2715622 TI - Chronic hepatitis B in male and female children of HBsAg carrier mothers. AB - We have studied a group of children born to HBsAg+ mothers, resident in the English West Midlands; none of the children had sought medical attention for hepatitis B-related problems. Forty-two out of 48 children born to HBeAg+ mothers were HBsAg+. Among these children, the mean age of the HBeAg+ girls was significantly lower than that of the HBeAg+ boys (P = 0.05), suggesting that girls eradicate HBeAg at a younger age than boys. Among all children born to HBsAg+ mothers, liver function tests were normal except in 2 HBsAg+ boys who had elevated serum aminotransferase activities. Excluding these boys, serum alanine aminotransferase activity, while within the normal range, was significantly higher in HBeAg+ and anti-HBe+ children than in their immune (anti-HBs+) and non infected siblings (P less than 0.01 and P less than 0.05). Waning infectivity was observed in many HBsAg+ mothers, giving rise to a typical pattern of infection within a family: older children, born to the still HBeAg+ mother, being HBeAg+ carriers, while younger siblings, born when the mother had become anti-HBe+, had no markers of infection. These younger children are vulnerable to 'horizontal' transmission. PMID- 2715623 TI - Recurrence of hepatitis B in children with serologic evidence of past hepatitis B virus infection undergoing antileukemic chemotherapy. AB - Two patients showed an unusual serologic response to hepatitis B virus infection during intensive chemotherapy for acute lymphoblastic leukemia. Before treatment, one patient was anti-HBs- and anti-HBc-positive. During intensive chemotherapy these antibodies disappeared and HBsAg and HBeAg became detectable. Twenty months later, still on maintenance chemotherapy, active viral replication with high DNA polymerase levels was present. The second patient developed anti-HBc during the first course of intensive chemotherapy for acute lymphoblastic leukemia. She had anti-HBc and anti-HBe when a bone marrow relapse of the leukemia was diagnosed 3 years later and became HBsAg-positive together with high DNA polymerase levels in the serum while receiving intensive chemotherapy. Clinically no signs of active hepatitis were noted in these patients. PMID- 2715624 TI - Response to surgeon-specific infection rates. PMID- 2715625 TI - How simple is disease-specific isolation? PMID- 2715626 TI - Shigellosis in the nursery. PMID- 2715627 TI - Proteeae groin skin carriage among nursing home residents--resistance to antiseptics. AB - Proteeae carriage was evaluated in groin skin carriers following vigorous antiseptic application. Three Proteus mirabilis carriers were treated with 60% isopropyl alcohol or 4% chlorhexidine, observed to prevent skin contact, and then recultured; at four and eight hours P mirabilis numbers remained undiminished. Ten Proteeae carriers received a series of nine body baths with soap, chlorhexidine, and 0.75% povidone-iodine plus three cefazolin injections over 16 to 34 days; cumulative treatments failed to clear seven carriers. Within three months, all were again carriers. Proteeae carriers also had affinity for groin carriage of various aerobic gram-negative bacilli (AGNB) including cefazolin resistant strains. In seven subjects, more than one AGNB species were recovered shortly after applying an antiseptic. Proteeae groin skin carriage appears to reflect a major change in the nature of resident bacteria on intact groin skin. PMID- 2715628 TI - The importance of nosocomial transmission of measles in the propagation of a community outbreak. AB - In late January 1985, a measles outbreak occurred at a community hospital in Columbia county, Florida. The outbreak spread throughout the county and to two neighboring counties (Alachua and Marion), resulting in 79 cases with a 29% hospitalization rate. Hospitals represented the site with the highest frequency of transmission. At the Alachua county hospitals, where strict respiratory isolation measures were taken, no secondary cases occurred among hospitalized patients. Two independent risk factors existed for hospitalization: measles exposure in a hospital setting (P less than 0.05) and nonvaccination (P less than 0.001). Of the total measles cases, 24% were under the age of 16 months and 47% of those aged 16 months or older had a history of appropriate vaccination. Columbia county, which experienced 86% of the cases, had a 5% frequency of unvaccinated students compared to 0.6% frequency at Alachua (P less than 0.001) where only 10% of the cases occurred. This outbreak demonstrates the role of uncontrolled nosocomial transmission of measles in the propagation of a community outbreak. PMID- 2715629 TI - Analytic strategies in hospital epidemiology: case-control studies. PMID- 2715630 TI - Infection control and hospital hygiene in Belgium. PMID- 2715631 TI - Chlamydia species strain TWAR. PMID- 2715632 TI - Comparison of transforming growth factor-beta and a macrophage- deactivating polypeptide from tumor cells. Differences in antigenicity and mechanism of action. AB - A factor in medium conditioned by mouse tumor cells was shown previously to suppress the capacity of mouse peritoneal macrophages to undergo a respiratory burst and to kill protozoal pathogens (macrophage deactivation factor, MDF). Recently, pure transforming growth factor-beta (TGF-beta) proved to be a potent macrophage deactivator as well. Two lines of evidence suggest that MDF is not identical with TGF-beta. First, rabbit anti-TGF-beta IgG neutralized the respiratory burst-suppressing activity of TGF-beta without affecting the bioactivity of MDF, even when the latter was treated with acid to activate potentially latent TGF-beta. Second, in contrast to MDF, which decreases the affinity of the NADPH oxidase for NADPH, permeabilized macrophages that had been deactivated with TGF-beta displayed the same Km and Vmax of the oxidase as activated macrophages. As with MDF, TGF-beta had no effect on two other potential control points over the secretion of respiratory burst products, namely, hydrogen peroxide catabolism or glucose uptake. Finally, neither MDF nor TGF-beta affected the extent or affinity of binding of phorbol diesters to macrophages, the activity or cofactor requirements for protein kinase C, or the ability of protein kinase C to translocate quantitatively from cytosol to membrane fractions in response to phorbol diesters. Thus, 1) MDF is not identical with TGF-beta, and 2) in contrast to the activation or deactivation of macrophages by numerous other agents, TGF-beta regulates macrophage respiratory burst capacity at a level other than the apparent affinity of the oxidase for its substrate. PMID- 2715633 TI - Reactivity of anti-human milk fat globule antibodies with synthetic peptides. AB - The nucleotide sequence of partial cDNA clones coding for the core protein of a human polymorphic epithelial mucin has recently been obtained, this mucin consists of a highly conserved 60 bp tandem repeat and the amino acids commonly found are PDTRPAPGSTAPPAHGVTSA. We synthesized three peptides, 1) P1.24 containing the 20 amino acids and four amino acids (PDTR) of the adjoining repeat; 2) P1.15 consisting of the first fifteen (PDTRPAPGSTAPPAH) and P1.09 the second nine amino acids (GVTSAPDTR) of peptide P1.24. The reactivities of the synthetic peptides with mAb known to react with breast cancer (BC1, BC2, BC3, HMFG-1, 3E1.2, and RCC-1) were studied. The synthetic peptide, P1.24, corresponding to the antigenic sequence predicted from the tandem repeat reacted with antibodies BC1, BC2, and BC3 (known to react with human milk mucin and mucin expressed in breast cancer) and the antibody HMFG-1 which was used to select the cDNA clones. In addition, the epitopes recognized by BC1, BC2, and BC3 appear to be in the same region of the molecule represented by their reactions with the nine amino acids in peptide P1.09 (GVTSAPDTR). By contrast, other antibodies such as 3E1.2 which reacts only weakly with components of human milk, and RCC-1 that detects a low Mr component (95 kDa) in breast cancer, had no specific reaction with the synthetic peptides, indicating that their epitopes are distinct from those of BC1, BC2, BC3, and HMFG-1. Inasmuch as the antibodies HMFG-1, BC1, BC2, and BC3 react with the fully processed milk mucin, it is likely that some of the peptide is exposed, even in the fully glycosylated molecule. Identification of the different epitopes could lead to the development of "second generation" mAb with enhanced specificity for breast carcinoma using the appropriate synthetic peptides as immunogens. PMID- 2715634 TI - Cessation of neutrophil influx in C5a-induced acute experimental arthritis is associated with loss of chemoattractant activity from the joint space. AB - Neutrophil emigration is a critical component of the inflammatory process and is generally thought to play a role in host defense as well as in the tissue injury that often accompanies inflammation. Most inflammatory reactions exhibit a sequence of emigrating cell types, thus clearly demonstrating that the neutrophil influx eventually ceases and that the neutrophils are then removed from the lesion. It has been our premise that in order to understand the processes that lead to the progressive inflammatory reactions that underly so many disease processes, it is important to determine the mechanism by which the "normal" inflammatory response resolves. The purpose of this study was to identify the time of cessation of neutrophil influx in experimental arthritis induced by the injection of C5 fragments (C5f) and to investigate mechanisms underlying the cessation process. The migration of i.v. delivery pulses to inflamed joints was assessed by lavage of the joint space and by external scintigraphy. We found no evidence for the development of inhibitory systems against chemotactic factors or "desensitization" of the inflamed site, because a second injection of C5f into joints which had been injected previously with C5f resulted in enhancement rather than inhibition of migration. Neither was evidence found for altered tissue barriers to migration or for desensitization of neutrophils as possible explanations for cessation of influx. The major mechanism appeared to be a loss of chemoattractant activity in the joint space between 2 h and 6 h after C5f injection which was detected by transfer into a fresh joint. Radiolabeled C5a des Arg had a t1/2 of disappearance from the joint of less than 1 h, which suggested that the transferred chemoattractant must, in part, have been due to the generation of new chemotaxins by C5f injection. These observations suggest that continued generation of chemoattractants or failure of their subsequent removal may be mechanisms leading to persistent neutrophil influx in chronic inflammation. PMID- 2715635 TI - Tumor necrosis factor inhibits the development of viral meningitis or induces rapid death depending on the severity of inflammation at time of administration. AB - Administration of human rTNF to both male and female mice with severe, but clinically inapparent, lymphocytic choriomeningitis caused death within 2 to 3 h. The development of fatal symptoms was accompanied by a two- to threefold reduction in the number of cells present in the cerebrospinal fluid, with this effect being more apparent in female mice. Giving the same dose of rTNF earlier in the course of the disease was not fatal and reduced the level of subsequent meningitis. In addition, prior exposure to rTNF protected against the acute development of lethal disease when a second dose of the cytokine was given later. The extent of this "tolerance" to rTNF was directly related to the degree of reduction of the inflammatory process resulting from the primary exposure to the cytokine. PMID- 2715636 TI - Characterization of MHC cDNA clones in the domestic cat. Diversity and evolution of class I genes. AB - The abundant functional polymorphism and evolutionary divergence of mammalian MHC class I genes has been affirmed recently by sequence analysis of more than 40 mouse H-2 and human HLA transcripts. In a comparative approach to the evolution of the MHC, we isolated eight molecular clones of feline MHC (termed FLA for feline leukocyte antigen) class I genes from a cDNA library of a cat T cell lymphoma line. DNA sequence analysis of eight clones revealed that they all fell into one of two internally identical allelic groups which differed by 9% of their nucleotide sequences. The occurrence of only two allelic cDNA clones is consistent with the expression of a single heterozygous functional class I gene in the studied cell line despite the occurrence of more than 20 class I copies estimated to be present in the cat genome. Comparison of the FLA class I coding sequence with other class I genes from other species revealed that the domestic cat genes display 81 to 82% sequence identity with human, and 73 to 79% sequence identity with mouse class I genes. Feline and human class I genes have similar sequences and protein structures, with three (alpha) extracellular domains, one transmembrane domain, and one cytoplasmic domain. Variable codons detected in FLA class I alleles were, in most cases, in positions which were also variable in humans and mice, whereas invariant positions with defined functional constraints were generally conserved and invariant between the three species as well. Southern analysis of DNA from diverse species of Felidae revealed a similar numerosity and restriction pattern indicating conservation of the organization of class I genes during the Felidae radiation. PMID- 2715637 TI - Antimitochondrial antibodies of primary biliary cirrhosis recognize dihydrolipoamide acyltransferase and inhibit enzyme function of the branched chain alpha-ketoacid dehydrogenase complex. AB - Antimitochondrial antibodies (AMA) recognizing the acetyltransferase (E2) of the pyruvate dehydrogenase (PDH) complex have been previously well-documented and the immunodominant epitope mapped. In this study, we demonstrate that sera from patients with primary biliary cirrhosis (PBC) react with another lipoic acid containing acyltransferase enzyme, namely the E2 of the branched chain alpha ketoacid dehydrogenase (BCKD) complex. Indeed, 85/120 (71%) sera from patients with PBC reacted with BCKD-E2 by immunoblotting against purified BCKD complex. In contrast, sera from patients with chronic active hepatitis or progressive sclerosing cholangitis as well as sera from healthy volunteers did not react with any component enzymes of the BCKD complex. More importantly, BCKD enzyme activity was inhibited after incubation of the BCKD complex with either PBC sera against BCKD-E2 or with affinity purified antisera to BCKD-E2. Enzyme activity was unaltered by control sera or with PBC sera that reacted with PDH-E2 but not BCKD E2. Furthermore, immunoblots of purified mitochondria probed with PBC sera absorbed with BCKD-E2 demonstrated that BCKD-E2 and PDH-E2 are each recognized by distinct AMA populations which do not cross-react. In addition, affinity purified PBC sera against BCKD-E2 did not react with PDH-E2 nor inhibit PDH enzyme activity, thus providing further evidence that BCKD-E2 and PDH-E2 are recognized by separate AMA. These data further suggest that the BCKD-E2 epitope recognized by AMA contains, or is close to, a functional domain of this enzyme. The availability of cDNA clones encoding BCKD-E2 and PDH-E2 will allow the study of how key metabolic enzymes may be involved in the immunology and pathology of PBC. PMID- 2715638 TI - Direct induction of Ia antigen on murine thyroid-derived epithelial cells by reovirus. AB - The ability of thyroid follicular epithelial cells (TFEC) to act as APC is linked to the expression of class II (Ia) molecules of the MHC. The cloned murine thyroid-derived epithelial cell line M.5 was used to demonstrate the potential effects of virus in the direct induction of Ia molecules on TFEC. Membrane binding and replication of reovirus type 1 in TFEC was demonstrated using fluorescein-labeled antireovirus antibody and fluorescence microscopy. One consequence of the interaction between reovirus and M.5 cells was the induction of Ia Ag and augmented class I molecule expression in M.5 cells. The levels of Ia expression at three days after reovirus binding were amplified 17.3-fold over controls and were 2-fold less than that seen upon treatment of M.5 cells with IFN gamma. Supernatant transfer experiments showed that the induction of Ia expression was directly linked to the binding of virus to M.5 cells, and was not dependent upon virus replication or the presence of IFN. These results indicate that early events of reovirus binding or receptor internalization on TFEC initiate a signaling process which results in the induction of class II and augmentation of class I MHC protein levels on the cell surface. PMID- 2715639 TI - Mixed IgA-IgG aggregates as a model of immune complexes in IgA nephropathy. AB - Patients with IgA nephropathy have circulating immune complexes containing IgA, IgG, and C3. We have mixed human IgG and IgA1 and heated them to form mixed aggregate. On sucrose density gradients IgG aggregates were 11 to 19S whereas IgA aggregates were either 11S or greater than 19S. Mixed aggregates had both an 19 and 11 S peak. The isoelectric point of aggregates with only IgG was 7 to 9 and of only IgA 4.5 to 5.5. The isoelectric point of mixed aggregates decreased as the percent IgA increased. IgG aggregates mixed with normal human serum caused 30% C3 activation (20 min, 37 degrees C) whereas IgA aggregates causes no activation. There was a linear decrease in C3 activation as the percent IgA increased. Mixed aggregates that contained either radiolabeled IgG or IgA were mixed with normal human serum (1 h, 37 degrees C) and then solubilized, reduced, and separated by 10% SDS-PAGE. Heavy m.w. bands, consistent with covalent bonding of C3b and C3bi to Ig H chain were only seen in lanes with labeled IgG. This was confirmed by Western blot analysis. A human dimeric IgA1 myeloma protein with rheumatoid factor activity was also studied. It caused 15% alternative pathway C3 activation but did not fix C3 to its H chain. Binding of aggregates (+/- C3) to E was tested. Aggregates with IgG C3 bound but IgA (+/- C3) did not. Addition of greater than 10% IgA to an IgG-C3 aggregate inhibited E binding. We conclude that IgG in mixed aggregates is the site of C3 fixation. In contrast, IgA does not fix C3 but instead lowers the isoelectric point, increases the size and inhibits binding to E. These properties would inhibit clearance and promote mesangial deposition and local C activation. PMID- 2715640 TI - Diversity and diversification of HLA-A,B,C alleles. AB - The nucleotide sequences encoding 14 HLA-A,B,C and 5 ChLA-A,B,C molecules have been determined. Combining these sequences with published data has enabled the polymorphism in 40 HLA-A,B,C and 9 ChLA-A,B,C alleles to be analyzed. Diversity is generated through assortment of point mutations by recombinational mechanisms including gene and allelic conversions. The distribution and frequency of silent and replacement substitutions indicate that there has been positive selection for allelic diversity in the 5' part of the gene (exons 1 to 3) and for allelic homogenization and locus specificity in the 3' part of the gene (exons 4 to 8). These differences may correlate with the lengths of converted sequences in the two parts of the gene and frequency of the CpG dinucleotide. Locus-specific divergence of HLA-A,B, and C demonstrates that recombinational events involving alleles of a locus have been more important than conversion between loci. This contrasts with the predominance of gene conversion events in the evolution of mutants of the H-2Kb gene. However, a striking example of gene conversion involving HLA-B and C alleles of an oriental haplotype has been found. Comparison of human and chimpanzee alleles reveals extensive sharing of polymorphisms, confirming that diversification is a slow process, and that much of contemporary polymorphism originated in ancestral primate species before the emergence of Homo sapiens. There is less polymorphism at the HLA-A locus compared to HLA-B, with greater similarity also being seen between HLA-A and ChLA-A alleles than between HLA-B and ChLA-B alleles. Although greater diversity is seen in the 5' "variable" exons of HLA-B compared to HLA-A, there is increased heterogeneity in the 3' "conserved" exons of HLA-A compared to HLA-B. PMID- 2715641 TI - Regulation of formyl peptide receptor binding to rabbit neutrophil plasma membranes. Use of monovalent cations, guanine nucleotides, and bacterial toxins to discriminate among different states of the receptor. AB - The regulation by monovalent cations, guanine nucleotides, and bacterial toxins of [3H]FMLP binding to rabbit neutrophil plasma membranes was studied by using dissociation techniques to identify regulatory effects on separate receptor states. Under conditions of low receptor occupancy (1 nM [3H]FMLP) and in both Na+ and K+ buffers, dissociation is heterogenous, displaying two distinct, statistically significant off rates. [3H]FMLP binding was enhanced by substituting other monovalent cations for Na+. In particular, enhanced binding in the presence of K+ relative to Na+ was caused by additional binding to both rapidly and slowly dissociating receptors. Three receptor dissociation rates, two of which appear to correspond to the two affinity states detected in equilibrium binding studies, were defined by specific GTP and pertussis toxin (PT) treatments. Neither GTP, nor PT or cholera toxins (CT) had an effect on the rate of dissociation of [3H]FMLP from the rapidly dissociating form of the receptor. Both 100 microM GTP and PT treatments increased the percentage of rapidly dissociating receptors, correspondingly decreasing the percentage of slowly dissociating receptors. The observed changes in the rapidly and slowly dissociating receptors after GTP, PT, and CT treatments were caused by an absolute decrease in the amount of binding to the slowly dissociating receptors. However, complete inhibition of slowly dissociating receptor binding by GTP, PT, or both was never observed. Both GTP and PT treatments, but not CT treatment, increased by two-fold the rate of dissociation of 1 nM [3H]FMLP from the slowly dissociating form of the receptor, resulting in a third dissociation rate. Thus, slowly dissociating receptors comprise two different receptor states, a G protein associated guanine nucleotide and PT-sensitive state and a guanine nucleotide insensitive state. PMID- 2715642 TI - Class II restriction in mice to the malaria candidate vaccine ring infected erythrocyte surface antigen (RESA) as synthetic peptides or as expressed in recombinant vaccinia. AB - The immune response to three peptides corresponding to the repeat regions of the malaria candidate vaccine ring infected E surface Ag (RESA) were studied. Both antibody responses and lymphocyte stimulation in mice injected with these peptides without carrier were found to be restricted to certain MHC class II haplotypes. Mice bearing IAk were strong responders to all three peptides. Mice bearing IAd were strong responders only to the 3' repeat peptides, the octamer and tetramer. Mice bearing Is or Iq did not respond to any repeat peptides. Remarkably, the pattern of genetic restriction of the antibody response to the entire RESA as expressed in vaccinia indicated that there were no other epitopes besides the three repeats. Because only one class II haplotype (i.e., k) out of five tested responded strongly to this peptide and only two out of five (i.e., k and d) responded to the octamer or tetramer, it may be difficult to achieve a good immune response against RESA in most or all humans. PMID- 2715643 TI - Differential expression of the class I MHC genes in the embryo and placenta during midgestational development in the mouse. AB - A sensitive RNase mapping technique was used to investigate the expression of individual class I mRNA in the embryo and placenta of the mouse from day 7.5 through day 13 of gestation. Transcripts of the H-2Kd and -Dd genes appeared in both placental and embryonic tissues as early as day 7.5 post coitum and continued to be expressed thereafter. In contrast, H-2Ld mRNA was barely detectable in embryonic RNA until day 18 of pregnancy, although it was present in placental RNA samples on days 10 to 13 of gestation. Qa-region genes demonstrated a different pattern of expression than H-2Dd, -Kd, and -Ld. Transcripts of Q7, one of the genes encoding Qa-2 surface Ag, were detected in the developing embryo on days 9 to 11 post coitum but decreased thereafter. However, Q7d transcripts were not detected in placental tissues at any stage. Q6 mRNA was not detected in any of the tissues, and Q10 mRNA was detected only in day 12 to 13 embryos, where expression is known to be restricted to the fetal liver. Transcripts from T13, a Tla-region gene, and D2d, a D-region gene, were not detected in any of the samples tested. This study has revealed a complex pattern of class I gene regulation both within the genes of the MHC and between the embryo and placental lineages during the midgestational stages of development. PMID- 2715644 TI - Effect of wavelength on cutaneous pigment using pulsed irradiation. AB - Several reports have been published over the last two decades describing the successful removal of benign cutaneous pigmented lesions such as lentigines, cafe au lait macules' nevi, nevus of Ota, and lentigo maligna by a variety of lasers such as the excimer (351 nm), argon (488,514 nm), ruby (694 nm), Nd:YAG (1060 nm), and CO2 (10,600 nm). Laser treatment has been applied to lesions with a range of pigment depths from superficial lentigines in the epidermis to the nevus of Ota in the reticular dermis. Widely divergent laser parameters of wavelength, pulse duration, energy density, and spotsizes have been used, but the laser parameters used to treat this range of lesions have been arbitrary, with little effort focused on defining optimal laser parameters for removal of each type. In this study, miniature black pig skin was exposed to five wavelengths (504, 590, 694, 720, and 750 nm) covering the absorption spectrum of melanin. At each wavelength, a range of energy densities was examined. Skin biopsies taken from laser-exposed sites were examined histologically in an attempt to establish whether optimal laser parameters exist for destroying pigment cells in skin. Of the five wavelengths examined, 504 nm produced the most pigment specific injury; this specificity being maintained even at the highest energy density of 7.0 J/cm2. Thus, for the destruction of melanin-containing cells in the epidermal compartment, 504 nm wavelength appears optimal. PMID- 2715645 TI - Subcutaneous blood flow in early male pattern baldness. AB - The subcutaneous blood flow (SBF) was measured by the 133Xe washout method in the scalp of 14 patients with early male pattern baldness. Control experiments were performed in 14 normal haired men matched for age. The SBF in the scalp of the normal individuals was about 10 times higher than previously reported SBF values in other anatomical regions. In patients with early male pattern baldness, SBF was 2.6 times lower than the values found in the normal individuals (13.7 +/- 9.6 vs 35.7 +/- 10.5 ml/100 g/min-1). This difference was statistically significant (p much less than 0.001). A reduced nutritive blood flow to the hair follicles might be a significant event in the pathogenesis of early male pattern baldness. PMID- 2715646 TI - Relationship of sebaceous cell stage to growth in culture. AB - The maturational stage at which sebaceous epithelial cells are irreversibly committed to autolysis has not been determined in a biologic system. The purpose of these experiments was to determine the relationship of sebocyte maturation to their ability to grow in culture. Single cell suspensions from adult rat preputial glands were prepared, and sebocyte stages were classified using lipid staining as one criterion of maturation. Cells were subjected to one-step, isokinetic discontinuous density gradient centrifugation in Percoll. Cells were cultured on 3T3 feeder layers in an epithelial cell medium containing 20% fetal calf serum, growth factors, and antibiotics. Growth in culture occurred from sebocytes in all gradient fractions. The least growth was found from cells in the lightest density fraction (1.020), which contained sebocytes with the most lipid, i.e., the most mature. Over fivefold more growth occurred from cells in the most dense fraction (1.080), which contained undifferentiated and immature sebocytes. Cell growth in culture was then correlated with the type of sebocyte in each fraction plated. Although cell growth in culture correlated significantly with the number of undifferentiated cells (r2 = 0.460), epithelial colonies were found in the absence of discernible undifferentiated cells in most fractions. Growth in culture correlated much better with the number of early plus mid-differentiated sebocytes (r2 = 0.702). These data suggest that, whereas mature sebocytes are not capable of attachment/proliferation, early differentiation of sebocytes is compatible with retention of the capacity to proliferate. If this property is shared by human sebocytes, it would contribute to the intransigence and diversity of acne-form lesions. PMID- 2715647 TI - Effects of topically applied antiandrogenic compounds on sebaceous glands of hamster ears and flank organs. AB - Growth of sebaceous glands in the ears and flank organs of castrated male hamsters is dependent on androgen substitution. Taking this for granted, a study was done to compare the effects of topical antiandrogenic treatment in vivo on the morphology and size of sebaceous glands with the concomitant changes in in vitro metabolism of 3H-testosterone. The role of dihydrotestosterone in sebaceous gland stimulation was thereby investigated. Topical treatment was carried out with the androgen antagonist 17 alpha-propylmesterolone (PM), with 4-androsten-3 one-17 beta-carboxylic acid (17 beta-C), and 17 beta-N,N-diethylcarbamoyl-4 methyl-4-aza-5 alpha-androstan-3-one (4-MA), both described as specific 4-steroid 5 alpha-reductase inhibitors, and with progesterone (PRO), which is an androgen receptor antagonist with 5 alpha-reductase inhibiting properties. Regrowth of sebaceous glands after castration and substitution with testosterone propionate or dihydrotestosterone could be inhibited by topical PM and PRO. This occurred irrespective of the influence on testosterone metabolism and irrespective of the mode of substitution. 4-MA, on the other hand, while exhibiting strong 5 alpha reductase inhibition in vitro, was ineffective in reducing sebaceous gland sizes in vivo. The compound 17 beta-C was ineffective in every respect. In no case were systemic antiandrogenic effects on prostates and seminal vesicles observed. Our results support the view that the DHT formation rate has no regulatory function for growth of sebaceous glands in hamsters and that PM and PRO counteract the androgenic stimulus by their competitive antagonistic binding to the androgen receptor, but not by their influence on testosterone metabolism. PMID- 2715648 TI - Regression of Kaposi's sarcoma and improvement of performance status by a combined interferon beta and zidovudine therapy in AIDS patients. PMID- 2715649 TI - U.S./Japan Cooperative Cancer Research Program. Proceedings of the United States Japan Melanoma and Skin Cancer Seminar on the Biology and Comparative Features. November 13-15, 1987, Tokyo. PMID- 2715650 TI - Report on United States--Japan Cooperative Cancer Research Program: melanoma and skin cancer--biology and comparative features in the United States and Japan. PMID- 2715651 TI - Comparative aspects of melanoma and non-melanoma skin cancers in Japan. AB - A total of 279 patients with squamous cell carcinoma (SCC), 169 with basal cell carcinoma (BCC), and 91 with malignant melanoma (MM) were treated at Saitama Medical School and the National Cancer Center (NCC). This statistical study was done to compare an early period (1962-1972) and recent period (1973-1985). The yearly onset of melanoma patients increased 3.4 times and that of basal cell carcinoma increased 1.8 times, while the percent of squamous cell carcinoma patients decreased slightly. The male/female ratio was 1.6 versus 1.1 for basal cell carcinoma, 2.0 versus 1.7 for squamous cell carcinoma, and 1.7 versus 1.2 for malignant melanoma in the early versus late periods. The age distribution of malignant melanoma patients showed a sudden increase after 20, which peaked in the fifties in the late period, while an even distribution between 40 and 60 was found in the early period. The frequency of preceding diseases in squamous cell carcinoma was 8 times for actinic keratosis, 0.6 times for scars and 1.1 times for radiodermatitis. Absences of preceding diseases for the different malignancies in the early and later periods were 28% vs 43% of squamous cell carcinoma, 76% vs 86% of basal cell carcinoma, and 93% vs 97% of malignant melanoma. The number of squamous cell carcinoma and malignant melanoma on the head and neck increased 1.2 times and 4.5 times, respectively. The frequency in each disease was 46.0% for squamous cell carcinoma and 11.1% for malignant melanoma. Palmo-plantar-subungual melanoma (PPSM) was seen in 40.7% and 34.5%. PMID- 2715652 TI - Clinical features and distribution of malignant melanoma and pigmented nevi on the soles of the feet in Japan. AB - This study, based on 842 cases of malignant melanoma from 108 medical schools and medical centers in Japan (from 1983 to 1985), presents information regarding the incidence, sex and age distribution, anatomical location, and clinical features of malignant melanoma in Japan and compares it with data from the United States. In the white population, the epidemiologic evidence indicates that exposure to sunlight may be an important causal factor of the disease. On the other hand, in more heavily pigmented races, such as Negroids and Orientals, many of the malignant melanomas occur on the skin of the unexposed soles of the foot. In our survey, 241 out of 833 cases of melanoma (28.9%) in Japanese patients involved the skin of the soles. Whites tend to have a wide distribution of cutaneous melanoma over the whole body surface, showing the greatest aggregation of lesions on the head, neck, and trunk, with small number on the soles of the feet. This comparative study revealed that the anatomical distribution and clinical types of malignant melanoma in the United States and Japan were different. The racial difference--the highest frequency or proportion of melanoma on the skin of the soles in the pigmented races, and the lowest ratio of this anatomical area in the least-pigmented races--remains to be investigated. PMID- 2715653 TI - Epidemiology and control of melanoma in white populations and in Japan. AB - In white populations living at moderate or low latitudes, melanoma has become one of the most common tumors in young adults. Epidemiologic studies show a complex association with sun exposure. Risk is related positively to the levels of exposure typical of the place of residence, and also to personally controlled exposure, with the maximum risk being related to acute intermittent exposure. Risk also varies with pigmentation, family history of melanoma, and the presence of benign and of dysplastic nevi. The following methods of control of melanoma in such populations are discussed: the most effective methods depend on early diagnosis; primary prevention appears difficult and requires evaluation; identification of very high-risk subjects on the basis of family history and dysplastic nevi will affect only a very small proportion of melanomas; the use of simpler methods to identify high-risk subjects is explored. In Japan, melanoma is comparatively rare, but increasing as rapidly as elsewhere. The incidence rate of acral lentiginous melanoma appears similar to that in whites, comprising a large proportion of melanoma in Japan. Control programs cannot be designed rationally, since basic information on the occurrence, presentation, and survival of melanoma in Japan is lacking. Some specific research questions are suggested. PMID- 2715654 TI - Comparison of acral nevomelanocytic proliferations in Japanese and whites. AB - The preponderance of malignant melanomas that occur in the Japanese population affect the palmar and plantar areas, in contrast to those of whites, which occur predominantly on the head, neck, and trunk. Furthermore, a precursor lesion, the dysplastic nevus, has been well defined in nonacral white skin but not in the Japanese. In this paper, a similarity between benign and atypical acral nevomelanocytic proliferations in Japanese and whites is described. However, it appears that in the Japanese group the melanocytes in benign and atypical proliferations are less dendritic than those noted in whites, and, in both groups, extensive pigmentation was noted in both the epidermal and dermal components of benign and malignant lesions in this limited review. A practical approach to classifications of atypism is, likewise, offered. PMID- 2715655 TI - Cutaneous melanoma in Japan and the United States: comparative prognostic factors. AB - The ability to predict outcome for an individual patient with melanoma is important not only for the prognostic interests of the particular patient involved, but also for the design and accurate interpretation of surgical and adjuvant therapy studies. Comparison of prognostic studies between centers in the United States and Japan may result in understanding biologic differences between the disease as it manifests in whites and mongoloids. Studies from the Melanoma Clinical Cooperative Group (U.S.A.) and from Tohoku University (Japan) show some significant similarities and some differences. Overall five-year survival is quite different for clinical state I patients, 85% and 65%, respectively. However, when five-year survival for lesions on the hands and feet in the U.S. series is compared with the mainly acral melanomas in the Japanese series, the results show five-year survivals of 63% and 73%, respectively. Comparison of five year survivals for clinical stage I acral lentigenous melanoma of the soles subdivided by thickness would establish whether data from the large series collected in the United States can be extrapolated to melanoma behavior in Japan. PMID- 2715656 TI - Porokeratosis has neoplastic clones in the epidermis: microfluorometric analysis of DNA content of epidermal cell nuclei. AB - Clinical evidence of malignant epithelial tumors developing on the lesions of porokeratosis has accumulated. To determine the cytologic basis for the malignant change of porokeratosis, the nuclear DNA content of epidermal cells from porokeratosis lesions was measured using microfluorometry. A total of 42% of 33 porokeratosis skin lesions in eight of the 16 patients showed DNA polyploidization in the epidermis. Most of the porokeratosis skin lesions, with or without DNA polyploidization, increased cell proportions in the S and G2/M phase range. These findings suggest that porokeratosis is undergoing the neoplastic process, and is the precursor skin manifestation of malignant tumors. PMID- 2715657 TI - Melanoma and other skin cancers in xeroderma pigmentosum patients and mutation in their cells. AB - Malignant melanomas were found in 15.8% of xeroderma pigmentosum (XP) patients with skin cancer in Japan. When multiple cancers were scored separately depending on the histopathologic types, 12.1% of the skin cancers in XP patients was malignant malignant melanoma. The relative incidence of malignant melanoma in skin cancer in XP patients is similar to that in skin cancer in general (12.6%), reported previously. Most of the malignant melanoma in XP patients developed in skin exposed to sunlight, in contrast to the high incidence of malignant melanoma in general in the unexposed skin of Japanese people. A DNA repair defect of UV damage is strongly suggested to be responsible for the high incidence of skin cancer in XP patients. The onset of malignant melanoma in XP patients was about ten years old, and was as early as those of basal cell carcinoma and squamous cell carcinoma in the patients with very low DNA repair capacities. Among nine genetic complementation groups and a variant type, group A XP cells were found to be extremely hypermutable by ultraviolet light, while group C XP cells were also hypermutable, but at the same level as normal cells when adjusted for survival. Mutagenesis as a possible mechanism of carcinogenesis in XP is supported by these results, but evidence in other cancer-prone hereditary diseases is yet to be obtained. PMID- 2715658 TI - Genetic control of signal transduction in mouse melanocytes. AB - At the final step of melanocyte differentiation in mouse hair follicles, the cells produce melanin. The type of melanin they produce is, however, determined by the tissue environment of hair follicles. In wild-type mice, melanocytes located in hair bulbs synthesize eumelanin at the beginning of hair growth. They subsequently produce pheomelanin and finally produce eumelanin again. Therefore, the hair is characterized by a subterminal band of yellow, with the rest of it displaying black. This characteristic is called the agouti pattern and is known to be determined by the wild-type allele, A at the a (agouti) locus, which is considered to function in the follicular cells. Expression of the agouti pattern is altered by genetic substitutions at the a locus and the e (extension) locus. Animals heterozygous for the Ay (lethal yellow) allele exhibit yellow coat color; those homozygous for the e (recessive yellow) also produce yellow hair exclusively. By using an organ culture method, we demonstrated that alpha-MSH and cholera toxin, as well as forskolin, induced eumelanin synthesis in explants from lethal yellow mice (Ay/a). On the other hand, these reagents did not induce eumelanogenesis in the hair follicles of recessive yellow (e/e) mice. Therefore, we assume that the product of the a locus, which probably functions in follicle cells, interacts with alpha-MSH at the alpha-MSH receptor and that the e locus controls the functionality of adenylate cyclase in the membrane of mouse melanocytes. PMID- 2715659 TI - Environment: peculiar pigment cell neoplasm in fish. AB - Chromatophoroma in the croaker (Nibea mitsukurii) showed a unique geographic distribution. The contribution of environmental chemicals to the cause of chromatophoroma in the feral croaker is considered likely on the basis of the following results in our studies. 1) Chromatophoroma was induced in tank-reared N. mitsukurii by administration of certain kinds of known carcinogens such as 7,12-dimethyl-benz(a)anthracene, N-methyl-N'-nitro-N-nitrosoguanidine, and nifurpirinol. 2) Local accumulation of pigment-cell hyperplasia in the catfish (Protosus anguillaris) showed similar tendencies to those of chromatophoroma in N. mitsukurii. 3) Removal of contaminated sediment from the harbor and the river appeared to reduce the incidence from 47% in 1973-1983 to about 20% in 1985-1987. 4) Waste water from a factory located at the station where the incidence of the neoplasm was the highest contained mutagenic substances such as chloroacetones and glyoxals [5]. Exposure of catfish to the waste water induced pigment-cell hyperplasia on the skin. PMID- 2715660 TI - Neural crest cell differentiation and carcinogenesis: capability of goldfish erythrophoroma cells for multiple differentiation and clonal polymorphism in their melanogenic variants. AB - Multiple differentiation shown by a single cell line (GEM 81) of goldfish erythrophoroma (tumors of integumental erythrophores) cells after administration of chemical induction in vitro includes 1) melanogenesis, 2) formation of reflecting platelets, 3) synthesis of pteridines heterogeneous to this species, 4) formation of dermal skeletons such as teeth and fin rays, 5) production of neuronal characters, and 6) genesis of lentoid bodies. Melanogenic cells, highest in inducibility, also show remarkable phenotypic diversification in their cell morphology, pigmentation, and physiologic response. In this paper, the following findings are presented; a) multiple differentiation shown by erythrophoroma cells occurs on a clonal basis, making whole component cells of a given induced colony strikingly similar in their cell characters, and b) induced melanogenic clones manifest a remarkable polymorphism in their melanosome ultrastructure and receptor composition associated with motile response. The divergence covers concentric lamellar, multivesicular, fibrillar, and macroglobular types for the former, and a varying combination of receptors for epinephrine, melanin concentrating hormone (MCH), and melatonin for the latter. Because a spectrum of phenotypes expressed by differentiation-induced erythrophoroma cells is restricted to those of neural crest origin (except lentoid bodies) and polymorphism in induced melanized cells is composed mostly of a collection of a variety of known melanogenic characters, it is presumed that erythrophoroma cells are capable of multiple differentiation within the commitment as neural crest cells. PMID- 2715661 TI - Genomic DNA with transformation-related activity and melanoma antigen expression. AB - We have analyzed the mouse melanoma antigen with monoclonal antibodies established by syngeneic immunization. To further understand the structure of this antigen at a molecular level, we have cloned the genomic DNA controlling the expression of melanoma antigen by cosmid library transfection and a monoclonal antibody. In the process of analyzing this DNA fragment we found that it contained a gene related with transformation, which was proved by tumor formation in nude mice inoculated with NIH/3T3 transfectants of this DNA fragment. We discuss the structure of the gene product based on the deduced amino acid sequence of cDNA, which maps the genome bearing transformation-related activity. PMID- 2715662 TI - Sister chromatid exchange-related characteristics of excision repair-proficient xeroderma pigmentosum cells. AB - A high incidence of skin cancer characterizes patients with xeroderma pigmentosum (XP). XP patients have hereditary defects in repair mechanisms of ultraviolet light (UV)-induced damage to DNA. Progress in elucidating the pathogenesis of cutaneous cancers can be expected by analysis of the biologic defects of cultured cells from XP patients. Such information may also contribute, at least in part, to an understanding of carcinogenesis in general. PMID- 2715663 TI - Fine structural and immunohistochemical properties of dysplastic melanocytic nevi: comparison with malignant melanoma. AB - This study will review the clinical features of dysplastic melanocytic nevi (DMN) in Japanese cases, and then show the fine structure of melanosomes/melanogenesis in the dysplastic melanocytes and the immunohistochemical property of DMN as identified by monoclonal antibodies against human melanosome specific antigen (HMSA). The incidence of DMN is quite low in the Japanese. It is indicated that this fact may partly explain the low incidence of malignant melanoma in Japanese; in particular, low incidence in sun-exposed areas. The patients with DMN were largely males. They were different from ordinary Japanese in that they usually burn and tan poorly after sun exposure. In addition, the synthesis of melanosomes in the dysplastic melanocytes was found to be abnormal and characterized by a significant alteration in the fine structure of the melanosomal matrix and the pattern of melanization. These abnormal melanosomes reacted positively with MoAb HMSA-1 and HMSA-2, which identify the structural matrix protein of melanosomes unique to neoplastic melanocytes. Importantly, HMSA was present in both dysplastic melanocytes and melanoma cells, but not in epidermal melanocytes (nevus cells) of common melanocytic nevi. PMID- 2715664 TI - Giant congenital nevus and malignant melanoma. AB - Frequency of malignant transformation arising in giant congenital nevi is considered to be 4%-5%. More than a half of the patients in which malignant melanoma developed in giant congenital nevi were under the age of 10. It may be hypothesized that dermabrasion of giant congenital nevus may provoke malignant transformation. Some of the cell groups in giant congenital nevus are potentially malignant. Some groups of nevus cells were larger in size than those of other portions of nevus. Electron microscopic observation revealed that nuclei of these larger nevus cells were significantly indented, and melanization of melanosomes was irregular. Coexistence of alpha-like actin with beta- and gamma-actins in giant congenital nevus cells and disappearance of alpha-like actin in malignant melanoma cells were noted. PMID- 2715665 TI - Proliferating giant pigmented nevus: a report of an unusual tumor occurring in association with a congenital giant pigmented nevus. AB - A 32-year-old Japanese woman with a giant pigmented congenital nevus of the torso presented with a massive pigmented tumor mass of the vulva which grew over an 8 year period. Histologically, the tumor was composed of benign appearing nevus like cells with focal areas of extensive fibrous response. The tumor cells were positive for S-100 protein and with an antihuman melanoma antibody (MoAb 225, 28S) stain. Electron microscopy confirmed the nevomelanocytic nature of the tumor cells and demonstrated peculiar cytoplasmic crystalline tubular structures similar to those seen in cells infected with herpes virus type II. We propose the term "proliferating giant pigmented nevus" for this previous undescribed tumor. PMID- 2715666 TI - Immunosurveillance and melanoma. AB - There is considerable indirect and some direct evidence that immune mechanisms can play an important role in controlling the growth of melanoma. In mice, melanoma can be prevented with vaccines. Consequently, even though naturally occurring immunosurveillance may not be sufficiently potent to prevent melanoma, it is possible that the prophylactic augmentation of immunity to melanoma with vaccines may eventually permit this cancer to be prevented in humans. PMID- 2715667 TI - Levodopa/dopamine analogs as inhibitors of DNA synthesis in human melanoma cells. AB - Compounds possessing the ortho-dihydroxybenzene moiety and structurally related to levodopa and dopamine appear to belong to a new class of biologically active agents that are capable of inhibiting DNA synthesis in a variety of normal and malignant eukaryotic cells. They appear to work in part through their properties as potent reducing agents, and thereby interfere with several redox reactions that are crucial to the synthesis of cellular DNA. Interestingly, the compounds can then be converted to their oxidized or quinone forms, which are powerful electrophiles, and further disrupt cellular metabolism. This latter mechanism appears to account for the relatively increased cytotoxicity observed in melanin producing cells. In addition to providing potential new agents for the treatment of advanced malignant melanoma, these compounds might prove to be valuable tools in determining the factors that influence rates of DNA synthesis in normal and malignant cells. PMID- 2715669 TI - The mapping of interferon-induced proteins and phosphoproteins from HeLa S3 cells. AB - Fourteen of 18 proteins induced by interferon-alpha (IFN-alpha) in HeLa S3 cells were labeled with [35S]methionine, resolved by two-dimensional electrophoresis, and assigned coordinates corresponding to HeLa proteins previously mapped by Bravo and Celis (Clin. Chem. 28, 766-781, 1982). Proteins phosphorylated with [gamma-32P]ATP in response to polyinosinic:polycytidylic acid [poly(I):poly(C)] were mapped similarly. Multiple phosphorylated species of a 72-kD protein were labeled in response to poly(I):poly(C) by extracts from IFN-treated cells but not by extracts from control cells. These are likely phosphorylated forms of the IFN induced poly(I):poly(C)-dependent protein kinase, the enzyme responsible for the phosphorylation of the alpha-subunit of eukaryotic initiation factor 2 (eIF-2 alpha). Two phosphorylated forms of eIF-2 alpha were labeled in extracts of IFN treated cells. One of these is a new phosphorylated product of the double stranded (ds) RNA-activated protein kinase. PMID- 2715668 TI - The effects of rHuIFN-alpha A/D on brain lipids and behavior of neonatal ICR Swiss albino mice. AB - Systemic administration of interferon (IFN) can cause reversible neurologic side effects, but there is little information on its effect on the developing nervous system. We studied the effects of daily, subcutaneous injections of recombinant human interferon-alpha A/D (rHuIFN-alpha A/D) (which has biological activity in mice) on brain development of neonatal ICR Swiss albino mice. Animals were treated daily between 8 and 20 days of age (doa) with 5 x 10(4) units (U) of rHuIFN-alpha A/D and sacrificed at 24, 62, and 111 doa following testing in an active avoidance paradigm. Results show that rHuIFN-alpha A/D causes transient decreases in body and brain weights. There were no changes in brain total lipid, ganglioside, phosphorus, or cholesterol content, but there was a transient decrease in neutral glycolipid content. In addition, treated animals exhibited decreased spontaneous activity levels and an impaired retention of a learned behavior. These results suggest that there are some long-term treatment effects on behavior following administration of rHuIFN-alpha A/D to mice during the neonatal period. PMID- 2715670 TI - 2',5' oligoadenylate synthetase activity in bovine peripheral blood mononuclear cells following bovine herpesvirus type-1-induced respiratory disease: a prognostic indicator? AB - Following aerosol-challenge of nonimmune calves with bovine herpesvirus type-1 (BHV-1) the levels of 2',5' oligoadenylate (2-5A) synthetase in peripheral blood mononuclear cells (PBML) increased significantly to peak 4-5 days after BHV-1 infection. This corresponded temporally to the period of highest susceptibility to secondary bacterial infection. Ten days post virus infection, the enzyme levels had returned to baseline values. Aerosol challenge with bacteria (Pasteurella haemolytica) did not induce 2-5A synthetase activity in PBML, neither did it influence the kinetics of 2-5A synthetase induction by virus infection during a dual viral-bacterial infection. Pretreatment of animals with bovine recombinant interferons (IFNs) 0-96 h prior to virus challenge curtailed the viral infection and thus reduced the levels of 2-5A synthetase induced by endogenously produced IFN. A relationship between 2-5A synthetase levels on day 5 post virus infection and clinical outcome of the dual infection was noted. Moreover, the high 2-5A synthetase levels could be correlated with low plasma Zn levels, another indicator of clinical respiratory disease. These results indicate that these two parameters, 2-5A synthetase and plasma Zn, in combination have potential prognostic value in viral-bacterial infections of the respiratory tract. PMID- 2715671 TI - Production of monoclonal antibodies toward bovine interferons-alpha suitable for immunopurification. AB - Five murine hybridoma clones, producing monoclonal antibodies (MAbs) to bovine interferon-alpha (BoIFN-alpha) were established. One of these, F12, secreted MAbs giving high titers, in ELISA tests, neutralizing both BoIFN-alpha, -alpha C, and BoIFN-alpha D activities, belonging to the mouse IgG1 class, and having a binding affinity constant of 10(8) M-1. F12 MAbs were used for immunoaffinity purification of BoIFN-alpha, and recombinant BoIFN-alpha C from Escherichia coli extracts was purified to homogeneity in SDS-PAGE analysis and to a specific activity of 2 X 10(8) U/mg with 90% recovery of activity. PMID- 2715672 TI - Heat shock proteins in normal and leukemic blood cells. AB - Heat shock proteins (HSPs) are though to represent a ubiquitous cellular response to heat or stress. We tested whether HSPs can be induced in hairy cells, other human leukemic cells, and normal lymphocytes, and whether there are additive or synergistic effects between heat shock and interferon-alpha 2b (IFN-alpha 2b) on these cells. We analyzed lysates of cells from 22 patients (6 with hairy cell leukemia, 12 with other acute and chronic leukemias and lymphocytes of 4 normals) after exposure to a heat shock and/or IFN-alpha 2b by one-dimensional polyacrylamide gel electrophoresis. In all cells a pattern of HSPs was readily induced with prominent bands identified at approximately 115, 90, and 65 kD. None of these major proteins appeared to represent the previously described IFN-alpha 2b induced band at 80 kD. IFN-alpha 2b by itself was not found to induce HSPs. We conclude that a pattern of HSPs can readily be induced in a variety of normal and leukemic human blood cells. IFN-alpha 2b is not a HSP inducer in these cells. The previously described IFN-induced p80 is apparently not a HSP. PMID- 2715673 TI - Interferon inhibition of bombesin-stimulated mitogenesis in Swiss 3T3 cells occurs without blocking c-fos and c-myc expression. AB - We have investigated the effect of murine interferon-beta on the growth of quiescent Swiss 3T3 cells stimulated by the amphibian tetradecapeptide mitogen bombesin. We found that IFN inhibited mitogenesis in bombesin-stimulated cells in a dose-dependent manner. In addition, bombesin, in common with platelet-derived growth factor (PDGF), was able to reverse the inhibitory effects of IFN in cells stimulated by epidermal growth factor (EGF) and insulin, which elicit a mitogenic response via a distinct signaling pathway. The observation that IFN was as effective in inhibiting DNA synthesis when added 48 h before or as late as 3 h after the mitogen, indicated that a block in one of the early regulatory signals was not essential for the anti-growth effects. Indeed, IFN did not inhibit the increased expression of c-fos and c-myc mRNA induced by bombesin in quiescent Swiss 3T3 cells. The combined data indicate that events occurring late in G1 are more likely targets for IFN action in Swiss 3T3 cells. PMID- 2715674 TI - The issue of interferon-alpha production in hemophiliacs with HIV antibodies: a slight but significant decrease? PMID- 2715675 TI - Aqueous humor concentration of metoprolol after oral administration. AB - The concentration of the beta-adrenergic blocking agent metoprolol was determined in the blood plasma and aqueous humor after oral administration of the compound. One group (10 cases) was receiving their prescribed continuous therapy and the other group (20 cases) received a single dose of metoprolol. The concentration of metoprolol was usually higher in aqueous than in plasma after continuous administration. This differs significantly from administration of a single dose where the concentration of metoprolol was higher in plasma. The result indicates an ocular accumulation of the drug in chronic systemic treatment. PMID- 2715676 TI - Testing a possible cocataractogenic potential of befunolol (Glauconex) with animal cataract models. AB - Befunolol was tested in an animal experiment with 2 cataract models of the Sprague-Dawley-rat. The treatment scheme was designed with 8 different treatment groups, such that befunolol could be tested single and in combination with one or two cataract models. Over the 6 weeks experimental period, slit lamp microscopy and Scheimpflug photography were employed as observation and documentation methods, extensive post-mortem biochemistry was carried out after sacrifice of the animals. Neither the in-vivo observation and documentation nor the biochemistry showed pronounced effects pointing to a cocataractogenic potential of the drug. Slit density enhancing effects were found in combining UV-B irradiation and befunolol treatment. This effect has also been found in other experiments with timolol. PMID- 2715677 TI - Peroxisomal palmityl CoA oxidase activity in ocular tissues and cultured ciliary epithelial cells. AB - The activity of palmityl CoA oxidase, a peroxisomal enzyme, was determined in bovine ocular tissues. Significant levels of activity were found in the iris, ciliary body and pigmented epithelium-choroid but little or no activity was detected in the corneal epithelium, lens capsule-epithelium and retina. Treatment of bovine ciliary epithelial cells with clofibric acid for 72 hours in culture resulted in a several fold enhancement of palmityl CoA oxidase activity. These results suggest that peroxisomal enzymes can be induced in uveal tissues when peroxisome proliferation is stimulated by certain drugs in these tissues. PMID- 2715679 TI - Sabbatical leave: an important mechanism for revitalizing faculty. PMID- 2715678 TI - Effects of benzydamine eye drops on the rabbit's eye reaction to surgical, physical, and chemical stimuli. AB - The effects of benzydamine eye drops on the ocular reaction to different irritating stimuli in rabbits are reported. Benzydamine at the concentration of 0.1% reduces inflammatory tissue changes induced by AgNO3 burning of the cornea and inhibits the blood-aqueous barrier breakdown due to peripheral iridectomy or laser irradiation of the iris. Benzydamine reduces the aqueous PGE2 concentration to a similar extent as a 0.5% commercially available eye drop formulation of piroxicam. This result is in contrast with previous in vitro results demonstrating that benzydamine is devoid of any effects on PG synthesis. The possibility that PGE2 reduction is an indirect effect due to other biochemical activities of benzydamine is discussed. In the normal eye benzydamine manifests a local anaesthetic effect which is not accompanied by irritative changes in the anterior segment of the eye, changes in the intraocular pressure or pupillary size. It is suggested that in the clinical use of benzydamine eye drops the local anaesthetic activity may contribute to reducing both the neurogenic component of ocular inflammation and acute pain following injuries to the eye. PMID- 2715680 TI - Attachment of neuroblastoma cells to extracellular matrix: correlation with metastatic capacity. AB - Extracellular matrix (ECM) serves important attachment functions during organogenesis in mammalian species. When layered on a plastic surface, ECM extracted from the rat lung, liver, or kidney enhances the attachment of C1300 murine neuroblastoma cells to that surface. Enhanced attachment to ECM by these cells correlates with their potential to form metastatic deposits in vivo. Conversely, neuroblastoma cells selected for increased metastatic potential by in vivo passaging demonstrate enhanced attachment to organ-derived ECM. However, although ECM provides attachment sites for these murine neuroblastoma cells, the attachment is not preferential for any of the organ ECMs tested (lung, liver, kidney). Histopathologic examination of the murine liver, lungs, and kidneys performed 20 to 22 days after intravenous inoculation of C1300 cells reveals notable metastatic seeding in each of these organs, but the liver clearly exhibits a greater degree of replacement by tumor metastases than the lungs or the kidneys. Therefore, the data from the attachment assays, coupled with the histopathologic findings obtained after tumor inoculation, suggest that although the ability to attach to ECM correlates with metastatic potential, additional factors are important in determining the preferential pattern of metastatic disease observed in murine neuroblastoma. PMID- 2715681 TI - Elevated plasma levels of ED1+ ("cellular") fibronectin in patients with vascular injury. AB - Using an enzyme-linked immunosorbent assay, we measured the concentration of fibronectin containing an extra type III domain (ED1) in the circulation of humans. Plasma levels of ED1 + fibronectin averaged 2.8 +/- 1.0 micrograms/ml in healthy individuals and did not differ substantially according to age or sex. In comparison with those from normal subjects, plasma samples obtained from patients with collagen vascular disorders contained increased average levels of ED1 + fibronectin. Among this group, levels of ED1 + fibronectin were significantly greater in samples taken from individuals with clinical evidence of vasculitis. Although levels of total (ED1 + plus ED1 -) fibronectin were also elevated in plasma samples from patients with vasculitis, only the concentration of the ED1 + variant correlated with severity of disease in two patients examined serially. Elevations in plasma content of ED1 + fibronectin, but not total fibronectin, were also noted in patients with acute vascular tissue injury associated with major trauma or sepsis syndrome. Western blot examination revealed the presence of intact dimeric ED1 + fibronectin in the circulation of all patients studied, although fragments bearing the ED1 were also detected. Human plasma normally contains small quantities of soluble ED1 + ("cellular") fibronectin, and these levels are increased in disorders involving vascular injury. PMID- 2715682 TI - Changes in collagen biosynthesis, types, and mechanics of aorta in hypertensive rats. AB - The purpose of this study was to relate changes in collagen composition with the mechanical properties of aortas of spontaneously hypertensive rats (SHRs). SHRs and normal Wistar-Kyoto (WKY) rats were killed at ages 6 and 20 weeks, and their aortas were removed. A portion of each aorta was used for determination of passive mechanical properties, and the remainder was incubated with carbon 14 labeled proline containing medium for 18 hours at 37 degrees C. After incubation, the tissues were lyophilized, and aliquots were used for sequential extraction with neutral salt, acetic acid, and pepsin at 4 degrees C. The pepsin extracts that contained most of the collagen were used for characterization of the collagen types and synthesis of collagen by the production of [14C]-labeled hydroxyproline. Collagen concentration decreased approximately 16% in both 6- and 20-week-old aortas, but collagen synthesis was about twofold higher in the aortas from both 6- and 20-week-old SHRs. Although type V collagen represented a minor fraction of total collagen (5%) in the aortas of WKY rats, it was twofold greater in the hypertensive animals. This increment in type V collagen in SHR aortas was accompanied by a reduction in the proportion of type I collagen, with no change in the proportion of type III. Study of the passive mechanical properties of the tissues showed that SHR aortas were stiffer compared with aortas of WKY rats, with a larger difference at 20 weeks than at 6 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715683 TI - Relationship between cell adenosine triphosphate and glutathione content and protection by glycine against hypoxic proximal tubule cell injury. AB - We designed studies to characterize metabolic aspects of the protective effects of glycine and glutathione against hypoxic proximal tubule cell injury b clarifying the relationship between protection and preservation of tubule cell adenosine triphosphate (ATP) and glutathione levels. The tubule preparation was glutatione depleted as isolated although some recovery occurred during incubation at 37 degrees C, and this recovery was enhanced by treatment with glutatione precursors. Increasing the duration of hypoxia from 30 minutes to 60 minutes produced increasingly extensive lethal tubule cell injury that was almost completely prevented, even at the 60-minute duration, by inclusion of either 2 mmol/L glutathione or 2 mmol/L glycine in the tubule incubation medium. Cell ATP levels decreased to the same extent and at the same rate in protected and unprotected hypoxic tubules. Glycine- and glutathione-protected tubules maintained higher cell glutathione levels than unprotected tubules at all durations of hypoxia studied. However, completely eliminating this increment of glutathione with either the gamma-glutamylcysteine synthetase inhibitor, buthionine sulfoximine, or the glutathione reductase inhibitor, 1,3-bis(2 chloroethyl)-1-nitrosourea, did not prevent protection. The data indicate that the striking protection against hypoxic injury to the isolated tubules provided by treatment with glycine or glutathione is independent of preservation of tubule cell ATP and glutathione levels, to the extent that difference of these levels can be discriminated in intact cells with present methods. PMID- 2715684 TI - Canine common duct and gallbladder bile contain antinucleating factors that inhibit CaCO3 precipitation. AB - We performed studies involving large incremental additions of calcium to bile to examine the degree of CaCO3 supersaturation that can be achieved in bile, as compared with that in simple NaCl-NaHCO3 solutions. The addition of CaCl2 to bile increased total and free ionized calcium by from four to 12 times their original values and by from two to three times the highest concentrations encountered in bile in vivo. The increase in [Ca++] resulted in fourfold to 12-fold increases in the saturation indexes of bile, with the saturation index reaching as high as 73.4 in a common duct sample. Despite the markedly elevated CaCO3 saturation indexes, evidence of CaCO3 precipitation was not observed in either common duct or gallbladder bile over a 24-hour period. For comparison, calcium added to NaCl NaHCO3 solutions resulted in the precipitation of CaCO3 within 4 hours if saturation indexes were greater than 12. These results indicate that native bile contains potent antinucleating factors that markedly inhibit CaCO3 precipitation, and they confirm our previous in vivo observations in canine common duct bile. PMID- 2715685 TI - Elevated circulating tumor necrosis factor-alpha in patients with Kawasaki disease. AB - The mechanism of vascular injury in Kawasaki disease (KD) is unclear. Recent studies suggest a role for circulating antibodies that are cytotoxic for endothelial cell antigens inducible by cytokines. Tumor necrosis factor-alpha (TNF, cachectin) is a monocyte- or macrophage-derived cytokine that has an important role as an effector molecule in various inflammatory processes. To study the possible involvement of TNF in KD, we measured the levels of circulating TNF in 39 patients with KD at various stages of the disease by using a newly developed sensitive radioimmunoassay. The TNF levels in sera from the acute and subacute phases of the disease were significantly (p less than 0.001) higher than in sera taken in the convalescence phase or in sera from children without inflammatory disease. In all patients from whom serial samples were available, the TNF level was higher during the acute and subacute phases than during convalescence. Coronary aneurysms developed in four of the patients, and these patients were among those who had the highest levels of circulating TNF during the acute and subacute phase (51.1 +/- 13.6 pg/ml (mean +/- SD) vs 30.4 +/ 15.8 pg/ml in patients without coronary aneurysms; p less than 0.001). No differences in circulating TNF levels were observed between patients who received as treatment aspirin plus intravenous immunoglobulin and those who received aspirin alone. The results show that the levels of circulating TNF are increased in acute KD and support the hypothesis that this cytokine may be involved in the pathogenesis of the vascular injury in KD. PMID- 2715686 TI - Heparin-associated thrombocytopenia and thrombosis. PMID- 2715687 TI - Is research worthwhile? PMID- 2715688 TI - The ENT consultation: a prospective study of the doctor's and the patient's perceptions. AB - In this prospective study of 126 patients attending the ENT outpatient clinic the doctor's and the patient's perception of the consultation were evaluated by questionnaire; 96 patients completed the questionnaire correctly. The results were analysed by scattergram plot and Wilcoxon's matched-pair signed ranks test. There was a statistically significant difference between the doctor's and the patient's perception of the 'history' (p less than 0.01) and the 'explanation of diagnosis and treatment' (p less than 0.05) in the consultation. There was no statistically significant difference between the doctor's and the patient's perception of the 'examination' in the consultation. The results are discussed. PMID- 2715689 TI - Histopathology of the soft parts in 50 patients with malignant external otitis. AB - Reports concerning the lesions of the skin coverage of the external ear canal in malignant external otitis (M.E.O.) are very few. To evaluate this problem, we studied the skin lesions of 45 skin biopsies from 40 M.E.O. patients, 23 from regions covering the osseous part of the ear structure, seven from the cartilaginous part of the external canal and 15 from both parts. The epidermis was normal in nine, thickened in 16, with acanthotic thickening and pseudoepitheliomatous hyperplasia in 20. In the dermis the amount of collagen was normal, but it was infiltrated by the inflammatory process. Acute inflammation was observed in 16 biopsies, subacute in 23, chronic in six. A mixture of acute and chronic changes was present in 18 biopsies. No major abnormalities of the vasculature could be detected. The distinguishing pathological feature of M.E.O. concerns the typical topographic distribution of the inflammation in the osseous part of the external ear canal. PMID- 2715690 TI - Nasopharyngeal bacterial flora before and after adenoidectomy. AB - Fifty patients (23 males and 27 females), with chronically hypertrophied and infected adenoids were subjected to adenoidectomy. Pre- and post-operative nasopharyngeal swabs were taken to study bacterial colonization of the nasopharynx both quantitatively and qualitatively. Twenty healthy controls were included in this study. The swabs were cultured on MacConkey's and Columbia blood agar plates. The rate of isolation of potentially pathogenic microorganisms decreased markedly following operation, while normal inhabitant organisms showed notable increase in their numbers post-operatively to reach a near normal level. It is concluded from this work that adenoidectomy produces a physiological effect on the nasopharyngeal microflora by conversion of an abnormal flora to a nearly normal one. PMID- 2715691 TI - Use of a Foley catheter for short-term drainage in frontal sinus surgery. AB - Frontal sinus surgery for chronic disease presents a variety of problems, in particular that of drainage. No matter how successful the surgical technique is in clearing disease from the sinus, it is still important that the fronto-nasal duct is kept patent unless the procedure is an obliterative one. Usually a tube is inserted for drainage and has to be kept in place for several weeks or months. This paper presents a study of 16 patients, suffering from frontal sinus disease, in whom a short-term drainage technique using a Foley catheter was employed between 1979 and 1988 at Lagos University Teaching Hospital, Nigeria. This type of drainage allows effective anchorage and irrigation with a decongestant. It has been found to give satisfactory results after 14 days in place and has had no unusual complications. It is therefore recommended for use in such cases. PMID- 2715692 TI - Resection with laser and high frequency cutting loop in tracheo-bronchial diseases. AB - A total of 23 patients have been treated endoscopically during the last three and a half years for a variety of diseases in the tracheo-bronchial tree; nine had a tracheal stenosis. Thirteen patients have been treated by resection with a high frequency cutting loop, eleven with a CO2-laser and one with an argon laser. A total of 44 treatments have been performed. Half of the treatments were given because of various malignant diseases. The results of the treatment of this very mixed group of patients were, as a whole, satisfactory with both CO2-laser and cutting loop. A more precise technique can be applied with the CO2-laser than the cutting loop, though the latter is the more efficient and easy to work with. Care must be taken with the loop because of its greater cutting depth. The argon laser has only limited use in the treatment of diseases in the trachea. PMID- 2715693 TI - Combined treatment of large head and neck capillaro-venous malformation by a fibrosing agent. AB - We report our experience of seven cases suffering from capillaro-venous malformation localized in the head and neck area, treated preoperatively by a fibrosing agent--ETHIBLOC. Four of the cases are presented and analysed. We suggest the pre-operative injection of Ethibloc as the treatment of choice for capillaro-venous malformations in the head and neck region. PMID- 2715694 TI - Flexible oesophagogastroscopy in otolaryngology. AB - We describe a technique of flexible endoscopy of the upper aerodigestive tract which provides excellent visualization for diagnostic and therapeutic purposes in ENT practice. With the present day need to reduce costs it is helpful to reduce inpatient workload and perform procedures as day cases where appropriate. The previous criticisms of flexible oesophagoscopy by ENT surgeons are unfounded and indeed there are situations where flexible endoscopy is superior to rigid examination. We would recommend that tuition in the use of the flexible gastroscope should be an integral part of ENT training. PMID- 2715695 TI - Middle ear neoplasms showing adenomatous and neuroendocrine components. AB - Middle ear adenomas are rare epithelial tumours. Reports indicate that neuroendocrine (carcinoid) tumours may also occur at this site, often in association with an adenomatous component. The clinico-pathological findings (including C.T. scan appearances) of such a 'mixed' neoplasm are presented together with a brief review of the few previously described cases. The importance of immuno-histochemistry and electron microscopy for accurate pathological diagnosis of these neoplasms is confirmed. PMID- 2715696 TI - Wildervanck's syndrome--unilateral Mondini dysplasia identified by computed tomography. AB - We present a case of the Wildervanck (cervico-oculo-acoustic) syndrome exhibiting congenital deafness. Klippel-Feil anomaly and lateral rectus palsy with enophthalmos. Audiometry indicated a predominantly conductive loss which, because of masking difficulties, was assumed to be bilateral: an erroneous assumption supported by results of conventional petrous bone tomography which failed to demonstrate any abnormality of the inner ears. Computed tomography (CT), however, revealed a severe Mondini dysplasia of one ear, a condition which must be assumed to be associated with severe sensorineural hearing loss. Reconstructive middle ear surgery for the conductive loss on the other side was therefore contraindicated. PMID- 2715697 TI - Sensorineural deafness associated with IgA nephropathy. AB - IgA nephropathy is an immune complex glomerulonephritis in which examination of the renal biopsy by immunofluorescence reveals IgA as the predominant antibody deposited in the glomerular mesangium (Clarkson et al., 1984). It was first described by Berger in 1969. The disease is more common in males and occurs generally during the second or third decades of life (Emancipator et al., 1985). A case of established IgA nephropathy with subsequent onset of sensorineural deafness is described. PMID- 2715698 TI - Eyelid necrosis complicating acute maxillary sinusitis. AB - Orbital cellulitis is a well recognized complication of paranasal sinusitis. Fearon et al. (1979) reviewed 6,770 cases of sinusitis, of which only 159 had orbital cellulitis. We report a case in which orbital cellulitis progressed to necrosis of the eyelids. This was treated by desloughing and split skin grafting. PMID- 2715699 TI - Verrucous carcinoma of the maxillary antrum. AB - Verrucous carcinoma is a rare type of squamous cell carcinoma which is most often seen in the oral cavity and larynx. This paper describes a case of verrucous carcinoma of the maxillary antrum, a site in which this tumour has been described on only two previous occasions in the English language literature. PMID- 2715700 TI - Metastatic renal carcinoma to the parotid gland. AB - A case of renal carcinoma metastatic to the left parotid gland is presented. A 60 year-old male patient developed a painful mass in his left parotid region one and a half years after he had undergone a left nephrectomy operation for renal carcinoma. The mass was excised surgically. The histopathological diagnosis was metastatic renal carcinoma. From a review of the literature, it is apparent that unlike most of the cases reported, this one had a very aggressive nature. The clinical presentation of the metastasis, and the factors determining the prognosis in cases of metastatic renal carcinoma to the head and neck are discussed. PMID- 2715701 TI - A case of jaw locking. AB - An unusual case of symptomatic enlargement of the hyoid bone is reported. The patient's main complaint was of pain on swallowing and opening of the jaw. Partial excision of the greater cornu of the hyoid on each side, resulted in a complete remission of the symptoms. PMID- 2715702 TI - Right vocal cord paralysis after internal jugular vein cannulation. AB - Neurological complications are rare after central venous cannulation. We report a case of right vocal cord paralysis after internal jugular vein cannulation. The mechanism of neural injury is discussed. PMID- 2715703 TI - Nontraumatic intracavernous carotid aneurysm presenting with epistaxis. AB - A patient with an intracavernous carotid aneurysm usually presents with symptoms and signs of a space occupying lesion, producing one of a variety of types of cavernous sinus syndromes (Jefferson, 1938). Epistaxis is an unusual feature in these patients and when present is nearly always associated with a traumatic aneurysm (Mahmoud, 1979). There are only two reported cases of non-traumatic intracavernous carotid aneurysms presenting with epistaxis and diagnosed during the lifetime of the patient (Troupp, 1962; Labayle and Legent, 1964). The authors present a third such case. The importance of considering aneurysms in the differential diagnosis of epistaxis is emphasised. The radiological investigations and management of these patients is discussed. PMID- 2715704 TI - Asthma therapy and a tracheostomy. AB - A spacer device was modified to deliver aerosols of beclomethasone diproprionate, ipratropium and bromide salbutamol, to an asthmatic child with a tracheostomy, where symptoms were poorly controlled with nebulized therapy. This resulted in a marked improvement in symptoms and a dramatic reduction in the time spent administering drugs. PMID- 2715705 TI - Airgun pellet injuries of the neck. AB - Penetrating injuries of the neck are a cause of retropharyngeal abscess. Should a foreign body become lodged in the retropharyngeal tissues its removal may avoid this complication, but surgery can in itself be hazardous. Between 10 and 15 per cent of cases of retropharyngeal cellulitis resulting from whatever cause do not progress to abscess formation if treated conservatively. Consequently, it is important to have evidence of abscess formation before surgery is undertaken, as illustrated by this paper in the form of a case report and a review of the current literature. PMID- 2715706 TI - Cervical echinococcal hydatid cyst. PMID- 2715707 TI - Gerald Cole's "The learning mystique: a critical look at "learning disabilities"". PMID- 2715708 TI - Excerpts from The Learning Mystique: a Critical Look at "Learning Disabilities". PMID- 2715709 TI - Coles's Learning Mystique: the good, the bad, and the irrelevant. PMID- 2715710 TI - Learning disability: biological, societal, or both? A response to Gerald Coles. PMID- 2715711 TI - The Learning Mystique: a fair appraisal, a fruitful new direction? PMID- 2715712 TI - Learning disabilities in broader context. PMID- 2715713 TI - An ecological response to Coles's interactivity alternative. PMID- 2715714 TI - Reaction to excerpts from The Learning Mystique: a rational appeal for change. PMID- 2715715 TI - Beyond the learning mystique: an interactional perspective on learning disabilities. PMID- 2715716 TI - LD theory and a tale from the Town of Chelm. PMID- 2715717 TI - Constructing a response to responses. PMID- 2715718 TI - The effects of daily homework assignments on the acquisition of basic skills by students with learning disabilities. AB - Examined in this two-study investigation was the effectiveness of supplemental homework assignments on the acquisition of basic skills by students with diagnosed learning disabilities (LD). In Experiment 1, an adapted alternating treatments design was used to investigate the efficacy of unstructured homework assignments with 6 elementary school-aged students having basic math problems. Although the impact of the homework assignments differed across students, three factors maximized the effectiveness of the homework assignments: rate of homework completion, percentage correct on the homework assignments, and the rate of acquisition of the content being presented. Experiment 2, designed to formally test the effectiveness of homework assignments structured specifically to address these identified factors, confirmed that homework can be employed to increase the effectiveness of direct instruction sequences with students diagnosed as LD. PMID- 2715719 TI - Frequency of adoption of children and adolescents with learning disabilities. AB - Students from three different facilities who were diagnosed as learning disabled were studied to determine the frequency of adoption with this population as compared to the national norm. The frequency of adoption was found to be 4.5 times higher than the norm, that is, 17.3% versus 3.9%. The possible reasons for this high incidence are discussed. PMID- 2715720 TI - Studies on oxidized low density lipoproteins. Controlled oxidation and a prostaglandin artifact. AB - Low density lipoproteins (LDL), isolated by ultracentrifugal flotation, were oxidized (LDLOXID) slowly during dialysis against 0.15 M NaCl and subsequent incubation in 96% air-4% CO2 at 37 degrees C. Butylated hydroxytoluene prevented LDL oxidation. LDL preparations from different sera were oxidized at different rates and the degree of lipid peroxidation was controlled by varying the incubation time. Mild oxidation did not alter the electrophoretic mobility of the LDLOXID preparations. LDLOXID contained lipid peroxides in neutral lipids, had increased amounts of lysophosphatidylcholine, and contained a number of complex oxidation products that were generated from the oxidation of free fatty acids. These oxidation products included large amounts of soluble material that cross reacted with antibodies to PGE2 but not 6-keto-PGF1 alpha. The amount of cross reacting material was proportional to the degree of lipid peroxidation. Cross reacting material in LDLOXID preparations was evidently formed from the oxidation of free fatty acids released from LDL, since cross-reacting material was also formed when a synthetic fat emulsion was oxidized in the presence of free arachidonic acid. PMID- 2715721 TI - Inhibition of lipid transfer by a unique high density lipoprotein subclass containing an inhibitor protein. AB - We have isolated from human plasma a unique subclass of the high density lipoproteins (HDL) which contains a potent lipid transfer inhibitor protein (LTIP) that inhibited cholesteryl ester, triglyceride, and phospholipid transfer mediated by the lipid transfer protein, LTP-I, and phospholipid transfer mediated by the phospholipid transfer protein, LTP-II. This HDL subclass not only inhibited cholesteryl ester transfer from HDL to LDL or VLDL, but also inhibited cholesteryl ester transfer from HDL to HDL. The inhibitor protein was isolated by sequential chromatography of human whole plasma on dextran sulfate-cellulose, phenyl-Sepharose, and chromatofocusing chromatography. Isolated LTIP had the following characteristics: an apparent molecular weight of 29,000 +/- 1,000, (n = 10) by sodium dodecyl sulfate gel electrophoresis, and an isoelectric point of 4.6 as determined by chromatofocusing. LTIP remained functional following delipidation with organic solvents. Antibody to LTIP was produced, and an immunoaffinity column of the anti-LTIP was prepared. Passage of human, rat, or pig whole plasma over the anti-LTIP column enhanced cholesteryl ester transfer activity in human (17%), pig (200%), and rat plasma (125%). The HDL subclass containing LTIP was isolated from whole human HDL (d 1.063-1.21 g/ml) by immunoaffinity chromatography. The isolated LTIP-HDL complex was shown to: i) contain about 60% protein and 40% lipid, ii) have alpha and pre-beta electrophoretic mobility, iii) have particle size distribution somewhat smaller than whole HDL, about 100,000 daltons, as determined by gradient gel electrophoresis, and iv) contain only a small amount of apoA-I (less than 5%) and a trace amount of apoA-II. Assay of ultracentrifugally obtained lipoprotein fractions revealed that approximately 85% of the total functional LTIP activity was in the d 1.063-1.21 g/ml HDL fraction. Furthermore, immunoblot analysis of whole plasma by nondenaturing gradient gel electrophoresis revealed that LTIP was found predominantly in particles in the size range of HDL. This unique HDL subclass may play an important role in the regulation of plasma lipid transfer and metabolism. PMID- 2715722 TI - Apolipoprotein B metabolism in homozygous familial hypercholesterolemia. AB - This report describes the metabolism of apolipoprotein B-containing lipoproteins in seven familial hypercholesterolemic (FH) homozygotes and compares the results to the values obtained from five healthy control subjects. The concentration, composition, and metabolism of large, triglyceride-rich very low density lipoproteins (VLDL1, Sf 60-400) were the same in the control and FH groups, indicating that this component of the VLDL delipidation cascade ws unaffected by the absence of receptors. In contrast, familial hypercholesterolemic small VLDL2 (Sf 20-60) was enriched with cholesterol and depleted in triglyceride. Moreover, its plasma concentration was elevated as a result of an increase in its synthesis and a defect in the removal of a remnant population within this density interval. The latter accounted for up to 50% of the total mass of the fraction. Onward transfer of apolipoprotein B (apoB) from small VLDL through intermediate density lipoprotein (IDL) to low density lipoprotein (LDL) was retarded, suggesting that receptors were involved in this supposedly lipase-mediated event. IDL and LDL concentrations increased up to fourfold above normal in the plasma of the FH patients due partly to the delay in maturation and partly to defective direct catabolism. We conclude that the LDL receptor plays multiple and important roles in the metabolism and transformation of apoB-containing particles in the Sf 0-400 flotation interval. PMID- 2715723 TI - Effects of inducers of differentiation on protein kinase C and CMP-N acetylneuraminic acid:lactosylceramide sialyltransferase activities of HL-60 leukemia cells. AB - Exposure of HL-60 leukemia cells to either 12-O-tetradecanoylphorbol-13-acetate (TPA), dimethylsulfoxide (DMSO), exogenous gangliosides GM3, GM1, or bovine brain ganglioside mixture (BBG) resulted in a marked inhibition of the growth of cells. The order of the inhibitory potency was TPA greater than GM3 greater than DMSO greater than BBG greater than GM1. In contrast, sulfatides were without effect on cellular replication. Treatment of HL-60 cells with TPA or GM3 induced differentiation along the monocyte/macrophage lineage, while treatment with DMSO induced maturation along the granulocytic pathway. These effects were accompanied by more than a twofold increase in protein kinase C (PKC) activity. In contrast, treatment with GM1, BBG, or sulfatides caused only a relatively small increase in PKC activity. The activity of CMP-N-acetylneuraminic acid:lactosylceramide sialyltransferase (ST1), a key enzyme for membrane gangliosides synthesis, in HL 60 cells was also influenced by the exposure to TPA, GM3, DMSO, GM1, or sulfatides. The inducers of differentiation, TPA and DMSO, caused an increase in ST1 activity, whereas GM3, which also induced cellular differentiation, inhibited ST1 activity, perhaps through the action of end-product inhibition. The non inducers of differentiation, GM1 and sulfatides, also increased the activity of ST1, but to a much lesser extent. The findings suggest that the direct or indirect modulation of PKC activity by some of these agents may be involved, at least in part, in the regulation of cellular growth and differentiation. Furthermore, it is conceivable that differences in PKC activity may be responsible for the changes in ST1 activity associated with cell differentiation and proliferation. PMID- 2715724 TI - Triglyceride and cholesteryl ester hydrolysis in a cell culture model of smooth muscle foam cells. AB - Cultured rabbit aortic smooth muscle cells were converted to foam cells by exposure to sonicated lipid droplets of defined composition using an inverted culture technique. Uptake of the lipid droplets by the cells was shown to be dependent on the time of exposure to the droplets and on the mass of droplets presented to the cells. A comparison of the hydrolysis of triolein and cholesteryl oleate by cells that had been exposed to isotropic lipid droplets containing equimolar amounts of the two lipids revealed that the rate of hydrolysis of triglyceride was 3 to 4 times faster than that for cholesteryl ester. The hydrolysis of cholesteryl oleate from cells loaded with the isotropic droplets was approximately 1.5 times as fast as that from cells loaded with anisotropic droplets containing only cholesteryl oleate. A comparison of the hydrolysis of cholesteryl ester in the presence and absence of Sandoz compound 58 035, an inhibitor of acyl CoA:cholesterol acyl transferase, by cells loaded with isotropic droplets showed that about 30% of the free cholesterol liberated by hydrolysis was reesterified regardless of the mass of free cholesterol. We conclude that cultured smooth muscle cells have a greater capacity to hydrolyze triglyceride than cholesteryl ester, and that the rate of hydrolysis of cholesteryl ester appears to be related to the physical state of the droplet in which the cholesteryl ester is stored. In addition, it appears that the smooth muscle cells have a cholesteryl ester cycle that is inefficient in the reesterification of excess free cholesterol. PMID- 2715726 TI - Novel molecular analogues of phosphatidylcholines in a lipid extract from bovine brain: 1-long-chain acyl-2-short-chain acyl-sn-glycero-3-phosphocholines. AB - A vasodepressor phospholipid fraction named Depressor-IA from a bovine brain lipid extract was analyzed by capillary gas-liquid chromatography-mass spectrometry as tert-butyldimethylsilyl derivatives after hydrolysis with phospholipase C. Results show that Depressor-IA is a mixture of 3 platelet activating factors and 17 1-acyl analogues. Three platelet-activating factors having sn-1-O-hexadecyl, octadecyl, and octadecenyl groups were suggested to account for the hypotensive activity of Depressor-IA, although the total amount of 1-acyl analogues of platelet-activating factor was much more than that of platelet-activating factor in the purified Depressor-IA. 1-Long-chain acyl-2 short-chain acyl-glycero-3-phosphocholines identified in Depressor-IA included novel molecular analogues having sn-2-propionyl, acryloyl, butyryl, valeryl, caproyl, and hepatonoyl groups. PMID- 2715725 TI - Intestinal apolipoprotein synthesis and secretion in the suckling pig. AB - The present studies report characterization of intestinal apolipoprotein (apoLp) synthesis and secretion in the suckling pig. Lipoproteins (d less than 1.006 g/ml) from mesenteric lymph were found to contain both apoB-100 and B-48, in addition to apoA-IV, E, A-I, and Cs. Lymph low density lipoproteins (LDL) and high density lipoproteins (HDL) contained mainly apoB-100 and apoA-I, respectively. Analysis of core cholesteryl ester fatty acid composition suggested filtration from plasma as the major source of lymph LDL and HDL. Dual radioisotope labeling of intestinal and hepatic apoLps in lymph, as well as immunoprecipitation of radiolabeled intestinal mucosa, demonstrated intestinal synthesis of apoB-48, A-IV, and A-I. There was no evidence for apoB-100 synthesis by intestinal mucosa. By contrast, piglet liver synthesized apoB-100, E, A-I, and Cs, but not apoB-48. Newly synthesized intracellular intestinal apoA-I was mainly (basic) isoform 1 (pI 5.58), while lymph and plasma HDL apoA-I were predominantly isoform 3 (pI 5.33), mature apoA-I. Lymph apoB (P less than 0.001) and apoA-I (P less than 0.04) mass output increased significantly during lipid absorption. Studies were subsequently conducted in fasting, fat-fed, bile-diverted, and sham operated animals to determine the role of both dietary and biliary lipid in regulating intestinal apoLp biosynthesis. Proximal and distal small intestinal loops were pulse-radiolabeled with [3H]leucine, and apoB-48 and A-I were immunoprecipitated from cytosolic supernatants. Although a proximal to distal gradient in intestinal synthesis rates for both apoB and A-I was noted in all groups, the acute absorption of dietary lipid did not significantly increase apoB or A-I synthesis in either location. Complete removal of biliary lipid for 48 hr did not alter synthesis rates in jejunum or ileum. These studies suggest that mesenteric lymph apoLps in the suckling pig are derived both by filtration from plasma and by direct secretion from the intestine. Physiologic regulation of intestinal apoA-I and B-48 synthesis rates appears to be independent of luminal lipid availability. PMID- 2715727 TI - Colestipol-induced changes in LDL composition and metabolism. II. Studies in humans. AB - We investigated the effect of the bile acid sequestrant, colestipol hydrochloride, on the composition and metabolism of human low density lipoprotein (LDL). Colestipol treatment produced a disproportionate decrease in LDL cholesterol compared to LDL apoB, resulting in a significant decrease in the LDL cholesterol/apoB ratio. Electron microscopy revealed that LDL particles were smaller in size and analytical ultracentrifugation demonstrated that colestipol therapy selectively depleted larger, more buoyant LDL particles of Sf degrees 6 7. Thus, colestipol therapy produced LDL that were smaller in size, more dense, and characterized by a decreased cholesterol to protein ratio. To determine whether the altered LDL had different metabolic properties, autologous LDL was isolated from subjects before and during colestipol therapy and their fractional catabolic rates (FCR) were then simultaneously determined in the same patient while on therapy. Eight LDL turnover studies comparing the catabolism of LDL isolated during therapy (Rx-LDL) and LDL isolated off therapy (Con-LDL) were performed in six subjects. All subjects responded to colestipol treatment, with an average 29% fall in LDL cholesterol. In four of six subjects, and in six of eight studies, the FCR of Rx-LDL was substantially slower than that of Con-LDL. These studies demonstrate that a drug intervention may alter subpopulations of LDL particles in such a way that overall LDL composition is changed. This alteration may independently affect the intrinsic metabolic behavior of the LDL. We suggest that such drug- (or dietary-) induced changes in LDL composition need to be considered in kinetic studies designed to assess the overall impact of the perturbation being studied. PMID- 2715728 TI - Interactions of sterols with antiestrogen-binding sites: structural requirements for high-affinity binding. AB - Animal and human tissues contain a microsomal protein that binds nonsteroidal antiestrogens with high affinity and specificity. The functions of these binding sites and the identity of their natural ligands are unknown. Following a report that certain sterols inhibit [3H]tamoxifen binding to this site, we attempted to define the structural requirements for maximal inhibition of [3H]tamoxifen binding to rat liver antiestrogen-binding sites. Our studies identified 5 alpha cholestan-3 beta-ol-7-one (7-ketocholestanol) as the most potent sterol, having an inhibitory activity that was 12% that of unlabeled tamoxifen and an equilibrium dissociation constant of 6.3 nM. Structural features that appeared important for the inhibitory activity of this sterol include the presence of i) a hydrocarbon side chain at C17; ii) an oxygen function at C7; iii) a hydroxyl group at C3; and iv) the absence of a double-bond between C5 and C6. Saturation analysis and kinetic studies of [3H]tamoxifen binding in the presence of varying concentrations of 7-ketocholestanol clearly indicated that this sterol competed directly with tamoxifen for the antiestrogen-binding site. Unlike tamoxifen, this sterol did not bind to the estrogen receptor. These features make 7 ketocholestanol a potentially valuable tool for studying the properties and functions of this site. PMID- 2715729 TI - Inhibitors of sterol synthesis. Chemical synthesis, structure, and biological activities of (25R)-3 beta,26-dihydroxy-5 alpha-cholest-8(14)-en-15-one, a metabolite of 3 beta-hydroxy-5 alpha-cholest-8(14)-en-15-one. AB - 3 beta-Hydroxy-5 alpha-cholest-8(14)-en-15-one (I) is a potent inhibitor of sterol synthesis with significant hypocholesterolemic activity. (25R)-3 beta,26 Dihydroxy-5 alpha-cholest-8(14)-en-15-one (II) has been shown to be a major metabolite of I after incubation with rat liver mitochondria. Described herein is the chemical synthesis of II from diosgenin. As part of this synthesis, improved conditions are described for the conversion of diosgenin to (25R)-26 hydroxycholesterol. Benzoylation of the latter compound gave (25R)-cholest-5-ene 3 beta,26-diol 3 beta,26-dibenzoate which, upon allylic bromination followed by dehydrobromination, gave (25R)-cholesta-5,7-diene-3 beta,26-diol 3 beta,26 dibenzoate. Hydrogenation-isomerization of the delta 5.7-3 beta,26-dibenzoate to (25R)-5 alpha-cholest-8(14)-ene-3 beta,26-diol 3 beta,26 bis(cyclohexanecarboxylate) followed by controlled oxidation with CrO3 dimethylpyrazole gave (25R)-3 beta,26-dihydroxy-5 alpha-cholest-8(14)-en-15-one 3 beta,26-bis(cyclohexanecarboxylate). Acid hydrolysis of the delta 8(14)-15 ketosteryl diester gave II. 13C NMR assignments are given for all synthetic intermediates and several major reaction byproducts. The structure of II was unequivocally established by X-ray crystal analysis. II was found to be highly active in the suppression of the levels of 3-hydroxy-3-methylglutaryl coenzyme A reductase in cultured mammalian cells and to inhibit oleoyl coenzyme A-dependent esterification of cholesterol in jejunal microsomes. PMID- 2715731 TI - Determination of stereo- and positional isomers of oxygenated triterpenoids by reversed phase high performance liquid chromatography. AB - Twenty four oxygenated triterpenoids, including eight pairs of stereoisomers and five pairs of positional isomers, could be separated by reversed phase HPLC. The capacity factors obtained in methanol-water and acetonitrile-water solvent systems made it possible to correlate the molecular polarities due to the presence of multiple oxygenated functional groups in these compounds. It was found that the number and position of functional groups as well as the stereochemistry of these functional groups played important roles in governing the polarity of these lanostanoid acids. The polarity weighting factors were in the following order: 3 beta-OH greater than 3 alpha-OH greater than 3 alpha-OAc greater than 3 beta-OAc. The contribution to polarity due to 15 alpha-OAc and 22 beta-OAc was probably very similar. The unique stereochemical character and eluting sequences of the lanostanoid acids provide information to generate empirical rules for predicting the role of individual polar functional groups in the chromatographic behavior in reversed phase HPLC. PMID- 2715730 TI - Development and partial metabolic characterization of a dietary cholesterol resistant colony of rabbits. AB - A colony of New Zealand white rabbits has been developed which, when fed a cholesterol-supplemented diet, exhibit unusual resistance to hypercholesterolemia and atherosclerosis, disorders usually observed in normal cholesterol-fed rabbits. When resistant rabbits (RT) were fed a normal low cholesterol diet (ND), their plasma lipoprotein patterns were significantly different from those of normal rabbits (NR) fed the same diet. The low density lipoprotein cholesterol (LDL-c)/high density lipoprotein cholesterol (HDL-c) ratio and LDL-c/very low density lipoprotein cholesterol (VLDL-c) ratio were lower in the resistant rabbits. The hydrated density of HDL of the normal-responsive rabbits was greater than that of the resistant rabbits. LDL from resistant rabbits contained a lower proportion of esterified cholesterol and protein than LDL from normal rabbits. Peripheral mononuclear cells from resistant rabbits bound about 30% more 125I labeled rabbit LDL than mononuclear cells from normal rabbits. These results demonstrate that the plasma cholesterol levels of these animals is at least partly under genetic control and that compositional differences exist between the major plasma lipoprotein classes of normal and resistant rabbits even during the ingestion of low-cholesterol diet. The results indicate that at least a part of the difference in the cholesterolemic responses between the two rabbit groups is due to an enhanced LDL uptake by the mononuclear cells, and presumably by other somatic cells of the resistant group. PMID- 2715732 TI - Scanning electron microscopy of very small fat cells and mature fat cells in human obesity. AB - To determine the effect of obesity on the size distribution of fat cell populations in human adipose tissue, omental fat tissue biopsies were obtained from lean, moderately obese, and massively obese patients. The size distributions of adipocytes from lean and obese fat tissues examined by the scanning electron microscopic method were bimodal, consisting of populations of very small fat cells and mature fat cells, in contrast to collagenase-derived isolated cells that showed only the large mature fat cells. The very small fat cell population represented 21 to 26% of the total fat cell number in the lean and in both obese groups. In contrast, preparations of human fat cells isolated by the collagenase method systematically excluded the very small fat cells. In massive obesity, both cell populations participated in the hyperplastic growth but only the larger mature fat cells increased in size, implying that these two cell populations differ in their physiological role. PMID- 2715733 TI - [Fibrinogen, atherosclerosis, inflammation. Satellite symposium. ANGIO DYN 88. Toulouse, 5 October 1988. Proceedings]. PMID- 2715734 TI - [Fibrinogen and pentoxifylline. Results of a French cooperative exploratory study of stage II arteritis]. AB - A collaborative exploratory study was undertaken by 139 private angiologists in 427 out-patients with PVD stage II treated for 90 days with Pentoxifylline 1 200 mg per day. In 306 patients (71,6%) the fibrinogen level was decreased by 0,21 g/l in mean (p less than 0.01). This significant decrease is correlated to the global improvement (p less than 0.01) and is within the magnitude of difference that is associated between vascular death and comparative groups in recent epidemiologic studies. In 121 patients (28, 4%) of the non responders in whom the claudication was not improved or was even worsened, no change in the fibrinogen level was seen. PMID- 2715735 TI - Atypical brachydactyly. AB - A case of atypical brachydactyly is reported with clinical and radiographic findings. A differential diagnosis is discussed. In light of the lack of corrective surgical techniques, conservative management is considered, including genetic consultation to prevent the deformity in future generations. PMID- 2715736 TI - The Wilk case. PMID- 2715737 TI - Beyond the theosophy of chiropractic. PMID- 2715738 TI - Reliability of the Derifield-Thompson test for leg length inequality, and use of the test to demonstrate cervical adjusting efficacy. PMID- 2715739 TI - A hypothesis introducing a new calculation for discal reduction emphasis on stentotic factors and manipulative treatment. PMID- 2715740 TI - A critical look at the subluxation hypothesis. PMID- 2715741 TI - Inter- and intraexaminer reliability of palpation for sacroiliac joint dysfunction. PMID- 2715742 TI - Reliability of motion palpation procedures to detect sacroiliac joint fixations. AB - The purpose of this study was to assess the inter- and intraexaminer reliability of the Gillet-motion palpation procedure using 10 qualified chiropractors and 11 patients with a sacroiliac joint problem. Intraexaminer reliability was found to be statistically significant for all agreement scores investigated. Interexaminer reliability was found to be statistically significant for some of the agreement scores investigated but not for others. Severity of the low back problems did not seem to influence intra- or interexaminer agreement scores; however, chiropractor expertise did. High expertise was associated with lower intraexaminer agreement scores than low expertise. This finding is in contradiction with traditional beliefs and reported findings. The gait of the patient group was found to be significantly different from that of normal subjects as noted in an earlier report. PMID- 2715743 TI - Interexaminer reliability of an isolation test for the identification of cervical subluxation. AB - A reliability study was conducted to determine whether prone leg length analysis in association with an isolation test maneuver was reproducible. Seventy-two subjects were evaluated by two examiners on separate occasions for the presence of C1 subluxation. Concordance was assessed by the Kappa statistic, and interexaminer percentage of agreement was compared. Agreement beyond chance for the two groups was K = 0.52, p less than 0.01 and 0.55, p less than 0.001, respectively. The results indicate good reliability using this method of analysis for putative upper cervical subluxation in this patient population. Further investigation is necessary to correlate this method of analysis with the empirical evidence of manipulable lesions or subluxations. PMID- 2715744 TI - Pulmonary complications in AIDS: the radiographic manifestations. AB - The AIDS epidemic continues to spread in Georgia. Almost every medical specialty is affected in some manner by the increased number of patients being diagnosed and treated with AIDS or the AIDS-related complex. Radiology has a pivotal role in documenting various opportunistic complications so that further testing and therapy may be instituted. Because of the large number of AIDS patients that develop thoracic disease, we have reviewed many of the potential pulmonary complications and their radiographic findings. Certain patterns of disease may suggest etiologies, though admittedly the chest radiograph is nonspecific. Diagnosis must be confirmed with sputum culture, bronchial lavage, and biopsy or open lung biopsy. There are key features that should be kept in mind. P. carinii, the most common pathogen, and several other opportunistic agents usually present with a fine bilateral interstitial or ground glass appearance. The presence of mediastinal adenopathy and/or pleural effusion suggests an etiology other than PCP. These findings are indicative of mycobacterial infection, KS, or lymphoma. PCP can present as a focal pulmonary consolidation, but this is unusual, and bacterial pneumonia must be considered. Finally, a small percentage of persons will present with a normal chest x-ray despite the presence of pulmonary infection or neoplasm. In those cases gallium lung scanning can help identify the affected individuals. PMID- 2715745 TI - Change the tort system: expose it to patients. PMID- 2715746 TI - Health care history and utilization for Atlantans who died homeless. AB - A limited study of 18 deaths among homeless persons in Atlanta, Georgia, has shown that about two-thirds had utilized public health care facilities prior to their death, often over a period of many years. Utilization of two available, specific clinics for the homeless could not be demonstrated. The county hospital and alcoholism treatment center accounted for all documented episodes of health care. Formal, medical documentation of significant alcohol-related morbidity was shown in 50% of those who died homeless. Other common medical problems included seizure disorders, hypertension, pneumonia, chronic pulmonary disease, and non lethal trauma. These data may be used practically during medico-legal death investigation and by public health agencies when planning policy and procedure relevant to the homeless population. Paucity of data concerning mortality in the homeless should prompt additional, region-specific studies to determine risk factors in areas where homelessness is manifest. PMID- 2715747 TI - "Just push away from the table"! PMID- 2715748 TI - Mental illness, substance abuse, and criminal behavior. AB - During a 6-month period, 423 inmates were referred to the mental health services in an urban county jail. The data gathered indicate significant psychopathology and recidivism in the group. Mentally disordered inmates reported a rather high rate of positive family history of psychopathology. The study points out the need for extensive mental services in city and urban county jails. PMID- 2715749 TI - Effect of the Tfm mutation on handedness in mice. AB - The hyposthesis has been proposed that testosterone is involved in the determination of handedness in man: a high sensitivity to testosterone being associated with left handedness. Handedness in mice is tested according to Collins' paradigm: most mice present either a right or a left paw preference but others are ambilateral. The hypothesis that there is an association between a low neonatal imprinting by testosterone and a strong handedness (right or left) is tested here using Tfm male mice which are testosterone insensitive. Our results confirmed the hypothesis, since Tfm males were as well lateralized as their female siblings and significantly more strongly lateralized than their male siblings not carrying the mutation. PMID- 2715750 TI - Temporal effects of progesterone inhibition of occupied nuclear oestrogen receptor retention in the rat uterus. AB - Previous studies have shown that progesterone rapidly inhibits retention of uterine nuclear oestrogen receptor in several mammalian species. This effect of progesterone may constitute a general mechanism by which progesterone modulates oestrogen action. The objective of the present study was to examine the temporal pattern of progesterone inhibition of retention of occupied nuclear oestrogen receptors in the rat uterus at various sustained serum concentrations of progesterone. Silicone elastomer implants (1 cm) packed with crystalline oestrogen were placed s.c. in the flank region of ovariectomized adult rats. Twenty-four hours after placement of the implants, animals were either injected s.c. with 5 mg progesterone in corn oil every 24 h, treated with 2 x 5 cm implants of progesterone, or treated with 1 x 5 cm silicone elastomer implants of progesterone. Serum concentrations of progesterone at the time of necropsy were 0.47 +/- 0.02, 0.18 +/- 0.02 and 0.10 +/- 0.01 mumol/l respectively. Control animals were given oestrogen implants alone and had a serum progesterone level of 0.03 +/- 0.01 mumol/l. Occupied nuclear oestrogen receptor and cytosolic oestrogen and progesterone receptor levels (pmol/uterus) were measured between 0 and 48 h following progesterone treatment. Cytosolic progesterone receptor levels were suppressed similarly in all progesterone-treated groups compared with controls given oestrogen alone throughout the 48-h test period. Cytosolic oestrogen receptor levels were significantly suppressed at 12 h following progesterone treatment in all groups. Except for the highest (pharmacological) serum progesterone concentration, cytosolic oestrogen receptor exhibited a replenishment phase between 12 and 48 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715751 TI - Ablation of the region anterior and ventral to the third ventricle (AV3V region) does not impede parturition in rats. AB - The region anterior and ventral to the third ventricle (AV3V) region is a major source of excitatory afferents to the magnocellular neuroendocrine system, and is essential for the osmotically regulated release of oxytocin. We investigated whether this input has a similarly essential role in parturition. Rats were implanted with a guide cannula in the AV3V region on days 9-18 of pregnancy. Following the birth of the third pup, rats were anaesthetized briefly with ether and either given an electrolytic AV3V lesion or a sham procedure was carried out. In eight AV3V-lesioned rats the mean (+/- S.E.M.) median interbirth interval following the lesion was 6.3 +/- 1.2 min compared with 5.2 +/- 0.6 min in 11 sham lesioned rats. All rats completed delivery of their litters. The mean plasma concentration of oxytocin was unchanged following the sham procedure (pre-sham 17.1 +/- 2.8 pmol/l, n = 8; 15 min post-sham 18.1 +/- 2.7 pmol/l, n = 8; 30 min post-sham 19.2 +/- 3.5 pmol/l, n = 8). In AV3V-lesioned rats, plasma oxytocin was significantly raised following the lesion (pre-lesion 14.6 +/- 1.3 pmol/l, n = 7; post-lesion 58.3 +/- 9.8 pmol/l, n = 7) and was still higher than the sham treated group after 30 min (55.8 +/- 9.9 pmol/l). Thus there was no significant difference in the time-course of parturition between AV3V-lesioned rats and sham lesioned rats, and no evidence that the lesion impaired the release of oxytocin. Furthermore, in rats given an AV3V lesion on the morning of the expected day of delivery, parturition was neither delayed nor disrupted, suggesting that the AV3V region does not contribute to the mechanisms controlling the onset of parturition. PMID- 2715752 TI - Effects of cholesterol and lipoproteins on aldosterone secretion by bovine zona glomerulosa cells. AB - Freshly isolated bovine adrenocortical cells were pretreated with various concentrations of cholesterol and of high- (HDL) and low-density lipoprotein (LDL) fractions of known cholesterol content and then incubated in medium alone with and without angiotensin II. Preincubation with cholesterol (323 mumol/l) caused basal aldosterone synthesis to increase from 0.89 +/- 0.08 to 2.77 +/- 0.22 pmol/10(6) cells per hour (+/- S.E.M.) but did not significantly affect angiotensin-stimulated synthesis. Human HDL containing cholesterol at a final concentration of 129-647 mumol/l increased both basal and angiotensin-stimulated aldosterone synthesis. In HDL-treated cells, both the threshold response and responses to increasing concentrations of angiotensin were raised. Human LDL had no effect on basal or stimulated aldosterone synthesis nor did LDL alter the effects of HDL when cells were incubated with HDL and LDL in combination. Qualitatively similar results were obtained with bovine lipoproteins. These studies show that, in short-term incubations of fresh tissue, the supply of cholesterol may be a limiting factor in aldosterone synthesis and that HDL rather than LDL is the preferred source. These observations are discussed in relation first to the mechanisms by which cholesterol/HDL might augment steroid responses and secondly to other studies with cultured cells which have demonstrated a role for LDL. PMID- 2715753 TI - Concentrations of dopamine and noradrenaline in hypophysial portal blood in the sheep and the rat. AB - The concentrations of dopamine, noradrenaline and their respective primary neuronal metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and 3,4 dihydroxyphenylethyleneglycol (DHPG) were measured in the hypophysial portal and peripheral plasma of sheep and rats by combined gas chromatography-mass spectrometry. Hypophysial portal and jugular blood samples were taken at 5- to 10 min intervals for 3-7 h from six conscious ovariectomized ewes. Blood was also collected for 30 min under urethane anaesthesia from the cut pituitary stalk from 16 pro-oestrous female and five intact male rats. In ovariectomized ewes, noradrenaline concentrations were higher in hypophysial portal plasma than in peripheral plasma (6.6 +/- 0.8 vs 2.2 +/- 0.4 nmol/l). In contrast, dopamine was undetectable (less than 1 nmol/l) in the portal and peripheral plasma of all ewes. Plasma levels of DOPAC and DHPG in portal and jugular samples were similar. In all pro-oestrous female rats, plasma concentrations of dopamine were higher in portal blood than in jugular blood (8.0 +/- 1.4 vs 4.8 +/- 0.6 nmol/l). Detectable concentrations of dopamine were measured in the portal plasma of two out of five male rats. Noradrenaline concentrations were higher in portal plasma than in peripheral plasma of both female (8.3 +/- 1.7 vs 3.7 +/- 0.6 nmol/l) and male (14.8 +/- 2.7 vs 6.1 +/- 1.2 nmol/l) rats. These data show that noradrenaline, but not dopamine, is secreted into the long portal vessels in sheep. The results suggest that there are species differences in the secretion of hypothalamic dopamine into hypophysial portal blood. PMID- 2715754 TI - Steroid hormone receptors and the sexual phenotype of the Harderian gland in hamsters. AB - To investigate the participation of intracellular steroid hormone receptors in the sexual transformation process of the Harderian gland, a series of experiments were undertaken in adult golden hamsters. The invitro labelling of cytosolic steroid-binding sites with appropriate radioligands revealed the presence of androgen, oestrogen and glucocorticoid but not progestin receptors in the glands from animals of both sexes. The androgen receptor of the female gland was further characterized because it was found to be the predominant intracellular steroid receptor. Studies of binding kinetics using [3H]7 alpha,17 alpha-dimethyl-17 beta hydroxy-4-oestren-3-one (DMNT) as ligand, demonstrated a high affinity androgen binding site with an apparent dissociation constant (Kd) of 0.7 nmol/l and maximal saturation binding capacity of 84.0 +/- 3.0 (S.D.) fmol/mg protein. Specificity of the androgen receptor was assessed by displacement analysis; DMNT, 5 alpha-dihydrotestosterone, testosterone and 3 alpha-androstanediol were efficient competitors for the androgen-binding site, while oestradiol-17 beta, progesterone and dexamethasone exhibited very little, if any, competitive potency. The sedimentation coefficient of the androgen receptor in sucrose density gradients was 8-9 S. These data indicate that the physicochemical characteristics of the androgen receptor from the female gland are similar to those previously described in the male gland. The striking observation of a complete lack of oestrogen-inducible and oestrogen-insensitive progestin receptors in glands cytosol, even after stimulation with cholera toxin, adds further support to the concept that the androgen receptor is the key molecule mediating the hormone-induced sexual transformation of the Harderian gland in this species. PMID- 2715755 TI - International Standards for human prolactin: calibration by international collaborative study. AB - Three ampouled preparations of purified human prolactin were assessed by 20 laboratories in eight countries for their suitability to serve as International Standards for the estimation of human prolactin in serum. Bioassays (pigeon crop sac assays and NB2 cell assays) were carried out in two laboratories, radioreceptor assays by one laboratory and radioimmunoassays by 17 laboratories. By physicochemical analysis the preparations appeared similar. Each preparation contained small amounts of contaminants and/or prolactin variants. No major differences among the three preparations were detected by immunoassay although, in one radioreceptor assay system, one of the preparations was found to differ from the other two. On the basis of all the available information, the Expert Committee on Biological Standardization of the World Health Organization (ECBS) in 1986 established the preparation in ampoules coded 83/562 as the Second International Standard for Prolactin and in October 1988 established the preparation in ampoules coded 84/500 as the Third International Standard for Prolactin. A value of 0.053 IU (53 mIU) prolactin activity/ampoule was assigned to both the Second and Third IS on the basis that this unitage would, insofar as possible, maintain continuity of the IU defined by the First International Reference Preparation of Prolactin, human, for Immunoassay (coded 75/504). PMID- 2715756 TI - Measurement of human growth hormone in urine: development and validation of a sensitive and specific assay. AB - A specific solid-phase immunoradiometric assay (IRMA), optimized for maximum sensitivity, has been developed for measurement of human GH (hGH) in urine. The sensitivity varied with sample size, giving a range of 0.001 to 0.003 mU/l for a sample volume of 2 ml. Recovery and dilution experiments, together with chromatography of urine samples, indicate that the method is specific for hGH. Added exogenous hGH was measured with a mean recovery of 101 +/- 10% (S.D.) for 1 ml samples and 87 +/- 8% for 2 ml samples. Measurements of samples diluted at 1:2 and 1:4 gave values of 97.4 and 96.6% respectively of those expected. Cross reactions of human placental lactogen and prolactin were less than 0.008 and 0.04% respectively on a mol/mol basis. The assay was insensitive to the presence of NaCl (50-500 mmol/l), urea (50-1000 mmol/l), creatinine (1-20 mmol/l), Ca2+ ions (1-20 mmol/l), SO4(2-) ions (1-1000 mmol/l), Mg2+ ions (0.05-50 mmol/l), 0.5 5% (w/v) glucose and a pH range of 6-9. Chromatography of unextracted samples showed that the immunoreactive material in urine eluted in a single homogenous peak with a similar position to monomeric pituitary hGH (22 kDa). Administered hGH (0.002%) was recovered in urine collected over a 2-h period following an intravenous injection. The urine output of hGH showed a good correlation with serum hGH in 18 patients following routine insulin tolerance tests and in 25 patients following an oral glucose tolerance test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715757 TI - LH in polycystic ovary syndrome: reproducibility and pulsatile secretion. AB - Serum concentrations of LH are increased in polycystic ovary syndrome (PCOS). We have investigated two aspects of LH secretion which have not previously been reported: its reproducibility within individuals and the pattern of superimposed pulses of LH secretion. In nine patients with PCOS the mean concentration of LH was calculated from 24 blood samples taken at 15-min intervals for 6 h on two or three occasions over 1 year. Results showed differences in mean LH between subjects but reproducible concentrations within subjects over that period. It has been shown that LH is secreted in a complicated pattern of superimposed pulses which can be characterized by using the statistical methods of time-series analysis. To evaluate these pulse patterns of LH we studied nine patients with PCOS and compared the results with those of 12 normal women in the early follicular phase of the ovarian cycle. Blood samples were taken at either 5-min intervals for 6 h of 1-min intervals for 1 h. Pulses were detected in both groups at frequencies of about 1 h and 2 to 3 min. There was no significant difference in the pulse frequencies between the patients and controls but the amplitude of both groups of pulses was increased in the PCOS patients. PMID- 2715758 TI - In-vivo uptake of human growth hormone in male rat liver. AB - 125I-Labelled human GH (hGH) was injected i.v. to male rats and its subcellular distribution in the hepatocyte was examined using fractionation techniques. Uptake into liver homogenates was maximal by 15 min after injection and represented 24% of the injected radioactivity; it was markedly inhibited by coinjection of native hGH. 125I-Labelled hGH taken up by the liver underwent a time-dependent translocation process. The peak of specific labelling of plasma membranes occurred at 3 min whereas later on the radioactivity was concentrated in low-density structures present in Golgi-endosome fractions. To characterize the ligand-associated structures better, endosome-enriched fractions were prepared from a microsomal fraction by isopycnic centrifugation in a sucrose gradient and a Nycodenz gradient. The radioactivity was in one peak with a median density of 1.096 g/cm3 in the Nycodenz gradient fractions. The peak of radioactivity was distinct from that of galactosyltransferase activity which appeared at a median density of 1.114 g/cm3. The labelled material eluted from the various subcellular fractions appeared as intact hGH. Upon in-vivo interaction with male rat hepatocytes, 125I-Labelled hGH was internalized with a sequential association with plasma membranes and endocytic structures distinct from Golgi elements. PMID- 2715759 TI - Rapid proliferative response of rat thyroid gland to a single injection of TSH in vivo. AB - Mitotic and labelling indices were studied in the thyroid follicular cells of the male rat within the first hour after a single injection of TSH or TSH vehicle, using the metaphase arrest agent vincristine sulphate. There was a significant increase in metaphase index over control values 5, 15, 30 and 60 min after injection of TSH. There was no significant change in the tritiated thymidine labelling index in TSH-treated rats in comparison with vehicle-injected controls. None of the metaphase figures was labelled, showing that G2 in this tissue is longer than 2 h. PMID- 2715760 TI - The testicular response to hemicastration in the male rat cannot be maintained in vitro. AB - The testicular response to hemicastration (in which testicular vein testosterone from the remaining testis doubles in concentration) was studied in vitro in order to establish whether the response is maintained after testicular tissue is removed from the animal. Decapsulated testes and collagenase-dispersed cells from decapsulated testes of rats were incubated for 24 h after hemicastration and testosterone production was compared with that in tissue collected at the time of surgery. Testosterone concentration in the remaining testis 24 h after hemicastration was significantly (P less than 0.05) higher than in the testis removed at the time of hemicastration, but testosterone production in vitro was similar in both tissues. Apparently the single testis remaining in a hemicastrated rat requires extratesticular support in order to maintain its stimulated state. PMID- 2715761 TI - The functional activity of hypothalamic dopamine in broody bantam hens. AB - An assessment was made of the possible role of hypothalamic dopamine in the regulation of changes in plasma prolactin and LH in laying and broody bantam hens. Specific dopamine-binding sites were identified, using [3H]domperidone, in the anterior pituitary gland and in the anterior and posterior hypothalamus. The mean concentrations of dopamine-binding sites in both parts of the hypothalamus were 59-66 fmol/mg protein and did not differ between laying and incubating hens. The concentration of dopamine binding sites in the anterior pituitary gland was significantly (P less than 0.001) greater in laying than in incubating hens (278 +/- 46 compared with 420 +/- 32 fmol/mg protein, n = 5). The turnover rates of dopamine were compared in the anterior and posterior hypothalami of laying, incubating and nest-deprived hens. The turnover rates were estimated from the rate of accumulation of dopamine after inhibiting its catabolism using the monoamine oxidase inhibitor, pargyline, or by measuring the ratio of the concentrations of dopamine and its major metabolite, homovanillic acid. Both methods gave the same results. The turnover of dopamine was increased in the anterior but not posterior hypothalamus of incubating hens when compared with laying or nest-deprived hens. These results show, for the first time in birds, that the anterior pituitary gland contains specific binding sites for dopamine and that the concentration of these binding sites is inversely related to the concentration of plasma prolactin. The marked increase in dopaminergic activity in the anterior hypothalamus of incubating hens may stimulate the release of unidentified prolactin-releasing factors and/or inhibit the release of LH by exerting an inhibitory influence in the area of the hypothalamus containing LHRH cell bodies. PMID- 2715762 TI - Vitamin A deficiency and tri-iodothyronine action at the cellular level in the rat. AB - Young rats were given a diet with or without vitamin A for a period of 7 weeks. In rats on the vitamin A-deficient diet, the formation of tri-iodothyronine (T3) complexes with nuclear proteins was reduced, and Scatchard analysis showed a decreased capacity of nuclear T3 receptors. In these rats, a decrease in growth and a decrease in the activity of lipogenic enzymes (glucose-6-phosphate dehydrogenase, phosphogluconate dehydrogenase and L-malate dehydrogenase) occurred, which could be related to the decreased formation of T3-nuclear protein complexes. PMID- 2715764 TI - 8th joint meeting of British Endocrine Societies. 10-13 April 1989 Manchester. Abstracts. PMID- 2715763 TI - Changes in serum concentrations of immunoreactive inhibin during the oestrous cycle of the rat. AB - Serum and ovarian concentrations of inhibin during the oestrous cycle of rats were determined by a radioimmunoassay (RIA) based on a porcine inhibin RIA. Serum concentrations of LH, FSH, oestradiol-17 beta, progesterone and testosterone were also determined during the cycle. Serum concentrations of inhibin were high (8.47 +/- 0.58 micrograms/l) during the morning of pro-oestrus and then dropped sharply to the lowest level (3.21 +/- 0.38 micrograms/l) at 24.00 h on the day of pro oestrus after the preovulatory LH and FSH surge. Inhibin concentrations then recovered rapidly, with a peak (7.94 +/- 0.97 micrograms/l) at 15.00 h on the day of oestrus. Inhibin concentrations in serum dropped again to their second lowest value (4.00 +/- 0.12 micrograms/l) at 24.00 h on the day of oestrus. The largest FSH surge observed from midnight of pro-oestrus to the morning of oestrus (the so called second FSH surge) was shown to be inversely related to the changes in serum concentrations of inhibin, suggesting a close relationship between the serum FSH and inhibin concentrations in cyclic rats. PMID- 2715765 TI - Expression of the third member of the serum amyloid A gene family in mouse adipocytes. AB - Three homologous genes that code for three related proteins comprise the serum amyloid A (SAA) family in the mouse. Endotoxin induces equally vigorous expression of mRNAs for the three SAA genes in liver. In extrahepatic tissues SAA1 and/or SAA2 mRNAs have been found only in kidney and intestine, however, SAA3 is expressed in all extrahepatic tissues thus far examined. This observation raised the question: is SAA3 mRNA expressed by a single cell system dispersed throughout all tissues, or by differentiated cells of each tissue? This question was explored in various tissues by in situ hybridization with a single-stranded cRNA probe specific for SAA3 mRNA. We found expression in the liver of SAA3 mRNA by other cells as well as by hepatocytes. A common feature among extrahepatic tissues was SAA3 mRNA expression in adipocytes. SAA3 mRNA was also found in two nonadipose cells, Leydig cells of the testis, and some of the cells located in parafollicular zones of the spleen. PMID- 2715766 TI - Obstetric outcomes in rural practice. PMID- 2715767 TI - Equivocal anemia in the elderly. PMID- 2715768 TI - Anemia in the elderly. A survey of physicians' approaches to diagnosis and workup. AB - Anemia is one of the most common clinical problems encountered by physicians caring for elderly patients. There is controversy about whether anemia should be regarded as a "normal" concomitant of the aging process. A survey of 232 Maryland physicians was conducted to examine how they approach this problem. The levels of both hemoglobin and hematocrit at which practicing physicians diagnose and perform an anemia workup on elderly patients were lower than currently recommended. Physicians who see more elderly patients used significantly lower values of hemoglobin and hematocrit for the diagnosis and workup of anemia. There were no significant differences between family physicians and internists in their approach to diagnosis or workup of anemia in the elderly. PMID- 2715769 TI - Family functioning and stress as predictors of influenza B infection. AB - A prospective cohort study was designed to study the effects of family functioning and stress on the incidence of influenza infection. Families from the clinic roster, containing two adults and at least one child between the ages of 1 and 18 years, were asked to participate. Baseline (pre-influenza) data included a serum determination for influenza A and B antibodies, family functioning as measured by the Family Adaptability and Cohesion Evaluation Scales (FACES) II and the Family APGAR, and parental stress as measured by the social readjustment rating scale (SRRS). During the study all family members of patients with upper respiratory tract infection symptoms or fever were seen, and throat swabs were obtained for viral culture. Approximately 2 weeks after the influenza epidemic ended (March 1984), sera for antibodies were again collected on all family members. Chi-square analysis showed that infection (defined as a fourfold titer rise or a positive viral throat culture) was significantly associated with both cohesion and adaptability as measured by FACES II. Neither the Family APGAR nor the SRRS was associated with influenza B infection. It was concluded that family functioning affects the frequency of influenza B infection within families. This finding raises the possibility that family dysfunction may lead to altered immune responses, which increases susceptibility to infection. PMID- 2715770 TI - Preventive services in a hybrid capitation and fee-for-service setting. AB - The potential omission of indicated tests for patients enrolled in prepaid health care plans has been raised as a possibility. This study reviewed the charts of 149 adult patients seen for routine physical examinations or checkups in university-based family medicine or internal medicine clinics. Of the patients included, 67 were enrolled in a capitated plan and 82 enrolled in fee-for-service based plans. Results showed that the rates of compliance with preventive services appropriate to patients' age and sex (Papanicolaou smears, breast examination, mammography, and stool examination for occult blood) were not significantly different for capitated and fee-for-service patients. PMID- 2715771 TI - Community use of paracervical block in labor. AB - Although controversy surrounds obstetric use of paracervical block, few articles report experience from community hospitals. Medical records of 883 obstetric patients at a community hospital were examined to determine frequency and efficacy of paracervical block as well as associated changes in electronic fetal monitor tracings, infant Apgars, and length of hospital stay. Nearly two thirds of laboring women received paracervical anesthesia, three fourths of whom obtained noticeable pain relief. Partial relief was obtained by another 20%. Infants delivered after paracervical block were compared with those unexposed to this therapy and found to be similar in regard to Apgar scores and length of hospital stay. Fetal monitor tracings showed highly concerning alterations in 6% of patients after the block. It is concluded that paracervical block done by the technique described remains an effective and low-risk form of obstetric anesthesia in most obstetric patients in a community hospital. PMID- 2715772 TI - The single-session family interview. AB - Currently, attempts are being made to integrate family systems theory and technique into the practice of family physicians. Although the importance of the family has been demonstrated in a number of medical situations and although several authors have indicated situations in which it is useful for the physician to convene the family, to date no explicit guidelines have been developed for conducting a single-session family interview. This article presents a framework for conducting such an interview, structured in three stages (contracting, exploration, and closure) with clinical examples for each stage. The single session family interview provides the family physician with realistic guidelines for helping families who face medical dilemmas and for improving the physician's practice. The guidelines have proven useful in teaching residents the skills involved in understanding family dynamics and conducting productive family meetings. PMID- 2715773 TI - Patients' attitudes toward the closing of a medical practice. AB - A questionnaire probing various aspects of the termination of the physician patient relationship was distributed to 200 consecutive patients during the last weeks of the author's private practice. The response rate was 89%. Although two thirds of the patients had already heard of the author's planned departure, only 25% of the respondents had made an attempt to secure a new physician. Their preference in most cases (92.5%) was to find another family physician. Examination of the physician-patient relationship revealed that most people felt there was a lag between the length of time it took the physician to understand their medical problems and the time it took to understand their emotional problems. Approximately one half (54.0%) of the respondents needed at least a few visits to become comfortable with a new physician. However, 8.6% needed years to gain that comfort. Eighty percent of those individuals who required years to become comfortable with a new physician were women. Further, the emotional attachment to the physician was greater in those families for whom the physician had delivered a baby. PMID- 2715774 TI - Rocky Mountain spotted fever presenting with chest pain and electrocardiogram ischemic changes. PMID- 2715775 TI - Sparing effect of sulindac on lithium levels. PMID- 2715776 TI - Factors influencing changes in obstetric care provided by family physicians: a national study. AB - In an effort to determine the factors underlying changes in obstetric practice by family physicians, a random sample of 505 residency-trained family physicians was surveyed by mailed questionnaire. Of the 329 who responded, 65% had at some time practiced obstetrics, but only 45% were practicing obstetrics at the time of the survey. Rising malpractice insurance premiums and fear of lawsuit were factors most likely to influence a family physician's decision to cease obstetric practice. Lifestyle concerns and the number of obstetricians practicing in the area were also important factors for all family physicians. Important differences were found between family physicians who never delivered babies and those who had at some time practiced obstetrics. Family physicians who have given up obstetric practice were found to feel well trained and competent in this practice. Since changes in obstetric practice patterns have had an adverse effect on the obstetric care of women in rural areas and for the medically indigent, these findings have important public health implications. PMID- 2715778 TI - [Proceedings of the 14th seminar of the European Club of Genetic Counseling. Clermont-Ferrand, 12-14 September 1988]. PMID- 2715777 TI - Religion and family medicine. PMID- 2715779 TI - [Collaboration between child psychiatry and medical genetics. Genetic diseases with an atypical beginning]. AB - When a children psychiatrist, faced to atypical psychological troubles, comes up against difficulties in establishing a precise diagnosis, he may consider a genetic etiology and ask for a genetic consultation. He may encounter many problems when he suggests this specialized consultation to the parents. These have often been prepared for a long time to the necessity of a psychiatric therapy in order to cure their child's troubles. The geneticist's diagnosis will induce the parents and the psychiatrist to have a different look on the child and mostly will set limits to the possibilities of treatment. PMID- 2715781 TI - [The geneticist and the psychiatrist]. AB - The author describes three different opportunities requiring a desirable collaboration between the geneticist and the psychiatrist: 1. More detailed analysis of the psychologic fallout inside a family with an handicapped person. 2. How a geneticist may contribute to a medical progress inside a psychiatric institution. 3. The possible convergence of their efforts in some fields of the neuropsychiatric research. PMID- 2715780 TI - [Psychological implications of family studies by molecular biology. An example- muscular dystrophy]. AB - A dialogue between a geneticist and a M.D. trained in medical psychology has been established about problems arising in genetic counselling. A better knowledge of themselves allows them to increase the quality of genetic counselling by improving the communication techniques. The whole personality and not only the genetic disease of the individuals seeking genetic counselling is taken into account during the counselling process. PMID- 2715782 TI - [Argininosuccinic aciduria. A new case revealed by psychiatric disorders]. AB - The case of a 4 years old boy, hospitalized for an unexplained coma, is reported. He is the first child of a non-consanguin couple. The psychomotor development of this child was considered as normal up to the age of 18 months; then, a delay in language development, behaviour disorders with an important instability interrupted by episodes of somnolence, were observed. This child was treated for psychotic disorders. At the age of 3 and half, he had two episodes of seizures associated with fever. He was hospitalized for a 24 hours coma (4 years old). An hepatomegaly and a dry, brittle hair were then observed. Hyperammonemia was made obvious by a protein tolerance test. The diagnosis of argininosuccinate lyase (ASAL) deficiency was based on the increased levels of ASA in plasma and urine. The deficiency was proved by a fibroblast culture. With protein restriction, hepatomegaly disappeared, hair became normal, the behaviour disorders and the delay in language development was improved. However, some school difficulties persist. This case shows that an hereditary metabolic syndrome can be revealed by psychotic like symptoms in childhood. PMID- 2715783 TI - [Stature after 18 months of treatment with synthetic growth hormone in 12 patients with Turner's syndrome]. AB - The increased availability of recombined human growth hormone (rhGH) allows its possible use in clinical situations not classically recognized as regular indications. Among these, the Turner's short stature is presently under experimental evaluation for its responsiveness to rhGH. Twelve patients, 10 with a 45, X karyotype, 1 46 XXiq, and 1 mosaicism, have been given rhGH at a dosage of 0.15 U/kg per injection six times a week. Mean age at onset of treatment was 12.8, mean growth retardation was 4.1 SDS according to Sempe. After 18 months of treatment mean growth catch-up was 0.9 SDS. Maximal velocity was reach during the first trimester of treatment and decreased thereafter but was above normal for bone age in all but 2 after 18 months. The bone age increased less than structural age. No side effects were reported. At the present time the efficacy of rhGH in increasing final height in Turner's patients is likely but not demonstrated by any studies. The exact place of ovarian substitution, even during the prepubertal period, is still matter of discussion. Since the velocity response to rhGH was maximal among the youngest patients an early diagnosis of the syndrome will likely be necessary to improve final stature. PMID- 2715785 TI - [Clinical and biological studies of 14 cases of the Prader-Labhart-Willi syndrome]. AB - Clinical and cytogenetic studies are performed on 14 patients with PWS including endocrinological investigations, as coagulation factor XI activity and pigmentation studies. Recent hypothesis from molecular analysis are discussed. PMID- 2715784 TI - [Chorionic villus sampling (CVS): level of activity and methods to resolve certain difficulties in interpretation]. AB - As of December 1, 1988, we had, as part of our prenatal diagnostic service, studied 458 transcervical chorionic villus biopsies. Three-fourths of these samples were taken because of advanced maternal age (greater than or equal to 35 years), whereas nearly one fifth were done to alleviate parental anxiety. The remainder were performed because of a precedent chromosomal anomaly in child or parent, to determine fetal sex in the case of X-linked familial disorders, or to obtain DNA for molecular analyses. Among the cytogenetic anomalies detected after 24 to 48 hours of culture, eight involved classical trisomies. In four other instances the chromosomal abnormalities were more difficult to interpret (mosaic trisomies 10, 13 and 15, an apparently uniform trisomy 7). All four were revealed to be "false positives", since neither the amniocenteses nor the karyotypes of the normal newborns (one pregnancy is still ongoing) confirmed an abnormal karyotype. In the case of the trisomy 7 we were able, after birth of the baby, to study two placental biopsies, one of which revealed an abnormality distinct from that detected in the chorionic villi. The observations concerning a fifth false positive are more worrisome, as an apparently uniform trisomy 18, with a fetus showing growth retardation on ultrasound, could not be confirmed in the abortus. Otherwise, we have not encountered a false negative result. In this article we discuss the mechanisms potentially responsible for the cytogenetic discrepancies sometimes observed between fetal and placental tissues. Molecular analyses may help to establish whether a chromosomal anomaly present in fetal chorionic villi had its origin in the pre- or post-zygotic stage; in the latter case the aneuploidy may be uniquely extrafetal. PMID- 2715786 TI - Mosaic trisomy 9 detected by amniocentesis. PMID- 2715787 TI - Emission of airborne bacteria from a hospital incinerator. AB - Only five studies have been found in the literature which provide any indication of the effectiveness of incineration for rendering infectious hospital waste innocuous. Although there is an indication from these studies for release of bacteria in stack gas, none of the studies identified the bacteria or determined the source of bacteria. The purpose of the present study was to investigate the potential for a hospital incinerator to release human pathogenic bacteria into the ambient environment. In this study, waste spiked with Bacillus subtillis was burned in a hospital incinerator. Although bacteria were found in the incinerator stack gas, (concentrations ranged from not detectable to 1157 colonies/m3 of air) no Bacillus subtilis was recovered from the stack gas. The results suggest that the source of the stack gas bacteria was not from unburned waste or from outdoor air. Analysis of samples of air from the incinerator room (not simultaneous with the stack gas samples) indicates that the source of the stack gas bacteria was most likely the combustion air. PMID- 2715788 TI - Adaptation by older individuals repeatedly exposed to 0.45 parts per million ozone for two hours. AB - To test for an increased reaction to ozone (O3) in older individuals following an initial exposure, and to test for adaptation and its duration, we exposed 10 men and 6 women (60-89 years old) in an environmental chamber to filtered air and 3 consecutive days of O3 exposure (0.45 ppm), followed by a fourth O3 exposure day after a two day hiatus. Subjects alternated 20-min exercise (minute ventilation = 27 L) and rest periods for 2 hours during each exposure. Subjects rated from one to five, 16 possible respiratory/exercise symptoms prior to and following the exposure. Pulmonary function tests were performed before, and during each rest period and following the exposure. Metabolic measurements were obtained during each exercise period. No significant changes in any symptom question occurred, in spite of a threefold increase in the total number of reported symptoms during O3 exposure. Small but significant pre-to-post decrements on the first and second O3 days in forced vital capacity (FVC-111 and 104 mL), forced expiratory volume in 1 (FEV1-171 and 164 mL) and 3 seconds (FEV3-185 and 172 mL) occurred without concomitant changes in any flow parameter of the forced expiratory maneuver. No differences in the group mean response in FVC, FEV1 or FEV3 on the third or fourth day of O3 exposure and the filtered air exposure were found. The observed changes were due to significant physiological changes in eight of the subjects. Unlike young subjects, no evidence of an increased pulmonary function response to a second consecutive O3 exposure was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715789 TI - A theoretical study of the Si-O bond in disiloxane and related molecules. AB - A comparison of semi-empirical (MNDO) and ab initio (GAUSSIAN) calculations for disiloxane and related molecules is given. The STO-3G* basis set well produced the observed geometries of disiloxane (less than SiOSi observed 144 degrees, calculated 140 degrees), dimethoxy-dimethylsilane (less than OSiO obsd tetrahedral, calc 102 degrees), methyl silyl ether (less than COSi obsd 121 degrees, calc 118 degrees) and correctly predicted the planar geometry found for cyclotrisiloxane. In contrast, more complex basis sets (3-21G(*), DZP, TZVP) gave much poorer agreement with the observed geometries. Comparison of the STO-3G* and the STO-3G basis sets demonstrates the necessity of including d-orbitals on the silicon. However, the semi-empirical MNDO program gave, despite the absence of d orbitals, a better approximation to the molecular geometry than the complex ab initio basis sets. Force field parameters have been calculated for kSiOSi, kOSiO, 0.089 and 0.73 mdyneA/rad2, and the SiOSiO torsion which has a V1 potential of 0.68 kcal/mol. In addition, the HSiOH torsion is shown to have a three-fold potential of 0.78 kcal/mol. These are profoundly different from the analogous carbon-oxygen force constants, demonstrating that C-O parameters cannot be transferred to the corresponding Si-O systems. PMID- 2715790 TI - Molecular mechanics calculations on deaminooxytocin and on deamino-arginine vasopressin and its analogues. AB - The backbone conformations of the cyclic moieties of 1-[beta-mercaptopropionic acid]-oxytocin [( Mpa1]-OT), [1-beta-mercaptopropionic acid]-arginine-vasopressin [( Mpa1]-AVP), [1-(beta'-mercapto-beta,beta-cyclopentamethylene)propionic acid] arginine-vasopressin [( Cpp1]-AVP), and [1-thiosalicylic acid]-arginine vasopressin [( Ths1]-AVP) have been analyzed by means of molecular mechanics. In these calculations, the side chains were simulated by pseudoatoms. For the three last compounds, the calculations were also performed on the whole molecules, in order to shed light on the differences in their biological activity. Their starting conformations were obtained by attaching the acyclic tail and side chains to the lowest energy conformations of the cyclic parts. In the case of [Ths1]-AVP, however, other starting conformations were also examined, which were obtained by attaching the planar benzene ring to the lowest energy conformations of [Mpa1]-AVP. In the calculations, all the degrees of freedom were relaxed and Weiner's force field was used, the parameters required for the benzene parts of [Ths1]-AVP being determined from the experimental data available, as well as from the results of molecular dynamics calculations on the model compounds. The lowest energy conformations of [Mpa1]-AVP and [Cpp1]-AVP are similar, while [Ths1]-AVP differs from them near the disulphide region, due to the presence of a planar benzene ring. Interactions involving the charged guanidine group of arginine make, in each case, an important contribution to the conformational energy. A model description of the shapes of the oxytocin and vasopressin ring has been proposed, which is based on the cyclohexane geometry. This description is in good correlation with the energetics of the conformations corresponding to different shapes. PMID- 2715791 TI - Upperbound procedures for the identification of similar three-dimensional chemical structures. AB - This paper describes techniques for calculating the degree of similarity between an input query molecule and each of the molecules in a database of 3-D chemical structures. The inter-molecular similarity measure used is the number of atoms in the 3-D common substructure (CS) between the two molecules which are being compared. The identification of 3-D CSs is very demanding of computational resources, even when an efficient clique detection algorithm is used for this purpose. Two types of upperbound calculation are described which allow reductions in the number of exact CS searches which need to be carried out to identify those molecules from a database which are similar to a 3-D target molecule. PMID- 2715792 TI - What is research? PMID- 2715793 TI - A theoretical study of Zn++ interacting with models of ligands present at the thermolysin active site. AB - The binding energy and the geometrical arrangements of the complexes formed by the zinc dication with OH-, one, four, five or six water molecules, SH-, H2S, formic acid, the formate anion, imidazole, its anion and formamide are calculated using the MNDO method. The comparison of the results obtained with those of ab initio computations on the same complexes induced us to propose for Zn++ a set of parameters different from the one determined by Dewar for the neutral metal atom. Using the two MNDO parametrizations, similar calculations are carried out for Zn++ interacting with two molecules of 2-aminoethanethiol and with models of the four ligands which are present at the thermolysin active site, in order to evaluate the possibilities and limitations of this semiempirical method for theoretical studies concerning zinc metalloenzymes. In the last case, the results obtained suggest that, in the crystal state, the water molecule could be deprotonated. This finding is discussed in relation with the mechanism of action of the enzyme which has been proposed. PMID- 2715794 TI - Constrained search of conformational hyperspace. AB - We introduce a new method for determining pharmacophore or active site geometries by analysis of the structures of a series of active compounds. The method, constrained search, and the key concepts on which it is based, is described and illustrated by its application to 28 potent inhibitors of angiotensin-converting enzyme (ACE). The data set is one utilized by Mayer et al. [J. Comput.-Aided Mol. Design, 1 (1987) 3-16] to determine a unique geometry for the active site. Our experiment validated the previously reported results, obtained by a systematic search, while reducing the computer time requirement by more than two orders of magnitude. The experiment also identified a previously unrecognized alternative active site geometry for the ACE series. PMID- 2715795 TI - Structural requirements of Na+-dependent antidopaminergic agents: Tropapride, Piquindone, Zetidoline, and Metoclopramide. Comparison with Na+-independent ligands. AB - Molecular graphic design coupled with PCILO and crystallographic results have been used to investigate the three-dimensional structure of Tropapride, Piquindone, Zetidoline, and Metoclopramide, four dopamine D-2 receptor antagonists showing Na+-dependent binding. Three putative pharmacophoric elements, a nitrogen lone pair, a phenyl ring and a carbonyl moiety, are similarly oriented in all the Na+-dependent drugs. Conversely, for Na+ independent analogs, the two latter pharmacophoric elements play a subordinate role, but two pi-electron regions are systematically localized on the other side of the molecule: the first is a phenyl group while the second is a carbonyl function as in butyrophenones, a cyano group as in R48455, or a phenyl ring as in diphenylbutylpiperidines or tricyclics. The presence of a benzyl ring on this side in Tropapride might explain its weak extrapyramidal effects. PMID- 2715796 TI - Geometries of functional group interactions in enzyme-ligand complexes: guides for receptor modelling. AB - An approach is described which makes use of X-ray structural data from enzyme ligand complexes in order to obtain information for application in receptor modelling. The atomic surroundings of five different ligand functional groups were determined for all complex structures recorded in the Brookhaven Protein Data Bank. These atomic surroundings were then superimposed with respect to the atoms of the functional groups of the ligands in order to obtain clouds of neighbouring atoms. General principles were sought to describe the orientation or favoured position of groups or atoms around those functional groups when bound to a macromolecule. Some simple conclusions and leads for further modelling were thus derived. PMID- 2715798 TI - The educational foundation of Computational Chemistry. PMID- 2715797 TI - Computer simulation of the conformational behavior of cholecystokinin fragments: conformational families of sulfated CCK8. AB - Display methods, such as principal component analysis, and clustering methods were applied to a sample of cholecystokinin, (sulfated CCK8) conformations obtained from a Monte Carlo simulation. It is shown that six families of conformations can entirely describe the sample. Each family represents a typical conformer. These theoretical models are in agreement with recent experimental results which stress the predominance of folded conformers in aqueous medium. PMID- 2715799 TI - Oh, what a tangled web. PMID- 2715800 TI - Should single agents be standard therapy for urothelial tract tumors? PMID- 2715801 TI - Can oncologists add? PMID- 2715802 TI - Antagonism of chemotherapy-induced cytotoxicity for human breast cancer cells by antiestrogens. AB - In a prior National Surgical Adjuvant Breast and Bowel Project (NSABP) adjuvant study, the addition of the antiestrogen tamoxifen to chemotherapy with melphalan and fluorouracil adversely affected survival in several patient subsets, suggesting an antagonistic drug interaction. To investigate this possibility, we studied the interaction of tamoxifen and other antiestrogens with several cytotoxic drugs in cultured human breast cancer cell lines. Clinically relevant concentrations of tamoxifen and melphalan reduced colony survival of estrogen receptor (ER)-positive breast cancer cells when used alone in a colony-forming assay. However, pretreatment of cells with tamoxifen followed by exposure to melphalan resulted in antagonism, with more colonies surviving treatment with the combination than with melphalan alone. Identical effects were seen using several other triphenylethelene antiestrogens. An antagonistic interaction was observed even with a brief preincubation with tamoxifen that had no effect on cell proliferation, indicating that antagonism was not due to tamoxifen's known cell kinetic effects. Tamoxifen even antagonized melphalan cytotoxicity in ER-negative breast cancer cells and in cultured liver cells. An additive drug interaction occurred when melphalan was combined with pharmacologic concentrations of estradiol or medroxyprogesterone acetate, but antagonism was also observed with dexamethasone. Tamoxifen also antagonized the cytotoxicity of fluorouracil in these cells. However, an additive interaction occurred when the antiestrogen was combined with doxorubicin or 4-hydroxy-cyclophosphamide, an alkylating agent that is transported into the cell by a different carrier-mediated mechanism than melphalan. To avoid potential antagonism in the clinic, combinations of tamoxifen with melphalan and/or fluorouracil should be avoided. PMID- 2715803 TI - MOPP chemotherapy versus extended-field radiotherapy in the management of pathological stages I-IIA Hodgkin's disease. AB - In order to assess whether mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy (CT), which is less expensive and more easily available than radiotherapy (RT), is at least as effective as RT in terms of cure rate and has less iatrogenic damage, 89 consecutive patients with Hodgkin's disease (HD) (pathological stage I-IIA) were randomly allocated to receive mantle plus lumbar bar RT (36-45 Gy) or CT (six courses of MOPP). Forty-five patients were entered in the RT group and 44 in the CT group. The median follow-up was 60 months. Complete remission (CR) was obtained in all patients in the RT group and in 40 of 44 patients in the CT group. Overall survival (OS) and disease-free survival (DFS) were, respectively, 87.2% and 72.7% in the CT group and 93.5% and 74% in the RT group. Survival probability of relapsing patients was 76% for the patients in the RT group and 45% in the CT group. Treatment-related complications were more severe in the CT group as compared with the RT group. PMID- 2715804 TI - Multivariate analysis of prognostic factors in acute myeloid leukemia: value of clonogenic leukemic cell properties. AB - The initial clinical and biological parameters, including clonogenic leukemic cell (CFU-L) assay, were reviewed for their prognostic significance in a cohort of 188 adult patients with newly diagnosed untreated acute myeloid leukemia (AML). Almost all patients received induction therapy with daunorubicin (DNR) and cytarabine (Ara-C) according to the European Organization for Research and Treatment of Cancer (EORTC) AML 5 to AML 9 trials. Bone marrow samples from 116 representative patients were obtained for CFU-L assay with an efficiency percentage of 89.6%; 76 patients had a measurement of the CFU-L self-renewal capacity (second plating efficiency [PE2]) and 91 patients had CFU-L inhibition test after exposure to DNR and/or Ara-C. The prognostic significance of parameters such as age, hematological antecedent, WBC count, liver enlargement, and Auer rods is confirmed in the present study. Moreover, high platelet and polymorphonuclear counts appeared to be related to resistance to induction course. However, through multivariate analysis, CFU-L sensitivity to drugs and self-renewal capacity appeared to be major independent prognostic factors in AML. A low CFU-L inhibition in the presence of the DNR and Ara-C combination correlates with a poorer complete remission (CR) rate, but not with CR duration. Patients with the lower PE2 values experienced both higher CR rate and longer CR duration. The practical interest of CFU-L study remains to be defined but, at least, PE2 measurement could be considered in the future as a major variable in determining therapeutic aggressiveness. PMID- 2715805 TI - Hearing loss in children and young adults receiving cisplatin with or without prior cranial irradiation. AB - One hundred seventy-seven children and young adults with various malignant neoplasms were prospectively tested for hearing loss after they had received cisplatin (n = 146), cranial irradiation (n = 18), or both (n = 13). Adequate renal function, no history of treatment with ototoxic drugs other than cisplatin, and availability for repeated audiometric testing were requirements for enrollment. Substantial hearing loss, defined as a hearing threshold of 50 dB or greater, was noted in only 11% of the cohort on tests conducted at the common speech frequencies (500 to 3,000 Hz). About half the patients had substantial deficits at higher frequencies (4,000 to 8,000 Hz). The probability of substantial hearing loss was directly related to the cumulative dose of cisplatin. In nonirradiated patients tested at the speech frequencies, there was a negligible risk of substantial deficits over the dose range of 90 to 360 mg/m2. As the dose increased to 720 mg/m2, the risk increased to 22%. In irradiated patients who later received cisplatin, cumulative drug doses as low as 270 mg/m2 were associated with a high probability of substantial hearing loss, suggesting potentiation of ototoxicity when these therapies are used together. Hearing acuity was either not affected or only minimally decreased in the irradiation only group. Younger age, prior irradiation, and the presence of a CNS tumor each contributed significantly to the severity of hearing deficits at given cisplatin dose levels. We conclude that early increases in hearing threshold at a stimulus frequency of 4,000 Hz indicate probable subsequent deficits at lower frequencies, especially in young children with CNS tumors who have received cranial irradiation. The probability charts derived from this analysis should provide a useful tool for predicting hearing loss in the speech frequencies. PMID- 2715807 TI - A phase I pharmacokinetic study of 21-day continuous infusion mitoxantrone. AB - A phase I study of mitoxantrone given as a continuous infusion for 21 days using a venous access port and a portable pump was performed. The first dose step was 0.3 mg/m2/d for 21 days. Courses were repeated every 6 weeks. Dose increment per step was 0.1 mg/m2/d in the first three dose steps and 0.2 mg/m2/d in the latter dose steps. Twenty-five patients entered the study and received a total of 50 courses, with a median of two courses (range, one to five). Up to 0.5 mg/m2/d, no toxicity (according to the World Health Organization [WHO] criteria) occurred. At 0.7 mg/m2/d, one patient experienced grade 2 leukocytopenia and at the 0.9 mg/m2/d dose step, one patient experienced grade 2 leukocytopenia, grade 1 thrombocytopenia, and grade 1 hair loss. At 1.1 mg/m2/d, two of six patients had grade 3 leukocytopenia, and in one patient treatment was discontinued after two days because of myocardial infarction. In both patients receiving 1.3 mg/m2/d, treatment was discontinued after 2 weeks because of grade 3 leukocytopenia. Three patients at the 1.1 mg/m2/d, dose step and two patients at the 1.3 mg/m2/d dose step experienced some nausea in the last week of the infusion period. One patient developed subclavian vein thrombosis. No infectious complications occurred. Pharmacokinetic studies were performed by high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection. Plasma steady-state was reached after 35 hours. During steady-state there was a linear relationship between the mitoxantrone dose administered and the level of mitoxantrone in plasma (r = .93, P less than .005). The mitoxantrone level in leukocytes increased significantly during the infusion period at the 0.9 mg/m2, the 1.1 mg/m2, and the 1.3 mg/m2 dose steps. The area under the curve (AUC) in leukocytes was higher with continuous infusion of 1.1 mg/m2/d for 21 days compared with bolus injection of 12 mg/m2. Mitoxantrone could be detected in plasma for at least five days after the end of the 21-day infusion period and in leukocytes for at least 14 days. Continuous infusion mitoxantrone may increase intracellular drug uptake as expressed by intracellular AUC. We recommend a dose of 1.1 mg/m2/d for 3 weeks for evaluation of antitumor efficacy in phase II studies. PMID- 2715806 TI - Hydroxyurea, fluorouracil, and concomitant radiotherapy in poor-prognosis head and neck cancer: a phase I-II study. AB - Hydroxyurea and fluorouracil (5-FU) are active cytotoxic drugs in head and neck cancer and have shown synergistic activity in vitro. Both drugs also act as radiosensitizers. Therefore, we administered radiotherapy at daily fractions of 180 to 200 cGy with simultaneous continuous infusion 5-FU at 800 mg/m2/d and escalating daily doses of hydroxyurea for five days. Cycles were repeated every other week until completion of radiotherapy. Thirty-nine inoperable patients were treated at six dose levels of hydroxyurea ranging from 500 mg to 3,000 mg orally daily. Little effect of hydroxyurea on the WBC or platelet count was noted in patients receiving less than 2,000 mg daily, whereas both parameters decreased progressively in patients receiving 2,000 mg daily or more. Mucositis occurred at all dose levels, requiring frequent dose reduction of 5-FU; however, in patients receiving a daily hydroxyurea dose of 2,000 mg or less, the median weekly 5-FU dose administered was 1,725 mg/m2 (86% of the intended 5-FU dose), whereas at daily hydroxyurea doses exceeding 2,000 mg, the median weekly 5-FU dose decreased to 1,133 mg/m2 (57%) (P = .001). Of 15 evaluable patients with recurrent disease after prior local therapy only one failed to respond; six had a complete response (CR), and eight a partial response (PR). Of 17 evaluable patients without prior local therapy, 12 had a CR, with no patient developing recurrence in the irradiated field to date; five patients had a PR. We conclude that the recommended dose of hydroxyurea in this regimen is 2,000 mg daily. That dose will cause mild to moderate myelosuppression and will allow for delivery of greater than 80% of the intended 5-FU dose. The activity of this regimen in poor prognosis head and neck cancer exceeds 90%; its further investigation in previously untreated patients is warranted. PMID- 2715808 TI - Management of spinal dural arteriovenous malformations. AB - Dura-based spinal arteriovenous malformations (AVM's) are being diagnosed with increasing frequency. The optimal management of such lesions remains a topic of discussion. In an effort to guide this discussion, the authors review their experience with 17 cases of spinal dural AVM treated between January, 1984, and July, 1987. All patients presented with a slowly progressive paraparesis. The abnormalities were initially identified on myelography and confirmed by selective spinal angiography. Fourteen patients underwent endovascular embolization as a primary treatment, and a total of 18 embolization procedures were performed. After all but two of these, obliteration was confirmed at angiography. Patients' symptoms improved following 15 or these procedures but early improvement was not sustained in 10 instances; patients were unchanged after two procedures and worse after one. Follow-up angiography was performed at varying intervals after 15 of the 18 procedures, and recanalization of the previously obliterated spinal dural AVM was demonstrated in 13 instances. Eight patients ultimately underwent surgical treatment of their dura-based spinal AVM. No patient suffered deterioration of symptoms following operation. While embolization may allow angiographic obliteration of a spinal dural AVM and early clinical improvement, for the majority of patients these are not sustained. The average time to treatment failure was 5 months. Newer embolization materials will be necessary to effect permanent treatment in many of these patients. PMID- 2715809 TI - Absence of collagen deficiency in familial cerebral aneurysms. AB - It has been suggested that a deficiency in the expression of type III collagen may play a role in the pathogenesis of cerebral aneurysms. To test this hypothesis in cases of familial cerebral aneurysms, fibroblast cell cultures were established and the expression of collagen types I and III was studied in a patient with three cerebral aneurysms whose mother and sister also had cerebral aneurysms. Cultured skin fibroblasts were labeled with tritiated proline. The collagens and procollagens were precipitated and run on sodium dodecyl sulfate polyacrylamide gel electrophoresis after reduction to analyze procollagen chains. Control cell lines were analyzed simultaneously. Quantitation of the ratios of type III to type I procollagen synthesis was achieved by integration of the intensities of the pro-alpha 1(III), pro-alpha 1(I), and pro-alpha 2(I) bands on fluorograms of electrophoretic gels of medium proteins. There was no difference in type I and III procollagen levels observed between the cells from the aneurysm patient and those from the control cell lines. These data do not support the hypothesis that familial cerebral aneurysms are caused by a deficiency of type III collagen. PMID- 2715810 TI - Outcome following aneurysm wrapping: a 10-year follow-up review of clipped and wrapped aneurysms. AB - One hundred and eighty-one patients with single aneurysms involving the anterior circulation were treated either by wrapping (60 cases) or clipping (121 cases), and 96.1% of them were followed for 10 years. The rate of early rebleeding (less than 6 months) from wrapped aneurysms was 8.6% (confidence interval 1.4% to 15.8%) and the late rebleeding (6 months to 10 years) rate was 1.5% per annum (confidence interval 0.3% to 2.5%/yr). Wrapping an aneurysm offers some protection from rebleeding, particularly during the first 6 months when the risk of rebleeding is high. PMID- 2715811 TI - Vascular malformations of the brain stem. AB - Vascular malformations of the brain stem are unusual lesions that may pose a diagnostic and therapeutic challenge. Seven patients with vascular malformations involving the brain stem were evaluated; six were treated surgically, with complete obliteration of the lesion in five patients. In five patients symptoms developed only after a hemorrhage had occurred, and three of these suffered a rebleed before appropriate treatment was given. Angiography failed to demonstrate lesions in three cases, which did not appear to protect from repeat hemorrhage since two of the three rebled. There were no operative deaths, and no patients were made permanently worse after surgery. Useful recovery occurred commonly after appropriate treatment and appeared to be possible even in patients who had suffered a catastrophic neurological deficit at the time of presentation. These data indicate that surgical removal of the lesion may be warranted in some patients with symptomatic brain-stem vascular malformation. PMID- 2715812 TI - Radiation therapy in the management of low-grade supratentorial astrocytomas. AB - The records of 167 patients with grade 1 or 2 supratentorial pilocytic astrocytomas (41 patients), ordinary astrocytomas (91 patients), or mixed oligoastrocytomas (35 patients) diagnosed between 1960 and 1982 are retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 33 patients (20%) and subtotal or biopsy only in the remaining 134 patients (80%). Postoperative radiation therapy was given to 139 (83%) of the 167 patients, with a median dose of 5000 cGy (range 600 to 6500 cGy). Multivariate analysis revealed that a pilocytic histology was the most significant prognostic variable associated with a good survival. The 5- and 10 year survival rates were, respectively, 85% and 79% for the 41 patients with pilocytic astrocytomas compared to 51% and 23% for the 126 patients with ordinary astrocytomas or mixed oligoastrocytomas. Postoperative irradiation did not appear to be associated with improved survival times in the patients with pilocytic astrocytomas; however, in the 126 patients with ordinary astrocytomas or mixed oligoastrocytomas, those who received "high-dose" radiation (greater than or equal to 5300 cGy) had significantly better survival times than those who received "low-dose" radiation (less than 5300 cGy) or surgery alone. The 5- and 10-year survival rates were, respectively, 68% and 39% for the 35 patients receiving high-dose radiation, 47% and 21% for the 67 receiving low-dose radiation, and 32% and 11% for the 19 treated with surgery alone. The survival rate was poor for the 23 patients with ordinary astrocytomas and oligoastrocytomas who underwent gross total or radical subtotal tumor removal (14 of whom were also irradiated): 52% at 5 years and 21% at 10 years, with 19 of 23 patients developing tumor progression and dying 1 to 12 years postoperatively. In contrast, all 10 patients with pilocytic astrocytomas who had gross total or radical subtotal tumor removal alone were long-term survivors, with follow-up periods of about 4 to 25 years. PMID- 2715813 TI - Prognostic factors for lower respiratory tract infections after brain-tumor surgery. AB - Nosocomial infection of the lower respiratory tract is a frequent and serious complication after major operations. A 32% incidence of lower respiratory tract infections was found after brain-tumor surgery in 289 patients, with a 21% incidence of pneumonia. In 186 of these patients (Group A), five factors were identified which were associated with an increased risk of postoperative lower respiratory tract infection. These were: age, tumor type, cardiac insufficiency, preoperative disturbances of consciousness, and preoperative corticosteroid treatment. Based on these factors, a risk score was developed which correlated well with the incidence of infection in this group of patients. In a second group of patients (Group B), the derived risk score was applied and was found to possess a high degree of validity. As long as patients were intubated postoperatively, their freedom from infection decreased exponentially, with a half-life of 3.5 days. PMID- 2715814 TI - Subtle huge intervertebral disc herniation. AB - The accuracy of computerized tomography (CT) in diagnosing herniated discs has been well established. Huge herniated discs, which paradoxically may be very subtle, have been mentioned but not stressed as potential causes of false negative diagnosis. Five cases during a 5-year period encompassing approximately 2500 examinations have been encountered by the authors. In this experience, the most consistent finding is the subtle increased density of the disc compared with the dural sac. The diagnosis is aided by awareness that huge discs severely compressing the dural sac may be very subtle; the use of narrower windows for CT scanning, sagittal re-formation, and occasionally the use of myelography with or without repeat CT scanning may also assist. PMID- 2715815 TI - Anterior cervical debridement and strut-grafting for osteomyelitis of the cervical spine. AB - A retrospective review of the surgical experience in treating 18 patients with osteomyelitis of the cervical spine is reported. The patients ranged in age from 20 to 60 years and all complained of neck pain upon admission. Ten patients had a prior history of intravenous drug abuse, three had previously suffered penetrating injuries of the neck, and one had an extraspinal site of osteomyelitis. Bacteria were isolated in 13 cases and tuberculosis in three. Neurological abnormalities were present in over one-half of the patients, consisting of myelopathy (nine cases) or radiculopathy (four cases). Plain cervical spine films and polytomography demonstrated vertebral and end-plate destruction, spinal instability, and increased paravertebral soft-tissue shadow in all cases. Computerized tomography and, more recently, magnetic resonance imaging have proven helpful in detecting bone involvement and the presence of epidural extension associated with cervical osteomyelitis. The risk of vertebral body collapse, kyphosis, and myelopathy in the osteomyelitic cervical spine has standardized the management of this problem in this institution to consist of skeletal traction, needle aspiration or blood culture for organism identification, anterior cervical debridement, autogenous iliac graft fusion, and intravenous administration of antibiotics. Spinal stability and neurological improvement were achieved in all 18 patients. PMID- 2715816 TI - Halo vest versus spinal fusion for cervical injury: evidence from an outcome study. AB - The indications for surgical fusion, as opposed to halo fixation, in the management of cervical spine injury are still unclear. At St. Louis University Medical Center a conservative protocol has been adopted to treat almost all cervical spine fractures with halo fixation. To determine what factors have contributed to failure of halo fixation, the records and radiographs of all patients with cervical spine injuries who were treated at that institution between 1984 and 1986 were reviewed. During this interval, 124 patients were treated, consisting of 93 men and 31 women between 6 and 94 years old. Of these, 15 (12%) had cervical fusion without preoperative halo device application. This group included eight patients with old injuries and delayed diagnosis, three with nonreducible locked facets, and four with miscellaneous indications. The remaining 109 patients were treated with halo vests. Four died before completing the 3-month standard treatment. Of those completing the treatment, 48 had C1-2 level injuries and 57 had C3-T1 level injuries. Sixteen patients (15%) failed their halo treatments and required surgical fusion: eight while still in halo fixation and eight after they had completed treatment with a halo device. Failure of halo treatment was indicated by recurrent dislocation in 13 patients and increased neurological deficit in three. Thirteen of the patients who failed treatment had C3-T1 injuries and three had C1-2 injuries. Of 27 patients with odontoid fractures, only two (7.4%) failed halo fixation. There were no failures in 11 patients with hangman's fractures. Of the 57 patients with C3-T1 injuries, 13 (23%) failed treatment, nine of whom had locked or "perched" facets. The factors causing failure of halo fixation were analyzed. The overall success rate was 85%, suggesting that the halo vest can be used to treat most patients with cervical spine injuries. Under certain circumstances (in the presence of old injuries, difficult reduction, or locked or "perched" facets), surgery may be indicated to avoid unnecessary delay in definitive management. PMID- 2715817 TI - Posterior cervical interspinous compression wiring and fusion for mid to low cervical spinal injuries. AB - A technique of posterior cervical interspinous compression wiring and fusion, which offers significant immediate stability, is presented. Its efficacy in 50 consecutive cases illustrates its utility. The technique involves the passage of an interspinous cerclage wire. Rather than placement of onlay laminar and facet grafts, a split-thickness tricortical iliac-crest graft is compressed against the involved medial laminae and spinous processes bilaterally. These grafts are held in place by a compression wire, which encircles the grafts and thus sandwiches the spinous processes between them. This virtually ensures subsequent bone fusion and offers substantial acute stability. The compression wire offers an added advantage of encircling the cerclage wire, thus pulling it dorsally. This significantly diminishes translational mobility at the unstable segment. It also minimizes hyperextension at the unstable segment via medial compression of the grafts into the interspinous space. The fusion of a minimal number of spinal segments is emphasized. This substantially diminishes the chance of flexible kyphosis and degenerative changes, both above and below the fusion site. A three- or four-level fusion was performed in only 11 patients. The remaining 39 patients underwent two-level fusion. A solid bone fusion was achieved in all cases, with a follow-up period of at least 6 months. In one patient, the spinous process fractured, necessitating an anterior fusion procedure. The technique presented here appears to acutely offer a very stable construct and, in addition, is a simple and straightforward procedure for the treatment of the unstable cervical spine. PMID- 2715818 TI - Xenogeneic pericardium as a dural substitute in reconstruction of suboccipital dura mater in children. AB - A 5-year experience with the glutaraldehyde-stabilized freeze-dried radiation sterilized calf pericardium used as a dural substitute is reported. The structure of pericardium xenograft is compared with other collagenous materials used for duraplasty (allogeneic fascia lata and dura mater) by light and electron microscopy. The special neurosurgical techniques involved in using pericardium xenografts in the reconstruction of suboccipital dura mater in children are presented in detail. PMID- 2715819 TI - Epidermal growth factor receptor in human glioma. AB - Distribution of the epidermal growth factor (EGF) receptor in the surgical specimen of the human glioma was studied by immunohistochemical techniques using a monoclonal anti-EGF receptor antibody. Of 11 gliomas examined, EGF receptors were detected in nine glioblastomas and in one fibrillary astrocytoma. In the majority of cells, staining was observed over the cell membrane. Nuclear and cytoplasmic staining was also seen. In four glioblastomas, EGF receptor-positive cells were diffusely distributed in the tumor tissue. In one glioblastoma and one fibrillary astrocytoma, only a few positive cells were observed. These results imply the possible role of EGF receptors in the cellular proliferation of the human glioma. PMID- 2715820 TI - A dose-response study of dexamethasone in a model of spinal cord compression caused by epidural tumor. AB - In order to assess the clinical and biological effects of glucocorticoids in the therapy of epidural spinal cord compression, the T8-10 epidural space of 50 rats was implanted with Walker 256 tumor. The rats were studied 10 to 20 days later when they became paraparetic. The regional blood-spinal cord transport constant (K, a function of the blood-spinal cord barrier) of 14Carbon-labeled aminoisobutyric acid was measured with quantitative autoradiography 6 hours after intravenous injection of low-dose (0.1 mg/kg), intermediate dose (1 mg/kg), and high-dose (10 mg/kg) dexamethasone. The effects of dexamethasone in these doses on the clinical signs and water content of the compressed cord were also evaluated 40 hours after treatment began. The K factor increased 730% in compressed compared with noncompressed spinal cords (p less than 0.001). Dexamethasone induced a dose-related reduction of both K (p = 0.007) and water content of the compressed cord (p less than 0.0001). Stabilization or, more rarely, improvement of weakness at 24 and 40 hours posttreatment correlated with the dose of dexamethasone (r = 0.88, p less than 0.001). This study demonstrates that dexamethasone has a dose-related beneficial clinical effect associated with an improvement of blood-spinal cord barrier breakdown and a reduction of the water content of the compressed cord. This study supports the use of highdose dexamethasone for the initial treatment of epidural spinal cord compression. PMID- 2715821 TI - Ultrastructure of the orbital pathway for cerebrospinal fluid drainage in rabbits. AB - An increasing number of physiological and morphological studies indicate that cerebrospinal fluid (CSF) drains via nonarachnoidal pathways in several mammalian species. Ultrastructural tracer studies were undertaken to examine the orbital route for CSF absorption in the rabbit. At the termination of the optic nerve subarachnoid space, an area of connective tissue containing numerous small tortuous channels is present. Ferritin (molecular weight 400,000) infused into the ventricles at normal and increased intraventricular pressure was present in these channels by 15 minutes postinfusion, and subsequently reached the intraorbital connective tissue. Elevating the intraventricular pressure did not noticeably alter the morphological appearance of this region or change the gross distribution pattern of the ferritin. Ferritin did not penetrate the scleral barrier to reach the choriocapillaris, nor did it breach the arachnoid barrier layer proximal to the transitional zone at the optic subarachnoid space to reach the dura mater. These results are very similar to those described for the hamster orbital region and the rabbit cribriform region. These experiments support the concept that macromolecules exit the subarachnoid space at the termination of the optic nerve via open channels, and that no significant barrier to drainage of macromolecules in CSF is present at this location. PMID- 2715822 TI - Effect of blood transfusion, dopamine, or normal saline on neurogenic shock secondary to acutely raised intracranial pressure. AB - An experimental model to simulate acutely raised intracranial pressure due to a rapidly expanding intracranial space-occupying lesion was used to produce neurogenic shock. Forty-one rats in neurogenic shock (defined as a mean systemic arterial pressure (SAP) of less than 60 mm Hg) were subjected to various treatments to increase the mean SAP to a level of more than 80 mm Hg. The control group with neurogenic shock received no treatment, and the six treatment groups received infusions of: whole blood, packed cells, plasma, normal saline, dopamine, or a combination of dopamine and saline. Detrimental effects were observed after transfusion of packed cells or whole blood, which caused further deterioration of mean SAP. Although dopamine or the combination of dopamine and saline were both effective (p = 0.0001) for reversing hypotension, the combination was the most effective. If this rat paradigm correlates with human disease, these results indicate that, in the absence of hypovolemia, neurogenic shock due to acute intracranial hypertension should be treated with a combined transfusion of dopamine and normal saline, but not blood since the latter could have a detrimental effect. PMID- 2715823 TI - Laboratory performance of single-piece ventriculoperitoneal shunts with distal slit-valve control. AB - Three different types of single-piece ventriculoperitoneal shunts with distal slit-valve control (Codman Unishunt, Codman Unishunt with chambers, and Heyer Schulte one-piece shunt) in their low- and medium-pressure forms were assessed in the laboratory by both static and dynamic tests. A statistical analysis of variance showed large differences in performance which were not confined to the different pressure ranges as may have been expected. Substantial variation occurred between nominally identical shunts and between identically rated shunts of different makes. Guidelines for an industry standard are proposed. PMID- 2715824 TI - Intradiploic arachnoid cysts. Report of two cases. AB - Two patients are presented in whom cranial arachnoid cysts developed as diverticuli of the arachnoid membrane through small defects in the dura mater, eroded through the inner table, expanded within the diploe, and eroded the outer table of the skull. Based on observations at the time of surgery and the histological examination of these lesions, it is proposed that they are congenital in origin. Previously reported cases of "traumatic arachnoid cyst without fracture," "intradiploic cerebrospinal fluid fistula," and "middle fossa pitholes" appear to represent the same pathological process as the lesions reported in this paper. It is proposed that "intradiploic arachnoid cyst" is the most appropriate term by which these lesions should be described. PMID- 2715825 TI - Intramedullary spinal Histoplasma granuloma. Case report. AB - While there have been several cases of cerebral histoplasmoma published in the literature, the occurrence of such a lesion in an intramedullary spinal location has not previously been reported. The authors present a patient with a Brown Sequard lesion secondary to an intramedullary Histoplasma granuloma in the cervical region. The case was successfully managed with surgical removal of the lesion. PMID- 2715826 TI - Construction of a simple multi-lead electrode for intraoperative nerve recording. Technical note. AB - In the operating room, a fast and accurate means of recording nerve action potentials (NAP's) is always desirable. The multi-lead recording electrode described in this paper contains these desirable features. It can survey and obtain a number of NAP's from different nerve segments at the same time and under the same recording condition. The fixed distances between the recording leads enable quick calculation of conduction velocities of different nerve segments. Construction of the electrode is simple, and it can be designed to suit individual needs. The cost is marginal, reflecting primarily the costs of the original subdermal needle electrodes. The device is both safe and disposable. PMID- 2715827 TI - Delayed ischemic deficit after SAH and aneurysm clipping. PMID- 2715828 TI - Scintigraphic features of choledochal cyst. AB - The scintigraphic appearances of 12 surgically proven cases of choledochal cyst were retrospectively reviewed. In seven of 12 cases, radionuclide accumulated in the choledochal cyst (i.e., the dilated common bile duct) in less than 1 hr. In three additional cases, delayed accumulation (1-24 hr) within the cyst was seen. In two of the 12 cases, no ductal activity appeared and the diagnosis of choledochal cyst could not be made, although in one of these two cases delayed images were not obtained. Other frequent findings included delayed or nonvisualization of the gallbladder (11 of 12) and the appearance of prominent intrahepatic ducts (five of 12). We conclude that hepatobiliary scintigraphy is a noninvasive test useful in the diagnosis of choledochal cyst. PMID- 2715829 TI - Evaluation method for krypton-81m reservoir administration systems. AB - Large variations have been reported in counting rates during lung ventilation studies using different 81mKr administration systems and among different patients. A method was set up to determine the activity utilization efficiency (AUE) using various administration systems. For that purpose a simple lung simulator was developed for combination with reservoir administration systems to be tested. It was found that under normal breathing conditions the AUE is 50% using a reservoir system and only 18% in the absence of a reservoir in the administration system. The measured results were confirmed by a mathematic model. The suggested simulator is suitable for use in hospitals and also enables an indirect check on the 81Rb/81mKr generator performance. PMID- 2715830 TI - Comparison of different radioactive renal agents in cisplatin-induced tubular toxicity in rats. AB - The efficacy of five different radiodiagnostic agents for detecting renal tubular dysfunction induced with cisplatin in rats was compared to controls. Diethylenetriaminepentaacetic acid (DTPA) labeled with 99mTc or 111In was administered simultaneously with each of the other four agents [99mTc]glucoheptonate, [99mTc]dimercaptosuccinic acid, [131I]hippuran and [111In]lysozyme) as a standard to normalize for differences in functional impairment from animal to animal from the same dose of cisplatin. The 2-hr plasma clearance and computer-generated 2- to 3-min uptake in the two kidneys with [99mTc]dimercaptosuccinic acid were significantly inferior to similar measurements with the other agents in differentiating abnormal from normal function. The 2-hr uptake of [99mTc]glucoheptonate and [111In]lysozyme proved of no value in this differentiation. The late renal retention of [99mTc]dimercaptosuccinic acid well separated the cisplatin from control rats, but the greatest difference was observed by the 2-hr uptakes of [131I]hippuran and DTPA. PMID- 2715831 TI - Effect of the Garren-Edwards gastric bubble on gastric emptying. AB - The Garren-Edwards Gastric Bubble (GEGB) was introduced in 1984 as an alternative to surgery (jaw wiring, gastrointestinal bypass, vertical banded gastroplasty) for the treatment of morbid obesity in patients who had failed behavior modification therapy or dietary management for weight reduction. Its mechanism of action is unclear and previous reports have not demonstrated any significant consistent alteration in gastric emptying (GE) as measured by radionuclide techniques. Other proposed mechanisms include: placebo, hormonal, mechanical "satiety", behavioral modification, and neuronal. In order to determine the effect of the GEGB on GE, ten obese (mean % overweight = 89%) patients, 27-50 yr old (mean = 36 yr), had solid GE scans before and 5 wk after endoscopic placement of the bubble. GE scans were performed in six patients after removal (12 = wk residence time). The meal consisted of 300 microCi [99mTc]sulfur colloid in the form of a 300 kcal egg sandwich (egg white 248 g, white bread 40 g, butter 6 g; composition = CHO 40:PR 40: FAT 20) with 180 ml deionized water. Images were obtained in the anterior and posterior projections at 15-min intervals for 1 hr (four patients) or 2 hr (six patients) and the %GE (decay corrected geometric mean) was calculated. Unlike other studies involving the GEGB, adjunctive therapy in the form of dieting and behavior modification were not employed in this study. The effect of the GEGB alone in the treatment of obesity has not been previously evaluated. There was a significant (p less than 0.025) delay in gastric emptying at 1 hr (pre-bubble mean % gastric retention = 46%; bubble mean = 57%; n = 10). After removal, GE returned toward baseline (mean % gastric retention = 51%; n = 6) (p less than 0.05) (Student's t-test). The average weight loss was 5.5 lb (n = 10; p less than 0.025). One mechanism of action of the GEGB may be delayed gastric emptying resulting in early satiety and decreased food intake with resultant weight loss. PMID- 2715832 TI - Detection of pulmonary aspiration in children by radionuclide "salivagram". AB - The radionuclide "salivagram" was introduced to document the aspiration of oral secretions in patients who are at risk. Approximately one-third of patients studied had positive tests. A positive study does not necessarily imply that patients are at risk for aspiration after gastroesophageal reflux. However, sequential images of the lung fields after the oral radioactivity has cleared may be a sensitive technique for detecting aspiration in infants and children following reflux. PMID- 2715833 TI - Radionuclide detection of duodenal ulcer perforation. AB - An elderly obese male with a lengthy history of melanotic stools was admitted and was shown to have a posterior duodenal ulcer by endoscopy. He became obtunded and developed infected ascites. Because of his obesity, ascites, and inability to cooperate, the GI radiologist felt that a Gastrografin upper GI series would not be helpful. We therefore gave the patient 99mTc-labeled sulfur colloid and tap water through his nasogastric tube. We were able to clearly image a site of perforation at the duodenal bulb communicating with the lesser sac. PMID- 2715835 TI - Swedish thyroid cancer risk from Chernobyl? PMID- 2715834 TI - Indium-111 leukocyte scintigraphic detection of myocardial abscess formation in patients with endocarditis. AB - Myocardial abscess formation in patients with bacterial endocarditis in most clinical settings, especially in patients with prosthetic valves, is a primary indicator for surgical valve replacement. We report the detection of myocardial abscesses using 111In leukocyte scintigraphy in three patients with prosthetic or native valve endocarditis and nondiagnostic echocardiograms. Leukocyte scintigraphy may allow identification of myocardial abscess formation earlier than other imaging modalities. PMID- 2715836 TI - The Society of Nuclear Medicine. Proceedings of the 36th annual meeting. St. Louis, Missouri, June 13-16 1989. Abstracts. PMID- 2715837 TI - Diphenylmethane diisocyanate hypersensitivity pneumonitis: a serologic evaluation. AB - We describe the clinical and immunologic evaluation of a steel plant maintenance supervisor who had clinical symptoms consistent with hypersensitivity pneumonitis. No antigen was obvious but after a thorough occupational history and review of the industrial hygiene data, the most likely antigen appeared to be diphenylmethane diisocyanate. Precipitating antibodies were not detected in the worker's serum; however, significant antibody levels of IgG specific for diphenylmethane diisocyanate-human serum albumin were detected by other immunoassays. This case highlights the importance of a thorough occupational history and an aggressive laboratory immunologic evaluation in identifying the offending agent in a worker with hypersensitivity pneumonitis. Hypersensitivity pneumonitis due to an inhaled reactive chemical may be present without precipitins demonstrated in vitro due to the nature of the haptenized chemical protein conjugate or the concentration of IgG antibody. PMID- 2715838 TI - Use of return-to-work medical clearance data for health surveillance. AB - The US Department of Energy's Health Surveillance System pilot project attempts to monitor the occurrence of major morbidity among active workers through return to-work medical clearance data. Anecdotal information has suggested that salaried and wage-earning employees differ in compliance with medical clearance policy. Personnel data regarding illness absences among one contractor's employees were used to identify 216 illness absences eligible for medical clearance and medical records were reviewed to determine whether return-to-work clearance had been obtained. Although compliance improved with increasing duration of absence among both salaried and wage-earning employees, overall it was significantly higher among wage-earning than salaried employees. PMID- 2715839 TI - A variant of mass (epidemic) psychogenic illness in the agricultural work setting. AB - California experiences episodes of suspected agricultural field worker poisonings annually. These episodes are not only disruptive to ongoing agricultural operations, but the prospect of such poisoning is a source of great concern to workers, employers, and government agencies alike. Three episodes of group illness are examined in which actual poisoning does not seem to be involved. Factors contributing to the generation of these episodes include fear, uncertainty, incomplete understanding of hazards, and social pressures. Physicians can minimize extended disability for workers by reassuring victims and waiting until circumstances are verified before issuing statements which may further alarm or add to already existing fears. PMID- 2715840 TI - Agreement of latest and longest occupation and industry as reported in the 1980 National Health Interview Survey. AB - The effectiveness of using the latest occupation instead of usual in studies of chronic disease was assessed by comparing latest and usual occupation for agreement. The 1980 National Health Interview Survey Occupational Supplement collected information on both latest and longest job and the lengths of the jobs. We compared the latest occupation and industry with the longest (usual) occupation and industry for agreement. For men, the industry agreement was 68.1% and the occupation agreement was 69.9%. Women had slightly higher agreement: 70.3% for industry and 70.5% for occupation. The percent of agreement varied by industry or occupation and age, sex, race, respondent, and length of latest job. We conclude that the percentage of agreement of latest occupation and industry with usual is sufficient for analyses of National Health Interview Survey chronic disease data using latest occupation or industry. PMID- 2715841 TI - Health status and sulfur dioxide exposure of nickel smelter workers and civic laborers. AB - We examined a group of 143 nickel smelter workers who processed a high sulfide ore, and compared their health status with that of 117 civic laborers. All subjects were studied over the first four days of a week of work, administering a health questionnaire on day 1, measuring their pulmonary function on the morning of day 1 and day 4, and monitoring their personal exposure to SO2 and particulates over the same period. The smelter workers were exposed to an average of 0.374 mg/m3 of respirable particulates, a threefold higher level than the controls, and to 0.67 ppm of sulfur dioxide, a 40-fold greater amount than the controls, but were found to show no excess of chronic respiratory symptoms and did not differ from the controls either in their baseline pulmonary function or in their change from the morning of day 1 to day 4. However, there were several indicators of a healthy worker effect in the smelter worker group. PMID- 2715842 TI - Work site blood pressure control: the evolution of a program. AB - In 1976, in an employee population of approximately 8700, there was little information about the prevalence of hypertension or the level of control in the known hypertensive workers. The problem was approached initially by screening and then by aggressive follow-up. Ultimately, 21.4% of the employees were identified as hypertensive or in a borderline range. In the population treated at the work site and those treated by outside sources, the level of control was brought to a point consistently over 80% by 1987. It is apparent that continued efforts to identify hypertension, combined with aggressive follow-up, can achieve a significant level of control in a work site population. PMID- 2715843 TI - Occupational differences in disability awards, benefit application, and awareness of the Social Security Administration Disability Program. AB - Previous studies have identified occupational differences in disabling illness among recipients of Social Security Administration (SSA) disability awards. Interpreting such differences as evidence of excess risk, however, assumes that medical factors are the primary criteria for receipt of benefits. The present study examined the influence of demographic, occupational, and medical factors on awareness, application, and receipt of SSA disability benefits. Bivariate and multiple logistic regression analyses indicated that awareness, benefit application, and receipt of awards were not well predicted by demographic, health related, or occupation variables. Occupation explained less than 1% of the variance in awareness, benefit application, and disability awards among severely disabled persons. The results suggest that occupational differences in disabling illnesses among SSA disability beneficiaries are not merely reflections of differences in awareness of the SSA benefit program or less frequent application for benefits. PMID- 2715844 TI - Quality and cost-effective management of mental health care. AB - Corporations have reduced their mental health care benefits by limits on coverage for such services. We report on a comprehensive mental health care program, including prevention and early intervention, hospital utilization review, and consulting psychiatrist, which has improved the quality and has significantly reduced inpatient insurance psychiatric hospitalization costs. Mental health service coverage was actually enhanced. Inpatient psychiatric hospitalization costs 12 months before and after the implementation of a concurrent psychiatric hospital utilization review program were reviewed for a major corporation. Total hospital days and average length of stay decreased by 43% whereas total inpatient psychiatric hospital charges decreased by $309,518. Total inpatient days decreased by 1045. Quality and cost-effective comprehensive psychiatric health care services can be offered by major corporations providing that such benefits are carefully designed and managed. PMID- 2715846 TI - American College of Occupational Medicine, 74th annual meeting. April 29-May 5, 1989, Boston, MA. Abstracts. PMID- 2715845 TI - Mortality patterns among employees exposed to acrylonitrile. AB - A cohort of 2671 men, 1774 of whom were exposed to acrylonitrile, was observed from 1951 through 1983 for mortality. No statistically significant excess of all cause or cause-specific mortality was observed. Analysis of exposure duration to acrylonitrile with respiratory cancer mortality showed no trend. Men exposed to high levels of acrylonitrile had respiratory cancer rates similar to men not exposed in the workplace and to the US general male population. These study results do not support the hypothesis that acrylonitrile is a human carcinogen. PMID- 2715847 TI - Lead exposure in an outdoor firing range. PMID- 2715848 TI - Physical symptoms after neurotoxic exposure. PMID- 2715849 TI - Cancerphobia: an emerging theory of compensable damages. PMID- 2715850 TI - A case-control study of cancer among du pont employees with potential for exposure to dimethylformamide. AB - This case-control study was undertaken to determine whether the risk of developing cancers of the buccal cavity and pharynx (N = 39), liver (N = 6), prostate (N = 43), testis (N = 11), or malignant melanoma of the skin (N = 39) is related to exposure to dimethylformamide (DMF). Case and control subjects were obtained from four Du Pont plants. DMF is produced at one plant and used at the other three. Cancer cases identified from the company Cancer Registry comprise those reported among active male employees at the study plants during 1956 to 1985. For each case, two control subjects were selected, matched on sex, payroll class (wage or salary), birth year, and plant. To determine whether an employee could have been exposed to DMF during his career at the plant, all jobs with potential for exposure to DMF were identified. Each job was assigned an exposure ranking based on DMF industrial hygiene air monitoring, DMF metabolite (measured as N-methylformamide in urine) monitoring, and knowledge of the evolution of manufacturing processes and workplace exposure controls. Each employee's DMF exposure pattern was then characterized as (a) ever v never having been exposed to DMF and (b) highest DMF exposure experienced. Summary analyses for all plants combined showed no statistically significant association between ever having been exposed to DMF and subsequent development of cancers of the buccal cavity and pharynx, liver, malignant melanoma, prostate, and testis. Examined by plant site, prostate cancer at one plant was significantly elevated, based on three case subjects exposed out of four.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2715851 TI - Baker's asthma: report of an unusual case. AB - Using immunologic techniques recently available, we report the evaluation of baker's asthma due to wheat flour and demonstrate the usefulness of these techniques in occupational asthma. The diagnosis of baker's asthma was very important in this case, as even a trial of avoidance of work exposure was not possible because of the social and economic factors involved. A commercial wheat extract was obtained and the wheat flour actually used at the work site was extracted. Prick skin testing with each of these extracts resulted in positive wheal and flare responses. Enzyme linked immunosorbent assay and inhibition assays were performed to assess the worker's antibody response to wheat flour and wheat extracts. Significant specific IgE and IgG levels to the wheat flour and wheat extracts were detected in the worker's serum. Because of unique psychosocial and educational factors, this worker was unable to change occupations. Even with respiratory protection, she continued to be symptomatic. She is currently controlled on bronchodilators and inhaled steroids. PMID- 2715852 TI - Health promotion in a scheduled cyclical format. AB - Many previously described health promotion programs focus on a limited number of issues, such as exercise, or direct their attention to multiple topics concurrently. In an effort to generate increased employee interest in important health concepts and to assure that appropriate emphasis is given to all relevant major health promotion topics, we have developed a four-year program, superimposed on our preexisting health maintenance/promotion structure. The first year of the program focuses on cardiovascular disease prevention; the second, on early cancer detection and prevention; the third, on psychologic and social issues; and the fourth, on other significant topics such as accidents, diabetes, pregnancy, and musculoskeletal disorders. Such an approach provides for a comprehensive program, maximizing the participation of available corporate and community resources, encourages employee participation by sequential attention to different issues, and affords the opportunity for directing attention to revisions and additions predicated by medical advances. PMID- 2715853 TI - The correlation between work environment and the occurrence of cervicobrachial symptoms. AB - The correlation between symptoms from the neck and upper extremities and some individual and work-related factors was analyzed in 2814 industrial workers. Physical stress by type of job was the factor most strongly correlated with ongoing cervicobrachial symptoms. Symptoms from the neck and upper extremities were twice as common in workers who used vibrating hand tools. Mental stress at the onset of the symptoms was associated with an increased prevalence of trapezius myalgia and with lateral humeral epicondylitis and "radial tunnel syndrome" in the dominant arm. Women had about double the rate of cervicobrachial symptoms as did men. Short stature increased the rate of symptoms from the neck, shoulders, and hands as did overweight. Playing of racquet sports decreased the risk of symptoms from the neck and hands. PMID- 2715854 TI - Effects on mood of a life-styles program for the rehabilitation of injured workers. AB - This study reports an examination into the effects on daily mood of participation in a life-styles program by injured workers. In the current prospective study, 14 participants completed the Memorial University Mood Scale (MUMS) prior to starting the program, at 1 month, 2 months, and at 3 months. They also completed the Memorial University Scale of Happiness (MUNSH) prior to entry and after three months. There were significant improvements on the MUMS subscales of positive mood and vigor as well as overall mood. There were no changes in negative mood. Neither the positive nor the negative dispositional subscales of the MUNSH revealed any change. The results were interpreted as indicating strong psychologic benefits of the life-styles program for injured workers and are also consistent with a recently proposed two-factor state/trait model of well-being. PMID- 2715855 TI - Factors associated with participation in an occupational program for colorectal cancer screening. AB - This study reports factors associated with participation in a colorectal cancer screening program for a cohort of workers on a polypropylene manufacturing unit. The impetus for the screening program was the discovery of a colorectal cancer cluster among workers on this unit. The program included a life-style/risk factor questionnaire, fecal occult blood test, a 60-cm colonoscopy, and an air-contrast barium enema. Overall, 52.5% of the 406 men who were offered screening participated in the program. Of those screened, only 40% attended a briefing, but over 80% of those who attended a briefing came for screening. Factors associated with completion of screening are analyzed and discussed in the context of the literature on participation in colorectal screening programs. The implications for colorectal cancer screening of occupational groups believed to be at high risk are considered. PMID- 2715856 TI - Effectiveness of the United Steel Workers of America Coke Oven Intervention Program. AB - This paper describes the implementation and evaluation of the Coke Oven Intervention Program developed jointly by the United Steel Workers of America and the University of Pittsburgh. The program was offered on four occasions at each of seven coke oven plants over a 2-year period. Participants were compared with nonparticipating co-workers and controls from matched plants on knowledge of the Coke Oven Standard and workplace behaviors. Few baseline differences were found among participants, nonparticipants, and controls. Participants improved significantly as a result of the program, with those attending multiple programs accruing the greatest benefits. Panel controls interviewed on six occasions throughout the 2-year period showed little improvement. Reasons for and implications of the effectiveness of the program are discussed. PMID- 2715857 TI - A health hazard evaluation of pheasant handlers. AB - Motivated by complaints of respiratory symptoms at a large state pheasant breeding farm, an evaluation of the health hazards of pheasant handling was undertaken. Pheasant workers (N = 24) were compared with age-, sex-, and smoking status-matched controls (N = 23) without occupational or home exposure to birds by a respiratory questionnaire, pulmonary function testing (before and after the season and pre- and post-shift), a number of fungal and chlamydial serology tests, and hypersensitivity immunoprecipitins. Despite a number of important differences in the prevalence of symptoms in the pheasant workers, no differences were found in the results of pulmonary function testing or serology tests. These data suggest that the symptoms were likely because of local irritant effects rather than via immunologic or infectious mechanisms. PMID- 2715858 TI - Chromosome aberrations in peripheral blood lymphocytes of welders and characterization of their exposure by biological samples analysis. AB - Chromosomal aberrations in cultured lymphocytes obtained from 55 welders and 55 matched controls were analyzed. Depending on the welding techniques and the nature of the consumables and metals welded, three separate groups of welders were examined. Chromium, nickel, and manganese levels in serum and urine were measured to assess the exposure to welding fumes. A statistically significant increase of chromosomal aberrations was found in one of the three analyzed groups of welders. This group used the semi-automatic metal active gas welding process with cored wire containing nickel for welding mild steel. These welders had significantly higher concentrations of serum and urine manganese and, unlike the other welders, significantly elevated concentrations of nickel, both in serum and urine. However, no significant correlations between nickel or manganese levels and the frequency of chromosomal aberrations were found. There was a significant correlation between the length of welding employment of these welders and the frequency of chromosomal breaks, although there was no significant correlation between age and the frequency of chromosomal aberrations. The other two groups of welders, for which the analyses of biologic fluids proved chromium and manganese exposure, had no statistically significant higher frequency of chromosomal aberrations. One of these groups used the manual metal arc welding process with coated electrodes for welding mainly mild steel and the other group used the tungsten inert gas welding process for welding stainless steel. A significant correlation between the daily amount of cigarettes smoked and the frequency of chromosomal breakages, in controls as in welders, was observed. The present data indicate that certain welding processes may generate fumes that seem to have a clastogenic activity. PMID- 2715859 TI - Nonfatal anaphylactic shock following an unusual sensitization. PMID- 2715860 TI - State agencies unite against AIDS, open new OK-CARE office in OKC. PMID- 2715861 TI - Wearing of removable partial dentures in relation to periodontal pockets. AB - Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s). PMID- 2715862 TI - The silent period in the masseter and the anterior temporalis muscles in adult patients with mild or moderate mandibular dysfunction symptoms. AB - The electromyographical silent period in the masseter and the anterior temporalis muscles during tooth tapping and jaw jerk were studied in patients with fairly mild temporomandibular joint dysfunction symptoms. The length of the silent periods in the patient group did not differ generally from that in a control group. During tooth tapping, however, patients with distinct muscular disorders had shorter silent period duration (7.7 ms) than patients with other symptoms or when compared with control subjects (10.5 and 11.3 ms, respectively). The duration returned to normal after correction of the muscular disorders. This finding suggests that the duration of the silent period is affected by the muscle condition. Patients with obvious muscular disorders of mild to moderate magnitude, thus, may show a shorter silent period duration during tooth tapping. PMID- 2715863 TI - Postural and maximum activity in elevators during mandible pre- and post-occlusal splint treatment of temporomandibular joint disturbance syndrome. AB - Electromyograms (EMGs) of the temporal and masseter muscles in sixty patients with temporomandibular joint disturbance syndrome (TMJDS) and thirty controls were recorded and integrated on-line in the postural position and during maximum clenching, before and after occlusal splint therapy. Contrasting with the controls, the myoelectrical activity of the patients was higher in the postural position and lower during maximum clenching, whilst the former in percentage terms increased when compared to the latter. After treatment, the EMG indexes in some patients returned partially, and in others completely, to a normal level. Tenderness in the mandibular elevators, deviated opening and organic change in the TMJ increased the postural myoelectrical activity, in percentage terms, against that of maximum clenching. The myoelectrical activity of the mandibular elevators in the postural position and during maximum clenching was smaller in patients with the occlusal splint than in those without. The results show that the mandibular elevators in the patients with TMJDS were hyperactive and tense, and that the occlusal splint was useful for treating such dysfunction. PMID- 2715864 TI - The immediate effect of splint-induced changes in jaw positioning on the asymmetry of submaximal masticatory muscle activity. AB - Maxillary full-arch splints in the retruded position (RP) and in a right lateral occlusion (1.0-1.5 mm to the right of the retruded contact position) were fabricated for ten subjects. Surface electromyography of the masseter and anterior temporal muscles was performed during submaximal clenching in order to investigate the immediate effects of the splints on the activity patterns of these muscles relative to the patterns found with the subjects occlusion in the inter-cuspal position. The splints in the RP were found to have no effect on the asymmetry of the activity of the masseter and the anterior temporal muscles, while the splints in a right lateral occlusion resulted in relative increases in right anterior temporal muscle activity (P less than 0.005). PMID- 2715865 TI - Short-term effect of a stabilization splint on the asymmetry of submaximal masticatory muscle activity. AB - Ten healthy subjects continuously wore equilibrated maxillary full-arch stabilization splints in the retruded position for 7 days. The muscular activity balance of the masseter muscles during submaximal isometric clenching at 10% and 50% of the maximum voluntary contraction (MVC) did not change immediately on insertion of the splint, but was improved at the 50% level after 7 days (P less than 0.05). While the muscular balance of the anterior temporal muscles was not affected, either immediately on splint insertion, or after wearing it for 7 days, temporal muscle activity at 10% of the MVC was greater on the side to which the mandible moved from the retruded contact position (RCP) to the inter-cuspal position (ICP), both before (P less than 0.025) and after (P less than 0.01) wearing the splint. Splint removal after 7 days resulted in increased awareness of interferences in the ICP and increases in masseter muscle asymmetry (10%, P less than 0.025; 50%, P less than 0.05) when the electromyograms in the ICP after splint removal were compared with those on the stabilization splint before removal. After wearing the splint, the masseter muscle activity at the 10% level was greater on the side where premature contacts were present in the RCP (P less than 0.01). The use of masticatory muscle asymmetry indices in the evaluation of splint treatment for craniomandibular dysfunction is indicated since submaximal masticatory muscle activity is related to occlusal stability, premature contacts in the RCP and the direction of lateral slides from the RCP to the ICP. PMID- 2715866 TI - Effects of texture of food on chewing patterns in the human subject. AB - To elucidate the effects of food character on chewing patterns in humans, the electromyographic activity (EMG) of the chewing muscles and also the jaw movements were recorded in twenty-nine young subjects during ordinary chewing of five different foods. The results obtained were as follows. (a) The harder food materials showed a higher amplitude of the masseter EMG than the softer ones. (b) Concerning the number of chewing strokes and the elapse of time until the last swallowing action, subjects could be divided into two groups. (i) In the first major group, the number of chewing strokes and chewing time until the last swallowing action increased following increase of hardness of the food. This suggests that chewing force and chewing movements may be strongly influenced by the texture of food, especially its hardness. Further, the degree of pulverization of eating materials appears to be the major factor in controlling the swallowing action. (ii) In the second minor group, the chewing strokes and the chewing time were less influenced by the hardness of food. Here, a certain number of chewing strokes could be stimulating the swallowing centre in the brain and so induce swallowing, regardless of the degree of pulverization of the food. PMID- 2715867 TI - A 2-year electromyographic study of patients with an immediate complete upper and a partial lower denture. AB - A longitudinal electromyographic (EMG) investigation was performed on thirty subjects provided with an immediate complete upper and a partial lower denture. Electromyographic recordings in maximal clench, light tapping and postural position were obtained from the anterior temporal and masseter muscles before final extractions and 7 weeks, 6 months, 1 year and 2 years after denture insertion. The maximal clench activity of the jaw closing muscles showed an average tendency to decrease upon insertion of the dentures, but thereafter significant increases in mean voltages were observed during the first year of denture wear. During the second year no significant changes in EMG clenching force were noted. At the 2-year stage most of the muscles showed significantly greater clench activity than at the post-insertion stage, but did not exceed the pre-extraction level. The jaw muscle activity in light tapping showed no significant mean changes during the observation period. The postural activity tended to decrease during the period of denture wear, the decrease being significant for some of the muscles at the 2-year stage. PMID- 2715868 TI - Physical properties of two new crown and bridge veneering resins. AB - The degree of conversion and physical properties of two contemporary resin veneers based on light-cured microfilled composite formulations and employing proprietary curing systems were evaluated. Visio-gem (V) and Dentacolor (D) were polymerized using the appropriate curing systems. Polymer structure and degree of conversion were determined by Fourier transform infra-red (FTIR) techniques. Physical properties, including depth of cure, compressive and diametral tensile strengths, hardness, thermal expansion and colour stability were determined by standard test modalities. Both materials appear to have the properties of typical microfilled resins including low compressive yield strengths and high thermal expansion coefficients. The curing system for V produced an increased depth of cure compared to conventional light curing techniques and the D system, but no clinically significant increase in the physical properties. PMID- 2715869 TI - The effects of cusp and jaw morphology on the forces on teeth and the temporomandibular joint. AB - Basic principles of engineering mechanics are used to solve for force vectors in the masticatory system. It was found that incisor guidance/cusp angulation, crown heights and the anterior-posterior location of contact can significantly affect the magnitudes and/or directions of forces acting on contacting teeth and the temporomandibular joint. The results provide insight into the function of the jaws and the diagnosis and treatment of occlusion-related trauma. PMID- 2715870 TI - Flow cytometric analysis of lymphocyte subpopulations in infants with congenital heart disease. AB - Premortem diagnosis of the DiGeorge syndrome and its partial variants relies on the demonstration of a primary defect in cell-mediated immunity, generally in the setting of an infant with congenital heart disease, hypocalcemia, absence of a thymic shadow, and typical dysmorphic features. Although T-cell enumeration is considered a vital part of the diagnostic evaluation, no studies to date have addressed the issue of appropriate reference data in infants with congenital heart disease. We therefore undertook a prospective descriptive study of lymphocyte phenotype analysis in 27 nontransfused infants undergoing diagnostic cardiac catheterization. Striking differences were seen between patients and adult controls in means percentages and numbers of most lymphocyte subsets analyzed. Few differences were found in comparing the patient data to values for age-matched control infants without heart disease. The data are discussed with reference to published values for patients with partial DiGeorge syndrome. It is concluded that lymphocyte phenotype analysis in the diagnostic evaluation of patients with suspected DiGeorge syndrome must utilize appropriate reference values. PMID- 2715871 TI - Flow cytometric analysis of cytologic specimens in hematologic disease. AB - Cytologic evaluation of body fluids and fine needle aspirations (FNA) is frequently required in patients with hematologic diseases. In this study we have correlated immunophenotyping and DNA analysis by flow cytometry with cytologic findings and tissue biopsies from 20 patients with body fluid specimens and 5 with FNA. Nineteen of 25 cases, including all FNA cases, had an immunophenotype consistent with malignancy: 12 monoclonal B-cell lymphomas, 2 T-cell lymphomas, 2 T-ALL and 3 non-T-ALL. By cytologic examination, 14 of these 19 cases were positive for malignant cells, 2 suspicious and 3 negative; the latter 5 cases, including 2 FNA cases, had small monoclonal B-cell populations detected by flow cytometry. Six cases had a benign immunophenotype; cytologic examination was benign in 4 of these and suspicious for lymphoma in 2. Our results show the feasibility of using flow cytometry to evaluate body fluids or FNA and demonstrate that small malignant populations that may be missed by routine cytology can be detected by flow cytometry. PMID- 2715872 TI - Sandwich immunoassay for the detection of lipoteichoic acid. AB - A sandwich immunoassay has been developed for the detection of lipoteichoic acid (LTA), a major cell wall constituent of gram-positive bacteria, from whole blood and ISOLATOR supernate. Monoclonal antibodies were produced to purified LTA from Streptococcus mutans, BHT and were further characterized for crossreactivity with gram-positive and negative bacteria and for reactivity to substituted and unsubstituted LTA. Eight monoclonal antibodies were identified that reacted exclusively with gram-positive bacteria. Those antibodies able to capture 3H-LTA were chosen to develop a sandwich immunoassay. The assay has a sensitivity of 0.2 ng LTA/mL in PBS, 0.5 ng/mL in whole blood and 2.0 ng/mL in whole blood that has been processed through the ISOLATOR. Further development of this assay may lead to the rapid detection of LTA from body fluids. PMID- 2715873 TI - Microplate ELISA for detection of antibodies to DNA in patients with systemic lupus erythematosus: specificity and correlation with Farr radioimmunoassay. AB - A 96-well microplate ELISA for the detection of antibodies to DNA is described. A number of buffers and precoating treatments were used to evaluate the optimal method for coating the plate with DNA. These included pretreatment of the plates with poly-L-lysine or protamine sulfate, and posttreatment with glutaraldehyde, none of which improved the performance of the assay. Whereas bicarbonate and borate coating buffers gave equivalent and satisfactory results, TRIS buffer resulted in very high binding of immunoglobulin to wells not coated with antigen. Sera from groups of patients with autoimmune disease as well as normal sera were tested against plates optimally coated with native E. coli DNA, calf thymus DNA, and heat-denatured DNA. Using native E. coli DNA, virtually none of 35 normal sera had any detectable antibody. With this antigen, as well as with native calf thymus DNA, significant levels of DNA antibody were found only in SLE patients. Most patients with SLE or drug-induced lupus, as well as some patients with rheumatoid arthritis and normal individuals had antibodies that bound to heat denatured (single-stranded) DNA. Using either native E. coli or calf thymus DNA, a good correlation was found between the amount of DNA antibody detected by ELISA and the Farr-type radioimmunoassay. PMID- 2715874 TI - Human monoclonal antibodies reactive with colon carcinoma: identification by a novel screening procedure with xenografts. AB - To identify tumor-associated antigens immunogenic to man, human monoclonal antibodies (MAbs) were generated by fusing regional lymph node lymphocytes (LNLs) of each of three colon adenocarcinoma patients with the M5 mouse myeloma cell line. Heterohybridomas in 19 wells secreted human immunoglobulin (Ig) for at least 60 days. To identify immunoreactive MAbs, we devised an immunohistochemical assay with xenografts of six colon tumors. Binding was visualized with a biotin conjugated goat antihuman Ig antibody followed by an avidin-biotin-peroxidase complex. This assay detected binding with a sensitivity of 0.5 microgram/ml human Ig. Reactivity against tumor-associated antigens (TAAs) in frozen sections of the colon xenografts was detected in 14 of the 19 supernates. However, only nine (three IgGs, five IgMs and one IgA) were reactive against formalin-fixed sections, showing that formalin-fixation destroyed some but not all antigenicity. Four MAbs were cloned and tested against the entire panel of 19 xenografts. One IgM MAb reacted only against colon carcinomas, while the other three (one each of IgA, IgG and IgM) had broader reactivities. Three of the four human MAbs did not cross-react with melanomas. In summary, human regional lymph nodes contain a high proportion of B lymphocytes sensitized to the autochthonous tumor. Immunostaining of human colon tumor xenografts can readily identify human MAbs reactive with colon carcinomas. PMID- 2715875 TI - Generation and selection of monoclonal antibodies identifying surface molecules discriminating between fetal and adult fibroblasts. AB - The present report describes the reactivity of two murine monoclonal antibodies, i.e., CB11 and CB43, the first obtained by using embryonic material as immunizer and the second elicited against a human cell line. These reagents recognize two distinct molecules marking a peculiar differentiation stage on fetal/embryonic fibroblasts. The first structure is a single chain of 14.5 kd, the second one a heterodimer of 40-80 kd. Even if these reagents are not strictly fibroblast restricted, translineage expression does not diminish the medical relevance of the reagents; in fact, they may have application in prenatal diagnostics and amniocentesis testing, in which it is necessary to discriminate between fetal and maternal cells. PMID- 2715876 TI - Assaying tetanus antitoxin antibody levels on samples of dried blood on filter paper discs in tropical countries. PMID- 2715877 TI - Cerebral infarction--its pathogenesis and interpretation. PMID- 2715878 TI - Updated Kiel classification for lymphomas. PMID- 2715879 TI - Silver-binding nucleolar organizer regions (AgNORs) in benign and malignant breast lesions: correlations with ploidy and growth phase by DNA flow cytometry. AB - Silver-binding nucleolar organizer regions (AgNORs) have been counted in sections of routinely processed paraffin-embedded tissue blocks and have been shown to assist in the distinction between benign and malignant lesions. We have examined 214 benign and malignant breast lesions by this method. The AgNOR counts were fibroadenomas 1.87 +/- 0.20 (mean +/- SD; n = 39), papillomas 1.92 +/- 0.21 (n = 28), sclerosing adenosis 1.96 +/- 0.24 (n = 23), epitheliosis 2.21 +/- 0.30 (n = 38), lobular carcinoma in situ 2.67 +/- 0.54 (n = 9), intraduct carcinoma 3.75 +/ 1.33 (n = 37), and invasive carcinoma 4.22 +/- 1.18 (n = 40). However, the counts in 25-30 per cent of epitheliosis lesions and intraduct carcinomas overlapped in the region of 2-3 AgNOR dots per nuclear profile. The AgNOR counts in carcinomas were also compared with ploidy and growth phase fractions (S + G2 + M%) by flow cytometry. Thirty-three of the 46 cancers with counts over 3 AgNOR dots per nuclear profile contained aneuploid cells (greater than 10 per cent of the total), whereas 8 of the 12 with counts below 3 comprised diploid cells only (P less than 0.05). Similar trends were noted with regard to growth phase fractions which were 19.15 per cent +/- 12.31 and 13.98 per cent +/- 5.55, respectively, for the two groups (P greater than 0.10). We conclude that this method alone does not offer a reliable histological discriminant for malignancy in the breast. However, AgNOR counting may provide information on breast cancer prognosis supplementary to that obtained from DNA flow cytometric analyses. PMID- 2715880 TI - Alveolar epithelial responses in experimental streptococcal pneumonia. AB - We describe an experimental model of pneumonia in Wistar rats evoked by Streptococcus sanguis. The lesion developed rapidly as a confluent bronchopneumonia of the single-lobed left lung. Except at the extreme base, where an abscess formed, the pneumonic process thereafter resolved, and most of the lung appeared microscopically and ultrastructurally normal 8 days after infection. Sequential electron microscopic studies revealed that in the areas of lung which subsequently resolved, damage was restricted to type 1 pneumocytes. Within 24 h of infection, the unaffected type 2 pneumocytes were observed to proliferate, transform into elongated pneumocytes of intermediate morphology, and then undermine and strip off the damaged type 1 cells from the subjacent basement membrane. Thereafter, the intermediate type pneumocytes completed their transformation into definitive type 1 cells, thus completing the repair process. We hypothesize that this represents an accelerated form of the normal type 1 replacement mechanism, and that uncomplicated epithelial repair following acute alveolar damage is possible if type 2 pneumocytes escape significant damage, so that they retain their capacity to proliferate and differentiate into type 1 epithelium. PMID- 2715881 TI - Morphometric analysis of coronary artery stenosis. PMID- 2715882 TI - Quality of terminal care: salient indicators identified by families. AB - This study was the second phase of a three phase project designed to develop and test a tool to measure family satisfaction with terminal care. The first phase was a qualitative study that identified indicators families of terminally ill cancer patients perceived to be important to patient and family care. In Phase II a Q-Sort was administered to 210 family members from three different care settings to obtain relative rankings of the items identified in Phase I. Items most and least important to patient care and family care were identified for the total sample and for each care setting. Patient comfort, the need for information regarding the patient's illness, and the availability of a hospital bed were ranked as most important by the total sample. The extent of agreement among family members and within care settings was estimated using Kendall's coefficient of concordance. Demographic variables that were significantly related to item rankings are reported. Phase III will use the most salient items identified in Phase II to develop and test a scale to measure family satisfaction with terminal care. PMID- 2715883 TI - The use of transdermal scopolamine in the control of death rattle. PMID- 2715884 TI - Mutual support groups for hospice staff: planned or ad hoc? PMID- 2715885 TI - The circle: death and dying from a native perspective. PMID- 2715886 TI - Before death: freeing time... PMID- 2715887 TI - Overnight centre-based respite care with hospice philosophy (an option in home and community care). PMID- 2715888 TI - Incidence and causes of sepsis in glucose-6-phosphate dehydrogenase-deficient newborn infants. AB - To determine the susceptibility to sepsis in newborn infants deficient in glucose 6-phosphate dehydrogenase (G6PD), we screened 33,943 Saudi Arab infants. Deficiency of G6PD was found in 18%. Sepsis was determined by the presence of clinical signs of sepsis and confirmed by positive blood cultures. Sepsis was documented in 75 infants (2.2/1000). The incidence of sepsis was significantly higher in 6138 G6PD-deficient infants (3.4/1000) than in the 27,805 with normal G6PD activity (1.9/1000; p less than 0.02). The incidence of catalase-positive organism sepsis was higher in G6PD-deficient infants (2.9/1000) compared with those with normal G6PD activity (1/1000; p less than 0.0002), whereas the incidence of catalase-negative organism sepsis did not differ (p less than 0.2). Deficiency of G6PD was more common in infants with late sepsis (46%) than in those with early sepsis (21%) and in all infants screened (18%) (p less than 0.03 and p less than 0.001, respectively). We conclude that neonates with G6PD deficiency are more susceptible to late sepsis and to infection with catalase positive organisms. The exact mechanism for the increased susceptibility is not clear, but a partial explanation could be lack of leukocyte bactericidal activity associated with G6PD deficiency, and an increased susceptibility to infection caused by hyperferremia resulting from lysis of G6PD-deficient erythrocytes. PMID- 2715889 TI - Recovery from milk allergy in early childhood: antibody studies. AB - We assessed the relationships of clinical symptoms and serum antibody levels during follow-up of 47 patients, aged 3 to 66 months, who were shown by formal milk challenge to have cow milk allergy. Three groups of patients were identified. Group 1 patients (n = 15) were sensitized to IgE and responded rapidly to small volumes of milk with urticaria, an exacerbation of eczema, wheeze, or vomiting. In the second group (n = 24), symptoms of milk enteropathy (vomiting and diarrhea) developed between 1 and 20 hours after milk ingestion. In the group 3 patients (n = 8), coughing, diarrhea, eczematoid rashes, or a combination of these developed more than 20 hours after normal volumes of milk were given. Serum levels of IgG, IgA, IgM, and IgE and of milk-specific anti-cow milk antibodies of these isotypes were measured initially and then at a median follow-up time of 16 months (range 6 to 39 months). In this investigation, changes in these immunologic measures during the study period were related to whether or not clinical tolerance to cow milk was achieved. At follow-up, six patients from group 1, ten from group 2, and two from group 3 were milk tolerant. No consistent change in any of the immunologic measurements was associated with remission of the disease. These findings raise the question of whether acquisition of clinical tolerance to cow milk in cow milk allergy can be attributed solely to immunologic events. PMID- 2715890 TI - Clinical and genetic comparisons of patients with cystic fibrosis, with or without meconium ileus. AB - We set out to determine if the clinical course or genetic profiles of patients with cystic fibrosis who had meconium ileus differed from those of other patients with cystic fibrosis. Since 1950 we have followed 158 patients with meconium ileus among 1175 patients with cystic fibrosis (13.4%). Patients with meconium ileus had lower birth weight (3026 +/- 610 gm) than patients with no meconium ileus (3169 +/- 534 gm; p less than 0.008); the deficit was especially evident in female patients. Survival in the first year of life increased from 55% in those born between 1958 and 1972 to 96% in those born between 1973 and 1987. Since 1973 the median survival of male and female patients with meconium ileus was similar to that in female patients with no meconium ileus (21 years), whereas 78% of males with no meconium ileus survived to this age (p less than 0.0001). Patients with meconium ileus born before 1972 had lower weight and height percentiles at age 13 years compared with patients with no meconium ileus, but this difference was not as apparent in patients born after 1973. There were no differences between the two groups in forced vital capacity, forced expiratory volume in 1 second, or forced expiratory flow in the middle half of forced vital capacity. Patients with meconium ileus acquired Pseudomonas aeruginosa at a younger age than did patients with no meconium ileus (4.20 +/- 4.67 vs 7.18 +/- 5.19 years), but there was no difference in age of acquisition of P. cepacia. In families in which the first child had meconium ileus, 29% of subsequent siblings with cystic fibrosis had meconium ileus, compared with 6% of siblings born to families in which the first child did not have meconium ileus. Allelic frequencies and haplotypic variants for cystic fibrosis chromosomes with respect to DNA markers closely linked to the cystic fibrosis locus were similar in families with cystic fibrosis with meconium ileus and those with no meconium ileus. These findings suggest that patients with cystic fibrosis and those without meconium ileus do not have major intrinsic differences and that the previously poor outlook in patients with meconium ileus has improved greatly. PMID- 2715892 TI - Thrombocytosis in pediatric outpatients. PMID- 2715891 TI - Ecology of passive smoking by young infants. AB - This study provides a detailed description of passive smoking by 433 infants (mean age 18 days) enrolled from a representative population of healthy neonates in central North Carolina during 1986 and 1987. Sixty-four percent (276) lived in households with smokers or had contact with nonhousehold smokers. During the week before data collection, two thirds (184) of these 276 infants reportedly had tobacco smoke produced in their presence. Seventy-five percent of smoking mothers smoked near their infants. The amount smoked by the mother near the infant correlated with the amount smoked near the infant by nonmaternal smokers. Cotinine, an indicator of smoke absorption, was found in the urine of 60% (258) of all study infants. The amount smoked in the infant's presence, as well as the amount smoked farther away from the infant, especially by the mother, were the most significant correlates of the urine cotinine concentration. The results of this study suggest that efforts to reduce passive smoking in young infants should emphasize the importance of the mother's smoking behavior, smoke produced anywhere in the home, and household social influences on smoking behavior near the infant. PMID- 2715893 TI - Prematurely erupted teeth in newborn infants. PMID- 2715894 TI - Infection with Ehrlichia canis in a child. PMID- 2715895 TI - Proctalgia fugax in teenagers. PMID- 2715896 TI - Familial, recurrent hemolytic-uremic syndrome. PMID- 2715897 TI - Dyslipoproteinemia in juvenile rheumatoid arthritis. PMID- 2715898 TI - Neonatal status and hearing loss in high-risk infants. AB - Neurophysiologic and behavioral assessments of auditory function were performed on 224 very low birth weight (less than or equal to 1500 gm) infants requiring intensive care in the nursery. The subjects were studied prospectively from 36 weeks to 4 years of age, as available for follow-up. To classify them according to their neonatal status, we applied a principal components analysis to a number of variables representative of the extent of illness and of patient care in early postnatal life. The subjects were then divided into neonatal status quartiles and evaluated for hearing outcome. All those with sensorineural hearing loss fell exclusively into the lowest neonatal status quartile. Sensorineural hearing loss was statistically associated (1) with greater amounts of furosemide administration for longer durations and in combination with aminoglycoside antibiotics and (2) with more episodes of low pH, hypoxemia, or both, higher total bilirubin levels, and substantially lower neonatal status scores. Birth weight, gestational age, highest creatinine level, Apgar score, and aminoglycosides alone were not systematically related to hearing capacity. Subjects in the lowest neonatal status quartile also had a considerably higher incidence of middle ear disorders, characterized by elevated thresholds and prolonged auditory brain stem-response latencies reflective of conductive hearing loss. We conclude that protracted illness and its associated treatment, independently of specific diagnostic categories, constitute important risk factors for permanent hearing loss and for transient hearing loss in early life. PMID- 2715899 TI - Management and follow-up of arterial thrombosis in the neonatal period. AB - The management and follow-up of 12 patients with major aortic thrombus formation occurring in the neonatal period between 1982 and 1987 are reported. Umbilical arterial catheters were inserted in 8 of the 12 patients before thrombus formation. Two patients had congenital thrombi. Hypertension, oliguria, hematuria, and elevated blood creatinine concentration were found at the time of diagnosis of the thrombus; nine of the patients had a patent ductus arteriosus. Supportive care was instituted in seven patients who were hemodynamically stable. Five of the patients had congestive heart failure, shock, or both, and were treated with surgical thrombectomy. Thrombolytic therapy was not used in either group. The five surgically treated patients and six of seven medically treated patients survived. Ultrasound examination suggested resolution of the thrombus in all survivors in 6 to 30 days. Sequelae from thrombus formation were present in all patients at the time of discharge and included hypertension in 9 of the 11 survivors and decreased renal function in six of them. Follow-up at 1 to 3 years revealed normal blood pressure, good growth, and good renal function in 10 of the survivors. PMID- 2715900 TI - Selenium deficiency in low birth weight neonates: an unrecognized problem. AB - To determine whether selenium deficiency is common among low birth weight infants in our neonatal intensive care unit, we surveyed blood samples from healthy full term and preterm infants born in our hospital over a 3-month period. Selenium was measured by electrothermal atomic absorption spectrometry. Glutathione peroxidase was measured in plasma by an automated method. Baseline (less than 72 hours postnatal) selenium concentration and glutathione peroxidase activity were significantly lower in low birth weight infants than in full-term babies. Sequential selenium analyses were obtained in 16 sick low birth weight neonates who remained in the intensive care nursery for up to 6 weeks because of lung disease. All were fed parenterally without supplemental selenium, with or without oral intake, for periods varying from 3 to 60 days. All had a marked decrease from baseline selenium levels, and values below the detection limit of our assay were found in seven infants. Selenium deficiency is much more common in small infants than is generally realized, but the clinical significance in neonates is poorly understood. PMID- 2715901 TI - Regional cerebral blood flow velocity after aminophylline therapy in premature newborn infants. PMID- 2715902 TI - Tuberculous meningitis in children: treatment with isoniazid and rifampicin for twelve months. AB - Patients with tuberculous meningitis were treated with isoniazid and rifampicin for 12 months. To evaluate the result of treatment, we studied the outcome of patients treated from January 1979 to December 1985. Of the 51 patients, 27 were female, and 5, 25, and 21 patients were in the first, second, and third stages of the disease, respectively. Increased intracranial pressure of greater than 200 mm H2O was observed in 42 patients. Three patients required ventriculostomy, and one of them needed ventriculoperitoneal shunting. Three patients died within the first week of admission, and four patients were lost to follow-up. Forty-four patients were followed for 1 1/2 to 7 years; 31 of them recovered completely. Thirteen patients recovered with neurologic sequelae, which included mental retardation, motor weakness, seizures, and hydrocephalus. No serious side effect of the drugs were observed except for transient elevation of liver enzyme activities in four patients. The combination of isoniazid and rifampicin for 1 year, with appropriate management of increased intracranial pressure, seemed to be safe and effective enough to be used as a routine treatment of tuberculous meningitis in areas where resistance to these drugs is uncommon. PMID- 2715903 TI - Pharmacokinetics of zidovudine administered intravenously and orally in children with human immunodeficiency virus infection. AB - Zidovudine pharmacokinetics were determined in 16 children with human immunodeficiency virus infection who were being treated intravenously and orally on an intermittent schedule (every 6 hours). The intravenous doses studied were 80 (n = 3), 120 (n = 4), and 160 (n = 5) mg/m2/dose, infused over 1 hour. Fourteen patients were monitored after an oral dose of zidovudine at 120 (n = 2), 180 (n = 7), or 240 (n = 5) mg/m2/dose. Zidovudine was assayed with a reverse phase high-pressure liquid chromatography method. Zidovudine disappearance after intravenous administration was rapid and biexponential, with half-lives of 14 and 90 minutes and a total clearance of 641 +/- 161 ml/min/m2. The volume of distribution at steady state was 45 +/- 28 L/m2. These pharmacokinetics parameters are very similar to those reported in adults. When administered orally, zidovudine was rapidly absorbed. The fraction of the oral dose that was bioavailable was 0.68 +/- 0.25, so that a 50% increment in the dose, in the conversion from intravenous to oral administration, resulted in plasma zidovudine concentrations after oral dosing that were nearly identical to those achieved with the 1-hour intravenous infusion. However, a dose of 180 mg/m2 given orally every 6 hours maintained plasma zidovudine concentrations in the target range of 1 mumol/L for less than half of the dosing interval. Other schedules, routes of administration, or oral drug formulations may have to be considered if sustained continuous exposure to micromolar zidovudine concentrations is desired. PMID- 2715904 TI - Bromate poisoning. PMID- 2715905 TI - Central nervous system involvement in hemolytic-uremic syndrome. PMID- 2715906 TI - Eleven pairs of ribs of trisomy 18. PMID- 2715907 TI - Assessing response to methylphenidate for attention deficit disorder. PMID- 2715908 TI - High-dose intravenous methylprednisolone therapy for anemia associated with diaphyseal dysplasia. PMID- 2715909 TI - Overt hypoparathyroidism developing after recovery from transient congenital hypoparathyroidism. PMID- 2715910 TI - Effect of liposome surface charge on the stability of technetium (99mTc) radiolabelled liposomes. AB - Using liposomes radiolabelled by the 99mTechnetium-stannous chloride technique we have investigated the effect of surface charge on the stability of the isotope in vitro and in vivo. Dialysis of 99mTc-labelled positive, negative and neutral liposomes, which had been incubated in either saline or normal rat serum showed no significant loss of the isotope from the liposome surface with only 2 per cent of the isotope dialysed. A comparison of gel chromatography with dialysis confirmed that most of the isotope remained attached to the liposome surface, but it did reveal greater loss of the isotope, between 15 and 23 per cent. The liposome clearance rates obtained from 125I-egg phosphatidylcholine (EPC) and 99mTc dual-labelled positive or neutral liposomes were significantly different. The 99mTc marker was cleared five times faster from the positive liposomes and twice as fast from the neutral liposomes as the 125I-EPC integral membrane marker. The 99mTc attached to liposomes with a negative surface charge was stable in vivo and had the same clearance rate from the circulation as the 125I-EPC marker. These results indicate that the commonly used in vitro techniques for assessing liposome radiolabel stability are unsuitable for predicting the stability of the 99mTc in vivo. PMID- 2715911 TI - Study of shellac glycerol esters as microencapsulating materials. AB - Shellac esters were prepared by heating shellac with glycerol and intermediate reaction products were withdrawn. Salicyclic acid granules were encapsulated using a 20 per cent w/v alcoholic solution of shellac and shellac esters. The coated microcapsules were evaluated for moisture absorption, flow properties, and dissolution studies. The drug release from coated granules was seen to depend upon the acid value of the esters. Results indicate that shellac esters could be better encapsulating material than shellac in sustained release formulation. PMID- 2715913 TI - Preparation of microencapsulated liposomes, II. Systems containing nylon-gelatin and nylon-gelatin-acacia walling material. AB - Liposome suspension was encapsulated and isolated in nylon-gelatin and nylon gelatin-acacia walled microcapsules. The resulting liposomal microcapsules could be stored in the dry state as a free-flowing powder. Liposomes remained intact after the microencapsulation, and encapsulation efficiency was greater than 90 per cent. The release of drug from microcapsules was retarded in the presence of drug-loaded liposomes. PMID- 2715912 TI - Microencapsulated monosialoganglioside GM1: physical properties and in vivo effects. AB - The prevention of the decrease of choline acetyltransferase (ChAT) enzymatic activity was achieved by applying GM1 in an animal model for studying retrograde degenerations of cholinergic neurons. Devascularizing lesions of the rat cortex led to a significant decrease in activity of ChAT in the nucleus basalis magnocellularis (NBM), but this decrease was effectively prevented by GM1 administration either centrally or locally in a microencapsulated form. Compared with the relatively large dose of GM1 which has to be given when the drug is administered. i.p. microencapsulated GM1 applied locally and directly over the lesioned cortical surface seems to be effective in much lower doses. PMID- 2715914 TI - Design and in vitro evaluation of polyvinyl chloride microcapsules containing sulphamethoxazole. AB - Polyvinyl chloride microcapsules containing sulphamethoxazole have been prepared by phase separation coacervation in non-aqueous solvents. Phase separation of the polyvinyl chloride in the solution of chloroform was achieved with n-hexane. Scanning electron micrographs revealed uniform encapsulation of the sulphamethoxazole particles. In vitro dissolution studies were conducted under changing pH conditions. The reproducibility of the in vitro drug release was highly significant. The mechanism of drug release was suggested as an integrated process of diffusion controlled dissolution. Controlled drug release was obtained over a prolonged period of 8 h. PMID- 2715915 TI - Periodic characteristics of composite membrane permeability. AB - The permeability of the microcapsule membrane is one of the important characteristics in evaluating the function of microcapsule. In order to specify the mechanism of the oscillatory permeation of electrolytes through composite membranes, we derived a solution to the equation for the transport phenomena through the membrane composed of different patches arranged in a parallel array of two different elements. This solution was applied to the experimental data for the transport process of phenobarbital through ethylcellulose/polystyrene microcapsule which has a patch work-like two-phase structure and exhibits an oscillatory permeation. The values of dispersivities for mass and ionic diffusion flows deduced from the experimental data of Ohara et al. (1985) are 4.0 x 10(-4) and 6.0 x 10(-13) cm2/sec respectively for the membrane thickness of 3.5 x 10(-4) cm. PMID- 2715916 TI - Evidence that the effect of soya bean phosphatidylinositol-cholesterol cyclosporin liposomes on the biosynthesis of acidic phospholipids in isolated subcellular membranes from rat liver and heart is attributable to the soya bean phosphatidylinositol-cholesterol liposomes. AB - This study examined the effect of adding soya bean phosphatidylinositol cholesterol (2:1 molar ratio) liposomes and soya bean phosphatidylinositol cholesterol (2:1 molar ratio)-cyclosporin liposomes on the biosynthesis of [3H]polyglycerophosphatides (phosphatidylglycerolphosphate, phosphatidyl-glycerol and cardiolipin) and [3H]phosphatidylinositol in mitochondria and microsomes, respectively, isolated from rat liver and heart. The results obtained with liposomes, and liposomes containing cyclosporin, established that cyclosporin did not participate in the metabolism of acidic phospholipids. In rat liver and heart mitochondria the amount of biosynthesized [3H]polyglycerophosphatides fell to one third and a half respectively in comparison with the amounts found when liposomes were not added. The composition of [3H]polyglycerophosphatides in both mitochondria showed an increased accumulation of [3H]phosphatidylglycerolphosphate with a concomitant decrease of about 30 per cent in [3H]phosphatidylglycerol. The biosynthesis of [3H]phosphatidylinositol in both rat liver and rat heart microsomes fell to one-third of that found in the absence of liposomes. Under similar conditions the biosynthesis of [3H]cardiolipin decreased by 50 per cent in both mitochondria. The incubation of the same liposomes and liposomes containing cyclosporin with isolated rat liver mitochondria and microsomes released about 5-7 per cent of the linoleic acid. When a corresponding amount of linoleic acid was added to the incubation mixture, the biosynthesis of [3H]polyglycerophosphatides in rat liver did not change significantly, whereas in rat heart mitochondria this biosynthesis decreased by about 33 per cent. Under these conditions, the accumulation of [3H]phosphatidylglycerolphosphate and the decrease of [3H]phosphatidylglycerol was established. The biosynthesis of [3H]phosphatidylinositol in the presence of linoleic acid in rat liver and rat heart microsomes was significantly reduced. Under similar conditions the addition of stearic acid did not significantly affect the level or composition of biosynthesized [3H]polyglycerophosphatides or biosynthesized [3H]phosphatidylinositol. PMID- 2715917 TI - Manufacture of polyalkylcyanoacrylate nanoparticles with pilocarpine and timolol by micelle polymerization: factors influencing particle formation. AB - Nanoparticles with pilocarpine and timolol were produced by micelle polymerization. The influence of manufacturing temperature, type of monomer, drug concentration and ethylcyanoacrylate concentration on the particle size were investigated with a Coulter Nano Sizer. The nanoencapsulation succeeded only with the pilocarpine or timolol base, not with the salts of these drugs. Different micelle formation in aqueous medium compared with organic solvents was evidently responsible for this phenomenon. The particle formation was affected both by the manufacturing temperature and the type of monomer. The smallest particles were produced at lower temperatures and with the most lipophilic monomers. The monomer and drug concentration had very little influence on the particle size. The nanoparticles made with pilocarpine were, in general, much bigger than those made with timolol. PMID- 2715918 TI - The preparation and characterization of lipid vesicles containing esters of sucrose and fatty acids. AB - Encapsulation and electron microscopy studies have shown that aqueous dispersions of several nonionic emulsifiers with sucrosepalmitatestearate (SPS) structure and cholesterol (Chol) result in synthetic lipid vesicles. This was demonstrated for the commercial emulsifier sucrosepalmitatestearate for the first time. Such vesicles were able to entrap aqueous solutes, for instance the fluorescence marker carboxyfluorescein (CF) for a period of more than 10 weeks with latencies of about 90 per cent. Though SPS/Chol-vesicles tended to flocculate--especially in concentrated solutions--the efflux of entrapped solutes after storage was lower in these vesicles compared with liposomes consisting of natural egg phosphatidylcholine (EPC) and cholesterol. PMID- 2715919 TI - Permeability of PEUU membranes: their modification towards blood compatibility. AB - An attempt was made to develop haemodialysis membranes using polyether urethane urea synthesised in our laboratory. It was observed that the processing parameters such as precipitation medium, precipitation temperature etc. can influence the porosity of the membrane and subsequently the permeability property. It was also noted that the permeability of the dried membrane was negligible even though it was kept in distilled water overnight before use. The effect of pH on permeability through the membrane was studied by dialysis experiment using mixtures of various components such as urea, creatinine, uric acid, inulin, albumin, NaCl and KCl at various pH. Standard cellulose acetate (CA) membrane was used for comparison. Membranes were also prepared using biomer solution by precipitating in distilled water at room temperature and the monomer, 2-hydroxy ethyl methacrylate (HEMA) was grafted onto it by glow discharge technique. It was found that the permeability was increased by HEMA grafting with some loss of tensile strength and strain. A comparative study of fibrinogen adsorption during dialysis and adsorption by direct exposure of samples to a mixture containing urea, uric acid, creatinine, dextran, fibrinogen and electrolytes like sodium and potassium ions was also done with 125I labelled fibrinogen. Platelet adhesion studies indicated that the number of adhered platelets was less on the HEMA grafted samples which may enhance blood compatibility. Finally, the membranes were subjected to different sterilization processes possible under wet conditions such as glutaraldehyde treatment and autoclaving. The contact angle, permeability, mechanical property and platelet adhesion studies indicated that the sterilization method can affect the performance of the membrane. PMID- 2715921 TI - Moving the national mental health agenda. An emerging spirit of collaboration. PMID- 2715920 TI - An arterial prosthesis from Argentina: the Barone Microvelour arterial graft. AB - The manufacture of a polyester vascular prosthesis in the southern hemisphere is a new development in the global dissemination of this maturing technology. Hence the recent introduction of the Barone Microvelour arterial graft from Argentina has highlighted the need for a comparative in vitro and in vivo study to compare its structure and performance with that of existing commercial products. Following a series of laboratory tests and implantations as a thoracoabdominal bypass in dogs, the Barone Microvelour has been identified as a strong graft constructed after the style of early weft-knitted designs. It provides an equivalent sequence and rate of healing to that of other polyester knitted grafts. PMID- 2715923 TI - Coalition of Psychiatric Nursing Organizations. PMID- 2715922 TI - Sex-role stereotyping: implications for the mental health of school-age children. AB - Theories related to sex-role stereotyping are reviewed, and the implications of these stereotypes for children's mental health are discussed. Attention is given to the impact of particular social trends, including political conservatism and religious fundamentalism. Case examples of children affected by sex-role stereotypes are presented and therapy approaches discussed. Overall intervention strategies are summarized. PMID- 2715924 TI - Neuman's systems model for nursing practice as a conceptual framework for a family assessment. AB - Neuman's Systems Model was used as a guide to the assessment and intervention for a dysfunctional family. The model gave direction to the selection of family therapy as the appropriate and successful intervention. The case example illustrates the application and use of Neuman's model in child and adolescent nursing practice. PMID- 2715925 TI - Children in crisis: a response to schools. PMID- 2715926 TI - Sibling incest. AB - Child sexual abuse has gained national attention within the last decade. The most reported and studied form of intrafamilial child sexual abuse is father-daughter incest. However, it is believed that sibling incest may be a more widespread form of intrafamilial sexual abuse. Yet, it has received the least amount of documentation and study. The purpose of this article is to describe sibling incest, including family dynamics. Implications for nursing intervention and research are proposed. PMID- 2715927 TI - Conduct disorder in childhood and adolescence: an update. AB - Conduct disorder is a diagnostic entity that has elicited controversy throughout the years. Classified as a psychiatric disorder of childhood and adolescence, the syndrome of conduct disorder recently was revised from four to three categories in the DSM-III-R (Revised). This article presents an overview of conduct disorders, including diagnostic criteria, epidemiology, etiology, treatment approaches and implications for nursing practice. PMID- 2715928 TI - Perceived life changes for children and adolescents following disclosure of father-daughter incest. AB - Eleven families comprised the sample for this qualitative study. The daughters in these families had allegedly been abused by a father or father-figure. The study showed four major life changes occurred for these girls. They were loss of father, placement away from home, alteration in familial roles, and participation in the investigation of sexual abuse. These interventions required to stop the abuse were viewed as further traumatizations. Implications of the study for child and adolescent psychiatric nursing practice are discussed. PMID- 2715929 TI - The pharmacokinetics of volatile anesthetic agent elimination: a theoretical study. AB - The theoretical groundwork for a rate constant formulation of inhaled anesthetic elimination kinetics is discussed. In an effort to simulate recent experimental results a linear flow-limited five-compartment model was used comprising lung, vessel-rich tissue, muscle, nonvisceral fat, and an additional compartment, marrow-visceral fat whose functional existence recently has been experimentally demonstrated. Hypothetical but plausible parameters for the marrow-visceral fat compartment were used. The theoretically predicted values were in good agreement with experimental results suggesting that this model is appropriate for the elimination kinetics of agents that are not metabolized to any significant degree. Simple approximate expressions for the rate constants were also derived and were in reasonable agreement with experimental results. The model was also employed to clarify the effect of anesthetic duration on subsequent elimination kinetics. PMID- 2715930 TI - An area function method for calculating the apparent elimination rate constant of a metabolite. AB - A simple method for determination of the apparent elimination rate constant of a metabolite (km) has been developed. This procedure requires calculation of area intervals under the plasma concentration-time curves of the parent drug and its derived metabolite. The method has been evaluated and compared with the Chan moment method using both errorless and errant data. The approach is accurate for various ratios of elimination rate constants of drug and metabolite, allows several values of km to be averaged, but works best using data prior to the metabolite tmax. PMID- 2715931 TI - Estimation of noncompartmental parameters: a technical note. AB - Noncompartmental pharmacokinetic parameters are usually expressed in terms of the area under the so-called first moment curve and the area under the plasma concentration-time curve. These areas are normally computed by numerical integration. There is an inconsistency in the way in which they are presently estimated. This inconsistency is detailed and a consistent approach to the computation of noncompartmental parameters is outlined. The difference between the two methods is illustrated using some data from the literature. PMID- 2715933 TI - Pharmacodynamic modeling of digoxin-induced bradycardia. AB - Digoxin-induced bradycardia in dogs was used to evaluate several pharmacodynamic models. Digoxin plasma concentrations and response were monitored in beagle dogs administered either 0.05 or 0.025 mg/kg of digoxin iv as an infusion over 5 min. The models investigated were the linking model, the linear model, the effect compartment model, and the inhibitory model. Regression procedures for investigating the effect compartment model were conducted with Emax (the maximal response, where response was the percentage decrease in heart rate) as a variable with an upper bound of 100%, with a constant value of 100%, or alternately with a constant value equal to the maximal observed response. Based on statistical criteria the effect model using Emax as a variable was found to be the best model for describing digoxin-induced bradycardia. For the effect compartment model, CPss(50) (concentration at steady state that will produce 50% of the maximal response) ranged from 3.8-9.8 ng/ml; delta (exponent describing the steepness of the concentration-response relationship) ranged from 0.6-7.1. The implication of these models in understanding concentration-effect relationships are discussed. PMID- 2715932 TI - The population pharmacokinetics of theophylline in neonates and young infants. AB - The population pharmacokinetics of theophylline were evaluated using 391 theophylline serum concentration measurements from 108 neonates and young infants (postnatal age 0-26 weeks), who received theophylline for the treatment of neonatal apnea. A one-compartment pharmacokinetic model with first-order elimination was used, with intravenous aminophylline and oral theophylline administration modeled as zero-order infusions. The effect of a variety of developmental and demographic factors on clearance (CL) and volume (V) were investigated. Hypothesis testing to evaluate potentially significant factors produced a final model in which clearance was based on weight (kg) raised to an exponential power and postnatal age (weeks), with CL (ml/hr) = 17.5 (weight)1.28 + 1.17 (postnatal age). Clearance was reduced by 12% for patients receiving parenteral nutrition. Volume of distribution in this population was adequately described using only weight, with V (L) = 0.858 L/kg. Bioavailability of orally administered drug was not significantly less than unity. Interindividual variability in clearance was modest, with a coefficient of variation for clearance of 16%. An estimate of interindividual variability in volume could not be obtained. As a measure of residual variability in theophylline serum concentrations, the coefficients of variation for theophylline serum concentrations of 5.0, 10.0, and 13.0 mg/L were found to be approximately, 25, 12, and 9%, respectively. The identification of influential patient factors and the quantification of their influence on theophylline disposition allow for a priori estimates of theophylline pharmacokinetic parameters in these patients. PMID- 2715934 TI - High-performance liquid chromatographic determination of prednisolone and its steroid 21-oate ester derivatives in rat plasma: pharmacokinetic applications. AB - A high-performance liquid chromatographic (HPLC) technique was developed for the determination of prednisolone and its local anti-inflammatory steroid 21-oate ester derivatives in rat plasma. These new steroid esters (methyl 20 alpha- and 20 beta-dihydroprednisolonate; P4 alpha and P4 beta), developed for local use, were found to exhibit minimal systemic side effects as compared with prednisolone. The described method involves a simple organic extraction procedure and separation of steroids using a C18 reversed-phase column for pharmacokinetic study. The method allows simultaneous measurement of endogenous corticosterone following administration of P4 alpha, P4 beta, and prednisolone. The calibration curves of the steroids were linear over a wide range of concentrations (0.05 to 10 micrograms/mL). The limit of detection of the assay for all tested steroids is 10-20 ng/mL. The method is reproducible, with a coefficient of variation of less than 10% for all steroids over a wide range of concentrations. No interference from endogenous steroids nor exogenous steroids was found. The presented method is simple, rapid, specific, sensitive, and reproducible. PMID- 2715935 TI - Pralidoxime chloride stability-indicating assay and analysis of solution samples stored at room temperature for ten years. AB - A high-performance liquid chromatographic (HPLC) method is described for quantitation of pralidoxime chloride and its decomposition products 2-carboxy-, 2 formyl-, and 2-(aminocarbonyl)-1-methylpyridinium chloride. These decomposition products and 2-cyano- and 2-(hydroxymethyl)-1-methylpyridinium chloride and 1 methyl-2(1H)-pyridinone were separated from pralidoxime chloride on a silica gel column using a mobile phase of acetonitrile:water (86:14) in which the aqueous component was 8.36 mM in tetraethylammonium chloride and 52.5 mM in acetic acid. This method allows quantitation of the relatively low levels of 2-formyl-1 methylpyridinium chloride formed in acidic solution at room temperature. Sensitivity was shown to be at least 5 ng of the pralidoxime chloride and 15 ng of the 2-carboxy-, 2-formyl-, and 2-(aminocarbonyl)-1-methylpyridinium chloride injected on column. The coefficient of variation was 4% or less for all components measured. Autoinjectors containing 300 mg/mL of pralidoxime chloride in water were stored at room temperature for 8-10 years, followed by analysis for hydrogen cyanide using an ion-selective electrode. Less than 15 micrograms of cyanide per autoinjector was detected. The HPLC analysis of the solutions after being stored an additional 3-4 years at approximately 5 degrees C demonstrated that greater than 90% of the total of all measured components consisted of pralidoxime chloride. The remaining percentage was made up of 2-carboxy-, 2 formyl-, and 2-(aminocarbonyl)-1-methylpyridinium chloride. PMID- 2715936 TI - Kinetics of drug action in disease states. XXXIII: Disparate effects of pentylenetetrazol in rats as a function of renal disease model and pharmacologic endpoint. AB - The purpose of this investigation was to determine if the pharmacodynamics of the central nervous system stimulant pentylenetetrazol (PTZ) are altered in renal dysfunction. Female rats subjected to bilateral ureteral ligation (with sham operated controls) or injected with uranyl nitrate (with saline injected controls) were infused intravenously with PTZ until the onset of either a minimal (myoclonic jerk) or maximal (tonic hindlimb extension) seizure. Neither chemically nor surgically induced renal dysfunction caused a change in the concentrations of PTZ in CSF, serum, or brain at onset of minimal seizures. When PTZ was infused to onset of maximal seizures, the rats with chemically induced renal dysfunction required higher concentrations, whereas the ureter-ligated rats convulsed at lower concentrations of PTZ than did the corresponding control animals. Thus, the effects of experimental renal dysfunction on the convulsant action of PTZ are dependent on both the disease model and the endpoint used for the pharmacodynamic measurement. Apparently, renal dysfunction did not affect the PTZ-induced seizure threshold, but inhibited the spread of seizures. The increased sensitivity of ureter-ligated rats may be due to their pronounced retention of water, since water loading is known to increase seizure susceptibility. PMID- 2715937 TI - Accessibility factors for diffusion-controlled drug delivery systems. AB - The idea of accessibility factors or parameters is introduced to describe the ability of a planar or spherical controlled-release system to deliver a specific drug (with a known diffusion coefficient) within a desired period of time. The accessibility factors are the maximum and minimum values of the drug diffusion coefficient, the geometric dimensions of the system, and the release time. The solutions of the general diffusion equations are plotted as generalized diffusional diagrams, indicating the accessibility region for drug delivery. Deviations from the quasi-equilibrium conditions can be represented in these diagrams. PMID- 2715938 TI - Penetration of theophylline and adenosine into excised human skin from binary and ternary vehicles: effect of a nonionic surfactant. AB - A nonionic surfactant, diethyleneglycol lauryl ether (PEG-2-L), increases the flux of either theophylline or adenosine by a factor of 2.2-2.7, when these are delivered from propionic acid solutions into human skin samples, with respect to propionic acid alone. At the same time, the flux of propionic acid from the same vehicles is decreased. Significant expansion of the partial molal volumes vi of both purines occurs following incorporation of PEG-2-L into their propionic acid solution. Hence, the enhancing effect of this surfactant arises mainly from an increase in the excess free energy of these solutes in the donor phase ("push" effect). Paraffin oil increases the flux of either drug from propionic acid by an entirely different mechanism. It enhances the flux of propionic acid into the skin, thus promoting the partitioning of the purine solute in the modified skin barrier ("pull" effect). Indeed, the magnitude of vi of either purine in propionic acid:paraffin oil solution gives no indication of a significant interaction between paraffin oil and the purine solute. Finally, the penetration enhancing effects of PEG-2-L and paraffin oil combined together in the same propionic acid vehicle are additive, resulting in a flux which is approximately the sum total of fluxes obtained separately with PEG-2-L or paraffin oil. PMID- 2715939 TI - Pharmacokinetic analysis of single- or multiple-dose plasma drug concentration data with a microcomputer using multi-fraction absorption models. AB - A Basic program for multi-fraction absorption models was developed to link with another microcomputer program, MULTI, and was named MFA-MULTI. A main frame computer program SIMP, based on a simplex method using differential equations, was also operated using a microcomputer equipped with a FORTRAN compiler and a 8087 floating-point coprocessor. These two programs [MFA-MULTI and SIMP (M)] were applied to the analysis of plasma concentration data of several drugs with irregular absorption profiles. The results by MFA-MULTI and SIMP(M) for the single- or multiple-dose data were almost coincident with those obtained by a SIMP program. The result for nalidixic acid estimated using MFA-MULTI or PKM MULTI was also compared. The plasma nalidixic acid concentration, with irregular absorption profiles due to characteristics of dissolution in the gastrointestinal tract, was found to be described by a two-fraction absorption model. The MFA MULTI program was applied to the analysis of plasma cimetidine concentration data with double peaks in humans. Pharmacokinetic absorption behavior of a sustained release preparation of theophylline after repetitive oral administration was adequately evaluated using MFA-MULTI. In addition, application of multi-fraction absorption models to population pharmacokinetics is discussed. PMID- 2715940 TI - Buccal drug absorption. II: In vitro diffusion across the hamster cheek pouch. AB - The in vitro diffusion of a series of substituted acetanilides across the hamster cheek pouch was studied. The keratinized epithelial layer of the cheek pouch appeared to provide the major barrier to diffusion of these compounds. Linear relationships were found for plots of log epithelial permeability (Pe) versus the log of the octanol-buffer partition coefficient (PCoct; r = 0.712), and log Pe versus the log of the isooctane-buffer partition coefficient (PCiso; r = 0.869). Comparison of the in vitro data with in vivo data obtained in humans using the buccal absorption test showed good correlation (r = 0.878) between Pe and percent buccal absorption in 5 min. These results suggest that diffusion across the hamster cheek pouch may have some utility in the prediction of human buccal absorption. PMID- 2715941 TI - Pharmacokinetics of low-dose methotrexate in rheumatoid arthritis patients. AB - The pharmacokinetics and bioavailability of low-dose methotrexate (MTX) (10 mg/m2) were evaluated in 41 subjects who had definite or classical rheumatoid arthritis as defined by the American Rheumatism Association criteria. Subjects received 10 mg/m2 (to the nearest 2.5 mg) of MTX in a single oral dose and a single intravenous (iv) dose one week apart. Serum concentrations for this low dose regimen were monitored using a radiochemical ligand binding assay. The results indicate the MTX is cleared from the plasma at a rate of 84.6 mL/min/m2. The terminal half-life was approximately 6 h. The volumes of distribution at steady state and for the central compartment were 22.2 and 13.5 L/m2, respectively. The mean residence time in the body, in the systemic circulation, and in the periphery were estimated to be 4.7, 3.0, and 1.7 h, respectively, with a peripheral single-pass mean transit time of 6.0 h and an intrinsic mean residence time in the periphery of 7.9 h. The mean absorption time was 1.2 h and the oral bioavailability was 0.70. The ratio of synovial fluid concentration to serum concentration 4 and 24 h after a dose was found to be approximately 1.0, indicating that at least within that time range serum and synovial fluid concentrations are approximately equal. Because of conflicting results and insufficient data from previous high-dose pharmacokinetic studies, it is difficult to say whether or not low-dose MTX pharmacokinetics differs from those of high-dose MTX. PMID- 2715942 TI - Stereoisomer differentiation for the analgesic drug nefopam hydrochloride using modeling studies of serotonin uptake area. AB - Equatorial and axial N-methyl diastereomers of the analgesic drug nefopam hydrochloride were differentiated using a hypothetical model of the serotonin (5 hydroxytryptamine) uptake area. Both diastereomers were placed within the hypothetical model area to form van der Waals interactions involving the phenyl group of nefopam, but only in the case of the equatorial N-methyl epimer was the +N--H bond able to be oriented towards the proposed hydrogen-bonding site. A comparison of equatorial N-methyl nefopam hydrochloride enantiomers in the proposed two-site binding mode points to less severe nonbonding steric interactions for the (+)-(1S,5S)-enantiomer compared with the (-)-(1R,5R)-isomer. PMID- 2715943 TI - Self-association and solubility behaviors of a novel anticancer agent, brequinar sodium. AB - To aid in the selection of appropriate excipients to formulate brequinar sodium [6-fluoro-2-(2'-fluoro-1,1'-biphenyl-4-yl)-3-methyl-4-quinolinecarboxyli c acid sodium salt; DuP 785], studies were initiated to characterize thoroughly its solubility behavior. The measured solubilities at RT (approximately 23 degrees C) agreed with the theoretical values in the pH range from 0.5 to 7.2, but became significantly greater than theoretical values at pH values above 7.2. This deviation was likely due to the vertical stacking-type self-association between brequinar molecules in water. The NMR and pH methods determined a critical association concentration of 15 mg/mL. Sodium salicylate, which has been proven to interfere with molecular self-association, reduced drug solubility from 116 to 10 mg/mL. But urea, another deaggregative agent, gave about a twofold increase rather than a decrease in solubility. Addition of sodium chloride caused a 226 fold decrease in solubility. The apparent solubility product did not remain constant but decreased as sodium chloride concentration increased, suggesting that the added salt decreased the degree of self-association between brequinar molecules. Among four surfactants examined (a bile salt with a rigid fused ring versus three ordinary surfactants with a flexible chain structure), only sodium cholate significantly increased the aqueous solubility of brequinar sodium. PMID- 2715944 TI - The polishability of posterior composites. AB - The polishability of six brands of posterior composites was evaluated by means of a stylus profile instrumentation and scanning electron microscopy and was compared with that of an anterior microfilled composite. A sedigraphic study was performed to estimate the size and distribution of their inorganic particles. The extent of the filler loading as well as the hardness values were also assessed to determine any relevant characteristics. Some of the findings indicated that posterior composites with large particles produced significantly higher surface roughness than those with small fiber particles. A direct correlation was also found between the hardness value and surface roughness value, indicating that a composite with higher hardness value yielded a higher roughness value. PMID- 2715945 TI - Endodontic access of all-ceramic crowns. AB - This study determines the effects of access opening on all-ceramic (Dicor) crowns. Forty-two extracted permanent teeth were selected to represent the various types of human teeth. Crown preparations were completed, polysulfide impressions made, and stone dies poured. The dies were forwarded to a commercial dental laboratory for fabrication of the restorations. The crowns were luted to the prepared teeth and endodontic access openings were completed by using established criteria for access preparation. The crowns were removed and examined by direct vision, transillumination, stereomicroscopy, and scanning electron microscopy. Two crowns fractured during access preparation, seven crowns exhibited craze lines, and 29 crowns exhibited chipping of the ceramic material adjacent to the access opening. There was no significant difference in the extent of chipping with diamond or carbide instrumentation. However, carbide instrumentation caused more fractures and craze lines than did diamond instrumentation. PMID- 2715946 TI - Effect of unit and operatory lights on the consistency of light-activated composites. AB - The extent to which the flow of composite resin is reduced when exposed to dental lights was studied. Samples were exposed to operating lights of various intensities for varying periods of time. After exposure each sample was placed under a fixed load and the resulting average diameter was calculated. Data from the testing of samples exposed to dental lights were analyzed by a two-way analysis of variance with subsequent Tukey multiple comparison test. Diameter comparisons were significant (p less than 0.05) between the controls and samples exposed to the 960 fc light at 6 minutes, the 1920 fc light at 4 minutes, the 2880 fc light at 2 minutes, and the 5120 and 7680 fc lights at 1 minute. The smaller diameters observed with respect to increased intensity and time of exposure show that either variable or the combination of both variables will alter the consistency of composite resin. PMID- 2715947 TI - Potential errors when using a computerized pantograph. AB - This study determined the effect on articulator settings of using an arbitrary hinge axis as compared with the terminal hinge axis in orienting a computerized pantograph on a patient. The effect of an error in measuring the reference plane angle or clutch angle was also determined. Two subjects were pantographed 30 times by using the terminal hinge axis and 30 times by using the arbitrary hinge axis. Statistically the articulator settings obtained by using the arbitrary hinge axis and the terminal hinge axis were different, but the difference was small. One subject was pantographed on 18 occasions by using different reference plane angle and clutch angle settings. Analysis showed that 1-degree change in the reference plane angle setting produced approximately 0.9-degree change in the protrusive and orbiting path articulator settings. A 1-degree change in the clutch angle setting produced approximately 0.9-degree change in the progressive side shift settings. It was concluded that the terminal hinge axis should be used as the posterior reference point and the reference plane angle and clutch angle should be carefully recorded. PMID- 2715948 TI - Scanning electron microscopic study of prepared cavities involving enamel, dentin, and cementum. AB - The dental treatment needs of many elderly people involve root surface caries and class V restorations. A scanning electron microscopic examination of extracted teeth with class V cavity preparations showed that well-developed cementum margins could be produced. Most studies regard the dentinocemental junction as behaving as dentin in relation to the restorative sealing process and possible marginal leakage. This study emphasizes the importance of the inclusion of cementum in class V cavity preparation and the possibility of marginal leakage occurring, depending on the restorative material used and whether acid-etch techniques are involved. Further studies on the cementum margin should be undertaken in regard to special treatment requirements related to bonding, marginal preparation, and marginal leakage. PMID- 2715949 TI - The use of light-cured material for immediate hollow obturator prosthesis. AB - Surgical obturator prostheses for oronasal defects frequently require major alterations because of rapid changes in the defect following surgery. When necessary, the closing of the superior surface of the obturator can be completed as an office procedure by using light-cured acrylic resin. A step-by-step method for this procedure is described. The nonporous nature of the material used prevents accumulation of mucous and debris in the hollow extension. PMID- 2715950 TI - A simplified psychologic questionnaire as a treatment planning aid for patients with temporomandibular joint disorders. AB - Psychologic factors are often believed to have a significant role in the etiology and maintenance of temporomandibular joint disorders. Anxiety and depression have received the greatest focus. Approximately 132 patients with temporomandibular joint disorders completed seven self-administered depression questionnaires and four anxiety questionnaires. Correlation among all 11 questionnaires was significant. Factor analysis was interpreted as indicating the 11 questionnaires were measuring a single factor. For preliminary screening diagnosis, two questions were suggested to be a good approximation of the total battery of questionnaires. PMID- 2715951 TI - An intraoral drug delivery system. AB - Topical drug therapy for ulcerative and vesiculobullous diseases of the oral mucosa has generally proved unsatisfactory because of the turbulent and changing nature of the oral cavity. The construction and use of an intraoral drug delivery system using custom carriers to deliver topical medication is described. The delivery system presented overcomes many of the obstacles associated with topical drug administration for oral lesions and provides a therapeutic alternative to systemic agents. PMID- 2715952 TI - Special matrix for restoring teeth with subgingival Class II root caries. PMID- 2715953 TI - Methods of filling teeth. PMID- 2715954 TI - Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. PMID- 2715955 TI - Centric relation and the treatment position in rehabilitating occlusions: a physiologic approach. Part I: Developing an optimum mandibular posture. PMID- 2715956 TI - Repatriation of chronic patients. What happens when the hospital closes? PMID- 2715957 TI - Survival skills for psychic trauma. PMID- 2715958 TI - Research & clinical practice. Building a nursing research culture. AB - The internalization of clinical nursing research values, norms, and attitudes via orientation and research development, along with the introduction of research tools (artifacts), constitutes the birthing phase of the acculturation process. The development of unit and individual research agendas and the implementation of research rounds illustrates a "bonding phase," in that nurses are bonding or weaving research into the fabric of their clinical practice. The final phase, stabilization, occurs when clinical nursing research is core to clinical nursing practice as illustrated by rewards or sanctions via performance evaluations, and provisions for release time for research participation. PMID- 2715959 TI - Gastrointestinal lymphoma in 20 dogs. A retrospective study. AB - The records of 20 dogs with histopathologically diagnosed gastrointestinal (GI) lymphoma (LSA) evaluated between 1970 and 1984 were reviewed. Fifteen dogs were considered to have primary GI LSA, while five dogs had GI involvement in association with the multicentric form. Most clinical and laboratory findings were nonspecific, but positive-contrast upper GI radiography was suggestive of GI LSA in all of the dogs evaluated. Nine dogs had extensive lymphocytic-plasmacytic inflammatory infiltrates around the neoplastic foci, resulting in difficulty in obtaining a diagnosis of GI LSA when samples were obtained by endoscopy. PMID- 2715960 TI - Probable essential thrombocythemia in a dog. AB - Essential thrombocythemia (ET) in an 11-year-old dog was characterized by persistently high platelet counts (range, 4.19 X 10(6)/microliters to 4.95 X 10(6)/microliters, abnormal platelet morphology, marked megakaryocytic hyperplasia in the bone marrow, absence of circulating megakaryoblasts, and history of splenomegaly and gastrointestinal bleeding. Increased numbers of megakaryocytes and megakaryoblasts (15% to 20%) in the bone marrow were confirmed by a positive acetylcholinesterase reaction. Another significant finding was the presence of a basophilia in blood (4,836/microliters) and bone marrow. The marked persistent thrombocytosis, absence of reactive (secondary) thrombocytosis, abnormal platelet morphology, and quantitative and qualitative changes in the megakaryocytic series in the bone marrow suggested the presence of a myeloproliferative disease. Cytochemical and ultrastructural findings aided in the diagnosis of ET. The dog was treated with radiophosphorus. The results was a rapid decline in the numbers of megakaryoblasts and megakaryocytes in the bone marrow and platelets and basophils in the peripheral blood. The dog died unexpectedly of acute necrotizing pancreatitis and diabetes mellitus before a complete remission was achieved. PMID- 2715961 TI - Intact parathyroid hormone assay and total calcium concentration in the diagnosis of disorders of calcium metabolism in dogs. AB - Serum samples from eight dogs with primary hyperparathyroidism, seven dogs with hypercalcemic lymphosarcoma (hypercalcemia of malignancy), and four dogs with primary hypoparathyroidism were submitted to the Animal Health Diagnostic Laboratory at Michigan State University for intact parathyroid hormone (PTH) assay. When compared with the adjusted total serum calcium concentration, the intact PTH concentration was consistent with the correct diagnosis in all cases. Two dogs with hypercalcemic lymphosarcoma were mildly azotemic. In both of these cases the intact PTH concentration was consistent with hypercalcemia of malignancy despite the presence of azotemia. These data support a significant role for intact serum PTH assay in the differential diagnosis of disorders of calcium metabolism. PMID- 2715962 TI - X-chromosomal monosomy (77,X0) in a Doberman Pinscher with gonadal dysgenesis. AB - A 6-month-old stunted female Doberman Pinscher was found to have a 77,X0 chromosomal complement. The ovaries were small, consisting primarily of interstitial-type cells and solid epithelial cords. The dam, sire, and a male littermate had normal karyotypes. PMID- 2715963 TI - [Computed tomography and magnetic resonance imaging in anomalies of neuronal migration]. AB - This is a report of the CAT-scan and MRI characteristics in 14 patients with anomalies of neuronal migration. There were 3 cases of heterotopia of the gray matter, 2 cases of agyria, 3 cases of pachygyria, 2 cases of schizencephaly and 4 cases of hemimegalencephaly. The primary advantages of MRI in comparison with CAT scanning, are better contrast between the white and gray matter; better delineation of the cerebral cortex and the possibility of direct mutiplanar imaging. NMRI will become the investigation of choice in children with epilepsy or psychomotor retardation. PMID- 2715964 TI - [Computed tomography in the evaluation of recent articular fractures of the calcaneus]. AB - After mentioning the results of a survey carried out on 28 patients suffering from recent calcaneus articular fractures, the authors point out 9 main points to take into account when a TDM analysis of these lesions is to be done: they recommend to practice a double obliquity incidence that seems to be an efficient guide for a therapeutic decision. They insist on the usefulness of the TDM examination provided it is undertaken after the operation and the removal of the osteosynthesis equipment. PMID- 2715965 TI - [The value of magnetic resonance imaging in the surveillance of fibromatosis. A study of 10 cases]. AB - Retrospective study of 10 patients followed for fibromatosis after initial treatment by magnetic resonance imaging. There is a close correlation between an intense signal on weighted T2 images and tumour recurrence. Inversely, a low signal on the weighted T2 image indicated fibrotic sequelae without tumour recurrence. The examination should commence with the weighted T2 sequence. The injection of contrast medium may be an alternative. PMID- 2715966 TI - [Mucoceles of the sphenoid sinus]. AB - Based on 5 personal cases, the authors conducted a study of sphenoid mucocele, based notably on the results of CAT-scanning. This is the key step in diagnosis. Indeed, it makes it possible to determine the origin of the mass, and its growth, and lysis or even consolidation of bone walls. Magnetic resonance should supply valuable information on the inflammatory nature of the mass, its relationship with the pituitary and chiasma, as well as the images on a sagittal section. The studies conducted to date in general show a different presentation of the tumors in comparison with mucoceles. Because of the latent character of mucoceles they are often diagnosed at a late stage on signs of local involvement. PMID- 2715967 TI - [Giant diverticulum of the colon. Apropos of 2 cases]. AB - Two cases of giant colonic diverticulum are reported. Clinical and radiological features are described. Surgery is absolutely necessary. PMID- 2715968 TI - [Pulmonary opacities in the shape of ribbon streamers. Apropos of a case]. AB - The authors report a case of chronic interstitial pneumonia with a very unusual appearance (on plain films and CT); in fact such ribbon-like linear opacities with concentric and pseudo-cavitary disposition have not been previously described. They are comparable but different from the linear opacities described by Carrington in some cases of chronic eosinophilic interstitial pneumonia, which are vertical and peripheral. They are also different from the curvilinear sub pleural opacities reported in some cases of asbestosis. On the basis of the anatomic findings they discuss the specificity of such radiologic patterns or their sole value as an evolutive state. PMID- 2715969 TI - [An arterio-cutaneous fistula following attempted thrombolysis and amputation]. AB - This report demonstrates an exceptional case of arteriocutaneous fistula developing after local thrombolysis. The arterial catheter was left in situ for four days and was removed after failure of lumen restoration. A complete ischemia of the lower leg persisted. Following above knee amputation, the patient developed a fistula at the medial side of the stump. Fistulography proved a direct communication with the lumen of the partially recanalized superficial femoral artery. At operation, a suppurative arteritis was found. After complete extirpation of the superficial femoral artery including the transcutaneous fistula, a complete healing could be achieved. PMID- 2715970 TI - [An antenna support table for studying the spinal cord and spine by magnetic resonance]. PMID- 2715971 TI - [Interventional computed tomography in thoracic oncology. Apropos of 170 cases]. AB - The authors report their experience with follow-up cytohistological examination of subclinical thoracic lesions in oncology by transparietal puncture with CAT scanning localization in 170 patients. They detail a few special points concerning the material used and their techniques, in view of reducing the most common incidents and of managing the most severe complications. They analyze their results in two groups of patients, one investigated in a context of known malignancy and the other, with no history of malignancy in whom bronchoscopy, bronchial lavage and brushing were negative. They found an overall sensitivity and specificity of 86% and 100%, respectively, in the diagnosis of malignant disease. The method showed an efficacy of 83.5%. For the two populations, sensitivity was 84% and 87% respectively, and efficacy was 82 and 85% respectively. Thus, the results were better in the patients who had never received anticancer therapy. They also observed significant differences depending on whether the targets were mediastinal, pleuropulmonary or parietal. While the rapid diagnostic information appears invaluable in both groups of patients, in contrast, the small volume of the specimens, which may be hemorrhagic, necrotic, with more or less extensive fibrosis of the stroma, and the immaturity of certain tumors, sometimes make it impossible for the pathologist to give a precise diagnosis of the tumor other than the benign or malignant structural character of the lesion. This represents a significant obstacle in hematology for affections which, although non surgical, nevertheless require precise identification of the lesion for effective therapy. The elaboration of more effective sampling material, repeated punctures and immunohistoenzymatic analysis techniques would probably further improve the results of the method. PMID- 2715972 TI - [Specific and non-specific contrast media for MRI of tumors. Experimental study of human breast carcinoma]. AB - MRI has been shown as an adapted non-invasive modality for the detection of tumours in humans. The development of paramagnetic contrast agents could add to the MRI diagnosis. With an experimental model of human breast (MX-1) carcinoma developed in nude mice, two different classes of contrast medium were tested. The first class includes the well-known Gd-DTPA and a new nitroxide compound on going development, representing non specific contrast agents. The specific contrast agents are represented by a metalloporphyrin Mn-TPPS4. Non specific contrast agents can add to the differentiation between well vascularized viable tissue and necrotic areas of tumors. While specific contrast agents may specifically target tumorous tissue. PMID- 2715973 TI - [Cerebral vascular clips in MRI. Absolute or relative contraindications]. AB - MRI is sometimes of no value in investigating a region close to a metallic foreign body. Presentation of a patient with non ferromagnetic cerebral vascular clips where MRI did not allow for the study of the chiasmatic region because of major artefacts. PMID- 2715974 TI - [The CT scanner and the temporomandibular joint. Anatomo-radiologic comparisons. Apropos of 14 cases of algodysfunctional of the manducator system]. AB - Among 500 CT scan of temporomandibular joint (TMJ), examined since 1982 by bilateral direct sagittal method (Department of Radiology, Pr. A. TREHEUX, CHU Nancy-Brabois), the authors have retained 14 cases of patients with symptoms related to TMJ's dysfunction cured by surgery (Department of Maxillo Facial Surgery, Pr STRICKER, CHU Nancy). These cases were chosen among hundred patients annually examined by CT scan, for various diseases (TMJ's dysfunctions, traumatisms, infections, inflammatory diseases...). These correlations between radiology and surgery about 26 TMJ (2 patients underwent surgery only on one side) were: an accuracy with surgical findings for 19 cases (76%); in 6 cases (23%), a meniscus anteriorly displaced, non detected by CT scan was found by surgery; 2 cases of meniscus perforations (one in the frontal plane, the other sagittal) were surgical findings; in 1 case, a displacement was under-valued by CT scan; in 3 cases, arthrosic changes (1 case of Reiter syndrome), were characterized by CT scan. The authors emphasize the value and the limits of evaluation of the internal derangements of the TMJ with direct sagittal CT. PMID- 2715975 TI - [Cortical metaphyseal groove in an adolescent of the VIIIth century]. PMID- 2715976 TI - [The case of the month. Post-traumatic trapping of the small intestine in the left sacroiliac joint]. PMID- 2715977 TI - [Contribution of imaging in complications of colo-anal anastomoses. Apropos of 61 cases]. AB - The authors studied the complications occurring in 61 cases of colo-anal anastomosis carried out for cancer in 55 cases. Fistula formation occurred in 14 cases i.e. approximately 23%. This was symptomatic in 11 cases i.e. 18%. Their clinical course was favourable. One case of necrosis of the reservoir was seen. The recurrence rate for neoplasms was 14.3% and was no higher than after abdomino perineal resection. The procedure is justified in terms of tumour recurrence. PMID- 2715978 TI - [X-ray computed tomographic aspects of medium-sized free peritoneal effusions (supramesocolic level)]. AB - This study was conducted in 10 patients recently treated by peritoneal dialysis, and without a previous history of peritoneal disorders. Its aim was to determine the normal distribution of a two litre liquid effusion in the mesocolic recesses. A detailed description of the anatomy of the supramesocolic peritoneum precedes the study CAT scan results. PMID- 2715980 TI - Peripheral K cells in normal human pregnancy: decrease during pregnancy and increase after delivery. AB - Peripheral blood levels of K cells were measured in normal pregnant and post partum women by a plaque-forming cell technique that detects K cells on the basis of their activity of antibody-dependent cell-mediated cytotoxicity (ADCC). Peripheral K cells decreased throughout normal pregnancy (n = 46; 7.8 +/- 3.4%, P less than 0.01; 0.13 +/- 0.08 X 10(9)/l, P less than 0.001) and increased in the post-partum period (n = 17; 14.2 +/- 6.1%, P less than 0.05; 0.32 +/- 0.20 X 10(9)/l, P less than 0.01) in comparison with those in normal non-pregnant controls (n = 29; 10.5 +/- 4.2%; 0.20 +/- 0.09 X 10(9)/l). These findings suggest that a decrease of K cells during pregnancy may contribute in part to maternal acceptance of the fetal allograft and that the post-partum increase of K cells may represent a post-partum increase of cell-mediated cytotoxicity, which may contribute to natural defense against puerperal infection. PMID- 2715979 TI - Ontogeny and distribution of cells expressing HLA-B locus-specific determinants in the placenta and extraplacental membranes. AB - Both the trophectoderm and the inner cell mass of the blastocyst contribute to the cell populations found in the placenta and extraplacental membranes. Previous studies have shown differences between those two embryologically distinct populations of cells in their expression of class I HLA, and further differences among trophectoderm-derived trophoblast cell subpopulations. Binding patterns for antibodies to both monomorphic and allotypic determinants on class I heavy chains have been reported. In the present study, extraembryonic cells were evaluated by immunohistology for binding of the monoclonal antibody 4E, which identifies locus specific determinants on HLA-B. Some inner cell mass-derived cells (mesenchymal cells) acquired high levels of HLA-B as gestation progressed and other continued to express low levels at late stages of gestation (amnion cells). In contrast, throughout gestation both villous and extravillous trophoblast cells failed to express detectable HLA-B. The binding patterns for 4E followed the patterns established by a monoclonal antibody to class I HLA heavy chains (61D2), and those reported for antisera to allotypic determinants. The findings support the suggestion that trophoblast cells forming the fetal component of the maternal fetal interface exert highly effective regulation over the expression of class I HLA. PMID- 2715981 TI - Suppression of lymphocyte proliferation in vitro by macromolecules in the vesicle fluid and tissue extracts of hydatidiform mole. AB - This study examines the effects of vesicle fluid and tissue extracts from hydatidiform mole trophoblast on lymphocyte proliferation in vitro. Samples were obtained by direct aspiration of vesicles (hydatidiform mole vesicle fluid (HMF] or homogenization of molar tissues (hydatidiform mole extract (HME] following therapeutic uterine evacuation of hydatidiform mole. Dialyzed and lyophylized HMF pooled from two patients exhibited a 30% suppression (P less than 0.05) of mitogen-induced lymphocyte proliferation at a concentration of 12.5 micrograms protein/ml. Similarly, lymphocyte transformation was significantly suppressed (P less than 0.05) by HME at concentrations of 500 and 250 micrograms/ml. Molecular weight chromatography of HME resolved 4 protein fractions. Fraction 3 (35--50 kDa) and fraction 4 (less than 35 kDa) significantly suppressed mitogen-induced lymphocyte transformation while fractions 1 and 2 demonstrated no immunosuppression. Heat treatment (56 degrees C, 30 min) abolished the immunosuppressive activity of HME as well as fractions 3 and 4. These results suggest that hydatidiform mole trophoblast contains heat-labile macromolecules which suppress mitogen-mediated lymphocyte transformation. Such trophoblast derived factors may interfere with maternal rejection of the allograft. PMID- 2715983 TI - Ovulation induction. State of the art. Proceedings of a symposium. PMID- 2715982 TI - Evaluation of the murine metrial gland for immunological function. AB - The metrial gland (MG) is a transient uterine structure associated with rodent pregnancy. The gland is a complex structure consisting of stromal and vascular elements, as well as a population of histologically distinctive, large, granulated metrial gland (GMG) cells. The functions of the MG and of the GMG cells, as well as their relationship to the success of pregnancy, are unknown. Based upon morphological and morphometric studies it has been proposed that the MG might be involved in the immunology of pregnancy and that GMG cells could be immunocompetent. Explant cultures of MG have therefore been evaluated for immunological function. Lytic activity against the NK sensitive target cell line YAC and mitogen responsiveness could not be detected. MG tissue and medium conditioned by overnight culture of MG tissue (MG-CM) suppressed the response of murine spleen cells to Con A. MG-CM also reduced the lytic activity of splenic NK cells against YAC target cells. However, uptake of [3H]thymidine was elevated when YAC cells were cultured in MG-CM. The response of embryonic and uterine cells to growth in MG-CM was complex. MG-CM had little effect on isotope incorporation by decidual cells recovered at 6.5 days or by embryonic cells recovered from 12.5 day embryos. However, thymidine incorporation was less in MG CM than in control medium for 12.5 day placental cells, 6.5 day embryonic sac, 6.5 day ectoplacental cone and 3.5 day blastocysts. Cytotoxicity and cytostasis accounted for reduced uptake of isotope in cultures of 3.5 day blastocysts and 6.5 day embryonic tissues. Loss of viability could not be detected in any other assays. Both YAC cells and unstimulated splenocytes showed altered morphology and improved viability when cultured in MG-CM. This study suggests that the only immunological role the MG might have during normal pregnancy is that of non specific intra-uterine suppression. Alternatively, differential regulation of cell proliferation might be a function of the MG, within the pregnant uterus. The latter mechanism could also account for the apparent observation of non-specific immunosuppression. PMID- 2715984 TI - Reproducibility of the indirect immunobead assay for detecting sperm antibodies in serum. AB - Although an immunobead assay (IBA) for the detection of antisperm antibodies was developed several years ago and has been used for the study of immunologic infertility, no data regarding its variability and reproducibility are yet available. We evaluated the intraassay reproducibility of the indirect IBA by testing aliquots of antisperm-antibody-positive sera from two patients against the same donor sperm sample. The interassay reproducibility was evaluated by testing a positive serum sample first with different sperm samples from the same donor and second with sperm samples from different donors. The results of those experiments showed that the indirect IBA has very low intraassay variation and greater interassay variability. PMID- 2715985 TI - Autoimmunity as a factor in recurrent vaginal candidosis and the minor vestibular gland syndrome. AB - Chronic vaginal candidosis is a significant cause of morbidity in women, but its causes are not yet understood. We propose that in genetically susceptible women a candidal infection elicits responses that cross-react with self-antigens. Control of these deleterious responses may compromise the normal mechanisms of resistance and predispose to recurrent infection. Furthermore, the local inflammation caused by these autoreactive cells may contribute to other forms of vaginitis. PMID- 2715986 TI - Effect of heparin on umbilical arterial blood gases. AB - Arterial blood gas analysis was performed utilizing different heparin volumes and concentrations on 20 umbilical cord blood samples. A significant decrease in the bicarbonate concentration and base excess was found when 10,000 instead of 1,000 U/mL heparin was used to coat the syringe. When 0.2 mL of 1,000 U/mL heparin was added to 0.8 mL of blood, significant decline in the PCO2, base excess and bicarbonate concentration occurred. When 0.2 mL of 10,000 U/mL heparin was added to 0.8 mL of blood, a significant decline in the pH, PCO2, bicarbonate concentration and base excess was noted. Increasing the dilution and/or quantity of heparin in an umbilical arterial blood specimen may result in a significant misinterpretation of the fetal acid-base status by indicating a more significant chronic metabolic acidosis component than really exists. PMID- 2715987 TI - Peritoneal pockets and endometriosis. Confirmation of an important relationship, with further observations. AB - Of 132 women with endometriosis, almost one-fifth had peritoneal pockets. Two thirds of the structures had endometriosis either around the rim or inside. Since one-third of the pockets lacked endometriosis and fibrosis was not present as a possible cause, endometriosis does not seem to have been the likely primary cause. Rather, such peritoneal invaginations and endometriosis may be ontologically related to a separate codevelopmental factor. PMID- 2715988 TI - Significance of umbilical and uterine artery velocimetry in the well-controlled pregnant diabetic. AB - The measurement of umbilical and uterine artery velocity waveforms was used to study pregnancies complicated by diabetes. Continuous wave Doppler velocimetry was used to identify the umbilical and uterine artery velocity waveforms. A systolic:end diastolic ratio (S:D ratio) was calculated to analyze the obtained velocity waveforms. We treated 33 tightly controlled and monitored diabetic gravidas. The mean blood sugar value for this population was 95 +/- 8 mg/dL, and the mean umbilical artery S:D ratio was 2.5 +/- 0.3. That group of patients was compared to a group on which we reported previously. Statistically significant differences were found between the well-controlled and poorly controlled populations in third-trimester S:D ratios, number of stillbirths and neonatal morbidity. Uterine artery velocimetry allowed the identification of a patient who developed preeclampsia. This study seems to have indicated that umbilical and uterine artery velocimetry may have an adjunctive role in the surveillance of pregnancies complicated by diabetes. PMID- 2715989 TI - Relationship of admissions for false labor to perinatal outcome. AB - While false labor is a common clinical problem, little information exists for correlating hospital visits (for false labor) with the subsequent labor course or perinatal outcome. We evaluated the obstetric and perinatal outcomes in 112 consecutive patients with one or more hospital visits for false labor and compared them with those in matched controls. The only statistically significant difference was the incidence of oxytocin induction following premature rupture of the membranes in the false-labor group (16 vs. 6, chi 2 = 5.05, P less than .05). This study suggests that a previous false-labor admission does not increase the risk of a labor abnormality or suboptimum perinatal outcome. PMID- 2715990 TI - The thromboelastogram and circulating lupus anticoagulant. AB - Abnormal lupus anticoagulant (LA) levels, as measured with the activated partial tissue thromboplastin and tissue thromboplastin inhibition tests, are associated with a predisposition toward thromboembolic phenomena. Thromboelastogram (TEG) measurements have been proposed as a standardized assay to predict such a predisposition. We therefore correlated LA and TEG assessments in 46 women who were either apparently healthy controls or who had abnormal LA levels with such conditions as endometriosis and repeated pregnancy wastage. The coefficient of correlation (Rho) was .3282 (P = .025). Seven patients with an abnormal LA demonstrated a normal TEG, and eight with a normal LA exhibited an abnormal TEG. Only nine had concomitant LA and TEG abnormalities. We conclude that LA and TEG apparently are not interchangeable as predictors of a hypercoagulable state. While this study did not address which of the two assays has a better predictive value for thromboembolic phenomena, it suggested that each can identify a different patient population. PMID- 2715991 TI - IgG and IgA content of vaginal fluid during the menstrual cycle. AB - Immunoglobulin levels in cervicovaginal secretions during the menstrual cycle have not been well characterized biochemically. We determined the IgG and IgA concentrations in vaginal fluid obtained by patient self-sampling with an Ovu Trac aspirator. Vaginal fluid IgG levels were less than 1-270 mg/dL. On the average the levels of IgG were relatively high after menstruation, declined during the ovulatory phase and remained relatively low during most of the luteal phase. The IgA levels were less than 10 mg/dL, and many samples contained IgA at our assay's lower limits of detection (microradial immunodiffusion). The preovulatory and luteal phase levels of IgG and IgA in vaginal fluid were generally lower than those reported for cervical mucus, but the ovulatory phase IgG and IgA composition was comparable between vaginal fluid and cervical mucus. PMID- 2715992 TI - Fetal arrhythmia masquerading as fetal distress. A case report. AB - Apparent fetal distress noted during the monitoring of a 28-week fetus during elective cholecystectomy proved to be a fetal arrhythmia. Inappropriate intervention in the pregnancy was averted by accurate interpretation of the available information. PMID- 2715993 TI - Massive ascites as a complication of severe preeclampsia. A case report. AB - A woman with severe preeclampsia and a vertex presentation at 31 weeks' gestation delivered by cesarean section, at which time massive abdominal ascites was found. Over 2 L of ascitic fluid was removed at the time of the section. Due to the rate at which ascitic fluid was accumulating at the time of the section, an abdominal drain was placed. Over the next three days 12 L more of ascitic fluid was removed. PMID- 2715994 TI - Fetal distress associated with the anticardiolipin antibody and a history of intrauterine fetal demise. A case report. AB - A woman with a history of fetal demise, an elevated anticardiolipin antibody titer, lupus anticoagulant but no evidence of systemic lupus erythematosus received anticoagulation with heparin in adjusted subcutaneous doses. Daily fetal monitoring demonstrated reactive nonstress tests and normal biophysical profiles initially. At 30 weeks' gestation, however, repeated spontaneous decelerations developed, and fetal bradycardia necessitated delivery. The combination of a poor obstetric history and the presence of high cardiolipin antibody titers requires close fetal surveillance. The benefits of anticoagulation in this setting deserve further study. PMID- 2715995 TI - Use of pancuronium bromide to inhibit fetal movement during magnetic resonance imaging. A case report. AB - Magnetic resonance imaging has been of limited value in fetal evaluation due to the prolonged duration of image construction and uncontrolled fetal movement. This limitation can be overcome safely by immobilizing the fetus with an intramuscular injection of pancuronium bromide. PMID- 2715996 TI - Visual analogue scales as a measure of pain in arthritis: a study of overall pain and pain in individual joints at rest and on movement. AB - Visual analogue scales (VAS) for overall and individual joint pain at rest and on movement were completed by 105 patients with polyarthritis as part of a study of the relationship between overall pain and pain in individual joints. Not all subjects recorded pain on a conventional VAS although all had at least 2 painful joints on movement. At best only 25% of the variance in overall pain was explained by pain in individual joints. Our findings suggest that conventional overall measures of pain in arthritis may neglect aspects of pain experience which relate to individual joints and to pain on movement. PMID- 2715997 TI - The quality of pain in arthritis: the words patients use to describe overall pain and pain in individual joints at rest and on movement. AB - One hundred and five patients with polyarthritis chose from 14 sensory and 5 affective pain descriptors derived from the McGill Pain Questionnaire (MPQ), and completed visual analogue scales (VAS) for overall and individual joint pain at rest and on movement. The relative frequency of sensory pain descriptor choice varied for the 4 different circumstances of pain. Over one third of patients volunteered affective words not included in the MPQ. This study suggests that conventional overall measures of pain, such as the MPQ, when used for patients with arthritis may neglect differences in pain experience perceived in individual joints and on movement. PMID- 2715998 TI - Pseudotumor cerebri in systemic lupus erythematosus. AB - Raised intracranial pressure in the absence of an intracranial mass or hydrocephalus (pseudotumor cerebri) has been described in association with many conditions including systemic lupus erythematosus (SLE). Papilledema is often listed in textbooks as one of the neurologic manifestations in SLE. However, the occurrence of this unusual neuroophthalmological presentation is infrequently encountered. We describe 3 women with SLE and pseudotumor cerebri who responded well to corticosteroid therapy. PMID- 2715999 TI - Legionnaires' disease in a patient with rheumatoid arthritis treated with cyclosporine. AB - We report a patient with long-standing rheumatoid arthritis (RA) treated with cyclosporine A; she developed a flare of her arthritis and evidence of vasculitis, cavitary pulmonary disease, nephritis and hepatitis, and was found to have Legionella pneumophila serotype I infection. Cyclosporine is a relatively new and investigational therapy in RA. Thus, it is important that any unusual complications in patients with RA treated with cyclosporine should be documented. PMID- 2716000 TI - Atlantoaxial subluxation and hydrocephalus [corrected] in rheumatoid arthritis. AB - We report a case of rheumatoid arthritis with anterior and vertical atlantoaxial subluxation. Our patient developed severe spastic quadriparesis and pyramidal tract signs. Cephalic computerized tomogram scan showed evidence of evolutive communicating hydrocephalus and the odontoid peg protruding in the posterior fossa. The patient recovered after cerebral spinal fluid ventricle-peritoneal shunting and occipitocervical arthrodesis. No other neurologic complications occurred during a 6-year followup. PMID- 2716001 TI - Giant cell arteritis associated with pericarditis and pancreatic insufficiency in a patient with psoriatic arthritis. AB - A 63-year-old woman with psoriatic arthritis developed arthralgias and shoulder girdle myalgias which were controlled with amitriptyline. Some months later she presented with headache, jaw claudication, weight loss, and chest pain. Anemia of chronic disease, cholestasis, steatorrhea, and pericardial effusion were noted. Giant cell arteritis (GCA) was diagnosed on temporal artery biopsy and prednisone was begun. Her symptoms rapidly abated but steatorrhea continued. It is suggested that these problems were related to GCA. Physicians need to be alert to the diverse presentations of GCA. PMID- 2716002 TI - Temporal arteritis revealed by upper limb gangrene. AB - An 80-year-old white man presented with gangrenous lesions involving several distal phalanges of his left hand and an elevated erythrocyte sedimentation rate (ESR). Temporal artery biopsy showed patchy destruction of the internal elastic lamina by mononuclear cell infiltration, consistent with the diagnosis of temporal arteritis. After amputation of gangrenous lesions, he was discharged taking prednisone (60 mg/day). Twelve months after discharge there was no recurrence of ischemic manifestations and ESR was normal. Association of digital gangrene and elevated ESR should alert the clinician toward this diagnosis once other diseases such as atherosclerosis, scleroderma, lupus erythematosus, periarteritis nodosa have been ruled out. PMID- 2716003 TI - Sacroiliitis and brucellosis. AB - A 21-year-old Peruvian man presented with sacroiliitis, fever, elevated liver enzymes, abdominal and right scrotal pain. Brucellosis was diagnosed based on culture and serological data. Appropriate therapy led to full recovery. Our case presents a timely reminder that brucellosis should always be considered as part of the differential diagnosis of sacroiliitis. PMID- 2716004 TI - Hydroxychloroquine overdosage. PMID- 2716005 TI - Increased carbonyl content of proteins in synovial fluid from patients with rheumatoid arthritis. AB - The carbonyl content of proteins in the synovial fluid (SF) of patients with rheumatoid arthritis was significantly (p less than or equal to 0.10) elevated over levels in the SF of patients with osteoarthritis (OA). Other indicators of oxidative damage including catalse, ceruloplasmin, ferritin and superoxide dismutase also showed statistically significant differences (p less than or equal to 0.05) compared to patients with OA. PMID- 2716006 TI - A "state model" of renal function in systemic lupus erythematosus: its value in the prediction of outcome in 292 patients. AB - We defined a clinical staging of renal function in systemic lupus erythematosus (SLE) which uses inexpensive outpatient measures to serially stage patient status and then analyzed the disease course of 292 patients followed since 1968. The 4 mutually exclusive states used were (1) normal (creatinine less than 1.2 mg/dl and protein less than 2+ on dipstick); (2) proteinuria alone (creatinine less than 1.2 mg/dl and protein greater than or equal to 2+ on dipstick); (3) moderate filtration dysfunction (creatinine greater than or equal to 1.2 mg/dl and less than 4.0 mg/dl); and (4) severe azotemia (creatinine greater than or equal to 4.0 mg/dl). Duration in each state and subsequent transitions were incorporated in an assessment of outcome. Prognostic variables were found which predicted different outcomes within each of the 4 states. This stratification, based on renal function over time, provides a useful analytical tool for comparing subsets of patients with lupus. We found that serum complement (C3) predicted progression in state 1 and 2 as well as potential responders to therapy in state 3. No improvement was noted for patients in state 4. PMID- 2716008 TI - Patient communication and effective rheumatology. PMID- 2716007 TI - Pregnancy outcome and autoantibodies in connective tissue disease. AB - Pregnancy outcome before and after onset of disease and the association with present levels of anticardiolipin antibodies (aCL) and other autoantibodies were investigated in rheumatoid arthritis (RA) (117 patients), systemic lupus erythematosus (SLE) (74 patients), and systemic sclerosis (28 patients). Although 78% of the 81 pregnancies in patients with systemic sclerosis occurred before disease onset, pregnancy loss rate was highest in this disease (44%) but in RA (17%) and SLE (18%) was similar to a control population (16%). Elevated levels of IgG aCL were present in one of 4 patients with RA, in one of 5 patients with systemic sclerosis and in the only patient with SLE to have recurrent previous pregnancy loss. Congenital heart block occurred in one of 28 pregnancies from 17 anti-Ro (SSA) positive women with SLE. PMID- 2716009 TI - The mechanism of chondrocyte hydrogen peroxide damage. Depletion of intracellular ATP due to suppression of glycolysis caused by oxidation of glyceraldehyde-3 phosphate dehydrogenase. AB - Exposure of articular cartilage to H2O2 in vitro inhibits proteoglycan synthesis in a fashion which parallels the inhibition which occurs in cartilage in animal models of acute inflammation. Our study shows that exposure to H2O2 also inhibits other chondrocyte functions, including total protein and DNA synthesis. Since these intracellular biosynthetic processes require adenosine triphosphate (ATP), the effect of exposure of H2O2 on chondrocyte ATP was measured. Exposure to H2O2 caused an immediate (less than 2 min) dose dependent decrease in cartilage ATP levels--found to be due to the oxidative inactivation of glyceraldehyde-3 phosphate dehydrogenase (G-3-PDH). We suggest that intrachondrocyte oxidant damage occurs through oxidation of the sensitive thiol (-SH) residue at the active center of G-3-PDH, with subsequent reduction in the rate of glycolytic ATP synthesis and the intracellular concentration of ATP which is required for DNA, protein, proteoglycan and hyaluronic acid synthesis. PMID- 2716010 TI - In vitro effect of select nonsteroidal antiinflammatory drugs on the synthesis and activity of anabolic regulatory factors produced by osteoarthritic and rheumatoid synovial tissue. AB - Nutriment replenished conditioned media derived from cultures of osteoarthritic and rheumatoid synovial tissue contain factors of variable molecular weight, independent of prostaglandin activity, which are capable of reversibly down regulating cartilage matrix proteoglycan synthesis. Piroxicam significantly reduced anabolic suppressant factor production on an apparent selective basis. It could be shown to partially modify the chromatographic profile of newly synthesized osteoarthritic synovial tissue protein fractions containing suppressant activity. Dependent on experimental design, piroxicam also partially blocked inhibitory activity at a chondrocyte level. Indomethacin and sodium salicylate were essentially without effect. PMID- 2716011 TI - Oligolamellar lubrication of joints by surface active phospholipid. AB - Six studies have been undertaken to test the hypothesis that oligolamellar phospholipid adsorbed to the articular surface contributes to joint lubrication. Synovial fluid (SF) proved highly surface active, rapidly depositing phosphatidylcholine (DPPC) on glass surfaces, rendering them hydrophobic--a property of well rinsed articular surface removable by the same fat solvents known to increase joint friction by 150%. Electron microscope studies demonstrated lamellar bodies (surface active DPPC) on the articular surface and in SF and lamellated phospholipid in light scrapings of joint surfaces. These were consistent with the quantity of phospholipid recovered by solvent rinsing. Friction measurements in vitro demonstrated excellent boundary lubrication imparted by multimolecular layers of DPPC under high load with coefficients of kinetic friction reaching physiological ranges (0.002-0.005). PMID- 2716012 TI - Electron microscopic studies of muscle biopsy in primary fibromyalgia syndrome: a controlled and blinded study. AB - Trapezius muscle biopsy was carried out in 21 patients with primary fibromyalgia syndrome (PFS) and 11 healthy controls, and assessed blindly by electron microscopy. Common findings in both the PFS and control groups were mild myofibrillar separation, papillary projections and subsarcolemmal accumulation of glycogen. However, the differences between the 2 groups were not statistically significant in any of the findings. PMID- 2716013 TI - Management of intra-oral squamous cell carcinoma. PMID- 2716014 TI - Wind of change. III. The Royal Colleges. PMID- 2716015 TI - Cavernous haemangioma of the head and neck in the adult. AB - This paper reviews a personal experience of 51 cases seen over a 30 year period. Patients were treated in either a combined Head and Neck clinic or a Combined Ophthalmology clinic and a balanced view is thus represented. A method of grading the severity of the disease is described as well as a method of assessing response. This approach has not been proposed hitherto. It is generally concluded that the preferred treatment for small lesions is excisional surgery and for larger lesions carefully planned and highly localized radiation. PMID- 2716016 TI - Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? AB - To investigate the present status of pulmonary embolism as a cause of death in a general hospital patient population, a 5-year retrospective study of all autopsy reports and associated hospital records was undertaken. Pulmonary embolism was thought to be the cause of death in 239 of 2388 autopsies performed (10%): 15% of these patients were aged less than 60 years and 68% did not have cancer. Of these patients, 83% had deep-vein thrombosis (DVT) in the legs at autopsy, of whom only 19% had symptoms of DVT before death. Only 3% of patients who had DVT at autopsy had undergone an investigation for such before death. Twenty-four per cent of patients who died from pulmonary embolism had undergone surgery a mean of 6.9 days before. Screening tests for DVT should be applied widely in the hospital population. PMID- 2716017 TI - Meningitis after splenectomy. AB - Five splenectomized patients suffered six episodes of bacterial meningitis with positive cerebrospinal fluid cultures. They were admitted to the Nottingham hospitals between 1974 and 1985. The infecting organism in all cases was Streptococcus pneumoniae. Only one patient, who survived, had had pneumococcal vaccine; two patients died in spite of intensive therapy. There is now good evidence for giving prophylactic penicillin to asplenic patients but the efficacy of the pneumococcal vaccine remains uncertain. PMID- 2716018 TI - Myalgic encephalomyelitis-a warning: discussion paper. PMID- 2716019 TI - Strategies for counselling the 'worried well' in relation to AIDS: discussion paper. PMID- 2716020 TI - An infant with chronic articular and cutaneous manifestations: a new syndrome? PMID- 2716021 TI - Clinical diversity of the Shy-Drager syndrome: a case in Hong Kong. PMID- 2716022 TI - Long term survival of male homosexual patients with Kaposi's sarcoma. PMID- 2716024 TI - Acalculous cholecystitis. PMID- 2716023 TI - Steroid responsive haemolytic anaemia due to dextropropoxyphene paracetamol combination. PMID- 2716025 TI - Fireworks and the eye. PMID- 2716026 TI - Early experience with gamete intrafallopian transfer (GIFT) and direct intraperitoneal insemination (DIPI) PMID- 2716027 TI - Origins of the AIDS viruses, HIV-1 and HIV-2: fact or fiction. PMID- 2716028 TI - Case-control studies and risk factors for cataracts. PMID- 2716029 TI - Research on traditional Chinese acupuncture--science or myth. PMID- 2716030 TI - Familial 'hashitoxic' periodic paralysis. PMID- 2716031 TI - Heart murmur: diagnostic tools. PMID- 2716032 TI - Molecular genetics as a diagnostic service. PMID- 2716033 TI - Demand for DNA probe testing in three genetic centres in Britain (August 1986 to July 1987). AB - We report a preliminary analysis of the data collected during the first year of the evaluation of clinical genetics in the context of DNA probes in three genetic centres, to show the pattern of the demand for genetic services in the three centres and the services used in meeting that demand. The analysis includes information on 10,185 persons from 2852 families. The results are presented according to mode of inheritance and according to the most common disorders for which DNA probes have been used in the three centres. The results indicate that the use of DNA probes is now a major element of activity in genetic departments, and that as long as indirect DNA probe testing is the predominant manner of using recombinant technology, the clinical input will be an important element of the costs, probably more so than that of the DNA laboratories, as a large number of family members needs to be tested. In most cases centres have concentrated activity on DNA testing for common and severe genetic disorders. However, there are disorders, such as familial hypercholesterolaemia, which have not been part of the established pattern of services. Conversely, a relatively high number of families have been studied for some disorders of very low incidence. This suggests that the number of DNA laboratories should be limited. The precise arrangements will need to be established. With such services the distribution of DNA testing facilities for different disorders can be controlled to limit duplication. The model followed in Scotland based on collaboration between centres is worth considering. We have detected very large differences in take up rate of services within and between regions. Although many factors may contribute to these differences, ease of access and lay and professional awareness are probably the most important. This is supported by the fact that more patients from the same or neighbouring DHAs attend the genetic centre than from those further away. We also concluded that published guidelines for clinicians in general on the uses of DNA probes, the type of families that could benefit, and the centres to which referrals should be sent would be very useful in increasing coverage and maximising the effectiveness of the services. Since this may increase demand, this educative tool should be coordinated and agreed by the Departments of Health with all the genetic departments and centres in the country. PMID- 2716034 TI - Guidelines for DNA banking. Report of the Clinical Genetics Society working party on DNA banking. PMID- 2716035 TI - Becker muscular dystrophy (BMD) and Klinefelter's syndrome: a possible cause of variable expression of BMD within a pedigree. AB - We describe a man with Becker muscular dystrophy whose weakness was minimal in contrast to that of his more severely affected nephews. This man had a Klinefelter karyotype (47,XXY) and his mild symptoms may be attributed to him being heterozygous for the muscular dystrophy gene. This is the first report of a person with both Klinefelter's syndrome and Becker muscular dystrophy. This combination may be one explanation for the variable expression of X linked muscular dystrophy noted in some pedigrees. PMID- 2716036 TI - Consanguinity related prenatal and postnatal mortality of the populations of seven Pakistani Punjab cities. AB - A retrospective study was conducted on prenatal and postnatal mortality among the populations of seven cities in the Pakistani province of Punjab. Consanguineous marriages were strongly favoured and the coefficients of inbreeding (F) for the present generation in each locality ranged from 0.0236 to 0.0286. There was a highly significant relationship between the degree of inbreeding and mortality, with most consanguinity related deaths reported in the neonatal, infantile, and childhood periods. The findings strongly suggest that consanguinity may play a major role in the high rates of postnatal mortality observed in Pakistani communities now resident in the United Kingdom. PMID- 2716037 TI - Thanatophoric dysplasia in identical twins. AB - Female twins concordant for thanatophoric dysplasia are presented. Monozygosity was confirmed using minisatellite DNA genetic fingerprinting. The evidence supporting new dominant mutations as the likely cause of thanatophoric dysplasia is reviewed. PMID- 2716038 TI - Gastrointestinal abnormalities in the syndrome of mosaic trisomy 9. PMID- 2716039 TI - Hirschsprung's disease, distinctive facies, and microcephaly. PMID- 2716040 TI - Plasma alpha-tocopherol, retinol, cholesterol, and mineral concentrations in captive gorillas. AB - Vitamins A, E, cholesterol, and mineral (calcium, copper, iron, magnesium, phosphorus, selenium, sodium, and zinc) concentrations were examined in the plasma of 74 captive lowland gorillas aged newborn to 41 years. Effects of age or sex on measured parameters were not significant. Plasma Mg and Ca concentrations were lower than reported captive gorilla means, whereas Na and P were higher. Since comparative gorilla values for certain blood components (vitamins E and A, copper, and selenium) are lacking, normal human values may provide the best available indicators for evaluating the plasma levels of these components in gorillas. PMID- 2716041 TI - Assay and characteristics of the iron binding moiety of reticulocyte endocytic vesicles. AB - A 59Fe assay was designed to detect an Fe(III) binding capacity in NP-40 solubilized proteins from rabbit reticulocyte endocytic vesicles. The iron binding capacity had an apparent molecular weight as determined by gel exclusion chromatography of 450,000 daltons. The iron binding moiety coincided with the major nontransferrin iron-containing material of endocytic vesicles labeled in vivo by incubation of cells with 59Fe, 125I-labeled transferrin. The material solubilized from vesicles with NP-40 exhibited two classes of saturable binding sites, one with an association constant for 59Fe-citrate of 3.63 x 10(9) M-1 and with 6.6 x 10(-12) moles of iron bound per mg protein and the other with a constant of 3.96 x 10(8) M-1 and 1.0 x 10(-12) moles of iron bound per mg protein. These affinities are sufficient to satisfy the solubility characteristics of Fe(III) at pH 5.0. Most of the 59Fe bound both in vivo and in vitro to the iron binding moiety could be displaced with 56Fe and an equivalent amount of 59Fe could subsequently be rebound in vitro. The iron binding assay was adopted to vesicle proteins separated by SDS-polyacrylamide gel electrophoresis with subsequent transfer to nitrocellulose and revealed an iron binding activity of molecular weight approximately 95,000 daltons. PMID- 2716042 TI - Activation of chloride conductance in pig jejunal brush border vesicles. AB - Requirements for the activation of Cl- conductance have been investigated in pig jejunal brush border vesicles. The stability of ATP as a substrate for protein kinase activity, the stability of the phosphoprotein product of protein kinase action, and the choice of buffer system used for vesicle preparation were studied as variables which affected the outcome of in vitro activation attempts. Arsenate was selected as the most effective agent in protecting ATP from hydrolysis by the phosphatase activity in this vesicle system. Brush border vesicle protein appeared to prevent the accumulation of phosphoprotein in a cAMP-dependent protein kinase reaction, and vesicle protein only had phosphate acceptor activity when KF was added as a presumptive inhibitor of phosphoprotein phosphatase. A Cl- conductance response to a potassium gradient and valinomycin was present in vesicles prepared in buffers containing tetramethylammonium. Cl- conductance activity was not increased in this system by the addition of ATP, dibutyryl cyclic AMP, and cyclic AMP-dependent protein kinase. There was no Cl conductance response to a potassium gradient in vesicles buffered with imidazolium-acetate. Incorporation of ATP, AsO4(3-), and F- into these nonconductive vesicles by homogenization, followed by addition of dibutyryl cAMP, produced substantial conductance activity. Maximal activation of Cl- conductance was obtained with vesicles prepared in imidazolium-acetate buffering, using precautions to stabilize ATP and phosphoprotein prior to conductance measurements. PMID- 2716043 TI - Validation of the use of the lipophilic thiocyanate anion for the determination of membrane potential in Ehrlich ascites tumor cells. AB - The utility of the lipophilic anion thiocyanate (SCN-) as a probe for the indirect estimation of the cell membrane potential (Vm) in Ehrlich ascites tumor cells has been evaluated by comparison to direct electrophysiological measurements. SCN accumulation is consistent with first-order uptake into a single, kinetically-identifiable cellular compartment, achieving steady-state distribution in 20-30 min at 22 degrees C. The steady state distribution ratio ([SCN-]e/[SCN-]e) in physiological saline is 0.44 +/- 0.02. Treatment of the cells with propranolol (0.13 mM), an activator of Ca2+ dependent K+ channels, reduces the steady-state distribution ratio to 0.19 +/- 0.02. Conversely, treatment with BaCl2 (10 mM), an antagonist of the pathway, increases the SCN- distribution ratio to 0.62 +/- 0.01. The equilibrium potentials (VSCN) calculated under these conditions are virtually identical to direct electrophysiological measurements of the Vm made under the same conditions. The effect of varying extracellular [K+] ([K+]e) in the presence of constant [Na+]e = 100 mM has also been tested. In control cells, elevation of [K+]e from 6 to 60 mM reduces VSCN from -20.6 +/- 1.0 to -13.2 +/- 1.2 mV. Again, microelectrode measurements give excellent quantitative agreement. Propranolol increases the sensitivity of the cells to varying [K+]e, so that a 10-fold elevation reduces VSCN by approximately 31 mV. BaCl2 greatly reduces this response: a 10-fold elevation in [K+]e yielding only a 4-mV reduction in VSCN. It is concluded that the membrane potential of Ehrlich cells can be estimated accurately from SCN- distribution measurements. PMID- 2716044 TI - Isolation of plasma membrane complexes from Xenopus oocytes. AB - A method for the isolation of plasma membrane fractions from Xenopus oocytes has been developed, and the membranes have been characterized biochemically and morphologically. Plasma membrane complexes prepared by this procedure consisted of large sheets of the membrane, with associated vitelline envelope (a nonmembranous meshwork of fibers) and cortical (secretory) granules still attached. The morphology of cell surface microvilli and coated pits was well preserved. Cortical granules were removed by gentle homogenization in a low ionic strength medium, and integral and peripheral membrane proteins were then separated from vitelline envelopes by detergent extraction and phase separation in Triton-X-114. Biochemical characterization of the plasma membrane fractions indicated substantial levels of 5'-nucleotidase and alkaline phosphodiesterase activity associated with the oocyte cell surface, with 44-66% recovery of these markers in the final membrane preparations. Lectin blotting and lectin affinity chromatography with Concanavalin A and wheat germ agglutinin were used to characterize the major glycoprotein species associated with the plasma membrane complexes. Plasma membrane fractions prepared by this procedure should be very useful in both biochemical and morphological studies of membrane protein sorting in the Xenopus oocyte system. PMID- 2716045 TI - Shape determinants of McLeod acanthocytes. AB - We have sought to elucidate the spiculated shape of McLeod erythrocytes. Red cells from a normal donor and from a McLeod patient were incubated in phosphate buffered saline containing 0, 0.05, or 0.1 mM chlorpromazine at 0 degrees C for 5 min, then glutaraldehyde-fixed, and examined by scanning electron microscopy. The normal red cells were biconcave disks in which chlorpromazine induced inward (negative) curvature: deep cupping (stomatocytosis) and multiple invaginations. The McLeod cells were mostly spiculated. Chlorpromazine at lower concentration converted them into biconcave disks and, at higher concentration, into stomatocytes. These results support the hypothesis that the spiculation of McLeod cells is the result of an imbalance of surface area between the two lipid leaflets of the membrane; that is, a bilayer couple effect. We determined the numerical density of intramembrane particles (IMP) in replicas of both fracture faces of red cells subjected to freeze fracture and rotary shadowing. These values were as follows (expressed per microns 2 of membrane +/- SD): the normal protoplasmic fracture face had 2200 +/- 306 and the McLeod had 2300 +/- 250. The normal exoplasmic fracture face had 388 +/- 75 and the McLeod had 330 +/- 59. We conclude that there is no evidence for derangement of band 3, the principal protein in the IMP, in McLeod erythrocytes. PMID- 2716046 TI - Quantitative analysis of outward rectifying K+ channel currents in guard cell protoplasts from Vicia faba. AB - A quantitative analysis of the time and voltage dependence of outward-rectifying K+ currents (IK+, out) in guard cells from Vicia faba is described using the whole-cell patch-clamp technique. After step depolarizations from -75 mV to potentials positive to -40 mV, time-dependent outward currents were produced, which have recently been identified as K+ channel currents. This K+ current was characterized according to its time dependence and its steady-state activation. IK+, out could be described in terms of a Hodgkin-Huxley type conductance. Activation of the current in time was sigmoid and was well fitted by raising the activation variable to the second power. Deactivating tail currents were single exponentials, which suggests that only one conductance underlies this slow outward K+ current. Rates of channel closing were strongly dependent on the membrane potential, while rates of channel opening showed only limited voltage dependence leading to a highly asymmetric voltage dependence for channel closing and opening. The presented analysis provides a quantitative basis for the understanding of IK+, out channel gating and IK+, out channel functions in plant cells. PMID- 2716047 TI - Ouabain-induced cell swelling in rabbit cortical collecting tubule: NaCl transport by principal cells. AB - Ouabain had no effect on the volume of intercalated cells of DOCA-stimulated rabbit cortical collecting tubules, but caused principal cells to swell rapidly at an initial rate of 67%/min. Principal cells swelled 133% then activated regulatory volume decrease mechanisms and shrank at an initial rate of -3%/min to a new volume 13% above control. The initial rate of ouabain swelling was completely inhibited by perfusate Na+ removal or reduced 95% by luminal addition of 10(-5) M amiloride. Luminal, peritubular, or bilateral Cl- removal each caused cell shrinkages of 10% and reduced the rate of ouabain swelling by 70, 85, and 99%, respectively. The presence of an apical Cl- transport step in principal cells was confirmed by increasing luminal K+ from 5 to 53 mM, which caused cell swelling of 22%. This volume increase was completely blocked by luminal Cl- removal, but was unaffected by peritubular Cl- substitution. Perfusion of CCT with 0.1 mM acetazolomide, 0.1 mM DPC or 0.5 mM SITS caused principal cell shrinkages of 7-9% and reduced the rate of ouabain swelling by 60, 70, and 40%, respectively. The initial rate of ouabain swelling was inhibited 70% by bilateral CO2/HCO3 removal and 50% by whole animal acid loading. Taken together these results demonstrate that ouabain swelling is due to cellular NaCl accumulation and that Na+ enters the cell primarily through apical Na+ channels. Cellular Cl- entry occurs at least partially through the apical membrane and may be mediated by a Cl-/HCO3- exchanger. Brief (45-90 sec) exposure of principal cells to ouabain is associated with a rapid inhibition of Na+ and/or Cl- entry steps, whereas long-term (greater than 5 min) ouabain exposure completely blocks one or both of these transport pathways. PMID- 2716049 TI - Cytosine-specific type II DNA methyltransferases. A conserved enzyme core with variable target-recognizing domains. AB - Comparisons of the amino acid sequences of m5C DNA methyltransferases (Mtases) from 11 prokaryotes and one eukaryote reveal a very similar organization. Among all the enzymes one can distinguish highly conserved "core" sequences and "variable" regions. The core sequences apparently mediate steps of the methylation reaction that are common to all the enzymes. The major variable region has been shown in our previous studies on multispecific phage Mtases to contain the target-recognizing domains (TRDs) of these enzymes. Here we have compared the amino acid sequences of various TRDs from phage Mtases. This has revealed the presence of both highly conserved and variable amino acids. We postulate that the conserved residues represent a "consensus" sequence defining a TRD, whereas the specificity of the TRD is determined by the variable residues. We have observed similarity between this consensus sequence and sequences in the variable region of the monospecific Mtases. We predict that the regions thus identified represent part of the TRDs of monospecific Mtases. PMID- 2716048 TI - Integral and peripheral protein composition of the apical and basolateral membrane domains in MDCK cells. AB - Selective biotinylation of the apical or basolateral domains of confluent MDCK monolayers grown on polycarbonate filters with a water soluble biotin analog, sulfo-NHS-biotin, was employed to reveal strikingly distinct patterns of endogenous "peripheral" and "integral" membrane proteins. "Peripheral" proteins were found to be approximately fivefold more abundant with this procedure than "integral" membrane proteins, both on the apical and on the basolateral surface. The distinct apical and basal patterns were shown to depend upon the integrity of the monolayer; when the tight junctions were disrupted by preincubation in calcium-depleted medium, the patterns appeared practically indistinguishable. Two dimensional gel electrophoresis demonstrated that only a very small percentage of the biotinylated proteins were found in similar amounts on both apical and basolateral domains. These results indicate that the sorting mechanisms that segregate apical and basolateral epithelial proteins are very strict. The simple procedure described here has clear advantages over other methods available to label apical and basal epithelial surface domains, namely, higher accessibility of the biotin probe to the basolateral membrane, possibility of purifying biotinylated proteins via immobilized streptavidin and minimal exposure of the researcher to isotopes. It should be very useful in characterizing the apical and basolateral protein compositions of other epithelial cells and in studies on the development of epithelial cell polarity. PMID- 2716050 TI - Concerning the axial rotational flexibility of the Fab regions of immunoglobulin G. AB - By electron microscopy, we have observed immunocomplexes with both negative stain and in amorphous ice using monoclonal antibodies directed against one of the 24 subunits of scorpion haemocyanin. A copy of this subunit occurs at each of the corners of the square-shaped haemocyanin molecule. Three distinct orientations of adjacent haemocyanin molecules may be observed in immunocomplex pairs or chains using both the above-mentioned methods. These observations, coupled with low resolution computer simulations of immunocomplex formation, argue strongly in favour of the existence of a considerable degree of rotational flexibility within the IgG molecule and around the long axis of the Fab arms, as was suggested by previous observations with negative stain. We find that the arms can rotate by up to 180 degrees with respect to the Fc region. PMID- 2716051 TI - Electron microscopic mappings of myosin head with site-directed antibodies. AB - Site-directed antibodies were raised against three synthetic peptides whose sequences correspond to a region around the reactive lysine residue and two protease-sensitive regions of subfragment 1 (S1) of skeletal muscle myosin (one at the junction of the 23,000 Mr and 50,000 Mr segments, the J1 junction; and the other at the junction of the 50,000 Mr and 20,000 Mr segments of the heavy chain, the J2 junction). The antisera cross-reacted with intact myosin with titres of 5 x 10(4) (anti-J1 antiserum) and 10(4) (anti-J2 and anti-reactive lysine residue antisera). Site-specific antibodies purified by S1-Sepharose readily bound to myosin. Electron microscopic examinations of antibody-myosin complexes revealed that the J1 and J2 junctions are located 15 nm and 16 nm from the head-rod junction, respectively, while the reactive lysine residue region is 13 nm from the junction. PMID- 2716052 TI - X-ray structure of lipoamide dehydrogenase from Azotobacter vinelandii determined by a combination of molecular and isomorphous replacement techniques. AB - The crystal structure of lipoamide dehydrogenase from Azotobacter vinelandii has been determined by a combination of molecular replacement and isomorphous replacement techniques yielding eventually a good-quality 2.8 A electron density map. Initially, the structure determination was attempted by molecular replacement procedures alone using a model of human glutathione reductase, which has 26% sequence identity with this bacterial dehydrogenase. The rotation function yielded the correct orientation of the model structure both when the glutathione reductase dimer and monomer were used as starting model. The translation function could not be solved, however. Consequently, data for two heavy-atom derivatives were collected using the Hamburg synchotron facilities. The derivatives had several sites in common, which was presumably a major reason why the electron density map obtained by isomorphous information alone was of poor quality. Application of solvent flattening procedures cleaned up the map considerably, however, showing clearly the outline of the lipoamide dehydrogenase dimer, which has a molecular weight of 100,000. Application of the "phased translation function", which combines the phase information of both isomorphous and molecular replacement, led to an unambiguous determination of the position of the model structure in the lipoamide dehydrogenase unit cell. The non crystallographic 2-fold axis of the dimer was optimized by several cycles of constrained-restrained least-squares refinement and subsequently used for phase improvement by 2-fold density averaging. After ten cycles at 3.5 A, the resolution was gradually extended to 2.8 A in another 140 cycles. The 2.8 A electron density distribution obtained in this manner was of much improved quality and allowed building of an atomic model of A. vinelandii lipoamide dehydrogenase. It appears that in the orthorhombic crystals used each dimer is involved in contacts with eight surrounding dimers, leaving unexplained why the crystals are rather fragile. Contacts between subunits within one dimer, which are quite extensive, can be divided into two regions separated by a cavity. In one of the contact regions, the level of sequence identity with glutathione reductase is very low but it is quite high in the other. The folding of the polypeptide chain in each subunit is quite similar to that of glutathione reductase, as is the extended conformation of the co-enzyme FAD.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2716053 TI - Engineering protein thermal stability. Sequence statistics point to residue substitutions in alpha-helices. AB - Amino acid sequences have been compared for thermophilic and mesophilic molecules from six different protein families, which include lactate and glyceraldehyde-3 phosphate dehydrogenases, triose phosphate isomerases, superoxide dismutases, thermolysins and subtilisins. Since a three-dimensional structure was known for at least one of the sequences in each family, analysis of preferred residue substitutions, presumably to achieve thermal stability, could be examined from a structural context. The overall results, which are generally consistent across all the families, suggested decreased flexibility and increased hydrophobicity in alpha-helical regions as the main stabilizing principles. The most favoured residual exchanges, hopefully useful in engineering stability into proteins, are discussed. PMID- 2716054 TI - 1H nuclear magnetic resonance assignments and secondary structure of porcine C5ades Arg. AB - Sequence-specific assignments of the 1H nuclear magnetic resonance spectrum of porcine C5ades Arg are described. Assignments were facilitated by comparison of spectra obtained in H2O with partially exchanged spectra obtained in 2H2O. The sequence-specific assignments thus obtained were used to characterized the regular secondary structure in the protein, which is helical in the regions 2 to 11, 16 to 27, 35 to 41 and 45 to 64. The structure is very similar to that of human and bovine C5a. PMID- 2716055 TI - Genomic organization of the glyceraldehyde-3-phosphate dehydrogenase gene family of Caenorhabditis elegans. AB - Glyceraldehyde-3-phosphate dehydrogenase (GAPDHase) is encoded by four genes designated gpd-1 through gpd-4 in the nematode Caenorhabditis elegans. gpd-1 has been isolated and sequenced, and is shown here to have a nearly identical copy (gpd-4) with respect to coding and regulatory flanking sequence information as well as to the placement of its two introns. Both genes, which are separated by 250,000 to 300,000 base-pairs were assigned to chromosome II by in situ hybridization and physically linked to a DNA polymorphism located near unc-4 on the genetic map. The genes gpd-2 and gpd-3 are also nearly identical with each other but differ from the gpd-1 and gpd-4 pair with respect to the positions of their two introns and a cluster of amino acid changes within the amino-terminal region of the enzyme. Furthermore, one gene from each pair (gpd-4 and gpd-2) exhibits a single amino acid substitution at positions heretofore known to be conserved in all other systems so far examined including the extreme thermophiles. gpd-2 and gpd-3 are organized as a direct tandem repeat separated by only 244 base-pairs. They have been assigned to an 85,200 base-pair contig that maps to the left end of the X chromosome. The absence of gpd-3 from C. elegans var. Bergerac was used as a marker to map the gpd-2,3 gene pair near unc 20. Northern analyses have shown that gpd-1 and gpd-4 are preferentially expressed in embryos, while the expression of gpd-2 and gpd-3 increases during postembryonic development. These analyses indicate that the gpd-1,4 gene pair encodes the minor isoenzyme, GAPDHase-1, present in all cells of the nematode while the other gene pair (gpd-2,3) encodes the major isoenzyme, GAPDHase-2, preferentially expressed in the bodywall muscle. The G + T-rich and T-rich regions essential for vertebrate beta-globin polyadenylation were also observed for gpd-3. PMID- 2716056 TI - Replication in vivo of mutant brome mosaic virus RNAs defective in aminoacylation. AB - In order to understand the relationship between replication and aminoacylation of the genomic RNAs of brome mosaic virus, the replication of four mutants, whose RNAs were expected (on the basis of their properties in vitro) to be inefficiently tyrosylated in vivo, was studied in barley protoplasts and plants. Test inocula consisted of capped transcripts of wild-type RNAs 1 and 2, and of RNA 3 variants with defined mutations in the 3' tRNA-like region. Mutant 5'PsK, which is defective in minus-strand promoter activity and a poor substrate in vitro for both tyrosylation and 3' adenylation, replicated in protoplasts to 20% of wild-type even though only about 6% of the progeny molecules had correct 3' termini that would permit tyrosylation. Mutant psi GG, which is defective in vitro for 3' adenylation and minus-strand promoter activities but accepts tyrosine at near-normal rates, replicated to 40% of wild-type in protoplasts although only 15% of the progeny molecules had correct 3' termini. Two other mutants (delta 5' and 5'AGA), with 20-fold lower rates of tyrosylation in vitro than wild-type RNA, replicated to 60 to 70% of wild-type levels in protoplasts and gave similar yields to wild-type in systemic infections of plants. All mutant sequences were preserved in progeny RNAs, indicating that no recombination between homologous 3' ends occurred. The 40% reduction of replication in protoplasts seen for mutant delta 5', whose only known functional lesion is depressed tyrosylation in vitro, may indicate that an indirect role for aminoacylation exists. However, the results obtained argue against an obligatory role for tyrosylation in RNA replication in vivo. PMID- 2716057 TI - Use of selectively trypsinized nucleosome core particles to analyze the role of the histone "tails" in the stabilization of the nucleosome. AB - Using immobilized trypsin and an appropriate fractionation procedure, we have been able to prepare, for the first time, nucleosome core particles containing selectively trypsinized histone domains. The particles thus obtained: [(H3T-H4T)2 2(H2AT-H2BT)].DNA; [(H3-H4)2-2(H2AT-H2BT)].DNA; [H3T-H4T)2-2(H2A-H2B)].DNA (where T means trypsinized), together with the non-trypsinized controls have been characterized using the following techniques: analytical ultracentrifugation, circular dichroism, thermal denaturation and DNAse I digestion. The major aim of this study was to analyze the role of the amino-terminal regions (the histone "tails") on the stability of the nucleosome in solution. The data obtained from this analysis clearly show that stability of the nucleosome core particle to dissociation (below a salt concentration of 0.7 M-NaCl) is not affected by the presence or the absence of any of the N-terminal regions of the histones. Furthermore, these histone regions make very little contribution, if any, to the conformational transition that nucleosomes undergo in this range of salt concentrations. They play, however, a very important role in determining the thermal stability of the particle, as reflected in the dramatic alterations exhibited by the melting profiles upon selective removal of these tails by trypsinization. The melting data can be explained by a simple hypothesis that ascribes interaction of H2A/H2B and H3/H4 tails to particular regions of the nucleosomal DNA. PMID- 2716058 TI - Co-operativity in protein-protein association. The structure and stability of the actin filament. AB - Co-operative association, in which a protein subunit is held simultaneously by two bonds, is enormously more favorable than association forming either bond alone. A theoretical framework for calculating the effect of co-operativity is developed here, which should have a broad application to protein-protein and protein-DNA associations. The theory is applied in detail to actin. Fragmentation of an actin filament is extremely unfavorable: the association constant for annealing-fragmentation is estimated here to be at least 10(13) M-1. In contrast to these very strong bonds within the filament, subunits are loosely attached at the end, with an association constant of 2 x 10(5) M-1. The eight orders of magnitude difference between annealing-fragmentation and end association can be attributed to the co-operative formation of one additional protein-protein bond in the annealing reaction. This observation, and a quantitative analysis of the co-operativity, lead to an important conclusion: the longitudinal bond, which connects subunits in the long-pitch helix, must be substantially stronger than the diagonal bond, which connect subunits between these helices. This conclusion contradicts some recent models based on Fourier construction, in which the longitudinal bond is weak or absent. Prominent longitudinal bonds also require a rigidity of the actin filament that must be reconciled with previous reports of torsional flexibility. A hinge within the actin subunit is suggested, separating it into two flexibly attached domains. In one possible model the two domains are oriented radially: the inner domains are connected by longitudinal and diagonal bonds to form a relatively rigid helical backbone, and the outer domains are attached to this backbone by flexible hinges, permitting them to move through angles of 10 degrees to 20 degrees or more. Flexibility of the outer, myosin binding domain should be functionally important, permitting attachment of myosin cross-bridges over a range of angles. PMID- 2716059 TI - X-ray crystal structure of the blue oxidase ascorbate oxidase from zucchini. Analysis of the polypeptide fold and a model of the copper sites and ligands. AB - Two crystal forms of the multi-copper protein ascorbate oxidase from Zucchini have been analysed at 2.5 A (1 A = 0.1 nm) resolution and a model of the polypeptide chain and the copper ions and their ligands has been built. Crystal forms M2 and M1 contain a dimer of 140,000 Mr and a tetramer of 280,000 Mr, respectively, in the asymmetric unit. The crystallographic analysis proceeded by multiple isomorphous replacement in M2 followed by solvent flattening and averaging about the local dyad axis. M1 was solved by Patterson search techniques using the M2 electron density. M1 was fourfold averaged. M1 and M2 were combined and the process of averaging repeated in cycles. An atomic model was built into the resulting electron density map and refinement initiated. The current R values of M2 and M1 are 24.5% and 32.6%, respectively. Excellent stereo chemistry was maintained, with root-mean-square deviations of bond lengths and bond angles from average values of 0.02 A and 3.1 degrees, respectively. Each subunit of about 550 amino acid residues has a globular shape with dimensions of 49 A x 53 A x 65 A. It is built up by three domains arranged sequentially on the polypeptide chain and tightly associated in space. The folding of all three domains is of a similar beta-barrel type. It is distantly related to plastocyanin. Each subunit has four copper atoms bound as mononuclear and trinuclear species. The mononuclear copper has two histidine, a cysteine, and a methionine ligand and represents the type-1 copper. It is located in the third domain. The trinuclear cluster has eight histidine ligands. It may be subdivided into a pair of copper atoms with six histidine ligands arranged trigonal prismatic. The pair probably represents the type-3 copper. The remaining copper has two histidine ligands. Its third site of co-ordination is formed by the pair of copper atoms. The fourth ligand may be OH- represented by a small protrusion of electron density. This copper probably is the type-2 copper. The symmetry of the trinuclear cluster is C2 and the ligands are supplied symmetrically by domains 1 and 3. However, domain 1 does not contain a type-1 copper and lacks the characteristic ligands. The unprecedented trinuclear cluster probably represents the oxygen binding and electron storage site. PMID- 2716060 TI - Pseudo 2-fold symmetry in the copper-binding domain of arthropodan haemocyanins. Possible implications for the evolution of oxygen transport proteins. AB - Investigation of the copper-binding centre of Panulirus interruptus haemocyanin led to the discovery of a pseudo 2-fold axis relating two helical pairs surrounding and co-ordinating the two copper ions. The pseudo 2-fold symmetry relating one helical pair, co-ordinating Cu-A, to the second helical pair co ordinating Cu-B is quite precise with 31 equivalent C alpha atoms having a root mean-square deviation of only 1.47 A. The 2-fold consists of a rotation of 174.6 degrees and a translation parallel to the rotation axis of 0.7 A. After superposition of the helical pairs, the two copper ions are within 1.1 A and the three C alpha atoms of the histidine ligands of Cu-A are within a root-mean square deviation of 1.0 A from the C alpha atoms of the histidine residues co ordinating Cu-B. Of the superimposed residues, 26% are identical in sequence. These data suggest that the current oxygen-binding centre of arthropodan haemocyanins is the result of dimerization, gene duplication and gene fusion of an ancestral mono-copper-binding helical pair. This suggestion is supported by the recent discovery that in the sequence of functional domains of molluscan haemocyanins only amino acid sequence homology with the arthropodan Cu-B helical pair has been found and no evidence for similarity with a Cu-A binding helical pair was observed. This provides strong evidence that a mono-copper-binding helical pair has been the ancestor of both the arthropodan and molluscan haemocyanins. Turning to the Fe-binding helical pairs in haemerythrins, it appears that they are less similar to each other than the two Cu-binding helical pairs in arthropodan haemocyanins. Nevertheless, the Fe-B haemerythrin helical pair superimposes well onto the Cu-A helical pair of Panulirus haemocyanin. A root-mean-square deviation of 1.9 A for 24 equivalent C alpha carbon atoms is obtained, while Fe-B deviates 1.4 A from Cu-A after superposition of the helices. Moreover, the three histidine ligands of the Cu-A helical pair are equivalent with three histidine ligands of the Fe-B pair. The structural similarity and correspondence in metal-binding ligands suggests that both haemocyanins and haemerythrins have originated from an ancestral mono-metal-binding helical pair having two ligands provided by the first helix and one ligand by the second helix.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2716061 TI - Characterization of the critical state in protein folding. Effects of guanidine hydrochloride and specific Ca2+ binding on the folding kinetics of alpha lactalbumin. AB - The reversible unfolding and refolding kinetics of alpha-lactalbumin induced by concentration jump of guanidine hydrochloride were measured at pH 7.0 and 25 degrees C using tryptophan absorption at 292 nm, with varying concentrations of the denaturant and free Ca2+. The refolding reaction of alpha-lactalbumin from the fully unfolded (D) state occurs through the two stages: (1) instantaneous formation of a compact intermediate (the A state) that has a native-like secondary structure; (2) tight packing of the preformed secondary structure segments to lead finally to the native structure, this stage being the rate determining step of the reaction and associated with acquisition of the specific structure necessary for strong Ca2+ binding. Under strongly native conditions, the observed kinetics of refolding is also complicated by the presence of a slow folding species (10%) in the unfolded state. Considering these facts, the microscopic rate constants in folding and unfolding directions have been evaluated from the observed kinetics and from the equilibrium constants of the transitions among the native (N), A and D states. Close linear relationships have been found in the plots of the activation free energies, obtained from the microscopic rate constants, against the denaturant concentration. They are similar to the linear relationship between the free energy of unfolding and the denaturant concentration. It was demonstrated that the slope of the plots should be approximately proportional to a change in accessible surface area of the protein during the respective activation process, and that only a third of the difference in accessible surface area between A and N is buried in the critical activated state of folding. However, the selective effect of Ca2+ binding on the folding rate constant has been observed also, demonstrating that the specific Ca2+-binding substructure in the N state is already organized in the activated state. Thus, only a part of the protein molecule involving the Ca2+-binding region is organized in the activated state, with the other part of the molecule being left less organized, suggesting that the second stage of folding may be a sequential growing process of organized assemblage of the performed secondary structure segments. PMID- 2716062 TI - Chromosome localization-dependent compositional bias of point mutations in Alu repetitive sequences. AB - The Alu repetitive sequence family originated from a common ancestor. Its members, apparently free from functional constraints, are interspersed throughout primate genomes. We have found that base substitutions occurring during the evolution of primates caused a decrease in the average G + C content of those members of the family that are located in an A + T-rich region of the genome. The family members that are located in a G + C-rich genomic region have not changed their, already high, G + C content. This suggests that the regional differences in G + C content, which are responsible for chromosomal banding, are caused by an accumulation of mutations that, although selectively neutral in the majority, show different compositional bias in different regions of the vertebrate chromosome. PMID- 2716063 TI - Coarctation of the stapedial artery: an unusual adaptive response to competing functional demands in the middle ear of some eutherians. AB - In primitive eutherians, the stapedial artery is the primary supplier of blood to the nonneural tissues of the head. Beyond a certain body size, the stapedial artery can no longer function as the sole supplier to its original territory because the diameter of its stem is limited by the size of the intercrural foramen of the stapes, which exhibits strong negative allometry. Some eutherians have extended the upper limit that the diameter of the stapedial stem can attain by developing a coarctation (narrowing) at the transcrual portion of the vessel. In the Norway rat (Rattus norvegicus) and the golden hamster (Mesocricetus auratus) the coarctation develops in postnatal life and is evidently caused by a retardation in growth that keeps the diameter of the vessel at infantile dimensions. In the rat, additional reduction in the external diameter is produced by a thinning of the tunica media of the arterial wall. A comfortable gap between the wall of the artery and the sides of the intercrural foramen is maintained that most likely facilitates the attenuation of potentially disruptive low frequency vibrations produced by the arterial pressure pulse. The only negative side effect of a coarctation in rat-sized animals is that resistance to flow is increased and volume flow rate is concomitantly diminished. The coarctation does not create flow disturbances downstream of the constriction. One possible additional benefit of the coarctation is a flattening out of the arterial pressure pulse. It is speculated that the capacity to develop a coarctation once a certain body size is reached is an ancient trait that dates at least as far back as the Early Cretaceous. PMID- 2716064 TI - Localization of types I, III and IV collagen mRNAs in rat heart cells by in situ hybridization. AB - Previous studies investigating the cellular origins of several collagens in young adult rat hearts (Eghbali et al., 1988) demonstrated that the mRNAs for types I and III collagen occurred in non-myocyte cells, mostly fibroblasts, whereas the mRNA for type IV collagen was observed in both myocytes and non-myocyte cells. In the present study, cellular localization of collagen mRNAs has been achieved by in situ hybridization in rat heart tissue and in isolated heart cells. Frozen tissue sections, isolated cardiomyocytes, cultured neonatal cardiomyocytes and fibroblasts were hybridized with DNA probes for type-specific collagens, actin, and myosin heavy chain. Silver grains were visualized by dark field imaging. In heart sections, types I and III mRNAs were observed predominantly adjacent to myocytes and in the interstitium, where fibroblasts are known to be present. In contrast, type IV collagen mRNA was identified both within the myocytes and the interstitium. In freshly isolated adult cardiomyocytes and in cultured neonatal cardiomyocytes, collagen type IV mRNA was observed but type I collagen mRNA was not. In cultured neonatal fibroblasts, both types IV and I collagen mRNAs were abundant. PMID- 2716065 TI - Ischaemia-induced and reperfusion-induced arrhythmias differ in their sensitivity to potassium: implications for mechanisms of initiation and maintenance of ventricular fibrillation. AB - The effects of four different K+ concentrations (2, 4, 6 or 8 mM) on arrhythmias resulting from ischaemia, and from reperfusion (after 3, 5, 7, 10, 15 or 30 min of ischaemia), in isolated perfused rat hearts were examined. A randomized experimental design with blind analysis was used. Regional myocardial ischaemia was produced by occlusion of the left main coronary artery. The incidence of ischaemia-induced ventricular fibrillation (VF) was inhibited by elevating K+ concentration, as reported previously. Furthermore, this effect was linearly and inversely related to the log of the K+ concentration (r = 0.99, P less than 0.001), a finding which has not been reported previously. This finding implies that the antiarrhythmic effect may result from depolarization in the non ischaemic tissue, since resting membrane potential is also linearly related to the log of the K+ concentration. The maintenance of ischaemia-induced VF (its tendency to sustain) was also influenced by K+, in that a significantly higher incidence of sustained VF (defined as VF still present at the end of the period of ischaemia) was seen with 2 mM K+ compared with higher K+ concentrations (P less than 0.05). In contrast with its effect on the incidence of ischaemia induced VF, K+ was without effect on the incidence of reperfusion-induced VF, indicating that reperfusion initiates VF independently of the K+ concentration in the perfusion fluid. However, the maintenance of reperfusion-induced VF was K+ dependent (in a similar manner to the maintenance of ischaemia-induced VF). In summary, the effects of K+ on ischaemia-induced VF were different from its effects on reperfusion-induced VF. We conclude that ischaemia-induced VF and reperfusion-induced VF are unlikely to be initiated by a common electrophysiological mechanism since only the former was influenced by K+. The mechanisms of maintenance of ischaemia-induced VF and reperfusion-induced VF might, however, be common, since the tendency for spontaneous defibrillation to occur (as reflected by the incidence of sustained VF) was equally sensitive to K+ in both settings. Finally, the nature of the time course of susceptibility to ischaemia-induced VF compared with that of reperfusion-induced VF raises the possibility that the reperfusion-induced VF may be clinically relevant as a cause of sudden death only when ischaemia-induced VF is suppressed. PMID- 2716066 TI - On the characteristics of the inward tail current induced by calcium overload. AB - The characterization of an inward tail current (Iex) induced by calcium overload and often associated with the oscillatory current (Ios) was studied by means of a two-microelectrode voltage clamp method in sheep cardiac Purkinje fibers. It was found that: (1) the inward tail current requires a prior depolarization to about 25 mV (or less negative values) in order to appear; (2) after depolarization to those values, the membrane needs to be repolarized to about -45 mV (or to more negative values) for the inward tail current to be initiated; (3) the inward tail current becomes larger after larger or longer clamp steps and increases progressively at more negative potentials; (4) the inward tail current can be separated from other known currents, notably from the pacemaker current; (5) the inward tail current is reduced by quinacrine, a blocker of Na-Ca exchange; (6) the inward tail current does not reverse at less negative potentials; (7) the membrane conductance does not increase during the inward tail current. Thus, the inward tail current shows similarities and dissimilarities with the oscillatory current, probably in relation to a common final pathway and to a different mode of onset of the two currents, respectively. PMID- 2716067 TI - Protection of isolated rat heart from oxidative stress by exogenous creatine phosphate. AB - The influence of exogenous creatine phosphate (CP) on peroxidative heart injury was investigated in two experimental models: isolated working rat hearts and myocardial membrane preparations. In the first model the addition of 190 microM hydrogen peroxide to the perfusion buffer caused a marked decrease of aortic flow, minute work and peak aortic pressure, and leakage of intracellular enzymes. In the presence of 10 mM CP the hemodynamic damage produced by the same concentration of hydrogen peroxide was significantly lower and enzyme release was also remarkably reduced. The protection was concentration-dependent and the whole structure of the molecule was required since creatine was found to be ineffective. In the absence of hydrogen peroxide, CP and creatine did not affect heart performance. In microsomal membrane preparations CP decreased the formation of thiobarbituric acid-reactive material (malonaldehyde) induced by hydrogen peroxide in the presence of ferrous ions. This protection was concentration dependent and occurred at physiological concentrations of CP. Also in this experimental model creatine had no effect and creatine plus inorganic phosphate was much less active than CP. The influence of CP on oxidative heart stress could account for the beneficial effect of this substance in different models of ischemic injury. PMID- 2716068 TI - Identification of and changes in the expression of troponin T isoforms in developing avian and mammalian heart. AB - Immunochemical studies have shown the presence of a single isoform of troponin T, the adult form, in all chambers of adult chicken and rat hearts. An additional isoform, the embryonic form, was detected during early development of the cardiac muscle. As the amount of adult isoform increased, the embryonic form decreased and was finally suppressed during early post-natal or post-hatch period. The replacement of the embryonic isoform by the adult form appeared slower in the atrium than in the ventricle. While the adult isoform of troponin T was not detected until late in gestation in the rat heart, this isoform of troponin T was present in the chicken heart even at 4 days in ovo. PMID- 2716069 TI - Fighting cancer with cigarette taxes. PMID- 2716070 TI - Uncertainties abound in radon research: lung cancer risk hard to quantify. PMID- 2716071 TI - Alleviating distress for children in treatment. PMID- 2716072 TI - The enduring animal issue. PMID- 2716073 TI - Reversal of the multidrug-resistant phenotype of Chinese hamster ovary cells by L histidinol. AB - The amino acid analogue L-histidinol reverses the multidrug-resistance (MDR) attribute of the colchicine-resistant (CHR) variant CHRC5, a Chinese hamster ovary cell line that overexpresses a plasma membrane-associated glycoprotein and is resistant to colchicine (CH), daunorubicin, and vinblastine sulfate (VS). The level of cell kill achieved in CHRC5 cells by combinations of L-histidinol and either daunorubicin or CH approached that achieved in AUXB1 parent cells by these two drugs, whereas L-histidinol-VS combinations killed even more CHRC5 cells than VS in the parental line. The capacity of L-histidinol to reverse the MDR phenotype of the CHRC5 line was time and dose dependent and was eliminated by the addition of a twofold molar excess of L-histidine. The reversal of the MDR trait by L-histidinol appears to be independent of the drug uptake mechanism. PMID- 2716074 TI - Cancer among epileptic patients exposed to anticonvulsant drugs. AB - Cancer incidence among 8,004 patients hospitalized for epilepsy between 1933 and 1962 in the Filadelfia treatment community in Denmark was compared to that of the general population. Patients received powerful and prolonged treatment with phenobarbital, phenytoin, and other anticonvulsants. This new survey extends the follow-up from 1976 through 1984. Among 7,864 patients with epilepsy not known to have received radioactive Thorotrast, record linkage with national cancer incidence files identified 789 cancers, compared to 664 expected [relative risk (RR) = 1.19; 95% confidence interval = 1.11-1.27]. Significant risks were found for cancers of the brain and central nervous system (RR = 5.7; n = 118) and the lung (RR = 1.4; n = 106). The excess numbers of brain cancer were concentrated within 10 years of hospitalization (RR = 20.7; n = 80) and decreased significantly over time, which suggests that brain tumors account for the seizure disorder and are not due to phenobarbital exposure as suggested by some epidemiologic studies. No overall risk was apparent when brain cancers were excluded (RR = 1.03). Because bladder cancer was significantly decreased (RR = 0.6; n = 18), the excess risk of lung cancer may not have been related to the "anecdotal" heavy smoking reported among confined groups of epileptic patients in the early years of the study period. The incidence of malignant melanoma was also significantly low (RR = 0.5; n = 7), which suggested limited exposure to sunlight among confined patients. The risk of non-Hodgkin's lymphoma was increased, but not significantly (RR = 1.4; n = 16), which is interesting in view of previous reports suggesting an association with phenytoin. Overall, these data provide little evidence that phenobarbital and phenytoin are carcinogenic to humans, but the excess risks of lung cancer and non-Hodgkin's lymphoma among epileptic patients in our study deserve further evaluation. PMID- 2716075 TI - Pharmacology of dichloromethotrexate. PMID- 2716076 TI - MRI of the thorax. State of the art. PMID- 2716077 TI - Pediatric thoracic applications of magnetic resonance imaging. AB - Magnetic resonance imaging (MRI) is the newest and most promising imaging modality for evaluating the pediatric thorax. Its ability to distinguish between mediastinal fat, blood vessels, and adjacent soft tissues, without the use of intravenous contrast agents or radiation, makes MRI advantageous for infants and children. The thoracic applications include evaluations of cardiac anomalies, mediastinal masses, extracardiac vascular anomalies, airway obstruction, and chest-wall lesions. This article describes the current and possible future applications of MRI of the pediatric thorax. PMID- 2716078 TI - Magnetic resonance imaging of cardiac and paracardiac masses. AB - Magnetic resonance imaging (MRI) with ECG-gated acquisition displays the blood pool as a signal void and thereby provides high contrast differentiation between cardiovascular structures and soft-tissue masses. The role of MRI for the detection and definition of the extent of paracardiac and intracardiac masses is reviewed. The extension of mediastinal, lung, and upper abdominal tumors to the heart and pericardium is depicted favorably by MRI and this attribute is also demonstrated. It is anticipated that MRI will have an increasing role in the evaluation of primary and secondary masses of the heart and pericardium. PMID- 2716079 TI - Acquired diseases of aberrant subclavian arteries. AB - The anatomic, clinical, and radiologic findings of aberrant subclavian arteries (ASAs) are well known. Acquired diseases such as aneurysms, dissections, or stenosis can complicate these anomalies. We propose that these complications are a result of atherosclerosis caused by abnormal turbulence around the ASA. Comparisons of computed tomographic and angiographic measurements of subclavian arteries in adults with and without arch anomalies and angiographic measurements of ASAs in children show that ASAs dilate in older patients. We describe six patients with acquired diseases of ASAs or the aorta adjacent to the ASA. Aneurysms, aortic dissections, and stenosis were each found in two patients. Problems in the radiologic diagnosis and clinical management of these diseases are emphasized. Radiologists should be cognizant of the significance of ASAs in patients with aortic aneurysms and dissections. PMID- 2716080 TI - The chest radiograph after resection of pulmonary nodules with a neodymium-YAG laser. AB - We studied the chest radiographs of 30 patients (39 thoracotomies) after resection of pulmonary nodules with a neodymium-YAG laser. New "nodules" were often visible in the resected areas. These gradually evolved into linear scars with or without a small, nodular component or disappeared. In 11 of 39 thoracotomies, postresection cavities developed at the site of the lesion. Familiarity with the typical radiographic findings after laser resection and their normal evolution is necessary to avoid confusing these expected findings with residual or recurrent disease or with infection following surgery. PMID- 2716081 TI - Chest-wall collapse as a complication of atelectasis. AB - A case of chest-wall collapse following atelectasis of the lung is reported. The presumed mechanism is abnormal compliance of the chest wall. PMID- 2716082 TI - Magnetic resonance imaging of cardiac sarcomas. AB - Two patients with cardiac sarcomas were evaluated with magnetic resonance imaging (MRI). In both cases, MRI provided more information regarding the extent of the tumor than computed tomography, two-dimensional echocardiography, or angiography. PMID- 2716083 TI - Carcinoma of the tongue in young patients. AB - Carcinoma of the tongue is the second most common malignancy of the oral cavity, predominantly affecting males in the sixth and seventh decades of life. The risk factors for this disease (primarily tobacco and ethanol abuse) are well documented in the literature. The current five-year survival for a T1 lesion without nodal involvement is approximately 80%. Over the past 10 years a group of younger patients (less than 40 years) has been identified. Eleven of these patients presenting to the London Regional Cancer Centre since 1976 are reviewed with respect to stage at diagnosis, known risk factors, and the outcome of treatment. Comparison is then made with a similar group of older (over 40 years) patients. The previously identified risk factors, and the male/female ratio are quite different from the older patients. This younger group would appear to have a biologically more aggressive tumor than the stage (TNM) at presentation would suggest. They require more complex treatment, frequently requiring major resections plus radiotherapy for what appears to be early disease. The role for more aggressive initial therapy must be considered. PMID- 2716084 TI - Peripheral ameloblastic carcinoma: a case report of a rare neoplasm. AB - An example of a rare peripheral ameloblastic carcinoma of the maxillary tuberosity is presented. A discussion of its possible relationship to the dental lamina and malignant ameloblastoma follows. PMID- 2716085 TI - Surgical exploration of enlarged lymph nodes at the root of the neck. AB - Surgical exploration of presumed enlarged lymph nodes at the root of the neck may sometimes result in the exposure of neurogenic lesions. Careful exposure of the lesion should precede mobilization and excision to prevent unavoidable iatrogenic injury. Experiences with 45 neoplasms in this region are described. PMID- 2716086 TI - Rhabdomyosarcoma of the alveolar ridge in an adult. AB - Rhabdomyosarcoma of the head and neck is rare in adults, and past reports indicate that it is a more aggressive disease than that which is found in children. We report the case of a 63-year-old woman with an alveolar type of rhabdomyosarcoma located on the mandibular alveolar ridge. Rhabdomyosarcoma of the oral cavity appears to carry a particularly poor prognosis, especially when bone is involved. Multimodal treatment with surgery, radiation therapy, and chemotherapy is indicated in all patients. PMID- 2716087 TI - Prostatic carcinoma presenting with neck metastasis. AB - Prostatic carcinoma is the second leading cause of cancer mortality in American men. Twenty-seven thousand deaths from this aggressive neoplasm were predicted for 1987. Although this malignancy has metastasized to almost all of the structures in the head and neck, it demonstrates a pathophysiologic proclivity for the supraclavicular lymph nodes. Combining fine-needle aspiration with immunohistochemical techniques produces a cost-effective method to expedite the diagnosis of this hormone-responsive tumor. Four patients presenting with prostatic carcinoma and neck metastasis in a three-year period are reported and discussed. PMID- 2716088 TI - Hemifacial atrophy: a case report of fat transplantation. AB - A case of hemifacial atrophy affecting a young female is presented and the manifestations of this uncommon disorder are reviewed. The various methods employed in correcting the facial deformity including the relatively new technique of fat injection are described. PMID- 2716089 TI - Clinical experience with the Xomed Audiant osteointegrated bone conducting hearing device: a preliminary report of seven cases. AB - An osteointegrated bone conducting hearing device has recently become available in North America. As with any new medical treatment, initial enthusiasm is soon tempered by its inherent limitations. Critical and objective analysis of results and candid reporting of clinical experiences will lead to the establishment of realistic indications for any new treatment. We present the current indications for insertion of the Xomed Audiant Bone Conductor, our early clinical experience and our thoughts on its future role in the management of patients with conductive hearing loss. PMID- 2716090 TI - Otitis media with effusion in the adult. AB - The etiologic factors associated with serous otitis media or otitis media with effusion (OME) are well described in children. Little has been published with regard to OME and its etiology in adults. Thirty-five adult patients who presented with OME in a referral-based otolaryngologic practice over a five-year period were studied by retrospective chart review with a follow-up telephone interview. OME in adults may be related to previous middle ear surgery in the contralateral ear, a history of middle ear disease in childhood, chronic nasal symptoms of obstruction and nasal fullness, cigarette smoking, and a family history of middle ear disease. The onset is often associated with upper respiratory tract infection. Nasopharyngeal carcinoma was uncommon. PMID- 2716091 TI - Neurothekeoma (peripheral nerve sheath myxoma) of the external auditory canal. AB - A patient who presented with an isolated soft-tissue tumor in the lateral portion of the external auditory canal, which after removal was diagnosed histopathologically as a peripheral nerve sheath neurothekeoma, is presented. Peripheral nerve sheath myxomas (neurothekeomas or perineural myxomas) have been reported to occur on the central area of the face, arms and shoulders. This is the first case in which a tumor of this type has been reported to develop in the external auditory canal. The distinguishing histopathological characteristics and the differential diagnosis of this tumor are discussed. PMID- 2716092 TI - Cavernous hemangioma of the incus (an incidental finding). AB - The incidental discovery of a cavernous hemangioma in an apparently normal incus found during pathological examination is reported. The incus had been removed during the course of a total osseous labyrinthectomy for delayed endolymphatic hydrops (DEH), and this unexpected finding noted. Although rare, hemangiomatous involvement of the temporal bone does occur and its manifestations are discussed. To date there have been no other reports of a hemangioma involving the incus solely. PMID- 2716093 TI - Recurrent vestibulopathy: support for a viral etiology. AB - Over an 18-month period, mother, father and child were seen with dizziness. The mother had Ramsay Hunt syndrome prior to developing recurrent vestibulopathy. A viral cause for recurrent vestibulopathy is suggested. PMID- 2716094 TI - Cystic fibrosis. PMID- 2716096 TI - Yohimbine reversal of ketamine-xylazine immobilization of raccoons (Procyon lotor). AB - Six adult raccoons (Procyon lotor) were sedated with a combination of ketamine hydrochloride (KH) at 10 mg/kg body weight and xylazine hydrochloride (XH) at 2 mg/kg body weight intramuscularly (i.m.). Twenty min after the KH-XH combination was given, yohimbine hydrochloride (YH) at either 0.1 mg/kg (Trial 1) or 0.2 mg/kg (Trial 2) body weight or a saline control (Trial 3) was administered intravenously (i.v.). The time to arousal, time to sternal recumbency and time to walking were recorded. These times were significantly shortened after YH administration [e.g., mean time to walking (MTW) at 0.2 mg/kg YH = 23.7 min] as compared to the saline controls (MTW = 108.8 min). Heart and respiratory rates both increased after YH administration, while body temperature remained constant. A fourth trial was performed using a higher ratio of KH to XH (45:1 rather than 5:1) to mimic sedation as performed in the field. The mean time to arousal (MTA) and MTW in this trial (1.3 and 23.7 min, respectively) were significantly shorter than controls and similar to YH trials performed after immobilization with 5:1 KH XH. Yohimbine hydrochloride may be useful in field studies that require sedation of raccoons using KH-XH combinations. PMID- 2716095 TI - Immobilization of polar bears (Ursus maritimus) with Telazol in the Canadian Arctic. AB - In 1986, 213 polar bears (Ursus maritimus) were immobilized with Telazol on the sea ice of the eastern Beaufort Sea during April and May, and 106 along the western coast of Hudson Bay near Churchill, Manitoba (Canada) in September. No animals died from handling. The efficacy of this drug at different seasons and the physiological responses of the immobilized bears were compared. A single injection of 8 to 9 mg of Telazol per kg of body weight gave a rapid full immobilization with satisfactory analgesia, and faster recovery than other drugs for which there is no antagonist. The reactions of the bears could be reliably and easily interpreted from a safe distance before the animal was approached. There was a wide range of tolerance to high dosages and bears appeared able to thermoregulate while immobilized. The mortality rate due to handling was lower than with any other drug used to date. PMID- 2716097 TI - Comparative toxicity of lead shot in black ducks (Anas rubripes) and mallards (Anas platyrhynchos). AB - In winter, pen-reared and wild black ducks (Anas rubripes), and game farm and wild mallards (Anas platyrhynchos), maintained on pelleted feed, were sham-dosed or given one number 4 lead shot. After 14 days, dosed birds were redosed with two or four additional lead shot. This dosing regimen also was repeated in summer using pen-reared black ducks and game farm mallards. Based upon mortality, overt intoxication, weight change, delta-aminolevulinic acid dehydratase activity and protoporphyrin concentration, black ducks and mallards were found to be equally tolerant to lead shot. However, captive wild ducks were more sensitive than their domesticated counterparts, as evidenced by greater mortality and weight loss following lead shot administration. This difference may be related to stress associated with captivity and unnatural diet. PMID- 2716098 TI - Case histories of wild birds killed intentionally with famphur in Georgia and West Virginia. AB - Five incidences of bird mortality in Georgia and West Virginia (USA) involving migratory waterfowl, cranes, raptors, corvids and songbirds were investigated during the first 6 mo of 1988. Gross and histopathologic examinations revealed no evidence of infectious or other diseases. However, severe depression of cholinesterase activity was evident in brains of birds found dead, suggesting gross exposure to an organophosphorus (OP) or carbamate pesticide. All of the gastrointestinal tract contents chemically analyzed contained famphur, an OP insecticide used as a pour-on treatment against lice and grubs on livestock, ranging from 5 to 1,480 ppm (wet weight). Grain scattered at two of the mortality sites contained 4,240 and 8,500 ppm famphur. Gastrointestinal tracts of most of the dead birds contained mainly corn and some wheat. This is the first report to document the use of famphur as an intentional means of killing wildlife thought to be depredating crops. PMID- 2716099 TI - Lagomorphs as sentinels for surveillance of borreliosis in the far western United States. AB - Brush rabbits (Sylvilagus bachmani) and black-tailed jackrabbits (Lepus californicus) from California (USA) were assayed for antibodies to Borrelia burgdorferi, the etiologic agent of Lyme borreliosis. Significant antibody titers were detected in 90% (range, 67 to 100%) of brush rabbits from four of six localities, and in 90% of jackrabbits from a single locality, in northern California. One of the populations of brush rabbits that did not yield seropositive individuals inhabited an oceanic island devoid of any other terrestrial mammal, whereas the other population was located on an isolated flood plain bordering San Francisco Bay. Absorption tests using B. burgdorferi as antigen revealed that antibodies detected in both species of lagomorphs were directed against borreliae. These findings reinforce the earlier suggestion that lagomorphs may be useful as sentinel animals for surveillance of borreliosis in the far western United States. PMID- 2716100 TI - A study of techniques for the distribution of oral rabies vaccine to wild raccoon populations. AB - This study evaluates a technique for delivering an oral rabies vaccine to wild raccoon (Procyon lotor) populations. Various baits and attractants were first tested on caged raccoons and baiting trials were then conducted in two distinct physiographic regions of Virginia (USA), the coastal plain and the Piedmont plateau. Raccoon population density studies preceded the field trials. Each polyurethane sponge bait distributed contained approximately 200 mg tetracycline as a tissue biomarker, and was presented in an outer bag with a fish-based attractant. Baits were frozen until used and distributed from an aeroplane throughout two 4-km2 sites in each region. One site received 450 baits/km2 and the other 120 baits/km2. Postbaiting evaluation included the direct observation of baits in the field and the examination of teeth and bone from trapped and hunted animals for evidence of the biomarker. Between 30% and 73% of the captured animals showed evidence of bait consumption. The proportion of animals with evidence of bait uptake changed when areas adjacent to the actual baiting site were included. The percentage of animals taking baits was not related to the density of baits that were distributed. PMID- 2716101 TI - Prevalence and pathology of nematode infections in the lungs of ringed seals (Phoca hispida) of the western arctic of Canada. AB - Two genera of lung nematodes were found in a sample of 382 wild ringed seals (Phoca hispida). Otostrongylus circumlitus were found mainly in young of the year where they occupied the main stem bronchi causing extensive mucus production, mucosal hyperplasia and peribronchitis. Immature stages of the nematode were found in pulmonary vessels causing end-arteritis. There was only a slight reduction in respiratory parenchyma in infected seals and no correlation between infection and size or body condition. However, the sharp decline of O. circumlitus infection from 32% in young of the year to 0.5% after the first winter suggests that this parasite may play a role in the population dynamics of ringed seals. Filaroides (Parafilaroides) hispidus was found in alveoli of seals throughout all age classes causing no significant lesions. The infection rate increased from 44 to 71% in the 7 to 13-yr-old animals and declined to 38% in older seals. Concurrent infections occurred in 28% of young of the year seals. PMID- 2716102 TI - Concentration of creatine kinase and aspartate aminotransferase in the blood of wild mallards following capture by three methods for banding. AB - The concentration of the enzymes creatine kinase (CK) and aspartate aminotransferase (AST), that are released from damaged muscle, was measured in the blood of wild adult male mallards (Anas platyrhynchos) captured for banding in decoy and bait traps and by rocket net. The concentration of CK and to a lesser extent AST was elevated markedly in ducks captured by all methods, indicating muscle injury. The level of CK was significantly greater in ducks captured in decoy traps and rocket net than in those captured in bait traps. This elevation appeared to be related to the length of time the birds were restrained and to the method of restraint. PMID- 2716103 TI - The effects of six environmental variables on Pasteurella multocida populations in water. AB - The effects of protein, pH, temperature, sodium chloride (NaCl), clays, sucrose, and their interactions on the survival and growth of Pasteurella multocida were evaluated. Pasteurellae populations declined rapidly in waters maintained at 2 C, compared to 18 C. Increasing water soluble proteins by 175 micrograms/ml, and NaCl by 0.5%, greatly enhanced survival of P. multocida, whereas variations in pH, clays, and sucrose had relatively minor effects. Pasteurella multocida survived for over 1 yr in some samples of water. This is the longest known survival of these bacteria in water. PMID- 2716104 TI - Epizootiological features of avian cholera on the north coast of California. AB - An avian cholera (Pasteurella multocida) epizootic was observed among wildfowl at the Centerville Gun Club, Humboldt County, California (USA) in January 1978. Compared to their live populations and use of the area, coots (Fulica americana) died in proportionately greater numbers than any other species. Coots collected by gunshot were evaluated for sex and age composition, and morphometry from November 1977 through mid-January 1978 at this site. There was no substantial difference in the sex, age or morphometry between birds dying of avian cholera and from those dying from gunshot. Assuming coots dying of gunshot are representative of the general population, it appears there was little selection among coots by P. multocida. There was evidence for a sequential mortality similar to that reported previously at this site: coots were the first birds to die, followed by American wigeon (Anas americana) and northern pintails (A. acuta acuta); northern shovelers (A. clypeata) and mallards (A. platyrhynchos) died late in the epizootic. PMID- 2716105 TI - Helminth parasites of northern spotted owls (Strix occidentalis caurina) from Oregon. AB - Helminth parasites are reported for the first time from northern spotted owls. Seventy-one percent of a sample of Strix occidentalis caurina from western Oregon was infected. Nematodes (Porrocaecum depressum, Capillaria falconis, Microtetrameres sp. and Synhimantus hamatus) were the most prevalent parasites although cestodes (Paruterina rauschi) and acanthocephalans (Centrorhynchus conspectus) were also represented. There was an association between components of this helminth fauna and the diet of spotted owls which is dominated by small rodents. The occurrence of P. rauschi rather than P. candelabraria in this geographic region and host-species may provide additional support for recognition of a parapatric distribution in the ranges of Paruterina spp. among strigiforms in the Nearctic. PMID- 2716106 TI - Helminth parasites of intermingling axis deer, wild swine and domestic cattle from the island of Molokai, Hawaii. AB - Helminth infections of axis deer (Cervus axis), wild swine (Sus scrofa) and domestic cattle (Bos taurus) were studied among intermingling herds on the Puu-O Hoku Ranch, Molokai, Hawaii. Twenty-four species of helminths were collected from the 10 deer, 10 swine and 10 cattle. Capillaria bovis, Cooperia punctata, Haemonchus contortus and Trichostrongylus axei infected both axis deer and cattle, whereas Gongylonema pulchrum infected both axis deer and wild swine. None of the species of helminths occurred in both wild swine and cattle nor was any species found in all three hosts. Wild swine and domestic cattle supported separate and distinct helminth communities. In contrast, the helminth community of axis deer appeared to be derived from the helminth communities of cattle and wild swine and consisted only of those species capable of parasitizing either a broad range of ruminants or many mammalian taxa. PMID- 2716107 TI - Cranial osteochondroma in a white-tailed deer (Odocoileus virginianus). AB - A large osteochondroma of the skull was diagnosed in a young adult free-ranging white-tailed deer (Odocoileus virginianus) from Wyoming. The 4.8-kg neoplasm primarily involved the left frontal bone with extension into the cranial cavity. Microscopically, the neoplasm was composed of well differentiated trabecular bone and islands of cartilage. This neoplasm is rare in domestic species and has not been reported in cervids. Though benign in morphology, the location and size of the neoplasm was probably responsible for debilitation of the deer. PMID- 2716108 TI - Fatal lungworm infection in an opossum. AB - A 3-mo-old male, feral opossum (Didelphis virginiana) was presented to the University of Tennessee College of Veterinary Medicine (USA) for evaluation of prolonged dyspnea. The animal died shortly after examination and a necropsy was performed. The cause of death was attributed to a verminous pneumonia, associated with numerous intrabronchial and intrabronchiolar nematodes, subsequently identified as Didelphostrongylus hayesi. PMID- 2716109 TI - Eurytrema procyonis in a raccoon (Procyon lotor) from New York state--a first report. AB - The digenean, Eurytrema procyonis, found in the pancreatic ducts of the raccoon (Procyon lotor), is reported for the first time from a juvenile female raccoon captured in July 1987, in New York State (USA). The presence of greater than 183 trematodes in the pancreatic ducts was an incidental finding at necropsy to an interstitial pneumonia which had caused emaciation, and for which the animal was euthanized. The pancreas, with the exception of the major pancreatic duct, was histologically normal. The duct, containing the parasites, was dilated and contained a diffuse subepithelial inflammatory infiltrate consisting primarily of eosinophils. Epithelial hyperplasia was present in tubulo-alveolar glands, and goblet cells were prominent. PMID- 2716110 TI - Phagicola angrense (Digenea: Heterophyidae) as a cause of enteritis in a raccoon (Procyon lotor). AB - Numerous Phagicola angrense were associated with enteritis in a single male juvenile raccoon (Procyon lotor) live-trapped on Parramore Island, Virginia (USA). The raccoon was weak, ataxic and had melenic soft feces. The carcass was emaciated, pale and had ascites. Mesenteric vessels appeared prominent and the stomach and the intestines contained fetid bloody material. The small intestinal mucosa contained three locally extensive sites of necrosis. Histopathologically, there were numerous small digeneans both attached to the mucosa and free within the lumen. Digeneans were usually found deep within the crypts where the epithelium was markedly attenuated and devoid of epithelial cells at the point of parasite attachment. In the lamina propria there were areas of acute hemorrhage and infiltration with plasma cells and eosinophils. This appears to be the first record of severe enteritis in the raccoon caused by this digenean. PMID- 2716111 TI - Presumed drowning of Aleutian Canada geese on the Pacific coast of California and Oregon. AB - Carcasses of 42 and 17 Aleutian Canada geese (Branta canadensis leucopareia), a federally listed endangered species, were found on ocean beaches near Crescent City, California, and near Pacific City, Oregon, respectively, following severe storms. Necropsies and other information suggest that the birds were flushed during the storms and somehow entered the water where they were washed into the surf and drowned. PMID- 2716112 TI - Epidemiologic and pathologic aspects of an epizootic of malignant catarrhal fever in exotic hoofstock. AB - An epizootic of malignant catarrhal fever (MCF) occurred at the Los Angeles Zoological Park which resulted in the deaths of four exotic ungulates. The source of infection was considered to be a newly purchased wildebeest bull (Connochaetes taurinus taurinus) that had been negative for antibody to MCF virus by an indirect immunofluorescent test. The need to re-evaluate regulations for the transportation and housing of young wildebeest is emphasized by this MCF outbreak. The diagnostic technology now available for identifying asymptomatic carriers of MCF virus and the present understanding of the behavior and pathogenesis of this highly cell-associated herpesvirus in exotic ruminants should provide a basis for the prevention and control of MCF in zoological parks. PMID- 2716113 TI - Occurrence of Yersinia enterocolitica in the Tokyo Tama Zoo. AB - Yersinia enterocolitica serogroups O5A and O8 were isolated from fecal samples of one colony of Japanese macaques (Macaca fuscata) from the Tokyo Tama Zoo (Japan). Serogroup O5A was detected in brown bear (Ursus arctos) prior to the isolation from the macaques. Serogroup O5A organisms also were isolated from the Japanese macaques' breeding area. Serogroup O5A and O8 isolates were not pathogenic. Serogroup O8 isolates did not possess the O7 or O19 antigens. PMID- 2716114 TI - Identification of dorsal-spined larvae from free-ranging wapiti (Cervus elaphus) in southwestern Manitoba, Canada. AB - Dorsal-spined first-stage larvae recovered from feces of free-ranging wapiti (Cervus elaphus) were passaged through snails (Triodopsis multilineata) and two hand-raised white-tailed deer fawns (Odocoileus virginianus). A total of 74 adult Parelaphostrongylus tenuis were recovered from the fawns; no other protostrongylid nematodes were recovered. The study indicates that wapiti may be infected with natural infections of meningeal worm and pass larvae suitable for transmission to gastropod intermediate hosts. Wapiti from areas endemic with P. tenuis should not be translocated to areas currently free of the parasite. PMID- 2716115 TI - New information on the location of Capillaria procyonis (Nematoda: Trichuroidea) in the tongue of a raccoon (Procyon lotor). AB - Histologic examination of the tongue of one juvenile male raccoon demonstrated the presence of adults and unembryonated eggs of the nematode Capillaria procyonis within parasite-induced tunnels in the stratified squamous epithelium. There was no inflammatory infiltrate within the epithelium or the subjacent lamina propria. The shape of tunnels approximated that of the resident nematodes and were lined by flattened and attenuated epithelial cells. Therefore, the site of infection of C. procyonis in the raccoon includes the oral, lingual and pharyngeal epithelium in addition to the esophagus. PMID- 2716116 TI - A comparison of two methods to establish the prevalence of lead shot ingestion in mallards (Anas platyrhynchos) from The Netherlands. AB - Two collection methods for screening the mallard (Anas platyrhynchos) population in the Netherlands for the ingestion of spent lead shot were compared. One method consisted of examination of gizzards from mallards shot by hunters (n = 2,859) and the other method consisted of examination of gizzards from mallards caught in duck traps (n = 865). The 95% confidence interval of lead shot ingestion in the mallard population estimated by the first method was 1.7 to 2.9% and by the second method 1.1 to 3.1%. These values were not significantly different. From the numbers of lead pellets embedded in the gizzard wall in hunter-killed and trapped mallards it was estimated that at least 22 to 68% of the trapped ducks had been hit by lead shot previously, but survived. Furthermore, this study shows that it is reasonable to assume that a substantial part of the pellets which are identified (in this study and other studies) as ingested, may well have been shot into the gizzard lumen at some time before the birds were actually killed. To avoid lead poisoning in mallards and in raptors depredating waterfowl hit by lead shot, a change to steel shot is advocated. PMID- 2716117 TI - Serologic evidence of arboviral infections in white-tailed deer from central Wisconsin. AB - A survey conducted during 1979-1980 on white-tailed deer (Odocoileus virginianus) in central Wisconsin revealed serological evidence of infection by selected arboviruses. Among sera from 41 deer, antibody was detected for Jamestown Canyon virus (56%) and Bunyamwera group virus (80%), demonstrating their continuing endemic activity. Antibody for La Crosse virus, not found previously in sera from deer in central Wisconsin, also was detected (5%) in this study. PMID- 2716119 TI - Neurologists join neurosurgeons in urging restraint in Parkinson's surgery. PMID- 2716118 TI - Parasites of prairie rattlesnakes (Crotalus viridis viridis) and gopher snakes (Pituophis melanoleucus sayi) from the eastern high plains of New Mexico. AB - Three prairie rattlesnakes (Crotalus viridis viridis) and two gopher snakes (Pituophis melanoleucus sayi) from the eastern high plains of New Mexico (USA) were examined for parasites. One cestode (Oochoristica osheroffi), and two nematode (Kalicephalus inermis and Physoloptera retusa) species were recovered from two infected rattlesnakes. One female gopher snake was infected with two nematode (K. inermis and Rhabdias spp.) and one mite (Entonyssus halli) species. PMID- 2716120 TI - Child abuse problem demands much of physician but also of the community and its officials. PMID- 2716121 TI - What to do when faced with troubling suspicion that young patient may be victim of abuse? PMID- 2716123 TI - Leads from the MMWR. A strategic plan for the elimination of tuberculosis in the United States. PMID- 2716122 TI - Second World No-Tobacco Day is next week. PMID- 2716124 TI - Leads from the MMWR. Smoking-attributable mortality, morbidity, and economic costs--California, 1985. PMID- 2716125 TI - The practice of medicine. PMID- 2716126 TI - J-drugs. PMID- 2716127 TI - Lipids and hypertension. PMID- 2716128 TI - School and work release evaluations. PMID- 2716129 TI - Neonatal adrenal hemorrhage presenting as a right scrotal mass. PMID- 2716130 TI - Physicians' attitudes toward using deception to resolve difficult ethical problems. AB - To assess physicians' attitudes toward the use of deception in medicine, we sent a questionnaire to 407 practicing physicians. The questionnaire asked for responses to difficult ethical problems potentially resolvable by deception and asked general questions about attitudes and practices. Two hundred eleven (52%) of the physicians responded. The majority indicated a willingness to misrepresent a screening test as a diagnostic test to secure an insurance payment and to allow the wife of a patient with gonorrhea to be misled about her husband's diagnosis if that were believed necessary to ensure her treatment and preserve a marriage. One third indicated they would offer incomplete or misleading information to a patient's family if a mistake led to a patient's death. Very few physicians would deceive a mother to avoid revealing an adolescent daughter's pregnancy. When forced to make difficult ethical choices, most physicians indicated some willingness to engage in forms of deception. They appear to justify their decisions in terms of the consequences and to place a higher value on their patients' welfare and keeping patients' confidences than truth telling for its own sake. PMID- 2716131 TI - Nonblack patients with sickle cell disease have African beta S gene cluster haplotypes. AB - Of 18 nonblack patients with sickle cell disease, 14 had sickle cell anemia, 2 had hemoglobin SC disease, and 2 had hemoglobin S-beta o-thalassemia. The beta s gene cluster haplotypes that were determined in 7 patients were of African origin and were identified as Central African Republic, Central African Republic minor II, Benin, and Senegal. The haplotype Central African Republic minor II was present on the beta o-thalassemia chromosome in 2 patients. None of 10 patients whose alpha-gene status was determined had alpha-thalassemia-2. These data strongly support the concept that the beta s gene on chromosome 11 of these individuals is of African origin and that the alpha-gene locus on chromosome 16 is of white or native American origin. The clinical severity of the disease in these nonblack patients is appropriate to their haplotype without alpha thalassemia-2 and is comparable with that of black patients. All persons with congenital hemolytic anemia should be examined for the presence of sickle cell disease regardless of physical appearance or ethnic background. PMID- 2716132 TI - Migrainelike headache and cocaine use. AB - Migrainelike headache is a sequela of cocaine use. This finding expands the range of neurological complications of cocaine use and is consistent with the potential role of serotonin in the development of migraine. In these subjects, the desire to avoid the cocaine-induced headache eventually became part of the resolve to quit use. PMID- 2716133 TI - Teleradiology for a family practice center. PMID- 2716134 TI - A piece of my mind. For want of a sail. PMID- 2716135 TI - Diagnostic and therapeutic technology assessment. Home monitoring of uterine activity. PMID- 2716136 TI - Evidence of new physical, genetic, links in autism. PMID- 2716137 TI - Paleontologist offers lessons from other eons. PMID- 2716138 TI - Seeking scientific acceptance of in vitro tests. PMID- 2716139 TI - Promising drug combination for sickle cell anemia. PMID- 2716140 TI - Exploring causes of paralysis in spina bifida. PMID- 2716141 TI - Information accumulating on how brain 'hears'. PMID- 2716142 TI - Serum immunoreactive erythropoietin in HIV-infected patients. AB - Serum immunoreactive erythropoietin (SIE) and hemoglobin levels were measured in 152 patients infected with the human immunodeficiency virus. Anemia was present in 18% of asymptomatic patients who tested positive for the human immunodeficiency virus, 50% of patients with a condition related to the acquired immunodeficiency syndrome (AIDS), and 75% of patients with AIDS. The mean SIE level for untreated AIDS patients (26.2 +/- 2.4 mU/mL) was greater than for patients who tested positive for human immunodeficiency virus or patients with an AIDS-related condition but not outside the normal range for SIE (4 to 26 mU/mL), and the incremental increase in SIE level for a given decline in hemoglobin level was much less in AIDS patients than in patients with uncomplicated iron deficiency anemia. Forty-two patients were treated with zidovudine, and the hemoglobin level fell 10 g/L or more in 48%. In contrast to the untreated patients, however, the mean SIE level rose 10-fold to 214 mU/mL, and the incremental change in SIE level for a given decline in hemoglobin level was markedly increased. In the zidovudine-treated patients, erythrocyte mean corpuscular volume also rose significantly from a mean of 88.1 fL to 102 fL. However, in only 1 patient was there a corresponding increase in reticulocytes and in none was there amelioration of anemia. The data indicate that SIE level is inappropriately low in anemic AIDS patients. The ability of these patients to produce erythropoietin is intact and can be expressed with zidovudine therapy. However, even very high levels of SIE fail to stimulate erythropoiesis adequately. PMID- 2716143 TI - Knowledge, attitudes, and reported practices of medical students and house staff regarding the diagnosis and treatment of alcoholism. AB - Although alcoholism is prevalent in both general and inpatient populations, barriers to its timely diagnosis and effective treatment exist. These are often attributed to physicians' inadequate understanding and skill development and negative attitudes toward the disease. All Johns Hopkins' medical students and house staff, during 1986 through 1987, received a self-administered survey of their attitudes, skills, perceived role responsibility, knowledge, and reported practices with regard to alcoholism. Results indicate a strong relationship between perceived role responsibility, confidence in skills, and reported screening and referral practices among students and house staff. Knowledge levels strengthened the association between skills and practices for medical students. House staff perceived less of a responsibility for screening than medical students. There was a trend toward lower confidence and more negative attitudes among house staff than medical students. The results point to areas where educational interventions can be improved to enhance quality of care and outcomes for this major chronic disease. PMID- 2716144 TI - Blastomycosis. PMID- 2716145 TI - The synergistic triangle. PMID- 2716146 TI - Medical grand rounds at Hopkins. PMID- 2716147 TI - As farmworkers help keep America healthy, illness may be their harvest. PMID- 2716148 TI - Leads from the MMWR. Prevention and control of influenza: Part I, Vaccines. PMID- 2716149 TI - The treatment of chemical dependence. PMID- 2716150 TI - Toward smoke-free VA hospitals. PMID- 2716151 TI - Smoking cessation: the side effects of clonidine. PMID- 2716152 TI - The AMA's Campaign Against Cholesterol. PMID- 2716153 TI - An isolated total cholesterol level is inadequate. PMID- 2716154 TI - Racial inequalities in the use of procedures for ischemic heart disease. PMID- 2716155 TI - Black medical student enrollment: let's hear it for East Carolina University School of Medicine. PMID- 2716156 TI - The post-Bell Commission residency: sleep vs care. PMID- 2716157 TI - The gamma knife. PMID- 2716158 TI - Peppers, capsaicin, and the gastric mucosa. PMID- 2716159 TI - To dot plot or not. PMID- 2716160 TI - A nowhere near-death experience: heavenly choirs interrupt myelography. PMID- 2716161 TI - Why hasn't BCG proved dangerous in HIV-infected patients? PMID- 2716162 TI - Determinants of the pressor effect of phenylpropanolamine in healthy subjects. AB - Phenylpropanolamine (PPA) is frequently used in over-the-counter diet aids and cold medicines, In view of concern about the safety of this sympathomimetic agent, we undertook a double-blind, multicenter clinical trial to determine the factors that influence the pressor effect of short-term oral administration of PPA in healthy individuals. Eight hundred eighty-one healthy individuals in four categories of body weight were randomized to receive placebo capsules three times per day (n = 286), a 75-mg sustained-release PPA hydrochloride preparation once per day (n = 296) followed by two doses of placebo capsules, or a 25-mg immediate release PPA hydrochloride preparation three times per day (n = 299). The median age of the study population was 28 years, 56% were men, 73% were white, and 47% were in excess of 30% above their ideal body weight. Measurements of pulse rate and supine and standing blood pressure were made 11 times during the day of PPA administration. A statistically significant but clinically unimportant pressor effect for the short-term administration of PPA was observed. The effect occurred in the first 6 hours after administration and was greater in the sustained release group. Significant independent determinants of the pressor effect of PPA were baseline diastolic blood pressure, baseline body weight, and treatment. PMID- 2716163 TI - How often is medication taken as prescribed? A novel assessment technique. AB - The evaluation of the efficacy of medication is confounded when patients do not adhere to prescribed regimens. Overdosing, underdosing, and erratic dosing intervals can diminish drug action or cause adverse effects. Using a new method with epilepsy as a model, we assessed compliance with long-term medications among newly treated and long-term patients. Medication Event Monitor Systems (Aprex Corporation, Fremont, Calif) are standard pill bottles with micro-processors in the cap to record every bottle opening as a presumptive dose. Compliance rates averaged 76% during 3428 days observed: 87% of the once daily, 81% of the twice daily, 77% of the three times a day, and 39% of the four times a day dosages were taken as prescribed. Coefficients of variation of drug serum concentrations had no significant relationship to compliance rates. Pill counts overestimated compliance increasingly as compliance with the prescribed regimen declined. Neither drug serum concentrations nor pill counts would have identified the frequency of missed doses that were revealed with continuous dose observations. PMID- 2716165 TI - Poliomyelitis: the battle continues. PMID- 2716164 TI - HIV infection following motor vehicle trauma in central Africa. AB - The prevention of human immunodeficiency virus (HIV) infection during international travel is gaining increased attention. In this report, a 32-year old man acquired the HIV following a motor vehicle accident in Rwanda. During the accident the patient received multiple lacerations and was covered with the blood of similarly injured and bleeding passengers. This exposure through lacerated skin to the blood of persons with a high probability of being infected with HIV demonstrates an unusual mode of transmission and emphasizes the importance of HIV prevention during travel and of motor vehicle safety. PMID- 2716166 TI - A piece of my mind. Sunday morning call. PMID- 2716167 TI - Impact of a family history of hypertension on blood pressure levels during early and late adolescence. AB - The aim of this study was to examine the impact of a family history of hypertension (FHH) on blood pressure levels in Japanese rural adolescents. The study population consisted of 458 and 553 subjects, aged 13 and 16 years, respectively. Particular attention was focussed on subjects with a FHH (13 years old, n = 38; 16 years old, n = 46) and those without a FHH (13 years old, n = 83; 16 years old, n = 97). Significant associations were found between FHH and systolic blood pressure for boys and girls at 16 years old and diastolic blood pressure for girls at 16 years old. The impact of a FHH on blood pressure mainly affected systolic blood pressure in late adolescence (16 years of age). In early adolescence (13 years of age), different physical maturation status may have masked the real impact of a FHH on blood pressure. PMID- 2716168 TI - Role of afterload in progression of dilated cardiomyopathy--evaluation with force velocity relation. AB - To evaluate the clinical role of afterload in progression of dilated cardiomyopathy (DCM), a loading examination (study 1) and a follow-up study (study 2) were carried out, using echocardiography, and analysed with Force Velocity relation (FVR). FVR was defined as the relation between end-systolic wall stress (WSes) and mean circumferential fiber shortening velocity (mVcf). In study 1, the cardiac responses to angiotensin II loading in 30 cases with DCM (17 cases with presumed causes, and 13 without) were observed. These cardiac responses could be described by a hyperbola (Y = 197/(X + 9) + 0.04, r = 0.63) on the graph of FVR, and each response also seemed to fit the hyperbola (Y = a/(X + 9) + 0.04). This "a" value differed according to the presumed causes, and had an inverse correlation with % fibrosis in the biopsied cardiac muscle (Y = 0.86 + 29.9, r = -0.64, p less than 0.02). In study 2, during a mean clinical course of 3.7 years, the cardiac function (mVcf) in 19 out of 25 cases with DCM changed inversely with the changes of WSes on FVR. The "a" value calculated by the same method as study 1 did not differ before and after the follow-up. It did, however, vary according to the clinical outcome. These results suggest that afterload plays an important role in progression of DCM, and that an evaluation of cardiac function employing FVR may be helpful for assessing the myocardial damage, causative factors, and the prognosis of DCM. PMID- 2716169 TI - Endogenous and exogenous catecholamines can accentuate myocardial ischemia only when coronary blood flow is below a critical level. AB - Seventy-eight dogs with graded constriction of the left main coronary artery were studied to determine the coronary blood flow at which the heart is vulnerable to catecholamine induced ischemia. The left main coronary artery was cannulated with a Griggs' type self-perfusing cannula. The coronary blood flow (CBF) was reduced by graded constriction of the extra-corporeal circuit connected with this cannula. Blood flow rates between 12 and 117 ml/min/100 g were studied. Cardiac activation was achieved by either intracoronary administration of a physiological dose of catecholamine (noradrenaline; 0.4 microgram/kg/min or adrenaline; 0.2 microgram/kg/min), or by electrical stimulation of the left stellate ganglion (4 Hz, 2 msec, 10 V for 5 min). When CBF was below 30 ml/min/100 g, accentuated myocardial ischemia was always indicated by lactate production, myocardial creatine phosphate depletion, ischemic ST segment changes, and elevated left ventricular end diastolic pressure (LVEDP) during these stimulations. When CBF was above 50 ml/min/100 g, catecholamine clearly accelerated the cardiac function and myocardial metabolism with no signs of ischemia. When CBF was between 30 and 50 ml/min/100 g signs of accentuated myocardial ischemia appeared during catecholamine activation in only 1/2 of the dogs. This study indicated that the critical level for CBF at which endogenous or exogenous catecholamine can produce ischemia is between 30 and 50 ml/min/100 g. PMID- 2716170 TI - Myocarditis and arrhythmia: a clinico-pathological study of conduction system based on serial section in 65 cases. AB - We studied the conduction system of 65 cases of proven active or healed myocarditis and related diseases among 7120 autopsy samples. For this purpose, we prepared serial sections by Lev's method. The pathological diagnoses were idiopathic acute myocarditis (5), giant cell myocarditis (3), chronic myocarditis (13), healed myocarditis (22), sarcoidosis (4), collagen or autoimmune disease (13) and complication of cachexia (5). Among all the autopsy cases, Fiedler's myocarditis was found in only one case, but myocarditis was revealed in 19 out of 30 cases of dilated cardiomyopathy, and 15 out of 25 cases of sick sinus syndrome. Conduction system lesions were divided into two groups. In older cases manifesting mainly arrhythmia, the SA node, atrial muscle and AV node were involved concomitantly with perimyocarditis. In younger cases mainly showing heart failure, the RBB, LBB and Purkinje fibers were damaged by endomyocarditis. Histologically, interstitial myocarditis was observed in the former group and parenchymatous myocarditis in the latter. PMID- 2716171 TI - Blood pressure distribution and determinants of higher levels of blood pressure in Japanese rural adolescents. AB - The blood pressures (BP) and anthropometric values of 1,014 Japanese rural school children aged 12-17 years old were measured at one-year interval. The strongest correlation for systolic BP (SBP) was weight and for diastolic BP (DBP) it was age. Larger values of weight, body mass index, triceps skinfold thickness and smaller increment of height showed significant discriminative powers in differentiating the subjects who had been above the age-sex specific 80th percentile value (H-H group) from those who had been below the 20th percentile value (L-L group) for both SBP and DBP. Subjects with a family history of hypertension (FHH) had higher SBP than those without a FHH, and were more prevalent in H-H group for SBP. These results indicate that larger body size and more mature stature are determinants of higher levels of BP during adolescence, and that FHH affects SBP only in this period. PMID- 2716173 TI - Symposium on Pathophysiology and Severity of Heart Failure in the Aspect of Circulatory Insufficiency. 52th annual scientific session of the Japanese Circulation Society. May 12, 1988, Akita. Proceedings. PMID- 2716172 TI - Effect of a Chinese medicine "kyushin" on serum digoxin concentration measurement in dogs. AB - The effect of the Chinese medicine kyushin administered orally on serum digoxin measurement was studied in an animal model. Administration of 6 pills of kyushin caused a significant increase in the serum concentration of a digoxin-like immunoreactive substance (DLIS). The DLIS concentration increased to a peak value of 1.14 ng/ml at 11/2 hours and declined to 0.5 ng/ml after 24 hours. A one-week administration of 10 pills of kyushin a day produced a steady-state DLIS concentration ranging from 0.91 to 1.07 ng/ml. Among the 7 different kyushin ingredients, toad venom (ch'an-su in Chinese) was the only drug that produced DLIS in the dogs' serum. The similarity in structures of digoxin and toad venom most likely plays an important role in producing a cross-reactivity of DLIS with immunoassay antibody to digoxin. Although these findings require confirmation in human beings, they suggest that this nonprescription drug may seriously compromise the accuracy and interpretation of digoxin concentration measurements. PMID- 2716175 TI - Pathophysiology and evaluation of severity of congestive heart failure on the basis of venous characteristics. AB - To elucidate the possibility of grading the severity of congestive heart failure by using venous characteristics, we constructed venous pressure-volume curves (PVR) and calculated venous stiffness constants (K). In addition, effects of vasoactive drugs on venous distensibility were studied. A venous pressure-volume curve could be fit well by an exponential curve (r = 0.98 +/- 0.01). The PVR was shifted to the left with an increase in the clinical severity of congestive heart failure. The exponent of these curves, K, increased as the PVR was shifted to the left. K correlated with heart rate (r = 0.52, p less than 0.01), right atrial pressure (r = 0.54, p less than 0.02) and mean pulmonary arterial pressure (r = 0.47, p less than 0.04). Nitroglycerin and amrinone dilated veins and decreased K by 19.6 +/- 6.9% (p less than 0.03) and 14.0 +/- 4.3% (p less than 0.02), respectively. Changes in K (delta K) during the nitroglycerin and amrinone infusions correlated closely with the baseline K (delta K = -0.41 K + 0.22, r = 0.92, p less than 0.01). Therefore, the venodilating effects of these drugs were greater in patients with more severe congestive heart failure. The venous stiffness constant could be useful to grade the severity of congestive heart failure. PMID- 2716176 TI - Severity and pathophysiology of heart failure on the basis of anaerobic threshold (AT) and related parameters. AB - Cardio-pulmonary exercise testing was performed in 99 normal subjects and 382 patients with cardiac disease in order to evaluate anaerobic threshold (AT) and related parameters as indices for assessing the severity of heart failure. AT could be determined easily during ergometer exercise testing with ramp protocol by monitoring minute ventilation (VE), oxygen uptake (VO2) and carbon dioxide output (VCO2). Peak VO2 and the ratio of VO2 rising to work rate increment (delta VO2/delta WR) were also determined. There was good correlation between the AT determined by respiratory measurement and that determined by arterial lactic acid concentration (r = 0.93, n = 15). The reproducibility of AT was excellent between 2 testings with a 3-hour interval. AT (ml/min/kg) and peak VO2 (ml/min/kg) declined with age, and males showed higher values than females in both indices. %AT, determined by the predicted AT values of each age and sex, decreased as NYHA class progressed as follows: 90.2 +/- 15.4% in class I, 76.9 +/- 13.8% in class II, and 59.7 +/- 11.9% in class III. Although delta VO2/delta WR was not influenced by age or sex, it also decreased as the severity of heart disease progressed. These results suggest that indices from cardiopulmonary exercise testing, especially AT, are closely related to the pathophysiology of heart failure, so that they are objective and reliable parameters for evaluation of the severity of heart failure and are sensitive enough to detect the efficacy of therapeutic intervention for heart failure. PMID- 2716174 TI - Relationship of plasma norepinephrine to ventricular-load coupling in patients with heart failure. AB - The relationship of plasma norepinephrine levels to the adaptational changes in ventricular-load coupling were studied at rest and during exercise in subjects with variably depressed ventricular function. Peak body oxygen consumption (VO2) and gas exchange anaerobic threshold (ATge) were measured to assess exercise capacity. Ventricular contractile properties were expressed by the slope (Ees) of the end-systolic pressure-volume relation and mechanical arterial properties were expressed by the slope (Ea) of the end-systolic pressure-stroke volume relation. Resting plasma norepinephrine was significantly elevated in patients with severe heart failure (New York Heart Association class III, IV) and correlated well with the magnitude of reduction in peak VO2 and ATge. In these patients, Ea/Ees ratio was also increased and correlated with the levels of resting plasma norepinephrine. Although pump efficiency of the left ventricle progressively fell with the development of heart failure, stroke volume was maintained within normal range by virtue of a compensatory increase in end-diastolic volume. Sympathetic activity was much higher in anaerobic exercise than in aerobic exercise. However, Ees (ventricular contractility) remained at the same value throughout the exercise period. Thus, an increase in stroke volume during anaerobic exercise was caused more by an increase in end-diastolic volume than by an enhanced contractility. Our results suggest that the level of resting plasma norepinephrine can be a good predictor of the modulation of ventricular-load coupling in patients with heart failure and that when contractile reserve is decreased, the Frank-Starling mechanism plays an important role in the control of stroke volume. PMID- 2716177 TI - Severity of cardiac failure from the standpoint of pulmonary circulation: studies centered on distribution of pulmonary perfusion. AB - In a normal man sitting upright, pulmonary perfusion is several times greater in the lower lung zone than in the upper zone. This pattern may sometimes be reversed in patients with cardiac disease. Tc99m-macro-aggregated albumin pulmonary perfusion images were computerized to isocounts area images (digital perfusion images; DPI). DPI were applied to various types of cardiac disease and patterns of DPI were divided into 4 classes according to amount of nonperfused pulmonary vascular bed. C-0; normal perfusion. C-1; decrease of nonperfused pulmonary vascular bed. C-2; disappearance of nonperfused pulmonary vascular bed. C-3; decrease of pulmonary vascular bed. In 71 patients with mitral stenosis relationships between pulmonary hemodynamics during exercise and distribution of pulmonary perfusion were studied, i.e. at rest (n = 71, mean pulmonary arterial pressure; 23 mmHg-cardiac index; 2.4 L/m) and during exercise C-0 (n = 13, 41 mmHg-5.4 L/m), C-1 (n = 17, 52 mmHg-5.2 L/m), C-2 (n = 27, 52 mmHg-4.5 L/m) and C 3 (n = 14, 65 mmHg-3.6 L/m) respectively. In patients with congestive heart failure cardiac status was classified to 4 classes according to ejection fraction and DPI. Patients with EF less than 30% and DPI more than C-2 showed high morbidity and mortality (two years mortality 47%; 27/40). Pulmonary venous pressure increases to maintain the cardiac index (Starling's law) in cases of decline in cardiac function or mitral stenosis. It was shown that increases in pulmonary venous pressure cause changes in distribution of pulmonary perfusion, which in turn works to depress the cardiac index. A decline in cardiac function and changes in the distribution of pulmonary perfusion coexist, mediated by pulmonary venous pressure and cardiac index. The distribution of pulmonary perfusion reflects the severity of cardiac failure itself, so by using DPI the severity of cardiac failure can be easily evaluated. PMID- 2716178 TI - Liver function in congestive heart failure: abnormal elevation of serum hepatic enzyme and hepatic venous flow velocity. AB - Fifty one patients (pts) with various heart diseases and 6 normal subjects (N) were studied. Four of the 51 pts showed unusually high GOT values (greater than 3000 IU) without preceding evidence of acute heart failure, myocardial infarction, or hepatitis. Of these 4 pts, either ventricular tachyarrhythmias, marked bradycardia, or rapid ventricular response with atrial fibrillation (af) were evident a few days prior to the GOT elevation. GOT values returned to below 100 IU within a few days, but hypotension and frequent arrhythmias were sustained in 3 of the 4 pts and these 3 pts died about one month later. The symptoms of the remaining one improved but he too died 9 months later of ventricular fibrillation. A postmortem histological examination revealed centrilobular necrosis of the liver cells. Thus, abnormal GOT elevation may result from hepatic cell necrosis, which is probably due to tissue hypoperfusion caused by severe arrhythmias. Hepatic venous flow velocity (HFV) was measured in the remaining 47 pts and 6N using a pulsed doppler echocardiogram. The HFV curve was biphasic, with the first curve corresponding to the forward flow velocity during ventricular systole (s-HFV) and the second corresponding to ventricular diastole (d-HFV). The ratio of the area under s-HFV curve to the sum of areas under s-HFV and d-HFV curves was defined as the VI ratio. In N, the VI ratio was 0.7 +/- 0.06 whereas the VI ratio in pts in sinus rhythm tended to be above 0.7. This indicated that s-HFV is greater than d-HFV in N while s-HFV is less than d-HFV in pts in sinus rhythm. There was a good negative correlation (n = 15: r = -0.70) between VI ratio and cardiac index (CI) in these pts, suggesting that the contribution of s-HFV to the venous return becomes greater as the cardiac function becomes more impaired. In pts with af, the VI ratio was below 0.5 and there was a good positive correlation (n = 14: r = 0.82) between the VI ratio and CI. This suggested that the s-HFV may be reduced due to a lack of atrial contribution in af so that contribution of d-HFV to venous return becomes greater as the cardiac function becomes more impaired. Thus, the HFV pattern may reflect the abnormality of the cardiac pump function in human beings. PMID- 2716180 TI - Clinical significance of renal hemodynamics in severe congestive heart failure: responsiveness to ultrafiltration therapies. AB - Isolated ultrafiltration, hemodialysis & peritoneal dialysis (Tx) were recently used in the treatment of intractable heart failure (HF). We examined the relation between the response of HF to Tx and the residual kidney functions. Tx was carried out in 17 patients (Pts) with HF who did not respond to aggressive medical treatment. Ten Pts (R) responded to Tx and 7 Pts (N) did not. Serum urea nitrogen (UN), creatinine (Cr), uric acid (UA), sodium (Na), potassium (K), and chloride (Cl) concentrations on admission and before Tx were not different between R and N. Urine UN, Cr, Na, K, and Cl on admission and before Tx were also not significantly different. Fractional sodium excretions (FENa), renal failure indices (RFI), and urine/plasma Cr ratios (U/P Cr) on admission were 2.0 +/- 1.6, 2.7 +/- 2.2, and 30.5 +/- 20.0 in R and 5.9 +/- 4.2, 8.2 +/- 6.0 and 11.5 +/- 3.8 in N. They were significantly different (p less than 0.05). However, these did not differ before and after Tx. These data show that FENa, RFI and U/P Cr might be useful indices in predicting the responsiveness of intractable HF to Tx. PMID- 2716181 TI - [Abstracts of papers presented at meetings of local sections of the Japanese Circulation Society]. PMID- 2716179 TI - Analysis of acute and chronic heart failure in view of hepatic oxygen supply demand relationship using hepatic venous oxygen saturation. AB - The adequacy of hepatic circulation in terms of oxygen supply-demand relation was assessed by measuring hepatic venous oxygen saturation (Shvo2) in patients. Among those with congenital cardiac lesions (n = 11), Shvo2 during the early postoperative period was markedly low as less than 20% in Fontan operation group (n = 5) with subsequent clinical findings of acute hepatic dysfunction. Significant correlations were found between Shvo2 values early after surgery and subsequent peak values in serum hepatic enzymes. Serum total bilirubin and prothrombin time started to deteriorate when Shvo2 became below 30%. Cardiac index, hepatic perfusion pressure and mixed venous oxygen saturation showed positive linear correlations with Shvo2, and central venous pressure (CVP) with an inverse relation. In chronic valvular disease (n = 28), those with NYHA class IV patients showed lower Shvo2 (average; 47.4%) at cardiac catheterization than the others (class-I; 66.4%, class-II; 63.9%, p less than 0.05). These results indicate that Shvo2 monitoring appears to be useful to assess the hepatic perfusion in terms of oxygen supply-demand relation in acute and chronic heart failure, and Shvo2 of 30% seems to be a critical level. PMID- 2716182 TI - [Radiation therapy of carcinoma of the hypopharynx and recurrence in the epipharynx and mesopharynx]. AB - The role that radiation therapy plays in the prophylaxis of an epi-and mesopharyngeal recurrence of a hypopharyngeal cancer remains undefined. Because of this 48 patients with a hypopharyngeal cancer, who had undergone radiation therapy from 1975 through 1987 at Chiba University Hospital, have been analyzed retrospectively. The 5-year-survival was 17% and an epi- or a mesopharyngeal recurrence was found in 8 patients. A radiation dose of more than 1350 ret seemed to prevent a recurrence in these regions, although it must be further studied as to whether an increase of the radiation field to include the epipharynx can be effectively improved the recurrence-free survival rate. PMID- 2716183 TI - [Causes of death after an early gastric cancer operation]. AB - From April, 1972 to December, 1984, 329 early gastric cancer case were operated on by this department. Results of these operations have revealed the following statistics: The 5-year survival rate of those with an m-cancer was 97.6% and for those with an sm-cancer, 92.6% and, the 10-year survival rate of m-cancer was 91.6% and sm-cancer, 89.9%, respectively. Twenty-nine postoperative deaths were recognized in this series, and the causes of death in each case have been analysed. Prophylactic measures to prevent postoperative death also are discussed. PMID- 2716184 TI - [Response to antitumoral agents of a human medulloblastoma implanted into the chorioallantoic membrane of a chick embryo]. AB - In a previous study the authors have reported on a correlation between the effects of drugs on gliomas grown in the eggs and in the nude mice, and in this study, they have observed the antineoplastic effects of ACNU or combined chemotherapy (CAP-cyclophosphamide, adriamycin, cisplatin) against a medulloblastoma applied onto the chorioallantoic membrane (CAM) of a chick embryo. In this model, ACNU was thought to be ineffective because of an intracerebral dissemination that occurred in spite of the administration of ACNU. ACNU also proved ineffective against the medulloblastoma that grew on the CAM. There seemed to be correlation between the results of this test and the clinical course of this model. Thus this sensitivity test is thought to be useful in the screening of drugs against gliomas. PMID- 2716185 TI - [An autopsied case of malignant paraganglioma of the posterior thoracic cavity]. AB - An autopsied case of a malignant paraganglioma of the posterior thoracic cavity is reported. A 68-year-old man had complained of chest discomfort, and serial examinations revealed a functioning paraganglioma with bone metastasis. After death a pathological examination revealed that the tumors consisted of alveolarly arranged cells and well developed capillary vessels. Numerous neurosecretory granules were observed on viewing by electron microscopy. An immunohistochemical examination showed that most of the tumor cells were positive for NSE, while only a few cells were positive for the S-100 protein. These results indicate that a paraganglioma originating from the aortic sympathetic paraganglia had similar features of a carcinoid and a neuroblastoma. PMID- 2716186 TI - [Limitations in diagnosing laryngeal lesions by physical inspection as against achieving diagnoses histologically]. AB - In diagnosing a lesion in the ENT area, an inspection that includes a physical examination and palpation is important. For a laryngeal lesion, however, the physical examination inspection becomes especially important, since palpation cannot be done. In most instance, the macroscopic diagnosis corresponds well with the findings uncovered by the histological diagnosis. However, we have found that a histological examination is crucial in diagnosing cases of a "White-pathy" lesion in the larynx, to confirm if the lesion is a so-called leukoplakia, a pre cancerous manifestation, or an early cancer. PMID- 2716187 TI - [A clinical study of a multiregression analysis on the NK activity and related clinical factors in patients with lung cancer]. AB - Using 24 lung cancer patients (20 males and 4 females) who had received radiotherapy, a multivariate analysis has been performed in relation to 19 factors suspected of exerting an effect on natural killer (NK) cell activity. As influencing factors, two factors of the disease, the stage (p less than 0.05) and the leukocyte count (p less than 0.08), were calculated to be significant. In the univariate analysis, the NK activity was found to be significantly low (p less than 0.05) when the leukocyte count was 7,000 or higher. In addition, patients who had died during the course of radiotherapy showed an NK activity which was significantly lower (p less than 0.05) than the activity manifested in both the disease-free patients and the relapsed progressive disease patients. Moreover, the patients with a PS of 40% or less had a significantly lower NK activity than the patients with a PS of 50% or more, though no correlation was found between the NK activity and the disease stage. In the use of this radiotherapy, the NK activity was found to be more strongly influenced by the size of the irradiated field than by the irradiated dose. PMID- 2716188 TI - [Double primary malignant tumors involving a lung cancer]. AB - Patients with multiple primary malignant tumors involving a primary lung cancer have been analyzed at our department in the Gunma University hospital. With reference to the lung cancer, three quarters of these patients were clinically in stages III or IV. The lung cancers were histologically classified into 26 epidermoid cancers, 14 adenocarcinomas, one large cell carcinoma, and one small cell carcinoma. Other primary cancers were 13 gastric cancers, 7 laryngeal cancers, 6 cervical cancers, 3 colon cancers, and other such cancers. Cases manifesting simultaneous cancers showing less than a one-year interval were 15 whereas 27 cases had double primary cancers with intervals of over one-year. Eleven patients had been given radiation therapy for their initial malignant tumor, but only two cases were considered to have incurred a radiation-induced lung cancer with a latent period of 5 and 12 years respectively. PMID- 2716189 TI - [Early carcinoma of the gastric remnant: pathological features relating to the interval between the initial and second surgery]. AB - Twenty cases of early carcinoma of the gastric remnant have been treated at our hospital and examined clinico-pathologically. In 11 cases, the interval after the initial gastrectomy, due to the gastric carcinoma, was done was short compared with length of the interval of 9 cases after a gastrectomy for a benign gastric disease. There were two types of gastric remnant carcinomas in cases in which the interval extended 10 years. The first type developed at the site of the gastro intestinal anastomosis, especially when the anastomosis was found to be joined by the Billroth II method, and the carcinoma was associated with a gastritis cystica polyposa (GCP). The other type showed a polypoid appearance except for the stomal site. PMID- 2716190 TI - [Clinical application of dynamic CT]. AB - 10 patients with primary pulmonary cancer were performed using of dynamic CT scanning with dynamic curve and obtained radiograms were analyzed with computer. Blood is supplied usually via a bronchial artery to primary pulmonary cancer. But we could be analyzed four types on blood supplying to the primary pulmonary cancer which are via aorta, pulmonary artery, aorta and pulmonary artery and non classified type. This technique be able to suggest of effectiveness of radiotherapy with analyzing of exist of center necrosis of the tumor. Therefore we radiotherapist and radiation oncologist be able to avoid radiation-induced pulmonary pneumonia and pulmonary fibrosis especially high aged patients. We are recommended to take a this technique as preirradiative examination for patient with pulmonary cancer because of avoiding of no available radiotherapy. PMID- 2716191 TI - [A review of childhood cases of malignant lymphoma in Osaka, Japan]. AB - Fifty-one cases of malignant lymphomas in patients under 20 years of age have been reviewed in Osaka, Japan. The breakdown of these cases revealed 6 cases (11.8%) of Hodgkin's disease (HD) and 45 cases (88.2%) of a non-Hodgkin's lymphoma (NHL). Both the HD and NHL cases were determined by using the Rye classification, as well as the Rappaport, Kiel, and LSG classifications, respectively. The results have shown that (1) the incidence of HD in childhood is the same as that seen in the adult in Japan; (2) that a NHL of the nodular type is rare in Japan as it is in Western countries; (3) that any significant differences were not present in the distribution of each histologic subtype in the cases of a NHL among Japan and Western countries, and that the lymphoblastic type was the most common. From this study it is concluded that geographical differences were not a factor in comparing cases of childhood malignant lymphomas in Japan and Western countries. PMID- 2716192 TI - [The trial use of alpha-IFN in treating a case of chronic myelomonocytic leukemia with splenic infarction]. AB - A 75-year-old man, previously diagnosed as having chronic myelomonocytic leukemia, suffered an attack of severe left hypochondralgia in July 1986. A splenic infarction was diagnosed by both ultrasound tomography and computerized tomography. The patient was treated with alpha-Interferon (600 M.U./day i.m.) for cytoreduction in order to prevent a recurrence of the splenic infarction. Twenty one days later, the peripheral white blood cell count decreased from 44,110 microliters to 9800/microliters and the monocytoid immature cells disappeared. However, severe dementia appeared and so alpha-Interferon therapy was abandoned. In this report the beneficial effects and side effects of alpha-interferon in the treatment of chronic myelomonocytic leukemia are discussed. PMID- 2716193 TI - [A case of pulmonary carcinoma presenting flow cytometrical heterogeneity of the nuclear DNA content between its primary focus and the metastatic foci]. AB - We have experienced case involving a 63-year-old patient with a pulmonary carcinoma, who was given an enterectomy following a lobectomy, due to minimal intestinal metastasis. In this case, using flow cytometry, the cancer cell nuclear DNA content was analyzed for the primary tumor focus, the mediastinal lymph node metastatic focus, and the small intestinal metastatic focus. For the primary focus, a cancer cellular population of polyploidy with 2 ploidies of DNA content was observed, while for both the metastatic foci, only a single cancer cellular population was observed, indicating the heterogeneity of the nuclear DNA content between the primary focus and metastatic foci. These 2 metastatic foci had DNA contents completely corresponding to that for a ploidy with a high DNA content in the primary focus, suggesting a metastasis of only the above population from the primary focus. The present case apparently formed metastatic foci in other organs than the lungs but only by cancer cells more susceptible to metastasis among the cancer cells found in the primary focus. PMID- 2716194 TI - [Therapeutic effectiveness of vitamin D3 in patients with myelodysplastic syndromes, leukemias and myeloproliferative disorders]. AB - We tried to treat 13 patients with myelodysplastic syndromes (MDS), leukemias and myeloproliferative disorders, with alfacalcidol for their hematological improvement. Eight of them had MDS, 2 acute leukemia (M3, M4), 1 chronic myelogenous leukemia and 2 primary myelofibrosis. All patients were untreated except for 3 patients (PASA, RAEB, AML-M4) who had been treated with mepitiostane, prednisolone and BH.AC-AMP regimen, respectively, prior to alfacalcidol therapy. All patients received alfacalcidol orally for at least one month. The dosage of alfacalcidol ranged from 0.25 to 10 micrograms/day, and the medicine was administrated intermittently when the dosage exceeded 6 micrograms/day to prevent hypercalcemia. The therapeutic effectiveness of alfacalcidol was evaluated according to a criteria by Koeffler (Cancer Treat Rep 69: 1399, 1985) with minor modifications. Three patients (PASA, RAEB, CMML) showed partial response, 3 (RAEB, RAEB in T, AML-M4) minor response and rest of the patients did not respond. The hematological improvement of 6 responders was transient (from 1 to 2 months), however, one patient (PASA) is still responding to alfacalcidol therapy (0.25 microgram/day) for over 12 months. The dysplastic features of hemopoietic cells in the bone marrow showed no noticeable change during the hematological improvement in these responders, suggesting the improvement was obtained as a result of alteration in the proliferation or differentiation of neoplastic clone. None of 13 patients developed hypercalcemia. One patient (AML-M4) became excitable on high dose alfacalcidol (10 micrograms/day). In conclusion, alfacalcidol therapy is effective in some patients with MDS or leukemias and appears worthy especially in the clinical state in which chemotherapy is not indicated. PMID- 2716195 TI - [ATP and ADP of platelets in chronic myeloproliferative disorders and multiple myeloma]. AB - The content of platelet adenine nucleotide in chronic myeloproliferative disorders (CMPD) and multiple myeloma (MM) was measured by a luciferin-luciferase method by Holmsen and Weiss. The release of ATP and ADP from platelet during aggregation induced by collagen and epinephrine were analyzed. The total 42 investigated cases consisted of 11 cases of polycythemia vera (PV), 7 cases of essential thrombocythemia (ET), 7 cases of chronic myeloid leukemia (CML), 9 cases of blastic crisis of CML (BC-CML), and 8 cases of multiple myeloma (MM). The healthy control was 19 cases. In CMPD and MM, the amount of ATP was normal in spite of decrease of ADP; therefore, the ratio of ATP/ADP increased. On the other hand, the ATP significantly increased in BC-CML. MM revealed a remarkable increase of ATP release due to the aggregation by collagen and epinephrine. The maximal rate of aggregation of collagen and epinephrine using Lumi-aggregometer indicated a positive relationship with the ATP release by the Holmsen and Weiss' method. The platelet volume in CMPD increased showing correlation with ATP content and not with ADP. In conclusion, CMPD and MM are regarded as acquired qualitative disorders of platelets or secondary storage pool diseases from the view points of the abnormalities in ATP, ADP contents and their release. However, BC-CML and MM revealed some different change from that of CMPD. PMID- 2716196 TI - [BCR rearrangement and cytogenetic findings in Philadelphia-positive chronic myelocytic leukemia in children]. AB - Eight children with Philadelphia (Ph1) chromosome positive chronic myelocytic leukemia (CML) were available for cytogenetic studies and breakpoint cluster region (bcr) rearrangement analysis as compared to the features of adults with Ph1-positive CML. In chronic phase additional abnormalities other than Ph1 chromosome were found in none of our cases. On the other hand, in blastic crisis all of 6 cases had additional chromosomal abnormalities like as i(17q), double Ph1 and +8. The frequency of the appearance of additional chromosomal abnormalities, especially i(17q), is higher in children than in adult cases. In the DNA of 7 of 7 examined patients, rearrangement of bcr could be demonstrated by Southern blot analysis. These findings were similar to those observed in adults. An analysis of the location of the bcr breakpoint indicated that 5' breakpoints were found in four cases who were long-term survivors, and two of the other cases had blastic crisis from the onset of the disease. These findings showed the cytogenetic findings of children with Ph1+CML were different from those of the adult cases in the frequency of the appearance of the additional chromosomal abnormalities, and the location of the bcr breakpoint in children cases might be different from that in the adult cases and influence its prognosis. PMID- 2716198 TI - [Megaloblastic anemia associated with diffuse intestinal Crohn's disease]. AB - A 40-year-old man who was resected ascending colon and terminal ileum (10 cm) in Aug. 1978, with the diagnosis of Crohn's disease, was admitted to our hospital with general fatigue, paresthesia and tremor in May. 1984. A peripheral blood examination on admission revealed Hb 10.1 g/dl, RBC 234 X 10(4)/mm3, MCV 131.4 fl, MCH 43.2 pg. A bone marrow specimen showed marked erythroid hyperplasia (W/E 1.44) with megaloblastic change. While serum folate level was normal, serum vitamin B12 value was low and Schilling test showed vitamin B12 malabsorption. Roentgenologic and endoscopic examinations revealed diffuse cobblestone appearances in small intestine (from anastomosis part to duodenal bulb). These examinations suggested vitamin B12 malabsorption with diffuse Crohn's disease caused megaloblastic anemia. The patient had been treated with vitamin B12 1,000 micrograms/day injection and, in Sep. 1984, he recovered from megaloblastic anemia (Hb 13.4 g/dl, RBC 440 X 10(4)/mm3, MCV 90.7 fl, MCH 30.4 pg). PMID- 2716199 TI - [Development of acute myelocytic leukemia in the course of Sjogren's syndrome]. AB - A 53-year-old female, who had been having xerostomia and xerophthalmia for two years, was admitted in November 1984, because of subfever and malaise. Laboratory examination revealed pancytopenia with appearance of blasts, mild hypergammaglobulinemia, and elevated titers of ANA, anti SS-A and anti SS-B. Bone marrow aspirate showed increased myeloblasts. Schirmer's test and Rose Bengal's test were both positive, and sialography showed apple tree like appearance. Pathological findings of biopsied lip mucosa showed remarkable infiltration of lymphocytes. The patient was diagnosed acute myelocytic leukemia and Sjogren's syndrome. In spite of recovery of peripheral blood after combination chemotherapy (BHAC-DMP), a disturbance of consciousness appeared and she died of its progression. It was suspected clinically that she was suffered from progressive multifocal leukoencephalopathy (PML). It is sometimes reported that patients with Sjogren's syndrome develop malignant lymphoma, but it is very rare that Sjogren syndrome develop AML. PMID- 2716197 TI - [Chronic neutrophilic leukemia clinicopathological investigation on Japanese cases: with the questionnaire]. AB - The clinical picture and disease features of chronic neutrophilic leukemia (CNL), a rare hematological disorder, were investigated among 38 patients collected from Japanese reports. According to the diagnostic criteria, review of Japanese literature was carried out, using the questionnaire to the reporters of CNL cases. The rate of return for the questionnaire was 23/29 (79.3%). Of the 38 CNL patients, 26 were men and 12 were women. Their mean age at diagnosis was 65.2 years. The mean value of initial laboratory data were as follows; leukocyte count 54,000/mm3 with 86.9% mature neutrophils, hemoglobin 10.6g/dl, platelet count 22.0 X 10(4)/mm3, NCC from the bone marrow 44.9 X 10(4)/mm3, and NAP score 400.5. The CFU-C value was decreased in 17 of 24 cases examined. Two among the thirteen cases showed an increase of CSF activity in serum, and none was detected in urine of four cases. The clinical course in 33 cases were evaluated, and the median survival after the diagnosis was 21 months. Three cases terminated blastic crisis. Two had features similar to polycythemia during their course. The association with monoclonal gammopathy or multiple myeloma was found in 8 cases (21.8%), and this appears to be among the presenting clinical characteristics. Hemorrhagic diathesis was often fatal and was the most frequent cause of death (13 out of 28 cases died). Postmortem examination showed occasional systemic infiltration with neutrophils or leukemic cells in most organs including liver and spleen. PMID- 2716200 TI - [Successful treatment with a small dose of N4-behenoyl-1-beta-D arabinofuranosylcytosine in a case of chronic myelomonocytic leukemia in blastic crisis]. AB - A 56-year-old female was admitted for the examination of leukocytosis in May, 1982. The hematological examination showed hemoglobin 12.0g/dl, platelets 14.5 X 10(4)/microliters and leukocytes 18,000/microliters with 28% of monocytes. A bone marrow aspiration revealed granulocytic hyperplasia. Granulocytes showed nuclear abnormalities, such as folding or lobulation. From these data, a diagnosis of chronic myelomonocytic leukemia (CMMoL) was made and followed with no treatment for 2 years. However, fever, bone pain, anemia, thrombocytopenia and the increase of monoblasts in the peripheral blood and bone marrow were observed in May, 1984. These findings indicated that she was in the blastic phase. She was treated by intensive combination chemotherapy (BHAC-AMP), but did not attain any remission. Therefore, a small dose of N4-behenoyl-1-beta-D-arabinofuranosylcytosine (BH-AC; 1 mg/kg/day) was administered for 70 days. As a result, complete remission was obtained and continued for 37 months with the same therapy. The experience of this case suggests that small dose of BH-AC could be applied to a case of CMMoL in blastic crisis. PMID- 2716201 TI - [Acute promyelocytic leukemia with a history of RAEB in transformation and the 15/17 translocation]. AB - A 34-year old female was admitted to our clinic because of fever and general fatigue on March 26, 1987. On admission, peripheral blood (PB) revealed pancytopenia. Bone marrow smears revealed 9. 0% of promyelocytic cells with or without Auer rods. Diagnosis of RAEB in transformation was made. Chromosome study of the bone marrow cells showed t(15; 17) in 3 out of 20 cells analysed. After 3 months, the leukemic cells were observed in PB and increased in number. Then the patient showed bleeding tendency and fibrin degradation products (FDP) increased up to 40 micrograms/ml. And the leukemic cells were over 30% in PB at the end of July, 1987. The diagnosis of APL with DIC was made. To our knowledge, this is the first case of APL with a history of MDS with t(15; 17). PMID- 2716202 TI - [Severe aplastic anemia remarkably improved by a treatment with antilymphocyte globulin, high-dose methylprednisolone and danazol]. AB - Sixteen-years-old female with severe aplastic anemia received a therapy combined with antilymphocyte globulin (ALG), high-dose methylprednisolone (m-PSL) and danazol. At the hospitalization, hematological examination demonstrated as follows; reticulocyte 21,000/microliters, granulocyte 350/microliters, platelet 10,000/microliters and hypocellular bone marrow. Treatment schedule were 1) m-PSL 1,000 mg (day 1-4), 500 mg (5-8)--then tapered. 2) ALG lg/day (day 4-8) 3) danazol 600 mg/day. During ALG administration, leukocytopenia and thrombocytopenia appeared but thereafter hematological recovery was obtained and the patient was free from supportive care. She developed mild diabetes mellitus and moderate liver dysfunction, nevertheless, both of which were controlled. At 3 months after the beginning of the treatment, hematological examination demonstrated as follows; reticulocyte 236,000/microliters, granulocyte 1,900/microliters, platelet 56,000/microliters and normocellular bone marrow. Although this immunosuppressive therapy was remarkably effective to this patient, immunological relation to the onset of aplastic anemia was not demonstrated in in vitro examination. This combined therapy seems to be effective one for patients with severe aplastic anemia. PMID- 2716203 TI - [An adolescent case of myelodysplastic syndrome following aplastic anemia]. AB - A male with myelodysplastic syndrome (MDS) following aplastic anemia is reported. The patient had been diagnosed as aplastic anemia at 8 years of age, and treated with blood transfusions, anabolic and glucocorticoid steroid hormones. Over a period of subsequent twelve years, he had remission and deterioration. At the age of 21, the patient developed a sudden progression of severe anemia, when his bone marrow showed hyperplasia with prominent dyshematopoiesis and excess of blasts, compatible with MDS by the definition of FAB classification. He received low dose Ara-C therapy, which was ineffective. Nine months later he developed acute monocytic leukemia (M5b) and died. Chromosomal analysis revealed 46, XY at the onset of aplastic anemia, 46, XY, del (6) (q21 q27) at the MDS and 46, XY, -7, +21, 6q-/47, XY, +Y, -7, +21, 6q- at the acute leukemic stage. PMID- 2716204 TI - [The successful surgery of lung abscess formed from pulmonary aspergilloma in a patient with recurrence of acute promyelocytic leukemia during remission induction therapy]. AB - This is a case report of a successful case of surgical treatment of a lung abscess formed from pulmonary aspergilloma in a patient with a recurrence of acute promyelocytic leukemia during remission induction therapy. A 39 year-old woman was admitted to our hospital for remission induction therapy of a recurrence of acute promyelocytic leukemia. We were successful in bringing her to a state of complete remission by a therapy of a intermediate-dose of Ara-C. Pulmonary aspergilloma was formed in the right lung during therapy. We performed transbronchial infusions to Amphotericin B which dissipated the fungus ball. However, a lung abscess was formed. We needed radical therapy, and there were no complications in the following surgical treatment. Recently, along with the tendency for the use of stronger chemotherapy treatment regimes for acute leukemia, there has been an increase of the number of mycosis cases such as the pulmonary aspergilloma case reported here. Accordingly, surgical treatment is becoming more and more a matter of necessity in the clinical course of leukemia patients. PMID- 2716206 TI - [73d congress of the Medico-Legal Society of Japan. 10-12 May 1989, Okayama City. Abstracts]. PMID- 2716207 TI - Bureau of standards. PMID- 2716205 TI - [Clinical evaluation of the control of antiplatelet therapy through platelet aggregation rate on polycythemia vera associated with thrombocytosis and erythromelalgia]. AB - A 60-years-old woman with polycythemia vera with marked thrombocytosis and intolerable erythromelalgia was presented. A single dose of 400 mg aspirin was effective to improve the pain and cyanosis. And we studied the relationship between platelet aggregation rate and symptoms after administration of several antiplatelet drugs. A single dose of 100, 200, 400 and 800 mg aspirin, 25 mg indomethacin (Id), 200 mg OKY-046, and daily dose of 300 and 600 mg dipyridamole (Dp) and 300 mg ticlopidine (Tc) were given. Aspirin, Id and OKY-046 were effective for the improvement of finger pain. The complete inhibition of spontaneous aggregation (SPA) and aggregation by 2.0 micrograms/ml of collagen were well parallel with the improvement of symptoms. But duration of effect of LKY-046 were only 6 hours. Dp and Tc were not effective for the improvement of pain, had no relation with platelet aggregation rate. The concentration level of aspirin in vivo which suppresses the platelet aggregation induced by SPA and 2.0 micrograms/ml of collagen coincided well with the concentration level of this drug which suppresses the same platelet aggregation in vitro. It seems to be useful to suppress the platelet aggregation induced by SPA and 2.0 micrograms/ml of collagen with aspirin and Id for controlling the platelet aggregation induced circulatory disturbance in patient with thrombocytosis. PMID- 2716208 TI - The roles of the office and hospital nurse. PMID- 2716209 TI - Maternal death studies. AB - Since its inception, the Maternal Health Committee has assumed as one of its primary functions the study of maternal deaths occurring in the state. The study includes investigation of each case, with interviews with the physicians involved, committee discussion and assignment of responsibility. Periodic publication of these studies in Kansas Medicine constitutes the completion of the educational process embodied in this effort to improve the health of Kansas mothers and newborns. PMID- 2716210 TI - Special project in Swaziland. PMID- 2716211 TI - Overseas elective in Swaziland. PMID- 2716212 TI - Health care in Okhaldhunga, Nepal. PMID- 2716213 TI - Common diseases in Nepal. PMID- 2716214 TI - Mexico: a special program in international health care. PMID- 2716215 TI - Studies on in vitro mechanisms of anti-tumor activity of the tumor necrosis factor alpha against human renal carcinoma cell line (KU-2). AB - To clarify the mechanisms of anti-tumor activity of human recombinant tumor necrosis factor alpha (rTNF alpha), an established cell line KU-2, derived from a patient with human renal cell carcinoma (RCC), was treated with rTNF alpha alone or in combination with anti-cancer agents: actinomycin-D (ACD), vinblastine sulfate (VLB), nimustine hydrochloride (ACNU), and methotrexate (MTX). Cytotoxic assay by crystal violet dye exclusion test showed that 21.0 +/- 4.0% and 34.8 +/- 4.7% of the cells were killed by 72 hours incubation with 100 ng/ml of rTNF alpha, alone and 1 ng/ml of ACD alone, respectively. Synergistic cytotoxicity of 75.0 +/- 0.3% was observed at 72 hours when 100 ng/ml of rTNF alpha and 1 ng/ml of ACD were added simultaneously. Furthermore, additive cytotoxicity of 48.5 +/- 1.1% was observed by 0.1 ng/ml of VLB and 100 ng/ml of rTNF alpha. However, when KU-2 was treated in conjunction with both 100 ng/ml of rTNF alpha and 3 micrograms/ml of ACNU or 2.5 ng/ml of MTX, no significant increase in cytotoxicity was demonstrated. When KU-2 was pretreated with 1 ng/ml of ACD for 24 hours, followed by adding 100 ng/ml of rTNF alpha, a synergistic cytotoxicity by ACD and rTNF alpha was observed at 24 hours. On the other hand, when KU-2 was pretreated with 100 ng/ml of rTNF alpha for 24 hours, followed by adding 1 ng/ml of ACD, no significant increase in cytotoxicity was demonstrated. In clonogenic assay studies, the colony forming efficiency (CE) of the control cultures was 31.8 +/- 8.1%. A 92.3 +/- 1.8% reduction in CE was observed when 100 ng/ml of rTNF alpha was added to the cultures. No significant synergistic or additive effects were demonstrated between rTNF alpha and chemotherapeutic agents in clonogenic assay studies. The effects of rTNF alpha on exponentially growing KU-2 cells were analyzed by studying the distribution of cells in the cell cycle. No cell cycle specific effect of rTNF alpha was demonstrated, regardless of whether or not chemotherapeutic agents were added. These results indicated that the cytotoxic and cytostatic activities of rTNF alpha may be mediated by separate mechanisms of action. Moreover, it was postulated that rTNF alpha may more significantly affect KU-2 cells having clonogenic potentials. rTNF alpha was concluded to have significant anti-tumor effects on renal cell carcinoma cells based on clonogenic assay studies.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2716216 TI - Natural killer cell activity and recycling capacity of natural killer cells in patients with carcinoma of the prostate. AB - Natural killer (NK) cell activity and recycling capacity of NK cells in patients with carcinoma of the prostate (CaP) was determined by combining the 51Cr-release cytotoxicity assay and single cell cytotoxicity assay in agarose. The NK cell activity in patients with advanced CaP (stage D) was significantly lower than the NK cell activity of normal controls and that of patients with localized CaP (stage B and C). The number of active NK cells in the peripheral blood lymphocytes was similar in all groups tested including normal controls, patients with localized CaP, and patients with advanced CaP. Maximal killing potential (Vmax) and maximal recycling capacity (MRC) were significantly reduced in patients with advanced CaP as compared to patients with localized CaP or normal controls. Obtained results indicated that the depressed NK cell activity in advanced CaP was not due to a reduced number of active NK cells but due to the decreased recycling capacity of the individual NK cells. PMID- 2716217 TI - Hormonal changes in major depressive disorder. AB - The dexamethasone suppression test (DST) was performed in 38 patients satisfying the Research Diagnostic Criteria (RDC) for cortisol, human growth hormone (hGH), prolactin, triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) were determined at 4:00 p.m. before the administration of dexamethasone, whereas cortisol, hGH and TSH were determined at 4:00 p.m. the day after. Among hormonal variables, only cortisol index (the ratio of the pre-DST cortisol to the post-DST cortisol) was barely useful for discriminating depression. The cortisol index was also correlated with RDC incapacitating subcategory and with symptoms of affect such as depressed mood and psychic anxiety. PMID- 2716218 TI - Severe electrolyte abnormalities and paralytic ileus complicating delirium tremens. AB - Pneumonia and cardiac arrhythmias represent the most common life-threatening complications during delirium tremens. Electrolyte abnormalities are common underlying conditions in chronic alcoholics and they may further complicate the management of patients with alcohol-withdrawal syndrome or with delirium tremens. The authors present two cases in which the clinical picture of severe paralytic ileus complicating delirium tremens was closely associated with electrolyte status and postulate that the two were cause-effect related. A careful electrolyte supplement therapy guided by a strict monitoring of electrolyte balance and renal function proved to be particularly useful in successful management. PMID- 2716219 TI - Biomimetic chemistry of hemeproteins. AB - Hemeproteins play important physiological roles for an oxygen metabolism in living organisms. Their functions are divided to three main groups, i) hemoglobins, myoglobins and the cytochromes which function by transporting and storing dioxygen and electrons; ii) catalase and peroxidases which are activated by hydrogen peroxide, iii) cytochrome oxidase and cytochrome P450 both of which bind dioxygen and use the dioxygen as an electron sink or by partially reducting the dioxygen to make a powerful oxidizing agent. The hemeproteins included to group ii) have been established to produce a reaction intermediate, oxo-ferry (Fe(IV] pi-cation radical, during the catalytic cycle. Recent model studies to mimic cytochrome P450 catalyzed-reaction have shown that the intermediate retains an activated oxygen and functions as a powerful oxidizing agent in the monoxygenase reaction. In this article, the properties of the intermediate and the role in cytochrome P450 monoxygenase reaction is summarized. PMID- 2716220 TI - Mortality rate of schizophrenic patients with tardive dyskinesia during 10 years: a controlled study. AB - We examined mortality rates (MR) during 10 years between schizophrenic inpatients with and without tardive dyskinesia (TD). The TD group had a significantly higher MR (41%), as compared with the control group (20%). However, we could not reveal critical factors to explain why the TD patients had the higher MR. PMID- 2716221 TI - Nursing shortage remedies. PMID- 2716222 TI - Retention of nurse employees: one hospitals' efforts. PMID- 2716223 TI - Taming the workplace environment. PMID- 2716224 TI - Kansas registered nurses: supply and demand. PMID- 2716225 TI - [Measuring cyclodeviations]. AB - This paper presents the results of a physiological study in which four methods used to measure cyclophoria were compared. A total of 50 persons without strabismus participated in a series of experiments. Monocular and binocular measurements were made in primary position. It was found that different methods have different means and ranges. Thus, when conducting clinical follow-up examinations, the same method should be used as before. The double-scale Maddox cylinder was found to be a simple and reliable screening method. The mean is close to 0 degrees and the physiologic range varies from 2 degrees incyclophoria to 2 degrees excyclophoria. PMID- 2716226 TI - [Facial hemiatrophy with monolateral fibrosis of all extraocular muscles]. AB - Cases of facial hemiatrophy manifest a variety of symptoms of monolateral atrophic processes of the skin, muscles, and bones. The symptoms are usually progressive and may also involve the ocular bulb and the orbit. In this paper the authors report the case of a 53-year-old woman with congenital fibrosis of all extraocular muscles and restricted motility of the enophthalmic bulb in all directions of gaze. Since, in addition, the ipsilateral side of the face is affected by discrete atrophy, this case has been classified as congenital, nonprogressive facial hemiatrophy. The findings are compared with those in other published cases. PMID- 2716227 TI - [Fluid-gas exchange in vitreous surgery using the BIOM, VPFS and SDI wide-angle observation systems]. AB - The wide-angle observation systems for vitreous surgery introduced by Spitznas and Reiner (BIOM, VPFS, and SDI) have the following advantages: (1) wide angle of view, (2) large depth of field, (3) stereopsis, (4) good visualization in hazy media (5) upright, true-to-side image, (6) magnification with the microscope zoom, (7) beam splitter for the assistant, (8) good visualization in gas-filled or silicone-filled eyes, (9) free mobility of the eye for peripheral surgery. With these systems, surgery is possible from the posterior pole to the vitreous base and the anterior loop traction, regardless of whether the eye is phakic, pseudophakic, or aphakic. This is not possible with conventional contact lenses for vitreous surgery. PMID- 2716228 TI - [Use and technic of the CO2 laser on the external surface of the eye]. AB - The CO2 laser, emitting at 10,600 nm in the extreme infrared wavelength has special advantages for ophthalmology: its hemostatic properties and its ability to cut, vaporize, and shrink tissue make it particularly effective on the external eye and adenexae. In particular, it can be used for layerwise removal of tissue on the conjunctiva, the sclera, and the lids. Energy and exposure time are especially important. Irradiation of sclera from enucleated globes showed that these two parameters have a direct effect on the depth of craters - the CO2 laser's typical impact - and the laser's thermal effect on tissue. Technical and practical observations and the clinical results of more than 80 cases treated with the CO2 laser are presented and discussed. The low-power CO2 laser is a useful ophthalmological tool which can partially replace conventional surgery and extend treatment indications. PMID- 2716229 TI - [Bilateral acute confluent disseminated choroiditis in Borrelia burgdorferi infection]. AB - Two patients with bilateral extensive confluent choroidal lesions, exudative retinal detachments, positive lyme serology and a typical history are documented: A 32-year-old woman presented 14 days after a "flu-like" illness with bilateral acute extensive choroidal lesions and exudative retinal detachments (OD from 5 to 8:30 o'clock, OS from 5 to 8 o'clock, both including the macula) accompanied by a mild lymphocytic meningitis. The laboratory work-up revealed increased serum and CSF titers of antibodies against Borrelia burgdorferi (Lyme immunofluorescent test (IFT) and Lyme-IgM IFT) which declined after a 14-day treatment with doxycycline (200 mg/d), CSF titers non-detectable (serum IgG: from 1:640 to 1:320, serum IgM: from 1:40 to 1:20). A distinct improvement with visual acuity increasing from OD 0.2/OS 0.3 p to OD/OS 0.8 p was observed after seven days of treatment. A 40-year-old man with a 14-day history of tick-bite developed the same, though more severe ocular findings and a lymphocytic meningitis. The serological work-up revealed increased antibody titers against Borrelia burgdorferi (ELISA); the IgM titer was normal. After a 10-day treatment with penicillin, antibody titers against the spirochete decreased slightly and the patient's neurologic and ophthalmologic status improved dramatically. Five weeks after admission visual acuity was OD/OS 0.5 (compared to OD/OS 0.1) and has remained at 0.8 p (OD/OS) since the ninth week after onset. The clinical course of the disease and the decreasing lyme serology strongly suggest an infection with Borrelia burgdorferi. The authors propose thorough laboratory work-ups including tests for Lyme disease in selected patients with diffuse choroidal lesions. PMID- 2716230 TI - [Arteriovenous malformation of the orbit]. AB - Arteriovenous malformation is a rare vascular disease of the orbit that has to be differentiated from arteriovenous fistulas (e.g., of the carotid sinus), arterial aneurysms, the varices and the angiomas. It develops in the presence of an underlying constitutional maldifferentiation of the vascular bed but usually only becomes manifest in early adulthood. Typical clinical signs are exophthalmos, often with pulsation and thrill; episcleral and conjunctival vascular congestion; secondary glaucoma; and, to varying degrees in the late stage, restricted movement with double images as well as functional losses. The therapeutic measures otherwise routinely applied for such vascular deformities - e.g., surgical excision or, even better, embolization - have to be handled with ease in the orbit, since these vascular convolutions are also supplied in all cases by the ophthalmic artery. Two typical cases are presented to illustrate the clinical picture, diagnosis, differential diagnosis, and treatment possibilities. PMID- 2716232 TI - [Therapy of pediatric anorectal incontinence with special reference to biofeedback training]. AB - During the last two years 108 children have been hospitalized for diagnosis and treatment of constipation and fecal incontinence. Standard examinations are followed by a strict regimen of nutritional and behaviour modification therapy and, if necessary, psychological treatment is added. In severe cases we had to extend this concept by a biofeedback conditioning as a specific organic training to improve anorectal sensibility and to strengthen sphincter force. By transformation of the sphincter contraction pressure into an analogous optical signal the patient is able to recognize the muscle activities and to increase their efficiency. The organic and psychic requirements to perform a biofeedback treatment are discussed based on the experience with eight patients suffering from fecal incontinence due to different etiologies. PMID- 2716231 TI - [The determination of heart minute volumes and systolic time intervals using echo and Doppler echocardiography in severely ill premature infants]. AB - The here represented echo- and doppler-echocardiographic measurements of critically ill preterm infants demonstrate the possibility to watch closely to hemodynamic changes due to new treatments of these patients, thus to gather more information than with the usual monitoring of a neonatal intensive care unit. Using systolic time intervals and cardiac output, measured in the ascending aorta and the pulmonary truncus by echo- and doppler echocardiography, gives more ease and accuracy in actual therapeutic decisions. This is demonstrated with the use of dopamine, prostaglandin E1 and indomethacin. PMID- 2716233 TI - [Echocardiography diagnosis of total anomalous pulmonary venous drainage in the neonatal period]. AB - A 20-days-old female newborn was referred to our hospital because of persistent respiratory distress and a mild central cyanosis. On echocardiography from the suprasternal notch all 4 pulmonary veins could be visualized entering a common chamber posterior to the left atrium. This chamber communicated with a left vertical vein which drained through a large innominate vein into the right superior vena cava. The diagnosis of supracardiac type of TAPVD was confirmed the following day by angiography. The child was successfully operated and the postoperative course was uneventful. Cardiac catheterization carries an increased risk in patients with TAPVD in case of pulmonary hypertension due to pulmonary venous obstruction. In experienced centers echocardiography has become the definite diagnostic method with a high level of sensitivity and specificity in patients with atrial sitlus solitus, unifocal pulmonary venous connection, and no evidence of other major congenital cardiac defects. With continuously improving knowledge an increasing number of newborns will benefit from improved ability to perform surgical repair without prior cardiac catheterization. PMID- 2716234 TI - [Clinical manifestation of Lyme borreliosis in childhood]. AB - We report on 4 children with different clinical manifestations of Lyme Borreliosis. One patient presented with a stage 2 typical aseptic meningitis and 2 others with symptoms of Schonlein-Henoch purpura and rheumatic disease respectively. A further case had bilateral palsy of abducens nerve and unilateral palsy of trochlearis nerve which are described for the first time in Lyme Borreliosis. Diagnosis was established by detection of specific antibodies to Borrelia in all patients. Differential diagnosis of these symptoms should include Lyme-Borreliosis. PMID- 2716235 TI - [Discordant manifestation of celiac disease in monozygotic twins]. AB - A monozygous pair of twins with discordant presentation of coeliac disease is reported. The gluten-sensitive enteropathy in one of the twins might have been initiated by a virus infection. PMID- 2716236 TI - [Seckel dwarfism based on a personal case]. AB - Report on a girl with Seckel-syndrome (bird-headed dwarfism). In addition to the known symptomatology she had a congenital heart failure (ASD II, VSD, PDA). Endocrine evaluation revealed decreased growth hormone stimulation. In the CT scan of the skull enlarged ventricles were demonstrated. PMID- 2716237 TI - [Infarct of the basal ganglia in childhood--clinico-neuroradiologic findings and differential diagnosis]. AB - Basal ganglionic infarctions during childhood are comparable in size and favourable prognosis with lacunary infarctions in adults. Considering their etiology they are comparable with capsular infarctions in adults. In four children with basal ganglionic infarctions and acute motoric hemiparesis, a quick and complete regression of clinical signs and CT-findings was observed. With regard to the differential diagnosis of basal ganglionic infarction we additionally report of a female patient with initially unilateral lesion who had silently developed the hemiparesis. In this case the clinical course and the neuroradiological follow-up findings suggested Leigh disease. PMID- 2716238 TI - [Diagnostic criteria in classical infantile subacute necrotizing encephalomyelopathy (Leigh's disease)]. AB - Subacute necrotizing encephalomyelopathy (SNE; Leigh's disease), though a defined entity in neuropathological and morphological terms, is characterized by high clinical heterogenity. SNE of infancy can be defined and diagnosed on the basis of clinical symptoms more readily than juvenile and adult forms. Four patients with SNE displayed combinations of recurrent vomiting, difficulty in swallowing, failure to thrive, impairment of ocular innervation, muscle tone regulation and central regulation of respiration. These symptoms, particularly in combination, point to a disorder of the brainstem and basal ganglia. In addition, all four patients were suffering from lactic acidosis. Other possible indicators, but not in all 4 patients, were abnormal CT brain scans, impaired nerve conduction velocity, elevated CSF protein levels and enlarged mitochondria in muscle cells. Abnormal brainstem auditory evoked potentials have proved to be one of the best criteria for early diagnosis of brainstem lesions. Enzyme assays of pyruvate degradation in cultured skin fibroblasts revealed diminished activity of the pyruvate dehydrogenase complex in one patient (52 pmol/mg protein x min; median range 313, 82-917, n: 58). This paper summarizes the findings and proposes primary and secondary criteria of assistance in establishing an initial clinical diagnosis of infantile SNE. As no common pathogenetic mechanisms have yet been recognized and no uniform diagnostic markers are yet available, the diagnosis still requires confirmation by histological examination of brain and brainstem, as was the case with all four patients presented. PMID- 2716239 TI - [Normal latencies of cortical somatosensory evoked potentials--an additional criterion for the diagnosis of Rett syndrome]. AB - In four girls aged from 2 1/2 to 17 years with Rett's syndrome confirmed on the basis of clinical criteria, somatosensorically evoked cortical potentials were led off contralaterally on both sides following stimulation of the median nerve (Med SEP). Like three other children with Rett's syndrome reported by Verma et al. (1987) the present author's patients had normal latency times. Determination of normal latency times for somatosensorically evoked potentials may thus be regarded as an important additional diagnostic criterion for the diagnosis of Rett's syndrome. PMID- 2716240 TI - [95th meeting of the German Society of Internal Medicine. 2-6 April 1989, Wiesbaden. Abstracts of papers and posters]. PMID- 2716241 TI - [Correction of secretory disorders in peptic ulcer]. AB - Study of basal acidic production and clinical manifestations of peptic ulcer in 117 patients has confirmed the adequate effectiveness of a combination of atropine and ephedrine for both the suppression of the basal hypersecretory syndrome and decrease in the terms of duodenal ulcer cicatrization. PMID- 2716242 TI - [Clinico-radiographic evaluation of the state of the spine in stomach and duodenal diseases]. AB - Data are given on the condition of the thoracic spine of 465 patients with certain gastric and duodenal diseases. Degenerative-dystrophic lesions (spondylosis deformans and intervertebral osteochondrosis) of the thoracic spine together with osteoarthritis deformans of the costovertebral and costotransverse articulations lead to neurodystrophy of the gastric and duodenal mucosa through chronic stimulation by osteophytes of the thoracic sympathetic ganglia. Disorders of gastric and duodenal motor activity are also important. The attendant reflux gastritis is stipulated by reflux of the intestinal contents into the gastric lumen. Condition of the stomach and duodenum can be improved by relieving changes in the spine. PMID- 2716243 TI - [Assessment of the results of the treatment of patients with cancer of the rectum]. PMID- 2716244 TI - [Differential diagnosis in various forms of chronic proctosigmoiditis]. PMID- 2716245 TI - [Idiopathic dissection of the aorta in a patient with dilated cardiomyopathy]. PMID- 2716246 TI - [Double penetration of kissing duodenal ulcers into the pancreas and organs of the biliary system]. PMID- 2716247 TI - [A case of perforating ulcer in monozygotic twins]. PMID- 2716248 TI - [A case of development of liver cirrhosis in Rendu-Osler disease]. PMID- 2716249 TI - [Volvulus of the epiploic appendices of the sigmoid in strangulated inguinal hernia]. PMID- 2716250 TI - [Emergencies in acute pneumonia]. PMID- 2716251 TI - [Considerations on the classification of peptic ulcer]. PMID- 2716252 TI - [Comparative characteristics of the psychological traits of teachers in different departments of medical institutes]. PMID- 2716253 TI - [So-called overstrained heart syndrome]. PMID- 2716254 TI - [Ways of improving the diagnosis and treatment of brain diseases under the control of computerized tomography]. PMID- 2716255 TI - [Chrono-pharmacodynamics of hypotensive preparations]. PMID- 2716256 TI - [Clinical aspects of patients with macrofocal myocardial infarction with a complicated or uncomplicated course]. AB - The clinical manifestations and parameters of the laboratory and biochemical diagnosis of uncomplicated and the healing course of complicated myocardial infarction were studied. Substantiation has been provided for recognition of patients with hypo- and hyper-reactive myocardial infarction. PMID- 2716257 TI - [Exacerbation of associated bronchial asthma in patients with myocardial infarct]. AB - During follow-up of 27 patients with previous long-term history of bronchial asthma it has been established that in 7 of them there was aggravation of broncho pulmonary illness in the late terms of setting in of myocardial infarction (on the 3rd-6th week, or in 30 days, on the average). Typical features in these patients were blood hypereosinophilia reaching 16-24 per cent and parallel development in some of them of clinical manifestations of the postinfarction syndrome such as pericarditis, pleurisy and transitory lung infiltration. It is believed that this spontaneous aggravation of bronchial asthma in late terms of myocardial infarction can be regarded as one of the manifestations of the postinfarction syndrome typical for this clinical condition. Long-action glucocorticoids (metipred) should be prescribed prior to the development of the clinical symptoms of bronchial asthma to this category of patients taking into consideration only the dynamics of blood eosinophil count. PMID- 2716258 TI - [Mental disorders in functional disorders of cardiac activity and results of psychotropic and anti-arrhythmia therapy]. PMID- 2716259 TI - [Nutrition factor in the treatment and prevention of ischemic heart disease under ambulatory care]. AB - Study of the influence of a long-term staged use of diet therapy during prophylactic medical observation of post-myocardial infarction patients has shown that the anti-sclerosis diet used under clinical conditions was effective for relieving the angina pectoris syndrome and obtaining favourable dynamic changes in a number of metabolic parameters. Among the out-patients the diet was used by only 76 per cent. A comparative study of the results of diet therapy during the 3 year medical observation has shown a clear tendency to a gradual reduction of hyperlipoproteinemia and excessive body weight in patients who adhered to the diet. The parameters under study in the group of patients who violated the diet returned to the original level. The incidence of recurrent myocardial infarctions in patients on a diet was twice as low as in those who violated it. Prolonged diet therapy considerably improved parameters of IHD patients' working capacity. A special model has been elaborated for adequate use of the nutritional factor at all stages of the rehabilitation program. PMID- 2716260 TI - [Diagnosis and treatment of gastric campylobacteriosis in patients with peptic ulcer and chronic gastritis]. AB - The endoscopic picture of peptic ulcer was studied in 104 patients; the gastric mucosa of 30 per cent of the patients was infected with Campylobacter pyloridis (CP) and had acute erosions in the pyloroduodenal zone. Erosions in uninfected patients were found in 3 per cent of the cases. The predominant lymphoid infiltration of the mucous coat of the stomach was revealed in 60 ulcer patients irrespective of the CP infection. Mucous infiltration with polymorphonuclear leukocytes was found in 13 chronic gastritis patients (in 6 of them gastritis was combined with CP infection). The urease test was positive during the first hour in 82 per cent of the cases in the presence of a large number of CP in histological specimens. Treatment of 31 patients with gastric campylobacteriosis using various antibacterial agents or their combination revealed that continuous 2 months bismuth subnitrate medication was more effective for gastric mucosa disinfection. In addition, favourable results were often obtained when a combination of two antimicrobial agents was used. PMID- 2716261 TI - [Bicarbonate secretion of the gastric mucosa in patients with diseases of the stomach and duodenum]. PMID- 2716262 TI - [Use of sucralfate in the treatment of peptic ulcer]. PMID- 2716263 TI - [The problem of information control in the pilot's reliability in extreme conditions]. AB - Principles and possibilities of information control of pilot reliability in an extreme or stressful situation are discussed. Experimental observations related to the use of information means and methods for the formation of an adequate psychic image of the flight as a foundation of the pilot's reliability in such situations are described. It is indicated that the patterns of psychic reflection of the flight profile by the pilot need to be properly understood in order to apply effectively information means and methods for increasing his reliability. PMID- 2716264 TI - [Substantiation of the system of sanitary-hygienic procedures]. AB - Various aspects of endogenous contamination of the human skin are discussed. The contamination rate and intensity were measured by analyzing wash water obtained after sanitary-hygienic procedures (SHP) in which no detergents were used. It was found that endogenous contamination of the human skin reached its maximum 3-4 days after the previous SHP and then became stabilized. The wash water composition was shown to be independent of the skin type. The endogenous contamination level did not influence the bactericidal effect of the skin of healthy people. Due to complementary processes such as epidermis desquamation and sebum cutaneum, the role of which is different for different skin types, the amount of indigenous microorganisms is maintained at an optimal level irrespective of the skin type. It is concluded that water SHPs should be performed no more than once every four days. If they are conducted oftener than that, the normal function of the human skin may become deteriorated: epidermis desquamation increases drastically, skin state changes, and the concentration of indigenous microorganisms on the skin surface decreases as compared to the individual norm. PMID- 2716265 TI - [Blood levels of hormones regulating calcium-phosphorus metabolism in men exposed to a 120-day period of hypokinesia]. AB - Nine healthy male volunteers were exposed to head-down tilt (-4.5 degrees) for 120 days. The concentrations of parathormone, calcitonin, gastrin, growth hormone, total and ionized calcium were measured in plasma. Prolonged exposure to antiorthostatic hypokinesia led to significant changes in the hormonal regulation of calcium-phosphorus metabolism, the most important of which was an enhanced secretion of the parathyroid hormone. The increased concentration of calcitonin and gastrin was a secondary response to the higher content of ionized calcium. The phase-like changes in the somatotrophic hormone secretion were induced by variations in the parathormone concentration in blood, on the one hand, and by a reduction of plastic processes, on the other. PMID- 2716266 TI - [Lipid peroxidation in the human blood during a 120-day period of anti orthostatic hypokinesia]. AB - Time-course variations in the accumulation of endogenous products of lipid peroxidation and the state of antioxidative enzymes--superoxide dismutase and catalase--in blood of men exposed to antiorthostatic hypokinesia (-4.5 degrees) for 120 days were investigated. It was found that bed rest led to stimulation of lipid peroxidation which was measured as increased concentrations of lipid hydroperoxides and final products of lipid peroxidation in blood. Vitamin E and drugs with a specific metabolic action produced a normalizing effect on the content of products of lipid oxidative destruction. Special exercise regimens had a similar but less significant effect. PMID- 2716267 TI - [Activity of the sympathetico-adrenal system in humans during modeling of weightlessness]. AB - The state of the sympathico-adrenal system (SAS) before and during three days of suited immersion was investigated in six male subjects on the basis of renal excretion of adrenaline (A), noradrenaline (NA), dopamine (DA) and DOPA according to Vasilyev. Computer-aided analysis of the experimental data by the method of principal components showed that the SAS was functionally stressed in all subjects. Suited immersion that simulated hemodynamic, metabolic and vestibulo motor effects of microgravity helped to distinguish between men with sustained and lowered capabilities of the SAS which are largely determined by the A-, NA-, and mixed type of its function. Clinical manifestations of A-crises in all subjects pointed to central genesis of SAS reactions to simulated microgravity. A correlation between the decline of SAS reserve capabilities and the level of the vestibulo-autonomic syndrome during suited immersion as well as drastic decrease of physical work capacity after immersion was established. It is emphasized that correction of unstable states of the SAS functional activity acquires special importance. PMID- 2716268 TI - [Effect of a 30-day period of hypokinesia on various physiologic and biochemical indicators during maximal physical load]. AB - Exercise tolerance of test subjects who remained bed rested (Group A) and who exercised while being supine (Group B) was measured before and after 30-day head down tilt (-8 degrees). Special attention was given to the parameters that characterize energy supply of working muscles. The data obtained after 30-day bed rest did not reveal any changes in the Group B subjects and showed the following changes in the Group A subjects: maximum oxygen consumption decreased by 10.1% (p less than 0.05), the time within which the anaerobic metabolism threshold was attained decreased by 17.2% (p less than 0.05), and lactate concentration at the workload end decreased by 24.7%, while the pyruvate concentration and the lactate/pyruvate ratio remained unchanged. The results indicate that prolonged aerobic workload after 30-day bed rest seems to be limited by functional changes in oxygen transport rather than by the factors associated with changes in energy supply of working muscles. PMID- 2716269 TI - [Collagen metabolism in the skin and bone tissue of rats after a 7-day space flight]. AB - Collagen metabolism in the skin and bone (femur) of 3-month male rats of the SPF Wistar strain was investigated. Bone of the flown rats showed an increase in pepsin-soluble collagen and a decrease in pepsin-insoluble collagen. The skin of the flown rats exhibited opposite changes. Both the skin and bone of the flown animals showed an increase of type III collagen (in the pepsin-soluble and pepsin insoluble fractions). Similar changes were previously observed in female rats, that were launched while being pregnant, and in their offspring. PMID- 2716270 TI - [Functional status of the hepatobiliary system during anti-orthostatic hypodynamia]. AB - In 16 male subjects, the hepatic absorption-excretion function and the gallbladder and biliary ducts were investigated using computer scintigraphy and 99mTs-HIDA. Comparison of the data obtained after 6-hour (-20 degrees) and 3-day (10 degrees) antiorthostatic hypodynamics with the baseline data obtained in the supine position demonstrated deterioration of the absorption-excretion function of the liver. In response to a short-term exposure (6 hour) the changes were seen only in subjects with latent or clinically nonmanifest pathologies of the digestive organs. As the exposure continued, changes in the hepatobiliary function became more manifest and significant. It is recommended to study in greater detail changes in the above function and their involvement in the symptom complex of an acute stage of adaptation to microgravity. PMID- 2716271 TI - [Trace element composition of bone tissue of mice in the normal state and in hypokinesia]. AB - Using neutron activation analysis, the concentration of 13 elements was measured in functionally different bones of mice: weight-bearing and dynamic femurs, essentially stationary temporal bones, and newly formed ectopis bones under the renal capsule developed at the site of implantation of syngenic bone marrow. It was found that the elementary composition of the above bones was different in the norm and that it varied in the course of 3-week hypokinesia produced by small size cages. It was shown that during hypokinesia the elementary composition changed according to four different patterns. Progressive demineralization due to Ca, P, Mg and Fe losses was accompanied by compensatory incorporation of Sr. In the course of the hypokinetic stress the content of trace elements (Zn, Cr, Ru, Rb, Br, Co, Sb) varied significantly. The mechanisms of action of these elements was related to the mobilization of activating elements at different stages of the general adaptation syndrome. PMID- 2716272 TI - [Species-specific reactions of succinate dehydrogenase of lymphocytes in animals to acute hypoxic hypoxia and its relation to the radiation resistance of the body]. AB - Experiments on rats and dogs showed that acute hypoxic hypoxia caused an increase of succinate dehydrogenase (SDH) in blood lymphocytes. The rate of SDH increase (VSDH) depended on the oxygen concentration in the breathing hypoxic mixture (BHM) and the animal species. In dogs it proved to be lower than in rats. Experiments on mice, rats and dogs were carried out to study the correlation between the level of the dose decrease factor (DDF) of the BHM and the animal species. The radiation resistance of the animal body in a hypoxic environment was evaluated with respect to the severity of the hypoxic state. A formula has been developed that can help determine ionizing radiation resistance of the animal in a hypoxic state. The formula based on the lymphocyte VSDH is as follows: DDF of BHM = 0.97 + 0.215 VSDH. By calculating the radioprotective effect of the BHM as a function of oxygen consumption, the applicability of the formula to such animal species as rats and dogs has been verified. PMID- 2716273 TI - [Evaluation of the effect of a single dose of ammonia on lettuce photosynthesis in a hermetically sealed phytotron]. AB - The threshold of the phytotoxic effect (PTE) of ammonia at a concentration of 10 to 20 mg/m3 on 28-day lettuce plants was evaluated during a single 2-hour exposure. The rate of Hill's reaction, level of energization of chloroplast membranes during leaf illumination as well as visible photosynthesis of lettuce plants from the beginning of fumigation to vegetation day 31 were recorded. Similar changes in the above parameters induced by ammonia were seen. This suggests that photosynthesis was inhibited already at light stages. As a measure of PTE, 10 per cent decrease of the photosynthetic productivity of plants exposed to fumigation was recommended in comparison with controls during the vegetation period. According to this measure, the PTE of ammonia amounted to 20 mg/m3 in the above experimental conditions. PMID- 2716274 TI - [Combined effects of beta radiation and shock wave on the seeds of lettuce Lactuca sativa L]. AB - The effect of shock wave (SW) and beta-radiation (beta) on Lactuca sativa L. seeds was investigated. Exposure to SW at an amplitude of 200 and 600 MPa in various combinations with beta caused a lower survival rate and development of abnormal plants. At an amplitude of 600 MPa, when the SW + beta protocol was used, the maximum amount of abnormalities was seen after 220-240 hours of wetting and when the beta + SW protocol was used the maximum amount of abnormalities was seen after 80-100 hours of wetting. At an amplitude of 600 MPa, the most significant changes in the germination of seeds at different SW and beta combinations were observed. When seeds were first exposed to beta and then to SW, most significant changes were recorded suggesting synergism of the above factors. These observations can be considered as indirect evidence in support of the hypothesis that SW may also occur around the track of a heavy charged particle. PMID- 2716275 TI - [Comparative ecologic study of microbial biocenosis of the lettuce rhizosphere under various conditions of cultivation]. AB - The qualitative and quantitative composition of microorganisms occurring in the rhizosphere of lettuce plants grown in a Svet hot-house on the Balcanin substrate using humates, canned and silvered water was investigated. Microbiological experiments were carried out during a 300-day study within which 5 plant vegetations took place. In the course of a long-term use of the substrate. Gram negative bacteria became inhibited, streptomycetes abundant and Penicillium and Trichoderma perdominant. The granulometric composition of the substrate and different photoperiods influenced rhizosphere microorganisms without changing substrate microorganisms. It can be concluded that humates and canned water help maintain microbiological activity of the plant rhizosphere which allows a longer term use of the Balcanin substrate for plant cultivation in the Svet hot-house. PMID- 2716276 TI - [Use of cluster analysis in medico-biological studies of the man-environment system in cases of limited sampling]. PMID- 2716277 TI - [Permeability of the blood-brain barrier in modeling motion sickness]. PMID- 2716278 TI - [Effect of adaptation to atmosphere exposure chamber hypoxia on various indicators of metabolism of biogenic amines in rats]. PMID- 2716279 TI - [RBE of low-dose fission neutrons evaluated on the basis of cytogenetic changes in the corneal epithelial cells of mice]. PMID- 2716280 TI - Regeneration of the skin after grafting of epidermal cultures. PMID- 2716281 TI - Studies of mechanisms and protective maneuvers in myoglobinuric acute renal injury. AB - To explore why urine pH affects myoglobin (M)-induced renal injury, rats were infused with M under aciduric (NH4Cl) or alkalinuric (KHCO3) conditions with or without additional solute loading. Acute renal M retention (R) was highly pH dependent (pH 5.77, 68% R; pH 6.45, 49% R; pH 8.0, 28% R), the % R positively affecting the severity of renal injury (azotemia, proximal tubular necrosis, M casts, medullary vascular congestion, assessed 3 and/or 24 hours later). However, nonreabsorbable, nonalkalinizing salts (SO4) equiosmolar to KHCO3 decreased M retention to 21% and produced comparable functional/morphologic protection as HCO3. Equiosmolar reabsorbable salt (NaCl) did not decrease M retention (67%) or confer significant protection. M, when suspended in urine, but not in 0.45% NaCl, was highly acid precipitable (73% versus 10%). Electrophoretic/solubility studies indicated that M, not hematin, precipitated. M infusion did not decrease renal cortical soluble thiol groups (principally glutathione) or raise malondialdehyde concentrations at a time that tubular damage was apparent. Neither deferoxamine nor 2 hydroxyl radical scavengers (dimethylthiouria, Na benzoate) conferred significant functional/morphologic protection. These results indicate that aciduria promotes myoglobinuric-renal injury by acutely trapping M within the kidney, not by causing hematin formation. HCO3 protects by increasing urinary M solubility and by providing nonreabsorbed solute, both facilitating its excretion. Fe-stimulated hydroxyl radical formation does not appear to be necessary for M to cause renal damage. PMID- 2716282 TI - Cellular composition of rat bone marrow stroma. Antigen-defined subpopulations. AB - Although stromal cells establish the architecture of mammalian bone marrow and organize hemopoiesis, the interrelationships among their macrophage, fibroblastic, endothelial, and adipocyte-like components are not wholly understood. Using murine monoclonal antibodies to cultured adherent cells of rat bone marrow, we observed that the predominant fibroblastoid cells grown from marrow differed from those of non-hemopoietic organs. The marrow type bore a detectable quantity of the ST3 but not ST4 antigen, whereas those from lung, diaphragm, and epididymal fat pad, bore more ST4 than ST3. Those from spleen were an equal mix of both types. Although the tissue distribution of the ST3 antigen was similar to that of Thy-1, it was not identical, and in the brain, the two structures were localized in different areas. While none of the ST3, ST4 (fibroblast directed), or BN(MB)35 (myeloid directed) antibodies recognized fat cells cultured from marrow, the ST10 antibody, selected for binding to marrow derived fat cells, stained peripheral adipose cells, unidentified aglobular cells in areas of fat cell formation, and macrophages, but not fibroblasts. On the basis of these observations, we suggest that the fibroblastoid cells of the marrow are different from those of non-hemopoietic tissues. PMID- 2716283 TI - Role of complement-derived peptides in thrombocytopenia elicited by soluble aggregates of immunoglobulin G in the rat. AB - The variations in platelet counts upon intravenous challenge with soluble aggregates of IgG were assessed in normal rats. A time- and dose-dependent thrombocytopenia, followed by recovery to preinfusion values after 30 minutes was observed. Rats injected with immune aggregates showed an increase in plasma levels of immunoreactive thromboxane B2, however, this increase was delayed as compared with the peak level of the thrombocytopenia. Previous treatment of rats with either indomethacin or aspirin, inhibited thromboxane B2 release, but did not affect thrombocytopenia. Pretreatment of the animals with BN 52021, a potent antagonist of platelet-activating factor binding to its receptor, also failed to block thrombocytopenia. Complement depletion by prior treatment with cobra venom factor, caused a significant reduction of the thrombocytopenia, whereas DL-2 mercaptomethyl-3-guanidinoethylthiopropanoic acid, an inhibitor of carboxypeptidase N, potentiated the thrombocytopenia elicited by submaximal doses of either IgG aggregates or a homogeneous preparation of rat anaphylatoxin containing C5a. In addition, rats challenged with doses of IgG aggregates higher than 5 mg/kg showed a massive complement consumption coincident with the onset of thrombocytopenia. "In vitro" aggregation/secretion experiments with rat platelets showed little platelet-stimulating activity either by aggregated IgG through the Fc receptor or through the CR1 receptor. By contrast, a preparation of rat serum anaphylatoxins containing C5a, showed a high platelet-secreting activity. These data suggest that a complement-derived peptide(s), most probably C5a, is one of the effector substances for platelet activation in response to soluble aggregates of IgG. PMID- 2716284 TI - Axonal dystrophy as a consequence of long-term demyelination. AB - Central nervous system lesions in guinea pigs sensitized for chronic relapsing experimental allergic encephalomyelitis for between 18 and 36 months have been found to possess a small but probably significant degree of axonal involvement. Axonal identity was established by light and electron microscopy and immunocytochemistry. The axonal changes were restricted to white matter and consisted of massive (up to 95 microns) scattered axonal spheroids which displayed lateral branches and vacuoles; small groups of spheroids filled with a wide assortment of axoplasmic organelles; and deeper, more extensive collections of affected demyelinated axons and spheroids which frequently displayed abortive axonal regeneration into the Virchow-Robin space. Although accumulations of most axoplasmic organelles occurred in the spheroids and reactive axons, microtubules were relatively rare. These formations were never seen in adjacent unaffected white matter and spinal cord tissue from normal aged animals contained only the occasional spheroid. It is hypothesized that the disease process in experimental allergic encephalomyelitis may be more dynamic than previously described and that prolonged interruption in normal axon-glial relationships in chronically demyelinated (sometimes remyelinated) gliotic lesions might lead to a block in axoplasmic transport and a disruption of the axonal cytoskeleton. Although most affected axons appeared intact, some of the spheroids probably represented proximal stumps from which sprouting occurred, leading to neuroma-like formations. The implications of the findings are discussed in reference to long term demyelination and multiple sclerosis where almost identical profiles have been documented. PMID- 2716286 TI - National Commission responds to questions regarding credentialing. PMID- 2716285 TI - CA 50 and CA 19-9 antigen expression in normal, hyperplastic, and neoplastic thyroid tissue. AB - The occurrence of the tumor-associated carbohydrate antigens defined by the monoclonal antibodies (moabs) C 50 and 19-9 has been studied by immunoperoxidase staining of formalin-fixed and paraffin-embedded tissue specimens from normal, hyperplastic, adenomatous, and carcinomatous thyroid tissues. Epithelial expression of these antigens was observed neither in normal nor in hyperplastic thyroid tissue. The antigens were expressed in only 1 of 26 follicular adenomas and the staining in this case was weak and restricted to a few cells. In contrast, the expression of this antigens is marked and progressive in carcinomatous tissues. A high proportion, 48 of 52 papillary carcinomas demonstrated C 50 reactivity, whereas 25 of these tumors expressed the CA 19-9 antigen. Of 25 follicular carcinomas, 15 gave a positive staining for the CA 50 and 6 for the CA 19-9 antigen. CA 50 antigen expression was still detected in tumor cells lacking the CA 19-9 antigen and C 50 reactive material was found in all tissue specimens from medullary carcinomas tested, whereas CA 19-9 antigen staining was consistently negative. This indicates that the moab C 50 which reacts, like the moab 19-9, with the sialylated Lewisa (Lea) blood group determinant also binds to other antigens apart from the sialylated Lea in CA 19-9 antigen negative tumor cells. Although, the functional significance of CA 50 and CA 19-9 antigen expression remains to be investigated, these results suggest that the demonstration of these antigens could provide additional differential diagnostic parameters for the characterization of hyperplastic and neoplastic lesions of the thyroid gland. Further clinical studies will show whether these carbohydrate antigens are useful serum markers for the monitoring of thyroid carcinomas. PMID- 2716287 TI - Highlights from the Canada youth and AIDS study. AB - The identification of Acquired Immunodeficiency Syndrome (AIDS) in 1981, and the subsequent isolation of the human immunodeficiency virus (HIV) in 1983, signaled the beginning of worldwide concern over the potential impact of the disease. As the global incidence of AIDS and HIV infection increased, Canadians expressed growing apprehension about the epidemic's affect on themselves. Because adolescents potentially are at risk for HIV infection, a special need existed to determine how Canadian youth were responding to the AIDS epidemic. During the summer of 1987, the Federal Centre for AIDS, in conjunction with the National Health Research and Development Program and the Canadian Public Health Association, commissioned a nationwide study. A national sample of more than 38,000 youth in grades 7, 9, 11, and the first year of college and university were surveyed about their knowledge, attitudes, and behavior concerning AIDS and other sexually transmitted diseases (STDs). Also included in the total sample were youth who had recently dropped out of school and those who lived on the streets of large cities. In this article, the authors summarize findings from the study and offer conclusions and recommendations for action. PMID- 2716288 TI - Safety and first aid behavioral intentions of supervised and unsupervised third grade students. AB - This study assessed the safety and first aid behavioral intentions of 285 third grade students. Of the participants, 19% were left at home unsupervised by someone older than age 12 at least three days a week. Students responded to a survey instrument that described situations related to stranger safety, fire safety, accident prevention, and first aid. Stranger safety items received the most correct responses, with females scoring significantly higher than males. Most responses to fire safety items were inappropriate, and 40% of accident prevention items received a dangerous response most frequently. First aid items received more dangerous responses than appropriate ones. Supervised students scored significantly higher than unsupervised students in accident prevention and first aid. Results indicated students' behavioral intentions often were dangerous for situations requiring judgments about safety or application of first aid. PMID- 2716289 TI - The influence of parental attitude and behavior on early adolescent cigarette smoking. AB - In 1983, Nolte and colleagues reported parental attitude may be more powerful than parental behavior in shaping adolescent cigarette smoking behavior. This study replicates the finding of Nolte et al and suggests parents need to be actively recruited to discourage their children from smoking, regardless of their own behavior. Fewer parents actively discourage youth smoking today than in 1983, a possible unfortunate result from an apparently successful effort to change the public attitude toward cigarette smoking. PMID- 2716290 TI - Perceived barriers to exercise among adolescents. AB - In this study, the authors identify differences in barriers to exercise among high school students (n = 236) according to gender and self-reported levels of physical activity. Major barriers to exercise were "time constraints," "unsuitable weather," "school and schoolwork," and "lack of interest or desire." Univariate ANOVAs revealed adolescent males had significantly higher scores than females for "use of alcohol and drugs" and "having a girlfriend," while "time constraints" was a significantly greater barrier to exercise among females. Discriminant analyses indicated the barriers of "having a girlfriend" and "use of alcohol and drugs" also distinguished highly active males from highly active females. Results are discussed and suggestions are offered concerning how to reduce perceived barriers to exercise among adolescents. PMID- 2716291 TI - Evaluation of training effects on teacher attitudes and concerns prior to implementing a human sexuality education program. AB - Teacher changes in knowledge, attitudes, and concerns about teaching a new human sexuality education curriculum due to inservice training were examined; 59 middle school teachers were surveyed before and after one week of training. Significant (p less than .05) increases in knowledge, perceptions of importance of teaching the curriculum, intent to teach, and level of comfort with course content suggest areas of positive learner changes. Effects were not noted for sexual orientation (liberal vs. conservative) or responsibility for student outcomes. Relationships (p less than .05) were noted between comfort, importance, responsibility, and intent to teach with expectations of how students, colleagues, administrators, parents, and community would respond, as well as perceptions of curriculum congruence with teaching style and the adequacy of preparation to teach the curriculum. Few responses were associated with teacher personal characteristics. PMID- 2716292 TI - Privacy circles: an affective teaching technique for controversial topics. PMID- 2716293 TI - Guidelines for nutrition support in AIDS. PMID- 2716294 TI - Occupational hygiene measurement strategy in the pharmaceutical industry. AB - In an industry which handles materials which are biologically active it is necessary to limit the exposure of workers engaged in both research and production to these materials. Part of the control procedure is to be able to demonstrate that whatever system is put in place is effective and remains so. This may require a programme of environmental monitoring. To be effective any monitoring programme must be properly planned and executed. This paper sets out the philosophy and practice of one multinational pharmaceutical company which may stimulate debate in the industry. PMID- 2716295 TI - Employment prospects for patients with intestinal stomas: the attitude of occupational physicians. AB - The attitude of 126 occupational physicians to the employment problems of patients with intestinal stomas were assessed by a postal questionnaire. Heavy work and work in hot places were commonly (65 and 49 per cent of respondents respectively) considered 'unsuitable'. Work as a food handler, handling toxic chemicals and driving duties was thought to be 'unsuitable' by 35, 14 and 10 per cent of respondents respectively and actually forbidden by a few physicians. Risk of spread of infection was perceived to be greater than normal for someone with a stoma by 28 per cent of respondents. This attitude was significantly more common (p less than 0.05 Chi square) among the associate members compared to full members of the Faculty of Occupational Medicine. Attitudes to people with either an ileostomy or a colostomy were similar. Most respondents (87 per cent) expected more sickness absences than normal for people with inflammatory bowel disease without a stoma but half appreciated that the creation of a stoma would result in normal amounts of sickness absence. The Occupational Physicians' views of which jobs within their industry were unsuitable for stoma patients were inconsistent. In practice most tasks can be performed normally by someone with a stoma so that each case should be assessed on an individual basis. There is a need for greater understanding and awareness by doctors of the good employment potential of people with intestinal stomas. The reasons for present attitudes are reviewed and new guidelines suggested. PMID- 2716296 TI - Occupational asthma due to a repair process for polyethylene-coated electrical cables. AB - We report the case of an electrical cable repairer who presented with symptoms suggestive of occupational asthma. A supervised workplace challenge test confirmed this diagnosis and laboratory challenge studies implicated heated polyethylene repair tape containing the chemical cross-linking agent dicumyl peroxide as the cause. Similar cross-linking processes are widely used in the cable manufacturing industry and the possibility of occupational asthma occurring in other settings may need to be considered. PMID- 2716297 TI - Childhood farm accidents: a continuing cause for concern. AB - Farms in Ireland remain a dangerous environment for children despite increasing publicity about farming hazards based on international research. A one year prospective study on farm accidents was carried out in four Irish accident and emergency departments. During this time, four deaths and 62 cases of injury aged 15 years and under were seen. Half the cases required admission to hospital; tractor accidents were common and serious. Most injuries occurred to the extremities but 13 (21 per cent) had multiple injuries. Forty-three (69 per cent) of the children required outpatient follow-up and twenty-seven of these (63 per cent) had more than one outpatient re-visit. The Irish farming community is still unappreciative of the risks to their children on the farm, and urgent attention needs to be directed towards educational and legislative measures to improve the safety profile of Irish farms. PMID- 2716298 TI - Accidents to children in agriculture. PMID- 2716299 TI - Occupational medicine. PMID- 2716300 TI - The new occupational health? PMID- 2716301 TI - Papers presented at the annual meeting of the Association for Academic Surgery. Salt Lake City, Utah, November 16-19, 1988. PMID- 2716302 TI - Organ-specific chemotactic factors present in lung extracellular matrix. AB - The preferential colonization of a distant organ by a circulating tumor cell (organ specific metastasis) may be regulated by chemotactic factors present within the extracellular matrix of the host organ. Organ-specific extracellular matrix was prepared from murine kidney and lung by high salt extraction and DNAase/RNAase digestion. A soluble protein fraction (S2) from each of the matricies was obtained by 4 M guanidine extraction and was tested for organ specific chemotactic activity in a modified Boyden chamber. The lung colonizing B16-F10 and B16-BL6 tumor cell lines demonstrated organ-specific motility only toward the lung extract. The low metastasizing B16 parental line and liver colonizing B16-L4b line showed no preference for either lung or kidney. The lung activity resolves into five fractions by gel filtration chromatography, with the highest activity eluting at Mr approximately 71,000. Chemotactic factors present in lung extracellular matrix may regulate the preferential colonization of an organ by stimulating the migration of tumor cells in a specific manner. These factors may be released during the degradation of the extracellular matrix. PMID- 2716303 TI - Impaired liver regeneration in the analbuminemic rat. AB - Albumin has been implicated as both an inhibitor and a stimulator of liver regeneration. We examined the rate of liver regeneration following partial hepatectomy in rats which are genetically analbuminemic. Adult male analbuminemic and Sprague-Dawley control rats underwent either a 70% partial hepatectomy or a sham operation. Twenty-four hours postoperatively, rats were injected iv with tritiated thymidine and the liver remnants were resected 1 hr later. Liver weight, protein and DNA contents, and the rate of tritiated thymidine incorporation into DNA were determined. The rate of DNA synthesis in control sham operated rats was greater (P less than 0.05) than that of analbuminemic rats. Following partial hepatectomy, there was a statistically significant (P less than 0.01) increase in DNA synthesis in control rats; no significant increase was noted in the analbuminemic rats. No significant differences in liver remnant weight or protein and DNA contents were noted between control and analbuminemic sham-operated or partially hepatectomized rats. Our data suggest that albumin plays a role in the regulation of DNA synthesis in both the resting and the regenerating liver and it may be essential in maintaining a normal rate of liver regeneration. PMID- 2716304 TI - Altered macrophage activity and tumor necrosis factor: tumor necrosis and host cachexia. AB - Tumor necrosis factor (TNF) may be a mediator of cancer cachexia. This study evaluates the activity of macrophages from non-tumor-bearing (NTB) and tumor bearing (TB) rats by measuring TNF production in response to endotoxin (LPS), both in vitro and in vivo, and correlates macrophage activity with tumor burden and parameters of host cachexia. Isolated macrophages from rats with small tumors, normal food intake, and weight gain secreted more TNF in response to 10 micrograms/ml LPS than macrophages from control NTB rats and behaved similar to activated macrophages from rats previously treated with thioglycollate. Heightened macrophage activity (increased production of TNF in response to LPS) in TB rats increased further as tumor burden increased (r = 0.889, P less than 0.001). Tumor resection reversed the heightened macrophage activity as LPS induced levels of TNF secreted by macrophages from resected TB rats were not different from those of sham-operated NTB control rats. TB rats had serum levels of TNF activity following an iv bolus of 10 mg/kg LPS greater than those of NTB rats (P less than 0.05). In addition, peak serum TNF activity levels following iv LPS increased directly as tumor burden increased (r = 0.91, P less than 0.001). Supernatants from tissue cultures of the tumor (MCA sarcoma) failed to have any detectable TNF activity. However, large tumors in vivo had increased amounts of necrosis (78 +/- 8%), increased numbers of infiltrating macrophages, and increased levels of TNF (480 +/- 68 U/ml) compared to small tumors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716305 TI - Nifedipine inhibits cholecystokinin-induced gallbladder contraction. AB - Nifedipine is a calcium channel blocker which results in relaxation of smooth muscle. Although it has been utilized clinically to treat cardiovascular disease, and more recently spastic disorders of the esophagus and colon, its effects on gallbladder contractility have not been clearly defined. We tested the effects of nifedipine on gallbladder contraction stimulated by cholecystokinin (CCK) in a conscious guinea pig model and in healthy human volunteers. Gallbladder contraction was measured in response to repeated injections of CCK before and after intravenous nifedipine given to groups of five guinea pigs in a dose of 100, 200, or 300 micrograms. Nifedipine virtually abolished spontaneous interdigestive gallbladder contractile activity and decreased resting gallbladder tone. The mean amplitude of gallbladder contraction in response to CCK was decreased by 45, 73, and 67% (P less than 0.01), in response to the nifedipine doses of 100, 200, and 300 micrograms, respectively. The integrated gallbladder contractile response and the rate of rise of gallbladder pressure in response to CCK were also significantly decreased by nifedipine. In nine healthy human volunteers, gallbladder emptying was measured by radionuclide cholescintigraphy in response to CCK infusion; on another day the study was repeated after oral administration of 10 mg nifedipine. Ejection fraction was significantly decreased by nifedipine from 72 +/- 5 to 51 +/- 5% (P less than 0.001). These data demonstrate that nifedipine is a potent inhibitor of gallbladder contractility in guinea pigs and man. This may provide the basis for the use of nifedipine clinically in the treatment of biliary colic and also raises questions about the potential effect of long-term nifedipine use on gallstone formation and cholecystitis. PMID- 2716306 TI - Luminal adrenergic agents modulate intestinal transport. AB - Intestinal transport is controlled by luminal solutes, neural pathways, and paracrine or humoral agents. The current study investigated the effect of luminally administered adrenergic agents on the intestinal transport of water and electrolytes. Dogs with 25-cm jejunal Thiry-Vella loops were studied. The loops were luminally perfused with an isotonic solution containing [14C]PEG, and the fluxes of H2O, Na+, and Cl- were calculated. Each experiment consisted of three 1 hr periods: basal, luminal agent infusion, and recovery. Luminal adrenergic agents did not alter heart rate. Norepinephrine (alpha 1 greater than alpha 2 and beta adrenergic agonist) and phenylephrine (alpha 1 adrenergic agonist) caused significant absorption of water and sodium. Clonidine (alpha 2 adrenergic agonist) and isoproterenol (beta adrenergic agonist) caused significant secretion of water, sodium, and chloride. Luminally administered adrenergic agents can influence small intestinal water and electrolyte transport. Alpha 1 agonists have a proabsorptive effect, while alpha 2 and beta agonists have a secretory effect. Luminally administered proabsorptive adrenergic agents may prove useful in pathologic secretory states such as diabetic diarrhea, small bowel transplantation, or diarrhea-associated endocrinopathies. PMID- 2716307 TI - Decreased parietal cell secretory capacity following vagotomy and pyloroplasty. AB - Although vagotomy reduces acid secretion in vivo, the effects of vagotomy at the level of the parietal cell are not known. In the present study we examined the in vitro secretory characteristics of parietal cells in rabbits 8 weeks following vagotomy compared to unoperated and sham-operated controls. Acid secretion was assessed by the uptake of [14C]aminopyrine (AP) in isolated gastric glands. Also, gastric fundus histology, mucosal thickness, parietal cell density, and gastric gland somatostatin content were examined. Basal AP uptake was decreased following vagotomy (8 +/- 0.4 pmole/mg dry wt) compared to controls (21 +/- 2) (P less than 0.001). Increase in AP uptake by the cholinergic agonist carbachol was unaffected after vagotomy (P greater than 0.5) suggesting intact muscarinic receptors and calcium second messenger system. Increase in AP uptake was significantly reduced following vagotomy by the cyclic AMP-mediated agonist histamine (P less than 0.05) and the cyclic AMP mimetic 8-bromo cyclic AMP (P less than 0.001) suggesting an alteration in the ability of the parietal cell to utilize cAMP following vagotomy. There were no discernible differences in histology, mucosal thickness, or parietal cell number in vagotomized animals compared to controls (P greater than 0.5). There was a significant increase in gastric gland somatostatin content following vagotomy (37 +/- 10 fmole/mg dry wt) compared to control (14 +/ 1.5) (P = 0.025). These results suggest that there is a decrease in the capacity of parietal cells to secrete acid following vagotomy. In addition, the decrease in cAMP utilization following vagotomy suggests that the cAMP second messenger system is dependent, at least in part, on an intact vagus nerve. PMID- 2716308 TI - Mechanisms of increased lower esophageal sphincter pressure following intraduodenal peptone infusion in dogs. AB - Peptone perfusion of the excluded duodenum in dogs is associated with an increase in lower esophageal sphincter pressure (LESP). This study investigates the role of cholinergic, adrenergic, and hormonal mediators in the response of the LES to intraduodenal peptone infusion. Adult dogs underwent duodenal exclusion via a Roux-en-Y pylorojejunostomy with formation of a mucocutaneous fistula. Manometric measurements of LESP and radioimmunoassay determinations of gastrin and pancreatic polypeptide (PP) blood levels were made at rest and at 15-min intervals following peptone infusion of the excluded duodenum. In control experiments, peptone infusion resulted in an increase in mean LESP at all time intervals (P less than 0.05). PP blood levels increased significantly, while gastrin levels remained unchanged. Both truncal vagotomy and pretreatment with atropine blocked the changes in LESP. PP release in response to peptone was accentuated in vagotomized dogs, while atropine suppressed the release of PP following peptone infusion. Treatment with 6-hydroxydopamine did not affect the increase in either LESP or PP blood levels observed in controls. Intravenous somatostatin suppressed the release of PP following intraduodenal peptone, but did not block the lower esophageal sphincter response. This data indicates that the increase in LESP seen following intraduodenal peptone infusion is centrally mediated and dependent on vagal innervation and cholinergic neurotransmission. PMID- 2716309 TI - Oxygen free radical mediated renal dysfunction. AB - Postischemic renal dysfunction (PIRD) is characterized by a reduction in glomerular filtration and tubular reabsorption of solute. The relative contribution of oxygen free radicals (OFRs) generated during reperfusion remains unclear. This study characterized the renal response to OFRs--independent of an ischemic insult. Isolated rat kidneys were perfused at 37 degrees C and 90-100 mm Hg with a modified Krebs' buffer. Hypoxanthine (25 mumole) and xanthine oxidase (1 unit) were combined and infused proximal to the kidney. There was a 50% increase in vascular resistance. This was accompanied by a 30% reduction in perfusate flow rate and a 70% reduction in glomerular filtration rate. There was also a significant reduction in urine flow rate and oxygen consumption. The percentage reabsorption of filtered water and sodium by the renal tubules was not diminished, however. This pattern was not observed when the xanthine oxidase was inactivated or when the perfusate was pretreated with superoxide dismutase (250 units/ml) and catalase (500 units/ml). The generation of OFRs, independent of an ischemic insult, causes a decrease in glomerular filtration out of proportion to the decrease in renal flow similar to that observed with PIRD. OFRs may contribute to the hemodynamic and glomerular alterations seen with PIRD. Factors other than OFRs, probably associated with ischemia, must be responsible for the tubular dysfunction. PMID- 2716310 TI - Pica: a clue to iron deficiency anemia. PMID- 2716311 TI - Intraoperative autologous transfusion during aortic reconstructive procedures. PMID- 2716312 TI - Duodenal rupture as a result of blunt abdominal trauma. PMID- 2716313 TI - A painful, swollen lower extremity. PMID- 2716314 TI - Informed consent--substandard care. PMID- 2716315 TI - An old prescription for a new era of medicine. PMID- 2716316 TI - Isolated eosinophilia associated with a squamous cell lung cancer. PMID- 2716317 TI - Staphylococcal pyomyositis with idiopathic dermatomyositis. AB - We have described a patient with staphylococcal pyomyositis of the left pectoralis major muscle, complicating idiopathic dermatomyositis. Dermatomyositis and corticosteroids are possible predisposing factors. Patients with idiopathic muscle inflammation should be considered at risk for bacterial superinfection. PMID- 2716319 TI - Atypical pneumonia. PMID- 2716318 TI - Experiences of the Southern Poison Center during 1986 and 1987. PMID- 2716320 TI - Distal digital necrosis. PMID- 2716321 TI - Blunt injury of the abdominal aorta. PMID- 2716322 TI - Radiology case of the month. Anterior bladder mass. Poorly differentiated adenocarcinoma of the urachus with invasion through the entire bladder wall thickness. PMID- 2716323 TI - Update on efforts to reduce black premature mortality. PMID- 2716324 TI - AIDS testing as a prerequisite to treatment. PMID- 2716325 TI - Somethin' gon' gitcha. PMID- 2716326 TI - Relativity revisited. PMID- 2716327 TI - SSA disability determinations. PMID- 2716328 TI - BC/BS Tennessee Provider Network. PMID- 2716329 TI - Predictability of in vivo chemosensitivity by in vitro MTT assay with reference to the clonogenic assay. AB - The MTT assay reported by Mosmann is a rapid and convenient colorimetric assay for cellular growth and survival in vitro. In this paper, the MTT assay was modified as a chemosensitivity test, and its potential was investigated. Using 10 human tumor xenografts in athymic nude mice, the predictability of in vitro antitumor effects of drugs using the MTT assay was compared with that using the clonogenic assay. The MTT assay showed excellent reproducibility, and the predictable rate in this assay was 86.7%, with 100% true-positive and 77.8% true negative rates, almost equivalent to the 90.0% predictable rate of the clonogenic assay. This method also has several advantages with respect to rapidity, quantitation, management of many samples, and cell number required for the assay. Application of this assay to chemosensitivity testing seems to be valuable and useful. PMID- 2716330 TI - Treatment of breast cancer in women older than 70 years. AB - Do age, associated diseases, general state, or the stage of tumor determine the operability of breast cancer in the elderly? Risk factors are studied on the basis of data on 465 patients over 70 years of age who had breast cancer surgery between 1977 and 1986. Operative mortality of patients is analyzed, and according to the results, the outcome of the surgery is mainly influenced by patients' performance status (Karnofsky/Zubrod index) and stage of disease and not by the associated diseases or patient age. PMID- 2716331 TI - Lung metastases after curative or noncurative irradiation of microscopic primary melanomas. AB - Melanomas growing in the feet of syngeneic C57BL/6 mice were treated with a single dose of X-irradiation. After doses of 0, 3.75, 7.5, 10, 20, or 30 Gy the tumor-bearing limb was amputated at tumor sizes 1, 2, 3, 4, or 5 mm. After doses of 40, 50, 62.5, or 72.5 Gy, progressive tumor growth did not occur, and amputation of tumor-bearing limbs was done when controls were 1, 2, 3, 4, or 5 mm in size. Eighteen days after amputation the mice were killed, and pulmonary metastases were documented at autopsy. None of the mice developed pulmonary metastases after curative irradiation of the primary foot tumor. After subcurative irradiation there was a significant increase (P less than .003) in pulmonary metastases. The size of the primary melanoma is important in the prediction of these metastases. In this model melanomas can be cured by an adequate dose of irradiation, but in those not cured the incidence of lung metastases is increased. The impact of this biologic phenomenon on survival is unclear. PMID- 2716332 TI - Implantable catheter system for long-term intravenous chemotherapy. AB - Fifty-three implantable catheter systems (Port-A-Cath) were placed subcutaneously in 48 patients with malignant tumours. This device consists of a stainless steel chamber covered by a silicone membrane connected to a silicone catheter placed in a central vein. All systems were used for administration of chemotherapy. The mean function time was 187 days (range 0-867). Complications necessitating reoperation occurred in six patients. In three cases, the catheter occluded from thromboses. In two patients, wound dehiscence occurred, and in one a wound infection developed. In one case, the catheter was disconnected from the port. Four patients who had had the port removed later received new ports. One patient had the second port removed and was given a third catheter system. It is concluded that subcutaneously implantable injection ports constitute a safe and convenient access for long-term intravenous chemotherapy. The complication rate is low, and it should be possible to avoid most recorded complications in the future. PMID- 2716333 TI - Surgery in patients with unsuspected pheochromocytomas. AB - In four of the 37 patients operated on for a pheochromocytoma in the last 12 years at Duke Medical Center, the tumor was unsuspected. The first of the four patients had stable blood pressure and pulse during the operative and postoperative period. Although the second patient was thought to have a normal response to surgery, in retrospect her blood pressure showed significant variation. In contrast, the other two patients had wide variations in blood pressure and pulse during the operative and postoperative period. Electron microscopy of the tumor demonstrated numerous dense-core neurosecretory granules suggestive of pheochromocytoma in all four patients. In three of the patients in which measurements could be made, there was a high concentration of norepinephrine (NE) in the tumors that was diagnostic of a pheochromocytoma. Although tissue from the fourth patient was not available for biochemical analysis, his urine and blood tests as well as his ultimate demise from the tumor confirmed that he had a malignant pheochromocytoma. Based on a negative chromaffin reaction--which might be anticipated in a NE-containing pheochromocytoma--one of the patients with the smooth operative course was incorrectly diagnosed as an adrenocortical adenoma. We conclude that although patients with unrecognized pheochromocytomas do not inevitably have wide swings in blood pressure during surgery, this cannot be predicted in a given patient. Thus one should carefully evaluate all patients with suspicious retroperitoneal or intraabdominal masses for possible pheochromocytomas prior to resection of the masses. PMID- 2716334 TI - Computer analysis, using a digitizer, of ataxic mouse gait due to drugs. AB - A simple objective method using the irregularity of the spacing of rats' footprints to determine drug-induced locomotor ataxia has been adapted for mice and for computer analysis, by means of a digitizer-based program. Results obtained by the usual manual method of measuring and analyzing the records are compared with results of the computerized method. The computer method improves speed, and perhaps accuracy, of measurement and analysis, especially with large numbers of records, although manual scoring gives satisfactory results and remains essential for unusual records. Inter-observer agreement of the computerized method was high, and there was good agreement between measurements and subjective ratings of ataxia. The use of footprints to measure ataxia, with or without computer aid, is recommended as a routine test in laboratory evaluation of psychoactive drugs. Other uses discussed include determining changes in different characteristics of gait such as step width and step length in animal and human subjects affected not only by drugs, but also by movement disorders such as Parkinsonism. PMID- 2716335 TI - Very rapid assay of gamma-aminobutyric acid in mouse brain regions within 3 minutes by high-performance liquid chromatography with electrochemical detection. AB - For assay of gamma-aminobutyric acid (GABA) in brain tissue, a very rapid and simple chromatographic procedure using high-performance liquid chromatography (HPLC) with electrochemical detection (ECD) in combination with precolumn o phthalaldehyde (OPA) derivatization is described. Perchloric acid extracts of the tissue were mixed with OPA/beta-mercaptoethanol solution and the mixture was injected onto the HPLC system. The present method permits GABA assay within less than 3 min in one chromatographic run. Up to 100 samples a working day can be analyzed in the present method. The present method has been applied to the measurement of GABA levels in discrete brain regions of mice treated with aminooxyacetic acid and isoniazid. PMID- 2716336 TI - Use of telemetry to record body temperature and activity in mice. AB - A complete, commercially available, integrated telemetry and data acquisition system is described, which is used to record core temperature and activity in mice. The system is comprised of a telemetry transmitter (implanted in the peritoneal cavity), a receiver (placed underneath the cage) connected to a computer with software (Dataquest), which converts the transmitter signals directly into core temperature and activity. The information is stored on either a floppy diskette or a hard disk in the computer. The effects of anesthesia (sodium pentobarbital, halothane), handling, aggregation, restraint, a cholinergic agonist (oxotremorine), and an anticholinesterase agent, soman (pinacolyl methylphosphonofluoridate), on core temperature and activity were examined. The telemetry system for the recording of core temperature and activity provides a more accurate assessment of the temporal effects of various drugs and is more efficient and less labor intensive than the use of a rectal temperature probe. PMID- 2716337 TI - Measurement of ventricular relaxation. An alternative index of isovolumic relaxation to the time constant. AB - The time constant (T) is commonly used for representing the isovolumic fall in left ventricular pressure (LVP) because the isovolumic fall is monoexponential under most circumstances. However, the determination of T is cumbersome due to the requirement of a set of LVP versus time values in fitting a monoexponential function. RT64, which is the time from the minimum value of the time derivative of LVP (-dp/dtmax) to 36% of -dP/dtmax, can be derived beat-by-beat, on-line, and may be a simple alternative to T. Through the use of 240 pairs of values derived from six conscious instrumented dogs treated with different cardiovascular active agents, RT64 and T were found to be significantly correlated (r = 0.835, p less than 0.05) according to the equation RT64 = 0.725T + 10.2. In conclusion, RT64 may provide a simple alternative to T in representing the isovolumic relaxation process of the left ventricle. PMID- 2716338 TI - Decapitation increases plasma sodium and potassium in the rat. AB - Sodium, potassium, and osmolality were measured in plasma obtained from conscious and decapitated rats. The sodium and potassium content of plasma derived from blood taken from decapitated rats via arterial cannulae or free-flowing trunk blood was significantly greater than that in conscious animals or animals killed by an overdose of pentobarbital. Plasma osmolality was not different. Hemoglobin was present in the plasma of decapitated rats, suggesting hemolysis. Hemolysis and subsequent release of intracellular potassium may be the cause of the elevated plasma potassium. The cause of the elevated sodium is unclear. This study points out the importance of considering the method of obtaining blood in determinations of plasma levels of biologic substances. PMID- 2716339 TI - In vitro method for measurement of cardiac performance and responses to inotropic drugs after experimentally induced myocardial infarction in the rat. AB - In this paper, a method is described for the measurement of the performance of rat hearts with an experimentally induced myocardial infarction of the left ventricle. After ether anesthesia of the animals and left thoracotomy, the left coronary artery was ligated, and the thorax was rapidly closed. The whole procedure took no more than 2 min. Forty-eight hours after the operation, the hearts were prepared for retrograde constant pressure perfusion, according to the Langendorff technique. The effects of the betasympathomimetic drug dobutamine and of the novel phosphodiesterase inhibitor milrinone on the contractile force of the right ventricle and the infarcted left ventricle, as well as on the total coronary flow, were quantified. Sham operated animals were used as control. The maximal obtainable stimulation of the contractility of infarcted hearts by dobutamine was significantly reduced from control. Milrinone increased the contractility in control animals, although to a much lesser extent. This increase was significantly smaller in infarcted hearts. The stimulation of the coronary flow by dobutamine and milrinone was significantly reduced in hearts with an infarction. Milrinone potentiated the effect of isoprenaline significantly. The results of the present study indicate the usefulness and reproducibility of this model for the evaluation of the efficacy of positive inotropic agents on the heart in the presence of a myocardial infarction. PMID- 2716340 TI - Collective bargaining. PMID- 2716341 TI - Pharmacological study of Cymbopogon citratus leaves. AB - Cymbopogon citratus leaves are employed by the Cuban population as an antihypertensive and anti-inflammatory folk medicine. A 10% or 20% decoction of leaves was tested using arterial pressure in rats, urine production and carrageenan-induced edema in rats. The decoction showed some dose-related hypotensive effects given intravenously and some weak diuretic and anti inflammatory effect when given orally. PMID- 2716342 TI - Tetrodotoxin and the zombi phenomenon. PMID- 2716343 TI - Ethnopharmacology of kratom and the Mitragyna alkaloids. PMID- 2716344 TI - An antifungal constituent from the stem bark of Butea monosperma. AB - The petroleum and ethyl acetate extracts of the stem bark from Butea monosperma displayed antifungal activity against Cladosporium cladosporioides. The active constituent of low polarity was isolated by bioassay-monitored chromatographic fractionation, and identified as (-)-medicarpin by comparison of physical data. The antifungal activity of (-)-medicarpin was found to be greater than that of Benlate, a standard fungicide, while (-)-medicarpin acetate also exhibited significant activity against C. cladosporiodes. PMID- 2716345 TI - New contribution to the ethnopharmacological study of the Canary Islands. AB - We present in this paper a report of 155 species used for medicinal purpose in the Canary Islands. These species have been compiled in 13 tables in accordance with their main medicinal use, indicating also other possible popular uses. We have made a short inventory of the rates of the most important medicinal applications. This new compilation shows once more the traditional use of the phytotherapeutic resources by the Canary population and also the wide possibilities of the phytochemical and pharmacological investigations of the Canary Islands Flora. PMID- 2716346 TI - Hepatoprotective effects of Wedelia calendulacea. AB - The alcoholic extract of whole plant Wedelia calendulacea exhibited protective activity against carbon tetrachloride-induced liver injury in vivo. The extract also increased the bile flow in rats suggesting a stimulation of liver secretory capacity. The minimum lethal dose was greater than 200 mg/kg p.o. in mice. PMID- 2716347 TI - Flow cytometric DNA analysis: a prognostic tool in non-Hodgkin's lymphoma. AB - Surgical biopsies from 234 untreated patients with non-Hodgkin's lymphoma (NHL), classified according to the Kiel nomenclature, were analysed with respect to proliferative activity (S-phase) and DNA content by flow cytofluorometric (FCF DNA) analysis. The percentage of cells in S-phase was significantly higher in lymphomas of high compared to low grade NHL (p less than 0.001). Patients with lymphomas of high grade histology and low S-phase values (less than 5.6%) achieved complete remission (CR) more often (p less than 0.05) and survived significantly longer than those with high S-phase values (p less than 0.05). In the low grade NHL group the S-phase value did not correlate to response. S-phase correlated to survival for patients with the lymphocytic (CLL & IC) (p less than 0.05) and follicle center cell (FCC) derived (p less than 0.01) but not in blastic (LB, IB, Burkitt) NHL. DNA-aneuploidy was associated with poor response to therapy and shorter CR duration in low grade NHL (p less than 0.05 for both). However, the degree of DNA-ploidy (neardiploid or aneuploid) did not correlate to survival in any of the NHL groups analysed (high- or low grade, lymphocytic, FCC derived or blastic). The Cox regression analysis indicated that the S-phase value was a stronger predictor of survival than histopathology, stage or age, especially in low grade NHL. These results suggest that S-phase analysis should be included in the clinical evaluation of NHL patients as a prognostic indicator. PMID- 2716349 TI - Restricted expression of an early myeloid and monocytic cell surface antigen defined by monoclonal antibody M195. AB - A mouse monoclonal IgG2a antibody, M195, with reactivity restricted to early myeloid cells, acute non-lymphoid leukemia cells (ANLL), and monocytic cells is described. The antibody was derived from a mouse immunized with live human leukemic myeloblasts. Specificity of binding of mAb M195 was determined by protein-A red blood cell rosetting assays, immunoabsorption, radioimmunoassays with iodine-125 labeled M195 IgG and F(Ab)'2, and complement cytotoxicity with live human cells and cell lines representing a broad range of lineages and tissues. Antigen expression was restricted to myeloid and monocytic leukemia cell lines and a fraction of mature adherent monocytes. Mature myeloid cells, T and B cells, erythrocytes, and platelets were negative. The antigen was not expressed on adult human tissues in immunoperoxidase and immunofluorescence assays. Blocking antigen was not found in the serum of patients with ANLL. Ten thousand sites per cell were expressed on myeloid or monocytic leukemia cell lines and 5000 sites per cell on mature monocytes. M195 IgG bound to its antigen target with an avidity of 3 x 10(9) liters/mol and induced rapid modulation of the antigen. M195 IgG was able to effectively kill cells with rabbit or guinea pig complement, but not human complement. The antibody did not mediate antibody dependent cellular cytotoxicity. The molecular nature of the target antigen remains unknown but it appears to be carried on the CD33 protein p67. Because of its restricted distribution on myelomonocytic cells, mAb M195 may be useful in studying myeloid differentiation, in the clinical diagnosis of ANLL, in purging of bone marrow of ANLL, and/or in monoclonal antibody therapy in vivo. PMID- 2716348 TI - Comparison of erythroid progenitor cell growth in vitro in polycythemia vera and chronic myelogenous leukemia: only polycythemia vera has endogenous colonies. AB - The ability of erythroid cultures to distinguish among myeloproliferative disorders was examined. We studied 14 patients with polycythemia vera (PV), 11 with chronic myelogenous leukemia (CML), four with non-PV erythrocytosis, two with agnogenic myeloid metaplasia, as well as three normal fetuses and greater than 25 normal adults. Endogenous, i.e. grew without added erythropoietin, bone marrow CFU-E-derived colonies were observed in all but one PV patient. However, endogenous blood BFU-E-derived bursts were observed in only eight of 14 PV patients. Endogenous erythroid colonies were not seen in cultures from any normal adults or fetuses, or patients with CML, erythrocytosis, or myeloid metaplasia. In PV, relative HbF synthesis was always greater in cultures without erythropoietin, while in cultures from all other patients relative HbF synthesis was similar to that observed in cultures from normal individuals. We conclude that PV and CML are distinguishable in culture since CML patients do not have endogenous growth. Most important, endogenous bone marrow CFU-E-derived colonies are the only consistently unique observation in patients with PV, and endogenous CFU-E- and BFU-E-derived colonies and bursts are not uniformly observed in PV blood cultures. In-vitro studies of erythropoiesis to confirm the diagnosis of PV, therefore, require marrow when endogenous colonies and bursts are absent from blood cultures. PMID- 2716350 TI - Relation between cell cycle stage and the activity of DNA-synthesizing enzymes in cultured human lymphoblasts: investigations on cells separated according to DNA content by way of a cell sorter. AB - Exponentially growing human lymphoblasts (culture LS-2) were separated by cell sorting (FACS II, Becton Dickinson) according to their deoxyribonucleic acid (DNA) content, designating them at particular phases of the cell cycle. Prior to cell sorting the DNA has been fluorochrome-labeled with the Hoechst stain H 33342. Maximum cell enrichments of 94% for G0 + G1 cells, 96% for S cells and 74% for G2 + M cells could be achieved. The enzyme activities of thymidine kinase (TK), thymidylate synthase (TS), DNA polymerase (DNA-P), dihydrofolate reductase (FH2-R), methionine synthase (MS), and hexokinase (HK) were determined in the obtained cell fractions. Although incorporation of 3H-thymidine (3H-dTR) and the 3H-dTR labeling index were significantly inhibited by the dye, no evidence of cell staining's having a significant effect on the enzyme activities was found. The enzyme activities for approximately 100% pure G0 + G1, S, and G2 + M cells were computed. With exception of TK, all the enzymes under study were shown to exhibit activities--although of differing degree--in the G0 + G1, S, and G2 + M cells. No TK activity was shown in G0 and G1 cells; its activity, however, was approximately the same in S and G2 + M cells. This applies likewise for TS which, in contrast to TK, exhibits minor activity in G0 + G1 cells. DNA-P was highly active in G0 + G1 cells, but maximum activity was in S cells. FH2-R exhibited maximum activity in S cells, although the difference in activity between S and G2 + M cells was not significant. None of the observed differences in MS activity was significant, indicating equally high activity in cells of all cell cycle phases. HK activity is approximately twice as high in G2 + M cells as in G0 + G1 cells. PMID- 2716351 TI - Serum thymidine kinase peaks early during AML induction therapy. PMID- 2716352 TI - Pulmonary artery catheter placement with two-dimensional echocardiographic guidance: a technique applicable in critically ill neonates. AB - In nine critically ill neonates with persistent fetal circulation, femoral venous catheters were inserted at the bedside to initiate treatment and provide venous access. After femoral vein puncture or cutdown, a 5-F sheath was placed in the inferior vena cava through the femoral vein. With use of two-dimensional echocardiographic guidance, a 5-F balloon angiographic catheter was advanced through the inferior vena cava into the right atrium and subsequently manipulated through the tricuspid valve and into the main pulmonary artery. No major complications were attributable to the procedure. When performed by a pediatric cardiologist, this technique is as safe as umbilical catheter placement. PMID- 2716353 TI - Antimicrobial susceptibilities of anaerobic bacteria isolated at the Mayo Clinic during 1982 through 1987: comparison with results from 1977 through 1981. AB - Results of antimicrobial susceptibility testing of anaerobic bacteria isolated at the Mayo Clinic were reviewed for 1982 through 1987 and compared with a previous survey during 1977 through 1981 at this institution. Between the earlier and the later period, clindamycin resistance increased in the Bacteroides fragilis group (from 4% of isolates to 8%). We noted continuing penicillin resistance among Bacteroides species other than B. fragilis and rare penicillin resistance among Fusobacterium organisms, with four isolates during the 1982 through 1987 period being beta-lactamase producers. The high levels of resistance to some agents seen in certain Clostridium species in 1977 through 1981 were not as great in the current survey. No major changes were noted in the susceptibilities of C. perfringens, anaerobic non-spore-forming gram-positive bacilli, and anaerobic gram-positive cocci. PMID- 2716354 TI - Risk of noncardiac surgical procedures in patients with aortic stenosis. AB - Although severe aortic stenosis has been reported to increase the risk of noncardiac operation, recent advances in anesthetic management may alter this risk. We reviewed the perioperative course of 48 consecutive patients (mean age, 73 years) with significant aortic stenosis who underwent a noncardiac operation or diagnostic procedure between 1985 and 1987. Twenty-five patients had local anesthesia with intravenous sedation, 22 (17 with severe and 5 with moderate aortic stenosis) underwent general anesthesia, and 1 had spinal anesthesia. Of the 48 patients, 36 (75%) had symptoms--congestive heart failure in 24, angina in 19, and syncope in 7. Doppler echocardiography, performed in all 48 patients, revealed a mean peak instantaneous gradient of 76 mm Hg and a calculated aortic valve area (in 22 patients) of 0.61 cm2. In the 20 patients who also underwent preoperative cardiac catheterization, the calculated mean aortic valve area was 0.59 cm2. Seven patients had one or more perioperative events, including intraoperative hypotension in five; all except one of these events were transient and without major sequelae. No intraoperative deaths occurred. Selected patients with severe aortic stenosis can undergo noncardiac procedures at a reasonably low risk with careful monitoring of anesthesia. PMID- 2716355 TI - Morning admission for a same-day surgical procedure: resolution of a blood bank problem. AB - To minimize the risks associated with an elective surgical procedure on the day of admission without adequate time for blood bank serologic analysis, we implemented two administrative changes: (1) collection of blood samples from patients on the evening before operation and (2) a system for recommending a 3 hour delay of the operation in those cases without such a sample. During a 4 month period before implementation of these changes, 70 patients had serologic problems; morning blood samples had been obtained from 36 of these patients. For a comparable time after implementation of these changes, a serologic problem was encountered in 41 surgical cases, in 7 of which morning blood samples had been obtained. Similarly, the number of cases in which the operation was begun before resolution of a serologic problem decreased from 19 to 3. These decreases occurred despite a 13.4% increase in total morning-admission cases between the first and second study periods. Although no patient experienced adverse transfusion-related events during either study period, simple administrative changes that necessitated no increases in costs were instrumental in substantially decreasing the risks to patients. PMID- 2716356 TI - Renal insufficiency in community patients with mild asymptomatic microhematuria. AB - Primary-care physicians often must decide when patients with asymptomatic microhematuria warrant further testing for renal parenchymal disease. Because previous data had shown a greater frequency of elevated serum creatinine concentration in a population with asymptomatic microhematuria than in control subjects without hematuria, we reviewed the records of 125 patients with isolated asymptomatic microhematuria and elevated serum creatinine (AM/EC) and 83 comparison patients with no hematuria and elevated serum creatinine (NH/EC) from a previous population-based study to determine the relationship between renal parenchymal disease and isolated asymptomatic microhematuria. Serum creatinine was often elevated transiently because of volume depletion or shock, or elevations occurred in relationship to a terminal illness. Thus, only 63 AM/EC patients and 45 NH/EC control subjects had primary renal parenchymal disease or systemic disorders that caused an elevated serum creatinine. The patients selected from the asymptomatic microhematuria population because of elevated serum creatinine most often had low-grade hematuria and were typically 75 years of age or older. No disease was consistently found more frequently in the AM/EC patients than in the NH/EC group. Intervention at the time of the detection of hematuria might have altered the prognosis in 8% and probably would not have altered the prognosis in 78%. Therefore, exhaustive diagnostic testing to detect renal parenchymal diseases cannot be advised in asymptomatic elderly patients with low-grade (grade 1) microhematuria unless more specific indications are present. PMID- 2716357 TI - Epicutaneous patch testing: current trends and controversial topics. AB - In the 20th century, epicutaneous patch testing has played an integral and central role in the assessment of allergic contact dermatitis and therefore in general dermatologic practice. After recent verification of the safety and accuracy of patch testing by the Food and Drug Administration, domestic distribution of testing materials has resumed for the first time in 5 years. Because of the importance of this procedure, it is timely to review current standards of epicutaneous patch testing with emphasis on proper use and interpretation, clinical applications, trends in allergic contact dermatitis, and selected controversial issues. PMID- 2716358 TI - Glasnost and Perestroika--a challenge for modern medicine. PMID- 2716360 TI - Hepatology: a coming of age. PMID- 2716359 TI - Update on renal neurology: role of the renal nerves in formation of edema. PMID- 2716361 TI - Mediastinal mass and tracheal obstruction during general anesthesia. PMID- 2716362 TI - Nutritional assessment of intensive-care unit patients. PMID- 2716363 TI - An obsolete procedure. PMID- 2716364 TI - Home mechanical ventilation. PMID- 2716365 TI - Age-related changes in the cholinergic components within the central nervous system of CW1 female mice. I. Structural analysis. AB - Histomorphometric analysis of age-related structural changes in the brain was performed in CW1 female mice, 3, 9, 24 and 32 months of age. Cholinergic regions, such as the hippocampus, NBM and the medial habenula (MH) were investigated in more detail focusing on morphological parameters. The thickness of the frontoparietal cortex (FPC), and the surface area of the dorsal hippocampus and the MH were found to decrease significantly from 9 to 24 months of age. Except for the unique appearance of pseudo-cysts within the FPC, the structural changes culminated by 24 months. Cells' degeneration, in the CA3 hippocampal subfield, was noted already by 9 months of age whereas in other regions the cells' surface area decreased only between 9 and 24 months. Lipofuscin accumulation was most pronounced in the large neurons of the cortex, hippocampus and NBM at 24 months of age. PMID- 2716366 TI - Note on the dispersion of generations among cells in senescing diploid fibroblast populations. AB - The cells in a cultured diploid fibroblast population have heterogeneous intermitotic times--even cells derived from the same mitosis may divide at different ages. This heterogeneity of inter-mitotic times results in asynchronous population growth and a dispersion of generations among members of the cell population. Because the appearance of non-dividing cells in middle-age populations has been attributed to the presence of lineages with more generations than average, we estimated the magnitude of the dispersion of cell generations as functions of the population doubling level and of the coefficient of variation of inter-mitotic times. For some data, such as that of Macieira-Coelho and Azzarone (Exp. Cell Res., 141 (1982) 325, the rate at which such non-proliferating lineages appear could be explained by a reasonable coefficient of variation of inter-mitotic times (25%). Most other data, however, would be fit only if the coefficient of variation of inter-mitotic times were 50% or greater, a variability that exceeds what has been observed in microcinematography experiments. PMID- 2716367 TI - Enzyme histochemistry of glutamate dehydrogenase in ageing rat cerebellar cortex. AB - The influence of ageing on glutamate dehydrogenase activity was studied in the cerebellar cortex of 3-month-old (young), 12-month-old (adult) and 26-month-old (aged) male Sprague-Dawley rats by using an enzyme histochemical technique. In young rats the enzyme reactivity was observed in the neuropil of the molecular layer as well as in the perikarya of basket cells and of stellate cells; within the cytoplasm of Purkinje neurons and in synaptic glomeruli of the granular layer. Glutamate dehydrogenase activity was significantly increased in the cerebellar cortex of adult rats and decreased in old animals. The synaptic glomeruli of the granular layer were the structures of the cerebellar cortex more remarkably affected by age-related changes. The possibility that decreased glutamate catabolism occurring in the ageing cerebellar cortex may result in an excess of the amino acid and may contribute to the nerve cell loss occurring in the cerebellum of old rats is discussed. PMID- 2716368 TI - Age-related alterations in duodenal calcium transport rate in rats. AB - To determine the age-related alterations in intestinal calcium transport under in vitro controlled conditions, we studied the calcium transport across duodenal segments of prepubertal (2 months), young adult (6 months) and aged (26 months) Fisher 344 male rats using the Ussing chamber technique. We also evaluated the effect of 10(-11) M 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] in tissue bathing media. The calcium transport rate from mucosa-to-serosa (Jms) and from serosa-to-mucosa (Jsm) in 26-month-old rats (33.5 +/- 6.6 nmol/h per cm2 and 25.4 +/- 3.1 nmol/h per cm2, respectively) were significantly larger than that in 6 month-old animals (18.1 +/- 2.6 nmol/h per cm2 and 17.7 +/- 1.7 nmol/h per cm2 respectively). The Jms (46.1 +/- 12.0 nmol/h per cm2) and Jsm (50.8 +/- 7.2 nmol/h per cm2) in 2-month-old rats were significantly larger than the respective rates measured in 6-month-old animals. The addition of 1,25-(OH)2D3 minimized the age-related differences in mucosal calcium transport but did not significantly stimulate Jms. The magnitude of change in 1,25-(OH)2D3-stimulated Jsm in 6-month old rats (17.7 +/- 1.7 vs. 29.4 +/- 2.2 nmol/h per cm2) was similar to that seen in 26-month-old rats (25.4 +/- 3.1 vs. 47.5 +/- 4.5 nmol/h per cm2). The results indicate that the maturational reduction in intestinal calcium transport capacity is followed by increased calcium fluxes in senescence. PMID- 2716369 TI - Red cell oxygen transport in man in relation to gender and age. AB - P50 values, the O2-partial pressure at 50% O2-saturation of hemoglobin, 2,3-DPG, hematological parameters and the plasma concentrations of sexual hormones were determined in 135 subjects of both sexes aged from 10 to 60 years. P50 was significantly higher in sexually mature women than in men, but did not differ between sexes before puberty and after menopause. In females P50 increased with sexual maturation by about 2 mmHg (0.27 kPa). RBC, Hb and Hct remained unchanged. In males Hb-O2-affinity, RBC, Hb and Hct increased with aging. In sexually mature females 2,3-DPG was significantly higher (2 mumol/gHb) than in males, although before puberty and postmaturity no difference was found. In males, 2,3-DPG increased slightly with maturation although P50 decreased. P50 values (pH = 7.4) correlated positively with red cell 2,3-DPG only when data from all groups were pooled (r = 0.330, P less than or equal to 0.0001). Hb was negatively correlated with P50 (r = 0.221, P less than or equal to 0.01). The data suggest a sex hormone and maturation induced influence in the development of the red cell O2 transport system. Estrogens seem to favour a decrease in Hb-O2-affinity rather than an elevation in O2-transport capacity, whereas androgens do the reverse. PMID- 2716370 TI - Influence of age upon the metabolism of zinc in livers of C57BL/6J mice. AB - The kinetics of accumulation and loss of zinc from the liver following subcutaneous administration of 10 mg of zinc per kg were examined in young adult (6 months old) and old (24 months old) male C57BL/6J mice. After zinc treatment, total liver zinc concentrations rose equally in both groups and returned to basal levels at 96 h post treatment. However, differences were found in the subcellular distribution of zinc in these two age groups. The concentration of zinc in the cytosolic fraction (104,000 g supernate) prepared from the livers of old mice attained its maximum at 24 h post treatment. In contrast, the concentration of zinc in the cytosolic fraction of liver from young adult mice peaked at 48 h post treatment. This difference in accumulation of zinc in the cytosol was reflected by differences in the binding of zinc to metallothionein, a cytosolic transition metal binding protein. In old mice the highest amounts of zinc bound to metallothionein were found at 24 h post treatment: in young adults the maximal zinc binding to this protein occurred at 48 h post treatment. Examination of the relationship between cytosolic zinc contents and the binding of zinc to metallothionein in young adult and old mice suggested similar regulatory processes in the two age groups. Thus, age-dependent differences in accumulation and loss of zinc from the cytosolic fraction of liver probably reflect factors other than differences in regulation of the synthesis of metallothionein by this essential metal. PMID- 2716371 TI - The removal of UV-induced pyrimidine dimers from DNA of rat skin cells in vitro and in vivo in relation to aging. AB - Young and old rats were compared with respect to the capacity of their skin fibroblasts and epidermal keratinocytes to remove low levels of ultraviolet light (UV) induced UV-endonuclease sensitive sites (pyrimidime dimers) from their DNA, in vitro and in vivo, respectively. In vitro, over a 24-h time period, fibroblasts from both young and old rats were found to remove about 20% of the pyrimidine dimers originally induced by 4.6 J/m2 of UV-C. In vivo, after 2.6 kJ/m2 of UV-B hardly any UV lesions were found to be present in fibroblasts, as demonstrated by immunohistochemistry using an anti-thymine dimer antibody. As reported earlier (Mullaart et al., J. Invest. Dermatol., 90 (1988) 346-349) cultured epidermal keratinocytes do not differ from cultured fibroblasts in UV repair kinetics, whereas in vivo they remove at least 50% of the pyrimidine dimers induced by 4 kJ/m2 of UV-B within 3 h. We now show that epidermal keratinocytes from old rats are not deficient in their in vivo repair characteristics upon this low UV-B dose. However, since a considerable fraction of the pyrimidine dimers appeared to be persistent in fibroblasts and keratinocytes, demonstrated by both enzymatic and immunochemical assays, the possibility is discussed that long-term exposure of skin cells to UV may lead to an accumulation of DNA damage with age. PMID- 2716372 TI - [Acute gastroenteritis due to Vibrio parahaemolyticus in Spain. Presentation of 8 cases]. AB - Eight cases of acute gastroenteritis caused by Vibrio parahaemolyticus in humans are described; to our knowledge, they are the first such reported cases in Spain. All cases appeared between August 20th and October 15th, with a frequency of 8.3% regarding the overall adult patients with acute gastroenteritis, and 11.5% regarding the overall patients with positive stool culture for any enteropathogenic organism. The eight strains were Kanagawa positive and in three patients other enteropathogenic organisms were isolated in addition to Vibrio parahaemolyticus, i.e. Aeromonas hydrophila in two and Salmonella serovariety enteritidis in another. In all cases fish or shellfish had been ingested outside the patients' homes; except for one patient, who ate living clams in the seaside of Galicia, all patients ingested them at seaside restaurants from the Barcelona province. The clinical features of acute gastroenteritis were definite in all patients, but no patients had significant electrolyte losses or required hospital admission. Recovery was spontaneous and no antimicrobial agents were required. All strains were sensitive to tetracyclines, aminoglycosides, cefotaxime, ceftazidime and nearly always to co-trimoxazole. PMID- 2716373 TI - [Morbidity and mortality of diabetic patients on dialysis in a 10-year program: value of combined treatment]. AB - Morbidity and mortality derived from the employed techniques after ten year experience in treating patients afflicted with end-stage diabetic nephropathy by means of dialysis are evaluated. Hemodialysis (HD) was applied to 24 patients, continuous ambulatory peritoneal dialysis (OCPD) was employed in 33 patients and intermittent peritoneal dialysis (IPD) in nine patients. Cumulated experience with each technique was 529, 644, and 107 months, respectively. Ten patients were treated with a combination of two or three techniques. Hospitalization rate in patients receiving CAPD was 32 days/year, peritonitis was the most frequent condition leading to admittance (54.8%), followed by cardiovascular alterations (14.4%) and gastrointestinal complications (10.5%). On hemodialyzed patients, hospitalization rate was 24.7 days/year and complications derived from vascular access were the most frequent admittance cause (34%), followed by cardiovascular complications (20.4%) and hypertension (11.3%). Peritonitis (45%), vascular complications (15%) and metabolic impairment (15%) were the most frequent causes of admittance in IPD patients; hospitalization rate was 88 days/year. Actuarial survival in patients on CAPD was 92% during first year, 79% during second, and 64% during third and fourth years. On hemodialyzed patients, 90% of patients survived during first year and 80%, 48%, and 36% during second, third, and fourth years, respectively. On IPD, survival during first year was 63% and 12% at 18 months. By combinating two or the three methods, survival was 100% at 12 months and 88% at 4 years. Although CAPD as isolated technique may offer to diabetic patients a longer survival and HD a lower hospitalization rate, combined treatment (HD-CAPD-IPD) may provide a survival matchable to that achieved in renal transplantation. PMID- 2716375 TI - [Infectious gastroenteritis]. PMID- 2716374 TI - [Deaths attributable to tobacco consumption in Spain]. AB - Spain is one of the European countries with greater prevalence of tobacco consumption among general population. In order to encourage the implementation of tobacco consumption reduction programmes, the number of deaths caused by cardiovascular diseases and chief cancer localizations attributable to tobacco consumption in Spain were calculated by epidemiologic methods. Estimates suggest that, in 1983, 39.816 tobacco related deaths occurred, which accounted for 13% of total deaths reported during that year. The four tobacco related diseases producing the greatest number of deaths were ischemic cardiopathy (10.821 deaths), bronchopulmonary cancer (8.337 deaths), chronic obstructive pulmonary disease (7.473 deaths), and acute cerebrovascular accident (6.636 deaths). These results suggest that tobacco consumption is the isolated cause responsible of the greatest number of deaths in Spain, whose control must become a priority objective in our health policy. PMID- 2716376 TI - [Chronic lymphatic leukemia and portal hypertension: a causal association?]. AB - The authors report two cases of chronic lymphocytic leukemia and portal hypertension without an apparent cause. In the first patient, the histopathological study disclosed severe lymphocytic infiltration of the liver with moderate fibrosis of portal spaces. In the second patient, regenerative nodular hyperplasia of the liver was shown to be associated with lymphocytic infiltration. On the basis of these two observations, the authors discuss the mechanisms of portal hypertension in chronic lymphocytic leukemia. It is concluded that there probably is a causal relationship between both disorders, although its pathogenesis may be diverse. PMID- 2716377 TI - [A 24-year-old man with hemopericardium]. PMID- 2716378 TI - [The primary care physician and the problems of aid to patients with acquired immunodeficiency syndrome]. PMID- 2716379 TI - [Control of adrenal adenocarcinoma and Cushing's syndrome with ketoconazole]. PMID- 2716380 TI - [IgE antibody detection by capture ELISA system in hydatidosis]. PMID- 2716381 TI - [Acute gastroenteritis due to Vibrio parahaemolyticus. Serotypes and presentation of 4 new cases]. PMID- 2716382 TI - [Vasculitis of the central nervous system and giant cell arteritis]. PMID- 2716383 TI - [Serum TAG-72 in women with breast cancer: an example of serum/tissue discrepancy of a tumor marker]. PMID- 2716384 TI - [Detection of carriers and prenatal diagnosis of cystic fibrosis in Spanish families using DNA markers]. AB - A molecular study of 36 Spanish families with cystic fibrosis (CF) patients is reported. The analysis of seven DNA polymorphisms adjacent to the CF gene permitted the diagnosis of 95% of the probable carriers and the antenatal diagnosis in the seven cases in which it was requested. The application of recombinant DNA techniques to the study of CF by means of the analysis of DNA markers linked to the CF gene is useful, not only to identify the latter, but also as a reference to investigate its molecular pathology and for diagnostic purposes in high risk families (families with involved members). PMID- 2716385 TI - [Comparative study on the clinico-serologic course of acute hepatitis B and hepatitis B with delta co-infection]. AB - The clinical and serological course of 35 instances of hepatitis B (22 hepatitis B alone and 13 with delta co-infection) was comparatively and prospectively studied for a mean follow-up period of 7.19 +/- 2.69 months. There were no significant differences between the clinical presentation and course between both types of patients. There were not, either, outstanding differences in the mean bilirubin and transaminase levels between both types of hepatitis, although the patients with delta co-infection initially showed a more pronounced cholestatic pattern than did patients with hepatitis B alone (p less than 0.05). In hepatitis B with delta co-infection, the serological markers of activity and/or replication of hepatitis B virus (HBV) showed an earlier serum clearance than in patients with hepatitis B alone, basically in relation with the "e" antigen of HBV. Serum measurement of hepatitis delta virus (HDV) antigen by means of ELISA was shown to be a high sensitivity test (69.23%) for the diagnosis of acute HDV hepatitis, which was carried out in an early stage since the development of symptoms. PMID- 2716386 TI - [Rubella sero-epidemiology in Catalonia]. AB - The prevalence rate of protecting antibodies against rubella was evaluated in a representative sample of the urban population of the Baix Camp (Tarragona) in a prospective study carried out from 1985 to 1987. In the study population there were 44.1% of males, with ages ranging from 1 to over 65 years. There was a past history of the disease in 11% of individuals, and 6.3% had been vaccinated; 82.7% had neither past history nor had been vaccinated. It was concluded that 89.62% of the surveyed population was immunologically protected against rubella. PMID- 2716387 TI - [Dysplastic nevus syndrome with familial melanoma (type D2)]. AB - A 37 year-old woman presented with type D2 familial dysplastic nevus syndrome with melanoma. A melanoma was excised of her back and more than one hundred pigmented lesions, four of which presented histologic characteristics of dysplastic nevus were observed. Several relatives of her presented multiple nevi and a sister of her mother and a brother of the patient had been diagnosed of melanoma. It is well established that such kind of nevi are precursor for melanomas, particularly familial forms. The clinical identification of such lesions is very simple and facilitates the diagnosis and early treatment of melanoma. PMID- 2716388 TI - [Distal tubular renal acidosis associated with hyperglobulinemic purpura and Sjogren's syndrome]. AB - A 35-year-old female with a diagnosis of Waldenstrom's benign hypergammaglobulinemic purpura developed bilateral renal stones during the course of her disease. Evaluation disclosed type I distal tubular renal acidosis. In addition, the patient developed Sjogren's syndrome seven years later. The etiology and pathogenesis of renal tubular acidosis secondary to autoimmune disease are reviewed, and the exceptional occurrence of the three conditions in a single patient is commented. PMID- 2716389 TI - [Eosinophilic granuloma of the lung. Complete response after treatment with thymic hormone]. PMID- 2716390 TI - [Detection of adverse reactions to drugs based on the diagnosis at the time of hospital admission. Methods and results]. PMID- 2716391 TI - [Lyme disease. Recurrence of the skin lesion after treatment]. PMID- 2716392 TI - [Systemic thrombotic microangiopathy secondary to diclofenac]. PMID- 2716393 TI - [Cushing disease and primary empty sella turcica]. PMID- 2716395 TI - [Injuries caused by snake bites]. PMID- 2716394 TI - [Surface antigen of hepatitis B in diabetes mellitus]. PMID- 2716396 TI - [Systemic lupus erythematosus as syndrome of anticardiolipin antibodies]. PMID- 2716397 TI - [Attitude of daily smoking students to smoking prohibition]. PMID- 2716398 TI - [Hydatidosis in Catalonia. Study of patients younger than 20 years of age (1977 1985)]. AB - To evaluate the epidemiological features of human hydatidosis during the first two decades of life, and to assess whether it exists autochthonously in Catalonia, we analysed the patients younger than 20 years who had been diagnosed and/or treated between 1977 and 1985 in 46 hospitals (representing 95% of the hospital beds in Catalonia where surgical therapy for hydatid disease is available). Ninety-five cases were detected in 87 patients. The mean yearly incidence rate was 0.53/100,000. In 81 patients hydatidosis was diagnosed for the first time in their lives, in 11 for the second time, and in three for the third time. Among the first there was a predominance of exclusively pulmonary cysts (41.9%) over those with exclusively hepatic localization (32%) and with simultaneous hepatic and pulmonary localization (13%). Surgical operations were undertaken in 112 instances, with a mortality rate of 2.2%. It was estimated, by the actuarial method, that the likelihood of a second diagnosis of hydatid disease after the surgical removal of all the cysts found at the time of the first diagnosis was 4.2% two years after the last operation, 9.5% after four years, and 24.6% after 7 years. The incidence rate in the immigrant population was 3.03 times higher than the recorded one for Catalonia. Sixteen patients born in Catalonia reported not to have ever traveled out of it; this information was confirmed by the separate parents report. This would confirm the occurrence of autochthonous hydatid disease. PMID- 2716399 TI - [Certification of main cause of death in Barcelona, 1985]. AB - The aim of the present study was the validation of the underlying cause of death of the patients who died in Barcelona hospitals in 1985. A sample of deaths was stratified on the basis of the 17 categories of International Classification of Diseases (ninth revision), and the underlying cause as stated in the Statistical Death Certificate was compared with the cause that was considered to be "more likely" according to the available clinical documentation. The agreement index in the 17 ICD-9 categories was 71.8%. The groups with reliable rates were tumours, congenital defects and perinatal abnormalities. It is concluded that the fulfillment of the Statistical Death Certificate should be improved following the WHO recommendations; this could be achieved with training programs for clinicians. PMID- 2716400 TI - [Natural history of prostatic cancer]. PMID- 2716401 TI - [Unusual association of Graves' disease and Bartter's syndrome]. PMID- 2716402 TI - [Enterobacter cloacae infection and marked hypophosphatemia in a patient on hemodialysis]. PMID- 2716403 TI - [Clinical records written in autonomic languages]. PMID- 2716404 TI - [Churg-Strauss syndrome: 8 cases in the last 10 years]. AB - The clinical and histopathological findings of 8 patients with a diagnosis of Churg-Strauss syndrome seen in our institution in a 10 year period have been reviewed. All patients had asthma and hypereosinophilia (mean eosinophil count 7.64 x 10(9); range: 0.748 x 10(9)-31.46 x 10(9) eosinophils/l). The organs and systems involved in the late phase of the syndrome (vasculitic phase) were: nervous system (16 cases), respiratory system (5 cases), skin and subcutaneous tissue (5 cases), heart (3 cases), digestive system (3 cases) and kidney (1 case). The diagnosis was made on the basis of the clinical and histopathological findings. In 7 cases necrotizing angiitis was shown, tissue eosinophilia in 4, and extravascular granulomas in 2. In most cases, corticosteroid therapy resulted in a favorable course, but cyclophosphamide was required in two patients. In the discussion, the evolution of the criteria for the diagnosis of this condition is analyzed. PMID- 2716405 TI - [Treatment of arterial hypertension in the aged]. AB - The response to different therapeutic schedules in arterial hypertension in the elderly is studied and compared with response to treatment in younger patients. Blood pressure in the elderly was best controlled with non pharmacologic measures and low doses of diuretics; there were no differences between both groups with respect to complications and side effects. The response to angiotensin-converting enzyme inhibitors is also evaluated, presenting good results on blood pressure control without side effects in the elderly, although efficaciousness was higher in younger patients. The possible therapeutic schedules in arterial hypertension in the aged are discussed. PMID- 2716406 TI - [Minimal change nephrotic syndrome in adults]. AB - Twenty five adult patients with minimal changes disease proven at kidney biopsy and 13 of them older than 50 years of age are reported. Clinically, 32% of cases behaved as "impure" nephrotic syndrome, with no one case of established renal insufficiency; in nine cases, the process was antedated by a triggering event, usually infective episodes. In four cases who received no treatment, spontaneous remission was observed. All treated patients but one, initially responded to corticosteroid treatment in a period shorter than 1 month and 40% of patients presented maintained remission. There were no important complications derived from the disease nor from the treatment and at the end of the follow up only one patient died from a disease unrelated to the nephropathy. PMID- 2716407 TI - [Osteopathy in internal diseases]. PMID- 2716408 TI - [New therapeutics in lupus nephritis]. PMID- 2716409 TI - [Diagnosis by DNA analysis in familial isolated growth hormone deficiency type I A]. AB - We show the autoradiograms of DNA from one child affected of familial isolated growth hormone deficiency type I-A. Restriction endonuclease analysis of DNA isolated from leukocytes was done using 32P-labeled human GH cDNA clone as a probe. DNA analysis using the restriction endonuclease Bam HI revealed that the 3.8 kb restriction fragment, which contain the normal hGH-N gene, was absent. Since these deletions preclude production of any GH-N protein, affected individuals tend to be immunologically intolerant to exogenous GH. The child was homozygote and after treatment with exogenous GH developed a high titre of antibodies to GH and growth arrest. This is the first case of this genetic disorder studied in Spain. PMID- 2716410 TI - [Research concerning human populations]. PMID- 2716411 TI - [Primary vaginal non-Hodgkin's lymphoma]. PMID- 2716412 TI - [Psychiatric diagnosis in patients with acquired immunodeficiency syndrome admitted to a general hospital]. PMID- 2716413 TI - [Sweet's syndrome in a patient with acute myelomonocytic leukemia: presentation during granulopenic phase]. PMID- 2716414 TI - [Use of aminopenicillins: first cause of error in the prescription of antimicrobial agents at a hospital]. AB - The patterns of use and quality of prescription of ampicillin and amoxycillin (A/A) as compared with the rest of antimicrobials (AM) was evaluated by means of the review of the therapeutic sheets of 4572 admitted patients, in coincidence with 5 calculations of prevalence in a university hospital. 25.7% of patients received AM. These were used in 865 instances, and 6% were disqualified. A/A participated in 57% of these errors (p = 0.002 as related with the rest of AM). 309 patients received AM as prophylactic drugs, and 70% of them did not comply with the standard rules. The election of A/A for prophylaxis was associated with 71% of these errors (p less than 0.0001). Nine out of every 10 prophylactic administrations of A/A were abnormal owing to incorrect indication (77%), dosage (10%), oral route (62%) or excessive duration (82%). The high prevalence of prescription of aminopenicillins (30%) was associated with 68% of the errors in the use of AM, owing, among other reasons, to the high resistance rates of the major recovered organisms excluding enterococci. The nonjustified overuse of aminopenicillins was the leading detected problem; it can be managed by a restrictive antibiotic policy and educational measures oriented to an adequate medical prescription. PMID- 2716415 TI - [Treatment of atypical pneumonia with josamycin]. AB - In the present study the clinical efficacy and tolerance of josamycin (1 g every 12 hours) was prospectively evaluated for the empirical therapy of patients below 70 years with community acquired pneumonia of atypical presentation (AP), without respiratory failure, radiological cavitation or risk factors of pharyngeal colonization by gram-negative bacilli. During a 28-month period 168 patients adequate for the study were included. The etiological diagnosis was established in 56 cases (33.3%); in 55 by seroconversion (28 Mycoplasma pneumoniae, 22 Legionella pneumophila, 1 Chlamydia psittaci and 4 Coxiella burnetii) and in only one case by positive blood culture (Streptococcus pneumoniae). The mean duration of therapy was 9 days and that of fever 1.4 days. Five patients (3%) had mild transient gastrointestinal complaints. No patient required a change of therapy. Relapses were not observed in the 45 days of follow up. In conclusion, josamycin (1 g/12 h p.o.) is an effective and well tolerated antibiotic for the therapy of pneumonia by M. pneumoniae or L. pneumophila, and it represents a good empirical treatment of AP in patients below 70 years without risk factors of GNB infection, respiratory failure or radiological cavitation. PMID- 2716416 TI - [Use of benzodiazepines at a general hospital]. AB - Anxiety and insomnia are frequent troubles among hospitalized patients and are often related to the underlying diseases, their diagnosis and treatment or to other conditions of the hospital environment. The primary therapeutic strategy consists of modifying such circumstances. Benzodiazepines may be useful in some patients but patterns of hospital use have been scarcely evaluated. We have studied the use of benzodiazepines in medical and surgical departments of our hospital for a 2-month period. From a total of 754 admitted patients, 116 (15.4%) received benzodiazepines orally, presumably for anxiety and insomnia. The proportion of treated patients differed remarkably oscillating between 4% and 58%. Mean daily doses of benzodiazepines were lower than defined daily doses. The schedules were remarkably rigid: 1) in none of the cases the initial dose nor therapeutic schedule were changed, 2) in most cases, schedules in the elderly were the same as in younger patients, and 3) in 80% of cases, the treatment was maintained till the patient was discharged. The present study emphasizes the necessity to modify overall strategy of the use of benzodiazepines. PMID- 2716417 TI - [Influence of passive exposure to tobacco on the development of sibilus in children]. AB - A case-control study was designed to assess the relationship between passive exposure of children to smoking and the development of respiratory diseases with ronchi and wheezing detected by the primary care physician. The clinical records of 530 children in whom at least one episode of ronchi and/or wheezing had been recorded during the four years of activity of the Family and Community Unit of Cornella were considered as cases. All the remaining children from the same age group were considered as controls. There were no significant differences in the proportion of smoking families between cases and controls (70.5% vs 71.9, chi 2 = 0.018, p = 0.89, NS). The mean number of cigarettes per family and day was not different either. It is a concluded that, in this age group, passive exposure to smoking does not result in an increase of respiratory diseases associated with ronchi and wheezing. PMID- 2716418 TI - [Malignant lymphomas (non-Hodgkin's lymphomas and Hodgkin's disease) associated with infection by the human immunodeficiency virus. Study of 9 cases]. AB - Six cases of non-Hodgkin's lymphoma and three of Hodgkin's disease in patients carrying antibodies against human immunodeficiency virus are reported. Mean age was 30.6 years (SD: 6). From the patients with non-Hodgkin's lymphoma, three were homosexual and three were parenteral drug users. The three patients with Hodgkin's disease were parenteral drug users. The primary features of the patients with non-Hodgkin's lymphoma were: degree of malignity intermediate (three patients) or high (three patients), initial extralymphatic involvement (five patients) and advanced stages (IIIA one patient, and IVB four patients). In turn, the patients with Hodgkin's disease presented the following histopathologic varieties: mixed cellularity (two cases) and lymphocytic depletion (one case); advanced stage (III two cases and IV one case) and B symptoms. We wish to emphasize the necessity of determining the existence of antibodies against human immunodeficiency virus in all patients with Hodgkin's disease or non-Hodgkin's lymphomas with high degree of malignity and extralymphatic involvement. In patients with antibodies against the human immunodeficiency virus who present a marked impairment of general condition and/or changes in the clinical features of their adenopathies, the development of a lymphoma must be ruled out. PMID- 2716419 TI - [Hemorrhagic recurrence in upper digestive hemorrhage caused by peptic ulcer]. PMID- 2716420 TI - [Diabetes mellitus 1 1/2]. PMID- 2716421 TI - [Molluscum contagiosum in children with acquired immunodeficiency syndrome]. PMID- 2716422 TI - [Hospital mortality]. PMID- 2716423 TI - [Mortality directly related to nosocomial bacteremia]. PMID- 2716424 TI - [Coexistence of more than one disease in HIV positive patients with lymphoma]. PMID- 2716425 TI - [Chemistry, pharmacology and pharmacokinetics of a new anxiolytic agent: buspirone]. PMID- 2716426 TI - [Prevalence of hepatitis B infection in institutions for the mentally retarded. Epidemiologic characteristics in the province of Vizcaya]. AB - The prevalence of hepatitis B virus (HBV) infection was studied in 346 subjects (148 employees and 198 mentally retarded) in four institutions for the mentally subnormal in Vizcaya-Spain. The prevalence of markers in the overall group was 32.6%; 13.5% in the employees and 46.9% in the mentally retarded. Early age and institutionalization time increases the risk of infection in the mentally retarded group, but not in the employees group. 220 subjects (118 employees and 102 mentally retarded) had negative HBV markers and were vaccinated with recombinant-DNA hepatitis B vaccine. The immunogenicity was 80% and the weight height index the only factor implicit in the group of subjects no seroconverters. The reactogenicity of vaccine was 6.7%. PMID- 2716427 TI - [Degradation of purine nucleotides in patients with chronic obstruction to airflow]. AB - The increase in hypoxanthine (Hx), xanthine (X), uric acid (VA) and total purines (TP) that may be found in several clinical conditions associated with tissue hypoxia has been attributed to an increase in adenine nucleotides degradation by a reduced ATP synthesis caused by oxygen deprivation. To test this hypothesis we have investigated the urinary excretion of Hx, X, VA, TP and radioactivity elimination after labeling the adenine nucleotides with adenine (8-14C) in 5 patients with chronic airflow obstruction (CAFO), in the basal state and after oxygen therapy (FiO2, 24%). The results were compared with those from 4 normal individuals. Patients with COFA showed an increase of the renal elimination of Hx, X, VA, TP and radioactivity, which was significantly different from the control group (p less than 0.05). Oxygen administration was associated with a significant reduction in the excretion of purines and radioactivity (p less than 0.01), which decreased to values similar to those found in normal individuals. These findings suggest that in patients with COFA and severe hypoxemia there is a marked increase in the degradation of adenine nucleotides. The normalization of the purine and radioactivity excretion after oxygen therapy points to a basic role of oxygen in the catabolism of adenine nucleotides. PMID- 2716428 TI - [Acute renal insufficiency induced at the hospital: prospective study and prevention]. AB - To prevent hospital-induced acute renal failure (ARF), a prospective study was carried out, consisting of the recording of all cass of ARF in the hospital for a two month period (phase one). Their causes, evolution, prognostic indicators and the potentially preventable iatrogenic factors were recorded. On the basis of these data, several preventive measures were instituted (phase two) during 6 months; subsequently, during an additional 2 month period, the incidence of ARF was evaluated with the same methodology as in phase one. The number of evaluated individuals at risk (patients admitted to the hospital during the phases one and three) was 1470 and 1232, respectively. The number of recorded ARF episodes was 23 (1.6%) and 8 (0.65%) during the two periods, respectively. This reduction after the institution of preventive measures was statistically significant (p less than 0.04), with a complete disappearance of aminoglycosides as etiological factor, and a practical disappearance of multifactorial etiology, where risk diseases and drugs were also implicated. Iatrogenic factors were reduced from 75% (phase one) to 25% (phase three). The mortality rate of these patients was about 50% in both periods, and the only identified unfavorable prognostic factor was oliguria associated with ARF. It is concluded that the number of episodes of ARF, their preventable etiology and iatrogenic factors can be reduced by several prevention measures. It is advisable to implement these controls in a periodic fashion and to create surveillance committees of ARF in the hospital. PMID- 2716429 TI - [Carcinoma of the kidney as a complication of acquired cystic disease of the kidney in patients subjected to treatment with periodical hemodialysis]. AB - Three cases of acquired cystic renal disease (ACRE) are reported in patients treated with periodical hemodialysis (HD) who developed neoplastic degeneration. In the first patient, diagnosis was a chance finding of nephrectomy during renal transplantation. The second patient was discovered following hematuria, and in the third patient disseminated metastases were the presenting feature of the disease. The finding of renal tumours associated with ACRE is a well known fact; however, metastatic disease has been infrequently reported. Generally, the denomination "adenoma" is adopted for tumours with a maximal diameter shorter than 3 cm, as they seldom develop metastases. However, the third patient had an adenocarcinoma measuring 2 cm in diameter. One of the parameters that best correlates the occurrence of ACRE and tumour development is the duration of HD; therefore, it is suggested that those patients who have received substitution therapy for longer than 3 years should undergo radiological studies for the early identification of these complications. PMID- 2716430 TI - [High-degree malignancy non-Hodgkin's lymphoma simulating a disseminated carcinoma. Presentation of 2 cases]. AB - Highly malignant non-Hodgkin lymphomas (HM-NHL) may sometimes develop clinical features simulating an epithelial carcinoma with metastatic dissemination. Conventional histopathological study may be insufficient to differentiate between both conditions. Two patients with HM-NHL are reported with a rapid general deterioration; one of them had osteolysis and hypercalcemia. In both cases a diffuse bone marrow infiltration by large sized cells with blastic appearance was found. The initial suspected diagnosis was occult epithelial neoplasia with metastatic dissemination. The morphological study with optic microscopy and the ultrastructural analysis did not establish the origin of these cells. The definitive diagnosis was obtained by immunohistochemical techniques. In both cases, the cells were positive for the CD 45 (common leukocyte antigen) monoclonal antibody (MoAb), and for several MoAbs of lymphoid B differentiation. In one of them, the B lymphoid lineage was confirmed by monoclonal reordering of the gene that synthetises the immunoglobulin heavy chain. PMID- 2716432 TI - [Are patients "materials"?]. PMID- 2716431 TI - [Europe against cancer. Clinical conference]. PMID- 2716433 TI - [Medullary carcinoma of the thyroid gland associated with previous cervical radiotherapy]. PMID- 2716434 TI - [Hyperpigmentation and zidovudine]. PMID- 2716435 TI - [Epidemic parotitis and Reiter's syndrome]. PMID- 2716436 TI - [Domiciliary hospitalization of patients with acquired immunodeficiency syndrome]. PMID- 2716437 TI - Plasma spermidine and putrescine as markers of cancer management. AB - The hypothesis was tested that dying tumor cells release spermidine and putrescine into the bloodstream. Therefore, a rhabdomyosarcoma was implanted in rats, irradiated and its growth and subsequent reduction compared with spermidine and putrescine plasma concentrations of the venous effluent from the tumor side and contralateral side. In the experimental set-up used the hypothesis could not be verified. It appeared that irradiation only, implantation and growth of a tumor only and an irradiated tumor, all caused elevated spermidine and putrescine concentrations in the effluent of both sides in approximately the same order of magnitude, compared to untreated controls. PMID- 2716438 TI - Psychophysiological research in psychiatry and neuropsychopharmacology. I. Methodological aspects of the Viennese Psychophysiological Test-System (VPTS). AB - In order to find a psychophysiological paradigm for clinical application we have developed the Viennese Psychophysiological Test-System (VPTS), which includes a special selection and combination of experimental situations, physiological measurements, behavioral measurements and data analysis. This study presents detailed information concerning these four aspects. Experimental situations are related to the human model of information processing, where short changes of stimulus-reaction-correlated processes are selected: resting conditions (eyes open, eyes closed), habituation-orienting test, psychomotor-performance test, signal-detection test and reaction-time test. Physiological measures include central and peripheral activity of the cerebrospinal and autonomic nervous system: cortical activity (spontaneous electroencephalogram, auditory evoked potentials, late positive components, slow potentials), ocular activity (eye and eyelid movements), electrodermal activity (skin conductance), cardiac activity (heart rate measurement), respiratory activity (rate of respiration) and peripheral vascular activity (finger pulse volume). Behavioral measurements extend from micro behavior to complex diagnostic systems: psychomotor measurements, self-reported mood, arousal and visceral perception, psychological and psychiatric interviews. The application of this test system in 15 elderly subjects of both sexes aged 58-77 years gives information which exceeds the sum of the singular constructing elements of the VPTS. PMID- 2716439 TI - Psychophysiological research in psychiatry and neuropsychopharmacology. II. The investigation of antihypoxidotic/nootropic drugs (tenilsetam and co-dergocrine mesylate) in elderlies with the Viennese Psychophysiological Test-System (VPTS). AB - In a double-blind placebo-controlled study, the effects of tenilsetam, a novel antihypoxidotic/nootropic agent, on spontaneous and event-related activity of the central and autonomous nervous system were studied in 15 elderly subjects of both sexes aged 58-77 years by means of the Viennese Psychophysiological Test-System (VPTS). The VPTS includes a special selection and combination of experimental situations, physiological measurements, behavioral measurements and data analysis. At weekly intervals, the subjects received randomized single oral doses of placebo, 150 mg, 300 mg and 900 mg tenilsetam (TEN) and 5 mg co-dergocrine mesylate (CDM) as reference drug. Psychophysiological testings were carried out before and 2 h after drug administration. Evaluation of the spontaneous EEG activity demonstrated no significant drug effects as compared to placebo. In contrast, TEN showed a dose-dependent augmentation of the N1-P2 and N2-P300 amplitudes of the event-related potentials (ERPs) in specific experimental conditions. In reference to placebo, the increase of N2-P300 amplitude after the highest dosage of TEN, as well as after CDM, amounted to approximately 5 microV, which confirms the hypothesis that nootropic drugs may influence the P300 amplitude in the sense of an improved availability of cognitive processing resources. There was no effect on ERP latencies, on mean amplitudes of contingent negative variation and of post-imperative negative variation, on autonomous nervous system, on psychological measurements, nor on reaction time. However, specific improvements were observed in psychomotor measures, such as synchronization accuracy and rhythmicity. These findings highlight the importance of using EEG and ERP measures in different experimental situations in conjunction with behavioral, psychological and autonomous nervous system measures to study nootropic drug effects. PMID- 2716440 TI - [Physicians against AIDS. Prevention of HIV prior to the 90's should be directed more towards the individual]. PMID- 2716441 TI - [Forensic psychiatry remains subjected to the government?]. PMID- 2716442 TI - [The length of time a drug patent is effective must be prolonged]. PMID- 2716443 TI - [Great variations in the guidance medical students receive in medicine and surgery]. PMID- 2716444 TI - [Increasing number of abortions among young women--a medical or a social problem?]. PMID- 2716445 TI - [Cancer--a part of natural aging]. PMID- 2716446 TI - [Difficulties in obtaining financial support for studies of hemorrhage during treatment with anticoagulants]. PMID- 2716447 TI - [Primary prevention in hypertension--how to explain mortality differences between therapeutic regimes?]. PMID- 2716448 TI - [Routine abdominal plain films detect swallowed narcotic capsules]. PMID- 2716449 TI - [Don't neglect physical and psychological integrity during urinary catheterization of children and adolescents]. PMID- 2716450 TI - [Urticaria pigmentosa and systemic mastocytosis]. PMID- 2716451 TI - [Medical ethics. Assume agreement to organ donation in unclear cases. That model is the best one from everyone's perspective]. PMID- 2716452 TI - [Medical ethics. A conflict in the ethics of care because of various ideas on the humanity of authorities and care personnel]. PMID- 2716453 TI - [A warning against non-competent cosmetic surgery. More and more complications and bad therapeutic results]. PMID- 2716454 TI - [The farewell lecture of Sam Brody: the cooperation of medicine and society. Resistance against new ideas causes debate]. PMID- 2716455 TI - American Society for Laser Medicine and Surgery, ninth annual meeting. Arlington, Virginia, April 15-17, 1989. Abstracts. PMID- 2716456 TI - Excimer ablation of human intervertebral disc at 308 nanometers. AB - Excimer laser energy, which has been shown to photoablate tissue at a precisely controllable rate with minimal thermal damage, was applied to human intervertebral disc in an effort to develop a technique for percutaneous discectomy. Cadaveric samples of human disc were used. Excimer laser energy was produced by a XeCl, magnetically switched, long-pulse laser working at 308 nm, 20 Hz. Annulus tissue of approximately 1 mm thickness was placed in contact with the output tip of a 400 microns core diameter quartz fiber, and measurements of ablation rate were made at different radiant exposures. Ablation rates were found to vary linearly with radiant exposure, from 0.7 micron/pulse at 10 mJ/mm2 to 11.0 microns/pulse at 55 mJ/mm2, with a correlation coefficient of 0.984. Threshold radiant exposure, calculated by extrapolation, was found to be about 7 mJ/mm2. Histologic analysis showed a minimum of thermal damage in these specimens, and when ablated with modification to maintain constant fiber-tissue contact, thermal injury was nearly absent, as compared to samples ablated with Nd:YAG through a contact probe. Thermographic analysis, performed using the AGA 782 Digital Thermography system, showed increasing temperature with increasing radiant exposure, with a maximum temperature of 47.2 degrees C at 55 mJ/mm2. In that precise tissue ablation was demonstrated with minimal generated heat, and excimer energy at 308 nm is transmissible through fiber optics, excimer holds great promise for the development of a percutaneous discectomy technique. PMID- 2716457 TI - Pulsed Er:YAG- and 308 nm UV-excimer laser: an in vitro and in vivo study of skin ablative effects. AB - Using a pulsed XeCl excimer laser (308 nm) and a pulsed Er:YAG laser (2,940 nm), we investigated skin ablation as a function of pulse number, radiant energy, and repetition rate. In vitro analysis of lesions performed in freshly excised human skin were consistent with in vivo results obtained from experiments on pig skin. Pulsed 308 nm laser radiation caused considerable nonspecific thermal tissue injury followed by an inflammatory reaction and impaired healing of lesions in vivo. These findings were especially pronounced with higher repetition rates, which would be required for efficient destruction of larger lesions. On the other hand, the 2.94 microns Er:YAG laser radiation produced clean and precise lesions with only minimal adjacent injury. In vivo skin ablation caused intraoperative bleeding with deeper penetration. The Er:YAG laser offers a promising surgical tool for careful removal of superficial epidermal lesions, if higher repetition rates, and an appropriate laser beam delivery system are available for clinical use. PMID- 2716458 TI - Ablation of bone and polymethylmethacrylate by an XeCl (308 nm) excimer laser. AB - One of the main problems in orthopaedics is the surgical removal of hard substances, such as bone and polymethylmethacrylate (PMMA). Such materials are often very difficult to remove without mechanical trauma to the remaining tissue. This study investigated the feasibility of the ultraviolet 308 nm excimer laser in the ablation of these materials. The beam was delivered through a 1 mm diameter fiber optic at 40 Hz with energy densities at the target surface of 20 80 J/cm2 per pulse. The goal of the study was to establish the ideal dosimetry for removing bone and PMMA with minimum trauma to the adjacent tissue. Histology revealed that the 308 nm laser effectively removed bone leaving a thermal damage zone of only 2-3 microns in the remaining tissue. Increasing the energy per pulse gave correspondingly larger and deeper cuts with increasing zones of thermal damage. The excimer laser was also effective in the ablation of PMMA, creating craters in the substrate with a thermal damage zone of 10-40 microns. The debris from both substrates was evaluated. PMID- 2716459 TI - Light distributions in artery tissue: Monte Carlo simulations for finite-diameter laser beams. AB - Finite-width light distributions in arterial tissue during Argon laser irradiation (476 nm) are simulated using the Monte Carlo method. Edge effects caused by radial diffusion of the light extend +/- 1.5 mm inward from the perimeter of a uniform incident beam. For beam diameters exceeding 3 mm the light distribution along the central axis can be described by the one-dimensional solution for an infinitely wide beam. The overlapping edge effects for beam diameters smaller than 3 mm reduce the penetration of the irradiance in the tissue. The beam profile influences the light distribution significantly. The fluence rates near the surface for a Gaussian beam are two times higher on the central axis and decrease faster radially than for a flat profile. The diverging light from a fiber penetrates tissue in a manner similar to collimated light. PMID- 2716460 TI - Welding of gallbladder tissue with a pulsed 2.15 microns thulium-holmium chromium:YAG laser. AB - Percutaneous endoscopic approaches to cholelithiasis would be facilitated by methods for welding gallbladder tissues. We evaluated the bursting pressure and histologic appearance of canine gallbladder tissue welded with a thulium-holmium chromium:YAG (THC:YAG) laser producing a 2.15 microns pulsed output. The tissue absorption characteristics at this wavelength as well as the pulsed nature of the output permit tissue welding with limited collateral thermal damage. The THC:YAG is compatible with a flexible fiberoptic delivery system. Bursting strengths of the welded junctions averaged 42 mm Hg, which is above physiologically encountered pressures. Histologic sections of the bonded tissues revealed tissue fusion and limited thermal injury to the surrounding tissue. We feel that THC:YAG laser welding may be a useful technique in the clinical development of percutaneous endoscopic biliary surgery. PMID- 2716461 TI - Microvascular anastomosis using a new diode laser system with a contact probe. AB - The aim of the present study was to demonstrate the usefulness of our newly produced diode laser device (an 830-nm output of 190 mW CW) for microvascular end to-end anastomoses. In the device, diode laser energy is delivered to a contact ceramic tip with a 200-microns diameter output end. Its wavelength is 830 nm and its power 60 mW. This device is small (30 x 25 x 10 cm), lightweight (gross weight 3kg), and easy to manipulate. Compared with conventional microvascular suture anastomosis (CMSA), the time required for the laser-assisted vascular anastomoses (LAVA) was reduced by almost half. Anastomosed portions of both methods were examined 1, 2, 4, 12, and 24 weeks later for patency and aneurysm formation. The patency rate and incidence of aneurysmal formation were the same in both groups. Histological examination revealed that LAVA is superior to CMSA in the smoothness of the inner surface, less inflammatory reaction, and normal collagen and elastic reorientation. The tensile strength and bursting pressure measured immediately after anastomosis demonstrated no significant difference between the two groups. It was concluded that this diode laser contact method may be clinically useful for microvascular surgery. PMID- 2716462 TI - Systemic effects of low-power laser irradiation on the peripheral and central nervous system, cutaneous wounds, and burns. AB - In this paper, we direct attention to the systemic effect of low-power helium neon (HeNe) laser irradiation on the recovery of the injured peripheral and central nervous system, as well as healing of cutaneous wounds and burns. Laser irradiation on only the right side in bilaterally inflicted cutaneous wounds enhanced recovery in both sides compared to the nonirradiated control group (P less than .01). Similar results were obtained in bilateral burns: irradiating one of the burned sites also caused accelerated healing in the nonirradiated site (P less than .01). However, in the nonirradiated control group, all rats suffered advanced necrosis of the feet and bilateral gangrene. Low-power HeNe laser irradiation applied to a crushed injured sciatic nerve in the right leg in a bilaterally inflicted crush injury, significantly increased the compound action potential in the left nonirradiated leg as well. The statistical analysis shows a highly significant difference between the laser-treated group and the control nonirradiated group (P less than .001). Finally, the systemic effect was found in the spinal cord segments corresponding to the crushed sciatic nerves. The bilateral retrograde degeneration of the motor neurons of the spinal cord expected after the bilateral crush injury of the peripheral nerves was greatly reduced in the laser treated group. The systemic effects reported here are relevant in terms of the clinical application of low-power laser irradiation as well as for basic research into the possible mechanisms involved. PMID- 2716463 TI - Fatal air embolism as a complication of laser-induced hyperthermia. AB - Laser-induced hyperthermia is a new treatment modality for malignancies. When large tumors are treated with laser thermia, relatively high laser powers (4-6 W) must be used to accomplish destruction of the cancerous cells. Overheating and burning of the laser fibers and contact tips during laser thermia treatment must be prevented by using coaxial gas or fluid flow. The present report describes a case of fatal air embolism as a complication of laser thermia using coaxial gas. The authors warn all surgeons performing this procedure not to use coaxial air flow for cooling the contact tips because of the potential risk of air embolism. PMID- 2716464 TI - Dynamic aspects of rhodamine dye photosensitization in vitro with an argon-ion laser. AB - Phototoxicity in cultured human bladder carcinoma cells treated by 514.5-nm argon ion laser irradiation plus rhodamine-123 (R123) or tetrabromo-R123 (TBR) was assessed counting total cell number and percent viability at 1, 24, 48, 72, and 96 h after irradiation. TBR was markedly more efficient than R123 at causing both reversible and persistent phototoxic cytostasis. Furthermore, TBR photosensitization caused net cytocidal effects at 0.5 J/cm2, which were not seen with R123 photosensitization at up to 40 J/cm2. The reduced phototoxic efficiency of R123 as compared to TBR appears, in part, to reflect the presence of a fraction of cells refractory to R123 photosensitization. PMID- 2716465 TI - Release of some endogenous trace amines from rat striatal slices in the presence and absence of a monoamine oxidase inhibitor. AB - The basal and 50 mM K+-stimulated release of m-tyramine (mTA), p-tyramine (pTA), tryptamine (TR) and phenylethylamine (PE) from striatal slices obtained from rats pretreated with a monoamine oxidase inhibitor (MAOI) was investigated. A K+ stimulated release of mTA and pTA was observed, but K+ did not stimulate either TR or PE release. The latter two amines, therefore, are unlikely to be conventional neurotransmitters in the rat striatum. The release of endogenous striatal pTA from control rats was also investigated. Veratridine stimulated endogenous pTA release, but 50 mM K+ did not. It is possible, therefore, that endogenous pTA can be released in a transmitter-like fashion. PMID- 2716466 TI - Radiation-induced volatile hydrocarbon production in platelets. AB - Generation of volatile hydrocarbons (ethane, pentane) as a measure of lipid peroxidation was followed in preparations from platelet-rich plasma irradiated in vitro. The hydrocarbons in the headspace of sealed vials containing irradiated and nonirradiated washed platelets, platelet-rich plasma, or platelet-poor plasma increased with time. The major hydrocarbon, pentane, increased linearly and significantly with increasing log radiation dose, suggesting that reactive oxygen species induced by ionizing radiation result in lipid peroxidation. Measurements of lipid peroxidation products may give an indication of suboptimal quality of stored and/or irradiated platelets. PMID- 2716467 TI - Urethane anesthesia blocks the development and expression of kindled seizures. AB - The effect of anesthetic and subanesthetic doses of urethane on the development of amygdala kindled seizures and on the expression of previously kindled seizures was studied in hooded rats. An anesthetic dose of urethane (1.5 g/kg) almost completely eliminated evoked afterdischarge and completely eliminated convulsive behavior in both groups. It also eliminated the seizure response to pentylenetetrazol. Subanesthetic doses of urethane (0.25 and 0.5 g/kg) strongly attenuated the expression of previously kindled seizures. These results suggest that urethane may not be an appropriate anesthetic for the study of epileptiform phenomena. PMID- 2716469 TI - Distribution of free N-acetylneuraminic acid in rat organs. AB - The concentration of free N-acetylneuraminic acid in various rat organs was estimated by gas chromatography/mass spectrometry. Its concentration was in the range of 3.95 to 104.72 micrograms/g wet tissues, being particularly high in the endocrine glands. The ratio of free N-acetylneuraminic acid to total N acetylneuraminic acid varied from 0.031 to 0.183, being especially high in the adrenal gland (0.181) and heart (0.183). PMID- 2716468 TI - A simple method for concentration of biogenic amines and their metabolites from biological samples for analysis by HPLC-EC. AB - This report describes a new rapid, convenient and inexpensive method of concentrating biogenic amines and their metabolites from biological samples for analysis by HPLC-EC. Recovery of standard monoamines and metabolites from artificial cerebrospinal fluid (CSF) solution following lyophilization in the presence of glutathione (1.2 mg/ml, final concentration) and EGTA (1.8 mg/ml, final concentration) was greater than 89%; the coefficient of variation was 0.6 3.7%, depending on the specific amine or metabolite concentrated. Lyophilization as a one step procedure is suitable for concentrating biogenic amines and metabolites from biological fluids such as CSF that contain low concentrations of protein and other interfering substances. When concentrating compounds from plasma, which contains large quantities of protein and other electrochemically active materials, it is necessary to add an extraction step, such as alumina extraction. By substituting 0.05 M HCl for the conventional eluent, 0.1 M HClO4, we were able to increase recoveries of catecholamines from plasma by approximately 20%. Recovery of endogenous catecholamines from plasma following the combined alumina extraction - lyophilization procedure was 81 +/- 1%. PMID- 2716470 TI - Serum albumin stimulates serotonin uptake into human blood platelets. AB - Active uptake of serotonin (5-hydroxytryptamine, 5-HT) into blood platelets from healthy donors exhibited a lower Vmax value in buffer media than in plasma. Also in plasma ultrafiltrate Vmax was reduced, but it returned to the level measured in plasma upon addition of human serum albumin (40 milligrams) containing fatty acids. Fatty-acid-free albumin was even more stimulatory and when added to platelets in a phosphate-buffered medium, it increased Vmax beyond the value observed in plasma. Km values calculated on the basis of unbound 5-HT were not affected by the media except for a slight decrease in ultrafiltrate as compared to plasma. The fraction of 5-HT (0.5 mumol/l) bound to 40 milligrams albumin was 17% with the preparation containing fatty acids and 22% with fatty-acid-free albumin, while total plasma proteins dissolved in phosphate buffer bound 24%. The uptake of 1 mumol/l 5-HT was enhanced by both albumin preparations already at 1 milligram and near-maximal effects occurred at 10 milligrams. PMID- 2716471 TI - Leucokinins, a new family of ion transport stimulators and inhibitors in insect Malpighian tubules. AB - Leucokinins are octapeptides isolated from heads of the cockroach Leucophaea maderae. In the cockroach they increase motility of the isolated hindgut. Surprisingly, synthetic leucokinins have biological activity in a different insect and in a different tissue. In isolated Malpighian tubules of the yellow fever mosquito Aedes aegypti, leucokinins depolarize the transepithelial voltage. This effect on voltage is dependent on extracellular Cl. One leucokinin, LK-8, the effects of which were studied further in isolated Malpighian tubules, was found to inhibit transepithelial fluid secretion at low concentrations (10(-11) M threshold), and to stimulate fluid secretion at high concentrations (3.5 x 10(-9) M threshold). Together, the depolarizing effects on voltage and the stimulation of fluid secretion suggest that leucokinins increase the Cl permeability of the tubule wall thereby increasing the availability of Cl for secretion with Na, K and water. Structure-function comparisons of the seven leucokinins studied suggest that the active region of the octapeptide is segregated to the C-terminal pentapeptide. In view of the known effects of leucokinins on hindgut motility in the cockroach, our finding of effects in mosquito Malpighian tubules suggests that leucokinins may be widely distributed in insects where they may have diverse functions in a variety of organs. PMID- 2716472 TI - Adenosine analogs inhibit fighting in isolated male mice. AB - The potent adenosine analogs N-ethylcarboxamide adenosine (NECA) and phenylisopropyladenosine (PIA) inhibit fighting and associated agonistic behaviors in isolated male mice. These effects are reversed by methylxanthines; moderate doses of NECA which inhibit fighting have minimal effects on spontaneous locomotor activity. At very low doses, both NECA and PIA increase fighting in parallel with previously reported increases of motor activity. Brain levels of [3H]-NECA and [3H]-PIA achieved at behaviorally effective doses suggest an involvement of adenosine receptors. The biochemical mechanism of adenosine receptor action with respect to fighting is unknown, but may include neuromodulatory effects on the release of other, more classical neurotransmitters. PMID- 2716473 TI - Stabilization of blood platelet microtubular system by staurosporine. AB - The stimulative effects of phorbol myristate acetate (PMA) on rabbit platelet shape change and platelet adhesion were completely inhibited by staurosporine (STS)-pretreatment. When the platelets were observed by whole mount immuno transmission electron microscopy (TEM), STS was found to stabilize platelet microtubular cytoskeleton. Electrophoretic analysis of the isolated marginal bundles of cytoskeleton after STS-PMA treatment revealed a newly formed 200 K high molecular weight protein band accompanied with heavy losses of tubulin monomers. These bundles of STS-treated platelets as observed in immuno TEM responded poorly to the anti alpha- or beta-tubulin antibody as compared with those of the control platelets. The results suggest that sts favour the specific assembly of tubulin bundles with a possible involvement of the microtubular associated proteins (MAPs). The resultant tight marginal bundles (MB) of cytoskeleton will stabilize the platelets and resist the effects of exogeneously added stimulants such as PMA. PMID- 2716474 TI - Augmented analgesic effects of enkephalinase inhibitors combined with transcranial electrostimulation. AB - The analgesic effects of very low current transcranial electrostimulation are naloxone-reversible and thus presumably mediated by endogenous opioid activity. The present experiments indicate that blocking enkephalinase activity by i.c.v. thiorphan or i.p. acetorphan results in an increased analgesic effect of electrostimulation as measured by the 50 degrees C wet tail flick test. In the case of each drug, rats receiving both drug and electrostimulation displayed significantly more analgesia than rats receiving electrostimulation and injection vehicle alone, rats receiving drug and sham stimulation or rats receiving vehicle and sham stimulation. PMID- 2716475 TI - Ethanol-induced hypothermia and hyperglycemia in genetically obese mice. AB - Blood glucose and rectal temperatures were monitored in two strains of genetically obese mice (C57 BL/6J ob/ob) prior to and following intragastric ethanol administration in an attempt to relate the hypothermic response to ethanol to extracellular glucose concentration. In contrast to expectation, ethanol administration was typically associated with a hyperglycemia and a hypothermic response. In the ob/ob genotype, the hypothermic response was associated with pronounced hyperglycemia which was more emphatic in older animals. The data support the conclusion that ethanol-induced hypothermia is independent of blood glucose levels. In light of the known sensitivity of ob/ob mice to insulin, it is suggested further that the observed hypothermic response was not a function of the animals' ability to transport glucose into peripheral cells. The observed hyperglycemia of the obese animals was most likely stress related. PMID- 2716476 TI - 5,6-Epoxyeicosatrienoic acid stimulates growth hormone release in rat anterior pituitary cells. AB - The effect of arachidonic acid and some of its metabolites have been examined in rat anterior pituitary cells for their ability to release growth hormone. The cytochrome P-450 metabolite, 5,6-epoxyeicosatrienoic acid is a much more effective growth-hormone releasing agent than 15-hydroxyeicosatetraenoic acid, 15 hydroxyeicosatetraenoic acid methyl ester, 5-hydroxyeicosatetraenoic acid or arachidonic acid. The release of growth hormone is rapid, dose-dependent and reaches an apparent saturation after eight minutes. These studies described herein provide evidence that lipoxygenase and cyclooxygenase products of arachidonic acid are less potent while cytochrome P-450 products are more potent in the release of growth hormone from anterior pituitary cells. PMID- 2716477 TI - Regulation of body temperature in postmenopausal women: interactions between bromocriptine and the endogenous opioid system. AB - The role exerted by the endogenous opioid system on thermoregulation has been studied in nine postmenopausal women before and after the chronic administration of the dopamine agonist bromocriptine (5 mg/day). These women randomly received an infusion of the opioid antagonist naloxone (1.6 mg/h for 4 h) or saline on two consecutive days, before and after 30 days of bromocriptine administration. Body temperature as evaluated by rectal temperature, did not vary during saline infusion performed both before and after 30 days of bromocriptine administration. In untreated women naloxone infusion significantly reduced body core temperature. The hypothermic response to naloxone was significantly greater following chronic bromocriptine administration. These results indicate that bromocriptine seems to increase the activity of the endogenous opioid system on the mechanisms which regulate body temperature in postmenopausal women. PMID- 2716479 TI - Implementation and evaluation of data compression of MR images. AB - A full-frame bit-allocation technique of data compression has been implemented using the existing computer facilities of an MR imager. Images reconstructed from compressed data files have been compared with the original image and changes in noise and pixel value measured to evaluate any image degradation introduced by the compression process. A 256 x 256 x 8 bit brain image can be compressed in 20 seconds with a compression ratio of greater than 4:1 without significant loss of information. PMID- 2716481 TI - Mechanical ventilation of the neonate during magnetic resonance imaging. AB - Minimum deadspace manifolds have shown promise as a means for assuring effective ventilation of the ventilator-dependent patient undergoing magnetic resonance (MR) imaging. The use of these manifolds in the neonatal patient requires some modification. Six neonatal patients were studied utilizing a modified neonatal ventilator tubing. The results of this study demonstrate no significant difference in pre-study and post-study parameters for heart rate, respiratory rate, transcutaneous oxygen and carbon dioxide levels, oxygen saturation and end tidal carbon dioxide levels, when utilizing the minimum deadspace manifold and single limb ventilator tubing. PMID- 2716478 TI - Pulse sequence optimization for T2-weighted MR imaging of the brain. AB - The authors implemented bipolar velocity compensated pulse techniques for T2 weighted MR imaging of the brain. Signal-to-noise (S/N) and image quality was compared for pulse sequences with standard and optimized RF pulses, low and regular bandwidth versions and cardiac triggering. Images from bipolar velocity compensated sequences allowed better visualization of vessels and basilar cisterns and improved image quality relative to standard sequences without velocity compensation. The implementation of optimized RF pulses with bipolar sequences resulted in further improvement in image quality. Single echo sequences consistently had improved image quality and signal-to-noise relative to the second echo of a double echo sequence. Low bandwidth bipolar sequences with extended sampling period had 30% higher S/N, but at the cost of slight loss in edge definition. The highest image quality was obtained with the bipolar, optimized RF, single echo sequence. Using this technique contiguous high quality image slices could be obtained with velocity compensation. The addition of cardiac triggering to bipolar sequences resulted in slight improvement in image quality, but this difference was marginal and probably rarely necessary for MR imaging of the brain. PMID- 2716480 TI - In vivo muscle magnetic resonance spectroscopy in a family with mitochondrial cytopathy: a defect in fat metabolism. AB - In vivo proton and phosphorus magnetic resonance spectroscopy (MRS) studies were performed at 1.5 T on two patients (siblings) diagnosed as having a mitochondrial cytopathy. The clinical diagnosis was based on a complete battery of biochemical tests, electron microscopy and modified Gomori trichrome stain studies of muscle. Proton spectra from the gastrocnemius muscle were recorded using the stimulated echo acquisition mode (STEAM) and the phosphorus spectra were obtained using the depth-resolved surface coil spectroscopy (DRESS) sequence. Proton resonances from neutral fats in the patients were found to be strikingly weak compared to normals. The ratios [PCr]/[ATP] and [PCr]/[Pi] and the pH values, as inferred from the phosphorus MRS, were found to be marginally decreased compared to normals. These studies indicate defective fatty acid metabolism in these two patients. It is, however, not known whether the abnormal mitochondrial ultrastructure represents a primary abnormality or secondary to defective fatty acid metabolism. PMID- 2716482 TI - MR imaging of acute cortical venous infarction: preliminary experience with an animal model. AB - Surgically ligated cortical veins in rabbits produced areas of hemorrhage and infarction. Pathological correlation with serial magnetic resonance (MR) imaging of these surgically created lesions was obtained. Imaging within 4 hours after ligation showed the site of venous infarction to be a focus of low signal intensity on T1-weighted images (T1WI) within a larger overlapping area of high intensity on T2-weighted images (T2WI). The serial imaging showed persistence of T1WI and T2WI changes without alteration of pattern. At 3-day follow-up, both the T1WI and T2WI changes were maximal. At 7- and 14-day follow-up, T1WI and T2WI changes showed regression. There was no identifiable site of paramagnetic influence within the lesions produced. This lack of local paramagnetic effect may be related to the acuteness and minute size of the lesions, partial volume effects, and/or atmospheric exposure of the lesion related to the surgical procedure. Our preliminary results are encouraging not only for trying to image cortical venous infarction but also in trying to define the sensitivity of MRI for small cortical lesions. PMID- 2716483 TI - Doubly tuned solenoidal resonators for small animal imaging and spectroscopy at 1.5 Tesla. AB - The design and construction of solenoidal resonators for use with small animals in a 1.5-Tesla clinical imaging system are described. The coils have been designed to exploit the B1 distributions of two resonant modes of a four-turn solenoid whose windings are in parallel. Both singly and doubly tuned versions have been constructed. 1H images of normal and pathologic anatomy in mice and rats as well as a 31P spectrum of a Walker 256 rat sarcoma are presented. A primary advantage of this design is that the coils are easy to build and implement while providing the necessary sensitivity to allow high quality images to be obtained with no changes to the hardware or software of the clinical unit. PMID- 2716484 TI - Gradient-echo imaging of hemorrhage at 1.5 Tesla. AB - We report in vitro and in vivo MR studies of hemorrhage using the gradient-echo pulse sequence, FISP (steady state free precession) and FLASH (spoiling of transverse magnetization) at 1.5 Tesla. Phantoms containing methemoglobin, ferromagnetic particles, human serum and blood clot were scanned using both spin echo and gradient-echo techniques. FLASH signal intensities were more sensitive to methemoglobin concentration than high T1-weighted spin-echo images. FISP showed little change in signal intensity with varying concentrations of methemoglobin and a contrast relationship similar to T2-weighted spin-echo techniques. FISP and FLASH showed intensity changes at lower concentrations of ferromagnetic material than T2-weighted spin-echo sequences. In vitro blood clot was less intense when observed by FISP and FLASH sequences than on the T2 weighted spin-echo sequences. Maximum contrast between clot and other blood components occurred at a flip angle of 45 degrees for FLASH and 60 degrees for FISP. FISP and FLASH scans of patients with hemorrhage demonstrated a marked decrease in signal intensity in the region of blood clot. This decrease was more pronounced with the gradient-echo sequences than with T2-weighted spin-echo images. We conclude that FLASH is useful for detecting methemoglobin and that both FISP and FLASH are useful for evaluating hemorrhage because of their sensitivity to methemoglobin. PMID- 2716485 TI - Degenerative cartilage lesions of the hip--magnetic resonance evaluation. AB - The capability of magnetic resonance imaging (MRI) to visualize early degenerative arthritis of the hip was investigated. The study was performed on 8 healthy students and 45 elderly volunteers. Images were obtained by using an electronically variable Helmholtz coil (switched-array coil, SAC). In order to diagnose degenerative lesions of the joint cartilage, FISP sequences with a flip angle of 70 degrees were found preferable to compared sequences. MRI-detectable signs of degenerative arthritis of the hip were narrowed joint space due to partially thinned cartilage layers, focal areas of either increased or decreased signal intensity in the hyaline cartilage, complete loss of cartilage, and signal variation in the bone marrow. MRI of the hip may be appropriate to detect early degenerative changes in the hips of young high-risk patients to facilitate therapy planning. PMID- 2716486 TI - Feasibility of fast MR imaging of the liver at 1.5 T. AB - A phantom with T1 and T2 relaxation times encompassing normal liver and liver lesions was constructed to evaluate fast magnetic resonance pulse sequences using TR from 21-100 milliseconds, TE 12-60 milliseconds and flip angles from 5 degrees 90 degrees. Ten of these fast MR sequences were then selected and compared with conventional spin-echo sequences in normal volunteers (n = 3) and in patients with liver lesions (n = 6). Subjectively, the fast MR sequences eliminated motion artefacts. Objectively, 8 of 10 fast sequences had signal-to-noise ratios comparable to spin-echo imaging whereas only 2 of 10 had contrast-to-noise ratios that were similar to spin-echo imaging. This preliminary study, performed at 1.5 Tesla, does not show any clear-cut advantage of fast imaging over spin-echo imaging in the detection of liver lesions. The use of a liver tissue equivalent phantom provides a rapid, practical approach in evaluation of fast scans. PMID- 2716487 TI - Magnetic resonance imaging of pediatric spinal dysraphism. AB - Thirty pediatric patients with spinal dysraphism were studied with magnetic resonance imaging. A variety of dysraphic anomalies were visualized, including syringohydromyelia, tethered cord, widened spinal canal, meningomyelocele, lipomyelomeningocele, lipomeningocele, intraspinal lipoma, congenital dermal sinus tract, and scoliosis. In 29 of 30 cases, MRI diagnostically visualized spinal cord and dysraphic anatomy. A combination of T1-weighted sagittal and axial imaging planes provided the most complete visualization. In specific cases, T2-weighted examinations were useful in demonstrating likely regions of inflammation bordering infected sinus tracts. MRI demonstrates a wide variety of dysraphic spinal anomalies and effectively screens children for occult spinal dysraphism. PMID- 2716488 TI - Ultra low field brain MRI in HIV transfusion infected patients. AB - In order to assess possible structural changes and possible alterations in T1 relaxation times in the brains in a group of female patients (67-74 years) infected with HIV following transfusion ultra low field (ULF) magnetic resonance imaging (MRI) was performed. The width of the ventricles, the width of the subarachnoid spaces, the degree of white matter lesions and T1 relaxation times in the frontal white matter, the basal ganglia and thalamus were studied. No temporal structural changes nor alterations in T1 relaxation times were found in the brains in this group of transfusion infected patients, who were followed regularly over a period of 12 months compared both to themselves and to age matched controls. PMID- 2716489 TI - In vivo measurements of T1 relaxation times of 31P-metabolites in human skeletal muscle. AB - The T1 relaxation times were estimated for 31P-metabolites in human skeletal muscle. Five healthy volunteers were examined in a 1.5 Tesla wholebody imaging system using an inversion recovery pulse sequence. The calculated T1 relaxation times ranged from 5.517 sec for phosphocreatine to 3.603 sec for -ATP. PMID- 2716490 TI - How to choose a hospital for diabetic care. PMID- 2716491 TI - The age of telecommunications. PMID- 2716493 TI - FAX technology, a useful medical tool. PMID- 2716492 TI - Why you should computerize your practice--and how. PMID- 2716494 TI - The last frontier: computerizing appointments. PMID- 2716495 TI - What else can computers do? PMID- 2716497 TI - Strain-specific differences in transcription of the gene for the epinephrine synthesizing enzyme phenylethanolamine N-methyltransferase. AB - Phenylethanolamine N-methyltransferase (PNMT), the enzyme which synthesizes the catecholamine epinephrine (adrenaline), may be regulated at many levels of expression. This study examines one level, the production of PNMT hnRNA, by measuring its rate of transcription in the rat adrenal gland and bovine adrenal medulla using an in vitro nuclear transcription run-on assay. Furthermore, when the transcriptional rate is compared in strains of rat known to possess distinctive levels of epinephrine and PNMT enzyme, the rate of PNMT transcription in Fischer rats is greater than in Buffalo or Sprague-Dawley rats: relative ratios are 0.54:1.00:1.6 for Buffalo:Sprague-Dawley:Fischer adrenal glands. As such, it appears that the rate of PNMT gene transcription is the major factor responsible for the strain-specific levels of PNMT mRNA among these rats. Therefore, in addition to regulation by neural and steroid influences, an intrinsic genetic component also governs the level of PNMT gene expression. PMID- 2716496 TI - Preproenkephalin DNA-binding proteins in the rat: 5' flanking region. AB - Various extracellular signals (i.e. transmitters, hormones, growth factors, etc.), together with their respective second-messenger pathways, regulate transmitter biosynthesis and neuronal function by altering gene expression. In this study we validated a protocol for isolating rat striatum and adrenal medullary nuclei for the purpose of extracting, identifying, and characterizing, nuclear regulatory factors which may serve a functional role in signal transduction processes. Through gel retardation studies using a 299 base pair (bp) XmnI-SacI 32P-labeled probe (derived from the 5' untranslated region of the rat preproenkephalin gene), we show that different patterns of retained bands result from nuclear extracts derived from rat adrenal medulla and striatum (as well as from other tissue). These tissue differences may have biological significance since rat adrenal medullae have low basal enkephalin levels while the striatum has high levels of this peptide and its respective mRNA. Additionally, certain retained bands were common to both cytosolic and nuclear compartments, suggesting binding factors may be located in either cell space. An initial biochemical characterization of these factors was also undertaken. Generally, salt levels of 100 mM or more reduced factor binding while 10-50 mM sodium ion levels showed preferentially enhanced bands. Binding activity appeared optimal at pH 6.8. As all retained bands were abrogated by proteinase K treatment, these factors appear to have a significant protein component. Finally, of particular interest is that this 299 bp region contains many sequences showing over 80% sequence identity with several previously characterized transcriptional control elements (i.e. cAMP and phorbol ester inducible enhancers, GCN4, AP1, Sp1, CCAAT binding factor, ATF, and AP2). If binding is confirmed (footprint analysis) and function validated (transfection studies), the evolutionary significance of the apparent presence of gene regulatory sequences and functional element divergence of the DNA region between different species can be evaluated. PMID- 2716499 TI - Testimony. Joint Committee on Health Care State House, Boston, February 27, 1989. S518--an act to amend the Massachusetts Nursing Practice Act. PMID- 2716498 TI - The in vitro processing of the NGF precursors by the gamma-subunit of the 7S NGF complex. AB - The in vitro translation of the capped nerve growth factor (NGF) mRNA in wheat germ extracts produced a major 34 kDa NGF precursor with translation starting at the first methionine residue and a minor 29 kDa precursor with translation starting probably at the second methionine. Digestion with the gamma-subunit generated the 22 and 18 kDa intermediates as well as a very small amount of NGF indicating that the gamma-subunit is able to carry out all the processing steps in NGF biosynthesis. The digestion also produced a large amount of a peptide from the N-terminus of the NGF precursors. The discrepancy between the yield of this peptide and of mature NGF emphasizes that inappropriate formation or the lack of formation of disulfide bridges in the NGF precursors, resulting in rapid proteolysis, probably accounts for the low yield of the NGF peptide chains. PMID- 2716500 TI - 36th annual meeting of the American College of Sports Medicine. Baltimore, May 31 June 3, 1989. Annual meeting abstracts. PMID- 2716501 TI - Multiple short-echo (2.5-ms) quantitation of in vivo sodium T2 relaxation. AB - The MR behavior of the sodium-23 nucleus in vivo is a complex problem which has generated considerable interest over the last 20 years. Early studies on excised tissue samples revealed that the sodium nucleus exhibited a two-component T2 relaxation. This biexponential T2 relaxation was characterized by a short component with a T2 = 0.7-4.8 ms, and a long component with a T2 = 7.0-26.0 ms. We have developed a 3D pulse sequence capable of performing multiple Hahn echo in vivo sodium-23 imaging at echo times as short as 2.5 ms. This sequence obtains the shorter spin echo times by presaturating the spins outside of the desired imaging region, allowing the use of nonselective rf pulses. Using this sequence we have been able to quantify the long and short T2 components of normal brain tissue, vitreous humor of the eye, and a rabbit VX-2 carcinoma. We found that gray matter and white matter of normal brain have a monoexponential T2 relaxation with T2 = 17.6 +/- 2.4 ms. The vitreous humor T2 relaxation is also monoexponential with T2 = 56.8 +/- 2.1 ms. However, we find that some of the rabbit VX2 carcinomas exhibit a biexponential T2 decay with a short component of 3.3 +/- 4.6 ms and a long component of 22.0 +/- 9.0 ms. PMID- 2716502 TI - Flow-induced phase effects and compensation technique for slice-selective pulses. AB - Flowing spins experience a time-varying frequency during the application of slice selective radiofrequency (RF) pulses. As a result the flowing spins accumulate phase relative to stationary spins as the spins are rotated toward the transverse plane. Using finite difference techniques to solve the Bloch equations for flowing spins, the phase of the transverse magnetization after a slice-selective pulse was evaluated for varying flow velocities and for tip angles which ranged between 0 degrees and 180 degrees. The following results were obtained for constant slice thickness: (1) For a fixed tip angle, the phase varies nonlinearly with velocity. (2) For a fixed velocity, the phase varies nonlinearly with tip angle. For small tip angles the nonlinearity in the variation as a function of velocity is very small but increases for tip angles greater than 90 degrees and becomes especially severe near 180 degrees. A method is proposed to desensitize the phase of flowing spins during the application of slice-selective pulses. The compensation scheme depends upon tip angle but is virtually independent of flow velocity. The technique was tested and verified with clinical images. PMID- 2716503 TI - A model of the temperature rise in the head due to magnetic resonance imaging procedures. AB - A simple model of power deposition in the head is presented in which the temperature increase in the head in general and, in particular, in a small spherical region of unperfused tissue contained within the head is calculated. The result of the calculation provides a limit on the SAR needed to ensure that a 1 degree C temperature rise is not exceeded for unperfused spheres of different sizes, imaging sessions of different lengths of time, and different blood flow rates to the head. The model assumes that the rest of the body during a head imaging session can act as a perfect heat sink at 37 degrees C. The model suggests that current practices in MRI imaging will not cause a temperature rise in the center of small unperfused regions such as the eye of more than 1 degree C. PMID- 2716504 TI - A quantitative study of relaxation rate enhancement produced by iron oxide particles in polyacrylamide gels and tissue. AB - The proton relaxation rate enhancements produced by two types of iron oxide particles, M4125 and AM125 (Advanced Magnetics, Cambridge, MA) designed as potential MR contrast agents, have been measured in polyacrylamide gels and in liver and spleen. The organ uptakes, time courses, and biodistributions of these materials have been measured using radiolabeling. The relaxation rate enhancements produced by these particles have been related to the concentration of iron per gram material at different magnetic field strengths. The relaxation rates increase linearly as a function of concentration at field strengths varying from 0.15 to 7 T. The relaxation effects of these particles in tissue are significantly different from the behavior in vitro. These results suggest that several different mechanisms contribute to relaxation effects in the presence of iron oxide particles and they depend strongly on the way the particles are sequestered. Diffusion effects for a specified TE may be enhanced using gradient or single-spin echoes rather than multiple echoes. AM125 is significantly more effective as a relaxation agent than paramagnetic metal ions only at relatively high fields, while M4125 is less effective per unit concentration. PMID- 2716505 TI - Projection flow imaging by bolus tracking using stimulated echoes. AB - Previous investigators have employed the concept of bolus tracking using either spin echoes or gradient echoes. In this paper we introduce two methods of bolus tracking using planar- and volume-selective stimulated echoes. The planar method employs a selective 90 degrees rf pulse which tags all spins in a particular plane. At a time tau 1 later, a nonselective 90 degrees rf pulse is employed, followed after a time tau 2, by another nonselective rf pulse. Only spins which experience all three rf pulses form a stimulated echo at time tau 1 after the third rf pulse. A balanced pair of flow-compensated dephasing (crusher) gradients further ensures that the stimulated echo is due only to the effect of all three rf pulses while minimizing flow dephasing. The first part of this gradient pair is applied after the initial rf pulse in the first tau 1 period to dephase the tagged spins. The second part of this gradient pair is applied after the third rf pulse to rephase the spins. Since the plane of the excited slice is orthogonal to the readout direction, flowing spins are imaged in an angiographic manner as they move away from the excited slice. A modification to this basic sequence excites only a small volume. In this manner, the suppression of stationary spins is effected by volume-selective excitation. In both the planar- and the volume selective techniques, the excited spins undergo T1 and T2 relaxation during the tau 1 period but only T1 relaxation in the tau 2 period. In blood, where T1 is much greater than T2, keeping tau 1 as short as possible minimizes signal loss due to T2 dephasing. These methods demonstrate increased sensitivity compared to similar bolus tracking methods using either spin echoes or gradient echoes. PMID- 2716506 TI - Determination of halothane distribution in the rat head using 19F NMR technique. AB - The distribution of halothane in the rat head was examined with 19F NMR rotating frame zuegmatography and 2DFT 19F NMR imaging. The rotating frame experiments were conducted at varying times following anesthesia to assess the time dependence of the halothane distribution. The results of these experiments demonstrate that halothane and halothane metabolite are unequally partitioned through the rat tissues examined. 19F spin-echo imaging experiments were conducted immediately following anesthesia. The results of these experiments are compared with those of the spectroscopic technique. PMID- 2716507 TI - Unified multiple-feature color display for MR images. AB - A display method is proposed in which the spin-lattice relaxation time T1, the spin-spin relaxation time T2, and the proton density rho of each pixel in a MR image are simultaneously expressed in color features in a unified way that allows international standardization. MR images were made from a phantom, a healthy volunteer, and patients in such a way that T1 and T2 and proton density images could be derived. T1 and T2 data were compared with accurate relaxation time measurements of the phantom content. Color images were computed from the acquired T1 and T2 images using matrix multiplication on a pixel base. In this way the color combination in each pixel represents the properties of that particular pixel by a unique mixing of the elementary colors red, green, and blue. Color resolution could be modified using different choices of the reference triangle in which the color combinations were defined. This method of representation offers a means for displaying multiple features as T1 and T2 in one directly interpretable image, independent of instrumental settings. PMID- 2716508 TI - Single-scan volume-selective spectral editing by homonuclear polarization transfer. AB - An RF and field gradient pulse sequence is presented permitting the single-scan volume-selective spectral editing of the signals of coupled spins. The attribute "single scan" means that the editing of resonance lines is performed in each accumulation or phase cycling scan rather than by subtraction of independently acquired signals. As an example the methyl line of lactate has been investigated. The method is considered to be a useful tool in biomedical research using lactate as an ischemic parameter. The basic principles applied are the VOSY pulse scheme for volume selection and the INEPT sequence for homonuclear polarization transfer from the CH to the CH3 groups. As an intrinsically single-scan editing method ("homonuclear single-scan VOSING procedure"), the pulse train is expected to provide results that are more reliable than the two-scan subtraction methods previously reported. PMID- 2716509 TI - Determination of triacylglycerol lipase activity using carbon-13-labeled triacylglycerols and nuclear magnetic resonance spectroscopy: evidence that hepatic lipase hydrolyzes medium-chain triacylglycerols. AB - Triacylglycerol lipase activity was studied using glycerol [1-13C]trioctanoate mixed with postheparin rat plasma. 13C NMR spectroscopy demonstrated triacylglycerol hydrolysis into free fatty acids with no difference at the 1,3 or 2 glycerol positions. There was no inhibition by high sodium concentration, consistent with lipase of hepatic origin. PMID- 2716510 TI - A fuse for magnetic resonance imaging probes. AB - In a research environment, a magnetic resonance imaging system's manufacturer supplied protection against excessive rf power deposition in the sample is often compromised. This paper presents a widely applicable scheme, based on a commonly available fuse, that simply and effectively limits the average rf power into a magnetic resonance imaging probe. PMID- 2716511 TI - 31P NMR Bayesian spectral analysis of rat brain in vivo. AB - Bayesian spectrum analysis for parameter estimation is a rigorous statistical (non-Fourier-based) method. Herein the Bayesian quadrature NMR model is introduced and applied to analysis of 31P NMR time domain data from in vivo rat brain. Immunity to both the brain spectrum "baseline hump" and the phase twist is demonstrated. PMID- 2716512 TI - Modulation of bovine neutrophil antibacterial activities by Pasteurella haemolytica A1 purified capsular polysaccharide. AB - Preincubation of bovine neutrophils with Pasteurella haemolytica A1 purified capsular polysaccharide markedly diminished their ability to ingest and kill P. haemolytica, but not Escherichia coli, in vitro. Ingestion and killing were impaired even when the P. haemolytica were preopsonized, thus suggesting that the inhibitory effects of the polysaccharide included a direct effect on bovine neutrophils rather than simply competition for serum opsonins. Preincubation of neutrophils with purified polysaccharide did not elicit a chemiluminescence response, nor did it alter the chemiluminescence response of neutrophils to subsequent stimulation with opsonized P. haemolytica or opsonized zymosan. In addition, purified polysaccharide alone was neither chemotactic nor did it induce a shape change in bovine neutrophils. These data suggest that the deposition of capsular polysaccharide in the lung during the onset of pulmonary pasteurellosis might impair the ability of neutrophils to ingest and kill P. haemolytica. The capsular polysaccharide of P. haemolytica, therefore, may contribute in part to the fibrinous pleuropneumonia that characterizes acute pasteurellosis. PMID- 2716513 TI - Invasion and lysis of HeLa cell monolayers by Salmonella typhi: the role of lipopolysaccharide. AB - Adhesion to and penetration of HeLa cell monolayers by Salmonella typhi Ty2 requires the presence of a complete lipopolysaccharide as demonstrated by the inability of polysaccharide-defective mutants to invade the monolayer. Lysis of HeLa cell monolayers by Salmonella typhi Ty2 is associated with intracellular bacterial multiplication and no detectable production of extracellular toxins. The ability of Salmonella typhi to invade and lyse monolayers could provide a novel system for the study of its ability to invade the bloodstream from the intestine. PMID- 2716514 TI - Bacteremia caused by non-sporulating anaerobes in cancer patients. A 12-year experience. AB - The clinical, epidemiological and laboratory characteristics of bacteremia caused by anaerobic organisms other than Clostridium spp. in cancer patients are described and compared to other previously reported series. Of the 315 episodes, 246 (78%) were caused by a single organism and 69 (22%) were polymicrobial. The most common underlying malignancies were genitourinary and gynecological tumors, acute leukemia, and gastrointestinal malignancies. Most patients (94%) were febrile, and septic shock was documented in 24% of monomicrobial episodes and in 58% of those with polymicrobial infection. Soft-tissue infection was present in 44% of the cases, and it presented as tissue necrosis in 11%. The most common sites identified as the portal of entry were intra-abdominal abscesses, soft tissue, and the oropharynx. The most common organisms were Bacteroides fragilis (57%) and other Bacteroides spp. (22%). Most polymicrobial infections were caused by 2 organisms, the second most commonly another anaerobe or an aerobic gram negative bacillus. The most active antibiotic in vitro was chloramphenicol. High rates of resistance to penicillin were observed not only among B. fragilis, but also among Bacteroides spp. The frequency of penicillin resistance increased throughout the study years. The overall survival was 70%. The cure rate for monomicrobial bacteremias was 76% vs. 51% for polymicrobial episodes. Infection was the cause of death in 20 and 16 episodes, respectively. The response rate for patients in septic shock was 47% in contrast to an 85% recovery rate for those without it. Ninety-five patients had documented abscesses accompanying the bacteremic episode. The most effective antibiotics were clindamycin and chloramphenicol. Overall response to penicillin was only 13%. Suboptimal responses were also observed for the antipseudomonal penicillins. High response rates (82%) were also obtained with cefoxitin, metronidazole, and moxalactam. PMID- 2716515 TI - Metabolic myopathies: evaluation by graded exercise testing. AB - Exertional muscle pain and fatigue are common complaints; some patients with these symptoms have a metabolic myopathy. We have performed graded exercise testing with analysis of expired ventilation on 13 individuals with various kinds of metabolic myopathies. Their results differed from normal and reflected the underlying biochemical abnormality. Patients with disorders of the mitochondrial electron transport chain demonstrated marked limitations in aerobic metabolism and a greatly reduced maximum oxygen consumption. During intense exertion, normal individuals increase carbon dioxide generation due to buffering of lactic acid. This did not occur in patients with McArdle disease, in whom the respiratory exchange ratio (carbon dioxide production/oxygen consumption) did not rise above 1.0 at maximum exercise. These results indicated a deficit in anaerobic metabolism. Pyruvate dehydrogenase complex allows pyruvate produced from carbohydrate metabolism to enter the citric acid cycle. Patients with this enzyme deficiency showed an initially normal pattern followed by an abrupt cessation in carbohydrate dependent aerobic metabolism at higher work loads. During high intensity exercise, progressive anaerobic metabolism was not accompanied by additional oxygen consumption. Finally, results from a patient with carnitine palmitoyl transferase deficiency revealed an early dependence on carbohydrate metabolism. The ventilatory threshold occurred at a low percentage of maximal oxygen consumption, reflecting the limited availability of lipid substrates for aerobic metabolism. Detection of some muscle metabolic abnormalities can be made on small biopsy specimens. However, definitive diagnosis of the defect nearly always requires studies on fresh or frozen muscle tissue obtained by an open biopsy. The decision on how the tissue should be processed and which metabolic studies should be performed frequently needs to be made before the biopsy is obtained. Thus, a noninvasive method to initially characterize patients with potential metabolic disorders is useful. Exercise testing with expired gas analysis can indicate the presence of a metabolic myopathy and results can then be used to direct the appropriate biochemical evaluations. PMID- 2716516 TI - Patterns of ribosomal RNA evolution in salamanders. AB - Sequence comparisons are presented for four segments of the large subunit of ribosomal RNA, including divergent domains D7a and D7b, portions of the large divergent domains D2, D3, and D8, and evolutionarily conservative sequences flanking divergent domains. These results resolve phylogenetic relationships among exemplars of seven families of salamanders and the three amphibian orders. Phylogenetic analysis confirms the prediction that divergent domains feature the highest relative rates of base substitution and length variation within the ribosome, but the divergent domains evolve more slowly than nuclear noncoding DNA and the silent sites of structural genes. Base substitutions demonstrate approximately twice as many transitions as transversions and an uneven distribution among sites within the divergent domains but no apparent bias in base composition. Length mutations are primarily small insertions and deletions, with deletions predominating. The divergent domains appear to be a good source of phylogenetic information for evolutionary events occurring approximately 100-200 million years ago. PMID- 2716517 TI - Structural and functional differentiation of two clinally distributed glucosephosphate isomerase allelic isozymes from the teleost Fundulus heteroclitus. AB - The teleost Fundulus heteroclitus (L.) possesses two loci, Gpi-A and Gpi-B, for the glycolytic enzyme, glucose-phosphate isomerase (GPI; D-glucose-6-phosphate ketol-isomerase; E.C. 5.3.1.9). The Gpi-B locus is polymorphic in Fundulus, with two common alleles, Gpi-Bb and Gpi-Bc, distributed in a clinal manner in populations along the east coast of North America. Since this clinal distribution is strongly correlated with a temperature gradient, we asked whether the GPI-B2 allozymes were functionally adapted to the thermal environment in which a given phenotype predominated. The two major GPI-B2 allozymes were purified to homogeneity and were characterized as to molecular weight, isoelectric pH, thermal denaturation, and kinetic parameters. Both GPI-Bb2 and GPI-Bc2 allozymes have molecular masses of 110 kD, and they have isoelectric pHs of 6.4 and 6.6, respectively. The GPI-Bb2 allozyme was more stable to thermal denaturation than was the GPI-Bc2 enzyme. Kinetic properties of the allelic isozymes were investigated both as a function of pH and as a function of temperature. At 25 degrees C, over the pH range considered, there were no significant differences between allozymes, either in Km for fructose-6-phosphate or in Ki for 6 phosphogluconate, but apparent Vmax values differed between pH 7.5 and pH 8.5. All steady-state kinetic parameters showed strong temperature dependence, but the allozymes differed only in the Ki for 6-phosphogluconate at temperatures greater than 30 degrees C. On the basis of the observed structural and functional differences alluded to above, the hypothesis that the major allelic isozymes of the Gpi-B locus were functionally equivalent was rejected. However, it is not yet known whether these structural and functional differences have any significance at higher levels of biological organization. PMID- 2716518 TI - The allelic isozymes of hexose-6-phosphate dehydrogenase isolated from Fundulus heteroclitus: physical characteristics and kinetic properties. AB - Hexose-6-phosphate dehydrogenase (H6PDH-A2; beta-D-glucose:NAD(P)+ oxido reductase; E.C. 1.1.1.47) of the teleost Fundulus heteroclitus (L.) shows clinal allelic variation along the east coast of North America. Three of the major allelic isozymes have been purified and compared for native molecular weight, subunit molecular weight, isoelectric point, thermal stability, and steady-state kinetic properties (pH 8.0 and 25 degrees C). Significant differences were found among the allelic isozymes for isoelectric point, thermal stability, and some kinetic parameters. The predominant allelic isozyme in northern populations (H6PDH-AcAc) was found to be more sensitive to heat denaturation than were the predominant homozygous allelic isozymes isolated from southern populations (H6PDH AaAa and H6PDH-AbAb). The H6PDH-AcAc allelic isozyme had both a significantly greater Km for glucose-6-phosphate than did either of the southern phenotypes and a significantly greater Km for NADP+ and Ki of NAD+ than did one of the southern phenotypes (H6PDH-AaAa). While the allelic isozymes are functionally nonequivalent, it is not yet known whether these differences are reflected at higher levels of biological organization. PMID- 2716519 TI - Tandem-repetitive noncoding DNA: forms and forces. AB - A model of sequence-dependent, unequal crossing-over and gene amplification (slippage replication) has been stimulated in order to account for various structural features of tandemly repeated DNA sequences. It is shown that DNA whose sequence is not maintained by natural selection will exhibit repetitive patterns over a wide range of recombination rates as a result of the interaction of unequal crossing-over and slippage replication, processes that depend on sequence similarity. At high crossing-over frequencies, the nucleotide patterns generated in the simulations are simple and highly regular, with short, nearly identical sequences repeated in tandem. Decreasing recombination rates increase the tendency to longer and more-complex repeat units. Periodicities have been observed down to very low recombination rates (one or more orders of magnitude lower than mutation rate). At such low rates, most of the sequences contain repeats which have an extensive substructure and a high degree of heterogeneity among each other; often higher-order structures are superimposed on a tandem array. These results are compared with various structural properties of tandemly repeated DNAs known from eukaryotes, the spectrum ranging from simple-sequence DNAs, particularly the hypervariable mini-satellites, to the classical satellite DNAs, located in chromosomal regions of low recombination, e.g., heterochromatin. PMID- 2716520 TI - Transcription of rhiA, a gene on a Rhizobium leguminosarum bv. viciae Sym plasmid, requires rhiR and is repressed by flavanoids that induce nod genes. AB - Strains of Rhizobium leguminosarum biovar viciae specifically make an abundant protein (Rhi) in free-living culture but not in bacteroids. Genes needed for Rhi synthesis are on a Sym plasmid and here we show that one of these genes, rhiA, is the structural gene that specifies this polypeptide. Transcription of rhiA requires a regulatory gene, rhiR, located close to rhiA and to nod genes involved in nodulation. Mutations in rhiA or rhiR do not appear to affect symbiotic nitrogen fixation. Transcription of rhiA is repressed in cells grown in the presence of the flavanone hesperetin or the flavone apigenin, both of which are potent inducers of transcription of nod genes. This was deduced from the use of rhiA-lacZ fusions; however, when the Rhi polypeptide was detected in SDS gels, there was no apparent difference in the intensity of its staining in extracts obtained from cells grown with or without these flavanoid nod gene inducer molecules. However, a mutation in a nodulation gene, nolR, also closely linked to the nod and rhi genes, caused a severe depression in the amount of Rhi (as seen on gels) that was made in cells grown in the presence of inducer flavanoids. PMID- 2716521 TI - Platelets: receptors, adhesion, secretion. Part A. PMID- 2716522 TI - Platelet interaction with artificial surfaces: in vitro evaluation. PMID- 2716523 TI - Isolation of human platelets by albumin gradient and gel filtration. PMID- 2716524 TI - Platelet aggregation measured by the photometric method. PMID- 2716525 TI - Platelet aggregation measured in vitro by microscopic and electronic particle counting. PMID- 2716526 TI - Measurement of secretion of adenine nucleotides. PMID- 2716527 TI - Isolation and characterization of porcine platelets. PMID- 2716528 TI - Secretion of thrombospondin from human blood platelets. PMID- 2716529 TI - Isolation of platelets from laboratory animals. PMID- 2716530 TI - Platelet alpha 2-antiplasmin. PMID- 2716531 TI - Isolation of human platelets from plasma by centrifugation and washing. PMID- 2716532 TI - Measurement of platelet cytoplasmic ionized calcium concentration with aequorin and fluorescent indicators. PMID- 2716533 TI - Measurement of platelet interaction with endothelial monolayers. PMID- 2716534 TI - Measurement of platelet and megakaryocyte interaction with the subendothelial extracellular matrix. PMID- 2716535 TI - Salmonella mbandaka isolated in Italy. 1979-1986. AB - A total of 350 strains of Salmonella mbandaka were isolated in Italy during the period 1979 to 1986. S. mbandaka was a rare serotype in Italy. It was first isolated from water in 1979. Since that year the number of isolates has increased: 1980 (3), 1981 (21), 1982 (21), 1983 (24), 1984 (54), 1985 (108), 1986 (118). 67.1% of the strains were isolated from humans, 14.6% from food, 15.1% from water and 2.9% from animals. Frozen eggs and egg-based products were the most frequently contaminated foods. Of the forty-six strains tested for drug resistance, two were multiresistant to gentamicin, nalidixic acid and nitrofurantoin and to chloramphenicol, kanamycin, tetracycline and tobramycin, respectively. PMID- 2716536 TI - The pattern of protein synthesis induced by heat-shock of the moderately halophilic bacterium Chromobacterium marismortui: protective effect of high salt concentration against the thermal shock. AB - The protein synthetic response to heat shock of the moderately halophilic bacterium Chromobacterium marismortui was examined. Upon exposure to elevated temperature there is an increased synthesis of a specific subset of proteins (heat shock proteins-hsps) in the molecular weight region of 15 to 90 kD, while normal protein synthesis is severely repressed. The synthesis of hsps reaches a maximum 5 min after heat shock at 42 degrees C. Cells recovered their normal protein synthesis patterns rapidly upon returning to their normal growth temperature following heat shock. When cells grown in 2.5M NaCl were challenged with heat shock at 42 degrees C, the synthesis of some normal proteins was permitted. Furthermore, growth in high salt concentration resulted in an extension of the upper temperature limits at which C. marismortui could synthesize hsps. Adaptation of C. marismortui to decreasing salinity stimulated the synthesis of new proteins distinct from the hsps. PMID- 2716537 TI - Antagonism and adhesion among isogenic strains of Lactobacillus reuteri in the caecum of gnotobiotic mice. AB - Interactions between a wild adhesive Lactobacillus reuteri strain isolated from chicken crop and its isogenic plasmid-free derivative were studied. Antagonism between these strains was tested in vitro or associated with gnotobiotic mice. The cured strains repressed the establishment of the wild, plasmid bearing strain in the gastrointestinal tract of gnotobiotic mice. Interactions between isogenic strains were independent of the amount of cells administered to mice. The cured derivative strain maintains its specific ability to adhere to epithelial cells of chicken crop. PMID- 2716538 TI - Detection of IgG anti-HIV antibodies in mice experimentally infected with HIV-1. AB - In the present work we report our preliminary data demonstrating the susceptibility of mouse to HIV infection. IgG antibodies were found in mice intraperitoneally inoculated with H9/HTLV-IIIB infected cells. Infected mice showed a humoral response and the antibodies detection includes specific immunoglobulin directed against the major gene product of HIV. Two weeks after infection with HIV infected cells we detected in mice IgG antibodies to p24, and the reactivity to gp41 was observed as early as reactivity to p24 and persisted throughout observation period. The persistence of specific antibody response to HIV after one year seems to demonstrate the possibility of the use of the mouse as animal model for HIV in vivo experiments. Studies concerning the degree and kinetic of HIV infection in mouse are in progress in our laboratory. PMID- 2716539 TI - Health care for the aging demands our attention. PMID- 2716540 TI - Midland County program provides alternative to mandatory assignment. PMID- 2716541 TI - Surviving the insurance crisis isn't enough. PMID- 2716542 TI - Providing better business for doctors. PMID- 2716543 TI - Health care for the aging needs to be approached cautiously. PMID- 2716544 TI - Electron microscopic observations on ciliated epithelium of tracheal organ cultures infected with Bordetella bronchiseptica. AB - Using mouse tracheal organ cultures, the pathogenic effect of Bordetella bronchiseptica to epithelial cells was studied by electron microscopy. The ultrastructure of epithelial cells in uninfected tracheal rings was preserved well for longer than 3 days. In mouse tracheal rings infected with graded doses (3 x 10(5) to 10(7) CFU/ml) of phase I B. bronchiseptica, the colonization in the interciliary spaces of ciliated epithelial cells was observed after a 20-hr infection period. The infected tracheal rings showed swelling of nonciliated cells as well as ciliated cells, rupture of cell membrane of cilia, swelling and disappearance of cilia, and atrophic cytomorphosis of epithelial cells. The severity of these changes occurred depending on the infection doses. These changes were essentially similar to those observed previously in the tracheal epithelia of the B. bronchiseptica-infected mice. The usefulness of this in vitro model was suggested for studying the pathogenesis of Bordetella infection. PMID- 2716545 TI - A non-radioactive DNA probe for the detection of Mycoplasma pulmonis in murine mycoplasmosis. AB - A non-radioactive DNA probe for the detection of Mycoplasma pulmonis was developed by using photobiotin. The probe detected 0.3 ng chromosomal DNA of M. pulmonis. No cross-hybridization was observed between the probe and the other murine mycoplasma species, M. arthritidis and M. neurolyticum. PMID- 2716546 TI - Single-serum diagnosis of recent rubella infection with the use of hemagglutination inhibition test and enzyme-linked immunosorbent assays. AB - Single-serum diagnosis of recent rubella infection was attempted with the use of hemagglutination inhibition (HI) test and two commercially available enzyme linked immunosorbent assays (ELISAs). The period during which IgM antibody was detectable by IgM capture ELISA was 4 to 30 days after the onset of rash. Rubella IgG ELISA values relative to HI titer were lower in the sera from the patients with recent infection than in the sera from the subjects with remote infection. IgM ELISA and the combined use of IgG ELISA and HI test are two useful methods of single-serum diagnosis of recent rubella infection. PMID- 2716547 TI - Electron microscopic study of a herpes-type virus isolated from an infant with exanthem subitum. AB - Human lymphocytes and MT4 cells infected with a virus isolated from a patient with exanthem subitum were examined by transmission and scanning electron microscopy. The most striking characteristic of the ultrastructure of this herpes type virus was that nucleocapsids located outside the nucleus were each coated distinctly with a tegument of moderate electron density. Tubular structures formed due to some mistakes in the viral assembly were also detected in the nucleus. Morphological differentiation of this virus from the other human herpesvirus was discussed. From these observations it was concluded that this virus has the same ultrastructural characteristics as HBLV (HHV-6). PMID- 2716548 TI - Location on the chromosome of the lac gene in a lactose-fermenting Salmonella litchfield strain. AB - We present conclusive evidence for the chromosomal location of the lac gene in a lactose-fermenting Salmonella litchfield strain (AO Lac+). Two Hfr strains constructed from AO Lac+ had abilities to transfer the lac gene to S. typhimurium LT2 at relatively high frequencies. Detailed characterization of the transconjugants suggested that the lac in AO Lac+ was located on the host chromosome between galE (18 min) and trpB (34 min). Transduction experiments using P22 phage showed that the lac was cotransduced with gal, but not with trpB. These results clearly indicate that the lac gene is located at a position near 18 min of the linkage map of Salmonella. PMID- 2716549 TI - The career aspirations of women doctors who qualified in 1974 and 1977 from a United Kingdom medical school. AB - The career aspirations of doctors who qualified from a UK medical school were examined in relation to firmness of career choice and marital and family circumstances 1 year and 7 years after qualification. Although there was greater certainty of career choice amongst all doctors, the women were consistently less likely to be certain than the men. The men were more likely than the women to be married (and more likely to have children). The main differences in patterns of career choice were the greater popularity of medicine and surgery among the men and of general practice and community medicine among the women. The most plausible explanation for these differences is the different marital and family pressures experienced by men and women. PMID- 2716550 TI - Short-listing of applicants from UCCA forms: the structure of pre-selection judgements. AB - Applicants for admission to St Mary's Hospital Medical School in 1986 were short listed for interview by one of four assessors, who each made their assessments on a nine-item pro forma. One short-lister had also been studied in detail during 1981. Short-listers used the full range of possible judgements, in approximately the proportions requested. Only minor differences were found between them in the mean and range of their judgements, suggesting that similarity of standards can be maintained while using a number of separate short-listers. A confirmatory factor analysis of individual short-listers' judgements showed that all were extracting three separate factors, named 'Academic ability', 'Interests' and 'Contribution to community', although the less experienced short-listers differentiated these items less well than the more experienced. The short-lister assessed in 1981 and 1986 had retained an almost identical factor structure over the 5-year period. PMID- 2716551 TI - Reliability of short-listing in medical student selection. AB - One in eight Universities Central Council on Admissions (UCCA) applications for admission to St Mary's Hospital Medical School in 1986 were in due course recirculated to the four short-listers, being seen again either by the same short lister or by another short-lister. Intrarater reliabilities were high, not only for measures of educational achievement, but also for the more subjective assessments. Interrater reliabilities were more variable, being very high for educational achievement, but rather lower for the more subjective items, and being lowest for the assessment of 'Interests', suggesting divergence between short-listers' perceptions of the terms. Nevertheless, all reliabilities were sufficiently high to justify the continued use of these criteria during selection. PMID- 2716552 TI - Sociology in the British medical curriculum: a survey. AB - A survey conducted among convenors of sociology courses in British medical schools showed a wide variation in course length, with two medical schools having no course, and two schools providing over 60 hours per year. A mean length of 32 hours was found, but there was considerable variation by region. London schools had a mean of 38.5 hours, compared with 40.5 hours in Scotland, and 22.3 hours in English provincial and Welsh schools. The latter group demonstrated a strong correlation between length of time the course had existed and the hours of tuition provided (r = 0.74, P = 0.007). No correlation was found at a significant level for London or Scottish courses. It is concluded that the London University edict making sociology compulsory in the medical curriculum has ensured a reasonable level of provision. Outside London, no such pressure has been available, and sociology has been squeezed as more subjects vie for curriculum time. Attitudes of non-sociology staff are reviewed and found to be predominantly negative. The recent report of the General Medical Council is noted, and it is suggested that the need for such a lobbyist outside London is necessary to ensure sociology attains a more secure and substantial place in the medical curriculum. PMID- 2716553 TI - Congruence between student and instructor perceptions of clinical teaching in paediatrics. AB - The purpose of this study was to examine the similarities and differences in what students and instructors perceive to be the importance, and instructor use of, representative effective clinical teaching skills noted in the literature. Teaching staff members (n = 74) and students (n = 96) in three successive quarters in a required clerkship in paediatrics completed parallel forms of a clinical teaching survey. Providing feedback and positive reinforcement, showing personal interest in students, communicating knowledge and learning objectives effectively, motivating students, exhibiting knowledge of current practice and physical diagnosis, and spending time reviewing histories and demonstrating and supervising physical examinations were all thought to be important by both students and teaching staff members. Both students and instructors, however, perceived history/physical examination skills to be somewhat less important than the other clinical teaching skills, although instructors believed this skill to be significantly more important than did students. In general there was a great deal of consistency and reliability among student and instructor perceptions of the importance of these representative effective clinical teaching skills. In contrast, teaching staff members consistently believed they used each skill significantly more than students judged they did. Not surprisingly, the more important that teaching staff members believed each skill to be, the more they reported using that skill in their own teaching. These findings suggest that it is important for clinical instructors to be vigilant in assessing the effectiveness of their teaching methods. PMID- 2716554 TI - Increasing empathy among medical students. AB - The objective of the research was to evaluate the short- and long-term effectiveness of teaching medical students interviewing skills. Methods of teaching communication skills included a workshop for clinical instructors, as an indirect approach, a workshop for medical students, as a direct approach, and a combination of both. Results demonstrated that in order to stimulate medical students to use supporting-interview skills, they themselves should participate in an interpersonal skills workshop. Being taught these skills by teachers who have participated in the workshop does not have the same positive effect. PMID- 2716555 TI - The development and evaluation of a method of teaching liaison psychiatry to medical students. AB - A method is described of teaching medical students aspects of psychiatry related to their work with physically ill patients. The teaching requires few resources and focuses on a limited number of educational objectives centred on the acquisition of knowledge of psychiatry relevant to medical practice. The course comprised eight weekly one-hour seminars held during the first clinical year attachment to medical firms, prior to the students' psychiatry attachments. Clinically based, traditional 'bedside' teaching was used, involving patients known to the students. In a preliminary analysis of the effects of the teaching, students who had participated in the seminars scored significantly better on a test of liaison psychiatry knowledge than a matched group who had not experienced the course. PMID- 2716556 TI - Problem-solving instruction during the clinical clerkship: description and preliminary evaluation of a programme. AB - A clerkship programme in general surgery is described whereby students acquire factual knowledge about disease entities through independent learning rather than through formal teaching. The objectives of the programme are to promote problem solving skills. It consists of clinical work (patient work-up, clinical rounds, participation in the activities in the operating room, out-patient clinic and emergency room) and of small-group tutorial sessions. The described programme has met with approval and satisfaction from both students and teachers. There were no significant differences in the average grades on the written and oral final examinations between the graduates of this clerkship programme and those of a traditional one. Independent learning and problem-solving instruction, which have been adopted by some medical schools in the preclinical phase of the curriculum, can be effectively implemented during the clinical phase as well. PMID- 2716557 TI - The effectiveness of immediate feedback during the objective structured clinical examination. AB - Using eight different physical examination or technical stations, 400 examinations were conducted to evaluate the effectiveness of immediate feedback during the Objective Structured Clinical Examination (OSCE). The test group comprised 50 medical students who underwent a standard 4-minute examination followed by 2 minutes of feedback. Immediately following feedback the students repeated an identical 4-minute examination scored by the same examiners. The control group consisted of 50 students from the same class who underwent an identical testing sequence, but instead of receiving feedback, they were instructed to continue their examinations for an additional 2 minutes before repeating the stations. Simple repetition of the task did not significantly improve score (mean increase 2.0%, NS). Extending the testing period from 4 to 6 minutes resulted in a small but significant increase in score (mean 6.7%, P less than 0.001). However, there was a much larger increase in the scores obtained following 2 minutes of immediate feedback compared to pre-feedback performance (mean 26.3%, P less than 0.0001). The majority of students and examiners felt that feedback, as administered in this study, was valuable both as a learning and teaching experience. Short periods of immediate feedback during an OSCE are practical and can improve competency in the performance of criterion-based tasks, at least over the short term. In addition, such feedback provides students with valuable self-assessment that may stimulate further learning. PMID- 2716558 TI - Education for practice: the role of practical experience in undergraduate and general clinical training. AB - A questionnaire and interview study in two London medical schools reviewed the undergraduate curricula and house year from the perspectives of graduates one year after qualification. Data from 113 house officers (44%), obtained by questionnaire and interview, showed general satisfaction with training. However, they also saw undergraduate preparation as deficient in exposure to some practical procedures and common conditions, and several difficult communication skills were not taught. Graduates reported that they would have liked more experience as undergraduates in resuscitation, lumbar puncture, inserting nasogastric tubes, endotracheal intubation, and in managing diabetic keto acidosis, asthmatic attacks, myocardial infarcts and respiratory failure. The purposes of the house year and the articulation between it and the undergraduate years require clarification. PMID- 2716559 TI - Gender as a factor in student learning: preliminary findings. PMID- 2716560 TI - The obstetrician's dilemma. PMID- 2716561 TI - Emergency medicine--no longer a casualty. PMID- 2716562 TI - Contraceptive efficacy of the pill. PMID- 2716563 TI - Inadvertent pregnancies in oral contraceptive users. AB - Two hundred and nine inadvertent pregnancies in oral contraceptive users were studied to determine the associated factors. The percentage of Pill types also were compared with the market usage over the same period. We found that the classically-suggested cofactors, such as missed pills, late pills, drug ingestion, and gastrointestinal upsets were reported commonly. The triphasic Pills also were represented more frequently than would have been expected from their share of the market. PMID- 2716564 TI - Cardiovascular disease-related knowledge and attitudes in a high-risk Australian population. AB - The population of Sydney's western suburbs has higher-than-average mortality rates of heart disease and has raised prevalence rates of the associated risk factors. To enquire into the cardiovascular disease-related knowledge, attitudes and behaviours of this population, a survey that used a multistage area probability sampling method was conducted in May 1987. A total of 484 subjects was interviewed. The self-reported prevalence rates of angina, heart attacks, strokes and diabetes all were high compared with the rates from the Australia wide National Heart Foundation's Risk Factor Prevalence Study in 1983. The rates of smoking, hypertension, high blood-lipid levels and sedentary life-style also were raised. Awareness of cardiovascular disease-related issues was high but detailed knowledge often was deficient. The majority of respondents reported having attempted to change their health-related behaviours. Of special note was the finding that 80% of current smokers had tried to quit smoking. The high level of awareness of the importance of making life-style changes, and the frequency with which attempts at behavioural changes were reported, suggest that improvements in the health of the population of Sydney's western suburbs will require two complementary strategies: the teaching of the skills that are needed to maintain healthy behaviours successfully and environmental changes to facilitate healthy life-style choices. PMID- 2716565 TI - The cost of intensive and special care of the newborn. AB - The cost of providing intensive (level-3) and special (level-2) care for newborn infants in a tertiary perinatal service was determined prospectively and was expressed in 1984 Australian dollars. Direct costs that were expressed per occupied bed-day were $690 for level-3, high-dependency care; $421 for level-3, low-dependency care; $544 for over-all level-3 care; $242 for level-2, high dependency care; $170 for level-2, low-dependency care; and $201 for over-all level-2 care. Each level of care generated additional costs of $42 per occupied bed-day. Taking these additional costs into account, the over-all occupied bed day cost of level-3 and level-2 neonatal care was $339. The major components of this over-all cost were: nursing staff members, 50%; medical staff members, 11%; consumable and recyclable items, 12%; and diagnostic services, 8%. PMID- 2716566 TI - Community-health needs assessment: use of the Nottingham health profile in an Australian study. AB - This article reports on the use of the Nottingham health profile (which was developed in the United Kingdom as a valid and reliable indicator of perceived health status) in a community-health survey in Noarlunga, an outer suburban area of Adelaide. The instrument appears valid for use with an Australian population. It was used in Noarlunga to demonstrate a correlation between health status and a range of social and economic variables. The uses of the Nottingham health profile in health-services planning are discussed. PMID- 2716567 TI - The boring story of Agent Orange and the Australian Royal Commission. PMID- 2716568 TI - Severe hypoglycaemia in the Wollongong area. PMID- 2716569 TI - Work-related injuries. PMID- 2716570 TI - Acute bronchiolitis in the Solomon Islands. PMID- 2716571 TI - Some answers to patients' questions about food. PMID- 2716572 TI - Allergy to the venom of jumper and bull ants. PMID- 2716573 TI - Schistosomiasis in Papua New Guinea? PMID- 2716574 TI - The rising epidemic of malignant mesothelioma. PMID- 2716575 TI - Vitamin E and human health: is our diet adequate? PMID- 2716576 TI - Fatal thermal injury. PMID- 2716577 TI - Teflon injection for ureteric reflux. PMID- 2716578 TI - Air shows and disaster planning--the Australian experience. PMID- 2716579 TI - Deaths as a result of work-related injury in Australia, 1982-1984. AB - A comprehensive study of deaths of work-related injuries which occurred throughout Australia in the years 1982-1984 was undertaken by means of coroners' records. Of 16,246 coroner-certified deaths that were attributed to trauma or to acute poisoning (excluding deaths of suicide or medical misadventure), the coroners' files were located for 15,462 (95.2%) deaths. From the files, a total of 1738 fatalities was judged to be work-related during the three-year period; of these, 1544 fatalities occurred in persons who were employed in the civilian labour force, which gave an average annual fatality incidence of 8.06 fatalities per 100,000 persons in the labour force. The death rate was much higher in men (12.05 fatalities per 100,000 men) than it was in women (1.34 fatalities per 100,000 women), increased with age, and was highest for the traditionally dangerous occupations (such as mining, transport and rural occupations). The distribution of work fatalities by the main cause of death, and the nature of the injury event is described. PMID- 2716580 TI - Sexual, reproductive and contraceptive risk factors for carcinoma-in-situ of the uterine cervix in Sydney. AB - Sexual, reproductive and contraceptive risk factors were investigated in a matched community-based case-control study of carcinoma-in-situ of the uterine cervix in Sydney. The risk was related strongly to the number of sexual partners: women who had had seven or more sexual partners in a lifetime had a six-fold increased risk compared with those with one or no partner. Early age at first sexual intercourse was also a risk factor, but this effect was reduced substantially after adjustment for the number of partners, with only a two-fold excess risk persisting for those with first intercourse before the age of 16 years as compared with those whose first sexual intercourse was at the age of 25 years or later. The long-term use of oral contraceptive agents was associated with an elevated risk (relative risk, 2.3 for more than six years of use); this effect was maintained for both oestrogen and progestogen doses. The risk increased with the number of induced abortions that had been undergone (relative risk, 2.2 for two or more abortions), but this effect was not statistically significant. A protective effect was found for women who had had a tubal ligation, for those who practised the rhythm method of birth control, and for women who breastfed. It is possible that these reduced risks may relate to unmeasured variables of life-style. PMID- 2716581 TI - Vitamin supplementation of patients receiving haemodialysis. AB - In order to assess the necessity of vitamin supplementation for patients who are receiving haemodialysis, measurements of vitamin status were made, and both dietary and supplementary intakes were assessed, in 26 patients who were undergoing haemodialysis. Blood samples were collected from these patients before they underwent haemodialysis, after an overnight fast, for the measurement of plasma retinol, alpha-tocopherol and ascorbate levels. Serum and erythrocyte folate levels were measured also. Thiamin status was assessed by the effect of added thiamin pyrophosphate on erythrocyte transketolase activity and pyridoxine status was assessed by the effect of added pyridoxal-5'-phosphate on erythrocyte aminotransferase activity. All patients had elevated plasma retinol levels; 48% of patients had elevated plasma alpha-tocopherol levels; the plasma ascorbate level was low in 50% of patients but was elevated in 25% of patients; and plasma and erythrocyte folate levels were elevated in 76% and 91% of patients, respectively. Thiamin status was normal in all but one patient and the pyridoxine level appeared to be low in two other patients. Many patients had low dietary intakes of vitamin C, folate and vitamin B6. We conclude that supplements of vitamins A and E are not required and, when dietary intakes of water-soluble vitamins are marginal, these should be supplemented at a dose as near as possible to the recommended dietary intake. PMID- 2716582 TI - Family-planning clinics and educational programmes--a rural experience. AB - Although family-planning clinics are numerous and well-accepted in most Australian capital cities, such clinics have been difficult to establish in some Victorian rural towns. One such clinic was established at a rural base hospital in a Victorian town in 1984. The history of the clinic's development and its mode of operation are discussed. The profiles of 157 consecutive new patients who attended the clinic are presented. Comparisons are made with the patient profiles from a Melbourne family-planning clinic. The clinic also provides a separate weekly educational programme. The effect of the educational service in attracting patients to the clinic also was evaluated. Over all, it was concluded that the successful establishment of this clinic has been a result of the appointment of female medical and nursing staff members, the support of the local base hospital, an active media campaign and the development of a separate and concurrent educational programme that was conducted by clinic staff members. It is recommended that these factors be considered in the future development of such clinics in rural areas. PMID- 2716583 TI - The gastrointestinal and hepatic manifestations of the acquired immunodeficiency syndrome. AB - Eighty-five patients with the acquired immunodeficiency syndrome (AIDS) were treated at Fairfield Infectious Diseases Hospital between April 1984 and June 1987. Sixty per cent of patients suffered gastrointestinal symptoms during the period of study, and in a further 15% of patients, abnormalities of the gastrointestinal tract were found incidentally. The principal manifestations were oropharyngeal ulceration, dysphagia/odynophagia, abdominal pain, diarrhoea, gastrointestinal bleeding, and perianal lesions. Opportunistic diseases involving all parts of the gastrointestinal system were encountered, the most prevalent being infections that were caused by Candida spp., cytomegalovirus, Mycobacterium avium-intracellulare and herpes simplex, and Kaposi's sarcoma. Abnormal liver function test-results were found in 41 patients; most commonly, these were attributable to minor drug reactions, and cytomegalovirus or Myco. avium intracellulare infection. Only one patient became jaundiced clinically. We conclude that involvement of the gastrointestinal tract is common in patients with AIDS, and that gastrointestinal lesions are an important cause of morbidity and mortality in these patients. PMID- 2716584 TI - Hyponatraemia in psychiatric patients. AB - Four cases of symptomatic hyponatraemia in psychiatric patients are described. All patients exhibited varying degrees of the compulsive intake of water. The initial urinary osmolalities in all cases suggested impaired clearance of free water. This may be related to an exacerbation of the psychotic state. All patients demonstrated a marked diuresis after treatment with a hypertonic (1.8%) saline solution. The underlying pathophysiology is discussed. This clinical syndrome may be associated with significant morbidity and occasional mortality that are related to the rapid development of hyponatraemia. PMID- 2716585 TI - A report of actinomycosis involving the lung and liver. AB - A case is presented of actinomycosis that involved the lung and the liver, which was diagnosed after a computed-tomographic-guided needle biopsy of a liver mass. The diagnosis was made on histological grounds that were based on the staining and morphological characteristics of Actinomyces spp. Imaging techniques suggested a communication between the lung and liver lesions. The regression of the disease was followed during 12 months of therapy. The patient remained free of disease for three months after the cessation of treatment. The relevant literature is reviewed. PMID- 2716587 TI - The politics of the sand-pit. PMID- 2716586 TI - Anorexia nervosa presenting in a prepubertal boy. AB - A case of anorexia nervosa that presented in a prepubertal boy is reported. It seemed that particular maternal attitudes towards dieting, paternal criticism of the boy's body shape and size, and severe family disruption were the major factors in the aetiology of this disorder. If such attitudes to food intake and body size and shape and major family disruptions become more prevalent in the community, then one might expect to see an increase in the prevalence of this serious disorder in younger children, which results in serious physical and psychological sequelae. PMID- 2716588 TI - Antibiotic-induced potentiation of oral anticoagulant agents. PMID- 2716589 TI - Early experience with the bird's nest inferior vena-caval filter. PMID- 2716590 TI - Autologous blood transfusion for ruptured ectopic pregnancy. PMID- 2716592 TI - Consumer Help against MalPractice. PMID- 2716591 TI - Malarial prophylaxis. PMID- 2716593 TI - Patients and clients. PMID- 2716594 TI - Accidental poisoning with agricultural chemicals. PMID- 2716595 TI - Atypical pneumonia. PMID- 2716596 TI - Consanguinity and birth defects. PMID- 2716597 TI - Preventing and dealing with scientific fraud in Australia. PMID- 2716598 TI - The dyspepsia stakes. PMID- 2716599 TI - Chlamydia trachomatis infections--the Royal Women's Hospital experience. AB - During the 18-month period from December 1, 1985 to May 31, 1987 Chlamydia trachomatis was the most-common sexually-transmitted agent to be identified at the Royal Women's Hospital, Melbourne. It was isolated from 4% of all specimens for which such culture was requested and was found five-times more frequently than was Neisseria gonorrhoeae. A review of the clinical presentation and the management of the 100 public patient for this period whose cervical specimens were found to give positive results for the presence of chlamydiae revealed that 77% of the women were less than 25 years of age, 78% of the women were single and 65% of the women were nulliparous. Thirty-five women were asymptomatic carriers of chlamydiae. Of the remaining 65 patients with symptoms, 46% experienced pelvic pain, 39% experienced a vaginal discharge and 26% experienced irregular bleeding. The importance of abnormal bleeding is emphasized. In patients who presented for therapeutic abortions, morbidity occurred in 19% of those who were carriers of Chl. trachomatis; accordingly, screening for chlamydiae as routine is recommended in such patients. Furthermore, because of the risk of pelvic inflammatory disease and its consequences, it is important not only to treat female patients in whom chlamydiae have been isolated, but also to treat and to follow-up their sexual partners simultaneously. PMID- 2716600 TI - Uvulopalatopharyngoplasty as a treatment for snoring. AB - Uvulopalatopharyngoplaty was performed in 18 consecutive patients (15 men and three women; mean +/- standard deviation [SD] age, 46.3 +/- 7.5 years) who presented for the treatment of heavy habitual snoring. No attempt was made to select patients who were ideal anatomically for palatal modification. The loudness of snoring was measured during sleep by integrating the output of a calibrated microphone. An assessment before operation showed that nine patients had obstructive sleep apnoea; four patients had an apnoea index of greater than or equal to 25 apnoeas per hour. The patients were overweight and consumed, on average, 38 g of alcohol per day, but these variables did not change after the operation. The postoperative assessment was performed 138 +/- 44 days after uvulopalatopharyngoplasty. Fourteen patients showed a reduction in the loudness of their snoring, although snoring was abolished in one patient only (average snoring loudness in arbitrary units/min of sleep, 2.8 +/- 2.1 before operation compared with 1.4 +/- 1.5 units/min of sleep after the operation; P less than 0.05. The loudest snore in arbitrary units measured 7.1 +/- 3.3 units compared with 4.8 +/- 3.3 units, respectively; P less than 0.05). The percentage of the sleep time that was spent at an arterial oxygen saturation of less than 90% was reduced after uvulopalatopharyngoplasty (28% +/- 32% of total sleep time compared with 17% +/- 24% of total sleep time, respectively; P less than 0.05). There was no change in the apnoea index. The diastolic blood pressure was lower at the postoperative assessment (94 +/- 11 mmHg compared with 87 +/- 8 mmHg; P less than 0.05); six of 10 subjects whose diastolic blood pressures were greater than or equal to 95 mmHg before the operation had a diastolic blood pressure of less than 95 mmHg after uvulopalatopharyngoplasty (P less than 0.02). Computed tomographic scans showed an increase in the upper airway cross-sectional area at 3 cm and 4 cm above the hyoid bone after uvulopalatopharyngoplasty (P less than 0.05). We conclude that uvulopalatopharyngoplasty is an effective treatment for habitual, heavy snoring in many patients, but it is not the treatment of choice for patients with clinically-significant obstructive sleep apnoea. PMID- 2716601 TI - Timing of surgery for cerebral aneurysms: a plea for early referral. AB - Two groups of patients with aneurysmal subarachnoid haemorrhages--111 patients who underwent surgery within three days of haemorrhage, and 203 patients who underwent operations four or more days after the haemorrhage--were compared. No significant differences were found in outcome between the two groups. This indicates that early operation, which has the advantage of minimizing the risk of recurrent haemorrhage, is safe. The importance of the early diagnosis of subarachnoid haemorrhage and of an urgent referral for neurosurgical management is stressed. PMID- 2716602 TI - A perplexing deterioration in neurological function. PMID- 2716603 TI - Gastroenteritis associated with Campylobacter cinaedi. AB - The atypical Campylobacter spp. are being associated increasingly with gastroenteritis in certain population groups. We report the clinical and laboratory features of four cases (in three homosexual men and one heterosexual man) of gastroenteritis that was associated with Campylobacter cinaedi. The infection that was caused by this organism clinically was indistinguishable from other mild gut infections and resolved spontaneously without treatment. Faecal microscopy was unhelpful in the diagnosis. Successful culture of C. cinaedi required incubation of the specimen at 37 degrees C under microaerophilic conditions on cephalothin-free media--a procedure that usually is not undertaken in culturing for the more-common faecal pathogens. C. cinaedi needs to be considered in the investigation of the cause of diarrhoea in population groups such as homosexual men. PMID- 2716604 TI - Fatal thermal injury. AB - Two fatal cases of thermal injury are described, one of which was the result of heat stroke and the other was the result of the uncommon condition, neuroleptic malignant syndrome. The clinical profiles, management and post-mortem findings of these two separate conditions are compared to highlight their important differences. PMID- 2716605 TI - Juxta-articular bone lesions in tertiary yaws. AB - A case of tertiary yaws in an immigrant from the Solomon Islands is presented. The report highlights the atypical features and diagnostic difficulties of late stage treponemal infection. PMID- 2716606 TI - The hazards of wool-presses. PMID- 2716607 TI - Techniques of lifting. PMID- 2716608 TI - Allergic reactions to blackwood (Acacia melanoxylon) PMID- 2716609 TI - The surgeon as a patient. PMID- 2716610 TI - Thiamin: to add or not to add? PMID- 2716611 TI - Do patients understand asthma? PMID- 2716612 TI - Helmets for motor-cyclists: are there any medical grounds for exemption? PMID- 2716613 TI - Health warnings on cigarette packets: are they getting through? PMID- 2716614 TI - Is it vaginal candidiasis? PMID- 2716615 TI - The threat of nuclear war. PMID- 2716616 TI - Clinical research after Auckland. PMID- 2716617 TI - Malignant mesothelioma--the rising epidemic. PMID- 2716618 TI - Myiasis in humans. PMID- 2716619 TI - Human cutaneous myiasis in Brisbane: a prospective study. AB - Although cases of human cutaneous myiasis do occur in Queensland, few have been reported in the medical literature. No prospective studies to record and to identify the Diptera that are responsible in a particular area seem to have been reported. Thus, a prospective study was undertaken in Brisbane hospitals between October 9, 1986 and March 15, 1988. Fourteen infestations were recorded and, in 12 cases, the larvae were bred through to adult flies. In 10 cases, Lucilia cuprina (Wiedemann) was identified and, in two cases, Parasarcophaga crassipalpis (Macquart) was identified. All cases, except one, occurred during warm weather. The patients mainly were old, ill and debilitated. Myiasis was present on admission to hospital in eight patients and occurred three days to two months after hospital admission in the other cases. It is believed that this is the first prospective study of human cutaneous myiasis to be published, with the largest series of Lucilia cuprina and the first study to incriminate Parasarcophaga crassipalpis in myiasis in humans. It also is the largest Australian series of human cutaneous myiasis, and the first to report Lucilia cuprina as an agent in human myiasis in Australia. PMID- 2716620 TI - The incidence of malignant mesothelioma in Australia, 1947-1980. AB - Details of patients with malignant mesothelioma that was diagnosed in Australia before 1981 were obtained by searching all possible sources throughout Australia as far into the past as possible and up to and including 1980. The earliest patient with mesothelioma who was identified was diagnosed in Victoria in 1947. By 1980, 535 (81%) men and 123 (19%) women had been diagnosed with the disease; only 14 persons were aged less than 35 years at the time of diagnosis (the youngest person was 15 years of age). The incidence rate in subjects who were 35 years or older at diagnosis was less than 1.0 cases per million person-years until 1964-1968, and then it rose progressively to 15.5 cases per million person years in 1979-1980. The highest rate (69.7 cases per million person-years) was observed in 65- to 74-year-old men in 1979-1980. The incidence rate in Western Australia was greater than were the rates in other states of Australia after the mid 1960s. Pleural mesotheliomas accounted for 88% of cases in which the site of the tumour was known; peritoneal mesotheliomas accounted for 10% of such cases and "other" sites for 2% of such cases. In 6% of cases the site was not specified. The exposure to asbestos was stated as "definite" in 59% of the cases with a recorded history of exposure: 8% of all the cases in the study had been exposed to crocidolite (blue asbestos) from Wittenoom Gorge in Western Australia. The age at diagnosis of patients with known exposure to asbestos was similar to that in those without known exposure. The increases in the incidence of malignant mesothelioma in Australia follow the published trends in the production and use of the amphibole varieties of asbestos in this country after a lag period of between 20 and 30 years. PMID- 2716621 TI - The use of State and hospital-based cancer-registry data to describe the epidemiological and clinical characteristics of laryngeal cancer in South Australia. AB - State and hospital-based cancer registries can be complementary sources for data that describe the general epidemiological and clinical features of cancers in specific populations. This has been illustrated with data on laryngeal cancer from registries in South Australia. The data were sufficiently detailed to indicate: trends in incidence by calendar year, age, sex, place of residence and country of birth; the distribution of cases by the subsite of the tumour, the histological type and grade, and the pretreatment clinical stage of the cancer at diagnosis; the complaints of patients at presentation; the modes of treatment by the stage of the cancer; and case-survival rates, both over all and as related to the subsite of the tumour, the sex and the stage of disease. Data also were available to indicate the increased risks of disease that were associated with tobacco smoking and alcohol consumption. The findings broadly are consistent with the results of previous epidemiological studies and show the utility of the combined use of state and hospital registry data to describe the general features of cancers in local populations. PMID- 2716623 TI - The restructuring of the Australian Medical Association. PMID- 2716622 TI - Admissions, patterns of utilization and disposition of cases of acute stroke in Brisbane hospitals. AB - In a population of slightly-more than one million persons, all cases of acute admission to hospital for cerebrovascular disease during 1984 were studied. Of the 2676 hospital admissions, 91% were of public-hospital patients. Of the 1908 patients who were aged more than 25 years and whose conditions were assigned the International classification of diseases' (ICD-9) codes (430-437) for cerebrovascular accidents, 1264 (1.8 patients per 1000 population of older than 25 years of age) cases were completed strokes, and 644 (1.0 patients per 1000 population of older than 25 years of age) cases were transient ischaemic attacks. There was no significant difference between the specific aetiological types of stroke that were diagnosed neuroradiologically and those that were diagnosed clinically. Among the cases of completed strokes, 54% of cases were thrombotic, 11% of cases were embolic, and 15% of cases were haemorrhagic, while nearly 20% of cases were unclassified. Twenty-one per cent of patients who were admitted to hospital with completed strokes died within two weeks of their admission, 28% of such patients were discharged home, 8% of such patients were transferred to full maintenance care, and the remaining 43% of such patients were transferred for inpatient rehabilitation. The median length of stay for patients with completed strokes was 11.8 days compared with 6.2 days for patients with transient ischaemic attacks. PMID- 2716624 TI - The implications for Australia of the New Zealand report of the cervical cancer inquiry: no cause for complacency. AB - The New Zealand Cervical Cancer Inquiry established that patients with carcinoma in-situ were left untreated in order to observe the natural history of their disease. Many patients developed invasive carcinoma unnecessarily and some died. The Inquiry found the research to have been unethical in that: the risk of progression to invasive carcinoma was known; the subjects had not consented to such study; and the study was designed and conducted poorly. The Inquiry was critical of the lack of proper review and the failure of responsible doctors and administrators to intervene in the interests of the patients. This article considers reasons for this failure and background issues of ethics and law. It is concluded that there is no cause for complacency in Australia in that provisions that are designed to protect patients may be ineffective. The NZ recommendations for changes in communication with patients, in the treatment of patients, in reviews of research, and in the training of doctors should be examined for their possible adoption in Australia. PMID- 2716625 TI - A comparative bronchodilator study of salbutamol and salbutamol sulphate that were administered by metered-dose inhalers. AB - Twenty-one patients with mild-to-moderately-severe asthma participated in a placebo-controlled, double-blind, cross-over, randomized bronchodilator study of 200 micrograms of salbutamol (Glaxo) and 200 micrograms of salbutamol in the form of salbutamol sulphate (Riker; 50-microL and 25-microL valves) that were administered by metered-dose inhalers. The mean baseline forced expired volumes in one second (FEV1) were similar for the four separate study days. The three active treatments caused a significantly-greater FEV1 response than did placebo for four hours (P less than 0.05) and no difference was found between the treatments (P greater than 0.05). The power of the study was 75% with a clinically-significant difference in the FEV1 response of 25%. The administration of 200 micrograms of salbutamol (Glaxo) caused the same FEV1 response as did that of 400 micrograms of salbutamol at the end of that study day (P greater than 0.05), but both 200-micrograms doses of salbutamol sulphate (Riker) caused a smaller FEV1 response than did the 400 micrograms of salbutamol sulphate (P less than 0.05). These observations indicate that no clinically-significant difference occurs between the bronchodilator effects of salbutamol and those of salbutamol sulphate which is administered as 200 micrograms of salbutamol equivalent, with different propellant mixtures, dispersal agents and valvular systems. PMID- 2716626 TI - Familial periodic ataxia. AB - A teen-age girl presented with recurrent stereotyped episodes of vertigo and ataxia and manifested constant horizontal gaze-evoked nystagmus. Cranial computed tomographic scans and metabolic biochemical screens gave normal results. The diagnosis of familial periodic ataxia was made from the family history and examination of the family members. Familial periodic ataxia is a rare disorder of cerebellar function which is inherited dominantly and has a benign prognosis. The underlying pathophysiology remains uncertain but a therapeutic response frequently is achieved with acetazolamide. PMID- 2716627 TI - Renal function in acute illness. PMID- 2716628 TI - Bicycle injuries in a rural community. PMID- 2716629 TI - Meningococcal disease and complement. PMID- 2716630 TI - Assessment of patients for nursing-home care. PMID- 2716631 TI - Regulation. PMID- 2716633 TI - Bee-sting anaphylaxis. PMID- 2716632 TI - Optic-nerve glioma and pregnancy. PMID- 2716634 TI - The availability of heroin. PMID- 2716635 TI - Retinopathy of prematurity: a second epidemic? PMID- 2716636 TI - Perinatal cocaine intoxication: a precaution. PMID- 2716637 TI - Renal aspects of lithium toxicity. PMID- 2716638 TI - Retinopathy of prematurity in infants of 24-30 weeks' gestational age. AB - Over the 10-year period from January 1, 1977 to December 31, 1986, 1114 infants with gestational ages of 24 to 30 completed weeks were cared for on a long-term basis in our nursery; 757 (68%) infants survived. As expected, both the mortality rate and the prevalence of stage-3 or stage-4 retinopathy of prematurity among survivors fell with increasing maturity at birth (P less than 0.0001). Adjusting for gestational age, and excluding infants with lethal malformations, the mortality rate decreased significantly (P = 0.018) over time by an estimated 11.5%; also the survival rate of infants with at least stage-3 retinopathy of prematurity increased significantly (P = 0.005) by an estimated 6.8%. In other words, for every 10 additional survivors over the decade, six survivors would have been expected to show at least stage-3 retinopathy of prematurity in either eye. Although the prevalence of advanced stages of retinopathy of prematurity increased in immature survivors, it was not in epidemic proportions; however, it was more likely to be related to the survival of the increasing numbers of at risk immature infants who, in earlier times, would have died. PMID- 2716639 TI - Retention of cardiopulmonary resuscitation knowledge and skills by 11- and 12 year-old children. AB - This article reports the results of a cardiopulmonary-resuscitation training programme by way of the retention of the knowledge and skills of cardiopulmonary resuscitation by 11- and 12-year-old children. The results indicate that cardiopulmonary resuscitation can be taught to some individuals at this age but that performance declines quite markedly over a period of five months after training. PMID- 2716640 TI - The growth of healthy Australian infants in relation to infant feeding and social group. AB - A joint survey of infant-feeding practices and infant growth was carried out in Western Australia and Tasmania in 1984-1985. Birthweights and growth from birth to one year of age were similar in both States and to the international growth references. Infants who were never breast-fed or who were breast-fed for only a short time gained significantly more weight over the year (most of it after the age of three months) than did infants who were breast-fed for six months or longer. Infants from families of a lower socioeconomic group gained more weight after six months of age than did those infants from higher socioeconomic families. Analysis showed that the growth differences between the social groups was a result of differences in feeding practices. Linear growth was similar among infants of all social groups, irrespective of the feeding method. PMID- 2716641 TI - A survey of deliberate self-poisoning. AB - Over a 12-month period in 1985-1986, 325 cases of deliberate self-poisoning were admitted to the Princess Alexandra Hospital in Brisbane. This survey confirms that deliberate self-poisoning remains common, accounting for 19.6% of all admissions to the intensive-care unit, and 5.4% of all medical-ward admissions. In 232 (71.4%) cases formal psychiatric consultation occurred, and some form of follow-up was organized in 227 (69.8%) cases. In the total group, the female-to male ratio was 1.5 to one. In the 325 cases, a total of 489 substances was consumed. Benzodiazepine agents were consumed the most often (39.5% of all substances), followed by antidepressant drugs (11.7% of substances) and paracetamol (7.2% of substances). Barbiturate drugs, which previously have been shown to be prominent in deliberate self-poisoning, accounted for only 1.6% of the substances that were used in this survey. Alcohol was consumed in almost one third (31.1%) of cases. The diagnosis of adjustment disorder with depressed mood was the most-frequent primary diagnosis (64.8% of diagnosed cases), followed by personality disorder (16.7% of diagnosed cases), schizophrenia (5.5% of diagnosed cases) and major depression (3.7% of diagnosed cases). Nearly one-half (46.8%) of all cases involved a past history of deliberate self-poisoning. Comparison of the results of this survey with those of past surveys shows that the profile of deliberate self-poisoning is changing. Barbiturate usage has declined markedly with a reciprocal increase in benzodiazepine usage. A review of the prescribing pattern of antidepressant agents in groups of individuals who are at high risk of deliberate self-poisoning is suggested in the light of the frequency of this phenomenon. PMID- 2716642 TI - ". . . and repose is taboo'd by anxiety". PMID- 2716643 TI - Participation of healthy volunteers in research projects. AB - Research that involves healthy normal volunteers frequently is performed. This article examines ethical guide-lines for the recruitment of healthy volunteers in research projects. Ethical decisions on projects that are based on patient volunteers or healthy normal volunteers should balance the risk to the volunteer and the collective benefit to the community. For healthy normal volunteers that risk should be minimal or trivial. Investigators should follow recruitment practices that avoid approaches to persons who are dependent upon them in some way, and should carry the day-to-day ethical responsibility even after institutional ethical approval has been granted. Pilot studies and self experimentation readily can transgress ethical guide-lines. Compensation for mishaps or injuries that occur during research in which there is no question of negligence (for example, an unforeseeable reaction in a phase-1 drug trial) is an unresolved issue which should be addressed by the research community. It is recommended that action be taken to ensure that healthy volunteers who participate in approved research have redress in the rare event of an accident, whether this is a result of negligence, chance or misadventure. Hospitals/institutions or other bodies that sponsor research should extend their insurance to cover specifically such unforeseeable events in which there may be liability, and to have the facility for a payment of beneficence in the case of accidents in which liability cannot be established. PMID- 2716644 TI - Adverse reactions to N-acetylcysteine during treatment for paracetamol poisoning. PMID- 2716645 TI - Perinatal cocaine intoxication. AB - This report describes a case in which cocaine abuse during pregnancy was related temporally to abruptio placentae, preterm labour and to rapid delivery. The neonate developed respiratory distress with features of persistent pulmonary hypertension of the newborn and also signs of neurological dysfunction. He was managed by supportive therapy and has been followed-up to nine months of age. Perinatal cocaine intoxication, either directly or indirectly, is discussed as a cause of his cardiorespiratory and neurological maladaptation. As cocaine abuse appears to be an escalating problem in Australia, increased public awareness of the dangers of both acute and long-term abuse of the drug is seen as a priority in preventive care. PMID- 2716646 TI - Zidovudine-related mania. AB - Two patients with the acquired immunodeficiency syndrome (AIDS), who had no past psychiatric history, developed a mania-like illness soon after commencing treatment with zidovudine. The neurotoxic effects of zidovudine have been described previously, but to our knowledge no reports of a psychiatric disorder that is related to the drug have appeared. Our report emphasizes the need to monitor patients with AIDS for neuropsychiatric problems. PMID- 2716647 TI - Blinking-blepharospasm after long-term neuroleptic treatment. AB - A patient is described who developed frequent blinking and blepharospasm after long-term treatment with trifluoperazine, whose condition improved dramatically after the cessation of the drug. The implications of this for our understanding of the manifestations and natural course of the late-onset side-effects of neuroleptic drugs are discussed. This case further supports the role of dopaminergic mechanisms in the aetiology of Meige's syndrome, which has blepharospasm and oromandibular dystonia as its main manifestations. PMID- 2716648 TI - Should all pregnant women be screened for hepatitis B surface antigen? PMID- 2716649 TI - Trends in risk factors for vascular disease. PMID- 2716650 TI - Serological survey of human T-cell leukaemia virus type I in homosexual men in Tahiti. PMID- 2716651 TI - Nosocomial prevalence survey. PMID- 2716652 TI - Curaderm. PMID- 2716653 TI - Chronic fatigue syndrome. PMID- 2716654 TI - Clomiphene citrate. PMID- 2716655 TI - Skin cancer and dietary polyunsaturated fats. PMID- 2716656 TI - The acquired immunodeficiency syndrome--what next? PMID- 2716658 TI - The health of Australian veterans. PMID- 2716657 TI - Relief of postoperative pain: advances awaiting application. PMID- 2716659 TI - Population-based epidemiology of human immunodeficiency virus infection in Western Australia. Western Australian AIDS Advisory Committee. AB - A total of 328 cases of infection with human immunodeficiency virus (HIV) in Western Australia in 1983-1987 was studied with respect to demographic factors, the risk profile, the clinical progression of disease, the utilization of inpatient services and trends in incidence over time. The crude incidence rates were 8.8 cases/100,000 person-years in men and 0.4 cases/100,000 person-years in women. Age-specific rates peaked at 25 to 29 years of age in men. The risk of HIV infection was associated with metropolitan residence, low socioeconomic level, and two specific occupational groups. Homosexual and bisexual men constituted 86% of all cases; the incidence rate of HIV infection in such men was approximately 1000-times higher than was the incidence rate by apparent sexual transmission in heterosexual persons. However, the proportion of cases that occurred in women or that apparently was caused by heterosexual sexual transmission increased from zero in 1983-1984 to 7.5% and 5.4%, respectively, in 1987. After two years of follow-up, 71% of preclinical (category-C) patients had developed signs, symptoms or evidence of immune dysfunction, and 12% of those patients with lymphadenopathy or with other early clinical features of disease (category-B) had progressed to the acquired immunodeficiency syndrome (AIDS). At 21 months of follow-up, the survival rate with AIDS was 9%. Patients with AIDS utilized an average of 68.9 short-stay hospital bed-days per person-year, while category-B patients used 11.5 hospital bed-days per person-year. Notifications of HIV infection increased each year from 1983 to 1986, but fell by 22% in 1987. The latter may have been as a result of chance, a screening artefact or a real reduction in the incidence rate. PMID- 2716660 TI - AIDS-related beliefs and behaviours of Australian university students. AB - Parallel questionnaires that enquired into the beliefs and behaviours which related to the acquired immunodeficiency syndrome (AIDS) were administered by postal survey during August and September 1987 to two separate samples of students. Each sample comprised 300 students who were selected at random, were aged up to 30 years, and at the time were enrolled at The University of Sydney; the response rate was 70%. Results showed a high level of "correctness" of belief about AIDS and safer sexual practices. More than half the population had experienced sexual intercourse during 1987, 25% of whom had experienced sexual intercourse on a casual basis. A marked discrepancy was found between the knowledge of and the performance of safer sexual behaviours, as measured by two sets of key questions, which covered condom use in casual vaginal encounters and enquiry into a casual partner's history with regard to sexual experience, abuse of intravenous drugs and history of blood transfusions. A log-linear regression analysis showed no correlation between scores on the two sets of key questions on knowledge of safer sexual practices and the demographic variables of age, sex, sexual experience or religious commitment. It is suggested that an educational campaign that is directed at the problem of behavioural change will fail to be productive if it is focused narrowly on the knowledge of safer sexual techniques; in addition, it should take into account other attitudinal components, such as the perception of social pressures from peer-groups. Within this particular student population, the most-effective immediate stratagem may be to restructure the perceived personal and peer-group risks. PMID- 2716661 TI - Efficient primary isolation of human immunodeficiency virus. AB - A highly-sensitive and efficient culture technique for human immunodeficiency virus type-1 (HIV-1) is described; HIV-1 was recovered from the lymphocytes of 44 (94%) antibody-seropositive healthy or symptomatic individuals. The reductions in the requirements for both the reagent volume and the number of patients' lymphocytes, together with an increased efficiency, has made this HIV-1 culture system more practical for diagnostic virology laboratories. PMID- 2716662 TI - Assessing agreement. AB - Formal evaluation of the ability of clinicians and researchers to agree, for example, on the clinical assessment of patients, increasingly is becoming important. Two measures of agreement, kappa and the intraclass correlation coefficient, are described and illustrated. The calculation of confidence intervals that correspond to these statistics by means of the "bootstrap" method also is discussed. PMID- 2716663 TI - Migratory polyarthralgia and haemoptysis. PMID- 2716664 TI - Public attitudes to smoke-free zones in restaurants. PMID- 2716665 TI - Intrauterine contraceptive devices and subfertility. PMID- 2716666 TI - Infant feeding--a clinical perspective. PMID- 2716667 TI - National campaign against drug abuse. PMID- 2716668 TI - Fractals and lightning injury. PMID- 2716669 TI - Lichen spinulosus after the ingestion of omeprazole. PMID- 2716670 TI - Drug advertising. PMID- 2716671 TI - Improving response rates with incentives. PMID- 2716672 TI - All that deposits eggs in tissues is not Schistosoma. PMID- 2716673 TI - Delayed response to chest pain. PMID- 2716674 TI - Are doctors doing enough to stop their patients smoking? PMID- 2716675 TI - Screening for cervical cancer--where are we going wrong? PMID- 2716676 TI - Migrants and medicine--many challenges. PMID- 2716677 TI - Cancer incidence among migrant populations in South Australia. AB - South Australian Cancer Registry data for 1977-1986 have been used to compare the incidence of cancer for overseas-born populations and for the State as a whole. British and Irish migrants were found to have a higher incidence of all cancer sites combined, largely because of elevations in the incidence of cancers of the lung, stomach and female breast, whereas southern-European migrants showed a lower incidence of cancer, mostly as a result of low incidence rates for cancers of the colon, prostate, lung (women only), melanoma and female breast. Differences in incidence also were evident by country of birth for cancers of the buccal cavity, oropharynx, nasopharynx, oesophagus, liver, larynx, pleura, testes, uterine body, bladder and kidney, and various lymphohaematopoietic cancers. The aetiological implications of these findings, particularly in relation to environmental and life-style factors, are considered. PMID- 2716679 TI - Older persons' definitions of good health: implications for general practitioners. AB - General practitioners are the major providers of health-care services for the older population in Australia. Care that is provided for older persons within the general-practice setting remains crisis-orientated. Nevertheless, many of the disabling health problems of older persons neither can be "solved" nor cured. Therefore, the older population is a unique population in which to study what constitutes good health and ways in which good health can be maintained. This article describes the perceptions of a group of older persons about their health. They define good health in a remarkably non-medical way. General practitioners need to take into account this knowledge when considering ways to improve the health of these patients. PMID- 2716678 TI - General practitioners' detection of patients' smoking status. AB - We examined the detection of smoking by 50 randomly-selected general practitioners. The practitioners said that they should detect smokers among their patients with a high degree of accuracy: a median of 100% of smokers under ideal conditions, and a median of 80% of smokers given the realities of practice. Practitioners actually identified 56.2% of their patients who were smokers--360 of 641 smokers among 2044 patients in the study. Some 65% of patients with a smoking-caused or smoking-exacerbated disease were detected, and this degree of detection was not related to age. For smokers of greater than 50 years of age and without any obvious smoking-related condition, the detection rates were similar to those of patients with smoking-related disease; however, in those patients who were less than 30 years of age, only 41% of smokers were detected--although the prevalence of smoking was higher in the younger than it was in the older patients. For all age-groups, the prevalence of smoking in men was about 15% higher than it was in women, but there was no significant difference between the detection rates in the sexes. In spite of their higher risks from smoking, the detection rates for pregnant women, or women who were taking oral contraceptive agents, were no higher than those for other women of less than 35 years of age. The doctors said that they had treated for smoking 78% of the detected smokers who had smoking-caused disease, compared with 35% of detected smokers with no smoking-related condition. They rated the value of such treatment higher in the former group than in those patients who had not yet developed smoking-related problems. Doctors appear to respond to the evidence of disease that is caused by smoking more than to the habit itself, which is a handicap in the prevention of smoking-related disease. PMID- 2716680 TI - The importance of the cell sample in cervical cytology: a controlled trial of a new sampling device. AB - The provision of a truly-representative cellular sample is the major prerequisite for reliable cervical cytology. We performed a trial with a cervical-sampling implement of innovative design, the Cervex Sampler. By means of the parameters of patient and doctor acceptability, the quality of the smear, the presence of endocervical cells, and the rate of squamous-cell atypia, the Cervex Sampler was compared with a modified Ayre spatula. One hundred samplers were distributed to each of 10 doctors. The parameters were assessed before, during and after the trial period. The consensus was that the Cervex Sampler was easier to use and did not cause patients any problems. Assessment of the smears that were made with the Cervex Sampler showed a significant improvement in the quantity and evenness of the distribution of the cellular sample. During the trial, statistically significant increases occurred in the percentage of smears that contained endocervical cells (P = 0.0001) and atypical squamous cells (P = 0.028). At the end of the trial, when the doctors again used the modified Ayre spatula, these rates reverted to the same levels as before. PMID- 2716681 TI - Is there a role for screening by cervicography in Australia? AB - A review of published studies that have evaluated cervicography as a screening test for the presence of cervical cancer is presented. Significant problems with the use of cervicography at a population level can be anticipated, in particular, a high proportion of women with uninterpretable test-results and an unacceptably low positive predictive value. Colposcopy was unable to distinguish adequately the true status of many women with suspicious cervicograms; half the women with a cervicogram that was suggestive of cancer and an abnormal result by colposcopy had normal or benign histological findings. The impact of cervicography on the morbidity and mortality of cervical cancer is unproved. On current evidence, cervicography would not appear to be suitable for use as a screening-test, either as a replacement for, or as a supplement to, the Papanicolaou smear-test. PMID- 2716682 TI - The use of non-prescription salbutamol inhalers by asthmatic patients in the Hunter Valley, New South Wales. Newcastle Retail Pharmacy Research Group. AB - Because of concern over the unsupervised use of bronchodilator aerosols, we studied the characteristics of a group of asthmatic subjects who purchased their salbutamol inhalers and a group of asthmatic subjects who obtained their inhalers by prescription. Community pharmacists distributed 360 questionnaires to consecutive patients who requested salbutamol inhalers; 320 questionnaires were returned (response rate, 89%). Of these, 240 respondents described themselves as asthmatic and stated that they obtained their inhalers exclusively or predominantly by either purchase (120 subjects) or prescription (120 subjects). Purchasers were younger than were users of prescribed inhalers and were more likely to be in current employment. The "purchase" group perceived less disability from chest disease than did the "prescription" group but were not different from the prescription group with respect to more-objective measures of disease severity, such as the occurrence of wheeze every day, nocturnal wakening with wheezing, and admissions to hospital with asthma. The purchasers had a low rate of consultation with family practitioners and specialists and reported a low use of prescription-only medications, particularly of inhaled corticosteroid agents. This study highlights the possible disadvantages of providing bronchodilator aerosols without prescription, and emphasizes an important counselling role for community pharmacists in the management of bronchial asthma. PMID- 2716683 TI - Hallucinations in children caused by oxolamine citrate. AB - Twenty reports in Australia, Belgium and The Netherlands have implicated oxolamine-citrate cough-mixtures as a cause of hallucinations in children of less than 10 years of age. Fever is not thought to be a likely alternative explanation. Similar reactions in older children and adults have not been reported and it is possible that the recommended doses for young children are too high. Information about the use of the drug in Australia suggests that such reactions are uncommon, but the information should be interpreted cautiously. PMID- 2716684 TI - The high price of "sleep": can Australia afford high-technology anaesthesia? PMID- 2716685 TI - Neuroleptic malignant syndrome and compulsive drinking of water. AB - In spite of multiple authoritative reviews in recent years on the subject of neuroleptic malignant syndrome, the association of neuroleptic malignant syndrome with excessive fluid consumption has received little attention. This association is described and comments are made as to its possible origins. Further investigations are required to determine the strength and nature of the association. Such findings may have implications not only for clinical management but also for the poorly-understood neurochemistry of the neuroleptic malignant syndrome. PMID- 2716686 TI - Non-traumatic cerebrospinal-fluid rhinorrhoea in cases of primary empty-sella syndrome. AB - Non-traumatic cerebrospinal-fluid rhinorrhoea is a rare condition. Its insidious onset may occur with a sneezing or coughing episode which may lead to an incorrect diagnosis of allergic rhinitis or vasomotor rhinorrhoea. Two cases that occurred in association with primary empty-sella syndrome are described--in the second case, the fistula arose from the pituitary fossa. The history, incidence, clinical profile, investigation and management of this condition are reviewed. PMID- 2716687 TI - Just in time with feeling. PMID- 2716688 TI - Publication pressures and disreputable behaviour. PMID- 2716689 TI - The proposal to make heroin available legally to intravenous drug abusers. PMID- 2716690 TI - Midazolam: an effective antiemetic agent for cytotoxic chemotherapy. PMID- 2716691 TI - Screening for congenital dislocation of the hip in Western Australia. PMID- 2716692 TI - Who should help to encourage healthy life-styles among schoolchildren? PMID- 2716693 TI - Tuberculous mastoiditis and laryngitis. PMID- 2716694 TI - Some Jewish teaching on doctor/patient relationships. PMID- 2716695 TI - A conference on no fault compensation. PMID- 2716696 TI - Euthanasia in The Netherlands. PMID- 2716697 TI - Disasters and mysteries at Heathrow. PMID- 2716698 TI - The contributions of medical physicists to radiation phobia. PMID- 2716699 TI - Contrast enhancement of noisy images by windowing: limitations due to the finite dynamic range of the display system. AB - A theoretical model has been developed to explain the effects of simple linear windowing on the apparent contrasts of signals in displayed digital images. The model predicts, and experimental results demonstrate, that the effective displayed contrast of a digital radiographic signal depends in a complex way upon interactions among the endpoints of the display scale, the signal contrast and noise level of the original data, the window center and display center selected, and the contrast enhancement factor applied. The results obtained from this work apply quantitatively to the highly idealized situation in which (i) a uniform signal is superimposed on a uniform background containing Gaussian pixel-value noise, and (ii) a linear (or exponential) relationship exists between the optical density of a film display (or the light intensity of a luminous display) and pixel value in some finite range. However, the qualitative effects demonstrated here may be expected to arise in a broad variety of situations involving strong digital contrast enhancement. PMID- 2716700 TI - Absolute diameter measurements of coronary arteries based on the first zero crossing of the Fourier spectrum. AB - Current edge detection methods used to determine coronary artery dimensions from digital (DSA) images suffer a strong dependence on the system's modulation transfer function (MTF). The videodensitometric algorithms are less sensitive to MTF blurring, yet still result in an overestimation of the vessel size of 10% to 25% for blurring aperture sizes of 50% to 80% of the vessel diameter. We propose a new algorithm to measure the absolute diameter of a vessel which has a lower sensitivity to the system MTF for blurring aperture sizes up to 80% of the vessel diameter. A consequence of the similarity theorem of Fourier transform pairs is that the "width" of the Fourier transform, as characterized by the first zero crossing in frequency space, is inversely proportional to the width of the vessel profile. For an ideal (unblurred) vessel image, the width of the vessel profile is equal to the diameter of the vessel. For a blurred image this is not true. In frequency space, however, the transform of the blurred profile is simply the product of the transformed ideal profile and the system MTF. Thus, if the blurring aperture of the system is below some critical value, the first zero of the unblurred profile will still dominate the transform of the blurred profile. For vessels of circular cross section and a rectangular blurring aperture, this critical aperture size is approximately 80% of the vessel diameter. A more detailed explanation of the theory and calculations involved in this measurement, along with measurements of computer simulated and phantom vessels is presented. PMID- 2716701 TI - Hybrid reconstruction algorithm for x-ray computed tomography. AB - A hybrid reconstruction algorithm (HRA) is derived for fan beam geometry for use with systems utilizing a linear array of detectors. The algorithm uses fan beam geometry with a modified parallel beam reconstruction formula. The parallel beam algorithm is used with fan beam geometry by a simple geometric conversion and a different back projection formula. Correction for center of rotation shift is done during the back projection. Computer simulations are shown, both with the center of rotation shift uncorrected and corrected. PMID- 2716702 TI - Effect of intervertebral changes of the spinal trabecular and cortical mineral content on the precision requirements in longitudinal single and dual energy computed tomography examinations. AB - Statistical considerations related to the measuring and analyzing procedures in computed tomography (CT) scans indicate that determination of a 2.5% change in spinal mineral content (SMC) which is assumed necessary in clinical practice, requires a 0.9% combined precision in setting the location and direction of the scan plane through the vertebral body, and defining the region of interest. In single energy examinations the short-term precision of CT scanners was found to be sufficiently high to achieve this goal, but the variability due to subjective finding of scan direction requires the automation of slice selection and additional averaging of data from more than one scan slice. The precision of calcium images was much lower, and one conclusion of this study is that dual energy technology is not suitable for longitudinal examinations, where small changes in SMC have to be determined. The SMC of the vertebrae T12, L1, L2, and L3 as measured in 41 subjects was compared and a significant decrease in trabecular bone in single energy examinations and increase in cortical bone was found from T12 to L3. This suggests that the comparison of SMC data should be done over time for each vertebra separately, in order to preserve diagnostic information. PMID- 2716703 TI - Accuracy and reproducibility of image derived relaxation times on a clinical 1.5 T magnetic resonance scanner. AB - A methodology for evaluating the accuracy and reproducibility of calculated T1's and T2's has been developed and applied to a General Electric 1.5 T Signa System. Specifically studied were absolute accuracy and temporal stability of image derived T1's and T2's as well as the dependence of calculated relaxation times on position in the scan plane, position along the axis of the magnet bore, the scan plane orientation (axial, sagittal, coronal), and the center frequency. The results of this study of the accuracy and reproducibility of image relaxation times have direct bearing on the design of clinical investigations assessing the diagnostic usefulness of these values. PMID- 2716704 TI - Analysis of capacitive coupling and associated loss for a solenoidal magnetic resonance imaging radio-frequency coil. AB - Presented is an analysis of the capacitive coupling between a magnetic resonance imaging radio-frequency (rf) coil and a dielectric sample. Calculated is the coil self-capacitance and power loss in the medium. The capacitively coupled power loss is compared with the more familiar inductively coupled eddy current loss and the predicted dependence of self-capacitance on coil and sample size is studied experimentally in a series of single-turn slotted solenoids of various sizes. PMID- 2716705 TI - Radial dose distribution of 192Ir and 137Cs seed sources. AB - The radial dose distributions in water around 192Ir seed sources with both platinum and stainless steel encapsulation have been measured using LiF thermoluminescent dosimeters (TLD) for distances of 1 to 12 cm along the perpendicular bisector of the source to determine the effect of source encapsulation. Similar measurements also have been made around a 137Cs seed source of comparable dimensions. The data were fit to a third order polynomial to obtain an empirical equation for the radial dose factor which then can be used in dosimetry. The coefficients of this equation for each of the three sources are given. The radial dose factor of the stainless steel encapsulated 192Ir and that of the platinum encapsulated 192Ir agree to within 2%. The radial dose distributions measured here for 192Ir with either type of encapsulation and for 137Cs are indistinguishable from those of other authors when considering uncertainties involved. For clinical dosimetry based on isotropic point or line source models, any of these equations may be used without significantly affecting accuracy. PMID- 2716706 TI - Application of the dyadic Green's function method to calculate the heat generated by a direct contact applicator. AB - A rigorous formalism using the dyadic Green's function to determine the relative heating pattern in a two-layer fat-muscle medium of a dipole-corner reflector applicator in direct contact with the finite fat layer is described. The results are compared with the earlier approximate calculations of Guy and Lehmann. Though the two theories give identical results for the relative heat produced in the muscle layer, the relative heating patterns predicted by the present theory in the fat layer are different. PMID- 2716707 TI - Film-screen mammography x-ray tube anodes: molybdenum versus tungsten. AB - Gridless screen-film mammography at 23 kVp with a W anode (inherent filtration: 0.1 mm A1, added filtration: 0.025 mm Mo) can achieve contrast identical to that achieved with gridless film-screen mammography at 27 kVp with a Mo anode (inherent filtration: 1.0 mm Be, added filtration: 0.025-mm Mo). However, W-anode film-screen mammograms obtained at 23 kVp require more radiation than Mo-anode film-screen mammograms obtained at 27 kVp. The lack of contrast of W-anode film screen images produced at the same kVp as Mo-anode images was verified clinically and with a low contrast test object imaged over a range of densities. A step wedge test object was then used to match contrast between Mo- and W-anode gridless film-screen images at various kVp. The low contrast test object images verified the contrast equivalence of images obtained at 23 kVp for a W anode and 27 kVp for a Mo anode. A comparison of the two kVp for different anode materials was tested clinically on ten patients. The clinical and low contrast test object experiments were reviewed by three radiologists specializing in mammography. PMID- 2716708 TI - Correction of phase wrapping in magnetic resonance imaging. AB - In phase reconstruction MR imaging, e.g., for velocity measurement, phase shifts beyond +/- pi radians will "wrap around" to smaller apparent phases. Such large phase shifts could arise either due to large background (non-flow-related) phase variations or due to large velocity-induced phase shifts. For sufficiently smooth phase variation, such discontinuities can be automatically recognized and corrected, thus restoring the correct phase values and extending the effective dynamic range of such phase imaging techniques. PMID- 2716709 TI - 137Cs dosimetry table for asymmetric source. AB - A common 137Cs brachytherapy source has a 2-cm physical length and 1.38-cm active length. The active length is not symmetric with respect to the source center because one source end contains an eyelet. Current dose rate tables assume a symmetric source loading with respect to the source center. A computer program was written to calculate an asymmetric distribution using the manufacturers' source specifications. Corrections were made for attenuation and obliquity through the source materials. Dose rate values in cGy/h for a 137Cs source equivalent to 1 mg of 226Ra are shown as a function of the radius from the source center and angle from the source end containing the eyelet. Dose rate values in the table were confirmed by ferrous sulfate measurements using small volumes. The table values agree with published values at points more distant than a few cm and lying at an angle such that the asymmetry of the source loading has its minimum influence. PMID- 2716710 TI - [Long-term study of endocrine ophthalmopathy and retrospective assessment of therapeutic measures]. AB - The follow-up of Graves' ophthalmopathy was analysed regarding to clinical and chemical data on the one hand and to dependence on different therapeutic alternatives on the other. 297 patients (44 +/- 14 years, 249 female, 48 men) were observed with inclusion of data from the history and clinical data as well (computer tomography and orbital sonography). At the onset of therapy 253 patients were hyperthyroid, 36 euthyroid and eight showed hypothyroidism. The staging was: I 13, II 54, III 113, IV 95, V five, VI eight patients. The HLA typing in 89 patients showed the following results: B8 in 32%, DR3 in 42%, B8 as well as DR3 in 24% of the patients. In about 50% of the cases there were raised microsomal and in about 18% there were raised thyroglobuline antibodies. 63% of the patients received immunosuppressive medication: corticosteroids in 100% (more than one time in 43%), cyclosporine A in 11%, ciamexone in 10%, other non-steroid immunosuppressants in 5% of the cases. The retrobulbar irradiation was performed in 9%, and total thyroidectomy in 7%. During therapy the inflammatory process was clearly ameliorated, however exophthalmos and diplopia were more resistant to treatment. In the group of patients with combined cyclosporine and prednisone therapy and in the group of patients with total thyroidectomy and partly retrobulbar radiotherapy, significant differences were observed regarding to visual acuity and Hertel values. None of the therapies applied constitutes an optimal treatment with the regard to the long-term course. Under therapy an improvement can be reached, but no complete healing. PMID- 2716712 TI - [Surgery of asymptomatic carotid artery stenoses?]. PMID- 2716711 TI - [The effect of a calcium carbonate-bismuth subsalicylate combination on intragastric acidity over the course of 24 hours. A randomized study of healthy probands]. AB - Bismuth salts are successfully used for the treatment of campylobacter-pylori associated gastritis. It cannot be excluded, however, that calcium carbonate, which is present in one of the recommended preparations (calcium carbonate/bismuth subsalicylate, Jatrox), may have an additional therapeutic effect due to an increase of intragastric pH. Therefore, the in-vitro H+ buffering capacity of Jatrox was determined in comparison to other antacids using the pH-stat technique, and its effect on intragastric acidity was tested in 15 healthy volunteers using ambulatory 24-hour pH-metry (combined glass electrode in gastric corpus, solid state memory recorder, sampling rate 30/min). At two study sessions, the volunteers received standardized normal meals (8:00 a.m., 12:00 noon, 6:00 p.m.) and, in randomized order, either Jatrox (three times 2 tablets one hour before meals) or no medication. Under in-vitro conditions, the buffering capacity of Jatrox amounts to 7.82 mmol H+ per tablet (equivalent to 47 mmol H+/24 h at recommended dosage), which is relatively low. Under in-vivo conditions, gastric pH only increases significantly during the first hour after medication. This short-lasting effect, however, has no influence on the 24-hour median pH. It is concluded from these results that the calcium carbonate contained in Jatrox probably does not contribute directly towards its therapeutic effect in promoting the healing of gastritis. PMID- 2716713 TI - [Medicine must become more than a natural science]. PMID- 2716714 TI - [The initial acute renal failure and late manifestation of extrarenal symptoms in Wegener's disease]. PMID- 2716715 TI - The future of rural hospitals. PMID- 2716716 TI - Job and life satisfaction among rural physicians. Results of a survey. AB - Results of a survey of approximately half of Minnesota's rural physicians show that these physicians appear to be well-satisfied with their jobs (average rating of 2.5 on a five-point scale with 2 = very satisfied and 3 = moderately satisfied). In aggregate, areas of greatest job satisfaction are the diversity of patients physicians see, physicians' contact with others, and their ability to derive personal gratification from patient care. Salary/income was not a source of dissatisfaction. Areas of least satisfaction are physicians' opportunities for promotion, their ability to remain knowledgeable, and their role in making organizational and administrative decisions. Rural Minnesota physicians feel least work stress about their feelings of clinical competence/interpersonal relations at work and anxieties about the future. Areas of greatest stress focus on time pressures and realities of medical practice, i.e., being reimbursed by third-party payers and meeting the need for certainty when medical knowledge only allows for approximation. These physicians are reasonably happy with their lives in general (5.4 on a seven-point scale with 7 = delighted, 1 = terrible). In aggregate, areas of lowest life satisfaction are physicians' social relations, leisure activities, and finances. Examination of subgroups shows that women are statistically less satisfied with their living situations; younger physicians are less satisfied with their work, their living situations, and their leisure activities; physicians who spend more than 10 hours per week on administrative duties are less satisfied with their living and social situations; and physicians who see more than 100 patients per week are less satisfied with their social relations. PMID- 2716717 TI - Community health centers and the rural economy. The struggle for survival. Joint Rural Task force of the National Association of Community Health Centers and the National Rural Health Association. PMID- 2716718 TI - New clinical laboratory standards. PMID- 2716719 TI - AIDS guidelines for emergency workers. PMID- 2716720 TI - Legal interest in mental health practice. PMID- 2716721 TI - A multivariate analysis of health law education in American medical schools. AB - With the growing impact of legal regulation of clinical practice, students of medicine and other clinical specialties need to know how these developing legal concepts apply to their future practices. PMID- 2716722 TI - The chemically dependent physician: clinical and legal considerations. AB - The medical community has made great advances in recognizing chemical dependence in the physician community. However, difficulties remain in terms of the clinician treating this disease and maintaining a liaison between legal and clinical aspects. PMID- 2716723 TI - The evaluation of the impaired physician. AB - Recent focus on impaired physicians has made it likely that psychiatrists and other mental health professionals will increasingly be involved in evaluating these individuals. In order to perform the job effectively, evaluators must familiarize themselves with a number of clinical and legal issues inherent in the evaluations. Preevaluation issues include receipt of sufficient information from the referral source, limits of confidentiality, and any potential conflict of interests between the evaluator and the physician to be evaluated. The clinical evaluation requires knowledge of the characteristics of physician substance abuse, of emotional disturbances including suicidality, of the emotional impact of litigation, and of the underlying causes of such unethical conduct as inappropriate prescribing of controlled substances and sexual contact with patients. Recommendations should be based on knowledge of available support systems, monitoring capacity, and options to restrict the physician's practice. Follow-up is essential for rehabilitation to be effective. Our obligations to our patients require our informed involvement with the problem of impaired physicians and with its solution. PMID- 2716724 TI - Sexual abuse of patients by therapists: strategies for offender management and rehabilitation. AB - Many therapists are unsure of how to respond to reports of sexual abuse of patients by previous therapists. The results of strategies developed in Minnesota and other jurisdictions suggest ways to handle the reporting, management, and rehabilitation of offenders in therapist-patient sexual abuse cases. PMID- 2716725 TI - Recent developments in antitrust: challenges to medical autonomy. AB - Once exemptions from antitrust scrutiny were removed, economic arguments have proved effective in dissolving the hegemony formerly held by psychiatrists over the provision of mental health services. A growing number of courts, legislatures, and insurance companies have been persuaded by psychologists that they can provide at least comparable services at lower costs than psychiatrists. The fact that psychotherapy is less obviously a "medical" procedure than surgery or other physical treatments has facilitated the establishment of the psychologists' position. After these gains, there are indications that other mental health providers will follow the paths established by psychologists. Cost containment efforts in the mental health care industry, particularly through health maintenance organizations, have already led to increased utilization of nondoctoral providers for initial screening services, and psychiatrists have even filed countersuits alleging restraint of their trade through the exclusive use of lower-cost providers (State Medical Society of Wisconsin v. Schweiker et al., 1982). With the clear message from many courts and legislatures that profession will no longer serve to distinguish among mental health providers, it appears that the validity of psychiatrists' assertions that independent practice by nonmedical mental health professionals will result in lower quality of care for patients will be tested in the marketplace, with peer review and tort litigation serving as the barometer by which that quality will be measured. And, as other nonmedical professionals establish their credentials through licensure and recognition by consumers, we can expect that they will also seek recognition of their capacities to provide (and be reimbursed for) professional services through the courts. With this greater access to consumers of mental health care will also come, of course, greater public scrutiny and greater risk of malpractice liability. PMID- 2716726 TI - Current legal developments in medical staff credentialing disputes. AB - Credentialing of hospital staff has become an important method by which to ensure and to monitor the quality of clinical practice. PMID- 2716727 TI - Legal issues in determining competence to make treatment decisions. AB - With the complexities of current medical care and the growing concern for patient autonomy in making decisions about whether or not to accept medical and surgical treatment, psychiatrists are increasingly called on to evaluate patients' competence to make treatment decisions. PMID- 2716728 TI - Effect of age on auditory evoked responses (AER) and augmenting-reducing. AB - Auditory evoked responses (AER) were obtained from Cz and Fz in 30 adults (14 male, 16 female) from 20-80 years old. Sound bursts (1000 Hz-200 msec) of four different intensities were used. Peak to trough amplitudes of P1N1 and N1P2 and latencies of P1, N1 and P2 peaks were measured with increasing stimulus intensity and slopes of amplitude - intensity and latency - intensity curves were analysed for assessment of an age effect. The main result is that the increase in P1N1 amplitude with increasing stimulus intensity is more pronounced in older persons. Previous studies have established a negative correlation between the augmenting reducing responses and HVA levels in the CSF (with lower amounts of HVA in the CSF of "augmenters"). Decreased dopamine metabolism in old subjects could account for our results, so further studies should focus on patients with pathological dopamine deficiencies. PMID- 2716730 TI - HIV exposure in the emergency department. PMID- 2716729 TI - [Clinical aspects, differential diagnosis and evolution of visual epileptic seizures in children]. AB - We studied 13 boys and girls, treated for ictal visual episodes, followed-up in the Center for Epilepsy of the University of Modena. In 10 cases visual symptoms (amaurosis, hallucinations, and illusions) started between 6 and 14 years, associated with occipital EEG anomalies. In 6 cases, EEG abnormalities (sharp waves, slow waves, spikes, spike-waves) disappeared after eyes opening. In the history of half of our cases, there was no significant antecedent. Normal intelligence and behaviour were present in all cases. Only in one case, CT demonstrated bilateral occipital calcifications. In the other 9, visual ictal symptoms disappeared after antiepileptic treatment. We think that these last cases present the characteristic features of Benign Occipital Epilepsy described by Gastaut (1982-1985). On the basis of our results, we can confirm the existence of this syndrome, even if it is rare. Nevertheless, 3 of our cases with visual symptoms, don't show the typical picture of BOE, and must be diagnostically distinguished from psychiatric disorders, basilar migraine, and other partial epilepsies. PMID- 2716731 TI - Physician stress: is it inevitable? AB - Early attempts to understand the causes of physician stress focused almost exclusively upon the role of external stressors and demands. Recent psychosocial and behavioral research, however, suggests that individual attitudes, beliefs, personality factors, and learned coping strategies probably play a more important role. In addition, such cognitive and behavioral tendencies are within the control of each individual, and clinical experience has shown that these factors can indeed be modified. Freudenberger noted that most health professionals who are experiencing high levels of stress fail to identify the role that they themselves play in generating such symptoms. Instead, they tend to blame others as the cause of their problems and tend to react cynically toward suggestions that they could benefit from help. A large-scale study of family physicians in North Carolina, conducted by May, Revicki, and Jones in 1983, confirmed the fact that most physicians who reported a high level of professional stress also tended to score high on measures of external locus of control--i.e. the perception that external or environmental factors are mainly responsible for one's problems or successes. My own experience in treating physicians and other people with stress tends to confirm these findings. More importantly, I have found that once individuals are helped to identify the role that their own cognitive and behavioral tendencies play in the origin of their stress, they can usually bring about impressive reductions in stress and tension without significant changes in environmental factors or demands. While many people advocate stress-releasing and other relaxation skills for physicians, I have found that such approaches are often counterproductive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716732 TI - Hepatitis A. Analysis of a community outbreak. AB - The 1987 outbreak of hepatitis A in the Southwest Missouri town of Nevada illustrates a number of public health measures that can quickly and effectively halt an epidemic. Cooperation among state health officials, individual physicians and the news media is just one aspect of the control of such an outbreak. PMID- 2716733 TI - Maxillofacial trauma in two rural level II trauma centers. AB - A 10-year retrospective study of maxillofacial trauma cases in Southeast Missouri reveals the causes of the trauma and profiles the age and gender of the victims. In contrast with the findings of urban institutional studies, which are more commonly reported, motor vehicle accidents accounted for the majority of these cases. PMID- 2716734 TI - Interaction of human IgG chimeric antibodies with the human FcRI and FcRII receptors: requirements for antibody-mediated host cell-target cell interaction. AB - Chimeric monoclonal antibodies (McAb), specific for the hapten 5-iodo-4-hydroxy-3 nitrophenacetyl (NIP), expressing human IgG1, IgG2, IgG3 and IgG4 subclass constant domains, have been examined for their ability to interact with the human FcRII receptor. Human red blood cells (RBC) sensitized by each of these McAbs have been assayed for their ability to form rosettes with the human histiocytic lymphoma U937 cell line, human B cell line Daudi and erythroblastoid K562 cell line. IgG1 and IgG3 sensitized RBC formed significant rosettes with the FcR- and FcRII+ Daudi and K562 cell lines, the percentage of cells forming rosettes being directly proportional to the degree of sensitization of the RBC. Bromelin treating Daudi cells did not alter this pattern of reactivity, whereas bromelin treated FcRI+ and FcRII+ U937 cells formed significant resettes with IgG1, IgG3 and IgG4 sensitized RBC, demonstrating a difference in the IgG subclass specificity between human FcRI and FcRII. Murine IgG2b anti-NIP sensitized RBC did not form rosettes with any cell line tested; however, RBC sensitized by some members of a panel of murine IgG1 McAb, specific for the glycophorin A molecule, were able to form rosettes with Daudi, U937 and K562 cells. This interaction was enhanced by bromelin treating the Daudi or U937 cells and can be correlated to the disposition of the epitopes recognized, relative to the target cell membrane, those McAbs recognizing epitopes furthest from the RBC surface being most effective in interacting with FcRII. The data are interpreted in terms of a simple model for antibody-mediated cell--cell interaction. PMID- 2716735 TI - Diagnosis and treatment of old age dementias. Symposium proceedings. Milan, June 6, 1987. PMID- 2716736 TI - [Neuroborreliosis: progressive encephalomyelitis with cerebral vasculitis]. AB - Encephaloborreliosis is described in a 16 year old patient. Besides the progressive encephalopathy this case presents symptoms and findings of a cerebral vasculitis. During and after antibiotic treatment all clinical symptoms and pathological changes in the cerebrospinal fluid almost completely disappeared. PMID- 2716738 TI - [Phrenic nerve paralysis with consecutive eventration of the diaphragm as a complication of thoracic drainage]. PMID- 2716737 TI - [Congestive heart failure in rickets caused by vitamin D deficiency]. AB - We describe a case of a three and half month old infant presenting with a congestive heart failure due to hypocalcemic cardiomyopathy. Vitamin D deficiency rickets was found to be the cause for the hypocalcemia. The heart failure responded promptly to adequate Calcium therapy accompanied by usual anticongestive therapy. PMID- 2716739 TI - [Annual meeting of the Society of Pediatric Gastroenterology and Nutrition. 2-4 March 1989, Goslar. Abstracts]. PMID- 2716740 TI - [Psychological management of patients and families with cystic fibrosis]. AB - The care of families with a child with cystic fibrosis requires a concept which includes psychological and social aspects caused by the disease. The contribution of a psychologist offers a valuable support for this. Methods for the emotional care of patients are presented. The importance of counselling and the possibility of preventive work and distribution of information are underlined. The example of psychosocial stress (coping with the diagnosis, self esteem, life crises etc.) permit insight into the requirements of patients and their relatives and contribute to increase the awareness of the caregiver for age-independent and for age-specific problems. PMID- 2716741 TI - [Reactions of patients and families with cystic fibrosis to psychological management]. AB - A model of care for patients with cystic fibrosis including the possibility for continuous psychological counselling besides medical care is presented. In order to evaluate reactions of those affected to the offer of counselling 243 sessions between 81 patients or/and parents and the psychologist (IJK) were attributed to one of the following reaction types: type 1: negation/rejection, type 2: acceptance of talks, type 3: reactive wish to be counselled, type 4: active acceptance. The high proportion of reaction type 4 in the age groups 0; 1-1 (65.0%), 1-3 (45%) and in adult patients (46.6%) shows that the majority of parents approach the psychologist with questions, anxieties and worries in the first months and years after the diagnosis has been established. In the adult age group patients themselves request support for coping with a variety of difficulties. Type 2 sought contact with the psychologist on the assumption that in the future they could draw on the help of someone familiar in moments of crisis; this reaction dominated in the 3 groups aged 3-15 years. In adolescents the offer of a counselling session is made use of to discuss current problems (type 3). PMID- 2716742 TI - [Spontaneous secretion of growth hormone in deep nocturnal sleep. II. Studies on hypophyseal dwarfism and constitutional developmental delay]. AB - To evaluate the somatotropic function of the pituitary, the measurement of the spontaneous nocturnal secretion of GH is a rather suitable method. Whereas the provocation tests check the capacity of the gland after intensive stimulation, spontaneous secretion reflects the behaviour of the hypothalamohypophyseal system under everyday conditions. The investigation of 65 children with pituitary dwarfism showed in all cases a strong diminution of the GH secretion. Overlapping with the control group was hardly seen. The maxima measured during sleep were identical with those reached in the provocation tests. The subdivision in complete and partial GH deficiencies is more precise with measuring the spontaneous secretion than with provocation tests. Nocturnal spontaneous GH secretion was determined in 128 patients with constitutional delay of growth and adolescence. Also in these children provocation tests were performed simultaneously. Spontaneous GH secretion was found significantly diminished in all stages of puberty, compared to the controls (p less than or equal to 0.01). By contrast, the provocation tests showed no significant differences from controls. According to these results, the retarded growth of the patients is due to a relative GH deficiency. As is evident from the normal results of the provocation tests, no organic insufficiency of the pituitary is demonstrable. Rather a cybernetic disorder is responsible for the reduced hormone secretion. PMID- 2716743 TI - [Thromboembolism as a complication of Pudenz-Heyer drainage with cardiac shunt]. AB - We report the case of a 2.7 year old boy with ventriculoatrial Pudenz Heyer shunt for hydrocephalus internus presenting with symptoms suggestive of shunt infection. 2D-echocardiography showed a pedunculated right atrial thrombus that prolapsed through the tricuspid valve in diastole. Scintigraphy of the lungs showed multiple defects suggestive of embolism. The thrombus was excised after exploratory surgery with cardiopulmonary bypass. No organisms could be isolated from the thrombus. In ventriculo-atrial Pudenz Heyer shunt thrombi and embolism are possible complications. The regular use of 2D-echocardiography in order to detect these thrombi at a very early stage is discussed. PMID- 2716744 TI - [Special heart diagnosis in the 1st year of life. An analysis of 1,131 infants with congenital heart defects 1972-1983]. AB - In the years 1972-1983, 1131 infants below one year of age have been investigated by means of heart catheterization and angiography, some only by echocardiography, -if necessary--operated and followed for at least one year. Ventricular septal defect was the most frequent congenital heart defect (16.6%), followed by transposition of the great arteries (12.1%), AV-canal (9.1%) and patent ductus arteriosus (8.1%). 58.3% of all patients had more than one lesion, 27.6% had critical lesions, which caused symptoms and had to be cured during the first month of life. 63.3% of patients with critical lesions were male. Clinical diagnosis could be improved considerably by means of echocardiography: in contrast to the years 1972-1974, where only in 49% of patients a clinical diagnosis was known before heart catheterization, this was the case in 73.1% in the years 1981-1983. Additional malformations of other organs were found in 28.6%, 19.9% had a birthweight below 2.5 kg. Concerning the various diagnoses, there were no regional or seasonal differences. The general rate of heart defects is said to be 0.8%, familiarity was 4.5%. Frequency of operations was 64.4%, mortality 37.4%, which could be improved by 10% in comparison of the beginning to the end of the time of observation. PMID- 2716745 TI - [Lyme borreliosis--the most frequent cause of acute peripheral facial paralysis in childhood]. AB - A prospective hospital-based multicentre study in Lower Saxony allowed to investigate the frequency of acute peripheral facial palsy due to Lyme borreliosis and its clinical and laboratory characteristics. Diagnosis of Lyme Borreliosis was based on detection of IgM antibodies against Borrelia burgdorferi in serum and CSF as well, using an IgM capture ELISA. Between June 1986 and October 1987 27 consecutive cases with acute peripheral facial palsy were studied. Lyme borreliosis is the main cause of peripheral facial palsy in childhood. It was verified serologically in two thirds of the cases. All cases with a positive history for a tick bite and/or an erythema migrans in the head neck region showed ipsilateral neurological affection suggesting a direct invasion via the affected nerve by Borrelia burgdorferi. Peripheral facial palsy due to Lyme borreliosis represents a monosymptomatic meningoradiculitis. All children with Lyme borreliosis revealed a lymphocytic CSF pleocytosis, whereas in cases of unknown etiology CSF findings usually were normal. Therefore, in any case of facial palsy with an inflammatory CSF syndrome Lyme borreliosis has to be suspected unless proven otherwise. PMID- 2716746 TI - [Chronic dysplasia of the respiratory ciliary epithelium]. AB - We report on a 14-year-old Turkish boy who suffered for more than seven years from recurrent pneumonia and bronchiectases. This led to the surgical removal of the left lower lobe. Brush biopsies taken from the bronchus and nose revealed severe dysmorphy of the ciliary epithelium with an altered cell-distribution of the normal surface pattern. PMID- 2716747 TI - [Lipoma of the corpus callosum in an infant with seizures]. AB - A 3 month-old boy was admitted because of short convulsions commencing with a peculiar grin. A lipoma of the corpus callosum was diagnosed by X-ray of the skull, cranial ultrasound, CT and magnetic resonance tomography. Following treatment with phenobarbital convulsions were not observed any longer. Surgical removal of the tumour was not indicated. PMID- 2716748 TI - [Thermal epiglottitis in a 3-month-old infant following feeding of hot vegetables]. AB - A thermal epiglottitis after feeding hot food is a rare event in infancy. A 3 month old infant developed typical symptoms of an acute epiglottitis after feeding him hot vegetables. The child was intubated and treated with steroids and antibiotics. A laryngo-tracheobronchoscopy was performed. After 48 h he was extubated. PMID- 2716749 TI - [Treatment of renal anemia with recombinant human erythropoietin]. AB - Anemia is an almost invariable feature of chronic renal failure and is particularly severe in children treated by long-term hemodialysis. Recombinant human erythropoietin (rhEPO) offers entirely new aspects in the treatment of renal anemia. This report presents three patients on maintenance hemodialysis aged 10, 10/10 12, and 18 years who were treated with rhEPO. Two suffered from hemochromatosis secondary to multiple transfusions. 100 U/kg rhEPO were administered three times weekly, and venesection after dialysis was performed when a target hematocrit value of 30% was achieved. Hematocrit, reticulocyte counts and hemoglobin rose within 3 to 6 weeks after initiation of therapy in all patients. Serumferritin levels declined significantly in the two patients with hemochromatosis. No deterioration of the metabolic status (i.e. increase of blood urea nitrogen, serum-creatinine, -phosphate or -potassium) could be detected. Therapy had to be discontinued in one patient who experienced hypertensive ceisis. This patient, however, had suffered from severe hypertension prior to rhEPO therapy. Blood pressure remained stable in the other patients. We conclude that renal anemia can be effectively treated by rhEPO in children. Increase of blood pressure may necessitate discontinuation of therapy especially in primary hypertensive patients. Extensive studies are necessary to eluciate long-term effects of rhEPO in children. PMID- 2716750 TI - [19th annual meeting of the Working Group on Pediatric Nephrology. 9-11 March 1989, Heidelberg. Abstracts]. PMID- 2716751 TI - [Basal membrane unevenness in glomerular amyloidosis]. AB - Author has studied in 5 needle-biopsy and 25 autopsy samples the wall unevennesses of the glomerular capillary loops developing in kidney amyloidosis. In all cases subepithelial spikes consisting of parallel amyloid fibres were observed. In half of the cases, similar structures occurred also subendothelially. In silver-stained preparations they were readily identified by their increased argyrophilia. In all cases nodular features composed of irregular amyloid fibres were subendothelially present resulting in a considerable narrowing of the lumen. The spikes and nodules causing the unevenness of the basement membrane are of diagnostic value in glomerular amyloidosis. PMID- 2716752 TI - [The course of the mandibular canal in fossils and forensic material]. AB - Authors have studied 220 fossil and 44 postmortem mandible-halves by measurements at identical points and in transverse slices cut in the plane of the teeth P2-M3. Parameters relevant to the course of the mandibular canal are summarized. Data add to the knowledge concerning the anatomy and topography of the mandible. PMID- 2716753 TI - [Pyridimocarbamate (prodectin)-induced acute liver damage, cirrhosis and primary liver cancer--accidental finding?]. AB - Authors have verified during the postmortem of a 60-year-old woman, in addition to clinically manifested vascularly and parenchymally decompensated cirrhosis a small hepatocellular carcinoma with signs of vascularization. The patient received since four years pyridinolcarbamate (Prodectin) because of obliterating peripheral arteriosclerosis. During treatment, icterus occurred the drug-induced nature of which was proved by the provocation-test. Owing to the known hepatotoxic effect of pyridinolcarbamate the question must be raised concerning a possible causal relationship between the acute hepatic damage having occurred four years ago and the cirrhosis and cancer observed in the autopsy material. The reporting of this case was aimed at drawing attention to such a possibility. PMID- 2716754 TI - [Lhermitte-Duclos disease. Case report and review of the literature]. AB - A new case of Lhermitte-Duclos disease was recognized as an accidental finding during the autopsy of a 58-year-old male who had died because of acute enteritis and shock-induced cardiac failure. Gross examination revealed focally disturbed cerebellar cortical structure in two foci. Microscopical investigation resulted in findings typical of Lhermitte-Duclos disease: 1. Broadened molecular layer containing myelinated axonal projections; 2. Disappearance of Purkinje cells; 3. Progressive hypertrophy of the granular cells within the granular layer; 4. Loss of the central white matter core of the cerebellar folia. The etiology and pathogenesis of the lesion is still unclear. With this first report in Hungarian the authors wish to call the attention to this rare disease. PMID- 2716755 TI - [Immunohistochemistry and ultrastructure of a granular cell tumor]. AB - In the cytoplasm and nucleus of granulated tumour-cells S-100 protein and neuro specific enolase were immunohistochemically detected supporting the Schwann-cell origin of the tumour. This was suggested also by electron microscopic findings. PMID- 2716756 TI - [Intraglomerular tubular epithelial emboli]. AB - A rare morphological phenomenon is described. In the glomeruli of a kidney needle biopsy sample, intracapillary cell-clusters were found showing the characteristics of proximal tubular epithelium. The phenomenon is thought to be an artifact of needle-biopsy. PMID- 2716757 TI - DNA repair. PMID- 2716758 TI - DNA-protein crosslinking in normal and solar UV-sensitive ICR 2A frog cell lines exposed to solar UV-radiation. AB - DNA-protein crosslinks (DPC) were measured following exposure to the solar UV wavelengths produced by a fluorescent sunlamp in ICR 2A frog cells and two solar UV-sensitive mutants derived from this cell line. Approx. 5-7 DPC per 10(10) dalton were induced in these cells by either 150 kJ/m2 of sunlamp UV greater than 315 nm plus photoreactivating light (PRL) or 10 kJ/m2 of sunlamp UV greater than 295 nm. The irradiated cells were then incubated for 0-24 h and the level of DPC measured using alkaline elution. It was found for the ICR 2A cells exposed to sunlamp UV greater than 315 nm that the level of DPC increased about 3-fold during a 2-h postirradiation incubation and then decreased. The mutant cell lines also showed an enhancement in the level of DPC following irradiation, although it was much less pronounced and the levels decreased much more rapidly. In a similar fashion, the level of DPC increased in ICR 2A cells exposed to sunlamp UV greater than 295 nm with more than a 5-fold enhancement after a 4-h incubation. Once again, the mutant cell lines showed an increase in the level of DPC that was smaller and more transient than the effect in the ICR 2A cells. These results suggests that this enhancement in DPC may be indicative of a process that plays a role in cellular survival following solar UV-irradiation. PMID- 2716759 TI - Tobacco smoke-induced clastogenicity in mouse fetuses and in newborn mice. AB - The clastogenic activity of tobacco smoke (TS) was established in mouse fetuses employing the micronucleus test. A 1-h exposure of pregnant mice BDF1 (C57Bl x DBA2) to TS (600 cm3 TS in a 14-l glass chamber, 4 exposures of 15 min each with 1 min intervals during which a total air change was made) on day 16/17 caused a 2 3-fold increase in the number of micronucleated polychromatic erythrocytes (MN PCEs) in fetal liver as well as in the liver of newborn mice (1-5 h after birth). A similar, although slightly greater micronucleus response occurred in fetuses obtained from pregnant mice treated repeatedly with TS (60 min/day in total) starting on day 11 of gestation. The in vivo clastogenic activity of TS was also established by evaluating the MN PCE level in the peripheral blood of newborn mice (1-5 h after birth and during the first several days of life) treated transplacentally with TS during the last third of pregnancy. The young animals (1 3 weeks old) were more sensitive to the clastogenic activity of TS as compared to their 6-month-old mothers but no data were obtained showing a possible passing of the TS-contained clastogens from 'smoking' lactating mothers to their suckling offspring. The combined application of micronucleus test proved to be very convenient and useful when studying the different aspects of TS-induced genotoxicity. PMID- 2716760 TI - Genetic toxicology testing and biomonitoring or environmental or occupational exposure. PMID- 2716761 TI - Mutagens in urine of non-smoking and smoking workers in an aircraft tyre retreading plant. Skin exposure as a causal factor? AB - In an aircraft type retreading plant environmental samples taken at several departments showed mutagenic properties. Thursday urine samples of non-smoking and smoking workers showed higher urinary mutagenicity than urine samples collected on Sundays, thus suggesting occupational exposure to mutagenic substances. A relation between urinary mutagenicity on Thursdays and skin contamination measured on Wednesdays was observed. The data suggest that intake through the skin plays an important role in the occupational exposure to mutagenic compounds of rubber workers. PMID- 2716762 TI - An increased frequency of structural chromosome aberrations in persons present in the vicinity of Chernobyl during and after the reactor accident. Is this effect caused by radiation exposure? AB - About a week after the reactor accident in Chernobyl, a number of German citizens returned to the Federal Republic of Germany from different places of residence in the U.S.S.R. Chromosome analyses of these individuals show a surprisingly significant increase in dicentric chromosomes in comparison to the laboratory control. Acentrics are nearly twice as frequent as dicentrics. Centric rings are also in evidence. Chromatid breaks do not significantly differ from the control with the exception of 1 place of residence. The frequency of aberrations is too high to be induced by absorbed doses calculated physically or by modelling techniques. So far, no explanation is available for the discrepancy-a factor of about 100-between calculated absorbed doses and the measured biological effect. PMID- 2716763 TI - Mutagen-induced recombination between stably integrated neo gene fragments in CHO and EM9 cells. AB - The ability of mutagenic agents to induce homologous recombination was studied in a 'normal' Chinese hamster ovary (CHO) cell clone (CHO:5) and a cell clone (EM9:2) derived from the presumptive DNA repair-deficient mutant cell line EM9, which has a high spontaneous sister-chromatid exchange (SCE) level and shows hypersensitivity towards monofunctional alkylating agents and bromodeoxyuridine (BrdUrd). The 2 cell clones have been transfected with and allowed to incorporate stable genomic inserts of the vector pIII-14gpt, which contains 2 tandemly arranged neo gene fragments with a common 400-bp region of homology. Recombination between the truncated neo genes gives rise to geneticin sulfate (G 418)-resistant revertants with a spontaneous frequency of about 10(-4) in both cell clones. In CHO:5 an increased frequency of revertants was obtained after treatment with methyl methanesulfonate (MMS) and mitomycin C (MMC), while HN2, benz[a]pyrene diolepoxide (BPDE) and X-irradiation gave negative results. EM9:2 showed about the same increase of revertants after treatment with MMS as CHO:5, but in a 10-fold lower dose range. HN2 as well as BrdUrd induced revertants in EM9:2. These results show that mutagenic agents (MMS, MMC, HN2, BrdUrd) can induce homologous recombination in this system. This effect does not seem to be an unspecific effect of DNA damage (no effect of X-ray and BPDE), or related to SCE induction in general (similar spontaneous and MMS-induced frequencies of revertants in CHO:5 and EM9:2). However, the positive effect of BrdUrd in EM9:2 and the difference between CHO:5 (negative) and EM9:2 (positive) with regard to HN2-induced revertants suggest that certain types of DNA damage are more recombinogenic in EM9 than in 'normal' CHO cells, which possibly reflects the specific mutation in the former cell line. PMID- 2716764 TI - Increased frequency of spontaneous and X-ray-induced chromosomal aberrations in lymphocytes from neonates and the influence of caffeine--an in vitro study. AB - We have examined lymphocytes from human preterm (PT) and fullterm (FT) babies for an effect of gestational age (GA) on chromosomal aberrations either occurring spontaneously or induced by treatment with X-rays (1 Gy) alone; or with caffeine (1,3,7-trimethylxanthine) supplementation (5 X 10(-4) M), in comparison to the lymphocytes of healthy adults (AD). Percent of abnormal cells (%Abn) was used as an indicator of chromosome sensitivity to the different treatments. PT babies had significantly higher spontaneous and X-ray-induced %Abn values than AD, but were comparable to FT. After X-irradiation + caffeine the yield of aberrations in any 2 groups was not significantly different. Chromosomal sensitivity may result from factors other than GA. This in vitro model may permit study of the mechanisms of chromosomal damage repair and prevention of free radical damage of DNA during the perinatal period. PMID- 2716765 TI - A comparison of chromosomal aberrations induced by in vivo radiotherapy in human sperm and lymphocytes. AB - Chromosomal aberrations in human sperm and lymphocytes were compared before and after in vivo radiation treatment of 13 cancer patients. The times of analyses after radiotherapy (RT) were 1, 3, 12, 24, 36, 48 and 60 months. The median total radiation dose was 30 Gy and the testicular dose varied from 0.4 to 5.0 Gy. Human sperm chromosome complements were analysed after fusion with golden hamster eggs. There were no abnormalities in sperm or lymphocytes before RT. Following RT there was an increase in the frequency of numerical and structural chromosomal abnormalities in both lymphocytes and sperm. For structural abnormalities there were more rejoined lesions (dicentrics, rings) in lymphocytes and more unrejoined lesions (chromosome breaks, fragments) in sperm. After RT there was a dramatic increase in the frequency of chromosomal abnormalities in lymphocytes: at 1 mo. the frequency was 42%, at 3 mo. 25%, at 12 mo. 14%, at 24 mo. 11%, at 36 mo. 9%, at 48 mo. 7% and at 6 mo. 4%. Since the majority of men were azoospermic after RT, there is little data on sperm chromosome complements before the analyses performed at 24 mo. post-RT. At 24 mo. the frequency of abnormalities was 13%, followed by 21% at 36 mo., 12% at 48 mo. and 22% at 60 mo. Thus it appears that the frequency of lymphocyte chromosomal abnormalities had an initial marked increase after RT followed by a gradual decrease with time whereas the frequency of sperm chromosomal abnormalities was elevated when sperm production recovered and remained elevated from 24 to 60 mo. post-RT. This difference in the effect of time makes it very difficult to compare abnormality rates in lymphocytes and sperm and to use analysis of induced damage in somatic cells as surrogates for germ cells since the ratio between sperm and lymphocytes varied from 1:1 (at 24 mo. post-RT) to 5:1 (at 60 mo. post-RT). PMID- 2716766 TI - Formaldehyde-induced and spontaneous alterations in human hprt DNA sequence and mRNA expression. AB - Human lymphoblast mutants at the X-linked hprt locus have been examined by Southern blot, Northern blot and DNA sequence analysis. A previous study had shown that approximately a third of the spontaneously-arising mutants and half those induced by formaldehyde showed no alteration in restriction fragment pattern and thus were classified as point mutations. In this report, Northern blot analysis was used to show that these point mutants fall into 4 categories: normal size and amount of RNA, normal size but reduced amounts, reduced size of RNA or no RNA. Sequence analyses of cDNAs prepared from hprt mRNAs were performed on 1 spontaneous and 7 formaldehyde-induced mutants with normal Northern blots. The spontaneous mutant was caused by an AT----GC transition. 6 of the formaldehyde-induced mutants were base substitutions, all of which occurred at AT base-pairs. There was an apparent hot spot, in that 4/6 independent mutants were AT----CG transversions at one specific site. The remaining mutant had lost exon 8. PMID- 2716767 TI - The involvement of dimethyl sulfoxide in a bacteriotoxic response of the Ames assay tester strains TA98 and TA100. AB - Dimethyl sulfoxide is a widely accepted and recommended solvent in which to dissolve compounds to be tested for mutagenicity via the Ames Salmonella/mammalian microsome assay. Using tester strains TA98 and TA100, we observed a bacteriotoxic response with various fractions isolated from beer when dissolved in DMSO but not when dissolved in water. Further characterization of the role of solvent in simple model systems consisting of butanol, DMSO and bacteria strongly suggests a chemical reaction occurs between dimethyl sulfoxide and specific chemical constituents of the test substance, nutrient broth, or the Ames bacterial strains. The result of such an interaction could be misinterpreted as a toxic response to the test substance when, in fact, the bacteriotoxicity could be due to another compound, chemically distinct from the test substance. PMID- 2716768 TI - Intermediate (6-4) photoproduct repair in Chinese hamster V79 mutant V-H1 correlates with intermediate levels of DNA incision and repair replication. AB - A DNA-repair mutant isolated from Chinese hamster V79 cells, V-H1, has been characterized as having only slightly reduced unscheduled DNA synthesis (UDS) and intermediate levels of DNA incision and repair replication after UV exposure. This observation was unexpected, since V-H1 has been shown by genetic complementation analysis to belong to the UV5 complementation class (i.e., class 2), exhibiting equivalent UV hypersensitivity and hypermutability as UV5 cells, which are defective in incision, UDS and repair replication. We have examined the repair of cyclobutane dimers and (6-4) photoproducts in V-H1 and V79 cells and shown that V-H1 cells are deficient in cyclobutane dimer repair, but exhibit intermediate (6-4) photoproduct repair, unlike UV5 cells which are completely deficient in (6-4) photoproduct repair. Our results confirm observations made in other UV-hypersensitive Chinese hamster cell mutants in CHO complementation class 2, and suggest that the gene affected in these mutants (ERCC2) may be involved in at least two distinct repair pathways in hamster cells. PMID- 2716769 TI - Chronic gamma-radiation sensitivity of skin fibroblasts from patients with non Hodgkin's lymphoma (NHL). AB - Cultured skin fibroblasts from 11 patients with non-Hodgkin's lymphoma (NHL), 3 with ataxia telangiectasia (AT), 3 AT heterozygotes and 6 healthy subjects were studied for impaired colony-forming ability upon chronic exposure to gamma radiation. A comparison of survival curves of the different cell lines revealed an AT heterozygote-like response (intermediate radiosensitivity) in 8 (73%) out of 11 NHL patients. These results suggested that the majority of the NHL patients may have an underlying abnormality of DNA repair. PMID- 2716770 TI - A restudy of the efficacy of adriamycin in inducing dominant lethals in mouse spermatogonia stems cells. PMID- 2716771 TI - Chromosomal aberrations in bone marrow and peripheral blood cells from the same rats. AB - Spontaneous cytogenetic aberrations were analyzed in bone-marrow cells and cultured peripheral lymphocytes from the same animals. No significant differences in the total number of cells with aberrations or total aberrations were detected between the bone-marrow cells and cultured lymphocytes. It was concluded that short-term culture does not contribute significantly to in vivo aberration yield within the experimental conditions used. PMID- 2716772 TI - Hyperthermia-induced modulation of killing and mutation by UV and N-methyl-N' nitro-N-nitrosoguanidine in V79 cells. AB - Hyperthermic exposures of V79 cells did not affect the killing by UV light, whereas it enhanced MNNG-induced killing. Such hyperthermic exposure increased the mutation induction (resistance to 6-thioguanine) by both UV and MNNG. The timing of heat exposure, before or after the treatments, had no effect on the result in cases of cytotoxicity and mutagenesis. PMID- 2716773 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 20-1989. A 33-year-old woman with exertional dyspnea and Raynaud's phenomenon. PMID- 2716774 TI - The mitochondrial genome--breaking the magic circle. PMID- 2716775 TI - Cardiac asthma--a fresh look at an old wheeze. PMID- 2716776 TI - Women in medical education. PMID- 2716777 TI - Ursodeoxycholic acid and gallstones during weight loss. PMID- 2716778 TI - Alcohol-induced injury to the liver. PMID- 2716780 TI - Endorsement of "patient promise" program. PMID- 2716779 TI - Superior limbic keratoconjunctivitis apparently related to particulate material from a ventilation system. PMID- 2716781 TI - A case-control study of the effectiveness of bicycle safety helmets. AB - Bicycling accidents cause many serious injuries and, in the United States, about 1300 deaths per year, mainly from head injuries. Safety helmets are widely recommended for cyclists, but convincing evidence of their effectiveness is lacking. Over one year we conducted a case-control study in which the case patients were 235 persons with head injuries received while bicycling, who sought emergency care at one of five hospitals. One control group consisted of 433 persons who received emergency care at the same hospitals for bicycling injuries not involving the head. A second control group consisted of 558 members of a large health maintenance organization who had had bicycling accidents during the previous year. Seven percent of the case patients were wearing helmets at the time of their head injuries, as compared with 24 percent of the emergency room controls and 23 percent of the second control group. Of the 99 cyclists with serious brain injury only 4 percent wore helmets. In regression analyses to control for age, sex, income, education, cycling experience, and the severity of the accident, we found that riders with helmets had an 85 percent reduction in their risk of head injury (odds ratio, 0.15; 95 percent confidence interval, 0.07 to 0.29) and an 88 percent reduction in their risk of brain injury (odds ratio, 0.12; 95 percent confidence interval, 0.04 to 0.40). We conclude that bicycle safety helmets are highly effective in preventing head injury. Helmets are particularly important for children, since they suffer the majority of serious head injuries from bicycling accidents. PMID- 2716782 TI - Mapping the gene for hereditary cutaneous malignant melanoma-dysplastic nevus to chromosome 1p. AB - We used molecular genetic techniques and multipoint linkage analyses to locate the gene responsible for cutaneous malignant melanoma-dysplastic nevus. We evaluated 99 relatives and 26 spouses in six families with a predisposition to melanoma. Thirty-four family members had cutaneous malignant melanoma, and 31 of these 34 also had histologically confirmed dysplastic nevi. Twenty-four family members had dysplastic nevi alone. An analysis of the cosegregation of the cutaneous malignant melanoma-dysplastic nevus trait with 26 polymorphic DNA markers on the short arm of chromosome 1 demonstrated the presence of a gene for susceptibility to melanoma. The gene was located between an anonymous DNA marker (D1S47) and the gene locus for pronatrodilatin, a commonly used reference gene (PND), in chromosome band 1p36. The odds were greater than 260,000:1 in favor of linkage at this location. PMID- 2716783 TI - Large community outbreak of cryptosporidiosis due to contamination of a filtered public water supply. AB - Between January 12 and February 7, 1987, an outbreak of gastroenteritis affected an estimated 13,000 people in a county of 64,900 residents in western Georgia. Cryptosporidium oocysts were identified in the stools of 58 of 147 patients with gastroenteritis (39 percent) tested during the outbreak. Studies for bacterial, viral, and other parasitic pathogens failed to implicate any other agent. In a random telephone survey, 299 of 489 household members exposed to the public water supply (61 percent) reported gastrointestinal illness, as compared with 64 of 322 (20 percent) who were not exposed (relative risk, 3.1; 95 percent confidence interval, 2.4 to 3.9). The prevalence of IgG to cryptosporidium was significantly higher among exposed respondents to the survey who had become ill than among nonresident controls. Cryptosporidium oocysts were identified in samples of treated public water with use of a monoclonal-antibody test. Although the sand filtered and chlorinated water system met all regulatory-agency quality standards, sub-optimal flocculation and filtration probably allowed the parasite to pass into the drinking-water supply. Low-level cryptosporidium infection in cattle in the watershed and a sewage overflow were considered as possible contributors to the contamination of the surface-water supply. We conclude that current standards for the treatment of public water supplies may not prevent the contamination of drinking water by cryptosporidium, with consequent outbreaks of cryptosporidiosis. PMID- 2716785 TI - A new prognostic staging system for the acquired immunodeficiency syndrome. AB - An improved prognostic staging system is needed for patients with the acquired immunodeficiency syndrome (AIDS). To construct such a system, we analyzed the course of 117 consecutive adults who received a diagnosis of AIDS at Yale-New Haven Hospital from 1981 through 1987. The staging system was developed from the data on the first 76 patients, confirmed in the remaining 41 patients, and then applied to the entire cohort. The staging system, which is based on physiologic deficits rather than demographic or diagnostic features, gives one point for each of the following: severe diarrhea or serum albumin level under 2.0 g per deciliter, any neurologic deficit, arterial oxygen tension of 50 mm Hg or less, hematocrit below 30 percent, lymphocyte count below 150 per microliter, white cell count below 2500, and platelet count below 140,000. The total score determines the presence of Stages I (0 points), II (1 point), or III (2 to 7 points). The three stages had distinctive prognostic gradients in our cohort. For patients in Stages I, II, and III, the median survival times were 11.6, 5.1, and 2.1 months, respectively, with one-year survival rates of 50, 30, and 8 percent. When the staging system was tested with a proportional-hazards model, no other descriptive or laboratory variable added any additional predictive power. Although this new staging system requires further validation in other populations, we believe it will be useful in evaluating new therapies and improving the precision of prognosis in patients with AIDS. PMID- 2716784 TI - Detection of autoantibodies to recombinant mitochondrial proteins in patients with primary biliary cirrhosis. AB - Primary biliary cirrhosis is characterized by the presence of autoantibodies to mitochondria with specific reactivity to proteins of 74 and 52 kilodaltons (kd). The 74-kd mitochondrial protein is the E2 component--dihydrolipoamide acetyltransferase--of the pyruvate dehydrogenase complex, and the 52-kd protein is the equivalent E2 component--dihydrolipoamide acyltransferase--of the branched chain alpha-keto acid dehydrogenase complex. Current methods for the detection of antibodies to these proteins lack specificity or sensitivity, or they are time consuming and not readily available. We therefore developed an enzyme-linked immunoassay to quantify specific antimitochondrial antibodies in patients with primary biliary cirrhosis. Recombinant polypeptides coding for both the 74-kd and the 52-kd mitochondrial autoantigens were used to analyze 217 coded serum samples, including samples from 93 patients with primary biliary cirrhosis and 124 controls, for reactivity by our immunoassay, immunoblotting, and immunofluorescence testing. Serum samples from 89 of the 93 patients with primary biliary cirrhosis reacted with either the pyruvate dehydrogenase-E2 or the branched-chain alpha-keto acid dehydrogenase protein. None of the 124 control samples from healthy volunteers (n = 86) or patients with primary sclerosing cholangitis (n = 38) had significant reactivity. Our results indicate that the use of recombinant, cloned autoantigens provides a simple, accurate, and rapid method of quantifying and monitoring the levels of specific mitochondrial autoantibodies in the serum of patients with primary biliary cirrhosis. PMID- 2716786 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 21-1989. A newborn girl with respiratory distress and vesicular skin lesions. PMID- 2716787 TI - Legislating safety--how far should we go? PMID- 2716788 TI - The safety of our drinking water: reason for concern but not alarm. PMID- 2716789 TI - Toward a better classification system for HIV infection. PMID- 2716791 TI - Urinary incontinence among elderly persons. PMID- 2716790 TI - High-output cardiac failure in multiple myeloma. PMID- 2716792 TI - HIV-2 infection in the United States. PMID- 2716793 TI - Malingering doubt about factitious AIDS. PMID- 2716794 TI - In-hospital outcome in patients with coronary artery disease in whom myocardial infarction has been ruled out. PMID- 2716795 TI - The ideal of continuous improvement. PMID- 2716796 TI - Effect of triglyceride levels on methyl and methylene envelope line widths in proton nuclear magnetic resonance spectroscopy of human plasma. AB - Recent studies have described a relation between the line widths of the methyl and methylene resonance envelopes in the proton nuclear magnetic resonance spectrum of human plasma and the occurrence of cancer. An average line width of less than 33 Hz has been reported to correlate with the presence of cancer, whereas greater line widths have not. In 26 normal volunteers, we found a significant inverse correlation between fasting triglyceride level and plasma spectral line width. We also observed that dietary lipids have measurable effects on spectral line widths. In another sample of seven normal persons (three of whom had elevated plasma triglyceride levels), the line widths of whole plasma varied widely (mean, 35.6 +/- 8.8 Hz); however, the mean line widths of the lipoprotein fractions isolated from those samples differed greatly, but the variance within each fraction was small (very-low-density lipoprotein, 22.0 +/- 1.9 Hz; low density lipoprotein, 35.0 +/- 2.8; high-density lipoprotein, 28.8 +/- 1.9). The results of this study indicate that the plasma triglyceride level has a profound effect on the average spectral line width of plasma. This effect can be explained by the relative amounts of lipoprotein fractions in whole plasma. Plasma triglyceride concentrations of more than 1.24 mmol per liter (greater than 110 mg per deciliter), whatever the source, produce average plasma methyl and methylene line widths of less than 33 Hz. PMID- 2716798 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 22-1989. Sudden collapse of a 17-year-old girl during exertion. PMID- 2716797 TI - Human immunodeficiency virus type 1 infection in homosexual men who remain seronegative for prolonged periods. AB - Infection with the human immunodeficiency virus type 1 (HIV-1), as demonstrated by viral cultures, has been described in some patients before antibodies to HIV-1 can be detected, but the duration and frequency of such latent infections are uncertain. We selected prospectively a cohort of 133 seronegative homosexual men who continued to be involved in high-risk sexual activity, and we cultured 225 samples of their peripheral-blood lymphocytes, using mitogen stimulation to activate the integrated HIV-1 genome. HIV-1 was isolated in blood samples from 31 of the 133 men (23 percent), 27 of whom have remained seronegative for up to 36 months after the positive culture. The other four men seroconverted 11 to 17 months after the isolation of HIV-1. In three of them, we studied cryopreserved lymphocytes obtained earlier, using the polymerase chain reaction to amplify small amounts of viral DNA, and we demonstrated that HIV-1 provirus had been present 23, 35, and 35 months before seroconversion. We conclude that HIV-1 infection in homosexual men at high risk may occur at least 35 months before antibodies to HIV-1 can be detected. A prolonged period of latency in such infections may be more common than previously recognized; the degree of infectiousness during such periods is unknown. PMID- 2716799 TI - Silent HIV infections. PMID- 2716800 TI - Acute mountain sickness. PMID- 2716801 TI - Female intravenous drug users and perinatal HIV transmission. PMID- 2716802 TI - Acute fatal HIV encephalitis with negative serologic assays for antibody and antigen: diagnosis by polymerase chain reaction. PMID- 2716803 TI - Experience with central venous catheters in patients with AIDS. PMID- 2716804 TI - Regression of Barrett's epithelium with omeprazole. PMID- 2716806 TI - Oral iron and the Hemoccult test: a controversy on the teaching wards. PMID- 2716805 TI - Plasmapheresis in the treatment of stiff-man syndrome. PMID- 2716807 TI - [Stability of changeability of food habits]. AB - Theoretic reflections were made about the relation between turning points in individual life and food habits. Interviews of 439 people indicate a flexible exploratory attitude of young adults concerning problems of nutrition, while food habits become more stable with increasing age. PMID- 2716809 TI - [Determination of saccharin in food]. PMID- 2716808 TI - The determination of milk powder added to whole milk. AB - The objective was to determine the adulteration of fresh milk with reconstituted full fat milk powder. The ultra violet and visible spectra (700 to 240 nm) indicated two empirical parameters which are used to detect and quantify adulteration. Each parameter was calibrated against standards of adulteration and then tested against samples of known adulteration. One parameter, tested against two known series (5, 10, 20, 40 and 80% adulteration) gave the best correlation (coefficient of variation, 2.9%) between 20 and 60% adulteration. Correlation decreased at 80% adulteration (coefficient of variation 6.7%) and at 0 to 20% adulteration (coefficient of variation 35.9%). The second parameter, used in the range of 0 to 10% adulteration, when tested against 14 known samples gave results with an average of 12.5% below the true values. Sensitivity was 2.5% added reconstituted milk powder. The effect of low fat values (less than 2.3%) is discussed and a correction factor derived. The method when tested against 12 known samples gave the correct result in all cases within the limitations of the method; 4 commercial samples of milk were also analyzed. PMID- 2716810 TI - Increased concentrations of liver cholesterol in rats fed lactulose. AB - The disaccharide lactulose (beta-D-galactopyranosyl-(1-4)-D-fructofuranose) is thought to be poorly hydrolized by intestinal enzymes but is broken down by microorganisms in the colon. Thus lactulose shares with pectin similar characteristics. Lactulose is used in the food industry and in the treatment of constipation. There is preliminary evidence that dietary lactulose (5%, w/w) causes increased concentrations of serum and liver cholesterol in rats when compared with pectin. This paper describes dose-response relationships between dietary lactulose and cholesterol in either serum or liver. PMID- 2716811 TI - Investigation of functional properties of partially hydrolyzed proteins. AB - Hydrolyzates were prepared from soy protein and milk protein by treatment with Alcalase(R) 0.6 L and Neutrase(R) 0.5 L (NOVO INDUSTRI A/S, Bagsvaerd, Denmark). The pH-stat is a good method to control the change of degree of hydrolysis (DH) during enzymatic reactions and gives as well a good possibility to produce partially hydrolyzed products. In case of both investigated substrates we found a good correlation between the DH-values measured by pH-stat and TNBS-method. Determining the functional properties, we found that the emulsifying activity of hydrolyzates with low DH (below 10%) is significantly improved. At the same time the enzymatic treatment decreases the water-binding considerably but increases the velocity of water binding. PMID- 2716812 TI - [Lipid composition of cyprinidae species. 1. Lipid content and fatty acid pattern of silver carp (Hypophthalmichthys molitris (Val.))]. PMID- 2716813 TI - [A micromethod for determining fat binding capacity of proteins]. PMID- 2716814 TI - Anti-terrorism bill introduced in Senate. PMID- 2716817 TI - AIDS. Controversial visa ban. PMID- 2716815 TI - Scientific misconduct. New office gets going. PMID- 2716816 TI - UK cancer fund finds new ways of making money. PMID- 2716818 TI - Apoptosis or apoptomeatic. PMID- 2716819 TI - Cognitive anatomy. The descent of the larynx? PMID- 2716820 TI - Molecular biology. One of the better models of European cooperation. PMID- 2716821 TI - EMBO. Workshops to postdocs and publishing. PMID- 2716822 TI - Differing strategies for organizing anterior and posterior body pattern in Drosophila embryos. AB - Opposing anterior and posterior morphogen systems specify the segmented body pattern of Drosophila. The anterior morphogen, bicoid, exerts a direct, instructive influence on head and thoracic pattern by triggering different outcomes according to changes in its concentration along the body. In contrast, the posterior morphogen, nanos, simply defines where abdominal patterning can occur by eliminating an otherwise ubiquitous repressor, hunchback protein, from the posterior half of the embryo. Within this hunchback-free domain the pattern of abdominal segments must be specified by other morphogens, possibly by shorter range gradients of the products of zygotic gap genes Kruppel, knirps and tailless. PMID- 2716823 TI - A Middle Palaeolithic human hyoid bone. AB - The origin of human language, and in particular the question of whether or not Neanderthal man was capable of language/speech, is of major interest to anthropologists but remains an area of great controversy. Despite palaeoneurological evidence to the contrary, many researchers hold to the view that Neanderthals were incapable of language/speech, basing their arguments largely on studies of laryngeal/basicranial morphology. Studies, however, have been hampered by the absence of unambiguous fossil evidence. We now report the discovery of a well-preserved human hyoid bone from Middle Palaeolithic layers of Kebara Cave, Mount Carmel, Israel, dating from about 60,000 years BP. The bone is almost identical in size and shape to the hyoid of present-day populations, suggesting that there has been little or no change in the visceral skeleton (including the hyoid, middle ear ossicles, and inferentially the larynx) during the past 60,000 years of human evolution. We conclude that the morphological basis for human speech capability appears to have been fully developed during the Middle Palaeolithic. PMID- 2716824 TI - Incubation time for AIDS from French transfusion-associated cases. AB - Although incubation time is a key parameter of the epidemiology of AIDS, statistical estimates based on transfusion-associated AIDS cases have, up to now, used only the single dataset provided by the AIDS program of the Centers for Disease Control (CDC) in Atlanta. Using a new dataset provided by the Direction Generale de la Sante (DGS), of the French Ministry of Health1, we estimate the mean incubation time for AIDS (median in brackets) to be 5.3 years (5.3 years) with a 90% confidence interval ranging from 4.4 to 8.9 years (4.4 to 8.8 years), when a Weibull distribution is postulated for incubation time. The previously encountered problem of very large confidence intervals (range larger than 100 years), is not observed, indicating that an accurate estimate for mean incubation time will be obtainable in the near future. PMID- 2716825 TI - Protein structure. Selecting buried residues. PMID- 2716826 TI - Radiation limits. PMID- 2716827 TI - Genome sequencing. HUGO to go international. PMID- 2716828 TI - Misconduct inquiry. Disputed paper still causing problems. PMID- 2716829 TI - Danish merger. PMID- 2716830 TI - Transfer of a beta-turn structure to a new protein context. AB - Four-residue beta-turns and larger loop structures represent a significant fraction of globular protein surfaces and play an important role in determining the conformation and specificity of enzyme active sites and antibody-combining sites. Turns are an attractive starting point to develop protein design methods, as they involve a small number of consecutive residues, adopt a limited number of defined conformations and are minimally constrained by packing interactions with the remainder of the protein. The ability to substitute one beta-turn geometry for another will extend protein engineering beyond the redecoration of fixed backbone conformations to include local restructuring and the repositioning of surface side chains. To determine the feasibility and to examine the effect of such a structural modification on the fold and thermodynamic stability of a globular protein, we have substituted a five-residue turn sequence from concanavalin A for a type I' beta-turn in staphylococcal nuclease. The resulting hybrid protein is folded and has full nuclease enzymatic activity but reduced thermodynamic stability. The crystal structure of the hybrid protein reveals that the guest turn sequence retains the conformation of the parent concanavalin A structure when substituted in the nuclease host. PMID- 2716831 TI - HIV testing. Human rights assessed. PMID- 2716832 TI - Stereopsis. Vision of solid objects. PMID- 2716833 TI - Disparity curvature and the perception of three-dimensional surfaces. AB - BINOCULAR stereopsis provides information about the relative distance of objects from the differences in the horizontal position of their images on the two retinas. Because the size of the disparity between two points is inversely related to the square of the viewing distance, it is usually assumed that disparities have to be scaled according to distance using the vergence angle of the eyes, or by using the small vertical disparities that also exist between corresponding points of the two images. Here we present evidence that the visual system could extract information about the shapes of surfaces (without the need for scaling) by using the second spatial derivative of disparity--disparity curvature--which remains invariant with viewing distance. Rather than computing the second derivative, we suggest that an approximation to disparity curvature could be derived from the differences in curvature of corresponding line elements in the two eyes. PMID- 2716834 TI - Accelerated evolution of a false-truffle from a mushroom ancestor. AB - THE false-truffles (Hymenogastrales) are a group of basidomycetous fungi that produce underground truffle-like basidiocarps. They are generally believed to be independently derived from several mushroom lineages, but extensive morphological divergence often obscures recognition of these phylogenetic connections. Comparisons of mitochondrial DNA now demonstrate a surprisingly close relationship between species of false-truffles in the genus Rhizopogon (Hymenogastraceae) and the mushroom genus Suillus (Boletaceae). The striking morphological differences separating all Suillus species from Rhizopogon imply an acceleration in the rate of morphological change relative to molecular change during the evolution of these false-truffles from their mushroom ancestors. This acceleration can best be explained by rapid morphological divergence resulting from selective pressures which may have acted on a small number of developmental genes. PMID- 2716835 TI - Origin of the algae. AB - Eukaryotic algae are traditionally separated into three broad divisions: the rhodophytes, the chromophytes and the chlorophytes. The evolutionary relationships between these groups, their links with other eukaryotes and with other photosynthetic groups, such as euglenophytes and cryptophytes, have been the subject of much debate and speculation. Here we analyse partial sequences of the large (28S) cytoplasmic ribosomal RNA from ten new species of protists belonging to various groups of unicellular algae. By combining them with the homologous sequences from 14 other unicellular and multicellular eukaryotes, we show that rhodophytes, chromophytes and chlorophytes emerge as three distinct groups late among eukaryotes, that is, close to the metazoa-metaphytes radiation. This implies a relatively late occurrence of eukaryotic photosynthetic symbiosis. We also provide details of intra- and inter-phyla relationships. PMID- 2716836 TI - Oral contraceptives. Increased cancer risk found. PMID- 2716837 TI - AIDS. Transfusion damages. PMID- 2716838 TI - Dna fingerprinting. Pitfalls come to light. PMID- 2716840 TI - Use of growth hormones. PMID- 2716839 TI - A view of misconduct in science. PMID- 2716841 TI - Peer review. Does it work efficiently? PMID- 2716842 TI - With dosimetry in the sarcophagus. PMID- 2716843 TI - Memory. Must what goes up come down? PMID- 2716845 TI - Dry drinking. PMID- 2716844 TI - Anthropology. A tale of three cities. PMID- 2716846 TI - Mossbauer cancer therapy doubts. PMID- 2716847 TI - Structural plasticity broadens the specificity of an engineered protease. AB - The substrate specificity of alpha-lytic protease has been changed dramatically, with a concomitant increase in activity, by replacing an active-site Met with Ala. The substrate specificity of both this mutant and another similar mutant are extraordinarily broad. X-ray crystallographic analysis shows that structural plasticity, a combination of alternate side-chain conformations and binding-site flexibility, allows both large and small substrates to be well accommodated. PMID- 2716848 TI - Associative long-term depression in the hippocampus induced by hebbian covariance. AB - A brief, high-frequency activation of excitatory synapses in the hippocampus produces a long-lasting increase in synaptic strengths called long-term potentiation (LTP). A test input, which by itself does not have a long-lasting effect on synaptic strengths, can be potentiated through association when it is activated at the same time as a separate conditioning input. Neural network modelling studies have also predicted that synaptic strengths should be weakened when test and conditioning inputs are anti-correlated. Evidence for such heterosynaptic depression in the hippocampus has been found for inputs that are inactive or weakly active during the stimulation of a conditioning input, but this depression does not depend on any pattern of test input activity and does not seem to last as long as LTP. We report here an associative long-term depression (LTD) in field CA1 that is produced when a low-frequency test input is negatively correlated in time with a high-frequency conditioning input. LTD of synaptic strength is also produced by activating presynaptic terminals while a postsynaptic neuron is hyperpolarized. This confirms theoretical predictions that the mechanism for associative LTD is homosynaptic and follows a hebbian covariance rule. PMID- 2716849 TI - Local positional cues in the neuroepithelium guide retinal axons in embryonic Xenopus brain. AB - Growing retinal axons home to their distant target, the tectum, even when they are displaced from their normal pathway. This argues for long-range guidance mechanisms in the embryonic brain. Growth cones may orientate to diffusible attractants released from the target, as proposed in other systems, or they may use a stable distribution of positional information in the neuroepithelium. To distinguish between these possibilities, small pieces of the presumptive optic tract, through which retinal axons will normally grow, were rotated by approximately 90 degrees either clockwise or counterclockwise. When the retinal axons later encountered the rotated neuroepithelium, they also turned clockwise or counterclockwise, in correspondence with the direction of rotation. This demonstrates that long-range navigation of retinal axons in the vertebrate brain is based partly on stable, local positional factors, rather than on remote diffusible factors. PMID- 2716850 TI - Retinoic acid regulates growth hormone gene expression. AB - Vitamin A is required for normal growth and development, and retinoic acid (RA) may be the active metabolite in this process. Recent evidence indicates that RA acts through binding to a nuclear receptor which belongs to the steroid/thyroid hormone receptor superfamily. The receptors seem to associate with hormone response elements in the target genes resulting in the activation (or inhibition) of transcription. Although no interaction of RA-receptor complex with specific DNA sequences has yet been reported, the homology of the different receptors suggests their mechanisms of action are similar. We therefore examined whether the effects of RA on growth could be related to changes in the expression of the growth hormone gene which is known to be transcriptionally regulated by both thyroid and glucocorticoid hormones. Our results show that RA controls growth hormone production in pituitary GH1 cells and that its effect is synergistic with that caused by these hormones. PMID- 2716851 TI - In vitro correction of G.T mispairs to G.C pairs in nuclear extracts from human cells. AB - In differentiated cells, only a specific subset of genes is expressed. Recently, several genes have been shown to be transcriptionally inactivated by methylation of cytosine residues, mainly within their promoter sequences. Spontaneous hydrolytic deamination of 5-methylcytosine to thymine, which has been estimated to generate up to 12 G.T mismatched base pairs in the human genome per day, could have a deleterious effect on the expression of such genes. We recently reported that mammalian cells possess a specific repair pathway, which counteracts the mutagenic effects of this deamination by correcting G.T mismatches almost exclusively to G.C pairs. We show here that, in nuclear extracts from HeLa cells, this repair is mediated by excision of the aberrant thymidine monophosphate residue, followed by gap-filling to generate a G.C pair. We also provide preliminary evidence that the initial step of this process involves a DNA glycosylase. PMID- 2716853 TI - Smokeless tobacco use in the United States. PMID- 2716852 TI - Avoiding false positives with PCR. AB - The exquisite sensitivity of the polymerase chain reaction means DNA contamination can ruin an entire experiment. Tidiness and adherence to a strict set of protocols can avoid disaster. PMID- 2716854 TI - Parent characteristics, perceived health risk, and smokeless tobacco use among white adolescent males. AB - The results of this study indicate that father education, father use of smokeless tobacco, and adolescent risk perception contribute to the use of smokeless tobacco by white males 12 to 14 years of age. However, risk perception does not account for the correlation between parent characteristics and child behavior. Father education and child smokeless tobacco use are inversely related if the father does not use it, and they are directly related if the father does; this finding is consistent with theories of modeling but is contrary to the common observation that the use of some abusive substances is relatively low among adolescents in higher social and economic levels. We concluded that father characteristics should be considered in research and in programs pertaining to the use of smokeless tobacco by white adolescent males. PMID- 2716855 TI - Development and evaluation of a smokeless tobacco cessation program: a pilot study. AB - A multicomponent, cognitive-behavioral intervention program, offered to 25 chronic, adolescent male users of smokeless tobacco, was divided into three sessions and involved self-monitoring of smokeless tobacco use, awareness of health risks, behavioral coping strategies, frequent phone contact, and relapse prevention training. Biochemical (carbon monoxide and cotinine) verification of self-reports was obtained, information about subject and environmental characteristics collected, and a 3-month follow-up conducted. Twenty-one of the 25 subjects completed treatment; 9 participants were abstinent at the conclusion of the program, and 4 remained successful in quitting at the 3-month follow-up. Participants who did not achieve complete abstinence reported substantial reductions in smokeless tobacco use, and no increase in cigarette consumption occurred as a result of reducing or quitting use of it. Subjects successful in achieving cessation had consumed a smaller amount of smokeless tobacco at baseline and were more likely to be involved in school athletics. PMID- 2716856 TI - Deutsche Gesellschaft fur Pharmakologie und Toxikologie. Abstracts of the 30th spring meeting. 14-17 March 1989, Mainz. PMID- 2716857 TI - Nursing and the 100th Congress--Part II. PMID- 2716858 TI - The dyad model of nursing practice. AB - A model reflecting the shared personnel of nursing service and nursing education is described. Experiential examples of how such a model is implemented are included. The examples, as well as the model description, is useful to both nursing educators and administrators to stimulate ideas on how nursing service and nursing education might better share resources. Advantages to faculty practice, the clinical specialist, and the graduate student are discussed as are facilitators, inhibitors, and evaluation methods. PMID- 2716859 TI - The needed perspective. PMID- 2716860 TI - Nursing and AIDS. PMID- 2716861 TI - Collaboration in action. AB - A neighborhood health center and a school of nursing in the southwest collaborated in a pilot project to offer two workshops for low-income, Hispanic diabetics. The collaboration process used participatory management and change theories, accepted and incorporated features of Hispanic culture, and fostered interpersonal relationships. The project enabled the center to augment its client education services while providing a teaching experience for nursing students. Through the workshops, clients gained knowledge and skills that enabled them to institute life-style changes in meal planning, medication management, exercise routines, and community involvement. PMID- 2716862 TI - Shaping the workplace for the year 2000. PMID- 2716863 TI - The professional practice climate and peer review. AB - Peer review, a mechanism of professional self-regulation, should not be viewed in isolation. It is one element of a professional practice climate and is interrelated to primary nursing, evaluation of patient outcomes, quality assurance, and self-governance. Much has been written about peer review but little of it describes how staff nurses and administrators can collaborate to operationalize the concept. The peer review system described represents the efforts of one unit's nursing staff at University Hospitals of Cleveland. PMID- 2716864 TI - The unification model: a collaborative effort. AB - The Rush unification model unites clinical practice with nursing education. In this system, nursing faculty possess joint responsibilities to the college of nursing and to a specific unit in the medical center. Collaboration among managers, clinical specialists, educators, and researchers leads to achievement of unit, college, and departmental goals. The collaborative process among the leadership group members in the medical intensive care unit, consisting of the unit leader, the assistant unit leader, the clinical nurse specialists, and the practitioner-teachers, is described in detail to show how utilization of the skills and strengths of each team member increases the benefits to the unit and the patient. PMID- 2716865 TI - The nurse as case manager. PMID- 2716867 TI - Nursing management considerations. Creating autonomy--the nurse manager's challenge. PMID- 2716866 TI - Enhancing publication success. AB - Because writing for publication is often a solitary and difficult process, a writing support group was formed to encourage and assist prospective authors. In addition to increasing participants' productivity in the publication arena, the group facilitates collaboration between nurses in academia and practice. The quality and quantity of publications increase when the expertise of educators, administrators, and clinicians is combined and their writing efforts are supported. PMID- 2716868 TI - Activating "inactive" registered nurses. PMID- 2716869 TI - Prospering nurse: overcoming oxymoron. PMID- 2716870 TI - A nurse retention program. AB - Hospitals have an obligation to not only retain nurses in their respective institutions but in the profession as well. This article details the five components of a successful nurse retention program at Mount Sinai Medical Center in New York City. PMID- 2716871 TI - Hospital best practices in nurse recruitment and retention. PMID- 2716872 TI - [Vasodilators in the treatment of hypertension]. PMID- 2716873 TI - [Medical experiments; advice from the National Council for Public Health]. PMID- 2716874 TI - [Chronic anticoagulant treatment of patients with non-rheumatic atrial fibrillation]. PMID- 2716875 TI - [Screening for hypertension by the dentist]. PMID- 2716876 TI - [Complications and results of diagnostic procedures in the vena cava superior syndrome]. AB - Diagnostic procedures in the presence of superior vena cava obstruction have been reported to be dangerous. We reviewed our experience in 58 patients who presented with this obstruction during the period 1976-1985, to establish the nature and frequency of complications. In 56 of 58 patients we could obtain a diagnosis before instituting therapy. The only complication was one case of peroperative haemorrhage. PMID- 2716877 TI - [An unusual sequela of a frequently occurring neurologic disorder: delirium caused by brain infarct]. AB - Six patients are described with delirium after cerebral infarction. Five had a right-sided parietal infarction with involvement of the inferior parietal lobule. One patient presented with a right-sided medial temporo-occipital infarction. The mild neurological signs were dominated by the delirium. The outcome was good in all patients. Delirium after cerebral infarction is probably caused by injury to one of the convergence sites for integration of sensory information with disturbance of the directed attention to relevant stimuli. These sites are localized in the right parietal cortex and the medial temporo-occipital regions. This cause of delirium is probably compatible with the supposition that the right hemisphere is mainly responsible for the distribution of directed attention within extrapersonal space. The importance of an accurate neurological examination in delirious patients is emphasized. PMID- 2716878 TI - [Nephrogenous diabetes insipidus caused by amphotericin B]. AB - A patient on systemic amphotericin B therapy developed polyuria with low osmolarity of the urine probably due to nephrogenic diabetes insipidus. This rarely reported side effect of amphotericin B appears not to necessitate discontinuation of the treatment provided adequate fluid intake can be guaranteed. The diabetes insipidus is reversible in 2-6 months after cessation of the treatment: in our patient the polyuria and the low urine osmolarity disappeared within a few days. PMID- 2716879 TI - [Epistaxis caused by an acquired thrombocytopathy]. AB - Epistaxis may be the sole manifestation of a platelet aggregation dysfunction. Bleeding time according to Ivy within normal ranges does not exclude a severe disturbance of primary haemostasis. In two women (aged 53 and 76 yr, respectively) persistent epistaxis could not be stopped by local therapy. The bleeding time according to Ivy was within normal ranges in both cases. In one patient a bleeding disorder was not recognized as laboratory screening tests were normal and her situation became life-threatening. Anamnesis, clinical history and platelet aggregation tests led to the correct diagnosis; in one patient the relation with acetylsalicylic acid treatment was clear. After administration of platelet concentrate the bleeding stopped within a few hours in both cases and did not recur. PMID- 2716880 TI - [Current developments in hepatology]. PMID- 2716881 TI - [Splitting of the lateral retinaculum of the knee in retropatellar chondropathy]. PMID- 2716882 TI - [Congenital vascular rings in children]. PMID- 2716883 TI - [Urticaria and angioedema caused by the use of kitchen herbs and spices]. PMID- 2716884 TI - [Influenza season 1988-89; vaccine composition for the 1989-90 season]. PMID- 2716885 TI - [Congenital atresia of the small intestine: a problem in adults?]. PMID- 2716886 TI - [Vaginal delivery following cesarean section]. AB - An analysis is presented of the outcome of labour in 462 women with a previous caesarean section, who delivered in the department of obstetrics of Leiden University Hospital in the period 1977-1986. Elective repeat section was performed in 26% of these women, while 83% of those accepted for a trial of labour had a vaginal delivery. In 196 women with a history of a previous caesarean section (1984-1986) a retrospective analysis was made of the influence of the indication for the previous caesarean section with respect of the outcome of labour in the following pregnancy. A trial of labour had the highest chance of success in those who had had a previous caesarean section because of a breech presentation. Sixty-five percent of women who had had a prior caesarean section because of cephalopelvic disproportion or failure to progress delivered by the vaginal route after a trial of labour. Foetal weight estimation by ultrasound could not predict the outcome of a trial of labour. It is concluded that a trial of labour after a previous caesarean section, even when the operation was performed because of cephalopelvic disproportion or failure to progress, is safe and rational. PMID- 2716887 TI - [Outcome of delivery following previous cesarean section]. AB - Of 249 women whose last pregnancy was terminated by a caesarean section, 57 (22.9%) were delivered again by a primary caesarean section. The other 192 (77.1%) were allowed to attempt vaginal birth. Of these, 151 (60.6%) were successful, and 41 (16.5%) underwent a repeat caesarean section. The percentage of successful vaginal births was strongly correlated with the indication for the previous caesarean section. There was one case of incomplete uterine rupture. The maternal morbidity was lowest in the group who had a vaginal delivery. One child developed an Erb-Duchenne paralysis in addition to a mechanical birth trauma. In the secondary caesarean section group there were more children with a low one minute Apgar score than in the group delivered vaginally or by a primary caesarean section. It is concluded that there are sufficient arguments against routinely performing a repeat caesarean section after a previous one. The indication for the previous caesarean section can be an important aid in the selection of women to be allowed to try a vaginal delivery. PMID- 2716888 TI - [Immigrants with abdominal pain: familial Mediterranean fever?]. AB - Three patients of Turkish origin with recurrent abdominal complaints and fever are presented. All had consanguineous parents and two were brothers. Biochemistry and haematology were normal except for a high sedimentation rate. With reference to these patients, some aspects of the diagnosis and the therapeutic approach of familial Mediterranean fever are discussed. In patients of Turkish origin who complain of abdominal pain, familial Mediterranean fever should probably be considered more often. PMID- 2716889 TI - [A patient with familial Mediterranean fever]. AB - Familial Mediterranean fever, a genetic disorder with an autosomal recessive pattern of inheritance, occurs in patients originating from the eastern Mediterranean. Characteristic features are attacks of fever, peritonitis, pleuritis, synovitis and skin rash. The disease may be complicated by amyloidosis. Treatment with colchicine is generally successful. PMID- 2716890 TI - [False aneurysm in prosthesis of the abdominal aorta]. AB - A false aneurysm in the suture line of a vascular prosthesis is reported in 4 patients. The complications encountered in these patients are discussed. In patients with an aortic bifurcation prosthesis and with unexplained pain, fever or intestinal bleeding further analysis is indicated to exclude a false aneurysm. PMID- 2716891 TI - [Anencephalic infants as organ donors; various ethical observations]. PMID- 2716892 TI - [Ethics education at the clinical stage]. PMID- 2716893 TI - [The other side of curls]. PMID- 2716894 TI - [The clinical importance of esophageal function studies]. PMID- 2716896 TI - [The cell in the living organism; on life and death]. PMID- 2716895 TI - [Depression in children and adolescents]. PMID- 2716897 TI - ['You can go home']. PMID- 2716898 TI - [Depression in patients with somatic illnesses]. PMID- 2716899 TI - [Functional treatment of Colles fractures and the relation of anatomic recovery and function]. AB - Functional treatment of Colles fractures is a recently developed approach to fracture injury. It aims to bring about faster recovery and a better functional end result by permitting early motion and function by means of a functional brace. Early motion and function, however, might jeopardize the anatomical result. Whether an inferior anatomical result jeopardizes the functional end result is not clear, as the relationship between anatomy and function has not been established. In a prospective clinical study it was concluded that in displaced Colles fractures functional treatment with a below-the-elbow functional brace offers little advantage over conventional plaster of Paris immobilisation. Minimally displaced Colles fractures (volar angle greater than or equal to 0 degrees) should be treated with a bandage after one week of plaster immobilisation. The relationship between the anatomical and functional end result is weak and probably depends on initial displacement and complications. To improve the functional result after a Colles fracture, prevention and better treatment of complications seem to be more important than improvement of the method of fracture treatment of the anatomical end result. PMID- 2716900 TI - [Marmor's method of hemi-arthroplasty of the knee in arthritic genu varum or genu valgum]. AB - During the period 1976-1986 the Department of Orthopaedic Surgery of the Reinier de Graaf Gasthuis in Delft performed 51 hemicompartmental resurfacing arthroplasties using the Marmor modular knee on 44 patients with moderate to serious degrees of genu varum/valgum arthroticum. This procedure gave a good result in 75% of the cases. The short period of hospitalisation was advantageous to the patients, whose average age was 71 years. When hemicompartmental osteoarthritis exists and corrective osteotomy is not indicated, hemicompartmental arthroplasty is considered preferable to a total knee procedure. PMID- 2716902 TI - [Non-therapeutic scientific studies in mentally incompetent persons]. PMID- 2716901 TI - [2 men with active syphilis infection and HIV-I infection]. AB - We report the case histories of two men who were living together and who were seropositive for human immune deficiency virus (HIV) and also had positive syphilis tests. Conceivably, reactivation of an earlier syphilis infection (which had been treated) had occurred after infection with HIV. It is therefore recommended to treat such patients according to the standard of treatment of neurosyphilis. PMID- 2716903 TI - [Measures for the prevention of puerperal mastitis]. PMID- 2716904 TI - [Admission and bed occupancy at hospitals before and following budgeting; a dance of billions]. PMID- 2716905 TI - [Organic psychiatric and psychoreactive disorders in AIDS]. PMID- 2716906 TI - [Extrapyramidal movement disorders following administration of flunarizine]. PMID- 2716907 TI - [Flatfoot in children]. PMID- 2716908 TI - [The antiprogesterone action of mifepristone]. PMID- 2716909 TI - [Autopsies at a nursing home]. AB - We studied the clinical data and the autopsy findings of 88 patients to evaluate the importance of autopsies in Dutch nursing homes. The results of this retrospective analysis showed that 28% of the clinical diagnoses were not confirmed by autopsy. In 40% of the cases the direct cause of death was different from that expected by the clinician. In particulars, pneumonia and congestive heart failure relatively often caused diagnostic problems in a psychogeriatric nursing home. Autopsies appear to be useful to study causes of death, to verify the clinical diagnoses and to evaluate the results of treatment. PMID- 2716910 TI - [Registration and cost estimation of clinical and outpatient activities of patients with HIV infection]. AB - The implications of AIDS for health care are unknown. Precise data about the extent to which patients appeal to hospital health care facilities and resulting costs are not available, mainly due to the absence of suitable methods for the registration of demographic, medical and financial data on individual patients in hospitals. In this paper we present the preliminary results of application of a new system which allows such a detailed collection and analysis of data. By evaluating patients with HIV infections treated in the University Hospital Utrecht between January 1, 1987 and July 1, 1988, the mean yearly costs of in- and outpatient treatment of a patient with AIDS (CDC-IV) were found to be Dfl. 40,267.-; those of treatment of patients with other HIV infections ranged from Dfl. 3,629.-(CDC-III) to Dfl. 5,115.-(CDC-II). Comparison of the mean costs for patients who died in that period with those for patients who did not, reveals that patients dead of AIDS would have cost Dfl. 75,289.-yearly and those with AIDS who were alive at July 1, 1988 Dfl. 27,308.-. PMID- 2716911 TI - [Not meningitis but septic shock as the killer in acute meningococcal disease]. AB - The symptoms and clinical course of meningococcaemia in 14 cases are described; 10 patients died; in one of the four survivors amputations were inevitable for necrosis of hands and feet. The foremost symptoms at the first time that a doctor was contacted were fever, lethargy, petechiae and purpura. The fulminant course is shown by the high number of resuscitation at the time of admission or in the first hours after admission, and by the time between first symptoms and death. The mortality of meningococcaemia is mostly not due to meningitis. Most patients die of septic shock even before signs of meningitis can develop. The early signs of meningococcaemia are not those of meningitis, but those of sepsis. Meningism and headache are rare symptoms. The severest symptoms are fever and lethargy, in combination with petechiae and purpura. The fulminant course of the disease requires immediate admission. Treatment of infection and septic shock may be lifesaving. PMID- 2716912 TI - [Direct arteriovenous fistula in the neck: one of the causes of tinnitus]. AB - The most frequent symptom of an arteriovenous fistula is a bruit, often audible to the patient himself. The indication for treatment of such fistulae depends on the severity of the symptoms and on the risks of excessive strain on the heart, circulatory insufficiency and haemorrhages. The treatment of choice of direct communications between arteries and veins is detachable balloon occlusion by a transvascular technique rather than surgery. The method is described and three personal cases are reported. There were no complications, and the hospital stay was limited to 2-3 days. PMID- 2716913 TI - [Psoriasis (day) treatment]. PMID- 2716914 TI - [Drugs in the doctor's bag]. PMID- 2716915 TI - [Thrombolytic therapy of acute heart infarct 1988]. PMID- 2716916 TI - Risk assessment of pressure sores: a comparative study of Norton and Waterlow scores. PMID- 2716917 TI - All change in Salisbury. PMID- 2716918 TI - Induction of gastric cancer in monkeys by N-methyl-N-nitro-N-nitrosoguanidine (MNNG). AB - N-methyl-N-nitro-N-nitrosoguanidine (MNNG) was administered to 9 Macaca fascicularis monkeys (7 males and 2 females) through a tube at a dose of 40 mg/kg body weight 3 times a month. Tumors of the pyloric part of the stomach were observed in 2 male monkeys after MNNG doses of 800 and 848 mg/kg body weight, with a latent period of tumor development of 49 and 50 weeks, respectively. Histologically, in one case the tumor was a solid carcinoma, and in the other it had a mixed structure showing alternating solid and signet ring cell carcinoma areas. PMID- 2716919 TI - In vivo autofluorescence investigations on animal tumors. AB - The in vivo fluorescence behavior of unmarked tissue (autofluorescence) of tumor bearing mice was investigated. An argon-ion laser was used as the excitation source emitting radiation at 351 nm and 364 nn. Fluorescence bands in the red spectral range were recorded. The spectral distribution of the fluorescence of the solid Ehrlich carcinoma was different from that of the neighboring tissue. PMID- 2716920 TI - Osmotic fragility, sialic acid content and survival of circulating erythrocytes in anemic tumor-bearing mice. AB - Effect of tumor growth on the survival of circulating erythrocytes was studied in mice bearing a wide spectrum of experimental tumors. RBC half-life (t1/2), measured by 51Cr-labeling technique, decreased significantly (p less than 0.05) in all the tumor types studied, particularly in transplantable Sarcoma-180 and benzo(a)pyrene-induced primary fibrosarcoma. Changes in erythrocyte morphology like anisopoikilocytosis were also observed in the tumor hosts. Cross-transfusion of 51Cr-labeled RBCs between normal and tumor-bearing animals revealed that both intrinsic and extrinsic factors are responsible for shortened RBC survival. As far as the cellular abnormalities are concerned, the decrease in RBC t1/2 was not attributable to increased osmotic fragility as the cells were observed to be osmotically more resistant. Similarly, membrane sialic acid content was markedly elevated in the tumor hosts, thus the shortened erythrocyte life-span cannot be attributed to decrease in sialic acid content of the erythrocyte membrane. PMID- 2716921 TI - Effect of cisplatin on con A agglutinability of different lymphoid cells of Swiss albino rats. AB - Thymocytes, splenocytes, and lymph node cells showed a differential degree of agglutination which con A, which was the lowest for thymocytes and the highest for lymph node cells. Cisplatin treatment of the cells showed a gradual increase and then decrease in the degree of agglutination of the cells which varied with cisplatin concentration and time of treatment. The cells treated with 20 micrograms/ml of cisplatin for 30 min showed the maximum increase in the degree of con A agglutination. Incubation of these cisplatin-treated cells with D xylose, D-glucose, or sialic acid before con A agglutination showed a decrease in the cell agglutinability which was the lowest for sialic acid-incubated cells. It is suggested that the removal of cell surface carbohydrate moieties after cisplatin treatment may play a role in the changes in con A agglutination of these cells. PMID- 2716922 TI - Blood coagulation changes in rats during development of epithelioma. AB - Coagulation activity in the blood of rats during the development of Guerin epithelioma was studied. Clotting time, level of fibrinogen and some coagulation factors (II, V, VII + X) in the plasma were determined and thromboelastographic studies were performed. Two periods of blood hypercoagulability were observed in the process of epithelioma development. The first a short-term period, was noticed during the first days following the implantation of the neoplastic tissue. The second took place during the intensive growth of the primary tumor and metastases. PMID- 2716923 TI - Retrovirus-neutralizing antibodies in AML and AMMoL patients: stage-specific distribution. AB - Plasma samples of patients with AML or AMMoL were tested for antibodies reacting with gp70 antigens of BaEV and GaLV as well as for antibodies neutralizing BaEV or GaLV. Both frequency and titer values of antibodies were higher in remission than in blastosis. Neutralizing activity could be detected only in those plasma samples which contained antibodies to the appropriate gp70 antigen. The data suggest the presence of retroviruses in humans as antigenic stimuli for the immune system in AML and AMMoL. PMID- 2716924 TI - Circulating immune complexes (CIC) in Hodgkin's disease. I. Levels and two dimensional analysis. AB - A polyethylene glycol 6000 (PEG) mediated precipitation procedure was used to estimate the levels of CIC in sera of healthy donors and patients with Hodgkin's disease (HD). In comparison with the normal serum samples, sera from untreated HD patients showed elevated CIC levels scattered over a wider range and a mean which differed significantly. Sera from treated patients who were in clinical remission exhibited decreased CIC levels. However, the mean level in this category was still above the mean found in the normal sera. The analysis of the data showed that the sera from HD patients in Stage I and II, and with LP and MC type histology showed preferential increase in CIC levels. The analysis of these CICs in 2D-SDS-PAGE and a careful scrutiny of the polypeptide patterns obtained revealed significantly elevated amounts of a component with a Mr of 40 kD and a pI of 5.6 in CICs from the untreated HD patients. Congruent peptide maps of this component and its decreased amounts in CICs from sera of patients in remission suggests its quantitative involvement in the disease. PMID- 2716925 TI - Uroporphyrinogen decarboxylase and porphyrins in the tissue of human clear-cell renal carcinoma and in its maternal renal cortex. AB - The activity of uroporphyrinogen decarboxylase and porphyrin concentration were determined in human clear-cell renal carcinomas and in their maternal renal cortex without evidence of malignancy in 24 men and 8 women. The obtained results were compared with the degree of morphological malignancy of various tumors. No positive correlation was found between the activity of uroporphyrinogen decarboxylase and the concentration of porphyrins in the studied tissues. There was no significant correlation between the activity of this enzyme and the porphyrin level and the degree of morphological malignancy of the tumors. However, in most cases the combined concentrations of three porphyrin fractions (uroporphyrin, coproporphyrin and protoporphyrin) were lower in carcinomas than in the unchanged renal cortex of the same kidney. PMID- 2716926 TI - Alpha-2b interferon in the treatment of advanced chronic lymphocytic leukemia. AB - In four patients treated for progressive B-CLL, stage C, with alpha-2b interferon a detailed analysis of the distribution of surface molecules characterizing both the leukemic and the residual populations of peripheral blood lymphocytes as evaluated by flow cytometry did not reveal any significant changes during and after the interferon therapy. With the dosage of 3 x 10(6) IU of interferon injected subcutaneously three times per week, no effect on progression of the disease was detected. The treatment was well tolerated, thrombocytopenia was the only side-effect observed. PMID- 2716927 TI - Descriptive epidemiology of childhood malignancies in Slovakia. AB - Over the period from 1978 to 1984, 673 neoplastic diseases were ascertained in boys and 517 in girls below the age of 15 years in the population-based cancer registry of Slovakia, giving average annual incidence rates of 142.7 and 114.2, respectively, per million population. With the large use of a standard international classification based on cell morphology, an analysis of very detailed structure of these tumors could be performed. Leukemias, tumors of the nervous system and lymphomas were responsible for nearly 70% of all malignancies in childhood during the period studied. Important increase of the total cancer incidence in boys accompanied only by its slight growth in girls during the longer period 1968-1984 was observed. The decline of the total childhood cancer mortality in Slovakia was less rapid than that observed in recent decades in some developed countries. These findings indicate at least the real existence of opportunities for the reduction of mortality from cancer in childhood in this country, too, obviously by a more effective and general application of actually available methods of treatment. PMID- 2716928 TI - Trends and patterns in cancer incidence in Czechoslovakia, 1968-1985. AB - Cancer incidence rates and trends in Czechoslovakia investigated in the present study are based for the first time on valid data derived mainly from population based cancer registries. All rates were age-adjusted using world standard population as a reference. The results confirmed first of all a real and apparent increase of the whole cancer incidence trends which was more expressed in males. The increase in the overall cancer incidence among males could be attributed to the steadily continuing growth of lung cancer, responsible for one-quarter of all new cases in recent years, and to a lesser extent, also to the rising rates of "other skin", prostatic, colonic and rectal cancer. The rates and trends among females were influenced by increase and dominant position of breast and "other skin" cancer, responsible together for one-third of new cases. Increasing trends were observed for the incidence of the uterine body, ovary, and for the great majority of digestive tract and other cancer sites. A reduction of incidence was seen only for stomach in both sexes, for the uterine cervix among females, and lip cancer among males. The actual rates and trends of cancer incidence in Czechoslovakia could be compared with those observed in other developed countries. The usefulness and unconditional necessity of adequately reliable data on cancer incidence for epidemiological research and administration of cancer control is emphasized. PMID- 2716929 TI - [Is there a specific cerebral organic psychosyndrome following craniocerebral trauma in childhood and adolescence? Neuropsychological and psychopathologic results]. AB - The main clinical features pertaining to the concept of the "psycho-organic syndrome" (POS) were investigated in a sample of children who suffered from severe craniocerebral trauma. The results of the present study failed to confirm the existence of a typical syndrome following cerebral trauma. As 69% of the children had psychiatric disorders, the risk for developing psychiatric disorders was significantly increased in children who had incurred a cortical injury. However, the symptomatology turned out to be nonspecific both in terms of neuropsychological and psychopathological sequelae. Thus, the notion of a unique POS was not supported by our study. Instead our results indicated that the concept should be reevaluated. Beyond that, our results demonstrated how important it is to assess the various behavioral and psychological functioning variables exactly, particularly because of their impact on rehabilitative treatment. PMID- 2716930 TI - [Borrelia encephalitis and catatonia in adolescence]. PMID- 2716931 TI - [Psychiatric symptoms and neuropsychologic manifestations in HIV-infected patients]. PMID- 2716932 TI - [Involvement of apparently normal white brain substance in the disease process of multiple sclerosis]. AB - In a group of patients with a clinically definite diagnosis of multiple sclerosis (MS) the cerebral white matter was investigated by means of quantitative nuclear magnetic resonance imaging (MRI). Measurements were taken from plaque-free regions and compared to a control group of healthy volunteers. A significant prolongation of T1 and T2 values was seen for all regions investigated (frontobasal, temporal, temporoparietal, and upper parietal white matter). In a comparison of MS patients with a short duration of the disease (mean: 1.7 years) with MS patients with a long-standing course of the disease (mean: 15.2 years) a significant prolongation of T2 relaxation times was found in the upper frontal and upper parietal white matter only for the latter group. In keeping with neuropathological findings the noted prolongation of T2 values might most probably be due to an increase of extracellular water secondary to astroglial proliferation. The increase of relaxation times could either be due to degeneration of commissural fibers or be the result of an exhausted capacity for remyelination. Both events are known to occur predominantly in the later stage of the disease. It is concluded that MS represents a disease which is not restricted to limited areas of demyelination but rather involves the entire cerebral white matter. These findings imply possibilities for the assessment of disease progression as well as for therapy. PMID- 2716933 TI - [Combined urodynamic-electromyography study in patients with multiple sclerosis and bladder disorders]. PMID- 2716934 TI - [Space-occupying cyst formation following surgery of malignant gliomas]. AB - Incidence and follow-up of patients with space-occupying cystic lesions after surgery of malignant gliomas are demonstrated. Aetiological aspects and therapeutic possibilities are mentioned. PMID- 2716935 TI - Periarthropathia humeroscapularis and cervical disc herniation. AB - Periarthropathia humeroscapularis (PHS) is a malfunction of the shoulder girdle due primarily to diseases of the periarticular tissue and the joint capsule. Clinically a primary and a secondary syndrome are defined. Spondylogenous cervical spine conditions play an important role as causative factors in secondary PHS, among them cervical disc herniation. Among 141 patients operated on for cervical disc herniation 14 presented with a PHS-syndrome prior to surgery, and 31 patients developed the syndrome postoperatively. The patients belong to a fairly young population and showed no high incidence of a particularly severe cervical spondylosis. PMID- 2716936 TI - [Initial experiences with implanted drug pumps for continuous intrathecal calcitonin therapy in therapy-resistant pain]. AB - The hormone calcitonin has proved itself for some years in the treatment of chronic pain syndromes. In addition to its known influence on calcium exchange it gives vise to an analgesic effect within the central nervous system and this follows systemic administration or after bolus intrathecal injection. Two patients with chronic non malignant pain are presented in whom continuous delivery pumps have been used for intrathecal Lachs-Calcitonin (Karil, Fa. Sandoz). PMID- 2716937 TI - [Occlusion of the intracranial segment of the carotid artery by a hypophyseal tumor]. AB - A patient of 49 years of age presented with clinical signs of acute stroke. Computed tomography revealed a suprasellar mass and cerebral infarct. Angiographically an occlusion of the intracavernous internal carotid artery was found, caused by pituitary tumour. After total removal of the tumour the internal carotid artery was recanalised, as the postoperative angiography showed. The patient's neurological deficiencies disappeared almost completely. The literature is reviewed and our diagnosis and procedures are compared with the published reports. PMID- 2716938 TI - [Non-surgical management of an infected ventriculo-atrial shunt]. AB - We report on a 81-year old patient who showed clinical signs of a shunt infection eight months after implantation of a ventriculo-atrial shunt system Heyer Schulte. The reason was identified to be a massive infection with staphylococcus albus. Elimination of the infection was achieved by intravenous administration of fosfomycine and local instillation of gentamycin into the valve. The follow-up was uneventful for more than two years until the death of the patient in January 1987. PMID- 2716939 TI - [Intracerebroventricular morphine therapy. Apropos of 79 patients]. AB - The authors report their experience in the treatment of 79 patients suffering from intractable cancer pain with intra-cerebro-ventricular morphine. They obtain a long-lasting analgesia (34.2 hours at the beginning of treatment and 27.9 hours at the end; mean follow-up of 65 days) with a very low daily morphine consumption. The results obtained, good and very good in 95% of the cases, could be explained by patients' selection criteria and quality of the follow-up (prospective sheet given to the patients, regular phone calls and consultations in the pain clinic). The authors discuss the indications of this technique in relation with other neurosurgical procedures, taking into account the neurophysiological mechanism of action of morphine. PMID- 2716940 TI - [Pharmacokinetics of cyclosporin A in patients with nephrotic syndrome]. AB - The pharmacokinetics of Cy A have been studied in patients with N.S.. Eight patients (7 M, 1 F) received a single 12.5 mg/kg oral dose and a single 4 mg/kg intravenous dose. Plasma was separated from red blood cells at 22 degrees C, at least 2 hr after drawing. Cy A plasma levels were determined by reverse HPLC. The comparison of our pharmacokinetic parameters for the oral route with those from reference patients showed significant differences for T1/2 Ka and Tmax which were decreased in N.S. For the I.V. route we found a decrease in total plasma clearance (CLTP). Absolute bioavailability (18%) was also diminished. Moreover total cholesterol and B apolipoprotein were increased in our nephrotic population. Cy A is highly bound to lipoprotein and we found a significant negative correlation between CLTP of Cy A and either B apolipoprotein or total cholesterol. We conclude that the increase of lipoprotein in N.S. is probably responsible of the modifications in pharmacokinetics of Cy A. Nevertheless Cy A dosage can be not modified in N.S. when oral route is used and divided by a factor two for the I.V. route. PMID- 2716941 TI - [Pharmacokinetics of intravenous ketoprofen. Therapeutic value in renal colic]. AB - The pharmacokinetics of intravenous ketoprofen were evaluated in 37 patients suffering from acute ureteral colic. Four studies were established to obtain a rapid and persistent analgesic effect: group I: 100 mg of ketoprofen as bolus; group II: short infusion of 100 mg of ketoprofen (1.5 or 2 hours); group III: loading dose of 35 mg ketoprofen plus an infusion of 25 mg/h and 33 mg/h. Serum concentrations of ketoprofen were measured by high pressure liquid chromatography. The mean (+/- SD) values of pharmacokinetic parameters measured with a 2 open compartment model were as follows: distribution half-life: 0.34 +/- 0.19 h; elimination half-life: 2.05 +/- 0.58 h; kel: 0.96 +/- 0.28 h-1; k21: 0.94 +/- 0.42 h-1; k12: 1.00 +/- 0.70 h-1; volume of central compartment: 5.58 +/- 1.67 l; volume of tissue compartment: 5.14 +/- 2.12 l; plasma clearance: 5.10 +/- 1.14 l. h-1. These results concur with previously published data obtained after oral, rectal or intramuscular administration. Ketoprofen due to its peripheric anti-inflammatory, antiprostaglandins and central actions gives the best results with the intravenous administration. Administration of a ketoprofen bolus suppressed pain within ten minutes in 71% of patients. PMID- 2716942 TI - [Experimental study of nephrotoxicity: effects, on the newborn rat kidney, of aminoglycoside administration during gestation]. AB - Treatment of the pregnant rat with aminoglycosides provokes nephrotoxicity in the newborn. This study compares the effects of three antibiotics belonging to this group: gentamicin (same day dose administered in one or two injections according to the groups), sisomicin and dibekacin, all administered during the last phase of gestation. Newborns were tested the day after birth, creatinine clearance was measured and then the kidneys were removed for histopathological examination. Functional variations (diuresis, creatinine clearance) and histological alterations of glomerula and tubules were observed. Slight differences suggest that, depending on the antibiotic used, intra-cellular nephrotoxic mechanisms are not completely identical. The modifications which occur after the administration of aminoglycosides, lead us to believe that further studies on the possible fetal nephrotoxic effects of drugs taken by mothers during gestation should be undertaken. PMID- 2716943 TI - [Anaphylactic shock in hemodialysis: apropos of 2 cases]. PMID- 2716944 TI - [Review: arterial hypertension and advanced age]. AB - In elderly and very old patients, arterial hypertension is a major cardiovascular risk factor. However, its management is still controversial. In this review paper, the effects of old age on cardiovascular homeostasis are discussed. Because of less efficient baroreflexes, increased blood pressure variability, postural hypotension, impaired renal and electrolytes regulation, elderly patients are more prone to side effects of treatment. Special attention should be paid to the blood pressure measurements: in this respect, ambulatory non invasive blood pressure profiles can be particularly helpful for the diagnosis and the control of hypertension. A practical approach acknowledging specific aspects of old age and recent advances in antihypertensive therapy is proposed. PMID- 2716945 TI - Chromogranin A messenger RNA expression in the rat anterior pituitary is permissively regulated by the adrenal gland. AB - The influence of the adrenal gland on the expression of chromogranin A in the anterior pituitary was studied in the rat. Adrenalectomy caused a progressive and pronounced (20% of control levels at day 10 after adrenalectomy) decrease of Chromogranin A mRNA levels in anterior pituitary. Daily injection of dexamethasone (15 micrograms/animal, s.c.) fully reversed the postadrenalectomy decrement in chromogranin A mRNA levels. Chromogranin A protein content, however, was unchanged 10 days after adrenalectomy. In contrast, pro-opiomelanocortin mRNA levels were significantly elevated after adrenalectomy and restored to normal by dexamethasone, with a time course similar to the changes in chromogranin A mRNA levels. These data demonstrate that the adrenal gland permissively regulates chromogranin A expression in the anterior pituitary, at a pretranslational locus, and that this regulation is probably mediated by glucocorticoids. PMID- 2716946 TI - A subset of neurons containing immunoreactive prolactin is a target for estrogen regulation of gene expression in rat hypothalamus. AB - Cells whose nuclei accumulated 3H-estradiol were identified autoradiographically in fixed, frozen sections of colchicine-treated rat hypothalamus (n = 3 animals). After autoradiogram development, these sections were subjected to immunocytochemistry using rabbit antirat prolactin antiserum and the avidin biotinylated horseradish peroxidase method. In the hypothalamus, a substantial subset of the neurons containing immunoreactive prolactin accumulated 3H estradiol in their nuclei: of 3, 642 immunoreactive cells examined, 1,216 had autoradiographically labeled nuclei, or about 33%. The immunoreactive prolactin neurons with autoradiographically labeled nuclei were located in the medial basal hypothalamus intermingled with immunoreactive prolactin neurons whose nuclei were not labeled autoradiographically. Since hypothalamic immunoreactive prolactin neurons have a rich and widely distributed fiber system, the present results suggest that estrogen, acting through a subset of these neurons, can modify directly the neuronal activity of several brain regions which regulate diverse aspects of the reproductive effort. Also, since immunoreactive prolactin and immunoreactive beta-endorphin exist in the same hypothalamic cell population, opioid peptides derived from pro-opiomelanocortin may mediate some effects of estrogen on the neural circuitry regulating reproduction. PMID- 2716947 TI - Receptive female rats stimulate norepinephrine release from olfactory bulbs of freely behaving male rats. AB - In vivo perfusion of the olfactory bulbs (OB) of freely behaving male rats by means of miniaturized push-pull cannulae (PPC) revealed consistently detectable and relatively stable levels of norepinephrine (NE) output. Introduction of a receptive female rat into the male's cage on three separate occasions resulted in a threefold increase in NE output following the second and third, but not the first exposure. No increase in NE was obtained when perfused males were similarly exposed to male rats or in the absence of social stimulation. These results demonstrate a complex, discriminatory in vivo response of the OB noradrenergic system in male rats which may be critically involved in the receipt and processing of socially stimulated memory/recognition cues related to reproduction. PMID- 2716948 TI - Epileptic but not psychogenic seizures are accompanied by simultaneous elevation of serum pituitary hormones and cortisol levels. AB - The circadian rhythm of serum prolactin was determined in 12 patients with seizures, and 28 age- and sex-matched healthy subjects (14 men and 14 women). Blood was also collected every 15 min for 2 h immediately after a simultaneously video/EEG-documented epileptic (6 patients) and psychogenic seizure (5 patients) for the determination of prolactin, thyrotropin, growth hormone, cortisol, melatonin, catecholamines and serotonin. During the seizure-free interval, the circadian profile of serum prolactin was lower in female patients than in healthy women. Serum prolactin, thyrotropin, growth hormone, and cortisol were increased postictally, followed by a decrease, after a grand mal or complex partial seizure, but not after a psychogenic seizure in comparison to baseline serum hormone levels obtained during the same time on a seizure-free day. During the seizure and for 2 h afterwards, blood serotonin, serum melatonin, dopamine, and epinephrine did not alter and were within the reference limits of healthy subjects. Serum norepinephrine was lower in patients compared to healthy subjects (p less than 0.05). The simultaneous elevation of serum prolactin, thyrotropin, growth hormone, and cortisol points to a central stimulation of the hypothalamic pituitary axis during an epileptic seizure, but not during seizures of psychogenic origin. PMID- 2716949 TI - Hypothalamic-hypophyseal vascular connections in the fetal sheep. AB - We have studied the development of the hypothalamic-pituitary vascular connections in the fetal sheep using ink-filling techniques. The presence of ink filled vessels in components of the hypothalamic-pituitary axis is interpreted as indicating patency of the system. Ink-filled vessels were identified in the median eminence, the pituitary stalk and the pituitary gland as early as 45 days of gestation and at all subsequent ages investigated. These results suggest that the pituitary could potentially respond to hypothalamic releasing factors from as early as 45 days of gestation in the fetal sheep. PMID- 2716950 TI - Neuroanatomical localization of sex steroid-concentrating cells in the Japanese quail (Coturnix japonica): autoradiography with [3H]-testosterone, [3H] estradiol, and [3H]-dihydrotestosterone. AB - Steroid autoradiography was undertaken to determine the neuroanatomical loci which might be involved in the activation of steroid-sensitive behaviors in the Japanese quail (Coturnix japonica). Male and female quail were either surgically gonadectomized or photically regressed and implanted with androgen or estrogen to restore normal sexual and courtship behavior. After gonadectomy or implant removal, each quail was injected with 250 microCi of [3H]-testosterone (3H-T), [3H]-estradiol (3H-E2), or [3H]-dihydrotestosterone (3H-DHT), sacrificed, processed for autoradiography, and the telencephalon, diencephalon, mesencephalon, and rhombencephalon were examined for labelled cells. Following 3H T or 3H-E2 injection and autoradiography, labelled cells were found in nucleus septalis lateralis (SL), nucleus preopticus medialis (POM), nucleus paraventricularis (PVN), regio lateralis hypothalami (LHy), nucleus inferior hypothalami (IH), nucleus infundibuli (IN), nucleus intercollicularis (ICo), substantia grisea centralis (GCt), nucleus taeniae (Tn), and in the reticular formation near nucleus motorius nervi trigemini (MV). In addition, following 3H E2 autoradiography, labelled cells were found around nucleus accumbens (Ac). Following 3H-DHT autoradiography, labelled cells were found only in SL, PVN, Tn, LHy, ICo, and CGt. No labelled cells were found in Ac, POM, IH, IN, or MV even after long exposure times. These results suggest that the nuclei labelled following 3H-E2 but not 3H-DHT administration bind exclusively the aromatized metabolites of T. Since quail show a sex difference in male-typical copulatory behavior in response to E2, labelled cells were counted in POM, LHy, IH, and Tn of male and female quail following 3H-E2 injection and autoradiography. No sex differences in the number of labelled cells were found in POM, LHy, or IH. Males were found to have more labelled cells than females in Tn. These results show that sex differences in male-typical copulatory behavior are not due to sex differences in the number of cells binding estrogens in POM. The results reported here constitute the most neuroanatomically extensive report of steroid binding cells to date for a galliform brain, the first comparison in a galliform bird of the distributions of cells labelled following injection of 3H-T, 3H-E2, and 3H DHT and the first analysis of sex differences in numbers of estrogen-binding cells in four nuclei in the avian brain. PMID- 2716951 TI - Distribution and partial characterization of immunoreactive prolactin in the rat brain. AB - Immunoreactive (IR) prolactin was localized immunocytochemically in cell bodies in the mediobasal hypothalamus and in fibers in many regions of the rat brain. The cell bodies were found in the arcuate nuclei and the adjacent areas ventral to the ventromedial nuclei. Fiber projections extended rostrally to and/or through the anterior hypothalamus, preoptic area, nucleus accumbens, septum, diagonal bands of Broca, caudate-putamen, frontal cortex and accessory olfactory bulb; laterally to the amygdala, especially the central nucleus and some parts of the medial nucleus; caudally to and/or through the midbrain central gray, reticular formation, parabrachial region, and several portions of the lower brain stem and spinal cord extending to sacral levels. The system appears to be essentially identical to that containing proopiomelanocortin (POMC) and its processed peptides, as shown by double immunocytochemistry. Preabsorption of the antiprolactin antiserum with either prolactin or the 16,000-dalton N-terminus of POMC eliminated immunoreactivity in the brain. Preabsorption with other POMC derived peptides, including beta-lipotropic hormone, beta-endorphin, met enkephalin, adrenocorticotrophic hormone (1-24), corticotropin-like intermediate lobe peptide, alpha- and gamma-melanocyte-stimulating hormones and an octapeptide region of the N-terminus of POMC bearing some homology with prolactin, did not eliminate immunoreactivity in the brain. Similarly, preabsorption with growth hormone, luteinizing hormone, follicle-stimulating hormone, motilin or fetuin did not eliminate immunoreactivity in the brain. The antiprolactin antiserum also recognized all cells in the intermediate lobe and a subset of cells in the anterior lobe of the Snell dwarf mouse pituitary. This immunoreactivity was eliminated by preabsorption of the antiserum with prolactin or with the 16,000 dalton N-terminus of POMC. These results suggest that IR prolactin in the brain may be related to the N-terminus of POMC. Additional results based on one- and two-dimensional gel electrophoresis and immunoblotting indicate that the antiprolactin antiserum used in the majority of the immunocytochemical studies recognized a number of proteins. PMID- 2716952 TI - Testicular interstitial cells as targets for peripheral benzodiazepines. AB - We evaluated the 'in vitro' effect of a selective peripheral benzodiazepine (BZD) receptor agonist, Ro 5-4864, on basal and hCG-stimulated androgen production by testicular interstitial cell suspensions. Ro 5-4864 (10(-9)-10(-5) M) induced a significant increment of basal testosterone release into the medium. In addition, under conditions of hCG stimulation, Ro 5-4864 (10(-7) M) induced a potentiated response to the gonadotropin in a dose-dependent manner. The selective peripheral BZD antagonist PK 11195 fully prevented the stimulatory effect of Ro 5-4864. On the other hand, clonazepam, a central BZD agonist, failed to affect androgen production significantly, whereas diazepam (10(-5)-10(-4) M), which binds to both central and peripheral BZD receptors, was able to induce a significant increment of basal and hCG-stimulated testosterone production. These results suggest that under our experimental conditions Ro 5-4864 exerts an effect on testicular steroidogenesis, presumably through binding to the previously described peripheral-type BZD receptor. PMID- 2716953 TI - Response of a GH- and TSH-secreting pituitary adenoma to a somatostatin analogue (SMS 201-995): evidence that GH and TSH coexist in the same cell and secretory granules. AB - A 29-year-old male presented with acromegaly and hyperthyroidism and was found to be hypersecreting both GH and TSH. A somatostatin analogue, SMS 201-995, at doses of 50 and 100 micrograms s.c. 3 times a day produced an acute decrease in serum GH and TSH levels to less than 20% of basal concentrations. An increase in serum SMS 201-995 levels preceded the decline in serum GH and TSH levels. Partial resolution of signs and symptoms related to GH excess occurred and the patient developed normal serum thyroxine levels. These latter effects were maintained during the 3.5 months of SMS 201-995 therapy; however, pituitary adenoma size as judged by MRI was unchanged. Side effects of therapy were minimal and included transient abdominal pain, diarrhea and weight gain. Adenomatous pituitary tissue was surgically removed and placed in monolayer culture. It was observed that SMS 201-995 produced significant inhibition of GH and TSH release. Histology revealed a partly chromophobic, partly acidophilic adenoma containing GH and TSH. Electron microscopy showed a pituitary adenoma which appeared to consist of smaller cells resembling somatotrophs and larger cells exhibiting ultrastructural features of thyrotrophs. Immunoelectron microscopy localized the two biochemically distinct peptides in the same cell type, often in the same secretory granules. No morphologic abnormality, attributable to SMS 201-995 medication, was evident. Thus it can be concluded that pituitary adenomas can simultaneously secrete GH and TSH which produce acromegaly and hyperthyroidism. These bi-hormonal tumors may synthesize GH and TSH in the same cell type.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716954 TI - Comparison of the duration of action of nalmefene and naloxone on the hypothalamic-pituitary axis of the rhesus monkey. AB - The duration of action of nalmefene, a relatively new opiate antagonist, on the hypothalamic-pituitary axis of the rhesus monkey was compared to that exhibited by naloxone. Ovariectomized monkeys (n = 5) were pretreated with 10 mg nalmefene, 10 mg naloxone or an equivalent volume of saline 12, 24, or 48 h prior to the administration of 10 mg morphine. Blood samples were collected by venipuncture 0, 1, 2, 3 and 4 h after injection of morphine and were assayed for luteinizing hormone (LH) and prolactin (PRL). Duration of action of these two opiate antagonists was estimated from their ability to block morphine inhibition and stimulation of LH and PRL release respectively. Morphine reduced serum LH concentration by 60% and increased PRL levels approximately 4-fold in saline pretreated animals. Administration of nalmefene either 12 or 24 h, but not 48 h prior to morphine, significantly antagonized the effects of this opiate on LH and PRL release. In contrast, naloxone at all pretreatment intervals failed to block morphine's effect. We conclude that a single 10 mg bolus injection of nalmefene exerts significant activity at the opiate receptors that mediate the effects of morphine on LH and PRL release for at least 24 h after administration, whereas the same dose of naloxone has a duration of action less than 12 h. Based on this finding it is likely that the effects of endogenous opioid peptides in the rhesus monkey can be chronically antagonized by the daily administration of nalmefene. PMID- 2716955 TI - Effect of morphine and naloxone on plasma prolactin concentrations in the fetal sheep and pregnant ewe during late gestation. AB - This study investigated the effects of intrafetal morphine or naloxone administration on fetal and maternal plasma prolactin concentrations in the sheep during late pregnancy (117-143 days gestation). After intravenous morphine (3 mg/kg) there was a significant increase (p less than 0.05) in fetal plasma prolactin concentrations which was sustained for 180 min post-injection. There was no significant effect of either gestational age (125-133 days compared to 134 143 days gestation) or repeated administration (up to 3 treatments) of morphine on the fetal prolactin response to morphine. Intrafetal administration of naloxone (3.8 mg/kg bolus + 9.9 mg/kg/60 min), blocked the fetal prolactin response to morphine. Maternal plasma concentrations of prolactin were significantly increased (p less than 0.05) at 180 min after the intrafetal morphine bolus. When naloxone alone was infused, there was no change in fetal plasma prolactin concentrations, but there was a significant fall (p less than 0.05) in maternal plasma prolactin from 25 min after the start of the naloxone infusion. Thus, acute administration of morphine is associated with fetal and maternal hyperprolactinaemia. Although the endogenous opioids do not appear to mediate basal prolactin secretion in the fetus, they may have a role in the control of prolactin release in the pregnant ewe during late gestation. PMID- 2716956 TI - Role of steroid 5 alpha-reductase activity in sexual differentiation of the guinea pig. AB - The possible role of 5 alpha-reduction of steroids in the sexual differentiation of guinea pigs was determined by treating pregnant guinea pigs with a 5 alpha reductase activity (5 alpha RA) inhibitor (17 beta-N,N-diethylcarbamoyl-4-methyl 4-aza-5 alpha-androstan-3-one, 4MA, 10 mg/day) from day 30 to 55 of gestation. 5 alpha RA in fetal diencephalon tissue obtained from 4MA-treated mothers on day 55 of gestation was suppressed compared to that of control tissue. Four litters receiving 4MA were carried to term along with an equal number of litters receiving the vehicle alone. Males that received 4MA in utero (n = 6) had altered external genitalia, i.e., hypospadias and reduced anogenital distances, but their adult copulatory behavior did not differ from that of controls (n = 7). In order to evaluate treatment effects on the hypothalamic-pituitary axis, all animals were challenged with estradiol benzoate (EB, 10 micrograms in oil, s.c.) 2 weeks after gonadectomy. Serial plasma samples were obtained and analyzed for luteinizing hormone (LH) using an heterologous radioimmunoassay. Control females (n = 13) and 4MA-treated females (n = 5) released LH in surge quantities about 42 h after EB treatment. Plasma from 4MA-treated females differed from controls in that it contained greater overall quantities of LH (p less than 0.05) and greater amounts at the time of the LH surge (p less than 0.05). Regardless of treatment males did not respond to EB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716957 TI - Presence of prolactin-like immunoreactivity and bioactivity in rat spinal cord. AB - Pursuant to our identification of prolactin-like immunoreactivity (PLI), widely distributed in rat brain, the spinal cord was examined for the presence of this pituitary-hormone-like protein. PLI was present in all spinal cord extracts examined and averaged 500 +/- 53 pg/mg protein. Hypophysectomy, causing a fall in serum prolactin to undetectable levels, was not associated with any change in levels of PLI in spinal cord. Recovery of rat prolactin standards added to spinal cord homogenates was 97.6 +/- 3.9%. When increasing concentrations of spinal cord extract were assayed in a prolactin radioimmunoassay, displacement of rat 125I Prolactin from antiserum was parallel to that displacement produced by increasing concentrations of rat anterior pituitary standards. Upon subjection to gel permeation chromatography, the elution profiles of immunoreactive prolactin from spinal cord were different from the profiles of anterior pituitary prolactin. In addition to an immunoreactive prolactin peak eluting with pituitary prolactin, spinal cord extracts showed a large void volume peak and late eluting low molecular-weight materials not seen with anterior pituitary. In the Nb2 lymphoma cell assay, all spinal cord extracts demonstrated prolactin-like bioactivity with a bioactivity/immunoreactivity ratio of 1.05 +/- 0.13. We conclude: (1) PLI, widely distributed in rat brain, is also present in spinal cord; (2) spinal cord prolactin levels are independent of levels in pituitary and peripheral circulation; (3) this immunoreactive prolactin is bioactive, and (4) differing gel permeation chromatographic elution profiles indicate that there may be some molecular differences between pituitary and spinal cord prolactin. PMID- 2716958 TI - Differential responses in vasopressin and oxytocin gene expression in distinct hypothalamic nuclei after hypothalamoneurohypophyseal disconnection and vasopressin substitution. AB - A possible feedback of circulating vasopressin (VP) on the expression of its gene in the hypothalamoneurohypophyseal system was studied in rats with depleted stores of neurohypophyseal hormones. The neural lobe of the pituitary gland was disconnected by anterolateral deafferentation of the basal hypothalamus using a Halasz knife cut. One group of lesioned animals was substituted continuously with VP using mini-osmopumps. After 1 week, the lesion had caused a complete disappearance of neurohypophyseal hormones from the neurointermediate pituitary and induced a 2-fold increase in water intake and an increase in plasma osmolality of approximately 7 m0sm/kg. VP mRNA levels of the supraoptic nucleus (SON), paraventricular nucleus (PVN) and suprachiasmatic nucleus (SCN) were measured in punched tissue by Northern blot analysis and dot-blot analysis. VP mRNA levels of the SON and PVN were reduced by 50% due to the deafferentiation, which might have been caused by degeneration. VP substitution of the lesioned animals normalized water intake but not plasma osmolality. In the VP-substituted animals, VP mRNA levels of the SON were 2-fold reduced compared to the nonsubstituted lesioned animals. The VP mRNA levels of the PVN were not affected by VP substitution. The VP mRNA levels of the SCN increased 2-fold after the lesion but were not influenced by VP substitution. Concomitant determination of oxytocin (OT) mRNA showed that OT mRNA levels in the PVN and SON were not affected by the deafferentiation and did not respond to VP substitution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716959 TI - Localization of aromatase in synaptosomal and microsomal subfractions of quail (Coturnix coturnix japonica) brain. AB - The subcellular distribution patterns of aromatase, 5 alpha- and 5 beta-reductase in the hypothalamus/preoptic area of Japanese quail were studied using standard methods of centrifugation, and fractional constituents were identified by marker enzymes. Aromatase was concentrated 8-fold in the 100,000 g pellet (P3) along with a 3-fold enrichment in the microsomal marker NADPH-cytochrome c reductase (NCR) a result consistent with glandular tissues. In addition, aromatase was enriched 2-fold in the 11,000 g pellet (P2) and, owing to its large size, this fraction accounted for more total activity than P3. Although P2 contained the mitochondrial marker succinate dehydrogenase (SDH), treatment with Triton X-100 to solubilize membranes and release occluded enzymes increased measured NCR and the cytosol marker lactate dehydrogenase (LDH) 2- and 4-fold, respectively- evidence that this fraction was composed of mitochondria plus synaptosomes (pinched-off nerve terminals). To further explore the location of aromatase in the 11,000 g fraction, P2 was exposed to hypotonic buffer, a treatment known to cause lysis of synaptosomes, and then separated into three fractions P2a (11,000 g pellet), P2b (100,000 g pellet) and P2s (100,000 g supernatant). Aromatase colocalized with the microsomal marker NCR (13- and 4-fold increase, respectively) in the 100,000 g (P2b) pellet which was, however, devoid of mitochondrial enzyme activity. We infer from this that a significant portion of aromatase in brain is associated with smooth membranes present inside synaptosomes. 5 beta-Reductase in quail brain subfractions was enriched 6-fold in the 100,000 g supernatant together with a 4-fold enrichment in the cytosolic marker LDH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716960 TI - Multimodality evoked potentials in children with moyamoya disease. AB - Twenty Japanese children with Moyamoya disease were investigated by examining the multimodality evoked potentials (BAEPs, FVEPs and SSEPs). BAEPs were abnormally prolonged wave I-III and wave III-V in each one (10%). FVEPs were abnormal in 6 (30%), included prolonged latencies, reduced amplitudes and poor waveform in one each, and delayed latencies as well as reduced amplitudes in three. FVEPs significantly correlated with intellectual deterioration (p less than 0.01). SSEPs were abnormal in 13 (65%) significantly more frequent than BAEPs and FVEPs (p less than 0.01); reduction of N20 in 7, delayed latencies of N13-N20 in 4, and both delayed latencies and reduced amplitudes of N20 in two. These findings correlated well with the neurologic deficits, CT findings and EEG findings in this progressive cerebrovascular disease (Moyamoya disease) in children. PMID- 2716961 TI - Posture during head turning in pre-term infants: a longitudinal study of 15 low risk infants of 32-36 weeks of conceptional age. AB - As part of a longitudinal study of spontaneous behaviour from 32-36 weeks of conceptional age, body posture was studied during spontaneous head movements in 15 low-risk pre-term infants. At the moment of an active head position in the midline, the most frequently observed posture was a symmetrical one in which the arms were fully flexed and the legs partly extended. With regard to the arm position no clearly developmental trend was noted. With regard to the leg position an increase of the partly flexed position of the limbs related to conceptional age was found. The observed postures during activity in our study showed a cephalocaudal acquisition of flexor tone. A symmetrical posture, when the head is in the midline, may be a sign of normality in pre-term infants. PMID- 2716962 TI - Kinetic study of catecholamine metabolism in hereditary progressive dystonia. AB - Kinetics of catecholamine biosynthesis and metabolism have been examined in patients with hereditary progressive dystonia with marked diurnal fluctuation of symptoms (HPD, Segawa's disease). Three patients and a healthy control received an oral load of deuterated tyrosine, and monodeuterium labelled catecholamines and their metabolites in urine and plasma were examined by gas chromatography mass spectrometry. Patients excreted normal amounts of the primary metabolites of dopamine (dihydroxyphenylacetic acid, homovanillic acid) in urine, suggesting normal rates of dopamine production. However, the biological half-life of dopamine in the patients was reduced to about half that of controls. Noradrenaline biosynthesis and metabolism were normal. Taken together, these results are interpreted to show a reduced biological half-life of dopamine in the brains of these patients, possibly caused by a defect in dopamine storage. Impaired dopamine storage may be the basis of the diurnal fluctuation in symptoms. PMID- 2716963 TI - Intermittent disconjugate eye movements--a sign of raised intracranial pressure with brain stem compression. AB - Two patients are reported who demonstrated disconjugate eye movements associated with raised intracranial pressure. This physical sign has not previously been recorded in association with raised intracranial pressure. PMID- 2716964 TI - Cerebral blood flow abnormalities in cerebral palsied children with a normal CT scan. AB - Cerebral palsy (CP) is often a consequence of a hypoxic-ischemic encephalopathy and/or intracerebral hemorrhage secondary to pre- and peri-natal asphyxia. Hypodense lesions on the CT-scan are found in about 70 to 80% of CP-patients. In the present study, regional cerebral blood flow (CBF) was measured in CP-patients having a normal CT-scan. The aim was to correlate the CBF changes with the clinical and the etiologic findings. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. The mean CBF value in 20 CP-patients, age 6-19 years, was 67 +/- 11 (1 SD) ml/100g/min, the same value as found in the 9 normal children. However, 16 of the 20 CP-patients had focal hypoperfused areas on the tomographic flow map. In the preterm infants (n = 7) the hypoperfused areas were mainly located in the posterior watershed areas, often in one hemisphere only. In the term infants (n = 13) both asymmetrical and symmetrical hypoperfused areas were observed in the anterior and posterior watershed areas. In addition, several children had larger low flow areas in the frontal and fronto parietal lobes. In both groups, a relatively poor concordance was observed between the clinical findings and the expected location of the low flow area. PMID- 2716965 TI - Epidemiology of spastic tetraplegic cerebral palsy in Sweden. I. Impairments and disabilities. AB - Ninety-six children and adolescents, born in 1959-78, with spastic tetraplegic cerebral palsy (TPL) were studied in terms of impairments and disabilities. The series was population-based and derived from 15 Swedish counties, and the city of Gothenburg, a population of 4.5 million people in all. All the patients had a pronounced motor disability with severe spastic pareses of all four limbs, and all of them were severely mentally retarded. None of them could speak. Ninety four percent had epilepsy, 47% were severely impaired visually. Additional impairments were hip luxation(s) in 75%, severe contractures in 73% and scoliosis in 72%. Sixty-eight percent of cases had secondary microcephaly; 13% were born microcephalic. - The general uniformity of the severity and multiplicity of the impairment and disability pattern is emphasized - making the TPL group suitable for scientific care load studies on the basic requirements for the care of the profoundly retarded with maximum multi-handicaps. PMID- 2716966 TI - Epidemiology of spastic tetraplegic cerebral palsy in Sweden. II. Prevalence, birth data and origin. AB - The prevalence and origin of spastic tetraplegic cerebral palsy (TPL) was investigated in a population-based study from 15 Swedish counties and the city of Gothenburg. The series comprised 96 children and adolescents born in 1959-1978. The prevalence at the ages of 5-24 years was 8 per 100,000. The etiological analysis was based on the 91 TPL subjects, born in Sweden. The preterm rate was 7%. There were 46 males and 45 females. Excluding postnatal cases, the mean birth weight was 2949 g and the proportion of SGA 21%. An obvious prenatal origin was found in 21 (mainly microcephaly, other CNS maldevelopment, intrauterine CMV infection), an obvious perinatal origin in nine (mainly cerebral hemorrhage), and an obvious postnatal origin in 16 (mainly CNS infection). A potential prenatal origin was considered in six, a combined pre- and perinatal in 15, a perinatal in 13 and in 11 the origin of TPL was untraceable. An optimality analysis showed that reduced optimality in the partum and postpartum periods discriminated between pre- and perinatal etiology of TPL. Cases with obvious perinatally derived TPL had a high load of complications in the partum and postpartum periods, whereas these periods had been fairly uncomplicated in cases with an obviously prenatal origin of TPL. - It was indicated that some 50-55% of TPL was prenatally, around 30% perinatally and some 15-20% postnatally derived. The low preterm rate as well as the proportion of perinatal brain damage in TPL cases has probably increased in recent birth year periods due to the appearance of very preterm, severely multi-impaired children in the CP panorama. PMID- 2716967 TI - Catalepsy induced by combinations of ketamine and morphine: potentiation, antagonism, tolerance and cross-tolerance in the rat. AB - Previous studies demonstrated that both ketamine and morphine induced analgesia and catalepsy in the rat. Pre-treatment with ketamine produced cross-tolerance to morphine, whereas pretreatment with morphine did not induce cross-tolerance to ketamine but rather augmented the cataleptic response; this augmentation was attributed to residual morphine in the brain. The present studies explored the duration of the loss of righting reflex induced by sub-effective doses of ketamine and morphine, administered simultaneously. There was mutual potentiation between sub-effective doses of ketamine and morphine, but sub-effective doses of ketamine partly antagonized fully-effective doses of morphine. Latency to the loss of righting reflex, rigidity and behavior on recovery, reflected the relative predominance of ketamine or morphine in each combination. Naloxone inhibited the induced cataleptic effects. The degree and time course of development of tolerance to daily administration of sub-effective dose combinations of ketamine and morphine were similar. Rats, tolerant to ketamine dominant combinations, were cross-tolerant to both drugs, while those tolerant to morphine-dominant combinations were cross-tolerant to morphine but showed either no cross-tolerance or an augmented response to ketamine. While the mutual potentiation, antagonism and tolerance suggest common mechanisms for the induced catalepsy, differences in latency, rigidity and behavior, asymmetry of cross tolerance and a widely-different ID50 for naloxone would argue against an action at a single opioid site. PMID- 2716968 TI - Role of endogenous enkephalins in locomotion and nociception studied with peptidase inhibitors in two inbred strains of mice (C57BL/6J and DBA/2J). AB - Acetorphan, a parenterally active enkephalinase inhibitor, induced dose dependently a naloxone-reversible analgesia on the hot-plate jump test in DBA/2J (DBA2) mice but was devoid of effects in C57BL/6J (C57) mice. By contrast, acetorphan increased locomotion in both strains; however, the DBA2 strain was much more sensitive than C57 mice to the locomotor stimulant effect. The increased locomotion was antagonized by naloxone in both strains. These data suggest that endogenous enkephalins modulate nociception and locomotion in the two inbred strains differently. PMID- 2716969 TI - Muscarinic pharmacology of the spinal cord of the neonatal rat in vitro. AB - The pharmacology of two muscarinic responses, recorded from the ventral roots of the spinal cord in the neonatal rat, have been compared: the depolarising response and the inhibition of the monosynaptic compound action potential (CAP). Pirenzepine was more potent than AF-DX 116 in antagonising the depolarising response. However, the potencies of these compounds indicated that this response may be mediated by neither M1 nor M2 (cardiac-like) receptors. The drug AF-DX 116 (1 microM), but not pirenzepine, selectively reduced the inhibitory effect. It is concluded that the receptors mediating these two responses are different. PMID- 2716970 TI - Effects of some centrally acting muscle relaxants on spinal root potentials: a comparative study. AB - The effects of intravenously administered mephenesin, tolperisone, baclofen, diazepam and midazolam on reflex activity were studied in unanesthetized spinal cats. Monosynaptic, as well as polysynaptic ventral root reflexes, the dorsal root potential and the dorsal root reflex were recorded simultaneously from L6-S1 segments. An analogue integrating method was developed for quantitative monitoring and recording ipsilateral spinal root potentials evoked by stimulation of the tibial nerve. Mephenesin (12.5-50 mg/kg) caused a significant and dose dependent reduction in the polysynaptic and the dorsal root reflexes, slightly decreased the dorsal root potential but minimally affected the monosynaptic ventral root reflex. Tolperisone (2.5-10 mg/kg) dose-dependently inhibited both ventral root reflexes and the dorsal root reflex. It slightly prolonged the dorsal root potential without affecting the amplitude. Baclofen (0.5 mg/kg) abolished the monosynaptic reflex, partially inhibited the polysynaptic reflex, while dorsal root responses were less attenuated. Both benzodiazepines exerted similar actions, both qualitatively as well as quantitatively: the polysynaptic reflex was partially reduced while the monosynaptic reflex was not modified by diazepam or midazolam. Dorsal root responses were enhanced and the half-time of decay of the dorsal root potential was prolonged. Different patterns of action of muscle relaxants studied here are discussed in terms of their possible mechanisms of action. Profound depressant effects of mephenesin and tolperisone on the dorsal root reflex are in contrast to the small effect of both drugs on the dorsal root potential and might reflect their inhibition of spike-generating mechanisms. For a yet unknown reason, various spinal pathways are affected differentially by baclofen. In spinal cats, the reduction by benzodiazepines of the polysynaptic reflex may be related to the potentiation of some unidentified GABA-ergic inhibitory processes. The use of water-soluble midazolam, as a model compound instead of diazepam, is suggested because the usual organic solvents for diazepam may affect its action. PMID- 2716971 TI - Distribution of the 4-aminopyridine derivative 3-methoxy-4-aminopyridine in mice. AB - The tissue distribution of [14C]3-Methoxy-4-aminopyridine was studied after intravenous administration in mice using whole body and microautoradiography. Dense accumulation was found in cholinergically innervated, secretory organs. High radioactivity was detected in the adrenal medulla suggesting that the observed excitement and hyperglycemia are due to the stimulation of catecholamine secretion. [14C]3-Methoxy-4-aminopyridine quickly passes the blood brain barrier and predominantly accumulates in the hippocampus, the thalamic nuclei and the cortex. PMID- 2716972 TI - Pentobarbital attenuates the antinociceptive effect of intranigral morphine. AB - This study was conducted to characterize the temporal relationship between intranigral injection of morphine and the onset of antinociception. The principal findings are: 1) morphine produces antinociception on the hot plate test within three minutes after intranigral injection, 2) the tail flick reflex cannot be measured within the first 30 minutes following intranigral morphine due to motor effects, and 3) pentobarbital suppresses the antinociceptive effect of intranigral morphine on the tail flick test. These findings support the conclusion that the antinociceptive effects of intranigral morphine are mediate by the substantia nigra. PMID- 2716973 TI - The surgical anatomy of the cerebral sulci. AB - Intraventricular and intra-axial lesions can be reached through a transsulcal approach, avoiding the more extensive cerebral tissue damage that may result from a conventional cortical incision. The sulci of five cadaver brains fixed in formalin solution were dissected using the operating microscope. The brains were photographed for surface mapping and x-rays to demonstrate underlying ventricular relationships were taken. The brains were then coronally sectioned to characterize anatomical relationships between sulci and deep brain structures. Three important sulci were identified and thoroughly characterized with respect to surface relationships, average depth, and underlying structures that can be readily approached. Surgical application of these findings is discussed. PMID- 2716974 TI - Microsurgical DREZ-otomy for the treatment of spasticity and pain in the lower limbs. AB - The authors report on a series of 53 bedridden patients suffering from harmful spasticity in one (6) or both (47) lower limbs, who were treated with microsurgical DREZ-otomy. Surgery was performed to treat fixed abnormal postures in flexion in 49 patients and hyperextension in 3, and, additionally, to treat pain in 37 patients. Microsurgical DREZ-otomy was introduced in 1972, on the basis of anatomical studies of the human dorsal root entry zone (DREZ) showing a topographical segregation of the afferent fibers according to their size and functional destinations. It consists of a 2 mm deep microsurgical lesion directed at a 45 degrees angle in the posterolateral sulcus and penetrating the dorsal root entry zone in its ventrolateral aspect, at the level of all the rootlets considered involved in spasticity (and pain). It destroys mainly the lateral (nociceptive) and central (myotatic) afferent fibers as well as the facilitatory medial part of the Lissauer tract, while sparing most of the medial (lemniscal) fibers, the suppressor lateral part of the Lissauer tract, and more or less of the dorsal horn (DH). The postoperative results were evaluated after a mean follow-up period of 3 years and 4 months. Both spasticity and spasms were significantly decreased or suppressed in 75% and 88.2% of the patients, respectively. When present, pain was relieved without abolition of sensation in 91.6%. These benefits--combined with complementary orthopedic surgery in 23 patients--resulted in either disappearance or marked reduction of the abnormal postures in 85.3% of the patients and of articular limitations in 96.8%. Mild-to severe complications occurred in 25 patients and precipitated or were responsible for death in 5. This is explained by the fact that the general and neurological conditions of most of the patients--especially those affected by multiple sclerosis--were precarious. MDT has, however, enabled a majority of these severely disabled patients to sit and lie comfortably, and has allowed them to reach a significantly improved quality of life. PMID- 2716975 TI - Acute effects of changing plasma osmolality and colloid oncotic pressure on the formation of brain edema after cryogenic injury. AB - The cerebral effects of alterations in plasma osmolality (Osm) and colloid oncotic pressure (COP) were examined in normocarbic, normothermic, pentobarbital anesthetized rabbits that had been subjected to cryogenic brain injury. Monitored variables in all animals included mean arterial, right atrial, and intracranial pressures (MAP, CVP, and ICP), electroencephalographic (EEG) recordings, and cerebral blood flow (CBF). When surgical preparation was complete, a left parietal lesion was produced with liquid nitrogen. Group 1 (control, n = 8) animals subsequently received only maintenance fluids [lactated Ringer's solution (LR)]. One hour after injury, 3 other groups of animals underwent 45 minutes of plasmapheresis, carried out by arterial phlebotomy (packed red cells returned), with separated plasma being replaced by one of three fluids given in amounts sufficient to maintain MAP and CVP at baseline values. The three fluids were 1) 6% hetastarch in hypo-osmotic LR [Group 2 (Hypo-Osm), n = 6; COP = 21 mm Hg, Osm = 130 mOsm/kg]; 2) iso-osmotic LR [Group 3 (Hypo-COP), n = 8; COP = 0; Osm = 305]; and 3) 6% hetastarch in iso-osmotic LR [Group 4 (Iso-Osm/COP), n = 8; COP = 21, Osm = 310]. The animals were killed by exsanguination 25 minutes after completion of plasmapheresis. The brain was removed, the hemispheres separated, weighed, and sliced, and the specific gravities (SpGr) of the regional tissue determined. There were no differences in MAP, CVP, regional CBF, or EEG activity among the groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2716976 TI - Prognostic factors in well-differentiated cerebral astrocytomas in the adult. AB - Eighty-five "well-differentiated" astrocytomas in adults (age, greater than or equal to 18 years), operated on between 1950 and 1982, were retrospectively reviewed. The pilocytic variant was not included. Twenty-four clinical and 8 histological factors were analyzed to investigate their importance in predicting length of survival. Multivariate analysis showed that the following variables were correlated with survival time (P less than 0.01): extent of surgical removal, altered consciousness during preoperative examination, focal deficit as presenting symptom, performance status (Karnofsky rating) after surgery, and vessel size in the surgical specimen. Total removal of the tumor was related to a higher 5-year survival rate (51%) than subtotal removal (23.5%), and none of the patients with partial removal survived more than 5 years. Postoperative radiotherapy (40-55 Gy) improved only the 1- and 3-year survival rates. Based on the significant factors provided by multivariate analysis, a score was developed to detect subgroups with different prognoses. Median survival time ranged from 383 days for patients with a score greater than or equal to 2.5 to 1,533 days for those with a score less than 0.5; no patient with a score greater than or equal to 1.5 survived more than 10 years. The percentage of recurring astrocytomas that showed anaplastic areas in the second biopsy specimen was 79%. Total surgical removal is the most important factor in the management of well-differentiated astrocytomas, whereas the efficacy of postoperative radiotherapy still needs to be confirmed by prospective and randomized studies. The rationale for treating incompletely resected astrocytomas with radiation therapy could lie in the high incidence of malignant transformation. PMID- 2716977 TI - Colloid cysts: experience with the management of 84 cases since the introduction of computed tomography. AB - A retrospective review of colloid cysts diagnosed from 1974 to 1986 emphasizes the presenting symptoms of these lesions, their surgical management, and the contribution of modern imaging techniques to their diagnosis and therapy. In this 12-year period, 84 patients (45 men and 39 women) had a colloid cyst diagnosed. The patients' mean age was 46 years (range, 7-82 years). Surgery was performed in 55 patients, 7 of whom had undergone prior surgery elsewhere. The surgical approaches used were transfrontal-transventricular, transcallosal, computer assisted stereotactic aspiration and resection by stereotactic craniotomy, and shunting of cerebrospinal fluid without removal of the lesion. There was no operative mortality, but complications occurred in 15 patients (27%). Preoperative imaging showed hydrocephalus in 93% of the patients: severe in 43%, moderate in 36%, and mild in 14%. In the surgically treated group, the most common presenting symptoms were headache, change in mental status, ataxia, nausea and vomiting, visual disturbance, emotional lability/inappropriate affect, depersonalization, and hypersomnolence. Twenty-four patients for whom surgery was not recommended are being followed up closely. Most of these patients had normal ventricles. The symptoms in this group included headache, anxiety/nervousness, ataxia, memory impairment, visual disturbance, and seizures. Five autopsy cases of patients with colloid cysts were available during this period and were reviewed. Direct removal of colloid cysts can be accomplished with low morbidity and mortality, avoiding the frequent revisions and complications related to shunt procedures. There is a subgroup of colloid cysts that can be operated upon electively or followed up closely with serial imaging studies. PMID- 2716979 TI - Noninvasive motor evoked potential monitoring during neurosurgical operations on the spinal cord. AB - We present the results of monitoring descending pathways with motor evoked potentials (MEP) in 50 patients during neurosurgical operations on the spinal cord. The electromyographic responses of the anterior tibial muscles were recorded. In addition, in 24 patients responses of the thenar muscles after transcranial electrical stimulation of the motor cortex were recorded. Usually, the averages of 5 to 15 signals were evaluated. Although potentials were obtained preoperatively in all 50 patients, during neuroleptanesthesia intraoperative recording from the anterior tibial muscles was possible in 43 patients (86%) and from the thenar muscles in 21 patients (87.5%). Amplitudes were superior to latencies as evaluation criteria for intraoperative changes in potentials. On the basis of acceptable changes in amplitudes of up to 50% at the end of the operation, 16 recordings from the thenar muscles (76.2%) and 35 from the anterior tibial muscles (81.4%) correlated correctly with the postoperative neurological status; there were false positive results in 5 (23.8%) and 8 (18.6%) patients, respectively. We did not observe false negative findings. Postoperative neurological complications coincided in every case with permanent reduction in amplitudes of more than 50% of the base lines or with intraoperative loss of potentials as observed in 3 and 1 patient, respectively. MEP monitoring during neurosurgical operations on the spinal cord is a sensitive method for early detection of impending neurological complications. Major problems are the influence of anesthesia and the definition of acceptable limits for changes in amplitudes. PMID- 2716978 TI - Ultrastructural microvascular response to boron neutron capture therapy in an experimental model. AB - A CD 344 rat glioma model currently used to investigate boron neutron capture therapy (BNCT) was used to demonstrate an increased survival rate after thermal neutron irradiation enhanced by administration of 10B-enriched polyhedral borane, Na2B12H11SH. To investigate the possible effects of BNCT on normal and tumor microvasculature, we subjected animals to sublethal neutron irradiation with and without intravenous injection of 50 mg/kg of enriched 10B and performed histological and ultrastructural analyses. In the rats that did not undergo tumor transplantation, minimal detectable morphological changes in the microvasculature of the central nervous system were observed after treatment, both in the immediate posttreatment phase and at 10 months. Light microscopy of cerebral cortex and caudate nucleus showed normal cytoarchitecture with no evidence of vessel occlusion, hyalinization, thickening, or reactive gliosis. Electron microscopy demonstrated that the junctional complexes of the endothelial cells, the basal lamina, and the perivascular glia were comparable in both treated and control animals. In those animals examined at 18 months, pathological membrane bound clusters of electron-dense vesicles were seen in pericytes. In the rats implanted with gliomas, vascular proliferation with evidence of breakdown of the blood-brain barrier and vasogenic edema occurred. In the irradiated animals, we noted increased peritumoral edema 3 days after treatment. At seven days, both increased peritumoral edema and necrosis were noted in the rats treated with BNCT. These observations show that the normal microvasculature of the central nervous system tolerates BNCT at the treatment parameters used in our experimental model; the progressive edema and necrosis found in the peritumoral region after BNCT indicate a pathological endothelial response. PMID- 2716980 TI - Anterior decompression and stabilization of the spine in malignant disease. AB - Evidence has accumulated that indicates that laminectomy with or without radiotherapy is not necessarily the best mode of treatment for all cases of spinal cord compression of malignant pathogenesis. Success is limited, and there is a high risk of adverse neurological developments, particularly where there is anterior vertebral collapse. A prospective series of 26 consecutive patients with neurological complications of neoplastic extradural cord compression is described. Anterior decompression followed by stabilization in a single stage procedure was selected as the most appropriate method of treatment for all 26 patients. Various techniques were used in the replacement of the excised vertebral body, including the use of two types of prosthesis created specifically for the purpose. Of the patients who were not ambulatory at the time of surgery, 62% became so postoperatively; 71% of those with intractable pain were pain free after surgery. The postoperative mortality rate was 30%, which reflected the poor condition of the patients; in light of this, the criteria for operative selection are reviewed. Neurological deterioration did not occur in any patient. The method is recommended, for selected patients, for the management of cord compression caused by collapse of the vertebral body. The patient's prospects of restored ability to walk after a single-stage operation are good, and the risk of adverse neurological effects is negligible. PMID- 2716981 TI - Failure of autologous fat grafts to prevent postoperative epidural fibrosis in surgery of the lumbar spine. AB - In three cases of lumbar disc herniation, autologous fat grafts were inserted over the dura mater and the exposed nerve roots during surgery with the aim of preventing postoperative epidural fibrosis. A second operation had to be performed in two of these cases as a result of the radiographic appearance of excessive scar formation in the epidural and adjacent regions of the nerve root giving rise to symptoms. In the third patient, myelographic studies revealed the development of this type of hypertrophic scarring; however, the patient refused a further operation. The hypertrophic epidural scarring occurred in these three cases despite the presence of autologous fat grafts. Histopathological examination of the fat removed from the two patients who were operated on a second time showed a fibrotic infiltration into the fat graft. PMID- 2716982 TI - Controlled pressure-volume factors in the enlargement of intracranial aneurysms. AB - Pressure-volume relations were investigated on a model aneurysm wall made of elastic tissue and collagen. The model wall had a Young's Modulus of 2 x 10(7) dynes/cm2, approximating the elastance of fresh aneurysm walls obtained at autopsy. The model wall was fixed over the top of a glass T-tube, 6 mm in diameter. Pressure pulse waves of water or outdated human blood entered at the bottom of the T-tube and exited by way of a controlled resistance, while pressure was monitored by a strain gauge and recorded on an ink writer from the other arm. Incremental increases in systolic pressure produced a nonlinear N-shaped pressure volume curve. There was an initial linear enlargement in volume with increased pressure until a pressure threshold was reached at a point of high nonlinear compliance. At this point there was an abrupt jump in volume (mean increase = 70 +/- 14%) to a new stable equilibrium volume. A further increase in pressure (24 +/- 7 mm Hg) could eventually cause aneurysm rupture. This always occurred in the thinner, more compliant part of the wall. With higher pulse rates, the jump in volume occurred at a smaller volume, whereas with thinner aneurysm walls of higher compliance the pressure threshold for a jump in volume was significantly lower. At a higher peripheral resistance there was a higher pressure threshold. The authors suggest that there is one possible mechanism that may occur in the neck of some developing human aneurysms and could explain early and rapid initial growth in size. PMID- 2716983 TI - Prolactin-secreting adenomas: surgical results and long-term follow-up. AB - Transsphenoidal surgery is an efficacious treatment for patients with prolactin (PRL)-secreting adenomas, even if disrupted pituitary-hypothalamic relationships may persist and/or a recurrence of the PRL-secreting tumor can occur. In this paper, we analyze the long-term follow-up of 119 consecutively treated women who underwent transsphenoidal microsurgery for PRL-secreting adenomas. Apparent total removal of the tumor was achieved in 98 patients who had enclosed tumors (58 with Grade-I tumors and 40 with Grade II). In the remaining patients, the removal was considered partial. Persistent normal basal PRL levels were achieved in 61 patients who had apparent total removal of the adenoma (44 with Grade I tumors and 17 with Grade II). Of the remaining 37 patients in whom surgical removal of the adenomatous tissue was thought to be total, 30 had persistent nonevolutive, high PRL levels ranging from 21 to 196 ng/ml, without clinical and radiological signs of tumor regrowth, and 7 with PRL levels ranging from 56 to 560 ng/ml had a recurrence of the PRL-secreting tumor. These data seem to indicate that a slightly elevated postsurgical PRL value does not imply that tumoral tissue is still present. Nontumoral conditions (i.e., a secondary empty sella) could induce functional hyperprolactinemia. PMID- 2716984 TI - Distribution of a somatostatin analog after continuous intraventricular administration. AB - Decreased somatostatin in the brains of patients with Alzheimer's disease has led to an investigation of the efficacy of neurotransmitter replacement therapy. The distribution of a somatostatin analog, octreotide, was determined after 2 to 6 days of continuous intraventricular infusion at 40 micrograms/h in dogs. The tissue concentration was greater than 100 ng/g wet weight in all parts of the brain, which is greater than the normal concentration of native somatostatin. There was no reduction in native somatostatin production because of the infusion of the analog. The cerebrospinal fluid octreotide concentration was 1000 times greater than the plasma concentration. The results demonstrate that neurotransmitter replacement for somatostatin can be achieved by chronic intraventricular infusion of a metabolically stable analog. PMID- 2716985 TI - Evaluation and follow-up of carotid-cavernous fistulas by transcranial Doppler sonography: illustrative case. AB - The availability of transcranial Doppler sonography has resulted in an easy, noninvasive, reproducible, and highly reliable method for evaluating the flow characteristics of carotid-cavernous sinus fistulas. It also allows the follow-up of the effect of different interventional measures, specifically, embolization with detachable balloons. An illustrative case is reported, in which the findings of serial transcranial Doppler sonograms are correlated with findings on computed tomographic scans and angiograms. The impact of our findings on future approaches to the hemodynamic classification of these acquired vascular shunts is discussed. PMID- 2716986 TI - Temporary motor and sensory paralysis associated with intrathecal administration of morphine. AB - We are reporting a temporary, totally reversed motor and sensory paralysis subsequent to the intrathecal administration of 1.6 mg of morphine sulfate. This may represent an event which is not based on medication-induced myelopathy but on cardiovascular changes occurring as a result of pain relief. PMID- 2716987 TI - Familial trigeminal neuralgia: case report. AB - Trigeminal neuralgia in its classic form is usually an isolated disease that occurs in sporadic fashion without epidemiological or genetic significance. This paper discusses a family with three nontwin sisters, all of whom have classic trigeminal neuralgia occurring in early middle age with symptoms severe enough to require medical and surgical treatment. These three sisters also have one aunt with a history of severe facial pain, although this has not been medically documented. Clustering of such cases in a given family has been reported before, but is rare. The pathophysiological implications of this genetic clustering are discussed. PMID- 2716988 TI - Multiple fractures of the cervical and upper thoracic spine without neurological deficit: case report. AB - The case of a patient with multiple contiguous fractures of the cervical and upper thoracic spine without neurological deficit or spinal instability is presented. Injury to each of the cervical vertebrae plus the upper two thoracic vertebrae is unusual and has not been previously reported. PMID- 2716989 TI - Massive craniospinal collagen deposition after persistent postoperative intraventricular bleeding. AB - A 39-year-old man developed persistent bleeding into the ventricular system after having undergone needle biopsy of what was presumed to be a left frontal neoplasm. He subsequently developed obstructive hydrocephalus that required shunting and died in a semivegetative state some 5 1/2 months later. At autopsy, although no neoplasm was identified at the operative site, there was massive collagen deposition within the ventricular system that extended into the spinal subarachnoid compartment. Although we have been able to find only three cases in the literature with detailed descriptions of similar pathological findings, we believe that our observations emphasize the potential for a complication of intraventricular and subarachnoid hemorrhage that is not widely recognized. PMID- 2716990 TI - Rectal sphincter pressure monitoring device. AB - A silicone, dual cuffed catheter designed for the control of nasal hemorrhage was used for rectal sphincter pressure monitoring. Patients with lipomyelomeningocele and tethered spinal cord were monitored during their operative procedures to aid in distinguishing sacral nerve roots from other tissues. Stimulation of sacral nerve roots was done with a disposable nerve stimulator. The use of a catheter with two balloons helps to keep the outer balloon placed against the rectal sphincter. PMID- 2716991 TI - Drug infusion to the central nervous system. PMID- 2716992 TI - Neuroradiology. PMID- 2716993 TI - Fat deposition surrounding intracerebral hemorrhage in a patient suffering from Zieve syndrome. AB - In a 42-year-old man, admitted a few hours after an acute cerebrovascular event, CT demonstrated a hyperdense hemorrhage surrounded by a hypodense rim similar to perifocal edema or liquefying blood, thus raising doubts about the acuteness of the event. Laboratory findings revealed Zieve-syndrome (alcoholic hyperlipemia, hemolytic anemia, and alcoholic fatty liver) and negative Hounsfield Unit measurement of the hypodense rim finally identified it as a layer of fat around the clot. PMID- 2716994 TI - CT of dens axis fractures. AB - The distinction between the different types of dens axis fracture is important. Fractures at the base of dens (Type II) may be overlooked if reformated images are not made. If the fracture extends downward into the body of the vertebra (Type III), the body fragment may rotate into the spinal canal. The rotation is difficult to see on plain films, but is easily seen at axial CT. PMID- 2716995 TI - Cerebral arteriovenous malformation--an unusual site. PMID- 2716996 TI - Magnetic resonance imaging in primary cerebral neuroblastoma. PMID- 2716997 TI - Quantitative evaluation of pontine atrophy using computer tomography. AB - Pontine volume was measured and evaluated by computer tomography (CT) in 37 healthy adults and in 29 adult autopsied brains which did not have chronic neurologic diseases. The pons was cut serially into 5 mm slices in the autopsied brains. In the CT examinations both 5 mm and 2 mm slices were studied. Pontine areas in horizontal planes were measured using an image analyzer, then pontine volume was calculated by accumulation of the mean value of the areas and cranio caudal length. Pontine volume was approximately 19 cm3 and pontine atrophy could be defined as less than 12 cm3 (i.e. the mean - 2 SD) in both methods, which heretofore have not been reported. PMID- 2716998 TI - Primary progressive cerebellar ataxia. AB - Thirty-two patients with primary progressive cerebellar ataxia were studied using MRI. This technique is better than CT in demonstrating atrophy of cerebellar structures as well as of brainstem and spinal cord. The differential diagnosis from other diseases particularly with multiple sclerosis is easier. The degree of ataxia correlated well with the degree of atrophy of cerebellum. However we could not see any correlation between the degree of atrophy and the onset and duration of the disease and no certain specific aspects could be demonstrated in the different groups examined. PMID- 2716999 TI - Computed tomography in intracranial, supratentorial metastases in children. AB - This study compares the CT characteristics in a consecutive sample of supratentorial metastases (n = 31) with primary tumors of the same location (n = 49) in childhood. Postcontrast CT was performed in all but one of the metastases cases. In all but one of these children the location and type of primary tumor was known at time of occurrence of cerebral metastasis. Primary CNS tumors (n = 12) had a higher incidense of supratentorial metastatic spread than tumor originating elsewhere. Three children had diffuse subarachnoid seeding, while 28 had solid tumors (21 solitary, 7 multiple). The predilection location for the solid metastases was the gray-white matter junction (n = 12). The following CT findings were significantly less frequent in metastases than in primary tumors (P less than 0.05): Midline location, calcification and cyst formation. On the other hand bleeding, pronounced contrast enhancement and location in the gray-white matter junction were more frequent in the metastatic group (P less than 0.05). PMID- 2717000 TI - Comparison of extensive brain calcification in postoperative hypoparathyroidism on CT and NMR scan. AB - A case of postoperative hypoparathyroidism is presented in which calcifications seen on CT scan were differently visualized on T2 weighted NMR images. High and low signal intensities may reflect different stages of the calcifying process thus confirming neuropathological findings. PMID- 2717001 TI - One-year MR imaging follow-up of patients with multiple sclerosis under cortisone therapy. AB - Twenty patients with relapsing/remitting course of MS were studied four times with MR imaging over the course of one year. First MR was undertaken during the acute relapse, afterwards patients were given cortisone therapy for four to six weeks. The second MR study followed 4-6 weeks after the first, the patients at this time being in remission. The third MR study was carried out 4 months after the first, the last scan one year after the first. The total number of lesions varied, though not greatly, over the whole follow-up, but there was an influence of the clinical course of MS on the pattern of lesions in MR imaging, mostly in respect to the number of confluences and the size of the lesions. Follow-up over one year showed that the inflammatory process produced an increase in the number of plaques, independent of the fact that most patients stayed in remission. A delayed effect of the cortisone therapy on the size, number, and confluence of plaques is suggested whilst clinical signs improved in most cases immediately after the beginning of drug therapy. Independent of the clinical course of the disease in some cases plaques previously seen vanished and others appeared in one and the same examination. PMID- 2717002 TI - Nervous system manifestations and neuroradiologic findings in acquired immunodeficiency syndrome (AIDS). AB - We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed. Five were homosexual men and eight patients (5 men, 3 women) were of African origin (Zaire and Rwanda) (n = 5) or had had sexual intercourse with the local African population (n = 3). The nervous system complications encountered included: toxoplasma gondii brain abscess (2 patients); cryptococcus neoformans meningitis + toxoplasmosis (1 patient); toxoplasmosis + lymphoma (2 patients); progressive multifocal leucoencephalopathy (1 patient); lymphocytic meningitis or encephalitis (3 patients); lymphoma (1 patient); polyradiculoneuritis (3 patients). Three of thirteen patients had multiple intracranial abnormalities: one had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis; in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess; conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma. In conclusion, in our experience, nervous system toxoplasmosis is the most frequent AIDS related CNS complication. Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately. In these cases, while CT may readily identify the intracranial abnormalities, it contributes little towards an etiological diagnosis. Finally, our series illustrates the importance of a central African endemic focus for AIDS. PMID- 2717003 TI - Brain damage in former association football players. An evaluation by cerebral computed tomography. AB - Thirty-three former football players from the National Football Team of Norway were examined by cerebral computer tomography (CT). The CT studies, evaluated for brain atrophy, visually and by linear measurements compared two different normal materials. One third of the players were found to have central cerebral atrophy. It is concluded that the atrophy probably was caused by repeated small head injuries during the football play, mainly in connection with heading the ball. PMID- 2717004 TI - Side effects after ambulatory lumbar iohexol myelography. AB - Side effect incidences after ambulatory (22G needle and two h bed rest) and after non-ambulatory (22 and 20G needles and 20 h bed rest) lumbar iohexol myelography have been estimated and compared. Headache incidence was significantly greater in ambulatory (50%, n = 107) as compared to non-ambulatory myelography (26%, n = 58). Headaches in the ambulatory group tended to be of shorter duration and the difference between severe headaches in ambulatory and non-ambulatory groups was not significant. Serious adverse reactions did not occur and none of the ambulatory patients required readmission because of side effects. The headache was predominantly postural and occurred significantly earlier in the ambulatory group. Headache incidence was significantly greater after 20G needle myelography (44%, n = 97) as compared to 22G needle iohexol myelography (26%, n = 58). The results supports the hypothesis that CSF leakage is a major cause of headache after lumbar iohexol myelography. PMID- 2717005 TI - Which factors affect reported headache incidences after lumbar myelography? A statistical analysis of publications in the literature. AB - Nineteen publications were reviewed and subjected to a combined statistical analysis (meta-analysis) regarding the influence of study design factors upon reported headache and total symptom incidences after lumbar iohexol myelography. A significant association was found between reported side effects on one hand and needle diameter, follow up time and the method of questioning respectively on the other. The combination of long follow-up time and specific questioning and the combination between larger diameter (20G) needles and long follow-up time, both seemed to be strong predictors for reporting high side effect incidences. Nine studies were similarly analyzed regarding the influence of early ambulation and contrast type upon reported headache incidences. Early ambulation significantly increased headache after iohexol or iopamidol lumbar myelography as opposed to metrizamide myelography. PMID- 2717006 TI - Computed tomography of lumbar apophyseal joint lipoma: report of three cases. AB - The authors report three cases of lumbar apophyseal joint lipoma located at the L4/L5 or L5/S1 level. CT scan makes the diagnosis easily possible; indeed erosive changes with enlargement of the upper portion of the lumbar articular joint and anterior displacement of the top of the superior facet are associated with intra articular fatty densities. Clinical symptoms are rarely encountered and may be related to narrowing of the upper portion of the intervertebral foramen. PMID- 2717007 TI - The tethered spinal cord syndrome: a correlation of radiological features and peroperative findings in 30 patients. AB - The aim of this investigation is to evaluate the accuracy of the diagnostic parameters of the radiological features, especially in conventional lumbar myelography, since these will be used in the future as a gold standard for new developing diagnostic methods like ultrasonography (US) and magnetic resonance imaging (MRI). A short review of the clinical symptoms and diagnostic radiology of the tethered spinal cord (TSC) is given. The radiological features of the TSC syndrome are compared with the peroperative findings in 30 patients investigated and operated in our hospital. All patients showed lumbar or sacral osseous malformations on the plain X-ray films. This means a high diagnostic sensitivity although the specificity for TSC is low. Conventional myelography had a sensitivity of 0.82 and positive predictive value of 0.94, while the specificity and negative predictive value are respectively 0.96 and 0.85. The positive predictive value of the total diagnostic procedure of plain X-ray films and lumbar myelography for TSC may be estimated at 1. PMID- 2717008 TI - Extraforaminal lumbar disc herniations: CT demonstration of Sharpey's fibers avulsion. AB - Forty-seven extraforaminal lumbar disc herniations (EFLDH) accounting for 7% of all lumbar disc herniations encountered during the same period of time were reviewed. L3-L4 or L4-L5 disc was involved in 89% of the cases giving rise to a L3 or L4 nerve root compression. An abnormal motion of lateral bending with rotation of the trunk was found retrospectively in 60% of the patients. In 53% of all EFLDH a bony avulsion of the vertebral end-plate facing the herniation was demonstrated at the site of attachment of Sharpey's fibers. This study suggests that this previously undescribed bony change witnesses a special injury of the spine responsible for most EFLDH. PMID- 2717010 TI - Cranial computed tomography in acute disseminated encephalomyelitis. AB - Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory disorder of the nervous system. The appearance of ADEM on cranial CT scans has rarely been reported. The author reports seven cases in two institutions during a period of seven years. Only four of the seven patients had hypodense lesions in the white matter and six patients showed spotty, nodular, or gyral enhancement after contrast injections. The enhancement resolved with steroid therapy, leaving some persistent hypoattenuated areas even after 10 months follow-up, these findings support the dual components of the pathogenesis of ADEM. The vasculitic component may be responsive to steroids, nevertheless the demyelinating or necrotic areas may not, and the latter may be responsible for the sequelae of ADEM. PMID- 2717009 TI - Gd-DTPA-enhanced MR in thoracic disc herniations. AB - The Gd-DTPA-enhanced magnetic resonance findings in two patients with herniated thoracic intervertebral discs are reported. The first patient was a 56-year-old woman with a small subligamentous T6-7 disc herniation, slightly lateralized to the right. The second patient was a 51-year-old man with a central and right posterolateral disc herniation, including a large calcified fragment, at the T8-9 level. The nonenhanced MR examination revealed the presence of an extradural mass lesion in both patients, impinging upon the dural sac and compressing and displacing the spinal cord posteriorly. The lesion was slightly hypointense on both T1- and T2-weighted spin echo sequences. Following intravenous injection of Gd-DTPA in a dosage of 0.1 mmol/kg body weight, enhancement of the posterior longitudinal ligament was noted and triangular areas of contrast uptake were seen to occur in the epidural space above and below the herniated disc. At surgery, they were found to correspond to dilated and congested epidural veins. PMID- 2717011 TI - Abnormal origin of the ophthalmic artery from the anterior cerebral artery: neuroradiological and intraoperative findings. AB - A 7-year old male child with an abnormal ophthalmic artery arising from the A1 segment of the anterior cerebral artery is described. The patient suffered growth inhibition which was thought to be caused by a craniobasal cystic lesion affecting the hypothalamus. Preoperative angiograms revealed no vascular abnormalities. The right ophthalmic artery, however, could not be identified. During resection of a large arachnoid cyst the ophthalmic artery was found to arise from the A1 segment of the anterior cerebral artery. To the best of our knowledge, this exact anomaly has not previously been reported. The clinical, neuroradiological and intraoperative findings are presented. PMID- 2717012 TI - Anomalous origin of anterior choroidal artery. AB - We report a very rare case of anomalous origin of anterior choroidal artery. In our case anterior choroidal artery arises from internal carotid artery proximal to the posterior communicating artery. PMID- 2717013 TI - MR demonstration of spontaneous acute epidural hematoma of the thoracic spine. AB - Two patients with spontaneous epidural hematoma of the thoracic spine are presented. The magnetic resonance (MR) examination performed within the first hours following the onset of symptoms demonstrated an epidural elongated lesion impinging on the spinal cord, compatible with hematoma. In one of the patients this finding was surgically confirmed. The second patient improved under steroid treatment. The MR findings were highly suggestive of the pathological nature of the lesion. The MR examination should replace other diagnostic procedures, such as computerised tomography (CT) and myelography. PMID- 2717014 TI - MR visualization of CSF flow through a ventriculo-cisternostomy. AB - The MRI findings in a 6-year-old boy with an astrocytoma of the mesancephalon are reported. A ventriculocisternostomy had been performed in order to reduce the hydrocephalus. At the site of the ventriculocisternostomy, the T2-weighted images showed a low signal in the anterior part of the third ventricle, the interpeduncular and the pontine cistern. This was attributed to CSF flow void. We conclude that MRI can provide information about the precise location and normal functioning of a ventriculocisternostomy. PMID- 2717015 TI - [Proceedings of the meeting of the Italian Section of the International College of Surgeons. II. "The development of surgery from the time of Pietro Valdoni to the present". Rome, 16-20 February 1987]. PMID- 2717016 TI - [The role of vagotomy in the therapy of duodenal ulcer]. PMID- 2717017 TI - [Long-term implications of gastroduodenal resection in peptic ulcer]. PMID- 2717018 TI - [Incidence of precancerous lesions and risk in endoscopic biopsies of the gastric mucosa]. PMID- 2717019 TI - [Early gastric cancer]. PMID- 2717020 TI - [Surgical treatment of stage III lung cancer invading the thoracic wall (non Pancoast)]. PMID- 2717021 TI - [Long-term results of radical surgical therapy of pulmonary carcinoma]. PMID- 2717022 TI - [Single suprarenal gland metastasis of lung cancer]. PMID- 2717023 TI - [Systematic hilar and mediastinal lymphadenectomy in pulmonary exeresis in cancer cases]. PMID- 2717024 TI - [Integrated diagnosis and staging of breast diseases]. PMID- 2717025 TI - [My philosophy on cancer of the breast]. PMID- 2717026 TI - [Therapeutic procedures in portal hypertension]. PMID- 2717027 TI - [Selective distal spleno-renal shunt vs. latero-lateral porta-caval shunt. Subsequent analysis of encephalopathy and survival]. PMID- 2717028 TI - [Prosthesis in surgery of portal hypertension]. PMID- 2717029 TI - [Cholecystectomy in cirrhotic patients]. PMID- 2717030 TI - [Proceedings of the meeting of the Italian Section of the International College of Surgeons. III. "The development of surgery from the time of Pietro Valdoni to the present". Rome, 16-20 February 1987]. PMID- 2717031 TI - [Informatics criteria in staging of cancer of the rectum]. PMID- 2717032 TI - [Technic development in the reconstruction of the breast. Our experience with 102 operated on cases]. PMID- 2717033 TI - [Therapy of early carcinoma of the colon and rectum]. PMID- 2717034 TI - [Our current approach to the surgical therapy of diverticular disease of the colon]. PMID- 2717035 TI - [Occult cancer of the thyroid gland]. PMID- 2717036 TI - [Colo-anal anastomosis using Parks' technic. Experience and prospective]. PMID- 2717037 TI - [Role of lymphadenectomy in the surgical treatment of cancer of the rectum]. PMID- 2717038 TI - [Ano-rectal function in stapled low colo-rectal reconstruction]. PMID- 2717039 TI - [Injuries of the brachial plexus]. PMID- 2717040 TI - [Role of TEA (trans-embolic anastomosis) in peripheral obstructions]. PMID- 2717041 TI - [Esophageal dilatation. Indications and technics]. PMID- 2717042 TI - [Determination of tumor-associated trypsin inhibitor (TATI) in subjects with gastrointestinal diseases. Preliminary data]. AB - Tumor-associated trypsin inhibitor (TATI) is a 6 K dalton protease inhibitor, that was isolated from urine of a patient with ovarian cancer. In our experience, mean serum level of TATI in healthy subjects (n. 120), is 13 micrograms/l (range 5.1-42 micrograms/l). The cut-off point is established in 32 micrograms/l (mean +/- 3 SD). We have examined 357 patients with gastrointestinal diseases: 98 gastric cancer, 50 colon cancers, 52 pancreatic cancers, 32 chronic pancreatitis, 38 IBD, 28 colon polyps, 40 gastric ulcers and 25 non-neoplastic biliary tree diseases. TATI may be a good tumor marker only in gastric cancer. Elevated levels of TATI also occur in obstructive hepatobiliary disease and active pancreatitis or IBD. PMID- 2717043 TI - [Cardiomyopathy due to adriamycin: the possibility of its prevention. Monitoring by noninvasive technics]. AB - To prevent delayed cardiomyopathy induced by adriamycin and subsequent severe congestive heart failure, a monitoring schedule with noninvasive techniques to measure cardiac performance (CPK-MB, electrocardiographic, systolic time intervals, echocardiography and quantitative radionuclide angiography) has been used. 15 patients, 33 to 65 years old, with metastatic breast carcinoma, previously treated with a polychemotherapy protocol not including adriamycin have been studied. Monitoring at 0 time allowed to exclude one patient with previous asymptomatic cardiomyopathy and to treat patients at risk with cardiovascular pathology, up to reach and even exceed the dosage of 550 mg/m2. Four of the treated patients showed positive findings of cardiomyopathy at different adriamycin dosage levels: 2 asymptomatic dilatative cardiomyopathies, 1 symptomatic and 1 with congestive heart failure remitted with medical therapy. No patient died because of cardiovascular complications. The results obtained show that of all noninvasive techniques used, only quantitative radionuclide angiocardiography allowed, when employed following an adequate monitoring schedule, to detect reliable findings of moderate and reversible cardiomyopathy thus indicating the appropriate time for drug discontinuation. PMID- 2717044 TI - [A retrospective clinico-endoscopic study of colorectal cancer. Personal case histories]. AB - Over a decade (1978-88), 180 cases of colorectal carcinoma were diagnosed. Twenty of the patients had shown no "precancerous" colonic conditions whereas screening had revealed various pathologies indicating risk in the remaining 160. The percentage distribution of the tumour in the large bowel was as follows: sigmoid colon 38%, rectum 25%, descending colon 21%, caecum 12%, transverse colon 4%. Dukes-type surgical staging of the screened patients revealed 42% in stage A, 48% stage B and 10% stage C. The sensitivity and specificity of the haemoccult test was 86% and 98% respectively while the diagnostic accuracy of double-contrast opaque enema was 79% compared to 84% for coloscopy alone and 98% for combined coloscopy and biopsy. PMID- 2717045 TI - [Preoperative determination of CEA and GICA in gastric neoplasms]. AB - Data are presented on a series of 39 stomach cancer patients subjected to preoperative assays of blood CEA and GICA. High levels of both markers were found in the advanced (stage III and IV) cases. The use of both markers together improved the sensitivity of the test but only to 30%. Nevertheless preoperative CEA and GICA assays are recommended because of the information they provide about tumor stage. PMID- 2717046 TI - [HDL cholesterol in diabetes mellitus type II]. AB - The results of a study conducted on 60 diabetics are reported. The HDL cholesterol levels of the diabetics and healthy controls of the same sex and age were compared and no statistically significant differences were found: 49.3 +/- 12 (diabetics) versus 47.6 +/- 9 (controls). PMID- 2717047 TI - [Talcosis as an occupational disease. Case histories]. AB - The case are examined of 49 people (45 males, 4 females), mean age 60 exposed to the risk of talc inhalation in a talc processing and packing factory who were granted disability pensions by the Turin I.N.A.I.L. on the grounds of silicosis in 1975-86. Radiologically the cases presented small round patches in 28 subjects small irregular ones in 15 and large patches in 6. In functional terms, examination revealed ventilatory insufficiency that was primarily restrictive in 17 cases, obstructive in 11 and mixed in 21. PMID- 2717048 TI - [Internal medicine and psychosomatic medicine between dualism and monism]. AB - This paper investigates the possibility that psychosomatics could overcome the dualistic concept of a human being divided into mind and body. According to S. Freud's theories about the individual uniqueness and to G. A. Kelly's personal construct theory, the authors try to determine a monistic concept of the human being also from the clinical standpoint. PMID- 2717049 TI - [Severe hyperparathyroidism in 2 uremic patients. Diagnostic and therapeutic difficulties]. AB - We report here the unusually difficult cases of two patients with end-stage renal failure who suffered from severe hyperparathyroidism requiring surgical correction. The first patient had previously undiagnosed primary hyperparathyroidism. A first surgical neck exploration led to the discovery of four glands, paradoxically normal in size and aspect, which were removed. Subsequently, a supernumerary gland was localized in the mediastinum by computerized tomography and removed via sternotomy. After confirming the hypoparathyroid state, parathyroid autotransplantation was performed using cryopreserved tissue. The second patient had five hyperplastic parathyroid glands removed during the first neck exploration, followed by immediate parathyroid autografting. Because of the persistence of severe hyperparathyroidism, forearm autografts were subsequently removed and a sternotomy performed. Both failed to improve parathyroid hyperfunction. Numerous localization procedures remained negative. A repeat surgical neck exploration was performed because of positive double isotope scanning but was of no success in preventing fatal outcome, as were all medical treatments. These observations of two patients illustrate the difficulties in localizing and removing ectopic parathyroid lesions. Even when relying on the presently available powerful diagnostic means, correction of severe hyperparathyroidism may be extremely difficult. PMID- 2717050 TI - [A case of thrombotic thrombocytopenic purpura]. AB - Thrombocytopenic thrombotic purpura is a comparatively rare disease and little is known about its aetiopathogenesis. Once almost invariably negative, the prognosis has been changed by the introduction of plasmapheresis. A particularly complex clinical case is described and a number of conclusions are drawn from it: 1) there is no criterion for opting for any particular therapeutic approach; 2) evaluation of the clinical response is the only criterion for monitoring the effectiveness of ongoing treatment; 3) plasmapheresis is proposed as the treatment of choice; 4) vincristine is a useful alternative in the treatment of recalcitrant cases. PMID- 2717051 TI - [Visceral leishmaniasis as an opportunistic infection. Our experience]. AB - A case of visceral leishmaniasis in a female patient suffering from acute nonlymphoid leukaemia is reported. Stress is laid on the atypical nature of the clinical picture, falsified by the underlying disease, and attention is called to the behaviour of Leishmania as an opportunistic agent in the immunodepressed host. PMID- 2717052 TI - Efferents to the labyrinth of the river lamprey (Lampetra fluviatilis) as revealed with retrograde tracing techniques. AB - The cells of origin of centrifugal fibres to the labyrinth were examined in a jawless vertebrate, the lamprey, with several retrograde tracers (horseradish peroxidase (HRP), fluorescein isothiocyanate (FITC) and rhodamine coupled dextran amines (FDA and RDA), and cobalt-lysine) that had been applied to the eighth nerve. With all 3 techniques, up to 20 cells were consistently labelled ipsilaterally, adjacent to the Mauthner cell; none were labelled on the contralateral side. The axons of the efferent cells emanate either from lateral dendrites or the perikaryon and course laterally towards the ipsilateral eighth nerve root. The dendrites ramify widely in the basal plate and may thus receive diverse inputs. The same tracers were applied to the lateral-line nerve and afferent fibres were labelled but no efferent cells, thus confirming previous reports. These data suggest that lampreys have an efferent innervation to the labyrinth but not to the lateral line. PMID- 2717053 TI - The pontomesencephalotegmental cholinergic system does not degenerate in Alzheimer's disease. AB - The pedunculopontine and laterodorsal tegmental nuclei comprising the pontomesencephalotegmental (PMT) cholinergic system were examined for the presence of neuropathology and loss of presumed cholinergic cells in patients diagnosed with Alzheimer's disease-senile dementia of the Alzheimer type (AD SDAT), Parkinsonian dementia, and multi-infarct dementia. Although neurofibrillary changes and plaque-like entities were observed in both nuclei in AD-SDAT and Parkinson's disease dementia, these pathologic indices were not seen consistently in control individuals or in those with multi-infarct dementia, and in none of the diagnostic categories was loss of neuronal somata found in the PMT cholinergic complex. Because appreciable degeneration of cholinergic neurons does occur in the basal forebrain in AD-SDAT, it is concluded that cholinergic phenotype alone is not a sufficient condition indicating predilection for neuronal loss in that dementing illness. PMID- 2717054 TI - Cells of the rat lateral habenula respond to high-threshold somatosensory inputs. AB - Extracellular electrical recordings of single units in the anaesthetized rat demonstrate that about two thirds of the neurons in the lateral habenula respond to peripheral noxious stimuli in a way similar to that of the cells in the centrum-medianum complex which can be activated (with several peaks of various latencies) or inhibited. The firing pattern of these lateral habenula cells is either excitatory (75%) or inhibitory (24%) and is related to the intensity of the stimulus; their receptive field is large and bilateral. Most of these cells also respond to other kinds of noxious but not to non-noxious stimuli. The present study strongly suggests that the lateral habenula is a central target at the upper brainstem level for nociceptive inputs. This original finding is consistent with our previous observation of naloxone reversible analgesia induced by stimulation of the habenula and suggests an involvement of this structure in the processing of noxious inputs. PMID- 2717055 TI - The effects of movements on caudate sensory responses. AB - The aim of this experiment was to assess the effects of movement on somatosensory processing in the caudate nucleus. Units were recorded extracellularly in the caudate of awake partially restrained cats. Unit responses were evoked by either natural stimuli (brushing and skin indentation) or transcutaneous electrical stimulation. Response patterns evoked by stimuli presented when the cat was at rest were compared to responses evoked by similar stimuli presented when the cat was either making buccolingual movements or turning its head. In the majority of cases, movement suppressed caudate somatosensory responses. However, impressive augmentation of responses was seen in some cells with either type of movement. PMID- 2717056 TI - Simultaneous motor output and sensory input: cortical interference site resolved in humans via neuromagnetic measurements. AB - Neuromagnetic measurements were carried out during median nerve stimulation at the wrist in complete relaxation (a) and during active contraction of the hand muscles (b). Firstly, activity of the generator source responsible for the major component of the sensory evoked magnetic fields (SEFs) was mapped and localized during condition (a) and (b). Then the subtraction maps ((a)-(b)) were obtained and the virtual 'dipole' responsible for the 'interference' (less than or equal to SEFs amplitude) between the afferent input and the motor output was tridimensionally localized in a position compatible with the knee and the convexity of the postcentral gyrus. PMID- 2717057 TI - Repeated exposure to sham testing procedures reduces reflex withdrawal and hot plate latencies: attenuation of tonic descending inhibition? AB - Five days' repeated exposure of experimentally naive rats to the experimental environment and to sham nociceptive testing procedures ('habituation') reduced the latency for reflex withdrawal of the hindpaw from hot water (49 degrees C) by 43%, to that of spinalised habituated or novice animals. Hot-plate (50 degrees C) paw lick latencies were reduced equally (40%) by habituation or parachlorophenylalanine, and were increased 32% by D,L-5-hydroxytryptophan. Neither drug affected hot-plate latencies of habituated animals. Naloxone had no effect on flexor withdrawal or hot-plate latencies in either novice or habituated animals. These results suggest that habituation substantially attenuates tonic serotonergic inhibition of spinal nociceptive transmission. PMID- 2717058 TI - Transduction mechanism involving the presynaptic adenosine receptor at mouse motor nerve terminals. AB - The inhibitory effect of 2-chloroadenosine on spontaneous quantal release of transmitter at the mouse neuromuscular junction was abolished after pretreating tissues either with pertussis toxin (PTX), or with H7, a protein kinase inhibitor. H7 alone caused a fall in miniature endplate potential (MEPP) frequency, but PTX did not. The results are consistent with the hypothesis that rates of neurotransmitter release are directly related to intraterminal cyclic AMP levels, and that these can be reduced by A1 adenosine receptor agonists through the mediation of a Gi protein. PMID- 2717059 TI - Time course of postmortem modifications in synaptosomal [3H]dopamine uptake and [3H]GBR 12783 binding to the dopamine uptake complex in the rat striatum. AB - The present study focuses on the changes of two biochemical markers of the striatal dopaminergic innervation evaluated after different postmortem storage periods of rat heads either at room temperature (21 degrees C) or at 4 degrees C: (i) the uptake of [3H]dopamine (DA) into striatal synaptosomes and (ii) the specific binding of [3H]GBR 12783, a selective ligand for the neuronal dopamine uptake sites, to a striatal membrane fraction. The uptake of [3H]DA was completely abolished after 24 and 72 h storage of the tissue at 21 degrees C and 4 degrees C, respectively, whereas in the same conditions, the binding of [3H]GBR 12783 was slightly decreased. The Km and Kd of these two processes were virtually unchanged after the different storage periods considered, whereas the Vmax and Bmax were markedly decreased. PMID- 2717060 TI - Differential distribution and non-collateralization of central amygdaloid neurons projecting to different medullary regions. AB - The distributions of central amygdaloid nucleus (Ce) neurons projecting to different medullary regions were investigated using the retrograde transport of iontophoretically applied Fast Blue or bisbenzimide. Neurons projecting to the nucleus of the solitary tract were located throughout the medial, lateral and ventral subdivisions of the Ce whereas cells projecting to the parvicellular reticular formation and ventrolateral medulla were confined to the medial subdivision of the Ce. Combined injections of fluorescent dyes into these medullary areas resulted in only occasional double-labelled cells. The results suggest that Ce projections to a variety of medullary sites arise from separate populations of neurons with partially overlapping distributions in the medial Ce. PMID- 2717061 TI - The amygdalo-brainstem pathway: selective innervation of dopaminergic, noradrenergic and adrenergic cells in the rat. AB - The present study investigated the organization and distribution of amygdaloid axons within the various brainstem dopaminergic, noradrenergic and adrenergic cell groups. This was accomplished via Phaseolus vulgaris leucoagglutinin lectin (PHA-L) anterograde tracing technique combined with glucose-oxidase immunocytochemistry to catecholamine markers (i.e. tyrosine hydroxylase, dopamine beta-hydroxylase, and phenylethanolamine N-methyltransferase). Injections of PHA L within the medial part of the central amygdaloid nucleus resulted in axonal labeling within most catecholamine containing cell groups within the brainstem. The most heavily innervated catecholaminergic groups were the A9 (lateral) cells of the substantia nigra, the A8 dopaminergic cells of the retrorubral field and the C2 adrenergic cells of nucleus of the solitary tract. Amygdaloid terminals frequently contacted cells within these regions. A moderate amount of amygdaloid terminals were located within the rostral A6 (locus coeruleus) and A2 (nucleus of the solitary tract) groups. Amygdaloid terminal contacts were apparent on the majority of the rostral A6 and A2 neurons. Light or no amygdaloid terminal labeling was observed within the other brainstem catecholaminergic cell groups. Thus, the amygdala mainly innervates the A8 and lateral A9 dopaminergic cells of midbrain, rostral locus coeruleus (A6) noradrenergic neurons and the adrenergic (C2) and noradrenergic (A2) cells within the nucleus of the solitary tract. Selective innervation of these brainstem catecholaminergic systems may be important for integration of amygdaloid-mediated defensive and stress-induced behaviors. PMID- 2717062 TI - Catecholamines in the carotid body are unaffected by hypercapnia. AB - In contrast to the increased content of dopamine and norepinephrine in rat carotid body during hypoxia (10% O2 in nitrogen) for 3 and 21 days, hypercapnia (8% CO2 in air) for 21 days failed to alter the catecholamine concentrations. DOPAC content was elevated in hypoxia whereas there were no significant changes in hypercapnia. This finding supports the view that the mechanisms of peripheral chemoreception differ, at least partly, in hypoxia and hypercapnia. PMID- 2717063 TI - Colchicine effect on B-50/GAP43 phosphoprotein localization in rat dorsal root ganglion explants. AB - In rat embryonic dorsal root ganglion explants stimulated by nerve growth factor, the neuron-specific phosphoprotein B-50 (GAP43) is primarily localized in the distal portion of outgrowing neurites. Addition of colchicine leads to a decrease in total amount of B-50 and a marked redistribution in the neurons. The data underscore the role of axonal transport in the concentration of B-50 in growth cones of growing neurites. PMID- 2717064 TI - Induction of GFAP production in human glioma lines grafted into the anterior chamber of the rat eye. AB - Three established glial fibrillary acidic protein (GFAP)-negative cell lines from human gliomas were transplanted to the anterior chamber of the rat eye. Short term survival was seen with all transplants. The cells expressed GFAP following transplantation. For comparison, 4 GFAP-positive cell lines were transplanted. With grafting of 5000 cells of any of 6 bipolar cell lines, the transplanted cells could be seen to develop multiple, slender processes reminiscent of mature astrocytes. When 50,000 cells were grafted, vascularized cell mats covering the corneae were seen. The induction of GFAP production and the phenotypic changes were interpreted as signs of differentiation induced by the new environment. All transplanted cells were rejected after 8 weeks. PMID- 2717065 TI - Electrophysiological properties of neurons in neonatal rat occipital cortex slices grown in a serum-free medium. AB - The electrophysiological properties of individual neurons within organotypic explants of neonatal rat cortex were examined via intracellular recordings. The explants were grown for two weeks in a serum-free medium. The electrophysiological properties of the neurons within these explants were similar to those reported for both adult cortex in vivo and short-term in vitro slice preparations. The results of the present study show that cortical explants grown under serum-free conditions can serve as a useful model for long-term developmental studies associated with the physiological basis of neural network formation. PMID- 2717066 TI - GABA triggers a Cl- efflux from cultured mouse oligodendrocytes. AB - gamma-Aminobutyric acid (GABA) has been shown to depolarize the membranes of astrocytes and oligodendrocytes taken from different tissues and species. The mechanism mediating this depolarization was identified, in cultured rat brain astrocytes, as an activation of GABA receptor-linked Cl- channels. A subpopulation of cultured oligodendrocytes from mouse spinal cord also responded to GABA with a membrane depolarization. In the present study we demonstrate that, in oligodendrocytes, the depolarization was accompanied by a decrease in intracellular Cl- activity [( Cl-]i) as measured with ion-selective microelectrodes. At rest, [Cl-]i was elevated above the passive distribution, and upon application of GABA, [Cl-]i decreased towards the level of passive distribution. Furosemide blocked the Cl- inward carrier which led to a passive Cl distribution; in the presence of furosemide, GABA no longer elicited a membrane depolarization or a change in [Cl-]i. We conclude that oligodendrocytes, which were depolarized by GABA, expressed GABA-activated Cl- channels. Oligodendrocytes which were unresponsive to GABA demonstrated a non-passive Cl- distribution indicating that they did express inward-directed Cl- carriers, but no GABA activated Cl- channels. PMID- 2717067 TI - Effect of in vivo glucocorticoid administration on histamine metabolism in rat brain synaptosomes. AB - The effect of in vivo administration of acetonide triamcinolone (AT) on histamine (HA) metabolism in synaptosomes, highly purified from rat brain by discontinuous Ficoll-sucrose gradient centrifugation, was investigated. AT decreases ability of synaptosomes to actively accumulate HA precursor, L-[U-14C]histidine, measured after rapid centrifugation of synaptosomes through silicone oil, as well as lowers activity of HA catabolizing enzyme histamine N-methyltransferase (by 57%). In contrast, no changes in the level of HA, assayed by the single isotope enzymatic method, and the activity of HA synthesizing enzyme, histidine decarboxylase, were found. The results indicate that under applied conditions glucocorticoid administration may decrease turnover of neuronal pool of HA without significant effect on HA level. PMID- 2717068 TI - Essential fatty acid deficiency in premature infants. PMID- 2717069 TI - Iron-deficiency anemia with hypoproteinemia in an infant. PMID- 2717070 TI - National Academy of Sciences report on diet and health. PMID- 2717071 TI - Epinephrine in an emergency. PMID- 2717072 TI - Never say "never". PMID- 2717074 TI - The voice of inexperience. PMID- 2717073 TI - Gastrointestinal emergencies. Test your knowledge. PMID- 2717075 TI - Neuromuscular blockers: administer with care. PMID- 2717076 TI - A.I.D.S. update--a roundup of news and trends. PMID- 2717077 TI - Managing with style--a self quiz. PMID- 2717078 TI - A few words about budgets. PMID- 2717080 TI - Giving trouble-free i.m. injections. PMID- 2717079 TI - 10 rules for successful confrontation. PMID- 2717081 TI - How to measure blood pressure accurately. PMID- 2717082 TI - Dialysis disequilibrium syndrome. Action stat! PMID- 2717083 TI - Pulmonary embolism. Anatomy of a crisis (continuing education credit). PMID- 2717084 TI - Michael's noble purpose. PMID- 2717085 TI - Preserving Adele's dignity. Nursing grand rounds. PMID- 2717086 TI - A new approach to better medication compliance. PMID- 2717087 TI - Managing a suspected spinal cord injury. PMID- 2717088 TI - Special messages. Bob's story--Janet's story. PMID- 2717090 TI - Time to show we care. PMID- 2717089 TI - IV solutions--which one's right for your patient? PMID- 2717091 TI - Percutaneous endoscopic gastrostomy. PMID- 2717092 TI - Patient falls--lowering the risk. PMID- 2717093 TI - Is it drug toxicity--or something else? PMID- 2717094 TI - Did this patient give informed consent? PMID- 2717095 TI - Four dimensionality: where to go with it. PMID- 2717097 TI - Professionalizing nursing: a Rogers legacy. PMID- 2717096 TI - Science of unitary human beings: changing research perspectives. PMID- 2717098 TI - Therapeutic touch as energy exchange: replication and extension. AB - This study replicated and extended previous published research which suggests that therapeutic touch involves an energy exchange. The theorem that eye and facial contact between therapeutic touch practitioners and subjects should not be necessary to produce the effect of anxiety reduction was deduced from the Rogerian conceptual system and tested. This theorem was not supported. Numerous explanations for the failure of the hypotheses to be supported are posited, among them the impact of the research design, effects related to the investigator as practitioner, and medication. The influence of medication in particular is so pervasive in the sample that it would seem to be the most reasonable explanation. PMID- 2717099 TI - Parental-fetal attachment and couvade: a study of patterns of human-environment integrality. AB - The general purpose of the study was to address the difficulty of explaining fathers' prenatal attachments to their unborn children and the difficulty of explaining the phenomenon of couvade. Rogers' principle of integrality was used to derive a theory of the nature of the interactions between fathers and their unborn children as being a human-environment energy field process. The theory held the possibility of fathers having a relationship with their unborn children which was not wholly derivative of their relationship with their pregnant partners; it posited the possible association of fathers' attachment, mothers' attachment, and fathers' couvade experiences. Couvade experiences, previously studied as male pregnancy-like symptoms, were conceptualized as fathers' recognition of changes in themselves and their environments which included their emerging children. Measures of fathers' and mothers' attachments and fathers' ratings of their couvade experiences were obtained during the third trimester for 110 couples' pregnancies. The hypothesized relations among parents' fetal attachments and couvade were not supported. An inverse relation (r = -0.47, p less than 0.001) between fathers' and mothers' attachment scores led to revisions of the interpretation of integrality as used in this study. PMID- 2717100 TI - Prenatal cranial haemorrhages in 47 Pacific Islander infants: is traditional massage the cause? AB - Intracranial haemorrhage is usually a very rare occurrence in the fetus before the onset of labour but we have identified major, mostly subdural, prenatal intracranial haemorrhages in 47 infants of immigrant Pacific Islander parentage. Forty-four infants have been stillborn and the numbers from 1983 to 1986 were sufficient to account for the stillbirth rate for Pacific Islanders in Auckland being approximately 60% higher than rates for Europeans or Maoris. Two of three liveborn infants survived with neurological sequelae. Similar haemorrhages may be the cause of a congenital hydrocephalus in Pacific Islanders. A bleeding disorder can be excluded in most cases, as can trauma from accidents or assaults. Trauma during attempts at cephalic version of breech presentations by traditional methods could explain why 53% of deliveries were breech and other pathological and clinical features. Advice at antenatal clinics about possible dangers of traditional massage has coincided with a reduction in the incidence of haemorrhages since 1986. PMID- 2717101 TI - Attendance failure at Middlemore Hospital asthma clinic. AB - A population of 138 outpatients' sociodemographic and sociobehavioural characteristics and clinic organisational factors were studied in response to a concern about poor attendance rates at Middlemore Hospital's asthma clinic. Low and nonattendance was found to be higher among Maoris (44.7%) and Pacific Islanders (31.6%), outpatients of lower socioeconomic status (SES group 5 and 6, 55.3%), and those referred from the accident and emergency (A & E) department (66%). Migration out of the south Auckland region was common among the group of low attending outpatients (23.9%). Since neither the clinic nor the outpatients' general practitioners were aware of this group's migrational movement there exists a large population who do not have regular medical care and are therefore at risk of significant morbidity or mortality from their asthma. PMID- 2717102 TI - Losing the battle against cancer. PMID- 2717103 TI - Neonatal surgery at Waikato Hospital 1978-87. AB - A ten year (1 January 1978 to 31 December 1987) review of neonatal surgery at Waikato Hospital is reported. There were 367 operations performed on 296 infants aged 0-28 days, with 144 of the operations being classified as a major. Of the 31 deaths, three occurred preoperatively and 28 postoperatively, with diaphragmatic hernia (n = 8) and necrotising enterocolitis (n = 7) being the commonest causes. A significant increase in the number of operations (% major operations), infants with birthweights less than 1500 g, preoperative ventilation and the proportion of operations performed by paediatric surgeons and anaesthetists was seen in the five year period 1983-7, when compared with 1978-82. It is recommended that neonatal surgery only be undertaken at hospitals with level III neonatal intensive care facilities and only by paediatric surgeons and anaesthetists. PMID- 2717105 TI - High mountains and medical emergencies. PMID- 2717104 TI - Adrenoleukodystrophy: manifestations of a protean disorder: report of a recently identified kindred. AB - Adrenoleukodystrophy is an inherited metabolic disorder resulting in accumulation of fatty acids in body tissues, principally the central nervous system. We report a recently identified kindred with this disease to highlight the varied clinical manifestations and recent advances in diagnosis and treatment. PMID- 2717106 TI - Acyclovir resistance. PMID- 2717107 TI - Scientific method. PMID- 2717108 TI - Abnormal erythrocytes in ME. PMID- 2717109 TI - ME syndrome or chronic viral fatigue syndrome? PMID- 2717110 TI - Acute respiratory virus infections in infants. PMID- 2717111 TI - Research and patient care: what needs review and by whom? PMID- 2717112 TI - Hospital ethical committees. PMID- 2717113 TI - Occupational HIV risk. PMID- 2717114 TI - Should hospitals be expected to carry a wide range of antibiotics? PMID- 2717115 TI - ACE inhibitor anaemia. PMID- 2717116 TI - Change and professional union. PMID- 2717117 TI - Marxism today. PMID- 2717118 TI - Pulsus paradoxus and tamponade. PMID- 2717120 TI - The physician and the computer: a tale of the future. PMID- 2717119 TI - Sudden infant death syndrome. PMID- 2717121 TI - Outpatient metabolic evaluation of patients with recurrent kidney stones. AB - We have designed an outpatient, comprehensive metabolic evaluation program for patients with recurrent kidney stone disease. This protocol can be expected to detect and identify specific biochemical abnormalities contributing to kidney stone formation in about 95% of these patients. Individualized therapy can then be started based on the particular metabolic defect discovered in each patient. This diagnostic and treatment program will stop new kidney stone formation in these high-risk patients virtually completely. For each stone-related hospitalization eliminated, the average savings are at least $2,700. The total potential savings in our small community alone are over $460,000! Our metabolic stone evaluation protocol is the only one with which we are familiar that was designed and implemented exclusively at the community hospital level. It is readily adaptable to other medical facilities. PMID- 2717122 TI - A combined group and individual approach to outpatient lithium treatment. AB - The authors describe a clinic they began in 1980 for patients who take lithium carbonate for the prophylaxis of recurrent psychiatric disorders. They discuss in detail what they have found to be the advantages of this approach. They recommend that other outpatient psychiatric facilities consider a similar program. PMID- 2717123 TI - Application of a new radiometric system for identification of potentially useful drug combinations for treatment of human gastrointestinal adenocarcinoma. AB - As an alternative to empirical clinical evaluation of combined drug effects in human tumors, and in an attempt to establish whether the combination of mitoxantrone (DHAD) with other standard drugs would be of any benefit to the patient with advanced gastrointestinal cancer, we have examined the results of simultaneous single-agent testing in vitro in a panel of 8 human colorectal (HCC) and 5 gastric cancer (HGC) cell lines. Cytotoxic drug effects were measured by the use of a new semiautomated radiometric technique (Bactec system), and were quantitated with attention to potentially clinically relevant plasma concentrations. Among several different drug combinations tested, maximal synergistic cell kill was found for DHAD + 5-fluorouracil; continuous incubation of the cells at 1/100 of the peak plasma concentration achievable in humans yielded in vitro responses in 8/8 HCC and 5/5 HGC cell lines. With regard to our results of single-agent testing, our finding of a significant level of in vitro arabinoside-C activity, using prolonged exposure at an in vitro dose corresponding to a clinical high-dose regimen, may provide a rational basis for (re)evaluation of the compound in gastrointestinal cancer patients. PMID- 2717124 TI - Cytostatic activity of commonly used tricyclic antidepressants. AB - Tricyclic antidepressants (TA) often used in the supportive care of cancer patients exhibit cytostatic properties on human renal cancer cells in vitro. Complete growth inhibition was observed with imipramine and clomipramine at concentrations similar to that of nitrogen mustard. Clinical side effects of TA (cardiotoxicity, agranulocytosis) and their binding to nucleotides may point to a mechanism of action similar to that of anthracyclines. Careful recording of TA applications during cancer chemotherapy or better randomized studies with or without TA should define the antineoplastic influence of TA in cancer chemotherapy. PMID- 2717125 TI - Epidermal growth factor receptor status and S-phase fractions in gastric carcinoma. AB - The correlation with epidermal growth factor (EGF) receptor expression and clinicopathologic findings were studied in 242 gastric carcinomas. They were stained for EGF receptor by means of an immunohistochemical technique using a monoclonal antibody against the receptor. S-Phase fractions were measured by in vivo bromodeoxyuridine (BrdU) labeling and indirect immunohistochemical staining using anti-BrdU monoclonal antibody. In normal gastric epithelium, EGF receptor immunoreactivity could not be found. EGF receptor was found in 76 (31.4%) of 242 gastric carcinomas. Diffusely infiltrating types of carcinomas were more likely than localized tumors to be EGF receptor-positive. In addition, EGF receptor positive tumors had significantly higher values of BrdU labeling indices than EGF receptor-negative tumors. The patients with EGF receptor-positive carcinomas also had a poorer prognosis than did negative cases. These results suggested that EGF receptor-positive tumors may have higher proliferative activity and local extension may progress more rapidly, and also seem to show that EGF receptor status may possibly be a useful prognostic marker for gastric carcinomas. PMID- 2717126 TI - Succinate dehydrogenase inhibition test for evaluating head and neck tumors. AB - In vitro chemosensitivity was evaluated in human head and neck cancers using the succinate dehydrogenase (SD) test and the results were compared to findings in cases of malignant lymphomas and gastric cancers. Tumor fragments were exposed to several antitumor drugs at ten times the peak plasma concentration and assayed for SD activity. Decrease of SD activity was most prominent in the malignant lymphomas in cases of exposure to ADM, ACR, DDP, MMC and CQ; in which the average of SD activity decreased to below 30%. In the squamous cell carcinomas, SD activity below 40% was also observed with the same drugs, while the SD activity of gastric cancers was about 50%. There was a change of chemosensitivity following chemotherapy. The use of the SDI test will aid in selecting drugs for the prevention of recurrence or metastasis in head and neck cancers. PMID- 2717127 TI - Antiemetic prophylaxis of cancer chemotherapy-induced nausea and vomiting with cinnarizine and lorazepam. AB - An oral combination of cinnarizine and lorazepam was studied for the prophylaxis of nausea and vomiting induced by strongly emetogenic cancer chemotherapy. 56% of 59 chemotherapy courses in 29 patients were completed without emesis. Of the 42 cisplatin-containing regimens, 52% were without vomiting and 62% free of nausea. A further 11 patients (17 courses) received non-cisplatin emetogenic chemotherapy. In this group full emetic control was achieved in 65% of the courses. Diarrhea in 4% of the courses was the only side effect of this new oral combination. PMID- 2717128 TI - Nutritional monitoring and counselling for cancer patients during chemotherapy. AB - The objective of the study was to try to monitor the nutritional status of cancer patients during chemotherapeutic treatment. Concomitantly with chemotherapeutic treatment administered to patients with cancer of the gastrointestinal tract and metastatic carcinoma of unknown origin, levels of carotene, retinol, thiamine, riboflavin, pyridoxine, iron, total protein and hemoglobin were measured in the blood periodically. In addition, anthropometric studies were performed and the nutritional status was established. A total of 19 patients were subject for final evaluation. These patients formed 3 groups according to their nutritional status (good, medium, poor). The effect of chemotherapy was correlated to the nutritional status at 3 different periods of chemotherapy. Most patients with good clinical status maintained the initial nutritional status. Half of the patients with medium nutritional status improved clinically during therapy, and patients initially with poor nutritional status further deteriorated. The levels of most vitamins decreased to a certain degree during therapy and returned to initial values thereafter. Our impression is that cancer patients might benefit from intensive ongoing personal nutritional monitoring and counselling. The results presented have a preliminary meaning because of the small number of patients included in this study. PMID- 2717129 TI - Ability of retinoic and ascorbic acid to interfere with the binding of benzo(a)pyrene to DNA in explants from donors with bronchial cancer. AB - The capability of ascorbic acid (AA) and transretinoic acid (RA) to interfere with 3H-benzo(a)pyrene [B(a)P] binding to DNA has been evaluated in cultured bronchial mucosa explants from patients with bronchial cancer. The results show that the DNA-bound 3H-B(a)P is smaller in treated cultures than in controls. To explain this finding, it is proposed that AA, acting as antioxidant, inhibits the oxidative degradation of B(a)P, and that RA, a lipophilic compound interacting with the lipid components of mixed function oxidases, could modify the activities of these enzymes. Both vitamins decrease the concentration of ultimate carcinogen metabolites, which can interact with DNA. Furthermore, the treatment with RA does not increase DNA synthesis, while AA inhibits 3H-thymidine incorporation. PMID- 2717130 TI - Conversion of Lewis lung carcinoma into ascitic form. AB - Lewis lung carcinoma (3LL), which has been most frequently used for various investigations of cancer, was converted to an ascitic form designated 3LL-SA. Ascites tumor cells showed a mixed population of single cells and about 10% islands which were made up of 2 to about 50 cells. Transplantability was 100%. The biological and metastatic capacities were preserved in this line as shown by its ability to form hemorrhagic and necrotic tumors, and by its multiple lung metastases. Moreover, histological and ultrastructural characteristics of this tumor line were identical to those of the parental 3LL. Thus, it can be seen that 3LL-SA will be a useful tool for the study of cancer. PMID- 2717131 TI - 1,10-phenanthroline potentiates cytotoxicity of hydroxyurea in human chronic myeloid leukemia cells. AB - The effect of the divalent hydrophobic metal chelator 1,10-phenanthroline was evaluated alone and in combination with the antineoplastic agent hydroxyurea on human chronic myeloid leukemia cells. The compound at concentrations of 10 and 5 micrograms/ml significantly (p less than 0.001) potentiates DNA biosynthesis inhibiting the activity of hydroxyurea in vitro. Synergistic inhibition was obtained when both 1,10-phenanthroline and hydroxyurea was used in combination at relatively nontoxic concentrations. Cytotoxicity due to the combination was found to be partially reversible and was marginally reversible in the presence of Fe+2 and Zn. The results strongly suggest the utility of the iron-chelating agent along with hydroxyurea for further evaluation to achieve a better therapeutic result in the clinic. PMID- 2717132 TI - Malignant lymphoma presenting in the retroperitoneum. AB - Twelve patients with untreated malignant lymphoma presenting in the retroperitoneum are reported. The mean age was 52 years. Pain and a palpable mass were the common symptoms. The high and intermediate grade non-Hodgkin's lymphoma types comprised more than half of the observed histopathology. Three patients survived for more than 5 years. PMID- 2717133 TI - [A method for determining optimal development conditions by summary oxygen consumption]. AB - The minimal overall oxygen consumption at a given developmental stage corresponds to the most favorable temperature conditions of development of poikilothermic animals. Theoretical considerations and experimental data are provided which substantiate this method of determination of the optimal developmental conditions and critical comments are analyzed. PMID- 2717134 TI - [An analysis of factors affecting efficiency in obtaining transgenic mice]. AB - Microinjection of exogenous DNA into male pronucleus at early stages of its formation leads to greater yield of transgenic mice than DNA introduction into male pronucleus at later stages. Dulbecco medium is more suitable for manipulation with murine zygotes than HEPES-containing Whitten medium. On the other side, albumin-free Whitten medium is better for dissolving exogenous DNA for introduction into murine zygote pronucleus as compared to Dulbecco medium and TE buffer. PMID- 2717135 TI - [The effectiveness of the microsurgical removal of the nuclei in early mouse embryos depending on the time before cleavage division]. AB - The efficiency of microsurgical enucleation of zygote and two-cell mice embryos was found to increase sharply 1-1.5 h before cleavage in "late" embryos, and 5-6 h before cleavage in "early" embryos. In "late" embryos, the share of successful enucleations constitutes 80-90%, and in "early" ones, 10-30%. This phenomenon is not connected with cytoskeleton restructuring during the cell cycle, but is determined by the increase in intracellular osmotic pressure at late stages of cell cycle. This process results in the increased elasticity of the embryo and, consequently, the penetration of surgical instruments and removal of karyoplast occurs more efficiently. The artificial increase in the intracellular pressure by addition of distilled water to culture medium also increases the efficiency of microsurgical enucleation. PMID- 2717136 TI - [Changes in the number and size of fibrillar centers in nucleolus inactivation during erythropoiesis]. AB - The size and number of fibrillar centers (FCs) was shown to be proportional to or correlate with the ploidy of the cell, respectively. In the active nucleoli of erythroblasts, the numbers of FCs exceeds several-fold that of nucleoli organizing regions (NORs). In the course of maturation, the number of FCs becomes 3-10 times lower than that of NORs. The total size of FCs decreases three-fold during differentiation, although the size of individual FCs increases. Inactivation of ribosomal genes in the process of erythropoiesis seems to be accompanied by fusion of individual FCs and compaction of their tissue. PMID- 2717137 TI - [The determination of ectodermal derivatives in various species of amphibia]. AB - The process of labyrinth determination has been studied in amphibians (three Urodela and seven Anura species) using homoplastic transplantation of ear ectoderm, containing labyrinth material onto the abdominal wall of embryos of the same stage of development. The stage of appearance of organ-specific properties in ear ectoderm was determined and the increase of these properties in the course of development was observed. The frequency of ear vesicles formation, the level of their differentiation and their size served as criteria. These criteria allow to align the studied species into a row, where organ-specific properties appear earlier and most completely in representatives of Ranidae family and in Bufo viridis, and weakest, in smooth newt. A comparison of properties of labyrinth material and other areas of ectoderm allowed to conclude that specific differences in determination of different ectodermal primordia are based on specific peculiarities of the whole ectoderm. The appearance of these differences can be explained by the shift in the beginning of gastrulation towards later stages of cleavage during the evolution of amphibians. PMID- 2717138 TI - [Duration of the mitotic cycle at the period of synchronous cleavage division (t0) in the starfish Asterina pectinifera (Muller et Troschel)]. AB - The duration of a single division (tau 0) in a period of synchronous cleavage, time of development before the start of cleavage, and rotation, hatching and gastrulation stages in A. pectinifera at different temperatures were estimated. The range of temperatures optimal for embryonic and early larval development of the starfish was determined. PMID- 2717139 TI - [Changes in the surface area and shape of growing organisms]. AB - Equations describing the changes in body surface area of rats and humans during ontogenesis are proposed. A function of difference between the body surface and the surface of sphere of similar weight and density was chosen in order to characterize the body plan formation. Equations describing these processes in rats and humans are proposed. PMID- 2717140 TI - Protein and elemental analysis of contact lenses of patients with superior limbic keratoconjunctivitis or giant papillary conjunctivitis. AB - Soft contact lenses worn by six patients (12 eyes) diagnosed as having contact lens-induced superior limbic keratoconjunctivitis (SLK) and from four patients (5 eyes) with giant papillary conjunctivitis (GPC) were analyzed for protein concentration and for elemental content. Fifty-five percent water content, ionic lenses containing methacrylic acid had high protein concentration. Calcium was not a common element found on protein-coated lenses. Sulfur and iron were found on used and new lenses. An elevated level of mercury was detected in one gray lens that had been disinfected in thimerosal-preserved saline with a high heat disinfection unit by a patient with SLK. PMID- 2717141 TI - Localized defects in ophthalmic lenses. AB - Ophthalmic lenses made from glass, hard resin, and polycarbonate are inspected with a shadowgraph to determine the nature, frequency, and severity of localized defects, including power aberrations. The most common localized defects are scratches and pits left by incomplete polishing and localized power aberrations caused by variations in the thickness of scratch-resistant coatings. Localized defects are more likely in polycarbonate lenses than in glass or hard resin lenses. The compliance of lenses with standards that limit localized defects is discussed. PMID- 2717142 TI - Refractive errors induced by displacement of intraocular lenses within the pseudophakic eye. AB - Simple methods were developed to estimate refractive errors when intraocular lenses are not fitted optimally within pseudophakic eyes. The accuracy of these methods was determined by comparing results obtained with them to results obtained by raytracing through a model eye. Accuracy was good for longitudinal displacement and tilting, and reasonable for transverse displacement. Refractive errors are related linearly to the magnitude of the longitudinal displacement, and are related to the square of the magnitude of tilt or transverse displacement. The refractive error upon transverse displacement is quadratically dependent upon lens shape. PMID- 2717143 TI - Appearance of color matchings under various chromatic adaptation conditions. AB - Three chromatic reference stimuli (red, green, and blue) seen under five adaptation conditions (red, green, blue, achromatic, and darkness) were appearance-matched to subsequent color stimuli seen under achromatic conditions. The experimental results have been used to verify the opponent-color color-vision model and also to check the validity of some of the published transformation equations for predicting the tristimulus values of colors matched to a reference stimulus seen under different chromatic-adaptation conditions. It is concluded that the extant transformation laws are not sufficiently general to be applied to all adaptation conditions. PMID- 2717144 TI - Aniseikonia and fixation performance: effect of retinal stimulus location. AB - It has been shown previously that induced aniseikonia amplifies any latent fixation eccentricity associated with binocular fusion stress. This study determines if the retinal location of the stimulus plays a part in this effect. The stimulus consisted of a vertical border formed by the juxtaposition of two fields of unequal luminances and a line segment parallel to the border whose distance from the border can be varied. At the same time, the border allowed the application of a previously tested method of measuring fixation eccentricity, based on the border-enhancement response. It was found that the fixation eccentricity produced by aniseikonia is maximal for the smallest distance of the variable target from the border but unaffected by the larger distances tested. It was concluded that the retinal location of the stimulus has an important influence on the response to aniseikonia. PMID- 2717145 TI - Correcting astigmatism. AB - Measurement of refraction in the principal meridians and off-axis meridians in both directions from the visual axis was undertaken. The extent of disagreement between the sine-squared law and the actual astigmatism of living astigmatic eyes was calculated. The corrected visual acuity correlates with the residual ametropia. The conoid of Sturm is not the same for each eye. PMID- 2717146 TI - The sagitta and lens thickness: the exact solution and a matrix approximation for lenses with toric, spherical, and cylindrical surfaces. AB - The exact equation for sagitta of spherical surfaces is generalized to toric surfaces which include spherical and cylindrical surfaces as special cases. Lens thickness, therefore, can be calculated accurately anywhere on a lens even in cases of extreme spherical and cylindrical powers and large diameters. The sagittae of tire- and barrel-form toric surfaces differ off the principal meridians, as is shown by a numerical example. The same holds for pulley- and capstan-form toric surfaces. A general expression is given for thickness at an arbitrary point on a toric lens. Approximate expressions are derived and re expressed in terms of matrices. The matrix provides an elegant means of generalizing equations for spherical surfaces and lenses to toric surfaces and lenses. PMID- 2717147 TI - Age-related changes in precorneal tear film stability. AB - For several years it has been known that the production rate of tears declines as age increases. Reports suggest that this reduction is more apparent in females than in males. Using a noninvasive method we report that a significant linear reduction in precorneal tear film stability occurs between the ages of 8 and 80 years. However, we found no significant differences in tear film stability between males and females. PMID- 2717148 TI - Oculogyric crisis after metoclopramide therapy. AB - Oculogyric crisis developed in a 21-year-old girl after 5 oral doses of 10 mg of metoclopramide. The symptoms were relieved by i.v. administration of diphenhydramine hydrochloride. Although ocular side effects of metoclopramide are rare, it can induce an alarming oculogyric crisis in some sensitive subjects. The mechanism of oculogyric crises is unclear but the characteristics of the condition and some known causes are discussed. Advice is given on optometric management. PMID- 2717149 TI - Proposed hypothesis for corneal infiltrates, microabrasions, and red eye associated with extended wear. PMID- 2717150 TI - Unusually aggressive osteomyelitis of the jaws. A report of two cases. AB - Two cases of unusually aggressive osteomyelitis of the jaws are reported. Both cases manifested severe, rapidly progressive lytic destruction of the maxilla in spite of the fact that patients were young, healthy adults with no local or systemic factors that would predispose them to severe infection in either case. Characteristic historical, clinical, radiographic, and histologic features are elaborated. Also, theoretical aspects of this disease entity are discussed in an effort to explain the unusually aggressive manner in which these cases presented. PMID- 2717151 TI - The reliability of personal and family medical histories in the identification of hepatitis B carriers. AB - Blood specimens were obtained from 300 patients and were tested for the five hepatitis B virus (HBV) serum markers: HBsAg, HbeAg, anti-HBs, anti-HBe and anti HBc. Medical histories were checked to determine any previous experience of HBV infection in the patients or their families. Serum markers showed that 54.3% of the group had evidence of earlier HBV infection, 10% were HBsAg carriers, and 3% were HBeAg-positive. The patients' own histories correctly identified carriers in 23.1% of those giving a positive HBV history (p less than 0.05). Family histories were found to be an unreliable means of detecting HBV carriers. HBeAg carriers were twice as likely to be identified by their histories than HBsAg carriers. Blood donation refusal was the most frequent indicator of previous HBV infection. PMID- 2717152 TI - A histopathologic study of oral mucosal lupus erythematosus. AB - Specimens representing 17 cases of each of oral mucosal lupus erythematosus (LE) and lichen planus were examined under the light microscope to establish a set of histopathologic criteria that would distinguish between the two. Statistical analysis showed that significant differences in histopathology exist between the two diseases. A classic case of LE was found to exhibit the following characteristics: vacuolization of keratinocytes, patchy PAS-positive deposits subepithelially, edema in the lamina propria, PAS-positive thickening of blood vessel walls, and the presence of a severe or perivascular inflammatory cell infiltrate. A number of other less significant alterations were also identified. It is concluded from this study that oral LE in most cases is characteristic enough to provide a definitive diagnosis at the light microscopic level. PMID- 2717153 TI - Mucocutaneous lymph node syndrome (Kawasaki disease). AB - Mucocutaneous lymph node syndrome has rarely been reported in the dental literature despite the orofacial features characteristic of the disease. A case is reported in which the cardinal signs were present: erythema of the oral mucosa, cervical lymphadenopathy, conjunctivitis, pyrexia, and desquamation of the skin of the hands and feet. In addition, hydrops of the gallbladder and cardiac disorder were also found. The patient may first seek treatment by the dental practitioner, by whom the diagnosis may be made. Attention is drawn to the possibility of cardiac abnormalities that may influence dental treatment. PMID- 2717154 TI - The efficiency and reliability of the Dentometer for detecting root canal length. AB - The accuracies of an analog-indicating electronic device, the Dentometer, and of an audio-indicating device, the Sono-Explorer, were compared to each other and to the radiographic method of tooth length determination. Readings obtained by the Dentometer were shorter, an average of 0.28 +/- 0.64 mm than those obtained by the Sono-Explorer (p less than 0.001) and 0.32 +/- 0.63 mm shorter than the results obtained by the calculated working length (p less than 0.001). No statistically significant difference was found between the readings of the Sono Explorer and the calculated radiographic working length. The results indicate that the measurements calculated by the radiographic method were longer than those obtained by the electronic method of tooth length determination. The statistically significant difference found between the two devices indicates that to determine the accuracy of electronic devices, they should be tested and compared to other methods or devices. PMID- 2717155 TI - External root resorption: an experimental radiographic evaluation. AB - Radiographs of a human mandibular premolar, in which five holes (resorptive defects) of differing diameters were drilled before its replacement into a human mandible, were evaluated by 11 dental faculty members. The radiographs were made at various exposure times and angulations. The observers' results were evaluated statistically. It was found that small resorptive defects were significantly more difficult to identify than larger ones. Also, angulation, exposure time, and location of the defects as defined in this study had no significant effect on the ability of observers to accurately identify them. PMID- 2717156 TI - Studies in tooth crown temperature gradients with the use of infrared thermography. AB - With the use of an infrared thermographic camera; temperature patterns over the crowns of teeth were recorded. The temperature of upper incisor teeth decreased from gingival margin to incisal edge by approximately 2.5 degrees C. Vital and nonvital teeth were the same temperature at rest, but after cooling with cold air, nonvital teeth were slower to rewarm than vital teeth. The infrared thermographic camera could provide a method of testing tooth vitality based on blood supply rather than nerve supply. PMID- 2717157 TI - Postoperative changes after bilateral mandibular osteotomies: a computed tomography study. AB - Twelve patients undergoing bilateral osteotomy of the ramus of the mandible were examined with CT preoperatively and postoperatively. The maximum area of the cheek and oropharynx was measured together with the thickness of the masseter muscle and the overlying subcutaneous tissue. The preoperative CT examinations showed wide anatomic variations. The postoperative examinations showed a diminished oropharynx lumen of approximately 43%. Swelling of the cheek averaged 61% and was associated with the well-vascularized masseter muscle. The TMJs were measured and a slight widening of the joint space was found postoperatively. PMID- 2717158 TI - Rheumatoid arthritis of the temporomandibular joint: radiologic evaluation based on standard reference films. AB - A radiologic scoring system that uses tomography and panoramic radiography to evaluate severity of rheumatoid arthritis in the temporomandibular joint of adults is presented. The scoring system is based on six verbally described grades illustrated by standard reference films. The interobserver agreement was significantly higher for the grading with reference films than for that without reference films. Intraobserver performance was similar for grading with and without reference films. The grading system with reference films is recommended in epidemiologic studies of rheumatoid arthritis localized to the temporomandibular joint or other studies in which multiple observers are involved. PMID- 2717159 TI - Radiographic appearance of nutrient canals in the region of the erupting permanent maxillary cuspid. AB - A retrospective radiographic search was made for nutrient canals situated immediately inferior to the incisal tip of the unerupted permanent maxillary cuspid. In this study, the structure was observed radiographically in 35.4% of the children between the ages of 6 and 10 years, with an apparently greater incidence among girls. PMID- 2717160 TI - Ankylosed deciduous maxillary molar mimicking sinus pathosis. PMID- 2717161 TI - Impacted molars. PMID- 2717163 TI - [Various remarks regarding the principles of the treatment of fractures]. PMID- 2717162 TI - "Stalactite" calculus formation. PMID- 2717164 TI - [Osteoid osteoma of the hands and feet]. AB - Having studied 38 patients with osteoid osteoma of the bones of hands and feet the authors have revealed a number of peculiarities in clinical and roentgenological picture of the tumour of this localization. The process involves neighbouring and even rather remote tissues (muscular atrophy, vegetative disturbances), quite often there are destruction of the bones adjacent to the affected one, articular changes looking like inflammation and pronounced sclerotic reaction. Osteoid osteoma of the bones of hands anf feet is characterized by subperiosteal form when the "nest" of the tumour is situated outside the bone, thus causing atrophy due to pressure of the tissues lying below. Since the only effective method of treatment of osteoid osteoma consists in surgical removal of the "nest", it is of utmost importance to take into consideration atypical course of the tumour of this localization when maring the diagnosis. Angiographic investigation may be of considerable help in diagnostics. PMID- 2717165 TI - [Fractures of the inner epicondyle of the humerus associated with dislocation of the forearm bones in children and adolescents]. AB - The authors attract attention to frequent association of fracture of the inner epicondyle of the humerus with dislocation of the bones of the forearm, which is of great practical importance. On this basis classification of fractures of the inner epicondyle of the humerus is presented. The authors believe that in treating this injury the method of choice should consist in open reposition, which allows to achieve accurate reposition, sanation of the ulnar joint cavity and stable fixation of the fragment. Osteosynthesis by screw-awl provides for reliable fixation of the fragment and allows for early development of the movements in the ulnar joint. Surgical treatment mostly gave excellent and good results and complications were few. The complications observed were mainly connected with late admission of the patients. PMID- 2717166 TI - [Pathomechanogenesis of contractures and deformities of the upper extremities in children with cerebral palsy]. AB - The authors carried out dynamic observation of 180 children aged 3-14 with infantile cerebral paralysis (ICP) who were treated for pronation flexion contractures of the forearm and of the hand, studied up to 45 values connected with the age of the patients, terms of appearance of the symptoms of the disease, subsequently processed the results of their investigations employing methods of analysis of variance, non-linear correlation and regression analysis and constructed analytical models of development of the pathologic process, which allowed to draw the following conclusions. Pathomechanogenesis of disturbances of the upper extremity in ICP includes primary muscular disbalance, successive formation of faulty postures, pathologic locomotor stereotype, vegetotrophic disturbances, contractures of the joint and anatomical changes of the skeleton. These changes are closely correlated with the age of the patients and according to the degree of the disturbances may be regarded as stages of the disease. PMID- 2717167 TI - [Electrophysiological and morphological changes in muscle-flexors of the fingers after injuries of the tendons in children]. AB - The investigation of bioelectrical activity of flexors of the fingers in children at different terms after the injury and subsequent restoration of the tendons allowed to determine the dynamics of bioelectrogenesis of the muscles. Decrease in bioelectrical activity of the muscles was most expressed and stable during the first 6 months after the injury. The morphological studies carried out at that time demonstrated presence of lysis of some muscle fibers. Complete restoration of bioelectrical activity of the muscles was observed after suture of the tendons and autotendoplastn which was performed not later thay 4-6 months after the trauma. The investigation of dynamics of restoration of bioelectrical activity of the muscles allowed to determine the optimal terms for performing tendolysis. PMID- 2717168 TI - [Pathogenetic aspects of decompression interventions in complicated injuries of the spine]. AB - The paper is based on the analysis of the results of clinical, pathophysiological and roentgenological examinations and on the data of surgical verification of the causes of neurologic deficiency in 163 patients. Proceeding from the condition that the principal operations in cases of complicated fractures of the spine are decompression and stabilization interventions, the authors have elaborated a system of such interventions and stated the main principles of choice of the methods of decompression. In particular they have proposed the following extents of decompression interventions: decompression of the contents of the vertebral canal, decompression of the contents of the dural sac and intratrunk decompression of the spinal cord. The methods of decompression interventions may be correction, correction and stabilization, resection and resection and stabilization. The proposed scheme allows to eliminate the existing terminological discord and provides for objective evaluation of the efficiency of the intervention. PMID- 2717169 TI - [Results of the complex conservative ambulatory treatment of cervical osteochondrosis including acupuncture-reflexotherapy]. AB - The authors have carried out clinical observation and treatment of 78 patients with cervical osteochondrosis with manifestations of hypermobility of the cervical spine. The complex of curative measures included administration of mild massage of the collar area and the upper extremities, stage-by-stage exercise therapy, distraction of the cervical spine according to a specially elaborated technique and acureflexotherapy (ART). A comparative analysis of efficiency of the treatment including ART and without it testified to considerable improvement of the results of the treatment in combination with ART. PMID- 2717170 TI - [Growth process and sex maturation in girls with dysplastic scoliosis]. PMID- 2717171 TI - [Use of controlled abacterial medium in the treatment of wound infection of the hand]. AB - The authors inform about their experience of employing controlled abacterial medium in 30 patients with severe forms of wound infection of the hand which developed after open injuries of the hand. There was a 3-fold reduction of the periods of preparation of the suppurative wounds of the hand for plastic closure and a 10% increase of the area of grafting of skin autotransplants. PMID- 2717172 TI - [Characteristics of spinal stress in modeling scoliotic deformity and the methods of its correction]. AB - Having studied the dynamics of stresses in models of scoliotic models of different types of surgical correction the authors have determined the optimal methods of treatment depending on the kind of deformation. PMID- 2717173 TI - [Pigmented villonodular synovitis of the hand]. PMID- 2717174 TI - [Inveterate dislocations and fractures-dislocations of the radius in the distal radioulnar joint and their treatment]. PMID- 2717175 TI - [Rare case of dislocation of the clavicle]. PMID- 2717176 TI - [Study of the muscles by artificial contrasting in patients with orthopedic diseases]. PMID- 2717177 TI - [Various clinical aspects of the treatment of patients with traumatic myositis ossificans (preliminary report)]. PMID- 2717178 TI - [Staphylococcal osteomyelitis of the spine as a complication of gunshot abdominal wound]. PMID- 2717179 TI - [A method of roentgenological diagnosis of bilateral spondylolysis]. PMID- 2717180 TI - [Use of damper hammocks in the treatment of spinal fractures]. PMID- 2717181 TI - [Causes of children's traumatism in the industrial region of the Donets Basin]. PMID- 2717182 TI - [Various problems of nosology of traumatic disease]. PMID- 2717183 TI - [Restoration of the function of the hand after combined injuries of the flexor tendons, nerves and arteries of the distal part of the forearm in children]. AB - The authors observed 25 children with combined injuries of flexor tendons and vascular nervous fascicles on the level of the lower third part of the forearm and the carpal canal. During the initial operation the flexors and the nerves were restored and the nerves were ligated in all patients. Precision equipment was employed when putting in the epineural stitches. A complex of electrophysiological non-invasive and clinical methods of investigation of regional hemodynamics and the neuromuscular apparatus of the hand were employed during this study. Long-term clinical and functional results of treatment of this category of patients are presented. PMID- 2717184 TI - Genomic organization of the human retinoblastoma gene. AB - Sequence analysis of the human retinoblastoma gene cDNA revealed the presence of repeated elements in the form of direct repeats, inverted repeats and dyad symmetries. The clustering of the dyad symmetrical elements in some exons, #16 and #17, coincides with the hot spots for structural aberrations of the RB-1 locus previously observed in tumors. The RB-1 gene is divided into at least 27 exons distributed over 200 kbp. Three potential Sp1 binding sites are presented within 600 bp upstream of the translation start site. A DNA fragment containing these Sp1 sites ligated to a promotorless CAT gene can promote its transcription in transfected cell culture. PMID- 2717185 TI - Localization of the pKs gene, a raf related sequence on human chromosomes X and 7. PMID- 2717186 TI - Growth factor independence and indefinite growth ("immortalization") appear simultaneously after crisis in murine myelocytes expressing v-myc. AB - In murine myelocytes doubly infected with the v-myc virus and the v-Ha-ras virus, or the v-myc virus and the v-abl virus, the emergence of growth factor independent cells is a rare event which coincides with crisis in the cultures. All growth factor-independent cells which emerge from crisis are also "immortalized", i.e., able to grow indefinitely. We wanted to determine whether the v-abl gene plays a role in the immortalization of the growth factor independent cells. Therefore we infected murine myelocytes with v-myc virus and a v-abl mutant virus coding for a temperature-sensitive tyrosine kinase. Growth factor-independent cell clones were isolated and their properties at the nonpermissive temperature analyzed. We observed that 4 hr after the shift to the nonpermissive temperature the expression of both the genomic and subgenomic viral v-myc transcripts decreased significantly, followed by a loss of the viability of the cells. However, several variants emerged which were able to grow at the nonpermissive temperature and showed elevated expression of v-myc. The results suggest: 1) that v-abl plays a role in the immortalization of the cell clones by maintaining a critical level of v-myc expression; 2) that rare genetic changes leading to constitutive v-myc expression independent of v-abl tyrosine kinase activity can also lead to immortalization in this model system, and 3) that immortalization and growth factor independence occur in post-crisis cells and are associated with constitutive expression of v-myc. PMID- 2717187 TI - For all the wrong reasons. PMID- 2717188 TI - State Board of Nursing's actions seen as a Pandora's box for scope of practice. PMID- 2717189 TI - [Resistance of staphylococci to intracellular killing by macrophages--a new pathophysiologic concept of acute hematogenous osteomyelitis in childhood and its therapeutic consequences]. AB - The pathophysiologic mechanism of acute hematogenous osteomyelitis in children has been further elucidated. Investigations revealed, that certain strains of staphylococcus aureus, responsible for the majority of infections, can resist intracellular killing after phagocytosis. Beta-lactam-antibiotics don't penetrate well into phagocytes and are unable to eradicate staphylococci surviving intracellularly. Fosfomycin, clindamycin and combinations of these antibiotics with beta-lactam-antibiotics are able to eradicate staphylococci also in phagocytic vacuoles. In a therapeutic investigation 36 patients have been treated with fosfomycin in combination with cefamandole intravenously for 10-14 days followed by clindamycin orally for 3-6 weeks. With this treatment schedule the therapeutic outcome was superior to previously employed therapeutic regimen. PMID- 2717190 TI - [Empirical antimicrobial therapy of infection and fever episodes in children and adolescents with neutropenia caused by cytotoxic chemotherapy]. AB - The experience with empirical antimicrobial therapy of septicemia and febrile episodes in pediatric neutropenic patients was analyzed retrospectively. Between January 1985 and March 1988 in 49 patients 77 episodes were observed. Bacteremia was found in 15 (20%), culture proven localized bacterial infection in 11 (14%) and clinically diagnosed bacterial infection was found in 7 (9%) of the febrile episodes. Thus, 33 (43%) documented bacterial infections were observed. For initial therapy a combination of aminoglycoside plus 2nd/3rd generation cephalosporin (60%) or aminoglycoside plus piperacillin (30%) was usually chosen. Both regimens were equally effective. 52% and 56%, respectively, were sufficiently treated with the initial regimen. 95% of all episodes resolved completely, the mortality rate was 5%. Central venous catheters remained in situ in 84% of the cases. The period of time necessary for recovery of granulopoiesis had an influence on the therapy success. PMID- 2717191 TI - [Infections of the cerebrospinal fluid shunt]. AB - The treatment of infectious complications of implanted foreign bodies into the CNS is unsatisfactory. In the majority of these patients staphylococci are responsible for these infections which elicit only a smoldering inflammatory response with poor penetration of antibiotics into the CSF. It is also very difficult to eradicate staphylococci from the surface of silastic material by antibiotics. Fosfomycin was investigated in the treatment of CSF infections in patients with infected ventriculoatrial shunts. Fosfomycin exhibits a potent antimicrobial activity against staphylococci; this drug also showed a favourable penetration into the CSF in moderately inflamed meninges. A 10 days therapeutic course with fosfomycin plus oxacillin or cefamandole and gentamycin in combination with external drainage of the CSF into a closed system made it possible to exchange all parts of the system in one session without reinfection. This procedure was followed by the same antibiotic regimen postoperatively for 10 14 days. Under this treatment schedule therapeutic results have been considerably better compared to previous treatment modalities. PMID- 2717192 TI - [Diagnosis and therapeutic strategies in pneumonia in childhood]. AB - Acute lower respiratory tract infections remain a major cause of morbidity in infants and children. In the majority of patients therapy is complicated by difficulties in securing a specific diagnosis and identification of the causative organism. Treatment is therefore largely based on experiential rather than experimental data. In our study we have tried in 722 patients with pneumonia to correlate the clinical findings with the causative agents. Age and a careful medical history give good clues towards the most probable aetiologic agent. Additional information is gained by the course of the illness. Physical examination, chest X-ray and few limited laboratory tests can also be of help to identify the most likely organism. Once the organism is identified, appropriate antimicrobial agent can be started. It is not only the choice of the antimicrobial substance, but also the choice of the proper total daily dose, dosage interval and mode of administration. By this management we had good results also in elimination of problem organism such as pseudomonas in CF. PMID- 2717193 TI - Reproductive aspects in spinal cord injured males. AB - Infertility in paraplegic males is determined by two major factors: (1) most patients with spinal cord lesions cannot ejaculate, and (2) if ejaculation is possible, then the features of the semen are constantly abnormal. Various methods have been proposed to stimulate the ejaculatory reflex in paraplegics. From 1983 we have used for this purpose a simple vibrator applied to the penis and with this method the ejaculatory response was obtained in 72 of 102 patients treated. Fifteen patients who desired a child, received instruction in self-using the vibrator at home weekly. Sperm characteristics were evaluated (mean of two samples) before and after 3 months of self-use of the vibrator. Statistical evaluation of the results was performed with Student t-test. At the end of the treatment an improvement of sperm concentration and progressive motility was evident, but the result of highest statistical significance was the decrease of abnormal sperm morphology. Three couples obtained a pregnancy with AIH. PMID- 2717194 TI - Lower limb fractures in the chronic spinal cord injured patient. AB - Experience in managing 33 lower limb fractures in 25 chronic spinal injured patients is described. An increased awareness among patients and medical staff is required to avoid misdiagnosis. Effort should be made to ensure bone union in satisfactory position, recognising the different requirements of ambulant and non ambulant patients. 'Soft pillow splints' were found to give the best results in all fractures other than those of the femoral neck. Operative treatment with antibiotic prophylaxis is only indicated to correct important deformity. PMID- 2717195 TI - Abdominal aortic aneurysm presenting as paraplegia: case report. AB - A 65-year-old man with a previously undiagnosed abdominal aortic aneurysm presented with acute paraplegia. Elective resection of the aneurysm was undertaken one week later. Following this, almost complete neurological recovery was regained by 11 months. PMID- 2717196 TI - Development of a live attenuated vaccine against coccidiosis of poultry. PMID- 2717197 TI - Free radical generation during primary infections with Nippostrongylus brasiliensis. AB - The production of free radicals during infection of the rat with Nippostrongylus brasiliensis was investigated. Lipid peroxidation, which is the best documented effect of free radicals, was monitored in the small intestines of infected rats by measurement of malonyldialdehyde and was found to be increased at the time of worm rejection. The capacity of peritoneal leucocytes to produce free radicals, as measured by chemiluminescence, was monitored in rats infected with different doses of N. brasiliensis. Rejection of N. brasiliensis from rats infected with 6000 third-stage larvae (L3) began 2 days earlier than in rats infected with only 600 L3. Maximal free radical generation also occurred 2 days earlier and was quantitatively greater in rats infected with 6000 L3. Free radical generation by leucocytes in response to live adult N. brasiliensis was enhanced by plasma from infected rats indicating the existence of a plasma-borne factor responsible for the initiation of free radical generation in response to N. brasiliensis. PMID- 2717198 TI - The effect of antioxidants on the rejection of Nippostrongylus brasiliensis. AB - The effect of the antioxidants, butylated hydroxy anisole (BHA) and vitamin E, on the rejection of Nippostrongylus brasiliensis from the small intestine of the rat was investigated. Worm expulsion was inhibited by BHA. Malonyldialdehyde production in the small intestines and free radical generation by peritoneal leucocytes from infected rats were also inhibited by BHA. Vitamin E, although inhibiting malonyldialdehyde production, did not prevent worm expulsion. Significantly, vitamin E was much less effective than BHA at reducing free radical generation by rat leucocytes in response to N. brasiliensis. PMID- 2717199 TI - [Sexual dimorphism of the nymphal phase of ixodid tick species in the genus Dermacentor]. AB - In four studied Dermacentor species at preimaginal phases sexual dimorphism hardly reveals itself in body size and mass of individuals. The formation of sexual distinctions at the nymphal phase concerns different characters as in different species so in populations of one species. In D. niveus male and female nymphs differ in the length of II-III palpal joints and width of gnathosoma, in D. ushakovae in the length of scutum and its proportions, in the width of gnathosoma and hypostome and in the diameter of peritreme. The sex of D. silvarum nymphs can be identified by the width of gnathosoma, length of hypostome and diameter of peritreme. Female and male nymphs of D. marginatus from the Stavropol Territory and Armenia differ in the scutum proportions and populations from the western Pamirs in the length of scutum and gnathosoma. PMID- 2717200 TI - [Harvest mites of the family Trombiculidae in the steppe zone of the southeastern Ukraine]. AB - Virgin and cultivated biotopes of the Sea of Azov area of Donetsk Province were investigated for parasite coenoses of small mammals. 469 animals and 210 nests were collected, Apodemus sylvaticus, Mus musculus, Microtus arvalis and Cricetulus migratorius being the most abundant species. In all 2940 larvae of trombiculids (18 species) were found on animals and in their nests (2846 specimens on animals and 94 specimens in nests). Two species, Hoffmannina theodori and Doloisia skljari, are new for science, the latter being the first find of the genus Doloisia member in the fauna of the USSR. The majority of parasites are collected from rodents inhabiting virgin biotopes (2328 specimens) while in cultivated biotopes 189 specimens were collected. More rich is the species composition of trombiculids in virgin biotopes (13 species) as compared to that in cultivated ones (5 species), Neotrombicula earis, N. japonica, N. autumnalis and N. vulgaris being mass species. 8 species of larvae are recorded from the nests of rodents. Seasonal dynamics of the abundance of mass species, their occurrence, index of abundance and infection intensity are shown. PMID- 2717201 TI - [Seasonal dynamics of the population count of Bothriocephalus opsariichthydis (Cestoda, Pseudophyllidea) and the differential infestation of carp yearlings of various genotypes]. PMID- 2717202 TI - [Changes in the monocercus cercomer in the cysticercoid cavity and the hemocoel of the nonspecific host]. AB - In order to elucidate the functional role of cercomer in larvae of the monocercus type their transplantation from the specific host Chironomus obtusidens to Gammarus lacustris was conducted. At early stages after the transplantation proceeds an increase in the functional activity of the tegument of follicles of the cercomer followed by their complete destruction in 3 or 4 days. On the surface of the exocyst membrane an adhesion of the host's haemocytes occurs, which becomes more distinct in 3-4 days when the process acquires a character of local encapsulation. Within the same period, in the places of haemocytes aggregation, a local resorption of the exocyst external membrane takes place. Later intensification of the host response to transplant is associated with the destruction of follicles of the cercomer. In one case the occurrence of follicles of the cercomer in the cavity of cysticercoid was observed that is caused by the microbe affection of the latter. In the zone of contact of the tegument of scolex and neck with follicles of the cercomer an increased secretion (the microapocrine type) of the tegument, disturbance of the microvillous tegument of the cercomer's follicles and their destruction are observed. Incompatibility of the tegument of definitive departments and cercomer, which arises during differentiation of larvae, is supposed to affect the formation of scolex invagination in the evolution of larvae of Hymenolepis. PMID- 2717203 TI - [Intrastrain heterogeneity of Trichinella spiralis: a sedimentation analysis]. AB - Intrastrain heterogeneity of muscular larvae of trichinellids has been revealed in experiments of free sedimentation and isopyknic division in the density gradient of saccharose, the presence of which is confirmed by the study of morphological characters and infection activity. The presence of intrastrain heterogeneity indicates the necessity of introduction of standard technique for studies of biological characters of different strains of trichinellids. PMID- 2717204 TI - [Histochemical reaction to biogenic amines of the nervous system of the larval and mature cestode Microsomacanthus microskrjabini]. AB - Histochemical reaction with glyoxylic acid has revealed a specific fluorescence caused by the presence of indolamine (apparently serotonin) in the nervous system of larva and mature cestode. Fluorescence manifests itself in neurons and nerve fibres of the central ganglion and its commissure, in nerve cells of the proboscis, in longitudinal trunks and transverse commissures, and in the nerve elements connected with genital system. PMID- 2717205 TI - Nonunion of a midshaft clavicle fracture associated with subclavian vein compression. A case report. AB - Fractures of the clavicle are usually treated by closed means and heal uneventfully. In this report, we present an unusual case in which the subclavian vein was compressed by a fracture callus that had formed around a clavicular nonunion. Treatment included dissection of the subclavian vein from the fracture callus and compression plating with autogenous bone grafting of the fracture. Symptoms from the patient's venous obstruction slowly resolved without further treatment. The fracture united postoperatively. PMID- 2717206 TI - The os in os appearance in the spine and pelvis of adults. AB - Three cases of radiodense lines contained within bone and coursing parallel to the bony surfaces in skeletally mature patients are discussed. These lines were found to be distinct with normal appearing bone on either side and formed a miniature model of the present bony structure. This "bone within a bone" appearance was discovered on roentgenograms of patients with no history of musculoskeletal disorders. This radiologic finding probably represents a time limited insult to the immature skeleton and appears to have no clinical significance. PMID- 2717207 TI - Intratendinous ganglion. A case report. AB - Intratendinous ganglion is a rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful swelling over the dorsum of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the ganglion and its capsule followed by meticulous repair of the tendon. PMID- 2717208 TI - Bullet within the spinal canal. AB - A 13-year-old girl suffered a single gunshot wound to the abdomen that resulted in multiple small bowel perforations and an incomplete neurologic injury involving her lower extremities. Physical exam failed to locate an exit wound. Radiographs revealed the bullet within the spinal canal at the thoracolumbar junction. It was subsequently removed on a non-urgent basis. PMID- 2717209 TI - Mallet thumb: an unusual association. AB - A case of simultaneous mallet thumb and complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb is described. This combination of injuries has not previously been reported. PMID- 2717210 TI - Tips of the trade #11. A technique for tendon and capsule separation in shoulder surgery. AB - Difficulty is frequently encountered in separating the rotator cuff tendons, particularly the subscapularis tendon, from the underlying and often adherent capsule. A safe and quick method of dissecting the tendon from the capsule using a Cobb elevator has proven effective without causing capsular penetration in well over 100 consecutive primary shoulder stabilizations. PMID- 2717211 TI - Immunological relationships during primary infection with Heligmosomoides polygyrus (Nematospiroides dubius): dose-dependent expulsion of adult worms. AB - The survival of Heligmosomoides polygyrus was monitored during primary infections in female C57Bl10, NIH and BALB/c mice at low and high intensities of infection. Survivorship curves were fitted for each data set and analysed. C57Bl10 mice, given either low or high intensities of infection, harboured parasites for 28-37 weeks, heavier infections surviving marginally but significantly longer. Essentially the survivorship curves of H. polygyrus in C57Bl10 mice could be accounted for by senility, the increased probability of worms with a longer life span occurring at high infection intensities and, possibly, by a contribution from host-protective immune mechanisms in the terminal stages of infection. The pattern of survivorship was different in NIH and BALB/c mice. NIH mice showed weak but significant density-dependent suppression of parasite loss and infections in this strain did not exceed 27.5 weeks in duration. Primary infections in BALB/c mice were briefer still and showed marked dependence on parasite density. Thus low-level infections lasted 10-15 weeks whereas heavier infections survived for 21-34 weeks. The data suggested that both strains developed host-protective responses to adult H. polygyrus and that parasite survival was curtailed earlier than would be expected if senility alone was involved. The hybrid strains (C57Bl10 x NIH)F1 and (B10G x NIH)F1 both expelled H. polygyrus in a dose-dependent manner, worm loss commencing within 10 weeks of infection. In some experiments worm loss was clearly evident by weeks 4 and 6. These hybrid strains showed gene complementation in that adult worms were cleared considerably earlier than in parental strains. PMID- 2717212 TI - The influence of individual, social group and household factors on the distribution of Ascaris lumbricoides within a community and implications for control strategies. AB - The distribution of Ascaris lumbricoides within a community was examined at an initial mass anthelmintic treatment programme (January 1984) and following an 11 month period of reinfection (November 1984). Similar patterns of the negative binomial parameter kappa (an inverse measure of parasite aggregation) and the proportion of parasites within the most heavily infected quartile of the community were recorded at the two dates. The pattern of parasite aggregation within individuals, measured by parameter k, appears to be a stable characteristic of this host-parasite relationship. Significant variation in the intensity of infection was observed between households in the community. The number of family members living in the house strongly influenced the mean Ascaris burden and proportion of relatively heavy infections within adults and children. This finding suggests that the density of people in a house positively influences the frequency of exposure to infective stages of Ascaris, which in turn plays a major role in determining which individuals will harbour heavy infections. Positive correlations were recorded between the initial and reinfection burdens of individuals, relative to others in the community. The correlations were strongest in the youngest and oldest age groups and were more frequently significant among age-stratified groups of females, compared to males. A comparative examination of hypothetical treatment strategies suggests that for Ascaris infections in this community, targetting age groups with anthelmintic treatment would probably be more cost-effective in the long term in reducing the abundance of this parasite than selective treatment of individually identified heavy infections. PMID- 2717213 TI - Echinococcus granulosus: a comparison of free amino acid concentration in hydatid fluid from primary and secondary cysts and host plasma. AB - A total of 28 components were detected in the free amino acid (FAA) pool of hydatid fluid from primary and secondary equine cysts, secondary ovine cysts and host plasma. Examination of data from equine cysts revealed that the majority of FAAs were present in significantly greater concentrations in secondary cysts, glycine being over 30 times more concentrated. Values for total carbohydrates and glucose did not, however, differ significantly and total protein content was greater in primary cysts. Comparison of the (FAA) pool of secondary equine and ovine cysts revealed strain variation. It was demonstrated that most FAAs were more concentrated in hydatid fluid than in the corresponding host plasma, many concentration ratios exceeding 10. The possible contribution that mediated amino acid transport across the cyst wall and parasite amino acid metabolism makes to the composition of the FAA pool was discussed. No significant plasma aminoacidaemia was associated with infection. PMID- 2717214 TI - Spatial and temporal variation in the infracommunity structure of helminths of Apodemus sylvaticus (Rodentia: Muridae). AB - Mean species richness and diversity of the helminth infracommunity of Apodemus sylvaticus in woodland areas of Co. Down, Northern Ireland, varied in time and space. Variation in infracommunity structure among individual hosts, however, always accounted for more than 60% of the variation in the data from different places or different times. Helminth species richness increased with increasing population density, the percentage of the host population 16 weeks old or older, and the proportion of the host population with animal material in their stomachs, at two sites monitored over 33 months. The basis for spatial variation in infracommunity structure is less certain but host dynamics and differences in diet are likely to play some role. It is concluded that analysis at the infracommunity level focuses closely on the potential for species interactions and overlap in resource utilization. Infracommunity structure, at least in the case of A. sylvaticus, varies markedly in time and space and between individual hosts. Such variations should not be ignored in comparative studies. PMID- 2717215 TI - Resistance to Millettia molluscicide in Biomphalaria glabrata: a quantitative genetical approach. AB - This paper demonstrates the use of a quantitative genetical technique to assess genetic variance in molluscicide resistance in a Millettia thonningii Biomphalaria glabrata system. Results indicated that there were significant genetic variances in both snail size and survival time in 10 p.p.m. molluscicide suspension. The possibility of wider applications of this technique in examining the genetic basis of molluscicide or pesticide resistance in target species is discussed. PMID- 2717216 TI - Spatial and temporal heterogeneity in the population dynamics of Bulinus globosus and Biomphalaria pfeifferi and in the epidemiology of their infection with schistosomes. AB - Populations of Bulinus globosus and Biomphalaria pfeifferi were studied in a river habitat in Zimbabwe over a period of 12 months. Data were obtained on the prevalences of infections of Schistosoma haematobium (also S. mattheei) and S. mansoni respectively. Population parameters showed the following patterns for both snail species. (1) A patchy distribution correlated with the distributions of aquatic plants. (2) Life-expectancies of only a few weeks. (3) Recruitment rates correlated with water temperature and showing a distinct seasonal peak. (4) Spatial variation in recruitment. (5) A redistribution of snails during the rainy season. Epidemiological parameters showed the following patterns. (1) Large seasonal variations in the prevalence of patent infections. (2) Evidence from size-prevalence curves that suggests a variable force-of-infection from man to snail, correlated with water temperature. (3) Prevalences of infection that were higher in the vicinity of (+/- 60 m from) major water contact sites. Local prevalences of infection for B. globosus sometimes exceeded 50% and may have approached 100% if pre-patent infections are included. Snail numbers may limit transmission at these locations. Attention is drawn to the need to make field observations at an appropriate spatial scale and also to the implications for the effectiveness of focal snail control as a means of reducing transmission. PMID- 2717217 TI - Effects of infection with Echinostoma paraensei on the circulating haemocyte population of the host snail Biomphalaria glabrata. AB - Circulating haemocytes from Echinostoma paraensei-infected M line Biomphalaria glabrata snails, or from age- and size-matched control snails, were studied on plastic slides with phase-contrast optics. Granulocytes, hyalinocytes, and round cells were consistently present; granulocytes were further categorized as 'fully spread' (FS) or 'partially spread' (PS). Among control snails, the relative percentage and estimated number/mm3 of round cells declined significantly with increased snail size, and the corresponding values for both categories of granulocytes increased. At 1 day post-infection (p.i.) with E. paraensei, overall composition of the haemocyte population was relatively unaffected, but by 8 days p.i. infected snails had significantly higher relative percentages of round cells and PS granulocytes than controls. Because a marked increase in the number of circulating haemocytes is also evident by 8 days p.i., infected snails had approximately 12 times more round cells and PS granulocytes/mm3 of haemolymph than did controls. At 30 days p.i. the relative and absolute abundance of PS granulocytes was still significantly elevated, but otherwise haemocyte populations did not differ from control snails. Alterations in granulocyte size in infected snails were also noted. Infection with E. paraensei has a striking impact of circulating haemocyte populations and also increases the relative concentration of haemocytes with less ability to adhere to a foreign surface. PMID- 2717218 TI - Schistosoma mansoni: circulating and pulmonary leucocyte responses related to the induction of protective immunity in mice by irradiated parasites. AB - The leucocyte responses in peripheral blood and pulmonary airways are described following vaccination of mice with radiation-attenuated parasites, and subsequent challenge with normal parasites. Percutaneous vaccination stimulated a large and sustained expansion of the circulating lymphocyte pool, more marked than after intradermal vaccination with lung schistosomula which induced comparable levels of resistance. Macrophages and lymphocytes infiltrated the pulmonary airways in response to vaccination by both routes, the lymphocytes being particularly abundant after intradermal vaccination. Exposure of mice to an equivalent number of normal cercariae induced an earlier lymphocytosis of short duration; far fewer macrophages and lymphocytes infiltrated the lungs than after vaccination. An intense but transient pulmonary eosinophilia peaked at 3 weeks after primary exposure to either normal or attenuated parasites. Percutaneous challenge of vaccinated mice elicited higher levels of circulating lymphocytes than challenge of unsensitized controls. However, whilst leucocyte numbers of all cell types were still elevated in the airways at challenge as a consequence of vaccination, no further cellular recruitment was observed coincident with parasite elimination. Our data are compatible with the hypothesis that the mechanism of immunity in once-vaccinated mice involves a T lymphocyte-macrophage interaction triggered by antigen release from lung schistosomula. PMID- 2717219 TI - Biochemical characteristics of the metacyclic forms of Leishmania major and L. mexicana mexicana. AB - Metacyclic forms of Leishmania major and putative metacyclics of L. mexicana mexicana were found to occur in abundance in stationary phase cultures. These forms have been compared in several ways with promastigotes from mid-log phase cultures and, in the case of L. m. mexicana, amastigotes. Metacyclics are smaller, contain less protein and appear more active than other promastigotes. Both forms of promastigote respire at a high rate in the absence of exogenous substrate. The free amino-acid contents of the various forms of the two species have been analysed. They differ in detail but alanine was the major amino acid in all cases. The isoenzyme content of the different forms differed significantly. That of the putative metacyclics of L. m. mexicana was in several respects more similar to amastigotes than promastigotes, suggesting that the form is pre adapted for life in a mammal. Metacyclics of L. major apparently did not divide in culture but transformed back over a period of 48 h to mid-log phase cells. The results provide further detail of the molecular differences between mid-log phase and metacyclic promastigotes and confirm that metacyclics are a distinct form in the life-cycle. PMID- 2717220 TI - Differentiation of Schistosoma mansoni from S. rodhaini using cloned DNA probes. AB - The ribosomal RNA (rRNA) gene units of Schistosoma mansoni and S. rodhaini, of the lateral spined egg group, have been studied. The schistosome rRNA gene unit consists of a regular interspersion of the two genes encoding the large and small rRNA units with two spacers. The large spacer is not transcribed while the small spacer is part of the transcription unit. Variation in the rRNA gene unit between the two species is demonstrated to take the form of loss or gain of restriction sites within the non-transcribed and transcribed spacers. This variation has been demonstrated to enable the differentiation of S. mansoni from S. rodhaini by Southern hybridization analysis. In addition, a DNA clone representing a female specific, tandemly repeated sequence, is demonstrated to enable differentiation of S. mansoni and S. rodhaini using dot blot hybridization analysis. PMID- 2717221 TI - Cloning of a repetitive DNA from the rickettsia-like organisms of tsetse flies (Glossina spp.). AB - Three DNA fragments from the genome of the rickettsia-like organism (RLO) symbiotic in tsetse flies (Glossina spp.) have been cloned. One of these fragments represents a family of highly conserved repeats, which occurs in RLO from all species of tsetse examined and has been amplified in the original RLO culture from which the DNA is cloned. This fragment serves as a highly sensitive and specific probe for the detection of RLO in tsetse midguts. As few as 30 organisms were unequivocally identified by dot blot hybridization of homogenized midgut preparations. Since the presence of RLO within tsetse midguts is associated with susceptibility to trypanosome infection, this technique provides a rapid and reliable method of assessing the potential susceptibility of a tsetse population to Trypanosoma brucei s.l. and T. congolense infections. PMID- 2717222 TI - [The effect of pain caused by multiple trauma on gamma-aminobutyric acid metabolism and the functional condition of animals]. AB - Multiple injury to the bone tissue in rats caused changes of gamma-aminobutyric acid (GABA) metabolism manifested first by activation of its synthesis and then by inhibition of enzymatic inactivation and increase in GABA content in the brain. The initial reaction of the GABA system was attended by a loss of total body and thymus weight, increase in adrenal weight, and bicocculin- and picrotoxin-sensitive hypoalgesia in the tail-flick test. The subsequent changes of GABA-ergic transmission developed during restoration of the animals' functional condition but body weight loss persisted. It is suggested that activation of the GABA system is a defence reaction tending to intensify the inhibition processes and increase the activity of the brain antinociceptive systems. PMID- 2717223 TI - [Prevention by electropuncture of the hypoalgesic effect of fasting]. AB - The influence of electropuncture preventive effect on the dynamics of the human nonciceptive system parameters under conditions of fasting stress was studied in 12 healthy volunteers. The results bear evidence that fasting, just like other types of stress, is attended by the development of hypoalgesia. Diminished appreciation of pain is determined by parameters characterizing the effective and sensory components of pain sense. Electropuncture conducted during fasting inhibits the development of pain sense disorders induced by fasting stress, reduces some of the emotional reactions, and has no unfavourable side-effects. The results of the study suggest that electropuncture can be applied as a stress limiting measure in fasting. PMID- 2717224 TI - [The role of group A5 catecholaminergic neurons in stress and morphine analgesia mechanisms in rats]. AB - The activity of antinociceptive mechanisms in cold stress and under the effect of morphine was studied in experiments on rats subjected to bilateral destruction of group A5 neurons. In cold stress in rats of the experimental and control groups the latent periods (LP) of pain reactions of limb licking differed significantly, both in initial values and between the groups; in contrast, the LP of the tail flick reaction did not differ significantly. Under the effect of morphine the pain reactions increased authentically as compared to the initial values both in the experimental and the control groups, but there were no significant differences between the groups. Thus, group A5 noradrenergic neurons have an effect on inhibiting some pain reaction components in cold stress, but are of no importance in the mechanisms of antinociceptive actions under the effect of morphine. PMID- 2717225 TI - [The effect of denervation on ligandin levels and glutathione S-transferase activity in the rat liver]. AB - The authors studied the effect of liver denervation (transection of the hepatic branch of the vagus nerve and/or both splanchnic nerves) on the content of the marker of highly-differentiated hepatocytes--ligandin and the activity of glutathione S-transferase (GT) in rat liver homogenate. The immunodiffusion method demonstrated a decrease in the ligandin level by 21-22% as compared to the value in intact rats 2 weeks after the operation. GT activity was reduced in rats with denervation of the liver but remained unchanged in sham-operated on animals. The results are evidence of diminished biochemical specialization of the tissue of a denervated liver and confirm the role of the peripheral nervous system, the afferent link in particular, in its regulation. PMID- 2717226 TI - [The effect of anti-orthostatic action on the resorption of cerebrospinal fluid and various hemodynamic indicators in increased intracranial pressure]. AB - Intracranial, systemic, arterial, and venous pressure as well as pressure in the sagittal sinus increased when dogs were given an antiorthostatic position. Changes of hemodynamic parameters in response to additional increase of intracranial pressure were more marked in an antiorthostatic than in a horizontal position. Hemodynamic shifts in an antiorthostatic position were attended by diminished rate of cerebrospinal fluid resorption and its increased production. PMID- 2717227 TI - [Central serotonin administration and post-stress damage of the gastric mucosa in inbred mice during various seasons]. AB - The severity of neurogenic damage to the gastric mucosa (GM) induced by emotional stress (ES) in administration of serotonin or its precursor in biosynthesis--5 hydroxytryptophan into the lateral ventricle of the brain was studied in experiments on mice of inbred strains. The development of lesions in the GM in the form of erosions and hemorrhages proved to be dependent on many factors, first of all on the time of administration of the preparations--before or after ES. The effect of 5-hydroxytryptophan on the formation of GM stress damage was less marked than that of serotonin. The intensifying effect of exogenous serotonin on post-stress GM damage was mainly manifested in the spring, which is associated with ES induced activation of the brain serotonergic system. The effect of exogenous serotonin on the degree of the neurogenous damage to the GM caused by ES is determined to a great measure by the genotype differences in the sensitivity of the central serotonergic mechanisms to the stimulating effect. PMID- 2717228 TI - [Oligopeptides in the mechanisms of resistance to emotional stress]. PMID- 2717229 TI - [Changes in systemic hemodynamics and vascular resistance in unilaterally nephrectomized rats with vasorenal hypertension]. AB - Cardiac output (CO), arterial pressure (AP), and total peripheral resistance of the vessels were studied in rats on the 1st, 5th, and 20th day after the onset of one-kidney vasorenal hypertension. The CO increased by 72% and the peripheral resistance reduced on the 1st day. In stable increase of AD the CO did not differ from the control level. In extracorporeal perfusion of the hindquarters of hypertensive rats in the indicated periods increased reactivity of the vessels to noradrenaline and resistance at maximal dilatation were revealed. These changes were encountered even before statistically significant increase in AP (5th day) and increased with the gradual development of hypertension. PMID- 2717230 TI - [Mechanisms of hemodynamic disorders in occlusion and subsequent revascularization of the mesenteric arteries]. AB - The author studied the main mechanisms of homeostasis disorders, systemic hemodynamics and metabolism in particular, in visceral-ischemic shock. Two complex hemocorrectors were elaborated. One of the hemocorrectors contains rheopolyglucin, mannitol, crystalloids, sodium succinate, and a derivative of 1,4 naphthoquinone which is a modifier of the respiratory chain of mitochondria; it is suggested for use in the treatment of the irreversible phase of shock. The hemocorrector in combination with the respiratory chain modifier possesses some advantages, evidence of which are the values of systemic hemodynamics and terms of survival of the experimental animals. PMID- 2717231 TI - [The effect of dalargin on systemic hemodynamics and microcirculation in experimental traumatic shock]. AB - Experiments were conducted on rats and hamsters to study the effect of the synthetic analogue of leu-enkephalin dalargin injected in the early phase of traumatic shock. In experiments on hamsters, short-term increase in arterial pressure (AP) and improvement of microcirculation occurred in the first minutes after the injection. The AP did not increase in rats. This was followed by reduction of AP, deceleration of the blood flow in the microvessels, and increase in the diameter of arterial vessels. These processes developed more rapidly than in the controls. Survival decreased significantly among rats and had a tendency to reduce among hamsters. It is assumed that the inhibiting effect of dalargin on the higher regulating centres of vegetative functions, which is characteristic of opioid peptides, contributed to aggravation of the pathological processes developing in shock and leading to the death of the animals. PMID- 2717232 TI - [Study of mechanisms of neurotropic action of middle molecular weight peptides in the blood of intact blood and dogs with burns]. AB - The authors studied the role of changes of lipid peroxidation and monoamine oxidase activity in the brain of mice under the effect of various fractions of middle-mass peptides (MMP) obtained from blood of intact dogs and dogs with burns. A marked neurotropic effect of MMP was manifested by changes of the behavior of rats in the "open field". The blood of dogs with burns was found to contain an MMP fraction whose neurotropic effect was caused by changes of the monoamine oxidase activity of the brain. The results bear evidence that the prooxidant action of MMP of blood of intact animals on brain tissue is associated with the neurotropic effect of these compounds. The data obtained is discussed from the standpoint of burn encephalopathy. PMID- 2717233 TI - [The effect of endotoxin on the cardiovascular system]. AB - The dynamics of changes in myocardial contractility and pressure in the left ventricle of the heart and the femoral artery were studied in rabbits before and after intravenous infusion of 2 mg/kg endotoxin. The left ventricle was catheterized. The signal from the left-ventricular pressure transducer was fed into a microcomputer after analog-digital conversion for calculating the maximal rate of increase in intraventricular pressure. All the parameters studied began decreasing as early as the 5th minute after endotoxin administration. A statistically significant decrease (p less than 0.05) of the heart rate was recorded first on the 30th minute, than the left-ventricular pressure and maximal rate of intraventricular pressure increase took place on the 45th minute, and systolic and diastolic pressure in the femoral artery decreased on the 60th minute. The detected disorders of myocardial contractility provoke the appearance of hypotension the main role in the development of which is played by damage to the peripheral vascular network. PMID- 2717234 TI - [Disrupted function of the cardiovascular system in fulgurant sepsis]. AB - The condition of cardiodynamics and the toxic properties of venous blood plasma in fulgurant staphylococcal sepsis were studied in 30 experiments on dogs. The values of myocardial contractile activity, the heart pumping function, and systemic hemodynamics were recorded. Blood plasma toxicity was determined according to the paramecium test and the content of medium-molecular peptides. A correlation between the degree of disorders of myocardial contractile activity and the degree of toxemia was revealed. PMID- 2717235 TI - [Participation of the thymus in controlling cytomedine activity]. AB - The authors studied the effect of the thymus on the composition and biological activity of cytomedines--mediators of intercellular interactions contained in the tissues. Samples of the liver, muscle, and spleen of thymectomized rats lacked some components of the polypeptide system which were found in these organs of animals subjected to sham operation and castration. Thymalin injection restored the initial polypeptide pattern. The factors studied also differed in biological activity: polypeptide factors isolated from organs of animals which underwent a sham operation stimulated the immunity of thymectomized rats, peptides from organs of thymectomized animals, in contrast, did not possess this property. PMID- 2717236 TI - [The role of glycosaminoglycans in regulation of medullary hematopoiesis in stress]. AB - The role of the constituents of hematopoiesis inducing bone marrow microenvironment in myelopoiesis regulation was studied. It was found that during the development of the general adaptation syndrome the functional activity of stroma cells and granulomonocytopoiesis precursor cells intensifies and the content of acid glycosaminoglycans in the bone marrow increases. It is shown that acid glycosaminoglycans produce an effect on the myelokaryocytes in intimate interrelationship with the prostaglandin system, changing the level of intracellular calcium and cAMP in the hematopoietic cells. PMID- 2717237 TI - [Mineralocorticoid function of the rat adrenal gland and thyroid hormones]. AB - Adrenal mineralocorticoid function was studied in 195 male albino Wistar rats with a different level of thyroid hormones in the organism. Aldosteronemia, aldosteronuria, and plasma renin activity were studied in in vivo experiments. In vitro experiments were carried out to study the content of aldosterone in the adrenals and its discharge into the incubation medium in euthyroid, hyper- and hypothyroid animals. Hyperthyroidization leads to manifest inhibition of the adrenal mineralocorticoid function, and suppresses aldosterone excretion in the urine and plasmic metabolic clearance in diminished formation of aldosterone in the glomerular zone. Changes of an opposite character occur in the renin angiotensin-aldosterone system of rats after total thyroidectomy. Injection of small doses of thyroxine also reduces aldosterone production in the adrenals of thyroidectomized animals. It is shown that an excess of endogenous thyroxine in the organism produces an inhibiting effect not only on the level of aldosterone production and secretion, but, to a definite measure, also on the level of the possible realization of its peripheral action. PMID- 2717238 TI - [Pathophysiological mechanisms of torsion dystonia]. AB - Sixty-three patients were subjected to clinico-electrophysiological examination for precise definition of the features of pathogenesis of the tonic and clonic forms of generalized torsion dystonia. Stimulation electromyography was conducted by the generally accepted method with determination of the composition of motor neurons involved in the reflex response. Torsion dystonia was found to be a pathogenetically heterogeneous disease. Registration of the motor neurons involved in the reflex response yielded additional information on the pathogenetic features of this disease. PMID- 2717239 TI - [A new method of assessing disorders of thyroid status experimentally]. PMID- 2717240 TI - Wheezing at 8 and 13 years: changing importance of bronchiolitis and passive smoking. AB - A group of 153 children (51 with a history of bronchiolitis and 102 matched controls) were evaluated in a historical cohort study at a mean age of 8 years and again at 13 years to test the primary hypothesis that mild bronchiolitis, far more common than severe (hospitalized) bronchiolitis, predicts wheezing. A secondary hypothesis was that passive smoking also predicts wheezing. Many potentially confounding variables such as family history of asthma were controlled in analyses. Analysis at 13 years produced results that were not anticipated from previous analysis of interviews at age 8. Although mild bronchiolitis was a powerful predictor of wheezing at age 8 years, it was no longer a strong predictor of wheezing at age 13 in either bivariate or multivariate analysis. Although epidemiologic studies, by their nature, cannot prove causality, findings are consistent with the hypothesis that sequelae often follow mild bronchiolitis but diminish during childhood. Maternal smoking was a powerful predictor of wheezing at age 13 in bivariate analysis (Kendall's Tau B = 0.19, P less than 0.01) and in multivariate analysis (odds ratio = 2.67, P less than 0.01). In children at highest risk for wheezing, males with a family history of asthma, multivariate analysis suggested that maternal smoking is associated with an increase in wheezing from 36% to 60%. We conclude that passive smoking, previously identified as a risk factor in this population for both bronchiolitis in infancy and wheezing at age 8, is a risk factor for wheezing-associated morbidity throughout the childhood years. PMID- 2717241 TI - Lung perfusion and aerosol distributions in preterm ventilated lambs. AB - The relative distributions of ventilation as measured by 99Tc-sulfur colloid aerosol deposition and pulmonary perfusion (measured with radiolabeled microspheres) were determined in 12 preterm lambs that were delivered at 138 days gestational age and ventilated for 4 hrs. To verify that unventilated lung segments in these lambs would have decreased perfusion, a balloon catheter was placed in a major bronchus either at birth or after 2 hrs of ventilation. This catheter prevented ventilation of 24.5 +/- 3.2% of the lung tissue. After 4 hrs of ventilation, the lambs were sacrificed and the lungs were divided into about 60 1-g pieces. Apart from the occluded, atelectatic segments, the lungs were visually well aerated with only 5.3 +/- 1.8% of the nonobstructed lungs being spontaneously atelectatic. There was a 66.5 +/- 0.07% decrease in blood flow to the area of lung made atelectatic by the balloon. The blood flow also was decreased to lung regions assessed to be spontaneously atelectatic. No 99Tc sulfur colloid was recovered from balloon-occluded lung regions, and less 99Tc sulfur colloid was found in the spontaneously atelectatic areas than in aerated lung regions. There were significant correlations (P less than 0.001) between pulmonary blood flow and aerosol recovery in each of the 12 animals. Premature lambs had a wide variability in ventilation and perfusion, but the relative ventilation to perfusion ratio was regulated to minimize the intrapulmonary shunt. PMID- 2717242 TI - Decreased incidence of subglottic stenosis using an "appropriate-sized" endotracheal tube in neonates. AB - In a previous study of factors influencing the development of acquired subglottic stenosis (SS) we proposed choosing an endotracheal tube (ETT) size such that the ratio of the external diameter divided by the gestational age of the infant in weeks was less than 0.1. We have prospectively followed 44 patients intubated longer than 25 days. One of 36 patients intubated according to the above protocol developed significant SS compared to 3 of 8 patients intubated with an ETT larger than suggested. In a previous study, 9 of 49 patients intubated longer than 25 days developed SS. The incidence of SS in patients intubated with "appropriate sized" ETT was less than either other group of patients (P less than 0.005 and P less than 0.05, respectively). This study confirms the suggestion that choosing ETT size by the above protocol will lessen, although by itself not eliminate, the incidence of acquired SS. PMID- 2717243 TI - Dimensions of the trachea to age 6 years related to height. AB - In an effort to establish normal values for both investigational and patient care purposes, computed tomography was used to determine the length, diameters, cross sectional area, and volume of the tracheas of 34 children up to the age of 6 years. The measurements were taken when patients were asleep or resting quietly during tidal breathing, at perhaps 30-60% of total lung capacity. The results were related to body height (in infancy, to body length). There was virtually no difference between boys and girls. Each mean diameter correlated well with mean cross-sectional area. Tracheal diameters and area were reasonably constant over the length of individual tracheas. The slopes of the functions relating height to tracheal dimensions in these 34 infants and young children were slightly less steep than those previously measured near total lung capacity in 90 older children and adolescents. PMID- 2717244 TI - Longitudinal evaluation of pulmonary function in an infant following chlorine gas exposure. PMID- 2717245 TI - Characterization of prolonged apneic episodes associated with respiratory syncytial virus infection. AB - We used high-speed polygraphic recordings to document in detail the sequence of events during prolonged apneic spells in two infants with respiratory syncytial viral (RSV) infection. Also, we elicited upper airway reflexes by stimulating the airway with saline during sleep. Spontaneous prolonged apneic spells were recorded in both infants, and these consisted of two distinctly different apnea types. A number of similarities between apnea of prematurity, upper airway reflex apnea and the apneas in these two infants with RSV infection suggests the possibility that these various kinds of apnea may have related causal mechanisms. PMID- 2717246 TI - Treatment of obstructive sleep apnea (OSA) PMID- 2717247 TI - Severe erythema multiforme (Stevens-Johnson syndrome) after taking sustained release theophylline. PMID- 2717248 TI - Long-term lung function is unaffected by antenatal dexamethasone treatment. PMID- 2717249 TI - The CT and MR evaluation of migrational disorders of the brain. Part I. Lissencephaly and pachygyria. AB - The migrational disorders are a rare group of congenital malformations of the brain. They consist of the following entities--lissencephaly (agyria-pachygyria), pachygyria, schizencephaly, heterotopia and polymicrogyria. We studied 40 children with migrational disorders radiologically with CT and MR. This article (part I) deals with our patients their characteristic CT and MR findings along with their clinical presentation and course. These patients presented with one or a combination of the following symptoms, hypotonia, seizures, failure to thrive, microcephaly and occasionally hydrocephalus. These two groups of migrational disorders have abnormalities affecting the gyral-sulcal pattern of the cortex and gray-white matter distribution of the brain. MR provided better delineation of these disorders than CT. Because some forms of the migrational disorders can be inherited, it is extremely important for the radiologist to understand the characteristic findings for correct diagnosis which is essential for parental counseling. PMID- 2717251 TI - CT invertograms. AB - Direct sagittal CT can provide an accurate assessment of anorectal anomalies in selected patients. Images are easily obtained and enable direct imaging of the soft tissues of the rectum and anus. PMID- 2717250 TI - Use of computed radiography in respiratory distress syndrome in the neonatal nursery. AB - A study was performed to establish the value of a computed radiography (CR) system in neonatal respiratory distress syndrome (RDS). CR images obtained with various X-ray doses were compared with the images of a standard film-screen system. The image quality of CR taken with about one half radiation exposure, was comparable to that of the standard high speed film-screen combination. The use of CR could lead to a significant reduction in radiation in the neonatal I.C.U. PMID- 2717253 TI - Peripheral dysplasia. Report of a new genetic syndrome. AB - A new, dominantly inherited form of peripheral dysplasia in three members of an Algerian family is reported. Two further individuals, not investigated, are also probably affected. The disease is characterised by distinctive clinico radiological findings. A case of acromesomelic dysplasia of Maroteaux is also reported and the differential diagnosis of peripheral dysplasias is discussed. PMID- 2717252 TI - The anorectal sphincter after rectal pull-through surgery for anorectal anomalies: MRI evaluation. AB - The puborectalis muscle sling was evaluated with MRI in 10 pediatric patients who had rectal pull-through surgery for anorectal anomalies. MRI (1.5T) demonstrated the puborectalis muscle equally or better than CT in 5 patients who had both CT and MRI. The amount of puborectalis muscle mass and the location of the pulled through intestine in relation to the puborectalis sling was well shown with MRI. Our study suggests that MRI can be reliably substituted for CT in the majority of these patients, to assist in planning further surgery for relief of persistent postoperative fecal incontinence. PMID- 2717254 TI - Late osteoarticular lesions following meningococcemia with disseminated intravascular coagulation. AB - Nineteen children, who had been admitted to the Pediatric Hospital of Coimbra with severe meningococcal infection with DIC, were submitted to clinical and radiological examination, an average of 4.2 years after hospitalization, in order to demonstrate late skeletal lesions. Patellar dystrophy, to our knowledge previously unreported, was found in 4 children, all of whom had overlying cutaneous scarring. PMID- 2717255 TI - Chest wall mesenchymoma (hamartoma) in infancy. CT and MR findings. AB - A case of a chest wall mesenchymoma in a five month old infant is presented, and the role of CT and MR are emphasized. There have been no prior reports of the CT or MR findings in this entity. PMID- 2717256 TI - Regulation of placental glucose transfer and consumption by fetal glucose production. AB - We studied ten normoglycemic [maternal glucose (GA) = 70 mg/dL] and six insulin induced hypoglycemic (GA = 22 mg/dL) pregnant sheep to test the hypothesis that development of fetal glucose production (GPR) could help maintain fetal glucose concentration, limit uteroplacental-fetal glucose transfer (UPGT), and sustain uteroplacental glucose consumption (UPGC). Compared with the normoglycemic group, the hypoglycemic group demonstrated the following values: fetal glucose concentration (Ga) was 9.8 +/- 0.8 mg/dL (51% lower, p less than 0.01), uterine glucose uptake (UtGU) was 16.7 +/- 1.4 mg/min (54% lower, p less than 0.01), UPGT was 3.1 +/- 0.6 mg/min (81% lower, p less than 0.001), and UPGC was 13.6 +/- 1.4 mg/min (30% lower, p less than 0.05). The reduction in UPGC was significantly less (p less than 0.05) than the reductions in UPGT and UtGU. Fetal glucose utilization rate (GUR) was decreased 20% (p less than 0.05) to 3.99 +/- 0.35 mg/min/kg. A further decrease in GUR was prevented by the appearance of fetal GPR of 2.82 +/- 0.32 mg/min/kg (p less than 0.05) compared with negligible GPR in the normoglycemic group. UPGT and UPGC in both groups were not influenced by maternal or fetal insulin infusions as long as Ga did not change; however, fetal glucose infusion that increased Ga increased UPGC in both groups. We conclude that, during chronic maternal hypoglycemia, increased fetal GPR limits the simultaneous decrease in fetal GUR and glucose concentration. By sustaining Ga fetal GPR limits UPGT to a significantly greater extent than UtGU, diverting UtGU to UPGC. Thus, fetal GPR promotes placental as well as fetal metabolic autonomy when the maternal supply of glucose is reduced. PMID- 2717257 TI - Placental transfer and fetal effects of maternal sodium beta-hydroxybutyrate infusion in the baboon. AB - We examined the effects of maternal sodium beta-hydroxybutyrate (NaBOHB) on the primate fetus to investigate the impact of ketosis not associated with acidosis on fetal metabolism. After a loading dose (600 mg/kg), NaBOHB was infused for 70 min (300 mg/kg.hr) into the maternal femoral vein of eight pregnant baboons, and placental transfer and fetal and maternal metabolic changes were observed during an acute experimental protocol. Maternal arterial levels rose from 0.70 +/- 0.21 to 5.42 +/- 0.93 mM (p less than 0.001), and fetal arterial levels from 0.34 +/- 0.09 to 2.76 +/- 0.64 mM (p less than 0.01). A maternal-fetal gradient of approximately 2:1 was observed in both baseline and steady-state infusion conditions and is similar to the human maternal-fetal ketone gradient. This is in contrast to the sheep where significantly higher gradients have been described. The elevated lactate, from 1.90 +/- 0.34 to 2.88 +/- 0.54 mM (p less than 0.05) and somewhat decreased pO2 values in the fetus from 54.8 +/- 8.9 to 45.0 +/- 3.8 mm Hg (p greater than 0.05 less than 0.1), without change in oxygen consumption (2.00 +/- 0.28 versus 1.73 +/- 0.15 mM/min) are features common to conditions of increased levels of fetal energy substrate. NaBOHB does not appear to contribute to oxidative energy metabolism of the whole fetus but may contribute to lipid stores. The significance of higher levels of BOHB in the primate fetus compared to the sheep fetus remains to be elucidated. PMID- 2717258 TI - Phosphorus metabolites and intracellular pH in the brains of normal and small for gestational age infants investigated by magnetic resonance spectroscopy. AB - The brains of 30 normal preterm and term infants whose birth wt were appropriate for gestational age and 13 who were small for gestational age but healthy were studied by phosphorus magnetic resonance spectroscopy to determine values for metabolite concentration ratios and intracellular pH. In the AGA infants, phosphocreatine/inorganic orthophosphate increased between 28 and 42 wk of gestational plus postnatal age, suggesting a rise in the phosphorylation potential of brain tissue. At the same time, the concentration of phosphomonoester (mainly phosphoethanolamine) fell and that of phosphodiester (including phosphatidylethanolamine and phosphatidylcholine) increased. These changes reflected myelination and proliferation of membranes. Intracellular pH was approximately 7.1 and did not change with brain maturation. No differences were detected in these variables between the infants who were small for gestational age and those who were appropriate for gestational age. PMID- 2717259 TI - Prognosis of newborn infants with hypoxic-ischemic brain injury assessed by phosphorus magnetic resonance spectroscopy. AB - To investigate the prognostic significance of abnormalities of oxidative phosphorylation, the brains of 61 newborn infants born at 27-42 wk of gestation and suspected of hypoxic-ischemic brain injury were examined by surface-coil phosphorus magnetic resonance spectroscopy. Of these infants, 23 died, and the neurodevelopmental status of the 38 survivors was assessed at 1 y of age. Of the 28 infants whose phosphocreatine/inorganic orthophosphate (PCr/Pi) ratios fell below 95% confidence limits for normal infants, 19 died, and of the nine survivors, seven had serious multiple impairments (sensitivity 74%, specificity 92%, positive predictive value for unfavorable outcome 93%). Of the 12 infants with ATP/total phosphorus ratios below 95% confidence limits 11 died (sensitivity 47%, specificity 97%, positive predictive value 91%). Among the 46 infants with increased cerebral echodensities, PCr/Pi was more likely to be low, and prognosis poor, in infants whose echodensities were diffuse or indicated intraparenchymal hemorrhage than in infants whose echodensities were consistent with periventricular leukomalacia. We conclude that when reduced values for PCr/Pi indicating severely impaired oxidative phosphorylation are found in the brains of infants suspected of hypoxic-ischemic injury, the prognosis for survival without serious multiple impairments is very poor, and that when ATP/total phosphorus is reduced, death is almost inevitable. PMID- 2717260 TI - Permeability of the blood brain barrier for 125I-albumin-bound bilirubin in newborn piglets. AB - Permeability of the blood brain barrier (BBB) for bilirubin and 125I-albumin was studied in 2-d- and 2-wk-old piglets. 125I-albumin was given by bolus at the beginning of each study. Hyperbilirubinemia was produced by an initial bolus infusion of bilirubin and sustained at a plasma bilirubin:albumin molar ratio of approximately 1.0 by continuous infusion of bilirubin for 3 h. During the study period, arterial pH and blood gas tensions, serum osmolarity, and mean arterial blood pressure were within the physiologic range for age in both groups. Serum albumin and serum total and unbound bilirubin concentrations were higher in the 2 wk-old piglets. Brain bilirubin concentrations and permeability (P.S product) of the BBB for bilirubin were higher in the 2-d-old than in the 2-wk-old piglets, but the values of P.S for albumin were not different between the two groups. In 2 d-old piglets, regional brain bilirubin concentrations and permeability of the BBB were higher in subcortical regions (cerebellum and brainstem) than in the cerebral cortex. Regional brain albumin concentrations and BBB permeability to albumin in 2-d-old piglets were higher only in the cerebellum. In all regions, the bilirubin:albumin molar ratio was higher in the brain tissues than in the blood. In 2-wk-old piglets, the brain concentrations and P.S products for bilirubin were lower and the regional differences were less marked than for 2-d old animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717261 TI - A comparison of the rheologic properties of neonatal and adult blood. AB - A number of studies have indicated that the rheologic properties of neonatal blood are different from those of the adult. The frequent administration of blood components to the neonate during intensive care make it important that these differences be established and their causes understood. The purpose of this study was to make a detailed comparison of the rheologic properties of neonatal and adult blood, with particular emphasis on low shear rate viscosity and rouleaux related phenomena. The viscometric data was obtained from seven preterm (PT) and 18 normal term (NT) babies and compared with those from 18 adults (A). In the present study, viscometry was performed over a wide range of shear rates, from about 0.3 to 130 s-1, and the low shear rate data were compared with direct measurement of rouleaux formation using the Myrenne Erythrocyte Aggregometer. A major factor leading to the viscometric differences observed was the high hematocrit common in the newborn (46.8 +/- 2.1% PT, 52.8 +/- 6.1% NT, 44.1 +/- 2.5% A males, 40.5 +/- 1.9% A females). However, this tended to be compensated for by the lower plasma viscosity (1.05 +/- 0.07 mPas PT, 1.23 +/- 0.14 mPas NT, 1.34 +/- 0.08 mPas A--no sex difference) and reduced rouleaux formation observed in the newborn and more marked in the preterm baby. The lowered levels of red cell aggregation were found not to be due to cellular differences between the adults and the babies but rather to differing plasma components. The presence of the fetal variant of fibrinogen and low levels of immunoglobulins, especially IgM and IgA, are likely to be of particular importance. PMID- 2717262 TI - Neonatal sympathoadrenal response to acute hypoxia: impairment after experimental intrauterine growth retardation. AB - Sympathoadrenal system function may be altered following intrauterine growth retardation (IUGR). We tested the hypothesis that the growth-retarded newborn rat pup has increased basal sympathoadrenal activity under normoxic conditions and a blunted sympathoadrenal response to acute hypoxia. IUGR was established by uterine artery ligation on d 18 of gestation in Sprague-Dawley rats. Growth retarded pups were chosen as those whose birth wt was more than 2 x SD below the mean birth wt of control pups delivered to sham-operated dams. At 24 +/- 12 h of age cardiac sympathetic neuronal activity (CSNA) was determined by 3H norepinephrine tracer and alpha-methyltyrosine techniques. Adrenal medullary catecholamine synthesis (CAT SYN) was measured by 14C-tyrosine precursor methods, and adrenal catecholamine release (CAT REL) was determined using alpha-methyl tyrosine. IUGR and control pups were studied over a 120-min period of normoxia or hypoxia (FiO2 = 0.09). Under normoxic conditions, the IUGR pups had increased CSNA and increased adrenal CAT SYN and CAT REL compared to controls. Adrenal CAT REL in normoxic IUGR pups was selective for epinephrine. In response to acute hypoxia, control pups had increased CSNA and increased adrenal CAT SYN and CAT REL compared to normoxic controls, with the proportion of norepinephrine and epinephrine released mimicking the ratio of the two amines in the adrenal. In contrast, in hypoxic IUGR pups CSNA and adrenal CAT SYN did not increase, and norepinephrine alone was released from the adrenal medulla.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717263 TI - Influence of carotid denervation on the arousal and cardiopulmonary response to rapidly developing hypoxemia in lambs. AB - Experiments were done on five lambs to determine if carotid denervation influences the arousal and cardiopulmonary responses to rapidly developing hypoxemia during sleep. Each lamb was anesthetized and instrumented for recordings of electrocorticogram, electrooculogram, nuchal and diaphragm electromyograms, and measurements of arterial blood pressure and arterial hemoglobin oxygen saturation. The carotid chemoreceptors and baroreceptors were denervated, a tracheostomy was done, and a fenestrated tracheostomy tube was placed in the trachea so that the inspired oxygen mixture could be changed quickly. No sooner than 3 d after surgery, measurements were made in quiet sleep and active sleep during control periods when the animal was breathing 21% oxygen and during experimental periods of rapidly developing hypoxemia when the animal was breathing 5% oxygen. Rapidly developing hypoxemia was terminated during each epoch by changing the inspired gas mixture back to 21% oxygen once the animal aroused from sleep or once the arterial Hb oxygen saturation decreased to 30%. Arousal occurred during only 4 of 11 epochs in quiet sleep and during only 3 of 14 epochs in active sleep before the arterial IIb oxygen saturation decreased to 30%. These data provide evidence that the carotid chemoreceptors and/or carotid baroreceptors play a major role in causing arousal from sleep during rapidly developing hypoxemia in lambs. PMID- 2717264 TI - Alterations of pancreatic growth and of GP-2 content in the reserpinized rat model of cystic fibrosis. AB - The chronically reserpinized rat is an experimental model for cystic fibrosis. In this study, we report the effects of two doses of reserpine (0.5 and 1.0 mg.kg 1.d-1) on the growth of the pancreas and on its content of the glycoprotein GP-2, a characteristic protein of the zymogen granule. An assessment of the effects of secondary malnutrition induced by the drug was also performed by adding a group of pair-fed animals. During the 7 d of treatment, body wt and food intake were monitored. These two parameters were significantly affected from the 4th d on. Pancreatic wt, DNA, protein, and activity of amylase and chymotrypsinogen were measured after 4 and 7 d of treatment; lipase activity and GP-2 content, after 7 d. Although the DNA content never did change, total protein diminished by 27% at the higher dose of reserpine. Pancreatic wt, amylase activity and GP-2 content were reduced by the treatment, while chymotrypsinogen and lipase activities were increased. Effects on pancreatic wt, amylase, chymotrypsinogen, and GP-2 were dose-dependent. Malnutrition had effects similar to reserpine on body wt, protein, amylase, and chymotrypsinogen. Pancreatic wt, lipase, and GP-2, however, were specifically altered by the chronic reserpine treatment. It is concluded from these results that reserpine induces, in the pancreas, specific alterations that are distinguishable from the accompanying malnutrition. These findings support the use of pancreatic wt, lipase, and GP-2 as specific markers of the effects of the drug on the pancreatic tissue in the chronically reserpinized rat model for cystic fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717265 TI - Light and electron microscopy of the exocrine pancreas in the chronically reserpinized rat. AB - The effects of reserpine injections were studied on the morphology of the pancreas in an experimental model for cystic fibrosis, the chronically reserpinized rat. A detailed examination of the tissue was carried out at the light and electron microscopic levels. The nonspecific effects of secondary malnutrition induced by the drug were assessed with a group of animals pair fed with the treated animals. In a companion paper, we show that pancreatic wt, lipase, and GP-2 contents also are affected by reserpine treatment. In this study, we report that no morphologic differences were observed between the exocrine pancreatic tissue of control and pair-fed animals. By contrast, reserpine induced an accumulation of zymogen granules in 60% of the treated animals and a concomitant decrease of the area occupied by the rough endoplasmic reticulum in the same cells. Finally, in all treated animals, at the light and electron microscopic levels, it was observed that some particular regions of the pancreatic tissue were strongly affected. In these regions, numerous autophagic bodies and lysosomes were observed. Cisternae of the Golgi complex were also more distended. Some acinar cells were in the process of lysis. Several vacuolar inclusions were present in some intralobular duct cells. Cellular material was seen in acinar and intralobular duct lumina. In these same regions, distended intralobular ducts and acinar lumina were observed. These last two features have never been reported in the reserpinized rat but are important manifestations of the pathology in cystic fibrosis patients where obstructions of ducts are believed to trigger focal destruction of the pancreatic tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717266 TI - Absorption of calcium and magnesium from fortified human milk by very low birth weight infants. AB - Absorption of calcium and magnesium endogenous to human milk, as well as calcium and magnesium added as an exogenous supplement to human milk, was determined in 9 very low birth wt infants. Human milk, intrinsically labeled with stable isotopic tracers of calcium and magnesium, was prepared by administering isotopic tracers intravenously to a lactating woman. Different isotopic tracers, which were representative of calcium and magnesium in the supplement (Enfamil Human Milk Fortifier, Mead Johnson Nutritional Div.), were added to the intrinsically labeled milk. The fortified milk, which was labeled with two calcium tracers and two magnesium tracers, was given orally to the test subjects in a single feeding. True absorption of calcium and magnesium was determined from differences between the doses of tracer ingested and the quantities of tracer excreted in the feces. Stable isotopic tracers were quantified by fast atom bombardment mass spectrometry. These results demonstrate that the fractional absorptions of calcium in the human milk and the added mineral supplement are 80 and 82%, respectively. A total of 89% magnesium endogenous to human milk and 86% of magnesium derived from the mineral supplement was absorbed by the VLBW infants. PMID- 2717267 TI - Benefit of moderate dietary protein restriction on growth in the young animal with experimental chronic renal insufficiency: importance of early growth. AB - Using a model of unilateral nephrectomy and contralateral heminephrectomy in weanling rats, we studied the effect of severe (6%) and moderate (14%) protein restriction on growth and renal function up to 24 wk of age. One-half the normal (N) and chronic renal insufficiency (CRI) rats underwent a cross-over protocol 6% ---14% and 14%----6% at 10wk of age to analyze the contribution of early growth on ultimate wt and length. N or CRI fed a 6% protein diet were the smallest. Animals switched from 6%----14% protein diet did not catch up to their counterparts started on a 14% protein diet (N or CRI). However, N or CRI animals started on a 14% protein diet and switched to a 6% protein diet grew along a curve similar to animals fed a 14% protein diet. Creatinine clearances for CRI rats were not different among the groups. However, protein excretion was highest in those animals completing the study on a 14% protein diet. Growth failure caused by severe protein restriction occurred primarily in the early accelerated growth phase (3-10 wk). We conclude that moderate protein restriction during the early rapid growth phase maintains growth, whereas severe protein restriction is detrimental to growth. Switching to a more restrictive protein intake after the rapid growth phase did appear to offer more renal protection (lower urinary protein excretion) at the end of 24 wk. Severe protein restriction to preserve renal function is a poor strategy for the young rapidly growing individual with chronic renal disease. PMID- 2717268 TI - Characterization of nonmotile neutrophil subpopulations in neonates and adults. AB - Previous studies have demonstrated that polymorphonuclear leukocytes (PMN) are not a homogeneous population of cells but differ significantly in their structure and function. PMN move at varying rates, and a fraction estimated from 20 to 70% do not move at all in response to chemotactic stimuli. To characterize this PMN subpopulation better, we studied PMN motility in neonates and adults using a polycarbonate micropore filter chemotactic assay and the 31D8 MAb. Most PMN strongly bind 31D8 MAb (31D8 "bright"), but a minority (31D8 "dull") weakly bind the antibody and in this respect are similar to immature PMN precursors. The 31D8 "dull" PMN have impaired function compared with 31D8 "bright" PMN. In the present study, a PMN subpopulation that failed to migrate using the micropore filter assay accounted for 58 +/- 7% of adult PMN and was similar to the migrating subpopulation in regard to viability and phagocytic function. The nonmotile subpopulation had a higher percentage of bands (5 +/- 3% versus 1 +/- 2%, p less than 0.01) and decreased binding of 31D8 MAb compared with the motile subpopulation. Neonates had a larger nonmigrating PMN subpopulation and 31D8 "dull" PMN subpopulation than those of adults (76 +/- 3% versus 58 +/- 7%, p = 0.04 and 26 +/- 11% versus 8 +/- 2%, p less than 0.01, respectively). These data indicate that although PMN appear morphologically as a homogeneous population of cells, there exists a viable, nonmotile PMN subpopulation that may be less mature than the motile PMN subpopulation. They also indicate that impaired neonatal PMN motility may be attributable in part to an increased size of the nonmotile PMN subpopulation. PMID- 2717269 TI - The preterm rat: a model for studies of acute and chronic neonatal lung disease. AB - A preterm rat model has been developed for studies of acute and chronic neonatal lung disease. Premature delivery 24 h before the normal time of delivery is associated with immature pulmonary phospholipid and antioxidant enzyme profiles. The premature lung is more fragile and ruptures at a lower lung vol (172 +/- 8 microL) than the full-term fetal lung (259 +/- 14 microL). Only 7% of premature lungs will float in liquid, after inflation to 85% of the rupture vol, compared with 87% of term fetal lungs. This lung immaturity was reflected in a survival rate of only 6% by 36 h after delivery if the preterm pups were placed in air, which increased to 47% when they were placed in greater than 95% oxygen. Though greater than 95% oxygen enhanced survival of preterm pups during the 1st wk of life, these survivors had a 50% mortality during the 2nd wk of exposure to greater than 95% oxygen. The preterm pup will tolerate intraperitoneal injection of antioxidant enzymes entrapped in liposomes and has a better retention of these liposomes in the lung compared with the term pup. We conclude that the preterm rat is a suitable model for studies of acute and chronic neonatal lung disease. PMID- 2717270 TI - Vitamin K-dependent carboxylase activity in fetal rat lung: developmental effects of dexamethasone and triiodothyronine. AB - Dexamethasone (Dex) and triiodothyronine (T3) were administered to pregnant rats during late gestation to evaluate potential developmental effects on fetal lung vitamin K-dependent carboxylation. Maternal rats were injected on the 2 d before study with Dex (0.2 mg/kg intraperitoneally), with T3 (0.7, 3.5, or 7 mg/kg intramuscularly), or with a combination of both hormones. Fetal lung microsomes were prepared at 18, 19, and 20 d of gestation, and carboxylase activity was assessed by measuring the incorporation of 14CO2 into a synthetic pentapeptide substrate. Dex alone resulted in a small but consistent increase in activity in all three gestational ages. T3 alone increased activity approximately 85% at 20 d of gestation. Treatment with a combination of Dex and T3 caused a 60% increase in vitamin K-dependent carboxylation at each gestational age. Decreased lung growth was noted with combination hormone treatment in all rats studied at 19 and 20 d of gestation. Lung growth expressed as lung wt/body wt was more sensitive to the effects of Dex plus T3 than was carboxylase activity. Decreased lung wt/body wt (decreased 25%) was noted with Dex plus T3 (0.7 mg/kg); however, no induction of carboxylase enzyme activity was evident at this dose. This study demonstrates that vitamin K-dependent carboxylase activity in fetal rat lung can be induced by the exogenous administration of Dex and T3 to pregnant rats. Fetal lung microsomes contain multiple endogenous substrates for the vitamin K-dependent carboxylase enzyme. These hormones play a significant developmental role not only in protein biosynthesis, but in posttranslational processing as well.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717272 TI - Towards optimum management of serious focal infections: the model of suppurative arthritis. PMID- 2717271 TI - Peroxisomal L-pipecolic acid oxidation is deficient in liver from Zellweger syndrome patients. AB - L-Pipecolic acid, a cyclic imino acid produced during the degradation of lysine, accumulates in body fluids of infants with the generalized peroxisomal disorders, including Zellweger syndrome, neonatal adrenoleukodystrophy, and infantile Refsum disease. Peroxisome-enriched fractions from normal human liver oxidized L [3H]pipecolic acid to alpha-[3H]aminoadipic acid (AAA). When human liver organelles were separated on a Percoll gradient, L-[3H]pipecolic acid oxidation activity (as measured by [3H]AAA formation) most closely segregated with the peroxisomal marker, catalase, and was not associated with the mitochondria. L Pipecolic acid oxidation was not inhibited by antimycin A and rotenone and produced H2O2, consistent with its involving a peroxisomal oxidase. We measured L pipecolic acid oxidation in liver specimens from patients with peroxisomal disorders. While liver homogenates from adult (n = 5) and infant (n = 10) controls formed 47.1 +/- 6.6 and 48.3 +/- 10.0 pmol AAA/mg protein/h, respectively, Zellweger syndrome livers (n = 8) formed only 1.7 +/- 0.3 pmol AAA/mg protein/h. L-pipecolic acid oxidation in normal infant livers was low at birth and increased with age, but Zellweger syndrome livers showed little activity at any age. Thus, the high circulating levels of L-pipecolic acid in Zellweger syndrome probably result from defective peroxisomal oxidation of L pipecolic acid to AAA. PMID- 2717273 TI - Child mortality related to seroconversion or lack of seroconversion after measles vaccination. AB - When blood samples were analyzed for seroconversion after measles vaccination, it was discovered that the vaccine had been ineffective for a certain period. During the 2 years between vaccination and the time of seroanalysis, nonseroconverters had a significantly higher mortality than seroconverters (P less than 0.05). The incidence of measles among nonseroconverters was 30% during the period. Between 9 months and 3 years of age, cumulative mortality was 15.1% for nonseroconverters and 4.5% for seroconverters. The difference in mortality was larger when high risk groups (twins, motherless children) were excluded from the analysis (P less than 0.01). The difference in mortality was particularly marked among children vaccinated in the age group 9 to 11 months. This as well as other community studies suggest that measles vaccination reduces child mortality from the age of vaccination by at least 30%. PMID- 2717274 TI - Prognosis of human immunodeficiency virus infection in children and adolescents. AB - The prognosis of 111 children and adolescents (from 2.5 months to 19.5 years of age) infected with human immunodeficiency virus (HIV) was assessed by survival analysis based on risk factors and clinical status. Risk factors included: maternal HIV infection 93; transfusion 12; both maternal HIV infection and transfusion 2; sexual abuse 1; and intravenous drug use and/or sexual activity 3. Children with perinatal infection survived from 2.5 months to 10.25 years (median, 1.87 years) and had inapparent infection from 6 weeks to 7.3 years (median, 0.75 years). Children who acquired HIV infection via transfusion had inapparent infection from 4 months to 5.7 years (median, 3.6 years). Actuarial survival following infection was not significantly different from maternally and transfusion-acquired infection; however, survival from infection was longer for children infected by transfusion beyond 2 years of age (mean, 7.5 years) than for children infected perinatally (mean, 5.6 years). The case-fatality ratio was 32%, with 25% of subjects succumbing within 1 year of developing an HIV-associated illness. Opportunistic infection was the most common acquired immunodeficiency syndrome-defining illness and the cause of death in 22 of the 35 children who died. Pneumocystis carinii and fungal pneumonias had the worst prognosis. Cryptosporidiosis and other opportunistic infections had a better prognosis. Because of difficulties in case finding, diagnosis of infection and variable survival of HIV-infected children, arge longitudinal studies and pooling of data among centers will be necessary to have an accurate understanding of the prognosis of individual clinical syndromes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717275 TI - Transient abdominal granulomas in children. AB - Space-occupying liver lesions in febrile patients are usually caused by tumor or infection and other causes are seldom encountered. In five patients age 20 months to 12 years who were evaluated for fever of unknown origin, imaging studies revealed hepatic nodules consisting of transient, sterile granulomas for which no cause could be determined. Stellate architecture histologically supported clinical evidence of subacute bacterial infection. Imaging modalities included: 99Tc-sulfur colloid (n = 2) and 67Ga (n = 2) scintigraphy; ultrasound (n = 5); computed tomography (n = 4); and magnetic resonance imaging (n = 2). Peripheral low density, as revealed by computed tomography in one and hyperintense halos on magnetic resonance imaging of another patient are both considered predictive for neoplastic disease but were associated with granulomas. The differential diagnosis of macroscopic liver lesions seen on imaging studies in febrile children should include the possibility of transient, idiopathic granulomas. PMID- 2717276 TI - Corynebacterium group JK infections in children. PMID- 2717277 TI - Febrile seizures after immunization with meningococcal A + C vaccine. PMID- 2717278 TI - Intravenous immunoglobulin in disseminated neonatal echovirus 11 infection. PMID- 2717279 TI - Outpatient management of bacterial meningitis. PMID- 2717280 TI - Blood pressure fluctuation and intraventricular hemorrhage in the preterm infant of less than 31 weeks' gestation. AB - A total of 22 infants of less than 31 weeks' gestation who were mechanically ventilated for a minimum of 12 hours for respiratory distress syndrome were studied. The coefficient of variation of direct systolic pressure was measured each minute from six to 36 hours of age and averaged per hour after birth with a microcomputer-based system of data collection. At the start of recording, the ultrasound scan appeared normal in each infant, but intraventricular hemorrhage developed in ten infants less than 36 hours of age. Twelve infants remained free of intraventricular hemorrhages. BP fluctuation was greater for a longer proportion of measured time in infants in whom intraventricular hemorrhage did not develop compared with those in whom it did develop P less than .05). These findings do not support a causal relationship between BP fluctuation and intraventricular hemorrhage within the range of coefficient of variation studied. PMID- 2717281 TI - Neonatal hyperviscosity association with lower achievement and IQ scores at school age. AB - A longitudinal study was conducted to determine whether the early neurologic and motor impairment observed in children with neonatal polycythemia and hyperviscosity persisted into school age. Forty-nine children who had neonatal polycythemia and hyperviscosity were evaluated at a mean age of 7 years. Of these, 21 (group 1) received a partial plasma exchange transfusion, whereas 28 (group 2) received symptomatic care. Forty control children (group 3) with a normal neonatal hematocrit were also evaluated. Testing consisted of a battery of measures to evaluate IQ, achievement, neuromotor function, and gross and fine motor skills. Maternal education and IQ were also assessed to avoid potential confounding by differences in the home environment. The neonatal course of the children with polycythemia and hyperviscosity was characterized by an increased number of problems, including hypoglycemia and cyanosis. At 7 years of age, the 49 children who had hyperviscosity (groups 1 and 2) had significantly lower "spelling" and arithmetic achievement test results and gross motor skill scores. Scores for reading, visual motor integration, and neurologic signs did not differ significantly from group 3. Maternal IQ scores were similar for both groups. Left hand preference was seen in 14% of group 1 and 2 children and 7% of group 3 children (not significant). The scores for IQ, achievement, neuromotor function, and visual motor integration were compared for the hyperviscosity group (groups 1 and 2) and the control group (group 3) by multivariate analysis of variance with sex and hyperviscous group as independent variables and maternal education and maternal IQ as covariates (P = .040).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717282 TI - Long-term development of children monitored as infants for an apparent life threatening event during sleep: a 10-year follow-up study. AB - The outcomes of 26 children who had an apparent life-threatening event during sleep and who were monitored at home were evaluated. In a preliminary study that was first reported when the children had a mean age of 2.7 years, only minor behavioral difficulties were seen. The children of this earlier study were characterized by more aggressive behavior, which was tentatively related to parental anxiety. The same children were retested at a mean age of 7 years (range 6 to 10 years), together with sex-, age-, and social class-matched control children. No significant differences were found in their clinical daytime and nighttime behavior or in IQ tests, although in some of the psychodevelopmental tests minor signs of anxiety were revealed. In conclusion, infants with an apparent life-threatening event who underwent continued cardiopulmonary home monitoring develop normally during preadolescence. A prolonged follow-up of the children during adolescence is needed to evaluate later school performance. PMID- 2717283 TI - Rapid sequential phenobarbital treatment of neonatal seizures. AB - The optimal serum concentration of phenobarbital in newborns and its safety at high doses are not well established. The dose response relationship of rapid sequential phenobarbital loading in the newborn was examined and the efficacy of high-dose monotherapy was compared with the addition of a second anticonvulsant for persistent seizure activity. A single loading dose of phenobarbital 15 to 20 mg/kg was initially administered to 120 newborns. Nonresponders received sequential bolus doses of 5 to 10 mg/kg until seizures ceased or a serum concentration of 40 micrograms/mL was obtained. Infants with refractory seizures received additional phenobarbital to a maximum serum concentration of 100 micrograms/mL. The seizures of 48 babies (40%) were controlled after initial loading and 37 of the remaining 72 subjects (51%) responded at serum concentrations of as great as 40 micrograms/mL. The seizures of only seven subjects were controlled at greater concentrations. A second anticonvulsant controlled seizures in 13 of the 28 subjects (46%) whose seizures were refractory to phenobarbital. A gestational age of less than 32 weeks was associated with a significantly better response to phenobarbital. Serum phenobarbital concentrations greater than 50 micrograms/mL produced only occasional feeding difficulty and sedation. It was concluded that sequentially administered IV phenobarbital controls seizures in both term and preterm newborns (77%). This therapeutic effect is dose dependent but plateaus at a serum concentration of 40 micrograms/mL. At greater serum concentrations, unresponsive patients should receive a second antiepileptic agent. PMID- 2717284 TI - Adverse reactions to diphtheria, tetanus, pertussis-polio vaccination at 18 months of age: effect of injection site and needle length. AB - Adverse reactions after diphtheria, pertussis, tetanus, polio vaccination at 18 months of age were investigated in three groups: 74 children injected in the deltoid muscle with a 16-mm (5/8-in) needle, 64 in the anterolateral thigh with a 16-mm needle, and 67 in the anterolateral thigh with a 25-mm (1-in) needle. No significant differences in systemic reactions were observed. Severe pain occurred in 30.5% of the groups injected in the thigh compared with only 8.1% of the group injected in the arm (P less than .001). Children vaccinated in the thigh had decreased movement of the extremity significantly more often than those injected in the arm (49.9% v 25.6%, P less than .0005), and two thirds of the former limped for 24 to 48 hours. Redness and swelling were observed more often after injection in the arm than in the thigh (58.1% v 26.7%, P less than .0005). The only effect of changing needle length in the groups injected in the thigh was the occurrence of more redness and swelling in children vaccinated with the 16-mm needle compared with the 25-mm needle. Overall, parents rated more reactions as moderate to severe among children injected in the thigh than among children injected in the arm (64.2% v 37.9%, P less than .001). The deltoid muscle appears to be the preferred site for administration of diphtheria, pertussis, tetanus, polio vaccine at 18 months of age. PMID- 2717285 TI - Daily single-dose and daily reduced-dose prednisone therapy for children with the nephrotic syndrome. AB - Most current reference sources recommend that initial therapy for minimal lesion nephrotic syndrome consist of prednisone, 60 mg/m2 per 24 hours or 2 mg/kg per 24 hours, given in divided doses, and that this regimen be repeated for each relapse. The need for divided-dose daily-administered prednisone is predicated on anecdotal observations that single-dose daily administration is not effective. Because single-dose daily-administered and reduced-dose daily-administered prednisone has been used to treat this condition for several years, experience with these regimens in nephrotic children was analyzed. Forty-one patients were studied, including 22 treated from the onset of their disease. Of these 22, 17 (77%) responded to single-dose daily-administered prednisone (2 mg/kg); after subsequent biospy, each of the nonresponders proved to have lesions other than minimal change disease. The mean response time with single-dose daily administered prednisone (9.6 days for treatment of the initial onset of nephrotic syndrome and 11.1 days for treatment of relapses) was comparable to that previously reported with divided-dose regimens. In 14 patients with frequent relapses, a single reduced-dose daily-administered dose of prednisone (0.2 to 1.5 mg/kg/d) successfully induced remissions in 55 of 63 relapse episodes. It is concluded that a single morning dose of prednisone effectively induces remission in children with minimal lesion nephrotic syndrome. Among selected patients with frequent relapses, additional steroid sparing may be achieved by the use of this regimen with reduced doses during treatment of relapses. PMID- 2717286 TI - Vasopressin levels and pediatric head trauma. AB - The syndrome of inappropriate secretion of antidiuretic hormone is associated with head trauma; however, there are no reports concerning vasopressin levels in pediatric patients with head trauma. Urine vasopressin in eight children (mean +/ SEM, age 7.5 +/- 1.6 years, range 1 to 15 years) was measured by radioimmunoassay during their hospitalization for head trauma. Urine vasopressin values for ten healthy children (mean age 5.4 +/- 1.3 years) and for eight children hospitalized for systemic antibiotic treatment of infections (age 5.9 +/ 1.8 years) also were obtained. Urine vasopressin, urine and serum sodium concentration and osmolality, urea nitrogen, creatinine, and fluid intake were measured within 24 hours of admission and daily for the following two days. For the first three days following head trauma, mean urine vasopressin levels in pediatric patients with head trauma were increased (P less than .05) compared with those of healthy children. Despite fluid restriction to 85% of maintenance level, 25% of patients with head trauma exhibited the clinical syndrome of inappropriate secretion of antidiuretic hormone (hyponatremia, increased urinary sodium, diminished serum osmolality, and urine osmolality greater than serum osmolality). Urine osmolality greater than 800 mosm/kg was associated with markedly increased urine vasopressin levels (200 to 1,650 pg/mL); children with this finding may be at particular risk for the syndrome of inappropriate secretion of anti-diuretic hormone without restrictive water intake. PMID- 2717287 TI - Lack of improved growth outcome related to nonnutritive sucking in very low birth weight premature infants fed a controlled nutrient intake: a randomized prospective study. AB - The effect of nonnutritive sucking during gavage feeding on nutritional outcome and gastrointestinal transit time was evaluated in 18 premature appropriate for gestational age infants whose birth weights were less than or equal to 1,400 g and gestational ages were less than or equal to 30 weeks. Infants were randomized to a treatment (nonnutritive sucking infants received a pacifier for 30 minutes with each feeding, 12 times per day until they reached a weight of 1,500 g, eight times per day thereafter) or control (no pacifier) group. The nine nonnutritive sucking (five girls, four boys) and nine control (five girls, four boys) infants were treated for 14 days. Infants were without medical complications and were fed a single premature formula by intermittent gastric gavage at exactly 120 kcal/kg/d throughout the study period. Weight gain, linear growth, subscapular and triceps skinfold, and arm circumference accretions were assessed weekly. Serum proteins (albumin, prealbumin, retinol-binding protein, and transferrin) were measured weekly. Gastrointestinal transit times were measured weekly using carmine red markers. In contrast to previous studies, these data indicate no apparent effect of nonnutritive sucking on growth outcome, serum proteins, or gastrointestinal transit time in growing, very low birth weight infants when nutrient intake was controlled. In a subgroup of eight boys (four nonnutritive sucking, four control), energy and fat excretions were determined from 72-hour fecal collections and energy expenditure was estimated from six-hour cumulative heart rate measurements. Neither excretion of fat and calories nor estimated energy expenditure was affected significantly by nonnutritive sucking in this subgroup of baby boys. Fat excretion correlated well (r = .987) with energy excretion. PMID- 2717288 TI - Neonatal pulse oximetry: accuracy and reliability. AB - Pulse oximetry has gained widespread use in neonatal oxygen monitoring. However, because specific morbidity in neonates has been related to abnormal levels of oxygen partial pressure (PaO2), it is essential to demonstrate that pulse oxygen saturation values (SpO2) are highly accurate and reflect with precision the simultaneous PaO2. In this report, data is presented that describe the accuracy of the Ohmeda Biox 3700 pulse oximeter. SpO2 was highly correlated with arterial blood oxygen saturation (r = .99) measured on arterial (catheter) blood using a two-wavelength Radiometer OSM2 Hemoximeter. When compared with PaO2, SpO2 values of 92% +/- 3% (mean +/- range) excluded all of the measured PaO2 values less than 45 mm Hg and greater than 100 mm Hg. SpO2-tcPO2 (transcutaneous PO2) and SpO2 PaO2 (catheter or percutaneous arterial PO2) correlations showed that bronchopulmonary dysplasia, percutaneous arterial sampling, and nipple feeding skewed the tcPO2 but not the PaO2 correlations with SpO2, indicating that SpO2 is not sensitive to peripheral factors that affect tcPO2. SpO2-PaO2 correlation was not affected by gestational age. A high degree of accuracy of SpO2 values and SpO2 prediction of normal appearing PaO2 values are defined by these results. PMID- 2717289 TI - Perioperative factors affecting the outcome following repair of biliary atresia. AB - The records of all patients with biliary atresia seen at the Childrens Hospital of Los Angeles during a 14-year period were reviewed. Of the 41 patients who could be evaluated, 32 were treated with trimethoprim and sulfamethoxazole prophylaxis, five were given other agents, and four received no prophylaxis after surgery. At least one episode of cholangitis occurred in nine patients. With one exception, all patients destined to have cholangitis did so within 9 months of surgery. Of the nine patients, five were receiving prophylaxis at the time the disease developed, but two were no longer receiving any prophylaxis. The other two patients in whom cholangitis developed never received antibiotic prophylaxis. In the 24 patients who had a Kasai type of portoenterostomy, cholangitis developed in three of the five (60%) with a Roux-en-Y limb length less than 40 cm and in two of the 19 (10.5%) with limb lengths greater than 40 cm (P less than .02). When performed earlier than 61 days after birth, surgery resulted in adequate bile flow in 64.7% (11/17) of patients who could be evaluated as compared with 31.8% (7/22) for surgery at 61 days or later (P less than .05). Of the patients with adequate biliary drainage 11 had no apparent liver disease, but only two of the patients with poor drainage were free of clinical liver disease. The conclusion from this series is that a combination of timely surgery, intestinal conduit at least 40 cm in length, and subsequent long-term antibiotic prophylaxis favors the best bile flow and reduces the occurrence of cholangitis, resulting in the best outcome. PMID- 2717290 TI - Lavage treatment of distal intestinal obstruction syndrome in children with cystic fibrosis. AB - The efficacy, adverse reactions, and long-term effects of intestinal lavage treatment with a balanced electrolyte solution (Golytely) was evaluated in patients with cystic fibrosis and distal intestinal obstruction syndrome. Twenty two patients with cystic fibrosis (mean age 21.8 years, range 14 to 34 years, 15 boys or men) who sought medical attention because of abdominal pain and a mass in the right iliac fossa received Golytely, 5.6 +/- 1.9 L (mean +/- 1 SD), either orally (n = 14) or via nasogastric tube (n = 8) during 5.6 +/- 2.4 hours. No serious side effects occurred. Serum electrolyte values remained within normal limits. Body weight did not change significantly. Minor adverse reactions included bloating (n = 12), nausea (n = 8), vomiting (n = 1), and chills (n = 3). All but one patient reported impressive relief of symptoms and remained pain free for an average of 3 months (range 1 to 19 months). Symptoms of abdominal pain and radiologic signs of fecal impaction assessed before and after lavage both decreased significantly (P less than .0001). During follow-up (mean 15.2 months, range 4 to 26 months), 11 patients required a total of 38 (range one to nine) additional doses of Golytely. Seven patients drank the solution at home (21 treatments); only two patients chose a nasogastric tube. In ten patients with symptoms of recurrent distal intestinal obstruction syndrome prior to institution of therapy, duration of hospitalization was significantly reduced by this treatment (5.1 +/- 7.6 v 2.3 +/- 6.3 hospital days per annum, P less than .02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717291 TI - Perceptions of parenthood among adolescent fathers. AB - To investigate perceptions of parenthood among adolescent fathers, we studied three groups of first-time fathers: adolescent fathers with adolescent partners (n = 21), adult fathers with adolescent partners (n = 14), and adult fathers with adult partners (n = 55). Subjects were interviewed during the immediate postpartum period and then again 3 months later. Group differences were noted concerning items related to paternal involvement, sex stereotypic behaviors, and stress, but not concerning preparation for parenthood. Fathers' perceptions appeared to be influenced by both their ages and those of the mothers as well as an interaction between these two fathers (adult fathers with adolescent partners v adult fathers with adult partners). Our results suggest that fathers with adolescent partners may benefit from interventions designed to promote more active involvement in parenthood. PMID- 2717292 TI - Liquid-crystal thermometer use in pediatric office counseling about tap water burn prevention. AB - Tap water scald burns are an important topic of injury prevention in pediatricians' offices. Consecutive pediatric clinic clients, randomized to two groups, received an informational pamphlet, a one-minute discussion about tap water safety, and a baseline questionnaire. The first group also received a liquid-crystal thermometer for testing maximum hot tap water temperature. One month later in a follow-up telephone interview (n = 503), the impact of the added thermometer on knowledge regarding scalding, temperature testing, and thermostat lowering was assessed. Approximately 80% of each group read the pamphlet. Reading the pamphlet was associated with greater temperature testing in the thermometer (T) group but not in the pamphlet only (P) group. Temperatures were checked by 46.4% of the T group but by only 23.0% of the P group (P less than .001). In the households in which the reported water temperature exceeded 54.4 degrees C (130 degrees F) and the water heater was accessible, 77.3% reported lowering the setting, independent of receiving the thermometer. The reliability of self reported water temperature was assessed after 1 year by home visits. The use of relevant facilitating devices, such as a liquid-crystal thermometer, in-office anticipatory guidance efforts may increase behavioral compliance. PMID- 2717293 TI - Parental administration of chemical agents: a cause of apparent life-threatening events. AB - Nine infants with apparent life-threatening events that occurred as a result of poisoning by a caretaker are described. These episodes were characterized by apnea plus some combination of color change, choking or gagging, and abnormal muscle tone. Five of the infants responded to vigorous stimulation, and four required cardiopulmonary resuscitation. Most poisonings (seven infants) were detected by a urine drug screen. Medications detected included acetaminophen, amphetamine, benzodiazepines (two infants), cocaine, codeine, meperidine (two infants), Methadone, phenobarbital, and phenothiazines (three infants). Four infants received two or more drugs. Most perpetrators of the poisonings were mothers (seven) and five of the parents admitted administering the various agents. Reasons for the poisonings included an apparent attempt to harm an infant, the need to sedate a fussy infant, or a gross misunderstanding of the potential risk of various agents to infants. Because no history of drug administration was elicited at the time of hospital admission, six infants might have been discharged with a diagnosis of apnea of infancy had not an attempt been made to investigate the possibility of poisoning. These cases suggest that poisoning by a caretaker should be added to the differential diagnosis of any infant brought to medical attention because of an apparent life-threatening event and that urine drug screening should be considered in the evaluation. PMID- 2717294 TI - High incidence of upper gastrointestinal tract involvement in children with Crohn disease. AB - This retrospective study of Crohn disease in 230 children and adolescents with a mean age of 12.5 years at the time of diagnosis and an average follow-up of 6.6 years showed that 30% had lesions of the esophagus, stomach, and duodenum. Three patients had Crohn disease isolated to the upper gastrointestinal tract. The 169 patients with both small and large bowel disease were at greater risk (33%, P less than .05) of having upper gastrointestinal lesions than the 37 with isolated small bowel disease and the 21 with disease limited to the colon and/or rectum. An aggregate of symptoms and signs more likely present in those with upper gastrointestinal involvement included: dysphagia, pain when eating, nausea and/or vomiting, and aphthous lesions of the mouth. Furthermore, weight loss was more severe and hypoalbuminemia more frequent. Because upper gastrointestinal series x ray studies failed to detect upper gastrointestinal lesions in 13 patients of 69 of those with upper gastrointestinal disease, endoscopy should be considered in all children and adolescents in whom a diagnosis of Crohn disease is entertained. Endoscopy and biopsy of the upper gastrointestinal tract should be done in any patient with symptoms suggestive of proximal involvement. Finally, in view of the fact that endoscopy established the diagnosis of Crohn disease in five patients previously thought to have chronic ulcerative colitis, the procedure should routinely be performed in all patients with chronic ulcerative colitis or indeterminate colitis before surgery is performed. PMID- 2717295 TI - Occult core hyperthermia complicating cardiogenic shock. PMID- 2717296 TI - Chest tube insertion: a simplified technique. PMID- 2717297 TI - Early treatment of congenital hypothyroidism. PMID- 2717298 TI - Changing profile of congenital heart disease. PMID- 2717299 TI - Recombinant erythropoietic growth factors as an alternative to erythrocyte transfusion for patients with "anemia of prematurity". PMID- 2717300 TI - American Academy of Pediatrics Committee on Environmental Hazards. Radon exposure: a hazard to children. PMID- 2717301 TI - American Academy of Pediatrics. Emergency drug doses for infants and children and naloxone use in newborns: clarification. PMID- 2717302 TI - Human immunodeficiency virus and artificial feeding. PMID- 2717303 TI - Antenatal transfers and bronchopulmonary dysplasia incidence. PMID- 2717304 TI - Residency training and child abuse. PMID- 2717305 TI - Late-onset hearing loss. PMID- 2717307 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. PMID- 2717306 TI - Precut endotracheal tubes for orotracheal intubation. PMID- 2717308 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Newborn screening in New York City. PMID- 2717309 TI - Value of screening umbilical cord blood for hemoglobinopathy. AB - Foremost among the beneficial effects of screening umbilical cord blood is the optimized quality of care that can follow the immediate involvement of an infant with sickle cell disease and his or her family in an appropriate health care system. This is exemplified by the reduction in the case fatality rate of pneumococcal septicemia that has been achieved. Appropriate follow-up of screening also includes transmission of information about the diagnosis of a hemoglobinopathy trait or alpha-thalassemia to affected families and their physicians, with ready availability of education and counseling. PMID- 2717310 TI - Diagnosis at birth improves survival of children with sickle cell anemia. PMID- 2717311 TI - Cellulose acetate/citrate agar electrophoresis of filter paper hemolysates from heel stick. PMID- 2717312 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Techniques' comparison and report of the North Carolina experience. PMID- 2717313 TI - Usefulness of cation exchange high performance liquid chromatography as a testing procedure. PMID- 2717314 TI - Experience with newborn screening using isoelectric focusing. AB - Electrophoretic techniques are used for hemoglobinopathy diagnosis. Confirmation of the hemoglobin variants is necessary. Currently, citrate agar electrophoresis is the most available, but high performance liquid chromatography is highly recommended in a reference laboratory. Thin layer isoelectric focusing is an excellent technique that can be easily adapted for large-scale newborn hemoglobinopathy screening. Although the initial instrument cost can be about twice as much as the cost for standard electrophoretic equipment, cost effectiveness for newborn screening is considerable because repeat analysis for uninterpretable results is not necessary. Resolution of hemoglobins is much better with thin layer isoelectric focusing than for any of the other electrophoretic methods currently available, and thin layer isoelectric focusing is the best method to use to establish a definitive diagnosis using newborn blood samples. Cord blood samples may be contaminated with maternal blood, and evaluation of Hb A2 levels in such samples can serve as the method to detect contamination. Follow-up testing is required regardless of the method of blood collection. PMID- 2717315 TI - Florida's experience with newborn screening. PMID- 2717316 TI - Experiences with sickle hemoglobin testing in the Texas Newborn Screening Program. PMID- 2717317 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. New York's experience. PMID- 2717318 TI - Follow-up of children with trait in a rural setting. PMID- 2717319 TI - Selected testing of newborns for sickle cell disease. PMID- 2717320 TI - Hemoglobinopathy screening during early pregnancy. PMID- 2717322 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Overview of legal issues. PMID- 2717321 TI - Screening of the mother during early pregnancy. PMID- 2717323 TI - Parental receptivity to neonatal sickle trait identification. PMID- 2717324 TI - Legal and ethical issues in newborn screening. PMID- 2717325 TI - Care of infants with sickle cell disease. PMID- 2717326 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Nursing perspective. PMID- 2717327 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Social work perspective. PMID- 2717328 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Perspective from the National Association for Sickle Cell Disease. PMID- 2717329 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Survey of comprehensive centers for sickle cell disease. PMID- 2717330 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Parental perspective. PMID- 2717331 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Perspective from the National Medical Association. PMID- 2717332 TI - Public health perspective on newborn screening for hemoglobinopathies. PMID- 2717333 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. Perspective from the American Academy of Pediatrics Committee on Genetics. PMID- 2717334 TI - [Idiopathic retroperitoneal hematoma. Apropos of a case]. AB - A 10 year-old girl presented with a progressive left ureteral colic with abdominal tenderness. Ultrasonography revealed pyelocalyceal dilatation and an intravenous pyelogram showed lateral deviation of the left ureter. Computed tomography confirmed retroperitoneal mass distinct from psoas. Laparotomy revealed an encapsulated retroperitoneal hematoma. No particular aetiology was found and the patient's health remained stable after treatment. PMID- 2717335 TI - [Detection of vision disorders in newborn infants and children]. AB - Early detection of visual deficits is of most importance in childhood. To be adequately treated; it requires systematic screening before 18 months of age. Basic tests include objective refraction study (skiascopy), preferential sight test with estimation of visual acuity which is possible after 3 months of age, and, if poor vision, is found, electroretinography evoked visual potentials is performed. Many disorders can be recognized early on and treated (mainly strabismus, congenital cataract or glaucoma). The early correction of refractive disorders results in good visual development and subsequent facility in reading and writing. PMID- 2717336 TI - [Neonatal mortality at the Ille-et-Vilaine department. Results in 1987]. AB - All 56 neonatal deaths that occurred during 1987 in Ille-et-Vilaine department (France) were systematically analysed, and the history of pregnancy, delivery, neonatal resuscitation, circumstances under which death occurred in neonatal care unit as well as autopsy findings were studied. Each case was then discussed by a multidisciplinary staff and consensus was obtained regarding diagnosis and cause of death. There were 2 separate categories: 26 deaths (46%) were due to related to malformation, or to metabolic dysfunction; 30 deaths were a result of other causes (54%): 9 low birth weight, 5 respiratory disorders, 5 neurologic disorders, 6 infectious diseases, 2 hemorrhagic shock and 3 were of unknown etiology. Information on causes of neonatal death in a specific region may aid in determining public health priorities for that region; if similar studies were carried out in each department, and results compared, this could aid in setting the guidelines for more efficient health treatments and lead to national choices about neonatal public health. PMID- 2717337 TI - [Complications of long-term corticotherapy: how to prevent?]. PMID- 2717338 TI - [A new etiology of traveler's diarrhea in children: Cryptosporidium diarrhea]. AB - Cryptosporidiosis is a frequent cause of Traveler's diarrhea in children. In its acute or chronic form, this diarrhea is often accompanied by dehydration and accompanying deterioration in health. Diagnosis may be reached by inspection of the stools, for parasites, utilising specific but simple procedures. The latter tests should be carried out by the laboratory in addition to the routine parasitological examination. Prognosis is good in immunocompetent children since the clinical signs spontaneously regress within about a month. The only treatment consists in symptomatic treatment of diarrhea. Spiramycin, though not constantly effective, is reserved for immunosuppressed patients. PMID- 2717339 TI - [Dermatomyositis in children]. AB - Dermatomyositis in childhood is an uncommon disease, affecting muscle and skin. The disease usually has an insidious onset; the proximal muscle groups are classically more affected than the distal group. If left untreated, the disease will either spontaneously arrest or will progress until the child is completely bedridden, with death secondary to hypoventilation and aspiration. For a definitive diagnosis 3 or 4 of the following criteria (plus rash) are required: 1) symmetrical limb girdle weakness; 2) muscle biopsy evidence of myositis and muscle necrosis; 3) elevation of muscle enzymes; 4) electromyographic changes of myositis. The main pathologic feature of juvenile dermatomyositis is vasculitis affecting small arteries and veins of muscle, skin and gastrointestinal tract. Whether muscle from patients with polymyositis contains a specific auto antigen or is contaminated with an immunogenic infectious agent such as a virus (coxsackie virus, for instance) remains unclear. Childhood dermatomyositis is almost uniformly responsive to steroid treatment; there is a good chance of remission with minimal risk of secondary complications with an initial low dosage of prednisone (1 mg/kg/day). The use of additional drugs such as azathioprine, methotrexate or cyclophosphamide is reserved for patients who are either not completely responsive to steroids or difficult to wean off steroids. Cyclosporine A has been proposed to achieve a reduction in steroid dosage. PMID- 2717340 TI - [A severe form of juvenile polyposis coli]. AB - The authors report a case of a life-threatening form of juvenile polyposis coli in a 7-year-old girl. The cure of this affection required a total coloproctectomy with ileoanal anastomosis. PMID- 2717341 TI - Field dependence: experimenters' expectancy, sex difference or no difference? AB - The possibility that sex differences found in previous research on field dependence may have been due partly to experimenters' expectancy, was investigated. Three pairs of naive student-experimenters received different information about expected outcomes for males and females on the Rod and Frame Test and the Embedded Figures Test. There was no evidence of an experimenters' expectancy effect, but there was also no significant difference in the performance of men and women on these two tests of field dependence. PMID- 2717342 TI - Hemispheric preference and progressive-part or whole practice in beginning typewriting. AB - This investigation explored the interaction of progressive-part versus whole methods of practice with hemispheric preference for processing information and the impact of each upon high school students' speed and accuracy in beginning typewriting. Zenhausern's Differential Hemispheric Activation Test was scored in such a way that it was possible to plot the scores along a continuum. Analysis of variance gave significant F ratios on 3 of the 4 testing days. The continuous scores were divided into five categories: middle, left moderates, right moderates, extreme rights, and extreme lefts. The moderate-left group speed was consistently the fastest group, and the extreme rights were consistently the slowest group. This difference was significant for all four testing days with the moderate-left mean speed varying between 4 to 6 words per minute faster each testing day. The extreme rights were consistently the most accurate, even though not statistically significantly so. There was no significant difference between method of practice and typewriting speed or between method of practice and typewriting accuracy; however, on all four testing days the mean gross speed of the whole practice learning group was 0.73 to 0.99 words per minute faster than the progressive-part group. A two-way analysis of variance indicated no interaction between method or practice and hemispheric preference. PMID- 2717343 TI - Processing of memories and knowledge in REM and NREM dreams. AB - Over 4 nights, 16 young-adult males each reported 2 REM and 2 nonREM dreams. They then identified possible sources of dream imagery in their waking memory and/or knowledge. A judge, naive as to conditions of data collection, reliably judged the closeness of correspondence of dream event to identified source. Correspondence was lower for REM than for nonREM reports and for longer than for shorter reports from either stage. PMID- 2717344 TI - Effects of time-compression on feature and frequency discrimination in aged listeners. AB - This study measured the ability of 16 aged listeners, normal for their age (age range, 63 to 84 yr.) to discriminate phonemic contrasts in sentential stimuli (Subtest 13 of the Carrow-Auditory Visual Abilities Test) presented at 50% time compression rate. A series of linear regression analyses were performed in which each independent variable was regressed against the continuous variable of age. Over-all performance on the time-compressed task significantly decreased as a function of age. Also discrimination of place of articulation and mid- to high frequency contrasts was significantly and negatively related to age. In general, such findings suggest that the course of aging continuously imposes degrading effects on speech-processing that are related to discrimination of place feature contrasts. PMID- 2717345 TI - Time perception: effects of sensory modality, ambient illumination and intervals. PMID- 2717346 TI - Bimanual handedness in adults who stutter. AB - 25 adult stutterers and 29 nonstutterers who were right-handed as defined by a positive Laterality Quotient on the Edinburgh Handedness Inventory were compared with respect to their pattern of hand use in performing seven common tasks that involve bimanual cooperation. Among the stutterers was a higher proportion of participants who showed anomalies in how they carried out the two tasks that required synchronous manipulation by the two hands. On two other tasks that required speeded performance, the groups were similar in dealing playing cards with the right or left hands, but the stutterers were slower than nonstutterers and did not show a right-hand advantage on a task requiring removal of a nut from a bolt. The results were interpreted as indicating difficulty by stutterers in carrying out synchronously different response elements of motoric tasks. PMID- 2717347 TI - Effects of eye color and sex on accuracy in archery. AB - 126 subjects were 47 children in Grade 7, 49 students in Grade 8, and 30 adults, who shot arrows at bull's-eye targets from varying distances. Analysis of variance of accuracy scores indicated that there was no difference for eye color, but boys scored more points than did girls. PMID- 2717348 TI - Neuropsychological characteristics of young adult chronic psychiatric patients: preliminary observations. AB - Psychological evaluation included tests of brain-behavior functioning and academic level for 110 young adults (16 to 39 yr. of age), each a moderate to heavy user of mental health services. The composite patient manifested borderline, diffuse brain dysfunction with deficiencies in language, visuospatial, motor, concentration, and higher-order problem-solving skills, together with below normal performance on tests of intelligence, reading comprehension, arithmetic calculation, and spelling. Standard mental health services appear inadequate for habilitation or rehabilitation of many such people. The findings suggest that one reason for these patients' lack of response to conventional mental health treatments is that clinicians fail to identify patients' fundamental deficiencies and to incorporate this knowledge in planning treatments and evaluating progress. Suggestions for further studies are offered. PMID- 2717349 TI - Physical fitness, body image, and locus of control in college freshman men and women. AB - This study examined the relations among physical fitness, body image, and locus of control. The Hall-Physical Fitness Test Profile, the Winstead and Cash Body Self-relations Questionnaire (BSRQ) and the Nowicki-Strickland Locus of Control Scale were administered to 243 freshmen. Women were significantly more positive about their physical appearance than men. Men were more positive about their physical fitness than women. Men were more physically fit than women. Men and women scoring in the internal direction viewed the physical fitness domain of their body image positively. Unlike men, internally oriented women had more positive perceptions of the health aspect of their body image. Physically fit men and women had positive attitudes toward the physical fitness component of their body image. Physically fit men differed from physically fit women in that men were more internal and held more positive attitudes toward the physical health dimension of their body images. PMID- 2717350 TI - Fixed set in the perception of size in relation to lightness. AB - When control subjects compared the sizes of two circles of different lightness, the lightness-size illusion was observed, i.e., the darker circle was perceived to be smaller. However, after experimental subjects were shown a large, light circle and a smaller, darker circle repeatedly, the subjective size of the dark circle increased. It decreased after repeated exposures to a small, light circle and a large, dark one. These changes in perception were assumed to be contrast effects produced by an experimentally fixed set and were similar to changes observed when the same method was previously applied by this author to the size weight illusion. Despite differences in modality and dimension of perception, every application of the fixed-set method resulted in analogous patterns. When the situation of the set-fixing experiment and that of the critical experiment were similar to each other, the fixed set was activated more and greater contrast effects were produced. PMID- 2717351 TI - Effect of starting position on reproduction of movement: further evidence of interference between location and distance information. AB - Two experiments done with a short-term memory paradigm examined the influence of shifts in the starting position on the reproduction of kinesthetic location (Exp. 1) and on distance cues (Exp. 2). We assessed possible causes of the systematic pattern of undershooting and overshooting as related to the shift in the starting position. In each experiment, two groups of 10 students were given 25 trials, and each had criterion and reproduction tasks involving linear-positioning movements with a 10-sec. retention interval. Each experiment had two independent variables, the group of subjects and the shift in the starting position. The two groups differed in the possible sources of information, the distance moved (Exp. 1) or the end-location (Exp. 2), which were assumed to cause undershooting and overshooting during reproduction. Analysis showed that the information about the distance moved may produce undershooting and overshooting in reproduction of the end-location (Exp. 2). Also, the information about the end-location may produce undershooting and overshooting in reproduction of the distance moved (Exp. 2). The findings were further evidence of interference between location and distance cues in motor short-term memory. PMID- 2717352 TI - Handedness affects emotional valence asymmetry. AB - Music was played monaurally to 80 right-handed and 80 left-handed subjects. Right handers reported more positive and less negative effect if the music was to the right ear. Left-handers reported experiencing more positive and less negative effect during music to the left ear. The hand x ear interaction was significant. The valence of emotional responses to the music seems influenced by a combination of at least two factors, (1) differences between left- and right-handers in the cerebral processing of emotional valence and (2) differences in the processing of emotional valence within each handedness group depending upon which hemisphere was initially most strongly engaged by the music. These results partially corroborate and extend stimuli were presented tachistoscopically or dichotically. It is concluded that, while there is hemispheric asymmetry in the processing of emotional valence, the direction of the asymmetry may be associated with the handedness of the subjects. PMID- 2717353 TI - Depressive and elative mood inductions as a function of exaggerated versus contradictory facial expressions. AB - Two studies concerned the relation between facial expression cognitive induction of mood and perception of mood in women undergraduates. In Exp. 1, 20 subjects were randomly assigned to a group who were instructed in exaggerated facial expressions (Demand Group) and 20 subjects were randomly assigned to a group who were not instructed (Nondemand Group). All subjects completed a modified Velten (1968) elation- and depression-induction sequence. Ratings of depression on the Multiple Affect Adjective Checklist increased during the depression condition and decreased during the elation condition. Subjects made more facial expressions in the Demand Group than the Nondemand Group from electromyogram measures of the zygomatic and corrugator muscles and from corresponding action unit measures from visual scoring using the Facial Action Scoring System. Subjects who were instructed in the Demand Group rated their depression as more severe during the depression slides than the other group. No such effect was noted during the elation condition. In Exp. 2, 16 women were randomly assigned to a group who were instructed in facial expressions contradictory to those expected on the depression and elation tasks (Contradictory Expression Group). Another 16 women were randomly assigned to a group who were given no instructions about facial expressions (Nondemand Group). All subjects completed the depression- and elation induction sequence mentioned in Exp. 1. No differences were reported between groups on the ratings of depression (MAACL) for the depression-induction or for the elation-induction but both groups rated depression higher after the depression condition and lower after the elation condition. Electromyographic and facial action scores verified that subjects in the Contradictory Expression Group were making the requested contradictory facial expressions during the mood induction sequences. It was concluded that the primary influence on emotion came from the cognitive mood-induction sequences. Facial expressions only seem to modify the emotion in the case of depression being exacerbated by frowning. A contradictory facial expression did not affect the rating of an emotion. PMID- 2717354 TI - Mother-blaming among college students. AB - The purpose of this study was to examine the tendency for mother-blaming among college students to determine if such a bias existed outside the clinical profession. The subjects were 49 men and 50 women at a small private university, who were asked to attribute responsibility for 45 behavioral and personal psychological problems to one of the following targets: Father, Individual, Mother, and Society. Analysis showed Individual receiving most attributions, followed by Society, Mother, and Father, in that order. Relatively more problems are blamed on Mother than on Father, with a tendency to blame mothers for emotional problems such as dependency and shyness and fathers for behavioral physiological problems such as child abuse and alcoholism. Intercorrelations of the number of attributions made to different targets clearly suggest that there are parent-blamers, society-blamers, and individual-blamers. Implications of blame attribution for mental health are acknowledged. PMID- 2717355 TI - Psychomotor performance as a function of time of day. AB - Previously reported data on mirror tracking were reexamined for time-of-day (TOD) effects on performance and for the interaction of these effects with sex and practice effects. Analyses showed a significant linear decline of mean score from 0900 through 1300 hours, a sharp postlunch recovery at 1400 hours, and another significant linear decline from 1400 through 1700 hours. These effects were orthogonal to sex and practice effects. Discussion emphasized the importance of control for time of day in experimental design and suggested several hypotheses about the decremental effects of time of day. PMID- 2717356 TI - Lights and lattices and where they are seen. AB - The article discusses characteristics of internal visual images and is based on personal observations of lucid dream and hypnopompic phenomena. In the context of lucid dreaming there sometimes occur persisting bright lights that do not behave like ordinary dream images. These phenomena appear as areas of light, peripheral light, disks of light, sun-like concentrations of light, and fullness of light. These luminous phenomena remain in a fixed location in my view in spite of any dreamed body movement, may appear in different dreams in the same locations, are not truly representational, and appear to be unrelated to other dream images, visual or otherwise. These stable intense lights remain in a fixed location in relation to an area defined by keeping the head still and moving the eyes. This area is the space that is filled at times by scannable hypnopompic geometrical patterns or scannable hypnagogic complex images. Although space-filling patterns look like they extend like a dome over the eyes, a close examination shows that they have a two-dimensional flatness that reaches over the entire scannable area. The observation of these patterns as flat becomes understandable when we think of the internal image as having no distance or separation from the seeing of the image, that is, as being experienced face on at every point. The flatness of the hypnopompic pattern implies the flatness of all internal images. The experiences translates the flat image to external positions around the eyes. This translation is explained. PMID- 2717357 TI - Uncertainty and visual strategies in table tennis. AB - Ball games are characterized by perceptual uncertainty and time-pressure. Of interest is the visual-search pattern carried out when these characteristics change. This is the case in table-tennis situations when comparing a drill situation, when one kind of stroke is constantly repeated, and a match situation, when the stroke is more often unpredictable. We analysed, during play, the visual search pattern of five expert table tennis players to examine the effect of uncertainty on visual behavior. Direction of gaze was recorded by a video oculographic recorder (NAC Eye Mark Recorder IV). Analysis showed that (i) visual fixations towards opponent player were only systematic in a match contrary to drill where they occurred less frequently. (ii) Whatever the situation, only the first part of the ball's trajectory was visually tracked. This occurred immediately after the opponent's release of the ball. Nevertheless, visual tracking was more frequent and of longer duration in a match. (iii) Analysis of motor behavior showed that the duration of the movement preparation was longer in a match while the duration of the execution phase was unchanged. PMID- 2717358 TI - Reaction time and movement time after active and passive smoking. AB - Reaction time and movement time were studied following active and passive smoking in two groups of 20 women. All subjects were tested under a clean air and smoky air condition and the results showed that, while there was no difference between groups for either measure in the clear air condition, the active smokers had faster reaction time and movement time in the smoky air condition. Smoky air had no significant effect on the responses of the passive smoking group. PMID- 2717359 TI - Shape preferences for simple Euclidian forms in three age groups. PMID- 2717360 TI - Effects of auditory masking on lingual vibrotactile magnitude-estimation scaling responses of young children. AB - Studies of lingual vibrotactile magnitude-estimation scaling have focused primarily on the responses of normal young adults. Little is known about the scaling responses of young children to suprathreshold vibratory stimulation because of the complexities of the experimental procedure. Binaural auditory masking is one aspect of the procedure that has recently been studied in adults. The purpose of this study was to investigate the effects of binaural auditory masking on lingual vibrotactile magnitude-estimation responses of young children. Four children whose mean age was 4.6 yr. completed magnitude-estimation scaling tasks for eight lingual vibrotactile suprathreshold intensity levels (6, 10, 16, 20, 26, 30, 36, 40 dB SL) under masking and no masking conditions. Results suggest possible effects of auditory masking on the lingual vibrotactile magnitude-estimation scaling responses of these young children that have not been found for such responses of adults. PMID- 2717361 TI - Listening rate and comprehension as a function of preference for and exposure to time-altered speech. AB - We conducted experiments on the effects of brief prior exposure to time-altered speech on preferred listening rate and the rate listeners would select when asked to listen to speech as fast as possible with good compression (induced listening rate). In Exp. 1, 48 participants were exposed either to normal rate speech or to speech compressed to twice-normal rate. Brief exposure to twice-normal rate speech led to a faster induced listening rate than exposure to normal rate speech. In Exp. 2, 31 participants were briefly exposed to normal rate speech, speech compressed to twice-normal rate, or speech expanded to half-normal rate. The faster the rate of the exposure speech, the faster the induced rate. Speech compressed to twice-normal rate led to a faster induced listening rate than exposure to speech expanded to half-normal rate. Normal rate speech was intermediate between twice-normal and half-normal rate and did not differ significantly from them. Induced listening rate was a linear combination of listening rate preference and recent forced exposure to time-altered speech. PMID- 2717362 TI - Aversiveness of denatonium saccharide and quinine in grasshopper mice Onychomys leukogaster. AB - The responses toward denatonium saccharide and quinine by three rodent species differ from those exhibited by humans. This study measured the relative aversiveness of these two compounds in grasshopper mice (Onychomys leucogaster) to determine if this species responded similarly to or differently from these other rodents. In a choice test, the mice clearly preferred quinine over denatonium saccharide at concentrations of 1/10,000 and 1/50,000, but only marginally preferred quinine at a concentration of 1/1000. When denatonium or quinine was paired with toxicosis, both suppressed drinking at concentrations from 1/10,000 to 1/50,000, but only denatonium suppressed drinking at 1/100,000. Neither compound suppressed drinking at 1 part in million. Grasshopper mice perceived denatonium saccharide as more aversive than quinine in both experiments. Such a response resembled the behavior of humans more than that of the other three rodents previously tested. PMID- 2717363 TI - Infant baboons spontaneously use an object to obtain distant food. PMID- 2717364 TI - Chicks' maze learning reinforced by visual pitfall extending downward. AB - The present study examined whether visually evoked fear of depth could reinforce a particular response of animals, i.e., to special maze learning. The maze was composed of four units of Y-shaped alley. In this maze, the visual pitfalls were set behind corners of the alley in place of a physical barrier. The experiments showed that eight of 13 male chicks could achieve the initial learning and that three successful ones could also achieve reversal learning. The results suggest that the visually evoked fear of depth provided by motion parallax can act as a reinforcer. PMID- 2717365 TI - Consciousness and abilities of dream characters observed during lucid dreaming. AB - A description of several phenomenological experiments is given. These were done to investigate of which cognitive accomplishments dream characters are capable in lucid dreams. Nine male experienced lucid dreamers participated as subjects. They were directed to set different tasks to dream characters they met while lucid dreaming. Dream characters were asked to draw or write, to name unknown words, to find rhyme words, to make verses, and to solve arithmetic problems. Part of the dream characters actually agreed to perform the tasks and were successful, although the arithmetic accomplishments were poor. From the phenomenological findings, nothing contradicts the assumption that dream characters have consciousness in a specific sense. Herefrom the conclusion was drawn, that in lucid dream therapy communication with dream characters should be handled as if they were rational beings. Finally, several possibilities of assessing the question, whether dream characters possess consciousness, can be examined with the aid of psychophysiological experiments. PMID- 2717366 TI - Spatial learning of visual 'nonsense figures' during experimental ethanol intoxication. AB - The interaction of alcohol and visuospatial learning was evaluated during two experimental sessions. During one session, participants were experimentally intoxicated to obtain a blood alcohol concentration of at least 0.10%. During another session, a nonalcohol placebo was administered. The learning task consisted of a paired-associate paradigm requiring participants to learn the distinct spatial positions of 6 visually presented "nonsense shapes." The visuospatial learning of participants in the placebo condition was generally superior to their learning while intoxicated. However, intercorrelations of performance measures indicated that the relation between alcohol ingestion and performance differences across conditions was not linear. PMID- 2717367 TI - Mood profiles of Masters track and field athletes. AB - In several studies attributing positive health benefits to running, the benefits include reduced depression, fatigue, anger, and increased vigor. Until now, little research has focused on Masters track and field athletes. The present study reports on 587 men and women Masters who participated in a mailed survey measuring mood states using the Profile of Mood States. In comparison to other groups of athletes, these Masters tend to be less depressed, less angry, and less fatigued. Attribution to lifestyle and maturity with their sport is discussed. PMID- 2717368 TI - On circadian variations in discrimination of duration. PMID- 2717369 TI - Effects of force output and preparatory set on premotor time of simultaneous bilateral responses. AB - Premotor times in simultaneous bilateral elbow-flexion movements were measured for 20 subjects when loads (light or heavy) were applied to both elbow joints. Premotor times for the heavy load were longer than those for the light load on both sides. The difference in premotor time between the two loads was larger for bilateral response than for unilateral response, suggesting that exertion of strength combines with response modality to increase the difference between the two loads. Preparatory set did not affect premotor time under the heavy load but affected premotor time under the light load. Possible mechanisms subserving these findings are discussed. PMID- 2717370 TI - Foot lateralization and psychomotor control in four-year-olds. AB - The assumption that young children who have established a preferred and consistent use of lateral limb control may have an advantage in motor skill competence over individuals who do not exhibit established dominant behaviors, was the focus of this investigation. The research identified the lateral foot preferences of 153 4-yr-olds and compared preference groups (right, nonestablished, left) with motor skill competence. Analysis indicated no statistically significant differences on the eight motor tasks among the three groups, however, right-footed children outperformed th subjects with nonestablished foot preference on six of the eight tasks. This speculation is in the direction predicted by previous researchers and demands further inquiry. PMID- 2717372 TI - Transport and utilization of alpha-ketoglutarate by the rat kidney in vivo. AB - In order to establish the characteristics of net renal transport and utilization of alpha-ketoglutarate (alpha-KG) in the rat, we have precisely quantified the renal blood flow, the urinary flow and the rates of alpha-KG delivery, filtration, reabsorption or secretion, excretion, uptake or production by an in vivo rat kidney preparation. In normal rats, alpha-KG uptake was higher than alpha-KG reabsorption at both endogenous and elevated plasma alpha-KG concentrations; thus, a net peritubular transport, which was the main supplier of alpha-KG to the renal cells, took place. Saturation of reabsorption and peritubular transport of alpha-KG occurred at blood alpha-KG concentrations about 30 and 150 times above normal, respectively. Acute metabolic acidosis was found to have no effect on renal handling of alpha-KG. At endogenous plasma alpha-KG concentrations, alkalosis converted net renal uptake into net renal production of alpha-KG resulting in addition of alpha-KG by the renal cells both to blood and to the luminal fluid. Elevation of blood alpha-KG concentration restored the renal uptake of alpha-KG. This uptake, which was entirely accounted for by the peritubular transport of alpha-KG, reached a maximum which was lower than that observed in normal and acidotic rats. PMID- 2717371 TI - Water, K+, H+, lactate and glucose fluxes during cell volume regulation in perfused rat liver. AB - The present study has been performed to test for ion release from isolated perfused rat liver exposed to hypotonic perfusates. Replacement of 40 mmol/l NaCl in perfusate by 80 mmol/l raffinose leads to slight alkalinization and slight decrease of liver weight. Subsequent decrease of perfusate osmolarity by omission of raffinose results in an increase of liver weight and a parallel increase of effluent sodium, chloride and potassium activity pointing to net uptake of solute free water. While effluent chloride and sodium activities approach perfusate activities within less than 2 min, a second, 6 min lasting increase of effluent potassium activity is observed, pointing to potassium release by the liver. This transient increase of effluent potassium activity is paralleled by a decrease of liver weight. Throughout exposure to hypotonic perfusates, lactate, pyruvate and glucose release by the liver is significantly decreased and effluent pH is rendered alkaline. Readdition of 80 mmol/l raffinose leads to rapid decrease of liver weight and a parallel decrease of effluent sodium, chloride and potassium activities followed by a 10-20 min lasting decrease of effluent potassium activity, pointing to net uptake of potassium, which almost matches the net release observed before. The transient decrease of potassium activity is paralleled by an increase of liver weight, an increase of effluent glucose, lactate and pyruvate concentration and an acidification of the effluent. Similar decrease of effluent potassium activity, acidification of effluent and increase of effluent glucose, lactate and pyruvate concentration are observed, if perfusates are made hypertonic by addition of raffinose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717373 TI - Tubulo-glomerular feedback response: enhancement in adult spontaneously hypertensive rats and effects of anaesthetics. AB - Open-loop tubulo-glomerular feedback (TGF) responses were measured in halothane anaesthetized spontaneously hypertensive rats (SHR), in normotensive Wistar Kyoto (WKY) and Sprague-Dawley rats (SPRD), and in inactin anaesthetized SPRD. Proximal intratubular free flow pressures (FFP) (13.8-14.7 mm Hg) and stop-flow pressures (40.0-42.4 mm Hg) were similar in the four groups, but systemic arterial pressure was significantly lower in WKY, and significantly higher in SHR than in SPRD. The turning point (Tp) of the feedback curve was 9.87 nl/min in SHR, significantly lower than the 13.04 nl/min found in WKY. Maximum TGF pressure response was 28.6% greater in SHR than in the normotensive rats (13.3 vs. 9.5 mm Hg; p less than 0.025). The sensitivity, as estimated from the slope of the feedback curve at the Tp [f'(Tp)] was 87% greater in SHR than in WKY. There was no significant difference between these parameters in WKY and SPRD. The TGF pressure response was biphasic in the 3 groups of halothane anaesthetized rats with a steady state level reached in about 2 min after the change in late proximal microperfusion rate. In inactin anaesthetized rats the sensitivity was 41% lower than in the halothane anaesthetized control group of SPRD, the feedback response was lower, and the feedback curve was displaced to the right with the Tp at 15.9 nl/min, significantly higher than in the control group (p less than 0.001). Although the steady state level also was reached within 2 min, the clearly biphasic pattern of the pressure response was less consistent. PMID- 2717374 TI - Arachidonic acid closes gap junction channels in rat lacrimal glands. AB - The effects of arachidonic acid (AA) on gap junction conductance of rat lacrimal glands have been studied with the double patch-clamp technique. Extracellular application of 50-100 microM AA for a few minutes induced a closure of gap junction channels. This effect was mimicked by linoleic acid and by other non degradable fatty acids (myristic and lauric), and was not blocked by inhibitors of AA metabolism. This suggests that the active molecule was the fatty acid itself, and not one of its oxidative derivatives. Inhibitors of AA metabolism caused a certain degree of uncoupling by themselves, probably due to the accumulation of AA. This effect was reduced in the presence of 10 microM 4 bromophenacylbromide, an inhibitor of phospholipase A2. The effect of AA did not seem to be mediated by an increase of intracellular Ca concentration, nor by a change in the activity of guanylate or adenylate cyclases, nor by activation of protein kinase C. Therefore it could be attributed to a direct effect of AA on gap junctions. Analysis of single gap junction channel currents showed that AA induced closure of these channels resulted from a change in the number of open channels, and not from a reduction of their conductance. Finally, acetylcholine induced closure of gap junction channels was not primarily mediated by an increase in AA concentration, although such an increase may well follow the activation of muscarinic receptors and play a role in the acetylcholine effect. PMID- 2717375 TI - Effect of amphotericin B on renal tubular acidification in the rat. AB - Amphotericin B, a polyene antibiotic known to induce cation-selective pore formation in biological cell membranes, was given to rats by peritoneal injection (10 mg/kg for 21-26 days) or added to luminal perfusates (2 x 10(-5) M). Kinetics of tubular acidification and alkalinization after perfusion with alkaline or acid phosphate Ringer's solution was studied by means of double barrelled antimony/reference microelectrodes in cortical distal tubules. Stationary pH increased both in early and late distal segments. Acidification and alkalinization half-times decreased markedly from 15-18 s to 6-8 s, a value similar to that found in proximal tubule. Net H-ion secretion rates as well as H ion back-flux approximately doubled after Amphotericin B. Apparent H-ion permeability of distal tubule epithelium measured during perfusion of lumen and peritubular capillaries with phosphate Ringer's solutions doubled both in early and late segments. These data show that amphotericin B produces a distal acidification defect which impairs formation of normal transepithelial pH gradients by increasing H-ion back-flux without reducing rates of net H-ion secretion. PMID- 2717376 TI - The slow inward calcium current is responsible for a part of the contraction of patch-clamped rat myoballs. AB - The slow inward calcium current and the contractile response were simultaneously recorded in voltage clamped (whole cell patch clamp recording) rat myoballs in primary culture. The shape of the contraction(T)/potential(V) relationship and the application of the inorganic calcium channel blocker cadmium (1.5 mM), which suppresses a part of the contractile activity, demonstrate the existence of two components of contraction. One of them is related to the slow calcium current. PMID- 2717378 TI - Deutsche Physiologische Gesellschaft, Israel Physiological and Pharmacological Society. Abstracts of the joint meeting (67th meeting). 5-10 March 1989, Jerusalem. PMID- 2717377 TI - Intracellular Ca modulates K-inward rectification in cardiac myocytes. AB - In cardiac myocytes, instantaneous inward rectification of the K-rectifying channel is abolished by removal of divalent cations from the intracellular environment and can be restored by addition of Mg ions at submillimolar concentrations, which has led to the proposal that Mg ions regulate inward rectification in these cells (Matsuda et al., 1987; Vandenberg, 1987; Matsuda, 1988). Here we report that Ca, too, reduces outward current flow through single inward rectifier channels in cell-free inside-out patches at much lower (submicromolar) concentrations. Intracellular Ca induces rectification by decreasing the probability of the main open channel state and by favouring the opening of channel substrates. Ca concentrations generating rectification are in the range of the Ca transient during activity, suggesting that Ca ions can contribute to K-rectification during cardiac muscle contraction. PMID- 2717379 TI - Factors related to successful upper extremity prosthetic use. AB - Surveys from 40 upper extremity amputees were analyzed to examine factors related to successful use of an upper extremity prosthesis. Factors which were associated with successful rehabilitation were fewer than two complicating factors, completion of high school education, employment at both the time of amputation and review, rapid return to work, acceptance of the amputation by the time of this review, and perception that the prosthesis was expensive. Factors which appeared unrelated to prosthetic success were age, loss of dominant hand, loss of elbow, marital status, use of rehabilitation services, use of a temporary prosthesis, and whether training in prosthetic use was provided. Many of these factors concurred with earlier studies. Previously unreported factors that may be of importance to the long-term success of upper limb amputees are the number of complicating factors and perceptions about the monetary value of the prosthesis. PMID- 2717380 TI - Comparison of CAD-CAM and hand made sockets for PTB prostheses. AB - The aim of the present study was to compare sockets for below-knee (BK) prostheses made by Computer Aided Design-Computer Aided Manufacture (CAD-CAM) to those made by hand. The patients in the study were provided with two prostheses each, which apart from the sockets, were identical. One socket was made by the CAD-CAM technique developed at the Bioengineering Centre, Roehampton, University College London and one was made by hand at the OT-Centre, Stockholm, Sweden. The results were based on investigation of eight unilateral below-knee amputees evaluating their own sockets by Visual Analogous Scale with respect to comfort, pressure, and pain. The sockets were evaluated on seven occasions, at two tests, on delivery, after use every second day for six days and every second week for two weeks. All CAD-CAM sockets except one had to be changed once as compared to the hand made of which only two had to be changed. As to comfort it could not be demonstrated that there was any significant difference between the two types of sockets and both types were well accepted by all patients. Differences in pressure and pain were rarely reported. There were obvious differences between the two types of socket with respect to height, width, and inner surface configuration. The authors feel that CAD-CAM will in the near future be an excellent tool for design and manufacture of prosthetic sockets. PMID- 2717381 TI - The CAPP terminal device, size 2: a new alternative for adolescents and adults. AB - CAPP Terminal Device, Size #2 for teenaged and adult amputees offers an alternative to hooks and hands available today. CAPP TD 2 is intended to be pleasing in appearance; it blends with the forearm in shape, colour and material to give a continuous flowing natural look. It was designed to provide secure grip through the combined action of a closing spring, a full frictional, resilient cover and an automatic lock. The lock operates as part of the voluntary opening control system and requires no conscious action by the amputee. CAPP TD 2 is a general purpose terminal device which especially serves unilateral amputees by performing functions usually carried out by the non-dominant hand. CAPP TD 2 comes with a built-in wrist connector which is available in two models; both offer quick disconnect. One wrist unit has adjustable friction and the other attaches to an existing friction wrist unit so CAPP TD 2 can be applied to an existing prosthesis. Ten patients have completed the evaluation programme with promising results. Prototypes of CAPP TD 2 are available for patients interested in evaluating it. The CAPP Terminal Device, Size #2 offers unilateral teenaged or adult amputee patients a unique alternative. It is introduced here in hope of stimulating researchers to explore new mechanical solutions in their component designs. The CAPP research designer, Mr. Carl T. Sumida. CPO, introduced the idea of a non-hand, non-hook TD with the CAPP TD 1 for infants (Sumida and Setoguchi, 1967); that terminal device had more function than a passive hand and it had a softer appearance than a hook.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717382 TI - Questionnaire assessment of patient satisfaction with lower limb orthoses from a district hospital. AB - A questionnaire survey of patient satisfaction with the provision of lower limb orthoses from a district general hospital was conducted. Lower limb orthoses included "made-to-measure" footwear, knee braces and ankle-foot-orthoses (AFO's). Prescriptions for footwear and AFO's during a one year period, and knee braces over a two year period were assessed. The survey did not confine itself to a single medical condition. The level of patient dissatisfaction with the various orthoses was as follows: AFO's 16%, footwear 24%, knee braces 42%. This level of dissatisfaction amounts to considerable financial waste. Although several recommendations can be made on the basis of these results, this study highlights the need for more detailed audit and research into the prescription and provision of orthoses in order to reduce this wastage. PMID- 2717383 TI - Use of the Femurett adjustable prosthesis in the assessment and walking training of new above-knee amputees. AB - The Lic Femurett adjustable training prosthesis was evaluated on 51 above-knee amputees attending the Oxford Disablement Services Centre. In the elderly it proved superior to the Pneumatic Post-Amputation Mobility Aid (P.P.A.M.-Aid) in the assessment of their ability to use a prosthesis, and is useful for walking training once the stump is fully healed; it does not replace the P.P.A.M-Aid at the early post-operative stage. PMID- 2717384 TI - Development of a universal wheelchair narrower. AB - A wheelchair user's mobility may be hampered by narrow doorways and restricted turning spaces. Mobility may be improved by undertaking expensive building alterations in the wheelchair user's own home and work environment. However, other environments, including modes of public transport, may still present considerable difficulties. One way of improving mobility is to reduce the overall width of a wheelchair with the occupant still seated within it. This is achieved by using a clamp, known as a "wheelchair narrower" which can be fitted and operated either by the wheelchair user or an attendant. The narrower takes advantage of the inherent design of a wheelchair which permits folding for storage. A universal wheelchair narrower was manufactured and tested at Tayside Rehabilitation Engineering Services. It was designed to be used on 69% of wheelchairs issued through the National Health Service in Scotland. Tests revealed that wheelchairs could be narrowed by between 38 and 127 mm depending upon the type of wheelchair. Active wheelchair users reported that the device was particularly useful when travelling. PMID- 2717385 TI - Measurements of pressure on the sole of the foot in plaster of Paris casts on the lower leg. AB - Pressure on the sole of the foot inside three different types of plaster cast, used in treatment of fracture of the lower leg, was measured on six normal persons. No significant difference was found between these pressures in below knee plaster, full length plaster including the thigh and patellar-tendon-bearing plaster. Only occasionally a relief in pressure was found in patellar-tendon bearing plasters. PMID- 2717386 TI - Cervical orthoses. AB - A biomechanical study is presented to compare the effectiveness of three types of off-the-shelf cervical orthoses and one custom-fit collar in restricting cervical spine motion. A group of 10 normal subjects was studied. The measurements of flexion and extension, lateral side flexion and axial rotation were recorded using various measurement techniques. Interface pressures at the chin and occiput were also measured, along with the warming effect of the collars. The results indicated that all the collars restricted neck movements, for example, the Plastazote collar by 50% of flexion and extension, and that there was no significant difference between off-the-shelf Plastazote and custom-fit collars in restricting movement. Significantly high interface pressures were recorded at the chin, with the subjects wearing the hard and Plastazote orthoses. The warming effect of the soft collar was equal to that of a wool scarf. The study was aimed at improving prescription and although the subjective observations were not validated, the subjects concluded that the custom-fit collars were more comfortable; an important point with such a high rejection rate. PMID- 2717387 TI - Midwife and other poems on caring. PMID- 2717388 TI - [A strong connection between family planning and health. Contraceptive technics today and in the future]. PMID- 2717389 TI - [Scandinavian research on contraception is important for developing countries]. PMID- 2717390 TI - [Musculoskeletal disorders in the Icelandic population]. AB - In an attempt to survey the prevalence of musculoskeletal symptoms in the Icelandic population, this study was carried out on a random sample of men and women of the ages 16 to 65 years. The aims were to gather reference material for future use as a basis for comparison with results from different subgroups of the working population. The cohort comprised 855 subjects, 421 men and 434 women. The questionnaires used had been developed by a working group supported by the Nordic Council of Ministers. The participation rate was 73.5 per cent. The highest prevalence of symptoms during previous 12 months was that for symptoms are reported by the men from the neck, shoulders, lower back and head. The prevalence of symptoms in each region differed considerably between age groups. We are not aware of any other study performed with such questionnaires on a representative national sample. In this sample, the prevalence of symptoms was high in both sexes, as compared to those prevalences found in a variety of Swedish populations representing a vide range of occupations and work tasks. PMID- 2717391 TI - [Hormonal regulation of bone remodeling]. AB - In the adult skeleton a continuous turnover of bone matrix and mineral takes place at discrete foci throughout life (bone remodeling). This process ensures the mechanical integrity of the skeleton and plays an important role in calcium homeostasis. It constitutes a very complex sequence of events, involving activation of several different stem cell populations and rigid regulation of two contrasting processes: bone resorption and bone formation. The study of factors involved in the control of bone remodeling is complicated by the involvement of local factors (growth factors, prostaglandins, inorganic ions) and systemic factors (calcitropic hormones), that interact at several different levels (cellular, tissue, and organ-levels). Most metabolic bone diseases, including osteoporosis, are caused by disturbances in the regulation of bone remodeling leading to an imbalance between resorption and formation. To understand these disturbances fully, it is necessary to study the different levels of skeletal organization, and the effect of different hormones and local factors on bone resorption and formation. In this review are described the effects of calcitropic hormones on bone cells at the cellular and tissue levels, and their interaction with local factors. PMID- 2717392 TI - Changing views on rheumatoid arthritis and new treatment regimens. PMID- 2717393 TI - [Wound infections after surgery. The interaction of surgical substances and bacteria]. AB - A series of experimental studies have shown that the infection dosage of S. aureus can be reduced from 10(6)-10(9) bacteria to a mere thousand or so, if the dose is given together with such foreign matter as suture material or glove talcum. Our knowledge of bacterial interactions with different substances, such as serum and connective tissue components that may act as links between bacteria and sutures, catheters or prosthetic surfaces, is still incomplete, however. PMID- 2717394 TI - [Health policy on research in Scandinavia]. PMID- 2717395 TI - [Adverse effects of alternative treatment]. PMID- 2717396 TI - [Family planning--a thorn in Chinese politics]. PMID- 2717397 TI - Solid-phase synthesis of oligoribonucleotides using 9-fluorenylmethoxycarbonyl (Fmoc) for 5'-hydroxyl protection. AB - Efficient solid-phase synthesis of a series of oligoribonucleotides of up to 20 residues is described that utilises the 9-fluorenylmethoxycarbonyl group (Fmoc) for 5'-protection and 4-methoxytetrahydropyran-4-yl (Mthp) for 2'-protection of ribonucleotide monomers and a phosphoramidite coupling procedure. The Fmoc group is removed after each coupling step by treatment with 0.1M DBU in acetonitrile. Oligoribonucleotides are isolated in 2'-protected form in good yield and shown to be readily and efficiently deprotected by mild acidic treatment. PMID- 2717398 TI - Predictive motifs derived from cytosine methyltransferases. AB - Thirteen bacterial DNA methyltransferases that catalyze the formation of 5 methylcytosine within specific DNA sequences possess related structures. Similar building blocks (motifs), containing invariant positions, can be found in the same order in all thirteen sequences. Five of these blocks are highly conserved while a further five contain weaker similarities. One block, which has the most invariant residues, contains the proline-cysteine dipeptide of the proposed catalytic site. A region in the second half of each sequence is unusually variable both in length and sequence composition. Those methyltransferases that exhibit significant homology in this region share common specificity in DNA recognition. The five highly conserved motifs can be used to discriminate the known 5-methylcytosine forming methyltransferases from all other methyltransferases of known sequence, and from all other identified proteins in the PIR, GenBank and EMBL databases. These five motifs occur in a mammalian methyltransferase responsible for the formation of 5-methylcytosine within CG dinucleotides. By searching the unidentified open reading frames present in the GenBank and EMBL databases, two potential 5-methylcytosine forming methyltransferases have been found. PMID- 2717399 TI - Detection of single DNA base differences by competitive oligonucleotide priming. AB - Synthetic DNA oligonucleotides can serve as efficient primers for DNA synthesis even when there is a single base mismatch between the primers and the corresponding DNA template. However, when the primer-template annealing is carried out with a mixture of primers and at low stringency the binding of a perfectly matched primer is strongly favored relative to a primer differing by a single base. This primer competition is observed over a range of oligonucleotide sizes from twelve to sixteen bases and with a variety of base mismatches. When coupled with the polymerase chain reaction, for the amplification of specific DNA sequences, competitive oligonucleotide priming provides a simple general strategy for the detection of single DNA base differences. PMID- 2717400 TI - Modulations of the in vitro translational efficiencies of Yellow Fever virus mRNAs: interactions between coding and noncoding regions. AB - As an approach to define the structural features within the 5' noncoding region of Yellow Fever virus (YFV) that modulate mRNA translational efficiency, we have studied how minor changes in this region affect the translational capacity in vitro of the corresponding mRNAs. A cDNA sequence coding for part of the YFV structural proteins was inserted into the vector pGEM3 containing the bacteriophage T7 promoter. This vector was engineered by site-directed mutagenesis to permit in vitro synthesis of transcripts containing only 5 vector nucleotides at their 5' end. The sequence of the YFV 5' untranslated region was further modified in order to alter the secondary structure of resulting T7 transcripts. The efficiency of these messengers in programming cell-free translation systems varied from 1- to 15-fold, correlating inversely with the potential of the 5' untranslated sequences to form stable secondary structures. A chimaeric messenger containing the YFV 5' noncoding (5' NC) region linked to a heterologous mRNA derived from Germiston virus, was tested for its in vitro translatability. We found a translational efficiency about 2-fold higher than that obtained with homologous transcripts, suggesting that YFV 5' NC region can function as a potential enhancer for gene expression. Data obtained with a series of plasmids constructed by linking the native YFV 5'NC region to various coding regions of the YFV genome indicated that interactions between the untranslated sequence and protein coding regions influence mRNAs translational efficiency. PMID- 2717401 TI - The GTm6AC sequence is overwound and bent. AB - By a combination of distance constraints obtained from NMR spectra and molecular mechanics calculations we have determined the three dimensional structure of the self-complementary decanucleotide d(CGCGTm6ACGCG). Methylation of an adenine at a position 3' to T induces significant conformational changes relative to B-DNA. This arises from the close proximity of the four methyl groups in the large groove in the centre of the sequence. The helical twist between the two T.m6A base pairs is found to be 45 degrees, as for D-DNA, and is accompanied by a high negative value of the wedge roll angle between these base pairs. The overall nonzero wedge roll observed shows that the helix is bent. These constraints appear to be material for the absence of the sequence T-m6A in natural DNAs. PMID- 2717402 TI - The contribution of the N- and C-terminal regions of steroid receptors to activation of transcription is both receptor and cell-specific. AB - Normalized dose response-curves for transcriptional activation of reporter genes were obtained by co-transfecting them with increasing amounts of wild-type (wt) progesterone (PR), glucocorticoid (GR) and oestrogen (ER) expression vectors. Marked differences in both shape and magnitude of the stimulation were observed depending on whether HeLa or CV1 cells were transfected. In HeLa cells the transcriptional stimulation from a reporter gene containing the hormone responsive element (RE) present in the mouse mammary tumour virus (MMTV) long terminal repeat (LTR) increased as increasing amounts (from 0.05 to 7.5 micrograms) of PR expression vector were transfected, whereas no such increase was observed in CV1 cells above 1 microgram of the same vector. In contrast, a PR mutant lacking the hormone binding domain (HBD, region E), exhibited increasing constitutive activity with increasing amounts of PR expression vector, such that in CV1 cells, but not in HeLa cells, similar activities were measured for the mutant and wt PR when 5 micrograms expression vectors were transfected. Western blot analyses indicated that the differences between the two cell lines were not due to differences in the amount of receptor proteins. Using the same MMTV LTR based reporter gene, cell-specific differences were also detected between the dose-response curves obtained for the human GR and a mutant which lacks the HBD. A PR mutant in which the N-terminal A/B region was deleted exhibited no (CV1 cells) or less than 5% (HeLa cells) of the wt-activity, whereas the corresponding GR mutant stimulated efficiently transcription in both cell lines. Identical studies with the wt human ER or a mutant truncated for the N-terminal A/B region resulted in bell-shaped dose-response curves in both HeLa and CV1 cells, whereas an ER mutant lacking the HBD was weakly active in either cell line. These data demonstrate cell- and receptor-specificity for the transcriptional activation functions present in the A/B region and the HBD of various steroid receptors and suggest that limiting factors mediate their action. The present study also emphasizes the need of establishing dose-response curves to correctly assess the relative contribution of the different regions of steroid hormone receptors in activation of transcription. PMID- 2717403 TI - Three mitochondrial tRNA genes from Arabidopsis thaliana: evidence for the conversion of a tRNAPhe gene into a tRNATyr gene. AB - Three tRNA genes have been isolated from a genomic library of Arabidopsis thaliana: a tRNASer (GCU), a tRNATyr (GUA) and a tRNAGlu (UUC) genes. These genes are located closely on the same DNA fragment. The tRNASer and the tRNAGlu genes have both 99% sequence similarity with their mitochondrial counterparts from higher plants indicating that these three tRNA genes are mitochondrial. The tRNATyr gene shows a particular high sequence similarity with the mitochondrial tRNAPhe pseudogene from maize, and both genes are flanked by a tRNASer gene in the upstream region. Extensive sequence comparisons of the Arabidopsis thaliana mitochondrial sequence containing the three tRNA genes and the corresponding region from maize and soybean mitochondria have shown evidence that the tRNA Tyr gene has been generated from a mitochondrial tRNAPhe gene. The conversion was accomplished by three genetic events: a 4 base-pair deletion, a mutation and a recombination, which led to the transformation of the acceptor stem and the anticodon. PMID- 2717404 TI - Purification and characterization of two serine isoacceptor tRNAs from bovine mitochondria by using a hybridization assay method. AB - For large scale preparation of mitochondrial tRNAs, a new hybridization assay method using synthetic oligodeoxyribonucleotide probes (16-17mer) complementary to individual tRNA sequences was developed and applied for the purification of two serine isoacceptor tRNAs (tRNASerAGY and tRNASerUCN) from bovine mitochondria. It is about 100 times more sensitive than the conventional aminoacylation assay method. 2-4 A260 units each of both tRNASer isoacceptors were purified from 17.5 kg of bovine liver, and they were characterized by means of nuclease digestion, melting profiles and aminoacylation activity. It is suggested that tRNASerUCN possesses the D loop/T loop interaction like usual L shaped tRNAs, and that tRNASerAGY lacking almost an entire D arm is aminoacylated with an efficiency not very much lower than that of tRNASerUCN. PMID- 2717405 TI - Measurement of the binding of transcription factor Sp1 to a single GC box recognition sequence. AB - The equilibrium constant was determined for the binding of the transcription factor Sp1 to a single consensus GC box DNA recognition site, (5'-GGGGCGGGGC-3'). For these experiments, single copies of the recognition site were synthesized and cloned in a standard plasmid background. Binding was measured either by a footprinting assay modified so that the binding reaction was at equilibrium, or by a gel mobility shift assay. The concentration of active Sp1 in the reactions and the dissociation constant were determined by computer-assisted fitting to theoretical curves. Values for the dissociation constant obtained in different experiments ranged from 4.1 X 10(-10) M to 5.3 X 10(-10) M. Several variants of the consensus recognition site were also tested. An A-substituted variant (5' GGGGAGGGGC-3') and a T-substituted variant (5'-GGGGTGGGGC-3') were bound 3-fold and 6-fold more weakly than the consensus site, respectively. A G-substituted variant (5'-GGGGGGGGGC-3') was bound at least 30-fold more weakly than the consensus site. These findings help distinguish between alternative models for Sp1-DNA recognition. They are consistent with the presence of specific hydrogen bond contacts between Sp1 and the central C-G base pair, but provide no particular evidence to support a model where local DNA structure is the dominant factor in the interaction. PMID- 2717406 TI - The degree of ultraviolet light damage to DNA containing iododeoxyuridine or bromodeoxyuridine is dependent on the DNA sequence. AB - The sequence selectivity of 300 nm ultraviolet light damage to DNA containing bromodeoxyuridine or iododeoxyuridine was examined on DNA sequencing gels. This was accomplished using a system where an M13 template was employed to direct synthesis of DNA in which thymidine was fully substituted with bromodeoxyuridine or iododeoxyuridine. The sites of damage corresponded to the positions of analogue incorporation. The extent of damage varied considerably at different sites of cleavage and ranged from the undetectable to over fifteen times the limit of detection (as assessed by laser densitometer scans). Strong damage sites had the "consensus" sequence CTT while sites of no detectable damage had the "consensus" sequence GTR. Bromodeoxyuridine and iododeoxyuridine had the same sites of damage although the extent of damage varied at different sites and bromodeoxyuridine damage was slightly greater than iododeoxyuridine. DNA containing thymidine was not damaged to any detectable level in this system with 300 nm ultraviolet light. The use of three closely related DNA sequences as targets for damage confirmed that (1) the sites of analogue incorporation are the cause of ultraviolet damage; and (2) that the neighbouring DNA sequence is an important parameter in determining the extent of damage. It is proposed that the microstructure of DNA--in particular the distance between the 5-carbon of the pyrimidine base (which is attached to the halogen) and hydrogen on the 2' carbon of the 5'-deoxyribose--ultimately determines the degree of cleavage with large distances giving a small degree of damage and smaller distances a large degree of damage. PMID- 2717407 TI - Alpha-DNA VIII: thermodynamic parameters of complexes formed between the oligo alpha-deoxynucleotides: alpha-d(GGAAGG) and alpha-d(CCTTCC) and their complementary oligo-beta-deoxynucleotides: beta-d(CCTTCC) and beta-d(GGAAGG) are different. AB - The temperature dependence of the formation of a complex between an alpha d(CCTTCC) hexanucleotide and its complementary beta-d(GGAAGG) sequence was studied and compared to the formation of the beta-d(CCTTCC):beta-d(GGAAGG) complex. Such alpha-beta complex is more stable than the regular beta:beta complex. The Tm value for the alpha:beta complex is 28 degrees C (delta G degrees = -7.3 kcal/mole) while Tm = 20, 1 degree C (delta G degrees = -6.3 kcal/mole) for the beta:beta complex. The stoechiometry of the alpha:beta complex corresponds to the formation of a 1:1 duplex. However, when the alpha- strand is made of alpha-purines: alpha-d(GGAAGG), the stability of the alpha:beta complex, alpha-d(GGAAGG):beta-d(CCTTCC) is found to be lower (Tm = 13.8 degrees C) than the stability of the regular beta-beta complex, leading to the conclusion that the nature of the alpha-sequence is important in terms of stability when considering the synthesis of such a sequence for using it as antisense oligonucleotide. PMID- 2717408 TI - DNA recognition element required for PUF-I mediated cell-type-specific transcription of the rat prolactin gene. AB - The cell-type-specific transcription of the prolactin gene in vitro is mediated through the interaction of prolactin upstream factor I (PUF-I) with a 28 basepair region of the gene promoter (-63 to -36) which contains an 18 bp A+T-rich imperfect palindrome (-63 to -46). Base substitutions were introduced into 16 of the 18 palindromic residues by targeted saturation mutagenesis. The GH3 binding and in vitro transcription assays of the mutated promoters showed that base substitutions within the 5'-ATATTCA-3' sequence located at -52 to -46 were detrimental to PUF-I binding and its cell-type-specific transcriptional enhancement activity. Transcription assays of the mutated promoters performed with several nonpituitary-derived extracts demonstrated that a distal TATA box located from -59 to -53 promotes initiation at -27. Thus, the cell-type-specific cis-acting element required by PUF-I for DNA recognition is immediately adjacent to a general TATA sequence. Base substitutions that decreased +1 transcription and PUF-I binding concomitantly increased -27 initiation of RNA in vitro. We suggest that PUF-I binding in pituitary cells potentiates +1 transcription and represses alternative TATA box activity for initiation events occurring at -27. This is the first known report of a eukaryotic DNA binding protein that has both an activator and repressor activity for a single transcription unit. PMID- 2717411 TI - Nucleotide sequence of a cDNA encoding a larval alpha-globin chain of the amphibian Pleurodeles waltlii. PMID- 2717409 TI - Ventricular myosin light chain 1 is developmentally regulated and does not change in hypertension. AB - Cardiac myosin heavy chain (MHC) isoform distribution has been shown to undergo changes during development, in response to hormonal stimuli, and during pathologic states like hypertension. We initiated a study of myosin light chain 1 (MLC1) expression in cardiac tissue to determine whether MLC1 undergoes changes similar to those seen for MHC. We isolated a full length cDNA for the predominant MLC1 sequence in rat hearts. This gene is expressed in ventricular tissue at much higher levels than in atrial tissue. Based on its expression pattern and sequence homology, this cDNA encodes the rat ventricular MLC1 and has been named RVMLC1. RVMLC1 is expressed at very low levels in cardiac tissue during early development and is expressed abundantly after birth and in adult hearts. The expression of RVMLC1 was found not to change in the hearts of rats with renovascular hypertension. PMID- 2717412 TI - Nucleotide sequence of the 18S-25S spacer region from rDNA of mung bean. PMID- 2717410 TI - DNA topology of the ordered chromatin domain 5' to the human c-myc gene. AB - DNA restriction fragments located 5' to the human c-myc gene display anomalous electrophoretic mobility on polyacrylamide gels. Computer modeling of the c-myc flanking DNA suggests that the slow-moving DNA fragments spanning nucleotides 1690 to -1054 (relative to c-myc promoter P1) and -718 to -452 form large left handed superhelices or curved structures while the fast-moving DNA fragment spanning nucleotides -407 to +78 has an unusually straight structure. These analyses also predict a periodic array of localized regions of bending through the superhelical domains. Micrococcal nuclease digestion of isolated nuclei reveals that the slow-moving DNA fragments exist in an ordered chromatin structure stable to nuclease, whereas the digestion pattern of the fast-moving DNA fragment suggests a less ordered array of nucleosomes or a non-nucleosomal chromatin structure. PMID- 2717413 TI - Sequence of cDNA for a novel light-induced glycine-rich protein. PMID- 2717414 TI - Total coding sequence of profilin cDNA from Mus musculus macrophage. PMID- 2717415 TI - The nucleotide sequences of nuclear 5S rRNA genes and spacer regions of Petunia hybrida. PMID- 2717416 TI - The sequence of the rice phytochrome gene. PMID- 2717417 TI - A calmodulin pseudogene on human chromosome 17. PMID- 2717418 TI - Human beta-casein: partial cDNA sequence and apparent polymorphism. PMID- 2717419 TI - Structure of an Arabidopsis thaliana cDNA encoding rubisco activase. PMID- 2717420 TI - The use of filter-bound DNA fragments as templates for radiolabelling by random priming. PMID- 2717421 TI - Objectives for the Nation: a national agenda for nursing education, research, and practice. AB - Nursing has tremendous potential to contribute to the nation's health agenda. Its ability to do so requires, first, a clear and widespread knowledge and understanding of, and commitment to, the blueprint provided through the objectives for the nation. It also requires initiative and activism on the part of nursing leaders at all levels of practice, education and research to make the changes in nursing necessary for realization of this potential. To accomplish this, nurses and others must enter into a process of assessment, diagnosis, planning, implementation and evaluation, in which the framework given in Objectives for the Nation is used as a guiding force and point of orientation. The result of this process should be a practical, achievable national agenda that will allow nursing to effectively and efficiently play its crucial role in meeting the health goals of the nation. PMID- 2717422 TI - ADN vs. BSN. PMID- 2717423 TI - Caring for mother and baby. PMID- 2717424 TI - Health for all at Ninth & P. PMID- 2717425 TI - BSN education in Saudi Arabia. PMID- 2717426 TI - Nursing and health care in the U.S.S.R. PMID- 2717427 TI - Development of nursing science in Scandinavia. PMID- 2717428 TI - Nursing in Korea. PMID- 2717429 TI - Planning an overseas extension program. AB - An educational program in another country established the mechanism for a variety of other possibilities. Faculty in the host country may provide the setting in which U.S. students can gain intercultural experience. Students may be able to conduct an independent study in the host country or, if sufficient numbers are available, a U.S. course may be adapted and offered in the host country. If ample funds exist, a two-way student and/or faculty exchange may be possible, thereby adding to the curricula of both schools. Opportunities for joint research and publishing may also become available. For example, long-term evaluation of the educational program and use of the program graduates in the host country would be of interest; research in the specialty areas of faculty may also be possible. The difficulties inherent in planning and implementing a program in another country are numerous; however, with foresight and ample time for planning, the benefits to both students and faculty in the host and home institutions can outweigh the drawbacks. PMID- 2717431 TI - Immigration: a short-term strategy, not a long-term cure. PMID- 2717430 TI - International research: a need or a luxury? PMID- 2717432 TI - A long transition. PMID- 2717433 TI - Nursing's image. PMID- 2717434 TI - The ethics of compromise. PMID- 2717435 TI - Glue. PMID- 2717436 TI - Digital measurement of pelvic muscle strength in childbearing women. AB - Fourteen primigravidas were evaluated at 32 and 36 weeks antepartum (AP) and 6 weeks postpartum (PP) to test the reliability and validity of a digital measure of pelvic muscle strength using urine control as the criterion. Interrater reliabilities ranged from .67 to .77. Convergent validity was shown by negative correlations between clinical muscle scores and time required to interrupt urine flow at 32 weeks AP (r = -.41), 36 weeks AP (r = -.64) and 6 weeks PP (r = -.71). Validity was also demonstrated in a pattern of lower scores in women who had urine loss during coughing or reported incontinence as compared with those who did not. Women who had cesarean births had higher postpartum pelvic muscle scores with progressively lower scores demonstrated by those who gave birth vaginally without laceration, with episiotomy, and with laceration, F(3, 10) = 5.40, p = .02. PMID- 2717437 TI - Preexisting physical activity level and cardiovascular responses across the Valsalva maneuver. AB - To determine the effect of preexisting physical activity level on resting cardiovascular measures and the intensity of cardiovascular responses across the Valsalva Maneuver (VM), 131 young (30-55 years) and 67 older (greater than 55 years) healthy adults, classified into sedentary, active, semitrained, or trained groups, were studied. Resting heart rate (HR) was lower in all trained subjects. In contrast, resting diastolic blood pressure was lower in young but not older trained subjects. During the VM, the expected fall in systolic blood pressure (SBP) from baseline during strain was less in young trained but not older trained subjects. Physical training significantly lessened the intensity of SBP and HR responses during the overshoot phase of the VM only in young subjects, most often in young males. PMID- 2717438 TI - Model confirmation of the MS-Related Symptom Checklist. AB - Data from a 26-item self-administered MS-Related Symptom Checklist (MS-RS), designed for persons diagnosed with multiple sclerosis (MS), were factored for the purpose of (a) providing further validity for the MS-RS Checklist, (b) determining structural relationships between and within MS symptom clusters, and (c) determining conceptual similarities between symptoms contained within the MS RS model and those associated with eight neurological functional systems. Data analyses were based on 491 MS subjects. Principal component analysis and Varimax rotated factor analysis were used to achieve scale parsimony. The resultant 22 item scale consisting of five factors was subjected to confirmatory factor analysis to determine relationships among factors, observed variables, and residual variance within the factor model. Modification of the initial factor model resulted in the inclusion of one additional relationship between an observed variable and a second factor and six paired relations among the residual variances. The modified factor model had a satisfactory GFI of .910. Signs and symptoms contained within the five-factor solution compared favorably with signs and symptoms assigned to the neurological functional systems which are used clinically in classifying MS disease impairment. PMID- 2717439 TI - Re: Conversion to SI units. PMID- 2717440 TI - Neonatal sucking as a clinical assessment tool: preliminary findings. AB - The sucking patterns of 42 healthy full-term and 44 preterm infants whose gestational age at birth was 30.9 +/- 2.1 weeks were compared using the Kron Nutritive Sucking Apparatus for a 5-minute period. The measured pressures were used to calculate six characteristics of the sucking response: maximum pressure generated, amount of nutrient consumed per suck, number of sucks per episode, the duration or width of each suck, the length of time between sucks, and the length of time between sucking episodes. The maximum pressure of the term infant (100.3 +/- 35) was higher, p less than .05, than the maximum pressure of the preterm infant (84 +/- 33). Term infants also consumed more formula per suck (45.3 +/- 20.3 vs. 37.6 +/- 15.9, p less than .05). In addition, they had more sucks/episode (13.6 +/- 8.7 vs. 7.7 +/- 4.1, p less than .001) and maintained the pressure longer for a wider suck width (0.49 +/- 0.1 vs. 0.45 +/- 0.08, p less than .05). Sucking profiles of the preterm infant are significantly different from the full-term infant. These sucking profiles can be developed as a clinically useful tool for nursing practice. PMID- 2717441 TI - Shared values: impact on staff nurse job satisfaction and perceived productivity. AB - A nationwide study on the impact of shared values on staff nurse job satisfaction and perceived productivity was done in 24 hospitals under different auspices, some of which were also Magnet Hospitals. Data were obtained from a 25% random sample of the staff nurse population (N = 2,336), 58% of the head nurse group, 65% of the clinical experts, and 66% of the top management. Staff nurses and clinical experts had more value congruence than did staff nurses and head nurses. A significant inverse correlation was found between value congruence and nurse job satisfaction and quality care. Explanations of the finding center on recent role changes for both staff nurses and head nurses, power differential, and evolving clarity of the staff nurse role. A serendipitious finding was that staff nurses reported fewer factors as important to their job satisfaction and perceived environment conducive to quality patient care than did other members of the nursing department. However, factors important to staff nurses were very important. PMID- 2717442 TI - Reliability of weighing procedures for preterm infants. PMID- 2717443 TI - Effects of walking on balance among elders. PMID- 2717444 TI - Methodological issues related to gerontological nursing research. PMID- 2717445 TI - QUAL: a mainframe program for qualitative data analysis. PMID- 2717446 TI - Sullied whiteness. PMID- 2717447 TI - A matter of judgement. PMID- 2717448 TI - Help for the homeless. PMID- 2717450 TI - Remanded in custody. PMID- 2717449 TI - Time to take stock. PMID- 2717451 TI - Nobody believed M.E. PMID- 2717452 TI - Altered images. PMID- 2717453 TI - Orchiectomy care study. PMID- 2717455 TI - Private lives. PMID- 2717454 TI - Cystic fibrosis: intravenous treatment at home. PMID- 2717456 TI - Fit for nursing. Well men. PMID- 2717457 TI - Fit for nursing. Running for health. PMID- 2717458 TI - NHS Review. Without a voice? PMID- 2717459 TI - Attendant dangers. PMID- 2717460 TI - Journal of the Wound Care Society. PMID- 2717461 TI - Journal of the Wound Care Society. Towards prevention. PMID- 2717462 TI - Going for green. PMID- 2717463 TI - Castle in the air. PMID- 2717464 TI - Out of touch with patients? PMID- 2717465 TI - Blessing or curse? PMID- 2717466 TI - Resolution of defiance. PMID- 2717467 TI - Double trouble. PMID- 2717468 TI - Twins: separating the inseparable. PMID- 2717469 TI - A team approach to home care. PMID- 2717470 TI - Fit for nursing. Highland slim. PMID- 2717471 TI - Fit for nursing. Fighting the fat. PMID- 2717472 TI - Time bomb 2000? PMID- 2717473 TI - NHS Review. Whitewashing the past. PMID- 2717475 TI - Talking back to happiness. PMID- 2717474 TI - The ileo-anal reservoir. PMID- 2717476 TI - A special kind of service. PMID- 2717477 TI - Spotlight on children. PMID- 2717478 TI - Spotlight on children. Freedom to learn. PMID- 2717479 TI - Spotlight on children. Making it feel worthwhile. PMID- 2717480 TI - Spotlight on children. Home truths. PMID- 2717481 TI - [Maxillary sinusitis in children: clinical and diagnostic aspects]. AB - Acute or chronic sinusitis is often overlooked and poorly understood in the pediatric population as many children have frequent episodes of upper respiratory infections that confuse accurate diagnosis. The authors present a prospective study in 89 children with clinical and radiographic presence of maxillary sinusitis in order to underline the most frequent clinical symptoms and signs and the most significant diagnostic procedures that help confirm precise definition of this common disease. The authors also discuss the relationship with allergic factors, clinical causes of poor sinus drainage, and environmental factors that may increase the possibility of sinus infection. PMID- 2717482 TI - [Newborn infants from epileptic mothers: malformation and auxonologic risk]. AB - A case-control study was performed to determine if newborns of epileptic mothers have a higher probability of having congenital malformations. Forty seven newborns of epileptic mothers and an equivalent number of controls with no history of epileptic disease and paired for mother's age, parity, type of education were examined. Thirty one mothers had been treated during the first term of pregnancy and 16 had not. A large number of anthropometric parameters were measured in each newborn to minimize the subjective component in diagnosing even minimal malformations and fetal growth abnormalities. To evaluate weight, length and head circumference the neonatal standards of Largo et al. were used. For all other measures the standards of Merlob et al. were used. Single absolute values of the parameters measured were converted into standard points to eliminate the effect of the sex and gestational age variables. The incidence of malformations was not seen to be significantly different in the newborns of epileptic mothers as a whole and divided into the two subgroups (treated and untreated) versus controls. The fetal syndromes described in literature were not observed. Of all the anthropometric measures examined only length was significantly reduced in newborns of epileptic mothers. Maternal epilepsy and its treatment do not appear to be a considerable risk factor for the newborn. PMID- 2717483 TI - [Anthropometric study of the Sassari population 6 to 11 years of age]. AB - The average values [+/- SD) for height and weight of 1518 males and 1333 females between 6 and 11 years of age from the city of Sassari (Sardinia) have been determined. Numerical values and smooth curves from the 3rd to the 97th percentile for height and weight have also been calculated. The results were compared with those of the literature and particularly with those published by De Toni et Al. 20 years ago. The data show a significant increase in height and weight among Sardinian children during the past 20 years. The availability of these new curves will permit a more correct evaluation of growth in Sardinian children. PMID- 2717484 TI - [Our experience in the subject of gastroesophageal reflux disease]. AB - From January 1st, 1983 to March 31st, 1988, 66 children with GER were tested with barium esophagogram, esophageal pH monitoring and esophagoscopy. A medical therapy was given to 49 children and 46 had a clinical improvement; 13 were operated. Early diagnosis is very important to prevent complications: in fact our data show that older children have the worst complications, while infants with GER and severe esophageal pH monitoring have only I-II grade esophagitis. PMID- 2717485 TI - [Intolerance to cow's milk proteins: cases contribution]. AB - The authors report their own case-report about cow's milk protein intolerance observed in the last seven years in the gastroenterology-department of Pediatric Clinic in Pisa. They underline the symptomatologic polymorphism of the illness and, analysing the laboratory data, point out the absence of absolute diagnostic assurance tests. For this reason they conclude that at the present state the diagnosis of certainty is overall committed to the resolution of the symptomatology after exclusion-diet and following clinic relapse after milk load. PMID- 2717486 TI - [Radiologic examination of the paranasal sinuses in asthmatic children]. AB - We examined the prevalence of abnormalities found by sinus X-Rays in 80 asthmatic children classified into three groups in relation to severity of their symptoms. All the children underwent skin tests and some of them methacholine challenge. 63.7% of asthmatics showed abnormalities in sinus X-Rays. No correlation was found between the severity of asthma, radiographic findings, and atopic status. Bronchial hyperreactivity studied using metacholine challenge according to the method of Chai was the same both in patients with asthma and sinusitis and in those with asthma only. In conclusion, abnormal sinus X-Rays do not seem to be an aggravating factor in asthmatic status. PMID- 2717487 TI - [Amoxicillin and clavulanic acid suspension for children in the treatment of bronchopulmonary infections]. AB - The present study has been tested on 30 children, 14 males and 16 females, average age 4.11 +/- 0.44 (range 9 months to 10 years), weight of 17.08 +/- 1.25 Kg, with infections concerning low respiratory tract (8 cases of broncho pneumonia, 9 cases of acute bronchitis and 13 cases of lobar pneumonia). It has been used a chemotherapy composed of amoxycillin and clavulanic acid in pediatric suspension of 312.5 mg/5 ml (in the ratio of 4 to 1); the daily dosage, related to the children's weight has been of 43.91 +/- 1.21 mg/Kg in two daily doses. On the average the therapy has lasted for 6.43 +/- 0.19 days from a minimum of 4 to a maximum of 8 days. During the treatment the symptomatologic parameters (dyspnoea, cough), and the objective ones (pathological lung signs, rales, hypophonesis, bronchial breath...) have progressively improved till they have disappeared; morning and evening body temperature has promptly returned to normal. Both the physical and radiological exams of the chest confirm either the improvement or the regression of the infection in most of the cases. Side effects due to the antibiotic have not been registered and local and general tolerability was excellent. Considering the more or less fast and complete symptomatological regression, the evolution of the infective clinical picture and the tolerability, the final evaluations have been: excellent efficacy in 13 cases, good efficacy in 9 cases, fairly good in 5 cases and poor in 3 cases. PMID- 2717489 TI - [Levels of myoglobin in umbilical cord blood of infants born by spontaneous labor and cesarean section]. AB - The levels of myoglobin in the umbilical cord blood of 20 full-term infants were studied in relation to spontaneous vaginal delivery and elective cesarean section, using the Rapitex Myoglobin (Behring Institute, Marburg, FRG). The content of myoglobin in umbilical cord blood was similar and within normal limits (less than 50 micrograms/l). We conclude that semiquantitative methods are not useful at birth to detect rhabdomyolysis and myoglobinuria secondary to the stress of vaginal delivery. PMID- 2717488 TI - [Chronic suppurative bronchopathy and motility defect of neutrophils: evaluation of an immunomodulating treatment]. AB - Five patients with recurrent infections of the lower respiratory tract, chronic bronchial suppuration and significant defect of polymorphonuclear granulocyte (PMN) motility were studied. Clinical evaluation and in vitro studies of PMN motility were performed before, during and after the treatment with levamisole chlorhydrate (2.5 mg/Kg twice a week). Clinical improvement was obtained in all the patients, together with a significant increase in the chemotactic response of PMN. No side effects were reported. After a follow-up of 7-18 months PMN chemotaxis remained normal in all the patients and a reappearance of respiratory symptoms was observed only in one subject. PMID- 2717490 TI - [Visceral leishmaniasis in infants without bioptic demonstration of the parasite. Presentation of 3 cases]. AB - The Authors describe three infants with visceral leishmaniasis in whom bioptic research (in marrow, spleen and liver) has not demonstrated presence of leishmania. They remark this unusual aspect of visceral leishmaniasis in infant and debate the epidemiological, diagnostic, and therapeutic aspects of these cases. PMID- 2717491 TI - [Retrotendinous ureter. An exceptional cause of obstruction in the upper urinary tract]. AB - Retrotendineus ureter is an exceptional anomaly presenting, in our experience, without clinical signs of urinary infection and obstruction. The radiological diagnosis was retrocaval ureter. The Authors report a case of a 9 years old boy who was successfully treated by ureteral section, excision of the obstructed ureteral segment and uretero-ureteral anastomosis. It seems that the case is the first reported in the medical literature of this anomaly. PMID- 2717492 TI - [Finding of focal heterotopy with magnetic resonance. Description of a case associated with late onset epilepsy]. AB - A case of late onset focal epilepsy in a mentally and neurologically normal girl in which the MRI showed a focal heterotopia is presented. The efficacy of this new procedure in detecting migratory disorders is discussed and the scanty literature reviewed. This case suggests that in the future more cases of epilepsy previously classified as "cryptogenetic" will be demonstrated as secondary to developmental abnormalities. PMID- 2717493 TI - [Post-traumatic inflammatory pseudotumor of the lung. Description of a case]. AB - Inflammatory pseudotumor (P.I.) of the lung is a rare benign lesion histologically characterized by a variety of inflammatory and mesenchymal cells (plasma cells, lymphocytes and histiocytes). The etiology remains obscure. We report a case of P.I. occurred immediately after a thoracic trauma. The infectious etiology is suggested by the growth of an anaerobic microorganism (Bacteroides) in tissue culture. PMID- 2717494 TI - [Unusual case of ano-rectal malformation]. AB - The authors present an unusual case of anorectal malformation: it's an intermediate from with a cutaneous fistulous tract. This case is similar to that described in 1982 by the Japan study group of anorectal anomalies. PMID- 2717496 TI - Changes in diagnostic pathology -- a paradigm of fashion. PMID- 2717497 TI - Primitive neuroectodermal tumor. PMID- 2717495 TI - [Ectopic bronchogenic cyst]. AB - The authors report a case of ectopic bronchogenic cyst. They review the literature and don't find any other similar case. This case is well explained by the embryology. PMID- 2717498 TI - Pulmonary hypoplasia in infants with giant abdominal wall defects. AB - The medical records of 114 infants with abdominal wall defects, including 35 infants examined at autopsy, were reviewed to determine if giant (liver containing) defects are associated with a narrow thoracic cage deformity and pulmonary hypoplasia. The study included 48 infants with gastroschisis, 60 with omphalocele, two with a lower midline syndrome (cloacal exstrophy) and four with an upper midline syndrome (Cantrell's pentalogy). A giant abdominal wall defect was present in 33 infants, including one with gastroschisis, 27 with omphalocele, two with a lower midline syndrome, and three with an upper midline syndrome. A thoracic cage deformity, characterized by a narrow chest and down-slanting ribs, was identified radiographically in 42% (14 of 33) of infants with giant abdominal wall defects. Among the 35 infants examined at autopsy, 14 infants with giant omphaloceles had mean chest circumference to occipital frontal circumference ratio and lung weight to body weight ratios that were significantly below the means for infants with gastroschisis or small omphalocele. Lung weight to body weight ratios indicated marked pulmonary hypoplasia in three of 12 (25%) of infants who had a narrow thoracic cage deformity, and radial alveolar counts indicated mild pulmonary hypoplasia in four additional infants. Prematurity (four infants), diaphragmatic abnormalities (seven infants), and congenital heart disease (four infants) potentially contributed to the respiratory distress experienced by these 12 infants. Infants with giant abdominal wall defects and narrow thoracic cages are at increased risk for pulmonary hypoplasia and respiratory distress. PMID- 2717499 TI - The disappearance of germinal centers in chronic lymphadeno-hepato-splenomegaly syndrome in childhood: report of three cases. AB - Three cases of a syndrome featuring massive splenomegaly, gross generalized lymphadenopathy, and moderate hepatomegaly are reported. Spleen weights ranged from 800 to 2400 g. Gradual depletion of lymphoid germinal centers, and prominent infiltration of the splenic and lymph node cords with plasma cells, immunoblasts and actively dividing B cells were the most distinctive histological features. The liver in two cases showed portal infiltrates. A marked hypergammaglobulinemia, a decrease in blood cholesterol level and hematological abnormalities related to hypersplenism were observed. The condition begins early in life and runs a chronic course, of up to 25 years. There was a family history in only one instance. Since there was no generalized immunodeficiency nor local depletion of T cells or dendritic reticulum cells, a failure in the local regulation of the immune response and possible cytokine production is postulated. This condition underlines the pivotal role of the local organization of the germinal centers in cellular cooperation and in the carrying out and regulation of the immune response. PMID- 2717500 TI - Pulmonary thromboembolism from a large hemangioma in a 4-week-old infant. AB - A female infant with an extensive congenital hemangioma of the left knee region was treated medically for consumption coagulopathy; the hemangioma began to shrink, the coagulopathy improved, and the infant was clinically well when she died suddenly at the age of 4 weeks. The cause of death was a saddle pulmonary thromboembolus which had originated in the hemangioma. This is the first documented case of fatal thromboembolism complicating a conservatively managed extensive neonatal hemangioma. Causes of neonatal thromboembolism are reviewed. PMID- 2717501 TI - Gastric leiomyoblastoma (epithelioid leiomyoma) occurring in a child: a case report. AB - Leiomyoblastomas are rare smooth muscle tumors occurring most commonly in the gastrointestinal tract of adults. We report the unusual occurrence of a gastric leiomyoblastoma in a child who presented with refractory iron deficiency anemia. The tumor had a superficial erosion which was apparently the source of intermittent hemorrhage resulting in anemia. Epithelioid cells, spindled cells, and cells arranged in a perithelial pattern were seen by microscopy, characteristic of a leiomyoblastoma. Immunohistochemical staining demonstrated muscle actin, vimentin, desmin, and alpha-1-antichymotrypsin, and electron microscopy showed focal densities alternating with thin filaments. All of these features help to differentiate the tumor from an inflammatory pseudotumor. Leiomyoblastomas are associated with paragangliomas and pulmonary chondromas in children, but these were not present in this child. The prognosis of leiomyoblastomas may be related to tumor size, mitotic rate, and cellular characteristics. PMID- 2717504 TI - The malpractice mess. PMID- 2717503 TI - Treating acute mandibular dislocations. PMID- 2717502 TI - Non-immune fetal hydrops with hepatic hemangioendothelioma and Kasabach-Merritt syndrome: a case report. AB - A premature infant presented with non-immune hydrops fetalis, a liver mass, thrombocytopenia, and hypofibrinogenemia. Histologic examination of the liver tumor showed an infantile hemangioendothelioma. The clinical features of this case can be explained by anemia, hypoalbuminemia, and coagulopathy. The association with Kasabach-Merritt syndrome, the pathophysiology of non-immune hydrops fetalis, and primary hepatic neoplasms of the neonate are discussed. PMID- 2717505 TI - More on malpractice. PMID- 2717506 TI - Addicts stole my prescription blanks. PMID- 2717507 TI - Physicians versus the feds. PMID- 2717508 TI - Notifying contacts of HIV-infected patients. Strategies to use until health agencies assume responsibility. AB - Although physicians have a moral and professional duty to prevent the spread of human immunodeficiency virus (HIV) by seeing that the infected patient's contacts are informed of the risks, they have no legal guidelines on how to approach the problem. Medical organizations recommend that physicians notify an endangered third party if the infected patient refuses to cease high-risk activity and the authorities do not take action. However, many questions remain about practical application of these recommendations. Some federal recommendations place the burden of notifying the third party on the infected patient, then on the public health authority, and finally on the physician. However, these suggestions are not law. Legal precedent has placed responsibility on the physician for warning persons exposed to an infected patient that a risk exists. However, warning someone who is not clearly at risk can also invite a lawsuit. At present, there is no clear public policy to give guidance either. By considering the infectivity of the virus, injury potential of the infection, and the exposed person's relationship with the patient, the physician can better weigh the risk of breaching patient confidentiality versus ignoring the health dangers to the third party. Thorough counseling of the patient about infectivity, careful documentation of all conversations and efforts, and use of good judgment are the best tools that physicians have at present for handling this legal void. PMID- 2717509 TI - Death from drug-induced hemolytic anemia. AB - Fatal hemolytic anemia occurred in a 71-year-old man after trimethoprim sulfamethoxazole was given for presumed cystitis. Administration of this combination has previously caused multiple hematologic reactions by affecting folic acid metabolism. Megaloblastic anemia and neutropenia have been produced by both of these agents, while sulfamethoxazole alone has induced acute hemolytic anemia in patients with hereditary deficiency of glucose-6-phosphate dehydrogenase. Although hematologic complications of trimethoprim sulfamethoxazole treatment usually follow long-term or high-dose therapy, acute reactions apparently may occur at lower doses as well. PMID- 2717510 TI - Reversed-phase high-performance liquid chromatographic analysis of oligoglycines (one to six amino acid residues). PMID- 2717511 TI - Phenotypic differences in dextromethorphan metabolism. AB - Polymorphic differences in dextromethorphan metabolism were observed in three studies conducted in a total of 44 subjects (of Dutch origin) administered 60 mg dextromethorphan hydrobromide as an OROS tablet. Mean plasma dextromethorphan (DM) concentrations after a single dose and at steady state were 4-75 times higher in the poor metabolizers (PM) relative to the extensive metabolizers (EM). Following a single dose, the mean areas under the plasma concentration-time curve (AUC, 0-24 hr) of DM, total dextrorphan (DR), and total 3-hydroxymorphinan (HM) were 6.9-fold higher, 17.4-fold lower, and 11-fold lower, respectively, for the PM than for the EM. Correspondingly, steady-state AUC values were 52.8 times higher, 6.7 times lower, and 3.3 times lower for DM, total DR, and total HM, respectively, for the PM relative to the EM. Drug/metabolite ratios (DMR) for amounts excreted in the urine of DR and HM indicated polymorphism in O demethylation of DM since DMR for PM was 352 and 338 times higher than that for EM for DR and HM, respectively. However, polymorphism in N-demethylation was not observed. Ratios of conjugated/free dextrorphan and 3-hydroxymorphinan excreted in the urine suggest also a lack of conjugative capacity in the PM, relative to the EM. The overall incidence of PM was 9.1% in this population. PMID- 2717512 TI - Kinetics of drug decomposition by heat conduction calorimetry. AB - The application of heat conduction calorimetry to the determination of decomposition mechanisms and rates for drugs is shown to be a rapid and generally useful method. The application of the method to determine the nature of the decomposition reaction, sources of systematic errors in the method, the equations relating the calorimetric signal to the kinetics of the reaction, and some examples of results are presented and discussed. PMID- 2717513 TI - Isolation of a novel morphinan 3-O-diglucuronide metabolite from dog urine. AB - Following oral administration of the narcotic antagonist nalmefene [17 (cyclopropylmethyl)-4,5 alpha-epoxy-6-methylenemorphinan-3,14-diol] labeled with 14C to the dog, approximately 50% of the dose was excreted in the urine as a highly polar water-soluble conjugate. Although this major metabolite could be hydrolyzed with beta-glucuronidase to yield nalmefene, the intact conjugate was chromatographically more polar on reversed-phase high-performance liquid chromatography (HPLC) than authentic nalmefene 3-O-glucuronide. Milligram quantities of the metabolite were subsequently isolated and subjected to fast atom bombardment (FAB) mass spectral and nuclear magnetic resonance (NMR) analyses. The conjugate was identified as nalmefene 3-O-beta-diglucuronide with a 1,2-beta linkage between the two glucuronic acids. It is unlikely that this novel form of conjugate is unique to nalmefene and it is probably a metabolite of other morphinans and/or similar drugs in the dog. Nalmefene 3-O-diglucuronide is not a metabolite of nalmefene in man. PMID- 2717514 TI - Transdermal drug transport and metabolism. I. Comparison of in vitro and in vivo results. AB - Using excised human skin and tissue grafted to athymic mice, the in vitro and in vivo delivery and metabolism of a salicylate diester were compared. Concentration profiles of this drug and its metabolites were obtained for the outer several hundred microns of the skin. These results show significant differences in the extent of enzymatic cleavage and distribution of metabolites between in vitro and in vivo studies. Furthermore, these data suggest that in vitro results may overestimate metabolism because of increased enzymatic activity and/or decreased capillary removal. PMID- 2717515 TI - Application of mean residence-time concepts to pharmacokinetic systems with noninstantaneous input and nonlinear elimination. AB - Equations describing the mean residence time (MRT) of drugs in the body are derived for drugs that are administered by first- and zero-order rates into systems with Michaelis-Menten elimination. With computer simulations, the validity of these equations, the differences between them, and the conventional approach using the AUMC/AUC or the summation of mean times are demonstrated by examining calculations of the percentage of the administered dose eliminated at the MRT and AUMC/AUC. The effects of the absorption rate on the AUC and on the approximate and true MRT values in a nonlinear pharmacokinetic system are also illustrated with computer simulations. It was previously found that the true MRTiv = Vss.AUCiv/dose for an iv bolus. The total MRT (sum of input and disposition) of a drug after noninstantaneous administration was found to be a function of the MRTiv, two values of AUC (iv and non-iv), and exactly how the drug is administered expressed as the mean absorption time (MAT). In addition, a theoretical basis is proposed for calculation of the bioavailability of drugs in both linear and nonlinear pharmacokinetic systems. PMID- 2717516 TI - Enhanced intestinal absorption of cyclosporine in rats through the reduction of emulsion droplet size. AB - The intestinal absorption of cyclosporine was measured in situ in rats using an olive oil emulsion prepared by either stirring or homogenization. The surface area of the homogenized dosage form was twice that of the stirred dosage form. The apparent permeability of cyclosporine from the homogenized emulsion was about twice that of the emulsion prepared by stirring. The examination of absorption in different intestinal segment lengths suggested the presence of an "absorption window." The absorption of cyclosporine appeared to be concentration independent and, therefore, non-carrier mediated. The dependence of absorption upon the intestinal perfusion rate suggested that the stagnant aqueous layer is the rate limiting barrier in cyclosporine absorption. These results indicate that the bioavailability of cyclosporine administered in an emulsion can possibly be increased by enhancing its rate of absorption through the reduction of droplet size. PMID- 2717517 TI - Influence of indomethacin amphoteric gel on gastric ulcerogenicity and absorption of indomethacin in rats. AB - Indomethacin is a potent and efficacious antiinflammatory agent. However, a limiting side effect is its ability to cause gastric ulceration. This study was designed to investigate the effects of an amphoteric gel on the gastric ulcerogenicity and pharmacokinetics of indomethacin. Oral administration (5 mg/kg) in a suspension and a gel formulation were compared to an intravenous (iv) formulation of indomethacin in rats. The iv formulation administered to rats produced large severe ulcers in some rats but not in others. In contrast, the oral suspension produced small ulcers in all rats. The difference in toxicities is attributed to a centrally mediated action as a result of high plasma levels of indomethacin following iv administration, compared to locally mediated action with the suspension, resulting from local high concentrations of indomethacin on the apical epithelial surface because of the presence of indomethacin crystals. Oral administration of the gel formulation did not result in any gastric ulceration and improved the bioavailability of indomethacin to 115.5%, compared with 68.2% for the suspension. The reduced gastrointestinal toxicity of indomethacin in the gel was attributed to the gel's ability to dissolve indomethacin, preventing the localized high concentration observed with the suspension and possibly providing a gastric protectant phospholipid. The gel formulation doubled the oral bioavailability and the tmax of indomethacin compared to the suspension but did not affect the half-life. The results indicate that the local irritant effect of indomethacin, in rats, can be reduced by appropriate formulation design and suggest that the ulcerogenicity index for indomethacin can be improved by the use of an amphoteric gel formulation. PMID- 2717518 TI - Hollow fibers as an oral sustained-release delivery system. AB - Phenylpropanolamine (PPA) bound to ion-exchange resin was encapsulated in hollow fibers made of segmented polyurethane. This system was examined as an oral sustained-release delivery system. The fibers were spun by the phase inversion process and cut into different aspect ratios (length/diameter). The U.S.P. basket dissolution method was used to evaluate the in vitro drug release kinetics and the effect of the aspect ratio on the release. For in vivo evaluation, selected fibers were orally administered to dogs in gelatin capsules. The fiber delivery system provided a sustained-release profile of plasma PPA and a longer terminal half-life when compared to an oral immediate-release formulation. PMID- 2717519 TI - Pharmacokinetics of furegrelate after oral administration to normal humans. AB - Furegrelate sodium is a thromboxane synthetase inhibitor with potential for the treatment of various diseases including hypertension, thrombosis, and renal disorders. The absorption and disposition of the parent drug in normal male volunteers have been studied after single- and multiple-dose oral administration. The results from the single-dose study indicate that furegrelate is rapidly absorbed, with a Tmax of 1.0-1.7 hr, has an apparent terminal disposition rate constant of 0.12-0.17 hr-1, and is eliminated primarily by the kidney, with 62 78% of the dose excreted as parent drug. After multiple-dose oral administration for 4.5 days using a b.i.d. dosing regimen, no apparent change in the absorption, disposition, and elimination kinetics is detected and only a slight potential for drug accumulation is observed. PMID- 2717520 TI - Complex formation between metronidazole and sodium urate: effect on photodegradation of metronidazole. AB - Photodegradation of solutions of metronidazole in the presence and absence of sodium urate was studied. Photodegradation appeared to follow zero-order kinetics and was found to be dependent on the pH, buffer species, sodium urate concentration, and light source. Complex formation between metronidazole and sodium urate accounted for the photostabilization of metronidazole. The dissociation constant for this complex was calculated to be 3.4 x 10(-3) M. PMID- 2717521 TI - Pharmacokinetics of ketorolac and p-hydroxyketorolac following oral and intramuscular administration of ketorolac tromethamine. AB - Ketorolac tromethamine (KT), a potent analgesic with cyclooxygenase inhibitory activity, was administered in an open, randomized, single-dose study of Latin square design to 12 healthy male volunteers. Doses of 30 mg oral (po) and 30, 60, and 90 mg intramuscular (im) KT were administered in solution. Plasma samples were analyzed for ketorolac (K) and its inactive metabolite, p-hydroxyketorolac (PHK), by reversed-phase high-performance liquid chromatography (HPLC). The 30-mg im dose was found to be similar to the 30-mg po dose with respect to total AUC values for both K and PHK. The amount of PHK circulating in plasma was very low as judged by AUC ratios (PHK/K x 100) of 1.9 and 1.5% for the 30-mg po and im doses, respectively. The rate of absorption of K and formation of PHK, as determined by Cmax and Tmax values, was significantly slower following the im doses. Total AUC and Cmax for K and PHK increased linearly with dose after im administration of 30, 60, and 90 mg of KT. The mean plasma half-life of K was remarkably consistent between po and im administration and was independent of dose, ranging from 5.21 to 5.56 hr. The plasma metabolic profile was similar following both routes of administration and graded im doses. PMID- 2717522 TI - Use of the peptide carrier system to improve the intestinal absorption of L-alpha methyldopa: carrier kinetics, intestinal permeabilities, and in vitro hydrolysis of dipeptidyl derivatives of L-alpha-methyldopa. AB - Intestinal permeabilities of five dipeptidyl derivatives of L-alpha-methyldopa (I) were studied by an in situ intestinal perfusion method. The dipeptides displayed a significant increase in their permeabilities compared to L-alpha methyldopa. The increases ranged from 4 to 20 times. These results suggest that the peptide transport system is less structurally specific than the amino acid transport systems and can be used as an absorption pathway for peptide analogues. The kinetic advantage demonstrated by the dipeptide, L-alpha-methyldopa-L phenylalanine, over the amino acid analogue, L-alpha-methyldopa, suggests that the peptide carrier would be a possible route for improving the intestinal absorption of pharmacologically active amino acid analogues. Furthermore, the preliminary results of in vitro hydrolysis studies of selected dipeptidyl derivatives indicate that the peptide carrier system could be used as a base for a prodrug strategy. PMID- 2717523 TI - Neutrophil-mediated transport of liposomes across the Madin Darby canine kidney epithelial cell monolayer. AB - Targeted drug delivery to peripheral blood neutrophils (PMNs) should be of therapeutic potential in various disease states. In addition, substances taken up by PMNs in the circulation may be delivered to an extravascular site via the naturally occurring cell infiltration. The present study employs an in vitro chemotaxis model to test whether particulate drug carriers such as liposomes can be transported across a cellular barrier by migrating PMNs. The system contained 10(7) human PMNs/ml, 0.3-micron liposomes at a total lipid concentration of 2.5 mM, and 10% autologous human serum in the apical side of a confluent Madin Darby canine kidney (MDCK) epithelial cell monolayer of 4.71 cm2. The MDCK cells were grown on a polycarbonate membrane with 3-micron pores without any extracellular matrix, and 10(-7) M f-Met-Leu-Phe was added to the basolateral side as a trigger of chemotaxis. The aqueous phase of the reverse-phase evaporation vesicles (REVs) contained lucifer yellow CH (LY) and [14C]sucrose. The lipid bilayer of the REVs was spiked with [3H]dipalmitoylphosphatidylcholine (DPPC). Transmission electron micrographs showed that, in response to the formyl peptide, PMNs adhered to the apical surface of MDCK cells, emigrated across the MDCK cell layer, passed through the 3-micron pores in the polycarbonate membrane, and finally, appeared in the bottom well. Epifluorescence micrographs showed that most, if not all, of the migrated PMNs contained punctate fluorescence derived from LY. Transport data over a 3.5-hr period indicated that those markers that appeared in the basal side were indeed transported by phagocytosis of REVs by PMNs and that intact serum was an essential component in the process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717524 TI - Iontophoretic transport of a homologous series of ionized and nonionized model compounds: influence of hydrophobicity and mechanistic interpretation. AB - An in vitro study was carried out to elucidate the mechanisms controlling iontophoretic transport. The investigation focused on three areas, including the nature of the permeant (state of ionization and hydrophobicity), skin structures (hair follicle distribution and stratum corneum), and various parameters influencing iontophoresis (current, permeant concentration, and competitive ion effects). The data indicate that iontophoretic-facilitated transport is essentially pore mediated and that the transport of ionized and nonionized molecules may be enhanced through the pore-type pathway. The data presented show that iontophoresis has a detrimental effect on the lipoidal transport pathway and that the transport of more hydrophobic nonionized molecules is decreased compared with passive diffusion. The iontophoretic enhancement values decreased linearly with increasing alkyl chain length of n-alkanols. The iontophoretic permeability coefficients of ionized n-alkanoic acids was shown to decrease with increasing permeant hydrophobicity. PMID- 2717525 TI - Drug delivery via ion exchange across a fiber membrane. PMID- 2717526 TI - New variants of B16 mouse melanoma: differentiation and metastatic properties. AB - A system of tumor transplantation has been developed to select metastatic variants of B16 in mutants of the C57BL/6J black strain of mice. The effects of transplantation into nonagouti a/a and mutant recipients on the production of melanin and on the metastatic potential of tumors were investigated. Transplantation of the pigmented B16 melanoma from a nonagouti black a/a host to a yellow mutant Ay/a recipient resulted in an achromic and metastatic variant melanoma, designated YB16. The amelanotic phenotype occurred consistently after more than ten passages through yellow mice and simultaneously with an increase in the incidence of pulmonary metastases. When YB16 was transplanted back to the nonagouti black a/a host, a second variant, MB16, characterized by its variable pigmentation, was obtained. Pigmented and/or entirely achromic tumors were observed. MB16 was dramatically more metastatic than B16 and YB16 when injected s.c. or i.v. Metastases in the lungs were pigmented and/or achromic. The properties of tumor cells derived from artificially induced metastases were investigated after s.c. and i.v. injections. Whereas the metastatic cells expressed a potent ability to generate metastases when injected s.c., no differences in the incidence of metastases, as compared to the metastatic potential of cells of parental origin, were observed after i.v. injection. In the MB16 variant, there appeared to be an inverse relationship between differentiation (production of melanins) and malignancy. Our results demonstrate that differentiation and metastatic behaviour are dependent on specific mutations in the host environment which generate a pool of tumor cells from which highly metastatic variants can be selected. PMID- 2717527 TI - Chromatophoromas in a pine snake. AB - Iridophoroma and melanophoroma were diagnosed in an adult male pine snake. Light microscopic examination of irregularly thickened white and black portions of abnormal scales demonstrated two distinctive populations of pigment-containing cells. Pigment cells within abnormal-appearing white scales had needle-shaped granules that were dark amber in color while black portions were composed of pigment cells typical of melanophores, with dark black, round granules. Both populations of cells showed junctional activity, and clusters of both neoplastic pigment cell types were found in adjoining areas of the epidermis. By electron microscopy, the pigment cell with amber-colored granules contained reflecting platelet profiles typical of iridophores while pigment cells with dark round granules contained melanosomes. At a junctional area between abnormal white and black scales, mosaic chromatophores containing reflecting platelet profiles and melanosomes were observed. At 1 1/2 years following initial diagnosis, the snake died and neoplastic iridophores were found at multiple visceral sites; there was no evidence of metastases of melanophores to any organ. The two pigment cell tumors are believed to have developed from either stem cells destined to become iridophores and melanophores or from prexisting iridophores and melanophores in the dermis. PMID- 2717528 TI - Phenolic melanin precursors provide a rational approach to the design of antitumor agents for melanoma. AB - A unique biological property of the melanocyte, melanin synthesis may permit a rational approach to design agents for better management of malignant melanoma. This in vivo and in vitro study examined the selective melanocytotoxicity and antimelanoma effects of phenolic compounds, cysteinylphenol (CP), cysteaminylphenol (CAP), and related compounds, and found (1) that both 4-S-CP and 4-S-CAP are melanin precursors, (2) that 4-S-CAP possesses a marked depigmenting potency with selective destruction of melanocytes in black follicles, and (3) a significant inhibition in the protein synthesis and tumor growth of B16 melanoma. Importantly, a whole body autoradiography indicated that these phenolic melanin precursors are selectively incorporated into melanoma tissues after i.p. administration. PMID- 2717529 TI - Gene transfer and expression studies in cultured avian neural crest cells differentiating into melanocytes. AB - Neural crest cells obtained from explanted neural tubes take up, express, and retain exogenous DNA applied by the CaPO4 co-precipitation method during their differentiation into melanocytes. High efficiencies of gene transfer were obtained with both supercoiled DNA and intact phage particles; linear DNA or DNA from the phage yielded very low efficiencies. There is some evidence that transferred gene expression is differentiation dependent. The system should be useful for studies concerned with the analysis of cell developmental genes and their regulatory elements. PMID- 2717530 TI - Isolation and characterization of a novel yellow pigment from human and primate tissue. AB - A novel lipophilic yellow pigment has been isolated from human and primate tissue. Field-desorption mass spectrometry suggests a molecular ion of mass 645 700, and electron-impact mass spectrometry gives a major fragment ion at 603.5348, which is consistent with the elemental composition C37H69N3O3. The ultraviolet/visible spectrum has two major absorption peaks at 423.6 nm and 398.8 nm and a smaller peak at 377.8 nm. The adrenal gland contains the highest concentration of the pigment; it is also present in the colon, kidney, lung, spleen, and stomach tissue. It is not present in brain or liver. The pigment has not been detected in the rat, mouse, cow, pig, or dog. PMID- 2717531 TI - Natural cytotoxicity of human serum. A natural IgM 'antibody' sensitizes transformed murine cells to the lytic action of complement. AB - The natural cytotoxicity of human serum on murine L cells, EA and Sa 180 cells is expressed as a rapid cytolysis at 37 degrees C. This cytotoxic system is analyzed as to its active constituents and their functional relationships. Ultrastructural studies indicate that cell injury and death are initiated within 10 min by membrane disruption. A trypan blue assay for cell death was used to study serum toxicity in individual normal healthy adults, pregnant females and newborn infants. Pregnancy sera, particularly in the 2nd and 3rd trimesters, were consistently more toxic than male serum or nonpregnant females. Cord serum was typically nontoxic. Pools of normal fresh pregnancy serum were used for immunochemical analysis of the cytotoxic activity. By a variety of immunologic and immunochemical techniques it was shown that the cytotoxicity was, in part, due to the combined action of alternative and classical pathways of complement, the former being more prominent. The lytic action of complement was shown to be greatly amplified by the prior adsorption of IgM on the target cells' surface. This IgM is a critical determinant of the cytotoxic reaction. It probably contains a natural 'antibody' to cell surface antigen(s), whose combination activates both pathways of C. PMID- 2717532 TI - Differentiation in human chorionic villus cultures: hCG and HLA expression. AB - The present report describes methods to separate, culture, and study syncytio cytotrophoblast and mesenchymal core of the first-trimester human chorionic villus. The cultured outer layer cells (syncytio-cytotrophoblast) are multinucleated, pleomorphic, and active in the formation of human chorionic gonadotrophin (hCG). The mesenchymal core cells are more fibroblast-like in appearance, do not show multinucleation, and have less hCG in their culture media. Both cultured cell types express HLA (ABC) Class I histocompatibility antigens but not HLA (DR) Class II antigens. These and previous studies from this laboratory postulate different embryonic origins: (1) Syncytio-cytotrophoblast cultures of chorionic villus derive from differentiated trophoblast and preserve multinucleation as well as hCG hormone function. (2) Cells cultured from the chorionic villus core originate from extraembryonic mesenchyme. (3) Amniocytes (AF cells) cultured from amniotic fluid resemble the multipotential and early stage trophoblast, retaining pleomorphism, multinucleation, and lacunae formation as well as production of hCG, progesterone, oestrogen, basement membrane glycoprotein, and Type IV collagen. These cell types cultured from the chorionic villus and amniotic fluid provide a means for in vitro study of specific embryonic cell lineages. PMID- 2717533 TI - Fetal liver alanine: glyoxylate aminotransferase and the prenatal diagnosis of primary hyperoxaluria type 1. AB - Primary hyperoxaluria type 1 (PH1) is caused by a deficiency of the hepatic peroxisomal enzyme alanine: glyoxylate aminotransferase (AGT, EC 2.6.1.44) (Danpure and Jennings, FEBS Lett., 201, 20-24, 1986). The activity of AGT has been measured in fetal livers of gestational age 14-21 weeks. Activity increases up to 17 weeks and then levels off between 17 and 21 weeks. At this time, the mean AGT activity is about 30 per cent of the mean normal postnatal level. As in adult liver, the AGT enzyme activity and the AGT immunoreactive protein are peroxisomal. Prenatal diagnosis has been performed by measuring AGT enzyme activity and immunoreactive AGT protein on liver biopsies from two fetuses at risk for primary hyperoxaluria type 1. One was unaffected and one was affected. PMID- 2717534 TI - Probable exclusion of juvenile neuronal ceroid lipofuscinosis in a fetus at risk: an interim report. AB - In a family with two children affected by juvenile neuronal ceroid lipofuscinosis (JNCL) an attempt was made at the prenatal diagnosis of the disorder. The following tissues from the fetus at risk were investigated by electron microscopy and were found to be free of fingerprint profiles and curvilinear bodies, typical for JNCL: uncultivated amniotic fluid cells, lymphocytes isolated from fetal blood, and fetal skin biopsy specimens. The child was born at the 34th week of gestation and was clinically normal at the age of 15 months. Postnatally, lymphocytes (isolated at the age of 6 and 15 months) and skin tissue (taken at the age of 15 months) were found to be morphologically normal. It is highly unlikely that the child is affected but definite proof of the absence of JNCL remains difficult at this age. PMID- 2717535 TI - Prenatal diagnosis of a fetus with an extra idic(X)(q27). AB - A fetus with an extra idic(X)(q27) was ascertained during prenatal diagnosis. The derived X and one normal X chromosome were late replicating. Due to lack of previous experience, genetic counselling presented obvious difficulties and the fetal phenotype could be only tentatively predicted. PMID- 2717536 TI - Usefulness of linkage disequilibrium of KM-19 and XV-2c DNA probes for genetic counselling in a high-risk CF family. AB - A French couple with an individual risk of carrying the cystic fibrosis (CF) mutation of 1/2 sought genetic counselling. From the DNA haplotypes generated by XV-2c and KM-19 RFLPs, it could be deduced that only one subject was a carrier, lowering the risk of having a CF baby from 1/16 to 1/200. The strong linkage disequilibrium between these RFLPs and the CF allele observed in France reduced the risk to 1/1600. PMID- 2717537 TI - [Distribution of asbestos bodies in human organs]. PMID- 2717538 TI - [The structure of the lower esophageal segment]. PMID- 2717540 TI - [Current pathology of the kidney. On the way to the 73d meeting of the German Society of Pathology in Koblenz!]. PMID- 2717539 TI - [A high- resolution video-graphic printer for the documentation of surgical specimens]. PMID- 2717541 TI - [Special problems in the histologic age determination of thrombi and emboli]. PMID- 2717542 TI - [Comparative study of the prognosis content of grading and morphometry in breast cancers]. PMID- 2717543 TI - Stimulatory effect of prolactin on human placental progesterone secretion at term in vitro: possible inhibitory effect on oestradiol secretion. AB - Maternal and fetal circulating prolactin (PRL) increases 10-fold compared with the non-pregnant state. We examined the effect of PRL upon placental steroidogenesis. It had a significant (P less than 0.05) time-dependent stimulatory effect upon placental explants/P4 accumulation and secretion into the medium. The maximal stimulatory effect (two-fold) in dose-dependent experiments was found to be 200 ng/ml. The effect of PRL upon oestradiol secretion was mainly inhibitory. This inhibition was most pronounced at 200 ng/ml. In conclusion, placental steroid secretion is modulated by PRL. This effect occurs mainly at concentrations seen in the placenta at term, suggestive of its physiologic role. PMID- 2717544 TI - Glycogen metabolism in the rat visceral yolk sac. I. Glycogen content and gestational age. AB - The glycogen content of the rat visceral yolk sac was determined between 13.5 and 20.5 days of gestation by the best available colorimetric method. The concentration of glycogen in the tissue increased ten-fold between 13.5 and 18.5 days, to reach a value similar to that for mammalian muscle, but then decreased by 50 per cent between 18.5 and 20.5 days. Determination of the iodine-iodide spectra and fractionation of the glycogen particles by a novel sodium citrate centrifugation method indicated broad similarities between the structures of glycogen particles, isolated by a mild phenol-water method, from the yolk sac and the liver of the rat. However, the proportion of 'high'-molecular-weight glycogen in the yolk sac increases between 18.5 and 20.5 days, as a result of the preferential loss of 'low'-molecular-weight glycogen, so that at term the proportion approaches that found in liver glycogen. PMID- 2717545 TI - Vascular anastomoses in fused, dichorionic twin placentas resulting in twin transfusion syndrome. AB - We have provided pathologic documentation of vascular anastomoses across fused, dichorionic placentas. These placental anastomoses resulted in the twin transfusion syndrome. PMID- 2717546 TI - Placental permeability for morphine-3-beta-D-glucuronide in the guinea pig. AB - The fetal Vd and the PS of the major metabolite of morphine, M3G, were studied in pregnant guinea pigs during the last half of gestation. Fetal Vd was determined to be 0.334 ml/g of fetal plus placental weight and did not vary as the gestation progressed. The mean +/- s.e. PS for M3G was 3.7 +/- 0.3 X 10(-5) ml/sec/g and was independent of anaesthesia. This value was consistent with previous studies of other hydrophilic compounds, indicating that diffusion governs the placental passage of M3G. The PS value increased with increasing fetal weight which was consistent with structural changes in the guinea pig placenta as fetal age progresses in late gestation. PMID- 2717547 TI - Comparison between measurements of maternal placental blood flow with dynamic placental scintigraphy and radioactive microspheres. AB - Two methods for measurements of maternal placental blood flow were compared, dynamic placental scintigraphy using 113mIndium and the radioactive microsphere distribution technique which was the reference method. These methods were both used before and after the blood flow was altered by a noradrenaline infusion in pregnant monkeys (Macaca fascicularis). The change of the blood flow values obtained by the two methods were compared. A statistically significant correlation between the two methods was found (r = 0.90, p less than 0.01). It is concluded that dynamic placental scintigraphy can be used as a technique for clinical measurements of relative changes of the maternal placental blood flow. PMID- 2717548 TI - Long term sequelae after talc pleurodesis for spontaneous pneumothorax. AB - After talc pleurodesis performed between 1954 and 1964 because of spontaneous pneumothorax during thoracoscopy, 99 patients were followed up. Only 2 patients experienced a pneumothorax relapse. Mesothelioma was not observed in any case, X ray changes in the Pleura were moderate, and lung function did not show any significant restriction. It is concluded therefrom that the method is effective and does also not produce any noticeable side effects on long-term observation. PMID- 2717549 TI - [Thoracoscopic sympathectomy in hyperhidrosis]. AB - The effectivity of sympathectomy performed via thoracoscopy as initiated by Kux, has been confirmed by examining two cases reported here. PMID- 2717550 TI - [Thoracoscopy in the treatment of bronchial asthma]. AB - The indications, complications and results obtained in asthma bronchiale are described on the basis of 132 thoracal vagotomies according to Kux. The operation was found to be effective in 60% of the patients, without however being able to compare them by means of control examination conducted with a comparative group. PMID- 2717551 TI - [Thoracoscopy in diffuse lung diseases]. AB - Thoracoscopy was performed under local anesthesia in 419 patients suffering from a diffuse lung disease. In 85% of the cases diagnosis was clarified by thoracoscopy. All other cases were confirmed by means of an open lung biopsy. The best results were obtained in sarcoidosis of the stages II and III, the sensitivity being 0.98. Tumour-conditioned diffuse lung diseases were clarified in 88% of the cases; proof of an interstitial pulmonary fibrosis or interstitial pneumonia was established in 85% of the patients. Results regarding histiocytosis X were poor: thoracoscopic-bioptic proof was successful in only 42% of the patients. In 419 examinations we only detected a severe complication (air embolism). Drainage times were on the average between 4 and 5 days. On the whole, the method was characterised in the field of diagnosis of diffuse lung diseases by a high degree of sensitivity and satisfactory specificity. Both in respect of the invasiveness of the examination and its sensitivity it occupies an intermediate position between peripheral bronchoscopically obtained biopsy and surgical open lung biopsy, representing a valuable extension of the diagnostic instrumentarium if the indication is carefully considered. PMID- 2717552 TI - [Thoracoscopy in the immunosuppressed patient]. AB - The article reports on diagnostic thoracoscopy in 65 patients suffering from pulmonary complications in immunosuppression. The high sensitivity of 98% and the relatively low rate of complications assign to thoracoscopy a place between transbronchial peripheral and surgical open lung biopsy. PMID- 2717553 TI - [Thoracoscopy in thoracic wall processes]. AB - Main emphasis in the diagnosis of diseases in the chest wall region is on modern imaging methods, perthoracic puncture, and surgery. It is only rarely that diagnostic thoracoscopy appears to be indicated, especially in patients with enhanced operative risk. PMID- 2717554 TI - [Diagnostic thoracoscopy in mediastinal space-occupying lesions]. AB - Thoracoscopy is a helpful and safe procedure for diagnosing a variety of mediastinal masses if adequate information cannot be obtained out due to biological risk or patient non-compliance. An explicit description of thoracoscopic technique is given along with case reports demonstrating the efficiency of the method. PMID- 2717555 TI - [Thoracoscopy Symposium 1987]. PMID- 2717556 TI - [Thoracoscopy: surgical technic]. AB - Presentation of a surgical method in thoracoscopy, pleura biopsy and open lung biopsy using an intercostally introduced mediastinoscope and unilateral contralateral respiration. The results and advantages are explained. PMID- 2717557 TI - Contraindications and complications to thoracoscopy. AB - Contraindications to thoracoscopy are mostly only relative. Complications are rare if the technical conditions are fulfilled. PMID- 2717558 TI - Diagnostic results in secondary malignant pleural effusions. AB - The results of thoracoscopy in over 365 secondary malignant pleural effusions are analysed with particular reference to the location of the primary tumour of the metastases and in comparison to "blind" methods. Thoracoscopy had a sensitivity of 95.6%. PMID- 2717559 TI - Thoracoscopy in malignant mesothelioma. AB - Thoracoscopy is a suitable diagnostic method in malignant mesothelioma, since it enables simultaneously histopathological diagnosis, identification of asbestos fibres, staging of tumour spread, and pleurodesis therapy. PMID- 2717560 TI - [Diagnosis of tuberculous pleural effusion]. AB - The endoscopic-macroscopic images of thoracoscopies performed in the presence of a pleural effusion, are analysed. When comparing the various forms of the disease, the image must be resolved into its elements. It is found that the optical image is characteristic for the disease patterns; the appearance of the image elements also depends on the time at which the examination is performed. PMID- 2717561 TI - Thoracoscopy in rheumatoid pleural effusion. AB - In rheumatoid pleural effusion a positive diagnosis can be made by thoracoscopy, preferably supported by the identification of microscopic structural changes in the parietal pleura. Biochemical changes and the finding of the so-called rheumatoid arthritis cells (RA-cells) are non-specific. PMID- 2717562 TI - Prediction of the diagnostic utility of thoracoscopy in pleural effusion. AB - Malignancies are today becoming a more and more common cause of pleural effusions and thereby also a major indication for thoracoscopy. To facilitate the choice of the most suitable diagnostic procedure, a method of estimating the risk of malignancy is required. In order to present such a method, 334 patients with pleural effusions were examined. The predictive value for malignancy was determined for 7 variables, viz. the patient's sex, age, smoking habits, asbestos exposure, size of effusion, pleural fluid colour and eosinophils. The variables were evaluated both separately, combining two by two and by a logistic regression function. Malignant effusions were revealed in 47% of the patients. A bloody pleural fluid showed the strongest positive predictive value for malignancy, while greater than 30% eosinophils in the fluid had the strongest negative predictive value. The predictive value was further improved by combining pleural fluid colour and eosinophils. A logistic regression function using all 7 registered variables could discriminate correctly between malignant and non malignant disease in 79% of all cases. Thus, patients at significant risk of having a malignant disease could be identified and referred for further examinations if needed. Thoracoscopy should be the method of choice for further examination of these patients as it reveals significant additional information beyond that achieved by cytology. PMID- 2717563 TI - [Indications for thoracoscopy in pleural empyema]. AB - If the acute empyema of the pleura is not treated well in time via thoracic drainage and lavage, a cavitated empyema of the pleura may result. Such cavitated empyemas may be drained via surgical thoracoscopy using the mediastinoscope in intubation anaesthesia. Major surgery as represented by standard thoracoscopy is thus avoided. By intraoperative positive pressure breathing the fibrin deposits on the visceral pleural are torn, thus enabling maximum possible re-expansion of the lungs. PMID- 2717564 TI - [Indications for thoracoscopy in secondary spontaneous pneumothorax]. AB - Secondary spontaneous pneumothorax (SP) is an indication for thoracoscopic exploration and treatment just like primary SP. The same guidelines apply to both. During the last 12 years a total of 243 patients with SP were admitted to our Department of Pneumology; of these, 156 = 62.2% were treated by thoracoscopy. We employed an operation method described by Youmans et al. that we modified for thoracoscopy, namely, pleural abrasion. The relative number of thoracoscopies rose during 1975-1980 from 47% of all SP to 75% during 1981-1986. The relapse quota was 5.4% (total value); of the operated patients, only 3 suffered a relapse (1.2%). Since our department is the only one for diseases of the lung for a total population of 537,000, we can assume that these relapse rates can be-if at all only slightly falsified by referrals to hospitals located in other Federal Lands. PMID- 2717565 TI - The laser in thoracoscopy. AB - The various possibilities of laser application in thoracoscopy are explained, such as closure of defects after lung biopsy or in pneumothorax, cauterisation of emphysematous bullae, etc. PMID- 2717566 TI - [Pleurodesis with tetracycline hydrochloride in spontaneous pneumothorax]. AB - Treatment of spontaneous pneumothorax aims at avoiding relapses besides achieving immediate reexpansion of the lung. Thoracoscopy should definitely occupy a well established position in the diagnostic and therapeutic step-by-step schedule. On the one hand, it enables local treatment methods, and on the other it helps in arriving at a decision with regard to the operation. If conditions permit, pleurodesis should be effected via the intrapleural rubber-tube drain, tetracycline hydrochloride having proved very suitable for this purpose. A retrospective review is given on the experiences with thoracoscopy and pleurodesis on the basis of own cases. PMID- 2717567 TI - [Glucocorticoids in patients with tumors of the adrenal cortex]. AB - Basal concentrations of plasma cortisol (F), corticosterone (B) and 11 desoxycortisol (S) and urinary excretion of glucocorticoids (17-OCS, F and B) were investigated in 50 patients with verified hormonally active adrenocortical tumors; 78 patients with Itsenko-Cushing disease (ICD) and 30 healthy controls of respective age were investigated in parallel with them. It was shown that judging by the nature of secretion, corticosteroma, corticoandrosteroma and androsteroma were mixed-type tumors producing the main glucocorticoids at substantial quantities. The levels of hormones did not differ considerably in patients with the above tumor types. When comparing patients with tumors and ICD a high basal concentration of B was found in the blood of tumor patients. In adenoma and ICD the blood and urinary level of glucocorticoids increased 2-3-fold, in malignant tumors it increased 3-5-fold and more. A noticeable rise of the blood concentration of S in a confirmed diagnosis of a tumor pointed to its malignant nature with a high degree of probability. PMID- 2717568 TI - [Dynamics of lipid peroxidation in patients with noninsulin-dependent diabetes mellitus]. AB - The time course of erythrocytic lipid peroxidation (LP) was studied in 55 patients with insulin independent diabetes mellitus aged 40 to 60 years LP was assessed by the content of malonic dialdehyde (MDA) and peroxidative hemolysis of erythrocytes (PHE). During diabetic decompensation LP activity was increased, especially in the presence of lower limb angiopathies. The authors assumed an idea of the involvement of LP products in the pathogenesis of vascular lesions. Diabetic compensation did not cause normalization of LP activity however the use of antioxidant (alpha-tocopherol acetate) led to a significant decrease in LP activity which can be of importance for the treatment of the early stages of diabetic angiopathies. PMID- 2717569 TI - [Clinical significance of the determination of serum fructosamine and albumin in children with diabetes mellitus]. AB - The paper is devoted to a study of the role of serum glycoprotein fructosamine and serum albumin in the pathogenesis of a severe course of insulin dependent diabetes mellitus (IDDM) in children. Fructosamine was determined in 43 pediatric patients with IDDM by direct spectrophotometry using Hoffman-La-Roche kits; albumin, C-peptide and malonic aldehyde were also determined. Disorder of the mechanism of regulation of homeostasis by albumin was shown to play an important role in the pathogenesis of a severe course of IDDM in children. It could be caused by its enhanced glycosylation and a decrease in liver synthesis in some cases as a result of considerable reduction of insulin secretion. A prognostically unfavorable sign was a raised ratio of fructosamine to albumin and enhanced lipid peroxidation against a background of low insulin secretion. The determination of serum levels of fructosamine and albumin can be a valuable diagnostic criterion in examination of children with diabetes mellitus. PMID- 2717570 TI - [Effects of pentagastrin in patients with diabetes mellitus]. AB - Pentagastrin used in patients with diabetes mellitus at a dose necessary for a study of gastric secretion regularly enhances the blood flow in the gastric mucosa and liver raising absorptive and antitoxic liver function. PMID- 2717571 TI - [Psycho-endocrine interrelations in patients in a state of emotional stress during cerebral obesity]. AB - A study was made of the psychoendocrine factor of pathogenesis of patients suffering from cerebral obesity with a hyperphagic reaction to stress and without it. The purpose was to study the hypothalamo-hypophyseo-adrenal system, emotional personality features and motivation sphere in patients with cerebral obesity as compared to a control group. The following methods of examination were used: cliniconeurological examination, psychological methods--MIL test, Spilberger's test, a radioimmunoassay for determination of the blood levels of ACTH, STH, prolaction and cortisol at rest and under experimentally simulated stress. These methods were followed by mathematical processing of the obtained data with a correlation analysis of psychological and hormonal indices. The conclusions were based on statistically significant results only. A variable psychohormonal complex of reaction to stress was revealed in the patients with relation to the presence or absence of a hyperphagic reaction to stress. In a hyperphagic reaction to stress an increase in the body mass under an emotional stress resulted mainly from inadequate psychomotivation shifts with further overeating. In the absence of such a reaction a body mass increase under a stress was associated mainly with the neuroendocrine factor with retardation of lipolysis. PMID- 2717572 TI - [Effect of merkazolyl on the level of thyrostimulating immunoglobulins of the blood in patients with diffuse toxic goiter]. AB - A study was made of the level of thyrostimulating immunoglobulins (TSI) in the blood of 31 untreated patients with diffuse toxic goiter (DTG). The effect of thiamazole applied at a daily dose of 30-60 mg for 3-4 weeks on a TSI level was investigated in 18 patients. The level was assessed by an increase in a cAMP level in thyroid paired lobes after incubation with immunoglobulins of DTG patients. The basal level of TSI does not correlate with the level of blood thyroxin, thyroid iodine absorptive capacity of DTG patients, and severity of thyrotoxicosis. Thiamazole produces a different effect depending on a degree of severity of thyrotoxicosis decreasing a TSI level in patients with disease of average severity and not changing the level in severe thyrotoxicosis. PMID- 2717573 TI - [A case of generalized xanthomatosis in a patient with diabetes mellitus]. PMID- 2717574 TI - [Diagnosis and treatment of bladder pheochromocytoma]. PMID- 2717575 TI - [Thyroid pathology and the female reproductive system]. PMID- 2717576 TI - [Experience of a day clinic in the treatment of patients with diabetes mellitus]. PMID- 2717577 TI - [Review of methodologic recommendations on endocrinology approved by the Ministries of Health of the Union Republics]. PMID- 2717578 TI - [Binding of glucocorticoids and glucocorticoid-receptor complexes with rat liver nuclear matrix]. AB - Studies on binding glucocorticoids and cytosol glucocorticoid-receptor complexes with rat liver nuclear matrix were conducted. Zones of binding 3H-dexamethasone and 3H-dexamethasone-receptor complexes, characterized by saturability and high affinity, were found in nuclear matrix structures. A lower level of binding was noted during incubation of nuclear matrix and cytosol from the liver of rats aged 24 mos. than in the use of the same subcellular fractions isolated from the liver of rats aged 6 mos. PMID- 2717579 TI - [Neonatal exposure to cortisol: disturbance of adrenal and reproductive system function in developing female rats]. AB - A study was made of the effect of cortisol administration on the 5th day of postnatal life on the development of the sexual system and adrenal function in female rats. Neonatal treatment with cortisol at a dose of 250 micrograms was shown to cause delayed maturity and a decrease in sex receptivity. This treatment also caused a decrease in adrenal and ovarian secretion in vitro of corticosterone and progesterone by rats aged 30 days and a decrease in the blood level of corticosterone of maturing animals. It was assumed that sex developmental disorder was determined by chronic deficiency of blood corticosterone. PMID- 2717580 TI - [Role of adrenal and sex steroids in the regulation of pancreatic exocrine function]. AB - The effect of deficiency of adrenal and sex steroids on the microstructure and some chemical compounds ensuring a secretory process in the pancreas was studied in experiments on adult albino rats of both sexes using morphological, histochemical and morphometric methods. Direct correlation of the number of zymogenic granules with steroid-hormonal balance was established. A secretory response of exocrine pancreacytes on steroid insufficiency was ambiguous in animals of different sexes. Bilateral adrenalectomy in male rats led to a complex of morphofunctional changes resulting in disorders of secretion formation and excretion in the pancreas whereas they were unnoticed in female rats. A similar effect was detected in them after combined adrenal- and ovariectomy. PMID- 2717581 TI - [The vascular response of spontaneously hypertensive and normotensive rats with diabetes mellitus]. AB - Streptozotocin-induced diabetes caused an increase in AP and reactivity to noradrenaline in perfused caudal artery of normotensive rats (WKY). In spontaneously hypertensive rats (SHR) diabetes led to an increase in reactivity not only to noradrenaline but also to alpha 1-agonist phenylephrine; a response to endothelium-dependent agent acetylcholine was decreased. Alterations in function of the vascular endothelium may be one of the factors causing elevation of vasoconstriction in diabetes mellitus. PMID- 2717582 TI - [Apoplexy of the hypophysis in acromegaly]. PMID- 2717584 TI - [Prevention of tuberculosis in the migrant rural population and means of improving its effectiveness]. AB - Detection of pulmonary tuberculosis, its clinical process and certain peculiarities of its prophylaxis in rural migrants and particularly in persons leaving the region during season work were analyzed. It was shown that the incidence of tuberculosis among the migrants was higher than that among non migrants of the control group. Often (11 per cent) they had severe acute specific lesions in the lungs usually not observed in persons not migrating. Unaccustomed climatic and geographical conditions, epidemiological situation with respect to tuberculosis in the new places, traces of cured intrathoracic primary tuberculosis, irregular fluorographic examinations and bad habits were the leading factors in development of the disease in the migrants. Recommendations for prophylaxis of respiratory tuberculosis in rural migrants are presented. PMID- 2717583 TI - [Effect of adrenergic innervation on the degree of reparation of the thyroid after its resection]. AB - The time course of thyroid functional changes in normal and in partial desympathization was observed in experiments on 250 albino male rats aged 15 days, 1, 3, 6, 12 and 24 mos. Desympathization was induced by the administration of guanethidine at a dose of 15 mg/kg of body mass in the first 14 days after birth. Resection of the two thirds of the gland was performed on the 3rd, 5th, 7th, 15th and 30th days before killing. T3, T4, CT and TSH levels were determined by radioimmunoassay. Analysis of thyroid hormonal patterns showed variability of functional changes of this organ in desympathization. Desympathization at the age of 15 days and one month led to thyroid functional suppression, later on a rise of hormonogenesis was noted as a result of enhanced production of the pituitary body and CT. At the age of 1 and 3 mos. after thyroidectomy the rates of implementation of thyroid reparative potentials in desympathization were much higher than those in controls and were accompanied by a more marked increase in TSH. At the age of 12 mos. the resection of the two thirds of the thyroid caused a progressive decrease in the level of serum TSH which determined a decrease in the rate of normalization of the thyroid status. PMID- 2717585 TI - [Differential x-ray diagnosis of disseminated tuberculosis and sarcoidosis of the lungs]. AB - In the polymorphous picture of roentgenological shifts in disseminated tuberculosis and sarcoidosis of the lungs the authors mark out x-ray symptom complexes of differential diagnosis value. The complexes are based on predominating affection of the bronchopulmonary structures, x-ray characteristics of granulomas, nature and extent of the affections of the lymph nodes of the lung roots and mediastinum and the type of hypertension development in pulmonary circulation. PMID- 2717586 TI - [Tuberculosis first detected in subjects over 70 years old]. AB - Characteristics of the tuberculosis process were studied in 43 patients at the age of 71 to 84 years. Patients with extended extrapulmonary tuberculosis and concomitant diseases predominated. Analysis of the causes of the late tuberculosis detection is presented and it is indicated that efficient prophylactic examination of the persons of this age group is needed. Investigation of the clinical picture of tuberculosis in the patients over 70 years revealed a number of peculiarities in its process under conditions of the Krasnoyarsk Territory. PMID- 2717587 TI - [Clinical forms of tuberculosis with minimal destruction of pulmonary tissue]. AB - Three hundred and eighty seven patients with pulmonary tuberculosis having single or multiple destructive cavities less than 2 cm in size were observed. Two thirds of the caverns became undetectable 2-4 months after the therapy start. The roentgenograms of the patients were analyzed, the time courses of the caverns were compared with those of lung tuberculomas of the same size and the disease outcomes were estimated. It was concluded that in the cases with small cavities not closing for prolonged periods tuberculomas with destructions in the infiltrate depth or caseous foci with their partial resolution might be suspected. It was indicated that tuberculin therapy increased the frequency of small cavern healing though their significant part closed at late periods which requires development of more efficient methods for their medication. On the whole, the outcomes of pulmonary tuberculosis with minimal destruction of the lung tissue were favourable. The disease progress was stated only in the patients who did not complete the treatment course. PMID- 2717588 TI - [X-ray characteristics of cirrhotic tuberculosis of the lungs (based on data from ambulatory care observations)]. PMID- 2717589 TI - [The effect of ibuprofen on the hemodynamics of the lesser circulation in patients with pulmonary hypertension]. AB - The effect of ibuprofen on pulmonary circulation hemodynamics, pulmonary ventilation and blood gaseous metabolism was studied under conditions of cardiac venous catheterization in 8 patients with pulmonary hypertension caused by chronic inflammatory diseases of the lungs. After oral use of ibuprofen in a dose of 0.4 g, there was (in 7 out of the 8 patients) an increase in the right ventricle systolic pressure at an average by 5.9 +/- 2.39 mm Hg (p less than 0.05). The time course of the echocardiographic indices in the majority of the patients was evident of an increase in the right ventricle postload. No definite tendencies in changing of pulmonary ventilation and blood gaseous metabolism were observed. Inhibition of synthesis of prostacyclin and type E prostaglandin having a vasodilating action is the most likely mechanism of the ibuprofen vasoconstrictive effect. PMID- 2717591 TI - [Isolation of non-spore-forming anaerobic bacteria from patients with tuberculosis of the lungs and other diseases of the respiratory organs]. AB - The use of specific means in bacteriological examination for anaerobic microflora in patients with purulent inflammatory diseases of the lungs including ones developing in the presence of pulmonary tuberculosis was validated. Isolation of nonsporulating anaerobic bacteria in monocultures or as a component of polymicrobial associations was shown important for correct diagnosis and using of etiotropic therapy and respective therapeutic measures. This should enable to prevent or to limit development of severe destructive affections of the lungs. PMID- 2717590 TI - [Long-term results of the use of osteoplastic thoracoplasty in the treatment of destructive tuberculosis of the lungs in patients with antisocial behavior]. AB - The results of osteoplastic thoracoplasty in 44 patients with antisocial behaviour and contraindications to lung resection because of the specific process marked activity are presented. Osteoplastic thoracoplasty is advantageous over the other collapse surgery procedures as there is no need of using therapeutic compressing bandages which makes it possible to discharge a patient from a hospital in case of infringing the hospital regimen. The use of osteoplastic thoracoplasty provided the clinical effect in 29.5 per cent of the patients. In 52.3 per cent of the patients it had a stabilizing effect before lung resection. On the whole, clinical rehabilitation at remote periods was stated in 81.8 per cent of the persons with antisocial behaviour. PMID- 2717592 TI - [Evolution of tuberculosis morbidity and the factors governing it at different stages of the anti-tuberculosis campaign]. AB - Characteristics of the tuberculosis incidence in the Ukrainian SSR since the beginning of the wide use of antibacterial therapy were studied. It was shown that the delayed decrease in the incidence of tuberculosis in young persons observed lately did not correlate with further improvement of the epidemiological situation with respect to tuberculosis. It was indicated that the phenomenon stemmed from insufficient control of heavy alcohol drinking and alcoholism in the population and tuberculous patients. PMID- 2717593 TI - [Measurement of the chemiluminescence of the urine and blood serum during the adverse effects of drugs on patients with tuberculosis]. AB - Materials on testing of urine and blood serum by chemiluminometry (CLM) for diagnosis of adverse reactions to drugs in patients with tuberculosis are presented. Urine and blood serum from 94 patients with pulmonary tuberculosis were tested. The group included 59 patients with allergic, toxico-allergic and toxic reactions to the antituberculous drugs used in their treatment, 17 patients with satisfactory tolerance of the treatment and 18 patients subjected to the tests prior to their treatment. The diagnostic value of the urine tests was rather high (84.7 per cent) and not inferior to that of the blood serum tests (86.4 per cent). The simultaneous testing of both the media increased the frequency of detecting the sensitizing drug. The procedure is simple, not harmful for the patients and provides rapid results (20-30 minutes) and objective estimation. It may be recommended for the use in medical institutions. PMID- 2717594 TI - [Experience with the organization of work on tuberculosis prevention in industrial enterprises]. PMID- 2717595 TI - [Occurrence, clinical manifestations, course and outcomes of tuberculosis of the lungs in patients with mental diseases and alcoholism]. PMID- 2717596 TI - [Organization of the differential diagnosis of tuberculosis and other diseases of the lungs in patients with tuberculosis, suffering from psychic disorders]. PMID- 2717597 TI - [Infectious allergic myocarditis of tubercular etiology]. PMID- 2717598 TI - [Diagnosis of disorders of the bile excretory system in patients with tuberculosis in association with chronic opisthorchiasis]. PMID- 2717599 TI - Age and enzyme specificity of the response of developing rat pancreas to the trophic effects of bombesin. AB - The immediate postnatal period is a time of rapid pancreatic growth and development. Gastrointestinal regulatory peptides have been shown to exert trophic effects on the pancreas, and one such peptide, bombesin, has been shown to exert trophic effects on the pancreas of both the suckling and adult rat. Our previous studies had suggested that the sensitivity of the rat pancreas to bombesin might be changing during the suckling period. We therefore conducted experiments to determine if age-related changes in the responsiveness of rat pancreas to chronic administration of exogenous bombesin occur, and to characterize these changes. Beginning on day 3 ("suckling") or 24 ("weanling") postnatally, groups of rats were injected subcutaneously with several doses of bombesin tetradecapeptide every 12 h for 7 days. Bombesin injection produced a dose-dependent increase in pancreatic protein content and trypsin activity in both suckling and weanling groups, although the degree of increase was greater in the weanling group than in the sucklings. Significant increases in pancreatic contents of DNA and amylase activity were observed only in the weanling group. We have thus demonstrated for the first time that the pancreas of the suckling rat exhibits a diminished response to chronic parenteral administration of bombesin in terms of changes in protein and DNA contents, as well as enzyme composition, compared to the pancreas of weanlings. The elucidation of the physiologic basis for these differences may provide specific information regarding the mechanism of bombesin-stimulated pancreatic growth, as well as general information concerning the control of pancreatic growth during development. PMID- 2717600 TI - The biological relevance of N-terminal neurotensin fragments in the regulation of exocrine pancreas secretion. AB - Stimulation of the exocrine pancreas is one of the biological effects attributed to the tridecapeptide neurotensin (NT). Only the C-terminal 8-13 fragment with its extremely short plasma half-life in the peripheral circulation was considered to be necessary for biological activity. The N-terminal fragments that are detectable in peripheral blood in much greater concentrations were considered to be of no importance. In order to elucidate the biological relevance of these N terminal fragments, five dogs were infused with neurotensin at a rate (50 pmol/kg/h) that had been determined to give physiological plasma concentrations. Pancreatic secretions were collected from previously implanted modified Herrera pouches. The effects of the N-terminal fragments NT 1-8 and NT 1-11 on the exocrine pancreas secretion were tested in the same way. It was possible for the first time to demonstrate a biological effect of the N-terminal fragments found in the postprandial circulation in vivo. The plasma concentrations determined by radioimmunoassay remained within the physiological range (less than 40 pg/ml). These N-terminal neurotensin fragments may therefore participate in the hormonal regulation of the exocrine pancreas secretion. PMID- 2717601 TI - Pancreatic abscess secondary to Candida albicans. AB - A case report is presented of a patient with acute postoperative pancreatitis who developed a pancreatic abscess secondary to Candida albicans. Recovery followed operative drainage and amphotericin B therapy. Because this is the only such patient in the author's career experience, and because only one other report currently addresses the problem, this report is offered. PMID- 2717602 TI - Effect of sodium butyrate, a differentiating agent, on cell surface glycoconjugates of a human pancreatic cell line. AB - The effects of sodium butyrate, a differentiating agent, on growth properties and glycoconjugates of a human pancreatic carcinoma cell line (CAPAN-1) were studied. Butyrate caused marked changes of in vitro growth properties including prolongation of doubling time and greatly reduced colony forming efficiency in soft agar. Cell surface labeling revealed significant alterations in proteins and glycoproteins after treatment with sodium butyrate (appearance of glycoproteins of molecular weight 250,000, 220,000, and 70,000; reduction of glycoproteins of 164,000, 148,000, 110,000, and 66,800 sizes; increases in proteins/glycoproteins of 85,000 and 78,000). Metabolic labeling of the cells with [3H]fucose or [3H]galactose revealed that sodium butyrate treatment caused a marked reduction in the fucose-containing neutral glycolipids with six or more carbohydrate side chains and an increase in [3H]galactose-labeled neutral glycolipids, particularly GL-3a, GL-4a, and GL-5a. There was marked reduction in the labeling of a ganglioside with mobility similar to that of GM4 and of sulfogalactosylceramide. An increase in a ganglioside with mobility above GM1 was also caused by butyrate. These data indicate that sodium butyrate may be useful in the identification of differentiation or malignancy-associated glycoconjugate markers of human pancreatic cells. PMID- 2717603 TI - Small intestinal transit, bacterial growth, and bowel habits in diabetes mellitus. AB - To investigate diabetic alterations of small intestinal transit and bacterial growth, we performed hydrogen breath tests (10 g lactulose via duodenal tube at the ligament of Treitz), bacterial cultures, and determinations of unconjugated serum bile acids in 19 patients with long-standing diabetes and 7 healthy controls. Asymptomatic diabetics had a late rise in breath hydrogen, indicating prolonged jejunal-cecal transit (86 +/- 10 min, p less than 0.05) as an early pathogenic event. Rise in breath hydrogen in symptomatic diabetics (constipation: 50 +/- 6 min; diarrhea: 41 +/- 11 min) was not significantly different from controls (57 +/- 8 min). Bacterial studies and increased unconjugated serum bile acids suggest bacterial overgrowth in some symptomatic diabetics. Bacterial overgrowth was associated more frequently (p less than 0.05) with a rise in breath hydrogen before 45 min or after 75 min. Changes in the hydrogen breath test, bacterial growth, or unconjugated serum bile acids did not correlate with gastrointestinal symptoms of diabetes. PMID- 2717604 TI - Urinary and serum zinc levels in chronic pancreatitis. AB - Urinary and serum zinc levels were determined in 51 patients with chronic pancreatitis. Urinary zinc excretion in patients with chronic calcified pancreatitis (832 +/- 111 micrograms/day) (mean +/- SE) but not in noncalcified pancreatitis (684 +/- 65 micrograms/day) was significantly higher than in normal controls (418 +/- 46 micrograms/day). The urinary zinc excretion increased with deterioration of exocrine pancreatic function. Serum zinc levels in advanced pancreatitis (105.9 +/- 4.5 micrograms/100 ml) were significantly higher when compared to the pancreatitis with normal exocrine pancreatic function (91.6 +/- 3.0 micrograms/100 ml), but the difference was less pronounced than for urinary zinc excretion. This may be due to complicating diabetes, which usually lowers serum zinc. Serum zinc and urinary zinc excretion were low in a patient with chronic calcified pancreatitis complicated with a pulmonary abscess and hypoalbuminemia. In conclusion, urinary and serum zinc levels in chronic pancreatitis were increased as a result of exocrine pancreatic dysfunction. Association of diabetes may lower serum zinc, and associated malnutrition depresses both urinary and serum zinc levels. PMID- 2717605 TI - Pancreatic exocrine function in unconscious rats treated with submaximal, maximal, and supramaximal doses of bombesin tetradecapeptide. AB - Supramaximal stimulation of the rat pancreas in vivo with caerulein elicits a sharp decline in pancreatic juice volume and protein outputs and initiates acute edematous pancreatitis within 30 min. Because of the similar effects of caerulein and bombesin on pancreatic exocrine function, we examined in unconscious rats (a) the effects of a continuous, 4-h intravenous infusion of varying doses (0.2-40.0 nmol/kg/h) of bombesin on pancreatic juice volume and protein output, and (b) whether supramaximal doses of bombesin produce acute edematous pancreatitis. A maximal, fivefold and 17-fold rise in pancreatic juice volume and protein output was achieved with intravenous doses of 1.0 and 4.0 nmol of bombesin/kg/h, respectively. Pancreas weights in rats infused with bombesin as high as 40.0 nmol/kg/h were not significantly different from control animal values (no bombesin infusion) and serum amylase concentrations were only moderately (twofold) elevated over control values in rats i.v. infused with 4.0-40.0 nmol of bombesin/kg/h. The pancreas in rats treated with the highest dose of bombesin (40.0 nmol/kg/h) revealed sparsely scattered microvacuoles in a few acinar cells and minor evidence of interacinar edema. It is concluded that supramaximal stimulation of the rat pancreas in vivo with bombesin fails to elicit acute edematous pancreatitis and appears to be related to the ability of bombesin, in contrast to supramaximal doses of caerulein, to continuously stimulate maximal pancreatic juice secretion. PMID- 2717606 TI - Intermittent chaos, self-organization, and learning from synchronous synaptic activity in model neuron networks. AB - Self-organization of frequencies is studied by using model neurons called VCONs (voltage-controlled oscillator neuron models). These models give direct access to frequency information, in contrast to all-or-none neuron models, and they generate voltage spikes that phase-lock to oscillatory stimulation, similar to phase-locking of action potentials to oscillatory voltage stimulation observed in Hodgkin-Huxley preparations of squid axons. The rotation vector method is described and used to study how networks synchronize, even in the presence of noise or when damaged; the entropy of ratios of phases is used to construct an energy function that characterizes organized behavior. Computer simulations show that rotation numbers (output frequency/input frequency) describe both chaotic and nonchaotic behavior. Learning occurs when synaptic connections strengthen in response to stimulation that is synchronous with cell activity. It is shown that intermittent chaotic firing is suppressed and simple stable responses are enhanced by such learning in VCON networks. This analysis provides a rigorous basis for further investigation of the ideas of Wiener [Wiener, N. (1961) Cybernetics (MIT Press, Cambridge, MA), p. 191] on the origin of slow brain waves due to "the pulling together of frequencies." PMID- 2717607 TI - Wall-thickness and midwall-radius variations in ventricular mechanics. AB - A fluid-fiber-collagen stress tensor is used to describe the rheology of the left ventricle of the heart. Linear theory is used to find the equilibrium solutions for the end-diastolic and end-systolic states of general axisymmetric shapes that are small perturbations of a thick-walled finite cylinder. The general problem can be studied by superposing the effects of variable midwall radius but constant wall thickness with those of variable wall thickness but constant midwall radius. A Fourier series representation is used to describe the midwall radius and thickness functions. Numerical calculations are performed to determine the deformed geometry and spatial distributions of tissue pressure, stresses, and fiber strains. The calculations proved to be highly accurate when compared to an analytical solution obtained for the special case of no fibers. The results show significant longitudinal differences when compared to results for the cylindrical geometry, with more sensitivity to variation in wall thickness than to variation in midwall radius. PMID- 2717608 TI - Estimating the superiority of a drug to a placebo when all and only those patients at risk are treated with the drug. AB - It is shown that, under certain assumptions, one can estimate the difference between the effect of a treatment and that of a placebo even when the treatment has been given to all and only those patients who are at risk (as evidenced by a screening examination). PMID- 2717609 TI - Unstable Hoogsteen base pairs adjacent to echinomycin binding sites within a DNA duplex. AB - The bisintercalation complex present between the DNA octamer [d(ACGTACGT)]2 and the cyclic octadepsipeptide antibiotic echinomycin has been studied by one- and two-dimensional proton NMR, and the results obtained have been compared with the crystal structures of related DNA-echinomycin complexes. Two echinomycins are found to bind cooperatively to each DNA duplex at the CpG steps, with the two quinoxaline rings of each echinomycin bisintercalating between the C.G and A.T base pairs. At low temperatures, the A.T base pairs on either side of the intercalation site adopt the Hoogsteen conformation, as observed in the crystal structures. However, as the temperature is raised, the Hoogsteen base pairs in the interior of the duplex are destabilized and are observed to be exchanging between the Hoogsteen base pair and either an open or a Watson-Crick base-paired state. The terminal A.T base pairs, which are not as constrained by the helix as the internal base pairs, remain stably Hoogsteen base-paired up to at least 45 degrees C. The implications of these results for the biological role of Hoogsteen base pairs in echinomycin-DNA complexes in vivo are discussed. PMID- 2717610 TI - A second exopolysaccharide of Rhizobium meliloti strain SU47 that can function in root nodule invasion. AB - Rhizobium meliloti strain SU47 produces the calcofluor-binding exopolysaccharide, succinoglycan, that is required for alfalfa root nodule invasion. Strains derived from R. meliloti SU47 secreted an acidic exopolysaccharide, EPSb, that replaced succinoglycan in nodule invasion. EPSb, which has not formerly been identified among the Rhizobiaceae, consisted of the repeating unit 4,6-O-(1 carboxyethylidene)-alpha-D-Galp1----3(X-O-Ac)-beta-D-G lcp1----3. EPSb synthesis occurred either in strains containing a mutation in a locus designated mucR or in strains with a recombinant cosmid pMuc. mucR mapped slightly counterclockwise from pyr49 on the chromosome, while pMuc contained genes mapping to the megaplasmid pRmeSU47b. In exoA, -F, and -H mutants, which are deficient in normal succinoglycan secretion and nodule invasion, a transposon Tn5 insertion in mucR or the presence of pMuc resulted in EPSb secretion and a restoration of nodule invasion on Medicago sativa and Melilotus alba. Mutants in exoB and exoC were incapable of succinoglycan and EPSb secretion as well as nodule invasion. A mutant that secreted succinoglycan but was incapable of EPSb secretion invaded nodules normally. PMID- 2717611 TI - Molecular cloning and sequencing of cDNAs encoding the entire rat fatty acid synthase. AB - Overlapping cloned cDNAs representing the entire sequence of the rat fatty acid synthase mRNA have been isolated from a cDNA library and sequenced. Authenticity of the cDNA clones was supported by hybridization to fatty acid synthase mRNA and by amino-terminal sequencing of 39 fatty acid synthase CNBr fragments. The full length fatty acid synthase mRNA is 9156 nucleotides long and includes an 84 nucleotide 5' noncoding region, a 7515-nucleotide coding sequence, and a 1537 nucleotide 3' noncoding region; a second mRNA species containing a shortened 3' noncoding sequence is also transcribed in the rat. The encoded fatty acid synthase subunit contains 2505 amino acids and has a molecular weight of 272,340. Active sites and substrate binding sites were located within the sequence, thus establishing the order of domains on the multifunctional animal fatty acid synthase as condensing enzyme-transferase-dehydrase-enoyl reductase-ketoreductase acyl carrier protein-thioesterase. PMID- 2717612 TI - Multigene families for anthracycline antibiotic production in Streptomyces peucetius. AB - Hybridization of polyketide synthase genes from heterologous Streptomyces sp. led to the identification of four unlinked regions of DNA from Streptomyces peucetius that contain genes that encode the production of the same or closely related metabolites, some of which are intermediates of the daunorubicin pathway. DNA fragments from each region that hybridized with the heterologous polyketide synthase genes were hybridized with each other, but very little sequence similarity was observed even though at least two of the regions have similar (if not identical) functions in metabolite production. Some regions, however, do have sequence similarity with other anthracycline-producing Streptomyces sp. PMID- 2717614 TI - Hydration forces between parallel DNA double helices: computer simulations. AB - We have performed two molecular dynamics computer simulations of two 10-base-pair segments of DNA molecules immersed in water. The goal of these simulations is to study the structural and dynamical properties of water between the DNA molecules. We have observed water ordering next to DNA surfaces. Existence of such ordering was proposed earlier by Marcelja and Radic [Marcelja, S. & Radic, N. (1976) Chem. Phys. Lett. 42, 129-130] to explain strong hydration forces between macromolecular surfaces. PMID- 2717613 TI - Harmonic vibrations and thermodynamic stability of a DNA oligomer in monovalent salt solution. AB - We compute the full harmonic vibrational spectrum and eigenmodes of a DNA oligomer, d(C-G)3, in optimized B and Z conformations in various ionic environments (0.01-5.0 M NaCl). The statistical interactions of DNA with the diffuse ionic cloud surrounding it in solution are approximately represented within the potential of mean force framework. The lowest eigenfrequency of the B conformation is found to drastically decrease with increased NaCl concentration. This suggests that a soft mode mechanism may be a precursor for the B-to-Z conversion. The free energy balance governing the B-Z isomerization of d(C-G)3 is dominated by the solvent-averaged effective phosphate-phosphate interactions due to substantial cancelations between the much larger intramolecular energy contributions. PMID- 2717615 TI - Differentiation-dependent expression of phosphatidylserine in mammalian plasma membranes: quantitative assessment of outer-leaflet lipid by prothrombinase complex formation. AB - Phosphatidylserine (PS) is asymmetrically distributed in mammalian cell membranes, being preferentially localized in the inner leaflet. Some studies have suggested that a disturbance in the normal asymmetric distribution of PS--e.g., PS exposure in the outer leaflet of the cell membrane, which can occur upon platelet activation as well as in certain pathologic red cells--serves as a potent procoagulant surface and as a signal for triggering their recognition by macrophages. These studies suggest that the regulation of PS distribution in cell membranes may be critical in controlling coagulation and in determining the survival of pathologic cells in the circulation. In this paper we describe a sensitive technique, based on PS-dependent prothrombinase complex activity, for assessing the amount of PS on the external leaflet of intact viable cells. Our results indicate that tumorigenic, undifferentiated murine erythroleukemic cells express 7- to 8-fold more PS in their outer leaflet than do their differentiated, nontumorigenic counterparts. Increased expression of PS in the tumorigenic cells directly correlated with their ability to be recognized and bound by macrophages. PMID- 2717616 TI - Evolution of mouse chromosome 17 and the origin of inversions associated with t haplotypes. AB - Mouse t haplotypes are variant forms of chromosome 17 that exist at high frequencies in worldwide populations of several species of house mouse. They are known to differ from wild-type chromosomes with respect to two relative inversions referred to as proximal and distal. An untested assumption has been that these two inversions originated in the chromosomal lineage leading to present-day t haplotypes. To investigate the evolutionary origins of these inversions and the possibility of additional inversions, interspecific crosses were performed between Mus spretus or Mus abbotti and laboratory strains of Mus domesticus that carried wild-type and t haplotypes forms of chromosome 17. The results provide evidence for the existence of two additional nonoverlapping inversions--one between the proximal and distal inversions and one between the centromere and the proximal inversion. These four inversions span nearly the entire region of t haplotype recombination suppression. Considering the distribution of these inversions among the species studied as well as the organization of the D17Leh66 family of DNA elements, we infer that the proximal inversion occurred on the lineage leading to the common ancestor of M. domesticus and M. abbotti, and that the other three inversions occurred on the separate lineage leading to present-day t haplotypes. Alternative models for the evolution of t haplotypes are discussed in light of these findings. PMID- 2717617 TI - Prediction of major histocompatibility complex binding regions of protein antigens by sequence pattern analysis. AB - We have previously experimentally analyzed the structural requirements for interaction between peptide antigens and mouse major histocompatibility complex (MHC) molecules of the d haplotype. We describe here two procedures devised to predict specifically the capacity of peptide molecules to interact with these MHC class II molecules (IAd and IEd). The accuracy of these procedures has been tested on a large panel of synthetic peptides of eukaryotic, prokaryotic, and viral origin, and also on a set of overlapping peptides encompassing the entire staphylococcal nuclease molecule. For both sets of peptides, IAd and IEd binding was successfully predicted in approximately 75% of the cases. This suggests that definition of such sequence "motifs" could be of general use in predicting potentially immunogenic peptide regions within proteins. PMID- 2717618 TI - Human immunodeficiency virus type 1 in spinal cords of acquired immunodeficiency syndrome patients with myelopathy: expression and replication in macrophages. AB - Spinal cord disease is common in patients infected with human immunodeficiency virus type 1 (HIV-1), and a characteristic vacuolar myelopathy is present at autopsy in approximately one-fourth of acquired immunodeficiency syndrome patients. Pathologic examination of the spinal cord shows vacuolation of white matter and infiltration by macrophages, a process distinct from HIV-1 encephalopathy. To determine the presence and localization of HIV-1 RNA in the spinal cords of acquired immunodeficiency syndrome patients with vacuolar myelopathy, we used the technique of combined in situ hybridization and immunohistochemical staining on the same slide. Spinal cord tissue sections were stained with markers for macrophages, endothelial cells, oligodendroglia, astrocytes, and myelin and then hybridized in situ with HIV-1-specific RNA probes. Combined in situ hybridization and immunohistochemical staining on three spinal cords showed HIV-1 expression in mononuclear and multinucleated macrophages localized mainly to areas of myelopathy in spinal cord white matter. Immunohistochemical staining and electron microscopy showed myelin within macrophages and electron microscopy revealed HIV-1 budding from macrophages. These data suggest a role for HIV-1-infected macrophages locally in the pathogenesis of vacuolar myelopathy and add to the body of evidence that these cells play a role systemically in the development of HIV-1-related disease. PMID- 2717619 TI - Direct and sex-specific stimulation by sex steroids of creatine kinase activity and DNA synthesis in rat bone. AB - A direct in vitro effect of 17 beta-estradiol (E2) was demonstrated on bone and cartilage cell energy metabolism. Sex-specific stimulation by E2 and testosterone was shown in diaphyseal bone of weanling rats. E2 (30 nM) caused, within 24 hr, a 70-200% increase in creatine kinase (CK; ATP:creatine N-phosphotransferase, EC 2.7.3.2) specific activity in ROS 17/2.8 rat osteogenic sarcoma cells, MC3T3-E1 mouse calvaria-derived cells, and rat fetal calvaria cells, and a 40% increase in rat epiphyseal cartilage cells. Stimulation of CK activity by E2 was dose and time dependent: in ROS 17/2.8 cells, a highly significant increase was found at 3 nM E2 and a greater than 100% increase in CK activity was found 1 hr after E2 administration. In female 20-day-old Wistar-derived rats, E2 (5 micrograms per rat) increased CK activity in diaphyseal bone by 82% within 1 hr of i.p. injection, with a maximal increase of 200% after 24 hr; neither the weakly estrogenic agonist 17 alpha-estradiol, testosterone, nor progesterone showed this effect. Conversely, in male rat diaphyseal bone, testosterone or dihydrotestosterone increased CK activity after 24 hr by approximately 100%, while E2 was ineffective. In epiphyseal cartilage, both E2 and testosterone increased CK activity. Stimulation of CK activity by sex hormones was paralleled by significant increases in [3H]thymidine incorporation into DNA. Therefore, it is possible that direct sex-specific actions of gonadal steroids may contribute to stimulating bone growth and maintaining balanced bone turnover. PMID- 2717620 TI - Saposin A: second cerebrosidase activator protein. AB - Saposin A, a heat-stable 16-kDa glycoprotein, was isolated from Gaucher disease spleen and purified to homogeneity. Chemical sequencing from its amino terminus and of peptides obtained by digestion with protease from Staphylococcus aureus strain V-8 demonstrated that saposin A is derived from proteolytic processing of domain 1 of its precursor protein, prosaposin. Processing of prosaposin (70 kDa) also generates three other previously reported saposin proteins, B, C, and D, from its second, third, and fourth domains. Similar to saposin C, saposin A stimulates the hydrolysis of 4-methylumbelliferyl beta-glucoside and glucocerebroside by beta-glucosylceramidase and of galactocerebroside by beta galactosylceramidase, mainly by increasing the maximal velocity of both reactions. Saposin A is as active as saposin C in these reactions. Saposin A has no significant effect on other sphingolipid and 4-methylumbelliferyl glycoside hydrolases tested. Saposin A has two potential glycosylation sites that appear to be glycosylated. After deglycosylation, saposin A had a subunit molecular mass of 10 kDa and was as active as native saposin A. However, reduction and alkylation abolished the activation. A three-dimensional model comparing saposins A and C reveals significant sequence homology between them, especially preservation of conserved acidic and basic residues in their middle regions. Each appears to possess a conformationally rigid hydrophobic pocket stabilized by three internal disulfide bridges, with amphipathic helical regions interrupted by helix breakers. PMID- 2717622 TI - Increased plasma levels of platelet-derived growth factor activity in patients with progressive systemic sclerosis. AB - We measured mitogenic activity of whole blood serum and platelet-poor plasma derived serum of a group of 10 patients with progressive systemic sclerosis and of 8 controls. Mitogenic activity of plasma-derived serum was greater in patients than in controls, in the absence of other signs of platelet activation. This increased activity was inhibited by specific antibodies, anti-platelet derived growth factor, suggesting that circulating levels of platelet-derived growth factor may be present in progressive systemic sclerosis patients. Platelet derived growth factor, released either by platelets or by monocytes, might play a role in the pathogenesis of scleroderma. PMID- 2717621 TI - Gestational changes in calbindin-D9k in rat uterus, yolk sac, and placenta: implications for maternal-fetal calcium transport and uterine muscle function. AB - Calbindin-D9k was quantified and its cellular location was defined in uterus, yolk sac, and placenta. In late gestation (days 17 to term) coordinated induction of calbindin-D9k was seen in uterine epithelial lining cells and juxtaposed yolk sac visceral epithelium as well as the intraplacental yolk sac epithelium. The induction of calbindin-D9k in these cells coincided with the time of exponential fetal bone growth and maximal fetal accumulation of calcium, suggesting a role of the protein in these epithelial layers in maternal-fetal calcium transport. Dynamic changes also occurred in the calbindin-D9k contents of the two layers of uterine smooth muscle (outer longitudinal and inner circular) during mid- and late gestation. During early pregnancy (days 0-4), calbindin-D9k was present in the two smooth muscle layers. By midgestation (day 10), calbindin-D9k had decreased by a factor of 10 in these tissue layers. During late gestation calbindin-D9k rebounded in the inner circular smooth muscle layer. These uterine changes of early and midgestation were reproduced by the endocrine changes of pseudopregnancy. Progesterone appeared to be a good candidate for controlling the midgestational decrease of uterine muscle calbindin-D9k, as it blunted estrogen's induction of the protein in the muscle layers and stroma in a dose-dependent manner. Changes in myometrial calbindin-D9k may reflect variations in muscular calcium storage, thereby representing alterations in potential for contraction. PMID- 2717624 TI - Distribution of alpha-aminoisobutyric acid in tissues of lean and genetically obese mice. AB - Distribution of tracer amounts of the nonmetabolizable neutral amino acid alpha [1-14C]aminoisobutyric acid (AIB) between blood and several tissues was measured in lean and ob/ob mice over an 8-hr period. As AIB was injected on the basis of body weight and as ob/ob mice have a relatively low blood volume, absolute concentrations of AIB in blood and tissues were almost always higher in the obese than the lean mice. However, the ratio of AIB concentration in the tissues to that in the blood was clearly higher in skeletal muscle, diaphragm, and brain, and possibly higher in liver of the lean than of the obese animals. Ratios in heart were similar. The results suggest that lean and genetically obese mice differ in their capacity to transport amino acids between blood and various tissues. PMID- 2717623 TI - Elevated glutathione reductase activity coefficients in erythrocytes after treatment in vitro with inosine and adenine. AB - Normal erythrocytes incubated with inosine and adenine in an acid citrate/dextrose medium underwent a marked, but reversible, loss of glutathione reductase activity reflected by erythrocyte glutathione reductase activity coefficients in the range 3.21 +/- 0.39. The system therefore appears to simulate riboflavin deficiency in isolated red cells as assessed by this index. Deactivation was dependent on cell metabolism and was inhibited by treatment with methylene blue, ascorbate, and fluoride or by low temperature. The rate of deactivation was greatly increased by lowering the pH and by the presence of phosphate ions. PMID- 2717625 TI - Total exchangeable sodium in rats with mestranol-induced hypertension. AB - Rats were fed a diet containing mestranol, an orally active estrogen, while control rats were fed the same diet without mestranol. After 6 months of these diets, the rats were weighed, blood pressures were measured, and total exchangeable sodium was determined by injecting 24Na and determining the amount of 24Na in the plasma, the plasma Na concentration, and the residual 24Na in each rat. The 16 mestranol-treated rats were hypertensive (mean arterial pressure 135 +/- 3 mm Hg) when compared with the 17 controls (116 +/- 3 mm Hg). Total exchangeable sodium in the mestranol-treated rats averaged 39.94 +/- 0.49 (SEM) mEq/kg body wt, which was very similar to the value of 39.87 +/- 0.63 mEq/kg found in the control rats. Thus, no changes in total exchangeable sodium in mestranol-hypertensive rats were found in these studies. PMID- 2717626 TI - Nickel absorption and kinetics in human volunteers. AB - Mathematical modeling of the kinetics of nickel absorption, distribution, and elimination was performed in healthy human volunteers who ingested NiSO4 drinking water (Experiment 1) or added to food (Experiment 2). Nickel was analyzed by electrothermal atomic absorption spectrophotometry in serum, urine, and feces collected during 2 days before and 4 days after a specified NiSO4 dose (12 micrograms of nickel/kg, n = 4; 18 micrograms of nickel/kg, n = 4; or 50 micrograms of nickel/kg, n = 1). In Experiment 1, each of the subjects fasted 12 hr before and 3 hr after drinking one of the specified NiSO4 doses dissolved in water; in Experiment 2, the respective subjects fasted 12 hr before consuming a standard American breakfast that contained the identical dose of NiSO4 added to scrambled eggs. Kinetic analyses, using a compartmental model, provided excellent goodness-of-fit for paired data sets from all subjects. Absorbed nickel averaged 27 +/- 17% (mean +/- SD) of the dose ingested in water vs 0.7 +/- 0.4% of the same dose ingested in food (a 40-fold difference); rate constants for nickel absorption, transfer, and elimination were not significantly influenced by the oral vehicle. The elimination half-time for absorbed nickel averaged 28 +/- 9 hr. Renal clearance of nickel averaged 8.3 +/- 2.0 ml/min/1.73 m2 in Experiment 1 and 5.8 +/- 4.3 ml/min/1.73 m2 in Experiment 2. This study confirms that dietary constituents profoundly reduce the bioavailability of Ni2+ for alimentary absorption; approximately one-quarter of nickel ingested in drinking water after an over-night fast is absorbed from the human intestine and excreted in urine, compared with only 1% of nickel ingested in food. The compartmental model and kinetic parameters provided by this study will reduce the uncertainty of toxicologic risk assessments of human exposures to nickel in drinking water and food. PMID- 2717627 TI - The effect of estradiol on collagen structure and organization in the immature rat uterus. AB - An examination of collagen ultrastructure in the lamina propria of the immature ovariectomized rat uterus revealed that a single injection of estradiol (40 micrograms/kg) produced a biphasic effect on collagen structure and organization. In saline-treated animals (controls) dense populations of collagen bundles were seen throughout the extracellular matrix (EX). Cross-sections of these bundles suggested that the bundles run parallel to the long axis of the uterus and thin filaments seemed to form cross-links between collagen fibers. In contrast, large clear spaces, collagen fragments, and loosely packed bundles of collagen were observed in the EX of animals injected with estradiol 24 hr earlier. In a time course study (0, 1, 2, 4, 24, and 48 hr), estradiol treatment altered collagen structure and organization 1 hr following administration. Collagen bundles did not appear to be as densely packed as in control tissues and large clear spaces were evident in the EX. Two hours following estrogen administration, collagen fibers appeared to be fragmented and seemed to be separating from the plasma membrane of stromal cells. Four hours following estrogen administration, large clear spaces occupied most of the EX in the lamina propria. Collagen fragments were diffusely distributed throughout the EX and small cross-sectional patches of collagen bundles were present. In 48-hr-treated animals, collagen bundles reappeared and were often closely associated with the plasma membrane of stromal cells. The collagen was not as abundant as in control animals. An overview of the cellular organization of the lamina propria revealed that stromal cells in control tissues were more densely packed than in estradiol-treated tissues (4, 24, and 48 hr) and the stromal cell size appeared to increase in hormone-treated tissues. These responses provide a good model system to study the role of estradiol in the control of collagen structure and organization in the uterus. PMID- 2717628 TI - Relationship between milk composition and pup's growth in mice. AB - The effect of lactation numbers (first, second, and third) on milk composition and the relationship between milk composition and pup's growth were examined in four strains of mice (SHN, SLN, C3H/He, and GR/A). Although the percentage of milk fat and moisture increased and decreased, respectively, through the first to third lactations in C3H/He mice, no differences in milk composition among lactation numbers were observed in the other mouse strains. In pooled data derived from the four strains of mice, there was no significant correlation between milk composition and body weight or growth rate of pups on Day 12 or 20 of the first lactation. In contrast, the amount of milk fat and moisture was the positively and negatively, respectively, correlated with the pup's growth parameters during the second and third lactations. This was reflected by a lower fat content and a higher moisture content in the milk of GR/A mice, especially evident during the second and third lactations and reduced pup's growth, when compared with the other mouse strains. Milk lactose and ash content was not correlated with pup's growth parameters. The results of our study stress the importance of milk fat for the growth of mouse pups. PMID- 2717629 TI - Effects of compound 48/80 and exogenous histamine on wound healing in mice. AB - Compound 48/80 has previously been shown to improve wound healing in rats, presumably through stimulation of histidine decarboxylase activity and mobilization of histamine from mast cells. In the present study, C57Bl/6 mice were wounded by dorsal skin incision followed by treatment with compound 48/80, exogenous histamine, or the combination of 48/80 plus histamine. Skin-breaking strength was significantly increased over saline-injected controls by the combined treatment with 48/80 and histamine. Neither 48/80 or histamine alone had any influence on wound healing. Histamine content of skin at the wound site was significantly reduced by 48/80 treatment, but was unaffected by 48/80 plus histamine or histamine given alone. In contrast, stomach and leg muscle histamine levels were significantly increased beyond those of unwounded, wounded saline- or 48/80-injected mice. These results were also confirmed in CD mice, and are in contrast to findings in rats in which treatment with 48/80 alone significantly improved wound healing of similarly injured animals. PMID- 2717630 TI - The age gap: teaching students about health education for the elderly. AB - In learning about caring for elderly people, student nurses need to be aware of their attitudes to the elderly and also what they themselves perceive to be their health needs. PMID- 2717631 TI - Delayed pressure sore healing can be prevented. AB - Delayed pressure sore healing is still a costly problem despite the advances in knowledge on wound healing. PMID- 2717632 TI - Cervical cancer: a preventable problem. AB - Incidence of cervical cancer appears to be increasing among younger women. With effective screening, treatment and health education, it is almost entirely preventable. PMID- 2717633 TI - Infection control: reducing the risk to medical patients. AB - Patients on medical wards are at risk of infections, both from their conditions and invasive procedures carried out on them. Scrupulous infection control by nurses can do much to reduce this risk. PMID- 2717634 TI - What are the legal implications of extended nursing roles? AB - There is an ever increasing expectation for nurses to take on extended roles. What are the legal implications of this, and are nurses made sufficiently aware of their position? PMID- 2717635 TI - Blood glucose monitoring in diabetic control. PMID- 2717636 TI - Wales is a front runner in nursing development. PMID- 2717637 TI - Immunity to cancer II. Proceedings of the Second Conference on Immunity to Cancer. Williamsburg, Virginia, November 9-11, 1987. PMID- 2717638 TI - The potential immunoregulation of metastases: the use of transfection to produce immunogenic tumor cells. PMID- 2717639 TI - Role of novel adjuvants in specific active immunotherapy. PMID- 2717640 TI - Laser-induced selective cytotoxicity using monoclonal antibody-chromophore conjugates. PMID- 2717641 TI - DU-PAN-2, mucin type differentiation antigen of normal and malignant pancreatic ductal cells. PMID- 2717642 TI - A monoclonal antibody (B72.3) to adenocarcinoma of the colon and related tumors. PMID- 2717643 TI - Human monoclonal antibodies. PMID- 2717644 TI - Human monoclonal antibodies to human leukemias. Initial characterization of specificities and antigens. PMID- 2717645 TI - [Biopharmaceutic aspects of prolonged-release formulations with a methylxanthine base. I]. PMID- 2717646 TI - [A quick DC method for simultaneous quantitative determination of paracetamol, caffeine, phenobarbital and propyphenazone in plasma]. AB - A fast and simple method for the simultaneous quantification of Paracetamol, Caffeine, Phenobarbital and Propyphenazone in plasma using diffuse reflectance measurements on hptlc-plates is described. The concentration range is from 0.5 to 2.5 micrograms/microL plasma for Paracetamol, Caffeine and Propyphenazone, and from 0.25 to 1.0 micrograms/microL plasma for Phenobarbital. The precision is 0.2 micrograms/microL. PMID- 2717647 TI - Effects of roll mixing with beta-cyclodextrin on enhancing solubilities of water insoluble drugs. AB - To increase a solubility of water insoluble drugs by the use of roll mixing with beta-cyclodextrin (CyD), equilibrium concentrations of ten medicinal drugs indomethacin, griseofulvin, nifedipine and so on were examined in comparison with those of different mixed systems as kneading with water and physical mixing. The equilibrium concentration of drug in the roll mixed systems was more advantageous than the others excluding the systems of cortisone acetate (CA), and it increased apparently as compared to the solubility of the drugs except for kitasamycin. Almost all of drugs being a crystalline state turned readily to an amorphous form by the procedures of roll mixing with CyD. The amorphous product roll mixed with CA or diethylstilbestrol (DB) changed to the crystalline form due to the inclusion complexes of CyD in X-ray diffraction patterns, when these were exposed on humidifing atmospheres of relative humidity (RH) 97% for 24 hours. The another roll mixed products exhibited the crystalline pattern of the hydrated CyD. Apparent increases in the solubility of drug roll mixed were expected to relate a formation of inclusion compounds or certain molecular interactions between the drug and CyD, which was based upon slight changes in absorption bands on IR spectra. PMID- 2717648 TI - [Purification, glucose-6-phosphate dehydrogenase inhibition, and HPLC analysis of four 1,8-dihydroxyanthrones]. AB - With regard to the examination of their antipsoriatic properties, four 1,8 dihydroxyanthrones were prepared in a purity greater than 99%: Dithranol (1, anthralin) by chromatographic purification, chrysarobin (2) either by work-up from commercial chrysarobin or by an oxidative cleavage (FeCl3) of aloin, followed by a reduction (SnCl2/HCl) of the produced anthraquinone derivative (6), aloe emodin anthrone (3) by the action of aquous sodium tetraborate on aloin and frangula emodin anthrone (4) by the SnCl2/HCl-reduction of frangula emodin (7) isolated from the dry extract of the bark of alder buckthorn. UV/VIS, IR, 1H-NMR and mass spectra confirmed the structures of the four anthrones which all distinctly inhibited G-6-P dehydrogenase (0.05 mmol, desactivation in 6 h). For clinical studies the anthrones were incorporated into white petrolatum with exclusion of oxygen (under Ar). The anthrone content of the preparations was determined by HPLC (LiChrosorb RP-18, 7 microns [280 x 4 mm]; 1.5 ml/min MeOH/water/HOAc [80:20:0.2]) after extraction with CH2Cl2 (tR = 1: 10.4 min, 2: 15.3 min, 3: 4.7 min, 4: 7.7 min). PMID- 2717649 TI - Freeze-drying of emulsions--influence of congealing on granulometry research of a cryoprotective agent. AB - Emulsions of three different size distributions and five oil/water ratios of the finest of these distributions were congealed according to three different congealing processes before the freeze-drying operation. The influence of the various cryoprotective agents added was studied and the size change of the dispersed phase after congealing was examined. PMID- 2717650 TI - Simultaneous determination of prostaglandins (PG) E2, A2 and B2 and stability studies of PGE2 in pharmaceutical preparations by ion-pair reversed phase HPLC. AB - In previous reports a direct thin-layer chromatographic method (TLC) for the determination of prostaglandins (PG) E2, A2, B2 and F2 alpha and a High Performance Liquid Chromatographic method (HPLC) for the determination of PGE2-, PGA2- and PGB2- descendants and for stability studies of PGE2-descendant in pharmaceutical preparations were described In this paper the described HPLC method and a newly developed technique based on ion-pair HPLC are given for the simultaneous determination of PGE2, PGA2 and PGB2 and for the stability studies of PGE2 in pharmaceutical preparations. The extraction of PG's from pharmaceutical preparations is performed in a fully automated, electronically controlled extraction apparatus within 3 minutes. Ion-pair reversed phase HPLC is performed on a column of LiChrosorb RP18 using either methanol-water-octan-1 sulfonic acid sodium salt (55 ml + 45 ml + 65 mg) or methanol-water tetrabutylammoniumperchlorate (360 ml + 290 ml + 1.0 g) as eluent. HPLC separation can also be performed on a column of mu-Bondapack C18 using methanol-n butanol-glacial acetic acid-water (350 ml + 45 ml + 5 ml + 400 ml) as solvent. The stability of PGE2 is investigated in pure substance, in ethanolic-aqueous solution, in absolute ethanolic solution and in freeze-dried ampoules. The examined preparations are stored at temperatures between 4 and 40 degrees C and are investigated periodically. The stability studies of PGE2 indicate that PGA2 and PGB2 are formed as degradation products of PGE2. The prediction of the stability studies of PGE2 indicate that this active drug is unstable in pure substance as well as in pharmaceutical preparations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717651 TI - A study of evening primrose seed oil in atopic asthma. AB - It has shown recently that Evening Primrose Oil (Efamol) produces a significant clinical improvement in atopic eczema. Efamol contains gamma-linolenic acid which is a precursor to PGE1 a more consistent bronchodilator than PGE2. We have conducted a double blind placebo controlled study in atopic asthmatics given Efamol for an eight week period looking at the control of asthma, including histamine challenge tests. We have found no effect on the asthma or challenge tests although Efamol produced an alteration in fatty acid profile. The patients showed an abnormal fatty acid profile. We speculate that such fatty acid abnormalities could be important in the aetiology of asthma. PMID- 2717652 TI - The prostaglandin outflow from perfused mesenteric vasculature of rats fed different fats. AB - The effects of dietary n-6 polyunsaturated fatty acids and replacement with saturated fat or fish oil on the prostaglandin outflow from perfused mesenteric vasculature in rats were studied. Seventy-two weanling male rats were fed ad libitum a semi-synthetic diet supplemented with 10% by weight of oil, composed wholly of n-6 fatty acid-rich evening primrose oil, or replaced partly or completely (25, 50, 75 or 100%) by n-6 fatty acid-deficient fish oil or hydrogenated coconut oil for 8 weeks. The outflows of 6-keto-PGF1 alpha, thromboxane B2, and prostaglandin E from the perfused mesenteric vasculature were measured at 60 min-time point after starting the perfusion. In general, the release of prostanoids from the mesenteric vasculature was significantly reduced in rats fed a diet in which evening primrose oil was partly or completely replaced by either hydrogenated coconut or fish oil. This was probably due to the insufficient conversion of linoleic acid to arachidonic acid. The extent of reduction was greater in fish oil-fed than in hydrogenated coconut oil-fed rats, while the levels of arachidonic acid in aortic phospholipids were similar between these two groups. This result implies that the greater reduction of prostaglandin synthesis in rats fed fish oil was due to the inhibitory effect of eicosapentaenoic and docosahexaenoic acids in fish oil on the conversion of arachidonate to eicosanoids. PMID- 2717653 TI - Amniotic fluid concentration of 5-hydroxyeicosatetraenoic acid is increased in human parturition at term. AB - 5-hydroxyeicosatetraenoic acid (5-HETE) is an arachidonate lipoxygenase product capable of stimulating uterine contractility in a dose-dependent manner in vitro. The purpose of this study was to determine if spontaneous human labor at term is associated with changes in the concentration of this metabolite in amniotic fluid. Fluid was retrieved from 36 women not in labor and from 30 women in active labor at term. 5-HETE was determined by radioimmunoassay. The median amniotic fluid concentration of 5-HETE of women in labor was significantly greater than that of women not in labor (3538 pg/ml vs. 1977 pg/ml, respectively; p = 0.05). This observation is consistent with activation of the lipoxygenase pathway of arachidonic acid metabolism during spontaneous human parturition at term. PMID- 2717655 TI - Platelet function--the role of essential fatty acids and eicosanoids. PMID- 2717654 TI - A biphasic response of urinary prostaglandin E2 excretion to water deprivation in conscious diabetes insipidus Brattleboro rats. AB - The effects of water deprivation on the urinary excretion rate of prostaglandin E2 (PGE2) were examined in conscious Brattleboro rats. In order to study the time course of the changes in the PGE2 excretory rate, urine was collected in 6 periods, CONTROL: 0-1 hour (h.). 1: 3-4.5 h., 8-10 h., III: 12-15 h., IV: 24-28 h. and V: 32-36 h. after removal of water and food. It was found that the PGE2 excretion rate changed in a biphasic pattern. During the first 2 experimental periods it increased. Thereafter it decreased towards the control value. There was an increase in PGE2 excretion with urinary flows down to 3 microliter/(min*100 g b. wt). At further reductions in urinary flow rate, PG excretion decreased towards basal levels. PMID- 2717656 TI - [Gum acacia, acacia gum. The substituents of a type of gum arabic from Africa]. PMID- 2717657 TI - [Feasibility of isolating and purifying thymidine kinases with the use of affinity chromatography]. PMID- 2717658 TI - Clinical efficacy of carbamazepine in affective, schizoaffective, and schizophrenic disorders. AB - The therapeutic effects of carbamazepine (CBZ) were evaluated in 103 patients with affective disorders, 54 with schizophrenic disorders, and 26 with schizoaffective disorders by a multi-institutional open study. The rate of marked and moderate improvement was 72.8% in affective disorders, 54.6% in schizophrenic disorders, and 61.5% in schizoaffective disorders. Symptom items of the Clinical Psychopharmacology Research Group rating scale for mania showed significant improvement in the patients with affective disorders as well as in those of the other two groups. In the Brief Psychiatric Rating Scale as applied to patients with schizophrenic or schizoaffective disorders, symptom items related to affect and emotion showed significant improvement. The antimanic efficacy of CBZ was also noted in many poor responders to lithium. Side-effects were observed in 82 patients (44.8%), and abnormal laboratory findings in 37 patients (44.8%), and abnormal laboratory findings in 37 patients. The present study seems to confirm the usefulness of CBZ for the treatment of affective disorders and in some cases, of schizophrenic and schizoaffective disorders. PMID- 2717659 TI - The prevalence of psychoactive drug intake in a metropolitan population. AB - Together with a survey conducted among the population of Vienna on the prevalence of hypertension, the consumption of psychotropic substances was investigated. In cooperation with a polling institute a quota-sample of 1,470 Viennese over 15 were visited in their homes by 50 physicians trained in interview techniques. The quota-sample comprised 1,470 people (0.959(0/00) of the population of 1,531,346 inhabitants) and was representative in terms of age, sex, social status, and area of residence. The overall prevalence of psychoactive drug consumption among the inhibitants of Vienna investigated was found to be 6.8%. The female to male ratio was 3.5 to 1. Furthermore, psychoactive drug use increased with age and was influenced by social status, with the highest consumption rate found among divorced women and widows. Using the Goldberg "General Health Questionnaire", data were collected on the presence of psychopathologic symptoms and the responders' subjective feeling of being under stress was elicited. A significant correlation could be shown between these two factors and the use of psychoactive drugs. The type of drugs most frequently used were tranquilizers (4.96%), followed by antidepressants (0.95%) and hypnotics (0.88%). PMID- 2717660 TI - Computerized documentation for lithium outpatients (routine and research data). AB - To follow up the status and further outcome of patients with recurrent affective and schizoaffective disorders treated in a lithium/prophylactic treatment outpatient (LOP) clinic the authors have developed a documentation system based on a database, which ASCII files. This system should be useful as a basis for optimal treatment and is helpful for special research purposes regarding prophylactic treatment (lithium salts, carbamazepine, antidepressants, etc.). The documentation system consists of two parts, one for routine documentation system consists of two parts, one for routine monitoring including basic data, global course, and routine form with side-effects, and another one for research purposes with documentation of laboratory findings, EEG, and documentation of every cycle which can be added easily. Moreover, with this documentation system it will be possible to compare results from different research centres. PMID- 2717661 TI - The syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). AB - Though the acute complications of lithium toxicity involving the central nervous system have been known for more than 70 years, it is only recently that the longlasting sequelae of lithium intoxication have come to be discussed at length; about fifty-five cases have been reported so far. The acronym SILENT (Syndrome of Irreversible Lithium-Effectuated Neurotoxicity) has been coined recently to denote these sequelae. The present report describes the typical profile of SILENT (persisting cerebellar dysfunction) and suggests measures to decrease the incidence of this potentially serious condition, for which no definitive treatment is available. PMID- 2717662 TI - Lithium treatment of a patient with Addison's disease and affective psychosis. AB - A female patient born in 1941, who suffers from affective psychosis and Addison's disease, first received lithium carbonate in 1983 during a severe, therapy resistent depression. With lithium treatment she showed a considerable improvement. In the following months, with a daily dosage of 24.4 mmol, the blood lithium levels were between 0.8 and 0.9 mmol/l. One year later she suffered a severe lithium intoxication after a virus infection. Shortly afterwards, she had a manic and then a depressive phase. She was now put on a regimen of with 12.2 mmol lithium carbonate per day, which produced blood levels between 0.3 and 0.4 mmol/l. In the following years, values of about 0.9 mmol/l were observed several times, therapy and clinical condition remaining unchanged. These spontaneous fluctuations of the blood lithium level, a hitherto unreported phenomenon are discussed as a possible cause of the lithium intoxication. The consequences for clinical practice are outlined. PMID- 2717663 TI - Lowered platelet [3H]-imipramine binding in panic disorder: reality or statistical artifact? PMID- 2717664 TI - Affective state and voice: results of a pilot study with six depressive patients. AB - As part of an investigation into the nonverbal information in human speech, a pilot study with depressive patients was designed in order to model the global affective state as a function of time and in terms of speech parameters. Over a two-week period, six patients were examined six times at two-day intervals under comparable experimental conditions. The psychopathologic status of these patients was assessed during a psychiatric exploration half an hour before the actual examination was carried out. Besides the solution of the baisc methodological problems, a principal goal of this study was to test the ability and cooperation of depressive patients when asked to speak in the laboratory. It turned out that even scalar parameters such as energy and dynamics give insight into the intraindividual variation of global affective state, and that the examination procedure is practicable even it patients are considerably handicapped by their illness. PMID- 2717665 TI - Dopaminergic and serotoninergic influence on duration discrimination and vigilance. AB - There is some evidence from animal studies suggesting that dopamine (DA) agonists speed up a hypothesised internal clock, whereas DA antagonists such as haloperidol slow down the clock rate. Furthermore, clinical studies on haloperidol have reported significant deficits in duration discrimination performance (DD). Two double-blind balanced crossover studies with 24 healthy male volunteers each were designed to answer the following questions: 1. Do the DA agonists L-dopa and the DA antagonist haloperidol induce changes in DD? 2. Do the 5-HT uptake inhibitor fluoxetine and the 5-HT receptor antagonist ritanserin induce changes in DD? 3. Can any relationship be demonstrated between changes in DD and changes in vigilance? Haloperidol produced a marked decrease in DD, whereas for the DA agonist no changes could be demonstrated. Performance in DD was slightly improved by the 5-HT agonist and the 5-HT antagonist. Both dopaminergic and serotoninergic changes in DD seemed to be independent of the level of vigilance. PMID- 2717666 TI - The photophysical properties of some C15 lupine alkaloids: sparteine, lupanine, thermospine, and alpha-diplospartyrine. PMID- 2717667 TI - Cytotoxic and mutagenic effects of the photodynamic action of chloroaluminum phthalocyanine and visible light in L5178Y cells. PMID- 2717668 TI - The 'Q-band' absorption spectra of hematoporphyrin monomer and aggregate in aqueous solution. PMID- 2717669 TI - Enhancement of UV-induced skin carcinogenesis by azathioprine: role of photochemical sensitisation. PMID- 2717670 TI - Photo-CIDNP evidence for charge-transfer interaction between synthetic water soluble porphyrins and guanine. PMID- 2717671 TI - Influence of dietary menhaden oil upon carcinogenesis and various cutaneous responses to ultraviolet radiation. PMID- 2717672 TI - [The scientific problems of nursing]. PMID- 2717673 TI - [Take care of your legs!]. PMID- 2717674 TI - [Leave of absence everyday]. PMID- 2717675 TI - [The "mysteries" of the entrance exam]. PMID- 2717676 TI - [From the experiences of the school commander of the Voluntary Labor Corps]. PMID- 2717677 TI - [Spinal injuries with damage to the spinal cord]. PMID- 2717678 TI - [The silent epidemic--chlamydial infections]. PMID- 2717680 TI - [Music lessens anxiety]. PMID- 2717679 TI - [Classification of the methods of nursing work]. PMID- 2717681 TI - [Care and the patients on respirators]. PMID- 2717682 TI - [The function of the anesthesiological nurse]. PMID- 2717683 TI - [Community health nurses and alcohol drinking]. PMID- 2717684 TI - The effect of gomisin A on immunologic liver injury in mice. AB - The hepatoprotective effect of Gomisin A (TJN-101), which is a lignan compound isolated from Schizandra fruits, was studied on three immunologic liver injury models in mice. The first liver injury model was produced by the injection of anti-basic liver protein (BLP) antibody into DBA/2 mice which had been previously immunized with rabbit IgG (RGG). Other models were effected by injection of anti liver specific protein (LSP) antibody into DBA/2 mice or by the injection of bacterial lipopolysaccharide (LPS) into ddY mice pretreated with Corynebacterium parvum (C. parvum). TJN-101 inhibited the elevation of transaminase (GOT and GPT) activities and showed the tendency to inhibit the histopathological changes of the liver in all models. Moreover, TJN-101 inhibited deoxycholic acid-induced release of transaminase from cultured rat hepatocytes in vitro, but did not affect the formation of hemolytic plaque forming cells in immunized mice spleens and hemolytic activity of guinea pig complement in immunohemolysis reaction. These results, therefore, suggested that the hepatoprotective effect of TJN-101 could be related to the protecting effect of hepatocyte plasma membrane rather than the inhibiting effects of the antibody formation and complement activity. PMID- 2717685 TI - Studies of Panax japonicus fibrinolysis. AB - The effects of a 70% methanol extract (PMe) obtained from the rhizomes of Panax japonicus C. A. Meyer on experimental thrombosis and fibrinolysis were investigated in vivo and in vitro. PMe showed a promotive effect on the activation of the fibrinolytic system as determined by the euglobulin lysis time (ELT) assay but was inactive to the inhibitory effect against endotoxin-induced disseminated intravascular coagulation (DIC) in rats. PMe and its major components, chikusetsusaponin III, IV, and V, strongly promoted the action of urokinase in fibrin plate. These results suggested that PMe promotes the fibrinolysis and its effective components are chikusetsusaponin III, IV, and V. PMID- 2717686 TI - Inhibition of mouse liver sialidase by the root of Scutellaria baicalensis. AB - Of 266 Chinese crude drugs, the hot water extract from the root of Scutellaria baicalensis showed potent mouse liver sialidase inhibitory activity; in addition, wogonin, wogonin glucuronide, baicalein, and baicalin were identified as the inhibitors. These flavonoids showed almost the same inhibitory activity when 50 125 micrograms/ml doses of the samples were used for the assay, while wogonin and baicalein showed a more potent activity than wogonin glucuronide and baicalin at the lower concentration (10 micrograms/ml). However, these flavonoids, except wogonin, showed negligible inhibitory activity against Arthrobacter ureafaciens sialidase. These results indicated that S. baicalensis extract contains the sialidase inhibitors which are specific to mouse liver sialidase. PMID- 2717687 TI - The complex nature of the mechanism of toxicity of antibiotic dithiacyclohexadiene polyines (thiarubrines) from the asteraceae. AB - Thiarubrine A, a dithiacyclohexadiene polyine from the roots of Chaenactis douglasii, and a related dithiacyclohexadiene from Rudbeckia hirta exhibit strong light-independent antibacterial and antifungal activity. This activity is enhanced by exposure to visible light. Visible light also converts the compounds to the corresponding thiophenes. These are antibiotic only when irradiated with UV-A. Dithiacyclohexadienes are the first polyines to exhibit such complex mechanisms of toxicity towards microorganisms. PMID- 2717688 TI - New hepatoprotective triterpenes from Canarium album. AB - Canarium album has yielded seven triterpenes of which two appear to be novel. The new triterpenes, which were identified on the basis of spectral characteristics, are urs-12-ene-3 alpha, 16 beta-diol and olean-12-ene-3 alpha, 16 beta-diol. Both compounds exhibited hepatoprotective activity in primary cultured rat hepatocytes intoxicated with D-galactosamine. PMID- 2717689 TI - Antihepatotoxic principles of Solanum capsicastrum. AB - Two new steroidal alkaloids named capsimine and isocapsicastrine were isolated from the root bark of Solanum capsicastrum. Their structures were elucidated by chemical degradation and spectral data as (22R, 25R)-22,26-epiminocholest-5-ene-3 beta, 16 alpha-diol and (22S,25S)-O(3)-beta-D-glucopyranosyl-22,26-epiminocholest 5-ene-3 beta-16 alpha-diol, respectively. Capsicastrine, capsicastrine acetate, isoteinemine acetate, and etioline exhibited strong activity against liver damage induced by CCl4. PMID- 2717690 TI - Possible active components of tan-shen (Salvia miltiorrhiza) for protection of the myocardium against ischemia-induced derangements. AB - Extract of Tan-Shen (Salvia miltiorrhiza, Labiatae), a Chinese traditional crude drug, was reported to show beneficial activity for heart disease. Chemical examination on the extract was performed on the basis of screening for protective action on the ischemic myocardium. Isolated hearts were subjected to hypoxic perfusion for 20 min, followed by 45 min reoxygenation, and the recovery of cardiac contractile force and changes in UV absorbance of the perfusate were examined. Among the components isolated, tanshinone I, cryptotanshinone, and tanshinone VI elicited a significant enhanced recovery of the contractile force upon reoxygenation. This was associated with a decrease in the increase in UV absorbance of the perfusate, suggesting the preservation of ATP metabolites in the myocardium. This, in turn, may enhance the restoration of ATP upon oxygen replenishment. The results suggest that tanshinone I, cryptotanshinone, and tanshinone VI can protect the myocardium against ischemia-induced derangements. PMID- 2717691 TI - Quantitative determination of allantoin in Dioscorea rhizome and an Oriental pharmaceutical preparation, hachimi-gan, by high-performance liquid chromatography. PMID- 2717692 TI - [The significance of theory formation in psychosomatic medicine. Presentation at the symposium "Research results in psychosomatic medicine" on the occasion of presenting an honorary doctorate to Prof. Dr. med. H. Weiner]. PMID- 2717693 TI - [The psychology of separation: animal experiments in psychosomatic medicine]. PMID- 2717694 TI - [Socio-psychosomatic aspects of cardiovascular risk factors]. PMID- 2717695 TI - [Psychotherapy of acute suicidality. "The anti-suicide promise" as a method of preventing suicide]. AB - A trustful therapeutic relationship is considered to be the most important suicide-preventing measure. Furthermore, it has frequently been recommended to have the severely suicidal patient promise not to commit suicide within a certain period of time. Using three clinical examples the unreliability of this suicide preventing method is demonstrated. When the patient can give such a promise responsibly, it probably is no longer necessary. Also, the patient's giving such a promise can negatively influence the development of the therapeutic relationship. A reciprocal contract should be preferred: the patient contacts the therapist whenever he feels to loose control over his suicidal potential whereas the therapist offers his availability to the patient. PMID- 2717696 TI - [Risk factors of classical conversion syndrome--psychogenic seizures and paralyses--observations at a neurologic clinic with 172 patients]. AB - Classical hysterical syndromes are not seldom today, either. In report on 172 patients with psychogenic fits (55% of them) or hysterical paralysis (45%) we found females preponderant in 2/3 of the cases. The beginning of symptoms was more frequent at an adolescent stage of 15 to 25 years of age and between 45 and 55. Nearly half the cases had no profession or were unskilled workers of lower strata in society. 80% of all cases have had severe conflicts or social problems in childhood or later in life. Men demonstrated more frequently professional problems: while female patients more often had problems in relationships. Younger patients were in 12% of the cases burdened with perinatal brain damages. 25% of patients with severe conversion reactions had been operated on for gastric or duodenal ulcers. Numerous occasions for symptoms manifestation are described. Long-lasting syndromes we found especially in women and in cases of psychogenic paralysis. PMID- 2717697 TI - [Effectiveness of a patient-centered psychosomatic consultation service. Report of a catamnestic study]. AB - After a short review of the latest scientific publications on psychosomatic consultation activity the results of an empirical study of the consultant service in the Department of Psychotherapy and Psychosomatic Medicine at the Frankfurt University Medical Center are presented. Patient documentations and data from a retrospective investigation were analysed in order to trace the effectivity of psychosomatic consultation activities. To document the various dimensions of the consultative process and their interdependence different groups of patients were derived by means of cluster analysis. The results are in many aspects encouraging for psychosomatic consultative practice, as they show that even few consultations can have an important influence on the patient's further development. PMID- 2717698 TI - [The significance of stressful life events and their management in patients with rheumatoid arthritis, essential hypertension and stomach and duodenal ulcer]. AB - In a multivariate approach critical life events and coping in 126 patients with rheumatoid arthritis, hypertension and gastrointestinal ulcers as well as healthy persons are researched with regard to their nosological meaning and their relationship to relevant clinical parameters. They answered a multi-dimensional coping questionnaire and an inventory which measures and evaluates individual relevant life events. With regard to this, different clinical information war processed. On the basis of the above named parameters, the four groups could be distinguished from one another. The interrelationship between psychosocial variables and clinical indices can be neglected. PMID- 2717699 TI - [The medicine of human relations. Remarks on receiving an honorary doctorate of medicine from the Munich Technical University, 14 November 1988]. PMID- 2717700 TI - Factors determining the digestive efficiency of the domesticated donkey (Equus asinus asinus). AB - Factors determining the digestive efficiency of donkeys were studied in animals fed either a low quality roughage (wheat straw: 77.1% neutral detergent fibre, 2.8% crude protein) or a high quality forage (alfalfa hay: 47.5% neutral detergent fibre, 22.7% crude protein). The neutral detergent fibre (NDF) intake when fed wheat straw was 1693 +/- 268 g animal-1 day-1, 10% higher than when fed alfalfa hay. Digestive coefficient of NDF and acid detergent fibre (ADF) when fed wheat straw amounted to 50.9 +/- 4.9 and 42.0 +/- 4.1% respectively. NDF and ADF apparent digestibilities and mean retention times (37.7 +/- 1.7 and 36.4 +/- 3.2 h respectively) were not significantly different (P greater than 0.05) between the two diets. The donkey appears to digest cell wall constituents as efficiently as the Bedouin goat when on low quality roughage, but less efficiently when fed alfalfa hay. Its energy digestibility is, however, as high as that reported for the Bedouin goat. The donkey's high energy digestibility is related to its capacity to digest soluble food components more efficiently than the ruminant. The mean retention time in the donkey is shorter than in the Bedouin goat and is consistent with its capacity to compensate for a lower quality diet by increasing its intake rate. Recycling of urea in donkeys maintained on wheat straw amounted to 75.5 +/- 13.0% of the entry rate. A decrease in the rate of renal urea filtration, coupled with an increase in the fraction reabsorbed, increased the retention of nitrogenous waste and permitted recycling of nitrogen into the gut. PMID- 2717701 TI - Effect of magnesium infusion on calcium handling in the rat kidney. AB - Anaesthesized rats were infused with 100 microliters min-1 of 0.9% saline or saline containing 2 or 4 mmol l-1 of magnesium chloride and renal function was studied. Magnesium had no effect on urine flow rate, excretion of sodium or potassium, or glomerular filtration rate (GFR). Infusion of either dose of magnesium increased calcium excretion and calcium concentration in the urine. The increased urinary calcium excretion is due to a decrease in tubular reabsorption of calcium. PMID- 2717702 TI - Glycogen metabolism and post-exercise ketosis in carbohydrate-restricted trained and untrained rats. AB - Liver and muscle glycogen, and blood 3-hydroxybutyrate concentrations were studied during and for 2 h after treadmill running for 1 h, in 144 carbohydrate starved trained and untrained rats. The resting liver glycogen concentration of the trained animals was 227 +/- 8 (mean +/- S.E.M.) mumol glucosyl units/g wet mass, compared with 162 +/- 12 mumol/g in the untrained animals. The muscle glycogen levels were 42 +/- 1 and 28 +/- 1 mumol/g respectively. Exercise reduced muscle and liver glycogen concentrations by approximately the same absolute amounts in both animal groups, leaving the trained rats with nearly 3 times as much residual glycogen as the untrained animals. There was very little resynthesis of muscle glycogen recovery, but the trained animals replenished approximately 43% of the liver glycogen used during exercise. The blood 3 hydroxybutyrate concentrations were negatively correlated with the simultaneous liver glycogen concentration of our experimental animals (r = -0.55; P less than 0.001). It is concluded that trained animals primarily owe their resistance to post-exercise ketosis to their large stores of glycogen. PMID- 2717703 TI - The effect of low mucosal pH on sodium and chloride movement across the isolated rumen mucosa of sheep. AB - Isolated sheets of sheep rumen mucosa were studied in vitro by using the Ussing chamber technique. The pH of the mucosal solution was altered by adding HCl. Using 22Na and 36Cl unidirectional fluxes of sodium and chloride were measured across the short-circuited and voltage-clamped rumen mucosa at mucosal pH 7.4 and 5.5. Lowering mucosal pH to 5.5 caused a rapid decline in the short-circuit current (Isc). The conductance (Gt) increased about 10 min after the drop in Isc. At pH 5.5, mucosal-to-serosal movement of Na+ and Cl- was decreased thus leading to a decreased net transport. These alterations were seen 30 min after mucosal acidification. They were intensified 120 min thereafter. Further studies showed that a clamped transmural potential difference (20 mV) influenced Na+ and Cl- transport only slightly more in acidified epithelia. Light and electron microscopy showed a swelling of the cells and especially of their mitochondria after acid exposure. These data indicate that lowering mucosal pH causes alterations in transepithelial Na+ and Cl- transport. We suggest a predominant effect on cellular transport mechanisms. PMID- 2717704 TI - Na+-Ca2+ exchange in limb muscles of dystrophic (C57 BL/6J dy2J/dy2J) mice. AB - Isometric tension of Na+-withdrawal contractures, membrane potential and intracellular Na+ activity (aiNa) have been measured in vitro under conditions which modify the activity of the Na+-Ca2+ exchanger of dystrophic limb muscles of (dy2J/dy2J) C57 BL/6J mice. In dystrophic soleus (Sol) and extensor digitorum longus (EDL) muscles exposed to Na+-free medium, there was a decrease in aiNa associated with a hyperpolarization of the membrane and the generation of a transient contracture. By contrast, exposing normal or denervated EDL muscles to Na+-free solution induced no change in aiNa nor in the resting tension. This study shows that Na+-Ca2+ exchange is still present in dystrophic Sol muscle. However from thermodynamic considerations, it could be suggested that the higher resting aiNa compared with that in normal muscle, may decrease the efficacy of the exchange. PMID- 2717705 TI - Estimation of the projection frequencies of single inhibitory interneurones to motoneurones in the cat spinal cord. AB - An estimate has been deduced for the percentage of motoneurones in the lumbosacral spinal cord inhibited by single interneurones mediating group I non reciprocal inhibition. The estimate is derived from data for the percentage of interneurones discharged, and percentage of motoneurones inhibited, by the same group I afferents. These experimental data are compared with theoretical curves for the percentage of motoneurones in which inhibition would be expected following discharges in various numbers of interneurones, for different values of projection frequency. It is estimated that each interneurone projects to less than 5% of target motoneurones. PMID- 2717706 TI - [A model of the stochastic dynamics of interphase lymphocyte death]. AB - Dynamics of interphase peripheral blood lymphocyte death is studied in terms of a general model based on a random damage distribution among cells and stochastic time of their death. Some particular cases of this model are analysed. Possible causes of shaping "biphase" dose-dependence curves for lymphoid cell survival after irradiation are discussed. PMID- 2717707 TI - [The content of phospholipids and free fatty acids in the sarcoplasmic reticulum membranes in the early stage of an x-ray radiation lesion]. AB - One and 24 h following single X-irradiation (0.21 C/kg) of rabbit hind leg the content of free fatty acids and phospholipid lysoforms increased in the sarcoplasmic reticulum (SR) membrane of skeletal muscles. The results obtained are important in estimating the mechanisms of action of ionizing radiation on the structural and functional properties of SR. PMID- 2717708 TI - [The RBE of 0.85-MeV neutrons in the intestinal form of radiation sickness in guinea pigs]. AB - Relative biological effectiveness (RBE) coefficient of 0.85 MeV neutrons was 1.87 in comparison with 0.66 MeV gamma radiation (137Cs) when estimated by the death rate of guinea pigs with intestinal form of radiation sickness. LD50/5 was 5.9 and 11.06 respectively. Features of the mortality rate dynamics, clinical picture and pathoanatomical changes are discussed. PMID- 2717709 TI - [Hyperbolic function of the neuroelectrical effects in the cerebral form of radiation lesions]. AB - A theoretical synthesis of electrical parameters of interaction between gamma radiation and excited membranes of nervous and muscular tissues suggests a correlation between power (dose-rate, R) and duration of exposure (T), of the liminal stimulation of a neuron by gamma radiation: R = 6 + 8/T. In studying early transient neurologic disorders (ETND) the threshold charges of ionizing radiation have been defined for various probabilities of occurrence of one of the ETND symptoms. PMID- 2717710 TI - [Lipid metabolic changes in rats with radiation sickness and a pronounced intestinal syndrome following the local irradiation of the abdominal area. The total lipid content of the blood serum and tissues]. AB - Local X irradiation of rat abdomen causes pronounced hyperlipemia after 4 and 72 h and a considerable accumulation of phospholipids and triacylglycerides in the liver after 72 h. In the thymus, the content of the nonesterified fatty acids decreased 4 h and that of cholesterol increased 72 h after irradiation. PMID- 2717711 TI - [The central regulation of pain sensitivity in rats after irradiation with high doses of ionizing radiation]. AB - It was shown that during 24 h following whole-body exposure of male rats to gamma quanta (150 Gy) the latent period of their response to the thermal effect increased a "tail-flick" test) and the threshold of the nociceptive response to an electric stimulus (the vocalization threshold) decreased. A correlation was found between the initial response to the nociceptive effects and variation of these values in irradiated animals. PMID- 2717712 TI - [The synergism of the action of gamma radiation and cardiovascular preparations on lymphoid cells in culture]. AB - In experiments with lymphoid human cells Raji synergism of the effects of gamma radiation and cardiovascular drugs (e. g. valocordin, valerian, ouabain, and digoxin), administered in nontoxic doses to culture medium 15 min after irradiation (0.5, 1, and 2.5 Gy) was displayed by the inhibition of cell proliferation. PMID- 2717713 TI - [The biological action of radioactive carbon. The metabolic kinetics and biological effects of the combined action of radioactive carbon (14C-glucose) and sodium nitrite chronically administered]. AB - A study was made of the effect of sodium nitrate (3.1 and 0.3 g/l) on the metabolism kinetics and the biological effects of 14C-glucose (13 kBq/rat/day) that were chronically administered to rats. After both separate and combined administration of the radiation and chemical agents, no substantial changes were detected in the kinetics of metabolism and biological effect of 14C. Six months after the onset of the experiment, the reproductive function of the experimental rats was impaired. PMID- 2717714 TI - [Effect of liposome-encapsulated pentacin on plutonium-239 excretion]. AB - A study was made of the influence of pentacin, encapsulated in liposomes, on the excretion of monomeric plutonium-239 from dogs and albino rats. Pentacin in a liposomal form, in comparison with free pentacin, increased the excretion of plutonium in urine from a dog body by 23.5% when administered in 24 h, and by 28% when administered in 20 days; in rats, the excretion increase made 40% after the administration in 30 or 45 days. PMID- 2717715 TI - [Lung histopathology during plutonium-238 incorporation]. AB - In experiments with albino mongrel female rats a study was made of the response of the lungs to a single intratracheal injection of nitrate of 238Pu (0.4-740 kBq/kg). The nature of the inflammatory disease, the lymphoid tissue condition, pneumosclerosis occurrence, and the frequency and spectrum of lung tumors were shown to be a function of dose of the radionuclide administered. PMID- 2717716 TI - [Biochemical changes of the liver in rats with a combined lesion from 89Sr and 131I]. AB - The results of the biochemical changes induced by 89Sr and 131I in a rat liver after their separate and combined administration within a wide range of doses are presented. Administered in a combination the radionuclides produced the additive effect when estimated by some indices, and more than additive, according to other tests. PMID- 2717717 TI - [The radioprotective action of long-term anoxia on the membrane lipids in irradiated turtles]. AB - It was shown that 80% of tortoises survived on day 45 after gamma irradiation (60Co, 4.2.10(2) Gy) in conditions of long-term (6 h) anoxia, against 5% survived after irradiation in normal conditions. It is suggested that the modifying effect of ionizing radiation under anoxic conditions is mainly associated with the decreased rate of peroxidation processes in membrane phospholipids and the enhanced radioresistance background during the first decade following irradiation. PMID- 2717718 TI - [Assessment of the degree of severity of radiation lesions in dogs using densitometric-geometric parameters of the blood lymphocytes]. AB - Changes in densitometric-geometric parameters of lymphocyte nuclei of dog peripheral blood detected at early times (6 and 24 H) following gamma irradiation with 2.5 and 6.0 Gy are given a composite description. Using densitometric geometric parameters the authors have developed an algorithm allowing for a 90% accuracy in the classification of objects according to the severity of radiation affection. PMID- 2717719 TI - [Potassium cyanate modification of the toxic and mutagenic effects of gamma radiation and benzo(a)pyrene]. AB - In experiments with CHO-AT3-2 cell culture, a study was made of the effect of potassium cyanate (KNCO) on the effect of gamma radiation and benzo(a)pyrene (BP) by the following tests: cell viability, induction of cells with micronuclei and fragmented nuclei and mutations by thymidine kinase (TK) and Na+/K+-ATPase loci. Some tests have revealed the increase in the effect of gamma radiation and BP produced by potassium cyanate. It is suggested that the sensitizing effects are related to repair system inhibition and/or changes in the cell chromatin structure produced by KNCO. PMID- 2717720 TI - [Comparative frequency of chromosome aberrations in a human lymphocyte culture depending on the mode of neutron irradiation]. AB - The study of the dose dependence of the incidence of chromosome aberrations in a human lymphocyte culture exposed at the G0 stage to pulsed neutrons of 0.7 MeV revealed no significant distinctions in the cytogenetic effect at the pulse frequency of 1 and 5 Hz, but at 100 Hz it was somewhat increased. As to the biological effectiveness, pulsed neutrons of 0.7 MeV occupied an intermediate position between 0.35 and 0.85 MeV static neutrons. PMID- 2717721 TI - [Characteristics of mouse hematopoietic stem cells in the phase of enhanced radioresistance after sublethal irradiation]. AB - Haemopoietic stem cells of mice which displayed an increased radioresistance 12 days following sublethal irradiation, exhibited higher proliferative, granulocyte repopulating and migration activities as compared with those of intact animals. PMID- 2717722 TI - [Changes in the cellularity and lipid concentration of the bone marrow in rats after a single gamma-ray irradiation]. AB - A study was made of the influence of gamma-irradiation of rats (14.4, 9.6, 7.2 and 4.8 Gy) on the number of nucleate cells, and the concentration of triacylglycerides (TG) and phospholipids (PL). Cellularity and concentration of PL decreased while that of TG increased under the effect of radiation. The degree of the changes in the above parameters was a function of dose and time after irradiation. PMID- 2717723 TI - [Aspartate aminotransferase and glutamate dehydrogenase activity in the rat brain during infrared laser exposure]. AB - In experiments in vivo it was shown that upon low-intensity infrared irradiation changes in the activity of main enzymes of glutamic acid metabolism are a function of time of exposure and flux density. PMID- 2717724 TI - [Modifying effect of oxolinic acid on the radiation-induced hemorrhagic syndrome]. AB - The radioprotective effect of oxolinic acid (200 mg/kg) was studied in irradiated guinea pigs (3 Gy, 0.83 cGy/min) by the following criteria: survival rate, hemorrhage severity, and homeostasis disturbance. Oxolinic acid was found to decrease the death rate, severity of hemorrhage and the degree of thrombo- and leukopenia, and to reduce the injury to blood coagulation and vascular wall of irradiated animals. PMID- 2717725 TI - [Dependence of the radioprotective effect of beta-mercaptoethylamine on the thiol level of the outer cell membrane]. AB - In experiments with Ehrlich ascites tumor cells with the use of a specific thiol blocker, 6,6'-dithiodinicotinic acid, it was shown that thiols of a cell plasmic membrane are necessary for the radioprotective effect of mercaptoethylamine to be realized. PMID- 2717726 TI - [Effect of chronic low-intensity gamma irradiation on embryogenesis in the silkworm (Bombyx mori L.)]. AB - Gamma irradiation of a grain during embryogenesis at an intensity only 100 times exceeding that of the natural radioactive background reduces by 4-7 h the average time of embryogenesis for different species and hybrids of thesilworm embryo. The 10- and 40-time increase in the radiation intensity decreases the stimulatory effect and leads to the delay in the development. PMID- 2717727 TI - Impact of a priori medical decisions on screening for breast cancer. PMID- 2717728 TI - Campylobacter pylori and large gastric folds. PMID- 2717729 TI - Radiologic research and education: now is the time for all to come to the aid. PMID- 2717730 TI - Sarcoidosis: correlation of extent of disease at CT with clinical, functional, and radiographic findings. AB - Computed tomography (CT) was compared with chest radiography in the assessment of disease severity in 27 patients with sarcoidosis. The CT scans and radiographs were each read twice by two independent observers. Disease extent was assessed on CT scans by visual scoring (0%-100% involvement of the lung parenchyma) and on radiographs by using an adaptation of the International Labour Office classification. The severity of parenchymal changes on the CT scan and on the radiograph was significantly correlated with the severity of dyspnea (r = .61 and .58, respectively; P less than .001), diffusing capacity (r = -.62 and -.52, P less than .01), and vital capacity (r = -.49 and -.51, P less than .01). Patients with predominantly irregular opacities had more severe dyspnea and lower lung volumes than patients with predominantly nodular opacities (P less than .05). The authors conclude that in patients with sarcoidosis, the radiographic and CT assessments of disease severity show similar correlation with clinical and functional impairment. PMID- 2717731 TI - Sarcoidosis: correlation of pulmonary parenchymal pattern at CT with results of pulmonary function tests. AB - The appearances of the lungs on radiographs and computed tomographic (CT) scans were correlated with degree of uptake on gallium scans and results of pulmonary function tests (PFTs) in 27 patients with sarcoidosis. CT scans were evaluated both qualitatively and quantitatively. Patients were divided into five categories on the basis of the pattern of abnormality at CT: 1 = normal (n = 4); 2 = segmental air-space disease (n = 4); 3 = spherical (alveolar) masslike opacities (n = 4); 4 = multiple, discrete, small nodules (n = 6); and 5 = distortion of parenchymal structures (fibrotic end-stage sarcoidosis) (n = 9). The percentage of the volume judged to be abnormal (CT grade) was correlated with PFT results for each CT and radiographic category. CT grades were also correlated with gallium scanning results and percentage of lymphocytes recovered from bronchoalveolar lavage (BAL). Patients in CT categories 1 and 2 had normal lung function, those in category 3 had mild functional impairment, and those in categories 4 and 5 showed moderate to severe dysfunction. The overall CT grade correlated well with PFT results expressed as a percentage of the predicted value. In five patients, CT scans showed extensive parenchymal disease not seen on radiographs. CT grades did not correlate with the results of gallium scanning or BAL lymphocytes. The authors conclude that patterns of parenchymal sarcoidosis seen at CT correlate with the PFT results and can be used to indicate respiratory impairment. PMID- 2717732 TI - The left paratracheal reflection. AB - The left paratracheal reflection, which is found medial to the left subclavian artery reflection, was sought in 302 normal posteroanterior (PA) chest radiographs, 93 conventional chest tomograms, and 113 thoracic computed tomographic (CT) scans. The left paratracheal reflection was visible on 31% of normal PA chest radiographs. Conventional tomography and CT showed that this finding is produced by contact of the lung with the mediastinum anterior to the left subclavian artery. The CT scans studied showed that the left paratracheal reflection actually represents contact of the lung with left paratracheal mediastinal fat 94% of the time, with the proximal 1-2 cm of the lateral wall of the left common carotid artery 5% of the time, and with the left tracheal wall 1% of the time. A variety of entities may alter the left paratracheal reflection. PMID- 2717733 TI - Varied appearance of AIDS-related lymphoma in the chest. AB - The authors reviewed all cases of acquired immunodeficiency syndrome (AIDS) related lymphoma (ARL) seen at their institution between January 1982 and September 1988 to determine the frequency and appearance of ARL in the chest. Of 35 patients with ARL, 11 (31%) had biopsy-proved thoracic involvement. This frequency is significantly greater than that previously reported. The radiologic appearance of the thoracic involvement varied. Pleural effusion, interstitial and alveolar lung disease, nodules, and, infrequently, hilar and mediastinal adenopathy were observed. ARL of the chest was most commonly extranodal. Pleural effusion and lung disease were the two most common manifestations of ARL on chest radiographs and computed tomographic scans. The authors recommend that clinicians treating patients with suspected or known AIDS consider ARL when a pleural effusion or a noninfective interstitial or alveolar process is present. PMID- 2717734 TI - Nonpalpable breast lesions: diagnosis with slightly overpenetrated screen-film mammography and hook wire-directed biopsy in 1,014 cases. AB - Slightly overpenetrated screen-film mammography and hook wire-directed localization were used in 1,014 breast biopsies performed for nonpalpable, mammographically detected breast abnormalities. One lymphoma and 205 breast cancers (20%) were found; 115 breast cancers (56%) were noninvasive, and 90 (44%) were invasive. Mastectomy was performed in 69 breast cancers (34%); 136 (66%) were treated conservatively, 28 with biopsy only and 108 with lumpectomy, node dissection, and radiation therapy. All patients with noninvasive breast cancers treated with axillary dissection had uninvolved lymph nodes. Of the 90 invasive breast cancers, six (7%) had metastases to axillary nodes, which, to the authors' knowledge, is lower than percentages reported in other studies of wire-directed breast biopsies. The authors believe that the slightly overpenetrated technique is a valuable adjunct to screen-film mammography. PMID- 2717735 TI - Mesenteric vascular occlusion: a new diagnostic method using a radiolabeled monoclonal antibody reactive with platelets. AB - A new method for diagnosing mesenteric vaso-occlusive bowel disease with the use of radioimmunoscintigraphy was developed and tested in experimental models of arterial and venous disease, as well as in a model simulating bowel strangulation. The method involves the use of a monoclonal antibody fragment mixture that binds to platelets. The antibody was labeled with technetium-99m, and imaging was performed with a gamma camera in the planar and single photon emission computed tomography modes. This method allowed visualization of areas of ischemia of 1-6 hours duration in bowel loops in 19 dogs 90-180 minutes after injection of the radiolabeled antibody. No bowel radioactivity accumulation occurred in dogs that underwent the same surgical procedure but were given a nonspecific Tc-99m-labeled antibody or in normal dogs given the specific antibody. It appears that the radiolabeled antibody used, which has higher reactivity with human platelets than with dog platelets, will be a good agent for noninvasive diagnosis of mesenteric vaso-occlusive disease in humans. It may also play a role in the intraoperative determination of the extent and location of ischemic bowel segments. PMID- 2717736 TI - MR characterization of adrenal masses: field strength and pulse sequence considerations. AB - The authors evaluated the ability of magnetic resonance (MR) imaging at 1.5 T to characterize 28 adrenal masses, using several variables: signal intensity ratios (adrenal/liver and adrenal/fat) on T2- and T1-weighted images, and the calculated T2 relaxation time of the adrenal mass. Signal intensity ratios were unreliable in distinguishing adenomas from nonadenomas. The calculated T2 relaxation time was more useful: All 15 adrenal masses with a T2 of less than 60 msec were adenomas. A T2 greater than 60 msec was less specific and included six metastases, two pheochromocytomas, one adrenal carcinoma, two adrenal hemorrhages, and two nonhyper-functioning adenomas. Therefore, T2 values are more accurate than signal intensity ratios for characterization of adrenal masses at 1.5 T. The unsuitability of previously published criteria determined with 0.35- and 0.5-T systems may reflect the change of T1 and T2 relaxation times with field strength, altering the relative T1 and T2 weighting by a given pulse sequence. PMID- 2717737 TI - Adrenal masses: evaluation with fast gradient-echo MR imaging and Gd-DTPA enhanced dynamic studies. AB - Fast gradient-echo magnetic resonance (MR) imaging of 38 adrenal masses with proved diagnosis was performed during suspended respiration with various repetition times (TRs), echo times (TEs), and flip angles. Dynamic perfusion studies after gadolinium diethylenetriamine-pentaacetic acid (DTPA) administration were performed by repeated imaging at short time intervals. With more T2 weighting (TR = 60 msec, TE = 30 msec, and flip angle = 15 degrees), malignant tumors and pheochromocytomas had a significantly higher relative signal intensity than adenomas; overlap of signal intensity led to equivocal findings in nine cases. After administration of Gd-DTPA, adenomas showed only mild enhancement and quick washout; malignant tumors and pheochromocytomas showed strong enhancement and slower washout. Five of the nine cases that were equivocal in precontrast images could thus be correctly classified. In addition to this improved classification of adrenal masses, fast, dynamic contrast material enhanced MR imaging resulted in a reduction in total examination time. PMID- 2717738 TI - Hyperfunctioning and nonhyperfunctioning benign adrenal cortical lesions: characterization and comparison with MR imaging. AB - The authors evaluated the potential of magnetic resonance (MR) imaging at 0.35 T to permit differentiation of nine hyperfunctioning adrenal cortical lesions from 21 nonhyperfunctioning adrenal cortical adenomas. Both qualitative data (visual assessment) and quantitative data (signal intensity ratios, T1, and T2) were used for tissue characterization. With a 2,000/56-100 sequence (repetition time msec/echo time msec), the majority of lesions were visually isointense to liver. Of 34 quantitative measures, only lesion-liver and lesion-kidney intensity ratios at 2,000/150 showed statistically significant differences among nonhyperfunctioning adenomas, aldosterone-producing lesions, and corticosteroid producing lesions; however, the authors question the significance of these differences because of the abundant noise associated with the 2,000/150 sequence. The results suggest that nonhyperfunctioning adrenal cortical adenomas cannot be distinguished from benign hyperfunctioning cortical lesions with use of MR imaging at 0.35 T. PMID- 2717739 TI - Pelvic endometriosis: MR imaging. AB - The value of magnetic resonance (MR) imaging at 0.35 T in detecting, characterizing, and staging pelvic endometriosis was prospectively investigated in 30 consecutive women in whom this disease was clinically suspected. MR findings were correlated with the results of laparoscopy (13 women) and laparotomy (17 women). Surgical examination revealed a normal pelvis in five patients and endometriosis in 25. Three of the five normal cases and 16 of the 25 cases of endometriosis were correctly identified with MR imaging (sensitivity, 64%; specificity, 60%; accuracy, 63%). MR imaging demonstrated seven of eight endometriomas but only 14 of 29 adhesions and only six of 45 endometrial implants. While MR imaging demonstrated endometriomas, ovarian adhesions, and extraperitoneal endometrial implants, it could not accurately depict extraovarian endometrial adhesions and intraperitoneal endometrial implants. In addition, MR imaging findings did not correlate with the surgically determined severity of the disease. These limitations indicate that MR imaging cannot be used as the primary modality in the detection, characterization, and staging of endometriosis; laparoscopy remains the procedure of choice. PMID- 2717740 TI - Endometriosis: appearance and detection at MR imaging. AB - Thirty-nine magnetic resonance (MR) studies were performed on 31 women with surgically proved endometriosis. A total of 88 endometriotic lesions ranging in size from 0.2 to 7.5 cm were detected on 24 of 30 MR images of women. The signal intensities ranged from hyperintense on all pulse sequences (41 of 88) to hypointense on all sequences (24 of 88); the remainder demonstrated signal intensities corresponding to the appearances of acute, subacute, and chronic hematomas. Hypointense or signal-void rims on both T1- and T2-weighted images were detected in 35 lesions. Identification of the disease with MR imaging versus concurrent surgery was compared for 76 sites in 19 patients. Findings were true positive in 24 cases, false-negative in ten, true-negative in 32, and false positive in seven, resulting in an MR sensitivity of 71% and specificity of 82%. Adhesions obscured the disease at laparoscopy in three patients. MR imaging cannot be used as a substitute for laparoscopy in the definitive diagnosis or staging of endometriosis. However, it can be used to monitor treatment response in place of laparoscopy once a diagnosis is firmly established. PMID- 2717741 TI - Cystic teratoma of the ovary: CT detection. AB - Computed tomography (CT) was performed in 38 patients with 41 benign cystic teratomas of the ovary and two patients with malignant transformation. CT depicted all tumors. The presence of fat in 40 of 43 cases (93%), tooth or calcification in 24 of 43 (56%), Rokitansky protuberance in 35 of 43 (81%), tufts of hair in 28 of 43 (65%), and a fat-fluid level in five of 43 (12%) allowed a definite diagnosis of ovarian cystic teratoma in 42 of 43 cases (98%). In the two cases of malignancy, single large (greater than 10 cm) plugs (with uptake of contrast medium in one) with a cauliflower appearance and an irregular border forming an obtuse angle with the inner wall of the cyst suggested malignant transformation. In three cases of benign cystic teratoma, a mucinous tumor (one benign, one borderline, one malignant) arising in the same ovary was seen at pathologic examination but was only diagnosed with the help of CT in two of three cases. Thickening of the tube was noted in two cases of torsion of the adnexa. CT findings were compared with findings at radiography of the abdomen and hysterosalpingography in 30 cases, ultrasound in 31, and magnetic resonance imaging in three. This study demonstrated that CT was the best procedure for imaging cystic teratomas of the ovary. PMID- 2717742 TI - Splenic trauma in adults: impact of CT grading on management. AB - The impact of computed tomographic (CT) grading of splenic injury on case management was evaluated in 64 adult patients who underwent abdominal CT within 24 hours of blunt abdominal trauma. Severity of splenic parenchymal disruption and the presence of hemoperitoneum were each graded on a scale of 0-3 (maximal total score = 6). The splenic injury was graded retrospectively (stage 1) in 29 patients and prospectively (stage 2) in 35 patients. Patients who were treated surgically had a significantly higher score than those who were treated conservatively (3.8 vs 1.9 in stage 1, 4.1 vs 1.7 in stage 2, P less than .001 for both stages). Data analysis showed that patients with a splenic score of less than 2.5 can be treated safely without surgery, while patients with a splenic score of 2.5 or more are more likely to need surgery. In the latter group of patients, CT scoring did not change the operative rate (74% vs 75%) but did prompt earlier surgical intervention in stage 2. This significantly increased the rate at which spleen-saving operations were performed (from 21% to 67%, P less than .032) and the overall rate of splenic salvage. The CT scoring system used in this study appears to be a simple, reproducible, and useful method for quantitating splenic injury in blunt abdominal trauma. PMID- 2717743 TI - Lymphadenopathy in primary biliary cirrhosis: CT observations. AB - The authors retrospectively evaluated computed tomographic (CT) scans obtained in 21 patients with primary biliary cirrhosis, 13 of whom subsequently underwent liver transplantation. Evidence of enlarged lymph nodes, primarily in the gastrohepatic ligament and porta hepatis, was seen on CT scans in 17 patients (81%). Lymphadenopathy also occurred in unusual sites for benign adenopathy, including the paracardiac (24%) and mesenteric (19%) lymph nodes. Surgical or autopsy confirmation of enlarged lymph nodes was made in 13 patients, and histologic analysis of the specimens revealed reactive hyperplasia, sinus hyperplasia, sinus histiocytosis, fibrosis, or normal architecture in these enlarged nodes. The authors conclude that lymphadenopathy is a frequent CT finding in primary biliary cirrhosis and that recognition can help prevent misdiagnosis of lymphoma or metastatic disease. PMID- 2717744 TI - Pylorus-preserving Whipple pancreaticoduodenectomy: postoperative evaluation. AB - The pylorus-preserving Whipple pancreaticoduodenectomy is becoming a popular alternative to the standard Whipple operation. Fluoroscopy plays an important role in postoperative assessment. The authors evaluated images of 50 consecutive patients who had undergone the newer procedure. Thirty-one complications were identified. Two normal variants that could be confused with abnormalities were noted: (a) the featureless appearance of the duodenal bulb may be mistaken for extravasation, and (b) contrastmaterial filling of the proximal jejunal loop at an end-to-end anastomosis with retained invaginated pancreas may be mistaken for intussusception. Another pitfall was failure to evaluate the pancreaticojejunostomy anastomosis fully, resulting in false-negative radiologic interpretations when leaks were present. The approach to postoperative examination of patients who have undergone the pylorus-preserving Whipple procedure is different from that of patients who have undergone the standard procedure. Radiologists should be familiar with this approach, the normal postoperative anatomy, and pitfalls in imaging so that complications can be diagnosed and treated. PMID- 2717745 TI - Acquired malposition of the colon and gallbladder in patients with cirrhosis: CT findings and clinical implications. AB - Topographic relationships among the gallbladder, liver, hepatic flexure of the colon, right hemidiaphragm, and anterolateral peritoneal reflection were evaluated with computed tomography in 75 patients with biopsy-proved cirrhosis and in 200 control subjects to determine the effect of cirrhotic liver morphology on the anatomy of the right upper quadrant of the abdomen. Interposition of the colon between the liver and anterolateral abdominal wall and/or diaphragm was seen in 18 of the 75 (24%) cirrhotic patients and in six of the 200 (3%) control subjects. There was a strong correlation among gallbladder malposition, colonic interposition, and a ratio of transverse caudate lobe width to right lobe width (C/RL) exceeding 0.60. Patients with cirrhosis, colonic interposition, and gallbladder malposition had a mean C/RL of 0.62, compared with a mean of 0.50 for cirrhotic patients without interposition (P less than .0001). The mean C/RL for control subjects without interposition was 0.43, as compared with 0.69 for control subjects with interposition (P less than .01). These acquired malpositions of the colon and gallbladder may pose a diagnostic dilemma and increase the risk of inadvertent injury during percutaneous liver biopsy, interventional biliary tract procedures, and laparotomy. PMID- 2717746 TI - Carpal tunnel: MR imaging. Part I. Normal anatomy. AB - To correlate the important structures of the carpal tunnel demonstrated on magnetic resonance (MR) images with gross anatomy, the authors imaged the wrists of 20 normal volunteers and nine cadavers. The cadaver specimens were sectioned in the same planes in which they were imaged, and three other specimens were dissected. The anatomy was directly correlated with the imaged morphology. Axial images delineated well the bone and ligament walls of the carpal tunnel. The median nerve was well delimited and of moderate signal intensity. It was surrounded in some cases by fat but was consistently bound by specific tendons. The ulnar nerve and artery were visualized as they traversed the Guyon canal to their division into superficial and deep branches. Coronal images permitted optimal visualization of the triangular fibrocartilage and the radial and ulnar collateral ligaments. Quantitative studies indicated that the normal median nerve does not significantly increase in size within the carpal tunnel but does become more flattened at the level of the pisiform bone. The normal flexor retinaculum may have a slight palmar bowing. PMID- 2717747 TI - Primary tumors of the foot: MR imaging. AB - The findings at magnetic resonance (MR) imaging of eight patients with primary tumors of the foot were compared with those at gross pathologic examination. In all cases, there was excellent correlation between the two studies. When compared with computed tomography (CT), MR imaging was superior in defining the presence and extent of local disease. While the appearances of various foot neoplasms are nonspecific, the ease of multiplanar imaging, the superior contrast resolution, and the sensitivity to marrow abnormalities are major advantages of MR imaging over CT in staging foot neoplasms. These advantages are crucial when foot-sparing curative resection of a malignancy is contemplated. The combination of plain radiography and MR imaging may be all that is necessary for optimal preoperative detection and local staging of tumors of the foot. PMID- 2717748 TI - Bone abnormalities of the knee: prevalence and significance at MR imaging. AB - Focal abnormal signal intensity within the distal femoral condyles or proximal tibial plateaus is frequently seen on T1- or intermediate-weighted magnetic resonance (MR) images of the knee. To characterize the prevalence and significance of these findings better, a retrospective study of MR imaging of the knee, performed on the first 434 consecutive patients at a primarily outpatient community MR imaging center, was undertaken. A signal intensity loss demonstrated on images with a short echo time (20 or 25 msec) was divided into three types based on morphologic criteria. A type 1 finding was a diffuse, often reticulated signal intensity loss in the metaphyseal and epiphyseal regions of bone. A type 2 loss was associated with an interruption in the smooth, black cortical line. A type 3 finding was a profound signal intensity loss primarily restricted to the immediate subcortical region. Seventeen percent of all cases revealed a type 1 or 2 loss that may have been compatible with acute bone injuries. These bone lesions were frequently associated with tears of the anterior cruciate ligament and contralateral collateral ligament, but infrequently these lesions were detected with plain radiography and arthroscopy. When associated with a weight-bearing cortex, bone injuries detected with MR imaging may explain clinical symptoms of pain on weight bearing, and type 1 injuries may represent regions of bone at increased risk for the subsequent development of insufficiency fractures if the bone is not adequately protected during trabecular healing. PMID- 2717749 TI - Musculoskeletal neoplasms: static and dynamic Gd-DTPA--enhanced MR imaging. AB - Static and dynamic magnetic resonance imaging studies were performed in 69 patients with bone and soft-tissue tumors. T1-weighted spin-echo (SE) imaging after intravenous administration of gadolinium diethylenetriaminepentaacetic acid (DTPA) improved the differentiation of necrotic from viable areas; the contrast to-noise ratio (C/N) between tumor and muscle was an average of 44% lower compared with that in T2-weighted SE imaging. The C/N between tumor and bone marrow or fatty tissue was 43% and 37% lower, respectively, compared with that in nonenhanced T1-weighted SE imaging. Dynamic changes of signal intensity (SI) after Gd-DTPA enhancement were assessed with fast low-angle shot imaging. Of malignant tumors, 84.1% exhibited slopes higher than 30% per minute; 72% of benign tumors showed slopes lower than 30% per minute. The dynamic technique enabled assessment of the malignant potential of a tumor with some overlap (accuracy, 79.7%). Necrotic areas and peritumorous edema showed significantly lower and more gradual increases in SI than adjacent neoplastic tissue. PMID- 2717750 TI - Obstructive sleep apnea: diagnosis with ultrafast CT. AB - Patients with sleep-disordered breathing often have physiologic and anatomic abnormalities of the upper airway that are demonstrable while awake. An ultrafast computed tomographic (CT) scanner was used to measure the oropharyngeal and nasopharyngeal cross-sectional areas of 11 patients with obstructive sleep apnea. Twenty-four healthy volunteers served as control subjects. The percentage of change in cross-sectional area during quiet tidal breathing was used as a measure of airway compliance. Compared with weight-matched control subjects, patients with obstructive sleep apnea had smaller oropharyngeal airways (40.4 vs 177.8 mm2) (P less than .001) and smaller nasopharyngeal airways (31.3 vs 134.2 mm2) (P less than .001). In addition, their oropharyngeal airways were significantly more compliant (75% vs 27%) (P less than .001). Patients with obstructive sleep apnea are characterized by a small, collapsible oropharyngeal airway and by nasopharyngeal airway narrowing. These abnormalities can cause sleep-disordered breathing. Ultrafast CT scanning allows rapid, noninvasive assessment of airway variables. PMID- 2717751 TI - Acquired disruptions of the incudostapedial articulation: diagnosis with CT. AB - To determine the best technique for diagnosing incudostapedial joint disruption with computed tomography (CT), the authors reviewed 15 surgically proved cases. In each case, the articulation was depicted on axial but not coronal images. Disruption was due to inflammation in ten cases and trauma in five. Axial high resolution CT is valuable in the diagnosis of traumatic and inflammatory disruption of the incudostapedial joint. PMID- 2717752 TI - Coronoid process hyperplasia: CT studies. AB - Coronoid process hyperplasia is a disorder that causes restricted jaw movement due to enlargement of the coronoid process of the mandible, which impinges on the zygomatic arch with mouth opening. The cause is unclear. Computed tomographic (CT) findings in three patients with this disorder (two bilateral, one unilateral)--including a 3-year-old boy who may be the youngest patient with this disorder ever reported--include an enlarged coronoid process, with sclerosis and erosion of the zygomatic arch. CT is an effective and rapid method for establishing the diagnosis. PMID- 2717753 TI - Intracranial circulation: pulse-sequence considerations in three-dimensional (volume) MR angiography. AB - The technique and feasibility of magnetic resonance (MR) angiography of intracranial vessels were studied in 35 healthy volunteers. Variations in image orientation, repetition time (TR), and flip angle were evaluated to determine their effects on flow-related enhancement. Gradient modifications--including echo time (TE), motion compensation, bandwidth, and field of view--were also studied in an effort to reduce motion-induced phase shifts. Results indicated that a FISP (fast imaging with steady precession) sequence with a TR of 50 msec, TE of 15 msec, velocity compensation in the read and section-select directions, acceleration compensation in the read direction, anisotropic volume, and a 1.25 mm partition thickness produced three-dimensional angiographic MR images that were accurate and reproducible in the depiction of the major intracranial vessels. Difficulties with field of view, persistent signal void secondary to higher-order motion, and spatial resolution remain major problems requiring additional study. PMID- 2717754 TI - Intracranial circulation: preliminary clinical results with three-dimensional (volume) MR angiography. AB - The authors assessed the clinical utility of a magnetic resonance angiography technique in the evaluation of intracranial circulation. Eighteen patients with a low likelihood of cerebrovascular disease (control group) and 40 patients with suspected cerebrovascular disease were imaged with a FISP (fast imaging with steady precession) sequence (repetition time of 50 msec, echo time of 15 msec, velocity compensation in the read and section-select directions with acceleration compensation in the read direction, 15 degrees anisotropic volume, and a 1.25-mm partition thickness). Ninety-four percent of images in the control group and 72% of images in the group with cerebrovascular disease were considered useful for diagnosis. This technique can provide accurate images of intracranial circulation and can be performed in conjunction with two-dimensional spin-echo or gradient echo imaging. It was most useful in the evaluation of patent intracranial aneurysms, vessel displacement, and large-vessel occlusive disease. Disadvantages included limited field of view, persistent signal voids, limited spatial resolution, and inadequate depiction of lesions with slow flow. PMID- 2717755 TI - Three-dimensional (volume) gradient-echo imaging of the carotid bifurcation: preliminary clinical experience. AB - This study was designed to test the accuracy of magnetic resonance (MR) imaging with a FLASH (fast low-angle shot) 40 degrees volume pulse sequence by comparing it with intraarterial digital subtraction angiography (DSA) in patients with suspected carotid artery stenoses. Fifteen patients referred for evaluation of anterior circulation in cerebrovascular disease composed the pilot group. Twelve patients underwent correlative intraarterial DSA examinations. The FLASH volume sequence, with an echo time of 7.7 seconds, produced high-signal-intensity vascular images for 28 of 30 bifurcations. Of the 24 carotid bifurcations studied with DSA, 22 were depicted with MR angiography. Among the depicted bifurcations, 21 showed good correlation with the DSA images. These included four of four normal bifurcations, three of three with mild stenosis, four of four with moderate stenosis, eight of nine with severe stenosis, and two of two with occlusions. With respect to ulceration, three of four MR angiographic studies showed good correlation with DSA images. This preliminary experience indicates that the method is reproducible and capable of delineating carotid lesions in patients and that it can be performed in conjunction with conventional spin-echo imaging of the brain with only a small increase in patient examination time. PMID- 2717756 TI - MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery. AB - The authors evaluated magnetic resonance (MR) images obtained with intravenously administered gadolinium in ten patients who had facial paralysis and no facial nerve tumor. In patients with either Bell palsy (four patients) or facial paralysis after temporal bone surgery (six patients), intratemporal facial nerve enhancement was seen. Facial nerve enhancement on MR images proved to be a nonspecific finding. PMID- 2717757 TI - Bronchopulmonary dysplasia: radiographic appearance in middle childhood. AB - Chest radiographs were compared for three groups of children 8-9 years old: 23 survivors of bronchopulmonary dysplasia (BPD), 33 survivors of hyaline membrane disease without BPD, and 35 survivors of premature birth without neonatal respiratory problems. Only four children in the second group and three in the third had abnormal lungs. Linear shadows, apparently representing strands of fibrosis or deep pleural fissuring, were seen more frequently (15 of 23) in the BPD group than in the others (P less than .0001). Seventeen children in the BPD group had definite pulmonary abnormalities, none of them severe. The anteroposterior dimension of the chest in survivors of BPD tended to be decreased (P less than .001 vs that of reported control subjects). PMID- 2717758 TI - Chest injury in children with blunt abdominal trauma: evaluation with CT. AB - One or more significant chest injuries were identified in 62 of 512 children (12%) examined with computed tomography (CT) after blunt abdominal trauma. Thirty eight percent of all abnormalities identified on CT scans were underestimated or missed on the initial chest radiograph. Pleural and parenchymal abnormalities were missed in 50% and 34% of initial chest radiographs, respectively. Chest injuries occurred more frequently in children less than 7 years of age than in older children (62% vs 38%, P less than .02). Children with chest injuries tended to be more physiologically unstable than children without, as determined with lower (worse) mean trauma scores (P less than .001). Both the presence and severity of chest injuries strongly affected outcome. Mortality was 1.3% in children with no chest injury, 10.8% in children with significant unilateral chest injury, and 40% in children with significant bilateral or mediastinal chest injury (P less than .0001). Significant unsuspected or underestimated thoracic injuries are relatively common in children, and CT scans of the chest obtained while examinations of the upper abdomen are being performed can be helpful in the early recognition of such injuries. PMID- 2717759 TI - Enlarged gastric folds in association with Campylobacter pylori gastritis. AB - Enlarged gastric folds in pediatric patients are uncommon. Fifteen patients with upper gastrointestinal (GI) tract symptoms of chronic epigastric abdominal pain, vomiting, or hematemesis underwent radiologic upper GI barium studies and were found to have Campylobacter pylori gastritis at endoscopic biopsy. Seven patients (47%) with C pylori gastric disease had radiologic evidence of enlarged folds. There was no clinical or pathologic evidence of Menetrier disease. Therefore, C pylori gastritis should be considered in the differential diagnosis of children with upper GI tract symptoms and radiologic evidence of enlarged folds. PMID- 2717760 TI - Atretic esophagus: transgastric balloon-assisted hydrostatic dilation. AB - Esophageal atresia may be associated with a long interval or gap between the upper and lower pouches. Despite a variety of procedures to elongate the esophagus, surgeons have been unable to achieve esophageal continuity in many patients. Three infants with esophageal atresia and long gaps recently underwent hydrostatic dilation of the distal esophageal pouch followed by primary anastomosis. The technique entailed passing a balloon-tipped catheter through a gastrostomy site to the distal esophageal pouch. The balloon was inflated to a diameter sufficient to occlude the distal esophagus. Dilute contrast material was then infused under fluoroscopic visualization to a maximal pressure of 145 cm H2O. Dilations were performed daily over a 2-week period, followed by surgery. Primary anastomosis was accomplished in all patients. The promising results in these patients should stimulate other investigators to assess this technique in infants with this challenging surgical problem. PMID- 2717761 TI - Experimental lymph node metastases: enhanced detection with MR lymphography. AB - Magnetic resonance (MR) lymphography with superparamagnetic iron oxide (AMI-25) as a contrast agent was developed in an animal model with tumor-bearing lymph nodes. After interstitial administration of 20 mumol of iron per kilogram of body weight into the footpads of rats, the T2 of popliteal and paraaortic lymph nodes decreased from 67 msec +/- 8.2 to 9.5 msec +/- 0.9 and 9.3 msec +/- 0.9, respectively. T2 relaxation times of lymph nodes containing metastases showed a significantly higher value (61 msec +/- 6.2, P less than .005) after interstitial administration of the contrast agent. Intravenous administration of AMI-25 did not produce enhancement of normal or metastatic lymph node relaxation times. The signal intensity of normal lymph nodes decreased profoundly on spin-echo MR images (repetition time of 500 msec, echo time of 30 msec) after interstitial administration, whereas lymph nodes with metastases showed no significant change in signal intensity. Experimental results indicate that MR lymphography may potentially increase the sensitivity of MR imaging the detection of lymphatic malignancy. PMID- 2717762 TI - MR imaging of motion with spatial modulation of magnetization. AB - A novel magnetic resonance imaging technique provides direct imaging of motion by spatially modulating the degree of magnetization prior to imaging. The preimaging pulse sequence consists of a radio-frequency (RF) pulse to produce transverse magnetization, a magnetic field gradient to "wrap" the phase along the direction of the gradient, and a second RF pulse to mix the modulated transverse magnetization with the longitudinal magnetization. The resulting images show periodic stripes due to the modulation. Motion between the time of striping and image formation is directly demonstrated as a corresponding displacement of the stripes. This technique can be used to study heart wall motion, to distinguish slowly moving blood from thrombus, and to study the flow of blood and cerebrospinal fluid. PMID- 2717763 TI - Full-frame transform compression of CT and MR images. AB - Compression algorithms based on full-frame discrete cosine transforms have achieved compression ratios as high as 10:1 to 20:1 with almost imperceptible image degradation, when applied to projection radiographs digitized with 2,048 X 2,048 X 8-bit matrices. Compared with such radiographs, images obtained with computed tomography (CT) and magnetic resonance (MR) are smaller in size, have lower signal-to-noise ratios, and, in the case of CT, have a larger dynamic range. These differences result in qualitatively different spectral properties. The authors studied the efficiency of the full-frame technique when applied to CT and MR images. They achieved excellent results, with compression ratios in the neighborhood of 5:1. The study was performed with the use of a hardware implementation of the authors' algorithm, which can compress a 512 X 512 X 12-bit image in less than 1.5 seconds. PMID- 2717764 TI - Temperature mapping with MR imaging of molecular diffusion: application to hyperthermia. AB - Efficacy and safety considerations for hyperthermia (HT) cancer therapy require accurate temperature measurements throughout the heated volume. Noninvasive thermometry methods have been proposed, including magnetic resonance (MR) imaging based on the temperature dependence of the relaxation time T1. However, the temperature accuracy achieved to date with T1 measurements does not fulfill the HT requirements (1 degree C/cm). The authors propose to use molecular diffusion, for which temperature dependence is well known. Molecular diffusion is more sensitive than T1 and can be determined with high accuracy with MR imaging. Diffusion and derived temperature images were obtained with a 2 X 2-mm pixel size in a polyacrylamide gel phantom heated inside the head coil of a clinical 0.5-T whole-body MR imaging system by means of a modified clinical HT device made compatible with the system. Temperatures determined from these images with 0.8 cm2 regions of interest were found to be within 0.5 degrees C of those recorded with thermocouples placed inside the gel. The utility of this method in clinical hyperthermia is enhanced by its potential to also help monitor blood perfusion. PMID- 2717765 TI - Ultra-high-speed teleradiology with ISDN technology. AB - A solid-state, personal computer-based, image digitization and transmission system was developed that uses integrated services digital network (ISDN), a technology under development for ultra-high-speed data transmission over normal phone lines. Thousands of images have been transmitted to a site more than 15 miles away, with data rates exceeding 56,000 bits or 7,000 bytes (1 byte = 8 bits) per second with nearly perfect accuracy. Present modification of the system hardware and software should increase the data rate to 128,000 bits, or 16,000 bytes, per second. With this rate of transmission, remote radiologic image transmission should become a practical, routinely available diagnostic tool. PMID- 2717766 TI - Retrorenal colon: implications for percutaneous diskectomy. AB - It has been recommended that computed tomography (CT) with the patient prone be performed in every patient undergoing percutaneous diskectomy; this would enable detection of a retrorenal location of the colon, which could interfere with the percutaneous procedure. In this evaluation of 346 prone CT studies, only one patient (0.29%) was found to have retrorenal or retropsoas bowel that would have been perforated at diskectomy. Because of this extremely low prevalence, the performance of prone CT in every patient undergoing percutaneous lumbar diskectomy is not believed to be necessary. PMID- 2717767 TI - Caudal-posteroanterior view in coronary arteriography. AB - Posteroanterior (PA) and caudally angulated PA views were obtained in 20 patients undergoing routine coronary arteriography. Although the left main coronary artery (LMCA) was seen well on both views in all patients, the PA-caudal view improved depiction of the LMCA bifurcation in 15 (75%). In addition, the PA-caudal view markedly improved depiction of the circumflex artery, affording optimal depiction of this artery and its branches in 78%-89% of patients. Neither the PA nor the PA caudal view allowed adequate depiction of the left anterior descending artery. Thus, the PA-caudal view should supplant the PA view in routine coronary arteriography. PMID- 2717768 TI - Carotid artery: percutaneous transbrachial selective arteriography with a 4-F catheter. AB - Bilateral selective common carotid artery catheterization was attempted in 72 patients by means of percutaneous placement of a 4-F catheter from a right brachial artery puncture site in the antecubital fossa. The success rate was high (95.8%) and the complication rate low (6.9%), and there were no instances of brachial artery spasm or thrombosis. The experience, while small, suggests that selective common carotid arteriography can be done safely and efficaciously from the right brachial artery approach. PMID- 2717769 TI - Direct coronal CT of the scaphoid bone. AB - A simple technique is described for the acquisition of coronal computed tomographic images of the wrist without positioning or immobilizing devices. The technique was used in four cases in which the radiographs were equivocal, to assess healing after scaphoid bone fracture or grafting. The greater resolution of the images provided more definitive information about healing. PMID- 2717770 TI - Carbon-fiber electrodes and leads for electrocardiography during MR imaging. AB - In an effort to minimize distortion and artifacts on magnetic resonance images obtained with electrocardiographic (ECG) gating, the authors tested the use of ECG electrodes and leads made of carbon fiber. These materials caused no image degradation and, because the leads were reinforced with plastic, were less vulnerable to bending than leads made of graphite. PMID- 2717771 TI - Research in departments of diagnostic radiology: a question of method limitation. AB - Research support, training, and methods in diagnostic radiology have been the focus of analysis for 2 decades and continue to be important in the effective competition for research grants, especially those granted by the National Institutes of Health. The limitation of hypothesis formation and testing to imaging methods alone, however, could be a major impediment to more successful sponsorship of research in this discipline. The author emphasizes that a well designed research plan in diagnostic radiology should not be restricted solely to imaging methods and should include such factors as the formation of well-defined hypotheses testable by means of inductive reasoning and, most important, flexibility in approaches to research methods. Other factors influencing effective research in diagnostic imaging include the establishment of mentors for continuous training and support, uninterrupted time for research, and a totally supportive environment. Improvements in these areas may enhance the competitiveness of research proposals from departments of diagnostic radiology. PMID- 2717772 TI - Mammographic reports and surgical referrals. PMID- 2717773 TI - Medullary carcinoma of the breast. PMID- 2717774 TI - Simulators of a breast mass on a mammogram. PMID- 2717775 TI - Statistical analysis: a procrustean bed for radiologists? PMID- 2717776 TI - Is reform needed in the book review process? PMID- 2717777 TI - Amniotic fluid concentrations of prostaglandin F2 alpha, 13,14-dihydro-15-keto prostaglandin F2 alpha (PGFM) and 11-deoxy-13,14-dihydro-15-keto-11, 16-cyclo prostaglandin E2 (PGEM-LL) in preterm labor. AB - Although prostaglandins (PGs) are considered the key mediators of human parturition at term, there is a paucity of data regarding their participation in the mechanisms responsible for preterm labor. The purpose of this study was to establish if preterm labor is associated with changes in the amniotic fluid concentrations of prostaglandins. PGF2 alpha, 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) and 11-deoxy-13,14-dihydro-15-keto-11,16-cyclo-prostaglandin E2 (PGEM-ll) were measured by using specific and sensitive radioimmunoassays. Amniotic fluid was retrieved by transabdominal amniocentesis from 55 women with preterm labor and intact membranes. Patients were divided into three groups according to the response to tocolysis and the presence or absence of an intra amniotic infection. Amniotic fluid concentrations of PGFM and PGEM-ll were significantly greater in women with preterm labor and intra-amniotic infection than in women without infection. In addition, patients unresponsive to tocolysis without intra-amniotic infection also had a significantly greater concentration of PGFM and PGEM-ll in amniotic fluid than those responsive to tocolysis. Amniotic fluid concentrations of PGF2 alpha were greater in women with intra amniotic infection than in women without intra-amniotic infection. In the absence of intra-amniotic infection, no difference in amniotic fluid PGF2 alpha concentrations could be found between women who responded to tocolytic treatment and those who did not. PMID- 2717778 TI - The effects of platelet-activating factor on flow rate and eicosanoid release in the isolated perfused rat gastric vascular bed. AB - In the isolated rat stomach perfused via the vasculature in situ under constant pressure bolus injections of platelet-activating factor (PAF, 3, 16, or 50 ng) induced dose-dependent, long-lasting reductions of flow rates and simultaneously significant increases in the release of cysteinyl-leukotrienes (cys-LT), thromboxane (TX) B2 and 6-keto-prostaglandin (PG) F1 alpha. Reversed phase high pressure liquid chromatography demonstrated the release of a mixture of comparable amounts of LTC4, LTD4 and LTE4 by PAF. Inhibition of cys-LT synthesis by the lipoxygenase inhibitors nordihydroguaiaretic acid (NDGA) and L-651,896 did not significantly affect PAF-induced flow reduction indicating that endogenous cys-LT are of minor importance for the PAF effect on gastric vascular flow. This conclusion is supported by the fact that the cys-LT receptor antagonist FPL 55712 in a concentration (1 x 10(-6) M) that completely antagonized gastric flow reduction by exogenous LTC4 (1 x 10(-7) M) had no effect on the PAF-induced reduction of flow. The cyclooxygenase inhibitor indomethacin aggravated the PAF induced flow reduction suggesting that the endogenous vasodilator PGI2 might act as a functional PAF antagonist in the rat gastric vascular bed. In contrast to FPL 55712 the PAF antagonist BN 52021 significantly and concentration-dependently antagonized the PAF effect on gastric vascular flow. The results demonstrate that PAF and LTC4 induce flow reductions in the rat gastric vascular bed by activating different receptors and that endogenous eicosanoids released by PAF do not contribute significantly to the PAF effect on gastric vascular flow. PMID- 2717779 TI - Synthesis and contractile activity of new acetylenic and allenic analogues of leukotrienes C4 and D4: importance of the Z-11,12 double bond. AB - The (5S,6R) isomers of new acetylenic and allenic analogues of leukotrienes C4 and D4 were synthesized for comparative pharmacological studies on intestinal smooth muscle preparations. These new analogues are poor spasmogenic agonists, the replacement of the 11,12-ene with a relatively more stable triple bond causing an important reduction in intrinsic activity. They did not show any significant antagonist activity. Unexpectedly, these results prove that the 11,12 portion in the triene structure of the lipophilic chain is critical for an agonist activity. PMID- 2717780 TI - [An interview with Herbert Rosenfeld. Interview by Phyllis Grosskurth]. PMID- 2717781 TI - [Critique of social criticism in the interpretation process]. AB - Parin discusses the objections that Rolf Vogt and Peter Passett have raised in Psyche and elsewhere against his call for the incorporation of social criticism into psychoanalytic interpretations. He sketches the development of his own thinking and demonstrates that the psychoanalytic method and a critical view of the societal conditions in which patients as well as therapists live are not incompatible as his critics unanimously alleged. PMID- 2717782 TI - Marked depression of brain cholecystokinin and vasoactive intestinal polypeptide levels in Eck fistula dogs. AB - Cholecystokinin-like immunoreactivity (CCK-LI) and vasoactive intestinal polypeptide-like immunoreactivity (VIP-LI) were measured in the brain of Eck fistula dogs and dimethylnitrosamine (DMN)-treated dogs which were prepared as experimental models of hepatic encephalopathy (HE). Significant reduction of CCK LI was observed in all cortical regions of Eck fistula dogs, especially in parietal and occipital cortex (approximately 40% of control values). In DMN dogs, CCK-LI was reduced in the temporal, parietal and occipital cortex (65%, 47% and 51% of control values, respectively). Significant reduction of VIP-LI was also observed in the occipital cortex of both Eck fistula and DMN dogs (75% and 70% of control values, respectively). These data were compared with the concentrations of tyrosine and phenylalanine, precursors of false neurotransmitters suggested as causing HE. Phenylalanine was significantly increased in all areas of cortex of both models. Tyrosine was also significantly increased in frontal, parietal and occipital cortex of Eck fistula dogs, and in temporal, parietal and occipital cortex of DMN dogs. However, reduced amounts of these peptides did not correlate with increased amounts of the aromatic amino acids in these models. The results imply that reduced levels of CCK and VIP may be elicited by a mechanism distinct from that inducing increase of false neurotransmitters. PMID- 2717783 TI - Depletion of large dense-cored vesicles from parasympathetic nerve terminals in rat parotid glands after prolonged stimulation of the auriculotemporal nerve. AB - Large dense-cored vesicles (60-100 nm in diameter) have been assessed electron microscopically in terminal parasympathetic axons at acinar neuro-effector sites in rat parotid glands. Their numbers in control unstimulated glands have been compared with those in the contralateral glands of the same animals after prolonged nerve stimulation. Bilateral postganglionic sympathectomy had been undertaken 4-6 weeks previously to remove adrenergic axons from the glands. Stimulation of the postganglionic parasympathetic nerve to the gland--the auriculotemporal nerve--for 80 min at 40 Hz caused a significant depletion of large dense-cored vesicles from the terminal axons. This depletion corresponded in time and magnitude to the depletion of vasoactive intestinal peptide and substance P from the glands that had been found previously to occur under identical conditions. This adds support to the belief that the neuropeptides are stored in such vesicles and that these vesicles release their contents at neuro effector sites as a result of propagated impulse formation in the axons. PMID- 2717784 TI - Peptide T does not affect induction of pineal N-acetyltransferase by vasoactive intestinal peptide. AB - It has been suggested that the HIV virus binds to VIP recognition sites which can be blocked by the octapeptide, peptide T. Stimulation of VIP receptors on pinealocytes activates adenylate cyclase and increases the activity of the enzyme serotonin N-acetyltransferase (NAT). We examined whether peptide T or D-Ala peptide T amide affected this induction. We found no evidence for peptide T interference with NAT induction and conclude that if peptide T inhibits attachment of HIV virus to VIP receptors, it does so at regions other than that occupied by VIP in stimulating adenylate cyclase and NAT. PMID- 2717785 TI - A substance resembling somatomedin C in the American cockroach. AB - Material antigenically resembling somatomedin C (type I insulin-like growth factor, IGF-I) is demonstrated in the American cockroach Periplaneta americana by means of a monoclonal antibody immunoperoxidase technique. It was localized histochemically in neuronal cell somata and axonal fibers (probably interneurons) of the central nervous/neuroendocrine system and in 'endocrine-type' cells lining the midgut epithelium. The IGF-I-like substance is different from vertebrate insulin and also distinct from materials immunostained by different insulin antibodies in the brain and neurohaemal complex of this insect species. These findings are viewed in the light of recent reports on the presence and action of insulin-like chemicals in insects, and with respect to the existence of an insect brain-midgut system similar to the mammalian brain-gastroenteropancreatic system. PMID- 2717786 TI - Preliminary estimates of the virtually safe dose for tumors obtained from the maximum tolerated dose. AB - The purpose of this paper was to examine the correlation between the maximum tolerated dose (MTD) and the low-dose estimate of the virtually safe dose (VSD) for animal carcinogens. Chronic bioassay results from the National Cancer Institute/National Toxicology Program carcinogenesis screening program were used. Estimates of the VSD were obtained by linear low-dose extrapolation for which an adequate dose-response relationship existed at the same tumor site in the same sex for both rats and mice. Estimates of the VSD were compared with the MTD for 69 tumor sites from 38 chemicals for rats and mice. The MTDs ranged from high to low toxicity (1 ppb to 4.4% in the diet). The overall geometric mean of the ratio of the MTD to the VSD corresponding to a maximum estimated risk of 10(-6) was 3.8 x 10(5). Of the 138 cases, only 3 cases were more than a factor of 10 from the mean ratio. This suggested that a quick estimate of the VSD could be obtained by dividing the MTD, obtained from a subchronic study, by 400,000. Further, if the human exposure is less than 10(-7) X MTD, the estimated risk is likely to be negligible even if the chemical is a carcinogen. It may not be worthwhile to conduct a chronic bioassay for the purpose of demonstrating a negligible risk, if the chemical is likely to be carcinogenic, unless the human exposure is extremely low.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717787 TI - Aflatoxin control--how a regulatory agency managed risk from an unavoidable natural toxicant in food and feed. AB - The control by the Food and Drug Administration (FDA) of aflatoxin, a relatively recently discovered, unavoidable natural contaminant produced by specific molds that invade a number of basic food and feedstuffs, provides an example of the varying forces that affect risk assessment and management by a regulatory Agency. This is the story of how the FDA responded to the initial discovery of a potential carcinogenic hazard to humans in a domestic commodity, to the developing information concerning the nature of the hazard, to the economic and political pressures that are created by the impact of natural forces on regulatory controls, and to the restraints of laws within which the Agency must work. This story covers four periods: the years of discovery and action decisions on the basis of meager knowledge and the fear of cancer; the years of tinkering on paper with the regulatory process, the years of digestion of the accumulating knowledge, and the application of that knowledge to actions forced by natural events; and an audit of the current status of knowledge about the hazard from aflatoxin, and proposals for regulatory control based on that knowledge. PMID- 2717788 TI - Risk assessment and the credibility of federal regulatory policy: an FDA perspective. AB - FDA's fundamental goals are to protect and promote the public health, using the best possible science and the law. The evolution of food safety policy toward potential carcinogens reflects a conscious decision by the agency and Administration to use risk assessment in carrying out these goals. Examples include FDA policies toward assessing the safety of animal drug residues, setting specifications for constituents of food and color additives, and most recently, a common sense de minimis interpretation of the "Delaney clause." While committed to risk assessment as a useful tool, FDA acknowledges that judgments must be made on less than perfect data. In addition, recent history shows that there may be a serious "credibility gap" in public acceptance of regulatory toxicology. To ensure that there is an adequate science base for regulatory decisions, the challenge is twofold: First, the data necessary for sound safety evaluations in individual cases must be developed, based on current knowledge; and, second, the validity of assumptions underlying risk assessment should be tested and refined and scientific consensus achieved. Otherwise, risk management policy will rely on assessments based on extremely conservative assumptions, tending to overestimate risk. Risk assessment assumptions must also be better communicated to policymakers and the public. If these challenges are successfully addressed, public confidence in marketed products, and in science-based regulatory policy, will be enhanced. PMID- 2717789 TI - A note on the role of background tumor incidence in risk assessment for carcinogens. AB - The extrapolation of animal bioassay data to humans for the purpose of estimating risk from food additives, drugs, pesticides, etc. is still the primary approach to carcinogenic risk assessment. When the extrapolation is based on tumor data with high background incidence (e.g., hepatocellular tumors in rodents), its direct relevance to the human situation is sometimes questioned. This paper suggests a method for adjusting the acceptable excess risk level for humans according to the background incidence of the tumor type used for extrapolating from animals to humans. Application of the suggested "fixed relative risk" extrapolation method in setting acceptable low-risk exposure levels for humans is illustrated for methylene chloride. PMID- 2717790 TI - [Diabetes mellitus and changes in hemostasis: study of the fibrinolytic response of insulin-dependent patients without vascular disease]. AB - Diabetes mellitus (DM) is characterized by a hypercoagulability state and many of these disorders are corrected with adequate metabolic control. The goal of this study was to assess diverse hemostatic and fibrinolytic parameters in 12 insulin dependent (IDDM) metabolically controlled patients without vascular lesions and in a group of 12 healthy volunteers. A significant difference was observed in the euglobulin lysis time (ELT), after a stress test, since only 3 patients had an adequate fibrinolytic response. These results suggest that the fibrinolytic alterations found in DM are not secondary to metabolic disorders caused by the disease and we can consider that the existence of subclinical alterations of the vascular endothelium would be responsible for these alterations. PMID- 2717791 TI - [Utility of systematically determining serum HBsAg in the 3d trimester of pregnancy]. AB - A group of pregnant women living in the south of the province of Pontevedra (Spain) have been studied in order to determine the prevalence of hepatitis B virus biological markers. For that respect we have prospectively studied HBsAg and other markers in 535 pregnant women from June 1987 to March 1988. The prevalence of HBsAg was 0.75%, and in 6.12% certain biological markers were detected. Only one carrier fulfilled the current criteria recommended by the Advisory Committee on Immunization Practices (ACIP) for selective screening of pregnant women. Although the prevalence and costs of the detection are similar to those for voluntary blood donors of the same region (1%), the frequency with which infected neonates develop chronic antigenemia along with the low sensitivity of the selective screening justifies the systematized serological study of the pregnant women. PMID- 2717792 TI - [Influence of some ambient factors in the epidemiology of essential hypertension]. AB - We studied a population of 13,963 subjects of whom 8,043 were group control and 1,915 were patients with undetected hypertension and the remaining patients were patients with hypertension diagnosed before the study. We analyzed age, sex, intake of alcohol, coffee, and saturated fats and compared these variables with the blood pressure readings. A significant statistical correlation between them was found. In addition the odd risks (OR) for each variable, such as alcohol showed a risk 2.26 times greater for drinkers than non-alcohol drinkers. This was 2.76 times greater in men than in women and 3.78 times greater in subjects 30 years old and over. PMID- 2717793 TI - [Type C hereditary brachydactyly]. AB - We report 2 generations with type C hereditary brachydactyly of dominant autosomal inheritance of variable expressiveness. The most characteristic data was the shortening of the middle phalanges of the second, third and fifth finger as well as the first metacarpal. Short stature was observed in three of the patients studied. The goal of this study was aimed at stimulating GH pharmacologically and determining its 24 h physiologic secretion, as well as somatomedin C levels. All the determinations were within the normal range. The deficient growth shown by these patients is a constitutional growth delay, possibly an expression of type C brachydactyly. PMID- 2717794 TI - [Fat consumption in the autonomous community of Madrid]. AB - The results, based on the study of total lipid and cholesterol intake in a representative population of the district of Madrid, reflect the unfavorable situation for this population in regards to the incidence of cardiovascular diseases when comparing our data with national data and that obtained in the district of Castilla-La Mancha. However, the results are similar to those from other developed countries. The consumption of total lipids and the percentage of energy obtained is greater in the district of Madrid than in the other two populations mentioned. The energy obtained from saturated fatty acids exceeds that recommended by the WHO. However, the consumption of polyunsaturated fatty acids and monounsaturated fatty acids was found satisfactory. Of the three populations, the district of Madrid has the highest cholesterol intake and, as in the other two groups, this substance comes from eggs. PMID- 2717795 TI - [Fever induced by cefuroxime]. PMID- 2717796 TI - [Addiction to buprenorphine]. PMID- 2717797 TI - [Unusual clinical and radiologic manifestations in Q fever]. PMID- 2717798 TI - [Hypophosphatasia: apropos of a case]. PMID- 2717799 TI - [Infiltrative ophthalmopathy associated with hypothyroidism]. PMID- 2717800 TI - Visual acuity after the repair of pseudophakic retinal detachments involving the macula. AB - Postoperative visual acuities were retrospectively evaluated in a series of 100 pseudophakic eyes in which rhegmatogenous retinal detachments involved the macula and in which reattachment surgery was anatomically successful. Preoperative visual acuity and duration of macular detachment were related to visual outcome. Eyes in which extracapsular surgery had been followed by posterior chamber lens implantation had significantly better postoperative visual acuities than cases in which older iris-fixation intraocular lenses (IOLS) were placed after intracapsular procedures. Retinal detachments associated with posterior chamber IOLs have a relatively favorable anatomical and visual prognosis. PMID- 2717801 TI - Photocoagulation using the Eisner cone. AB - Thirteen patients with clinical or subclinical retinal detachments were treated with photocoagulation with the aid of a device for scleral depression and the three mirror contact lens. The Eisner cone has proven helpful in achieving clinically white retinal burns at the margins of retinal breaks by displacing subretinal fluid at the time of treatment. Patients selected for treatment had adequate pigmentation for a good photocoagulation response, nearly clear ocular media, and minimal vitreo retinal traction. Extent of retinal detachment was not a determinant, but minimal retinal elevation at break locations proved beneficial. No immediate flattening or adhesion of the retina was seen on release of scleral depression at the time of photocoagulation. White clinical burns remained visible. In 12 of 13 patients the retina was in apposition to the retinal pigment epithelium around the breaks at the first post-treatment examination. The remaining subretinal fluid absorbed in even the most extensive detachment in 2 weeks. One patient with multiple breaks at the equator failed to respond to this technique and required a scleral buckle. PMID- 2717802 TI - Solar retinopathy. A photobiologic and geophysical analysis. AB - A series of young adult patients developed solar retinopathy during sun exposure over a two-day period in a particular region of the United States during March of 1986. Evaluation of the photobiological and geophysical parameters involved in solar retinitis are presented. A multifactorial pathogenesis is proposed. Of interest, a possible increase in terrestrial ultraviolet B radiation secondary to a localized relatively low ozone column during the days involved may have contributed to the retinal damage. Recommendations for protection from solar retinitis are noted. PMID- 2717803 TI - Congenital hypertrophy of the pigment epithelium: light microscopic and ultrastructural findings in young children. AB - Two cases of autoptically observed congenital hypertrophy of the retinal pigment epithelium (CHRPE) in a newborn and in an infant, one with electron photomicrographs, are presented. In contrast to the adjacent RPE cells, the apical cellular surface of CHRPE cells shows only rare small microvilli, mostly at the cell border. The prominent findings are large pigment granules from 3.5 to 8 microns protruding towards the apical cellular surface. These macromelanosomes do not exhibit coalescence as noted by others, but show a concentric lamellar structure that may be the result of a disturbed development sequence in melanin granule formation. The authors' observation of CHRPE in a newborn and in an infant suggests that the term congenital HRPE is appropriate. The presence of these changes at this early age is consistent with the condition being a primary failure of differentiation. Finally, the authors present evidence of a disturbed melanogenesis in CHRPE cells resulting in macromelanosomes formation. PMID- 2717804 TI - Experimental autonomic neuropathy in the choroid of streptozotocin-diabetic rats. Electron microscopic observations. AB - The authors used transmission electron microscopy to examine the autonomic nerve plexus of the choroid, in Wistar albino rats with long-term streptozotocin diabetes. Axonal alterations included massive glycogen deposits, honeycomb arrangement of synaptic vesicles, and an accumulation of dense, lamellated, tubulovesicular and multivesicular bodies within the transmitter segments. The alterations affected not only the neuroeffector areas of arterial and venous vessels, but also the close contacts between transmitter segments and melanocytes. Morphometric analysis lead the authors to conclude that the axonal alterations do not simply represent accentuation of age-related phenomena. Instead, they should be considered as manifestations of diabetic autonomic neuropathy. PMID- 2717805 TI - Very large neurons of the inner retina of humans and other mammals. AB - Large ganglion cells, called parasol cells, are known to occur in the Golgi stained, human retina. This report describes a population of much larger cells that is not stained by Golgi technique. These cells may be located in the human ganglion cell layer using Nomarski differential interference contrast optics and unstained, flatmounted tissue. These cells are regularly distributed in young and old adults in a Gaussian fashion along the radii that extend from the perimacula toward the far periphery. The author did not find the cells in the central retina. The most frequent (J-type) cells have soma diameters between 26 and 40 microns. Rare (S-type) cells measure up to 55 microns in diameter. Many cells have processes that appear to be axons or dendrites. These cell types may be especially sensitive to damage early in diseases of the inner retina. PMID- 2717806 TI - A modified illuminated membrane pick. PMID- 2717807 TI - Silicone oil implantation in penetrating injuries complicated by PVR. Results from 1982 to 1986. AB - Between 1982 and 1986, the authors implanted silicone oil in 34 eyes with retinal detachment and proliferative vitreoretinopathy (PVR) stages C-3 to D-3 caused by penetrating injuries. The retina had failed to reattach after initial vitrectomy, membrane peeling, and scleral buckling. Complete anatomic reattachment was achieved in 62%, partial reattachment in an additional 9%. Useful functional results were achieved in 68% of cases (visual acuity of 1/60 to 20/20). Postoperative complications included elevated intraocular pressure in 38% and progress of PVR with membrane formation under the silicone oil in 21% of the cases. Sixty-eight percent of the aphakic eyes developed band-shaped keratopathy. Because most of the eyes were aphakic, the authors do not report cataract incidence. In 15 eyes (44%) the silicone oil was removed. In 14 of these eyes the retina remains attached, in one eye silicone oil removal was followed by phthisis bulbi. PMID- 2717808 TI - The development of pulmonary surfactant lipids in a neonatal marsupial and the rat. AB - The composition of pulmonary surfactant during development was compared in a marsupial, the tammar wallaby, and the rat. For both species phospholipid fatty acid and neutral lipid fatty acid composition is similar, and phosphatidylcholine was the principal phospholipid at each age group. The relative amount of each phospholipid class significantly changed with time in both species but the extent of these changes did not vary between species. The neutral lipid component of surfactant varied significantly between the marsupial and eutherian, with higher levels of free cholesterol observed in the former. Overall the lipid composition of pulmonary surfactant in the developing wallaby is similar to that seen in eutherians with the exception being the level of free cholesterol. PMID- 2717809 TI - Pleural pressure from abdominal to pulmonary rib cage: sweep of the lung border. AB - Pleural pressure was measured by a capsule placed in the superior part of right 8th or 9th intercostal space of dogs in left lateral posture. Transit of lung border was observed through endothoracic fascia at sides of the capsule. During inspiration the capsule membrane faced sequentially: diaphragm, lung border, lung; vice versa during expiration. Pressure on the diaphragm at end expiration was -5.3 +/- 0.5 cm H2O, reflecting outward recoil of the rib cage. At transit of lung border during inspiration (bor. I) a marked negative pressure spike occurred; a smaller spike occurred at expiratory transit (bor. E). These spikes should reflect pleural liquid pressure at lung border. At bor. I lung volume and radial displacement of rib 9 or 10 were greater during active than passive ventilation, whereas at bor. E they were similar under both conditions. Hence, during spontaneous inspiration displacement of lung border lags behind lung and rib expansion. Speed of lung border (assessed from duration of negative spike) ranged from 0.8 to 2.3 cm/sec during spontaneous breathing. On average it was similar at bor. I and bor. E, while air flow was greater at bor. I. PMID- 2717810 TI - Alveolar hypoxia, inhibition of hypoxic pulmonary vasoconstriction, and permeability edema. AB - We previously reported that regional alveolar hypoxia reduces oleic acid-induced permeability edema formation [Cheney et al. (1987). J. Appl. Physiol. 62: 1690 1697]. In order to define the role of hypoxic pulmonary vasoconstriction (HPV) on this effect, we studied the effects of regional alveolar hypoxia on permeability edema formation with this response inhibited. Dogs weighing 25 +/- 1 kg in which the HPV response had been inhibited by the administration of minoxidil (1 mg/kg i.v.) were anesthetized, mechanically ventilated and had a bronchial divider placed so the left lower lobe (LLL) could be ventilated with an FIO2 = 0.05 or FIO2 = 1, while the right lung was continuously ventilated with an FIO2 = 1.0. In 10 study animals the LLL was ventilated with an FIO2 = 0.05 for 4 h after induction of bilateral permeability pulmonary edema with 0.05 ml/kg of intravenous oleic acid. In six control animals the LLL was ventilated with an FIO2 = 1 for 4 h after the same injury. Postmortem gravimetric analysis indicates that alveolar hypoxia of the LLL with the HPV response inhibited had no effect on pulmonary edema formation. We conclude that inhibition of HPV abolishes the protective effect of regional alveolar hypoxia on oleic acid-induced permeability edema formation. PMID- 2717811 TI - Pleural liquid pressure at the caudal border of the lung. AB - Model simulation indicates that pressure recorded through a capsule, when lung border is under it, is essentially equal to pressure of pleural liquid (Pliq) surrounding lung border, though only a strip of capsule membrane is exposed to this liquid (the rest is facing diaphragm and lung). At the top of the right 8th or 9th intercostal space of dogs in left lateral posture Pliq recorded through a capsule at transit of lung border during inspiration (bor. I) or expiration (bor. E) was -19.7 +/- 1.1 and -11.2 +/- 0.3 cm H2O, respectively. Pliq recorded simultaneously through a cannula on the flat surface of lung in 5th or 6th intercostal space (corrected for 1 cm lower height) was -18.7 +/- 1.4 and -12.4 +/- 0.8 cm H2O. Similar values of Pliq on lung border and on flat surface of lung, despite different kinds of deformation and different measuring devices, provide further evidence that Pliq is more subatmospheric than pleural surface pressure. Seventy percent of difference in Pliq between bor. I and bor. E was accounted for by: (a) corresponding difference in pleural surface pressure, and (b) greater tidal change of liquid than surface pressure. Possible factors accounting for the remaining 30% are discussed. PMID- 2717812 TI - Expiratory airflow patterns and gas exchange in the newborn infant: results of model simulations. AB - A mathematical model simulating the newborn human infant's respiratory system was used to study the effects on gas exchange of varying expiratory airflow pattern and end expiratory lung volume (FRC). Inspiratory flow was modelled as a square wave and was constant for all simulations as were inspiratory and expiratory times. Expiratory airflow was also modelled as a square wave and was varied between 21 and 75 ml/sec with FRC held constant at either 30.2 or 21.2 ml/kg for each simulation. At a given FRC, expiratory airflow pattern had only a trivial effect on blood gases in the steady state. Comparing the extreme cases, fast expiration (75 ml/sec) at low FRC (21.1 ml/kg) with slow expiration (21 ml/sec) at high FRC (30.2 ml/kg), arterial PO2 was 3.8 mm Hg higher and arterial PCO2 1.0 mm Hg lower under the latter conditions. However, when short apneas were imposed, blood gases deteriorated less precipitously following the slow expiration at high FRC. We conclude that expiratory airflow retardation and the resultant elevation in end expiratory lung volume do not greatly enhance gas exchange in the healthy full term infant. However, mechanisms which slow expiratory airflow do provide a buffer for gas exchange during the short apneas often observed in infants. PMID- 2717813 TI - Nasal 'flow' receptors of the rat. AB - This study was performed to identify trigeminal nasal 'flow' receptors and to investigate their firing characteristics. For this purpose, single unit afferent activity was recorded from the anterior ethmoidal nerve in anesthetized rats breathing through the nose or a tracheostomy. In fourteen rats breathing through the nose, 40 of 73 endings tested were identified as 'flow' receptors for the following characteristics: their spontaneous activity had an inspiratory modulation that disappeared during nasal occlusions, they were markedly stimulated by exposure to cold air and inhibited by warm air. In eleven rats breathing through a tracheostomy, 85 endings were identified as 'flow' receptors being stimulated by a constant nasal airflow (100-300 ml/min) with room air (22 26 degrees C) or cold air (0-15 degrees C), but inhibited with warm air (30-45 degrees C). Fifty-five 'flow' receptors (Type R1 and R2) exhibited a dynamic response to the constant airflow, while the other 30 receptors (Type S) showed a static response. A large proportion of 'flow' receptors (more than 52%) were responsive to tactile stimuli. For all the flow receptors, a decrease in intranasal temperature was the primary factor to excite them. These results suggest that the trigeminal nerve has a number of 'flow' receptors which operate as thermoreceptors. PMID- 2717815 TI - Effects of water temperature on pulmonary volumes in immersed human subjects. AB - Pulmonary volumes and capacities have been measured at three water temperatures (Tw = 25, 34, 40 degrees C) in standing subjects immersed up to the shoulders. The comparison of data obtained in air with those obtained in thermoneutral immersion (Tw = 34 degrees C) confirms the results previously published in several studies. The comparison of data obtained in immersion at different Tw shows: 1. A significant decrease in vital capacity (VC) with bath temperature (VC 40 degrees C greater than VC 34 degrees C greater than VC 25 degrees C). The same decrease is observed in the inspiratory reserve volume (IRV) while the expiratory reserve volume (ERV), the residual volume (RV) and the functional residual capacity (FRC) do not vary. 2. A significant decrease in maximum breathing capacity (MBC) with bath temperature (MBC 40 degrees C greater than MBC 25 degrees C). 3. A significant increase in tidal volume (VT) in cold or hot water compared to thermoneutral water (VT40 degrees C greater than VT34 degrees C; VT34 degrees C less than VT25 degrees C) during quiet breathing. Breathing frequency does not change, thus ventilation (V) follows the same evolution as VT. The relative abdominal (ABD) contribution to VT, estimated by a double belt inductance plethysmograph, is reduced at Tw = 25 degrees C but unchanged at Tw = 40 degrees C compared to thermoneutral bath. Beside variations in the metabolic state, the variations of the pulmonary volumes as a function of Tw are estimated to be mainly due to alterations in respiratory muscles functioning. PMID- 2717814 TI - The effects of pentobarbitone, diazepam and alcohol on oral breathing in neonatal and mature sheep. AB - Our aim was to determine the effects of pharmacological sedation on oral breathing induced by nasal obstruction in chronically prepared newborn and mature sheep. Nasal obstruction (5 min) was achieved by blocking tubes temporarily fixed into the nostrils. We continuously recorded EMG activity of the diaphragm, genioglossus and digastric muscles, intrapleural pressure and percent O2 saturation in arterial blood (SaO2). Blood samples were taken intermittently and analysed for SaO2, P02, PCO2 and pH. As previously reported, nasal obstruction in lambs and ewes led to asphyxial changes in blood gases and pH; lambs were affected more than ewes. Respiratory responses to nasal obstruction were retested after administration of pentobarbitone Na (5 and 10 mg/kg), diazepam (0.2 and 0.4 mg/kg) and alcohol (nominally 0.075 and 0.11% of blood w/v). Pentobarbitone and diazepam, both of which produced sedation, delayed the onset of oral breathing and led to a greater degree of asphyxia during nasal obstruction. EMG activities in the genioglossus and digastric muscles were inhibited by the drugs, whereas the depth of inspiratory efforts was not. Alcohol had no apparent sedative effect, nor did it significantly affect responses to nasal occlusion. We conclude that sedating doses of pentobarbitone and diazepam depress the effectiveness of oral breathing when the nose is blocked, probably owing to their inhibitory effects on activation of muscles maintaining patency of an oral airway. PMID- 2717816 TI - Afferent vagal activity during hyperthermic polypnea in the pigeon. AB - Respiration-modulated activity in afferent vagal fibers was recorded in 10 pigeons during euthermic breathing and thermal panting. Of these fibers, 13 were identified as intra-pulmonary chemoreceptors (IPCs), that increased discharge with diminishing lung gas PCO2, and 13 as mechanoreceptors, that increased firing with lung inflation. Two types of IPC were observed that were distinct by their firing pattern during panting. Phasic IPCs displayed phasic discharge within the respiratory cycle, even at respiratory frequencies (fresp) as high as 400 min-1. Tonic IPC fired tonically and increased their discharge as fresp increased. Several IPCs were silent during euthermic breathing, but discharged tonically as fresp increased with thermal polypnea. Discharge of neither type of IPC was consistently related to PaCO2. Discharge from mechanoreceptors was phasic with respiration, up to values of fresp as high as 350 min-1. However, the average number of impulses per breath decreased as fresp increased. We conclude that discharge from phasic intrapulmonary chemoreceptors and mechanoreceptors may contribute to setting the respiratory pattern during hyperthermic polypnea. PMID- 2717817 TI - Diaphragmatic vasodilation elicited by pulmonary C-fiber stimulation. AB - This study was performed to assess the effect of pulmonary C-fiber stimulation with capsaicin on vascular resistance in the diaphragm. Nine dogs were anesthetized with pentobarbital sodium and were instrumented with right and left ventricular catheters. The left phrenic artery was isolated and perfused from an extracorporeal reservoir. Right ventricular capsaicin injections (5-20 micrograms/kg) caused significant decreases in phrenic perfusion pressure (-16%), systemic arterial pressure (-32%), and heart rate (-19%). Injection of identical doses of capsaicin into the left ventricle led to no significant changes in phrenic arterial perfusion pressure or systemic arterial pressure but a 10% decrease in heart rate. Bilateral cervical vagotomy eliminated the response to both right and left ventricular injection of capsaicin, as did administration of the autonomic ganglion blocker hexamethonium bromide. The results indicate that pulmonary C-fiber stimulation reflexly vasodilates vessels in the diaphragm. PMID- 2717818 TI - Response of stretch receptors to static inflations and deflations in an isolated tracheal segment. AB - It has been proposed on the basis of differing responses to static lung inflations that there are two types of pulmonary stretch receptor which are organized in series or in parallel with airway smooth muscle. However, in prior studies, in which we examined the responses of a few receptors in a number of animals, we were unable to confirm this finding. In the present study we sought to definitively address this question by examining the response of a reasonable sample of receptors (greater than or equal to 5) from a single airway with a controlled mechanical environment. We examined the firing patterns of slowly adapting receptors in a tracheal segment, isolated in vivo, during inflations and deflations to different static levels of pressure between -20 and +30 cm H2O. The relationship between afferent firing and intra-tracheal pressure under static conditions was determined. We did not observe any evidence to support the existence of two distinct subtypes of receptors. During these studies we also looked for abrupt changes in the variability of afferent firing during the period of adaptation after the end of an inflation or deflation. Such changes have been described for other receptors with branched endings capable of generating spike potentials. These changes occur when the region generating the spike train seen in the parent fiber switches from one branch to another (pace-maker switching) and reflect the difference in the intrinsic variability of each branch. In the majority of fibers studied we saw no evidence of such switching and thus of the presence of multiple encoders in the receptor structure. PMID- 2717820 TI - Cardiorespiratory functions in the fetal llama. AB - Factors which allow the adaptation of adult llamas to oxygen limitation include principally: low P50, small elliptical red cells with high hemoglobin concentration, high muscle myoglobin concentration, high capillary density and a more efficient O2 extraction at tissue levels. The fetal llama is known to have blood with a low P50 but it is not known whether it has further cardiorespiratory adaptations which could allow it to cope with a low oxygen milieu. To investigate this, we have measured fetal blood flow and blood oxygen content in 8 fetal llamas and compared the findings to similar measurements in 10 low altitude bred fetal sheep, during the last third of gestation. The llamas were born and raised at 4500 m. They were brought to Santiago (586 m) and were studied one week later. The results show that there was higher hemoglobin concentration and higher oxygen capacity in blood from the fetal llama compared to the fetal sheep. Fetal llama combined ventricular output and umbilical blood flow were less than one fourth of those found in fetal sheep. Regional blood flows and oxygen delivery to fetal tissues were in most cases less than half those found in the fetal sheep. Calculated vascular resistances in the fetal llama in almost all vascular beds are higher than those in fetal sheep. These studies suggest that basal fetal llama oxygen uptake is maintained due to an increased oxygen extraction by fetal llama tissues. This increased oxygen extraction may be the result of a high capillary density.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2717819 TI - Fetal lung growth: influence of maternal exposure to cold and exercise in rats. AB - The consequences of maternal exposure to low ambient temperature and exercise on maternal and fetal lung growth and in particular on the relationship between the three gas exchange organs (lungs and placenta) were studied in albino rats. Pregnant rats were subjected to 10 degrees C ambient temperature or to daily 10 min swimming exercise beginning at day 3 or day 11 of pregnancy till day 21 when they were sacrificed. Maternal lung growth was assessed by measuring the lung weight, lung air volume and lung DNA content, and the fetal lung growth by lung DNA content. Comparisons were made in rats with litter sizes of 9-14. The major findings were as follows. Cold increased: (1) the maternal lung, liver, kidney and heart size, and fetal body weight, in both groups, but to a greater degree in rats exposed to cold at day 3; and (2) fetal lung DNA content in rats subjected to cold at late gestation. It abolished the relationship between maternal and fetal lung DNA content which exists in large litter size pregnancies. Exercise did not enlarge the maternal lungs; it decreased the placental weight and fetal lung DNA content and abolished the relationship between maternal and fetal lung DNA content in rats subjected to exercise at early gestation. Neither cold nor exercise had an effect on fetal lung maturation. It is postulated that reduction in fetal lung DNA content with maternal exercise may result from the effects of hypoxemia which may be the consequence of reduced uterine blood flow; and that abolition of normally existing direct relationship between maternal and fetal lung DNA content may be the outcome of the effects of alterations in metabolic and endocrine functions, in both the mother and the fetus, in response to cold temperature and exercise, offsetting the influence the growing maternal lung may have on fetal lung growth. PMID- 2717822 TI - Pleural liquid pressure in the zone of apposition and in the lung zone. AB - Pleural liquid pressure in zone of apposition (Pliq,ap) and in lung zone (Pliq,L) was measured simultaneously through liquid filled cannulas in anesthetized dogs in lateral posture. At top Pliq,ap and Pliq,L at iso-height were -9.7 +/- 0.4 and -11.9 +/- 0.3 cm H2O, respectively, at end expiration (eE; P of delta less than 0.01; 11 dogs); -9.6 +/- 0.7 and -19.8 +/- 0.7 cm H2O at end inspiration (eI). At bottom they were -0.6 +/- 0.2 and -2.4 +/- 0.4 cm H2O, respectively, at eE (P of delta less than 0.05; 4 dogs); -1.5 +/- 0.3 and -8.5 +/- 1.0 cm H2O at eI. Vertical gradient of Pliq,ap was -0.97 +/- 0.02 cm H2O/cm. A 132% increase in ventilation (after 10 min dead space breathing) did not change eE and eI Pliq,ap, and eE Pliq,L, but decreased eI Pliq,L. These results imply: (1) no transmission to zone of apposition of tidal changes in Pliq,L; (2) a liquid flow from zone of apposition to lung zone; (3) a net filtration into zone of apposition. They suggest that absorption pressure of capillaries of visceral pleura is greater than that of lymphatics of zone of apposition. Lymphatic role in setting Pliq,L is discussed. PMID- 2717821 TI - A comparison of the surfactant associated lipids derived from reptilian and mammalian lungs. AB - The lungs of the central netted dragon Ctenophorus nuchalis are bag-like, with most of the gas exchange region located in the anterior third. Although the faveoli are much larger than the mammalian alveoli, the lizard at 37 degrees C has approximately 70 times more surfactant phospholipid per unit area of respiratory surface than does a similar sized mammal. However, when expressed as per wet lung weight, lizards and rats possessed similar amounts of phospholipids. Dipalmitoylphosphatidylcholine was the principal phospholipid in both species. However, major differences existed in the phospholipid, neutral lipid and fatty acid profiles. Whereas the lizard contained neither phosphatidylglycerol nor phosphatidylethanolamine it had more cholesterol, esterified cholesterol, acylglycerides and unsaturated fatty acids. Although the ratio of saturated:unsaturated fatty acids was similar in rats and lizards, palmitic acid predominated in the former. The composition of lizard surfactant suggests that it would adsorb rapidly at reduced body temperature. PMID- 2717823 TI - Oxygen transfer kinetics of red blood cells of the turtle Pseudemys scripta elegans. AB - The kinetics of O2 uptake into, and release from, the red blood cells (RBC) of the turtle Pseudemys scripta elegans were determined with a stopped-flow technique at varied temperature (10-30 degrees C) and pH (7.5-7.9). The results were compared to those obtained for RBC of other vertebrates and related to morphometric and physiological data on gas/blood diffusion in turtle lungs. The O2 transfer conductance of RBC, G, for O2 release into high concentrations of dithionite, considered to represent the best estimate of true RBC transfer conductance for O2 uptake and release, averaged 0.17 +/- 0.01 at 30 degrees C, 0.13 +/- 0.01 at 20 degrees C, 0.09 +/- 0.01 at 10 degrees C (mean +/- SD, in mmol.min-1.Torr-1.(mlRBC)-1). These values are about one half the corresponding value for human RBC, and this difference may be due to the larger size of turtle RBC (volume, 327 microns 3) compared to human RBC (90 microns 3). The temperature dependence of G, Q10 = 1.3 indicates that, as in human RBC, diffusion through aqueous media is the main limiting factor for O2 exchange. Morphometric data on the lungs of Pseudemys scripta suggest that the resistance to O2 transfer by RBC is lower than that offered by the gas-blood barrier. The total apparent transfer resistance to CO, obtained from previous measurements of pulmonary diffusing capacity for CO in the same species, is much higher than that predicted from the combination of RBC O2 kinetics and morphometric data on gas-blood barrier. PMID- 2717824 TI - [Cytochrome P-450. Structure, function and role in various drug interactions]. PMID- 2717825 TI - [Extreme hypogammaglobulinemia disclosing large granular lymphocytes with hepatosplenorenal infiltration]. AB - We report a case of large granular lymphocytosis, or chronic "natural killer" lymphocytosis, a newly described entity. We were able to demonstrate the proliferative character of the disease by the finding of karyotype abnormalities. This case was remarkable for the pre-existence, for at least three years, of severe hypogammaglobulinaemia, for the very slow course of the proliferative process and for the progressive and tumoral infiltration of the spleen and liver, then kidney. PMID- 2717826 TI - [Transthoracic puncture and excavated pulmonary lesion. Diagnostic contribution and value of the extemporaneous cytologic test]. AB - Twenty-six cases of excavated pulmonary masses are reported. In 18 cases malignancy was proven by transparietal needle aspiration. A false-negative result was due to the needle being introduced too centrally and bringing pus, whereas the tumour was an epidermoid carcinoma. The seven non-malignant lesions consisted of abscess in 4 cases, tuberculosis in 1 case and pulmonary embolism in 2 cases. The sensitivity and specificity of the technique were similar to those observed in large series of transparietal needle aspiration of solid masses. Using thin needles and extemporaneous cytology reduced the number of complications: haemothorax 6 percent, haemoptysis 0.4 percent. The authors conclude that in excavated pulmonary masses transparietal needle aspiration provides a diagnosis of malignancy when the radiological and clinical courses and bronchial fibroscopy are inconclusive. Transparietal needle aspiration avoids the need for other investigations, such as exploratory thoracotomy, thereby reducing the cost of diagnosis. PMID- 2717827 TI - [Severe complications related to metabisulfites]. AB - Metabisulfite intolerance is encountered in 8 p. 100 of cases of extrinsic asthma and in 20 p. 100 of cases of the "aspirin triad" with nasosinusal polyposis, asthma and aspirin sensitivity. The possibility that anaphylactoid shock or acute severe asthma leading to status asthmaticus, might be related to sulfite sensitivity must be well known. Two case reports are set out. The first observation is that of a 35-year-old woman suffering from intrinsic asthma with alcohol intolerance, who developed status asthmaticus a few minutes after intravenous administration of Doxycycline associated with a metabisulfite preservative. The other 33-year-old patient presented with an acute bronchospasm in the course of a fiberoscopy using Lidocaine associated by mishap with epinephrine, as local anesthetic. The authors point to the miscellaneous drugs containing sulfites, that are employed in asthmatics by different routes, i.e. parenteral, oral, inhalational and other local treatments. Heavy metabisulfite intake may also arise from daily alcohol consumption. Sulfite intolerance could contribute to the persistence of chronic inflammatory processes in bronchial asthma and therefore should be systematically investigated. PMID- 2717828 TI - [Diaphragmatic paralysis and neurologic diseases]. PMID- 2717829 TI - [What viral serologies should be done in immunological thrombopenic purpura in patients without human immunodeficiency virus infection?]. PMID- 2717830 TI - [Excretion of porphyrin and porphyrin precursor during ethylene oxide inhalation]. AB - The effect of chronic inhalation of ethylene oxide on urinary coproporphyrin and delta-aminolevulinic acid were studied. When Wistar male rats were exposed to 500 ppm ethylene oxide three times a week, daily urine volume was increased by 200 300% from the first week to the fifth week of the experimental period. After exposure, daily coproporphyrin excretion and urinary coproporphyrin per mg of creatinine increased by 250% and 141%, respectively. On the other hand, daily excretion of delta-aminolevulinic acid in urine tended to increase but did not increase significantly by creatinine-correction. We think this is the first report of ethylene oxide induced experimental porphyria. PMID- 2717831 TI - [Evaluation of testicular damage by flow cytometry: testicular atrophy caused by ethylene oxide]. AB - The new method using flow cytometry was applied to analyse the testicular toxicity of ethylene oxide, and the usefulness of this method is discussed. When Wistar male rats were exposed to ethylene oxide for six hours a day, three times a week for six weeks, the testicular weights of the exposed group significantly decreased. When the cells of these testes were stained by propidium iodide and analysed by flow cytometry, four peaks which corresponded to maturation phase spermatids (less than C), the other haploid cells (C), diploid cells (2C) and tetraploid cells (4C) were obtained. Calculating the ratio of the percentage of less than C, C and 4C to that of 2C, the ratio of less than C of the exposed group decreased by 72.9%, 2C by 53.5% and 4C by 5.1% when compared with the control group. As these changes were almost consistent with that of histopathological examinations, we are able to conclude that more mature germ cells were affected by ethylene oxide. This method by flow cytometry is thought to be objective, quantitative and convenient to evaluate testicular damage by chemicals. PMID- 2717832 TI - [The racial differences of plasminogen A gene (PLG* A) frequencies]. AB - The present authors investigated racial differences of PLG* A frequencies by literature search. From the results of these investigations it was seen that the frequency of Mongoloids was higher than those of Negroids and Caucasoids, and the frequency of Negroids and that of Caucasoids was almost equal. There is a great variation in the distribution of PLG* A in Negroid and Caucasoid populations. Further studies are necessary to obtain more data regarding PLG* A frequency. PMID- 2717833 TI - A case of giant cell interstitial pneumonia. AB - This report is of a case of giant cell interstitial pneumonia (GIP) diagnosed by transbronchial lung biopsy (TBLB) and treated effectively with corticosteroid. The patient was a 61-year-old man with cough, dyspnea and findings of diffuse reticular opacities on chest X-ray. In the microscopic section of a biopsied specimen, varied forms of giant cells were observed, some with a cannibalistic appearance. Numerous giant cells and some lymphocytes were also observed in the bronchoalveolar lavage fluid. The possibility of measles pneumonia was ruled out by a negative serum antibody test and the absence of inclusion bodies in the giant cells. The patient had neither a past history of exposure to heavy metals nor to organic dusts. A distinct improvement was obtained with 30 mg of prednisolone administered daily for two weeks and then tapered off gradually. PMID- 2717834 TI - [Continuing education and residency program of occupational medicine in U. S. A]. AB - To investigate postgraduate education of occupational medicine in the U. S. A., the author was sent to take some courses in occupational medicine continuing education supported by the National Institute of Occupational Health (NIOSH) in February and March of 1988. The course participants were mainly industrial hygienists. The contents of the courses were approximately the same as those of the Three-Month Course in Fundamental Occupational Health held in UOEH for medical doctors. The physicians in occupational medicine in the U. S. A. take mainly mini-residency courses from the NIOSH programs. The Curriculum of the Intensive Residency Program at the University of California San Francisco (UCSF) is presented in this report as a reference. According to the information I acquired, well-trained industrial hygienists are maintaining a high standard of control over the workplace environment. I received the impression that the industrial hygienists are playing an important part in occupational health in the U. S. A. Physicians specializing in occupational medicine are interested more in the clinical diagnosis of occupational diseases than in preventive measures such as environmental control of the workplace. PMID- 2717835 TI - Industrial physician's responsibilities to his patients and to management- confidential records. AB - There is no disagreement with the principle that the physician in industry should guard the confidentiality of information given to him by employees with the same consideration as any other physician. In practice, there are often pressures to violate this principle, especially with respect to disease-detection programs, but ultimately, industry, management and worker are served best where the physician can establish a reputation for trustworthiness, concern for individuals, and ability to convey information that management legitimately needs without compromising private information. PMID- 2717836 TI - [Snoring]. PMID- 2717837 TI - [Parathyroid carcinoma]. PMID- 2717838 TI - [Medical French. II (a plea for the correct use of French)]. PMID- 2717839 TI - [Anaphylactic shock]. PMID- 2717840 TI - [Autoimmunity: various current aspects]. PMID- 2717841 TI - [HIV in 1989: frequent questions and elements of response]. PMID- 2717842 TI - [The value of preoperative studies. Prospective study of preoperative thoracic radiographs and ECGs of 201 patients]. PMID- 2717843 TI - [The practitioner's actions in cases of severe cardiac disorders]. PMID- 2717844 TI - [Theoretical aspects of signal processing]. PMID- 2717845 TI - [Practical aspects of signal processing in perinatal medicine]. PMID- 2717846 TI - [Signal processing in neonatology]. PMID- 2717847 TI - [Automatic computer analysis of fetal cardiac rhythm]. AB - In utero cardiotocographic recording is currently one of the best means of diagnosis of fetal distress. The purpose of automatic tracing of the fetal heart rate is to prevent inter- and intra-individual variability in order to better evaluate the condition of the fetus. This study was carried out with the assistance of a cardiotocograph HP 8040A connected to a microcomputer equipped with a clock card. The heart signal may then be continuously recorded and stored on floppy disks, which are then reread and processed by microcomputer. The data are divided into time intervals (3, 5 or 10 seconds), selected by the physician. At each stage, mean, median and sample variation are calculated. Losses of signal are read. In a second stage, the use of a digital, linear and predictive filter (Kalman filter) applied to heart rates, allows baseline extraction as well as the detection of variations about this baseline (accelerations, decelerations). With the use of this filter on sample variations, it is possible to detect various variability periods, via two different approaches: classification of variability values in three groups: 0-5 bpm, 5-10 bpm, greater than 10 bpm, detection of increases or decreases of the variability as compared to the mean variability during the recording. Comparison of automatic analysis and visual analysis by segmentation is satisfactory in terms of variability. Detection of accelerations and decelerations is more problematic, for two reasons: the notion of baseline, the accuracy of digital detection: 15 bpm, 15 sec. All these problems are discussed. PMID- 2717848 TI - [The pregnancy file on a magnetic card (CAM)]. PMID- 2717849 TI - [Computerized obstetrical record of the North Pas-de-Calais region]. AB - The computerized obstetrical record of the North-Pas-de-Calais region proceeds from the desire of a number of people from the Regional Health Observatory, to dispose of a prospective epidemiologic tool in the field of perinatology. The objective is a better knowledge of the cause of perinatal death, analyzing the modalities of prenatal monitoring, delivery conditions, transfer of the newborns, as well as socio-economical conditions. The program manages the computerization of a usual obstetrical file, in the region, including approximately 200 items and allowing every possible comparison with the well-known CCIM record. The program permits local treatment of the data (statistical calculations) in each maternity hospital: rapid transmission of information between maternity and correspondents (computerized personalized mail), a base of agreement between the different protagonists: midwives, pediatricians, specialists, an easier collaboration with the protection agencies and, especially, the Regional Direction of Sanitary and Social Affairs, with automatic response to hundreds of questions of the yearly questionnaire, which saves a great deal of time and an extreme reliability of the information. This program is compatible with any IBM PC microcomputer and includes a hard disk of 10 or 20 mega-octets. The current price (microcomputer with hard disk, monitor, keyboard, letter-quality printer, management program) make all these performances available at a relatively low expense, under 25,000 francs (not including the tax). PMID- 2717850 TI - [Real-time collection of obstetrical and neonatal data. 1 years' experience]. AB - A real-time program for obstetrical and neonatal data was developed in June 1986 at the maternity hospital in Haguenau. Used routinely, this program has raised comments and controversy. With investigative questionnaires, we have attempted to evaluate how the introduction of computer sciences was perceived by the personnel as well as the patients. PMID- 2717851 TI - [Attempted analysis of the progressive development of prematurity between 1980 and 1985 at the maternity hospital in Haguenau]. AB - The recent increase of premature births has led the authors to conduct an exhaustive, prospective investigation from computerized data, including 8,618 pregnant women who delivered at the Maternity Hospital in Haguenau between January 1980 and December 1985. Their results disclose a significantly increased ratio of premature births in the gravida I group and in women with a primary level of education, who were followed by a general practitioner. On the other hand, the ratio of premature births at 34 weeks and less, is also increased in people followed by a general practitioner, which is not the case for induced prematurity. These results, although preliminary, prompt the consultant to reconsider primary prevention in these groups with particular risks. PMID- 2717852 TI - [Reflections on the systematic screening of cervico-vaginal smears rich in polynuclear cells]. AB - The authors sometimes see cervico-vaginal smears with too many white cells. The question is: what is the meaning of these smears, and what must be the physician's attitude? The authors try to answer this question in this paper. They find 8 p. cent of genital tract infections in their observations. PMID- 2717853 TI - [Vaginal tablets, pills and intrauterine devices. Study of their comparative pathogenicity]. PMID- 2717854 TI - [Equity in health policy. From evidence to action]. PMID- 2717855 TI - [Suicide]. PMID- 2717856 TI - [The perception of caring]. PMID- 2717857 TI - [Orthopedic sitting posture and aging]. PMID- 2717859 TI - [Iron and steel metallurgy. A study of work accidents]. PMID- 2717858 TI - [The positions for childbirth. Standing or supine?]. PMID- 2717860 TI - [Ergometers for exercise tests. Ergometric bicycles and the "endless belt" or treadmill]. PMID- 2717861 TI - [Continuing education. 35. Subject: the behavioral sciences. Topic: the health professional and the patient from the communication angle]. PMID- 2717862 TI - [Woman and nurse]. PMID- 2717863 TI - [Metabolism of calcium and phosphorus]. AB - More than 99 p. 100 of calcium and 90 p. 100 of phosphorus are located in the bone tissue in the form of hydroxy-apatite crystals. Plasma ionized calcium is very tightly regulated, in order to stabilize the membranes of excitable cells, such as nerve and muscle. The PTH-1,25 (OH)2 D axis, triggered by very small variations in plasma ionized calcium (negative feedback) is the major control system of intestinal absorption, movements between bone cells and extracellular fluid, and tubular reabsorption of calcium by the kidney. Thus, usual variations in dietary intake induced no detectable change in plasma calcium and only small variations in 24 h-urinary calcium excretion rate. Plasma phosphate fluctuates over 24h-periods, and homeostatic mechanisms seem to control the concentration and/or content of phosphate in soft tissue cells (phosphate is necessary to ATP synthesis and phosphorylation of intermediate metabolites). The PTH-1,25 (OH)2D axis which is not triggered by variations in plasma phosphate, does not control tightly intestinal absorption, movements between bone cells and extracellular fluid, or tubular reabsorption of phosphate by the kidney. However, the phosphate reabsorption in the proximal tubule of the kidney is rigidly adjusted to the phosphate available in the digestive lumen and the phosphate needs of soft tissue cells, probably via as yet undetermined factor(s). Thus, usual variations in dietary phosphate intake influence notably the plasma concentration and 24 h urinary excretion rate. PMID- 2717864 TI - [Non-neoplastic hypercalcemia]. AB - Hypercalcaemia is a frequent situation in clinical practice. An earlier detection is facilitated by routine analysis of serum calcium. The clinical manifestations depend on severity and the rate of onset of hypercalcaemia. Paucisymptomatic and asymptomatic presentations are the most frequent. Causes of hypercalcaemia are numerous and the mechanisms are various. PTH and vit. D play a preponderant part. In first of all iatrogenic cause are eliminated (all vit D preparations, thiazide diuretics, milk-alkali syndrome). Among non neoplastic hypercalcaemia primary hyperparathyroidism is the first diagnosis. Nephrolithiasis and asymptomatic forms are the most frequent presentations actually. The biochemical profile is not always typical. Generally the association of echography and tomodensitometry lead to the topographic diagnosis. Parathyroid surgical exploration is often necessary in difficult cases. Secondary, the other rare causes of hypercalcaemia are studied: sarcoidosis and granulomatosis disease, thyrotoxicosis and dome endocrinopathies, immobilisation hypercalcaemia, familial hypocalciuric, hypercalcaemia. All of this causes of hypercalcaemia are potentially reversible. PMID- 2717865 TI - [Hypercalcemia in blood diseases and cancers]. AB - The clinical classification of malignant hypercalcaemias according to the presence or absence of bone lesions no longer corresponds to the physiopathology of these hypercalcaemias as it is known today. Both focal osteolysis and humoral hypercalcaemia involve a number of substances, such as prostaglandins, cytokines, growth factors, PTH-rp and calcitriol, the action of which is neither specific nor single. A knowledge of their role in the pathogenesis of hypercalcaemia should lead to the development of antagonists for therapeutic purpose and to a better understanding of their individual physiological effects, since some of these mediators are present in non-tumoral tissues. In humoral hypercalcaemia, PTH-rp seems to play a major role on kidneys and bones. PMID- 2717866 TI - [Hypocalcemia in infants and children]. AB - The hypocalcaemia observed in infants and children may have different causes, the most common being vitamin D deficiency rickets, which still exists, and hypoparathyroidism, which is rare. The clinical manifestations of hypocalcaemia may be neurological disorders, such as seizures, respiratory disorders with possible laryngospasm or severe cardiac disorders that may result in sudden death. Pronounced or symptomatic hypoglycaemia requires hospitalization and active therapy. Treatment has now been improved by the 1-hydroxyle derivatives of vitamin D. PMID- 2717867 TI - [Hyperphosphoremia and hypophosphoremia]. AB - Disorders of phosphate metabolism are caused by a disrupted balance between intestinal absorption and renal excretion or by an altered distribution between intra- and extracellular pools. Hyperphosphatemia per se does not have any clinical effects except for ectopic calfifications. The most frequent cause is chronic renal disease. Other causes - increased tubular reabsorption as seen for instance un hypoparathyroidism; increased intertinal absorption as seen with vitamin D excess; redistribution to the extracellular pool, as seen with the tumor lysis syndrome, are uncommon; and no one cause is outstanding in frequency. Hypophosphatemia is frequent caused by a redistribution of phosphate to the cellular pool, associated for instance with respiratory alkalosis or infusion of glucose and fructose. Hyperphosphaturia as a cause of hypophosphatemia is seen in primary and secondary hyperparathyroidism as well as in familial hypophosphatemic rickets. Decreased intake of phosphate may be secondary to intravenous hyperalimentation, chronic ingestion of phosphate-binding antacids or vitamin D deficiency. Hypophosphatemia does not appear to produce any harmful effects. However acute hypophosphatemia, if it occurs in the presence of preexisting cellular injury and phosphate depletion, as in chronic alcoholic patients for instance, has been implicated as a cause of severe clinical syndromes. Chronic hypophosphatemia in children may induce rickets, and osteomalacia in adults. PMID- 2717868 TI - [Peculiar problems of phosphocalcium metabolism in chronic renal insufficiency]. AB - Chronic renal failure is associated with a disturbance of calcium and phosphate metabolism. During the initial stage of chronic renal failure plasma calcium and phosphorus are either slightly diminished or at the lower limit of the normal range, most probably due to a decrease in renal 1-alpha-hydroxylase activity. This leads to a decrease in circulating calcitriol and a stimulation of parathyroid hormone secretion. The underlying anomaly could be an as yet hypothetical elevation of the cytoplasmic phosphorus concentration within the renal tubular epithelium. During more advanced stages of chronic renal failure, a retention of phosphate occurs which induces hyperphosphatemia and contributes, either directly or indirectly, to the progressive worsening of secondary hyperparathyroidism with its skeletal expression of renal osteodystrophy. PMID- 2717869 TI - [Hypocalcemia in adults and their treatment]. AB - The first thing to do is to confirm that the number of circulating calcium ions has really decreased. This is achieved either by correction of the total blood calcium level, taking into account possible variations in albuminaemia and pH, or by direct measurement of plasma calcium ions, using a special electrode. The aetiological diagnosis may be easy in some clinical situations, but it often demands a systematic approach, which implies a specialized and brief exploration, feasible in out-patients, with simultaneous measurement, under basal conditions, not only of plasma calcium ions, but also of plasma magnesium, intact 1-84 parathyroid hormone (PTH), nephrogenic cyclic AMP and 25 (OH) D. Rationally, hypocalcaemias may be divided into two groups : (1) extraparathyroid, where hyperparathyroidism is constant and hypocalcaemia is due either to calcium intake reduction, vitamin deficiency of high bone accretion, or to a primary renal calcium leakage; (2) parathyroid, by impaired secretion of PTH or alteration of PTH receptors, which means hypoparathyroidism or pseudohypoparathyroidism. The diagnostic and therapeutic possibilities in both groups are discussed. PMID- 2717870 TI - [A French consensus on cholesterol]. PMID- 2717871 TI - [Radiotherapy of carcinoma of the oropharynx. Results of 10 years' experience at the University Hospital Center, Tours]. AB - In our centre, the vast majority of patients with oropharyngeal tumours are treated by irradiation. Over a period of 10 years, between 1976 and 1986 we treated 305 patients with squamous carcinomas of the oropharynx. The mean age was 58.2 years. There were 24 women and 281 men. 59% of the patients had advanced tumours, classified as T3 or T4, 54% of the patients showed the presence of adenopathy at the first examination. All patients received radiation therapy. 69 patients had surgical treatment of the tumour or glands. 21 patients had implant therapy (most often combined with transcutaneous irradiation). 165 patients had induction chemotherapy. Local tumour control was obtained in 124 patients (41%), i.e. 82, 56, 31 and 4% for T1, T2, T3 and T4 respectively. The 5 years survival rate of the overall population was 28%. The principle causes of failure were local progression for T3 and T4 tumours and metastases and second cancers in patients with T1 or T2 tumours. The prognostic factors were gland involvement and general health. The site of the tumour, sex and histological type were not prognostic factors. Induction chemotherapy did not improve the results of treatment. PMID- 2717872 TI - [The abandonment of treatment in orthodontics]. AB - Orthodontic treatments are frequently given up: a recent study of the C.N.A.M.* has shown a rate of 51%. In spite of lightest and least constraining therapeutic methods, the authors estimate that 27% of the patients stop their treatment before the end. --Looking for the reasons why, they have found a "central nucleus" of about 27% which builds up a constancy of abandoned treatment undeniably in relation with an ethical phenomenon, plainly concerning the individual or the family. --That is to show the advantage of our adapted therapeutic possibilities to answer the patients' requests, and to clearly explain their benefits and their possible difficulties. In other words we have to admit the necessity of a more medical than mechanical approach in orthodontics. PMID- 2717873 TI - [Facial asymmetry due to hemi-mandibular hypertrophy]. AB - A relatively frequent disorder, hemi-mandibular hypertrophy is today well identified clinically and radiologically. Its expression varies from one case to another but it becomes stabilized at the end of growth. Its etiology is unclear and it can only be corrected surgically: the habitual inclination of the plane of occlusion leads to a bimaxillary action with a tridimensional effect. The results of these osteotomies performed at the same time is stable and dramatic. Although isolated osteotomy of the basilar excess has become a last resort procedure, isolated condylectomy is still an acceptable compromise in toothless patients. The diagnostic approach and result of surgical treatment are analyzed in light of a homogeneous series of 12 cases. PMID- 2717874 TI - [Computerized medical records. The experience of the Francois Baclesse Center]. AB - Information regarding the patient needs to be known before all consultations or treatment. There may only be one medical file in which this information is contained and hence there are problems regarding storage and transport which slow down the diagnostic process and treatment. The replacement of this file on paper by a completely computerised record file (observations, laboratory results, hospital reports) allows instantaneous consultation and access to such a record. For the last two years the traditional paper file has been replaced by more than 130 terminals distributed throughout this establishment. Additional functions may be added (statistics, internal information, etc...). PMID- 2717875 TI - [The effect of age and sex on bone retention of radioactive strontium 85Sr in rats]. AB - Retention of radioactive strontium 85Sr (18,5 kBq i.e. 0.5 microCi i.p.)- concerning the whole body and in distal epiphysis, distal metaphysis and in the thigh bone diaphysis--was followed up in two similar experiments for the period of 5-6 weeks in rats of both sexes and different age (younger category 40-45 days, older category 120-140 days). In both experiments bone retention 85Sr in older female rats is lower than in younger female rats. In male rats similar difference has not been constantly proved. Retention seems to be higher in female rats in comparison with males in the category of young rats. On the contrary in the category of older rats the retention is lower in female rats. In epiphysis and diaphysis of the thigh bone the differences are analogous to whole body differences; 85Sr reacts in the opposite way in distal metaphysis--retention is here extensively higher in older rats than in younger ones. The results obtained confirm the conclusion interesting from the point of view of clinical problem: avidity of the skelet to administered radioactive strontium is in younger female rats higher than in young male rats. However it is severely declining especially in female rats--in the second experiment as far as the level significantly lower than in male rats of the same older age category. PMID- 2717876 TI - [Comparison of the excretion of 3 androgens registered in Czechoslovakia]. AB - Hypogonadal men of different aetiology were administered testesterone undecanoate (Andriol, Organon) and methyltestosterone (Agovirin coated tablets, Spofa) for three months alternatively. By means of specific radioimmunoassays excretion of testosterone and methyltestosterone respectively in the urine was observed in 20 and 5 patients respectively. The course of excretion of both the preparations is possible to illustrate by decreasing curves with apparent half-lives 1.74 and 3.90 day respectively. Analogous observation of testosterone excretion after three-month administration of testosterone isobutyrate (Agovirin depot) to five female-to-male transsexual patients was observed. Excretion course shows the maximum on 27th day after the treatment was discontinued and it is not possible to illustrate it by a monotonous curve. PMID- 2717877 TI - [Equipment for lyoluminescent dosimetry]. AB - The paper deals with experience gained during construction of photometry set suitable for application in lyoluminiscent dosimetry. Results of stability measurement are presented and possibilities of constructing these apparatuses using Czechoslovak parts are discussed. PMID- 2717878 TI - [Aspects of children with combined defects]. AB - Eleven children with slight cerebral dysfunction (SCD) were recorded in the process of admission to the social care home (SCH). The children came from the families of older parents with genetic disorder either in the parents themselves or in their families. Due to educational faults combined with uncritical use of excessively protective means symptomatology of disharmonic personality development began to develop in children in which gradual decrease of mental capacity occurred. Symptomatology of disharmonic personality development slowly prevailed over that of SCD. Although the mental capacity was at the lower level of debility, these children were not able to finish their school education. Similarly it may happen in combination of sense organs defects, serious somatic and speech defects. Such children find their place in society with great difficulties. PMID- 2717879 TI - Immunochemical and biological reactivity of human anti-lipopolysaccharide IgG obtained by screening of blood donors. AB - An anti-lipopolysaccharide (LPS) preparation for the intravenous treatment of septic endotoxic shock was prepared by purifying immunoglobulin G (IgG) from pooled serum from Danish blood donors. The sera were selected by the use of an enzyme-linked immunosorbent assay (ELISA) to screen blood donors for high concentrations of antibodies to a mixture of LPS from 11 different Gram-negative bacteria. ELISA was also used for indirect quantification of IgG antibodies to lipid A, and to rough LPS from Escherichia coli Ra and Salmonella minnesota R60 (Ra). The concentration of human antibodies to the LPS mixture correlated with the concentration of antibodies to the E. coli and S. minnesota rough LPS and to lipid A. The specificity of sera with high concentrations of anti-LPS IgG was investigated by immunoblotting. Sera from individual donors reacted with LPS from different bacteria and recognized different sites on the LPS molecules. The range of specificities to different LPS was increased by the pooling of selected sera. The IgG fraction from the high titre donor pool neutralized biological activities of LPS such as activation of the Limulus amoebocyte lysate reaction and induction of tumour necrosis factor secretion from human monocytes. PMID- 2717880 TI - Molecular characteristics of IgA in infant saliva. AB - Saliva was collected from 57 infants aged 6 weeks to 2.5 years and the molecular form of IgA was studied by centrifugation on sucrose density gradients. Two distinct populations were identified. Seventy-two per cent of the children had secretory IgA in their salivary secretions, while 28% had a molecular form corresponding to monomeric IgA. No samples with concurrent monomeric and secretory forms were detected. Monomeric IgA was not detected in any infant over 12 months of age. Secretory component was detected in all samples but was not associated with monomeric IgA. Forty-seven per cent of the samples contained IgA fragments of approximately 40,600 molecular weight. The presence of fragments dominated in the group of children with monomeric IgA. The presence of monomeric IgA in infant saliva did not result from degradation due to storage or proteolysis. The study demonstrated an apparent maturation sequence in the molecular form of IgA present in the salivary secretions of infants. PMID- 2717881 TI - Macrophages and dendritic cells during the early stages of antigen-induced arthritis in rats: immunohistochemical analysis of cryostat sections of the whole knee joint. AB - The appearance of different macrophage subpopulations, Ia-positive antigen presenting dendritic cells and of T and B lymphocytes was studied in early phases of antigen-induced arthritis in rat knee joints. Cryostat sections of whole knee joints were analysed with immunohistochemical techniques using monoclonal antibodies against rat macrophages, Ia-antigen, and lymphocyte subpopulations. The results showed that in the early phases of the development of arthritis, the synovium was already infiltrated by many monocytes, young macrophages, granulocytes, perivascular Ia-positive non-lymphoid cells, some mature tissue macrophages, and only few T lymphocytes. In later phases not only monocytes, young macrophages and Ia-positive cells became more prominent but also the more mature ED2 positive macrophages and the ED3 positive macrophages that are normally confined to lymphoid organs became increasingly important. The T-cell population increased to some extent in later phases of arthritis induction, possibly induced by clustering with the Ia-positive cells. PMID- 2717882 TI - Effect of physical exercise on blood mononuclear cell subpopulations and in vitro proliferative responses. AB - The present study was designed to examine the effect of physical exercise on subsets and proliferative responses of blood mononuclear cells. Sixteen young, healthy volunteers underwent 60 min of bicycle exercise at 75% of maximal oxygen uptake (VO2max). After an interval of at least 1 week, six of the subjects underwent a 60-min back muscle training period at up to 30% of VO2max. Blood samples were collected before and during the last minutes of exercise, as well as 2 and 24 h later. Blood mononuclear cell (BMNC) subpopulations were determined and the proliferative responses after incubation with phytohaemagglutinin (PHA) or purified derivative of tuberculin (PPD), were quantified by [3H]thymidine incorporation. During bicycle exercise the relative blood concentration of T cells (CD3+ cells) declined, mainly due to a fall in T helper cells (CD4+ cells). The natural killer (NK) cell subset (CD16+ cells) increased during work, but reverted after; the monocytes (CD14+ cells) increased 2 h after work, whereas the B-cell subset (CD20+ cells) did not change. BMNC subsets were not significantly changed by back muscle exercise. The PHA-induced proliferative response decreased during bicycle exercise, whereas the PPD-induced response did not change. No significant changes occurred during back muscle exercise. Investigation of subgroups after incubation with [3H]thymidine showed that the proliferative response per CD4+ cell did not change in relation to exercise, but the contribution of the CD4+ subgroup to proliferation declined during bicycle exercise due to the decreased proportion of CD4+ cells. The suppression of the PHA response during bicycle exercise can be explained in part by a relative fall in CD4+ cells. The pool sizes of BMNC subfraction may be elicited by increased catecholamine and cortisol levels. PMID- 2717883 TI - Opioid peptides modulate the organization of vimentin filaments, phagocytic activity, and expression of surface molecules in monocytes. AB - It is theorized that intermediate filaments are important in the modulation of membrane activity and cell motility; however, their functions are unknown. The assembly and organization of these filaments are under hormonal regulation. We investigated in human monocytes the in vitro effects of Met-enkephalin, Leu enkephalin, and beta-endorphin on the expression of immunoreactive cytoskeletal vimentin filaments. We simultaneously examined their effect on the phagocytosis of Candida albicans and on the membrane display of surface molecules. The three opioid peptides markedly reduced the expression of vimentin filaments, the phagocytic activity, and the display of HLA-DR molecules at concentrations of 10( 6), 10(-8), and 10(-10) M. On the other hand, the intravenous administration of fentanyl, a synthetic opiate agonist, to patients undergoing surgery induced similar changes in monocytes. In other experiments, 10(-8) M beta-endorphin also decreased the expression of CR3 but did not influence the display of CD13, a surface protein of unknown function. Expression of vimentin filaments correlated directly with the display of HLA-DR antigens and CR3 and with the phagocytic activity. The results of this paper indicate that opiates and opioids, neuropeptides known to be released during stress, can directly depress several monocyte functions. Furthermore, from these data it may be speculated that intermediate filaments may regulate the membrane expression of some surface molecules and the phagocytic process. PMID- 2717885 TI - Innovations in the assessment of thought disorder. PMID- 2717884 TI - Translocation of protein kinase C to subcellular fractions of human neutrophils. AB - The subcellular localization of protein kinase C in unstimulated human neutrophils and neutrophils stimulated by phorbol-myristate-acetate (PMA), 1 oleoyl-2-acetyl-rac-glycerol (OAG), and ionomycin was investigated in subcellular fractions obtained by nitrogen cavitation and Percoll density gradient centrifugation. Protein kinase C was found to be localized mainly in the cytosol in unstimulated cells, whereas significant translocation to fractions containing the plasma membrane was observed after stimulation by PMA, OAG, and ionomycin. At the same time, phospholipid-insensitive protein kinase activity appeared in the cytosol and the plasma membrane fractions. To determine whether binding of protein kinase C occurred to the plasma membrane or to intracellular membranes that had translocated to the plasma membrane, we investigated the ability of isolated azurophil, specific and secretory granules, and plasma membrane vesicles to bind protein kinase C in response to addition of PMA and OAG. Only fractions containing plasma membranes and secretory granules were able to bind protein kinase C. The observation explains the selective activation of plasma membrane structures by protein kinase C. PMID- 2717886 TI - Family views of stigma. AB - The views of 487 members of the National Alliance for the Mentally Ill (NAMI) concerning stigma were surveyed in 20 different States. Almost all identified stigma as a problem for their mentally ill relatives and for families in general. The most frequently cited effects of stigma on ill relatives were damage to self esteem, difficulty making and keeping friends, difficulty finding a job, and reluctance to admit mental illness. The most frequently cited effects on families were lowered self-esteem and damaged family relationships. NAMI respondents identified popular movies about mentally ill killers, news coverage of tragedies caused by mentally ill people, casual use of terms like "crazy" and "psycho," and jokes about mental illness as prominent sources of stigma. The things families reportedly found most helpful in dealing with stigma were factual information about mental illness, interaction with other families with mentally ill relatives, support within the family, and research findings that establish a biological basis for mental illness. Mental health professionals received mixed reviews from family members. While not generally viewed as contributing to stigma, mental health professionals were seen as least helpful in dealing with stigma. Overall, survey results indicate that considerable concern about stigma exists among families with mentally ill relatives and that substantial numbers of family members experience the stigma of mental illness in one form or another and perceive that their ill relatives experience it as well. PMID- 2717887 TI - Fetal neural development and schizophrenia. AB - The conference on Fetal Neural Development and Schizophrenia which was held in Washington, DC, May 31-June 1, 1988, focused on factors of possible etiological significance in fetal development. Schizophrenia researchers joined experts in brain imaging, neuropathological, and neurochemical changes in brain development and investigators of potential genetic and neurobehavioral causes of psychosis. The combined evidence suggested dysfunction in frontal and parieto-occipital neocortex, basal ganglia, hippocampus, and amygdala. Dopamine transmission was implicated both in basal ganglia deficits and in widespread neocortical disturbances. Viral infection, or excessive stress, during the second trimester of pregnancy, as well as obstetrical complications, minor physical anomalies, and brain defects, correlated positively with incidence of adult schizophrenia. Autonomic nonresponding, birth complications, and ventricular enlargement were found to be closely related to negative symptom schizophrenia in high-risk populations. A dual factor model of schizophrenia was suggested, where genetic and environmental influences combine to produce psychosis. PMID- 2717888 TI - First person account: fighting the fight--the schizophrenic's nightmare. PMID- 2717890 TI - Schizophrenia: a life-shortening disease. AB - The author reviews a number of studies which have shown that the overall mortality among patients with schizophrenia is about twice that in the general population. The highest excess mortality is found in suicide and violent death, but there seems to be an increased mortality also in cardiovascular disorders. Whether there is an increased mortality in cancer among schizophrenic patients remains a controversial issue. A reduced mortality, and particularly a reduced suicide rate, must be an important aim for any treatment policy or therapeutic program. The use of computerized patient data bases, linked to cause-of-death registers, is recommended to permit regular followup studies of large patient populations and facilitate the access to medical records and death records for more detailed analyses. A 10-year followup of 1,190 patients with schizophrenia, selected from the Stockholm County inpatient register is described. The overall mortality was more than twice that in the general population, and the mortality in suicide was more than 10 times higher. The inpatient register was used to identify hospital episodes. Medical records were then obtained for studies on the validity of diagnoses and causes of death and for analyses of risk factors for suicide. PMID- 2717889 TI - Care of persons with schizophrenia: a statistical profile. AB - This article presents the latest information available from the National Reporting Program for Mental Health Statistics on the distribution and characteristics of persons with schizophrenia served by organized, specialty inpatient, outpatient, and partial care mental health programs. Results are presented separately for persons under care at one point in time and for persons admitted over a 1-year period, in order to examine the potential for change in each type of care. Findings show that about 900,000 persons with schizophrenia were served in 1986; that inpatient and outpatient programs were relatively equivalent in total numbers served, but that considerably more patient turnover occurred in inpatient programs; and that partial care programs, although small, were evolving as a locus of care for persons with schizophrenia. Some variations were observed among the different types of organizations offering each type of care, and characteristics of clients/patients that could lead to changes in each type of care were evident. Overall, the findings present a useful composite picture of specialty mental health care for persons with schizophrenia. The need for longitudinal, prospective research is noted. PMID- 2717891 TI - Minor physical anomalies in schizophrenia. AB - This study was conducted to investigate the value of using physical anomalies (PAs) to evaluate early prenatal injury in schizophrenia. PAs are minor abnormalities in development of the head, hands, and feet that are presumably associated with insult during the first trimester. Sixty-seven schizophrenic inpatients and 88 normal controls were evaluated for PAs. The schizophrenic patients showed significantly more anomalies than the controls. The difference remained significant even when patients were compared to controls of low socioeconomic status. Both male and female patients showed a high incidence of mouth abnormalities, and female patients showed a high incidence of abnormalities in head circumference. Patients with early age of onset (less than or equal to 18 years) had more physical anomalies than did later onset patients. This relationship was most noticeable for males. Physical anomalies were not associated with deficits on measures of vigilance, selective attention, or orientation. PMID- 2717893 TI - [The treatment of an embolized central venous catheter]. AB - The frequent use of central venous catheters for pressure monitoring or long-term administration of fluids can in rare cases lead to embolization of catheter fragments. In view of the potential complications, extractions, extraction is mandatory. The fragments may be removed by use of a loop snare, a helical basket or a myocardial biopsy catheter. The specific approach is described. PMID- 2717892 TI - [Invasive monitoring: goals and hazards]. AB - While no firm recommendations are given as to when and in whom invasive monitoring should be employed, the potential risks involved in invasive monitoring are discussed. Every physician in an intensive care unit must perform a risk/benefit analysis regarding the use of invasive monitors. Aspects of these analyses are discussed with a view to assisting decision making in individual cases. PMID- 2717894 TI - [Invasive monitoring of arterial gases in intensive care. Indications, misuse and hazards]. AB - Although arterial blood gas analysis remains the "gold standard" for oxygen (O2) and carbon dioxide (CO2) measurements during critical illness, several new techniques are now available for clinicians in this field, i.e. pulse oximetry, transcutaneous (PtcO2) and transconjunctival (PcjO2) O2 monitoring, CO2 continuous measurements in expired gases (capnography) and transcutaneous PCO2 (PtcCO2). While it seems too early to assign a definite role to all these techniques in the management of critically ill patients, several points can be emphasized: 1. pulse oximetry is a cheap, versatile device for monitoring of nonhypoxemic patients; 2. PtcO2 is a good index of poor skin oxygenation and is related to PaO2, but this index should be interpreted with caution in unsteady patients; perhaps its main value is as an early warning that "something is wrong with the patient". PcjO2 may be promising, but more data are needed; 3. PtcCO2 and capnography seem more suitable for research purposes or for patient monitoring in the operating theatre. Finally, it should be emphasized that invasive arterial blood gas measurements using an indwelliing arterial catheter are safe and provide with the best possible acid-base and hemodynamic monitoring. Noncontinuous monitoring of blood gases and, perhaps, the delay between arterial puncture and completion of the analysis seem to be the only drawbacks of this technique. PMID- 2717895 TI - [Intracranial pressure determination in neuro-traumatology. Indications, interpretation and complications]. AB - Intracranial pressure (ICP) monitoring in patients with severe head injury is useful in understanding the physiopathology of cerebral contusion, proper planning of treatment and assessment of prognosis. ICP should be monitored in patients with severe head injury presenting with coma, signs of brainstem involvement and an abnormal CT-scan. ICP values must be considered in conjunction with other parameters, especially blood pressure. Normal ICP does not rule out the development of intracranial hematoma, thus emphasizing the importance of clinical examination and of control CT-scans if the patients are paralyzed and artificially ventilated. Monitoring should be discontinued as soon as possible since, the complication rate correlates with the duration of ICP monitoring. PMID- 2717896 TI - [Intravascular catheter: prevention and therapy of infection]. AB - Intravascular devices are widely used. If certain precautions are taken, catheter related infections, and especially bacteremia, are infrequent. Special attention should be paid to the correct access (peripheral versus V. subclavia or V. jugularis interna), immediate stabilization of the position, the choice of dry dressings (transparent plastic dressings should be avoided on newly inserted or arterial catheters, as well as on damp wounds), and regular changing of peripheral lines. In the febrile patient with vascular access the infective source should be sought. If the insertion site shows signs of inflammation, or if septicemia occurs, catheters must be removed. In patients with peripheral suppurative thrombophlebitis, surgical excision of the vein must be considered. In contrast, in septic thrombophlebitis of a central vein, removal of the catheter and antibiotic and anticoagulation therapy may be sufficient. PMID- 2717897 TI - [Post-traumatic pulmonary insufficiency: therapeutic measures]. AB - The pathophysiology of posttraumatic pulmonary failure is today reasonably well known. Interaction of altered granulocytes with the pulmonary parenchyma in the form of an inflammatory reaction plays an important role. Gas exchange failure can be a major problem in these patients and influence the prognosis. No effective preventive treatment is known at present except for rapid and appropriate surgical management together with an adequate fluid resuscitation. In addition, the risk of infection and sepsis must be reduced as far as possible and dysfunction of other organ systems prevented if the prognosis is to be improved. Administration of anti-inflammatory agents and corticosteroids has been shown to be without beneficial effect and dangerous in this situation. Intubation and ventilatory assistance should be used depending on respiratory status and pulmonary gas exchange, although potentially lifethreatening side effects of this treatment must be considered. Continuous specific monitoring of respiratory function must be started in the patient after multiple trauma to follow the course of pulmonary dysfunction and adapt therapy. PMID- 2717898 TI - [Mortality in influenza epidemics in Switzerland 1969-1985]. AB - In Switzerland from 1969-1985, 9 out of 11 influenza epidemics were associated with a statistically significant increase in mortality. A total of 12,202 excess deaths from all causes was identified. Expected deaths were forecast for each epidemic period separately for 4 age groups using Fourier and Arima modeling. 75.7% of all-cause excess deaths occurred in age group 70 to 89 and 5.1% in age group 1-59. In the 70-89 years old group the excess mortality risk during influenza epidemics was 271.6 per 100,000, whereas in age group 1-59 it was only 1.7 per 100,000. Only 40% of all excess deaths had been ascribed to acute respiratory conditions. Influenza viruses A H3N2 were the most frequently identified agents. In some instances mortality increased before the morbidity reports of the Swiss practitioners indicated the occurrence of an epidemic. Also, morbidity reporting decreased over successive years. A decrease in mortality following the epidemics was not observed. A more complete vaccination of high risk patients in Switzerland is desirable. PMID- 2717899 TI - [Acute pregnancy fatty liver with survival of the mother and child]. AB - A case of acute fatty liver as a rare cause of pregnancy-induced jaundice is reported. Near term the 25-year-old patient became rapidly jaundiced. On admission laboratory tests showed signs of incipient coagulopathy and impaired renal function. When fetal vital signs deteriorated cesarean section was performed. After surgery the fullblown picture of disseminated intravascular coagulation developed, with profuse bleeding only controllable by rigorous substitution of plasma factors. Acute hepatic insufficiency with ascites followed. Despite the marked bilirubin elevation the hepatic enzymes were only slightly raised. In addition, acute renal insufficiency, pancreatitis and hyperuricemia developed. Under intensive care the patient recovered slowly and was discharged after 4 weeks with a healthy baby. PMID- 2717900 TI - [Blastocystis hominis, a parasitic cause of diarrhea]. AB - The frequency of detection of Blastocystis hominis in the stools of patients with gastroenteritis is reported. Over a twelve-month period B. hominis was identified in the stools of 69 (4.72%) out of 1460 patients. Of these 69 positive samples, 45 (65%) contained B. hominis alone and in 24 (35%) it was present together with other parasites such as Lamblia intestinalis, Entamoeba histolytica, Entamoeba coli, Endolimax nana, Iodamoeba buetschlii, Ancylostoma duodenale, Ascaris lumbricoides, Trichuris trichiura, and Hymenolepis nana. In 19 of the 69 patients with B. hominis, the parasite was found only in small numbers but as the sole pathogen. It is still unclear whether B. hominis must be considered a pathogenic agent; the clinician should however be aware of this parasite as a possible cause of gastroenteritis, particularly when no other pathogen can be identified. PMID- 2717901 TI - [Epileptic seizures in patients with a cerebrovascular infarction]. AB - In view of the possible occurrence of epileptic manifestations and possible factors predisposing to them, the clinical course of 90 cerebral infarct patients was studied retrospectively and prospectively in a medical rehabilitation department for an average of 29 1/2 months. The following results were obtained: "prodromal" seizures (i.e. those preceding a cerebral insult) were not detectable in any of the study patients. 25 patients (27.7%) suffered epileptic seizures, 1 (1.1%) in the acute insult phase only, 2 (2.2%) in this as well as in the later phase, and 22 (24.4%) in the late phase only. All seizures in the acute insult phase were focal-motor or secondary generalized. Among all 24 patients (26.6%), the latency of late epileptic manifestations ranged from 2 1/2 months to 3 3/4 years and averaged about 12 months. Patients with cortical or cortical subcortical brain lesions suffered epileptic seizures-as reported in the literature-significantly more frequently than those with exclusively subcortical insults. Based on the features of the focal (motor or psychomotor) seizures and/or interictal focal EEG spikes, there was clear evidence of a focus giving rise to epileptic discharges in the insulted hemisphere in 75% of the patients with late seizures. Under antiepileptic therapy (chiefly with phenytoin), the seizure frequency was slight (not exceeding 2 per year in 3/4 of the patients). PMID- 2717902 TI - [Blood pressure values during an exercise test]. AB - High blood pressure readings are relatively frequent during dynamic exercise testing. However, because of the paucity of date concerning normal blood pressure values during exertion and the prognostic significance of exertion hypertension, the attitude to be adopted towards such patients is ill-defined. The present study proposes mean values for BP at a given workload, per age group (less than 20, 20-39, 40-59, greater than 60) and per sex. These values were computed from measurements during dynamic exercise tests performed by 303 subjects (177 male, 126 female) at 100 and 150 watts workloads. Systolic and diastolic pressures during exertion correlated positively with resting blood pressure values (p less than 0.001) and increased with age (p less than 0.001). Hypertension during exertion was defined as values more than 2 SD above mean values for the corresponding age group and sex. 20 subjects met these criteria in our study. PMID- 2717903 TI - [AIDS: its early detection in dental practice]. PMID- 2717904 TI - [Acceleration of orthodontically induced tooth movement through the local application of prostaglandin (PGE1)]. AB - A preliminary study was designed to assess the effect of prostaglandin E1 on tooth movement. In 5 patients palatal attachments were bonded on corresponding upper left and right premolars which were to be extracted later in the course of routine orthodontic treatment. A transpalatal elastic exerted reciprocal force on the teeth. Following local anaesthesia, 0.1 ml of a 0.01% (w/v) PGE1 solution in saline was injected under the mucoperiosteum palatal to the test tooth and 0.1 ml saline palatal to the contralateral control tooth. Injections were repeated at weekly intervals. On average, the PGE1-treated teeth moved 3 times faster than the controls but the rate of movement differed individually. Clinical and x-ray examinations of the teeth involved in the study as well as the surrounding tissues showed no evidence of pathologic changes. No negative side effects were noticed by the patients. Despite positive experiences, this treatment is not to be recommended for use in dental offices yet. PMID- 2717905 TI - [The incidence of enamel projections on the roots of the permanent teeth]. AB - In this study we examined the incidence of enamel pearls, projections islets and drops on account of 7388 extracted human permanent teeth. According to the macroscopic examination there were 54 (1.6%) enamel pearls situated on the molars of the upper and lower jaw. Pairs of enamel pearls were observed on three teeth, i.e. in 0.09% of the patients. Three enamel pearls were diagnosed on one tooth. Enamel pearls were most frequently found in the cervical third of the mesio- and disto-approximal root surfaces. However, they were not so frequent in the area of the tooth neck, i.e. on the passage to the root furcation. Enamel pearls were 0.3 to 2.8 mm in diameter. Enamel projections, islets and drops were identified on account of stereomicroscopic examinations of the tooth neck and the root furcation. These paraplastic enamel formations were observed in 560 teeth, i.e. in 14.1% of the patients. Enamel pearls and islets were most often situated on the buccal surface of the tooth neck along the inter-radicular groove and enamel drops on the buccal surface of the furcation roof. PMID- 2717906 TI - [HIV gingivitis/HIV periodontitis in practice. HIV-associated periodontal changes: diagnosis and therapy]. PMID- 2717907 TI - [Oral Kaposi's sarcoma (AIDS). X-ray findings in oral Kaposi's sarcoma (AIDS)]. PMID- 2717908 TI - [Electrogalvanism in the oral cavity]. PMID- 2717909 TI - [The SSO-qualified assistant. The training and employment of the SSO-qualified dental assistant. Societe Suisse d'Odonto-Stomatologie]. PMID- 2717910 TI - [SSO funds: a million and a half devoted to research in a little more than 30 years. Societe Suisse d'Odonto-Stomatologie. Interview by K. Venner]. PMID- 2717912 TI - [Informatics in the dental office]. PMID- 2717911 TI - [Dental offices in proportion to the population: how many?]. PMID- 2717913 TI - Optical fibers in medicine. PMID- 2717915 TI - Risky business. PMID- 2717914 TI - Aging comes of age. PMID- 2717916 TI - Topobiology. PMID- 2717917 TI - Accumulation, distribution and loss of cadmium in the marine prosobranch Littorina littorea (L.). AB - In the present investigation cadmium was studied in Littorina littorea exposed to two ambient concentrations and for various exposure times, as well as after a detoxification period of 74 days. The results are expressed as whole body and individual organ burdens of metal. Organ metal analyses, exposure time and external metal concentrations were correlated using tetradic diagrams to represent four different organ burdens. Linear accumulation appeared to occur in the whole soft body at the cadmium concentrations and times studied. There was also a general linear trend in the accumulation of cadmium in the various organs (gills, kidney, digestive gland/gonad complex and remaining tissue), but at certain exposure times the tissue concentration of cadmium differed from what was expected. Different cadmium distribution patterns were observed as a result of the relative intensity of the accumulation and elimination processes. Because of these inconsistent variables it is generally concluded that for bioindication purposes it is preferable to use the cadmium burdens of the whole soft body rather than those of individual organs. For physiological studies of cadmium, however, the pattern of metal distribution in the organs is necessary to describe the metabolic pathways through the organism. PMID- 2717918 TI - Changes in the polynuclear aromatic hydrocarbon content of wheat grain and pasture grassland over the last century from one site in the U.K. AB - Crops harvested and stored from two long-term agricultural experiments started in the 1840-1850s at Rothamsted Experimental Station (U.K.) have been analyzed for polynuclear aromatic hydrocarbons (PAHs) because PAHs have increased four-to-five fold in the underlying 0-23 cm depth of soil over the last century due to atmospheric deposition. Bulked samples of herbage and wheat grain were analyzed for 16 compounds by gas chromatography-mass spectrometry for groups of years between 1860 and 1986. The sigma PAH (16 PAH) concentrations in herbage ranged between 110 and 6900 micrograms kg-1 dry weight, with fluoranthene, pyrene, benzofluoranthenes (b + j + k), chrysene and triphenylene consistently the most abundant. Benz[a]anthracene, benzo[ghi]perylene, benzo[a]pyrene, benzo[e]pyrene and indeno(1,2,3-cd)pyrene were also all important constituents. PAH concentrations in wheat grain ranged from 4 to 46 micrograms sigma PAH kg-1; the mixture of individual compounds was similar to that in herbage. Correcting for yield differences these corresponded to 37-1500 and 2.4-8.8 micrograms sigma PAH m-2 for herbage and wheat grain respectively. The lowest values were found in the most recent samples (1980s) and the highest for samples collected in 1879-81. Generally, there was a decline in the PAH burden of the vegetation with time. The temporal trends of PAHs in the samples are discussed in the context of possible sources of PAHs. Various lines of evidence indicate that the PAH concentrations in vegetation are an indication of atmospheric deposition directly onto the above ground plant portions, and that uptake and translocation of soil-bound PAHs is of minor importance. PMID- 2717919 TI - Trace element profiles in oesophageal neoplasms determined by proton-induced X ray emission. AB - Trace element concentrations were determined in surgically resected, cancerous human oesophageal tissue by proton-induced X-ray emission (PIXE) analysis. Each sample was divided into six zones, E3 and E4 formed the central tumour region, E1 and E2 were proximal to the oesophagus and E5 and E6 distal to the oesophagus. Malignancy was confirmed histopathologically in all cases. Samples were dissolved in NaOH solution and pipetted onto a thin mylar film for analysis by a proton beam from a Van de Graaff accelerator. Titanium, Fe, Cu, Zn, As, Rb, Br and Pb were detected in varying concentrations. Of these, Ti, Fe, Cu, Zn and As showed specific behaviour in the six zones. PMID- 2717920 TI - Repeated surveillance of lead poisoning among children. AB - In 1980, a survey of lead poisoning was carried out among 592 children aged 1 to 9 years living within 900 m of a lead smelter in Santo Amaro, Brazil. From 1980 to 1985, the lead smelter carried out a number of major improvements aimed at reducing environmental pollution. In January, 1985, a second survey was carried out among a sample of 250 children living in this same geographical area. The geometric mean of zinc protoporphyrin (ZPP) concentration in whole blood was 1.17 (standard deviation = 1.5) mumol l-1. Blood lead concentrations (PbB) determined in a subsample of 53 children had an arithmetic mean and standard deviation of 1.77 +/- 1.00 mumol l-1, with 22 children showing PbB greater than or equal to 1.68 mumol l-1. Twenty-nine (11.6%) of the 250 children lived in houses where the lead content of the soil was greater than 10,000 ppm, and they presented higher ZPP levels than the rest of the population. Children with the habit of pica for soil had elevated ZPP levels. Comparing the results from the 1980 and 1985 surveys, slight improvements in ZPP and PbB levels were observed. However, new cases of lead poisoning are still occurring in the area. The soil is highly contaminated by lead and represents a long-lasting risk factor for child intoxication. PMID- 2717921 TI - Current standards and their relation to environmental behaviour and effects--the case of lead. AB - Lead enters the environment from a large number of point and diffuse sources. Several control options are available to reduce the input of lead to the environment and these have been utilised in the large number of European Community (EC) Directives adopted to control lead. The use of Environmental Quality Standards (EQS) is the most effective option to control pollutants entering an individual compartment from both point and diffuse sources since EQS take into account behaviour and effects of the pollutant in the environment. Future legislation to control pollution in one compartment should consider the potential implications for effects on the other compartments by using the "Best Environmental Options" approach and by combining the different options available to achieve environmental improvement. PMID- 2717922 TI - Selenium, mercury, arsenic and cadmium in the lifecycle of the dunlin, Calidris alpina, a migrant wader. AB - Migrant waders accumulate pollutants from their marine moulting and wintering grounds in Western Europe. In examining the possible consequences on the reproduction of the Dunlin (Calidris alpina), it was found that no adverse effects are to be expected from selenium, mercury, arsenic or cadmium. Though selenium is accumulated in very high concentrations in the kidney, after the bird's departure from the marine environment for the freshwater breeding areas, levels decline rapidly. Mercury exposure in Western Europe is not excessive, as shown by the relatively low levels in the summer plumage. Feather element concentrations proved to be a useful indicator of the different moulting and wintering areas used by the birds. PMID- 2717923 TI - Distribution of dietary mercury in a dog. Quantitation and localization of total mercury in organs and central nervous system. AB - An Alsatian dog which had been fed fish contaminated with methyl mercury for 7 years was examined after its death at the age of 12, 4 years after the exposure to methyl mercury had ceased. Two dogs of the same age and breed served as controls. In the exposed dog, mercury was found in all of the organs examined; the highest concentrations were found in the kidneys, and the lowest in the gastrointestinal tract and skeletal muscles. In the central nervous system (CNS) the mercury was fairly uniformly distributed, with 93% in the inorganic state, whereas the skeletal muscles contained approximately 30% inorganic mercury. This demonstrates time-dependent demethylation and suggests a variation in the rate from one type of tissue to another. At the time of death, the mercury level in the dog was still falling. In the control dogs, detectable amounts (0.01 mg kg-1) of mercury were only found in the kidney and liver. The distribution of mercury was determined by a histochemical method (autometallography) for locating mercury in tissue sections. Sections from autometallography of the central nervous system showed large deposits of mercury in all areas of the cerebral hemispheres, the brainstem and the spinal cord, including nerve cells, astrocytes, microglial cells and vessel walls. The granular layer of the cerebellar hemispheres was especially loaded, while only a few granules were present in the Purkinje cells. In the leptomeninges the vessels and the macrophages were heavily encrusted. High amounts of histochemically demonstrable mercury were observed in the liver, thyroid gland and kidney. In the control dogs, all the organs examined were practically devoid of deposits. PMID- 2717924 TI - Trace element levels in the blood of workers in two steel works and a non-ferrous plant handling lead and cadmium compared with a non-exposed population. AB - The concentrations of 14 elements in the blood of steelworkers and industrial workers exposed to lead- and cadmium-containing dusts were measured and compared with a control group drawn from University and hospital laboratory staff. Measurements were also made of the concentrations of 20 elements in the dusts. Significantly elevated levels were observed for cadmium and lead in whole blood, but no other significant variations were noted. The concentrations of these two elements in the dusts confirmed the exposure of those groups showing high levels of cadmium and lead. High levels of iron or chromium in some of the dusts were not correlated with any changes in the mean blood levels of the exposed groups. PMID- 2717925 TI - The effect of ambient cadmium air pollution on the hair mineral content of children. AB - Hair analyses of 80 children with learning and behavioral problems were assessed by age, sex, season, place of residence, exposure to passive smoke and excess contact with known cadmium air pollutant sources. All children had been exposed for at least 2 years to air pollution from a refuse-derived fuel incineration plant. All of the patients had increased hair cadmium compared with a control group, but there was a strong seasonal influence on hair cadmium. Exposure to cadmium was ubiquitous. A neurobehavioral toxic effect was found in children who showed evidence of inhibition of pyrimidine-5'-nucleotidase by low hair phosphorus levels and low zinc levels in whom there was enhanced lead absorption. Hair analyses appear to be a useful biological monitor for detecting toxic effects from ambient air cadmium levels in subsets of the population at risk for heavy metal toxicity. Air filter measurements appear worthless for detecting environmental contamination with cadmium in air with low levels of lead. Trees, on the other hand, which are more adversely affected by cadmium than other heavy metals, show evidence of inhibition of pyrimidine-5'-nucleosidase by excess seeding. PMID- 2717926 TI - Effect of industrial pollution on seafood content and dietary intake of total and methylmercury. AB - The total mercury and methylmercury content of seafood was studied in an area of the Adriatic Sea polluted with inorganic mercury from a local industrial plant. The industrial pollution has affected both the total and the methylmercury content of seafood, but only the difference in the total mercury level was statistically significant when compared with a control area with no local industry. Studies of seafood consumption patterns indicate that, when the subjects examined from both areas were matched by their seafood consumption, both total mercury and methylmercury intake was higher in the industrially polluted area. The percentage of subjects ingesting total mercury above the WHO Provisional Weekly Tolerance Intake (PWTI) of 300 micrograms was also higher in the industrially polluted area. However, the percentage of subjects whose methylmercury intake was above the PWTI of 200 micrograms was higher in the control area, primarily due to the increased number of subjects consuming fish more than 5 times a week. PMID- 2717927 TI - Environmental stress in five aquatic ecosystems in the floodplain of the River Rhine. AB - General theories of stress ecology were applied to aquatic communities in the floodplain of the polluted River Rhine. These communities inhabited (i) a brackish section of the Ems-Dollard estuary with large intertidal flats, (ii) the coastal waters of the North Sea and the adjacent Wadden Sea, (iii) a former estuary of the Rivers Rhine and Meuse: the newly endiked Lake Grevelingen, (iv) the shallow Loosdrecht Lakes, and (v) the lower River Rhine. These systems are characterized by natural perturbations, such as suspension of sediments and flushing of the shallow waters. Organic pollution, eutrophication and chemical pollution reinforce the natural tendency to severe selection in the communities, in extreme cases leading to an abundance of small and opportunistic species participating in relatively simple food chains. Signs of ecosystem distress, as defined by Rapport et al., were detectable in all five ecosystems. The application of the theory of Odum et al. on stimulation and inhibition of ecosystems helped in identifying the positive impact of man. The role of stress in natural aquatic ecosystems in the delta, together with observations on ecological recovery under reduced man-made perturbation, suggest that there is scope for effective water management that exploits the resilience of these ecosystems. PMID- 2717929 TI - Photochemical conversion of chlorinated phenolic substances in aquatic media as studied by AOX and Microtox tests. AB - Six chlorophenolic substances were photochemically converted by illumination with xenon light. The AOX (adsorbable organic halogens) contents were determined after illumination for various periods. Pure chlorinated phenolic substances were readily detected by AOX. Both adsorbable and non-adsorbable chlorinated products were formed. Chloride analysis indicated that most (if not all) of the non adsorbable products consisted of chloride ions. Microtox, a bacterial bioluminescence test, was used as a screening test for toxic properties of the photolysis products. Products from 2,4,6-trichlorophenol were more toxic than the original substance. Other compounds tested had less toxic products as measured by their combined effect on the Microtox system. Products of 2,4-dichlorophenol, 2,3,4-trichlorophenol, 4,5,6-trichloroguaiacol and 2,3,4,5-tetrachlorophenol did not seem to contribute to the combined toxic properties after partial photolysis of the parent compound. Pentachlorophenol was converted into products which had substantial effects on the Microtox system. PMID- 2717928 TI - Interception and retention of Chernobyl-derived 134Cs, 137Cs and 106Ru in a spruce stand. AB - The time dependence of the specific activity of Chernobyl-derived 134Cs, 137Cs and 106Ru was determined in vegetation and soil samples from an old spruce stand within a period of 600 days after the beginning of the radioactive fallout. The results show that 70% of the total activity of radiocesium and 60% of radioruthenium deposited in the spruce stand were retained initially in the canopy. They were removed from the needles and twigs as a result of weathering (rain, wind, litter fall) and transferred to the forest floor, but only rather slowly (half-lives in the canopy: radiocesium, 90 days for the period 0-130 days, 230 days for the period 130-600 days; radioruthenium, 95 days for the period 0 200 days). The transfer of radiocesium and ruthenium to the forest floor by litter-fall was small when compared with that of weathering by rain or wind (radiocesium 7%, radioruthenium 8%, with respect to the total activity deposited in the canopy). The total deposition of radiocesium and ruthenium in the spruce stand was higher by 20 and 24%, respectively, than that observed in nearby grassland. The deposition velocity of radiocesium in the spruce stand was estimated at 5.5 mm s-1, higher by a factor of 10 than the figure for grassland. Similar values were found for radioruthenium. PMID- 2717930 TI - Human exposure to environmental polychlorinated dibenzo-p-dioxins and dibenzofurans: an exposure commitment assessment for 2,3,7,8-TCDD. AB - Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs and PCDFs) are released into the environment from the use of chemicals contaminated with PCDDs/PCDFs, the improper disposal of contaminated production wastes and incineration/other high-temperature processes. Certain congeners are extremely stable compounds which are persistent in the environment once released. An assessment is made of the sources of human exposure to one particular dioxin congener, 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD). Representative values of 2,3,7,8-TCDD concentrations in the background environment and in man are selected from available data or, when not available, inferred from other relevant information. A pathway analysis is performed utilizing the exposure commitment method. Normal dietary intake of 2,3,7,8-TCDD is quite variable depending primarily on consumption of contaminated fish. Representative intake for the average adult of 0.1 ng day-1 may be associated with a human body burden of 100 ng (approximately 7 ng 2,3,7,8-TCDD kg-1 adipose tissue). The inferred biological half-time of this compound in the body is approximately 5 years. The exposure evaluation also accounts for secondary pathways to man of 2,3,7,8-TCDD in air and drinking water. Estimates of transfer factors obtained from the representative background levels should be generally relevant and may be applied to more specific cases of exposure. PMID- 2717931 TI - Animals in the laboratory. AB - The first sentence of reference 15 in the report "Single-chain antigen-binding proteins" by Robert E. Bird et al. (21 Oct., p. 423) should have read, 'The majority of experiments have produced Ka's within a factor of 2 of these values; therefore, log K(a)'s for the 4-4-20 I, Fab, and 4-4-20/20' single-chain protein are 10.2, 9.9, and 9.0+/-0.3, respectively. PMID- 2717932 TI - A preemptive strike for animal research. PMID- 2717933 TI - WHO seeks global data on sexual practices. PMID- 2717934 TI - U.S. probe meets resistance. PMID- 2717935 TI - Genome mapping goal now in reach. PMID- 2717936 TI - Catalytic antibodies with lipase activity and R or S substrate selectivity. AB - The specific hydrolysis of unactivated esters bearing an R or S enantiomeric alcohol has been achieved by two separate classes of catalytic antibodies induced to bind either the R or S substrates. The antibodies exhibit rate accelerations (10(3) to 10(5] above background hydrolysis that, coupled with their antipodal specificity, provide a novel set of reagents for use in synthesis. PMID- 2717937 TI - Drunk driving and statistical morality. PMID- 2717938 TI - Alar and apples. PMID- 2717939 TI - NIH reopens Baltimore inquiry. PMID- 2717940 TI - Watson floats a plan to carve up the genome. PMID- 2717941 TI - Nobelists back animal research. PMID- 2717942 TI - Synaptic connections in vitro: modulation of number and efficacy by electrical activity. AB - The functional architecture of synaptic circuits is determined to a crucial degree by the patterns of electrical activity that occur during development. Studies with an in vitro preparation of mammalian sensory neurons projecting to ventral spinal cord neurons slow that electrical activity induces competitive processes that regulate synaptic efficacy so as to favor activated pathways over inactive convergent pathways. At the same time, electrical activity initiates noncompetitive processes that increase the number of axonal connections between these sensory and spinal cord neurons. PMID- 2717943 TI - Budget cuts at NIH. PMID- 2717944 TI - New chip may speed genome analysis. PMID- 2717945 TI - Fibroblast growth factor in the extracellular matrix of dystrophic (mdx) mouse muscle. AB - Polyclonal antibody F547 reacts with a bovine basic fibroblast growth factor (bFGF) and a human recombinant bFGF, but not with bovine acidic fibroblast growth factor. This antibody localized bFGF in the extracellular matrix of mouse skeletal muscle, primarily in the fiber endomysium, which includes the heparin containing basal lamina. In mdx mouse muscle, which displays persistent regeneration, FGF levels in the extracellular matrix are higher than those in controls. Overabundance of matrix FGF in mdx muscles may be related to an increase in both satellite cell and regenerative activity in the dystrophic muscle and may help explain the benign phenotype of mdx animals compared with the genetically identical human Duchenne muscular dystrophy. PMID- 2717946 TI - Calicheamicin gamma 1I and DNA: molecular recognition process responsible for site-specificity. AB - Calicheamicin gamma 1I is a recently discovered diyne-ene-containing antitumor antibiotic that cleaves DNA in a double-stranded fashion, a rarity among drugs, at specific sequences. It is proposed that the cutting specificity is due to a combination of the complementarity of the diyne-ene portion of the aglycone with DNA secondary structures and stabilization by association of the thiobenzoate carbohydrate tail with the minor groove. PMID- 2717947 TI - Receptor-mediated drug delivery to macrophages in chemotherapy of leishmaniasis. AB - Methotrexate coupled to maleylated bovine serum albumin was taken up efficiently through the "scavenger" receptors present on macrophages and led to selective killing of intracellular Leishmania mexicana amazonensis amastigotes in cultured hamster peritoneal macrophages. The drug conjugate was nearly 100 times as effective as free methotrexate in eliminating the intracellular parasites. Furthermore, in a model of experimental cutaneous leishmaniasis in hamsters, the drug conjugate brought about more than 90% reduction in the size of footpad lesions within 11 days. In contrast, the free drug at a similar concentration did not significantly affect lesion size. These studies demonstrate the potential of receptor-mediated drug delivery in the therapy of macrophage-associated diseases. PMID- 2717948 TI - Neural integration of information specifying structure from stereopsis and motion. AB - When one views a two-dimensional parallel projection of dots on the surface of a rotating globe, the direction of rotation is ambiguous, and the perceived direction of rotation of the two-dimensional figure is unstable over time. Stability can be temporarily induced by adaptation to a three-dimensional globe with a direction of rotation unambiguously specified by stereo disparity; adaptation causes the two-dimensional figure to appear to rotate in the direction opposite that experienced during stereoscopic adaptation. This adaptation effect is selective for axis of rotation but is not shape-specific. It does depend on simultaneous stimulation by multiple depth planes defined by elements moving in different directions. Evidently information about stereopsis and information about structure from motion are integrated within a common neural site in the brain. PMID- 2717949 TI - Aneurysmal bone cyst of the sacrum. AB - A series of five cases of sacral aneurysmal bone cyst is presented. There were three females and two males, the youngest patient being 11 years old, the oldest 41 years old. All patients had pain of long duration with varying signs of nerve root compression. Three patients had micturitional problems. Four patients had a palpable mass which was tender. All had standard radiographs. Tomograms, computed tomography (CT) scans or MRI (magnetic resonance imaging) were obtained in some patients. In all patients a definite histologic diagnosis was established. Four lesions healed after resection (two cases) or curettage (two cases). One patient is considered to have a stable lesion which is not progressing. PMID- 2717950 TI - Longitudinal tibial epiphyseal bracket in Nievergelt syndrome. AB - A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment. PMID- 2717951 TI - Case report 526: Intraosseous pneumocyst of the ilium. PMID- 2717952 TI - Case report 527: Giant bone island of tibia. PMID- 2717953 TI - Case report 528: Tuberculous dactylitis (right great toe). PMID- 2717954 TI - Case report 529: Osteosarcoma of calcaneus with Rothmund-Thompson syndrome (RTS). PMID- 2717955 TI - Case report 530: Paget disease engrafted on congenitally fused cervical vertebrae (C3-C4). PMID- 2717956 TI - Case report 531: Epiphyseal osteoblastoma distal end of femur. PMID- 2717958 TI - Case report 533: Tuberculosis of calcaneus and talus with negative tuberculin skin test. PMID- 2717957 TI - Case report 532: Extraosseus intra-abdominal osteosarcoma. PMID- 2717959 TI - Case report 534: Simple bone cyst of the acetabulum and ischium. PMID- 2717960 TI - Verbum sapienti. PMID- 2717961 TI - Shoulder arthrography with sodium meglumine metrizoate and iopamidol. AB - The purpose of this study was to analyze arthrographic imaging of the structures of the shoulder joint when using either sodium meglumine metrizoate or iopamidol as a contrast medium. Two hundred and ten patients underwent single-contrast shoulder arthrography. In patients with a full-thickness tear of the rotator cuff, both contrast agents reliably revealed this lesion. However, in patients with a full-thickness rotator cuff tear, the biceps tendon could be demonstrated more readily with iopamidol, which is a non-ionic contrast medium. PMID- 2717962 TI - Post-traumatic cysts and cyst-like lesions of bone. AB - We describe two patients with cyst-like lesions of bone that developed at sites of healed or healing fractures. One case showed histological features of a unicameral bone cyst, which, to the best of our knowledge, is a previously unreported finding in a post-traumatic cyst. It is suggested that there are two principal clinical and radiological types of post-traumatic cyst, of which each of our cases represents an example: (1) asymptomatic transient cortical lesions, found only in children, and (2) more central expanding lesions, found in a wider age group and associated with pain, swelling, and pathological fractures. PMID- 2717964 TI - Community-based health care 10 years post Alma Ata. PMID- 2717963 TI - Spinal hyperostosis in comparative pathology. A useful approach to the concept. AB - Spinal hyperostosis, an anatomical and radiological concept primarily described in man, is characterized by enthesopathic bony overgrowth on vertebral bodies in the form of spurs or intervertebral bridges. It can also be part of a more diffuse enthesopathic condition, including the appendicular skeleton. These changes are distinct from those of osteoarthrosis. Similar changes can be observed in all kinds of mammals, independent of their type of locomotion (bipodic, quadrumanous, quadrupedic, or aquatic). An anatomical and radiological study is presented of six cases (with histological examination of two dogs and one horse, and observation of macerated specimens of one horse, one equida, and one whale). Comparative pathology allows for a better understanding of the concept of hyperostosis and, even more clearly than in man, this can be distinguished from that of discovertebral pathology although both conditions could be associated in older subjects. The knowledge of spinal hyperostosis in veterinary medicine could--as in man--be of interest to differentiate between this process and other features of vertebral pathology. PMID- 2717965 TI - Hospital outreach community-based health care: the case of Chogoria, Kenya. AB - This article presents an analysis of the community health activities of Chogoria Hospital, Kenya, as they evolved from a typical 'outreach' programme to a heavily community-based one, and the factors that contributed to this conversion. Factors considered include family planning, being the central theme of the programme since its inception, financing, and the impact of the programme is illustrated with data from an extensive evaluation carried out in 1985. The question of long term financial viability is addressed, contrasting the desired self-sufficiency with the need and extent of donor contributions and finally a number of key factors are listed that may have been important to the success of the programme. PMID- 2717966 TI - Primary health care in northwestern Somalia: a case study. AB - This paper examines the problem of initiating health care programmes in areas where there is no effective infrastructure. The problem is examined using Northwestern Somalia as a case study. The project focussed on the establishment of well-trained and well-supported CHWs at the community level. Many of these communities are (semi-)nomadic. The roles of middle-level management staff, community leaders and committees, CHW remuneration and health effects of the project are discussed. PMID- 2717967 TI - A people-centered approach to primary health care implementation in Mvumi, Tanzania. AB - The Mvumi community-based health care programme in Dodoma Region has been attempting to involve communities in promoting their health. It established a dialogue using communication and adult training skills and assisted communities only in those activities which they themselves planned and which they were ready to finance. Such activities included training of community resource persons such as traditional midwives and village health promoters/workers. Within only 4 years substantial output and outcome results could be demonstrated. Many village communities, for example, have assumed responsibility for the village-based nutrition rehabilitation of their severely malnourished children. PMID- 2717968 TI - Community-based health care in Kibwezi, Kenya: 10 years in retrospect. AB - In response to the interest of the Kenya government in community-based health care, the Kibwezi Rural Health Scheme was developed by the African Medical and Research Foundation (AMREF) in a semi-arid district in eastern Kenya. Based on a community co-operative philosophy and focussing on health promotion and prevention, the scheme includes the following: a health centre with a 15-bed in patient unit including four maternity beds, out-patient services, and a 15-bed nutrition rehabilitation unit; a cadre of volunteer community health workers, trained by AMREF, who form the backbone of the project; maternal child health/family planning and nutrition services including an applied nutrition programme, a water project; and a mobile health unit. Designed as a replicable model health programme, the intention was that services would be gradually taken over by the Ministry of Health of Kenya. Much has been learned in the development of the project which should be meaningful to others considering similar endeavours. One of the first lessons learned was that the time taken to sensitize the community to community-based health care is critical to the success of the project and may need to be as long as 1-2 years. Another was that gaining the support of the community for the community health workers (CHW) requires a considerable effort on the part of project staff, but seems to be the only viable solution to the remuneration and recognition of the CHW's work. It also became apparent that preventive and promotive health services should be integrated structurally and operationally with curative health services to provide the most benefits for the community served. Finally, although there are some differences of opinion, it is felt that with some refinements, the project could be replicated in other parts of Kenya. PMID- 2717969 TI - A tale of two clinics--primary health care in refugee settings: lessons from Sudan and Somalia. AB - The elements and techniques of PHC were not developed in and for refugee situations, and the acute needs and transient situation of refugees sometimes attracts a more traditional medical approach. However, as refugees remain in a host country and their situation stabilizes there, attempts are made to convert to PHC. Refugee health programmes face some unique challenges when attempting this transformation, problems that exist even when PHC techniques were present at the onset of the programme. The challenge is to adapt PHC principles for use in acute and chronic refugee situations, and to find ways to develop a community base for health care programmes while at the same time meeting the acute medical needs unique to refugees. PMID- 2717970 TI - A case study of the Tenwek hospital community health programme in Kenya. AB - Tenwek mission hospital, situated in the west-central highlands of Kenya, initiated a community health programme in 1984. This paper describes the major features of the programme and assesses the impact on a number of health and family planning practices after 3 years of implementation. Comparison of the results in the programme areas with the baseline survey and with control areas show significant changes in several indicators. It is concluded that Tenwek hospital demonstrated the impact a hospital can have on health of communities by effectively moving into community-based health care. PMID- 2717971 TI - An integrated rural health project in Saradidi, Kenya. AB - In 1979 a community self help health development programme was initiated in Saradidi, Kenya, as the community's response to its problems. In line with the theoretical considerations made for the implementation of primary health care the community was involved in planning, organization, setting of priorities and objectives, implementation and evaluation of the programme. The Saradidi Health Development Project (SHDP) was initiated by people from the area with material assistance from within and outside Saradidi. Nearly 10 years since the beginning of the project, the SHDP still runs more or less on its own providing experiences for other projects and initiators. PMID- 2717972 TI - Whither community-based health care? AB - This paper identifies implications for community-based health care (CBHC). Sustainability of CBHC depends on effective community involvement, power sharing, adequate resources and, above all else careful planning with the community expected to benefit from CBHC. PMID- 2717973 TI - Mass produced village health workers and the promise of primary health care. AB - The most evident aspect of primary health care (PHC) development in many countries is the mass recruitment and training of village health workers (VHWs). These VHW schemes are often merely an extension of the organized government health services. This paper takes the view that over emphasis of VHWs is a fatal limitation and narrowing of the original idea of PHC. In the spirit of PHC, communities should be allowed to go through the process of identifying their problems, sorting out their priorities, means of solving identified problems through the material and human resources they have at their disposal. Before communities have been allowed to go through such a process, the selection of VHWs is at best, an imposition from above. PHC is thus robbed of its most fundamental components, of community participation, self-determination and self-reliance. PMID- 2717974 TI - The dilemma of essential drugs in primary health care. AB - This article describes the evolution of essential drug programmes in eastern Africa from national donor assisted programmes to community-based drug programmes. Problems of the transition towards cost recovery are discussed and greater dialogue between government, donors and communities will be required if real community management is to be commenced. PMID- 2717975 TI - Simplifying the evaluation of primary health care programmes. AB - Currently, there is considerable attention for health impact--as measured by mortality, morbidity or nutrition indicators, in the evaluation of primary health care (PHC) programmes. In most cases, health impact evaluations tend to be dominated by methodological discussions on data collection, analysis and interpretation, which are not relevant to the majority of PHC programmes. In this paper a theoretical framework of variables, affecting child survival, is presented. The key to this action-oriented framework is the identification of a set of intermediate variables which directly affect the health status of children, but can be influenced by PHC interventions as well. It is recommended that evaluations of PHC programmes should focus on these intermediate variables and be less concerned with health impact of the interventions. PMID- 2717976 TI - [Prognosis of burns in adults]. AB - Based on a group of 220 deaths from sequelae of burns in 1966-1985 the author calculated from the area of the burns injury (grade II and III). from the period of survival and age of the patients the values of LA50 (lethal area 50), i. e. values, expressed in per cent of the body surface, when half the patients die. In the age group of 15-50-year-old ones the LA50 value was 55%, in the group of 51 60-year-old ones 32%, in the group aged 61-70-years 17%, in the group aged 71-80 years 12% and in those above 80 years 9%. On comparison with LA50 values assessed in the same manner in 133 deaths in 1966-1971 an increase of values was found in particular in young and middle aged patients which deadlined with the advancing age of the affected persons. The revealed increase suggesting a more favourable prognosis of burns is due to better therapy. PMID- 2717978 TI - Addled brains and coffin nails. PMID- 2717977 TI - [Pitfalls in the serological study of biological traces on motor vehicles]. AB - Using the saturation method, the author examined 18 specimens of impurities from the baitom part of Skoda motor cars and buses and motor oil and lubricant. Using diagnostic sera O, anti-A, anti-B, anti-H in as many as 13 specimens of impurities an obviously non-specifik drop of the titre by 1 to 4 degrees was found. Even specimens of cooked grass saturated the diagnostic sera. PMID- 2717979 TI - Boxing-related ocular injuries in the United States Army, 1980 to 1985. AB - Boxing is a controversial sport in which neurologic and ocular injuries can be particularly devastating. Currently, competitive boxing is promoted throughout the military. Ocular injuries attributable to military boxing were studied as a subset of a larger study of boxing-related injuries. Ocular injuries occurred in 5% (22/401) of soldiers hospitalized for boxing-related trauma. The 22 patients with eye injuries spent an average of 8.1 days in the hospital and 17.8 days unfit for duty. Ocular injuries, on average, resulted in a longer hospitalization and disability than all other boxing injuries. One soldier was blind in one eye after complications from a ruptured globe. PMID- 2717980 TI - Naloxone and mortality in the gerbil stroke model. AB - Endorphins and narcotics have been implicated in the exacerbation of neurologic deficits after stroke. To test the theory that narcotic antagonists might offer an improvement in neurologic sequelae following stroke, we administered various doses of naloxone intraperitoneally to 50 adult gerbils 45 minutes after carotid artery transsection. Low-dose naloxone therapy (1.0 to 2.5 mg/kg) was more effective in preventing death than either control (sterile saline) or high-dose naloxone (10 mg/kg). A naloxone dose of 1.0 or 2.5 mg/kg offered a significant improvement in mortality over both the control and the high-dose therapy (P = .026). It appears that an appropriate dose of naloxone (1.0 to 2.5 mg/kg), given early enough to alter outcome, offers an improved survival in the gerbil stroke model. This finding obviously has significant implications for the use of narcotic antagonists in human beings with stroke. PMID- 2717981 TI - Xanthelasma: clinical indicator of decreased levels of high-density lipoprotein cholesterol. AB - The fasting plasma lipid and lipoprotein levels were measured prospectively in 41 consecutive patients with xanthelasma seen over a four-year period. The study group included 25 women and 16 men with mean ages of 60 and 56 years, respectively. Each patient had clinical evaluation for medications or illnesses that might affect plasma lipid levels before entry into the study. The most striking lipid abnormality was the preponderance of decreased levels of high density lipoprotein cholesterol (HDL-C). In 94% of the study population, HDL-C values were less than the mean values of the age-matched reference population. For men the mean HDL-C level was 30.8 mg/dl (vs 45 mg/dl in the reference population, P less than .001); for women the mean HDL-C level was 33 mg/dl (vs 50 mg/dl, P less than .001). The total cholesterol, low-density lipoprotein, and triglyceride levels of those in the study were not significantly different from those of the patients in the reference population. Evaluation of cardiac risk based solely on HDL-C levels showed 80% of the study population to have three to four times the average risk. This study points out the high probability of decreased HDL-C levels in patients with xanthelasma. Since the level of HDL-C has been shown to be inversely related to the incidence of cardiovascular disease, it may be prudent to evaluate HDL-C levels and do a thorough cardiovascular evaluation in patients with xanthelasma. PMID- 2717982 TI - Musculoskeletal chest pain in patients with "angina": a prospective study. AB - We prospectively evaluated 62 adults referred for coronary arteriography, using a systematic physical examination protocol to identify musculoskeletal sources of chest pain. In seven patients (11%) the chest pain was reproduced on physical examination; six of them ultimately had a diagnosis of nonanginal chest pain made by their cardiologist, based on history and data from noninvasive and coronary arteriographic studies. Five had normal coronary arteriograms. These patients described their pain in terms often associated with true angina. Musculoskeletal tenderness that did not reproduce the pain was common and was unrelated to coronary artery disease. Demonstration of musculoskeletal tenderness that reproduces chest pain, when combined with noninvasive findings suggesting low probability of coronary artery disease, may be useful in decreasing the incidence of unnecessary invasive cardiac evaluation, and appropriately directing initial therapy. PMID- 2717983 TI - Blunt pancreatic trauma: prospective evaluation of early endoscopic retrograde pancreatography. AB - Major ductal injury is a determining factor in the outcome after pancreatic trauma. The purpose of this study was to determine the value of early endoscopic retrograde pancreatography (ERP) in patients with blunt pancreatic trauma. We attempted ERP in nine patients. Indications were abnormal pancreatic findings on CT scanning in five patients, a suboptimal view on CT scanning in three patients, and a high index of suspicion in one patient. ERP was successful in eight patients. Two had major ductal injury treated operatively and were discharged without complications. In six, ERP showed a normal pancreatic duct. These patients were treated conservatively; five were eventually discharged, and one died of necrotizing pneumonia. Our results suggest that ERP is safe and accurate in the diagnosis of blunt pancreatic ductal injuries. If the pancreatic ductal system is intact, conservative management is appropriate, but if ERP shows major ductal injury, surgical intervention is indicated. PMID- 2717984 TI - Osteoplastic pterional craniotomy. AB - We describe a new method for small frontotemporal craniotomies. Adequate exposure is obtained. Sparing of the trunk of the frontotemporal branch of the facial nerve as it passes near the eyebrow preserves forehead mimetic function, and maintenance of the blood supply to the bone flap helps to prevent resorption. PMID- 2717985 TI - Height-adjusted, rate-specific, single-stage step test for predicting maximal oxygen consumption. AB - A suitable ergometer that is generally favored for estimating maximal oxygen consumption (VO2 max) under field conditions or in environments where testing equipment is limited is the step test. Recently a mathematical model was reported to standardize the height of stepping for individuals of various heights. We designed a study to validate this model using a three-minute single-stage step test for predicting VO2 max in women. Seventeen women aged 19 to 33 performed each of three rate-specific step tests and a Bruce treadmill test. Direct measurements of VO2 max obtained from the treadmill test were correlated with the 15 second recovery heart rates after three different step tests done at stepping frequencies of 22, 26, and 30 step-ups per minute. The correlation coefficients of prediction of VO2 max from 15 second recovery pulse counts and directly measured oxygen consumption were 0.74 at 22 step-ups/min, 0.77 at 30 step ups/min, and 0.8 at 26 step-ups/min. Each relationship was significant at the P less than .01 level. It can be concluded that the single-stage step test described in this study provides an effective predictor of VO2 max in young women and can be used when more complex methods of laboratory testing are unavailable or not feasible. PMID- 2717986 TI - Wound hematoma: prophylaxis with topical thrombin. AB - We studied 123 patients having elective exploratory laparotomy through a midline vertical incision for gynecologic disease; patients were randomized to receive wound irrigation with either saline or topical thrombin before closure of the incision. Seven patients were not evaluable. No patient received low-dose heparin therapy perioperatively. No patient in either group had a clinically significant wound hematoma or disruption. Minor wound hematomas were more common in the saline group, a finding that approached statistical significance. Blood coagulation profiles were not different in the two groups either preoperatively or postoperatively. Topical thrombin is probably not clinically useful in preventing wound hematomas in patients who do not receive perioperative treatment with low-dose heparin; however, it seems to be safe for application to open wounds. PMID- 2717987 TI - Why medicine residencies? AB - Over the last several decades the context of the medicine residency has changed. These changes are described and attributed in considerable degree to bureaucratic impositions. I consider it paradoxic that there is finally a move afoot to reverse the changing nature of medicine residencies, yet this effort appears in the form of yet another bureaucratic imposition. PMID- 2717988 TI - Group G streptococcal bacteremia in a healthy young man. AB - Group G streptococcal bacteremia was detected in a 20-year-old man in association with bilateral epididymitis and orchitis. This patient showed none of the predisposing risk factors for group G streptococcal bacteremia which have been documented previously. PMID- 2717989 TI - Viscerotropic Rocky Mountain spotted fever in southeastern Texas: report of a survivor with atypical manifestations and multiple organ failure. AB - A 32-year-old black man from rural southeastern Texas had headache, fever, chills, bronchopneumonia, and an atypical rash, complicated by hypotension, lethargy, confusion, liver dysfunction, thrombocytopenia, and acute renal failure. The diagnosis of Rocky Mountain spotted fever (RMSF) was not suspected until eight days after the onset of symptoms. He was subsequently treated with chloramphenicol, followed by hemodialysis and aggressive supportive therapy. He recovered uneventfully with complete return of renal function. This case emphasizes that RMSF should be considered in the differential diagnosis of any obscure febrile illness even in nonendemic areas. PMID- 2717990 TI - Mucoepidermoid carcinoma of the lacrimal gland fossa: confirmation by ultrastructural study. AB - We have described a patient with a biopsy-proven mucoepidermoid carcinoma of the orbit. Although it may have represented a metastasis from a malignancy of the upper respiratory tract, clinically it appeared to be a primary neoplasm of the lacrimal gland. This case emphasizes the value of transmission electron microscopy in diagnosing poorly differentiated orbital tumors. PMID- 2717991 TI - Autoimmune thyroiditis manifested as a systemic febrile illness: diagnosis by gallium scan and fine needle aspiration biopsy. PMID- 2717992 TI - Reversible profound neurologic deficits associated with transient cranial CT abnormalities and systemic lupus erythematosus. AB - In the case we have reported, there is a combination of factors that can be attributed to SLE and its associated complications, which may explain the transient hypodensities seen on cranial CT scan. Vasculitis and uncontrolled hypertension lead to arterial spasm, ischemia, and increased vascular permeability, all of which eventually cause cerebral edema. This edema may manifest itself clinically as profound but transient neurologic deficits. PMID- 2717993 TI - Trigeminal neurilemoma: appearance on magnetic resonance imaging. AB - Neurilemomas can arise anywhere along the trigeminal nerve, and therefore can be either intra-axial or extra-axial. Small neurilemomas in Meckel's cavity may not be detectable with CT scanning because of bone artifact or normal enhancement of the cavernous sinus. We have reported two patients with trigeminal neurilemoma who were evaluated preoperatively with magnetic resonance imaging. PMID- 2717994 TI - Emergency cricothyrotomy: a flexible device in the operating room. PMID- 2717995 TI - Profound thrombocytosis in a patient with iron-lack anemia. AB - Platelet counts in excess of 1 million/cu mm are generally associated with a primary hematologic disorder such as a myeloproliferative syndrome. We describe a patient whose thrombocytosis (platelet count 1.6 million) was due solely to iron lack, and whose platelet count rapidly returned to normal with iron repletion. Clinicians are encouraged to consider reactive causes of thrombocytosis when evaluating platelet counts in excess of 1 million. PMID- 2717996 TI - Simultaneous pneumococcal arthritis and osteoarticular tuberculosis. AB - We have reported the case of a 79-year-old woman who had a pneumococcal pyarthrosis in a chronically swollen knee. Expected improvement did not occur despite appropriate medical and surgical therapy. Mycobacterium tuberculosis was subsequently cultured from fluid aspirated from the patient's joint. This is the first reported case of concomitant pneumococcal pyarthrosis and osteoarticular tuberculosis. PMID- 2717997 TI - "Nutcracker esophagus": a case of false-negative radionuclide esophageal transit study. PMID- 2717998 TI - Neonatal hyperbilirubinemia after treatment of maternal leprosy. AB - Leprosy occurs rarely in women of reproductive age. Until this report, the treatment of leprosy with dapsone has not been associated with any adverse fetal or neonatal side effects. We have reported what we believe to be the first case of neonatal hyperbilirubinemia after maternal dapsone therapy for leprosy. PMID- 2718000 TI - Religion and medicine. PMID- 2717999 TI - Ehrlichia in Tennessee. PMID- 2718001 TI - Temporal artery biopsy. PMID- 2718002 TI - Prophylactic epidural blood patch in parturients. PMID- 2718003 TI - Marijuana as a potential carcinogen. PMID- 2718004 TI - [The role of family in providing harmonious development of children]. AB - The study results on young families with children aged 0-5 are presented. The first group included 345 families having children with perinatal risk factors. The second group comprised 900 young families which had no violations in children's care but couldn't provide the necessary level of their upbringing and medical care. The disease frequency and distribution of children by health groups in the studied families were analyzed. It was shown that not only risk factors but also behavioral ones had significant impact on the health status of the children aged 0-5. PMID- 2718005 TI - [Socio-hygienic characteristics of families with risk factors of child morbidity]. PMID- 2718006 TI - [Risk factors and prevention of perinatal pathology]. PMID- 2718007 TI - [Development of groups of frequently ill children]. AB - The study demonstrates that age-specific disease rates and dynamics of the frequently ill population are governed by a number of biologic and social factors. A significant premorbid effect is primarily attributed to background disorders, i.e., rickets, anemia, exudative diathesis, etc., formed due to unfavourable social impact (complications of pregnancy, artificial feeding, low sanitary and cultural level of the family, mother's bad habits). Thus, the problem of the promotion of preschoolchildren's health can be solved only by means of a comprehensive approach realized through the system of a family doctor. This system helps to find out negative social factors and accordingly to carry out the goal-oriented primary prevention programme. PMID- 2718008 TI - [Maternal and child health services at the current stage: their problems and ways of their solution]. PMID- 2718009 TI - [Development of emergency pediatric services]. AB - The survey is undertaken to analyze the problems of children's applications for emergency and urgent medical care. The basic data on the functioning of urgent care units of territorial children's polyclinics and emergency care stations are presented. The study findings indicate the legitimate character and expediency of a separate system of urgent and emergency medical care delivery for children at the prehospital stage. PMID- 2718010 TI - [Anti-alcoholism education of future married couples]. PMID- 2718011 TI - [Anti-smoking propaganda among pregnant women]. AB - The study was designed to analyze the work of women's consultation clinics and maternity homes on antitobacco propaganda among pregnant women. 428 physicians were interviewed. It was shown that 21.7% of physicians at women's consultation clinics and 22.9% of those of maternity homes were constantly engaged in such propaganda activities. The majority of physicians discussed tobacco smoking only in case when the patients had some smoking-associated problems. It was recommended to intensify antitobacco propaganda, to develop the movement under the slogan "Smoking and doctors are incompatible", to raise the responsibility of physicians for health education. PMID- 2718012 TI - [Health education in urban pediatric polyclinics]. AB - The state of health education in city children's polyclinics was analyzed in 7 republics (RSFSR, the Lithuanian, Estonian, Kirghiz, Kazakh, Turkmenian and Azerbaijan SSR) and parents' preparedness to bring up a healthy child was evaluated in children's polyclinics of Moscow, Alma-Ata, Rostov-on-Don and the Rostov Region. 1126 medical workers (chief physicians, sector pediatricians, different specialists) and 435 parents of infants of the first year were interviewed. Unsatisfactory state and insufficient efficacy of health education pertaining to the problems of upbringing a healthy child were pointed out along with the absence of modern scientifically proved programme, methodological materials on health education of the parents with infants, necessary printed and visual materials for parents. The study findings helped to determine ways for further improvement of health education and family training at city children's polyclinics. PMID- 2718013 TI - [Reducing children's morbidity in departmental preschool institutions]. AB - The study reveals that the work aimed at decreasing morbidity rates and promoting children's health including the organization of the preschool convalescent home for 110 beds, special shifts in convalescent homes for mother and child, summer health-promotion groups results in a significant decrease of disease prevalence in preschool establishments. It is pointed out that rehabilitative treatment of convalescents, children's protection from influenza and acute respiratory virus infections, other organizational measures are of great importance for the process. PMID- 2718014 TI - [Effectiveness of postgraduate training of the heads of women's consultation clinics]. AB - The second stage of the efficacy assessment of the postgraduate education of the heads of women's consultation clinics was analyzed. They underwent training at the Central Order of V.I. Lenin Institute of Advanced Training of Physicians according to the experimental cycle of the problem-target programme which was developed on the basis of the claims raised for heads of women's consultation clinics. Postgraduate students were characterized according to their length of service and the posts occupied. The second stage of the efficacy assessment of advanced education involved the analysis of the introduction of new forms and methods of work in women's consultation clinics. The analysis was carried out by means of introduction charts used at the students' places of work, special assessment criteria being applied. The study findings were grouped by the type of activity of the clinic's heads. The conclusions were very specific and indicated the necessity of improving the work of this out-patient chain of the obstetric and gynecologic service. PMID- 2718015 TI - [Child mortality in the developing countries of Africa]. PMID- 2718016 TI - [Family physician in the Republic of Cuba]. PMID- 2718017 TI - [Changes of blood phospholipids in food poisoning]. PMID- 2718018 TI - [Efferent methods in the complex treatment of myasthenia gravis]. AB - The results obtained with exchange plasmapheresis and hemosorption used as elements of myasthenic patient preparation for thymectomy and postoperative treatment are summarized. The efferent methods were used in 95 patients, and positive shifts were recorded by electromyography and immunologic studies. Isolated or combined use of exchange plasmapheresis and hemosorption in severe myasthenia makes it possible to prevent postoperative myasthenic crisis and prolong remission or essentially improve patient's condition at late dates after thymectomy. PMID- 2718019 TI - [Isolated ultrafiltration in refractory cardiac insufficiency]. AB - The efficiency of isolated ultrafiltration was demonstrated in 101 patients with refractory heart failure developing in the presence of myocardial abnormalities. Catheterization of major (femoral or subclavian) veins is shown to be the optimum vascular access for isolated ultrafiltration; patient's blood can be returned through the needle catheter placed into the cubital vein. To prevent possible complications of isolated ultrafiltration, packed cell volume, central venous pressure and end diastolic pressure in the pulmonary artery should be monitored. PMID- 2718020 TI - [Sodium and lithium transport and steroid hormones of the adrenal glands]. AB - Erythrocyte Na-Li countertransport was determined in 42 patients with essential hypertension (EH), 36 patients with hypertensive chronic diffuse glomerulonephritis, 47 patients with chronic pyelonephritis, 19 patients with renovascular hypertension and 9 patients with primary aldosteronism (PA). None of PA patients was treated with verospiron. Individual assessment of Na-Li exchange was made in 15 patients with nonspecific aorto-arteritis (NAA), untreated by steroid hormones, and in 2 glucocorticoid-treated NAA patients. Na-Li exchange parameters were compared before and after surgery in 7 patients with arterial hypertension (AH). Mean rate of Na-Li countertransport was nearly twice as high in EH patients as compared to the respective rate in patients with renal AH, whereas the difference in mean countertransport rates was not significant between EH and PA patients. Increased Na-Li exchange rate went down to normal values in a PA patient, while postoperative hydrocortizone treatment increased this rate in a patient with pheochromocytoma. In the remaining patients with symptomatic hypertensions (renovascular hypertension, pyelonephritic granular kidney, aortic coarctation, pheochromocytoma), Na-Li exchange remained unchanged after surgery. The rate of Na-Li exchange was increased in prednisolone-treated NAA patients, as compared to NAA patients receiving no glucocorticoids. The level of Na-Li exchange was stable over 9-18 months in AH patients with normal plasma aldosterone levels. No effects of obsidan, corinfar, clophelin, furosemide, hypothiazide and triampur on Na-Li exchange were identified. PMID- 2718021 TI - [Treatment of peptic ulcer by electromagnetic irradiation of the millimetric range]. AB - Blood rheologic properties (blood and plasma viscosity, packed cell volume, erythrocyte aggregation rate and deformability) were examined in 40 patients with gastric and duodenal ulcers during a relapse and after treatment with millimetric electromagnetic waves (21) and medication (19). Relapses were associated with considerable disorders of both macrorheology and microrheologic erythrocyte properties. Conventional medication has no significant effect on those. Therapeutic use of millimetric electromagnetic waves contributes to the normalization of blood rheologic properties and thus improves the efficiency of treatment for gastric and duodenal ulcers. PMID- 2718022 TI - [Adaptation of the myocardium after correction of isolated pulmonary valve stenosis]. AB - Abnormal and compensatory reactions, arising in the course of myocardial adaptation to a new hemodynamic situation following the elimination of isolated pulmonary arterial stenosis have been studied. Rational treatment is proposed for the early postoperative period in this category of patients. PMID- 2718023 TI - [Pathogenesis and treatment of inflammatory diseases of the large intestine]. PMID- 2718024 TI - [Treatment of chronic gastritis]. PMID- 2718025 TI - [The role and place of clinico-statistical units in the economic evaluation of hospital activities]. PMID- 2718026 TI - ["Telephone patronage" for elderly psychiatric patients]. PMID- 2718027 TI - [Functional morphology of the hypothalamus in cardiovascular pathology]. AB - A morphologic study of the hypothalamus in the presence of various cardiovascular disorders has demonstrated discirculatory processes involving the microcirculatory network and resulting in the death of individual neurons. The number of disintegrating neurons is dependent on the pattern of the disease. Pathogenetic features of the disease are accompanied with changes in mean neuronic karyon volume that reflect variations in hypothalamic nuclear activity. PMID- 2718028 TI - [Diagnosis of myxoma of the left atrium]. PMID- 2718029 TI - [Functional characteristics of alveolar macrophages in chronic bronchitis]. PMID- 2718030 TI - [Therapeutic endoscopy in emergency surgical treatment of diseases of the biliary tract and pancreas]. PMID- 2718031 TI - [Hyperbaric oxygenation in inhalation toxicomania]. PMID- 2718032 TI - [Cerebral vasculitis in ocular herpes simplex]. PMID- 2718033 TI - [Levamisole in autoimmune complications of chronic lymphocytic leukemia]. PMID- 2718034 TI - [External respiration in botulism]. PMID- 2718035 TI - [Roentgenography with direct manifold magnification in primary osteoarthrosis deformans]. PMID- 2718036 TI - Fusions and transfusions. An analysis of blood loss and autologous replacement during lumbar fusions. AB - Blood losses and transfusions have been analyzed prospectively for 63 lumbar fusion operations in 55 patients. The mean intraoperative loss was 550 ml, with a further 336 ml in postoperative drains. Factors increasing intraoperative loss included posterior vs. anterior approach, the use of instrumentation, multiple levels fused, male vs. female, and younger age. For anterior procedures (without instrumentation and using homograft bone) and single-level posterolateral fusions (PLF) without instrumentation, neither predeposit nor intraoperative salvage (cell saver) was required. Single-level PLF with instrumentation and two-level PLF without instrumentation required either cell saver or predeposit of one or two units. Multiple-level PLF with instrumentation and all 360 degrees procedures required cell saver and two units of predeposit. Two patients received homologous blood. PMID- 2718037 TI - Intraspinal narcotic analgesia. A comparison of two methods of postoperative pain relief. AB - Postoperative analgesia using continuous epidural morphine or a single intrathecal injection of morphine has been compared with standard patient controlled analgesia (PCA) in lumbar fusion patients. Pain relief with epidural morphine was dramatic in some cases (3/12) but was not predictable, and catheter displacement was a frequent occurrence. A single intrathecal bolus of morphine had no advantage over PCA alone. Complications of both intraspinal techniques included nausea and pruritus. No respiratory depression was observed. PMID- 2718038 TI - Anatomic analysis of pedicle cortical and cancellous diameter as related to screw size. AB - The effective thoracic and lumbar pedicle diameter as related to screw size for that pedicle was studied in six fresh-frozen human cadaver spines. Measurements of the pedicle were obtained before screw insertion using axial and coronal reformatted computed tomographic (CT) images, as well as graduated sounding of the pedicle. After sequentially loading each pedicle with increasingly larger screws, measurements were taken of the outer cortical diameters. Plastic deformation of the pedicle preceded pedicle fracture or cutout when the screw thread diameter became larger than the endosteal diameter or within 80% of the outer cortical diameter as measured from the CT scan. Pedicle screws did not obtain cortical purchase within the pedicle. PMID- 2718039 TI - The AO spinal internal fixator. AB - The AO spinal internal fixation system uses 5.0 mm diameter transpedicular Schanz screws with 7.0 mm diameter fully threaded stainless steel rods. Originally developed for the treatment of thoracolumbar and lumbar spine fractures, it can be used for a variety of spinal disorders. A prospective study has been carried out, and the first 48 patients have been reviewed. The results for those patients with fractures are excellent. In burst fractures, it has been possible to decompress the canal and restore lordosis. In only half of the cases of spondylolisthesis has it been possible to improve the degree of slip. The fixator has provided rigid stabilization for a variety of other spinal problems. PMID- 2718040 TI - Anterior stabilization, instrumentation, and decompression for post-traumatic kyphosis. AB - Thirty-seven patients underwent surgery for late post-traumatic kyphosis in the lumbar, thoracolumbar, or thoracic spine. Indications for surgery included: increasing deformity, pain, and persistent neurologic deficit with paraparesis in eight, and development of late spinal stenosis in a further nine patients. All patients underwent anterior correction with Kostuik-Harrington instrumentation. Seventeen patients with neurologic deficit underwent decompression over appropriate levels as well. No posterior fusions or instrumentation were carried out. Stable arthrodesis with correction of the deformity occurred in 36 of 37 patients with only one nonunion. Pain was reduced significantly in 78% of patients. Late neurologic improvement of a significant functional degree occurred in three of eight paraparetics. All patients with spinal stenosis had relief of their symptoms and signs. PMID- 2718041 TI - Histochemistry and morphology of erector spinae muscle in lumbar disc herniation. AB - The purpose of this study was to detect any changes in the erector spinae muscles in patients undergoing surgery for lumbar disc herniation (LDH) and to analyze which factors (sex, age, the level and site of disc protrusion, and duration of symptoms) would be related to these changes. The percentage of mean area of the type I fibers was significantly larger in males and in the older age group (P less than 0.05), due to the decreasing size of type IIa and IIb fibers. Patients with LDH have: 1) angulated and selective atrophy of type II fibers with a higher type IIb/IIa ratio; 2) with increasing age and duration of symptoms, more marked atrophy of type II fibers; and 3) other unspecific pathologic changes. PMID- 2718042 TI - Healing potential of the anulus fibrosus. AB - The purpose of this study was to investigate the healing of surgically created defects in the anulus fibrosus in an effort to determine the healing potential of this structure. Four identical lesions were made in the anulus fibrosus of ten dogs at levels L2-L5. Two dogs were killed at 3, 6, and 9 weeks. Four dogs were killed at 12 weeks. The spines were harvested during a 3- to 12-week period and evaluated grossly and microscopically. Our study demonstrated that a stab wound of the anulus has a limited healing potential and the persisting defect could provide a pathway for irritating nuclear fluid escape onto perineural tissue, possibly resulting in persistent low-back pain. PMID- 2718043 TI - Long-term strength assessment of postoperative diskectomy patients. AB - A test battery was used to measure abdominal and back muscle strength and endurance in 20 patients at least 1 year after surgical diskectomy. There were ten men and ten women. Data on isometric and isokinetic performance were compared with previously reported normal values. The data showed that every strength parameter tested except male isokinetic flexion strength showed at least a 30% decrease when compared with normal values. Compared with strength data on these same patients immediately after surgery, a 2-tailed Student t test demonstrated a significant difference only in male isokinetic strength (P less than 0.10) and in female isokinetic strength (P less than 0.05). No other difference was found in isometric strength or endurance compared with data obtained from these patients 4 to 6 weeks postoperatively. From these data, it is obvious that more intensive physical therapy is necessary to improve postoperative strength in patients undergoing surgical diskectomy. These data allow for the design of specific isometric, isokinetic, and endurance rehabilitation programs for the postoperative diskectomy patient. PMID- 2718044 TI - A database of isoinertial trunk strength tests against three resistance levels in sagittal, frontal, and transverse planes in normal male subjects. AB - Spatial joint complexes, such as the spine, require multiaxial systems to adequately assess their functional capacity. The B200 Isostation (Isotechnologies, Inc., Carrboro, North Carolina) is a triaxial system that has three hydraulic pumps under control of an IBM-XT. The transducers measure the torque, angular position, and velocity for all axes simultaneously. There is no isoinertial data base available for strength at different resistances in the sagittal, coronal, and transverse planes. A normal data base for dynamic performance against resistances equal to 30%, 50%, and 70% of the maximum isometric strength of trunk muscles in all three planes was established. PMID- 2718045 TI - The importance of pelvic tilt in reducing compressive stress in the spine during flexion-extension exercises. AB - An explanation for the importance of pelvic tilt exercises is proposed. This explanation derives from a mathematical model that predicts the existence of a relationship between lordosis (pelvic tilt) and the distribution of stresses within the spine. The model predicts that, for every angle of forward flexion, there is a unique degree of lordosis that will minimize and equalize the compressive stress within the spine. This stress-minimizing posture also is associated with the minimum muscular activity; the balance of the moment is supported by passive stretching of the connective tissues. These predictions were tested by comparing them with empirical values of spinal geometry and muscular activity, as measured simultaneously by an opto-electronic motion analysis and electromyographic (EMG) data collection system. PMID- 2718046 TI - Does discography injure normal discs? An analysis of repeat discograms. AB - This study was done to look for evidence of damage to a healthy disc resulting from diagnostic discography. Thirty-four patients had undergone a second discogram at 80 lumbar levels. There were 22 men and 12 women. The mean interval between discograms was 16.7 months (range, 3-38). Of 42 levels that were reported to be radiologically normal on the first discogram, ten were reported to be abnormal on the second discogram (24%). On review of these films, the abnormality was in fact present on the first discogram at two levels, and the second discogram was normal at two levels (radiologist error). Fusions had been done in three patients at adjacent levels between discograms. A compression fracture was present in adjacent vertebrae at two levels. Only one level was found to be truly abnormal on the second discogram for no obvious reason. The authors found no evidence that diagnostic discography damaged a normal disc. PMID- 2718047 TI - Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. AB - The functional outcome of patients with lumbar herniated nucleus pulposus without significant stenosis was analyzed in a retrospective cohort study. Inclusion criteria were as follows: 1) a chief complaint of leg pain, primarily; 2) a positive straight leg raising (SLR) at less than 60 degrees reproducing the leg pain; 3) a computed tomography (CT) scan demonstrating a herniated nucleus pulposus without significant stenosis by a radiologist's reading, which was also confirmed by the authors; 4) a positive electromyogram (EMG) demonstrating evidence of radiculopathy; and 5) response to a follow-up questionnaire. All patients had undergone an aggressive physical rehabilitation program consisting of back school and stabilization exercise training. Of a total of 347 consecutively identified patients, 64 patients with an average follow-up time of 31.1 months met the inclusion criteria and constituted the study population. They were sent questionnaires that inquired about activity level, pain level, work status, and further medical care. The patients with neurologic loss, extruded discs, and those seeking a second opinion regarding surgery were identified and subgrouped. Results for the total group included 90% good or excellent outcome with a 92% return to work rate. For the subgroups with extruded discs and second opinions, 87% and 83% had good or excellent outcomes, respectively, all (100%) of whom returned to work. Sick leave time for these subgroups was 2.9 months (+/- 1.4 months) and 3.4 months (+/- 1.7 months), respectively. These results compared favorably with previously published surgical studies. Four of six patients who required surgery were found to have stenosis at operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718048 TI - The use of dexamethasone in primary lumbar disc surgery. A prospective, randomized, double-blind study. AB - Corticosteroids have been used by many spine surgeons in the postoperative management of lumbar disc surgery patients. The potential side effects of these medications are significant, and yet there is little information available either supporting or contraindicating their use in the postoperative setting. This prospective, randomized double-blind study was designed to assess the effectiveness of the corticosteroid dexamethasone in decreasing postoperative pain and hospital stay after primary lumbar disc surgery. The patients' pain status was assessed both preoperatively and postoperatively by a standard pain questionnaire and pain drawing. Each patient's response to the questionnaire and pain drawing, as well as his usage of narcotics and days of postoperative hospitalization, were recorded and analyzed. Dexamethasone was shown to have a significant and selective effect on reducing leg pain postoperatively, while also significantly reducing the usage of injectable narcotics and shortening the postoperative hospital stay. PMID- 2718049 TI - Long-term results of lumbar spine surgery complicated by unintended incidental durotomy. AB - Unintended incidental durotomy is not an infrequent complication of spinal surgery (incidence, 0.3-13% reported). Although prompt repair is advocated, little has been written regarding any consequences of primarily repaired durotomies on long-term patient outcome. A retrospective review of 450 patients undergoing lumbar spine surgery revealed 17 cases (4%) of incidental durotomy, recognized intraoperatively and repaired primarily. These patients were evaluated at long-term follow-up (mean, 25.1 months); and their results were compared with controls matched for age, diagnosis, procedure, and length of follow-up. No differences of statistical significance could be identified in comparing the outcomes of the two groups. Incidental durotomy, when recognized and repaired intraoperatively, does not increase perioperative morbidity or compromise final result. PMID- 2718050 TI - Segmental ("floating") lumbar spine fusions. AB - A traditional teaching in orthopaedic surgery has been that, in cases of fusion for L4-5 discopathy or instability, one must include the lumbosacral joint. There is nothing in the literature to support this time-honored dictum. The senior author, among others, has rejected this concept; and, the authors are, therefore, in a position to present a 32-year experience with segmental or "floating" fusion. Two hundred six floating fusions were performed, of which 184 were available for follow-up. Of these, 83.7% achieved "Excellent" or "Good" results; 15.2% were rated "Fair"; and 2% were rated "Poor." Only five patients (2.7%) had subsequent disc herniation at the lumbosacral level necessitating discectomy and extension of fusion to incorporate the sacrum. PMID- 2718051 TI - Rationale for spinal fusion in lumbar spinal stenosis. AB - In order to define the indications for spinal fusion in patients undergoing decompression for lumbar spinal stenosis, 114 patients surgically treated were reviewed. Follow-up was 24 to 108 months. Patients were grouped into four categories: 15 with lateral recess stenosis, 45 with central-mixed stenosis, 43 with stenosis following prior lumbar surgery(s), and 11 with scoliosis and spinal stenosis. Only two patients with lateral recess stenosis underwent fusion with fair results. Approximately one-third of those with central-mixed stenosis required a fusion. Results were good in 70%. In those with stenosis following prior lumbar surgeries, although not statistically significant, those who had concomitant decompression and arthrodesis had a better outcome than those in whom decompression only was done. Patients with scoliosis and stenosis had decompression for significant motor and reflex deficits and fusion over the length of their major curves. Patients having decompression for lumbar stenosis with degenerative spondylolisthesis, isolated disc resorption with degenerative facet joints, intervertebral disc disease with instability, and those with scoliosis with multidirectional instabilities benefit from concomitant spinal fusion. PMID- 2718053 TI - Posterior lumbar interbody fusion with facet-screw fixation. AB - The optimal surgical construct for lumbar fusion remains controversial. The posterior lumbar interbody fusion (PLIF) operation offers advantages including total nuclear disc excision, restoration of disc-space height, root decompression, limited muscle retraction and injury, and solid mechanical arthrodesis. Major disadvantages have included graft displacement, neurologic injury and nonunion. The use of posterior fixation as an adjunct to PLIF reduces the probability of these complications and increases the chances of fusion. This study examines 35 patients who underwent PLIF and facet-screw fixation. Indications for surgery included disabling low-back pain with discographic/MRI demonstrated disc derrangement, recurrent disc herniation, and failed inter transverse process fusions. Follow-up ranged from 6 to 18 months. There were no patients with significant neurologic injury or functional root loss. One patient developed graft displacement and failure of fixation (laminar fracture in markedly obese patient). Three patients had subcutaneous hematomas (no surgical treatment required). None of the cases required blood replacement. The authors have concluded that the addition of facet fixation/fusion to the PLIF operation substantially reduces the complication rate of the procedure. PMID- 2718052 TI - The Wiltse pedicle screw fixation system. Early clinical results. AB - Ninety-nine patients were studied prospectively after spine fusion augmented with the Wiltse pedicle screw fixation system. Follow-up ranged from 12 to 34 months, averaging 20 months. There were 33 men and 66 women. Their ages ranged from 20 to 86, with the average age of 52. This was the first spine surgery in 23 patients. Seventy-six patients had had prior spine surgery. Spine fusion was attempted at one to four levels of the lumbosacral spine. Major perioperative complications were seen in seven patients (7%). Hardware failure was seen in seven cases (7%). Union was assessed by radiographs at 1 year or more after surgery in 82 patients (85%). In those 82 patients, union was seen in 56 (68%) and nonunion in 26 (32%). Change in lordosis was measured in 54 patients. The average change was a loss of 1.7 degrees lordosis per level fused. A questionnaire was answered by 79 patients (81%). Overall, 55 (70%) stated that they had some benefit from surgery, ten (13%) had no change, and 13 (17%) were worse. PMID- 2718054 TI - Complications with the variable spinal plating system. AB - From January 1986 to June of 1987, 40 patients underwent transpedicle fixation and fusion using the variable spinal plate system. Nineteen patients had undergone surgery at the same level or levels, and 21 patients had undergone no previous surgery. Diagnostic categories include spondylolisthesis, thoracolumbar and lumbar fractures, internal disc derangement, spinal stenosis, pseudarthrosis, mechanical instability, and fracture mal-union. Minimum follow-up has been 14 months, with the average being 20 months. Overall results showed 13 excellent, 12 good, seven fair, and eight poor. The overall complication rate was 45%. In those patients undergoing no previous surgery, it was 29%, but with those patients having previous surgery, it was 63%. Most of these complications were minor in nature and resolved before discharge. Implant failure occurred in seven patients, and consisted of screw breakage. Design modifications currently available should help minimize this complication. Although this method of internal fixation and fusion is technically demanding and has a high complication rate, it is considered to be indicated in lumbar fractures, revision of pseudarthrosis, spondylolisthesis with or without reduction, and failed surgery with marked instability. PMID- 2718055 TI - [Chronic volvulus of the stomach]. AB - An acute gastric volvulus calls for an urgent operation, while a chronic volvulus can be indicated for operation only after a careful clinical and paraclinical examination which rules out other causes of the symptoms. The authors describe a case of secondary gastric volvulus successfully treated by a causal surgical operation involving elimination of adhesions without gastropexy. PMID- 2718056 TI - [Fine morphology of the lymphatics and tissue spaces in the liver parenchyma in man and its significance in hepatobiliary surgery]. AB - The authors investigated the intrahepatic lymphatic vessels of the human liver under a light and electron microscope. The histological material was obtained from 10 patients operated on account of simple cholecystolithiasis. The beginnings of the lymphatic capillaries are in the periphery of the perilobular connective tissue of the portobiliary space in the vicinity of openings of Mall's space. Communication between lymphatic capillaries and Mall's space was not proved. The fine structure of the openings in Mall's space with numerous microvilli of hepatocytes pointing towards the perilobular connective tissue were described. Mall's space communicates and is interconnected in a multiple way with intercellular spaces between neighbouring hepatocytes. Here also the plasmalemma of hepatocytes forms a system of microvilli which form the borderline of the interhepatocytic space. The ultrastructure of both systems of spaces corresponds to the pattern on the hepatocyte surface in Disse's perisinusoid space. The cell population of hepatocytes holds a special position because it lacks the lamina basalis as a selective barrier against the connective tissue interstitium. This structural specificity indicates the extensive and rapid transport of lymph via the perisinusoid Disse spaces into the blood stream of the hepatic sinusoids, also lacking lamina basalis. Mall's space and the system of interhepatocytic spaces form a continuous system which is in close but not direct contact with the incipient intrahepatic lymphatic capillaries. PMID- 2718057 TI - [Personal experience with isolated regional hyperthermic perfusion of cytostatic agents in tumors of the extremities]. AB - The paper demonstrates on brief case-histories of a small group of patients some possibilities how to use isolated regional perfusion of cytostatics combined with hyperthermia as an adjuvant therapeutic method in case of melanoblastomas and liposarcomas of the extremities. PMID- 2718058 TI - [Changes in the distal end of the radius from the aspect of the injured person]. AB - Based on an evaluation of a group of patients treated on account of fractures of the wrist. Colles type, we assume that the decisive factor is the type of fracture. We recommend therefore to divide these fractures into two groups. The first one includes all types where the fracture line does not involve the radiocarpal or radioulnar joint. The second one includes all multifragmental intraarticular fractures where an active surgical procedure can improve hitherto achieved therapeutic results. PMID- 2718059 TI - [The post-traumatic carpal tunnel syndrome]. AB - Chronic carpal canal syndrome (CCC) is a relatively rare post-traumatic complication in the area of the wrist. It develops either as the direct consequence of anatomical narrowing of the osteofibrous canal or hypertrophy of structures inside the canal, most frequently tendon sheaths. As the clinical finding in all our patients improved after release of the compressed median nerve after resection of the ligamentum carpi transversum, we consider this operation absolutely indicated in all posttraumatic carpal canal syndromes. PMID- 2718060 TI - [Injuries of the ligaments of the talar joint]. AB - Based on experience with the treatment of 404 patients with injuries of the soft parts of the talus the authors maintain that markedly better results are achieved in patients where sufficiently long immobilization with a plaster bandage was used or where early reconstruction of the injured ligaments was performed. A very important negative factor is treatment of these injuries without immobilization or inadequate immobilization, as a high percentage of the patients develop instability of the talus with all its consequences. The authors consider arthrography the exact diagnostic method, the results of which are decisive for the therapeutic procedure. PMID- 2718061 TI - [Surgical treatment of postinfarction heart aneurysms and akinesias]. AB - The paper deals with the problem of surgical treatment of cardiac aneurysms and akinesias from the aspect of indication of surgical tactics and technique, risk factors and achieved results. The group of 117 patients is divided into 74 patients operated in 1970-1982 and 43 patients operated in 1983-1987 when already medium hyperthermia was used permanently, similarly as cold cardioplegia, complete haemodilution, pulsed extracorporeal circulation and relieving drainage of the left ventricle via the pulmonary artery. The reduction of early mortality from 24.3% to 4.7% provides clear evidence of the advantages of this procedure. The authors draw attention to differences in indications of surgical treatment between classical aneurysms and akinesians and to the importance of revascularization operations performed nowadays, using aortocoronary bypasses. PMID- 2718062 TI - [Surgical treatment of tumors of the heart]. AB - The authors present an account on four cases of cardiac myxoma and two cases of a secondary malignant tumour. Despite the low incidence of cardiac tumours this disease must be taken into consideration. The diagnosis was established by echocardiography and angiography. Two-dimensional echocardiography is, however, often sufficient. Early surgical treatment has very favourable results in bening tumours. The prognosis of patients with malignant tumours is very poor and experience with treatment is scanty. PMID- 2718063 TI - [Stress perfusion tomography of the myocardium using the 201 thallium isotope in cardiac surgery--evaluation of initial results]. AB - Initial results of evaluation of scintigraphic examinations by means of the isotope 201thallium indicate the importance of this method in cardiosurgery, in particular in the postoperative evaluation of the effect of bypass operations. In patients with an objective improvement on the postoperative scintigrams also subjective improvement of the condition was recorded. PMID- 2718064 TI - [Long-term results after implantation of the femoro-popliteal vein graft in relation to preoperative values of the ankle pressure index and peroperative flow]. AB - The authors investigated the importance of ankle pressure indices (aPi), peroperative blood flow and angiographic findings on peripheral arteries for the long-term patency of F-P venous bypasses. They found that neither the preoperative value of aPi nor the size of the peroperative flow through the bypass has an impact on the long-term patency of the reconstruction. As a result of general factors which lead to progression of the atherothrombosis in the arterial circulation in the implanted bypass, obstructions of the reconstruction occur even in patients with high preoperative aPi values and with a major preoperative flow, with patent peripheral arteries at the time of operation. To improve long-term results after implantation of F-P venous bypasses therefore above all prevention of the progression of atherosclerosis is essential. PMID- 2718066 TI - Time to ban tobacco advertising. PMID- 2718065 TI - [Results of surgical treatment of pulmonary carcinoma in patients over 60 years of age]. AB - The authors submit an analysis of patients operated in 1972-1982 at the First Surgical Clinic, Faculty of General Medicine, Charles University Prague. The group of patients was divided into those under 65 years and those above this age. The effect of the patients' age on the postoperative course was investigated, the survival of the two groups was compared, the causes of early postoperative deaths, the extent of the disease and histological type of tumour were evaluated. In was revealed that the risk of early postoperative death within one month is greater in patients above 65 years where it is 19.6%, as compared with 11.3% in the younger group. The risk increases in particular in patients above 70 years where it is as high as 26%. There is no fundamental difference in the causes of death between the two groups. The highest percentage of operated patients dies from embolism (40% and 42% in the patients above 65 years), the second place is held by inflammatory pulmonary complications which are somewhat more frequent in patients of the younger age group (24% as compared with 15% in the older patients). The survival curves of patients who had a radical operation in stage I and II of the neoplastic disease are almost identical and there is no significant difference in the survival of the two groups. In the group under 65 years 30% survive five years, in the older group 25%. The ratio of differentiated types of lung cancer, i.e. adenocarcinoma and epidermoid carcinoma is equal in both groups, contrary to small-cell carcinoma which was recorded in 6% in the older patients, as compared with 15% in the younger ones. PMID- 2718067 TI - Call for psychiatric wards in hospitals. PMID- 2718068 TI - Quantitative ECG changes and patency of infarct-related arteries after intravenous streptokinase. AB - Thirty-three patients with acute inferior myocardial infarction (MI), who were treated with intravenous streptokinase, were studied by serial 12-lead ECGs for 48 hours to determine the relationship between early changes in the sum of elevations above the baseline 40 ms after the end of the QRS complex in leads II, III and AFV (SumST), the sum of amplitude of R waves in leads II, III and AVF, the sum of the Q waves in leads II, III and AVF, the sum of ST-segment depression in leads V1-V4 as measured from the baseline to 80 ms after the J point (SumST (V1-V4] and the patency of the infarct-related artery at angiography after MI. Patients with patent arteries had a faster rate of decline in the SumST during the first 2.5 hours; reached the steady state earlier; had a more pronounced decrease in the SumST at 1.25 hours; a larger percentage drop in SumR at 4.5 hours and a more pronounced SumST (V1-V4) early on but resolution times similar to that of patients with closed arteries. Several ECG indices may indicate reperfusion of the infarct-related artery in patients with inferior MI. PMID- 2718069 TI - Smoking practices in the black township population of Cape Town. AB - A smoking prevalence survey was conducted in the black township population of Cape Town in order to assist with the planning of an anti-smoking campaign. Three townships were selected to reflect different levels of urbanisation: Langa (a settled urban community), Site B (a population of recent arrivals in the urban environment) and Khayelitsha (of intermediate urban status). Using World Health Organisation guidelines a school survey and an adult survey were conducted in each area. Of the 673 school pupils who were interviewed, 0.8% of girls and 23.7% of boys were current smokers. There was a trend to increasing smoking prevalence with increasing age among boys. After age-adjustment there was no difference in smoking prevalence between boys at the three schools. Information from 1320 adult respondents and 1,401 proxy-reported adults yielded an overall smoking prevalence of 7% (95% confidence interval 5.6-8.4%) for women and 60% (95% confidence intervals 57.5-62.5%) for men. Two-thirds of male smokers were smoking 10 or more cigarettes per day. The preferred mode of tobacco consumption in 87% of adults and 91% of school pupils was manufactured cigarettes. The survey has established three target groups for intervention in the black townships of Cape Town: boys in their early teens for prevention of initiation of smoking; adult men for assistance with smoking cessation; and girls and women to maintain their non smoking status. PMID- 2718070 TI - Economic aspects of smoking in South Africa. AB - A conservative analysis of some of the costs and benefits of smoking to our society are presented. This preliminary investigation updates and refines the methodology of a previous study. Depending on the underlying economic assumption, smoking cost South Africa between R212 and R481 million in 1985 as a result of lost productivity due to premature death. Lost productivity while smokers were undergoing treatment cost at least R22 million. Hospitalisation and other health care costs amounted to R128 million in public institutions alone. It is likely that the current level of excise duty does not compensate for the high social costs resulting from smoking. Although many of the costs and benefits of smoking are not quantifiable in monetary units, the available information as presented in this study suggests that the cost of the tobacco industry to South Africa at present, and particularly its potential cost in the future, outweigh any possible economic benefit. PMID- 2718071 TI - Byssinosis in South Africa. A survey of 2411 textile workers. AB - The first study of the prevalence of byssinosis in the South African cotton textile industry is described. Questionnaires were administered to 2411 subjects from six textile mills. Height and weight were measured and pulmonary function was tested before and after the first shift of a working week. Dust concentrations were measured using a Lumsden-Lynch vertical elutriator sampler. The prevalence of byssinosis (all grades) according to work departments was as follows: spinning 11.2%, winding 6.1%, and weaving 6.4%. Subjects with symptoms of byssinosis had a significantly reduced forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity ratio when compared with controls matched for age, height and weight. Dust concentrations in many areas of the preparation and spinning processes exceeded the World Health Organisation's recommended permissible exposure limit for cotton dust in spinning operations. The prevalence of byssinosis in this study appears to be lower than that documented elsewhere. The mill design, machinery in use and environmental conditions in the South African cotton textile industry appear to be similar to those in Egypt and the USA before 1978. South Africa differs from these and other countries, including the UK, in having an exceptionally high labour turnover rate, which has reduced exposure periods. The subjects were found to have a high prevalence of previously treated pulmonary tuberculosis (3.4% for males and 2.2% for females), and in this population this disease appeared to cause more respiratory impairment than byssinosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718072 TI - Bilateral chorea associated with caudate nuclei lacunar infarcts. A case report. AB - A woman with ischaemic heart disease, hypertension and diabetes, who presented with bilateral chorea associated with lacunar infarcts in the caudate nuclei, is described. PMID- 2718073 TI - Recurrent spontaneous bladder rupture. A case report. AB - Spontaneous (non-traumatic) intraperitoneal rupture of the bladder in a 37-year old pregnant woman was repaired at laparotomy. Nine months later she again presented with an intraperitoneal bladder rupture during pregnancy and fatal sepsis. Histological examination of the resected bladder wall showed acute ulcerative and necrotising cystitis. All patients with apparently spontaneous bladder rupture should undergo full urological evaluation to identify possible disease which might lead to recurrent rupture. PMID- 2718075 TI - Attitudes of health personnel towards smoking and smoking restrictions. PMID- 2718074 TI - Giant colonic diverticulum--a radiological diagnostic problem. A case report. AB - Giant diverticulum of the colon is a rare condition, mentioned only sporadically in the literature and usually presenting on an abdominal radiograph as an air filled cyst. This poses an interesting clinical and radiological diagnostic problem. A case is presented and a radiological approach suggested. PMID- 2718076 TI - Restaurant manager's attitudes towards the smoking restrictions. PMID- 2718077 TI - Exposure to dust in the reprocessing of mine waste dumps. PMID- 2718078 TI - The 'clenched fist' sign of myocardial ischaemia. PMID- 2718079 TI - Infectious disease rates among white children. PMID- 2718080 TI - Lymph nodes in South African children. PMID- 2718081 TI - Poisoning of children. PMID- 2718082 TI - Telephone calls to a paediatric department. PMID- 2718083 TI - Social Security related legislation in 1988. PMID- 2718084 TI - Pleural peritoneal shunting for benign and malignant pleural effusions. AB - Pleural peritoneal shunting is a new technique that can be used for patients with symptomatic pleural effusion recalcitrant to the usual methods of treatment. Sclerotherapy with a thoracostomy tube is still the mainstay of treatment, but this new procedure has a place if other methods fail. Success can be anticipated in most of the patients with simple insertion under local anesthesia. The occasional obstructed shunt is readily remedied by easy insertion of another pleural peritoneal shunt. No adverse long-term effects have been noted, and satisfactory function can be achieved with minimal morbidity for at least 21 months. PMID- 2718085 TI - Cavernous angioma of the optic nerve. Case report. AB - The case of a 24-year-old woman with a cavernoma of the right optic nerve is presented. She suffered recurrent headaches and showed a deficit of the right nasal visual field. A computed tomography scan, a computed tomography cisternography, and magnetic resonance imaging revealed a lesion in projection on the right suprasellar cistern, yet angiography was inconspicuous. On operation, an angiomatous tumor of the right optic nerve with a surrounding hemorrhage was found. Histological examination of the specimen confirmed the intraoperative diagnosis of a cavernoma. Postoperatively, the right nasal visual field deficit increased slightly. PMID- 2718086 TI - Epithelium-lined cyst of the pretectal region: case report and electron microscope study. AB - Ultrastructural findings of an epithelium-lined cyst in the left pretectal region are reported. A 38-year-old woman developed a sensory disturbance on her right side and blurring of vision. Computed tomography scans and magnetic resonance images disclosed a round cystic lesion in the left pretectum. Light microscopically, the cyst was found to be lined by a single layer of cuboidal epithelial cells. Electron microscope examination revealed that the epithelial cells of the cyst possessed clear nuclei, abundant tonofilaments, and glycogen granules, featured as well as the usual organellae. The free surface of the epithelial cells had numerous finger-like microvilli with coating materials. These cells were interconnected by well-developed desmosomes and interdigitations, and also possessed basal lamina materials on the basal surface. These cytological features suggest a heterogenous origin of the cells rather than a neuroepithelial one. PMID- 2718087 TI - Cervical osteochondroma (C2 level) with vertebral artery occlusion and second cervical nerve root irritation. AB - A case of osteochondroma arising from the C2 transverse process, responsible for vertebral artery compression with complete occlusion and C2 nerve root irritation with C2 neuralgia, is reported. Complete surgical removal was achieved via the lateral anterior approach. PMID- 2718089 TI - Brain tumor imaging with synthesized 18F-fluorophenylalanine and positron emission tomography. AB - Two patients with cerebral gliomas were studied with 18F-fluorophenylalanine, newly synthesized by the electrophilic substitution reaction, using positron emission tomography. The tracer accumulated markedly in the tumor lesion and delineated the extent of the lesion. This new tracer will be promising in the diagnosis of gliomas. PMID- 2718088 TI - Spinal cord compression caused by bilateral nerve root hypertrophy. AB - We report the case of a 68-year-old man who developed compression of the spinal cord as a result of bilateral hypertrophy of the first dorsal nerve roots. There was no clinical or electrical evidence of a generalized disorder of the peripheral nerves. PMID- 2718090 TI - Dural mesenchymal chondrosarcoma of the lumbar spine. Case report. AB - A case of a lumbar mesenchymal chondrosarcoma is reported. Radical removal of the lesion, irradiation, and chemotherapy led to a long and favorable outcome in this patient. PMID- 2718092 TI - Euthanasia. PMID- 2718091 TI - Upper thoracic disk herniation secondary to vertebral metastases. AB - Thoracic disk herniations are exceedingly rare, particularly those in the upper thoracic region. The etiology of these protrusions is generally considered to be either traumatic or degenerative in nature. A case of upper thoracic disk herniation secondary to destructive changes caused by breast cancer metastatic to the vertebral body is presented. PMID- 2718093 TI - Animal versus human rights. PMID- 2718094 TI - Venous Angiomas: An Underestimated Cause of Intracranial Hemorrhage. PMID- 2718095 TI - Visual function in glaucoma. Proceedings of a symposium. Sarasota, Florida, May 19, 1987. PMID- 2718096 TI - New theory of hippocampal function: associated rehearsal of multiplexed coded symbols. AB - A new theory of the role of the hippocampus in the selective storage of information in long-term memory is presented. This theory is based on the very recent discovery that neurons in the mammalian cerebral cortex transmit extremely precise copies of patterns of discharge in time when specific sensory inputs are presented, patterns that are interpreted to code for or symbolize specific items of information. The theory incorporates and provides an explanation for both the complex and unique internal structure of the hippocampal formation (the hippocampus and associated dentate gyrus) and the roles of many of the direct and indirect connections that structure makes with other brain structures. It also explains the deficits in learning that result from damage to the hippocampus and/or tracts that provide inputs to (or outputs from) this body as well as the role of the hippocampal formation in mapping the relationship of an individual to objects in its environment. The proposed enplanation is as follows. The hippocampal formation functions as a coordinated structure that, specifically, generates multiple copies of two different kinds of symbols (i.e., specific patterns of trains of nerve discharges in time). These two kinds of patterns are respectively provided by the entorhinal cortex through the perforant-alvear pathways and by the septal region, through the fornix, one of the two inputs to and the only output from the hippocampal formation. These two separate and different kinds of patterns are used to make multiplexed patterns that are ultimately transmitted to the cingulate gyrus and from there to other cortical memory storage locations. This transmission of amplified representations of different symbols occurs through the fornix. From there they are either transmitted to the mammilary bodies in the hypothalamus and from there to the anterior thalamic nuclei or, alternatively, directly to the anterior thalamic nuclei, bypassing the mammilary bodies. These thalamic nuclei in turn project the information to the cingulate gyrus of the cortex. The effect of the transmission of these mixtures of symbols is to cause the coordinated rehearsal and selective storage of relationships between separate inputs (specifically, patterns of discharge that symbolize different aspects of input) that are of probable significance to the survival of the system. The repeated presentation of such specific combinations of representations (symbols) then causes rehearsal consolidation of these symbol associations as more permanent memories.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2718097 TI - Inhibitory effect of norepinephrine on the single-unit activity of caudally projecting paraventricular neurons. AB - The role of norepinephrine (NE) in controlling the single-unit activity of paraventricular (PVN) neurons projecting to or passing through the caudal ventrolateral medulla (CVLM) was investigated in adult male rats anesthetized with urethane. Of 72 PVN neurons studied, 19 were antidromically activated by CVLM stimulation (Group I) and 48 were antidromically activated by posterior pituitary (PP) stimulation (Group II). The remaining 5 neurons were antidromically driven by both CVLM and PP stimulation (Group III). In 14 of the 19 Group I neurons and in all the 5 Group III neurons, iontophoretically applied NE was demonstrated to be inhibitory to the single-unit activity. No excitatory effect of NE was observed. In contrast, both excitatory and inhibitory actions of NE were observed in the Group II neurons. Of 37 Group II neurons tested, 28 were excited and 7 were inhibited by NE. The inhibitory effect of NE in Group I and Group III neurons was selectively blocked by the alpha antagonist, phentolamine, that was coiontophoresed with NE, but not by the beta antagonist, timolol (n = 9). The unit activity of Group I neurons that were inhibited by NE was not altered by an increase in arterial blood pressure (n = 3), whereas the unit activity of one NE-insensitive Group I neuron was decreased by an increase in blood pressure. Taken together, the results suggest that NE plays an alpha adrenoreceptor-mediated inhibitory role in controlling the single-unit activity of caudally projecting PVN neurons. These neurons include a subpopulation of PVN neurons that project caudally as well as to the PP. The possible function associated with the NE-sensitive, caudally projecting PVN neurons may be other than the regulation of blood pressure. PMID- 2718098 TI - Classical conditioning in rabbits using pontine nucleus stimulation as a conditioned stimulus and inferior olive stimulation as an unconditioned stimulus. AB - Classical conditioning of skeletal muscle responses was accomplished by pairing microstimulation of the pontine nuclei as a conditioned stimulus (CS) with microstimulation of the dorsal accessory olive as an unconditioned stimulus (US). A conditioned response identical in form to the behavioral response elicited by the olivary stimulation was established when the CS was forward paired with the US, and behavioral extinction occurred with CS-alone presentations or unpaired CS US presentations. Conditioned responding could not be established or maintained when the CS and US were simultaneously presented or when the US preceded the CS (i.e., backward paired). Complete lesions of the interpositus nucleus abolished both conditioned and unconditioned responses. These findings support the idea that plasticity associated with classical conditioning of skeletal muscle responses occurs in regions of the cerebellum that receive convergent CS and US input. PMID- 2718101 TI - [Magnetopuncture therapy of patients with chronic alcoholism]. PMID- 2718099 TI - Long-term blockade of the dopamine uptake complex by metaphit, an isothiocyanate derivative of phencyclidine. AB - [3H]Mazindol was used to label the dopamine uptake complex in mouse striatum in vitro in the presence and absence of metaphit, an isothiocyanate derivative of phencyclidine. In some experiments, metaphit was present in the incubation fluid throughout the procedure; in other experiments it was eliminated by several washings and centrifugations. It was found that after removal of the metaphit by washing and centrifugation, the mazindol binding was not restored. Membranes that were pretreated with metaphit and washed had a lower density of mazindol binding sites than control membranes; the remaining mazindol sites had the same afinity for [3H]mazindol. These findings are in agreement with the previous studies on [3H]cocaine and [3H]methylphenidate binding. The following observations support that metaphit is irreversibly acting and not slowly dissociating from the mazindol recognition sites of the dopamine uptake carrier complex: 1) Metaphit did not change the off-rate of [3H]mazindol binding, arguing against an allosteric action at a distinct site. 2) The presence of cocaine protected the mazindol binding sites from the action of metaphit, supporting binding of metaphit and mazindol to the same site. 3) Nine hours after metaphit pretreatment and removal, the degree of inhibition of mazindol binding was the same as immediately after pretreatment, consonant with an irreversible effect of metaphit. 4) The potency of metaphit in inhibiting mazindol binding was greater under slightly alkaline conditions, consistent with acylation of the mazindol sites. Furthermore, it was found that intracerebroventricular application of metaphit did not result in a decrease in the binding of [3H]mazindol 5 hr after the administration. PMID- 2718100 TI - Localization and regulation of vasopressin mRNA in human neurons. AB - Vasopressin (prepropressophysin) mRNA is detected in neurons of the supraoptic, suprachiasmatic, and paraventricular nuclei of human postmortem hypothalamic specimens by quantitated in situ hybridization using 35S-labeled single-stranded cDNA probes directed against exon C of the human vasopressin gene. This hybridization displays the anticipated anatomic distribution, as well as several biochemical features supporting its specificity. Hybridization densities in supraoptic neurons, a measure of vasopressin gene expression, display substantial variability from brain-to-brain. We can attribute much of this brain-to-brain variability to differences in antemortem extracellular volume status. This conclusion is based on a) animal models of the human postmortem process, b) animal models of common agonal events, c) good correlations between antemortem volume status and neuronal vasopressin mRNA hybridization densities in human postmortem specimens matched for age and postmortem interval, and d) our inability to correlate human neuronal vasopressin mRNA hybridization densities with other clinical and postmortem features. These results provide an example of antemortem regulation of a human neuroendocrine gene using postmortem tissue. PMID- 2718102 TI - [Role of outpatient therapeutic preparation of subinterns in training as future general practitioners]. PMID- 2718103 TI - [Medicine and society]. PMID- 2718104 TI - [The policy on treating patients with generalized acute intestinal infections]. PMID- 2718105 TI - [The significance of the modern leukogram in clinical practice]. PMID- 2718106 TI - [The anti-inflammatory drug diclofenac]. PMID- 2718108 TI - [A case of hepatocerebral dystrophy (Konovalov-Wilson's disease) in twins]. PMID- 2718107 TI - [Knowledge of the rural population on factors promoting the emergence of arterial hypertension]. AB - A random sample of the rural community (two villages) were examined by means of questionnaire. Seventy-four percent of the community could not denote any risk factors of arterial hypertension. A very low percentage were informed of the role played by sodium chloride in the genesis of hypertension. Moreover, the community was very poorly informed of the adverse effects of overweight, tobacco smoking, and alcohol abuse. Excess use of sodium chloride was likely to be one of the causes promoting high prevalence of arterial hypertension. Some of the people were of opinion that arterial blood pressure might be influenced by definite nutritional and non-nutritional factors. The data obtained point to a low enough level of hygienic knowledge of the rural community regarding arterial hypertension risk factors. It is concluded that high prevalence of arterial hypertension risk factors and the low level of information of those factors provide evidence in favour of carrying out large-scale measures aimed at primary prophylaxis of arterial hypertension in the rural community. It is stressed that one should begin with the raising of the hygienic knowledge standards of the community. PMID- 2718109 TI - [Moderate arterial hypertension during its natural course and in drug correction]. AB - The clinical and morbid anatomy data on 295 patients with arterial hypertension were examined. Two hundred patients had moderate hypertension with the diastolic pressure under 110 mm Hg. Of these, 103 patients had received rauwolfia drugs and 13 patients had been given hypothiazide in addition. Eighty patients who died before 1953 had not received any specific hypotensive drugs. Early hypotensive therapy of moderate hypertension was noted to promote a decrease in arterial blood pressure to normal and to raise the mean lifespan by 8 years. Furthermore the number of fatal brain strokes and myocardial infarctions decreased almost 2 fold. PMID- 2718110 TI - [Study of arterial pressure, body weight, motor activity and prevalence of smoking in two independent samples of Moscow schoolchildren 11 and 14 years of age]. AB - The paper treats the results of a comparative 6-year study of arterial blood pressure, body weight, motor activity, and tobacco-smoking prevalence with respect to two representative samples of schoolchildren aged 11 and 14 years living in one of the districts of Moscow. A total of 1999 and 1219 persons were examined. The scope of examination amounted to 88 to 93 percent. From 1978-1980 to 1985-1986 the levels of systolic and diastolic arterial blood pressure increased whereas the physical activity of the schoolchildren of the same age declined. The situation with tobacco-smoking changed towards better. Thus the number of tobacco-smoking boys aged 14 years reduced almost 2-fold in spite of the lack of any prophylactic interventions in that population. PMID- 2718111 TI - [Importance of parameters of central hemodynamics in examining working capacity of patients with renovascular hypertension]. AB - Cardiovascular system parameters were measured in 80 patients with renovascular hypertension using resting and bicycle exercise readings of tetrapolar chest rheography. The findings were indicative of various defects in central hemodynamics. Signs of subclinical initial stage of cardiac insufficiency were revealed in 57.5% of cases. Cardiovascular reserves were reduced in patients operated on fading with increasing duration of the disease. Labor prognosis appeared more favorable in operated on patients with good hypotensive effect of the surgery. PMID- 2718112 TI - [Development of a postal questionnaire for the detection of persons with arterial hypertension]. PMID- 2718113 TI - [A follow-up study of patients with a history of myocardial infarction]. AB - A 2-year follow-up of 200 myocardial infarction patients with regard to clinical findings, intracardiac hemodynamics, oxygen and hemodynamic provision of loading tests has furnished evidence on validity of the proposed scheme of the patients long-term monitoring survey. The scheme is adjusted for season, functional class, follow-up duration and permits reduced number of 2-year follow-up examinations of patients with a history of myocardial infarction. PMID- 2718114 TI - [Improvement of medical care in the light of the decision of the 27th Congress of the CPSU and the 12th All-Union Party Conference]. PMID- 2718115 TI - [Clinical and functional features of the development of myocardial infarction in miners engaged in deep coal mines]. AB - It is shown that miners engaged in deep coal mines develop myocardial infarction (MI) at a young age, the mean age being 42.8 years. The foregoing clinical picture was characterized by an atypical, painless course. In some cases (20 percent) the typical pain syndrome did not manifest itself even in the preinfarction period making the diagnosis difficult. MI develops under the conditions of relatively preserved coronary reserves (functional class I-II). The leading factors that promote IM development are intense hard physical work combined with a heating microclimate. This is evidenced by the high rate of its occurrence during work and the first 1 to 4 hours after work (74.2 percent), large zones of affection (large-focal and transmural infarctions), and by the development of disorders in cardiac rhythm and conduction. The low percentage of persons registered at the health centers before MI development, and late hospitalization indicate the necessity of improving the system of the treatment and prevention of diseases among the group of patients under consideration. PMID- 2718116 TI - [Evaluation of the risk of fatal outcome in patients with stable stenocardia over a 5-year period]. AB - The results have been analyzed of the 5-year prospective observation over patients with associated coronary heart disease (CHD) and stable angina pectoris without grave concomitant diseases and heart failure signs. A rule of prediction has been elaborated enabling one to distinguish on the basis of the clinical data a group of patients in whom the disease runs a favourable course. It is unlikely that in the future such a group of patients would require any combined instrumental examination or surgical intervention. The use of the common therapeutic measures (long-acting nitrates, beta-blockers, and calcium antagonists) can be recognized as quite sufficient and effective. The clinical observation can be limited by the patient's attendance of the health center for repeated examination and specification of the further prognosis, which is to be made once a year. The above-said confirms the importance of defining CHD prognosis, since the properly chosen tactics of such patients' management makes it possible to attain the maximal efficacy of the diagnostic and treatment measures and to save costs as well. PMID- 2718117 TI - [Tobacco smoking and various measures to control it]. AB - The prevalence of smoking has been studied in a population of a Moscow district. The data obtained evidence that 49.0-54.6% of men and 9.2-13.5% of women, aged 20 59, smoke. Smoking was most common at the age of 20-39 (62.6 and 19.0% for males and females, respectively). Regular smoking was registered in 14.4-53.3% of schoolboys and 0.8-28.2% of schoolgirls (pupils of forms 5-10), the habituation being dependent on the number of smoking relatives. A 5-year prospective investigation of 40-59-year-old males allowed the conclusion on high mortality rate among heavy smokers: a three-fold difference for all reasons and cancer, and 2.5-fold difference for cardiovascular diseases compared to respective mortality in non-smokers. A special age-adjusted program designed for smoking control in schoolchildren produced positive 3-year results: a decrease from 17 to 5.9% in smoking incidence among boys of forms 5-7, from 42.1 to 20.7% for boys and from 9.6 to 6% for girls of higher forms. A pilot experience gained in a special office organized for those willing to give up smoking is presented. The treatment involved acupuncture, chemotherapy and psychotherapy. PMID- 2718118 TI - [Association of the lipid composition of the blood and other risk factors of ischemic heart disease with tolerance to physical load according to data of repeated random examination of a male population]. AB - The paper is concerned with the results obtained during repeated examinations (an interval amounts to 7.6 years) of 479 men who were divided into 4 population groups. Of these, groups I and III including persons under and over 55 years were selected according to the tables of random numbers whereas the remaining two groups of the same age were selected during the primary screening with respect to hyperlipidemia signs. Groups I and III showed a significant rise of the share of persons with two or three risk factors (from 25.3 to 39.5 percent and from 40.8 to 51.6 percent, respectively). Groups II and IV, especially group II, demonstrated an opposite time-course of changes. The share of such persons decreased from 67.8 to 56.5 percent, which is most likely to be related with improvement of the nutrition regimen. Group I had an increase in the rate of ischemic responses (from 5.3 to 15.7 percent), while in the remaining groups it was unchanged. Groups II and IV were characterized by two tendencies: a rise of the share of persons with contraindications to the physical load and stabilization of the percentage of adequate responses to the treadmill test. PMID- 2718119 TI - [Efficacy of 3-year prophylaxis of coronary heart disease risk factors in an organized population]. AB - An organized community numbering 1563 men aged 20 to 59 years engaged in scientific activity were entered into an experimental and prophylactic study. The intervention measures were exercised in a high risk group with dyslipoproteinemia, borderline hypertension and coronary heart disease (CHD), mainly at the expense of alterations in nutrition. The three-year prophylaxis resulted in a 7-percent decrease in blood plasma cholesterol and a 13-percent fall in triglycerides. The prevalence of arterial hypertension declined by 3 and the excess body weight by 3.7 percent, which led to a 33-percent decrease in CHD risk development calculated with the aid of the R. P. Prochorskas risk logistic function. Advantages of the individual strategy of CHD prevention are discussed. PMID- 2718120 TI - [Comparative evaluation of tolerance to exercise and various features of cardiodynamics in healthy men and women 20-69 years of age]. AB - The analysis of clinical and polycardiographic findings for 568 healthy males and females provided the basis for development of the criteria for standard exercise tolerance and normal range of cardiac cycle phases in relation to 5 ten-year age groups. With age, physical and mental performance was found to be on the decrease, circulatory adaptation and contractile cardiac reserve deteriorated. PMID- 2718121 TI - [Experience in organizing and preliminary results of the work of the Educational Scientific-Practical Association (Research Institute-High Medical School Hospital) with respect to problems of preventive cardiology]. PMID- 2718122 TI - [Ten-year trends in acute cardiovascular morbidity in an open population]. AB - The paper treats the data concerning the acute cardiovascular pathology occurrence examined during ten years in an open population of one of the districts of Novosibirsk. It is shown that at first there was a tendency towards the incidence increase followed by its stabilization and then by a tendency towards reduction over the last year. It is proved that the district selected for prolonged monitoring is a typical district of the city and that the tendencies in the incidence among its community should be classified as objective. Comparison of the WHO programs: The Register of Acute Myocardial Infarction (1969) and the Monitoring of the Trends in Cardiovascular Diseases and Determining Factors (1983) has shown no substantial differences in the incidence and death rates obtained in accordance with both programs. It is stressed that this enables one to compare the data of both programs applied to different populations. PMID- 2718123 TI - [Development of an integral program of preventing noninfectious diseases]. PMID- 2718124 TI - [Pilot experience with implantations of 100 continuous atrial pacemakers in sick sinus syndrome: advances, problems, prospects]. AB - Long-term results of continuous atrial pacing were assessed in 100 patients with sick sinus syndrome followed up for 6 years. Implantation of the pacemaker was performed via extrapleural and extraperitoneal approaches using serial myocardial non-suture electrodes. Antiarrhythmic efficacy of atrial pacing was found insufficient. Continuous atrial pacing proved advantageous only in Wenckebach point at 100-120 per min. PMID- 2718125 TI - [Status of fitness for work of patients with sick sinus syndrome treated by implantation of a pacemaker]. PMID- 2718126 TI - [Results of a 5-year follow-up study and prognosis in patients with cardiac insufficiency]. PMID- 2718127 TI - [Sudden death in therapeutic practice]. AB - Cases of sudden death most frequent among coronary patients are becoming more common in the practice of therapeutists accounting for the one-fourth of the overall death rate in adult population. Most cases of sudden death take place outside hospital setting and terminate rapidly hindering effective resuscitation. Annual routine mass health examinations in accordance with current instructions fail to detect a great number of individuals at high risk for sudden death. This urges on further studies in this field aimed at development and introduction into wide outpatient practice of up-to-date methods of effective prevention of sudden death. PMID- 2718128 TI - [Outpatient clinic treatment of broncho-obstructive syndrome using an artificial regulator of respiration]. AB - The artificial respiration regulator (ARR) employed by the authors belongs to the series of analogous apparatuses rendering resistance to expiration and preventing hyperventilation in broncho-obstructive syndromes. The device used is more compact and simple in management. It promotes improvement in the condition of patients with severe forms of bronchial asthma and chronic bronchitis complicated by expiration, stenosis, permits discontinuation of drugs and hormones in the majority of patients. ARR is believed efficient in the outpatient treatment of broncho-obstructive syndrome. PMID- 2718129 TI - [Temporary disability in patients with acute pneumonia at an outpatient clinic]. AB - Temporary disability was analysed for 186 patients with acute pneumonia (AP) treated in outpatient clinics. On demand, the patients were referred to hospitals. The disability duration was assessed in relation to the patients' age, associated diseases, smoking, time to diagnosis and hospitalization. It is shown that late diagnosis and hospitalization as well as misdiagnosis which is not uncommon lead to a prolonged period of temporary disability. Questions of the follow-up policy in acute pneumonia are covered. PMID- 2718130 TI - [Changes in the function of external respiration and circulation in patients with acute pneumonia at the outpatient clinic stage of rehabilitation]. AB - External respiration, circulation and gas exchange trends were investigated in acute pneumonia convalescents followed up on an outpatient basis. It was found that 72% of patients admitted to hospital for acute pneumonia, upon discharge demonstrated residual clinicoroentgenological effects. Cardiorespiratory distress, more pronounced in concomitant chronic bronchitis was recorded in 82% of acute pneumonia convalescents. Long-term tachycardia, hyperventilation, disturbed bronchial permeability, low aerobic productivity registered at outpatient stage of rehabilitation after acute pneumonia indicated ineffectiveness of the aftercare being a sign of a poor prognosis. Variations in cardiorespiratory basic parameters revealed suggest additional criteria of the assessment of the completeness of the recovery after acute pneumonia and promote more individualized approach to the patients' aftercare. PMID- 2718131 TI - [Effect of synoptic-meteorologic factors on the course of bronchial asthma in adolescents]. AB - Asthmatic attacks observed in 1131 adolescents on sanatorium treatment are related to passing of atmospheric fronts. The attacks predominated in those patients who had come to the spa in condition of uncured bronchial asthma aggravation. As the episodes of asphyxia prevent the asthmatic adolescents from benefits of spa factors it is necessary to perform more differentiated selection to sanatorium treatment. PMID- 2718132 TI - [Incidence of temporary disability due to essential hypertension and coronary heart disease and ways to reduce it (a population study)]. AB - A three-percent random sample (1267 persons) of the unorganized population of one of the administrative districts of Moscow was examined. Arterial hypertension (AH) was diagnosed in 38.5 percent of the examinees of both sexes aged 35 to 64 years. 65.9 percent of men and 80.9 percent of women were fully aware of being affected with AH. However, only 10.1 percent had received efficient treatment. According to the Rose questionnaire angina pectoris of effort was discovered in 9.6 percent of the examinees. In all 25.8 percent of cases and 30 percent of disability days fell to the lot of essential hypertension and coronary heart disease. The repeated issue of sick-leaves (from 2 to 6 times a year) due to essential hypertension was recorded in 33.8 percent of cases which indicates the lack of regular treatment and control on the part of the treating physician. The sick-leaves were found to be closed irregularly but with the definite intervals, primarily on the 7th, 14th, 21st and 30th days of disability. If hypotensive treatment was given routinely, the mean duration of disability per one patient was two times shorter as compared to that in patients who did not receive any regular treatment. PMID- 2718133 TI - [The syndrome of disseminated intravascular coagulation in marathon athletes]. AB - The paper is concerned with four Marathon athletes who developed grave impairments in hemodynamics and microcirculatory disorders in the organs (collapse, acute renal failure, cerebral abnormalities) and signs of the grave acute syndrome of disseminated intravascular coagulation with thrombohemorrhage and bleeding after competitions carried out under unfavourable conditions (a temperature of 30 degrees C and high air humidity). Three patients died. The diagnosis of the syndrome of disseminated intravascular coagulation was supported at autopsy. One of the athletes suffered brain stroke. The clinical and laboratory examination of the other 19 Marathon athletes showed that after competitions 6 persons had subclinical hemostatic disorders characteristic of the syndrome of disseminated intravascular coagulation. It is recommended that control and correction of hemostatic disorders should be strictly exercised in athletes experiencing hard and prolonged physical exercise. PMID- 2718134 TI - [Effect of iron deficiency of the body on the work capacity of women engaged in mental work]. AB - Iron deficiency in the body of women engaged in intellectual activities, is accompanied by efficiency reduction, more noticeable fatigue in the course of a working day and week, deterioration of body functions. The correction of iron deficiency with iron preparations results in a raised volume of work, improvement of its quality, improvement of the state of health, activity and mood. The results of a corrective test (the state of health, activity, mood) can serve a criterion of correction efficacy. PMID- 2718135 TI - [Diagnosis, clinical picture and therapy of acute radiation disease in victims of the accident at the Chernobyl nuclear power station. I. Conditions of irradiation, dose levels, bone marrow syndrome and its therapy]. AB - A follow-up of 115 patients with acute radiation disease resulting from external gamma-beta-radiation confirmed a high value of the previously proposed principles of predicting a degree of severity on the basis of the clinical manifestations of a primary reaction of disease and some syndromes using methods of hematological and cytogenetic analysis. Early isolation of patients with ARD of II-IV degree, selective intestinal decontamination, administration of antibiotics of a broad spectrum of action, antimycotic and antiviral drugs, and gamma-globulin can practically eliminate the risk of development of fatal infectious complications in medullary and transient types of radiation disease. The efficient use of thrombomass transfusion completely prevents development of the thrombocytopenic hemorrhagic syndrome. Experience in bone marrow transplantation requires a review of therapeutic indications. PMID- 2718136 TI - Association of tracheoesophageal anomalies with visceral and parietal malformations in a human embryo (Carnegie stage 21). AB - A human embryo (Carnegie stage 21) with tracheoesophageal malformations (esophageal atresia and tracheoesophageal fistula) and anomalies at the caudal end of the embryo (anorectal atresia, rectovesical fistula, vertebral and notochordal defects, and agenesis of the metanephros) was studied. Other anomalies observed were: absence of right umbilical artery, fusion of spinal ganglia, and absence of cloacal outlet of mesonephric ducts. The possible pathogenesis of these associated malformations is discussed. PMID- 2718137 TI - Cadmium exposure on day 12 of gestation in the Wistar rat: distribution, uteroplacental blood flow, and fetal viability. AB - The effects of cadmium exposure (40 mumole CdCl2/kg, s.c.) on day 12 of gestation were evaluated in the Wistar rat. At 16-18 hours following such cadmium exposure, blood flow (as determined by radiolabeled microspheres) to the chorioallantoic placenta (CAP) was significantly reduced by 35%; at 24-26 hours, blood flow to the CAP had returned to control levels and was still unaffected at 38-43 hours. Uterine blood flow was not significantly altered at any of these timepoints. Between 16-18 and 24-26 hours after cadmium exposure, the concentration of cadmium in the placenta decreased significantly, while total cadmium content did not change. By 38-43 hours after cadmium exposure, total cadmium content of the placenta had increased significantly, although cadmium concentration was unchanged. There were no adverse effects on fetal viability or growth, as determined on day 20 of gestation. In sharp contrast, near-term (day 18) exposure to 40 or 50 mumole CdCl2/kg (s.c.) resulted in 53% and 82% mean incidences of fetolethality, respectively, within 24 hours. Administration of 50 mumole CdCl2/kg (sc) on day 12 also had no effect on fetal growth but resulted in increased fetolethality (12%). Thus midgestational cadmium exposure and its accompanying alterations in placental blood flow do not compromise fetal viability or growth. The differential response to cadmium at mid- and late gestation, in terms of fetolethality, is not due to maternal cadmium dose. PMID- 2718138 TI - Embryotoxicity of phenyl ketone analogs of cyclophosphamide. AB - Phenylketophosphamide and phenylketoisophosphamide are preactivated acyclic ketone analogs of cyclophosphamide and isophosphamide with antitumor activity. These compounds undergo an elimination reaction to yield phosphoramide or isophosphoramide mustard and phenyl vinyl ketone. In this study, the embryotoxicity of phenylketophosphamide, phenylketoisophosphamide, and phenyl vinyl ketone were determined. Embryotoxicity was assessed in vitro in whole rat embryos cultured on day 10.5 of gestation in the absence and presence of an activating system derived from maternal liver. Both phenylketophosphamide and phenylketoisophosphamide were embryotoxic in the absence of metabolic activation. Moreover, there was no enhancement of this embryotoxicity in the presence of an activating system. A 10-microM concentration of phenylketophosphamide produced 100% malformed embryos, while this concentration of phenylketoisophosphamide was not teratogenic. At 25 microM phenylketoisophosphamide, all the surviving exposed embryos were malformed. Phenylketophosphamide was embryolethal to more than 50% of the exposed embryos at a concentration of 50 microM. In contrast, a concentration of phenylketoisophosphamide of 100 microM was required to produce significant embryolethality. Phenyl vinyl ketone was not embryotoxic at any of the concentrations tested. The major malformation observed, a hypoplastic prosencephalon, and the growth retardation effects were not only similar for phenylketophosphamide and phenylketoisophosphamide, but also similar to those previously reported for "activated" cyclophosphamide. Unlike the results with cyclophosphamide, where both phosphoramide mustard and the aldehydic metabolite of cyclophosphamide, acrolein, are toxic, the embryotoxic effects of phenylketophosphamide and phenylketoisophosphamide are mediated only by the mustard metabolite. PMID- 2718139 TI - Embryotoxicity studies of norfloxacin in cynomolgus monkeys: I. Teratology studies and norfloxacin plasma concentration in pregnant and nonpregnant monkeys. AB - Norfloxacin, a new orally active antibiotic, was investigated in cynomolgus monkeys for potential developmental toxicity. Fifty-seven monkeys were administered a control vehicle or norfloxacin by nasogastric gavage during the major period of organogenesis on gestational days (GD) 21 through 50 at doses of 0, 50, 100, 150, or 200/300 mg/kg/day. There was no evidence of teratogenicity at any dose level. Maternotoxicity and a significant increase in embryolethality occurred following doses of 200/300 mg/kg/day. The maternotoxicity was not expected based on range-finding studies in nonpregnant female monkeys, which showed no signs of toxicity in doses up to 500 mg/kg/day. Additional studies were conducted to determine if norfloxacin caused similar toxicity later in gestation. Forty-six pregnant monkeys were dosed with a control vehicle or 200 mg/kg/day norfloxacin for one of three 10-day periods on GD 36-45, 71-80, or 111-120. There were no maternotoxic, embryotoxic, or fetotoxic effects observed. Plasma concentrations of norfloxacin in five cynomolgus monkeys following 50 and 200 mg/kg oral doses were not dose-proportionate. However, at a given dose, administered in cross-over fashion, plasma concentrations of norfloxacin were higher in nonpregnant females (approximately 20-40%) than during pregnancy when the same subject was compared. At the no-observed-effect dose for maternal and embryotoxicity (50 mg/kg), peak plasma concentrations of norfloxacin in pregnant cynomolgus monkeys are approximately threefold higher than those observed in human volunteers receiving norfloxacin at the maximum recommended therapeutic dose of 400 mg (5.7 mg/kg based on 70 kg body weight) twice per day. PMID- 2718140 TI - Teratogenicity of 3,3-dimethyl-1-phenyltriazene in the rat: gross malformations including micrognathism. AB - 3,3-Dimethyl-1-phenyltriazene (DMPT), an alkylating agent, has been reported to be teratogenic in chickens, mice, and rats. One of the most commonly affected structures is the mandible; however, a complete description and incidence rates of all malformations produced have not been published. Rats were treated on day 12 of gestation (day 0 = sperm in vaginal smear) with a single intraperitoneal injection of 30 mg DMPT/kg. Fetuses were examined on each subsequent day of gestation for external and skeletal abnormalities. Standard soft tissue examinations were performed on day-20 fetuses. A high percentage (greater than or equal to 80%) of treated litters contained numerous fetuses with micrognathism, cleft palates, syndactyly, adactyly, and misshapen digits and limbs. Lordosis, cerebellar and cerebral hypoplasia, decreased fetal size, and generalized delayed ossification were also observed. Dams exposed to DMPT had decreased food consumption and weight gains, although clinicopathologic and histopathologic evaluations failed to indicate other evidence of maternal toxicity. DMPT caused numerous permanent structural alterations that were not attributed to maternal toxicity. PMID- 2718141 TI - Studies of mechanisms of niridazole-elicited embryotoxicity: evidence against a major role for covalent binding. AB - Studies reported here were designed to examine the hypothesis that covalent binding of reactive intermediates to macromolecules of the conceptus represents a major mechanism for the embryotoxicity of niridazole (NDZ). The roles of embryonic thiol content and oxygenation on: 1) malformation incidence; 2) reductive metabolism; and 3) covalent binding to embryonic macromolecules of metabolites resulting from reductive biotransformation of NDZ were studied. Results were compared with those from studies with the nondysmorphogenic analog of NDZ, 4'-methylniridazole (MNDZ). Day 10 rat embryos were pretreated for 5 hours in vitro with either L-buthionine-S, R-sulfoximine (BSO) or N acetylcysteine (NAC) to modulate their glutathione (GSH) content. BSO reduced GSH levels, but NAC was ineffective. Following pretreatment, embryos were cultured for an additional 15 hours in the presence of [14C]NDZ or [14C]MNDZ with an initial oxygen concentration of 5%. At the end of the culture period (day 11, AM), those embryos with active heartbeat and vitelline circulation were examined for asymmetric malformations. Drug metabolites were subjected to multiple extractions from the culture medium and subjected to quantitative high performance liquid chromatography (HPLC) analysis. Homogenates of the embryos were extracted with trichloroacetic acid (TCA) to estimate the covalent binding of radiolabeled parent compound/metabolites. Autoradiographic analyses were performed on other embryos. BSO pretreatment, which reduces embryonic GSH tissue levels, dramatically increased both the conversion of NDZ to 1-thiocarbamoyl-2 imidazolidinone (TCI) (generated via reductive metabolism of NDZ) and covalently bound label but failed to increase embryotoxicity. NAC, by contrast, did not significantly affect embryonic GSH levels, TCI generation, or covalent binding. Because both rates of metabolism of NDZ to TCI and covalent binding could vary independently of malformation incidence, we concluded that they do not represent critical mechanistic factors for the embryotoxicity of NDZ and related nitroheterocycles. PMID- 2718142 TI - Central nervous system malformations induced by triamcinolone acetonide in nonhuman primates: pathology. AB - Triamcinolone acetonide (TAC) was administered to pregnant macaques (Macaca mulatta [15] and M. radiata [7]) during gestational days (GD) 23 to 41 using various dosing schedules. A daily dose of 10 mg/kg is approximately equal to 100 x the human dose equivalent. The brains of the fetuses and infants were studied grossly and histologically. All cases displayed either the mild form of the TAC induced syndrome (craniofacial dysmorphia, cranium bifidum occultum, meningocele, and mild distortion of the midbrain) or the more severe form (occipital encephalocele, hydrocephalus, severe distortion of the midbrain or midbrain "beaking," shunting of cerebrospinal fluid, and craniofacial malformations). The dysmorphology was dose-related, with severity increasing at higher doses or with increased numbers of treatments. Individual cases were assessed for the severity of the syndrome by comparison of like components between groups. The lesions observed were morphologically comparable to those described in spontaneous human cases; the TAC-induced occipital encephaloceles were associated with brainstem and cerebellar abnormalities, and, with the less severe form of the syndrome, brainstem abnormalities were occasionally present, with occipital meningoceles. Controversy exists concerning the significance and temporal development of the midbrain changes. However, the associated alteration in aqueduct conformation may have been responsible for functional compromise and ensuing hydrocephalus. PMID- 2718143 TI - Effects of human diabetic serum on the in vitro development of early somite rat embryos. AB - High levels of glucose, beta-hydroxybutyrate (B-HOB), and acetoacetate are known to have embryotoxic and teratogenic effects on rat embryos in culture, especially when added concomitantly to the culture medium. We studied the effects of human serum from different types of diabetes mellitus on the in vitro development of 10 1/2-day-old rat embryos cultured for 48 hours. We used serum from type I diabetes with and without ketoacidosis and type II diabetes either untreated or treated with insulin or with daonil. Type I diabetes without ketoacidosis increased the rate of malformations to 27% vs. 11% in controls. Serum from type I diabetes with ketoacidosis further increased the malformation rate to 44%. The rate of malformations induced by serum of type II diabetes was dependent on the treatment. It was relatively low among embryos cultured on serum from untreated (16%) or treated with daonil (19%) and rose to 27% among embryos cultured on serum from type II diabetes treated with insulin. No significant correlation was found between the rate of malformations and the concentrations of glucose, B-HOB, acetoacetate, and HbA1c in all diabetic sera except serum from type I diabetes with ketoacidosis. We may therefore conclude that for most types of diabetes in humans, neither the high blood glucose concentrations nor the high levels of ketone bodies seem to be the main reason for the high rate of malformations. However, we used cultured rat embryos, and the effects on the human embryo may be different. The results of studies on various experimental animal models in diabetes teratogenicity seem to have only partial relevance to the human situation. PMID- 2718144 TI - Kudos to the Food and Drug Administration: reversal of the package insert warning for birth defects for oral contraceptives. PMID- 2718145 TI - [The study of intra-articular infectious agents in reactive arthritis]. AB - Reactive arthritis is differentiated from infectious arthritis by the lack of intraarticular infectious agents. Recently 2 groups, using different techniques have demonstrated intra-articular antigens in cases of reactive arthritis associated with Chlamydia and Yersinia infections. In this article we report the preliminary results of screening cells from synovial fluid for DNA of certain microorganisms by in situ hybridization. Our findings provide complementary evidence of the intra-articular presence of at least parts of microbes. PMID- 2718146 TI - [The therapy of reactive arthritis and of Reiter's syndrome]. AB - The treatment of reactive arthritis and Reiter's syndrome depends on the joints affected, on extra-articular symptoms, and the infection responsible for the disease. Purely symptomatic measures are inadequate in the treatment of therapy resistant or chronic arthritis. The choice of a suitable "remission-inducing agent" is also frequently determined by the involvement of the skin, intestines or eyes which may dominate. Antibiotics are necessary if the infectious process does not clear up completely. The survey systematically discusses the different methods of treatment and presents them in tabular form. PMID- 2718147 TI - [Rheumatic disorders and AIDS]. AB - Various rheumatologic diseases were reported in patients infected by the HIV (human immunodeficiency virus); in most cases, they are related to Reiter's syndrome, reactive arthritis and opportunistic germs arthritis. Based on three cases we summarize the present knowledge in this field. PMID- 2718148 TI - [Assessment and course of 110 patients with mono-arthritis]. AB - This is a follow up study of 110 patients referred to the hospital because of mono-arthritis of unknown etiology. Patients with mechanical synovitis and infectious arthritis have been excluded from this study initially. From a total of 110 patients (100%) a diagnosis could be made in 49 patients (44.6%), namely in 24 (21.8%) by the initial very thorough work up or by the repeated examinations during the follow up period in 25 patients (22.8%). In 61 patients (55.4%) the cause of the disease remained unknown despite extensive investigations and follow up controls for many years. Of these 61 cases three (2.7%) developed polyarthritis and six (5.5%) oligoarthritis still of unknown origin. The rest, namely 52 (47.2%) remained mono-arthritis and are called mono arthritis of unknown origin ("Arthritis unbekannter Ursache"). 67% of these 52 patients with mono-arthritis of unknown origin went into complete remission after one year and 80% after two years. 13 patients (11.8%) of the 110 developed rheumatoid arthritis within one month up to three years. Arthroscopy was important in making some diagnosis initially. Twelve patients had relief of symptoms after arthroscopy, ten of the group with mono-arthritis of unknown origin. 19 patients claimed that the initiating factor was a trauma to the joint. PMID- 2718149 TI - Tumor necrosis factor enhances expression of tissue factor mRNA in endothelial cells. AB - We have examined the effect of recombinant tumor necrosis factor on the expression of tissue factor activity and tissue factor mRNA levels in vascular endothelial cells. Following exposure of human umbilical vein endothelial cells to this cytokine, the appearance of tissue factor procoagulant activity was detected following cell disruption, and was maximal at 6 hours. Northern blot analysis of cytokine-treated cells demonstrated a similar increase in the synthesis of tissue factor mRNA, followed by a gradual decline to the basal level by 18 hours. Cycloheximide by itself induced the accumulation of high levels of tissue factor mRNA in these cells. This result suggests that the proteins necessary for transcription of the tissue factor gene are present in the endothelial cell prior to cytokine stimulation, and synthesis of the tissue factor mRNA may be controlled, in part, by a labile repressor protein. PMID- 2718150 TI - Protective effects of a specific platelet activating factor (PAF) antagonist, WEB 2086, in traumatic shock. AB - We have investigated the role of platelet activating factor (PAF) in the pathogenesis of a murine model of traumatic shock using WEB 2086, a specific antagonist of PAF. WEB 2086 (0.5 mg/kg) significantly reversed the decrease in mean arterial blood pressure (MABP) induced by PAF (0.3 micrograms/kg) in anesthetized rats. Anesthetized rats were subjected to Noble-Collip drum trauma. Traumatized rats treated with WEB 2086 (0.5 mg/kg bolus followed by infusion at 0.5 mg/kg/hr) maintained a higher MABP than those receiving only the vehicle (0.9% NaCl). Improvement in MABP paralleled a significant increase in overall survival time (p less than 0.01) in rats receiving WEB 2086 (0.5 mg/kg). WEB 2086 also significantly attenuated the plasma accumulation of the lysosomal hydrolase, cathepsin D and of free amino-nitrogen compounds, compared to shocked rats receiving only the vehicle. Furthermore, the production of the cardiotoxic peptide, myocardial depressant factor (MDF) was also blunted by WEB 2086. These results suggest that PAF may be an important mediator in the pathogenesis of traumatic shock in rats. Furthermore, PAF receptor antagonists may be useful as therapeutic agents when given early in the course of ischemic and shock states. PMID- 2718151 TI - A novel microtiter plate assay for the quantitation of procoagulant activity on adherent monocytes, macrophage and endothelial cells. AB - The interaction of monocytes, macrophages and endothelial cells with inflammatory agents induces cell surface changes resulting in the activation of the coagulation cascade. A large volume 96 well plate microtiter assay has been developed which permits the quantitation of procoagulant activity on endotoxin stimulated cells without requiring the use of purified coagulation factors. Procoagulant activity is measured through a two stage amidolytic assay using commercially available Proplex as a source of factors VII and X and the chromogenic substrate S2222. The assay is rapid, linear, and sensitive as procoagulant activity can be detected on as few as 5 X 10(3) monocytes or macrophages and 3 X 10(2) endothelial cells. PMID- 2718152 TI - [The early chemotactic reaction of the equine uterus to acute inflammatory stimulation]. AB - The uteri of normal pony mares in oestrus were infected experimentally with Streptococcus zooepidemicus. Uterine contents were collected 30, 60, 120 or 240 minutes later and were tested for their chemotactic effect on equine-neutrophils both with a morphological assay based on neutrophil shape changes and with a modified Boyden chamber technique. By 30 minutes after infection the uterine contents were markedly chemotactic for isolated peripheral neutrophils and remained so at the 240-minute collection. Uterine contents from uninfected mares had minimal chemotactic properties. These results could explain the early neutrophil response to acute endometritis in the mare which probably involves activation of an endogenous chemotactic system. PMID- 2718154 TI - [The separation of viable X and Y chromosome-bearing spermatozoa in domestic animal species]. PMID- 2718153 TI - [Embryo transfer in swine in relation to a gene transfer program]. AB - The production of the recommended embryonic stage for microinjection of foreign DNA into pronuclei needs a precisely timed preparation of donor pigs. For oestrus induction 1250 IU of PMSG is used at a body weight of 60 kg to 90 kg. To induce ovulation 750 IU of HCG are injected 3 days later. After two inseminations eggs are collected by surgical flush of the oviducts and centrifuged for 3 min at 15,000 g for visualization of the pronuclei. After DNA-microinjection the embryos are transferred to 12 h asynchronous recipients. About 50% of the collected eggs could be used for our experiments. The number and quality of the recovered eggs was related to the body weight of the donors. An in vivo culture system in the non-ligated pig oviduct was established in order to measure the effects of the distinct steps in microinjection on embryo survival. The survival rate of untreated zygotes was 52%. After centrifugation the rate was reduced to 38% and after microinjection to 12%. Pregnancy rate after 98 transfers was 37% and an average of 3.9 piglets were born per litter. PMID- 2718155 TI - [Pregnancy and labor in the mare: uterine activity and endocrinology]. AB - Electromyographic (EMG) recordings were made during the last two weeks of pregnancy from two mares. Four bipolar EMG electrodes were implanted in the uteri of the mares; near the tubo-uterine junction and bifurcation of the pregnant horn, in the body of the uterus and near the cervix. Plasma samples were collected every 4 hours during the same period and more intensely during parturition. Estradiol 17 beta, progesterone, PGF2 alpha metabolite and oxytocin were measured by radioimmunoassay. During the last week preceding delivery, EMG activity was elevated and was greatest at night. EMG activity was further increased during the last 24 hours before delivery of the foal and reached its highest intensity for 7 to 13 hours immediately prepartum. This period of intense activity is described as stage I of parturition. EMG activity decreased to very low levels 2 to 4 hours before delivery but abruptly increased again at rupture of the choriollantois and continued through delivery when activity decreased again until delivery of the placenta. The ratio of estradiol 17 beta to progesterone (E 17 beta/P) increased through the last week prepartum due to an increase in the level of estradiol 17 beta concentrations and during the last 24 hours the change in the E 17 beta/P ratio was due to a significant decrease in progesterone. Oxytocin and PGF2 alpha metabolite increased abruptly just before rupture of the fetal membranes and there is some evidence that oxytocin increased prior to PGF2 alpha metabolite. We hypothesize that the increasing E 17 beta/P ratio allows the evolution of labor to occur during the daylight hours preceding parturition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718156 TI - [The determination of the urea content in cow's milk with the help of the dry chemical system Reflotron]. AB - The dry chemistry laboratory unit "Reflotron" (Boehringer Mannheim) is tested for its efficacy in the determination of urea in dairy milk with the test Urea. It gives reliable results. The system is easy to handle. The storage of milk is of no influence on the level of urea. PMID- 2718157 TI - [Abscess forming mandibular osteomyelitis following actinomycosis]. PMID- 2718158 TI - [An unusual complication after the partial resection of the ascending duodenum of a cow]. AB - In a heifer portions of the ascending duodenum, which had been perforated by an obstructing phytobezoar, were resected. This resulted in an unexpected complication. The shortened ligamentum duodenocolicum exerted steady traction on the descending colon. This traction caused a kink and finally resulted in a total obstruction of the colon. The pathogenesis of this complication is illustrated. Surgical--possibly preventive--procedures are discussed. PMID- 2718159 TI - [Practice relevant rapid tests for milk progesterone in cattle compared with a laboratory-connected routine method]. AB - Four commercially available semiquantitative milk progesterone tests (Ovucheck Praxistest: Cambridge Veterinary Science/Smith Kline), Progestassay Milchprogesteron (Pitman-Moore/Janssen), Reprostrip-Progesteron-Schnelltest (Noctech/Albrecht), Enzygnost-Milchprogesteron (IQ, 'Bio' UK/Hoechst Veterinar) were examined for their accuracy by using them for the determination of progesterone levels of 64 milk samples, i.e. 1556 single assays. Several test series were performed, using codified samples and changing sequences. Three or four test persons respectively, performed the tests independently and classified the samples semiquantitatively. These test results were then compared to the results acquired by measuring the progesterone levels of the same samples by means of an approved quantitative, labor-bound progesterone test (Hormonost: Biolab). These control tests were performed at a specialized routine labor, by different personnel and at a different location. Lastly, in 48 out of the 64 sampled animals the reproductive status could be evaluated clinically and was taken into account as well. Samples yielding high progesterone levels, i.e. greater than or equal to 9 ng/ml were classified correctly in 84.4 to 96.5% of the cases, whereas samples with low levels (less than or equal to 2.5 ng/ml) were classified correctly in 68.8 to 90.0% of the cases only. Samples ranging between this spectrum (greater than 2.5 less than 9 ng/ml) were classified correctly only in 42.1 to 52.6% of the cases. However, this range appears to be of the most interest for the veterinary practitioner since cows in proestrus or early interestrus tend to have mild progesterone levels within these values. On the other hand, clinical findings are often insufficient for a proper diagnosis just in these animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718160 TI - [Changes in the blood coagulation potential of premature calves with and without respiratory distress syndrome]. AB - In 46 newborn calves with and without respiratory distress syndrome which had been delivered prematurely by caesarean section a blood coagulation profile was established. These animals were compared with 26 healthy, 5- to 8-day-old calves. Prematurely delivered calves showed a lower average plasma fibrinogen concentration than animals delivered in due time. Calves which developed a respiratory distress syndrome had a slightly prolonged prothrombin time and partial thromboplastin time as well as a lower antithrombin III activity already immediately postnatum compared with healthy prematures and some-day-old calves. It has to be assumed that in calves with respiratory distress syndrome--in analogy to pulmonary immaturity--the blood clotting mechanism is not yet fully developed. In healthy prematures and surviving asphyctic calves hemostasis remains largely stable during the first day of life, whereas plasma fibrinogen concentration increases. In the calves not surviving the examination period prothrombin time and partial thromboplastin time postnatum became significantly longer. Only in these severely asphyctic calves the presence of a consumption coagulopathy seems likely. A secondary reactive fibrinolysis was not observed. PMID- 2718161 TI - [A balloon probe for the treatment of recurrent bloat in calves and young cattle]. AB - For the treatment of recurrent bloat a soft-rubber balloon tube which is inserted through the nose into the rumen and can stay there for several days was developed. The inflated balloon ensures a floating of the tip of the tube in the dorsal gas cap above the rumen contents. The tube can also be used as a prophylactic measure to avoid excessive ruminal gas accumulation in recumbent patients during surgery. This report describes the experiences with this balloon tube gathered in 23 clinical patients. PMID- 2718162 TI - [The importance of exogenous factors on the composition of the urine of breeding sows]. AB - The influence of protein content in feed, of reduced and increased water-intake, of different hygienic situations and of antibiotic feed-medication on urine contents was controlled in healthy and cystitis diseased sows. It could be shown, that the urinary quality of healthy and ill sows was influenced in the same direction by exogenous factors. The amount of water-intake shows the greatest influence. Its rinsing effect on the quantity of relevant parameters of the urine examination (bacterial count, protein content, cell content) can induce misleading findings. Therefore the evaluation of the urinary status should be completed by anamnestic information, especially concerning increased or reduced water-intake. PMID- 2718163 TI - [The removal of foreign bodies in different birds]. AB - Following problems are shown using slides: --ingrown rings and their removal with follow-up treatment, --the removal of fishhooks, especially in swans, --the removal of projectiles from the bird's body, --the removal of lead slivers from the digestive tract of parrots as well as the follow-up treatment, --the removal of gold chains, plastic tubing and other "toys" from the intestine. Gastrotomy in the parrot is described. PMID- 2718164 TI - [Bilateral rupture of two head flexors with synchondrolysis of the base of the skull in a horse]. AB - Bilateral rupture of the musculus longus capitis from the tuberculum musculare of the os occipitale and of the musculus rectus capitis ventralis from the os occipitale combined with a synchondrolysis of the synchondrosis sphenooccipitalis in a 17 months old thoroughbred stallion is reported. PMID- 2718165 TI - [Age-related changes in the intervertebral disks of the cervical vertebrae of the horse]. AB - The cervical vertebral column of 103 horses of different age (42 weeks old fetus to 23 years) were examined with respect to age-related changes of the intervertebral disks. On gross examination the cervical intervertebral disks in the horse miss a pulpy nucleus but consist of a fibrocartilaginous tissue only, which is in contrast to literature. Age-related degenerative lesions as disintegration of connective tissue fibers leading to partial or complete loss of connection between the disks were found. In the more severe cases a yellow discoloration of the separated disks could be seen. Incidence and grade of the lesions increased with age and from the cranial to the caudal regions of the cervical vertebral column. Even in cases with a high degree degenerative separation clinical symptoms had not been reported. PMID- 2718166 TI - [The appearance of subchondral cystoid defects in the joints of the distal extremities of the horse]. AB - Subchondral bone cysts or cyst like lesions are an important hint in the radiographic diagnosis of degenerative joint disease. In this study we set artificial lesions of different size in the subchondral bone of different joint surfaces of horses, and we then tried to determine from which size on these lesions could be made visible on radiographs in different projections. It shows that the possibility of visualization of such lesions is frequently overestimated, cyst like lesions have to be quite large, before they can be seen on routine radiographs. PMID- 2718167 TI - [The smallest toy dog from the Roman empire]. AB - This study deals with osseous remains of the smallest breed of dogs found in deposits related to the Roman Imperial period. The bone material has been collected at the Colonia Ulpia Traiana near Xanten on the Rhine. It has been observed that the bones match in size with the smallest breeds of dogs known today. PMID- 2718168 TI - [The immobilization of giraffes]. AB - The anatomical and physiological conditions of blood circulation in the giraffe are pointed out. 16 immobilizations in the giraffe of either sex are reported, of which 10 were immobilized according to the following scheme. 1. Premedication: 30 mg Xylazine 150 mg Hyaluronidase 2. 15 minutes later a halter with two long ropes is put on to hold up the animals' heads after they lay down. 3. 20 minutes after premedication the injection of 5.6-6.0 mg Etorphine (2.5-2.7 ml Immobilon) together with 150 I.U. Hyaluronidase follows. 4. We think that the most important fact is to hold the animals head and neck in an upright position during the whole time of immobilization. 5. Within 3 to 5 minutes after the intravenous application of 15 mg Diprenorphine (5.0 ml Revivon) the animals raise without any problems. PMID- 2718169 TI - Relative contributions of protein sulfhydryl loss and lipid peroxidation to allyl alcohol-induced cytotoxicity in isolated rat hepatocytes. AB - The time course of allyl alcohol-induced toxicity was studied in freshly isolated rat hepatocytes. The sequence of events was as follows: an initial, rapid depletion of glutathione (GSH), a subsequent increase in malondialdehyde (MDA) and decrease in protein sulfhydryl groups (PSH), and the eventual loss of membrane integrity. The sulfhydryl compounds, N-acetylcysteine and dithiothreitol, markedly delayed the depletion of GSH, prevented significant loss of PSH, and protected the cells against viability loss. In contrast, the antioxidants, butylated hydroxytoluene and Trolox C, and the iron-chelating agent, deferoxamine, suppressed allyl alcohol-induced MDA production without affecting the depletion of cellular thiols or the loss of viability. The results suggest that the inactivation of protein thiol groups is critical for allyl alcohol toxicity whereas lipid peroxidation is not essential to the toxic process. PMID- 2718170 TI - The uptake and elimination of 1,1,1-trichloroethane during and following inhalation exposures in rats. AB - The pharmacokinetics of 1,1,1-trichloroethane (TRI) was studied in male Sprague Dawley rats in order to characterize and quantify TRI uptake and elimination oby direct measurements of the inhaled and exhaled compound. Fifty or 500 ppm TRI was inhaled for 2 hr through a one-way breathing valve by unanesthetized rats of 325 375 g. Repetitive samples of the separate inhaled and exhaled breath streams, as well as arterial blood, were collected concurrently both during and following TRI inhalation and analyzed for TRI by gas chromatography. Respiratory rates and volumes were continuously monitored during and following exposure and were used in conjunction with the pharmacokinetic data to characterize profiles of uptake and elimination. TRI was very rapidly absorbed from the lung, in that substantial levels were present in arterial blood at the first sampling time (i.e., 2 min). Blood and exhaled breath concentrations of TRI increased rapidly after the initiation of exposure, approaching but not reaching steady state during the 2-hr exposures. The blood and exhaled breath concentrations were directly proportional to the exposure concentration during the exposures. Percentage uptake of TRI decreased 30-35% during the first hour of inhalation, diminishing to approximately 45-50% by the end of the exposure. Total cumulative uptake in the 50 and 500 ppm groups over the 2-hr inhalation exposures was determined to be 6 and 48 mg/kg body wt, respectively. By the end of the exposure period, 2.1 and 20.8 mg, respectively, of inhaled TRI was eliminated from rats inhaling 50 and 500 ppm TRI. A physiological pharmacokinetic model for TRI inhalation was utilized to predict blood and exhaled breath concentrations for comparison with observed experimental values. Overall, values predicted by the physiological pharmacokinetic model for TRI levels in the blood and exhaled breath were in close agreement with measured values both during and following TRI inhalation. PMID- 2718171 TI - Type I and type II pyrethroids increase inhibition in the hippocampal dentate gyrus of the rat. AB - Urethane-anesthetized rats were prepared for stimulation of the perforant path and for recording from the granule cell region of the hippocampal dentate gyrus. Subjects were administered varying doses of allethrin (a prototype type I pyrethroid) or deltamethrin (a prototype type II pyrethroid), and the excitability of the perforant path and granule cells was tested. Both pyrethroids produced a dose-dependent decrease in the responsiveness of granule cells, following stimulation of the perforant path, that lasted up to 100 msec. Analysis suggested that the pyrethroid-induced effects were associated with an increase in interneuronally mediated inhibition. Neither the perforant path axon or terminal nor the granule cell was affected by doses which appeared to affect interneurons. Basal excitability of the granule cells was also decreased by deltamethrin. This effect may have been secondary to an increase in tonic inhibition evoked by the same mechanisms responsible for the increase in phasic inhibition. PMID- 2718172 TI - Comparative pneumotoxicity of cyclopentadienyl manganese tricarbonyl and methylcyclopentadienyl manganese tricarbonyl. AB - The acute pneumotoxic effects of cyclopentadienyl manganese tricarbonyl (CMT) and methylcyclopentadienyl manganese tricarbonyl (MMT) were compared to delineate the role of the methyl side chain in the toxicity of these organomanganese compounds and to further our understanding of the mechanisms by which these compounds act. Specifically, lung manganese (Mn) burdens and the pneumotoxic response, as measured by bronchoalveolar lavage parameters, were determined in male Sprague Dawley rats 24 hr after sc administration of 0.5, 1.0, or 2.5 mg Mn/kg as CMT or MMT. The pneumotoxic response to either compound was characterized by large increases in lavage albumin and protein content with smaller increases in lactate dehydrogenase levels. CMT was approximately twice as potent as MMT. This difference in potency may be due to methyl side chain oxidation, a metabolic detoxification pathway unavailable to CMT. Lung Mn content was significantly elevated after treatment with either CMT or MMT. Heptane extraction studies revealed that Mn was accumulated in a nonlipid soluble form, suggesting the accumulation of metabolites rather than heptane soluble parent MMT or CMT. A strong correlation between pulmonary Mn content and toxicity was observed, suggesting a causal relationship between the accumulation of CMT or MMT metabolites and toxicity. Piperonyl butoxide diminished both the pneumotoxicity and Mn accumulation resulting from CMT or MMT, suggesting both phenomena are due to monooxygenase metabolites. Pulmonary nonprotein sulfhydryl (NPSH) levels were increased twofold 24 hr after administration of either CMT or MMT. Depletion of NPSH was not observed 1.5 or 6 hr after administration. The mechanisms of this response are unclear but may be due to the metabolism of CMT or MMT to unstable compounds which release inorganic Mn within pulmonary cells. PMID- 2718173 TI - Toxicity and pharmacokinetics of the antibiotic fumagillin in yearling rainbow trout (Salmo gairdneri). AB - Yearling trout were administered fumagillin dicyclohexylamine (FDCH), an antibiotic that has shown promise for controlling myxozoan parasites in fish. FDCH was fed at 0.25 or 1 g/kg food at 1.5% body weight per day for 60 days, and gill, liver, kidney, spleen, thymus, intestine, and heart were examined histologically. In both treatment groups the hematopoietic tissue of the kidney and spleen was reduced and hematocrit was significantly lower relative to controls. No alteration was found in liver, intestine, heart, thymus, or gill. FDCH was also administered to trout through an indwelling catheter placed in the dorsal aorta. Plasma FDCH was measured using reverse-phase HPLC, and clearance microconstants were estimated. At the highest doses (60 and 30 mg/kg body wt) fumagillin was lethal within about 6 hr, and histological examination revealed extensive toxic alteration in liver and posterior kidney. Plasma clearance at 6 and 3 mg/kg fit a two-compartment model with a rapid alpha phase (i.e., 20 min) but a prolonged beta phase (5.4 days). Although these fish survived for at least 96 hr, renal tubular alteration remained. PMID- 2718174 TI - Decreased ligand binding to the hepatic glucocorticoid and epidermal growth factor receptors after 2,3,4,7,8-pentachlorodibenzofuran and 1,2,3,4,7,8 hexachlorodibenzofuran treatment of pregnant mice. AB - 2,3,4,7,8-Pentachlorodibenzofuran (PeCDF) and 1,2,3,4,7,8-hexachlorodibenzofuran (HCDF) are environmental contaminants which mimic many of the toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Like TCDD, these polychlorinated dibenzofurans (PCDFs) induce hepatic benzo[a]pyrene hydroxylase activity (BPH) and possess high affinity for the Ah receptor. Another similarity of these PCDFs to TCDD is their ability to induce teratogenic effects such as cleft palate and hydronephrosis in mice. Recent studies have shown that TCDD modifies the equilibrium binding kinetics of the rat liver cytosolic glucocorticoid receptor (GRc) and the hepatic plasma membrane epidermal growth factor (EGF) receptor. To gain a better understanding of the action of halogenated hydrocarbons on these cytosolic and membrane-bound receptor systems during pregnancy, we investigated the biochemical effects of PeCDF and HCDF on the binding kinetics of maternal mouse liver GRc and EGF receptors and the induction of BPH activities. Pregnant C57BL/6N mice were treated once daily on gestation Days 10 through 13 with PeCDF (0-30 micrograms/kg) or HCDF (0-300 micrograms/kg). Hepatic [3H]dexamethasone and [125I]EGF equilibrium binding studies indicated that all doses of PeCDF tested (10, 20, and 30 micrograms/kg) significantly reduced the GRc and EGF receptor maximum binding capacities but did not affect the binding affinities of these receptors when compared to corn oil-treated control pregnant mice. Similar effects were observed for doses of HCDF greater than or equal to 100 micrograms/kg. These data suggest that the dibenzofuran-mediated decreases in GRc and EGF receptor binding capacities are similar to those caused by TCDD. Although the mechanism of action is not yet clear, our results indicate that halogenated aromatic compounds in addition to TCDD have profound effects on both steroid and growth factor receptor systems. PMID- 2718175 TI - Long-term morphologic and biochemical changes induced by O,O,S-trimethyl phosphorothioate in the rat lung. AB - The long-term pulmonary morphologic and biochemical changes induced by a single, sublethal dose of O,O,S-trimethyl phosphorothioate (OOS-TMP), an impurity present in organophosphorus insecticides, was examined in female WAG/Rij rats. Animals received either corn oil or a corn oil solution of OOS-TMP at a dose of 40 mg/kg body weight by gavage and were studied at the following time intervals after treatment: 10 days, 30 days, 90 days, 6 months, and 1 year. No control or OOS-TMP treated animal died spontaneously. Significant increases in wet and dry lung weights occurred at all times examined in OOS-TMP-treated rats compared to those in age-matched controls. No difference was observed in percentage lung water content between treated and control rats. OOS-TMP treatment resulted in hypertrophy and hyperplasia of type II alveolar epithelial cells having morphologic alterations in the size and number of osmiophilic lamellar bodies. Interstitial changes were characterized as increased numbers of fibroblasts accompanied by increased amounts of collagen fibrils and basement membrane alterations. There was also a significant increase in pulmonary hydroxyproline content in OOS-TMP-treated animals compared to that in controls at all time periods. Collagen deposition was predominantly associated with the interalveolar septa rather than being oriented around airways. The results of this study indicate that a single, sublethal dose of OOS-TMP induces long-term structural and biochemical changes in the rat lung. PMID- 2718176 TI - Retinoic acid and 2,3,7,8-tetrachlorodibenzo-p-dioxin selectively enhance teratogenesis in C57BL/6N mice. AB - TCDD is one of the most toxic man-made compounds and an extremely potent teratogen in mice. Many of its toxic symptoms resemble those seen during vitamin A deficiency. Vitamin A and its derivatives, such as alltrans-retinoic acid (RA), are also teratogenic in mice, as well as many other species. Both TCDD and RA produce cleft palate in susceptible strains of mice. However, while TCDD produces hydronephrosis, RA does not, and TCDD does not produce limb bud defects while RA does. To determine whether TCDD and RA would enhance or antagonize the teratogenic effects of the other compound, C57BL/6N dams were treated po on Gestation Day (gd) 10 or 12 with 10 ml corn oil/kg containing TCDD (0-18 micrograms/kg), RA (0-200 mg/kg), or combinations of the two chemicals. Dams were killed on gd 18 and toxicity and teratogenicity assessed. Coadministration of TCDD and RA had no effect on maternal or fetal toxicity beyond what would be expected by either compound alone. Cleft palate was induced by RA at lower doses on gd 10 than on gd 12, but by TCDD at lower doses on gd 12 than on gd 10. Sensitivity to TCDD-induced hydronephrosis was similar on both gd 10 and 12. The limb bud defects were only observed when RA was administered on gd 10, not when given on gd 12. No other soft tissue or skeletal malformations were related to administration of TCDD or RA. No effect of TCDD was observed on the incidence or severity of limb bud defects induced by RA, nor did RA influence the incidence or severity of hydronephrosis induced by TCDD. However, the incidence of cleft palate was dramatically enhanced by coadministration of the xenobiotic and vitamin. On both gd 10 and 12, the dose-response curves for cleft palate induction were parallel, suggesting some similarities in mechanism between the two compounds. However, combination treatment resulted in a synergistic response that varied with the stage of development and was tissue specific. PMID- 2718177 TI - Differences between rodents and humans in the metabolic toxification of N,N dimethylformamide. AB - The widely used industrial solvent N,N-dimethylformamide (DMF) causes liver damage in occupationally exposed persons and is suspected of involvement in the generation of certain occupational malignancies. Here the extent of the biotransformation of DMF to three urinary metabolites has been compared in humans and rodents. The metabolites, which were quantified by gas chromatography (GC) are N-(hydroxymethyl)-N-methylformamide (HMMF), which yielded N-methylformamide on GC analysis, a species which decomposed to formamide on GC analysis, and N acetyl-S-(N-methylcarbamoyl) cysteine (AMCC), measured after derivatization with ethanol to give ethyl N-methylcarbamate. Ten volunteers who absorbed between 28 and 60 mumol/kg DMF during an 8-hr exposure to DMF in the air at 60 mg/m3 excreted in the urine within 72 hr between 16.1 and 48.7% of the dose as HMMF, between 8.3 and 23.9% as formamide, and between 9.7 and 22.8% as AMCC. AMCC, together with HMMF, was also detected in the urine of workers after occupational exposure to DMF. The portion of the dose (0.1, 0.7, or 7.0 mmol/kg given ip) which was metabolized in mice, rats, or hamsters to HMMF varied between 8.4 and 47.3% of the dose; between 7.9 and 37.5% were excreted as formamide and only between 1.1 and 5.2%, as AMCC. The results suggest that there is a quantitative difference between the metabolic pathway of DMF to AMCC in humans and rodents. It is argued that the hepatotoxic potential of DMF may be linked to the extent of its metabolic conversion to AMCC. PMID- 2718178 TI - Selective protein arylation and the age dependency of acetaminophen hepatotoxicity in mice. AB - Male CD-1 mice 1, 1.5, 2, and 3 months old were given 600 mg of acetaminophen (APAP)/kg, po, and liver damage was assessed 12 hr later. The most severe hepatotoxicity was in 3-month-old mice, while the other age groups exhibited little damage. The onset of susceptibility to APAP hepatotoxicity did not correlate with the level of activity of the mixed-function oxidase system as assessed in vitro, since drug metabolizing capability was similar between 2- and 3-month-old mice. Through 4 hr after administration of APAP to 2- and 3-month-old mice in vivo, glutathione (GSH) depletion and both plasma and liver APAP concentrations were similar between ages. Additionally, 24 hr after dosing, 3 month-old mice excreted marginally more APAP-glucuronide conjugate and parent compound in urine than 2-month-old animals, while both age groups excreted similar amounts of the APAP-sulfate and GSH-derived conjugates. Even though the extent of binding of radioactive APAP to macromolecules at 4 hr was similar between 2- and 3-month-old animals, the pattern of immunochemically targetted cytosolic and microsomal proteins was different. Thus, in APAP exposure the extent of binding to specific proteins rather than the overall amount of covalent binding may be the critical determinant of the hepatotoxic response. In the present study, the age-related differences in susceptibility to APAP-induced hepatotoxicity were related to the differences in selective protein arylation. PMID- 2718179 TI - Quantitative interactions between Pb2+ and Ca2+ homeostasis in cultured osteoclastic bone cells. AB - Cellular calcium homeostasis and calcium-mediated cell functions are conceptually attractive processes to be involved in the manifestation(s) of lead toxicity including impaired skeletal growth and cardiovascular and neurological dysfunction. Knowledge of Ca:Pb and Pb:Ca ratios in different structural and functional compartments of cells is essential for identifying, characterizing, and understanding the significance of Pb2+-Ca2+ interactions. Experiments were conducted to characterize the steady-state kinetic distribution and behavior of 45Ca in primary cultures of murine osteoclastic bone cells. Bone cells, derived from mouse calvaria, were enriched for osteoclasts by a sequential collagenase digestion and maintained in primary culture for 1 week. Cultures were labeled with 45Ca for two or 24 hr and the kinetic parameters were obtained by analysis of 45Ca washout curves. Cellular metabolism was based upon a model with three kinetic pools of intracellular Ca2+ containing approximately 45, 25, and 30% of the total cell calcium. In addition, we describe quantitative measurements of Ca:Pb and Pb:Ca ratios at important functional cell sites of Ca2+ transport and storage in intact cells. The intracellular relationships of Ca2+ and Pb2+ were calculated concurrently in individual cultures, using kinetic analysis of dual label 45Ca and 203Pb washout curves. The Ca:Pb ratios of the rate constants and half-times were approximately 1:1, supporting the concept of similar cellular metabolism of the two elements. The Ca:Pb ratios for the kinetic pools and fluxes were considerably higher than 1:1. These in situ Ca:Pb relationships should be useful for designing and evaluating Ca-Pb studies with calmodulin, isolated mitochondria, and other individual components of the calcium messenger system. Moreover, these data demonstrate both similarities and differences in the kinetic distribution and behavior of Ca2+ and Pb2+ in osteoclastic bone cells. PMID- 2718180 TI - Renal glutathione depletion and nephrotoxicity of cadmium-metallothionein in rats. AB - Renal glutathione (GSH) concentrations were reduced approximately 80% at 4 hr after a single injection of buthionine sulfoxime (BSO) (4 mmol/kg body wt) and remained reduced for at least 16 hr in male rats. Following BSO injection, rats were injected with a nephrotoxic dose of cadmium-metallothionein (Cd-MT) (0.3 mg Cd as Cd-MT/kg body wt) and killed 1, 4, or 12 hr later. Damage to the kidney was assessed histologically and by measurement of p-aminohippuric acid (PAH) uptake into renal cortical slices. Although the renal accumulation of Cd following Cd-MT injection was significantly lower in BSO-pretreated rats as compared to nonpretreated rats, the damage to kidney was more severe. At 4 and 12 hr, both Cd MT-induced inhibition of PAH uptake and morphological damage were significantly increased in BSO-pretreated rats. In certain experiments, the induction of renal intracellular MT synthesis by zinc pretreatment slightly decreased the renal toxicity of Cd-MT in the BSO-treated rats. The results demonstrate that although GSH depletion decreases the renal accumulation of Cd in rats injected with Cd-MT, the nephrotoxicity of Cd-MT is increased. Preinduction of MT in the kidney can only partially overcome this increase in toxicity. Therefore both GSH and intracellular MT levels can influence the renal toxicity of injected Cd-MT. PMID- 2718181 TI - Metallothionein immunoreactivity in the liver and kidney of copper injected rats. AB - Adult male rats were injected intraperitoneally with copper sulphate in physiological saline (3 mg copper/kg body wt). Metallothionein-I (MT-I) levels in liver, kidney, plasma and red blood cells were measured by radioimmunoassay (RIA), prior to the injection and after 7, 16 and 24 h. Copper and zinc levels in liver and kidneys were also monitored. Concentrations of MT-I in liver and kidneys showed a rapid increase and remained elevated for 24 h. Copper concentrations also increased in both tissues but zinc levels remained constant in the kidney and rose only slightly in the liver. MT-I levels increased gradually in plasma but decreased in the red blood cells. Immunochemistry of liver and kidney, using the direct peroxidase technique with antiserum to rat MT I, revealed an increase in staining in both tissues after copper administration, consistent with the RIA results. The change in distribution of immunoreactive material with time after copper injection indicates a role for MT in the sequestration and excretion of copper in acutely loaded animals. PMID- 2718182 TI - Renal binding of cadmium in the rat following intragastric exposure. AB - Renal binding of cadmium was compared in groups of rats administered cadmium intragastrically or subcutaneously in doses resulting in similar renal cadmium concentrations. In rats administered cadmium intragastrically the renal concentrations of copper and metallothionein were lower, suggesting disturbance in copper metabolism. These changes were alleviated gradually in the post exposure period. In experiments with 64Cu it has been shown that intragastric exposure to cadmium reduced copper absorption to about 21% of that in the control rats, thus explaining the poor copper availability for renal binding of cadmium in the form of Cd,Cu-metallothionein. Changes in zinc uptake were less strongly marked and were limited to slight decrease of zinc content in the kidneys. PMID- 2718183 TI - Animal rights and modern toxicology. PMID- 2718184 TI - Chronic toxicity tests of sodium thiocyanate with sodium nitrite in F344 rats. AB - Sodium thiocyanate, a common environmental chemical, was found to increase the incidence of liver tumors in a group of rats treated with 0.08% in drinking water. To test the possibility that thiocyanate was catalyzing the formation of carcinogenic nitrosamines from amines and nitrite in the food, a group of 20 male and 20 female rats was given a higher dose of sodium thiocyanate (0.32%) together with sodium nitrite (0.2%) in drinking water. Similar groups of rats were given 0.32% sodium thiocyanate or 0.2% sodium nitrite in drinking water or were untreated. All treatments lasted most of the lifetime of the rats, at least 2 years. There was no difference between the groups, treated or untreated, in survival, or in the incidence of any tumor that could be related to the treatment. The results indicate that sodium thiocyanate is without carcinogenic activity in rats, alone or combined with sodium nitrite. PMID- 2718185 TI - The acute toxicity of tris(dimethylamino)silane. AB - The acute handling hazards of tris(dimethylamino)silane [TDMAS] were investigated. The acute male rat peroral LD50 (with 95% confidence limits) was 0.71 (0.51-0.97) ml/kg, and the acute male rabbit percutaneous LD50 was 0.57 (0.35-0.92) ml/kg. The liquid was severely irritating to the rabbit eye and skin, and the vapor severely irritating to the rat eye. The dynamically generated saturated vapor Lt50 in female rats was 12 (9.7-15) min. The effect of varying the atmospheric concentration of vapor from TDMAS on acute inhalation toxicity was investigated by passing ordinary moist air countercurrent to liquid TDMAS metered into a slightly heated glass tube. Based on nominal concentrations, the 4 hr-LC50 for vapor from TDMAS was 734 (603-893) ppm in female rats by this procedure. Stoichiometrically, this accords with toxicity due to liberation of dimethylamine (DMA) from TDMAS. In a subsequent study designed to assess the influence of relative humidity on vapor toxicity, nitrogen was passed over heated liquid TDMAS and the resultant atmosphere was introduced into the air intake duct of the inhalation exposure chamber. Gas chromatographically measured TDMAS concentrations (+/- SD) were 395 +/- 111, 127 +/- 25, 62 +/- 8 and 23 +/- 21 ppm; the corresponding DMA vapor concentrations were 112 +/- 171, 31 +/- 43, 10 +/- 6 and 26 +/- 44 ppm. The 4-hr LC50 (males and females) was 38 (34-43) ppm TDMAS vapor. Thus, TDMAS is of moderate acute peroral and percutaneous toxicity, a severe primary skin and eye irritant, an aspiration hazard, and of high intrinsic acute inhalation toxicity, but in moist air conditions lethal toxicity may be reduced and in such circumstances DMA may be a significant factor in toxicity. PMID- 2718186 TI - Lack of effect of selenium on induction of tumors of esophagus and bladder in rats by two nitrosamines. AB - The effect of differences in level of dietary selenium on the induction of esophageal and bladder tumors in rats by two nitrosamines was investigated. Groups of 20 female F344 rats were given a synthetic diet containing less than 0.05 ppm Se to which selenium (as sodium selenite) was added at the concentration of 0.35, 0.7, 1.4 and 2.1 ppm selenium. These four groups, plus one without added Se, were treated with 20 ml per rat per day, 5 days a week, of a solution of nitrosomethylcyclohexylamine containing 5 mg/liter. A parallel five groups were treated in the same way with a solution of nitrosomethyl-3-carboxypropylamine in drinking water containing 600 mg per liter, as drinking water. Treatment lasted 28 weeks, at which time some animals had developed tumors. A group of 20 rats fed 0, 1.4 and 2.1 ppm Se was not treated with carcinogen. Rats consuming 1.4 ppm or 2.1 ppm Se gained weight more slowly than other groups. There was no significant difference in survival between the five groups treated with each carcinogen but receiving different dietary levels of selenium. Neither was there any significant difference between groups receiving each carcinogen in the incidence of tumors of the esophagus induced by nitrosomethylcyclohexylamine or of tumors of the urinary bladder induced by nitrosomethylcarboxypropylamine. Control rats on the synthetic diets did not survive as well as untreated rats eating regular chow diet. In these conditions there was no effect of dietary selenium levels on the induction of tumors in female rats by the two carcinogenic nitrosamines we used. PMID- 2718188 TI - Immunological comparison of hemorrhagic principles present in venoms of the Crotalinae and Viperinae subfamilies. AB - Antibodies were raised against hemorrhagic factors HF1, HF2 and HF3 isolated from the venom of Bothrops jararaca and NHFa,b from the venom of Bothrops neuwiedi. Crude venoms of different species of snakes were assayed with the rabbit antisera specific for the hemorrhagic factors. Results of immunodiffusion, neutralization of hemorrhagic activity and micro-complement fixation indicated that there is an immunological relationship between the venom hemorrhagic components of the Bothrops species and those of other species of the Crotalinae subfamily. The factors of Bothrops species seem to be structurally similar. The hemorrhagic proteins from the venoms of Lachesis, North American Crotalus, Asian Trimeresurus and Agkistrodon species show some resemblance to the Bothrops factors. The venom hemorrhagic principles from snakes of the Viperinae subfamily (Bitis and Vipera species) might have few epitopes similar to those of Bothrops species as the only relation shown was the partial neutralization by the immune sera. PMID- 2718187 TI - Do chemical modifications dissociate between the enzymatic and pharmacological activities of beta bungarotoxin and notexin? AB - We have measured enzymatic, hemolytic and anticoagulant activities, lethal potencies and effects on contractions of the phrenic nerve-diaphragm preparation, by chemically modified derivatives of beta bungarotoxin (beta BuTX) and notexin, two presynaptically acting toxins which have PLA2 activity. The following chemical modifications of beta BuTX were tested: alkylation and methylation of histidine 48, alkylation of tryptophan 19, sulfonylation of tyrosine 68, oxidation of methionines 6 and 8, semicarbazide addition under varied conditions to carboxyl groups, varied extents of carbamylation or trinitrophenylation of lysines and guanidination of all lysines with or without trinitrophenylation of the N-terminal asparagine. Only the histidine, tryptophan and tyrosine residues were modified in notexin. The results obtained were compared with those previously obtained using chemically modified derivatives of Naja nigricollis and Naja naja atra PLA2 enzymes which do not have a specific presynaptic site of action. The results with oxidized methionine and lysine-modified derivatives of beta BuTX are supportive of the suggestions of others that the N-terminal region and basic residues away from the enzymatic active region contribute towards the beta type presynaptic neurotoxicity of the PLA2 toxins. Using modified derivatives of beta BuTX and notexin, the dissociations between enzymatic activities and pharmacological properties were not as marked as previously observed with N. nigricollis and N. n. atra PLA2; nevertheless, several dissociations were noted. We conclude that, just as with non-presynaptically acting PLA2 enzymes, some pharmacological actions of presynaptically acting PLA2 toxins may occur independently of phospholipid hydrolysis. PMID- 2718189 TI - Biological activity of saponins and saponin-like compounds from starfish and brittle-stars. AB - Twenty-four saponins and saponin-like compounds, isolated from starfish and brittle-stars, have been tested in four in vitro tests, based upon bacterial and cell tissue cultures. Saponin-like compounds from brittle-stars have previously not been tested for biological activity. In an antibacterial test based on an agar diffusion test, the Gram positive bacterium S. aureus was affected by the polyhydroxylated steroidal glycosides, polyhydroxylated sterols and disulfated sterols. However, none of the 21 compounds tested were active against the Gram negative bacterium E. coli. In a cytotoxicity test all 21 compounds tested influenced the cells at a concentration of 100 micrograms/ml, while the cells were unaffected at 1 microgram/ml. In an antitumor test, 16 compounds were tested on two lymphoma cell lines. Inhibition of cell growth, at a concentration of 5 ng/ml, was seen for three polyhydroxylated sterols, in one cell line. Weak activity was seen in an antiviral test at a concentration of 10 micrograms/ml. PMID- 2718190 TI - Behavioural, electroencephalographic and neuropathological effects of the intrahippocampal injection of the venom of the South American rattlesnake (Crotalus durissus terrificus). AB - Venom was microinjected into the dorsal hippocampus of rats and electroencephalographic recordings were obtained from the hippocampus and occipital cortex. Behavioural alterations consisted of circling, wet shaking and scratching that evolved to head and body jerks and isolated clonic episodes and then to wild running followed by tonic-clonic generalized seizures and status epilepticus. Electroencephalographic alterations consisted of high frequency and high voltage spikes together with epileptiform seizures beginning in the hippocampus and evolving to the cortex. However there was only a poor electrographic-behavioural correlation between the generalized tonic-clonic seizures preceded by wild running and the electrical recordings from hippocampus and occipital cortex. Histology revealed lesions at the site of injection as well as at distant sites. Severity of neuronal damage was associated with seizure intensity. Damaged areas were almost the same as found within other models of epilepsy. Nevertheless a remarkable difference was the highly lesioned hypothalamus seen in this experiment. We discuss our results in relation to results obtained with other methods of inducing epilepsy. This venom may be a useful tool for studying the nervous system. PMID- 2718191 TI - Purification and characterization of a major phospholipase A2 from Russell's viper (Vipera russelli) venom. AB - A major phospholipase A2 (VRV PL-VIIIa) which constitutes 24% of the whole Vipera russelli venom was purified to homogeneity by CM-Sephadex C-25 column chromatography followed by gel filtration on Sephadex G-50. VRV PL-VIIIa is a basic protein with a molecular weight of 11,800 by SDS-PAGE. This enzyme contributes 45% of the total PLA2 activity of the venom, but it is least toxic compared to other purified basic PLA2 enzymes prepared from V. russelli venom. The LD50 value (i.p.) of VRV PL-VIIIa is 5.3 mg/kg body wt. It shows neurotoxic symptoms and damages vital organs such as lung, liver and kidney at LD50 doses. It induces myonecrosis when injected i.m. into the thigh muscle of mice and edema when injected into the foot pads. PMID- 2718192 TI - Antigenic relationships of fractionated western diamondback rattlesnake (Crotalus atrox) hemorrhagic toxins and other rattlesnake venoms as indicated by monoclonal antibodies. AB - Seven hemorrhagic factors have been isolated from Crotalus atrox venom, but their antigenic relationships have not been well studied. In this study, two different monoclonal antibodies, C. atrox peak 8 (CA-P-8) and C. atrox subclone 5 (CA-5+), were produced against two C. atrox venom hemorrhagic fractions and used in an ELISA (enzyme-linked immunosorbent assay) to determine if the hemorrhagic factors in C. atrox venom are antigenically related. The same ELISA test was used to determine cross-reactivity of seven other crude Crotalidae venoms. The two monoclonal antibodies were tested for their ability to neutralize each hemorrhagic HPLC fraction separated from C. atrox venom. C. atrox venom was fractionated into 22 fractions using HPLC analytical DEAE ion exchange. Fractions 4-17 were hemorrhagic. The CA-P-8 monoclonal antibody reacted strongly with hemorrhagic fraction 8; CA-5+ had a broader reactivity and reacted with several HPLC hemorrhagic and non-hemorrhagic fractions. Crude venoms of C. adamanteus, C. scutulatus scutulatus and C. viridis lutosus reacted with CA-P-8, while C. viridis lutosus, C. viridis oreganus, C. scutulatus scutulatus and C. horridus horridus reacted with CA-5+. C. molossus molossus and C. lepidus lepidus did not react with CA-P-8 and CA-5+. Hemorrhagic HPLC fractions 6, 7, 8, were completely neutralized by monoclonal antibody CA-P-8; fraction 9 was partially neutralized. The present study indicated that some C. atrox venom HPLC hemorrhagic fractions have both common and unique epitopes. Antigenic determinants were also found to be shared among different Crotalus species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718193 TI - Factors influencing the hemolysis of human erythrocytes by cardiotoxins from Naja naja kaouthia and Naja naja atra venoms and a phospholipase A2 with cardiotoxin like activities from Bungarus fasciatus venom. AB - The effects of red blood cell age and incubation conditions (temperature, divalent cation type and concentration, pH and glucose) on hemolysis induced by cardiotoxin fractions from Naja naja atra and Naja naja kaouthia venoms, a phospholipase A2 with cardiotoxin-like activities from Bungarus fasciatus venom and bee venom phospholipase A2 were examined. Hemolysis by the snake venom toxins was dependent on red blood cell age (aged more susceptible than fresh) and the temperature of incubation (37 degrees C greater than 20 degrees C). Divalent cations at 0.5-2.0 mM enhanced (Ca2+) or slightly decreased (Sr2+, Ba2+) hemolysis due to N. n. kaouthia and N. n. atra toxins, and greatly decreased (Ca2+, Sr2+, Ba2+) hemolysis by these toxins at higher concentrations (5-40 mM). For the B. fasciatus phospholipase A2, Ba2+ and Sr2+ could not fully support hemolysis in any concentration while both low (less than 0.5 mM) and high (greater than 40 mM) Ca2+ enhanced hemolysis. Bee venom phospholipase A2 only induced hemolysis (greater than 10% at greater than 40 mM) at high concentrations of Ca2+. Increasing the pH from 7.5 to 8.5 greatly increased the levels of hemolysis by the snake venom toxins and enzyme. Glucose (5.3 mM) increased hemolysis by the snake venom components at low concentrations of divalent cations (2 mM) and slightly decreased hemolysis at high concentrations (40 mM). Treatment with p-bromophenacyl bromide abolished phospholipase A2 activity of bee venom and B. fasciatus phospholipases, but did not affect hemolytic potency of N. n. kaouthia or B. fasciatus toxins. A similar mechanism, which is independent of phospholipase A2 activity, may be involved in hemolysis by the N. n. kaouthia and N. n. atra cardiotoxins. The B. fasciatus cardiotoxin-like phospholipase A2 appears to have two mechanisms of hemolysis; the first is similar to that of the two typical cardiotoxins and the second appears dependent on phospholipase A2 activity and is only evident at high Ca2+ concentrations. PMID- 2718194 TI - Monoclonal antibody raised against tetrodonic acid, a derivative of tetrodotoxin. AB - Tetrodonic acid, a relatively non-toxic derivative of tetrodotoxin, was conjugated with bovine serum albumin and injected i.p. to BALB/c mice. After several injections, spleen cells were isolated, fused with myeloma cells X63-Ag8 6.5.3. and cloned by the limiting dilution method. The monoclonal antibody produced in ascites fluid in the mouse by the cloned cell showed an increasing reactivity with tetrodotoxin at concentrations ranging from 0.03 to 100 micrograms per well. PMID- 2718195 TI - Histopathological studies on experimental marine toxin poisoning--III. Morphological changes in the liver and thymus of male ICR mice induced by goniodomin A, isolated from the dinoflagellate Goniodoma pseudogoniaulax. AB - The i.p. LD50 values of goniodomin A, a novel polyether macrolide, in male ICR mice were 1.2 and 0.7 mg/kg at 24 and 48 hr, respectively. Histologically, perihepatitis, non-fatty vacuoles in the hepatocytes, central necrosis of the liver and massive necrosis of lymphocytes, in the cortical layer of the thymus, were prominent. PMID- 2718196 TI - Incidence rates of stroke in the eighties: the end of the decline in stroke? AB - Studies of the population of Rochester, Minnesota, have provided the only data on temporal trends for the incidence of stroke in North America. Among the residents of Rochester, the average annual incidence rate of stroke declined by 46%, from 213 to 115 per 100,000 population, between 1950-1954 and 1975-1979. The decline occurred in all age and sex groups, but it occurred earlier in women than in men. The rates stabilized in the 1970s, and did so earlier in women. For 1980-1984, the incidence rate of stroke was 17% higher than that for 1975-1979. The onset of the decline in incidence rates coincided with the introduction of effective antihypertensive therapy, but stabilized and increased rates were associated with continuing improvement in the control of hypertension. The increase in the incidence rates of stroke coincided with the introduction of computed tomography, which appeared to increase the detection of less severe strokes. PMID- 2718197 TI - Frequency, etiology, and prevention of stroke in patients with systemic lupus erythematosus. AB - We retrospectively and prospectively reviewed the incidence of stroke in 105 patients with systemic lupus erythematosus (SLE). Stroke occurred in 14 (15%) of 91 consecutive patients with documented SLE; nine (64%) of the 14 had multiple cerebral infarcts. Factors associated with stroke and the frequency of stroke were systemic thrombosis (30%), elevated partial thromboplastin time (36%), spontaneous abortion (50%), age over 60 years (57%), transient ischemic attacks (57%), previous stroke (64%), and cardiac valvular disease (86%). The major period of risk for the first stroke was during the first 5 years of SLE. The most frequent etiology was a cardiogenic embolus or an antibody-mediated hypercoagulable state, with cerebral vasculitis occurring only in association with infection. Because of the decreased fibrinolysis seen in patients with SLE, anticoagulant therapy may be the most effective preventive treatment currently available. Anticoagulant therapy seemed to prevent recurrent focal cerebral ischemia in our patients and was associated with relatively few and minor complications. Patients with a history of transient ischemic attacks or cardiac valvular lesions are at high (57% and 87%, respectively) risk of stroke. Patients who have had a stroke are at high (64%) risk for a recurrent stroke. Anticoagulant therapy is recommended for all of these patients. PMID- 2718198 TI - Hemostatic markers in acute stroke. AB - To assess the time course of thrombosis and fibrinolysis after acute stroke, we measured concentrations of fibrinopeptide A (FpA), B-beta 1-42 peptide (B-beta 1 42), B-beta 15-42 peptide (B-beta 15-42), and crosslinked D-dimer (XDP) in 31 patients at varying times following acute ischemic stroke and in 13 neurologically stable patients with chronic strokes. FpA levels were markedly elevated during the first week after stroke and declined slowly during the first month. Mean FpA levels were not significantly elevated in chronic stroke patients. Mean XDP levels were slightly elevated during the first week and increased during the next 2 weeks after stroke. B-beta 1-42 and B-beta 15-42 levels were not elevated at any time following acute stroke. Our data suggest that fibrin formation greatly exceeds endogenous fibrinolysis during the acute phase of ischemic stroke. Endogenous fibrinolysis develops slowly following stroke. Prolonged elevation of FpA concentration suggests that thrombin activity and fibrin formation continue for up to 4 weeks in some patients with ischemic stroke. PMID- 2718199 TI - Hemorrhagic transformation in cerebral embolism. AB - We studied the mechanism of hemorrhagic infarction after acute cerebral embolism in 160 patients by brain computed tomography and angiography. Hemorrhagic infarction during the month after the embolic event was evident in 65 patients (40.6%). Initial angiography a median of 1.5 (range 1-60) days after the event revealed occlusion of the cerebral arteries in 117 of 142 patients (82.4%), and reopening of the vessels was observed in 56 (94.9%) of 59 patients who had follow up angiography a median of 20 (range 3-47) days after the event. The incidence of hemorrhagic infarction was higher in patients greater than or equal to 70 years old (31 of 61, 50.8%) than in those aged 50-69 years (27 of 72, 37.5%) or less than 50 years (seven of 27, 25.9%) (greater than or equal to 70 vs. less than 50, p less than 0.05). In patients with moderate or large infarcts, hemorrhagic infarction developed in 50.0% or 51.5%, respectively, while in those with small infarcts it developed in only 2.9% (p less than 0.05). No correlation was found between hemorrhagic infarction and history of hypertension or blood pressure during the acute stage of stroke. Thrombolytic and/or anticoagulant therapy did not affect the incidence of hemorrhagic infarction (40.0% with vs. 40.7% without therapy) but tended to cause massive hematoma. Our results indicate that hemorrhagic transformation in cerebral embolism is caused not only by reopening of the occluded vessels but also by other factors such as age and size of the infarct. Hypertension per se seems to be less important for hemorrhagic infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718200 TI - Effect of therapy on platelet activating factor-induced aggregation in acute stroke. AB - Platelet activating factor, a potent inducer of in vivo platelet activation and thrombosis, has been shown to be excessively active in acute ischemic stroke patients. Therefore, we studied the effect of aspirin/dipyridamole therapy in inhibiting platelet activating factor-induced platelet activation in acute ischemic stroke patients, 23 taking aspirin/dipyridamole and 21 untreated. Aspirin/dipyridamole-treated patients failed to show suppression of platelet activating factor-induced platelet aggregation even though collagen-induced activation was inhibited, suggesting that platelet activating factor acts by cyclooxygenase-independent mechanisms. Failure to suppress cyclooxygenase independent mechanisms of platelet activation may explain the limited usefulness of current antiplatelet therapy, aspirin in particular, in stroke prevention. The role of selective platelet activating factor antagonists both in isolation and combined with aspirin needs to be investigated for their usefulness in the treatment and prevention of ischemic stroke. PMID- 2718201 TI - Anterior choroidal artery territory infarction: a small vessel disease. AB - To investigate the cause(s) of infarction in the anterior choroidal artery territory, we studied 31 patients (18 men, 13 women) aged 19-82 (mean 58) years, with infarction in this territory documented by computed tomography. All patients were evaluated within 30 days after infarction and had carotid artery studies (arteriography in 17, duplex ultrasound in 14). Fifteen patients had echocardiography. Risk factors for atherosclerosis were chronic hypertension in 20 patients, smoking in 17, diabetes in 10, age greater than 69 years in eight, and elevated serum cholesterol concentration in three. The percentage of patients with extracranial carotid artery stenosis (four of 31, 13%) and the severity of stenosis (mild in two, moderate in two) were similar to that reported in neurologically asymptomatic individuals. The percentage of patients with intracranial carotid artery stenosis (one of 17, 6%) or potential cardiac sources of emboli (two of 31, 6%) was also low. Our findings suggest that infarctions in the anterior choroidal artery territory usually result from small-vessel disease. Associated carotid artery stenosis and potential sources of cardiac emboli are rare and may be coincidental. PMID- 2718202 TI - Ischemic threshold of brain protein synthesis after unilateral carotid artery occlusion in gerbils. AB - The threshold of the relation between regional cerebral blood flow and regional cerebral protein synthesis was investigated in gerbils submitted to a 1-hour occlusion of the left common carotid artery. Blood flow was measured with [131I]iodoantipyrine and protein synthesis with [14C]leucine using double-tracer autoradiography and trichloroacetic acid wash-incubation for removal of nonincorporated tracer radioactivity. Specific activity of blood and brain leucine and [14C]leucine incorporation into brain proteins was also measured by conventional high-performance liquid chromatography to validate the autoradiographic approach. In control gerbils, gray matter blood flow ranged between 180 and 220 ml/100 g/min and fractional amino acid incorporation was approximately 80%. Unilateral carotid artery occlusion resulted in graded ischemia with blood flow between 10 and 100 ml/100 g/min. Regional cerebral protein synthesis gradually declined at blood flows of less than 100 ml/100 g/min and approached 0 at a blood flow of 40 ml/100 g/min. This threshold for complete suppression of protein synthesis is much higher than that for maintenance of tissue energy state and suggests that the size of an infarct after focal ischemia is determined by the suppression of protein synthesis rather than by the breakdown of energy metabolism. PMID- 2718203 TI - Effect of thromboxane synthase inhibition on eicosanoid levels and blood flow in ischemic rat brain. AB - Reperfusion of ischemic brain is associated with production of thromboxane A2 (TXA2), a proaggregatory vasoconstrictor. We used an animal model of transient forebrain ischemia to study the effects of 1-benzylimidazole (1-BI), a selective inhibitor of thromboxane synthase, upon cerebral eicosanoid levels and cerebral blood flow. Male Wistar rats were subjected to 30 minutes of four-vessel occlusion. The mean +/- SEM brain level of TXB2, the stable metabolite of TXA2, determined after 60 minutes of reperfusion was 101 +/- 20 pg/mg brain protein in five ischemic control rats. Infusion of 10 micrograms/g 1-BI reduced mean +/- SEM cerebral TXB2 concentration to 11 +/- 3 pg/mg brain protein in five rats (p less than or equal to 0.002). Mean +/- SEM hemispheric cerebral blood flow measured in four ischemic control rats after 60 minutes of reperfusion was 42 +/- 9 ml/100 g brain/min compared with 104 +/- 13 ml/100 g brain/min in three 1-BI-treated rats (p less than or equal to 0.001). Mean +/- SEM hippocampal blood flow in four ischemic control rats after 60 minutes of reperfusion was 51 +/- 14 ml/100 g brain/min compared with 125 +/- 25 ml/100 g brain/min in three 1-BI-treated rats (p less than or equal to 0.04). We conclude that selective inhibition of thromboxane synthase may alleviate ischemic brain damage by reducing cerebral TXA2 concentrations and elevating cerebral blood flow. PMID- 2718204 TI - Nuclear magnetic resonance study of regional metabolism after forebrain ischemia in rats. AB - Proton nuclear magnetic resonance (NMR) spectroscopy of perchloric acid tissue extracts has been used to follow serial postischemic changes in the levels of metabolites in the hippocampus, cerebellum, frontal lobes, and parietal/occipital lobes in a rat model of short-duration (10 minutes) forebrain ischemia. Shortly (10 minutes, 1 hour) after the ischemic insult, the levels of the amino acids alanine and gamma-aminobutyric acid are elevated and that of glutamate is depressed in all regions except the cerebellum. The levels of these species return to control values by 24 hours postischemia. No changes are observed in the levels of aspartate or N-acetylaspartate. Greatly elevated levels of acetate 10 minutes postischemia, particularly in the hippocampus, may be due in part to metabolic degradation of fatty acids released due to membrane breakdown. Elevated levels of lactate persist for up to 7 days postischemia, suggesting that normal mitochondrial functioning is not fully restored following the ischemic insult. PMID- 2718205 TI - Neurologic and neuropathologic outcome after middle cerebral artery occlusion in rats. AB - Focal cerebral ischemia was produced in 45 rats by occlusion of the left middle cerebral artery. Groups of rats were investigated over a long period after occlusion, that is, from a few hours to 42 days after the production of focal ischemia. Light microscopy showed infarcts in the frontoparietal cortex and the lateral caudoputamen. The ischemic changes closely resembled those found in ischemic infarcts in humans and followed a similar pattern over time. Measurements of the sizes of the infarct, the ipsilateral (operated) hemisphere, and the contralateral hemisphere from camera lucida drawings revealed that the infarct size changed with time after occlusion. Rats killed during the first 7 days (acute phase) had the largest infarcts; in rats killed thereafter, the infarct size diminished. The size of the ipsilateral hemisphere also changed with time; during the first 7 days after occlusion this hemisphere was swollen and larger than the contralateral hemisphere. We suggest that these acute changes are caused by cerebral edema. After the first 7 days, enlargement of the ipsilateral hemisphere gave way to a significant reduction in the size of both the ipsilateral hemisphere and the infarct. We believe that the major reasons for this shift in size are resorption of fluid together with diminished production of edema and elimination of dead cells by macrophages. We suggest that the amount of tissue loss (i.e., the degree of atrophy and the remaining infarct "scar") found 21-42 days after occlusion (during the late phase) is a measure of the total amount of tissue that succumbed as a consequence of ischemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718206 TI - Influence of monosialoganglioside inner ester on neurologic recovery after global cerebral ischemia in monkeys. AB - We assessed the consequences of transitory global cerebral ischemia and the influence of monosialoganglioside inner ester (AGF 2) treatment on neurologic outcome, cerebral blood flow, and cerebral metabolic rate in monkeys over 48 hours. Global cerebral ischemia was produced by a cervical tourniquet and a lowering of blood pressure to 6.65 kPa; recirculation followed after 30 minutes. AGF 2 (30 mg/kg) was administered intravenously immediately after initiation of recirculation and intramuscularly twice a day for 48 hours. Our results show that treatment with AGF 2 significantly accelerated the rate of neurologic recovery. Improvement was evident 5 hours after ischemia; full neurologic recovery was observed in half of the monkeys 48 hours after ischemia. This recovery was associated with a less severe reduction in cerebral blood flow without a concomitant increase in the cerebral metabolic rate. PMID- 2718207 TI - Selective platelet deposition during focal cerebral ischemia in cats. AB - Platelet deposition in the microcirculation may play a role in focal cerebral ischemia. We investigated platelet deposition in selected parts of the cat brain after temporary middle cerebral artery occlusion. Ten anesthesized cats were given autologous indium-111-labeled platelets and chromium-51-labeled erythrocytes. The right middle cerebral artery was occluded with miniature aneurysm clips for 3 hours via a transorbital approach; blood pressure was reduced concomitantly to decrease the collateral circulation. Removal of the clips initiated a 45-minute period of normotensive reperfusion. After sacrifice, the brain was removed and sectioned for comparison of right- versus left hemisphere platelet deposition. Platelets were selectively deposited in the territory of the occluded right middle cerebral artery. Significant deposition was found in the caudate nucleus, internal capsule, parietal cortex, and the centrum semiovale. Our findings support the evidence that platelets are deposited in the microvasculature during temporary severe focal cerebral ischemia. PMID- 2718209 TI - Mitochondrial function after asphyxia in newborn lambs. AB - We examined mitochondrial oxidative function 5 minutes and 2 hours after a gradual asphyxial insult in newborn lambs. We subjected 16 ventilated newborn lambs to 75-90 minutes of hypoxia and hypercarbia that resulted in bradycardia and systemic hypotension over the final 15 minutes of the insult. At the end of asphyxia, the lambs were resuscitated and returned to control ventilator settings. Samples of brain were removed 5 minutes (n = 8) and 2 hours (n = 8) after asphyxia. Each group of eight lambs was subdivided into those less than 3 or greater than 3 days old to evaluate the effect of age on postasphyxia mitochondrial function. After classification into nonsynaptic and synaptic mitochondria, mitochondrial respiration (oxygen consumption) was measured using five different substrates. Data from asphyxiated lambs were compared with that from a control group of ventilated nonasphyxiated lambs (n = 8). In the lambs less than 3 days old, there was significant depression of mean +/- SEM nonsynaptic mitochondrial state 3 (adenosine diphosphate-dependent) respiration to 29.5 +/- 5.2% of control with four of the five substrates and of state 4 respiration to 33.7 +/- 0.9% of control with three of the five substrates 5 minutes after asphyxia. By 2 hours after asphyxia, mean +/- SEM nonsynaptic mitochondria state 3 respiration increased to 70.4 +/- 6.4% of control while state 4 respiration increased to 58.2 +/- 4.5% of control. In contrast, lambs greater than 3 days old exhibited no inhibition of nonsynaptic mitochondrial function after asphyxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718208 TI - Effects of a selective inhibitor of cyclic AMP phosphodiesterase on the pial microcirculation in feline cerebral ischemia. AB - We evaluated the effects of cilostazol, a selective inhibitor of cyclic adenosine monophosphate phosphodiesterase, on the pial vessels of adult cats subjected to endothelial damage followed by middle cerebral artery occlusion. Six cats were treated with cilostazol and four with 30% N,N-dimethylformamide in 70% saline (solvent). The brain surface was irradiated with ultraviolet rays through a cranial window for 3 minutes to selectively damage the endothelium of the pial vessels in both groups. Beginning 32 minutes after termination of the irradiation, the middle cerebral artery was occluded for 30 minutes. Thirty minutes before occlusion, intravenous infusion of 30 micrograms/kg/min cilostazol or 0.1 ml/kg/min solvent was begun and continued until the end of the study. Before occlusion, the infusion of cilostazol induced a significant (p less than 0.05) dilatation while the infusion of solvent produced no significant changes in the diameter of the pial arteries. The pial veins of solvent-treated cats showed significant (p less than 0.05) constriction during occlusion, whereas cilostazol treated cats exhibited only mild constriction of the pial veins. The formation of platelet thrombi after occlusion was significantly (p less than 0.05) inhibited in the pial veins of cilostazol-treated compared with solvent-treated cats. Similarly, the microcirculation of the pial veins was effectively restored after reopening of the middle cerebral artery in cilostazol-treated compared with solvent-treated cats. Our data suggest that cilostazol is an effective antithrombotic agent as well as a potent vasodilator acting on vascular smooth muscle. PMID- 2718210 TI - Positive platelet scintigram of a vertebral aneurysm presenting thromboembolic transient ischemic attacks. AB - We describe a patient with transient ischemic attacks secondary to a giant aneurysm who showed increased activity on platelet scintigrams at the origin of the left vertebral artery. This is assumed to be the first report of a presumed embolizing aneurysm with positive activity of labeled platelets. Platelet scintigraphy is useful for diagnosing transient ischemic attacks as being secondary to an aneurysm and was proved to provide direct evidence of a thromboembolic source in vivo. PMID- 2718211 TI - Intensive care for acute stroke in the community hospital setting. The first 24 hours. PMID- 2718213 TI - Clinical relevance of stroke models. PMID- 2718212 TI - Short-term results of carotid endarterectomy. PMID- 2718214 TI - Menstrual regulation training and service programs in Bangladesh: results from a national survey. AB - Using nationally representative sample survey data collected in 1986, this study evaluates the training and service programs for menstrual regulation (MR), and estimates the number of MR procedures performed during 1986, in Bangladesh. The results show that most of the MR providers, who received either formal or informal training, were physicians and family welfare visitors (paramedics) employed by the government. They were trained in various aspects of MR performance, including contraindications and complications associated with MR, the techniques of MR performance and follow-up procedures, and maintenance and sterilization of MR equipment. Averages of 20.5 and 13.0 MR procedures were performed by formally and informally trained physicians, respectively, in the three-month period preceding the date of interview. The corresponding average numbers for formally and informally trained family welfare visitors were 11.6 and 9.1, respectively. A total of 241,442 MR cases were estimated to have been performed between August 1985 and July 1986. PMID- 2718215 TI - Ecuador 1987: results from the demographic and health survey. PMID- 2718217 TI - Artificial and reconstituted membrane systems. PMID- 2718216 TI - The cross-cultural study of fertility among Hispanic adolescents in the Americas. AB - This paper examines various definitions of marriage in order to compare the nonmarital fertility of Hispanic adolescents in the Americas. The data include distributions of legal marriages and consensual unions among adolescents in Latin America, proportions of Latin American adolescents who have borne a child by categories of marriage and consensual unions, marital distributions among Hispanic adolescents in the United States, and fertility by marital status for young US Hispanics. The vast majority of young women in Latin America report never having been married or in union, although more reported living in consensual union than in legal marriages. Rates of childbearing are low among women who report never having been consensually or legally married. Foreign-born Hispanic women are considerably more likely to be married than their US-born compatriots. Foreign-born women from countries with high rates of consensual unions are more likely than young US-born women to have had a premarital birth; in contrast, foreign-born women from countries with low rates of consensual unions are less likely to have borne a child. PMID- 2718218 TI - Individual variability of amiodarone distribution in plasma and erythrocytes: implications for therapeutic monitoring. AB - The complexity of amiodarone disposition in blood and tissues gives rise to difficulty in determination of optimal therapeutic monitoring strategies. We have defined the within-patient variability of plasma and erythrocyte amiodarone and desethylamiodarone concentrations and electrocardiogram intervals [PR and corrected QT (QTc)] in 27 patients each sampled on three to four occasions during long-term stable amiodarone therapy. All individual repeated measurements were included in the concentration-effect analysis. The mean within-patient coefficients of variation for amiodarone and desethylamiodarone were significantly greater in erythrocytes, 46.0 and 24.5%, respectively, compared with plasma, 12.7 and 12.3%. Amiodarone and desethylamiodarone were significantly greater in erythrocytes, 46.0 and 24.5%, respectively, compared with plasma, 12.7 and 12.3%. Amiodarone and desethylamiodarone were strongly correlated (r = 0.29 p less than 0.004). There was a 10-fold variability in erythrocyte amiodarone for a given plasma level. These data emphasize the highly variable cellular distribution of amiodarone and desethylamiodarone in the same patient on stable dosage over time. Plasma amiodarone was significantly correlated with dosage (r = 0.98), and percent change in QTc, (r = 0.56, p less than 0.0001), but there was a fourfold variation in plasma amiodarone for a given QTc. Side-effect frequency was not related to plasma or erythrocyte amiodarone or desethylamiodarone concentrations. A clinically useful relationship between plasma concentration and effect could not be consistently demonstrated for amiodarone in the same individual during stable dosage. PMID- 2718219 TI - Pharmacokinetics of daunorubicin and doxorubicin in plasma and leukemic cells from patients with acute nonlymphoblastic leukemia. AB - The pharmacokinetics of daunorubicin and doxorubicin were studied in plasma and leukemic cells from 16 patients with acute nonlymphoblastic leukemia during 19 courses of treatment with the unconjugated or DNA-conjugated drugs. Daunorubicin and doxorubicin are high-clearance drugs with very high apparent volumes of distribution, indicating a pronounced tissue affinity. This was more pronounced in the case of doxorubicin and may explain the reduced cardiotoxicity of the DNA complexes. Daunorubicin reached higher intracellular peak concentrations than doxorubicin, but the latter drug was retained much longer. The cell/plasma concentration ratio was higher for daunorubicin than for its reduced metabolite daunorubicinol. No doxorubicinol was found intracellularly. The observed differences in cellular pharmacokinetics between daunorubicin and doxorubicin may explain the difference between the clinical activity spectras of these two drugs. DNA-conjugation did not markedly modify the uptake of daunorubicin in the leukemic cells, whereas the mean intracellular accumulation of doxorubicin was 60% higher when the drug was administered as a DNA-conjugate. This may enhance the selectivity of doxorubicin in the treatment of acute leukemia. PMID- 2718220 TI - Comparison of aminoglycoside clearance and calculated serum creatinine clearances. AB - Calculated creatinine clearance (CrCL) estimates are frequently used as estimates of aminoglycoside clearance (AGCL), despite being inadequately studied. Thirty surgical intensive care unit (SICU) patients with stable serum creatinines (0.6 6.3 mg/dl) and steady-state aminoglycoside levels were studied. A one-compartment pharmacokinetic infusion model was used to calculate k and Vd; AGCL = (k) (Vd). CrCLs using the equations of Cockroft-Gault (CGCL), Jelliffe (JCL), and Jelliffe uncorrected for body surface area (JCLu) were calculated, then compared to the AGCL. The JCLu was a better fit to the data (y = 0.98x + 0.44, r = 0.91) with a superior regression correlation (p less than 0.02) than CGCL (y = 0.91x + 6.07, R = 0.89) and JCL (y = 1.11x + 2.11, R = 0.89) correlations. CGCL overpredicted the AGCL whereas JCL and JCLu underpredicted the AGCL. All three methods showed a precision of approximately 20 ml/min. Relative bias and precision show JCLu better than JCL, CGCL better than JCL only for bias, and CGCL and JCLu not different. The absolute percentage error of the CrCL estimates tended to be lower at higher AGCL and did not differ for CGCL, JCL, and JCLu. In the SICU setting, we suggest the use of the JCLu for estimating the AGCL. PMID- 2718221 TI - Distribution of enprofylline and theophylline between plasma and cerebrospinal fluid. AB - Six patients undergoing diagnostic lumbar myelography were studied with respect to plasma and cerebrospinal fluid (CSF) concentrations of two xanthine drugs- enprofylline and theophylline. Three patients received enprofylline and three patients received theophylline, 200 mg t.i.d., and plasma and CSF were sampled on the morning of the third day of treatment. CSF plasma ratios averaged 0.095 with enprofylline (range of 0.094-0.097) and 0.36 with theophylline (range of 0.35 0.37). The different ratios of the two drugs contrast to their similar plasma protein binding, about 50%. Different lipophilicity or differences with regard to transport out of the CSF may explain the discrepancy. PMID- 2718222 TI - Clinical assessment of a published model to predict aminoglycoside-induced nephrotoxicity. AB - During the past decade, several patient risk factors have been identified as contributing to the development of aminoglycoside nephrotoxicity. Sawyers et al. recently published a method for estimating the probability of aminoglycoside nephrotoxicity on an individual patient basis. The present work represents a refinement of previous publications and has not been tested with the common variations used in aminoglycoside dosing. The purpose of this study was to determine both the qualitative and quantitative value of this method in predicting aminoglycoside induced nephrotoxicity. Eighty-three patients (47 male, 36 female) meeting the inclusion criteria of Sawyers et al. were entered into the study. Patient risk factors (age, sex, initial 1-h postinfusion aminoglycoside serum level, initial calculated creatinine clearance, duration of therapy, and presence of liver disease) were entered into a logistic regression analysis to determine the individual patient's risk of developing nephrotoxicity. These calculated probability scores were then compared with the observed nephrotoxicity in specific groups within our patient sample to see how effectively the model quantitatively performed. Twelve patients (14.5%) developed nephrotoxicity. The model predicted only 5 of the 12 patients developing nephrotoxicity (sensitivity or true positive = 42%). In the nonnephrotoxic group, the model accurately predicted only 38 of 71 patients (specificity or true negative = 54%). These data suggest that the model may accurately quantitate the number of patients likely to develop nephrotoxicity from a specific group but is unable to discriminate specific patients at risk of developing aminoglycoside-induced nephrotoxicity. PMID- 2718223 TI - Stereoselective interaction of omeprazole with warfarin in healthy men. AB - The effect of concomitant treatment with omeprazole (20 mg/day) on the plasma concentration and anticoagulation effect of warfarin was studied in 21 young healthy men. An initial three weeks' treatment with warfarin alone was administered to determine the doses required for the subjects' vitamin K dependent coagulation factors to fall within 10-20% of the normal range, as determined by the Trombotest. Omeprazole and placebo were then administered concomitantly with warfarin for 2 weeks each in a double-blind, randomized, crossover fashion. Plasma concentrations of (R)- and (S)-warfarin, and Trombotest values were measured daily on weekdays throughout the crossover period. Omeprazole had no apparent effect on the mean (S)-warfarin plasma concentration (379 ng/ml with, versus 387 ng/ml without, omeprazole), but caused a slight (12%) although statistically significant increase in the mean (R)-warfarin concentration from 490 to 548 ng/ml (95% confidence interval for difference of means: 28-88). The Trombotest values exhibited large inter- and intrasubject variability during both omeprazole and placebo treatment; however, there was a small, although statistically significant decrease in the mean value from 21.1% without to 18.7% with omeprazole treatment (95% CI for difference of means: -4.6- -0.1). Those subjects with Trombotest values nearest the therapeutic range (5 15%) exhibited less change during omeprazole treatment, and no changes occurred that required a change in warfarin dosing. The interaction of omeprazole with warfarin was attributed to a stereoselective inhibition of the hepatic metabolism of the less potent (R)-warfarin enantiomer. The small effect of omeprazole on the anticoagulation activity of warfarin is not likely to be of clinical importance. PMID- 2718224 TI - External quality assurance of tricyclic antidepressant measurements in serum: eight years of progress? AB - Comparison of the precision and accuracy of measurements made between December 1979 and January 1988 of tricyclic antidepressant drug concentrations in freeze dried external quality-assurance samples of human serum showed only occasional significant differences between the different chromatographic techniques used for drug assay. Larger differences between data collected in different years correlated with changes in the source of the sample matrix and the personnel responsible for sample preparation. Measurements of amitriptyline and imipramine were more precise than those of nortriptyline and desipramine; the mean coefficients of variation of measurements were 20.2, 19.6, 26.6 and 25.3%, respectively. The data indicate the need for further interlaboratory studies directed at reducing the high level of variability in tricyclic measurements. PMID- 2718225 TI - Thin-layer chromatographic screening test for polymorphic sparteine oxidation. PMID- 2718226 TI - No significant in vitro interference of diltiazem and metabolites in digoxin radioimmunoassay (four assay methods). PMID- 2718227 TI - Indications and applications for iontophoresis. AB - 1. As a noninvasive therapy, iontophoresis is growing in popularity among anesthesiologists, pediatricians, general and orthopedic surgeons, burn specialists, and the dental community. 2. As specific conductivity potentials were established for various chemicals and drugs, it has been shown that numerous broad spectrum, site-specific, systemic-acting medications can be directly introduced across intact skin to treat a wide range of maladies. 3. Unlike injectable medications which tend to peak and trough, phoresed medications can be accurately controlled and titrated over a specific period of time. 4. As health professionals re-evaluate where and how care is delivered, many are selecting iontophoresis as a cost-effective alternative to traditional therapy. PMID- 2718228 TI - Proper positioning eliminates patient injury. AB - 1. Pre-existing disorders such as poor nutritional state, diabetes, respiratory disorders arthritis, and cardiac status compound the effects of positioning. 2. Under anesthesia, the patient may be placed in a potentially injurious position that he could protect himself against otherwise. 3. Position influences respiration by mechanical restriction of the ribs and sternum, and by reduced ability of the diaphragm to push down against the abdominal contents. 4. Informed involvement of the operating room nurse will minimize risk to the patient who is defenseless under anesthesia. PMID- 2718229 TI - Selective extraction of plasma constituents. PMID- 2718230 TI - Donor pool sizes for HLA matching. PMID- 2718231 TI - 5-day storage of single-donor platelets obtained using a blood cell separator. AB - Platelets were collected from normal donors via a blood cell separator (Fenwal CS 3000). Platelets were stored initially in two separate 1000-ml bags (average count per bag, 2.3 +/- 0.5 x 10(11)) in 100 ml of autologous plasma for 5 days. Little change in platelet count was noted after 5 days of storage; however, the white cell count fell from 5.1 +/- 1.7 x 10(9) at Time 0 to 3.4 +/- 2.3 x 10(9) per l at Day five. The initial lactate values were 32 +/- 11 mg per dl and rose to 165 +/- 28 mg per/dl by 5 days. Platelet aggregation was impaired both by the collection procedure and during storage: whereas the response to ADP of the donors' platelets before the procedure was 100 percent, samples taken from the product immediately after collection had only a 45 percent response, which fell to 12 percent by Day 5. Aggregation using epinephrine was similarly affected, with a 75 percent response after collection and 0 percent response by Day 5. The plasma beta-thromboglobulin (beta-TG) level was high, both after collection (5.0 micrograms/ml at Time 0) and after storage (11.0 micrograms/ml), indicating a considerable effect of collection on platelet alpha granule release. In vivo recovery of these platelets was very good at 67 +/- 6 percent, with an average survival of 7.3 +/- 1.4 days (multiple hit; n = 4).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718232 TI - Evidence that SE is distal to LU on chromosome 19q. AB - Analysis of a family informative for chromosome 19 loci establishes that the Lutheran blood group locus (LU) lies between the third component of human complement (C3) and the secretor loci (SE). Previously published lod scores for C3:LU are increased from 2.94 to 3.80. The linkage relationships (zeta and theta) between C3, LU, and SE are examined, and the proposed order and approximate genetic distances are determined to be: pter--C3-10.6cM-cen-7.4cM-LU-9cM-SE- qter. PMID- 2718233 TI - A model to determine required pool size for HLA-typed community donor apheresis programs. AB - Community donor plateletpheresis programs must have adequate numbers of HLA-typed donors to support the transfusion needs of alloimmunized patients, and donor pool size calculations should reflect the fact that each patient needs more than one donor to provide his or her support. The average number of donors needed to provide a patient's support was estimated as a function of donor usage and commitment. A model was developed for determining an appropriate size of the donor pool for a community donor plateletpheresis program that would incorporate the average number of donors needed per patient, the level of HLA compatibility to be maintained between patient and donor, and the frequencies of patient and donor HLA phenotypes. A database of 4338 plateletpheresis transfusions given to 591 patients from a pool of up to 870 community donors over a 3-year period was analyzed retrospectively to validate the estimates of the average number of donors needed to support a patient, which ranged from 4 to 33 donors. This database was also used to illustrate the application of the pool size determination model. Model results suggest that plateletpheresis donor pools of 1000 to 3000 donors are capable of meeting the transfusion needs of most patients at an HLA-match grade of B2 or better. PMID- 2718234 TI - Stability of platelet and plasma HLA concentrations in healthy adults or random donor platelet concentrates. AB - The quantitative differences between the platelet HLA antigens of different individuals are potentially significant in determining the survival of transfused platelets in allosensitized patients. To learn whether platelet HLA concentration is sufficiently stable to be documented for each donor and used for donor selection, platelet and plasma HLA concentrations in five healthy adults were measured monthly for 5 consecutive months. HLA concentrations were measured by using a competitive enzyme-linked immunoassay. The results showed that both platelet and plasma HLA concentrations varied within +/- 20 percent of the mean values in each individual. Changes in plasma and platelet HLA concentrations were also studied in 5 units of random-donor platelets during in vitro storage. HLA concentrations were determined every other day over a 5-day period. There was no significant quantitative change in the platelet and plasma HLA concentrations during the 5 days of in vitro storage. Thus, platelet HLA concentrations in healthy individuals are stable and may be quantitatively documented for donor selection. PMID- 2718235 TI - Homozygous familial hypercholesterolemia. Selective removal of low-density lipoproteins by secondary membrane filtration. AB - Selective plasma filtration with a hollow-fiber membrane device was compared prospectively to plasma exchange in the therapy of a patient with homozygous familial hypercholesterolemia. Four liters of patient plasma was removed biweekly during each of six consecutive plasma exchanges, after which 20 consecutive biweekly 4-liter filtration procedures were conducted. The hollow-fiber membrane retained 94 percent of the low-density lipoprotein (LDL) cholesterol presented to it, and allowed passage of 83 percent of the albumin, 68 percent of the IgG, and 47 percent of the high-density lipoprotein (HDL) cholesterol. Both plasma exchange and plasma filtration decreased the patient's total and LDL cholesterol levels by 80 percent. However, filtration removed significantly less HDL than did exchange (54 versus 71% reduction in HDL levels, respectively); preserved significantly higher levels of IgG, clotting factors, and complement components; and avoided the need for expensive albumin replacement solutions. In addition, the patient tolerated the filtration procedures significantly better than the exchanges. Newer apheresis techniques that selectively deplete plasma of LDL cholesterol, such as secondary membrane filtration, are likely to replace plasma exchange as the therapy of choice in patients with homozygous hypercholesterolemia. PMID- 2718236 TI - Impact of explicit questions about high-risk activities on donor attitudes and donor deferral patterns. Results in two community blood centers. AB - Concern about the ineffectiveness of indirect questioning of donors about participation in activities with a high-risk of exposure to human immunodeficiency virus (HIV) led our two community blood centers independently to begin direct and explicit questioning of donors about such activities. The impact of direct questioning was assessed via a donor attitude survey and by comparing the number of donors deferred for a positive response to a direct verbal question with the number previously deferred for a positive response to indirect questions. Our donor attitude survey indicated 90% donor approval of direct questioning, and analysis of donor deferral patterns indicated almost a five-fold increase in the number of donors deferred for participation in high-risk activities. Our experience documents the acceptability of direct questioning of donors and indicates that such questioning may well have a positive impact on blood safety. PMID- 2718237 TI - HIV 2 infection among blood donors and other subjects in France. The "Retrovirus" Study Group of the French Society of Blood Transfusion. AB - During a 3 year period, from August 1985 to August 1988, 18 HIV 2-infected blood donors were detected in France as a result of systematic HIV 1 screening. These sera were characterized as HIV 2 by specific Western blot and synthetic peptides. Within the same period, 40 other HIV 2 infected subjects were identified by our study group, independently of blood donations. Thirty of these 58 subjects living in France originate from West Africa (8 blood donors), 3 (I blood donor) are Portuguese men who had lived in West Africa and 25 (9 blood donors) are of French origin; among these, 16 have had a known close contact with West Africa. When HIV 2-infected subjects were asymptomatic, cross reactivity between antibodies to HIV 2 and HIV 1 proteins was generally observed with the two-step ELISA assays using total HIV 1 proteins; it was poor with the competitive assays and variable with the assays using recombinant proteins. When the subjects had signs of immunodeficiency, cross reactivity decreased. The data confirm that HIV 2 is not widespread in France and that most of HIV 2-infected but asymptomatic subjects are recognized by several HIV 1 ELISA assays. Accordingly, systematic screening for HIV 2 with an additional test cannot be recommended at the present time, but a combined HIV 1 and HIV 2 test will be useful when available. PMID- 2718238 TI - DDAVP and blood donors. PMID- 2718239 TI - Prevention of transmission of human T-cell lymphotropic virus type-I by blood transfusion by screening of donors. PMID- 2718240 TI - Infectious complications due to transfusion acquired Yersinia enterocolitica. PMID- 2718241 TI - Estimating the safety of autologous blood units available for transfusion to homologous recipients. PMID- 2718242 TI - Clinicopathological study of livers from brain-dead patients treated with a combination of vasopressin and epinephrine. AB - Studies were made on the pathological lesions and biochemical indices of the livers of 22 patients in whom normal hemodynamics was maintained for 0-48 days after brain death by administration of vasopressin and epinephrine. Thirty-one specimens of liver tissues were obtained by percutaneous biopsy or at autopsy. The degrees of central venous congestion, central fibrosis, focal fibrosis, fatty metamorphosis, piecemeal necrosis, periportal fibrosis, and intrahepatic cholangitis in livers on various days after brain death were compared with those on the day of brain death (day 0). Central venous congestion was extensive on days 0-4, significantly less on days 5-14, and then again extensive on days 15 48. Central fibrosis and focal fibrosis showed no remarkable change during the 48 day period. Fatty metamorphosis, piecemeal necrosis, and periportal fibrosis showed no significant changes until day 16, but spread extensively on days 40-48. Intrahepatic cholangitis was scarcely observed on day 0 but began to increase after day 3, and spread extensively after day 5. The level of serum glutamic pyruvic transaminase did not increase in most patients until day 15. The mean value of prothrombin activity also did not decrease until day 15. However, the mean value of serum alkaline phosphatase increased gradually after day 3, and was correlated with cholangitis. The present study showed that during prolonged hemodynamic maintenance of brain-dead patients, pathological lesions did not spread or diminished and that biochemical indices did not become worse, or improved, in the first 2 weeks, except for increases in cholangitis and the serum alkaline phosphatase level. PMID- 2718243 TI - Anterior and posterior pituitary function in brain-stem-dead donors. A possible role for hormonal replacement therapy. AB - Blood samples were obtained, at the time of organ donation, from 31 consecutive brain-stem-dead (BSD) donors referred to one transplant coordinator during a 9 month period. Twenty-four cases (77%) had clinical diabetes insipidus (DI), which was poorly controlled with marked dehydration in a majority of cases (serum osmolality range 268-357; median 302 mOSM/kg). Serum triiodothyronine (T3) was subnormal in 25 (81%); all had normal or high serum reverse T3; and the serum free thyroxine (T4) index was subnormal in 9 (29%), and TSH was subnormal in 7 (23%). In no case were T4 and TSH both subnormal and results were typical of the sick euthyroid syndrome rather than TSH deficiency. Of 21 cases not receiving corticosteroids, 5 (24%) had a serum cortisol above 550 nmol/L (20 micrograms/dl), excluding ACTH deficiency, and only 1 had undetectable cortisol levels. Those with severe hypotension did not have significantly lower serum cortisol (mean 354 vs. 416; P greater than 0.5). Levels of prolactin, growth hormone, gonadotrophins, and gonadal steroids were variable, but only a minority were frankly deficient in these hormones. BSD donors frequently have DI, which is often managed poorly by nonspecialists and requires appropriate replacement therapy. In contrast most patients are not totally deficient in anterior pituitary hormones. Routine hormonal therapy with cortisol and T3 cannot, therefore, be justified on endocrinological grounds. Widespread introduction of such treatment should only follow controlled trials that clearly demonstrate clinically significant improvement in the transplanted organ function, without detriment to the donor. PMID- 2718244 TI - The quick western blot, a novel transportable 50-minute HIV-1 antibody test. Application in organ procurement for transplantation. AB - HIV-1 antibody determination by ELISA screening takes 4 hr to complete and is not reliable. Regular Western blot can take up to 24 hr. This makes organ transplantation both difficult and risky with regard to HIV-1 transmission. We developed a modification of the Western blot technique that takes under 50 min, is transportable, is definitive on site, and does not delay organ retrieval. This test has been called the Quick Western Blot. We examined 459 serum specimens from referrals; from the AIDS Testing Proficiency Panel, Walter Reed Army Institute of Research; and from 36 organ donors. All specimens were tested by ELISA HIV-1 Ab screening, the regular Western blot, and by the Quick Western Blot. The organ donors were initially tested on-site during organ procurement by the Quick Western Blot and later had complete testing by the reference methods. Compared with regular Western blot, the ELISA showed a specificity of 78.4% and a positive predictive value of 65.5%, whereas the Quick Western Blot was as reliable and specific as the regular Western blot, but much quicker. Because of the rapidity and specificity of the test, this test has particular utility in the screening of organ donors, as was shown in a case of multiple organ donation where the ELISA was negative, but the Quick Western Blot was found positive and thereby prevented the donation of HIV-1 infected organs. PMID- 2718245 TI - In vitro cytotoxicity in adult Xenopus generated against larval targets and minor histocompatibility antigens. AB - Our experiments reveal that application of several minor H antigen-disparate skin grafts to adult Xenopus over an 18-month period can lead to in vitro generation of CML reactivity toward these minor antigens. Furthermore, we demonstrate that, following MHC-disparate skin graft rejection, adult effectors can efficiently kill both adult and larval donor-strain targets; this killing is MHC-specific and requires MLC restimulation with cells syngeneic to the skin graft donor. The ability to kill larval lymphoblasts, which have been shown elsewhere to be MHC class I-negative but class II-positive, suggests the probable importance of class II-restricted killing in this species. PMID- 2718246 TI - Longitudinal monitoring of cyclosporine using a radioimmunoassay specific for the parent drug. PMID- 2718247 TI - Disparate activities of human natural killer cell clones against allogeneic bone marrow and tumor cell targets. PMID- 2718248 TI - Short-term immunologic memory in the allograft response of the American cockroach, Periplaneta americana. PMID- 2718249 TI - Protection of mice against acute lethal graft-versus-host disease by treatment with anti-asialo GM1 antibody. Alopecia dermatitis in long-term survivors. PMID- 2718250 TI - Absence of interaction between cyclosporine and spiramycin. PMID- 2718251 TI - Spreadsheets, data handling and statistics. PMID- 2718252 TI - Prognostic factors in intestinal gangrene. AB - 103 patients with intestinal gangrene were treated over a ten-year period in Ile Ife, Nigeria. The various causes of the intestinal gangrene were herniae (63%), intussusception (20%), adhesions (12%), volvulus (3%) and mesenteric vascular occlusion (2%). The presence of pre-operative shock, purulent and faeculent peritonitis, intra-peritoneal perforation of bowel and involvement of long bowel segments in the gangrene process; constitutes the important prognostic factors. The presence of a pre-operative febrile response also influences the course of the disease while the age and sex of the patient, the duration of symptoms and the portion of bowel involved showed no relationship with the ultimate outcome. It is recommended that the patients with the ominous prognostic factors constitute a high risk group and should be given intensive care to ensure survival. PMID- 2718253 TI - Malignancies of upper gastrointestinal tract in Nigerians: early symptoms and prognosis. AB - A total of 237 patients with confirmed malignancies of the upper-gastrointestinal tract (UGIT) were studied. Of these, 143 (60.34%) were gastric cancers, 66 (27.85) were oesophageal malignancies and 28 (11.81%) were in the small intestine. Epigastric pain accompanied by vomiting after meals was the commonest first symptom in patients of gastric cancer whereas dysphagia formed the commonest first symptom in oesophageal cancer. However, no definite first symptom could be attributed to those with small intestinal tumors. As many as 134 patients (56.54%) had advanced malignancies at presentation itself. The usefullness of first symptoms in early diagnosis and prognosis is discussed. PMID- 2718254 TI - Acute intestinal obstruction in Nigerian children. AB - Over a 7 year period, intestinal obstruction accounted for 41.7 per cent of abdominal emergencies and 1.03 per cent of all paediatric admissions at the Obafemi Awolowo University Teaching Hospital in Ile-Ife, Nigeria. Of the total 76 cases of acute intestinal obstruction, intussuception was seen in 34 (44.7%), peritoneal adhesions in 17 (22.4%), obstructed hernia in 14 (18.4%), roundworm impaction in 4 (5.3%), volvulus in 3 (4.0%) while faecal impaction and mesenteric cysts were encountered in 2 children each (2.6%). Generally the patients presented late to the hospital and this accounted for the high post-operative morbidity and prolonged hospital stay. Wound infection occurred in 21.1 per cent of patients and formed the commonest post-operative complication. The overall mortality was 21.1 per cent. PMID- 2718255 TI - Differential diagnosis of ascitic fluid: evaluation and comparison of various biochemical criteria with a special reference to serum ascites albumin concentration gradient and its relation to portal pressure. AB - Among various biochemical indices measured in 93 patients with ascites, ascitic LDH estimation was proved to be indiscreminatory, while ascites/serum LDH ratio has shown a diagnostic accuracy of 85 per cent. Ascitic total protein levels and ascites/serum total protein ratio (accuracy rates of 72 and 77% respectively) were limited, especially in differentiating the ascites due to heart failure. Serum ascites albumin gradient, showed a strong correlation to portal pressure (r, + 0.83 + 0.88), and was found to be the best diagnostic index (with an overall accuracy of 97 per cent) in distinguishing the 'transudative' from 'exudative' ascites. However, no index could discreminate the 'mixed' cases and provide the etiological diagnosis of the ascites. PMID- 2718256 TI - Western blotting. PMID- 2718257 TI - [Use of a gelatin substrate for culturing diploid human skin fibroblasts]. AB - Gelatin coating of the growth surface of commercially available polystyrene Petri dishes is proposed for successful cultivation of human skin fibroblasts. A comparison of culture growth dynamics on gelatin, glass and polystyrene allowed to recommend gelatin as the substrate in order to receive an abundant similar material with a low population density viability. The absence of changes in carbohydrate metabolism changes during cell culturing on gelatin provides an opportunity to use these cells in studying regulation of carbohydrate metabolism. PMID- 2718258 TI - [Electron microscopic research on the manifestations of transport-metabolic interactions in intraocular nerve tissue grafts]. AB - Electron microscopic study of intraocular grafts of the septal and hippocampal nervous tissue revealed intensive transport and metabolic interactions between various types of the cells. High level of transport exists between the recipient's blood and intraocular fluid, on the one hand, and the graft, on the other one; the abundance of pinocytotic vesicles in the endothelium, pericytes and the glial end-feet of the capillaries, and the presence of microvilli and cilia on the graft limiting glia. Signs of active communications between interstitial glial cells, as well as between gliocytes and neurons, such as pinocytosis and gap junctions were observed. Similar interactions exist between various parts of nerve cells. Besides, there is an evidence of microphagocytic interactions, particularly between pre- and postsynaptic elements, as shown by the presence of so-called spinules. An unusual fact was observed of internalization of cytoplasmic fragments of the degenerating neuron by contacting synaptic boutons. It is suggested that the high level of transport and metabolic processes may reflect adaptive and compensatory processes in the nervous tissue developing under strict limitations of the neural and neurotrophic influences. PMID- 2718259 TI - [The action of inhibitors of sugar transport phlorizin, phloretin and cytochalasin B in model systems]. AB - Phlorizin, phloretin and cytochalasin B are known to be specific sugar transport inhibitors. A study was made of their effects on the carbohydrate-protein interaction in solution as a model system for examining the initial steps of sugar membrane transport. Glycogen precipitation by concanavalin A is inhibited only by alpha-methylmannoside, whereas both phlorizin and phloretin inhibit interactions between hexokinase and glucose, and between glucose-6-phosphate dehydrogenase and glucose-6-phosphate. Cytochalasin B was found to exert no effect on both the concanavalin A--glycogen interaction and the enzyme reactions investigated. The data obtained in the model system examination may suggest that the sites of glucose and cytochalasin binding are, respectively, spatially uncoupled. PMID- 2718260 TI - [Effect of the innervation on the structural state of F-actin in rat fast muscles]. AB - Effect of denervation and damage of the spinal cord on the structural state of F actin in muscle extensor digitorum longus of a rat was studied by polarized microfluorimetry in the ultraviolet light region. The ability of F-actin to change its conformation at ATP binding was used as a test. The character of the changes in tryptophan polarized fluorescence induced by ATP binding was different at muscle denervation and at the damage of the spinal cord. A suggestion is made that the structural state of F-action in muscle fibres may depend on muscle innervation. PMID- 2718261 TI - [Enzymes of the phosphogluconate pathway in amebas]. AB - Glucose-6-phosphate and 6-phosphogluconate dehydrogenases (G6PD and 6PGD) are revealed in Amoeba proteus by electrophoresis in polyacrylamide gels, thus proving the availability of the phosphogluconic pathway in amoebae. 6PGD is marked as a single band, and G6PD shows multiple banding. When an amoebic homogenate is obtained using Triton-100, a supplementary form of G6PD extracted from membranes of some cell organelles (presumably mitochondria) becomes apparent. Hexose-6-phosphate dehydrogenase seems to be absent and therefore all the G6PD forms found may be specific G6PDs proper. PMID- 2718262 TI - [A new cell line of rat gasserian ganglion neurinoma NGUK-1]. AB - A new cell line has been derived from the rat gasserian ganglion neurinoma NGUK-1 induced by transplacental administration of ethylnitrosourea. It is characterized by an astrocyte-like growth pattern at the low cell density, and by an epitheliocyte-like pattern in the confluent monolayer. The cell line displays a high proliferative activity, its maximum mitotic index and proliferative pool being--2.5 and 96%, respectively. The chromosome number ranges between 20 to 100. The chromosome modal number is 39--44. The new cell line has been used for the express diagnostic of rabies, for determination of serum glial toxicity in neurologic patients, and interferon titration. PMID- 2718263 TI - [Indications for elective surgery of stomach ulcer. A physician's views]. AB - The surgical as well as the medical treatment of peptic ulcer disease has changed significantly during the last 15 years, and as a consequence, indications for surgery have also changed. It is pointed out that "persistent ulcer" is not as clear an indication as often thought because persistence is only relative, depending on length and intensity of treatment. Furthermore studies have shown bad results after surgery for ulcers "resistant" to medical treatment. Frequent relapses after short-term treatments represent an indication for either prophylactic long-term medical treatment or surgery. Long-term treatment with H2 antagonists has only rare, benign and reversible side-effects. A proximal gastric vagotomy has a near-zero mortality and complications are rare, but the recurrence rate varies from 5 til 30% in five years, depending on the surgeon's skill. The indication for surgery should therefore also consider the local recurrence rate. Some ulcers relapse during prophylactic long-term medical treatment, and this is often considered an indication for surgery. It should however be kept in mind that the efficacy of surgery is only due to acid reduction, and therefore a similar effect can be obtained by adjusting the acid inhibitory drugs to the same level of acid secretion. A few patients who need long-term treatment cannot afford to buy the drugs and ask for a "free" operation, and some patients are so worried about taking drugs that they should be offered an operation. PMID- 2718264 TI - [Myelomatosis. A study of 138 patients treated with melphalan, prednisone and vincristine with particular attention to the prognostic value of a stage subdivision]. AB - With the object of evaluating three recognized prognostic stage subdivision systems for myelomatosis, retrospective data from 138 patients treated from 1976 to 1986 were employed. During this period, uniform therapeutic principles were employed, viz interval treatment with melphalan and prednisone supplemented, in cases of anaemia or raised serum creatinine, with vincristine. The prognostic significance for survival was calculated from variables at the time of diagnosis. The major prognostic factors were: age, tumour cell mass assessed by plasma cell percentage in the bone-marrow aspirate and/or M-component concentration, demonstration of Bence-Jones protein, renal function and the haemoglobin and calcium concentrations in the blood. Stage subdivision according the principles established by the Medical Research Council based on haemoglobin concentration and renal function were the best for assessing the prognosis in treated patients. Autopsy was performed on 55 out of the 96 patients who had died. The commonest cause of death was infection (75%). PMID- 2718265 TI - [Preoperative evaluation of arteriosclerotic symptoms in the lower extremities by means of intravenous digital subtraction angiography]. AB - Intravenous DSA was performed in 106 patients with symptoms of arterial insufficiency in the lower extremities, requiring treatment according to preceding clinical examination. The examinations were carried out using a 36.5 cm (14 in.) intensifier and a 5.5 F pigtail catheter located centrally. 71% of the examinations were carried out on out-patients. No complications were observed. In 96% of the cases, the intravenous DSA provided sufficient information to make decisions about treatment. PMID- 2718266 TI - [Use of controlled hyperventilation in the treatment of comatose patients with cranial injuries]. AB - Controlled hyperventilation is a recognized method by which it is possible to reduce the intracerebral blood volume and thus the intracranial pressure (ICP). In the review, the physiological conditions involved in the regulation of ICP are illustrated, particularly in connection with acute cranial traumata and effect of controlled hyperventilation in these situations is discussed. Controlled hyperventilation is recommended in the hyperacute phase for all patients with cranial trauma prolonged impairment of consciousness (Glasgow Coma Scale less than 7 for more than 30 minutes) and other clinical evidence of expanding space occupying intracranial process. Prolonged hyperventilation is recommended for younger patients as these have most frequently hyperaemia and retained CO2 reactivity and for patients with predominantly cortical lesions as assessed by CT scanning. Caution in the employment of hyperventilation is advised in elderly patients, severely traumatized patients and late in the course of cerebral trauma. PMID- 2718267 TI - [The suicidal patient. 1. Occurrence and relevance of contact with a general practitioner prior to the suicidal actions]. AB - A multipractice investigation was undertaken concerning suicidal behaviour. Sixty six patients committed suicide and 227 attempted suicide. During the month prior to the suicidal actions, 2/3 of the patients had had contact with their general practitioners. Only very few had been in contact with a psychiatric department or with a practising psychiatrist during the same period. In a few cases, the general practitioner found that the most recent consultation was relevant in cases of patients who committed suicide. 28% of the patients who committed suicide and also were seen by their general practitioners within the last month suffered from serious somatic disease. Where the cases of attempted suicide were concerned, the general practitioners considered that 40% of the most recent consultations were relevant. In order to improve attention to suicidal signals, other forms of cooperation between the primary sector and hospitals, eg in the form of district psychiatric teams, are suggested. PMID- 2718268 TI - [The suicidal patient. 2. Methods of suicide, diagnoses and social conditions]. AB - By means of a multipractice investigation in which 347 general practitioners participated, 293 schemata were collected about patients who had undertaken suicidal acts. The material consists of 66 suicides and 227 attempted suicides. By and large, the sex and age distributions correspond to those in previous investigations. The number of attempted suicides in this investigation was only half of that anticipated. This may be due to lapse, seasonal variations, underrepresentation of urban practice etc. Strikingly many patients undertook acts in this material without having psychiatric diagnoses and the psychiatric diagnosis did not appear to play any part as regards whether the suicidal act lead to suicide. The methods employed appear otherwise to reflect development in society and pharmacotherapy. Where men were concerned, it appears that suicide is relatively most common among widowers, unemployed and early retirees while, where women were concerned, divorcees and early retirees were most frequently involved. Attempted suicide is most frequently carried out by unemployed men and by divorced and early retirees of both sexes. This investigation cannot indicate any definite occupational group which involves a risk as regards suicidal acts and economical factors appear only to play a part where attempted suicide is concerned. PMID- 2718269 TI - [Priapism. New diagnostic and therapeutic methods]. AB - Priapism (P) may develop from unknown causes or may occur secondary to other disease or as a side effect of medication. The occurrence of pharmacologically induced erection by intracavernous injection of drugs has resulted in a number of cases of iatrogenic priapism. Priapism may be ischaemic or non-ischaemic and determination of the acid-base status in the cavernous blood may be of value in the choice of treatment. The non-ischaemic cases should be treated primarily by aspiration of blood, possibly followed by intracavernous injection of a vaso constrictive agent, eg 15 micrograms adrenaline or noradrenaline, repeated if necessary. Cases which do not respond to this and severe ischaemic cases should be treated with glando-cavernous anastomosis. PMID- 2718270 TI - [JJ-catheters for internal urinary diversion]. AB - Sixty-four patients with obstruction or lesions of the ureter were, on 115 therapeutic sessions, submitted to internal diversion of urine employing JJ catheters. Prior to the first treatment, 53% of the patients had been treated with nephrostomy catheters on account of postrenal obstruction. In 12% of the therapeutic sessions, the patients developed pyrexia of over 38.5 degrees C (101.3 degrees F) in the 24 hours immediately after introduction of the catheter. Only few patients had complications in the form of macroscopic haematuria, migration of the catheter, incrustations and perforation of the ureter. It is concluded that JJ-catheters provide a good and gentle method of relieving obstruction in the upper urinary passages. Bacteriological investigation and treatment of urinary infection is recommended prior to introduction of the catheter. PMID- 2718271 TI - [Second-look surgery in ischemic volvulus of the small intestine]. AB - A case of volvulus of the small intestine in a child is reported. At the primary exploration, a segment of the small intestine measuring 240 cm was found to be clinically devitalized. Repeated exploration three days later revealed 90 cm of gangrenous intestine with distinct delimitation from the vital intestine. A second look operation may thus limit intestinal resection in cases of extensive ischaemia of the intestine and indefinite delimitation of the devitalized intestine. PMID- 2718272 TI - [Giant skin horn]. AB - Cornu cutaneum is the clinical designation for skin tumours caused by a number of benign, premalignant or malignant conditions, the commonest of which are: actinic keratosis, verruca vulgaris, seborrheic keratosis and squamous cell carcinoma. A case of giant cornu cutaneum measuring 9 x 1.5 cm is reported. The tumour was removed from a patient who had had this increasing tumour for 30 years. It had been pared from time to time but had not caused inconvenience of significance on account of local traditional clothing, culture and religion. PMID- 2718273 TI - [Information for children and adolescents about nuclear warfare]. PMID- 2718274 TI - [Civil defense, disaster medicine and medical ethics]. PMID- 2718275 TI - [Retinoblastoma: model for heredity and cancer]. PMID- 2718277 TI - Program and abstracts. Undersea and Hyperbaric Medical Society, annual scientific meeting. 6-11 June 1989, Honolulu, Hawaii, U.S.A. PMID- 2718276 TI - [Primary health services in China]. PMID- 2718278 TI - [Cystoscopy and endovesical biopsy in renal tuberculosis]. AB - Cystoscopy and endovesical biopsy of the bladder wall were performed at early stages of investigation prior to the onset of tuberculostatic treatment in 77 patients with destructive renal tuberculosis, verified both bacteriologically and histologically. Cystoscopy proved to be valuable in 83.2% of the cases, particularly so where the destruction focus communicated with the renal calyx pelvis system. Cystoscopic symptoms of renal tuberculosis occurred at the following rates: tubercles in 6.5%, focal hyperemia, in 18.2%, erosion and ulcer, in 9.1%, bullous edema of the ureteral opening, in 11.6%, all kinds of changes of ureteral opening, in 37.6%. There were no visible changes of vesical mucosa in 16.8%. The pattern of mucosal changes correlated with the markedness of X-ray morphological changes in the kidney. Endovesical biopsy was positive in 52%, its results, being significant in cases of open destructive developments and ureteral affection. The value of endovesical biopsy increased where it was performed at the peak of clinical and cystoscopic symptoms, at early stages of disease, before the onset of tuberculostatic treatment. False-negative results of endovesical biopsy do not exclude renal tuberculosis. High value of cystoscopy and endovesical biopsy makes them up-to-date diagnostic tests for renal tuberculosis. PMID- 2718280 TI - [A method of surgery in bilateral vesico-ureteral reflux in children with a double ureter]. AB - An original method of bilateral ureteral transplantation for vesico-ureteral reflux is proposed. The technique described, based on 3 or 4 ureters being placed in a common submucosal canal, was used in 7 children. Clinical and radiologic follow-up demonstrated a good anti-reflux effect. PMID- 2718279 TI - [The role of thermography in the diagnosis of testicular diseases]. AB - Combined clinical and thermovision investigation was carried out in 104 patients with various scrotal diseases. Acute epididymitis and orchidoepididymitis (42 patients) were associated with the following thermographic signs: thermo asymmetric intensity of infrared emission with hyperthermia (0.6 to 2 degrees C) on the affected side, a greater glow area, as compared to actual anatomical size of the organ, "truncal" inguino-iliac hyperthermia in cases of ascending lymphangitis. Asymmetry of heat pattern diminished or disappeared altogether in cases of successful treatment. Hydrocele (32 patients) was associated with enlarged heat outlines on the affected side of the scrotum, without any apparent heat pattern asymmetry. Malignant testicular tumors (30 patients) were associated with enlarged outline of the affected scrotal side with a temperature difference of 1.2 degrees C and more, as compared to the normal side, persistent hyperthermia at repeated examinations, small- and medium-sized hyperthermic foci over the projected liver, lungs, mediastinum, meso- and hypogastrium, lumbar region and in the area of lateral neck surface in cases of metastatic growth. A clear-cut homogeneous hyperthermia over the anterior abdominal wall and in the lumbar region is registered as a post-gamma teletherapy condition. Thermovision is an effective instrument for the diagnosis of benign and malignant scrotal diseases; it makes possible early detection of complications (lymphangitis, lymphadenitis, metastases) providing for an objective assessment of treatment efficiency. The accuracy of thermovision diagnosis was 100% in cases of hydrocele and acute orchidoepididymitis, and 89.6% in cases of testicular tumors. PMID- 2718281 TI - [Treatment of strictures of the urethra in men]. AB - Treatment of urethral strictures was conducted in 84 male patients, aged 15 to 78 years. Combined treatment included optical (retrograde and antegrade) urethrotomy and transurethral electroresection (TUR) of scar tissues, combined with postoperative endourethral phonophoresis with lidase (64 units) and an antibiotic. Retrograde urethrotomy was performed under visual control. Scar tissues were dissected layer by layer until the resectoscope could be introduced. Antegrade urethrotomy was performed after bougies were passed through the stricture. To improve the results of endourethral surgery, all patients underwent endourethral lidase and antibiotic phonophoresis, using "C" irradiator of the Soviet Sterzhen' device, on postoperative day 3. The duration of phonophoretic session was 6 to 12 min at 0.1-0.3 kW. There were 8 to 10 sessions to a course of physiotherapy. This combined treatment stabilized urodynamic parameters at 1 to 1.5 years' follow-up, as evidenced by significantly increased mean and peak urinary flow rate and shorter bladder evacuation time. There were basically no postoperative relapses in 92.1% of the patients. PMID- 2718282 TI - [The content of the carcinoembryonic antigen in the blood serum of patients with bladder tumors at various stages of combined treatment in relation to the disease stage]. AB - Serum level of a tumor marker, carcinoembryonic antigen (CEA), was examined in patients at different stages of vesical cancer before and during combined treatment, including preoperative large-fraction radiotherapy and surgery. Sixty patients with histologically documented vesical cancer, stages T1N0M0, T2N0M0, T3N0-1M0 and T4N0M0 were investigated. All patients underwent large-fraction radiotherapy prior to surgery. Transvesical resection of the bladder wall with the tumor or cystectomy was performed within 24-72 hrs after radiation exposure. Serum CEA was measured repeatedly (on admission, after preoperative radiotherapy, postoperatively, at discharge) by enzyme immunoassays. It is demonstrated that CEA variation in the course of combined treatment depends on the stage of cancer. CEA level decreased after preoperative large-fraction radiotherapy in patients with T1, T3 and T4 stages of cancer, and increased in patients at the T2 stage. Following combined treatment, serum CEA was reduced two-fourfold as compared to pretreatment values in patients with first, third and fourth stages of vesical cancer, an evidence of the adequacy and radical quality of treatment and a favorable predictive sign. PMID- 2718283 TI - [The efficacy of rigid and flexible endoscopes in the diagnosis of bladder diseases]. AB - A comparative assessment of the efficiency of rigid and flexible endoscopes used for the diagnosis of bladder diseases (cystitis, papilloma, carcinoma in a total of 250 patients) is reported. Cystoscopy made use of a rigid catheter in 101 patients and of a flexible one, in 149. With rigid cystoscope procedure, the diagnosis was correct in 72.2%, doubtful in 13.9%, and erroneous in 13.9%. Major causes of the failure of cystoscopy in this group of patients were bleedings small volume of the bladder, tumor disintegration incontinence, prostatic adenoma, fistula, the tumor outside rigid endoscope's visibility range, or grave condition of the patient. Fiber cystoscopy made use of 6 mm endoscopes, corresponding to No 18 by Charriere's scale. Flexible endoscope procedure proved effective in 98.7% of the patients, including 11 patients after a failure with rigid cystoscopy. Principal advantages of vesicle fibroscopy are that the method is absolutely atraumatic, painless, quick, has no dead zones and makes possible complete examination of the mucosa of diverticula or any exophytic formation, and target biopsy. PMID- 2718284 TI - [Anemia in patients with chronic kidney failure undergoing systematic hemodialysis treatment]. AB - A study of 24 patients with chronic renal failure and varying degrees of uremia and clinical symptoms was carried out in order to assess the mechanisms of anemia developing in patients on systematic hemodialysis for chronic renal failure. Blood clinical and biochemical parameters were evaluated. Sternal bone marrow puncture was performed to assess erythron status. Proliferative activity of bone marrow erythroid cells was assessed by autoradiography. Ineffective erythropoiesis was studied using MacManus' PAS test. The results of the study suggest that proliferative activity of bone-marrow erythroid cells is reduced while ineffective erythropoiesis is increased in patients with terminal chronic renal failure, treated by systematic hemodialysis, and largely explain the mechanism of anemia in these patients. PMID- 2718285 TI - [Reprocessing of capillary dialyzers]. AB - Changes in biocompatibility parameters of the cuprophan membrane, used repeatedly after reprocessing, were assessed. It is demonstrated that when the dialyzer is applied for the second of third time, cuprophan membrane loses its ability to induce acute dialysis leucopenia, typical for first application. Repeatedly used dialyzers also failed to cause bone-marrow irritation, which at first use induced a release of juvenile neutrophils into the circulation. Prior to first application, 6 dialyzers were subjected to 3 reprocessing procedures each. In all three, the cellulose membrane did not lose its ability to cause acute leucopenia. Therefore, the chemical reagents used in reprocessing (hydrogen peroxide, sodium hypochlorite and formaldehyde) are not the cause of membrane's loss of ability to induce leucopenia. Used for 3 times running, capillary dialyzers do not essentially lose their effective capillary volume. To determine whether the dialyzer is suitable for repeated use, both visual and objective check-up of the device is necessary. Some aspects of reprocessing technology are discussed. PMID- 2718286 TI - [Arterial hypertension and fatty acids of the blood in patients with chronic glomerulonephritis without the nephrotic syndrome]. AB - The study involved 33 patients with chronic glomerulonephritis of hypertonic type (CGNHT), in their number 8 with the signs of a moderate renal failure, 25 with a latent form of the disease (CGNLF), 10 ones with hypertension, and 20 healthy age matched subjects. Patients with CGNHT and hypertension patients were comparatively studies for the blood pressure values. Fatty acid, glycerine, malonic dialdehyde contents were investigated in all the examinees. Some patients were studied for the fraction composition of fatty acids as well. The majority of CGNHT and hypertensive patients demonstrated a significant increase in the levels of fatty acids, glycerine and malonic dialdehyde versus healthy and CGNLF subjects, whereas the content of polyunsaturated fatty acids was found to be decreased (exemplified by linoleic acid) and the content of monounsaturated ones increased (exemplified by myristic acid). The aforementioned changes were mostly pronounced in those CGNHT patients who had higher systolic pressure whereas the signs of renal failure were of no importance for the value variance. No differences were revealed in the parameters of hypertensive and CGNHT patients. Accounting for the role of fatty acids, polyunsaturated ones predominantly, which provide the energy consumption of myocardium (raised in those with higher blood pressure values) the authors suggested that arterial hypertension played a definite role in the aforementioned alterations. The results obtained could be of a certain clinical value for dietetic and medicamentous improvement of the deficiency in the levels of polyunsaturated fatty acids in the patients with CGNHT, possible normalization of fatty acid content and composition during the decrease of the blood pressure. PMID- 2718287 TI - [Transient obstructive aspermia and transient obstructive oligospermia]. AB - The article is a continuation of a series of papers dealing with changes of ejaculatory ducts associated with various diseases of the prostatic gland and posterior urethra. Clinical description of patients, earlier treated for aspermia or oligospermia is presented. In some of the patients with such clinical manifestations, complete or partial compression of the ejaculatory ducts by the inflamed prostate or seminal bulb may be the cause and the disorder may be transitory rather than continuous. Twenty-six cases of transitory aspermia are reported, with special reference to laboratory and instrumental findings and treatment results. A group of patients (43) with transitory oligospermia is also described, and the results of investigation and treatment are presented. PMID- 2718288 TI - [Leukoplakia of the urethra]. PMID- 2718289 TI - [Successful surgical treatment of injury of the single dystopic kidney]. PMID- 2718290 TI - [Function of the kallikrein-kinin and prostaglandin systems of the kidneys in patients with chronic pyelonephritis]. AB - The activity of the kallikrein-kinin, prostaglandin and cyclase systems was assessed in 117 patients with chronic pyelonephritis with and without arterial hypertension. Pyelonephritis is shown to be associated with a dysfunction of the pressor-depressor mechanisms examined, featuring a depression of vasodepressor reactions. Patients with normal, increased and depressed humoral parameters could be found in each study group, the changes being particularly marked in patients with chronic pyelonephritis, combined with arterial hypertension. PMID- 2718291 TI - [New methods in the laboratory diagnosis of chronic glomerulonephritis and chronic pyelonephritis]. AB - Two new laboratory diagnostic tests for chronic glomerulonephritis and pyelonephritis have been developed. The first one is based on electrophoretic mobility of urinary lysozyme under certain conditions, such as the use of 12% polyacrylamide gel with pH of 4.3 and acid electrode buffer with pH of 4.0. After electrophoresis was discontinued, lysozyme position was determined by lysis of Micrococcus lysodeikticus, used as test agents and added to the gel as a suspension prior to polymerization. Urinary lysozyme was found to be in the anode area of the gel in 95% of patients with chronic pyelonephritis, and in its cathode area in 92% of patients with chronic glomerulonephritis. There was no lysozyme in the urine of normal subjects. The other laboratory technique, the ethanol test, is based on comparative assessment of the degree of urinary opacification after ethanol is added in conditions of neutral reaction (following the addition of physiologic saline) and marked alkaline reaction (following the addition of sodium hydroxide solution). The ratio of optic density of the alkaline specimen to that of the neutral specimen was above 1 in patients with chronic glomerulonephritis, and below 1 in patients with chronic pyelonephritis and normal subjects. Examination of biochemical mechanisms of the proposed tests has demonstrated that the pattern of proteinuria is the most important factor affecting the results. PMID- 2718292 TI - [Age dependence of kidney function]. AB - Although kidney function is immature in infants and decreases with increasing age in adults, when assessing the kidney clearance, it is not common to make an adjustment for age. On the other hand, correction for the standard body surface is generally accepted. Previous studies have yielded contradictory results, probably due to the small numbers of patients studied. To obtain the statistically significant relationship between age and kidney clearance, we compiled more than 1000 studies. These studies were divided into three groups: (1) children under 2 years of age (n = 71); (2) children and adolescents from 2 to 15 years (n = 64 male/58 female); (3) adults (n = 474 male/424 female; age: 16 80 years). Total clearance determinations were only considered if there were no differences between the two kidneys and if there was no obstruction of micturition or other pathological findings. Surprisingly, the statistical analysis showed no differences in clearance values between sexes. The maximal clearance values were found in the groups with children about 8 years old and the greatest scatter of values was seen in children under 2 years of age (a discrepancy between maturation age and calendar age). The complete set of data was based on the presumption that continuous function consisting of three trunks describes the course of normal kidney clearance in relation to patient age. If one determines an arbitrary reference value (e.g., 25 years), correction factors can easily be derived from the function described in order to compare individual clearance with a normal value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718293 TI - [Calcium and citrate excretion by patients with calculi and healthy probands during induced acidosis]. AB - Acidosis induced increase in renal calcium excretion and decrease in renal citrate excretion was produced by means of ammonium chloride load in 15 patients with recurrent oxalate lithiasis and in 15 control subjects. The expected increase in the calcium citrate relationship in urine is more marked and more lasting in stone patients. Stone formers obviously respond to an acidotic metabolic situation by a more clear relative decrease in citrate excretion, in addition to more intensive calcium excretion, which is known. A certain individual sensitivity of renal tubular mechanisms is discussed with regard to acid base changes. PMID- 2718294 TI - [Fluorescence diagnosis of porphyrin-marked urothelial tumors. Status of experimental development]. AB - On the basis of selective storage of fluorescing hematoporphyrin derivative (HpD) in tumors, a method has been developed that enables the endoscopic detection of early-stage cancer by monitoring fluorescent images. The contrast-reducing portion of the superposed tissue autofluorescence is suppressed by the use of two wavelength excitation and subsequent image processing in realtime. The amount of photosensitizing HpD necessary for diagnostic purposes is considerably reduced by means of sensitive detection devices. A clear distinction between benign and malignant bladder tissue seems possible according to the results of animal studies. PMID- 2718295 TI - [The clinical value of preoperative staging of bladder and prostatic cancers with nuclear magnetic resonance and computerized tomography]. AB - To evaluate the diagnostic value of preoperative staging of bladder cancer and cancer of the prostate, CT and NMR scans of 45 histologically defined tumors of the bladder and the scans of 24 patients with radical prostatectomy were compared. Lack of extravesical spread was imaged correctly by NMR in all cases of urothelial cancer (pT1-pT3a). CT diagnosis failed in 39%. False-negative results were obtained in 2 of 5 invading tumors (pT3b) by NMR and in 3 of 5 by CT. Extraglandular spread of cancer of the prostate was diagnosed with an accuracy rate of 79% by NMR and of 46% by CT. The diagnostic value for detection of pelvic lymph node metastases had a low-sensitivity rate of 26% in NMR and of 22% in CT. PMID- 2718296 TI - [Pressure constant, transurethral resection with the new suprapubic "overflow regulator"]. AB - A new suprapubic device that regulates the intravesical pressure automatically during TUR is introduced. This flow controller ensures a constantly low intravesical pressure during TUR. The irrigation fluid constantly flows over into a small open glass jar adjusted to the trocar immediately above the abdominal wall. In this way the pressure is determined by the height of the jar above the bladder, which makes it independent of the irrigation flow. Having constant low pressure conditions between 14 and 18 cm H2O, the bladder wall does not collapse. Thus, the anatomical situation does not change throughout the entire operation, which leads to markedly better overall vision. PMID- 2718297 TI - [Congenital urethral polyps. A rare cause of obstructive uropathy in childhood]. AB - Congenital urethral polyps are an extremely rare cause of obstructive uropathy in childhood. Obstructing polyps arise on the seminal colliculus or the floor of the prostatic urethra. They are pedunculated, and the stalk can be several centimetres in length. Primarily they are composed of connective tissue covered by epithelium. Additionally, smooth muscles and islands of glandular cells and even nerve tissue have been found. We present three cases of children with congenital posterior urethral polyps causing severe infravesical obstruction. In two cases the polyps were excised at open cystotomy and in one case, transurethrally. The follow-up investigations confirmed a good prognosis of these patients: micturition behaviour had normalized and the symptoms of urinary obstruction had either markedly improved or completely disappeared. Dilatation of the upper urinary tract and loss of function resulting from recurrent urinary tract infection remained stable after relief of the obstruction by polypectomy. PMID- 2718298 TI - [Drug-induced priapism--a report of experiences in 101 cases]. AB - Within a period of 3 1/2 years, 101 patients with drug-induced priapism lasting more than 6 h were observed. In 73 of the 101 patients (average age 47.4 years) with an average duration of priapism of 11.9 h priapism was interrupted by means including cavernosal puncture, evacuation, and injection of metaraminol. In 28 patients priapism subsided after an average duration of 8.8 h without medical intervention. Intracavernous blood gas analyses revealed unphysiological acid values with clearly negative excess base values. Nevertheless, in the present series only 3 patients had irreversible damage of cavernosal function as a sequela of priapism of more than 24 h duration. Intracavernosal injection of meta ramininol was followed by severe hypertensive crisis in 2 patients. These results show convincingly that the demand for early interruption of drug-induced priapism within a time limit of 6 h is not based on objective necessity. Interruption of drug-induced priapism within 6-8 h seems to be adequate. Prostaglandin E1 has proved a reliable means of preventing priapism in the initial test period. PMID- 2718299 TI - [Laser trabeculoplasty and the status of the crystalline lens in open-angle glaucoma]. AB - The authors analyze the frequency of cataract progression in patients with open angle glaucomas after laser trabeculoplasty. 132 patients (148 eyes) have been followed up for 1 to 6 yrs. A considerable deterioration of the vision acuity (by 0.4 and more) has been observed in 10 (6.8%) eyes; in this group of patients the vision acuity decrease on the involved eye has been 0.59 +/- 0.25, whereas on the other (control) eye, not exposed to laser trabeculoplasty, the vision acuity has decreased by 0.09 on an average. The vision acuity has deteriorated at the expense of the already developed cataract progression. This appears to be induced by laser trabeculoplasty. It is noteworthy, however, that the incidence rate of cataract progression after laser trabeculoplasty is much lower than after antiglaucoma surgery (6.68 vs. 30-80%). No cases of the development of a cataract in a transparent lens (a phenomenon observed after antiglaucoma surgery) have been recorded after laser trabeculoplasty. PMID- 2718300 TI - [Methods of capsular and intracapsular microsurgery, intracapsular implantation and sutureless fixation of artificial lenses]. AB - The author recommends mastering the methods of capsular and intracapsular microsurgery for cataracts on cadaver eyes. He advises to remove the cornea and the iris to have a better view of the technique. As the physician masters the technique, he screens the lens sac equatorial area by keeping the iris and later the cornea (to make the conditions as close to clinical surgery as possible) and then removes the iris and the cornea for controlling the quality of the capsular pocket preparation. Artificial lenses similar in shape to B. N. Alexeev's design may be implanted in the prepared lens sac; then the anterior capsule of the lower capsular pocket in the central area is removed. The training may be completed by removal of the anterior capsule alone, i.e. by extracapsular extraction. The described methodology helps more rapidly master the techniques of capsular and intracapsular microsurgery and intracapsular implantation of artificial lenses and thus promotes a wide practical employment of these microsurgical techniques. PMID- 2718301 TI - [Clinico-immunologic aspects of development of cataracts in patients with myopia]. AB - The present study has been aimed at the detection of specific antibodies to the lens and its capsule in the circulating blood of patients with complicated myopic cataracts. The presence of these antibodies results in the development of the posterior capsule fibrosis, this leading to the migration of the cells from the equatorial area to the site of the capsule injury. The detection of the specific antibodies in the blood will help single out the risk group among the patients for whom implantation of a negative intraocular lens is indicated for the correction of high myopia. The presence of these antibodies may also help predict the development of a cataract in the postoperative period; besides, it may be used to create an immunological certificate, informing on the presence of antibodies specific for the lens or its capsule in the patient's circulating blood. PMID- 2718302 TI - [Significance of the study of the pachymetric index in the evaluation of the process of eye adaptation to contact lenses]. AB - The authors have examined the thickness of the cornea in 270 patients with weak and moderate myopia during adaptation of the eye to soft or rigid contact lenses. They have revealed a linear correlation between the period of wearing the lens and the degree of the pachometric index change during adaptation of the eye to contact lenses. The maximum permissible period for daily wearing of contact lenses have been determined, not involving essential shifts in water-salt metabolism of the cornea. Optimal schedules for managing the adaptation process with rigid and soft contact lenses have been developed, based on the regularities of the corneal thickness changes related to the length of the lens wearing. PMID- 2718303 TI - [Congenital cataract extraction in children during lst months of life]. AB - The examinations have involved 89 children with bilateral congenital cataracts aged 2-6 months (n = 68) and 7-10 months (n = 21). The preoperative examinations have been carried out under anesthesia and included biomicroscopy, retinoscopy, ultrasonic and electrophysiologic examinations. A number of specific clinical and functional features have been revealed in these babies. Surgery has been performed in 148 eyes. Various types of microsurgical techniques of the closed type have been employed: aspiration-irrigation method; operations with ultrasonic equipment y3X-phi-p04-0 and Sparta, lensectomy using the Okutom system. An anterior approach to the lens via an incision in the limbus has been used. Good optical and functional results have been achieved. No grave intraoperative complications have been recorded. The postoperative period has been areactive in 84.5% of cases. In 6% of cases secondary cataracts have developed, mostly of Elschnig's pearls. Early surgery (at the age of 2-6 mos) is indicated in all forms of congenital cataracts inducing deprivation amblyopia. PMID- 2718304 TI - [Development of astigmatism in primary surgical treatment of penetrating wounds of the cornea (preliminary report)]. AB - The paper concerns the studies into astigmatism development after penetrating wounds of the cornea depending on subjective and objective surgical factors. The attempt is made to design a set of measures aimed at the prevention of refractive complications upon the treatment of penetrating wounds of the cornea. PMID- 2718305 TI - [Current problems of optical correction of vision (information for ophthalmologists and optometrists)]. PMID- 2718306 TI - [Surgical tactics and results of the treatment of penetrating wounds of the eye with foreign bodies in the posterior segment]. AB - Analyzes 147 cases with perforating wounds of the eyes and foreign bodies in the posterior segment. Describes the surgical policy in removing the foreign bodies in cases with transparent and opaque refracting madia. Recommends the transciliary methods providing better functional results. PMID- 2718307 TI - [Use of electroacupuncture reflexotherapy in myopia]. AB - Electroacupuncture (EAP) has been used in the management of schoolchildren with slight myopia and of senior schoolchildren with high myopia. A follow-up of 5 years has demonstrated that EAP has stopped the progress of myopia, normalized the accommodation system, improved the natural vision acuity and other visual functions. PMID- 2718308 TI - [Findings of electrophysiological studies at various stages of combined surgical treatment of patients with proliferative diabetic retinopathy]. AB - Electrophysiological examinations of the pigmented epithelium, retina, and optic nerve have demonstrated the efficacy of combined surgical treatment for proliferative diabetic retinopathy at various stages of the condition. The findings are indicative of the process stabilization and of a reduction of the exudative component in the retina in late periods of the follow-up. The authors recommend combined electrophysiological examinations for monitoring the treatment results and for assessing the course of the process. PMID- 2718309 TI - [Exchange plasmapheresis in combined treatment of severe uveitis]. AB - Exchange plasmapheresis (EP) has been employed in multiple-modality therapy of 15 patients suffering from severe uveitis. The traditional therapy has yielded but a short-term effect and failed to stabilize the process in these patients. EP has resulted in improvement in all the patients: the injection has reduced, as well as the number of precipitates and oracities in the vitreous body; hemorrhages in the fundus oculi have resolved, and the vision acuity has considerably improved in 11 of the 15 patients; no cases of the deterioration of the vision acuity have been recorded. The relapses have ceased in 10 patients. EP has been well tolerated and yielded no complications; it has normalized the levels of the blood serum immunoglobulins and circulating immune complexes and activized phagocytosis. PMID- 2718310 TI - [Morphometric analysis of lens opacification]. AB - A method of classifying cataractous changes in excised human cataracts that was based on separate and independent photographic documentation with subsequent quantitative evaluation of lens opacification has been proposed. The degree of lens clouding was evaluated quantitatively by measuring the optical density index and the area of clouding with certain optical density parameters (equidensities) by use of a texture analyzer system apparatus. This technique made it possible to obtain the contrast image of the lens clouding areas in the frontal projection and to determine their share in the total area of the lens surface. The precise topography of the opacities was established. The data obtained for different clinical types of cataracts help the scientist in his effort to measure clinically or scientifically significant quantitative associations between laboratory measures and cataractous changes. PMID- 2718311 TI - [Age-related morphometry of the intraorbital part of the optic nerve and the distance from the point of its emergence from the eye to the tendinous annulus]. PMID- 2718313 TI - [Theoretical bases of convex tonometry and potentialities of its use]. AB - The authors consider the theoretical foundations of the convex tonometry principle: a universal formula is suggested for the calculation of intraocular pressure measured by a tonometer of any preset curvature. They suggest a new microdeformation convex tonometer with a constant deformation diameter, that makes possible tonometry with a less compression than during standard tonometry according to Goldman. The suggested method has been compared with Goldman's technique, and the results evidence a higher accuracy of convex tonometry. Statistical processing of the data has demonstrated that the new method conforms to the international standards. The design of convex attachment helps widen the sphere of practical applications of the new method. PMID- 2718312 TI - [Pupillographic effects of atropine on diaphragmatic properties of the iris in patients with pseudoexfoliation]. PMID- 2718314 TI - [True tolerant intraocular pressure in glaucoma, ocular hypertension and low tension glaucoma]. AB - Measurements of the true tolerant intraocular pressure (IOP) in 500 eyes of 384 patients with primary glaucoma and in 26 eyes of 13 patients with ophthalmic hypertension have demonstrated that the value of the true tolerant 10P is close to the lowest border of the mean statistical range of normal ophthalmic tone values, this value being, on an average, 13.4 mm Hg in primary glaucoma and 10.2 mm Hg in low-pressure glaucoma, whereas in ophthalmic hypertension it has been much higher - 24.8 mm Hg. The intolerance index in stabilized glaucoma does not surpass 4 mm Hg with both the true and the tonometric 10P. PMID- 2718315 TI - [Development of neuroparalytic keratitis after retrobulbar administration of trimecaine]. AB - The blood flow in the iris vessels slowed down and the vessel permeability increased early after a retrobulbar injection of trimecaine, a local anesthetic, this resulting in the development of tissue edema. Two days later neuroparalytic keratitis developed. The authors suppose that early vascular disorders resultant from blocking of the sensitive nerves are among the causes responsible for later changes in the corneal trophics. PMID- 2718316 TI - [Economic effectiveness of the introduction of a new method of conservative treatment of chalazion]. AB - The authors analyze the economic efficacy of a new method for chalazion therapy: corticosteroid injections deep into the pathologic focus. Such therapy may be carried out on an outpatient basis, the patients do not have to cease work for it. The authors emphasize high socioeconomic significance of introducing this method into clinical practice. PMID- 2718317 TI - [A rare clinical variant of the course of acute anterior uveitis]. PMID- 2718319 TI - [Dacryocystitis of mycotic etiology (based on the data of the Moscow Ophthalmological Clinical Hospital during the period 1979 to 1985)]. PMID- 2718318 TI - [Retinal angiomatosis in a child]. PMID- 2718320 TI - [A method for assessing the resistance of the optic nerve to increased intraocular pressure]. AB - The examinations have involved 62 subjects (116 eyes), of these 48 ones with open angle glaucoma and 14 with suspected glaucoma. Vacuum compression of the eye with simultaneous recording of the visual evoked potentials (electroencephalodynamography) has been carried out. The studies have revealed increased, vs. the initial level, latent period and decreased amplitude of evoked potentials during the eye compression in 74% of patients with primary glaucoma and in 69% of subjects with suspected glaucoma. These results permit recommending electroencephalodynamography for the early diagnosis and prognosis of glaucoma. PMID- 2718322 TI - Killing with kindness. PMID- 2718321 TI - Medical management of Cushing's syndrome in dogs. PMID- 2718323 TI - Biomicroscopy of the tear film: the tear film of the pekingese dog. AB - Polarised light biomicroscopy was used to examine the normal pre-corneal tear film in 21 eyes of 12 pekingese dogs. The purpose of the study was to examine the influence of excessive exophthalmos on the pre-corneal tear film in the dog. The majority of the animals were found to have high levels of ocular surface contamination by particulate material and plaques of viscous mucus. Other abnormalities included surface lipid with an abnormal granular (three dogs) or 'curdled' (two dogs) appearance; excessive thinning of the lipid layer of the tear film; and the presence of dark globular structures in two dogs, which were presumed to be abnormal meibomian lipid. Break up of the tear film was observed in one dog. Grossly, a thread of viscous mucus was frequently observed along the margin of the lower eyelid. It is postulated that this thread forms because of the excessively exophthalmic conformation of the breed, which prevents the normal access of effete mucus and entrapped debris to the lower conjunctival fornix. The combination of the above factors in the pekingese is suggested as the mechanism whereby the tear film has a reduced stability, thus enhancing the risk from factors more usually considered to initiate corneal ulceration in the breed. The possible adverse effects of lid splitting for the mass removal of distichiae in exophthalmic dogs is discussed. PMID- 2718324 TI - Histological analysis of a central tarsal implant in a racing greyhound. AB - The hock of a greyhound containing a titanium alloy central tarsal replacement was examined histologically. The animal had raced competitively 43 times before retirement. The examination showed that the adaptation and encapsulation of the implant by the surrounding bones, together with the excellent purchase of the screw into the fourth tarsal bone, had maintained the implant in excellent position during vigorous load-bearing. There was no histopathological evidence to suggest that the fixation of the implant was failing. The results provide evidence for the value of titanium alloy implants as a central tarsal replacement in greyhounds with type V fractures, and as a feasible alternative to euthanasia. PMID- 2718325 TI - Post traumatic tracheal stenosis in a cat. PMID- 2718326 TI - Atoxoplasma in greenfinches (Carduelis chloris) as a possible cause of 'going light'. PMID- 2718327 TI - Ancylostoma caninum in British greyhounds. PMID- 2718328 TI - Prolonged recumbency in a small horse (Equus caballus var roccianus) with unusual sequelae. PMID- 2718329 TI - Nitroxynil residues in meat. PMID- 2718330 TI - Therapy using reproductive hormones. PMID- 2718331 TI - Homoeopathy. PMID- 2718332 TI - Unusual neoplasms in cyprinids. PMID- 2718333 TI - Certifying temperament. PMID- 2718334 TI - Stray dog problem. PMID- 2718335 TI - Partnership contracts. PMID- 2718336 TI - Accidental carbadox overdosage in pigs in an Irish weaner-producing herd. AB - A weaner ration containing carbadox at concentrations of 331 to 363 mg/kg was accidentally fed to suckling and weaned pigs in an 84 sow herd. Discarded ration was fed to 36 sows. One hundred and sixty five weaner pigs died in a 10 week period with clinical signs including refusal to eat, ill thrift, the passing of hard pelleted faeces, posterior paresis and death in seven to nine days. The surviving weaners did not thrive and some males showed poor testicular development. Sows and suckling pigs that consumed the ration also failed to thrive as did the progeny of affected sows. The main pathological finding was obliteration of the zona glomerulosa of the adrenal cortex. Increased potassium and decreased sodium concentrations in serum were the most notable and consistent biochemical findings. PMID- 2718337 TI - Effect of prostaglandin F2 alpha on hormone concentrations in dairy cows after parturition. AB - This study was designed to evaluate the effects of exogenous prostaglandin F2 alpha (PGF2 alpha) on hormone secretion in cows without a corpus luteum. Blood samples were taken from 10 Friesian dairy cows at frequent intervals from a jugular vein and the caudal vena cava starting between nine and 20 days after parturition. PGF2 alpha (25 mg dinoprost) was injected intramuscularly into five cows after the first eight hours of sampling. Plasma concentrations of 13,14 dihydro 15-keto PGF2 alpha (PGFM) increased rapidly but had returned to baseline by 14 hours after injection. There was no significant effect of the treatment on the time taken by the cows to resume ovarian cycles, and it had no consistent effect on plasma luteinising hormone (LH) patterns; however the amplitude of pulses of LH was temporarily suppressed in two cows and the frequency of pulses of LH was immediately increased in one cow. Treatment with PGF2 alpha had no significant effect on the concentration of oestradiol in blood from the vena cava. It is concluded that any enhancement of the reproductive performance of cows treated with PGF2 alpha after parturition is not due to a direct effect on pituitary-ovarian function. PMID- 2718338 TI - Reflux of bile acids from the duodenum into the rumen of cows with a reduced intestinal passage. AB - The purpose of this study was to find out whether the concentration of bile acids in the rumen of healthy cows differs from that of cows with a reduced gastrointestinal passage. The investigations were performed on 277 heifers and cows of the Swiss Braunvieh, Simmental and Swiss Holstein breeds. Forty of these had traumatic reticuloperitonitis, 30 had right or left abomasal displacement, 14 had an ileus of the duodenum, 36 had an ileus of the jejunum and 54 had a caecal dilatation. The other 103 animals had disorders which did not affect the digestive system and were used as controls. The mean (+/- se) bile acid concentration in the rumen fluid of the control animals was 1.0 +/- 0.30 mumol/litre. The bile acid concentrations in the rumen fluid of the cows with a duodenal or jejunal ileus were significantly higher than those of the other groups, demonstrating that bile acids may reflux from the duodenum into the rumen of cows with an ileus in the small intestine. PMID- 2718339 TI - Leech infestation of mute swans (Cygnus olor) PMID- 2718340 TI - Addison's disease in the dog. PMID- 2718342 TI - Animals' rights. PMID- 2718341 TI - Fatal dog bites: DF-2 infection. PMID- 2718343 TI - Rare condition in a rottweiler. PMID- 2718345 TI - Perineal hernia repair in the dog by transposition of the internal obturator muscle. I. Surgical technique. PMID- 2718344 TI - Application of diethylstilbestrol dipropionate in bulls. I. Excretion of residues in urine and faeces and histological and immunohistochemical changes in the prostate. AB - In this experiment 20 one year old bulls received a single intramuscular injection of the anabolic preparation diethylstilbestrol dipropionate (DES-DP) (an oil preparation or an emulsion). Four animals received a corresponding placebo. The application of DES-DP to bulls caused characteristic histological alterations in the peripheral glandular epithelium of the prostate, which could be observed until four weeks after treatment. The value of histological investigation as a screening method was, however, limited by the occurrence of only few metaplastic lesions and a rapid recovery. By contrast, immunohistochemistry using a polyclonal cytokeratin antiserum K40 appeared to be a specific and very sensitive method to detect oestrogen-induced lesions in the prostate. In only two animals, six weeks after injection with the DES-emulsion, false-negative results were obtained, demonstrating the potential value of this screening method. The excretion of DES in the urine and faeces was monitored using radioimmunoassay following chromatographic purification of the urine and faeces extracts. The excretion of DES in urine was faster for animals of the oil group. The DES content in urine decreased to the 1 microgram/l level after 42 days (emulsion group) or 70 days (oil group). The excretion in faeces was comparable to that in urine. After day 21 the excretion patterns of the two excreta were indistinguishable. PMID- 2718346 TI - Perineal hernia repair in the dog by transposition of the internal obturator muscle. II. Complications and results in 100 patients. AB - A modified technique for transposition of the internal obturator muscle was used to repair perineal hernias in 100 dogs. Complications and long-term results are described. The most important complications were wound infection (45%), faecal incontinence (15%), and perineal fistula (7%). These complications often occurred in combination. The recurrence rate of perineal hernia was 5%. Nine of the 15 patients with faecal incontinence had paresis of the external anal sphincter or faecal incontinence before surgery. We suggest that in numerous patients, faecal incontinence is a complication of the condition rather than a complication of treatment. The owner's assessment of the surgical result was good in 71% and moderate in 18% of the cases. PMID- 2718349 TI - A Hypoderma diana (Diptera: Hypodermatidae) infection in a horse. AB - An infection with second-stage larvae of the warble-fly H. diana in a horse is described. The second-stage larvae were incapable of developing into the third stage, because horses are unsuitable hosts and because the infected horse was treated with an insecticide. Since the horse was used for dragging trees in the forests, the infection was likely contracted via contact with H. diana, a normal parasite of roe deer in the Netherlands. PMID- 2718348 TI - The prevalence of lead shot ingestion in wild mallards (Anas platyrhynchos) in the Netherlands. AB - During the hunting season 1986-1987, 2859 gizzards from mallards shot in the Netherlands were collected. Gizzards were selected radiographically and examined visually for ingested lead shot. The 95% confidence interval of the prevalence of lead shot ingestion was calculated to be 1.7 to 2.9%. In some gizzards a large number of lead shot (12-16) were seen. This is an indication for locally heavily contaminated areas. Especially places where mallards are attracted for hunting purposes, by daily feeding of corn, predispose these birds to lead poisoning. A ban with regard to these hunting practices will probably drastically reduce the prevalence of lead shot ingestion. A change from lead shot to steel shot will solve the problem completely. PMID- 2718347 TI - Clinical signs and biochemical changes in calves caused by injection of ivermectin. AB - Eight-month-old Jersey bull calves given ivermectin intravenously or subcutaneously showed signs of depression, ataxia, difficulty in breathing, tachycardia, salivation, diarrhoea, miosis, and an increase in pseudocholinesterase activity. The clinical signs were severe in calves given the drug intravenously. The findings suggest that the cholinergic nervous system may be involved in some of the adverse effects of ivermectin observed in calves. PMID- 2718350 TI - Excretion and metabolism of a series of xanthines by the turtle Pseudemys scripta elegans. AB - The xanthines paraxanthine, xanthine, and uric acid are absorbed completely by the turtle Pseudemys scripta elegans and metabolised presumably into CO2 and NH3. No intermediate metabolites are excreted. Caffeine, hydroxycaffein, theobromine, hydroxytheobromine, and hydroxypraxanthine are absorbed and excreted in different amounts or percentages of the dose administered. Intermediate metabolites of these compounds are not excreted. The turtle Pseudemys scripta elegans may, therefore, be ammonotelic. PMID- 2718351 TI - Comparison of fat and cream content in normal and mastitic milk of cows. AB - Two methods for estimating fat and cream content in cow's milk were compared in normal and mastitic milk. Fat content in milk from periparturient cows was estimated simultaneously by the method of Gerber and by simply spinning small samples of untreated milk in a haematocrit centrifuge. Mastitis was experimentally induced by inoculating mammary glands with Escherichia coli. On the average, cream content in milk from normal, and uninfected mammary glands measured by the haematocrit method was 20 to 23% higher than milk fat measured by the method of Gerber. In mastitic milk from infected mammary glands haematocrit readings were 40% higher than those of Gerber. Milk fat values as measured by both methods were highly correlated. It is concluded that the haematocrit method can be used for rapid estimation of milk fat content in normal milk of cows. The greater difference between cream and fat content in mastitic milk compared to normal milk can probably, at least partly, be ascribed to the presence of large clots of cells and fat in the milk during mastitis. During centrifugation of the viscous mastitic milk samples, milk cells and fat probably are not completely separated. This results in overestimated readings of milk cream content with the haematocrit method. It therefore seems advisable to use the Gerber method for accurate measurements of milk fat in mastitic milk. PMID- 2718352 TI - Immunoblotting analysis of the reaction of wildebeest, sheep and cattle sera with the structural antigens of alcelaphine herpesvirus-1 (malignant catarrhal fever virus). AB - Malignant catarrhal fever (MCF) is a disease of cattle and some other ruminants caused by alcelaphine herpesvirus-1 (AHV-1), a virus of wildebeest. The disease also occurs in the absence of wildebeest and is then thought to be caused by a viral agent harboured by the sheep. The structural proteins of AHV-1 have been used as antigens for the immunoblotting analysis of sera from wildebeest, sheep and cattle infected by either AHV-1 or the "sheep-associated" form of the disease. Wildebeest sera showed a uniform response reacting strongly with six polypeptides. Sheep sera also gave positive results but individual sera reacted with varying subsets of the antigens recognized by wildebeest. These results support the earlier suggestion that sheep harbour a herpesvirus related to AHV-1. A bovine serum from a case of MCF caused by AHV-1 also reacted only with a subset of the six wildebeest-reactive polypeptides. Sera from cattle affected with the "sheep-associated" form of the disease gave reactions in only two of the eight cases tested; both positive sera reacted to a few polypeptides only. PMID- 2718354 TI - Bacteroides species from the oral cavity and oral-associated diseases of cats. AB - One hundred and sixty-seven strains of Bacteroides were isolated from 71 subcutaneous fight-wound abscesses of cats, 21 cases of feline pyothorax, normal gingival margins from 10 cats and 6 cases of feline gingivitis. Bacteroides species constituted (as a proportion of all anaerobic isolates examined) 44.5% from subcutaneous abscesses, 33.7% from pyothoraxes, 37.5% from normal gingiva and 27.7% from diseased gingiva. Bacteroides tectum comprised 43.7% or 73 of 167 strains, followed by the black- or brown-pigmented asaccharolytic feline species of B. gingivalis, B. salivosus and Group B, comprising 32.3% or 54 of 167 strains. B. heparinolyticus (some 10% or 17 of 167 strains) was the next most common species described. The remainder consisted of two strains of B. fragilis and 21 unspeciated strains. Bacteroides tectum was frequently isolated from subcutaneous abscesses (43.7%) and pyothoraxes (46.6%), and it constituted some 33% of anaerobic isolated from normal gingiva. Bacteroides heparinolyticus was more commonly encountered in purulent lesions (abscesses and pyothoraxes) than in the oral cavity. PMID- 2718353 TI - Seroepidemiology of Breda virus in cattle using ELISA. AB - Two direct blocking enzyme linked immunosorbent assays (ELISA) for the detection of antibodies to Breda virus in sera of cattle were compared. An ELISA with consecutive addition of antigen and test serum to an antibody-coated plate gave higher positive: negative absorbence ratios than an ELISA in which antigen and test serum were added simultaneously. Sera collected from breeding and fattening herds in The Netherlands (n = 1313) and the F.R.G. (n = 716) were tested, and antibodies to Breda virus were demonstrated in 94% of adult cattle. Ninety percent of newborn calves had high levels of maternal antibodies, which waned until the age of 3 months. Active seroconversion occurred between 7 and 24 months in most animals. PMID- 2718355 TI - [A comparative evaluation of the results of classical x-ray study and computed tomography in patients with exogenous allergic alveolitis]. AB - A correlative study of the results of x-ray investigation using routine methods and computerized tomography (CT) was conducted to specify the roentgenomorphological substrate of changes in patients with exogenous allergic alveolitis. The established complex of routine methods is informative enough to interpret the revealed changes. However, at early stages CT helps to specify semiotics and permits obtaining additional information, particularly on quantitative, i.e. densitometric changes. In diffuse and disseminated pulmonary lesions CT can be used as an additional method. PMID- 2718356 TI - [Angiographic diagnosis of hemorrhagic myocardial infarct]. AB - Hemorrhagic myocardial infarction (HMI) has certain angiographic features that make it possible to diagnose it during the patient's life. HMI angiographic criteria are hypervascularization of an infarction zone in the late arterial phase, an intense contrast of an infarction zone in the parenchymal phase, extravasation of a contrast medium in an infarction zone in the venous phase of coronarography lasting for a long time, and slow discharge of a contrast medium from the distal vascular channel of an infarction zone. HMI characteristic features require thorough phase-by-phase angiographic investigation of the coronary arteries in all MI patients, especially in young ones and those after intracoronary thrombolytic therapy. The detected morphological spasm of microcirculatory vessels and veins disturbing the blood outflow from an infarction zone, noticeable hemorrhages in its interstice prove to be the morphological substantiation of HMI angiographic signs. PMID- 2718357 TI - [A study of aneurysmal lesions of the aorta using magnetic resonance tomography]. AB - Altogether 23 patients with aneurysmal aortic lesions of various sites were investigated using MR-tomography. Sagittal and axial projections were used for visualization of the thoracic aorta, frontal and axial ones--for visualization of the abdominal aorta. As compared to radionuclide and x-ray methods of investigation, MR-tomography was characterized by a high informative value in the detection of aneurysmal lesions. Despite a limited number of patients the authors managed to diagnose aortic stratification which could be well visualized in the abdominal aorta. PMID- 2718358 TI - [A comparative evaluation of methods of radiologic diagnosis in determining the functional status of the right ventricular myocardium in tetralogy of Fallot]. AB - In order to study the informative value of two-dimensional echocardiography (EchoCG) in the assessment of right ventricular function in Fallot's tetrad the results of echocardiography were compared with those of angiocardiography. A total of 40 patients aged 2 to 13 with the cyanotic form of the defect were investigated. Functional indices were calculated using Simpson's rule. The highest correlation in comparing echo- and angiocardiography results was obtained for the end-diastolic volume (r = 0.94), a slightly lower one--for the end systolic volume (r = 0.92). The mean value of the right ventricular ejection fraction (EF) by the results of echocardiography was 0.62 +/- 0.05 +/- 0.08, by the results of angiocardiography--0.62 +/- 0.05 +/- 0.09. The correlation coefficient characterizing the proximity of EF values, obtained by the above methods, was 0.89. The greatest divergences in the results were noted in the calculation of the minute volume. It can be accounted for by the patients' different state at the time of invasive and non-invasive investigation. A high informative value and accuracy of two-dimensional echocardiography was proved in the assessment of right ventricular function in Fallot's tetrad. PMID- 2718359 TI - [An automated evaluation of cineangiograms of patients with interatrial septal defects]. AB - Curves of contrast medium dilution based on cineangiograms of patients with congenital heart disease, allow the calculation of a relative shunt value, the assessment of topographic anatomical features of an interatrial septal defect, and the detection of phasic manifestations of change in a contrast medium concentration. PMID- 2718360 TI - [Regional phlebography in patients with recurrences of varicocele]. AB - Diagnostic potentialities of phlebography were studied in 50 patients with varicocele recurrences. Two methods of phlebography: transfemoral renospermaticography and transscrotal orthograde testiculophlebography--were employed. The main cause of recurrence development was shown to be the abnormality of venous outflow from the testicle in the region of the left renal vein, testicular vein and in the pelvic veins. The effectiveness of both methods was 71.9 and 94.4%, respectively, their combined use provided additional information. PMID- 2718361 TI - [Computed tomographic diagnosis of cancer of the gallbladder]. AB - The authors have summed up the experience in the use of CT diagnosis of gall bladder cancer. The investigation of 17 patients with cancer of this site showed a high informative value of the method. A retrospective comparative study of the results of CT and surgical interventions was carried out. It has been concluded that CT makes it possible not only to diagnose malignant lesions of the bile ducts but also to assess a possible scope of a forthcoming operation. PMID- 2718362 TI - [Computed tomography in the Multidisciplinary Science and Technology Complex "Eye Microsurgery"]. AB - The paper is devoted to analysis of the results of CT in 1000 patients examined in the Multibranch Research and Technology Complex "Eye Microsurgery". The specific feature of CT in this institution is that 52% of all investigations of ophthalmological patients fall to the share of eyeball abnormality and 40%--to a study of the other parts of the organ of vision. CT indications are extended for low tension glaucoma, complicated high myopia, and for monitoring the position of microsurgical implants. The use of CT in such a highly specialized medical institution as the MRTC "Eye Microsurgery" is considered indispensable. PMID- 2718363 TI - [Radiation exposure of patients examined by a digital x-ray unit]. AB - Performance principles are given for a digital x-ray unit. Radiation doses are compared with a standard diagnostic x-ray unit. It is shown that a digital x-ray unit provides frontal view radiographs with 40 +/- 10 mR radiation dose which is 40 times less than that for the film. PMID- 2718364 TI - [Thermography in clinical practice]. PMID- 2718365 TI - [X-ray and computed tomographic diagnosis of aneurysm of the thoracic aorta]. AB - The paper is concerned with the results of x-ray and CT investigations conducted in 62 patients with suspected aneurysm of the thoracic aorta. The diagnosis was confirmed in 56. Of them 38 patients were operated on, 2 died without surgical intervention. X-ray investigations permitted differential diagnosis of mediastinal formations in 91.5% of cases. However in 2 cases when the combined method of intravenous administration of a contrast medium by means of a syringe was not used, aneurysmal aortic dilatation was not detected by CT. This method was found to be effective for diagnosis of complications of aneurysms of the thoracic aorta (calcinosis, aortic wall stratification and thrombosis of aneurysmal cavity). PMID- 2718366 TI - [Computed tomographic anatomy of the kidneys and the retroperitoneal space]. AB - The authors described the anatomy of the kidneys and retroperitoneal space in health on the basis of CT of 90 patients. Five typical levels in CT (ensuring all necessary data on roentgenomorphological traits of the kidneys and retroperitoneal space in the kidney area) were singled out. Some roentgenometric data on kidney cross-sections as well as the quantitative densitometric characterization of the parenchyma of the kidneys, renal sinus and adjacent tissues were presented. X-ray anatomy of the renal fascia, pararenal space and perirenal fatty space of the kidney with different parts of the retroperitoneal space was described. PMID- 2718367 TI - [Computed tomography in the x-ray diagnosis of pneumonia]. AB - Experience in the use of CT in combined radiodiagnosis of pneumonia was analysed. It has been concluded that CT objectively reflects morphological inflammatory pulmonary changes and permits their all-round assessment over time. The diagnosis of pneumonia in CT is based on classical x-ray symptoms. As compared to survey radiography CT reveals symptoms of pneumonia to the full at earlier stages. CT is an important additional method of investigation of inflammatory pulmonary diseases, but it should not be used separately without survey radiography. In a majority of cases when CT is performed there is no need in x-ray tomography. PMID- 2718368 TI - [Computed tomography of idiopathic fibrosing alveolitis (Hamman-Rich syndrome)]. PMID- 2718369 TI - [The use of absolute alcohol in the endovascular therapy of varicoceles]. PMID- 2718370 TI - [Radionuclide diagnosis of false aneurysm in injuries of the arteries of the lower extremities]. PMID- 2718371 TI - [X-ray endoscopic study of the bile ducts following endoscopic papillosphincterotomy]. PMID- 2718372 TI - Detection of IgE antibodies to bovine respiratory syncytial virus. AB - The role of IgE antibodies against respiratory syncytial virus has attracted attention for both human and bovine disease. To detect such antibodies, we have developed an enzyme-linked immunosorbent assay (ELISA) specific for bovine respiratory syncytial virus (BRSV). Firstly, antiserum strongly positive for BRSV specific IgE was produced by immunizing a levamisole-treated calf with BRSV. The presence and specificity of BRSV-specific IgE in this animal was confirmed with the Praunitz-Kustner (PK) technique. Potential interference in an ELISA by other BRSV-specific immunoglobulin isotypes was eliminated by preferential precipitation of serum samples with 27.5% saturated ammonium sulfate. The correlation between the PK and the assay was greater than 93% and the ELISA was found to be more specific than the PK. Indeed, in a pilot experimental infection study, the serum levels of BRSV-specific IgE were found to correlate with the symptom expression following repetitive live virus aerosolization. This may prove to be a useful rapid test to study both herd immunity and the potential pathogenic influence of IgE. PMID- 2718373 TI - Colostral transfer of bovine immunoglobulin E and dynamics of serum IgE in calves. AB - The role of IgE in protective immunity is becoming understood, therefore the colostral transfer of IgE and the age-dependent changes of IgE levels may be important for neonatal immunity. To investigate this question, serum samples were collected from range-fed Hereford cows and their calves from birth through 9 months of age. The sera were assayed for total IgE during the first week postpartum, indicating colostral transfer of IgE. Thereafter, serum levels declined rapidly within 3 weeks from birth. The IgE levels began to increase after 12 weeks of age, and in some cases reached adult levels. The passive transfer of maternal IgE through colostrum may be important in providing early protection from disease, especially against intestinal parasites. PMID- 2718374 TI - Degradation of bovine C3 by serine proteases from parasites Hypoderma lineatum (Diptera, Oestridae). AB - Purified enzymes of Hypoderma lineatum (Insecta, Oestridae), were assayed for their proteolytic activity on bovine C3 in normal cattle sera. The products of cleavage by these serine proteases (hypodermins A, B, and C), were analysed by electrophoresis in SDS polyacrylamide gels followed by immunoblotting. The enzymatic attack was initially directed at the alpha polypeptide chain by hypodermin A at a concentration of 1 micrograms/ml of serum and by hypodermin B at 5 micrograms/ml. The generated peptides differed in their molecular size from those produced during natural degradation of C3 in a control serum by physiologically relevant enzymes. Hypodermin A, at a concentration of 1 microgram/ml, also caused a cleavage of the beta chain. At 5 micrograms/ml, hypodermin A induced total degradation of the C3 molecule. Hypodermin B (5 micrograms/ml) starts splitting C3 near cleavage sites of factor I. Bovine C3 appears to be highly sensitive to hypodermins A and B in normal sera. Apparent molecular sizes and alignment of the bovine C3 cleavage products are presented schematically. Hypodermin C, a collagenolytic enzyme, had no effect on C3 in normal sera. The biological consequences for the immunopathological reactions associated with hypodermosis are discussed. PMID- 2718375 TI - Immunization with a vaccinia recombinant expressing the F protein protects rabbits from challenge with a lethal dose of rinderpest virus. AB - A cDNA clone containing the complete coding sequence of the rinderpest fusion protein (F) gene was inserted into the thymidine kinase gene of vaccinia virus (WR strain) under the control of the 7.5K early/late vaccinia virus promoter. All forms of the F protein, i.e., the glycosylated F0 precursor, the unglycosylated F1 protein, and the glycosylated F2 protein, were detected in cells infected with the recombinant virus. Vaccination of rabbits with the recombinant virus induced antibodies which reacted in an ELISA system specific for rinderpest. The rabbit sera contained neutralizing antibodies against rinderpest virus and precipitated the F protein from lysates of rinderpest infected cells. Rabbits vaccinated with the recombinant rinderpest F gene vaccinia virus were protected from a lethal challenge with the lapinized Nakamura 3 strain of rinderpest virus. Variations in the severity of clinical symptoms correlated with the level of anti-F protein antibodies produced. PMID- 2718376 TI - Intracellular transport and processing of Sindbis virus glycoproteins. AB - The intracellular transport and processing of Sindbis virus envelope glycoproteins were studied in cells infected with Sindbis virus using the mannose specific enzyme, endoglycosidase H (endo H). In pulse/chase labeling experiments of hamster cells with [35S]methionine, Sindbis glycoproteins PE2 and E1 became endo H resistant in two steps at 12.5 and 20.0 min after a 5-min pulse, suggesting that the glycoproteins required this period of time to be transported to the Golgi compartments containing the enzymes which process the high mannose side chains acquired in the endoplasmic reticulum. E2 could be detected at the end of a 5-min pulse and the E2 produced early was found to be endo H sensitive. The rate at which PE2 was converted to E2, relative to the acquisition of endo H resistance, suggests the independence of this proteolytic event from cellular protein transport and raises the possibility that the proteolytic function is of viral origin. PMID- 2718377 TI - Host age and cell type influence measles virus protein expression in the central nervous system. AB - Measles virus infection of the central nervous system (CNS) of children can result in a slow, progressive fatal disease, subacute sclerosing panencephalitis (SSPE). The pathogenesis of persistent measles virus infection of the CNS has been studied by comparing viral protein expression in suckling or weanling hamsters infected with the HBS strain of measles virus. Suckling animals develop a rapidly progressive fatal encephalitis while weanling animals survive and are persistently infected. Viral nucleocapsid (NP) and hemagglutinin (H) proteins have been examined during acute infection in suckling and weanling animals. Viral H protein expression is selectively inhibited in infected neurons of weanling animals, while infected ependymal cells retain the capability to express H protein at the cell surface; suckling animals express high levels of both proteins. Anti-measles antibodies are not responsible for the inhibition of H protein since immunosuppression does not restore protein expression. The cell associated virus which is recovered late in infection by co-cultivation with Vero cells expresses all viral proteins. These results suggest that intact viral genome is present in persistent infections, and cell type or state of differentiation of infected cells may be instrumental in expression of viral proteins which can influence lytic or persistent outcome of infection. PMID- 2718378 TI - Nucleotide sequence and translation of satellite tobacco mosaic virus RNA. AB - Satellite tobacco mosaic virus (STMV) is a plant virus with a 17-nm icosahedral particle encapsidating a 0.3 X 10(6) Mr ssRNA genome that depends on tobamoviruses for its replication. The complete nucleotide sequence of STMV RNA deduced in the experiments described here was 1059 nucleotides in length. The efficiency of labeling viral RNA with [gamma-32P]ATP using T4 polynucleotide kinase was not affected by treatment with tobacco acid pyrophosphatase and/or bacterial alkaline phosphatase, indicating that the majority of the 5' termini of encapsidated STMV RNAs were not phosphorylated. The 240 3'-terminal nucleotides of STMV RNA and either tobacco mosaic virus (TMV) U1 RNA or TMV U2/U5 RNA had greater than 65% overall sequence similarity, with two nearly identical regions of 40 and 50 bases, respectively. There were no other regions of sequence relatedness to TMV RNA. The 19 5'-terminal nucleotides of STMV RNA had greater than 65% sequence similarity with the 16 5'-terminal nucleotides of brome mosaic virus (RNA 3 and 50% sequence similarity with the 12 5'-terminal nucleotides of the Q strain of cucumber mosaic virus RNA 3. The first open reading frame (ORF) beginning at base 53 encoded a 6800 Mr protein that corresponded in size to a major in vitro translation product directed by STMV RNA. A second ORF, beginning at nucleotide 163, had the capacity to code for a protein that corresponded in size (17,500 Mr) to the other major in vitro translation product. The first 12 codons of this ORF corresponded to the sequence of the N-terminal amino acids of the capsid protein. Western-blot analysis of the in vitro translation products revealed that the 17,500 Mr protein had the same electrophoretic mobility as the authentic capsid protein; it was also antigenically related to the capsid protein, but the 6800 Mr protein was not. Time course analysis of in vitro translation demonstrated that the 6800 Mr protein was synthesized at the same time as the capsid protein and did not arise by the proteolytic cleavage of a larger precursor polypeptide. These results suggest that the genome of STMV functioned as a polycistronic messenger RNA. It has not been determined if the 6800 Mr protein is synthesized in vivo. STMV RNA had untranslated regions of 52 and 418 nucleotides at its 5' and 3' termini, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2718379 TI - Cloning and molecular characterization of the myxoma virus genome. AB - Restriction enzyme cleavage maps of the genomes of the Uriarra (Ur), Glenfield (GV), and Lausanne (Lu) strains of myxoma virus were deduced for the enzymes EcoRI, KpnI, BamHI, SalI, HindIII, BglI, PstI, and PvuII. Restriction maps for the three strains were indistinguishable with the exception of an additional KpnI site in the Lu genome at map position 38.8. Genomic DNA fragments were cloned into the plasmid vector pGEM-3 and the viral genome was determined to be 163.6 (+/- 0.2) kb in length. Covalently closed terminal fragments were identified by electrophoresis of "snapback" fragments and the 5.3 kb BglI end fragment was cloned after S1 nuclease digestion of the hairpin structure. PMID- 2718381 TI - The genome structure of turnip crinkle virus. AB - The nucleotide sequence of turnip crinkle virus (TCV) genomic RNA has been determined from cDNA clones representing most of the genome. Segments were confirmed using dideoxynucleotide sequencing directly from viral RNA, and the 3' terminal sequence was confirmed by chemical sequencing of end-labeled genomic RNA. Three open reading frames (ORFs) have been identified by examination of the deduced amino acid sequences and by comparison with the ORFs found in the genome of carnation mottle virus. ORF 1 initiates near the 5' terminus of the genome and is punctuated by an amber termination codon. Translation of ORF 1 would yield a 28-kDa protein and an 88-kDa read-through product. The read-through domain possesses amino acid sequence similarities with putative viral RNA polymerases. ORFs 2 and 3 encode products of 38 (coat protein) and 8 kDa, respectively, which are expressed from subgenomic mRNAs. The organization of the TCV genome suggests that TCV is closely related to carnation mottle virus and distinct from members classified in other small RNA virus groups, such as the tombus- and sobemoviruses. PMID- 2718380 TI - Turnip crinkle virus infection from RNA synthesized in vitro. AB - Genome-length cDNA clones of turnip crinkle virus (TCV) were constructed with SmaI and XbaI restriction sites engineered at the 5' and 3' termini, respectively. The genome-length cDNAs were positioned downstream of modified lambda and T7 phage promoters such that in vitro transcription resulted in RNAs with 5 extra nucleotides at the 3' end, and 1, 2, or 14 extra nucleotides at the 5' end depending on the construction. Transcripts with 14 extraviral 5' nucleotides were not infectious, while transcripts with 1 or 2 additional 5' nucleotides, with or without 5'-cap analog included in transcription reactions, were biologically active. These were approximately an order of magnitude less infectious than RNA extracted from TCV virions. The additional 5' nucleotides were not maintained in progeny viral RNAs isolated from plants. PMID- 2718383 TI - Nucleotide sequence from the ssRNA bacteriophage JP34 resolves the discrepancy between serological and biophysical classification. AB - The nucleotide sequence of the coat and lysis genes of the single-stranded RNA bacteriophage JP34 is presented. Serological inactivation studies classified this phage as an intermediate between groups I and II. We show that the nucleotide similarity with group I is less than 45% but more than 95% for group II, classifying JP34 as a member of group II. The altered serotype of JP34 is most likely due to the change of three critical amino acids of the coat protein to residues present in group I phage MS2 at the homologous positions. Serological characterization of RNA bacteriophages is thus not unambiguous. Phylogenetic sequence comparison between JP34, GA, and MS2 confirms the existence of a conserved helix in the coat gene of group I and group II phages. We also show that the JP34 coat and lysis genes can be expressed in cDNA clones and that the translation of the lysis gene is coupled to coat gene translation analogous to the regulation found in the group I phages. PMID- 2718382 TI - Rifampicin prevents virosome localization of L65, an essential vaccinia virus polypeptide. AB - In contrast to its irreversible effect on the Escherichia coliRNA polymerase beta subunit, the antibiotic rifampicin reversibly inhibits vaccinia virus morphogenesis at a step during the formation of immature viral particles. The protein affected by the presence of rifampicin is L65, a major late vaccinia polypeptide to which mutations that confer rifampicin resistance have been mapped. We now provide evidence using a monospecific anti-L65 serum in concert with immunofluorescence and sucrose gradient analysis that the mechanism of action of rifampicin on vaccinia virus replication involves the inhibition of localization of L65 to the viral factories (virosomes) thereby blocking further development. Studies on the expression and distribution of L65 during the infection cycle reveal that L65 is a stable, nonglycosylated late protein associated with virions. These results are discussed in relationship to the possible in vivo functions of the L65 protein. PMID- 2718384 TI - Negative regulation of the hepatitis B virus pre-S1 promoter by internal DNA sequences. AB - Expression of the surface antigen gene (S gene) of hepatitis B virus is directed by two distinct promoter elements with markedly different activities. The upstream (pre-S1) promoter produces a 2.4-kb transcript at very low levels while the downstream (pre-S2) promoter produces an approximately 2.1-kb transcript in relative abundance. We have constructed a series of internal deletion mutants to analyze differential regulation of the two S gene promoters. We show here that expression directed by the pre-S1 promoter is negatively regulated by DNA sequences containing the downstream pre-S2 promoter region. Nuclear run-on analysis indicates this down-regulation to be at the level of transcription. Furthermore, promoter repression does not appear to be due to products of the S gene region. Deletion mutagenesis studies have permitted the localization of a 61 bp region that may be involved in the apparent down-regulation of the pre-S1 promoter. These results suggest the use of an unusual regulatory mechanism by a dipromoter gene in which an active internal promoter may preclude efficient use of an upstream promoter. PMID- 2718385 TI - The sequences of the S2 genome segments of reovirus serotype 3 and of the dsRNA negative mutant ts447. AB - The most temperature-sensitive dsRNA-negative mutant of reovirus serotype 3 is ts447; the amount of dsRNA formed in cells infected with it at 39 degrees is less than 0.1% of that formed in cells with wt virus at 37 degrees. The genome segment in which this mutation is located is S2. We compare here the sequence of the S2 genome segment of wt reovirus serotype 3 with that of mutant ts447. The two sequences differ in three locations, at two of which there are C to U transitions, while at the third there is an A to G transition. All cause amino acid changes (Ala to Val, Ala to Val, and Asn to Asp, respectively). One mutation (at nucleotide position 581, which causes an Ala to Val change) causes the length of an alpha-helix to be significantly reduced and may be that which is responsible for the ts phenotype. PMID- 2718386 TI - Sialic acid is cleaved from glycoconjugates at the cell surface when influenza virus neuraminidases are expressed from recombinant vaccinia viruses. AB - Three different influenza virus neuraminidase (NA) genes have been subcloned into the vector pSC11 and expressed from the recombinant vaccinia viruses. These genes are from influenza viruses A/Tokyo/3/67 (N2); A/tern/Australia/G70c/75 (N9); and B/Hong Kong (HG)(NA of B/Lee/40). Cells infected with recombinants containing the NA gene express enzymatically active NA on the cell surface. The expressed protein results in the infected cells beings stripped of sialic acid, the receptor for influenza virus. This is not due to cleavage by NA from detached cells since at low multiplicity of infection only cells present at plaques are devoid of sialic acid. Thus NA is able to cleave sialic acid from neighboring glycoconjugates on the same membrane. PMID- 2718388 TI - Kinetics of velvet tobacco mottle virus satellite RNA synthesis and encapsidation. AB - Synthesis of circular (RNA 2) and linear (RNA 3) molecules of velvet tobacco mottle virus (VTMoV) satellite RNA (sat RNA) has been studied by incubating strips of tissues excised from systemically infected Nicotiana clevelandii in solutions of [14C]uridine. After a short lag, RNA and virus synthesis proceeded at a constant rate for at least 24 hr, during which time most of the synthesis was directed to the production of RNAs 2 and 3. The kinetics of [14C]uridine incorporation into the sat RNA molecules after increasing times of incubation and during pulses of [14C]uridine followed by chase incubation with excess [12C]uridine suggest that RNA 3 is a percursor of RNA 2. However, not all the RNA 3 synthesized was shown to end up as RNA 2, even after 72 hr of incubation. Several lines of evidence are presented supporting the conclusion that VTMoV infected cells contain large pools of unencapsidated sat RNA. It is suggested that the sat RNA may have a greater affinity for the VTMoV replicase than the helper viral RNA which results in copious production of the sat RNA. PMID- 2718387 TI - Tacaribe virus L gene encodes a protein of 2210 amino acid residues. AB - The nucleotide sequence of Tacaribe virus (TV) L gene was obtained from two sets of overlapping cDNA clones constructed by walking along the virus L RNA using two successive synthetic DNA primers. Analysis of the sequence indicated the existence of a unique long open reading frame in the viral complementary strand. The first in-phase AUG codon is in positions 31-33 from the 5' end of the viral complementary L RNA surrounded by a sequence favorable for initiation of protein synthesis. The open reading frame ends at positions 6661-6663. The predicted TV L protein is a 2210 amino acid long polypeptide with an estimated molecular weight of 251,942. Comparison of the amino acid sequence of TV L protein with peptide sequences predicted from L-derived cDNA clones of lymphocytic choriomeningitis virus shows an overall 42% of homology. PMID- 2718389 TI - Two subtypes of nucleoproteins (NP) of influenza A viruses. AB - The nucleoprotein (NP) genes of nine influenza A virus strains isolated from different species have been sequenced and the deduced amino acid sequences have been compared to published NP sequences and sequences in press. Two "subtypes" of NPs can clearly be defined, one "subtype" comprises the NPs found with all tested human and one porcine strain, and another "subtype" comprises the NPs found with all tested avian and equine, and some porcine strains and a mink virus. There are no significant differences between these two groups concerning secondary structure predictions. Pig viruses were the only ones whose NP can belong to the one or the other "subtype." Therefore, pigs can be regarded as "mixing vessels," where the two independently evolving reservoirs of influenza A viruses can meet for the creation of new pandemic strains by reassortment. PMID- 2718390 TI - The nucleoprotein gene of Ebola virus: cloning, sequencing, and in vitro expression. AB - Genomic and messenger RNAs of a Zaire strain of Ebola virus were cloned, and inserts specific for the nucleoprotein gene were isolated and sequenced. The nucleoprotein gene is located proximal to the 3' end of the genome and is preceeded by a putative leader sequence. The gene begins with the transcriptional start site sequence 3'-UACUCCUUCUAAUU..., and ends with the polyadenylation site sequence 3'-... UAAUUCUUUUUU. The predicted coding region is 2217 bases in length and encodes a protein that contains 739 amino acids, with a calculated molecular weight of 83.3 kDa. The protein has an approximate net charge of -30 and can be divided into a hydrophobic N-terminal half and a hydrophilic and highly acidic C terminal half. An in vitro transcript, generated from plasmid DNA containing the entire coding region, directs the synthesis of authentic nucleoprotein in a rabbit reticulocyte lysate system. The genomic organization and transcriptional signals of Ebola are similar to those of other nonsegmented, negative-strand RNA viruses, but nucleic acid or amino acid sequence comparisons indicate a lack of similarity. PMID- 2718393 TI - [Let us bring democratization and glasnost to the work of military medical personnel]. PMID- 2718394 TI - [The pride of the faculty]. PMID- 2718391 TI - Functional mapping of the activity of the R region in the human T-cell leukemia virus type I long terminal repeat to increase gene expression. AB - We previously demonstrated the activity of the R fragment in the long terminal repeat of human T-cell leukemia virus type I for elevation of the level of gene expression. In this study, the fragment was deleted with BAL31 nuclease to determine its functional domain. Series of the shortened R fragments were linked to the simian virus 40 promoter unit, which regulated expression of a reporter gene. Examination with the R fragments deleted from the 5' and 3' ends showed that borders of the functional domain were mapped within nucleotide positions 458 to 473 for the 5' end and nucleotide positions 559 to 594 for the 3' end, respectively. Thus we conclude that a 136-base-pair fragment corresponding to the second half of the R region was sufficient to allow elevation of the level of gene expression. PMID- 2718392 TI - A very small viral double-stranded RNA. AB - UmV is a double-stranded RNA (dsRNA) virus of the corn fungal pathogen Ustilago maydis. UmV has no infectious cycle. Some UmV subtypes have viral dsRNAs encoding secreted toxins that kill sensitive cells of the same species and related species. There are three viral subtypes, P1, P4 and P6, which differ in the specificity of their secreted killer toxins. Each has three size classes of dsRNA: H (heavy), M (medium) and L (light). The L segments of UmV are unique in being derived from one end of the larger M segments. We have sequenced P1 L and placed it at the 3' end of the P1 M1 plus strand. In their overlapping regions, these dsRNAs are identical in sequence. In vitro translation of P1 M1 results in a peptide whose size is consistent with its being encoded by the non-L region of M1. P1 L is a very small dsRNA of 355 bp. It has no long open reading frames and produces no detectable in vitro translation product. The sequence of P1 L suggests that it is derived by a process unique among dsRNA viruses: replication and packaging of the 3' end fragment of a processed mRNA. PMID- 2718395 TI - [Use of computers in the management of ambulatory care]. PMID- 2718396 TI - [Algorithms for improving laboratory diagnosis at a military polyclinic]. PMID- 2718397 TI - [Experience in organizing surgical care for the wounded in the Army of the Republic of Afghanistan]. PMID- 2718398 TI - [The results of the work of the medical service of the Armed Forces in 1988 and tasks for the new academic year]. PMID- 2718399 TI - [A complex clinical x-ray morphologic approach to determining the surgical procedure in mine-blast wounds]. PMID- 2718400 TI - [The processing and analysis of radiocardiograms using computers]. PMID- 2718401 TI - [Medical rehabilitation of hypertension patients]. PMID- 2718402 TI - [The importance of electrophysiologic study of the heart in determining the activity of primary rheumatic carditis]. PMID- 2718403 TI - [The incidence of detecting and the clinico-functional characteristics of the premature ventricular repolarization syndrome]. PMID- 2718405 TI - [Auscultation of patients with congenital heart defects]. PMID- 2718404 TI - [Use of prostenon in treating arterial hypertension]. PMID- 2718407 TI - [Use of the constitutional approach in assessing the activities of sensing equipment operators]. PMID- 2718406 TI - [Experience in organizing personnel hygiene education]. PMID- 2718408 TI - [Psychophysiologic evaluation of the motor habit of flying a plane in pilots during retraining]. PMID- 2718409 TI - [Criteria for the comparative evaluation of the toxicity of combustion products of synthetic materials used in ship construction]. PMID- 2718410 TI - [Excess body weight at a young age as a risk factor for developing metabolic diseases]. AB - A total of 100 patients, aged 16-25 years, suffering from metabolic-alimentary obesity were investigated under clinical conditions. An analysis was made of deviations from the normal parameters of arterial pressure, blood serum lipids, and other risk factors of the development of atherosclerosis, coronary heart disease, essential hypertension and other metabolic diseases. The shifts detected could be directly dependent of the disorders in nutrition. Alimentary correction of the disorders noted, reduction of body mass resulted in the improvement of the subjective conditions of patients, and in normalization of the above parameters. However, in some patients significant improvement in the metabolic status of the patients (lipid, in particular) was not achieved. The necessity of dispensary follow-up of young patients with obesity has been considered. PMID- 2718411 TI - [Anti-atherosclerotic properties of higher mushrooms (a clinico-experimental investigation)]. AB - Antiatherosclerotic properties of water and alcoholic extracts of 20 types of high-species mushrooms were investigated by evaluation of intracellular cholesterol accumulation and 3H-thymidine inclusion into the cells of the human aortal intima in culture. The influence of a single intake of some mushroom species on antiatherosclerotic properties of the human sera was studied. It has been shown that Ganoderma lucidum and Lentinus edodes possess pronounced antiatherosclerotic properties. PMID- 2718412 TI - [New data on the metabolism and physiologic mechanisms of aspartame action]. AB - A comprehensive investigation of the physiological action of aspartame was conducted in 11 volunteers (healthy subjects, aged 18-37 years, with normal bw), and in experiments on 90 male Wistar rats, that were given aspartame in doses of 40 and 4000 mg/kg during 90 days, and in 3 dogs with gastric fistulas according to Basov. The study of microsomal and lysosomal activities in the liver, the turnover rate of liver proteins and blood plasma in rats revealed changes in the activity of liver cathepsins and in blood plasma albumin life time. The reaction of food thermogenesis after aspartame intake was recorded in experiments on dogs, that received sham feeding, and in the volunteers. As a whole, in the experiments including aspartame intake in a permissible daily dose for humans (40 mg/kg) no unfavourable action of the agent on the metabolic parameters studied was recorded. PMID- 2718413 TI - [Prospects of using new low-calorie products based on a soybean protein isolate in the prevention and treatment of metabolic diseases]. AB - In an experiment on 14 clinically healthy volunteers (12 women and 2 men) a study was made of the tolerance, assimilation and metabolic effectiveness of high protein low-calorie food products in dietetic correction of excessive body mass. It has been noted that using soybean protein isolate as a component of low calorie food is promising. PMID- 2718414 TI - [Use of dietetic canned meats in the nutrition of infants with food allergy]. AB - Formulas have been developed for special canned pig meat "Pig meat puree" and "Cheburashka" and horse meat "Konek-gorbunok", and a combination of pig and horse meat "Vinni Pukh", without extractives. The above canned meat produced a high therapeutic effect when it was included into the diet of infants suffering from food allergy because of sensitization to cow milk and beef proteins. The canned meat permits correcting the ration by protein component and providing 25-30% of daily protein requirement of an infant. PMID- 2718415 TI - [Experience in the use of anti-colibacillus and Proteus lactoglobulin as a supplement to milk products in diet therapy at a specialized childrens' collective]. AB - A new biologically active supplement (BAS) for infant food was tested at an Infant's Home. BAS-IG contains lactoglobulin, an immune preparation against colibacillus and Proteus. During the primary examination of the infants in the Infant's Home intestinal dysbacteriosis was revealed in 100% of the infants, clinical signs of dysbacteriosis were detected in 88.4% of the infants. Two successive courses of feeding the infants with products enriched with the new supplement resulted in a significant improvement of the microflora composition in them and in normalizing their clinical condition. At the same time positive changes in a number of immunological factors were recorded. The authors have recommended using BAS-IG for correction of dysbacteriosis in children at Infant's Homes. PMID- 2718416 TI - [Epidemiologic characteristics of nutrition of school children at high risk for developing ischemic heart disease and atherosclerosis]. AB - The results of the investigation of a representative sample of Moscow schoolchildren, aged 11-14 years, are described. The investigation included a triple arterial pressure measuring, anthropometry, numerical score of sexual development, assay of cholesterol, triglycerides and high-density lipoprotein cholesterol levels in the blood serum. The character of nutrition of 250 (20% of the sample) schoolchildren was studied by the method of dietary inquiry (daily ration) with the use of food patterns. The data of the multivariative analysis have shown that sexual development, a low educational level of the parents (among them subjects engaged in the manual labor being predominant) influence the development of the risk factors of ischemic heart disease and atherosclerosis. Composition of food is of great importance, especially for boys with dislipoproteinemias (low consumption of starch per 1 kg bw, high consumption of total protein, low consumption of fat in cal %), and for those with excessive body mass and low physical activity (low consumption of total fat, polyunsaturated fat per 1 kg bw, as well as high consumption of total protein in cal %). PMID- 2718417 TI - [An experimental study of the enzyme systems of the initial and final stages of nutrient hydrolysis in the small intestine upon an early transition to qualitatively different rations]. AB - It is shown that when small rats are early (beginning with the 18th day of life) given semisynthetic diets the reactions of the pancreatic and intestinal enzyme systems become nonspecific, and they are expressed in a rise of both proteolytic and carbohydrase activities, regardless of the content of proteins or carbohydrates in the diet. This reaction is of stress nature, and the hypothalamo hypophysial-medullar system participates in its realization. During further maintenance of the small rats on special diets (30 days) it is recorded that the enzyme spectrum corresponds to the diet composition: when the protein diet is used proteolytic enzyme activity prevails, while in case of carbohydrate diets enzyme activities of pancreatic and enteral carbohydrases predominate. A conclusion has been made that under conditions of early semisynthetic feeding the adaptation of the digestive system to the food content is first realized through the mechanisms of hormonal regulation, and then--the substrate one. PMID- 2718418 TI - [The significance of the structure of dietary oligosaccharides in their metabolism into liver lipids]. AB - In experiments on 24 Wistar male rats the time course of incorporation of radioactive carbon and hydrogen of glucose and fructose into liver lipids was studied, as well as the influence on this process of the animals feeding with rations containing sucrose and inverted sugar (17% calory value). A mathematical model has been suggested for the evaluation of the effect of sugar and a glucose fructose mixture on monosugar utilization into liver lipids. It was found that sucrose led to an increase in the rate of the label incorporation into liver lipids from glucose and fructose, and to a growth in the constant of the label release from lipids, i.e. induced acceleration of the liver lipid turnover. These effects were absent in rats given inverted sugar. PMID- 2718419 TI - [The effect of saccharose on the growth and structure of bone tissue]. AB - The content of organic mineral components in bones was studied after substitution of 25 and 50% of carbohydrate energy value in rations for saccharose. It was established that saccharose stimulated the growth of experimental animals, this was attended by increased phosphomonoesterase-1 activity, epiphyseal cartilage thickening, hyperfunction of the growth zone and changes in the phosphorus calcium metabolism. PMID- 2718420 TI - [Calcium metabolism in the case of vitamin D and K deficiencies]. AB - Moderate vitamin K deficiency was induced in growing rats by 4-week food ration deficient in vitamin K. It was characterized by prolongation of prothrombin time by 35%, and reduced by 23% in vitro calcium absorption by the duodenal disks in the animals provided with vitamin K, producing no significant effect on calcium concentration in the blood serum of rats with varying vitamin providing. Vitamin K deficiency did not influence the concentration of parathormone and 25 hydroxyvitamin D in the blood serum of rats provided with vitamin D, but it did not raise the degree of hyperparathemia in vitamin D deficiency and prevented the normalization of parathormone level after administration of physiological doses of vitamin D to rats deprived of this vitamin. PMID- 2718421 TI - [Simulation of the Baird-Parker media formula based on Soviet ingredients for the isolation of Staphylococcus aureus]. AB - A medium has been prepared based on Soviet nutrient agar and reagents supplemented by ingredients from Baird-Parker's medium. Its growth and selective properties are close to those of Baird-Parker's medium. The new selective medium has been recommended for isolation of S. aureus from food products and environment objects. PMID- 2718422 TI - [Selenium content in food products, rations and blood serum in humans in an area endemic with respect to Keshan's disease]. PMID- 2718423 TI - [Colonization of unboiled milk with toxigenic Staphylococcus and its resistance upon pasteurization]. PMID- 2718424 TI - [Peroxide content of dietary vegetable oils under various storage conditions]. PMID- 2718426 TI - [Facial pains in alcohol abuse]. AB - The authors describe the peculiar aspects of the course of facial pain in patients with alcohol abuse and recommend complex treatment of this condition. PMID- 2718425 TI - [Criteria for assessment of nutritional status]. PMID- 2718427 TI - [Rehabilitation of patients with chronic bronchitis who are engaged in agricultural work]. AB - The efficiency was studied of rehabilitation of 115 patients with chronic bronchitis engaged in agricultural work under the effect of a complex of traditional health-resort climatic factors as well as this complex supplemented by breathing exercises with additional dead space or intensified graded physical exercises (cycling, running). Only the therapeutic complex including physical exercises proved efficient. PMID- 2718428 TI - [Standardized methods for detecting arterial hypertension and ischemic heart disease among the workers of industrial enterprises]. AB - Results are reported of a clinico-epidemiological study of 9000 workers with the purpose of evaluation of the incidence of arterial hypertension (AII) and ischemic heart disease (IHD). The incidence of AH was 29% and IHD was 6.5%. This high incidence of these conditions was low according to findings of dispensarization examination of professional collectives, namely, 1-1.5% for AH and 0.8-1% for IHD. PMID- 2718429 TI - [Arterial pressure in female combers depending on age and the length of work service]. AB - The arterial pressure values were examined in 111 female workers of a combing shop. Hypotension was diagnosed in 22.5% of workers and hypertension in 5.4% of workers. The authors use a complex of measures to reduce noxious effects of industrial factors with the purpose of stabilization of the arterial pressure. PMID- 2718430 TI - [Effect of electrolysis oxygen on the human body]. AB - Volunteers were subjected to the effect of electrolysis oxygen received from different moisture materials in a system with hard polymer electrolyte. Results indicate that a 30-minute inhalation of electrolysis gaseous oxygen in mixture with gaseous nitrogen (1:4) produced no negative effect on the vital systems of the human body. Electrolysis gaseous oxygen is recommended for breathing and medical purposes. PMID- 2718431 TI - [Cerebral blood flow in meningitis]. AB - The cerebral blood flow was studied rheoencephalographically in patients with a grave clinical course of purulent meningitides. The main rheographic parameters showed changes in the dynamics of the disease. It is concluded that there is a lack of coordination between the clinical and morphofunctional cure by the time of discharge from the hospital and, thus, rehabilitative treatment should be continued in out-patient conditions. PMID- 2718432 TI - [Reiter's syndrome in patients with yersiniosis]. AB - Reiter's syndrome is a rare pathology in patients with yersiniosis and occurs in 0.9% of all clinical forms of the disease. Yersiniosis etiology was established in 7 patients with Reiter's syndrome. The diagnosis was confirmed serologically. Treatment consisted of levomycetin, gentamycin, in one patient--tetracycline as well as non-steroidal anti-inflammatory drugs indomethacin, metindol. All patients recovered completely within 1-2 months. No recurrences were noted within a 6-18 month follow-up. PMID- 2718434 TI - [Effect of hemosorption on indices of natural resistance in chronic kidney failure]. PMID- 2718433 TI - [Central hemodynamic indices of patients with chronic kidney failure treated by hemodialysis]. AB - Examination of the central hemodynamics in patients with chronic renal failure and of symptomatic arterial hypertension revealed two hemodynamic variants of hypertension, namely, that corrected by dialysis arterial hypertension is based on an increase of the cardiac output associated with decrease of the peripheral resistance in the course of treatment and that noncorrectable by dialysis hypertension characterized by a stably high resistance of the arteriolar bed associated with an increased minute blood volume. It was also established that working overloading by resistance and volume results in essential disorders of the intracardiac hemodynamics. PMID- 2718435 TI - [Lyell's syndrome and pulmonary artery thromboembolism in a patient with pyelonephritis of the single kidney]. PMID- 2718436 TI - [Hypophyseal and adrenal hormones and the immune reactivity of patients with Itsenko-Cushing disease after an adrenal autograft]. AB - The authors employed for the first time the method of heterotopic autotransplantation of the adrenals on a vascular pedicle in patients with Itsenko-Cushing disease. It was established that heterotopic transplantation of the adrenals results early in a significant reduction of the level of cortical hormones and insignificant change as compared with initial state of the immune status. All terms were characterized by humoral and cellular immune deficit. Results indicate the expediency of using this method. Adrenal transplantation prevents the development of hypocorticism. PMID- 2718437 TI - [Thrombocyte function and the repair of myocardial infarct]. AB - The functional state of thrombocytes (aggregation capacity and sensitivity to prostacyclin) was studied in 77 patients with myocardial infarction. Reparation processes were assessed. In cases of high initial activity of thrombocytes disorders were revealed in the processes of infarction healing. Low aspirin doses resulted in an improvement of the functional state of thrombocytes and normalization of reparative processes in the myocardium. PMID- 2718438 TI - [The motor regimen for myocardial infarct patients at the stage of hospital treatment]. AB - Long-term observations are presented in a differentially selected group of patients with macrofocal and transmural myocardial infarction subjected to an extensive program of motor exercises during hospital treatment. Results of rehabilitative treatment proved better in this group in the long-term follow-up. Hospitalization time was reduced approximately in 1/6 of patients with macrofocal and transmural myocardial infarction. PMID- 2718440 TI - [Hemorheologic indices of patients with chronic ischemic heart disease]. AB - The authors examined 35 patients suffering from ischemic heart disease with signs of stage-I circulatory insufficiency. It was established that the hemorheological values were distinctly increased. This increase was associated with an increase of the general peripheral resistance. PMID- 2718439 TI - [Autocoagulogram indices of patients with ischemic heart disease]. AB - Data are presented of an investigation of the coagulation activity of the blood plasma and whole erythrocytes carried by means of autocoagulography in 84 patients in the dynamics of ischemic heart disease. The patients showed an increased coagulation activity of the blood plasma and an insufficient compensation by erythrocytes in the course of the disease. Complex treatment including heparin did not change the procoagulant activity of erythrocytes. PMID- 2718441 TI - [Effect of hypolipidemic agents on the content of sterol-fibrinogen complexes of the blood in patients with ischemic heart disease]. AB - Comparative data are presented on the effect of hypolipidemic agents on the content and composition of sterol-fibrinogen complexes of the blood in patients with ischemic heart disease. Inclusion of heparin, miscleron, complamin in the complex treatment was accompanied by a distinct reduction of the concentration of sterol-fibrinogen complexes, normalization of the ratio of polar sterols. The employment of miscleron and heparin furthered a reduction of the load of sterols on fibrinogen. The use of diosponin did not essentially effect the above mentioned values. PMID- 2718442 TI - [Acute disorders of cerebral circulation in young people]. PMID- 2718443 TI - [Treatment characteristics of patients with the initial manifestations of failure of the cerebral blood supply at a sanatorium]. AB - A comparative evaluation is presented of the efficacy of complex treatment in health resort conditions of cerebral circulatory insufficiency associated with vertebrogenic cervicoalgia. Treatment included climatic factors, diet, exercises, radon baths, massage, acupuncture and supplementation of this complex by manual therapy and electric stimulation of muscles of the collar system. Inclusion of manual therapy and electric stimulation allowed to improve treatment results. PMID- 2718444 TI - [Psychoautonomic syndrome in occlusive lesions of the basin of the internal carotid artery]. AB - A complex psychophysiological investigation of 120 patients with occlusions in the territory of the internal carotid artery revealed regular disorders of the suprasegmental vegetative structures manifested as psychovegetative syndrome. This may be considered as one of the cases of limitation of the adaptation capacities of the of these patients. PMID- 2718446 TI - [Neurologic care in the public health system of the Ukrainian SSR]. PMID- 2718445 TI - [The fibrinogen-fibrin-fibrinolysis system in rheumatoid arthritis]. AB - The enzymatic, nonenzymatic and XIIa-dependent fibrinolysis was inhibited. In RA without systemic manifestations the main cause of appearance of soluble complexes of monomeric fibrins (SCMF) in the blood is a local activation of coagulation in the inflamed joint tissues. It is suggested that an increase of SCMF concentration in the blood in patients with RA is a reliable and dynamic index of the activity of the inflammatory process. PMID- 2718447 TI - [Characteristics of the thrombohemorrhagic syndrome in patients with systemic lupus erythematosus]. AB - The authors analyzed data of the clinical picture and autopsy results in 26 patients with systemic lupus erythematosus. During life hemorrhagic complications were revealed in 19% of patients, thrombotic--in 12%, while pathoanatomically they were found correspondingly in 46% and 27% of cases. In 15% of cases thromboses and hemorrhages were registered simultaneously. An interrelationship was noted between the activity of the disease and frequency of hemorrhagic complications as well as between the duration of the disease and quantity of thrombotic complications. PMID- 2718449 TI - [Opsonic cooperation in the neutrophil phagocytosis system in acute myeloblastic leukemia]. AB - Investigation of opsonic activity of the serum (OAS) and indices of neutrophil phagocytosis in 35 patients with acute myeloblastic leucosis (AML) and 20 healthy subjects indicates that reduction of OAS in AML results in disturbances of the processes of reception and absorption of microorganisms by granulocytes while insufficient activation of oxygen-dependent metabolism favours disorders of bactericidal activity of neutrophils. PMID- 2718448 TI - [The treatment of relapses of non-Hodgkin's lymphomas]. AB - It was established that radiation treatment followed by 1-2 courses of polychemotherapy proved optimal in the management of the first recurrences of non Hodgkin's lymphomas with a favourable course of the local character. It is concluded that in the treatment of the first recurrences of non-Hodgkin's lymphomas choice of the treatment tactics should depend on the cytomorphological variant of the primary tumour, character of the recurrence. PMID- 2718450 TI - [Vasoconstrictor action of ibuprofen in treating patients with pulmonary hypertension]. AB - A study of patients with pulmonary hypertension caused by chronic inflammatory pulmonary diseases revealed that ibuprofen may induce an elevation of the pressure in the lesser circulation that is most probably connected with inhibition of synthesis of prostacyclin and prostaglandins of type E. PMID- 2718451 TI - [Changes in the spectrum of low-molecular physiologically active substances in patients with acute pneumonia who abuse alcohol]. AB - A study of low-molecular substances in the blood serum of patients with acute pneumonia showing different risk factors as evidenced by fluid chromatography and gel chromatography showed its high value in prognosis of immunosuppression, in assessing the activity of the inflammatory process, an indicator for detoxicating and immunostimulating therapy and determination of treatment efficacy. PMID- 2718452 TI - [Solitary contusion hematoma of the lungs with air cysts]. PMID- 2718453 TI - [Lung study in bronchial asthma using x-ray pneumopolygraphy]. AB - Roentgenpneumopolygraphy (RPPG) was used to examine 48 patients with bronchial asthma and all patients showed a reduction of one or several indices of zonal ventilation and/or biomechanics of the respiratory act. Inhalation of broncholytics improved all indices of RPPG. But most patients revealed local disorders of ventilation resistant to the effect of broncholytic agents. Local therapy of the corresponding lung regions produced a positive effect. PMID- 2718454 TI - [A case of inguinal lymphogranulomatosis]. PMID- 2718455 TI - [Clinical characteristics of pulmonary tuberculosis detected in groups at risk]. AB - It was established according to dispensarization data that more than a half of all patients with freshly detected pulmonary tuberculosis were revealed among the contingents of risk groups (54.6%), i.e. significantly more frequent than among other groups of the population diagnosed during prophylactic fluorography and characterized by larger extension, severity of clinical disorders, prevalence of infiltrative and disseminated forms and frequency of bacteria elimination and the clinical cure was essentially lower as compared with patients showing no aggravating factors. Cessation of bacteria elimination, healing of caverns of disintegration was similar in the groups. PMID- 2718456 TI - [Comparative evaluation of the efficacy of surgical treatment methods in duodenal ulcers]. AB - On the basis of an analysis of organic and functional disorders revealed in 195 patients operated on for duodenal ulcer with a 1 to 20 years follow-up the authors propose a classification of evaluation of long-term results with consideration of rehabilitative and prophylactic measures. It was established that long-term results revealed a tendency to the increase of good and excellent outcomes both after gastric resection and after the two types of vagotomy. PMID- 2718457 TI - [Treatment of peptic ulcer patients using yellow laser light]. AB - A group of 26 patients received a course of endoscopic therapy for gastroduodenal ulcers using yellow laser light on copper vapours. Treatment was carried complexly with traditional drug therapy. Phototreatment (0.58 mcm) of the mucosal defects was carried out every other day, single dose equalling 2--3 joules; 12 +/ 2.0 days from the beginning of treatment were required for complete scarring of the duodenal ulcerations and 11.8 +/- 8.0 days for healing of gastric ulcers. PMID- 2718458 TI - [The significance of chronic cholecystitis and disorders of the acid-forming function of the stomach in the development of reflux esophagitis]. PMID- 2718459 TI - [Late results of the surgical treatment of chronic calculous cholecystitis in young patients]. AB - Long-term results of surgical treatment of chronic calculous cholecystitis were investigated in 139 patients of young age. Good results were observed in 83.5% of cases, satisfactory--in 11.5% of cases and failures--in 5% of cases. The authors present an analysis of the dependence of long-term results of surgical treatment of cholelithiasis in the young on the duration of the diseases before the surgical intervention, clinicomorphological form of cholecystitis, the degree of extension of the pathological process in the bile ducts and neighbouring organs volume of the operation and its character. PMID- 2718460 TI - [Experience in treating atopic dermatitis in children with vilozen]. AB - The authors present data on the treatment of 150 children with atopic dermatitis. The patients were examined by related specialists. After complex immunological examination the patients received intranasally vilozen for two weeks. It was established that the immune state normalized as a result of the above-mentioned treatment. PMID- 2718462 TI - [Structural characteristics of the thymus in a large fetus]. PMID- 2718461 TI - [Clinico-mycologic analysis of the effectiveness of treatment in patients with rubrophytosis of the feet]. AB - The authors carried out a clinico-mycological study of an extensive method of treatment of patients with rubrophytosis pedis based on an analysis of 34 patients with different clinical forms of the disease. It was established that the complex use of different antibiotics (ketoconazole, clotrimazole, chlorhexidine) proved highly effective. PMID- 2718465 TI - Radiation therapy with/without simultaneous weekly 5 F.U. in locally recurrent carcinoma of the recto-sigmoid. AB - Forty-eight patients received radiation therapy to the pelvis for locally recurrent carcinoma of the recto-sigmoid. The average duration before the development of local recurrence in the pelvis after curative surgery was 18 months. Thirty-seven patients had undergone a previous adbominoperineal resection. Twenty-five patients had Dukes' Stage-C carcinoma. Twenty-one patients had Stage-B and only two patients had Stage-A carcinoma of the rectosigmoid according to the Dukes' classification. All patients received radiation therapy to the pelvis to an average total dose of 5,000 rads in 25 to 28 fractions over a period of five to five and one half weeks. Twenty-three patients also received simultaneous weekly 5 F.U. by a single I.V. bolus of 1000mg to potentiate the action of radiation therapy. The treatments were well tolerated. The major complication was diarrhea, which responded satisfactorily to antidiarrheals such as Lomotil or Immodium tablets. Eighty per cent of the patients had pain relief. The median survival was 18 months for the patients receiving radiation therapy alone, but the patients treated with both radiation therapy and 5 F.U. had an average survival of 21 months and better palliation of symptoms. PMID- 2718464 TI - [Enzymes and metabolic products in the cerebrospinal fluid in acute craniocerebral trauma]. AB - A study of the activity of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, lactate and pyruvate in the CSF of patients with head injuries in the acute period revealed a high activity of the above enzymes and increased content of lactate as compared with a control group of patients. The activity of alanine aminotransferase and aspartate aminotransferase as well as the content of lactate showed a tendency to rise in patients with an unfavourable outcome of the disease. PMID- 2718463 TI - [Combined immunocorrection--a prospective method for treating secondary immunodeficiency]. AB - Clinico-immunological examination of 180 patients with chronic bronchitis and 207 patients with rheumatic heart disease revealed high therapeutic efficacy of combined use of such immunomodulators as levamisole, hemodes, sodium nucleinate. Combined treatment removes immunity defects and normalizes clinical symptoms. PMID- 2718466 TI - Metastatic renal cell carcinoma of the nasal septum. AB - Renal cell carcinoma tends to metastasize early to nearly all organs. In the head and neck region, the nasal cavities and paranasal sinuses are targets for its hematogenous spread. This is a case report of a renal cell carcinoma involving the nasal septum that presented as severe epistaxis after a nephrectomy for its primary and after a finger amputation for its metastatic site. PMID- 2718467 TI - Medical grand rounds. West Virginia University Health Sciences Center. Bites and stings. Part 1. Spiders. AB - Most animals can bite or sting. In narrowing the kingdom down to those that harm humans, the field still is vast. It would be interesting to explore the rich variety of pathology produced in us by moray eels, lionfish, sea urchins, jellyfish, sting rays, fire ants, kissing bugs, flies, lice, mosquitoes, ticks, mites, fleas, puss caterpillars, centipedes, snakes, dogs and cats, camels, and myriad other creatures including homo sapiens (not a trivial biter)--but for this grand rounds, the topic will simply be spiders (Part 1), bees and vespid (Part 2). Vespids are the wasps, yellow jackets and hornets. PMID- 2718468 TI - [Incidence of Giardia intestinalis in family environments in the light of epidemiologic studies]. AB - Coproscopy parasitological studies were carried out in family environments. Samples of feces were taken three times from 1728 persons (400 families) from urban and rural environments in south-eastern regions of Poland. The general extensity of giardiasis amounted to 39.6% and was higher in urban families (average 41.3%) than in those inhabiting rural areas (average 36.6%). The giardiasis dominated in children from 1 to 4 years (average more than 78% infected), especially in urban areas (extensity of infection 80.1%). It was also frequent in persons of male sex. PMID- 2718469 TI - [Nematoda of the gastrointestinal system of Gavia stellata and Gavia arctica (Gaviidae)]. AB - Four species of Nematoda: Capillaria mergi, Contracaecum rudolphii, Paracuaria tridentata, Stegophorus stellaepolaris were detected for the first time in Poland in two red-throated divers (G. stellata). Species P. tridentata and S. stellaepolaris appeared to be new for the Polish fauna. In turn black-throated diver (G. arctica) is a new host to C. mergi. PMID- 2718470 TI - New canestriniid mites (Acari, Astigmata, Canestriniidae) connected with beetles of the subfamilies Dynastinae and Cetoniinae (Insecta, Coleoptera, Scarabaeidae). PMID- 2718471 TI - [Activating group work with residents of retirement and nursing homes]. AB - Taking care for older people in homes for the aged and nursing homes should be improved and broadened concerning a higher activity of these people. A very good method seems to be group work. In this investigation group sessions with people in a nursing home have been made during the time of half a year. PMID- 2718472 TI - [Cultural management of citizens of retirement age in the South Magdeburg city district and initial results of implementing the 21 December 1987 ministerial decision for federal promotion of clubs and meetings of public solidarity]. AB - It is spoken about cultural taking care of old-age pensioners of the town district Magdeburg-Sud in good co-operation between the Magdeburg Council and factories, firms, social organizations, and deputies as well as voluntary workers. The realization of the Cabinet Council resolution is first estimated and further tasks are shown. PMID- 2718473 TI - [Perimortal management--humanistic assignment and responsibility. Attempt at status determination]. AB - The scientific research and practical use of all questions concerning life demands interdisciplinary cooperation. This is the result of neglection of death and dying and new social and medical developments as there are institutionalisation of dying and scientific-technical progress. The foundation of the working group "perimortal medicine" in 1983 in the Association for clinical medicine gives the possibility to discuss theoretical and practical questions concerning the end of life, death and dying. It seems to be important, that also bereavement and sympathy belongs to the topics. The results will help to develop the quality of care for the dying and the survivors. PMID- 2718474 TI - [Initial experiences in developing family groups]. AB - First experiences are told about activity of a group of relationship, who care for old members of family. Important are not only instructions for nursing and remedial gymnastics but also conversations in the group, by which individual problems are decreased and willingness for care of old patients in the family is promoted. PMID- 2718475 TI - [Experiences with low-power laser therapy in internal medicine geriatrics]. AB - The use of low power laser therapy in 30 in-patients aged from 72 to 86 years suffering from diseases of the movement apparatus resistant to treatment and from chronic peripheral and cerebral circulation disorders based on arteriosclerosis is proofed as efficient, riskless physicaltherapy method to improve the complaints and to economize with medicamentation. PMID- 2718476 TI - [The effect of propranolol on the functional condition of the central and autonomic nervous system in persons of various ages]. AB - The effect of propranolol (0.6 mg/kg b.w.) on the functional state of the central and vegetative nervous system was studied in 60 apparently healthy of different age by means of electroencephalography and spectral analysis of the cardiac rhythm. In the young subjects propranolol produced inhibitory effects on the central nervous system, while in the elderly and very elderly subjects it was predominantly an activating one. The elderly versus young subjects showed a more marked impairment of the sympathetic effects on the cardiac rhythm due to propranolol administration. It was a characteristic feature of propranolol action to display a disaccord between its effects on the central nervous system and vegetative control of the cardiac rhythm in the very elderly people. PMID- 2718477 TI - [The health status and biochemical parameters of 98 long-surviving persons]. AB - During 8 years authors examined 98 persons of the age ranging from 90 to 99 years. The results of the longevity phenomenon analysis suggest its relationship to hereditary factor, female sex, occupation in agriculture and absence of the life shortening diseases in anamnesis. Clinical diagnoses of all the longaged have been analyzed to confirm the multimorbidity and the so called senile polypathy which is frequent in this age. All the longaged were divided into 3 groups according to their vitality degree. Erythrocyte sedimentation, basic biochemical and haematological tests were carried out and the values obtained were analyzed following the 3 vitality degrees mentioned. The authors' aim is to point out some problems especially the difficulty of interpretation of some laboratory tests results in this longaged patient category and thus contribute to a certain extent to the description of the longevity phenomenon from the modern clinical gerontology viewpoint. PMID- 2718478 TI - [Risk of temporary inpatient admission of the aged during the vacation of care providing family members]. AB - 104 chronically ill patients of an average age of 82.7 years were accommodated on geriatric wards of hospitals totaling 152 times during vacation, stay at a health resort, or illness of their attending relatives. On average, they stayed in hospital for 3 to 4 weeks. Main diagnoses were cerebrovascular circulatory disturbances or condition after insultus, chronic ischaemic heart disease, and tumor diseases. The morbidity rate during that stay was 9.2%, the mortality rate 6.8%. In 8 out of 10 cases the immediate cause of death was directly causally associated with the primary disease. Any severe nosocomial infections did not occur. The authors consider the risk of the temporary hospitalization of people in need of care for the temporary relief of their relatives, with regard to the patient's age and primary diseases, as justifiable. PMID- 2718479 TI - Effects of magnesium citrate and clidinium bromide on the excretion of activated charcoal in normal subjects. AB - The efficacy of cathartics in shortening the gastrointestinal transit time of activate charcoal (AC) in the presence of drugs that alter gastrointestinal motility has not been determined. We evaluated the effects of magnesium citrate (MC) on the excretion of activated charcoal in healthy volunteers alone and with concurrent administration of the anticholinergic drug clidinium bromide. Forty subjects were randomized to clidinium bromide 5 mg or placebo capsule (PC), followed by activated charcoal 15 g and magnesium citrate or a placebo liquid (PL). The onset and duration of excretion of activated charcoal were noted. Mean onset times for activated charcoal were: group I (CB, MC) 4.5 +/- 2.1 h; group II (CB, PL) 17.0 +/- 10.0 h; group III (PC, MC) 6.3 +/- 5.8 h; and group IV (PC, PL) 20.6 +/- 8.4 h. The onset of excretion of activated charcoal was statistically different in both magnesium citrate groups as compared with the placebo liquid groups. The duration of activated charcoal in the stool was similar among the groups. The addition of clidinium bromide did not appear to affect gastrointestinal transit time. These results support previous studies of the effects of cathartics on the excretion of activated charcoal, and suggest that cathartic efficacy is not inhibited by anticholinergic drugs when used in therapeutic doses. PMID- 2718480 TI - Comparative bioavailability of praziquantel tablets. AB - Six different brands of 600 mg praziquantel tablets were evaluated. In vitro studies demonstrated that all but one of the products met the British Pharmacopoeia 1980 disintegration time specifications. The comparative bioavailability of four of the internationally available brands of praziquantel tablets were then studied in eight healthy volunteers using a crossover design. Serum praziquantel levels were determined by high-performance liquid chromatography. Individual serum profiles were analyzed for pharmacokinetic parameters such as maximum serum concentration, time to reach maximum, and area under the curve. Following administration of praziquantel 40 mg/kg po, the mean peak serum concentrations and the time to reach the peak ranged from 1.007 to 1.625 micrograms/ml and from 1.72 to 2.81 hours, respectively. The elimination half-life of praziquantel was 1.15 (0.94-1.25) hours. Differences greater than 20 percent (p less than 0.05) were noted for these parameters between the original brand and the generic formulations. The relative bioavailabilities of the generic praziquantel formulations, with respect to the original brand, were 91.25, 80.95, and 69.86 percent. This is due to the failure of disintegration and subsequently poor dissolution. The effect of 30 percent reduction of bioavailability may lead to unacceptably high rates of treatment failure. PMID- 2718481 TI - Allergic reaction to antipyrine, a marker of hepatic enzyme activity. AB - Antipyrine is a pyrazole derivative used extensively as a marker for hepatic drug metabolizing enzyme activity. A subject participating in a clinical trial employing antipyrine experienced an acute allergic reaction to the drug which was characterized by diaphoresis, flushing, swelling of the throat, difficulty in breathing, vomiting, swelling of the upper lip, and a diffuse urticarial rash. Intravenous administration of diphenhydramine markedly improved the symptomatology. Clinical investigators as well as study participants should be alerted to the potential for antipyrine to cause an acute allergic reaction. PMID- 2718482 TI - Prolonged use of intravenous isoniazid and rifampin. AB - We present a case of a 55-year-old woman requiring prolonged therapy with intravenous isoniazid and rifampin secondary to extensive bowel disease. We believe that this is the first U.S. report of a patient receiving both medications by the iv route. After months of therapy the patient has not experienced side effects secondary to this route of administration. We believe that iv isoniazid and rifampin provides a safe alternative method of delivery when clinical situations dictate this route. PMID- 2718483 TI - Amoxapine-induced neuroleptic malignant syndrome. AB - Amoxapine is a second-generation antidepressant possessing significant dopamine blocking activity and extra-pyramidal side effects. The occurrence of neuroleptic malignant syndrome is described in a patient treated with amoxapine. The syndrome resolved rapidly following discontinuation of the drug. Older patients may be particularly at risk for this adverse reaction with amoxapine. PMID- 2718484 TI - Disopyramide and N-monodesalkyl disopyramide in serum and breast milk. AB - Maternal serum and breast milk were obtained to determine the concentration of disopyramide (DP) and its metabolite N-monodesalkyl disopyramide (NMD) from a woman requiring antidysrhythmic drug therapy. Infant serum and urine were also obtained for drug concentrations. DP 450 mg tid resulted in peak maternal serum concentrations of 4.0 micrograms/mL and 2.2 micrograms/mL for DP and NMD, respectively. Breast milk concentrations averaged 1.06 and 6.24 times the serum levels for DP and NMD, respectively. No DP was measurable in the infant's serum except for cord blood, which contained 0.7 micrograms/mL DP, 26 percent of simultaneous maternal concentration, and 0.9 micrograms/mL NMD, which represented 43 percent of the maternal concentration. Infant urine collected over an eight hour period contained 3.3 micrograms/mL of DP and 3.7 micrograms/mL of NMD. PMID- 2718485 TI - Methazolamide-associated temporary leukopenia and thrombocytopenia. AB - A three-week course of methazolamide therapy for chronic open-angle glaucoma resulted in marked leukopenia and thrombocytopenia. Prompt discontinuation of therapy resulted in complete recovery of white blood cell and platelet counts within five days. The recommendations for patients receiving carbonic anhydrase inhibitors for blood count control at six-month intervals are discussed. PMID- 2718486 TI - Home intermittent amrinone infusions in terminal congestive heart failure. AB - The prevalence of congestive heart failure (CHF) and its progressive degenerative course continue to generate pressure for alternative, more effective means of treatment. A confluence of factors, including the number of Americans with CHF, the spiraling costs of hospital care, and increasing interest in cost-effective home care, contribute to the current efforts to develop an effective, nontoxic therapy that effectively increases myocardial contractility and output and can be administered within the confines of the home. Given that preliminary clinical trials in the hospital setting with amrinone have produced positive results, the transition of this therapy to the home, when administered intermittently via central venous catheter and infusion pump, was undertaken. In order to prolong and increase quality of life in terminal CHF patients, intermittent amrinone infusions were provided at home to four patients as part of our pilot program. All four patients met the criteria for New York Heart Association (NYHA) functional class IV heart failure, and none had responded to conventional therapy suitable for outpatient maintenance. The patients also shared strong family support and an intense desire to improve the quality of remaining life. All four patients and designated family members were trained in the specifics of aseptic technique, medication dose preparation, central venous catheter care, and operation of an infusion pump. An ambulatory pump was used in three of the four patients. Subsequent to the initiation of intermittent home amrinone infusions, all four patients had greater tolerance to limited exercise and/or ambulation secondary to increased cardiac output and diuresis. Patients survived 8, 10, 47, and 56 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718487 TI - Accuracy of two equations in determining normalized phenytoin concentrations. AB - The accuracy of two equations in normalizing total phenytoin concentrations in the presence of renal failure or hypoalbuminemia was evaluated in 11 renal failure and 23 hypoalbuminemic patients. Blood samples were obtained from hospitalized patients receiving phenytoin and were assayed for free and total phenytoin concentrations. Estimated normalized phenytoin concentrations based on free drug concentration were compared statistically with normalized concentrations calculated from the two equations via Student's t-test. The equation for normalizing phenytoin concentrations in hypoalbuminemic patients significantly underpredicted normalized phenytoin concentrations 15.7 +/- 8.5 versus 19.9 +/- 12.1 mg/L (p less than 0.001). In patients with renal failure, the mean phenytoin concentration from the respective equations and that based on free concentration were 14.1 +/- 6.2 and 14.0 +/- 7.9 mg/L, respectively. However, in 5 of 11 renal failure patients the equation resulted in over- or underprediction by at least 25 percent. Neither equation should be used clinically to normalize phenytoin concentrations in these patient populations. PMID- 2718488 TI - The Annals of Pharmacotherapy--more than a face lift. PMID- 2718489 TI - Nifedipine-induced nonthrombocytopenic purpura. PMID- 2718490 TI - Cyclophosphamide anaphylaxis. PMID- 2718491 TI - Topical promethazine intoxication. PMID- 2718492 TI - Nitrofurantoin hypersensitivity masquerading as pneumonia. PMID- 2718493 TI - Norfloxacin hypersensitivity. PMID- 2718494 TI - Quinolones and penicillins incompatibility. PMID- 2718495 TI - Fish oil controversy. PMID- 2718496 TI - Cost comparison of ciprofloxacin versus cefamandole. PMID- 2718497 TI - Comment: unusual digoxin concentrations. PMID- 2718498 TI - Albumin utilization in a university hospital. AB - The inappropriate use of high-priced agents such as human serum albumin significantly contributes to the rising cost of medical care. A utilization review was conducted at the University of Michigan Hospital in order to identify the appropriateness of use of this agent. Criteria were developed and prescribing was retrospectively evaluated for 81 patients. Of the 935 units administered to these patients, 692 (74 percent) were judged to be inappropriate. This inappropriate use accounted for a projected annual expenditure of nearly $281,000. Interventions have previously demonstrated success in improving prescribing. PMID- 2718499 TI - Consumer use of nondispensing professional pharmacy services. AB - This study attempted to identify and develop an understanding of the use of 13 nondispensing services (NDSs) by consumers in the community pharmacy practice setting. A self-administered, postage prepaid questionnaire was sent to 1000 Indiana consumers randomly selected from telephone directories. A 45.5 percent response rate was achieved after one original mailing and two follow-ups. Most consumers had not used NDSs except for advice on nonprescription drugs and advice on minor health problems. Nevertheless, a substantial number of consumers expressed interest in many of the remaining services, including advice on diagnostic test kits and information on poison prevention. Consumers' past use of NDSs and their perceptions of pharmacists as providers of these services were important factors in the consumers' intention to use NDSs. Other variables significantly correlated with average intention to use NDSs were: type of pharmacy patronized, anxiety about health, age, and education. It is recommended that future investigations explore in detail consumer behavior with regard to nondispensing services. PMID- 2718500 TI - Ranitidine-induced chest pain. AB - A 45-year-old woman with no history of heart disease twice experienced chest pain after consuming a dose of ranitidine. The chest pain, which lasted about one hour, was substernal, left of midline, dull, and pounding. H2-receptors are present in cardiovascular tissues. Although several studies have not noted an effect of ranitidine on cardiac indices there have been case reports indicating a cardiac effect. There are no reports of chest pain associated with H2-blocker ingestion; however, both bradycardia and hypotension (reported effects) might cause chest pain. A discussion of the possible mechanisms is presented. PMID- 2718501 TI - Drug-induced esophageal injury: a case report of percogesic. AB - This is the first case report of esophageal injury caused by Percogesic. A 31 year-old healthy white woman presented with dysphagia and retrosternal pain following the ingestion of a Percogesic tablet. The patient felt the tablet lodge in her mid-esophagus even though she ingested it with a cupful of water and in the upright position. Additional fluid was taken to dislodge the tablet with no success. Past medical history was unremarkable for heartburn, regurgitation, or dysphagia. Upper gastrointestinal endoscopy revealed a well-circumscribed deep ulceration in the mid-esophagus. Hospitalization was required due to persistent dysphagia. Treatment consisted of a three-day regimen of liquid antacid, intravenous ranitidine hydrochloride, and metoclopramide. This case emphasizes that pill entrapment can occur in the esophagus in healthy individuals, even when taken in the upright position with plenty of fluid; and mucosal injury can be produced by drugs not generally reported to cause gastrointestinal adverse effects or mucosal injury. PMID- 2718502 TI - Phenytoin-carbamazepine cross-sensitivity. AB - A case of phenytoin-carbamazepine cross-sensitivity is presented. Similar signs and symptoms occurred during administration of both drugs. A common metabolic intermediate is offered as a possible explanation of the mechanism. Clinicians should be careful when choosing alternatives in patients with hypersensitivity reactions to anticonvulsants. Valproic acid may be the safest choice in this setting. PMID- 2718503 TI - Diabetogenic effect of nifedipine. AB - This case report describes a 60-year-old diabetic patient whose daily insulin requirements increased by 30 percent following nifedipine administration. Glucagon and intravenous glucose tolerance tests were performed with and without nifedipine treatment, in order to evaluate the roles of decreased pancreatic beta islet cell function and augmented insulin peripheral resistance in the diabetogenic effect of nifedipine. Insulin and calculated glucose peripheral utilization extrapolated from the glucose concentration curves were not significantly different. C-peptide levels tended to be lower with nifedipine treatment at baseline and during the glucagon tests. This may suggest that the altered glycemic control associated with nifedipine was mediated by a suppressed islet beta cell function. The effect of calcium channel-blockers upon glycemic control and the possible mechanisms involved are discussed. PMID- 2718504 TI - Probability assessment approach to therapeutic drug monitoring: tobramycin. AB - Pharmacokinetic monitoring is an important therapeutic goal of aminoglycoside therapy. The overall goal of this study was to identify specific patient groups that would derive the maximum benefit from therapeutic drug monitoring services. These groups are patient populations with high probabilities of achieving toxic or subtherapeutic concentrations. Out of a total population of 86 stable, noncritically ill patients, 27 toxic concentrations (trough greater than 2.0 micrograms/mL) occurred in 15 patients. In comparison to patients (n = 46) with therapeutic concentrations (trough less than 2.0 micrograms/mL, peak greater than 4.0 micrograms/mL), these patients were older (64 +/- 11 vs. 54 +/- 18 years; p less than 0.02) and had a higher percentage of females (66.7 vs. 37 percent; p less than 0.05). Those patients with subtherapeutic concentrations (43 concentrations in 25 patients) had higher estimated creatinine clearance values than those with therapeutic concentrations (94 +/- 45 vs. 74 +/- 27 mL/min; p less than 0.005). Probability assessment analysis of the data showed a sevenfold increase in toxic concentrations in patients above 50 years. Females over age 50 had 2.3 times the risk of developing toxic concentrations as males over age 50. In contrast, the development of low concentrations was not predicted by age or sex. Underdosage by greater than or equal to 30 percent was a reasonable predictor (75 percent) of low peak concentrations. Furthermore, toxic concentrations did not occur in patients who were underdosed, justifying dosage increases prior to obtaining serum concentrations in these patients. The group with the highest probability of attaining therapeutic concentrations was males receiving therapeutic doses who were under age 50 (85.5 percent).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718505 TI - Issues facing clinical pharmacy education for undergraduate students. PMID- 2718506 TI - Some observations about health care in India. PMID- 2718507 TI - Theophylline--pyrantel pamoate interaction. PMID- 2718509 TI - Comment: effects of labels on patient knowledge. PMID- 2718508 TI - Comment: pneumococcal revaccination. PMID- 2718510 TI - Comment: pharmacy education and its impact on practice. PMID- 2718511 TI - Comment: pharmacist not an advisor. PMID- 2718512 TI - [Release from mandatory physical education in East Germany--status and requirements]. PMID- 2718513 TI - [Abnormalities, aseptic necroses, disorders of function of the spine--its relation to capacity in performance sports]. PMID- 2718514 TI - [Knee joint endoscopy--indications, possibilities, results]. PMID- 2718515 TI - [Capsule, ligament and internal injuries of the knee joint]. PMID- 2718516 TI - [Experiences in the diagnosis, therapy and rehabilitation of fresh and chronic fibular capsule and ligament injuries of the upper ankle joint]. PMID- 2718517 TI - [Early functional treatment following sports injuries]. PMID- 2718518 TI - [Discussion comments on the dissemination of knowledge and values orientation within the scope of health education]. PMID- 2718519 TI - [Differential diagnostic aspects of trichinosis in childhood with special reference to neurologic manifestations]. PMID- 2718520 TI - [Varicellas and herpes zoster in children with oncologic diseases. 1: Clinical characteristics]. PMID- 2718521 TI - [Varicellas and herpes zoster in children with oncologic diseases. 2: Prevention and therapy]. PMID- 2718522 TI - [Epidemiology of nosocomial infections in urology. 1: Nature and incidence of nosocomial infections in urologic patients]. PMID- 2718523 TI - [Epidemiology of nosocomial infections in urology. 2: Risk of nosocomial infection in urologic patients caused by dispositional influences]. PMID- 2718524 TI - [Studies and results of the etiology and prevention of lip-jaw-palate clefts]. PMID- 2718525 TI - [Control of arterial hypertension at population level]. PMID- 2718526 TI - [The transformation of gamma-tocopherol to alpha-tocopherol in the animal organism; a generational study in rats]. AB - The biosynthesis of alpha-tocopherol, the most effective vitamer among the vitamin E-group, is found only in higher plants and microorganisms. Due to the lack of the shikimate pathway, animals are not able to synthesize alpha tocopherol. Also not found is a whole enteral synthesis; only the conversion of dimethyletocol to trimethyletocol seems to be possible. Using four generations of rats, we sought to determine: Is a transformation of gamma-tocopherol to alpha tocopherol in the animal body possible? Are there any differences in the transformation rates in organs, tissues, or in the entire body along the generations? Does gut flora play any role in the conversion of gamma-tocopherol? Is it possible to increase the efficiency of the transformation by supplying additional CH3-groups? Wistar rats were fed a semisynthetic basal diet, supplemented with 78.8 mg DL-gamma-tocopherol/kg in the first three generations (F1-F3). In the fourth generation (F4), some of the animals were fed a vitamin E free diet and gamma-tocopherol (approx. 1.5 mg on alternate days) was injected s.c. Two other groups of animals received the basal diet containing additional methionine (0.25%) or choline (0.45%), as well as gamma-tocopherol (as in F1-F3). alpha- and gamma-tocopherol were analyzed by HPTLC in the whole body and in serum, liver, heart, lung, gut, gonads, and feces. The ratio of alpha-/gamma tocopherol (micrograms/micrograms) as transformation rate and vitamin E biopotency (microgram alpha-tocopherol equivalents/g) were calculated. Growth and fertility were normal until the fourth generation; no abnormal developments could be recognized. alpha-tocopherol was found in the whole-body as well as in all tissues and organs. In the whole-body, vitamin E-biopotency decreased 25-70% in F2 and F3. On the other hand, the increase of the transformation rate of gamma- to alpha-tocopherol amounted to 23% (F2) and 168% (F3). Highest conversion rates were found in F2 and F3 for feces, followed by gonads and lungs; the lowest rates were found for serum and liver. Due to the s.c. injection of gamma-tocopherol, feces showed a four-times lower transformation rate in F4 than in F3. There was an increase in heart, gut, lung and serum for both transformation rate and vitamin E-biopotency. These parameters could be improved also by the additional supplements of methionine and choline. Both methyl-group-donators revealed nearly the same positive effect. The results show that the animal organism can adapt to gamma-tocopherol supply over generations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718527 TI - [Contaminating substances in 22 over-the-counter fish oil and cod liver oil preparations: cholesterol, heavy metals and vitamin A]. AB - Fish oil capsules are increasingly used by self-medicating patients. We studied 22 commercial fish oil and menhaden oil preparations in respect to accompanying substances that could be harmful. The substances measured were: cholesterol as determined by gas liquid chromatography, heavy metals measured by atomic absorption, and vitamin A as determined by high-performance liquid chromatography (HPLC). The contents of cholesterol and heavy metals were in ranges which can be regarded as negligible; the content of vitamin A in menhaden oils, however, was found in amounts which warrant that pregnant women do not exceed the dosage as recommended by the manufacturers. PMID- 2718528 TI - [The effects of the intake of cod liver oil on the blood lipid level, the lipoprotein profile and bleeding time]. AB - In a research study performed over eight months with five female and six male subjects (age 35-67 years) the effect of cod liver oil on the lipoprotein composition in the blood was tested. The main goal was to prove that the regular administration of so-called highly unsaturated omega-3-fatty acid components in fish oil (4 g per day over six months) may lead to a reduction of triglyceride and total cholesterol values. Furthermore, any changes in HDL and LDL cholesterol fractions as well as the bleeding time were registered. The average values of all subjects showed an essential reduction of the triglyceride and cholesterol values. The control examination after 8 months even showed a continuous trend. The LDL fractions on an average remained unchanged. It can be taken for granted that the administration of unsaturated fatty acids in cod liver oil shows a successful therapeutic effect by the reduction of triglyceride and cholesterol values. The anti-atherosclerotic and the anti-platelet aggregational effect of fish oil has been described in many publications. PMID- 2718529 TI - [The incidence of fatal lung emboli with special reference to the underlying disease and the effect of weather]. AB - The frequency of the fatal pulmonary embolism in the autopsy material of Rostock University undergoes greater variations. After an increase of the incidence in connection with hyperalimentation and increase of age to the twofold to threefold between 1922 and 1974 as possible sequel of a prophylaxis of thrombosis a decrease of maximally 12.4 to 8.2% is to be established. The average age is 67.8 years, females are more affected to the relation of 1:1.6. Clinically the diagnosis of causes of death was exactly made in 25.9%. In the relation of causes dominate basic diseases of the cardiovascular and respiratory system with disturbances of the haemodynamics, malignant tumours without significant preference of certain organ carcinomas and infectious-toxic complications. A conspicuous accumulation concerned the chronic respiratory syndrome, often a polypathia existed. In the region of the coast of the Baltic Sea pulmonary embolisms appeared statistically significantly more frequently in fine weather phases and at beginning fine weather, respectively, with indifferent or tendencially rising global radiation on the day of the event and particularly in winter season. An influence of passages of weather fronts could not be established. PMID- 2718530 TI - [TSH receptor antibody determination using the TSH radioreceptor antibody assay in clinical practice]. AB - We tested the clinical valency of the TSH-receptor antibody (TBIAb) determination (TRAK assay, Fa. Henning) for the differential diagnostics of various diseases of the thyroid gland (n = 259), particularly of the hyperthyroidism. In 110 out of 114 basedowians TBAIAb could be proved (sensitivity 96%). The specifity to healthy persons (n = 20) was 100%, to the disseminated autonomy (n = 61) 92%. In 43 bland strumas and 22 cases of primary hypothyroidisms no circulating TBIAb were found. Of 40 cases of Basedow's hyperthyroidism the TBIAb titres were pursued during a 12-month methimazol therapy. In these cases was shown that negative antibody titres at the end of the treatment were connected with an essentially lower rate of early relapses than positive ones. Moreover, a highly dosed application of methimazol revealed a more favourable tendency than a low dosed one. From this we conclude that the TBIAb measurement with a commercial kit is a sensitive, sufficiently specific and practicable method for the differential diagnostics of hyperthyroidism and that to a certain degree it allows conclusions on the course of Basedow's disease after thyrostatic long-term therapy. PMID- 2718531 TI - [Intracardiac recording of potentials in placing a thermodilution catheter]. AB - It is reported on methods of positioning our former described flow directed thermodilution (TD) catheter by the intracardiac ECG derived from two electrodes, one at the tip of the catheter near the temperature sensor and the other six centimeter proximally of it. The typical criterion of the intracardiac ECG in the outflow tract of the right ventricle and in the pulmonary artery are listed, especially the amplitudes, the QRS-splits, T-wave inversion and P-wave configuration. PMID- 2718532 TI - [Farmer's lung]. AB - Report on a pneumokoniosis caused by organic dust in a 66-year-old man. The case in question was a farmer's lung. Discussion of the possible causes, clinical and cellular findings as well as of the diagnosis and differential diagnosis. PMID- 2718533 TI - [Procollagen-III-peptide in the serum of patients with Crohn disease]. AB - Serum procollagen-III-peptide (PP III) concentrations were measured in 54 patients with Crohn's disease and compared with data obtained from healthy controls and patients with liver fibrosis or ulcerative colitis. Whereas in alcoholic liver cirrhosis and chronic active hepatitis PP III was increased up to 18-fold as described by others, only 3 patients with Crohn's disease had slightly elevated PP III concentrations. In 2 of them, increased PP III could be explained by adolescence. In 5 other patients, PP III levels were at the upper limit of normal. Subgroup analysis showed that high clinical disease activity, recurrence after intestinal resection, presence of strictures and long disease duration did not elevate PP III levels. We therefore conclude that determination of serum PP III is of no value in the follow-up patients with Crohn's disease. In ulcerative colitis, PP III levels were uniformly normal. An additional result was a decreased PP III during corticosteroid therapy, suggesting a direct effect on collagen metabolism. PMID- 2718534 TI - [Cystic pancreas adenoma. On the clinical relevance of histologic typing]. AB - Although pancreatic cystadenomas are rare neoplasms, they are found today in rising frequencies due to improvement of diagnostic tools. There exist two types of cystadenoma: microcystic serous cystadenoma and mucinous cystadenoma. Usually, histological distinction from cystadenocarcinoma is readily made, but it may be difficult in the case of the mucinous variant. This subtype is supposed to be potentially malignant, whereas microcystic serous cystadenoma is always benign. In order to elucidate the characteristics of both variants, 5 own cases are reported in this article. PMID- 2718535 TI - [Carbohydrate malabsorption (fructose, sorbitol) and functional intestinal disorders]. PMID- 2718536 TI - [Therapy of chronic hepatitis B]. PMID- 2718537 TI - European Association for Gastroenterology and Endoscopy, 21st congress. Graz, Austria, May 3-6, 1989. Abstracts. PMID- 2718538 TI - [The effect of the alpha1-receptor blocker prazosin on the microcirculation in the terminal ileum of rabbits]. AB - The effect of the specific alpha1-blocker prazosin (Adversuten) on the microcirculation in the region of the terminal ileum was examined on 10 rabbits. Before and after injection of prazosin into the superior mesenteric artery an isotope-clearance of a 133Xe-solution, applied into the intestinal wall, was performed. Because of the systemic blood pressure decreasing effect of prazosin the circulation of the examined part of the intestine was reduced in spite of the intended vasodilation of the intestinal vessels. The therapeutic applicability of alpha-blockers for intestinal diseases of vascular genesis remains questionable. PMID- 2718539 TI - [Postoperative behavior of parameters of intravascular lipid metabolism]. AB - In order to investigate alterations of intravascular lipoprotein metabolism under postoperative conditions, clinical investigations and animal experiments with female Wistar rats were carried out. Total serum cholesterol, HDL-cholesterol and LDL-cholesterol are diminished in the postoperative state. In the immediate postoperative phase there is a rapid decrease of serum triglycerides. Post heparin-lipolytic-activity is found initially enhanced whereas there is no change of triglyceride secretion rate. It is concluded that the decreased triglyceride level is the result of an elevated catabolism of triglyceride rich lipoproteins. Besides the fall of VLDL level the relative composition of VLDL changes. The quotients VLDL triglycerides/VLDL-phospholipids and VLDL-cholesterol/VLDL phospholipids decrease under postoperative conditions. PMID- 2718540 TI - [Electrophysiologic and histomorphological studies on the nervus ischiadicus of rats. I. The uninjured nerves]. AB - We report in the model described above on measurements of striking features of the normal sciatic nerve of adult male Wistarrats (250-300 g). Electrophysiological parameters were measured by means of an Electromyoneurograph (needle stimulation). The calculation of the maximum motor nerve conduction velocity results in a mean value of 59.6 ms-1. The mean compound action potentials of the foot muscle are 9.2 mV (proximal stimulated) and 10.1 mV (distal stimulated). Counting out 10011 nerve fibres in Light Microscoping Findings for histological studies we got a nearly Normal distribution of the fibre diameters with a mean fibre diameter of 7.09 microns. The corresponding density of nerve fibres is 8700.4 mm-2. The calculated percentage of neural tissue, related to the surrounding connective tissue is about 36.32%. PMID- 2718541 TI - [A method for the standardized in vitro testing of biomaterials with bacterial cultures]. AB - The preclinical investigation of potential biomaterials requires a comprehensive profile of biological parameters. In the present paper a new in vitro test will be described which allows a standardized testing of the effect of biomaterials on the proliferation of bacteria. For this test eluates of solid materials, granulates or powders of potential biomaterials were prepared. These eluates were mixed a bacterial culture containing a definite number of microbes and incubated for 4-20 hours at 37 degrees C. The effect on bacterial growth was determined photometrically. PMID- 2718542 TI - [The production of eluates for testing acute cytotoxicity by a new method]. AB - In vitro tests of new biomaterials require internationally and nationally eluates increasingly. Only the extracted substances become effective in the cells in that way. The material surface has the greatest influence on the quantity of the released substances by elution. The surface of diverse undefined mixture quantities is definable exactly by means of a gas adsorption method (BET method). The influence of the secondary technologies was tested by the atom adsorption spectrometry. The Jena bioglass ceramics could be estimated successfully by this method. PMID- 2718543 TI - [The adhesive strength of tissue adhesives]. AB - Twenty concentrates were produced of the blood from voluntary healthy donors by a method for producing autologous tissue adhesive. Their adhesive strength were tested by means of Thermo-fleece-specimens. A review was elaborated about the kinetics and the testing of the fibrin fixation. Methodical faults were found out. Possible ways for improving autologous adhesive variants and for producing homologue tissue adhesive are shown. PMID- 2718544 TI - Hemoperfusion effect on oxygen-carrying function of preserved donor blood and erythrocytic mass. AB - The purpose of the study was to explore the preserved (7-21 days) donor blood and erythrocytic mass, following perfusion through hemosorbent SKN-D. After the sorption the oxygen-transport function of erythrocytes was found to improve considerably (oxyhemoglobin dissociation curve was shifted to the right on average by 4-4.2 mm Hg). The energy supply became better (ATP level was increased by 38-59%). In view of the above, long-preserved blood and erythrocytic mass following their perfusion through SKN-D hemosorbent can be considered a sufficiently valid transfusion medium. PMID- 2718545 TI - [The hemodynamics of the intestinal arteries of the dog with special reference to the flow rate]. AB - Intestinal haemodynamics was examined invasively in 30 mongrel dogs. Beside registration of blood pressure values of the blood flow were evaluated especially. Measured flow values in the three main intestinal vessels - Truncus coeliacus, A. mesenterica superior and A. mesenterica inferior - were compared to aortal flow. Thereby the sum of intestinal arteries values was equal to intrarenal aortal flow. Two thirds of aortal flow may be expected in the portal vein. These relations make in possible to get informations about physiological intestinal circulation from single values without measurement of all intestinal vessels. PMID- 2718547 TI - [Malignant melanoma. A model case of early cancer detection]. PMID- 2718546 TI - [Significance of the dose of josamycin in the treatment of chlamydia infected pregnant patients]. AB - Erythromycin and josamycin are the antibiotics of choice in the treatment of pregnant women with Chlamydia infection. On the basis of differing recommendations in the literature regarding treatment period and dosage, two groups of pregnant women were treated with josamycin according to different dosage schedules: Group A: 170 patients treated with 2 x 500 mg daily for 12 days. Group B: 120 patients treated with 3 x 500 mg daily for 8 days. The diagnosis was confirmed by immunofluorescence with monoclonal antibodies. Non responding patients were treated again with a similar dose. 17% of the patients in group A and 9.1% in group B were still positive for Chlamydia after the first course of treatment. After a second course, 13.6% of group A and none of group B showed positive controls. Failures of therapy after the first treatment course can be attributed to errors in dosage or re-infection, whereas failures after the second course must be due to bad compliance. Our results suggest that pregnant women with Chlamydia infection are most efficiently treated with high dosages of josamycin over a short period of time. PMID- 2718548 TI - [Striated nail discoloration caused by zidovudine]. AB - We report on 2 male patients treated with zidovudine (azidothymidine), who developed longitudinally striated coloration of their nails and lentigines. Both patients are suffering from advanced HIV disease with opportunistic infections. Following treatment with zidovudine 1200 mg daily for 3 and 6 months resp., we observed longitudinal streaks of brownish color in both patients; they did not receive any other drugs known to induce discoloration of the nail plate. Our cases possibly reflect antiproliferative effects of zidovudine at the particularly susceptible nail matrix. PMID- 2718549 TI - [Churg-Strauss syndrome]. AB - Churg-Strauss syndrome is a systemic, granulomatous, necrotizing, and eosinophilic angiitis, associated with febrile bronchitis. The full-blown picture of the disease does not develop, however, but in the course of several years. We discuss the problems of diagnosis and treatment of this syndrome in the light of a case report concerning a 43-year-old woman suffering from Churg-Strauss syndrome. PMID- 2718550 TI - [Leg-/pelvic vein thrombosis from the viewpoint of the surgeon]. AB - The pathogenesis of venous thrombosis is far less clear than that of arterial thrombosis. In spite of physical and medical prophylaxis, there is still a risk of thrombosis of approx. 5% left after elective abdominal surgery. Ascending phlebography cannot be dispensed with in case of an active therapeutic procedure such as fibrinolysis or venous thromectomy. In order to settle the question of thrombolysis or thrombectomy, we have to consider (1) the extent of the thrombosis, (2) the time of existence of the thrombosis, and (3) possible contra indication of either method. Thus the two techniques do not compete with each other but are complementary. Because of the heterogeinity of the patients and the different indications for treatment, the results obtained in these two methods are hardly comparable. PMID- 2718551 TI - [Depth of invasion of basaliomas]. AB - The infiltration depths of 1421 basal cell carcinomas (BCC) were determined by means of the mid and basic sections of excised tumor specimens. According to our findings, BCC shows peripheral spreading in the majority of the cases. Deep infiltration primarily occurs in large tumors, scirrhous forms, tumors with exophytic growth or ulceration, and particularly in recurrent BCC. Because of the asymmetric infiltrative growth in depth, conventional evaluation of the mid section does not provide satisfactory information on the question of radical removal in depth. Therefore, histological control of excisional margins is absolutely essential at least in the tumors mentioned above. The proportion of the tumors with subtotal excision in depth at the first operation was 5.9% for primary BCC and 14.8% for recurrent BCC. In almost all these cases, radical removal could be achieved by re-excision into a deeper layer. PMID- 2718552 TI - [Increase of oxygen partial pressure and acceleration of wound healing by tetrachlorodecaoxide]. AB - 63 transcutaneous measurements of oxygen pressure and 36 series of infrared thermograms in 9 hypoxic wounds showed that topical administration of tetrachlorine decaoxide (TCDO) results in increased oxygen supply of the wound. This effect is associated with improvement of the skin temperature and decrease of the pathological temperature difference between the wound and the surrounding tissue. TCDO can induce physiological wound healing, since it improves the mechanisms of the immune defence system, wound cleansing, granulation, and epithelialization in slow-healing wounds. PMID- 2718553 TI - [Sclerosing lipogranuloma of the male genitals]. AB - We report on a 23-year-old male patient showing sclerosing lipogranuloma of the genitalia and surface ulceration of the penis. Histologic investigation revealed a granuloma of the foreign body type spreading both dermally and subcutaneously and showing cavities of varying sizes, resembling Swiss cheese, which were partly coated with macrophages. Histochemical tests with Sudan Ill, Sudan-black B and OsO4, as well as chromatographic analysis confirmed the presence of a hydrophobic unpolar lipid, such as liquid paraffin. PMID- 2718554 TI - [4th International AIDS Conference in Stockholm 1988]. PMID- 2718555 TI - [Contrast-color Doppler echocardiography. Improved right heart diagnosis following intravenous injection of Echovist]. AB - Flow patterns in the right heart are often difficult to visualize by color-coded Doppler flow imaging. The echogenicity of blood was increased in 48 patients by intravenous injection of 10 ml echovist (200 mg/ml), a saccharide solution with defined size and concentration of microbubbles. Its effect on improving color coding was compared with the effect of agitated gelifundol (10 ml) in 21 patients with tricuspid valve regurgitation. The non-controlled size and concentration of microbubbles resulted in weaker or uncontrollably exaggerated color-coding in half of the patients. In eight normals biphasic atrial flow was visible only after injection of echovist. In 25 patients with tricuspid regurgitation the blue coded area of reflux was 25 +/- 21% of the atrial area from the parasternal approach and 10 +/- 9% from the apical approach without correlation of these results. After echovist the area of reflux was 57 +/- 31% (p less than 0.001) in the parasternal and 53 +/- 26% (p less than 0.001) in the apical approach (r = 0.83). This was paralleled by an increase of the severity of tricuspid regurgitation as defined by the length or area of reflux (p less than 0.01 0.001). The qualitative diagnosis was safely established in the five patients with VSD in the control color Doppler flow imaging, but only in three out of 10 patients with ASD, and in nine of 10 after injection of echovist. The intravenous injection of echovist, when using color-coded Doppler flow imaging for evaluation of right heart disease, facilitates the qualitative diagnosis of ASD and also of tricuspid regurgitation, particularly in the apical approach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718556 TI - [Magnetic resonance tomography in the assessment of questionable aneurysm of the thoracic aorta with or without dissection of the intima]. AB - To assess the value of MRI in the diagnosis of aneurysm of the thoracic aorta with suspected or known dissection 23 patients were imaged with cardiac gating. Seven patients (group 1) had known dissection of the thoracic aorta; in 16 patients (group 2) an aneurysm was suspected by chest x-ray or 2D echocardiography. Reference methods were: x-ray, 2D-echocardiography, angiography, and computered tomography. In the first group MRI clearly identified the intimal flap, could differentiate between true and false lumen, slow flow, and thrombus, respectively. In the second group MRI could exclude a dissection of the ectatic part of the thoracic aorta in 11 patients and demonstrate paracardiac or mediastinal mass in five patients. MRI can serve as an important diagnostic tool in known or suspected aneurysm of the thoracic aorta. PMID- 2718557 TI - [Magnetic resonance tomography in pediatric cardiology]. AB - Magnetic resonance imaging (MR) is a relatively new non-invasive imaging method that has not been used as a routine procedure in pediatric cardiology. To evaluate MR in pediatric cardiology we performed 110 examinations in 91 children during the period from December, 1984, to November, 1987. The children were divided into the following groups: 1) Diseases of the great vessels (54 examinations in 39 children); 2) Cardiac diseases (42 examinations in 39 children); 3) Diseases of the pericardium (four examinations in three children); 4) Ten children without cardiovascular diseases (imaging of the heart in conjunction with examination of other organs). The ages of the children ranged from five weeks to 19 years in the following distribution: 13% infants, 20% children 2-5 years, 30% children 6-14 years, 37% adolescents from 15 to 19 years. On the basis of our experiences we conclude that MR can be used as an additional diagnostic tool in pediatric cardiology, especially for imaging of areas that are not well visualized by echocardiography, i.e., the great vessels and their branches and in addition, the right ventricle, in older children. PMID- 2718558 TI - [Modification of blood coagulation by the anti-arrhythmia drug prajmalium bitartrate in vivo]. AB - We studied the effects of prajmaliumbitartrate (PBT, Neo-Gilurytmal, Giulini Pharma, Hannover, FRG), an antiarrhythmic drug on some parameters of blood coagulation in patients. PBT, 20 mg given three times a day, significantly prolonged template bleeding time and ex vivo thrombus formation time in a modified Chandler's loop. Ex vivo platelet aggregation using different agonists and tests of the plasmatic coagulation system remained unchanged. PMID- 2718559 TI - [Annual meeting of the Working Group on Cardiac Pacemakers of the German Society of Heart and Circulatory Research. Munster, 2-4 March 1989. Abstracts]. PMID- 2718560 TI - [Balloon valvuloplasty of calcified aortic stenosis is a realistic alternative to surgery: clinical and invasive results 17 months following the 1st or 2d dilatation]. AB - Aortic balloon valvuloplasty was performed in 33 elderly patients (age 60-84, mean 74 years). In six cases, repeat-valvuloplasty was performed six months later. Mean follow-up so far has been 17 months (10-24 months). Follow-up included 23 invasive controls and repeat Doppler-echocardiographic estimation of valve gradient in all patients. At valvuloplasty, peak aortic gradient was reduced from 84 +/- 27 mm Hg to 40 +/- 18 mm Hg, valve area was increased from 0.39 +/- 0.11 cm2 to 0.74 +/- 0.16 cm2. Immediately after valvuloplasty, 76% of the patients were asymptomatic or significantly improved. At follow-up, 10 patients died and 12 patients underwent surgical valve replacement. Only seven patients are still improved or asymptomatic after 1st or 2nd valvuloplasty. Invasive control six to nine months after the 1st valvuloplasty showed satisfactory results for valve gradient and valve area in only one patient. At repeat-valvuloplasty, a mean valve gradient of 29.6 +/- 12.5 mm Hg was achieved. All patients with repeat-valvuloplasty again had invasive control after six months; peak gradient then was 56 +/- 17 mm Hg. Balloon valvuloplasty of acquired aortic valve stenosis is a palliative procedure with a high restenosis-rate. At the most, aortic valve area is doubled. In our opinion, it is only indicated in patients with an unacceptable high surgical risk. Today, old age alone is no contraindication to surgical valve replacement. PMID- 2718561 TI - [Right heart ventriculography using Gelifundol]. AB - Forty patients (14 women, 26 men, mean age 58 years) with suspected anomaly of the right heart and suspected tricuspid insufficiency or atrial septal defect were given four injections of Gelifundol in five-minute intervals via the right cubital vein. Before, during, and after each injection an echocardiogram was obtained (four-chamber-view). One subcostal view was recorded. Contrast echocardiograms were analyzed according to a subjective score scheme by two independent observers and by video-intensitometry. After injection of contrast medium no patient showed ECG changes, nor did any patient report side effects after the injection of Gelifundol. Concerning the subjective parameters there were no significant differences between both observers. Score points varied between 5.2 to 5.5, intensitometric maxima lay between 54.6 and 58.0 relative intensity units, and the half-time of the intensity maximum (T1/2) varied between 7.2 s and 8.1 s. There were no statistical differences between the two observers. In all patients a diagnotic improvement could be achieved. A tricuspid insufficiency which was not diagnosed in the native echocardiogram could be diagnosed in 13 patients with Gelfundol. Thus, Gelifundol seems well suited for the assessment of right ventricular lesions in man. PMID- 2718562 TI - [Update in thrombolytic therapy of acute myocardial infarction. International symposium. 27 November 1988, Berlin]. PMID- 2718563 TI - [Abstracts of the 55th annual meeting of the German Society for Cardiovascular Research. 31 March-2 April 1989, Mannheim]. PMID- 2718564 TI - [Nutrition and aging]. PMID- 2718565 TI - [Dietary habits of the aged--frequency of intake of foods of high nutritive value]. AB - The high rate of malnutrition in the elderly suggests the need for increased availability of high nutrient density foods such as fruits, vegetables, milk, and whole grain products. An analysis of nutritional habits of 100 persons 75+ years showed that 75% had insufficient intake of whole grain products, 50% an insufficient intake of milk and dairy products, and 25% an insufficient intake of fruits and vegetables. Food intake was shown to be largely independent of such factors as sex, age, or life situation. Only for milk and dairy products could a better supply be shown for institutionalized persons than for independent-living persons. The results of the study emphasize the need for better nutritional information and education of the elderly regarding the importance of high nutrient density foods. PMID- 2718566 TI - Relationships between nutrient intake, nutritional status and activity levels in an elderly and in a younger population; a comparison of physically more active and more inactive people. AB - Differences in absolute nutrient intakes, nutrient densities, and nutritional status between more physically active and more physically inactive elderly persons were analyzed from data of the Heidelberg-Michelstadt-Berlin Study. Comparisons were made in the different sex groups for older persons, the same comparisons were made for a group of younger persons. Although there was no significant statistical difference, the active persons had higher absolute energy intakes compared with inactive persons in all groups, except in the younger female group. Active older women have statistically significant higher vitamin B2, iodine, and calcium intakes than less active older women. Active older men have higher energy, carbohydrate, carotene, vitamin E, vitamin C, and calcium intakes than the less active older men. A totally different pattern of intakes is seen in the group of younger persons. The more active younger women show lower absolute intakes of vitamin A, vitamin E, vitamin B1, niacin, vitamin B6, vitamin B12, and sodium in comparison with the less active young women. Active young men show higher iodine intakes compared with the inactives. The differences in intakes however are not reflected in the nutritional status. The nutritional status of more active people is therefore neither endangered nor improved in comparison with less active. PMID- 2718567 TI - [Lipogenesis, aging and hormonal regulation]. AB - Thyroid hormones stimulate hepatic synthesis of fatty acids as well as activities of lipogenic enzymes. According to the present study, there also partially exists an age dependency. In livers of 3- and 18-month-old rats of the Wistar strain both the velocity of fatty acid synthesis and the activities of lipogenic enzymes were measured in dependence on thyroid function. An impaired stimulation of malic enzyme activity under hyperthyreosis conditions was found in the older animals. The velocity of fatty acid synthesis was diminished in the group of 18-month-old rats, but there was no age dependence with respect of the effect of a variation in thyroid status. In the adipose tissue of the older animals, the activities of lipogenic enzymes were lowered. In this tissue no effects of thyreohormones in either young or old rats were observed. PMID- 2718568 TI - [Functions of sports activities in aging]. AB - Senior citizens' sports, as shown clearly in written questionnaires of 101 senior gymnasts, both male and female, in the canton of Bern (Switzerland), prove to be definitely multifunctional. Indeed, at the least the triad of physical, psychological and social functions must be taken into account; accordingly, subjects gain three things from sports: agility, well-being and social activity. PMID- 2718569 TI - [Determinants of the socioeconomic status of the aged in Ewe in Togo]. AB - This investigation of the Ewe tribe in Togo tries to analyse the determining factors of the living conditions of the elderly in the rural areas. The migration from these areas into the cities is not clearly responsible for the economic situation of the old people. Rather, connected with supposed social problem are the negative image of the old and the education gap between the generations. The declining status is perceived by analysing shifts in the system of village government, which is a province of the old men. The structure of the decision making system is described in the text. PMID- 2718570 TI - [Continuous pattern recognition in the assessment of memory disorders in dementia]. AB - A simple and short method for assessing visual short term memory is presented, based on continuous picture recognition, which is not explicitly dependent on input or output language abilities. The material was gathered from Kimura's Recurring Figures Test (RFT) and Erzigkeit's SKT. Two of three parallel series which are characterized by different levels of "nameability" and familiarity are apt to distinguish between demented patients and patients without memory problems. Objectivity is assured by a simle scoring system which allows rapid transformation into d'-values according to signal detection theory. It is expected that by this procedure not only screening for memory problems in the demented will be facilitated, but also the impact of language disorders will be minimized. PMID- 2718571 TI - [Malnutrition in the aged--effect of physical, mental, psychological and social factors]. AB - The elderly are considered a risk group for malnutrition, due not only to poor nutrition, but also to other aspects of daily life which affect food intake and nutritional status. In this study 11 factors of physical, mental, psychical, and social origin have been defined as risk-factors leading to malnutrition. Their appearance in a group of 100 geriatric patients above the age of 75 years has been examined. Immobility and difficulties with chewing were found in nearly 50% of the patients. Social problems were observed in 22%-31%. In contrast, there was usually a daily hot meal available to those studied. The relation between the number of risk factors and the nutritional status was obvious. None of the 23 underweight patients was without a risk factor. In 17 (74%) of these patients four or more risk factors were found. For an amelioration of the nutritional situation not only a well balanced diet should be available but the elderly person's complete life situation must be considered. PMID- 2718572 TI - [1st bilateral symposium of the Society of Clinical Chemistry and Laboratory Diagnosis of the German Democratic Republic and the Austrian Society of Clinical Chemistry. 7-8 April 1988, Dresden/DDR. Proceedings]. PMID- 2718573 TI - [Glycogen phosphorylase as a marker for damage to the heart muscle]. PMID- 2718574 TI - [The behavior of ASAT, CK and LDH and lactate in patients with cardiac diseases in relation to graded ergometric stress with reference to assessing the performance capacity of patients]. PMID- 2718575 TI - [Apolipoproteins as risk factors of atherosclerosis]. PMID- 2718576 TI - [The clinical significance of apolipoprotein determinations for assessment of the risk of atherosclerosis]. PMID- 2718577 TI - [Laboratory diagnostic monitoring of individually dosed antithrombotic therapy with acetylsalicylic acid in patients with atherosclerosis]. PMID- 2718578 TI - [Diagnosis of thrombophilia in atherosclerosis patients]. PMID- 2718579 TI - [Individually different hormonal reactions to blood loss as a cause to the development of different sensitivity to shock]. PMID- 2718580 TI - [Changes in the pathobiochemical reactions in traumatic-hemorrhagic shock following therapy with blood substitutes based on perfluorocarbon]. PMID- 2718581 TI - [Changes in the microcirculation in traumatic-hemorrhagic shock following therapy with blood substitutes based on perfluorocarbons]. PMID- 2718582 TI - [Etiopathogenesis, diagnosis and follow-up of non-insulin-dependent diabetes mellitus]. PMID- 2718583 TI - [Value of the determination of glycosylated proteins and glycosylated hemoglobin in therapy control of diabetic patients]. PMID- 2718584 TI - [HbA1 and glycosylated serum proteins in type I diabetic patients]. PMID- 2718585 TI - [Results of treatment in a 6-month movement and sports therapy rehabilitation program of children with cerebral palsy]. AB - The dynamic gait patterns in 9 children with cerebral palsy aged from 8 to 13 years was evaluated with a force plate before and after 6 months of movement- and sportstherapy. After the therapy clear modifications were found in timeparameters. The outstanding parameter was the vertical ground reaction force, which showed a positive increment in all important characteristics. PMID- 2718586 TI - [The magnitude of forces acting on the proximal femur in various weight alleviating gait forms with reduced ground reaction forces]. AB - To estimate the forces of the hip during partial or non-body-weight-bearing-gait a simple mechanical principle was used. For identification of the acting muscles of the hip during the swing period Electromyography was used. In the pure swing period without ground touch, being recommended as "de-loading" for the hip, forces resulted up to 85% of body-weight. In contrast to that, partial body weight-bearing with limb-weight (approximately 12-15% body weight) resulted in the most efficient reduction of hip forces. PMID- 2718587 TI - [Spherical calculation of the contact surface between the acetabulum and femur head]. AB - A template for calculating the contact area between the femoral head and the acetabulum is described. The projected image of a sphere is divided into segments of equal surface areas, each segment comprising 0.5% of the total surface area of the sphere. By adding the segments and multiplying the resulting percentage by the total surface area resulting from the radius of the sphere, any partial area of the sphere can be calculated. It is thus possible, without any special mathematical knowledge, to calculate the contact area between the femoral head and the acetabulum, as well as any partial surface area relevant to loading of the joint, on the a.p. roentgenogram. A prerequisite for this is a sufficient area of spherical femoral head in the region in question. In addition, the template can also be used to calculate the biomechanically relevant angle between the frontal plane, set through the center of the femoral head, and the anterior limit of the acetabulum, on the a.p. roentgenogram of the hip. PMID- 2718588 TI - [Epiphysiodesis as a means of controlling growth (calculation of angle function for planning the correction of axis errors)]. AB - At the Orthopedic clinic of the university of Vienna epiphysiodeses have been used for treatment of leg-length-discrepancies and varus and valgus malformation. A physiological state was achieved in twelve joints out of 24 operated in sixteen patients. Bone age was to advanced in some of the other cases, while the staples were removed too late in the rest. We found the exclusive use of the growth prognosis for planning of the surgical procedure to be extremely difficult, which is why we now use fixed parameters (epiphyseal distance and growth prognosis) to define the ctg for exact mathematical evaluation. Not the surgical procedure is the problem in epiphysiodeses but planning of the operation. PMID- 2718589 TI - [The effect of various surgical technics on neuroma development using the neodymium laser]. AB - The development of neuroma after surgery of peripheral nerves is an unsolved problem. Conventional methods like suture after cutting by seizure or bipolar coagulation cannot control it until today. Contradict results are reported since different types of laser were introduced in surgery. In an animal experimental study on rats the Neodym Yag laser is superior to conventional methods described above. After severance and reanastomosis of the sciatic nerve by laser in none of these cases a development of neuroma could be observed until three months of surviving. PMID- 2718590 TI - [Treatment of positional anomalies of the foot with a functional supportive inlay]. AB - Sometimes conventional shoe inlays are not able to treat foot disorders. Often clinically unsuspicious pathomechanical foottypes are the reason for these failures. In a prospective study we treated 35 patients with a so called functional orthotic. Most of them had used common arch supports without any effect. These functional orthotic devices are made of subortholene, they need a more sophisticated casting technique and fabrication. Facing the preliminary results with 81.2% satisfied patients, these efforts are worth for problem patients. PMID- 2718591 TI - [Osteochondroma as an unusual cause of metatarsus primus varus]. AB - A solitary osteochondroma of the metatarsale II of an adolescent is presented which led to a painful Metatarsus primus varus. After resection of the tumor the patient was free of symptoms, the postoperative resulting form of the foot was normal. One should be aware of a tumor as a possible cause of foot deformities. PMID- 2718592 TI - [Vertebral implant as a treatment principle in tumors and metastases of the thoracic and lumbar spine]. AB - We report the clinical course of 31 patients suffering from primary tumors or vertebral metastases treated by osteosynthesis with vertebral body implant. Surgical treatment of vertebral tumors aims at eliminating the compression, thus relieving the myelon and the roots as well as the reestablishment of the supporting function of the involved segments. Subjective and objective improvement was found in 64.5 per cent of the 31 patients. The conditions remained the same in 22.5 per cent. New symptoms occurred in 13.0 per cent. After tumor specific evaluation of the over-all survival period, plasmacytoma were found to have a more favourable course of a little more than two years. Patients with vertebral metastases died after an average of 10 months. In nearly all cases with postoperative improvement on the initial symptoms and signs, the symptoms could be improved permanently. We thus regard ventral curettage and parallel stabilisation, may be combined with dorsal stabilisation, as a means of improving the quality of life in these patients. By using the surgical technique employed by us sufficient stabilisation of the vertebral column can be achieved in order to enable quick mobilisation of the patients. PMID- 2718593 TI - [CT in the surgical planning in tumorous processes of the sacrum]. AB - The value of CT in the preoperative management of tumors of the sacrum is demonstrated. Essential informations for treatment planning are: involved sacral segment, infiltration of sacral foramina and nerve roots, involvement of the sacroiliac joints, ingression of the lumbar spine, infiltration of the pelvic organs and vessels, sciatic nerve and the dorsal soft tissues. In order to prove the competence of the CT in answering these questions we evaluated the CT examinations of 30 pat. with 14 primary tumors, 9 metastatic tumors and 7 tumors involving secondary the sacrum. The CT findings were correlated with clinical symptoms and surgical reports in 11 pat., with clinical symptoms alone in 19 pat. There was good correlation in the criterias: location and number of involved segments (8/11, 17/19), infiltr. of SI-joints (11/11), infiltr. of lumbar spine (9/11, 18/19), and infiltr. of pelvic organs (10/11), worse correlation in the criterias: nerve root-involvement (2/11, 3/19), and sciatic nerve-infiltr. (7/11, 15/19). Our conclusions are that CT gives helpful preoperative informations deciding about extent of surgical procedure, and surgical approach. The major problem, however, consist in diagnosis of nerve root and sciatic nerve involvement, therefore in poor prediction of postoperative conservation of neural functions. The knowledge of CT-anatomy of sacrum- and important condition for correct segment-location of the tumor is refreshed by outlines of characteristic segmental CT-sections of the sacrum. PMID- 2718594 TI - [Ventral interligamental-intercorporal spondylodesis in spondylolisthesis]. AB - From November 1982 to March 1986 ventral interligamental intercorporal spondylodesis was accomplished at 69 patients with spondylolisthesis staging from MEYERDING I-IV in the vertebral segments L 4-5 and L 5-S 1. By the spondylodesis we succeeded in 90% of cases in attaining a firm osseous fusion of the vertebral moving segment. In 85% we gained a good clinical result. The period of follow-up is on average of 26 months. The average age of the patients is 38.8 years. PMID- 2718595 TI - [Progression of Paget's disease of the spine 10 years following posterolateral spondylodesis]. AB - M. Paget is regarded as a disease confined to the bone. Its chief characteristics are increased bone metabolism with accelerated bone reduction and precipitate bone reconstruction. One of the most common sites of the disease is the lumbar spine. Encroachment of Paget's disease from the third lumbar body to the neighbouring spinal structures is described 10 years after a lumbar spondylodesis. PMID- 2718596 TI - [Methods of surface measurements in idiopathic scoliosis]. AB - The radiologic evaluation of scoliotic spines is a well established, exact method. In long follow-up histories these patients aquire a remarcable radiation exposure. Measurement of additional clinical parameters intends since decades to minimize this exposure. Documentation of surface deformities follows the presumption of a correlation between these and the radiologic angles. The analysis of 714 completely documented untreated idiopathic scoliotic curves showed a good overall correlation between surface deformity and Cobb angle, but single measurements varied too widely to make the used surface documentation a real alternative to x-rays. Treated scoliosis patients pose additional problems in the evaluation, a any treatment - brace and operation - further diminish the correlation. Obviously the usual clinical surface evaluation can only document the cosmetic appearance. Regular radiologic follow-up stays inevitable especially in treated scoliotic patients. PMID- 2718597 TI - [Polymyography recording in epicondylopathia humeri radialis]. AB - The innervation pattern of arm muscles in tennis elbow during defined movement of the wrist was analysed by polymyography. 30 patients with tennis elbow and 40 control persons had been investigated. Dorsal and palmar movements of the wrist joint lifting 5 kg had been performed. The electromyogram of 8 muscles had been registered. There was no abnormality in palmar flexion. The height and integrals of amplitudes in extensor muscles during extension had been considerably smaller. It is suggested that in tennis elbow the dorsal extension is exerted by a smaller number of fibers. This might be the cause of enthesiopathy. PMID- 2718598 TI - [Late synovectomy of the elbow and resection of the radius head in chronic polyarthritis]. AB - Between 1974 and 1984 16 patients with rheumatoid arthritis, who had elbow synovectomy and excision of the radial head, were revised with an average follow up of 5 years after operation. Resection of the radial head was performed on 16 elbows, in 3 elbows the ulnar nerve was transposed. The indication for the operation were pain, swelling, warmth and radiological destruction. The parameters used, to assess efficacy of the operation were range of motion, local finding and patient satisfaction. Synovectomy results were good especially in respect of relief of pain and range of motion. The good results justify elbow synovectomy even in the late stages of disease. PMID- 2718599 TI - [Giant cell tumor of bone]. AB - This retrospective study analyses 67 patients with 69 giant cell tumors of bone staged according to the Surgical Staging System of benign and malignant lesions of Enneking (1980, 1986). A significant correlation between Stage 2 and Stage 3 benign lesions in respect to local recurrence as well as between the therapeutic procedures and recurrence was found. Intralesional excision with temporary acrylic cement implantation showed to be the preferable initial treatment of these tumors. Special attention to surgical staging, surgical techniques and a supervised rehabilitation program minimize the incidence of recurrence and at the same time giving am maximum of joint function. PMID- 2718600 TI - [The status and outlook of the study of nervous system physiology in the USSR]. PMID- 2718601 TI - [Developmental prospects in human physiology]. PMID- 2718602 TI - [Trends in the development of physiologic research in the USSR in light of the acceleration of socioeconomic progress]. PMID- 2718603 TI - Adverse effects of equine rabies immune gobulin. AB - Following a recently published prospective study of 485 recipients of equine rabies immune globulin (ERIG) manufactured by Pasteur Vaccins (Paris), this paper reports a study of 323 postexposure rabies patients receiving ERIG manufactured by the Swiss Vaccine and Serum Institute (Berna). It is concluded that there may be significant differences in adverse reaction rates, reflecting differing manufacturing or purification processes and protein content. Further studies of different ERIG products and of different lots of the same product are needed while ERIG remains an essential component of postexposure rabies treatment in developing countries. PMID- 2718604 TI - Experimental polyvalent ISCOMs subunit vaccine induces antibodies that neutralize human and bovine respiratory syncytial virus. AB - The purpose of the present study was to evaluate experimentally, in guinea-pigs, the immunogenicity of respiratory syncytial (RS) virus subunit vaccines. Immunostimulating complexes (ISCOMs), made from the surface proteins of both human (Long) and bovine (A-51908) RS strains adsorbed to the adjuvant Quil A, were assayed for their capacity to induce neutralizing antibodies, in comparison to experimental live virus vaccines. Serums from animals vaccinated with either the human or bovine RS subunit vaccines were equally efficient in neutralizing human or bovine RS virus. ISCOMs prepared with bovine RS virus proteins were significantly (p less than 0.05%) more efficient than their human counterpart, in inducing neutralizing antibodies, suggesting their greater potential as a subunit vaccine. PMID- 2718605 TI - Enhancement of humoral immune responses against viral vaccines by a non-pyrogenic 6-O-acylmuramyldipeptide and synthetic low toxicity analogues of lipid A. AB - 6-O-Acyl derivatives of N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP) and synthetic, low toxicity lipid-A analogues were examined for their ability to enhance the potency of current viral vaccines. 6-O-(2-Tetradecylhexadecanoyl)-MDP (B30-MDP) in non-irritative vehicles such as physiological saline, phosphate buffered saline (PBS), squalene-PBS emulsion, Intralipid or liposomes, significantly stimulated the primary and secondary antibody production of guinea pigs against influenza split or subunit vaccine and inactivated the hepatitis B virus surface (HBs) antigen. Mice seemed less responsive to the adjuvanticity of B30-MDP than guinea-pigs. Two low toxicity lipid A analogues, acylated beta(1-6) D-glucosamine disaccharide bisphosphates (which do not have amide-bound or ester bound 3-acyloxyacyl groups unlike fully toxic Escherichia coli-type lipid A), caused significantly enhanced antibody responses, primary or secondary, when administered to mice by incorporation into liposomes with inactivated HBs antigen. PMID- 2718606 TI - Failure of rabies postexposure treatment in Thailand. AB - Three failures of postexposure rabies treatment using imported purified duck embryo cell and Vero cell rabies vaccines are reported from Thailand. Reference is made to eight additional previously reported Thai patients, six of whom had received human diploid cell vaccine. An analysis of these cases reveals that there were serious flaws in management in all of these patients. It is stressed that 45% of human rabies deaths in Thailand occur within 20 days of being bitten and 71% are dead within 28 days. This short incubation period does not allow much time to start immunotherapy. Of Bangkok dogs found to have rabies at autopsy, approximately 8% have a rabies immunization history. Once a dog has bitten a patient immunotherapy should not be delayed in countries with a high incidence of dog rabies. Patients with chronic disease, alcoholics and drug addicts may have an impaired immune response to postexposure rabies vaccines. PMID- 2718607 TI - Improved recombinant LC16m0 or LC16m8 vaccinia virus successfully expressing hepatitis B surface antigen. AB - An attempt was made to develop a safe, efficacious live recombinant vaccine using low neurovirulent strains of vaccinia virus: LC16m0 (m0) or LC16m8 (m8). Recombinant vaccinia virus (RVV) was constructed by inserting the hepatitis B surface antigen (HBsAg) gene fused to a 7.5 kDa protein promoter (7.5 kDa promoter) within the vaccinia virus thymidine kinase (TK) gene using the m0 or m8 strain as vectors. These RVVs expressed significant amounts of HBsAg (1.1 microgram/2 X 10(5) cells) consisting of 24.5 and 28 kDa (glycosylated) proteins. HBsAg produced by RVV (vaccinia HBsAg) had physical properties very similar to plasma-derived HBsAg. Considering the safety of RVVs from m0 or m8 that have been constructed with HBsAg without the addition of a promoter and the high induction of anti-HBs antibody with RVV from m0 strain in rabbits, the RVVs constructed in the present study are likely to form the basis of a safe live RVV vaccine for hepatitis B virus (HBV). PMID- 2718608 TI - Purification and characterization of pre-S-containing hepatitis B surface antigens produced in recombinant mammalian cell culture. AB - Heterogeneous, pre-S-rich HBsAg particles were expressed in recombinant mammalian cell culture and purified to near homogeneity. The purification process comprises: concentration of cell culture medium, protein precipitation by poly(ethylene glycol), gel filtration column chromatography, isopycnic ultracentrifugation by KBr and sucrose density gradient ultracentrifugation. The resulting HBsAg product was greater than 98% pure, and contained much of pre-S1 and pre-S2 components. Scanning densitometry analysis of the silver-stained HBsAg product showed approximately 70-80% S protein, approximately 10-20% pre-S2 protein, and approximately 5-15% pre-S1 protein. It was estimated that the amount of HBV-specific DNA present the final product was less than 7 pg mg-1 HBsAg. Further biochemical analysis has demonstrated that the HBsAg particles are very heterogeneous in charge and density. Charge heterogeneity was quite random among the particles, but density heterogeneity could be related to the different amounts of pre-S2 component in the particles. PMID- 2718609 TI - Directed AIDS Research in Britain, 1988: a partial report of the second annual workshop of the Medical Research Council AIDS Directed Research Programme. 12-13 September 1988, Oxford, UK. PMID- 2718610 TI - [The content of thromboxane B2 and 6-ketoprostaglandin F1 alpha of the blood plasma in patients with psoriasis and children with allergic dermatoses]. AB - The blood plasma levels of a number of endogenous prostaglandins have been measured by column chromatography followed by radioimmunoassay in 33 patients with psoriasis and in 22 children with allergic dermatoses. The findings evidence an increase of these prostanoids at the peak of the skin process exacerbation, thus indicating their role in the pathogenesis of psoriasis and allergic dermatoses in children. PMID- 2718611 TI - [Electron microscopic study of Darier's follicular dyskeratosis]. AB - Ultrastructure of the skin biopsy specimens of 10 patients with Darier's keratosis follicularis (DKF), 6 of them with the vesicular form of the dermatosis, has been examined by electron microscopy. The study has revealed dyskeratosis with tonofilament homogenization and well-developed keratohyalin granules, round bodies and granules, and acantholysis less manifest than in Hailey-Hailey's chronic benign familial pemphigus. Ultrastructural features of the skin in vesicular DKF present as acantholysis and dyskeratosis more manifest than in typical DKF. Similarity of the morphologic signs of the typical and vesicular DKF permit considering the vesicular form of this keratosis as one of DKF variants. PMID- 2718612 TI - [Dermatoglyphic characteristics in hereditary ichthyosis]. AB - Examination of 530 dermatoglyphic patterns of the palms and fingers in 265 patients with 5 nosologic forms of hereditary ichthyoses (autosomal dominant ichthyosis vulgaris, X-linked, congenital, lamellar, epidermolytic ichthyoses) have revealed significant differences in the pattern intensities and in the incidence rate of certain types of these patterns, associated with this or that form of ichthyosis; abnormalities in the flexor wrinkles of the ridge skin have been observed in all the studied forms of the disease, except the X-linked condition. The studies have revealed an abnormal roughness of the papillae on the epidermal ridges in epidermolytic ichthyosis and an obliterated dermatoglyphic pattern in lamellar ichthyosis. The detected changes in the ridge skin and the dermatoglyphic phenotypes may be useful for the differential diagnosis of these conditions. PMID- 2718613 TI - ["Atopic dermatitis"--terminology questions]. AB - The authors give their comments on the paper by A. A. Kalamkarian and V. A. Samsonov on the taxonomy of diffuse neurodermatitis and atopic dermatitis. They consider that the term "atopic disease" is more validated; discussing the wording of a detailed diagnosis, they come to the conclusion that the term "diffuse" should be used only as a characteristic of the process dissemination in neurodermatitis. PMID- 2718614 TI - [Endolymphatic antibiotic therapy of allergic vasculitis]. AB - Inadequacy of the routine methods for therapy of infectious allergic vasculitides and the necessity of sanitizing the foci of infection have prompted the application of endolymphatic administration of antibiotics. Studies of ampicillin pharmacokinetics have demonstrated that a single endolymphatic injection in a dose of 1 x 10(6) U is sufficient to maintain the therapeutic concentration of the drug in the blood serum for 24 hrs. Ampicillin has been injected into the lymph vessels of both soles in the above dose once daily for 5-7 days to 10 patients suffering from allergic vasculitis for a long time. The pathologic elements regressed by the end of the course of therapy in all the cases; only two patients have developed relapses in several months, that have been rapidly arrested. PMID- 2718615 TI - [The efficacy of health resort treatment of psoriatic arthritis at Yevpatoriya]. AB - The authors analyze the efficacy of treatment of 162 patients suffering from psoriatic arthritis in Evpatoria health resort. The treatment modalities included brine baths, mud applications, climatotherapy, etc. Clinical cure or considerable improvement has been achieved in 21.8% of patients, improvement in 74.3%, no therapeutic effect in 3.9%. Along with alleviation of the clinical manifestations of psoriatic arthritis, a number of immunological and biochemical parameters (albumin, lysozyme, IgM levels) have shown a tendency to normalization. The combined health resort therapy is an effective means of the after-care of psoriatic arthritis. PMID- 2718616 TI - [Sleep disorders in adolescents and youths with atopic dermatitis and its pharmacologic correction]. AB - Clinical and actographic examinations of various sleep stages in 52 patients with atopic dermatitis have revealed a variety of sleep disturbances in the majority of cases. 56% of the examinees fell asleep with difficulty; it took them 1.5 times longer to fall asleep, vs. the normal subjects. Not deep sleep with frequent awakening at night has been recorded in 67% of the patients, and 42% did not feel rested after night sleep. The type of sleep disturbances depended on the clinical structure of mental disorders, that included asthenic (42%) and depressive (39%) disturbances with explosive, anxiety, and phobic symptoms. Patients with atopic dermatitis should be administered multiple-modality therapy carried out by a dermatologist and a psychiatrist. Besides the drugs for skin condition, psychotropic agents should be administered for 3-4 weeks. Combined therapy of neurotic disorders is most effective with tranquilizers (phenazepam, nitrazepam, radedorm or eunoktin). PMID- 2718617 TI - [Kaposi's sarcoma in a female patient taking corticosteroids for a long time]. AB - A 65-year-old female patient has been orally taking corticosteroids (8 pills of prednisolone) for a severe form of bronchial asthma. In 1979 Kaposi's sarcoma was diagnosed for the first time; the diagnosis has been histologically confirmed. Several times the patient has been effectively treated with prospidin. The disease course got worse from 1984 on: the eruptions disseminated and the condition recurred every 2-3 months. This case is remarkable because Kaposi's sarcoma has developed in a patient treated with corticosteroids for asthma for a long time. PMID- 2718618 TI - [Experience with the comprehensive examination and treatment of patients with reactive urogenous arthritis]. AB - The authors emphasize that urogenous arthritides (UA) be distinguished among other inflammatory diseases of the joints. They analyze 51 case histories of UA patients; these cases have made up 9.5% of the total number of patients with articular inflammations. UA are characterized by an early onset, by a relationship between the articular syndrome and the urologic infection, an asymmetric pattern of articular involvement (mainly in the lower limbs), and by a dependence of the therapeutic effect on the urogenital condition (i.e. arthritides can be cured only if the urologic disease is cured). Chlamydial infection is the most frequent (71%) reason of UA. Cooperation of a venereologist and rheumatologist in the detection and rational therapy of UA patients provides clinical cure or a considerable reduction of the number of relapses. PMID- 2718619 TI - [Errors in the diagnosis of early forms of syphilis]. AB - Reviews the results of diagnostic errors made by physicians of various specialties during examinations of patients with early syphilis. Suggests measures to improve timely diagnosis of this disease. PMID- 2718620 TI - [The combined treatment of venereal diseases and alcoholism]. AB - Combined therapy for a sexually transmitted disease and chronic alcoholism or alcohol abuse has been administered in a hospital for sexually transmitted diseases. No side effects were recorded. Late results have been followed up in 111 patients; a stable remission has been achieved in 40%. PMID- 2718621 TI - [Chronic lichenoid keratosis]. AB - This is the first case of chronic lichenoid keratosis described in this country. The clinical picture and histologic findings suggest that this dermatosis be regarded as an atypical variety of lichen ruber planus. PMID- 2718622 TI - [Local PUVA therapy of patients with psoriasis]. AB - Various external photosensitizers have been compared in local PUVA therapy of 280 patients with psoriasis treated in Moscow at the Central Research Institute for Skin and Sexually Transmitted Diseases, the USSR Ministry of Health, and in Warsaw at the Dermatology Hospital. In Moscow 127 patients have been administered 0.3% ammifurin solution, 73 ones 0.1% psoralen solution; in Warsaw 50 patients have been administered 0.1% puvaderm ointment (Basan) made in Finland and 30 patients 0.1% oxoralen emulsion manufactured in Austria. A good clinical effect has been achieved in 252 patients (90%). Ammifurin 0.3% solution and puvaderm 0.1% ointment have proved to be the most effective. External photosensitizers are recommended for local or as a supplement to total PUVA therapy. PMID- 2718623 TI - [Carcinoma cuniculatum]. AB - A 62-year-old male subject has developed carcinoma cuniculatum on the sole. The authors consider that the physician should bear in mind the possibility of a diagnostic error when selecting the therapeutic method. They suppose that carcinoma cuniculatum should be referred to verruciform carcinomas. PMID- 2718624 TI - [Experience in the photochemotherapy of psoriasis with rectal administration of the photosensitizer]. AB - The authors compare the efficacy and tolerance of rectal (in suppositories) and oral administration of puvalen in 117 patients. The therapy has been highly effective in both the groups; clinical remission has been achieved in 78% of Group 1 patients and in 80% of Group 2 ones. Rectal puvalen has been better tolerated; the incidence rate of side effects has been 4 times lower. This recommends the rectal route of puvalen administration for wide practice, particularly in patients with subclinical abnormalities of the liver and gastrointestinal system. PMID- 2718625 TI - Nucleotide sequence of the matrix, fusion and putative SH protein genes of mumps virus and their deduced amino acid sequences. AB - cDNA clones representing the M, F and a putative SH gene of the SBL strain of mumps virus have been prepared and their nucleotide sequence determined. The M gene of mumps virus appears to contain 1253 nucleotides and codes for a protein of 375 amino acid residues (Mr 41,589). The protein is hydrophobic and the deduced amino acid sequence shows homologies with those of other paramyxoviruses. The F gene of the SBL strain was compared to that of the RW strain [Waxham et al. (1987) Virology 159, 381-388]. The F gene is 1727 nucleotides long and codes for a protein of 538 amino acids (Mr 58,789). There are substantial variations between the F gene sequences of various mumps virus strains. The F gene is followed by a small (315 nt) transcription unit which contains an open reading frame of 57 amino acids encoding a very hydrophobic protein (Mr 6712). This may be similar to the SH gene of SV5, although there appears to be no sequence homology between the SV5 SH protein and the putative SH protein of mumps virus. A physical and transcription map of mumps virus indicates the gene order to be 3'-N P-M-F-SH-HN, similar to that of other paramyxoviruses and SV5 in particular. PMID- 2718626 TI - The mumps virus nucleocapsid mRNA sequence and homology among the Paramyxoviridae proteins. AB - The nucleotide sequence of mumps virus nucleocapsid protein (NP) mRNA has been determined from two overlapping cDNA clones and confirmed by partial sequencing of the mRNA and the genome. The mRNA contains 1844 nucleotides excluding poly(A) and encodes a protein of 553 amino acids with a calculated molecular weight of 61,792. A comparison of the mumps virus nucleocapsid protein sequence with that of other paramyxoviruses revealed a moderate degree of homology (33.1%) with the Newcastle disease virus (NDV) only. The nucleocapsid proteins of all paramyxoviruses studied to date, excluding that of the genus pneumovirus, have a conserved sequence of six amino acids (Ser-Tyr-Ala-Met-Gly-Val) except that of NDV which has a mismatch of two amino acids (Ser-Phe-Ala-Met-Gly-Met) in that sequence. In addition, there is another conserved region of seven amino acids (Phe-Ala-Pro-Gly-X-Tyr-Pro) in the nucleocapsid proteins of mumps virus, Sendai virus and parainfluenza virus type 3. The nucleocapsid proteins of measles virus and canine distemper virus (CDV) also have this conserved region but with three conservative amino acid changes. PMID- 2718627 TI - Complete nucleotide sequence of the hemagglutinin-neuraminidase (HN) mRNA of mumps virus and comparison of paramyxovirus HN proteins. AB - The complete nucleotide sequence of the hemagglutinin-neuraminidase protein (HN) mRNA of the virulent SBL-1 strain of mumps virus has been determined. The mRNA contains 1887 nucleotides excluding the poly(A). The protein encoded by the mRNA has 582 amino acids and a membrane anchorage domain near the amino terminus. The calculated molecular mass (64 kDa) of the protein is in good agreement with that of the unglycosylated HN protein (63 kDa) identified in tunicamycin treated mumps virus infected cells (Herrler and Compans, 1983). The predicted sequence has nine potential N-glycosylation sites out of which two contain a cysteine residue and one has a proline residue as the variable amino acid X in the glycosylation site (Asn-X-Ser or Asn-X-Thr) and therefore, may not be utilized. One potential glycosylation site is in the cytoplasmic region which may not also be glycosylated. Comparison of the mumps HN protein sequence with the HN protein sequences of Sendai virus, simian-virus 5 (SV5), parainfluenza virus type 3 and Newcastle disease virus (NDV) shows two major homology regions, one region near the middle of the protein and the other in the second half of the molecule. In terms of percentage amino acid homology, the HN proteins of mumps virus, SV5 and NDV are closely related to each other but distinct from Sendai virus and parainfluenza virus type 3 HN proteins. PMID- 2718628 TI - [Further comment on the significance of data on fish parasites for related disciplines]. AB - The significance of data on fish parasites was earlier considered by V. A. Dogel', S. S. Shul'man, S. M. Konovalov, and other Soviet parasitologists. These data are inadequately used by related disciplines. The possibility to use parasitological data for studying fish feeding pattern, peculiarities of their bathymetric distribution, migration routes, taxonomy, phylogenetic origin, and revealing the origin of marine basins and their ichthyofauna has been demonstrated. PMID- 2718629 TI - [Optimal strategies of spatial distribution: the Olli effect]. AB - The selection of strategies of spatial distribution of individuals has been studied. In case of non-monotonous dependence of reproduction coefficient on the mean population density, a cluster formation is possible. At low mean densities, parity strategies of spatial distribution are realized, and at high densities, non-parity ones. A generalized notion of parity strategy of spatial distribution has been proposed. It includes such expenditures as expenditure for the movement of an individual, defense of the territory etc. A problem of evolutionary stability of different strategies of spatial distribution has been discussed. PMID- 2718630 TI - [Distribution of the species-specific lifespan in various taxonomic animal groups]. AB - A distribution of specific lifespan has been studied in different taxonomic groups of animals. A positive skewness has been observed in animal kingdom as well as in smaller taxonomic groups. The skewness is higher in groups with relatively short lifespan (Insecta, Rotatoria, Mollusca). A coefficient of variation and excess is also higher in the above groups. A comparison of these coefficients with paleontological age of the group allows to conclude that evolutionary progress of animals was accompanied by the increase in skewness, variation and excess of specific lifespan distribution. PMID- 2718631 TI - [Mathematical model study of the dynamics of an exploited population of the common fox (Vulpes vulpes L.)]. AB - The observed dependence of intensity of hunting intensity and the share of reproducing females on fox population density was shown to cause the existence of several stable equilibrium values of fox numbers and incompatibility of requirements for both maximal prey and prey stability. Organization of forbid forests is an acceptable way to regulate hunting in this situation. PMID- 2718632 TI - [The organization of time in biological systems]. AB - A notion of organization of time similar to the notion of organization of space in architecture has been introduced. The level and pattern of organization of time in biological systems differs from that in physical and chemical systems, which presents an independent problem. Analysis of the problem leads to a new definition of life as a process of renormalization of possibilities described by a Bayes formula. This definition leads to the notion of self-monitoring as a property of every biological system, and of complicated structure of the biological present, including the physical past and physical future. This is naturally followed by determination by far past, and, hence, memory, and determination by future, i.e. preadaptation, surpassing reflection, aim-setting etc. A direct dependence of a number of elements of a complex system on its stability has been demonstrated. The self-monitoring and organization of time can be traced at various levels of biological hierarchy from intracellular to biosphere level. PMID- 2718633 TI - [Detection of fruit juice adulteration in apple and pear juice]. AB - A method has been developed to detect the adulteration of pear juice with apples and apple juice with pears. In different varieties of apples and pears and in several commercial juices the flavonoids were examined by HPLC with respect to their quality and quantity. The chalcones phloretin glucoside and phloretin xyloglucoside are typical compounds found in apples (detection limit 7 ng). They are suitable indicators for detecting adulteration of pear juice with apples. Isohamnetin glucoside cannot be detected in apples (detection limit 10 ng), but can be used to detect pears in apple juice. The extract or juice was purified with the aid of a polyamide column. The evaporated eluate of methanol was analysed by HPLC (gradient: acetonitrile/1% acetic acid). An RP-18 column and a UV-detector were used. Additionally, the UV spectra of the compounds indicating an adulteration were recorded by a diode array detector. PMID- 2718634 TI - Determination of residual bromopropylate and coumaphos in honey and honeycomb by capillary gas chromatography. AB - This study describes a method for the quantitative determination of residual bromopropylate (BP) and coumaphos (Cph) in honey and honeycomb. It is based on a reversed phase extraction technique on sorbent octadecyl. Both phyto pharmaceuticals are determined by electron-capture using a fused silica capillary column CP Sil 5 CB. The absolute detection limit for BP and Cph is 2.5 and 5 pg, respectively. Recoveries of 99.6% and 94.4% are obtained for samples fortified at levels of 400 micrograms BP/kg and 1,000 micrograms Cph/kg. Twelve samples of honey and 8 samples of honey-honeycomb have been analysed using this method. BP and Cph could not be detected in the honey samples. Samples of honey-honeycomb recently treated with Perizin (Cph) and Folbex VA (BP) contained different amounts of BP and Cph. PMID- 2718635 TI - The impact of preoperative chemotherapy on resectability of primary tumour and complication rate in metastatic neuroblastoma. AB - 231 children with metastatic neuroblastoma prospectively followed up in three clinical trials underwent first look surgery at diagnosis or delayed first look operation after application of chemotherapy and partly second look surgery and were evaluated for resectability and complication rate. More than 85% of the primary tumours were located within the abdomen. The incidence of macroscopically complete removal increased from 30% to 60% after preoperative chemotherapy (p less than 0.001). There was no difference between the efficacy of delayed first look and second look surgery and between children with stage IV and stage IV S neuroblastoma. The mean complication rate was 20% (complication per patient) and 23% (complication per operation). Complications included local problems (7.9%), infections (5.9%), organ dysfunctions (8.3%) and rare other complications (1.3%). No significant difference was found between the three surgical modalities, i.e. preoperative chemotherapy did neither increase the complication rate nor change the complication pattern. The biological meaning of primary tumour control is still unclear. However, a 40% local recurrence rate suggests an aggressive surgical attitude. Our study provides a basis that preoperative chemotherapy may be an effective tool to achieve complete removal of initially non-resectable primary tumours without increasing the complication rate. PMID- 2718636 TI - In-vitro motility of normal and pathological smooth muscle of colon. AB - This study is based on the in-vitro analysis of the normal and pathological colon smooth muscle contraction. Two different methods, supported by computer analysis, are presented. This approach will probably help the physician and the surgeon to better understand the physiopathology of some characteristical diseases, such as Hirschsprung's disease. PMID- 2718637 TI - [Acetylcholinesterase negativity in the lamina propria in the first 8 weeks of life does not exclude Hirschsprung disease]. AB - In a total of 34 children with Hirschsprung's disease, 7 cases showed at first biopsy a normal lamina propria mucosae without aberrant acetylcholine esterase (ACHE)-positive fibres. In further biopsies all 7 cases showed the typical pattern of abundant ACHE-positive nerve fibres in the lamina propria, the last one at the age of 8 weeks. This data suggests that in children with Hirschsprung's disease who have not yet attained their 8th week of life, approximately one-third are without the typical aberrant nerves in the lamina propria. Therefore, we emphasize that a biopsy taken before the 8th week of life showing a negative morphological result should be repeated if the clinical suspicion remains. The late sprouting of the pathological nerves should be considered especially if there are abundant ACHE-positive fibres in the lamina muscularis mucosae. PMID- 2718638 TI - [The development of the early genital anlage and its significance for the development of the large intestine--studies of rat embryos]. AB - The morphology of infraumbilical malformations suggests that the development of the genital anlage is of great importance for the embryology of the cloaca. In rat embryos the development of the genital anlage is documented using scanning electron microscopy. This documentation suggests that the genital anlage develops in three phases. Of these, the development of the unpaired glandular hillock seems to be especially important. The genital anlage affects the development of the cloaca in two ways: firstly its ventral growth causes a ventral shifting of the greater part of the cloaca into the region of the genitalia and secondly the cloaca gains its definite position through the development and growth of the glandular hillock. PMID- 2718639 TI - [Epithelium and anal glands in rectal pouches and fistula. Histologic studies of swine with congenital anal atresia]. AB - The epithelial coating of the rectal pouch and fistula was studied morphologically in 33 newborn piglets with high and low forms of anal atresia and was found to be similar to the epithelial coating of the anal canal in normal piglets: the typical epithelium of the rectum changed its character into transitional epithelium at the region of the internal sphincter which surrounded the fistulae in all animals. In the caudal part of the fistula the transitional epithelium was followed by squamous epithelium. Only in male piglets with deformities and recto-urethral fistulae no squamous epithelium was found. In these cases transitional epithelium covered all parts of the fistula and the region of the internal sphincter. Anal glands were found in all animals, with or without anorectal malformations. They always invaded the internal sphincter. According to our morphological studies the fistula in anorectal malformations represents an ectopic anal canal. PMID- 2718640 TI - Circular myotomy for mid-oesophageal stricture. AB - In this paper we describe the use of circular myotomies to approximate the oesophageal ends resulting from resection of an oesophageal stricture due to ingestion of domestic bleach. This procedure has spared the child from major oesophageal surgery with its known morbidity. This is the second case described using this method from this institute. PMID- 2718641 TI - [Endoscopic percutaneous placement of a guide thread for bouginage treatment of the esophagus following 3d degree chemical burn: a new method without laparotomy]. AB - For successful treatment of third degree caustic burns of the esophagus, early bouginage and cortisone medication are mandatory. We use Rehbein bougies under guidance of a orogastric thread. To place this, laparotomy had been required so far. A new procedure for endoscopic gastrostomy is described to avoid the laparotomy. This method was performed in 7 children and one adult. There were no complications. The introduced procedure is recommended as a simple and safe technique, using endoscopy for thread placement as well as for diagnostic evaluation. PMID- 2718642 TI - [Fibrocystic mastopathy as a cancer risk]. AB - Between 1963 and 1970, 136 cases of mastopathy were recorded from among 558 women who had undergone outpatient breast surgery. These cases were histomorphologically rated and were followed up for periods between 15 and 22 years. Carcinoma developed in nine of 121 patients, accounting for a 7.5-fold cancer risk. The cancer risk was separately calculated for each of the subtypes involved, and variations between groups were remarkably rare. Hence, an eight fold carcinoma rate for mastopathy I seems to put into question the prognostic value of epithelial proliferation. PMID- 2718643 TI - [Breast cancers in pregnancy and lactation]. AB - Four cases of rare coincidence of pregnancy and mammary carcinoma are described in this paper. Tumour growth was at an advanced stage and prognosis thus deteriorated due to delayed diagnosis. The therapeutic concept should be in keeping with the stage of tumour growth and should be formulated with due consideration of the patient's individual peculiarities. PMID- 2718644 TI - [Mammographic findings following reduction mammaplasty]. AB - Clinical and mammographic follow-up checks were made on 64 women with a record of breast reduction surgery. Mammographic changes, such as thickened skin, distortion of nipples as well as thickening and dislocation of parenchymal tissue, can be relatively easily differentiated from malignant changes, primarily in cases in which such changes are symmetrical and in which case histories and earlier clinical findings are known. Bilateral calcifications in most cases are caused by calcified fat necrosis. PMID- 2718645 TI - [Malignant retroperitoneal schwannoma]. PMID- 2718646 TI - [Cystadenoma of the liver and bile ducts with ovarian stroma]. PMID- 2718647 TI - [Transareomamillary incision in gynecomastia]. PMID- 2718648 TI - [Abstracts of the Surgical Oncology Section of the East German Society for Surgery. 2d meeting. 26 February 1988, Leipzig]. PMID- 2718649 TI - [Breast cancer. Principles of prevention, early detection, treatment and after care]. PMID- 2718650 TI - [Experimental and histologic studies on fetal membrane tensility and membrane rupture]. AB - The collagen microfibrils of the amniotic connective tissue are irregularly textured. In all a preference for a meridional orientation perpendicular to the placental-rim can be observed. There are randomly dispersed weak spots between dense bundles of collagen fibres. The chorion connective tissue consists also of fibril bundles in a meridional main orientation. Within the bundles or bands there is an unmistakable pattern of latticed arranged fibrils. The framework receives its stability from the bundles that run perpendicular or inclined to the previously mentioned bundles. There are randomly dispersed weak areas between the dense fibril aggregates. In general the amniotic and chorionic connective tissues are both of variable strength. The tensile strength of both membranes is regionally varying due to the irregular texture. At times it varies within the same fetal membrane or from fetal membrane to fetal membrane considerably, where by the variation in membrane thickness also is of influence. It is to be observed that in general the resistance perpendicular to the meridian direction is smaller than along the meridian direction. During the rupture of the membranes the latticed arranged fibres from the bundles of the chorionic connective tissue give way and tear in an arbitrary weak spot. In the amniotic tissue the tearing also begins in a weak spot and continues to tear in a non predictable direction between the irregular pattern of bundles. PMID- 2718651 TI - [The frequency of anemia in pregnancy and the effect of Folicombin]. AB - During pregnancy in 151 of 500 pregnant women at last once a decrease of hemoglobin below 7.5 mmol/l could be detected. 25.8 per cent of the anemias have been found in the first trimester, 58.3 per cent in the second one and only 15.9 per cent in the third one. Older women, multiparae and women with infections of urinary tract had an elevated risk of anemia. Weight increase was lower in anemic pregnants than in non-anemic ones. In 85.8 per cent we observed a remission by early treatment with folicombin (iron and folic acid). Only 14.2 per cent of the anemias remain refractory against treatment. The frequency of anemia in our group of 8.6 per cent was considerably below of that of untreated ones. Additionally the small portion of severe anemias of 2.6 per cent underlines the value of an early treatment of pregnancy anemia using a combination of iron and folic acid. PMID- 2718652 TI - [Effect of heavy metal ions on male fertility]. AB - In this study 67 workmen exposed to ions of heavy metals have been investigated because of their fertility. Concentrations of the noxious substances and their metabolites in blood and urine have been estimated and spermiograms were performed. The investigations demonstrated that a correlation exists between the concentrations of noxious substances in the place of employment, in the blood, and in the ejaculate, besides of zinc. An increased number of pathological spermiograms could be established especially in cases with an exceed of maximum permitted concentrations in the place of employment. PMID- 2718653 TI - [Psychotherapy of psychopathic patients and patients with slowly progressing schizophrenia with defensive manifestations using a method of creative self expression]. AB - Summarized is a several years' experience of the out-patient psychotherapy of 312 psychopathologic patients of different clinical groups manifesting defensive disorders (psychasthenic, asthenic, defensive cycloid, schizoid, epileptoid, defensive hysterical psychopathic, anankastic personalities) and patients with defensiveness due to slowly progressing schizophrenia. The described technique allowed steady remissions and compensation in 80.1% of the cases. The results of the 2-5-year therapy included the psychotherapeutically raised creative inspiration and capacity of seriously and efficiently coping with the patients' own pathology and everyday life problems through the knowledge of life and human nature. PMID- 2718654 TI - [Memory changes in patients with functional and vascular psychic disorders at a late age]. AB - Mnestic functions were studied in 220 senile patients with neuroses, neurosis like vascular disorders, endogenous depression, initial vascular psycho-organic syndrome. In senile functional psychic disorders a secondary affect-bound reduction of short-term memory was detected. Dynamic (affect-related) components could be shown as parts of initial vasculogenic psycho-organic syndrome. Relieving these affective disorders and asthenia was conductive to evaluation of the true degree of partially reversible mnestic disorders. Subjective estimates of memory deficit in these patients were inconsistent with actual conditions and correlated with asthenia, affective disorders, somatic state, microsocial environmental impacts. Goal-directed action on these components which are secondary ones in the memory defect structure can promote the treatment efficiency in these patients. PMID- 2718655 TI - [The effect of aminazine therapy on the functional state of the brain in children with behavioral disorders]. AB - The study deals with the influence of therapy with chlorpromazine on EEG in children aged 9 to 15 with psychopath-like affective-excitable behavior of residual-organic origin (21 patients, and with pathologic personality development of affective-excitable type (15 patients). Baseline indices of the brain electric activity were compared with those during chlorpromazine treatment. Histographic analysis was applied to EEG. The rate of extinction of various components of orienting response to sound (activation response, vertex-potential, galvanic skin response) were also recorded, as was the reproduction of the rhythm of light flashed at different rates. The results pointed to the increase in pathological signs in the patients' EEG during the prolonged chlorpromazine course that suggested its more careful use in children with psychopath-like affective excitable behavior. PMID- 2718656 TI - [Visual evoked potentials in the differential diagnosis of vascular and demyelinating disorders of the optic nerve]. AB - In 21 patients with idiopathic retrobulbar neuritis (IRN) the optic nerve function was assessed using visual evoked potentials under a reversible black-and white chessboard pattern stimulation. Latencies of the large positive wave P100 significantly increased in all IRN patients ipsilaterally to the diseased eye and in a half of the patients contralaterally. Amplitude reduction in the evoked response to the diseased eye stimulation with unaffected eye P100 parameters within the normal range was most characteristic of IRN. These criteria can be used for differential diagnosis of vasculogenic and demyelinating lesions of the optic nerve. PMID- 2718657 TI - [Initial dyscirculatory encephalopathy in middle-aged and elderly patients (problems of early diagnosis and therapy)]. AB - Combined clinicophysiological investigation was performed in IDE (195 patients) in order to assess the degree of cerebral circulation disorders and their impact on the levels of brain functional activity. The informative values of several quantitative indices of brain hemodynamics and neurodynamics were assessed with respect to the patients' age. Single administration and full course of cavinton and sermion (nicergoline) were effective as judged by cerebral circulation studies (133Xe clearance), brain bioelectric activity (EEG frequency integration analysis, visual evoked potentials). In senile patients, the effect of i.v. sermion administration was dose-dependent. PMID- 2718658 TI - [Clinico-electroencephalographic characteristics of various stages of dyscirculatory encephalopathy]. AB - Clinical manifestations of dyscirculatory encephalopathy (DE) were studied in 548 patients. The occurrence of the major signs and syndromes as well as their course at different stages of the disease were revealed. Clinical criteria of classifying the patients into one of the stages were clarified. In 372 recordings of baseline and response EEG of patients at diverse stages of DE the course of various EEG indices and precise EEG characterization of each stage were given as the disease progressed. Good correlation between the course of the disease and EEG shifts allows the brain bioelectrical activity to be a tool in DE staging. PMID- 2718659 TI - [Prognostically significant indices of the bioenergetic metabolism of the brain in experimental ischemia (a NMR spectroscopic study)]. AB - Initial levels of phosphate brain metabolites were measured using 31P NMR spectroscopy in rats which subsequently died or survived under bilateral ligation of common carotid arteries. A multidimensional analysis was applied. In the rats which died after the brain ischemia: (1), NAD and NADH+ concentrations were much higher than those of creatine phosphate or ATP (i.e. baseline dysbalance existed between the systems of hydrogen acceptors and major macroergic substances); (2), the force of relationships between parameters of NMR spectra in each correlation matrix were 10 times higher and the variability of elements in each matrix was significantly lower than those of the surviving group. These regularities can be used in detection of special groups at high professional risk and in designing individual procedures of prevention and treatment of cerebral circulation disorders. The data are valuable in terms of development of drugs which would correct the dysbalance between hydrogen acceptors and macroergic systems thus providing a metabolic defense for the ischemic brain. PMID- 2718660 TI - [Immunologic disorders in cerebrovascular lesions associated with livedo (Sneddon's syndrome)]. AB - In combined immunological investigation of 24 patients with Sneddon syndrome, 16 showed the decreased content of T-lymphocytes and theophylline-sensitive cells, increased content of B-lymphocytes, increased levels of IgM and circulating immune complexes. In 80% of the patients the leukocyte adherence inhibition test has revealed the blood cell sensitization against nervous tissue antigens, basic myelin protein of purified protein derivative. The data suggest the participation of autoimmune mechanisms in the Sneddon syndrome pathogenesis. PMID- 2718661 TI - [Determination of the professional work capacity of patients with initial manifestations of cerebral circulatory insufficiency]. AB - In 45 patients with initial signs of cerebral circulation insufficiency involved professionally in work demanding high attention levels, the deceleration and instability of all time parameters of attention (rate, quality, productivity, precision) was detected with its exhaustiveness increased, active attention levels and switch-over capabilities decreased. This suggested the instability and reduced mobility of nervous processes with restricted capability of adaptation to mental loading. This approach can yield clinical criteria of professional rehabilitation potentialities of these patients. PMID- 2718662 TI - [Nonspecific systems of the brain in insomnia and parkinsonism in old age]. AB - Conventional clinical investigation, electropolygraphy of the structure of night sleep and wakefulness, diurnal fluctuations of catecholamine excretion, psychological testing have revealed that both insomnia (995 patients) and parkinsonism (88 patients) involve the impairment of the integrative action of unspecific brain structures. Diurnal rhythm of these systems activity was inverted with activating influences preponderant at night and synchronizing ones at day. Unlike insomnia, parkinsonism showed distinct traits of increased activity of synchronizing brain structures during the cycle of sleep-wakefulness. The treatment of these disorders should be designed with due consideration for age related and biorhythmic changes as well as personal 'patients' peculiarities and general gerontological principles. PMID- 2718663 TI - [Experience in the use of finoptin (verapamil) in cerebrovascular diseases]. AB - Twenty-seven patients with dyscirculatory encephalopathies grades I and II and 20 acute ischemic stroke patients received finoptin (verapamil) at daily 5 to 10 mg i. v. or 120 to 240 mg oral doses. The course lasted for 2 months. Rheoencephalography (RhEG) revealed an increase in cerebral blood filling 3 to 5 min after the single finoptin administration. The effect lasted for an average of 40 to 60 min. Central hemodynamic changes were represented by lowering blood pressure and total peripheral vascular resistance, increasing stroke volume and cardiac output. The effect was observable 40 min after a single i. v. injection of the drug. Beginning from the 2nd to 3rd day of the treatment, the patients' subjective conditions improved with reduced strength of general cerebral signs of stroke, RhEG and ECG changes indicating the permanent increase in cerebral circulation and reduced left ventricular overload. PMID- 2718664 TI - [Neurologic complications in otitis and rhinosinusitis]. AB - In 67 patients (32 with otitis and 35 with rhinosinusitis) otorhinosinusogenic complications were detected (cerebral abscesses, meningoencephalitides, cerebral arachnoiditides, encephalopathies, vasoautonomic forms of hypothalamic syndrome). In one patient testaceous pachymeningitis ran uncommon course with a fatal outcome. PMID- 2718665 TI - [A new highly active proteolytic myelin enzyme and its possible role in the mechanism of the demyelinating process]. AB - The study of the myelin in the rabbit brain and in biological fluids of patients with multiple sclerosis has revealed the presence of a new highly active proteolytic enzyme. The article describes the physicochemical properties of this enzyme. Its role in the pathogenesis of the demyelinizing process is emphasized: normally being coupled with an inhibitor the enzyme is released as a result of the demyelinizing process and becomes active. This leads to the destruction of myelin proteins. Possible factors of enzyme activation are considered. The authors discuss the significance of differences in the activities depending on the stage of the process and the course of multiple sclerosis. PMID- 2718666 TI - [Treatment of migraine with vasopressin]. AB - Clinicophysiological studies were performed in 186 patients with different variants of migraine. Of these, 153 received a course of treatment with the neuropeptide 8-arginine vasopressin. The pain paroxysms were reduced in intensity and duration in 87% of the cases in which also the cerebral hemodynamics, psychoemotional state, autonomic vascular conditions and working capacities improved. Prophylactic courses yielded positive results in 63 patients. The therapeutic effectiveness of 8-arginine vasopressin, and the simplicity of its administration without untoward effects and complications allowed us to recommend the drug to use in migraines, especially during the attacks. PMID- 2718667 TI - [Emotional stress psychotherapy]. AB - The concept of emotional stress psychotherapy (ESP) is based on the theoretical understanding of mental process as a system of cross-potentiating synergism of consciousness and the unconscious. Therefore, one can regard this kind of treatment as an appeal to the spiritual components of personality arousing its need of self-perfectioning. Owing to this, ESP turns the demands and higher interests creating a personality dominant to oppose the illness with ensuing depression and apathy. In a sense, this method is a qualitative contrast to S. Freud's psychoanalysis digging in the dark compartments of the soul. As a result of treatment of thousands of neurotic patients and those with psychosomatic disorders and alcoholism, the following techniques of ESP were elaborated: rational, shaped as a socratic dialogue; hypnosuggestive comprising individual or collective hypnosis, extremely loaded with emotions; autosuggestive like mental self-regulation and autogenic training filled with specific emotions. PMID- 2718668 TI - [Clinico-diagnostic evaluation of acute delirious syndromes in schizophrenia]. AB - Psychopathologic and nosologic issues of acute paranoid and Kandinsky-Clerambault syndromes are discussed on the background of clinical studies of 225 schizophrenic patients with these syndromes being initial manifestations. The data on the syndromes typology, clinical value and prognosis of acute delirious disorders are presented. These are shown to be not confined to progredient schizophrenia, including its paranoid form. Rather, they can manifest a course of the disease unspecific for schizophrenia, the so-called schizophrenic reactions and phasic states thus reflecting the course of latent schizophrenia. A differentiated approach to clinical and psychopathological analysis of acute delirious syndromes in schizophrenia is essential for adequate choice of medicosocial measures and epidemiologic investigations. PMID- 2718669 TI - [Heritability of clinical forms of childhood schizophrenia]. AB - Investigated and genetically analyzed were inheritance variants in 225 families of probands with different forms of development of child schizophrenia and 519 blood relatives as well as in 1714 relatives of the 2nd and 3rd grades. Child schizophrenia as seen from the viewpoint of the monogenic model of inheritance with total or partial penetrance of the "major" gene proved inconsistent with the characteristics of family history and population distributions in the disease. The multifactorial model appeared the most adequate to describe the susceptibility system. In the framework of this model the correlation between the susceptibility components specific for a clinical form could be derived from distinguishing between genotypic and environmental components. The data indicate that in malignant and slow progredient schizophrenia the probands were genotypically similar to a greater extent that they were in paroxysmal progredient form, as revealed by the inheritance coefficient of the former group (28-35%) which was lower than that of the latter group (64%). PMID- 2718670 TI - [Diagnostic potential of phonoangiography of extracranial arteries]. AB - Phonoangiography (PAG) was applied to study the extracranial parts of cerebral blood vessels in 16 symptom-free healthy individuals and 92 patients with cerebrovascular disorders. The conductance of cardiac tones to the cerebral arteries was assessed in comparison between PAG and phonocardiography. Correlations were found between the arterial wall elasticity, luminal changes and heart sounds conduction. As the atherosclerotic changes increased in arteries under study, the tones conductance velocity increased and their amplitude decreased. With the vascular tone reduced, the heart sounds conduction velocity decreased and their amplitude increased. The 1st and 2nd tones displayed differential increase in conduction velocity in distorted and dilated arteries. PAG vascular bruits were characteristic hemodynamic disorders. PMID- 2718671 TI - [Characteristics of early childhood schizophrenia proceeding with astheno adynamic, adynamic and affective-catatonic attacks (a clinico-catamnestic study)]. AB - Clinico-catamnestic approach was applied to study 40 children with early schizophrenia with astheno-adynamic, adynamic and affective-catatonic attacks. Catamnesis duration was 15 to 20 years. The authors describe the psychopathologic disorders and their repercussion around astheno-adynamic, adynamic, affective catatonic attacks within four age periods: under 1 year, 1 to 4 years, 5 to 10 years, 11 to 17 and older. The remission structure and quality was clarified, its stage-by-stage development and defect types characterized. The described version of early child paroxysmal schizophrenia had relatively favorable prognosis: clear regression in 45% of the cases relative regression with shift to symptom-depleted steady level in 55%. PMID- 2718672 TI - [Remission of paroxysmal progredient schizophrenia in forensic psychiatric practice]. AB - The medico-legal investigation of remissions was performed in 107 patients with paroxysmal progredient schizophrenia admitted to the V.P. Serbsky All-Union Institute of Forensic Psychiatry. The study yielded some particular clinical variants of the remissions: asthenic, hyperthymic-hypersthenic, explosive and paranoid. The relation was shown between social danger imposed by the patients, their remission form and various social factors. PMID- 2718673 TI - [The hypertensive-hydrocephalic syndrome in the clinical picture of schizophrenia]. AB - Combined clinical neurological study was performed in 111 schizophrenic patients with acute, subacute psychotic signs and at the end of psychosis. Techniques included echoencephalography, eye fundus study, spinal puncture. None of the patients had a history of craniocerebral trauma, neuroinfections, chronic alcoholism, severe somatic diseases. In 53.1% of the patients intracranial hypertension syndrome was detected with the highest rate in patients with acute psychotic signs. Besides, the hypertension syndrome was found to be related to the type of schizophrenia course: it was twice as frequent in attack forms as in permanent ones. The authors suggest that intracranial hypertension has a distinct role to play in the pathogenesis of acute schizophrenic attacks. PMID- 2718674 TI - [Relation of electrophysiological indices in various degrees of negative disorders in patients with schizophrenia]. AB - Preliminary results of the investigation of "expectation wave" phenomenon in 25 schizophrenic patients aged 17 to 41 years (20 or less years since the onset of the disease) are presented. The control group consisted of 10 healthy persons. The characters of evoked responses in patients and normals were essentially different. The decrease in the energy of potentials was found in lower frontal brain leads which was most pronounced while fulfilling a "motivational" task, and in patients with the history of the disease over 10 years. The data are consistent with the literature indications on the morphological disorders and metabolism reduction in the frontal lobes of schizophrenic patients. PMID- 2718675 TI - [Study of the processes of lipid peroxidation in patients with endogenous psychoses using gas chromatography]. AB - The processes of lipid peroxidation were studied in healthy subjects and patients with manic-depressive psychosis and schizophrenia using a non-invasive method based on chromatographic determination of endogenic pentane in the expired air. In patients with circular psychosis pentane concentration in the expired air did not differ from the norm, yet with advancing age it decreased (in contrast to an elevation in normal subjects). In schizophrenic patients pentane levels were significantly higher than in age-matched normal subjects. The level of the studied parameter was not correlated with the duration of the disease but showed a definite correlation with the severity of adverse disturbances in schizophrenia. PMID- 2718676 TI - Results on postcoital and penetration test. AB - Since adequate transcervical passage of sperm is indispensable to the natural fertilization, the sperm-cervical mucus studies provide a new possibility for investigating the marriages infertile due to unknown causes. The behaviour of sperm in the cervical mucus is also important from the point of view of selecting the mode of insemination. Consequently, the comparative evaluation of postcoital, slide penetration and capillary tests were made by the authors. PMID- 2718677 TI - Effects of operations on lymphocyte glucocorticoid receptors. AB - The changes in the glucocorticoid receptor count of lymphocytes was studied in diseases requiring various surgical treatments. Based on their studies, authors established that the number of receptors increased in most cases after operation. The increase in receptor count depends on operative stress. As a result, the stimulated receptor count increased to double or triple that of the normal value, decreasing then to normal during the postoperative phase. The change in receptor count can be used in assessing the reactivity of the organism and prognosis. PMID- 2718678 TI - Segmental spinal instrumentation in the early fixation of the fracture dislocations of the dorsal and lumbar spine (S.S.1). AB - A total of 24 patients were admitted to the Department of Neurosurgery and Traumatology between April 1, 1985 and March 31, 1987 for fracture-dislocation of the dorsal and lumbar spine. Review of the observation of the patients is given from their hospitalization to the surgical indication. The patients with unstable spinal fracture were operated independent of their neurological status. The operative technique which contains in fixing the spine according to the operative technique elaborated by Edwardo Luque is reviewed in detail. The advantage of their method is that bent Steinmann rods are used for fixation of the spine. A detailed review of the postoperative treatment and the complications is given. PMID- 2718679 TI - Use of laser knife in thoracic surgery. AB - CO2 laser knife was applied in 18 thoracic operations. The laser knife can be used for the sterile and ablastic cutting of skin, soft parts, ribs, sternum, bronchi and lung parenchyma. By its use intraoperative bleeding is substantially diminished. PMID- 2718680 TI - Surgical solution of femoral fibrosarcoma. Experience obtained by a 9-year follow up. AB - Biopsy followed by tumour removal and replacement by autologous bone tumour at the distal end of the femur were performed. Histologically, the tumour proved to be benign. Three years later progression was observed and epiphyseodiaphyseal resection was made because of on excessive tumour. Histology revealed a fibrosarcoma. Consolidation was hindered by osteomyelitis and fracture, recovery could be achieved only by a series of operations. These histological and operative difficulties are documented and the importance of extremity-saving operations is discussed. Our patient has been free of complaints 9 years after epiphyseodiaphyseal reseaction. PMID- 2718681 TI - [Analysis of severely injured patients admitted via an emergency service]. AB - Data about the number and treatment of trauma-patients are, certainly in our country, very rare. In this study we showed that such a registration with grading of the severity of the injuries following the ISS-Score is feasible and useful. Further and more extensive registration seems necessary in order to obtain a better insight in epidemiology and treatment of trauma patients in our country. PMID- 2718682 TI - Leaflet escape of a mitral Duromedics prosthesis. Case report. AB - This article reports a case of leaflet embolization of a mitral Edwards Duromedics prosthesis. The patient had abrupt onset of acute pulmonary edema and was initially treated medically for 3 days. Fluoroscopy showed only one freely moving leaflet and the other was (incorrectly) assumed to be blocked in the closed position. The patient received IV thrombolysis for another 3 days and was finally operated. He died 8 days later from sepsis and the leaflet was recovered at autopsy in the abdominal aorta. Leaflet escape of a mitral Edwards-Duromedics prosthesis is a rare, potentially curable mode of valve failure. Correct interpretation of clinical signs and symptoms and of fluoroscopy should allow early diagnosis and surgical therapy. PMID- 2718683 TI - Anthropometric parameters for preoperative screening to predict high-risk patients. AB - Prediction of serious postoperative complications by using standard anthropometric variables was attempted in 460 patients undergoing a major surgical procedure. Handgrip dynamometry was also carried out in 249 of the patients. None of the preoperative variables were of predictive value to postoperative complications, relating the method to its specified, sensitivity and validity. Upper arm anthropometry and handgrip dynamometry are rapid and inexpensive tests for detecting malnutrition, but they are not useful for preoperative screening to predict postoperative morbidity because appropriate standards are locking. PMID- 2718684 TI - [Surgery of foreign bodies in the esophagus in case of failure of noninvasive extraction technics]. AB - In the period 1957-1987, 240 corpora aliena in the esophagus were treated. The foreign body could be extracted under endoscopy in 228 cases (95%). In 12 cases the non-invasive extraction technic failed, so we have to remove the foreign body surgically. The most difficult bodies to extract by endoscopic way are the big, the sharp or pointed ones. On the surgical point of view, the way of approach depends on the level of the impacted body. The problem of post-operative fistula and abscess formation after surgery, can be avoided by a correct technic, exclusion of underlying pathology, an adequate drainage and consequent infection treatment. PMID- 2718685 TI - Solitary exulceratio simplex (ulcer of Dieulafoy). AB - Solitary exulceratio simplex (ulcer of Dieulafoy--Dieulafoy vascular malformation) is a rare and frequently overlooked cause of massive gastric hemorrhage. The source of the bleeding, a large, submucosal artery penetrating the centre of a small mucosal defect, is usually located in the upper portion of the stomach. The pathogenesis of this entity is not known. We report on two patients who were successfully treated by surgery. Clinical, morphological and pathogenetic aspects are discussed. PMID- 2718686 TI - [The treatment of post-infarction interventricular septal rupture]. AB - From 1976 to 1988, 15 patients with septal rupture after acute myocardial infarction were admitted to our department of Cardiovascular Surgery. Fourteen patients were operated on. In 8 cases, surgical correction was carried out in the acute phase (delay: less than 10 days). Operative mortality was 36%. Patch loosening was observed in 4 patients who were operated on in the acute phase. Five patients are still in life with a survival of 5 months to 5 years. This report deals with the risk factors, determinant for survival: localization of the myocardial infarction and the septal rupture, preoperative clinical and hemodynamical status of the patient, persistence of a residual shunt and severity of coronary atherosclerosis. PMID- 2718687 TI - [Indications for and contribution of diagnostic arthroscopy of the knee joint]. AB - The paper deals with indications and diagnostic possibilities of arthroscopy of the knee joint. The first part is devoted to the application of arthroscopy in the diagnosis of acute knee injuries. The Gillquists scheme of diagnostic procedure is outlined. Acute arthroscopy is indicate in acute blockade and in hemarthros. Arthroscopy has made the highest contribution in the diagnosis and treatment of damaged meniscus. High attention is devoted to chondropathy of patella and femoropatellar joint. Possibilities of arthroscopy in the evaluation of femoropatellar congruence are described. Less frequent causes of pains in anterior parts of the knee joint are mentioned (overuse sy, patellofemoral impingement sy, etc.). Arthroscopy is a method of choice in the identification and therapy of synovial plicae. In suspected disease of synovial lining the possibility of aimed biopsy is the main advantage. Other indications are as follows: dissecting osteochondrosis, intrajoint bodies of various etiologies, gonarthrosis. Arthroscopy enables a better planning of some operation interventions and to determine further prognosis. In the conclusion the authors draw attention to the contribution of diagnostic arthroscopy of knee joint in younger children, where a clinical examination and, particularly, its evaluation may be difficult. PMID- 2718688 TI - [Osteochondritis ischiopubica--van Neck-Odelberg disease in the differential diagnosis of coxalgia]. AB - The authors describe five cases from out-patient practice, whose pains were localized into lumbar joint due to the damage of ischiopubic joint in children at the age of five to twelve years. Aseptic necrosis of ischiopubic localization has been described in available literature as morbus van Neck-Odelberg. A description of clinical and X-ray picture is described, in the first case being typical in all stages of X-ray symptoms. Some symptoms described in literature were or were not identical. It proved to be impossible to demonstrate the influence of an injury as a trigger factor, but limitation in the homolateral lumbar joint (abduction or adduction component) as well as spontaneous tension of adductors were regularly observed. Flexion and extension were not limited with the exception of the fifth patient. A general picture of the described disease may be established on the basis of clinical and, particularly, X-ray picture. PMID- 2718689 TI - [Partial rupture of the Achilles tendon in athletes]. AB - The author discusses a group of ten sportsmen who suffered from achillodynia in the most distant part of the Achilles tendon, where the immediate cause was partial rupture. In seven instances the rupture was at the site of contact of the tendon with the prominent posterior part of the calcaneus. In the remaining three patients it was above the calcaneus. Two of these ruptures may have developed in conjunction with the application of a hydrocortisone preparation in the neighbourhood of the tendon. Treatment involved ablation of the prominent calcaneus, excision of the retrocalcanear bursa and suture of the tendon, depending on the extent of the defect. When the lesion was beyond contact with the calcaneus, the tendon was treated in the same way. The follow-up period of the patients is 7 months to 4 years. Nine sportsmen resumed their contest activities. PMID- 2718690 TI - [Basic requirements of care in polytrauma]. AB - The authors analyze briefly the criteria for the classification of multiple injuries and submit the definition they suggest: "Polytraumatism is a supraluminal injury of more than one bodily system which threatens the life and is associated with a serious traumatic response". The authors outline the minimal conditions which must be met by hospitals treating multiple injuries, which must operate continuously. Polytraumatism must be treated at surgical departments, only. The surgeon has in a multidisciplinary team the leading position and defines the order of therapeutic and surgical operations. Depending on the urgency of these operations, it is possible to classify injuries into four grades, which are defined in more detail. The paper contains the authors' own group of multiple injuries formed by 47 casualties in 1984-1987. The lethality was 31.9% and is evidence of the serious character of polytraumatism. PMID- 2718691 TI - [Our 2-year experience with diagnostic arthroscopy of the knee joint]. AB - The authors performed 200 arthroscopic examinations of the knee joint from April 1986 through March 1988. A suspected lesion of medial meniscus (in 52.5%) was the most frequent indication for the examination. Chondromalatia of patella was the most frequent arthroscopic finding (in 50.5% of examinations), two thirds of these findings were clinically inapparent. The ratio of arthroscopic findings of damage on the medial and lateral meniscus was 1.5:1. The lesions of medial meniscus were more frequently erroneously diagnosed clinically (32.4%), than the lateral meniscus lesions (25%), whereas the rupture of lateral meniscus was a more frequent accidental finding (19%) as compared with medial meniscus (11%). In 35% of cases the diagnostic arthroscopy saved the patient a useless revision of the joint. Reliability of the arthroscopic findings evaluated according to subsequent revisions proved to be 90.7%. PMID- 2718692 TI - [Experimental implantation of hydrogel into bone]. AB - In spite of the rapid development of various natural and artifical implants of bone tissue, bones or whole joints, no material was found as yet which would maximally resemble the structure of the bone tissue and would also be maximally compatible. The present study deals with the application possibilities of unsoluble hydrophilic gels (hydrogels) as substitutes of bone tissue in experiment. The study concerns above all their biocompatibility with regard to the porous qualities of the implant and to its chemical structure, and evaluates their behaviour in the spongious and compact bone. It was used polyhydroxyethylmethacrylate (polyHEMA) which is crossling with small amount of glycoldimethacrylate when by changing of ratio monomer: water is possible obtain from homogeneous to macroporous structure of polymers. The macroporous structure was increased and the surface of the macroporous structure of polymers. The macroporous structure was increased and the surface of the macroporous, sinterted HEMA modified and implanted. The so-called double porosity was thus obtained. The implants were prepared in the form of cylinders (3.5 mm in diameter) in 8 different modifications and surgically implanted into the subtrochanteric and supracondylic part of the rabbit femurs. 42 animals were operated on. The obtained preparations were then evaluated macroscopically, and histologically processed in half-thin cuts (3-4 micrones). 124 samples were thus obtained. Some samples were radiographically contrasting. The rabbits were killed at intervals from 1-6 months, i.e. 32-193 days. It was found that the hydrogels modifications used in the experiment are biocompatible, their compatibility increasing in dependence on the increasing porosity. The non-porous and microporous hydrogels are not compatible and are damarked. The sintered macroporous gel is surrounded by a thin fibrine membrane signifying a high degree of compatibility with the bone tissue. By adding metacrylate acid to the hydrogel, the adhesivity of the macrophages increases markedly. There also appears the destruction of the polymer, marked, above all, in the spongious bone. The gel is actively degraded in the marrow, although the direct phagocytosis can be proved. At degradation of the implant in the compact bone the activity of the macrophages is belated; at application of the gel without methacrylate acid it does not occur even after 193 days and the implant is pervaded only by the bone beams. When adding methacrylate acid to the polymer degradation occurs, in which process there play also an active role the blood vessels pervading the site of the gel implantation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2718693 TI - [The role of compression plates and screws on changes in the internal conditions in long bones]. AB - Morphological and biomechanical changes of the course of healing of cavities after screws in compression AO plates applied for 8 weeks and simple drilling revealed that in the long-term reduction of mechanical properties of these sites as a rule a major influence is played by transverse drillingholes of 3.4 mm and holes after 4.0 mm screws rather than by plates. The healing of cavities after simple drillingholes and after removal of screws is similar. In both instances a transversally oriented trabecular bony tissue is formed, i.e. transversally oriented to the original direction of osteones. This transverse orientation of trabecular bone matrix than causes poor distribution and spread of forces acting at these sites with a different vascular supply nutrition and biochemical changes. This reduces on a long-term basis biomechanical and other properties of these sites. Tranverse drillingholes and holes after screws are more important than plates in the subsequent reconstruction of osseous tissue after their removal. Therefore it is important when treating fractures using compression plates to keep in mind this adverse late effect of transverse cavities after screws and use them as little as possible. PMID- 2718694 TI - [Changes in the femoral neck in tabes dorsalis. Case report]. AB - The authors analyze diagnostic and therapeutic problems in fractures associated with tabes dorsalis. In the foreground of the clinical picture are in the majority neurological symptoms. The first symptoms develop 15 years after the primary infection. The laboratory results are not decisive for the diagnosis. Previously treatment of these fractures was conservative in rare instances arthrodesis of the affected joint was performed. In the case-history the authors submit new therapeutic possibilities in fractures of the neck of the femur associated with tabes dorsalis, using total endoprostheses of the hip joint. The authors mention also possible complications. The subjective evaluation by the patient is, however, very favourable. PMID- 2718695 TI - Final height of patients with idiopathic growth hormone deficiency after long term growth hormone treatment. Committee for Treatment of Growth Hormone Deficient Children, Growth Science Foundation, Japan. AB - One hundred and 8 patients with idiopathic growth hormone deficiency with spontaneous pubertal maturation (group A), were followed until they reached their final height after hGH treatment lasting between 2 and 11.1 (average 5.5) years. Their standard deviation scores of final height averaged 3.3 SD below the population mean, which was significantly lower than 1.1 standard deviation below the mean in 29 GH deficient patients without spontaneous puberty (group B) who were treated with hGH and sex hormones. The presence of gonadal function was found to be unbeneficial for final height. The final height of the patients in both groups was not related to either 1) age at the start of hGH treatment, 2) age at the onset of puberty, or 3) the duration of hGH treatment. It was, however, significantly related to the standard deviation score of height at the start of hGH treatment in both groups and to that of height at the onset of puberty in group A. The findings demonstrated that earlier introduction of hGH treatment resulted in earlier onset of puberty in group A, because the chronological age at the onset of puberty was positively correlated to the chronological age at the start of hGH treatment. It was also confirmed that the later puberty began, the taller the final height in GH deficient patients who had the same degree of standard deviation score of height for chronological age before puberty. PMID- 2718696 TI - D-glucose uptake is increased in jejunal brush-border membrane vesicles from hyperthyroid chicks. AB - Jejunal brush-border membrane vesicles were harvested from 4-week old chicks whose thyroid status had been altered either by a daily injection of 20 micrograms T3 for 1 week or which through the preceding 4 weeks had received propylthiouracil and that had been repleted with either 20 or 80 micrograms T3 in divided doses within 48 h. T3 markedly stimulated D-glucose uptake in brush border membrane vesicles in the presence of an outside/inside (100/0 mmol/l) Na+ gradient. T3 administration had no detectable influence on the Na+ permeability of the isolated vesicles. The effect of the thyroid hormone on Na+ gradient driven D-glucose uptake was fully preserved at zero transmembrane potential difference. These findings exclude that T3 stimulates Na+-dependent D-glucose transport in the small intestine through changes of the electrochemical Na+ gradient or through alteration of the transmembrane potential difference. Tracer exchange experiments under equilibrium and voltage-clamp conditions revealed a significantly shorter half-time of D-glucose uptake in brush-border membrane vesicles from T3-treated chicks. Kinetic analysis showed that T3 administration significantly increases the apparent maximal velocity of D-glucose transport in brush-border membrane vesicles, whereas the apparent Km values were virtually unaltered. From these data we conclude that T3 increases the activity of Na+ dependent D-glucose carriers in the brush-border membrane. This is interpreted as consistent with a greater rate of D-glucose absorption from the intestinal lumen under conditions of hyperthyroidism. PMID- 2718697 TI - Effects of urea on the in vitro production of prostaglandins and on urinary excretion in Brattleboro rats. AB - Brattleboro rats with hereditary diabetes insipidus make it possible to investigate effects of the urea concentration on the in vitro and in vivo production of prostaglandins E2 and F2 alpha (PGE2 and PGF2 alpha) by the renal papilla independently of any vasopressin effects. The rates of prostaglandin production in vitro are increasing between 100 and 1030 mmol/l urea and decreasing above 1030 mmol/l. The ratio PGE2/PGF2 alpha remains constant at about 4. Normally hydrated and 24 h water-deprived animals in steady state of urine formation were compared in vivo. Urine osmolality increased from 167 +/- 6 (N = 5) to 1113 +/- 35 (N = 15) mosmol/kg water and papillary urea concentration from 50 +/- 7 to 304 +/- 19 mmol/l after water deprivation. Urinary excretion rates of PGF2 alpha increased from 0.83 +/- 0.12 to 3.80 +/- 0.37 ng/h. The excretion of PGE2 was unaffected. PGE2 + PGF2 alpha excretion rates increased from 1.62 +/- 0.25 to 4.61 +/- 0.42 ng/h. These values are in accordance with values predicted from work with Sprague-Dawley rats. Together with previously published data on Sprague-Dawley rats these results indicate that variations of prostaglandin production in the conscious rat in steady state of urine formation can be accounted for by variations of plasma vasopressin and of papillary urea concentration. Variations in the excretion fraction are due to other causes. PMID- 2718698 TI - Regulation of uterine insulin-like growth factor I mRNA and insulin-like growth factor II mRNA by estrogen in the rat. AB - IGF-I and IGF-II are peptides with mitogenic properties. In this study mRNA for IGF-I and IGF-II was analysed in rat uterine tissue after different endocrine manipulations and the possibility of an estrogenic regulation of IGF expression was investigated. Both IGF-I and IGF-II mRNA were present in uterine tissue. The level of IGF-I mRNA, but not IGF-II mRNA, was reduced following ovariectomy. Administration of estradiol (2.5 micrograms/day for 4 days) to ovariectomized rats increased IGF-I mRNA 8-fold to levels seen in intact animals. In adult animals hepatic IGF-I mRNA did not appear to be increased by estrogen treatment. Low levels of IGF-II mRNA were detected in the uterus, but showed no dependence on estrogen. The inductive effect of estrogen on uterine IGF-I mRNA could not be substituted for by growth hormone administration (0.5 mg/100 g, ip for 6 h). The present results suggest IGF-I as a potential candidate for a mediator of estrogen induced growth. Both estrogen and GH induce IGF-I mRNA and a tissue specificity for these hormones is indicated where GH regulates hepatic and estrogen uterine IGF-I mRNA. PMID- 2718699 TI - Studies on the occurrence of ophthalmopathy in Graves' disease. AB - Eye disease was associated with hyperthyroidism in 202 of 221 patients with active Graves' ophthalmopathy (91.4%) and was not accompanied by thyroid hyperfunction (euthyroid Graves' disease) in the remaining 19 (8.6%). All the latter patients had some mild thyroid abnormalities (thyroid autoantibodies, negative TRH test, negative T3 suppression test, goitre). Sex distribution analysis evidenced a higher prevalence in females with a female/male ratio of 2.1 which was, however, significantly lower (P less than 0.05) than that observed in control (Graves' disease patients without overt ophthalmopathy (female/male ratio = 3.4]. Patients with euthyroid Graves' disease showed a female/male ratio of 0.7. Age distribution revealed a peak prevalence in the 5th decade of life, identical to that of Graves' disease without ophthalmopathy. A close temporal relationship between the onset of hyperthyroidism and the onset of ophthalmopathy was found, since in about 85% of the patients the first ocular manifestations occurred within +/-18 months around the onset of hyperthyroidism. PMID- 2718700 TI - Cholecystokinin, gastrin and their precursors in pheochromocytomas. AB - Using sequence-specific radioimmunoassays before and after cleavage with trypsin and carboxypeptidase B, we have examined the occurrence and molecular nature of cholecystokinin (CCK) and gastrin peptides in bioactive (i.e. alpha carboxyamidated) as well as non-amidated precursor forms in extracts from 13 human pheochromocytomas. All but one tumour contained amidated CCK, but only in moderate amounts (less than or equal to 20 pmol/g tissue). In contrast to the complete sulphation in tissues which normally produce CCK (the brain and small intestine), the amidated adrenal CCK peptides were poorly sulphated (less than or equal to 17%). Four pheochromocytomas, including the one without amidated CCK, contained between 28 and 0.2 pmol amidated gastrin/g, mainly in the form of sulphated gastrin-17. In addition, all tumours contained biosynthetic precursors of both CCK and gastrin. In most extracts there was more precursor than bioactive peptide(s), the progastrin concentration ranging up to 338 pmol/g. The results show that pheochromocytomas synthesize CCK and gastrin. The posttranslational processing differs, however, markedly from that of the principal CCK and gastrin producing tissues, with respect to both proteolytic cleavages and amino acid derivatization. This emphasizes that accurate quantitation in tumours requires assays which measure the translation products irrespective of their degree of processing. PMID- 2718701 TI - Generalized deficiency of 3,5,3'-triiodo-L-thyronine (T3) in tissues from rats on a low iodine intake, despite normal circulating T3 levels. AB - Rats fed a low iodine diet have decreased total and nuclear T3 concentrations in the liver and brain, as compared with rats supplemented with iodine, possibly because of the very low plasma and tissue T4 pools in low-iodine diet rats, leading to decreased intracellular generation of T3 in those tissues. If so, T3 levels should not decrease in heart and skeletal muscle, as plasma T3 is normal in low-iodine diet rats and these two tissues derive their intracellular T3 directly from plasma T3. We have studied this point in male rats fed a low-iodine diet, a low-iodine diet + iodine, and the stock diet. As in previous studies, low iodine rats had very low plasma T4 and high plasma TSH levels, plasma T3 levels being normal. Liver T3 decreased, and so did the brain T3 levels despite a compensatory increase in type II 5' iodothyronine deiodinase activity. Contrary to expectations, T3 concentrations were lower in the heart and skeletal muscle of low-iodine diet rats. Attempts to clarify the possible mechanism(s) involved have been unsuccessful so far. The present results show that, despite normal plasma T3, a deficiency of T3 occurs in more tissues of rats on a low iodine intake than previously assumed. If the present results are pertinent to inhabitants from areas with severe iodine deficiency, it would appear that they might suffer from a generalized tissue T3 deficiency (and hypothyroidism?), even if overt clinical signs are not usually present. PMID- 2718702 TI - Inhibin production by porcine granulosa and luteal cells: development and biological validation of a RIA. AB - We describe the development and biological validation of a radioimmunoassay for immuno- and bioactive porcine inhibin. A synthetic 1-32 porcine inhibin peptide was used to raise an antiserum and Tyr-1-32 peptide as tracer. As standard we employed porcine follicular fluid calibrated with the 1-32 alpha-inhibin. Medium obtained from serum-free cultured porcine granulosa cells was chromatographed on Superose S-12 and Mono-Q. Resulting fractions were analysed for inhibin bio- and immunoreactivity. It is shown that granulosa cells produce at least two types of bioactive inhibins, one being also immunoactive in our RIA. We studied secretion of immunoreactive inhibin from porcine ovarian cells under various conditions: Inhibin secretion from mature and immature granulosa cells can be stimulated by FSH, whereas hCG enhances inhibin secretion only from mature granulosa cells. During extended time of culture, the capability of granulosa cells to secrete inhibin is reduced. In contrast, progesterone secretion from these cells increases; this is due to spontaneous functional luteinization. This assumption is supported by the low inhibin secretion of luteal cells in comparison to granulosa cells. Intracellular inhibin content in luteal cells is below detection limit of the RIA, whereas granulosa cells contain readily detectable amounts of this hormone. PMID- 2718703 TI - Growth hormone stimulates the growth of mouse neonatal condylar cartilage in vitro. AB - This study used an organ culture system of neonatal condylar cartilage to study the in vitro effects of recombinant human growth hormone on the growth of cartilage and its inherent cell populations: progenitor cells, chondroblasts and early hypertrophic chondrocytes. Growth hormone at a dose of 2.5 nmol/l enhanced the overall growth of cartilage explant and stimulated the differentiation of its cells. Hence, growth hormone-treated explants revealed a substantial increase in the number of chondroblasts and young hypertrophic chondrocytes. Along with its effects upon cartilage the hormone also stimulated new bone formation adjacent to mineralized hypertrophic chondrocytes. These results provide support to the notion that growth hormone stimulates cartilage growth which in turn is followed by endochondral ossification. In spite of its in vitro effect it is not as yet clear whether the effect of growth hormone is indeed a direct one or is mediated via the local production of IGF-I. PMID- 2718704 TI - Decrease of serum sex hormone-binding globulin as a marker of androgen sensitivity. Correlation with clinical response. AB - An evaluation of the usefulness of determining the decrease in serum sex hormone binding globulin after exogenous testosterone was studied in 55 prepubertal patients with ambiguous external genitalia or micropenis. The biochemical response (androgen sensitivity test) was compared with the clinical response as judged by signs of androgen stimulation of external genitalia. Patients were divided in two groups according to age. Group I, 11 patients younger than 3 months and Group II, 44 patients older than 3 months. Only in 54% of Group I was there a correlation between the androgen sensitivity test and the clinical response to androgens in either a positive (4 patients) or negative sense (2 patients). On the other hand, the androgen sensitivity test and the clinical response to androgens correlated in 91% of the patients of Group II in either a positive (35 patients) or negative sense (5 patients). Two of the 4 patients with lacking correlation had a negative androgen sensitivity test and micropenis secondary to pituitary deficiency. It is concluded that in prepubertal patients older than 3 months with abnormalities of sex differentiation, the androgen sensitivity test and the clinical response to androgens are useful for evaluating androgen sensitivity. The clinical response to androgens is useful in early life when a positive response is found. PMID- 2718705 TI - Decrease in plasma volume from intraabdominal trauma in rats. AB - Intraabdominal surgery tends to lower circulating blood volume by mechanisms unrelated to bleeding. This phenomenon was investigated in chloralose anesthetized rats. Plasma volume was determined with radiolabelled albumin. Animals were subjected to a standardized abdominal trauma, eliciting minimal bleeding and evaporation, and others served as controls. The trauma decreased plasma volume and increased hematocrit significantly, whereas the plasma concentration of labelled albumin followed a similar time course in traumatized animals and in controls. It is concluded that experimental abdominal trauma may decrease blood volume by a loss of fluid with virtually the same albumin concentration as that of plasma. PMID- 2718706 TI - Deliberate hypotension induced by labetalol with halothane, enflurane or isoflurane for middle-ear surgery. AB - The feasibility of using labetalol, an alpha- and beta-adrenergic blocking agent, as a hypotensive agent in combination with inhalation anaesthetics (halothane, enflurane or isoflurane) was studied in 23 adult patients undergoing middle-ear surgery. The mean arterial pressure was decreased from 86 +/- 5 (s.e. mean) mmHg to 52 +/- 1 mmHg (11.5 +/- 0.7 to 6.9 +/- 0.1 kPa) for 98 +/- 10 min in the halothane (H) group, from 79 +/- 5 to 53 +/- 1 mmHg (10.5 +/- 0.7 to 7.1 +/- 0.1 kPa) for 129 +/- 11 min in the enflurane (E) group, and from 80 +/- 4 to 49 +/- 1 mmHg (10.7 +/- 0.5 to 6.5 +/- 0.1 kPa) for 135 +/- 15 min in the isoflurane (I) group. The mean H concentration during hypotension in the inspiratory gas was 0.7 +/- 0.1 vol%, the mean E concentration 1.6 +/- 0.2 vol%, and the mean I concentration 1.0 +/- 0.1 vol%. In addition, the patients received fentanyl and d tubocurarine. The initial dose of labetalol for lowering blood pressure was similar, 0.52-0.59 mg/kg, in all the groups. During hypotension, the heart rate was stable without tachy- or bradycardia. The operating conditions regarding bleeding were estimated in a double-blind manner, and did not differ significantly between the groups. During hypotension, the serum creatinine concentration rose significantly in all groups from the values before hypotension and returned postoperatively to the initial level in the other groups, except the isoflurane group. After hypotension there was no rebound phenomenon in either blood pressure or heart rate. These results indicate that labetalol induces easily adjustable hypotension without compensatory tachycardia and rebound hypertension. PMID- 2718707 TI - EEG spectral power during halothane anaesthesia. A comparison of spectral bands in the monitoring of anaesthesia level. AB - The EEG of ten elective abdominal surgery patients was studied during halothane anaesthesia. The EEG was analysed by compressed spectral array. The total power and various power bands were analysed. Anaesthesia was induced by mask with halothane in air. EEG analysis was performed from the data collected before induction and during anaesthesia at steady states of 1 MAC, 1.5 MAC, and 2 MAC. The correlation between deepening anaesthesia and power values was strongest in the 10-14 Hz band power and in the 18-32 Hz band power. This study confirms the usefulness of high frequency power in estimating the effect of halothane in patients. PMID- 2718708 TI - Comparison of the effects of general and epidural anaesthesia for caesarean section on the neurobehavioural responses of newborn infants. AB - Thirty-one neonates delivered by elective caesarean section were evaluated at the ages of 3 h, 1 day, 2 days and 4-5 days using Scanlon's Early Neonatal Neurobehavioural Scale and tests for orientation. Thirteen of the mothers received general anaesthesia and 18 epidural anaesthesia. All the mothers were healthy and not in labour. All the neonates weighed 2500 g or more and had Apgar scores of 7 or more at 1, 5 and 15 min. The neonates delivered with epidural anaesthesia scored significantly lower on rooting at the age of 3 h than those delivered with general anaesthesia, but the latter scored significantly lower on habituation to sound and orientation to both animate and inanimate visual stimuli. General anaesthesia seemed to depress the infants' interactive processes (orientation items), and their ability to make an appropriate response to repetitive stimuli (habituation) more than did epidural anaesthesia, indicating greater global depression. This depression was short-lived, however, and there were no differences between the groups on any of the parameters after 24 h. PMID- 2718709 TI - The effect of lumbar epidural analgesia on the neurobehavioural responses of newborn infants. AB - The effects of maternal lumbar epidural analgesia (Th10-L5) on the neonatal neurobehavioural response were studied at the ages of 3 h, 1 day, 2 days and 4-5 days. The subjects were healthy, full-term neonates, born vaginally to 15 mothers with lumbar epidural block and 19 mothers without analgesia. Those delivered with epidural analgesia scored significantly better on alertness at the age of 3 h, 2 days and 4-5 days than the control group. No other statistically significant differences were found between the groups. The formation of the two groups according to the mothers' desire for epidural analgesia may have contributed to differences in the process of labour, but with this reservation it may be suggested that lumbar epidural analgesia may enhance the infant's recovery from the stress of labour and vaginal delivery. PMID- 2718710 TI - Erosion of the foramen transversarium of the axis. Anatomical observations. AB - Six hundred foramina transversaria (FT) of the axis vertebrae of 4 population groups were examined for the presence of erosion of the lateral articular mass. Of these, 127 (21%) and 72 (12%) presented with moderate and marked erosion, respectively. Evidence is presented incriminating the tortuosity of the vertebral artery as well as congenital factors in the etiology of the erosion of the FT. Attention is drawn to the possible correlation between angulation of the transverse process of the axis and erosion of the FT. PMID- 2718711 TI - Structural changes of the guinea pig prostatic epithelial cells after gossypol treatment. AB - The effect of gossypol acetic acid on the prostate gland of the guinea pig was assessed ultrastructurally. The three lobes of the gland showed differences in sensitivity and reacted differently to gossypol treatment. In the lateral prostate, there was a reduction in the profile of the granular endoplasmic reticulum and dense secretory granules with a concurrent appearance of smaller clear granules and an increase in cytoplasmic filamentous bundles. The latter feature was similar to that of the coagulating gland. In the dorsal prostate, the general reaction was similar to that in the lateral prostate except that there was no increase in filamentous content. In the coagulating gland, there was a reduction or total disappearance of apical secretory blebs and an increase in lysosomes, a feature not found in the lateral and dorsal lobes. Damages to mitochondria were observed in the dorsal prostate and coagulating gland but not in the lateral prostate. It is concluded that gossypol affects not only the testis, but also alters the structure and functions of the prostate gland. PMID- 2718712 TI - Histochemical and immunohistochemical studies on the articular disk of the temporomandibular joint in rats. AB - The effects of surgically induced malocclusion upon the articular disk of the temporomandibular joint in adult male rats were investigated histochemically and immunohistochemically using antibody against type II collagen. In the intermediate portion of the articular disk, the number of collagen fibers and chondrocytes was much less and the collagen fibers became more wavy, rough and irregular in surgically operated rats than in control rats. Clusters of chondrocytes were found in some experimental rats. The present experiments revealed that surgically induced malocclusion causes noticeable changes in collagen fibers and chondrocytes within the extracellular matrix of the articular disk of the temporomandibular joint. PMID- 2718713 TI - Comparative mucosal microvasculature of the mammalian stomach. AB - The comparative morphology of the gastric mucosal microvasculature was investigated using the corrosion casting technique. The vascular pattern consisted of a hexagonally arranged capillary plexus surrounding the gastric glands and terminating in venules running perpendicular to the mucosal axis. Vessels of the pyloric antrum demonstrated an acute angle between capillaries and venules, whereas vessels of the gastroduodenal junction changed from a honeycomb pattern to a leaf-like arrangement. PMID- 2718714 TI - Ultrastructural changes associated with weaning in the mandibular condyle of the rat. AB - To determine the postnatal structural changes due to increasing articular activity, we have compared the development of the posterior and posterosuperior superficial layers of the rat mandibular condylar cartilage by electron microscopy. In contrast to the uniform development posteriorly, the posterosuperior articular zone showed an extensive remodelling process with collagen breakdown and replacement between the ages of 21 and 28 days, i.e. during weaning. Enlarged spheroid fibroblasts contained numerous micropynocytotic vesicles, collagen debris enclosing vacuoles and a nuclear fibrous lamina enveloping the nucleus; abundant electron-dense amorphous material was present in the matrix as well as covering the surface. An increased number of metabolically active fibroblasts was supplied by the mesenchymal stem cells of the underlying chondrogenic zone. The adaptation process resulted in the replacement of small randomly oriented collagen fibers by large compact bundles running parallel to the glenoid fossa, providing protection to the condyle against excessive wear and tear during incisal biting and grinding. The direct local relationship between (ultra) structure and functional load can be utilized in experimental research on the role of biomechanical forces in mandibular condylar growth and development. PMID- 2718715 TI - Optic nerve sectioning does not affect the development of the retina. AB - The development of the retina of the albino rat was studied after sectioning of the optic nerves on the 2nd postnatal day. The 2nd day represents a stage at which the retina shows only the ganglion cell layer clearly delineated from an undifferentiated mass. Section of optic nerves at this stage did not affect the subsequent retinal development. Both control and experimental eyes developed at the same pace. Some minor degrees of 'retardation' e.g. the sizes of outer segments, appeared to deviate in the experimental retinae. PMID- 2718716 TI - Intra- and extracellular lysosomes in tendon tissue of the mouse after treatment with an anabolic steroid hormone. Ultrastructural and cytochemical study. AB - Ultrastructural observations of fibroblasts from 6-week-old mouse tendons were carried out at different times after treatment with an anabolic steroid. The characteristic response of the fibroblasts involves the appearance of great numbers of intracellular lysosomes and the emergence of matrix vesicles, some of which could be identified ultrastructurally by their positive reaction for acid phosphatase as extracellular lysosomes. It is suggested that this fine structural gradient after treatment with the anabolic steroid results from, and may be directly the cause of, an increased level of cyclic AMP. The experimental design and the discussion of the findings consider, on the one hand, the use of anabolic steroid hormones in clinical practice and, on the other hand, the appearance of a collagen dysplasia in competitive sports. PMID- 2718717 TI - Ontogeny of relationship of middle ear and temporomandibular (squamomandibular) joint in mammals. II. Morphology and ontogeny in insectivores. AB - The ontogeny of the mandibular joint and the middle ear region was studied in Erinaceus europaeus, Sorex araneus, Talpa europaea and Elephantulus rozeti. During development, a passage connection was found between the mandibular condyle and Meckel's cartilage that is produced by the primordium of the lateral pterygoid muscle. The articular disk is formed apart and it appears later in development. PMID- 2718718 TI - Drainage of the prelymphatics of the brain via the adventitia of the vertebral artery. AB - Carbon particles injected into the cortex of the cerebellum of the rat were found in the Virchow-Robin spaces of the adjacent capillaries, and in the adventitia of the cerebellar artery, basilar artery and vertebral artery--both inside and outside the skull. They were also found in some portions of the deeper cervical lymph nodes. However, while tracers injected into the cerebral hemispheres are drained via the tissue channels in the adventitia of the internal carotid arteries, tracers injected into the cerebellar hemispheres are drained via those of the vertebral arteries. PMID- 2718719 TI - Ultrastructure of secretory ameloblasts in the house musk shrew, Suncus murinus, Insectivora. AB - Tooth germs from neonatal house musk shrews, Suncus murinus, were used for the study. The tooth morphogenesis was compared electron microscopically to that of Primates. In the tooth germ at the bell stage, the ameloblast was 3 x 50 microns in size, columnar in shape and had several tubular-type Golgi apparatus which were at the distal end of the cell. Most mitochondria were noted at the proximal end of ameloblasts. Tomes' processes were 1 micron in width, protruded 10 microns from the ameloblast and had many dense bodies and two kinds of vesicles. They were morphologically different from human ameloblasts and enamel rods. PMID- 2718720 TI - Peripheral vascularization of the dermal laminae of the equine hoof. AB - The vascular architecture of the dermal laminae was studied by scanning electron microscopy of vascular corrosion casts. Ultrastructurally, the laminar vasculature consisted of arterioles, capillaries, venules and veins, arranged in a sheet-like network. Through the laminae, arterioles ran parallel to the solar surface and branched at two levels to form a continuous arteriolar arcade, parallel to the hoof wall. Capillaries originating from these arcades formed hairpin loops joining the marginal vein prior to forming an axially situated venous network. Additional capillaries were also given off by the arterioles, forming an abaxially arranged capillary plexus. PMID- 2718721 TI - Ultrastructural findings in the wound healing of the colonic mucosa of rabbits. AB - The wound healing of the rabbit colonic mucosa after experimental excision was observed with the electron microscope. Between 5 and 7 days, considerable numbers of undifferentiated mesenchymal cells (group I), differentiating muscle cells (group II) and histiocyte-like cells (group III) appear in the regions where the muscularis mucosae is re-establishing. Our electron micrographs indicate that group I cells are stem cells which differentiate to group II cells involved in muscle regeneration or to group III cells involved in phagocytosis. The mitotic proliferation of pre-existing smooth-muscle cells at the ulcer margin does not seem to be the major reason for the re-establishment of the muscular layer. Multinucleated cells occurring in this healing mucosa are considered to be formed by successive fusions between the group III cells and to play a role in enclosure of cell debris such as fragments of elastin. PMID- 2718722 TI - Configuration of the magnocellular nuclei in the basal forebrain of the human adult. AB - With the use of gapless series of thick sections (800 microns) stained for lipofuscin pigment as a stable intraneuronal characteristic, it was found in the human brain that the three magnocellular nuclei in the basal forebrain-the medial septal nucleus, the nucleus of the diagonal band (vertical and horizontal limb) and the basal nucleus of Meynert located within the substantia innominata-were tightly connected with each other. A band-like anteromedial subnucleus and a semilunar posterolateral subnucleus could be delineated in the basal nucleus and were found to be embedded in a zone of low cell density, the substantia innominata, which medially blends into the horizontal limb of the diagonal band nucleus. A three-dimensional reconstruction was made to demonstrate the complex shape of the magnocellular basal forebrain nuclei. PMID- 2718723 TI - Microscopic and ultrastructural study of the lymphatic system in the human parotid gland. AB - The localization and fine structure of the lymphatic system vessels are examined in the human parotid gland. A network of lymphatic capillaries extends in the intralobular connective septa around the striated ducts. These lymphatics converge in collectors frequently bordering the excretory ducts. On the contrary, no lymphatics are present next to the intercalated ducts and adhenomers. Ultrastructurally, the lymphatic capillaries are characterized by a very thin endothelial wall and by slightly complicated intercellular adhesions. Open junctions are also present. The presence of numerous lymphatic capillaries bordering the striated ducts and their blood microvasculature is discussed in relation to the functional activities of the striated ducts in the modification of the saliva. PMID- 2718724 TI - Regeneration of the growth plate. AB - The occurrence of growth plate regeneration has been doubted. However, in 5 different series of experiments reported between 1950 and 1986 regeneration of injured parts of growth plates in long bones of rabbits and pigs could be demonstrated. The 1st series implied partial X-ray injury of growth plates in rabbits aged 3-6 weeks. The 2nd series implied autotransplantation of the head of the fibula in rabbits aged 10-21 days. The 3rd, 4th and 5th series implied transplantation of autologous fat grafts into provoked defects of growth plates in rabbits and pigs. The findings show that regeneration of a growth plate occurs when a part of it is injured in such a manner that a bone bridge is not formed between the epiphysis and the metaphysis. Regeneration of a plate is much faster in relation to the growth in length of the bone in the rabbit than in the pig. The 1st and 2nd series suggest that regeneration takes place by interstitial proliferation of cells from the germinal layer of the uninjured parts of the plate. Signs of partial regeneration of growth plates have been seen in radiographs after operation for partial closure of growth plates in children. PMID- 2718725 TI - Talar articular facets (facies articulares talares) in human calcanei. AB - The variations of the talar articular facets in 176 calcanei were studied and classified. Three types were considered: type A = calcanei with two articular facets for the talar head, with four subtypes; type B = calcanei with one articular facet for the talar head, and two subtypes, and type C = unique articular facies in the superior surface of the calcaneus for the talus. We found 53% (94 cases) type B calcanei and 46% (82 cases) type A calcanei. No calcanei of type C were seen. PMID- 2718726 TI - Responsiveness of mouse parametrial fat to relaxin. AB - The effects of relaxin on the hypertrophy of the parametrial fat cells in ovariectomized virgin mice have been studied histologically and morphometrically. This hormone has been previously demonstrated by us to induce hypertrophy also in the adipose cells of the mouse mammary gland. This effect produced by relaxin on mammary adipocytes was greater than that due to estrogen alone and independent of pretreatment with estrogen. When insulin was given after estrogen in place of relaxin the effect was nearly the same as that following relaxin alone. On the contrary, in parametrial adipocytes under the same hormonal conditions, we found an increase in the mean diameter of 28% following estrogen alone, 57% following relaxin alone, 80% when relaxin was given after pretreatment with estrogen, and 60% when insulin was given after pretreatment with estrogen at the same dose as relaxin. These results clearly reveal that relaxin is a very active hormone in promoting lipid deposition in the parametrial adipose cells, and that such an effect attains a maximum following a pretreatment with estrogen. Moreover, these findings indicate that the parametrial fat cells can be included in the list of the targets of relaxin. PMID- 2718727 TI - Morphological evidence of the formation of intracellular collagen fibrils in the embryonic mouse molar odontoblasts induced by colchicine administration. AB - The effects of colchicine on collagen formation were examined ultrastructurally using secretory odontoblasts in mouse molar tooth germs isografted to the spleen for 1 week. Colchicine in concentrations of 0.025 or 0.05 mg/0.1 ml was injected intravenously 12-24 h prior to harvesting. Colchicine induced the disruption of the Golgi apparatus and caused the accumulation of various types of Golgi associated vacuoles containing collagenous fibrillar structures. Many vacuoles containing fine particles, nonstriated parallel filaments, banding patterns with a periodicity of approximately 63-nm intervals, and occasionally segment-long spacing-like assemblies were aggregated in the cytoplasm during the experimental period. These morphological changes in vacuole contents may reflect the initial steps for polymerization of the intracellular collagen fibrils. The majority of the aggregated vacuoles were degraded by fusion with lysosomes but banded filamentous material in some vacuoles appeared to polymerize into the collagen fibrils with native structures. These results suggested that in unsecreted vacuoles accumulated in the odontoblasts as a result of colchicine administration the polymerization of collagen fibrils with native structures can occur. PMID- 2718728 TI - Light- and electron-microscopic observations of the spinal ganglion cells of mice. AB - Under the light microscope, large and small types of spinal ganglion cells can be seen in the mouse. Among those of the small type bipolar cells are observed. By electron microscopy, the cells of the large type have a low electron density and those of the small type a high electron density. Bipolar cells continue to be observed among the latter. The cells of the spinal ganglia contain different cellular apparatus in enormous quantity. There are four kinds of lysosomes in the GERL, i.e. the coated vesicles, dense bodies, multivesicular bodies and autophagic vacuoles. PMID- 2718729 TI - Permeability of regenerating and atrophic choriocapillaris in the rabbit. AB - When rabbits receive intravenous injections of sodium iodate, large expanses of the retinal pigment epithelium are destroyed. The adjacent capillary bed, the choriocapillaris, atrophies in response to the loss of the pigment epithelium and then regenerates. This provides a model of the permeability of regenerating and atrophic choriocapillaris, which we studied using intravenously injected horseradish peroxidase and catalase. Regenerating capillaries were permeable to peroxidase but not catalase. The permeability to peroxidase was probably due to endothelial fenestrations, since catalase (which is larger than peroxidase and does not penetrate endothelial fenestrae) was retarded at interendothelial junctional complexes, indicating that they were intact. Atrophic choriocapillaries were impermeable to catalase but displayed a heterogeneous permeability to peroxidase. This was correlated with the presence or absence of fenestrae; capillary profiles lacking fenestrae retained peroxidase in their lumina, whereas if fenestrae were present the tracer penetrated into the pericapillary space. The observations indicate that: (1) the permeability of the regenerating choriocapillaris is qualitatively similar to the mature choriocapillaris, and (2) the atrophic choriocapillaris undergoes changes in permeability that are primarily correlated with the loss of endothelial fenestrae. The observations provide a functional correlate - change in permeability - for structural changes in choriocapillaris endothelium (thickening, loss of fenestrae) in response to destruction of the retinal pigment epithelium, which has been postulated to exert a trophic effect on these capillaries. PMID- 2718730 TI - Proximal communication between the glossopharyngeal and facial nerves. AB - The facial nerve branch termed Ramus communicans cum nervo glossopharyngeo in the current Nomina anatomica was investigated in 245 Japanese, especially as regards the frequency and pertinence as an approved definition. The communication was found in only 18.8%. It runs, if present, either medially, laterally or through the digastric posterior muscle. Teasing examination reveals that it always originates from the ninth nerve instead of the seventh and that it is destined to the back of the pinna. Its terminal bundle leaves the seventh nerve somewhat distally than the posterior auricular nerve in many examples, but the communication is likely to represent the auricular branch of the ninth nerve. As an offshoot of the seventh nerve, it is ill-defined, and should be affiliated to the ninth nerve in the Nomina anatomica. If it pierces the digastric muscle, half examples certainly give additional innervation to this muscle, but the fundamental disposition of the communication itself is not affected. PMID- 2718731 TI - Immunocytochemical studies of astrocytes following injury to the cerebral cortex of the rat. AB - The morphological change of cerebral cortex astrocytes from protoplasmic to glial fibrillary acidic protein (GFAP)-containing cells is induced by injury. Protoplasmic astrocytes that contain no detectable amount of GFAP become filled with GFAP and their processes extend to form the glial scar around the wound. It is hypothesized that this transformation is induced by cAMP and neurotransmitters released from damaged neuronal cells. A similar mechanism may be present in other brain regions following injury or disease. PMID- 2718732 TI - Fine structure of the porcine myometrium during the oestrous cycle. AB - The ultrastructure of the porcine myometrium was studied at well-defined stages of the oestrous cycle by transmission electron microscopy. The fine structure of the myometrium in the pig was found to be similar to that observed in other genital organs and species and did not show obvious variations through the oestrous cycle. The cell-to-cell contacts between smooth-muscle cells most consistently found were intermediate junctions and simple appositions, whereas interdigitations of muscle cell processes were more sparse. Gap junctions were few and small. Nerve terminals possessing presynaptic vesicles typical of the adrenergic and cholinergic type were found, though sparsely, both within and close to muscle bundles. PMID- 2718733 TI - Effects of hypergravity environment on the parathyroid gland of the isoproterenol treated hamster. AB - The ultrastructure of the parathyroid glands of hamsters subjected to 5 g environment after an intraperitoneal injection of isoproterenol was studied. In the isoproterenol-treated hamsters exposed to hypergravity environment, the Golgi complexes, cisternae of the granular endoplasmic reticulum and lipid droplets were significantly increased and secretory granules were significantly decreased compared with those of the control group. In addition, many chief cells contained numerous prosecretory granules in the Golgi areas and several secretory granules were situated close to the plasma membrane of the chief cells. These results suggest that the synthesis and release of parathyroid hormone may be markedly stimulated in the parathyroid glands of the isoproterenol-treated hamsters exposed to hypergravity environment. PMID- 2718734 TI - Survival and weight increase in the fetal rat after selective hypophysectomy in utero. AB - Rat fetuses were subjected to selective hypophysectomy in utero on day 16, 17 or 18 of gestation and inspected on day 22 (the day before birth). The survival rate of fetuses operated on day 17 and 18 was about 20 and 50%, respectively. Losses were mostly caused by the surgery preceding the removal of the pituitary, and no significant survival-promoting activity of the gland could be demonstrated. The surgical injuries, as such, also reduced the weight increase substantially. Still, the loss of the pituitary was followed by a further reduction in weight gain, which on day 22 was about 10% lower than that of the sham-operated fetuses. PMID- 2718735 TI - Neuropeptides and neural cell adhesion molecule (NCAM) in CSF from patients with ALS. AB - In 10 patients with amyotrophic lateral sclerosis (ALS), the CSF content of the neuropeptides vasoactive intestinal polypeptide (VIP) and cholecystokinin (CCK) as well as neural cell adhesion molecule (NCAM) was investigated. Compared with normal controls, no deviations were found in CCK or NCAM, while the values of VIP were significantly lower in ALS patients. This finding may reflect a loss of motor neurons. PMID- 2718736 TI - Autonomic neuropathy in familial amyloidotic polyneuropathy. A clinical study based on heart rate variability. AB - Familial amyloidotic polyneuropathy (FAP) is characterized by both sensimotor and autonomic dysfunction. Autonomic disturbance involving the gastrointestinal tract, the urinary bladder, the cardiac conduction system, and the peripheral circulation has been described. In this study simple, non-invasive tests of autonomic function based on heart rate variability were applied to 12 patients with FAP and 12 healthy volunteers. The heart rate variation during normal breathing, deep breathing and during tilt from recumbent to standing position was measured. All tests showed significantly less heart rate variation in patients than in controls and the heart rate variation decreased with increasing severity of neurological disability, but the small number of patients in our study does not allow any further comparison between subgroups. Our study thus indicates impaired cardiovascular autonomic function in patients with FAP and we believe that these findings might also be of importance in other forms of systemic amyloidosis. PMID- 2718737 TI - Screening for neurotrophic disturbances in amyotrophic lateral sclerosis. AB - Neurotrophic activities in human serum and post-mortem muscle and spinal cord of possible relevance to pathophysiological mechanisms in amyotrophic lateral sclerosis (ALS) were studied. Tests included in vitro assays for nerve fibre outgrowth from sympathetic ganglia and for survival promotion of dissociated ciliary neurons, both types of neurons, of chicken embryo origin. Extracts of postmortem biceps muscle promoted survival of ciliary neurons in a dose-dependent manner. Half-maximum effect was found at a protein concentration of about 450 micrograms/ml for both ALS and control muscle. Ventral horn extracts were about 5 times as efficient as muscle in promoting neuron survival, again with no differences seen between control and ALS samples. Sera from patients suffering from ALS as well as normal sera did not enhance survival of ciliary neurons to any considerable extent, nor did they induce fibre outgrowth from sympathetic ganglia. Both groups of sera, if present above 5% in the medium, suppressed fibre outgrowth induced by added nerve growth factor (NGF). Sera from some of the ALS patients impaired survival in dissociated ciliary neurons supported by a trophic activity in choroid extract. The results do not indicate major neurotrophic deficits as the cause of ALS disease but suggest that a neurotoxic mechanism may be involved. PMID- 2718738 TI - Giant cell glioblastoma: a work-up of 2 cases with long survival. AB - Two patients, in whom visual disturbance (Case 1) and sudden hemiparalysis due to a hemorrhagic lesion (Case 2) had led to craniotomy and histological diagnosis of giant cell glioblastoma, each had an unexpectedly long survival period of 7 and 9 years, respectively. Radiologically, the tumours were well demarcated, but without any distinguishing features, by comparison with glioblastomas in general. The tumours, to a great extent, consisted of cells with large, bizarre multiple nuclei. The highly pleomorphic cells displayed strong cytoplasmic GFAP immunopositivity, which suggested an astroglial origin. Thus, these tumours were considered a variant of glioblastoma ("giant cell glioblastoma") with a more favourable prognosis than experienced by most patients with glioblastoma. PMID- 2718739 TI - Long-term prognosis and quality of life after reversible cerebral ischemic attacks. AB - The long-term prognosis and quality of life of 201 patients admitted to hospital with reversible ischemic attacks (RIA) were estimated in a prospective study. The median follow-up time was 58 months. Further RIAs were reported by 91 patients (45%) and 48 (24%) suffered a stroke. The risk of stroke was markedly higher in the first 6 months after RIA, after which the annual stroke rate was rather constant with an average of 4.8%, about 8 times higher than expected. The average annual mortality rate for the RIA patients was 5.9%, which is significantly higher than expected. Cardiovascular deaths accounted for more than half of all deaths, stroke for one fourth. Life-table analysis of subgroups disclosed a much more favorable prognosis for women under 60 years. High systolic blood pressure, diabetes, and previous myocardial infarction were identified as risk factors. The occurrence of RIA had significantly influenced the quality of life and occupational status for the majority of the patients, even for those who did not suffer a subsequent stroke. Decreased working capacity, general asthenia and fatigue and impaired memory were the most common complaints. We conclude that RIA may be a more serious vascular event than generally believed. Apart from carrying a substantial risk of stroke and death, even a single RIA can cause permanent psychological dysfunction influencing the quality of life. PMID- 2718740 TI - A large Japanese family with Machado-Joseph disease: clinical and genetic studies. AB - A large Japanese family with probable Machado-Joseph disease (MJD) is described. Detailed neurological examination in 12 patients from 3 generations revealed variable combinations of cerebellar ataxia, ocular paresis, difficulty in eye-lid opening, bulging eyes, facial "myokymia", facial dystonia, pyramidal signs, extrapyramidal signs, and peripheral neuropathy. Mode of inheritance was in all likelihood autosomal dominant. Blood components were typed for 19 conventional chromosome markers. Although association of the affected members with the PGM1 system was high, linkage analysis failed to reveal any markers studied with a lod score higher than 3. The unique constellation of symptoms appeared sufficient to rule out other types of spinocerebellar degeneration. When there is a typical case in a given family, MJD appears to be a clinically recognizable entity. PMID- 2718741 TI - Disability profiles and objective quantitative assessment in Parkinson's disease. AB - A new technique for quick objective and quantitative determination of important aspects of the motor handicap in movement disorders is presented. A compound, but natural, test movement was used to find out if the degree of dysfunction in postural, locomotor and manual motor functions differed among the patients and if medication influenced these functions differently. After 12 h without medication, 16 patients with Parkinson's disease showed a movement time between 1.5 and 13.6 times that of an age-matched normal subject and a greater performance variability on repeated examination. In some patients the increase of test movement time was caused mainly by the locomotion component while in others the time for the postural or manual part of the movement was more markedly augmented. Thus, a specific motor disability profile was found for each patient and expressed in quantitative terms. The effects of l-dopa treatment were quantified in each patient. PMID- 2718742 TI - Preventive effect of vinpocetine on calcifications: atherosclerosis in experimental rabbits. AB - The action of vinpocetine (14-ethoxycarbonyl-(3 alpha, 16 alpha-ethyl)-14, 15 eburnamine) on calcifications in liver, kidney, and CNS tissues from cholesterol induced atherosclerosis in 16 experimental rabbits was studied. Three of 4 groups (4 rabbits each group) feeding on a cholesterol-rich diet developed atherosclerosis after 3 months. Two of the 4 groups were also fed vinpocetine supplements and analysis by neutron activation method showed a decrease in calcium content in CNS tissues and in liver and kidney. Results suggest that vinpocetine acts to decalcify cholesterol-induced atherosclerotic lesions in these tissues. PMID- 2718743 TI - Third joint meeting on neurochemical approaches to the understanding of cerebral disorders. June 9-12, 1988, Helsingor/Copenhagen. Abstracts. PMID- 2718744 TI - Ultrastructural and ultracytochemical studies on the blood-brain barrier in chronic relapsing experimental allergic encephalomyelitis. AB - We induced chronic relapsing experimental allergic encephalomyelitis (EAE), and studied the ultrastructural and ultracytochemical changes of the blood-brain barrier (BBB) in the demyelinating lesions of various stages of EAE. In the chronic, inactive stage with gliosis and perivascular fibrosis, the basal lamina (BL) of the perivascular processes of astrocytes was formed only partially, and neural parenchyma was not fully separated from the perivascular mesenchymal tissues by the BL of astrocytic processes. Vascular permeability of the BBB was studied using exogenous horseradish peroxidase (HRP) as the tracer: HRP extravasation was marked during the stages of both active myelin breakdown and removal of debris, and was recognized even at the inactive stage, although the degree was reduced to a very low level. The functions of the endothelia, assessed by ouabain-sensitive, K+-dependent p-nitrophenylphosphatase activity, were impaired as EAE progressed. The decrease in HRP leakage at the inactive stage suggests the endothelial impairment of active transport of metabolites including HRP. Along with the development of inflammatory demyelination in EAE, the BBB in affected areas became more and more altered, and gradual morphological and functional impairment of the BBB developed. PMID- 2718745 TI - High voltage electron microscopic studies of endothelial cell tubular structures in the mouse blood-brain barrier following brain trauma. AB - High-voltage electron microscopy was applied to the study of endothelial cell (EC) transport of macromolecules in a murine model of blood-brain barrier injury to study the role of the EC canalicular system following brain insult. Semithick sections from mouse brains subjected to acute (2-3 h) mechanical trauma demonstrated permeation of intravenously injected horseradish peroxidase via tubular structures either (a) in the absence of lysosome-associated structures in close proximity, or (b) in association with lysosomes, dense bodies or multivesicular bodies. Our data suggest a dual-purposed system of tubules, one portion that supplies the metabolic requirements of the cell and another portion, suggested to be more limited, that opens up as a result of brain injury. PMID- 2718746 TI - Cerebral aging: a quantitative study of gliosis in old nude mice. AB - Morphometric glial fibrillary acidic protein (GFAP) studies of the brains of 11 old (18-29 months) female, outbred athymic mice demonstrated astrocytic gliosis (increase in GFAP-positive astrocytes; GFAP-PA) in all mice with a consistent distribution pattern. Specific areas such as the central white matter, hippocampus, diencephalon, gray matter at the floor of the 4th ventricle, and posterior colliculi showed the change most conspicuously, revealing GFAP-PA both interstitially and perivascularly. There was no apparent demyelination in the affected white matter. In addition, there was an increase in GFAP-PA in the external limiting membrane surrounding the diencephalon and base of brain stem, but only to a minor degree over the cerebral hemispheres. The cerebral and cerebellar cortices and hypothalamus showed no significant increase. In contrast, all of the 2-month-old control animals showed only minor amounts of GFAP-PA, seen in the external limiting membrane and a trace in the cerebral white matter. The present data suggest that astroglial sclerotic change in various regions of the brain is an important morphological expression of cerebral aging. In view of the lack of other demonstrable histological changes (i.e., silver and amyloid stains were negative) or significant atrophy, the cause of the observed gliosis in BALB/c mice might represent a genuine aging change. As an incidental finding, aggregates of PAS-positive granules were noted in the Ammon's horn of most old animals, while none were seen in the young controls. PMID- 2718747 TI - Peripheral nerve regeneration through optic nerve grafts. AB - Grafts of optic nerve were placed end-to-end with the proximal stumps of severed common peroneal nerves in inbred mice. It was found that fraying the proximal end of adult optic nerve grafts to disrupt the glia limitans increased their chances of being penetrated by regenerating peripheral nerve fibres. Suturing grafts to the proximal stump also enhanced their penetration by axons. The maximum distance to which the axons grew through the CNS tissue remained about 1.5 mm from 2-12 weeks after grafting. Schwann cells were seldom identified in the grafts. Varicose and degenerating nerve fibres were often seen within the grafts. Some varicose profiles were shown to be the terminal parts of axons within the grafts. Axons containing clusters of organelles resembling synaptic vesicles became more abundant in the longer-term grafts. Immunohistochemical studies performed on sutured grafts using a polyclonal antiserum to neurofilaments confirmed the impressions given by the electron microscopical observations. Grafts of neonatal optic nerve lacked myelin debris but were not usually penetrated by regenerating peripheral axons within a 6-week period. Sixty minutes after the intravenous injection of horseradish peroxidase, reaction product could be detected in the extracellular spaces around blood vessels in all types of living optic nerve graft. This indicates that blood-borne macromolecules could penetrate the grafts. However, the profiles of axons which were found within living optic nerve grafts had no obvious relationship to blood vessels and were usually surrounded by astrocytic processes. These results suggest that living astrocytes, rather than the absence of serum-derived trophic factors or the presence of CNS myelin, constitute the major barrier to the extension of axons and the migration of Schwann cells into CNS tissue. PMID- 2718748 TI - Evidence of oligodendrocyte infection and degeneration in canine distemper encephalomyelitis. AB - Canine distemper encephalomyelitis is an important neurological disease of the dog and is also of comparative medical interest. With some viral strains, demyelinating encephalomyelitis is seen; whether or not oligodendrocyte infection occurs has remained controversial. By examining very early white matter lesions unequivocal oligodendrocyte infection has been identified. Accordingly the direct effect of virus on oligodendrocyte viability must be weighed in considering the pathogenesis of this canine CNS infection. PMID- 2718749 TI - Striatal degeneration in glutaric acidaemia type II. AB - A girl of first cousin parents presented in the 1st year of life with a progressive neurological disease with muscle weakness and hypotonia, accompanied later by dystonia. Investigations, including gas chromatography of urine, showed no abnormality. Autopsy showed marked neuronal loss and gliosis in the putamen and globus pallidus. The activity of glutaryl-CoA dehydrogenase in cultured fibroblasts was normal, but the activity of electron transfer flavoprotein was markedly diminished. Retrospective study of urine by capillary gas chromatography/mass spectrometry showed small amounts of glutaric and other organic acids. This is the first report of striatal degeneration in association with glutaric acidaemia type II. The neuropathological changes were milder than those in glutaric acidaemia type I. PMID- 2718750 TI - Some characteristics of patients given dental treatment under general anesthesia. AB - The attitude to treatment of dental diseases under general anesthesia has been rather restricted in the dental profession in Scandinavia. Yet, some patients with certain medical conditions and patients haunted by anxiety may not be able to have conventional dental treatment. During the period 1975-1983, 1067 patients were treated in a group practice in Oslo. These patients are described with regard to gender, age, reasons for treatment, place of residence, source of referral, and type of treatment given. Some of the data are related to the year of treatment. The profile of patients changed during the observation period. At the beginning most of the patients came from Oslo and were less than 6 years old, whereas at the end most of the patients were more than 15 years old, lived outside Oslo, and had more conservative than radical treatment. It is concluded that there will probably always be a small group for whom dental treatment under general anesthesia will be necessary. PMID- 2718751 TI - Effects of TiF4 solutions on root surfaces in vitro after different application periods. AB - Topical application of aqueous solutions of TiF4 to root surfaces has been shown to result in a rapid uptake of fluoride. The purpose of this study was to assess whether the application period and/or the ionic strength of the TiF4 solution can be reduced without a corresponding reduction in the fluoride uptake. Root halves from human teeth were exposed to (a) 1% TiF4 for 10 sec and 1, 2, and 4 min, and (b) 3.4% TiF4 for the same application periods. Root surface areas protected by nail polish served as controls. Transverse ground sections through the treated root surface areas were then prepared and analyzed for F by electron microprobe analysis. Most treated specimens showed F concentrations in the 0.60-1.94% range, whereas control surfaces contained less than 0.30%. Similar F concentrations were found in the surfaces treated with the two solutions. Reducing the application period resulted in a shallower penetration of F into the hard tissue but only a slight reduction of the F concentration in the surface layer. High concentrations of Ti were found on the surface of all treated specimens. This shows that both the application period and the ionic strength of TiF4 solutions can be considerably reduced and still enable a high uptake of fluoride. The results indicate that TiF4 may be an efficacious agent for F application to root surfaces under clinical conditions. PMID- 2718752 TI - Oxygen-inhibited surface layers on Microfill Pontic. AB - Radical polymerization of composite resins is inhibited by oxygen. For Microfill Pontic, a self- and photo-curing resin cement, irradiation is proposed as a means to reduce the thickness of the oxygen-inhibited surface layer. The thickness of the layer was measured by a dial gauge technique on irradiated and non-irradiated specimens, to determine a possible effect of irradiation. The results indicate that the depth of inhibition is reduced by irradiation and that an irradiation time of 20 sec is sufficient to give the maximum reduction. PMID- 2718753 TI - Differences in functional variables, fillings, and tooth wear in two groups of 19 year-old individuals. AB - Fifty-one individuals (28 girls and 23 boys) who had received orthodontic treatment were compared with 47 subjects (19 girls and 28 boys) without such treatment as to maximal mandibular mobility, chewing muscle tenderness, morphologic occlusion, occlusal/incisal state, and degree of tooth wear. All were 19 years old. There were no statistically significant differences between the groups except for the number of teeth present and maximal mouth opening, which were both smallest in those who had received treatment. The first finding is evident, extraction of premolars being an accepted mode of orthodontic treatment. The reduced mouth opening capacity was related to an increased number of individuals with four or more palpably tender muscle sites in that group of individuals. PMID- 2718754 TI - Dentin and osteodentin matrix formation in apicoectomized replanted incisors in cats. AB - The reestablishment and rate of osteodentin and dentin matrix formation in 27 apicoectomized replanted and 20 control incisors in cats were studied after Procion H8-BS vital staining. In control teeth the pattern of matrix formation differed in the various pulpal zones, with a higher rate of matrix formed toward apical areas, most dominantly in maxillary incisors. Osteodentin formation could be traced after a lag period of more than 10 days after replantation. Thirty and 60 days postoperatively osteodentin matrix was found in the total pulpal length in 83% and 73% of the teeth, respectively. A common finding was a tubular osteodentin matrix in the pulpal apical third in the replanted teeth. Tubular osteodentin matrix was, however, present most incisally in some teeth 60 days postoperatively. Internal resorption corresponding to outer cervical lesions dominated the pulpal reactions in the maxillary replanted teeth after 60 days. It is concluded that under the present experimental conditions the pulp tissue possesses a high healing potential and that the osteodentin formation reflects the pulpal healing pattern after replantation traumas. The results also indicate that successful pulpal healing depends on unexposed dentinal tubules. PMID- 2718755 TI - The quality of routine class II cavity preparations for amalgam. AB - In spite of many improvements in operative dentistry, the incidence of replacements of amalgam restorations remains high. It is possible that specific cavity features are important for the longevity of the restorations. Six hundred and ten epoxy plastic models, made from impressions of permanent teeth in which class II cavities had been prepared by eight Scandinavian dentists, were examined. The examination showed prevalent imperfect external and internal cavity features. These may reflect the operators' opinion of adequate operative dentistry, neglect to control design features, or lack of training in examining a cavity critically. PMID- 2718756 TI - Electron microscopic studies of human mixed saliva. AB - With foam components removed, mixed saliva from three donors were solidified in liquid nitrogen and sectioned, mounted, and fixed. Examination by transmission (TEM) and scanning (SEM) electron microscopy and energy-dispersive X-ray (EDAX) analysis were performed for paraformaldehyde-fixed sections, some of which were OsO4-postfixed. The TEM and certain SEM examinations showed the presence of fine and dense salivary network structures, seemingly originating from the major fibrous components. In OsO4-treated sections, TEM pictures showed reticulated arrangements with open cellular diameters down to 0.2 microns. The EDAX analyses particularly showed the presence of Ca, Fe, K, P, and S, with increased Ca readings in major components. Untreated sections showed that strands, with diameters of more than 1-2 microns, had more electron-dense central portions than peripheries and sometimes had interior, very electron-dense, granules. The observed features indicate that saliva has internal structures consistent with its colloid chemical characteristics. PMID- 2718757 TI - Natural head position recording on frontal skull radiographs. AB - This paper sets out to evaluate the variability and reproducibility of frontal head position in healthy young adults. Two posteroanterior skull radiographs of 22 dental students and 2 frontal photographs of these and 24 other students, taken at a 1-week interval, were analyzed with regard to head position and cervical spine inclination. Head position varied in the range of +/- 5 degrees with regard to the vertical. The cervical spine was more often inclined to the right than to the left. The reproducibility of the head position with regard to the craniovertical angle was 1.15 degrees and that of the craniocervical and cervicohorizontal angles 0.93 degrees and 1.45 degrees, respectively. Any deviation in the frontal head position tended to be spontaneously corrected on looking in a mirror. It is concluded that the frontal head position is slightly more accurately reproducible than the sagittal head position. The use of a mirror in front of the patient when recording the frontal natural head position is not to be recommended. PMID- 2718758 TI - Thin-section transmission electron microscopy of human saliva. AB - Thin sections (90-100 nm) of flash-frozen human saliva fractions and whole saliva were examined by transmission electron microscopy. Inside the major filamentous structural components numerous ultrastructural details were observed, especially for whole saliva and submandibular/sublingual fractions. An outer reticulated zone believed to contain the major salivary glycoproteins surrounded an inner core consisting of a continuous, more electron dense phase with multiple vacuoles and granules of different sizes, shapes, and electron densities. The observed structures suggest a complex microarchitectural model for whole saliva. PMID- 2718759 TI - Chewing sticks, toothpaste, and plaque removal. AB - The aim of the present study was to assess the efficacy of brushing with chewing sticks in removing plaque and to evaluate whether toothpaste has any additional effect on the removal of established dental plaque. Kenyan schoolchildren had their plaque deposits disclosed by means of disclosing tablets and subsequently recorded on four buccal sites of all permanent teeth. The children were then allocated to two groups in a crossover design; in one group the children brushed with chewing sticks and toothpaste; the other group brushed with chewing sticks only. Substantial amounts of plaque were recorded at base line in most children. Brushing with a chewing stick for 5 min resulted in a net reduction of the proportion of plaque deposit sites per child. Toothpaste resulted in no additional effect. PMID- 2718760 TI - Blood mercury content after chewing. PMID- 2718761 TI - In vivo uptake and retention of fluoride after a brief application of TiF4 to dentin. AB - The purpose of this study was to examine the long-term retention of F and Ti in dentin after a brief application of 1% TiF4. Six facets of exposed dentin in each of four beagle dogs were treated for 10 sec or 1 min with a 1% solution of TiF4. Four control facets in a fifth dog were left untreated and extracted after 12 weeks. The TiF4-treated teeth were harvested after 4, 8, and 22 weeks and analyzed for F and Ti with an electron microprobe. The F concentrations in dentin surfaces of specimens retained in the mouth for 4, 8, and 22 weeks were after the 10-sec treatment 0.48% +/- 0.24, 0.51% +/- 0.20, and 0.56% +/- 0.20, respectively, and after the 1-min treatment 0.64% +/- 0.20, 0.66% +/- 0.18, and 0.71% +/- 0.19. High concentrations of Ti were found at the specimen surfaces in all groups. None of the control specimens showed F or Ti contents above the detection limits for the method used. The results showed that a very brief application of 1% TiF4 deposited high concentrations of F and Ti which were retained for at least 22 weeks. PMID- 2718762 TI - Quantification of incipient approximal caries during fructose and sucrose consumption. AB - The purpose of this study was to quantify the changes in the size of approximal caries lesions during regular sucrose or fructose consumption. The material consisted of the subjects in the 2-year Turku Sugar Study, with an observation period of 19 months. Planimetric evaluation showed a highly significant increase in the approximal lesions of both groups. There was no difference between the groups in the rate of the increase in the sizes of the lesions. Initially, small lesions increased at a higher rate than initially large lesions in both groups. It is concluded that a fructose diet enhances the progression of carious lesions as much as a sucrose diet. PMID- 2718763 TI - Osteotomy length and postoperative stability in vertical subcondylar ramus osteotomy. AB - The osteotomy sites in 80 patients treated for mandibular prognathism by intraoral (IVSO) or extraoral (EVSO) vertical subcondylar ramus osteotomy and their relationships to post-operative mandibular stability were studied. A model study demonstrated that metric orthopantomographic measurements of the ramus showed insignificant variability of magnification and distortion. The relative osteotomy length and the bony overlapping area of the osteotomized fragments were evaluated on 6-week postoperative orthopantomograms. High correlation was found between the clinical estimate of osteotomy length and metric registrations. Bony overlapping area of the IVSO and the EVSO group did not reveal differences. The mandibular positional changes during the fixation/postfixation periods were analyzed on 6-week and 6-month postoperative lateral cephalograms. Significant correlations could not be demonstrated between postoperative stability and osteotomy length or overlapping bony area. Thus the osteotomy length appears to be factor of minor importance for postoperative stability. PMID- 2718764 TI - The dimensions of everyday class-II cavity preparations for amalgam. AB - Six hundred and ten epoxy plastic models, made from impressions of permanent teeth in which class-II cavity preparations for amalgam restorations had been prepared by eight Scandinavian dentists, were examined. The outlines of the cavity preparations were relatively large, with mean buccolingual extensions occlusally of 50% of the intercuspal distance and proximally of 40% of the length of the circumference of the proximal surface. There was a gradual increase in the size of the cavities towards the distal part of the dental arch, measured both in millimeters and in relation to the anatomic structures. The amount of hard tissue being removed varied among the operators and was possibly influenced by the dentist's ability to handle the cutting instruments. The large cavity preparations may be the result of using procedures for cavity preparation which are not adjusted to the tremendous cutting potential of modern dental instruments to produce stereotyped 'ideally designed' cavities. PMID- 2718765 TI - Endocardium of the left ventricle in volume-loaded canine heart. A histological and ultrastructural study. AB - To investigate the effects of volume loading of the heart, the endocardium was studied histologically and ultrastructurally. Thirteen adult female beagle dogs were used. An arterio-venous shunt was constructed between the right common carotid artery and the right external jugular vein in nine animals to induce a volume load. Four animals were used as controls. All were kept for 6-12 months. Heart weight, relative heart weight (heart weight/body weight), cardiac output index, stroke volume index and volumes of both ventricles in the experimental animals were significantly larger than in the controls. Shunted blood volume was significantly correlated with heart weight. The endocardium of the left ventricle in the experimental animals showed elastofibrosis and was significantly thicker than in the controls. In 5 hearts, it was more than 20 microns thick and its endothelial cells showed many long microvilli with a very thick basement membrane (1.5-2.0 microns). The thickness of the endocardium was significantly correlated with the heart weight, relative heart weight and cardiac output index, within 1%, 5% and 5% risk, respectively. These endocardial changes were thought to be induced by hemodynamic changes in the left ventricle of the volume-loaded heart, probably being correlated with changes in cardiac function and morphology. PMID- 2718766 TI - A morphological and immunohistochemical study of lymphoid germinal centers in synovial and lymph node tissues from rheumatoid arthritis patients with special reference to complement components and their receptors. AB - Rheumatoid arthritis (RA) is one of the immune complex (IC) diseases in which lymphoid germinal centers (GCs) are found in the synovial tissue. Simultaneously, patients with RA often show swelling of lymph nodes. The morphology and function of the lymph-node GCs in patients with RA is not clear. The aim of this study was to evaluate the differences in morphology and immunoreactions to complement (C) components, their receptors, and IgM-rheumatoid factor (RF) between synovial GCs and lymph-node GCs in RA. Furthermore, the relationship between these immunoreactive substances and follicular dendritic cells (FDCs) in GCs was investigated. The tissues examined were 41 RA synovial specimens, seven RA lymph nodes with massive lymphadenopathy, and 10 non-RA lymph nodes. The number of synovial GCs was relatively decreased in comparison with lymph-node GCs in RA, and the diameter of each synovial GC was smaller than that of each lymph-node GC. The synovial GCs were edematous and less cellular, and moreover, those from RF seronegative cases were smaller than those from RF-seropositive cases. On the other hand, the lymph-node GCs in RA were larger, more cellular and hyperplastic, but contained more tingible-body macrophages (TBMs) and neutrophils. In the GCs of both synovial tissues and lymph nodes in RA, early C components (C1q, C4, C3c, C3d), IgM-RF, and C3b receptor (C3bR) and C3d receptor (C3dR) were expressed as a lacy network by light microscopy, and were demonstrated on the surfaces of FDCs and lymphocytes, and in the intercellular spaces by electron microscopy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718767 TI - Spinal pencil-shaped softening. Report of an autopsy case studied using a three dimensional model. AB - The pathologic features of a case of spinal pencil-shaped softening (PS) were studied by detailed step-sectioning and reconstruction using a three-dimensional (3D) model. The spinal cord was obtained at autopsy from a patient who had developed paraplegia due to extradural involvement of lung cancer. Above and below the area of transverse necrosis were PSs containing necrotic debris. They compressed the surrounding tissue and extended longitudinally over several segments. The PS was continuous with the area of transverse necrosis. These findings support the hypothesis that PS is formed by penetration of necrotic debris. The 3D model revealed that the PS was cylindrical to spindle-shaped. It showed a remarkable change in width along its course, with an unusual expanding shape. The PS was mainly located in the ventral part of the posterior column but was also observed in other locations in the segment near the transverse necrosis. Detailed step-sectioning showed that the PS changed in width mainly in response to intrapial pressure, and that it occurred where the parenchymal tissue was fragile. The expansion produced by penetration of necrotic debris may thus play an important role in the morphogenesis of this unusual lesion. Furthermore, the condition of the surrounding tissue may also be an important factor influencing the width and location of PS. PMID- 2718768 TI - Combined choriocarcinoma and adenocarcinoma of the lung. AB - Combined choriocarcinoma and adenocarcinoma in the lung of a 71-year-old Japanese male is reported. In the upper lobe of the right lung (S1 + 2), a choriocarcinoma coexisted with an adenocarcinoma, but distinct metastatic lesions were noticed separately in the lungs, kidney, bone marrow and lymph nodes. Although immunohistochemical examination revealed intensely positive reactivity with anti human chorionic gonadotropin (HCG) in trophoblastic cells, weak immunoreactivities were also observed in a few cells with anti-human placental lactogen (HPL), anti-pregnancy-specific beta glycoprotein (SPI), anti-epithelial membrane antigen (EMA), anti-carcinoembryonic antigen (CEA), anti-cytokeratin (keratin) and KM-93 (lung adenocarcinoma-associated antibody). In the adenocarcinoma, the tumor cells were positively stained for CEA, EMA, keratin and KM-93, but there were no positive reactivities for HCG, HPL and SPI. These findings suggest that primary choriocarcinoma of the lung may arise through dedifferentiation of adenocarcinoma. PMID- 2718769 TI - Determination of the isoelectric point value of 3-mercaptopyruvate sulfurtransferase and its shift by treatment with oxidized glutathione. AB - The isoelectric point (pI) value of 3-mercaptopyruvate sulfurtransferase (MST) from human erythrocytes was determined to be 6.3 at 10 degrees C by isoelectric focusing in horizontal slab polyacrylamide gel containing 2% carrier ampholyte (pH 3-10). The value was determined by comparison with the electrofocused bands of bovine pancreatic ribonuclease A-glutathione mixed disulfides (RNase-SG), which were composed of 8 species containing 1 (RNase-SG1) through 8 (RNase-SG8) moles of glutathione per mole of ribonuclease A with different pI values ranging from 5.3 (RNase-SG8) to 8.8 (RNase-SG1). The pI value of the same enzyme in a 110,000 X g supernatant of rat liver was 5.9, which was the same as that of rat erythrocyte enzyme. Treatments of rat hemolysate with oxidized glutathione or diamide resulted in a shift of the pI of MST to a lower value, 5.7-5.5. This shift was inhibited when these treatments were performed in the presence of dithiothreitol. These results indicate that the treatment of the enzyme with oxidized glutathione results in the formation of enzyme-glutathione mixed disulfide. PMID- 2718770 TI - Lipid malnutrition of patients with liver cirrhosis: effect of low intake of dietary lipid on plasma fatty acid composition. AB - The plasma fatty acid composition of cirrhotic patients and their dietary intake of fatty acids were determined. Significantly lower plasma arachidonic, docosahexaenoic, dihomo-gamma-linolenic and eicosapentaenoic acid levels were observed in cirrhotic patients than in healthy controls. A remarkably low dietary intake of polyunsaturated fatty acids supplied from fish, vegetable oil and pulses was shown in cirrhotic patients. Positive correlations were observed between plasma arachidonic acid concentrations and clearance rate of indocyanine green (KICG) (r = 0.826, p less than 0.05) and between dihomo-gamma-linolenic acid levels and cholinesterase activities (r = 0.841, p less than 0.05). From these results, we conclude that a supply of polyunsaturated fatty acids is necessary for the nutritional treatment of patients with liver cirrhosis. PMID- 2718771 TI - Angiocardiographic quantitative evaluation of double-outlet right ventricle: special reference to the morphology of the common outflow tract. AB - Geometrical measurements of angiocardiograms of the common outflow tract (COT) of 13 patients were made to determine in which cases internal conduit repair was feasible, and under which conditions a patch enlargement of the COT was indicated. In the pulmonary stenosis (PS) group, the area of the narrowest cross section of the COT was significantly smaller than that in the pulmonary hypertension (PH) group (p less than 0.025). In the PS group, the area was rarely sufficient to be shared by systemic and pulmonary circulation. Therefore, stenosis in the outflow tract to the pulmonary artery will occur if the intraventricular tunnel technique is applied, without patch enlargement of this portion, to patients with PS. On the contrary, the cross-sectional areas of the COT and pulmonary arteries were significantly larger in the PH group than in the PS group. Accordingly, the intracardiac conduit operation may be possible in such patients without a patch enlargement, even in young patients if other intracardiac conditions allow. Preoperative angiocardiographic evaluation of the COT is helpful in preoperatively selecting the proper operative procedure for this anomaly. PMID- 2718772 TI - The secretion of high molecular weight cathepsin B from cultured human liver cancers. AB - The biochemical characteristics of cathepsin B secreted from cultured human liver cancer cells were examined. The enzyme activity of culture medium against a synthetic substrate, N-carbobenzoxy-L-arginyl-L-arginine-4-methyl-coumaryl-7 amide, was dependent on the addition of cysteine, and the optimal pH was found to be 6.0. No activity was observed when the enzyme source was fresh medium not used for culture. These results suggest that the enzyme released from liver cancer cells is the thiol-protease cathepsin B. The molecular weight of the enzyme with 90% of the total activity was 40,000. Two cathepsin B molecules were found in liver tissue from patients with hepatocellular carcinoma (HCC); one was equivalent in size to the secreted enzyme, and a smaller one was the same as normal liver cathepsin B (27,000), which was also obtained from HCC-bearing cirrhotic liver. These results demonstrate that two molecules of cathepsin B are synthesized in liver cancer, and that the larger one is released into the surrounding tissue. PMID- 2718773 TI - Contrasting mechanisms of hypercalcemia in patients with early and advanced humoral hypercalcemia of malignancy. AB - The mechanisms of hypercalcemia were assessed in 15 patients with humoral hypercalcemia of malignancy (HHM) who had tumors at various stages of progression. In patients with early tumors, bone biopsies were generally normal and the hypercalcemia was due to an elevation in renal tubular resorption of calcium. Conversely, osteoclastic resorption was markedly increased in patients with advanced tumors, particularly those in whom the biopsies were obtained postmortem. Osteoclast surface (Oc.S) correlated positively with the stage of tumor progression (r = 0.80, p less than 0.002), degree of immobility (r = 0.87, p less than 0.002), and level of urinary cyclic AMP excretion (r = 0.60, p less than 0.02). When compared with a group of ambulant patients with primary hyperparathyroidism (HPT), osteoblast surface (Ob.S%) in HHM was depressed (median and range): 1.2% (0-11.6%) versus 5.3% (1.1-32.0%) (p less than 0.001). However, a relatively low Ob.S (4%) and raised Oc.S (43.5%) were also seen in an immobilized patient with severe HPT. These data suggest that the PTH-related peptides currently invoked in the pathogenesis of HHM may initially cause hypercalcemia by enhancing renal tubular calcium resorption. The increase in osteoclastic activity and depression of osteoblastic activity that subsequently occurs is probably due to the combined effects of immobilization and higher circulating levels of PTHrP on the skeleton. However, the release of other bone resorbing factors by the tumor, which have a depressant effect on osteoblastic activity, remains possible. PMID- 2718774 TI - A model system for assessing physicochemical factors affecting calcium absorbability from the intestinal tract. AB - An in vitro model system was utilized to critically examine physicochemical factors that could play a role in determining the amount of potentially absorbable ionic calcium as well as soluble complexes in the proximal jejunum following ingestion of tricalcium dicitrate, calcium carbonate, or tricalcium diphosphate. The solubility of calcium salts (500 mg calcium each) was tested in 300 ml water containing varying amounts of hydrochloric acid (0, 0.72, 2.4, 7.26, and 24.2 mEq) intended to mimic achlorhydric to peak acid secretory states. Whereas 20% of calcium citrate dissolved in the absence of hydrochloric acid, a negligible amount of calcium carbonate and calcium phosphate underwent dissolution. In solutions containing 0.72-7.26 mEq hydrochloric acid, calcium citrate was more than twofold soluble than calcium carbonate, and calcium phosphate had intermediate solubility. At simulated peak acid secretion, all three salts were completely soluble, or nearly so. To simulate pancreatic bicarbonate secretion, the filtrates obtained from solubility studies were titrated to pH 5, 6, and 7 with sodium hydroxide. Reprecipitation of calcium citrate and calcium carbonate did not occur. However, substantial calcium phosphate reprecipitation took place especially at high pH and in filtrates derived from high hydrochloric acid content. In filtrates derived from reprecipitation experiments (at pH 6 and 7), anionic complexation of calcium was calculated in order to estimate the amount of ionic and complexed calcium. Considerable amount of calcium from dissolved calcium citrate was complexed (60 65%), principally as soluble CaCit-, whereas calcium complexation was negligible in the calcium carbonate and calcium phosphate systems. PMID- 2718775 TI - Characteristics of an ovariectomized osteopenic rat model. AB - Although osteoporosis induced by ovariectomy (Ovx) in the rat has been widely used as a model for postmenopausal osteoporosis in humans, the findings of different investigators are not always consistent. This might be mainly due to differences in the age of the animals at Ovx, time after Ovx, and the variables measured. Therefore, in the present study, Ovx was performed at 4, 10, or 52 weeks and bone changes were observed in rats for 6 months. The effects of Ovx on body weight, femoral length, and femoral volume were marked in rats operated on at the age of 4 weeks, slight in rats operated on at the age of 52 weeks, and intermediate in rats operated on at the age of 10 weeks. A reduction in the ratio of cortical thickness to bone width at the midshaft of the femur was observed only in rats ovariectomized at 52 weeks of age. The specific gravity of the femur and the density of the metaphysis of the femur decreased after Ovx in all rats. The ratio of ash weight to dry weight of the femur, a measure of the normal calcification of bone, was unchanged shortly after Ovx but gradually decreased in all rats. PMID- 2718776 TI - The direct examination of three-dimensional bone architecture in vitro by computed tomography. AB - We describe a new method for the direct examination of three-dimensional bone structure in vitro based on high-resolution computed tomography (CT). Unlike clinical CT, a three-dimensional reconstruction array is created directly, rather than a series of two-dimensional slices. All structural indices commonly determined from two-dimensional histologic sections can be obtained nondestructively from a large number of slices in each of three orthogonal directions. This permits a comprehensive description of structural variation within a specimen and greatly facilitates the study of structural anisotropy. A measure of three-dimensional connectivity (Euler number/tissue volume) has been determined for the first time in human cancellous bone and shown to correlate with several two-dimensional histomorphometric indices. The method has the potential for overcoming many of the limitations of current approaches to the study of bone architecture at the microscopic level. PMID- 2718777 TI - Effects of transforming growth factors beta 1 and beta 2 on a mouse clonal, osteoblastlike cell line MC3T3-E1. AB - Transforming growth factors (TGF-beta 1 and TGF-beta 2) are polypeptide growth factors with a wide range of effects on the growth and differentiated function of a variety of cell types. Transforming growth factors of the beta class (TGF-beta) are found in large quantities in bone matrix and are synthesized by osteoblasts. For these reasons, it has been suggested that TGF-beta may play a major role in the regulation of bone cell metabolism. We have studied the effects of porcine TGF-beta 1 and the recently described porcine TGF-beta 2 in a mouse clonal, osteoblastlike cell line MC3T3-E1 that has previously been shown to have many characteristics of osteoblasts. In serum-containing medium, TGF-beta 1 inhibited alkaline phosphatase activity. The inhibition of alkaline phosphatase activity persisted for at least 72 h following a brief (24 h) exposure to TGF-beta 1. TGF beta 1 also caused a marked change in cell morphology. High doses inhibited collagen synthesis; lower concentrations caused a small increase. Under serum free conditions, TGF-beta 1 had biphasic effects on alkaline phosphatase activity inhibiting at high but stimulating at low concentrations and had only a slight stimulatory effect on collagen synthesis. Under the experimental conditions used, the effects of TGF-beta 1 on alkaline phosphatase activity and collagen synthesis were independent of effects on cell proliferation. In serum-containing medium, TGF-beta 2 inhibited alkaline phosphatase activity, an effect that was independent of changes in cell proliferation and caused shape changes in an identical fashion to that observed with TGF-beta 1. PMID- 2718778 TI - Purification and characterization of human bone tartrate-resistant acid phosphatase. AB - Tartrate-resistant acid phosphatase (TRAP) is a histochemical marker for osteoclasts, the multinucleated bone resorbing cell. This type 5 acid phosphatase has been purified 500-fold from human bone by three chromatographic steps: cation exchange, gel filtration, and HPLC cation exchange. Like most other TRAPs isolated, it is a basic glycoprotein of a molecular weight about 33,000. Its pH optimum Km, and Vmax for p-nitrophenyl phosphate are 5.7, 0.8 mM, and 12 units/mg, respectively. Human bone TRAP hydrolyzes aryl phosphates, nucleoside di and triphosphates, pyrophosphate, and phosphoproteins. It is activated by mild reducing agents but inhibited by molybdate, fluoride, arsenate, phosphate, and dithionite. Its activity is not inhibited by tartrate, a feature that distinguishes it from other acid phosphatases. Sodium etridonate, the bisphosphonate used clinically to reduce bone resorption, is a relatively poor inhibitor of bone TRAP. Human bone TRAP is immunologically related to the porcine uterine secretory TRAP, uteroferrin. Monospecific rabbit antibodies to the bone TRAP have been immunopurified by using affinity chromatography with uteroferrin immobilized on Sepharose and can be used to detect low amounts of the enzyme in a simple dot-blot assay. PMID- 2718779 TI - Treatment of congenital osteopetrosis in the rabbit with high-dose 1,25 dihydroxyvitamin D. AB - Osteopetrosis is a congenital metabolic bone disease characterized by skeletal sclerosis resulting from defective osteoclast-mediated bone resorption. Osteopetrosis has been described in several animal species (mouse, rat, and rabbit) and in children. Bone marrow transplantation, originally shown to reverse the skeletal sclerosis in some animal mutations, has been effective in curing osteopetrosis in some children. Unfortunately, not all children with osteopetrosis are candidates for or respond to bone marrow transplantation. Recent studies have shown that several animal mutations and some children inheriting osteopetrosis have significantly elevated serum levels of 1,25-(OH)2D. Based on the possibility that there may be a resistance to 1,25-(OH)2D, high-dose calcitriol therapy has been used to treat some children and stimulated some parameters of resorption. In this study, we have examined the effects of high dose calcitriol therapy on various serum and skeletal parameters in the osteopetrotic rabbit. Mutant rabbits and normal littermates were given continuous infusions of calcitriol via subcutaneously implanted osmotic minipumps for 2 weeks at a dose of 0.5, 2.5, or 25 micrograms/kg/per day. Untreated mutant rabbits are hypocalcemic and hypophosphatemic in the presence of elevated serum 1,25-(OH)2 levels in comparison with their normal littermates. Calcitriol infusions resulted in dose-dependent increases in circulating 1,25-(OH)2D levels in both normal and mutant rabbits. However, evaluation of other serum parameters and the skeletal response demonstrated significant differences between osteopetrotic and normal rabbits. At the highest dose, normal animals rapidly became hypercalcemic and osteoporotic, accompanied by weight loss and a failure to thrive; mutants remained hypocalcemic and osteopetrotic but did not exhibit the deleterious physical effects seen in treated normal littermates. Although the number of osteoclasts increased in both mutants and normals, osteoclast phenotype in the former remained abnormal. These data indicate that although very high levels of circulating 1,25-(OH)2D were achieved in osteopetrotic mutants, activation of osteoclast-mediated bone resorption with subsequent improvement of skeletal sclerosis was not observed. PMID- 2718780 TI - Characterization of insulin binding in the UMR-106 rat osteoblastic osteosarcoma cell. AB - The correlation of insulin receptor occupancy with classic insulin effects, such as stimulation of glucose uptake, have not been examined in osteoblastlike cells. Accordingly, we characterized insulin binding and examined its relationship to stimulation of glucose analog transport in the UMR-106 rat osteoblastic osteosarcoma cell line. Insulin binding in UMR-106 cells was found to be pH sensitive, temperature dependent, saturable, and specific. Proinsulin was 100 fold less effective than insulin in displacing specific [125I]insulin binding in these cells, whereas IGF-I at concentrations between 0.1 and 10 nM produced no displacement of [125I]insulin but did produce significant displacement of insulin binding at 100 and 1000 nM. Insulin receptor downregulation was observed after exposure to 100 nM insulin for 6 h at 37 degrees C and was temperature dependent. Insulin binding was reversible after 24 h at 4 degrees C. Insulin binding correlated directly with stimulation of 2-deoxyglucose uptake at insulin concentrations between 0.1 and 100 nM, with a half-maximal concentration (ED50) of 0.9 nM for both [125I]insulin binding displacement and stimulation of 2 deoxyglucose uptake. Hence, there was no evidence for spare insulin receptors with regard to stimulation of glucose analog transport. Scatchard analysis of insulin binding kinetics yielded a curvilinear plot, suggesting negative cooperativity. Analysis of insulin binding kinetics using a two-site model yielded a KD of 0.9 nM for the apparent high-affinity binding site and an estimated 80,000 high-affinity binding sites per cell. These findings demonstrate that osteoblastlike cells exhibit a relationship between insulin binding and glucose transport stimulation that is similar to that in liver cells and other insulin-sensitive tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718781 TI - Parathyroid function in Paget's disease of bone. AB - In order to determine the prevalence of secondary hyperparathyroidism in patients with Paget's disease of bone, we measured serum parathyroid hormone levels (N terminal assay) in 39 patients with a wide range of pagetic activity. All patients had normal serum calcium levels. A total of 30 patients were either untreated or had received no treatment for 6 months or longer when studied; the other 9 were receiving either salmon calcitonin (3) or EHDP (6). The results showed that in 7 of the 39 patients (18%) parathyroid hormone levels were increased above normal. These were among the most severely affected cases, as manifested by the degree of elevation of three pagetic biochemical indices: serum alkaline phosphatase, plasma bone Gla protein, and 24 h urinary hydroxyproline creatinine ratios. Levels of 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 were normal. We examined the relationships between parathyroid hormone and each of the three pagetic indices as well as serum calcium for the entire group of 39 patients. Parathyroid hormone values did not correlate with serum calcium measurements (r = -0.241, p = NS) but did correlate significantly with serum alkaline phosphatase (r = 0.496, p less than 0.001), plasma bone Gla protein (r = 0.537, p less than 0.001), and urinary hydroxyproline (r = 0.450, p less than 0.011). We conclude that relative or absolute increases in parathyroid hormone may occur in moderately active Paget's disease, possibly in the setting of greater calcium demands during periods of increased pagetic new bone formation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718782 TI - Histomorphometric effects of calcium or calcium plus 25-hydroxyvitamin D3 therapy in senile osteoporosis. AB - To evaluate the effects of calcium and 25-OHD in the therapy of senile osteoporosis, we studied a group of 39 women aged 69 +/- 7 (standard deviation, SD) years with severe osteoporosis. The group was characterized histomorphometrically by depressed bone remodeling rates without hyperosteoidosis. No subject had risk factors for osteopenia other than their age and postmenopausal status, and no subject was receiving therapy for bone disease at the onset of the study. Subjects were followed for 2 years after randomization to receive either 1200 mg/day of calcium (as calcium carbonate) and 40 micrograms/day of 25-OHD (calcium-25-OHD group), or 1200 mg/day of calcium plus placebo (calcium-placebo group). Calcium-25-OHD resulted in a clear increase in 25-OHD levels (p less than 0.001) and an increase in calcium absorption as indicated by urinary calcium excretion. Nevertheless, there was no significant change in fasting serum calcium, phosphorus, alkaline phosphatase, PTH, or 1,25 (OH)2D in either group. Radial and phalangeal bone mineral content and trabecular bone volume in the biopsied patients remained stable in both groups over the 2 year period. Unexpectedly, repeat bone biopsies revealed a clear improvement in the rate of mineralization in both groups, presumably as a result of the calcium supplementation alone. In summary, calcium-placebo and calcium-25-OHD treatment were both associated with stable appendicular bone mineral content in women with senile osteopenia. The finding of an effect of calcium supplementation on the rate of mineralization indicates that relative calcium deficiency may impair the mineralization phase of remodeling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718783 TI - Effects of oral contraceptive and estrogen administration on plasma calcitonin in pre- and postmenopausal women. AB - Estrogen (E) therapy and administration of oral contraceptives (OC) reportedly increase plasma calcitonin (CT) concentrations in women, effects said to mediate in part the beneficial actions of E on bone. To further examine this theory, we tested the effects of three cycles of OC therapy in 12 young women, comparing them to 10 healthy women before and after three normal menstrual cycles. We also determined the effects of 3 months of E therapy (ethinyl estradiol, 20 micrograms/day, 25 of 30 days) in 14 healthy postmenopausal women, using a crossover design (studied after 3 months with and 3 months without E). We determined CT by radioimmunoassay (antiserum G-1701) in whole plasma (iCT) and silica cartridge extracts of plasma (exCT) after overnight fasting, after calcium (Ca) infusion (2 mg Ca/kg over 5 minutes), and during a normal day at 0800, 1200, 1700, and 2000 h. In no control study was there a significant diurnal change in iCT or exCT, and neither OC nor E therapy altered this. Similarly, OC administration did not affect basal CT levels or the normal iCT and exCT responses to Ca infusion. E therapy induced expected changes in serum Ca, phosphorus, and alkaline phosphatase and urinary Ca and cAMP excretion; basal and diurnal plasma exCT levels were decreased significantly, consonant with the decrement in serum Ca. E did not alter normal iCT and exCT responses to Ca infusion. Thus, administration of either OC or E has no stimulatory effect on CT secretion, which suggests that the beneficial actions of E on bone are not mediated through CT-induced inhibition of bone resorption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718784 TI - Bone mineral density in women with type II diabetes mellitus. AB - Bone mineral density (BMD) was assessed in 28 women with type II diabetes mellitus and compared to 207 age-matched nondiabetic women. Mean BMD, as measured by dual-photon absorptiometry, 1.12 +/- 0.3 g/cm2 (+/- SEM), was similar to the mean BMD of control subjects, 1.06 +/- 0.1 g/cm2. Only 1 of the 28 diabetic patients had a BMD less than 0.95 g/cm2 ("fracture threshold"), whereas 25% of the control subjects had a BMD below that level. When diabetic and control subjects were matched for weight as well as age, the data continued to show similar BMD among both groups. Moreover, the disparity between the proportion of weight-matched controls (25%) and diabetic subjects (1 of 28) with a BMD below the fracture threshold persisted. Among the group of 17 diabetic subjects receiving insulin, there was a positive relationship between BMD and insulin dose. There was no significant relationship between BMD, duration of diabetes, or hemoglobin Alc. Thus, women with type II diabetes are not at increased risk for diminished BMD and may be protected against bone loss. PMID- 2718785 TI - Properties of the visually driven neurons of cat's hippocampal regions CA 1 and CA 3. AB - Neurons in areas CA 1 and 3 of cat's dorsal hippocampus were studied. Fifteen percent of the investigated cells were influenced by visual stimuli. Eighty five such neurons were investigated. The organization of their receptive fields was tested with stationary and moving visual stimuli. Twenty eight percent of neurons had small receptive fields (10-20 deg square). Forty one neurons responded to stationary flashing spots. They were ON-OFF, ON and OFF types with phasic (66%) and tonic (34%) characteristics. Seventy five responded to dark and bright stimuli moving across their receptive fields. Twenty five neurons were direction sensitive and 21 responded better to the dark moving stimuli than to the bright ones. No significant differences in the response properties of neurons in the CA 1 and CA 3 fields were observed. PMID- 2718786 TI - EEG afterdischarge patterns and performance of the avoidance response in hippocampally kindled cats. AB - The relation between EEG limbic afterdischarge patterns and the performance of avoidance response was studied in eight hippocampally kindled cats. Five basic types of EEG afterdischarge patterns were identified in the hippocampal formation: (i) continuous 2-4/s high amplitude spikes or spike and wave complexes; (ii) continuous, 4.5-12/s high amplitude spikes or spike and wave complexes; (iii) dysrhythmic pattern: disorganized irregular spiking, mixed with slow waves at 3-20/s frequency; (iv) continuous, 20-30/s comb-like shaped spiking of moderate amplitude, and (v) trains of high amplitude and frequency irregular spikes, lasting for 0.2-1 s. followed by EEG depression lasting 0.3-1 s. The performance of conditioned response was tested during first 10 s. of afterdischarge development after kindling electrical stimulation of the hippocampus. A statistically significant relation was observed between the EEG afterdischarge patterns seen at the beginning of afterdischarge formation (basically types I, II and III) and the performance of avoidance response, with greatest probability of the response failure with type III of afterdischarge pattern. Latencies of the avoidance responses were prolonged during afterdischarges, in comparison to latencies observed before and after kindling hippocampal stimulation. PMID- 2718787 TI - Differential projection from the motor and limbic cortical regions to the mediodorsal thalamic nucleus in the dog. AB - The cortical afferents to the mediodorsal thalamic nucleus in the dog were studied by using horseradish peroxidase. Small injections allowed to establish two specific projection zones connected separately with the lateral and medial segments of the nucleus. The lateral segment received the major projection from the dorsal half of the hemisphere. It included premotor and part of the motor cortices in the anterior sigmoid gyrus and precruciate areas as well as the presylvian cortex. The medial segment of the nucleus was innervated by the limbic areas of the ventral half of the hemisphere. These areas included the medioventrally located genual, subcallosal and piriform cortices, as well as the cortex of the ventral bank of the anterior rhinal sulcus and the caudal part of the orbital gyrus. The cortical fields situated between these two main cortical zones, both on the lateral and medial surfaces (rhinal and sylvian sulci and anterior cingular gyrus, respectively) sent projections to both medial and lateral segments of the nucleus. These results indicate that in the mediodorsal thalamic nucleus may take place the integration of information from two functionally defined systems, the motor and limbic ones. PMID- 2718788 TI - Alteration in the pattern of locomotion following a partial movement restraint in puppies. AB - The pattern of locomotion following a partial movement restraint was studied in five mongrel puppies. The locomotion of the animals was characterized by enforced pacing during the restraint period and exhibited significant, time dependent gait alterations after removal of the restraint. These changes involved gradual recovery to normal trotting. The time course and the degree of recovery in the animals were dependent on the period of movement restraint. Puppy that was forced to practice pacing for only two months switched almost instantaneously to the normal trotting, whereas in those dogs with a longer selective movement restraint, a significant long lasting incidence of pacing was observed. The study describes an animal model which can be useful as tool in future studies of the plasticity of motor system and its basic mechanisms in various physiological conditions. PMID- 2718789 TI - Is the 45 degrees-oblique a third dominant direction? AB - Vertical and horizontal are widely accepted as dominant directions or norms of visual orientation in the frontoparallel plane. They are supposed to cause a normalization effect consisting in the apparent rotation of a tilted straight line towards the nearest dominant direction. The evidence for tilt normalization towards the vertical or horizontal visual meridia is indirect. On the other hand, human observers are very sensitive to departures from the vertical and horizontal, which means that most orientations in the frontoparallel plane are termed tilted rather than vertical or horizontal. By measuring directly the orientation of dot patterns we found that estimated orientation was systematically biased towards the nearest 45 degrees-oblique visual meridian. This finding is interpreted as evidence for the existence of an oblique norm in visual tilt. PMID- 2718790 TI - The development of sustained attention in children might be related to the maturation of frontal cortical functions. AB - The relationship between the development of sustained attention and the ability to inhibit responding to external stimuli was investigated in seventy five children, 8, 10 and 12 years old. An important period in the development of both functions is between 8 and 10 years of age. A positive correlation was found between the number of signals detected (sustained attention) and the number of successfully suppressed reflexive saccades to the peripherally located target (the ability to inhibit responding to external stimuli). PMID- 2718791 TI - Craniocerebral epidermoids and dermoids. A review of 44 cases. AB - We review 40 epidermoids and 4 dermoids of the skull and brain treated surgically in our Department between 1976 and 1987. Fourteen were extradural and 30 intradural. The mean duration of symptoms was 3 years for extradural and 10 years for intradural tumours. Symptoms varied with tumour site, in some sites being helpful in differential diagnosis. Skull X-rays and CT were the key diagnostic investigations in extradural and CT in intradural lesions, the latter, with few exceptions, presenting a characteristic CT scan. In 7 cases MRI supplied important details on the tumour boundaries. All the diploic and orbital lesions were removed totally, with a good outcome. Twelve of the intradural lesions were removed totally, 9 subtotally and 9 partially, with a good outcome in 21 patients and a poor outcome in 4; 5 patients died. Outcome was unrelated to degree of removal. PMID- 2718792 TI - Malignant monstrocellular brain tumours. A study of 42 surgically treated cases. AB - A series of 42 cases of monstrocellular brain tumour (MBT) who received surgery over a 34 year period is reviewed with the aim of gaining more understanding of the biology of this oncotype. A case of benign pleomorphic xanthoastrocytoma was identified among the cases and is discussed in another paper. In this series, as in most others taken from the literature, MBTs were more frequent in young subjects (55% were under 50 years of age and 17% were children) and presented as a superficially located (63%), often sharply circumscribed (42%) mass. The mean survival time for 24 patients treated by surgery and radiotherapy (RT) was 57 weeks compared to 32 weeks for 12 treated by surgery alone (p less than 0.02). Patients younger and older than 50 years showed the same survival and the slightly better course of children did not reach statistical significance. Besides postoperative RT, the only other factor that showed a significantly positive influence on survival was the presence of a definite lymphocytic infiltration (LI) in the tumour (p less than 0.05). This result confirms our previous study on the prognostic influence of LI in glioblastoma (GB). Actually, we noted that the prolonged survival of both MBT and GB patients exhibiting a definite LI (67% and 11.5%, respectively, in the two series) was strikingly similar. We conclude that MBT is a peculiar oncotype with a probably better prognosis than GB in the majority of cases. Lymphocytes seem to play a major prognostic role and giant-monstrous cells are indirectly implicated, reasonably enhancing the host's immune response by magnifying the antigenic stimulus. PMID- 2718793 TI - Ruptured intracranial aneurysms. The influence of sex and fibromuscular dysplasia upon prognosis. AB - From a statistical analysis of a series of 214 cases of ruptured intracranial aneurysms, it was demonstrated that only four parameters among those collected on the admission day, are predictive of the final functional result: sex (p less than 0.001); age (p less than 0.02); clinical grade (p less than 0.001) and angiographic spasm (p less than 0.01). The surprisingly poor prognosis in women was explained by the higher frequency of spasm (p less than 0.005). Aneurysms in women predominated on the intracranial carotid artery (38%) and were frequently multiple (12%). A further angiographic study on 87 cases was then carried out including a systematic investigation of the cervical part of the vessels; it permitted one to identify angiographic features of fibromuscular dysplasia (FMD) on the cervical vessels in 20 cases. In those cases it was also observed that there was a marked female predominance (F/M = 5.6), a frequent localization on the internal carotid artery (50%), a high rate of multiple aneurysms (60%) and a poor prognosis related to spasm (50%). Therefore, intracranial aneurysms appear far more frequently than usually reported, to be related to FMD. The worse prognosis of ruptured intracranial aneurysms in females can be, at least partly explained by the association with FMD and the frequent occurrence of spasm. A careful investigation of patients exhibiting features of FMD in order to detect intracranial aneurysms before rupture, is suggested. PMID- 2718794 TI - Subarachnoid haemorrhage of unknown origin: clinical and tomographical aspects. AB - 65 patients with negative but technically satisfactory 4 vessel angiography - all admitted to our Department in the years 1976-1983 - were evaluated in the present study. CT scan was undertaken in all cases (in 47 cases within 4 days of haemorrhage). Arterial hypertension was present on admission in 9% of cases. The period of follow-up ranged from 4 to 11 years, with a mean of 5.3 years. The study group was compared to a control group, comprising 760 patients with subarachnoid haemorrhage from ruptured aneurysms, admitted during the same period. Clinical grade on admission (Hunt's classification) was better in patients belonging to the study group. The amount of cisternal deposition on CT scan was less significant than in patients with ruptured aneurysms, and the deposition was often atypical (circumpeduncular, ambiental, and/or tentorial). Clinical deterioration associated with vasospasm was observed in 5% of patients in this study and in 27% of patients in the control group. In patients with a consistent or thick cisternal layer (CT scan "at risk") the incidence of clinical vasospasm was 21%, against 47% in controls. One or more rebleedings occurred in 12% of patients in the study group, against 25% of patients in the control group. A significant ventricular dilatation was observed in 15% of patients in the first group (requiring a shunt in 8%), against 25% of patients in the second group (requiring a shunt in 11%). Final outcome was favourable in 95% of patients in this study group and in 63% of patients in the control group, with a mortality rate of 5% in the first group and 32% in the second group. PMID- 2718795 TI - Hypokalaemia in severe head trauma. AB - Forty-six consecutive patients with severe isolated head trauma (GCS less than or equal to 7) had significant hypokalaemia averaging 3.1 +/- 0.4 (S.D.) mmol/litre upon admission to the emergency room. This electrolyte imbalance occurred within hours of the trauma and resolved under treatment within the first day. There was no correlation between serum potassium and pH, glucose, urine electrolytes, patient age or sex, admission Glasgow Coma Score or the Glasgow Outcome Score. Sixteen patients with multiple trauma but without head trauma had an average serum potassium of 3.5 +/- 1.1 mmolar. Mechanisms of serum potassium level control and their correlation with brain trauma are addressed in a search for an explanation of this phenomenon. We believe that the most appropriate explanation for this hypokalaemia is the large catecholamine discharge that is known to accompany severe head trauma, with resultant beta 2-adrenergic stimulation of the Na+ -K+ pump. The formation of a prospective on-going study to clarify the basic mechanism of hypokalaemia in severe head trauma is presented. PMID- 2718796 TI - Immunological method for prediction of progress in neurological deficit in patients with intracranial aneurysm rupture. AB - Skin tests of nonspecific antigens (immunoskin test Sevac) were performed on patients suffering from intracranial aneurysms, scheduled for surgical clipping. It was found that high antibody titre correlated well with the severity and progress of neurological deficit developing after surgery. This deficit was absent in patients who exhibited low antibody titre in response to the skin test before surgery. These results indicate that the immunological processes may play a role in the development of neurological deficit after neurosurgical procedures. Thus the skin test employed may have prognostic value in predicting neurological deficit following intracranial aneurysm surgery. PMID- 2718797 TI - Enzymatic changes in the cerebrospinal fluid as indices of pathological change. AB - Enzymatic determinations in cerebrospinal fluid (CSF) of lactic dehydrogenase (LDH), creatine phosphokinase (CPK) and creatine kinase BB (CK-BB) were performed on 94 patients presenting with a range of disorders of the central nervous system. Enzyme results from 37 patients undergoing myelography were used as controls. The highest concentration of these enzymes appeared in patients with the most severe brain injury. In head-injured patients with a Glasgow Coma Score (GCS) of 3 to 7, only the CK-BB correlated with the degree of injury and with the ultimate outcome. Within the subgroup of spinal cord injuries none of the enzymes correlated with the severity of neurological injury. However, patients with acute spinal cord trauma who demonstrated CSF CK-BB values greater than 10 U/litre had never recovered. The present study confirms that CSF CK-BB seems to be a sensitive index of acute brain damage, but it reflects best the extent of CNS tissue disruption rather than the severity of neurological deficits. PMID- 2718798 TI - Effect of hypoxia on endothelium-dependent relaxation of canine and rabbit basilar arteries. AB - An important role of endothelium-dependent relaxation in the local regulation of vascular tone has been suggested. In the present study, the effect of hypoxia on endothelium-dependent relaxation was investigated in canine and rabbit basilar and in rabbit common carotid arteries in vitro, using an isometric tension recording method. Hypoxia was introduced by changing the gas mixture in the in vitro chamber from 95% O2-5% CO2 to 95% N2-5% CO2. Thrombin and acetylcholine were used to induce endothelium-dependent relaxation. Thrombin at 0.1 and 1.0 U/ml, respectively, caused dose-dependent relaxation of the canine basilar artery precontracted by 10(-6)M prostaglandin F2 alpha. Acetylcholine also evoked dose dependent relaxation of rabbit basilar and common carotid arteries precontracted by serotonin. Under hypoxic conditions, the relaxing effect of thrombin or acetylcholine decreased both in canine and in rabbit arteries, although it was not significant in rabbit basilar arteries. It has been postulated that following subarachnoid haemorrhage, diffusion of oxygen to the walls of the major cerebral arteries might be impaired by the subarachnoid clot. This could cause hypoxia of the arteries and contribute to vasospasm by suppressing endothelium-dependent relaxation, as well as by enhancing the contractile responses of the cerebral arteries to the vasoconstrictor agents in the bloody cerebrospinal fluid. PMID- 2718799 TI - Subperiosteal intraorbital haematoma following minor head trauma. Case report. AB - Subperiosteal haematoma of the orbit following minor head trauma is extremely rare. A 5-year-old girl is presented with bilateral proptosis, chemosis, extraocular palsy, and progressive visual loss after minor head trauma. She had no evidence of fracture or abnormality of coagulation. The intraorbital haematoma resulted most probably from the oozings of a subgaleal haemorrhage which entered the subperiosteal space and then dissected over the supraorbital ridge into the orbit. PMID- 2718800 TI - Craniofacial morphology in untreated shunt-treated hydrocephalic children. AB - Craniofacial morphology was studied in 45 shunt-treated hydrocephalic children and 7 untreated hydrocephalic patients. A sample of 74 normal children from northern Finland were used as controls. Following shunt treatment the sella turcica became shallow and J-shaped. The cranial base angles changed markedly during shunt treatment. The cranial base angles were more obtuse in untreated patients than in control subjects, whereas the opposite was the case in shunt treated patients. The Nasion-Sella-Basion angle was 143.4 degrees in untreated hydrocephalic patients, 132.6 degrees in normal subjects and 127.9 in shunt treated hydrocephalics. The changes in cranial base angles appeared to be progressive during a two-year follow-up period. PMID- 2718801 TI - Stunning device as a suicide weapon. AB - Thirteen patients who had attempted suicide with the stunning device, were treated over a time span of eleven years. Five of them died. The survivors made a satisfactory recovery with minor neurological sequelae only. The characteristics of this type of brain injury are: high incidence of infection (all developed meningitis and six of them brain abscesses), with prevalence of gram negative animal strains and technical difficulties in removing foreign bodies from the deeper part of the missile track. PMID- 2718802 TI - Prognosis in traumatic basal ganglia haematoma. AB - Twenty two patients with traumatic basal ganglia haematoma were studied. The mean Glasgow Coma Score on admission was 7. 17 patients had sustained high acceleration/deceleration injuries. The location and size of haematoma did not correlate with prognosis. Outcome was poor in 7 patients, while 8 patients died. PMID- 2718803 TI - Primary internal ophthalmoplegia due to head injury. AB - Six cases of internal ophthalmoplegia due to direct head injury are presented. All six patients had a dilated, nonreactive pupil. Four had no extraocular palsies or ptosis and two had partial extraocular palsies or ptosis. Disturbance of consciousness was absent or very mild, and all patients fully recovered within 1 to 7 days after the traumatic event. No patient had a history that suggested a cause for oculomotor nerve palsy, and emergency CTscans showed no mass lesions. The internal ophthalmoplegia was recognized immediately after trauma. Although minimal oculomotor nerve palsies due to unruptured intracranial aneurysms have been described, none of our patients complained of periorbital or retroorbital pain either before or after the trauma, which rules out intracranial aneurysms as the cause of the internal ophthalmoplegia. Therefore, we concluded that the internal ophthalmoplegia was due to direct head injury. The pathophysiological mechanism of the internal ophthalmoplegia appeared to be slight injury of the pupillomotor fibres on the ventromedial surface of the third nerve at the posterior petroclinoid ligament, which acted as the fulcrum due to the downward displacement of the brainstem at the time of impact. PMID- 2718805 TI - Cerebral sinus thrombosis in patients with severe iron deficiency anaemia due to myoma uteri. AB - Two middle-aged women with haemorrhagic infarction due to thrombosis of the superior sagittal and transverse sinus, respectively, are herein reported. Severe iron deficiency anaemia secondary to myoma uteri seen in these patients was suggested to play a significant role in the development of the sinus thrombosis. In middle-aged women, myoma uteri deserves special attention as a possible aetiological contributor to cerebral sinus thrombosis. PMID- 2718804 TI - Diencephalic syndrome following cervical spinal cord trauma. AB - The authors discuss about five cases of diabetes insipidus observed in patients affected by traumatic cervical spine fractures and/or dislocations, without either evident lesions of the cerebral structures at CT scan examination, or important craniocerebral trauma. In all patients polyuria and hyperthermia arose some days after the traumatic accident and regressed spontaneously or after exogeneous vasopressin administration. Vasopressin urinary levels confirmed the presence of a true diabetes insipidus, the origin of which is in largely obscure. A central medullary vasopressin mediated pathway, demonstrated only in experimental animals, may be responsible for such a finding. PMID- 2718806 TI - Age-related changes of cerebral ventricular size. Part II: Normalization of ventricular size following shunting. AB - Thirty-one hydrocephalic patients were investigated prospectively by means of computed tomographic scan performed prior to and one week after cerebrospinal fluid (CSF) shunting. Planimetric measurements of the size of the cerebral ventricles were compared before and after shunting. Children under two years of age and elderly patients showed significantly less reduction of ventricular size (8.5 +/- 6.3% and 9.7 +/- 3.5% respectively) than older children and young adults (61.2 +/- 5.2%). The degree of reduction of ventricular size did not correlate with pre-operative size of ventricles, duration of disease, or clinical improvement. These findings suggest that reduction of ventricular size following CSF shunting is related to age. We postulate that the size of cerebral ventricles in hydrocephalic patients is not exclusively related to CSF dynamics, but also depends upon the intrinsic elastic properties of the cerebral parenchyma which vary with age. PMID- 2718807 TI - Pedicle origin and intervertebral compartment in the lumbar and upper sacral spine. A biometric study. AB - The osseous boundaries of the intervertebral compartment are described. Measurements of the pedicles demonstrate that their configuration determines the shape of the intervertebral compartment. The pedicles originate in the upper lumbar spine (L 1 and L 2) in a vertical direction from the posterior aspects of the vertebral bodies. In the caudal lumbar spine (L 4 and L 5) the origin of the pedicles is more oblique and thereby moves much more laterally and ventrally. As a consequence the horizontal extension of the pedicles is increasing in the lower lumbar spine. In the upper lumbar region the intervertebral compartment corresponds more to a foramen, in the lower lumbar spine more to a canal. The resulting clinical relevance for the length of the intervertebral compartment and the nerve root course is discussed. PMID- 2718808 TI - Pulse amplitude and volume-pressure relationships in experimental hydrocephalus. AB - The bolus injection test was used to study the intracranial volume pressure relationships in an experimental population of normal and hydrocephalic dogs. Hydrocephalus was developed by means of an intracisternal injection of a kaolin powder solution. Hydrocephalic animals were tested a mean of 15 days after kaolin injection. The intraventricular pressure (ICPo) and amplitude of intraventricular pulse wave (AMPo) were measured at baseline steady-state. Pressure-volume index (PVI) and intracranial compliance (C) were calculated from bolus injection tests. The ICPo (p less than 0.01) and AMPo (p less than 0.001) were much higher in hydrocephalic animals and C decreased significantly (p less than 0.001). There were no statistical differences regarding PVI. A direct linear correlation was found between AMPo and ICPo (p less than 0.001) and between PVI and ICPo (p less than 0.05) but no correlations were found between PVI and AMPo. The regression analysis showed a non-linear correlation between C and ICPo (p less than 0.01) and between C and AMPo (p less than 0.001). The results of our experimental study suggest that: 1) pulse amplitude relates to the intracranial compliance, and 2) the intracranial compliance is a better parameter of the volume-pressure response than PVI. PMID- 2718809 TI - Epidemiologic and clinical features of optic neuritis in the 20th and 21st sanitary districts of the Sardinia (Italy). AB - An epidemiologic and clinical study on optic neuritis in two sanitary districts of the Sardinia was carried out. The results were partially in agreement, partially in contrast with the literature data. The most important datum is that the annual incidence rate of optic neuritis in Sardinia is similar to the rates observed in medium-high risk for MS geographical areas, according to observation which showed that frequency of MS in Italy, and in Sardinia particularly, is much higher than that indicated by previous studies. PMID- 2718810 TI - Epidemiologic and clinical features of the Guillain-Barre' syndrome in Sardinia in the 1961-1980 period. AB - Epidemiologic and clinical features of the Guillain-Barre syndrome in Sardinia, in a twenty years period, were studied. 120 subjects (62 males and 58 females) with Guillain-Barre syndrome were identified. An annual incidence rate of 0.4/100,000 population was found. The results were compared both with national and international data of the literature. The peculiarity of some aspects was pointed out. PMID- 2718811 TI - Cerebellar metastasis from prostatic carcinoma simulating, on CT-scan, a cerebellopontine angle tumor. Case report. AB - The authors report a rare case of cerebellar metastasis from prostatic carcinoma simulating on computerized tomography a cerebellopontine angle tumor. Solitary intracerebral metastases from prostatic cancer are infrequent, and their location in the posterior fossa with extension in the cerebellopontine angle is quite unusual. The differential CT findings from more common benign cerebellopontine angle tumors are briefly outlined. PMID- 2718813 TI - Fisher syndrome. An infantile case. AB - A case of acute onset of partial ophthalmoplegia, ataxia and areflexia in a child is described. This case closely resembles those described by Fisher (Fisher syndrome). Clinical data, also in relation to the few cases previously reported, are discussed. PMID- 2718812 TI - Tumors of the neuron series presenting as cysts with mural nodules. AB - Two cases of tumors of the neuron series presenting as cysts with mural tumor nodules are described. This radiographic and surgical aspect may be observed in astrocytomas, meningiomas or ependymomas, whereas it is more rare for neuroblastomas and ganglioneuromas. There are not CT features which allow to differentiate cystic tumors of the neuron series from the other cystic tumors. The finding of cyst with enhancing mural tumor nodule and unenhanced wall is more favorable from a surgical point of view; the complete removal of the nodule with preservation of the reactive cyst wall results in the cure of patients with ganglioneuroma and ganglioglioma and in good long-term survival in those with cerebral neuroblastomas. PMID- 2718814 TI - Intracerebral pneumocephalus after ventriculoperitoneal shunt. AB - A case of pneumocephalus, secondary to a liquoral shunt operation, is described. The patient had a massive neuroma of cranial mixed nerves occupying the whole region of the cerebello-pontine angle. The diagnosis was possible by changing the position of the patient's head under radioscopic control, while repeatedly applying pressure with the fingers on the shunt reservoir. PMID- 2718816 TI - [Evaluation of DS III-R in the diagnosis of schizophrenic disorders]. PMID- 2718815 TI - [Factorial structure and internal consistency of the psychiatric evaluation scale of Krawiecka]. AB - An analysis of internal consistency and factorial structure of Krawiecka's Psychiatric Evaluation Scale was carried out. Global alpha coefficient was found to be 0.36. Factorial analysis revealed the presence of three factors that accounted for 60% of total variance. Factor one included blunted-incongruent affect, poverty of speed and psychomotor retardation. Factor two loaded on delusions, hallucinations and anxiety-agitation and the third factor on incoherent-irrelevant speech and depression. PMID- 2718817 TI - [Illness behavior. Attempt to identify clinical types]. AB - The present study brings for the first time the description and assess of several types of "abnormal illness behavior" by using the I.B.Q. in 571 general practice psychiatric ambulatory and hospital surgery and medical patients. Using multivariate analysis techniques (Cluster and Discriminant) we found five patterns of response with the I.B.Q. Two of them (50.5%) showed adaptative response, the other three patterns (49.5%) are classified as "abnormal illness behavior". Its importance and repercussion in medical care is discussed. PMID- 2718819 TI - Changes of drinking goals in a two-year out-patient alcoholic treatment program. AB - Choice of drinking goals were studied in a two-year out-patient alcoholic treatment program with a low attrition rate. Eighty-four percent of the alcoholics (N = 50) preferred abstinence during the first 3-month period and 64% during the last 3-month period. Forty-four percent changed drinking goals (abstinence or controlled drinking) during the 2-year period. Women had a more stable choice than men (p less than .1). Patients with an abstinence drinking goal during the total 2-year period were more often physically dependent on alcohol and had more drinks during abuse days than the other patients. Patients did not differ in number of abuse days during the 2-year program as a function of goal choice. PMID- 2718818 TI - [Relationship between psychiatric emergencies and meteorologic factors]. AB - Man's environment, natural as well as artificial, may exert a pathogenic influence on man's life, according to which we could divide the population in meteorosensitive (about 60%) and non meteorosensitive. Psychic patients and patients who suffer from certain organic diseases are those ones who more frequently behave as meteorosensitive. We accept this as starting point of our work. In our paper we analysed statistically the relation among different cosmo meteorologic factors in the incidence of psychiatric emergencies during two years separated by five years and the probable existence of seasonal rhythms in the different studied diagnostic categories. As well as partial results for every diagnostic category we elaborate as final conclusion that these relations have a multifactorial character, that is to say, there are several factors that interact to unchain certain pathology in meteorosensitive people. We emphasize the existence of seasonal cycles in certain psychiatric syndromes. These conclusions are seen specially in personality disorders, suicide attempts, anxiety crisis and disorders, drug addictions and psycho-organic diseases. PMID- 2718820 TI - Psychometric properties and social correlates of assertion measures in chronic alcoholics. AB - Assertion is a major focus of many social skills interventions for alcoholics. The assessment of assertion often relies on self-report measures. However, few psychometric data are available on the most frequently used instruments. This study determined the internal characteristics and structure of two commonly employed measures of assertion: the Wolpe-Lazarus Assertion Inventory and the Callner-Ross Assertion Inventory. In addition, the relationship between responses on these devices and demographic variables, extent of substance abuse, and level of social functioning were examined. Results indicated that both inventories exhibit adequate internal consistency and test-retest reliability. Factor structures were relatively simple and represented general assertion situations. Results are discussed in terms of the need for further refinement of these instruments. PMID- 2718821 TI - Self-help approaches to smoking cessation: a report from the normative aging study. AB - Self-quitters make up by far the largest proportion of ex-cigarette smokers, yet this population has not been extensively characterized to date. We compared male self-quitters (N = 191) and age-matched recidivists (N = 110) on smoking histories, psychosocial attributes and quitting methods. A number of significant relationships were found, some of which may have clinical implications. those who substituted cigars or pipes for cigarettes were nearly four times more likely to be successful, and those who reported consuming more food/snacks after quitting were 80% more likely to be successful quitters. Subjects who reported using no coping strategies in former smoking settings after cessation because they had no urges to smoke in these settings were also much more likely to be successful quitters. Recidivists were more likely to report using physical activity as a means of coping with temptations to smoke, and were somewhat older at the time of the quit attempt. Withdrawal symptoms and psychosocial stress were reported as reasons for relapse by early relapsers, while late relapsers reported being around other smokers on social occasions, and psychosocial stress. PMID- 2718822 TI - Potentiation of cigarette craving and satisfaction by two types of meals. AB - This study investigated the effects of consuming different meal types on cigarette craving and satisfaction. Twelve heavy smokers were tested on three evenings. Each day, they smoked three cigarettes and received either a solid meal, an equicaloric liquid meal, or no meal. Subjects smoked the first cigarette one half hour after the experiment began, the second immediately after finishing the meal, and the third 35 min after smoking the second cigarette. Cigarette craving increased most after the solid meal, less so after the liquid meal, and least after no meal. Subjects reported that the cigarette after the solid meal tasted the best, was the most satisfying, enjoyable, and desirable as compared to the cigarette following no meal at all. These results indicate that there is a robust postprandial enhancement of cigarette smoking after a solid meal but less after a liquid meal. PMID- 2718823 TI - Cognitive and behavioral features of adolescent coping in high-risk drinking situations. AB - The present study examined the coping responses used by adolescents in high-risk situations. Sixty-six adolescents described situations in which it was difficult to resist drinking alcohol. Cognitive and behavioral responses in the perceived high-risk alcohol situations were examined. Abusing and nonabusing adolescents reported similar high-risk situations, but differed significantly in the cognitive and behavioral strategies used to cope with drinking pressures. Cognitive strategies associated with abstaining from alcohol use included defining oneself as a nondrinker and viewing other drinkers negatively. Behavioral responses associated with not drinking included engaging in an alternative activity and avoiding or limiting direct exposure to the high-risk situations. Theoretical and clinical implications for effective coping in alcohol situations are discussed. PMID- 2718824 TI - The relationship between panic attacks and chemical dependencies. AB - The purposes of the present study were to (a) determine the prevalence and characteristics of panic attacks in an alcohol/drug abuse inpatient population, (b) compare patients who reported experiencing panic attacks to patients who have never experienced a panic attack on various self-report measures of psychopathology and on ratings completed by Caregivers, and (c) to examine differences within groups of panickers. One hundred forty-four patients completed the questionnaires over a 17 week period. Over 50% of the patients reported experiencing one or more attacks in the three weeks prior to testing. These panickers scored higher than non-panickers on various measures of psychopathology. Over 83% of panickers reported using alcohol to self-medicate their panic attacks with almost 72% of them believing this procedure to be effective for preventing or reducing panic attacks. Male panickers differed from female panickers on several measures as did panickers who reported their panic attacks began before the alcohol abuse compared to those who did not believe this. The mean history of panic attacks was 103.4 months while the mean history of alcohol abuse was 134.6 months. PMID- 2718825 TI - Some physical characteristics of NIDA marijuana cigarettes. AB - Marijuana cigarettes of three different potencies (0.0%, 1.4% and 2.7% delta-9 tetrahydrocannabinol (THC) content) provided by the National Institute on Drug Abuse (NIDA) were compared on a variety of characteristics, including physical appearance, weight, burn rate, and deliveries of total particulate matter and carbon monoxide. Significant differences between the different potency cigarettes were obtained on most measures. These differences could be relevant to the design and interpretation of pharmacologic/toxicologic and behavioral studies conducted with these cigarettes. The possible basis for these observed differences, methods for minimizing some of them, and other potential problems related to the use of NIDA marijuana cigarettes are discussed. PMID- 2718826 TI - Extending relapse prevention models to couples. AB - A model is proposed which extends Marlatt's Relapse Prevention model to couples. The model includes macroscopic and microscopic levels of analysis. At the macroscopic level, it is proposed that the probability of client coping responses is affected by the quality of the client's social support network, the quality of primary intimate relationships, the density of reinforcement for abstinence, and the expectation of loss of reinforcement for drinking. At the microscopic level, it is proposed that spouses may engage in a variety of coping responses that may either facilitate client coping and help maintain changes in drinking, or which are nonfacilitative and increase the likelihood of relapse. Clinical implications of the model are discussed. PMID- 2718827 TI - Can across-treatment changes in cumulative puff duration predict treatment outcome during nicotine fading. AB - The smoking behavior of 10 male and 15 female smokers was assessed weekly during a standardized nicotine fading program to examine the relationship between compensatory smoking (i.e., increases in the number of cigarettes smoked per day, expired air carbon monoxide (CO), or the frequency and duration of puffs) and posttreatment abstinence from tobacco. Subjects who continued to smoke or relapsed immediately following treatment (Nonabstainers) smoked significantly more cigarettes per day during the program (p less than .05) and exhibited greater across-treatment increases in the time spent puffing a cigarette (i.e., cumulative puff duration) (p less than .05) than subjects who successfully quit smoking (Abstainers). Both Nonabstainers and Abstainers exhibited across treatment decreases in expired air CO (p less than .001). Similar analyses conducted between subjects who were abstinent versus relapsed 3-6 months following treatment revealed no significant differences in smoking behavior, although both groups exhibited similar across-treatment decreases in CO (p less than .001) and time spent smoking a cigarette (i.e., time alite) (p less than .05). The findings are discussed in reference to their relevance to (a) the development of differential assessment procedures to match smokers to appropriate treatments; (b) the determination of appropriate procedural modifications in the nicotine fading protocol; and (c) nicotine regulation research. PMID- 2718828 TI - Cardiovascular reactivity and smoking in coronary prone (type A) and non-coronary prone (type B) subjects. AB - Twenty-nine Type A subjects, (greater than 75 percentile on the Jenkins Activity Survey) and 28 Type B's (less than 25 percentile of Jenkins) were asked to smoke 1 cigarette (1.0 mg nicotine, 16 mg tar, 14 mg CO) using a standardized smoking procedure. The results showed that both Type A and B subjects experienced significant smoking induced changes in heart rate, skin temperature and pulse transit time. An analysis of covariance also revealed that the Type A subjects exhibited greater heart rate reactivity due to smoking than their type B counter parts. The results are discussed in terms of the possible role of cardiovascular reactivity in the mediation of the subjective and behavioral effects of smoking in the type A individual. PMID- 2718829 TI - Modification of the balanced-placebo design for use at high blood alcohol levels. AB - One hundred seventy-nine volunteer male subjects participated in a test of a modified version of the balanced-placebo design at clinically significant B.A.L.s (.081-.105 mg/dl). Half of these subjects were given dose and instructions according to a standard balanced-placebo design; the others received active placebos where appropriate, and instructions tailored to accomodate the mismatch between dose and expectancy. A measure of subjective intoxication was taken after a forty-minute drinking period, and again thirty minutes later. The results showed the modified balanced placebo design to be superior to the standard approach in creating subjective intoxication consistent with instructions and stable over time. An attributional formulation of the results is offered and the modified balanced-placebo design is advanced as an alternative particularly useful for the investigation of dose/expectancy effects at high B.A.L.s. PMID- 2718830 TI - Patterns of drug use among young adults. AB - The present study assessed patterns of multiple drug use among a sample of university employees and students who had been identified as having moderately high drug use habits. Use of eleven categories of legal and illegal drugs was tested and subjects reported how much of each drug they currently and habitually used. Factor analysis yielded three factors of drug use. Four of the items in the first factor (hallucinogens, cocaine, marijuana, alcohol) exhibited moderately strong and positive intercorrelations, suggesting that this particular pattern of drug use was the most common and/or reliable among young adult drug users. Sedatives and opiates were the highest loading items on the second factor, suggesting a pattern of drug use motivated by the desire for relaxation and stress avoidance. The third factor identified a pattern of legal stimulant use involving two of the three food-like categories of items employed in the present study (i.e., caffeinated cola beverages and chocolate, but not coffee). The results provided only mixed support for the hypothesis that categories of drugs with similar pharmacological properties define patterns of multiple drug use. PMID- 2718831 TI - [Male sexual infertility. Papers presented at the 53d Congress of the Belgian Society of Urology. Wepion, 28 and 29 May 1988]. PMID- 2718832 TI - [Vasectomy and its reversibility]. AB - The authors report their experience of 2000 vasectomies. They discuss the indications, the technical aspects, the complications, the immunological consequences and the pathological results on the vas deferens, the epididymis and the testis. They report thereafter their experience of vaso-vasostomies (320 cases). They discuss their results on a mechanical (repermeabilization) and functional (% of pregnancies) point of view. PMID- 2718833 TI - [Genetic aspects of male infertility]. AB - Cytogenetic analyses performed in infertile men showed a frequency of genetic abnormalities definitely higher than in normal population. Cytogenetic analysis is perfectly justified in infertile men with normal phenotype. PMID- 2718834 TI - Contraception in men: efficacy and immediate toxicity. A study of 18 cases. AB - Ten years ago research into a reversible method of male contraception proved unsuccessful, not for any objective reasons but because volunteers failed to comply with treatment. A change in social attitudes towards contraception, a constant demand for a reversible method of male contraception and the current interest in protecting germinal cell lines by blockage of spermatogenesis during chemotherapy led the authors to reactivate the study. Eighteen volunteers received a synthetic progestogen (Norluten) and a percutaneous testosterone gel. Clinical, biological, hormonal and seminal tests were performed each month. One patient, however, had to withdraw from the trial on medical grounds (hyperlipidaemia). Ten patients achieved azoospermia which is the only guarantee of efficacy. Immediate tolerance was good but protocol compliance was poor since 8 of the 17 volunteers abandoned the trial within a year. Treatment reversibility was evaluated in 15 patients whose F.S.H. level and spermatogenesis returned to normal when contraception was ended. This additional study demonstrates that hormone contraception in males is effective and well-tolerated, but the protocol placed too great a demand on the patients and 50% withdrew from the trial within a year. PMID- 2718835 TI - [Physiopathological model of sexual dysfunctions for the use of somatists]. AB - The author exposes a multifactorial physiopathological model of sexual dysfunctions in males. He stresses the usual interconnection of different etiological factors and the need to consider all the factors at the same time: organic, psychological (primary: personal or relational and secondary) to elaborate efficient treatments. PMID- 2718836 TI - [Assuming responsibility for sexual inspiration. Backdrop to the treatment of all sexual dysfunctions]. PMID- 2718837 TI - [Electron microscopy of spermatozoa. Indications and results]. AB - Electron microscopy of spermatozoa is required in cases of important and persistent disorders of motility. Within the frame of fertility investigations, it can also prove useful in cases of in vitro fertilisation failures where structural defects of acrosome may be detected. Lastly subclinical seminal infections are diagnosed in more than 20% and account for a substantial number of acquired head anomalies and necrospermia. PMID- 2718838 TI - Women's role in male sexual dysfunction. AB - The author analyses the patient's emotional reactions to his sexual problems and those of his partner. A first study is reported showing that feminists are more tolerant and supportive. A second study performed on diabetic males with sexual dysfunction shows that the psychological consequences of impotence are less important in the partners than in the patients and that a positive attitude of the wife does not necessarily help in improving the sexual relationship. PMID- 2718839 TI - [The wife of the impotent person. Key element in the prognosis]. AB - The authors develop the key position of the wife in male impotence, even if organic. This influence may be positive or negative and plays an important role in the prognosis. PMID- 2718840 TI - Sexotherapy and disorders of ejaculation. AB - The author reviews the disorders of ejaculation: premature ejaculation delayed ejaculation and retarded ejaculation. She proposes behavioral treatments adapted to each disorder: single techniques provide most often excellent results. PMID- 2718841 TI - [Retarded ejaculation and anejaculation without orgasm. Apropos of the results of studies and of treatment in 60 cases]. AB - The physiological mechanism of ejaculation is recalled. The different kinds of abnormalities of ejaculation and their etiologies (drugs, post-surgery, neurological, endocrinological, psychological) are specified. The diagnosis and the therapeutical management of the different varieties are discussed and the results of a personal experience of 60 cases are reported. PMID- 2718842 TI - [Sexual dysfunction in males in long-term hemodialysis]. AB - A quick survey of the literature and the author's own observations in 93 males in dialysis enable them to define the model of sexual dysfunction affecting this kind of patients. Psychological, organic and iatrogenic factors are often linked to create complex troubles, often minimized by the patients themselves. It is still difficult to know whether the important biological - in particular hormonal - disorders necessarily induce impotence. Big efforts in the research and the management of these patients are needed to help them in improving their quality of life. PMID- 2718843 TI - Sexual dysfunction after excision of the rectum. AB - From January 1986 up January 1988 a series of 18 patients--age average 49--were studied. All of them had undergone the amputation of the rectum for carcinoma with the Miles resection technique (15 p.), or for ulcerous rectumcolitis (3 p.). Six months after operation the patients were given a questionnaire in order to obtain information about their sexual activity. Exams on the liverkidney functioning, the hormone dosage (FSH, LH, prolactin, testosterone), penile Doppler flowmetry, and the sacral latency test were performed. The patients were also given a Jonas erectiometer to be used at home. The procedures followed have shown in most patients normal hormonal, vascular, and neurologic parameters, thus confirming the absence of relevant erectile deficits. Only one patient no longer had erections after the surgical intervention. It was reported a decrease and some sort of difficulty in the sexual intercourse owing to the presence of colostomy conditioning the physical and psychological relations with the partner. Spermatic fluid results altered after operation: absent in 8 cases, backwards in 3, diminished in 6, and normal in 4. PMID- 2718844 TI - [Surgical solutions to iatrogenic impotence following total cysto-prostatectomy]. AB - Sixty-nine patients who underwent major pelvic surgery for bladder cancer were evaluated for sexual consequences. Impotence was observed in 85% of the patients after 48 radical cysto-prostatectomies. Among them, one third developed a parallel sexuality without erection but with orgasm: they are candidates for penile implants. In a small number (15%) of the patients, erections were preserved: this was observed in 5 out of 12 patients (41%) who were operated with the new technique sparing the cavernous nerves. An optimistic note emerges from surgical solutions, whether prophylactic or palliative, but one must insist on the necessity of a psychological support before and after the operation. PMID- 2718845 TI - Chemical prosthesis. AB - The approach to patients suffering from erectile failure includes medical and sexual anamnesis, Doppler ultrasound, Jonas erectiometer and Sacral Latency Test. At present, the use of papaverine directly in corpora cavernosa seems indicated in performance anxiety dysfunctions used together with psycotherapy and in slight arterial deficiencies, diabetes, after destructive pelvic surgery and in neurological lesions. From January 1986 we have performed 150 I.C. injections of papaverine. Experience in 60 patients is described. Seven patients are now self injecting. PMID- 2718846 TI - [12 years experience with semi-rigid intracavernous implants. Indications and results]. AB - Since 1976, 782 impotent patients were explored in our Center. Ninety-nine underwent an implantation of Dow-Corning semi-rigid prosthesis. Indications are reviewed and results analysed taking into consideration specific criteria to evaluate the new sexuality. On the whole, the impression is favorable for men, less enthusiastic for women, but with a possible adaptation. Persisting erection around the prosthesis in 73% of the cases justifies this inert prosthesis and which is simple, low cost, easy to insert. These qualities must be taken into consideration in regard of expensive inflatable prosthesis reserved to a small number of patients in our country. PMID- 2718847 TI - [Modifications in spermatogenesis following antibiotic therapy]. AB - Among eleven antibiotics with a high activity on the mitosis and on the meiosis of the seminal cells, gentamycin sulfate and cefuroxime are both the most aggressive. After 8, 15 or 30 days of treatment, a stop of the mitosis and of the meiosis, pyknosis and karyolysis are morphologically visualized in male adult rats. Histoenzymatic studies show first a decrease of the protein synthesis in the nuclei of the spermatogonia and of the spermatocytes, and second a decrease of the glucose metabolism in the spermatocytes layers. In other groups of rats treated, the sacrifice was performed after arrest of antibiotics, the morphological recuperation is slow after 8 days of treatment, none after 15 or 30 days. Histoenzymatic studies show that the recuperation of the protein metabolism is quicker than the glucose one. Arising after 8 days it can be complete after 15 to 30 days of rest. Some coincidences between these experimental works and some clinical disturbances in the fertility of men and animals after high doses of antibiotic may be pointed out. PMID- 2718848 TI - Hypofertility in males due to a secretion anomaly of the seminal vesicles and its treatment. AB - Between 1981 and 1986, 5,000 males with infertility were treated. Eight (0.16%) of them had hypospermia, a decrease in seminal fructose, asthenospermia without oligospermia considered as a secretion anomaly of the seminal vesicles. Artificial Insemination with the Husband's sperm (AIH) combined with vesiculo prostatic plasma from a vasectomized donor was performed successfully in 3 couples. In this series, failures were associated with an important fertility factor in the female. AIH combined with vesiculo-prostatic plasma from a vasectomized donor is considered as an effective treatment of male hypofertility caused by vesicular dysfunction. PMID- 2718849 TI - [The hamster test. Practical consequences]. AB - The result of the in vitro human sperm penetration test into hamster eggs must not be considered as absolute. It is a step in the management of male infertility and must be interpreted in regard of the results of other tests. In our experience, if the test is negative, the probability to observe a pregnancy in the patient's partner is about one in seven and half years; if the test is positive, it is about one in two and half years. On the other hand, if a pregnancy occurs, with a positive or a negative test, it will start 5 to 7 months later. PMID- 2718850 TI - [Should one use fresh or frozen sperm in in-vitro fertilization with donors?]. AB - Between 1984 and 1987, 66 women whose partner had severe oligo asthenoteratospermia or azoospermia underwent in vitro fertilization (IVF) with donor sperm. The mean duration of sterility was 7.5 +/- 3.2 years. Investigations performed in the women showed no abnormality in 30%, pure endocrinopathies in 21% or tubal diseases isolated or associated with other pathologies in 40%. Most of these women (86%) had had previous unsuccessful inseminations with donor sperm. Our study involves 129 attempts of IVF with donor sperm (1 to 3 attempts per patient); the sperm was fresh in 59% of the cases and cryopreserved in 41%. Initial and final motility and sperm density are significantly lower for cryopreserved sperm (p less than 0.001). The fertilization rate is lower with cryo-preserved sperm but the difference is not statistically significant. Moreover, the score of embryonal vitality and the number of embryos that can be cryopreserved are lower with cryopreserved sperm (p +/- 0.05). However the number of pregnancies is identical with one or another type of sperm (40% of the women after 3 IVF). To conclude, cryopreserved sperm may be used for IVF without lowering the percentage of success. In fact, the fertilization rate, the embryonal score and the number of embryos to deep freeze are slightly less with cryopreserved sperm and this difference could reveal to be significant with a larger cohort of patients. But the advantage of fresh sperm must be balanced by the risk of AIDS contamination, avoided with cryopreserved sperm. PMID- 2718851 TI - [Male infertility and medically assisted procreation]. AB - Three hundred thirty patients underwent in vitro fertilization in our centre since 1985. Fifty two percent of them presented an abnormal spermogram (sperm count less than or equal to 20 X 10/ml; mobility less than 40%; teratospermia greater than 60%). In those cases, lack of fertilization is statistically increased but pregnancy rate per transfer is similar to this observed with pure female cases. Sperm count, mobility and teratospermia influence the success rate but are not sufficient criteria of ability to fertilize. On the other hand, hamster test is without predictive interest. PMID- 2718852 TI - Low-attenuation mediastinal masses on CT. PMID- 2718853 TI - The CT findings of pulmonary sarcoidosis: analysis of 25 patients. AB - We analyzed the CT findings in 25 patients with biopsy-proved pulmonary sarcoidosis. In all 25 patients, 10-mm collimation scans were available. In 16 of the 25 patients, select 1.5-mm scans were obtained. These were retrospectively targeted by using a 20- to 25-cm field of view and a high-spatial-resolution algorithm. The CT and pathologic findings were compared in two patients in whom surgical specimens of the lung were available. CT findings included hilar and mediastinal adenopathy (n = 22), subpleural nodules (n = 19), and 1- to 10-mm diameter nodules (n = 17) and irregular linear densities (n = 12), both mainly along the bronchovascular structures. High-resolution CT was superior to conventional CT in the assessment of subpleural nodules and irregular linear densities, but conventional CT was superior in the assessment of peribronchovascular nodules. The two gross pathologic specimens showed the sarcoid granulomas to be mostly along the lymphatics in the peribronchovascular sheath and, to a lesser extent, in subpleural and interlobar septal lymphatics. We conclude that the characteristic CT appearance of pulmonary sarcoidosis consists of small nodules and irregular linear densities along the bronchovascular bundles. PMID- 2718854 TI - Chronic lung diseases: specific diagnosis by using CT. AB - We evaluated patterns of abnormal lung parenchyma on CT scans in six specific chronic lung diseases and then applied those findings in the differential diagnosis of these lung parenchymal patterns in 56 subjects. There were 48 patients with chronic lung diseases (43 with histologic proof) consisting of usual interstitial pneumonia (n = 20), sarcoidosis (n = 16), lymphangitic carcinomatosis (n = 7), lymphangioleiomyomatosis (n = 2), drug toxicity (n = 2), and eosinophilic granuloma (n = 1). Including eight CT scans of normal control subjects, 56 CT scans were assessed independently by two readers (R1 and R2). Chest radiographs, most of which were obtained within 1 week of CT examination, were available in 48 of the 56 subjects. CT scans were evaluated for specific parenchymal features including disease distribution, lung distortion, thickening of bronchovascular bundles and polygon walls, bronchiectasis, cysts, and nodules, to determine the association of each abnormal feature with the different diseases. Diagnosis was then made from the overall CT appearance of the lungs and, on a separate occasion, from the appearance of the chest radiograph. The correct diagnosis was made from the CT appearance in 54 of 56 patients (R1) and in 50 of 56 patients (R2). Correct diagnoses were made from the chest radiographs in 42 of 48 patients (R1) and 43 of 48 patients (R2). We have identified features that are reproducible and useful when describing CT scans of patients with chronic lung diseases. Interpretation of the appearance of the lung on CT scans was accurate in diagnosing usual interstitial pneumonia, sarcoidosis, and lymphangitic carcinomatosis. PMID- 2718855 TI - Goblet cell metaplasia causing alveolar disease of the lung: radiographic and pathologic findings. PMID- 2718856 TI - Diagnosis of acute cholecystitis by cholescintigraphy: significance of pericholecystic hepatic uptake. AB - Uptake of radionuclide by the liver next to the gallbladder in cholescintigraphy has been described as a useful secondary sign with a high positive predictive value for the diagnosis of acute cholecystitis. We retrospectively examined 780 consecutive cholescintigrams to (1) determine the positive predictive value at 1 hr of this sign for acute cholecystitis and (2) ascertain if the presence or absence of this finding could differentiate acute from gangrenous cholecystitis. Pericholecystic hepatic activity was present at 1 hr in 48 (34%) of 141 scans in which the gallbladder was not visualized, and cholecystectomy was performed within 6 days of scintigraphy. Forty-five of these patients had acute and three had chronic cholecystitis (94% positive predictive value for acute cholecystitis). In addition, 57% of patients with gangrenous cholecystitis exhibited pericholecystic hepatic activity, and the frequency of this finding was significantly higher (p less than .006) in gangrenous than in acute cholecystitis. In summary, pericholecystic hepatic uptake is a valuable secondary sign in the cholescintigraphic diagnosis of acute cholecystitis. The significance of the finding is (1) a high positive predictive value for acute disease at 1 hr and (2) a statistically significant increased frequency in patients with gangrenous cholecystitis. PMID- 2718857 TI - MR appearance of the liver after partial hepatectomy. AB - To define the MR appearance of the liver after partial hepatectomy, we reviewed retrospectively 61 MR examinations performed on 25 patients 10 days to 48 months after surgery. Twenty-seven partial hepatectomies performed in the 25 patients included right lobectomy in 11, trisegmentectomy in two, left lobectomy in five, and wedge resection in nine. By using vascular landmarks, demonstration of the falciform ligament, and the presence of surgical clips, we correctly identified the type of partial hepatectomy in 21 of the 25 patients. The signal intensity of the resection margin was similar to that of the remaining parenchyma in 16 of 18 patients and was poorly defined and had a higher signal intensity (T2-weighted image) in the remaining two. Liver regeneration was observed on serial MR scans 2 16 months after surgery. Findings related to chemotherapy, including periportal changes and inhomogeneous appearance of the liver, were shown in six of eight patients. Tumor recurrence was present in nine patients, either intrahepatic (seven patients) or at the resection margin (two patients), and was consistently identified with MR imaging. The ability of MR imaging to produce images without artifacts from surgical clips is helpful in displaying the MR appearance of the liver after partial hepatectomy. Anatomic landmarks, findings related to chemotherapy, and tumor recurrence were shown well. PMID- 2718858 TI - Giant cavernous hemangioma of the liver: CT and MR imaging in 10 cases. AB - Ten giant cavernous hemangiomas of the liver in eight patients were examined with both MR imaging and dynamic bolus CT. The maximal diameters of the tumors were 6.5-19 cm (mean, 10.8 cm). MR imaging was done with a 2.0-T superconducting magnet and spin-echo imaging. CT was done with single-bolus dynamic scans. On MR images, all 10 hemangiomas had a heterogeneous appearance. The main part of the tumor comprised uniform, well-defined, high-intensity areas on T2-weighted images, with increasing intensity ratios with prolongation of TR and TE. Other parts of the tumor were cleftlike and were of lower intensity than the remainder of the tumor on T1-weighted images and of higher intensity on heavily T2-weighted images. These parts corresponded to the areas of the tumor that were of lower density on dynamic bolus CT scans. Internal septa in the tumor of low intensity were also noted on all MR pulse sequences. These parts corresponded to low density areas on delayed contrast-enhanced CT. Familiarity with the characteristics of the internal architecture of giant cavernous hemangiomas on MR imaging or dynamic bolus CT might be useful in making the correct diagnosis of this tumor. PMID- 2718859 TI - Pancreatic plasmacytoma: CT findings. PMID- 2718860 TI - Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization. AB - Renal artery branch injury resulting from stab wounds of iatrogenic origin or street violence is an important cause of renal hemorrhage. Over a period of 10 years we accurately diagnosed the injury and successfully managed the associated hemorrhage in 15 patients by using angiography and percutaneous embolization techniques. Nine branch injuries in eight patients were due to street knifings and seven injuries were complications of invasive medical procedures (four from renal biopsy, two from nephrostolithotomy, and one from nephrostomy). All patients had gross hematuria at the time of angiographic evaluation. False aneurysms were present in six patients (one with associated frank extravasation), false aneurysm/arteriovenous fistula in three, false aneurysm/arteriocaliceal fistula in one, and isolated arteriovenous fistula in two. Frank extravasation without associated false aneurysm/arteriovenous fistula was present in two. One patient had two injuries, an upper-pole false aneurysm and a lower-pole false aneurysm/arteriovenous fistula. In the eight patients injured in street knifings, hematuria recurred after surgical exploration and treatment. None of the 16 injuries involved the main renal artery. Gelfoam was used for embolization of nine lesions and steel coils for four. Three others were treated with Gelfoam plus coils. Hemostasis was achieved in all and none required subsequent surgery. Renal tissue loss was small to moderate (less than 30%) in 12 patients and large (30-50%) in three patients. Transient postembolization hypertension occurred in one of the latter. We consider selective angiography/embolization to be an effective and safe means for diagnosing and treating wounds of the renal artery branches. PMID- 2718861 TI - MR imaging of the temporomandibular joint: comparison of images of autopsy specimens made at 0.3 T and 1.5 T with anatomic cryosections. AB - We made MR images of 39 autopsy specimens of the temporomandibular joint at 0.3 and 1.5 T and compared the images with anatomic cryosections. Imaging time and slice thickness were the same on scans made at each field strength. The purpose was to determine which field strength provides the best scans for imaging of the joint. Additionally, we used imaging times two and four times longer on the 0.3-T scanner to assess to what extent image quality and diagnostic accuracy could be improved. The cryosections showed that 27 of the joints were normal. Twelve had disk displacements. Ten of the joints with disk displacement also had disk deformities, and seven had bony abnormalities. Investigators who analyzed the MR images had no knowledge of the findings on the cryosections. The disk position, disk configuration, and bony abnormalities were correctly diagnosed in 85%, 77%, and 100%, respectively, on 1.5-T MR images compared with 46%, 41%, and 85%, respectively, on the 0.3-T images. When the imaging time was increased by a factor of four, the accuracy rate on the 0.3-T system became comparable to that of the 1.5-T MR scanner: 73% for disk position, 67% for disk configuration. The results suggest that the diagnostic quality of MR images of the temporomandibular joint is better on scans made at 1.5 T than on those done at 0.3 T when comparable imaging times are used. PMID- 2718862 TI - Recurrent occult medullary thyroid carcinoma detected by MR imaging. PMID- 2718863 TI - Juvenile pilocytic astrocytomas: CT and MR characteristics. AB - Thirty-seven cases of juvenile pilocytic astrocytoma were reviewed retrospectively to determine their CT and MR characteristics. All cases occurred in pediatric patients, except for one in a young adult. There was a propensity for tumors to be located around the third and fourth ventricles. On CT the tumors were all sharply demarcated and smoothly marginated and rarely had associated edema. The lesions tended to be round or oval. The tumor matrix was most often hypo- or isodense with marked enhancement. Cyst formation, either micro- or macrocystic or combined, was frequently observed, and tumor calcification occurred occasionally. On MR the tumors appeared hypo- or isointense on T1 weighted images and hyperintense on T2-weighted images. The radiologic appearances of juvenile pilocytic astrocytomas are quite characteristic. By using age of presentation, typical location, configuration, and enhancement patterns, the presurgical diagnosis of juvenile pilocytic astrocytoma can be made with a high index of confidence. PMID- 2718864 TI - MR imaging of intracranial carotid occlusion. AB - The MR scans of seven patients with intracranial carotid occlusion (five proved, two presumed) were reviewed to evaluate the MR signal characteristics seen in this disorder. Five patients had clinical signs of cerebral infarction. Of the remaining two patients, one was asymptomatic and the other had a long-standing occlusion and headaches. We correlated the MR findings with cerebral angiography in five patients and with CT scans in six patients. All occluded vessels demonstrated MR signal predominantly isointense to brain on proton-density- T1- and T2-weighted images. Since there is an absence of flow, the MR signal is based on the intrinsic properties of the arterial thrombus and possibly on the chronicity of the occlusion. The pathogenesis and histopathology of intravascular thrombus differ significantly from extravascular hematoma, which accounts for the differences in their MR signal characteristics. The demonstration of occluded intracranial vessels may solidify the diagnosis of stroke in cases in which clinical and/or CT findings are equivocal. In patients presenting with infarction, an occluded carotid artery by MR may obviate the need for angiography; however, the demonstration of a patent carotid in conjunction with infarction suggests the possibility of an embolus, which may require angiography. We believe that MR is a valuable adjunct to CT in evaluating patients with cerebrovascular infarction. PMID- 2718865 TI - The anatomic basis of vertebrogenic pain and the autonomic syndrome associated with lumbar disk extrusion. AB - Extruded lumbar intervertebral disks traditionally have been classified as posterior or central in location. A retrospective review of 250 MR imaging examinations of the lumbar spine that used mid- and high-field imagers revealed 145 positive studies, which included a significant number of extrusions extending anteriorly. With the lateral margin of the neural foramen/pedicle as the boundary, 29.2% of peripheral disk extrusions were anterior and 56.4% were posterior. In addition, a prevalence of 14.4% was found for central disk extrusions, in which there was a rupture of disk material into or through the vertebral body itself. The clinical state of neurogenic spinal radiculopathy accompanying posterior disk extrusion has been well defined; however, uncomplicated anterior and central disk extrusions also may be associated with a definite clinical syndrome. The vertebrogenic symptom complex includes (1) local and referred pain and (2) autonomic reflex dysfunction within the lumbosacral zones of Head. Generalized alterations in viscerosomatic tone potentially may also be observed. The anatomic basis for the mediation of clinical signs and symptoms generated within the disk and paradiskal structures rests with afferent sensory fibers from two primary sources: (1) posterolateral neural branches emanating from the ventral ramus of the somatic spinal root and (2) neural rami projecting directly to the paravertebral autonomic neural plexus. Thus, conscious perception and unconscious effects originating in the vertebral column, although complex, have definite pathways represented in this dual peripheral innervation associated with intimately related and/or parallel central ramifications. It is further proposed that the specific clinical manifestations of the autonomic syndrome are mediated predominantly, if not entirely, within the sympathetic nervous system. The directional differentiation of lumbar disk extrusions by MR, together with a clarification and appreciation of the accompanying clinical somatic and autonomic syndromes, should contribute both to understanding the specific causes as well as to establishing the appropriate treatment of acute and chronic signs and symptoms engendered by many nonspecific disease processes involving the spinal column. PMID- 2718866 TI - MR imaging of experimental demyelination. AB - Seventeen rabbit sciatic nerves undergoing experimental demyelination and 17 control nerves were imaged in vivo with a 0.3-T MR imaging system using a silicone chamber wrapped around the nerves to isolate them from surrounding tissues. Three pulse sequences were used for each nerve: (1) spin-echo 500/28 (TR/TE), (2) spin-echo 2000/56, and (3) inversion recovery 1000/300/30 (TR/TI/TE). Image intensity data were acquired for each nerve by placing a region of interest over the nerve and measuring pixel brightness within the region of interest by means of a computer algorithm. The mean signal intensity of the experimental nerve was then compared with the mean signal intensity of the contralateral control nerve on the same image. Histologic sections of the nerves were stained with Loyez's stain for myelin and thionin for glial cells. MR findings were then compared with histopathologic data. Experimental nerves showed distinct stages of demyelination. Two fundamental observations were surmised from the data: (1) Perceptible MR signal changes are associated with early nerve degeneration, in which there is demyelination in the absence of glial cell proliferation; these changes are appreciated as increased intensity on heavily T2 weighted sequence. In these nerves no signal changes are seen on T1-weighted sequences. (2) Perceptible MR signal changes are associated with more advanced nerve degeneration, in which there is an increase in the number of glial cells in the absence of further demyelination; these changes are appreciated as decreased intensity on T1-weighted sequences and markedly increased intensity on T2 weighted sequences, respectively. The results show that MR can distinguish stages of demyelination in degenerating nerves, thereby providing a powerful method for the diagnosis and characterization of demyelinating disease. PMID- 2718867 TI - Blood flow in the carotid arteries: quantification by using phase-sensitive MR imaging. AB - The feasibility of MR phase-sensitive imaging for the quantification of blood flow in the carotid arteries was studied in two normal volunteers and six patients with carotid artery and/or cerebrovascular disease. The technique consists of sensitizing the phase of the MR signal to blood flow velocity gated to different times in the cardiac cycle. Flow velocities and volumes were measured by using transverse planes in the common, internal, and external carotid arteries, and flow curves were generated. Measurements made by using flow phantoms correlated well with calculated results. The MR measurements yielded values between 250 and 580 ml/min for the total flow through each of the common carotid arteries in the two normal volunteers. Markedly reduced flow (about 50% below normal) was detected in a patient whose arteriogram showed severe occlusion of the internal carotid artery. In a second patient, who had a large frontal intracranial arteriovenous malformation noted by arteriography, the MR-quantified flow was abnormally high (about 1 liter/min). In the remaining four patients, the findings on phase-sensitive quantification were consistent with those expected from clinical and other laboratory studies (including arteriography and sonography). These preliminary findings suggest that MR phase mapping may be a feasible tool for the noninvasive quantification of carotid blood flow. PMID- 2718868 TI - General diagnosis case of the day. Pulmonary Arteriovenous malformations. PMID- 2718869 TI - General diagnosis case of the day. Eosinophilic gastritis. PMID- 2718870 TI - Pediatric radiology case of the day. Oncogenic rickets (Feuerstein and Mims syndrome with resistant rickets). PMID- 2718871 TI - Pediatric radiology case of the day. Diffuse infiltrating lipomatosis. PMID- 2718872 TI - Neuroradiology case of the day. Chordoma of the clivus. PMID- 2718873 TI - Neuroradiology case of the day. Choroid plexus papilloma, third ventricle. PMID- 2718874 TI - Neuroradiology case of the day. Plasmacytoma of the skull vault. PMID- 2718875 TI - Neuroradiology case of the day. Moyamoya disease. PMID- 2718876 TI - Agenesis of the lungs. PMID- 2718877 TI - CT findings of a posterior false aneurysm of the left ventricle. PMID- 2718878 TI - Superior mediastinal widening from spine fractures mimicking aortic rupture on chest radiographs. PMID- 2718879 TI - Cost of breast localization devices. PMID- 2718880 TI - Portal hypertension in Behcet syndrome. PMID- 2718881 TI - Percutaneous extraction of renal fungus ball. PMID- 2718882 TI - The laminar space sign: is it reliable, specific? PMID- 2718884 TI - Improved catheter introducer with recessed sheath. PMID- 2718883 TI - Gantry angulation for CT-guided biopsy or aspiration. PMID- 2718885 TI - Gadolinium-DPTA: a radiographic contrast agent. PMID- 2718886 TI - Simple method to identify sequential images. PMID- 2718887 TI - [Monoclonal anti-HIV antibodies in HIV/AIDS research. Diagnosis and therapy]. AB - It will be given an overview on several aspects of structure proteins of the HIV and monoclonal antibodies against these. Monoclonal antibodies (mabs) are helpful in research on structure of the virus and pathogenesis of AIDS. A lot of mabs from mice to env, gag and pol gene products has been established. Published human mabs were directed to gp41 and p25 structures of HIV. In future mabs could be used as helpful therapeutical agents especially as immunotoxins against infected cells or as vaccines in form of antiidiotypic mabs. PMID- 2718888 TI - [Stimulation of nonspecific immune defense and antibody synthesis with zymosan]. AB - A local sterile inflammation was induced in mice of different inbred strains by means of an i.p. injection of zymosan, a water-insoluble polysaccharide of the cell wall of Saccharomyces cerevisiae. This resulted in a strong enhancement of the unspecific resistance against infections with a LD 90 of gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Bordetella bronchiseptica). Furthermore, the treatment with zymosan before or after an immunization with sheep erythrocytes (SE) resulted in a significantly increased specific IgM and IgG primary response in the spleen. However, it was particularly striking that the number of plaque-forming cells against SE was very drastically enhanced in non-immunized mice, in particular cases even up to more than 70 times over the background. Consequently, zymosan possesses immunomodulating effects both on the unspecific resistance and on immune reactions. These results are discussed in relation to the Lyt+-B-cells and an acute phase reaction of B-cells. PMID- 2718889 TI - [Determination of cellular and humoral parameters of fatty liver]. AB - Cellular and humoral immunological parameters were examined in mononuclear cells from peripheral blood of patients with alcoholic and nonalcoholic steatosis hepatis. The ratio of T4 and T8 positive lymphocytes and the number of monocytes of these patients were in the normal range. The percentage of NK-cells, B lymphocytes and DR-antigen-positive cells was increased. PMID- 2718890 TI - MCAD deficiency: what family physicians need to know. PMID- 2718891 TI - Meeting society's need for family physicians. PMID- 2718892 TI - The Academy's core educational guidelines. PMID- 2718893 TI - Adolescent privacy and health care. PMID- 2718894 TI - Pheochromocytoma. PMID- 2718895 TI - Guillain-Barre syndrome in pregnancy. AB - Guillain-Barre syndrome is an acquired demyelinating neurologic disorder that may present in pregnancy as either a coincidental or an antecedent event. The physician with an obstetric practice must not ignore complaints of muscle weakness, general malaise, tingling of the fingers and respiratory discomfort. In this high-risk complication of pregnancy, intensive multidisciplinary management improves the prognosis for both mother and fetus. PMID- 2718896 TI - Health hazards of unusual herbal teas. AB - Some unusual herbal teas have potentially serious toxic effects. Because most commercially available herbal products are safe, a high index of suspicion is required to detect subtle cases of herbal tea toxicity. Reported effects include anticoagulation, hepatic veno-occlusive disease, orthostatic hypotension, anticholinergic syndrome and cardiac arrhythmias. PMID- 2718897 TI - Primary congenital glaucoma. AB - Primary congenital glaucoma is a rare but potentially devastating disorder that family physicians must recognize as early as possible in infants and young children. Symptoms, which may not be present at birth, classically include photophobia, excessive tearing and blepharospasm. The cornea may be enlarged and hazy. Increased intraocular pressure rapidly damages the optic nerve in infants. Treatment includes surgery with regular follow-up evaluation. PMID- 2718898 TI - The small colonic polyp. PMID- 2718899 TI - Medium-chain acyl-CoA dehydrogenase deficiency. AB - Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the most frequently diagnosed defect in fatty acid metabolism and is one of the most common inborn errors of metabolism. Diagnosis may be difficult, since the disorder may present as hypoglycemia, sudden infant death syndrome or a Reye's syndrome-like illness. Because of the abrupt clinical deterioration seen with MCAD deficiency, as well as its treatable nature and its genetic implications, this disorder presents a significant challenge for family physicians. PMID- 2718900 TI - The diaphragm. AB - Use of a diaphragm plus spermicide provides effective protection against pregnancy in motivated women and decreases the risk for some sexually transmitted diseases. Potential risks of this contraceptive method include the development of urinary tract infections and the possible teratogenic effects of nonoxynol-9, the active agent in most spermicides. Contraindications include a large cystocele or rectocele, uterine prolapse and recurrent urinary tract infections. PMID- 2718901 TI - Tympanostomy tubes. PMID- 2718902 TI - Further reflections on merging specialties. PMID- 2718903 TI - Recommended Core Educational Guidelines on Allergy/Immunology for family practice residents. PMID- 2718904 TI - Quinolones. PMID- 2718905 TI - Dust inhalation exposures from the handling of small volumes of powders. AB - Worker exposure to airborne particulates was stimulated in a laboratory under controlled conditions. Small volumes, 3.8 L (1 gal.), of finely divided powders were transferred at 1-min intervals to 23-L (6-gal.) containers over 30-min time intervals. A high-volume filter array in the exit vent of the specially designed exposure laboratory was used both to control the ventilation rate and to determine the emission factor of the pouring operation. The room ventilation rate, method of transfer, and drop height were varied, and the resulting particulate concentrations were monitored by personal and area samplers. The four powders studied were talc, sodium chloride, Portland cement, and Direct Yellow 4 dye. Based on this study, a model was developed to predict potential worker exposure from the pouring of small volumes of powders. The model is based on the following major conclusions. First, the space- and time-averaged concentration of suspended particulate matter at breathing height agrees well with the mean concentration of suspended particulate matter in the room air effluent. Second, material-specific suspended particulate emission factors vary approximately in direct proportion to the drop height. Third, emission factors for scooping/dumping operations agree well with factors for pouring operations for a given drop height. Fourth, emission factors compare well with dustiness indexes that were determined using a bench-scale dustiness test chamber described in a companion paper. Parameters of the exposure model include dustiness index, drop height of the pouring operation, total quantity of material poured, averaging time, and the fraction of respirable material. For the validation of the model, additional data would be necessary. PMID- 2718906 TI - Alterations in physiological and perceptual variables during exhaustive endurance work while wearing a pressure-demand respirator. AB - The purpose of this investigation was to describe the time course of changes in physiological and perceptual variables during exhaustive endurance work with and without an air-supplied, full-facepiece, pressure-demand respirator. Thirty-eight healthy subjects (24 to 51 years of age) volunteered for this study. Treadmill speed was set at 5.5 kph (3.4 mph) and elevation was set at a level calculated to elicit 70% of a previously determined maximal aerobic capacity (VO2max). Subjects continued at this rate to exhaustion. Despite a constant work rate, VO2 and %VO2max increased during exercise and were significantly greater with the respirator (34.4 +/- 1.1 mL/kg.min; 84% VO2max) than without the respirator (31.9 +/- 1.1 mL/kg.min; 76% VO2max) at the "final" measurement point prior to termination of exercise by each subject. The final values for ventilation volume (VE) also were significantly greater with the respirator (89.2 +/- 3.4 L/min) than without (73.4 +/- 3.7 L/min). At the conclusion of the endurance walk, dyspnea index (VE/MMV.25) remained well below maximal values (with = 58.6 +/- 2%; without = 44.6 +/- 2%; p less than 0.001). Also, at the final period, no significant differences occurred in the subjects' perceptual ratings of work of breathing, yet work performance time was significantly reduced (p less than 0.0001) from 69.1 +/- 4.4 min (without) to 55.6 +/- 3.8 min (with). A significantly greater swing in peak pressure (maximum pressure measured within the facepiece of respirator), however, from inspired (PPi) to expired (PPe) occurred with the respirator (13.42 cmH2O) than without the respirator (9.25 cmH2O).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718907 TI - Insert-type hearing protector stability as a function of controlled jaw movement. AB - Samples of five insert-type hearing protectors (three viscose foam, one poly flanged, and one glass fiber) were evaluated for change in attenuation as a result of 30 min of controlled jaw movement. Protected-ear, narrow-band noise thresholds were obtained at octave intervals (between 0.25 and 4.0 kHz) before and after the jaw-movement activity. Frequency and interaction effects were not significant. Protector effects were significant beyond the 0.01 level of probability that chance caused the observed differences. As a group, the viscose foam protectors were more stable than the others. The most stable protector was E.A.R., and the least stable was Bilsom Soft. PMID- 2718908 TI - Decontamination of chemical protective clothing. AB - This study explored decontamination procedures for removing some organic solvents from protective clothing. The permeation experiments were performed on new and decontaminated specimens in seven polymer/chemical pairs. The decontamination methods investigated were thermal decontamination and air drying at room temperatures followed by detergent washing. Breakthrough time and steady-state permeation rate were determined by two different methods for new and decontaminated materials. The results showed that unless the contamination is limited to the outside surface of an elastomer (a material found in most barrier fabrics used in chemical protective clothing) or the chemical has a very large diffusion coefficient in the material, aeration and washing with detergent may not be an effective decontamination procedure for the type of solvent studied. On the other hand, thermal decontamination was shown to be effective in removing the contaminant from the matrix of the elastomers, and the decontaminated materials had permeation parameters similar to the new materials. PMID- 2718909 TI - An evaluation of the NIOSH guidelines for manual lifting, with special reference to horizontal distance. AB - A laboratory study was conducted to determine the percentage of subjects capable of lifting loads at the maximum permissible limit (MPL) and the corresponding energy expenditure, heart rate, compressive force on the L5/S1 disc, and ratings of perceived exertion. A second objective was to compare MPLs based on measured horizontal distances with those based on the rule of thumb proposed in the National Institute for Occupational Safety and Health (NIOSH) guide (H = 15 + w/2 cm). Thirteen male subjects were required to lift three different boxes (25, 38, and 51 cm wide) at four different frequencies (0.2, 3, 6, and 9 lifts/min) and at two heights (floor level to bench height [0.8 m] and bench height to 1.5 m). Each lift was performed for 1 hr, and horizontal distances for all 13 subjects were measured at the origin of the lifts. MPLs were computed for all lifting tasks. A psychophysical method was used to determine the maximum acceptable weight of a lift. This weight, however, was not allowed to exceed the corresponding MPL. Maximum acceptable weights for all 13 subjects were equal to the MPLs. Of 13 subjects, 9 indicated that they could lift weights significantly greater than the MPLs. MPLs for the bench to 1.5-m height were significantly greater than the corresponding MPLs for the floor to 0.8-m height. The mean heart rate for 1-hr lifting tasks ranged from 104 to 114 beats/min. The estimated compressive force on the L5/S1 disc ranged from 340 to 598 kg. The mean ratings of perceived exertion for floor level to bench height and bench height to 1.5-m lifts were 12 and 9.6 for the back and 9.3 and 13 for the shoulder, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718910 TI - Analysis of manual lifting tasks: a qualitative alternative to the NIOSH work practices guide. AB - A new method for evaluating ergonomic stresses on lifting tasks has been developed. This method utilizes the general procedures and hazard classification categories described in the National Institute for Occupational Safety and Health's (NIOSH) Work Practices Guide for Manual Lifting. The quantitative measurements of workplace dimensions and computations used by the NIOSH method to classify a job as "acceptable," "administrative controls required," or "hazardous" have been eliminated in favor of a table look-up procedure. A computer simulation was performed to compare results generated by the new method to results generated by the NIOSH method. The results of this simulation found that the new method was unbiased and was reasonably precise for most lifting activities. PMID- 2718911 TI - Acute diaphragmatic changes induced by starvation in rats. AB - The aim of this study was to assess in an in vivo rat model the effects of total starvation for 4 d on diaphragmatic strength and endurance. Twenty-four rats were divided equally into a control (CTL) group and a starved (ST) group. Diaphragmatic strength was assessed and endurance index was calculated. Starvation induced a parallel decrease in body weight and diaphragmatic weight amounting to 18% of the control group. Diaphragmatic contractility was impaired in the ST group. This reduction was associated with a significant reduction in transdiaphragmatic pressure (Pdi) for all the frequencies of stimulation, except 20 Hz, in the ST animals as compared with the CTL animals; however, no significant difference in Pdi expressed per gram of diaphragmatic mass was observed. Endurance index was 0.63 +/- 0.01 1.4 +/- 0.02 in the ST and CTL animals (p less than 0.01), respectively. We conclude that a 4-d total fast produces a reduction in diaphragmatic weight, which is associated with a decreased diaphragmatic strength and reduced endurance capacity. PMID- 2718912 TI - Metabolic response to low- and very-low-calorie diets. AB - We compared the metabolic effects of 8-wk caloric restrictions with 330 or 780 kcal/d in two groups of eight obese hospitalized subjects; six control subjects were also studied. Loss of weight but not of adipose tissue was significantly greater on the 330-kcal/d diet. It is likely that dehydration rather than protein catabolism was responsible for additional loss of fat-free mass in the 330-kcal/d group because the nitrogen deficit was not excessive. The thermic response to food was blunted only in the 330-kcal/d group whereas resting oxygen uptake decreased by equal amounts in both groups. There was a decrease in 24-h urinary noradrenaline in the 330-kcal/d group but plasma fT4 was sustained when compared with the 780-kcal/d group; fT3 decreased significantly more quickly in the 330 kcal/d group. There was no correlation between plasma hormone levels and changes in oxygen uptake. Hunger scores were greater on the 780-kcal/d diet. PMID- 2718913 TI - Body fat mass and basal metabolic rate in Dutch women before, during, and after pregnancy: a reappraisal of energy cost of pregnancy. AB - Body weight, fat mass, and basal metabolic rate were measured longitudinally from early pregnancy until 2 mo postpartum in 57 healthy Dutch women; 23 of whom were also studied before pregnancy. Weight gain over pregnancy was 11.8 +/- 3.7 kg and weight gain from 12 wk gestation to delivery was 10.3 +/- 3.8 kg. Birth weights and placental weights were 3458 +/- 527 and 657 +/- 114 g, respectively. Gain in maternal fat stores over pregnancy was 2.0 +/- 2.6 kg and difference in fat mass from 12 wk gestation to 5 wk postpartum was 1.2 +/- 2.2 kg. The energy equivalent of the gain in fat stores, including costs of synthesizing, can be estimated as 22,000 kcal. The cumulative increment in basal metabolism over pregnancy was 34,350 +/- 30,000 kcal. When the energy equivalent of the gain in tissue other than fat stores is assumed to be approximately 11,750 kcal, total energy cost of pregnancy is at 68,100 +/- 38,560 kcal. PMID- 2718914 TI - Studies in human lactation: secretion of zinc, copper, and manganese in human milk. AB - Zinc, copper, and manganese were measured in milk samples collected longitudinally from 13 highly selected, healthy lactating women. Samples were obtained at least weekly up to 1 mo and then monthly up to 18 mo postpartum or to weaning. Zn concentrations in milk declined throughout lactation from 71.9 +/- 18.3 mumol/L (means +/- SD) at 7 d to 44.3 +/- 10.7 mumol/L at 1 mo and 7.64 +/- 4.59 mumol/L at 12 mo. Cu levels also declined from 9.76 +/- 2.05 mumol/L at 7 d to 3.46 +/- 0.79 mumol/L at 5 mo with little change thereafter. Zn and Cu were not affected by weaning. Mn concentrations declined from 67.4 +/- 23.7 nmol/L at 1 mo to approximately 36 nmol/L by 3 mo and then remained constant to 7 mo when mean levels started to rise. Gradual weaning was associated with large and irregular changes in Mn levels. Total daily outputs in milk averaged 26.0 mumol Zn, 3.9 mumol Cu, and 35 nmol Mn over the first 3 mo postpartum and 13.8 mumol Zn, 2.7 mumol Cu, and 29 nmol Mn over the second 3 mo. PMID- 2718915 TI - Impact of dietary fat content and fat oxidation on energy intake in humans. AB - Three studies were performed to assess the effects of a high-fat diet and exercise-induced changes in fat oxidation on energy intake in humans. In the first study the short-term effect of a high-fat diet on spontaneous energy intake was investigated. The second study evaluated the long-term effect of a high-fat diet on adiposity and the third study evaluated the effect of exercise-induced changes in fat oxidation on short-term regulation of energy intake when subjects were consuming a high-fat diet. The results of these studies indicate that a high fat diet induces a short-term hyperphagia, a high percentage of lipids in the usual diet is associated with a higher adiposity, and exercise may attenuate or amplify the high-fat, diet-induced hyperphagia, depending on the magnitude of the exercise-induced increase in fat oxidation. PMID- 2718916 TI - Aminoaciduria of severe trauma. AB - Plasma and urine levels of free amino acids were measured in 15 severely traumatized adult patients while they were receiving fluids free of calories and nitrogen. Endogenous plasma clearance and the relative rates of reabsorption of free amino acids from renal tubules were calculated. These data were compared with similar studies of eight control subjects. Multiple injury provoked distinct patterns of free amino acids in plasma and urine. Hypoaminoacidemia and hyperaminoaciduria were seen in severe trauma. There was a marked depletion of nonessential amino acids in plasma of trauma victims. In contrast, the urinary loss of all amino acids was increased 5-10 times. This enhanced loss in patients, however, represented only 2.1% of total N excreted compared with 0.7% in control subjects. Considerable variations were seen in the selectivity with which various amino acids were reabsorbed by renal tubules. This may partly be due to the abnormal pattern of amino acids presented to renal tubules. PMID- 2718917 TI - Cocoa feeding and human lactose intolerance. AB - On the basis of evidence of the suppressing effect of cocoa on human lactose intolerance, a feeding study was conducted on 35 subjects with a commercial chocolate-milk formula. Variables studied were breath hydrogen level (BHL), symptoms, and onset time. Data from repeated feeding were analyzed by paired t tests. The addition of cocoa significantly reduced BHL (p less than 0.005) as well as the symptom score of both bloating (p less than 0.05) and cramping (p less than 0.025). Individual lactose intolerance levels ranged from 5% (basal milk) to 12.5% with an average of 7.8% upon consumption of 250 mL milk. Having both plain and cocoa formulas contain sucrose and carrageenan led to a conclusion that the suppressive effect of cocoa observed was independent of the presence of sucrose and carrageenan. Ninety-five percent of the subjects responded positively (BHL greater than 17 ppm) to the plain and 51% to the cocoa formula. PMID- 2718919 TI - Vitamin A activity of buriti (Mauritia vinifera Mart) and its effectiveness in the treatment and prevention of xerophthalmia. AB - The fruit of buriti, a palm tree that grows wild in some regions of Brazil, contains beta-carotene in its oily fraction in a concentration 10 times higher than that of red-palm oil. The effectiveness of buriti sweet in the treatment and prevention of xerophthalmia was tested in 44 children aged 43-144 mo through daily supplementation with an amount corresponding to 134 micrograms retinol equivalent over 20 d. The results demonstrated that this natural food source of vitamin A can reverse clinical xerophthalmia and restore liver reserves of the vitamin, suggesting its possible utilization in intervention programs to combat vitamin A deficiency in countries where the fruit is available or has the potential for cultivation. PMID- 2718918 TI - Oral contraceptives: effect of long-term use on liver vitamin A storage assessed by the relative dose response test. AB - Vitamin A status measured by the relative dose response (RDR) test was determined among groups of Northern Thai women who had used estrogen-containing oral contraceptives (OCs) with or without multivitamin supplements through 13 cycles. Mean serum vitamin A values were elevated approximately 40% above those of control subjects (intrauterine contraceptive device (IUCD) users) during OC usage. Daily (one capsule) or periodic (two capsules 7 d/mo) multivitamin supplementation that included 1700 micrograms vitamin A per capsule did not significantly influence vitamin A serum values. The RDR test after 13 cycles was elevated in one individual who had taken OCs and the periodic multivitamin supplement. It reverted to normal after supplementation with vitamin A. A single high-dose vitamin A supplement (68,000 micrograms) did not change circulating levels of the vitamin. Among this population there is little evidence that use of estrogen-containing OCs for greater than 1 y resulted in a physiologically significant deterioration of vitamin A status. PMID- 2718920 TI - Experimental selenium restriction in healthy adult humans: changes in selenium metabolism studied with stable-isotope methodology. AB - Mechanisms responsible for selenium homeostasis were investigated in healthy adult men receiving diets adequate or low in Se (eight subjects per group). The appearance of a stable isotope of Se, 74Se, in plasma, urine, and feces was measured after oral administration of 74Se-selenite. One group received a restricted level of Se (18 +/- 1 micrograms/d) for 30 d, which resulted in a decrease in urinary, fecal, and plasma Se content compared with the group that consumed 119 +/- 1 micrograms/d. Low Se intake also resulted in decreased urinary 74Se excretion (27.2 +/- 1.4% vs 32.5 +/- 2.3% of the absorbed dose for the adequate intake), increased body retention of 74Se (74.8 +/- 3.1% vs 67.6 +/- 3.8% of the absorbed dose for the adequate group), and a contracted selenite exchangeable metabolic pool (Se-EMP) (9782 micrograms for adequate Se and 6314 micrograms for the low-Se group; p less than or equal to 0.05). Measurement of Se EMP may provide an additional and sensitive approach for assessing Se nutriture in human subjects. PMID- 2718921 TI - Ascorbic acid-selenite interactions in humans studied with an oral dose of 74SeO3(2-). AB - The interaction between dietary ascorbic acid at extremes of ascorbic acid intake and selenium in young adult male humans was investigated with a stable-isotope approach using 74Se-selenite. Measurements were made of 74Se in plasma, urine, and feces with neutron-activation analysis after oral administration of 74SeO3(2 ). Urine excretion and total body retention of isotope and the selenite exchangeable metabolic pool (Se-EMP) were calculated. Limiting dietary ascorbic acid to about 20 mg/d appeared to reduce the time-related retention of absorbed selenite and the size of Se-EMP. Compared with a diet providing 1 g ascorbic acid/d the low ascorbic acid intake was associated with a lower fractional absorption of the isotope, a reduced retention of the label, and a smaller Se EMP. These data and those previously obtained in subjects with more usual ascorbic acid intakes point to a possible important role for ascorbic acid in the maintenance of Se homeostasis. PMID- 2718922 TI - Copper absorption and retention in young men at three levels of dietary copper by use of the stable isotope 65Cu. AB - Eleven young men were confined to a metabolic research unit for 90 d to determine the effect of the level of dietary copper on absorption and retention. Cu absorption was determined by feeding the stable isotope 65Cu. Absorption and retention averaged 36.3 +/- 1.3% and 0.17 mg/d, respectively, with an adequate-Cu diet (1.68 mg/d). Absorption averaged 55.6 +/- 0.9% and retention averaged -0.316 mg/d for 6 d and 0.093 mg/d for the next 36 d of a low-Cu diet (0.785 mg/d). Absorption averaged 12.4 +/- 0.9% with a high-Cu diet (7.53 mg/d) and retention was strongly positive at first, decreasing linearly with time. The study demonstrated that Cu absorption is strongly dependent on dietary Cu level and that Cu balance can be achieved by most young men from a diet of 0.8 mg Cu/d. These results suggest that current dietary Cu recommendations may be higher than necessary. The apparent regulation of Cu absorption and endogenous losses would tend to protect humans from Cu deficiency and toxicity. PMID- 2718923 TI - Anthropometric indicators and risk of death. AB - Six anthropometric indicators based on weight, height, arm circumference (AC), and age were examined to predict mortality risk of children aged 12-59 mo in a rural area of Teknaf, Bangladesh. In the period 1981-85, 9861 measurements at 6 mo intervals were made on 2449 children. For all indices mortality risk was greater in the first 3 mo than in the second 3 mo in severely malnourished children. Mortality discriminating power of the indicators in terms of sensitivity and specificity was highest for AC and AC for age and lowest for weight-for-height. Logistic regression analysis showed that the predictive power of weight-, height-, and age-based indicators improved after adding AC whereas predictive power of AC did not improve after adding weight-based indicators. The relative risk of death in children with ACs measuring less than or equal to 120 mm was 12 times higher than in those whose ACs measured greater than 140 mm. PMID- 2718924 TI - Food consumption patterns in the 1960s in seven countries. AB - At the end of the 1950s the Seven Countries Study was designed to investigate the relations between diet and cardiovascular diseases. Sixteen cohorts were selected in Finland, Greece, Italy, Japan, The Netherlands, United States, and Yugoslavia. During the 1960s food consumption data were collected from random samples of these cohorts by use of the record method. In Finland the intake of milk, potatoes, edible fats, and sugar products was very high. A similar but lower intake pattern was observed in The Netherlands. Fruit, meat, and pastry consumption was high in the United States; cereal and alcoholic drink consumption was high in Italy; and bread consumption high in Yugoslavians except for those in Belgrade. In Greece the intake of olive oil and fruit was high and the Japanese cohorts were characterized by a high consumption of fish, rice, and soy products. These differences in food consumption patterns have lessened during the past 25 y. PMID- 2718925 TI - Serologic precursors of cancer: serum micronutrients and the subsequent risk of pancreatic cancer. AB - In a nested case-control study the stored, frozen sera from 22 cases of cancer of the pancreas and 44 matched control subjects were assayed for retinol, retinol binding protein, total carotenoids, beta-carotene, lycopene, vitamin E (alpha tocopherol), and selenium. Prediagnostic serum levels of lycopene and Se were lower among cases than among matched control subjects. These differences remained after adjustment was made for possible confounding by smoking, educational level, and the other measured serum levels. Low levels of serum vitamin E appeared to have a protective effect but a chance association between vitamin E and cancer of the pancreas could not reasonably be excluded. The association between cancer of the pancreas and serum Se was significant when the data were analyzed as a whole but its effect was seen principally in men. PMID- 2718926 TI - Physical activity, fitness, and diet: behavior in the population compared with elite athletes in the GDR. PMID- 2718927 TI - Nutrition as a component in community control of cardiovascular disease (the North Karelia Project). PMID- 2718928 TI - Policies and programs in nutrition and physical fitness in Australia. PMID- 2718929 TI - Policies and programs in nutrition and physical fitness in Italy. PMID- 2718930 TI - United States government policies and programs in nutrition and physical fitness. PMID- 2718931 TI - Changes of nutrition patterns and health indicators at the population level in Greece. PMID- 2718932 TI - Assessment of youth fitness: the European perspective. PMID- 2718933 TI - Fitness and nutrition policy in developing nations: Kenya's example. PMID- 2718934 TI - Policies and programs in nutrition and physical fitness in Venezuela. PMID- 2718935 TI - Some nutrition policies in China. PMID- 2718936 TI - A priority for the World Health Organization: promoting healthy ways of life. PMID- 2718937 TI - International Olympic Committee Medical Commission's policies and programs in nutrition and physical fitness. PMID- 2718938 TI - Eating for health or for athletic performance? PMID- 2718939 TI - Macronutrient intake of US athletes compared with the general population and recommendations made for athletes. PMID- 2718940 TI - Weight cycling: the experience of human dieters. PMID- 2718941 TI - Physical activity as a supplement to a weight-loss dietary regimen. PMID- 2718942 TI - First International Conference on Nutrition and Fitness. Proceedings of a conference. Ancient Olympia, Greece, May 21-26, 1988. PMID- 2718943 TI - Special presentation. Health, fitness, and sport. PMID- 2718944 TI - Metabolic fuels, utilization, and exercise. PMID- 2718945 TI - Diet and energy expenditure. PMID- 2718946 TI - The role of nutrition and fitness in chronic diseases. PMID- 2718947 TI - Policies and programs in nutrition and physical fitness: framework for a national physical activity policy. PMID- 2718948 TI - What constitutes good nutrition for the athlete and postathlete. PMID- 2718949 TI - Weight cycling. PMID- 2718950 TI - Energy balance in ultramarathon running. PMID- 2718951 TI - Lipids and lipoprotein profiles in a 4-h endurance test on a recumbent cycloergometer. PMID- 2718952 TI - The pathologic characteristics of interstitial pneumonia cystic fibrosis. A retrospective autopsy study. AB - Interstitial pneumonia is a poorly understood variant of lung injury in patients with cystic fibrosis (CF). The authors identified prominent interstitial pneumonia (defined as an inflammatory reaction predominantly involving alveolar septa) in 9 of 43 autopsied patients with CF. Lungs from these nine were studied by light microscopy to determine the histopathologic features, clinicopathologic correlates, and potential causes of CF-associated interstitial pneumonia. Two histologic variants were identified, alveoloseptal (in which the inflammatory reaction was confined to the alveolar wall) and organizing (in which intraalveolar granulation tissue was present in addition to septal inflammation), which respectively affected four and five patients. Cholesterol deposits and capillary proliferation were prominent associated features in some patients. Interstitial pneumonia was not diagnosed antemortem and was identified on chest roentgenogram in only two patients. There were no distinctive clinical features associated with different histologic subtypes, nor did histologic or clinical data identify a specific cause(s) of interstitial pneumonia. The authors conclude that CF-associated interstitial pneumonia, although usually an incidental finding at autopsy, may potentially contribute to respiratory impairment and death. Although there are multiple possible causes of interstitial lung injury associated with CF, the authors were unable to identify, with certainty, the pathogenesis of interstitial pneumonia in any patient in this study. PMID- 2718953 TI - Interstitial fibrosis in the pancreas. AB - Pancreas specimens from 76 autopsies were examined histologically to evaluate the degree and extent of interstitial fibrosis (IF) and its clinicopathologic relationships. Fifty-two cases (68%) showed IF, a fairly high prevalence, that was not statistically related to age. There was a significantly higher prevalence of IF in patients with diabetes mellitus, most of whom had type 2 diabetes. No statistically significant relationships between IF and the cause of death or other clinical conditions were found. Acinar atrophy, periductal fibrosis, and nonpapillary ductal hyperplasia were often associated with IF. All cases with periductal fibrosis (PF) also showed IF, so PF may be a part of this process. Eight cases (11%) of chronic terminal pancreatitis were noted, which is defined as a lesion of moderate to severe chronic inflammation and various degree of IF in cases without any clinical evidence of pancreatic disease before death. PMID- 2718954 TI - Monocyte induces alkaline phosphatase synthesis in neutrophils of chronic myeloid leukemia and myelofibrosis with myeloid metaplasia patients. AB - Studies were done to test the neutrophil alkaline phosphatase (NAP) synthesizing capacity of the neutrophils of patients with chronic phase chronic myeloid leukemia (CML) and of patients with stable-phase myeloid metaplasia (MM) and to test the NAP synthesis-inducing capacity of monocytes (Mos) of patients with CML. Suspension cultures of the blood light density (LD) cells, LD cells depleted of T cells and Mos (LD-T-Mo), and cocultures of LD-T-Mo with Mos were performed. NAP synthesis occurred in a normal fashion in LD cell cultures of five of seven patients with CML and of two patients with MM. The NAP synthesis was very slight or did not occur in cultures of LD-T-Mo cells of all patients with chronic-phase CML and MM. However, addition of allogeneic or autologous Mos to the LD-T-Mo cultures restored the NAP synthesis. These results confirm the previous finding that the low or absent NAP in CML is caused by a relative reduction in the monocyte mass and they further indicate the mechanism to be the same for the low or absent NAP in patients with MM. The results also indicate that the NAP synthesizing capacity of neutrophils of CML and MM patients and the NAP synthesis inducing capacity of the Mos of patients with CML are normal. PMID- 2718955 TI - Laboratory evaluation of differential white blood cell count information from the Coulter S-plus IV and Technicon H-1 in patient populations requiring rapid "turnaround" time. AB - Automated differential counts produced by the Coulter S-Plus IV (S + 4) and the Technicon H-1 (H-1) were compared with routine and reference manual differentials with the use of samples from the adult emergency room (ER) and the neonatal intensive care unit (NICU), populations in which rapid reporting of laboratory results is considered important. Error rates for routine technologists were 9.3% in the ER and 15.3% in the NICU. Error rates for the two instruments were higher than those for technologists with samples from the ER but could be reduced to 4 5% if instrument flags and additional criteria were used to signal the need for a conventional differential. Instrument error rates were higher yet with NICU samples, and specificity was very low (10% for each device). There were small differences between the instruments in detection of immature neutrophils, but flags from the H-1 were more specific (except for detection of nucleated red blood cells in samples from the ER). If either instrument were used in an adult ER and flags and additional criteria were used to signal the need for conventional differentials, 64-75% fewer manual counts would be performed with no decrease in accuracy and a considerable improvement in turnaround time. PMID- 2718956 TI - Glycohemoglobin quantitation by alkaline gel electrophoresis. A reliable technique with practical clinical advantages. AB - The Beckman Paragon alkaline gel electrophoresis system was evaluated for utility in identification and quantitation of glycosylated hemoglobin in the clinical laboratory setting. In contrast to other alkaline hemoglobin electrophoresis systems, this system provides adequate separation of HbA0 from its glycosylated form. A band anodal to HbA0 was identified as glycohemoglobin; in vitro synthesis of glycohemoglobin confirmed the migration pattern of the glycohemoglobin band. In both in vitro synthesis studies and in a series of 48 patients, quantitation of the glycohemoglobin band by densitometry showed good correlation (r = 0.99 and r = 0.96, respectively) with values obtained by a standard column chromatographic technique. Beyond reliable quantitation of glycohemoglobin, this system offers two advantages. First, it discriminates hemoglobin F and hemoglobins with low isoelectric points that may coincidentally be measured as glycohemoglobin by other techniques. Second, it provides simultaneous detection of common hemoglobinopathies, a necessity for accurate reporting of glycohemoglobin in the diabetic patient with a concomitant hemoglobinopathy. PMID- 2718957 TI - Invasive carcinomas of the urinary bladder. Evaluation of tunica muscularis mucosae involvement. AB - Awareness of the existence of a tunica muscularis mucosae in the urinary bladder complicates the assessment of muscle invasive carcinomas on bladder biopsy. Sixty cystectomy specimens and select bladder biopsies were reviewed to analyze this problem. The patterns of development of the tunica muscularis mucosae were categorized as continuous, interrupted, scattered, or absent. Most bladders demonstrated several patterns of development rather than a uniform appearance. The most frequently observed pattern was that of scattered smooth muscle fibers seen in 33 of 40 (82.5%) cases. The rarity of carcinomatous invasion limited to the tunica muscularis mucosae is emphasized. The authors conclude that the potential for overstaging bladder carcinomas because of misinterpretation of this structure is small. PMID- 2718958 TI - Immunophenotypic diagnosis of non-Hodgkin's lymphoma in paraffin sections. Co expression of L60 (Leu-22) and L26 antigens correlates with malignant histologic findings. AB - The recent availability of monoclonal antibodies immunoreactive to T- or B lineage antigens in formalin-fixed, paraffin-embedded tissue has permitted the adaptation of frozen-section immunodiagnostic criteria to paraffin-embedded tissue. Among a variety of reactive lymphoid processes, monoclonal antibody L26 showed a pattern of staining consistent with pan-B reactivity. Antibodies L60 (Leu-22) and UCHL-1 showed a pan-T and T-subset pattern of reactivity, respectively. In benign processes, L26 and L60 (or UCHL-1) were not coexpressed. In contrast, among 77 B-lineage non-Hodgkin's lymphomas, 42% showed aberrant co expression of L26 and L60. The L26+/L60+ phenotype was most common in small lymphocytic lymphomas (80%) but was also noted in one third of diffuse large cell lymphomas. Expression of UCHL-1 was not identified in B-lineage neoplasms but was found, along with L60, on four of five T-lineage lymphomas studied as controls. The authors conclude that the anomalous coexpression of L60 and L26 antigens is a unique feature of B-lineage lymphomas and can be used for the immunodiagnosis of these malignancies in routinely processed tissue. PMID- 2718959 TI - Inversion of the gallbladder. AB - A case of inversion of the gallbladder is described, in which the fundus was inverted into the body of the organ. A localized area of adenomyomatosis (adenomyoma) was present at the apex of the invertum. PMID- 2718960 TI - Secondary massive ovarian edema with Meig's syndrome. AB - Primary massive ovarian edema is uncommon, particularly when it involves both ovaries before puberty. Ovarian edema secondary to a preexisting ovarian lesion is one of the postulated mechanisms. A prepubertal girl presented with bilateral massive ovarian edema with stromal hyperthecosis, which may have predisposed both ovaries to undergo partial torsion. The associations with Meig's syndrome, greatly elevated hormone levels and presence of omental and retroperitoneal nodules, raised a suspicion of malignancy. PMID- 2718961 TI - A case of plasmacytoma in muscle as a complication of needle tract seeding after percutaneous bone marrow biopsy. AB - A 56-year-old man who presented with backache, anemia, and renal insufficiency had an unsuccessful bone marrow biopsy from the right posterior iliac crest. A diagnosis of multiple myeloma was subsequently made on the basis of a sternal bone marrow aspiration and the presence of serum IgD/lambda monoclonal gammopathy with free lambda light chain. Since the time of iliac crest biopsy, the patient experienced persistent pain and progressive swelling at the biopsy site. Nine months later he was readmitted for a possible right gluteal abscess. A biopsy specimen disclosed an intramuscular infiltration by atypical plasma cells with positive findings for lambda light chain. This is the first reported case of needle tract seeding after bone marrow biopsy in multiple myeloma. PMID- 2718962 TI - Fatal Streptobacillus moniliformis infection in a two-month-old infant. AB - Streptobacillus moniliformis is an uncommon human pathogen contracted from exposure to rodents. It usually produces a mild, protracted illness (rat-bite fever, Haverhill fever, erythema arthriticum epidemicum) that has either a favorable response to antibiotic therapy or spontaneously resolves. This report describes a fatal case of Streptobacillus moniliformis in an infant bitten by a wild rat. The autopsy findings included an interstitial pneumonia, fibrinous endocarditis, mild mononuclear meningitis, hepatosplenomegaly and lymphadenopathy, erythrophagocytosis, and sinusoidal mononuclear cell infiltrates in regional lymph nodes and the liver. To the authors' knowledge, this is the first report of the autopsy pathology findings of this agent. PMID- 2718963 TI - Pathology of culture-proven JK Corynebacterium pneumonia. An autopsy case report. AB - The first description of the pathologic characteristics of JK Corynebacterium pneumonia is presented. Occurring in a profoundly neutropenic patient, the pneumonia was characterized by massive fluid exudation in the alveoli with acute hemorrhage, significant proliferation of the bacteria beginning along the alveolar walls, and eventual alveolar wall necrosis. Other cases of JK Corynebacterium pneumonia are reviewed. This report emphasizes that JK Corynebacterium pneumonia has a high mortality and should be considered in patients with pulmonary deterioration and blood cultures positive for diphtheroids. PMID- 2718964 TI - Molecular analysis of viridans and nutritionally deficient (variant) streptococci causing sequential episodes of endocarditis in a patient. AB - Clinical blood isolates from sequential episodes of endocarditis occurring over a six-month period of time in an addict were investigated. The pathogens were Streptococcus sanguis II, Streptococcus mitis, and a nutritionally deficient (variant) streptococcus. The authors determined the DNA relatedness of these isolates by antibiograms, plasmid profiles, chromosomal endonuclease restriction digestions, and dot blot DNA-DNA hybridization analyses. The S. sanguis II and nutritionally deficient streptococcal strain had similar antibiograms being resistant to penicillin; neither produced beta-lactamase. No plasmids were found. The restriction endonuclease chromosomal digestion patterns of these isolates were unique and epidemiologically unrelated to each other. Dot blot DNA-DNA hybridizations, using the nutritionally deficient streptococcal DNA as the probe, showed homology to the preceding clinical isolates, S. sanguis II and S. mitis, at 15.4% and 45.1% hybridization levels, respectively. The nutritionally deficient streptococcus was only 4.2% homologous to a S. mitis ATCC strain and another nutritionally deficient streptococci isolate. Therefore, this patient had endocarditis with three distinct streptococcal strains. PMID- 2718965 TI - Estrogen receptors. PMID- 2718966 TI - The specialty of orthodontics. PMID- 2718967 TI - The search continues for an orthodontic assistant profile. PMID- 2718968 TI - Functional orthopedic magnetic appliance (FOMA) II--modus operandi. AB - A new functional appliance (FA) to correct Class II dentoskeletal malocclusions is introduced. The functional orthopedic magnetic appliance (FOMA) II uses upper and lower attracting magnetic means (Nd2Fe14B) to constrain the lower jaw in an advanced sagittal posture. In vitro, a special gauge transducer measured the magnetic attractive path and forces. In vivo, 13 prepubertal female Macaca fascicularis monkeys received facial implants and were treated for 4 months with the following appliances: conventional FA (four subjects), FOMA II (five subjects), a combined FOMA II + FA (two subjects), and sham (control) appliance (two subjects). The in vitro results showed the following: vertico-sagitally displaced upper and lower magnets attracted ultimately along an oblique line with a terminal horizonal slide to become fully superimposed; the functional performance improved when the magnetic interface acted as a magnetic inclined plane; and the magnetic force was able to guide and constrain the mandible toward the constructive protrusive closure position (CPCP) (1.2 mm, F = 570 gm) from levels below the habitual rest position (3 mm, F = 219 gm) and the electromyographic (EMG) relaxed position (8.5 mm, F = 45 gm). The in vivo results demonstrated the following: functional performance increased in FOMA II (22%) and in the combined FOMA II + FA (28%) over the conventional FA; mandibular length increased significantly in the treated animals (means = 2.83 +/- 0.70 mm) over the control animals (means = 0.43 +/- 0.08 mm); incisor proclination was lower in magnetic appliances (means = 4.57 +/- 1.76 degrees) than in the conventional FA (means = 8.75 +/- 1.85 degrees); mandibular elongation and condylar posterior inclination resulted from posterosuperior endochondral growth (increased cell proliferation and/or hyperplasia of functional chondroblasts) and by bony remodeling of the condylar neck (apposition posterior border, resorption anterior border), respectively; virtually no anterior displacement of the postglenoid spine (means = 0.19 +/- 0.68 mm) nor the articular eminence (means = 0.36 +/- 0.69 mm) was found. Increased lower posterior alveolar height (means = 1.71 +/- 0.82 mm) is a major impediment in the correction of excessive lower anterior facial height. The results of the study highly recommend the exploration of the clinical application of the FOMA II. PMID- 2718969 TI - Physical and mechanical properties of elastomers in orthodontic positioners. AB - Elastomers for conventional Kesling-type tooth positioners are relatively inelastic and are primarily indicated as finishing devices. However, new materials, first described in the Japanese literature, with claims of a greater range of tooth movement warrant a comparison with conventional materials. Physical and mechanical property testing of positioner elastomers has not been reported in the orthodontic literature. This investigation compared properties of a high temperature vulcanizing (HTV) Japanese silicone (Orthocon) to three traditional polyurethane and vinyl-based polymers and five experimental silicone elastomers. Fourier transform infrared spectroscopy established the definitive chemical composition of the urethane and vinyl materials obtained from a commercial positioner laboratory. Tear strength, tensile strength, tensile stress at selected elongations, and ultimate elongation of all materials were evaluated at 37 degrees C in an aqueous environment. Hardness and water sorption values also were determined and an in vitro force measurement apparatus was fabricated to determine force levels exerted by positioner materials at low displacements. Orthocon was statistically different (Duncan's multiple range test, p less than 0.05) from the traditional commercial urethane and vinyl materials. Orthocon had lower tear strength than the traditional materials. It also demonstrated lower stress values below 100% elongation. The parameters of tensile stress at 50% elongation and ultimate elongation were statistically identical for Orthocon and one experimental silicone material. PMID- 2718970 TI - The effect of the amount of protrusion built into the bionator on condylar growth and displacement: a clinical study. AB - To evaluate the treatment effects of a variable degree of forward posturing of the mandible incorporated into the Bionator, a study was undertaken on 14 patients with Class II, Division 1 malocclusion, treated for 1 year with a Bionator, maintaining the mandible in an edge-to-edge incisal position (Be group). This group was compared with a matched group of patients treated with the Bionator in whom the mandible was maintained in a "functional maxipropulsion" (Bmax group). Both groups were subdivided further according to sex for selected parameters. Twenty-nine measurements on cephalometric x-ray films taken before and after 1 year of treatment were statistically analyzed. According to this study, "edge-to-edge" protrusion is superior to "functional maxipropulsion" in increasing ramal height. The difference in increase in corpus length after treatment (greater in boys than in girls) was sex related rather than dependent on appliance characteristics. When studying the effect of functional appliances, it is suggested that a patient group be subdivided by sex. After treatment a repositioning of the condyle was found in a more downward and possibly slightly forward direction relative to sella point (S) in both groups. A relocation of the condyle should be considered as another treatment effect of functional appliances. The more important lowering of the condyle found in the Bmax group may partly explain the significant increase in SNB, the 1.6-fold larger decrease in overbite, and the highly significant increase in anterior lower facial height in this group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718971 TI - Perioral force measurement by a radiotelemetry device. AB - A telemetric method was developed to monitor the active and passive perioral forces exerted on the maxillary dental arch. The system consists of intraoral and extraoral units. An electromagnetic coupling between intraoral and extraoral coils supplies the power of the intraoral unit and transmits the signals induced by variations in perioral forces. The force sensor has a diameter of 6 mm, a thickness of 1 mm, and is constructed of an 0.08 mm thick cantilever beam to which semiconductor strain gauges are cemented. Clinical application of the system was tested in four adult subjects. The forces on the labial surface of an upper central incisor were 1.5 gm/cm2 during rest, 10.9 gm/cm2 during swallowing, and 5.0 gm/cm2 during speech; the corresponding lingual forces were 4.0 gm/cm2, 19.1 gm/cm2, and 13.9 gm/cm2, respectively. Lingual forces were always higher than labial forces. The telemetry system can be used to monitor up to 6 hours of continual variations in perioral forces. PMID- 2718972 TI - Maxillary superimposition: a comparison of three methods for cephalometric evaluation of growth and treatment change. AB - Two anatomic methods are statistically compared with the implant method for superimposing serial head films in 18 subjects with metallic implants. Findings showed that the "best fit" method--that is, superimposition along the palatal plane registered at ANS--traditionally used by orthodontists, significantly underestimates the eruption of the teeth by 30% to 50%. The "structural method," which is based on the use of stable structures in the maxilla, showed no significant differences in vertical displacement of selected landmarks in comparison with the implant method. PMID- 2718973 TI - Partitioning of ventilation between nose and mouth: the role of nasal resistance. AB - We have examined the relationship between nasal resistance (Rna) and the distribution of ventilation between the nose and mouth in 10 normal breathing children and 15 children who met clinical criteria of mouth breathing. We studied Rna by posterior rhinometry. We used a face mask divided into separate oral and nasal chambers to measure oral and nasal components of ventilation. Each chamber of the mask was connected to a separate pneumotachograph. We measured oral and nasal tidal volumes (VTna) by integration of the oral and nasal flow, and calculated the total tidal volume (VTtot) by summing the oral and nasal components. The nasal fraction of ventilation (F-VTna) was calculated by dividing VTna by VTtot. We found a weak inverse correlation between Rna and F-VTna, but eight of 25 children did not breathe as one might predict on the basis of Rna, and eight of 15 children who appeared to be mouth breathers actually breathed through the nose. We administered a vasoconstricting nasal spray and a placebo nasal spray to the children and, although Rna changed significantly, we observed no change in the distribution of flow between the nose and mouth. In summary we found that clinical criteria of mouth breathing do not accurately identify children who actually breathe mainly through the mouth. Moreover Rna is only a weak predictor of the pattern of breathing; hence other factors may be important determinants of the distribution of flow between the nose and mouth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2718974 TI - Maxillary canine-lateral incisor transposition--orthodontic management. AB - A case of maxillary canine-lateral incisor complete transposition is presented. Treatment options for transposed teeth, including alignment in their transposed positions, extraction of one or both transposed teeth, and orthodontic alignment to their normal positions in the arch, are discussed. The orthodontic technique and sequence used in this challenging case to align the fully transposed teeth to their normal position in the dental arch are described. PMID- 2718975 TI - Legal aspects of orthodontic practice: risk management concepts. Periodontal disease in orthodontic practice. 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. PMID- 2718976 TI - Adolescents' knowledge and beliefs about AIDS: did the government brochure help? PMID- 2718977 TI - Interactions of alcohol and nutrition. PMID- 2718978 TI - Tack up a warning on TAC. PMID- 2718979 TI - Telephone etiquette: the telephone, one of the physician's most necessary and, at times, most hated devices. PMID- 2718980 TI - Prolonged intravenous infusions. PMID- 2718981 TI - Research during residency. PMID- 2718982 TI - Prolactinoma in an adolescent girl: unusual response to bromocriptine therapy. PMID- 2718983 TI - Is standard practice in pediatrics 'standard'? A potential lesson for experts and practitioners. PMID- 2718984 TI - Dietary advice. Responsibility for monitoring. PMID- 2718985 TI - Growth failure. A complication of dietary treatment of hypercholesterolemia. AB - We describe 8 children among a group of 40 in whom growth failure was associated with unsupervised dietary treatment of hypercholesterolemia. In 3 children, nutritional dwarfing ensued, and in 5, weight loss or insufficient weight gain occurred. Children with growth failure consumed significantly less energy and zinc than those children growing well. The dietary intakes of the 3 children with nutritional dwarfing were the most markedly deficient in total energy, fat, and micronutrients. These data suggest that the diagnosis and dietary treatment of hypercholesterolemia have potentially adverse consequences. Overzealous application of a low-fat, low-cholesterol diet may lead to growth failure due to inadequate intake of energy, vitamins, and minerals. Careful monitoring of children receiving modified fat and cholesterol intakes for hypercholesterolemia treatment is mandatory to ensure adequate nutrition for normal growth and development. PMID- 2718986 TI - Tracheobronchial foreign bodies. A persistent problem in pediatric patients. AB - Extraction of a foreign body from the tracheobronchial tree was accomplished for 83 children. The mean age was 1 year 9 months for the 27 girls and 3 years 1 month for the 56 boys; 46 children (55%) were younger than 2 years of age. Sixteen (19%) of the foreign bodies were radiopaque, and 35 (42%) were either verified or suspected radiologically before endoscopy. Forty-one foreign bodies (49%) were situated in the right bronchial tree. Extraction was successful in 81 children (98%) and was performed on 50 children (60%) during the first 24 hours. Twenty-five (30%) of the foreign bodies were peanuts. Three children experienced a residual foreign body, without serious complications. We believe that an open tube bronchoscopy should be performed whenever abnormal stridor or cough is observed in a healthy child and when appropriate antibiotic therapy is unsuccessful. PMID- 2718987 TI - Pediatric coin ingestions. A prospective study of coin location and symptoms. AB - Coins are the most common esophageal foreign body in children. We prospectively evaluated 52 consecutive children who had swallowed coins to determine the incidence of asymptomatic esophageal coins and the rate of spontaneous passage. All patients had a roentgenogram; coins were removed from the esophagus if the patient was symptomatic. children with asymptomatic esophageal coins were allowed less than 24 hours to pass the coin to the stomach. Thirty children had esophageal coins; of these, 9 (30%) were asymptomatic. The presence of symptoms was significantly associated with esophageal coins, but the absence of symptoms did not reliably exclude the possibility of an esophageal coin. All children who swallow coins should undergo roentgenographic evaluation. PMID- 2718988 TI - Pediatric coin ingestion. A prospective study on the utility of routine roentgenograms. AB - It has been recommended that all children with a history of coin ingestion immediately undergo roentgenography to locate the coin, regardless of symptoms. We performed a prospective evaluation of these ingestions to determine the risk of asymptomatic esophageal impaction and the need for routine roentgenography. One hundred sixty-two children (mean +/- SD age, 3.6 +/- 2.1 years) were evaluated. All were referred for immediate roentgenography after ingestion and followed up daily by telephone for 5 days. Sixty-six patients (41%) did comply and 96 (59%) did not comply with the roentgenogram recommendation. A coin was visualized in the esophagus of 13 patients (20%); 11 were symptomatic and 2 were asymptomatic at the time of ingestion. Symptomatic patients had a 42% risk of a coin later being located in the esophagus compared with a 5% risk for asymptomatic patients. The asymptomatic patients with lodged coins passed them without difficulty after the administration of oral fluids. Nineteen percent of the patients who did not undergo roentgenography were symptomatic and all became asymptomatic within 24 hours of ingestion. There was no difference in morbidity between the group that underwent roentgenography and the group that did not undergo roentgenography at 5 days after ingestion. Children who are asymptomatic at the time of coin ingestion may not need routine roentgenography if they can tolerate oral fluids and telephone follow-up is available. PMID- 2718989 TI - Unintentional injuries. Risk factors in preschool children. AB - Successful strategies for preventing childhood injuries require better understanding of injury epidemiology. A case-control study was designed to identify risk factors for injury among preschool patients of a university affiliated, community-based family practice center. Thirty-four children who were injured during a 1-year period and 36 age- and sex-matched controls were included. A description of the injury incident and data from each child's medical record and a parent interview were recorded. All injuries were relatively minor. The following were associated with increased injury risk: a history of a chronic medical condition; weight in the lowest 25th percentile of the national distribution; birth order of third or later in the family; maternal education higher than the high school level; and, possibly, a history of previous injury. PMID- 2718990 TI - Strength, flexibility, and maturity in adolescent athletes. AB - The relationship between lower-extremity strength and flexibility and maturational status as measured by Tanner staging (TS) was assessed in 84 male high school athletes. The sum of one-repetition maximum lifts for knee extension and flexion was determined and flexibility was measured with the American Alliance of Health, Physical Education, Recreation, and Dance sit-and-reach test. Chronologic age, body weight, and percent fat were also recorded. Strength and flexibility were compared for each maturational and chronologic age category. Maturational age was better correlated with strength and flexibility than was chronologic age. All correlations were significant. Multiple regression analysis demonstrated significant correlations of TS and age with strength and flexibility. Tanner staging had greater predictive value than age for strength and flexibility. After adjusting for age, the relationship between TS and strength remained significant. PMID- 2718991 TI - Smoking policy in pediatric hospitals and wards. AB - The American Academy of Pediatrics has recommended that pediatricians take the lead in banning cigarette smoking in all pediatric health care facilities. This study investigated the use of "nonsmoking" policies and their planned revisions, problems in enforcement, and any history of challenges to restrictive or lenient policies. The surveys were mailed to 329 hospitals affiliated with pediatric training programs as the institutions most likely to attempt to comply with the American Academy of Pediatrics recommendations. Representatives from 199 (60%) of the programs responded. The programs had a range of 12 to 350 pediatric beds in children's hospitals (27%), pediatric wards (69%), or general hospitals (4%). Only nine hospitals were "smoke-free," ie, having no designated indoor area for smoking. Another 35 had "restrictive" policies allowing smoking in only a single site or two preselected sites. Pediatric hospitals or wards were no more likely to have smoke-free policies than general hospitals. Existence of smoke-free or restrictive policies was unrelated to any other factor examined. Smoke-free and restrictive policies were more likely to be rigorously enforced but not more likely to engender formal challenges. Although almost all policies had been recently or are being revised, pediatric hospitals and wards remain remiss in controlling childhood smoke exposure. PMID- 2718992 TI - Ebstein's anomaly and extracardiac defects. AB - Ebstein's anomaly of the tricuspid valve occurs as an isolated defect with other forms of congenital heart disease such as transposition of the great arteries or tetralogy of Fallot or, rarely, in association with extracardiac malformations. Because so little is known about this latter group, we studied four cases clinically, at autopsy, and by means of a retrospective chart review. Major extracardiac changes most often involved the craniofacial region, central nervous system, and limbs. Karyotypes were normal, and no distinctive syndromes or anatomic patterns were identified. Since the timing of Ebstein's anomaly is quite precise, ascertainment of such cases on the basis of cardiac morphology may enhance the understanding of etiology and pathogenesis. Both causes and mechanisms may well be diverse, for the clinical histories and anatomic findings in present and previously reported cases vary considerably. Isolated Ebstein's anomaly may develop from topographically and temporally localized damage. Ebstein's anomaly with extracardiac defects may involve damage during a longer, and perhaps earlier, period. PMID- 2718993 TI - Documentation of students' clinical reasoning using a computer simulation. AB - Computer simulations can provide both a clinical experience for teaching problem solving and a method of documenting a student's clinical reasoning style. The CAMPS simulation consists of approximately 500 items describing a patient's history, physical examination and laboratory results, and treatments. The student has full option to select any item in any order, producing a wide variation of performances. Since all of the students interact with the same clinical problems, the faculty member can make comparisons of that individual student with the class. From the record of the simulation encounter, the person responsible for student evaluations can prepare a narrative that lists the overall performance, the specific omissions and commissions, and comparisons with the class. Experience with a group of 111 students in a basic pediatric course showed that this method of documenting clinical inquiry detected a variety of levels of performances. Comparisons of the results of these tests with the faculty observations showed that 16% of these students who were judged to be very good or excellent in problem solving by the faculty performed at least 1 SD below the class average on the simulations. This project highlights the power of computer simulations to provide documentation of student performance with the additional benefit of a cost of less than $1 per student. PMID- 2718994 TI - Neonatal Staphylococcus epidermidis meningitis with unremarkable CSF examination results. AB - We identified 10 infants (mean +/- SD birth weight, 1000 +/- 500 g; gestation, 29 +/- 3 weeks; postnatal age, 24 +/- 19 days) who had Staphylococcus epidermidis meningitis despite unremarkable cerebrospinal fluid (CSF) blood cell counts and glucose and protein levels. Staphylococcus epidermidis meningitis was diagnosed if all the following criteria were satisfied: (1) a CSF culture positive for S epidermidis within 48 hours, (2) a blood culture positive for S epidermidis with antibiotic sensitivities identical to those of the CSF isolate, and (3) clinical symptomatology. Lumbar puncture yielded white blood cell counts lower than 10 x 10(6)/L in 8 infants. Two subjects had CSF white blood cell counts of 11 x 10(6)/L and 14 x 10(6)/L. Cerebrospinal fluid glucose (2.8 +/- 0.9 mmol/L) and protein (1.15 +/- 0.32 g/L) concentrations were also unremarkable. Infants were treated with parenteral antibiotics for 19 +/- 5 days. There was no mortality or short-term morbidity. Staphylococcus epidermidis is a recognized cause of nosocomial meningitis in low-birth-weight infants and frequently occurs without CSF abnormalities. PMID- 2718995 TI - Sucking and breathing patterns during breast- and bottle-feeding in term neonates. Effects of nutrient delivery and composition. AB - We attempted to determine whether differences in milk composition or flow rate are the primary determinants in altering breathing pattern during nipple-feeding. In the first phase of the study, 15 neonates were studied during breast-feeding and bottle-feeding; in the second phase, 15 were evaluated during bottle-feeding of expressed human milk and formula. A reduction in inspiratory duration was observed with all feeding regimens. Moreover, significant prolongation in expiratory duration and reduction in breathing frequency were observed during bottle-feeding of formula and expressed human milk (compared with control); these effects were greater with formula feeding. Higher sucking frequency was observed during breast-feeding compared with bottle-feeding; no difference in suckling frequency or sucking pressure was observed between bottle-feeding of expressed human milk and formula. We conclude that most of the differences in sucking and breathing patterns between breast- and bottle-feeding can be attributed to nutrient delivery rather than nutrient composition. PMID- 2718996 TI - Transient erythroblastopenia of childhood. A review of 26 cases and reassessment of indications for bone marrow aspiration. AB - Clinical and hematological presentations of 26 consecutive patients with transient erythroblastopenia of childhood diagnosed during July 1979 to September 1986 were compared with 26 patients with acute leukemia who presented with anemia and a normal platelet count. It was easy to distinguish acute leukemia from transient erythroblastopenia of childhood on a clinical and laboratory basis. In most cases, bone marrow examination was not necessary. PMID- 2718997 TI - Abnormal zinc content in human milk. Risk for development of nutritional zinc deficiency in infants. AB - An abnormally low concentration of zinc in mother's milk has been associated with clinical nutritional zinc deficiency in premature and term newborns. Defective mammary gland secretion of zinc was suggested as the causative factor. We investigated whether low milk zinc concentration might be reflected in an abnormality of the distribution of zinc between casein, whey, and fat components of the milk, in a reduction in the levels of milk citrate, a zinc-binding ligand, or in abnormal levels of copper and iron. Milk from mothers of four low-birth weight infants was identified as being deficient in zinc content for the lactational stage. One infant had clinical signs of nutritional zinc deficiency. For two of the three infants with subclinical deficiencies in whom balance study data were available, the apparent zinc balance was negative (-5.7 and -6.0 mumol/kg per day). These milks were examined for content and distribution of zinc, copper, and iron, and citrate concentration. Although total zinc concentration (4.5 to 17.2 mumol/L) was below the 95% prediction interval (15.2 to 59.7 mumol/L) for the lactational stage, the distribution of zinc was normal between milk components. Levels of citrate (1.46 to 5.13 mmol/L) were also within normal limits, as were levels of copper (0.27 to 0.85 mumol/L and iron (0.41 to 1.13 mumol/L). We concluded that there was no indirect evidence of a secretory abnormality in milk zinc deficiency, but speculated that there might instead be an abnormality of zinc uptake by the mammary gland from the plasma. PMID- 2718998 TI - Acute systemic organ injury in term infants after asphyxia. AB - The systemic manifestations of "asphyxia" were evaluated prospectively in 35 consecutively intubated term newborn infants. The following systemic organ injuries were identified most often: (1) renal, ie, oliguria less than 1 mL/kg per hour for at lest 24 hours (40%), an elevated urinary beta-2-microglobulin concentration (57%), azotemia (11%), and an elevated serum creatinine level (17%); (2) central nervous system, ie, hypoxic-ischemic encephalopathy (including seizures) (31%) or an abnormal cranial ultrasound scan, ie, diffuse parenchymal echogenicity, slitlike ventricles, and poor visualization of the sulci, and/or intracranial hemorrhage (26%); (3) cardiovascular, ie, an abnormal echocardiogram (25%) or abnormal electrocardiogram (11%); (4) pulmonary complications, including persistent pulmonary hypertension (23%); and (5) gastrointestinal complications, which were rare. Traditional markers of fetal distress were not related to the frequency and/or distribution of systemic organ injury. An important implication of this study relates to the recognition of the extent and distribution of organ injury in the "asphyxiated" infant. PMID- 2718999 TI - Picture of the month. PMID- 2719000 TI - Radiological cases of the month. Osteonecrosis of the femoral head diagnosed by magnetic resonance imaging. PMID- 2719001 TI - Radiological cases of the month. Congenital laryngeal atresia. PMID- 2719002 TI - The gastroenterologist and the graying of America. PMID- 2719003 TI - Placebos in clinical trials of peptic ulcer. ACG Committee on FDA-Related Matters. AB - Placebo use in controlled clinical trials is often challenged as being unethical, as though the investigator in a clinical trial and the clinician are in conflict, one interested primarily in scientific validity, the other in patient care. This paper will review the specific issues in trials for short term (4-8 wk) peptic ulcer disease, demonstrating that controlled trials utilizing placebo are worthwhile, are safe, offer distinct advantages over alternative trials, and impose no real ethical conflict. The ethics regarding the use of a placebo for a controlled trial have been reviewed previously in this column (1). Placebo controls are appropriate in therapeutic trials when 1) standard therapy is either unavailable, of unproven efficacy, or possesses unacceptable side effects, 2) placebo itself is an effective therapy, or 3) the ongoing disease has little adverse effect on the patient. Furthermore, the use of placebo is considered advisable (2), "when the disease process is characterized by frequent spontaneous exacerbations and remissions." Certainly, peptic ulcer is such a disease. It has been argued that the decision to utilize placebo might be between only two individuals, the physician and his patient (3), but realistically, many more must approve the trial, through multi-center participation, involvement by the pharmaceutical industry, and peer review (including human research committee approvals). PMID- 2719004 TI - A personal experience in comparing three nonoperative techniques for treating internal hemorrhoids. AB - Infrared photocoagulation therapy was used on a total of 302 patients. Approximately 20% of the patients experienced minor bleeding; however, two required surgery, and 30% of the patients experienced discomfort during a 14-day period following the procedure. Good results were obtained in patients with first and second-degree hemorrhoids. Heater probe coagulation therapy was conducted in a total of 264 patients. Good results were achieved in 90% of patients with first and second-degree hemorrhoids, minor pain and bleeding occurred in approximately 10% of these patients, and one patient with third-degree hemorrhoids who was treated with this technique failed to respond and required surgery. Ultroid d.c. current therapy was utilized in 192 patients, and follow-up results were good in 95% of these cases. Minor bleeding occurred in four patients. It is concluded that all three techniques, performed on an outpatient basis with little or no sedation, are effective modalities for first- and second-degree hemorrhoids, but that Ultroid d.c. current therapy is associated with less discomfort and fewer complications and that Ultroid therapy may yield good results in some patients with third- or even fourth-degree hemorrhoids. PMID- 2719005 TI - The gastroenterologist and the treatment of hemorrhoids: is it about time? PMID- 2719006 TI - Factors influencing the healing rate of gastric ulcer under treatment with cimetidine. AB - Factors influencing the healing rate were evaluated by multivariate analysis on 148 patients with gastric ulcer who were under treatment with cimetidine at a daily dose of 800 mg. Factors used were age, sex, therapeutic environment, duration of present ulcer pain, past history of gastric ulcer, the amount of tobacco, alcohol, and coffee consumed before and during the treatment, the period until symptoms disappeared after the commencement of the treatment, and the characteristics of the ulcers themselves. Of these factors, the five factors that had a significant delaying effect on the healing of gastric ulcers were: 1) having a past history of gastric ulcers, 2) symptoms not disappearing within 1 wk after the commencement of the treatment, 3) size over 20 mm, 4) ulcer located in an angle, and 5) round or oval shape of the ulcer. The patients with less than one of the unfavorable factors (n = 36) had the best healing rate (97.2%), compared with those with two (n = 61), three (n = 39), or four or more (n = 12) unfavorable factors. The healing rate of the latter three groups was 75.4%, 53.8%, and 33.3%, respectively (p less than 0.01). Thus, a prognostic score based on these five factors represents the severity of gastric ulcers with regard to the healing in patients prescribed cimetidine. PMID- 2719007 TI - Patterns of physical modes of contact between Campylobacter pylori and gastric epithelium: implications about the bacterial pathogenicity. AB - Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we performed an ultrastructural study with the aim of focusing on patterns of possible physical contact between C. pylori and gastric epithelium, and of considering them in relation to the bacterial pathogenicity. Among 20 random consecutive patients referred for routine gastroscopy, we studied ultrathin sections from the 11 patients with Campylobacter-like organisms, and recognized three patterns of physical contact between bacteria and epithelial cells. These patterns seem in accord with published data of C. pylori toxicity, and they could represent different evolutive stages of the infection. PMID- 2719008 TI - Endoscopic placement of biliary stents for treatment of high risk geriatric patients with common duct stones. AB - Ten elderly (mean age, 77 yr) sick patients with large common duct stones were managed with stents when conventional nonsurgical methods for stone extraction failed. Five subjects had intact gallbladders, and four of these had cholelithiasis. Patients were at increased risk for perioperative complications- yet endoscopic placement of stents was performed safely in all instances. Pain and jaundice resolved and elevated serum bilirubin values returned to normal in all patients. After a maximum follow up of 35 months, no subject has required surgery for biliary symptoms or complications. Two patients have died, one following elective cholecystectomy and common duct exploration and another from unrelated causes. These results suggest that endoscopic placement of stents for management of large common duct stones is safe, and favorable long-term results can be achieved. Geriatric patients who are unfit for surgery are probably good candidates for this treatment. PMID- 2719009 TI - Coffee and alcohol use and the risk of ulcerative colitis. AB - We performed a population-based, case-control study of the risk of ulcerative colitis associated with coffee and alcohol use among the 304,000 members of a prepaid health plan. We compared coffee and alcohol use histories before ulcerative colitis onset in 209 cases and an equal number of age- and sex-matched controls selected from the enrollment file of the prepaid health plan. Neither coffee use, amount of coffee consumed daily, or cumulative coffee consumption before disease onset altered the risk of developing ulcerative colitis. A decreased risk of ulcerative colitis was associated with alcohol consumption before disease onset among never-smokers only. This risk declined as daily alcohol consumption increased. These results suggest that alcohol consumption may lower ulcerative colitis incidence. PMID- 2719010 TI - Occurrence of immunohistochemically detected small Mallory bodies in liver disease. AB - To determine the diagnostic significance of immunohistochemically detected small Mallory bodies (MBs) which are invisible by conventional stainings, we investigated the occurrence of MBs in liver tissue with alcoholic and nonalcoholic liver disease by immunoperoxidase staining with monoclonal anti-MB antibody, anti-NMB-3. In conventional stainings, MBs were detected in only six of 26 (23%) patients with alcoholic liver disease, and nine of 63 (14%) patients with nonalcoholic liver disease. On the other hand, MBs were detected in 20 of 26 (77%) patients with alcoholic liver disease, and 25 of 63 (40%) patients with nonalcoholic liver disease by immunoperoxidase staining. Immunohistochemically detected MBs were shown to possess the ultrastructural characteristics of MBs by immunoelectronmicroscopy in the four specimens. Our result indicates that the small MBs are not rare in nonalcoholic liver disease, and the presence of immunohistochemically detected small MBs is not a good marker of an alcoholic etiology. PMID- 2719011 TI - Poor outcome from peritoneovenous shunts for refractory ascites. AB - We reviewed in retrospect the records of all patients at our institution in whom peritoneovenous shunts were placed to manage refractory ascites due to chronic liver disease from 1977 through 1986. There was a wide spectrum of underlying liver disease in these 23 patients; most frequent was alcoholic cirrhosis. Five were in modified Child's class A, 14 were in class B, and four were in class C. Fourteen of 23 patients had some complication associated with peritoneovenous shunt placement; clinical consumptive coagulopathy, infection, and gastrointestinal hemorrhage while hospitalized were most frequent. Fifteen of 23 died, 12 while hospitalized or within 1 month of hospitalization. Death in eight patients appeared to be related to shunt placement and was due to sepsis in five, hepatorenal syndrome with an obstructed shunt in one, consumptive coagulopathy in one, and pulmonary edema in one. All modified Child's class C patients, six of seven patients with clinical consumptive coagulopathy, and all patients with a preshunt total bilirubin greater than 3.7 mg/dl died while hospitalized or within 1 month of hospitalization. This review supports studies showing that placement of peritoneovenous shunts for refractory ascites has a high morbidity and mortality in patients with advanced liver disease, and does not support their use in the management of refractory ascites. PMID- 2719012 TI - Closure of interposition mesocaval shunt in a case of idiopathic portal hypertension. AB - Interposition mesocaval shunt for hemorrhagic esophageal varices was carried out in a patient with idiopathic portal hypertension without preoperative hepatic dysfunction. The esophageal varices were controlled, but the hemodynamics of the portal vein subsequently underwent gradual change and attacks of hepatic encephalopathy occurred frequently the following year. Therefore, the shunt was closed after about 2 yr. Hepatic encephalopathy disappeared after this surgery, but the varices obviously worsened on the 5th postoperative day and bled spontaneously on the 33rd postoperative day. A distal splenorenal shunt constructed 35 days after the operation resulted in the reduction, but not the complete disappearance, of esophageal varices. Episodes of hepatic encephalopathy or bleeding from the esophageal varices were not observed in the 24 months following the second shunt surgery. PMID- 2719013 TI - Aspiration pneumonia complicating small bowel biopsy. AB - The use of peroral small bowel biopsies has been shown to be a safe and effective procedure, useful in the diagnostic evaluation of malabsorption and other intestinal pathology. This report describes a young man who aspirated a small bowel biopsy capsule as part of an investigation of malabsorption. Forty-eight hours after this episode, he developed pneumonia. In this context, the literature of complications from small bowel biopsies is reviewed. PMID- 2719014 TI - Thrombocytopenia associated with hypersensitivity to ranitidine: possible cross reactivity with cimetidine. AB - A rare case of thrombocytopenia associated with ranitidine is described. The thrombocytopenia was accompanied by eosinophilia and slightly elevated serum IgE. The platelet and eosinophilic counts returned to normal as soon as the drug was stopped. Cell-mediated immunity (CMI) determined in vitro by the leukocyte migration inhibition factor test was found against ranitidine and cimetidine. IgE antibody response against both drugs was also found by the mast cell degranulation test. These data suggest an association between the ranitidine induced thrombocytopenia and both humoral antibody response and CMI. Cross reactivity between the two H2-receptor antagonists is suggested, as well. PMID- 2719015 TI - Cimetidine-induced galactorrhea. AB - Various breast abnormalities have been described in patients treated chronically with cimetidine, but galactorrhea has been reported only twice in the medical literature. In both cases, there appeared to be an associated hyperprolactinemia. These problems could well represent a consequence of histamine2-receptor blockade. We report here a female patient with hepatic cirrhosis and portal hypertension who developed hyperprolactinemia and galactorrhea while on long-term cimetidine therapy. Both the hyperprolactinemia and the galactorrhea disappeared when the patient was switched to ranitidine, an alternative H2-receptor blocker. A review of the previous case reports and relevant literature is included. PMID- 2719016 TI - Increasing percentage of adenocarcinoma in primary carcinoma of the esophagus. PMID- 2719017 TI - Response to W. A. Webb. Esophageal dilatation: personal experience, current instruments and techniques. PMID- 2719018 TI - Familial Menetrier's disease. PMID- 2719019 TI - Dysplasia in inflammatory bowel disease. PMID- 2719020 TI - Fatal cerebral venous thrombosis complicating acute ulcerative colitis. PMID- 2719021 TI - Transient hepatitis due to low dose neuroleptic medication. PMID- 2719022 TI - A case of membranous glomerulonephritis in the course of primary biliary cirrhosis. PMID- 2719023 TI - Tuberculous pancreatic abscess as a manifestation of AIDS. PMID- 2719024 TI - Catheter infections as a factor in the transfer of continuous ambulatory peritoneal dialysis patients to hemodialysis. AB - The effect of peritoneal catheter infections on the transfer of continuous ambulatory peritoneal dialysis (CAPD) patients to hemodialysis over a 9-year period were examined. Twenty-seven percent (68/247) of all patients were transferred permanently to hemodialysis after a mean of 15 +/- 14 months of CAPD. An additional 29% transferred temporarily one or more times during the study period (mean time of peritoneal dialysis, 35 +/- 23 months). The reasons for permanent transfer to hemodialysis were catheter infections (15/68, 22%), peritonitis (13/68, 19%), catheter infections associated with peritonitis (10/68, 15%), patient preference (9/68, 13%), mechanical problems (4/68, 6%), noncompliance (7/68, 10%), inadequate clearance or ultrafiltration (6/68, 9%), with other reasons for the remainder (4/68, 6%). Temporary transfers to hemodialysis were also mainly due to catheter infections (32%), peritonitis (23%), and simultaneous catheter infections and peritonitis (24%). Catheter infection rates were much higher in the groups that permanently and temporarily were transferred to hemodialysis in comparison with those patients who remained on peritoneal dialysis. We conclude that catheter infections are a leading cause of both temporary and permanent transfer of CAPD patients to hemodialysis. PMID- 2719025 TI - A hypothesis: the protein catabolic rate is dependent upon the type and amount of treatment in dialyzed uremic patients. AB - Urea kinetic modelling was performed serially, over 24 months, on 55 patients undergoing hemodialysis and eight patients receiving peritoneal dialysis. The data obtained, together with changes in therapy aimed at increasing or decreasing the normalized dose of dialysis [KT/V (urea)], suggested the dependence of dietary protein intake and protein catabolic rate (PCR; g/kg/d) on the KT/V (urea). The studies also indicated that the nature of this relationship may be dependent upon the dialysis treatment used; dialysis by AN69S membrane hemodialyzers required less KT/V (urea) than hemodialysis by cellulosic membranes to obtain a given PCR. This difference may be explained by the beneficial effect of removal of "middle molecular weight" uremic toxins by the AN69S membrane, which has a different solute clearance profile than the cellulosic membrane. The studies also indicated a similar relationship between PCR and KT/V (urea) for peritoneal dialysis. With this form of therapy, however, it is difficult to obtain a PCR greater than 1 g/kg/d without first achieving very high values for KT/V (urea). It is postulated that this is due to an independent adverse effect of peritoneal dialysate in suppressing appetite. The data presented suggest that the conclusions of the National Cooperative Dialysis Study may be reinterpreted by assigning a major role to the nutritional status of patients in morbidity, with satisfactory nutritional status attained only in patients receiving adequate dialysis which, in turn, ensures control of plasma urea levels. Studies to prove this hypothesis are indicated. PMID- 2719026 TI - Membranoproliferative glomerulonephritis in a patient with congenital deficiency of the third component of complement: effect of treatment with plasma. AB - A 21-year-old woman with a known congenital complement component 3 (C3) deficiency developed membranoproliferative glomerulonephritis. The kidney biopsy exhibited deposits of immunoglobulins and complement components despite the C3 deficiency. The administration of fresh frozen plasma was without therapeutic benefit. Corticosteroid treatment was followed by an improvement in kidney function. PMID- 2719027 TI - Neurological deterioration following treatment for hyponatremia. PMID- 2719028 TI - Information sheet for discharge counseling of home i.v. antimicrobial therapy patients. PMID- 2719029 TI - True reason for pharmacist turnover may not be reported. PMID- 2719030 TI - Excessively thick extemporaneous spironolactone suspension. PMID- 2719031 TI - The need for collective action on technician issues. PMID- 2719032 TI - The pharmacy technician--an occupation in search of consensus. AB - These are some of the issues that warrant consideration as we examine the development of a more efficient manpower model for pharmacy. We all realize that we have reached a point in the delivery of health services where inefficiency will have a very direct impact on economic viability. It is imperative that we develop a more rational manpower model that takes advantage of appropriately trained supportive personnel who will be functioning in an environment greatly influenced by advancing technology. As we develop our manpower model, we should also understand that pharmacy is still evolving as a profession. It, too, has problems in identifying uniform standards of practice. We in academia have not yet reached agreement on the appropriate degree required to prepare individuals for the present and future practice of pharmacy. In spite of our inability to reach consensus on a number of important issues, we continue to realize an expansion of our professional roles. As these gains in professionalization continue, we will most likely see a concomitant need for growth in the support base required by pharmacists. This need will be met by either technicians or technology. One of my favorite quotes is taken from a book title by humorist and author Lewis Grizzard: Shoot Low Boys--They're Riding Shetland Ponies. Just as the imaginary speaker above was telling his companions to change their frame of reference, I believe we, too, must change our frame of reference. PMID- 2719033 TI - Auxiliary personnel in dentistry: an epoch of turf, trends, and territoriality. PMID- 2719034 TI - Pharmacy technicians and the military. PMID- 2719035 TI - Some economic aspects of pharmacy manpower. PMID- 2719036 TI - Issues in the education and training of technicians. PMID- 2719037 TI - Education and training: some long-range solutions. PMID- 2719039 TI - A board of pharmacy member's viewpoints on the technician issue. PMID- 2719038 TI - Issues in the supervision and legal control of pharmacy technicians. PMID- 2719040 TI - Technicians and pharmacy manpower: future directions. PMID- 2719041 TI - Use and reported adverse effects of new chemical entities. AB - Reports submitted to the FDA through 1987 of adverse drug reactions (ADRs) to new chemical entities (NCEs) approved after 1983 are described, and estimates of each NCE's proportionate use in hospitals and within its therapeutic class are reported. This review was limited to those domestic spontaneous ADR reports submitted to the FDA by healthcare professionals. NCEs accounted for approximately 20% of the total number of domestic spontaneous ADR reports received in 1987, 22% of the reports of serious ADRs, and 24% of the reports that listed death as an outcome. Data on the use of these NCEs were obtained through the U.S. Pharmaceutical Market--Drugstores and Hospitals and the National Prescription Audit. Of the 93 drugs designated as NCEs in 1987, 65 had measurable use, with 41% of those used principally in hospitals. Most hospital-use NCEs were injectable antimicrobial agents, surgical drugs, and radioactive diagnostic agents. Because NCEs account for a disproportionate share of the ADRs reported to the FDA, and because of the high use of NCEs in hospitals, hospital pharmacists should be aware of the importance of monitoring and reporting serious ADRs associated with NCEs. PMID- 2719042 TI - National survey of recent changes in hospital policies on pharmaceutical sales representatives' activities. AB - Data from a national survey of recent changes in hospital policies on the activities of pharmaceutical sales representatives (PSRs) are presented. Data were collected by means of a mail survey sent in October 1985 to pharmacy directors of 857 randomly selected hospitals. The questionnaire asked them to identify recent (since 1983) and anticipated changes in restrictions on policies concerning products that PSRs are permitted to detail and sample, persons with whom PSRs can have business contact, requirements for drug exhibits and displays, and areas where PSRs can detail products. Respondents also were asked to describe which PSR services they found to be most useful, which services they would like to see discontinued, and what new services they would like PSRs to provide. Data from 446 of 451 (52.2%) returned questionnaires were included in the analysis. For each of the four policy areas, approximately one fifth of the directors indicated that changes had been made during the previous two years, and nearly all of the changes involved increased restrictions. Half of the respondents reported that their hospitals planned to increase restrictions on products that PSRs would be permitted to detail or sample. The most common reason given for anticipated policy changes was a desire to improve control of the formulary. The directors viewed information about new products as the most useful PSR service, most directors wanted PSRs to discontinue sampling or excessive sampling, and most desired greater educational support from PSRs. From late 1983 to 1986, approximately 20% of hospitals had increased restrictions on the activities of PSRs, and many of the respondents anticipated further increases in restrictions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719043 TI - Drug allergy documentation by physicians, nurses, and medical students. AB - The completeness and accuracy of drug allergy documentation by medical residents, medical students, and primary-care nurses in a 450-bed teaching hospital were assessed, along with patients' knowledge of their drug allergy status. During a three-month period, the current admission notes written by medical residents, medical students, and primary-care nurses for adult medicine patients with drug allergies were reviewed by a pharmacy student. Patients with drug allergies were identified by the presence of drug hypersensitivity labels on the front of the medical charts. The student collected information about each reaction and determined whether it was a true allergic reaction, a nonallergic adverse reaction, or unclassifiable. A second pharmacy student interviewed the same patients whose medical charts had been reviewed and asked seven open-ended questions about the allergy status of each patient. For the 49 patients included in the study, 75 drugs were listed as allergens on the front of the patients' charts and 78 drugs were reported as allergens during patient interviews; only 66 of those drugs were identified both on the charts and by the patients. Approximately 20% of the health-care professionals failed to document the drug allergies in their admission notes. Although the majority of patients could recall the dosage form of the offending drug, the time that had elapsed between administration of the drug and appearance of symptoms, and how long ago the reaction had occurred, none of this information was recorded by the health-care professionals. Incomplete documentation of the drug allergy status of patients in our hospital does not appear to be related to patients' inability to provide accurate information. PMID- 2719044 TI - Pharmacy participation in nursing orientation programs. PMID- 2719045 TI - Monitoring system to verify activation of ADD-Vantage system doses. PMID- 2719047 TI - Compositions of commercial amino acid injections. PMID- 2719046 TI - Pharmaceutical companies should offer reliable information, not freebies. PMID- 2719048 TI - Pharmacists should not borrow prescription drug products for personal use. PMID- 2719049 TI - Clinical considerations and costs associated with formulary conversion from tobramycin to gentamicin. AB - The clinical and financial effects of replacing tobramycin with gentamicin on the formulary of a 550-bed teaching hospital were studied. On the recommendation of the pharmacy and therapeutics committee, the formulary aminoglycoside was changed from tobramycin to gentamicin in June 1985; the nonformulary status of amikacin was unchanged. Five weeks later, physician compliance was assessed and the reasons for prescribing nonformulary aminoglycosides were determined. Two four month-long evaluations were done at 6 and 18 months after implementation to assess patterns of use of nonformulary aminoglycosides. The impact on costs was determined after one and two years by considering use patterns of formulary and nonformulary aminoglycosides, as well as those of third-generation cephalosporins and mezlocillin. Resistance patterns of two gram-negative organisms, Pseudomonas aeruginosa and Serratia marcescens, were assessed for 1982-1987. Finally, the rate of nephrotoxicity in gentamicin-treated patients was determined. During the first five weeks after the formulary conversion, 80.3% (106 of 132) of the aminoglycoside orders received were for gentamicin. After telephone follow-up by the pharmacy department, that figure rose to 93.9%. During the four-month reviews beginning at 6 and 18 months, nonformulary orders accounted for 10.9% and 7.4%, respectively, of the total number of courses of aminoglycosides prescribed. In the majority of these cases, tobramycin and amikacin were used to treat infections caused by organisms with documented resistance to gentamicin or to gentamicin and tobramycin, respectively. No clear-cut changes in resistance patterns for Ps. aeruginosa or S. marcescens could be associated with the formulary conversion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719050 TI - Multidisciplinary approach to improving documentation of medications used during surgical procedures. AB - A multidisplinary approach to improving medication documentation in the operating room (OR) of a 350-bed teaching hospital is described. A committee composed of the OR pharmacy supervisor, the assistant director of nursing in charge of the ORs, and a review coordinator from the auditing department developed a medication accountability system for the OR. The system consisted of a medication use record created by the pharmacy member of the committee for each of the hospital's two ORs (main OR and eye and ear infirmary OR). The nonsterile nurse in each OR suite would complete these forms by placing check marks next to the names of the medications used. A separate medication use record was created by the chief perfusionist for use in cardiopulmonary bypass cases; this form would be completed by the perfusionist at the end of each major heart case. Once the forms were approved by the form committee, inservice-education programs were conducted for nursing and perfusion staff members; the system was implemented in both OR areas in November 1986. Errors made in completing these forms were addressed by further inservice education and individual instruction. The new accountability system was effective in improving medication documentation in the OR. Immediately after implementation of the system, 83% of medications were accounted for on the forms; after six months that figure was 90%. Before the system was implemented, only 23% of patient charts reviewed contained no errors in documentation; after six months that figure had improved to 71%. The improved medication documentation allowed for more consistent collection of the assessed pharmacy charges on bills audited by third-party payers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719051 TI - Indicators for the selection of ambulatory patients who warrant pharmacist monitoring. AB - The development of indicators to identify ambulatory patients who might benefit from pharmacist monitoring is described. With the assistance of an eight-member panel of ambulatory-care pharmacists, six prognostic indicators were identified: (1) five or more medications in present drug regimen, (2) 12 or more medication doses per day, (3) medication regimen changed four or more times during the past 12 months, (4) more than three concurrent disease states present, (5) history of noncompliance, and (6) presence of drugs that require therapeutic drug monitoring. The charts of patients who had visited the internal medicine, general surgery, pediatric, and obstetric/gynecology clinics during five randomly selected weeks in 1985 and 1986 were reviewed to determine the presence or absence of the six prognostic indicators and their adverse outcomes. Evidence of drug-therapy-related adverse outcomes was present in 79 (33.1%) of 239 charts. Charts of patients with a documented history of noncompliance were most likely to show evidence of an adverse outcome. The likelihood that a patient chart would show evidence of an adverse outcome increased as the number of prognostic indicators present increased. The presence of individual or multiple prognostic indicators in the charts of ambulatory-care patients should enable pharmacists to identify patients at greatest risk of experiencing drug-therapy-related adverse outcomes. PMID- 2719052 TI - Offering referral fees to physicians for home-health-care patients. PMID- 2719053 TI - Managed health care. AB - The fundamental components of managed-care plans are described; the development of managed-care programs is discussed; and the impact of managed care on pharmacy services and the price, quality, and accessibility of health care are reviewed. Health care can be considered to be managed when at least one of the following fundamental components is present: prospective pricing, "UCR" (usual, customary, and reasonable) pricing of services, peer review, mandatory use review, benefit redesign, capitation payments, channeling, quality criteria, and health promotion. The managed-care industry consists of health maintenance organizations (HMOs), preferred provider organizations (PPOs), and managed fee-for-service plans. Managed-care reimbursement principles involve transferring some or all of the impetus for controlling use of services to the health-care provider. Means by which this is done include prospective pricing, services bundling, price discounts and negotiated fees, and capitation financing and reimbursement. Financial risk-sharing arrangements with providers--including hospitals, physicians, pharmacies, and home-care companies--are necessary for any managed care plan to attain true control over its service costs. Use-review and use management services are also fundamental to containing health-care spending. These include retrospective, concurrent, and prospective reviews of the necessity and appropriateness of medical services. Use management, like services bundling and prospective pricing, has been more effective in reducing costs of hospital inpatient services than costs associated with ambulatory care. Per case payments and services bundling have made individual charges for items irrelevant to hospital revenue. This has forced hospital pharmacy managers to become more sensitive to cost management. Drug formularies, improved productivity, and use of prescribing protocols are means by which hospital pharmacies have controlled costs. However, since shorter hospital stays are not associated with a linear decline in the need for drug therapy, reducing pharmacy operating expenses in proportion to the decline in hospital occupancy is probably not possible. Community pharmacies have responded to managed care by forming pharmacy services administrative organizations. Application of managed-care principles has reduced the use of inpatient hospital services by Medicare beneficiaries, helped HMOs and PPOs to lower prices for some services, reduced use of hospital services by HMO members, and redirected some inpatient hospital care to alternate-care providers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2719054 TI - Echocardiographic functions and blood pressure levels in children and young adults from a biracial population: the Bogalusa Heart Study. AB - M-mode echocardiograms were obtained on 651 healthy subjects, 7-22 years of age, whose diastolic blood pressure levels remained in the same height-, race-, and sex-specific decile during two biannual examinations. Echocardiographic measures of heart size and dynamics were compared across the total blood pressure distribution. Left ventricular stroke volume, cardiac output and ejection fraction, minor axis shortening, velocity of circumferential fiber shortening, and peripheral vascular resistance were correlated with blood pressure levels. There were positive correlations (p less than .001) of cardiac output and stroke volume with both systolic and diastolic blood pressure levels. Left ventricular output and stroke volume were associated with measures of body size, especially height, weight, ponderal index, and body surface area (p less than .001). The left ventricular output and stroke volume increased with age and with systolic blood pressure quintiles in the four race-sex groups. With adjustment for systolic blood pressure and measures of body size, white males had greater cardiac output (1.25 l/minute for ages 18-22 years, p = .01) and stroke volume than black males. Black males had higher peripheral resistance (4.5 mm Hg/(l/minute), p = .01) than whites. These results suggest that different hemodynamic mechanisms operate in the early phase of hypertension in blacks vs. whites in this population. PMID- 2719055 TI - Radiofrequency hyperthermia and topical retinoic acid therapy in murine melanoma. AB - Malignant cells are known to be sensitive to increased temperature. The effects of hyperthermia (HT) on intradermally implanted S91 melanoma cells in syngeneic mice were investigated with a hand-held radiofrequency generator. The possible additive effects of topical retinoic acid (RA) in this system also were studied. Five millimeter diameter melanomas were treated with either HT alone, RA alone, or a combination of HT and RA and were then evaluated after 43 days and 59 days. Eighteen of 20 tumors treated with HT alone and all 20 melanomas treated with HT/RA were eradicated. RA alone caused complete regression in 11 of 19 treated tumors. It is concluded that radiofrequency HT is an effective treatment in intradermal murine melanoma and that the addition of RA does not significantly alter the outcome because of the extreme effectiveness of HT alone. PMID- 2719056 TI - Improved brain metabolism with fructose 1-6 diphosphate during insulin-induced hypoglycemic coma. AB - The effect of fructose 1-6 diphosphate (FDP) on brain metabolism and brain function was investigated in hypoglycemic rabbits. The electroencephalogram and differences in oxygen content of arterial and cerebral venous blood were used as indicators for brain metabolic activity. Hypoglycemic coma was induced and maintained for 1 hour by insulin administration. At the onset of isoelectric EEG, six rabbits were treated with FDP and five rabbits received 0.9% saline. The animals were killed by an overdose of barbiturate 60 minutes after hypoglycemic recovery with glucose. FDP-treated rabbits had lower arterial glucose concentration after 40 minutes of treatment (p less than .05) and a significantly greater difference between the oxygen content of arterial and venous blood after 40 minutes (p less than .01), and after 60 minutes (p less than .025) of FDP infusion than saline-treated rabbits. FDP-treated rabbits also had a lower cerebral glucose-oxygen index than did saline-treated rabbits (p less than .005, after 20 and 40 minutes of FDP infusion). FDP administration was followed by a return of EEG activity during hypoglycemia, whereas saline produced no such effect. After glucose infusion, EEG activity was improved in FDP-treated rabbits; in saline-treated rabbits, minimal or no EEG activity was observed. The data suggest the possibility that, at the doses given in this study, FDP is taken up and used as a metabolic substrate by the brain. PMID- 2719057 TI - Analysis of the quantitative relationship between anemia and chronic renal failure. AB - The authors analyzed data from 106 adults with chronic renal failure [(CRF), serum creatinine (Scr) greater than 132.6 mumol/l (1.5 mg/dl)], to define the precision of, and effects of covariables on, the relationship between anemia and CRF. We excluded dialyzed or patients who had received transplants and those with obvious potential nonrenal causes of anemia. Hct was a linear function of BUN and Scr (r = -0.48, and r = -0.67, respectively), and a curvilinear function of creatinine clearance (r = 0.68), all p less than .0001. Confidence interval analysis revealed a +/- 10 volume percent variation in Hct at any level of renal function. Sex was the only covariable that affected Hct independently of CRF. This study suggests that CRF may have a different effect on Hct in males and females and indicates that the range of Hct possible at a given level of CRF precludes attributing anemia to CRF with assurance. PMID- 2719058 TI - Cocaine-associated rhabdomyolysis. AB - Three male patients developed a total of four episodes of acute rhabdomyolysis associated with documented cocaine intoxication (two caused "crack" and two caused by intravenous cocaine). Included is one patient who developed rhabdomyolysis after injecting cocaine and then redeveloped it 6 months later on "rechallenge." One of the four cases resulted in death related to severe hyperkalemia and ischemic bowel. The remaining three episodes followed a course of nonoliguric renal failure. PMID- 2719059 TI - Thyrotoxic periodic paralysis in a Latin-American taking acetazolamide. AB - A Latin-American teenager was begun on a regimen of acetazolamide for a presumptive diagnosis of familial periodic paralysis. He presented 2 weeks later with near total body paralysis and was found to have florid manifestations of Graves' disease. Although thyrotoxic periodic paralysis occurs most frequently in Oriental males, it occasionally is found in Caucasians. Unlike familial, euthyroid, and periodic paralysis, thyrotoxic periodic paralysis may be worsened by administration of acetazolamide. Physical signs and laboratory evidence of hyperthyroidism must be sought in cases of periodic paralysis to differentiate the two diseases. PMID- 2719060 TI - Significance of tubulointerstitial lesions in biopsy specimens of glomerulonephritic patients. AB - To evaluate the significance of tubulointerstitial lesions in the cortical area of renal biopsy specimens, clinicopathological studies were performed on 101 cases of IgA nephropathy, 31 cases of IgA-negative (non-IgA) proliferative glomerulonephritis and 75 cases of idiopathic membranous glomerulonephritis. The degree of tubulointerstitial lesions was assessed semiquantitatively by light microscopic observation and was correlated with the several histopathological and clinical parameters at biopsy, as well as with status at final follow-up (average follow-up period: 72 months). In these three types of glomerulonephritis, the degree of tubulointerstitial lesions in the cortical area was clearly correlated with the severity of glomerular injury, the prevalence of segmental sclerosis, global sclerosis, arteriolosclerosis, decreased renal function (GFR less than 70 ml/min) and hypertension (greater than 150/90 mm Hg) at the time of biopsy. The prevalence of stable renal function at final follow-up was statistically higher in the cases without tubulointerstitial lesions or with those whose lesions included less than 20% of the cortical area. From the above data, it was concluded that a semiquantitative evaluation of tubulointerstitial lesions in the cortex would reflect the severity of glomerular injury and also contribute to the assessment of prognosis in such primary glomerulonephritic patients. PMID- 2719061 TI - End-stage renal disease (ESRD) secondary to chronic glomerulonephritis. PMID- 2719062 TI - Bilateral pelviureteric junction obstruction causing renal failure in two elderly patients. AB - Two elderly patients presented with renal failure due to pelviureteric junction (PUJ) obstruction. After dialysis, obstruction was relieved by percutaneous nephrostomy and the diagnosis was established radiologically. Differential renal function was assessed by direct measurement or isotope scanning. Surgical correction resulted in both patients remaining free of dialysis at follow-up 2 years later. PUJ obstruction is an uncommon cause of renal failure, particularly in the elderly, but is potentially correctable. PMID- 2719063 TI - Granulomatous interstitial nephritis after a jejunoileal bypass: an ultrastructural and histochemical study. AB - We present a case of granulomatous interstitial nephritis and renal failure after a jejunoileal bypass for obesity. Improvement of the renal function occurred after reversal of the intestinal bypass. The renal biopsy showed an interstitial nephritis, oxalate crystal deposition and several aggregates of multinucleated giant cells related to the crystal material (granulomatous reaction). By ultrastructural and histochemical studies we demonstrated mitochondrial alterations in the tubular epithelial cells, and we suggested the proximal tubule origin of the giant cells. The association of the oxalate crystals with damaged tubules and giant cells suggests that the oxalate crystals are responsible for these alterations. The possibility of an associated immunological process as the cause of the interstitial nephritis cannot be excluded. PMID- 2719064 TI - Renal dysfunction and lead exposure. PMID- 2719065 TI - Atheroembolic renal disease: preferential occurrence in whites only. PMID- 2719066 TI - From menarche to menopause: enhancing the quality of life. Vienna, Austria, March 7-12, 1988. Proceedings. PMID- 2719067 TI - From menarche to menopause: coronary artery atherosclerosis and protection in cynomolgus monkeys. AB - The effects on atherogenesis of stress, pregnancy, and oral contraceptive therapy were studied in a nonhuman primate model. The stress of social subordination was associated with ovarian dysfunction, unfavorable lipoprotein changes, and increased coronary artery atherosclerosis compared with nonstressed (socially dominant) or normal monkeys. Although pregnant animals exhibited lower high density lipoprotein cholesterol concentrations, they had only one half as much diet-induced coronary artery atherosclerosis as their nonpregnant counterparts. Monkeys treated with an Ovral-like regimen also exhibited adverse lipoprotein changes. Nevertheless, prevalence and extent of coronary artery plaques decreased. We conclude that estrogen is an important factor in the animals' "female protection" against diet-induced atherosclerosis. We also suggest that the lowering of high-density lipoproteins by the progestin component of higher dose contraceptives is not necessarily atherogenic if a sufficiently potent exogenous estrogen is administered concomitantly. PMID- 2719068 TI - Occupational therapy and motor control. PMID- 2719069 TI - The biomechanics of prehension. AB - Occupational therapists who work with people who have physical dysfunctions are often involved in the treatment of hand injuries or disabilities. This article describes some of the mechanical principles that affect hand function, including kinematics, kinetics (force and torque), friction, stress, and strain. Practical occupational therapy examples are used to explain these principles. PMID- 2719070 TI - Living with Meniere disease: an occupational therapist's perspective. PMID- 2719071 TI - The binding of human low-density lipoproteins to the surface of schistosomula of Schistosoma mansoni is inhibited by polyanions and reduces the binding of anti schistosomal antibodies. AB - Host molecules such as serum lipoproteins, blood group glycolipids, and histocompatibility antigens may bind to schistosomes and thereby prevent immune recognition of the parasite. This study examines the kinetics of lipoprotein binding, the ability of polyanions to inhibit lipoprotein binding, the binding of anti-schistosomal antibodies to worms that have previously bound low-density lipoprotein (LDL), and the distribution of lipoproteins bound to the parasites. Lipoproteins in human serum (HS) and purified LDL, very low-density lipoprotein (VLDL), and apolipoprotein B (apo B) in defined media were demonstrated on the surface of schistosomula of Schistosoma mansoni by fluorescence and immunoelectron microscopy using a polyclonal goat anti-human apolipoprotein B antibody (anti-apo B). By fluorophotometric microscopy, lipoprotein binding began within 15 minutes and was largely completed within 3 hours of exposure. Lipoprotein binding saturated at 10% HS or 20 micrograms protein/300 microliters of purified LDL. Suramin inhibited LDL binding by 59% in a dose-dependent fashion. In the absence of LDL in the medium, 2 mM suramin dissociated 41% of bound LDL from the worm surface within 15 minutes and 10 mg/ml heparin dissociated 36%. The binding of human anti-schistosomal antibodies to schistosomula was inhibited by bound LDL. By fluorescence microscopy, serum or purified lipoproteins were distributed over the entire surface of the parasite with focal areas of high intensity. Ultrastructurally, reaction product was seen on the outer leaflet of the outer tegumental membrane and in aggregates and surrounding vesicular structures varying in diameter from 13 to 83 nm. These studies demonstrate that lipoproteins bind to the surface of schistosomula. The binding of lipoproteins is partially inhibited by polyanions, reduces the binding of human anti-schistosomal antibodies, and may help the parasite escape the immune response. PMID- 2719072 TI - A hypothetical explanation for the aging of skin. Chronologic alteration of the three-dimensional arrangement of collagen and elastic fibers in connective tissue. AB - To provide a morphologic basis for a better understanding of the "aging" of human skin, the authors studied the three-dimensional arrangement and chronological alterations of the fibrous components of the connective tissue using rats aged 2 weeks to 24 months with a new technique for scanning electron microscopy. These studies showed that with postnatal growth there was a dynamic rearrangement of the collagen and elastic fibers: an ordered arrangement of mature collagen bundles was attained by producing a distortion of the elastic fiber meshwork of relatively straight fibers. During adulthood, there was a subsequent tortuosity of the distorted elastic fibers coupled with an incomplete rebuilding of the elastic fiber network, laid down in a form to interlock with the collagen bundles. These changes provide a model for explaining manifestations of aged skin, such as laxity, sagging, and wrinkling. The tortuously fixed elastic fibers imply that they have been stretched and have lost their original elasticity and ability to restitute short and straight. Interlocking of both collagen and elastic fibers should disturb the two independent fibrous systems, as would normally be the case, and thus decrease tissue compliance. PMID- 2719073 TI - Morphologic demonstration of adrenergic influences on the glomerulus. AB - Previous micropuncture studies found that increasing the adrenergic nerve activity to the kidneys elevates the pre- and postglomerular arteriolar resistances and decreases the glomerular capillary ultrafiltration coefficient (product of the filtration surface area and the hydraulic conductivity to water). To define the morphologic expression of this adrenergic effect on the glomerular capillaries the authors compared the microscopic vascular casts of entire glomeruli from right and left kidneys that were simultaneously perfusion-fixed during selective stimulation of only the left renal nerves. The maximum cross sectional diameter of ten randomly chosen glomeruli from each stimulated and contralateral kidneys of eight rats averaged 123.7 +/- 4.1 mu in stimulated kidneys compared with a maximum diameter of 136.3 +/- 6.4 in the contralateral kidneys (P less than 0.001). The average perpendicular diameter of 100.4 +/- 1.5 mu in the stimulated kidneys was also significantly smaller than the average diameter of 110.7 +/- 1.9 mu in the contralateral kidneys (P less than 0.005). To examine if morphologic changes analogous to those found in whole glomeruli can be demonstrated at the single cell level, the authors assessed the size of mesangial cells in vitro before, during, and after exposure to the adrenergic neurotransmitter, norepinephrine. First passage mesangial cells approximately 4 weeks after explantation were studied by phase-contrast microscopy and recorded on time-lapse video recorder. The planar surface area of individual mesangial cells was measured by electronic planimeter from photographs of the video images. In response to norepinephrine (1 microM), the surface area decreased significantly on average, from 3.58 +/- 0.28 X 10(-6) sq mm to 3.38 +/- 0.27 (P less than 0.005). Washout of norepinephrine and replacement with hormone-free media in other cells led an increase in the surface area (from 2.47 +/- 0.43 X 10(-6) sq mm to 2.61 +/- 0.40, P less than 0.005). No changes were observed in cells initially bathed in hormone-free media. Thus, the morphologic equivalent of the adrenergic nerve-induced reduction in the ultrafiltration coefficient is a contraction of the glomerular corpuscle. By regulating the configuration of mesangial cells that anchor the glomerular capillary network to the vascular pole, the adrenergic nerve may concurrently determine the number of capillary channels available for filtration as well as the glomerular corpuscular volume. PMID- 2719074 TI - The NC1 domain of collagen type IV in neonatal dog glomerular basement membranes. Significance in Samoyed hereditary glomerulopathy. AB - Patients with hereditary nephritis (HN) present with renal disease after infancy, suggesting that the lesion of glomerular basement membranes (GBM) may not be congenital. Therefore, the NC1 domain of collagen type IV in normal neonatal dog GBM was compared with NC1 in normal adult GBM by SDS-PAGE and Western blotting, using two anti-NC1 antibodies. Similar results were obtained, indicating that the NC1 domain is present and immunoreactive in the neonatal period. Next, serial renal biopsies were performed on a family of Samoyed dogs with hereditary glomerulopathy (SHG), an animal model of HN, and assessed by immunofluorescence. One of the anti-NC1 antibodies produced global staining of GBM in unaffected dogs, and global/segmental staining in carrier females; however, no staining was seen in affected males as early as the neonatal period. Electron microscopy (EM) failed to demonstrate any lesion of GBM in neonatal dogs. Thus, in SHG, and presumably in human HN, the abnormality in the NC1 domain is congenital, and precedes the changes seen by EM in GBM. PMID- 2719075 TI - Hepatic immunohistochemical localization of the tight junction protein ZO-1 in rat models of cholestasis. AB - Structural alterations in hepatocyte tight junctions accompanying cholestasis were investigated using immunolocalization of ZO-1, the first known protein component of the tight junction. Disruption in the paracellular barrier function of the tight junction has been proposed to allow reflux of bile into the blood. Cholestasis was induced in 210 to 235 g male Sprague-Dawley rats either by five consecutive daily subcutaneous injections of 17-alpha-ethinyl estradiol (0.5 mg/kg/d in propylene glycol) or ligation of the common bile duct for 72 hours. The structural organization of the tight junction was assessed in each model by indirect immunofluorescent and immunoperoxidase staining for ZO-1 on frozen sections of liver and compared with controls. In control, sham-operated, and estradiol-injected animals, ZO-1 localizes in a uniform continuous manner along the margins of the canaliculi. In contrast, bile duct ligation results in the appearance of numerous discontinuities in ZO-1 staining accompanied by dilation or collapse of the lumenal space. Tissue content of the ZO-1 protein, as determined by quantitative immunoblotting, was unaffected in either cholestatic model compared with controls. These findings indicate that the molecular organization of the tight junction can be assessed from immunostaining patterns of ZO-1 in frozen sections of cholestatic livers. Under these experimental conditions, the organization of the tight junction at the level of the ZO-1 protein is altered by bile duct obstruction but not by ethinyl estradiol. PMID- 2719076 TI - Tumor cell growth fractions in human malignant melanomas and the correlation to histopathologic tumor grading. AB - The growth fraction (GF) of 72 human malignant melanomas was determined by immunostaining with monoclonal antibody Ki-67. A positive correlation of GF and histopathologically-assessed prognostic variables, such as tumor thickness, mitotic rate, and prognostic index, was found. Individual Ki-67 values were considerably scattered in all histologically defined groups of malignancy. Thus, GF as determined by Ki-67 was used to calculate a modified prognostic index. In contrast to the histologically defined prognostic index, the Ki-67 based prognostic index allows further subdivision of thin malignant melanomas with no or few mitotic figures. This may be of help in identifying tumors with a high recurrence potential. PMID- 2719077 TI - Selective cellular expression of tissue factor in human tissues. Implications for disorders of hemostasis and thrombosis. AB - Tissue factor (TF), the primary cellular initiator of the coagulation protease cascade, is implicated in having important roles in hemostasis, thrombogenesis, inflammation, and the cellular immune response, although the cytologic distribution of TF in tissues has yet to be described. This study used epitope defined monoclonal antibodies to human tissue factor for immunohistochemical localization of TF in normal human tissues. TF was selectively expressed in tissues and was associated with cells rather than extracellular matrix. It was anatomically sequestered from blood, being undetectable in endothelium and peripheral blood cells. TF was present in vascular adventitia, organ capsules, epidermis, and mucosal epithelium. Most dermal and submucosal fibroblasts were negative. Except for alveolar macrophages and possibly dendritic cells of some lymphoid follicles, tissue macrophages did not express TF; (expression was demonstrable in LPS stimulated monocytes). Cerebral cortex, renal glomeruli, and cardiac myocytes were additional sites of prominent TF expression. Based on the cellular distribution of TF, it is hypothesized that intravascular initiation of coagulation requires induced expression by intravascular cells, and that the normal distribution of TF represents a hemostatic "envelope" ready to activate coagulation when vascular integrity is disrupted. PMID- 2719078 TI - Histopathology of Lyme arthritis in LSH hamsters. AB - The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis. PMID- 2719079 TI - Sequential changes of lamellar body hydrolases during ozone-induced alveolar injury and repair. AB - Lamellar body hydrolases in acutely damaged and regenerating type II cells were determined using an established rat model with well-defined stages of bronchiolo alveolar injury and repair. Lamellar bodies were isolated from control and ozone exposed (3.0 ppm for 8 hours) adult male rats by sucrose density gradient centrifugation and analyzed for their content of six different lysosomal hydrolases. Immediately after 3 ppm ozone exposure (zero-time) there was a significant decrease in specific enzyme activity (units/mg protein) of five lamellar body hydrolases and these activities remained depressed for at least 24 hours after exposure. In addition, total enzyme activity (units/lung) was reduced at zero-time for beta-hexosaminidase and at 24 hours postexposure for alpha mannosidase and alpha-L-fucosidase. During the reparative and recovery stages (48 to 96 hours) the hydrolases demonstrated variable elevations in both specific activity and total activity (units/lung). Characteristically, beta-hexosaminidase and beta-galactosidase reached supranormal values at 96 hours, whereas alpha mannosidase remained below normal levels through the recovery stage. Moreover, at 24 to 48 hours the lamellar body fraction demonstrated prominent enzyme depletion relative to the expanding pool of stored surfactant. It is concluded that acute ozone stress initiates the development of hydrolase deficiency within the lamellar bodies of injured and regenerating type II cells. This deficiency state is followed by asynchronous lamellar body hydrolase elevations that reflect distinct patterns of response rather than uniform return to normal condition. The lysosomal enzyme changes of lamellar bodies may be pathogenetically linked to the development of associated alterations in the storage and secretion of surfactant. PMID- 2719080 TI - Cardiac pathology in the hypertensive diabetic rat. Biventricular damage with right ventricular predominance. AB - The hypertensive-diabetic rat is a new small animal model of cardiomyopathy characterized by ventricular damage. To determine the extent of pathology in this model, quantitation of light microscopic changes in hearts from 15 hypertensive diabetic rats and 15 age-matched controls was performed. The fraction of myocardium involved by interstitial fibrosis, myocyte necrosis, replacement fibrosis, vascular sclerosis and perivascular fibrosis was computed separately for right and left ventricles. Spontaneously dying as well as deliberately killed hypertensive-diabetic rats were studied. Spontaneously dying animals had higher systolic blood pressures compared with rats killed deliberately. Body weights were lower and lung weights higher in the former group. Left and right ventricular necrosis and fibrosis were increased in spontaneously dying compared with deliberately killed rats. The degree of right ventricular necrosis and fibrosis paralleled that in the left ventricle, but was, unexpectedly, several times greater in magnitude. Thus, quantitative histology in the hypertensive diabetic rat reveals more cardiac necrosis and fibrosis, in either ventricle, from spontaneously dying animals compared with deliberately killed rats. This damage, coupled with major functional alterations in the viable myocardium, may lead to congestive heart failure or arrhythmia. PMID- 2719081 TI - Renal oncocytoma. A phenotypic and genotypic entity of renal parenchymal tumors. AB - The light and electron microscopic morphology of two renal parenchymal tumors was consistent with the diagnosis of renal oncocytoma. Both tumors had a mosaic chromosome pattern of cells with normal and abnormal karyotypes. No recurrent chromosome aberration and also no rearrangement of chromosome 3p was found. Restriction analysis of the mitochondrial DNA revealed a new autoradiographic band at about 50 basepairs in size occurring exclusively in oncocytomas. The possible use of these findings in the diagnosis of renal oncocytomas is discussed. PMID- 2719083 TI - Low frequency air-bone gap in Meniere's disease without middle ear pathology. A preliminary report. AB - The audiograms of some patients suffering from Meniere's disease show an unexplained conductive component, or air-bone gap (ABG), predominantly in the low frequencies. Neither the history nor physical findings support poor eustachian tube function, ossicular chain abnormalities, chronic ear disease, physical trauma, or otosclerosis as a cause of this audiometric finding. In the present study, 40 patients diagnosed as suffering from classical Meniere's disease were evaluated audiometrically. Thirteen (32.5%) of these patients demonstrated a low frequency ABG. An otologic evaluation was performed on each patient who exhibited the abnormal finding, but no middle ear pathology was discovered. An otherwise unexplained low frequency ABG in patients with Meniere's disease suggests the possibility of an "inner ear" conductive hearing loss. This conductive component may result from endolymphatic hydrops or perilymphatic hypertension (i.e., an inner ear hyperpressure exerted against the medial surface of the stapedial footplate) rather than from middle ear pathology. "Inner ear" conductive hearing loss is thought to be caused by an increase in inner ear fluid volume (endolymphatic hydrops) and pressure (endolymphatic or perilymphatic hypertension), which dampens footplate mobility medially and which is directly related to a relative inner ear or labyrinthine hyperpressure. Since the footplate mobility is only dampened and not fixed, a stapedial reflex may still be elicited. PMID- 2719082 TI - Connective tissue cells in healing rat myocardium. A study of cell reactions in rhythmically contracting environment. AB - To better understand the tendency of myocardium to heal by scarring rather than regeneration, the authors examined the responses of connective tissue cells (CTCs) after three types of necrotizing injuries. Derived from myocardial interstitial cells, CTCs proliferated in both the connective tissue space and the compartment of necrotic myocytes. They assumed various cell forms: fibrocytelike CTCs throughout the sites of injury deposited extracellular scar tissue elements, established CTC-myocyte contacts, and helped anchor myocytes to scar tissue with myotendonlike specializations; CTCs with more complex forms established CTC myocyte relationships, suggesting important roles in communication and tissue remodeling. CTCs within scar tissue differentiated into myofibrocytes, chondrocytes, and possibly smooth muscle cells. Most scar tissue elements were disposed in the long axis of myocytes. These alterations in form indicate that CTCs have various roles in myocardial repair and suggest that a number of the roles are modulated by contractile forces. PMID- 2719084 TI - Evaluation of vitamin D metabolism in patients with bilateral sensorineural hearing loss. AB - The possible role of vitamin D in hearing impairment was investigated by the measurement of three metabolites of vitamin D in 28 patients with bilateral sensorineural hearing loss (BSNHL). Twenty-three of 28 patients showed a significantly decreased level of 1,25-dihydroxyvitamin D3, with a normal value of 25-hydroxyvitamin D3. In addition to experimental and clinical reports regarding vitamin D deficiency, the present study suggests that vitamin D deficiency is one of the etiologies of BSNHL, through the calcium metabolism and microcirculation in the cochlea. PMID- 2719085 TI - Magnetic stimulation of the facial nerve. AB - Electrical testing of the facial nerve has evolved into an important means of assessing neural injury. However, the inability to stimulate the intratemporal facial nerve electrically results in a delay in diagnosis, because axonal degeneration must progress distal to the stylomastoid foramen before testing can be meaningful. To circumvent this problem, we began an investigation of magnetic stimulation of the facial nerve, because pulsed magnetic fields can pass unattenuated through all body structures, including bone. Normal volunteers and one patient with acute facial paralysis were studied with both magnetic and electric stimulation of the facial nerve. The results indicate that (1) magnetic stimulation was more comfortable because high current levels were not required at the skin surface to assure indepth stimulation, (2) magnetic and electric stimulation of the extratemporal facial nerve resulted in nearly identical compound muscle action potentials, indicating that the sites and mechanisms of neural depolarization are similar, and (3) transtemporal magnetic stimulation appears to allow depolarization of the proximal intratemporal nerve. These preliminary results are encouraging and indicate that magnetic stimulation of the facial nerve warrants further investigation. PMID- 2719086 TI - Electrocochleographic effects of ear canal pressure change. AB - A series of Swedish studies has shown that the application of middle ear over pressure may be effective in ameliorating the symptoms associated with Meniere's disease. Other studies have shown that electrocochleography (ECochG) is an effective tool in the identification of Meniere's disease, especially in the presence of active symptoms. Based on the therapeutic potential of middle ear overpressure as a treatment for Meniere's symptoms and on the relationship between these symptoms and ECochG, we investigated the effects of ear canal pressure change on human electrocochleographic components in normally hearing subjects. An experimental system combining an immittance audiometer probe and ear canal electrode was utilized to record extratympanic ECochG when different atmospheric pressures were applied indirectly to the middle ear via the sealed ear canal. All ECochG parameters except for the duration of the whole nerve action potential (AP) of the auditory nerve were significantly affected by pressure changes in the ear canal. Effects included an enlargement of the summating potential (SP) amplitude and of the SP:AP amplitude ratio at pressures above and below 0 decaPa (daPa). An important implication of our findings is that the status of the middle ear must be taken into account in the interpretation of ECochG results. PMID- 2719087 TI - Neuromas of the facial nerve. AB - Forty-eight patients with facial nerve neuromas were treated at the Otologic Medical Group Inc. between 1974 and 1985. The most common presenting symptoms were hearing loss and tinnitus. Facial paralysis occurred in 22 patients (46%). A mass behind the tympanic membrane was seen on otoscopy in 14 patients (29%). These tumors typically involved more than one segment of the nerve and eroded otic capsule bone in 14 patients (29%). High resolution computed tomography (CT) was highly accurate in determining the extent and location of these tumors. Restoration of the continuity of the nerve was undertaken at the time of tumor removal. The major determinant of the ultimate status of facial nerve function was the duration of preoperative paralysis. PMID- 2719088 TI - Labyrinthine fistulae caused by cholesteatoma. Improved bone conduction by treatment. AB - In five cases of labyrinthine fistulae caused by extensive cholesteatoma, more than 30-dB improvement in bone conduction was observed in four postoperative cases and in one case after preoperative administration of antibiotics. In each case, a fistula of more than 2 mm in length was present at the lateral semicircular canal, and membranous labyrinthine wall was exposed when the cholesteatoma membrane was removed. These five cases were considered to be in the stage of serous labyrinthitis. The experience with these cases shows that emergent antibiotic treatment and surgery are appropriate for cases with reduced bone conduction in which labyrinthine fistula caused by cholesteatoma is suspected. In addition, as the reduction of bone conduction does not necessarily preclude the possibility of good postoperative hearing, tympanoplasty may be appropriate even for cases with markedly reduced bone conduction due to labyrinthine fistulae. PMID- 2719089 TI - Progressive facial paralysis. A management dilemma. PMID- 2719090 TI - A medical management for Meniere's disease. PMID- 2719091 TI - Activation of potassium channels in renal epithelioid cells (MDCK) by extracellular ATP. AB - Extracellular ATP has been shown to stimulate transepithelial chloride transport in confluent Madin-Darby canine kidney (MDCK) cell layers and to enhance potassium conductance in subconfluent MDCK cells. The present study has been performed to test for the effect of extracellular ATP on channel activity in patches from subconfluent MDCK cells. Within 8 s, addition of extracellular ATP (10 mumol/l) leads to a sustained, but fully reversible, appearance of potassium selective channels in cell-attached patches [increase of open probability from 0.03 +/- 0.02 (n = 10) to 0.50 +/- 0.07 (n = 6)]. With the use of pipettes filled with 145 mmol/l KCl, inwardly rectifying property of the channels is disclosed with a single-channel conductance of 65.7 +/- 3.1 pS (n = 9) at zero potential difference between pipette and bath and with a reversal potential of 75.4 +/- 2.0 mV (n = 5; pipette negative vs. reference in the bath). The open probability of the channels is not significantly modified by altering pipette potential from -50 mV, pipette positive, to 50 mV, pipette negative. At extracellular calcium activities of less than 10 nmol/l, ATP leads to a transient activation of channels. In conclusion, extracellular ATP activates inwardly rectifying potassium channels in the cell membrane of subconfluent MDCK cells. A sustained activation of the channels requires the presence of extracellular calcium and is probably mediated by increases in intracellular calcium. PMID- 2719092 TI - Basolateral impalement of intestinal villus cells: electrophysiology of Cl- transport. AB - A method of dissecting the serosal muscle layers is described that transforms the villus of isolated Amphiuma small intestine into a flat sheet one cell layer thick, allowing rapid equilibration of the serosal medium with the basolateral membrane of the villus tip cells and direct access of the basal membrane to microelectrodes. The "villus sheet" preparation was used to examine the luminal and basolateral mechanisms of Cl- transport. The serosal membrane potential (Vs), measured with conventional microelectrodes, averaged -79.7 mV in tissues bathed in Cl- -free medium; the mucosal membrane potential (Vm) averaged -80.9 mV. Fractional resistance measured directly was 0.82 and 0.14 for the mucosal and serosal membranes, respectively. Elevation of bath [K] reduced Vm and Vs by 30.3 and 44.5 mV, respectively. Cl- (20 mM) added to the luminal medium reduced Vm by 23.9 mV and stimulated Cl- transport; luminal addition of furosemide then increased Vm by 5.6 mV and reduced Cl- transport. Addition of Cl- (20 mM) to the Cl- -free serosal fluid increased Vs 2.0 +/- 1.9 mV. On reducing the serosal [Cl] 10-fold Vs decreased 2.0 +/- 2.2 mV. These and other results indicate that basolateral Cl- exit is not over a conductive pathway. The villus sheet affords new opportunities for studying enterocyte function in the intact mucosa. PMID- 2719093 TI - Intracellular Cl- activity and cellular Cl- pathways in cultured human airway epithelium. AB - Cl- transport was studied in human nasal epithelium, a predominantly Na+ absorbing proximal airway epithelium. Intracellular Cl- activity (aClc) and the electrical potentials across the apical (Va) and basolateral (Vb) membranes were measured with double-barreled, Cl- -selective microelectrodes to characterize the driving forces for Cl- flow across each membrane. Under control conditions (bilateral Krebs-bicarbonate Ringer), Va was -26.1 +/- 1.2 mV, Vb was -36.2 +/- 1.2 mV, and aCL(c) was 42.7 +/- 2.0 mM (n = 34), indicating that Cl- is near electrochemical equilibrium across the apical membrane but significantly above equilibrium across the basolateral membrane. Reduction of luminal [Cl-] from 120 to 3 mM reduced aClc from 42.7 +/- 4.0 to 27.0 +/- 3.5 mM, depolarized Va, and increased fractional apical membrane resistance (fRa) and transepithelial resistance (Rt). Serosal bumetanide reduced aClc by 10 mM without affecting electrical parameters. Reduction of serosal [Cl-] from 120 to 3 mM resulted in a rapid decrease in Vb, a decrease in fRa and an increase in Rt. Also, serosal [Cl ] reduction led to a slow decrease in aClc rom 45.5 +/- 2.5 to 31.1 +/- 4.2 mM) that could be inhibited by bumetanide. The data are consistent with the following conclusions: 1) Cl- is transported across the apical membrane through a conductive pathway; and 2) Cl- is translocated across the basolateral membrane by an electrically silent bumetanide-sensitive cotransport system and by a minor conductive path. PMID- 2719094 TI - Cellular Cl- transport in cultured cystic fibrosis airway epithelium. AB - Cultured human nasal epithelia derived from cystic fibrosis (CF) patients were studied with double-barreled, Cl- -selective microelectrodes to measure membrane potentials and intracellular Cl- activity (aClc). The aClc of CF cultures was 46.5 +/- 2.5 mM (n = 28), a value not significantly different from aClc of normal human nasal cells. Reduction of the luminal [Cl-] from 120 to 3 mM failed to reveal any apical Cl- permeability (conductive or nonconductive) in CF cultures. Bumetanide (10(-4) M, serosal) led to a 10 mM decrease in aClc without affecting the electrical parameters of the cells. Reduction of serosal [Cl-] led to a marked decrease in aClc (from 58.0 +/- 6.7 to 26.8 +/- 2.9 mM) that could partly be blocked by bumetanide. Reduction of serosal [Cl-] led to a rapid depolarization (5.4 +/- 0.7 mV) of the basolateral membrane potential (Vb), a decrease of the fractional apical membrane resistance (0.03 +/- 0.01), and an increase (34 +/- omega.cm2) in the transepithelial resistance (Rt). We conclude that 1) the apical membrane of CF airway epithelia is impermeable to Cl-, and 2) Cl- transport across the basolateral membrane occurs mainly through a bumetanide inhibitable cotransport system but also through a Cl- conductance, neither of which appears to be affected by CF. PMID- 2719095 TI - Shunt resistance and ion permeabilities in normal and cystic fibrosis airway epithelia. AB - A method for determination of shunt resistance (Rs) and absolute conductive ion permeabilities of the apical membrane in epithelia from steady-state data is described. The method assumes that the currents are satisfactorily described by the Goldman-Hodgkin-Katz regime. Its application requires measurements of standard transepithelial electrophysiological parameters and of one or more intracellular ion activities. It is applicable under both open- and short-circuit conditions. The method was tested in an electrophysiological analysis of cultured normal and cystic fibrosis (CF) human nasal epithelium. In 15 normal and 10 CF preparations with mean transepithelial resistances of 338 and 427 omega.cm2, Rs was 412 and 623 omega.cm2, respectively. The Rs values determined with the present method were strongly correlated (r = 0.94) with those obtained with another method available in the electrophysiological literature but were as a mean 20% lower. Amiloride increased Rs by 25% in CF and by 8% in normal preparations. In normal preparations, the apical Cl permeability (PCla) was 3.6 x 10(-6) cm/s, and the apical Na permeability (PNaa) was 1.6 x 10(-6) cm/s. In CF preparations, PCla was reduced to a maximum of 2.3 x 10(-7) cm/s, whereas PNaa was increased to 6.2 x 10(-6) cm/s. The apical membrane electromotive force was 1 mV in normal and 43 mV in CF preparations. It is concluded that the method can be used to calculate Rs, apical membrane ion permeabilities, and electromotive forces from steady-state electrophysiological data. PMID- 2719096 TI - Rocking promotes differentiated properties in LLC-PK cells by improved oxygenation. AB - Previous studies from our laboratory indicated that in contrast to cells cultured under still conditions, LLC-PK cells cultured under conditions of continuous rocking exhibit pH-modulated ammonia production and also manifest lower levels of lactate dehydrogenase activity. In the present studies, we assessed whether other metabolic features and parameters of differentiation are modified by rocking. Rocked, as contrasted with still, cultures exhibited decreased medium lactate production and increased cellular ATP content consistent with heightened oxidative metabolism. Still cultures did not exhibit either dome formation or sodium-dependent alpha-methylglucoside uptake until the cultures reached full confluency. By contrast, rocked cultures underwent dome formation as well as enhanced alpha-methylglucoside uptake during the growth phase, and these parameters were quantitatively greater than in still culture even after full confluency was achieved. Thus rocking promotes several functions, which can reflect differentiation in LLC-PK cells. To determine whether provision of adequate oxygen accounts for the enhancement of cellular metabolism and differentiated functions by rocking, still cultures grown in a high oxygen concentration of 36% were compared with standard cultures grown in 18% oxygen. The high oxygen environment resulted in the development of pH-modulated ammonia production, a decrease in lactate dehydrogenase activity, lower medium lactate formation, increased ATP levels, more copious dome formation, and increased alpha methylglucoside uptake. Thus rocking promotes cellular metabolism and differentiated functions by the provision of adequate oxygenation. PMID- 2719097 TI - Single muscle fiber enzyme shifts with hindlimb suspension and immobilization. AB - The purpose of this investigation was to determine how models of weightlessness, hindlimb suspension (HS), and hindlimb immobilization (HI) affect the metabolic enzyme profile in the slow oxidative (SO), fast oxidative glycolytic (FOG), and fast glycolytic (FG) fibers of rat hindlimb. After 1, 2, or 4 wk of HS or HI, single fibers were isolated from freeze-dried soleus and gastrocnemius muscles; a small section of each fiber was run on sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels to identify fiber type, and the remaining piece was assayed for either lactate dehydrogenase (LDH) and citrate synthase (CS) or phosphofructokinase (PFK) and beta-hydroxyacyl-CoA dehydrogenase (beta-OH-acyl CoA). Two weeks of HS induced an almost twofold increase in the activity of CS (2.13 +/- 0.13 vs. 3.60 +/- 0.26 mol.kg dry wt-1.h-1) in the SO fiber of the soleus, and the activity stayed high at 4 wk. Although the FOG fiber had significantly higher CS activity (3.85 +/- 0.29) than either the SO or FG (1.59 +/- 0.16 mol.kg dry wt-1.h-1) fiber, neither fast fiber type was altered by HS. The glycolytic enzymes LDH and PFK were both elevated in the SO fiber after HS. The increase in LDH occurred by 1 wk (14.80 +/- 1.51 vs. 8.83 +/- 0.78), whereas the activity of PFK was not significantly changed until 4 wk (1.16 +/- 0.13 vs. 0.68 +/- 0.05 mol.kg dry wt-1.h-1). The control FG fiber had the highest LDH (44.30 +/- 2.29) and PFK (2.40 +/- 0.16) activities, followed by the FOG fiber (LDH, 34.10 +/- 2.83; PFK, 1.62 +/- 0.17 mol.kg dry wt-1.h-1); however, the activities of these glycolytic enzymes in the fast fiber types were unaltered by HS. The activity of beta-OH-acyl-CoA was not affected by HS in either the slow or fast fiber types. HI showed qualitatively similar changes to those observed with HS; however, the enzyme shifts developed with a slower time course. In conclusion, both HS and HI shifted the SO fiber enzyme pattern toward that of the control FOG fiber; however, a complete conversion from the SO to FOG fiber did not occur within the 4-wk treatment period. PMID- 2719098 TI - A review of water diffusion measurement by NMR in human red blood cells. AB - This review of water transport measurement in normal human erythrocytes attempts to harmonize discordant results obtained under diverse study conditions with two different techniques: nuclear magnetic resonance (NMR) and radioactive tracer (THO) diffusion. Natural aggregation of red cells into rouleaux appeared to cause most of the variation among results from NMR experiments. The remainder of the discrepancy was attributed to the use of inappropriate mathematical approximations of the two-site exchange equations, differences in blood storage time, and failure to adjust NMR calculations for the nonwater protons. Differences in hematocrit, frequency-magnetic field strength, or NMR pulse technique played no apparent role in the disparity among NMR reports. When these confounding factors were removed, diffusion results obtained by NMR or by influx or bulk diffusion of radioactive tracer agreed within a relatively narrow range of values. These techniques place the mean lifetime of water inside fresh normal human erythrocytes at room temperature (20-25 degrees C) between the extremes of 9.8 and 14 ms, where the uncorrected range was previously 9.8-21.7 ms. This new range of water exchange times corresponds to a range of diffusional permeability between 3.3 and 4.7 x 10(-3) cm/s. PMID- 2719099 TI - Extracellular Na+ electrode for monitoring net Na+ flux in cell suspensions. AB - A computer-linked extracellular sodium-sensitive electrode system is described that is suitable for the routine measurement of net Na+ transport in cell suspensions. The commercially available Na+ electrode exhibited high selectivity for Na+ over other cations and a rapid response time (less than 3 s). This system resolved changes of 0.4 mM in the presence of 147 mM extracellular Na+. Measurements of Na+ transport in suspensions of rabbit proximal tubules showed that ouabain caused a dose-dependent net Na+ influx with an inhibitor constant (Ki) of 2.5 +/- 0.2 microM and a maximal velocity (Vmax) of 229 +/- 7 nmol Na+.min-1.mg protein-1. This compared favorably with the ouabain-induced K+ efflux (Ki = 2.4 microM; Vmax = 160 +/- 3.3 nmol K+.min-1.mg protein-1) and the ouabain-induced inhibition of respiration (Ki = 3.3 microM; Vmax = 11.8 nmol O2.min-1.mg protein-1). In addition, Ba2+, a K+ channel blocker known to depolarize the cell, caused a net Na+ efflux, whereas glucose, a Na+ cotransported solute, promoted a net Na+ influx. This system should be a powerful tool for continuous monitoring of net Na+ fluxes in cell suspensions. PMID- 2719100 TI - Angiotensin receptors in pulmonary arterial and aortic endothelial cells. AB - Angiotensin II (ANG II) is formed from angiotensin I by the action of angiotensin converting enzyme located on the luminal surface of vascular endothelial cells. We determined whether binding sites specific for ANG II exist on pulmonary artery and aortic endothelial cells. The binding of 125I-ANG II to pulmonary artery and aortic endothelial cells was time dependent, saturable, and reversible. Scatchard analysis indicated a single class of high-affinity binding sites with equilibrium dissociation constants (Kd) of 0.85 and 0.81 nM and total binding capacities of 70 and 73 fmol/mg protein in pulmonary artery and aortic endothelial cells, respectively. Angiotensin analogues [Sar1,Ile8]ANG II and [Sar1,Ala8]ANG II, as well as angiotensin I and angiotensin III, competitively displaced 125I-ANG II in both pulmonary artery and aortic endothelial cells. The degree of inhibition of 125I-ANG II binding by these angiotensin analogues and antagonists was comparable except that [Sar1,Ala8]ANG II was 65% less potent than the other antagonists in both cell types. The binding of 125I-ANG II in pulmonary artery and aortic endothelial cells was not affected by vasopressin, substance P, or insulin, suggesting the presence of specific angiotensin receptors on these cells. These receptors appear to recognize the general configuration of angiotensin peptide rather than being specific to ANG II with no major differences between endothelial cells from pulmonary arterial or aortic vessels. PMID- 2719101 TI - Role of chloride in potassium transport through a K-Cl cotransport system in human red blood cells. AB - In this paper, we report experiments demonstrating the coupling of Cl and K movements in a volume-dependent K-Cl cotransport system in human red blood cells. We show that an outwardly directed Cl gradient can promote net K efflux against an inwardly directed K gradient at constant membrane potential. Red blood cell membrane potential was kept constant by using anions that are not transported through the K-Cl cotransport system but that are more permeable than Cl (NO3 and SCN). Under these conditions, when the activities of band 3 (capnophorin) mediated anion exchange and of the carbonic anhydrase have been inhibited, it is possible to maintain a Cl gradient at constant membrane potential. Similar data were obtained in human red blood cells (least dense fraction from normal subjects and whole blood from patients with homozygous hemoglobin S disease), in rabbit red blood cells, and in low-K sheep red blood cells. These data confirm that the volume-dependent Cl-dependent K movement in these cells operates through coupled K-Cl cotransport. PMID- 2719102 TI - Impact of body fat mass and percent fat on metabolic rate and thermogenesis in men. AB - To clarify further the independent relationships of body composition parameters to energy expenditure, resting metabolic rate (RMR) and postprandial thermogenesis were studied in four groups who were matched for absolute fat mass (study 1) and relative fatness (study 2). In study 1, five lean [group A, 15.4 +/ 0.6% (+/- SE) body fat] and five obese men (group B, 25.0 +/- 0.9% fat) were matched on body fat mass (13.0 +/- 0.9 vs. 14.4 +/- 0.8 kg, respectively). Fat free mass (FFM) and total weight were greater for group A than B. RMR was measured for 3 h in the fasted state and after a 720-kcal mixed meal. RMR was greater for group A than B (1.38 +/- 0.08 vs. 1.14 +/- 0.04 kcal/min, P less than 0.05). The thermic effect of food, calculated as 3 h postprandial minus fasting RMR, was greater for group A than B (65 +/- 6 vs. 23 +/- 9 kcal/3 h; P less than 0.05). In study 2, two groups (n = 6 men/group) were matched for percent body fat (33 +/- 1% fat for both) but differed in lean, fat, and total weights: 50.8 +/- 3.1 kg FFM for the lighter (group C) vs. 68.0 +/- 2.8 kg FFM for the heavier (group D) group, P less than 0.05. RMR was lower for group C than D (1.17 +/- 0.06 vs. 1.33 +/- 0.04 kcal/min, P less than 0.05), but the thermic effect of food was not significantly different (31 +/- 3 vs. 20 +/- 6 kcal/3 h).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719103 TI - Rapid measurement of whole body and forearm protein turnover using a [2H5]phenylalanine model. AB - Whole body protein turnover was measured in six normal adults using a model based on a primed constant infusion of [2H5]phenylalanine and, independently, by an established method of a primed constant infusion of [1-13C]leucine. Isotopic plateau in plasma was achieved within 2 h for [2H5]phenylalanine and, in four of the subjects who received a priming dose of [2H4]tyrosine, for [2H4]tyrosine. In all subjects whole body protein turnover measured with the phenylalanine model (mean protein synthesis, 2.65 +/- (SD) 0.16 g.kg-1.24 h-1; catabolism, 3.58 +/- 0.26 g.kg-1.24 h-1) was similar to that measured using the leucine model (synthesis, 3.09 +/- 0.27 g.kg-1.24 h-1; catabolism, 3.70 +/- 0.35 g.kg-1.24 h 1). Mean forearm fractional muscle protein synthesis calculated by the phenylalanine model was 0.06 +/- 0.03%/h, which compares closely with literature values derived by other methods. The phenylalanine model allows the rapid assessment of whole body and muscle protein turnover from plasma samples alone, obviating the need for measurement of expired air CO2 production or enrichment. PMID- 2719104 TI - Testing of the assumptions made in estimating the extent of futile cycling. AB - In estimating glucose and fructose 6-phosphate futile cycling in vivo, complete detritiation of [2-3H]glucose is assumed at the glucose 6-phosphate level, [3 3H]glucose at triose phosphate formation, and [6-3H]glucose in its conversion to glucose via pyruvate. [3-3H]glucose detritiation via the pentose cycle is assumed to be negligible. Normal and non-insulin-dependent diabetic subjects, in the basal state and infused with glucose, were given [2-3H,2-14C]galactose, and 3H-to 14C ratios in blood glucose were determined. [2-3H,2-14C]glucose was given with acetaminophen, and 3H/14C in urinary glucuronide was determined. Detritiation at glucose 6-phosphate was approximately 80%. [3-3H,1-14C]fructose was infused, and 3H/14C was determined in blood glucose and urinary glucuronide. At triose phosphate, 75-90% of the 3H was removed. The pentose cycle contribution was only a few percent. [6-3H,6-14C]glucose was infused, and 3H/14C in blood lactate was determined. [3-3H,3-14C]lactate was infused, and ratios in blood glucose were determined. Maximally, 10% of 3H from [6-3H]glucose was retained. If glucose and galactose are metabolized in the same hepatic site(s), glucose conversion to three-carbon intermediates in the indirect pathway of glycogen formation occurs in extrahepatic tissue(s). Reported estimates of futile cycling, although qualitatively correct, quantitatively require correction. PMID- 2719105 TI - Role of antiglucocorticoid RU 486 on dexamethasone-induced hypertension in rats. AB - This study was conducted to investigate whether hypertension induced by long-term in vivo administration of dexamethasone in rats could be prevented by the newly synthesized potent antiglucocorticoid drug RU 486. Subcutaneous implantation of 5 mg of dexamethasone pellets in Sprague-Dawley rats resulted in a rapid increase in the blood pressure that remained elevated during the 3 wk of experimental observation. RU 486 (50 mg) administered alone surprisingly showed slight elevation of blood pressure over untreated control animals. However, the blood pressure leveled off to control levels over the next 2 wk. Interestingly, a 50-mg RU 486 pellet implanted along with 5 mg of dexamethasone effectively prevented the dexamethasone-induced increase in blood pressure. RU 486 administered together with dexamethasone prevented dexamethasone-induced diuresis and urinary Na+ excretion. However, RU 486 was unable to reverse the weight loss or involution of thymus observed by long-term treatment with dexamethasone alone. No abnormalities were found in either kidneys or hearts in any of the treated groups under microscopic examination. These results suggest that RU 486 successfully prevented the hypertension produced by the long-term administration of dexamethasone in male Sprague-Dawley rats. PMID- 2719106 TI - Medium-chain fatty acids increase glucose production in normal and low birth weight newborns. AB - To study the pathogenesis of hypoglycemia in low birth weight infants, glucose production was measured in five hypotrophic and four premature newborns with glycemia of 45 +/- 6 and 59 +/- 10 mg/dl, respectively. Hepatic glucose output averaged 5.7 +/- 0.4 and 5.3 +/- 0.5 mg.kg-1.min-1 in these neonates vs. 8.2 +/- 0.5 mg.kg-1.min-1 in five normal at term newborns and was correlated with glycemia (P less than 0.02). Despite normal plasma free fatty acids, the low birth weight infants had low ketone levels of 163 +/- 72 and 126 +/- 65 vs. 263 +/- 60 microM in normals. Oral administration of medium-chain triglycerides to the neonates increased their circulating ketones by two- to threefold and restored near-normal glycemia (51 +/- 9 and 76 +/- 8 mg/dl) and production of glucose (6.7 +/- 0.7 and 6.6 +/- 0.8 mg.kg-1.min-1) in the hypotrophic and premature vs. normals (8.7 +/- 0.7 mg.kg-1.min-1). Individual rates of glucose production correlated with ketone concentrations (P less than 0.02). We conclude that the hypoglycemia characterizing low birth weight neonates is primarily due to impaired glucose production. That exogenous lipids were able to increase glucose production indicates that fatty acid oxidation plays an important glucoregulatory role in the human newborn. PMID- 2719107 TI - Voltage-driven, taurocholate-dependent secretion in isolated hepatocyte couplets. AB - Bile formation by the liver is largely dependent on the transport of bile acids by hepatocytes. This process is thought to result from Na-coupled uptake of bile acids into the cell and voltage-dependent, carrier-mediated transport from cell to canaliculus. However, the dependence of bile secretion on membrane potential has not yet been observed. In this study, the effect of changes in membrane potential differences on bile secretion was tested by impaling rat hepatocyte couplets with microelectrodes, changing membrane potential by intracellular current injection, and measuring fluid secretion by optically determining canalicular size. In the presence of 50 microM taurocholate, membrane potential was -33.3 +/- 5.8 mV and canalicular area increased by 6 +/- 6%/min, corresponding to a fluid secretion rate of 2-4 fl/min. In contrast, when intracellular voltage was suddenly changed to -109.9 +/- 15.0 mV, the canalicular area increased by 20 +/- 4%/min, corresponding to a secretion rate of 19 fl/min. When these experiments were repeated in the absence of taurocholate, the negative clamp had no effect on canalicular size. Taurocholate itself did not alter membrane potential. These findings support the hypothesis that canalicular bile secretion depends on a process equivalent to electrodiffusion. We therefore conclude that membrane voltage is a driving force for taurocholate-dependent fluid secretion by the liver. PMID- 2719108 TI - Effect of VIP antagonist on VIP-, PGE2-, and acid-stimulated duodenal bicarbonate secretion. AB - Vasoactive intestinal peptide (VIP), prostaglandin E2 (PGE2), and luminal acidification are each potent stimulants of duodenal mucosal bicarbonate secretion. The present experiments were performed to determine whether the recently described VIP antagonist, [4Cl-D-Phe6,Leu17]VIP, suppresses VIP stimulated duodenal mucosal bicarbonate secretion and to determine whether VIP serves as a mediator of bicarbonate secretion stimulated by acid or PGE2. In anesthetized rats, the effects of intravenous VIP, intraluminal PGE2, and intraluminal HCl on duodenal mucosal bicarbonate secretion both in the presence and absence of [4Cl-D-Phe6,Leu17]VIP were measured. The VIP antagonist inhibited duodenal bicarbonate secretion stimulated by both intravenous VIP and luminal acidification but not luminal PGE2. These findings suggest that VIP could be one mediator of acid-induced duodenal bicarbonate secretion and that the mechanism of PGE2-stimulated bicarbonate secretion is independent of VIP. PMID- 2719109 TI - Cholecystokinin and gastrin peptides stimulate ODC activity in a rat pancreatic cell line. AB - Recent studies have demonstrated that cholecystokinin (CCK) receptors are heterologous in peripheral tissues and in the central nervous system and that CCK gastrin (CCK-G) peptides are potent trophic factors for the gastrointestinal tract. In the present study we used 125I-labeled gastrin and 125I-labeled CCK to demonstrate the heterogeneity of CCK receptors on a rat pancreatic acinar cell line (AR4-2J) and analyze the role of these receptors in increasing the activity of ornithine decarboxylase. Pharmacological analysis of radioligand binding fit well with the presence of two different receptors: 1) a CCK-selective receptor having the characteristics of the CCK receptor present on normal pancreatic cells and 2) a high-affinity, low-selectivity CCK-G binding site that interacts with all CCK-G peptides sulfated and nonsulfated. CCK-G peptides stimulate ornithine decarboxylase activity with the following order of potencies (EC50): G-(2-17)-ds (0.1 nM) greater than or equal to CCK-9 (0.25 nM) greater than or equal to pentagastrin (0.4 nM) greater than CCK-4 (6 nM). This stimulation was not inhibited by CCK antagonist (asperlicin) at a concentration range that blocks the CCK receptor but does not compete with 125I-labeled gastrin binding to the CCK-G receptor. These results, obtained with CCK-G agonists and antagonists, demonstrate that ornithine decarboxylase stimulation in these cells is mediated via the CCK-G receptor. PMID- 2719110 TI - Modulation of the duration of human postprandial motor activity by sleep. AB - We have measured the effect of the presence of food in the gastrointestinal tract on proximal small bowel motility during sleep. Motility was measured in eight healthy ambulant subjects using two strain-gauge microtransducers incorporated in a fine (2.5 mm OD) nasojejunal tube. The subjects ate a 540-cal evening meal (EM) on the first day. On the following day they ate an equicaloric meal (with similar proportion of carbohydrates, proteins, and fats) at lunch time (MM) and then another equicaloric late meal (LM) 15 min before going to bed. All subjects were asleep within 30 min of completing the LM. Postprandial activity was significantly (P less than 0.001) shortened after LM, but there was no difference in the postprandial motor activity after MM and EM. Migrating motor complex (MMC) cycle lengths were similar after MM, EM, and LM. There was no difference in the duration of phase II of the MMC cycle after MM, EM, and LM even though subjects were asleep during the MMC cycles after LM. The MMC propagation velocity after LM and EM was significantly (P less than 0.01, P less than 0.001, respectively) slower than the diurnal MMC propagation velocity after MM. In health, postprandial activity is diminished during sleep, whereas the consumption of a LM restores the phase II activity usually absent during sleep. A LM also abolishes the expected reduction in nocturnal MMC cycle length but maintains the circadian variation in the propagation velocity of the MMC cycle. PMID- 2719111 TI - Putrescine uptake and release by colon cancer cells. AB - We have investigated the uptake and release of [3H]putrescine by a human colon adenocarcinoma cell line (LoVo) maintained on filter inserts. This culture system permits the cells to develop morphological polarity and provides separate access to the basolateral and apical surfaces of the cells. [3H]putrescine was taken up more readily by the basolateral than by the apical side of the cells. [3H]putrescine uptake could be stimulated greater than 300 times by either 10 mM asparagine or 10% fetal bovine serum. [3H]putrescine was accumulated to a concentration gradient of approximately 300-fold; uptake could be inhibited 50% by 7.5 microM unlabeled putrescine and was not dependent on Na+. The release of [3H]putrescine into the apical medium was inhibited by asparagine or fetal bovine serum. Usually, less than one-thousandth of the [3H]putrescine taken up into the cells was released into the apical medium. Release of [3H]putrescine did not correspond to the accumulation of [14C]-inulin in the apical medium. For these reasons we concluded that putrescine release was not simply passive leakage but was responsive to intracellular demand. The [3H]putrescine taken up by the cells as well as that released into the apical medium was greater than 90% unmetabolized at 4h. PMID- 2719112 TI - Characteristics of spermidine uptake by isolated rat enterocytes. AB - Eukaryotic cells require polyamines for growth. The supply of polyamines to growing cells may be increased either by new synthesis or increased uptake. We have recently shown that putrescine uptake by isolated rat enterocytes is energy dependent, saturable, and ouabain insensitive. Although putrescine uptake was inhibited by putrescine and cadaverine, it was not inhibited by equal concentrations of spermine and spermidine. These data indicated that a carrier mechanism separate from that putrescine existed for spermidine and spermine. In the current study spermidine uptake by isolated enterocytes was saturable, temperature dependent, and inhibited by 1 mM KCN. Kinetic analysis resulted in a Km = 2.51 x 10(-6) M and a Vmax = 3.57 x 10(-12) mol.10(6) cells-1.15 min-1. Spermidine uptake was 70% inhibited by 1 mM ouabain. Replacement of sodium by choline, lithium, tetramethylammonium, or N-methyl-D-glucamine also inhibited spermidine uptake. Replacement of Na+ by mannitol or sucrose, however, depressed uptake but not significantly. Spermidine uptake was inhibited by 1 mM ouabain. Spermidine uptake was inhibited by relatively low concentrations of spermine and high concentrations of putrescine; while putrescine uptake was inhibited by relatively high concentrations of both spermine and spermidine. Kinetic data indicated that spermidine and spermine share a carrier that is distinct from the one mediating the uptake of putrescine. While spermidine uptake does not appear to depend on Na+ cotransport, it may be dependent on the electrical gradient established by the Na+-K+-ATPase. PMID- 2719113 TI - Noradrenergic influence on epithelial responses of rabbit ileum to secretagogues. AB - Norepinephrine is one of three neurotransmitters that may act directly on enterocytes to enhance absorption; its interaction with secretagogues is of physiological importance. We have studied the influence of norepinephrine on the short-circuit current (Isc) responses to acetylcholine (ACh; 10 microM), vasoactive intestinal polypeptide (VIP; 100 pM-10 nM), peptide histidine isoleucine (PHI; 100 pM-10 nM), histamine (0.1 mM), and to electrical field stimulation (EFS) of rabbit ileum mounted in flux chambers. Tetrodotoxin reduced the response to norepinephrine (10 microM) by 40% and to histamine by 32% but did not affect responses to VIP or PHI. Norepinephrine decreased the ACh response (EC50, 70 nM) and reduced the responses to PHI (less than or equal to 87%), to EFS (less than or equal to 75%), and to histamine (less than or equal to 42%). Norepinephrine decreased the response to VIP (500 pM) but not to higher or lower VIP concentrations. It enhanced the response to VIP (10 nM) and to theophylline (5 mM). We conclude that 1) norepinephrine increases absorption by acting on nerves and enterocytes; 2) the failure of norepinephrine to reduce the Isc response to VIP when the VIP-induced increment in Isc is comparable to that caused by EFS is evidence that VIP does not mediate the EFS response; 3) PHI might mediate the EFS response; and 4) VIP, PHI, and histamine affect enterocytes directly; histamine also affects intrinsic nerves. PMID- 2719114 TI - Development of rat jejunum: lipid permeability, physical properties, and chemical composition. AB - This study reports the correlation between jejunal microvillus membrane's chemical composition, physical properties, and lipid permeability over the age range of 9-25 days in the rat. During this period of time the diet varies from entirely maternal milk (9 days, suckling) to milk plus chow (18 days, weaning) to finally predominantly chow (25 days, weaned). Lipid permeability was found to be greatest during the suckling period but decreased rapidly over the subsequent 2 wk of life. Alterations in lipid permeability were correlated with maturation of the microvillus membrane, both in terms of its lipid fluidity and chemical composition. The static component of membrane fluidity did not vary significantly over this time period, in agreement with a constant molar ratio of cholesterol-to phospholipid (0.87 +/- 0.08, 0.94 +/- 0.07, and 0.84 +/- 0.04 at ages 9, 18, and 25 days, respectively). However, decreasing membrane lipid permeability correlated with decreasing lipid fluidity assessed by probes sensitive to the dynamic component of membrane lipid fluidity within the superficial regions of the bilayer. Furthermore, by measurement of the incremental change in free energy associated with a methylene group partitioning into the microvillus membrane, the hydrophobicity of the membrane could be assessed in vivo. These data demonstrate that suckling rats have the most hydrophobic microvillus membrane (-459 +/- 30 cal/mol), but with maturation a decline in membrane hydrophobicity occurred (-358 +/- 60 cal/mol). The results suggest that during the first 3 wk of life the jejunal microvillus membrane of the rat undergoes a maturation process that is well suited to the change in dietary nutrients ingested. Furthermore, changes in lipid permeability, in vivo properties of the microvillus membrane, and the associated change in lipid fluidity are similar to associations recently recognized in the adult animal. PMID- 2719115 TI - Sodium excretion during elevation of renal venous pressure: modulation by dDAVP. AB - Studies were performed to determine the effects of elevation of renal venous pressure on sodium excretion by the isolated perfused rat kidney in the presence and absence of a specific V2-receptor agonist, 1-des-amino-8-D-arginine vasopressin (dDAVP), at a concentration (1 ng/ml) expected to have maximal antidiuretic activity but minor vasopressor action. In either the presence or absence of dDAVP, increments in venous pressure led to falls in perfusate flow rate and glomerular filtration rate, which became significant at an imposed pressure greater than or equal to 18.75 mmHg. In the absence of dDAVP, absolute sodium excretion fell as venous pressure increased, and there was a negative correlation between fractional sodium excretion (FENa) and renal venous pressure (RVP) within each experiment and when all data points were combined: FENa = 3.46 0.072RVP (r = -0.608, P less than 0.01). In contrast, in the presence of dDAVP, absolute sodium excretion was unchanged, and in four of five experiments FENa rose as venous pressure increased (in one it remained unchanged). Linear regression analysis of all data points showed a positive correlation between FENa and RVP: FENa = 1.27 + 0.127RVP (r = 0.392, P less than 0.05). The slopes of the two regression lines were significantly different (P less than 0.001). It is postulated that this effect of dDAVP may be mediated via changes in the distal tubular pressure response to elevation of RVP. Such an effect of vasopressin could explain the observation that the response to renal vein constriction in vivo is dependent on volume status. PMID- 2719116 TI - Regulation of plasminogen activation in isolated perfused rat kidney. AB - To better understand the mechanism and regulation of plasminogen activation within the kidney, the release and excretion of plasminogen activator activities was studied in the isolated perfused rat kidney in the absence and presence of plasminogen substrate. In the absence of plasminogen, the kidneys released a constant amount of plasminogen activator activity into both the urine and the perfusate. On continuous infusion of purified human plasminogen into the perfusate, the release of plasminogen activator activity into the urine slightly increased, and plasmin generated could be detected in both urine and perfusate. With the use of specific antibodies against the tissue-type (t-PA) and the urokinase-type plasminogen activator (u-PA), respectively, the activity in the perfusate could be identified as t-PA, whereas the activity in the urine could be ascribed to u-PA. A bolus injection of either antibody into the plasminogen supplemented perfusion medium completely inhibited plasminogen activator activity and generation of plasmin in the vascular or tubular compartment. Furthermore, intrarenal inhibition of t-PA activity by the specific antibody significantly increased the concentration of plasminogen in the perfusate, indicating decreased consumption. This effect was accompanied by increased excretion of u-PA into the urine, suggesting that the availability of intact plasminogen in the renal circulation directly or indirectly might participate in the regulation of u-PA excretion into the urine. PMID- 2719117 TI - Role of renal nerves in renal sodium retention of nephrotic syndrome. AB - To define the role of the renal nerves in the renal sodium retention of the nephrotic syndrome, experiments were conducted in rats given adriamycin to produce nephrotic syndrome. All rats developed proteinuria and hypoalbuminemia and exhibited edema formation. Adriamycin-injected nephrotic rats were subjected to bilateral renal denervation (ADRIADNX) or sham renal denervation (ADRIASHAM). Rats injected with adriamycin vehicle were subjected to bilateral renal denervation (DNX) or sham renal denervation (SHAM). Metabolic balance studies were carried out in all rats beginning on the 8th day after bilateral or sham renal denervation. Dietary sodium content was 210 meq/kg Na on days 8-12 and days 24-26 and was 10 meq/kg Na on days 13-23. Nephrotic rats demonstrated significantly greater overall (19 days) cumulative sodium balance than vehicle control rats, ADRIASHAM 8.47 +/- 0.81 vs. SHAM 5.74 +/- 0.34 meq Na, P less than 0.01. Bilateral renal denervation did not significantly affect overall cumulative sodium balance in the vehicle control rats, DNX 6.15 +/- 0.71 vs. SHAM 5.74 +/- 0.34 meq Na. However, bilateral renal denervation significantly decreased overall cumulative sodium balance in the nephrotic rats, ADRIADNX 6.59 +/- 0.56 vs. ADRIASHAM 8.47 +/- 0.81 meq Na, P less than 0.01. Results indicated that the increased renal sodium retention characteristic of nephrotic syndrome is dependent, in large part, on increased efferent renal sympathetic nerve activity. PMID- 2719118 TI - Net calcium efflux from live bone during chronic metabolic, but not respiratory, acidosis. AB - In vivo chronic metabolic acidosis induces bone mineral dissolution. Whether the dissolution is due to alterations in physicochemical factors alone, as in acute metabolic acidosis, or requires participation of bone cells is not clear. The effect of chronic respiratory acidosis on bone has also not been established. To determine the effects of chronic metabolic and respiratory acidosis on net calcium flux from bone, we cultured live and dead neonatal mouse calvariae for 99 h in control medium or in medium acidified (pH approximately equal to 7.1) either by lowering the bicarbonate concentration (Met) or by increasing the PCO2 (Resp). We measured net calcium flux (JCa) over 0-48, 48-96, and 96-99 h. Over the first 48 h, there was greater net calcium efflux from live and dead Met than from both Resp groups. All four acidic groups had greater net calcium efflux than controls. Over the last 51 h of the chronic 99 h culture, there was net calcium efflux only from live Met (JCa = 285 +/- 129 nmol.bone-1.3 h-1) and not from any of the other groups (live control, JCa = -183 +/- 24; live Resp, JCa = -110 +/- 22; dead control, JCa = -256 +/- 12; dead Met, JCa = 11 +/- 78; dead Resp, JCa = -27 +/- 47; each P less than 0.02 vs. live Met). There is net calcium efflux from live cultured neonatal mouse calvariae during chronic metabolic, but not respiratory, acidosis. During chronic acidosis, decreased medium bicarbonate, and not just a fall in pH, is necessary to enhance net calcium efflux from live bone. PMID- 2719119 TI - Characterization of apical and basolateral membrane conductances of rat inner medullary collecting duct. AB - Initial segments of the inner medullary collecting duct of the rat were perfused in vitro, and the electrophysiological properties of the apical and basolateral membranes were examined with KCl-filled microelectrodes. The fractional resistance of the apical membrane (FRa = Ra/Ra + Rbl) and the transepithelial resistance (RT) were estimated by cable analysis. In control tubules the transepithelial voltage (VT) averaged -2.2 mV, and the voltage across the basolateral membrane (Vbl) averaged -51.1 mV. RT was 11.9 k omega.cm (72.8 omega.cm2), and FRa was 0.94. Pretreatment of the rats with deoxycorticosterone (DOC)-pivalate for 7-10 days did not alter these electrophysiological properties. In control tubules, amiloride in the lumen (10(-5) M) changed VT from -3.0 to +1.4 mV and increased Vbl from -49.4 to -53.8 mV, RT from 12.5 to 13.6 k omega.cm, and FRa from 0.92 to 0.98. Thus the apical membrane is conductive to Na+. An increase of the bath K+ concentration from 4 to 15 mM caused an 18.8 mV depolarization of Vbl: barium in the bath also depolarized Vbl. A fivefold decrease in the [HCO3-] in the bath depolarized Vbl by 13.1 mV. 4,4' Diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS) blocked this depolarization. Thus the basolateral membrane is conductive to K+ and HCO3-. Experiments with ouabain revealed a Na+-K+-ATPase in the basolateral membrane. Taken together, the results support a model in which electrogenic Na+ absorption is driven by the Na+ K+-ATPase in the basolateral membrane, with passive movement of Na+ occurring through an amiloride-sensitive conductive pathway in the apical membrane. PMID- 2719120 TI - Phorbol esters and arginine vasopressin in vascular smooth muscle cell activation. AB - Vascular smooth muscle cell (VSMC) contraction is the result of several interacting mechanisms. In this study such interactions in rat aortic VSMC in culture were examined with a focus on the role of protein kinase C-mediated mechanisms. The change in shape of VSMC was used as a functional parameter representative of contraction. The protein kinase C agonist, phorbol myristate acetate (PMA), and arginine vasopressin (AVP) induced a dose-dependent, progressive change in VSMC shape. The effects of PMA differed from AVP in the delay time necessary to reach the plateau of the response and in the absence with PMA of a transient rise in cytosolic free Ca2+ [( Ca2+]i). The effect of PMA was potentiated by the Ca2+ ionophore, ionomycin, and involved a verapamil inhibitable transmembrane Ca2+ transport system. Protein kinase C inhibition by either isoquinolin-sulfonyl-O-2-methylpiperazine or protein kinase C desensitization significantly reduced the cell shape change induced by either PMA or AVP. In the case of AVP, this inhibitory effect occurred without affecting the [Ca2+]i transient. Therefore, the [Ca2+]i transient appears to be independent of acute protein kinase C regulation, since it is apparently not affected by the absence of protein kinase C activity. Protein kinase C activation by PMA produced intracellular alkalinization that is blocked by the sodium transport antagonist, amiloride. Amiloride also blocked the cell shape change induced by PMA or AVP. The intracellular alkalinization, however, was not necessary for the cell shape change to occur. Specifically, with the use of VSMC preincubated with fetal calf serum, PMA did not induce cellular pH changes but still produced cell shape changes. PMID- 2719121 TI - Organic osmolytes in inner medulla of Brattleboro rat: effects of ADH and dehydration. AB - Inner medullary methylamine [glycerophosphorylcholine (GPC) and glycine betaine (betaine)] and polyol [sorbitol and myo-inositol (inositol)] osmolytes were measured in water-restricted and antidiuretic hormone (ADH)-infused Brattleboro (DI) rats. Compared with DI rats allowed water ad libitum, rats dehydrated for 3 days had higher urinary osmolality (Uosmol) (812 vs. 239 mosmol/kgH2O) and plasma osmolality (Posmol) (333 vs. 296 mosmol/kgH2O). Dehydration reduced betaine content (36 vs. 66 nmol/mg protein) but had no significant effect on GPC, sorbitol, or inositol. In separate protocols, DI rats, allowed water ad libitum, were infused for either 3 or 12 days with either ADH in saline (+ADH) or saline alone (-ADH). Compared with -ADH controls, 3- or 12-day ADH-infused rats were antidiuretic (Uosmol, 1,000-1,300 mosmol/kgH2O) but not dehydrated (Posmol, 297 300 mosmol/kgH2O). Three days of ADH infusion caused an increase in GPC (340%), betaine (80%), and sorbitol (248%) but not in inositol. After 12 days of ADH, further increases were observed in GPC (730%) and sorbitol (870%); inositol was also elevated (170%), whereas betaine was unchanged. Consequently, the total osmolyte content was significantly higher in +ADH than in -ADH [449 vs. 256 (3 days) and 778 vs. 199 (12 day) nmol/mg protein], whereas total osmolyte levels in dehydrated and control rats were similar (222 vs. 219 nmol/mg protein).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719122 TI - Flow dependence of K+ secretion in cortical distal tubules of the rat. AB - Superficial distal tubules were pump perfused (range 0-35 nl/min), generally with solutions similar in composition to early distal tubule fluid, in control, K+ depleted, acutely K+-loaded, and K+-adapted rats with the use of double-barreled resin-reference microelectrodes to measure K+ and Na+ activities and transepithelial potential differences (PD). When perfusion rate decreased from 35 to 5 nl/min in control animals, [K+] increased from 2 mM to between 10 and 20 mM, remaining at these levels as perfusion rate was decreased further. In low-K+ rats, the change in K+ activity with flow was greatly attenuated. In K+-loaded and K+-adapted rats, [K+] was higher than in controls at all flow rates. Na+ concentrations and lumen-negative PD increased with high flow rates in control rats. Addition of 10(-3) M amiloride blocked the increase in luminal K+ with low flow rates. In the physiological range of late distal flow rates, luminal [K+] remains constant and similar to the concentration attained in the steady state. At higher flow rates, [K+] declines, and K+ balance, PD, and Na+ reabsorption modulate the relationship between K+ secretion and flow rate. PMID- 2719123 TI - Regulation of erythropoietin production is related to proximal tubular function. AB - Regulation of renal erythropoietin (EPO) production is based on an intrarenal oxygen sensor. Whereas the sensitivity of this oxygen sensor to variations in renal oxygen supply is well established, the influence of changes in renal oxygen consumption has not yet been elucidated. Diuretic drugs, which inhibit active sodium reabsorption, reduce tubular oxygen consumption. We therefore investigated the effects of acetazolamide, furosemide, hydrochlorothiazide, and amiloride, known to preferentially inhibit sodium reabsorption at different segments of the nephron, on hypoxia-induced EPO formation in mice. Those drugs that are considered to act mainly in the loop of Henle, distal tubule, and collecting duct (furosemide, hydrochlorothiazide, and amiloride) did not impair EPO formation. Acetazolamide on the other hand, which is thought to act predominantly at the proximal tubular site, significantly reduced EPO formation in response to normobaric hypoxia (8 and 14% O2) and functional anemia (0.1% carbon monoxide). This inhibitory effect of acetazolamide was dose dependent and correlated with the natriuresis induced. It appeared not to depend on the metabolic acidosis induced by the drug, since the simultaneous administration of sodium bicarbonate, which restored standard bicarbonate levels to normal, did not diminish the inhibitory effect of acetazolamide on EPO production. In conclusion the data suggest that the regulation of EPO production is likely to be related to proximal tubular function. PMID- 2719124 TI - A simple HPLC method for quantitating major organic solutes of renal medulla. AB - A simple high performance liquid chromatography (HPLC) method of separating and quantitating the predominant organic solutes of the renal medulla is described. These organic solutes include myo-inositol, glycerophosphorylcholine, sorbitol, betaine, and urea. Other physiologically significant solutes, including glucose and mannitol, can be separated and quantitated concurrently with this method. With the use of this technique, the organic solutes of the rabbit kidney were determined. No new organic compounds were detected by HPLC that could significantly contribute to intracellular osmolality of the medulla. The values for the organic solutes already described were similar to those obtained by more complicated and limited approaches such as classical enzymatic techniques, ion electrodes, nuclear magnetic resonance spectroscopy, and gas chromatography-mass spectroscopy. PMID- 2719125 TI - Use of fluorescent dye BCECF to measure intracellular pH in cortical collecting tubule. AB - The compound 2'-7'-bis(carboxyethyl)-5(6)-carboxyfluorescein (BCECF) is being extensively used to measure intracellular pH (pHi) in a variety of tissue preparations. Use of this dye in the isolated perfused rabbit cortical collecting tubule (CCT) revealed two previously unreported findings. Apical incubation via luminal perfusion with the acetoxymethyl ester of BCECF (BCECF-AM) resulted in intense uptake into a minority cell population. Basolateral incubation via the peritubular bathing solution resulted in apparent homogenous uptake into all cells. The minority cells were identified as intercalated cells by the use of fluorescent probes specific for intercalated cells. Minority cell pHi was 7.34 +/ 0.06 (n = 9); majority cell pHi was 7.41 +/- 0.05 (n = 6). In addition, prolonged excitation of BCECF resulted in adverse effects. Intense continuous excitation for 1-3 min resulted in a fall in apparent pHi of 0.53 +/- 0.05 pH units (n = 6, P less than 0.001). After reloading with fresh BCECF-AM, the calculated pHi was 0.05 +/- 0.07 pH units higher than before prolonged excitation (P = NS), suggesting that the apparent decrease was due to changes in the pH sensitivity of BCECF as a result of the prolonged excitation. Prolonged excitation of cells with pHi clamped at 7.50 resulted in a decline in apparent pHi at the rate of 0.15 +/- 0.02 pH units/min (n = 4).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719126 TI - Multiple tracer studies of bone uptake of 99mTc-MDP and 85Sr. AB - Multiple tracer outflow dilution studies were performed on the normal canine tibia. In all cases 125I-labeled albumin was used as a vascular tracer. In one series of experiments 99mTc-labeled methylene diphosphonate and [14C]sucrose were used as test tracers, and in a second series 85Sr and 22Na were used. A bolus of three tracers was injected into the tibial nutrient artery, and fractional concentrations appearing in the ipsilateral femoral vein were measured for a period of 5 min. A distributed model, containing parameters for capillary and bone permeability and apparent volumes of distribution of interstitial fluid, was fitted to these data. It was found that there was no discrimination between movement of 85Sr or 22Na from interstitial fluid space into bone. Transcapillary exchange does not appear to be a significant barrier to exchange between blood and bone surfaces. PMID- 2719127 TI - Cell-to-cell interaction: a mechanism to explain wave-front progression of myocardial necrosis. AB - Histological sections performed 24 h after coronary occlusion in eight pigs displayed compact infarcts extending transmurally with well-defined edges; reconstruction and inspection of the area of necrosis showed a geometric distribution of the infarcts with very irregular, interdigitating edges always in continuity with the main mass of necrosis. Reperfusion in 32 pigs after periods of coronary occlusion of 90, 60, 45, and 30 min exponentially reduced infarct size and transmural extension of the infarct but did not modify its geometry. The two-dimensional size, progression, and geometry of the infarcts could be reproduced by a computer model. In the simulated infarcts, each myocardial cell within the area at risk was represented by a pixel. The algorithm included an inner loop, which determined at random at each iteration a status of reversible or irreversible damage to all pixels. The number of iterations could reproduce infarct of various sizes. With the addition of an index of transmural sensitivity to ischemia, progression of the infarct area could also be reproduced. The only possible means of reproducing the geometry of the infarct was to enter into the program a contiguity condition requiring a direct contact between irreversibly damaged pixels. These observations suggest that the physical interaction between cells is an important determinant of progression of necrosis during coronary occlusion. PMID- 2719128 TI - Alterations in vascular smooth muscle contractility during ovine pregnancy. AB - During pregnancy, sheep develop attenuated systemic and uterine vascular responsiveness to alpha-adrenergic stimulation. To determine whether this reflects altered vascular smooth muscle function, we studied the responsiveness of smooth muscle isolated from systemic and uterine arteries to KCl and phenylephrine. Uterine, renal, and carotid arteries were collected from nonpregnant, pregnant (131 +/- 2 days, +/- SD), and late postpartum (144 +/- 4 days) ewes; endothelium was removed and open rings were hung for measurement of isometric force. There were no differences in concentration-response relationships nor maximal stresses generated to phenylephrine between nonpregnant, pregnant, and late postpartum states for carotid or renal arteries. However, the 50% maximal concentration for phenylephrine of uterine arteries in the nonpregnant state (2.8 +/- 0.9 x 10(-6) M) was greater than the pregnant state (0.76 +/- 0.05 x 10(-6) M). Moreover, uterine arteries from pregnant sheep generated significantly more stress than those from nonpregnant sheep (2.2 +/- 0.23 vs. 0.73 +/- 0.23 x 10(6) dyn/cm2, P less than 0.01). The attenuated systemic and uterine vascular responses associated with pregnancy do not result from diminished adrenergic sensitivity or contractile capability of arterial smooth muscle. In contrast, there is increased stress-generating capacity of uterine arterial smooth muscle during pregnancy, which is reversed during the postpartum period. PMID- 2719129 TI - Minor preload dependence of O2 consumption of unloaded contraction in dog heart. AB - We studied whether end-diastolic volume (EDV) would affect myocardial oxygen consumption (VO2) of mechanically unloaded contraction in the cross-circulated dog heart, as expected from the concept of the myocardial length-dependent activation. We made preloaded but maximally unloaded contractions from different EDVs by quickly releasing ventricular volume to eliminate systolic pressure development and hence to minimize the VO2 for mechanical load during the contraction. We then studied the relation between VO2 and EDV. The VO2 of the almost unloaded contraction from a relatively large EDV slightly exceeded the VO2 of the isovolumic contraction at V0, where V0 is the volume at which peak isovolumic pressure was zero. However, the excess VO2 could be ascribed to the residual systolic pressure-volume area (PVA) adversely produced from the large EDV, where PVA is a measure of the total mechanical energy generated during contraction. Therefore, we considered that VO2 was practically little dependent on EDV. We interpreted this finding as an indication that an increase, if any, in VO2 due to the length-dependent activation of the excitation-contraction coupling was practically negligible in the whole heart preparation. PMID- 2719130 TI - Effects of vagus nerve on heart rate and ventricular contractility in chicken. AB - We determined the effects of vagus nerve stimulation on cardiac cycle length and on ventricular contraction and relaxation in 18 chickens anesthetized with pentobarbital. Right vagus stimulation at a constant frequency of 35 Hz prolonged cycle length by 190%, whereas left vagus stimulation at the same frequency increased cycle length by 136%. When one burst of stimuli was delivered to the right vagus nerve each cardiac cycle, but the timing of the stimuli was changed within the cardiac cycle, the response of the avian pacemaker cells varied substantially with the timing of the stimuli. Right and left vagus stimulation at a constant frequency of 20 Hz depressed ventricular contraction by 62 +/- 6 and 52 +/- 6%, respectively, and depressed ventricular relaxation by 56 +/- 7 and 53 +/- 7%, respectively. These results indicate that in the chicken the chronotropic effects of right vagus stimulation are greater than those of left vagus stimulation, whereas right and left vagus stimulation are approximately equipotent on ventricular contraction and relaxation. PMID- 2719131 TI - Preservation of coronary flow reserve in stunned myocardium. AB - Microvascular obstruction and persistent focal ischemia have been suggested as a possible cause of myocardial dysfunction (stunning) after brief coronary occlusion. Microvascular occlusion should result in a reduction in maximal coronary flow reserve, although resting transmural coronary flow may be maintained by release of local vasodilators, such as adenosine. To test the microvascular occlusion hypothesis, coronary flow reserve was measured in 14 anesthetized dogs, before and after myocardial stunning produced by 10 min of ischemia. Intracoronary adenosine infusion (5,900 microM/min) increased coronary flow to the same degree in normal [195 +/- 20 (SE) ml/min] and stunned (212 +/- 23 ml/min) myocardium. Peak hyperemic flow after 100 s of coronary occlusion was also similar in normal (205 +/- 25 ml/min) and stunned (218 +/- 23 ml/min) myocardium. The adenosine antagonist 8-phenyltheophylline (5 mg/kg) reduced the flow response to exogenous adenosine, but neither resting coronary flow nor peak hyperemic flow in stunned myocardium was altered. In stunned myocardium, myocardial shortening at rest (0.2 +/- 2.0%) increased during reactive hyperemia (to 13.8 +/- 2.5%, P less than 0.01), but shortening promptly returned to basal levels after each hyperemia. These findings indicate that fixed microvascular occlusion is unlikely to be an important factor in the pathogenesis of stunned myocardium and that local adenosine release does not appear to have a compensatory role in coronary vasoregulation in stunned myocardium. PMID- 2719132 TI - Effects of hypoxia on atrioventricular node of adult and neonatal rabbit hearts. AB - We used an isolated perfused heart model to assess the effects of graded hypoxia (95, 45, 20, 10, or 0% O2, exposure for 5 min) on the adult and neonatal (0-3 days) rabbit atrioventricular (AV) node. The AV nodal function was assessed by measuring the A-H interval at a constant atrial pacing cycle length, the longest pacing cycle length resulting in Wenckebach periodicity [Wenckebach cycle length (WCL)] and the AV nodal effective refractory period (AVNERP). The A-H intervals remained stable in neonatal hearts until O2 saturation was decreased to 10%. On the other hand, the A-H intervals began to increase in adult rabbit hearts at 20% O2. In 95% O2, the AV nodal WCL was longer in adult hearts than in the neonatal hearts (165 +/- 8 ms vs. 142 +/- 7 ms). The effect of hypoxia on the AV nodal WCL was significantly greater in adult hearts than in neonatal hearts when the O2 saturation was decreased to 20% (a 54% increase in adults vs. a 14% increase in neonates, P = 0.02). The difference was greater at lower levels of O2. In 95% O2 at comparable basis driving cycle length (240 ms), the A-H intervals were equal in neonatal and adult hearts (43 +/- 3 vs. 43 +/- 7 ms), but the AVNERP of the neonates was significantly longer than that of the adults (133 +/- 21 vs. 97 +/- 19 ms, P = 0.007).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719133 TI - Reperfusion arrhythmias: dose-related protection by anti-free radical interventions. AB - Isolated rat hearts (n = 15 per group) were subjected to regional ischemia (10 min) and reperfusion. Superoxide dismutase (SOD; 8 X 10(3), 2 X 10(4), 4 X 10(4), 6 X 10(4), 8 X 10(4), 1.2 X 10(5), or 1.6 X 10(5) IU/l) given early (i.e., throughout the experiment) reduced the incidence of reperfusion-induced ventricular fibrillation (VF), the dose-response characteristics describing an asymmetric U-shaped curve. The optimal dose of SOD (8 X 10(4) IU/l) reduced VF incidence from its control value of 87 to 27% (P less than 0.05). Given late (i.e., 2 min before reperfusion), this dose of SOD exerted a reduced but nonetheless significant antifibrillatory effect. Early administration of catalase (1 X 10(3), 1 X 10(4), 2.5 X 10(4), 5 X 10(4), 1 X 10(5), 1.5 X 10(5), or 1 X 10(6) IU/l) reduced VF incidence in a linear dose-dependent manner, from its control value of 87 to 7% with 1 X 10(6) IU/l (P less than 0.05). Late administration of this dose reduced VF incidence from its control value of 87 to 27% (P less than 0.05). Allopurinol (0.07, 0.15, 0.37, 0.73, 1.10, or 1.47 mM added to the perfusate throughout the experiment) significantly reduced VF incidence over a wide range of doses, but low and high doses were ineffective. Pretreatment with allopurinol (0, 0.01, 0.02, 0.05, 0.10, 0.20, or 0.50 g.kg 1.day-1 per os 48, 24, and 1 h before study) reduced VF incidence from its control value of 93 to less than 50% at several doses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719134 TI - Central oxytocin systems may mediate a cardiovascular response to acute stress in rats. AB - The role of central nervous system arginine vasopressin (AVP) and oxytocin (OXY) in the cardiovascular response to acute stress was examined using three experimental models: pharmacological antagonism of central AVP-OXY receptors; lesions of the paraventricular nucleus (PVN); and rats genetically lacking in AVP synthesis, i.e., the Brattleboro strain. Central administration of an AVP-OXY antagonist abolished the increase in heart rate (HR) seen following acute footshock stress. The group receiving centrally administered antagonist increased HR 15 +/- 17 (SE) beats/min, whereas, in contrast, the group receiving intravenous administration of the antagonist showed a 66 +/- 17 beats/min increase, and the group receiving intraventricular antagonist vehicle showed a 101 +/- 14 beats/min increase in response to stress. In a second study, electrolytic lesions of the PVN also blocked the increase in HR seen following stress, 20 +/- 12 beats/min for PVN-lesioned rats, 74 +/- 25 beats/min for sham lesion rats, and 93 +/- 7 beats/min for rats with a lesion not destroying the PVN. In the final study, the responses of Brattleboro rats, i.e., rats genetically deficient in vasopressin synthesis, were equivalent to their Long Evans controls (131 +/- 13 and 147 +/- 12 beats/min, respectively). In each of these studies, the blood pressure responses to the stressor were equivalent for control and experimental groups. The results of these studies suggest that a neuropeptide system originating in or passing through the PVN may play an important role in the cardiovascular responses to stress and further suggest that the central OXY system may be one pathway mediating this response. PMID- 2719135 TI - Differential effects of sleep stage on coronary hemodynamic function. AB - The sleep-wake cycle results in distinctive patterns of autonomic nervous system activity. The present study examined the effects of rapid eye movement and slow wave sleep on coronary hemodynamic function in chronically instrumented dogs. Mean arterial blood pressure was measured via a catheter in the aorta, and coronary blood flow was determined with Doppler probes placed around the left circumflex and right coronary artery. Identification of sleep stages was accomplished by means of electrodes implanted via the frontal sinus to record electro-oculogram, electromyogram, and electroencephalogram. Results indicated that during slow-wave sleep there were moderate but significant reductions in heart rate, 9% decreases in left coronary blood flow, and increases in coronary vascular resistance. In rapid-eye-movement sleep, the circumflex coronary blood flow base line returned to awake levels, and there were pronounced, phasic 35% increases in heart rate and 35% increases in coronary blood flow lasting 15-20 s. These surges were eliminated by stellectomy, indicating that they were mediated by the sympathetic nervous system. PMID- 2719136 TI - Age-related central and baroreceptor impairment in female Sprague-Dawley rats. AB - To determine whether baroreflex sensitivity changes with age, we compared drug induced reflex responses in 2- and 9-mo-old female Sprague-Dawley rats anesthetized with urethan-chloralose. Baroreflexes were stimulated by elevating or lowering blood pressure with intravenous infusions of phenylephrine or sodium nitroprusside. Reflex responses in heart rate and sympathetic nerve activity during phenylephrine infusions were weaker in 9- than in 2-mo-old rats, as were reflex tachycardia during sodium nitroprusside infusion and decreases in heart rate and sympathetic nerve activity elicited by electrical stimulation of the left aortic depressor nerve. Afferent aortic nerve activity was also appreciably lower in 9-mo-old rats at pressures greater than 130 mmHg but did not differ between rat groups at normotensive pressures. These results suggest that baroreflex sensitivity in 9-mo-old rats can be characterized as follows: 1) impaired at pressures greater than 130 mmHg but still adequate at normotensive pressures, and 2) all reflex arc components may be impaired. PMID- 2719137 TI - Acetylcholine increases intracellular sodium activity in sheep cardiac Purkinje fibers. AB - The action of acetylcholine (ACh) on intracellular sodium activity (alpha iNa) was studied in sheep Purkinje fibers by means of a Na+-selective microelectrode technique while transmembrane potentials and contractile force were simultaneously recorded. In quiescent fibers, 10(-4) to 10(-5) M ACh shifted the resting potential to less negative values and increased alpha iNa from 5.57 +/- 0.21 to 6.45 +/- 0.35 mM (+15.8%, P less than 0.005). In other experiments, ACh induced a depolarization that initiated spontaneous activity. In fibers driven at 60 beats/min, ACh prolonged the action potential, increased alpha iNa from 7.98 +/- 0.15 to 9.36 +/- 0.3 mM (+17.29%, P less than 0.005), and increased contractile force. Norepinephrine (10(-5) to 10(-6) M) increased contractile force and decreased alpha iNa, but in its presence ACh still increased force and alpha iNa and vice versa. Strophanthidin (10(-4) M) increased alpha iNa, and 3 x 10(-6) M propranolol and 10(-6) M atropine decreased alpha iNa. Both strophanthidin and atropine (but not propranolol) prevented the increase in alpha iNa by ACh. It is concluded that the ACh increases alpha iNa and contractile force through the inhibition of the sodium pump and that these actions are due to the activation of the muscarinic receptor and not to endogenously released norepinephrine. PMID- 2719138 TI - Influence of site of regional ischemia on nonischemic thickening in anesthetized dogs. AB - The effect of varying the site of acute regional ischemia on nonischemic myocardial function was examined by comparing regional thickening during 2-3 min circumflex (Circ) vs. left anterior descending (LAD) coronary artery occlusions in eight open-chest dogs. Cross-sectional midwall two-dimensional echocardiograms were obtained, and systolic thickening was measured at 16 equal-spaced points around the circumference. The distribution and extent of hypoperfusion was assessed by radiolabeled microspheres. The echo slice was subdivided into a hypoperfused region (Hypo), four adjacent nonischemic regions (ADJ1-4), and the remaining remote segments (Remote). The extent of hypoperfusion (%LV mass) was similar with both sets of occlusions (LAD, 29.4 +/- 2.8%; Circ, 26.0 +/- 4.4%; P = NS), as was endo- and epicardial flow in the nonischemic regions. Yet, even with like-sized Hypo regions, thickening of nonischemic myocardium was significantly greater during Circ than during LAD occlusions (P less than 0.001). These results are consistent with recently reported disparities of global functional impairment during LAD vs. Circ ischemia. The responses likely reflect differences in regional wall geometry, loading, and the three-dimensional distribution of coronary hypoperfusion between the two vascular territories. PMID- 2719139 TI - Effects of age on mechanical and structural properties of myocardium of Fischer 344 rats. AB - To determine whether the mechanical and structural characteristics of the myocardium from the left and right ventricles are comparable in the adult rat and whether aging affects the two ventricles in a similar manner, the left and right posterior papillary muscles of rats at 10-11 and 19-20 mo of age were studied in terms of function and quantitative morphology. At 10-11 mo of age, the duration of isometric contraction was shorter and resting tension higher in the right muscle than in the left muscle. Isotonic velocity of shortening and relengthening were quicker in the left, but time-to-peak shortening was faster in the right. With aging (19-20 mo), velocity of shortening fell in the left ventricle while duration of contraction became prolonged. No such age-related effects were found in the right papillary muscle. On a structural basis, myocardial damage in the form of replacement scarring was present in the left and right muscles at 10-11 mo of age. However, the left muscle was more severely injured, and this difference persisted with age because a comparable increase in replacement fibrosis occurred in both muscles. It was concluded that cardiac performance is distinctly different in the left and right papillary muscles and aging exerts its detrimental impact on the left more than in the right myocardium, an observation that is further supported by the magnitude of tissue injury. PMID- 2719140 TI - Cumulative deterioration of myocardial function after repeated episodes of exercise-induced ischemia. AB - To determine whether progressive regional myocardial dysfunction occurs after repetitive episodes of exercise-induced ischemia, 10 dogs were instrumented with ultrasonic microcrystals for determination of regional myocardial wall thickening, circumflex artery electromagnetic flow probes, and hydraulic coronary artery occluders. Dogs performed treadmill exercise in the presence of a coronary artery stenosis, which limited coronary blood flow to control levels. Dogs performed a single 10-min exercise period one day and three identical runs separated by 1-h rest periods on the alternate day. At rest before the first exercise period, circumflex wall thickening was 18.8 +/- 6.7% and increased to 25.5 +/- 10.6% during exercise before the application of coronary stenosis. On the day that three exercise trials were performed, circumflex systolic wall thickening at rest before the third exercise period (9.7 +/- 4.0%) and during exercise without coronary stenosis (17.3 +/- 7.3%) were both significantly lower than during the first exercise period (P less than 0.0125). During exercise with stenosis, circumflex systolic wall thickening fell to 4.6 +/- 4.7% during a single run, and 5.0 +/- 2.0% during the third of three consecutive runs. Wall thickening was significantly lower 2 h after the third consecutive run (9.1 +/- 2.4%) than 2 h after a single period of exercise-induced ischemia (14.8 +/- 7.6%; P 0.0125). Transmural myocardial blood flow to circumflex myocardium during the third period of exercise-induced ischemia (0.93 +/- 0.47 ml.min-1.g-1) was not different than during the single period of exercise (0.84 +/- 0.47 ml.min-1.g-1). It is concluded that repetitive episodes of exercise-induced ischemia result in cumulative postexercise regional myocardial dysfunction. PMID- 2719141 TI - Role of iron in postischemic microvascular injury. AB - Iron-catalyzed formation of hydroxyl radicals has been postulated to occur during reperfusion of ischemic tissues. To assess the role of iron-catalyzed oxidant production in ischemia/reperfusion (I/R) injury to skeletal muscle, we examined the effects of deferoxamine (an iron chelator) and apotransferrin (an iron binding protein) on the increased vascular permeability produced by I/R in isolated, pump-perfused rat hindquarters. Solvent drag reflection coefficients (sigma) were measured in hindquarters subjected to 2 h of ischemia and 30 min of reperfusion with either no pretreatment, pretreatment with 50 mg/kg deferoxamine, 200 mg/kg apotransferrin, or iron-loaded deferoxamine (50 mg/kg). I/R alone was associated with an increase in vascular permeability as indicated by the significantly lower estimates of sigma obtained after I/R (0.68 +/- 0.03) compared with those obtained in nonischemic preparations (0.82 +/- 0.02). Pretreatment with deferoxamine or apotransferrin attenuated this permeability increase (sigma = 0.83 +/- 0.03 and 0.86 +/- 0.02, respectively), whereas pretreatment with iron-loaded deferoxamine afforded no protection (sigma = 0.71 +/- 0.02). These findings are consistent with the hypothesis that iron-catalyzed oxidant production is important in the genesis of microvascular injury following I/R. Since the enzyme xanthine oxidase has been implicated as a major source of oxidants generated during reperfusion, we also measured tissue levels of xanthine oxidase and xanthine dehydrogenase in muscle samples obtained from the same hindquarters in which we measured permeability changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719142 TI - Noninvasive determination of hemoglobin saturation in dogs by derivative near infrared spectroscopy. AB - An in vivo method utilizing derivative near-infrared spectroscopy was developed to noninvasively determine cerebral venous hemoglobin O2 saturation (SVO2). The method was tested on eight pentobarbital-anesthetized dogs ventilated with differing inspired O2 mixtures to force changes in SVO2 over a wide range. Spectral data obtained by transilluminating the tissues surrounding the superior sagittal sinus (SS) were transformed into first derivative units for correlation with SVO2 data measured from the SS. Linear regression analysis was applied to data obtained from five dogs and used to build a three-wavelength algorithm for predicting brain SVO2. In three dogs, SVO2 was varied to test this equation ability to predict SVO2. The standard deviation of differences between measured SVO2 and SVO2 predicted from 31 separate spectra was 3.2%. These predicted values, when regressed against the sampled SVO2, yielded an r value of 0.97. The results demonstrate that during hypoxic hypoxia (HH) it is possible to noninvasively quantify SVO2 with the use of infrared spectroscopy. PMID- 2719143 TI - Low-threshold current is major calcium current in chick ventricle cells. AB - Single myocytes were dissociated from the apical ventricles of 14-day-old chick embryos and were maintained in culture for 24 h. Isolated rounded cells, 13-18 microns in diameter with input capacitance averaging 5.2 pF, were selected for whole cell patch-clamp analysis of calcium current (ICa). Two current components, T-type (IT) and L-type (IL), were identified by differences in their voltage thresholds and pharmacological sensitivity, IL was activated by depolarizing steps from -40 mV and was selectively blocked by 1 microM D 600 (methoxyverapamil). IT was obtained by subtracting IL from total ICa and was blocked by 120 microM Ni2+. Identified by threshold potential, sensitivity to Ni2+, or resistance to D 600, IT had a greater current density than has been reported in any adult cardiac tissue. It was also larger than IL and was therefore the major contributor to ICa in this preparation. PMID- 2719144 TI - Arginine vasopressin mediates cardiovascular responses to hypoxemia in fetal sheep. AB - Acute hypoxemia results in hypertension, bradycardia, and cardiac output redistribution in fetal sheep. The blood flow redistribution is produced by differential changes in vascular resistance of various fetal organs. alpha Adrenergic activity is one of the few vasoconstrictor mechanisms thus far identified in the hypoxemic fetal sheep. Arginine vasopressin (AVP) is a potent vasoconstrictor in adults. Since AVP administration to the normoxic fetus mimics some of the fetal cardiovascular responses to hypoxemia and fetal plasma AVP levels increase with hypoxemia, we examined the hypothesis that AVP modifies the fetal cardiovascular response to hypoxemia by changing the vascular resistance of some fetal vascular beds. To test this we determined fetal systemic arterial pressure and fetal cardiac output and its distribution during hypoxemia with and without the V1 AVP antagonist d(CH2)5-Tyr(Me)AVP. Fourteen fetal sheep (0.79-0.90 of gestation) were chronically catheterized. Five days after surgery fetal hypoxemia was induced by introducing a mixture of 95% N2-5% CO2 (10-20 l/min) into a maternal tracheal catheter. The hypoxemia was maintained for 40 min. Fetal heart rate, systemic arterial blood pressure, and combined ventricular output and its distribution (radiolabeled microspheres) were measured before hypoxemia, at 20 min of hypoxemia alone, and at 20 min of hypoxemia plus either AVP antagonist (n = 5) or NaCl 0.9% (n = 5, controls). Fetal hypertension and bradycardia were partially reversed after the AVP antagonist administration during hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719145 TI - Ventromedial hypothalamic regulation of hormonal and metabolic responses to exercise. AB - Recent studies have indicated a neural regulation of hormonal and metabolic responses to exercise. Studies on the ventromedial hypothalamus (VMH) suggest that the VMH might be involved in neural control of exercise metabolism. We therefore studied 25 rats with or without Marcain-anesthetized VMH (Marcain and control rats, respectively) at rest or during treadmill running (26 m/min). The rats had cannulas aimed bilaterally at the VMH and chronic catheters in the left jugular vein and right carotid artery. At rest, glucose turnover and plasma concentrations of glucose, lactate, glycerol, epinephrine, norepinephrine, insulin, and corticosterone remained stable in control rats, whereas in Marcain rats these parameters, except for unchanged insulin and glucose utilization, increased after Marcain administration along with increases in hepatic and muscular glycogenolysis. During exercise, glucose turnover, hepatic and muscular glycogenolysis, and plasma concentrations of glucose, lactate, glycerol, catecholamines, and corticosterone increased, and insulin decreased in both Marcain and control rats. However, during exercise, initial hepatic glucose production, plasma catecholamines, and subsequent plasma glucose concentrations and overall hepatic glycogenolysis were lower in Marcain compared with control rats. In conclusion, glucose mobilization is enhanced by the VMH during exercise. The results suggest that decreased and increased activity in sympathetic inhibitory and facilitating VMH areas, respectively, are involved in the VMH's response to exercise. PMID- 2719147 TI - Regional alterations in hexokinase activity within rat brain during dehydration and rehydration. AB - Histochemical localization and photodensitometric quantification of the metabolic enzyme, hexokinase (HK), were used to study changes in brain metabolic activity that occur during the development of (5 days) and recovery from (7 days) dehydration. In water-deprived (WD) rats, HK activity increased after 2 days in the subfornical organ (SFO, 22%), nucleus circularis (NC, 36%), parvo- and magnocellular divisions of the paraventricular nucleus (pPVH, 17%; mPVH, 46%) and supraoptic nucleus (SON, 46%). Activity in SFO declined to control levels at 3 days but increased again thereafter. In pPVH, mPVH, and SON, activity was elevated until the end of the experiment. In NC, activity returned to control levels within 2 days of drinking by the rats. In salt-loaded (2% NaCl in water) rats, changes were similar to those of WD rats up to 2 days of dehydration (SFO, 25%; NC, 20%; pPVH, 16%; mPVH, 38%; SON, 50%). Activity in SFO and pPVH returned to control levels after 3 days and remained unchanged. In mPVH, SON, and NC, activity remained elevated and declined to control levels when salt-free water was provided. Results confirm that water deprivation is a stronger dehydrating stimulus than salt loading. In addition, metabolic activity, as measured by HK activity, varies daily during periods of dehydration and rehydration. These changes cannot always be predicted from results obtained only at the end of a period of dehydration. It is concluded that it is necessary to study dehydration induced changes in brain metabolism on a daily basis to more fully understand the roles of discrete brain regions in the regulation of body fluids. PMID- 2719146 TI - Mechanisms of fetal blood volume restoration after slow fetal hemorrhage. AB - Previous studies have shown that blood volume returns to normal within 24-48 h after hemorrhage in the adult of several species, whereas vascular volume restoration occurs within 3-4 h after a 2-h hemorrhage of the sheep fetus. The purpose of the present study was to determine whether an increase in fetal osmolality and/or circulating plasma protein mass contribute to the rapid volume restoration in the fetus. Nine chronically catheterized fetal sheep at 132 +/- 2 days gestation (term = 145-150 days) were hemorrhaged 30.9 +/- 2.2% of their initial blood volume over 2 h. Blood volume returned to normal 3 h after the hemorrhage. No change in fetal osmolality or in the fetal-maternal osmotic gradient occurred during or after the hemorrhage. However, there was a near perfect correlation between blood volume and circulating plasma protein mass during and after the hemorrhage. Thus the present study provides no evidence for either a fetal cellular or transplacental source of fluid during fetal posthemorrhage volume restoration because osmolality was unchanged. Instead it appears that a rapid redistribution of proteins and fluid from the fetal interstitial space most likely mediates the vascular volume restoration. PMID- 2719148 TI - Vasomotor responses of the umbilical circulation in fetal sheep. AB - The effects of vasoactive agents on the distribution of vascular resistance within the umbilical circulation of fetal sheep in utero has been assessed under general anesthesia. Under control conditions, 37% of the arterial to venous pressure drop occurred across the umbilical arteries and their major tributaries, 8% occurred across umbilical veins, and the remaining 55% occurred across the cotyledons. Isoproterenol had no significant effect on these resistances. Norepinephrine and angiotensin II both dramatically increased placental vascular resistance, but the distribution of resistances was altered in different ways. Angiotensin caused a 13-fold increase in the umbilical arterial resistance, whereas there were no changes in cotyledon or venous resistances. Norepinephrine also had no effect on cotyledon vascular resistance but it constricted downstream vessels (6-fold increase). These results suggest that norepinephrine and angiotensin II regulate fetal placental blood flow and that they can independently control pressure in placental exchange vessels. As a consequence, these agents may play an important role in controlling fetal-maternal fluid transport. PMID- 2719149 TI - Role of endogenous opioids in the cardiovascular responses to asphyxia in fetal sheep. AB - Intravenous administration of the opioid receptor antagonist naloxone to asphyxiated fetal sheep increases the arterial blood pressure. We examined the hypothesis that endogenous opioids modify the cardiac output distribution during asphyxia due to changes in the vascular resistance of some fetal organs. Thirteen fetal sheep (0.8-0.9 of gestation) were chronically catheterized. Fetal asphyxia was induced by reducing the uterine blood flow with an inflatable occluder around the common internal iliac artery to approximately 50% of control for 40 min. Naloxone solution or the solvent alone was added for the last 20 min. Asphyxia caused hypertension, and the fetal arterial blood pressure further increased when asphyxiated fetuses received naloxone. Heart, brain, and adrenal blood flows increased due to the increase in blood pressure, with no changes in their vascular resistances. In contrast, kidney and carcass blood flows decreased, and their vascular resistances increased. We conclude that endogenous opioids inhibit the vasoconstriction of these vascular beds during fetal asphyxia. PMID- 2719150 TI - Regional blood flow of exercise-trained younger and older cold-exposed rats. AB - O2 consumption (thermogenesis) and regional blood flows (measured using radioactively labeled microspheres) were evaluated in younger (12 mo) and older (24 mo) sedentary and exercised male Fischer 344 (F-344) rats. These variables were measured at rest and during exposure to 6 degrees C. Exercise-trained rats were run on a motor-driven treadmill 5 days/wk, 1 h/day, at 20 m/min for 6 mo. Resting rates of O2 consumption did not differ with age or exercise training. However, thermogenesis during cold exposure was significantly greater in the older exercised rats than in the other three groups. This difference did not reflect a greater contribution from brown fat as indicated by the fact that total blood flow to the brown fat depots during cold exposure was not greater in the older exercised vs. the other rat groups. Neither exercise training nor age had a significant effect on specific resting blood flow (expressed as ml.min-1.g tissue mass-1) to most of the organs measured, including heart, kidney, brown fat, white fat, and skeletal muscle. The notable exception to this was in the spleen of the older sedentary animals where flow was diminished compared with that in the older exercised animals. We conclude that aging, between 12 and 24 mo of age, and/or exercise training have only a minor effect on regional blood flow of F-344 rats during rest or cold exposure and that the enhanced thermogenesis seen in cold exposed older exercised vs. sedentary F-344 rats cannot be explained by a greater contribution from brown fat. PMID- 2719151 TI - Reticulospinal vasomotor neurons in the RVL mediate the somatosympathetic reflex. AB - Sympathoexcitatory neurons in the C1 area of the rostral ventrolateral medulla (RVL) that project to the spinal intermediolateral nucleus play an important role in the maintenance of basal sympathetic tone and in the reflex adjustments of sympathetic activity to internal and external stimuli. We sought to determine whether the sympathetic response to somatic afferent activation, the somatosympathetic reflex, also arises from the excitation of reticulospinal vasomotor neurons in the RVL. In urethan-anesthetized, paralyzed, ventilated rats, single sciatic nerve stimuli evoked an early (latency: 26 ms) and a late (latency: 117 ms) excitation of antidromically identified, RVL-spinal, sympathoexcitatory neurons that paralleled and preceded the biphasic increases in splanchnic nerve activity (peak latencies: 87 and 176 ms). The differences between the respective latencies of the RVL unit responses and those recorded in the splanchnic nerve were comparable to the conduction time in the sympathoexcitatory pathway from the RVL to the splanchnic nerve. Both the threshold intensity and the response amplitude vs. stimulus intensity relationship for the sympathetic response were comparable to those for the A delta-fiber component of the dorsal root response to sciatic stimulation. We conclude that the rat somatosympathetic reflex consists of an early excitatory component due to the early activation of RVL-spinal sympathoexcitatory neurons with rapidly conducting axons and a later peak that may arise from the late activation of these same neurons as well as the early activation of RVL vasomotor neurons with more slowly conducting spinal axons. PMID- 2719152 TI - Sinoaortic denervation attenuates the reflex responses to hypotension in fetal sheep. AB - Hypotension in fetal sheep stimulates reflex decreases in heart rate and increases in the secretion of several hormones, including adrenocorticotropin (ACTH), cortisol, vasopressin, and renin. However, little is known about the afferent limb(s) of the reflex(es) controlling these responses. Fetal sheep between 122 and 134 days gestation were prepared with chronic vascular catheters, intravascular balloon-tipped catheters, and amniotic fluid catheters. Seven fetal sheep were also subjected to sinoaortic denervation, and nine remained intact. After recovery from surgery for 2-5 days, fetuses were subjected to a 10-min period of hypotension produced by vena caval obstruction, produced by inflation of balloons in the superior and inferior venae cavae. Vena caval obstruction produced decreases in fetal heart rate and increases in fetal plasma ACTH, vasopressin, and renin activity, which were related to the degree of hypotension. Prior sinoaortic denervation attenuated all of these responses. It is concluded that afferent fibers in the carotid sinus and/or aortic depressor nerves mediate part of the heart rate, ACTH, vasopressin, and renin responses to vena caval obstruction in late-gestation fetal sheep. PMID- 2719153 TI - Characterization of midline medulla role in the trigeminal depressor response. AB - The purpose of the present investigation was to determine the role of the midline medulla in mediating the trigeminal depressor response. Previously we found that lesions of the midline medulla abolished the decrease in blood pressure resulting from electrical stimulation of the spinal trigeminal complex. Electrical stimulation (5 Hz) of the spinal trigeminal tract elicited a decrease in arterial blood pressure that was associated with an inhibition of sympathetic nerve activity recorded from the inferior cardiac nerve of anesthetized cats. The effect of single shocks applied to the trigeminal complex on sympathetic activity was determined using computer-averaging techniques. Single shock stimulation consistently elicited an excitation of sympathetic activity that was followed by an inhibition of sympathetic nerve discharge. The gamma-aminobutyric acid antagonist picrotoxin blocked the depressor response elicited by electrical stimulation of the midline medulla but not by stimulation of the spinal trigeminal complex. Extracellular recordings of the discharges of midline medullary neurons were made to determine the effects of trigeminal stimulation on sympathoinhibitory, sympathoexcitatory, and serotonin neurons. Sympathoinhibitory and sympathoexcitatory neurons were identified by the relationship between unitary discharges and sympathetic nerve activity and by their response to baroreceptor reflex activation. Serotonin (5-HT) neurons were identified using criteria previously developed in our laboratory. These included 1) a slow regular discharge rate, 2) sensitivity to the inhibitory action of the 5-HT1A agonist 8 OH 8-hydroxy-2-(di-n-propylamino)tetralin, 3) failure to respond to baroreceptor reflex activation, and 4) the discharges of the 5-HT neurons were not related to sympathetic activity. Stimulation of the spinal trigeminal complex typically inhibited the discharges of sympathoinhibitory neurons. In contrast, stimulation of the trigeminal complex consistently excited both sympathoexcitatory and 5-HT neurons. These results are discussed in relationship to the role of the midline medulla in mediating the trigeminal depressor response. PMID- 2719154 TI - Characterization of cardiovascular and behavioral responses to alerting stimuli in rats. AB - Freely moving rats exhibit complex motor and cardiovascular responses to tactile stimulation (12.5 psi air puff, 100-ms duration). In naive Wistar-Kyoto rats, the behavioral response is characterized by a short-latency (25 +/- 1 ms) jumping event, the magnitude of which habituates to repeated stimuli. In a paradigm of consecutive tactile stimuli, each delivered at 30-s intervals, the arterial pressure (AP) response is consistent in profile (36.4 +/- 1.7 mmHg, initial stimulus) and habituates rapidly (15.4 +/- 2.2 mmHg, at 20th stimulus). Rates of habituation of the jumping behavior and AP increase are similar and significantly correlated (P less than 0.01), suggesting partial common mediation. Heart rate changes are bimodal and highly dependent on stimulus number. Initial stimuli elicit bradycardia (-42 +/- 7 beats/min), habituating to extinction by stimulus 10. A temporally delayed tachycardia becomes evident by trial 5 (19 +/- 5 beats/min) and persists unchanged throughout the remainder of the 30-stimulus session. Delayed tachycardia may represent activation of secondary autonomic mechanisms. The nature of cardiovascular responses elicited by the tactile stimulus suggests a somatomotor reflex mediated through the ventrolateral medulla. Adrenal enucleation exaggerated the magnitude of transient bradycardia and abolished extinction of bradycardia with repeated stimuli. Adrenal medullary secretion has only minor importance in direct mediation of the response, but this study suggests that adrenal function plays an important role in tonically setting the level of cardiac responsiveness to parasympathetic vs. sympathetic stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719155 TI - Cholecystokinin-induced anorexia depends on serotoninergic function. AB - The existence of a relationship between cholecystokinin (CCK)-induced satiety and the serotoninergic system was evaluated. The food intake of 3-h-fasted male rats was studied after treatment with the COOH-terminal octapeptide of CCK (CCK-8) alone or in combination with one of two blockers of serotonin (5-HT) receptors, metergoline (MET; 1.0 or 0.06 mg/kg), active in both the periphery and brain, or xylamidine tosylate (XYL; 1.5 mg/kg), active only in the periphery. CCK-8 reduced food intake in the 30 min after food presentation by 37% at 2 micrograms/kg, 68% at 4 micrograms/kg, and 80% at 8 micrograms/kg compared with controls. Both doses of MET attenuated CCK-8-induced satiety, increasing food intake of rats treated with all doses of CCK-8 to control values. Food intake was significantly increased over base line by the 1.0-mg/kg dose of MET alone but unaffected by the 0.06-mg/kg dose of MET alone. XYL had no effect either given alone or in combination with CCK-8. These results indicate that the inhibitory action of CCK 8 on food intake is dependent on intact functioning of the serotoninergic system, probably at central sites. PMID- 2719156 TI - Postabsorptive glucose decreases excitatory effects of taste on ingestion. AB - To test the hypothesis that postprandial rises of plasma glucose attenuate the motivation derived from positive tastes, we analyzed the effects of intraperitoneal (ip) injections of glucose on sham feeding, a preparation in which food intake is motivated primarily by taste sensations. Ip glucose suppressed sham feeding, with maximal suppressions approximately 42% but only when glucose was administered contiguous with oropharyngeal stimulation. The food intake inhibition produced by ip glucose interacted with palatability; smaller doses of glucose were required to suppress less concentrated sucrose solutions. Closing the gastric cannula increased the potency with which ip glucose inhibited eating, suggesting synergy of postabsorptive glucose with other postgastric satiety signals. The inhibition of eating produced by ip glucose did not result from malaise. Thus postabsorptive rises of plasma glucose decrease the ability of taste cues to drive ingestion and suggest that this phenomenon may contribute to spontaneous meal termination. PMID- 2719157 TI - Plasma CCK levels after food intake and infusion of CCK analogues that inhibit feeding in dogs. AB - To determine whether postprandial plasma levels of cholecystokinin (CCK) are sufficient to produce satiety, we compared CCK levels after food intake and administration of CCK analogues that suppress feeding. Seven beagles were adapted to ad libitum access to solid food for 18 h, which was followed by 4 h of food deprivation and a 1-h test session. Plasma CCK increased from 2.7 +/- 0.2 pM before to a maximum of 5.0 +/- 0.7 pM after ingestion of solid food. Intravenous cholecystokinin octapeptide (CCK-8; 0, 50, 100, 200, 400, 800 pmol.kg-1.h-1), caerulein (0, 25, 50, 100, 200, 400 pmol.kg-1.h-1), and [Thr4,Nle7]CCK-9 (0, 25, 50, 100, 200, 400 pmol.kg-1.h-1), at a rate of 1 dose/day given 15 min before feeding and during a 45-min feeding period, caused similar dose-dependent suppression of feeding at 200 pmol.kg-1.h-1 and greater. On separate days blood samples for peptide assay were collected during infusion of scalar ascending doses of CCK-8 or [Thr4,Nle7]CCK-9 (0, 25, 50, 100, 200, 400 pmol.kg-1.h-1) or caerulein (0, 16.7, 50, and 150 pmol.kg-1.h-1), with each dose being administered for 30 min. Peptide levels were highly correlated with dose (r = 0.94, 0.87, and 0.95 for CCK-8, caerulein, and [Thr4,Nle7]CCK-9, respectively). Peptide levels after minimal effective doses for suppression of feeding were 59 +/- 6, 54 +/- 7, and 70 +/- 5 pM for CCK-8, caerulein, and [Thr4,Nle7]CCK-9. These results suggest that postprandial plasma levels of CCK are not sufficient to produce satiety. PMID- 2719158 TI - Thermal sensitivity of reptilian melatonin rhythms: "cold" tuatara vs. "warm" skink. AB - Daily rhythms in plasma melatonin levels were compared in two ecologically diverse reptilian species under natural environmental conditions in autumn. The nocturnal, cold temperature-adapted tuatara (Sphenodon punctatus) had a melatonin rhythm of much lower amplitude than did the diurnal desert-adapted sleepy lizard (Tiliqua rugosa). Experiments in controlled laboratory environments showed that, although both species are capable of attaining a comparable melatonin peak (approximately 750 pmol/l), the threshold temperature at which a significant daily rhythm occurs is approximately 15 degrees C in S. punctatus compared with approximately 25 degrees C in T. rugosa. This difference probably reflects the disparate thermoregulatory adaptations of the two species, S. punctatus favoring mean activity temperatures of 11.5 degrees C and T. rugosa, 32.5 degrees C. In ectotherms such as reptiles, therefore, species-typical thermoregulatory behavior may provide thermal cues that interact with photoperiod to provide the appropriate melatonin signal for the regulation of annual physiological cycles. PMID- 2719160 TI - [Pathogenetic therapy of chronic salpingo-oophoritis]. AB - The practicability of using neurotropic agents as part of combined rehabilitation program in patients with residual chronic salpingo-oophoritis and reproductive disorders is discussed. The results of the assessment of sympatho-adrenal and endocrine status by radioimmune assays in 87 patients are reported. The treatment normalized catecholamine levels, which was accompanied by a tendency to normalization at different levels of the reproductive system. Pregnancy resulted in 33.2% of the patients. PMID- 2719159 TI - A structural study of the rat proximal and distal nephron: effect of peptide and thyroid hormones. AB - The effects of the absence of various hormones (antidiuretic hormone, thyroid hormone, parathyroid hormone, and calcitonin) on proximal and distal structures were studied in diabetes insipidus (DI) Brattleboro rats. The cross-sectional area of the first segment of proximal convoluted tubules (S1) was significantly reduced in thyroparathyroidectomized (TPTX) DI rats compared with Long-Evans rats (the strain of origin of DI rats) and untreated DI rats. Administration of triiodothyronine (T3, 10 micrograms/day for 7 days) to TPTX-DI rats restored the proximal tubule structure. In the distal convoluted tubule (DCT) the cross sectional area of the epithelium and the number of nuclei per cross-sectional area were significantly greater in untreated ADH-deficient DI rats than in the control Long-Evans rats. Daily administration of 1-desamino-8-D-arginine vasopressin (dDAVP, 500 ng/day for 3 wk) significantly reduced the size and the number of DCT cells in DI rats. Cortical micropuncture data indicated that the Na+ concentration in the fluid delivered to the DCT and the absolute amount of Na+ reabsorbed along the DCT were higher in DI than in dDAVP-treated DI rats. It is concluded that functional changes in the PCT, subsequent to chronic TPTX, are accompanied by marked alteration of the cell anatomy of this nephron segment, and that the processes that modify the Na load delivered to the DCT and the Na transport in the DCT are accompanied by structural modifications of this segment. PMID- 2719161 TI - [Scientific and technological progress in gynecology]. PMID- 2719162 TI - [Criteria of the severity of the course of acute nonspecific salpingo oophoritis]. AB - Differential-diagnostic value of various clinical and laboratory tests was assessed in 105 patients with acute nonspecific salpingo-oophoritis. Auxiliary methods, such as cytochemical studies of neutrophil alkaline phosphatase, lymphocyte acid phosphatase, lymphocyte glycogen and lymphocyte succinate dehydrogenase, as well as the identification of auto-organic antibodies to the enosalpinx and ovarian tissue, were used to assess the severity of the condition. Their diagnostic value is stated with reference to the severity of adnexal inflammation. PMID- 2719163 TI - [The role of environmental and genetic factors in the development of pathology of the reproductive system in girls]. AB - Genetic and environmental effects on reproductive development of girls are described. Possible genetic involvement is postulated in girls with opsomenorrhea, second-degree amenorrhea and juvenile bleedings. Abnormal development of the menstrual function is more commonly associated with chronic tonsillitis, stress or weight loss. Environmental effects are particularly frequent and pronounced one year before or during the menarche. Central menstrual disorders were associated with parental reproductive disorders in 47% of the cases. PMID- 2719164 TI - [Characteristics of sexual maturation of girls born in the state of hypotrophy]. AB - A total of 156 adolescent and young girls, delivered at term with birth weights below 3000 g were examined. In puberty, they showed a considerable incidence of skeletal disproportions, a retardation in the increment of pelvic dimensions, disturbed menarche, disrupted sequence and degree of development of secondary sexual characters. Continuity of medical surveillance of children, delivered with low birth weights, by a pediatrician and a pediatric gynecologist is essential in order to prevent reproductive disorders. PMID- 2719165 TI - [Indicators of lipid metabolism and aminotransferase activity in girls with dysfunctional uterine hemorrhage]. AB - In a study of 42 girls, aged 12 to 15 years, including 27 patients with dysfunctional uterine bleedings (DUB) and 15 normal controls, the levels of glucose, total lipids, beta-lipoproteins, total cholesterol, as well as beta lipoprotein, triglycerides, nonesterified fatty acid (NEFA) cholesterol and aminotransferrase activity were compared. NEFA levels were found to be increased fivefold over the normal values in DUB patients. PMID- 2719166 TI - [Clinico-dermatoglyphic correlations in patients with hyperandrogenia]. AB - A clinical dermatoglyphic study of 100 infertile hyperandrogenic patients demonstrated signs of androgenization in all of those. Their dermatoglyphic parameters differed from normal. Hyperandrogenic patients with treatment resistant infertility showed a higher degree of androgenization and more significant deviations of dermatoglyphic parameters, as compared to the patients whose treatment resulted in pregnancy. Dermatoglyphic characteristics should be taken into account in predicting the practicability of treatment in patients with infertility due to hyperandrogenism. PMID- 2719167 TI - [Clinico-morphological characteristics of retrocervical endometriosis]. AB - Clinico-morphologic parameters are described in 18 patients of reproductive age before and after hormonal treatment. There was no clear-cut correlation between morphofunctional endometrial state and endometrioid heterotopies. It did not seem possible to identify the phase of the cycle on the basis of the structural pattern of retrocervical endometriosis. Electron microscopic findings in endometriosis sites were suggestive of considerable variability of epithelial cell activity in different glands as well as within the same gland. Post treatment structural pattern of retrocervical endometriosis does not exclude the possibility that steroids only block cyclic changes in the functional glandular epithelium, having no effect on nonactive cell elements. In spite of dystrophic changes, present in many retrocervical endometriosis sites, hormonal treatment did not eliminate endometrioid heterotopies, but only relieved pain. PMID- 2719168 TI - [Increased sensitivity to drugs and endometriosis]. AB - Increasing incidence of predominantly polyvalent drug allergy was demonstrated in patients with endometriosis as an obstacle to their purposive treatment. For this reason, a system of measures aiming to prevent allergic and pseudoallergic reactions has been developed with respect to pathogenetic mechanisms involved, to be used in conjunction with conservative treatment, general anesthesia for surgical interventions and roentgenocontrast investigation in patients with endometriosis and polyvalent hypersensitivity to medication. PMID- 2719169 TI - [Menstrual and reproductive functions in women with diseases of the central nervous system]. AB - Assessment of the reproductive status in 200 patients with organic and functional nervous diseases demonstrated a high incidence of ovarian dysfunction. Mental stress was a factor, contributing to menstrual and reproductive disorders in many of those. Epileptic patients showed the greatest reproductive changes. A hereditary predisposition to the hypothalamic syndrome was demonstrated in some neurotic patients. PMID- 2719170 TI - [Steroid-receptor systems in the endometrium and endometrioid heterotopies of retrocervical location]. PMID- 2719171 TI - [Estrogen- and progesterone receptor systems in the endometrium in patients with "minor" forms of endometriosis]. PMID- 2719172 TI - [Experience with using acupuncture-reflexotherapy in oligomenorrhea]. PMID- 2719173 TI - [Methods of studying gynecologic morbidity]. PMID- 2719174 TI - Evaluating the penetration of Cladosporium spores into the human respiratory system on the basis of aerobiological sampling results. AB - The penetration of Cladosporium spores and spore aggregates into human airways was studied using three different spore sampling methods: 1) a Burkard spore trap for determining the aggregation degree of Cladosporium; two samplers, simulating the human respiratory system, 2) a 6-stage Andersen 2000 sampler, and 3) a new size-selective bioaerosol sampler (SSBAS), designed specifically for immunochemical and chemical analyses. The aggregation degree of Cladosporium spores varied between 1.0 and 1.3 spores per dispersal unit. Grouping seems to be of little if any importance to the penetration ability of Cladosporium spores into the respiratory tract. The distribution of spores in the Andersen and SSBAS differed significantly in the largest size class (spores greater than 7 microns in diameter); with the Andersen sampler only 10.8% of the spores were detected in stage 1, compared with 43% with the SSBAS. On the Andersen culture plates 95% of all colonies were detected in stages 1-4, where particles greater than 2.1 microns in diameter are trapped. In the SSBAS altogether 99.4% of spores were found in the first two filter stages (cutoff point approx. 2.5 microns in diameter). Conclusions regarding the penetration of spores to the lungs on the basis of aerobiological results should always be based on the use of properly calibrated spore traps. PMID- 2719175 TI - Histamine control affects the weal produced by the adjacent diluent control in skin prick tests. AB - The effect of histamine chloride control (10 mg/ml) on the weal reaction produced by the adjacent test solution (buffered glycerol-saline diluent control) in skin prick tests was studied among 270 peat workers and 214 lumberjacks. The diluent control was placed on the skin at two test sites: 3-4 cm and 18-19 cm from the site of the histamine control. Prick-test lancets (Dome/Hollister-Stier) were used to prick the skin. Weal areas of 6 mm2 or larger were considered to be positive reactions. In both populations the diluent control caused positive reactions nearly three times more often when the test site was 3-4 cm from the site of the histamine control than when it was 18-19 cm away from the control (P less than 0.001). Similar relationships might be found between histamine control and allergen solutions. This finding should be taken into account in histamine based standardisation of the results of skin prick tests as well as in biological standardization of allergen solutions. PMID- 2719177 TI - Immunochemical estimations of allergenic activities from outdoor aero-allergens, collected by a high-volume air sampler. AB - To quantify airborne allergens in amorphus and morphological particles, a survey with collection of aero-allergens on glass fibre filters by means of a high volume air-sampler (HIVOL) was conducted. In preliminary laboratory experiments we compared various filter elution techniques, and the pulverizing elution technique was found to be optimal with regard to yield and convenience. When a surfactant, Tween 20 (0.5% v/v), was added to the elution buffer, a recovery of 80% could be obtained. Allergens in eluates were analysed by means of an IgG subclass RAST inhibition assay. This immunochemical method for quantification of airborne allergens was validated, as a high recovery of timothy grass pollen allergens was eluted from air filters, and eluates were shown specific by RAST inhibition. The amount of immunochemically measured airborne timothy and birch allergens collected by means of the HIVOL sampler was highly correlated with pollen counts obtained with a Burkard sampler (pollen trap) situated in the same place. PMID- 2719176 TI - Mucosal blood flow in the human nose following local challenge with histamine. AB - Nasal blood flow was measured using the 133Xe wash-out method in 10 non-allergic subjects and 13 asymptomatic hay fever patients. Determinations were made before and 15 min after challenge with diluent, 0.13 mg, 1.3 mg and 13 mg of histamine/nasal cavity. Nasal symptom scores were recorded. The nasal inspiratory peak flow was determined simultaneously in the hay fever patients. No differences in blood flow or symptom score recordings were found between the normal subjects and allergic patients under basal conditions or after histamine challenge. The nasal blood flow increased after challenge with the highest histamine dose. The increase was 34% (P less than 0.05) from baseline in normals and 47% (P less than 0.05) in allergics. There was a dose-dependent increase in nasal symptom scores following histamine challenge, again with no difference between normal and allergic subjects. The nasal peak flow decreased in a similar manner with a maximum decrease of 74% (P less than 0.001). The present study gives further support to the notion that histamine is not the only mediator involved in vascular reactions during allergic rhinitis. PMID- 2719178 TI - Spice allergy: results of skin prick tests and RAST with spice extracts. AB - Skin prick tests (SPT) with freeze-dried spices and 5% (w/v) spice extracts were performed on 50 patients with 2+ or stronger SPT reactions to spices per se, and RAST were performed on 10 of them. Freeze-dried extracts produced mostly equal or stronger SPT reactions than corresponding whole spices, but 5% (w/v) extracts produced weaker reactions and also remained totally negative in some patients. Positive RAST results were seen in all 10 patients tested. The correlation between the RAST and SPT results was good for mustard and paprika, but poor for cayenne, coriander, caraway and white pepper. Five patients with positive SPT and RAST for spices contracted rhinitis from powdered spices in their working environments, and one patient suffered from gastrointestinal pains caused by spiced food. The others had noticed no clinical symptoms caused by spices. The present results thus indicate that both SPT and RAST should include purified spice extracts. PMID- 2719179 TI - Allergen-containing immune complexes used for immunotherapy of allergic asthma. Preparation of complexes and evaluation of their clinical performance in guinea pigs. AB - Guinea pigs inbred for their ability to develop respiratory anaphylaxis to experimental antigens have been used for comparison of different forms of immunotherapy (IT). Passive, active and combined (immune complexes between antigen and specific IgG) IT were compared with placebo. The bronchial reactivity of the animals to the antigen was monitored regularly before, during (35 weeks) and after IT (20 weeks). Animals treated with passive IT did not improve clinically. Active and combined IT abolished most symptoms within 7 weeks of treatment. During the post-treatment period, animals from both groups surprisingly recovered their original sensitivity to inhalation of the antigen. PMID- 2719180 TI - Is thrombopenia in cord blood indicative of intra-uterine sensitization? AB - The relation between platelet counts (PCT) and IgE was studied in cord blood from 136 European newborns. PCT was significantly lower (P = 0.0014) when cord-IgE was superior to 1.20 IU/ml (n = 29; 245,000/microliter) than when it was inferior to this value (n = 107; 284,080/microliter) which resulted in a significant negative Spearman rank correlation between PCT and cord-IgE (P = 0.002; rs = -0.25). A follow-up by questionnaire in 97 of the newborns revealed that those newborns who had developed definite atopy within 18 months of age had significantly (P = 0.002) lower PCT at birth (n = 8; 196,000/microliter) than those free of atopic symptoms (n = 61; 286,000/microliters). Further newborns to atopic mothers (n = 23; 245,000/microliters) had significantly (P = 0.014) lower PCT than newborns to non-atopic mothers (n = 74; 286,000/microliters). The lowest PCT was recorded when both the mother was atopic and the newborn had developed definite or probable atopy by the age of 18 months (n = 7; 175,000/microliters) as compared to atopy alone in mothers (n = 16; 276,000/microliters; P = 0.005), to atopy alone in infants (n = 9; 281,000/microliters; P = 0.005) and to non-atopic infants of non-atopic mothers (n = 65; 286,000/microliters; P = 0.0007). Significantly (P = 0.03) lower PCT amongst boys (n = 49; 259,000/microliters) compared with girls (n = 48; 294,000/microliters) was attributed to the higher incidence of elevated cord-IgE and infant atopy among boys.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719181 TI - Farmer's lung in infants and small children. AB - A boy and a girl, 10 weeks and 3 years of age, respectively, were admitted to our department with low temperature, dry cough, fatigue and weight loss. In both patients pulmonary X-rays showed diffuse, bilateral, micronodular infiltrations, and sparse signs of fibrosis. Serum IgG and blood eosinophils were abnormally high. After a stay in hospital for 3 weeks, the patients recovered slowly. However, after a few days at home, they were readmitted with the same symptoms. Family histories revealed that the children lived on farms with huge grain magazines and dryers, where moist grain and straw were stored. Massive amounts of mould spores were cultured from the residential areas, and, in addition, the male patient had an elevated titer to Micropolyspora faeni and the female patient, elevated titers to Thermoactinomyces vulgaris, Micropolyspora faeni, Aspergillus fumigatus and Alternaria alternans. The patients and their families moved from the farms and, for approximately a year, have been without lung symptoms. Farmer's disease in infants and small children is extremely rare. However, the incidence may be increasing due to the tendency in latter years to decentralize grain dryers and store moist grain and straw in big magazines, often close to residential areas. PMID- 2719182 TI - Occupational asthma caused by iroko wood. AB - We report on a patient with occupational asthma caused by iroko. BPT induced an early and late response with a long recovery period, and absence of inhibition on pretreatment with cromoglycate and beclomethasone. Three months after leaving his job, the patient was symptom-free, but non-specific bronchial hyperreactivity was still demonstrated. PMID- 2719183 TI - Inflammatory response in bronchoalveolar lavage fluid after inhaling histamine. AB - To examine the influence of the histamine chloride challenge test on the bronchoalveolar lavage cell population, lavage fluid from 15 subjects was collected 24 h after the histamine test, and was compared with the lavage fluid from a reference group of 25 subjects. Inhaled histamine is commonly used to quantitate non-specific bronchial responsiveness. Increase in airway responsiveness after exposure to ozone or allergen is associated with airway inflammation. Bronchoalveolar lavage, has therefore become a valuable tool in the study of bronchoalveolar cells and mediators in subjects with asthma and bronchial hyperresponsiveness. The total cell number and differential cell counts in bronchoalveolar lavage fluid 24 h after inhalation challenge test with histamine-chloride were studied. There was a significant increase in lymphocytes, mast cells and neutrophils after histamine test. The conclusion was that inhaled histamine-chloride can induce an inflammatory cell response in the lung. Thus the histamine-chloride test should not be performed before bronchoalveolar lavage. PMID- 2719184 TI - [Fiber endoscopy of the nasopharynx: its indications]. AB - The AA have planned a series of indications regarding the endoscopy of the nasoopharynx. Among 631 explorations done in a three-year term, normal findings were seen in 260 subjects. In the other cases several aspects of the inflammatory or neoplastic pathology could be verified. One individual showed an esthesioneuroblastoma in an early evolutive stage. PMID- 2719185 TI - [Radiotherapy of early glottic carcinoma. Experience at the "La Fe" Hospital]. AB - The paper deals with the experience gained by the AA (Hospital "La Fe", Valencia) through 49 glottic cancers treated with x-ray therapy. The results are very gratifying since the percentage of survivals and cures at 10 years accounts for 96 and 92 per cent, respectively. Five failures (10%) underwent salvage surgery (T. laryngectomy), 3 with good outcome. With regard to the prognostic factors it is important to recall the great number of recurrences among the cordectomy patients (preceding the x-ray therapy) with seeded borders (4 among 10) than in the rest of the group (1 among 39). PMID- 2719186 TI - [Electric stimulation of the inner ear]. AB - Electrical stimulation of the inner ear is a valuable tool for the diagnosis and treatment of inner ear disorders. Its most known application is the cochlear implant, but it is also useful in the assessment of high frequency hearing and for the management of tinnitus. Patients receiving ototoxic drugs can be audiometrically followed with high-frequency electrostimulation audiometry. Results obtained with this technique are discussed. Tests for tinnitus suppression by means of transcutaneous electrostimulation are also presented. PMID- 2719187 TI - [Application of the trigemino-facial reflex in acquired peripheral facial paralysis in childhood]. AB - The AA report the results of the blink reflex and facial nerve stimulation in 16 children with acquired facial paralysis. Generally these verifications permitted the localization of the most impaired nerve segment and thereafter to give a recovery prognosis. PMID- 2719188 TI - [Malignant otitis externa]. AB - This is an aggressive infectious disease caused by Pseudomonas aeruginosa, especially seen in diabetics and elderly, sometimes coming to and end in those cases in which the diagnosis has been protracted or the treatment misleading. But it must be said that the diagnosis is not easy, either because of the insidiousness of the onset or the hidden difficulties when dealing with malignant growths of the meatus. The AA report a case of the kind emphasizing the importance of the real diagnosis as well as the right treatment. This should be prudently prolonged beyond the apparent healing until the cultures show a total sterilization. PMID- 2719189 TI - [Otic cholesteatoma. Some comments]. AB - Comments of the AA regarding the diagnosis and management of cholesteatoma and description of their current surgical procedure are presented. PMID- 2719190 TI - [Laryngeal cancer at the "Arnau de Vilanova" Hospital in Lleida]. AB - Cancer of the larynx in the province of Lerida and its west border affects men (52:1). The majority are engaged in rural activities, ranging in age between 50 70 years. Supraglottic site showed predominance. At first examination in 73 per cent of the cases no palpable cervical nodes could be detected. Almost all the cases belong to the epidermoid carcinoma type (98 per cent). PMID- 2719191 TI - [Facial paralysis caused by compression by a tumor]. AB - Tumors on the course of the 7th nerve are seldom met. Inthe present case the growth caused the palsy and showed, at surgical removal, single apposition to the trunk. Surprisingly on microscopic examination the detached mass disclosed normal striated muscle. The localization in the middle of the vertical portion of the facial canal of such a tumor, so far from other muscular structures, makes this case a rare anomaly. PMID- 2719192 TI - [Vasomotor rhinitis. Clinical study: an attempt at classification]. AB - In the AA's opinion the greatest number of rhinitis cases seen in the doctor's office are vasomotor rhinitis. The vasomotor response being determined because of the hyper-reactivity of the subject in face of several agents. After explanations of the fundamentals of their theory a perusal of the more frequent etiologies and differential symptoms are listed. The paper ends with a summary of the medications available, their pharmacologic activity and their respective indications. PMID- 2719193 TI - [Mucoceles of the maxillary sinus. Report of a case]. AB - Mucoceles are retention cysts of the paranasal sinuses, specially developed on the anterior ethmoid and frontal sinuses and seldom seen on the maxillary cavity, as was the reported case. The authors underline the bone deformities sometimes seen and the difficulties when interpreting the meaning of x-ray records, both circumstances leading, from time to time, to the suspicion of a malignant tumor. PMID- 2719194 TI - [Tumors of the lip]. AB - The AA report two cases of reconstruction of the lower lip (after removal of the growth) following the Bernard-Brown procedure. They discuss other technics for lip repair. In both instances the achieved results were good, both aesthetically and functionally, attaining the goals of this surgery: normal aspect of the lip borderline, good sensitivity, tonus of the muscles, and also suitable size of the mouth. All the objectives were accomplished in a single operation. PMID- 2719195 TI - [Functional microsurgery of the ethmoid sinus using an endonasal approach and preserving the middle turbinate]. AB - The paper deals with the endonasal approach and the functional surgery of the ethmoidal region with respect to the middle concha. First of all, an anatomical survey of the ethmoid, pointing out the many useful topographic and vicinity particulars for endonasal management are displayed. His technique is detailed step by step, adding some modifications and variations introduced as a result of his own experience gained through 36 years of practice. The A stresses to the specialists the importance of being acquainted with the endonasal approach to the ethmoid sparing the middle turbinate, because it is very useful and gratifying. PMID- 2719196 TI - [Serous otitis: long-term efficacy of transtympanic drainage]. AB - The A. has followed for a whole year (1982), 50 patients chosen at random who underwent transtympanic ventilation, with the goal of assessing the long-term results (both audiometric and tympanometric) linked with the previous pathology. PMID- 2719197 TI - [Laryngeal reinnervation in the dog]. AB - In a group of 7 operated dogs, atrophy of the laryngeal musculature begins 3-4 weeks after recurrent nerve division. The atrophy increases progressively as time runs out, so that at the ninth week (last control done) the degree of atrophy of the posterior cricoarytenoid muscle is well marked as compared with that of the initial stage (4-5 weeks). In another set of 8 dogs reinnervation of this muscle was successful in 5 animals. In some of them up to 36 months elapsed after the cutting of the recurrent nerve and 14 weeks after application of a neuromuscular graft (composed of the hypoglossal ansa and a sheet of sternothyroid muscle). Histologic recuperation was good in all cases, but in only 2 of them the motility of the vocal cord at stimulation of the branch of the nerve was effective. The conclusion drawn is that histologic regeneration does now always parallel the functional one. Nevertheless, it seems possible that the elapsing of more time should be necessary in order to restore motility. This point demands new and broader experience before a positive answer can be given. PMID- 2719198 TI - [Exploration, diagnosis and treatment of eustachian tube diseases by means of positive pressure through a tympanic membrane perforation, or by paracentesis and transtympanic drainage]. AB - The A. discuss a manoeuvre seldom done in otology, consisting in the forced passage of air through the external canal and through perforations in the drum (also through paracentesis with an inserted ventilation tube) in those cases of otitis sharing tubal pathology. Medicines in solution or given by aerosol therapy led sometimes to surprising outcomes when dealing with chronic stubborn middle ear infections withstanding conventional treatments. Besides, the flow of air, as well as radio-opaque drugs, introduced this way, aid both the examination and the inventory of the actual state of the tube prior to functional operations on the ear. The paper recalls the danger of repeated topical administration of ear drops (as once was the usual mode of management) with alcohol or formol solutions, so endangering irreversibly the mucous membrane of the cavum tympani, with the subsequent difficulties. Finally, the A. report on the salpingitis accompanying the dyscrasias of the respiratory tract in relation to the reflex zone of the nasopharynx. PMID- 2719199 TI - The College of Anaesthetists. PMID- 2719200 TI - Neostigmine after spontaneous recovery from neuromuscular blockade. Effect on depth of blockade monitored with train-of-four and tetanic stimuli. AB - The effect of neostigmine on neuromuscular function was examined after spontaneous recovery from an atracurium-induced neuromuscular blockade, which reached a train-of-four ratio of either 0.5 or 0.9. Two doses of neostigmine 2.5 mg were given 5 minutes apart. Neuromuscular recovery was assessed with train-of four and tetanic stimuli. The first dose of neostigmine antagonised the neuromuscular blockade. The second dose diminished tetanic height and increased tetanic fade. The train-of-four measured mechanically was adversely affected to a small degree, but when measured with the electromyograph no significant change occurred. Neostigmine may adversely affect neuromuscular function after spontaneous recovery from a non-depolarising block. This is unlikely with a single modest dose and any effects are probably short-lived. PMID- 2719201 TI - Rebreathing during spontaneous and controlled ventilation with T-piece breathing systems: a general solution. AB - A general solution is presented to the problem of finding the degree of rebreathing generated by T-piece breathing systems. The solution is applicable to any ventilatory waveform, dead space volume and tidal volume and is identical for spontaneous and controlled ventilation for any given ventilatory waveform. The method is graphical and its use and understanding require no mathematical skills. However, if an analytical form of the ventilatory waveform is known, the method is easily extended by use of calculus to obtain a precise analytical solution. PMID- 2719202 TI - The value of postoperative chest radiology after major abdominal surgery. AB - A prospective study was carried out in which a chest radiograph was performed routinely on the third postoperative day on 35 consecutive patients who had elective abdominal surgery. The aim was to determine whether clinical symptoms and signs could be correlated with the radiographic appearances and whether the routine use of such an X ray could detect serious chest pathology before clinical signs developed. Thirteen patients (37%) had radiological evidence of complications and all had symptoms and (or) signs which suggested postoperative chest pathology. The 22 patients (63%) who had no radiological abnormality, could be subdivided clinically into those who were normal (29%) and those who had symptoms and (or) signs (34%). There was no significant difference between the groups in terms of previous surgery, sex, smoking, nature of surgical incision, age or duration of anaesthesia. There was a poor correlation between the diagnosis of the chest abnormality detected clinically and the diagnosis suggested by the radiographs. These findings suggest that a routine postoperative chest X ray is unnecessary in the absence of clinically detectable chest pathology. PMID- 2719203 TI - Epidural anaesthesia and spinal arachnoiditis. AB - Six patients were referred to our hospital with spinal arachnoiditis after epidural anaesthesia performed one month to 3 years before the onset of symptoms. None had had previous lumbar surgery or trauma, intraspinal haemorrhage, infections or other known causative factors of arachnoiditis. All the patients were free of neurological symptoms before epidural anaesthesia and only two had transient distress in the period immediately following the procedure. The clinical signs and symptoms of spinal arachnoiditis were severe and in every case the diagnosis was confirmed by myelography. Three patients were confined to a wheelchair after 3 years of follow-up. To our knowledge, the anaesthetic procedures were performed according to standard methods. Arachnoiditis seems to be due to the epidural injection of foreign substances, and may be related to anaesthetic-vasoconstrictor solution or contaminants. PMID- 2719204 TI - Termination of paroxysmal supraventricular tachycardia by intravenous adenosine in a child. AB - A fit 6-year-old child developed paroxysmal supraventricular tachycardia at the end of an operation for adenotonsillectomy. Sinus rhythm was rapidly restored with intravenous adenosine. PMID- 2719205 TI - Pulse oximetry in methaemoglobinaemia. Failure to detect low oxygen saturation. AB - The results of pulse oximetry saturation in a patient with a high level of methaemoglobinaemia, who subsequently underwent intravenous methylene blue treatment, are presented. The reasons for the erroneously low values after treatment are explained. Pulse oximeters currently available are not helpful in patients treated with methylene blue and should be used with caution in patients who present with cyanosis of unknown origin. PMID- 2719206 TI - The Cyclops 33 radiation thermometer. An appraisal for use in anaesthesia. AB - The Cyclops 33 is a portable infrared radiation thermometer. It has many potential advantages over existing thermometers in anaesthetic practice. The technical details are described and the benefits over other instruments discussed. This apparatus offers considerable scope for advance in the field of thermometry in anaesthesia. PMID- 2719207 TI - A Kynar piezoelectric film respirometer. AB - This paper describes a new technique for measuring respiratory gas flows and volumes using polyvinylidene fluoride film. PMID- 2719208 TI - Measurement of the flow-resistive properties of double-lumen bronchial tubes in vitro. AB - This study measures the resistance to gas flow of different double-lumen bronchial tubes used for separate ventilation of each lung in critically ill patients. Different-sized Robertshaw and Carlens' tubes were studied, as well as a new device that consisted of a cuffed bronchial catheter introduced through a standard tracheal tube. The pressure-flow relationship was curvilinear in all cases. Robertshaw and Carlens' tubes were generally found to have bronchial and tracheal channels with almost similar resistance and offered total resistances similar to those of 7.0-8.0 mm internal diameter tracheal tubes. The new device had a higher resistance than others of equal external diameter. This must be taken into account when its use is recommended for prolonged respiratory support. PMID- 2719209 TI - Epidural fentanyl and perineal pain in labour. AB - Perineal pain during the course of routine epidural analgesia with bupivacaine was treated with a 10-ml top-up of either bupivacaine 25 mg, fentanyl 100 micrograms or fentanyl 100 micrograms plus bupivacaine 10 mg, in 46 women in the first stage of labour. Only fentanyl plus bupivacaine produced consistently reliable analgesia which was quicker in onset and longer in duration (140, SD 26 minutes) than either fentanyl (114, SD 26 minutes) or bupivacaine (99, SD 44 minutes) alone. Side effects, itching and drowsiness, which were not troublesome, were more frequent in the groups given fentanyl. PMID- 2719210 TI - Anaesthesia and the law. Awareness and pain during anaesthesia. PMID- 2719211 TI - Clinical freedom and clinical behaviour. PMID- 2719212 TI - Wolff-Parkinson-White syndrome and ECG after operation. PMID- 2719213 TI - Absorption of buccal morphine. PMID- 2719214 TI - Permanent record of findings at laryngoscopy. PMID- 2719215 TI - Adrenaline and anaphylaxis. PMID- 2719216 TI - Defibrillator failure in a magnetic resonance unit. PMID- 2719217 TI - Unusual tracheal tube obstruction leading to an unusual bronchoscopic technique. PMID- 2719218 TI - Extradural fentanyl and dystrophia myotonica. PMID- 2719219 TI - The epidural space. PMID- 2719220 TI - Shivering and epidural blockade. PMID- 2719221 TI - DDAVP and open heart surgery. PMID- 2719222 TI - Ketamine-midazolam continuous infusion in cardiac surgical patients. PMID- 2719223 TI - Normal chest expansion with oesophageal placement of a tracheal tube. PMID- 2719224 TI - [Cardiovascular and pulmonary changes in patients with an isolated cerebral lesion. I. Hemodynamics]. AB - This study included 44 patients with a severe isolated cerebral lesion (decerebrate posturing on admission) with the purpose of examining the hemodynamic changes caused by cerebral trauma to see whether these changes might give additional information as to the prognosis of these patients. Patients with a previous myocardial infarction, pulmonary edema or embolism, chronic obstructive or restrictive pulmonary disease, proven or suspected aspiration, and polytrauma patients with an accompanying cerebral lesion were excluded. The study started on the day of admission to the intensive care unit and lasted for up to 6 days maximally. Both on admission and throughout the observation period, survivors (S) showed a higher neurological status score on the Innsbruck Coma Scale than non-survivors (NS). The hemodynamic profile was characterized by a hyperdynamic reaction with an increase in cardiac index and systemic arterial pressure. The hyperdynamic state was much more pronounced in S than in NS, who tended to show a normo-or even hypodynamic state. On admission to the intensive care unit 13 of 31 NS (41.9%) had a cardiac index less than 3.01/min.m2 as compared to only 1 of the 13 S (7.7%). With regard to pulmonary artery pressure, there was no difference between S and NS, while the pulmonary vascular resistance was significantly higher in NS than in S. In addition, S showed a kind of circadian rhythm of systemic arterial pressure, that was absent in NS. Rather than one single hemodynamic parameter being of prognostic relevance it is the complex parameter "left-ventricular work index" (LVWI) includes all the relevant parameters of left-ventricular mechanical work. Throughout the observation period, this parameter was consistently higher in S than in NS, although the left ventricular filling pressure (represented by the diastolic pulmonary artery pressure) was equal in both groups. While an inverse relationship between age and LVWI could be shown in S, this could not be demonstrated for NS, indicating that the differences in hemodynamic patterns between S and NS should be due to other reasons, such as the degree of the cerebral lesion affecting the trauma-adaptive regulation of the cardiovascular reaction to a severe isolated cerebral lesion. PMID- 2719225 TI - [Intra- and postoperative complications in infrarenal abdominal aortic aneurysms]. AB - Patients scheduled for operation of an abdominal aortic aneurysm are a challenge to the anesthesiologist due to multiple coexisting diseases and serious intraoperative hemodynamic changes caused by cross-clamping. The aim of this study was to investigate the incidence of intra- and postoperative complications and to analyze the coexisting diseases in order to estimate complications and risks. PATIENTS AND METHOD: The charts of 72 patients scheduled for resection of an abdominal aortic aneurysm in 1984 and 1985 were retrospectively analysed. The patients are divided into 6 groups: E: elective operation; K: without pulmonary catheterization; N: emergency operation; R: ruptured aneurysm; D: acute dissection. The statistical analysis was performed by chi-square test. RESULTS: Patients monitored by Swan-Ganz catheter suffered more frequently from chronic obstructive or restrictive pulmonary diseases and coronary heart disease or cardiac failure. INTRAOPERATIVE COMPLICATIONS: Emergency patients showed more than twice as many intraoperative cardiovascular complications than scheduled patients; 3 fatal cases were observed in this group. Renal complications (anuria) occurred in 2% during elective operations and in 30% during emergency operations. POSTOPERATIVE COMPLICATIONS: Most of the postoperative complications - 75% - were associated with the cardiovascular system, followed by disturbances of gas exchange and hypoxemia. Two patients in group E had a short-lasting renal insufficiency; 1 patient died of myocardial infarction 3 weeks postoperatively. Emergency procedures were much more risky, with a 90% incidence of cardiovascular complications; 4 patients died within 5 days, 1 other after 1 week. Patients monitored by Swan-Ganz catheter showed more arrhythmias and hypotension than the others. Atelectasis was seen on X-rays in 46% of emergency patients, 35% of group P, and 2.6% of group K. CONCLUSIONS: Retrospective studies of special and high risk patients are very useful in assessing the individual clinical standard, despite problems with data acquisition. This study permitted the assessment of perioperative complications and risks in these patients. PMID- 2719226 TI - [The adverse effects of indigo carmine]. AB - A case of diencephalic dysregulation is reported during urological endoscopy following the intravenous administration of indigo carmine. It should be kept in mind that according to the literature, indigo carmine has severe side-effects on the cardiovascular system caused by vasoconstriction. Ergotamine-like effects of indigo carmine due to direct vasoconstriction with spasm of the cerebral arteries are discussed. PMID- 2719227 TI - [The Tube-Stat: a useful aid in difficult intubation]. AB - A patient (ASA class I) scheduled for an elective gynecological operation, could not be intubated by conventional means, as no part of the glottis could be seen on direct laryngoscopy. Endotracheal intubation was successful on the first attempt using a lighted intubation stylet (Tube-Stat, Concept Corporation, Clearwater, Florida, USA). Transillumination of the neck tissues acted as a guide for correct placement of the endotracheal tube. Postoperatively, the patient complained of hoarseness and sore throat that cleared up completely within 5 days. Cases of difficult-intubation are often impossible to recognize preoperatively [3]. When problems arise, a difficult-intubation drill should be instituted without delay. The view obtained at laryngoscopy in our patient corresponded to a Grade III case according to the classification of Cormack and Lehane [3]. Our usual routine in such cases calls for blind intubation using a flexible introducer passed posteriorly to the epiglottis or blind nasal intubation. Recent reports testify to the potential dangers of blind procedures [4, 19, 23]. Light-wand-guided intubation has been reported to be an easily learned, atraumatic alternative to laryngoscopic or blind nasal intubation [6, 9]. We employed the Tube-Stat light-wand in a series of routine surgical cases with encouraging results. Our case report documents our first patient intubated with the light-wand after failure of conventional larnygoscopy. The first lighted stylet was described some 30 years ago, and the method of transillumination as an aid in difficult intubation developed over the following years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719228 TI - [The microlaryngeal tube--a new tube for direct laryngoscopy in the ENT field]. AB - We describe our experience with a new orotracheal tube with low-pressure cuff for anesthesia during endoscopic laryngeal surgery. Twelve consecutive patients (ASA groups II and III) undergoing microlaryngoscopy for diagnostic or operative reasons were intubated orotracheally with the tube. No complications associated with intubation or anesthesia occurred. In comparison with normal armored tubes (i.e. Woodbridge tubes), the microlaryngeal tube gives the surgeon better operating conditions and still permits conventional intermittent positive pressure ventilation without excessive increases in ventilation pressure. The advantages from the low-pressure cuff could only be seen in 7 patients. With this foregoing restriction, we recommend the use of the new microlaryngeal tube for anesthesia during microlaryngoscopy. PMID- 2719229 TI - [Initial clinical experiences with the S & W Kaloximet, a device for measuring oxygen consumption in anesthesia and intensive medicine]. AB - The system is based on the principle of indirect calorimetry in the closed circuit rebreathing system with CO2 absorber. The decrease in circulating gas volume (i.e. O2 uptake) is measured by an ultrasonic technique and a microprocessor controls the replenishment of the system with oxygen from an external O2 supply. The Kaloximet can be used to measure the O2 uptake of both spontaneously breathing and mechanically ventilated patients. In ventilator patients, the system works according to the bag-in-bottle principle. The O2 consumption is measured as the average of at least 50 breaths and then this value is used to calculate the resting energy expenditure. The estimated value of the respiratory quotient is entered on the keyboard, either before or after measurement. We tested the accuracy of the system in 48 measurements of O2 consumption using the Kaloximet and the Fick principle (cardiac output x arteriovenous O2-content difference) simultaneously. We found a mean difference of 5.6% and a positive correlation (r = 0.97). Our results indicate that the Kaloximet is suitable for measurements of O2-consumption, especially in ICU patients. Intraoperatively, it can be used only in the absence of inhalation anesthetics. PMID- 2719230 TI - [Faulty functioning of the expiration valve in the Drager circle system]. PMID- 2719232 TI - Open cardiac compression in the postoperative cardiac intensive care unit. AB - Thirty-nine patients required heroic resuscitative measures for sudden hypotension and cardiac arrest in the first 72 hours following cardiac surgery between January 1, 1984 and May 31, 1988. Emergency sternotomy with open cardiac compression was performed in twenty-four of these patients when external cardiac compression failed. These were categorised as Group A. Group B comprised the fifteen patients in whom resuscitation was entirely by means of external compression and adjuvant measures. Survival with NYHA Functional Class I and II status was noted in 75% of patients in Group A, compared with 20% in Group B (P less than 0.002). Emergency sternotomy with open cardiac compression is an effective way of resuscitating patients in the intensive care unit in the first few days following open heart surgery. PMID- 2719231 TI - [Frequency of colonization and pneumonia and development of resistance in long term ventilated intensive-care patients subjected to selective decontamination of the digestive tract]. AB - Colonization of the oropharynx with potentially pathogenic microorganisms (PPM) is a highly significant factor in the pathogenesis of bacterial pneumonia in intensive care patients. Via colonization of the oropharynx, bacteria pass into the tracheobronchial tree, where they can give rise to pneumonia after overcoming pulmonary resistance mechanisms. By a new, prophylactic antibiotic treatment schedule consisting in selective decontamination of the digestive tract (SDD) with locally applied nonabsorbable antibiotics, Stoutenbeek achieved drastic lowering of the colonization and infection rate in trauma patients. In the present study, we wanted to check whether this new prophylactic antibiotic schedule can be applied on a surgical intensive care ward in all patients with long-term ventilation, irrespective of the diagnosis, and whether it affords advantages over a conventional antibiotic schedule. MATERIALS AND METHODS. All patients on a surgical intensive care ward in whom it was expected that mechanical ventilation would be necessary for more than 4 days were included in the study. During the first 6 months 83 patients were investigated, in whom antibiotics were only administered when the presence of infection had been confirmed, in accordance with generally accepted guidelines (control group). In the second 6-month period, 82 patients were selectively decontaminated with 4 x 100 mg polymyxin E, 4 x 80 mg tobramycin and 4 x 500 mg amphotericin B, administered through the gastric tube and in an antimicrobial paste in the oropharynx (SDD group). The SDD schedule entailed systemic administration of cefotaxime in the first 3-4 days. RESULTS. In the control group, enterobacteria/Pseudomonas spp. were isolated significantly more frequently than in the SDD group (P less than 0.001): in the pharyngeal smear in up to 53%, in the tracheal secretion up to 36%, and in the rectal smear in up to 93% of the patients In the SDD group in the 1 week the frequency of gram-negative aerobic bacteria in the pharynx decreased from 33% to 5%, in the tracheal secretion from 23% to 14% and in the rectum from 86% to 52% (24% in the second week). However, the decrease in gram-negative microorganisms was accompanied by significant increase in the frequency of Staphylococcus epidermidis and enterococci. The SDD schedule proved to be effective with regard to the rate of infection. In the control group, 35 patients developed pneumonia (42%) as against 5 patients receiving SDD prophylaxis (6%). The duration of mechanical ventilation in the patients with pneumonia was 5 days longer than in patients without pneumonia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2719233 TI - Leg blood flow during total hip replacement under spinal or general anaesthesia. AB - Calf blood flow was studied using venous occlusion impedance plethysmography during 122 total hip arthroplasties. Patients were randomly allocated to receive spinal or general anaesthesia. Blood flow was measured nine times perioperatively. In the non-surgical leg, mean blood flow rose by over 50% in both groups following anaesthetic induction, remaining significantly elevated with spinal but falling back gradually to baseline with general anaesthesia. In the surgical leg, surgical manipulations produced marked falls in flow in many patients, particularly with femoral component insertion. If this occurred, hyperaemia was commonly seen with spinal anaesthesia but rarely with general anaesthesia once the joint was relocated. Venous outflow resistance rose slightly during anaesthesia in both groups, more so with general anaesthesia. In the surgical leg, marked rises occurred with surgical manipulations, but resistance fell abruptly once the joint was relocated. No clear relationship between these observations and the occurrence of deep vein thrombosis postoperatively was established. PMID- 2719234 TI - Patient-administered anxiolysis--a pilot study. AB - The feasibility of self-premedication with intravenous diazepam was examined in an open study of 50 preoperative patients. Using a Bard 'Harvard PCA' patient controlled analgesia system, patients were instructed to deliver the drug in a dose sufficient to remove their anxiety for the scheduled surgical procedure. Aliquots of diazepam 2 mg were delivered on demand up to a total dose of 20 mg over a 30 minute premedication period. The mean dose administered was 8.1 mg (range 0-16 mg) producing a highly significant reduction in both patient- and anaesthetist-assessed anxiety rating. Neither the patient's sex nor the nature of the surgical procedure influenced the dose administered. Although poor, the best predictor of self-premedicating dose was patient's own preoperative anxiety rating with the anaesthetist's assessment of patient anxiety not correlating with the dose administered. No patient was considered excessively sedated by the premedication. Patient-administered anxiolysis is suggested as a useful research tool in the examination of anxiety and of value in premedicating patients with high preoperative anxiety levels. PMID- 2719235 TI - Epidural pethidine or fentanyl during caesarean section: a double-blind comparison. AB - The onset, quality and duration of analgesia and side-effects of a single bolus dose of either epidural pethidine 50 mg or fentanyl 100 mcg, administered immediately post-delivery, were compared in a randomised, double-blind study of fifty-five women undergoing epidural caesarean section. The onset of effect was more rapid with fentanyl, a significantly larger number of women achieving complete pain relief fifteen minutes post-administration (P less than 0.05). The quality of analgesia was good in both groups and the quality and duration of effective analgesia not significantly different. The incidence and severity of side-effects were low, with no significant difference between groups. One patient in the pethidine group experienced early onset respiratory depression; however, she did not require active treatment. Epidural fentanyl 100 mcg appears to offer a small clinical advantage over pethidine 50 mg for intraoperative use during caesarean section. PMID- 2719236 TI - Epidural morphine by the thoracic or lumbar routes in cholecystectomy. Effect on postoperative pain and respiratory variables. AB - Thirty-seven women undergoing elective cholecystectomy were randomised into two groups, receiving either lumbar epidural morphine (group L) or epidural morphine via the thoracic route (group T). The effect on pain relief was assessed by a visual analogue scale and included both resting pain and 'provoked' pain. Respiratory parameters (PEF, FEVI and FVC) were also studied. The patients were investigated preoperatively, and 4, 6, 12 and 24 hours after the start of surgery. No significant difference was observed between the groups concerning pain relief or respiratory performance. We conclude that after cholecystectomy lumbar epidural morphine is as effective as thoracic epidural morphine in relieving postoperative pain. PMID- 2719237 TI - Mandatory minute volume weaning in patients with pulmonary pathology. AB - This study evaluates mandatory minute volume (MMV) weaning in patients with pulmonary pathology. When weaning criteria were fulfilled, 22 patients were randomised to MMV and 18 to a control intermittent mandatory ventilation (IMV) group. With IMV weaning the ventilator rate was decreased by two breaths per minute at 3-4 hourly intervals during daylight hours. In the MMV group a target of 75% of the ventilator minute volume was set. All weans were considered complete four hours after the cessation of mechanical support, and were deemed successful if no further ventilation was required. The success rate was 86% in the IMV and 89% in the MMV group. MMV weaning was rapid (4.75 + 1.5 hrs) and proved less demanding on the ICU staff by providing a safe trial of spontaneous respiration, while retaining the facility for partial ventilation. PMID- 2719238 TI - The oxygen delivery characteristics of the Hudson Oxy-one face mask. AB - The inspired oxygen fraction (FIO2) delivered by the Hudson Oxy-one face mask was measured under changing conditions of ventilation, oxygen flow rate to mask, and mask fit. A single trained subject sat in a body plethysmograph to measure ventilation and breathed at a constant rate of 15 per minute at three different tidal volumes, of approximately 0.3, 0.6, and 1.2 litres, from the mouthpiece in the plethysmograph. The Oxy-one face mask was fitted to a plaster-of-Paris face model on the outside of the plethysmograph in a loose and then in a tight fashion. Oxygen concentration was continuously monitored from a point in the metal tube connecting the face model to the mouthpiece. The tightly fitting mask demonstrated an orderly reduction in FIO2 as ventilation increased and oxygen flow rate to the mask decreased. The mean FIO2 at a ventilation of 4.5 l.min-1 and 8 l.min-1 oxygen flow was 78% and this fell to 27% at a ventilation of 16 l.min-1 and oxygen flow of 2 l.min-1. The loosely fitting mask demonstrated larger SD of measurements and lower mean maximum FIO2 values of 46 to 49% and these fell in an irregular fashion to similar minimum values as ventilation increased and oxygen flow decreased. Although the precise definition of the FIO2 for each breath from the changing concentration during each inspiration was not possible, these results indicate that FIO2 changes in a predictable way as a function of ventilation and oxygen flow, if the mask is close fitting. This method could be conveniently used to study other oxygen delivery systems. PMID- 2719239 TI - Local anaesthetic infiltration for caesarean section. PMID- 2719240 TI - Placental transfer of succinylcholine causing transient respiratory depression in the newborn. PMID- 2719241 TI - Removal of proximal and peripheral endobronchial foreign bodies with the flexible fibreoptic bronchoscope. PMID- 2719242 TI - Pulse oximetry in malignant hyperthermia. PMID- 2719243 TI - Adult acute epiglottitis in association with infection of an epiglottic cyst. PMID- 2719244 TI - Epidural bupivacaine v. lidocaine. PMID- 2719245 TI - Minireg failure. PMID- 2719246 TI - An unusual case of failure to pace. PMID- 2719247 TI - Patient reports. PMID- 2719248 TI - CIG 'Pulsealert' modification. PMID- 2719249 TI - Future unavailability of trimetaphan (Arfonad) PMID- 2719250 TI - Failure of test for tracheal intubation. PMID- 2719251 TI - Why monitor the ECG? PMID- 2719252 TI - Pulse oximeters and poor perfusion. PMID- 2719253 TI - Comparison of pulse oximeters--comment. PMID- 2719254 TI - Analysis of antimycin A by reversed-phase liquid chromatography/nuclear magnetic resonance spectrometry. AB - A mixture of closely related streptomyces fermentation products, antimycin A, is separated, and the components are identified by using reversed-phase high performance liquid chromatography with directly linked 400-MHz proton nuclear magnetic resonance detection. Analyses of mixtures of three amino acids, alanine, glycine, and valine, are used to determine optimal measurement conditions. Sensitivity increases of as much as a factor of 3 are achieved, at the expense of some loss in chromatographic resolution, by use of an 80-microL NMR cell, instead of a smaller 14-microL cell. Analysis of the antimycin A mixture, using the optimal analytical high-performance liquid chromatography/nuclear magnetic resonance conditions, reveals it to consist of at least 10 closely related components. PMID- 2719255 TI - Plasma desorption mass spectrometric analysis of mycobacterial glycolipids. AB - Mycobacteria are characterized by species- or type-specific glycolipid antigens. These are generally of the following three types: the trehalose-containing, acylated lipooligosaccharides (LOS), the C-mycoside glycopeptidolipids (GPL), and the phenolic glycolipids (PGL). To date, convenient mass spectrometric analysis of the intact form of these complex glycolipids has proved to be difficult. The successful plasma desorption mass spectrometric analysis of intact mycobacterial glycolipids of the LOS, GPL, and PGL types is now reported, allowing location of the acyl residues and providing oligosaccharide sequence and molecular weight information. PMID- 2719256 TI - Hartley transform ion cyclotron resonance mass spectrometry. AB - The Hartley transform offers a useful alternative to the Fourier transform for the conversion of a time-domain ion cyclotron resonance (ICR) signal into its corresponding frequency-domain mass spectrum. The Hartley transform has the advantage that it eliminates the need for complex variables, when (as for linearly polarized signals) the time-domain signal can be represented by a mathematically real function. Moreover, the Hartley transform produces the same spectra (absorption mode, dispersion mode, magnitude mode) as does the Fourier transform. In particular, the discrete fast Hartley transform (FHT) produces the same spectrum at twice the speed of a complex fast Fourier transform (FFT), making the FHT equivalent in speed to a "real" FFT. Hartley and Fourier transform methods in ICR mass spectrometry are compared and demonstrated experimentally. Essentially the same advantages and computational methods should apply to the use of the Hartley transform in place of the Fourier transform in other forms of spectrometry (e.g., nuclear magnetic resonance, infrared, etc.). PMID- 2719257 TI - Determination of naphthalene-2,3-dicarboxaldehyde-labeled amino acids by open tubular liquid chromatography with electrochemical detection. AB - Naphthalene-2,3-dicarboxaldehyde (NDA) has been investigated as a new derivatizing reagent for the electrochemical detection of tagged amino acids. Gradient elution allowed for the separation of 18 NDA-derivatized amino acids on an open tubular liquid chromatography column in less than 50 min. Gradient elution and electrochemical detection were found to be compatible. A detection limit of 36 amol was obtained for the asparagine-NDA derivative. The usefulness of this technique for quantitation was demonstrated by the analysis of the NDA tagged hydrolysis products from bovine chymotrypsinogen. PMID- 2719258 TI - Quantitative analysis of individual neurons by open tubular liquid chromatography with voltammetric detection. AB - The ability to analyze individual cells is often important in biology because of the heterogeneity of tissue; this is especially true in the area of neurobiology. A method is described for the determination of trace levels of organic compounds in individual cells by open tubular liquid chromatography with voltammetric detection. In the method, a cell is isolated, an internal standard is added, the cell is homogenized and centrifuged, and the supernatant is injected directly onto the chromatography column. Since data are collected in both the electrochemical and chromatographic domains, the resolution of the method is better than that obtained by using amperometric detection. The combination of voltammetry and chromatography also aids in the identification of compounds. By use of this method three different neurons, D2, E4, and F1, from the land snail Helix aspersa are analyzed. The data show that the cells give certain unique and repeatable chemical profiles. Dopamine, serotonin, tyrosine, and tryptophan were identified and quantified in two of the cells at the femtomole level. In the third cell, only the two amino acids were observed and measured. The quantitative data indicate that the method is at least as reliable as other methods that have been applied to single cells and considerably more sensitive. The combination of qualitative and quantitative information allows for the chemical mapping of cells. PMID- 2719259 TI - Liquid chromatographic determination of cyclophosphamide enantiomers in plasma by precolumn chiral derivatization. AB - On the basis of reactions described in the synthetic literature, a two-step chiral derivatization sequence was developed for the anticancer agent cyclophosphamide (CP). The sequence involves amidoalkylation of CP with anhydrous chloral containing 1% dimethylformamide followed by acylation of the resulting secondary alcohol with a chiral carboxylic acid chloride, (+)-6-methoxy-alpha methyl-2-naphthaleneacetyl chloride, to form a diastereomeric pair. Derivatized ( )-CP and (+)-CP exhibited retention times of 17.2 and 20.7 min, respectively, when chromatographed on Hypersil ODS with acetonitrile/phosphate buffer (pH 6.8) as the mobile phase. Preparation of the individual diastereomers from enantiomerically pure CP enabled correlation of the chromatographically observed peaks with a particular enantiomer. Various aspects of the overall assay methodology have been systematically investigated (derivatization solvents, temperatures, reaction time, and work-up procedure) and optimized on the scale required for trace analysis in biological fluids. Calibration curves were established for each enantiomer in spiked human plasma over the therapeutically relevant concentration range of 0.99-49.94 micrograms/mL. PMID- 2719260 TI - Algae columns with anodic stripping voltammetric detection. AB - The use of silica-immobilized algal cells for on-line column separation in conjunction with continuous monitoring of trace metals is described. Algae-silica preparations are highly suitable for flow analysis as they couple the unique reactivity patterns and high binding capacity of algal biomass with the hydrodynamic and mechanical features of porous silica. Such advantages are illustrated by using on-line anodic stripping voltammetry and the alga Chlorella pyrenidosa. Selective and exhaustive removal of interfering constituents circumvents common problems such as overlapping peaks and intermetallic effects. Effects of flow rate, pH, operation time, and other variables are reported. The system is characterized by high durability, simplicity, and economy and offers an attractive alternative to prevalent columns used for flow analysis. PMID- 2719261 TI - Polishable and robust modified graphite epoxy electrodes. PMID- 2719262 TI - Investigations of protein structure with optical spectroscopy: bovine growth hormone. AB - Optical spectroscopy provides a wealth of information about protein structure that is difficult to obtain from other methods. Investigations of changes in primary, secondary, tertiary, and quaternary structure are particularly well suited for optical techniques such as UV absorption, circular dichroism, fluorescence, Raman and infrared spectroscopy, as well as light scattering methods. Each method has unique areas of applicability and contributes to structure determination in a different manner. The application of these methods is demonstrated with examples of studies performed on bovine growth hormone. Some of these include: determination of solution-state structure, monitoring differences between solution- and solid-state structure, determination of molecular size distribution, and investigations of protein folding mechanisms. It is demonstrated that by judicious choice of methods, a reasonably complete description of protein structure can be obtained. PMID- 2719263 TI - Structure elucidation methodology for disaccharides based on carbon-13 nuclear magnetic resonance spectrum simulation. AB - Molecular mechanics techniques are used to derive structural parameters that allow carbon-13 nuclear magnetic resonance spectra of disaccharides to be modeled. On the basis of a collection of 40 disaccharide spectra, four linear models are derived that allow complete spectra to be simulated. On the basis of these 40 compounds, the average difference between simulated and observed chemical shifts is +/- 0.45 ppm. The majority of structural parameters used are based on interatomic distances computed from modeled three-dimensional atomic coordinates. Found particularly useful in modeling the disaccharide spectra are the effects of oxygen electron lone pairs and encodings of the structural environments of hydrogens alpha to the carbon whose chemical shift is being predicted. The computed models are examined, and their predictive ability is assessed. The potential application of the methodology to the structure elucidation of disaccharides is demonstrated. PMID- 2719264 TI - Determination of aqueous fluoride with a helium microwave-induced plasma and flow injection analysis. AB - The determination of aqueous fluoride by flow injection analysis (FIA) with a helium microwave-induced plasma (He-MIP) is described. This system operates at 500 W and utilizes a modified TM010 resonator cavity with a demountable plasma torch. Both direct nebulization and FIA in conjunction with ultrasonic nebulization (USN) were investigated. FIA was found to be the most reliable method because extended nebulization of aqueous fluoride was found to cause memory effects. Detection limits for aqueous fluoride of 35 and 4 ppm were observed for FIA and direct USN, respectively. The interference effects of pH and selected elements were also studied. PMID- 2719265 TI - Fourier transform infrared least-squares methods for the quantitative analysis of multicomponent mixtures of airborne vapors of industrial hygiene concern. AB - Air monitoring methods suitable for use in the workplace, though accurate for monitoring individual compounds or classes of compounds, cannot be used to monitor several compounds or classes of compounds simultaneously. In the past few years, Fourier transform infrared (FT-IR) spectroscopy has been investigated for use as a method for multicomponent quantitative analysis. This work focuses on quantitative analysis of six mixtures in ambient air. The concentration ranges of the two- to six-component mixtures are from 50 ppm to 100 ppb. The optimal least squares fit (LSF) method selected, background reference file chosen, and quantitative peak windows picked were evaluated in this effort. The quantitative results of six mixtures were accurate at the 50, 10, and 1 ppm levels. There were some components for which the analysis was also accurate at the 0.1 ppm level. The data indicate that the LSF program could be used to quantify strongly overlapping multicomponent mixtures. The results support the conclusion that the FT-IR spectrometer is appropriate for the direct quantification of multicomponent mixtures of many airborne gases and vapors of industrial hygiene concern. PMID- 2719266 TI - Photodissociation of laser-desorbed ions as a structure determination tool. AB - Laser desorption Fourier transform mass spectrometry (LD/FTMS) of porphyrins, metalloporphyrins, and alkaloids is used to investigate XeCl excimer laser photodissociation of trapped ions as an alternative to collision-induced dissociation for structure analysis purposes. It is shown that the presence of an appropriate metal enhances photodissociation and that in situ metal attachment during the laser desorption event may be a useful analytical strategy. Iron-, manganese-, and chromium-attached species are examined in order to assess the effect of metal upon the propensity for photodissociation with 308-nm excitation. PMID- 2719267 TI - Analysis of butter fat triacylglycerols by supercritical fluid chromatography/electron impact mass spectrometry. AB - Triacylglycerols (TAGs) from butter fat isolated by solvent extraction were analyzed by use of a capillary column supercritical fluid chromatograph (SFC) combined with a flame ionization detector or a double focusing mass spectrometer. The chromatographic separation was achieved by using a dimethyldiphenylpolysiloxane phase (DB-5) to bundle up the TAGs with the same carbon number. The ratio of TAGs with varying degree of unsaturation in each SFC peak was determined by using the selected ion monitoring of the molecular ions with electron impact mode. The discrimination between the fatty acids at the position sn-2 and positions sn-1/3 in a triacylglycerol molecule was demonstrated by monitoring the ions [M - RCO2CH2]+ from reference compounds. PMID- 2719268 TI - Comparison of pneumatic nebulization and hydride generation inductively coupled plasma mass spectrometry for isotopic analysis of selenium. AB - A comparative investigation between pneumatic nebulization and continuous hydride generation as sample introduction methods for inductively coupled plasma mass spectrometry was carried out for isotopic analysis of selenium in biological samples of interest to human metabolic studies. Experimental parameters known to affect the analytical performance of the system were evaluated: instrument operating parameters, analyte solution/NaBH4 flow rate, and NaBH4 concentration. Signal-to-background ratio was examined for the three stable isotopes 74Se, 77Se, and 82Se. While background count rates for the hydride system were 3-5 times larger than those for the nebulization method, the signal-to-background ratios, normalized for Se concentration, were 30-50 times greater for the hydride system. Absolute detection limits (3 sigma) for the two systems were 20-60 (nebulization) and 0.6-1.8 (hydride) ng of Se. Overall memory of the hydride system was evaluated. Measurable effects were observed within 400 s from switching to analyte solution with differing isotopic composition, only if the sequence of analysis was from high to low ratio (1-4% bias). However, if the sequence was from low to high ratio, precise and linear calibration plots could be obtained over the isotope ratio range of an order of magnitude or higher. While further improvements might lead to potential enhancement of sensitivity and precision of as much as an order of magnitude, the present performance of the hydride system was satisfactory in relation to the requirements of isotopic analysis for metabolic investigations employing 74Se as the in vivo stable isotope tracer. PMID- 2719269 TI - Simultaneous determination of bromide and iodide as acetone derivatives by gas chromatography and electron capture detection in natural waters and biological fluids. AB - Oxidation of bromide and iodide ions in acidic solutions in the presence of acetone forms the corresponding acetone derivatives. Iodate was reduced with thiosulfate prior to the determination. After extraction with benzene the bromo- and iodoacetone were measured by gas chromatography using electron capture detection. The bromide and iodide contents of rainwater, drinking water, river water, seawater, oil brine, common salt, cow milk, and human blood serum were determined. The relative standard deviations for bromide at 10(-7) M and for iodide at 10(-8) M concentration were 1.9% and 3.0%, respectively, using a 10-mL sample for the determination without preconcentration. PMID- 2719270 TI - Sucrose enzyme electrode. PMID- 2719271 TI - Liquid chromatographic determination of theophylline concentration with syringe type minicolumns for direct plasma injection. PMID- 2719272 TI - Neuronal biosensors. PMID- 2719273 TI - Gel electrophoresis of DNA. PMID- 2719274 TI - Comparison of an enzyme-linked immunosorbent assay and a gas chromatographic procedure for the determination of molinate residues. AB - An enzyme-linked immunosorbent assay (ELISA) was compared to a gas chromatographic method for the analysis of the thiocarbamate herbicide molinate (S-ethyl hexahydroazepine-1-carbothioate). Apparent recoveries from water spiked at 1 ppb to 1 ppm levels were comparable when liquid-liquid extraction was used. Solid-phase extraction was also examined and apparent recoveries by both ELISA and gas chromatography (GC) were comparable to each other as well as to the liquid-liquid extraction method. Methanol, acetonitrile, and ethyl acetate were equally effective in eluting molinate from solid-phase columns. An excellent correlation was obtained between the ELISA and GC method for field-treated water samples extracted by using the solid phase method and either ethyl acetate or methanol as the eluting solvent. Air and soil samples from this same study correlated well when analyzed by ELISA or GC, but ELISA results for soil were generally higher than GC data and of slightly lower precision than GC. Tests with a coated plate, pipettors, and the plate reader amounted to 8.0% error, the majority of which was attributable to the coating antigen binding and to antigen antibody reactions. PMID- 2719275 TI - Determination of mono- and oligosaccharides in fermentation broths by liquid chromatographic separation and amperometric detection using immobilized enzyme reactors and a chemically modified electrode. AB - Liquid chromatographic (LC) determinations of mono- and disaccharides in complex fermentation broths and beverage samples are disturbed by the presence of interfering matrix components. High selectivity can be performed by coupling of LC to immobilized enzyme reactors and amperometric detection. The carbohydrates eluting from the column are first introduced into a reactor containing immobilized amyloglucosidase which hydrolyses the oligosaccharides into glucose. A second reactor follows the first one and contains coimmobilized glucosedehydrogenase and mutarotase. The monosaccharides eluting from the first reactor are mixed with a make-up flow consisting of a nicotineamide adenine dinucleotide (NAD+) buffer. The carbohydrates are oxidized in an equivalent amount of reduced coenzyme (NADH) which is detected electrochemically by using an electrode modified with a phenoxazine derivative. The postcolumn system was applied to a high-energy soft drink, malt beer, and fermentation broths from the penicillin industry. PMID- 2719276 TI - Surface-enhanced resonance Raman spectroscopy as an ancillary high-performance liquid chromatography detector for nitrophenol compounds. AB - In this study, the potential application of surface-enhanced resonance Raman scattering (SERRS) spectroscopy as an off-line secondary detector for HPLC has been evaluated. Four nitrophenol compounds, 2-nitrophenol, 4-nitrophenol, 2,4 dinitrophenol, and 4,6-dinitrocresol were separated by isocratic reverse-phase high-performance liquid chromatography (RP-HPLC) and monitored with a conventional UV detector. Resonance Raman (RR) and SERRS spectroscopy were next used to provide the required specificity for distinguishing the nitrophenol compounds. The SERRS detection limit for both 2-nitrophenol and 4-nitrophenol was calculated to be 14 ppb and that for 2,4-dinitrophenol and 4,6-dinitrocresol was estimated to lie near the parts-per-billion level as well. This detection limit is 2-3 orders of magnitude lower than that obtained by RR spectroscopy. PMID- 2719277 TI - Thermodynamic study on the effects of beta-cyclodextrin inclusion with anilinonaphthalenesulfonates. AB - Thermodynamic parameters and stoichiometries for the binding of anilinonaphthalenesulfonates to beta-cyclodextrin are obtained from steady-state fluorescence intensity and anisotropy measurements. Specifically, formation constant, enthalpy, and entropy values are obtained for complexes of beta cyclodextrin with eight different substrate molecules at five different temperatures and six different pH values, and their associated errors are given. We propose an explanation of the relative magnitudes of the values obtained with regard to the geometry of the substrate and the importance of the various noncovalent interactions responsible for the complexation. PMID- 2719278 TI - Separation of two components of horse myoglobin by isoelectric focusing field flow fractionation. PMID- 2719279 TI - Determination of formaldehyde and acetaldehyde in mainstream cigarette smoke by high-performance liquid chromatography. AB - A method is described for the determination of formaldehyde and acetaldehyde in mainstream cigarette smoke. This involved the collection and reaction of the aldehydes with 2,4-dinitrophenylhydrazine in aqueous acetonitrile. The high performance liquid chromatographic separation and measurement of the various components directly in this reaction solution eliminated the need for a clean-up stage. Cigarette yields of greater than 5 micrograms of formaldehyde and 50 micrograms of acetaldehyde could be determined to estimated relative standard deviations of 0.07 and 0.05, respectively. PMID- 2719280 TI - Stability-indicating high-performance liquid chromatographic assay for the determination of metoclopramide hydrochloride in pharmaceutical dosage forms. AB - A simple, reliable and selective high-performance liquid chromatographic method for the determination of metoclopramide hydrochloride in pharmaceutical dosage forms has been developed and evaluated. The drug and the internal standard (phenobarbitone) were eluted from a 5-micron C8 reversed-phase column at ambient temperature with a mobile phase consisting of phosphate buffer (10 mM)-methanol acetonitrile (50 + 28 + 22) adjusted to pH 4.8 with orthophosphoric acid. The mobile phase was pumped at a flow-rate of 1.5 ml min-1 and the effluent was monitored spectrophotometrically at 214 nm. The retention times of the internal standard and metoclopramide hydrochloride were 3.0 and 7.5 min, respectively. Quantification was achieved by measuring the peak-height ratio of the drug to the internal standard. A linear relationship was found over the range 1-10 micrograms ml-1. Within-day coefficients of variation (CVs) ranged from 0.50 to 1.70% and between-day CVs from 0.68 to 4.07% at three different concentrations. The developed procedure was compared with the current BP method for the assay of metoclopramide hydrochloride in tablets. The proposed method was also used to study the stability of metoclopramide hydrochloride. PMID- 2719281 TI - Rapid determination of the glucose content of molasses using a biosensor. AB - A knowledge of the sugar content of molasses is of commercial importance to a number of industrial fermentations. Hence the feasibility of using a glucose oxidase biosensor to determine the glucose content of molasses samples was investigated. This method was compared with standard high-performance liquid chromatographic (HPLC) and gas-liquid chromatographic (GLC) procedures and with the use of a commercially available glucose analyser. A good correlation was obtained between the standard acetic anhydride GLC and glucose oxidase biosensor results (correlation coefficient = 0.98). Rapid and accurate measurements could be carried out using the biosensor without the need to employ the sample preparation step required in standard GLC methods. It was concluded that the use of the biosensor technique for the determination of glucose in molasses samples has distinct advantages over conventional methods. PMID- 2719282 TI - Construction of a naproxen ion-selective electrode and its application to pharmaceutical analysis. AB - A naproxenate-selective electrode with a liquid membrane consisting of a tetraheptylammonium-naproxenate ion pair dissolved in p-nitrocumene is described. The electrode exhibits a rapid and near-Nernstian response to naproxenate activity from 10(-1) to 10(-4) M at pH 9.0 (borate buffer). No serious interference from common ions and tablet excipients was found and the electrode was used for the direct assay of naproxen tablets by means of the calibration graph technique and of suppositories using the standard additions technique. A dissolution study of naproxen tablets was also carried out and the results compared favourably with those given by the USP XXI methods. PMID- 2719283 TI - Application of adsorptive stripping voltammetry to the study of immunoglobulin A and its interaction with benzodiazepine drugs. AB - The adsorptive stripping voltammetric behaviour of immunoglobulin A has been optimised with respect to accumulation time, accumulation potential, scan rate and drop size and its interaction with benzodiazepine drugs in 0.05 M phosphate buffer (pH 7.4) has been studied. Immunoglobulin A was observed to form a strongly reducible complex with diazepam and a labile non-reducible complex with flurazepam. PMID- 2719284 TI - Use of palladium(II) chloride as a colour-forming reagent for the determination of N-acetyl-L-cysteine in water and fluimukan injections. AB - The formation of the complex between N-acetyl-L-cysteine and palladium(II) chloride in Britton-Robinson buffer solution in the pH range 2.08-8.00 was studied. The optimum conditions for this reaction were ascertained and a spectrophotometric method was developed for the determination of N-acetyl-L cysteine in the concentration range 4.0-65.3 micrograms ml-1, using PdCl2 as the reagent. The detection limit was 1.63 micrograms ml-1 and the relative standard deviation varied from 0.63 to 1.92%. The method was applied to the determination of N-acetyl-L-cysteine in water and in injection solutions. PMID- 2719285 TI - Rapid method for the determination of alachlor, atrazine and metolachlor in groundwater by solid-phase extraction. AB - A solid-phase extraction method is described for the separation of alachlor, atrazine and metolachlor from groundwater using solid-phase disposable columns. The method is rapid, reproducible and uses considerably fewer reagents than classical liquid-liquid methods. The average recoveries were greater than 90% for all three compounds. PMID- 2719286 TI - Spectrophotometric determination of ascorbic acid in pharmaceutical preparations and fruit juices. AB - Conditions were established for the determination of ascorbic acid using phsophovanadotungstic acid as reagent. The method was applied to the determination of ascorbic acid in pure form, pharmaceutical preparations and fruit juices. The method is sensitive (2-24 micrograms ml-1 of ascorbic acid) and rapid and tolerates the presence of common ingredients usually found in fruit juices. The results obtained with the proposed method showed good agreement with those given by the standard method. PMID- 2719287 TI - Does 1 + 1 = 2? PMID- 2719288 TI - The long and the short of conduction block. PMID- 2719289 TI - The nonlinear contribution of nitrous oxide at sub-MAC concentrations to enflurane MAC in rats. AB - The presumed linear relationship describing the contribution of nitrous oxide (N2O) to the enflurane requirement necessary to achieve a 1.0 MAC level of anesthesia was tested in rats (N = 84). Each rat received one of six different concentrations of N2O, and enflurane was adjusted to attain 1.0 MAC with the use of a standard tail clamp method. The resultant group MAC anesthetic concentrations were Group I-N2O = 0.0%, enflurane = 2.30%; Group II-N2O = 10.4%, enflurane = 2.19%; Group III-N2O = 30.7%, enflurane = 1.85%; Group IV-N2O = 61.8%, enflurane = 1.75%; Group V-N2O = 70.9%, enflurane = 1.56%; and Group VI N2O = 80.3%, enflurane = 1.54%. Increasing the N2O concentration from 0-10%, from 30-60%, or 70-80% did not significantly decrease the enflurane requirement; however, increasing the N2O concentration from 10-30% or 60-70% produced a significant decrease (P less than 0.05) in the concentration of enflurane required for 1.0 MAC of anesthesia. Thus, in rats, increasing the concentration of N2O in sub-MAC ranges did not produce a linear decrease in the enflurane concentration required to add up to 1.0 MAC of anesthesia. These results are consistent with a dose-dependent interaction between N2O and the excitatory properties of enflurane; this interaction could represent synergism at low concentrations or antagonism at higher concentration of N2O. PMID- 2719290 TI - Halogenation and anesthetic potency. AB - Previous studies have shown that the anesthetic potency of organic compounds increases as a given halogen is replaced with successively larger halogens. These studies often are limited in the accuracy of determination of potency, rarely correlate potency with physical properties, and usually fail to include ether compounds. Because establishing relationships between structure and activity may shed light on anesthetic action, we studied the new anesthetic, I-537 (CHF2-O CHBr-CF3), relative to two other ether anesthetics, I-653 (CHF2-O-CHF-CF3) and isoflurane (CHF2-O-CHCl-CF3) for both of which MAC and oil/gas partition coefficients are accurately known. The oil/gas partition coefficient of I-537 at 37 degrees C was found to be 245 +/- 6 (mean +/- SD) and the MAC in Sprague Dawley rats 0.52 +/- 0.07%. Increasing atomic weight of the 1-ethyl halogen (i.e., F in I-653, Cl in isoflurane, and Br in I-537) progressively decreases MAC (increases potency) and increases lipid solubility. Although potency and solubility change by more than 10-fold, the product of MAC and the oil/gas partition coefficient remains essentially constant (120 +/- 11). However, this product is significantly less than that for other inhaled anesthetics, a finding which either challenges the unitary theory of narcosis or suggests that the lipid solvent classically used to model the site of anesthetic action (olive oil) is inappropriate. PMID- 2719291 TI - Intubation with low-dose atracurium in children. AB - The objective of this study was to compare intubating conditions and neuromuscular effects using smaller doses of atracurium (0.25 mg/kg and 0.3 mg/kg) with the recommended dose of 0.4 mg/kg for intubation in children anesthetized with halothane, N2O and oxygen undergoing strabismus repair. All patients (10 in each group) had good or excellent intubating conditions at 80% depression of twitch height [T1 of train-of-four (TOF) stimulation]. Mean times to intubation were 2.6 +/- 0.2 minutes following 0.25 mg/kg and 2.2 +/- 0.2 minutes following 0.3 mg/kg. These times were significantly longer (P less than 0.05) than the mean intubation time of 1.5 +/- 0.2 minutes following 0.4 mg/kg. Mean times to recovery, defined as times from injection of atracurium to return of T1 of TOF to 10%, 25%, and 95% of control measurements, were significantly shorter with the smaller doses. Atracurium at these low doses may provide an alternative to succinylcholine for intubating children during halothane anesthesia for surgical procedures lasting 20-30 min. PMID- 2719292 TI - Cognitive impairment after neuroleptanalgesia in cataract surgery. AB - This study was undertaken to evaluate the mental recovery of patients following cataract operations under neuroleptanalgesia. Mental function was assessed by Mini-Mental State (MMS) preoperatively and at 6 and 24 hours postoperatively. Preoperatively, 18.7% of the elderly had cognitive impairment of mental function while none in the younger group had any impairment (P less than 0.02). At six hours postoperatively, 29.7% of the elderly had cognitive impairment compared with 4% of the younger group (P less than 0.01). At 24 hours postoperatively, the percentage of elderly and younger patients with cognitive impairment had returned to preoperative levels. Baseline score and age were found to be significant predictors (P less than 0.004) of the 6-hour score and 24-hour score. In conclusion, cognitive impairment of mental function occurred in patients undergoing cataract operation with retrobulbar block and intravenous sedation at 6 hours postoperatively; MMS has the potential for use as a screening preoperative test for outpatients to identify those at risk for developing cognitive impairment. PMID- 2719293 TI - Dose-related prolongation of hyperbaric tetracaine spinal anesthesia by clonidine in humans. AB - The effect of clonidine, an alpha 2 agonist, on sensory and motor blockade during spinal anesthesia was studied in 44 ASA physical status I II patients scheduled for orthopedic surgery. The patients were randomly allocated into three groups given 15 mg of 0.5% hyperbaric tetracaine (HT), within group I (N = 14) 1 ml isotonic saline, in group II (N = 15) 0.5 ml saline solution and 0.5 ml clonidine (75 micrograms), and in group III (N = 15) 1 ml clonidine (150 micrograms). Sensory blockade (SB) was evaluated by pinprick and motor blockade (MB) according to Bromage's scale. The level of SB was comparable in the three groups but the duration was different. The 75 micrograms clonidine was associated with 25% prolongation of SB at L2 and 29% prolongation of grade 3 MB Clonidine 150 micrograms prolonged the time of SB at L2 by 72% and grade 3 MB by 96%. Colloid infusion and the decrease in diastolic blood pressure were significantly greater in the clonidine 150 micrograms group compared to group I. A dose related prolongation of spinal anesthesia is demonstrated with clonidine. PMID- 2719294 TI - Lidocaine disposition following intravenous regional anesthesia with different tourniquet deflation technics. AB - It has been claimed that tourniquet cycling, cyclic deflation and reinflation of the tourniquet at the termination of intravenous regional anesthesia (IVRA), enhances the safety of IVRA by minimizing the peak blood level of local anesthetics. To evaluate the validity of these claims and to determine the optimal cycling technic, peak arterial (Cmax) plasma concentrations of lidocaine were determined as well as the time to reach these peaks (Tmax) utilizing contralateral radial arterial blood samples in three groups of volunteers after 30 minutes of IVRA: In all three groups IVRA was induced with 3 mg/kg of lidocaine and maintained for 30 min. In the first group the tourniquet was then simply deflated once (and not reinflated); in the second group the tourniquet was deflated three times with variable periods of deflation (0, 10 and 30 seconds) separated by 1-minute periods of reinflation; and in the third group the tourniquet was again deflated 3 times but with fixed periods of deflation (10 sec) separated by 1 min periods of reinflation. The results obtained indicate that cycling technics do not appear to significantly reduce Cmax, but they do significantly prolong Tmax. Of the two cycling technics, the 10-second deflation interval technic appeared to be superior, both clinically and pharmacologically, as it was associated with less venous congestion and therefore less discomfort, and it sequentially decreased the arterial plasma concentration of lidocaine with each subsequent deflation-reinflation cycle. PMID- 2719295 TI - Species variation in the site and mechanism of the neuromuscular effects of diadonium in rodents. AB - The unusually wide, 80-fold species variation observed by others (1,2) in the neuromuscular (NM) potency of diadonium, a nondepolarizing muscle relaxant (MR), between cat and man suggested that the site and mechanism of its NM effect may vary in different species. To obtain information on this question, the NM potency of diadonium and the reversibility of its NM effect by neostigmine and/or 4 aminopyridine (4AP) was investigated on the in vitro phrenic nerve--hemidiaphragm preparations of rats, mice and guinea pigs. The concentration of diadonium that caused 90% NM block (IC90) was much greater in guinea pigs, 1.74 +/- 0.02 and 1.28 +/- 0.01 mu, when the preparations were stimulated with single stimuli at 0.1 Hz or with 0.1 s trains of 50 Hz tetani every 10 s, respectively, than in rats (IC90 = 62.4 +/- 0.89 and 52.1 +/- 1.00 microM) or mice (IC90 = 51.9 +/- 0.98 and 44.4 +/- 0.22 microM). In guinea pigs, the NM blocking effect of diadonium could be antagonized by neostigmine. This indicates that in this species the NM blocking effect of diadonium is primarily caused by inhibition of the interaction of acetylcholine (ACh), released by the nerve impulse, with the cholinergic receptors (cholinoceptors) of the postjunctional membrane (p.j.m.). By contrast, in rats and mice diadonium was not antagonized by neostigmine but was reversed by 4-aminopyridine. This suggests that in these species, in contrast to other nondepolarizing MR, diadonium does not inhibit NM transmission postsynaptically, but by inhibiting the positive nicotinic feedback mechanism of mobilization of ACh from reserve depots to release sites, causes a presynaptic NM block.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719296 TI - Timing of the anesthetist's preoperative outpatient interview. AB - Hospitalization arouses anxiety among patients admitted for day bed surgery. The effect of the anesthetist's routine preoperative interview on the anxiety levels of 63 unpremedicated women scheduled for elective outpatient therapeutic abortions was examined using the State-Trait Anxiety Inventory. The anesthetist's preoperative interviews were performed at the following times: Group 1, in the outpatient clinic one week before surgery; group 2, in the day bed unit at the time of admission to hospital; group 3, outside the operating room immediately prior to surgery. State anxiety was measured before and after patients were seen by the anesthetists. In group 1, and in groups 1 and 2, it was readministered outside the operating room immediately before surgery. Baseline anxiety Trait and State scores were not significantly different in the 3 groups (Trait: group 1, 43.3 +/- 2.2; group 2, 36.9 +/- 2.3; group 3, 38.8 +/- 2.2. State: group 1, 50.6 +/- 3.5; group 2, 43.0 +/- 2.4; group 3, 49.0 +/- 3.0). Only in group 3 did the anesthetist's interview significantly reduce patient's anxiety (before visit 49.1 +/- 3.0; after visit 46.0 +/- 2.8; P less than 0.05). A small but statistically significant reduction in State anxiety scores is achieved when patients are seen by the anesthetist immediately prior to surgery. PMID- 2719297 TI - The influence of electrical variables on analgesia produced by low current transcranial electrostimulation of rats. AB - Pulsed low current transcranial electrostimulation (TE) has been shown to induce analgesia in rats as measured by the wet tail flick test. This study investigates the effect of varying stimulus frequency, pulse width, charge balance and polarity, as well as the influence of electrode placement and time of day at which stimulus occurred. A biphasic, charge balanced waveform with a first phase duration of 2 msec, current 10 microA and repetition rate 10 Hz was found to induce maximum tail flick latency changes. The effects of morning or nighttime stimulation were statistically indistinguishable, as were the differences between monophasic and biphasic stimulation. Analgesia was maximized when a positive first phase was delivered into the right ears of the rats, but monolateral stimulation with both electrodes on either the left or the right ear produced no measurable effect. Examination of TE responses in sham and stimulated populations reveals normal response distributions with the stimulated group skewed toward a positive effect. PMID- 2719298 TI - First rib palpation: a safer, easier technique for supraclavicular brachial plexus block. PMID- 2719299 TI - Long-term post-thoracotomy cancer pain management with interpleural bupivacaine. PMID- 2719300 TI - A modified stretcher-lifter device for transfer of patients during extra corporeal shock wave lithotripsy (ESWL) PMID- 2719301 TI - Suction catheter to facilitate blind nasal intubation. PMID- 2719302 TI - Effect of transparent adhesive tape on pulse oximetry. PMID- 2719303 TI - Major thoracic incisional injury: ventilatory management. PMID- 2719304 TI - The long and short of differential block. PMID- 2719305 TI - Two-dose technique to create an individual dose-response curve for atracurium. AB - While monitoring the thenar EMG response to ulnar nerve stimulation, the authors gave either 105, 150, 210, or 300 micrograms/kg of atracurium to 60 patients. The maximal neuromuscular responses were plotted on a log-probit paper. The individual second dose required to produce 95% neuromuscular block (NMB) was estimated from a graph drawn on the paper. The maximal response following this second dose was then plotted. The mean maximal response following the second atracurium dose was 95.5% (SD range, 92.6-97.4%) NMB. The two dose-response points thus acquired resulted in the individual two-dose dose-response curve. The ED50 and ED95 and slope of the two-dose dose-response curve were compared with the single-dose dose-response curve. The average ED50 and ED95 determined by the two-dose and the single-dose techniques were nearly identical [160 micrograms/kg (SD range, 126-201 micrograms/kg) vs. 164 micrograms/kg (SD range, 150-179 micrograms/kg) and 302 micrograms/kg (SD range, 251-363 micrograms/kg) vs. 336 micrograms/kg (SD range, 274-411 micrograms/kg) respectively]. Also, the slopes of the curves were similar [6.2 (SD range, 5.2-7.2) vs. 5.4 (SD range, 4.5-6.4) probit/log]. It is therefore possible to construct an individual dose-response curve for atracurium within 7-9 min and to determine individual pharmacodynamic characteristics of atracurium from this curve. PMID- 2719306 TI - Efficacy of noninvasive transcutaneous cardiac pacing patients undergoing cardiac surgery. AB - Noninvasive transcutaneous cardiac pacing (NTP) is a rapid, safe, and easily utilized form of emergency cardiac pacing, with hemodynamics similar to right ventricular endocardial pacing. Although the technique has proven effective for hemodynamically significant bradycardias and early use during cardiopulmonary resuscitation, NTP under anesthetic conditions has been poorly characterized. In particular, it is unknown to what degree the multiple physiologic perturbations of cardiac surgery and cardiopulmonary bypass (CPB) affect myocardial thresholds and the efficacy of the unit itself. Patients undergoing procedures utilizing CPB (n = 23) were studied in an effort to address these issues. All patients were able to be paced at all points throughout the 24-h study interval, although four patients developed hemodynamic instability during this period causing their exclusion from additional investigation. Only one patient requested discontinuation from the study due to discomfort. A statistically significant increase in mean current requirements for capture was demonstrated over time (P less than 0.0001), with baseline thresholds being significantly less than other study points (P less than or equal to 0.05). Thresholds following chest wall closure were significantly greater than all other study points (P less than or equal to 0.05), possibly due to accumulation of pericardial and mediastinal air. Multiple measured variables changed significantly during the study, but only increases in cardiac output and core temperature were related to statistically significant increases in current thresholds (P less than or equal to 0.05). Increasing age and pump time were of borderline importance. NTP represents an effective pacing alternative in cardiac surgical patients. PMID- 2719307 TI - Effect of thermal injury on the pharmacokinetics and pharmacodynamics of atracurium in humans. AB - Thermal injury causes resistance to many nondepolarizing muscle relaxants including d-tubocurarine, metocurine, pancuronium, and atracurium. To evaluate the role of pharmacokinetics and pharmacodynamics in this phenomenon, the disposition and effect of atracurium (0.5 mg/kg iv) were studied in thermally injured patients (5 males, 16-43 yr) in comparison with that in nonburned control patients (3 males, 1 female, 24-53 yr). The decline of plasma atracurium concentration with time was biexponential in both groups of patients. There were no significant differences in the mean value of any pharmacokinetic parameter (clearance, V1, V beta, alpha and beta half-lives). The time course of effect was also similar, although the maximum twitch depression was significantly smaller (66.1% vs. 100% maximal twitch depression) and time to recover to 50% of maximal twitch depression was significantly shorter (14.2 vs. 52 min) in thermally injured patients. Patients with thermal injury had an EC50 (plasma concentration of atracurium required for 50% of the maximum possible response) 3.4 times that of control patients. Plasma-free fraction of atracurium in the thermally injured patients was 75% that in controls, and free EC50 (the product of free fraction and EC50) of the thermally injured group was 2.7 times that of controls. The results of this study confirm a pharmacodynamic mechanism for the majority of resistance to atracurium, with a diminished free fraction in plasma also contributing to this effect. PMID- 2719308 TI - Hypertension does not cause spontaneous hemorrhage of intracranial arteriovenous malformations. AB - The authors measured blood pressure changes non-invasively in 56 conscious, unpremedicated patients with cerebral arteriovenous malformations (AVMs) during preparation for proton beam therapy. The procedure requires six injections of local anesthetic and application of a stereotactic frame by fixation into the outer table of the skull, and has been used during the past 20 yr to treat over 1,000 patients with cerebral AVMs. No effort was made to control blood pressure. Blood pressure increased during administration of the local anesthetic and application of the frame. Maximum systolic and mean arterial pressures averaged 160 +/- 17 and 118 +/- 7 mmHg (mean +/- SD), respectively. This represented an average increase of 44 mmHg (38%) in systolic pressure and 32 mmHg (37%) in mean blood pressure at some point during the procedure (P less than 0.01 compared with pretreatment control pressures). Systolic pressure increased more than 60 mmHg in 21% of patients. Nevertheless, none of these 56 patients nor any of the more than 1,000 patients treated in similar fashion suffered a clinically evident AVM hemorrhage during the procedure. Since the treatment protocol has not changed materially during the past 20 yr, the authors assume that most patients treated in this fashion developed a similar degree of hypertension and conclude from this large clinical experience that moderate arterial hypertension does not precipitate spontaneous hemorrhage of intracranial AVMs. PMID- 2719309 TI - The interaction of nitrous oxide and isoflurane with incomplete cerebral ischemia in the rat. AB - In rats with incomplete cerebral ischemia the effects of 70% N2O alone, isoflurane alone (0.5 and 1 MAC), and the combination of N2O + isoflurane on neurologic outcome, neurohistopathology, and EEG were compared. Moderate and severe ischemia were produced by right carotid artery occlusion combined with hemorrhagic hypotension (moderate ischemia, MAP = 30 mmHg, FIO2 = 0.30; severe ischemia, MAP = 25 mmHg, FIO2 = 0.20). Neurologic outcome was evaluated using a graded deficit score from 0 to 5 (0 = normal, 5 = death associated with stroke), and neurohistopathology was evaluated using a 40-point scale from 0 = normal to 40 = total hemisphere infarct at the level of the caudate nucleus in coronal section. Compared with N2O alone, isoflurane (0.5 and 1 MAC) improved neurologic outcome following moderate ischemia (P less than 0.05). Isoflurane also decreased histopathologic damage following moderate ischemia (N2O control = 33 +/- 1 vs. 0.5 MAC isoflurane = 11 +/- 4 and 1 MAC isoflurane = 12 +/- 3, P less than 0.05), whereas only 0.5 MAC isoflurane decreased histopathologic damage following severe ischemia (N2O control = 38 +/- 1 vs. 0.5 MAC isoflurane = 25 +/- 5; P less than 0.05) Adding N2O to 0.5 MAC isoflurane attenuated the neurologic protective effect of isoflurane alone and increased histopathologic damage following both moderate and severe ischemia (moderate = 23 +/- 5, severe = 37 +/- 2; both P greater than 0.05 compared with N2O controls). The effect of adding 70% N2O to isoflurane on cerebral blood flow (CBF) and cerebral oxygen consumption(CMRO2) was also evaluated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719310 TI - Barbiturate anesthetics inhibit thromboxane-, potassium-, but not angiotensin induced pulmonary vasoconstriction. AB - Administration of the oxidant lipid peroxide tertiary butyl hydroperoxide (t-bu OOH) in the isolated rabbit lung leads to acute pulmonary vasoconstriction, which is caused by the synthesis of thromboxane. The inhalational anesthetics, halothane, nitrous oxide, and cyclopropane, markedly enhance t-bu-OOH-induced pulmonary vasoconstriction and thromboxane production. The effects of the intravenous (iv) barbiturates thiopental and pentobarbital on t-bu-OOH-induced vasoconstriction were studied. Thiopental completely and pentobarbital partially blocked t-bu-OOH-induced vasoconstriction. Thiopental inhibited t-bu-OOH-induced synthesis of thromboxane and prostacyclin but pentobarbital did not. This inhibitory action of thiopental may be due to its antioxidant properties because similar inhibition has been observed of t-bu-OOH-induced thromboxane production with the antioxidants, vitamin E, or butylated hydroxylanisole. Thiopental and pentobarbital also inhibited the vasoconstriction induced by a thromboxane analog, epoxymethano prostaglandin H2 (U46619). Finally, both barbiturates partially inhibited the pulmonary vasoconstriction caused by potassium chloride, which requires calcium entry, but they did not inhibit the constriction caused by angiotensin II, which does not require calcium entry. These results suggest that pentobarbital and thiopental may block pulmonary vasoconstriction by inhibiting calcium entry. PMID- 2719311 TI - Intrathecal midazolam and fentanyl in the rat: evidence for different spinal antinociceptive effects. AB - The effects of intrathecal midazolam and fentanyl on electrical current threshold for pain were measured using stimulating electrodes in the neck and tail of rats with chronically implanted lumbar subarachnoid catheters. This involved the measurement of the minimum current (50 Hz 2 ms pulses 0-5 mA), which made the rat squeak when applied alternately to electrodes at each skin site. The responses measured in milliamperes were expressed as a number of times control readings. Equieffective doses of both midazolam and fentanyl produced a significant increase in electrical threshold for pain in the tail (mean +/- SEM 3.14 +/- 0.51 and 2.89 +/- 0.35: P less than 0.05; Wilcoxon sum rank test) in the absence of any change in the neck (mean +/- SEM 1.28 +/- 0.13 and 0.96 +/- 0.12, NS), thus demonstrating a spinal effect. Fentanyl caused a significant simultaneous increase in tail flick latency (mean +/- SEM 67.8 +/- 20.1%, P less than 0.05), but midazolam did not (mean +/- SEM 4.22 +/- 2.76%, NS). Intraperitoneal injections of naloxone (0.25 mg/kg) blocked the response to fentanyl in both tests and did not affect the response to midazolam. Intraperitoneal flumazenil (5 mg/kg) blocked the midazolam antinociceptive effect but did not affect the response to fentanyl in either test. Tail withdrawal in response to non-noxious stimulation was preserved in all animals with spinal analgesia, indicating that myelinated afferent and efferent pathways were still functioning. Righting reflex, coordination, motor power, and alertness were also preserved in the presence of both drugs. Both drugs caused spinally mediated antinociceptive effects that were qualitatively different. PMID- 2719312 TI - Different 1.2 MAC combinations of nitrous oxide-enflurane cause unique cerebral and spinal cord metabolic responses in the rat. AB - The effect of three different 1.2 MAC combinations of nitrous oxide (N2O) and enflurane upon glucose metabolism in the central nervous system was evaluated in male rats (n = 30). Anesthesia was induced with enflurane and N2O prior to tracheal intubation and mechanical ventilation. Physiologic variables (temperature, blood pressure, pH, PaO2, PaCO2, serum glucose, and hematocrit) were maintained within normal limits. Each rat was randomly assigned one of the following 1.2 MAC anesthetic regimens: 1) control--0% N2O/2.76% enflurane, 2) treatment 1--30% N2O/2.26% enflurane, or 3) treatment II--60% N2O/2.12% enflurane. Following anesthetic equilibration, an autoradiographic evaluation of local cerebral and spinal cord glucose utilization was performed. There were no differences in the physiologic data. As enflurane was partially replaced by an equivalent MAC fraction of N2O (0-30%), a heterogeneous activation of cerebral metabolism was observed in selected sensory input structures, and in components of the limbic system. The values tended to return to control when N2O was increased to 60% (and the enflurane was appropriately reduced). At all spinal cord levels, a homogeneous increase in metabolism was observed in both white and grey matter when enflurane was replaced by the 0-30% N2O change, with a return to control when the N2O was further increased from 30-60%. Thus, in rats, increasing the N2O concentration (while concurrently decreasing enflurane) produced a biphasic metabolic response. Metabolism was activated when N2O was increased from 0-30%, with a relative depression in metabolism when N2O was further increased from 30-60%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719313 TI - Cardiovascular safety and actions of high concentrations of I-653 and isoflurane in swine. AB - The ratio of lethal-to-anesthetic concentration can be used to define the margin of safety of an inhaled anesthetic. In mechanically ventilated swine the fatal concentration of I-653, a new inhaled anesthetic, was 23.9 +/- 0.06% (mean +/- SE), and of isoflurane, 6.22 +/- 0.23%. The ratio of fatal anesthetic concentration-to-MAC for I-653 (2.45 +/- 0.11) was less than that determined for isoflurane (3.02 +/- 0.13; P less than 0.01) but relatively greater than that reported previously for other inhaled anesthetics. As with other inhaled anesthetics, the concentration of I-653 causing cardiovascular collapse exceeds that producing apnea, making cardiovascular collapse during spontaneous ventilation unlikely. Mean aortic blood pressure and cardiac output decreased as linear functions of anesthetic concentration. Values for these variables for isoflurane were greater than those for I-653 at concentrations exceeding 1.5 MAC. Heart rate, blood lactate concentration, and base-deficit did not change with anesthetic depth. Mixed venous PO2, mixed venous oxyhemoglobin saturation, and the ratio of oxygen transport to oxygen consumption remained at or above values in conscious swine but decreased similarly with both anesthetics when anesthetic concentration increased to within 0.5 MAC of the fatal concentration. Thus, the latter three variables, reflecting the fraction of delivered oxygen that is consumed, and "mean" tissue PO2 appear to be useful indices of anesthetic concentrations approaching those producing cardiovascular collapse.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719314 TI - Potentiation by mild hypothermia of ventricular conduction disturbances and reentrant arrhythmias induced by bupivacaine in dogs. AB - High concentrations of bupivacaine and profound hypothermia individually cause intraventricular conduction disturbances and reentrant arrhythmias. The effects of the combination of relatively low concentrations of bupivacaine and mild hypothermia are unknown and are the subject of this study. Three groups (n = 10 12) of dogs anesthetized with thiopental-chloralose were treated as follows: group 1, bupivacaine + hypothermia; group 2, bupivacaine alone; group 3, hypothermia alone. Bupivacaine was administered as a 4 mg/kg iv bolus followed by an iv infusion of 0.1 mg.kg-1.min-1. Hypothermia, i.e., a 4 degrees C reduction in core temperature, was produced by cooling the blood with an extracorporeal circuit. The peripheral ECG was recorded to determine the duration of QRS complexes and the QT interval. Conduction time and effective refractory period (ERP) of ventricular contractile tissue were measured with right ventricular endocavitary electrodes. Measurements were made with the heart paced at 180 beats/min and without pacing. In group 1 dogs, bupivacaine (plasma level, 2.8 +/- 0.3 microgram/ml) initially caused a prolongation of conduction time and QRS duration, which were further lengthened (approximately doubled) by a temperature decrease of 4 degrees C from baseline. The QT interval and ERP also were increased but to a lesser degree. In dogs in which the effects were most pronounced, rhythm disorders, such as wave burst arrhythmias (most common), premature systoles, ventricular tachycardia, and even ventricular fibrillation, occurred either spontaneously or during pacing. Bupivacaine alone (group 2) increased QRS duration and conduction time significantly, whereas hypothermia alone (Group 3) did not cause changes in any conduction variables. In neither group were dysrhythmias observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719316 TI - Effects of varying concentrations of halothane on the activity of the genioglossus, intercostals, and diaphragm in cats: an electromyographic study. AB - To determine the possible differential effects of depth of inhalation anesthetics on inspiratory muscle activity, the following were studied in seven adult cats: the phasic activity of the diaphragm, the external intercostals, and the genioglossus, by means of electromyography (EMG) and its moving time average (MTA). The animals spontaneously breathed 1.0-3.0% halothane in O2, while arterial PCO2 was maintained constant at approximately 60 mmHg by adjusting CO2 in the inspired gas mixture. Muscle activity was evaluated in terms of peak height of MTA, with measurements at 1% halothane used as control values. Halothane anesthesia attenuated inspiratory muscle activity significantly (P less than 0.05) in a dose-dependent fashion; muscle activity decreased most in the genioglossus, least in the diaphragm, and intermediately in the intercostals. Respiratory frequency, inspiratory time, and inspiratory duty cycle did not change significantly with increasing concentration of halothane. PMID- 2719315 TI - Local anesthetics inhibit endothelium-dependent vasodilation. AB - The effect of local anesthetics on endothelium-dependent and endothelium independent vasodilation was determined using isolated rat thoracic aorta. Endothelium-intact rat aortic rings were mounted for isometric tension recording. Cumulative concentration-dependent vascular relaxation responses to the endothelium-dependent vasodilators methacholine (1 x 10(-8) to 3 x 10(-5) M), the calcium ionophore A23187 (1 x 10(-8) to 3 x 10(-7) M) and the endothelium independent vasodilator sodium nitroprusside (1 x 10(-9) to 1 x 10(-7) M) were determined in the presence or absence of bupivacaine, lidocaine, etidocaine, or 2 chloroprocaine (1 x 10(-4) M). All of the local anesthetics studied significantly (P less than 0.05) inhibited endothelium-dependent relaxations to the receptor mediated methacholine and the nonreceptor-mediated A23187. Bupivacaine was more potent (P less than 0.01) than the other three anesthetics tested. Direct, endothelium-independent vasodilation by sodium nitroprusside was not affected. The local anesthetics appear to exert their inhibitory effect on endothelium dependent vasodilation at a site distal to receptor activation at the endothelial cell and proximal to guanylate cyclase activation in the vascular smooth muscle. PMID- 2719317 TI - Distribution of 3H-morphine following lumbar subarachnoid injection in unanesthetized rabbits. AB - Morphine sulfate (40-100 micrograms) and 3H-morphine (125-200 pmol) were injected into the lumbar subarachnoid space of 18 unanesthetized rabbits through a surgically implanted catheter. Radioactivity remaining in the spinal cord 2, 4, 6, and 12 h later revealed recovery (mean +/- SEM) of 45 +/- 5.6% (n = 3), 30.5 +/- 14.1% (n = 4), 11.23 +/- 4.4% (n = 3), and 3.7 +/- 1.1% (n = 3), respectively, of the injected radioactivity. Tritiated morphine was found to be predominantly centered around the injection site, with limited rostral and caudal spread in the cord. No significant radioactivity was detected in plasma or cerebrospinal fluid (CSF) samples from the cisterna magna taken at 5, 15, 30, min and 1, 2, 4, 6, 12, and 24 h after receiving radioactive labeled drug (with the exception of that in one rabbit). Of the injected radioactivity, 75% was recovered in the urine in 12 h. These results suggest that the persistence of morphine in the spinal cord could account for its prolonged analgesic effect following intrathecal administration. PMID- 2719318 TI - Pulmonary vascular responses to hypercalcemia and hypocalcemia in the dog. AB - The pulmonary artery responses in the isolated whole-blood perfused canine lung to ionized calcium ([Ca++]) were quantified over a range of hypercalcemia and hypocalcemia values ([Ca++] = 0.23-1.88 mM) under conditions of controlled pulmonary blood flow and constant mean aortic and left atrial pressures. Calcium chloride, administered as bolus doses in the clinical range (5-15 mg.kg-1) at initial normocalcemia and without interventions producing vasoconstriction did not influence mean pulmonary artery pressure at constant pulmonary blood flow. Stable hypercalcemia ([Ca++] = 1.88 +/- 0.05 mM) did not influence the slope of the pulmonary artery pressure-flow plot. Because normal pulmonary vasomotor tone is low and cannot readily be lowered further, the possible vasodilator action of hypocalcemia was assessed by its ability to decrease the slope of the mean pulmonary artery pressure-flow plot, which had been first increased by alveolar hypoxia (AHX) or infusion of the prostaglandin endoperoxide analog U46619 (PG). During AHX (n = 5), a graded reduction from normocalcemia ([Ca++] = 1.08 +/- 0.02 mM) to moderate hypocalcemia ([Ca++] = 0.8 and 0.5 mM) did not alter the pulmonary artery pressure-flow plot, but severe hypocalcemia ([Ca++] = 0.26 +/- 0.01 mM) decreased the slope by 13 +/- 0.9 mmHg.l-1.min-1. The comparison of severe hypocalcemia ([Ca++] = 0.23-0.27 mM) versus a high dose of nifedipine (bolus of 10 micrograms/kg followed by continuous infusion at 40 micrograms.kg 1.h-1) on pulmonary vascular tone increased by either AHX or PG infusion indicated that both hypocalcemia and nifedipine decreased the slope of the relationship between mean pulmonary artery pressure and flow (during AHX: -16.1 +/- 1.38 and -23.3 +/- 1.73 mmHg.l-1.min-1, both P = 0.0001 vs. AHX alone, and during PG: -17.05 +/- 1.95 and -8.4 +/- 1.78 mmHg.l-1.min-1, P = 0.0001 vs. PG alone). Two principal conclusions emerge. First, the pulmonary vessels are minimally sensitive to changes in ionized calcium throughout the clinical hypercalcemia and hypocalcemia ranges; extreme hypocalcemia is required to produce vasodilation, which was reversed with calcium infusion. Second, whereas the pulmonary vasodilator effects of extreme hypocalcemia were independent of the intervention inducing pulmonary vasoconstriction (AHX vs. PG), those of nifedipine were much more pronounced with AHX. PMID- 2719319 TI - Isoflurane and halothane inhibit tetanic contractions in rabbit myocardium in vitro. AB - Rabbit right ventricular papillary muscles were tetanized by rapid stimulation in the presence of 1 microM ryanodine, an inhibitor of sarcoplasmic reticular function. Tetanic contractions elicited in this manner increased in strength as extracellular calcium concentration [Ca+2]ext was raised from 0.5 to 5 mM, exhibited saturation behavior above [Ca+2]ext = 5 mM, and were blocked by nifedipine. Accompanying membrane potentials depolarized to +10 mV and repolarized to -60 mV between stimuli. These data suggest that rabbit myocardial tetany is supported in large part by extracellular calcium influx via slow (L type) calcium channels, consistent with similar recent findings in the ferret. At [Ca+2]ext = 2.5 mM, isoflurane (0.6-2.3%, gas phase) and halothane (0.4-1.5%) inhibited the strength of tetanic contractions in dose-dependent fashion. At [Ca+2]ext = 20 mM neither isoflurane (1.2%) nor halothane (0.8%) inhibited tetanic contraction strength. These data demonstrate that isoflurane and halothane inhibit contractile activity that is dependent on transsarcolemmal calcium influx via pathways independent of the ryanodine-sensitive sarcoplasmic reticulum. The exact sites of inhibition (e.g., slow channel vs. intracellular transit vs. myofibrillar binding) are not identified, but inhibition by either anesthetic may be competitively reversed by high extracellular calcium concentrations. PMID- 2719320 TI - Mechanisms of differential axial blockade in epidural and subarachnoid anesthesia. AB - The mechanisms of persistent differential blocks that accompany subarachnoid and epidural anesthesia are clarified here with the aid of two principles derived from in vitro study of individual myelinated axons: 1) conduction can leap two consecutive blocked nodes but not three, and 2) a fiber length with more than three consecutive nodes bathed by weak anesthetic may block by decremental conduction, the requisite concentration varying inversely with the number of nodes bathed by anesthetic. Principle 1 applies in epidural blockade, where anesthetic bathes only a few millimeters of segmental nerve extradurally in the intervertebral foramen. Here, three-node block will be rare in large, long internode fibers but likely in small, short internode fibers, thus explaining the differential retention of motor power in the presence of block of pain, which is achieved in epidural anesthesia when relatively weak solutions are used, as in obstetrics. Principle 2 may intervene in subarachnoid blockade where, cephalad to the site of puncture, increasingly concentrated anesthetic bathes increasing lengths of fibers in the craniocaudal succession of spinal nerve roots. This will produce decremental conduction block in increasingly long internode fibers in successive roots, reflected in a corresponding craniocaudal segmental sequence of blocked physiological functions: vasoconstriction, cutaneous temperature discrimination, pinprick pain sensibility, and skeletal motor activity. The segmental spatial differential sequence migrates with time but resembles the temporal differential sequence of loss seen at the onset of peripheral nerve blocks. Several other previously disparate clinical observations follow logically from the new interpretation. PMID- 2719321 TI - Glass particle contamination: influence of aspiration methods and ampule types. AB - Glass particle contamination of the contents of single-dose glass ampules can occur upon opening. In our study we determined if different aspirating techniques or different ampule types had any effect on glass particle contamination. In part 1 of this study different aspiration techniques were evaluated. The four groups included a control group of 3 mm tubing, an 18-g 1.5-inch needle, a filter needle, and an in-line filter. A significant reduction in glass particle contamination was found when using either an in-line filter or a filter needle compared with the control group or when aspirating through an 18-g needle. The average number of glass particles found per ampule for each group was 100.6 +/- 16.3, 65.6 +/- 18.7, 1.3 +/- 0.3, and 1.2 +/- 0.3, respectively, for the control group, 18-g needle, filter needle, and in-line filter. In part 2 we examined four types of glass ampules: transparent metal etched, transparent chemically etched, amber metal etched, and amber chemically etched. There was a significantly greater number of glass particles found in the transparent metal etched ampules compared with that found in the other three ampule types. Transparent metal etched ampules yielded an average total number of particles per ampule of 45.9 +/ 15.4 compared with 3.2 +/- 0.9, 6.0 +/- 1.7, and 3.1 +/- 0.6, in the transparent chemically etched, amber metal etched, and amber chemically etched ampule types, respectively. This study demonstrates that using drugs supplied in ampules other than transparent metal etched type and by using filters will decrease the risk of parenteral injection of glass particles. PMID- 2719322 TI - Anesthetic management of tetralogy of Fallot with absent pulmonary valve. PMID- 2719323 TI - Unsuspected cervical fractures: a common problem in ankylosing spondylitis. PMID- 2719324 TI - Respiratory effects of pain in a child after thoracotomy. PMID- 2719325 TI - More on succinylcholine and trismus in children. PMID- 2719326 TI - Use of the cell saver in patients with sickle cell trait. PMID- 2719327 TI - A humidification device for nasal oxygen. PMID- 2719328 TI - Postoperative apnea in a full-term infant. PMID- 2719329 TI - Safety of PCA devices. PMID- 2719330 TI - Serum samples from patients with hepatic dysfunction following enflurane. PMID- 2719331 TI - Hanging-drop technique for intrapleural analgesia. PMID- 2719332 TI - Horner's syndrome resulting from a lumbar sympathetic block. PMID- 2719333 TI - An unusual cause of endotracheal tube obstruction. PMID- 2719335 TI - Pulse oximetry is presently not on American Society of Anesthesiologists standard. PMID- 2719334 TI - A problem with metal endotracheal tubes and plastic-coated stylets. PMID- 2719336 TI - Gated intracoronary thallium201 scintigraphy: feasibility and potential clinical advantages. AB - Visualization of ventricular walls with true global motion and myocardial thickening is not possible with use of present scintigraphic techniques. When thallium 201 (201TI) is injected intravenously (IV), only about 5% reaches the myocardium. However, if 201TI is injected intracoronarily, 100% reaches, and approximately 88% localizes in, the myocardium, which results in higher count rates than when given IV, permitting acceptable acquisition times for gated true wall motion studies. The authors describe a new technique using intracoronary (IC) 201TI to acquire high count rate, high contrast, and short acquisition time in gated true wall motion studies. Thirteen patients were studied at rest with gated IC thallium. Six of these patients also had resting IV 201TI myocardial studies. After routine coronary angiography, 0.75 mCi of 201TI was injected into each coronary artery. Multiple sequential one-minute gated studies were obtained in LAO and RAO projections, followed by sequential five-minute images for two hours to determine 201TI redistribution kinetics. Regions of interest over segments of left and right ventricles and background permitted definition of temporal and spatial distributions. Three one-minute gated studies were summed with a total count of 2,100 K for a three-minute acquisition. Myocardium-to background ratios were as high as 13:1 with a mean of 11.4:1 in the IC study compared with 2.3:1 in the IV studies. Washout half-time in normal myocardium was 95 +/- 5 min. The detectability and size of perfusion defects were different on gated diastolic and systolic, nongated, and IV studies. Questionable defects seen on nongated studies or after IV administration were easily noted on gated diastolic images.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719337 TI - Systolic and diastolic septal and posterior wall echocardiographic measurements in normal subjects. AB - M-mode echocardiographic measurement of septal and left ventricular excursions and velocities was attempted in 109 subjects. Seventy subjects had adequate echocardiograms enabling detailed measurement. Two groups of subjects were studied: a group of normal adults aged nineteen to seventy-eight years and a group of normal juveniles aged nine to eighteen years. The posterior wall excursion (PWE), systolic septal excursion (SSE), diastolic septal excursion (DSE), and diastolic septal velocity (DSV) did not differ in these groups. There were significant differences in the posterior wall excursion during isovolumetric contraction (B-Ce, p less than 0.002), mean posterior wall velocity (PWV mean, p less than 0.002), and systolic septal velocity (SSV, p = 0.05) between the two groups. The measurements were obtained by using the recently published method of the specific points for labeling and description of the wall motion. PMID- 2719338 TI - Importance of blood viscoelasticity in arteriosclerosis. AB - Corpuscular and biochemical components of blood create the viscoelastic nature of blood flow, which varies because of changes in flow velocity. The flow properties of blood are of special interest in arteriosclerotic diseases for vasoregulatory mechanisms are often disturbed in these states. The authors compared the rheologic properties of blood in patients with arteriosclerotic lesions (coronary heart disease: n = 56; cerebrovascular disease: n = 37; peripheral arterial occlusive disease: n = 29 and healthy controls: n = 42). With a new oscillating capillary rheometer imitating the physiologic pulsations of blood flow in an unbranched artery, the viscosity (eta') and elasticity (eta") of whole blood and plasma were measured (diameter of the capillary: 0.9928 mm; pulse rate: 2/s; shear rate: gamma = 0.03-200/s; temperature: 37 degrees C). In arteriosclerotic patients a statistically significant elevation of the viscoelasticity of whole blood and plasma was found. In addition, plasma fibrinogen levels were augmented in the patients' groups. Clotting parameters (Quick, partial thromboplastin time, platelet count) and total serum protein levels were in the normal range in all patients investigated. In conclusion the question arises whether the increase of blood viscoelasticity is an additional risk factor for patients with arteriosclerotic disease or if it is just a consequence of the underlying disease. The authors' observations concerning blood viscoelasticity support the clinical importance of improving blood rheology by appropriate therapeutic measures. PMID- 2719339 TI - Blackfoot disease in Taiwan: a 30-year follow-up study. AB - Blackfoot disease is an endemic peripheral vascular disease found among the inhabitants of a limited area on the southwest coast of Taiwan, where artesian well water with a high concentration of arsenic has been used for more than eighty years. The natural history of blackfoot disease, based on a prospective study of 1,300 patients, is presented. The overall male/female ratio was 1.5:1. Although the clinical onset was usually insidious, it may be quite sudden and almost always begins with numbness or coldness in one or more extremities, usually the feet. Ultimately, rest pain develops and progresses to gangrene. In this series, 68% of the patients underwent spontaneous or operative amputation, and the reamputation rate was 23.3%. Lower extremity involvement in blackfoot disease was observed in 97.7% of the cases. The average annual rate for major amputation was 3.81 per 100 patient-years. The factors influencing the prognosis, such as amputation in relation to age and disease onset, are analyzed. The case fatality rate was 66.5% during thirty years; 44% of these were cardiovascular deaths. The annual death rate was 4.84 per 100 patient-years. Other reported case fatality rates for vascular insufficiency are reviewed. A dose-response relationship between blackfoot disease and the duration of water intake was also noted. The survival rates after the onset of blackfoot disease were: five years, 76.0%; ten years, 59.5%; twenty years, 38.2%; thirty years, 28.6%. The 50% survival point was 13.5 years after onset of the disease. PMID- 2719340 TI - Effect of buflomedil chlorhydrate on local oxygen delivery in peripheral vascular disease. AB - Modifications in transcutaneous oxygen pressure (TcPO2), induced by the administration of 3 mg/kg/day buflomedil chlorhydrate for seven days were evaluated in 12 subjects suffering from peripheral vascular disease (PVD). After the treatment a significant increase in TcPO2 basal values was observed in Stage III and Stage IV PVD patients (+32.2%) while a significant reduction of 12% in the half-recovery time to basal values after an induced ischemia was recorded in Stage II PVD patients by the seventh day. Buflomedil did not, however, cause any significant variations in the ankle/arm pressure ratio or in the plethysmographic peak flow. PMID- 2719341 TI - Paroxysmal supraventricular tachycardia: experience with propafenone. AB - The authors studied the efficacy of intravenous (IV) (1.5-2 mg/kg) and oral propafenone (450 to 900 mg/day) in 16 patients with paroxysmal, sustained, recurrent supraventricular tachycardia (SVT). In 5 patients IV propafenone was not given, because of intolerant SVT. Nine patients had Wolff-Parkinson-White syndrome. IV propafenone immediately stopped and prevented reinduction of SVT in 9/11 patients. Oral propafenone prevented SVT induction in 3 of 5 patients. In the 9 patients responsive to IV propafenone, oral propafenone was effective: in particular, in 6 patients SVT tachycardia was not induced by serial transesophageal pacings, and in the remaining 3 patients the arrhythmia was still induced but was slower and of brief duration (3-5 seconds). In 11/12 patients responsive to oral propafenone the minimum effective dosage in preventing the induction of the arrhythmia was 600 mg/day. In only 1 patient was the dose of 450 mg/day equally effective. Propafenone administration was not associated with major side effects. In conclusion, propafenone is very effective in the control of paroxysmal supraventricular tachycardia; intravenous propafenone can predict the efficacy of oral therapy. PMID- 2719342 TI - Percutaneous subclavian vein catheterization for hemodialysis: a report of 57 insertions. AB - The authors report an analysis of 57 subclavian vein catheterizations for hemodialysis. A total of 51 patients (34 men, 17 women) kept the Cobe single- and double-lumen catheters for 1,726 days. The youngest patient was eighteen and the oldest seventy-two years of age. There were no catheter-related deaths. Complications were encountered in 9 patients. The only life-threatening complication was cardiac arrest, which occurred during flushing of the catheter. The patient was successfully revived. The other complications were pneumothorax and hydrothorax in 1 patient, catheter site infection in 5 patients, and arrhythmias in 2 patients, which stopped after readjustment of the catheter tips. Their experience indicates that percutaneous subclavian vein catheterization is safe and provides quick access for hemodialysis with no morbidity and mortality if done correctly, patiently, and meticulously. The authors believe that this should be the first choice in patients with reversible renal failure and in patients with chronic renal failure, who are usually elderly and medically compromised, till a permanent vascular access is ready for use. PMID- 2719343 TI - Clinical significance of cerebral aneurysm in renovascular hypertension due to fibromuscular dysplasia: two cases in siblings. AB - Two cases, in siblings, of renovascular hypertension caused by fibromuscular dysplasia (FMD) of the renal artery associated with cerebral aneurysms are reported. Both of the cases were found to have cerebral aneurysm, as well as multiple stenotic or occluded lesions in arteries such as renal, mesenteric, celiac, and internal carotid arteries. One case died of subarachnoid hemorrhage and the other case was successfully operated on for the aneurysm. This report suggests that FMD should be considered to be a systemic angiopathy including the cerebral artery, as well as the renal artery. Thus, cerebral angiography is recommended to detect the association with cerebral aneurysm, at least, in cases with multiple lesions of FMD. Occurrence of FMD in siblings also indicates that a genetic factor might be involved in the pathogenesis of FMD. PMID- 2719345 TI - How will allergy be affected by resource-based relative value scale? PMID- 2719344 TI - Fear of AIDS propels sale of antiviral drugs in Europe. PMID- 2719346 TI - Is the choice of allergy skin testing versus in vitro determination of specific IgE no longer a scientific issue? PMID- 2719347 TI - Recurrent fever and abdominal pain in a 4-year-old boy. PMID- 2719348 TI - Pharmacokinetic properties of sustained-release theophylline (Theolair-SR) in relation to timing of doses after low-fat meals. AB - Pharmacodynamic and pharmacokinetic properties of sustained-release anyhdrous theophylline (Theolair-SR) were similar when doses were given either immediately after or two hours after low-fat meals in children with moderate asthma requiring daily theophylline maintenance. Asthma and pulmonary function values were maintained and approached values for healthy subjects during both treatment regimens. PMID- 2719349 TI - Sulfite sensitivity: relationship between sulfite plasma levels and bronchospasm: case report. AB - The present study describes a case of a 38-year-old nurse with asthma and probable sensitivity to sulfites. A double-blind challenge with sulfite and placebo was performed, pulmonary function tests were measured along with plasma levels of sulfites. A deficiency in sulfite-oxidase is suggested as the trigger mechanism of bronchospasm. PMID- 2719350 TI - Serum IgE and atopy in drug-sensitive patients. AB - One of the most interesting aspects of the pathogenesis of the allergic and pseudo-allergic reactions to drugs is the one concerning the possible roles of genetic factors, in general, and the relationship with atopy, in particular. We decided to study the correlation between the serum level of total IgE, the personal and familial history of atopy, and the allergologic tests (skin test, PRIST, RAST, etc) for one or more drugs taken by 465 patients with personal history of allergic reactions. From the data, we observed that the average amount of total IgE lies within the norm, 125.4 KU/L (+/- 209.2), without any significant difference between the allergic (132 KU/L) and the pseudo-allergic (121.8 KU/L) patients. The IgE levels tend to be higher in that part of the tested population which presented a circumstantial atopic status (11.8%) and they are not influenced by an allergic or pseudo-allergic reaction to drugs. According to these results, the relationship between drug hypersensitivity and atopy needs further investigation. PMID- 2719351 TI - Intractable paroxysmal sneezing in an adolescent. AB - Intractable paroxysmal sneezing in an 11 1/2-year-old girl was characterized by sneezing with her eyes open, no sneezing while asleep, and sneezing that was refractory to various medications. Results of physical examination were unremarkable. A review of the literature reveals that the disorder is usually psychogenic and responds to psychotherapy. PMID- 2719352 TI - Total serum IgE, allergy skin testing, and the radioallergosorbent test for the diagnosis of allergy in asthmatic children. AB - Correlations of total serum IgE, skin test reactivity, and specific IgE antibodies to selected antigens were evaluated in asthmatic children. There was a significant difference in mean IgE level of each positive RAST score group compared with that of the RAST-negative score for dog epithelium, Candida, ragweed, and Bermuda grass allergen. The correlation coefficient between the total IgE and the RAST to D. farinae was 0.39 (P less than .05). There was no significant correlation between the total IgE and the RAST to D. pteronyssinus, Candida, dog epithelium, ragweed, Eucalyptus pollen, and Bermuda grass (P greater than .05). This indicates a low total serum IgE concentration does not exclude the possibility of significant elevation of specific IgE to a common allergen. Concordance for results of intradermal skin testing and RAST was high for most allergens. Lower efficiency for dog allergen and Candida suggests greater sensitivity of allergy skin testing for these allergens. PMID- 2719353 TI - Use of transfer factor in a pediatric AIDS patient with disseminated Mycobacterium avium intracellulare. AB - An 8-year-old male with AIDS and disseminated Mycobacterium avium intracellulare infection was treated with transfer factor (TF) prepared from maternal lymphocytes. Subsequent lymphocyte stimulation studies and repeat cultures failed to demonstrate improvement during treatment. His overall clinical status remained unchanged. No adverse effects of TF were noted. PMID- 2719354 TI - The ability of granulocytes to engulf latex particles and Staphylococcus aureus in healthy children of parents with atopic asthma. AB - The test of engulfing of neutral latex particles and Staphylococcus aureus by peripheral blood granulocytes was carried out in 37 healthy children who had at least one parent with asthma and in 14 children, both of whose parents had asthma. A defect of engulfing neutral latex particles and S. aureus by granulocytes was demonstrated in children who had both parents with asthma. PMID- 2719355 TI - Comparative efficiency of a laboratory and examining room assay for therapeutic drug monitoring of theophylline in ambulatory patients. AB - The total clinical personnel time for therapeutic drug monitoring of theophylline with a non-instrumented disposable examining room assay was 446 seconds. For a traditional assay, 1115 seconds of clinical personnel time was required to obtain the sample, send it to the laboratory, and subsequently act on the results. The corresponding costs for time, materials, and laboratory charges were +18.02 and +37.25, respectively. PMID- 2719356 TI - Magnetic resonance imaging of the paranasal sinuses: frequency and type of abnormalities. AB - This retrospective study reports on sinus abnormalities detected in patients having magnetic resonance imaging (MRI) scans. Over a 12-month period, 1120 patients (aged 2-87 years) had MRI scans done for suspected intracranial pathology. Scans were reviewed independently for abnormal sinuses using four criteria: increased signal of the epithelial lining, cloudy or opacified sinus cavity, air-fluid levels, and intrasinus polyps. Thirteen percent of the 1120 patients had abnormal sinus images with the maxillary being the most involved cavity. A cloudy or opacified sinus was found in 43% of these cases. An increased signal to the epithelial lining was present in 44%. Intrasinus polyps were found in 27 paranasal sinus cavities (27 subjects). Furthermore, a seasonal pattern was evident for abnormal sinus scans. The months of July, August, September, and December had the highest frequency of abnormalities noted (greater than 16% of total scans done) whereas there was a low percentage (less than 8%) found during February and November. In summary, abnormalities of the paranasal sinuses occur frequently and vary with the time of year. PMID- 2719357 TI - Nasal provocative tests for the diagnosis of nasal allergy. PMID- 2719358 TI - A reaction that occurs immediately after food ingestion can easily be interpreted as food allergy. PMID- 2719360 TI - Endotracheal intubation of pediatric patients by paramedics. AB - Although a number of studies have described endotracheal intubation of adult patients in the prehospital setting, there are few studies on prehospital endotracheal intubation of pediatric patients. The purposes of our study were to determine how frequently prehospital endotracheal intubation was used in pediatric cardiopulmonary arrests when a paramedic trained in endotracheal intubation was present, to determine the success rate and complications associated with the procedure in the field, and to compare resuscitation rates and outcome in patients with and without prehospital endotracheal intubation. Our retrospective study covered a 38-month period and included all prehospital victims of medical cardiopulmonary arrest under the age of 19 years. Data were collected from field assessment forms and validated by hospital charts, autopsy reports, coroner's reports, death certificates, and emergency medical services central dispatch logs. Of 63 victims of medical cardiorespiratory arrest, 42 had intubating paramedics present at the scene. Twenty-eight of 42 patients (66%) had endotracheal intubation attempted. Eighteen of 28 attempts (64%) were successful, associated with a major complication rate of 7% (two of 28) and a minor complication rate of 39% (11 of 28). In patients less than 1 year old, only six of 16 (38%) had endotracheal intubation attempted and only three of six (50%) attempts were successful. Of the 18 patients who were intubated successfully before arrival at the hospital, nine (50%) survived to hospital admission and one (6%) survived to discharge. The remainder died in the emergency department.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719359 TI - Evaluation of patients for the need of thrombolytic therapy in the prehospital setting. AB - Maximum benefit from thrombolytic therapy in acute myocardial infarction is obtained with early therapy. The earliest possible time to treat is during the initial evaluation of the patient in the home or ambulance, which requires accurate diagnosis of acute myocardial infarction in the prehospital setting. In our study, paramedics evaluated patients who had chest pain with a 12-lead ECG transmitted by cellular telephone and a checklist for inclusion and exclusion criteria for thrombolytic therapy. This information was transmitted to a hospital based telemetry physician who diagnosed or excluded acute myocardial infarction and made a mock decision to withhold or administer a thrombolytic agent. Forty eight patients with chest pain were evaluated. Six were diagnosed as having overt acute myocardial infarction by the hospital-based telemetry physician. All six patients had the diagnosis substantiated by both ECG and enzyme studies on hospital admission. Based on the data supplied by paramedics, two of these six patients were considered eligible for thrombolytic therapy by the physician. Hospital evaluation confirmed the prehospital decision to treat with a thrombolytic agent. In addition, all other patients were appropriately diagnosed as ineligible. Prehospital ECG diagnosis resulted in two patients going directly to the catheterization lab, thereby bypassing the emergency department. Overt acute myocardial infarction can be accurately identified by a prehospital acquired 12-lead ECG transmitted to a hospital-based physician. Our study demonstrates that in conjunction with specially trained paramedics, the hospital physician can decide whether to administer thrombolytic therapy to such patients in the prehospital setting. PMID- 2719361 TI - Prehospital care by EMTs and EMT-Is in a rural setting: prolongation of scene times by ALS procedures. AB - Because the initiation of IV lines by emergency medical technicians-Intermediates (EMT-Is) appeared to delay the patient's transport to the hospital, we undertook a retrospective study of 370 patients to compare prehospital care rendered by EMTs (EMT-A equivalent) and EMT-Is in a rural setting. Our study was limited to acute medical conditions in which protocols called for IV lines (124 patients with chest pain, 122 with acute respiratory distress, 99 with seizures, and only 25 with cardiac arrest) (the cardiac arrest cases were too few for statistical significance). We found that the difference in scene times for EMTs and EMT-Is not attempting IV lines was 6.1 and 6.9 minutes, respectively. The average scene time of EMT-Is attempting an IV line was 19.6 minutes (P less than .001) compared with EMT times, or times for EMT-Is not attempting an IV line. One hundred twenty eight of 370 patients received IV medication within ten minutes of arrival in the emergency department, and ten of these patients had their IV lines initiated successfully in the field. Thirty-nine percent of patients with ED IV lines received IV medication within ten minutes of arrival, while only 21% of patients with a field IV line received medication in this period (P less than .05). We conclude that initiating a field IV line in this specific patient population significantly increased scene time and did not improve the chances of these patients receiving IV medication within ten minutes of arrival in the emergency department. PMID- 2719362 TI - Use of emergency medical services by patients with decompensated obstructive lung disease. AB - Little information is available about the risk of relapse when patients with decompensated obstructive lung disease are treated in an emergency department for dyspnea. The purpose of our study was to determine if the risk of relapse was related to the severity and type of airway obstruction or to the time and duration of treatment. Over a period of 29 months, 496 patients with decompensated chronic obstructive pulmonary disease (COPD), asthma, or both were seen in the ED of the Albuquerque Veterans Administration Medical Center. Of 868 visits in which patients were treated and released, 244 (28.1%) were followed by a relapse within 14 days. Those who relapsed had a slightly higher one-second forced expiratory volume at baseline than those who did not (50.1 +/- 22.2% versus 45.5 +/- 20.6% predicted, P = .054). For 94 patients (group 1), asthma was the exclusive clinical diagnosis, and all available pulmonary function tests showed a bronchodilator response. For 268 patients (group 2), COPD was the exclusive diagnosis, and all tests showed no bronchodilator response. One hundred thirty-four patients (group 3) were either diagnosed as having both disorders or had varying bronchodilator response on sequential testing. The risk of relapse for group 3 patients (35.6%) was higher than for those in groups 2 (23.1%, P less than .001) or 1 (19.7%, P = .001). The frequency of relapse was higher for nighttime than daytime visits (36.1% versus 24.5%, P = .006) and for weekend than weekday visits (33.6% versus 26.6%, P = .049). Prognosis did not vary with the season or duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719363 TI - Neutrophil depletion fails to improve neurologic outcome after cardiac arrest in dogs. AB - We tested the hypothesis that polymorphonuclear leukocytes (neutrophils) contribute to morbidity and mortality in a canine model of cardiac arrest-induced central nervous system ischemia. Circulating neutrophils were depleted by administration of a neutrophil-specific sheep immune serum before a ten-minute cardiac arrest in ten experimental animals. Ischemic damage measured by a neurologic deficit score in these animals was compared with that in 12 animals that received either vehicle control or nonimmune sheep serum. Animals receiving immune serum averaged 89% depletion of neutrophils immediately after resuscitation (neutrophils +/- SEM: 703 +/- 123/mm3 after antiserum versus 6,384 +/- 1,171/mm3 before immune serum) and 70% depletion over the first three hours after resuscitation. Neurologic deficit scores assessed at one, two, six, 12, and 24 hours after arrest did not vary between depleted dogs and controls. Overall survival time in neutrophil-depleted dogs was less than in controls (15.5 +/- 1.3 versus 19.5 +/- 1.3 hours; P = .04). These results suggest that neutrophils may not contribute to clinically important central nervous system dysfunction after resuscitation from a ten-minute cardiac arrest. PMID- 2719364 TI - Intramuscular meperidine, promethazine, and chlorpromazine: analysis of use and complications in 487 pediatric emergency department patients. AB - Despite widespread use of a parenterally administered mixture of meperidine, promethazine, and chlorpromazine (Demerol, Phenergan, and Thorazine, DPT), there has been no systematic evaluation of its efficacy and complications in emergency department patients. We reviewed the medical records of all patients less than 16 years old who received DPT in our ED during the 24-month period ending December 31, 1987. Of 487 patients who received DPT, the maximum dose was 50/25/25 mg, respectively. Wound repair (69%) and fracture reduction (12%) were the two most common indications. Lacerations most commonly involved the face (65%) or digits (20%). Efficacy was not directly reported, but only eight patients received repeat sedation. Head injuries and a lower mean initial meperidine dosage were more prevalent in patients requiring repeat sedation (P less than .05). Three patients (0.6%) experienced significant complications. All had respiratory depression and received IV naloxone. An abnormal initial mental status examination or an underlying neurologic abnormality was significantly associated with complications (P less than .05). DPT appears to be a safe and relatively effective sedative for selected pediatric ED patients when administered as a ratio of 2:1:1 mg/kg, respectively. Complications are increased in patients with acute or underlying neurologic abnormalities. PMID- 2719365 TI - Diazepam in the prevention of seizures and death in cocaine-intoxicated rats. AB - Rats were exposed to high-dose intraperitoneal cocaine. Pretreatment with diazepam was found to be highly effective in reducing observed seizures from 90% to 0% and reducing the incidence of death from 85% to 10%. Furthermore, diazepam treatment after cocaine exposure was also effective in decreasing deaths, from 80% to 21%, even when given after the onset of seizures. Although diazepam pretreatment was shown to prevent clinically overt seizures, cortical EEGs in these rats demonstrated a continuum of convulsantlike electrical activity. Our study points to the protective effects of diazepam when given before or after cocaine exposure. Together, these data suggest that diazepam has significant efficacy against cocaine intoxication even though it does not totally suppress cocaine-induced cortical EEG seizure activity. PMID- 2719366 TI - Large surface area activated charcoal and the inhibition of aspirin absorption. AB - Activated charcoal's adsorptive capacity, and therefore potential efficacy, is generally related to its surface area. In our study, the efficacy of two activated charcoal preparations, Actidose-Aqua 1,500 m2/g and Super Char, 3,000 m2/g, were compared on the basis of their ability to inhibit aspirin absorption. Twelve healthy male subjects fasted for eight hours before and four hours after a 20 mg/kg oral dose of aspirin. One hour after aspirin dosing, each subject received either no charcoal, 25 g Actidose-Aqua, or 25 g Super Char in a randomized crossover design. Each aspirin dose was separated from the previous dose by at least seven days. Total urine volumes were collected over 12-hour intervals, beginning 12 hours before the aspirin dose and continuing for 72 hours after dosing. Urine salicylate concentration was measured with a colorimetric assay. The fraction of aspirin dose recovered in the urine was 0.96 +/- 0.13, 0.78 +/- 0.18, and 0.50 +/- 0.20 for the control, Actidose-Aqua, and Super Char treatment phases, respectively. In vitro, Super Char was found to bind more salicylic acid than Actidose-Aqua at pH 8.1. We conclude that both activated charcoal preparations significantly reduced the gastrointestinal absorption of aspirin (P less than .05) and that Super Char was significantly more effective than Actidose-Aqua in reducing the gastrointestinal absorption of aspirin (P less than .01). PMID- 2719367 TI - Early fresh frozen plasma prophylaxis of abnormal coagulation parameters in the severely head-injured patient is not effective. AB - Serious head injury may be complicated by coagulation abnormalities. Fresh frozen plasma (FFP) has been advocated as resuscitation fluid, in patients with head injury, to prevent the development of abnormal coagulation. The efficacy of this practice has never been established. We retrospectively reviewed the records of 149 head-injured patients having a Glasgow Coma Scale of 9 or less. One hundred six received FFP and were without evidence of coagulopathies, while 42 received no FFP or had coagulopathies. Group 1 received FFP within a time from injury (T1) and group 2 received FFP after time (T2) or not at all. Groups were similar in demographics, injuries, presenting Glasgow Coma Scale, and presenting hematologic parameters in serial pretreatment or posttreatment hematologic parameters (P less than .05). There were no differences between patients receiving "early" FFP, as compared with those receiving FFP later or not at all. The time of FFP administration did not appear to be critical for effective prophylaxis against coagulopathy. PMID- 2719368 TI - Reliability of a urine dipstick in emergency department patients. AB - We conducted a study to examine whether a negative Chemstrip 9 result for leukocyte esterase and nitrite would reliably exclude an abnormal microscopic examination of the urine of emergency department patients. Three hundred urine specimens were subjected to Chemstrip 9 evaluations and full microscopic examinations in the microscopy laboratory. As the microscopy laboratory examination identified lower WBC and bacteria counts, increasing numbers of false negative urine dipsticks results occurred. The results of our study reveal that the nitrite and leukocyte esterase assays miss significant microscopic findings with corresponding clinical pathology, with the nitrite examination being the less sensitive of the two tests. Based on our results, we believe it would not be prudent to use the Chemstrip 9 dipstick in the ED to exclude the presence of WBC and bacteria in the urine. PMID- 2719369 TI - Emergency medicine in the Third World: two years as director of the Kingston, Jamaica, Public Hospital Casualty Department. AB - A US emergency physician worked for two years as director of a busy emergency department in a large public hospital in Kingston, Jamaica (West Indies). As expected, medical practice in the Third World required caring for patients with far less than he was accustomed to in the way of diagnostic and therapeutic resources. However, more than one lesson in clinical medicine was provided by local approaches to local problems. Despite resource limitations, innovations and improvements were effected, particularly in wound care. Although working in the Third World can be a rewarding experience, well-meaning health workers from advantaged countries should ensure that their efforts contribute to, rather than detract from, the ability of their hosts to independently provide medical care. PMID- 2719370 TI - Implementation of a computerized management information system in an urban fire department. AB - An important aspect in the effective management of an emergency medical services system is the ability to monitor system performance. To provide this information on a timely basis, a comprehensive data collection system is required. We describe the design, implementation, use, and effect of a comprehensive, computerized data retrieval system within an urban fire department. Building on a data collection system already in place, it was possible to minimize the cost and accelerate the training process. A comparison is included between the different type of systems available for use with prehospital providers. Use of prehospital data collection systems results in more in-depth understanding of system operations and the status of prehospital medical care provided to the community. PMID- 2719371 TI - The implantable defibrillator and the emergency physician. AB - The automatic implantable cardioverter defibrillator (AICD) is a proven therapy for preventing the potentially lethal consequences of recurrent ventricular arrhythmias. Given the ever-increasing number of patients who have these devices, it can be anticipated that an increasing number of these patients will likely present to emergency departments with problems associated with this therapy. We review normal automatic implantable cardioverter defibrillator function and focus on the evaluation and treatment of problems that may bring a patient to the ED. Included are interaction with the device by magnets, assessment of the propriety of shocks received by the patient, and what to do when patients state they have received a shock from the device. An algorithmic approach is presented to facilitate management of these patients. PMID- 2719372 TI - The automatic internal cardioverter defibrillator (AICD): description and guidelines for interaction during cardiac arrest. AB - The development and increasing use of the automatic implantable cardioverter defibrillator (AICD) represents a major therapeutic advance for management of recurrent ventricular tachycardia and ventricular fibrillation. However, the AICD sensing functions that determine appropriate energy discharge may complicate resuscitation from cardiac arrest. This care report illustrates a properly functioning AICD interfering with the resuscitation of a 67-year-old man. In the presence of persistent ventricular tachycardia and ventricular fibrillation or successful conversion to a supraventricular tachycardia with pulses that exceed the rate cutoff, it may be helpful to inactivate the AICD with a magnet to prevent unneeded discharges during resuscitation and stabilization. PMID- 2719373 TI - Anterior dislocation of the shoulders with bilateral brachial plexus injury. AB - A case of bilateral anterior shoulder dislocation accompanied by bilateral brachial plexus injuries is presented. A 53-year-old man fell and landed on his chest and arms flexed at the elbows. The dislocations were satisfactorily reduced using the forward elevation, flexion maneuver. Electromyography and nerve conduction studies confirmed bilateral brachial plexus lesions. Arthrogram of the right shoulder demonstrated a rotator cuff tear. The patient is undergoing physical therapy and making a slow recovery. PMID- 2719374 TI - An algorithm for computed tomography & diagnostic peritoneal lavage. PMID- 2719376 TI - Should we terminate futile resuscitations in the field? Can we afford not to? PMID- 2719375 TI - Analgesia for children--options and choices. PMID- 2719377 TI - Butorphanol versus morphine: equally ineffective when given incorrectly. PMID- 2719378 TI - Magnesium levels. PMID- 2719379 TI - Emergency care knowledge of medical students: results and implications. PMID- 2719380 TI - Etiologic agents, incidence, and improved diagnostic methods of cantharidin toxicosis in horses. AB - In addition to the 3-striped blister beetles (Epicauta temexa and E occidentalis), other sources of equine cantharidin toxicosis were identified at the Texas Veterinary Medical Diagnostic Laboratory and included E albida and E attrivittata and the previously incriminated E pardalis and E pennsylvanica. Improved methods for diagnosing cantharidin or blister beetle toxicosis involve partial purification of urine and gastric content extracts, using silica cartridges, followed by analysis, using capillary gas chromatography/mass spectrometry. During a 26-month period, 53 episodes of cantharidin toxicosis in horses were confirmed at our diagnostic laboratory. Concentrations of cantharidin in urine and gastric contents ranged from 0.0003 to 3.50 micrograms/g. Peak incidences were observed in late summer and early fall. PMID- 2719381 TI - Echocardiographic assessment of cardiac chamber size and functional performance in swine. AB - Ninety nonanesthetized 7- to 16-week-old pigs were studied, using 2-dimensional echocardiography that permits orientation of a targeted M-mode beam perpendicular to structures being studied and allows serial studies of the same cardiac regions. Normative data were obtained and included body weight and measurements of left atrial diameter, mitral valve excursion, aortic root diameter, left ventricular end-diastolic and end-systolic diameters, and left ventricular fractional shortening. A positive correlation was found between body weight and measurements of left atrial diameter, mitral valve excursion, aortic root diameter, left ventricular end-diastolic and end-systolic diameters, and fractional shortening. A correlation was found between body weight and age. Best fit analysis resulted in all measurements fitting either a first- or second degree polynomial. PMID- 2719382 TI - Relationship of serum ferritin and iron concentrations and serum total iron binding capacity to nonheme iron stores in dogs. AB - The relationships of various iron-related analytes were evaluated in 95 dogs. Liver and spleen nonheme iron content was determined coulometrically on acid digested tissue specimens. Serum iron concentration and total iron-binding capacity also were measured coulometrically, whereas serum ferritin concentration was measured by ELISA. Significant (P less than 0.0002) correlation was found between serum ferritin concentration and nonheme iron stores. Significant correlation was not found between nonheme iron stores and serum iron concentration or total iron-binding capacity. Serum ferritin concentration should provide a convenient and relatively noninvasive means of estimating iron stores in dogs. PMID- 2719383 TI - Alterations in bovine lymphocyte function during the periparturient period. AB - Lymphocytes from 8 Holstein heifers were evaluated during the periparturient period for mitogen-induced lymphocyte blastogenic responses. Phytohemagglutinin P and concanavalin A-induced lymphocyte blastogenesis increased 2 and 3 weeks before parturition, respectively. However, by the first week after parturition, lymphocyte blastogenesis was markedly impaired. PMID- 2719384 TI - Blood bactericidal assay (Pasteurella haemolytica) comparison of morbidity in marketed feeder calves. AB - An in vitro bactericidal assay that used bovine heparinized blood was investigated for its usefulness in detecting differences in the bactericidal immunity of calves against Pasteurella haemolytica serotype 1 (Ph1). Greater than 90% of killing occurred within 30 minutes. The substitution of fetal calf serum for autologous calf plasma caused loss of bactericidal activity of the blood. Decomplemented calf serum also was low in bactericidal activity. The blood bactericidal assay appears to be opsonin antibody-dependent and complement dependent. The coefficient of variation (CV) that can be expected with this assay was established by use of a group of 8 calves; within-day CV maximum was 0.9, and between-day CV maximum was 2.1. The blood bactericidal assay was used to evaluate 30 calves under typical market stress from 4 farms in eastern Tennessee. All calves had decreased bactericidal activity, as they moved into a feedyard in Texas. The bactericidal activity was reduced among sick calves, based on the severity of clinical signs. Morbidity was highest during the first 14 days in the feedlot. During this period, healthy calves had a decreased bactericidal index (BI) of 4 points, and calves with clinical signs of bovine respiratory tract disease for 3 days had a decreased BI of 8 points. The average reduction in the BI of calves with clinical signs of bovine respiratory tract disease for 6 or more days was 14 points. PMID- 2719385 TI - Neutralizing antibodies for infectious hematopoietic necrosis virus in eggs of steelhead trout (Salmo gairdneri). AB - Neutralizing antibodies specific for infectious hematopoietic necrosis virus (IHNV) were isolated from eggs of spawning Steelhead trout (Salmo gairdneri), using sodium sulfate precipitation. The isolated material was used in place of the primary antibody (rabbit anti-IHNV) in a protein immunoblotting assay to detect IHNV proteins specifically. The egg component that bound specifically to IHNV proteins was determined to be trout antibody by using antiserum toward trout immune globulins as the second antibody conjugate in the protein immunoblotting assay. The antibody recovered from eggs neutralized IHNV infectivity in cell culture. An average of 87.5% decrease in infectivity was observed. PMID- 2719386 TI - Reactivity of dorsal pedal vein of cattle to selected alkaloids associated with Acremonium coenophialum-infected fescue grass. AB - We determined the vasoconstrictive effects of selected ergot alkaloids, and a sample containing loline and its derivative alkaloids, on the isolated dorsal pedal vein of cattle, as a model system to study one of the toxic effects that result from cattle ingesting fescue forage infected with the endophytic fungus Acremonium coenophilalum. The ergot compounds ergotamine, ergosine, and agroclavine constricted this peripheral vein of cattle, but much less so than did the alpha-adrenergic agonist norepinephrine, which supports the ergots acting as partial agonists for these receptors. However, the sample of loline and loline derivative alkaloids did not affect the dorsal pedal vein when given at concentrations similar to those of the ergot compounds. Loline and loline derivative alkaloid sample at high concentrations partially inhibited norepinephrine-elicited vascular contraction, an effect that appeared to be unrelated to alpha-adrenoceptor activity. Thus, in the dorsal pedal vein model in cattle, the ergopeptide alkaloids were more venoconstrictive than were loline and its derivative alkaloids. PMID- 2719387 TI - Effects of 4% pilocarpine gel on normotensive and glaucomatous canine eyes. AB - A 4% pilocarpine gel applied topically to eyes was evaluated in glaucomatous Beagles and normotensive Miniature Schnauzers to determine its efficacy in reducing intraocular pressure (IOP) and to assess any side effects. Pilocarpine gel significantly (P less than 0.05) reduced IOP for 24 hours after treatment, compared with baseline (pre-drug) values, untreated fellow eyes, and placebo treated eyes. The IOP remained significantly lower (P less than 0.05) during 3 treatment days, as well as the first 2 days after treatment. The pupil sizes were significantly smaller (P less than 0.01) in all treated dogs after the first administration of pilocarpine, compared with baseline values, untreated eyes, and placebo-treated eyes. The subsequent pilocarpine gel administrations induced significant miosis (P less than 0.01), compared with baseline values, but the extent of miosis and duration were significantly less (P less than 0.01) as the number of treatments increased. Conjunctival irritation and blepharospasm were observed mainly in the first 2 days of treatment and were minimal after subsequent applications. There was no contralateral effect on IOP or pupil size, compared with baseline values and placebo-treated eyes. PMID- 2719388 TI - Effects of ketamine, xylazine, and a combination of ketamine and xylazine in Pekin ducks. AB - Effects of ketamine, xylazine, and a combination of ketamine and xylazine were studied in 12 male Pekin ducks (7 to 12 weeks old; mean [+/- SD] body weight, 3.1 +/- 0.3 kg). After venous and arterial catheterization and fixation of a temperature probe in the cloaca, each awake duck was confined, but not restrained, in an open box in a dimly lit room. Blood pressure and lead-II ECG were recorded. Three arterial blood samples were collected every 15 minutes over a 45-minute period (control period) and were analyzed for pHa, PaCO2 and PaO2. After the control period, each duck was assigned at random to 1 of 3 drug groups: (1) ketamine (KET; 20 mg/kg of body weight, IV), (2) xylazine (XYL; 1 mg/kg, IV), and (3) KET + XYL (KET 20 mg/kg and XYL, 1 mg/kg; IV). Measurements were made at 1, 5, 10, 15, 30, 45, 60, and 90 minutes after drug administration. All ducks survived the drug study. Cloacal temperature was significantly (P less than or equal to 0.05) increased above control cloacal temperature at 90 minutes after the administration of ketamine, and from 10 through 90 minutes after administration of ketamine plus xylazine. In ducks of the KET group, pHa, PaCO2, and PaO2, remained unchanged after administration of the drug. In ducks of the XYL group, pHa and PaO2 decreased significantly (P less than or equal to 0.05) from control values for all time points up to and including 15 minutes after drug administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719389 TI - Pharmacokinetics of amikacin in African gray parrots. AB - Amikacin sulfate was administered to African gray parrots at 3 dosages (5, 10, and 20 mg/kg) via 2 routes (IV and IM). The elimination half-time was approximately 1 hour (range, 0.9 to 1.34 hour). The apparent bioavailability of IM administered drug was 61 to 106% and was not dose-related. PMID- 2719390 TI - Digestion, fecal, and blood variables associated with extensive large colon resection in the horse. AB - Nutritional alterations were evaluated in 9 horses before surgery and 3 weeks, 3 months, and 6 months (4 total trials) after sham operation (group 1; n = 3) or extensive large colon resection (group 2; n = 6). Feed and fecal analyses were performed to determine apparent digestion of dry matter, organic matter, crude protein, calcium, phosphorus, magnesium, potassium, manganese, zinc, copper, and iron, and true digestion of dry matter, organic matter, crude protein, total plant cell wall, hemicellulose, cellulose, and lignin. Additional fecal and metabolic variables included the percentage of fecal water (water in the feces), total fecal water, metabolic organic matter, metabolic crude protein, and metabolic nitrogen. A CBC and standard series of biochemical tests were performed. Large colon resection decreased (P less than 0.05) the true digestion of dietary crude protein and cellulose and apparent digestion of phosphorus, and it increased the fecal metabolic matter and water loss. Total fecal output increased 45% and total fecal water increased 55%. Phosphorus digestion was decreased (P less than 0.05) in group-2 horses, but effects of this were not detected on analysis of blood variables or on physical examination. Nevertheless, after extensive large colon resection, horses can regain body weight lost after surgery and have no overt physical changes when fed an alfalfa pellet diet that meets greater-than-maintenance requirements. Ad libitum water access is suggested, because these horses may have to consume 2 gal/day more than would normal horses. PMID- 2719391 TI - Influence of dietary source of phosphorus on fecal and urinary excretion of phosphorus and other minerals by male cats. AB - Twelve male cats were fed 2 diets that differed in the source of P. In diet 1 (1.4% P), 62.7% of P originated from poultry, meat, and fish meal, and the remainder from other organic ingredients of food. In diet 2 (1.6% P), 63.5% of P was derived from neutral monobasic/dibasic salts, and the remainder from other organic ingredients of the food. The P intake was nearly the same with both diets, but there was a significant (P less than 0.05) difference between diets in the percentage of ingested P that was excreted in the urine (14.7 +/- 5.3% for diet 1; 34.9 +/- 8.4% for diet 2), and in 6-day urinary P excretion (774 +/- 290 mg for diet 1; 2,004 +/- 556 mg for diet 2). The P concentrations in urine samples obtained by cystocentesis after cats ate were significantly (P less than 0.05) higher when cats were fed diet 2 than when those same cats were fed diet 1. Plasma P concentrations increased after ingestion of diet 2, but were unchanged after ingestion of diet 1. Seemingly, urinary excretion of P was markedly influenced by dietary composition. Diets with the same P content have potential for different biologic effects because of differences in availability of P. PMID- 2719392 TI - Duration of experimentally induced Corynebacterium bovis colonization of bovine mammary glands during the lactating, nonlactating, and peripartum periods. AB - Bovine mammary glands were inoculated intracisternally with a streptomycin resistant (SR) strain of Corynebacterium bovis to determine the number of colony forming units (CFU) required to induce colonization and to maintain persistence of C bovis colonization throughout lactation and involution. Streptomycin resistance was used as a strain marker. Uninfected quarters in cows during midlactation were challenge exposed with successively higher numbers of SR C bovis until all quarters became colonized. Inoculum containing 790 CFU of SR C bovis established colonization in only 7 of 38 quarters. Colonization persisted in only 4 of these quarters by 23 days after inoculation. Eleven quarters were reinoculated with higher numbers of SR C bovis, and all became colonized by the time challenge-exposure inoculum contained 8 X 10(4) CFU. Colonization persisted throughout the 93-day experimental period. Somatic cell counts were significantly (P less than 0.01) higher in SR C bovis-colonized quarters after inoculation than before. Sixteen additional quarters were inoculated with a mean number of 8 X 10(4) CFU of SR C bovis 7 days before suppression of lactation. All quarters became colonized, and SR C bovis was shed during the experimental period; throughout the nonlactating and peripartum periods, high numbers of SR C bovis in pure culture were shed from 13 of 16 quarters. PMID- 2719393 TI - Effects of Pasteurella haemolytica leukotoxin on cultured bovine lymphoma cells. AB - Leukotoxin activity from culture supernatants of Pasteurella haemolytica serotype 1 in logarithmic growth phase caused rapid (less than 5 min) release of intracellular K+, uptake of extracellular Ca2+, and swelling of cultured bovine lymphoma cells (BL3 cells). Release of 51CrO4(2-) and lactate dehydrogenase (LDH) from BL3 cells began after 15 minutes of incubation with leukotoxin at 37 C and was completed between 60 and 120 minutes of incubation. In addition, leukotoxin exposure of BL3 cells resulted in cell aggregation and adherence to glass surfaces. Scanning electron microscopy indicated that after 10 minutes of leukotoxin exposure, BL3 cells increased in size, and large membrane defects developed between 20 and 60 minutes of exposure. The rate of release of LDH from leukotoxin-exposed BL3 cells was proportional to the amount of leukotoxin added. At high cell concentrations, the activity of LDH released at completion was directly proportional to the amount of leukotoxin added. Leukotoxin-induced release of LDH required a divalent cation, whereas K+ release and cell swelling did not. The addition of Ca2+, Mn2+, and Ba2+ resulted in increased leukotoxin induced release of LDH. Divalent cation concentrations of 0.5 to 2.5 mM resulted in 50% of maximal stimulation. Ethylene glycol-bis(beta-aminoethyl ether) N,N,N',N'-tetraacetic acid blocked increased release of LDH caused by Ca2+ addition, but had no effect on K+ release or cell swelling. Leukotoxin action on BL3 cells (K+ release, cell swelling, Ca2+ uptake, and release of LDH) was prevented by incubation at 4 C. PMID- 2719394 TI - Effect of water vapor-saturated air therapy on bronchoalveolar lavage and tracheal mucus transport rate in clinically normal horses. AB - Water vapor-saturated air was delivered to 12 healthy, housed horses for 2 hours daily for 5 days. Treatment had no effect on tracheal mucus transport rate, bronchoalveolar lavage total and differential cell counts, blood cell counts, or plasma fibrinogen concentration. PMID- 2719395 TI - Cardiopulmonary changes in conscious dogs with induced progressive pneumothorax. AB - Cardiopulmonary function was measured in 6 conscious dogs with progressive degrees of induced pneumothorax. Minute volume, respiratory rate, central venous pressure, systemic arterial pressure, pulmonary arterial pressure, pulmonary arterial occlusion pressure, heart rate, cardiac output, and arterial and mixed venous blood gases were determined before pneumothorax and at progressive volumes of pneumothorax equivalent to 50, 100, and 150% of the calculated lung volume. Tidal volume, pulmonary vascular resistance, alveolar to arterial O2 tension difference, physiologic dead space fraction, and pulmonary venous admixture also were calculated. Linear increases in respiratory rate, central venous pressure, alveolar to arterial O2 tension difference, and pulmonary venous admixture differed significantly (P less than 0.05). Linear decreases in tidal volume, pHv, pHa, PvO2, and PaO2 were also significantly different. Quadratic increases were significantly different for pulmonary arterial pressure and pulmonary vascular resistance. Trends were not significantly different for other values. PMID- 2719396 TI - Evaluation of histopathologic and physiologic changes in cows having premature births after consuming Ponderosa pine needles. AB - Premature calving, typified by early expulsion (17 to 43 days) of weak or dead calves and accompanied by retained placentas, was induced in 8 of 9 pregnant cows fed a mixture of Ponderosa pine needles and alfalfa hay. Five control cows of comparable gestation age fed only alfalfa hay maintained normal pregnancies until they were euthanatized at the time the pine needle-treated cows were producing premature calves. Serum specimens from all cows were assayed for progesterone concentration and ovaries and placentomes were examined for histopathologic changes. There were no bacterial, fungal, chlamydial, or viral agents determined to be associated with the premature births. Serum progesterone concentration in the treated cows decreased progressively and were 0.4 to 1.5 ng/ml at the time of premature calving. Histopathologic changes were evident in the placenta and corpora lutea of treated cows only. The number of binucleate trophoblastic giant cells in placentomes was less than normal and the number of necrotic luteal cells in corpora lutea was greater than normal. PMID- 2719397 TI - Effect of subchondral drilling on repair of partial-thickness cartilage defects of third carpal bones in horses. AB - Arthrotomies of middle carpal joints were done on 13 horses, and a 1-cm partial thickness, round defect was made on the radial facet of both third carpal bones. In one joint, 1-mm diameter 1-cm deep holes were drilled within the defect, and one joint was used as a control. horses were assigned to 2 groups--group 1 (n = 6 horses), 5 drill holes; group 2 (n = 7 horses), 11 drill holes. At 1 and 3 weeks after surgery, differences between joints in synovial fluid total protein values, WBC counts, or results of mucin precipitate tests were not significant (P = 0.005). Physically and radiographically, horses were the same during the 12 initial weeks they were housed in stalls and the 9 weeks they were kept in paddocks. Twenty-one weeks after surgery, horses were euthanatized. Joints with drill holes had a significantly greater area (P less than 0.05) of healthy fibrocartilage new tissue: group 1-33 to 68% new tissue, compared with 0 to 23% new tissue in controls; and group 2-22 to 64% new tissue, compared with 0 to 37% new tissue in controls. Differences between healing of defects with drill holes in groups 1 and 2 were not significant. Thickness of new tissue over drill holes was 33 to 61% of thickness of cartilage adjacent to the defect, and thickness of tissue between drill holes was 11 to 43% (group 1) and 8 to 79% (group 2) of the thickness of cartilage adjacent to the defect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719398 TI - Questions conclusions on spinal fixation technique. PMID- 2719399 TI - Preparing for life. The critical transition of adolescence. PMID- 2719400 TI - The life you save may be your own. New Jersey addresses prevention of adolescent problems. PMID- 2719401 TI - Educating young adolescents. Why we must restructure middle grade schools. PMID- 2719402 TI - Adolescent health. Challenges for behavioral scientists. AB - Clearly, the role of behavioral scientists in adolescent health is not limited to service delivery. They also have a role to play via their contributions to basic knowledge of adolescent health and development, their involvement with the design and evaluation of health systems, their efforts to design and evaluate interventions to reduce adolescent morbidity and mortality, and their contributions to adolescent health policy. The once popular view of adolescence as a period of inevitable storm and stress has been replaced by one that emphasizes the potential of this developmental stage for constructive adaptation and maturation. Behavioral scientists have an important role to play in assuring that the potential of this life stage is reached for future generations of youth. PMID- 2719403 TI - The impact of video endoscopy on surgical training. AB - The impact of video endoscopy on surgical resident training was assessed by an analysis of 1531 endoscopic procedures (1057 video endoscopy and 474 fiberoptic endoscopy) and a standardized questionnaire response of surgical staff and residents. Video endoscopy provided advantages in the following areas: 1) Technical. Superior quality of image with a significantly greater resolution. 2) Procedural. Multiple simultaneous viewers for teaching and increased coordination for therapeutic maneuvers. 3) Educational. "Freeze frame" capability for real time teaching; video taping for subsequent consultation, review, or teaching conference, video tape evaluation at preoperative conferences, and archive of video tape for teaching file. 4) Documentation. For use review and quality assurance or for patient education. 5) Research. Investigation of video image enhancement techniques. 6) Physical comfort. Relief of many causes of strain and fatigue and elimination of potential danger to the endoscopist in certain therapeutic maneuvers. Residents learned video and fiberoptic endoscopy equally well, requiring only 3 to 5 procedures to learn each type of system. Experience in this teaching program indicates a decided advantage to incorporating video endoscopy into surgical residency training. After more than 1000 video endoscopy procedures, the novelty has worn off but enthusiasm persists; the video system is now a workhorse that provides greater technical capabilities and broader educational horizons while returning endoscopy to the realm of surgical education. PMID- 2719404 TI - Intra-operative and postoperative biliary endoscopy (choledochoscopy). The role of the surgeons. AB - Intra-operative and postoperative choledochoscopy is an important adjunct to biliary surgery. In the last two decades, the necessity of this examination became obvious but two surveys clearly indicated that despite the availability of instruments surgeons do not use it routinely. One of the reasons is the long learning curve and the limited experience. The introduction of the video choledochoscope opened a new chapter because the surgeon could learn it faster and the technique is easier to use. Choledochoscopy is a "two man" job, requiring four hands. Using video choledochoscopy, the assistant and the operator can observe the situation together, therefore coordination of movement is easier. The actual endoscopic procedure is faster and the location of the stone, its removal, and the sphincter function are recorded on tape. This is a great step forward in analyzing sphincter function. It became the method of choice in teaching. It is assumed that, with the introduction of video choledochoscopy, the incidence of missed stones will be decreased significantly. PMID- 2719405 TI - Endoscopy of vertical banded gastroplasty. AB - Vertical banded gastroplasty is the most common operation for morbid obesity. Postoperative gastroscopy was needed 91 times in 79 of 696 patients for 1) abdominal pain (23), 2) excess vomiting (22), 3) inadequate weight loss (14), 4) excess weight loss (13), 5) and a sudden increase in eating capacity (7). A normal appearance consisted of a clean gastric channel 6.8 +/- 1.4 SD cm long, with a rosette 46.6 +/- 2.1 cm from the incisors and, with insufflation, an 11 mm scope passed through this pseudopylorus snugly, but without difficulty. In Group 1, no problem was seen in the channel, and cholecystitis was found to be the cause. In Group 2, no problem was observed in ten (poor teeth and chewing), six experienced stasis or pill ulcerations, four had bezoars (fragmented or removed with basket), and two had intraluminal mesh. In Group 3, the scope floated through too large an outlet (greater than or equal to 13 mm) in eight, and no cause was seen in six (gorgers, sweets-eaters). In Group 4, tightness or stricture resolved with dilatations (Eder-Puestow; Savary; balloon dilators) in six, but seven required re-operation. In Group 5, the scope travelled through four breakdowns in the partition and three outlets were too large. Gastroscopy viewed problems accurately, indicated treatment and suggested modifications in gastroplasty technique. PMID- 2719406 TI - The duodenum. Surgical anatomy. AB - The second part of this monograph on the duodenum describes the muscular and mucosal changes observed at the gastroduodenal junction. The structure of the duodenal wall and details of the intramural portion of the common bile and pancreatic ducts are described, together with the surgical anatomy of the four parts of the duodenum. The arterial supply, the venous and lymphatic drainage, and the innervations are described from the surgeon's point of view. PMID- 2719407 TI - Massive retroperitoneal hemorrhage from an asymptomatic adrenal cortical adenoma. Report of a case. AB - A 52-year-old man was admitted to the General Surgical Service, with acute onset of left back and flank pain. Two weeks prior to admission he had been subjected to a 3G to 4G acceleration in an ejection seat training simulator. On the day of admission, he had performed a 100 yard swim in flight gear following a seven foot jump into water. He denied any injury during the above exercises or any other trauma. A falling hematocrit was demonstrated by serial determinations and a computerized tomography scan revealed a left retroperitoneal hematoma with normal bilateral renal function and no obvious renal injury. Continued hemorrhage resulted in laparotomy, which showed an 11 cm left adrenal tumor with massive hemorrhage into the retroperitoneum. Histologically the tumor was a benign non functioning adrenal cortical adenoma. PMID- 2719408 TI - Diagnosis and management of acute laryngeal trauma. AB - Retrospective chart analysis was carried out on 13 patients presenting to the trauma service at the Humana Hospital University in Louisville, from January, 1984 through December, 1987 with a diagnosis of acute laryngeal injury. The most common cause of injury was blunt trauma suffered in a motor vehicle accident. Stridor was the most common presenting symptom and the thyroid cartilage was the most common site of fracture. Seven patients underwent immediate open exploration and repair, three underwent tracheostomy without exploration, and three were treated conservatively with voice rest, humidity, and steroids. All 13 patients had a favorable result. The purpose of this paper is to review the findings of our study and to discuss diagnostic and management recommendations for laryngeal trauma. PMID- 2719409 TI - The role of intra-operative biopsy in the treatment of resectable neoplasms of the pancreas and periampullary region. AB - Controversy persists regarding the role of intraoperative biopsy in the treatment of resectable pancreatic and periampullary masses. The authors report their experience with intraoperative biopsy in 37 patients in whom preoperative diagnosis was unsuccessful. Tru-cut needle biopsy was positive in 86 per cent of patients with carcinoma of the pancreas, but was negative in all patients having periampullary neoplasms. Incisional biopsy was positive in 75 per cent of all patients, its accuracy being approximately equal in both groups of patients. Duodenotomy with open biopsy was performed in eight patients having periampullary lesions and was accurate in 88 per cent. Biopsy of lymph nodes not contraindicating resection was performed in 11 patients and was positive in only 18 per cent. Resections based on clinical findings suspicious of malignancy with either a negative biopsy or no biopsy attempted resulted in a 13 percent resection rate of patients having benign disease. These results indicate that while histologic determination of malignancy can be obtained in most resectable pancreatic and periampullary lesions, at least 12 per cent of such tumors remain undiagnosed by standard operative biopsy techniques. Pancreatoduodenectomy should proceed in these patients based on their clinical status and the surgeon's degree of experience with the procedure. PMID- 2719410 TI - Current treatment of traumatic aortic disruptions. AB - Eighteen patients with traumatic disruptions of the descending thoracic aorta were treated at the Wake Forest University Medical Center from 1979 through 1986. Their preoperative evaluation and operative management are presented, with emphasis being placed on methods for preventing complications related specifically to aortic cross-clamping. Two patients died, for an operative mortality of 11 per cent. One of the two patients had exsanguinating hemorrhage with profound shock on the way to the operating room; in the second patient, the aorta was occluded just beyond the disruption, and there had been no distal perfusion for several hours before operation. Four patients (22%), three of whom had not had a shunting procedure, had major neurologic complications relating to the spinal cord. Thus, shunting procedures during repair of descending aortic disruption appear to offer some protection from neurologic deficits. PMID- 2719411 TI - [Publications on adverse reactions to drugs in Spanish pediatric journals between 1980 and 1984]. AB - Papers concerning to adverse drug reactions published from 1980 to 1984 in four spanish pediatric journals has been analyzed. 29 of 1690 published papers described adverse drug reactions, 26 of these were clinical observations, including two previously not described reactions. The pharmacological groups responsible for 10 different clinical manifestations were 19. All papers came from hospitals. In 20 papers the correct treatment schedule were included. Key words were present in 69.23% of the papers, but only half of them were adequate for an easy retrieval of the information. The paper call for the communication of adverse drug reactions. PMID- 2719412 TI - [Restricted intake of sodium in newborn infants with very low birth weight in the first days of life]. AB - A prospective study on the amount of sodium administered in the first five days of life in a group of 18 low-birth-weight infants is presented. Their mean birth weight, and gestational age were 1.150 gm., and 28.8 weeks. Patients were cared for in radiant warmers, and protected with a plastic blanket. Minimum amount of sodium necessary to maintain a normal plasma sodium concentration was given. Mean daily sodium and free water given was 0.96 mEq/kg/day, and 108.4 ml/kg/day, respectively. In day 5, there was a mean accumulated body weight loss of ten per cent. This group of patients were compared with a similar group in whom plastic blanket was not used, and who received a sodium intake of 1.5 mEq/kg/day. In this latter group of patients there was a higher incidence of hypernatremia (p less than 0.005). The incidence of hyponatremia was similar in both groups. Daily sodium intake might be very low, in infants of very-low-birth-weight if a negative weight balance is allowed in the first days of life. PMID- 2719413 TI - [Apnea attacks in infants: study of 7 cases]. AB - Authors study seven young infants suffering from apneic spells, without clear origin. Diagnosis was gastroesophageal reflux in the two most torpid evolution: others had hyponatremia. RVS infection, inborn cytomegaly and prematurity apnea. PMID- 2719414 TI - [Cardiac complications in Kawasaki disease]. AB - We present 3 patients, aged 7 and 12 months. and 5 years, who meet the diagnostic criteria for Kawasaki's disease. In these, there was coronary artery involvement. which was identified by two dimensional echocardiography. In two of these, a coronary artery involvement which was identified by two dimensional echocardiography. In two of these, a coronary artery aneurysm was demonstrated within the 3rd week. The aneurysm resolved after 4 months in one patient, and still persist after 15 months in the other. The third patient had a left coronary artery aneurysm, confirmed by angiocardiography, which also showed small aneurysms in the right coronary artery. The electrocardiographic study of this patient, performed 3 months after onset, showed a patterns of necrosis (anterolateral infarction), confirmed by mean of a thallium scintigraphy. We have performed a study about the management of this kind of patients, and can conclude: 1. Coronary angiocardiography may permit the detection of right coronary artery aneurysms, not visualized by echocardiography. 2. Patients with coronary artery aneurysms, with no stenotic lesions 1 the coronary angiocardiography, may evolve into myocardia infarction. 3. We expose our doubts about the indication and right time to perform the angiocardiographic study. PMID- 2719415 TI - [Extrinsic allergic alveolitis: apropos of a case in a child]. AB - We present a young male (12 years) with low grade fever, weight loose, anorexia and progressive dyspnea. The clinical, roentgenological and pulmonary function pictures are close with interstitial pneumonitis. The patient had a pigeon loft on his house, thus we tried confirmed the diagnosis of extrinsic allergic alveolitis: pigeon breeder's lung. We believed at any patient age the pigeon breeder's lung must be considered in the differential diagnosis of interstitial pneumonitis. A good anamnesis will avoid unnecessary complementary test. PMID- 2719416 TI - [Bronchiolitis obliterans with secondary pneumoconiosis]. AB - A seven year old girl developed recurrent bronchitis since three month of life. Chronic wheezing remain between exacerbations. Pathological examination of her lung biopsy disclosed bronchiolar obstruction due to peribronchiolar fibroses. Storage of anthracoid material, compatible with pneumoconiosis in relation to impairment on mucociliary function, was present. This is an unusual picture in childhood. PMID- 2719417 TI - [Reversible Pelger-Huet anomaly associated with acute gastroenteritis caused by salmonella group D]. PMID- 2719418 TI - [Enemas of glycerol and acute kidney failure]. PMID- 2719420 TI - [Adolescents and pediatricians]. PMID- 2719419 TI - [Familial thallium poisoning. Clinical and therapeutic considerations]. PMID- 2719421 TI - [Neuroendocrine changes induced by craniospinal radiation in children with acute lymphoblastic leukemia and medulloblastoma]. AB - In order to investigate effects produced by external cranial irradiation on neuroendocrine systems. GH secretion (elicited by oral clonidine and by GRF-29 as iv bolus) and TSH and PRL responses to an iv bolus of TRH were evaluated in children previously irradiated for LLA (n-7) or medulloblastoma (n-3). Growth velocity was also periodically evaluated. Three years after radiotherapy, while a normal GH response to clonidine challenge was observed in 60% of cases, growth velocity was impaired in 83.3% of them. GH release induced by GRF-29 was normal in another 60% of patients. Either basal TSH values or its' response to TRH were significantly increased in the three medulloblastomas, in spite of clinical and biochemical euthyroid status of these patients. Our data indicate that cranial radiotherapy produces functional neuroendocrine alterations; specificity and degree of these are dependent on the dose received. Therefore, to allow a suitable replacement hormonal therapy as soon as possible, this type of patients need a periodic evaluation of their endocrine status. PMID- 2719422 TI - [Viral infection and obstructive cholangiography in children]. AB - In the last years it has been suggested that idiopathic obstructive cholangiopathy is a pathologic process with evolutive studies: extrahepatic biliary atresia and neonatal hepatitis. The possibility of a viral agent as the inciting factor has been investigated. This report shows four male and one female with confirmed idiopathic obstructive cholangiopathy with different clinical picture. There was evidence of cytomegalovirus infection in two patients, rubella infection in one patient, hepatitis B virus infection in one patient and Epstein Barr virus infection in one patient. While other causes of neonatal cholestasis were excluded, we suggest that those viruses has an etiologic role in the initial injury and the progression of the disease. PMID- 2719423 TI - The box plot: a simple visual method to interpret data. AB - Exploratory data analysis involves the use of statistical techniques to identify patterns that may be hidden in a group of numbers. One of these techniques is the "box plot," which is used to visually summarize and compare groups of data. The box plot uses the median, the approximate quartiles, and the lowest and highest data points to convey the level, spread, and symmetry of a distribution of data values. It can also be easily refined to identify outlier data values and can be easily constructed by hand. We apply box plots to tabular data from two recently published articles to show how readers can use box plots to improve the interpretation of data in complex tables. The box plot, like other visual methods, is more than a substitute for a table: It is a tool that can improve our reasoning about quantitative information. We recommend that the box plot be used more frequently. PMID- 2719424 TI - National Study of Internal Medicine Manpower: XV. A decade of change in residency training in internal medicine. AB - We report on trends in the characteristics of residency training programs in internal medicine from 1976 to 1988 and make some comparisons with other specialties. Internal medicine is faring less well in the residency match compared with other specialties than it did 10 years ago. It has also increased the number of residency positions offered more than other major specialties. A sizable proportion of first-year residency positions in internal medicine are not filled through the Match. Foreign medical graduates account for almost 50% of the first-year resident (R1) positions filled outside the Match. Programs most dependent on foreign medical graduates are in hospitals with limited medical school affiliation, smaller size, operated by churches or the Veterans Administration, and located in eastern states and large metropolitan areas. Despite concerns about quality and oversupply, almost 50% of the program directors expected to increase the size of their programs in 1988-1990. Residents are not being scheduled for fewer hours per week than they were 12 years ago but they are being scheduled for fewer nights. No trends were noted toward increased ambulatory care training sites away from the hospital campus. PMID- 2719425 TI - Health care needs of the adolescent. American College of Physicians. PMID- 2719426 TI - Serum hepatitis B viral DNA in acute viral hepatitis B. PMID- 2719427 TI - Clinical effect of glucocorticoids on Kaposi sarcoma related to the acquired immunodeficiency syndrome (AIDS). PMID- 2719428 TI - The periodic physical examination in asymptomatic persons. PMID- 2719429 TI - The geriatric consultation team. PMID- 2719430 TI - Anaphylactic shock and vitamin K1. PMID- 2719431 TI - Flutamide and hepatitis. PMID- 2719432 TI - Lovastatin and visual changes. PMID- 2719433 TI - Isoniazid and rhabdomyolysis. PMID- 2719434 TI - Seroreversions in human immunodeficiency virus (HIV) infection. PMID- 2719435 TI - Splenic abscess from Fusobacterium nucleatum. PMID- 2719436 TI - [High frequency audiometry]. AB - The authors have performed a series of high frequency audiograms in order to assess its value in routine otological practice. Initially, they conducted a statistical study on subjects with so-called normal hearing in order to establish standardised normal values. As in the earlier studies, a physiological alteration was observed in the high frequencies which was progressively accentuated with age. Audiometric results should therefore always be considered in relation to the patient's age. A standard graph is proposed for the presentation of the results. The authors subsequently performed high frequency audiometry in patients with internal ear disorders. High frequency audiometry allowed early detection of an alteration in the internal ear, when conventional audiometry was normal. The authors believe that high frequency audiometry should be part of the otological assessment as its allows early detection of internal ear disease. PMID- 2719437 TI - [Sudden deafness: apropos of 19 cases. Results of treatment with pentoxifylline. Value of erythrocyte filtration time]. AB - Between March 85 and November 86, 20 patients underwent treatment for sudden deafness [19] or bilateral tinnitus [1] by Pentoxifylline (1 200 mg/24 Hrs, including 400 mg IV over 24 Hrs) and Carbogen sessions (2 or 3/24 Hrs), during six days on an in-patient basis, followed by 1 200 mg/24 Hrs orally during another eight days. The results, assessed by clinical examination, audiometry, and erythrocyte filtration time (using the Reid and Dormandy method) on the first, sixth, and fourtheenth days, were: -- good or very good a little more than 75%, -- moderate: 5%, -- poor: a little fewer than 20%. Filtration times in a group of asymptomatic patients, determined by the same method, were used as a reference. PMID- 2719438 TI - [Cervicofacial non-Hodgkin's malignant lymphoma. Classification, prognosis and treatment apropos of 65 cases]. AB - The approach to non hodgkins malignant lymphomas (NHML) has changed in recent years, notably because of advances in pathological evaluation due to histo-immuno labelling leading to a more accurate classification. Such pathology being relatively common in the cervical facial region, with a figure of 10 to 25%, this report concerns the personal experience of the authors based upon 65 cases treated in the department between 1975 and 1985. PMID- 2719440 TI - [Melkersson-Rosenthal syndrome. Current data and a report of a case]. AB - The author reviews recent data from the literature in the light of a case of Melkersson-Rosenthal syndrome. It would appear that the triad (plicated tongue, macrocheilia and facial paralysis) forming the syndrome may be accompanied by other bucco-facial oedematous manifestations. The etiology remains unknown and treatment is symptomatic based upon the aesthetic and symptomatic requirements of each patient. PMID- 2719439 TI - [Cervical spondylodiscitis. A rare complication of intubation]. AB - The authors present two cases of cervical spondylodiscitis occurring following intubation. The most probably mechanism was direct contamination of the inter vertebral disk through a lesion of the posterior pharyngeal wall, but other possible mechanisms for the spread of infection are discussed. This very rare complication should be borne in mind and routinely sought when there is persistence of cervical pain following intubation. PMID- 2719441 TI - [Problem of the preservation of hearing in acoustic neuroma. Value of the mixed supra petrous and retrosigmoid approach]. AB - The authors described their experience of the possibilities of preservation of hearing on the basis of a series including approximately 180 acoustic neurinomas. Whilst the initial experimental approach involving the use of a sub-occipital approach in seated position was abandoned, in view of the risk of complications inherent to the use of this approach, the authors progressively developed the possibility of the preservation of hearing by a retro-sigmoid approach in horizontal position as described in France by Bremond, Magnand and Garcin, and taken up subsequently by Sterkers. Currently, a retro-sigmoid approach is used combined with a classical supra petral approach which can be used in all cases to assess the tumour at the base of the internal auditory meatus and identify the position of the facial nerve. This surgery by mixed approach can safeguard hearing in small tumours (grades I, II and IIIa) in approximately 75% of cases. Functional hearing should nevertheless be differentiated (approximately one case out of two) in other cases where only residual auditory tissue remains. It is highly likely that improvement in radiological techniques (leading to earlier diagnosis) as well as surgical techniques will lead to the safeguard of hearing in even more cases, and hence the importance of evaluation of these techniques in terms of their relative indication in comparison with the translabyrinthine approach which the authors consider to remain the approach of choice in large tumours (grades IIIb and IV). PMID- 2719442 TI - [The diffuse lymphatic system of the nasal mucosa in allergic rhinitis]. AB - Morphologic and immunologic study were performed on the mucosa associated lymphoid tissue (MALT) of patients with allergic rhinitis. Scraping from 14 healthy subjects and 36 allergic ones were used. Besides ordinary hystological methods immunohistochemical ones wilk polyclonal antibodies were employed to study IgG, IgA, IgM, IgE and monoclonal antibodies used for B and T lymphocyte and subset T-suppressor cell identification. In a comparison between normal and allergic mucosa, the morphopathology show an accentuated edema and a slight fibrosis. Among the IgG, IgA and IgM do not show any substantial differences in the samples in normal or in allergic subjects; white traces of IgE are found in allergic patients, but are totally absent in normal ones. In the lymphocyte populations does not show any substantial changes between the two groups. Was also analyzed the mechanism and the majority of the factors by which were obtained the results. PMID- 2719443 TI - [The cochlear aqueduct and congenital perilymphatic fistula. An initial report]. AB - The authors present 3 preliminary case reports of congenital perilymphatic fistula and describe their approach, which in the presence of clinical symptoms composed of progressive or fluctuating deafness, should suggest the diagnosis of congenital perilymphatic fistula leading to examination of the cochlear aqueduct by high resolution computed tomography. An anomaly detected on the CT scan, particularly on the intermediate and internal segments, is a decisive argument in the decision to operate on these congenital perilymphatic fistulae. PMID- 2719444 TI - [Percutaneous endoscopic gastrostomy. Indications and results in 31 patients]. AB - Nutritional assistance was indicated in 31 patients with an ENT tumour at different stages of treatment and different stages of the disease. These patients presented with disorders of deglutition with false passages (68%), aspiration pneumonia (10%), dysphagia (35%) or denutrition (17%). We used an endoscopic percutaneous gastrotomy kit produced by the Bioser company (pull technique). In 29 patients, the tube was inserted under general anaesthesia in the operating theatre to prevent dyspnoea during introduction of the tube in these patients with alteration of the airway-gastrointestinal tract junction or because the tube was inserted at the beginning of anaesthesia for ENT surgery. The tube was able to be inserted in every case, with cardiac arrest in one patient who was effectively resuscitated without sequelae, two obstructions of the cuff requiring advancement of the tube with a bougie, 2 ruptures of the thread and one case of dyspnoea. Two patients subsequently developed a wound abscess which was drained and one patient required removal of the tube. Follow-up of the patients demonstrated the good tolerance of this tube which was maintained for an average of 2.9 +/- 0.5 months (0.1 to 9 months) without any major complications. 3 benign wound infections, 4 inflammatory reactions, 4 minimal leaks, 1 case of hyperthermia, 12 cases of abdominal distension and 2 cases of displacement of the tube were observed. The weight gain was equal to 4%. The authors believe that this technique of endoscopic gastrostomy should be preferred to surgical gastrostomy. PMID- 2719445 TI - [Deafness surgery in adults. The growing role of improved local anesthesia]. AB - As deafness surgery is subject to the two imperatives of safety and reduction of bleeding, local anaesthesia constitutes a very satisfactory solution. The concomitant administration of Midazolam and Buprenorphine relaxes the patient and ensures analgesia and anterograde amnesia, allowing the surgeon to operate under excellent conditions. Over the last 6 months, except in one subject under the age of 16 years and one psychologically very fragile patient, all surgical operations for deafness, regardless of their importance, have been performed under local anaesthesia improved by means of diazanalgesia. It is probable that in the future, numerous cophosurgeons will adopt a similar protocol. PMID- 2719446 TI - [The tip correction phase in esthetic reduction rhinoplasty]. AB - The tip correction phase in reduction rhinoplasty cannot and must not be performed according to the same protocol in all patients. Simple clinical examination can determine the predominant element in projection of the tip: lateral crus, medial crus, the septum, which may participate to varying degrees in this projection. Precise procedures are performed on the basis of the elements observed on clinical examination. PMID- 2719447 TI - [Repair of the attic wall by a mastoid osteofibrous graft]. AB - Closed techniques for the management of cholesteatomas often require repair of the external auditory meatus. Small losses of substance around the tympanic membrane or in the attic wall can be repaired by a mastoid cortical autograft. The originality of the procedure described on the basis of the various operative stages is based above all on the preservation of an osteoperiosteal fringe contiguous with the bone graft used. The value of the technique lies in availability of the graft at the operative site and the ease of its insertion into the defect requiring repair. PMID- 2719448 TI - Clinical applications of evoked acoustic emissions: results in normally hearing and hearing-impaired subjects. AB - Click-evoked otoacoustic emissions were recorded in a group of normally hearing subjects (n = 52 ears) and a group of patients demonstrating several common types of sensorineural hearing loss (n = 85 ears) in order to study the clinical applicability of acoustic emissions. In the normally hearing population, all ears demonstrated acoustic emissions that could be elicited at intensities below the normal subjective threshold for the sequence of clicks (mean, -5.2 dB hearing level [HL]). Sixty-seven percent of the normal ears showed long (greater than 20 ms) click-evoked emissions, and spectral analysis showed a broadband spectral component with several narrowband frequency peaks. In patients with sensorineural hearing loss, the incidence of acoustic emissions decreased and the detection threshold increased linearly with increasing threshold. No emissions were elicited from ears exhibiting subjective click thresholds greater than 35 dB HL. Hearing-impaired ears showed a significantly higher proportion of short duration emissions and a significant reduction in the mean number of narrowband frequency peaks in comparison to the controls. Therefore, acoustic emissions can be used as a reliable technique for objective study of normal micromechanical activity within the cochlea and for detection of subtle changes in cochlear disease. However, they have not been demonstrated to be useful in differentiating cochlear disease. PMID- 2719449 TI - Recurrent tonsillitis: histologic and bacteriologic evaluation. AB - Histologic and bacteriologic evaluations of tonsils removed at surgery from ten patients with a diagnosis of recurrent tonsillitis were performed. The bacteriology was complex, with an average of 6.3 aerobic bacteria and 3.3 anaerobic bacteria isolated from each patient. Histologic sections revealed chronic cryptitis, with intact tonsillar architecture. These findings provide a possible explanation for the failure of commonly used antibiotic regimens to eradicate recurrent infection from this site. PMID- 2719450 TI - Dimensions of the extended facial recess. AB - The variability of the dimensions of the facial recess and extended facial recess with age, sex, and degree of pneumatization was measured in 87 temporal bones serially sectioned in the horizontal plane. Although some statistically significant differences in dimensions were identified, the absolute differences were small compared to the range of measurements. The mean dimensions were very similar in all groups studied. The clinical relevance of the data to mastoid surgery and cochlear implantation is discussed. PMID- 2719451 TI - Transmucosal electrical stimulation of laryngeal muscles. AB - A new technique is described that enables discrete activation of individual laryngeal muscles by electrical stimulation across overlying mucosa. In 15 dogs, we defined six distinct motor points by transmucosal stimulation at 3 mA while observing the resulting characteristic position of the arytenoid and true vocal cord. Five dogs were then paralyzed with succinylcholine in order to simulate bilateral vocal cord paralysis. Application of a 3-mA stimulus at each motor point yielded no motion of the cords, but when the current was increased to 20 mA, characteristic responses were elicited. In five other dogs, botulinum toxin was injected directly into laryngeal muscles. Stimulation was used in an attempt to quantify the degree of neuromuscular blockade. In the last group of five dogs, we simulated cricoarytenoid arthritis by scarifying the joint. The extent and nature of the joint's impairment could be demonstrated by stimulation. Transmucosal stimulation appears promising as a clinical technique for correlating particular vocal cord movements and thresholds of activation with specific laryngeal disorders. Additionally, such a technique may be useful in clarifying how each laryngeal muscle acts upon the cricoarytenoid joint. PMID- 2719452 TI - Temporal bone computed tomography in the preoperative evaluation for cochlear implantation. AB - High resolution computed tomography of the temporal bone is performed routinely in the preoperative evaluation for cochlear implantation. A retrospective review was performed to determine the effect of these studies. The clinical significance was determined through consultation with the referring otolaryngologist and review of the operative reports. Twelve examinations were reviewed. Abnormalities were identified in 12 of the 24 ears examined (eight of 12 patients studied). In two patients the CT examination strongly influenced the selection of the ear to be implanted. In four additional cases information felt to be useful in preoperative planning was provided. Useful information related to potential complications with the mechanical insertion of the electrode apparatus. We conclude that temporal bone abnormalities are common in the population undergoing cochlear implantation and that high resolution temporal bone CT is essential in preoperative evaluation. The CT scan should be interpreted with adequate knowledge of the operative procedure to evaluate any possible barriers to the mechanical insertion of the internal components of the system. PMID- 2719453 TI - Evaluation of pure tone and speech discrimination changes in Usher's syndrome. AB - Twenty-three adult patients with type 2 Usher's syndrome were evaluated for changes in pure tone average (PTA), discrete frequency thresholds, and speech discrimination scores. These patients were evaluated over a period of 5 years on the average (range, 2 to 9 years). Analyses of ear data showed a less than 10-dB change on PTA and discrete frequency thresholds for most ears. Of the ears that showed a threshold change greater than or equal to 10 dB, statistical significance was reached only at 4,000 Hz (p less than .01), where 11 ears representing ten patients dropped 10 to 15 dB. Speech discrimination data showed a greater than or equal to 16% change in score for 18 ears (12 patients). Sixteen of those ears (ten patients) had a 16% to 52% decrease in score (p less than .01), and the remaining two ears (two patients) showed a 20% and 30% improvement in score. These findings document little or no change in pure tone sensitivity for type 2 Usher's syndrome patients, but demonstrate the importance of monitoring their speech discrimination performance. PMID- 2719454 TI - Effect of temperature on fixation suppression ability in normal subjects: the need for temperature- and age-dependent normal values. AB - The purpose of the present investigation was to determine whether temperature has an effect on the magnitude of fixation suppression (FS) in normal subjects. The subject population consisted of 23 patients ranging in age from 35 to 74 years (mean age of 58.13 years). Each subject received a conventional vestibulometric test battery that included bithermal caloric testing and the FS test. The warm caloric media elicited larger nystagmus slow-phase eye velocities than the cool caloric media. Following warm caloric irrigations, FS was significantly smaller than that following cool caloric irrigations. It also worsened as a function of subject age. The results suggest that separate normal upper limits for FS need to be determined for cool and warm caloric testing. They also suggest that FS ability may decrease with age. PMID- 2719455 TI - Effects of recurrent laryngeal nerve transection and vagotomy on respiratory contraction of the cricothyroid muscle. AB - The cricothyroid muscle (CT) appears to be an accessory muscle of respiration. Phasic inspiratory contraction is stimulated by increasing respiratory demand. Reflex activation of the CT may be responsible for the paramedian position of the vocal folds, and hence airway obstruction, in patients with bilateral recurrent laryngeal nerve (RLN) paralysis. Previous research has demonstrated the influence of superior laryngeal nerve (SLN) afferents on CT activity. The present study addresses the effects of vagal and RLN afferents. Electromyographic activity of the CT and right posterior cricoarytenoid muscle was monitored in anesthetized cats during tracheotomy breathing and in response to tracheal or upper airway occlusion in the intact animal. This was repeated following left RLN transection, bilateral vagotomy, and bilateral SLN transection. Vagotomy abolished CT response to tracheal occlusion and markedly reduced the response to upper airway occlusion. Vocal fold position following RLN transection appeared to correlate with CT activity; however, observed changes were minor. PMID- 2719456 TI - Extracranial carotid artery aneurysm: an unusual neck mass in a young adult. PMID- 2719457 TI - Chloramphenicol resistance in Pseudomonas cepacia because of decreased permeability. AB - The mechanism of chloramphenicol resistance was examined in a high-level resistant isolate of Pseudomonas cepacia from a patient with cystic fibrosis. We investigated potential resistance mechanisms, including production of chloramphenicol acetyltransferase, ribosomal resistance, and decreased permeability. This strain (MIC, 200 micrograms/ml) had no detectable chloramphenicol acetyltransferase activity. In in vitro translation experiments in which we compared the resistant isolate with a susceptible strain of P. cepacia, inhibition of amino acid incorporation was equivalent even in organisms that were preincubated with sub-MICs of chloramphenicol. A 21.9-kilobase (kb) fragment of DNA was cloned which coded for chloramphenicol resistance; this fragment was expressed in P. cepacia but not in Escherichia coli. Quantitation of chloramphenicol uptake in the isogenic pair of susceptible and resistant organisms revealed a nearly 10-fold decrease of drug entry into the resistant strain. Comparison of isolated outer membrane proteins and lipopolysaccharide patterns identified no significant differences between the isogenic pair of organisms. We concluded that the mechanism of chloramphenicol resistance in this strain is decreased permeability. PMID- 2719458 TI - Effect of age and renal function on cefonicid pharmacokinetics. AB - Cefonicid (15 mg/kg) was administered intravenously at a constant rate of infusion over 15 min to 10 geriatric patients (mean age, 77 years) and to 4 young subjects (mean age, 35 years). Model-dependent and noncompartmental pharmacokinetic parameters were calculated and found to be congruous; noncompartmental data are reported. Significant differences in the values for area under the curve, mean residence time, total body clearance, and renal clearance were observed between the geriatric and young groups. Mean elimination half-life values were 9.59 and 4.88 h for the geriatric and young groups, respectively. Total body and renal clearances were inversely correlated to age and directly correlated to creatinine clearance. Free fraction was not correlated to albumin concentration but was correlated exponentially to total cefonicid concentration. Despite the prolonged half-life values observed in our geriatric patients, the difference in mean trough concentrations was slight. Daily administration of a 15-mg/kg dose should provide adequate concentrations in serum and should not produce appreciable accumulation in geriatric patients. PMID- 2719459 TI - Multicenter randomized study of single-dose ofloxacin versus amoxicillin probenecid for treatment of uncomplicated gonococcal infection. AB - The safety and efficacy of ofloxacin, 400 mg orally, were compared with those of amoxicillin, 3.0 g, plus probenecid, 1.0 g orally, as single-dose therapy in 201 heterosexual patients (101 men and 100 women) with uncomplicated gonococcal infection. Treatment groups were comparable in age, duration of symptoms, number of sexual partners within the previous month, and number of previous episodes of sexually transmitted diseases. The cure rate for men treated with ofloxacin was 98% (47 of 48), and that for women was 100% (52 of 52). Cure rates for both men and women treated with amoxicillin-probenecid were 96% (51 of 53 men; 46 of 48 women). All 13 patients with positive rectal cultures and 7 of 8 patients with positive pharyngeal cultures treated with ofloxacin were cured. Neither regimen reliably eradicated coexistent infection with Chlamydia trachomatis. The MIC of ofloxacin for all but two of 198 pretreatment isolates was 0.3 microgram/ml or less. The MIC of amoxicillin for 90% of isolates tested was 1.0 microgram/ml. Single oral doses of ofloxacin and of amoxicillin plus probenecid were equally effective for treatment of urethral and cervical gonorrhea. Ofloxacin appears promising as treatment for rectal and pharyngeal infection, but studies with larger numbers of patients with rectal or pharyngeal infection or both are required for confirmation. Relative contraindications in children and possibly pregnant women plus the potential for single-step, high-level resistance may limit the usefulness of quinolone therapy for gonorrhea. PMID- 2719460 TI - Pharmacokinetics and bioavailability of carbovir, a carbocyclic nucleoside active against human immunodeficiency virus, in rats. AB - Carbovir is a novel carbocyclic nucleoside which has been shown to have potent in vitro activity against human immunodeficiency virus, the causative agent of acquired immunodeficiency syndrome. Sprague-Dawley male rats were used to investigate the pharmacokinetics and bioavailability of carbovir. Six rats received carbovir (20 mg/kg of body weight) through the jugular vein, and blood samples were collected through the femoral vein 2, 5, 10, 15, 20, 30, 45, 60, 75, 90, 120, 150, 180, and 240 min after the dose. Four of these rats also received a 60-mg/kg oral dose of carbovir, and a similar blood sampling schedule was followed. Whole-blood samples were prepared by solid-phase extraction, and the carbovir concentration in the samples was analyzed by reversed-phase high pressure liquid chromatography. The profile of carbovir concentration in blood versus time after the intravenous dose was biexponential, with a very rapid distribution phase. Terminal elimination half-life was 21.4 +/- 4.37 min, and total body clearance was 55.2 +/- 13.8 ml/min per kg, which was within the range of the hepatic blood flow. The volume of distribution at steady state was 1,123 +/- 250 ml/kg. The blood/plasma ratio and the plasma protein binding of carbovir in rat blood were determined in vitro by ultrafiltration. The plasma protein binding of carbovir was only 20% and was not concentration dependent. However, the blood/plasma ratio decreased significantly as concentration increased, indicating saturable binding sites in erythrocytes. After the oral dose, the terminal half-life was 81.0 +/- 67.6 min, indicating that oral carbovir followed "flip-flop" kinetics, with absorption being much slower than elimination of the drug from the body. Oral bioavailability was 0.101 +/- 0.035. Double peaks were present in the concentration-time profile for each rat receiving the oral dose, indicating either a delay in stomach emptying of the drug or slow dissolution of precipitated carbovir in the stomach and upper small intestine. PMID- 2719461 TI - Amikacin, ciprofloxacin, and imipenem treatment for disseminated Mycobacterium avium complex infection of beige mice. AB - The Mycobacterium avium complex (MAC) is a common cause of disseminated infection in patients with acquired immunodeficiency syndrome and is increasingly seen as a cause of infection in other immunocompromised patients. Traditional antimycobacterial therapy often is ineffective, and there is a clear need for antibiotics with proven activity against the MAC. Three agents, amikacin, ciprofloxacin, and imipenem, were tested in vitro for activity against MAC strain 101. Amikacin was bacteriostatic, with an MIC of 4.8 micrograms/ml, which is significantly lower than the concentration in serum obtained with standard dosing. Imipenem and ciprofloxacin had little or no activity alone (MICs, greater than 16 and 4.7 micrograms/ml, respectively), but when they were combined with amikacin there was bactericidal activity. Each agent was tested individually and in combination by using the beige mouse model of disseminated MAC infection. There was no mortality in a group of animals infected with MAC 101 and treated with amikacin alone; also, there was a significant decrease in the infection of the blood, liver, and spleen. There was no apparent improvement in therapeutic effectiveness when amikacin was combined with the other agents. Neither ciprofloxacin nor imipenem was active as a single agent, which was consistent with the in vitro activities of these agents. Amikacin in combination with traditional antimycobacterial agents warrants further study as potential therapy for disseminated MAC infections. PMID- 2719462 TI - Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations. AB - Thirty patients were treated for colonization or for skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus. Three treatment regimens were evaluated, each progressively more aggressive. Our regimen was 750 mg of ciprofloxacin twice daily for 5 days, the second regimen was 750 mg of ciprofloxacin twice daily for 10 to 14 days, and the final regimen was 750 mg of ciprofloxacin twice daily plus 300 mg of rifampin twice daily for 21 days. It appears that ciprofloxacin alone produced an initial eradication rate in at least one site in 50% of the patients, regardless of whether the treatment was for 5 or up to 14 days. All of the patients with eradication became recolonized within 1 week posttherapy. When rifampin was combined with ciprofloxacin, the eradication rate was 100% when the isolates were susceptible to both agents, and these patients remained free of methicillin-resistant S. aureus at 1-week and 1-month follow-ups. PMID- 2719463 TI - Efficacy of phosphonylmethoxyalkyl derivatives of adenine in experimental herpes simplex virus and vaccinia virus infections in vivo. AB - The phosphonylmethoxyalkyl derivatives (S)-9-(3-hydroxy-2 phosphonylmethoxypropyl)adenine [(S)-HPMPA], 9-(2-phosphonylmethoxyethyl)adenine (PMEA), and 9-(2-phosphonylmethoxyethyl)-2,6-diaminopurine (PMEDAP) were evaluated for their in vivo efficacies in several animal model infections, i.e., mice infected intravenously with vaccinia virus and mice infected intracutaneously, intraperitoneally, or intracerebrally with herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2) or thymidine kinase-deficient (TK-) HSV-1. (S) HPMPA inhibited the development of tail lesions caused by vaccinia virus if it was administered intraperitoneally or subcutaneously at a dosage as low as 5 mg/kg per day. All three compounds completely suppressed the development of skin lesions and the mortality associated therewith in hairless or athymic nude mice inoculated intracutaneously with HSV-1 or TK- HSV-1, if they were administered topically at a concentration as low as 0.1%; when (S)-HPMPA was applied topically at a concentration of greater than or equal to 0.3%, it completely abrogated mortality resulting from intracutaneous HSV-2 infection. Most dramatic were the effects shown by the compounds in mice inoculated intracerebrally with HSV-1, HSV 2, or TK- HSV-1, in which all three compounds given intraperitoneally at a dose of 50 or 100 mg/kg per day effected a significant reduction in the mortality rate of HSV-1-infected mice. The mortality of mice infected intracerebrally with HSV-2 or TK- HSV-1 was significantly reduced even when (S)-HPMPA was given at doses as low as 10 mg/kg per day. These data point to the great potential of the phosphonylmethoxyalkylpurines for both topical and parenteral treatment of HSV-1, HSV-2, and TK- HSV-1 infections. PMID- 2719464 TI - Imipenem concentrations in colorectal surgery and impact on the colonic microflora. AB - Twenty patients undergoing colorectal surgery were given, as prophylaxis, imipenem-cilastatin intravenously. Ten of them received a dose of 0.5/0.5 g of imipenem-cilastatin at induction of anesthesia, followed by subsequent doses of 0.5/0.5 g every 6 h for 48 h. The other 10 patients were given 1.0/1.0 g imipenem cilastatin in the same way for 48 h. Samples from serum, intestinal mucosa, and feces were taken for analysis of imipenem concentrations during the day of surgery. The mean concentrations in serum at 1 h after the first imipenem dose were 15.9 +/- 1.7 micrograms/ml for the 0.5-g dose and 68.2 +/- 8.2 micrograms/ml for the 1.0-g dose. The mean half-lives were 1.5 and 1.4 h, respectively, and the mean areas under the serum concentration-time curve were 41.2 +/- 6.0 and 128.3 +/- 13.5 mg.h/liter, respectively. The imipenem concentrations in the intestinal mucosa varied between less than 0.1 and 3.6 mg/kg for the 0.5-g dose and 3.2 and 13.4 mg/kg for the 1.0-g dose. The concentrations in the fecal samples varied between less than 0.1 and 5.0 mg/kg for the 0.5-g dose and 0.7 and 11.3 mg/kg for the 1.0-g dose. Fecal samples were also collected during the investigation period for cultivation of aerobic and anaerobic bacteria. The aerobic bacteria- staphylococci, streptococci, enterococci, and enteroaerobic enterococci, and enterobacteria--were and anaerobic bacteria. The aerobic bacteria--staphylococci, streptococci, enterococci, and enterobacteria--were suppressed significantly during the imipenem prophylaxis period. Among the anaerobic bacteria, cocci, bifidobacteria, eubacteria, lactobacilli, clostridia, fusobacteria, and bacteroides decreased markedly during the same period. The microfloras were normalized after 2 weeks. There were no differences between the patients receiving 0.5-g doses of imipenem and those receiving 1.0-g of imipenem. No postoperative infections occurred. PMID- 2719465 TI - Comparative in vitro activities of new fluorinated quinolones and other antibiotics against coagulase-negative Staphylococcus blood isolates from neutropenic patients, and relationship between susceptibility and slime production. AB - We evaluated the in vitro antibiotic susceptibilities of 31 coagulase-negative Staphylococcus isolates causing septicemia in neutropenic patients undergoing norfloxacin prophylaxis. All the strains but one were resistant to 1 microgram of norfloxacin per ml. At the same concentration, ciprofloxacin, ofloxacin, imipenem, and pefloxacin were inhibitory for 19 (61%), 19 (61%), 18 (58%), and 14 (45%) of the evaluated strains, respectively. Imipenem had an MBC/MIC ratio of greater than or equal to 32 against 19 (61%) of the evaluated isolates, and resistant subpopulations were detected at 5 micrograms/ml in 16 of 17 oxacillin resistant strains and in 3 of 14 oxacillin-susceptible or -tolerant strains. Resistance to gentamicin was seen with increased frequency among slime-producing strains. PMID- 2719466 TI - Effect of norfloxacin on theophylline metabolism. AB - The purpose of this study was to investigate the effect of norfloxacin on theophylline elimination. Ten normal volunteers were studied. In a randomized crossover sequence, each subject received 6 mg of aminophylline per kg of body weight by a 30-min intravenous infusion on day 4 of taking norfloxacin (400 mg every 12 h) or while drug free. Mean theophylline clearance decreased and mean elimination half-life increased after norfloxacin administration (from 0.036 +/- 0.006 to 0.033 +/- 0.004 liter/h per kg and from 8.7 +/- 1.2 to 9.5 +/- 1.5 h, respectively; P less than 0.05, Wilcoxon signed-ranks test). We conclude that norfloxacin taken in recommended doses for 3 days has a small inhibitory effect on theophylline metabolism that would probably not cause clinically important elevations in theophylline concentrations in most patients. PMID- 2719467 TI - Macrolide accumulation by Bacteroides fragilis ATCC 25285. AB - The accumulation of macrolide antibiotics in Bacteroides fragilis ATCC 25285 was increased in the order erythromycin, josamycin, and rokitamycin, depending on hydrophobicity. The half-times of efflux were also prolonged in the same order. Furthermore, MICs of the antibiotics were correlated with the extent of hydrophobicity. These findings suggest that the macrolide antibiotics are accumulated in B. fragilis by means of their hydrophobic properties, and the efficient accumulation of the drugs may explain the susceptibility of this gram negative bacterium to macrolides. PMID- 2719468 TI - In vitro interaction between rifampin and clindamycin against pathogenic coagulase-negative staphylococci. AB - The MICs and MBCs for 90% of strains tested (MIC90 and MBC90, respectively) of rifampin for 75 clinical isolates of pathogenic coagulase-negative staphylococci (PCNS) were 0.03 and 0.25 microgram/ml, respectively, while the MIC90 and MBC90 of clindamycin were both greater than 25 micrograms/ml. Although no synergy between rifampicin and clindamycin was found among the 15 strains studied by the checkerboard method, 6 of 12 selected strains showed synergy by the kill-curve method. No antagonism was observed by either method. All 30 strains rapidly developed resistance to rifampin in vitro, and this could be prevented by the simultaneous presence of 1.0 microgram of clindamycin per ml in the 24 methicillin-susceptible PCNS strains. The synergy between rifampin and clindamycin observed in vitro for some strains of PCNS, together with the prevention of emergence of resistance to rifampin by clindamycin, suggests that this antibiotic combination may be useful for the treatment of infections caused by methicillin-susceptible PCNS. PMID- 2719469 TI - Treatment failure of norfloxacin against Campylobacter pylori and chronic gastritis in patients with nonulcerative dyspepsia. AB - Several reports have been published to show the in vitro susceptibility of Campylobacter pylori to different classes of antibiotics, including fluoroquinolones. The purpose of this study was to describe the clinical effect of norfloxacin on eradication of C. pylori in patients with gastritis. Endoscopy was performed in 38 patients with symptoms of nonulcerative dyspepsia. Of these, 20 patients had a C. pylori-positive culture. From this group, 17 patients were treated with norfloxacin for 1 month. After therapy, 15 patients still had positive cultures, and in 9 cases the strain was resistant to norfloxacin. These data, which confirm previous studies, support the concept that the in vitro activity of norfloxacin against C. pylori cannot be transposed to an in vivo effect. PMID- 2719470 TI - Drinking saccharin increases food intake and preference--I. Comparison with other drinks. AB - To examine the orosensory and postingestive effects of saccharin solution on food intake and food preference, freely feeding rats were given flavored food to eat and a solution to drink for 2 h on eight to ten occasions. Relative to trials with a different flavored food and only water to drink, food intake was increased by drinking 0.2% saccharin or 0.45% NaCl, unaffected by drinking 1% almond extract, and decreased by drinking 10% glucose. Food preference, which was assessed in a choice test with simultaneous access to the two flavored foods, was increased by drinking 0.2% saccharin or 10% glucose and unaffected by drinking 1% almond extract or 0.45% NaCl. These results are consistent with the possibility that a combination of the oral and hydrational properties of saccharin solution increase food intake. Saccharin's sweet taste may be responsible for its effects on food preference. PMID- 2719471 TI - Drinking saccharin increases food intake and preference--II. Hydrational factors. AB - Rats that drink saccharin solution increase their short-term food intake and develop a preference for flavored food eaten when saccharin is ingested. In this paper, we examined whether these changes in feeding behavior were due to overhydration resulting from drinking hyposmotic saccharin solution. Consistent with this possibility, the short-term food intake of rats was increased by drinking hyposmotic 0.2% saccharin dissolved in water, unaffected by drinking isosmotic 0.9% NaCl, and decreased by drinking 0.2% saccharin dissolved in 0.9% NaCl. In addition, rats showed a sustained increase in saccharin-induced food intake after antidiuretic hormone treatment, which was designed to exacerbate their positive water balance. Less consistent with a hydrational explanation of saccharin-induced feeding was the finding that rats drinking only 2ml 0.2% saccharin solution increased food intake. Also, gastric intubation of similar volumes of water produced a small, transient increase in feeding behavior, which was apparent after the first intubation only and could not be preserved by adding water-contingent flavors to the food. Taken together, these results suggest that the hydrational effects of drinking hyposmotic saccharin solution contribute to, but cannot account for, the increase in food intake. Hydration had no observable influence on the acquisition of flavored food preference. PMID- 2719472 TI - Drinking saccharin increases food intake and preference--III. Sensory and associative factors. AB - Rats that drink saccharin solution increase their short-term food intake and develop a preference for flavored food eaten when saccharin is ingested. Here we describe experiments that examined whether these changes in feeding behavior were due to learning and/or the reinforcing sensory properties of saccharin solution. It was found that learning was unnecessary for the feeding response, as rats that drank saccharin increased food intake whether or not their food contained saccharin-contingent flavor cues. However, learning helped support and maintain the response, as rats repeatedly given flavored food together with saccharin to drink later increased intake when given the flavored food without saccharin (i.e. in extinction). The rewarding or hedonic effects of the immediate orosensory properties of saccharin were not responsible for its effects on feeding, as drinking saccharin before but not after eating flavored food increased food intake and food preference. Furthermore, hungry rats developed an aversion to flavored food paired with saccharin ingestion when the quantity of food was limited. This implies that the flavored food preference produced by drinking saccharin involves an association between sensory aspects of the food and the metabolic consequences of food ingestion, which interact with a postingestive action of drinking saccharin that is related to the rat's metabolic state. PMID- 2719473 TI - The time course of sensory-specific satiety. AB - The time course of the changes in hedonic response following ingestion of three different foods was investigated. Normal weight, non-dieting female subjects rated the pleasantness of the appearance, smell, texture and taste of nine foods and then consumed as much as they wanted of cheese on cracker, tomato soup or orange jello. After this first course, subjects re-rated the pleasantness of the foods at 2, 20, 40 and 60 min. Following the 60 min rating, subjects were offered a second course of cheese on cracker or chocolate bar. For all sensory variables measured and for all foods consumed, the greatest decline in pleasantness occurred for the eaten food 2 min after consumption. For the food rate as most palatable (cheese on cracker) there was some recovery of pleasantness of the texture and taste over the hour. Intake in the second course was similar regardless of whether the food offered was different or the same as the food consumed in the first course. Since changes in the pleasantness of the foods occurred rapidly for all sensory variables studied and since the magnitude of these changes did not increase over time, it is concluded that the development of sensory-specific satiety is related primarily to the sensory stimulation accompanying ingestion as opposed to the postabsorptive effects of consuming these foods. PMID- 2719474 TI - Colonization of the porcine gastrointestinal tract by lactobacilli. AB - Eight strains of lactobacillus isolated from the porcine gastrointestinal tract were tested for their ability to adhere in vitro to cells collected from stratified squamous epithelium in the digestive tracts of newborn piglets. Piglets were inoculated with individual strains, and their digestive tracts were sampled at intervals to determine the colonizing ability of the lactobacilli. The results of the in vitro test did not predict whether a lactobacillus strain would associate with stratified squamous epithelium in the piglet digestive tract, but epithelial association in vivo appeared to be an important factor in the maintenance of lactobacillus populations in the tract. None of the lactobacillus strains used as inocula was numerically dominant in the tract 7 days after inoculation of the piglets with a single dose of the bacteria. PMID- 2719475 TI - Phosphotransbutyrylase from Clostridium acetobutylicum ATCC 824 and its role in acidogenesis. AB - Phosphotransbutyrylase (phosphate butyryltransferase [EC 2.3.1.19]) from Clostridium acetobutylicum ATCC 824 was purified approximately 200-fold to homogeneity with a yield of 13%. Steps used in the purification procedure were fractional precipitation with (NH4)2SO4, Phenyl Sepharose CL-4B chromatography, DEAE-Sephacel chromatography, high-pressure liquid chromatography with an anion exchange column, and high-pressure liquid chromatography with a hydrophobic interaction column. Gel filtration and denaturing gel electrophoresis data were consistent with a native enzyme having eight 31,000-molecular-weight subunits. Within the physiological range of pH 5.5 to 7, the enzyme was very sensitive to pH change in the butyryl phosphate-forming direction and showed virtually no activity below pH 6. This finding indicates that a change in internal pH may be one important factor in the regulation of the enzyme. The enzyme was less sensitive to pH change in the reverse direction. The enzyme could use a number of substrates in addition to butyryl coenzyme A (butyryl-CoA) but had the highest relative activity with butyryl-CoA, isovaleryl-CoA, and valeryl-CoA. The Km values at 30 degrees C and pH 8.0 for butyryl-CoA, phosphate, butyryl phosphate, and CoASH (reduced form of CoA) were 0.11, 14, 0.26, and 0.077 mM, respectively. Results of product inhibition studies were consistent with a random Bi Bi binding mechanism in which phosphate binds at more than one site. PMID- 2719476 TI - Coenzyme A transferase from Clostridium acetobutylicum ATCC 824 and its role in the uptake of acids. AB - Coenzyme A (CoA) transferase from Clostridium acetobutylicum ATCC 824 was purified 81-fold to homogeneity. This enzyme was stable in the presence of 0.5 M ammonium sulfate and 20% (vol/vol) glycerol, whereas activity was rapidly lost in the absence of these stabilizers. The kinetic binding mechanism was Ping Pong Bi Bi, and the Km values at pH 7.5 and 30 degrees C for acetate, propionate, and butyrate were, respectively, 1,200, 1,000, and 660 mM, while the Km value for acetoacetyl-CoA ranged from about 7 to 56 microM, depending on the acid substrate. The Km values for butyrate and acetate were high relative to the intracellular concentrations of these species; consequently, in vivo enzyme activity is expected to be sensitive to changes in those concentrations. In addition to the carboxylic acids listed above, this CoA transferase was able to convert valerate, isobutyrate, and crotonate; however, the conversion of formate, n-caproate, and isovalerate was not detected. The acetate and butyrate conversion reactions in vitro were inhibited by physiological levels of acetone and butanol, and this may be another factor in the in vivo regulation of enzyme activity. The optimum pH of acetate conversion was broad, with at least 80% of maximal activity from pH 5.9 to greater than 7.8. The purified enzyme was a heterotetramer with subunit molecular weights of about 23,000 and 25,000. PMID- 2719477 TI - Anaerobic biodegradation of 2,4-dichlorophenol in freshwater lake sediments at different temperatures. AB - Anaerobic degradation of 2,4-dichlorophenol (2,4-DCP) between 5 and 72 degrees C was investigated. Anaerobic sediment slurries prepared from local freshwater pond sediments were partitioned into anaerobic tubes or serum vials, which then were incubated separately at the various temperatures. Reductive 2,4-DCP dechlorination occurred only in the temperature range between 5 and 50 degrees C, although methane was formed up to 60 degrees C. In sediment samples from two sites and at all tested temperatures from 5 to 50 degrees C, 2,4-DCP was transformed to 4-chlorophenol (4-CP). The 4-CP intermediate was subsequently degraded after an extended lag period in the temperature range from 15 to 40 degrees C. Adaptation periods for 2,4-DCP transformation decreased between 5 and 25 degrees C, were essentially constant between 25 and 35 degrees C, and increased in the tubes incubated at temperatures between 35 and 40 degrees C. The degradation rates increased exponentially between 15 and 30 degrees C, had a second peak at 35 degrees C, and decreased to about 5% of the peak activity by 40 degrees C. In tubes from one sediment sample, incubated at temperatures above 40 degrees C, an increase in the degradation rate was observed following the minimum at 40 degrees C. This suggests that at least two different organisms were involved in the transformation of 2,4-DCP to 4-CP. Storage of the original sediment slurries for 2 months at 12 degrees C resulted in increased adaptation times, but did not affect the degradation rates. PMID- 2719478 TI - Degradation of p-chlorotoluene by a mutant of Pseudomonas sp. strain JS6. AB - Pseudomonas sp. strain JS6 grows on chlorobenzene, p-dichlorobenzene, or toluene as a sole source of carbon and energy. It does not grow on p-chlorotoluene (p CT). Growth on glucose in the presence of p-CT resulted in the accumulation of 4 chloro-2,3-dihydroxy-1-methylbenzene (3-chloro-6-methylcatechol), 4-chloro-2,3 dihydroxy-1-methylcyclohexa-4,6-diene (p-CT dihydrodiol), and 2-methyl-4 carboxymethylenebut-2-en-4-olide (2-methyl dienelactone). Strain JS21, a spontaneous mutant capable of growth on p-CT, was isolated from cultures of strain JS6 after extended exposure to p-CT. In addition to growing on p-CT, JS21 grew on all of the substrates that supported growth of the parent strain, including p-dichlorobenzene, chlorobenzene, benzene, toluene, benzoate, p hydroxybenzoate, phenol, and ethylbenzene. The pathway for degradation of p-CT by JS21 was investigated by respirometry, isolation of intermediates, and assay of enzymes in cell extracts. p-CT was converted to 3-chloro-6-methylcatechol by dioxygenase and dihydrodiol dehydrogenase enzymes. 3-Chloro-6-methylcatechol underwent ortho ring cleavage catalyzed by a catechol 1,2-dioxygenase to form 2 chloro-5-methyl-cis,cis-muconate, which was converted to 2-methyl dienelactone. A dienelactone hydrolase converted 2-methyl dienelactone to 2-methylmaleylacetic acid. Preliminary results indicate that a change in wild-type induction patterns allows JS21 to grow on p-CT. PMID- 2719479 TI - Absence of association between total heterotrophic and total coliform bacteria from a public water supply. AB - Heterotrophic plate counts (HPC) and total coliforms (TC) are two major microbial indicators that are used to monitor the potability of water. Although the presence of heterotrophs has been hypothesized to predict the presence of TC, there have been few documented reports. Intensive sampling of raw, treated effluent and distribution water from a public water supply serving 400,000 people provided an opportunity to study the relationship between these two indicator groups of bacteria. A total of 26,158 samples were analyzed, including 12,970 from 1986 and 13,188 from 1985. There were 13,429 samples from the distribution system, 5,524 from treatment effluents, and 7,205 from raw water. The associations between HPC and TC were made on both a hits-and-misses and numerical comparison (CFU per milliliter) basis. The periodicity of the two indicators was also analyzed to determine whether the presence of one group could predict the presence of the other. Atypical bacteria were also related to the presence of these two indicator bacteria. Venn diagrams and nonparametric statistics revealed the following correlation coefficients for HPC and TC for 1985 and 1986 combined: raw water r = 0.45, treated effluent r = 0.06, and distribution system r = 0.10. Atypical bacteria showed a similar relationship with HPC. There was no predictive periodicity for HPC and TC within +/- 10 days of isolation of each other. Therefore, in a 2-year survey of a public water supply, the presence of HPC had a low correlation coefficient with TC, as determined by hits-and-misses and numerical comparisons. The enumeration of one group was found to be independent of the other. PMID- 2719480 TI - Biotin-labeled plasmid DNA probes for detection of epithelium-associated strains of lactobacilli. AB - Biotin-labeled DNA probes prepared from whole plasmids (5.5 and 4.8 kilobases) of two lactobacillus strains (Lactobacillus delbrueckii 21 and Lactobacillus reuteri 100-23) were used to detect the homologous bacteria in microtome-cryostat prepared sections of murine forestomach. The forestomach sections were incubated on nylon filter membranes placed on agar plates and, after lysis of the lactobacillus cells and denaturation of their DNA, were used in hybridization experiments with the strain-specific DNA probes. Hybridization of the probes to membranes containing sections from lactobacillus-free mice did not occur. The probes detected the presence of homologous strains of lactobacilli in sections cut from the forestomach of mice harboring one or both of the strains. PMID- 2719481 TI - Isolation of phenol-degrading Bacillus stearothermophilus and partial characterization of the phenol hydroxylase. AB - Bacillus stearothermophilus BR219, isolated from river sediment, degraded phenol at levels to 15 mM at a rate of 0.85 mumol/h (4 x 10(6) cells). The solubilized phenol hydroxylase was NADH dependent, exhibited a 55 degrees C temperature optimum for activity, and was not inhibited by 0.5 mM phenol. PMID- 2719482 TI - Effect of temperature on aflatoxin production in Mucuna pruriens seeds. AB - This paper describes the effect of temperature on the level of aflatoxin production in Mucuna pruriens seeds. The highest level of aflatoxin B1 (1.75 micrograms/g) was detected in the samples incubated at 25 degrees C for three weeks. At 20, 30, and 35 degrees C, aflatoxin levels were 0.30 to 0.56, 0.37 to 1.20, and 0.26 to 0.65 micrograms/g, respectively. The lowest concentration of aflatoxin B1 (0.10 to 0.29 microgram/g) was produced at 15 degrees C. PMID- 2719483 TI - Qualitative research? Ask an expert. PMID- 2719484 TI - Reorganizing nursing for the future: nursing commission recommendations and research implications. AB - The department of Health and Human Services Commission on Nursing, along with various nurse advisors, has developed a series of findings and recommendations relevant to the nursing shortage. This article discusses the findings and recommendations and their relevance to practice in the current climate of the nursing shortage and changing work environment, and presents implications for future organizational and clinical research. PMID- 2719485 TI - A nursing intervention to increase compliance in otitis media patients. AB - This study was conducted to evaluate two forms of a clinical nursing intervention based on the Health Belief Model (HBM) and designed to increase compliance among 59 otitis media (OM) patients (14 adults and 45 children) visiting an emergency department (ED). Subjects (adult patients or caretakers of child patients) who received an HBM clinical intervention administered by a nurse in the ED, and HBM phone intervention 2 to 4 days after the ED visit, or both interventions were much more likely than control subjects to comply with a follow-up referral appointment. Both the clinical and phone interventions were designed to increase perceived susceptibility to complications of the OM, seriousness of the complications, and benefits and costs of action. Other factors predicting compliance included subjects' unmet needs for child care, perceived seriousness of the OM, and degree of knowledge of the etiology, pathophysiology, and management of OM. PMID- 2719486 TI - ICU family support group sessions: family members' perceived benefits. AB - The purpose of this research was to identify the relationship between attending an ICU family support group and the family's appraisal of stress, social support, and hope. In addition, the family members' perceived benefits of attending an ICU family support family support group session does not significantly change stress levels, feelings of hope, and social support. Analysis of data reconfirms that family members of critically ill patients have a tremendous need for information. Although findings revealed that the majority of the family members who attended the support session would recommend attending again, it is unclear whether the support session method is the most beneficial and cost-effective means to support families of critically ill patients. PMID- 2719487 TI - NANDA taxonomy I: proposed ICD-CD 10 version. PMID- 2719488 TI - Evaluation of a scale to assess nurses' attitudes toward written care plans. PMID- 2719489 TI - Measurement of chemotherapy-induced nausea and vomiting. PMID- 2719490 TI - Treatment preferences of infertile couples. PMID- 2719491 TI - Designing and testing self-help interventions. PMID- 2719492 TI - Productivity measurement in nursing. PMID- 2719493 TI - Tenure for a new age. Ideas for the turn of the century. PMID- 2719494 TI - Fiscal scarcity and the inevitability of bedside budget balancing. AB - Until recently, generous third-party reimbursements enabled physicians to pursue each patient's interests with little regard to costs. Conscious rationing was required only episodically as some particular commodity, eg, transplant organs, was too scarce to meet demand, or as some patients lacked basic access to the health care system. Cost containment and the economic reorganization of medicine introduce a new sort of scarcity, requiring a different sort of rationing. "Fiscal scarcity," the general contraction of health care dollars, means that because every medical decision has its cost, every decision is now subject to scrutiny for its economic as well as its medical wisdom. Therefore, every detail of medicine is an allocation problem. Many observers argue that physicians can nevertheless avoid directly trading patients' interests against economic considerations: through "efficiency protocols" that eliminate marginal benefits, through turning economic rationing decisions over to outside parties, through avoiding cost constraints until society has established a just health care allocation system. This article shows that none of these proposals permits the physician to escape cost-cutting at the bedside. PMID- 2719495 TI - Does determining serum alcohol concentrations in emergency department patients influence physicians' civil suit liability? AB - Emergency physicians may incur liability when impaired patients who have been treated and released are subsequently involved in traffic crashes. We surveyed attorneys to assess their perception of how serum alcohol determinations might influence their liability in civil suits. Overall, 63.9% of the attorneys surveyed would advise patients that they received potentially negligent care if they were impaired following treatment in the emergency department and were involved in a traffic crashes. Perceived liability was altered by physician behavior as follows: 43.1% of attorneys would advise clients that they received potentially negligent care when impairment was documented by a test for serum alcohol concentration and no advice was given regarding drunk driving, and 17.3% of attorneys would give similar advice when impairment was not documented by a test for serum alcohol concentration and no advice was given regarding drunk driving. In contrast, only 3.5% of attorneys would suggest possible negligence when impairment was documented by a test for serum alcohol concentration and with advice subsequently given not to drive. The coupling of diagnosing impairment by the serum alcohol concentration and driving advice is medically sensible and might result in minimal civil liability. PMID- 2719496 TI - Risk and cost of gastrointestinal side effects associated with nonsteroidal anti inflammatory drugs. AB - A retrospective cohort study determined the risk and cost of gastrointestinal side effects associated with the use of nonsteroidal anti-inflammatory drugs for an at-risk period from January 1, 1985, through March 31, 1985. Overall relative risk, adjusted for sex and race, was 2.52 (95% confidence interval, 2.25 to 2.82) and varied from 1.64 (95% confidence interval, 0.92 to 2.91) for duodenal ulcer to 3.27 (95% confidence interval, 1.40 to 7.66) for gastrointestinal bleeding. After deleting cases with a history of steroid or anticoagulant use or an alcohol related diagnosis, adjusted relative risk was 2.58 (95% confidence interval, 2.29 to 2.90) and varied from 1.45 (95% confidence interval, 0.73 to 2.89) for all other cases of peptic ulcer to 2.37 (95% confidence interval, 1.26 to 4.46) for disorders of stomach function. There was a bimodal distribution of expenditures of Medicaid-paid gastrointestinal side effects. Most patients had low hospitalization costs, but an important minority had high hospitalization costs. Median ambulatory treatment costs during the 3-month study period for persons with gastrointestinal side effects was $27 and varied from $14 for those diagnosed as having nausea, vomiting, or heartburn to $393 for those diagnosed as having gastrointestinal bleeding. Median inpatient costs were $2006 and ranged from $1487 for persons with nausea, vomiting, or heartburn to $2486 for those with duodenal ulcer. For patients who had undergone an inpatient surgical procedure other than endoscopy alone, median hospital costs were $7209. An approximately twofold increase in payment for the same services would be expected if private third-party payers were responsible for the bill. PMID- 2719497 TI - Hyperparathyroidism, hypothyroidism, and impaired renal function after 10 to 20 years of lithium treatment. AB - Of 19 patients who had been receiving a therapeutic dosage of lithium carbonate for 10 to 20 years, 8 (42%) were found to have some laboratory evidence of hyperparathyroidism. Of the 3 who had parathyroid surgery, 2 had hyperplasia and 1 had a solitary adenoma, an unusually high incidence of hyperparathyroidism. Unusual features of lithium-induced hyperparathyroidism in this series include (1) low urinary calcium excretion and the absence of nephrolithiasis, (2) normal urinary cyclic adenosine monophosphate excretion, and (3) normal plasma inorganic phosphate. Eight patients (42%) required treatment for hypothyroidism. Three patients (16%) had impaired kidney function. While these observations do not contraindicate the continued use of lithium carbonate in manic depression, they strongly emphasize the need for close laboratory surveillance. PMID- 2719498 TI - Influence of magnesium substitution therapy on blood lipid composition in patients with ischemic heart disease. A double-blind, placebo controlled study. AB - In a double-blind, placebo-controlled study, 47 patients with ischemic heart disease and acute myocardial infarction were allocated to 3 months' treatment with peroral magnesium (15 mmol/d) or placebo. Before, during, and after treatment, blood samples were taken to determine serum concentrations of cholesterol; triglyceride; high-density, low-density, and very-low-density lipoprotein; apolipoprotein A1 and B; and magnesium. We found a 13% increase in molar ratio of apolipoprotein A1:apolipoprotein B after magnesium treatment, as compared with a 2% increase in the placebo group (for mean differences between changes of the magnesium and the placebo groups). This increase was caused by a decrease in apolipoprotein B concentrations, which were reduced by 15% from 1.44 to 1.23 mmol/L in the magnesium group as compared with a slight increase in the placebo group. Triglyceride, and thereby very-low-density lipoprotein concentrations decreased by 27% after magnesium treatment (from 2.41 to 1.76 mmol/L, and from 1.1 to 0.79 mmol/L, respectively) as compared with much smaller decrements in the placebo group. Likewise, we found tendencies toward an increase in high-density lipoprotein cholesterol and in high-density lipoprotein cholesterol ratio/(low-density lipoprotein cholesterol:very-low-density lipoprotein cholesterol) after magnesium treatment. The observed findings support the hypothesis that magnesium deficiency might be involved in the pathogenesis of ischemic heart disease by altering the blood lipid composition in a way that disposes to atherosclerosis. PMID- 2719499 TI - The effect of verapamil in patients with asymptomatic stress-induced ischemia. AB - In 25 patients with asymptomatic exercise-induced positive stress tests heart rate, blood pressure, double product, exercise duration, and ST-segment changes were studied prior to and 4 weeks after administration of 120 mg of verapamil therapy three times a day. Significant improvement was observed at rest and at peak exercise in heart rate, pressure values, double product, and maximal ST depression with a prolongation of exercise duration. Measurements at the same work load in the post-verapamil test as at the pretreatment peak exercise showed a slower heart rate, lower blood pressure, less double product, and less ST depression as a more pronounced expression of drug efficacy. There was no deterioration in any parameter. In conclusion, improved myocardial performance can be demonstrated in asymptomatic ischemic patients when treated with verapamil, and this effect is particularly evident when data are compared with equal exercise duration in the posttreatment test as with peak exercise prior to therapy. PMID- 2719500 TI - Contributing diagnoses in osteoporosis. The value of a complete medical evaluation. AB - Osteoporosis often occurs as a consequence of, or is accelerated by, many medical diseases, drug exposures, or other conditions. We called these conditions contributing diagnoses. Although technological advances permit the accurate measurement of bone density, identifying osteoporosis without searching for contributing diagnoses may result in remediable diseases being missed or in the initiation of inadvisable therapy. The value of comprehensive medical evaluation in conjunction with appropriate diagnostic studies was demonstrated in an osteoporosis referral center. We studied 300 consecutive persons who presented to an osteoporosis clinic. Using strict criteria, 180 patients (60%) had osteoporosis. Of these 180 patients, 83 (46%) had one or more contributing diagnosis, ie, a condition thought to accelerate bone loss. The largest single group was composed of persons with past or present exposure to glucocorticoids; the second largest group consisted of women who had undergone premature menopause. In all, 27 different contributing diagnoses were identified. Additionally, in 19 (11%) of the 180 patients with osteoporosis, a contributing diagnosis new to those patients was made. The evaluation of osteoporosis does not only entail measurement of bone density but must also take into consideration a patient's entire medical milieu. PMID- 2719501 TI - Brain metastases from undiagnosed systemic neoplasms. AB - Fifty-six patients presenting with symptomatic brain metastasis but undiagnosed primary neoplasm were retrospectively studied. Metastases were almost equally solitary (57%) as multiple (43%), and 30% were cerebellar. Cerebral metastases were most often parietal (67%). Underlying cancers were diagnosed in 84% of patients, usually before death, with the remainder having equivocal or unknown primary cancers. Lung cancer was most common (68%), especially adenocarcinoma or small ("oat")-cell types, followed by gastrointestinal primary cancers (9%), cancers of the bladder and thyroid (2% each), melanoma (2%), and lymphoma (2%). Breast cancer was remarkably absent, perhaps due to its greater systemic involvement prior to brain metastasis, or its earlier detection on physical examination. Overall group survival rates were 55% (6 months) and 13% (12 months), and cerebellar and noncerebellar metastases had the same survival rate at 12 months. The diagnostic evaluation of these patients, often extensive and costly, should be individually tailored, as 23% had complaints or findings indicative of their underlying primary cancer. Overall, chest roentgenograms and computed tomograms of the chest were the tests of greatest yield, followed by computed tomograms of the abdomen and pelvis. A rationale for evaluation is presented. PMID- 2719502 TI - Prediction of outcome from critical illness. A comparison of clinical judgment with a prediction rule. AB - Quantitative methods to enhance clinical judgment would be of tremendous benefit to physicians caring for the critically ill. The ability of physicians to predict outcome is a logical standard on which to base the prospective evaluation of a prediction rule intended for this clinical use. The APACHE (acute physiology and chronic health evaluation)-II score was compared with critical care physicians' prediction of outcome for a group of patients in a medical intensive care unit. Physicians were significantly better in predicting outcome in the critically ill. However, the APACHE-II score was still a good predictor of outcome in the intensive care unit and, according to analysis using Bayes' theorem, might still be a useful test to support physicians' judgment, especially in patients with a predicted mortality risk of less than 30%. PMID- 2719503 TI - The efficacy of atenolol in the outpatient management of the alcohol withdrawal syndrome. Results of a randomized clinical trial. AB - We conducted a randomized, double-blind, clinical trial of atenolol compared with placebo in the outpatient management of patients with the alcohol withdrawal syndrome. In addition to receiving customary therapy, 88 patients were randomly assigned to receive atenolol and 92 to receive placebo. Outcome during the next 14 days was assessed using two main measures: the patient's clinical course as assessed by an alcohol withdrawal severity index; and the occurrence of treatment failure (composite measure including return to drinking, dropouts, and withdrawal lasting longer than 5 days). In addition, levels of craving for alcohol were assessed as an associated response variable. Overall, treatment failure occurred for 37% of the patients receiving atenolol and 52% of those receiving placebo. Among patients who had withdrawal symptoms at baseline, vital signs became normal more rapidly in the patients receiving atenolol, and their abnormal behavioral characteristics also resolved more rapidly. Levels of craving for alcohol were strongly associated with treatment failure; the group of patients who received atenolol included significantly fewer who reported high levels of craving 24 hours after treatment began (7% of patients receiving atenolol and 20% of those receiving placebo). We conclude that the outpatient management and treatment outcomes of the alcohol withdrawal syndrome are improved in patients who receive atenolol, and that the beneficial effects are associated with reduced levels of craving for alcohol. If these results are confirmed by other investigators, atenolol may prove to play an important role in the outpatient management of the alcohol withdrawal syndrome. PMID- 2719504 TI - Ethics consultants and ethics committees. AB - To address moral questions in patient care, hospitals and health care systems have enlisted the help of hospital ethicists, ethics committees, and ethics consultation services. Most physicians have not been trained in the concepts, skills, or language of clinical ethics, and few ethicists have been trained in clinical medicine, so neither group can fully identify, analyze, and resolve clinical ethical problems. Some ethics committees have undertaken clinical consultations themselves, but liability concerns and variable standards for membership hinder their efforts. An ethics consultation service comprising both physician-ethicists and nonphysician-ethicists brings complementary viewpoints to the management of particular cases. If they are to be effective consultants, however, nonphysician-ethicists need to be "clinicians": professionals who understand an individual patient's medical condition and personal situation well enough to help in managing the case. Ethics consultants and ethics committees may work together, but they have separate identities and distinct objectives: ethics consultants are responsible for patient care, while ethics committees are administrative bodies whose primary task is to advise in creating institutional policy. PMID- 2719505 TI - Indomethacin in the treatment of lithium-induced nephrogenic diabetes insipidus. AB - Nephrogenic diabetes insipidus (NDI) is a frequent complication in patients receiving long-term lithium therapy. Both thiazide diuretics and amiloride may reduce the polyuria, but the use of each is associated with problems. We report the results of a clinical trial using the nonsteroidal anti-inflammatory drug indomethacin to treat a patient with well-documented lithium-induced NDI that persisted following cessation of lithium treatment. The administration of a single dose of indomethacin resulted in a dramatic decrease in urine volume and increase in urine osmolality that persisted for several hours, and was independent of renal hemodynamic changes. Subsequently, the patient experienced a sustained, favorable effect on her polyuria during long-term (3 months) indomethacin therapy without a deleterious effect on her renal function. Indomethacin may be a useful therapeutic tool for the amelioration of lithium induced NDI. PMID- 2719506 TI - Prolonged dietary protein restriction in diabetic nephropathy. AB - Eleven patients with insulin-dependent diabetes, advancing renal insufficiency, and proteinuria were placed on a diet containing 0.6 g/kg per day of high biologic-value protein. Selected clinical variables were observed over a 2-year interval. The rate of decline in renal function was significantly decreased during the intervals of protein restriction. The rate during the second 12 months of the study, however, was increased, when compared with the first 12-month interval. Urinary protein excretion decreased significantly, from 2.27 +/- 0.49 g/d to 0.57 +/- 0.40 g/d after the first 12 months of the study, but increased to 1.43 +/- 0.63 g/d after the second 12 months of the study. The dietary protein intake estimated from urea nitrogen excretion in urine samples correlated significantly with urinary protein excretion. These findings suggest that dietary protein restriction has a sustained beneficial effect on the course of diabetic nephropathy, if compliance to the diet can be maintained. PMID- 2719507 TI - Home intravenous antibiotic therapy using a programmable infusion pump. AB - Several publications have demonstrated the efficacy, safety, and cost effectiveness of home intravenous antibiotic therapy. The development of a computerized ambulatory infusion drug delivery pump has enabled us to treat patients previously considered ineligible for home intravenous antibiotic therapy. Seventeen patients were treated at home with the infusion pump for a range of 6 to 49 days. Selection of the infusion pump was made for a variety of reasons: the need for frequent intravenous drug administration (9 patients); impaired manual dexterity (5 patients) or cognitive function (3 patients); unwillingness to learn the necessary techniques (3 patients); and lack of support persons at home (3 patients). Of the 17 patients, 15 could not have been discharged from hospital to home without the use of the pump or a similar device. PMID- 2719508 TI - Is coffee consumption a contributor to cardiovascular disease? Insights from the Framingham Study. AB - Reported coffee consumption during 1954 to 1958 and 1971 to 1973 was used to test for association with cardiovascular disease (CVD) incidence and lipid values in the Framingham cohort. Multivariate analysis was employed, regressing CVD on age, systolic pressure, cigarette use, body mass index, total cholesterol, and coffee intake. In pooled analyses (2648 men with 549 CVD cases and 3566 women with 462 CVD cases) coffee intake was not associated with CVD incidence in either smokers or nonsmokers, irrespective of sex. Similarly, multivariate analyses for individuals with existing cardiovascular disease showed no association between coffee intake and subsequent cardiovascular disease. In men significant negative associations between coffee and total cholesterol, and very-low-density lipoprotein cholesterol were seen, whereas in women positive associations with low-density lipoprotein cholesterol were observed. Although inconsistent effects on the lipid profile were seen, no increase in primary or secondary CVD was seen with coffee drinking. PMID- 2719509 TI - Uveitis. An internist's view. AB - The utility of an evaluation for systemic disease in a patient with uveitis is controversial. To address this issue, we reviewed the records of 236 consecutive patients with uveitis who were referred primarily by ophthalmologists to an internist in a university-based clinic. Patients were referred for a variety of purposes, including differential diagnosis, treatment recommendations, and desire for a second opinion. The study population included 121 male patients and 115 female patients. In 40% of all patients, a systemic disease thought to be causally related to the eye inflammation was diagnosed or its diagnosis was confirmed. While 53% of patients with anterior uveitis had a causally related systemic illness, only 17% of patients with posterior uveitis and 22% of patients with chorioretinitis had an associated systemic disease. The most frequently diagnosed systemic diseases were Reiter's syndrome, ankylosing spondylitis, Sjogren's syndrome, and sarcoidosis. These diagnoses were usually not known prior to referral. An internist can make a significant contribution to the evaluation of many patients with uveitis. Furthermore, most diagnoses can be established by a thorough history and physical examination, without extensive laboratory testing. PMID- 2719510 TI - Clinical experience and predicting survival in coronary disease. AB - To study the accuracy with which long-term prognosis can be predicted in patients with coronary artery disease, prognostic predictions obtained from a large, diverse sample of practicing cardiologists were compared with predictions from a multivariable statistical model. Test samples of 10 patients each were selected from a large series of medically treated patients with significant coronary disease. Using detailed clinical summaries, 49 cardiologists each predicted the probability of 3-year survival and infarction-free survival for 10 patients. Cox regression models, developed using patients who were not in the test samples, were also used to predict corresponding outcome probabilities for each test patient. Overall, the model estimates of prognosis were significantly better than the doctors' predictions. The rank correlation of model predictions with 3-year survival was 0.60, compared with 0.52 for the physicians. Model predictions added significant prognostic information to the doctors' predictions, whereas the converse was not true. Where predictions were made by multiple doctors, the inter physician variability was substantial. Neither practice characteristics nor extent of clinical experience significantly affected the physicians' predictive accuracy. In coronary artery disease, statistical models developed from carefully collected data can provide prognostic predictions that are more accurate than predictions of experienced clinicians made from detailed case summaries. PMID- 2719511 TI - Rhabdomyosarcoma and hypercalcemia. AB - Hypercalcemia has not been reported as a complication of rhabdomyosarcoma in adults. We present the case of a 56-year-old man with pain in his right leg and hypercalcemia secondary to a large pelvic tumor. He had a rapidly progressive downhill course resulting in death due to tonsillar herniation. Although the results of special stains were negative, light microscopy showed poorly differentiated tumor, with features consistent with rhabdomyosarcoma. In children, hypercalcemia secondary to rhabdomyosarcoma is not uncommon and has been associated with bony metastasis, increased parathyroid hormone, and increased levels of prostaglandin E2. PMID- 2719512 TI - Flaccid quadriparesis associated with Yersinia enterocolitis-induced hypokalemia. AB - A 23-year-old woman presented with diarrhea, flaccid quadriparesis, a low serum potassium level, and an elevated creatine kinase level. A stool culture yielded Yersinia enterocolitica, and a muscle biopsy was compatible with a hypokalemic myopathy. The patient's diarrhea responded to sulfamethoxazole and trimethoprim therapy. We suggest that Y enterocolitica be added to the group of intestinal pathogens capable of producing hypokalemia and rhabdomyolysis. PMID- 2719513 TI - Phenytoin hepatotoxicity masked by corticosteroids. AB - The association of phenytoin and liver toxicity is well documented. This article describes a patient who underwent a transsphenoidal resection of a pituitary tumor who developed phenytoin-induced hepatotoxicity that was masked by the simultaneous administration of corticosteroids for treatment of cerebral edema. In a patient receiving both medications, the systemic manifestations of the hypersensitivity to phenytoin may go unrecognized, leading to delayed identification of a potentially lethal complication of this commonly prescribed anticonvulsant. PMID- 2719514 TI - Urokinase. A cost-effective alternative treatment of superior vena cava thrombosis and obstruction. AB - Venous thrombosis and subsequent obstruction of the superior vena cava may be life threatening and therefore warrant immediate attention. This case report represents the successful treatment of superior vena cava thrombosis with urokinase in a patient with an indwelling Hickman catheter. Patency of the occluded vessel and resolution of clinical symptoms were achieved within 24 hours of initiation of a 12-hour urokinase infusion. PMID- 2719515 TI - Acquired angioedema and anti-C1-inhibitor autoantibody. PMID- 2719516 TI - Technology and the goals of medicine. PMID- 2719517 TI - Diltiazem for the treatment of thyrotoxicosis. PMID- 2719518 TI - Caffeine, oral contraceptives, and over-the-counter drugs. PMID- 2719519 TI - Diagnosis of iron deficiency. PMID- 2719520 TI - Beta-blockers and cognitive performance in older patients. PMID- 2719521 TI - Coexistence of pyoderma gangrenosum and arteritis in ulcerative colitis. PMID- 2719522 TI - Motor cortex projections to the thalamus. An autoradiographic study in the cat. AB - Adult cats received tritiated proline-leucine injections into the pericruciate cortex (areas 4 gamma and 3a) unilaterally and the projections to the thalamus were analyzed. Ipsilateral projections were found in the following nuclei, from rostral to caudal: ventral anterior, reticular, ventral lateral, central medial, paracentral, central lateral, ventral medial, mediodorsal, ventral posterolateral, ventral posteroinferior, centre median, parafascicular and posterior complex. In the contralateral hemithalamus sparse projections were found within the paracentral, central lateral and ventral medial nuclei. PMID- 2719523 TI - Inhibition of vestibulospinal reflexes during the episodes of postural atonia induced by unilateral lesion of the locus coeruleus in the decerebrate cat. AB - 1. The spontaneous EMG activity of the forelimb extensor triceps brachii of both sides as well as their responses to roll tilt of the animal at 0.15 Hz, +/- 10 degrees leading to sinusoidal stimulation of labyrinth receptors were tested in precollicular decerebrate cats, before and after unilateral electrolytic lesion of the locus coeruleus (LC). 2. Lesion of the LC of one side decreased the tonic contraction of the ipsilateral limb extensors, but greatly increased the amplitude of modulation and the response gain of the corresponding triceps brachii to animal tilt; however, no change in the phase angle of the responses was observed. A slight increase in the response gain affected also the contralateral triceps brachii. 3. The postural asymmetry described above was followed from time to time by short-lasting episodes of postural atonia, which affected not only the ipsilateral but also the contralateral limb extensors. These episodes were also associated with a suppression of the EMG responses of the triceps brachii of both sides to sinusoidal stimulation of labyrinth receptors. 4. The episodes of postural atonia which appeared after unilateral lesion of the LC were not associated with rapid eye movements; however, the slow horizontal eye movements, which may occur in normal decerebrate animals, increased in amplitude throughout these episodes. Both the postural atonia as well as the related suppression of the vestibulospinal reflexes, which lasted for 5-10 min, disappeared either spontaneously or following acoustic or somatosensory stimulations. 5. Histological controls indicated that unilateral lesions limited to the caudal part of the LC produced only a permanent decrease in postural activity of the ipsilateral limbs, associated with an increase in gain of the vestibulospinal reflex. However, in order to elicit episodes of bilateral postural atonia associated with the suppression of the vestibulospinal reflexes it was necessary to extend the lesion to more rostral aspects of the LC. 6. Since the effects described above were similar to those elicited in decerebrate cats by local injection of cholinergic agonists into the dorsal part of the pontine reticular formation, we postulated that the postural atonia as well as the related suppression of the vestibulospinal reflexes was due to transient release from LC inhibition of these dorsal pontine reticular structures, which might in turn excite the medullary reticulospinal neurons, thus leading to inhibition of the extensor motoneurons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2719524 TI - On the nature of the afferent fibers of oculomotor nerve. AB - The oculogyric nerves contain afferent fibers originating from the ophthalmic territory, the somata of which are located in the ipsilateral semilunar ganglion. These primary sensory neurons project to the Subnucleus Gelatinosus of the Nucleus Caudalis Trigemini, where they make presynaptic contact with the central endings of the primary trigeminal afferents running in the fifth cranial nerve. After complete section of the trigeminal root, the antidromic volleys elicited in the trunk of the third cranial nerve by stimulating SG of NCT consisted of two waves belonging to the A delta and C groups. The area of both components of the antidromic volleys decreased both after bradykinin and hystamine injection into the corresponding cutaneous region and after thermic stimulation of the ipsilateral trigeminal ophthalmic territory. The reduction of such potentials can be explained in terms of collision between the antidromic volleys and those elicited orthodromically by chemical and thermic stimulation. Also, capsaicin applied on the nerve induced an immediate increase, followed by a long lasting decrease, of orthodromic evoked response area. These findings bring further support to the nociceptive nature of the afferent fibers running into the oculomotor nerve. PMID- 2719527 TI - Circadian control of heat tolerance in stationary phase cultures of Schizosaccharomyces pombe. AB - The capacity of stationary phase cultures of Schizosaccharomyces pombe to survive a heat treatment at 55 degrees C is controlled by a circadian rhythm. In a synchronizing light-dark-cycle this rhythm shows a stable phase relationship to the onset of light. In continuous darkness it persists for several cycles without marked damping. The free-running period of about 27 h at 30 degrees C is only slightly longer at 20 degrees C, hence temperature-compensated. These results indicate that S. pombe is a suitable experimental organism for further research into both heat tolerance and circadian rhythms. PMID- 2719525 TI - Lipid A with 2,3-diamino-2,3-dideoxy-glucose in lipopolysaccharides from slow growing members of Rhizobiaceae and from "Pseudomonas carboxydovorans". AB - Lipid A's from two Bradyrhizobium species and from the phylogenetically closely related species "Pseudomonas carboxydovorans" were found to contain 2,3-diamino 2,3-dideoxy-glucose as lipid A backbone sugar. In contrast, three representatives of the genus Rhizobium, as well as the phylogenetically related species Agrobacterium tumefaciens, contain solely glucosamine as lipid A backbone sugar. These findings support independent studies on the phylogenetical relatedness based on 16S rRNA-data of the genus Bradyrhizobium with "Pseudomonas carboxydovorans" and Rhodopseudomonas palustris, which form a tight phylogenetical cluster and which all contain the 2,3-diamino-2,3-dideoxy-glucose containing lipid A. The relatedness of these species to the glucosamine containing species of the genus Rhizobium and to Agrobacterium tumefaciens is rather distant as documented by 16S rRNA studies. PMID- 2719526 TI - Selected low-cohesion variants of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus lack distinct antigens recognized by human antibodies. AB - Actinobacillus actinomycetemcomitans OMZ 346 A and Haemophilus aphrophilus OMZ 384 A, isolated on a synthetic selective and differentiating agar, show the highly cohesive and wall adherent growth in liquid medium which is typical for all primary oral isolates of these species. From each of them a low cohesion variant, OMZ 346 F and OMZ 384 F, respectively, was obtained by selection for cells growing in suspension. Screening of Western blots of these four strains with several human sera revealed the loss of a 4000 Mr antigen in both F strains. Human antibodies bound to the 4000 Mr band material on preparative Western blots of the A strains were eluted with 4 M magnesium chloride. These antibodies showed no cross-reaction between the 4000 Mr material of the two closely related species. PMID- 2719528 TI - Oxygen activation and defence against oxygen toxicity in a psychrophilic Bacteroidaceae. AB - When suddenly exposed to air the growth of the obligate anaerobic bacterium of the bacteroidaceae type, strain B6, continues for a few hours before coming to a complete stop. When air is shut off soon after growth has ceased, the organism is able to reestablish anaerobic conditions due to an ability to reduce O2, and resumes normal growth after another few hours. The O2 reducing ability of the organism is due to the presence in the cells of a particle-bound NADH oxidase, a soluble NADPH oxidase and a soluble pyruvate oxidase. The two pyridine nucleotide oxidases reduce O2 to H2O2, the pyruvate oxidase reduces O2 to H2O. Catalase and peroxidase were not detected in anaerobically grown cells. Kinetic studies with cell-free extracts showed that the pyruvate oxidase had a considerably greater affinity (smaller Km) for O2 and capacity (higher Vmax) for O2 reduction than the two other oxidases. It is postulated that the pyruvate oxidase acts as a scavenger for O2, leading to the non-toxic reduction product H2O, and thus functions as a defense mechanism against oxygen toxicity when the organism is exposed to aerobic condition. PMID- 2719529 TI - [Stages in the postnatal maturation of the optic nerve: morphometric changes during the critical period]. AB - The postnatal differentiation in rat optic nerve fibers was examined by electron microscopy from birth until the age of 44 days. We have estimated the evolution of the following parameters: nerve, axons and fibers caliber, number of axons, number and density of microtubules and neurofilaments, and number of myelin lamellae. In this study, we have determined four phases in the postnatal maturation of the optic nerve fibers, and we have described the ultrastructural changes during the critical period. The first week is a period of slow growth in axonal size and there is a lack of myelinated fibers. Microtubules and neurofilaments are relatively stable at this time, being the microtubules more numerous. The second phase corresponds with the second and third postnatal weeks, and shows a rapid increase in axonal size, microtubule and neurofilament number. The number of neurofilaments was more numerous than the number of microtubules. The third phase corresponds with the fifth postnatal week, and there are no changes in axonal caliber and in microtubule and neurofilament number. The fourth and last phase occurred from the sixth postnatal week to adult age. In this phase the axonal size, the fiber caliber, the microtubule and the neurofilament number increased. Our findings support the idea that neurofilaments are the most relevant morphological structure in the determination of axonal maturation in rat optic nerve. PMID- 2719530 TI - [Study of cognitive functions in autistic children by means of electrical brain mapping]. AB - Brain electrical activity of 20 autistic children and 19 controls, age range 7-13 years, was recorded employing brain mapping technics, during different test conditions: closed eyes, open eyes, listening music, puzzle task, receptive language, expressive language, writing and reading. The maps let us to analyze the differentiation and topographic organization of brain electrical activity, and the changes induced by psychological tasks over the different brain areas. The autistics children show, versus controls, slowed brain electrical activity, less organization and topographic differentiation, and also poor reactivity to the different test conditions in relationship with the ethiological diversity of this syndrome. PMID- 2719531 TI - [Determination of N-acetylneuraminic acid for the differential diagnosis of cystic ovarian tumors]. AB - The concentrations of N-acetylneuraminic acid (NANA) were determined in the fluid of cystic ovarian tumors and in the blood serum from a total of 95 patients. The estimation of NANA was based on the method of Svennerholm. It was found that the mean content of NANA in the cystic fluid is more than 3.0 mmol/l in serous and more than 5.5 mmol/l in mucinous malignant ovarian tumors. The mean value of NANA in the serum of patients is mostly more than 3.5 mmol/l if there is an ovarian cancer. The estimation of NANA is useful for the preoperative diagnosis of cystic ovarian tumors. PMID- 2719532 TI - Clear cell thyroid cancer--undifferentiated type--an immunohistochemical and electron microscopical study. AB - Two cases of clear cell thyroid cancer are described. In both tumors immunohistochemical methods detected the presence of intracytoplasmic thyroglobulin that confirmed the follicular origin. Simultaneously performed electron microscopic studies visualized the accumulation of smooth surfaced, membrane coated vesicles of varying size in the cytoplasm. Bad prognosis predicted on the base of undifferentiated histological structure was confirmed by extended hematogenic metastases. PMID- 2719534 TI - Organization of cancer care in Slovakia. PMID- 2719533 TI - [NMR research on blood plasma for tumor detection--a method for mass screening?]. AB - Recently, a simple NMR test was proposed to distinguish patients with and without malignant diseases by line-width analysis of methyl and methylene lipoprotein resonances in human plasma (4). We have reevaluated this proposed cancer detection technique at 250 MHz (magnet field strength 5.9T). The mean line width for 11 controls was 31.2 Hz (SD 4.1 Hz). For 8 patients with untreated malignant tumors, the line width was 27.5 Hz (SD 3.9 Hz). The data confirm the reported lower line widths of human plasma NMR resonances for patients with malignant tumors compared with controls (4). However, the statistical significance (P greater than 0.07) does not justify to use this technique for individual differential diagnostic purposes without further improvements of the method. PMID- 2719535 TI - Comprehensive cancer centres in the Federal Republic of Germany. PMID- 2719536 TI - Cancer in Finland. PMID- 2719537 TI - [Effect of various forms of diet on the nitrosation of sodium metamizole (analgin tablets) under simulated conditions of the human stomach]. AB - The influence of a simple and a more complex diet on the formation of nitrosometamizole from sodium metamizole (analgin tablets) under simulated human gastric conditions was estimated with extremely different nitrite concentrations. Only with the complex diet and only with low nitrite concentrations, the formation of nitrosometamizole was distinctly lowered. The quantitative estimation of the formed amounts was done by a colorimetric method after extraction with dichloromethane. PMID- 2719538 TI - [Precancerous diseases and the early recognition of pharyngeal and laryngeal carcinomas]. AB - Precursors and early symptoms of pharyngeal cancers generally appear without specificity. Mostly they are recognized in the stage of progressive carcinoma, so requiring a more radical therapy. Another situation you will find in laryngeal tumours. The early detection of laryngeal cancers has been mainly influenced by the favourable experiences of gynecologists with portio precancerous diseases. So an essential contribution to early detection of laryngeal cancer was given here by using a system of graduated methods regarding precursors and early stages of laryngeal carcinoma supplied by critical evaluation of early symptoms (hoarseness, disturbances of swallowing). The principle of clinical diagnostics turns out to be an exact observation of laryngeal mucosa surface by means of microscope, occasionally supported and extended by means of further investigations, e.g. exfoliative cytology and supravital staining. Moreover, for instance laryngostroboscopy permits to record vocal folds' movements so enabling a careful registration of laryngeal function. Nevertheless therapy of precancerous epithelial lesions in the larynx can be determined by histology only. Thereto we could demonstrate by means of evaluation of numerous patients' data as by scanning electron microscopic investigations of the laryngeal mucosa, that the rate of malignant transformation of localized (leukoplasia, pachyderma, keratosis) and diffuse epithelial lesions (chronic laryngitis) obviously seems to be greater in cases of verrucous or papillary surface structure of mucosa than in plain one. Finally, general recommendations for diagnostics and therapy of epithelial dysplasias and carcinoma in situ of the larynx according to the ORL society of the GDR are presented now. PMID- 2719539 TI - Symptoms and clinical impressions of patients seen in a postpolio clinic. AB - A retrospective study was performed to identify symptoms and clinical findings in postpolio patients seen in a postpolio clinic. Charts of 79 consecutive patients (28 men and 51 women) with histories and examinations compatible with the diagnosis of poliomyelitis were reviewed. The average current age of our patients was 47.3 +/- 10.4 years; the average age at onset of acute polio was 10.4 +/- 9.4 years; and the average number of years since function was first noticed to decline was 7.8 +/- 6.4 years. The most common symptoms acknowledged were progressive weakness (87%), muscle pain (86%), fatigue (86%), decreased activity level (78%), joint pain (77%), and back pain (70%). The clinical impression in most of these patients was arthritis/arthralgia (71% of the patients) or muscle overuse or myofascial pain (71%). Eleven (14%) had evidence of nerve compression, although 39% complained of sensory loss. Five patients had respiratory problems that required evaluation. Recommendations proved helpful for 78% of those seen at follow-up. These recommendations included pacing, energy conservation (planning, use of wheelchair or motorized scooter), gentle stretching or strengthening exercise, use of orthotic devices, weight loss or nutritional counseling, gentle aerobic exercise, use of a cane, and use of adaptive equipment. PMID- 2719540 TI - Influence of appropriate lower extremity orthotic management on ambulation, pain, and fatigue in a postpolio population. AB - A major functional problem for the postpolio patient is the loss of ambulation ability. A retrospective study of lower extremity orthotic management for ambulation was made of 104 subjects with histories of paralytic poliomyelitis who received treatment and evaluation in a postpolio clinic. Thirty-six patients (35%) had a remote history of a surgical arthrodesis of the ankle. Fifty-six subjects (54%) reported using lower extremity orthoses after the onset of their polio. At initial postpolio clinic evaluation 19 subjects (18%) were using lower extremity orthoses, and all of these patients had a remote history of orthotic use. After clinical evaluation, a new lower extremity orthosis was recommended for 37 subjects (36%). Nine of these patients had never used orthotic devices. New orthoses for a previously braced limb or an additional orthosis for a previously unbraced limb were prescribed more frequently in previously braced patients (28 of 56 vs 9 of 48, p less than 0.02). Seventy-two percent of subjects with ankle fusion required new orthoses; 19% of those without fusion required one (p less than 0.001). A questionnaire returned by 81 subjects (78%) indicated that appropriate orthotic prescription significantly improved the ability to walk, increased perceived walking safety, and reduced knee and overall pain (p = 0.04 to 0.008). PMID- 2719541 TI - Pyuria: its relationship to bacteriuria in spinal cord injured patients on intermittent catheterization. AB - Observations made during a study of intermittently catheterized spinal cord injured patients suggested that leukocyte counts yield higher results in aliquots of terminal-catheter urine (TCU) than in midstream-catheter urine (MCU) or suprapubic aspirate (SPA). The purpose of this study was to confirm that observation, to examine the relationship of leukocyte counts in TCU, MCU, and SPA to the leukocyte excretion rate (LER), and of pyuria to bacteriuria in this population. We collected sets of urine specimens obtained by SPA and intermittent catheterization (for leukocyte counts and quantitative culture) and timed urine collections (for LER determination). Fifty-two patients were studied for an average of five days. Leukocyte counts were performed in 241 SPA, 250 MCU, and 236 TCU specimens, and LER in 131 timed collections. The mean of the logarithm of leukocyte counts differed significantly between TCU and both MCU and SPA (p less than .0001). The difference between TCU and MCU was greater than 150 leukocytes/mm3 for 25% of paired specimens (mean 624 leukocytes/mm3, median 15 leukocytes/mm3). The statistical correlation between LER and leukocyte counts in all catheter specimens was significant; however, SPA and MCU frequently underestimated LER and TCU overestimated LER. Estimates of pyuria do not clearly separate bacteriuric from abacteriuric specimens. In spinal cord injured patients on intermittent catheterization, aliquots of catheter urine are not suitable for estimation of pyuria, and estimation of pyuria is not a feasible screening test for bacteriuria. PMID- 2719542 TI - Burns after spinal cord injury. AB - The problem of burns after spinal cord injury is described. Chart review was performed on thirty-five known cases. All burns occurred below the level of the lesion (p less than .001). Causes included bathing and showering, food and beverage, and therapeutic and environmental heating devices. We conclude that spinal cord injured patients should be educated about the risk of burn injury and the situations in which burns can occur. PMID- 2719543 TI - Strength in an elderly population. AB - Strengths of several upper- and lower-limb muscle groups were measured in an elderly population by using a simple, adaptable dynamometer. The bladder of a sphygmomanometer was modified by folding and surrounding it in a sewn cloth bag. It was then attached to a board for improved stability during the tests. Thirty seven men and 81 women aged 62 to 102 years were tested. Four muscle groups were statistically determined to best represent strength-two for upper limb and two for lower limb. These strength measures were correlated with anthropometric indices, and a step-wise multiple regression was used to determine the degree of association between the variables. Men were significantly stronger than women in absolute strength, but were not different when strength was expressed relative to body weight. Within each sex, however, age was the most important variable related to loss of strength; body weight was secondary or not significant. These results suggest that age is the most important factor for relating differences in strength in an older elderly population (those aged 75 to 90 or more years). This factor must be accounted for just as body weight or cross-sectional muscle area often are, when comparing strengths in a younger population. PMID- 2719544 TI - Spinal fractures complicating ankylosing spondylitis. AB - Individuals with ankylosing spondylitis (AS) are at increased risk for developing fractures of the spine, especially in the cervical region. This tendency is related to the ossification of spinal ligaments and osteopenic changes in the spinal vertebrae. We reviewed our clinical experience of SCI occurring due to AS, and the literature regarding the natural history of these fractures. A significant number of individuals are not aware of their increased risk for spinal fracture and sustain spinal fractures without realizing it. Difficulties in diagnosis and inappropriate management of spinal fractures in these individuals have often resulted in severe neurologic sequelae and a mortality rate approximately twice that observed with similar fractures in a normal spine. The need for better patient education emphasizing the significance of even minor trauma, and a thorough evaluation of AS patients with a history of trauma is stressed. PMID- 2719545 TI - The shoulder abduction relief sign in cervical radiculopathy. AB - A patient with C6 cervical radiculopathy reported that sustained shoulder abduction significantly diminished this upper extremity pain. The patient was instructed to adopt this position for prolonged periods during rest and at work. Pain relief was temporary and lasted as long as the arm was in abduction. Relief of pain, induced by arm abduction, may be observed in cervical radiculopathy in which the lower cervical roots are involved. Reduced tension at the nerve root is the probable underlying mechanism that leads to pain relief. Shoulder abduction can be used not only as a diagnostic sign but also may be incorporated in the conservative management of patients suffering from cervical radiculopathy affecting the lower cervical roots. PMID- 2719546 TI - Disseminated fat necrosis: a rehabilitation challenge. AB - Disseminated fat necrosis (DFN) is a rare complication of pancreatic disease characterized by subcutaneous nodules, visceral effusions, osseous intramedullary fat necrosis, and arthritis. The rehabilitation of a 33-year-old patient with DFN is described here. The patient had a history of alcoholic pancreatitis for which she underwent a subtotal pancreatectomy. Three months later she developed subcutaneous nodules and migratory polyarthralgias. The diagnosis of DFN as the etiology of her arthritis was confirmed by synovial fluid analysis; in addition, magnetic resonance imaging of her long bones revealed multiple marrow infarcts. She was nonambulatory and required assistance with transfers because of severe joint pain. Treatment included local ice, prednisone, methadone, instruction on joint preservation and proper body mechanics, and ambulation with weight-bearing as tolerated with an assistive device. At the patient's discharge, her joint inflammation was clinically improved but not resolved, and she was independent in transfers and ambulation with a walker for short distances. Despite ongoing inflammation, functional improvement was accomplished through a rehabilitation program emphasizing partial weight-bearing ambulation rather than strengthening exercises. PMID- 2719547 TI - Cineradiography of the hypomobile first rib. AB - A patient with bilateral chronic brachialgia was cineradiographically shown to have hypomobile first ribs bilaterally. This finding can be elicited by the Expiration-Inspiration (E-I) test, in which the patient is palpated just beneath the clavicles while breathing. Right side scalenus muscle activation restored the movement of the right first rib. The cineradiography confirms the validity of the palpatory E-I test which has been previously described. PMID- 2719549 TI - Monopolar needle stimulation: safety considerations. AB - Stimulation of nerves for conduction studies can be performed with a monopolar needle used routinely for electromyographic studies. Although invasive, this technique allows precise localization of stimulation and access to deeply situated nerve trunks, thus providing otherwise unobtainable information regarding peripheral nerve function. The electric current at the needle tip was measured during supramaximal stimulation of the median and peroneal nerves at distal and proximal sites. After measuring the area of uninsulated needle tip, the local current density was calculated. The maximum current during the stimulation of 0.05msec duration was 0.80mA and the resulting current density was 4.1mA/mm2. It is calculated that this current could cause a local maximum temperature rise of 2.5C in the tissue within 0.5mm of the needle tip. This current flow would not be expected to cause either direct electric or heat damage to the tissue. PMID- 2719548 TI - Gluteal abscess causing sciatica in a patient with systemic lupus erythematosus. AB - Low back pain and sciatica may be caused by pathology remote from disc and lumbosacral vertebral segments. We report on a 59-year-old patient with systemic lupus erythematosis whose history illustrates this point. The patient was evaluated and diagnosed to have a septic arthritis of the wrist and lumbar spinal stenosis, for which she was treated. The patient's failure to respond to therapy led to further evaluation. A massive gluteal abscess was identified and drained, and with appropriate antibiotic therapy, the patient recovered. Patients with lupus have increased likelihood of infection, and their evaluation should include a search to discover unusual locations in cases that are unresponsive to standard and seemingly appropriate therapy. PMID- 2719550 TI - The convergence projection theory. PMID- 2719551 TI - Pediatric rehabilitation. 6. Musculoskeletal and soft tissue disorders. AB - This self-directed learning module highlights advances in evaluation and treatment of congenital and acquired musculoskeletal disorders in the child. It is a section of the chapter on pediatric rehabilitation for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section contains information on alterations of limb structure and gait, scoliosis, torticollis, sports injuries and overuse syndromes, and unexplained pain in children. PMID- 2719552 TI - Partial deletion of the human host range gene in the attenuated vaccinia virus MVA. AB - The genome of a strongly attenuated vaccinia virus strain, MVA, was investigated by Southern blot and sequence analyses. Three major deletions, relative to the WR strain, were localized in MVA DNA. The deletions occurred near both ends of the viral genome and one of them affected a 55 K as well as the 32 K human host range gene. Although more than two thirds of the host range gene were eliminated from the MVA, the virus could still multiply in certain human cells. PMID- 2719553 TI - Studies on the genetic basis of human influenza A virus adaptation to mice: degrees of virulence of reassortants with defined genetic content. AB - A highly virulent mouse-adapted variant of influenza virus A/Aichi/2/68 (H3N2) was crossed either with the original A/USSR/90/77 (H1N1) influenza virus strain or with its mouse-adapted, moderately mouse virulent variant. The reassortants were characterized with respect to their genetic content and pneumovirulence for mice. The reassortants fell into three categories: avirulent, highly virulent (resembling in this respect the parent A/Aichi/2/68 virus) and moderately virulent (resembling the mouse-adapted A/USSR/90/77 parent virus). The analysis of the parental origin of the genes of 6 reassortants allowed to suggest that changes in the HA gene and in a polymerase gene (most likely, PB1) were necessary for the acquisition of virulence by the A/USSR/90/77 virus in the course of adaptation to mice, whereas the changes in two other polymerase genes as well as in the genes NA and NS were not involved. The low degree of pathogenicity characteristic of the mouse-adapted A/USSR/90/77 virus was determined by gene(s) other than HA. PMID- 2719554 TI - Variation of the nucleotide and encoded amino acid sequences of the envelope gene from eight dengue-2 viruses. AB - The nucleotide sequences of the envelope genes from five Thai and three Sri Lankan dengue-2 viruses were determined by sequencing the viral RNA using synthetic oligonucleotide primers. The results were compared with the four published dengue-2 envelope sequences to obtain a classification of these viruses, which showed that the Thai isolates could be divided into two separate groups while the Sri Lankan isolates were distinct. There was no correlation between disease severity and envelope protein sequence, or between year of isolation and sequence. No particular amino acid changes were associated with virulence or a change in hydrophilic region which could perhaps act as an epitope. PMID- 2719555 TI - Coat protein of potyviruses. 6. Amino acid sequences suggest watermelon mosaic virus 2 and soybean mosaic virus-N are strains of the same potyvirus. AB - The amino acid sequence of the coat protein of watermelon mosaic virus 2 (WMV 2) was determined by a combination of peptide and nucleic acid sequencing. The coat protein of WMV 2 contained 281 amino acid residues including a single cysteine at position 132 and a blocked amino terminus. Comparison with the coat protein sequences of 20 strains of ten distinct potyviruses showed sequence homologies ranging from 43% to 69% except for the N strain of soybean mosaic virus (SMV-N), where the sequence homology with WMV 2 was 83%. This degree of homology and the location of sequence differences between WMV 2 and SMV-N is much closer to that observed between strains of the same virus than that found between distinct potyviruses. These data suggest that WMV 2 and SMV-N may be strains of the same virus. PMID- 2719556 TI - Interprotein disulfide bonding between F and G glycoproteins of human respiratory syncytial virus. AB - The envelope glycoprotein G, of human respiratory virus was purified by immunoaffinity chromatography using a monoclonal antibody reacting with G glycoprotein. The purified material was analyzed for its protein patterns and by western blot for its reactivity with specific monoclonal antibodies. In addition to the G specific proteins at 90 and 55 kilodalton (kDa) range, high molecular weight species were coeluted with G protein. Three high molecular weight species were noticed: one (140 kDa) reacting with fusion protein (F) monoclonal antibody and two other species (230 and 195 kDa) reacting with both fusion protein and G protein monoclonal antibodies. The protein reacting only with F monoclonal antibody consists of fusion protein dimer. Western blot and two dimensional gel electrophoretic analysis revealed that each of the other two complexes is composed of two moles of F protein and one mole of G protein. These two complexes differ in their molecular sizes depending on whether G is in the form of 90 or 55 kDa. Upon heat denaturation, fusion protein monomer (70 kDa) is released from the complex, leaving the two complexes, consisting of one mole of F protein and one mole of G protein (160 and 125 kDa species respectively). Disulfide-reducing agents are required to break the monomers of F and G complexes. These results provide a direct evidence for the presence of envelope glycoprotein complexes linked by interprotein disulfide bonding. This may have implications on the structural and functional properties of envelope glycoproteins. PMID- 2719557 TI - [Results of implantation of teflon paste into the vocal cord according to the data of light and electron microscopy]. AB - Light and electron microscopy was used to study 5 observations of the tissue response to the teflon paste implanted into the vocal cords to modulate the vocal function. The study showed that teflon was not an absolutely inert substance, it produced inflammation as giant cell granuloma of foreign bodies. Giant cells of foreign bodies (GCFB) enclosing and resorbing the particles of teflon were found to have all the ultrastructural signs of actively phagocytizing cells presenting with various differentiation. The ultrastructure of GCFB provides support for the fact that the cells making up polykaryons belong to the system of mononuclear phagocytes. PMID- 2719558 TI - [Endoscopic laser therapy of chemical burns of the esophagus (clinico-morphologic studies)]. AB - Clinical and morphological studies were performed to evaluate the results of endoscopic helium-neon laser therapy in 34 patients with chemical esophageal burns. There was an accelerated epithelization of the impaired esophageal mucosa, which occurred on the second week following the esophageal burning. It was concluded that it was advisable to include local endoscopic laser therapy into the combined treatment of patients with chemical esophageal lesions. PMID- 2719559 TI - [Clinico-morphologic parallels in aseptic necrosis of the head of the femur in adults]. AB - The authors reviewed clinical findings from 57 adult patients with aseptic necrosis of the head of the femur. A statistical processing of the findings showed a significant direct correlation between the stages of the process and the degree of femoral muscular atrophy, degree of internal rotation and abduction limitations, thermographic activity, and intraosteal blood pressure. A pathohistological examination of osseous tissue specimens from the head of the femur revealed that at an early pre-X-ray stage, pathological changes involved only the microcirculatory bed of the bone marrow; in this consequence, extra articular implantation of the inferior epigastric artery with concomitant veins into the neck and head of the femur is likely to be justifiable at this stage. PMID- 2719560 TI - [The surfactant system and ultrastructure of the lungs after surgical correction of cardiac defects during extracorporeal circulation]. AB - Using bronchoalveolar lavage (BAL), two-dimensional thin-layer chromatography, and electron, microscopy, the surfactant system and ultrastructure of the lung were examined in 32 patients with mitral valvular disease before cardiac interventions, after closed mitral commissurotomy, and surgeries under extracorporeal circulation (EC). The magnitude of changes in the pulmonary surfactant and structure was shown to be determined by the degree of circulatory decompensation and to vary with duration of the disease. In 23.7% of the patients, there were significant changes in the pulmonary surfactant system and ultrastructure, which were characterized by phospholipid metabolic disturbances in the surfactant, destructure of osmophilic lamellated corpuscles of type II alveolocytes (AII), decrease in their relative volume, a substantial increase in the minimal BAL superficial tension, and aerohematic barrier fibrosis. Concurrent with the magnitude of morphological changes in the lung, time of EC, composition of a perfusate, the presurgical abnormality of the surfactant system is essential to the development of its postperfusion insufficiency and pulmonary dysfunction. The pulmonary ultrastructural alterations in these patients were expressed by impairment in capillary endotheliocytes, their accumulation of leucocytic aggregates, interstitial and intracellular edemas, partial alveolar collapse, destructive-and-necrotic and compensatory-and-adaptative changes in AII. The above abnormalities were seen in 27.7% of the patients operated on under EC. PMID- 2719561 TI - [Pathologic anatomy of subtypes of immunoblastic lymphosarcoma]. AB - Morphological parameters for immunoblastic lymphosarcoma (IL) subtypes: plasmocytic IL (PIL) and polymorphocellular IL (PMIL) were determined through a comparative morphological analysis of 56 sections and 64 respective diagnostic biopsies. PIL was found to more frequently affect the gastrointestinal tract. Tumors were found to be selective in damaging the organs, e.g. white pulp was affected in PIL, marginal follicular areas, in PMIL. Clinical and anatomical analyses of the death causes in patients with IL showed that they all had died of neoplastic progression (67.9%), concurrent diseases (23.2%) or complications resulted from the therapy performed (8.9%) upon tumor progression. PMID- 2719562 TI - [Morphology of pneumococcal meningitis in adults]. AB - Morphologically, acute pneumococcal meningitis runs like meningoencephalitis. A major part of pneumococcal meningitides belongs to primary ones. Liquor bacterioscopy using Gram's smear staining is an early method for their diagnosis. PMID- 2719563 TI - [The question of the functional significance and origin of pulmonary "tumorlets"]. AB - In 1955, the term "tumorlets" was proposed to denote unusual microscopic clusters of epithelial cells occasionally detectable in the lung. The endocrinal nature of these formations has been proved, but there are conflicting opinions on the essence of the process (hyperplasia, dysplasia, and neoplasia). Pulmonary proliferation of endocrinal cells, which was similar to that of tumorlets, was found in 2 of 4 observations. The analysis of the results of the studies performed by the authors and of data available in the literature makes it possible to conclude that the proliferates of pulmonary endocrinal cells are, in terms of their functional significance, heterogeneous. Some of them appear as preneoplastic hyperplasia of endocrinal cells. The individual clusters acquiring independent blood circulation (stroma) may be regarded as true tumor microcarcinoids. The authors also define the transitional forms between hyperplasia and neoplasia. PMID- 2719564 TI - [Hepatoduodenal ligament teratoma followed by hypertensive syndrome of the portal vein]. AB - A rare localization of teratoma was observed in the hepatoduodenal ligament. In a 6-year-old child, the tumor blocked the partial vein followed by the hypertensive syndrome that resulted in death. PMID- 2719565 TI - [Methods for verifying forms of amyloidosis by a pathologist]. AB - Potassium permanganate reaction, immunohistochemical assay using immune sera, and autoclave method combined with alkaline guanidine one are considered to be the most effective methods among those designed for verifying forms (primary, secondary, hereditary, senile systemic) of systemic amyloidosis. PMID- 2719566 TI - [Work of pathology bureaus]. PMID- 2719567 TI - [Various mechanisms of reducing the vascular system of granulation tissue in the process of its maturation]. AB - Rat granulation tissues were histologically and electron radioautographically examined at Days 7, 20, 30, 40, 53, and 60 after making a 3 X 4-cm2 wound in the back. During the entire period of cicatrization, alterations were shown to occur in the capillaries, as manifested by destructive changes in endotheliocytes, break in their contacts, thinning of the capillary wall with occasional lacerations, disintegrity of the basal membrane and, finally, vessel-composing cell dissociation and departure, as well as unusual arrangement among other cells and fibrous structures. On the basis of the findings it is proposed that the known diminished numbers of vessels during granulation tissue maturation involves not only disappeared vessels due to their progressive dystrophic changes, but the described unusual capillary alterations whereby the vascular wall cells are gradually converted to the cellular elements freely located in the interstitial tissue. PMID- 2719568 TI - A comparative study of the central nervous system effects of betaxolol vs timolol. PMID- 2719569 TI - From timolol to betaxolol. PMID- 2719570 TI - Evaluation of the relative afferent pupillary defect in pseudotumor cerebri in regard to surgical intervention. PMID- 2719571 TI - Less painful alcohol block. PMID- 2719572 TI - Excimer laser ablation in a human eye. Case report. PMID- 2719573 TI - Spontaneous in vivo fracture of an anterior chamber intraocular lens loop. Case report. PMID- 2719574 TI - Sterno-induced methanol toxicity and visual recovery after prompt hemodialysis. Case report. PMID- 2719575 TI - Court upholds ruling in radial keratotomy suit. PMID- 2719576 TI - The 50-year epidemic of pseudophakic corneal edema. PMID- 2719577 TI - Age-related cataract in the Tibet Eye Study. AB - The Tibet Eye Study was designed to estimate the prevalence of age-related cataract in Duilong-Deqing County, west of Lhasa, China (altitude, 4000 m). Previous reports have suggested an unusually high prevalence of age-related cataract in Tibet. A two-stage probability sample of persons aged 20 years or older from the 35 townships of the county targeted 2884 persons for inclusion in the study; 2665 (92.4%) were examined. Age-related cataract was diagnosed when (1) visual acuity was worse than 6/12 (20/40) because of nuclear or cortical (including posterior subcapsular) opacities, or (2) aphakia associated with a history of age-related cataract was present in either eye. The prevalence of age related cataract among persons aged 20 to 39 years was 0.2%; among persons 40 years old or older, the prevalence was 11.8%. Cortical cataracts were by far the most common type of cataract diagnosed. Age- and sex-adjusted prevalence in Tibet was 60% higher than the prevalence in a similar, previously conducted study of 6951 person in Shunyi County, northeast of Beijing (altitude, 50 m). A second, independent slit-lamp classification of lens status was conducted in the Tibet Eye Study using standard photographs previously described. Age-specific cataract prevalence was similar with the two examination techniques. Results from the Tibet Eye Study support previous suggestions of a high prevalence of age-related cataract in Tibet. PMID- 2719578 TI - Kinetics of intraocular gases. Disappearance of air, sulfur hexafluoride, and perfluoropropane after pars plana vitrectomy. AB - Intraocular gas bubbles are an important source of internal tamponade for the treatment of retinal breaks in eyes requiring vitrectomy. The kinetics of disappearance of air, 20% sulfur hexafluoride, and 10% perfluoropropane were prospectively evaluated in 76 eyes undergoing pars plana vitrectomy. The absorption of each gas approximated a first-order kinetic equation with respect to bubble volume. The half-life of air was 1.6 days in phakic and 0.9 days in aphakic eyes. The half-life of 20% sulfur hexafluoride was 2.8 days in phakic and 2.4 days in aphakic eyes. The half-life of 10% perfluoropropane was 5.7 days in phakic, 4.5 days in aphakic, and 4.3 days in pseudophakic eyes. The difference in half-life among the three gases was significant. Intraocular gases had a shorter half-life in aphakic than in phakic eyes. PMID- 2719579 TI - Ophthalmic manifestations of leukemia. AB - We prospectively examined the eyes of 120 patients with leukemia. Only 38% of patients had normal results of examination. Leukemic infiltrates were present in 3% of patients, other findings related to leukemia were seen in 39% of patients, and 20% of patients had unrelated abnormalities. Visual loss was seen in at least 5% of the patients in this study. PMID- 2719580 TI - Cone-rod dystrophy. Phenotypic diversity by retinal function testing. AB - Three patterns of visual dysfunction were identified in patients with autosomal recessive or simplex cone-rod dystrophy using rod and cone electroretinography and light- and dark-adapted static threshold perimetry. In the first pattern, there was a central rod and cone scotoma with eccentric fixation, mild peripheral retinal dysfunction equally affecting rod and cone systems, and slow progression. The second pattern, which was relatively more severe, also showed a central rod and cone scotoma and eccentric fixation; however, there was more cone than rod dysfunction detected by electroretinography, and function was lost in the peripheral visual field before it was lost in the midperipheral field. A third pattern, which was rapidly progressive, showed central unsteady fixation and no measurable cone function. Patches of rod function were retained in the central and inferotemporal regions of the visual field. Most of the patients studied fit within the three patterns and the patterns were consistent within families. PMID- 2719581 TI - Pseudo-Schnabel's cavernous degeneration of the optic nerve secondary to intraocular silicone oil. AB - A 29-year-old man sustained severe trauma to his left eye requiring corneoscleral wound repair and retinal detachment repair. Because of a persistent retinal detachment, he underwent vitrectomy and silicone oil implantation into the vitreous cavity. Over the ensuing 2 years 4 months, the eye gradually became glaucomatous, blind, and painful, requiring enucleation. Histopathologic examination revealed that coalescent globules of silicone oil had infiltrated the entire length of the attached atrophic optic nerve. Superficially reminiscent of the changes seen in Schnabel's cavernous optic atrophy, this observation provides evidence for the theory of Zimmerman et al concerning the pathogenesis of cavernous degeneration of the optic nerve in glaucomatous eyes. PMID- 2719582 TI - Granulomatous uveitis in Crohn's disease. A clinicopathologic case report. AB - Recurrent episodes of uveitis occurred in a young male patient with clinical as well as radiologic and histologic evidence of Crohn's ileocolitis. His left eye became blind and painful, and was enucleated. Histopathologic examination of the eye revealed a panuveitis with evidence of granuloma formation in the choroid. While granulomatous inflammation has previously been demonstrated in extraintestinal sites, to our knowledge, this is the first histopathologic evidence of granuloma formation within the eye in Crohn's disease. PMID- 2719583 TI - Biodegradable mechanical retinal fixation. A pilot study. AB - Mechanical retinal fixation is a useful tool in the armamentarium of vitreoretinal surgeons. Unfortunately, the use of metallic retinal tacks on a permanent basic mandates a retained intraocular foreign body that poses some potential for long-range toxic effects. Herein, we report the results of our initial experience with a temporary, biodegradable mechanical retinal fixation device ("biopin") in rabbits. When compared with metallic tacks, the biopins appeared to be well tolerated intraocularly, with minimal damage detectable at the light microscopic level. Disinsertion of the biopins occurred in 46% of the eyes within two weeks and in all eyes by four weeks. Initial signs of degradation of the biopins were observed at six weeks (median) in the ensectomized/vitrectomized eyes and at 12 weeks (median) in the nonvitrectomized eyes. Differences were found in the occurrence of retinal detachment between animals that underwent lensectomy/vitrectomy with insertion of two metallic tacks and animals that underwent insertion of one biopin without vitrectomy. The biopin has a potential as a vehicle for sustained release of pharmacologic agents to inhibit directly the development of vitreoretinal proliferation, thereby retarding or preventing subsequent retinal traction and detachment. PMID- 2719584 TI - Obstruction of the trabecular meshwork by retinal rod outer segments. AB - Rod outer segments (ROS) have been described in the anterior chamber of patients with the Schwartz syndrome (retinal detachment, uveitis, and glaucoma). The effect of ROS on aqueous outflow was studied by intracameral injection of ROS in human eye bank eyes and in vivo in the cat. Injection of 10(8) ROS in eye bank eyes (n = 8) caused a 19.7% decrease in outflow facility. This was significantly different than in control eyes (n = 8), where the outflow facility decreased 5.2%. Injection of intracameral ROS in the cat resulted in a rise in intraocular pressure (IOP) from a baseline of 19.7 +/- 1.3 mm Hg to a peak of 30.0 +/- 0.7 mm Hg at 24 hours. By 48 hours, IOP returned to baseline. Control injection did not cause a change in IOP. Electron microscopy of the cat trabecular meshwork revealed occlusion of the intratrabecular spaces by ROS with little evidence of inflammatory activity. PMID- 2719585 TI - Idiopathic recurrent branch retinal arterial occlusion. PMID- 2719586 TI - Lower lid reconstruction using tarsoconjunctival grafts and bipedicle skin-muscle flap. AB - We describe a method of subtotal lower eyelid reconstruction employing either a free tarsoconjunctival graft or a transpositional tarsoconjunctival flap from the upper lid together with a bipedicle skin-muscle advancement flap from the lower lid. A full-thickness skin graft is placed into the defect created by the movement of the bipedicle flap. This technique obviates the need to use a lid sharing procedure that occludes the fissure and would be indicated for the monocular patient or one who would be at a serious disadvantage with the eye covered for several weeks. PMID- 2719587 TI - Giant retinal tears. Surgical techniques and results using perfluorocarbon liquids. AB - Three low-viscosity perfluorocarbon liquids provided an intraoperative tool during vitrectomy to manage giant retinal tears. These clear fluids have a high specific gravity (1.8 to 1.9) and are immiscible with water. In six eyes, the giant tear was less than 180 degrees; in 11 eyes, it was 180 degrees or greater. In all eyes, the tear was unfolded and the retina was flattened while the patient was supine. The perfluorocarbon liquid was aspirated and replaced by air perfluorocarbon gas mixtures (16 eyes) or silicone oil (one eye) at the end of the operation. The retina was reattached in 16 eyes (94%), with a minimum follow up period of 6 months. In five eyes (29%), the retina was reattached without scleral buckling. Residual droplets of perfluorocarbon liquid were observed in four patients. These new materials complement present surgical techniques for managing giant retinal tears. PMID- 2719588 TI - Ultrasound spatula. AB - A spatulalike tip is made from a 0.9-mm ultrasound (Fragmatome) tip. It is attached to a Fragmatome handpiece and used with ultrasound vibration at an intensity of about 6 W/cm2. (An infusion needle [May Needle] is used as a separate irrigating instrument.) Because the apex of the tip is rounded and lacks a simultaneous aspirating function, there is almost no danger of damaging the capsule if used carefully. This instrument is useful for dissecting the cataract to remove it through a smaller capsular incision, and in removing lens epithelial cell by applying it from the outer surface of the anterior capsule without damaging the capsule. PMID- 2719589 TI - A modified fascia needle. AB - A new fascia needle has been designed. It is considerably easier to handle and does not have any of the problems surgeons typically encounter with the Wright needle. PMID- 2719590 TI - Bromodeoxyuridine uptake in the assessment of hyperthermic therapy for intraocular tumor. AB - Assessment of uveal melanoma response after many nonenucleation therapies is difficult with current modalities, since tumor regression is usually delayed. The goal of most treatments, including ionizing radiation or radiation and adjunct hyperthermia, is to destroy the reproductive capacity of the tumor. Cell cycling analysis with bromodeoxyuridine, a thymidine analogue only incorporated during DNA synthesis, was a useful indication of tumor control after hyperthermia was used to treat a Greene intraocular melanoma model. Cell cycling decreased from a mean of 16% before therapy to less than 1% in all the successfully treated tumors. Cell cycling changes preceded histologic evidence of cell death. In contrast, tumors that grew after insufficient treatment had increased cell cycling to a mean of 25%. Cell cycling studies with bromodeoxyuridine represent a sensitive gauge of the reproductive integrity of the tumor. PMID- 2719591 TI - Balloon catheter injury to rabbit carotid artery. I. Changes in smooth muscle phenotype. AB - Stereology was used to investigate the changes in ultrastructure of smooth muscle cells during the formation of an experimental intimal thickening induced by injury with an inflated balloon catheter. The volume density of myofilaments in the cell cytoplasm was measured in smooth muscle cell-lined areas (which are freely permeable to Evans blue dye and, hence, stain blue) and in re endothelialized areas (which remain white after injection of Evans blue) of the rabbit carotid artery. Two weeks after injury, the volume densities of myofilaments in the intimal smooth muscle cells in both white and blue areas were significantly less than that for control medial smooth muscle (67.9% +/- 3.6%; mean +/- SE), being 38.8% +/- 1.0% and 35.9 +/- 3.3%, respectively. By 6 weeks after injury, the volume density had increased significantly in both white (55.1% +/- 3.4%) and blue areas (53.5% +/- 3.0%), and these values did not change significantly by 18 weeks. The volume density of myofilaments in the luminal (lining) smooth muscle cells in the blue areas was significantly less than that of control medial cells and remained low (26.7% +/- 2.1%) up to 18 weeks after injury. The initial balloon-induced injury caused considerable damage to the smooth muscle cells in the media, and the remaining medial cells underwent similar changes in ultrastructure to the cells in the neointima. At 2 weeks, the cells had a low volume density of myofilaments (44.9% +/- 2.4%), which returned to a level not significantly different from the control artery by 6 weeks after injury. There were no differences in the estimates of the volume density of myofilaments between the inner and outer media of the injured arteries. These findings suggest that, after injury produced by a balloon catheter, the smooth muscle cells in both the media and the resultant intimal thickening undergo a reversible change in ultrastructure. PMID- 2719592 TI - Balloon catheter injury to rabbit carotid artery. II. Selective increase in reactivity to some vasoconstrictor drugs. AB - The present study examined the changes in reactivity to a variety of vasoconstrictor drugs of the rabbit carotid artery during development of an intimal thickening induced by injury with an inflated balloon catheter. The injured and the unoperated contralateral carotid arteries were studied at 2 and 6 weeks after the operation. To differentiate areas of the injured artery lined by modified smooth muscle cells from areas lined by regenerated endothelial cells, each rabbit was injected with Evans blue dye before sacrifice. Ring segments (3 mm length) from the control and injured arteries were mounted in organ baths to record the circumferential isometric force with a technique that ensured that all rings were set to equivalent initial resting conditions of passive transmural stretch. Compared with the controls, the experimental arteries had a significantly decreased maximum contraction (Emax) in response to KCl at both 2 and 6 weeks. The experimental arteries were also significantly less sensitive to the alpha 1-adrenoceptor agonist, methoxamine, at both 2 weeks (approximately sevenfold) and 6 weeks (fourfold), with a marked decrease in Emax at 2 weeks, which returned to control values at 6 weeks. There was no change in Emax to either serotonin or the thromboxane A2-mimetic, U46619, in the experimental arteries at either time. There was, however, a small but significant increase in the sensitivity to both drugs. There was no difference in response to any of the constrictor agents between the white and blue regions of the experimental vessels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719593 TI - Genetic and environmental determinants of serum lipids and lipoproteins in French Canadian families. AB - The contribution of genetic and environmental factors in serum triglycerides (TG), total cholesterol (CHOL), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and HDL-C/CHOL ratio were studied in 1630 subjects from 375 families of French descent by using a path analysis procedure. Familial correlations were computed in several pairs of biological relatives and relatives by adoption after adjustment for age and gender effects and after further adjustment for physical fitness, level of habitual physical activity, total body fat and fat distribution, diet, smoking, and alcohol consumption. The model of path analysis allowed the separation of transmissible variance (t2) into genetic (h2) and cultural (b2) components of inheritance. Under the most parsimonious solution and after adjustment for age, gender, and concomitants, the transmissible variance was entirely accounted for by genetic factors (t2 = h2), with h2 estimates of 0.52, 0.55, 0.60, and 0.63 for TG, CHOL, LDL-C, HDL-C, and HDL-C/CHOL, respectively. These estimates were similar to those obtained after adjustment for age and gender effects only. The contribution of nontransmissible environmental factors ranged from 0.48 for TG to 0.37 for HDL C/CHOL ratio. These results suggest that both genetic and environmental factors contribute to the variation in blood lipids and lipoproteins in this population and that nongenetic influences are not associated with cultural factors transmitted across generations. PMID- 2719594 TI - Large buoyant LDL-like particles in hepatic lipase deficiency. AB - Hepatic lipase (HL) is thought to play a role in processing very low density lipoprotein to low density lipoprotein (LDL). To analyze the relationship between HL and LDL, the density, size, and chemical composition of LDL isolated from 18 normal subjects and from three subjects with reduced or absent levels of HL activity were compared. In an HL-deficient subject, the major peak of apoprotein (apo) B-containing lipoproteins ('LDL') had a density of 1.023 g/ml and a diameter of 26.4 nm compared to male control subjects (1.044 +/- 0.006 g/ml and 25.3 +/- 0.3 nm). Two half-sisters of the HL-deficient subject with half the normal levels of HL activity had LDL that also were more buoyant and slightly larger than the LDL isolated from female control subjects. The peak density and average diameter of LDL were correlated with HL activity, consistent with the hypothesis that HL influenced formation and physical characteristics of typical LDL. Apo B-100 was the major apoprotein in the 'LDL' isolated from the HL deficient subject and contained a greater proportion of triglyceride compared to the control subjects' LDL. The absence of HL appears to prevent the production of classical LDL. Our data support the hypothesis that HL helps determine normal LDL characteristics. PMID- 2719596 TI - Cholesterol homeostasis in mononuclear leukocytes from patients with familial hypercholesterolemia treated with lovastatin. AB - We evaluated the effects of different doses of lovastatin, a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG CoA reductase) and the rate-limiting enzyme in cholesterol biosynthesis, on parameters of cholesterol homeostasis in freshly isolated mononuclear leukocytes from 19 patients with heterozygous familial hypercholesterolemia. Patients were treated with sequentially increasing doses of lovastatin (10 to 80 mg/day in a twice daily regimen). The in vitro activity of HMG CoA reductase and cholesterol synthesis from 2-14C-acetate was determined in mononuclear cells obtained under steady-state conditions after patients had spent 6 weeks on doses of 20, 40, or 80 mg/day. The total and high affinity degradation of 125I-low density lipoprotein (LDL) was determined at baseline and on lovastatin at a dose of 80 mg/day. LDL cholesterol levels fell progressively on lovastatin (38% reduction on 80 mg daily, p less than 0.005). These changes were paralleled by a 121% increase in the activity of HMG CoA reductase (p less than 0.05) and a 39% increase in cholesterol synthesis from 2-14C-acetate (p less than 0.005). Total and high affinity degradation of 125I-LDL increased from 27 +/- 3.3 and 12.1 +/- 1.6 ng/4 x 10(6) cells/4 hours on the diet only to 69.7 +/- 7.2 and 32.9 +/- 3.6 ng/4 x 10(6) cells/4 hours, respectively, (mean +/- SEM) in mononuclear cells isolated from patients on 80 mg of lovastatin daily (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719595 TI - Detection and characterization of the heterozygote state for lipoprotein lipase deficiency. AB - Because there are no characteristic clinical or biochemical manifestations, the heterozygote state for lipoprotein lipase (LPL) deficiency has been difficult to detect. Measurements of postheparin plasma LPL activity and of LPL mass were performed in six families of probands with LPL deficiency to characterize the heterozygote state. LPL mass was measured in a sandwich enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody (5D2) that had been produced against bovine milk LPL. Thirteen obligate heterozygotes from these families had reduced LPL activity and mass below the 95th percent confidence limits of 34 normal controls, while one obligate heterozygote had LPL activity and mass between the 90th and 95th percent confidence limits. Potential heterozygotes in these families were identified as normal (n = 8) or heterozygotes (n = 6) by comparison to the 95th percent confidence limits of the controls. Some relatives in four of the six families exhibited mild hyperlipidemia, similar to the pattern seen in familial combined hyperlipidemia (FCHL). The hyperlipidemia segregated with the heterozygote state for LPL deficiency in these families (p less than 0.03). High density lipoprotein (HDL) cholesterol was significantly reduced in the heterozygotes for LPL deficiency (p less than 0.01). The measurement of LPL activity and mass allows identification of the heterozygote state for LPL deficiency, which is characterized by variable expressions of hyperlipidemia and reduced HDL cholesterol. These results suggest that the heterozygote state for LPL deficiency may form one subset of FCHL. PMID- 2719597 TI - Atherosclerosis in rabbit vein grafts. AB - Human coronary saphenous vein bypass grafts develop atherosclerosis more readily than do grafts made of internal mammary artery. The reasons for this increased susceptibility, particularly in the presence of hyperlipidemia, are not known. In this study in rabbits, we investigated the possibility that the increased susceptibility might be attributed to increased smooth muscle proliferation and foam cell accumulation in vein grafts compared to native artery. Hypercholesterolemic and control rabbits underwent placement of jugular vein grafts in the carotid artery. Dietary cholesterol content was adjusted to maintain serum cholesterol levels of 200 to 600 mg/dl in the fat-fed rabbits. The vein graft intimal thickness in hypercholesterolemic rabbits was greater than in normolipemic rabbits at 3 and 6 months after implant. The increased thickness in the hypercholesterolemic group was largely accounted for by an accumulation of lipid-laden macrophages. Medial thicknesses increased during the first month, remained constant at later times, and were similar in control and hypercholesterolemic animals. In both groups, endothelial and smooth muscle cell proliferation (thymidine labeling) increased immediately after graft implantation and declined at 3 and 6 months. No incremental mitogenic stimulus could be attributed to the hypercholesterolemia. In immunohistochemical preparations, the large foam cells were noted to be macrophages, and the intimal proliferating cells, to be smooth muscle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719598 TI - Factors associated with high density lipoprotein cholesterol in a population with high high density lipoprotein cholesterol levels. AB - A cross-sectional study of a random sample of 976 coloureds (mixed race) of the Cape Peninsula, ages 15 to 64 years old, revealed a population with unexpectedly high levels of high density lipoprotein (HDL) cholesterol. The mean level for men was 55.4 +/- 16.1 mg/dl (SD) and for women, 60.8 +/- 16.0 mg/dl. The ratio of HDL cholesterol to total cholesterol expressed as a percentage was 26.3% +/- 9.5% for men and 28.1% +/- 9.3% for women. The HDL cholesterol levels were apparently lower than those of black and Negro populations, yet higher than those of Caucasian populations. Men with levels of HDL cholesterol above the median reported a personal history and a family history of coronary heart disease less frequently than did men with lower levels, while women with high levels of HDL cholesterol were less likely to have a history of hypertension or diabetes. Stepwise multiple regression analysis of variables significantly associated with HDL cholesterol levels showed that they explained 29.7% and 24.7%, respectively, of the variation in HDL cholesterol in men and women. Those variables independently associated with HDL cholesterol in both men and women were: serum triglyceride (-), cigarette consumption (-), alcohol, body mass index (-), age, and serum low density lipoprotein cholesterol levels (-). The reasons for the relatively high HDL cholesterol levels in this population are unknown. However, it would seem possible that these levels offer some protection against the high risk factors of smoking, hypertension, and hypercholesterolemia. PMID- 2719599 TI - Oxidative modification of beta-very low density lipoprotein. Potential role in monocyte recruitment and foam cell formation. AB - Oxidative modification of low density lipoprotein (LDL) generates a form that is degraded much more rapidly by macrophages and may thus be more atherogenic than unoxidized LDL. Recently, we provided evidence that oxidative modification of LDL may play a significant role in the generation of fatty streaks in the LDL receptor-deficient rabbit. The major lipoprotein in cholesterol-fed animals is the beta-very low density lipoprotein (beta-VLDL). Since beta-VLDL is avidly taken up by macrophages, it could lead to foam cell formation without the need for oxidative modification or modification of other kinds. However, the present studies show that beta-VLDL can be oxidized by incubation with endothelial cells or with copper ions. Oxidized beta-VLDL was degraded by macrophages at about twice the rate of unoxidized beta-VLDL, and it stimulated cholesterol esterification twice as much as unoxidized beta-VLDL. The degradation of oxidized beta-VLDL was inhibited either by oxidized beta-VLDL itself or by oxidized LDL, but not by unoxidized beta-VLDL. beta-VLDL was chemotactic for human monocytes and contained significant amounts of lysophosphatidylcholine, previously shown to be a chemotactic agent. In summary, oxidized LDL is degraded by macrophages proportionately more than oxidized beta-VLDL as compared to the unmodified lipoproteins. However, the twofold increase may, nevertheless, be significant in the atherogenicity of beta-VLDL. PMID- 2719600 TI - Differential distribution of apolipoprotein E isoforms in human plasma lipoproteins. AB - The polymorphism of apolipoprotein E (apo E) accounts for a substantial amount of the genetic variance of cholesterol levels in man. The epsilon-2 allele and the epsilon-4 allele raises plasma and low density lipoprotein cholesterol levels as compared to the epsilon-3 allele. Whereas the lower cholesterol levels in carriers of the epsilon-2 allele can, at least in part, be attributed to the grossly deficient binding of apo E-2 to the apo B,E receptor, apo E-3 and E-4 bind to the same degree. We used gel filtration and ultracentrifugation to separate lipoproteins and subsequent immunoblotting analysis to study the apo E isoform distribution. We always found lipoproteins of lower density relatively enriched in apo E-4 and high density lipoproteins relatively depleted of apo E-4 as compared to apo E-3. This was also seen in plasma of heterozygous subjects that simultaneously express two apo E isoforms. Also, the apo E-A-II complex was directly shown by immunoblotting. Furthermore, when purified iodinated apo E was incubated with plasma in vitro, apo E-4 also reassociated more with lipoproteins of lower density than apo E-3. We conclude that apo E-3 and apo E-4 have a different lipoprotein particle distribution in vivo. This differential lipoprotein distribution may account for differences in the metabolism between apo E-3 and E-4. PMID- 2719601 TI - Quality assurance in dietetics: a criteria audit study. PMID- 2719603 TI - Audit of investigation and follow-up of patients with raised monoclonal proteins. AB - OBJECTIVE: To assess the adequacy of investigation and later review of patients with serum monoclonal proteins detected in our laboratory. METHOD: To review all monoclonal proteins detected and to search through the laboratory computerized records for evidence of further investigation and later review. RESULTS: Nine per cent of monoclonal proteins detected were not followed up at all. A urine examination to detect Bence-Jones protein was not requested in 12% of those regularly followed up. The mean age of the patients studied was 69 years, but there were eight patients under 60 years who had multiple myeloma. PMID- 2719602 TI - Residents' evaluation of a therapeutic community. AB - OBJECTIVE: To determine former residents' views of a therapeutic community and factors associated with a good response to therapy. METHOD: Retrospective, using a self-report questionnaire. RESULTS: Of 51 contactable former residents, 32 completed the questionnaire. Responses were generally very positive, although the best outcome was reported by those who held a social-interpersonal rather than a biological view of psychiatric disorder, and who scored close to normal on a measure of intropunitiveness. Respondents emphasized the crucial role of feedback and confrontation by staff and co-residents in changing their unhelpful behaviour and attitudes, although a few thought that confrontations were too forceful. The mean duration of psychiatric disorder (mainly substance abuse and personality disorder) was more than 4.5 years. Many respondents emphasized the failure of orthodox treatments to help them, adding that their disorders would probably have continued indefinitely without treatment in a therapeutic community. PMID- 2719604 TI - Results of cardiopulmonary resuscitation in adult patients managed in a teaching hospital: clinical outcome and implications. AB - OBJECTIVE: To assess the impact and clinical implications of therapeutic strategies for managing sudden cardiac arrest in a teaching hospital. METHOD: A prospective audit of the results of out-of-hospital and in-hospital cardiac arrest. RESULTS: Compared with other studies, our results for resuscitation of out-of-hospital cardiac arrest were poor, only 5% of patients being discharged. This probably relates to the inability to revert ventricular tachycardia or ventricular fibrillation promptly by defibrillation. Improving access to defibrillation at the scene of cardiac arrest could improve the results of out-of hospital cardiac arrest. In contrast, among patients with in-hospital cardiac arrest. In contrast, among patients with in-hospital cardiac arrest, 14% of patients in monitored wards, and 24% of patients in unmonitored wards, were discharged (P less than 0.05). When cardiac arrest is not associated with acute myocardial infarction, survivors require thorough investigation and treatment to prevent recurrence. PMID- 2719605 TI - A test of infection control reporting. PMID- 2719606 TI - What constitutes a quality health service in the 1980s? PMID- 2719608 TI - Craniofacial surgery: the interface. PMID- 2719607 TI - Survey of falls of inpatients at the Ryde Hospital in 1986. AB - OBJECTIVE: To outline the findings of one survey, and to raise some general issues about falls. METHOD: A retrospective survey of all recorded inpatient falls in 1986. RESULTS: There were 74 falls recorded in 1986, which gave an incidence rate of 0.184 falls per hundred bed days. Due to the lack of data on falls from other local hospitals, no meaningful comparison can be made. Not unexpectedly, the elderly were at greatest risk of falling, and the most common type of fall was from bed. Most falls caused no major injuries. PMID- 2719609 TI - Place and training of the surgeon in breast cancer screening. AB - The screening service needs to function efficiently and fulfil its objectives with the minimum of disturbance to the woman screened; for this to happen the full involvement of specialists with extra expertise in the subject is required. The surgeon should be involved in the interests of the programme, of the women screened and of surgery as a whole; if surgeons do not become involved they could find themselves bypassed by screening units referring to radiation oncologists, which would be to the great detriment of the patients. Local issues as to who should become the involved surgeon and with regard to the general practitioners' standing must be resolved. It would indeed be a damning indictment of medical ethics if these issues of self-interest were to stand in the way of lowering mortality rates due to breast cancer. PMID- 2719610 TI - An approach to malignant parotid tumours. AB - A series of 30 patients with malignant parotid tumours selected for surgical treatment is presented. There were 18 males and 12 females, with an age range of 12-80 years. All presented with a parotid lump, one had an associated painful facial nerve palsy and one had clinically involved neck nodes. Four had previous surgery, surgical biopsy or radiotherapy. Pre-operative fine needle aspiration was performed on one patient. Postoperative radiotherapy was administered to 14 patients. Follow-up was for a mean of 5.5 years. The primary tumour was controlled by surgery alone in 15 of the 16 patients. There was one local recurrence and two patients in this group died from distant metastases. Of the group receiving postoperative radiotherapy, there was one local recurrence, one local and neck recurrence and one death from distant metastases. Mobile, discrete tumours can be treated by parotidectomy with preservation of the facial nerve and the selective use of radiotherapy. The malignant tumour with restricted mobility but no facial palsy is treated by parotidectomy, sacrificing only involved branches and postoperative radiotherapy. The clinically fixed lesions with facial palsy demand total parotidectomy in operable cases, nerve sacrifice and postoperative radiotherapy. PMID- 2719611 TI - Management of solitary melanoma metastasis of the brain. AB - A retrospective analysis of 31 patients operated upon for cerebral secondary melanoma was conducted. There was no operative mortality and no operative complications in 76% of cases. Significant and life-threatening complications occurred in five patients (17%). The major benefit from surgical excision is relief of symptoms: 64% had complete remission of symptoms while a further 20% were substantially improved. A few patients' lives were prolonged by surgery and there are a number of long-term survivors. Surgical excision should be performed when a patient has an accessible solitary cerebral secondary without evidence of melanoma elsewhere. PMID- 2719612 TI - Primary gastric lymphoma in Auckland, New Zealand. AB - The case-notes of 30 patients presenting with primary gastric lymphoma in the Auckland area during 1969-87 have been reviewed. The mean age of the study group was 62 years, and 16 were female and 14 were male. There were 22 European, one Maori and seven Polynesian patients. The most common presenting symptom was abdominal pain and five patients presented acutely with gastrointestinal haemorrhage. The lesions occurred more frequently in the distal stomach and half were polypoid and half were ulcerating. They tended to be of substantial size at presentation, with seven being greater than 10 cm in diameter. Nine lesions were confined to the stomach, 12 involved the surrounding lymph nodes and eight were invading adjacent organs. Twenty-three patients underwent partial or total gastrectomy. Four of these received postoperative radiotherapy, and adjuvant chemotherapy was administered to 13. Chemotherapy, or combination chemo- and radiotherapy were used as the primary treatment in seven patients. Following surgical treatment, 18 patients remained alive and well. Five of the seven patients treated nonsurgically were dead of disease at the time of study and the other two remained alive with persisting disease. The following factors were found to affect prognosis adversely: weight loss of greater than 5 kg, tumour invasion of adjacent organs, and non-surgical primary treatment. Involvement of the lymph nodes draining the stomach did not appear to worsen the outlook, and there was little correlation between lesion size and prognosis. PMID- 2719613 TI - Aneurysms of the visceral arteries. AB - Visceral artery aneurysms are uncommon. During the period 1975-88, 32 patients were treated at the Royal Melbourne Hospital for true and false visceral artery aneurysms. There were 18 males and 14 females, with an age range of 12-86 years. Of the 32 patients, 26 were symptomatic and six were asymptomatic. True aneurysms were found in 20 patients and false aneurysms in 10. A further two were dissecting aneurysms. Of the arteries involved, 17 were renal, six were hepatic, five were splenic, one was superior mesenteric, one was left colic and there were two patients with aneurysms at multiple sites. Aetiological factors included atherosclerosis, fibromuscular dysplasia, pancreatitis, and trauma. Only one patient presented in pregnancy. Rupture occurred in 12 patients and two died as a result of this complication. All the true hepatic artery aneurysms presented in this way. Pre-operative investigations included plain radiology, computerized tomography with contrast, nuclear scanning and selective angiography. Operative treatment was required in 22 cases, 12 as an emergency and 10 as an elective procedure. Surgical options included aneurysm excision with or without arterial reconstruction, aneurysmorrhaphy with flap arterioplasty, or ligation of the aneurysm. Embolization was successfully employed in two patients and eight were merely observed without complications. Surgical therapy is recommended for any patient with symptoms, for any woman of child-bearing age and for all hepatic artery aneurysms. PMID- 2719614 TI - Chronic Budd-Chiari syndrome due to congenital membranous obstruction of the inferior vena cava: clinical experience. AB - Budd-Chiari syndrome due to congenital membranous obstruction of inferior vena cava can be cured by appropriate surgical correction. A high index of suspicion is required to identify this condition and investigate it properly. Experience of three such cases is presented; two had a successful surgical correction and one refused any surgical intervention. Both patients who underwent operation are doing well and are symptom-free after 4 and 6 years, respectively. The diagnosis and the presentation of inferior vena caval obstruction and the various surgical procedures that are available for relieving the congenital obstruction of inferior vena cava are reviewed. PMID- 2719615 TI - Management of the pelvic space following low anterior resection. AB - Four cases of low anterior resection without pelvic drainage are described. The outcome was unsatisfactory in three of the four patients. The role of pelvic drains and omentum in the management of the pelvic space following low anterior resection for rectal cancer is reviewed and discussed. Pelvic drains are required to remove blood and omentum may be used to fill the pelvic space. Pelvic collections are related to anastomotic leakage and the optimal management of the pelvic space can reduce the incidence of this complication. A suggested regimen for management of the pelvic space after low anterior resection is outlined. PMID- 2719616 TI - A comparison of heat exchangers for blood cardioplegia. AB - During open heart surgery, myocardial protection provided by oxygenated blood based cardioplegia is superior to that provided by non-oxygenated crystalloid cardioplegia. However, the widespread use of blood cardioplegia has been limited by the cost and complexity of the associated cooling and delivery systems. The performance of a simple system--a polyethylene coil immersed in ice--has been compared with three systems incorporating specialized, water-jacketed heat exchangers: Buckberg Shiley, Shiley BCD and Bentley HE-100. Blood was diluted to a haematocrit of 22% and delivered to each cooling system at flow rates of 200 500 mL/min and temperatures of 25 degrees C and 30 degrees C. Cooling water at 0 1 degree C was supplied to the heat exchangers at flow rates of 2, 4, and 6 L/min. Performance was measured by comparing the blood outflow temperatures at the same inflow temperature under a variety of test conditions which simulated those occurring in clinical practice. All cooling systems, except the Buckberg Shiley, were able consistently to cool blood cardioplegia adequately (below 10 degrees C), but the ice coil was the most effective. The heat exchanger systems are 3-4 times more expensive than the ice coil and require an external source of cold water. Thus the ice coil system has the advantages of simplicity, efficiency, and economy. PMID- 2719617 TI - Metastasis in a patella: a rare site. AB - Primary neoplasms of the patella are rare, and metastases of the patella are rarer still. A case is presented of a 64 year old woman whose pain in the left knee, resulting from patellar neoplasms, was subsequently found to result from secondary spread from a renal adenocarcinoma. PMID- 2719618 TI - Conservative management of a Yersinia enterocolitica hepatic abscess. AB - Yersinia hepatic abscesses are rare, and are more likely to occur in patients with iron overload. A diabetic patient with haemochromatosis presented with a hepatic abscess due to Yersinia enterocolitica, which was treated successfully by the use of a single antibiotic. PMID- 2719619 TI - Rectal endometriosis. PMID- 2719620 TI - Bias in correlations from selected samples of relatives: the effects of soft selection. AB - Martin and Wilson (1982) describe two forms of sampling bias in twin studies. One is "hard selection," where individuals above a threshold participate, and those below do not. The second is "soft selection," where the probability of including a pair of relatives varies over the range of the character. We present an alternative model of soft selection which has strikingly different consequences for the resemblance between relatives. In general, the softer the threshold, the more the correlation resembles that in the underlying population. Results are presented where the probability of selection equals the cumulative distribution function of a normal distribution with 10% of the variance of the selected variable. In these circumstances, soft selection usually leads to less severely attenuated correlations than truncate selection. PMID- 2719621 TI - Genotypic influences on lead-induced hyperactivity in mice. AB - Male mice, genetically selected for differences in brain weight or from a heterogeneous (HET) stock, were used to explore potential interactions between genotype and exposure to lead as manifested in activity. At the time of birth dams and their pups were given either water or a 0.5% lead acetate solution as the sole source of fluid. Fluid conditions remained constant throughout the experiment. The effects of chronic lead on activity in young adult mice depended on the genotype of the individual. Specifically, in an open field, HET mice exposed to lead tended to be more active than their control counterparts. Low- and high-brain weight lead-exposed mice at times were hypoactive but this effect depended on the specific nature of the measure. PMID- 2719622 TI - Genetic and environmental determinants of musical ability in twins. AB - Analyses of musical ability data from the Loehlin and Nichols National Merit Scholarship study are presented. Musical ability is indexed by four measures: interest in a profession in music, performance in school, performance outside of school, and receiving honors in music. These variables pose a challenge for behavior genetic analysis since they do not conform to the assumptions of traditional linear models. For example, there is a dependent relationship between the honors and the performance variables; one cannot obtain honors without performance. Several methods were employed to deal with these relationships, and the following conclusions appeared regardless of the method used. First, twin correlations were always high, ranging from 0.44 to 0.90 in monozygotic (MZ) twins and from 0.34 to 0.83 in dizygotic (DZ) twins. Second, although there was evidence for heritable variation, the effects of common environment were almost always larger than the effects of heredity. Third, marital assortment was not of sufficient magnitude to account for these common environment effects. In the young adults in this sample, musical ability is influenced more by shared family environment than by shared genes. PMID- 2719623 TI - Multivariate path analysis of specific cognitive abilities in the Colorado Adoption Project: conditional path model of assortative mating. AB - A multivariate path model of genetic and environmental transmission employing a conditional path representation of assortative mating was fitted to specific cognitive abilities data from the Colorado Adoption Project and evaluated using a maximum-likelihood estimation procedure. In agreement with results obtained from a previous analysis of a smaller data set, significant genetic covariation among the cognitive variables was indicated and evidence for a general genetic factor was found. However, cultural transmission parameters are nonsignificant and environmental correlations among the measures are relatively small. PMID- 2719624 TI - Genetic and environmental contributions to the covariance between occupational status, educational attainment, and IQ: a study of twins. AB - Scores of occupational status, educational attainment, and IQ were obtained for 507 monozygotic and 575 dizygotic male twin pairs born 1931-1935 and 1944-1960. A multivariate genetic analysis with statistics from different cohorts showed heterogeneity between cohorts, and analyses were performed in four separate cohorts. The only set of results which departed clearly from the rest was found for the group born 1931-1935, where the ratio of environmental to genetic effects exceeded those of the other groups. Typical heritability values in the three youngest groups (weighted means) were .43, .51, and .66 for occupation, education, and IQ, respectively. The values in the oldest group were .16, .10, and .37, but this sample is small and the estimates are unstable. Genetic variance influencing educational attainment also contributed approximately one fourth of the genetic variance for occupational status and nearly half the genetic variance for IQ. The values for the between-families variances (reflecting family environment and assortative mating) varied from 2 to 35% in the three youngest groups but were higher for education (62%) and IQ (45%) in the oldest groups. All the between-families variance was common to all three variables. For educational attainment and IQ, the bulk of this between-families variance is probably genetic variance due to assortative mating. The common factor environmental within-family variances were generally small, and the specific estimates seemed to contain mainly measurement error. PMID- 2719625 TI - Spouse similarity for IQ and personality and convergence. AB - A similar pattern of spousal association for IQ scores and personality traits was found in two British samples from Oxford and Cambridge. There was no indirect evidence from either sample to suggest that convergence occurred during marriage. All observed assortative mating might well be due to initial assortment. PMID- 2719627 TI - Environmental influences on the preferences of wild female house mice for males of differing t-complex genotypes. AB - Twenty-five percent of wild house mice are heterozygous (+/t) for a deleterious, recessive mutation at the t complex. In previous studies we have demonstrated that wild female house mice can discriminate +/+ from +/t males and show strong preferences for the odors of males who do not carry t mutations. In the present study we examine the extent to which preferences of +/+ female mice are influenced by the genotype of their parents and or littermates. Our data indicate that when +/+ females are reared by two +/+ parents, they exhibit strong preferences for the odors of +/+ males. In contrast, when a +/+ female is reared by one +/+ and one +/t parent she shows no preference for males of either genotype. A second experiment using mice carrying recombinant chromosomes indicates that the genes responsible for the parental (or family) odor cue are not the deleterious t mutations per se but rather other genes linked to these mutations. PMID- 2719626 TI - Genetic influences on spatial ability: transmission in an extended kindred. AB - Transmission of six spatial tests, Card Rotations, Cube Comparisons, Group Embedded Figures, Hidden Patterns, Mental Rotations, and portable Rod and Frame, is examined among 73 members in four generations of an extended kindred. Nonadditive genetic variance is substantial for one of the six tests, Card Rotations. Whether this nonadditive genetic variance is due to a major autosomal gene is equivocal based on results from segregation and linkage analysis. There is no evidence for genetic variance for Mental Rotations or Hidden Patterns, in contrast to previous findings suggesting major gene involvement (Ashton et al., 1979). If spatial ability is due, in part, to an autosomal major gene, the gene has variable expression (reflected in different tests) or genetic heterogeneity is pronounced. PMID- 2719629 TI - [The occurrence of Treponema in fecal samples from dogs and cats with and without intestinal diseases]. AB - 6 (6.9%) of 87 examined dogs without diarrhoea proved to be carriers of Treponema (1x T. hyodysenteriae, 5x T. innocens), whereas in fecal samples from 62 dogs with enteric symptoms no isolation of Treponema succeeded. 5 fecal samples (3.7%) of cats without signs of diarrhoea were found to contain Treponema (1x T. hyodysenteriae, 4x T. innocens), whereas the fecal samples of 31 cats with diarrhoea didn't show any growth of Treponema by cultural investigations. Due to the results of these investigations the conclusion can be drawn that Treponema belong to the usual bacteria of dogs' and cats' intestines and cannot be suspected to cause diarrhoea in these animals primarily. PMID- 2719628 TI - Studies into the mechanisms of strain differences in hippocampus-related behaviors. AB - The heterogeneous mouse stocks HS/Ibg and SABRA/HUC and the inbred strains C57BL/6J, CBA/LAC, and BALB/Crgl were employed in an investigation of strain differences in delayed spontaneous alteration (SA) and eight-arm maze performance (EAM). Intact male mice were tested for SA at age 41 days for 2 consecutive days and for EAM at age 50-54 days, under conditions of water deprivation that commenced on day 43. In SA, BALB mice had a lower score than all other strains on day 1 but differed significantly only from SABRA; performance on day 2 was not consistent with that on day 1. In EAM, HS was first, CBA second, C57 third, SABRA fourth, and BALB fifth. HS was superior to the other strains, while BALB fell far below all other strains in both tests. Except for these two strains, the correlation between the two tests across the other strains was low. A study was undertaken to investigate the role of the hippocampus in the deficits in the performance of BALB mice in the two behaviors. Noradrenergic neurons were transplanted to hippocampus or cortex, and cholinergic neurons to their hippocampus. There were no significant differences in performance between the control and transplanted mice. The possibility was discussed that the behavioral differences are the outcome of variability in the neurotransmitters systems of the hippocampus but probably not the noradrenergic system. PMID- 2719630 TI - [Risks of intravenous injection into the tail of cattle]. AB - Since several years collecting blood from the tail vessels in bovine practice gained a wider range of propagation. Recently veterinarians tried to inject drugs intravenously into the tail vessels of the bovine tail. Therefore we carried out anatomical studies concerning the position of the blood vessels of the bovine tail. 24 tails of slaughtered cattle, which were of different breeds and age (1-4 years old), were examined in respect to the course of their arteries and veins as well on the ventral side. By means of necropsy, frozen cross sections, corrosion anatomy and radiography the position of the tail vessels to each other were compared. In the area of the 2nd to 7th coccygeal vertebra the position of the arteries and veins were being determined. Following results were obtained: 1. The A. cocc. med. runs always ventral in the midline of the tail. 2. The number of ventral veins proximal on the tail varies from 1 to 3. 3. The course of the Vena(ae) cocc. mediana(ae) in the tail region examined is inconstant. The vein lies either left, right, dorsal or ventral of the A. cocc. med. The vein can also cross the area. 4. In 8 of 19 examined cases the V. cocc. med. was closely left to the artery (area of the 5th coccygeal vertebra). After radiologic examination it can be stated that this region can be used for collecting blood of the V. cocc. med. In case of intravenous application of considerable amounts of drugs into the vein of the tail a certain portion can get easily into the closely attached artery and severe complications, as necrosis of the tail can occur. Therefore our clinic recommends generally the use of the Vena jugularis externa for intravenous injection. PMID- 2719631 TI - [Aeromonas hydrophila-related septicemia in the Nile tilapia Oreochromis niloticus]. AB - From diseased wild and cultured Oreochromis niloticus in Lower Egypt, 17 Aeromonas hydrophila isolates were recovered. The mortality was between 10% and 70% in among cultured fish. The course of the disease ran in an acute manner. For cultured fish, the disease outbreaks were found mainly in winter and for the wild Nile fish, mortalities were observed in late spring and summer. Additionally wild fish were affected with ectoparasites. The LD50 values of the isolates ranged between 10(3) and 10(7). Isolates of high virulence were resistant to 1 hr boiling and to the bactericidal effect of fresh normal guinea pig serum. Moreover, they did not agglutinate in acriflavin. Only the virulent isolates could agglutinate tilapia erythrocytes. The above effects were reversed for avirulent isolates while moderately virulent isolates showed no consistency in their reactions. Tube agglutination test using O and WC antisera prepared against 6 isolates versus O and WC antigens of 17 isolates indicated an antigenic heterogenicity of different isolates. While some isolates were identical, 4 antigens out of 17 did not react with any of the sera. PMID- 2719632 TI - [New approaches to the secretolytic therapy of chronic bronchitis in dogs]. AB - 6 dogs with chronic obstructive pulmonary disease (COPD) are treated with acetylcysteine and get three infusions of isotonic NaCl (7-10% of body weight). Their dyspnea is visibly improved. Their therapeutic benefit is objectified by radiology and blood gas parameters. PMID- 2719633 TI - [The prevention of atrophic rhinitis of swine]. AB - In a pig breeding unit that for years had been infected with Atrophic Rhinitis, the weaned piglets were divided into four groups. Group 1 (10 weaned piglets) - Their mother was vaccinated with 2 ml Rhinipig i.m. 3 weeks prior to farrowing. - The piglets received 0.2 ml each of Pargenta 50 (= 10 mg Gentamycin) i.m. on the third, fifth and seventh days after birth. --The piglets were fed a food containing 10 ppm Gentamycin-base during the 6 weeks following their weaning. Group 2 (10 weaned piglets) --Their mother was vaccinated with 2 ml Rhinipig i.m. 3 weeks prior to farrowing. --The piglets received 0.2 ml each of Pargenta 50 (= 10 mg Gentamycin) i.m. on the third, fifth and seventh days after birth. Group 3 (10 weaned piglets) --Their mother was vaccinated with 2 ml Rhinipig i.m. 3 weeks prior to farrowing. Group 4 (10 weaned piglets, untreated, experimental control group) After 6 weeks of treatment, Group 1 showed significantly better food conversion and daily weight gain when compared to the other groups. PMID- 2719634 TI - [A simple test phantom in the form of a staircase for running control of the image in veterinary roentgenology]. AB - Quality control in veterinary radiology seems to be neglected. For the correct estimation of the radiographic quality, there is no adequate phantom available. Although measurements have shown that the exposure to radiation is far under the admissible limits, the quantity of repeated examination has to be reduced. So it was necessary to create a phantom, which allows the objective judgement of the x ray photograph taken immediately from the patient. The phantom shows the following characteristics: 1) It is small-sized, so that it can be represented on the radiograph together with the object, but without remarkable enlargement of the beam and additional exposure to radiation. 2) It consists of tissue-similar material, which absorbs and scatters x-rays similar to the body region. According to the fact that the indications for radiographs in veterinary medicine are mostly problems in skeleton regions, this region is represented first of all. 3) Therefore the phantom shows variable thickness, so that it can simulate different skeleton parts. 4) The represented parameters are: 4.1 the different radiographic densities; 4.2 the latitude; 4.3 the radiographic contrast; 4.4 the radiographic detail visibility (film-far, film-close) in the relevant parts of the x-ray picture 5) The phantom is universally applicable. By a way of "calibration" it is multipurpose for certain kinds and sizes of animals. PMID- 2719635 TI - [Variations in the concentrations of the immunoglobulins IgG1, IgG2, IgM and IgA in sheep. 1. Changes in the blood serum and in the milk of sheep of different breeds and cross-breeds during lactation]. AB - A total of 103 ewes from the breeds Black mutt., Texel, Finn. L., Heidschnucke and the crossbreeds Texel x Finn. L. and Black. mutt. x Finn. L. was studied. Blood samples were drawn at days 1, 7, 21 and 42 and milk samples at the 4th, 12th, 24th and 72nd hour after the onset of lactation and subsequently on days 7, 21 and 42. The concentrations of the immunoglobulins IgG1, IgG2, IgM and IgA were assayed in serum and milk. The following results were obtained: 1. The total immunoglobulin contents in the serum was not significantly different between breeds. 2. All ewes showed a rise in serum immunoglobulin concentrations by about one third over the first six weeks of lactation. Between 50-60% of this increase were on the account of IgG1. 3. The serum concentration of IgG1 and IgG1 rose as of the third day, those of IgM as of day 21 after lambing. 4. The rise in serum immunoglobulin concentration continued after the weaning of the lambs. 5. The ratio of IgG1 to IgG1 in ewe serum was 2:1. 6. The immunoglobulin concentration in milk dropped sharply on the first day of lactation, followed by a continuous, more gradual decrease over the entire course of lactation. A terminal rise, as observed in sows, could not be detected. 7. The ratio of IgG1:IgG2 : IgM : IgA in the whey changed from 85 : 1 : 12 : 2 on day one to 70 : 7 : 12 : 11 on the last day of lactation. 8. While characteristic trends in immunoglobulin patterns in the sera of ewes over the course of lactation are clearly discernible, it is not possible to denote "normal" values. PMID- 2719636 TI - Purification of aldehyde dehydrogenase from rat liver mitochondria by alpha cyanocinnamate affinity chromatography. AB - 1. alpha-Cyano-4-hydroxycinnamate was coupled to Sepharose CL-4B activated with 1,2:3,4-bisepoxybutane. 2. The low-Km rat liver mitochondrial aldehyde dehydrogenase was specifically bound to this affinity medium, and could subsequently be eluted with alpha-cyano-4-hydroxycinnamate. 3. The enzyme purified in this manner had a subunit molecular mass of 55 kDa and a pI of approx. 6.5. A minor component of approx. 57 kDa was also present and had a significantly higher pI value; this may be the precursor for aldehyde dehydrogenase. 4. alpha-Cyanocinnamate and some related compounds were found to be uncompetitive inhibitors of the enzyme. 5. No cytosolic aldehyde dehydrogenase was bound to the affinity column, but a protein from a rat liver post mitochondrial supernatant with a molecular mass of approx. 25 kDa was bound, and could be eluted subsequently with alpha-cyano-4-hydroxycinnamate. PMID- 2719637 TI - Involvement of thiol transferase- and thioredoxin-dependent systems in the protection of 'essential' thiol groups of ornithine decarboxylase. AB - Ornithine decarboxylase (ODC), an enzyme with 'essential' thiol group(s), may be inactivated in vitro by removal of thiol reducing agents and re-activated by soluble factors from rat liver in the presence of NADPH or GSH. The NADPH- and GSH-dependent reducing systems were separated and resolved into three components, called factors A, B1 and B2, by chromatographic techniques. Factor B1 (Mr 12,000) could reactivate ODC in the presence of GSH and co-purified with thiol transferase activity. Factor B2 (Mr 12,000) and factor A (Mr approx. 110,000) were both needed to re-activate ODC in the presence of NADPH, and co-purified with thioredoxin and thioredoxin reductase activity respectively. In an attempt to investigate the physiological role of the 'essential' thiol group(s) of ODC, erythroleukaemia cells were incubated with NN-bis-(2-chloroethyl)-N'-nitrosourea, t-butyl hydroperoxide and vinblastine, which are known to increase the cellular GSSG/GSH ratio, azelaic acid, an inhibitor of thioredoxin reductase, and sodium arsenite, a strong inhibitor of the ODC-re-activating factors. All these compounds were able to decrease significantly the ODC activity induced in these cells. These results suggest that the thiol transferase- and thioredoxin dependent systems may be physiologically relevant in maintaining ODC in the active, reduced, state. PMID- 2719638 TI - Primary role of calcium ions in arachidonic acid release from rat platelet membranes. Comparison with human platelet membranes. AB - The liberation of arachidonic acid (AA) was investigated in platelet membranes prelabelled with [3H]AA. In rat platelet membranes, Ca2+ at concentrations over several hundred nanomolar induced [3H]AA release, with a concurrent decrease in 3H radioactivity of phosphatidylethanolamine and phosphatidylcholine. Some 4-6% of total radioactivity incorporated into platelet membrane lipids was released at 1-10 microM-Ca2+, which is nearly equivalent to that attained in agonist stimulated platelets. Formation of lysophospholipids in [3H]glycerol-labelled membranes and decrease in [3H]AA liberated by the phospholipase A2 inhibitors mepacrine and ONO-RS-082 suggest that [3H]AA release is mainly catalysed by phospholipase A2. In intact platelets agonist-stimulated [3H]AA release was markedly decreased in the absence of extracellular Ca2+ or in the presence of the intracellular Ca2+ chelator quin 2. These results indicate that in rat platelets the rise of intracellular Ca2+ plays a primary role in the activation of phospholipase A2. In contrast, Ca2+ even at high millimolar concentrations did not effectively stimulate [3H]AA release in human platelet membranes. Thus factor(s) additional to or independent of Ca2+ is required for the liberation of AA in human platelets. PMID- 2719639 TI - Unusual amino acid sequence of fasciatoxin, a weak reversibly acting neurotoxin in the venom of the banded krait, Bungarus fasciatus. AB - A weak reversibly acting neurotoxin, fasciatoxin, was found in the venom of Bungarus fasciatus. The sequencing was completed by manual and automated Edman analyses of the reduced and carboxymethylated protein and of the peptides obtained from enzyme digestions. It is composed of 63 amino acid residues with four disulphide bonds and a unique sequence at the C-terminal end. According to the criteria set by Ryden, Gabel & Eaker [(1973) Int. J. Pept. Protein Res. 5, 261-273], fasciatoxin lacks all of the five functionally invariant residues of neurotoxins. The hydropathy index indicates that fasciatoxin is devoid of a strong hydrophilicity domain for binding to the receptor site. Structural comparison with some typical neurotoxins also reveals the uniqueness of fasciatoxin in that the extent of similarity is only about 30%. PMID- 2719640 TI - Lipoprotein lipase activity in neonatal-rat liver cell types. AB - The lipoprotein lipase activity in the liver of neonatal (1 day old) rats was about 3 times that in the liver of adult rats. Perfusion of the neonatal liver with collagenase decreased the tissue-associated activity by 77%. When neonatal rat liver cells were dispersed, hepatocyte-enriched (fraction I) and haemopoietic cell-enriched (fraction II) populations were obtained. The lipoprotein lipase activity in fraction I was 7 times that in fraction II. On the basis of those activities and the proportion of both cell types in either fraction, it was estimated that hepatocytes contained most, if not all, the lipoprotein lipase activity detected in collagenase-perfused neonatal-rat livers. From those calculations it was also concluded that haemopoietic cells did not contain lipoprotein lipase activity. When the hepatocyte-enriched cell population was incubated at 25 degrees C for up to 3 h, a slow but progressive release of enzyme activity to the incubation medium was found. However, the total activity (cells + medium) did not significantly change through the incubation period. Cycloheximide produced a time-dependent decrease in the cell-associated activity. Heparin increased the amount of lipoprotein lipase activity released to the medium. Because the cell-associated activity was unchanged, heparin also produced a time dependent increase in the total activity. In those cells incubated with heparin, cycloheximide did not affect the initial release of lipoprotein lipase activity to the medium, but blocked further release. The cell-associated activity was also decreased by the presence of cycloheximide in those cells. It is concluded that neonatal-rat hepatocytes synthesize active lipoprotein lipase. PMID- 2719641 TI - Effects of increasing extracellular pH on protein synthesis and protein degradation in the perfused working rat heart. AB - Increasing the extracellular pH over the range pH 7.4-8.9 stimulated protein synthesis by about 60% in the rat heart preparation anterogradely perfused in vitro. Protein degradation was inhibited by this pH increase. The magnitudes of the effects at pH 8.9 on protein synthesis and degradation were similar to those of high concentrations of insulin. Cardiac outputs were increased, as were cardiac phosphocreatine contents, indicating that the alterations in extracellular pH did not adversely affect the physiological viability of the preparation. ATP contents were unaltered. The creatine kinase equilibrium was used to assess the magnitude of the change in intracellular pH induced by these treatments. The increase in intracellular pH was about 0.2 for a 1-unit increase in extracellular pH. Thus small changes in intracellular pH have dramatic effects on cardiac protein turnover. PMID- 2719642 TI - Oxidative and non-oxidative mechanisms in the inactivation of cardiac mitochondrial electron transport chain components by doxorubicin. AB - The quinonoid anthracycline, doxorubicin (Adriamycin) is a potent anti-neoplastic agent whose clinical use is limited by severe cardiotoxicity. Mitochondrial damage is a major component of this cardiotoxicity, and rival oxidative and non oxidative mechanisms for inactivation of the electron transport chain have been proposed. Using bovine heart submitochondrial preparations (SMP) we have now found that both oxidative and non-oxidative mechanisms occur in vitro, depending solely on the concentration of doxorubicin employed. Redox cycling of doxorubicin by Complex I of the respiratory chain (which generates doxorubicin semiquinone radicals, O2-, H2O2, and .OH) caused a 70% decrease in the Vmax. for NADH dehydrogenase during 15 min incubation of SMP, and an 80% decrease in NADH oxidase activity after 2 h incubation. This inactivation required only 25-50 microM-doxorubicin and represents true oxidative damage, since both NADH (for doxorubicin redox cycling) and oxygen were obligatory participants. The damage appears localized between the NADH dehydrogenase flavin (site of doxorubicin reduction) and iron-sulphur centre N-1. Succinate dehydrogenase, succinate oxidase, and cytochrome c oxidase activities were strongly inhibited by higher doxorubicin concentrations, but this phenomenon did not involve doxorubicin redox cycling (no NADH or oxygen requirement). Doxorubicin concentrations of 0.5 mM were required for 50% decreases in these activities, except for cytochrome c oxidase which was only 30% inhibited following incubation with even 1.0 mM doxorubicin. Our results indicate that low concentrations of doxorubicin (50 microM or less) can catalyse a site-specific oxidative damage to the NADH oxidation pathway. In contrast, ten-fold higher doxorubicin concentrations (or more) are required for non-oxidative inactivation of the electron transport chain; probably via binding to cardiolipin and/or generalized membrane chaotropic effects. The development of agents to block doxorubicin toxicity in vivo will clearly require detailed clinical studies of doxorubicin uptake in the heart. PMID- 2719643 TI - Turnover of proteoglycans in articular-cartilage cultures. Characterization of proteoglycans released into the medium. AB - By using an e.l.i.s.a. method it was demonstrated that the majority of proteoglycans released into the medium of both control and retinoic acid-treated explant cultures of bovine articular cartilage did not contain a hyaluronate binding region. This supports our previous findings [Campbell & Handley (1987) Arch. Biochem. Biophys. 258, 143-155] that proteoglycans released into the medium of both cultures were of smaller hydrodynamic size, more polydisperse and unable to form aggregates with hyaluronate. Analysis of 35S-labelled core proteins associated with proteoglycans released into the medium of both cultures by using SDS/polyacrylamide-gel electrophoresis and fluorography indicated the presence of a series of core-protein bands (Mr approx. 300,000, 230,000, 215,000, 200,000, 180,000, 140,000, 135,000, 105,000, 85,000 and 60,000) compared with three core proteins derived from the proteoglycans remaining in the matrix (Mr 300,000, 230,000 and 215,000). Further analysis of the core proteins released into the medium indicated that the larger core proteins associated with medium proteoglycans contain both chondroitin sulphate and keratan sulphate glycosaminoglycans whereas the smaller core proteins contain only chondroitin sulphate chains. These experiments provide definitive evidence that the loss of proteoglycans from the matrix involves proteolytic cleavage at various sites along the proteoglycan core protein. PMID- 2719644 TI - The effect of chronic ethanol ingestion on synthesis and degradation of soluble, contractile and stromal protein fractions of skeletal muscles from immature and mature rats. AB - 1. An investigation was carried out into the response of soluble, myofibrillar and stromal protein fractions of skeletal muscle to chronic ethanol feeding. Groups of male Wistar rats, of approx. 85 or 280 g body wt., were pair-fed on a nutritionally complete liquid diet containing glucose or a diet in which 36% of the total energy was provided by ethanol. After 6 weeks, rates of protein synthesis were measured with a flooding dose of L-[4-3H]phenylalanine. 2. The protein contents of soluble, myofibrillar and stromal fractions in gastrocnemius muscle from small and large rats were decreased by ethanol feeding. Greater changes were observed in small than in large rats. 3. Fractional synthesis rates of soluble, myofibrillar and stromal proteins of gastrocnemius were all decreased by ethanol treatment. All fractions responded similarly, though percentage decreases in large rats were greater than in small rats. Absolute synthesis rates in gastrocnemius muscles were also decreased after ethanol treatment. All protein fractions responded similarly, and the magnitudes of the responses in large and small rats were also similar. 4. Fractional rates of breakdown, measured by the difference between fractional growth and synthesis rates, were apparently decreased, in both sets of rats, in all protein fractions. 5. It was concluded that chronic ethanol exposure causes perturbations in soluble, myofibrillar and stromal protein accretion by a mechanism involving unidirectional changes in protein synthesis and possibly breakdown. PMID- 2719645 TI - Effects of antibody to 5 S-RNA-binding protein on protein synthesis in Artemia salina ribosomes. AB - The effects of an affinity-purified polyclonal antibody to Artemia salina ribosomal protein L5 on protein synthesis in vitro were examined. The antibody interacted with 60 S subunits more strongly than with 80 S ribosomes, and inhibited reassociation of ribosomal subunits to some extent at 5 mM-Mg2+ but not at 10 mM. Polyphenylalanine synthesis in vitro at 10 mM-Mg2+ was significantly inhibited, especially when the antibody was first preincubated with 60 S subunits prior to the assay. The incorporation of amino acid directed by globin mRNA was inhibited only when the preincubation with 60 S subunits was carried out. On the other hand, no effect was detected on elongation factor 2- and 60 S subunit dependent uncoupled GTPase activity. These results suggest that L5 is probably located at or near the subunit interface and may play an important role in protein synthesis. PMID- 2719646 TI - Evidence that the 14 kDa soluble beta-galactoside-binding lectin in man is encoded by a single gene. AB - A full-length cDNA clone for the 14 kDa soluble beta-galactoside-binding lectin of man has been isolated from a cDNA library from HepG2 hepatoma cells. The derived amino acid sequence is identical with that of the 14 kDa lectin from human placenta. The results of Northern and Southern blotting of several different human cell lines using a cDNA probe for the 14 kDa lectin suggest the presence of a single gene for this protein. Thus, although there are multiple proteins in the range 14-200 kDa which are antigenically related to this lectin, we would conclude from the present study that there is only one gene for the 14 kDa lectin. PMID- 2719647 TI - The interaction of cations with the dye arsenazo III. AB - 1. The dye arsenazo III combines with a selection of cations to give an altered absorption spectrum. 2. Large metal cations such as Ca2+, La3+ and quadrivalent cations give a 1:1 complex with two new absorption peaks at about 610 nm and 655 nm and a KD of about 10(-6) M. 3. Aliphatic polyamines and complex cobalt ions give a 1:1 complex, with one absorption peak at about 610 nm and a KD from 10(-6) to 10(-3) M. 4. Small metal cations finally form a 2:1 complex and also have one absorption peak at about 610 nm, but with a KD of 10(-5)-10(-4) M. 5. The absorption peak at 610 nm is similar to that formed at high pH in the absence of bivalent cations and is due to ionization of phenolic groups with the dye molecule in an extended form. 6. The peak at 655 nm with 1:1 complex can be explained as a change in orientation of the diazo bonds caused by a conformational change of the molecule when it wraps around the single atom of Ca2+ or other large cation. PMID- 2719648 TI - Reaction of 3-dehydroecdysone with certain n.m.r. solvents. AB - Synthetically prepared 3-dehydroecdysone shows by n.m.r. spectroscopy a mixture of two and three components in 2H2O and [2H4]methanol respectively; only 3 dehydroecdysone is indicated in [2H5]pyridine. Although 3-dehydroecdysone is the sole component in [2H5]pyridine, it represents only 62% and 55% in 2H2O and [2H4]methanol respectively. Evidence indicates that the other component in 2H2O is a 3-[2H2]hydrate of 3-dehydroecdysone, and that in [2H4]methanol the other two components are isomeric [2H3]hemiacetals of 3-dehydroecdysone. PMID- 2719649 TI - Inhibition by glycosaminoglycans of CaCO3 (calcite) crystallization. AB - Of a range of glycosaminoglycans, heparin and heparan sulphate were the most effective inhibitors in vitro of CaCO3 (calcite) crystallization as assayed by conductimetric measurements. The possible role of such glycosaminoglycans in modulating calcium-salt crystallizations in vivo is discussed. PMID- 2719650 TI - Effect of pH on the interaction of botulinum neurotoxins A, B and E with liposomes. AB - The interaction of botulinum neurotoxin serotypes A, B and E with membranes of different lipid compositions was examined by photolabelling with two photoreactive phosphatidylcholine analogues that monitor the polar region and the hydrophobic core of the lipid bilayer. At neutral pH the neurotoxins interacted both with the polar head groups and with fatty acid chains of phospholipids. At acidic pHs the neurotoxins underwent structural changes characterized by a more extensive interaction with lipids. Both the heavy and light chain subunits of the neurotoxins were involved in the process. The change in the nature and extent of toxin-lipid interaction occurred in the pH range 4-6 and was not influenced by the presence of polysialogangliosides. The present data are in agreement with the idea that botulinum neurotoxins enter into nerve cells from a low pH intracellular compartment. PMID- 2719651 TI - Degradation of proteoglycan aggregate by a cartilage metalloproteinase. Evidence for the involvement of stromelysin in the generation of link protein heterogeneity in situ. AB - Cartilage proteoglycan aggregates were subjected to degradation by a metalloproteinase, capable of degrading proteoglycan, released from cartilage in culture. This proteinase was demonstrated to be immunologically identical with fibroblast stromelysin. An early release of hyaluronic acid-binding region and large glycosaminoglycan-attachment regions was observed. With increasing time the glycosaminoglycan-attachment regions were digested into smaller fragments and the hyaluronic acid-binding regions accumulated. The degradation of link proteins also occurred concomitantly with these events. Link proteins were converted into a component of similar size to that of the smallest native link protein component. N-Terminal sequence analysis of the three human link protein components indicated that they are all derived from the same protein core, which is closely homologous to that of the rat chondrosarcoma link protein. The two larger link proteins (Mr 48,000 and 44,000) contain the same N-terminal sequence, but they differ by the apparent presence of an N-linked oligosaccharide at residue 6 of the largest link protein component. The smallest link protein (Mr 41,000), however, has an N-terminal sequence equivalent to that commencing at residue 17 in the larger link proteins. It was found that the cartilage metalloproteinase cleaves link proteins in human neonatal cartilage proteoglycan aggregates at the His-16-Ile-17 bond, the same position at which the smallest link protein component appears to be derived naturally from the two larger link protein components. These results suggest that stromelysin secreted by chondrocytes can account for the increased accumulation of hyaluronic acid binding regions and much of the degradation of link protein observed during aging within human articular cartilage. PMID- 2719652 TI - A theoretical study on the expression of enzymic activity in reverse micelles. AB - The present work deals with a theoretical model of catalysis by enzymes entrapped in reverse micelles. Three aspects of the enzyme-reverse-micelle system have been considered: structure, dynamics and enzyme distribution and catalysis in reverse micelles. A proposed structural model of reverse micelles [El Seoud (1984) in Reverse Micelles (Luisi, P. L. & Straub, B. E., eds.), p. 81, Plenum Press, New York] consists of three domains: surfactant apolar tails, bound water and free water. Dynamics are based on a dynamic equilibrium of association-dissociation that lead one to consider the dispersed polar phase as a pseudo-continuous phase [Luisi, Giomini, Pileni & Robinson (1988) Biochim. Biophys. Acta 947, 207-246]. Enzyme is distributed among the reverse-micelle domains and it expresses a catalytic constant for each one of them. The overall activity is calculated taking into account the volume in which enzyme is solubilized, and expressed as a function of the whole volume (V). The characteristic parameters of reverse micelles, omega 0 (= [H2O]/[surfactant]) and theta (= % water, v/v), were investigated as modulators of enzymic activity. Three basic patterns of modulation by omega 0 were found depending on which domain the enzyme expressed the highest catalytic constant. Combinations of those basic patterns lead to other modulation types that can be found experimentally, such as superactivation. Other combinations predict behaviour patterns not described to date, such as superinhibition. Dependence of catalytic activity on theta was only stated at omega 0 values around a critical value, which coincides with the appearance of free water. PMID- 2719653 TI - The role of succinate in the respiratory chain of Trypanosoma brucei procyclic trypomastigotes. AB - Trypanosoma brucei procyclic trypomastigotes were made permeable by using digitonin (0-70 micrograms/mg of protein). This procedure allowed exposure of coupled mitochondria to different substrates. Only succinate and glycerol phosphate (but not NADH-dependent substrates) were capable of stimulating oxygen consumption. Fluorescence studies on intact cells indicated that addition of succinate stimulates NAD(P)H oxidation, contrary to what happens in mammalian mitochondria. Addition of malonate, an inhibitor of succinate dehydrogenase, stimulated NAD(P)H reduction. Malonate also inhibited intact-cell respiration and motility, both of which were restored by further addition of succinate. Experiments carried out with isolated mitochondrial membranes showed that, although the electron transfer from succinate to cytochrome c was inhibitable by antimycin, NADH-cytochrome c reductase was antimycin-insensitive. We postulate that the NADH-ubiquinone segment of the respiratory chain is replaced by NADH fumarate reductase, which reoxidizes the mitochondrial NADH and in turn generates succinate for the respiratory chain. This hypothesis is further supported by the inhibitory effect on cell growth and respiration of 3-methoxyphenylacetic acid, an inhibitor of the NADH-fumarate reductase of T. brucei. PMID- 2719654 TI - Postsecretory modifications of streptavidin. AB - Streptavidin, an extracellular biotin-binding protein from Streptomyces avidinii, exhibits a multiplicity in its electrophoretic mobility pattern which depends both upon the conditions for growth of the bacterium and upon the protocol used in the purification of the protein. The observed structural heterogeneity appears to reflect the action of two types of postsecretory molecular events: proteolytic digestion of the intact Mr-18,000 subunit to a minimal molecular size (approx. Mr 14,000), and aggregation of the native tetramer into higher-order oligomeric forms. The extent of subunit degradation and/or tetrameric aggregation affects the capacity of a given streptavidin preparation to interact with biotin conjugated proteins in different assay systems. PMID- 2719655 TI - The cilia of Paramecium tetraurelia contain both Ca2+-dependent and Ca2+ inhibitable calmodulin-binding proteins. AB - To identify protein targets for calmodulin (CaM) in the cilia of Paramecium tetraurelia, we employed a 125I-CaM blot assay after resolution of ciliary proteins on SDS/polyacrylamide gels. Two distinct types of CaM-binding proteins were detected. One group bound 125I-CaM at free Ca2+ concentrations above 0.5-1 microM and included a major binding activity of 63 kDa (C63) and activities of 126 kDa (C126), 96 kDa (C96), and 36 kDa (C36). CaM bound these proteins with high (nanomolar) affinity and specificity relative to related Ca2+ receptors. The second type of protein bound 125I-CaM only when the free Ca2+ concentration was below 1-2 microM and included polypeptides of 95 kDa (E95) and 105 kDa (E105). E105 may also contain Ca2+-dependent binding sites for CaM. Both E95 and E105 exhibited strong specificity for Paramecium CaM over bovine CaM. Ciliary subfractionation experiments suggested that C63, C126, C96, E95, and E105 are bound to the axoneme, whereas C36 is a soluble and/or membrane-associated protein. Additional Ca2+-dependent CaM-binding proteins of 63, 70, and 120 kDa were found associated with ciliary membrane vesicles. In support of these results, filtration binding assays also indicated high-affinity binding sites for CaM on isolated intact axonemes and suggested the presence of both Ca2+-dependent and Ca2+-inhibitable targets. Like E95 and E105, the Ca2+-inhibitable CaM-binding sites showed strong preference for Paramecium CaM over vertebrate CaM and troponin C. Together, these results suggest that CaM has multiple targets in the cilium and hence may regulate ciliary motility in a complex and pleiotropic fashion. PMID- 2719656 TI - The primary structure of bovine monoamine oxidase type A. Comparison with peptide sequences of bovine monoamine oxidase type B and other flavoenzymes. AB - We have isolated cDNA clones believed to encompass the full-length coding sequences for a subunit of bovine monoamine oxidase type A (MAO-A). The clones code for an apoprotein of 527 amino acid residues corresponding to a molecular mass of 59,806 Da. The inferred protein sequences show an overall similarity of 68% with partial amino acid sequences of bovine type B MAO (about 41% of the total sequence), as well as a greater similarity (greater than 90%) with some regions including that for the published sequence of the flavin-binding region. Sequence comparisons indicate that these two forms of MAO are encoded by distinct genes. Comparison of this sequence with other flavoenzymes showed similarity with regions associated with non-covalent flavin-binding sites. Analysis of mRNAs coding for MAO enzymes showed a heterogeneity of transcripts consistent with several different forms of monoamine oxidase. PMID- 2719657 TI - Comparison of desialylation of rat transferrin by cellular and non-cellular methods. AB - We have previously shown that the liver endothelium can desialylate the glycoprotein transferrin (Tf). In the present work we provide evidence that asialotransferrin obtained by this means behaves differently on Ricinus communis agglutinin (RCA120) lectin affinity chromatography from asialotransferrin obtained by either neuraminidase treatment or acid hydrolysis. Purified rat transferrin was radiolabelled either with 125I (protein moiety) or with 3H (sialyl residues), and subsequently saturated with iron. It was then passed through an RCA120-agarose column to isolate the fully sialylated component. Sialylated Tf was then desialylated either by incubation with purified rat liver endothelium or, in vitro, by neuraminidase treatment or by acid hydrolysis. The protein was again subjected to RCA120 column chromatography. Although both neuraminidase treatment and acid hydrolysis almost completely desialylated the glycoprotein (as evidenced by near absence of 3H label), the glycoprotein was not retained by the RCA120-agarose column. By contrast, liver endothelium partially desialylated the glycoprotein, but this desialylated fraction was retained by the RCA120-agarose column. These results suggest that desialylation with neuraminidase or acid hydrolysis may be inadequate for functional studies of asialotransferrin. PMID- 2719658 TI - Interaction of the antitumour antibiotic luzopeptin with the hexanucleotide duplex d(5'-GCATGC)2. One-dimensional and two-dimensional n.m.r. studies. AB - 1H- and 31P-n.m.r. spectroscopy were used to characterize the solution structure of the 1:1 complex formed between the antitumour antibiotic luzopeptin and the self-complementary hexanucleotide d(5'-GCATGC)2. Eighteen nuclear Overhauser effects between antibiotic and nucleotide protons, together with ring-current induced perturbations to base-pair and quinoline 1H resonances, define the position and orientation of the bound drug molecule. Luzopeptin binds in the minor groove of the DNA with full retention of dyad symmetry, its quinoline chromophores intercalating at the 5'-CpA and 5'-TpG steps and its depsipeptide ring spanning the central two A.T base-pairs. The chromophores stack principally on the adenine base with their carbocyclic rings pointing towards the deoxyribose of the cytosine. There is no evidence for Hoogsteen base-pairing in the complex, all glycosidic bond angles and sugar puckers being typical of B-DNA as found for the free hexanucleotide. The 'breathing' motions of the A.T and internal G.C base pairs are substantially slowed in the complex compared with the free DNA, and the observation that two phosphate resonances are shifted downfield by at least 0.5 p.p.m. in the 31P-n.m.r. spectrum of the complex suggests pronounced local helix unwinding at the intercalation sites. The data are consistent with a model of the complex in which luzopeptin bisintercalates with its depsipeptide essentially in the conformation found in the crystal of the free antibiotic [Arnold & Clardy (1981) J. Am. Chem. Soc. 103, 1243-1244]. We postulate only one conformational change within the peptide ring, which involves rotation of the pyridazine-glycine amide group linkage by 90 degrees towards the DNA surface. This manoeuvre breaks the glycine-to-glycine transannular hydrogen bonds and enables the glycine NH groups to bond to the thymine O-2 atoms of the sandwiched A.T base-pairs. It also shortens the major axis of the depsipeptide so that the interchromophore distance is more suitable for spanning two base-pairs. The model further implies that the carboxy and hydroxy groups of the L-beta-hydroxyvaline residue are appropriately positioned for hydrogen-bonding to the 2-amino group of guanine and the O-2 atom of cytosine of the adjacent G.C base-pair. PMID- 2719660 TI - Conformational studies of a synthetic peptide corresponding to the repeat motif of C hordein. AB - C hordein, a storage protein from barley grains, has an Mr of about 53,000, and consists predominantly of repeated octapeptides with a consensus sequence of Pro Gln-Gln-Pro-Phe-Pro-Gln-Gln. Previously reported hydrodynamic and c.d. studies indicate the presence of beta-turns, the repetitive nature of which may lead to the formation of a loose spiral. In order to study these turns we have compared the structures of a synthetic peptide corresponding to the consensus repeat motif and total C hordein by using c.d. and Fourier-transform i.r. spectroscopy. The synthetic peptide exhibited spectra typical of beta I/III reverse turns when dissolved in trifluoroethanol at 22 degrees C and in water at 70 degrees C, but 'random-coil'-like spectra in water at 22 degrees C. The whole protein also showed increases in beta I/III reverse turns when dissolved in increasing concentrations of trifluoroethanol (50-100%, v/v) or heated in ethanol/water (7:3, v/v). Two cryogenic solvent systems were used to determine the c.d. spectra of the peptide and protein at temperatures down to -100 degrees C. Methanol/glycerol (9:1, v/v) and ethanediol/water (2:1, v/v) were selected as analogues of trifluoroethanol/water and water respectively. The peptide exhibited beta I/III-reverse-turn and 'random-coil'-like spectra in methanol/glycerol and ethanediol/water respectively at 22 degrees C, but a spectrum similar to that of a poly-L-proline II helix in both solvents at -100 degrees C. Similarly the proportion of this spectral type also increased when the whole protein was cooled in both solvents. These results indicate that a poly-L-proline II conformation at low temperatures is in equilibrium with a beta I/III-turn-rich conformation at higher temperatures. The latter conformation is also favoured in solvents of low dielectric constant such as trifluoroethanol. The 'random-coil'-like spectra exhibited by the protein and peptide in high-dielectric-constant solvents at room temperature may result from a mixture of the two conformations rather than from the random-coil state. PMID- 2719659 TI - The interplay of electrostatic fields and binding interactions determining catalytic-site reactivity in actinidin. A possible origin of differences in the behaviour of actinidin and papain. AB - 1. The pH-dependence of the second-order rate constant (k) for the reaction of actinidin (EC 3.4.22.14) with 2-(N'-acetyl-L-phenylalanylamino)ethyl 2'-pyridyl disulphide was determined and the contributions to k of various hydronic states were evaluated. 2. The data were used to assess the consequences for transition state geometry of providing P2/S2 hydrophobic contacts in addition to hydrogen bonding opportunities in the S1-S2 intersubsite region. 3. The P2/S2 contacts (a) substantially improve enzyme-ligand binding, (b) greatly enhance the contribution to reactivity of the hydronic state bounded by pKa 3 (the pKa characteristic of the formation of catalytic-site-S-/-ImH+ state) and pKa 5 (a relatively minor contributor in reactions that lack the P2/S2 contacts), such that the major rate optimum occurs at pH 4 instead of at pH 2.8-2.9, and (c) reveal the kinetic influence of a pKa approx. 6.3 not hitherto observed in reactions of actinidin. 4. Possibilities for the interplay of electrostatic effects and binding interactions in both actinidin and papain (EC 3.4.22.2) are discussed. PMID- 2719661 TI - Free concentrations of sodium, potassium and calcium in chromaffin granules. AB - We have measured the contents of Na+ and K+ in isolated chromaffin granules. Total contents varied between 227 and 283 nmol/mg of protein, equivalent to matrix concentrations of 53-66 mM. The value found depended on the isolation buffer used, and the ratio of the two ions reflected the composition of the buffer. We then measured the free concentration of each of these ions, and of Ca2+, in the matrix, by using a null-point method with acridine-fluorescence quenching. This monitored H+ fluxes induced by an ionophore in the presence of known concentrations of the ion in the supporting medium. In contrast with organic constituents of the matrix, which have low activity coefficients, Na+ and K+ were found to have activity coefficients around 0.8 Ca2+, however, was strongly bound: its free concentration was only 0.03% of the total. PMID- 2719662 TI - Studies on the biotin-binding sites of avidin and streptavidin. A chemically induced dynamic nuclear polarization investigation of the status of tyrosine residues. AB - We applied the protein photochemically induced dynamic nuclear polarization (photo-c.i.d.n.p.) method to explore the conformation of the side chains of tyrosine, tryptophan and histidine residues in three biotin-binding proteins. The c.i.d.n.p. spectra of avidin, streptavidin and 'core' streptavidin were compared with those of their complexes with biotin and its derivatives. The data indicate that the single tyrosine residue (Tyr-33) of avidin is clearly inaccessible to the triplet flavin photo-c.i.d.n.p. probe. The same holds for all tryptophan and histidine side chains. Although the analogous Tyr-43 residue of streptavidin is also buried, at least three of the other tyrosine residues of this protein are exposed. The same conclusions apply to the truncated form of the protein, core streptavidin. As judged by the photo-c.i.d.n.p. results, complexing of avidin and streptavidin with biotin, N-epsilon-biotinyl-L-lysine (biocytin) or biotinyltyrosine has little or no effect on tyrosine accessibility in these proteins. Biotinyltyrosine can be used to probe the depth of the corresponding binding site. The accessibility of the tyrosine side chain of biotinyltyrosine in the complex demonstrates the exquisite fit of the biotin-binding cleft of avidin: only the biotin moiety appears to be accommodated, leaving the tyrosine side chain exposed. PMID- 2719664 TI - Glutathione-dependent dechlorination of 1,6-dichloro-1,6-dideoxyfructose. AB - The metabolism of 14C- and 36Cl-labelled 1,6-dichloro-1,6-dideoxyfructose (DCF) was studied in the isolated perfused rat liver system. Dechlorination of DCF occurred in the liver and erythrocytes and was GSH-dependent. The GSH conjugate formed was identified by 13C and 1H n.m.r. as the 6-chlorofructos-1-yl-SG conjugate. It is proposed that the GS- anion attacks the low steady-state concentration of the reactive keto form of DCF and that the conjugate formed cyclizes to the dominant beta-anomer. 6-Chlorofructos-1-yl-SG conjugate of hepatic origin is excreted into bile, whereas that produced in erythrocytes does not enter the liver. PMID- 2719663 TI - Proteolytic generation of constitutive tyrosine kinase activity of the human insulin receptor. AB - Structural modification induced by partial digestion with trypsin has been shown to stimulate the tyrosine kinase activity of the insulin receptor both in solution and in intact cells [Tamura, Fujita-Yamaguchi & Larner (1983) J. Biol. Chem. 258, 14749-14752; Goren, White & Kahn (1987) Biochemistry 26, 2374-2382; Leef & Larner (1987) J. Biol. Chem. 262, 14837-14842]. Furthermore, experiments involving deletion of sequences encoding the extracellular domain of the insulin receptor suggest that it may function as a protooncogene in fibroblasts [Wang et al., (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 5725-5729]. To further understand the structural requirements that generate this activity, the major activated fragments generated in solution following trypsin digestion have been characterized here, one of which is shown to have a similar amino acid sequence to a transforming protein. Furthermore, treatment with trypsin of intact Chinese hamster ovary cells that overexpress the human insulin receptor stimulates both autophosphorylation of the receptor and 2-deoxyglucose uptake into the cells, but does not enhance receptor internalization. Unlike digestion in solution, no proteolysis or loss of activity of the activated insulin receptor beta-subunit could be detected using intact cells, even at high trypsin concentrations, despite the existence of extracellular sites that are readily cleaved by trypsin in the solubilized receptor. These studies provide further detail of a mechanism used during trypsinization of cells in culture which mimics activation of the insulin receptor and contributes to stimulation of growth. PMID- 2719665 TI - Entrapment of high-molecular-mass DNA molecules in liposomes for the genetic transformation of animal cells. AB - We modified the Ca/EDTA procedure for the production of liposomes [Papahadjopoulos, Vail, Jacobson & Poste (1975) Biochim. Biophys. Acta 394, 483 491] to entrap intact DNA molecules of very high molecular mass into large unilamellar phospholipid vesicles. The use of DNA-protein complexes and phage particles instead of naked linear DNA increases the efficiency of entrapment and protects the integrity of DNA molecules. We investigated the interaction of mammalian cells with liposome-encapsulated recombinant lambda bacteriophages carrying marker genes. The liposomes bind surprisingly fast to the cellular surface and are taken up by the cells. A significant proportion of the encapsulated DNA is transported to and soon located in or around the nuclei. Experiments prove that these liposomes can be used for the genetic transformation of mammalian cells. PMID- 2719666 TI - Iodothyronine 5'-deiodinase activity as an early event of prenatal brown-fat differentiation in bovine development. AB - Iodothyronine 5'-deiodinase activity appears to be a type I enzyme in bovine brown adipose tissue, on the basis of its high Km for 3,3',5'-tri-iodothyronine ('reverse T3') (in the micromolar range) and sensitivity to propylthiouracil inhibition. This enzyme activity is already detectable in perirenal adipose tissue of bovine fetuses in the second month of gestation, reaches peak values around the seventh month of fetal life, declines before birth, becomes lower after parturition and finally undetectable in the adult cow. Iodothyronine 5' deiodinase activity is present in the pericardic, peritoneal and intermuscular adipose depots of the neonatal calf, but it is always undetectable in the subcutaneous adipose tissue. It is concluded that iodothyronine 5'-deiodinase is a specific feature of brown fat in the bovine species that is not shared by white adipose tissue. white adipose tissue. Peak values of 5'-deiodinating activity appear as an early event in the prenatal differentiation programme of bovine brown-fat cells as they occur when uncoupling-protein-gene expression first starts. PMID- 2719667 TI - Solubilization and reconstitution of kidney 25-hydroxyvitamin D3 1 alpha- and 24 hydroxylases from vitamin D-replete pigs. AB - Pig kidney mitochondrial 25-hydroxyvitamin D3 1 alpha- and 24-hydroxylase activities have been solubilized with cholate/Emulgen 911 and reconstituted with NADPH, ferredoxin reductase and ferredoxin. All three of these components are required for full catalytic activity of both enzymes. Both products were identified by co-chromatography with authentic metabolites on both normal and reverse-phase h.p.l.c. using solvent systems which were shown to separate 10-oxo 19-nor-25-hydroxyvitamin D3 from 1,25-dihydroxyvitamin D3 [1,25-(OH)2-D3]. In addition, periodate treatment of the 24,25-(OH)2-D3 product resulted in complete loss of the product as measured by protein-binding assay. Further purification by p-chloroamphetamine-Sepharose chromatography of a solubilized extract from a pig fed a normal diet increased the specific content of the cytochrome P-450 from 0.019 to 0.239 nmol/mg and the 1 alpha-hydroxylase activity from 4.75 to 268 pmol/h per mg. Activity of the 24-hydroxylase in the crude solubilized extract was 6.3 pmol/h per mg, but was undetectable after partial purification by a p chloroamphetamine-Sepharose column. However, further fractionation of this material by DEAE-Sepharose chromatography resulted in a further increase in 1 alpha-hydroxylase activity to 430 pmol/h per mg and detection of 24-hydroxylase in a separate fraction at a level of 53 pmol/h per mg. Production of 1,25-(OH)2 D3 was linear with time up to 2 h and was dependent upon ferredoxin concentration as well as cytochrome P-450 concentration in the range of 0-40 nM. In the presence of excess ferredoxin and adequate amounts of cytochrome P-450, 1,25 (OH)2-D3 production was also dependent upon substrate concentrations in the range of 0.25 to 2.5 microM yielding an estimated Km of 1 microM. In the presence of excess substrate and ferredoxin, the catalytic-centre activity of the enzyme was estimated to be 1 h-1. PMID- 2719668 TI - Purification of two glycoproteins expressing beta 1-6 branched Asn-linked oligosaccharides from metastatic tumour cells. AB - Increased branching at the trimannosyl core of 'complex-type' Asn-linked oligosaccharides has been observed in both human and murine tumour cells, and appears to be associated with enhanced metastatic potential in several murine tumour models [Dennis, Laferte, Waghorne, Breitman & Kerbel (1987), Science 236, 582-585]. The lectin leucoagglutinin (L-PHA) requires the-GlcNAc beta 1-6Man alpha 1-6Man-linked lactosamine antenna in complex-type oligosaccharides for high affinity binding and can be used to detect these structures in glycoproteins separated on SDS/polyacrylamide-gel electrophoresis. The major L-PHA-binding glycoproteins in the highly metastatic lymphoid tumour cell line called MDAY-D2 were purified and resolved into two major species, termed P2A (110 kDa) and P2B (130 kDa). P2A had L-PHA-reactive Asn-linked oligosaccharides with polylactosamine sequences as well as a large component of sialylated O-linked carbohydrates. The glycoprotein showed structural characteristics similar to those of leukosialin (i.e. CD43), a glycoprotein previously identified on the surface of leukocytes. Based on monosaccharide compositional analysis and glycosidase digestions, P2B was found to be 50-60% Asn-linked oligosaccharide containing polylactosamine sequences and sialic acid. The N-terminal peptide sequence of P2B was determined to be very similar to that of murine lysosomal membrane glycoprotein (LAMP-1), a ubiquitous glycoprotein found largely in the lysosomal membranes but also in the plasma membrane of several murine and human tumour cell lines. PMID- 2719669 TI - A gated 31P-n.m.r. study of bioenergetic recovery in rat skeletal muscle after tetanic contraction. AB - 1. Gated 31P-n.m.r. spectra were obtained from the ankle flexor muscles of the rat at various times after 3 s isometric tetanic contraction. This allowed the time course of changes in phosphocreatine (PCr), Pi and free ADP concentrations and intracellular pH to be monitored in skeletal muscle in vivo with 1 s time resolution. 2. ATP concentration did not change significantly, either during the recovery from a 3 s tetanus or during the overall protocol. 3. The calculated rate of recovery of ADP towards pre-stimulation levels was very rapid (t1/2 less than 5 s). The rate of Pi disappearance (t1/2 = 14 s) was more rapid than the rate of PCr synthesis (t1/2 = 24 s), resulting in a significant transient decrease in n.m.r.-visible PCr + Pi between 25 and 45 s after tetanic contraction. 4. The rates of PCr, Pi and ADP recovery are higher than those previously reported for recovery from steady-state exercise in humans or twitch isometric contraction in animals. PMID- 2719670 TI - Still degrading after all these years. PMID- 2719671 TI - Fructose 2,6-bisphosphate in rat small intestine. PMID- 2719672 TI - Neurons, neural networks and molecular biology. PMID- 2719673 TI - Fibroblast growth factors are present in adult cardiac myocytes, in vivo [corrected and issued with original paging in Biochem Biophys Res Commun 1988 Dec 30;157(3)]. AB - We have previously shown that the adult heart contains mitogens immunologically identical to acidic and basic fibroblast growth factors. To determine whether these proteins are present in myocytes, we subjected lysates of freshly isolated myocytes to heparin-affinity chromatography. The 1.1 M - 3 M NaCl eluates stimulated incorporation of thymidine into DNA in quiescent Balb/c 3T3 fibroblasts, caused proliferation of vascular endothelial cells, and cross reacted with antisera raised against acidic (1.1 M) and basic FGF's (1.5 M) by Western blotting and by RIA. These proteins may be involved in cellular differentiation and proliferation and may play an important role in regenerative and repair processes in the heart. PMID- 2719674 TI - Affinity of osteogenin, an extracellular bone matrix associated protein initiating bone differentiation, for concanavalin A. AB - Subcutaneous implantation of demineralized bone matrix results in bone differentiation. The bone inductive protein, osteogenin, was isolated recently by heparin affinity chromatography. The affinity of osteogenin for various lectins was examined to attain further purification and characterization. Osteogenin extracted from bovine bone matrix binds to concanavalin A (Con A) but not to wheat germ agglutinin or soybean lectin. The present data indicate that the bone inductive protein, osteogenin, is a glycoprotein. The use of a Con A Sepharose affinity column followed by preparative gel electrophoresis resulted in a greater than 250,000 fold purification of osteogenin. PMID- 2719675 TI - ATP-dependent and DCCD-insensitive Cl- uptake by membrane vesicles from the rat brain plasma membrane fractions. AB - ATP-dependent Cl- uptake by membrane vesicles from the rat brain plasma membrane fractions was not affected by the addition of 40 mM of K+, Na+ or HCO3- to the assay medium. Na+ and K+ did not alter the uptake even in the presence of a K+ ionophore, valinomycin (10 microM), or a H+/K+ exchanger, nigericin (10 microM), whereas in the presence of both of these ionophores, K+, but not Na+, reduced the Cl- uptake. Inhibitors of proton pump activity, N,N'-dicyclohexylcarbodiimide (1 mM) and 5-(N,N-hexamethylene)amiloride (40 microM), however, did not affect the Cl- uptake. These findings suggest the presence of a primary Cl- transport system probably associated with passive H+ flux in the brain plasma membranes. PMID- 2719676 TI - Role of calcium in the phenylephrine-induced activation of phosphorylase "A" in isolated liver cells. AB - The ability of phenylephrine to activate phosphorylase in liver cells with variable degrees of Ca2+ loading was studied. Phenylephrine has been found to be capable of stimulating phosphorylase at saturating Ca2+ concentrations that precluded any further action of this ion. Furthermore the degree of activation was proportional to the cellular calcium content. These results allow to conclude that alpha-adrenergic agonists activate phosphorylase by a mechanism apparently unrelated to their ability to mobilize and subsequently increase the cytosolic concentration of free Ca2+. PMID- 2719677 TI - Histatins, a family of salivary histidine-rich proteins, are encoded by at least two loci (HIS1 and HIS2). AB - We screened a human parotid gland cDNA library with mixed synthetic oligonucleotide probes representing a central coding region common to histatins 1 and 3. Sequence analysis of 12 histatin cDNA clones strongly suggests that the histatin protein family is encoded by at least two closely related loci (HIS1 and HIS2) such that histatins 1 and 3 are primary products of HIS1(1) and HIS2(1) alleles, respectively, and that histatins 4-6 are derived from histatin 3 by proteolysis. We present additional data indicating that histatin 2 may represent the non-phosphorylated form of histatin 1. PMID- 2719678 TI - Evidence that the enoyl-CoA hydratase bifunctional protein of mouse liver peroxisomes is identical with the 70,000 dalton peroxisomal membrane protein. AB - Peroxisomal enoyl-CoA hydratase was purified from livers of mice treated with di (2-ethylhexyl)phthalate and its properties compared with those of the 70 kDa protein present in the membranes prepared by carbonate extraction of peroxisomes. The two proteins had identical subunit molecular masses, of about 70,000 daltons. Limited proteolysis of these proteins using the V8 proteinase of S. aureus yielded identical peptide maps, with these peptides crossreacting with antiserum raised against the 70 kDa membrane protein. These data are consistent with the proposal that the peroxisomal 70 kDa membrane protein and the peroxisomal enoyl CoA hydratase are the same protein. PMID- 2719679 TI - Characterization of a translation inhibitory protein from Luffa aegyptiaca. AB - A protein with a molecular weight of about 30,000 was purified from the seeds of Luffa aegyptiaca. This protein inhibited cell free translation at pM concentrations. In spite of functional similarity to other ribosomal inhibitory proteins, the NH2-terminal analysis did not show any significant homology. Competitive inhibition studies indicate no immunological crossreactivity between the inhibitory protein from Luffa aegyptiaca, pokeweed antiviral protein (PAP) and recombinant ricin A chain. Chemical linkage of the protein to a monoclonal antibody reactive to transferrin receptor resulted in a highly cytotoxic conjugate. PMID- 2719680 TI - Selective inactivation of MAO-B by benzyl-dimethyl-silyl-methanamines in vitro. AB - The alpha-silyl amines benzyl-dimethyl-silyl-methanamine and the p-fluoro and p chloro derivatives are potent time-dependent inhibitors of rat brain MAO-B. The inhibition exhibits saturation kinetics, takes place in the enzyme active-site and is irreversible. The most potent inhibitor in the series is 4-fluorobenzyl dimethyl-silyl-methanamine (KI = 11 microM, tau 1/2 = 2.3 min). Its selectivity for the B-form relative to the A-form of rat brain MAO is higher than 10(4). Benzyl-dimethyl-silyl-methanamines may represent a new family of anti Parkinsonian agents. PMID- 2719681 TI - Prostaglandin and thromboxane in liposomes: suppression of the primary immune response to liposomal antigens. AB - Liposomes containing lipid A as adjuvant and also containing prostaglandin E2 or thromboxane B2 were examined for the ability to influence induction of humoral immunity against liposomal protein or lipid antigens in rabbits. The protein antigen consisted of cholera toxin that was bound to ganglioside GM1 on the surface of the liposomes. High titers of anti-cholera toxin antibodies were produced and IgM and IgG responses were detected. When the immunizing liposomes contained either prostaglandin E2 or thromboxane B2 as part of the lipid bilayer, the primary immune response, involving both IgM and IgG antibodies, was greatly reduced. The secondary immune response observed after a boosting immunization was not suppressed by liposomal eicosanoids. A similar inhibitory effect on the primary response was observed when liposomal lipid antigens were examined instead of cholera toxin. An inhibitory effect of liposomal prostaglandin E2 on the phagocytic uptake of opsonized liposomes by cultured macrophages was also observed, suggesting that liposomal eicosanoids can have direct local effects on macrophages that might influence the immune response to liposomal antigens. PMID- 2719682 TI - The stereospecific suicide inhibition of human melanoma thioredoxin reductase by 13-cis-retinoic acid. AB - 13-cis retinoic acid has been shown to be a stereospecific suicide inhibitor of thioredoxin reductase purified from human melanoma tissue. All trans retinoic acid does not inhibit this enzyme. The covalent addition of 13-cis retinoic acid to the thiolate active site of thioredoxin reductase produces a thioether enzyme inhibitor complex. This has been established by a kinetic analysis and by active site labeling with 3H-13 cis retinoic acid. A mechanism involving Michael addition of the thiolate group in the active site of thioredoxin reductase to the 13-cis double bond of enzyme-bound inhibitor has been proposed. This reaction may be important in the human epidermis because thioredoxin reductase has been shown to be a major antioxidant catalyst in human keratinocytes, melanocytes, melanoma cells, and in human skin as well as in melanoma tissues. PMID- 2719683 TI - Catalytic subunit of cAMP-dependent protein kinase from bovine heart: several isoforms demonstrated by high resolution focusing in immobilized pH gradient. AB - The catalytic subunit (C) of cAMP-dependent protein kinase holoenzyme type II from bovine cardiac muscle was separated by isoelectric focusing in Immobiline polyacrylamide gels into 9 protein forms. The major forms (i) appeared at pH 7.1, 7.4, 7.5, and 7.7, (ii) exhibited protein kinase activity and were inhibited by heat and acid stable inhibitor, (iii) represented approx. 30%, 4%, 64%, and 1% of the protein respectively, (iv) refocused in the same position from which they had been eluted from the first gel. Antibodies against C detected additional proteins at approx. pH 7.55, 7.75, and 7.8. Two more bands became detectable at approx. pH 7.3 and 7.45 by application of antibody against C beta (Uhler, M.D. & McKnight G.S. 1987, J.Biol.Chem. 262, 15202-15207). The relation of the different forms of C to the fractions CA and CB (Kinzel V. et al. 1987 Arch. Biochem. Biophys. 253, 341-349) is demonstrated. PMID- 2719684 TI - Thyroid hormone suppression of hepatic levels of phenobarbital-inducible P-450b and P-450e and other neonatal P-450s in hypophysectomized rats. AB - Mechanism of developmental suppression of cytochrome P-450 (P-450) in rat livers was studied using Western blots. The contents of phenobarbital (PB)-inducible P 450b and P-450e, expressed constitutively in livers, were higher in neonate than in adult rats. The contents were also 10 approximately 50 fold higher in hypophysectomized than in intact adult male rats. Administration of L triiodothyronine (T3, 50 micrograms/kg) or human growth hormone (4 U/kg) reversed almost completely the increased amounts of P-450b and P-450e. T3-induced suppression was also observed on two other neonatal P-450s (P-450 6 beta-1 and P 448-H), which are expressed in neonatal periods in livers. The postnatal developmental profiles of hepatic P-450b were correlated inversely with that of serum free T3 level in rats reported (Walker et al. (1980) Pediat. Res. 14, 249). These results suggest, in addition to pituitary growth hormone (Yamazoe et al. (1987) J. Biol. Chem. 262, 7423), the possible involvement of T3 on the suppressive regulation of PB-inducible and other neonatal P-450s. PMID- 2719685 TI - Tissue specific defect of complex I of the mitochondrial respiratory chain. AB - Deficiency of complex I is one of the most commonly reported defects of the mitochondrial respiratory chain in man. Clinical evidence of tissue specific expression of complex I deficiency has not previously been confirmed biochemically. We report here slow oxidation of NAD+-linked substrates, low activity of complex I and low amounts of immunoreactive complex I peptides in skeletal muscle mitochondria from a patient with muscle weakness and lactic acidosis. In liver mitochondria complex I activity was normal and all the immunoreactive subunits of complex I were present in normal amounts. PMID- 2719686 TI - Ionic strength-dependent interaction of rat liver casein kinase I with plasma membrane. AB - Casein kinase I binding to rat liver plasma membrane was rapidly released from membrane by increasing the ionic strength above physiological level. The released activities at 250-300 mM NaCl were 3-4-fold higher than those obtained under lower ionic strength below 100 mM NaCl. This reaction occurred nonenzymatically and was reversible. By lowering the ionic strength from 250 mM to 50 mM NaCl by dilution at least 50% of the released enzyme was rebound to plasma membrane. By gel filtration analysis, most of the released enzyme activity under higher NaCl concentration was recovered around the molecular mass of 35,000 which corresponded to that of casein kinase I. This enzyme showed the tendency to aggregate under lower ionic strength (50 mM NaCl), but existed as monomer under higher ionic strength (250 mM NaCl). These results suggest that the release of casein kinase I from plasma membrane and the rebinding to membrane induced by the alteration of ionic strength seem to be an important regulatory mechanism in determining the subcellular distribution of this enzyme. PMID- 2719687 TI - A promising genomic transfectant into Xeroderma pigmentosum group A with highly amplified mouse DNA and intermediate UV resistance turns revertant. AB - Following transfection of genomic mouse DNA into an SV40 transformed fibroblast cell line from a patient with Xeroderma pigmentosum (complementation group A, XPA), a single UV resistant cell clone was isolated out of a total of 10(4) independent transfectants. The recipient XPA cell line has as yet not produced spontaneous revertants among 2.2 x 10(8) cells. The isolated cell clone contains 50-70 kb of mouse sequences which are heavily amplified (500-fold), and has acquired both intermediate resistance to UV killing and intermediate unscheduled DNA synthesis (UDS) capacity. By continued passage without selective pressure, cells were generated, which had lost both the dominant marker gene and repetitive mouse sequences. Single colonies of these cells were still intermediately resistant to UV suggesting that either undetected unique mouse DNA had segregated from the bulk of repetitive DNA, or, more likely, that the initially isolated transfectant was a spontaneous revertant. This documents that a persuasive clone isolated can still be a false positive (spontaneous revertant) and that an extremely laborious approach may lead into a dead end. PMID- 2719688 TI - A pro-drug of zidovudine with enhanced efficacy against human immunodeficiency virus. AB - In an attempt to alleviate the drug-related toxicity of zidovudine in patients with AIDS, a pro-drug of zidovudine, 5'-[(1,4-dihydro-1-methyl-3 pyridinylcarbonyl)oxy]-3'-azido-2',3'- dideoxythymidine (DP-AZT), has been evaluated. Cellular uptake by H9 cells and peripheral blood lymphocytes (PBL) with zidovudine and DP-AZT showed at least a 50% greater intracellular concentration of DP-AZT within 2 hr. DP-AZT was significantly less toxic to murine bone marrow cells as measured by CFU-E assay. The ED50 concentration to inhibit the production of HIV specific p24 antigen was 0.05 microM for DP-AZT whereas zidovudine required 0.125 microM. These results demonstrated that DP-AZT has a higher therapeutic ratio than zidovudine as an anti-HIV-1 agent. PMID- 2719689 TI - Mutations at the distal and proximal sites of cytochrome P-450d changed regio specificity of acetanilide hydroxylations. AB - Regio-specificities of acetanilide hydroxylations were studied for 11 distal, 9 proximal and 3 aromatic mutants of cytochrome P-450d. Ratios of turnover numbers among these products were remarkably changed depending on the mutants. For example, the ratio of turnover number, para:ortho:meta = 7:0.1:0.3 for the wild type changed to 11:4:3 for a distal mutant, Thr322Ala, or to 13:13:1 for a proximal mutant, Arg455Gly. It was suggested that regio-specificities of microsomal P-450 enzymes are controlled cooperatively by the whole structure of the protein molecules which influences the tertiary structure of the distal environment. PMID- 2719690 TI - Induction of plasminogen activator activity by phorbol ester in transformed fetal bovine aortic endothelial cells. Possible independence from protein kinase C. AB - 12-O-tetradecanoyl phorbol 13-acetate (TPA) and 1,2-dioctanoyl-sn-glycerol (diC8) activate protein kinase C (PKC) in transformed fetal bovine aortic endothelial GM 7373 cells. Both molecules cause a similar increase in membrane-associated PKC activity and in the phosphorylation of a PKC-specific endogenous 87-kDa substrate in intact cells. Even though both TPA and diC8 exert a mitogenic activity in GM 7373 cells, only TPA induces also an increase in cell-associated plasminogen activator (PA) activity. Down-regulation of PKC which follows TPA-pretreatment completely abolishes the mitogenic activity of diC8 and the mitogenic and PA inducing activity of TPA. However, both the PKC inhibitor H-7 and the down regulation of PKC which follows a prolonged stimulation with diC8 do not abolish the PA-inducing activity of TPA. The PA-inducing activity of TPA is instead inhibited in cultures incubated in the presence of 1 mM EGTA or in a calcium-free medium. The data indicate that TPA and diC8 induce a different pattern of cellular activation in GM 7373 cells and that the PA-inducing activity of TPA might not be mediated by PKC. PMID- 2719691 TI - Extremely low frequency pulsed electromagnetic fields increase cell proliferation in lymphocytes from young and aged subjects. AB - The effect of the in vitro exposure to extremely low frequency pulsed electromagnetic fields (PEMFs) on the proliferation of human lymphocytes from 24 young and 24 old subjects was studied. The exposure to PEMFs during a 3-days culture period or during the first 24 hours was able to increase phytohaemagglutinin-induced lymphocyte proliferation in both groups. Such effect was greater in lymphocytes from old people which showed a markedly reduced proliferative capability and, after PEMF exposure, reached values of 3H-TdR incorporation similar to those of young subjects. The relevance of these data for the understanding and the reversibility of the proliferative defects in cells from aged subjects and for the assessment of risk related to the environmental exposure to PEMFs has to be considered. PMID- 2719692 TI - Characteristic effects of taste-compounds on the dynamic behavior of oleate monolayer. AB - Dynamic behavior of the monolayer of oleic acid on an aqueous solution was studied. The hysteresis loop of the surface, pressure (pi)-area (A) curve, was found to be characteristically dependent on the chemical stimuli with different taste-categories: salty, sweet, bitter and sour. The characteristic response of the dynamic surface behavior was discussed in relation with our recent finding, i.e., the features of the oscillation change in a different manner with the addition of various chemical species belonging to different taste categories in an excitable artificial liquid-membrane of oleic acid (Yoshikawa, et al, Langmuir, 4, 759-762 (1988). PMID- 2719693 TI - Alteration of DNA primase activity by phosphorylation and de-phosphorylation of histone H1. AB - To investigate the effect of histone H1 on DNA primase activity, partially purified DNA primase from mouse FM3A cells was used. It was found that histone H1 dose dependently inhibited DNA primase. Interestingly phosphorylation of histone H1 reduced the inhibitory activity of the histone. However, de-phosphorylation of the phosphorylated histone H1 resumed the inhibitory activity of DNA primase. These findings lead us to the assumption that phosphorylation and de phosphorylation of histone may regulate the cell cycle by controlling DNA synthesis through reverse inhibition of DNA primase. PMID- 2719694 TI - Role of protein X in the function of the mammalian pyruvate dehydrogenase complex. AB - Two lipoyl-bearing subunits--the dihydrolipoyl transacetylase and protein X--form the core of the mammalian pyruvate dehydrogenase complex. Selective removal of the lipoyl domain of protein X results in loss in the activity of the complex with a relationship suggesting the involvement of the lipoyl domain of protein X in a key but not rate limiting step. The dihydrolipoyl dehydrogenase component markedly reduces both the cleavage of protein X and the loss in activity. Using a microplate binding assay, we demonstrate that the lipoyl domain of protein X and the transacetylase component contribute to the binding of the dihydrolipoyl dehydrogenase component. These roles of protein X in the catalytic function and organization of the complex require new reactions and afford an explanation for the unusual stoichiometry of dihydrolipoyl dehydrogenase dimers in the complex. PMID- 2719695 TI - Phosphorylation of peripherin, an intermediate filament protein, in mouse neuroblastoma NIE 115 cell line and in sympathetic neurons. AB - Peripherin, an intermediate filament protein, described recently, is expressed in well defined neuronal populations. We studied the phosphorylation, in vivo, of this protein in mouse neuroblastoma NIE 115 cell line and in sympathetic neurons labelled with [32P]-orthophosphate. The autoradiograms of proteins separated on two-dimensional polyacrylamide gels were compared with the Coomassie-blue stainings. The results show that peripherin occurs as a mixture of phosphorylated and non-phosphorylated isoforms, and that these forms coexist in both differentiated and non-differentiated cells. We demonstrate by cleavage at the unique tryptophan residue, a characteristic shared by most other intermediate filament proteins (IFP), that the phosphorylation sites are located on the amino terminal half of peripherin as it is for vimentin and desmin. These results are discussed in relation to the organization of the filamentous network constituted by peripherin. PMID- 2719697 TI - Release of insulin-like growth factor carrier proteins by osteoblasts: stimulation by estradiol and growth hormone. AB - Osteoblast-like rat calvaria cells release specific insulin-like growth factor (IGF) carrier proteins (CPs). As analyzed by SDS-PAGE under nonreducing conditions, Western blotting and detection by 125I-IGFs, CPs migrating with the IGF-binding subunits of the major CP species of rat serum (42/45/49 kDa) accumulate in cell culture medium. Treatment of the cells with growth hormone and estradiol increases the abundance of this glycosylated CP species. Since the two hormones were previously found to stimulate osteoblast replication via an IGF I dependent mechanism, the data indicate that hormones may control local IGF action not only by regulating synthesis of IGFs and their receptors but also their presentation by CPs. PMID- 2719696 TI - Competitive binding of gangliosides and glycophorin to wheat germ agglutinin. AB - Gangliosides and glycophorin are receptors for wheat germ agglutinin. The competitive binding of these molecules to wheat germ agglutinin is studied by electron spin resonance spectroscopy with spin labels attached to the oligosaccharide chains of gangliosides. Evidence shows that glycophorin is more accessible to wheat germ agglutinin binding than gangliosides. The interactions of gangliosides and glycophorin in liposomes is disrupted on low level binding of WGA. PMID- 2719698 TI - Infusion of human insulin-like growth factor I (IGF-I) into malnourished rats reduces hepatic IGF-I mRNA abundance. AB - To determine whether the serum level of IGF-I influences its hepatic synthesis through negative feedback regulation, we infused 200 micrograms/d of human IGF-I subcutaneously into young male rats eating either an energy-restricted or ad lib diet. In energy-restricted rats, a two-fold increase in serum IGF-I concentration produced a 41% increase in growth rate at the end of one week, and a 30% decrease in steady state hepatic IGF-I mRNA and 56% drop in serum GH at the end of two weeks. In ad lib fed rats, the increased serum IGF-I concentration neither enhanced growth rate nor significantly reduced hepatic IGF-I mRNA abundance or serum GH levels. These data suggest that the abundance of hepatic IGF-I mRNA in energy-restricted rats is controlled, in part, by serum IGF-I levels via negative feedback regulation. PMID- 2719699 TI - Steroid induced exocytosis: the human sperm acrosome reaction. AB - By a combination of organic precipitation and high pressure liquid chromatography, human sperm acrosome reaction inducing activity has been purified from the fluid aspirated from preovulatory human ovarian follicles and identified as 4-pregnen-3,20-dione (progesterone) and 4-pregnen-17 alpha-ol-3,20-dione (17 alpha-hydroxyprogesterone). It is argued that progesterone is present at the site of fertilization of placental mammals in concentrations sufficient for activity, and hence provides a mechanism of inducing the acrosome reaction, an exocytotic event, in vivo. PMID- 2719700 TI - Iron binding to alpha-tocopherol-containing phospholipid liposomes. AB - Tocopherols (vitamin E) located in the hydrophobic domains of biological membranes act as chain breaking antioxidants preventing the propagation of free radical reactions of lipid peroxidation. The naturally occurring form, d-alpha tocopherol is an exquisite molecule in that it is intercalated in the membrane in such a way that the hydrophobic tail anchors the molecule positioning the chromanol ring containing the hydroxyl group, which is the essence of its antioxidant function, at the polar hydrocarbon interface of phospholipid membranes. The interaction of this group with water soluble substances is not very well understood. In the present study, an investigation was made of the interaction of ascorbate and ferrous ions (Fe+2) initiators of lipid peroxidation with alpha tocopherol. The results show that tocopherol increases membrane associated iron. The formation of a tocopherol iron complex in the presence of phospholipid liposomes and ascorbate in its reduced form is indicated. These results suggest a new way in which tocopherols act to inhibit lipid peroxidation. PMID- 2719701 TI - Deuterium isotope effects on toluene metabolism. Product release as a rate limiting step in cytochrome P-450 catalysis. AB - Liver microsomes from phenobarbital-induced rats oxidize toluene to a mixture of benzyl alcohol plus o-, m- and p-cresol (ca. 69:31). Stepwise deuteration of the methyl group causes stepwise decreases in the yield of benzyl alcohol relative to cresols (ca. 24:76 for toluene-d3). For benzyl alcohol formation from toluene-d3 DV = 1.92 and D(V/K) = 3.53. Surprisingly, however, stepwise deuteration induces stepwise increases in total oxidation, giving rise to an inverse isotope effect overall (DV = 0.67 for toluene-d3). Throughout the series (i.e. d0, d1, d2, d3) the ratios of cresol isomers remain constant. These results are interpreted in terms of product release for benzyl alcohol being slower than release of cresols (or their epoxide precursors), and slow enough to be partially rate-limiting in turnover. Thus metabolic switching to cresol formation causes a net acceleration of turnover. PMID- 2719702 TI - Isolation, primary structure and bioactivity of schistoflrf-amide, a FMRF-amide like neuropeptide from the locust, Schistocerca gregaria. AB - We have isolated a neuropeptide, related to the Phe-Met-Arg-Phe-NH2 family, from the thoracic nervous system of the locust, Schistocerca gregaria, using a purification system based on the radioimmunoassay of high pressure liquid chromatography fractions. The primary sequence of this locust peptide is Pro-Asp Val-Asp-His-Val-Phe-Leu-Arg-Phe-NH2. The bioactivities of the native and synthetic neuropeptide are identical in both the locust heart and hindleg extensor-tibiae muscle bioassays. PMID- 2719703 TI - Alpha-sarcin impairs the N-glycosidase activity of ricin on ribosomes. AB - In a recently described method the RNA N-glycosidase activity of ricin is measured by h.p.l.c. determination of the adenine released from ribosomes after conversion of the base into its fluorescent 1-N6-etheno derivative [Zamboni et al. (1989) Biochem. J., 259, in press]. Unlike previously available methods, based on the separation of RNA fragments by gel electrophoresis, the new method allows one to investigate the activity of ricin on ribosomes pretreated with alpha-sarcin, a cytotoxin which cleaves 28S rRNA at one nucleotide distance from the site of attack of ricin. alpha-Sarcin makes ribosomes a poor substrate for ricin, the release of adenine requiring concentrations of ricin 50-times higher than those effective on untreated ribosomes. PMID- 2719704 TI - Isolation and primary structure of rat secretin. AB - A major form of rat secretin was purified to homogeneity from small intestine, being detected with a porcine secretin radioimmunoassay throughout 7 chromatographic steps. The sequence of the heptacosapeptide amide H-S-D-G-T-F-T-S E-L-S-R-L-Q-D-S-A-R-L-Q-R-L-L-Q-G-L-V-NH2 shows that rat secretin has a glutamine residue in position 14 instead of arginine as in pig secretin. PMID- 2719705 TI - NG-methylarginine, an inhibitor of endothelium-derived nitric oxide synthesis, is a potent pressor agent in the guinea pig: does nitric oxide regulate blood pressure in vivo? AB - Nitric oxide is a major endothelium-derived vascular smooth muscle relaxing factor; its synthesis from L-arginine is selectively inhibited by L-NG methylarginine. To assess whether basal nitric oxide release contributes to blood pressure regulation in vivo, we have investigated the cardiovascular effects of L NG-methylarginine in the anesthetized guinea pig. L-NG-methylarginine (0.1-10 mg/kg, i.v. bolus) elicited a sustained, dose-dependent, increase in arterial pressure and a moderate bradycardia. L-arginine (30 mg/kg i.v.) prevented or reversed the pressor effect of L-NG-methylarginine, while atropine (2 mg/kg) abolished the associated bradycardia. In contrast, L-arginine did not attenuate the pressor effect of norepinephrine or angiotensin. Our findings suggest that basal nitric oxide production is sufficient to modulate peripheral vascular resistance; hence nitric oxide may play a role in arterial pressure homeostasis. PMID- 2719706 TI - The latent form of macropain (high molecular weight multicatalytic protease) restores ATP-dependent proteolysis to soluble extracts of BHK fibroblasts pretreated with anti-macropain antibodies. AB - Specific immunoadsorption of the high molecular weight multicatalytic protease, macropain, from postmicrosomal extracts of BHK fibroblasts inhibited ATP dependent proteolysis of exogenous protein substrates. The immunoprecipitated macropain represented the latent (L) form of the protease because it had low protease activity but was activated by methods that activate purified macropain L. Reconstitution of the antibody-treated extracts with purified macropain L, but not macropain A, from bovine heart or human erythrocytes, completely restored ATP dependent proteolysis, even though ATP did not directly activate either purified macropain L or the immunoprecipitated protease. Reconstituted ATP-dependent proteolysis was saturable with respect to added macropain and never exceeded the level of proteolysis present in the original extract. These results indicate that macropain L plays a key role in ATP-dependent proteolysis but suggest that the protease may require interaction with or modification by another cellular component to demonstrate this effect. PMID- 2719707 TI - Glass transition of deoxymyoglobin probed by optical absorption spectroscopy. AB - We have measured the absorption spectrum of horse deoxymyoglobin in glycerol water mixture around 430 nm in the 130 - 320 K temperature range. The observed asymmetric spectral shape of the Soret band was analyzed using a configuration coordinate model. The results support the idea that myoglobin is liquid-like at physiological temperatures, but is glass-like below about 250 K. The equilibrium position of the iron atom in the heme group in the electronic excited state was estimated from the determined parameter values. PMID- 2719708 TI - Occurrence of the erythroid cell specific arachidonate 15-lipoxygenase in human reticulocytes. AB - Human reticulocytes obtained from patients suffering from various haemolytic disorders convert exogenous [1-14C]-arachidonic acid to 15-hydroxy 5,8,11,13(Z,Z,Z,E)-eicosatetraenoic acid (15-HETE). Immunological studies (dot blot, Western blot) indicated that human reticulocytes contain a lipoxygenase which cross-reacts with a polyclonal antiserum against the rabbit reticulocyte lipoxygenase. Northern blotting with a cloned lipoxygenase cDNA probe shows that the specific mRNA is also present. Reaction of the lipoxygenase with submitochondrial particles caused inactivation of respiratory enzymes. The occurrence of an erythroid cell specific lipoxygenase of similar type in reticulocytes of various mammals and man suggests the general role of this enzyme in the maturational degradation of mitochondria. PMID- 2719709 TI - Modification of cell growth-dependent gene transcript levels by sodium butyrate in serum stimulated fibroblasts. AB - We have analyzed the effect of sodium butyrate, under conditions which block the transition from G0 to S phase, on the steady-state levels of several cell growth dependent mRNAs in ts13 cells, a G1-specific temperature sensitive mutant of the BHK cell line. The RNAs studied were: beta-actin, vimentin, ATP/ADP translocase, histone H3 and p1B6, a cell growth-dependent sequence selected from a ts13 derived cDNA library. We found that induction of p1B6 RNA by serum in the presence of butyrate is greater than in its absence. The levels of histone and ATP/ADP translocase transcripts are lower when induced in the presence of butyrate, while beta-actin and vimentin RNA levels are little modified by the drug. Mitoguazone and incubation at the non-permissive temperature which, also, arrest cells at the pre-replicative stage, and hydroxyurea and cytosine arabinoside, which block them at the early S phase, have different effects on the levels of these transcripts. PMID- 2719710 TI - An improved purification procedure for rat liver lysosomal phospholipase A1. AB - A purification procedure is presented for the isolation of lysosomal acid phospholipase A1 (PLA1) from livers of non-pretreated rats, in a high yield and purity. The purification starts from a crude mitochondrial-lysosomal fraction. PLA1 is solubilised and subsequently purified by chromatography on concanavalin A Sepharose, by chromatofocusing, and by gel filtration. After chromatofocusing, the enzyme is already purified 50200-fold with a yield of 50%, and after gel filtration 56600-fold with a yield of 7%. Purified PLA1 exhibits a specific activity of approx. 8.2 mumol phosphatidylethanolamine (preferred substrate) hydrolysed per min per mg protein, and upon chromatofocusing an apparent isoelectric point of 5.3 Gel filtration of purified PLA1 suggests a molecular mass of about 29 kDa, whereas in SDS-PAGE two proteins of 27 kDa and 55 kDa (mass ratio about 1/2) were visualised. PMID- 2719711 TI - Dynamic properties of interaction between nucleic acid bases and models of amino acids. AB - We have discussed the possible hydrogen bonding mode of adenine-uracil base dimers and peptide side chains, together with their characteristic effects on the stability of adenine-uracil base pairing in chloroform solution by using proton nuclear magnetic resonance methods, where acetamide and butyric acid were used as a model of residues of glutamine and glutamic acid, respectively, and were added to an adenine-uracil equimolar mixture. The stability of base pairing was affected significantly when the model compounds approached the adenine-uracil base pairs; that is, the Hoogsteen type was destroyed, while the Watson-Crick type was formed more favorably. PMID- 2719712 TI - Stabilization of hexokinases I and II of ELD cells by binding to mitochondria. AB - Significance of the binding of hexokinase to mitochondria was examined with respect to stabilization of the enzyme by the binding. Stability during the incubation of the mitochondria-bound forms of hexokinases I and II, both prepared from Ehrlich-Lettre ascites hyperdiploid tumor cells (ELD cells), were compared with that of the corresponding free forms. During the incubation at pH 7.4 and 37 degrees C up to 60 min, hexokinase activities decreased gradually, and the decrease in the activity of the free form was much more marked than that of the bound form for both hexokinases. Hexokinase II was much less stable than I, and the activity of the free form of the former was almost lost by the incubation for 15 min. But, more than a half of the original activity of hexokinase II was retained even after 60 min of the incubation when the enzyme was bound to mitochondria. Addition of 50 mM glucose increased the stability of hexokinase II, but the stabilizing effect was less marked for hexokinase I. On the other hand, addition of 28 mg/ml of bovine serum albumin markedly stabilized hexokinase I to almost the same extent as was observed with mitochondria. On the contrary, the serum albumin had little stabilizing effect on hexokinase II. These findings indicate that the binding to mitochondria stabilizes the hexokinases of ELD cells, though the stability is different by nature between hexokinases I and II. PMID- 2719713 TI - Interaction of caffeine and of theophylline with liver glutamate dehydrogenase. AB - Caffeine and theophylline inhibited the activity of rat liver glutamate dehydrogenase (GDH), but not that of beef liver GDH, in forward and reverse directions of the enzyme reaction. In the forward direction, approximately 16 mM caffeine or 16 mM theophylline inhibited 50 per cent of the rat liver GDH activity (I50); while in the reverse direction, the I50 of caffeine and theophylline was 15 mM and 8 mM, respectively. The inhibition produced by caffeine was cooperative in both directions, while that of theophylline was negatively cooperative in the forward direction and non-cooperative in the reverse. However, ADP reduced the inhibitory effect of caffeine and theophylline to the extent of 40% and 80%, respectively. The Ki values obtained for caffeine and theophylline were different in the presence of various concentrations of substrates and coenzymes. Based upon these data, we presume that certain subtle changes occurring in the conformation of the rat liver GDH (probably at the ADP/NADH site) in comparison with those of the beef liver GDH may be responsible for its inhibition by caffeine and theophylline. PMID- 2719714 TI - Effect of H-7 on the modulation of glucagon actions by activators of protein kinase-C. AB - The stimulations of ureagenesis and cyclic AMP accumulation induced by glucagon were inhibited by 10 nM vasopressin or 100 nM phorbol 12-myristate 13-acetate (PMA). The maximal accumulation of cyclic AMP induced by glucagon was clearly diminished by these agents without change in the EC50 for the peptide hormone suggesting a non-competitive type of inhibition. H-7 blocked the inhibition of glucagon-stimulated ureagenesis induced by PMA and vasopressin and diminished their effect on the accumulation of cyclic AMP induced by glucagon. It is concluded that activation of protein kinase C inhibits the stimulation of ureagenesis and the accumulation of cyclic AMP induced by glucagon in liver cells from hypothyroid rats; H-7 inhibits the effects of protein kinase C activation. PMID- 2719715 TI - A novel transcription unit within the exon sequence of the rat insulin like growth factor II gene. AB - We identified a transcription unit within a single exon of the rat insulin like growth factor II (rIGFII) gene by a combination of Northern blotting, S1 nuclease mapping and primer extension analyses. Among multiple mRNA products of rIGFII, the 1.8kb transcript has a discrete 5' terminus and is encoded exclusively in a single 3'-extreme exon with no trace of the coding region. The upstream region of the 5' terminus contains a completely matching GC-rich 16bp palindrome and several sequence motifs highly homologous to the consensus sequences of binding sites for transcriptional regulatory proteins AP2, H2TF1 and NF-kappa B. PMID- 2719716 TI - cis-beta-acetylacrylate is a substrate for maleylacetoacetate cis-trans isomerase. Mechanistic implications. AB - Maleylacetoacetate cis-trans isomerase together with coenzyme glutathione catalyzes cis-trans isomerization of cis-beta-acetylacrylate strongly suggesting that the isomerase directly catalyzes isomerization of the diketo forms in addition to the ketoenol forms of maleylacetone and maleylacetoacetate. The isomerase exhibits wider substrate acceptance than previously thought. PMID- 2719717 TI - Glucuronidation of 3'-azido-3'-deoxythymidine: human and rat enzyme specificity. AB - Since preclinical studies indicated that 3'-azido-3'-deoxythymidine (AZT, zidovudine, Retrovir, BW A509U), a potent anti-HIV agent, is not metabolized extensively in rats, rabbits, mice, guinea pigs, cats, or dogs, the extensive biotransformation of AZT observed in humans was not expected. On average, approximately 75% of an oral AZT dose is recovered in human urine as a single metabolite while only 14-18% of the dose is recovered unchanged. Ultraviolet, infrared, nuclear magnetic resonance, and mass spectra and enzymatic degradation characterized the isolated major metabolite as a 5'-O-glucuronide (3'-azido-3' deoxy-5'-beta-D-glucopyranuronosylthymidine, GAZT), a very unique nucleoside metabolite. These observations suggest that UDP-glucuronosyltransferase (UDPGT), EC2.4.1.17, mediates the in vivo biotransformation of AZT to GAZT. Since glucuronidation is one of the major conjugation reactions involved in the metabolic conversion of xenobiotics to more polar, water-soluble metabolites, it is an important detoxification pathway in humans. Therefore, it is important to understand the enzymatic basis for the discrepancy between metabolism of AZT in laboratory mammals and humans. This is especially relevant in light of the use of laboratory mammals to predict the metabolism of novel pharmaceutical agents in humans. The study presented herein confirms that liver UDPGT does catalyze the glucuronidation of AZT and that the higher substrate efficiency of AZT with human enzyme compared to rodent enzyme may account for metabolic differences observed in vivo. PMID- 2719718 TI - Interrelationship between affinity for DNA, cytotoxicity and induction of DNA breaks in cultured L1210 cells for two series of tricyclic intercalators. Simplified analogues of ellipticine derivatives. AB - The interrelationship between affinity for DNA, cytotoxicity and induction of single-strand DNA breaks in cultured L1210 cells was studied for 21 compounds belonging to two series of tricyclic intercalators: 1-amino-substituted 4-methyl 5H-pyrido[4,3-b]indoles (gamma CARB) and 1-amino-substituted 4-methyl-5H pyrido[3',4':4,5]pyrrolo[2,3-c]pyridines (PPP), which are simplified analogues of Ellipticine derivatives obtained by deletion of one cycle. Adriamycin, m-AMSA (4' (9-acridinylamino) methanesulfon-m-anisidide), PZE (10-[diethylaminopropyl amino] 6-methyl-5H-pyrido[3',4':4,5]-pyrrolo[2,3-g] isoquinoline and RTE [( 1-(3 diethylaminopropylamino)-9-methoxy ellipticine, bimaleate) are used as reference compounds. The intercalation of these compounds into DNA was strongly suggested by three experimental observations: (i) the competitive inhibition of ethidium bromide intercalation, (ii) bathochromic and hypochromic effects on absorption spectra induced by DNA, and (iii) drug-induced increase of the DNA length, measured by viscosimetry. PPP derivatives are generally less cytotoxic and induce DNA breaks less efficiently than the gamma CARB ones, both in terms of maximum breakage frequencies and required drug concentrations. The most active compounds induced SSB in the DNA of L1210 cells, in a bell-shaped manner: the SSB frequency increased, rose to a maximum and then decreased as the drug concentrations increased. The maximum SSB frequencies induced by the most active compounds are of the same order as those of reference compounds Adriamycin and PZE. The structurally important requirements are essentially the same for both DNA breakage activity and cytotoxicity: (i) a N-CH3 in the 5-position, (ii) a CH3 in the 4-position, (iii) a hydroxy in the 8-position and (iv) the presence of an (aminoalkyl)amino side chain with preferentially a 3 carbon unit. There is no direct relationship between DNA affinity in vitro and induction of DNA breaks in cells, although a relatively high affinity seemed to be a necessary condition, since the most active compounds have the highest affinities and compounds having a very low affinity are totally inactive. The close correlation between cytotoxicity and extent of induction of DNA breaks suggests that these breaks may be in fact the lethal lesions responsible for cell death and thereby for the antitumor properties of these tricyclic intercalators. PMID- 2719719 TI - Oxygen dependence of salbutamol elimination by the isolated perfused rat liver. AB - Although impairment of drug metabolism by severe hypoxia is well documented in perfused liver preparations, the degree of hypoxia required to produce inhibition of drug elimination pathways in the intact liver has not been defined. In this study, in the isolated perfused rat liver, we examined the relationship between the rate of hepatic oxygen supply and the elimination rate of the drug salbutamol, which in the rat liver is eliminated largely by glucuronidation. Livers (N = 15) from male Sprague-Dawley rats were perfused in a non-recycling design with 10% human red cells in a Krebs-Henseleit electrolyte solution. Salbutamol elimination was examined during normal oxygenation (perfusate equilibrated with 100% O2; mean O2 delivery 3.21 mumol/min/g liver), at a given lower rate of oxygen delivery (achieved by producing different mixtures of N2 with O2 in the perfusate oxygenator) and after reoxygenation. In these experiments, hepatic clearance of salbutamol (perfusate concentration 50 ng/ml) was essentially independent of oxygen delivery above a rate of 2.0 mumol/min/g liver; below this level, clearance fell linearly as O2 supply was reduced. In all livers, reoxygenation restored drug elimination to control levels. In further experiments using a recycling design (N = 22), the effect of hypoxia on salbutamol elimination was found to be very similar. In recycling normoxic experiments (N = 3), the glucuronide metabolite was detected in perfusate and bile, but no sulphate metabolite was detected. While previous studies indicate that elimination of some oxidatively metabolised substrates is very sensitive to reductions in hepatic oxygenation, the present study shows that, in the isolated liver, large reductions in hepatic oxygen supply were required to produce significant impairment of the glucuronidation-dependent elimination of salbutamol. PMID- 2719720 TI - Diurnal variation and melatonin induction of hepatic molybdenum hydroxylase activity in the guinea-pig. AB - The activities of the xenobiotic metabolizing enzymes, aldehyde oxidase and xanthine oxidase, were determined in partially purified fractions of adult guinea pig liver at given times in the day or night. A marked circadian variation in aldehyde oxidase activity was observed with several substrates (phthalazine, phenanthridine, N-phenylquinolinium and 3,4-dihydro-4-hydroxy-3-methyl-2 quinazolinone). The main peak occurred at 0300 hr with minimum activity from 1200 to 1800 hr, the differences between rhythmic extremes being statistically significant (P less than 0.005). Xanthine oxidase activity also exhibited a daily rhythm but with a lower amplitude. Guinea-pig serum melatonin showed a synchronous circadian fluctuation with peak values at 0300 hr falling throughout the day to a minimum at 1800 hr. Exogenously administered melatonin caused a significant increase in aldehyde oxidase activity at 0900 and 1200 hr and in xanthine oxidase activity at 0900 hr. It was concluded that melatonin concentrations may be related to the circadian variation in liver molybdenum hydroxylase activity. PMID- 2719721 TI - Structure-activity relationship of ligands of dihydrouracil dehydrogenase from mouse liver. AB - One hundred and five nucleobase analogues were screened as inhibitors of dihydrouracil dehydrogenase (DHUDase, EC 1.3.1.2) from mouse liver. 5 Benzyloxybenzyluracil, 1-deazauracil (2,6-pyridinediol), 3-deazauracil (2,4 pyridinediol), 5-benzyluracil, 5-nitrobarbituric acid and 5,6-dioxyuracil (alloxan) were identified as potent inhibitors of this activity, with apparent Ki values of 0.2, 0.5, 2.1, 3.4, 3.8 and 6.6 microM respectively. Both 5 benzyloxybenzyluracil and 1-deazauracil were also potent inhibitors of DHUDase from human livers. These findings along with an extensive review of literature allowed the formulation of a structure-activity relationship. The binding to DHUDase required intact C2 and C4 oxo groups. Replacement of N1 or N3 by an endocyclic carbon enhanced binding. In contrast, replacement of C5 or C6 by an endocyclic nitrogen abolished binding. Addition of a charged group to C5 and/or C6, and of a hydrophobic group to C5 but not C6 improved the binding. PMID- 2719722 TI - Effects of the catecholaminergic neurotoxin N-(2-chloroethyl)-N-ethyl-2 bromobenzylamine (DSP-4) on adrenal chromaffin cells in culture. AB - N-(2-Chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) is an inhibitor of noradrenaline uptake and a neurotoxin known to deplete noradrenaline levels with little effect on dopamine, serotonin or adrenaline in the central nervous system. The present study tested the effects of DSP-4 on catecholamine uptake, release and content in cultures of isolated bovine adrenal chromaffin cells. DSP-4 selectively inhibited the acute uptake of [3H]noradrenaline with little or no effect on [3H]adrenaline or [3H]dopamine uptake. In cultures preloaded with [3H]catecholamines, DSP-4 stimulated the release of [3H]noradrenaline and, to a small extent, also [3H]adrenaline and [3H]dopamine. However, the drug did not stimulate the release of appreciable amounts of endogenous adrenaline, noradrenaline or dopamine. A high concentration of DSP-4 inhibited the carbachol stimulated release of adrenaline, noradrenaline and dopamine from the cells. Following a 1-hr exposure to the drug, DSP-4 decreased adrenaline, noradrenaline and dopamine levels in the cells with no gross morphologic changes in the cells. Reductions in adrenaline and noradrenaline levels were almost equal in magnitude, while dopamine was depleted to a somewhat greater extent under some conditions. Longer exposure to DSP-4 resulted in morphological changes in the cells, suggesting that the drug is also toxic to chromaffin cells in culture. PMID- 2719723 TI - Semicarbazide-sensitive amine oxidase (SSAO) of the rat aorta. Interactions with some naturally occurring amines and their structural analogues. AB - The influence of a number of naturally occurring amines and their structural analogues has been examined on the metabolism of radiolabelled benzylamine (BZ) by the membrane bound semicarbazide-sensitive amine oxidase (SSAO) of the rat aorta. Only primary monoamines were effective in reducing the deamination of BZ. In the phenylethylamine series, addition of hydroxyl groups to the benzene ring decreased their potency as inhibitors while addition of a hydroxyl group at the beta position increased the inhibitory potency. Stereoselectivity of action was shown with octopamine, the L-isomer being the more active form. Kinetic analysis of these interactions showed predominantly competitive inhibition and kynuramine had the lowest Ki of 5.4 microM. The aliphatic monoamines, isoamylamine and isobutylamine both competed with BZ. 5-Hydroxytryptamine (5-HT) was the only amine that inhibited non-competitively. Direct evidence for metabolism by SSAO of some of the competing amines such as isoamylamine, phenylethylamine, tyramine and tryptamine was obtained by fluorimetric or radiochemical assays. The inhibitors clorgyline and (E)-2-(3',4'-dimethoxyphenyl)-3-fluoroallylamine (MDL 72145) were used to characterise the amine oxidase activity responsible for the deamination. Octopamine and phenylethanolamine (PeOH) were not SSAO substrates and inhibited BZ metabolism in the fluorimetric assay. It is possible that the activity of SSAO is controlled by octopamine released from sympathetic nerve endings or 5-HT released from platelets. PMID- 2719724 TI - Degradation by rat tissues in vitro of organophosphorus esters which inhibit cholinesterase. AB - Hydrolytic "A"-esterase activities of various tissues of rat (plasma, liver, kidney, brain and intestinal mucosa) against selected OP esters of diverse structure as potential substrates (paraoxon, di-n-propyl paraoxon, di-n-butyl paraoxon, chlorpyrifos oxon, di-(4-phenyl butyl) phosphorofluoridate and the chiral isomers of ethyl 4-nitrophenyl phenylphosphonate) were studied. We have developed a sensitive and widely applicable assay depending on measuring decline in residual inhibitory power of any chosen OP against horse serum cholinesterase: for seven compounds examined so far I50s against BuChE ranged from 0.07 to 70 nM, and it is easy to monitor loss of OP starting from an initial 25 microM concentration. Progressive destruction rates were always highest in liver and plasma with activity sometimes detectable in kidney, brain but not in intestinal mucosa, but the ratios of activity between tissues differed for different substrates. At 25 microM/37 degrees/pH 7.2 hydrolysis rates ranged from 8500 nmol/min/g liver for di-(4-phenylbutyl) phosphorofluoridate down to 0.8 nmol/min for the butyl analogue of paraoxon; the rate for L(-) isomer of EPN oxon (23 nmol/min/g liver) was greater than 2x that for the D(+) isomer and for paraoxon. From our data we conclude that several OP hydrolases exist whose identity may be further characterised by use of selective substrates. PMID- 2719725 TI - Cytochromes P-450 in the intestinal mucosa of man. AB - With monoclonal antibodies against cytochrome P-450(5) and P-450(4,5,6), 52 and 54 kDa bands are visualized in microsomes from proximal as well as distal human small intestine. These bands most probably correspond to cytochrome P-450(5) and P-450(4), respectively. This and several other cytochrome P-450 related proteins are present in hepatic microsomes from the same patient. In both hepatic and intestinal microsomes from this patient cytochrome P-450(8) is hardly detectable. In contrast to the small intestine and liver, large intestinal tissue from several other patients does not contain cytochrome P-450(5). Here the 54 kDa isoenzyme, possibly cytochrome P-450(4), is most prominent. Earlier we found a higher content of total cytochrome P-450 in the proximal as compared to the distal small intestine. A similar distribution is now found with regard to aldrin epoxidase activity. PMID- 2719726 TI - Potentially-implantable, amperometric glucose sensors with mediated electron transfer: improving the operating stability. AB - The major problems with existing amperometric enzyme electrodes for glucose sensing are oxygen sensitivity and output drift. The recently described miniature glucose sensors using immobilised ferrocene (dicyclopentadienyl iron) to mediate electron transfer from glucose oxidase to a base electrode are oxygen-independent but are often unstable. In this study, we test the hypothesis that the stability of ferrocene-based sensors can be markedly improved by better retention of the enzyme at the electrode. Sensors with graphite foil as the base electrode, dimethylferrocene as the mediator and carbodiimide/glutaraldehyde for enzyme immobilisation lost most of their activity when calibration curves were compared before and after 18 h operation in vitro at 37 degrees C (mean current decrease at 20 mmol/litre glucose was 91%). This sensor type with a covering cellulose membrane also lost activity (mean current decrease of 40% after 18 h). Electrodes in which the base sensor was platinum and the enzyme was covalently attached to agarose lost no activity when operated either at 700 mV without mediator (as a hydrogen peroxide detector) or at 160 mV with mediator. We conclude that both ferrocene-mediated and hydrogen peroxide-detecting amperometric glucose sensors with a high density of covalently-linked enzyme have an operating stability in vitro which may render them suitable for clinical use as, for example, an overnight hypoglycaemia alarm. PMID- 2719727 TI - Lymphoid irradiation in intractable rheumatoid arthritis. Long-term followup of patients treated with 750 rads or 2,000 rads. AB - Twenty patients with intractable rheumatoid arthritis were randomized to receive 750 or 2,000 rads of lymphoid irradiation (LI) in a double-blind comparative study, and were followed for a maximum of 48 months (mean 40 months) after treatment. During followup, sustained immunomodulation (including lymphopenia, particularly of the T helper cell subset; reduced ratio of helper cells to suppressor cells; and impaired in vitro lymphocyte proliferation in response to phytohemagglutinin and pokeweed mitogen) was observed. Significant improvements in early morning stiffness, Ritchie articular index, pain score, grip strength, and 15-meter walk time were observed in both treatment groups, but these were not sustained through the followup period. Progressive joint damage was observed radiologically in both groups during followup. Thus, LI induced sustained immunosuppression, but resulted in only short-lived clinical improvement and was associated with progressive joint erosion in these patients. PMID- 2719728 TI - A simplified twenty-eight-joint quantitative articular index in rheumatoid arthritis. AB - We describe a joint index that includes only 28 joints: 10 proximal interphalangeal joints of the fingers, 10 metacarpophalangeal joints, and the wrists, elbows, shoulders, and knees. These joints are evaluated for swelling, tenderness, and limited motion, with the findings scored as abnormal or normal. The 28-joint index is considerably easier to use than traditional methods, and appears to yield as much information in terms of correlation with other measures of clinical status, including hand radiograph scores, American Rheumatism Association functional class, grip strength, walking time, and activities of daily living questionnaire scores (r = 0.25-0.53, P less than 0.001). Simplified joint counts might facilitate acquisition of quantitative articular data in research and clinical rheumatologic settings. PMID- 2719729 TI - Work disability among women with rheumatoid arthritis. The relative importance of disease, social, work, and family factors. AB - Yelin and others have shown social work factors to be more important than disease factors in predicting work disability among arthritis patients; however, the effects of family factors on work role functioning have not been considered in previous explanatory models. In this study, we use Yelin's model to explain work disability among 122 women with rheumatoid arthritis and to incorporate family factors into the model. Using logistic regression, we found, as with previous studies, that work autonomy, social factors, and disease factors are important predictors of work disability. In the logistic regression model, self-assessed health status seemed to be more important than work factors in predicting work status. Further, family factors significantly contributed to the explanatory model, in that having more home responsibilities was associated with lower risk of work disability. PMID- 2719730 TI - Synovial fluid characteristics and the lupus erythematosus cell phenomenon in drug-induced lupus. Findings in three patients and review of pertinent literature. AB - The characteristics of synovial fluid obtained from 3 patients with drug-induced lupus erythematosus are described. Two patients had "inflammatory" counts of synovial leukocytes, in the range of 2,500-39,000/mm3, with mononuclear predominance in 1 patient and neutrophil predominance in the other. The third patient had "noninflammatory" fluid, with mononuclear predominance. Lupus erythematosus cells formed in vivo were observed in the synovial fluid of 2 of the patients. Biopsy of the synovium of 1 patient showed nonspecific chronic inflammatory changes. Our findings in these patients with drug-induced lupus are indistinguishable from those previously described in patients with idiopathic lupus erythematosus. PMID- 2719731 TI - Spontaneous production of fibronectin by alveolar macrophages in patients with scleroderma. AB - Interstitial pulmonary fibrosis is a common manifestation of systemic sclerosis (SSc) and is a pathologic feature shared by a variety of other diseases. In these other disease processes, the glycoprotein fibronectin (FN) has been shown to be released by the alveolar macrophage, and is thus implicated in the development of fibrosis. We therefore studied the release of FN by alveolar macrophages obtained by bronchoalveolar lavage of 17 patients with SSc and 14 controls. We found that SSc alveolar macrophages released significantly more FN than did those of controls. Furthermore, the level of FN correlated positively with the level of inflammation determined by cellular analysis of lavage fluid and negatively with carbon monoxide diffusing capacity. FN may therefore play a role in the development of lung fibrosis in SSc and may be a marker of alveolitis. PMID- 2719732 TI - Changes in the metaphysis and diaphysis of the femur proximal to the knee in rabbits with experimentally induced inflammatory arthritis. AB - We quantified the cross-sectional cortical bone area and remodeling rates in the ipsilateral femoral diaphysis and metaphysis of rabbits with carrageenan-induced inflammatory monarthritis of the knee. Although osteogenesis rates were significantly elevated (approximately threefold in diaphyses and sixfold in metaphyses), the cross-sectional bone area of the diaphysis was significantly diminished. Fivefold and sixfold increases in bone resorption rates were calculated in diaphyses and metaphyses, respectively. Other morphologic changes observed were porosity and net resorption of the anterior cortex and net accretion on the posteromedial cortex ("drift" of bone). These findings may have clinical significance with regard to the mechanisms and consequences of bone changes in patients with rheumatoid arthritis. PMID- 2719733 TI - Retinyl acetate-induced arthritis in C3H-A(vy) mice. AB - Severely impaired musculoskeletal mobility in C3H-A(vy) mice was noted during a pharmacologic trial evaluating the antitumorigenic properties of retinyl acetate (RAc). To determine the etiology of this impairment, we studied 103 female C3H A(vy) mice that were fed RAc in daily doses of 75-300 micrograms or placebo and were killed after 3-16 months. Whole-body radiographs and histologic sections of the hindlimbs were scored for presence and severity of arthritis. C3H-A(vy) mice treated with RAc in any dose had a significantly higher incidence of arthritis than placebo-treated mice. Histologic evidence of enthesopathic disease closely paralleled the radiographic changes and ranged from small enthesophytes at tendinous and capsular insertions to complete periarticular bony bridging. Articular cartilage was not grossly affected. The incidence and severity of arthritis were significantly correlated with the total dose of RAc administered. The bony metaplasia induced by RAc was similar to the pathologic changes caused by other retinoids. This model may be useful for studying the pathogenesis of periarticular bone formation in diffuse idiopathic skeletal hyperostosis and related syndromes. PMID- 2719734 TI - Treatment of the anemia of rheumatoid arthritis with recombinant human erythropoietin: clinical and in vitro studies. AB - Two anemic patients with rheumatoid arthritis were treated with recombinant human erythropoietin (EPO) for 5 months. Both patients showed significant increases in hematocrit, red cell volumes, and marrow erythroid and megakaryocyte progenitor cells. No significant toxic effects from EPO were observed. These data indicate that EPO may be effective in overcoming the pathogenetic factors that limit erythropoiesis in rheumatoid arthritis. PMID- 2719735 TI - Medical treatment of synovial cysts of the zygapophyseal joints: four cases with long-term followup. PMID- 2719736 TI - Metabolism of trimipramine in man. AB - This paper describes studies on the metabolism of the tricyclic antidepressant 5 (3-dimethylamino-2-methylpropyl)-10,11-dihydro-5H-dibenz[b,f]azepine (trimipramine, Stangyl) in man. The metabolites were identified after cleavage of conjugates, extraction and derivatisation by acetylation in human urine using gas chromatography-mass spectrometry. Besides the unchanged trimipramine (T), the following 15 metabolites could be identified: mono- and dihydroxy-T, hydroxy methoxy-T; iminodibenzyl (I), mono- and dihydroxy-I, hydroxy-methoxy-I; nor-T (NT), mono- and dihydroxy-NT, hydroxy-methoxy-NT; bis-nor-T (BNT), mono- and dihydroxy-BNT and hydroxy-methoxy-BNT. Therefore 3 overlapping metabolic pathways can be postulated: N-dealkylation of the nitrogen in the iminodibenzyl ring, 1- and 2-fold N-demethylation of the nitrogen in the side chain and 1- and 2-fold aromatic hydroxylation of the iminodibenzyl ring. The dihydroxy metabolites are partly methylated at one of the hydroxy groups. The hydroxy metabolites are conjugated additionally. PMID- 2719737 TI - Meeting the regulatory requirements for pharmaceutical production of recombinant DNA derived products. AB - Genetic engineering provides the opportunity for the synthesis of human proteins and derivatives thereof which are of significant value for replacement therapy. However, in addition to genetic engineering an extensive process development has to be carried out in order to establish an economic production process and to guarantee consistently high product quality from batch to batch. This includes the characterization of the production host cell vector construct, the validation of the fermentation and the protein purification process as well as the lyophilization and the reconstitution of the final product. A number of in process and final product controls have to be established and limits for the specification have to be elaborated to provide consistent product quality. Real time stability data have to be supplied because data from accelerated conditions do not allow extrapolation of the shelf life of proteins. Data obtained from process development and validation of the production process contributes to the preparation of the chemical pharmaceutical dossier and the expert report to be submitted to the regulatory authorities. PMID- 2719738 TI - Hoe/Bay 946--a new compound with activity against the AIDS virus. PMID- 2719739 TI - Alpha-monoamides of methotrexate as potential prodrugs. AB - alpha-Monoamides of methotrexate were evaluated for their potential as prodrugs. Studies on 11 alpha-monoamides and 5 gamma-monoamides of methotrexate showed that the gamma-monoamides were about as strong inhibitors of Lactobacillus casei dihydrofolate reductase as methotrexate, while I50 of the alpha-monoamides were 1 2 orders higher. The concentration for growth inhibition of murine L1210 cells for methotrexate gamma-propylamide and alpha-propylamide were respectively 1-2 and 2-3 orders higher than that of methotrexate. In contrast, only alpha monoamides caused significant increase in life span of mice with transplanted L1210 leukaemia, the highest effect being given by the alpha-propyl and the alpha butylamide. The possibility that the in vivo activity of the alpha-monoamides might be related to in vivo transformation to methotrexate was studied by HPLC analysis of mice serum after administration of the alpha- and gamma-propylamides. PMID- 2719740 TI - Effect of heparin-like compounds on the in vitro proliferation and protein synthesis of various cell types. AB - Previous studies have shown that heparin and heparin-like compounds inhibit the proliferation of arterial smooth muscle cells (SMC) both in vivo and in vitro. This anti-proliferative effect seems to be exerted almost exclusively on arterial SMC and related cell types. In the present study the effect of heparin (HTh) is compared with that of two sulfated glycosaminoglycans with low anticoagulant activity, sulodexide (SDX) and low molecular weight heparin (OP/LMWH) on cell proliferation and protein synthesis of 3 cell types: human arterial smooth muscle cells (SMC), fibroblast-like cells (BHK-21) and epithelial cells (rat hepatoma cells, FAO). HTh, SDX and OP/LMWH (5-100 micrograms/ml) are equally effective in reducing the proliferation of human arterial SMC. This inhibition is dose dependent and reversible. BHK-21 and FAO cells are even more sensitive than SMC to heparin-like compounds. For example 1 microgram/ml of heparin-like compounds is sufficient to produce 40-60% inhibition of FAO cell proliferation. In all types of cells HTh, SDX and OP/LMWH do not reduce the incorporation of 35S methionine into cellular and medium proteins; they increase the radioactivity incorporated into some proteins secreted into the medium. In the case of SMC this effect is dependent on the concentration and the length of exposure to heparin like compounds. These findings demonstrate that several cell types are sensitive to the anti-proliferative effect of heparin-like compounds. PMID- 2719741 TI - A novel class of local antiinflammatory steroids. 1st communication: analogues of methyl 11 beta,17 alpha,21-trihydroxy-3,20-dioxo-pregna-1,4-diene-16 alpha carboxylate. AB - A novel class of steroidal 16-esters and amides, 1-8 has been synthesized and evaluated as safer local antiinflammatory agents. These compounds retain the intact ketol side-chain of prednisolone and have an alkanoate ester or carboxamide function at the C-16 of the steroid nucleus. In the cotton pellet granuloma assay a correlation was observed between the size of the C-16 substituent group and the local antiinflammatory activity. The incorporation of a methyl carboxylate group at the C-16 position of prednisolone as in methyl 11 beta,17 alpha,21-trihydroxy-3,20-dioxo-pregna-1,4-diene-16 alpha-carboxylate, 5, resulted in an increase in antiinflammatory activity. The 17-deoxy analogue of 5, 1, retained one-half the activity of prednisolone. These two compounds were further evaluated for their effects on plasma corticosterone, adrenal and thymic weights at their ID50 doses for granuloma formation. Neither 5 nor 1 depressed plasma corticosterone levels or significantly altered adrenal weights. Compound 1 was also devoid of thymolytic activity, whereas 5 produced a 33% thymic involution at its ID50 compared to 47% for prednisolone at its equiactive dose. PMID- 2719742 TI - Cardiovascular effects of the new cardiotonic agent 1,2-dihydro-6-methyl-2-oxo-5 (imidazo[1,2-a]pyridin-6-yl)-3-pyridine carbonitrile hydrochloride monohydrate. 2nd communication: studies in dogs. AB - The cardiovascular effects of 1,2-dihydro-6-methyl-2-oxo-5-(imidazo[1,2-a]pyridin 6-yl)-3-pyridine carbonitrile hydrochloride monohydrate (E-1020), a new nonglycoside, noncatechol cardiotonic agent, were investigated in dogs. In anesthetized dogs, E-1020 (10-100 micrograms/kg i.v.) dose-relatedly increased cardiac contractility (LV dP/dtmax), enhanced cardiac index and decreased systemic vascular resistance accompanying relatively small reduction in mean aortic pressure and a mild increase in heart rate. Coronary and femoral arterial blood flow were increased by either systemic intravenous or topical administration of E-1020. The degree of increase in myocardial oxygen consumption was only slight (10% at 30 micrograms/kg i.v.). The inotropic effect of E-1020 was not markedly affected by pretreatment with beta-adrenoceptor blockade, reserpine or other cardiotonic agents such as dobutamine or ouabain. In two experimental heart failure models induced by an excessive dose of propranolol or by coronary occlusion following volume-loading, E-1020 (30 micrograms/kg i.v.) rapidly reversed the cardiac depression. In chronically instrumented conscious dogs, E-1020 (30-100 micrograms/kg i.v. or 0.3-10 mg/kg p.o.) produced dose dependent increases in LV dP/dtmax with minor increases in heart rate. E-1020 did not exacerbate arrhythmias of several experimental models in anesthetized dogs even at high dose of 100 micrograms/kg i.v. These results indicate that E-1020 is an intravenously and orally effective cardiotonic agent with vasodilating property, and that it may be beneficial in the treatment of acute and chronic congestive heart failure. PMID- 2719743 TI - Electrophysiological effects of the new antiarrhythmic drug 3 (diisopropylaminoethylamino)-2',6'-dimethylpropionanilide++ + on dog cardiac muscle. AB - The effects of 3-(diisopropylaminoethylamino)-2',6'-dimethylpropionanilide (AN 132), a new antiarrhythmic drug, on the electrical activities of dog ventricular muscles and Purkinje fibers were studied using standard microelectrode techniques. In ventricular muscles, AN-132 (10(-5)-10(-4) mol/l) decreased the overshoot potential and the maximum rate of rise of the action potential without changing the resting membrane potential, the plateau potential and the action potential duration at a driving rate of 0.5 Hz. These results indicate that AN 132 belongs to class 1 antiarrhythmic drugs. Lidocaine (10(-6)-10(-4) mol/l) failed to affect these parameters under the same conditions. In Purkinje fibers, both drugs decreased the plateau potential and shortened the action potential duration. To subclassify AN-132 among class 1 antiarrhythmic drugs, the kinetics of onset of rate-dependent effect of AN-132 (10(-4) mol/l) was compared with that of lidocaine (10(-4) mol/l), and AN-132 was found to have the slower onset kinetics than lidocaine. PMID- 2719744 TI - [The effect of benzenecarboxylic acids--in particular mellitic acid--in in vitro biological system]. AB - Influence of Benzenecarboxylic Acids, Particularly Mellitic Acid, on Biological in vitro Systems. In a first part of the present paper influences of mellitic acid and some other benzenecarboxylic acids on reduplication of Ehrlich ascites tumor cells cultured in vitro are reported. Mellitic acid in the concentration range between 1 and 5 mmol/l caused an increase, in concentrations of 10 mmol/l and above an inhibition of cell multiplication. Benzoic acid, phthalic acid, hemimellitic acid and pyromellitic acid showed in concentrations above 6 to 10 mmol/l inhibitory effects on cell multiplication. The second part reports studies on potential influences of mellitic acid on growth and mesenchymal metabolism of explanted murine fetal tibiae cultured in vitro for six days. Mellitic acid effected in concentrations between 0.5 and 15 mmol/l as compared with control cultures a concentration dependent inhibition of calcification and in concentrations above 2 mmol/l significant increases of the glycosaminoglycan content and growth of the explants, whereas DNA-, total protein- and hydroxyprolin content were not significantly influenced by concentrations up to 10 mmol/l. PMID- 2719745 TI - Disposition of [14C]-benazepril hydrochloride in rat, dog and baboon. Absorption, distribution, kinetics, biotransformation and excretion. AB - The compound 3-[(1-ethoxycarbonyl-3-phenyl-(1S)-propyl)-amino]-2,3,4,5- tetrahydro-2-oxo-1-(3S)-benzazepine-1-acetic acid hydrochloride (benazepril.HCl, CGS 14 824 A) is an ethyl ester prodrug of the angiotensin converting enzyme (ACE) inhibitor benazeprilat (CGS 14 831). The disposition of both compounds was studied in rat, dog and baboon after peroral and intravenous dosing of 14C labelled preparations (2.5-3 mg/kg). Perorally dosed benazeprilat was poorly absorbed in rats, whereas benazepril.HCl was well absorbed in all species. Onset of absorption of benazepril.HCl was fast. Plasma concentrations of radioactivity indicated a prolonged absorption process. Upon intravenous benazepril.HCl, plasma levels declined rapidly in all species but showed a slow terminal elimination phase. Distribution to all organs and tissues occurred rapidly and was typical for an acid compound. Passage of the blood-brain barrier and of the placenta occurred to a minimal extent. No accumulation was observed after repeated dose. Radioactivity was rapidly and completely eliminated; biliary excretion was important. In the rat, benazepril was completely hydrolysed by first pass metabolism to the pharmacologically active benazeprilat. In dog and baboon hydrolysis was incomplete and additional hydrophilic metabolites were formed also. PMID- 2719746 TI - Pharmacokinetics of fosfosal in rats and dogs. AB - Fosfosal (Disdolen) is a non acetyl derivative of salicylic acid with antiinflammatory and analgesic properties and a greater tolerance than acetylsalicylic acid and lysine acetylsalicylate. In the present work the pharmacokinetics of fosfosal have been studied after oral and intravenous administrations of 100 and 80 mg/kg in rats and dogs, respectively. Plasma concentrations of fosfosal and salicylic acid were determined by an HPLC method. After intravenous administration fosfosal plasma levels decreased rapidly showing a half-life of 2.7 min in rats and 6.7 min in dogs. Fosfosal in plasma is quickly hydrolyzed into salicylic acid producing high concentrations in few minutes after administration. The half-life of salicylic acid was 13.8 and 7.1 h for rats and dogs, respectively. After oral administration only salicylic acid was detected in plasma, indicating that fosfosal, when orally administered, behaves as a prodrug. From the comparison of the AUC for salicylic acid obtained after oral and intravenous administrations it can be deduced that fosfosal it totally absorbed in the two species studied. PMID- 2719747 TI - Experimental antitumor activity of new azathioprine analogues. AB - Two newly synthesized azathioprine (AZA) analogues, 6-(1,2-dimethyl-4-nitro-5 imidazolyl)thiopurine (Met-AZA) and 6-(2-methyl-5-nitro-4-imidazolyl)thiopurine (IZO-AZA), were investigated against KB human tumor cells. In 5 transplantable murine tumor models, including sc Sa180, sc Ca755, ip LL and ip leukemias; L1210 and P388 both drugs were found to be antitumor active in all the experiments carried out regardless of dosing regimen or the route of administration. Similar good activity was shown in the KB, ip Sa180, and Ca755 systems and partly against LL as compared to AZA. However, Met-AZA against ip P388 demonstrated therapeutic advantage following qd 1-9 daily dosing, 0.33 log10 tumor cell kill; therapeutic index (TI = ILSmax/ILS 25) = 2, and ILS = 69% in comparison to AZA and IZO-AZA, TI = 1.3, 1.2, and ILS = 31%, 40%, respectively. Met-AZA is comparable to AZA, while seeming to display greater antileukemic activity than AZA. PMID- 2719749 TI - [Cellular electrolyte metabolism and regulation of vascular tonus. Clinical aspects]. AB - In the pathogenesis of essential hypertension the role of intracellular Na+ concentrations due to the secretion of a yet unidentified natriuretic factor is being discussed. Proceeding from the role of Ca++ in vascular smooth muscle contraction the hypothesis of increased intracellular free Ca++ concentrations in essential hypertension has been proposed. The measurements described here first revealed increased cellular concentrations of free Ca++ in essential hypertensives. Furthermore in essential hypertensives and in the spontaneously hypertensive rat a circulating factor was demonstrated increasing blood pressure and stimulating cellular Ca++ uptake. PMID- 2719748 TI - Restorative effect of muroctasin on leukopenia caused by anticancer chemotherapy in lung cancer. Comparative study by envelope method. AB - N2-[(N-Acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP Lys(L18), muroctasin), a derivative of muramyl dipeptide, is known to have the activity to augment the number of white blood cells (WBC) via colony-stimulating factor. Muroctasin has been expected to be applied to leukopenia caused by anticancer chemotherapy. When WBC decreased to less than or equal to 3,000/mm3 after the 1st course of chemotherapy, 131 patients with lung cancer, who were previously classified by the combination regimens of chemotherapy, were enrolled in the study and randomized into 3 groups, 200 micrograms (H), 100 micrograms (L) and untreated control (C) groups. The patients were then subcutaneously treated once daily for 6 consecutive days. WBC and its differential count were measured on Days 4, 7 and 15 after commencement of the study. WBCs in H and L groups were recovered greater than in C group. In WBC differential count, the recovery of neutrophil was prominent in muroctasin treated groups. The portion of immature neutrophil in the bone marrow was also increased by muroctasin treatment. A restorative effect on WBC and neutrophil counts was also confirmed only in the second course of H group. On the other hand, fever and pain in the injected site as side effects were common in the H group and L group in both of courses. In this study, the usefulness of muroctasin in leukopenia was suggested when administered at dosages of 200 micrograms for 6 days. PMID- 2719750 TI - The doctoring degree in audiology. PMID- 2719751 TI - Dysphagia. Learning, accepting, and rejecting limits. PMID- 2719752 TI - Alzheimer's. Patient management means family education. PMID- 2719753 TI - Hearing loss. A hearing aid for a dead ear? PMID- 2719754 TI - Laryngectomy. Support starts pre-op and goes on. PMID- 2719756 TI - Teamwork for the problems of aging. PMID- 2719755 TI - An aging society. The government's response to meeting health care needs. PMID- 2719757 TI - Effects of diets supplemented with lard fat or mackerel oil on plasma lipoprotein lipid concentrations and lipoprotein lipase activities in domestic swine. AB - Levels of plasma lipoproteins and lipoprotein lipase activities in post-heparin serum were measured in 24-h fasted pigs which were fed a diet containing either 21 energy % mackerel oil or 21 energy % lard fat for 8 weeks. Lipoprotein fractionation was performed separately by density gradient ultracentrifugation and agarose gel chromatography. After 8 weeks levels of plasma triacylglycerol ( 62%) and cholesterol (-55%) were lower in the mackerel oil than in the lard fat fed animals. The triacylglycerol decline was exclusively due to the VLDL fraction, while cholesterol was reduced in all lipoprotein fractions (VLDL, IDL, LDL and HDL). Lipoprotein lipase activity in post-heparin serum, taken 6 h after a meal, was 31% decreased in mackerel oil-fed animals. The results support the hypothesis that regular intake of fish oil reduces VLDL secretion. PMID- 2719758 TI - Intestinal apolipoprotein B-48 synthesis and lymphatic cholesterol transport are lower in swine fed high fat, high cholesterol diet with soy protein than with casein. AB - Effects of dietary proteins on intestinal lipoproteins were studied in 8 Yorkshire swine fed a high fat, high cholesterol diet with either casein or soy protein. After 5 weeks of feeding, the casein group exhibited moderately elevated levels of serum cholesterol (334 +/- 46 mg/dl). The soy protein group showed significantly less hypercholesterolemia as compared to the casein group (122 +/- 8 mg/dl). Swine were subjected to cannulation of mesenteric lymph duct under halothane anesthesia. A single dose of 250 microCi [14C]cholesterol and 10 mCi [3H]leucine was infused into the upper jejunum 2 h after one-fifth of daily food was given. The 3-h lymphatic transport of cholesterol in casein-fed swine was significantly higher than in those fed soy protein. Triglyceride transport values were similar in the 2 groups. The [3H]leucine incorporation study revealed that transport of apo B-48 bore a significant positive relationship to transport of cholesterol in both chylomicron and VLDL fractions of mesenteric lymph. A greater apo B-48 secretion with higher specific activity was probably responsible for the greater transport of cholesterol in chylomicrons in casein-fed than in soy protein-fed swine. Similarly, the transport of lymph VLDL cholesterol in swine fed casein or soy protein paralleled the amount of accompanying apo B-48. Dietary proteins probably influence the intestinal synthesis of apo B-48 which in turn affects cholesterol transport into the lymphatics. PMID- 2719759 TI - Plasma vitamin E, apolipoprotein B and HDL-cholesterol in middle-aged men from southern Italy. AB - Plasma vitamin E, HDL-cholesterol, apolipoprotein B and triglycerides were measured in an apparently healthy, male, random population sample (n = 74) from Southern Italy. Plasma vitamin E concentration was positively correlated to that of serum cholesterol, non-HDL cholesterol, triglycerides and apolipoprotein B (all P less than 0.001). The results of partial correlation analysis showed that apo B, the apolipoprotein constituent of LDL, was related to vitamin E independently of serum triglycerides, a fairly accurate marker of VLDL. On the other hand, triglycerides were related to vitamin E independently of apo B. Both correlations were much weaker if an adjustment was performed for non-HDL cholesterol. No independent relationship was demonstrated between plasma vitamin E and HDL-cholesterol. PMID- 2719760 TI - Effects of magnesium oxide on the lipid profile of healthy volunteers. AB - Elevated serum cholesterol is a risk factor in the development of coronary artery disease. Magnesium has been reported to decrease total serum cholesterol, low density lipoprotein, and very low density lipoprotein, and increase high density lipoprotein. A randomized, double-blind, placebo-controlled, crossover study was completed to determine if supplemented magnesium, in the form of magnesium oxide, would produce changes in the lipid profile. Fifty normal volunteers received placebo or magnesium oxide, 400 mg capsules, twice a day for 60 days, then switched to the alternate treatment. Weight, height, blood pressure, serum potassium, serum magnesium, and a lipid profile were determined initially and after each treatment. Analysis of variance (ANOVA), comparing the mean of each component of the lipid profile at baseline and after each treatment, showed no significant difference. In conclusion, supplemental magnesium oxide did not produce statistically significant changes in the lipid profile in this group of healthy volunteers. PMID- 2719761 TI - Limitations of the lipid state hypothesis for atherosclerosis are revealed by X ray diffraction measurements. AB - The lipid state hypothesis proposes that liquid crystalline states of cholesteryl esters play a role in the development and persistence of the fatty streak lesions characteristic of atherosclerosis. We have tested several corollaries suggested by this hypothesis and find that the ensemble of droplets in atherosclerotic tissue are predominantly in the isotropic (fluid) state at 37.0 degrees C. Furthermore, the liquid-crystalline state transition behavior of these droplets is not influenced significantly by the distribution of component cholesteryl ester species. There are no significant correlations between the transition behavior of the droplets and the age, sex, or race of the subjects from which tissue samples were taken. These results show that the lipid state hypothesis is weak, and that the origin and persistence of fatty streak lesions in humans is probably dominated by other factors. PMID- 2719762 TI - Cod liver oil inhibits neutrophil and monocyte chemotaxis in healthy males. AB - Epidemiological evidence suggests a reduced rate of chronic inflammatory diseases and ischaemic heart disease in populations with a high consumption of fish. This has been ascribed to the high content in sea food of polyunsaturated fatty acids (PUFAs), belonging to the n - 3 family. We have studied neutrophil and monocyte chemotaxis in 12 healthy males before and after 6 weeks supplementation with cod liver oil, corresponding to 5.3 g n - 3 PUFAs daily. Neutrophil and monocyte chemotaxis were investigated using the under agarose technique with N-formyl methionyl-leucyl-phenylalanine (N-FMLP) and autologous serum as chemoattractants. Neutrophil chemotaxis towards both chemoattractants and monocyte chemotaxis towards N-FMLP were significantly reduced after supplementation with cod liver oil. PMID- 2719763 TI - The relevance of a protein-enriched low density lipoprotein as a risk for coronary heart disease in relation to other known risk factors. AB - The significance of a decreased low density lipoprotein cholesterol/apolipoprotein B ratio (LDL-chol/LDL apo B), or protein-enriched LDL, to predict atherosclerosis was studied in 121 males with angiographically defined coronary artery disease (CAD) and compared to 98 male controls, without history or complaints of vascular disease. Controls were selected for similar age, smoking habits and relative body weight characteristics compared to the CAD group. Covariance analysis with adjustment for hyperlipoproteinemia, apoprotein E phenotype, smoking, age and relative body weight revealed that high density lipoprotein (HDL)-cholesterol was the only parameter that differed significantly between both groups. By logistic regression analysis HDL-cholesterol had the highest predictive power for the development of CAD. The LDL-chol/LDL apo B ratio appeared significantly different between controls and CAD patients (3.1 +/- 0.7 vs. 2.9 +/- 0.6 mmol/g, P less than 0.05), indicating a predominance of subjects with protein-enriched LDL in the CAD group. However, within the group of CAD patients with normal LDL-cholesterol levels no clear distinction could be found between patients with normal and increased LDL apo B levels. Furthermore, it appeared that the LDL-chol/LDL apo B ratio correlated significantly with age (p = -0.24), serum triglycerides (p = -0.24), and HDL-cholesterol (p = 0.24). Thus, the LDL-chol/LDL apo B ratio cannot be considered an independent risk factor for CAD. When adjusted for age, smoking habits and relative body weight the significance of protein-enriched LDL as a risk factor for coronary heart disease diminishes, and HDL-cholesterol appears to be the best indicator for CAD. PMID- 2719764 TI - Social deprivation and coronary artery atherosclerosis in female cynomolgus monkeys. AB - Plasma lipid concentrations and coronary artery atherosclerosis extent were compared in a retrospective study of female cynomolgus monkeys consuming a moderately atherogenic diet and housed in single cages or social groups. There was no difference between single caged and socially housed monkeys in plasma lipid concentrations. However, females housed in single cages had significantly more coronary artery atherosclerosis than those housed in social groups. It has been found previously that socially subordinate females have more extensive coronary artery atherosclerosis than social dominants, and that subordinates spend more time alone than dominants. Subsequent analyses of the data presented here revealed that single caged monkeys had significantly more coronary artery atherosclerosis than socially dominant, but not socially subordinate, monkeys. Characteristics of single cage housing which could be disease promoting include restraint and social isolation. These findings should be considered preliminary, and serve as a basis for further study. PMID- 2719765 TI - Lecithin: cholesterol acyltransferase activity in children and young adults. AB - The association between serum lecithin: cholesterol acyltransferase (LCAT) activity and demographic and environmental factors, and the correlation of LCAT activity with serum lipids and lipoproteins were studied in a representative series of 1071 9-24-year-old subjects from East and West Finland. LCAT activity was determined by a method involving the use of exogenous substrate. Males had higher LCAT activity than females and subjects from East Finland had significantly higher activity than those from West Finland. LCAT activity tended to be lowest shortly after puberty. Women using oral contraceptives had significantly lower LCAT activity than women not using them. Serum LCAT activity was not associated with body mass index, physical activity index or smoking. Serum LCAT activity correlated positively with most serum lipid and lipoprotein variables. The highest correlation coefficients were found between LCAT activity and total cholesterol. LCAT activity correlated positively with the change in serum total cholesterol which had occurred during the preceding 3 and 6 years in men. Our results suggest that sex hormonal factors are associated with serum LCAT activity. The results are also in accordance with the idea that activity of LCAT increases in response to enhanced demands for cholesterol esterification in plasma. PMID- 2719766 TI - Effects of cigarette smoke, carbon monoxide and nicotine on the uptake of fibrinogen by the canine arterial wall. AB - An animal model has been used to investigate the effects of cigarette smoke, carbon monoxide and nicotine on the uptake of 125I-labelled fibrinogen by the arterial wall. The uptake of fibrinogen in the smoking group (5.5 +/- 2.8 counts.cm-2 x 10(-4)) and carbon monoxide group (6.1 +/- 2.7 counts.cm-2 x 10( 4)) was greater than the uptake in the control group (4.5 +/- 1.4 counts.cm-2 x 10(-4)) but this difference was not significant. In the nicotine group, there was a highly significant increase in wall uptake of 125I-fibrinogen (9.1 +/- 2.1 counts.cm-2 x 10(-4)) (P less than or equal to 0.001). These results suggest that nicotine, a major constituent of cigarette smoke, increases the retention of 125I fibrinogen by the arterial wall and that this might be one mechanism by which cigarette smoking exerts its atherogenic effect. PMID- 2719767 TI - Digoxin-like immunoreactive factor measurements in pregnant women treated with digoxin because of fetal indications. PMID- 2719768 TI - Determinations of ethanol, acetaldehyde and acetate in blood and urine during alcohol oxidation in man. AB - Blood and urine samples were analyzed for ethanol, acetaldehyde and acetate during alcohol oxidation in Japanese men by head space gas chromatography, following the consumption of 16 ml/kg of beer during a 20 min period. The maximum level of blood/urine ethanol was found to be 15-17 mM (20-22 mM), while that of acetaldehyde in a flusher and in non-flushers was 20 microM (52 microM) and 2-5 microM (10-13 microM), respectively. Acetate levels in these groups ranged from 0.2 mM (0.1 mM) to 0.8 mM (1.0 mM). Blood ethanol levels were dose dependent, whereas acetaldehyde and acetate levels reflected individual metabolic rates. The relative concentrations of ethanol and acetaldehyde in blood and that of acetate in alcohol metabolism could be summarized as follows: 7500 (15 mM): 1-3 (2-5 microM); 250-400 (0.5-0.8 mM) for non-flushers; and 7500 (15 mM): 5-10 (10-20 microM): 250-400 (0.5-0.8 mM) for a flusher. PMID- 2719769 TI - Hepatic lipid peroxidation and aldehyde dehydrogenase activity in alcoholic and non alcoholic liver disease. AB - It has been suggested that lipid peroxidation plays a role in the pathogenesis of chronic alcoholic liver disease (CALD). However, whether or not CALD differs from chronic non alcoholic liver disease (CLD) in lipid peroxidation, is still questionable. Thirty-eight patients affected by CALD and CLD who were matched for age, sex, nutrition and liver function tests (LFTs) and 17 controls (C) took part in this study. The following tests were performed: serum and liver malondialdehyde (MDA) determination by the TBA test, liver total glutathione (GSH) estimate, mitochondrial (ALDH2) and cytosolic (ALDH1) aldehyde dehydrogenase activity determinations. Patients who showed signs of malnutrition were excluded from this study. Serum and hepatic TBA-reactive substances resulted in a slight increase in chronic liver patients compared to controls but did not show any difference between CALD and CLD groups. Liver total glutathione did not show any change. Hepatic ALDH2 activity was significantly (P less than 0.01) higher in CALD than in CLD and control patients whereas ALDH1 did not show any difference. These results suggest that the increased lipid peroxidation in CALD and in CLD is probably secondary to liver damage rather than being the pathogenic factor. PMID- 2719770 TI - Repeated automated assessment of abstinent male alcoholics: essential fatty acid supplementation and age effects. AB - A double-blind trial carried out with alcohol-dependent males randomly allocated to n-6 essential fatty acid (EFA) supplementation or placebo capsules over a 6 month period incorporated a battery of automated neuropsychological tests. Results from problem-solving and perceptual motor speed tests are used. The effect that EFA supplementation had on recovery over 6 months of abstinence is shown, as well as the tests in which younger (aged 20-39) alcohol-dependent males differ from the older (aged 40-59) subjects. PMID- 2719771 TI - The effects of chronic ethanol administration on stimulated parotid secretion in the rat. AB - Young adult male rats were maintained on a regimen of twice daily intragastric administration of 4 ml of 35% (v/v) ethanol in water (daily dose approximately 7.0 g/kg) or 4 ml of calorifically equivalent sucrose solution over approximately 100 days. A second control group received no intragastric solutions. Under Valium Hypnorm anaesthesia, parotid saliva was collected by intra-oral duct cannulation following stimulation by pilocarpine (10 mg/kg, subcutaneously) or by isoprenaline (30 mg/kg s.c.). In the ethanol-dosed rats the initial parotid salivary flow rate was raised in comparison to control animals by 39% after pilocarpine stimulation and by 37% after isoprenaline stimulation. The protein concentration was significantly reduced in saliva from ethanol-dosed rats compared to control groups but the amylase activity per ml of saliva was not significantly different from control groups. After pilocarpine stimulation, the [K+] was significantly higher in ethanol-dosed rats than in controls, but the [Na+] was effectively lower (allowing for flow rate differences). The blood ethanol level was zero at the time of collection of saliva, suggesting that the salivary differences are due to functional adaptation induced in acinar and ductal epithelia by prolonged repeated exposure to high doses of ethanol. PMID- 2719772 TI - Alcohol and drug services: the case for combining. PMID- 2719773 TI - Effect of chronic ethanol administration on thiamine transport in microvillous vesicles of rat small intestine. AB - The effect of long-term ethanol administration on the membrane mechanism of thiamine entry in rat enterocytes was investigated by using microvillous vesicles of small intestine. Experiments were carried out in three groups of Wistar albino rats of both sexes (290-400 g of initial body wt). Group I did not receive any treatment, group II received 4.7 g of ethanol/kg body wt (as a 50% hydroalcoholic solution) daily by gastric gavage for 35 days and group III (pair-fed controls) received a daily solution of saccharose (isoenergetic with the dose of ethanol administered to group II) by gastric gavage for 35 days. Ethanol or saccharose were administered in the morning and a standard diet was given throughout the treatment period. All animals were killed by decapitation 24 hr after the last administration, when the blood level of ethanol was virtually zero. Microvillous small intestinal vesicles were incubated with 3H-thiamine (3H-T) at 25 degrees C and the amount of 3H-T taken up was measured by a rapid filtration method. Compared with data obtained in groups I and III, chronic ethanol administration was found to induce a statistically significant decrease in 3H-T vesicular uptake at 4 sec (determined at 3H-T concentrations ranging from 0.12 to 7.5 microM) and a decrease in the apparent Jmax (maximal transport rate) value of the saturable component, without affecting the apparent Km (half-saturation concentration) value. These results indicate that in rats chronic ethanol administration may impair the intestinal absorption of thiamine by reducing thiamine entry into the enterocyte. PMID- 2719774 TI - Why is our population of uninsured and underinsured persons growing? The consequences of the "deindustrialization" of America. PMID- 2719775 TI - [An approach to the study of class I anti-HLA antibodies in flow cytometry]. PMID- 2719776 TI - [Delayed hemolytic transfusion reaction caused by an anti-U]. AB - Delayed hemolytic transfusion reactions due to anti-U are rare, only two (2) cases having been reported in the literature. We now report a third case: a multiparous black woman without any transfusion history was admitted to hospital for severe microlytic anemia (31 g/l). The patient was group AB negative, the direct antiglobulin test was negative and an anti P1 cold allo-antibody was present in her serum. Five A, Rh negative, P2 packed red cells were cross-marched with the sample obtained at admission on January 8, 1988. She was transfused on January 8, 9, 10, 11 and 12. On the 12th of January her hemoglobin level reached 125 g/l. On January 13, the patient presented clinical signs of hemolysis and her hemoglobin fell to 60 g/l within 24 hours. On January 15, the direct antiglobulin test was positive and an antibody found in her serum was reactive with all the red cells of the commercial panel. The sample was referred to our red cell serology reference laboratory. The phenotype of the pre-transfusion sample was found to be Fy(a-b-) M, N, S-s-U-. An anti-U was detected in the eluate and the serum. The patient was transfused with two (2) units of O-P2, U-red cells obtained from the American Red Cross, Syracuse, and her hemoglobin reached 90 g/l within 48 hours. This is the third reported case of a delayed hemolytic transfusion reaction due to anti-U. This case illustrates the need to perform cross-matches with samples obtained within 48 hours of the scheduled transfusion for patients who have been transfused with blood in the preceding 3 months. Also, this case emphasises the need to recruit U negative blood donors for the Canadian rare donor file. PMID- 2719777 TI - [Viability of human red blood cells preserved for 35 days after leukocyte depletion (in vitro study)]. AB - 24 leukocyte poor red cells concentrates (L.P.R.C.) were prepared by sterile connection of a leucocyte filter between the primary bag and the SAGM bag of a blood unit after centrifugation. Their quality was followed up to 42 days by means of a panel of tests including, ATP and 2,3-DPG levels, hemolysis, plasma potassium, lactate and glucose, and counts of the microaggregates. 24 standard units acted as a control group. Results showed better preservation of LPRC and especially less hemolysis, higher ATP levels and at least equal oxyphoric capacity (explored by 2,3-DPG). Microaggregate formation was dramatically reduced and bacteriologic checks (48 at day 25 and 48 at day 42) were all negative. Leucocyte depletion appears as a new way to improve functionality of erythrocytes during storage in the SAGM medium. 35 days shelf life will allow this blood product to be more available and its preparation more standardised. PMID- 2719778 TI - [Deformability and hemolysis of red cells processed by the "Cell-Saver"]. PMID- 2719779 TI - [Serum levels of alanine aminotransferase and anti-HBc antibodies in blood donors: analysis of a group of 5000 donors from the Lorraine region]. PMID- 2719780 TI - [The nursing problems in the country]. AB - The nursing problem in Greece has been approached in three dimensions as a problem-challenge: the holistic patient care, nursing research and staffing nursing services. The shortage of graduate nurses, the many levels of nursing education, inadequate organization of nursing services, lack of nurses participation in decision taking for Nursing and inadequate research development have been considered as the main obstacles. Disengagement of professional nurses from civil servants salary with higher financial earning along with their university nursing education are suggested as the most appropriate incentives to attract adequate numbers of nursing candidates and remain to the profession to cover the increased needs of nursing care and the provision of quality nursing services. In addition a great number of unemployed manpower will be used and actualized in nursing where mostly is needed while there is a surplus in almost all the other professions. PMID- 2719781 TI - [The problems of holistic nursing care]. PMID- 2719782 TI - [The problem: nursing research]. PMID- 2719783 TI - [Collecting blood specimens]. AB - For the correct procedure of vein puncture--to collect blood specimens--it is necessary to keep strictly the rules of securing the safety of patient, the one who collects the specimen and also the specimen. The preparation of the patient for the vein puncture, the using of the correct method and vein, the appropriate time of doing this procedure, the using of the sufficient quantity of blood for every blood examination are included to the main elements for the success of the purpose of vein puncture. Another important element for the success of the above procedure is the comfortable and appropriate position of the patient, which gives the blood taker comfort in his work and keeps the patient free from undesirable events. The steps taken after this procedure can help: (a) keeping the vein in a good condition, (b) preventing undesirable events in the point of vein puncture, (c) sending the blood specimen safely to the laboratory, (d) safe disposal of the material used in the procedure. Undesirable events during the vein puncture should be faced immediately. In the newborn children blood specimen is collected from the finger with a different procedure. Also in isolated or mentally ill patients and those under radiation treatment the procedure is different. Those who collect and handle the blood specimens, nurses or laboratory technicians, do face important problems. For the prevention of harmful events special rules must be kept. PMID- 2719784 TI - [Nursing the patient with AIDS and the AIDS carrier]. AB - The nursing care of the patient with AIDS consists of a challenge for the improvement of Nursing in general not only because of the gravity of the disease and the very bad prognosis but also because of the great socioeconomic and psychological effects that accompany it. Nursing care in the hospital consists of facing the symptomatology of the disease and meeting the many physical, psychological and social needs of the patient. Nursing care at home is influenced by many factors and is dependent on the good information given to the members of the family through a well organized service of the community nursing. PMID- 2719785 TI - The New Mexico experiment: educational innovation and institutional change. AB - Over the past ten years the University of New Mexico School of Medicine has conducted an educational experiment featuring learner-centered, problem-based, community-oriented learning. The experiment was introduced into an established institution by means of an innovative educational track running parallel to the more conventional curriculum. Students in the innovative track, compared with those in the conventional tract, tended to score lower on the National Board of Medical Examiners (NBME) Part I examination (basic sciences) and higher on NBME Part II (clinical sciences), received higher clinical grades on clinical clerkships, and experienced less distress. They were more likely than conventional-track students to retain their initial interest in or switch their preference to careers in family medicine. The parallel-track strategy for introducing curriculum reform succeeded in fostering institutional acceptance of continuing educational innovation. Generic steps in overcoming institutional barriers to change are identified. PMID- 2719786 TI - The case for a national center for health professions education research. AB - Overall concerns with the health care system have raised important questions concerning educating health professionals. The need to study and perhaps alter the assumptions of this education has been raised, but data on which to base programmatic change have not been generated, since neither the assumptions nor proposed educational innovations have been adequately tested. A national center for health professions education research is proposed to facilitate well-funded, peer-reviewed, and academically credible research in health professions education. The goals of the center would allow for the testing of models to provide physicians and other health professionals with education grounded in sound methodology and content. PMID- 2719787 TI - Preventing infant mortality. PMID- 2719788 TI - Health services research. PMID- 2719789 TI - Scientific methodology in curricular reform. PMID- 2719790 TI - Education costs in two public teaching hospitals. AB - The authors examined the impact of costs of education on the overall expenses of two major teaching hospitals during a period of rapid growth and change in the Minneapolis and St. Paul, Minnesota, health care environment. By using a retrospective faculty-time study and the two hospitals' estimated costs for education, education costs of each hospital were compared--within and across facilities--with annual hospital operating expenses, with inflation, and by educational program. Unit costs were estimated for undergraduate and graduate medical students. Over the study period, allocated education costs averaged 13 14% of the hospitals' operating budgets. The combined mean allocated cost per medical student and resident was approximately +73,000 in 1983-84. During this period, allocated education costs were in line with medical inflationary trends and did not drive hospital expense increases. These findings suggest that policymakers wishing to restrain the rise in health care costs should look beyond cutting the costs of education programs and find other solutions. PMID- 2719791 TI - Assessing research productivity: evaluating journal publication across academic departments. AB - Publications produced by faculty over a three-year period are used in analyzing the relative research productivity of basic and clinical science departments in a college of medicine. The citation ratings of the journals, the number of authors, and the byline position of the faculty member are used in various publication evaluation schemes. The departments vary almost tenfold in research productivity per faculty member. Results of the analysis demonstrate that the number of authors and the byline position influence departmental productivity rankings very little. Rankings are substantially affected, however, when the journals are weighted based heavily on citation ratings. PMID- 2719792 TI - High school students' motivations for a career as a physician. AB - Ask achievement-oriented high school students what they think of becoming a physician and they will respond that it is not their top career choice. Of the 180 high-achieving students surveyed by the authors in 1986, 93% of the white students and 82% of the black students aspired to graduate and professional degrees. "Physician" was listed as the second career choice by 30% of the white students and 17% of the black students. The two groups differed in some of the motivation factors stated for considering any career choice and in their perceptions of the values that are offered in a career as a physician. PMID- 2719793 TI - Using hospital site visits for teaching occupational health. AB - In medical schools, the factory visit is an important ingredient of occupational health instruction at all levels. Usually the time allotted for teaching this subject in the undergraduate curriculum is limited; as a response to this constraint, the Tel Aviv University Sackler Faculty of Medicine has used its associated teaching hospitals as the "factory" since 1982. Following an introductory discussion, the students are divided into small groups and sent to various departments of the hospital--wards, kitchen, laundry, maintenance workshop, X-ray department, and surgery--to observe and evaluate the work environment. Following this activity, the students reconvene and discuss the health implications of what they have seen. This way of providing the factory visit is well accepted by the students, saves time, and contributes directly to the students' awareness of their own working environment. PMID- 2719794 TI - Immunohistochemical studies with monoclonal antibodies B72.3 and MA5 on histologic and cytologic specimens from benign and malignant breast lesions. AB - Monoclonal antibodies B72.3 and MA5 were tested by the avidin-biotin immunoperoxidase method in histologic sections of 38 benign, 22 precancerous and 22 cancerous breast lesions, as well as in fine needle aspiration (FNA) smears and cell blocks of 25 breast carcinomas. Neither B72.3 nor MA5 was specific for breast cancer cells: both also reacted with cells from benign and precancerous conditions. B72.3 as a "detector" of malignant cells or their precursors was superior to MA5, however: it was not reactive to cells in most benign breast lesions (mammary duct ectasia, fibroadenoma and ductal hyperplasia, with and without atypia). Cancerous cells had heterogeneous immunostaining with B72.3, which may lead to false-negative results in relatively hypocellular FNA samples. FNA samples prepared as both smears and cell blocks provided the most abundant cellular samples and the lowest false-negative immunostaining reaction of cancerous cells with B72.3. PMID- 2719795 TI - Quantitative pathologic analysis of first and second primary cancers in double tumors of the lung. AB - In spite of the frequent occurrence of double tumors of the lung, pathologic reports on these tumors are rare. In this study, 34 patients with double tumors (10 metachronous and 24 synchronous) were quantitatively analyzed; in all cases, both the first and second tumors had been completely resected and had adequate archival material. One aim of the study was to investigate whether there was a difference in the malignancy of the first and second tumors, as evaluated from their pathologic features. A second question was whether the length of the disease-free interval between the first and second tumors or the survival could be predicted on the basis of any of the investigated features. It was found that the first and second tumors, whether synchronous or metachronous, were strikingly similar: there was no difference in any of the quantitative pathologic features studied (epithelial percentage, DNA index, mean nuclear area and standard deviation of the nuclear area). It was not possible to predict by either univariate or multivariate analysis from any of the parameters either the length of the disease-free interval between the first and second tumors or the survival. These quantitative pathologic similarities suggest that the malignancy of the second tumor (synchronous as well as metachronous) is not higher than that of the first tumor. Thus, in the case of metachronous tumors, the fact that most of the second tumors (60%) are detected at a higher (inoperable) stage is probably caused by inadequate follow-up and not by increased malignancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719796 TI - Comparison of flow cytometric data obtained using fresh and paraffin-embedded lymphoid tissue. AB - Flow cytometric (FCM) DNA analysis was carried out on 24 lymph nodes: 13 from benign reactive hyperplasias and 11 from non-Hodgkin's lymphomas. FCM was performed on two types of samples: (1) fresh cell suspensions and (2) suspensions prepared from formalin-fixed, paraffin-embedded sections. FCM of fresh samples detected aneuploidy in 23 of the 24 cases while FCM of paraffin-embedded samples detected aneuploidy in only 6 of the 24 cases. Those six cases were lymphomas considered histologically as having a poor prognosis. Only one case, a lymphoma, was euploid with both methods. The coefficients of variance determined in each case for both methods were found to be within "normal ranges," but were greater in the paraffin-embedded specimens. The results suggest that FCM DNA analysis of formalin-fixed, paraffin-embedded sections does not have as great a resolution capacity as does analysis of fresh cell suspensions, since the former failed to detect cell populations that had a small degree of aneuploidy (close to the 2n population). PMID- 2719797 TI - A comparative study of morphometric measurements of nucleoli in uveal melanomas from electron micrographs and plastic-embedded and paraffin-embedded sections. AB - Morphometric measurements of nucleoli were done on uveal melanomas from surviving and nonsurviving patients. The melanomas were embedded in paraffin and plastic, and measurement data from Papanicolaou-stained paraffin-embedded sections, toluidine blue-stained plastic-embedded sections and scanning transmission electron micrographs (STEM) of plastic-embedded sections were compared. The results showed that one parameter, the coefficient of variation (CV) of nucleolar area, correctly classified 80% of the cases as to survival when plastic-embedded material was used and 70% of the cases when paraffin-embedded material or STEM micrographs were used. The inverse standard deviation of the nucleolar area was a better predictor of outcome than was the CV of nucleolar area only in the paraffin-embedded sections. The nucleolar measurements were most easily and rapidly performed in the plastic-embedded sections. PMID- 2719798 TI - A method of quantitating Paneth cell metaplasia of the stomach by image analysis. AB - Paneth cells are one of the histologic components of intestinal metaplasia of the stomach, as are mucin-producing goblet cells. With the aid of an image quantifier, the distribution of Paneth cells histochemically labeled with acid fuchsin was analyzed for a gastrectomy specimen containing an adenocarcinoma of the intestinal type; the topographic distribution of goblet cells histochemically labeled with Alcian blue (pH 2.5) was also analyzed. The specimen was cut into 63 blocks (0.5 X 4.0 cm) in four zones; antrum (zone I), intermediate region (zone II) and fundus (zones III and IV). Paneth cells were found only in sections containing mucin-producing goblet cells. Paneth cells were found in 12.5% of the 16 sections from the antral zone I containing Alcian blue-positive goblet cells. The rates were 44.4% for the intermediate zone II and 55.5% for the distal fundic zone III. The total area occupied by Paneth cells was significantly lower in the gastric mucosa as compared to the duodenal mucosa. The "Paneth cell index" (total Paneth cell area/total goblet cell area) was highest in the duodenum, followed by the distal fundic zone III. This method of quantitating Paneth cell metaplasia of the stomach will be used to investigate the topographic distribution of those cells in populations with low and high incidences of intestinal metaplasia. PMID- 2719799 TI - Subclassification of follicular lymphomas by computerized image processing. AB - Non-Hodgkin's lymphomas with a follicular pattern are subdivided on the basis of morphologic criteria into four subtypes. Each subtype has a distinctive natural history, response to therapy and survival, and precise histologic diagnosis is essential for optimal treatment. However, recent studies by a panel of seven expert hematopathologists showed that there was a 20% to 40% likelihood of disagreement in subtyping non-Hodgkin's follicular lymphomas; thus, the likelihood of a patient receiving inappropriate treatment is high. To resolve some of the problems relating to subjective morphologic diagnosis, we have continued to investigate the possibility of using computerized image analysis to perform automated subtyping of follicular lymphomas. In the portion of the study reported herein, a total of 37 cases were selected from the set subtyped by the panel of expert hematopathologists, and digitized images of slides from each case were processed by computer. The computer-generated subtypes were compared with those arrived at by the panel. For the cases analyzed, the computer subtyping was at least as good as, and in some instances superior to, that of most of the expert panelists. PMID- 2719800 TI - Immunocytochemical analysis of cytocentrifuged fine needle aspirates. A study based on lung tumors aspirated in vitro. AB - The value of Cytospin preparations of fine needle aspiration (FNA) biopsy material for immunocytochemical analysis was investigated using aspirates obtained from 23 resected human lung tumors. The results were compared with those on cryostat sections from the same tumors. The Cytospin preparations of the FNA biopsies gave the best immunostaining reactions and enabled a comprehensive range of monoclonal antibodies (MAbs) to be utilized. The quality of the Cytospin immunostaining compared favorably with that on cryostat sections of the same tumors and generally yielded a similar immunophenotype. However, the Cytospin preparations were not suitable for staining with MAb Ki67, which detects an antigen associated with cellular proliferation. With Ki67, conventionally prepared smears were much superior and enabled an assessment of tumor growth fraction that concurred with the growth fraction calculated from cryostat sections in most cases. PMID- 2719801 TI - DNA grading of malignancy in breast cancer. Prognostic validity, reproducibility and comparison with other classifications. AB - The prognostic significance of the "DNA malignancy grade" (DNA-MG) was tested in a series of 104 breast cancer patients in comparison with TNM staging, histomorphologic grading according to Bloom and Richardson, mean nuclear area (MNA) and DNA-histogram classification according to Auer. The reproducibility and representativity of the grading systems were investigated, and their results in primary tumors and lymph node metastases were compared. The scalar DNA-MG was assessed on monolayer smears prepared from paraffin-embedded tissues; the smears were automatically Feulgen stained and used for rapid interactive DNA cytometric evaluation by an automated microscope and a TV image-analysis system. TNM staging showed the highest correlation with survival, followed by histomorphologic grading and DNA-MG; MNA and the DNA-histogram classification failed to give statistically significant prognostic information. Both histomorphologic grading and DNA-MG were identified as parameters adding independent prognostic information to the TNM staging. However, only DNA-MG demonstrated an acceptable reliability, with small 95% ranges between repeated measurements within the primary tumor (+/- 0.3 DNA-MG) and a strong correlation between the results in the primary tumor and its lymph node metastases. These findings show that the DNA MG is a valid and reliable prognostic index that adds significant prognostic information to TNM staging. PMID- 2719802 TI - Ploidy and morphology in osteosarcoma. AB - In a cytometric DNA study of high-grade osteosarcoma, the relationship between DNA content and morphology was analyzed. The investigation, based on microspectrophotometry of tissue sections and flow cytometry (FCM), included both primary lesions and recurrences. FCM analysis, applied to a consecutive series of 47 primary osteosarcomas, disclosed that 2 were diploid and 45 were nondiploid, 8 of which were tetraploid. Multiple aneuploid peaks were detected in 13 tumors. Among the nondiploid tumors, there was no clear relationship between the peak DNA value(s) and the histologic subtype (osteoblastic, chondroblastic, fibroblastic) or grade (III-IV). The proliferative activity, as reflected by the percentage of S-phase cells, could be determined in 38 of the 47 tumors analyzed by FCM. The percentage was higher for aneuploid than for tetraploid lesions; however, the distribution of S-phase cells was not related to the histologic subtype or the grade of the tumors. To assess the reliability of a single sample for FCM, the DNA content of biopsy and surgical specimens was compared in 20 tumors; there was complete agreement in all cases with respect to the classification of the lesion as diploid, tetraploid or aneuploid. Analysis by FCM or microspectrophotometry of 12 local recurrences and 16 metastases and the corresponding 19 primary tumors showed that an aneuploid characteristic of the primary lesion was retained during progression of the disease. In 12 tumors analyzed by microspectrophotometry in tissue sections, comparison of chondroblastic and osteoblastic/fibroblastic areas within the same lesion consistently disclosed hyperploidy in both areas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719803 TI - Hydrocolloid wafer dressings and atrial catheter access sites. PMID- 2719804 TI - A strategy for the management of pressure ulcers in nursing homes. PMID- 2719805 TI - Use of directional flow irrigation. PMID- 2719806 TI - Effectiveness of dermagran dual therapeutic system in the treatment of chronic skin ulcers. PMID- 2719807 TI - Comprehensive wound management with topical growth factors. PMID- 2719808 TI - Managing peristomal wounds with a hydrocolloid dressing (Duoderm). PMID- 2719809 TI - [Acquired immunodeficiency syndrome (AIDS). Present and future]. PMID- 2719810 TI - [Pulmonary function tests in asthmatic children in treatment with tulobuterol]. AB - The objective of the present study was to evaluate the effectiveness and tolerance of a new beta-2 agonist, tulobuterol, in children. Fifteen patients with acute asthma were studied, during a period of 21 days. Significant increase in forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1), and forced expiratory flow 25-75% (FEF 25-75%) were observed after treatment with tulobuterol (p less than 0.01). Clinical improvement was evident as measured by a clinical-scale and a functional scale. The only side effect attributable to the drug was a tremor which was observed in three patients. PMID- 2719811 TI - [Neurologic follow-up of polycythemic newborn infants]. AB - Seventy five newborn infants with neonatal polycythemia diagnosis (venous hematocrit levels greater than 65% were studied). They were born in the Instituto Nacional de Perinatologia and follow through their first year of life searching for neurologic findings. The more frequent signs related to polycythemia in this group were: presence of plethora, respiratory distress, cyanosis and tremors; the associated findings were hypoglycemia, hyperbilirubinemia, necrotizing enterocolitis and meconium aspiratum. Sixty eight of the seventy five neonates developed symptomatology and seven didn't. The eight neonates who developed neurologic transient impairments belonged to the symptomatic group in a 0.11 proportion. We concluded that the number of babies with neurologic findings in our sample was small in comparison with other reference studies; we also found that the exchange transfusion is not a preventive measure for neurologic sequel, but it is useful to diminish the symptomatology caused by polycythemia; besides we don't recommend this procedure in asymptomatic babies because the complication risks as the enterocolitis. We propose a simple treatment scheme. PMID- 2719812 TI - [Conductive education in integral rehabilitation of patients with cerebral palsy]. AB - "Conductive education" was thought out and developed by Andres Peto in Budapest. Its main goal is "orthofunction". Such a system was used in 22 children with cerebral palsy. These children were divided in two groups, one with 10 pre-school and school age children and the other of "parents and babies" with 12 infants. From the first group, six children had received physiotherapy in our Center following an eclectic method at least for one year and from the second group seven infants had received also physiotherapy at least for six months; these children were used as controls. The rest of the children were new admissions. A special evaluating scale was developed to evaluate all the children involved. In the control group the evaluation was performed before the initiation of the program (12 and six months respectively), at the beginning in all of them and at 12 and 16 months in the pre-school and school age group, and at six and 12 months in the infants of the "parents and babies" group. The results showed a definite advantage in both groups of Conductive education in the motor, cognitive and social areas compared with the results with physiotherapy in the control group. PMID- 2719814 TI - [Antral membrane. Presentation of a case]. AB - A case of antral membrane in a 23 month old child is presented. He developed an extremely rapid clinical course characterized by vomiting, 4 kg weight loss and acute malnutrition. The UGI showed a probable antropyloric obstruction which was confirmed by endoscopy and lately by surgery. It is suggested that in the approach of a patient with vomit it is very important to make an oriented clinical history and always complete the study of the patients with radiological and endoscopic procedures. PMID- 2719813 TI - [Endocrine behavior of battered children in the acute stage of the aggression]. AB - To date the cause of growth retardation of children who have suffered physical abuse and emotional deprivation is unknown. Hypophyseal disturbances in these patients have been proposed of the cause but there are still several concerns on the dynamics of growth hormone secretion in these children. In this study, eleven out of sixteen patients had a low height without important diminution of corporal weight. Growth hormone under basal conditions was found to be elevated in battered children compared with a control group (15.2 +/- 4.7 ng/mL vs 9.6 +/- 1.9 ng/mL, p = 0.025). Two weeks after hospitalization a tendency towards normalization was apparent (13.8 +/- 3.0, NS vs controls). Cortisol, thyroid hormones T3 and T4 as well as thyrotrophin did not show significant changes under basal conditions with respect to control patients although there were some isolated cases with abnormal values. While chronic stress could adversely affect hypophyseal trophic hormone secretion, our study did not show either this were effect nor a clear association between growth retardation and a characteristic abnormal endocrine pattern. It seems that the cause growth and developmental retardation in battered children is of a multifactorial. PMID- 2719815 TI - [Robinow's syndrome in a family of consanguineous marriages]. PMID- 2719816 TI - Blood and brain ethanol concentrations during absorption and distribution in long sleep and short-sleep mice. AB - It is often assumed that blood ethanol content accurately reflects brain ethanol content. In previous studies we have found that at the time of regaining the righting response blood and brain ethanol levels were identical, and blood ethanol could be used to predict brain ethanol level. It is likely, however that shortly after the administration of ethanol, blood and brain ethanol levels would differ. For this study, venous blood (orbital sinus) and brain ethanol levels were measured in long-sleep and short-sleep mice within the first 30 min following ethanol administration (2.5-6.0 g/kg). Ethanol was administered intraperitoneally or intragastrically. For both lines of mice and for every dose, brain ethanol concentrations were significantly greater (as much as 100 mg/dl) than blood ethanol levels for the first 6 min, and peak blood and brain ethanol levels were reached 4 to 6 min after dosing. Approximately 6 to 10 minutes (depending on dose and line of mouse) was required for blood and brain concentrations to reach equilibrium. At the time of loss of the righting response, brain ethanol levels were significantly higher than blood ethanol levels. These results indicate that within the first 6 min after administration of ethanol, blood ethanol level is not suitable for the assessment of brain ethanol content. PMID- 2719817 TI - Concentrations of ethanol in rebreathed air of rats: correlation with the discriminative stimulus effects of ethanol. AB - We modified the method of Pohorecky and Brick (14) for determination of ethanol (ETOH) concentrations in rebreathed air of rats. Rats were injected with different doses (1-2 g/kg) of ETOH and both arterial blood and rebreathed air samples were collected at various time intervals (15-120 min) after administration. We found a very good correlation (r = .96) between ETOH concentrations in arterial blood and in rebreathed air; the blood/breath conversion factor (+/- SEM) was 3241 +/- 55. In the second part of the study, rats were trained to discriminate between IP administered ETOH (1.2 g/kg) and the saline vehicle (12 ml/kg). Training occurred 15 min after administrations. Once trained to reliably differentiate between ETOH/saline training sessions, different doses (0.6, 0.9 and 1.2 g/kg) of ETOH were examined at various time intervals (1, 7.5, 15, 30, 60, 120 and 240 min) after administrations on certain test days. The results indicated a good correlation (r = .65) between the discriminative stimulus effects of ETOH and the concentrations measured in rebreathed air. The behavioral effects as well as the concentrations of ETOH in rebreathed air have a fast onset. The peak occurred 7.5 min after injection, and both the stimulus effects and concentrations of ETOH were time- and dose dependent. PMID- 2719818 TI - Behavioral desensitization to nicotine is enhanced differentially by ethanol in long-sleep and short-sleep mice. AB - In order to assess the anticonvulsant potency of ethanol, male and female long sleep (LS) and short-sleep (SS) mice were pretreated with ethanol 7.5 min prior to challenge with an ED80 dose of nicotine (LS: 4.25 mg/kg; SS: 6.25 mg/kg). LS mice were more sensitive to the anticonvulsant effects of ethanol than were SS mice. In order to assess the effect of ethanol on the nicotine-induced behavioral desensitization to nicotine observed previously in these mice, animals were pretreated with saline, nonanticonvulsant doses of ethanol (0.25 g/kg, 0.75 g/kg or 1.5 g/kg), a subseizure-producing dose of nicotine (2.0 mg/kg) or a combination of these two drugs 15 or 30 min prior to nicotine challenge. Ethanol enhanced the nicotine-induced behavioral desensitization in both mouse lines; however, this effect was seen at lower ethanol doses and was more pronounced in LS mice. Ethanol pretreatment did not affect brain nicotine concentrations; therefore, the ethanol effect probably involves changes in brain sensitivity to nicotine. PMID- 2719819 TI - Drinking variables, affective measures and neuropsychological performance: familial alcoholism and gender correlates. AB - The relationships between five measures of alcohol consumption and five summary measures of diverse neuropsychological test performances were studied in 76 male and 67 female alcoholics as a function of family history of alcoholism and affective symptomatology. No significant relationships were obtained between drinking variables and neuropsychological performance scores for the overall groups of male and female alcoholics. In family history positive (FH+) males, correlations between a number of drinking variables and neuropsychological measures neared significance. The Beck Depression Inventory (BDI) scores correlated most strongly with the overall impairment index in both family history positive (FH+) and family history negative (FH-) alcoholics. Depression and anxiety scores in the female alcoholics significantly correlated with three of the five alcohol consumption variables. Possible confounding factors in the relationships between alcohol intake measures and cognitive functioning were discussed. PMID- 2719820 TI - EEG effects of a single low dose of ethanol on afternoon sleep in the nonalcohol dependent adult. AB - Three polygraphic recordings (PGR) of afternoon sleep (ANS) related to the duration of one sleep cycle, i.e., 90 min, were performed in 14 healthy adult volunteers (7 men and 7 women): two reference PGR, on two consecutive days (before ingestion of alcohol). Only the second being retained: reference PGR = P1; another recording, on day 3, 50 min after the start of single slow oral ingestion of the equivalent of 0.25 g 95% ethyl alcohol (ETOH) per kg body weight. Alcohol was ingested as 40 degrees whiskey, and the volume administered ranged from 34.5 to 66 ml (ETOH polygraphic recording = P2). Analysis of polygraphic traces was carried out according to the criteria of Rechtschaffen and Kales, and results were presented using the parameters adopted by Gross et al. (2). A single low dose of alcohol, leading to a low mean blood alcohol level (below 30 mg/100 ml, range 9 to 29 mg/100 ml), clearly perturbs sleep in the normal nonalcohol-dependent adult. In this context, ETOH does not appear to be a hypnotic since: a) the latencies to onset of sleep and the appearance of stages II, III, and IV of slow-wave sleep (SWS) are not shortened; b) the total duration of sleep, the percentage of delta sleep, and the duration (and percentage) of rapid eye movement sleep (REMS) are decreased; c) the number, duration, and percentages of intrasleep awakenings are increased, as are the number of stage changes. In addition, the study of afternoon sleep has shown itself to be a sensitive and reliable test for the analysis of the effects of a low dose of alcohol on nonalcohol-dependent subjects. PMID- 2719822 TI - Mapping and sequencing the human genome. PMID- 2719821 TI - Effect of varying concentration of ethanol on systemic hemodynamics and regional circulation. AB - The effect of ethanol (0.5 g/kg, IV) at different concentrations (30%, 60%, and 90%) was studied in male cats using radioactive microspheres on systemic hemodynamics and regional circulation. Ethanol produced a significant fall in systolic, diastolic and mean blood pressure. A significant reduction in heart rate, left ventricular work, cardiac output and total peripheral resistance was also observed. No change occurred in stroke volume. A significant decrease in blood flow to left ventricle, right ventricle and interventricular septum was observed, but the vascular resistance of these regions was unaltered. Brain blood flow was not affected by various concentrations of ethanol. The vascular resistance significantly decreased in spinal cord, medulla, pons, midbrain, hypothalamus, thalamus, caudate nucleus, cerebellum and cortex. The average brain blood flow (ml/min/100 g) was 35.63 in control, 37.17 in 30%, 35.56 in 60% and 35.05 in 90% ethanol-treated cats. Spleen, liver, pancreas, gastrointestinal tract, skin, muscle and bone did not show any significant change in the blood flow, while vascular resistance following ethanol treatment. The blood passing through the arteriovenous shunts was significantly decreased by ethanol. It is concluded that ethanol produces marked cardiovascular changes which are not affected by varying the concentration of ethanol. PMID- 2719823 TI - Angiotensin II receptors in the gonads. AB - The presence of components of the renin-angiotensin system in ovaries and testes suggests that angiotensin II (AII) is involved in gonadal function, and thus we sought to characterize receptors for AII in rat and primate gonads. In the testes, autoradiographic studies showed receptors in the interstitium in all species. In rat interstitial cells fractionated by Percoll gradient, AII receptors coincided with hCG receptors indicating that AII receptors are located on the Leydig cells. In Leydig cells and membranes from rat and rhesus monkey prepuberal testes, AII receptors were specific for AII analogues and of high affinity (Kd=nM). During development, AII receptor content in rat testes decreases with age parallel to a fall in the ratio of interstitial to tubular tissue. In the ovary, the distribution of AII receptors was dependent on the stage of development, being high in the germinal epithelium and stromal tissue between five and 15 days, and becoming localized in secondary follicles in 20-and 40-day-old rats. No binding was found in primordial or primary follicles. In rhesus monkey ovary, AII receptors were higher in stromal tissue and lower in granulosa and luteal cells of the follicles. Characterization of the binding in rat and monkey ovarian membranes showed a single class of sites with a Kd in the nmol/L range and specificity similar to that of the adrenal glomerulosa and testicular AII receptors. Receptors for AII were also present in membrane fractions from PMSG/hCG primed rat ovaries. Infusion of AII (25 ng/min) or captopril (1.4 micrograms/min) during the PMSG/hCG induction period had no effect on ovarian weight or AII receptor concentration in the ovaries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719824 TI - Immunochemical comparison of high molecular weight angiotensinogen from amniotic fluid, plasma of men, and plasma of pregnant women. AB - A high molecular weight form of angiotensinogen (HMrA) is present in low quantities in plasma from men, in moderate quantities in plasma from pregnant women, and in larger quantities in amniotic fluid. It was shown that immobilized IgG from anti-low molecular weight angiotensinogen (LMrA) sera effectively removed HMrA from all three sources. Immunoblots of sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) using anti-LMrA sera showed that HMrA from each of the three sources contained a subunit that was identical to LMrA with respect to molecular weight and heterogeneity. Thus, no difference in the HMrA from these three sources could be demonstrated. It is concluded that HMrA contains at least one subunit that is very similar if not identical to LMrA. PMID- 2719825 TI - The role of hemilaryngectomy in the management of T1 vocal cord cancer. AB - A retrospective study was undertaken to assess the outcome of 54 patients who have elected to undergo vertical hemilaryngectomy for T1, NO squamous cell carcinoma of the glottic larynx. Fifty-one (94%) of 54 patients were cured with surgery alone. The voice was preserved in 52 (96%) of 54 patients. In the subgroup of patients who had received no prior radiation therapy, voice preservation was achieved in 98% of patients and ultimate control of disease with cure was achieved in 95%. These data substantiate the contention that vertical hemilaryngectomy offers better cure rates than external beam radiation therapy alone. Our data support the efficacy of hemilaryngectomy in T1, NO glottic carcinoma. These data question the traditional belief that surgery effects its success at the expense of voice preservation, whereas external beam radiation therapy does not. PMID- 2719826 TI - Transoral carbon dioxide laser ablation for cancer, tumors, and other diseases. AB - A carbon dioxide laser was used on 71 patients for the removal of oral cavity or oropharyngeal cancers, premalignant lesions, benign tumors, or elongated soft palates. Evaluation of patient morbidity, speech, and swallowing, as well as survival data, suggests that the use of this modality for treatment of these conditions is highly successful, with excellent preservation of oral and pharyngeal function and minimal patient morbidity. Deep excisions of tumors that could lead to restricted motion of the tongue and/or jaw tended to have an adverse effect on both speech and swallowing. Immediate reconstruction should be considered, especially for defects created by excision of large tumors in the anterior oral cavity or in the lateral oropharyngeal wall cancers. Multimodality cancer therapy should be considered for large oral cavity and oropharyngeal cancers that have been treated by carbon dioxide laser excision. PMID- 2719827 TI - Treatment of the clinically negative neck in advanced cancer of the head and neck. AB - The proper management of the clinically negative neck in primary squamous cell carcinomas of the head and neck remains controversial. Although many clinicians believe that elective neck dissection or neck irradiation are equally effective for controlling subclinical disease, previous studies have not directly addressed this question. The charts of 195 patients with advanced primary squamous carcinoma, yet with clinically negative necks, were reviewed. There were no significant differences in the rates of neck cancer recurrence among the elective neck irradiation, dissection, and combined treatment groups. Elective neck irradiation and neck dissection in patients with clinically negative nodes seemed equivalent in their ability to control neck disease. The decision as to which form of therapy is preferable must therefore be based on other criteria. PMID- 2719829 TI - The effect of facial animation on the aging upper half of the face. AB - Sixty patients, ranging in age from 29 to 74 years, were studied for the effect of animation of the upper half of the face on the aging features. Patients were divided into three categories according to the dominant behavioral pattern: brow lifters, frowners, and squinters. Brow ptosis was accentuated laterally in the squinters and medially in the frowners. The brow-lifter group showed more uniform displacement of the eyebrow. The coarse wrinkles or the animation lines also correlated well with the animation pattern. These patterns are acquired in childhood and remain subconsciously in effect throughout adult life and therefore have a significant effect on brow ptosis. PMID- 2719828 TI - Augmented fixation of mandibular fractures with a threaded Kirschner wire. AB - The maxillofacial surgeon uses a variety of techniques when treating mandibular fractures. The aim of treatment is to restore structure and function while minimizing morbidity. This requires adequate anatomic reduction and immobilization. The surgeon's choice of techniques should be safe, simple, economic, and effective. In this article, we discuss a previously described, yet little known, technique that fulfilled these criteria. The technique of augmented fixation of mandibular fractures using a threaded basal Kirschner wire was successfully used in seven patients. It offered the distinct advantage of rigid basal fixation that augmented interosseous and maxillomandibular fixation techniques. It was especially effective in stabilizing and promoting bone healing in unfavorable comminuted parasymphyseal fractures. Its ease and rapidity of application from readily available materials made it an effective alternate to elaborate techniques such as compression-plating systems. PMID- 2719830 TI - Auricular injury and the use of headgear in wrestlers. AB - Questionnaires designed to assess attitudes and use of headgear were completed by 537 Division I collegiate wrestlers. Only 35.2% of the wrestlers wore headgear all of the time during practice as opposed to 92.4% during competition, which was a statistically significant difference. The most common reason for not wearing headgear was discomfort (35%). There were 482 participating in nonschool team events, and 203 (42%) described headgear use as "seldom or never." However, there was a statistically significant difference of developing auricular hematoma while wearing headgear (26%) vs not wearing headgear (52%). There were 208 (39%) who reported a permanent auricular deformity resulting from an injury that occurred with (10.6%) or without (26.6%) headgear. These results suggest that headgear provides only partial protection and that nonuse is widespread, causing a surprisingly high frequency of permanent auricular deformities. PMID- 2719831 TI - Microbiology of obstructive tonsillar hypertrophy and recurrent tonsillitis. AB - A qualitative and quantitative analysis of the tonsillar surface and core of children with recurrent streptococcal tonsillitis and children with obstructive tonsillar hypertrophy was performed. No qualitative difference was found within the two population groups. Haemophilus influenzae and Bacteroides melaninogenicus were the most prevalent beta-lactamase-producing isolates in both groups. Staphylococcus aureus had the highest rate of beta-lactamase production on the tonsillar surface of children with recurrent tonsillitis, while Streptococcus pyogenes was more prevalent in the tonsillar surface cultures of children with obstructive tonsillar hypertrophy. The bacterial density was high but not significantly different in both groups of children. The similar microbial composition and density of both groups and the higher rate of S pyogenes recovery may signify a subclinical disease or normal flora in children with obstructive tonsillar hypertrophy. PMID- 2719832 TI - Sphenoid sinus mucocele. AB - Sphenoid sinus mucocele is a rare entity that can occur alone or as a result of ethmoid sinusitis and polyposis. A myriad of presentations is possible due to the presence of important contiguous neurologic and vascular structures. Past surgical approaches to the sphenoid sinus have problems associated with them. The endoscopic sinus technique offers outstanding visualization and a safe, straight forward approach to the sphenoid sinus. Four patients with documented mucocele of the sphenoid sinus were treated successfully with endoscopic sinus surgery. The technique involves partial removal of the inferior middle turbinate and direct entrance into the sphenoid sinus through the anterior sinus wall. Other sinus abnormalities can be treated simultaneously as required. Sphenoid sinus mucocele is discussed from the standpoint of cause, clinical presentation, and treatment options. PMID- 2719833 TI - Inherited nasal and laryngeal degenerative chondropathy. AB - Four rare cases of congenital saddle-nose deformity and slowly progressive degeneration of laryngeal cartilages with stenosis are described. The term inherited degenerative chondropathy is suggested for this disease entity. To our knowledge this is the first article on such a disease. PMID- 2719834 TI - Slow-intensity diathermy for juvenile laryngeal papillomas. PMID- 2719835 TI - Treatment of patients with cleft palate in consideration of nasal breathing and speech. PMID- 2719836 TI - Pathologic quiz case 1. Sudoriferous cysts (cysts of Moll's glands). PMID- 2719838 TI - Second International Symposium on Familial Alzheimer's Disease. Seattle, Washington, 14-17 May 1989. Abstracts. PMID- 2719837 TI - Pathologic quiz case 2. Epidermoid cyst and thyroglossal duct (TGD) cyst. PMID- 2719839 TI - Discontinuation of antiepileptic medications in patients with developmental disability and the diagnosis of epilepsy. PMID- 2719840 TI - Anticonvulsants for mentally retarded persons. PMID- 2719841 TI - Antiepileptic medication for persons with mental retardation. PMID- 2719842 TI - The clinical challenge of a complex population: seizures, anticonvulsants, mental retardation, and institutions. PMID- 2719843 TI - Comments on discontinuance of antiepileptic medications. PMID- 2719844 TI - Psychotropic drug patterns in a large ICF/MR facility: a ten-year experience. AB - Psychotropic drug-prescribing patterns for a stable cohort of 474 persons in continuous residence at an ICF/MR facility for a 10-year period were recorded and classified by drug type. Results indicated a progressive, marked decrease in total psychotropic drug usage and changes in the type of drugs prescribed. The findings indicate the importance of physician awareness of drug side-effects and alternate treatment possibilities. PMID- 2719845 TI - Prevalence and prediction of psychotropic drug use in California developmental centers. AB - The extent of psychotropic drug use was evaluated in California's institutionalized developmentally disabled population (N = 6,450). Mean psychotropic drug use was 35.4% for the entire population (range = 13.7% to 63.6% across institutions), with antipsychotic drug use at 26.8% (range = 11.0% to 59.6%). Psychotropic drug use was positively associated with aggression, IQ, depression, and self-injurious behavior, ps less than .0001; it was inversely associated with cerebral palsy and epilepsy. When the influence of demographic and behavioral factors was controlled, significant institutional differences in drug use remained. PMID- 2719846 TI - Monitoring and evaluating psychotropic drug use for persons with mental retardation: a follow-up report. AB - Psychotropic drug use in a large Massachusetts public facility for mentally retarded adults was reduced and maintained at approximately 20% over an 8-year period during which a monitoring and evaluating procedure (including interdisciplinary team review, identification of target behaviors, and concurrent alternative forms of treatment) was in effect. Average daily dosages for antipsychotics were lower than usually reported in institutional settings. Follow up of 225 individuals receiving psychotropics showed that of 130 withdrawn, 69% remained off drugs, demonstrating sustained effectiveness of the review process. PMID- 2719847 TI - A retrospective study of mentally retarded patients with behavioral disorders who were treated with carbamazapine. AB - Institutionalized mentally retarded residents (N = 76) referred to a psychiatry clinic for behavioral disorders were prescribed carbamazapine after other medications had proved ineffective. Target symptoms were identified and severity and frequency scales established on the basis of multidiscipline input. A retrospective study was then conducted using previous medications and behavioral data as controls. Thirty patients responded significantly, with essentially complete remission of symptoms; 10 improved but did not meet study criteria; and 31 showed no benefit. Of the 30 responders, 27 had a previously diagnosed EEG abnormality or a seizure disorder well-controlled with other anticonvulsants. PMID- 2719848 TI - Review of states' practices on the use of psychotropic medication. AB - Concerns involved with prescription of psychotropic medication to persons with developmental disabilities to ameliorate maladaptive behavior were described. Responses to a national survey of state agencies regarding statutes, regulations, and operating procedures for initiating and monitoring psychotropic drug regimens were examined. The survey showed that most states had more rules and regulations for persons in institutions than in community settings. It also showed that some states have initiated rules similar to court-ordered guidelines for assessing tardive dyskinesia, restricting the use of antiparkinson drugs and polypharmacy, and implementing periodic drug interruptions. Recommendations were made based on these findings. PMID- 2719849 TI - Nutrient and environmental growth factors for nine oral small-sized spirochete strains containing one endoflagellum from each cell end. AB - The present investigation was carried out in order to obtain better information about the growth requirements of small-sized spirochetes containing one endoflagellum from each cell end. Nine strains of such spirochetes were isolated from subgingival plaque in patients suffering from advanced marginal periodontitis. The strains were maintained in fluid NOS medium with 0.07% Noble Agar. The following environmental factors were studied: Oxygen in the incubation atmosphere and the pH value of the medium. The following nutrient factors were studied: Rabbit serum, heart infusion and trypticase, bovine albumin, human globulin, long-chain fatty acids, volatile fatty acids, steroids, amino acids, carbohydrates, and Na-bicarbonate. Growth was normally determined after 3 days' incubation at 35 degrees C by counting numbers of spirochete cells in a Petroff Hausser counting chamber. All strains tolerated 3% oxygen in the atmosphere and the pH-optimum was 7.5. Rabbit serum was found not to be an essential nutrient factor. Human globulin stimulated growth, while bovine albumin inhibited growth. Heart infusion and trypticase influenced growth moderately. Of the remaining nutrient factors the long-chain fatty acids inhibited growth and the volatile fatty acids did not affect growth, while certain carbohydrates, especially glucose, stimulated growth. Na-bicarbonate in low concentrations stimulated growth, while higher concentrations inhibited growth. PMID- 2719850 TI - Mucosal cysts in Barrett's mucosa with dysplasia. AB - The frequency of glandular cysts occurring in the Barrett's mucosa was investigated in areas adjacent to invasive adenocarcinoma in 32 resected esophagi. Cysts in the metaplastic glands of the Barrett mucosa were present in areas with and without dysplasia in 31 of the 32 specimens. The mean cyst index (i.e. the number of glandular cysts divided by the length-in mm-of mucosa analyzed) was 2.3 in the non-dysplastic Barrett mucosa, and 2.5 in the Barrett mucosa with dysplasia. Significantly lower indices (p less than 0.001) were found in areas with metaplastic glands covered by "healing" squamous epithelium (0.47) and in the gastric mucosa of the same patients (0.15) as well as in 10 control esophagi underneath normal squamous epithelium (0.11). The outlet of the dilated glands was often obstructed by clusters of dysplastic cells or papillary formations with atypical cells, substantiating on obstructive-causal mechanism in these cysts. Other cysts were partially or totally replaced by dysplastic epithelium. The present findings may be of importance for the histological differential diagnosis between dysplasia and highly differentiated adenocarcinomas in biopsy specimens from the Barrett Mucosa. PMID- 2719851 TI - Histomorphometric analysis of bone in idiopathic hypercalciuria before and after treatment with thiazide. AB - Twenty-seven normocalcemic patients aged 11-69 yrs with recurrent renal stone formation and idiopathic hypercalciuria were studied before and after treatment with hydrochlorthiazide (TD) 50 mg twice a day for 6 months. Hypercalciuria was defined as a 24 h renal calcium excretion of more than 7.5 mmol for males and 6.3 mmol for females. Quantitative histomorphometric analysis of iliac crest bone biopsies were performed before and after treatment. TD treatment increased the adjusted serum calcium level (p less than 0.01), whereas no significant effects on the serum levels of phosphorous, alkaline phosphatase or iPTH were found. The urinary calcium/creatinine ratio decreased (p less than 0.01) during TD treatment, whereas no change in the urinary phosphorous/creatinine ratio was found. The histomorphometric analysis revealed a reduction in the extent of eroded surfaces (p less than 0.05) and bone formation rate (p less than 0.05) as well as a decrease in the osteoid thickness (p less than 0.05) during TD treatment. No effect on the trabecular bone volume was found. A reduction in the activation frequency of new remodeling sites and thereby a reduced bone turnover during TD treatment can explain the observed histomorphometric changes. The decrease in osteoid thickness may be related to the increased serum calcium concentration leading to better conditions for mineralization. PMID- 2719852 TI - A histomorphometric determination of iliac bone remodeling in patients with recurrent renal stone formation and idiopathic hypercalciuria. AB - 33 normocalcemic patients (22 males and 11 females) aged 20-68 years with recurrent renal stone formation and idiopathic hypercalciuria were compared to 33 approximately sex- and age-matched normal controls. Quantitative histomorphometric analysis of iliac crest biopsies were performed after intravital tetracycline double labeling in the patients and in 30 sex- and age matched normal controls. No difference was found between patients and controls in albumin adjusted serum calcium levels. Serum phosphorus was significantly reduced (p less than 0.01) in the patient group whereas the urinary phosphorus/creatinine ratio was increased (p less than 0.01). The serum calcium phosphate product (S CaxS-P) was significantly reduced in the patients (p less than 0.05). As expected, the urinary calcium/creatinine ratio was higher in the patient group than in the controls (p less than 0.001). Serum parathyroid hormone was normal. The histomorphometric analysis revealed signs of a moderate mineralization defect (reduced adjusted appositional rate (p less than 0.05), prolonged mineralization lag time (p less than 0.05) and prolonged formation (p less than 0.05)), and an increased extension of eroded surfaces (P less than 0.05) in the patients. The amount of trabecular bone and the balance between the thickness of bone resorbed and later formed per remodeling cycle and all other histomorphometric parameters were found normal in the patients. The combined histomorphometric and biochemical data are best explained by a primary renal phosphate leak leading to hypophosphataemia and a slight mineralization defect. The hypercalciuria may be explained by an enhanced renal production of 1.25-dihydroxyvitamin D secondary to the reduced serum levels of phosphorus. No signs of secondary or primary hyperparathyroidism were observed. PMID- 2719853 TI - Lectinohistochemistry of human bladder cancer: loss of lectin binding structures in invasive carcinomas. AB - With the purpose of studying changes in the expression of glycoconjugate structures in urothelium, nine different lectins (PNA, WGA, VFA, GSA II, STA, UEA I, LCA, DBA and HPA) with specificity for mono- or oligo-saccharides were used on formalin-fixed, paraffin-embedded tissue sections from 47 patients who had undergone surgical resection for bladder tumors and on normal urothelial biopsies from 10 patients. The tumors were graded and a lectinohistochemical method using biotinylated lectins and avidin-biotin-peroxidase complex was used to demonstrate the lectin binding. Positive staining reactions of cells in cytoplasm and on membranes were evaluated in the basal, the intermediate, and the luminal cell layers, respectively. In both normal and atypical urothelium lectin binding predominated in the luminal cell layer and decreased towards the basal cell layer. In normal urothelium all lectins stained greater than 66% of the cells in the luminal cell layer in cytoplasm and between 5 and 100% of the cells on membranes depending on the lectin used. A gradual loss of lectin-binding structures was seen with increasing grade of atypia. The range of this decrease varied considerably from one lectin to another, but it was consistently found that the percentage of cells stained in cytoplasm and on membranes decreased. A significantly lower percentage of cells stained in cytoplasm was found in invasive tumor cell-islands compared to normal urothelium. In invasive tumor cell islands staining of cells on membranes was completely absent, except for HPA lectin that stained less than 10% of the cells. In conclusion, we demonstrate a dramatic decrease in lectin-binding carbohydrate structures associated with urothelial malignant progression. PMID- 2719854 TI - Characterization of the first tick isolate of Borrelia burgdorferi from Italy. AB - We report on the first isolation of a spirochetal organism from Ixodes ricinus ticks of the Trieste area (Northern Italy) which was identified as Borrelia burgdorferi by its reactivity with specific monoclonal antibodies directed against the OSPA and flagella proteins. PMID- 2719855 TI - Functional differences in the catabolism of branched-chain L-amino acids in cultured normal and maple syrup urine disease fibroblasts. AB - Possible functional differences in the catabolism of the four branched-chain L amino acids in maple syrup urine disease were assessed using cultured human skin fibroblast stains. Transamination and oxidative decarboxylation were comparatively studied in 90-min incubations with 1 mmole/liter of 1-14C-labeled substrates. In normal cell strains (n = 5), apparent transamination rates (sum of branched-chain 2-oxo[14C]acid and 14CO2 release; means expressed in nmole/90 min/mg of cell protein) were in the order L-leucine (32) greater than L-valine (17) greater than or equal to L-isoleucine (14) greater than L-allo-isoleucine (8); 14CO2 production was in the order L-valine (9) greater than L-isoleucine (6) greater than or equal to L-leucine (5) greater than L-allo-isoleucine (2). In variant (n = 5) as well as classical (n = 2) MSUD cell lines, branched-chain 2 oxo-[14C]acid release rates were generally comparable to the control values. As compared to the 14CO2 release in controls (= 100%), branched-chain 2-oxo acid dehydrogenase activity in MSUD fibroblasts was individually reduced and varied considerably between strains (residual activity 2-38%). Within individual strains, only small differences in the residual decarboxylation activity were observed in incubations with L-valine, L-leucine, and L-isoleucine. It was remarkably high, however, when L-allo-isoleucine was applied as a substrate. With the exception of L-allo-isoleucine, apparent total transamination rates of branched-chain L-amino acids were therefore distinctly lower in MSUD cells than in normal cells. PMID- 2719856 TI - Low-density lipoprotein derived from atherosclerotic patients enhances macrophage cholesterol accumulation and in vitro platelet aggregation. AB - The aims of our study were to assess the differences between plasma lipoproteins separated from five angiographically normal subjects and five patients with proven CHD. The patients with CHD had significantly higher levels of LDL cholesterol and apo-B, and reduced levels of HDL-cholesterol and apo-Al. The biological characteristics of LDL and HDL from both groups of patients demonstrated that the LDL from the CHD patients enhanced platelet aggregation and increased cholesterol content and cholesterol esterification in MPM compared to the normal patients. HDL had no significant effect on MPM; however, there was an increased platelet aggregation with HDL derived from the CHD patients, while the HDL from the normal group decreased platelet aggregation. The data suggest that lipoproteins isolated from CHD patients are more atherogenic than lipoproteins from normal patients. PMID- 2719857 TI - Synthesis and characterization of a bovine hexokinase 1 cDNA probe by mixed oligonucleotide primed amplification of cDNA using high complexity primer mixtures. AB - Hexokinase (EC 2.7.1.1) catalyzes the first step in glucose metabolism, using ATP for the phosphorylation of glucose to glucose 6-phosphate. A portion of the HK1 gene was cloned by mixed oligonucleotide primer amplification of cDNA using primers of high complexity. The amino acid sequence for a partial fragment of bovine cardiac muscle HK was determined and used to create primer mixtures of 256 and 1024-fold complexity. Two products were generated from bovine cardiac muscle cDNA which show 82% nucleotide and 93% amino acid identity with a region of rat brain HK1 and cDNA. This work demonstrates that extension and amplification of cDNA probes may be successful even when amino acid sequence data indicate substantial codon degeneracy. PMID- 2719858 TI - Changes in membrane properties of erythrocytes and polymorphonuclear cells in psoriasis. AB - Using fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene and its cationic derivative, 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene, we evaluated membrane fluidity in living polymorphonuclear leukocytes and in erythrocytes of psoriatic patients. Our results have shown that erythrocyte membranes of psoriatic patients exhibit a decrease of fluidity. These changes were not associated with any relevant modifications of the cholesterol to phospholipid molar ratio. Moreover, we observed a decrease in polymorphonuclear leukocytes membrane fluidity associated with changes in chemotactic migration. Our results indicate changes of membrane fluidity involving membranes different from the epidermal cells and suggest the hypothesis of a defective membrane-cytoskeleton interaction in psoriasis. PMID- 2719859 TI - Aminopeptidases in human retroplacental sera: purification and characterization of two enzymes. AB - Ten different maternal serum samples were analyzed for the hydrolysis of S-Bz-Cys pNA (substrate for CAP) and Ala-pNA. The results showed clear differences in the activities in individual sera. Similar S-Bz-Cys-pNA hydrolysis activity was detected for all sera. However, Ala-pNA hydrolysis activity differed remarkably. Serum exhibiting low Ala-pNA hydrolysis activity contained only CAP, and that exhibiting high Ala-pNA hydrolyzing activity contained CAP and AAP. The two aminopeptidases were independently purified to a homogeneous state through the same purification procedures and some of their biochemical properties were compared. The enzymes were quite different with respect to molecular mass, the substrate specificities for some aminoacyl-pNA substrates, and the effects of inhibitors. Among various natural peptides tested for hydrolysis, the enzymes hydrolyzed Met-enkephalin most rapidly, but their modes of action were different. Furthermore, only CAP degraded oxytocin and AAP exhibited a high kinin-converting activity. PMID- 2719860 TI - Change of glycosaminoglycan in pus of patients with purulent pleurisy. AB - The glycosaminoglycan content in pus from patients with purulent pleurisy was studied. The uronic acid content rose in the first 4 hospital days, continued at a high level during hospital days 5-8, and then fell to a low level after 9 hospital days. Four glycosaminoglycans were isolated from the preparation; they were identified as hyaluronic acid, chondroitin 4-sulfate, chondroitin 6-sulfate, and dermatan sulfate. Hyaluronic acid was the main component and its relative proportion increased with increasing hospital days. The relative proportions of chondroitin 4-sulfate and chondroitin 6-sulfate were low during the first 4 day and during Days 10-21, whereas they were high during Days 5-9. The proportion of dermatan sulfate was high during the early hospital days, and thereafter decreased with increasing hospital days. PMID- 2719861 TI - HIV appears to have some susceptibility to heat. PMID- 2719862 TI - [Transplantation of embryonic medulla oblongata into cerebella of adult rats]. AB - Pieces of medulla oblongata anlagen were dissected free from embryonic 13-20 day (E 13 to E 20) rat brain, and these were transplanted into the cerebellar vermis of adult rats (Fischer 344). After grafting, host animals survived for 4-9 months. Cytoarchitectonic organization of the graft and the relationship between host and graft were analyzed light microscopically in 34 animals using the Nissl and silver impregnation methods. Fine structures of the graft were analyzed in 4 animals using electron microscope. Grafts from E 13-14 donor tissue showed the highest survival rate (90%), which decreased as the donor embryonic age increased (i.e., E 15-16: 33%, E 17-20: 15%). In the surviving grafts, small (5-10 microns diameter), medium-sized (10-20 microns) and large (20-30 microns) neurons, whose cytoplasmic organelles appeared normal, were observed. Bundles of myelinated fibers traversed in every direction and neurons were often clustered, indicating characteristic features of the medulla oblongata. Electron microscopically, various types of synaptic formations were also observed. Degenerative profiles of nerve-fiber endings, containing dense bodies and lysosomal figures, were also seen. The degeneration seemed to be caused by the failure of their establishing connections with their proper targets in the host. In both the host tissue and the graft-host interface, neuronal processes apparently derived from the graft were frequently observed. Some axonal processes contained large-cored vesicles, and some dendritic processes were enlarged at their stalks and tips. Aberrant axon terminals of unmyelinated fibers in the host medullary layer were considered to be the graft origin. These fibers were always accompanied by prominent glial proliferation. There was no indication of forming myelinated fiber bundles that entered the host cerebellum from the donor tissue, although the former was the target of the latter. Cell bodies of host granule cells and oligodendroglia in the graft-host interface were surrounded by processes of oligodendroglia, forming thin myelin lamellae. The present study showed that unmyelinated fibers from the graft could enter the host cerebellum non-specifically accompanied by glial proliferation, whereas myelinated fibers could hardly penetrate into the host crossing the glial scar. PMID- 2719863 TI - [Transplantation of embryonic cerebella into adult rat cerebella]. AB - Cerebellar primordia of rat embryos (embryonic days of 14-20) were transplanted into mature cerebella of normal adult rats (Fischer 344). After 1-12 months, animals were sacrificed, and the development of grafts and the interaction between host and graft were examined by light and electron microscopy. Grafts from E14 rat cerebella showed the highest survival rate (85%), which decreased with increasing donor age. In some experiments, the donor tissue developed and differentiated to form folia with the trilaminar organization of the cerebellar cortex. Synaptic connections between neuronal elements in the graft showed basically the normal pattern. Thus, mossy terminals formed synaptic contacts with dendrites of granule cells, and axons of basket cells made synaptic contacts with somata of Purkinje cells. Many spines of Purkinje dendrites were contacted with parallel fibers, while others were surrounded by processes of astroglia. Migration of donor Purkinje and granule cells in the host molecular layer was frequently observed. Some donor granule cells, implanted in the superficial aspect of the host molecular layer, migrated down along processes of Bergmann glia, which resembled the migration pattern of the normal development. Other granule cells attached to neuroglial processes which ensheathed capillary walls. While the migration of granule cells was found to be glial-dependent, the glial role in the migration of Purkinje cells was not clear. Purkinje cells probably migrated into the host molecular layer under favorable conditions where the loss of host Purkinje cells had been occurred to some extent and consequently followed by the increase of free axon endings of parallel fibers and interneurons of the host.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719864 TI - [Substantia innominata kindling in rats]. AB - With a combination of electrolytic lesion and choline acetyltransferase histochemistry, Kimura et al. suggested that cholinergic neurons in the substantia innominata (SI) plays an important role in accessing non-motor structure, such as the amygdala (AM), to the motor system during AM kindling. More recent studies demonstrated that intra-SI injection of GABAergic agent or excitatory amino acid antagonist suppresses the kindled generalized convulsion without blocking afterdischarge (AD) generation in the AM. In order to gain further insight into the role played by the SI in AM kindling, we examined the comparative electroclinical features of AM and SI kindling in addition to the transferability of the SI to the ipsilateral AM. Male Wistar rats were electrically kindled at the left AM or the left SI at the AD threshold (ADT) until five consecutive Stage 5 generalized convulsions were evoked. Subsequently, the stimulus intensity was gradually reduced and the last intensity to induce Stage 5 seizure was designated as the generalized seizure triggering threshold (GST). Following the determination of the GST, the SI stimulation was switched to the ipsilateral AM. All the animals were perfused and electrode placements were identified histologically. The electrode placements distributed in the medial SI (N = 5), lateral SI (N = 9), Globus Pallidum (GP) (N = 5) and Nucleus Accumbens (NA) (N = 2). All electrodes of the AM (N = 9) were located within the AM. The 3/5 of GP rats kindled, while the 2/5 did not kindle. The 2/2 of NA rats kindled.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719865 TI - [Lipid metabolism of the patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm--with special reference to the occurrence of cerebral angiospasm]. AB - Lipid metabolism, which can be an important factor for arteriosclerosis, was studied in the patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm. Total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride and Atherogenic Index were determined in 131 patients, who were admitted to our hospital since May, 1984 to March, 1986. Those results were analyzed in relation to the grading on admission, outcome and especially cerebral angiospasm. Serum levels of LDL-cholesterol and Atherogenic Index tended to correlate with the grading on admission. Total cholesterol, Atherogenic Index well correlated with the recovery of the patients and the activity of daily life. In this study, we especially examined the relationship with cerebral angiospasm. The results suggested that the role of cerebral arteriosclerosis caused by disturbance of lipid metabolism was rather negative to the development of cerebral angiospasm after subarachnoid hemorrhage. PMID- 2719866 TI - [Evaluation of electrophysiological neuromonitoring in the diagnosis of brain death: Part I. Brainstem auditory evoked potentials]. AB - Electrophysiological neuromonitoring of brainstem auditory evoked potentials (BAEP), short-latency somatosensory evoked potentials (SSEP) and compressed spectral array (CSA) EEG can provide precise and immediate information concerning functional integrity of the brain, brainstem and upper spinal cord of severely brain-damaged patients. We applied this neuromonitoring system in the cases of 154 severely brain-damaged patients in order to evaluate its reliability in the diagnosis of brain death. In particular, this study considers the relationships between BAEP and neurological findings, conventional EEG findings and factors affecting final BAEP findings. As a result, we evaluated the significance of BAEP in the diagnosis of brain death. A total of 109 brain-dead patients were divided into two groups: group A with 48 patients determined brain dead neurologically and by EEG prior to BAEP monitoring, and group B with 61 patients who had undergone automatic BAEP monitoring every 10 to 30 minutes before and/or after determination of clinical brain death. A third group, C, included 45 non brain dead patients subjected to neuromonitoring, and served as a comparative group. Brain damage was caused by subarachnoid hemorrhage in 50 patients, intracerebral hemorrhage in 36, cerebral infarction in 8, head injury in 47, meningitis in 3, brain tumor in 3 and anoxia in 7. There were no significant differences in causes among the three groups (chi 2 = 20.3). The mean ages in the three groups were 50 (ages 10-91) in group A, 51 (14-86) in group B, and 50 (5-87) in group C. There were no significant differences in age distribution among the three group (chi = 25.0). The last BAEP findings of the 109 brain-dead patients indicated loss of all waves in 99 (91%), the presence of wave I in 9 (8%), and the presence of waves I and II in one patient (1%) (Table 1). Only three of the 45 group C non brain-dead patients indicated loss of all BAEP waves within one month after onset (Table 1). The one demonstrated loss of all BAEP waves 17 days after her accident, with recovery of waves I to V three months later. The temporal relationships in group B patients of the course of BAEP findings and the time of neurological brain death diagnosis are shown in Table 2 and Fig. 1. All but two of the 61 patients were followed up until final loss of BAEP waves (Fig. 1).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2719867 TI - [A case report of hypoplasia of the root portion and the intermediate portion of the left internal carotid artery associated with an unusual primitive collateral circulation between the left internal carotid artery and the left external carotid artery]. AB - The internal carotid artery is one of the most stable arteries and its absence is very rare. We reported a case of hypoplasia of the root portion and the intermediate portion of the left internal carotid artery associated with an usual primitive collateral circulation between the left internal carotid artery and the left external carotid artery. A 57-year-old male developed right hemiparesis of sudden onset 3 days prior to admission. On admission, right hemiparesis and right minimal facial palsy was observed. The left direct carotid angiogram revealed that the root portion and the intermediate portion of the left internal carotid artery were hypoplastic. There was an unusual primitive collateral circulation between the left internal carotid artery and the left external carotid artery. From an embryological point of view, normally, the internal carotid artery is derived from the third aortic arch and the dorsal aorta when the embryo is attained the 3-mm stage. The root portion of the internal carotid artery is formed from the third aortic arch. The dorsal aorta between the third and the first aortic arch form the intermediate portion. The distal part of the internal carotid artery originates from the dorsal end of the first aortic arch. The common carotid artery begins to form in the 12-mm to 14-mm embryo, following involution of portion of the ventral aortic root between the third and the fourth aortic arch. The external carotid artery arises from the aortic sac and migrate up to the third aortic arch.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719868 TI - [Essential thrombocythemia associated with subdural hematoma and postoperative intracerebral hemorrhage--a case report]. AB - A case of essential thrombocythemia (ET) associated with subdural hematoma and postoperative intracerebral hemorrhage was reported. A 57-year-old man had complained headache in the morning. Six hours later he was found unconsciousness and soon he was brought to our hospital. On admission he was comatose. There was no evidences of head injury and the X-rays were normal. A computed tomography (CT) scan revealed an acute subdural hematoma over the left temporoparietal region. Laboratory data revealed thrombocytosis of 85.7 x 10(4)/mm3 with increased red and white blood cell counts. Emergent right craniotomy was performed and a subdural clot was evacuated. Neither cortical damage nor vascular malformations were seen on the cortical surface. But a spurting cortical artery with a pin-hole could be seen. A postoperative CT scan revealed an intracerebral hemorrhage deep in the right hemisphere. Cerebral angiograms revealed no vascular anomalies. Postoperatively, the platelet count remained high and laboratory data including bone marrow finding, neutrophil alkali-phosphatase score and chromosome analysis were consistent with the diagnosis of essential thrombocythemia. The mechanisms of subdural hematoma formation and postoperative intracerebral hemorrhage associated with essential thrombocythemia were discussed. PMID- 2719869 TI - Endemic goitre in Sri Lanka. AB - This survey examined 59,158 children from 87 schools in 17 out of 24 districts in Sri Lanka for goitre. The overall prevalence rate was 18.8%: 23.2% for girls and 14.0% for boys. Prevalence in districts varied from 30.2% in Kalutara to 6.5% in Matale. It was higher in rural than urban areas, and in inland than coastal areas. The sex ratio of prevalence rates was directly related and the ratio of palpable to visible goitre was inversely related to the severity of the endemic. It is suggested that for a rapid epidemiological assessment when the latter ratio is less than four, it is indicative of endemicity for public health purposes and calls for intervention. The iodination of salt is both practical and feasible in Sri Lanka. PMID- 2719870 TI - Health programme effects upon acceptance of immunisation in northeast Thailand. PMID- 2719871 TI - Mortality trends in a rapidly developing economy in Taiwan. Part I: Comparison with the USA and Japan 1976-1983. AB - The mortality experience of Taiwan was examined for two time periods (1976 and 1983) to determine the magnitude and direction of change in age-adjusted mortality and to identify deviation from the expected progress by comparison with two industrialized nations, the USA and Japan. Between 1976 and 1983 the overall mortality showed an annual average of nearly 2% decrease, mostly contributed by the marked reduction in the number of young. Significant reductions were also observed for deaths from strokes, rheumatic heart disease, ill-defined conditions, cancer of the stomach, and infectious diseases such as tuberculosis. A disturbing increase in suicide as well as accidents primarily caused by motor vehicles was noted. In general, cancer increased, to an alarming degree for environmentally implicated cancers such as lung, pancreas, nasopharynx, brain and liver in men. When compared to that of the USA or Japan, the mortality experience of Taiwan showed the following increases: overall female mortality, accidental deaths, suicide among elderly women, deaths from strokes, ulcers, asthma, and liver, nasopharyngeal and cervical cancers. However, the overall cancer mortality rate was still much lower than that either in the USA or Japan. Despite marked reductions in infectious disease mortality, deaths from tuberculosis were nearly 40 times those of the USA. Although deaths from ill-defined conditions decreased by half during this study period, they were still high, particularly among elderly women (13% of all deaths and 22 times higher than the USA), which probably reflects inadequate medical services for women. The role of the Taiwanese government in the financing of health services was found to be far smaller than that of the USA or Japan. Expanding health care expenditure by the government is desirable if improvement in the maldistribution of medical services is to be achieved and the untoward health effects of rapid industrialization is to be reduced. PMID- 2719872 TI - Ethics in public health research. PMID- 2719873 TI - Environmental health education in Micronesia. AB - Water supply and sanitation programmes in Micronesia require substantial capital investments. In the past, many of these projects have failed to achieve their maximum impact on preventing water-related diseases. Cases of cholera and the continuation of frequently occurring gastro-intestinal diseases undermine the expectations that new and planned water and sanitation systems will result in disease prevention. This report indicates that knowledge of water-related diseases and the understanding of the benefits of safe water supply and sanitation are limited as programmes in Micronesia that would educate the different sectors of the community have never been institutionalised. We have developed the first comprehensive system for teaching about water supply, sanitation and health in a Micronesian environment. The educational materials will be used as curricula in public education and as information resources for appropriate individuals in these remote and scattered communities of the Pacific. PMID- 2719874 TI - Mexico, maquiladoras, and occupational medicine training. AB - Industrialization and its concomitant social and environmental effects in developing countries are considered in this paper. Mexico offers one example of economic progress achieved through the promotion of industrial growth. Recognising the need for trained experts with global experience in occupational health, the University of Arizona (UA) has begun a programme to train occupational and preventive medicine residents in international aspects of occupational health in the nearby industrialized border regions of Mexico. By using the maquiladora (assembly plant) industries and the resources of the Instituto Mexicano del Seguro Social with the State of Sonora, residents observe existing problems in occupational safety and health in addition to adding to their understanding of the need for worldwide cooperation for research and reform in this field. PMID- 2719876 TI - Who killed Cock Robin? Causal relationships in occupational cancer. PMID- 2719875 TI - Physician distribution and health manpower policy in Korea. AB - This research studied the impact of increased physician supply on geographical distribution and identified the variables, both demographic and socio-economic, that account for physician maldistribution between urban and rural areas. Increased physician supply did not necessarily improve physician availability and access to health care in many rural and inner-city areas of Korea. Observed performance indicates that most physicians newly qualified since 1974 chose to work in major urban areas, while most rural areas had a shortage of physicians and health facilities. Physicians also tended to work in areas where there were supportive medical facilities, where the distance to major metropolitan areas was not great, where medical schools were located or nearby, and where consumers lived in pleasant surroundings. PMID- 2719877 TI - The prevalence of endemic goitre in the Keningau Division of Sabah. AB - Four areas of differing remoteness were studied to determine the prevalence of goitre in the Keningau Division of Sabah. These areas were Keningau town, the Biah Resettlement Scheme, the Dalit subdistrict and the Pagalunggan subdistrict. The predominant ethnic group in these areas is the Murut. The overall endemicity of goitre for the study population was 76.5% for females aged 15 years and above. There was a significant correlation between the incidence of goitre and the remoteness of an area. The Dalit subdistrict has the highest incidence of goitre (82.6%) followed by the Pagalunggan subdistrict (77.8%), the majority of these goitre cases being classified as grade 2 (visible goitres). These were the two most remote areas in the study. In contrast, Keningau town, the least remote area has the lowest incidence of goitre (62.5%) with most of the goitres being relatively small. With regards to salt usage in the Dalit subdistrict, only 3.0% used iodised salt; 28.0% used fine salt; 3.6% used coarse salt and 65.5% used both fine and coarse salt. In the Pagalunggan subdistrict, all females used uniodised salt with 17.6% using fine salt, 20% using coarse salt and the remainder using both fine and coarse salt. As yet, there is no legislation for the iodisation of salt in Sabah. It is clear that all types of salt need to be iodised and adequately distributed to deprived areas, particularly inland areas. PMID- 2719879 TI - Audit--a cause for TMJ dysfunction. AB - The last few years have seen those of us in hospital practice confronted by clinical audit and unit budgeting. We have recently been advised, by our unit general manager, that in the next financial year we must make a 1% saving, followed by 2% the subsequent year. Of course, clinical budgeting is nothing new for our colleagues in general practice. They have been working within its confines almost since the inception of the Health Service, in the guise of item of service payment. However, for those of us in hospital practice who have hitherto been relatively cushioned from economic realities, this can come as quite a shock. PMID- 2719878 TI - Cost estimate of health care coverage for the medically indigent in Hawaii. AB - The objective of the study was to estimate the cost of health insurance coverage of the medically indigent in Hawaii. The number of uninsured was estimated deductively from the coverages of those insurance companies doing business in the state, with an additional factor for persons with more than one policy coverage. Age and sex breakdowns of the uninsured were entered into actuarial tables and fee-for-service and HMO plan costs were obtained for the most prevalent health plan in the state. Annual coverage is estimated at US$46.090866 million and US$58.040700 million for fee-for-service and HMO plans, respectively. Seven potential sources of financing and five recommendations for further research are given. PMID- 2719880 TI - 'Postgraduate education--who does what?'. PMID- 2719881 TI - Preventive dental care for toddlers. PMID- 2719882 TI - Management of the small child with gross caries. PMID- 2719883 TI - 'Lip numbness--sometimes a sinister symptom'. PMID- 2719884 TI - 'Community orthodontic services: a local review'. PMID- 2719885 TI - 'Intracranial tumour presenting with facial pain'. PMID- 2719886 TI - 'Oral surgery: assessment and treatment'. PMID- 2719887 TI - Benefits of orthodontic treatment. PMID- 2719888 TI - Speed variability of air-driven motors in the self-threading pin technique. AB - Effective pin placement is dependent upon correct preparation of the dentine channel. Various factors contribute to the success or otherwise of this channel preparation. One such factor is the rotational speed of the twist drill. It is widely recommended that the twist drill be operated within the 500-800 rpm speed range, in order to prevent a temperature rise in the pulp during the cutting process. This paper examines the ability of air-driven dental motors, when coupled to two speed-reduction handpieces with differing reducing ratios, to operate within this range. The results reveal a wide variation in the speed ranges of the motors tested. Of the two types of handpiece examined, it appears that a 10:1 speed reduction is appropriate for the majority of motors. PMID- 2719889 TI - Management science. AB - Many dentists believe that they are poor businessmen. Some even take the view that business is none of their business. Neither attitude is realistic. This is the first of a series of six articles which, by outlining some basic ideas, will demonstrate that efficient practice management is not only desirable, but also achievable. PMID- 2719890 TI - Analysing the association between two variables. AB - Techniques of linear regression and correlation analysis are discussed and illustrated by means of dentally-related examples. PMID- 2719891 TI - Career patterns of dental hygienists qualifying from the Liverpool Dental Hospital School of Dental Hygiene. AB - This study assesses the pattern of employment of dental hygienists who qualified from the Liverpool Dental Hospital School of Dental Hygiene between 1977 and 1986. Of the 100 students who qualified during this period, 98 responded to a questionnaire. Seventy-seven per cent were employed as dental hygienists or dental health educators at the time of the survey, which took place between October 1987 and February 1988. The results show that after an initial slight under-employment, the majority quickly found as much work as they wanted and worked for an average of 2.24 practices each. The majority chose part-time employment and there was a steady decline in the number of sessions worked from the third year after qualifying. This decline was due to domestic commitments rather than dissatisfaction with the job. Only 4% stated they would definitely not return to work as a hygienist whilst a further 10% were uncertain. PMID- 2719892 TI - The value of therapeutic drug monitoring to the practising physician--an hypothesis in need of testing. PMID- 2719893 TI - The tubular excretion of benzylpenicillin in patients with cystic fibrosis. AB - 1. The tubular excretion of benzylpenicillin (BP) was investigated in six volunteers with cystic fibrosis. 2. The volunteers received a continuous infusion of BP at increasing infusion rates in order to maintain constant plasma concentrations at three different levels. Blood and urine samples were taken every 30 min. Sufficient urinary flow was ensured by a saline infusion (500 ml h 1). 3. The renal clearance of BP was calculated for the non-protein bound fraction of the drug. 4. Tubular clearance and tubular excretion rate were estimated from the renal clearance of the antibiotic minus the glomerular filtration rate; the latter was considered to be equal to creatinine clearance. 5. The data were analysed according to a Scatchard plot and values for ECu50 and maximal tubular excretion rate were calculated. The mean value of ECu50 was 89 +/ 24 (mg l-1 +/- s.d.) and that for the maximal tubular excretion rate was 2603 +/ 714 (mg h-1 +/- s.d.). The latter value was significantly less than that found in a previous study of healthy volunteers, but the ECu50 was similar. 6. It is concluded that the tubular excretory capacity for BP is decreased in patients with cystic fibrosis in direct relation to their low body weight. PMID- 2719894 TI - Cardiovascular (ECG and systolic time intervals) and anticholinergic effects of repeated doses of femoxetine--a comparison with amitriptyline and placebo in healthy men. AB - 1. The cardiovascular and anticholinergic effects of femoxetine and amitriptyline were compared with those of placebo in a double-blind cross-over trial in 12 healthy men. The daily doses administered were therapeutic: 600 mg femoxetine and 150 mg amitriptyline. Duration of treatment with each drug was 13 days. 2. The statistically significant effects on systolic time intervals and ECG comprised a larger decrease of QS2 index during femoxetine than during amitriptyline, and an increase of PEP/LVET ratio and QRS duration by amitriptyline. These results suggest that femoxetine and, to a lesser extent, amitriptyline increase contractility compared with placebo, and amitriptyline, but not femoxetine, causes delay in intracardiac conduction. 3. The effects of amitriptyline on the systolic time intervals are difficult to interpret because of the changes in heart rate and intracardiac electrical conduction caused by the drug. These problems of interpretation are discussed. 4. No significant changes in blood pressure were observed. The heart rate during both femoxetine and amitriptyline periods was significantly faster than during the placebo period, amitriptyline causing a significantly greater increase. 5. Salivary secretion was decreased more by amitriptyline (26%) than by femoxetine (8%), the latter being not significantly different from placebo. Femoxetine tended to increase pupil diameter and amitriptyline to increase accommodation near point, but no visual disturbances were reported on any treatment. Symptoms such as dry mouth, constipation and sedation were significantly less frequently reported during femoxetine than during amitriptyline treatment. PMID- 2719895 TI - The need for reassessment of digoxin prescribing for the elderly. AB - 1. The prevalence and circumstance of digoxin prescribing was assessed in five private nursing homes. 2. Forty-one patients (21% residents) were taking digoxin. 3. Seventeen patients were in atrial fibrillation and the remainder in sinus rhythm. The ventricular rate exceeded 100 beats min-1 in eight of the 17 patients in atrial fibrillation. 4. Thirty-seven patients were prescribed 0.0625 mg digoxin daily and serum digoxin concentrations were subtherapeutic in 20 of 32 patients in whom concentrations were measured. 5. These data indicate a need for more careful review of the need for maintenance digoxin and illustrate the inappropriateness of routinely prescribing very low doses in all elderly patients. PMID- 2719896 TI - An investigation of premedication with morphine given by the buccal or intramuscular route. AB - 1. Premedication with 30 mg buccal morphine or 10 mg intramuscular morphine was evaluated in 40 healthy women undergoing major gynaecological surgery. 2. Buccal administration of morphine produced lower plasma morphine concentrations than intramuscular injection of morphine (P less than 0.01). 3. The mean systemic availability of the buccal tablet, during the first 5 h after administration, was approximately 3% relative to that of the intramuscular preparation. 4. Poor absorption of buccal morphine resulted in inadequate sedation prior to surgery and poor post-operative analgesia. 5. Patients experienced difficulty with the buccal formulation of morphine; tablet bitterness and failure to dissolve were particular problems. PMID- 2719897 TI - Extensive oxidative metabolism of dextromethorphan in patients with almitrine neuropathy. AB - Almitrine bismesylate can induce a stereotypical sensory peripheral neuropathy probably through a toxic mechanism. High plasma concentrations of almitrine have been reported in a patient with neuropathy. Since large inter-individual variations in plasma drug concentrations are found it is possible that the development of toxicity may be linked to genetically determined polymorphic oxidation of the drug. Oxidation phenotyping was performed in fifteen patients with almitrine neuropathy using dextromethorphan, a test compound subject to oxidative metabolism similar to that of debrisoquine. All patients were of the extensive metaboliser phenotype. This result shows that, in contrast to perhexiline neuropathy, almitrine neuropathy is not related to slow oxidation of the compound with regard to the particular P-450 iso-enzyme involved in dextromethorphan and debrisoquine metabolism. PMID- 2719898 TI - Variable metabolism of pinacidil: lack of correlation with the debrisoquine and trimethylamine C- and N-oxidative polymorphisms. AB - 1. The urinary excretion of pinacidil and its N-oxide in man was found to vary over a five-fold range. 2. Studies in individuals with inherited deficiencies for C-hydroxylation (debrisoquine type) and trimethylamine N-oxidation showed that the N-oxidation of pinacidil did not co-segregate with these oxidative polymorphisms. 3. It is concluded that the variable N-oxidation of pinacidil is most likely to be due to variations in the activity of the P-450 isozymes rather than in the microsomal flavoprotein containing mixed-function amine oxidase of Ziegler which is considered to be responsible for the N-oxidation of trimethylamine. PMID- 2719899 TI - Timolol metabolism and debrisoquine oxidation polymorphism: a population study. AB - 1. The metabolism of orally administered timolol (T) to its ring cleavage ethanolamine (TE) and glycine (TG) products was studied in 108 unrelated hypertensive patients. 2. Statistically significant correlations between the 0-8 h urinary debrisoquine/4-hydroxy-debrisoquine ratio and the T/TE (rs = 0.74, P less than 0.001), T/TG (rs = 0.42, P less than 0.001) and T/TE + TG (rs = 0.49, P less than 0.001) ratios were found. 3. The log10 T/TE, T/TG and T/TE + TG ratios from poor metabolisers of debrisoquine (PMs) were grouped at the upper end of a unimodal distribution. 4. These results indicate that timolol metabolism is partly under monogenic control of the debrisoquine-type. 5. The mean +/- s.d. plasma timolol concentration in PMs (82 +/- 43 ng ml-1) was double that in extensive metabolisers (45 +/- 19 ng ml-1) (P = 0.011). The clinical significance of this observation remains to be established. PMID- 2719900 TI - Genetically-determined interaction between propafenone and low dose quinidine: role of active metabolites in modulating net drug effect. AB - 1. Quinidine is a potent inhibitor of the genetically-determined debrisoquine 4 hydroxylation. Oxidation reactions of several other drugs, including the 5 hydroxylation of the new antiarrhythmic drug propafenone, depend on the isozyme responsible for debrisoquine 4-hydroxylation. 2. The effect of quinidine on the debrisoquine phenotype-dependent 5-hydroxylation and the pharmacological activity of propafenone was studied in seven 'extensive' metabolizers and two 'poor' metabolizers of the drug receiving propafenone for the treatment of ventricular arrhythmias. 3. In patients with the extensive metabolizer phenotype, quinidine increased mean steady-state plasma propafenone concentrations more than two fold, from 408 +/- 351 (mean +/- s.d.) to 1096 +/- 644 ng ml-1 (P less than 0.001), decreased 5-hydroxypropafenone concentrations from 242 +/- 196 to 125 +/- 97 ng ml-1 (P less than 0.02) and reduced propafenone oral clearance by 58 +/- 23%. 4. Despite these changes in plasma concentrations, electrocardiographic intervals and arrhythmia frequency were unaltered by quinidine coadministration, indicating that 5-hydroxypropafenone contributes to the pharmacologic effects of propafenone therapy in extensive metabolizers. 5. In contrasts, plasma concentrations of propafenone and 5-hydroxypropafenone remained unchanged in the two patients with the poor metabolizer phenotype. 6. Biotransformation of substrates for the debrisoquine pathway can be markedly perturbed by even low doses of quinidine; interindividual variability in drug interactions may have a genetic component. PMID- 2719901 TI - Variability in the elimination of mianserin in elderly patients. AB - 1. Two studies of the elimination of mianserin are reported. 2. In the first study, the oral clearance of mianserin was measured in 15 elderly patients at steady state. In a sub-group of eight patients who completed studies at two different doses there was evidence of enhanced oral clearance at the higher dose. 3. In the second study, the elimination half-life was estimated in 12 patients who were observed to have disproportionately high mianserin concentrations with respect to dose. All had half-lives greater than or equal to 2.5 days with a mean of 6 +/- 2.8 (s.d.) days. In six of the patients the profile of elimination was suggestive of saturable elimination. 4. The sparteine oxidation status was measured in seven of the patients showing slow mianserin elimination. Only one was a 'poor oxidiser' of sparteine, suggesting no concordance with this phenotype. 5. It is concluded that there is marked variability in the elimination of mianserin in elderly patients. PMID- 2719902 TI - Cimetidine-nicoumalone interaction in man: stereochemical considerations. AB - 1. The cimetidine-nicoumalone interaction was studied in five subjects who received a single 10 mg oral dose of racemic nicoumalone alone and 3 days into an oral regimen of cimetidine of 200 mg three times daily and 400 mg at night. 2. The concentrations of R(+)- and S(-)-nicoumalone in plasma were measured using a stereospecific h.p.l.c assay; augmentation of prothrombin time was used as a measure of response. 3. Cimetidine increased the rate (but not extent) of absorption of both R(+)- and S(-)-nicoumalone, and reduced the clearance of R(+) nicoumalone but not that of the S(-)-enantiomer. 4. Cimetidine increased the anticoagulant response produced by nicoumalone in some but not all subjects, despite a consistent effect on the pharmacokinetics of the oral anti-coagulant. 5. Cimetidine appears to produce its effect by stereoselectively inhibiting the elimination of R(+)-nicoumalone. PMID- 2719903 TI - The bioavailability and pharmacokinetics of morphine after intravenous, oral and buccal administration in healthy volunteers. AB - 1. The absolute bioavailability of morphine from oral aqueous solution, a controlled release oral tablet (MST-Continus) and a controlled release buccal tablet has been investigated in six healthy volunteers. 2. Analysis of plasma samples for morphine and its active metabolite morphine-6-glucuronide (M6G) was by means of a differential radioimmunoassay technique. Absolute bioavailability for morphine was estimated to be 23.9% after oral solution, 22.4% after MST Continus and 18.7% after the buccal tablet. Maximum plasma morphine concentrations were seen at 45 min (oral solution), 2.5 h (MST) and 6 h (buccal). 3. There was no difference in the amount of M6G appearing in plasma after intravenous, oral or buccal administration but the mean ratio of AUCs for M6G: morphine in plasma after intravenous morphine was 2 : 1 compared with 11 : 1 after oral and buccal morphine. PMID- 2719904 TI - Self-report reliability and symptomatology of habitual caffeine consumption. AB - 1. A large body of research on the demography of caffeine use and its potential health consequences has been undermined by the absence of empirical data on the reliability of retrospective self-reports of caffeine consumption. 2. The principal aim of the present study was to use standard bioanalytic method to assess the reliability of subjects' self-reported caffeine use. Saliva samples were obtained from 142 first-and second-year medical students and assayed for caffeine and paraxanthine. 3. Self-reported caffeine use was found to be significantly correlated with salivary caffeine (r = 0.31, P less than 0.001) and paraxanthine (r = 0.42, P less than 0.001), thereby providing qualified support for use of questionnaires to estimate patterns of caffeine consumption. 4. A secondary aim of the study was to extend previous research concerning the symptomatology of caffeine use by examining the association between caffeine exposure and a variety of measures of somatic and psychological health. Caffeine consumption was reliably associated with the self-reported occurrence of somatic symptoms, but not psychological well-being. PMID- 2719905 TI - Long lasting respiratory depression induced by morphine-6-glucuronide? AB - We report a case of long lasting respiratory depression after intravenous administration of morphine to a 7 year old girl with haemolytic uraemic syndrome. The plasma concentrations of the active metabolite M6G were more than 10 times those normally seen and the half-lives of M6G and morphine were prolonged. PMID- 2719906 TI - Stereoselective binding of propranolol in the elderly. AB - The influence of age on the stereoselective serum protein binding of propranolol was investigated. Serum was obtained from 10 young (mean age 23 +/- 2 years) and ten elderly (mean age 68 +/- 2 years) healthy male volunteers. The free fraction of propranolol (fu) was measured by equilibrium dialysis, using tritium labeled (+/-)- and (-)-propranolol. The fu values were 0.159 +/- 0.049 and 0.148 +/- 0.028 (+/-), 0.135 +/- 0.041 and 0.136 +/- 0.04 (-), 0.174 +/- 0.056 and 0.161 +/ 0.028 (+) in the young and elderly subjects, respectively. Serum alpha 1-acid glycoprotein (AAG) concentrations were 81.4 +/- 33.0 and 81.0 +/- 21.6 mg 100 ml 1 in young and elderly respectively (P greater than 0.05). Variability in AAG concentration accounted for most of the observed intersubject variability in the binding of both propranolol isomers. The stereoselective binding of propranolol does not appear to be affected by age. PMID- 2719907 TI - The phosphorylation state of the reticulocyte 90-kDa heat shock protein affects its ability to increase phosphorylation of peptide initiation factor 2 alpha subunit by the heme-sensitive kinase. AB - The rabbit reticulocyte Mr 90,000 protein associated with the heme-sensitive eIF 2 alpha kinase has been identified previously as the mammalian heat shock protein of this size class (hsp 90). Purified reticulocyte hsp 90 when added exogenously to the kinase increases its activity. This stimulatory effect is abolished after incubation of hsp 90 with a highly purified type 1 phosphoprotein phosphatase isolated from reticulocytes. Phosphorylation of dephosphorylated hsp 90 by casein kinase II but not by cAMP-dependent protein kinase restores the biological activity of hsp 90 to stimulate eIF-2 alpha phosphorylation. PMID- 2719908 TI - Chemical probes of the conformation of DNA modified by cis diamminedichloroplatinum(II). AB - The purpose of this work was to analyze at the nucleotide level the distortions induced by the binding of cis-diamminedichloroplatinum(II) (cis-DDP) to DNA by means of chemical probes. In order to test the chemical probes, experiments were first carried out on two platinated oligonucleotides. It has been verified by circular dichroism and gel electrophoresis that the binding of cis-DDP to an AG or to a GTG site within a double-stranded oligonucleotide distorts the double helix. The anomalously slow electrophoretic mobility of the multimers of the platinated and ligated oligomers strongly suggests that the platinated oligonucleotides are bent. The reactivity of the oligonucleotide platinated at the GTG site with chloroacetaldehyde, diethyl pyrocarbonate, and osmium tetraoxide, respectively, suggests a local denaturation of the double helix. The 5'G residue and the T residue within the adduct are no longer paired, while the 3'G residue is paired. The double helix is more distorted (but not denatured) at the 5' side of the adduct than at the 3' side. In the case of the oligonucleotide platinated at the AG site, the double helix is also more distorted at the 5' side of the adduct than at the 3' side. The G residue within the adduct is paired. The reactivities of the chemical probes with six platinated DNA restriction fragments show that even at a relatively high level of platination only a few base pairs are unpaired but the double helix is largely distorted. No local denaturation has been detected at the GG sites separated from the nearest GG or AG sites by at least three bases pairs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719909 TI - Conformational studies of d-(AAAAATTTTT)2 using constraints from nuclear overhauser effects and from quantitative analysis of the cross-peak fine structures in two-dimensional 1H nuclear magnetic resonance spectra. AB - The conformation at the dA-dT junction in d-(AAAAATTTTT)2 was investigated by using a variety of phase-sensitive two-dimensional nuclear magnetic resonance experiments at 500 MHz for detailed studies of the deoxyribose ring puckers. Conformational constraints were collected from two-dimensional nuclear Overhauser enhancement spectra recorded with short mixing times and from quantitative simulations of the cross-peaks in two-dimensional correlated spectra. Overall, the decamer duplex adopts a conformation of the B-DNA type, and for dA4 and dA5 the pseudorotation phase angle P is in the standard range 150-180 degrees. The deoxyribose puckers for the other nucleotides deviate significantly from the standard B-DNA structure. Spectrum simulations assuming either static deviations from standard B-DNA or a simple two-state dynamic equilibrium between the C2' endo and C3'-endo forms of the deoxyribose were used to analyze the experimental data. It was thus found that the ring pucker for dT6 deviates from the regular C2'-endo form of B-DNA by a static distortion, with the pseudorotation phase angle P in the range 100-130 degrees, and a similar value of P is indicated for dT7. For the peripheral base pairs dynamic distortions of the C2'-endo form of the deoxyribose were found. In agreement with recent papers on related duplexes containing (dA)n tracts, we observed prominent nuclear Overhauser effects between adenine-2H and deoxyribose-1'H, which could be largely due to pronounced propeller twisting as observed in the crystal structures of (dA)n-containing compounds. PMID- 2719910 TI - Solid-phase synthesis and side reactions of oligonucleotides containing O alkylthymine residues. AB - As part of our studies on the molecular mechanism of mutation [Chambers, R. W. (1982) in Molecular and Cellular Mechanisms of Mutagenesis (Lemontt, J. F., & Generoso, W. M., Eds.) pp 121-145, Plenum, New York and London], we wanted to prepare specific oligonucleotides carrying O2- or O4-alkylthymidine residues. Since O-alkylthymine moieties are known to be alkali labile, side reactions were expected during the deprotection procedures used for synthesis of oligonucleotides on a solid support by the classical phosphoramidite method. We have studied these side reactions in detail. Kinetic data show the deprotection procedures displace most O-alkyl groups at rates that make these procedures inappropriate for synthesis of most oligonucleotides carrying O-alkylthymine moieties. We describe alternative deprotection procedures, using readily accessible reagents, that we have used successfully to synthesize a series of oligonucleotides carrying several different O-alkylthymine moieties. The oligonucleotides synthesized are d(A-A-A-A-G-T-alkT-T-A-A-A-A-C-A-T), where alk = O2-methyl, O2-isopropyl, O4-methyl, O4-isopropyl, and O4-n-butyl. This work extends the previously described procedure for the chemical synthesis of oligonucleotides carrying an O4-methylthymine moiety [Li, B. F., Reese, C. B., & Swann, P. F. (1987) Biochemistry 26, 1086-1093] and reports the first chemical synthesis of an oligonucleotide carrying an O2-alkylthymine. The oligonucleotides synthesized have a sequence corresponding to the minus strand that is complementary to the viral strand at the start of gene G in bacteriophage phi X174 replicative form DNA where the normal third codon has been replaced with the ocher codon, TAA. PMID- 2719911 TI - Comparison of polymerase insertion and extension kinetics of a series of O2 alkyldeoxythymidine triphosphates and O4-methyldeoxythymidine triphosphate. AB - The effect of alkyl group size on ability to act as deoxythymidine triphosphate (dTTP) has been studied for the carcinogen products O2-methyl-, O2-ethyl-, and O2 isopropyl-dTTP by using three types of nucleic acids as template and DNA polymerase I (Pol I) or Klenow fragment as the polymerizing enzymes. Apparent Km and relative Vmax values were determined in primer extension on M13 DNA at a single defined site, in poly[d(A-T)], and in nicked DNA. These data are the basis for calculation of the relative rate of insertion opposite A, relative to dTTP. The insertion rate for any O2-alkyl-dTTP is much higher than for a mismatch between unmodified dNTPs. Unexpectedly, O2-isopropyl-dTTP is more efficiently utilized than O2-methyl-dTTP or O2-ethyl-dTTP on each of the templates. O2 isopropyl-dTTP also substitutes for dTTP over extended times of DNA synthesis at a rate only slightly lower than that of dTTP. Parallel experiments using O4 methyl-dTTP under the same conditions show that it is incorporated opposite A more frequently than is O2-methyl-dTTP. Therefore, both the ring position and the size of the alkyl group influence polymerase recognition. Once formed, all O2 alkyl-T.A termini permit elongation, as does O4-methyl-T.A. In contrast to the relative difficulty of incorporating the O-alkyl-dTTPs, formation of the following normal base pair (C.G) occurs rapidly when dGTP is present. This indicates that a single O-alkyl-T.A pair does not confer significant structural distortion recognized by Pol I. PMID- 2719912 TI - Thiorphan and retro-thiorphan display equivalent interactions when bound to crystalline thermolysin. AB - The three-dimensional structures of (S)-thiorphan and (R)-retro-thiorphan bound to thermolysin have been determined crystallographically and refined to residuals of 0.183 and 0.187 at 1.7-A resolution. Thiorphan [N-[(S)-2-(mercaptomethyl)-1 oxo-3-phenylpropyl]glycine] [HSCH2CH(CH2C6H5)CONHC-H2COOH] and retro-thiorphan [[[(R)-1-(mercaptomethyl)-2-phenylethyl] amino]-3-oxopropanoic acid] [HSCH2CH(CH2C6H5)NHCOCH2COOH] are isomeric thiol-containing inhibitors of endopeptidase EC 24-11 (also called "enkephalinase"). The mode of binding of thiorphan to thermolysin is similar to that of (2-benzyl-3-mercaptopropanoyl)-L alanylglycinamide [Monzingo, A.F., & Matthews, B.W. (1982) Biochemistry 21, 3390 3394] with the inhibitor sulfur atom coordinated to the active site zinc and the peptide portion forming substrate-like interactions with the enzyme. The isomeric inhibitor retro-thiorphan, which differs from thiorphan by the inversion of an amide bond, utilizes very similar interactions with enzyme. Despite the inversion of the -CO-NH- linkage the carbonyl oxygen and amide nitrogen display very similar hydrogen bonding, as anticipated by B.P. Roques et al. [(1983) Proc. Natl. Acad. Sci. U.S.A. 80, 3178-3182]. These results explain why thermolysin and possibly other zinc endopeptidases such as endopeptidase EC 24-11 fail to discriminate between these retro-inverso inhibitors. PMID- 2719913 TI - Complete assignment of the hydrogen out-of-plane wagging vibrations of bathorhodopsin: chromophore structure and energy storage in the primary photoproduct of vision. AB - Resonance Raman vibrational spectra of the retinal chromophore in bathorhodopsin have been obtained after regenerating bovine visual pigments with an extensive series of 13C- and deuterium-labeled retinals. A low-temperature spinning cell technique was used to produce high-quality bathorhodopsin spectra exhibiting resolved hydrogen out-of-plane wagging vibrations at 838, 850, 858, 875, and 921 cm-1. The isotopic shifts and a normal coordinate analysis permit the assignment of these lines to the HC7 = C8H Bg, C14H, C12H, C10H, and C11H hydrogen out-of plane wagging modes, respectively. The coupling constant between the C11H and C12H wags as well as the C12H wag force constant are unusually low compared to those of retinal model compounds. This quantitatively confirms the lack of coupling between the C11H and C12H wags and the low C12H wag vibrational frequency noted earlier by Eyring et al. [(1982) Biochemistry 21, 384]. The force constants for the C10H and C14H wags are also significantly below the values observed in model compounds. We suggest that the perturbed hydrogen out-of-plane wagging and C-C stretching force constants for the C10-C11 = C12-C13 region of the chromophore in bathorhodopsin result from electrostatic interactions with a charged protein residue. This interaction may also contribute to the 33 kcal/mol energy storage in bathorhodopsin. PMID- 2719914 TI - Multiple conformational states in myoglobin revealed by frequency domain fluorometry. AB - The tryptophanyl fluorescence decays of two myoglobins, i.e., sperm whale and tuna myoglobin, have been examined in the frequency domain with an apparatus which utilizes the harmonic content of a mode-locked laser. Data analysis was performed in terms of continuous distribution of lifetime having a Lorentzian shape. Data relative to sperm whale myoglobin, which possesses two tryptophanyl residues, i.e., Trp-A-5 and -A-12, provided a broad lifetime distribution including decay rates from a few picoseconds to about 10 ns. By contrast, the tryptophanyl lifetime distribution of tuna myoglobin, which contains only Trp-A 12, showed two well-separated and narrow Lorentzian components having centers at about 50 ps and 3.37 ns, respectively. In both cases, the chi 2 obtained from distribution analysis was lower than that provided by a fit using the sum of exponential components. The long-lived components present in the fluorescence decay of the two myoglobins do not correspond to any of those observed for the apoproteins at neutral pH. The tryptophanyl lifetime distribution of sperm whale apomyoglobin consists of two separated Lorentzian components centered at 2.25 and 5.4 ns, whereas that of tuna apomyoglobin consists of a single Lorentzian component, whose center is at 2.19 ns. Acidification of apomyoglobin to pH 3.5 produced a shift of the distribution centers toward longer lifetimes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719915 TI - Determination of the chirality of the saturated pyrrole in sulfmyoglobin using the nuclear Overhauser effect. AB - The interproton nuclear Overhauser effect (NOE) and paramagnetic dipolar relaxation rates for hyperfine-shifted resonances in the proton NMR spectra of sperm whale met-cyano sulfmyoglobin have led to the location and assignment of the proton signals of the heme pocket residue isoleucine 99 (FG5) in two sulfmyoglobin isomers. Dipolar relaxation rates of these protein signals indicate a highly conserved geometry of the heme pocket upon sulfmyoglobin formation, while the similar upfield direction of dipolar shifts for this residue to that observed in native sperm whale myoglobin reflects largely retained magnetic properties. Dipolar connectivity of this protein residue to the substituents of the reacted heme pyrrole ring B defines the stereochemistry of the puckered thiolene ring found in one isomer, with the 3-CH3 tilted out of the heme plane proximally. The chirality of the saturated carbons of pyrrole ring B in both the initial sulfmyoglobin product and the terminal alkaline product is consistent with a mechanism of formation in which an atom of sulfur is incorporated distally to form an episulfide across ring B, followed by reaction of the vinyl group to yield the thiolene ring that retains the C3 chirality. PMID- 2719916 TI - Classical Raman spectroscopic studies of NADH and NAD+ bound to lactate dehydrogenase by difference techniques. AB - The binding of the coenzymes NAD+ and NADH to lactate dehydrogenase causes significant changes in the Raman spectra of both of these molecules relative to spectra obtained in the absence of enzyme. The molecular motions of the bound adenine moiety of both NAD+ and NADH as well as adenine containing analogues of these coenzymes produce Raman bands that are essentially identical, suggesting that the binding of adenine to the enzyme is the same regardless of the nicotinamide head-group nature. We also have observed that the molecular motions of the bound adenine moiety are different from both those obtained when it is in either water, various hydrophobic solvents, or various other solvent compositions. Protonation of the bound adenine ring at the 3-position is offered as a possible explanation. Significant shifts are observed in both the stretching frequency of the carboxamide carbonyl of NAD+ and the rocking motion of the carboxamide NH2 group of NADH. These shifts are probably caused by hydrogen bonding with the enzyme. The interaction energies of these hydrogen-bonding patterns are discussed. The aromatic nature of the nicotinamide moiety of NAD+ appears to be unchanged upon binding. Pronounced changes in the Raman spectrum of the nicotinamide moiety of NADH are observed upon binding; some of these changes are understood and discussed. Finally, these results are compared to analogous results that were recently reported for liver alcohol dehydrogenase [Chen et al. (1987) Biochemistry 26, 4776-4784]. In general, the coenzyme binding properties are found to be quite similar, but not identical, for the two enzymes. PMID- 2719917 TI - Proton nuclear magnetic resonance studies on the variant-3 neurotoxin from Centruroides sculpturatus Ewing: sequential assignment of resonances. AB - We report the sequential assignment of resonances to specific residues in the proton nuclear magnetic resonance spectrum of the variant-3 neurotoxin from the scorpion Centruroides sculpturatus Ewing (range southwestern U.S.A.). A combination of two-dimensional NMR experiments such as 2D-COSY, 2D-NOESY, and single- and double-RELAY coherence transfer spectroscopy has been employed on samples of the protein dissolved in D2O and in H2O for assignment purposes. These studies provide a basis for the determination of the solution-phase conformation of this protein and for undertaking detailed structure-function studies of these neurotoxins that modulate the flow of sodium current by binding to the sodium channels of excitable membranes. PMID- 2719918 TI - Proton nuclear magnetic resonance characterization of the aromatic residues in the variant-3 neurotoxin from Centruroides sculpturatus Ewing. AB - The amino acid sequence for the variant-3 (CsE-v3) toxin from the venom of the scorpion Centruroides sculpturatus Ewing contains eight aromatic residues. By use of 2D NMR spectroscopic methods, the resonances from the individual protons (NH, C alpha H, C beta H',H", and the ring) for each of the individual aromatic residues have been completely assigned. The spatial arrangement of the aromatic ring systems with respect to each other has been qualitatively analyzed by 2D NOESY techniques. The results show that Trp-47, Tyr-4, and Tyr-42 are in close spatial proximity to each other. The NOESY contacts and the ring current induced shifts in the resonances of the individual protons of Tyr-4 and Trp-47 suggest that the aromatic ring planes of these residues are in an orthogonal arrangement. In addition, the spatial proximity of the rings in the pairs Tyr-4, Tyr-58; Tyr 42, Tyr-40; and Tyr-40, Tyr-38 has also been established. A comparison with the published crystal structure suggests that there is a minor rearrangement of the aromatic rings in the solution phase. No 2D-NOESY contacts involving Phe-44 and Tyr-14 to any other aromatic ring protons have been observed. The pH dependence of the aromatic ring proton chemical shifts has also been studied. These results suggest that the Tyr-58 phenolic group is experiencing a hydrogen-bonding interaction with a positively charged group, while Tyr-4, -14, -38, and -40 are experiencing through-space interactions with proximal negatively charged groups. The Trp-47 indole NH is interacting with the carboxylate groups of two proximal acidic residues. These studies define the microenvironment of the aromatic residues in the variant-3 neurotoxin in aqueous solution. PMID- 2719919 TI - Photochemical labeling of bovine pancreatic ribonuclease A with 8-azidoadenosine 3',5'-bisphosphate. AB - A simple method has been developed for the preparation of 5'-32P-labeled 8 azidoadenosine 3',5'-bisphosphate (p8N3Ap) for use in photoaffinity labeling studies. Irradiation of a complex between p8N3Ap and bovine pancreatic ribonuclease A (RNase A) with light of 300-350 nm led to the covalent attachment of the nucleotide to the enzyme. RNase A could also be labeled in the dark with prephotolyzed p8N3Ap. In either case, the nucleotide reacted with the same tryptic peptide, encompassing amino acids 67-85 of the protein. The site of labeling was determined to be either Thr-78 or Thr-82, both of which are close to or at the pyrimidine binding site of the enzyme. This result is consistent with recent nuclear magnetic resonance and X-ray studies which indicate that 8 substituted adenine nucleotides interact with the pyrimidine binding site of RNase A. PMID- 2719920 TI - Kinetics of binding of chicken cystatin to papain. AB - The kinetics of binding of chicken cystatin to papain were studied by stopped flow fluorometry under pseudo-first-order conditions, i.e., with an excess of inhibitor. All reactions showed first-order behavior, and the observed pseudo first-order rate constant increased linearly with the cystatin concentration up to the highest concentration that could be studied, 35 microM. The analyses thus provided no evidence for a limiting rate resulting from a conformational change stabilizing an initial encounter complex, in contrast with previous studies of reactions between serine proteinases and their protein inhibitors. The second order association rate constant for complex formation was 9.9 X 10(6) M-1 s-1 at 25 degrees C, pH 7.4, I = 0.15, for both forms of cystatin, 1 and 2. This value approaches that expected for a diffusion-controlled rate. The temperature dependence of the association rate constant gave an enthalpy of activation at 25 degrees C of 31.5 kJ mol-1 and an entropy of activation at 25 degrees C of -7 J K 1 mol-1, compatible with no appreciable conformational change during the reaction. The association rate constant was independent of pH between pH 6 and 8 but decreased at lower and higher pH in a manner consistent with involvement of an unprotonated acid group with a pKa of 4-4.5 and a protonated basic group with a pKa of 9-9.5 in the interaction. The association rate constant was unaffected by ionic strengths between 0.15 and 1.0 but decreased somewhat at lower ionic strengths. Incubation of the complex between cystatin 2 and papain with an excess of cystatin 1 resulted in slow displacement of cystatin 2 from the complex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719921 TI - Fluorinated and deoxygenated substrates as probes of transition-state structure in glycogen phosphorylase. AB - A series of deoxyfluoro- and deoxy-alpha-D-glucopyranosyl phosphates have been tested as substrates of rabbit muscle glycogen phosphorylase b. All are found to be utilized by the enzyme, but at substantially reduced rates. Values of Vm/Km for these analogues range from 10(2) to 10(5) times lower than that for the parent substrate. The large rate reductions are suggested to arise from a combination of intrinsic electronic effects and poorer binding of these substrates at the transition state. The data provide substantial evidence for an oxocarbonium-ion-like transition state. They also provide estimates of the strengths of hydrogen bonds to individual sugar hydroxyls at the transition state of the reaction. Further, comparison of such data with those obtained for glucose analogues binding as inhibitors to T-state phosphorylase suggests that these two glucose subsites are essentially identical; thus, the glucose pocket remains intact during the conformational transition associated with activation of the enzyme. PMID- 2719922 TI - Sulfuryl transfer catalyzed by pyruvate kinase. AB - Sulfoenolpyruvate, the analogue of phosphoenolpyruvate in which the phosphate ester has been replaced by a sulfate ester, has been synthesized in three chemical steps from ethyl bromopyruvate in 40% overall yield. This compound is a substrate for pyruvate kinase, producing pyruvate and adenosine 5' sulfatopyrophosphate. The latter compound has been identified by NMR spectroscopy and by comparison with an authentic sample. Sulfuryl transfer from sulfoenolpyruvate is 250-600-fold slower than phosphate transfer from phosphoenolpyruvate under identical conditions. Sulfoenolpyruvate is not a substrate for phosphoenolpyruvate carboxylase. Kinetic studies reveal that it does not bind to the active site; instead, it binds to the site normally occupied by glucose 6-phosphate and activates the enzyme in a manner similar to that shown by glucose 6-phosphate. PMID- 2719923 TI - Characterization of fucosyltransferase activity during mouse spermatogenesis: evidence for a cell surface fucosyltransferase. AB - Fucosyltransferase activity was quantified in mouse germ cells at different stages of spermatogenesis. Specifically, fucosyltransferase activities of pachytene spermatocytes, round spermatids, and cauda epididymal sperm were compared. Fucosyltransferase activity of mixed germ cells displayed an apparent Vmax of 17 pmol (mg of protein)-1 min-1 and an apparent Km of approximately 13 microM for GDP-L-[14C]fucose in the presence of saturating amounts of asialofetuin at 33 degrees C. Under these conditions, cellular fucosyltransferase activity was found to increase during spermatogenesis. In agreement with assays of intact cells, examination of subcellular fractions indicated that a large fraction of fucosyltransferase activity was associated with the cell surface. The fraction of fucosyltransferase activity that was associated with the cell surface progressively increased throughout spermatogenesis and epididymal maturation so that nearly all of the fucosyltransferase in epididymal sperm was on the cell surface. Specifically, by comparison of activities in the presence and absence of the detergent NP-40, the fraction of fucosyltransferase activity that was associated with the cell surface in pachytene spermatocytes, round spermatids, and epididymal sperm was 0.36, 0.5, and 0.85, respectively. These results suggest that a cell surface fucosyltransferase may be important during differentiation of spermatogenic cells in the testis as well as during epididymal maturation and fertilization. PMID- 2719924 TI - Citrate synthase stabilizes the enethiolate of acetyldithio coenzyme A. AB - Citrate synthase catalyzes the slow condensation of acetyldithio-CoA [Ac(= S)CoA] with oxalacetate to form thiocitrate [Wlassics, I.D., Stille, C., & Anderson, V.E. (1988) Biochim. Biophys. Acta 952, 269]. During the transient approach to steady state an observable amount of the dithioester absorbance disappears. The amplitude of the decrease in absorbance corresponds to 0.32, 0.03, and 0.02 enzyme equiv at pH 8.3, 7.5, and 6.6, respectively. The difference spectra from before and after the transient exhibit the dithioester lambda max at 306 nm. Acid quenching of a stiochiometric reaction between Ac(= S)CoA and citrate synthase following the transient quantitatively regenerates Ac(= S)CoA, indicating carbon carbon bond formation had not yet occurred. The apparent first-order rate constant of the transient is independent of Ac(= S)CoA concentration and increases with decreasing pH, being 0.007, 0.016, and 0.04 s-1 at pH 8.3, 7.5, and 6.6, respectively. 2-Fluoroacetyldithio-CoA is a better inhibitor of citrate synthase, Ki = 300 nM, and substrate, Vmax = 2 X 10(-3) s-1, than Ac(= S)CoA. 1H NMR experiments indicate that citrate synthase catalyzes the exchange of the alpha-hydrogens of Ac(= S)CoA with turnover numbers of 0.13 and 0.54 s-1 at pD 7.9 and 7.2, respectively. Analysis of the proton and deuterium decoupled 13C NMR spectra of [2-13C]Ac(= S)CoA that has exchanged 37% of the alpha-hydrogens in the presence of citrate synthase indicates that the relative proportions of CH3, CH2D, CHD2, and CD3 were 0.29, 0.39, 0.25, and 0.07, respectively. This statistical distribution indicates each exchange event is independent. The data indicate that citrate synthase stabilizes the ionized form of Ac(= S)CoA by 5 kcal/mol relative to the un-ionized form, that the ionized dithioester is on the reaction pathway, and that below pH 8.3 the slow carbon-carbon bond forming reaction is responsible for the 10(6) decrease in Vmax caused by substituting sulfur for oxygen in the thioester carbonyl. PMID- 2719925 TI - Low-temperature photoreactions of halorhodopsin. 1. Detection of conformational substates of the chromoprotein. AB - Absorption spectra of halorhodopsin (HR), a retinal protein in the halobacterial membrane, and its photostationary states were determined at 80 K. The absorption lines appear to narrow upon cooling, thereby revealing complex spectral fine structure of the main absorption band in the visible region, characteristic of conformational substates of HR. Illumination causes (1) the redistribution of these substrates and consequent changing of the fine structure ("hole-burning") and (2) the appearance of a hypsoproduct of undefined nature, in addition to the previously described bathoproduct HR600. Bacteriorhodopsin, a related retinal pigment, gives rise only to the bathointermediate (i.e., K590) under these conditions. After warming of illuminated HR to 110 K, and recooling to 80 K, relaxation of the illumination-induced change in spectral fine structure, and decay of the hypsoproduct but not the bathoproduct, was observed. The results are explained with a model in which one ensemble of HR conformational substates at 80 K is converted to another in a photoequilibrium via the excited state, which also produces the batho- and hypsoproducts. The original ensemble can be regained through thermal pathways at a somewhat higher temperature, and only the bathoproduct will decay thermally into the next intermediate of the HR photocycle. PMID- 2719926 TI - Low-temperature photoreactions of halorhodopsin. 2. Description of the photocycle and its intermediates. AB - Photostationary states of halorhodopsin (HR, a retinal protein in the halobacterial membrane) and their further thermal conversions were investigated at 140-230 K by absorption spectroscopy in the visible. The difference spectra confirm several steps of the all-trans-HR photocycle, in the presence of chloride, proposed earlier on the basis of room temperature flash spectroscopy. Thus, at 140 K, the spectra reveal the HR600----HR520 reaction, and at 170-230 K the HR640----HR578 and the HR520----HR578 reactions can be seen. No evidence for the expected HR520 in equilibrium HR640 process was found, however. From the difference spectra at various temperatures, exact absorption spectra of HR600 and HR520 were calculated, and an estimate of the HR640 spectrum in a mixture also containing HR520 was obtained. The low-temperature absorption maxima of HR578 and its photointermediates relate to the room temperature maxima differently from what is expected from the spectra of the corresponding intermediates in the bacteriorhodopsin photocycle. PMID- 2719927 TI - Procaine rapidly inactivates acetylcholine receptors from Torpedo and competes with agonist for inhibition sites. AB - The relationship between the high-affinity procaine channel inhibition site (apparent dissociation constant Kp congruent to 200 microM) and the agonist self inhibition site on acetylcholine receptors (AChRs) from Torpedo electroplaque was investigated by using rapid 86Rb+ quenched-flux assays at 4 degrees C in native AChR-rich vesicles on which 50-60% of ACh activation sites were blocked with alpha-bungarotoxin (alpha-BTX). In the presence of channel-activating acetylcholine (ACh) concentrations (10 microM-10 mM) alone, AChR undergoes one phase of inactivation (fast desensitization, rate = kd) in under a second. Addition of procaine produces two-phase inactivation similar to that seen with self-inhibiting (greater than 10 mM) ACh concentrations [Forman & Miller (1988) Biophys. J. 54, 149-158]--rapid inactivation (rate = kr) complete in 30-75 ms is followed by fast desensitization at the same kd observed without procaine. The dependence of kr on [procaine] is consistent with a bimolecular association between procaine and its AChR site with kon = 2.5 X 10(5) M-1 s-1, koff = 36 s-1, and Kp = 145 +/- 36 microM). Inhibition of AChR function by mixtures of procaine (up to 12Kp) plus self-inhibiting concentrations of ACh or suberyldicholine ([SubCh] up to 13 X the 50% self-inhibiting agonist concentration, KB) was studied by reducing the level of alpha-BTX block in vesicles. The apparent KB increased in the presence of procaine, and the apparent KP increased linearly with [SubCh], indicating mutually exclusive actions at a common AChR site. Our data support a mechanism where procaine binds preferentially to the open-channel AChR state, since no procaine-induced inactivation is observed without agonist and kr's dependence on [ACh] in the channel-activating range closely parallels that of 86Rb+ flux response to ACh. PMID- 2719928 TI - Reserpine binding to chromaffin granules suggests the existence of two conformations of the monoamine transporter. AB - The binding of [3H]reserpine ([3H]RES) to purified bovine chromaffin granule membranes has been studied at low membrane concentration. Saturation isotherms indicated a dissociation equilibrium constant KD of 30 pM and a density of binding sites of 8 pmol/mg of protein at 30 degrees C. The association rate constant was 4.0 X 10(5) M-1 s-1, and the calculated dissociation rate constant was 1.2 X 10(-5) s-1, corresponding to a half-lifetime of about 16 h. Although this dissociation was too low to be measured directly, [3H]RES binding was indeed reversible since it was lost after addition of the detergent Triton X-100. Dihydrotetrabenazine (TBZOH) inhibited [3H]RES binding in a time-dependent manner, EC50 varying from 37 nM after a 1-h incubation to 600 nM after 16 h. On the contrary, [3H]RES binding inhibition by the substrate noradrenaline was time independent. It is proposed that the transporter exists in two different conformations which bind exclusively either tetrabenazine (TBZ) or RES and which are in equilibrium. The effects of detergents were consistent with this two conformation model. The transporter solubilized by cholate bound [3H]TBZOH, but not [3H]RES. On the other hand, addition of cholate to membrane-bound [3H]RES solubilized the membrane without releasing the ligand from its binding site. It is proposed that the TBZ-binding conformation is obtained by solubilization with cholate and that RES stabilizes the RES-binding conformation, allowing its solubilization by this detergent. PMID- 2719929 TI - Membrane fusion activity of influenza virus. Effects of gangliosides and negatively charged phospholipids in target liposomes. AB - Fusion of influenza virus with liposomes composed of negatively charged phospholipids differs from fusion with biological membranes or zwitterionic liposomes with ganglioside receptors [Stegmann, T., Hoekstra, D., Scherphof, G., & Wilschut, J. (1986) J. Biol. Chem. 261, 10966-10969]. In this study, we investigated how the kinetics and extent of fusion of influenza virus, monitored with a fluorescence resonance energy-transfer assay, are influenced by the surface charge and the presence of receptors on liposomal membranes. The results were analyzed in terms of mass action kinetic model, providing separate rate constants for the initial virus-liposome adhesion, or aggregation, and for the actual fusion reaction. Incorporation of increasing amounts of cardiolipin (CL) or phosphatidylserine (PS) into otherwise zwitterionic phosphatidylcholine (PC)/phosphatidylethanolamine (PE) vesicles results in a gradual shift of the pH threshold of fusion to neutral, relative to the pH threshold obtained with PC/PE vesicles containing the ganglioside GD1a, while also the rate of fusion increases. This indicates the emergence of a fusion mechanism not involving the well-documented conformational change in the viral hemagglutinin (HA). However, only with pure CL liposomes this nonphysiological fusion reaction dominates the overall fusion process; with pure PS or with zwitterionic vesicles containing CL or PS, the contribution of the nonphysiological fusion reaction is small. Accordingly, preincubation of the virus alone at low pH results in a rapid inactivation of the viral fusion capacity toward all liposome compositions studied, except pure CL liposomes. The results of the kinetic analyses show that with pure CL liposomes the rates of both virus-liposome adhesion and fusion are considerably higher than with all other liposome compositions studied.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719930 TI - Selective labeling of the erythrocyte hexose carrier with a maleimide derivative of glucosamine: relationship of an exofacial sulfhydryl to carrier conformation and structure. AB - Sulfhydryl-reactive derivatives of glucosamine were synthesized as potentially transportable affinity labels of the human erythrocyte hexose carrier. N Maleoylglycyl derivatives of either 6- or 2-amino-2-deoxy-D-glucopyranose were the most potent inhibitors of 3-O-methylglucose uptake, with concentrations of half-maximal irreversible inhibition of about 1 mM. Surprisingly, these derivatives were very poorly transported into erythrocytes. They reacted rather with an exofacial sulfhydryl on the carrier following a reversible binding step, the latter possibly to the exofacial substrate binding site. However, their reactivity was determined primarily by access to the exofacial sulfhydryl, which, as predicted by the one-site model of transport, required a carrier conformation with the exofacial substrate binding site exposed. Once reacted, the carrier was "locked" in a conformation unable to reorient inwardly and bind cytochalasin B. In intact erythrocytes the N-maleoylglycyl derivative of 2-[3H]glucosamine labeled predominantly an Mr 45,000-66,000 protein on gel electrophoresis in a quantitative and cytochalasin B inhibitable fashion. By use of changes in carrier conformation induced by competitive transport inhibitors in a "double" differential labeling method, virtually complete selectivity of labeling of the carrier protein was achieved, the latter permitting localization of the reactive exofacial sulfhydryl to an Mr 18,000-20,000 tryptic fragment of the carrier. PMID- 2719931 TI - Complete sequence of the human tissue factor gene, a highly regulated cellular receptor that initiates the coagulation protease cascade. AB - Tissue factor (TF) is the high-affinity receptor for plasma factors VII and VIIa. TF plays a role in normal hemostasis by initiating the cell-surface assembly and propagation of the coagulation protease cascade. Outside the vasculature, TF expression is highly dependent upon cell type. TF can also be induced by inflammatory mediators to appear on monocytes and vascular endothelial cells as a component of cellular immune responses. As an initial step toward elucidating the regulatory regions involved in control of TF gene expression, we have established the organization of the 12.4 kbp human TF gene and its complete DNA sequence. There are six exons separated by five introns. Within intron 5, we have mapped the single nucleotide difference which leads to the previously described MspI polymorphism; the same intron also contains an apparently polymorphic PstI site. The TF gene also contains three full-length Alu repeats and one partial Alu repeat. A single major transcription start site was identified 26 bp downstream from a TATA consensus promoter element. The putative promoter and first exon are located within a 1.2 kbp region of very high G + C content which fits the criteria of an HTF island. A cluster of predicted binding sites for a number of known transcription factors was found to coincide with this putative promoter region. These factors included AP-1 and AP-2 which can mediate the effects of phorbol esters, agonists known to induce TF expression in monocytes and vascular endothelial cells. PMID- 2719932 TI - Calcitroic acid, end product of renal metabolism of 1,25-dihydroxyvitamin D3 through C-24 oxidation pathway. AB - About a decade ago calcitroic acid was isolated as a major side chain cleaved water-soluble metabolite of 1,25-dihydroxyvitamin D3 [Esvelt, R. P., Schnoes, H. K., & Decula, H. F. (1979) Biochemistry 18, 3977]. Presently, calcitroic acid is being considered as the major excretory form of 1,25-dihydroxyvitamin D3. However, the exact site or sites of calcitroic acid production and the possible side chain modified intermediary metabolites that may be formed during the conversion of 1,25-dihydroxyvitamin D3 into calcitroic acid are not fully understood. In the mean time there have been many advances in our understanding of the side-chain metabolism of 1,25-dihydroxyvitamin D3. It is now well established that both the kidney and the intestine metabolize 1,25 dihydroxyvitamin D3 through the C-24 oxidation pathway according to the following steps: 1,25-dihydroxyvitamin D3----1,24,25-trihydroxyvitamin D3----1,25-dihydroxy 24-oxovitamin D3-----1,23,25-trihydroxy-24-oxovitamin D3. Recently, we identified 1,23-dihydroxy-24,25,26,27-tetranorvitamin D3 (C-23 alcohol) as a major side chain cleaved lipid-soluble metabolite of 1,25-dihydroxyvitamin D3 and further extended the aforementioned C-24 oxidation pathway in the kidney by demonstrating 1,23,25-trihydroxy-24-oxovitamin D3 as the precursor of C-23 alcohol [Reddy, G. S., Tserng, K. Y., Thomas, B. R., Dayal, R., & Norman, A. W. (1987) Biochemistry 26, 324]. In this present study, we investigated the metabolic fate of 1,25 dihydroxyvitamin D3 (3 X 10(-10) M) in the perfused rat kidney and identified calcitroic acid as the major water-soluble metabolite of 1,25-dihydroxyvitamin D3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719933 TI - Kinetics, binding constant, and activation energy of the 48-kDa protein-rhodopsin complex by extra-metarhodopsin II. AB - We have found that the 48-kDa protein (or S-antigen 48k) of the rod photoreceptor enhances the light-induced formation of the photoproduct metarhodopsin II (MII) from prephosphorylated rhodopsin. The effect is analogous to the known enhancement of MII (extra-MII) that results from selective interaction of MII with G-protein. We have determined some parameters of the MII-48k interaction by measuring the extra-MII absorption change induced by the 48-kDa protein. The amplitude saturation yields a dissociation constant for the MII-48k complex on the order of 50 nM. At the technical limit of these measurements, 13.7 degrees C and 12 microM 48-kDa protein, we find a rate of 2.3 s-1 for formation of the 48k MII complex. Extrapolation of these values to cellular conditions yields an occupation time of phosphorylated MII by 48k less than 200 ms. This is short compared to estimated rates of phosphorylation. The temperature dependence of the MII-48k formation rate is very high (Q10 for 5 degrees C/15 degrees C = 9-10). The related Arrhenius activation energy (165 kJ mol-1) is correspondingly high and indicates a considerable transient chemical change during the binding process. PMID- 2719934 TI - Mechanism of GTP hydrolysis in tubulin polymerization: characterization of the kinetic intermediate microtubule-GDP-Pi using phosphate analogues. AB - Beryllium fluoride (BeF3-) has previously been shown to bind tightly to microtubules as a structural analogue of Pi and to mimic the GDP-Pi transient state in tubulin polymerization [Carlier, M.-F., Didry, D., Melki, R., Chabre, M., & Pantaloni, D. (1988) Biochemistry 27, 3555-3559]. The interaction of BeF3- with tubulin is analyzed here in greater detail. BeF3- binds to and dissociates from microtubule GDP subunits at very slow rates (k+ congruent to 100 M-1 s-1; k- congruent to 6 x 10(-4) s-1), suggesting that a slow conformation change of tubulin, linked to the stabilization of the microtubule structure, follows BeF3- binding. The possibility is evoked that BeF3- acts as a transition-state analogue in the GTPase reaction of tubulin. BeF3- does not bind to dimeric nor to oligomeric GDP-tubulin with high affinity. Substoichiometric binding of BeF3- to microtubules provides extensive stabilization of the structure. An original mechanistic model that accounts for the data is proposed. The kinetic parameters for microtubule elongation in the presence of GTP- and GDP-tubulin with and without BeF3- have been determined. Data support the following views: (i) Microtubules at steady state and in a regime of slow growth in the presence of GTP are stabilized by a cap of GDP-Pi subunits functionally similar to GDP-BeF3 subunits. (ii) In the presence of BeF3-, microtubules elongate from GDP-tubulin within the following sequence of reactions: initial nonproductive binding of GDP tubulin to microtubule ends is followed by the binding of BeF3- and the associated conformation change allowing sustained elongation. PMID- 2719935 TI - Structure of a single amino acid mutant of aspartate carbamoyltransferase at 2.5 A resolution: implications for the cooperative mechanism. AB - One of the many interactions important for stabilizing the T state of aspartate carbamoyltransferase occurs between residues Tyr240 and Asp271 within one catalytic chain. The functional importance of this polar interaction was documented by site-directed mutagenesis in which the tyrosine was replaced by a phenylalanine [Middleton, S. A., & Kantrowitz, E. R. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 5866-5870]. In the Tyr240----Phe mutant, the aspartate concentration required to achieve half-maximum velocity is reduced to 4.7 from 11.9 mM for the native enzyme. Here, we report an X-ray crystallographic study of the Tyr240----Phe enzyme at 2.5-A resolution. While employing crystallization conditions identical with those used to grow cytidine triphosphate ligated T state crystals of the native enzyme, we obtain crystals of the mutant enzyme that are isomorphous to those of the native enzyme. Refinement of the mutant structure to an R factor of 0.219 (only eight solvent molecules included) and subsequent comparison to the native T-state structure indicate that the quaternary, tertiary, and secondary structures of the mutant are similar to those for the native T-state enzyme. However, the conformation of Phe240 in one of the two crystallographically independent catalytic chains contained in the asymmetric unit is significantly different from the conformation of Tyr240 in the native T state enzyme and similar to the conformation of Tyr240 as determined from the R state structure [Ke, H.-M., Lipscomb, W. N., Cho, Y. J., & Honzatko, R. B. (1988) J. Mol. Biol. (in press)], thereby indicating that the mutant has made a conformational change toward the R state, localized at the site of the mutation in one of the catalytic chains. PMID- 2719936 TI - Glycolipid membrane surface structure: orientation, conformation, and motion of a disaccharide headgroup. AB - The orientation of the disaccharide headgroup of a lactose-containing lipid, 3-O (4-O-beta-D-galactopyranosyl-beta-D-glucopyranosyl)-1,2-di-O-tetrade cyl-sn- glycerol (DTLL), relative to the surface of bilayer membranes has been determined via 2H NMR. The lactosyl headgroup is extended away from the membrane surface into the aqueous phase. The headgroup motion has axial symmetry as evidenced by the spectral line shape and order parameter tensor. 2H NMR of oriented multibilayers of DTLL confirms that the director of motional averaging is the bilayer normal. The two sugar residues have segmental order parameters S (glucose, 0.53; galactose, 0.51) which indicate that the headgroup fluctuates about the bilayer normal as a rigid unit. 2H spin-lattice relaxation times T1z for deuterons on each of the two sugar rings are similar, indicating further that there is no substantial motion about the disaccharide linkage within the headgroup. The magnitude of the relaxation times (4 ms) suggests that the rigid body motions of the headgroup are approaching the Larmor frequency; however, they increase with increasing temperature, indicating that the motions are rapid enough to be in the fast motional regime (omega o2 tau c2 less than 1). The conformation about the galactose-glucose intersaccharide linkage, calculated from the 2H NMR data, is shown to differ substantially from those found in X-ray diffraction studies of crystalline lactose and high-resolution NMR studies of methyl lactoside in nonviscous solution. The orientations of the hydroxymethyl groups in the headgroup have been calculated from the 2H NMR data. For the galactosyl residue the data are consistent with the presence of more than one rotamer about the C5"-C6" bond which are in fast exchange on the 2H NMR time scale. The hydroxymethyl group of the glucose residue exists in two rotameric forms about the C5'-C6' bond which have relative populations of ca. 2:1 and which are in slow exchange on the 2H NMR time scale (10(-5) s). The two rotamers differ from those deduced from X-ray crystallography of crystalline lactose and 13C NMR studies of methyl lactoside in solution. PMID- 2719937 TI - Identical linkage and cooperativity of oxygen and carbon monoxide binding to Octopus dofleini hemocyanin. AB - Employment of high-precision thin-layer methods has enabled detailed functional characterization of oxygen and carbon monoxide binding for (1) the fully assembled form with 70 binding sites and (2) the isolated chains with 7 binding sites of Octopus dofleini hemocyanin. The striking difference in the cooperativities of the two ligands for the assembled decamer is revealed through an examination of the binding capacities and the partition coefficient, determined as functions of the activities of both ligands. A global analysis of the data sets supported a two-state allosteric model assuming an allosteric unit of 7. Higher level allosteric interactions were not indicated. This contrasts to results obtained for arthropod hemocyanins. Oxygen and carbon monoxide experiments performed on the isolated subunit chain confirmed the presence of functional heterogeneity reported previously [Miller, K. (1985) Biochemistry 24, 4582-4586]. The analysis shows two types of binding sites in the ratio of 4:3. PMID- 2719938 TI - Interaction of zinc protoporphyrin with intact oxyhemoglobin. AB - In erythropoietic protoporphyria and lead poisoning, free protoporphyrin (PPIX) and zinc protoporphyrin (ZPP), respectively, accumulate in erythrocytes. That PPIX and ZPP bind to human hemoglobin A (Hb4) is established, but the site of binding is still a matter of controversy. We investigated the interaction of ZPP with intact, tetrameric oxy Hb4, using batch microcalorimetry, front-face fluorometry, absorption difference spectroscopy, oxygen equilibrium studies, and isoelectric focusing (IEF). In the presence of oxy Hb4 (pH 7.35, 0.05 M phosphate), the fluorescence emission maximum (excitation at 420 nm) of ZPP immediately shifts from 587 nm (ZPP alone) to 594 nm, as expected when binding to protein. The fluorescence intensity increases with time and is correlated with the ZPP:Hb4 mole ratio. A slow, time-dependent reaction is also observed with microcalorimetry: the rate of heat of reaction exhibits both a fast and a slow component. The heats of reaction range from -2.1 to -14.8 mcal depending upon the ZPP:Hb4 ratio of 4:1 (0.4 mM:0.1 mM) to 38:1 (3.8 mM:0.1 mM), respectively, and are typical of weak, noncovalent protein-ligand interactions. The optical difference spectra are a function of the ZPP:Hb4 molar ratio and also exhibit a slow increase in intensity over time. No time-dependent optical difference spectra are observed with ZPP or with Hb4 alone. The oxygen affinity of Hb4 in the presence of ZPP decreases with increasing mole ratio. During IEF, all ZPP separates from Hb4, consistent with a weak, noncovalent interaction at a non-heme pocket site. We conclude that ZPP binds to intact, tetrameric hemoglobin at non heme pocket sites in a nonspecific, weak, noncovalent interaction. PMID- 2719939 TI - A covalent angiogenin/ribonuclease hybrid with a fourth disulfide bond generated by regional mutagenesis. AB - Human angiogenin is a blood vessel inducing protein whose primary structure displays 33% identity to that of bovine pancreatic ribonuclease A (RNase A). Angiogenin catalyzes limited cleavage of 18S and 28S ribosomal RNA and is several orders of magnitude less potent than RNase A toward conventional substrates. A striking structural difference between angiogenin and RNase is the virtual absence of sequence similarity within the region of RNase that contains the Cys 65--Cys-72 disulfide bond. Indeed, angiogenin lacks this disulfide linkage. The present report describes the use of regional mutagenesis to generate a covalent angiogenin/RNase hybrid protein, ARH-I, where residues 58-70 of angiogenin have been replaced by the corresponding segment of RNase A (residues 59-73). The protein expressed in Escherichia coli readily folds at pH 8.5 to form the four expected disulfide bonds. The in vivo angiogenic potency of ARH-I is markedly diminished compared with that of angiogenin when examined using the chick chorioallantoic membrane assay. In contrast, its enzymatic activity is dramatically increased. With high molecular weight wheat germ RNA and tRNA, ARH-I is 660- and 300-fold more active than angiogenin, respectively, while with poly(uridylic acid), poly(cytidylic acid), cytidylyl(3'----5')adenosine (CpA), and uridylyl(3'----5')adenosine (UpA) activity is enhanced by about 200-fold. In addition, the specificity of ARH-I toward dinucleoside 3',5'-phosphates is qualitatively similar to RNase A; while angiogenin prefers cytidylyl(3'--- 5')guanosine (CpG) to UpA, both RNase and the hybrid prefer UpA to CpG. ARH-I also displays greater than 10-fold enhanced activity toward rRNA in intact ribosomes, while abolishing the capacity of the ribosome to support cell-free protein synthesis. The enhanced enzymatic properties of ARH-I parallel a 2-fold increase in chemical reactivity of active-site lysine and histidine residues based on rates of chemical modification. The data indicate that introduction of a region of RNase A containing the Cys-65--Cys-72 disulfide bond into angiogenin dramatically increases RNase-like enzymatic activity while reducing its angiogenicity. PMID- 2719940 TI - Characterization of human glucocorticoid receptor complexes formed with DNA fragments containing or lacking glucocorticoid response elements. AB - Sucrose density gradient shift assays were used to study the interactions of human glucocorticoid receptors (GR) with small DNA fragments either containing or lacking glucocorticoid response element (GRE) DNA consensus sequences. When crude cytoplasmic extracts containing [3H]triamcinolone acetonide [( 3H]TA) labeled GR were incubated with unlabeled DNA under conditions of DNA excess, a GRE containing DNA fragment obtained from the 5' long terminal repeat of mouse mammary tumor virus (MMTV LTR) formed a stable 12-16S complex with activated, but not nonactivated, [3H]TA receptor. By contrast, if the cytosols were treated with calf thymus DNA-cellulose to deplete non-GR-DNA-binding proteins prior to heat activation, a smaller 7-10S complex was formed with the MMTV LTR DNA fragment. When similar experiments were conducted under conditions of large receptor excess, using 3' [32P]-MMTV LTR DNA, the trace quantity of DNA formed a stable 10 14S complex with DNA-cellulose pretreated cytosols or with untreated cytosols in the presence of excess Escherichia coli competitor DNA. If trace quantities of the 3' [32P]-MMTV LTR DNA were incubated with untreated crude cytosols, much larger complexes were formed, indicating the association of other cytosolic proteins with the MMTV LTR DNA fragment. Activated [3H]TA receptor from DNA cellulose pretreated cytosols also interacted with two similarly sized fragments from pBR322 DNA, but with lower apparent affinities in the order MMTV LTR DNA fragment much greater than pBR322 fragment containing a single GRE DNA consensus sequence greater than non-GRE-containing pBR322 fragment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719941 TI - Interaction of unfused tricyclic aromatic cations with DNA: a new class of intercalators. AB - Unfused tricyclic aromatic ring systems 1-6 with one or two cationic side chains have been synthesized and their interactions with DNA and synthetic polymers probed with a variety of techniques. Molecular mechanics calculations indicate that the torsional angle between ring planes in the minimum energy conformation of the tricyclic molecules can range from 0 degree to as high as 50 degrees depending on the type of rings and substituents. Viscometric titrations with linear and supercoiled DNA, linear dichroism, and NMR studies indicated that all compounds with torsional angles of approximately 20 degrees or less bind to DNA by intercalation. The more highly twisted intercalators caused significant perturbation of DNA structure. Unfused intercalators with twist angles of approximately 20 degrees have reduced binding constants, suggesting that they could not form an optimum interaction with the DNA base pairs. Unfused intercalators with twist less than 20 degrees formed strong complexes with DNA. The structures of these unfused intercalators are more analogous to typical groove-binding molecules, and an analysis of their interaction with DNA provides a better understanding of the subtle differences between intercalation and groove binding modes for aromatic cations. The results indicate that intercalation and groove-binding modes should be viewed as two potential wells on a continuous energy surface. The results also suggest design strategies for intercalators that can optimally complement DNA base pair propeller twist or that can induce bends in DNA at the intercalation site. PMID- 2719942 TI - A premelting conformational transition in poly(dA)-Poly(dT) coupled to daunomycin binding. AB - Circular dichroism and UV absorbance spectroscopy were used to monitor and characterize a premelting conformational transition of poly(dA)-poly(dT) from one helical form to another. The transition was found to be broad, with a midpoint of tm = 29.9 degrees C and delta HVH = +19.9 kcal mol-1. The transition renders poly(dA)-poly(dT) more susceptible to digestion by DNase I and facilitates binding of the intercalator daunomycin. Dimethyl sulfoxide was found to perturb poly(dA)-poly(dT) structure in a manner similar to temperature. These combined results suggest that disruption of bound water might be linked to the observed transition. A thermodynamic analysis of daunomycin binding to poly(dA)-poly(dT) shows that antibiotic binding is coupled to the polynucleotide conformational transition. Daunomycin binding renders poly(dA)-poly(dT) more susceptible to DNase I digestion at low binding ratios, in contrast to the normal behavior of intercalators, indicating that antibiotic binding alters the conformation of the polynucleotide. The unusual thermodynamic profiles previously observed for the binding of many antibiotics to poly(dA)-poly(dT) can be explained by our results as arising from the coupling of ligand binding to the polynucleotide conformational transition. Our data further suggest a physical basis for the temperature dependence of DNA bending. PMID- 2719943 TI - Environmentally induced conformational changes in B-type DNA: comparison of the conformation of the oligonucleotide d(TCGCGAATTCGCG) in solution and in its crystalline complex with the restriction nuclease EcoRI. AB - Raman spectroscopic analysis of the secondary structure of the crystalline restriction endonuclease EcoRI, the oligonucleotide d(TCGCGAATTCGCG) in solution, and the corresponding crystalline EcoRI-oligonucleotide complex reveals structural differences between the complexed and uncomplexed protein and oligonucleotide components that appear to be linked to complex formation. Structural differences that are spectroscopically identified include (1) an increase in the population of furanose rings adopting the C3'-endo conformation and (2) spectroscopically observed changes in base stacking which are probably associated with the crystallographically observed distortion of the phosphate backbone about positions C(3)-G(4) and C(9)-G(10) and unwinding between the symmetry-related segments GAA-TTC which make up the central recognition core (McClarin et al., 1986). Changes in base stacking due to distortions and unwinding along the oligonucleotide result in differences in the base vibrational region between the spectra of the complex and the oligonucleotide in solution. The spectroscopic analysis indicates that the C2'-endo population is similar for the oligonucleotide in solution and in the complex. The additional C3'-endo population in the complex appears to arise from the conversion of rings adopting alternative conformations such as C1'-exo and O1'-endo. Analysis of the vibrational bands derived from guanine indicates that the population of guanine residues associated with furanose rings in a C2'-endo conformation is similar for the oligonucleotide in solution and in the crystalline complex. This implies that the increase in C3'-endo population is not associated with guanine residues. Large conformational distortions such as those observed in the crystal distortions are not observed in either the crystal or the solution of the oligomer d(CGCGAATTCGCG).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719944 TI - Time-resolved fluorescence spectroscopy of human adenosine deaminase: effects of enzyme inhibitors on protein conformation. AB - Adenosine deaminase, a purine salvage enzyme essential for immune competence, was studied by time-resolved fluorescence spectroscopy. The heterogeneous emission from this four-tryptophan protein was separated into three lifetime components: tau 1 = 1 ns and tau 2 = 2.2 ns an emission maximum at about 330 nm and tau 3 = 6.3 ns with emission maximum at about 340 nm. Solvent accessibility of the tryptophan emission was probed with polar and nonpolar fluorescence quenchers. Acrylamide, iodide, and trichloroethanol quenched emission from all three components. Acrylamide quenching caused a blue shift in the decay-associated spectrum of component 3. The ground-state analogue enzyme inhibitor purine riboside quenched emission associated with component 2 whereas the transition state analogue inhibitor deoxycoformycin quenched emission from both components 2 and 3. The quenching due to inhibitor binding had no effect on the lifetimes or emission maxima of the decay-associated spectra. These observations can be explained by a simple model of four tryptophan environments. Quenching studies of the enzyme-inhibitor complexes indicate that adenosine deaminase undergoes different protein conformation changes upon binding of ground- and transition state analogue inhibitors. The results are consistent with localized structural alterations in the enzyme. PMID- 2719945 TI - 31P NMR of covalent phosphorylated derivatives of alpha-chymotrypsin. AB - The structures of various covalent phosphorylated derivatives of alpha chymotrypsin (alpha-CT) have been studied by 31P NMR spectroscopy. Diisopropylphosphoryl-alpha-chymotrypsin (alpha-DIPCT) shows a single 31P signal at ca. 0.0 ppm (pH 4). At low pH, the 31P NMR spectrum of alpha-DIPCT gradually changed with the appearance of one or two additional peaks. The ratio of the peaks varied with pH, time, and concentration. One of these two new downfield peaks (both at ca. 2.0 ppm) has been previously identified by Markley and co workers (Markley, 1979; Porubcan et al., 1979) and van der Drift et al. (1985) as an aged monoisopropylphosphoryl-alpha-chymotrypsin (alpha-MIPCT) and is confirmed by our studies. A new additional downfield signal, separate from the alpha-MIPCT signal, is attributed to a dimer of the phosphorylated alpha-DIPCT. Phosphorylation of the enzyme with diphenyl chlorophosphate yields a monophenylphosphoryl-alpha-chymotrypsin (alpha-MPPCT) that also showed a single 31P signal at -2.1 ppm (pH 7). However, the spectrum did not change as a function of pH, incubation time, or concentration. Comparison of the 31P chemical shifts of the native and denatured phosphorylated derivatives of alpha-chymotrypsin suggests changes in the conformation about the P-O ester bonds are at least partially responsible for the various 31P chemical shift differences. PMID- 2719946 TI - Substitution of valine for glycine-558 in the congenital dysthrombin thrombin Quick II alters primary substrate specificity. AB - Thrombin Quick II is one of two dysfunctional forms of thrombin derived from the previously described congenital dysprothrombin prothrombin Quick. Thrombin Quick II does not clot fibrinogen, hydrolyze p-nitroanilide substrates of thrombin, or bind N2-[5-(dimethylamino)naphthalene-1-sulfonyl]arginine N,N-(3-ethyl-1,5 pentanediyl)amide, a high-affinity competitive inhibitor of thrombin. To determine the structural alteration in thrombin Quick II, the reduced, carboxymethylated protein was hydrolyzed by a lysyl endopeptidase. A peptide not present in a parallel thrombin hydrolysate was identified by reverse-phase chromatography. The peptide was purified by rechromatography and subjected to Edman degradation which showed that Gly-558 of human prothrombin had been replaced by Val. This corresponds to a point mutation of the Gly codon GGC to GUC. This Gly residue, which is highly conserved in the chymotrypsin family of serine proteases, forms part of the substrate binding pocket for bulky aromatic and basic side chains in chymotrypsin and trypsin, respectively. However, in porcine elastase 1, the corresponding residue is threonine. Consistent with the identified structural alteration, thrombin Quick II incorporates [3H]diisopropyl fluorophosphate stoichiometrically and hydrolyzes the elastase substrate succinyl Ala-Ala-Pro-Leu-p-nitroanilide with a relative kcat/KM of 0.14 when compared to thrombin. This results from a 3-fold increase in KM and a 2.5-fold decrease in kcat for thrombin Quick II when compared to thrombin acting on the same substrate. These results and those of other investigators studying mutant trypsins support the conclusion that the catalytic activity of serine proteases is very sensitive to structural alterations in the primary substrate binding pocket. PMID- 2719947 TI - Mechanistic studies on phenylalanine hydroxylase from Chromobacterium violaceum. Evidence for the formation of an enzyme-oxygen complex. AB - Steady-state kinetic analysis of pterin-dependent phenylalanine hydroxylase from Chromobacterium violaceum indicated that the enzyme follows a partially ordered reaction mechanism. The data suggested that oxygen is the first substrate to bind to the enzyme. This result was further supported by rapid-quench experiments in which the enzyme-oxygen complex was trapped to yield product. Additional support for the presence of an enzyme-oxygen complex was derived from magnetic susceptibility measurements of molecular oxygen in the presence and absence of cuprous phenylalanine hydroxylase. The magnetic susceptibility of dissolved oxygen decreased in the presence of the enzyme, supporting a direct oxygen-metal interaction. PMID- 2719948 TI - Effect of the substitution Ala----Gly at each of five residue positions in the C peptide helix. AB - The substitution Ala----Gly has been studied in a unique-sequence peptide (related in sequence to the C-peptide of ribonuclease A) to determine its effect on C-peptide helicity at different residue positions. There is a substantial decrease in helicity for Ala----Gly at residue position 4, 5, or 6 but only a small decrease in helicity for Ala----Gly at end residue 1 and no decrease at end residue 13. The change for Ala----Gly is similar at position 4, 5, or 6; the change is caused chiefly by the difference in s, the helix growth parameter in the Zimm-Bragg model for alpha-helix formation, between Ala and Gly. Thus, the helicity of C-peptide depends sensitively on s at interior positions. The small change in helicity found for Ala----Gly at either end position suggests that the end residues are largely excluded from the helix, with the result that helicity is relatively unaffected by replacement of an end residue. Another possibility is that some helix-stabilizing effect is exerted by Gly only at an end position. Exclusion of an end residue from the helix might be caused either by fraying of the helix ends or by helix termination at an interior residue, resulting from a helix stop signal such as the Glu-2- -Arg-10+ salt bridge or the Phe-8-His-12+ ring interaction. PMID- 2719949 TI - Phosphorus nuclear magnetic resonance studies of lipid-protein interactions: human erythrocyte glycophorin and phospholipids. AB - Human erythrocyte glycophorin containing four molecules of phospholipid tightly bound to the protein was isolated from human red cell ghosts. This protein preparation was reconstituted into a digalactosyl diglyceride bilayer. The 31P NMR spectrum of this reconstituted membrane produced an axially symmetric powder pattern arising exclusively from the phospholipids bound to glycophorin. The width of the powder pattern, about 90 ppm, is about twice as broad as that normally exhibited by a phospholipid bilayer. The chemical shift tensor is perturbed relative to phospholipids in a bilayer. The spin-lattice relaxation rate of these protein-bound phospholipids is found to be nearly an order of magnitude faster than phospholipids in a bilayer. The results are consistent with phospholipids tightly bound to the membrane protein and undergoing rotational diffusion, perhaps as a complex of phospholipid and protein. PMID- 2719950 TI - Perturbation of tryptophan residues by point mutations in bacteriophage T4 lysozyme studied by optical detection of triplet-state magnetic resonance spectroscopy. AB - We have investigated perturbations of the triplet-state properties of Trp residues in bacteriophage T4 lysozyme caused by point mutations using low temperature phosphorescence and optical detection of triplet-state magnetic resonance (ODMR) spectroscopy. Five temperature-sensitive mutants have been studied in detail. These include lysozymes with the point mutations Gln-105--- Ala, Gln-105----Gly, Gln-105----Glu, Ala-146----Thr, and Trp-126----Gln. Changes in phosphorescence 0,0 band wavelength, intensity, the triplet-state zero-field splitting (ZFS), and the wavelength dependence of the ZFS were detected only from Trp-138 in each mutant. In the case of the Q105A mutation, the perturbations on Trp-138 have been ascribed to the combination of an increase in the polarizability of the environment and to the loss of hydrogen bonding of the enamine nitrogen of indole. For the Q105G mutation, we believe that Q is replaced by a solvent molecule in H bonding, leading to relatively small changes. In the Q105E mutation, the perturbation results largely from the introduction of a charged residue. In the case of the mutation A146T, the perturbation is associated with a local conformational change in which Trp-138 is shifted to a more solvent-exposed location. On the other hand, no significant spectroscopic changes in Trp-126 and Trp-158 were found in any of the mutants, suggesting that the perturbations are probably localized near Trp-138 for the mutations of positions 105 and 146. However, in the mutation W126Q, which occurs approximately 16 A away from Trp-138, significant changes of Trp-138 are detected, suggesting that the effects of this mutation are propagated over large distances. PMID- 2719951 TI - Time-resolved absorption, circular dichroism, and emission of tRNA. Evidence that the photo-cross-linking of 4-thiouridine in tRNA occurs from the triplet state. AB - The time-resolved optical density (TROD) and time-resolved circular dichroism (TRCD) spectra of the lowest triplet state of 4-thiouridine (4t-Urd) in aqueous solutions of tRNA are reported. The TROD spectrum is consistent with the triplet state being primarily in the thione tautomer. The intersystem crossing yield to the triplet is 0.35 and 0.27 (+/- 10%), respectively, with and without 10(-2) Mg2+ added to the solution. Upon addition of increasing amounts of I- to solutions of tRNA, the initial triplet yield decreases, the rate of the observed triplet decay increases, and the quantum yield of internal photo-cross-linking decreases for the 4t-Urd chromophore. The results show quantitatively that the near-UV-induced photo-cross-linking reaction in tRNA occurs from the triplet state of 4t-Urd. From the TRCD spectrum the dissymmetry factor (delta epsilon/epsilon) of some of the triplet-triplet absorption bands is shown to be significantly larger than for any of the ground-state absorption bands. Two CD transitions are seen in the triplet-triplet spectrum which are obscured in the TROD spectrum by the strong ground-state bleaching signal near 335 nm. This shows that TRCD may be useful, in some cases, in locating electronic transitions that are not observed in TROD spectra. PMID- 2719952 TI - Photoaffinity labeling of the monoamine transporter of bovine chromaffin granules and other monoamine storage vesicles using 7-azido-8-[125I]iodoketanserin. AB - An iodinated azido derivative of ketanserin, 7-azido-8-[125I]iodoketanserin ( [125I]AZIK), has been used to label the monoamine transporter of bovine chromaffin granule membranes by the technique of photoaffinity labeling. In the dark, this derivative was found to bind reversibly to the membranes, with an equilibrium dissociation constant estimated to be 6 nM at 0 degrees C. As for ketanserin, binding occurred at the tetrabenazine site: (i) [125I]AZIK was displaced efficiently from its binding site by tetrabenazine, ketanserin, and 7 azidoketanserin, whereas serotonin, which is a substrate for the transporter but has a low affinity for tetrabenazine binding site, was a poor displacer; pipamperone and pyrilamine, two antagonists of respectively serotonin S2 and histamine H1 receptors, were inactive. (ii) 7-Azidoketanserin was a competitive inhibitor of [3H]dihydrotetrabenazine binding, and it inhibited the ATP-dependent uptake of serotonin by chromaffin granule ghosts. Irradiation of [125I]AZIK with long-wavelength UV light, followed by electrophoresis on sodium dodecyl sulfate/polyacrylamide gels and autoradiography, revealed irreversible labeling of a membrane component with an apparent molecular weight of 73,000. Tetrabenazine inhibited the labeling of this 73-kDa band in a manner parallel to the binding of [125I]AZIK in the dark. Such a labeling is totally compatible with previous results obtained through photolabeling with a tetrabenazine derivative or by target size analysis. Moreover, preliminary experiments showed that [125I]AZIK can label the tetrabenazine binding sites of various sources including rat striatum, rabbit platelets, human pheochromocytoma, and human adrenal medulla. Therefore, this molecule appears to be an excellent probe to label the monoamine transporter of different amine storage vesicles even without purification. PMID- 2719953 TI - Salt-induced release of DNA from nucleosome core particles. AB - At elevated salt concentrations, the structure of chromatin is destabilized. This paper is concerned with the processes by which DNA is released from nucleosome core particles in free, uncomplexed form. Our experiments indicate that the DNA release reaction has distinctly different characteristics below and above approximately 0.75 M NaCl. Below this concentration of salt, release of the histones from the DNA is highly cooperative, so that no dissociation intermediates are even seen. Above this salt concentration, histone release is not so cooperative; H2A and H2B are released from the DNA more readily than are H3 and H4. This results in an apparently heterogeneous population of (H2A, H2B) depleted intermediate species sedimenting at rates between that of free DNA and that of intact core particles. Dissociation of core particles at NaCl concentrations below 0.75 M is readily reversible. Reassociation of DNA and histones from higher salt concentrations is nearly quantitative if carried out by gradual decrease of salt concentration, but rapid dilution to low salt results in the formation of a fraction of metastable nucleosome multimers. To help organize our description of the DNA release process, we introduce a stability diagram for the core particle, defined with respect to the independent variables of salt concentration and particle concentration. We draw upon our own experimental work and also upon the work of several other laboratories. We distinguish five major regions in this diagram. PMID- 2719954 TI - Carboxypeptidase-mediated release of methotrexate from methotrexate alpha peptides. AB - Methotrexate (MTX) alpha-peptides containing representative neutral (alanine), acidic (aspartic acid), and basic (arginine) amino acids were synthesized by a regiospecific route. Purity and authenticity of MTX-Ala, MTX-Asp, and MTX-Arg were established by TLC, HPLC, elemental analysis, and NMR and absorbance spectra. These peptides were hydrolyzed by carboxypeptidases to yield MTX and the amino acids. Reactions were monitored by using a ninhydrin assay for the amino acids and HPLC and spectrophotometric assays for MTX. Pancreatic carboxypeptidase A (CP-A) hydrolyzed MTX-Ala and, at a much slower rate, MTX-Asp and MTX-Arg. MTX Ala was also a substrate for pancreatic carboxypeptidase B (CP-B); marginal activity was observed with this enzyme and MTX-Arg. Human serum hydrolyzed only MTX-Arg; biphasic inhibition of this activity by 2-(mercaptomethyl)-3 (guanidinoethyl)thiopropionate was consistent with the known presence of two types of endogenous carboxypeptidase (CP-N). Cytotoxicity of the MTX peptides toward L1210 cells in culture was enhanced considerably in the presence of the appropriate carboxypeptidases. MTX-Ala was much less toxic than MTX (ID50 values of 2.0 X 10(-6) M and 2.4 x 10(-8) M, respectively), but in the presence of CP-A the ID50 of the peptide improved to 8.5 X 10(-8) M. Similar results were obtained with MTX-Asp/CP-A and MTX-Ala/CP-B combinations. MTX-Arg showed good cytotoxicity (ID50 of 5.0 X 10(-8) M), due to CP-N activity in the fetal bovine serum of the culture medium; inclusion of CP-B lowered the ID50 to that of MTX. Possible clinical uses of MTX peptides are discussed. PMID- 2719955 TI - Transcriptional switching by the metalloregulatory MerR protein: initial characterization of DNA and mercury (II) binding activities. AB - The MerR protein from the Tn501 mercury resistance operon is a metalloregulatory transcriptional switch, converting from repressor to activator on binding of Hg(II). We have determined via binding studies with 203Hg(II) that a single Hg(II) atom binds to the MerR dimer (32 kDa) with a half-saturation concentration of 10(-7) M in the presence of up to 10(-3) M exogenous thiols. This 10(4) selective binding is specific for the binding of Hg(II) and corresponds to concentrations of metal that induce mercury(II) resistance in vivo. Kd values for MerR binding, in the absence and presence of Hg(II), to a 305 bp DNA fragment containing the 18 bp dyad symmetry element, DS1, located at -35 to -10 upstream of the mer structural genes, were determined by a gel shift assay. A Kd of 10( 10) M for free MerR and 10(-11) M for Hg(II)-MerR complexes was revealed. Measurements of koff values, by this assay, show equally long-lived complexes of MerR-DNA (51-min half-life) and Hg(II)-MerR-DNA (49-min half-life), suggesting that Hg(II) accelerates MerR binding to DNA rather than influencing the dissociation rate of the protein-DNA complex. In contrast, 203Hg(II) studies reveal that mercuric ions rapidly dissociate and associate with MerR-DNA complexes. Extensive footprinting studies by DNase I, methylation protection, and hydroxyl radicals indicate MerR stays bound to DS1 even on addition of Hg(II) and shares no interaction in vitro with a second dyad symmetry element, DS2, centered at -79/-80.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2719956 TI - Interaction of clotting factor V heavy chain with prothrombin and prethrombin 1 and role of activated protein C in regulating this interaction: analysis by analytical ultracentrifugation. AB - Changes in the affinity of the heavy subunit of blood coagulation factor Va (Vh) for prothrombin are thought to be important in regulating the rate of thrombin production. Using analytical ultracentrifugation, we have measured the affinity of bovine Vh for prothrombin and for the prethrombin 1 fragment of prothrombin at 23.3 degrees C, pH 7.65, in 50 mM tris(hydroxymethyl)aminomethane, 0.1 M NaCl, 0.1 mM benzamidine, and either 2 mM Ca2+ or 2 mM ethylenediaminetetraacetate (EDTA). Under these conditions a 1:1 complex of Vh with prothrombin is formed that is governed by a dissociation constant (Kd) of 10 microM, regardless of whether the buffer contains Ca2+ or EDTA. An identical Kd is observed when prethrombin 1 is substituted for prothrombin. This indicates that the fragment 1 portion of prothrombin, containing the gamma-carboxyglutamic acid residues, does not influence the association. Substitution of human prethrombin 1 for the bovine molecule also results in a 1:1 Vh-prethrombin 1 complex governed by a slightly weaker Kd (27 microM). Discrete proteolysis of bovine Vh by the anticoagulant activated protein C converts the Vh to a form with little or no affinity for prethrombin 1 (Kd greater than 1 mM), without detectable change in the mass of the Vh. PMID- 2719957 TI - Transient chloramphenicol acetyltransferase expression of the G gamma globin gene 5'-flanking regions containing substitutions of C----T at position -158, G----A at position -161, and T----A at position -175 in K562 cells. AB - The expression of G gamma is affected by mutations that occur in promoter sequences located in the 5'-flanking region of the gene. We have assayed the promoter activity of G gamma genes that have mutations of C----T at position -158 or G----A at position -161. In addition, we determined the activity of a promoter fragment containing T----A at position -175 (in the octamer motif) in combination with a -158 C----T which was produced during the polymerase chain reaction amplification procedure. Constructs containing these fragments were transfected by electroporation into K562 cells and the promoter activity was measured as chloramphenicol acetyltransferase activity. The data show a 4-5-fold enhancement of activity for the -158 C----T and the -161 G----A promoters over the 'normal' G gamma promoter and an 8-fold increase in the activity of the promoter with the double mutation (-158 C----T and -175 T----A). These results are consistent with data involving the increase in G gamma production in patients heterozygous for these mutations. PMID- 2719958 TI - Cloning of rabbit uricase cDNA reveals a conserved carboxy-terminal tripeptide in three species. AB - cDNA clones encoding uricase have been isolated from a rabbit liver cDNA library. The nucleotide sequences of the cDNAs have been determined and those of the rat uricase cDNA have been revised. In all three uricases, the carboxy-terminal tripeptides are Ser-Arg/Lys-Leu sequences, which have recently been suggested as an essential element of peroxisomal targetting signals for many but not all peroxisomal proteins. PMID- 2719959 TI - Nucleotide sequence of the full-length mouse lamin C cDNA and its deduced amino acid sequence. AB - We have cloned and sequenced the cDNA comprizing the entire coding region and several hundred base-pairs of its flanks for the mouse nuclear envelope protein lamin C mRNA. The nucleotide sequence and the deduced amino-acid sequence of the mouse lamin C are compared with the previously published human lamin A/C sequences with respect to (a) the general organisation, (b) homologies, (c) predictions for the essential structural characteristics of lamins and (d) the localization of the most conserved region. Moreover, the mouse lamin C sequence presented allows the first intraspecies comparison between A/C-type and B-type lamins. PMID- 2719960 TI - Genes for human U3 small nucleolar RNA contain highly conserved flanking sequences. AB - Six human genomic clones containing sequences homologous to the U3 small nuclear RNA (snRNA) were isolated and characterized. Four of these clones were real U3 snRNA genes because they were transcribed in frog oocytes and the DNA sequences corresponding to the U3 snRNA were identical to the U3 snRNA of HeLa cells. The nucleotide sequences of four true U3 snRNA genes, 537 nucleotides on the 5' flanking region and 340 nucleotides on the 3'-flanking region, were found to be identical. In addition, the restriction patterns, upto 2 kb on the 5' side and 2.2 kb on the 3' side, appeared to be same. All the isolated U3 clones, containing 15-20 kb of genomic DNA, contained only one U3 snRNA gene, indicating that the human U3 snRNA genes are several kilobases apart. One of the U3 clones contained a full-length U3 pseudogene. Southern blot analysis of genomic DNA with cloned U3 DNA as probe indicated that human DNA contains two families of U3 genes which differ in their flanking sequences. In the 5' flanking region of human U3 snRNA genes, homology to U-gene promoter element, an octamer motif, the 'U3 box', SP1 binding sites and a consensus 3' box in the 3' flanking region, were observed. These data show that the genomic organization and the sequence motifs that control transcription of human nucleolar U3 snRNA genes are similar to those of human U1 and U2 snRNA genes and suggest common mechanism(s) in the evolution of snRNA genes. PMID- 2719961 TI - The DNA guanyl radical: kinetics and mechanisms of generation and repair. AB - The one-electron oxidation of DNA bases and single-stranded DNA was studied by pulse radiolysis of aqueous solutions from pH 7-7.4 at 20 degrees C. Thallic ions, Tl(II), were found to rapidly oxidize the purine nucleotides, deoxyguanosine 5'-monophosphate, k[Tl(II) + dGMP2-] = 3.4.10(9) M-1.s-1, and deoxyadenosine 5'-monophosphate, k[Tl(II) + dAMP2-] = 1.3.10(8) M-1.s-1. The reactivities of Tl(II) ions with model pyrimidine DNA bases, 1-methylcytosine and 1-methylthymine, were too low to be measured by pulse radiolysis, k less than 10(7) M-1.s-1. The Tl(II)-mediated oxidation of ssDNA, k = 2.8.10(8) M-1.s-1, produces DNA-guanyl radical, DNA-G.(-H), exclusively. The DNA-guanyl radical is found to be a potent oxidant in neutral media, E7 = 1.04 +/- 0.05 V. It rapidly oxidizes the aromatic amino acids in glycyl-tryptophan and tyrosine methyl ester, k = 3.6.10(7) M-1.s-1 and k = 1.7.10(8) M-1.s-1, respectively. These electron transfer processes indicate that a positive 'hole' may be transferred from DNA to a DNA-associated protein. The positive 'hole' in DNA can also be repaired by antioxidants, which are electron donors. The chemical repair of the DNA-guanyl radical by negatively charged antioxidants is slower than that by positively charged and neutral antioxidants. PMID- 2719962 TI - Non-random reconstitution of HMG1 and HMG2 in chromatin. Determination of the histone contacts. AB - We have studied how non-histone proteins HMG1 and HMG2 interact with rat liver chromatin using reconstitution and chemical cross-linking procedures. Both proteins were found to associate to chromatin only to some extent and always with a marked preference for short oligonucleosomes, mainly mono- and dinucleosomes. However, a slight reconstitution with the long polynucleosomal fraction can be observed in H1-depleted chromatin. Reconstitution is non-random and a clear preference for regions highly sensitive to staphylococcal nuclease (EC 3.1.31.1) is observed. Chemical cross-linking has allowed us to identify H1, H2A and H2B as the histones contacted by HMG1 and HMG2 upon reconstitution. Also, we present evidence that HMG1 and HMG2 interact with the nucleosomal particle without replacing H1 or any other histone. PMID- 2719963 TI - Stage-specific detection of a DNA-binding protein for the storage protein gene of Sarcophaga peregrina. AB - A nuclear extract of fat body prepared from third instar larvae of Sarcophaga peregrina (flesh fly) was found to contain a DNA-binding protein that specifically bound to 5'-upstream region of the storage protein (arylphorin) gene. This protein was found only in larvae harvested 46 h after larval emergence, indicating that its appearance was strictly regulated by the developmental stage of the insect. Since the storage protein gene is actively transcribed in the fat body at this stage, this protein is probably a specific transcription factor for the storage protein gene. DNase I footprinting analysis showed that the nucleotide sequence of the binding site of this protein is ACCACAACA, which is located at residues -247 to -255 upstream of the +1 site. Results indicated that formation of the DNA-protein complex required Zn2+. PMID- 2719964 TI - Cloning and nucleotide sequence of a full-length cDNA for human 14 kDa beta galactoside-binding lectin. AB - A full-length cDNA for a 14K-type human lung beta-galactoside-binding lectin was cloned. The cDNA includes a 405 bp open reading frame coding 135 amino acids including the initiator methionine, and having a single internal EcoRI site and a polyadenylation signal. The deduced amino-acid sequence agreed completely with the sequence of a human placenta lectin determined by direct amino-acid sequence analysis (Hirabayashi, J. and Kasai, K. (1988) J. Biochem. 104, 1-4). It showed extensive sequence similarity with other vertebrate 14K-type lectins and a 35K type lectin (carbohydrate-binding protein 35) of mouse 3T3 cell. Search of a Genbank sequence data base revealed significant sequence similarity between the beta-galactoside-binding lectins and the carboxyl-terminal half of an IgE-binding protein, the cDNA of which has been cloned from rat basophilic leukemia cells. Thus, 14K-type lectin, 35K-type lectin and IgE-binding protein appeared to form a superfamily of proteins. Almost all invariant residues are located in the central region of the 14K-type lectins, so this region may constitute an essential part of the lectins, such as the sugar-binding domain. PMID- 2719965 TI - Avian adipose lipoprotein lipase: cDNA sequence and reciprocal regulation of mRNA levels in adipose and heart. AB - cDNA clones for chicken adipose lipoprotein lipase were isolated from an expression library in lambda gt11 by antibody screening and characterized by hybridization selection and nucleotide sequencing. Based on the cDNA sequence and on N-terminal sequence analysis of the purified enzyme, chicken adipose lipoprotein lipase is a mature protein of 465 amino acids with a signal peptide of 19 or 25 amino acids, depending on which of two methionine residues is used for translation initiation. The predicted amino-acid sequence was found to be 73 77% identical to the four known mammalian adipose lipoprotein lipase sequences, with conservation of position of cysteine residues and putative functional domains, and number of potential N-glycosylation sites. Chicken lipoprotein lipase differs from mammalian lipoprotein lipases with respect to the position of one N-glycosylation site and the presence of an additional 15-17 C-terminal amino acids. 32P-labeled cDNA clones hybridized to mRNA species of 3.7 and 4.0 kb in Northern blots of heart and adipose, but not of liver RNA. In chickens that were fasted for 48 h and then refed, lipoprotein lipase mRNA levels in adipose increased to a maximal level of 350% that of controls at 10 h, whereas heart lipoprotein lipase mRNA levels fell to 40% of controls at 14 h. Concomitantly, no changes in total RNA were observed. Thus, avian lipoprotein lipase is subject to reciprocal pretranslational regulation in adipose and heart. PMID- 2719966 TI - Effect of procainamide on renal tubular transport of cimetidine in the isolated perfused rat kidney. AB - The effect of procainamide on renal tubular transport of cimetidine was studied in isolated perfused rat kidney based on the multiple indicator dilution (MID) technique. T-1824-labeled albumin (a vascular reference), [14C]creatine (an extracellular reference), and [3H]cimetidine were rapidly injected into the renal artery of isolated perfused rat kidney in the presence or absence of procainamide (100 microM) in the perfusate, and normalized outflow-time patterns were secured from rapidly sampled renal perfusate. A distributed two-compartmental model was fitted to the dilution data by non-linear least-squares regression, and the influx, efflux and sequestration rate constants were estimated. Net transport and influx processes of cimetidine were competitively inhibited by procainamide (PA), while the efflux and sequestration processes were increased. The increase in the values of the efflux and sequestration rate constants by addition of procainamide may be explained by the increase in the tissue binding of cimetidine. However, these three processes were not significantly affected by p-aminohippurate (PAH). These results suggest that both cimetidine and procainamide are secreted into the lumen by an organic base transport mechanism in the perfused kidney, in which the spatial organization and cell polarity of the kidney are maintained. PMID- 2719967 TI - Bilitranslocase is the protein responsible for the electrogenic movement of sulfobromophthalein in plasma membrane vesicles from rat liver: immunochemical evidence using mono- and poly-clonal antibodies. AB - Monoclonal antibodies raised against bilitranslocase, may display either inhibitory or enhancing activity on the electrogenic transport of sulfobromophthalein, evoked in rat liver plasma-membrane vesicles by the addition of valinomycin in the presence of K+. In both cases, the target protein is identified with a 37 kDa band in SDS-mercaptoethanol gel electrophoresis of solubilized membranes. The electrophoretically homogeneous protein isolated by ion-exchange chromatography, corresponds in all respects to the 37 kDa protein band of bilitranslocase, obtained in the past by different techniques. Using this protein as antigen, a polyclonal monospecific antibody preparation has been obtained. As expected, the antibody preparation inhibits the electrogenic movement of sulfobromophthalein in plasma membrane vesicles from rat liver. It is concluded that the 37 kDa protein of bilitranslocase is at least a necessary component of the transport system involved in the sulfobromophthalein movement in plasma membrane. PMID- 2719969 TI - Basic amphipathic helical peptides induce destabilization and fusion of acidic and neutral liposomes. AB - We have studied the fusion of small unilamellar vesicles composed of egg PC and of a mixture of egg PC plus egg PA using various basic amphipathic peptides. Fusion was monitored by carboxyfluorescein leakage assay, light scattering, membrane intermixing assay, contents mixing assay and electron microscopy. Ac-(L Leu-L-Ala-L-Arg-L-Leu)3-NHCH3 (peptide 4(3] and Ac-(L-Leu-L-Ala-L-Lys-L-Leu)3 NHCH3 (peptide 4'3), which have high hydrophobic moments, caused transformation of small unilamellar vesicles into larger and relatively homogeneous ones. Ac-(L Leu-L-Leu-L-Ala-L-Arg-L-Leu)2-NHCH3 (5(2], which has medium hydrophobic moment, induced weak but appreciable fusion, while Ac-(L-Ala-L-Arg-L-Leu)3-NHCH3 (3(3] which has no helical structure did not show any fusion. However, peptides 4(3), 4'3 and 5(2) caused massive leakage of the contents from small unilamellar vesicles. These results indicated that interaction of the peptides with artificial membranes caused extensive perturbation of the lipid bilayer, followed by fusion. The fusogenic capacity of model basic peptides was correlated with the hydrophobic moment of each peptide when the peptides adopted an alpha-helical structure in the presence of acidic liposomes. Peptides 4(3) and 4'3 also showed weak fusogenic ability for neutral liposomes, while 5(2) and 3(3) showed no ability, suggesting that highly amphipathic peptides, such as 4(3), interact weakly but distinctly with neutral liposomes to fuse them. PMID- 2719968 TI - Magainin 1-induced leakage of entrapped calcein out of negatively-charged lipid vesicles. AB - Effects of magainin 1, a novel antimicrobial peptide, on the permeability of lipid vesicles were investigated by using calcein as a trapped fluorescent marker. Magainin 1 induces the leakage of calcein specifically out of negatively charged vesicles. The peptide binds to bovine brain phosphatidylserine sonicated vesicles according to the Langmuir isotherm with a binding constant of 3.8.10(5) M-1 and a binding-site number of 0.10 per lipid molecule. The leakage seems to occur at a critical binding number of approx. 0.03 per lipid molecule. A circular dichroism study revealed that magainin 1 conforms mainly to an unordered structure both in an aqueous solution and in the presence of egg yolk phosphatidylcholine vesicles, whereas to an amphiphilic helix with the phosphatidylserine vesicles. In conclusion, magainin 1 interacts with acidic lipids through electrostatic interactions followed by hydrophobic interactions to form an amphiphilic helix, inducing the leakage. PMID- 2719970 TI - Involvement of ATP-dependent aminophospholipid translocation in maintaining phospholipid asymmetry in diamide-treated human erythrocytes. AB - Crosslinking of membrane skeletal proteins such as spectrin by oxidation of their SH-groups can be provoked by treatment of intact erythrocytes with diamide. Shortly after exposure of human erythrocytes to diamide and despite the transverse destabilization of the lipid bilayer that was observed in these cells (Franck, P.F.H., Op den Kamp, J.A.F., Roelofsen, B. and Van Deenen, L.L.M. (1986) Biochim. Biophys. Acta 857, 127-130), no abnormalities could be detected regarding the asymmetric distribution of the phospholipids when probed by either the prothrombinase assay or brief exposure of the cells to a modified phospholipase A2 with enhanced membrane penetrating capacity. This asymmetry appeared to undergo dramatic changes however, when the ATP content of the cytosol had decreased to less than 10% of its original level during prolonged incubation of the treated cells. These observations indicate that the initial maintenance of phospholipid asymmetry in diamide-treated erythrocytes can be solely ascribed to the action of the ATP-dependent aminophospholipid translocase. This view is supported by experiments involving radiolabeled phospholipids of which trace amounts had been inserted into the outer membrane leaflet of diamide-treated red cells and which still showed a preferential translocation of both aminophospholipids in favour of the inner monolayer, be it that the efficiency of the translocase was found to be impaired when compared to control cells. PMID- 2719971 TI - Liposomes with prolonged circulation times: factors affecting uptake by reticuloendothelial and other tissues. AB - Many of the applications of liposomes drug-delivery systems have been limited by their short circulation half-lives as a result of rapid uptake into the reticuloendothelial (mononuclear phagocyte) system. We have recently described liposomes formulations with long circulation half-lives in mice (Allen, T.M. and Chonn, A. (1987) FEBS Lett. 223, 42-46). A study of the principal factors important to the attainment of liposomes with prolonged circulation half-lives is presented in this manuscript. Liposomes with the longest circulation half-lives, in mice, had compositions which mimicked the outer leaflet of red blood cell membranes (egg phosphatidylcholine/sphingomyelin/cholesterol/ganglioside GM1, molar ratio 1:1:1:0.14). Several other gangliosides and glycolipids were examined, but none could substitute for GM1 in their ability to prolong circulation half-lives. However, other negatively charged lipids with bulky headgroups, i.e., sulfatides and phosphatidylinositol, had some effect in prolonging circulation half-lives, but GM1 was clearly superior in this regard. Bilayer rigidity, imparted by sphingomyelin or other high-phase-transition lipids, acted synergistically with the negatively charged components, especially GM1, in extending circulation times. Circulation half-lives of liposomes increased with decreasing size, but even larger (0.2-0.4 microns) liposomes of the optimum formulations had significantly prolonged half-lives in circulation. Uptake of liposomes into tissues other than liver and spleen increased with increasing circulation times of the liposomes for i.v. and for i.p. injections. Liposomes appeared to move from the circulation into the carcass between 6 and 24 h post-injection. Our ability to achieve significant prolongation in circulation times of liposomes makes possible a number of therapeutic applications of liposomes which, until now, have not been achievable. PMID- 2719972 TI - Kinetic study of the reaction of vitamin C with vitamin E radicals (tocopheroxyls) in solution. AB - New stable vitamin E radicals (7-tert-butyl-5-isopropyltocopheroxyl (4), 5,7 diisopropyltocopheroxyl (5), 7-tert-butyl-5-methyltocopheroxyl (6), and 5,7 diethyltocopheroxyl (7] with two bulky alkyl substituents at ortho positions (C-5 and C-7) have been prepared, and the reaction rates of vitamin C (ascorbic acid (1) and 6-O-stearyl ascorbic acid (2] with these tocopheroxyl radicals in benzene/ethanol/water (2:1:0.1, v/v) solution have been determined spectrophotometrically, using a stopped-flow technique. The second-order rate constants, k2, obtained vary in the order of 10(3), and decrease dramatically in the order 7 greater than 6 greater than 5 greater than 4, as the size of two ortho-alkyl groups in tocopheroxyl increases. The result suggests that the effect of steric hindrance on the reaction rate is considerable. These reaction rates were compared with those of vitamin C with alpha-tocopheroxyl reported by Packer et al. (Nature 278 (1979) 737-738) and Scarpa et al. (Biochim. Biophys. Acta 801 (1984) 215-219). PMID- 2719973 TI - The induced circular dichroism of bilirubin complexed with the alpha-helix form of poly(L-lysine). AB - Binding of bilirubin by the alpha-helix conformation of poly(L-lysine) in water induces optical activity. The bisignate circular dichroism spectrum exhibits exciton bands centred at 444 nm, negative, and at 525 nm, positive. The magnitude of the induced circular dichroism depends on the concentration of total bilirubin and total lysine residues, the molar ratio of total lysine residues-to-total bilirubin molecules, the pH and the degree of polymerization of poly(L-lysine). Although bilirubin binds to the random coil conformation of poly(L-lysine), as evidence by the absorption spectrum, the complex is optically inactive. The results suggest that bilirubin binds to the poly(L-lysine) in the form of dimers and oligomers. PMID- 2719974 TI - Changes in polyamine-oxidizing capacity of peroxisomes under various physiological conditions in rats. AB - Rat liver peroxisomal polyamine oxidase activity was determined under various physiological conditions by using the peroxidase method with phenol and 4 aminoantipyrine. N1-Acetylpolyamines such as N1-acetylspermine and N1 acetylspermidine were better substrates than the free polyamines. The polyamine oxidase activity in rat peroxisomes increased significantly when cell proliferation was high. The activity began to appear in fetal liver at the 16th approximately 18th day of pregnancy and peaked in neonatal liver on the first day (approx. 1.7-times higher than in adult liver). In regenerating rat liver, only polyamine oxidase activity among the peroxisomal enzymes tested was increased considerably 12 h after partial hepatectomy (approx. 2.8-fold over the control liver). Finally, the enzyme activity was significantly increased by administration of clofibrate, a peroxisome proliferator, which also causes hepatomegaly. In all cases, the increase in polyamine oxidase activity was not more than 3-fold. Since the level of polyamine oxidase activity in the normal liver is more than adequate in relation to the level of the substrates, the slight but significant increase under conditions of cell proliferation may have a role in modulating levels of polyamines in the proliferating liver tissue. PMID- 2719975 TI - The net electric charge of proteins. A comparison of determinations by Donnan potential measurements and by gel electrophoresis. AB - We compare a new method for the determination of the net charge of proteins based on Donnan potential measurements, as described briefly by Ojteg, G., Nygren, K. and Wolgast, M. (1987) Acta Physiol. Scand. 129, 277-286, with a conventional method using polyacrylamide gel electrophoresis. The new technique utilizes the Donnan potential, which develops over a semipermeable membrane that separates the non-permeating protein from the surrounding bath of the same ionic composition as the protein solution, to determine the net valency. The advantages of this method, besides its simplicity, are that it can determine the charge of, e.g., a protein in a free-fluid phase and that the pH and ionic composition of the bathing fluid can be varied over a broad range. The Donnan potential decreased to half its original value when the ionic strength was doubled. Usually a protein concentration of 1-10 mg.ml-1 must be used. The Donnan potential method was applied to determine the net charges of a series of proteins with different isoelectric points. The values showed close agreement with the data obtained by gel electrophoresis. PMID- 2719976 TI - A physico-chemical approach to the study of the binding interaction between S adenosyl-L-methionine and polyanions: binding constants and nature of the interaction with sodium poly(styrene sulfonate). AB - The interaction between S-adenosyl-L-methionine (AdoMet) and sodium poly(styrene sulfonate) NaPSS) was studied by means of ultrafiltration and ultraviolet absorption spectroscopy at several pH values and sodium sulfate concentrations. The results obtained are interpreted mainly in terms of electrostatic interactions and permit the evaluation of the binding constants under different experimental conditions. Furthermore, ultraviolet absorption spectroscopy data show a specific short-range interaction between the aromatic electronic system of AdoMet and the NaPSS aromatic ring. The results indicate that the binding strength is greatly affected by the AdoMet positive charge on the adenine ring. The other positive charges on both the sulfonic pole and the amino acidic group of AdoMet contribute only weakly to the binding to the polyanionic matrix, thus assuring some stability of AdoMet even at physiological pH. PMID- 2719977 TI - Kinetic properties of a sn-glycerol-3-phosphate dehydrogenase purified from the unicellular alga Chlamydomonas reinhardtii. AB - A sn-glycerol-3-phosphate dehydrogenase (sn-glycerol-3-phosphate:NAD+ 2 oxidoreductase, EC 1.1.1.8) has been purified from the unicellular green alga Chlamydomonas reinhardtii 3400-fold to a specific activity of 34 mumol/mg protein per min by a simple procedure involving two chromatographic steps on affinity dyes. The pH optimum for reduction of dihydroxyacetone phosphate was 6.8 and for glycerol 3-phosphate oxidation it was 9.5. In the direction of dihydroxyacetone phosphate reduction, the enzyme showed Michaelis-Menten kinetics. The enzyme reacted specifically with NADH and dihydroxyacetone phosphate as substrates with affinity constants of 16 and 12 microM, respectively. Product inhibition as well as competitive inhibition pattern indicated a random-bi-bi reaction mechanism for sn-glycerol-3-phosphate dehydrogenase from C. reinhardtii. The effective control of dihydroxyacetone reduction catalysed via this enzyme by ATP, Pi and NAD gave evidence for a physiological role of the enzyme in plastidic glycolysis. PMID- 2719978 TI - Monooxygenation of N-acetylhistamine mediated by L-ascorbate. AB - In the presence of molecular oxygen and a catalytic amount of copper(II) ion, ascorbate almost completely degraded histamine (approx. 72%). The reaction was shown to occur at the imidazole group but not at the primary amino group in histamine. 4-[2-(Acetylamino)ethyl]-2,3-dihydroimidazol-2-one, a monooxygenated form of N-acetylhistamine, was first isolated as the primary product. PMID- 2719979 TI - Considerations on Listing's Law and the primary position by means of a matrix description of eye position control. AB - Voluntary gaze control obeys the law of Listing. This law specifies the torsion of the eye in every direction of gaze, when the so-called "primary position" of the eye is known. In the present article, some interesting relations between Listing's Law and the primary position on the one hand, and eye muscle innervation on the other hand are derived. A new vectorial description of eye position is introduced which permits to represent Listing's Law by a very simple equation. It also allows to approximate the transformation between eye muscle innervation and eye position by a 3 x 3-matrix in a large field of gaze and with quantities of innervation which are directly related to motoneuron firing rates. It is shown that these innervation quantities must be linearly coupled to yield Listing's Law and that the parameters of this coupling determine the primary position. Finally, relations between innervations and eye muscle forces are considered, and a hypothesis concerning the cooperation of voluntary gaze control and otolith or vergence inputs is presented. PMID- 2719980 TI - Amplification and latency in photoreceptors: integrated or separated phenomena? AB - It is shown that the models for the transduction process in photoreceptors which treat latency and amplification as integrated phenomena ("integrated models") yield time scales for single photon signals ("quantum bumps") which distinctly conflict with the experimentally observed ones for the ventral nerve photoreceptor of Limulus: the ratio of bump duration/latency tB/tlat is predicted by integrated models to be approximately 3 in contrast to the experimental result of approximately 0.5. Moreover, integrated models lead to a predicted value of an extinction rate of approximately 50%, i.e., 50% of the absorbed photons should be expected to cause no signal in the dark adapted state of the cell. In this paper it is shown that separation of latency and amplification in such a way that the latency causing process precedes amplification in the transduction process eliminates these discrepancies. In addition, the separate modeling of latency and amplification resolves the rather large ambiguity in determining the exponent n of the initial signal current J(t) approximately tn reported in the literature to be between n approximately 2 (from noise analysis) up to n approximately 17 (from flash experiments). Two alternative models for the latency part of transduction are suggested which give a qualitatively much better agreement with the experimental histograms of latencies. PMID- 2719981 TI - Model investigations of the temperature dependence of demyelinated and reorganized axonal membrane. AB - The temperature dependence (from 10 degrees to 50 degrees C) of the intracellular action potentials' parameters in a fiber with a simulated reorganization of the axonal membrane against the background of a systematic paranodal demyelination of the fiber was investigated. The temporal and spatial distribution of the potential as well as the ionic currents' kinetics have been represented. The reorganization of the axonal membrane was achieved by means of potassium channels blocking and increase of the sodium-channel permeability, while the demyelination was achieved by means of elongation of the nodes of Ranvier. In order to account for the temperature dependence of the rate constants and of the maximal sodium and potassium permeabilities, the temperature coefficients (Q10) have been used. It has been shown for the demyelinated and reorganized membrane that increased temperature blocks the conduction at temperatures much higher than the blocking temperature for the demyelinated fiber only. When temperature increases the amplitude of the potential decreases while the velocity increases up to temperatures approaching the blocking temperature after which it abruptly drops. The dependence of the asymmetry and the wavelength of the potential on temperature is complex and nonmonotonic. For the reorganized membrane at the background of a given degree of demyelination with increasing temperature the ionic currents' flow and the membrane conduction respectively increase, but, at lower temperatures, when the temperature increase is combined with the increased degree of the fiber demyelination, the conduction is blocked. PMID- 2719982 TI - On the kinetic depth effect. AB - The problem of the kinetic depth effect is revisited. We study how many points in how many views are necessary and sufficient to recover structure. The constraints in the cases where the velocities of the image points are known, and the positions of the image points are known with the correspondence between them established, are different and they have to be studied separately. In the case of two projections of any number of points there are infinitely many solutions, but if we regularize the problem we get a unique solution under some assumptions. Finally, an algorithm is discussed for learning this particular kind of regularization. PMID- 2719983 TI - Response histogram shapes and tuning curves: the predicted responses of several cortical cell types to drifting gratings stimuli. AB - The responses to visual stimuli of simple cortical cells show linear spatial summation within and between their receptive field subunits. Complex cortical cells do not show this linearity. We analyzed the simulated responses to drifting sinusoidal grating stimuli of simple and of several types of complex cells. The complex cells, whose responses are seen to be half-wave rectified before pooling, have receptive fields consisting of two or more DOG (difference-of-Gaussians) shaped subunits. In both cases of stimulation by contrast-reversal gratings or drifting gratings, the cells' response as a function of spatial frequency is affected by the subunit distances 2 lambda and the stimulation frequency omega. Furthermore, an increased number of subunits (a larger receptive field) yields a narrower peak tuning curve with decreased modulation depth for many of the spatial frequencies. The average and the peak response tuning curves are compared for the different receptive field types. PMID- 2719984 TI - [A study of the mechanism of cyanide resistant oxidation of succinate from rat liver mitochondria in the presence of menadione]. AB - Two operation regimes of the electron transport system were found in rat liver mitochondria during the cyanide-resistant succinate oxidation catalyzed by menadione. Under isotonic conditions, the mitochondria were found to contain two electron transport components, one of which was sensitive to mucidin, whereas the other one was inhibited by antimycin A. Both electron transport components were inhibited by thenoyltrifluoroacetone (TTFA). In hypotonic media, the polyenzymatic respiratory complex of mitochondria underwent transformations. In this case the electron transport during the cyanide-resistant succinate oxidation was insensitive to mucidin and antimycin A and was suppressed only by TTFA. Some experimental evidence in favour of pathways of electron transfer under different regimes of mitochondrial function was obtained. It was supposed that in isotonic incubation media the cyanide-resistant respiration is mainly due to menadione reduction in two points of the Q-cycle, i.e., in the region of the "i" center and in the "o" center. Under hypotonic conditions, the main electron flux to menadione occurs only via the Q-cycle "i" center. The observed relatively slow reduction of cytochromes b and ci+c plays an insignificant role in the cyanide resistant respiration. It was shown that the ability of menadione to stimulate the cyanide-resistant respiration is correlated with a higher polarity of this compound as compared with CoQ2 and endogenous CoQ10 of mitochondria. The role of the polyisoprenoid substituent in CoQ10 as a structural component providing for the specificity of interaction with mitochondrial respiratory chain carriers is discussed. PMID- 2719985 TI - [Protective effect of high density lipoproteins, their subfractions and lecithin cholesterol-acyltransferases on the peroxidation modification of low density lipoproteins]. AB - The role of high density lipoproteins (HDL), their subfractions (HDL2 and HDL3) and lecithin: cholesterol acyltransferase (LCAT) on peroxidative modification of low density lipoproteins (LDL) in vitro was studied. Peroxidative modification was estimated by the formation of malonic dialdehyde (MDA) and LDL aggregates during LDL incubation at 37 degrees C for several days without Fe2+ or for 2 hours in the presence of Fe2+ in EDTA-free media. It was shown that the addition of HDL3 (but not HDL2) markedly decreases the formation of both MDA and LDL aggregates. Since LCAT is bound to HDL3, its effect was examined. An addition of LCAT isolated from human plasma (650-fold purification) at a concentration of 450 micrograms/ml resulted in a complete inhibition of LDL peroxidation and LDL aggregate formation. Heat-inactivated LCAT had no effect. Possible mechanisms of the protective effect of LCAT on LDL peroxidative modification are discussed. PMID- 2719986 TI - [Localization of segments, phosphorylated by Ca-phospolipid-dependent protein kinase in smooth muscle caldesmon]. AB - Phosphorylation of caldesmon from duck gizzard by Ca-phospholipid-dependent protein kinase was investigated. Ca-phospholipid-dependent protein kinase transfers about 3.5 moles of phosphate per mole of caldesmon (140 kDa). Tropomyosin does not affect, while calmodulin strongly inhibits the phosphorylation of caldesmon by Ca-phospholipid-dependent protein kinase. Data from one-dimensional peptide mapping suggest that the sites phosphorylated by the enzyme are located in fragments with apparent molecular weights of 43 and 35 kDa, which are supposed to be located in the vicinity of N- or C-termini of the protein molecule and involved in the caldesmon interaction with actin and calmodulin. PMID- 2719987 TI - [Effect of phosphorylation of light chain myosin and Ca2+ on the conformation of F-actin during skeletal muscle contraction]. AB - The dependence of polarized fluorescence of rhodaminylphalloin specifically bound to F-actin and the tension developed by a fiber upon phosphorylation of myosin (18.5 kD) light chains as well as on the concentration of free Ca2+ was observed during the contraction of glycerinated rabbit skeletal muscle fibers. Still greater changes in the polarized fluorescence and higher values of tension were recorded for fibers with phosphorylated light chains at low (0.6 microM) Ca2+ concentrations as well as for those with dephosphorylated light chains at high (10 microM) Ca2+ concentrations. It is concluded that phosphorylation of myosin light chains modulates skeletal muscle contraction. The mechanisms of modulation involve conformational changes in F-actin. PMID- 2719988 TI - [Oxidation of orcinol by ceruloplasmin and mixed-ligand copper complexes]. AB - Unable to oxidize orcinol (3,5-dihydroxytoluene) under conventional conditions, ceruloplasmin (Cp) catalyzes its oxidation when superoxide radicals are injected into the solution with the aid of a high-voltage generator. The O2-. to oxidized orcinol ratio in solution is close to 2:1. The concentration of hydrogen peroxide, which is the product of the Cp-catalyzed dismutase reaction, is about half that of O2-. No slower than by the native enzyme, orcinol in the presence of O2-. is oxidized by Cp depleted of all its type 2 coppers and partly of type 1 Cu2+. Copper complexes with oxalate and pyrophosphate are able to oxidize orcinol under aerobic conditions, one molecule of oxygen being consumed per each oxidized molecule of orcinol. Both the oxidation of orcinol by Cp and by copper complexes are inhibited by cyanide. Orcinol oxidation seems to be caused by singlet oxygen produced in the Cp-catalyzed dismutase reaction. PMID- 2719989 TI - [Octameric mitochondrial and dimeric cytoplasmic creatine kinase. The number of subunits, participating in catalysis]. AB - It was found that in the octameric form of mitochondrial creatine kinase (Mr = 340 kD), only 52% of active centers bind Mg-ADP into a E-Mg-ADP-creatine complex with the dissociation constant, K(Cr)ADP, of 0.105 mM, which is close to the Km value for the enzyme (0.072 mM). In the dimeric form of cytoplasmic creatine kinase (Mr = 82 kD), 100% of active centers bind Mg--ADP; the K(Cr)ADP value (0.11 mM) is close to the Km value for the given enzyme preparation (0.083 mM). All active centers of rabbit muscle cytoplasmic creatine kinase were shown to form an analog of the transition state complex (ATSC) - E-Mg-ADP-NO3- -creatine. The constant for Mg-ADP dissociation from ATSC is identical for all centers of cytoplasmic creatine kinase and equals to 6.0 microM. The curves for ATSC saturation with Mg-ADP in the presence of iodacetamide for mitochondrial creatine kinase were constructed and computer analyzed. It was shown that in the octameric form of the enzyme only 54 +/- 13% of subunits can form ATSC. The constant for Mg ADP dissociation from ATSC, KATSCADP is equal to 1.9 +/- 0.8 microM. It was concluded that 50% of subunits of the octameric form of mitochondrial creatine kinase are not involved in the catalytic act due to masking of their active centres and their inability to form transition state complexes. A model of regulation of cell supply with high energy compounds, e.g., ATP, creatine phosphate, via association-dissociation of mitochondrial creatine kinase oligomers is proposed. PMID- 2719990 TI - [Dual center binding of cocarcinogens of the phorbol series with a receptor]. AB - A systemic study based on literature data concerning the structure-activity relationships within a set of phorbol derivatives was carried out. Evidence in favour of the existence of two binding sites for phorbol derivatives on the receptor surface was obtained. The diterpenoid cycle binding site and the hydrophobic site for the binding of acyl hydrocarbon chains 12 and 13 were identified. The tumour-promoting effects of phorbol esters are due to their capability to simultaneously interact with the both sites of the receptor. PMID- 2719991 TI - Cholinergic responsiveness of goblet cells during intestinal maturation. AB - In adult rat intestine, cholinergic stimulation accelerates discharge of mucus from crypt, but not villus, goblet cells. It was not known whether goblet cells in fetal or suckling rats are cholinergically sensitive. Rat pups (20 days of gestation to 30 postnatal days) were given subcutaneous injections of carbachol and the intestines were fixed 5 min later. Accelerated mucus secretion was assessed by light microscopy of semithin plastic sections. Goblet cells in ileal and colonic crypts did not show an adult-like response until 20-25 days after birth. Ileal and colonic mucosal explants in vitro showed age-dependent responses identical to those observed in vivo. The onset of cholinergic sensitivity occurred well after the formation of crypts and was always limited to crypt goblet cells. PMID- 2719992 TI - Trace elements in meconium from preterm and full-term infants. AB - Meconium samples from 23 preterm infants (birth weight = 1,097 +/- 359 g; gestational age 29 +/- 3 weeks, mean +/- SD) and 27 full-term infants (3,453 +/- 476 g; 39.5 +/- 1 weeks) were analyzed for zinc, copper, manganese, chromium and iron by atomic absorption spectrometry. Compared to meconium from preterm infants, full-term infants had an elevated (p less than 0.05) total excretion (microgram) of zinc (957 +/- 545 vs. 503 +/- 506), copper (245 +/- 256 vs. 128 +/ 94) and manganese (62 +/- 55 vs. 29 +/- 29), but not iron (190 +/- 147 vs. 332 +/- 532) or chromium (0.4 +/- 0.19 vs. 0.75 +/- 1.0). Two preterm infants had high losses (1.5 and 2 mg) of iron in their meconium. Zinc, copper and manganese losses into meconium appear to increase with gestation, whereas iron and chromium losses occur early in gestation and may be reabsorbed by term. PMID- 2719993 TI - Congenital hypothyroidism: decreased growth velocity in the first weeks of life. AB - The growth velocity of 46 infants with congenital hypothyroidism, classified into three groups: athyreosis (n = 12), ectopic (n = 25) and eutopic gland (n = 9), was analyzed. Height, expressed as the standard deviation score (SDS), was measured at birth, at diagnosis and 2, 4, and 8 weeks after initiation of therapy. Bone age was retarded at birth and at diagnosis, epiphyseal surfaces of the knee were correlated with serum T4 values. By contrast, height (mean +/- SD) at birth was normal (0.3 +/- 0.8 SDS) with identical distribution among the three subgroups. Growth velocity was decreased during the first weeks of life: height at diagnosis was -0.1 +/- 0.6 SDS, a value significantly different from size at birth (p less than 0.02). After therapy was started, a continuous decline in growth velocity was observed, reaching -0.2 +/- 0.7 and -0.2 +/- 0.6 SDS, respectively, at 2 and 4 weeks of therapy (p less than 0.01 vs. size at birth). Growth retardation was correlated with the degree of thyroid deficiency. Mean height after 2 weeks of therapy was at -0.6, -0.1, 0.1 SDS in patients with athyreosis, ectopic and eutopic gland, respectively. Catch-up growth occurred thereafter, and the mean height reached 0.3 SDS at 12 weeks for the entire group. A correlation between the decrease in growth velocity and T4 levels at diagnosis was found (p less than 0.05). The normal size at birth and the decreased growth rate observed at diagnosis seem to indicate that growth becomes thyroid hormone dependent immediately after birth. PMID- 2719994 TI - Free tryptophan decrease in jaundiced newborn infants during phototherapy. AB - Tryptophan and nonesterified fatty acids (NEFA) are bound to serum albumin. NEFA displace tryptophan from their binding sites. Since NEFA decrease during phototherapy, we examined reciprocal variations of NEFA, total and free tryptophan in jaundiced newborn infants during phototherapy. After 24 h of phototherapy, we noticed a significant decrease of both NEFA and free tryptophan (p less than 0.001). Free tryptophan variations might affect the synthesis of cerebral neutrotransmitter 5-hydroxytryptamine, which depends on the passing of free tryptophan through the blood-brain barrier. PMID- 2719995 TI - Posttransfusion hemoglobinuria and myoglobinuria in neonates. AB - Posttransfusion positive dipsticks for occult blood do not differentiate hemoglobinuria from myoglobinuria, relatively common events in infants admitted to the neonatal intensive care unit. We studied posttransfusion plasma and urine hemoglobin and myoglobin in relation to occult blood positivity in the urine dipsticks, in 48 consecutive transfusions with packed RBC (28 neonates, birth weight 850-3,700 g, postnatal age 3-167 days). Urine dipsticks show a low sensitivity for detecting hemoglobin and also undervalue myoglobin, both possible in different amounts in the plasma and urine of ill neonates. However, posttransfusion occult blood positive urine dipsticks due to myoglobinuria are present in 10% of transfused neonates. PMID- 2719996 TI - Influence of adrenalectomy on the development of the neonatal thymus in the rat. AB - Adrenalectomy of 1-, 6-, 11- and 16-day-old male and female rats did not cause any changes in the weight of thymus 5 days later. Adrenalectomy on days 21, 26, 31 and 81 of age induced a significant hypertrophy of the thymus 5 days later. These results indicate that after about the time of weaning, the thymus is under some inhibitory regulation by the adrenal gland. PMID- 2719997 TI - Morphological changes in the placentas of smoking mothers: a histomorphometric study. AB - The morphological changes in the functional structure of placentas from women who smoke cigarettes during pregnancy have been investigated by quantitative, light microscopic techniques. It has been demonstrated that the placentas of the smoking mothers were morphologically very similar to the placentas of the nonsmokers. The results only showed a tendency for the placentas in the study group to contain proportionally more nonparenchymal and less parenchymal tissue than the control group, mainly in terms of a relative reduction in the intervillous space volume and peripheral villous mass and surface area. The findings of this study support the hypothesis that the perinatal morbidity associated with cigarette smoking during pregnancy is probably more related to the ischemic and/or toxic effects of several compounds in tobacco smoke, partly on placental function and also directly on the fetus, than to significant alterations in the functional structure of the placenta. PMID- 2719998 TI - Effects of early postnatal undernutrition on brainstem auditory evoked potentials in weanling rats. AB - The effect of early postnatal undernutrition on the development of brainstem auditory evoked potentials (BAEPs) was examined using rats during the weanling period. Undernutrition was achieved by separating the suckling rats from the mother for 24 h every other day from 1 day through 10 days of age (group 1) or from 1 day through 14 days of age (group 2). Both groups were rehabilitated nutritionally after these periods. The littermates which were not separated from the mother were used as well-fed control. At 14 days of age, wave IV of BAEPs was detected in 44% of group 1 and in 69% of group 2, where it was detected in all control rats. Peak latency of wave IV and I-IV interpeak latency (IPL) of group 2 rats were significantly longer than those in control rats from 14 through 22 days of age. Similarly, those of group 1 rats were significantly longer than those in control rats at 14 and 18 days of age. At 33 days of age, there were no significant differences in terms of peak latencies (waves I, III and IV) and IPLs (I-III and I-IV) between both the undernourished groups and the control group. These results indicate that early postnatal undernutrition delays the development of BAEPs in rats transiently, and nutritional rehabilitation can make the group 'catch up' on BAEPs. PMID- 2719999 TI - Cerebral blood flow and metabolism in fasting neonatal piglets. AB - Cerebral blood flow and cerebral metabolism were studied in 8 fasting neonatal piglets. Cerebral blood flow was not significantly different (p greater than 0.1) at 24 h (75.0 +/- 30.7 ml/min/100 g) and 48 h (74.2 +/- 32.3 ml/min/100 g) of age. Blood glucose concentration was lower in 48-hour-old fasted piglets (1.27 +/ 0.60 mmol/l) in comparison with 24-hour-old fasted animals (2.90 +/- 0.52 mmol/l), and cerebral glucose utilisation rate was also reduced in the 48-hour old piglets (17.6 +/- 6.0 mumol/min/100 g at 48 h, 34.2 +/- 12.2 mumol/min/100 g at 24 h). Blood lactate concentration and cerebral lactate utilisation rate were not significantly different at 24 and 48 h of age. Brain lactate utilisation accounted for approximately 10% of cerebral oxygen utilisation at 48 h in fasted piglets. Cerebral glucose and lactate utilisation at 48 h accounted for approximately 66% of cerebral oxygen uptake, indicating that other substrates make a major contribution to cerebral metabolic requirements in fasting neonatal piglets. PMID- 2720000 TI - Sex and the cerebral cortex. PMID- 2720001 TI - Folate, B12, and life course of depressive illness. AB - Forty-four consecutive, unmedicated outpatients with a major depressive disorder were evaluated to determine the relationships in life course, severity of depressive illness, and serum folate and B12 levels. Duration of current episode was significantly inversely correlated with folate levels. Age at onset of illness was significantly correlated with B12. In a subgroup of recurrent depressives, current age and age at onset of depressive illness were positively correlated with folate. The findings are discussed in light of the current hypotheses regarding the association of folate and mood. PMID- 2720002 TI - Direct comparison of urinary free cortisol excretion in patients with depression and panic disorder. AB - Urinary free cortisol (UFC) excretion in 31 patients with major depression is directly compared to UFC levels in 65 patients with panic disorder and 36 controls. Patients with depression demonstrated significantly higher UFC excretion [43 +/- 37 micrograms/g creatinine (cr)] than patients with panic disorder (29 +/- 13 micrograms/g-cr) or controls (22 +/- 10 micrograms/g-cr) (F = 8.5, df = 129, p less than 0.001). Panic patients with a secondary depression (35 +/- 17 micrograms/g-cr) or those with agoraphobia (34 +/- 14 micrograms/g-cr) had UFC levels that were in-between patients with primary major depression and panic patients without these complications (25 +/- 11 micrograms/g-cr). These findings support the hypothesis that patients with major depression, whether primary or secondary, and those with agoraphobia excrete more UFC than patients with uncomplicated panic disorder. This occurs despite the fact that panic disorder might also be expected to raise the stress-responsive hormone cortisol. PMID- 2720003 TI - Specificity of the salivary cortisol dexamethasone suppression test across psychiatric diagnoses. AB - One hundred forty-eight psychiatric inpatients, 12 outpatients, and 17 normal controls were given the 1.0-mg overnight Dexamethasone Suppression Test (DST), with salivary cortisol concentrations being measured as the dependent variable. Based on the Structured Clinical Interview for DSM-III, the patients were diagnosed as having major depression with melancholia (n = 21), nonmelancholic major depression (n = 50), mania (n = 15), schizophrenia (n = 32), dementia (n = 6), substance dependence/abuse n = 18), and miscellaneous (n = 18). Neither the melancholic major depressives nor the entire group of major depressives had significantly higher salivary cortisol pre- or postdexamethasone as compared with all the other patients combined, nor did the melancholic patients have significantly higher cortisol than the nonmelancholic depressives. The inpatients as a group had significantly higher pre- and postdexamethasone cortisol values than the normal controls; cortisol values for the outpatients were intermediate between these two groups. Illness severity (in the depressives), length of time in hospital before the DST, and medication regimen were all unrelated to DST outcome. Thus, in this study, the salivary cortisol DST showed little clinical utility in discriminating major depressives with and without melancholia from other patients with a broad range of psychiatric diagnoses. The test did distinguish between hospitalized psychiatric patients and normal control subjects and between depressed inpatients and depressed outpatients, indicating that hospitalization-related variables contributed to DST outcome. PMID- 2720004 TI - Cerebral atrophy in bulimia. AB - The extent of cerebral atrophy in 8 consecutively chosen unmedicated bulimics and 8 normal controls was determined by magnetic resonance imaging. There was no history of anorexia nervosa or alcoholism in either group. Measures obtained included the ratio of cerebral to cranial area at the midsagittal section, as well as maximum ventricle/brain ratio in the axial plane. Sagittal cerebral/cranial ratio was significantly less in the bulimic group than in controls [0.82 +/- 0.04 (SD) versus 0.90 +/- 0.03, Z = -2.74, p = 0.006, two tailed Mann-Whitney U-test], whereas ventricle/brain ratio was not significantly different between groups. Implications for the occurrence of cortical atrophy in normal-weight bulimics, as well as for the relative absence of ventricular enlargement in these patients, are discussed. PMID- 2720005 TI - Subchronic methamphetamine treatment enhances methamphetamine- or cocaine-induced dopamine efflux in vivo. AB - Intracerebral dialysis was used to study the mechanism underlying behavioral sensitization. Rats were divided into two groups: a control group that received intraperitoneal injections of saline and an experimental group that was given methamphetamine (MAP) (4 mg/kg) once a day for 14 days. Seven days after the last injection, dopamine (DA) and its metabolites were measured in striatal dialysates obtained from awake freely moving rats. A challenge injection of MAP (4 mg/kg) caused a marked increase in the extracellular concentrations of DA, and the extent of the increase was significantly greater in MAP-pretreated rats than in the saline-pretreated controls. A challenge injection of cocaine (20 mg/kg) also caused a significantly greater increase in extracellular DA levels in MAP pretreated rats than in saline-pretreated rats. These results suggest that an enhancement in striatal DA efflux may play an important role in MAP-induced behavioral sensitization and cross-sensitization to cocaine. PMID- 2720006 TI - Deficit in cognitive shifting ability in patients with obsessive-compulsive disorder. AB - Reports on cognitive test deficits in patients with obsessive-compulsive disorders and interpretations of the underlying dysfunction have been conflicting. In the present study, 15 obsessive-compulsive patients were compared with 15 matched normal controls on three types of test sensitive to: spatial ability, ability to shift cognitive set, and combinations of both. Performance deficits as compared with controls were shown in Block Design, the Short Wisconsin Card Sort, the Word Fluency Test, and on the Money Road Map Test. No deficits were present on a number of other measures. The pattern of results is interpreted partly as revealing deficits in ability to shift cognitive set, more particularly with nonverbal material. PMID- 2720007 TI - Recurrent neuroleptic malignant syndrome due to haloperidol and amantadine. PMID- 2720008 TI - Dawn and dusk simulation as a therapeutic intervention. PMID- 2720009 TI - Folic acid and cognition in the elderly depressed. PMID- 2720010 TI - Morphometry of the entorhinal cortex. PMID- 2720011 TI - Nocturnal panic in depression. PMID- 2720012 TI - Middle latency evoked potentials in obsessive-compulsive disorder. PMID- 2720013 TI - The biology of personality. Society of Biological Psychiatry, forty-fourth annual convention & scientific program. May 4-8, 1989, San Francisco, California. Abstracts. PMID- 2720014 TI - Visual evoked potentials in dementia: a meta-analysis and empirical study of Alzheimer's disease patients. AB - A meta-analytic review of flash and pattern reversal visual evoked potential research indicates that elderly demented patients have longer P100 latencies than age-matched control subjects. In the present empirical research, patients with research diagnoses of probable Alzheimer's disease were compared with sex- and age-matched control subjects using P100 latencies of visual evoked potentials (VEP) elicited by flash and pattern reversal. As compared to control subjects, Alzheimer's disease patients showed significantly longer P100 latencies of the VEP elicited by pattern reversal; the flash P100 only marginally distinguished them. These findings are discussed within the context of VEP recording practices, patient selection, sex and age matching of control subjects, and the visual system. PMID- 2720015 TI - Stress lymphocytes and the dexamethasone suppression test in major depressive disorders. AB - The Dexamethasone Suppression Test (DST) was administered to 12 patients with major depression and 4 normal controls. Peripheral blood smears were collected before and after the DST, and atypical lymphocytes were counted. Six patients who were nonsuppressors on the DST had a high percentage of so-called stress lymphocytes (Downey type II atypical lymphocytes). Five of six subjects with normal suppressor responses had low stress lymphocyte counts or no such cells (p less than 0.01). The findings suggest that the stress lymphocyte response might be related to nonsuppression on the DST in major depression. PMID- 2720016 TI - Psychobiological effects of carbohydrate- and protein-rich meals in patients with seasonal affective disorder and normal controls. AB - Patients with seasonal affective disorder (SAD) frequently report carbohydrate craving and note that carbohydrate ingestion energizes them. Bright artificial light has been shown to reverse the symptoms of SAD, including carbohydrate craving. In this study, 16 depressed SAD patients and 16 matched controls were fed two different isocaloric meals, one rich in protein and one rich in carbohydrates, in a crossover design. Although their biochemical response in terms of plasma large neutral amino acid concentrations was identical, SAD patients reported activation following carbohydrate ingestion, whereas normal controls reported sedation. Marked ordering effects on psychological parameters were noted, suggesting that order should be taken into account as a methodological consideration in meal studies. PMID- 2720017 TI - Impulsivity, aggression, and neuroendocrine responses to serotonergic stimulation in substance abusers. AB - Alterations in the activity of central serotonergic systems have been implicated in impulsive and aggressive behavior. We examined the neuroendocrine and psychological responses of 24 substance users with differing levels of aggressiveness and impulsivity to the oral administration of an indirect serotonin agonist fenfluramine (60 mg) or placebo given in a double-blind crossover design. All subjects were volunteers on a closed research ward and were abstinent from drugs for a minimum of 5 days. Baseline plasma prolactin (PRL) levels were greater in the groups with higher levels of self-reported aggressiveness and impulsivity. When adjusted for the baseline, PRL and cortisol responses 180 min after fenfluramine administration were significantly elevated in subjects with higher levels of aggressiveness and impulsivity. Peak cortisol levels were correlated with impulsivity. PRL and cortisol responses to fenfluramine were more strongly correlated with impulsivity than aggressiveness. Also, the more impulsive subjects reported a decrease in subjective states of depression, hostility and anxiety after drug treatment. These data further support the hypothesis of altered serotonergic activity in aggressive and impulsive behaviors. PMID- 2720018 TI - The significance of HPA axis disturbance in panic disorder. AB - Agoraphobic and panic disorder patients underwent 1-mg Dexamethasone Suppression Tests (DST) before, during, and after an 8-week trial of diazepam, alprazolam, or placebo. Previously described, never-ill controls underwent similar testing. At baseline, 21 of 82 (25.6%) panic disorder and 5 of 38 (13.2%) controls were nonsuppressors. This difference grew more marked with multiple testing over a 2 month period; 18 of 44 (40.9%) panic disorder patients were nonsuppressors on at least 1 of 3 tests compared with only 5 of 35 (14.3%) controls (p = 0.006). DST results were related to severity, but not to the presence or absence, of depressive syndromes. Control for plasma dexamethasone levels left highly significant differences in postdexamethasone cortisol across diagnostic groups. Neither DST results nor plasma dexamethasone levels changed in concert with clinical change, and type of treatment had little differential effect on these measures. Nor did DST results predict subsequent course when active treatment was extended by 6 months. However, DST results during the initial 8 weeks of treatment were strongly related to relapse when medications were tapered, even though this occurred 6 months after the last DST. PMID- 2720019 TI - Remedial life-styles. PMID- 2720020 TI - Behavioral and biochemical effects of intranigral injection of phospholipase-A2. PMID- 2720021 TI - Differential sensitivity to dexamethasone suppression in an animal model of the DST. AB - The present study reports the feedback suppression of basal and stimulated corticosterone secretion in rats by low doses of dexamethasone (DEX). DEX suppression of basal secretion 6 hr after administration was observed with doses as low as 0.005 mg/kg. The lowest dose capable of suppressing basal corticosterone levels for 24 hr with a return to normal values by 36 hr was established to be 0.025 mg/kg. The ability of DEX to decrease corticosterone responses to physostigmine, morphine, immobilization, and ether stress was determined. Although the magnitude of the rise in corticosterone did not differ significantly among these evocative stimuli, the degree to which DEX attenuated these responses varied. The response to morphine was completely prevented by 0.025 mg/kg and the rises following ether or immobilization were decreased significantly. In contrast, the response to physostigmine was not affected by DEX. With a higher dose of DEX (0.25 mg/kg), responses to morphine, ether, and immobilization were completely eliminated, but the response to physostigmine was only attenuated partway. The time course of the suppression in basal levels, the attenuation of several stimuli for corticosterone secretion, and the "escape" of physostigmine-induced corticosterone secretion resemble the clinical Dexamethasone Suppression Test of endogenous depression and suggest that this test might be useful in the study of animal models of depression. PMID- 2720022 TI - Clinical, psychophysiological, and neurological characteristics of volunteers with impaired smooth pursuit eye movements. AB - Two hundred eighty-five volunteers from a community college were screened on campus for accuracy of their smooth pursuit eye movements (SPEM) by electrooculograph (EOG). Those volunteers with the least and the most accurate SPEM were recalled to the laboratory for a comprehensive evaluation of clinical and demographic characteristics, family history, neurological status, and psychophysiological and biological measures, including SPEM [repeat EOG test and infrared (IR) test], an electroencephalogram, auditory and visual evoked potentials, reaction time (RT), the continuous performance task (CPT), platelet monoamine oxidase (MAO), plasma amine oxidase, and dopamine-beta-hydroxylase (DBH). Low-accuracy SPEM was associated with social isolation, inadequate rapport, eccentricity, and a variety of related schizotypal or schizophrenia-like characteristics, but not with generalized psychopathology or other demographic/medical/clinical history variables. Low-accuracy SPEM also was associated with neurological and psychophysiological abnormalities frequently observed in schizophrenic patients. These results suggest that impaired SPEM may reflect an underlying central nervous system dysfunction that is specifically associated with clinical and biological characteristics related to schizophrenia, even in the absence of overt schizophrenia. PMID- 2720023 TI - Free and conjugated plasma homovanillic acid in schizophrenic patients. AB - It has recently been suggested that the plasma level of homovanillic acid (HVA) may provide an index of central dopaminergic activity in humans. Clinical studies have shown that in schizophrenic patients, plasma HVA levels increase with the severity of psychopathology. However, these studies only considered the plasma free HVA fraction whereas investigations on conjugated HVA in humans are sparse and results remain controversial. The aim of this study was to measure both plasma free and conjugated HVA in healthy volunteers and drug-free schizophrenic patients. The mean values and the ranges of plasma free HVA in volunteers and patients were similar to those described in the literature. A substantial and significant increase in plasma free HVA was observed in schizophrenic patients compared with normal subjects. In contrast, plasma conjugated HVA was significatively decreased in schizophrenics. The plasma total HVA was nevertheless higher in schizophrenics compared with controls. No significant correlations were observed between plasma HVA levels and the clinical features of schizophrenic patients rated by various psychiatric scales. These findings suggest that there is an imbalance between plasma free and conjugated HVA in schizophrenic patients, who present an increase in total HVA when compared with controls. Paranoid schizophrenic patients, who present mainly positive symptoms, show the most marked plasma free/conjugated HVA imbalance. PMID- 2720024 TI - Autofluorescence of the porcine endometrium during early pregnancy. AB - Uteri recovered from cyclic gilts (n = 5) on Days 15-19 and pregnant animals (n = 34) on Days 13-40 were opened and examined under UV light. A line of greenish fluorescence was present in the mesometrial region in contact with embryonic membranes at Day 13. Small patches of reddish fluorescence subsequently appeared on the uterine mucosa near the embryonic disc, and these increased in intensity and size until they encompassed the entire area of contact between each conceptus and the endometrium, for lengths of about 20 cm, by Day 29. Fluorescence then diminished gradually and was almost totally absent by Day 40. Three additional gilts were unilaterally hysterectomized on Day 15 and treated with Evans blue dye 10 min before removal of the second uterine horn. Both horns were opened and compared under UV light, but no difference in the pattern of fluorescence could be detected. All fluorescence was associated with uterine rather than conceptus tissues. The occurrence of autofluorescence in uteri of pregnant pigs precludes use of Evans blue dye as an indicator of vascular permeability. PMID- 2720025 TI - Rabbit placental-conditioned medium stimulates progesterone accumulation by granulosa-lutein cells in culture: preliminary characterization of a placental luteotropic hormone. AB - The rabbit fetal placenta plays an important physiological role in luteal maintenance in pregnancy, probably via the secretion of an unidentified placental "luteotropin." The objective of these studies was to examine conditioned medium from fetal placental-tissue incubations (FPI) for the presence of placental luteotropic hormones/factors, using the stimulation of progesterone accumulation by rabbit granulosa-lutein cells in culture, as an in vitro luteotropic bioassay. Progesterone accumulation by rabbit granulosa-lutein cells (during 5 days of culture) was increased (compared with controls), 1.5-fold by 10(-8) M estradiol 17 beta (E2) and 11.5-fold by 100 ng/ml luteinizing hormone (oLH). FPI stimulated progesterone accumulation (approximately 3-fold) and this was further increased in the presence of E2 (FPI + E2; approximately 6-fold). Luteotropic bioactivity in FPI (+ E2) was retained after dialysis (6000-8000 MW cutoff; 7.8-fold) and heating (90-95 degrees C for 1 h; 7.5-fold), but was destroyed after incubation with trypsin (1 mg/ml, 1 h at 37 degrees C; 0.9-fold). Media conditioned with skeletal muscle (1.2-fold), heart (1.6-fold), liver (1.5-fold), and uterus (0.5 fold) and 5-10% serum (less than 1-fold), from pseudopregnant rabbits, had little or no luteotropic bioactivity. These data indicate that FPI contains a luteotropic hormone/factor that is probably a heat-stable, trypsin-sensitive, protein/peptide of greater than 6000-8000 MW that acts in synergy with E2 to promote granulosa-lutein cell steroidogenesis. This placental hormone/factor is a good candidate for the elusive rabbit placental luteotropin. PMID- 2720026 TI - The vaginal epithelium of immature rats metabolizes androgens through an aromatase-like reaction: changes during the time of puberty. AB - Testosterone (T) at physiological levels can induce precocious vaginal opening without advancing the time of first ovulation. The present experiments were undertaken to test the hypothesis that the vaginal epithelium has the ability to aromatize androgens to estrogens. Using standardized conditions, we estimated aromatase activity using both 3H2O-release from [1 beta-3H]T and thin-layer chromatographic (TLC) characterization of estrogen formed after incubations with [1,2,6,7-3H] testosterone. Vaginal aromatase-like activity, as measured by the 3H2O-release assay, increased between the juvenile and peripubertal phases of development and remained elevated throughout puberty. In contrast, ovarian aromatase increased markedly during the early proestrus (EP) and late (first) proestrus (LP) phases of puberty but declined after the first ovulation. Vaginal aromatase-like activity was induced in vivo by either stimulation of ovarian steroidogenesis with pregnant mare's serum gonadotropin (PMSG), or by producing EP levels of serum T via testosterone-containing Silastic capsules. 4-Hydroxy androstenedione, a potent aromatase inhibitor, decreased both vaginal and ovarian aromatase activity in vitro in a concentration-dependent manner. Although the principal product of ovarian aromatase derived from [1,2,6,7-3H] T was identified as estradiol (E2), the identity of the vaginal estrogen product could not be firmly established. The vaginal metabolite comigrated with 16-keto-E2 in two TLC systems before and one TLC system after acetylation but failed to recrystallize as 16-keto-E2 diacetate and failed to co-elute with 16-keto-E2 diacetate on high performance liquid chromatography. This vaginal metabolite does not correspond to any of 13 steroids tested, including 2-hydroxy-E2, and it does not represent a 5 alpha-reduced metabolite of T.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720027 TI - Estrogen receptors in quail brain: a functional relationship to aromatase and aggressiveness. AB - Estradiol (E2) mediates many of the activational effects of testosterone (T) on masculine reproductive and aggressive behaviors. Using Japanese quail (Coturnix coturnix japonica) as an animal model, together with a newly devised procedure for quantifying aggressiveness, we recently showed that aggression is E2 dependent and that individual differences in behavioral intensity are correlated with aromatase in the hypothalamus/preoptic area (HPOA). In this study we characterized estrogen receptors (ER) in quail brain and tested the hypothesis that aromatase in brain regulates T-induced behavioral responsiveness by regulating the quantity of E2 available for receptor binding. Based on standard binding assays and Sephadex LH-20 chromatography, quail brain ER was shown to be estrogen-specific, of high affinity (Kd = 0.88 nM), and of limited capacity with highest concentrations in limbic brain areas (Bmax 23-27 fmoles/gm HPOA). In addition, this ER adhered to DNA-cellulose under activating conditions. The quantitative relationship between aromatization, ER, and aggressiveness was tested in reproductively inactive (nonaggressive) males by treatment with T +/- the aromatase inhibitor 4-hydroxyandrostenedione (OHA). After 5 days, T markedly stimulated aggressiveness, and elevated aromatase and nuclear (occupied) ER in HPOA. Simultaneous treatment with OHA blocked effects on aggressiveness and aromatase, and lowered nuclear ER, but increased cytosolic (empty) ER. Total ER (nuclear plus cytosolic) was higher after T treatment whether or not OHA was administered, suggesting that androgen per se induces ER in quail HPOA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720028 TI - Identification of a major secretory glycoprotein from rat epididymis: interaction with spermatozoa. AB - A polypeptide with molecular mass of 17 kDa has been partially purified and identified as a major secretory glycoprotein in the rat epididymis. It is phosphorylated and contains high mannose-type oligosaccharides with 5 and 6 mannose units predominantly. These sugar residues are sufficiently exposed in the molecule to be released by endo-beta-N-acetylglucosaminidase H without prior denaturation or protease digestion. Specific binding of the glycoprotein to testicular spermatozoa was demonstrated with Ka 0.2 x 10(9) M-1 and 17,200 sites per cell, while no binding to epididymal spermatozoa was detectable. Direct labeling of surface proteins on cauda epididymis spermatozoa revealed the presence of a major band of 16.2 kDa, which may be equivalent to GP17. The interaction of the epididymal secretory protein with sperm suggests a possible role in the maturation process. PMID- 2720029 TI - Spermatogenic cell-somatic cell interactions are required for maintenance of spermatogenic cell glutathione. AB - Sertoli cells play a major role in the regulation of spermatogenic cell energy metabolism and differentiation. This study demonstrates that Sertoli cells are essential for the maintenance of spermatogenic cell glutathione (GSH), an important intracellular reductant and detoxicant. Primary spermatocytes and round spermatids isolated from Xenopus laevis contained 1.5 +/- 0.1 mM GSH, but sperm lacked detectable GSH. During a 5-day culture period, isolated spermatocytes and spermatids lost 80% of the initial GSH (t 1/2 = 55 h). The levels of GSH were unaffected by L-buthionine-SR-sulfoximine (BSO), a selective inhibitor of GSH synthesis. Cultures of testicular lobules and spermatocysts (composed of germ cells and Sertoli cells) depleted of interstitial tissue lost only 30% of their initial GSH in 4.5 days; the GSH levels decreased during treatment with BSO. Spermatogenic cells in cultured testes maintained their GSH levels for 7 days by a BSO-sensitive mechanism. These results demonstrate that the intracellular GSH levels of spermatogenic cells are dependent upon germ cell-somatic cell interactions. Spermatogenic cells were shown to possess gamma-glutamyl transpeptidase, glutathione synthetase, 5-oxoprolinase, and gamma glutamylcysteine synthetase activities. [35S] Cysteine incorporation and distribution as analyzed by high performance liquid chromatography (HPLC) showed that isolated spermatogenic cells are capable of GSH synthesis. The rate of GSH synthesis, however, was insufficient to compensate for GSH turnover. These results demonstrate that production of spermatogenic cell GSH is dependent upon Sertoli cells. To our knowledge, this is the first evidence that interactions between different cell types may be of significance in GSH metabolism. PMID- 2720030 TI - Electron microscopic immunolocalization of seminal vesicle-specific antigen in human seminal vesicle. AB - Seminal vesicle-specific antigen (SVSA) has been shown to be a polymorphic antigen represented by multiple immunoreactive peptides when fresh human semen is probed with monoclonal antibody (MHS-5) on Western blots. Semen samples collected directly into sodium dodecyl sulfate (SDS) demonstrate major immunoreactive peptide bands at 69-71 kDa and 58 kDa as well as a series of peptides of lower molecular mass. As semen liquefies, the higher molecular mass forms of SVSA are transformed into lower molecular mass bands, with 10-13 kDa immunoreactive peptides predominating after 8 h of liquefaction (McGee and Herr, Biol. Reprod. 37:431-439, 1987). In the present study, the 10-13 kDa form of SVSA was purified by preparative electrophoresis from SDS gels and a polyclonal antibody was generated in guinea pigs. Human seminal vesicle was fixed by immersion in combinations of glutaraldehyde and paraformaldehyde and embedded in Araldite or LR Gold. Both the guinea pig polyclonal antibody and the murine monoclonal antibody MHS-5 were employed to localize SVSA in human seminal vesicle by immunoelectron microscopy using Protein-A gold complexes. Gold particles were quantified in various subcellular compartments by a Videoplan computer. With either antibody probe, SVSA was found predominantly in the central electron-dense cores of secretory granules, with no staining evident over the electron lucent halo surrounding the granule core. With preimmune serum, the mean number of gold particles overlying secretory granules was 3/microns2; with polyclonal anti-SVSA, the mean number of particles observed over secretory granules was 182/microns2. This study represents, to our knowledge, the first fine-structural localization of a specific secretory protein to the electron-dense cores of secretory granules in principal cells of the human seminal vesicle. PMID- 2720031 TI - Isolation, characterization and immunocytochemical localization of bovine trophoblast protein-1. AB - Bovine trophoblast protein-1 (bTP-1) was isolated to 90% purity from culture medium of Day 18-20 conceptuses incubated in vitro (in the presence of L [3H]leucine) by a combination of Sephacryl S-200 gel filtration chromatography and O-(diethylaminoethyl) (DEAE) anion-exchange high-performance liquid chromatography (DEAE-HPLC). The radiolabeled protein had an Mr of 21,200 +/- 800 by one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS PAGE) and had three isoelectric variants (pI 5.7-6.5) by two-dimensional SDS PAGE. DEAE-HPLC-enriched bTP-1 cross-reacted with anti-o TP-1 serum on Western blots. A monospecific antiserum against bTP-1 was produced by excising the bTP-1 polypeptide band from preparative SDS-PAGE gels. Antiserum reacted with a single polypeptide with an Mr of 21,200 as determined by Western blotting of SDS-PAGE separated conceptus medium proteins and by immunoprecipitation from L [35S]methionine-labeled medium proteins followed by SDS-PAGE and autoradiography. Bovine trophoblast protein-1 was localized by immunocytochemistry in the cytoplasm of both mono- and binuclear trophectoderm cells of Day 20 bovine conceptuses, indicating that it is a product of the trophoblast. PMID- 2720032 TI - The influence of vasovasostomy on antisperm antibodies in rats. AB - Serum antisperm antibodies were studied in Sprague-Dawley rats after vasectomy and vasovasostomy. Animals received a bilateral vasectomy, a vasectomy followed 3 mo later by vasovasostomy, or sham operations. Blood samples were obtained at 1, 3, 4, and 7 mo, and antisperm antibodies were assayed by an enzyme-linked immunosorbent assay. After vasectomy reversal was performed at 3 mo, antisperm antibodies were significantly higher in rats in the vasovasostomy group at 4 mo than in animals that had a persisting vasectomy or sham operations. At 7 mo, the antisperm antibody level for the vasovasostomy group was approximately double that for the vasectomized rats. Spermatic granulomas occurred in 76% of rats after vasovasostomy. Antisperm antibody levels were higher in vasovasostomized animals with granulomas than in those lacking granulomas. The results suggest that vasovasostomy may stimulate an antibody response to sperm rather than lead to a reduced response, as was anticipated upon removal of the obstruction. Spermatic granulomas may serve as sires for continued antigenic challenge. The observed increase in antisperm antibodies after vasovasostomy in Sprague-Dawley rats may be related to their relatively low immunologic responsiveness to vasectomy, with vasovasostomy serving as a second major immunologic challenge, aided by the formation of an additional granuloma. In the more responsive Lewis strain, we previously observed a rise in antisperm antibodies after the initial vasectomy, with no further increase after vasovasostomy. PMID- 2720033 TI - Ultrastructural observations of human and mouse oocytes treated with cryopreservatives. AB - The effects of the cryopreservative agents dimethylsulfoxide (DMSO) and propanediol (PROH) on mature human and mature mouse oocytes have been examined with transmission electron microscopy. Treatment of CD-1 mouse oocytes and human preovulatory oocytes in a stepwise manner with either DMSO or PROH up to 1.5 M appears to trigger the exocytosis of 70-80% of the cortical granules in all oocytes. Successive stages in premature dehiscence, including a loss in granule electron density, fusion of the granule-limiting membrane with the oolemma, and extrusion of the cortical granule core into the perivitelline space, have been observed in all human oocytes studied. In addition, all human DMSO- and PROH treated oocytes exhibited crypt-like invaginations and clusters of endocytic vesicles that subtend the oolemma. The presence of these crypts and pinocytotic vesicles in treated oocytes may suggest a mechanism for the retrieval of cortical granule membrane that is inserted into the original plasmalemma during exocytosis. The paucity of cortical granules in treated mouse and human oocytes as it potentially relates to an impaired ability to elicit the cortical reaction at fertilization is discussed. PMID- 2720034 TI - Expression of RNAs for calmodulin, actins, and tubulins in rat testis cells. AB - Messenger RNAs encoding calmodulin, alpha- and beta-tubulins, and actins were analyzed in nucleic acid isolated from purified rat testis cell populations. Cell specific patterns were discovered that suggest coordinate regulation of members of different gene families. Genes that are candidates for coordinate regulation include those encoding 1.4 kb calmodulin RNA and 1.8 kb alpha-tubulin RNAs; 1.6 kb calmodulin RNA and a 1.8 kb beta-tubulin RNA; and 1.6 kb actin and 2.1 kb alpha-tubulin RNAs. The steady state level of the 2.2 kb actin RNA(s) varies less than any other RNA analyzed. Actin RNAs of approximately 1.6 kb are observed in fractions enriched for A spermatogonia or round spermatids or cytoplasts shed from elongating spermatids. The level of 1.8 kb alpha-tubulin RNA increases in a fraction enriched for leptotene-zygotene spermatocytes and peaks in pachytene spermatocytes. As the level of this alpha-tubulin RNA species decreases in maturing spermatids a new 2.1 kb alpha-tubulin RNA increases. beta-Tubulin RNAs of 2.7 and 1.8 kb are present in somatic and premeiotic cell fractions. beta Tubulin RNA transcripts of 1.8 kb that increase in pachytene spermatocytes are derived from a different gene than that expressed in premeiotic cells. The major RNA that hybridizes to the chicken calmodulin cDNA is 1.4 kb; it increases during the development of spermatocytes, reaching a maximum level in pachytene spermatocytes before it declines during spermiogenesis. Calmodulin RNAs of 1.6 and 1.0 kb are clearly evident in the round spermatid fraction. These data reveal that mechanisms exist for cell-selective elevation of mRNAs encoding cytoskeletal proteins during rat spermatogenesis. PMID- 2720035 TI - Changes in ovine conceptus and endometrial function following asynchronous embryo transfer or administration of progesterone. AB - The secretory protein profile from conceptuses collected from naturally mated ewes on Days 10, 12, 14, and 16 was characterized by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and fluorography. The presence of the anti-luteolysin ovine trophoblast protein-1 (oTP-1) in culture medium from Day 10 conceptuses was confirmed by fluorography, Western blotting, and radioimmunoassay (RIA). On each of the days studied, oTP-1 was the dominant secretory protein, and was secreted in increasing quantities as pregnancy progressed. In a second experiment, Day 6 embryos were transferred to either Day 6 (SR) or Day 4 (AR) recipients. Three mated ewes (P) received daily injections of 50 mg progesterone on Days 4-9. Controls consisted of 2 groups of pregnant ewes (D8 and D10). Conceptuses and ipsilateral endometrium were collected 4 days following transfer of conceptuses to SR and AR ewes, on Day 10 in P and D10 ewes, and on Day 8 in D8 ewes. Conceptus volume was estimated upon recovery from the uterus. Tissues were cultured with 35S-methionine, and the medium was analyzed for total and trichloroacetic acid-precipitable radiolabeled proteins. Levels of specific endometrial secretory proteins were determined after protein separation by 2D-PAGE and estimation of the radioactivity associated with discrete radiolabeled proteins on fluorographs. The concentration of oTP-1 in conceptus culture medium was estimated by RIA. Thirty endometrial proteins were investigated. All 30 proteins were present in endometrial cultures from SR, AR, D10, and P ewes, but 13 proteins were absent from D8 ewes. Levels of three proteins were higher in AR compared to D8 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720036 TI - Collagen coatings as biological sealants for textile arterial prostheses. AB - Two collagen-coated grafts were studied: Hemashield (bovine collagen cross-linked with formaldehyde vapours and softened by exposure to glycerol) and Tascon (collagen fibres cross-linked with glutaraldehyde solution). The weight of the coating was 310 +/- 5 mg/g for Hemashield and 45 +/- 2.5 mg/g for Tascon. However, notwithstanding these differences, both coatings were efficient in making the walls of the grafts impervious to blood. The water permeabilities for the Hemashield and the Tascon were 8.7 and 5.9 ml.min-1.cm-2 at 120 mmHg respectively. The Hemashield collagen coating was rapidly eroded in vitro (4 h) after exposure to buffer, trypsin or pancreatin solutions, whereas the Tascon collagen coating remained well preserved after 7 d incubation. Both coatings were safe and did not interfere with the physical properties of the graft which was used as a skeleton. The healing properties of the Hemashield were similar to that observed with preclotted polyester prostheses, except in the early hours following graft implantation. On the other hand, the absence of erosion in the coating of the Tascon seemed to contribute to early antithrombogenicity. It also induced marked inflammatory reactions in the surrounding tissues and thus the healing appeared to be delayed. PMID- 2720037 TI - Wear of ion-implanted pure titanium against UHMWPE. AB - Six specimens were manufactured from commercially pure titanium (grade IV) to resemble femoral head prostheses, and five of them ion implanted to increase the wear properties. Together with three cobalt-chrome controls they were run for one million cycles on a 10-station joint simulator. For the first time both the polymer and metallic wear were quantified in the same study. The purpose of the investigation was to estimate the potential for using commercially pure titanium as a bearing surface against ultrahigh-molecular-weight polyethylene for total joint application. It was concluded that the wear properties of titanium were improved by ion implantation, and that these positive effects could probably be enhanced with development of a better polishing technique, and by finding methods of extending the penetration depth of the nitrogen ions. PMID- 2720038 TI - Torsional moment to failure for carbon fibre polysulphone expandable rivets as compared with stainless steel screws for carbon fibre-reinforced epoxy fracture plate fixation. AB - A method of securing carbon fibre-reinforced epoxy bone plates with carbon fibre polysulphone expanding rivets was investigated. Six carbon fibre-reinforced epoxy bone plates were secured to rods with carbon fibre polysulphone rivets and six were secured with standard cortical stainless steel screws. These constructions were then subjected to pure torsional load to failure. The carbon fibre expandable rivets failed at a greater torsional moment. PMID- 2720039 TI - Contribution of hydroxyapatite to the tensile strength of the isobutyl-2 cyanoacrylate-bone bond. AB - The bonding strength between bone and alpha-2-cyanoacrylate polymers, with or without the addition of powdered hydroxyapatite, was determined. The tensile strength of a bone-cyanoacrylate bond was measured for each polymer: 4.31 +/- 0.88 MPa (methyl-), 5.74 +/- 0.62 MPa (ethyl-), and 8.33 +/- 0.41 MPa (isobutyl ). The tensile strength of the isobutyl-2-cyanoacrylate bond increased to 12.03 +/- 0.72 MPa with the addition of 10% (w/v) hydroxyapatite before decreasing to 7.89 +/- 0.58 MPa on addition of 15% (w/v) hydroxyapatite. An optimal concentration of hydroxyapatite significantly increased the tensile strength of a bone-cyanocacrylate bond in vitro in a manner comparable to reinforced bone replacement materials. PMID- 2720040 TI - Electrical conduction in some nucleic acid base complexes with acridine orange dye: study of localized levels. AB - Semiconduction activation energies of adenine, guanine, thymine and uracil complexes with acridine orange dye at various dye concentrations were measured in both Ohmic and space charge limited (SCL) current regimes. The behaviour of the complexes is non-extrinsic at high dye concentrations but extrinsic at low dye concentrations. Dominant electron and hole levels are shown to depend also on dye concentration. Various transport parameters have been evaluated. PMID- 2720041 TI - Gel content determination in cross-linked polyethylene. AB - Gel content is the dominating parameter which affects properties and prescribes the behaviour of a given type of cross-linked polyethylene. Researchers have determined the gel content by several methods based on solvent extraction, a process which dissolves the linear thermoplastic polymer but swells only the cross-linked fraction. In this work, a comparative evaluation was made using model samples to select the most effective solvents and the suitable extraction conditions leading to increased reliability. PMID- 2720042 TI - X-ray study and microhardness data of some dental enamel species. AB - X-ray analysis and microhardness of dental enamel of some human and animal species were investigated. Human enamel is composed mainly of hydroxyapatite and fluorapatite together with traces of delta calcium metaphosphate. Prominant apatite phases with a small amount of basic calcium carbonate are also present in the enamel of dog canine teeth. Calcite forms the main crystalline components of rat enamel with some hydroxyapatite. A relatively higher hardness value was detected for enamels of human incisors than for that of rats; the dog enamel was, however, apparently harder than that of the human variety. The hardness values generally decreased with increasing the applied load. The correlation between the phase analysis of the enamel materials and their microhardness values and the dependence of this property on the load applied are discussed. PMID- 2720043 TI - Characterization of the inner surface of tubular substrates by contact angle measurement. AB - A new method for the direct measurement of the contact angle on the inner surface of tubular substrates is described. It is shown that the measured contact angles are in good accordance with those obtained on flat surfaces. PMID- 2720044 TI - Hydrogel coating of urinary catheters. PMID- 2720045 TI - [Comparative study of unidirectional transducers for invasive blood pressure monitoring]. AB - This paper reports on the results of a study in which the offset drift, sensitivity error and drift, as well as the linearity error of six DPT's were investigated under normal ambient conditions and varying conditions of temperature, light, operating time and variation of supply voltage. In addition, the dynamic response, and the influence of storage at extreme temperatures, and resterilisation, was examined. The electrical and mechanical safety/reliability of DPT's was also investigated. The results obtained are compared. PMID- 2720046 TI - [Power curves in rhinomanometry]. AB - In diagnostic evaluation of the nose and allergology, the transnasal pressure delta p and the volume flow V is measured during breathing. It is shown that information is lost when measurements are represented form of a rhinomanogram. It is proposed using the measurements to derive the power during breathing and the mean volume flow of a breathing cycle. At a variable amplitude of breathing, the respiration power can be represented as a function of the mean air flow. For this purpose the software of available rhinomanometers merely has to be modified. PMID- 2720047 TI - [An Experiment to calculate the theoretical temperature at the drill-cortical bone interface]. AB - To date, analysis of temperature in the drill area of cortical bone have been limited to measurements with thermocouple systems at a certain distance from the drill hole. Many authors equate this temperature measurement with the drill- cortical bone interface temperature. In order show that there is a temperature difference, a drill hole was simulated with the aid of the "Finite Element Method". The interface temperature was calculated by the energy distribution. It was shown, that for "dry" and "watercooled" drilling, the drill hole temperature was 13 degrees C higher than the temperature measured with the thermocouple systems at a distance 0.5 mm of from the drill hole. In particular when using "watercooled" drills for bone and dental surgery, the temperature may be higher than the bone damage limit of 44 degrees C for lengthy and 50 degrees C for brief drilling. PMID- 2720048 TI - Assessing the significance of the correlation between two spatial processes. AB - Modified tests of association based on the correlation coefficient or the covariance between two spatially autocorrelated processes are presented. These tests can be used both for lattice and nonlattice data. They are based on the evaluation of an effective sample size that takes into account the spatial structure. For positively autocorrelated processes, the effective sample size is reduced. A method for evaluating this reduction via an approximation of the variance of the correlation coefficient is developed. The performance of the tests is assessed by Monte Carlo simulations. The method is illustrated by examples from geographical epidemiology. PMID- 2720049 TI - Score tests for homogeneity of regression effect in the proportional hazards model. AB - A simple model, containing the proportional hazards regression model as a special case, is presented. The purpose of the model is to provide a framework in which specific alternatives to the proportional hazards assumption may be tested. Rank invariant score tests for linear, quadratic, or exponential trends can, for instance, all be undertaken within this framework. In the case of the two-sample problem the required calculations are shown to take a particularly simple form. Special consideration is given to the two-sample case in which there is an inversion of the regression effect, i.e., where the hazard functions cross at some given point. Both of the motivating examples are concerned with this problem. Computational aspects are relatively straightforward and some discussion on this is provided. PMID- 2720050 TI - A Monte Carlo investigation of homogeneity tests of the odds ratio under various sample size configurations. AB - Epidemiologic data for case-control studies are often summarized into K 2 x 2 tables. Given a fixed number of cases and controls, the degree of sparseness in the data depends on the number of strata, K. The effect of increasing stratification on size and power of seven tests of homogeneity of the odds ratio is studied using Monte Carlo methods. In all the designs considered here, the numbers of cases and controls per stratum are the same. Considering both size and power in non-sparse-data settings, we recommend the Breslow-Day statistic (1980, Statistical Methods in Cancer Research, 1. The Analysis of Case-Control Studies, p. 142; Lyon: International Agency for Research on Cancer) for general use. In sparse-data settings the T4 statistic of Liang and Self (1985, Biometrika 72, 353 358) performs the best when all tables, regardless of sample size, have odds ratios generated from the same distribution. In sparse-data settings characterized by a large table with an odds ratio of 1 and many small tables with odds ratios greater than 1, the T5 statistic of Liang and Self (1985) performs the best. One of the most important results of this study is the generally low power for all homogeneity tests especially when the data are sparse. PMID- 2720051 TI - Generalized Mantel-Haenszel estimators for K 2 x J tables. AB - Mickey and Elashoff (1985, Biometrics 41, 623-635) gave an extension of Mantel Haenszel estimation to log-linear models for 2 x J x K tables. Their extension yields two generalizations of the Mantel-Haenszel odds ratio estimator to K 2 x J tables. This paper provides variance and covariance estimators for these generalized Mantel-Haenszel estimators that are dually consistent (i.e., consistent in both large strata and sparse data), and presents comparisons of the efficiency of the generalized Mantel-Haenszel estimators. PMID- 2720052 TI - Analysis of multiple tumor data from a rodent carcinogenicity experiment. AB - Rodent tumorigenicity experiments are conducted to determine the safety of substances for human exposure. The carcinogenicity of a substance is generally determined by statistical tests that compare the effects of treatment on the rate of tumor development at several body sites. The statistical analysis of such studies often includes hypothesis testing of the dose effect at each of the sites. However, the multiplicity of the significance tests may cause an excess overall false positive rate. In consideration of this problem, recent interest has focused on developing methods to test simultaneously for the treatment effect at multiple sites. In this paper, we propose a test that is based on the count of tumor-bearing sites. The test is appropriate regardless of tumor lethality or of treatment-related differences in the underlying mortality. Simulations are given which compare the performance of the proposed test to several other tests including a Bonferroni adjustment of site-specific tests, and the test is illustrated using the data from the large ED01 experiment. PMID- 2720053 TI - On testing departure from the binomial and multinomial assumptions. AB - This paper is concerned with testing the multinomial (binomial) assumption against the Dirichlet-multinomial (beta-binomial) alternatives. In particular, we discuss the distribution of the asymptotic likelihood ratio (LR) test and obtain the C(alpha) goodness-of-fit test statistic. The inadequacy of the regular chi square approximation to the LR test is supported by some Monte Carlo experiments. The C(alpha) test is recommended based on empirical significance level and power and also computational simplicity. Two examples are given. PMID- 2720054 TI - Confidence intervals for a normal mean following a group sequential test. AB - This paper presents methodology based on the likelihood-ratio test, developed for construction of confidence intervals for a normal mean, following a group sequential test. Examples show that the confidence intervals produced by this method have accurate nominal probability of coverage and have generally shorter average length than that produced by Tsiatis, Rosner, and Mehta (1984, Biometrics 40, 797-803). PMID- 2720055 TI - A concordance correlation coefficient to evaluate reproducibility. AB - A new reproducibility index is developed and studied. This index is the correlation between the two readings that fall on the 45 degree line through the origin. It is simple to use and possesses desirable properties. The statistical properties of this estimate can be satisfactorily evaluated using an inverse hyperbolic tangent transformation. A Monte Carlo experiment with 5,000 runs was performed to confirm the estimate's validity. An application using actual data is given. PMID- 2720056 TI - Estimation of error rates in discriminant analysis with selection of variables. AB - Accurate estimation of misclassification rates in discriminant analysis with selection of variables by, for example, a stepwise algorithm, is complicated by the large optimistic bias inherent in standard estimators such as those obtained by the resubstitution method. Application of a bootstrap adjustment can reduce the bias of the resubstitution method; however, the bootstrap technique requires the variable selection procedure to be repeated many times and is therefore difficult to compute. In this paper we propose a smoothed estimator that requires relatively little computation and which, on the basis of a Monte Carlo sampling study, is found to perform generally at least as well as the bootstrap method. PMID- 2720057 TI - Monitoring clinical trials based on predictive probability of significance. AB - At a given point in a clinical trial, investigators may ask the question: "What is the likelihood of a significant result if the trial were continued?" One possible answer to this question is to examine a predictive probability of the significant difference with further patient accrual. [See, for example, Choi, Smith, and Becker (1985, Controlled Clinical Trials 6, 280-288).] This paper proposes and investigates the approach in trials for comparing the means of two normal populations. Two methods for calculating the predictive probability are examined. The results indicate that the predictive probability can be a useful conservative measure in monitoring trials. PMID- 2720058 TI - Censoring in an epidemic with an application to hemophilia-associated AIDS. AB - In epidemiologic studies of infectious diseases, the times of infection may be known only up to an interval. A two-stage parametric regression model is proposed for the analysis of cohort studies during an epidemic in which the exact times of infection cannot be ascertained. The methods permit joint estimation of the effects of covariates both on the risk of infection and the risk of progression to clinical disease once infected. The methodology is applied to a cohort of hemophiliacs who were at risk of infection with the AIDS virus. It was found that hemophiliacs with severe Type A hemophilia were at highest risk of infection, and the risk of infection increased sharply in the early 1980s. Hemophiliacs who were over the age of 20 at infection were at higher risk of progression to AIDS than hemophiliacs who were under age 20. The estimate of the cumulative probability of developing AIDS within t years of infection (the incubation period distribution) for hemophiliacs over age 20 was 1 - exp(-.0021t2.516). Since follow-up in this cohort was restricted to about 10 years from infection, estimates of the incubation period distribution beyond 10 years depend on model extrapolation and should be interpreted cautiously. PMID- 2720059 TI - The distribution of the frequency of occurrence of nucleotide subsequences, based on their overlap capability. AB - DNA's genetic code can be represented as an alphabetic sequence composed of the four letters A, C, G, and T, which represent the four types of nucleotides- adenylic, cytidylic, guanylic, and thymidylic acid--of which DNA is composed. Now that these sequences have been identified for many genes and are available in computer-readable form, scientists can analyze these data and search for patterns in an attempt to learn more about the regulatory functions of the gene. One area of study is that of the frequency of occurrence of specific nucleotide subsequences (e.g., ACAC) within part or all of a nucleotide sequence. This paper derives the probability distribution of the frequency of occurrence of a subsequence within a nucleotide sequence, under the hypothesis that the four nucleotides occur at random and with equal probability. This distribution is nontrivial because different subsequences have different "overlap capability." For example, the subsequence AAAA can occur up to 17 times in a sequence of length 20 (which would happen if the sequence were composed solely of A's), but the subsequence ACGT cannot occur more than 5 times in a sequence of length 20. Thus, the frequency distributions are different for each type of overlap capability. It is of interest to assess and compare the degree of nonrandomness for different subsequences or among different portions of a sequence; the existence and degree of nonrandomness may be related to the type and degree of functionality of a nucleotide (sub)sequence. The frequency distributions provided here can be used to perform exact significance tests of the hypothesis of randomness. An approximate test is also described for use with long sequences; this can be used to test a more general null hypothesis of nucleotides occurring with unequal probabilities. PMID- 2720060 TI - A disequilibrium coefficient approach to Hardy-Weinberg testing. AB - A comparison was made of various tests for Hardy-Weinberg equilibrium, with emphasis on methods for multiple alleles. For an overall test of deviations from equilibrium, the classical chi-square goodness-of-fit test generally performs well, with continuity corrections needed for extreme gene frequencies or extreme departures from equilibrium. For small samples, probability tests are preferable and for multiple alleles these probability tests may be performed on a sample of all possible sets of genotypic frequencies having a fixed set of sample gene frequencies. Numerical work showed that the continuity-corrected chi-square was the most conservative test procedure, and the uncorrected chi-square the least conservative. With multiple alleles, a better appreciation of the nature of departures from equilibrium is given by the use of disequilibrium coefficients, defined for each heterozygote as the difference between observed and expected frequencies. Likelihood-ratio tests can be used to test each of these coefficients individually but a satisfactory procedure is to divide the squared estimate of each coefficient by its estimated variance and regard the ratio as a single-degree-of-freedom chi-square. Numerical studies confirmed the validity of this approach, which has the great advantage of not requiring solutions of nonlinear equations. PMID- 2720061 TI - Nicotinamide adenine dinucleotide fluorescence spectroscopy and imaging of isolated cardiac myocytes. AB - Nicotinamide adenine dinucleotide (NADH) plays a critical role in oxidative phosphorylation as the primary source of reducing equivalents to the respiratory chain. Using a modified fluorescence microscope, we have obtained spectra and images of the blue autofluorescence from single rat cardiac myocytes. The optical setup permitted rapid acquisition of fluorescence emission spectra (390-595 nm) or intensified digital video images of individual myocytes. The spectra showed a broad fluorescence centered at 447 +/- 0.2 nm, consistent with mitochondrial NADH. Addition of cyanide resulted in a 100 +/- 10% increase in fluorescence, while the uncoupler FCCP resulted in a 82 +/- 4% decrease. These two transitions were consistent with mitochondrial NADH and implied that the myocytes were 44 +/- 6% reduced under the resting control conditions. Intracellular fluorescent structures were observed that correlated with the distribution of a mitochondrial selective fluorescent probe (DASPMI), the mitochondrial distribution seen in published electron micrographs, and a metabolic digital subtraction image of the cyanide fluorescence transition. These data are consistent with the notion that the blue autofluorescence of rat cardiac myocytes originates from mitochondrial NADH. PMID- 2720062 TI - On the coordination of La3+ by phosphatidylserine. AB - In a recent study by Bentz, J., D. Alford, J. Cohen, and N. Duzgunes (1988. Biophys. J. 53:593-607), La3+ was found to be more effective than Ca2+ in causing nonleaky fusion of phosphatidylserine vesicles. It was proposed that this difference in fusion efficiency may be due, in part, to a difference in coordination of the two cations. That is, Ca2+ was presumed to bind to the lipid phosphate, whereas La3+ was proposed to be coordinated by the serine carboxylate and amine. 31P and 13C NMR results presented here demonstrate that the lanthanides, Tb3+ and La3+, are coordinated by the phosphodiester and carboxylate moieties of phosphatidylserine. Tb3+-Phosphatidylserine optical experiments suggest that the serine amine does not coordinate the lanthanide below pH 10, at least not while the membrane has a net negative surface charge. Although these observations disagree with the structural details proposed by Bentz et al. (1988), they are not in conflict with their general fusion mechanism. The work presented here also demonstrates that La3+ affects the inner surface phosphodiesters differently than those on the outer surface of phosphatidylserine vesicles. The vesicles studied are of an intermediate size, having diameters on the order of 150-200 nm. The cation appears to have a more immediate effect on the packing of the crowded headgroups on the inner surface. Higher levels of bound La3+ on the outer surface may be required to induce the same changes in headgroup conformation. PMID- 2720063 TI - Ultrasonic Cole-Cole diagram for solutions and application to alpha-chymotrypsin. AB - Deconvolution of ultrasonic data into single relaxations is rarely feasible when only the absorption or the velocity of the waves is measured. Here we use both series of data to construct a Cole-Cole diagram for a solution. When applied to alpha-chymotrypsin, this method shows two relaxations that are well separated on the time scale, a result that will help simplify analyses of the ultrasonic data for this enzyme. PMID- 2720064 TI - A nonlinear cascade model for action potential encoding in an insect sensory neuron. AB - Action potential encoding in the cockroach tactile spine neuron can be represented as a single-input single-output nonlinear dynamic process. We have used a new functional expansion method to characterize the nonlinear behavior of the neural encoder. This method, which yields similar kernels to the Wiener method, is more accurate than the latter and is efficient enough to obtain reasonable kernels in less than 15 min using a personal computer. The input stimulus was band-limited white Gaussian noise and the output consisted of the resulting train of action potentials, which were unitized to give binary values. The kernels and the system input-output signals were used to identify a model for encoding comprising a cascade of dynamic linear, static nonlinear, and dynamic linear components. The two dynamic linear components had repeatable and distinctive forms with the first being low-pass and the second being high-pass. The static nonlinearity was fitted with a fifth-order polynomial function over several input amplitude ranges and had the form of a half-wave rectifier. The complete model gave a good approximation to the output of the neuron when both were subjected to the same novel white noise input signal. PMID- 2720065 TI - Simultaneous measurement of changes in current and tracer flux in voltage-clamped squid giant axon. AB - A method is described for the simultaneous measurement of changes in membrane current and unidirectional radiotracer flux in internally dialyzed voltage clamped squid giant axons. The small currents that are produced by electrogenic transport processes or steady-state ionic currents can be resolved using this method. Because the use of grounded guard electrodes in the end pools is not, by itself, an adequate means of eliminating end-effects, two ancillary end pool clamp circuits are described to eliminate extraneous current flow from the ends of the axon. The end pool voltage-clamp circuits serve to minimize net current flow between the end pools and center pool, and employ stable, low-impedance calomel electrodes to monitor the potentials of the end and center pools. The adequacy of the method is demonstrated by experiments in which unidirectional 22Na efflux and current, flowing through tetrodotoxin (TTX)-sensitive Na channels into Na-free seawater, under K-free conditions, are shown to be equal. The equality of unidirectional TTX-sensitive flux and current is maintained over the entire range of membrane potentials examined (-60 to +20 mV). The method has been applied to a series of experiments in which the voltage dependence and stoichiometry of the Na/K pump have been measured (Rakowski et al., 1989), and can be applied in general to the simultaneous measurement of changes in current and flux of other electrogenic transport processes, and of currents through ionic channels that open under steady-state conditions. PMID- 2720066 TI - Cell poking: quantitative analysis of indentation of thick viscoelastic layers. AB - A recently introduced device, the cell poker, measures the force required to indent the exposed surface of a cell adherent to a rigid substratum. The cell poker has provided phenomenological information about the viscoelastic properties of several different types of cells, about mechanical changes triggered by external stimuli, and about the role of the cytoskeleton in these mechanical functions. Except in special cases, however, it has not been possible to extract quantitative estimates of viscosity and elasticity moduli from cell poker measurements. This paper presents cell poker measurements of well characterized viscoelastic polymeric materials, polydimethylsiloxanes of different degrees of polymerization, in a simple shape, a flat, thick layer, which for our purposes can be treated as a half space. Analysis of the measurements in terms of a linear viscoelasticity theory yields viscosity values for three polymer samples in agreement with those determined by measurements on a macroscopic scale. Theoretical analysis further indicates that the measured limiting static elasticity of the layers may result from the tension generated at the interface between the polymer and water. This work demonstrates the possibility of obtaining quantitative viscoelastic material properties from cell poker measurements and represents the first step in extending these quantitative studies to more complicated structures including cells. PMID- 2720067 TI - An extended Monod-Wyman-Changeaux-model expressed in terms of the Herzfeld Stanley formalism applied to oxygen and carbonmonoxide binding curves of hemoglobin trout IV. AB - An extended Monod, Wyman, Changeaux (MWC)-model, the mathematical basis of which had been formulated by Herzfeld and Stanley (J. Mol. Blol. 82:231. 1974.) was used to fit oxygen and CO-binding curves of hemoglobin trout IV measured at different pH-values between pH = 8.0 and 6.0. From this calculation one obtains that even the fully liganded molecule exhibits a R----T quaternary transition upon approaching the acid pH-region. In the case of O2-binding, the cooperativity becomes negative below pH = 6.5. This can be related to the difference between the equilibrium constants of proton binding to the alpha- and beta-subunits. Furthermore, it can be shown that the interaction between the quaternary T----R- and the tertiary t----r-transitions is different for the alpha- and beta subunits. PMID- 2720068 TI - Detection of the heme perturbations caused by the quaternary R----T transition in oxyhemoglobin trout IV by resonance Raman scattering. AB - The depolarization ratio dispersion and the respective excitation profiles of two structural sensitive Raman lines of oxyhemoglobin-trout IV (1,375 and 1,638 cm-1) have been measured at pH-values between 6.5 and 8.5. They were analyzed by employing a fifth order time dependent perturbation theory to calculate the polarizability tensor. This provides information about the pH-dependence of parameters reflecting symmetry classified distortions of the prosthetic heme groups. In order to correlate these distortions with functional properties of the molecule the following protocol has been employed: (a) a titration model was formulated relating each conformation of the molecule to a distinct set of distortion parameters the incoherent superposition of which provides the respective distortion parameter obtained from our Raman data. (b) The thermodynamic constants determining the equilibrium between these molecular conformations (i.e., the quaternary T and R-states, the low affinity t and the high affinity r-states of the distinct subunits, the pK-values of the Root- and Bohr groups) were obtained from a set of O2-binding curves that were analyzed in terms of an allosteric model suggested by Herzfeld and Stanley 1974. J. Mol. Biol. 82:231. The application of this procedure yields excellent reproduction of the pH-dependent effective distortion parameters of both Raman lines investigated. Thus established correlation between hemoglobin function (O2 binding) and structure (asymmetric perturbation of the hemegroup) provides some interesting insights into the molecular basis of the allosteric Root effect. PMID- 2720069 TI - Interactions between actin and myosin filaments in skeletal muscle visualized in frozen-hydrated thin sections. AB - For the purpose of determining net interactions between actin and myosin filaments in muscle cells, perhaps the single most informative view of the myofilament lattice is its averaged axial projection. We have studied frozen hydrated transverse thin sections with the goal of obtaining axial projections that are not subject to the limitations of conventional thin sectioning (suspect preservation of native structure) or of equatorial x-ray diffraction analysis (lack of experimental phases). In principle, good preservation of native structure may be achieved with fast freezing, followed by low-dose electron imaging of unstained vitrified cryosections. In practice, however, cryosections undergo large-scale distortions, including irreversible compression; furthermore, phase contrast imaging results in a nonlinear relationship between the projected density of the specimen and the optical density of the micrograph. To overcome these limitations, we have devised methods of image restoration and generalized correlation averaging, and applied them to cryosections of rabbit psoas fibers in both the relaxed and rigor states. Thus visualized, myosin filaments appear thicker than actin filaments by a much smaller margin than in conventional thin sections, and particularly so for rigor muscle. This may result from a significant fraction of the myosin S1-cross-bridges averaging out in projection and thus contributing only to the baseline of projected density. Entering rigor incurs a loss of density from an annulus around the myosin filament, with a compensating accumulation of density around the actin filament. This redistribution of mass represents attachment of the fraction of cross-bridges that are visible above background. Myosin filaments in the "nonoverlap" zone appear to broaden on entering rigor, suggesting that on deprivation of ATP, cross bridges in situ move outwards even without actin in their immediate proximity. PMID- 2720070 TI - Nonstationary fluctuation analysis of the delayed rectifier K channel in cardiac Purkinje fibers. Actions of norepinephrine on single-channel current. AB - We have studied the large increase in macroscopic potassium channel current caused by catecholamines in mammalian cardiac cells. An increase in macroscopic K current could result from either an increase in the single-channel current or by an increase in the number of channels that are open. Therefore, we have measured nonstationary potassium current fluctuations under voltage clamp conditions to determine whether norepinephrine increases the current through this channel. The single-channel current (at a potential of -30 mV in 4 mM external [K]) was estimated to be 3.7 pA and was not altered by concentrations of norepinephrine up to 2 microM. The spectral density of the current fluctuations were fitted well by a sum of 2 Lorentzians with corner frequencies that correspond with the measured time constants for deactivation of the macroscopic K current tails. We conclude that the increase in macroscopic K current caused by norepinephrine in these cells is not the result of an increase in single-channel conductance and therefore must involve an increase in the number of open K channels. PMID- 2720071 TI - Lysophosphatidylcholine stabilizes small unilamellar phosphatidylcholine vesicles. Phosphorus-31 NMR evidence for the "wedge" effect. AB - Sonication of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) and 1 palmitoyl-sn-glycero-3-phosphocholine (lysoPC, up to approximately 30 mol %) produces small unilamellar vesicles (SUV, 250-265 A diameter). Phosphorus-31 NMR of the POPC/lysoPC vesicles gives rise to four distinct peaks for POPC and lysoPC in the outer and in the inner bilayer leaflet which can be used to localize and quantify the phospholipids in both vesicle shells. Addition of paramagnetic ions (3 mM Pr3+) enhances outside/inside chemical shift differences and allows monitoring of membrane integrity by the absence of Pr3+ in the vesicle interior. 31P NMR shows that lysoPC in these highly curved POPC/lysoPC vesicles prefers the outer bilayer leaflet. LysoPC incorporation into POPC SUV furthermore causes a substantial and concentration-dependent decrease in spin-spin relaxations (T*2) of the outside POPC phosphorus signals from 55 ms for pure POPC vesicles (v1/2, 5.8 Hz) to 29.5 ms (v1/2, 10.8 Hz) for POPC/lysoPC vesicles containing 25 mol % lysoPC. Our findings are consistent with the idea of a cone-shaped lysoPC molecule which, for geometric reasons, is preferentially accommodated in the outer bilayer leaflet. LysoPC incorporation into POPC SUV restricts POPC headgroup motion and tightens phospholipid packing, but only in the outer bilayer shell. PMID- 2720072 TI - Caffeine slows turn-off of calcium release in voltage clamped skeletal muscle fibers. AB - Myoplasmic free calcium transients delta [Ca2+] were monitored with the calcium indicators antipyrylazo III and fura-2 in voltage clamped cut frog skeletal muscle fibers, in the presence and absence of 0.5 mM caffeine. Without caffeine delta [Ca2+] began to decline within a few milliseconds of fiber repolarization for pulses of all durations. In caffeine delta [Ca2+] continued to rise for 10-60 ms after 10 or 20 ms depolarizing pulses, indicating that the release of calcium from the sarcoplasmic reticulum (SR) continued well after repolarization of transverse tubular (TT) membranes in the presence of caffeine. Caffeine also increased the peak amplitude of delta [Ca2+] for all pulses and slowed the decline of delta [Ca2+] after pulses of all durations. The rate of calcium release from the SR calculated from delta [Ca2+] showed that for 10 ms pulses in caffeine release did not turn off abruptly on repolarization but instead declined to zero with a time constant essentially the same as the time constant for inactivation of SR calcium release during depolarizing pulses in the presence or absence of caffeine. The observed loss of TT membrane potential control of SR calcium release in the presence of caffeine suggests the appearance of a significant component of cytosolic Ca2+-induced calcium release in caffeine. PMID- 2720073 TI - New class of 19F pH indicators: fluoroanilines. AB - The pH dependence of the 19F chemical shift has been characterized for a number of fluorine-substituted aniline derivatives. These compounds constitute a new class of 19F nuclear magnetic resonance (NMR) pH indicators, characterized by single 19F resonance lines with sensitivities ranging from 2 to 7 ppm/pH unit near the aniline pKa; total shifts between conjugate acid and base of 5-15 ppm; and pKas ranging from 1 to 7. One compound, N,N-(methyl-2-carboxyisopropyl)-4 fluoroaniline, has a pKa of 6.8 and a sensitivity of 5 ppm/pH unit. This compound displays significant broadening of its 19F resonance near the aniline pKa (6.8), due to a decreased rate of exchange between conjugate acid and base species. Our results are consistent with slow dissociation of an intramolecular hydrogen bond in the zwitterionic species that limits the exchange rate between protonated and unprotonated forms for N,N-(methyl-2-carboxyisopropyl)-4-fluoroaniline. PMID- 2720074 TI - Lateral diffusion of membrane proteins in protein-rich membranes. A simple hard particle model for concentration dependence of the two-dimensional diffusion coefficient. AB - A model for the effect of protein concentration on the rate of lateral diffusion of integral membrane proteins is presented, in which the proteins are represented by equivalent hard circular particles on a surface. As the density of particles increases, the probability of finding a vacancy immediately adjacent to a tracer particle into which it may diffuse decreases, resulting in a concomitant reduction of the tracer diffusion coefficient. Using scaled particle theory to calculate the concentration-dependent probabilities, a simple approximate result is obtained in closed form, that is compared with the results of previously published Monte Carlo lattice simulations and experimental observations. PMID- 2720076 TI - Mitotic orientation in three dimensions determined from multiple projections. AB - The three-dimensional orientation of mitoses in mouse small intestinal crypts of Lieberkuhn was determined from multiple projections of the mitotic figures in whole mounts of isolated intestinal crypts. We found evidence of a significant orientational bias for mitoses whose daughter cells would be added along the long axis of the crypt, and thus conform to the maintenance of the cylindrical shape of the intestinal crypt. However, we also observed many mitoses whose progeny must be rearranged if the simple cylindrical shape of the intestinal crypt is to be maintained. Our results indicate that the ultimate behavior of progeny cells and hence of local tissue form may not strictly depend on the orientation of mitosis. The methods presented may also be used in the study of mitotic orientation in other tissues. PMID- 2720075 TI - Electro-mechanical permeabilization of lipid vesicles. Role of membrane tension and compressibility. AB - A simple micropipet technique was used to determine the critical electric field strength for membrane breakdown as a function of the applied membrane tension for three different reconstituted membranes: stearoyloleoylphosphatidylcholine (SOPC), red blood cell (RBC) lipid extract, and SOPC cholesterol (CHOL), 1:1. For these membranes the elastic area expansivity modulus increases from approximately 200 to 600 dyn/cm, and the tension at lysis increases from 5.7 to 13.2 dyn/cm, i.e., the membranes become more cohesive with increasing cholesterol content. The critical membrane voltage, Vc, required for breakdown was also found to increase with increasing cholesterol from 1.1 to 1.8 V at zero membrane tension. We have modeled the behavior in terms of the bilayer expansivity. Membrane area can be increased by either tensile or electrocompressive stresses. Both can store elastic energy in the membrane and eventually cause breakdown at a critical area dilation or critical energy. The model predicts a relation between tension and voltage at breakdown and this relation is verified experimentally for the three reconstituted membrane systems studied here. PMID- 2720077 TI - Self diffusion of interacting membrane proteins. AB - A two-dimensional version of the generalized Smoluchowski equation is used to analyze the time (or distance) dependent self diffusion of interacting membrane proteins in concentrated membrane systems. This equation provides a well established starting point for descriptions of the diffusion of particles that interact through both direct and hydrodynamic forces; in this initial work only the effects of direct interactions are explicitly considered. Data describing diffusion in the presence of hard-core repulsions, soft repulsions, and soft repulsions with weak attractions are presented. The effect that interactions have on the self-diffusion coefficient of a real protein molecule from mouse liver gap junctions is also calculated. The results indicate that self diffusion is always inhibited by direct interactions; this observation is interpreted in terms of the caging that will exist at finite protein concentration. It is also noted that, over small distance scales, the diffusion coefficient is determined entirely by the very strong Brownian forces; therefore, as a function of displacement the self-diffusion coefficient decays (rapidly) from its value at infinite dilution to its steady-state interaction-averaged value. The steady-state self-diffusion coefficient describes motion over distance scales that range from approximately 10 nm to cellular dimensions and is the quantity measured in fluorescence recovery after photobleaching experiments. The short-ranged behavior of the diffusion coefficient is important on the interparticle-distance scale and may therefore influence the rate at which nearest-neighbor collisional processes take place. The hard-disk theoretical results presented here are in excellent agreement with lattice Monte-Carlo results obtained by other workers. The concentration dependence of experimentally measured diffusion coefficients of antibody-hapten complexes bound to the membrane surface is consistent with that predicted by the theory. The variation in experimental diffusion coefficients of integral membrane proteins is greater than that predicted by the theory, and may also reflect protein-induced perturbations in membrane viscosity. PMID- 2720078 TI - Sequential model to describe the nicotinic synaptic current. AB - An analytical formula is derived to describe the synaptic end plate current (epc) at the nicotinic receptor. Various concurrently occurring underlying processes, including (a) diffusion, (b) hydrolysis of acetylcholine, and (c) its binding to the dimeric receptor, were considered in order to develop the equation. Numeric solution of the equations that describe the events underlying the epc showed that these events occur in sequence, rather than concurrently. This sequential occurrence of the processes allowed for simplifications, which were used as the basis for the new description of the epc. The resulting formula serves as a tool for evaluating the relative contribution of the various processes in formation of the natural occurring transient epc. PMID- 2720079 TI - Quenching of fluorescence of pyrene-substituted lecithin by tetracyanoquinodimethane in liposomes. AB - In this work we have applied a kinetic scheme derived from fluorescence kinetics of pyrene-labeled phosphatidylcholine in phosphatidylcholine membrane to explain the fluorescence quenching of 1-palmitoyl-2-(10-[pyrenl-yl]-sn-glycerol-3 phosphatidylchol ine (PPDPC) liposomes by tetracyanoquinodimethane (TCNQ). The scheme was also found to be applicable to neat PPDPC and the effect of the quencher could be attributed to certain steps of the proposed mechanism. The TCNQ molecules influence the fluorescence of pyrene moieties in PPDPC liposome in two ways. Firstly, an interaction between the quencher molecule and the pyrene monomer in the excited state quenches monomer fluorescence and effectively prevents the diffusional formation of the excimer. Secondly, an interaction between the quencher molecule and the excited dimer quenches the excimer fluorescence. The TCNQ molecule does not prevent the formation of the excimer in pyrene moieties aggregated in such a way that they require only a small rotational motion to attain excimer configuration. The diffusional quenching rate constant is calculated to be 1.0 x 10(8) M-1 s-1 for the pyrene monomer quenching and 1.3 x 10(7) M-1 s-1 for the pyrene excimer quenching. The diffusion constant of TCNQ is 1.5 x 10(-7) cm2 s-1 for the interaction radii of 0.8-0.9 nm. The TCNQ molecules are practically totally partitioned in the membrane phase. PMID- 2720080 TI - Repulsive interactions between uncharged bilayers. Hydration and fluctuation pressures for monoglycerides. AB - Pressure versus distance relations have been obtained for solid (gel) and neat (liquid-crystalline) phase uncharged lipid bilayers by the use of x-ray diffraction analysis of osmotically stressed monoglyceride aqueous dispersions and multilayers. For solid phase monoelaidin bilayers, the interbilayer repulsive pressure decays exponentially from a bilayer separation of approximately 7 A at an applied pressure of 3 x 10(7) dyn/cm2 to a separation of approximately 11 A at zero applied pressure, where an excess water phase forms. The decay length is approximately 1.3 A, which is similar to the value previously measured for gel phase phosphatidylcholine bilayers. This implies that the decay length of the hydration pressure does not depend critically on the presence of zwitterionic head groups in the bilayer surface. For liquid-crystalline monocaprylin, the repulsive pressure versus distance curve has two distinct regions. In the first region, for bilayer separations of approximately 3-8 A and applied pressures of 3 x 10(8) to 4 x 10(6) dyn/cm2, the pressure decays exponentially with a decay length of approximately 1.3 A. In the second region, for bilayer separations of approximately 8-22 A and applied pressures of 4 x 10(6) to 1 x 10(5) dyn/cm2, the pressure decays much more gradually and is inversely proportional to the cube of the distance between bilayers. These data imply that two repulsive pressures operate between liquid-crystalline monocaprylin bilayers, the hydration pressure, which dominates at small (3-8 A) bilayer separations, and the fluctuation pressure, which dominates at larger bilayer separations (greater than 8 A) and strongly influences the hydration properties of the liquid-crystalline bilayers. Thus, due primarily to thermally induced fluctuations, monocaprylin bilayers imbibe considerably more water than do monoelaidin bilayers. For both monoelaidin andmonocaprylin, the measured magnitude of the hydration pressure is found to be proportional to the square of the dipole potential. PMID- 2720081 TI - Dynamics of a tightly coupled mechanism for flagellar rotation. Bacterial motility, chemiosmotic coupling, protonmotive force. AB - The bacterial flagellar motor is a molecular engine that couples the flow of protons across the cytoplasmic membrane to rotation of the flagellar filament. We analyze the steady-state behavior of an explicit mechanical model in which a fixed number of protons carries the filament through one revolution. Predictions of this model are compared with experimentally determined relationships between protonmotive force, proton flux, torque, and speed. All such tightly coupled mechanisms produce the same torque when the motor is stalled but vary greatly in their behavior at high speed. The speed at zero load predicted by our model is limited by the rates of association and dissociation of protons at binding sites on the rotor and by the mobility of force generators containing transmembrane channels that interact with these sites. Our analysis suggests that more could be learned about the motor if it were driven by an externally applied torque backwards (at negative speed) or forwards at speeds greater than the zero-load speed. PMID- 2720082 TI - Order and dynamics in the lamellar L alpha and in the hexagonal HII phase. Dioleoylphosphatidylethanolamine studied with angle-resolved fluorescence depolarization. AB - Fluorescence depolarization techniques are used to determine the molecular order and reorientational dynamics of the probe molecule TMA-DPH embedded in the lamellar L alpha and the hexagonal HII phases of lipid/water mixtures. The thermotropically induced L alpha----HII phase transition of the lipid DOPE is used to obtain macroscopically aligned samples in the hexagonal HII phase at 45 degrees C from samples prepared in the lamellar L alpha phase at 7 degrees C. The interpretation of angle-resolved fluorescence depolarization experiments on these phases, within the framework of the rotational diffusion model, yields the order parameters (P2) and (P4), and the diffusion constants for the reorientational motions. The reorientational motion rates of the TMA-DPH molecules in the hexagonal HII phase are comparable with those in the lamellar L alpha phase. Furthermore, the lateral diffusion of the probe molecule on the surface of the lipid/water cylinder in the hexagonal phase is found to be considerably slower than the reorientational motion. PMID- 2720083 TI - Fusion of synaptic vesicle membranes with planar bilayer membranes. AB - The interaction of synaptic vesicles with horizontal bilayer lipid membranes (BLMs) was investigated as a model system for neurotransmitter release. High concentrations (200 mM) of the fluorescent dye, calcein, were trapped within synaptic vesicles by freezing and thawing. In the presence of divalent ions (usually 15 mM CaCl2), these frozen and thawed synaptic vesicles (FTSVs) adhere to squalene-based phosphatidylserine-phosphatidylethanolamine BLMs whereupon they spontaneously release their contents which is visible by fluorescence microscopy as bright flashes. The highest rate of release was obtained in KCl solutions. Release was virtually eliminated in isotonic glucose, but could be elicited by perfusion with KCl or by addition of urea. The fusion and lysis of adhering FTSVs appears to be the consequence of stress resulting from entry of permeable external solute (KCl, urea) and accompanying water. An analysis of flash diameters in experiments where Co+2, which quenches calcein fluorescence, was present on one or both sides of the BLM, indicates that more than half of the flashes represent fusion events, i.e., release of vesicle contents on the trans side of the BLM. A population of small, barely visible FTSVs bind to BLMs at calcium ion concentrations of 100 microM. Although fusion of these small FTSVs to BLMs could not be demonstrated, fusion with giant lipid vesicles was obvious and dramatic, albeit infrequent. Addition of FTSVs or synaptic vesicles to BLMs in the presence of 100 microM-15 mM Ca2+ produced large increases in BLM conductance. The results presented demonstrate that synaptic vesicles are capable of fusing with model lipid membranes in the presence of Ca+2 ion which, at the lower limit, may begin to approach physiological concentrations. PMID- 2720084 TI - Current injection into a two-dimensional anisotropic bidomain. AB - A two-dimensional sheet of anisotropic cardiac tissue is represented with the bidomain model, and the finite element method is used to solve the bidomain equations. When the anisotropy ratios of the intracellular and extracellular spaces are not equal, the injection of current into the tissue induces a transmembrane potential that has a complicated spatial dependence, including adjacent regions of depolarized and hyperpolarized tissue. This behavior may have important implications for the electrical stimulation of cardiac tissue and for defibrillation. PMID- 2720085 TI - Cooperative ligand-lattice binding. Approximate Gaussian binding distribution. AB - Nearest-neighbor cooperative binding of a ligand covering n sites and binding with equilibrium constant K and cooperativity factor omega to a large molecule with m binding sites (m much greater than n omega, n/omega) can be approximately described by a Gaussian distribution P(q-qmax), where q is the number of ligands bound and qmax the most probable value of q. The variance of the Gaussian is equal to the derivative dqmax/d ln(L), where L is the free ligand concentration. This variance, sigma 2, is a complicated function of qmax. However, in the limits of very large cooperativity, omega much greater than 1, very large anticooperativity, omega much less than 1, or noncooperativity, omega = 1, simpler expressions for sigma 2 can be given. For qmax = m/(n + 1), where the most probable number of bound ligands equals the number of free binding sites, sigma 2 has a particularly simple form: sigma 2 = 2m omega 1/2/(n + 1)3. The Gaussian and the infinite lattice approximations for the average number of ligands bound are good approximations only if sigma is much smaller than the number of binding sites. The variance may therefore provide an easy check on the validity of the infinite lattice approximation, which is commonly used to analyze experimental binding data. PMID- 2720086 TI - An unusual electrooptical effect observed for DNA fragments and its apparent relation to a permanent electric moment associated with bent DNA. AB - Dichroism decay curves of DNA fragments with chain lengths in the range of 179 256 bp show an amplitude inversion suggesting the existence of a positive dichroism component, when these fragments are dissolved at monovalent salt concentrations above approx. 5 mM and are exposed to field pulses with amplitudes and/or lengths above critical values. At the critical values, the unusual dichroism is reflected by an apparent acceleration of the decay curves, which can be fitted by single exponentials with time constants much below the values expected from the DNA contour lengths. The critical pulse amplitudes and lengths decrease with increasing DNA chain length and increasing salt concentration. The experimental data are consistent with results obtained by hydrodynamic and electric model calculations on smoothly bent DNA double helices. The DNA is represented by a string of overlapping beads, which is used to calculate the rotational diffusion tensor and the center of diffusion. The distribution of phosphate charges is asymmetric with respect to this center and thus gives rise to a substantial permanent dipole moment. The magnitude of this dipole moment is calculated as a function of DNA curvature and is used together with experimental values of polarizabilities for simulations of dichroism decay curves. The curves simulated for bent DNA show the same phenomenon as observed experimentally. The ionic strength dependence of the unusual dichroism is explained by an independently observed strong decrease of the polarizability with increasing salt concentration. The field strength dependence is probably due to field-induced bending of double helices driven by the change of the dipole moment. Although our calculations are on rigid models of DNA and thus any flexibility of the double helix has not been considered, we conclude that the essential part of our experimental results can be explained by our model. PMID- 2720087 TI - Characterization of non-linear behaviour of an animal membrane using electro kinetic studies. AB - Electro-kinetic studies of water, aqueous solutions of urea, thiourea, glucose, creatinine and urine solution across urinary bladder membranes of goat have been used to explain non-linear behaviour. It has been found that fluxes are non linearly related with forces. The structure of the membrane is a decisive factor when the range of driving forces is not too high. Stability of the steady state has also been examined and has been found to remain quite stable even in non linear regions. The results have been examined using the methodology of non equilibrium thermodynamics. PMID- 2720088 TI - Conformational preferences of sequential fragments of the hinge region of human IgA1 immunoglobulin molecule: II. AB - The mean solution conformation of tetrapeptide fragments of the hinge region of human IgA1 molecule was investigated by CD and 13C-NMR methods. Distinct conformational differences for the partial sequences were found. Tetrapeptides with the Thr-Pro-Ser-Pro sequence were found to show a clear preference for the beta-turn conformation. Conformational equilibria of these peptides are only slightly affected by acetylation or pH changes. In the case of Pro-Thr-Pro-Ser tetrapeptides conformational equilibria are dominated by unordered forms. PMID- 2720089 TI - Kinetic study of the effects of solvation on the dimerization process of alpha chymotrypsin. AB - The dimeric association process of alpha-chymotrypsin has been studied with the aid of a stopped-flow spectrophotometer at various temperatures and pH values. From the temperature dependences of the forward reaction rate constant (kf) and the equilibrium dimerization constant (KD), the reaction system observed here is concluded to be entropy-driven. The increase in entropy can be attributed to the release of water molecules from both the active site and the surface part of the protein molecule during the course of dimerization. From the pH dependences of the reaction rate constants and the equilibrium constant, the reaction is concluded to depend strongly on the dissociations of the site between the carboxyl group of the aspartic acid and imidazolyl group of the histidine residues (in the higher pH region), and the site between the imidazolyl group of the histidine and the carboxyl group of the tyrosine residue (in the lower pH region), respectively. PMID- 2720090 TI - Reinterpretation of fluorescence of terbium ion-DNA complexes. AB - Terbium (Tb3+) fluorescence was used to investigate local non-denaturation perturbations of double-helical DNA structure induced in this nucleic acid by various physical and chemical agents. It has been shown that the interaction of Tb3+ with DNA into which single-strand or double-strand breaks have been introduced by DNase I or by low doses of ionizing radiation does not influence the fluorescence of the lanthanide cation. On the other hand, interaction of terbium with DNA modified by the antitumour drug cis-diamminedichloroplatinum(II) at low levels of binding and by low doses of ultraviolet radiation (wavelength 254 nm) has been shown to result in substantial enhancement of the fluorescence of this cation. It has been proposed that the terbium fluorescent probe can also be exploited successfully for the purpose of analysing the guanine bases present in distorted double-stranded regions of DNA, in which only the vertical stacking of the base-pairs is altered. PMID- 2720091 TI - The liquid condensed diffusional transition of dipalmitoylphosphoglycerocholine in monolayers. AB - The fine details of the phase transition of dipalmitoylphosphoglycerocholine (DPPC) monolayers at air/NaCl solution interfaces were investigated at 21 +/- 1 degrees C by using the fluorescence after photobleaching technique employing 12 (9-anthroyloxy)stearic acid as fluorescent probe. The mode of compression of the monolayer (i.e., continuous compression or successive additions of the lipid at fixed area) together with the ionic strength of the subphase (0.1 or 1.0 M NaCl) were particularly studied. The photobleaching results show that the lateral diffusion coefficient of the probe molecules decreases drastically within the liquid-condensed phase, i.e., from the end of the liquid-expanded-liquid condensed phase transition to the beginning of the solid-condensed phase. The molecular areas at which the phase transition occurs under the various experimental conditions, together with a parallel analysis of the hydration states and related molecular areas of the DPPC molecules in multilayers, strongly suggest that the steric hindrance associated with the hydration water of the polar head of DPPC molecules in the monolayer is responsible for the drastic decrease in diffusion coefficient in the liquid-condensed phase. Furthermore, the fluorescence characteristics of the probe molecules also show that, together with the aforementioned reorganization of the polar head, a structural reorganization of the aliphatic chains of the lipid molecules also takes place in the liquid condensed phase. The liquid-condensed phase therefore appears as a transition region from liquid to solid phases in which the lipid molecules present a significant decrease in their lateral diffusion related to a structural reorganization of both their polar and aliphatic components. PMID- 2720092 TI - The effect of a distribution of separations upon intramolecular distances in biopolymers, as determined by radiationless energy transfer. AB - In a fluorescent donor group and a nonfluorescent acceptor group are incorporated into a biopolymer, so that radiationless energy transfer occurs between the two groups, the apparent separation of the groups, as determined by energy transfer, will be influenced by the existence of a distribution of separations. This might arise from the presence of significant localized flexibility at the sites of attachment of the two groups, or from internal flexibility involving the biopolymer itself. If a Gaussian form is assumed for the distribution of separations of the donor and acceptor groups, the efficiency of transfer is dependent upon the width of the distribution, as well as the average distance between the groups. Significant differences may thereby arise between the true average separation and the separation computed from transfer efficiencies by the usual procedures. The deviations are different for transfer efficiencies computed from quantum yields and from decay times. They become more important with increasing width of the distribution of separations and increasing efficiency of transfer. In general, if a distribution of separations is present, the average separation is most reliably computed by procedures which take into account the effects of this distribution. PMID- 2720093 TI - Simultaneous analysis of single-photon timing data for the one-step determination of activation energies, frequency factors and quenching rate constants. Application to tryptophan photophysics. AB - A general global analysis of single-photon timing data is presented in which each fluorescence decay curve can be described by a different decay law. The model parameters can be held in common within one curve and/or between related curves. Any or all parameters can be kept fixed, or they may be variable to seek optimum values. This general analysis allows the determination of activation energies, frequency factors and quenching rate constants in one step. The construction of the global mapping table which relates parameters in one experiment to those in another is explained in detail. The use and performance of this general simultaneous analysis are examined using tryptophan fluorescence decays at pH 6.0 obtained at various emission wavelengths as a function of temperature and added solute quencher. The results show that tryptophan at pH 6.0 decays as a biexponential with decay times which are independent of the analysis wavelength. The decay component with the short lifetime has a deactivation rate constant of 1.4 x 10(9) s-1 independent of temperature. The decay component with the long lifetime has an activation energy of 28 kJ/mol and a frequency factor of 3 x 10(13) s-1; its temperature-independent decay rate constant equals 1 x 10(8) s-1. Recursion formulas for a computer program to estimate activation energies, frequency factors, and decay rate constants are provided. PMID- 2720094 TI - Linkage effects in a model for cell survival after radiation. AB - A thermodynamic treatment for the effects of radiation on cell survival is proposed. The treatment is an extension of the linear-quadratic model (K.H. Chadwick and H.P. Leenhouts, Phys. Med. Biol. 13 (1973) 78) following the principles of linkage thermodynamics (E. Di Cera, S.J. Gill and J. Wyman, Proc. Natl. Acad. Sci. U.S.A. 85 (1988) 5077). Linkage effects between chemical binding to DNA and radiation action are considered, along with the synergism between different types of radiations. A simple mathematical condition is found for the additivity of radiation doses that result in an isoeffect. The resolvability of the model parameter is investigated by simulations and statistical analysis of the distributions obtained. PMID- 2720095 TI - Dynamic fluorescence study of the interaction of lumazine protein with bacterial luciferases. AB - The equilibrium association of lumazine protein from Photobacterium phosphoreum with luciferases from either P. phosphoreum or an aldehyde-requiring dark mutant of Vibrio harveyi is measured from changes of the rotational correlation time which is derived from the decay of the lumazine ligand's fluorescence anisotropy. The rotational correlation time of lumazine protein is 23 ns (2 degrees C, 0.25 M Pi) and is increased on addition of luciferase due to the formation of a higher molecular weight complex. The V. harveyi luciferase exhibits full competence for the association and a 1:1 stoichiometry with a Kd in the range 40-90 microM. At lower ionic strength (0.05 M Pi), the Kd increases but is reduced again by the addition of dodecanol or dimyristoyllecithin. In contrast, tetradecanal, a substrate for the bioluminescence reaction, exerts no influence on the association. The equilibration rate is found to be too slow and for both luciferases the Kd values are too high for the interaction of the native proteins to account quantitatively for the spectral shifting of the bioluminescence by lumazine protein. PMID- 2720096 TI - Conformational characteristics of peptides and unanticipated results from crystal structure analyses. AB - Preferred conformation and types of molecular folding are some of the topics that can be addressed by structure analysis using x-ray diffraction of single crystals. The conformations of small linear peptide molecules with 2-6 residues are affected by polarity of solvent, presence of water molecules, hydrogen bonding with neighboring molecules, and other packing forces. Larger peptides, both cyclic and linear, have many intramolecular hydrogen bonds, the effect of which outweighs any intermolecular attractions. Numerous polymorphs of decapeptides grown from a variety of solvents, with different cocrystallized solvents, show a constant conformation for each peptide. Large conformational changes occur, however, upon complexation with metal ions. A new form of free valinomycin grown from DMSO exhibits near three-fold symmetry with only three intramolecular hydrogen bonds. The peptide is in the form of a shallow bowl with a hydrophobic exterior. Near the bottom of the interior of the bowl are three carbonyl oxygens, spaced and directed so that they are in position to form three ligands to a K+, e.g., complexation can be completed by the three lobes containing the beta-bends closing over and encapsulating the K+ ion. In another example, free antamanide and the biologically inactive perhydro analogue, in which four phenyl groups become cyclic hexyl groups, have essentially the same folding of backbone and side chains. The conformation changes drastically upon complexation with Li+ or Na+. However, the metal ion complex of natural antamanide has a hydrophobic globlar form whereas the metal ion complex of the inactive perhydro analogue has a polar band around the middle. The structure results indicate that the antamanide molecule is in a complexed form during its biological activity. Single crystal x-ray diffraction structure analyses have identified the manner in which water molecules are essential to creating minipolar areas on apolar helices. Completely apolar peptides, such as membrane active peptides, can acquire amphiphilic character by insertion of a water molecule into the helical backbone of Boc-Aib-Ala-Leu-Aib-Ala-Leu-Aib-Ala-Leu-Aib OMe, for example. The C-terminal half assumes an alpha-helix conformation, whereas the N-terminal half is distorted by an insertion of a water molecule W(1) between N(Ala5) and O(Ala2), forming hydrogen bonds N(5)H...W(1) and W(1)...O(2). The distortion of the helix exposes C = O(Aib1) and C = O(Aib4) to the outside environment with the consequence of attracting additional water molecules. The leucyl side chains are on the other side of the molecule. Thus a helix with an apolar sequence can mimic an amphiphilic helix. PMID- 2720097 TI - First Naples Workshop on Bioactive Peptides. Conformation-activity relationships interactions. May 24-26, 1988, Capri, Italy. Proceedings. PMID- 2720098 TI - Pseudopeptides and beta folding: x-ray structures compared with structures in solution. AB - In order to restrain the flexibility of the peptide molecules and reduce their biodegradation, modifications of the main chain are now introduced in pseudopeptide analogues. Surprisingly, there is very little data on the conformational properties of these derivatives. We have examined pseudopeptide analogues of RCO-X-Y-NHR' model dipeptides in the depsi, N-methylated, reduced, retro, alpha, beta-dehydro, beta-amino acid, and hydrazino series, in the solid state by x-ray diffraction, and in solution by ir and 1H-nmr spectroscopy. This study provides us with accurate dimensions of the peptide surrogates, and gives some information on the conformational tendencies induced by these substitutions, with reference to those of the related dipeptide sequences. PMID- 2720099 TI - NMR studies of a series of dehydrodermorphins. AB - The third and fifth aromatic residues of dermorphin, a potent mu-opioid peptide, and of its N-terminal fragments, from the pentapeptide to the parent heptapeptide amide, have been systematically substituted with Z-dehydrophenylalanine (delta Phe) and/or Phe to investigate the conformation-activity relationship. The characterization in DMSO-d6 at 500 MHz indicates that, in this solvent, all peptides adopt essentially random, extended conformations, as a consequence of the strong solvation. The chemical shift of the methyl group of D-Ala is influenced by the precise orientation of the side chain of the third residue in a fashion that can be correlated to the mu potency, consistently with our model of mu-receptor. However, the complexes of the pentapeptides with 18-crown-6-ether, when dissolved in chloroform, adopt ordered, folded conformations, a behavior that closely parallels the CD observations in methanol. PMID- 2720100 TI - Solid-state conformations of aminosuccinyl peptides: crystal structure of tert butyloxycarbonyl-L-leucyl-L-aminosuccinyl-L-phenylalaninami de. AB - The protected tripeptide tert-butyloxycarbonyl-L-leucyl-L-aminosuccinyl-L phenylalaninamide crystallizes in the orthorhombic space group P2(1)2(1)2(1), with a = 6.214(3), b = 12.832(3), c = 33.094(4) A, Z = 4. The structure was solved by direct methods using MULTAN 80 and refined to an R value of 0.055 for 1458 reflections. The bond lengths and angles are in good agreement with the standard values. The peptide backbone adopts a type II' beta-bend conformation with a weak intramolecular hydrogen bond between the CO group of the leucyl residue and the C-terminal NH2 group. In agreement with previous studies, this structure confirms the high propensity of aminosuccinyl peptides to adopt a type II' beta-bend conformation. The role of this conformation in relation to the deamidation process in proteins is also discussed. PMID- 2720101 TI - Synthesis and structural studies of N-p-toluensulfonyl cyclodipeptides. AB - In view of the chemical and structural interest of cyclopeptides bearing an electron withdrawing substituent directly bonded at the amide nitrogen atom, the two N-p-toluensulfonyl (N-tosyl) derivatives cyclo[-Phe(Tos)-D-Phe-] (I) and cyclo[-Phe(Tos)-D-Pro-] (II) have been synthesized and their stereochemistry defined. The molecular structure of I, as determined by x-ray diffraction analysis, is reported together with 1H-nmr parameters indicating the preferred rotameric conformation in chloroform solution. The N-tosyl group alters the geometry of the cyclodipeptide ring by lengthening both the N-C bonds departing from the tosylated nitrogen and reducing the corresponding ring angle. The 6 membered peptide ring adopts an unusual "sofa" conformation with the Tos-Phe C alpha atom deviating 0.230(3) A out of the mean plane of the other five ring atoms. One of the two S-O bonds forms a planar system that involves the tosylated nitrogen and the corresponding amide carbonyl. In the crystal, both the benzylic side chains are folded over the heterocyclic ring, whereas in chloroform solution, the benzylic side chain of the D-Phe prefers an extended conformation. PMID- 2720102 TI - 17O-NMR studies of the conformational and dynamic properties of enkephalins in aqueous and organic solutions using selectively labeled analogues. AB - The synthesis of Leu-enkephalin selectively 17O-enriched in Gly2 and Gly3 is reported. The 17O-nmr chemical shifts of [17O-Gly2, Leu5]- and [17O-Gly3, Leu5] enkephalins in H2O are almost identical and independent of the pH. Since hydrogen bonding is the dominant factor governing the chemical shifts of the peptide oxygen, it can be concluded that the hydration state of both oxygens is identical and independent of the pH. The 17O chemical shifts of the [17O-Leu5]-enkephalin terminal carboxyl group at pH approximately 1.9 and 5.6 are very different in H2O but very similar in CH3CN/DMSO (4:1) solution. This suggests that the protonation state of the carboxyl group at both pH values in CH3CN/DMSO solution is the same and consequently that Leu-enkephalin exists in the neutral form at pH approximately 5.6. In this organic mixed solvent system both Gly2 and Gly3 oxygen resonances exhibit a significant shift to high frequency by the same extent (delta delta approximately 30 ppm). It is concluded that both peptide oxygens are not hydrogen bonded to an appreciable extent and that no specific 2----5 hydrogen bonding exists to an appreciable extent. This conclusion is in agreement with the energy of activation for molecular rotation, as determined from T1 measurements, which was found to be almost identical for both [17O-Gly2, Leu5]- and [17O-Gly3, Leu5]-enkephalins in CH3CN/DMSO (4:1) mixed solvent. PMID- 2720103 TI - Conformationally constrained D,L-alternating oligopeptides. AB - The possibility of selectively reducing the number of beta-helical structures theoretically possible for a D,L-alternating peptide by using a N-methyl group as conformational constraint is considered. Some 1H-nmr data regarding Boc(L-Nle-D Nle)3-L-Nle-D-MeNle-L-Nle-D-Nle-L-Nle-OMe (I), its formyl analogue (II), and the pentadecapeptide Boc(D-Leu-L-Leu)5-D-MeLeu-(L-Leu-D-Leu)2-OMe (III) are presented. It is shown that these alternating stereocooligopeptides with a N methyl group in the (n - 3) (I and II) or (n - 4) position (III) differ drastically in their behavior from the corresponding nonmethylated compounds. In chloroform, I and II form predominantly -- beta 7.2-helices and III forms almost exclusively -- beta 5.6 or -- beta 7.2-helices. The helices are in every case those having the maximum possible number of interchain H bonds. PMID- 2720104 TI - Regularly alternating L,D-peptides. I. The double-stranded left-handed antiparallel beta-helix in the structure of Boc-(L-Val-D-Val)4-OMe. AB - The structure of Boc-(L-Val-D-Val)4-OMe has been determined by x-ray single crystal diffraction analysis. The octapeptide crystallizes in the trigonal system, space group P3(2)21 with a = b = 12.760 A, c = 63.190 A and Z = 6. The independent unit is represented by one octapeptide chain. The structure has been solved by direct methods and it was anisotropically refined by least-squares procedures to a final R value of 0.08 for the 3018 "observed" reflections. One molecule of water was also located in the unit cell. Two octapeptide chains, related by a crystallographic binary axis, wind up around each other giving rise to a double-stranded left-handed antiparallel increases decreases beta 5.6-helix. The dimer, stabilized by 14 interstrand N--H....O = C hydrogen bonds, can be regarded as a cylinder with an hydrophilic inner core represented by the peptide units and an hydrophobic exterior of isopropyl groups. The inner diameter of the cylinder is 5.1 A. PMID- 2720105 TI - Regularly alternating L,D-peptides. II. The double-stranded right-handed antiparallel beta-helix in the structure of t-Boc-(L-Phe-D-Phe)4-OMe. AB - The crystal structure of Boc-(L-Phe-D-Phe)4-OMe has been determined by x-ray diffraction analysis. The peptide crystallizes in the triclinic system, space group P1 with a = 15.290 A, b = 15.163 A, c = 19.789 A, alpha = 102.49 degrees, beta = 96.59 degrees, gamma = 74.22 degrees, and Z = 2. The structure has been solved by coupling of the molecular replacement technique and expansion by tangent formula refinement of the set of known phases. Several cycles of Fourier calculations and least-squares refinement led to the location of 194 atoms of the two independent octapeptide chains and few molecules of cocrystallized solvent (chloroform, water, and methanol). The isotropic refinement converged to R = 0.13 for the 3077 "observed" reflections. The two independent octapeptide molecule form a dimer in the solid state: the two chains are associated by interstrand hydrogen bonds (12 of the type N-H ... O = C) with the formation of a double stranded antiparallel right-handed -- beta 5.6-helix. These double helices can be represented as a cylinder with a hydrophilic inner core represented by the peptide units and an hydrophobic exterior constituted by the aromatic moieties. The dimensions of the cylinder are equal to those observed for Boc-(L-Val-D-Val)4 OMe. In the solid state the dimers pack with each other in an hexagonal fashion with the formation of layers; between the layers, solvent molecules fill empty spaces. PMID- 2720106 TI - Regularly alternating L,D-peptides. III. Hexacyclic peptides from valine or phenylalanine. AB - In the present paper we describe the single-crystal x-ray analyses of two cyclic hexapeptides containing an equal number of alternating L,D-residues as putative analogues of the metal binding compounds, enniatin and beauvericine. Both the molecules of c(L-Val-D-Val)3 and C(L-Phe-D-Phe)3 retain in the solid state the center of symmetry and crystallize with six and eight trifluoroacetic acid molecules, respectively. The peptides are strongly hydrogen bonded to the solvent molecules. We estimate, on the basis of the molecular geometry and spatial arrangement of the peptide carbonyl groups and in comparison with other metal binding cyclic peptides, the ability of these molecules to interact with metal ions as 1:1 complexes. PMID- 2720107 TI - Structure of conformationally constrained peptides: from model compounds to bioactive peptides. AB - The use of backbone conformational constraints has acquired increasing importance in the design and synthesis of structurally restricted agonists and antagonists of bioactive peptides. Here I discuss the preferred conformations of four among the most popular types of such peptide surrogates: (a) Peptides from C alpha, alpha-dialkylated residues, (b) tetrazolyl peptides, (c) (gamma- and delta-) lactam-containing peptides, and (d) thiated peptides. Emphasis is given to conformational energy computations and x-ray diffraction analyses of selected model compounds and analogues of small bioactive peptides such as the formylmethionyl tripeptide chemoattractant and MIF. PMID- 2720108 TI - A crystal molecular conformation of leucine-enkephalin related to the morphine molecule. AB - Leucine-enkephalin (Try1-Gly2-Gly3-Phe4-Leu5) has been crystallized as a trihydrate from water solution. X-ray diffraction reveals a tightly folded molecular conformation with two fused beta III- (Gly2-Gly3) and beta I- (Gly3 Phe4) turns. The Tyr1 and Phe4 aromatic rings have a close orthogonal arrangement analogous to the tyramine and cyclohexenyl rings in morphine. This suggests that the conformation found in the trihydrate crystal structure could be required for recognition by mu-receptor sites. PMID- 2720109 TI - Design and conformation of non-Aib synthetic peptides enjoying alamethicin-like ionophore activity. AB - Analogues of alamethicin, a 20-mer amphipathic helical peptide with ionophore activity, in the sequence of which all Aib residues were substituted by Ala (A1) or Leu (L1), were synthesized by the solid phase method, purified by high performance liquid chromatography and characterized by fast atomic bombardment mass spectrometry. Infrared and CD studies showed that A1 easily underwent a transconformation to beta-structure whereas L1 displayed a predominant alpha helical character, thus being a potential ionophore model. Its voltage-dependent multistate activity in model membranes showed that Aib is not a requisite residue to observe an alamethicin-like behavior. However, as the lifetime of the single channels was much shorter than for alamethicin, the peptide chain was lengthened by a Leu (LL1) or a Ser (SL1) residue. The last peptide gave an increased channel lifetime, but the design of other non-Aib peptides, taking into account the hydroxyl C-terminus and side-chain interactions between helices in a barrel-stave bundle, is desirable to approach more closely the alamethicin activity. PMID- 2720110 TI - Tooth enamel protein, amelogenin, has a probable beta-spiral internal channel, Gln112-Leu138, within a single polypeptide chain: preliminary molecular mechanics and dynamics studies. AB - Molecular dynamics simulation, with backbone constraints for 20 ps of equilibration and simulation, of a repeating polypeptide segment, Gln-Pro-His-Gln Pro-Leu-Gln-Pro-His-Gln-Pro-Leu-Gln-Pro-Met-(Gln-Pro-Leu )4, constituting residues 112-138 of bovine amelolgenin, a 19.35 kD hydrophobic protein, are discussed. It is generally believed that the above polypeptide segment is important for the interaction of amelogenin with Ca++ ions, which occurs in the early phases of enamel mineralization. An energetically stable structure of the above polypeptide with recurrent beta-turns is observed and contains a pore of approximately 1 A radius along the helical that can accommodate an unhydrated Ca++ ion. The length of the polypeptide possesses correct dimensions to span a bilayer. The proposed structure is unique among known polypeptide and protein structures. PMID- 2720111 TI - Bicyclic peptides: solution conformation and Ca2+ binding of the heterodetic bicyclic decapeptide cyclo(Glu1-Leu2-Pro3-Gly4-Ser5-Ile6-Pro7-Ala8)- cyclo(1 gamma----5 beta)Phe9-Gly10. AB - The conformational behavior of a heterodetic bicyclic decapeptide (BCPLT) in the absence and in the presence of calcium ions has been studied by means of mono and two-dimensional nmr techniques. Free BCPLT possesses a quite compact structure stabilized by intramolecular bonds and turns. In the structure a cluster of carbonyls is located in a cavity that is supposed to be the cation binding site. PMID- 2720112 TI - Synthesis of the dodecapeptide corresponding to domain III of bovine brain calmodulin: alpha-beta shift side reactions during the synthesis by the classical method in solution. AB - We report details of the chemical synthesis of the dodecapeptide corresponding to the calcium binding loop III of bovine brain calmodulin (sequence 93-104) and its fragments 96-04, 93-98, and 99-104. The preparation of the peptides employed classical solution methods and a fragment-condensation strategy. The major difficulties were encountered during the synthesis of the peptides containing the N-terminal sequences -Gly-Asn-Gly- and -Asp-Lys-Asp-Gly-Ans-Gly-, in which alpha beta shift side reactions were observed. PMID- 2720113 TI - Conformation and ion binding properties of peptides related to calcium binding domain III of bovine brain calmodulin. AB - The conformational and ion binding properties of the sequences 93-104, 96-104, and 93-98 of domain III of bovine brain calmodulin (CaM) have been studied by CD and Tb3+-mediated fluorescence. In aqueous solution the interaction of all fragments with Ca2+ and Mg2+ ions is very weak and without any effect on the peptide conformation, which remains always random. In trifluoroethanol the interaction is very strong and the different fragments exhibit very distinct binding properties. In particular, the dodecapeptide fragment 93-104, and its N terminal hexapeptide 98-104, bind calcium and magnesium with a very high binding constant (Kb greater than 10(5) M-1), undergoing a substantial conformational change. The structural rearrangement is particularly evident in the hexapeptide fragment, which tend to form a beta-bend. The C-terminal nonapeptide fragment 96 104 interacts with calcium and magnesium more weakly, and the binding process causes a decrease of ordered structure. These results suggest that, even in the entire dodecapeptide sequence corresponding to the loop of domain III of CaM, the calcium binding site is shifted toward the N-terminal hexapeptide segment. This interpretation is consistent with the results of crystallographic studies of CaM, which show that the calcium ions are located toward the amino terminal portion of the loop. PMID- 2720114 TI - Ala analogues of the cyclolinopeptide A. AB - Analogues of cyclolinopeptide A, due to the replacement of each amino acid in the Pro1-Pro2-Phe3-Phe4 sequences with an L-Ala residue, were synthesized by classical method in solution. Mixed anhydride and N,N'-dicyclohexylcarbodiimide coupling methods have been used for the synthesis of both linear and cyclic peptides. The products were characterized by Rf values and uv spectra, as well as by fast atom bombardment spectroscopy. 1H-nmr studies on [Ala2] analogues are also reported. Preliminary data in CDCl3 solution, at low temperature, seems more promising. PMID- 2720115 TI - Conformational analysis of cyclic peptides in solution. AB - The strategy and tactics of conformational analysis of cyclic peptides in solution is demonstrated by the example of cyclo(-D-Pro-Phe-Thr-Phe-Trp-Phe-). Spin-locked experiments like rotating frame nuclear Overhauser enhancement spectroscopy (ROESY), ROTO, and TOCSY are successfully applied to assign all proton signals and to obtain distance information. A crude conformational model was built using the nmr data. This starting model was refined by restrained molecular dynamics (MD) calculations using ROE derived distances and fixed bond angles as determined from homo- and heteronuclear coupling constants. To mimic the solvent and to reduce artifacts in an in vacuo calculation the charges of the solvent-exposed NH protons were gradually reduced according to the temperature gradients. The thus obtained "conformation" (mean of a 40 ps MD trajectory) shows very close similarity to x-ray structures in an orthorhombic and in two monoclinic crystal modifications of the same compound. The main difference is the breaking of an intermolecular hydrogen bond of the threonine hydroxyl group on dissolution of the crystal and forming an intramolecular hydrogen bond in solution. PMID- 2720116 TI - Interactive NMR and computer simulation studies of lanthionine-ring structures. AB - We report progress in elucidating the structure of nisin, a naturally occurring peptide antibiotic. Nisin contains five rings constrained by lanthionine or methyllanthionine bridges, as well as alpha, beta-unsaturated amino acids. We have determined conformations for two model compounds of ring A and a derivative of ring B through interactive nmr and computer simulation studies. High resolution nmr techniques provides structural information, which was further refined through molecular dynamics simulations. These methods are being applied to the remaining constrained fragments of the molecule. This conformational information will be employed in an aufbau approach to determining the structure of the entire molecule. PMID- 2720117 TI - The crystal and molecular structure of the alpha-helical nonapeptide antibiotic leucinostatin A. AB - The crystal and molecular structure of the nonapeptide antibiotic leucinostatin A, containing some uncommon amino acids and three Aib residues, has been determined by x-ray diffraction analysis. The molecule crystallizes in the orthorhombic space group P2(1)2(1)2(1), a = 10.924, b = 17.810, c = 40.50 A, C62H111N11O13, HCl.H2O, Z = 4. The peptide backbone folds in a regular right handed alpha-helix conformation, with six intramolecular i----(i + 4) hydrogen bonds, forming C13 rings. The nonapeptide chain includes at the C end an unusual beta-Ala residue, which also adopts the helical structure of the other eight residues. In the crystal the helices are linked head to tail by electrostatic and hydrogen-bond interactions, forming continuous helical rods. The crystal packing is formed by adjacent parallel and antiparallel helical rods. Between adjacent parallel helical columns there are only van der Waals contacts, while between adjacent antiparallel helical columns hydrogen-bond interactions are formed. PMID- 2720118 TI - Mono and two-dimensional 500-MHz characterization of synthetic bombesin and related peptides in DMSO and DMSO-water. AB - The proton nmr characterization of bombesin (BBS) and of two peptide fragments corresponding to the (1-6) and (6-14) sequences has been carried out at 500 MHz in dimethyl sulfoxide (DMSO-d6) using two-dimensional (2D) homo and 1H-13C heterocorrelated techniques. All resonances in the nmr spectra have been assigned and several coupling constants have been measured. The backbone J alpha CH-NH coupling constants are quite similar and around 7.8-8.2 Hz, pointing to an unfolded structure in DMSO-d6. The possibility of secondary structures in highly viscous mixtures of DMSO-d6-water was investigated. The existence of sequential nuclear Overhauser enhancement (NOE) effects in the C-terminal nonapeptide section may indicate a preferential site for secondary structuring. PMID- 2720119 TI - Conformation of bombesin in buffer and in the presence of lysolecithin micelles: NMR, CD, and fluorescence studies. AB - The conformation of the tetradecapeptide hormone bombesin has been studied in buffer and in the presence of lysolecithin micelles, using static and dynamic fluorescence, CD, and one- and two-dimensional nmr. The results obtained show that in buffer bombesin is present in an extended flexible chain, with no evidence for any ordered secondary structure. A marked change in the CD spectrum is observed changing from buffer to the lipid suspension. Concomitantly, the 1H nmr spectrum of bombesin, in a D2O lipid dispersion, shows the persistence of resonances due to exchangeable protons and in similar conditions the fluorescence intensity increases. We think therefore that these results strongly support the hypothesis that bombesin interacts with the lipid phase, assuming ordered secondary structure. Finally, the marked dependence of tryptophan fluorescence quantum efficiency and order parameter from the hormone concentration in the presence of lysolecithin but not in buffer leads to the conclusion that bombesin can associate into the lipid matrix. PMID- 2720120 TI - Conformational analysis of peptide T and of its C-pentapeptide fragment. AB - The synthetic peptide of sequence H-Ala-Ser-Thr-Thr-Thr-Asn-Tyr-Thr-OH, termed peptide T, a competitor of the Human Immunodeficiency Virus in the binding to human T cells, and its C-terminal pentapeptide fragment, were studied by 1H-nmr in DMSO solution to determine conformational preferences. The observation of nuclear Overhauser enhancements (NOEs) for both peptides, and unusual finding for small linear peptides, allowed complete sequence-specific resonance assignments. Long-range NOEs, ring-current shifts, and the very small temperature coefficient of the Thr8 NH chemical shift suggest, for the zwitterionic form of peptide T, the presence in solution of a beta-turn involving Thr5, Asn6, Tyr7 and Thr8. This conformational feature is consistent with previous structure-activity relationship studies indicating the invariance of the same residues in several potent pentapeptide analogues. The studied pentapeptide fragment, although less structured, shows some tendency to fold even in a polar solvent such as DMSO. Preliminary chemotaxis data on some pentapeptide analogues are consistent with our structural model. PMID- 2720121 TI - Comparison of the conformations of cyclolinopeptide A in the solid state and in solution. AB - Cyclolinopeptide A, a cyclic nonapeptide isolated from linseed, has lately attracted large interest for its cytoprotective activity. The recent elucidation of its solid state structure has prompted us to undertake a detailed conformational analysis in solution. Room-temperature 1H-nmr spectra in several solvents (DMSO-d6, DMSO-d6/D2O/H2O, CD3OH, (CD3)2CDOH, CDCl3) all show very broad lines, indicating the presence of chemical exchange among several conformers. It proved possible to freeze a single conformational state in CDCl3 at 214 K. Unusual chemical shifts and nuclear Overhauser enhancements are consistent with the main features of the solid state structure. PMID- 2720122 TI - Conformational behavior of cyclic CCK-related peptides determined by 400-MHz 1H NMR: relationships with affinity and selectivity for brain receptors. AB - The conformational study of a homogenous series of cyclic analogues of CCK8, selective for central receptors, such as Boc-X-Tyr(SO3H)-Nle-D-Lys-Trp-Nle-Asp Phe-NH2, where X = L-Glu, D-Glu, or gamma-D-Glu, was performed by 400-MHz 1H-nmr. The regular increase in affinity for central receptors when going from [L-Glu] to [gamma-D-Glu] is correlated to (a) an enhancement in internal flexibility of the cyclic moiety, (b) an external orientation of the tyrosine side chain, and (c) a restructuring of the C-terminal part of the peptide. All these results could permit a modeling of biologically active conformation of CCK8 for both receptors types to be performed. PMID- 2720123 TI - Dynamic light scattering studies of porcine submaxillary mucin fractions in dilute solution at intermediate scattering vectors. AB - We report dynamic light scattering measurements over a wide range of scattering vectors for fractionated samples of porcine submaxillary mucin (PSM) glycoproteins in two different solvents: 0.1M NaCl, and 6M GdnHCl. The relaxation spectrum has been successfully resolved into a slow mode corresponding to pure translational diffusion and a fast mode containing information on the relaxation times for intramolecular motion. Analysis of the slow mode permits a light scattering evaluation of the polydispersity of these high molecular weight mucin glycoprotein fractions. Determination of the longest intramolecular relaxation times tau 1 shows that these are much longer for the PSM fractions in 0.1M NaCl compared to 6M GdnHCl. These data are consistent with earlier studies showing that the chain conformation is the same in both solvents, but that in 0.1M NaCl, the PSM glycoprotein undergoes a self-association process that is end-to-end in nature. Since the tau 1 value is intimately related to the viscoelastic behavior of PSM solutions and gels, it is interesting to speculate that the end-to-end association process may be physiologically important. PMID- 2720124 TI - Effect of the mitogenic lectin concanavalin A on the thermotropic behavior of glycosyl-free cationic lipids and their mixtures with zwitterionic lipids. AB - The effect of concanavalin A (Con A) on the thermotropic behavior of positively charged, glycosyl-free lipids and their mixtures with zwitterionic lipids was investigated by differential scanning calorimetry. The gel to liquid-crystal phase transition enthalpy of pure dipalmitoylcholine (DPC) was found to be significantly increased in the presence of Con A (delta H = 31.2 and 42.5 KJ mol 1 lipid in the presence and in absence of Con A, respectively). Addition of the lectin to DPC liposomes, furthermore, induces the appearance of a new phase transition centered at 320 K. These results are interpretable by a partial hydrophobic interdigitation of the lectin molecule into the liposomal bilayer. The effect of Con A on the phase behavior of three 2:1 mixtures of zwitterionic and of positively charged lipids was also investigated. Phase diagrams of the systems dipalmitoyl-phosphatidylcholine-dihydrosphingosine (DPPC-DHS), sphingomyelin-dipalmitoylcholine (SPM-DPC), and dimyristoylphosphatidylcholine dipalmitoylcholine (DMPC-DPC) are presented. In lipid mixtures of limited miscibility (DPPC-DHS and SPM-DPC), Con A induces pronounced phase-separation effects. These effects are attributable to a direct hydrophobic interaction of the lectin with the liposomal bilayer and do not require the presence of specific receptor groups. The possible relationship between lectin-induced phase separations in the lipid matrix of biomembranes, and the observed changes in membrane permeability, membranal enzymatic activities, etc., is briefly discussed. PMID- 2720125 TI - Two-dimensional proton NMR studies on poly(VPGVG) and its cyclic conformational correlate, cyclo(VPGVG)3. AB - Two-dimensional nuclear Overhauser enhancement (2D NOESY) data are reported for the polypentapeptide of elastin, poly(VPGVG), and the cyclopentadecapeptide, cyclo(VPGVG)3. In both, the repeating type II Pro2-Gly3 beta-turn can be derived from the NOE data, providing confirmation of many previous studies. In addition, other through-space connectivities are detailed that also compare favorably with previously determined crystal and solution structures for cyclo(VPGVG)3. Also, near identical data for the cyclopentadecapeptide and the polypentapeptide demonstrate the cyclic conformation-linear (helical) conformational correlate relationship between the two molecules. The 2D NOESY experiment is seen to be an effective means of establishing the presence or absence of a conformational relationship between a cyclic repeating sequence and its higher molecular weight linear counterpart. This is an approach of substantial practical value when developing the conformation of sequential polypeptides and when attempting to identify the presence of the conformation of a repeating peptide sequence within a more complex primary structure. Having established the basic conformational relationship between a cyclic conformation and its linear helical counterpart, cross peaks present in the linear helical structure that are not present in the cyclic conformational correlate can provide information on the interactions between adjacent turns of the helix. In this connection, a Val gamma CH3 in equilibrium Pro beta CH2 interaction is reported that can be the basis for determining the number of pentamers per turn of helix once it is determined whether it is dominantly the Val1 or Val4 gamma CH3 that is interacting with the Pro2 beta CH2. PMID- 2720126 TI - A theoretical investigation of the intercalative binding of 7-H pyrido[4.3C]carbazole chromophore into a d(CpG)2 minihelix. AB - Theoretical computations are performed of the intercalative binding to a model d(CpG)2 minihelix of 7-H pyrido[4.3C]carbazole, the precursor of the antitumor bisintercalating drug ditercalinium. The conformations of the intercalation site are generated by the AGNAS procedure (algorithm to generate nucleic acid structures) of Miller and co-workers. The ligand-nucleotide interactions and the nucleotide conformational energies are computed with the SIBFA procedures (sum of interactions between fragments ab initio computed), which use formulas of empirical origin that reproduce ab initio SCF (self-consistent field) computations. Among the candidate intercalation sites most favored energetically, one has a pattern of conformational angles related to the one determined crystallographically by Sobell et al. in a series of x-ray structural studies of small intercalator-dinucleotide monophosphate complexes. Optimal values of the unwinding angle, found in the range of -12 degrees to -14 degrees, are consistent with available experimental data on DNA. PMID- 2720127 TI - Harmonic dynamics of a DNA hexamer in the absence and presence of the intercalator ethidium. AB - Vibrational normal mode calculations are presented for a DNA hexanucleoside pentaphosphate, d(CpGpCpGpCpG)2, and for its complex with the cationic intercalator ethidium. Two intercalation sites are modeled that differ in DNA backbone torsion angles. Normal mode frequencies for the DNA fragment itself are significantly lower than those reported earlier using different force fields, but an analysis of "effective" frequencies suggests that somewhat higher frequencies are more appropriate. Intercalation leads to significant lowering of mobility for the base pairs adjacent to the drug; in this sequence, the ethidium binding affects the guanosine atoms more strongly than the cytosine atoms. Motions of the bases and the intercalator are analyzed in terms of "twist" about the local helix axis and a "tilt" angle relative to this axis, and the results are compared to fluorescence studies of ethidium-DNA complexes. PMID- 2720128 TI - Modeling DNA supercoils and knots with B-spline functions. AB - A method is offered to model the complex trajectories of closed circular DNA supercoils and knots. The trajectories are approximated by polygons and analytical expressions of the curves are generated from the polygons with B spline functions. The resulting curves are used to evaluate the writhe and elastic energy of a series of interrelated supercoils, and to generate detailed atomic models of the deformed double helix. PMID- 2720129 TI - The effect of sequence-specific interactions on the stability of the alpha-helix in synthetic tropomyosin-analogue peptides. PMID- 2720130 TI - Release of 5-fluorouracil from intramuscular w/o/w multiple emulsions. AB - Comparative in vivo studies of aqueous solution, multiple w/o/w, and w/o emulsions showed that formulating 5-fluorouracil in emulsion systems significantly sustained the release of the drug from intramuscular injection sites in the rat. Intramuscular injection of the drug in both w/o and w/o/w emulsion systems produced sustained blood concentrations with a later blood level peak than observed following intramuscular injection of aqueous solutions of the drug. The multiple w/o/w emulsion exhibited a more rapid release of drug from the injection site than the w/o emulsion because of partitioning of the drug to the external aqueous phase during secondary emulsification. The fate of the oil phase following intramuscular injection of a water/hexadecane/water multiple emulsion spiked with 1-14C-hexadecane has been studied in rats as a function of stabilizer concentrations. Increasing the lipophilic surfactant (Span 80) concentration facilitated the clearance of the oily vehicle from the injection site, by mechanisms which remain to be elucidated. PMID- 2720131 TI - Absorption kinetics of rectally and orally administered ibuprofen. AB - The bioavailability of rectally administered sodium ibuprofen solution and aluminum ibuprofen suspension was determined in eight normal subjects relative to the same treatments administered orally. The results indicate that the suspension was less bioavailable than the solution irrespective of the route of administration. Although not bioequivalent, rectally administered ibuprofen solution compared favourably with orally administered ibuprofen solution. The mean AUC and Cmax from rectal administration were 87 per cent and 62 per cent of the corresponding values achieved after oral administration. Mean residence times and peak times were 1-3 h longer with the rectal solution, indicating a slower rate of absorption. Absorption after rectal administration was zero order in some subjects while absorption after oral administration was first order. This may be due to the large differences in surface area between absorption sites. Since sodium ibuprofen solution is absorbed when given rectally, this route of administration could be used in patients unable to take oral ibuprofen. PMID- 2720132 TI - Evidence of a specialized transport mechanism for the intestinal absorption of baclofen. AB - Absorption of the spasmolytic drug baclofen in three selected intestinal segments of living anaesthetized rats in situ, is shown to be a specialized transport mechanism obeying Michaelis-Menten kinetics. Equation parameters were calculated through different procedures, whose features are discussed. A computer method based on the integrated form of Michaelis-Menten equation which reproduces the entire time course of drug absorption from the data found in three intestinal perfusion series at different initial concentrations, yielded Vm and Km values of 12.0 mg h-1 and 8.0 mg, respectively, in the mean segment of the small intestine, a rather selective absorption site for baclofen. Lesser but comparable absorption rates were found in the proximal and distal segments of the small intestine, whereas in colon, drug absorption was negligible. Baclofen transport was significantly reduced in the presence of the enzymatic inhibitor sodium azide. If these results were extrapolated to humans, they would explain the excellent bioavailability profiles reported for baclofen at normal doses in spite of its physicochemical properties, which do not favour passive diffusion. Based on the same principle, the administration of usual doses at shorter time intervals could be recommended, instead of high, when higher plasma levels at steady-state are needed. On the other hand, more than 8-h sustained-release preparations of baclofen should, probably, be avoided. PMID- 2720133 TI - Further observations on the disposition characteristics of salicylic acid in analbuminemic rats. AB - The disposition characteristics of salicylic acid (SA) were investigated in analbuminemic rats after intravenous bolus injection of 10 and 173 mg kg-1 of SA to study the effects of plasma protein binding on drug disposition. Following the administration of 10 mg kg-1 of SA, total body SA clearance (CL) was markedly faster and its apparent volume of distribution (Vd) significantly greater in the analbuminemic rats in comparison to the controls. Further, the apparent elimination rate constant (kj) was two-fold greater and the corresponding elimination half-life (t 1/2) shorter in the rats with low plasma albumin. Whole body autoradiograms obtained following the administration of 14C-salicylic acid demonstrated that the tissue distribution of SA was greater in the analbuminemic rats which was in agreement with the larger Vd observed in this group of rats. After the administration of 173 mg kg-1 of SA, no differences in CL, Vd, kk or t 1/2 were noted between the analbuminemic and control rats. Dose-dependent SA disposition was observed in both the analbuminemic and control rats with the effects being more pronounced in the rats with low plasma albumin. The results suggested that the disposition characteristics of SA were markedly altered in the presence of low plasma albumin concentrations due to reduced plasma SA protein binding. PMID- 2720134 TI - Multiple dose comparison of a whole 240 mg verapamil sustained-release tablet with two half tablets. AB - Twelve healthy male volunteers were studied in a balanced crossover comparison of an intact 240 mg verapamil sustained-release tablet (Securon SR, Isoptin Forte Retard) given once daily for 7 days, and the same dose given as two half tablets. One subject was withdrawn because of asymptomatic second degree heart block on day 3 of verapamil treatment. The mean Cmax after dosing with whole tablets, 143 (95 per cent confidence limits 91.6-223) ng ml-1 was lower than after dosing with half tablets, 160 (107-241) ng ml-1, but this was not significant (p = 0.49). The mean steady-state Cmin values after whole and half tablets were also similar: 22.2 (12.6-39.4) ng ml-1 and 22.0 (16.2-29.9) ng ml-1, respectively (p = 0.96). The mean (+/- S.D.) tmax, AUC0-24 and t 1/2 were not significantly different: whole tablet 3.5 +/- 1.2 h, 1733 +/- 1125 ng.h ml-1 and 10.5 +/- 3.4 h, respectively, and half tablets 3.6 +/- 1.0 h, 1780 +/- 1057 ng.h ml-1 and 9.6 +/- 2.3 h, respectively. The findings for plasma norverapamil were generally similar to those for the parent drug. This investigation indicates that the formulation is sufficiently robust to retain its sustained-release properties when the tablet is halved. PMID- 2720135 TI - In vitro and in vivo evaluation of seven 50 mg and 100 mg nitrofurantoin tablets. AB - Four 50 mg and three 100 mg marketed nitrofurantoin tablets were studied in 14 healthy male subjects. Urine was collected 1, 2, 3, 4, 6, 8, 12, and 23 h after each dose, and nitrofurantoin was assayed by HPLC. The in vitro dissolution of the tablets was determined using USP Apparatus 1 and 2, with 0.1 N hydrochloric acid and pH 7.2 buffer as the dissolution fluids. One of the 50 mg tablets was more rapidly and completely absorbed than the other six products. The incidence of side-effects for this product was as low or lower than the other products. It was determined that the use of the USP Apparatus 1, at 100 rev min-1, with sampling of the pH 7.2 fluid at 30 min, provided for the best overall relationship between the urinary excretion and in vitro dissolution. PMID- 2720136 TI - A high-affinity folate binding protein in human urine. Radioligand binding characteristics, immunological properties and molecular size. AB - High-affinity binding of [3H]folate in human urine displayed characteristics, e.g. apparent positive cooperativity, which are typical of specific folate binding. By means of a two-site enzyme-linked immunosorbent assay (ELISA) with rabbit antibodies against the low molecular weight folate binding protein from human milk, we measured folate binding protein concentrations in the range of 0.51 to 4.13 nM in urine samples from 16 apparently healthy individuals. Ultrogel AcA 44 chromatography of the urine showed that immunoreactive and radioligand bound folate binding protein coeluted in one large peak (Mr approximately 25,000). PMID- 2720137 TI - Implications for evolution of nuclear structures of animals, plants, fungi and protoctists. AB - The evolutionary variations of nuclear structure of animals, plants, fungi and protoctists were studied with electron microscopy by using techniques preferentially staining ribonucleoprotein (RNP) particles and chromatin. A remarkable similarity in the general morphological features of the RNP particles and chromatin arrangement is found in animals, plants and fungi. Important variations of these features were found in protoctists. These observations suggest that major evolutionary changes in the nuclear structure predate the acquisition of plastids by the ancestors of green plants. Once evolved, the nuclear structural pattern is conserved in plants and animals. Among protoctists studied, Kinetoplastida, Cryptomonadida and Volvocida have RNP particles and chromatin arrangement resembling those of plants and animals. These similarities may indicate a common ancestor. Important differences in the nuclear structure among Euglenida, Amebida, Cryptomonadida, Volvocida and Kinetoplastida support the view that Sarcomastigophora is a polyphyletic taxon. For the same reason Kinetoplastida and Euglenida must not be grouped in a monophyletic taxon. We propose that the variations of RNP particles may be related to the initial evolution of post-transcriptional processing. PMID- 2720138 TI - Cell motility: an interplay between local and non-local measurement. AB - The bending motions of an ATP-activated actin filament and a flagellar axoneme of starfish spermatozoon exhibit a one-to-many correspondence between the displacement of the medium and the force actualized in the medium, demonstrating sharp contrast to the one-to-one correspondence in classical mechanics. Uniqueness of the actualized forces is lacking. Cell motility suggests the absence of a completely specifiable boundary condition that would unambiguously control the dynamics of generating mechanical forces in motile cells. The one-to many relationship between the displacement of the medium and the force actualized in the medium necessitates a materialistic capacity for making choices on the part of molecules and cells in transforming future possibilities into actualized reality, the latter of which again serves as the source of the further future possibilities. PMID- 2720139 TI - Biochemical switching device: how to turn on (off) the switch. AB - We previously showed with computer simulations that cyclic enzyme systems have the reliability of ON-OFF types of operation (McCulloch-Pitts' neuronic equation) and the applicability for a switching circuit in a biocomputer. The switching time was inevitably determined in accordance with the difference in amount between two inputs of the system. This characteristic is, however, a disadvantage for practical use of a switching device; we need to improve the system in order for the switching time to optionally be changed. We shall present here how to turn on (off) the switch independently of the modes of two inputs. By introducing pulse perturbation, we could optionally set up the switching time of a cyclic enzyme system (biochemical switching device). PMID- 2720140 TI - Population processing--a powerful class of parallel algorithms. AB - We present a model of optimization of cost functions by a population of parallel processors and argue that especially diploid recombination of gene strings is a promising recipe for optimization which nature proliferates. Based on a simulated evolutionary search strategy diploidy is introduced as a means for maintaining variability in computational problems with large numbers of local extrema. A differentiation into genotypes and phenotypes is performed. The applied strategy is compared to some traditional algorithms simulating evolution on the basis of two sample cost functions. PMID- 2720141 TI - Supramolecular organization of tricarboxylic acid cycle enzymes. AB - We propose a spatial structure for the tricarboxylic acid cycle enzyme complex (tricarboxylic acid cycle metabolon). The structure is based on an analysis of data on the interaction between tricarboxylic acid cycle enzymes and the mitochondrial inner membrane, as well as on data on enzyme-enzyme interactions. The alpha-ketoglutarate dehydrogenase complex, adsorbed along one of the 3-fold symmetry axes of the mitochondrial inner membrane, plays a key role in formation of the metabolon. In the interaction with the membrane, two association sites of the alpha-ketoglutarate dehydrogenase complex participate, placed on opposite sides of the complex. The tricarboxylic acid cycle enzyme complex contains one molecule of the alpha-ketoglutarate dehydrogenase complex and six molecules of each of the other enzymes of the tricarboxylic acid cycle, as well as aspartate aminotransferase and nucleoside-diphosphate kinase. Succinate dehydrogenase, which is the integral protein of the mitochondrial inner membrane, is a component of the anchor site responsible for the assembly of the metabolon on the membrane. The molecular mass of the complex (without regard to succinate dehydrogenase) is 8 x 10(6) Da. The metabolon symmetry corresponds to the D3 point symmetry group. PMID- 2720142 TI - Genetic susceptibility to environmental mutagens and carcinogens. PMID- 2720143 TI - [The role of adrenergic innervation in distributing systemic and coronary fractions of left ventricular output under increased pressure in the ascending aorta]. AB - The significance of neurogenic influences upon the distribution of systemic and coronary fraction during rise of aortic pressure by step occlusion of ascending aorta was studied in anesthetized cats. Under elevation of aortic pressure up to 60 mm Hg the increase in systemic fraction and less pronounced rise of coronary fraction were observed. When aortic pressure elevation was more than 60 mm Hg commensurable increase of both fractions occurred. Under beta-adrenoreceptor blockade elevation of aortic pressure more than 60 mm Hg evoked the significant increase in systemic fraction and reduction in coronary fraction. PMID- 2720144 TI - [Evaluation of airway resistance determined by whole-body plethysmography]. AB - Methods of estimation of the airway resistance by flow-pressure curve obtained in whole-body plethysmography are investigated. The analysis of the physical processes controlling the flow-limitation during expiration shows that these methods are useful only for healthy subjects for the estimation of the airway resistance. The way for estimation of the airway resistance by flow-pressure curve is proposed. PMID- 2720145 TI - [Selective electric-current inhibition of signals from the C fibers in nerve fiber microbundles: a method for identifying A and C afferents]. AB - Direct electric current of 3 microA applied through platinum electrode during 10 s to a fine strand teased mechanically from saphenous nerve, inhibits selectively C-fibre spikes in the strand and does not inhibit A-fiber spikes. The selective inhibition of C-fibers spikes in a fine strand is proposed as a method to identify a type of a single nerve fiber. PMID- 2720146 TI - [Angiotensin II in the organization of rat feeding behavior]. AB - Intraventricular injection of angiotensin-II (100 ng) increased the latency period and decreased the amount of food intake in the hungry rats. Preliminary administration of saralasin (100 ng) blocked the inhibitory effect of angiotensin II on food consumption. In contrast to the above mentioned intraperitoneal injection of angiotensin-II (10 ng/kg) 10 min before food and water admission results in the tendency to increase the food intake. And the same application of angiotensin-II 60 min before food and water admission increased by 49% of food intake in hungry rats. Saralasin (50 ng/kg) given prior to the angiotensin-II administration blocked the angiotensin-II effects. Moreover a significant decrease in the food intake was found after intraperitoneal injection of saralasin only. No significant changes in the drinking behavior in response to the intraventricular and intraperitoneal drugs administration were registered. PMID- 2720147 TI - [Changes in the balance of biogenic monoamines and their metabolites in the organs of rats with oxygen-induced epilepsy]. AB - The content of some biogenic monoamines and their metabolites in rat brain and heart in different periods of oxygen epilepsia was studied using high performance liquid chromatography with electrochemical detection. It was shown that already at the 5th minute of exposure to oxygen adrenaline, DOPA and some noradrenaline metabolites disappeared in the brain and noradrenaline level reduced. At this period in rat heart the reduction of catecholamine content was the most distinct and serotonin level was unchanged. At the beginning of convulsive period the modifications of biogenic amines content were nonparallel in brain regions: in the heart the reduction of catecholamine level went on, especially in right ventricle. In the terminal phase of oxygen epilepsia brain biogenic amines increased, however, not up to normal meaning, heart catecholamines at this period were at the same level as at the beginning of the convulsive period. PMID- 2720148 TI - [The activity of postural asymmetry factors in symmetrical sections of the rat spinal cord]. AB - The distribution of the low-molecular weight and high-molecular weight postural asymmetry factors (FPA) activity in the left and right parts of the lumbal region of the rat spinal cord was studied. Low-molecular weight FPA induces flexion of the hind limb ipsilateral to the half of the spinal cord from which FPA was isolated, while high-molecular weight FPA induces contralateral flexion. The activities of the low- and high-molecular weight FPAs in each half of the spinal cord are comparable in normal rat. After the suction lesion of the motor areas in the left hemisphere the increase of the low-molecular weight FPA activity in the right half of the lumbal region of the spinal cord was observed. PMID- 2720149 TI - [Restoration of myocardial contractile function during gradual reperfusion after total ischemia]. AB - Isolated guinea pig hearts subjected to 25-min total normothermic ischemia and 30 min reperfusion with the initial rate exhibited a great rise in isovolumic diastolic pressure while the contractile function recovered to 34 +/- 4% of initial value. Reperfusion with gradually increased rate from 13% of initial rate to 100% resulted in better recovery of the contractile function--to 54 +/- 3% and markedly less rise in the diastolic pressure. This coincided with 28% less inosine loss. More better recovery of the myocardial contractile function (to 80 +/- 5%) was observed in experiments in which gradual reperfusion was combined with recirculation. In both gradual reperfusion series, the recovery of the heart rate and the contractile function were much delayed during first 5 min reperfusion and were associated with a rise in coronary resistance. PMID- 2720150 TI - [Effect of adenosine on hemodynamic changes during the development of neurogenic myocardial lesions]. AB - The influence of adenosine on hemodynamic changes induced by electrostimulation of reflexogenic zone of aorta was studied in this article. It was shown that 3 hour electrostimulation increased the total peripheral resistance and decreased cardiac output and aortic pressure. Intravenous infusion of adenosine during electrostimulation led to the normalization of main indices of hemodynamics. PMID- 2720151 TI - [Body adaptation to stress exposure enhances cardiac resistance to adrenotoxic damage]. AB - Models of adrenergic arrhythmias were produced on isolated rat heart under the adrenalin concentration in the perfusion solution of 5.10(-5) M. The rhythm disturbances were accompanied by a pronounced depression of contractile function. It was shown that preliminary adaptation of animals to short-term stress exposures reduced the duration of arrhythmias more than sixfold the contractile function, being maintained at a higher level than in control. The adaptation cardioprotective effect was compared with the effects of adaptation and propranolol appeared similar. PMID- 2720152 TI - [Alpha-tocopherol protection of erythrocytes from hemolysis induced by thermal injury]. AB - It is shown that skin burn is accompanied by activation of lipid peroxidation (accumulation of TBA-reactive substances and of fluorescent end-products) in the blood of experimental animals. The decrease in red blood cell membrane stability was demonstrated exerting as increase in the rate of spontaneous hemolysis, content of extraerythrocyte++ haemoglobin and increased sensitivity to exogenous oleic acid. It is estimated that alpha-tocopherol possesses protective stabilizing effect on red blood cell membrane. This stabilizing action is observed when alpha-tocopherol was injected both before the skin burn and immediately after it. It is concluded that two different mechanisms are responsible for stabilizing effect of tocopherol, namely: 1) antiradical, realized via inhibition of lipid peroxidation, and 2) non-antioxidant, caused by interaction of tocopherol with phospholipid hydrolysis products by phospholipases A2 (free fatty acids and lysophospholipids). PMID- 2720153 TI - [Macroproteinemia and the prognostic assessment of blood loss]. AB - The dependence of blood loss quantitative indices (duration, number and volume of exfusions) on the initial state of the blood protein system was studied in experiments with dogs. The true correlation was found between the macroprotein contents in plasma and the duration of the arterial pressure compensation phase at the level of 5.3 kPa (40 mm Hg). Hypermacroproteinemia is evident of low organism stability (resistance) and is an unfavourable prognostic characteristic in experimental blood loss. PMID- 2720154 TI - [Kinetics of the oxidative deamination reaction in the preconvulsive period of oxygen-induced epilepsy]. AB - Kinetic parameters of monoamine oxidative deamination in compensatory and preconvulsive periods of oxygen epilepsia were studied. It was shown that in rat brain MAO's affinity for serotonin reduced from the 5th minute of exposure to hyperbaric oxygen and went on reducing on the 15th minute. In rat heart the affinity of MAO for serotonin firstly decreased and then returned to normal meaning. Dopamine deamination in rat brain in compensatory period of epilepsia was activated and then was inhibited. In rat heart from the 5th minute of exposure to oxygen dopamine and 2-phenylethylamine deamination was blocked. Tyramine deamination in preconvulsive period of epilepsia changed in a complex manner. It is concluded that the kinetic parameters of monoamine deamination change in the initial phases of exposure to hyperbaric oxygen, and the most distinct modifications take place in rat heart, but not in rat brain. PMID- 2720155 TI - [The action of a homologous series of ubiquinols on lipid peroxidation in brain mitochondrial and synaptosomal membranes]. AB - The effects of inhibition of ubiquinols and ubiquinones with various length of isoprenoid chain on the lipid peroxidation in membranes of brain mitochondria and synaptosomes were studied. The efficiency of inhibition effects of ubiquinols depends on the length of isoprenoid chain. Ubiquinols with shorter isoprenoid chains demonstrated more effective inhibition. PMID- 2720156 TI - [The action of ultrasound on the contraction strength and action potential of the papillary muscle of the rat heart]. AB - In experiments on isolated rat papillary muscles the effects of therapeutic doses of ultrasound (US) (intensity, less than 2 W/cm2) with frequency of 0.88 MHz on contraction force and action potential (AP) were studied. 12 muscles (from 14) responded to 3-min exposition of the US with a rise both in contraction force and in resting tension. Sensitivity to US and a value of inotropic effect changed significantly between the preparation, and the threshold intensities of US varied from 0.3 to 2 W/cm2. In 3 experiments the inotropic effect of US was more than 100%, but in others it was about 50%. Two preparations were not sensitive to the US. The positive inotropic effect of US was accompanied by membrane depolarization (up to 20 mV) and by prolongation of AP duration measured at 10% of its amplitude (APD10). The correlation between the increase in contraction force and APD10 was demonstrated. Some preparations responded to US with high depolarization (up to 50 mV) and were inexcitable. The US induced an increase in temperature less than 1 degree C, therefore all the effects of US could not be explained as a result of temperature rise. PMID- 2720158 TI - [An external oxidation pathway in nerve tissue]. PMID- 2720157 TI - [Effect of dekaris and sodium nucleinate on the blood antioxidant system of guinea pigs exposed to paprin inhalation]. AB - The changes of lipid peroxidation, thiol disulfide equilibrium, glucoso-6 phosphate dehydrogenase, catalase and superoxide dismutase activity under influence of immunostimulants during paprin inhalation were studied. Pro-oxidant effect of dekaris has been established. The conclusion on the necessity to estimate the level of antioxidant system under immunocorrection has been made. PMID- 2720159 TI - [Effect of acute intestinal obstruction on erythrocyte membrane function]. AB - The amino acid composition of red blood cell membrane proteins had been studied in different stages of acute intestinal obstruction. Hydrophobic amino acids were revealed to increase and glutamate was found to decrease during the early period of acute intestinal obstruction. Later neutral amino acids and some of the main amino acids were stated to decrease. Shifts in the ratio of protein fractions seen in red blood cell membrane of rats with acute intestinal obstruction could be explained by changes followed in the amino acid composition. The data accumulated had demonstrated that such a significant modification of protein component of the red blood cell membrane could be one of the reasons of the erythrocyte membrane penetrability violation and could play the pathogenetic role in the occurrence of irreversibility changes in cases of the intestinal obstruction. All that was mentioned above had shown the necessity to use membrane protectors and antienzyme drugs in the postoperative period. PMID- 2720160 TI - [Glutathione and ascorbic acid metabolism and antioxidant enzyme activity in the tissues of vitamin E-deficient rats]. AB - In has been shown in the experiments on male rats that alimentary vitamin E deficit causes the decrease of reduced glutathione and ascorbic acid concentration in the liver and lungs and that of glutathione-S-transferase, glutathione reductase in the liver and lungs, catalase in the liver and glutathione peroxidase in the heart activity, but increases the amount of glutathione disulfide in the liver and lungs and superoxide dismutase and gamma glutamyltransferase activity in the liver. The data obtained show the selective character of reaction participants of the antioxidant system of rats' organism to the deficit of one of the antioxidant factors--vitamin E and also testify to complex interrelation between separate members of this system. PMID- 2720161 TI - [Mechanism of the action of the delta sleep-inducing peptide against a background of L-DOPA administration]. AB - A reciprocal nature of the shifts in activity of type A and B monoamine oxidases has been observed under the effect of DSIP against the background of L-DOPA administration (50 micrograms/kg) in the subfractions from the rabbit sensorimotor cortex. The results suggest that the activation of type A monoamine oxidase and serotoninergic system is the basis of the adaptive behavior of animals. PMID- 2720162 TI - [Glycerinated myocardiocyte fibers in the rat myocardium as one of the models in a preclinical assessment of antianginal agents]. AB - A number of cardiotropic preparations (verapamil, obsidan, pyroxan) were studied in glycerinated fibres (GF) in the experiments on rats during five twenty four hours after ligation of coronary artery. Their ability in different degree to preserve cardiomyocyte contractile fibers from the injury of ischemic processes is revealed. Positive influence of antianginal therapy was also confirmed in the experiments with coronary artery ligation on awake animals, and in experiments on the identification of actomyosin complex components. PMID- 2720163 TI - [Peripheral cholinolytic action--one of the effects of sidnofen]. AB - Intravenous bolus injection of sydnophen (0.002-20 micrograms/kg) resulted in decrease or complete abolition of bradycardia induced by electrical stimulation of vagal peripheral end of anesthetized cats. The cholinolytic effects are dose dependent. The small dose of sydnophen (0.002 micrograms/kg) which wasn't able to cause any alteration of EEG, heart rate and arterial pressure induced decrease of vagal bradycardia. PMID- 2720165 TI - [Characteristics of the formation of a free-amino acid brain pool in rats differing in their ethanol consumption]. AB - The concentrations of free amino acids were studied in the right and left hemispheres, cerebellum and brain stem of AA and ANA strain rats differing in their voluntary consumption of ethanol solutions. Animals of both the strains were shown to be differentiated by distribution, functional utilization and metabolism of some amino acids in the right and left hemispheres, cerebellum and brain stem. PMID- 2720164 TI - [Possible approaches to creating phospholipid preparations--acceptors of membrane cholesterol]. AB - The capability of liposomes with plant phosphatidylcholine to extract cholesterol from erythrocyte membrane was investigated. It was shown, that plant phosphatidylcholine extracted 42% of membrane cholesterol, without causing haemolysis. This cholesterol extraction was responsible for the decrease of membrane microviscosity and for the increase of Na+, K+-ATPase activity. It is suggested that it is possible to create the extractive agent of cholesterol with plant phosphatidylcholine. PMID- 2720166 TI - [Electron microscopic-cytochemical study of the enzyme activity of energy metabolism in "dark" and "light" neurons of the rat cerebral cortex]. AB - The ultrastructural localization of succinate dehydrogenase (SDH) and lactate dehydrogenase (LDH) activity in "dark" and "light" neurons of the intact rat's frontal brain cortex has been studied. The enzymes' activity was detected with using potassium ferricyanide as artificial acceptor of electrons. In the "light" cells SDH activity is localized in the mitochondria and plasma membranes. LDH activity is localized in the mitochondria, plasma membranes and hyaloplasm. SDH and LDH activity was not found in the "dark" cells. PMID- 2720167 TI - [Ultrastructural mechanisms of myocardial atrophy in white rats during starvation]. AB - By means of complex morphological, morphometrical and stereological analyses the myocardium of Wistar rats was studied in full alimentary starvation during 6 days. The availability of two mechanisms of myocardial atrophy in adaptation to full starvation was revealed, these are the diminution of dimensions of parenchymatous elements and the decrease of muscle cell number. By ultrastructural investigation of cardiomyocytes the signs of structural protein synthesis decline were revealed, this is a simple myocardial atrophy. In quantitative analysis of cardiomyocytes the decrease of their number without changes in proportions of cells with different nuclei number was observed, that indicated systematic character of muscle cell elimination out of myocardium by apoptosis mechanism involvement, this is a numerical myocardial atrophy. Stereological analysis of myocardial atrophy development in conditions of full starvation determined the main regulated indices, these are the absolute total myofibril mass and mitochondrial mass and surface area. PMID- 2720168 TI - [Characteristics of the interaction of blood monocytes with the arterial intima in swine exposed to catecholamines]. AB - Adhesion and transendothelial migration of autologous blood monocytes have been studied in perfused swine arteries before and after injury produced by catecholamines. It has been shown that in the absence of plasma chemoattractant factors the damage of the vessel wall provides a significant increase in the number of monocytes adhered to the intima or migrated into intimal layer. The proportion of monocytes in these areas becomes 5 folds higher than in control regions. Possible immunological and not immunological mechanisms of mononuclear cells infiltration of the arterial intima are discussed. PMID- 2720169 TI - [Changes in the peripheral blood, liver and spleen during the long-term experimental administration of modified hemoglobin]. AB - The study of chronic toxicity of polymerized hemoglobin solutions (PHb) has demonstrated the relationship between the dose of the solution administered and the level of functional and morphological changes induced in various organs of experimental animals. Lower doses (1.8 g/kg) of PHb had no effect on the values of protein and carbohydrate metabolism, while the high doses (10-15 g/kg) of PHb resulted in the impairment of protein synthesis, morphological changes in the spleen and lymphatic nodes. PMID- 2720170 TI - [Compensatory-adaptative processes of the kidney after undergoing hydronephrotic transformation]. AB - In experiments on 30 white mongrel adult rats of both sexes pathologic and reparative alterations in the kidney by the 30th day after recanalization of the ureter occluded for 1, 3, 7, 10, 15, 30 days have been studied using microdissection, light optic and electron microscopic methods. The fact has been established that in early times of HT (1 to 3 days) with the following reduction of urinary passage through the ureter (30 days), the canalicular-vascular formations of the kidney acquire normal morphological structure. In cases of more prolonged occlusion of the ureter (15 to 30 days) in the kidney noticeable destructive alterations prevail with replacement of parenchymatous elements by connective tissue. PMID- 2720171 TI - [Radioautographic research on human epidermocytes cultured in a medium with a low calcium content]. AB - The process of human skin epidermocyte culturing in low calcium medium has been studied with radioautographic and electron microscopic methods. Epidermocyte culturing in 0.15 mM calcium medium has been proved to suppress the differentiation inside as well as to stimulate cell dividing process. Considerable amount of dividing cells in cultures makes it possible to use them both for grafting on wound surfaces and for the further cultivation. PMID- 2720172 TI - [A method for obtaining a long-lived intestinal tissue culture]. AB - The interest in the studies of the intestines using the method of tissue organ culture has considerably grown in recent years. It can be explained by the great possibilities of obtaining unique data about the state of intestines in normal and pathological condition, e.g. malabsorption syndrome. The paper deals with the method modified by the authors to obtain long-living (24 hours) intestinal tissue organ culture. The investigations used bioptic sections which were obtained by jejunoscopy with spot biopsy of children suffering from intestinal malabsorption. The viability of the explants was proved by histological and histochemical tests. The promise held by the methods is emphasized. PMID- 2720175 TI - Therapy of liver disease. PMID- 2720173 TI - Immunophenotyping of acute myeloid leukaemia: relevance of analysing different lineage-associated markers. AB - The immunophenotype of 135 previously untreated patients with FAB defined acute myeloid leukaemia (AML) was studied at diagnosis. The panel of reagents included monoclonal antibodies (MoAb) recognising myeloid-associated determinants (CD11, CD13, CD14, CD33 and others) as well as MoAb directed towards lymphoid antigens (CD7, CD10, CD19) and TdT. The results indicate that CD13 and/or CD33 are consistently expressed in AML and only rarely in ALL blasts (131/135 + ve cases, versus 4/130 in ALL). Lymphoid antigen expression was rarely detected when CD10 and CD19 were investigated in AML (0.9% and 2% + ve cases, respectively), whereas significant positivities were found for TdT and CD7 (20% and 10% respectively). Concerning FAB subtypes, two new MoAb (LAM3 and LAM7) proved very useful in the specific recognition of AML with monocytic features. The phenotype CD13+ and/or CD33+, CD9+, HLA-DR- was found to be almost exclusive for M3 AML. The response to induction chemotherapy was analysed in CD7+ and in TdT+ patients. In the latter group a statistically significant lower response rate was found with respect to TdT-ve-AML patients. PMID- 2720176 TI - Jaundice. PMID- 2720174 TI - Morphological and immunological changes of hairy cell leukemia during alpha-2 interferon therapy. AB - We describe a patient who presented with the clinical picture of hairy cell leukemia (HCL). Bone marrow and peripheral blood lymphoma cells showed morphological and immunological features of HCL. Under recombinant alpha-2 interferon (alpha-2-IF) therapy the characteristic morphology changed from HCL to prolymphocytic leukemia (PLL). At diagnosis the lymphoma cells expressed CD24 and FMC7 surface antigen, but stained negative for surface immunoglobulins, light chains and anti-CD5. During alpha-2-IF treatment surface antigen expression changed to CD24, CD5 and FMC7. Surface IgD and lambda light chains became strongly positive. Southern Blot analysis of peripheral blood mononuclear cells showed two rearranged immunoglobulin bands at diagnosis but only one upon alpha-2 IF therapy. These data suggest, that this patient suffered from a biclonal lymphoma, HCL and PLL. While undergoing alpha-2-IF treatment the HCL came into remission, whereas the PLL clone proved to be poorly sensitive to alpha-2-IF therapy. PMID- 2720177 TI - Nitrite inhalants: promising and discouraging news. PMID- 2720178 TI - Conversation with Don Cahalan. PMID- 2720179 TI - The therapeutic community: exploring the boundaries. AB - The past 20 years have demonstrated the effectiveness of therapeutic community (TC) treatment for drug abuse as it evolved in the United States. We now better understand the influence that psychodynamic features of TC treatment have on character disorder. Best perceived as a setting designed--as society is not--to encourage and support social learning, the TC has succeeded in modifying its programs and adapting self-help methods to serve drug abusers of all kinds and abusers of all drugs. Continued evolution of the TC depends upon development of its already-demonstrated capacity to affect disordered behaviour other than drug abuse. The growth of disordered populations in the United States and increasingly in Great Britain gives urgency to such future employment. Therapeutic communities and TC-like programs for non-drug abusers already exist. But widespread use depends upon strengthening the theoretical underpinnings of TC treatment and establishing closer working relationships between TC's and mainstream medical, mental health and social service institutions. PMID- 2720180 TI - The diet of steady drinkers with special reference to social variables. AB - The influence of a number of variables on the diets of 65 steady drinkers from alcohol rehabilitation units on Merseyside, United Kingdom was investigated. All drank principally beer or spirits. Social variables studied included age, sex, living alone or with others, employment status and socio-economic status. Alcohol related variables included quantity consumed and preferred beverage. Dietary outcome was assessed in terms of the variety of foods and the number of meals eaten per week. Living alone proved by far the most important determinant of reduced diet. Spirit drinkers ate more meals than beer drinkers, but only if living with others. Increased alcohol consumption related modestly to fewer foods and meals being consumed. Drinkers living alone constitute a much larger proportion of those entering rehabilitation programmes in Queensland, Australia than in the United Kingdom. The present findings may help to explain the high incidence in Queensland of thiamin deficiency syndromes including the Wernicke Korsakoff syndrome. PMID- 2720181 TI - Diet and opiate addiction: a quantitative assessment of the diet of non institutionalized opiate addicts. AB - The diet, weight and height of 38 non-institutionalized chronic opiate addicts have been assessed and compared to those of a random sample of the 20-35 year old general population of Canton Geneva, Switzerland. A history questionnaire was administered by specially trained dietitians. Results show that, after adjustment for age and alcohol intake, male addicts have the same caloric intake as non addicts. However, addicts tend to replace foods that are rich in fat and proteins with foods rich in sucrose and relatively poor in vitamins and minerals. Beer is the major component of their much larger alcohol consumption. On the other hand, the body mass index (kg/m2) of the male addicts is within the normal range, suggesting this may not be a good indicator of their unbalanced diet. This study gives a quantitative assessment, in terms of nutrient intake, of the typical craving for sweet described by opiate addicts. PMID- 2720182 TI - Personality and substance use among adolescents: a longitudinal study. AB - The following hypotheses have been tested: (a) sensation seeking, A-State and Trait and Depressive Mood should positively affect the initiation and continuation of adolescent substance use: and (b) Following Zuckerman's conclusion with regard to the relationships between sensation seeking and drug use, and Khantzian's 'self medication hypothesis', different patterns of relationships between personality variables and substance use should be found: Whereas sensation seeking will be associated with substance use regardless of the specific psychopharmacological properties of a given substance, anxiety and depressive mood will be primarily associated with the use of depressants. One thousand nine hundred adolescents, 14-19 years old, were tested twice, 12 months apart, for alcohol and drug use. The major findings were as follows: (a) Sensation seeking was found to affect substance use among adolescents more than State and Trait Anxiety, and Depressive Mood; (b) Sensation seeking differentiated among abstainers, beginners, and users of all substances. A different pattern of relationship between State-Trait Anxiety, and Depressive Moods and substance use was found. These personality variables appeared to differentiate only among those subjects who used depressants; (c) It is also evident that previous experimentation with drugs significantly affect current use. The implications of these findings for interventions among adolescents are discussed. PMID- 2720183 TI - The integration of an educational program into a treatment facility. AB - This paper reviews the integration of an active teaching program into a busy treatment facility. All first and second year medical students at the University of California, San Diego take part in a series of didactic lectures and small group discussions, while third and fourth year students have the opportunity of joining a treatment team for 4 to 6 weeks. All psychiatric residents spend a minimum of 8 weeks working on the unit, and one fourth year resident is chosen to work with the staff for a year. The interactions between treatment teams and students in various stages of development help maximize enthusiasm and the commitment to the best patient care possible. PMID- 2720184 TI - Undergraduate training in substance abuse in the United Kingdom. AB - During 1987 thirteen departments in each of 28 medical schools were surveyed about the training their undergraduate medical students received in substance abuse. There was a 70% response rate, and of the departments that responded, 54% provided formal teaching (lectures, seminars, symposia), on average 14 hours over the 5 year training. Forty-three per cent of the major clinical specialities provided clinical exposure to addiction problems, but only 21% of clinical and non-clinical departments ensured that students were examined on the topic. There is a need to focus teaching in addiction behaviour either by co-ordinated effort over all departments, or by integration within departments. It is pressing to review and revise the medical curriculum because of the escalation of substance abuse, the need for resources, the pivotal role of the medical profession and the relation of drug abuse to the acquired immunodeficiency syndrome. The development of a 'core' curriculum which demarcates key topics, and which encompasses and links pre-clinical and clinical training in addiction behaviour would be valuable. PMID- 2720185 TI - Health authority policies for the prevention of alcohol problems. AB - Although national policy has a major influence in preventing alcohol problems, much can be done at a local level. In addition national policy can either be made or at least influenced from the local level, and local communities are well placed to change attitudes and influence key processes, thus creating a climate for appropriate national debates and policy developments. This paper addresses why a local policy is needed for the prevention of alcohol problems, and then considers a number of the components of such a policy, how such a policy might be implemented, and how such a policy might be evaluated. PMID- 2720186 TI - The feasibility of effective psychopharmacological treatments for alcoholism. PMID- 2720187 TI - Butterfly wings flapping: do we need more 'chaos' in understanding addictions. PMID- 2720188 TI - Is it possible to recommend safe drinking levels without increasing per capita consumption? Another aspect of the prevention paradox. AB - A number of countries have recently embarked on responsible drinking or safe drinking educational campaigns. The object of these campaigns is to discourage people from exceeding levels of alcohol consumption considered compatible with good health. One possible implication of the success of these campaigns is an increase in per capita alcohol consumption. Such increases are usually thought of as inimical to health and therefore present the health educator with a dilemma. Reference is made to Australian data in an examination of this paradox. PMID- 2720189 TI - Treatment of drug misuse in the general practice setting. AB - Despite several decades of contact between health workers and drug misusers and recent publicity aimed at increasing the use of this contact to control HIV infection, there remains a persistent belief that control of drug taking is possible either by medical intervention with substitute drugs or provision of facilities to detoxify those addicted. This paper describes, in the absence of a cure or control for drug abuse, the role of the primary care physician in preventing illness and promoting less damaging drug use among drug users and their social, sexual and domestic contacts. Extensive involvement with family and non-statutory workers is seen as the best way to understand the pressures and dangers to which individual patients are exposed. PMID- 2720190 TI - Interactions among DUI offender characteristics and traditional intervention modalities: a long-term recidivism follow-up. AB - Using long-term DUI (Driving Under the Influence of Alcohol) arrest recidivism data from a controlled study of DUI intervention effectiveness, interactions among DUI interventions, age, race, education, and alcohol severity were estimated using logit analysis. Data were collected in a 9-year follow-up study of the Mississippi DUI Probation Project. The effects of short-term interventions (alcohol education schools for low alcohol severity offenders and structured group interventions for high alcohol severity offenders) were specified by educational level. Short-term rehabilitation was modestly effective for those with less than 12 years of education, but less effective or detrimental for the more highly educated. The effects of probation were specified by age and education, being more effective for those under 30 years and 55 years or older than for the middle age group. Probation was most effective for well-educated older (55+) offenders. An analysis of the under 30 years group also suggested that probation was especially effective for young well-educated Minority offenders. PMID- 2720191 TI - The relationship between impulsivity, empathy and involvement in twelve step self help substance abuse treatment groups. AB - The relationship between impulsivity, empathy, substance-free lifestyle and participation in Twelve Step self-help groups is investigated. Utilizing S. B. G. Eysenck et al.s' Impulsivity Questionnaire (1-7) members of three self-help 'clubs' were assessed for traits of empathy and impulsiveness. Impulsivity correlated positively with total number of substance abuse 'slips', and negatively with total months of substance abstinence. Empathy was correlated positively with length of abstinence and hours spent in Twelve Step self-help activities per week. Possible interpretations and application of these findings to clinical recommendations are discussed. PMID- 2720192 TI - Superior outcome of females over males after brief treatment for the reduction of heavy drinking. AB - Problem drinkers (52 males, 38 females) recruited through advertisements were randomly assigned to one of three treatments: GUIDELINES: three sessions of advice using a pamphlet outlining basic steps for achieving abstinence or moderate drinking. Manual: three sessions of instruction in the use of a 'self help' manual presenting a step-by-step approach for attaining abstinence or moderate drinking. Therapist: six or more sessions of instruction in the methods outlined in the 'self-help' manual. At 3, 6 and 12 months follow-up, no significant differences were found among the groups in reduction of heavy drinking days (i.e. days when consumption exceeded four drinks, each containing 13.6 g/ethanol). Overall, the number of heavy days were reduced from an average of 43 at intake, to 20 over the 1-year follow-up period. Females, however, had significantly greater reductions than males (75% versus 35%). Three months after treatment the rate of successful moderate drinkers was significantly higher for females than males in the GUIDELINES (60% versus 33%) and the Manual condition (63% versus 18%), but not in the Therapist condition (25% versus 35%). At 1-year follow-up, females were more successful than males in all conditions. Mean changes in GGT and MCV levels lended support to the change in drinking status (from heavy drinker at intake to moderate drinker at follow-up), based on clients' self-reports. PMID- 2720193 TI - State monopoly systems and alcohol prevention in developing countries: report on a collaborative international study. AB - In many countries, state alcohol monopoly systems have been adopted as a means of public control over alcohol availability. These countries include industrialized as well as developing countries. In this paper, an analysis is presented on the present state and potentials of state alcohol monopoly systems in preventing alcohol abuse. Special reference is given to the specificity of alcoholic beverages supply in developing countries and the potential contributions of existing state monopoly systems in developed countries to assist developing countries willing to adopt and implement preventive national alcohol policies. PMID- 2720194 TI - An 11-year follow-up of a network of cocaine users. AB - This paper presents findings from an exploratory 11-year follow-up study of a small network of cocaine users. These findings suggest that while serious abuse potential exists, addiction is not a uniform outcome of sustained use and that long-term controlled use is possible. In all, four types of career use pattern are described, in addition to one case of regular abuse. These data also suggest the importance of user norms and informal social controls in mitigating against the force of pharmacological and physiological factors leading toward dependence or addiction. PMID- 2720195 TI - Alcohol histories taken by psychiatric registrars: a comparative study in a non teaching hospital. PMID- 2720196 TI - Multivariate data and type I error. PMID- 2720197 TI - The combined approach: a further comment. PMID- 2720198 TI - Determinants for serum 1,25-dihydroxycholecalciferol in primary hyperparathyroidism. AB - Serum levels of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), 25-hydroxyvitamin D3 (25(OH)D3), C-terminal immunoreactive PTH (iPTH), calcium and phosphate, and endogenous creatinine clearance (Clcr) were measured in 34 patients with primary hyperparathyroidism. Clcr ranged from 13 to 161 ml/min (mean 72). S-iPTH was elevated in 82% of the patients and correlated positively to serum calcium (r = 0.74, P less than 0.001) and inversely to Clcr (r = -0.50, P less than 0.02). S 25(OH)D3 was reduced in 28% of the patients and depended on regular multivitamin supplementation (P less than 0.005). S-1,25(OH)2D3 was increased in 26% of the patients and decreased in 9%. It was positively correlated to S-25(OH)D3 (r = 0.39, P less than 0.05) and Clcr (r = 0.42, P less than 0.02) and inversely to serum levels of calcium (r = -0.39, P less than 0.05), phosphate (r = -0.42, P less than 0.02) and iPTH (r = -0.40, P less than 0.05). Multiple regression analysis revealed a positive correlation to 25(OH)D3 when Clcr was taken into account and to Clcr when S-25(OH)D3 was taken into account. When both variables were considered no significant partial correlations were found between S 1,25(OH)2D3 and serum calcium, phosphate and PTH, respectively. It is concluded that serum levels of 25(OH)D3 and renal function are the main determinants for S 1,25(OH)2D3 in primary hyperparathyroidism. PMID- 2720199 TI - Adverse effects of a high-glucose diet on body weight and plasma calcium and 1,25 dihydroxyvitamin D3 levels in calcium-deficient growing rats. AB - We tested the hypothesis that dietary calcium would lead to greater impairment of body weight gain and calcium homeostasis if rats are fed a diet with a high glucose content compared with our standard diet in which the carbohydrate is supplied by whole wheat flour. Groups of female rats at 21 days of age were given either of two equivalent calcium-deficient diets with carbohydrate supplied either by glucose (LCaG) or by wheat flour (LCaW). Control rats were fed the wheat-flour diet containing 0.4% calcium. Since previous studies indicated divergent effects of glucose-based and flour-based diets on body weight in vitamin D-deficient rats, we designed a parallel study with vitamin D-deprived rats. Compared with rats fed the LCaW diet, the rats fed the LCaG diet had inferior body weight gain and more severe hypocalcemia (1-2 mg/ml lower) over a 40-day period, and no significant elevation of the plasma 1,25(OH)2D3 level at 61 days of age. Rats fed the LCaW diet maintained a 3-fold elevation of plasma 1,25(OH)2D3 relative to the level of control rats fed the 0.4% calcium diet. The dry weight and percent ash of tibias were similarly reduced in the two calcium restricted groups compared to the control group. Among the vitamin D-deprived rats, those fed the glucose diet had poorer weight gain than those fed the wheat flour diet. However, both groups had similarly depressed serum calcium level, tibia ash content and 1,25(OH)2D3 level. Thus, a glucose diet combined with calcium restriction or vitamin D deprivation appears to accentuate the impairment of body weight gain and, when combined with calcium restriction, it also accentuates the impairment of calcium homeostasis and interferes with the adaptive increase in plasma 1,25(OH)2D3. PMID- 2720200 TI - Cooperation of synthetic insulin-like growth factor I/somatomedin C and 1,25 dihydroxyvitamin D3 on regulation of function in clonal osteoblastic cells. AB - We investigated the effects of insulin-like growth factor I/somatomedin C (IGF I/SM-C), and the interaction of IGF-I and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on mouse clonal osteoblasts, MC3T3-E1. IGF-I stimulated [3H]thymidine incorporation into the DNA of the cells at concentrations of 1.3-130 X 10(-9) M. The alkaline phosphatase (ALP) activity in cultures was also raised by the hormone at the same concentrations. The optimal dose of IGF-I was 13 X 10(-9) M. Co-addition of IGF-I (1.3-130 X 10(-9) M) and 1,25(OH)2D3 (10(-11) to 10(-10) M) to the culture of MC3T3-E1 cells caused a synergistic increase in ALP activity. 25(OH)D3 and 24,25(OH)2D3 showed a similar effect with IGF-I at 1000-2000 times higher concentrations than 1,25(OH)2D3. [3H]Proline incorporation into collagenase digestible protein (CDP) in media was stimulated dose-dependently by IGF-I up to 2.2-fold over the control levels at 130 X 10(-9) M. Addition of 1,25(OH)2D3 (5 X 10(-11) M) and IGF-I further elevated the proline incorporation into CDP. However, the increment in CDP synthesis, induced by the two hormones was less than the increment in ALP activity. Thus, we conclude (1) that IGF-I stimulates both cell replication and differentiated functions in cultured murine osteoblasts and (2) that IGF-I and 1,25(OH)2D3 have the synergistic effect on ALP activity and the additive effect on collagen synthesis in MC3T3-E1 cells. PMID- 2720201 TI - Spinal osteoporosis in men. AB - In 94 men with crush fracture, 40 were found to have primary osteoporosis. Cross sectional measurements of a number of variables related to bone in these 40 patients were compared to the values in various groups of healthy men aged 20-96. In healthy men, metacarpal and femoral cortical area/total area, bone volume, osteoid surfaces, seam and trabecular width, plasma dihydroepiandrosterone and estrone, and radiocalcium absorption fell with age, whereas eroded surfaces, trabecular number, urine hydroxyproline and calcium/creatinine ratios, plasma alkaline phosphatase, estradiol, androstenedione, cortisol and testosterone remained constant with age. As compared with healthy men, men with primary osteoporosis had reduced femoral cortical area/total area (P less than 0.05), and Singh grade (P less than 0.001) and in seven there was a history of forearm or femoral fracture. On iliac crest biopsy, bone volume (P less than 0.001) and trabecular number (P less than 0.01) were decreased. Plasma alkaline phosphatase (P less than 0.02) was increased but urine hydroxyproline and calcium excretion were not significantly raised. Calcium balance was negative due to failure of absorption to match urinary calcium loss and radiocalcium absorption (P less than 0.01) and plasma 1,25-dihydroxyvitamin D (P less than 0.05) were reduced. PMID- 2720202 TI - Science, government, and information: 1988 perspective. AB - Twenty-five years have passed since the appearance of Science, Government, and Information (SGI), the 1963 report by the President's Science Advisory Committee (PSAC). The Information Analysis Center, which was prominently recommended in SGI, has not become a central element of the information system. Instead automation, which was only beginning in 1963, has become dominant. Though extreme automation may be appropriate for those activities that are time constrained, it may lead to clogged information channels for those scientific activities for which time is less important than depth of understanding. PMID- 2720203 TI - Communication: a means to an end. PMID- 2720204 TI - The switch library: new service in rehabilitation librarianship. AB - This article discusses the role of assistive devices in patient rehabilitation programs and the problems in evaluating and assessing patients for prescribing these devices. The rehabilitation library can solve many of these problems and enhance patient rehabilitation programs by providing a circulation service for adapted microswitches and other assistive devices. The article outlines library management of such a program, including funding, acquisitions, classification, and cataloging strategies. A comprehensive library classification scheme for assistive devices is proposed, and schedules are given for microswitches and environmental controls. It is predicted that this service will rapidly expand nationally over the next decade to become an integral part of rehabilitation library patient services. PMID- 2720205 TI - BioSYNTHESIS: bridging the information gap. AB - BioSYNTHESIS is a prototype intelligent retrieval system under development as part of the IAIMS project at Georgetown University. The aim is to create an integrated system that can retrieve information located on disparate computer systems. The project work has been divided in two phases: BioSYNTHESIS I, development of a single menu to access various databases which reside on different computers; and BioSYNTHESIS II, development of a search component that facilitates complex searching for the user. BioSYNTHESIS II will accept a user's query and conduct a search for appropriate information in the IAIMS databases at Georgetown. For information not available at Georgetown, such as full text, it will access selected remote systems and translate the search query as appropriate for the target system. The search through various computer systems and different databases with unique storage and retrieval structures will be transparent to the user. BioSYNTHESIS I is complete and available to users. The design work for BioSYNTHESIS II is under development and will continue as a multiyear technical research effort of the proposed Georgetown IAIMS implementation project. PMID- 2720206 TI - Innovation and education: unlimited potential for the teaching library. AB - The information age demands that health sciences librarians take active roles in the educational process. Librarians have traditionally taught users how to access information. Now, with the proliferation of information, librarians must accept new roles and teach the user efficient techniques for evaluating and processing information as well. Innovative roles for librarians at Texas Tech University Health Sciences Center include teaching users to use technology for information management, to appraise literature critically for quality, and to develop skills for lifelong learning. This paper reviews the history of educational activities in health sciences libraries and describes the teaching programs at Texas Tech. PMID- 2720207 TI - The health sciences librarian's exposure to malpractice liability because of negligent provision of information. AB - This article discusses personal and organizational liability for the negligent provision of information by health science librarians providing information regarding patient diagnosis and treatment. It notes claims in the library literature that liability exists for providing faulty information, but these claims do not state or explain the legal basis for such liability. It identifies three basic information retrieval and communication services provided by reference librarians and characterizes the negligent provision of information as a failure to exercise care in one or more of the three. With regard to personal liability, it identifies the relevant law, the tort of negligent misrepresentation involving risk of physical harm, and outlines the elements that a plaintiff would have to establish to sue successfully. With regard to organizational liability, it notes that a plaintiff would use one of two common law theories: either the vicarious liability doctrine of respondeat superior or the direct liability negligent hire theory of recovery. PMID- 2720208 TI - Book prices and costs for a small-hospital library: a subject analysis. AB - An analysis of the Brandon/Hill lists has provided individual price figures to assist the librarian of a small hospital in calculating book costs associated with establishing and maintaining an up-to-date collection suited to institutional needs. For the fifty-three subject categories analyzed, the following were calculated over the past twenty-two years: average price per title, size and cost of the category, number of new titles or editions, percentages price increases, and cost of maintaining a basic collection. Used in conjunction with local purchasing data, these figures can be useful in budget preparation. PMID- 2720209 TI - Impact of DOCLINE on interlibrary loan service at the National Library of Medicine. AB - In March 1985, the National Library of Medicine (NLM) began implementation of DOCLINE, its automated interlibrary loan request routing and referral system. By the end of fiscal year (FY) 1987, over 1,400 biomedical libraries in all seven regions of the Regional Medical Library network were using the system. This report summarizes the findings of an analysis of the interlibrary loan (ILL) requests received in FY 1987, comparing the results with a similar analysis done in FY 1984 to describe any changes in the requests or service which might be attributable to DOCLINE implementation. DOCLINE has had a substantial impact upon ILL loan service at NLM. An increase in the number of ILL requests (35% over FY 1984) can be attributed to the speed and ease with which requests may be routed to NLM through DOCLINE. Requests which cannot be filled by local or regional libraries are automatically routed by the system to NLM as the library of last resort. NLM's fill rate for serial requests has declined, however, from 78% filled in FY 1984 to 67% filled in FY 1987. Some of the decline results from the 11,000 requests that NLM did not fill because the borrowing libraries were not willing to pay the NLM charge for filling the loans. PMID- 2720210 TI - Characteristics of early adopters of end-user online searching in the health professions. AB - This paper examines end-user, online searching using data from a questionnaire mailed to 150 Canadian health professionals in practice settings. The response rate was 83% (n = 124). The data provide a demographic profile of early adopters of end-user searching in the health care community. Positive correlations with the user's level of implementation of end-user searching were found for the following variables: amount of time spent in research activities, amount of system training received, and use of Medical Subject Headings (MeSH). There was a negative association between the amount of time spent in patient care and implementation level. General practitioners and family physicians had lower implementation levels than physicians in other specialties. Successful implementers were more likely to be computer literate and to place a high value on formal information sources such as books, journals, and libraries. Health professionals using so-called "user-friendly" or menu-based software had lower levels of personal commitment to using online databases, as measured by a combination of continuance of use, willingness to pay personally, type of recommendations made to colleagues, and hardware ownership. PMID- 2720211 TI - Update on inflation of journal prices: medical journals, U.S. journals, and Brandon/Hill list journals. AB - This paper examines the increases in prices for the last twenty years for the journals listed in the 1987 Brandon/Hill list and for the last twelve years for those on a list of medical and general periodicals published annually in Library Journal. This information is compared to the general U.S. inflation rate as measured by the Consumer Price Index. Despite the decline in the general rate of inflation, the buying power of libraries has continued to dwindle. Librarians need to use this information when justifying increased budget requests. They also need to interact more effectively with publishers to resolve this problem. The buying power of the dollar (as compared to the 1975 dollar) spent on the Brandon/Hill list journals is now 59% of that of a dollar spent in the general economy. This compares to 64% in 1983, when this research was last updated. PMID- 2720212 TI - Backup of online public access catalogs in academic health sciences libraries. PMID- 2720214 TI - Effects of cost sharing and end-user searching on a clinical medical librarian program. PMID- 2720213 TI - Effects on media materials of storage in proximity to a magnetic resonance imaging scanner. PMID- 2720215 TI - The information resources of the food and nutrition information center. PMID- 2720216 TI - Library support for an effective infection control--hazardous materials program. PMID- 2720217 TI - Comment on the second report of the register of Copyrights: Library Reproduction of Copyrighted Works (17 U.S.C. 108). PMID- 2720218 TI - The CRISP system: an untapped resource for biomedical research project information. AB - CRISP (Computer Retrieval of Information on Scientific Projects) is a large database maintained and operated by the National Institutes of Health (NIH). It contains comprehensive scientific and selected administrative data on research carried out by the U.S. Public Health Service (PHS) or supported by PHS grants and contracts. Developed originally to meet the needs of NIH, it is an excellent, largely untapped resource for health information professionals at large, revealing new trends, methods, and techniques, often before they appear in the published literature. CRISP uses its own controlled vocabulary, developed to permit indexing of new and active research areas. Queries can combine subject headings with a great variety of administrative data elements (e.g., research category or principal investigator's name). Output is available in a variety of formats and media. While information professionals cannot directly access the CRISP system, abridged CRISP records are merged into the FEDRIP (Federal Research in Progress) database, and FEDRIP is publicly accessible through DIALOG. CRISP records in toxicology are also furnished to the National Library of Medicine's TOXLINE database. This paper discusses the indexing, information retrieval, publication products, and search services of the CRISP system, and how users of medical information can benefit from it. PMID- 2720219 TI - Medical student, resident, and faculty use of a computerized literature searching system. AB - The experiences of medical students, residents, and faculty with a computerized literature searching system were evaluated. Third-year medical students, internal medicine and family practice residents, and full-time and voluntary faculty at one medical school had the opportunity to use a full-text and bibliographic medical literature retrieval system free of charge for an eleven-month period. Subjects conducted nearly nine thousand literature searches over a period of 942 system hours. Questionnaire data showed that participants could learn to use and would use an electronic information system, felt capable of using the system, utilized the system for a variety of purposes and in a number of different ways, and viewed the system as a valuable tool in searching the medical literature. The results are discussed in the context of the educational needs of the four user groups and medical education planning by institutions. PMID- 2720220 TI - Work/training programs for international health science librarians in American medical school libraries. AB - World understanding is more than a desirable goal today: it may be crucial to our survival. Many universities realize this and have in the past decade spent a great deal of time and money to ensure a steady flow of faculty and students between the U.S. and other countries. Librarians with faculty or academic status may benefit from promoting such relationships themselves. Job exchanges and training programs offer librarians in the United States the opportunity to become acquainted with their counterparts in other countries. Such programs enable librarians of various countries to become aware of one another's special needs and common problems, and allow them to share ideas and expertise. This paper presents an overview of international training programs for foreign librarians in the United States, focusing on programs for health sciences librarians in United States medical school libraries. Information is given on the availability and types of institutionally sponsored programs, as well as on MLA's Cunningham Fellowship Program. Some of the difficulties and the benefits of such programs are discussed. PMID- 2720221 TI - Career progression of academic medical library directors. AB - While females are still underrepresented as directors overall, the results of our survey indicate that in the past ten years female library directors have been hired in numbers nearly matching their overall percentage of the medical library profession. When the personal characteristics of medical library directors are compared by gender, male directors are more likely to be married, have children, and be somewhat younger upon attaining their first directorship. When the professional characteristics are compared, the only notable difference is that a greater portion of males hold a second master's degree. Despite the changing numbers of female library directors in the past ten years, these differences all held constant before and after 1977. Only the number of internal successions to directorship changed over time. The succession patterns of medical library directors now match more closely those of other academic library directors. PMID- 2720222 TI - Subpoenas and library operations: rules and recourse. AB - The subpoena process represents a legal obligation and duty of citizenry and is becoming a fact of life in the operations of many libraries. Regardless of whether a library is directly involved in litigation, the library director may be faced with adjusting operations to compensate for the loss of personnel, collection materials, or other resources in order to accommodate the demands of a subpoena. This paper outlines the formal subpoena process and highlights a number of scenarios by which the library may become a part of the process. The area of computer law, in particular, may present a "growth phase" in library litigation. In addition, recommendations to minimize the service interruptions caused by the subpoena are offered. The director must assist library counsel in formulating a response to challenge, modify, or quash (throw out) the subpoena. Efforts to quash the subpoena require proof that the materials requested are irrelevant to the case, not subpoenaed for "good cause," or that compliance would be unduly oppressive and burdensome. In any case, the library director must be fully prepared to educate counsel on the potential impact of the subpoena. PMID- 2720223 TI - The South Dakota Med-Fax network. AB - Health sciences librarians established a statewide medical information network in South Dakota to provide rural physicians with database access and rapid document delivery. A private grant funded equipment for interactive simultaneous remote searching (ISRS) and telefacsimile transmission, as well as for a coordinator for training and follow-up support. In less than one year, telefacsimile technology has become an integral part of library information transfer among sixteen network sites, and ISRS is gaining acceptance among physicians who lack local access to online databases. PMID- 2720224 TI - Analyzing in-house journal utilization: an added dimension in decision making. PMID- 2720225 TI - Statistical measures for shelf reading in an academic health sciences center library. PMID- 2720226 TI - The Bulletin--a special interest journal? PMID- 2720227 TI - Membership: return on investment. PMID- 2720228 TI - Between patient and doctor. Improving the quality of care for serious mental illness. AB - The quality of care typically rendered to seriously mentally ill patients in this country does not reflect the extraordinary expansion and refinement in recent decades of scientifically based psychiatric diagnostic and therapeutic capacities. In this paper, the authors examine reasons for the disparity between the quality of the scientific base and the quality of care, citing recent historical influences and contemporary obstacles, and then propose strategies for change. PMID- 2720229 TI - A new parcellation of the human thalamus on the basis of histochemical staining. AB - Serial sections of human thalami, cut in the 3 standard planes, were stained in alternating series for Nissl substance, myelin, cytochrome oxidase and acetylcholinesterase. Nissl and acetylcholinesterase-stained sections revealed a parcellation of the nuclei that could be correlated with that used in the macaque monkey thalamus. Human nuclei were accordingly re-named using the monkey nomenclature. Apart from differences of size, the nuclei of the human and monkey thalamus are remarkably similar. In the human ventral nuclear complex there is a very clear histochemical distinction between nuclei which, on the basis of comparison with the monkey, probably form the pallidal, cerebellar and lemniscal relays to premotor, motor and somatic sensory cortex, respectively. In the human somatic sensory relay nucleus there is a further clear cytoarchitectonic distinction between components that are probably equivalent to the relays for deep and cutaneous receptors in the equivalent monkey nucleus. PMID- 2720230 TI - Distribution of tachykinin- and enkephalin-immunoreactive fibers in the human thalamus. AB - Sections at regular intervals through the human thalamus and alternating with those used for histochemical and cytoarchitectonic analysis in the companion paper, were stained immunocytochemically with a monoclonal antibody that recognizes tachykinins, including substance P, and with an antiserum against metenkephalin-arg-gly-leu (MERGL). Immunoreactivity for both types of molecule is found in fiber systems that enter the thalamus: (a) anteromedially, from the hypothalamus and prethalamic regions; (b) posterolaterally, from the midbrain tegmentum. No immunoreactive somata were observed in the thalamus. The chief nuclei in which dense, apparently terminal, ramifications of both sets of immunoreactive fibers are found include the posterior complex (Po, L and Sg), the intralaminar nuclei except the centre median, and a small nucleus tentatively identified as the nucleus submedius. It is significant that many of these nuclei have been implicated in pain phenomena, that most of them receive spinothalamic inputs, and that spinal cells at the origins of the tract are immunoreactive for substance P or metenkephalin. This study provides further evidence for the close similarity between nuclear delineation in the human and monkey thalami. PMID- 2720232 TI - Special issue on AIDS. PMID- 2720231 TI - The AIDS epidemic. PMID- 2720233 TI - Canadian experiences with AIDS and HIV infection. AB - Canada's first AIDS case was diagnosed in 1978, and a total of 2,003 cases had been recorded up to 19 September 1988. Nationwide, 82% of those afflicted have been homosexual or bisexual men, 5% have been immigrants from endemic regions, and 4.6% have been recipients of blood or blood products. Estimates of Canadians infected with HIV range from 10,000 to 50,000. A system of voluntary testing of individuals, combined with anonymous screening of populations for epidemiologic purposes, comprises the HIV testing program in Canada. Most major cities have volunteer AIDS support committees conducting education, advocacy, and support activities; Can$48 million has been allocated to educate the public about AIDS over the next five years. Research and international cooperation are also receiving increased priority and funding. PMID- 2720234 TI - Prevention of HIV transmission through blood and blood products: experiences in Mexico. AB - As of August 1988, 1,628 cases of AIDS had been reported in Mexico, of which 12% were ascribed to transmission through blood. Of the 201 subjects infected by blood, 159 (79%) were infected through transfusions. The relatively high number of such cases was found to be associated with a prevalence of HIV infection of 7% among paid donors as compared with a prevalence of 0.1% among volunteer donors. A National AIDS Prevention Committee has been established in Mexico, and amendments to the country's General Health Law mandate compulsory screening to detect HIV infection among all donors and prohibit the sale of blood. A national network of screening laboratories was established and an educational campaign initiated among health personnel. Evaluation of this program shows that the current frequency of HIV infection in donors is 0.04%. PMID- 2720235 TI - The Canadian national AIDS program. AB - Canada's federal AIDS program is orchestrated by the Federal Center for AIDS (FCA), created in 1987. The Center is made up of six bureaus: Program Analysis and Resources, the focal point for policy and program development; AIDS Prevention and Services Program, which focuses on education, liason with health care workers and community groups, and the psychosocial aspects of the epidemic; AIDS Epidemiology and Surveillance, which monitors trends and assesses the extent of the disease; Laboratories and Research, which provides reference services for laboratories engaged in HIV screening and diagnosis, and collaborates with national and international researchers; External Cooperation, which promotes international collaboration in AIDS research, policy, and programs; and Clinical Studies, which promotes studies on drugs and vaccines. The fight against AIDS is also assisted by the National Health Research and Development Program, provincial and territorial governments, and community-based support groups. PMID- 2720236 TI - AIDS projections are too high. PMID- 2720237 TI - Projection of AIDS cases, USA. PMID- 2720238 TI - AIDS projections, a Jamaican perspective. PMID- 2720240 TI - Who is really right? PMID- 2720239 TI - Changing pattern of HIV transmission in the Caribbean. PMID- 2720241 TI - Status of the AIDS epidemic. PMID- 2720242 TI - The World Health Organization's Global Program on AIDS. PMID- 2720243 TI - The response to AIDS in the region of the Americas. PMID- 2720244 TI - PAHO guidelines for AIDS. PMID- 2720245 TI - First Pan American Teleconference on AIDS. PMID- 2720246 TI - Sexual transmission of AIDS. PMID- 2720247 TI - Criteria for HIV screening programs. PMID- 2720248 TI - Arming health workers for the AIDS challenge. PMID- 2720249 TI - AIDS and the workplace. PMID- 2720250 TI - AIDS prevention through health promotion: a planning guide. PMID- 2720251 TI - Report of the consultation on the neuropsychiatric aspects of HIV infection. PMID- 2720252 TI - AIDS in Mexico: trends and projections. AB - The first case of AIDS in Mexico was reported in 1981. Through mid-1988, 1,502 cases had been reported, the incidence of cases having doubled every 7.7 months. Of the cases in adults, 87.6% were sexually transmitted, transfusion with contaminated blood or blood products accounted for 10.8%, and intravenous drug abuse for 0.3%. In the 56 pediatric AIDS cases reported, transmission through contaminated blood accounted for 67.9%, sexual contact for 5.4%, and perinatal transmission for 19.6%. The disease appears to be spreading from the large cities to peripheral and rural areas, and to be spreading faster among heterosexuals than among homosexual and bisexual males. Projections based on continued exponential doubling at the 1983-1986 rate suggest the cumulative AIDS case total could exceed 75,000 by the end of 1991. More conservative estimates based on an observed lengthening of the doubling time predict as many as 260,000 cases by the end of 1994. PMID- 2720253 TI - Symposium on nutrition and AIDS. PMID- 2720254 TI - Measurement of antibodies to human immunodeficiency virus: an international collaborative study to evaluate WHO reference sera. PMID- 2720255 TI - AIDS in Brazil, 1982-1988. AB - AIDS was first identified in Brazil in 1982, and by mid-1988 a total of 3,952 cases had been detected. The highest concentrations of cases have occurred in the Southeast region of the country (81.8%), which includes the States of Rio de Janeiro and Sao Paulo, and in the 25-to-40 year-old age group (58.2%). Sexual transmission is responsible for 72.8% of the cases; 18.8% of the cases were transmitted by contact with contaminated blood or blood products; perinatal transmission is responsible for 1.0% of the total recorded cases. On the basis of serologic surveys of certain population groups and projections of the prevalence of infection based on the number of actual cases at the end of 1987, the number of asymptomatic infected individuals would be between 200,000 and 400,000. PMID- 2720256 TI - HIV-1 infection in intravenous drug abusers with clinical manifestations of hepatitis in the city of Buenos Aires. AB - A serologic study of hepatitis and HIV infections among 99 I.V. drug abusers with hepatitis was conducted between December 1986 and September 1987. The average age of the study subjects was 21 years. Eighty-nine (90%) of the subjects were male, including four whose sexual orientation was homosexual/bisexual. Serologic tests indicated that 87 of the 99 subjects had hepatitis B virus infections, 62 acute and 25 chronic. Nine (10%) of these 87 patients were coinfected with the delta agent. Two subjects had acute cases of hepatitis A, and the 10 remaining subjects had non-A non-B hepatitis. Forty-seven of the study subjects were also found to be infected with HIV-1. The prevalence of the delta marker was surprisingly high, because Argentina has been regarded as nonendemic for the delta virus. Given the trend of increasing I.V. drug abuse in Argentina, these results presage a significant increase in the delta agent's prevalence in the immediate future. PMID- 2720257 TI - Epidemiology of AIDS and HIV infection in the Caribbean. AB - A review of surveillance data on AIDS and HIV infection in the 18 English speaking Caribbean countries and Suriname suggests that the epidemiologic pattern of AIDS in the Caribbean is evolving from an epidemic that began in 1983 among homosexual and bisexual males to one in which cases are increasingly resulting from heterosexual contact, with different countries at various stages of transition. Overall, there has been a decline in the male to female case ratio. Perinatal transmission is already a major problem in many countries--19% of cases in the Bahamas are among children under 15 years of age. Serosurveys conducted in Trinidad and Tobago, Jamaica, Antigua, St. Vincent and the Grenadines, and other countries show high HIV seroprevalence among homosexuals (15-40%), prisoners (4 10%), prostitutes (up to 13%), and cocaine users (2%); at present, prevalence in the general population continues to be low. PMID- 2720258 TI - Prevalence of infection with human immunodeficiency virus in Cuba. AB - This article describes the National AIDS Prevention and Control Program in Cuba and presents the results of serologic studies of HIV prevalence. As of 30 May 1988 2,224,748 individuals (approximately one-third of the Cuban population plus 32,750 foreigners) of sexually active age from high-risk and other population groups had been screened to detect HIV antibody. Among resident Cubans a total of 227 HIV infections were found, indicating a prevalence of 0.01 seropositives per 100 people tested. The seroprevalence of HIV among blood donors is on the order of one infection per 50,000 people, and appears to have declined since 1986. The seroprevalence of HIV among groups at risk is relatively low compared to that found among similar groups in other countries. PMID- 2720259 TI - Retroviruses in the Caribbean. AB - Transmission of HIV in many Caribbean countries has followed the pattern of initial predominance among homosexual and bisexual males, with the infection subsequently spreading into the heterosexual community. However, on Saint Lucia the epidemic began among heterosexual contacts of Saint Lucian laborers from Florida; in Bermuda 58% of AIDS cases have been in intravenous drug abusers; and in the Bahamas 59% of the AIDS patients have been heterosexuals and 19% children infected via the perinatal route. Seroprevalence of the human T-lymphotropic virus, type 1 (HTLV-I), whose modes of transmission resemble those of HIV, has been found to range from 2.3% in Trinidad and Tobago to 5.4% in Jamaica. In a study of HIV and HTLV-1 infection patterns in homosexual males in Trinidad and Tobago, the cohort was too small for confirmation that coinfection with these two viruses hastened progression in AIDS, but further investigation is warranted. PMID- 2720260 TI - Public information about AIDS in Brazil, the Dominican Republic, Haiti, and Mexico. AB - Surveys of public knowledge and attitudes regarding AIDS have been conducted in Brazil, Haiti, Mexico, and the Dominican Republic. In Brazil two-thirds of the 5,000 survey subjects were aware of how HIV is transmitted, and 20% said they had changed their lifestyles or sexual practices to reduce their risk of infection. Of the 1,961 subjects surveyed in Mexico City, Mexico, 86% knew that AIDS was an infectious disease, and 52% believed condoms were an effective barrier against HIV. A 1987 survey in the Dominican Republic showed that awareness of AIDS, its modes of transmission, and preventive measures had improved since a similar survey conducted in 1985. In the Haitian survey in 1987, 24% to 68% of the respondents could identify high-risk groups, but there was some uncertainty about modes of transmission, the effectiveness of medical care, and the efficacy of measures to prevent HIV transmission. PMID- 2720261 TI - Perspectives on the AIDS epidemic: the experience within the United States. AB - As of 13 June 1988 a cumulative total of 64,896 AIDS cases and 36,480 AIDS related deaths had been reported to the United States Centers for Disease Control (CDC). Of the 63,880 adults afflicted, 63% were homosexual or bisexual men; 19% were intravenous drug users; 7% were homosexual men who were also I.V. drug users; 4% were heterosexuals; 3% were blood transfusion recipients; 1% were hemophiliacs; and 3% were people for whom risk factor information was incomplete. Of the 1,016 children with AIDS, 77% were born to a parent who had or was at risk for AIDS, 13% were blood transfusion recipients, 6% were hemophiliacs, and 4% were children for whom risk factor information was incomplete. Serologic surveys have provided information regarding the extent of HIV infection in high-risk groups. The number of AIDS cases projected through 1992 using the methods of extrapolation and back-calculation are 310,000 and 380,000 cases, respectively. PMID- 2720262 TI - AIDS: social, legal, and ethical issues of the "third epidemic". AB - The "first" and "second" epidemics of AIDS are considered to be the spread of HIV infection and subsequent development of AIDS cases; what has been termed the "third epidemic" is the widespread economic, social, and cultural reaction to the disease, raising crucial social, humanitarian, and legal issues. This article deals with four questions arising from these issues: (1) What is the best public health approach to people with HIV/AIDS, and what rights should they have? (2) Who should be subjected to mandatory testing? (3) Who has a right to know or be warned if someone has HIV/AIDS? and (4) How can society be protected against people who irresponsibly or deliberately set out to infect others? It is concluded that, as recommended by the World Health Organization, policies which balance concern for public health with respect for individual rights are both the most humane and the most effective ways to control the spread of AIDS. PMID- 2720263 TI - Patient transport: an organized method with direct clinical benefits. PMID- 2720264 TI - A practical introduction to databases: Part 2. PMID- 2720265 TI - Using productivity measures in clinical engineering departments. PMID- 2720266 TI - Contrast testing for magnetic resonance imaging. AB - A test phantom for evaluating magnetic resonance image contrast was constructed using separate chambers filled with manganese chloride (MnCl2) solutions of different concentrations. The concentrations were chosen so that the relaxation times produced were distributed over the range appropriate for human tissues in brain imaging. Specific solutions had relaxation properties similar to those of white matter, gray matter, and brain tumors. The region surrounding the chambers was filled with a sodium chloride solution with conductivity similar to that of brain tissue so that radiofrequency signal absorption would be appropriate. When magnetic resonance relaxation response curves were obtained with the phantom, relaxation contrast and latitude could be compared for different imaging pulse sequences. Contrast responses for gradient echo sequences differed considerably when the flip angle was changed. PMID- 2720268 TI - Do we have the standards we need? Do we need the standards we have? PMID- 2720267 TI - A closed-loop system for pressure-controlled intermittent coronary sinus occlusion. AB - Computer-based instrumentation of a closed-loop system for pressure-controlled intermittent coronary sinus occlusion (PICSO) is described. PICSO is a procedure for treatment of ischemic myocardium via the venous side of the coronary circulation. The coronary venous outflow is intermittently obstructed with a balloon-tip catheter positioned in the coronary sinus, with the object of washing out toxic metabolites and redistributing the blood flow in the myocardium. Because of the relatively large capacitance in the coronary venous system, a PICSO occlusion-release cycle usually lasts for several cardiac cycles to achieve a significant pressure perturbation in the coronary sinus. The PICSO cycle should be adapted to the physiologic state of the heart. The closed-loop system described monitors the coronary sinus occlusion pressure and predicts the appropriate occlusion-release timing. The system should be useful for optimizing PICSO in animal studies as well as in clinical trials. PMID- 2720270 TI - How to recruit and retain staff: Part 1. PMID- 2720269 TI - International standards: how will the United States respond? PMID- 2720271 TI - Clinical engineering in clinical departments. PMID- 2720272 TI - What is rehabilitation? PMID- 2720273 TI - Panic disorder: a new entity? PMID- 2720274 TI - Getting it taped: the 'bad news' consultation with cancer patients. AB - 'Not being told what is wrong' is the most frequent complaint patients make (Fletcher, 1980). In cancer a lack of information greatly increases the stress and anxiety experienced. In this report, 46 patients with cancer were given audiotape recordings of their 'bad news' consultations to take home. Analysis of subsequent questionnaire data revealed that both patients and their families benefited enormously from the opportunity to hear the details of their diagnosis and treatment again. PMID- 2720275 TI - How to perform arterial cannulation. AB - Arterial cannulation is a common and informative procedure. This article outlines its indications and contra-indications and illustrates the common methods of insertion. Good technique minimises subsequent complications, even when insertion is difficult. PMID- 2720276 TI - Central diabetes insipidus with congenital cerebral anomaly. PMID- 2720277 TI - Late presentation of diaphragmatic rupture following blunt trauma. PMID- 2720278 TI - Medical audit. PMID- 2720280 TI - Funding and contracts. PMID- 2720279 TI - NHS consultants. PMID- 2720281 TI - Self-governing hospitals. PMID- 2720282 TI - Capital charges. PMID- 2720283 TI - Complications in caesarean section. PMID- 2720284 TI - Selection of cases for autopsy. PMID- 2720285 TI - What do we tell patients about mammography? PMID- 2720286 TI - The false negative mammogram. PMID- 2720287 TI - Peritoneal-venous shunting for refractory ascites. PMID- 2720288 TI - An A2-purinoceptor agonist, NECA, potentiates acetylcholine-induced glucagon secretion. AB - The effect of a stable structural analogue of adenosine, 5'-N ethylcarboxamidoadenosine (NECA), was studied on glucagon secretion induced by acetylcholine (ACh) in the isolated perfused pancreas of the newborn dog. The perfusion solution contained a physiological concentration of glucose (4.2 mM). In the first set of experiments, ACh (0.5 microM) infused alone for 10 min induced a significant rise of glucagon secretion (370 +/- 98%, 4 min after the beginning of infusion). In the second set, NECA (2.2 nM) infused 10 min before ACh administration, had no effect per se, but considerably increased the response to ACh (929 +/- 262% of basal value within 3 min). So, the more specific A2 purinoceptor agonist, NECA, potentiated glucagon secretion induced by the cholinoceptor agonist, ACh. PMID- 2720289 TI - Acute stress and GABAergic function in the rat brain. AB - 1. The function of the gamma-aminobutyric acid (GABA)-ergic system in certain areas of the rat brain was investigated after acute (5 min) exposure to immobilization stress. 2. The activities of glutamate decarboxylase and GABA transaminase, GABA concentrations, GABA turnover in vivo and uptake of [3H]-GABA were measured. 3. After 5 min of immobilization stress, GABA concentrations and [3H]-GABA uptake were reduced, and GABA turnover stimulated in the olfactory bulbs. In contrast the uptake of [3H]-GABA was increased in the corpus striatum after 5 min of immobilization stress. 4. None of the parameters measured was significantly altered by acute immobilization stress in the frontal cortex, hippocampus or medio-basal hypothalamus. 5. These findings show that the olfactory bulbs and the corpus striatum are sensitive to the effects of acute stress. Since GABA in the olfactory bulbs is involved in the development of aggression and increased emotional state, it follows that neurochemical changes induced by acute stress might underlie some behavioural manifestations observed after stress. PMID- 2720290 TI - The effects of vasoactive intestinal peptide (VIP) antagonists, and VIP and peptide histidine isoleucine antisera on non-adrenergic, non-cholinergic relaxations of tracheal smooth muscle. AB - 1. The effects of several drugs, including antagonists of vasoactive intestinal peptide (VIP), and antisera to VIP or peptide histidine isoleucine (PHI), on relaxation responses of guinea-pig isolated trachea to electrical field stimulation (EFS) have been examined. 2. beta-Adrenoceptor blockade with propranolol only partially blocked the inhibitory response to EFS, but had no effect in tissues from animals pretreated with 6-hydroxydopamine or reserpine. 3. Neither adenosine deaminase, in the presence of dipyridamole, nor the potent adenosine antagonist NPC205 (1,3-n-dipropyl-8-(4-hydroxyphenyl)-xanthine) had any effect on the inhibitory response to EFS. 4. The VIP antagonists, [Ac-Tyr1, D Phe2]-GRF(1-29)-NH2 and [4-Cl-D-Phe6, Leu17]-VIP had no effect on the inhibitory response to EFS. Moreover, they were without effect on responses to exogenous VIP or PHI. 5. Overnight incubation with VIP antisera markedly reduced the inhibitory response to EFS. PHI antisera had a similar, but smaller effect. 6. In the presence of a concentration of VIP that is maximal for its relaxant effect, inhibitory responses to electrical stimulation were greatly inhibited. 7. Naloxone and reactive blue 2 each had no effect on inhibitory responses indicating that endogenous opioids and adenosine 5'-triphosphate (ATP) respectively are not involved. 8. The results suggest that VIP and PHI, but not adenosine, contribute to non-adrenergic, noncholinergic inhibitory nerve responses of guinea-pig trachea. Moreover, the surprising lack of effect of both VIP antagonists on these responses, and in particular, on responses to exogenous VIP, suggests that the receptors mediating VIP-induced tracheal relaxation are different from those that mediate pancreatic secretion. PMID- 2720291 TI - The effect of glucocorticosteroids on in vitro motility of the ureter of the sheep. AB - 1. The effects of three glucocorticosteroids, hydrocortisone, methylprednisolone and dexamethasone, as well as two non-steroidal anti-inflammatory agents (NSAIDs) indomethacin and diclofenac sodium were tested in vitro on the spontaneously rhythmic contracting ureteral preparation of the sheep. 2. The NSAIDs and the steroids methylprednisolone (10(-7)-10(-4) M) and dexamethasone (10(-8) - 10(-4) M), dose-dependently inhibited ureteral motility. Hydrocortisone caused a cessation of spontaneous contractions only at the high concentration of 10(-4) M. 3. Pretreatment of ureteral strips with the protein synthesis inhibitor cycloheximide (10(-6) M) abolished the inhibitory action of the corticosteroids on peristalsis, consistent with the suggestion that the action of steroids on the ureter is mediated via the synthesis of the anti-phospholipase protein, lipocortin. 4. The potency of the steroids in descending order was found to be dexamethasone greater than methylprednisolone greater than hydrocortisone. PMID- 2720292 TI - Effects of capsaicin desensitization on the stimulatory effect of kinins, prostaglandins, biogenic amines and various drugs in guinea-pig isolated atria. AB - 1. A simple desensitization protocol was set up using capsaicin and isolated, spontaneously beating atria of guinea-pigs to assess the possible participation of cardiac, capsaicin-sensitive, substance P (SP)- and calcitonin gene-related peptide (CGRP)-containing sensory nerve fibres, in the cardiac stimulatory effects of bradykinin (Bk), kallidin (Kd), 5-hydroxytryptamine (5-HT), histamine, prostaglandin E2 (PGE2), prostaglandin E1 (PGE1), prostaglandin F2 alpha, (PGF2 alpha), adrenaline (Ad), glucagon, nicotine and angiotensin II (AII). 2. The positive chronotropic and inotropic effects of Bk, Kd and 5-HT were markedly reduced in capsaicin-desensitized atria compared to control. The percentage inhibition of the chronotropic and inotropic responses to the three agonists seemed to be inversely related to the concentration of agonist used and to vary also with the type of cardiac effect produced by the drug (for Bk the percentage inhibition was: 36-81% (chronotropic effect) and 62-86% (inotropic effect); for Kd: 61-78% (chronotropic effect) and 53-77% (inotropic effect); for 5-HT: 25-66% (chronotropic effect) and 40-64% (inotropic effect]. 3. The positive chronotropic and inotropic effects of histamine, PGE1, PGE2, PGF2 alpha, glucagon and AII had similar amplitudes in capsaicin-desensitized and control atria. 4. The positive chronotropic and inotropic effects of Ad and nicotine were differentially affected by capsaicin desensitization. The inotropic effects of 7.5 x 10(-7) and 7.5 x 10(-6) M Ad were reduced by 41 and 27% respectively, in capsaicin desensitized atria compared to control. The chronotropic effects of 1.54 x 10(-5) and 6.17 x 10(-5) M nicotine were inhibited by 57 and 26% respectively, by capsaicin desensitization. On the other hand, the chronotropic effect of Ad and the inotropic action of nicotine were of similar amplitude in capsaicin desensitized and control atria. 5. These results were taken as an indication that a substantial part of the chronotropic and inotropic effects of Bk, Kd or 5-HT in guinea-pig atria, unlike those of histamine, PGE1, PGE2 PGF2 alpha, glucagon and AII, might be the result of stimulation of capsaicin-sensitive, SP- and CGRP- containing sensory nerve fibres. The slight, differential inhibition of the chronotropic and inotropic effects of Ad and nicotine by capsaicin desensitization suggests a minor contribution by cardiac, capsaicin-sensitive sensory nerve fibres to the effects of nicotine and Ad in guinea-pig atria. PMID- 2720293 TI - Electrophysiological estimation of the actions of acetylcholinesterase inhibitors on acetylcholine receptor and cholinesterase in physically isolated Aplysia neurones. AB - 1. The actions of representative cholinesterase inhibitors on the acetylcholine responses of physically isolated single neurones from the pedal ganglion of Aplysia californica were studied, using electrophysiological techniques and rapid agonist application to analyse both the inhibitory actions on the acetylcholine receptor-channel complex and the degree of inhibition of acetylcholinesterase activity on the same neurone. The inhibitors used were physostigmine, edrophonium and diisopropylfluorophosphate (DFP). 2. When selected neurones were suddenly exposed to 50 microM acetylcholine by a 'concentration clamp' technique a large Na-dependent inward current was initiated, and decayed in the continued presence of acetylcholine without external perfusion. However, if perfusion of the acetylcholine solution was reinitiated the current increased somewhat, indicating that the decay of current was due to some combination of receptor desensitization and local depletion of acetylcholine at the membrane by acetylcholinesterase. 3. With simultaneous application of acetylcholine (50 microM) and physostigmine (0.1 to 100 microM) there was a dose-dependent reduction of peak amplitude of the acetylcholine response. However, physostigmine at low concentrations (0.1 to 10 microM) caused a time-dependent increase in the current amplitude alone with a time- and dose-dependent inhibition of acetylcholinesterase activity. At the highest concentration of physostigmine (100 microM) acetylcholinesterase activity was abolished but the current peak was very depressed. After removal of physostigmine from the bathing solution, the current amplitude decreased toward the control at the two lower concentrations as the inhibitory actions on acetylcholinesterase activity were almost reversible, while at the two higher concentrations (10 and 100 microM) the current increased and the inhibition of acethylcholinesterase remained. 4. When acetylcholine (50 microM) and edrophonium (0.1 to 10 microM) were applied simultaneously, edrophonium caused a dose dependent increase in the peak amplitude that was correlated with a dose dependent inhibition of acetylcholinesterase activity. Prolonged exposure to edrophonium did not change the peak amplitude and there was no time-dependent change in the inhibition of acetylcholinesterase activity. At the highest concentration of edrophonium used (100 microM), simultaneous application with acetylcholine augmented the peak amplitude relative to control, but to a lesser extent than 10 microM. Prolonged exposure to the highest concentration of edrophonium caused a time-dependent reduction in the peak amplitude. The effects of edrophonium were quickly reversible after the removal of the drug from the bathing solution. 5. DFP (1 and 10mM), similar to 1OO microM physostigmine, caused a dramatic reduction of the peak current on simultaneous application with ftetylcholine. During exposure to DFP the current amplitude and acetylcholinesterase activity were very depressed. After removing DFP from the bathing solution the current amplitude increased to more than the control level after 1 mm DFP, while it did not recover to the control level after 10mM DFP. The inhibition of acetylcholinesterase activity remained at both concentrations. 6. These results indicate that all three cholinesterase inhibitors have dose dependent actions both at the acetylcholine receptor-channel complex and at acetylcholinesterase. The methods we have developed may be useful in the evaluation of various cholinesterase inhibitors. PMID- 2720294 TI - Analysis of the hyperpolarizing effect of catecholamines on canine cardiac Purkinje fibres. AB - 1. The hyperpolarization induced by catecholamines on barium-depolarized (0.2-0.8 mM BaCl) canine cardiac Purkinje fibres, in vitro, was studied by use of conventional microelectrode recordings of transmembrane electrical potentials. 2. Noradrenaline, adrenaline and isoprenaline hyperpolarized Purkinje fibres in a concentration-dependent manner from a threshold concentration around 5 nM. The three catecholamines were shown to be approximately equipotent. Tachyphylaxis was observed when the interval between catecholamine applications was less than 15 min. 3. Atenolol (10 microM) blocked the hyperpolarization reversibly and theophylline (0.5 mM) potentiated it. 4. Tetrodotoxin (5 microM) did not affect the hyperpolarization induced by isoprenaline. Acetylcholine and histamine, up to 10 microM, were not effective in hyperpolarizing Purkinje fibres. 5. Low extracellular potassium concentrations (zero and 1 mM) did not affect the hyperpolarization, but high extracellular potassium concentrations (10-20 mM), markedly reduced the effect of isoprenaline (100 nM). 6. Reduction of the extracellular sodium concentration produced a roughly proportional reduction in the isoprenaline-induced hyperpolarization. The hyperpolarization was reversibly blocked in 34 mM sodium Tris-Tyrode solution. 7. The hyperpolarization was not reduced in Tyrode solution containing 0.6 mM calcium, but was drastically reduced in zero-calcium Tyrode solution. This effect was reversible. 8. Addition of verapamil (5-10 microM) diminished the hyperpolarization, in a concentration dependent manner. This effect was partially reversed after washing. 9. Ouabain (0.7-1 microM) significantly reduced the isoprenaline-induced hyperpolarization, but 2,4-dinitrophenol (0.2 mM) did not affect it. 10. Caesium chloride (20 mM) abolished the hyperpolarization. The blockade was only partially reversed upon washing. 11. It is suggested that the hyperpolarization induced by a short exposure to catecholamines is mainly due to an increase in potassium permeability (PK). A mechanism involving calciumdependent potassium channels might underlie the increase in PK. PMID- 2720295 TI - Effect of phorbol ester and pertussis toxin on the enhancement of noradrenaline release by angiotensin II in mouse atria. AB - 1. Mouse atria were incubated with [3H]-noradrenaline, and the outflow of radioactivity due to electrical field stimulation (5 Hz, 60 s) was used as an index of noradrenaline release. Angiotensin II (0.01 and 0.1 microM) significantly enhanced the stimulation-induced (S-I) outflow of radioactivity. 2. Phorbol 12-myristate 13-acetate (0.001, 0.03, 0.1 and 1.0 microM), a protein kinase C activating phorbol ester, significantly enhanced the S-I outflow of radioactivity. When angiotensin II (0.1 microM) was present with the concentration of phorbol 12-myristate 13-acetate that was maximally effective in increasing the S-I outflow (0.1 microM), the enhancement of S-I outflow produced by angiotensin II was maintained. 3. Polymyxin B (70 microM), an inhibitor of protein kinase C, significantly inhibited the S-I outflow. Polymyxin B also inhibited the enhancement of the S-I outflow produced by angiotensin II (0.1 microM). 4. In another series of experiments mice were injected with pertussis toxin (1.5 micrograms per mouse), 4 days before their atria were removed. The effectiveness of pertussis toxin pretreatment was determined indirectly using carbachol. Carbachol caused a concentration-dependent fall in both the rate and force of beating of isolated spontaneously beating atria from mice pretreated with vehicle. This effect of carbachol was not seen with atria from mice pretreated with pertussis toxin. 5. Pertussis toxin pretreatment did not alter the enhancement of the S-I outflow of radioactivity produced by angiotensin II (0.01 and 0.1 microM). 6. These results suggest that angiotensin II receptor modulation of noradrenaline release is not mediated through either a pertussis toxin sensitive guanine nucleotide-binding protein or activation of protein kinase C. PMID- 2720297 TI - Electrophysiological and antiarrhythmic effects of UK 52,046-27 during ischaemia and reperfusion in the guinea-pig heart. AB - 1. We studied the antiarrhythmic and electrophysiological effects of UK 52,046-27 (10(-8) M and 5 x 10(-8) M), a highly selective alpha 1-adrenoceptor antagonist, during global ischaemia (flow reduced to 10% of control for 30 min) and reperfusion, in isolated, buffer-perfused hearts of guinea-pigs. 2. The compound had few electrophysiological effects during normal perfusion, although action potential amplitude and Vmax were reduced with 10(-8) M (by 9% and 22%) and refractory period was increased with 5 x 10(-8) M (by 13%) compared to control hearts. 3. Perfusion with 5 x 10(-8) M UK 52,046-27 reduced the incidence of ventricular tachycardia during ischaemia from 67% to 25%, and during reperfusion reduced the incidence of ventricular tachycardia (from 83% to 17%) and ventricular fibrillation (from 67% to 8%). 4. The compound prolonged significantly action potential duration and refractory period during ischaemia and reperfusion. Vmax was reduced to a greater extent during reperfusion in the treated hearts, while greater increases in QRS width and stimulation threshold occurred during ischaemia in the treated group. 5. These results confirm that blockade of the alpha 1-adrenoceptor subpopulation during myocardial ischaemia and reperfusion decreases the incidence of arrhythmias and alters cellular electrophysiology during ischaemia and reperfusion. PMID- 2720296 TI - Swim-stress-induced antinociception in young rats. AB - 1. Opioid and non-opioid mechanisms have been implicated in the phenomenon of stress-induced antinociception in adult rodents. We have studied stress-induced antinociception in developing rats and characterized differences in the neurochemical basis of this effect in pre- and post-weanling animals. 2. Twenty and 25 day old rats were stressed using warm water (20 degrees C) swimming for 3 or 10 min periods and antinociception was assessed by the tail immersion test (50 degrees C). 3. A 3 min swim in 20 and 25 day old rats produced marked antinociception which was blocked by naloxone, Mr 1452, 16-methyl cyprenorphine and levallorphan but not Mr 1453 or N-methyl levallorphan. The delta-opioid receptor antagonist ICI 174,864 attenuated stress-induced antinociception in 25 day old rats but was without effect in 20 day old animals. 4. A 10 min swim in 25 day old rats produced antinociception which was non-opioid in nature. In contrast, antinociception was not observed in 20 day old rats after a 10 min swim stress. 5. Pretreatment of animals with dexamethasone blocked 3 min swim-stress antinociception in 20 and 25 day old animals but had no effect on antinociception induced by a 10 min swim. 6. Swim-stress-induced antinociception can be observed in young rats and dissociated into opioid and non-opioid types dependent on the duration of swimming stress. The non-opioid type appears to develop more slowly and cannot be observed in preweanling rats. The opioid type is a predominantly mu receptor phenomenon in preweanling animals but delta-receptor components are observable in postweanling rats. PMID- 2720298 TI - Prostanoid-induced contraction of human bronchial smooth muscle is mediated by TP receptors. AB - 1. A range of naturally-occurring prostaglandins sulprostone, 16,16-dimethyl prostaglandin E2 (DME2) and the thromboxane A2 (TXA2)-mimetic, 11 alpha,9 alpha epoxymethano prostaglandin H2 (U-46619) have been tested for contractile agonist activity on human isolated bronchial smooth muscle. 2. Prostaglandin D2 (PGD2), PGF2 alpha, 9 alpha,11 beta-PGF2 (11 beta-PGF2) and U-46619 all caused concentration-related contractions. U46619 was at least 300 fold more potent than the other prostanoids with a mean EC50 of 12 nM. Sulprostone caused contraction only at the highest concentration tested (30 microM). PGE2 and PGI2 caused relaxations at low concentrations, and only caused contractile responses at high concentrations (greater than or equal to 10 microM). In contrast, DME2 caused small contractions at low concentrations but relaxation at the highest concentration tested (30 microM). 3. The rank order of contractile agonist potency was: U-46619 much greater than 11 beta-PGF2 congruent to PGF2 alpha greater than PGD2 greater than PGE2 greater than PGI2 congruent to sulprostone congruent to DME2. 4. The TP-receptor blocking drug, AH23848 (1 microM) antagonized the contractile effects of U-46619, PGD2, PGF2 alpha and 11 beta PGF2, but had no effect against contractions to carbachol. In a single experiment, a pA2 of 8.3 (slope = 1.2) was obtained for AH23848 against U-46619. 5. In most preparations, administration of AH23848 (1 microM) to human bronchus resulted in small, transient contractile responses. 6. The results obtained with both the agonists and the antagonist, AH23848 are therefore consistent with prostanoid-induced contractions of human bronchial smooth muscle being mediated by TP-receptors. PMID- 2720299 TI - Capsaicin and nicotine-sensitive afferent neurones and nasal secretion in healthy human volunteers and in patients with vasomotor rhinitis. AB - 1. Applications of capsaicin, nicotine and methacholine were made locally onto the nasal mucosa in human controls and patients suffering from hyperreactive nasal disorders. Perception of sensation was registered as a sympton score and secretion quantified. The sensory reaction (irritation - pain) to capsaicin was similar in the three groups studied, i.e. controls, a group of patients with the diagnosis of vasomotor rhinitis and a group of patients with increased nasal secretion as the main symptom of the hyperreactive disorder. Nicotine induced only a mild itching sensation in the three groups. However, capsaicin and nicotine challenge caused a significantly larger secretory response in the last group than in the unselected vasomotor rhinitis group and in the control group. 2. Pretreatment with muscarinic receptor antagonists almost completely abolished the secretory response to both capsaicin and nicotine, and blocked methacholine induced secretion. Furthermore, pretreatment with a combination of local anaesthetic and vasoconstrictor agent abolished the capsaicin-induced irritation, as well as the capsaicin- and nicotine-induced secretion on both the ipsilateral and the contralateral side. Therefore, no clearcut contribution seems to be exerted by locally released peptides from sensory neurones as direct trigger substances for the secretory response to capsaicin. 3. In conclusion, the nasal secretory response, in man, to both capsaicin and nicotine, seems to be mediated via cholinergic parasympathetic reflexes. In patients with hyperreactive non allergic disorders of the nasal mucosa with rhinorrhea as the main complaint, the enhanced secretion may be due to a hyperreactive efferent cholinergic mechanism rather than hypersensitive irritant receptors on capsaicin- and nicotine sensitive sensory neurones. Challenge with irritant agents seems a useful test for the evaluation of both afferent and efferent reflexogenic responses in hyperreactive disorders of the nasal mucosa. PMID- 2720300 TI - Variable, voltage-dependent, blocking effects of nitrendipine, verapamil, diltiazem, cinnarizine and cadmium on adrenomedullary secretion. AB - 1. Catecholamine release from cat adrenal glands perfused at a high rate (4 ml min-1) at 37 degrees C with modified Krebs solutions lacking Ca and containing 1.2 mM K (hyperpolarizing solution) or 118 mM K (depolarizing solution) was triggered by 10-s pulses of Ca (0.5 mM) in the presence of 118 mM K. Hyperpolarized glands released 1280 +/- 135 ng per pulse and depolarized glands 831 +/- 98 ng per pulse (n = 29). 2. While the dihydropyridine Ca channel blocker nitrendipine inhibited secretion in hyperpolarized glands with an IC50 of 214 nM, in depolarizing conditions the drug was much more potent (IC50 = 0.99 nM). In contrast, the inorganic Ca channel blocker cadmium inhibited secretion with the same potency both in hyperpolarized or depolarized glands. 3. Cinnarizine, diltiazem and verapamil exhibited intermediate degrees of voltage-dependence in blocking secretion. The IC50 ratios between hyperpolarized and depolarized glands were 215, 36, 19, 8 and 0.76 respectively for nitrendipine, cinnarizine, diltiazem, verapamil and cadmium. Because the experimental design (strong depolarization in the absence of Ca) favours the highest opening probability of Ca channels, it seems that these drugs bind preferentially to their receptors when these channels are in their open state. 4. Variable voltage-dependent effects of the five Ca channel blockers on adrenomedullary catecholamine release suggests different sites and mechanisms of action on, or near L-type Ca channels in chromaffin cells. In addition, these findings might help to explain why these drugs exhibit tissue selectivity and why they act differently in normal polarized as compared to ischaemic depolarized cells. PMID- 2720301 TI - Tolerance to cromakalim in the rat uterus in vivo. AB - 1. Cromakalim (0.1 and 1 mg kg-1) produced inhibition of uterine contractions and falls in mean blood pressure in ovariectomized, non-pregnant rats, the durations of which were dose-dependent. Frequency of contractions was inhibited selectively compared to amplitude. 2. The durations of the uterine effect of cromakalim (1 mg kg-1), when given at 12 h intervals, were less after the second, third and fourth doses compared to the first dose in non-pregnant rats. In ovariectomized rats treated from day 18 of pregnancy, using the same experimental design, no uterine relaxant effects were seen to the third and fourth doses. The timing of delivery and foetal viability were unaffected by cromakalim. 3. The sensitivity of the uterus to cromakalim was tested using small doses before and after three cromakalim doses (1 mg kg-1) given at 8 h intervals in non-pregnant rats. This regime resulted in a 25 fold decrease in the sensitivity of the uterus to cromakalim. 4. Cromakalim can produce long-lasting inhibition of uterine contractions in the rat after bolus i.v. dose but it exhibits little selectivity relative to its vasodepressor action and there appears to be tolerance to the uterine relaxant action of cromakalim in vivo. PMID- 2720302 TI - Vasoactive intestinal polypeptide and non-adrenergic, non-cholinergic inhibition in lower oesophageal sphincter of opossum. AB - 1. Field stimulation or vasoactive intestinal polypeptide (VIP) relaxed lower oesophageal sphincter (LOS) from North American opossum. Pretreatment with carbachol in Cl-ion-containing or Cl-ion-free Krebs solution or with 10(-3) M 9 aminoacridine abolished or markedly reduced relaxation due to VIP applied exogenously but not that elicited by field stimulation of non-adrenergic, non cholinergic nerves. 2. Inhibitory junction potentials (7.5 +/- 1.2 mV, n = 5) could be recorded in LOS strips with the sucrose gap technique. They lacked significant after-depolarizations but were accompanied by decreased membrane resistance (61 +/- 6%, n = 3). In these strips, VIP (10(-6) M) produced small hyperpolarizations (2.1 +/- 1.1 mV, n = 5) sometimes followed by membrane potential oscillations but no change in conductance. 3. Removal of external chloride depolarized the membranes (7.6 +/- 1.7 mV) but did not prevent the hyperpolarization to VIP or the occurrence of inhibitory junction potentials. Restoration of external chloride repolarized the cells. It appears that an appreciable chloride conductance may be present in sphincter muscle cells and this may cause them to be more depolarized than non-sphincter muscle. 4. We conclude that it is very unlikely that VIP is the inhibitory NANC neurotransmitter since it does not mimic the inhibitory junction potential. PMID- 2720303 TI - The effects of infusions of arginine vasopressin or 1-deamino-8-D-arginine vasopressin on common carotid vascular resistance in conscious, Long Evans rats. AB - 1. Intravenous infusions of arginine vasopressin or 1-deamino-8-D-arginine vasopressin (DDAVP) were given to conscious, Long Evans rats chronically instrumented with bilateral, common carotid, pulsed Doppler probes and intravascular catheters. 2. During infusion of vasopressin at 0.3 nmol min-1 there was an increase in common carotid vascular resistance with no change in mean blood pressure or heart rate. Following infusion there was a common carotid vasodilatation. 3. During infusion of vasopressin at 3.0 nmol min-1 there were increases in mean arterial blood pressure and in common carotid vascular resistances, accompanied by bilateral reductions in flow and in heart rate. Administration of (+)-(CH2)5Tyr(Et)DAVP (a V1-receptor antagonist), during the continued infusion of vasopressin, reversed the effects of the latter on mean blood pressure and heart rate; under these conditions there were increases in common carotid blood flows above baseline, in company with bilateral vasodilatations. The latter effects persisted after cessation of vasopressin infusion. 4. Infusions of DDAVP were without significant effects on any measured cardiovascular variable. 5. The results do not provide straightforward support for the claim that vasopressin acts to promote cerebral perfusion, at least when V1-receptor effects are unopposed. Furthermore, it seems likely tha the vasodilator influence of vasopressin on the common carotid vascular bed is not due to stimulation of V2-receptors. PMID- 2720304 TI - Reactive blue 2 selectively inhibits P2y-purinoceptor-stimulated surfactant phospholipid secretion from rat isolated alveolar type II cells. AB - 1. The effect of reactive blue 2 on adenosine 5'-triphosphate (ATP), 12-O tetradecanoylphorbol 13-acetate (TPA) and terbutaline-induced surfactant phospholipid secretion from rat isolated alveolar Type II cells was studied. 2. Reactive blue 2 significantly inhibited ATP-induced surfactant phospholipid secretion, but was without effect on C-kinase agonist (TPA) or beta-adrenoceptor agonist (terbutaline)-stimulated surfactant phospholipid secretion. The IC50 for inhibition of ATP-induced surfactant secretion was 1.5 x 10(-4)M. 3. These data are consistent with a P2y-purinoceptor regulating surfactant phospholipid secretion from isolated Type II cells and support previous work suggesting reactive blue 2 is a specific inhibitor at P2y-purinoceptors. PMID- 2720305 TI - Pertussis toxin prevents the inhibitory effect of adenosine and unmasks adenosine induced excitation of mammalian motor nerve endings. AB - Pertussis toxin (PTX), which blocks certain classes of guanine nucleotide binding proteins (G proteins), consistently blocked the inhibitory effects of adenosine (100 microM-250 microM) on quantal acetylcholine (ACh) secretion in rat phrenic nerve hemidiaphragm preparations. PTX pretreatment also highlighted long-lasting increases in evoked ACh release elicited by adenosine. The results suggest that specific G proteins are involved in mediating the inhibitory effects of adenosine at motor nerve endings. PMID- 2720306 TI - Antagonism of Paf-induced oedema formation in rabbit skin: a comparison of different antagonists. AB - 1. Eight platelet activating factor (Paf) antagonists were evaluated as inhibitors of oedema formation in rabbit skin induced by intradermal injection of Paf plus prostaglandin E2 (PGE2). Antagonists were tested by both intradermal (i.d.) and intravenous (i.v.) routes. 2. Intradermal injection of two antagonists structurally-related to Paf (SRI 63-675 and CV-3988) resulted in a partial inhibition of Paf-induced oedema formation but at high doses of antagonist, marked agonist activities were detected. CV-3988 administered i.v. inhibited Paf induced plasma leakage by 73-80%; however, oedema responses to a range of other inflammatory mediators were also reduced, albeit to a lesser extent (40-60%). SRI 63-675 administered i.v. did not significantly inhibit Paf-induced oedema. 3. The antagonist 48740 RP administered either i.d. or i.v. showed partial, but selective, inhibition of Paf-induced oedema formation, although the doses required were high when compared with other antagonists. 4. BN 52021 was a weak Paf antagonist when injected i.d., but following i.v. administration the responses to Paf were inhibited by 63-71%. Responses to all other mediators tested were unaffected. 5. Kadsurenone and its synthetic derivatives, L-652,731 and L-659,989 all blocked responses to Paf in the skin. L-659,989 was the most potent, achieving almost total inhibition when injected i.d. and i.v.; moreover, it was selective for Paf. L-652,731 was more potent than kadsurenone. 6. WEB 2086 given i.d. and i.v. showed similar activity to L-659,989 and it was also selective for Paf-induced oedema formation. 7. These results illustrate that in rabbit skin not all Paf antagonists are selective for Paf, some showing agonist like activity which can mask antagonist properties. It is suggested that before ascribing a role for endogenous Paf in an inflammatory reaction based on results with antagonists, the activity of the antagonists in the model under investigation should be rigorously established. PMID- 2720307 TI - Antagonism of calcium by zinc in guinea-pig isolated taenia caeci and trachealis muscle. AB - 1 In guinea-pig isolated taenia caeci and trachealis bathed in a K+-rich, Ca2+ free medium, CaCl2 (0.01-10 mM) produced a concentration-dependent contraction. Zn2+ (0.01-1 mM), Cd2+ (0.01-1 mM), verapamil (0.01-100 microM) and trifluoperazine (1-100 microM) were effective antagonists of CaCl2-induced responses. 2 Zn2+ and Cd2+ in concentrations from 0.01 to 1 mM were without effect on the tone of taenia and trachea in normal Tris solution. Conversely, Zn2+ and Cd2+, in concentrations of 1 mM, caused contraction of these tissues in a K+-rich, Ca2+-free medium. Zn2+ (1 mM)-induced contractions of taenia and trachea were completely inhibited by verapamil (10 microM). 3 In taenia and trachea skinned of their plasma membranes, tension development induced by Ca2+ (10 microM or 1 microM, respectively) was unaffected by verapamil (100 microM), whereas trifluoperazine (100 microM) depressed the maximal tension produced by Ca2+. Segments of skinned preparations contracted in response to low concentrations of Zn2+ (10 microM) or Cd2+ (10 microM). 4 It is concluded that Zn2+ may suppress Ca2+-induced spasm by a direct action on the binding sites of the Ca2+ channel. PMID- 2720308 TI - An in vivo dialysis and behavioural study of the release of 5-HT by p chloroamphetamine in reserpine-treated rats. AB - 1. Reserpine (2.5 mg kg-1 i.p.) decreased rat brain 5-hydroxytryptamine (5-HT) by 86% 24 h later but most components of the 5-HT-dependent behavioural syndrome induced by p-chloroamphetamine (PCA, 5 mg kg-1 i.p.) or 5-methoxy-N,N dimethyltryptamine (5-MeODMT, 5 mg kg-1 i.p.) over 1 h after administration were unaffected. However, Straub tail was increased after giving PCA or 5-MeODMT and head weaving was decreased after giving 5-MeODMT. 2. Frontal cortex extracellular 5-HT concentrations of vehicle pretreated rats before injection of PCA, as calculated from dialysate 5-HT concentrations, were about 1/1000th of corresponding brain values. Extracellular 5-hydroxyindoleacetic acid (5-HIAA) and brain values were comparable with each other. Dialysate 5-HT increased after PCA with peak values at 20-40 min. 3. Reserpine pretreatment reduced dialysate 5-HT concentration before PCA was given but the net increase (AUC) over the 1 h after PCA did not differ significantly from that seen in animals pretreated with vehicle. Dialysate 5-HIAA values slowly decreased after PCA injection in both reserpine and vehicle pretreated groups. 4. The results suggest that PCA causes the 5-HT syndrome by releasing 5-HT from the neuronal cytoplasm but that physiological release of 5-HT occurs from vesicular stores. PMID- 2720309 TI - Electrophysiological effects of adenosine and adenosine triphosphate on sheep Purkinje fibres under normal and simulated ischaemic conditions. AB - 1. The electrophysiological effects of adenosine and adenosine triphosphate (ATP) were examined in sheep Purkinje fibres, superfused in vitro with either a normal or a hypoxic, hyperkalaemic and acidotic physiological salt solution (PSS). The ability of adenosine to modify the effects of noradrenaline on action potential characteristics was also investigated. 2. The only statistically significant effects of adenosine (10(-6)-10(4) M) and of ATP (10(-6)-10(-4) M) on normal action potential characteristics were a slight dose-dependent shortening of the action potential by adenosine and a depolarization by ATP, 10(-4) M. 3. Superfusion with a hypoxic, hyperkalaemic and acidotic PSS caused marked reductions in resting membrane potential, upstroke and duration of the action potential. 4. Both adenosine and ATP attenuated the reduction in the rate of rise of the upstroke and the amplitude of the action potential caused by the modified PSS. 5. Adenosine did not alter the noradrenaline-induced effects on automaticity or on action potentials of normal or depressed Purkinje fibres. 6. Adenosine and ATP had electrophysiological effects on Purkinje fibres, exposed to conditions in vitro that mimic mild myocardial ischaemia, that were different from those observed on normally polarized fibres. PMID- 2720310 TI - 5-HT3 receptor antagonists injected into the area postrema inhibit cisplatin induced emesis in the ferret. AB - 1. The purpose of the present study was to identify and investigate the role of 5 hydroxytryptamine3 (5-HT3) receptors in the area postrema in the control of cisplatin-induced emesis in the ferret. 2. Homogenate binding and autoradiography experiments using the high affinity 5-HT3 receptor ligand, [3H]-GR65630, identified the presence of a high concentration of 5-HT3 receptors in the area postrema of the ferret. 3. Intraperitoneal injection of the 5-HT3 receptor antagonists, GR38032F, GR65630A and MDL72222, at doses of 1, 0.1 and 1 mg kg-1 respectively, inhibited emesis induced by cisplatin, 9 mg kg-1 i.p. 4. Discrete injection of low doses of the 5-HT3 receptor antagonists directly into the area postrema region also inhibited cisplatin-induced (9 mg kg-1 i.p.) emesis. The dose ranges used were: GR38032F, 0.01-1 microgram; GR65630A, 0.001-0.1 microgram; MDL72222, 0.1-10 micrograms. 5. Cisplatin-induced emesis was not inhibited by discrete injection of ketanserin (30 micrograms) or methiothepin (30 micrograms) into the area postrema. Injection of the 5-HT3 receptor agonist, 2-methyl-5-HT, directly into the area postrema produced an incomplete emetic response. 6. These results confirm a role of 5-HT, and in particular 5-HT3 receptors, in the control of cisplatin-induced emesis, and show that at least one functional site for these receptors in modulating the emetic response is the area postrema, the locus of the chemoreceptor trigger zone. PMID- 2720311 TI - The properties of 5-HT3 receptors in clonal cell lines studied by patch-clamp techniques. AB - 1 The characteristics of transmembrane currents evoked by 5-hydroxytryptamine (5 HT) in the neuroblastoma x Chinese hamster brain cell line NCB-20 and neuroblastoma clonal cell line N1E-115 have been studied under voltage-clamp conditions by the whole-cell recording and outside-out membrane patch modes of the patch-clamp technique. 2 In 73% of NCB-20 cells examined (n = 221), and all N1E-115 cells studied (n = 80), 5-HT (10 microM) elicited a transient inward current at negative holding potentials, this being associated with an increase in membrane conductance. In both cell lines responses to 5-HT reversed in sign at a potential of approximately -2 mV and demonstrated inward rectification. 3 The reversal potential of 5-HT-induced currents (E5-HT) recorded from either NCB-20 or N1E-115 cells was unaffected by total replacement of internal K+ by Cs+. In N1E-115 cells, reducing internal K+ concentration from 140 to 20 mM produced a positive shift in E5-HT of approximately 28 mV, whereas reducing external Na+ from 143 to 20 mM was associated with a negative shift in E5-HT of about 37 mV. A large reduction in internal Cl- concentration (from 144 to 6 mM) had little effect on E5-HT. 4 5-HT-induced currents of NCB-20 cells were unaffected by methysergide (1 microM) or ketanserin (1 microM), but were reversibly antagonized by GR38032F (0.1-1.0 nM) with an IC50 of 0.25 nM. GR 38032F (0.3 nM) reduced 5-HT induced currents in N1E-115 cells to approximately 26% of their control value. 5 On outside-out membrane patches excised from both NCB-20 and N1E-115 cells, 5-HT induced small inward currents which could not be clearly resolved into discrete single channel events. Such responses were: (i) reversibly antagonized by GR 38032F (1 nM) (ii) reversed in sign at 0 mV, and (iii) subject to desensitization. 6 Fluctuation analysis of inward currents evoked by 5-HT (1 microM) in N1E-115 cells suggests that 5-HT gates a channel with a conductance of approximately 310fS. Such a relatively small conductance could readily explain why the response of outside-out membrane patches to 5-HT cannot at present be resolved into clear single channel events. PMID- 2720312 TI - The effect of cromakalim on the smooth muscle of the guinea-pig urinary bladder. AB - 1. The actions of cromakalim were studied on the detrusor muscle from guinea-pig urinary bladder. Cromakalim reduced the frequency and amplitude of spontaneous contractile activity of the smooth muscle of the guinea-pig urinary bladder at 5 x 10(-8)M and abolished the activity at concentrations above 5 x 10(-7)M. 2. Electrophysiological experiments demonstrated that cromakalim increased membrane conductance, caused a dose-dependent hyperpolarization of the cell membrane and loss of spike activity. These events are consistent with the opening of K+ channels. 3. The effects of 10(-6)M and 10(-5)M cromakalim on the contractile responses to carbachol, potassium and transmural nerve stimulation were studied. Cromakalim did not prevent the detrusor from responding to these agents, although it significantly reduced the contractile response to K+ at concentrations below 70 mM. 4. Uptake and efflux experiments using 86Rb+ were unable to demonstrate any significant effect on transmembrane movement produced by cromakalim (10( 5)M). 5. 43K+ efflux showed a dose-dependent increase in the rate constant on addition of cromakalim. The difference in the selectivity for K+ over Rb+ was confirmed in dual label uptake experiments. 6. Substitution experiments in which the K+ ions in the tissue were gradually replaced by Rb+ demonstrated that cromakalim had a progressively decreasing effect on spontaneous activity as internal K+ was lowered. When all the K+ was replaced by Rb+, cromakalim no longer inhibited spontaneous activity, confirming that the channel opened by cromakalim appears relatively impermeant to Rb+. PMID- 2720313 TI - Prejunctional modulation of acetylcholine release from the skeletal neuromuscular junction: link between positive (nicotinic)- and negative (muscarinic)-feedback modulation. AB - 1. Presynaptic receptor-mediated modulation of stimulation-evoked [3H] acetylcholine[( 3H]-ACh) release from the neuromuscular junction was studied in the region of the mouse hemidiaphragm which contains the motor endplates, and which can easily be loaded with [3H]-choline. This method made it possible to detect exclusively the [Ca2+]0-dependent, quantal release of [3H]-ACh in response to axonal stimulation. 2. Atropine enhanced, and non-depolarizing muscle relaxants [+)-tubocurarine, pancuronium and pipecuronium) reduced, the release of [3H]-ACh evoked by high frequency trains of stimulation (50 Hz, 40 shocks) of the phrenic nerve. The effect of (+)-tubocurarine was frequency-dependent as at 5 Hz (40 shocks) it was less effective than at 50 Hz. The resting release of [3H]-ACh was not affected by these compounds. These findings indicate that ACh released into the synaptic gap by axonal firing reaches a concentration sufficient to influence its own release by a prejunctional effect. 3. The anticholinesterase, physostigmine sulphate, enhanced the release of [3H]-ACh in a concentration dependent manner. This effect was mediated via prejunctional nicotinic receptor stimulation: (+)-tubocurarine, pancuronium and pipecuronium completely prevented the effect of physostigmine. 4. When the prejunctional nicotinic and muscarinic receptors were stimulated by a high concentration of extracellular ACh which had accumulated in the junctional gap in the presence of physostigmine, atropine did not influence the evoked release of [3H]-ACh. However, when the effect of endogenous ACh on nicotinic receptors was prevented by (+)-tubocurarine, atropine enhanced the release. 5. It is concluded that quantally-released ACh from motor endplates is subject to prejunctional automodulation: (a) ACh facilitates its own release via an effect on prejunctional nicotinic receptors (positive feedback), (b) ACh release is reduced by an action on muscarinic receptors. When the nicotinic receptor-mediated facilitation is fully operative, the muscarinic receptor-mediated negative feedback is much less effective. It is supposed that there is a link between the two feedback mechanisms possibly at the level of the second messenger system(s). PMID- 2720315 TI - Editorial process at the British Journal of Surgery. PMID- 2720314 TI - Sympathetic denervation caused by long-term noradrenaline infusions; prevention by desipramine and superoxide dismutase. AB - 1. The effects of continuous intravenous infusion of noradrenaline (0.01 and 0.1 microgram kg-1 h-1) were studied in both the infused lateral saphenous vein and the contralateral saphenous vein of normal dogs. Noradrenaline, saline, noradrenaline + desipramine or noradrenaline + superoxide dismutase were infused using Alzet osmotic minipumps. 2. After a 5 day infusion period, the noradrenaline content in plasma and in both saphenous veins was determined, and the venous tissues submitted to light microscope morphometry and ultrastructural study and used for the determination of their O-methylation capacity (with [3H] isoprenaline as a substrate). 3. Noradrenaline caused dose-dependent damage to the sympathetic nerve endings of the lateral saphenous veins. Concomitant changes in extraneuronal structure and function were observed (hypertrophy of smooth muscle cells, nuclear dysmorphy, thickening of the vessel wall, impairment in O methylation capacity). 4. Desipramine and superoxide dismutase prevented or reduced the effects of noradrenaline on both the morphological and the biochemical parameters; the protection afforded by superoxide dismutase was more marked than that by desipramine. 5. It is concluded that moderately high doses of noradrenaline exert a 6-hydroxydopamine-like effect and that this chemical sympathectomy is partially or totally prevented by desipramine or superoxide dismutase. The data suggest that a substance derived from noradrenaline, in the formation of which free oxygen radicals are involved and which is subject to neuronal uptake, is the chemical entity responsible for the neurotoxic effect observed. PMID- 2720316 TI - Mortality and perforated peptic ulcer: a case for risk stratification in elderly patients. AB - In a consecutive series of 284 patients with a perforated peptic ulcer (229 pyloroduodenal, 55 gastric) there was a 26 per cent hospital mortality rate, and patients aged greater than or equal to 70 years (n = 176) had a significantly higher mortality rate (34 per cent) than patients aged less than 70 years (14 per cent, P less than 0.001). Multiple clinical variables were significantly more common in the elderly group of patients (65 per cent), in those having non steroidal anti-inflammatory drugs or steroid therapy (56 per cent), in patients where there is an absence of a previous dyspeptic history (69 per cent), and when risk factors such as delayed presentation (33 per cent) and the presence of shock on admission to hospital (27 per cent) are present. Definitive operations (vagotomy or gastrectomy) had an increased mortality rate in the elderly (P = 0.018). Risk scores based upon the presence of shock, delayed presentation or concurrent medical illness could have predicted 87 per cent of postoperative deaths in elderly subjects, and it is suggested that risk stratification and greater caution in the use of definitive operations for perforated ulcer may result in a reduction in the high mortality rate in elderly subjects. PMID- 2720317 TI - A clinicopathological study of synchronous multiple gastric cancer. AB - In a 7 1/2-year period (from 1 January 1980 to 30 June 1987), 997 patients with gastric cancer underwent gastric resection at the Department of Surgery, Matsuyama Red Cross Hospital, Japan. We studied clinicopathologically 83 patients (182 lesions) with synchronous multiple gastric cancer and compared them with patients who had solitary cancers only in the same period. We found that elderly men had a relatively high incidence of multiple gastric cancer, and that early cancer of the elevated well differentiated type was the most common. Of the 182 lesions, as many as 42 (23.1 per cent) were missed in the preoperative examination. Eighteen of these 42 lesions were found only with the aid of a microscope in sections almost incidentally excised. Small flat lesions tended to be missed. We should always be conscious that other gastric lesions may be present when treating patients with gastric cancer. PMID- 2720318 TI - Determinants of gastro-oesophageal reflux and their inter-relationships. AB - Gastro-oesophageal reflux was measured by 24-h ambulatory oesophageal pH monitoring in 220 patients with symptoms suggestive of gastro-oesophageal reflux disease. By multiple regression analysis it was found that the pressure in the distal oesophageal high pressure zone, the presence of a hiatal hernia, the intra abdominal length of the high pressure zone, the amplitude of the contraction waves in the distal oesophagus and age all significantly participated in the determination of the amount of gastro-oesophageal reflux. The pressure in the distal oesophageal high pressure zone was the single variable that correlated most strongly to the amount of reflux. Although the amount of reflux increased significantly with increasing weight as measured by Broca's index, this variable did not participate in the determination of reflux by the multiple regression test. The study emphasizes the role of the pressure and intra-abdominal length of the distal oesophageal high pressure zone as the primary antireflux barrier. It also shows that a hiatal hernia plays a role in generating gastro-oesophageal reflux through a mechanism other than affecting the pressure and the intra abdominal length of the high pressure zone. PMID- 2720319 TI - Oesophageal transit of marshmallow after the Angelchik procedure. AB - The oesophageal transit time of half a marshmallow was measured radiologically in 17 controls, 28 patients with gastro-oesophageal reflux pre-operatively, 36 patients soon after implantation of the Angelchik prosthesis (2-9 weeks) and in 23 patients later postoperatively (9-48 months). Sixteen postoperative patients also underwent oesophageal manometry. All control and pre-operative patients had a marshmallow transit time of less than 1 min; 67 per cent of the early postoperative patients had prolonged transit and 70 per cent of the late tests were similarly abnormal. Prolonged oesophageal transit as measured by marshmallow swallow correlated well with symptoms of solid food dysphagia. Most, but not all, patients with an abnormal marshmallow swallow had abnormal manometric findings. The oesophageal transit of solid food is significantly slowed after the Angelchik procedure and this is not a transient postoperative phenomenon. PMID- 2720320 TI - Alcohol sclerotherapy of non-parasitic cysts of the liver. AB - Between 1980 and 1987, nine patients with non-parasitic cysts of the liver were treated with computed tomography-guided percutaneous puncture and evacuation of the cyst contents followed by injection of absolute alcohol as a sclerosing agent. During the same period only one patient was treated with surgery. The patients included seven women and two men with a mean age of 62 years. Three patients had a single cyst and six patients had multiple cysts. The size of the largest cysts varied between 5 and 20 cm (mean 10 cm). Patients with multiple liver cysts had repeated punctures and sclerosing procedures (up to eight times); 50-3100 ml of cyst fluid (mean 650 ml) was drained per procedure. One patient had symptoms of moderate alcohol intoxication; otherwise no complications were noted. Follow-up was performed with computed tomography or ultrasonography for 8-54 months (median 18 months). The results have been considered successful in eight out of nine patients who had cyst regression and reduced symptoms. Two patients, however, required additional surgical treatment due to residual and multiple cysts. Computed tomography-guided alcohol sclerotherapy of non-parasitic liver cysts appears to be a safe and effective initial therapy. PMID- 2720321 TI - Surgical options in traumatic injury to the extrahepatic biliary tract. AB - A series of 53 patients who sustained extrahepatic biliary tract trauma were analysed to define the role of the various surgical options. Of the 45 patients with gallbladder injuries, 39 were due to stab wounds. Nine of the 45 injuries were repaired by primary suture without complication. Five patients underwent cholecystostomy and all developed biliary fistulae, which resulted in prolonged hospitalization. Cholecystectomy was performed in 31 patients; in retrospect many of these gallbladders could have been preserved because on only eight occasions was the gallbladder extensively damaged. Of eight extrahepatic bile duct injuries, the three partial transections managed by primary repair had a successful outcome, while the five complete transections were managed by a variety of techniques. Delayed diagnosis, failure of operative recognition of the injury and improper management were factors that led to mortality in two patients and prolonged morbidity in another. We conclude that suture repair is the operation of choice for gallbladder stab wounds without extensive injury. Ductal injury must be recognized. Partial transections are best managed by primary repair. Complete transections should be managed by primary duct jejunal anastomosis if the expertise is available. PMID- 2720322 TI - Changes in the hepatic perfusion index during the development of experimental hepatic tumours. AB - A model of microscopic liver tumour has been developed in the Fisher rat by intraportal injection of 1.6 x 10(7) Walker 256 carcinosarcoma cells. Rats were studied at 2, 4 and 6 days after the inoculation of live Walker cells. A control group received dead Walker cells. No tumour was visible in control groups at 2, 4 and 6 days after inoculation. Similarly in rats injected with live cells no tumour was visible at 2 days after inoculation but at 4 and 6 days the percentage hepatic replacement was (mean +/- s.d.) 7.0 +/- 2.3 and 27.9 +/- 6.80 respectively. The hepatic perfusion index was significantly raised at 4 and 6 days after inoculation of live cells compared with control animals and those receiving viable cells after 2 days inoculation. Portal flow and portal venous inflow were significantly reduced when the hepatic perfusion index increased but hepatic arterial flow did not alter. Changes in the hepatic haemodynamics were accompanied by increases in the portal and splanchnic vascular resistance and an increase in the amount of arteriovenous shunting through the liver. These findings confirm studies that the hepatic perfusion index is useful in the detection of occult liver metastases but that the change is not a consequence of an increase in the hepatic arterial flow. PMID- 2720323 TI - Direct retroperitoneal approach to necrosis in severe acute pancreatitis. AB - From 1981 to 1987, 40 patients with severe acute pancreatitis were operated on using a direct retroperitoneal approach, 22 primarily and 18 after a first operation performed through another incision. The severity of the disease was assessed by Ranson's bioclinical and computed tomography scan scoring systems. The retroperitoneal approach consisted of a left lateral incision, just anterior to the 12th rib, allowing direct access to the pancreas and a complete manual exploration of the gland and peripancreatic spaces. All patients but one were operated on for infected necrosis. The overall mortality rate was 33 per cent but was lower in the patients operated on primarily through a direct retroperitoneal approach (18.2 per cent). Twenty patients (50 per cent) developed a local complication (haemorrhage, colon fistula and/or necrosis). The direct retroperitoneal approach permits the removal of necrosis and several reoperations without the risk of large wound dehiscence and does not preclude the extension of the incision to a subcostal incision when necessary. PMID- 2720324 TI - Contrast-enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: a prospective study. AB - One hundred and fifty-two patients were admitted to a single hospital with a diagnosis of acute pancreatitis during a 31-month period. Of these, 126 patients had contrast-enhanced abdominal computed tomography (CT) scans within 72 h of admission; 92 of these attacks were clinically mild, 34 were clinically severe. A single consultant radiologist reported the scans 'blind' and noted whether pancreatic enhancement was normal, increased or decreased, and whether there was loss of peripancreatic tissue planes. The maximum anteroposterior measurement of the pancreatic head and body were multiplied together to produce a 'pancreatic size index' (cm2). Significantly more patients with severe attacks had decreased pancreatic enhancement (79 versus 58 per cent, P = 0.01) and loss of peripancreatic tissue planes (82 versus 54 per cent, P = 0.006). The median (range) pancreatic size index for clinically severe attacks was 12.8 cm2 (3.0 52.5), and for mild attacks was 6.0 cm2 (1.1-23.4), P less than 0.0001. Modified Glasgow criteria had a sensitivity of 85 per cent and specificity of 79 per cent for clinically severe attacks. A pancreatic size index of greater than or equal to 10 cm2 had a sensitivity of 71 per cent and specificity of 77 per cent for clinically severe attacks. In conclusion, although there were highly significant differences between the clinically severe and mild groups with respect to pancreatic enhancement, peripancreatic tissue planes and pancreatic size indices, these CT criteria did not improve on modified Glasgow criteria for prediction of disease severity. PMID- 2720325 TI - Proctocolectomy and ileoanal pouch anastomosis without conservation of a rectal muscular cuff. AB - The technique of proctocolectomy and formation of an ileal reservoir with ileoanal anastomosis is well described. It is believed that the conservation of a rectal muscular cuff is necessary for continence but no data are available to support this contention. The aims of this study were to describe the clinical and physiological aspects of continence after proctocolectomy and ileal J pouch anastomosis without conservation of a rectal muscular cuff. Eighteen consecutive patients (mean age 37.3 years, 16 ulcerative colitis, two familial polyposis) who underwent proctocolectomy and ileoanal anastomosis on the dentate line were studied 6 months after closure of the loop ileostomy. The 18 patients and eight controls underwent: (a) anal manometry; (b) determination of maximum tolerable volume (MTV); (c) liquid continence test (infusion of NaCl at 60 ml/min for 25 min) with simultaneous measurement of ileal reservoir pressure. The volume evacuated during 5 min after the continence test was also measured. The frequency of bowel actions was (mean +/- s.e.m.) 5.3 +/- 0.4 per 24 h (nocturnal 1.14 +/- 0.26). Seventeen of 18 patients (94 per cent) had normal continence and defaecation; one patient was incontinent. A decrease in resting anal canal pressure (102.5 +/- 4 versus 47.5 +/- 6 cmH2O) was observed after ileoanal anastomosis. A rectoanal inhibitory reflex was elicited in one of the 18 patients (6 per cent). Patients were able to retain 1023 +/- 68 ml saline during the liquid continence test. The percentage evacuation of the ileal reservoir was 61 +/- 4.5 per cent. Correlations were found (P = 0.05) between daily stool frequency and the volume of saline retained during the liquid continence test. It is concluded that conservation of a rectal muscular cuff is not necessary for the achievement of good clinical results. PMID- 2720326 TI - Value of a risk questionnaire in screening for colorectal neoplasm. AB - The value of a postal questionnaire and of Hemoccult II (Smith Klein Diagnostic Inc., Sunnyvale, California, USA) testing in screening for colorectal neoplasms was compared. In the questionnaire, the subjects were asked about previous treatment for colorectal neoplasm and rectal bleeding during the previous 6 months, specified as to type. All participants were asked to perform Hemoccult II blood testing over 3 days. Of 13,759 randomly selected subjects 9040 (66 per cent) performed the test and returned the questionnaire. Three hundred and fifty four subjects with a positive Hemoccult II test and/or a proven previous colorectal neoplasm had a full assessment including double-contrast enema and rectosigmoidoscopy to 60 cm. Eighteen carcinomas and 61 adenomas were thus diagnosed. The population was followed for from 20 to 29 months, during which time rescreening was undertaken. An additional 34 subjects with carcinomas and 90 with adenomas were identified during this period. A significant correlation between the presence of a colorectal neoplasm and a previous history of colorectal neoplasm, a positive Hemoccult II and a previous history of bright red bleeding but not dark bleeding was found. The possibility of diagnosing a neoplasm was two, four and 19 times higher in a subject with a previous history of bleeding, a history of colorectal neoplasm, or a positive Hemoccult II respectively. Screening by faecal occult blood testing, therefore, at the moment seems to be the best and only practicable method. PMID- 2720327 TI - A common pathophysiology for full thickness rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer. AB - Anorectal pressures at rest, during conscious contraction of the external sphincter, during serial distension of the rectum and during straining to inflate a balloon were measured in 56 patients (21 patients with full thickness rectal prolapse, 24 patients with anterior mucosal prolapse, 11 patients with solitary rectal ulcer) and in 30 normal subjects. Both basal and squeeze pressures were significantly lower in the three groups of patients compared with matched normal controls (P less than 0.05). During increases in intra-abdominal pressure, anal pressure remained above maximum rectal pressure (P less than 0.05) in normal controls, with the highest anal pressures being recorded in the most caudal anal channels. In contrast, anal pressures tended to be lower than rectal pressures during this manoeuvre in patients with rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer, and the highest pressures were recorded in the channels nearest the rectum. During serial distension of the rectum, 64 per cent of patients with solitary rectal ulcer, 75 per cent with anterior mucosal prolapse and 76 per cent with rectal prolapse, but only 10 per cent of controls, showed repetitive rectal contractions. The highest anal pressure always remained higher than rectal pressure during rectal distension in normal subjects (P less than 0.05) but not in patients. The threshold rectal volume required to cause a desire to defaecate and the maximum tolerable volume were significantly lower (P less than 0.05) in each of the patient groups, compared with normal subjects. The similarity in the results from patients with rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer support the hypothesis that they share a common pathophysiology. In each of the groups, the rectum is hypersensitive and hyper-reactive, and weakness of the anal sphincter creates the conditions for prolapse of the rectum to occur into or through the anal canal. PMID- 2720328 TI - Thigh length versus knee length stockings in the prevention of deep vein thrombosis. AB - Above-knee graduated compression stockings are effective in preventing postoperative deep vein thrombosis, but are more expensive and less acceptable than below-knee stockings. One hundred and fourteen patients undergoing major abdominal surgery were randomly allocated to wear above-knee or below-knee graduated compression stockings. Deep vein thromboses were diagnosed by isotope uptake in three of 56 patients (5.4 per cent) in the above-knee group and one of 58 patients (1.7 per cent) in the below-knee group. These differences are not statistically significant. Results suggest that below-knee stockings are as effective as above-knee in the prevention of postoperative deep vein thrombosis. PMID- 2720329 TI - Crossover femoral grafting to allow subsequent donor limb angioplasty. PMID- 2720330 TI - Major amputation in a defined population: incidence, mortality and results of treatment. AB - Medical records of all patients, from a defined population of 88,000 inhabitants, who underwent major lower limb amputation during 1980-82 were retrospectively scrutinized. The records showed 131 amputations were performed in 106 patients at the district hospital and 22 amputations on 17 patients at the local university hospital, referral centre, altogether 57 men and 66 women. This gave an amputation incidence of 46 per 10(5) inhabitants per year. Of the amputees 47 per cent were older than 80 years. Only two patients underwent reconstructive vascular surgery (at the university hospital) before surgery. Final amputation level was above-knee in 61 per cent of the patients treated at the district hospital. Mortality rates at 30 days and 2 years after the amputation were 23 and 56 per cent, respectively, and the age-corrected survival after 2 years was 55 per cent. For patients who came from and eventually returned to their own homes the mean hospital stay amounted to 184 days (postoperative deaths excluded). After amputation 26 patients were trained to wear a prosthesis and 16 of these used the prosthesis 2 years after amputation. The present study underlines the need for prospective and parallel studies of vascular surgery and amputation as well as analyses of the risk factors involved in lower limb ischaemia in defined populations. PMID- 2720331 TI - A simple specimen mount for the orientation of breast biopsies. PMID- 2720332 TI - Biliopancreatic bypass in the Prader-Willi syndrome. PMID- 2720333 TI - Peritoneal lavage with mercuric chloride: toxic and unnecessary. PMID- 2720334 TI - Wound instillation for postoperative pain relief. PMID- 2720335 TI - Benign breast lump. PMID- 2720336 TI - Endoscopic sphincterotomy. PMID- 2720337 TI - Fine needle aspiration cytology. PMID- 2720338 TI - Intragastric pH and duodenal ulcer. PMID- 2720339 TI - Tumour calcification after hepatic dearterialization. PMID- 2720340 TI - Recurrence after strictureplasty or resection for Crohn's disease. AB - This study attempts to define whether there is an increased need for reoperation in patients with small bowel Crohn's disease treated by strictureplasty compared with those treated by small bowel resection. Previous studies of the rate of reoperation for small bowel Crohn's disease do not distinguish between reoperation performed because of a lesion at the original operation site and that undertaken because of a lesion at a distant site. This study analyses the need for reoperation only at the original site of operation and measures operation free intervals. The site specific operation-free intervals in 41 patients with small bowel Crohn's disease treated by strictureplasty were not significantly different from the similar intervals in 41 patients treated by a small bowel resection. PMID- 2720341 TI - Ten-year experience of strictureplasty for obstructive Crohn's disease. AB - Strictureplasty is controversial in the management of obstructive Crohn's disease. Only a small proportion of patients undergoing surgery for obstructive Crohn's disease are suitable for strictureplasty. Lesions which are most amenable for this procedure are short, fibrous strictures. Over a 10-year period 24 patients have undergone 30 operations at which 86 strictureplasties were performed. The median follow-up has been 40 (range 4-112) months. No leaks or fistulae arose from the strictureplasties. The median weight gain 3 months postoperatively was +4.0 kg. Four patients subsequently required a further 13 strictureplasty procedures, between 12 and 36 (median 18) months after the initial operation; all but one of the previous strictureplasties were patent. Thirteen patients have been symptom free following surgery, four have required further medical therapy for recurrent Crohn's disease and three have sustained episodes of self-limiting intestinal colic. Strictureplasty is a safe and effective procedure in selected patients undergoing surgery for obstructive Crohn's disease. PMID- 2720342 TI - T tubes: a comparison of virgin, slit, guttered and sculpted design. PMID- 2720343 TI - An improved technique of J pouch construction and ileoanal anastomosis. PMID- 2720344 TI - Psychiatric screening for patients with faecal incontinence or chronic constipation referred for surgical treatment. AB - Fifty patients attending for surgical treatment of chronic constipation (n = 21) or faecal incontinence (n = 29) were studied using two psychiatric screening tests: the Hospital Anxiety and Depression (HAD) scale and the General Health Questionnaire (GHQ). Each patient was assessed preoperatively and 6-12 months postoperatively. Results were compared with age and sex-matched controls (n = 50). Constipated patients had significantly higher HAD depression scores compared with controls (median and range): 6 (2-12) versus 4 (0-8), P less than 0.05. Constipated patients who were improved by operation (n = 13) had significantly lower preoperative HAD anxiety scores compared with those who were not improved (n = 8): 8 (3-14) versus 15 (10-19), P less than 0.01; they also had significantly lower HAD depression scores: 4 (2-12) versus 7 (5-11), P less than 0.05. Using these parameters incontinent patients did not differ from controls, but patients who had a bad result after operation (n = 15) had significantly higher HAD anxiety scores than those who obtained clinical benefit (n = 14): 10 (2-15) versus 6 (2-12), P less than 0.05; HAD depression scores were also greater: 5 (2-15) versus 3 (0-9), P less than 0.05; and GHQ scores were greater: 12 (0-47) versus 4 (0-41), P less than 0.05. PMID- 2720345 TI - Anorectal physiology measurement: report of a working party. AB - A 2-day meeting was held in Bristol on 5 and 6 July 1988 immediately before the Tripartite meeting of the Surgical Research Society in order to discuss methods and identify areas of agreement with regard to measurement of indices of anorectal physiology. The following report highlights our findings. PMID- 2720346 TI - Appendicitis and appendicectomy in a Melanesian population. AB - A prospective study of patients with appendicitis has been conducted over a 3 year period in the Melanesian population of the North Solomons. Patients presented with suspected appendicitis at an annual rate of 39 per 100,000 population. Appendicitis was confirmed at operation at an annual rate of 22 per 100,000 population. The disease was considerably more frequent in male than in female patients. The annual appendicectomy rate was 29 per 100,000 population. Thirty per cent of patients presented with signs of late or complicated appendicitis, while 37 per cent of patients submitted to operation were found to have advanced appendicitis. The incidence and pattern of appendicitis in the North Solomons are quite different from those seen in the urbanized populations of developed countries. PMID- 2720347 TI - Low power interstitial Nd YAG laser photocoagulation: studies in a transplantable fibrosarcoma. AB - The effects of interstitial delivery of low power (1.2-2 W), long exposure (600 1200 s) Nd YAG laser light on a transplantable fibrosarcoma in rats have been studied. Three cohorts of ten animals were treated either by 1.2 W for 600 s, 1.2 W for 1200 s or 2 W for 600 s to each tumour nodule. An additional untreated cohort served as controls and a further cohort was treated by radical surgical resection. A partial response as evidenced by ulceration was seen in all laser treated tumours. In the cohort treated by 2 W for 600 s there was complete loss of palpable tumour, and in five out of the ten animals there was no evidence of local recurrence following a prolonged period of observation. Three of these eventually died from metastatic disease and two were cured. There was a significant prolongation of survival in this cohort compared with the controls (median 70 days versus 30 days, P less than 0.05), but not in any of the other cohorts. Histological assessment of tumours 2 days after laser treatment showed a central area of degeneration with shrunken and densely staining nuclei and disorganized cytoplasm, the boundary between the degenerate zone and surrounding viable tumour being well defined. The technique might be used to induce necrosis of intrahepatic and other solid organ tumours. PMID- 2720348 TI - Reduced human peritoneal plasminogen activating activity: possible mechanism of adhesion formation. AB - A unifying pathophysiological hypothesis states that the plasminogen activating activity (PAA) of the peritoneal mesothelium determines whether the fibrin which forms after peritoneal injury is either lysed or organized into permanent fibrous adhesions. The PAA of human peritoneal biopsies was measured using a fibrin plate lysis technique to assess the changes that occur in inflammation and ischaemia, conditions which both produce fibrous adhesions. Activity was found in all biopsies from normal parietal and visceral (appendix, bowel and omentum) peritoneum with no significant site-to-site variation. Inflamed peritoneum (parietal, appendicular and mesenteric) had significantly less PAA compared with normal peritoneum; visceral ischaemia also resulted in a significant decrease of PAA. These reductions in human peritoneal PAA observed in inflammation and ischaemia support the view that mesothelial PAA plays a key part in the prevention of events leading to the production of fibrous adhesions. PMID- 2720349 TI - Surgical strategy in primary retroperitoneal tumours. AB - Sixty-nine patients with primary retroperitoneal tumours (17 benign, 52 malignant including 4 malignant tumours of uncertain origin) were reviewed to determine the best form of surgical strategy. Total resection was performed in 88 per cent of benign cases and in 65 per cent of malignant cases. In 62 per cent of the total resections for malignant tumours, en bloc excision included adjacent organs or anatomical structures. Operative mortality rate (in terms of the total number of operations performed) was 5 per cent. Postoperative complications occurred in 14 per cent and recurrences in 35 per cent. The overall 5-year survival rate was 67 per cent in patients with totally resected tumours and zero in patients whose tumours were treated by partial resection or biopsy. An aggressive surgical approach aimed at total excision of the tumour is the best form of therapy currently available. In the totally resected retroperitoneal tumour, the use of adjuvant radiotherapy and/or chemotherapy depends on the grade of the malignancy and clearance as assessed histologically. Careful follow-up based on the use of computerized axial tomography and ultrasound allows early identification of recurrence at a stage when the recurrence is amenable to total resection. PMID- 2720350 TI - Fibroadenoma of the breast: a follow-up of conservative management. AB - This report details the outcome after clinical diagnosis of mammary fibroadenoma in 110 women aged under 35 years. After fine needle aspiration cytology, and subsequent exclusions and failures of follow-up, 92 lesions were observed for a mean of 47 weeks (range 13-90 weeks), with regular measurements until removal of persisting lesions at 12 months. Fifteen lesions disappeared and 56 had the classical histology of fibroadenoma, mean size 2.5 cm; 30 of the latter continued to grow throughout the study. Cytology is essential to exclude malignancy if conservative treatment is considered, and is helpful in identifying a benign lesion. A period longer than 12 months may be required for resolution of a fibroadenoma and removal under local anaesthesia as a day case offers a simple alternative. PMID- 2720351 TI - Surgical significance of non-toxic iodine-avid goitre. AB - During the period 1970-87, of 1580 patients operated on for non-toxic nodular goitre, 17 satisfied the laboratory criteria for iodine avidity. All of these goitres were non-endemic, with no evidence of enzymatic deficiency. Preoperative thyroxine markedly reduced the surgical morbidity by decreasing the size and vascularity of the gland. PMID- 2720352 TI - Splenectomy for massive splenomegaly. AB - Twenty-four patients who underwent resection of giant spleen (spleen weight greater than 1.5 kg) have been reviewed to determine the difficulties and benefits of the procedure and, in particular, whether the use of adrenaline injection into the splenic artery could safely reduce technical difficulty. Although morbidity was higher in patients with giant spleens compared with those undergoing resection of smaller spleens the incidence of serious complications was small, and there were no operative or in-hospital deaths. In addition, virtually all patients benefited either on the basis of minimized haematological defect, or palliation of symptoms. Further, the injection of 1 ml of 1:10,000 adrenaline into the splenic artery before splenic mobilization reduced the splenic volume by approximately 40 per cent on average, and resulted in improved exposure, thereby facilitating the procedure. PMID- 2720353 TI - Right splenorenal bypass: a technical suggestion. PMID- 2720354 TI - Use of deep tension sutures and buttress plates for frequent relaparotomy. PMID- 2720355 TI - Plasma eicosanoids, platelet function and cold sensitivity. AB - As abnormal eicosanoid (prostaglandin) metabolism has been suggested as a factor in the aetiology of vasospastic diseases we have measured levels of stable eicosanoid metabolites using a radioimmunoassay in 30 normal subjects and 31 patients with Raynaud's phenomenon. There were 13 patients with primary Raynaud's, ten with Raynaud's secondary to scleroderma and eight men with vibration white finger (VWF) disease. We have also measured platelet aggregation to adenosine diphosphate (ADP), collagen and adrenaline in 19 normal subjects, 22 patients with primary Raynaud's, 12 with Raynaud's secondary to scleroderma and 14 men with VWF. When compared with our normal subjects, patients with VWF have an elevated thromboxane B2 level, with a normal 6-keto-prostaglandin F1 alpha (6 keto-PGF1 alpha) level. Their platelets are less sensitive to ADP and collagen. Patients with primary and secondary Raynaud's have elevated thromboxane B2 levels but this is much more marked in the secondary group. Patients with primary Raynaud's have a normal 6-keto-PGF1 alpha level but in patients with secondary Raynaud's the 6-keto-PGF1 alpha level is markedly raised. The platelets from both groups are more sensitive to ADP and collagen and this is more marked in the secondary group. Whether these phenomena are a cause or an effect of vasospasm remains unknown. PMID- 2720356 TI - Out-patient operation of inguinal hernia in children. AB - A retrospective review is presented of 496 children with a median age of 4 years (range 0-13 years) on whom a total of 527 hernia repairs were performed as out patients. No wound infections were observed, and the rate of early surgical complications was 1.5 per cent. There were 15 (3.7 per cent) known recurrences. No complications from the anaesthetic were recorded. Owing to the negligible infection rate and the low surgical complication and recurrence rates it is concluded that children with inguinal hernia would benefit from operation as out patients, and that they should be operated on immediately after diagnosis, irrespective of age. Besides probably minimizing the children's psychological trauma, out-patient surgery provided considerable savings to the health service in the present study. PMID- 2720357 TI - Use of the ultrasonic aspirator in splenic preservation. PMID- 2720359 TI - Pernasal catheter perfusion without dissolution agents following endoscopic sphincterotomy for common duct stones. PMID- 2720358 TI - Treatment of chronic hepatic encephalopathy by the progressive suppression of a spontaneous portacaval shunt via the umbilical vein. PMID- 2720360 TI - Congenital tracheo-oesophageal fistula in an adult. PMID- 2720361 TI - The Vascular Surgical Society of Great Britain and Ireland. Leeds, 24-25 November 1988. Abstracts. PMID- 2720362 TI - Severe intra-abdominal sepsis. PMID- 2720363 TI - Subtotal colectomy or colonic preservation in the treatment of colonic cancer? PMID- 2720364 TI - Non-operative management of splenic trauma in adults. PMID- 2720365 TI - Thermal gradients. PMID- 2720366 TI - Reptilian somatosensory midbrain: identification based on input from the spinal cord and dorsal column nucleus. AB - A midbrain somatosensory area was identified in reptiles Caiman crocodilus, by orthograde degeneration techniques after midcervical spinal cord transections or after dorsal column lesions. Terminations of these somesthetic inputs were located in a caudal lateral part of the central nucleus of the torus semicircularis and contiguous dorsal mesencephalon. Dorsal column projections were contralateral while spinal connections were mainly ipsilateral. In order to confirm the results of the anterograde degeneration experiments independently, injections of horseradish peroxidase were placed in this midbrain somatosensory recipient area. Retrogradely labeled neurons were identified in the contralateral dorsal column nucleus. These findings indicated that the pattern of degeneration seen after dorsal column lesions originated from the dorsal column nucleus itself. The results of the present experiments when compared with similar studies in other amniotes emphasize the following two points. First, dorsal column and spinal cord projections to the midbrain are features common to reptiles, birds, and mammals. Second, since these pathways and midbrain somatosensory terminations are common to amniotes, dorsal column nucleus and spinal circuits to the midbrain and their mesencephalic projection areas are phylogenetically ancient. PMID- 2720367 TI - Evolution of spinal nerve number in anuran larvae. AB - We examined the number of segmental spinal nerves in 60 premetamorphic tadpoles, representing 43 species, 33 genera and 12 families of anurans. The number of spinal nerves shows a clear phylogenetic pattern, in which the primitive condition is variable, ranging from 23 to 29 pairs. Reduction of caudal spinal nerve number has occurred independently at least 7 times during anuran phylogeny. Reduction events have occurred among species within genera, among subfamilies within families, as well as at familial and higher taxonomic levels. In general, arachaeobatrachian larvae have significantly more spinal nerves than neobatrachian larvae. While 2 of the 7 reduction events have occurred within the Archaeobatrachia, both of these have occurred at low taxonomic levels. In the Neobatrachia, 3 of the 5 reductions have occurred at subfamilial or higher taxonomic levels. Overall, reduced spinal nerve number correlates with tadpole body size, but not with relative tail length or with developmental stage, at least within the range of stages we examined. There is a positive correlation between number of spinal nerves and minimum time from hatching to metamorphosis, at least within the Archaeobatrachia. Species with more pairs of nerves take longer to reach metamorphosis, possibly because they have more neural tissue to produce and to resorb. Spinal nerve number per se does not appear to be associated with larval microhabitat ecology or swimming behavior. Tadpoles exhibit greater variation in spinal nerve number than adult frogs. This greater variation is tolerated presumably because the tail is an expendable organ, which is lost at metamorphosis. PMID- 2720369 TI - Semantic abilities in dementia of the Alzheimer type. II. Grammatical semantics. AB - The grammatical semantic abilities of 18 Alzheimer patients were investigated using picture description tasks and compared to those of a group of institutionalized, nonneurologically impaired control subjects matched for age, sex, and educational level. During picture description, Alzheimer patients showed that they were able to provide as much information about the target picture as control subjects, but were less concise in their verbal representation of the information. The lack of conciseness was reflected in the DAT patients requiring more time and more syllables to communicate a similar quantity of information than the control subjects. The appropriateness of using a picture description task which involves a perceptual step-by-step account of unrelated events to assess sentential semantics and the conveying of information at a conceptual level is discussed. PMID- 2720368 TI - Comparative study of brain morphology in ants. AB - Brain morphology, with special attention to the three dimensional form of the corpora pedunculata, was studied in thirteen species of ants, representing four subfamilies of Formicidae. The results can be summarized as follows. (1) The neural systems processing optic and olfactory information differ in the evolutionary history among the studied taxa. A positive correlation can be demonstrated in the phylogenetic history of the corpora pedunculata, central body, cerebral bridge and olfactory lobe, but not the optic lobe. Ant species with very large eyes and thus, probably, highly developed vision, show gigantic optic lobes, with no exaggeration of any other brain structure. (2) More social species have more complex chemical communication systems and better developed corpora pedunculata (more surface in foldings of the calyces) and olfactory lobes; however, this tendency seems to reverse in highly social species with a sophisticated polymorphic caste system: individuals of these species are generally less developed neurally. (3) There are differences between the form of the internal and external calyces of the corpora pedunculata, and these differences are proportionately more pronounced in species with complex social organization. (4) Individuals from different worker castes of the same species differ in their brain morphology, but each species shows a different pattern of variation among their castes. (5) Brain structure shows characteristic marks due to the different phylogenetic developments in the taxa studied. For example the trends in brain volume-body size ratio are different for the various subfamilies, suggesting a divergent phylogenetic history. PMID- 2720370 TI - Differential perseverations in verbal retrieval related to anterior and posterior left hemisphere lesions. AB - Sixty-two patients with focal cerebral lesions and 11 control patients were examined using alternating tasks of learning, generation, and recall of words beginning with "K." The results supported the hypothesis that "recurrent" and "stuck-in-set" varieties of perserveration are related to posterior and anterior left hemisphere lesions, respectively. Patients with left posterior lesions usually failed to suppress the expression of previously generated words in the subsequent generation task, whereas patients with left anterior lesions stated a greater number of new (incorrect) words in the recall of previously learned words, presumed to indicate stuck-in-set perseveration of the previous generation performance. PMID- 2720371 TI - Cerebral lateralization of language in deaf and hearing people. AB - In Experiment 1 neither hearing nor prelingually deaf signing adolescents showed marked lateralization for lexical decision but, unlike the hearing, the deaf were not impaired by the introduction of pseudohomophones. In Experiment 2 semantic categorization produced a left hemisphere advantage in the hearing for words but not pictures whereas in the deaf words and signs but not pictures showed a right hemisphere advantage. In Experiment 3 the lexical decision and semantic categorization findings were confirmed and both groups showed a right hemisphere advantage for a face/nonface decision task. The possible effect of initial language acquisition on the development of hemispheric lateralization for language is discussed. PMID- 2720372 TI - An auditory Stroop effect for pitch, loudness, and time. AB - Increased reaction time to pitch, loudness, or duration of an auditorily presented word whose meaning is in conflict with the response label (i.e., high/low, loud/soft, or fast/slow) demonstrates an auditory Stroop effect. Fifteen normal adults participated in an auditory Stroop test. Analysis of reaction time data supports the existence of an auditory Stroop effect for pitch and loudness, but not duration. The interaction between psychoacoustic and semantic attributes of speech stimuli is discussed. PMID- 2720373 TI - Auditory temporal pattern learning in children with speech and language impairments. AB - Four children demonstrating speech and language impairments were examined with respect to their ability to learn to identify certain auditory temporal perceptual information. These children listened to six-element temporal patterns and made judgments about the temporal proximity of two of the elements. Subjects listened to the patterns over a number of exposures ranging from 6 to 14, depending on the subject. Performance on the task improved significantly with repeated exposures. However, the disordered subjects' best performance was still significantly poorer than normal children who had only 1 exposure to the task. These results suggest that, in part, performance differences on temporal perceptual tasks between speech and language disordered children and normal children can be accounted for by differences in perceptual learning. However, because the disordered children never reached normal levels, learning differences may be associated with a fundamental deficit in temporal processing or some other mechanism such as impaired attention. PMID- 2720374 TI - Discourse in aphasia: integration deficits in processing reference. AB - The present study investigated moderately impaired aphasic subjects' ability to integrate information across sentences by having them identify antecedents for ambiguous pronouns in brief narratives. In order to disambiguate the pronouns, the subjects had to consult either textual cues and/or extratextual cues. In addition, the subjects' ability to retrieve factual information was measured by having them identify explicitly stated noun referents. The results show that the aphasic subjects had significant difficulty using textual cues to resolve referents when the referents were not readily accessible through world knowledge. The patients had little difficulty interpreting referents which were recoverable from world knowledge or were stated explicitly. The explanatory power of world knowledge effects, grammatical class effects, memory effects, and linguistic integration effects in accounting for the deficit pattern observed is considered. PMID- 2720375 TI - Lateralization in the visual perception of Chinese characters and words. AB - It has been reported that tachistoscopic perception of single Chinese characters is better with a left-visual-field (LVF) than with a right-visual-field (RVF) presentation and that of Chinese words consisting of characters is better with a RVF presentation (O. J. L. Tzeng, D. L. Hung, B. Cotton, & S.-Y. Wang, 1979, Nature (London), 382, 499-501). In this study, the nature of this character-word difference in lateralization was explored in a task in which stimuli were presented unilaterally to a visual field for recognition test. Four types of stimuli were used: Single character, single pseudo- or noncharacter, two character word, and two-character pseudoword. Results show (a) no visual-field advantage for illegal characters and words, (b) a LVF-advantage effect for characters associated with a more prominent LVF than RVF character-superiority effect, (c) a RVF-advantage effect for words associated with a more prominent RVF than LVF word-superiority effect, and (d) these two visual-field effects for characters and words being not absolute, they occur only with a low rather than with a high recognition for their respective illegal counterparts. These results suggest that the character-word difference is due to a more efficient lexical interpretation of character stimuli in the right than in the left hemisphere and a more efficient lexical interpretation of word stimuli in the left than in the right hemisphere. PMID- 2720376 TI - Regional cerebral blood flow for singers and nonsingers while speaking, singing, and humming a rote passage. AB - Two groups of singers (n = 12,13) and a group of nonsingers (n = 12) each produced the national anthem by (1) speaking and (2) singing the words and by (3) humming the melody. Regional cerebral blood flow (rCBF) was measured at rest and during each phonation task from seven areas in each hemisphere by the 133Xe inhalation method. Intrahemisphere, interhemisphere, and global rCBF were generally similar across phonation tasks and did not yield appreciable differences among the nonsingers and the singers. PMID- 2720377 TI - Induction of LTP in rat primary visual cortex: tetanus parameters. AB - Long-term potentiation (LTP), intensively studied in the hippocampus as a possible mnemonic device, has begun to be studied in the neocortex. In this study the effects of varying tetanic stimulus parameters on LTP of field potentials recorded from layer II/III induced by white matter stimulation in the in vitro rat visual cortical slice were examined. Low intensity tetanus was more effective in producing LTP than high-intensity tetanus, although single pulses of very high intensity reliably resulted in LTP. LTP consistently occurred following 2 Hz-60 min, or 100 Hz-10 min tetanus; whereas, 10 min of 7 and 25 Hz tetanus usually resulted in long-lasting depression. Although no obvious rule related tetanus frequency and duration to the incidence of LTP, an inverted-U relationship was found between tetanus frequency and LTP magnitude. PMID- 2720378 TI - Awaking effect of prostaglandin E2 in freely moving rats. AB - The awaking effect of prostaglandin (PG) E2 was further examined in a long-term bioassay system. PGE2 in saline solution was infused between 11.00 and 17.00 h at 0.1, 1, 10, and 100 pmol/min (infusion volume 10 microliters/h) into the third cerebral ventricle of freely moving rats. These rats were otherwise infused with saline continuously and exhibited a circadian cycle, spending 70% of the daytime and 37% of the night in sleep. In the rats that received PGE2 infusion at 1, 10, and 100 pmol/min, slow wave sleep (SWS) decreased to 84%, 69% and 71% and paradoxical sleep (PS) to 85%, 37% and 40% of the paired controls. Thus, the effect of PGE2 was not specific to either SWS or PS. No effects were observed in the rats that received PGE2 at 0.1 pmol/min. After PGE2 infusion at 10 and 100 pmol/min, marked rebounds of both SWS and PS occurred during the night. SWS reduction by PGE2 was due to the shortened duration of SWS episodes, while SWS increase in the rebound phase was due to the increased number of episodes. PS reduction was due to both the shortened duration and decreased number of PS episodes and PS rebound was due to both the prolonged duration and increased number of episodes. The circadian sleep-wake cycle returned to the baseline on the first or second recovery day after PGE2 infusion. Sleep reduction by PGE2 was accompanied by elevation of the brain temperature and rebound increase of sleep occurred with the fall of the brain temperature.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720379 TI - Effects of cyanide and uncouplers on chemoreceptor activity and ATP content of the cat carotid body. AB - In cat carotid bodies (c.b.'s) incubated in vitro with [3H]tyrosine to label the stores of catecholamines, it was found that CN promotes dose- and Ca2+-dependent release of [3H]dopamine (DA) from c.b. tissues in parallel to the increased electrical activity recorded from the carotid sinus nerve (c.s.n.). Two different uncouplers, dinitrophenol (DNP) and carbonyl-cyanide-m-chlorophenyl-hydrazone (CCCP), both activate also in a dose-dependent fashion, release of DA and electrical activity in the c.s.n. However, while cyanide (CN) (10(-4) M) applied during 5 min reduced the adenosine triphosphate (ATP) content of the c.b. by 45%, DNP (2.5 x 10(-4) M) and CCCP (10(-6) M) applied for the same period of time did not modify the ATP levels of the organ. At the above concentrations, the 3 agents increased about 8-fold the electrical activity recorded from the c.s.n. Thus, contrary to the postulates of the metabolic hypotheses, our findings indicate that the decrease in the ATP content in the c.b. is not a prerequisite for the activation of the chemoreceptors. We propose alternative mechanisms to explain the chemostimulant action of the metabolic poisons. PMID- 2720380 TI - Studies of the in vivo catabolism of exogenous dopamine as infused through a push pull cannula implanted in the rat caudate nucleus. AB - In this report, using a push-pull perfusion technique, we examined in vivo the effects of exogenous dopamine (DA) on the output of neurochemical substances from the caudate nucleus (CN) of freely behaving rats. Exogenous DA, at concentrations of 10(-5) M, 5 x 10(-5) M and 10(-4) M, in modified Krebs-Ringer phosphate medium (KRP) was infused directly into the CN for 15 min each. Exogenous DA at the doses tested elicited increases in 3,4-dihydroxyphenylacetic acid (DOPAC) output in a dose-dependent manner. In addition, the higher two doses of exogenous DA also induced increases in homovanillic acid (HVA) output from the rat CN. The increases in DOPAC output by 5 x 10(-5) M DA was partially blocked by the inclusion of 10(-3) M nomifensine in KRP. Interestingly, exogenous DA-induced increases in HVA output were little affected by the nomifensine treatment. However, the catabolism of exogenous DA was almost completely eliminated by a prior 6-hydroxydopamine lesion in the ipsilateral substantia nigra. Furthermore, infusions of exogenous DA did not change 5-hydroxyindoleacetic acid output from the CN. In conclusion, our results confirm in vivo that (a) DA catabolic pathway via DOPAC intermediate predominates over the alternative pathway via 3 methoxytyramine, (b) increases in extracellular DA will lead to increases in DOPAC and HVA levels in extracellular space and (c) the majority of the DA is oxidized by intradopaminergic monoamine oxidase. PMID- 2720381 TI - Response properties of lateral hypothalamic neurons during ingestive behavior with special reference to licking of various taste solutions. AB - Activity of 58 single neurons in the lateral hypothalamic area (LHA) was recorded while Wistar male rats were drinking water and various taste solutions in a test box. A cue tone was presented before opening of a shutter for access to a drinking spout. Except 8 neurons which were non-responsive in the present experimental paradigm, 50 neurons were classified into 3 types according to their response properties: (1) 10 neurons changed their activity with arousal state or circadian rhythm, (2) 10 neurons responded to specific sensory stimuli, i.e. 2 were classified as taste-responsive neurons, which responded excitatory to sodium salts, 3 neurons responded to olfactory stimulation, 5 to somatosensory stimulation applied to the perioral region, and (3) the remaining 30 decreased their activity during licking of liquids regardless of their qualities. Besides this classification, activity of 28 of 58 LHA neurons was altered after onset of the cue tone (or before start of licking), i.e. 24 increased their activity (learned anticipatory response), and 3 modulated their tonic activity into burst discharges corresponding to sniffing, and 1 increased its activity in relation to stepping toward the drinking spout. These data suggest that about half of the LHA neurons increased their activity in anticipatory (searching or approaching) periods just before ingestion, and decreased activity in rewarding periods during ingestion of water or sapid solutions. PMID- 2720382 TI - Danger stimulus-induced analgesia in the crab Chasmagnathus granulatus. AB - When a danger stimulus (a passing shadow) is presented to the crab Chasmagnathus granulatus, an escape response is elicited that habituates after repeated stimulation. Results from previous work suggest that this habituation might be mediated by endogenous opiates and, thus, that after an habituation session an analgesic effect on the response to a painful stimulus should be found. The purpose here was to test this contention. Each crab was lodged in an actometer where two 2-trial sessions with electrical shock stimulation were given (SS1, SS2), the intersession interval being 60 or 105 min, and the response activity recorded. In some experiments, repeated shadow stimulation was inserted during the interval, and the response activity also recorded. In Expt. 1, shadow sessions of 15 and 30 trials were tested and a significant decrease of the reactivity to the shock was only shown with 30 trials. In Expt. 2, crabs were immediately injected after SS1 with distilled water (d.w.) or naloxone (NX) (3.2 micrograms/g), and a shadow session of 30 trials was given to half of the d.w. animals and to half of the NX ones. NX injected crabs showed an increased responsiveness to the danger stimulus during the shadow session but no inhibitory effect on pain reactivity to the subsequent painful stimulus. Issues concerning dependence of the analgesia on danger stimulus iteration and on stimulus controllability, as well as the opioid nature of the analgesia, are discussed. PMID- 2720383 TI - Effects of two nucleoside transport inhibitors, dipyridamole and soluflazine, on purine release from the rat cerebral cortex. AB - The effects of two nucleoside transport inhibitors, dipyridamole and soluflazine, on adenosine, inosine and oxypurine release from the normoxic and hypoxic/ischemic rat cerebral cortex have been studied. Dipyridamole (500 micrograms/kg) enhanced adenosine release during hypoxic/ischemic challenges in comparison with saline-injected controls. It decreased the hypoxia/ischemia elicited releases of inosine, hypoxanthine and xanthine. Both basal and hypoxia/ischemia-elicited releases of uric acid were elevated. Soluflazine, administered topically or systemically, failed to enhance adenosine release and did not consistently alter the hypoxia/ischemia-evoked releases of inosine, hypoxanthine and xanthine. Basal release of uric acid was elevated. The failure of either drug to elevate the basal or hypoxia/ischemia-evoked releases of adenosine above predrug levels illustrates one of the problems which may be inherent in the use of bidirectional nucleoside transport inhibitors for the manipulation of adenosine levels in the cerebral interstitial fluid. PMID- 2720384 TI - Heterogeneity and properties of transformation of corticosteroid receptors in spinal cord and hippocampus. AB - The central nervous system contains two classes of corticoid receptors, named types I and II following terminology accepted for the kidney. Phenotypically, type I sites are differentiated into a corticosterone (CORT)-preferring species (Ia) and a mineralocorticoid receptor (Ib). These populations were tentatively compared in the spinal cord and hippocampus. Using [3H]dexamethasone (DEX) and selective blockage of sites, we have observed that type II receptors were comparable in both tissues, while Ia was almost exclusive of the hippocampus. Saturation analysis using [3H]DEX demonstrated that type Ia was a low affinity receptor (Kd approximately equal to 2-5 nM) while type II was a higher affinity site (KdII less than KdI). Using [3H]CORT, or [3H]aldosterone (ALDO), as ligand, preferential labeling of type I sites was achieved, always showing higher concentrations in the hippocampus. Therefore, [3H]DEX seems a ligand of choice to visualize types Ia and II receptors. Another difference noted between the spinal cord and hippocampus, pertained to the sensitivity towards the enzyme RNAse A, which increases heat-induced transformation of the bound receptor, according to the results of DNA cellulose affinity chromatography. In these experiments, type I sites of both spinal cord and hippocampus, plus type II of hippocampus, showed sensitivity toward the enzyme, whereas type II of the spinal cord was refractory to RNAse A enhancement of transformation. These results indicate that the dynamics of transformation is different among receptors showing similar affinity and competition, suggesting further heterogeneity due to receptors themselves, or to tissue factors regulating their biochemical properties. PMID- 2720385 TI - A comparative study of 2-deoxyglucose patterns of glomerular activation in the olfactory bulbs of C57 BL/6J and AKR/J mice. AB - We have studied the patterns of glomerular activation evoked in the olfactory bulbs of C57BL/6J and AKR/J mice by olfactory stimulations with amyl acetate or isovaleric acid. Patterns of glomerular activation were obtained with the 2 deoxyglucose method and subsequently compared using a computer-assisted image analysis. The mice of both inbred strains stimulated with amyl acetate or isovaleric acid were characterized by areas of high 2-deoxyglucose uptake in their glomerular layer. Statistical comparisons of the patterns demonstrated that they were odor-specific. Although C57BL/6J mice have been found to be specifically anosmic to isovaleric acid, our findings indicate that their olfactory system is topographically activated by olfactory stimulations with this odorant. However, patterns of glomerular activity evoked by isovaleric acid stimulations are not similar in the two studied strains. PMID- 2720386 TI - Induction of astroglial growth inhibition and differentiation by sialosyl cholesterol. AB - Normal rat astroblasts in culture were exposed to 11 sialosyl or cholesterol derivatives at concentrations lower than 20 microM. Synthesized sialosyl cholesterols (alpha- and beta-D-N-acetyl neuraminyl cholesterols) and cholesterol sulfate showed a marked growth inhibitory action. Sialosyl cholesterol uniquely evoked an astroglia-like stellation resembling that induced by glia maturation factor (GMF) as well as a suppression of GMF-induced mitogenesis of astroblasts. The minimal incubation period of sialosyl cholesterol for the initiation of growth inhibition was as short as one hour. The inhibitory effect retained an irreversibility even after removal of the drug. Cytosolic protein with 58 kDa Mr in size was specifically phosphorylated by sialosyl cholesterol through a certain protein kinase dependent on neither Ca2+ nor cyclic AMP. The competition experiment of sialosyl cholesterol action revealed that sialosyl and cholesterol moieties were indispensable for the phenomena. These results most likely imply that sialosyl cholesterol alters the membrane microenvironment to affect the affinity of growth factor receptor, protein kinase activity, and/or cytoskeletal anchorages. PMID- 2720387 TI - Electrophysiological identification of spinally projecting neurons in the lateral reticular nucleus of the rat. AB - Eighty-four neurons in the caudal ventrolateral medullary reticular formation were antidromically activated by the stimulation of the dorsolateral funiculus in 49 urethane-anesthetized rats. Of 76 neurons, 37 had no spontaneous discharge. Of the neurons that had spontaneous discharges, 80% had firing rates between 0.1 and 15 Hz. The average conduction velocity, determined among 70 neurons, was 15.20 +/ 1.23 m/s, and 87% had conduction velocities within the range of 2-30 m/s. This study further confirms the existence of spinally-projecting neurons in the lateral reticular nucleus (LRN) of the caudal medulla, and some of them are probably responsible for the descending controls of nociception from the LRN. PMID- 2720388 TI - Transient expression of Alz-50 immunoreactivity in developing rat neocortex: a marker for naturally occurring neuronal death? AB - Alz-50-immunoreactive neurons were evident in the subplate and cortical plate of the neonatal rat, but immunoreactivity was lost by the beginning of the second postnatal week. Many of these neurons were double-labeled by an injection of [3H]thymidine on gestational day (G) 12. Moreover, subplate neurons that were generated on G12 were eliminated from cortex by the end of the third postnatal week. Thus, Alz-50 immunoreactivity may be an early indicator of naturally occurring neuronal death. PMID- 2720389 TI - Peripheral nerve injury causes transient expression of MHC class I antigens in rat motor neurons and skeletal muscles. AB - After a peripheral nerve lesion (rat facial and sciatic) an induction of major histocompatibility complex (MHC) antigens class I was detected immunohistochemically in skeletal muscle fibers and motor neurons. This MHC expression was transient after a nerve crush, when regeneration occurred, but persisted after a nerve cut, when regeneration was prevented. Since the time course of MHC class I expression correlates to that of regeneration a role for this cell surface molecule in regeneration may be considered. PMID- 2720390 TI - Noradrenergic innervation of human pineal gland: abnormalities in aging and Alzheimer's disease. AB - Using previously characterized polyclonal antibody directed against dopamine beta hydroxylase (DBH), immunoreactive fibers were demonstrable in pineals of 6 controls of various ages and of 3 individuals with Alzheimer's disease (AD). Abnormal, swollen axons were present in pineals from aged individuals and from individuals with AD. The pathology of noradrenergic axons in a structure innervated by the superior cervical ganglion suggests that peripheral noradrenergic systems may be affected in aging and in AD. PMID- 2720391 TI - Distribution and size of GABAergic neurons in area 7b and the retroinsular cortex of the monkey. AB - The distribution of gamma-aminobutyric acid (GABA) neurons was examined in the retroinsular cortex (Ri) and area 7b of the monkey. GABA-immunoreactive somata and puncta were observed in all layers of Ri and area 7b. The densest concentration of these neurons was located in layers I and II. The vast majority (98.9%) of GABA-immunoreactive somata were less than 15 microns in major diameter. These data demonstrate that high concentrations of GABAergic neurons are located in those cortical layers that have been shown to receive afferent projections from corticocortical fibers. PMID- 2720392 TI - Facilitatory role of central dopamine in the osmotic release of vasopressin. AB - In conscious rats, intracerebroventricular (i.c.v.) injection of the dopamine antagonist haloperidol (0.15 mumol) blocked increases in plasma vasopressin (AVP) and arterial pressure caused by i.c.v. administration of a hypertonic solution (990 mOsm/kg, 10 microliters), without affecting plasma osmolality, electrolytes or hematocrit. The application of the alpha-adrenergic antagonist phenoxybenzamine (0.15 mumol), however, did not significantly inhibit the responses of plasma AVP and arterial pressure to the hypertonic solution. We concluded that brain dopamine may play a facilitatory role in the osmotically stimulated AVP secretion. PMID- 2720393 TI - Enhancement of kainate-gated currents in retinal horizontal cells by cyclic AMP dependent protein kinase. AB - Dopamine, acting via cyclic adenosine 3':5'-monophosphate (cAMP), has been shown to enhance a kainate-gated ionic conductance in white perch retinal horizontal cells in vitro. To determine whether this effect involves stimulation of a protein kinase, kainate-gated currents were observed in cultured horizontal cells that were dialyzed with the catalytic subunit of cAMP-dependent protein kinase. Intracellular application of catalytic subunit or cAMP, but not heat-inactivated catalytic subunit, caused significant enhancement of the kainate-evoked currents. These results suggest that kainate-gated channels in horizontal cells may be modified by a phosphorylation event. PMID- 2720394 TI - Insulin-like growth factor (IGF-1) as a stimulator of regeneration in the freeze injured rat sciatic nerve. AB - The effect of insulin-like growth factor (IGF-1) on the ability of the rat sciatic nerve to regenerate into a freeze-injured nerve segment was investigated. The freeze-injured segment was perfused for 6 days with Ringer solution and different concentrations of IGF-1, dispensed by a subcutaneously implanted osmotic minipump. At a pump concentration of 50, 100 and 200 micrograms IGF-1/ml the regeneration length increased with 14, 25 and 26%, respectively, as measured by the pinch test and by immunocytochemical staining for neurofilaments (NF) in the growing neurites. Schwann cells invading the freeze-injured segment were visualized by immunostaining for S-100 protein. In nerves perfused with Ringer solution alone the Schwann cells were present as far as the neurites had regenerated, while neurites seemed to grow slightly ahead of the Schwann cells in the nerves perfused with IGF-1. Incorporation of [3H]thymidine increased in IGF-1 treated nerves. However, IGF-1 perfusion did not increase thymidine incorporation when outgrowth of neurites was detained by a transection proximal to the freeze injured area. The results suggest that IGF-1 affects regeneration by local stimulation of the growing neurites and that IGF-1 stimulates the proliferation of non-neuronal cells indirectly. PMID- 2720395 TI - Embryonic spinal cord neurons develop preferential cholinergic projections to sympathetic ganglia explanted from appropriate levels of the neuraxis. AB - To determine whether cholinergic spinal cord neurons can develop preferential projections in vitro within sympathetic ganglia (SGs) of appropriate levels of the neuraxis, organotypic explants of fetal mouse spinal cord (E13) from cervical, thoracic (upper and lower) and lumbar segments were co-cultured with either pairs of neonatal SGs: the rostral superior cervical ganglion (SCG) or a caudally located upper lumbar ganglion (LG). After 3.5-4 weeks of co-culture, levels of the enzyme, choline acetyltransferase (ChAT), were measured in individual spinal cord explants and SCGs or double LGs (to match the target mass of a single SCG). Interaction was assumed to occur primarily between an SCG or LG doublet and the adjacent ipsilateral half of the co-cultured cord segment. An index of cholinergic interaction was defined as the ganglion ChAT activity per unit ChAT activity in half co-cultured cord segment. The index of interaction with the SCG was highest with the T1/T2 (1.4) as compared with the T10/T11 (0.79), L1/L2 (0.38) and C2/C3 (0.11) segments. In contrast, the index of cholinergic interaction with double LGs was highest with the more caudally located T10/T11 (0.62) cord segment as compared with the rostral T1/T2 (0.33), cervical C2/C3 (0.2) and lumbar L1/L2 (0.17) segments. Ganglion compound action potentials evoked in LGs by stimulation of the ipsilateral portion of T10/T11 cord were blocked by the ganglionic antagonist, hexamethonium, as previously observed in co-cultures of SCGs with T1/T2 cord. These results indicate that pools of preganglionic neurons in thoracic cord segments can develop in vitro preferential cholinergic projections within SGs of appropriate position. Cervical and lumbar cord segments which contain a preponderance of somatic motoneurons over preganglionic neurons did not interact as effectively with either type of SG. The preferential cholinergic projections from rostral thoracic cord explants within co-cultured SCGs and from caudal thoracic cord explants within co-cultured SCGs and from caudal thoracic cord explants within LGs may reflect some degree of positional preference intrinsic to embryonic spinal cord neurons and/or their appropriate target SGs, consistent with the positional specificity expressed by preganglionic neurons and SGs in situ. PMID- 2720396 TI - Regional brain IR-Met-, IR-Leu-enkephalin concentrations during progress and full electrical amygdaloid kindling. AB - Using amygdaloid kindling in chronic rats, we were able to observe behavioral, electrographic and IR-Met- and IR-Leu-enkephalin changes throughout the progress of different stages of convulsive activity. Rats presenting the initial stages of kindling, rats presenting the first generalized motor seizure, and rats with at least 10 generalized seizures were sacrificed 24 h after the last stimulus; also rats with at least 10 generalized seizures but sacrificed 21 days after the last seizure were compared with control and sham-operated groups of rats. The IR-Met and IR-Leu enkephalin concentrations in each group were measured in the striatum, amygdala, hypothalamus, medulla oblongata (including pons), hippocampus, mid brain, spinal cord and cerebral cortex. A progressive increase in IR-Leu enkephalin in amygdala and hippocampus was observed over the course of kindling. These increases remained until 21 days after rats were fully kindled (at least 10 generalized seizures). We observed increased and decreased concentration of each peptide in different regions. We discussed the regional and the differential effects of each peptide. The increased concentrations in limbic structures were associated with the amygdaloid increased excitability through the kindling process. We suggest that the decreases in concentrations are related with structures involved in the output behavior manifestations produced by kindling stimulation. PMID- 2720397 TI - Androgen increases the number of cells in fetal mouse spinal cord cultures: implications for motoneuron survival. AB - Androgen effects were studied in organotypic cultures of the E12 fetal mouse lumbosacral spinal cord labeled in utero with [3H]thymidine on E10. Following continuous exposure to androgens for one month in vitro, the number of labeled cells was significantly increased in whole explants, and in hemisected segments in the presence or absence of co-cultured fetal thigh muscle. Because lumbosacral motoneurons undergo their final mitosis predominantly on E10 and thus remain permanently labeled, the results suggest that androgens increase neuronal numbers by directly modulating motoneuron survival rather than stimulating mitosis. These findings demonstrate for the first time that in addition to the well documented role of the muscle target in motoneuron survival, the direct neuronotrophic effects of androgen at the level of the spinal cord must also be considered. PMID- 2720398 TI - Topography of the corpus callosum in the cat. AB - Discrete application of horseradish peroxidase to the corpus callosum in cats produced labeled neurons within a dorsoventrally elongated cortical territory. The rostrocaudal position of the territory corresponded with that of the applications. Callosal fibers from the ventral half of the frontal cortex passed through the rostrum, and those from the ventral occipital and dorsal temporal cortex passed through the ventral splenium. These results indicate a sectorial topographical correspondence between the corpus callosum and the cortex. PMID- 2720399 TI - Inspiratory-modulated neurons of the rostrolateral pons: effects of pulmonary afferent input. AB - In decerebrate, paralyzed cats ventilated with a cycle-triggered pump, firing of inspiratory (I) and I-modulated neurons in the pontine respiratory group was markedly increased by withholding lung inflation, indicating strong inhibition by lung afferents. Spectral analysis showed that only a small minority of I modulated neurons had high-frequency oscillations (HFO), in contrast to medullary I neurons, indicating that the pontine neurons are not closely linked to medullary I networks. PMID- 2720400 TI - Monosynaptic striatal inputs to the nigrotegmental neurons: an electron microscopic study in the cat. AB - The cat substantia nigra (SN) pars reticulata (SNR) has been observed electron microscopically after ibotenic acid injections into the caudate nucleus (Cd) and horseradish peroxidase injections into the nucleus tegmenti pedunculopontinus pars compacta (TPC). As a result, degenerating striatal terminals were found to make symmetric synaptic contacts on retrogradely labeled SNR neurons. The present findings, together with our previous study on the tegmentonigrostriatal projection (Tokuno et al., Neurosci. Lett. 85 (1988) 1-4), confirm that the Cd has indirect reciprocal connections with the TPC via the SN. PMID- 2720401 TI - Involvement of fast synaptic inhibition in the generation of high-frequency oscillation in central respiratory system. AB - During moderate hypercapnia, spectrum analysis of efferent phrenic nerve activity (PNA) of urethane anesthetized rabbits revealed high-frequency oscillations (HFO). The spectral peak (mean frequency 111 Hz) was reversibly eliminated by the glycine receptor antagonist strychnine administered into the 4th cerebral ventricle. In contrast, blockade of brainstem GABAA receptors by bicuculline did not abolish HFO but even reinforced or induced HFO. Thus, there is evidence that fast synaptic inhibition via glycine receptors is involved in the generation of HFO within the medullary respiratory center, whereas GABA may play a modulatory role. PMID- 2720402 TI - Effects of altered thyroid states and undernutrition on the calbindin-D28K (calcium-binding protein) content of the hippocampal formation in the developing rat. AB - A quantitative study of calbindin-D28K (calcium-binding protein) was carried out on the developing hippocampal formation in normal, hypothyroid, hyperthyroid, and underfed rats. In normal animals, the calbindin-D28K content increased after birth in agreement with the distribution of the protein previously reported by immunocytochemistry. Calbindin-D28K was strikingly spared, compared to the other proteins, from the effects of hypothyroidism. On the contrary, the calbindin D28K:protein ratio was transiently reduced by hyperthyroidism. Corrective doses of thyroxine to hypothyroid rats increased the calbindin-D28K content whatever the period of the hormonal treatment, but they also had a marked effect on the hippocampal weight and the protein content, especially when the hormone was given on days 2-3. With this latter replacement therapy schedule, the calbindin D28K:protein ratio dropped from the high value of the hypothyroid animal to normal. Taken together, the results obtained in hypothyroidism, hyperthyroidism and replacement therapy are consistent with a pronounced action of thyroid hormone on hippocampal structures other than those containing calbindin-D28K. Undernutrition, which, like hypo- or hyperthyroidism, also markedly impairs hippocampal growth, affected the calbindin-D28K content per hippocampus but not the calbindin-D28K:protein ratio. This emphasizes the unique influence of thyroid hormone on brain development. The relative preservation of calbindin-D28K in the hippocampal formation of animals lacking thyroid hormone suggests that calbindin D28K function may be crucial in this brain region. PMID- 2720403 TI - Central terminations of periodontal mechanoreceptive and tooth pulp afferents in the trigeminal principal and oral nuclei of the cat. AB - Intra-axonal recording and horseradish peroxidase (HRP) injection techniques were employed to define the response properties of low-threshold mechanoreceptive periodontal afferents and of the tooth pulp afferents and the morphological characteristics of their axon arbors in the nucleus principalis (Vp) and rostrodorsomedial (Vo.r) and dorsomedial parts (Vo.dm) of the nucleus oralis (Vo). The central terminals of 3 fast adapting (FA) and 4 slowly adapting (SA) periodontal afferents and 4 tooth pulp (TP) afferents were recovered for detailed analyses. Stained axons in the trigeminal sensory tract ascended and descended (bifurcating fibers), or descended without bifurcation (descending non bifurcating fibers). The ratio of the bifurcating fibers to the descending non bifurcating fibers was about three to one for each type of afferents. The main collaterals given off from the ascending branches terminated in the Vp. Most collaterals given off from the descending branches terminated in the Vo with the exception of few instances. In case of the FA afferents, the ascending branches gave off all main collaterals into the Vp with rostrocaudal and dorsoventral continuities in their arbors, whereas the descending branches gave off all main collaterals, except two collaterals, into the Vo with rostrocaudal discontinuities. The projections from the FA afferents to the Vo.dm was predominant in terms of the number of boutons and the length of preterminal and terminal branches. In case of the SA afferents, the collaterals from the ascending and descending branches formed rostrocaudally and dorsoventrally discontinuous terminal arbors. In terms of the density of boutons the SA afferents were divided into two subtypes. One had a preferential projection into the Vp or Vo, whereas others lacked a selective projection. In case of the TP afferents, the main collaterals of the ascending branches formed partially overlapping terminal arbors, but the terminal arbors formed by the collateral of the descending branches did not overlap. The frequency of collaterals of the TP afferents was less than that of the other types of afferents. The terminal arbors including the density of boutons of the pulpal afferents were less extensive than those of the other types of afferents. The average size of varicosities became smaller in the following subdivisions. Vp, Vo.r and Vo.dm for SA and TP afferents. The size of varicosities of the TP afferents was smaller and that of the FA afferents was larger than that of the SA afferents.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2720404 TI - Cholecystokinin antagonism by anthramycin, a benzodiazepine antibiotic, in the central nervous system in mice. AB - Anthramycin (ATM) which is a product of some streptomyces micro-organisms was shown to antagonize the central effects of cholecystokinin (CCK) such as antinociception and satiety and to displace CCK bound to the slices from the brains of mice. Sulfated octapeptide CCK (CCK8) was administered intracisternally to mice at doses of 1 microgram/mouse for inducing antinociception and 200 ng/mouse for satiety. ATM was administered intraperitoneally to mice at doses such as 0.3 and 0.5 mg/kg. CCK8-induced antinociception and satiety were significantly reversed by ATM in those doses. [125I]CCK8 binding to the brain slices was observed autoradiographically. The autoradiograms from the slices were converted to false color images by using a microcomputer. The radioactivity in the autoradiograms was expressed by color spectra in the false color images. Comparison of the binding of [125I]CCK8 to the brain slices in the presence and the absence of ATM revealed that ATM (10(-6) M) clearly displaced the CCK8 binding in the various regions, especially in the cortex, of the brain. These findings suggest that ATM acts as an potent antagonist of CCK in the central nervous system in mice. PMID- 2720405 TI - Morphometric study on the postnatal growth of non-cortical brain regions in Australian aborigines and Caucasians. AB - In an autopsy study on 29 male and 27 female Aborigines and 57 male and 37 female Caucasians the volumes of a large number of brain regions were determined and fitted to logistic growth functions. For Aboriginal adults significantly smaller values were found for weight and volume of the whole brain, cerebrum, and cerebellum and for the volumes of cerebral white matter, thalamus, amygdaloid body (females only), and globus pallidus (males only). No significant differences were found for caudate nucleus, putamen, amygdaloid body (males only), and globus pallidus (females only). Almost every region studied showed later half-value times, slower growth rates, and prolonged growth phases for Aborigines compared to Caucasians. These results are discussed in relation to secular changes of growth parameters of the human brain during the last century, timing of growth phases for each area, and the socioeconomical and health status of Aborigines. PMID- 2720406 TI - Activation of adenylate cyclase by forskolin prolongs calcium action potential duration in lamprey sensory neurons. AB - Calcium-dependent action potentials of primary sensory neurons in the isolated spinal cord of the lamprey were greatly prolonged in duration by forskolin, an activator of adenylate cyclase in other systems. This effect was dose-dependent over the tested range of 25-400 microM with an EC50 of 55 microM. Experiments were performed to establish a role for adenylate cyclase and adenosine 3',5' cyclic monophosphate (cAMP) as mediators of the forskolin effect. The prolonging action of forskolin on the Ca action potential was significantly reduced in the presence of the adenylate cyclase inhibitor 2',5'-dideoxyadenosine. The inactive forskolin analogue 1,9-dideoxyforskolin did not prolong the duration of the Ca action potential, while forskolin treatment of the same cells produced a large and rapid increase in action potential duration. In addition, the prolonging action of forskolin was potentiated by the phosphodiesterase inhibitor, theophylline. It is concluded that forskolin acts in lamprey sensory neurons to activate adenylate cyclase and raise intracellular cAMP levels which in turn mediate the increase in Ca action potential duration. PMID- 2720407 TI - Potassium currents of acutely isolated adult rat superior cervical ganglion neurons. AB - K+ currents of adult rat superior cervical ganglion neurons were studied using the voltage-clamp technique. Neuronal somata were dissociated from the ganglion using an enzymatic dispersion technique and voltage-clamped using the whole-cell patch-clamp technique. In solutions designed to isolate K+ currents, depolarization from a prepulse potential of -100 mV induced both transient and sustained outward current components. The transient current was completely eliminated by depolarization to -50 mV. The remaining sustained current component could be separated further into Ca2+-sensitive and Ca2+-insensitive components by superfusion with a Ca2+-free external solution. The transient current, which could be isolated by digital subtraction, rose rapidly and decayed over the subsequent 80 ms. Reversal potential determinations in different K+-containing solutions demonstrated that the current was carried primarily by K+. The transient current showed voltage-dependent inactivation, showing 50% inactivation near -87 mV and was completely inactivated at potentials more positive than -60 mV. The transient current recovered from inactivation with a voltage-dependent time course, the time course of inactivation decreasing with hyperpolarization. This transient outward current had characteristics of IA. The sustained Ca2+ insensitive outward current showed little decay over 800 ms and was also carried primarily by K+. This current component had characteristics similar to the delayed rectifier. A third sustained outward current eliminated by superfusion with Ca2+-free external solution had characteristics similar to the Ca2+ dependent K+ current. PMID- 2720408 TI - Lactic acid-induced swelling in C6 glial cells via Na+/H+ exchange. AB - One of the primary consequences of ischemia is tissue acidification due to anaerobic production of lactic acid. Upon reperfusion and recovery of pH, cytotoxic edema often ensues. Na+/H+ exchange, a mechanism involved in the regulation of intracellular pH (pHi), is activated by low intracellular pH, is dependent on extracellular Na+, and is inhibited by low extracellular pH (pH less than 6) or by amiloride. In this study we explore the role of Na+/H+ exchange in cell swelling following cytoplasmic acidification of C6 glioma cells. Postischemic intracellular acidification was simulated in vitro by exposure of cells in suspension to: (1) 20 or 140 mM lactic acid; or (2) 10 microM oligomycin. pHi was monitored fluorimetrically using the intracellularly trapped pH-sensitive dye bis(carboxyethyl)carboxyfluorescein. Cell volume was measured electronically with a Coulter Counter/Channelyzer. Both simulations of ischemia caused intracellular acidification followed by recovery. pHi recovery was mediated by Na+/H+ exchange, since it was amiloride-sensitive and Na+-dependent. This pHi reversal following lactic acid-induced acidification was also inhibited at pHo less than 6. Volume measurements showed that cells suspended in 140 mM Na lactate/lactic acid swelled by 19% over 15 min. This swelling was Na+-dependent, and inhibited by amiloride and pHo less than 6. These results suggest that Na+/H+ exchange may be involved in cell swelling following cytoplasmic acidification, and thus may be involved in postischemic cytotoxic brain edema. PMID- 2720409 TI - Protein associated with the sensory cell layer of the rainbow trout saccular macula. AB - A protein has been detected that is associated with the saccular hair cell layer of the rainbow trout, Salmo gairdnerii R. By one- and two-dimensional SDS polyacrylamide gel electrophoresis, the molecular weight and isoelectric point of this protein are estimated to be 13.6 and 8.8 kDa, respectively. The 13.6 kDa protein cannot be detected electrophoretically in brain, gill, liver, and fractions containing the basal lamina, non-sensory epithelium, and saccular nerve. This protein does not bind antibodies to bovine myelin basic protein, while trout myelin basic proteins in the same molecular weight range do. In addition, the protein does not bind concanavalin A or react with the periodic acid-Schiff reagent. The 13.6 kDa band represents about 1% of the total protein in saccular sensory epithelium, and may be a marker protein for the hair cell layer. PMID- 2720410 TI - Spatiotemporal patterns of the astroglial proliferation in rat brain injured at the postmitotic stage of postnatal development: a combined immunocytochemical and autoradiographic study. AB - Proliferative response of astrocytes to unilateral injury of the cerebral hemisphere was investigated in 30-day-old rats using a combination of [3H]thymidine autoradiography and immunocytochemical staining for glial fibrillary acidic protein. At different intervals following injury the animals were injected with [3H]thymidine and the distribution of double-labeled cells was recorded 4 h (short-term experiment) or 40-days (long-term experiment) after each injection. Within the region of the lesion a strong reactive proliferation of astrocytes began as early as 2 h after injury, although, at that time all dividing neuroglial cells were located at a relatively long distance from the lesion margin. Forty days later, however, autoradiographically labeled astrocytes were observed in the center of the lesion. This was regarded as evidence for the ability of astrocytes to migrate towards the site of injury. Maximal reactive proliferation of astroglial cells was observed at day 2 after injury and then reached the postmitotic plateau at about day 8. The cells, while dividing, were mostly GFAP-negative. Therefore, the number of astrocytes produced at particular days after injury, and their contribution to post-traumatic scar formation could be assessed only in the long-term experiment, after the newly formed cells became GFAP-positive. PMID- 2720411 TI - Intracranial microinfusion of pancreastatin elevates blood glucose, free fatty acids, and corticosterone in rats. AB - Pancreastatin, a novel peptide recently isolated from porcine pancreas, significantly inhibits insulin and somatostatin release and augments glucagon release from the isolated perfused rat pancreas. This implies a role for endogenous pancreatic pancreastatin in the regulation of blood glucose and free fatty acids, the two major metabolic fuels. Since many peptides have similar biological effects when administered centrally and peripherally, the effects of centrally administered pancreastatin on blood glucose and free fatty acids were examined in 3 studies. Corticosterone was also measured in two of these studies. Intraventricular microinfusion of pancreastatin significantly elevated blood glucose, free fatty acid, and corticosterone concentrations in a dose-related manner. None of these effects was seen after subcutaneous injection of the same doses. Centrally administered pancreastatin appears to produce its effects on glucose and free fatty acids through actions in the brain, and either the brain, the median eminence, and/or pituitary for corticosterone. PMID- 2720412 TI - Lesion of the PGO pathways in the kitten. II. Impairment of physiological and morphological maturation of the lateral geniculate nucleus. AB - Suppression of the geniculate ponto-geniculo-occipital (PGO) waves by bilateral lesions of PGO pathways at the mesencephalic level in 15-day-old kittens has been shown to induce a significant reduction of the mean discharge frequency recorded in the lateral geniculate nucleus (LGN) during paradoxical sleep. The present paper reports that one month after the bilateral lesion (i.e., 6-7 weeks of age) important deficits in the maturation of the LGN were observed: (1) electrophysiologically, the latencies of the LGN cellular responses to stimulation of the optic chiasm were significantly longer than those of age paired controls or of unilaterally lesioned animals, and the proportion of visual cells characterized as type X by stimulation of the visual field was smaller; and (2) morphologically, the volume of the LGN and the size of its neuronal somata were smaller than those in control. These data suggest that bilateral suppression of extraretinal PGO afferents to the LGN in the kitten induces a significant delay in the development of this nucleus. PMID- 2720413 TI - Quantitative distribution of GABA-immunoreactive neurons in cetacean visual cortex is similar to that in land mammals. AB - Sections of the anterior portion of the visual cortex in the lateral gyrus of the Black Sea porpoise were studied to determine the neuronal architecture and numerical density, and the distribution of neurons immunoreactive to gamma aminobutyric acid (GABA). Cytoarchitecture and neuronal density are similar to those described in another cetacean, the bottlenose dolphin. GABA-positive neurons are distributed through all layers of the visual cortex but are especially dense in layers II and III, and comprise some 20% of the total neuronal population in this part of the cortex. The distribution of GABA-positive neurons is similar to that found in land mammals. PMID- 2720414 TI - Possible locations of pH-dependent central chemoreceptors: intramedullary regions with acidic shift of extracellular fluid pH during hypercapnia. AB - Using liquid membrane pH microelectrodes, we evaluated rapid and transient changes in extracellular fluid (ECF) pH within the medulla during vertebral artery injections of CO2-saturated saline (0.5 ml) in anesthetized (Dial urethane), spontaneously breathing cats. We found intramedullary regions where ECF pH shifted to the acid side in the time course analogous to respiratory excitation during the CO2 loadings: the acidic shift occurred just before the respiratory excitation. Since most of the tested regions showed no or few changes in ECF pH, the responsive regions are thought to be specific local environments fitting the central chemoreceptors. Forty (85%) out of the 47 responsive regions were found to be scattered in the ventrolateral medulla, i.e. a long narrow zone extending from the ventrolateral surface to the ventral respiratory group (VRG) areas where inspiratory or expiratory activity was frequently recorded. The responsive regions were not necessarily restricted to the superficial ventral layers. We were also able to find the responsive regions in the dorsal area ventral to the nucleus tractus solitarii, though they were fewer in number (7/47). The distributions corresponded rougly to the areas where we had previously identified the tonically firing neurons excited exclusively by stimulation of the central chemoreceptors. These results indicate a possibility that the pH-dependent central chemoreceptors, if any, would be located within the regions demonstrated in this study. PMID- 2720415 TI - Suppressant effects of selective 5-HT2 antagonists on rapid eye movement sleep in rats. AB - The effects of the novel, highly selective serotonin-2 (5-HT2) antagonists, ICI 169,369 and ICI 170,809, on 24 h EEG sleep-wake activity were studied in the rat. Both compounds caused a dose-related increase in the latency to rapid eye movement sleep (REMS) and significantly suppressed cumulative REMS time up to 12 h postinjection. In contrast, neither drug disrupted slow-wave sleep continuity in as much as the latency to non-REMS (NREMS) and cumulative NREMS time were unchanged. However, at the highest dose tested (20 mg/kg) ICI 170,809 did produce a significant increase in total NREMS time during the second half of the sleep awake cycle. These results demonstrate effects of selective 5-HT2 antagonists on sleep in rats which appear to be specific for REMS behavior, suggesting that the priming influence of serotonin on REMS may involve 5-HT2 receptor subtypes. The relationship between the REMS suppressant actions of these compounds and their consideration as therapeutic agents in depression is discussed. PMID- 2720416 TI - Increases in muscarinic stimulated hydrolysis of inositol phospholipids in rat hippocampus following cholinergic deafferentation are not parallelled by alterations in cholinergic receptor density. AB - The effect of electrolytic fimbria/fornix lesions on muscarinic receptor subtypes and putative nicotinic binding sites in the hippocampus has been studied using [3H]N-methylscopolamine, [3H]pirenzepine and [3H]L-nicotine, respectively. In parallel experiments the carbachol-stimulated hydrolysis of inositol phospholipids was measured after incorporation of [3H]inositol into hippocampal slice preparations. Ten days after lesioning there were no apparent changes in either receptor density or affinities despite extensive reductions in choline acetyltransferase. In contrast a significant increase in carbachol stimulated turnover of inositol phospholipids was measured. These observations suggest that whilst loss of cholinergic afferents may not affect receptor density per se, the efficacy of the post synaptic muscarinic receptors can be up-regulated at least in the short term. PMID- 2720417 TI - Possible modulation of the medullary respiratory rhythm generator by the noradrenergic A5 area: an in vitro study in the newborn rat. AB - Respiratory activity was recorded on hypoglossal nerve or ventral cervical roots during in vitro experiments performed in the superfused brainstem-cervical cord preparation of newborn rats. Section and coagulation experiments revealed that the medullary respiratory generator was tonically inhibited by a structure located in the caudal ventrolateral pons. Electrical and pharmacological stimulations located this structure more precisely between the superior olivary nuclei and the sensory nucleus of the Vth nerve, i.e. in an area containing the A5 noradrenergic nucleus. Norepinephrine and alpha 2-antagonists (yohimbine, idazoxan) added to the bathing medium modified the respiratory frequency. Norepinephrine decreased respiratory frequency whereas norepinephrine antagonists increased respiratory rate. The electrical stimulation of the caudal ventrolateral pons which inhibited the respiratory rhythm under normal bathing medium became ineffective after alpha 2-antagonist. The results herein suggest that a noradrenergic inhibitory drive, originating from the A5 area or surrounding structures modulates the activity of the medullary respiratory generator. This hypothesis is discussed in relation to A5 involvement in cardiovascular regulation. PMID- 2720418 TI - Electrical stimulation of the rat ventral midbrain elicits antinociception via the dorsolateral funiculus. AB - The pain-suppressive effects of focal electrical stimulation of sites throughout the ventral midbrain were examined in awake rats. Chronic bipolar electrodes were implanted in medial and lateral regions of the midbrain. Current thresholds for suppression of the tail-flick reflex in response to noxious heat were determined for both a biphasic and a monophasic stimulation parameter at each site. Stimulation of areas throughout the ventral midbrain produced tail-flick suppression (TFS), but no one area was consistently effective in all animals. Monophasic and biphasic stimulation were qualitatively equal in the duration of TFS and the distribution of effective sites. The production of TFS was not correlated with other behavioral reactions to brain stimulation. TFS appeared to be mediated by non-opiate pathways since naloxone administration (10 mg/kg) had no discernible effect on the production of TFS. The current threshold for producing TFS was extremely variable over both short (one half hour) and long (one week) intervals. The incidence of TFS from previously effective sites was significantly less following bilateral dorsolateral funiculus (DLF) lesions, indicating that the antinociceptive effects of ventral midbrain stimulation are mediated by this spinal pathway. PMID- 2720419 TI - Changes in mechanoreceptive field properties of trigeminal somatosensory brainstem neurons induced by stimulation of nucleus raphe magnus in cats. AB - Experiments were carried out on adult anesthetized cats in which the effects of nucleus raphe magnus (NRM) conditioning stimulation (20 ms) were tested on the responses evoked by orofacial stimuli in single brainstem neurons of trigeminal (V) subnucleus oralis. The NRM stimulation induced inhibition of the responses of 57 of 77 low-threshold mechanoreceptive (LTM) neurons and the one wide-dynamic range (WDR) neuron tested. The duration of the neuronal inhibition ranged from 300-600 ms and the mean threshold for inhibition ranged from 47.8 +/- 4.8 to 102.7 +/- 15 microA depending on the orofacial stimulation site (skin or tooth pulp) and form (mechanical or electrical) of cutaneous stimuli used to evoke neuronal responses. In 20 LTM neurons showing NRM-induced inhibition that were specifically examined for the effects of NRM stimulation on the mechanoreceptive field, one population (n = 11) showed shrinkage (mean 55 +/- 4.4% from control area) of the mechanoreceptive field while the remaining neurons (n = 9) showed no change in mechanoreceptive field size during NRM stimulation. The former group of neurons were also distinguished from the latter neurons by their significantly larger mechanoreceptive field and the activation of the majority of them by electrical stimuli applied outside their mechanoreceptive field. The responses of these neurons evoked by low-threshold inputs from the edge of the mechanoreceptive field were more sensitive to NRM conditioning stimulation than responses evoked from the mechanoreceptive field center, as judged by threshold, magnitude and duration of the NRM-induced inhibition. These findings underscore the sensitivity of LTM neurons to NRM influences. They also reveal a particular population of oralis neurons which have a differential sensitivity of low threshold inputs evoked from the edge compared to the center of the mechanoreceptive field. PMID- 2720420 TI - Subpallidal-pedunculopontine projections but not subpallidal-mediodorsal thalamus projections contribute to spontaneous exploratory locomotor activity. AB - The contribution of the pedunculopontine nucleus to exploratory locomotion was investigated in rats. Locomotor activity recorded in a standard open-field apparatus was increased more than two-fold when wooden panels were inserted. This novelty-elicited locomotion was reduced significantly when procaine was injected bilaterally into the pedunculopontine nucleus but not when procaine was injected bilaterally into the mediodorsal thalamus, a second major projection site of the subpallidal area. These results support observations from earlier studies implicating hippocampal-accumbens-subpallidal-pedunculopontine projections in exploratory locomotion. PMID- 2720421 TI - Tonic and baroreflex effects on arterial pressure and ventilation of pentobarbital and nicotine on the rat ventral medullary surface. AB - Unilateral aortic depressor nerve stimulation caused depression of arterial pressure (baropressure reflex) and ventilation (baro-ventilatory reflex) in urethane-anesthetized, spontaneously breathing Sprague-Dawley rats. Application of sodium pentobarbital to the ventral medullary surface (VMS) depressed baseline arterial pressure and ventilation, and attenuated the baro-pressure reflex, but not the baro-ventilatory reflex. Application of nicotine on the VMS decreased baseline arterial pressure and increased ventilation, but left both baro-pressure and baro-ventilatory reflexes unaltered. The results suggest that some of the structures that affect vasomotor tone may not be involved in the baroreflex inhibition of arterial pressure. Additionally, neither the neural structures near the VMS which modulate CO2 control of ventilation, nor those that affect tonic control of vasomotor tone are likely to be significantly involved in the baro ventilatory reflex. PMID- 2720422 TI - Electrophysiological properties of ventromedial medulla neurons in response to noxious and non-noxious stimuli in the awake, freely moving rat: a single-unit study. AB - The spontaneous and evoked activities of ventromedial medulla (VMM) neurons have been recorded in the chronic, awake, freely moving rat. The vast majority of neurons located at the level of the nucleus raphe magnus exhibited an irregular and variable (2-16 Hz) spontaneous activity and were activated by either cutaneous or auditory stimuli. Within this convergent neuronal class the neurons were activated by either cutaneous noxious and non-noxious inputs. The threshold for cutaneous activation was likely very low since a majority of units responded to air puffs, but the application of controlled brushing and pin-prick revealed that the VMM convergent neurons responded more for the noxious mechanical stimulation. Similar findings were found with pinch application. For both innocuous and noxious stimuli, the cutaneous receptive field was extremely extensive (almost all of the body); however, the application of the controlled brushing showed that for this innocuous stimulation, the most sensitive regions were the tail, back, snout and vibrissae and, to a lesser extent, the flank and paws. Preliminary experiments indicated that both the spontaneous and evoked activities of VMM convergent neurons were inhibited during stressful manipulations such as scruff lifting or defense reactions. These data contrast with other studies on VMM single unit recordings in anesthetized rats since the majority of these studies did not emphasize the VMM convergent group; in addition, with one exception, we did not find neurons exclusively driven by noxious inputs. Without excluding a role of the VMM convergent group in pain descending control systems, we proposed that this neuronal class is perhaps also involved in pain transmission or in general processess such as alertness and stress. Experiments are proposed in order to precisely determine the involvement of the VMM convergent neurons in alertness versus sensory discriminative aspects of nociception in the awake, freely moving rat. PMID- 2720423 TI - Metabolic adjustments to dynamic hypoxic hypoxemia in feline brain tissue. AB - Three different metabolic models were incorporated in a compartmental simulation of brain tissue pO2 response to rapid changes in arterial pO2. The first was the frequently utilized constant metabolism assumption. The second model was a 4-step kinetic simplification of glucose conversion to CO2 with an intermediate reversible reaction of pyrovate to lactate. The most sophisticated model was a new 11-step reaction scheme with the same start and end points accounting for glycolysis, the tricarboxylic acid cycle, and oxidative phosphorylation. A unique representation was derived for the oxygen consumption depending on reduced cytochrome a3+(3) consistent with diverse observations in the literature. The theoretical predictions were compared to previously published cortical tissue pO2 recordings from detailed experiments with pentobarbital anesthetized cats. The 11 step metabolic model invariably provided the best match between the theoretical calculations and the observed responses. These results indicate that cellular metabolism rapidly adjusts to changes in O2 in a manner which reduces the tissue pO2 fluctuation. In concert with the large compensatory arterial blood flow response there was extensive damping of intracellular pO2 compared to arterial O2 changes. PMID- 2720424 TI - Characterization of pretentorial periaqueductal gray matter neurons mediating intraspecific defensive behaviors in the rat by microinjections of kainic acid. AB - Unilateral microinjections of 40 pmol of kainic acid (KA; in 0.2 microliter) within the periaqueductal gray matter (PAG) evoked intraspecific defensive postures (defensive uprights, defensive alterting, defensive sideways, backing) in rats confronted with a conspecific. These reactions, which lasted for up to 30 min, were seemingly identical to the rat's natural defensive reaction to attacks by a conspecific although they were evoked by the investigatory approach, rather than the attack, of another rat. Histological analysis revealed that the strongest defensive reactions were evoked from sites within a restricted part of the pretentorial periaqueductal gray matter. Lower doses of KA induced fewer (20 pmol) or non-significant increases (4 pmol) in defensive reactions. Higher doses (100 and 200 pmol) increased the percentage of defensive behavior and also induced oriented jumps out of the test cage. In tests with a conspecific, defensive reactions were elicited most frequently when investigation by the partner was localized to the side of the body contralateral to the injection site. This was confirmed in a sensory reactivity test in which tactile stimulation by the experimenter elicited most defensive reactions when applied on the side of the body contralateral to the injection side. This test also revealed a somatotopic gradient in the animal's reaction: tactile stimulation of the contralateral head and the forelimb evoked the strongest reactions, whereas no responses were observed upon tactile stimulation of the contralateral flank or hindlimb. Measurement of electroencephalographic activity at the cortical, hippocampal, amygdala and PAG levels indicated that the evoked defensive reactions were not secondary to epileptogenic effects. Finally, quantitative analysis of an autoradiographic study found that [3H]KA diffused within a diameter of 1.0-1.2 mm around the cannula tip. Taken together, these results indicate the existence of a population of neurons within a restricted part of the pretentorial PAG of the rat, the excitation of which produces defensive responses and demonstrate that these defensive reactions have a socially adaptive value. PMID- 2720425 TI - Comparison of the neurotoxic effects of colchicine, the vinca alkaloids, and other microtubule poisons. AB - Previous studies have revealed that colchicine is selectively toxic to certain neuronal populations in the CNS, particularly granule cells of the dentate gyrus. The present study evaluates whether other microtubule poisons exhibit similar neurotoxic effects. Equimolar solutions of colchicine, colcemid, podophyllotoxin, vinblastine, vincristine and lumicolchine, the non-binding analog of colchicine, were injected into the dentate gyrus. Neurotoxicity was evaluated histologically. As previously reported, colchicine selectively destroyed dentate granule cells with minimal damage to other neurons including hippocampal pyramidal cells. Vincristine was very toxic and was not selective for granule cells. Vinblastine was relatively selective in destroying granule cells, but was not as potent as colchine. Colcemid and podophyllotoxin had minimal toxic effects. Lumicolchine injections caused no more damage than injections of vehicle. This ordering appears to correlate with the reversibility of binding tubulin. PMID- 2720427 TI - Calbindin-D 28K in hippocampal organotypic cultures. AB - Slices of hippocampus from 6-day-old rats were cultured for 2-4 weeks using the roller-tube technique. The organization of these explants was studied by immunocytochemical labeling of calbindin-D 28K (CaBP 28K). The development of the CaBP 28K staining was very close to that of the rat hippocampus in vivo with only 3 subpopulations of labeled cells: granule cells and their mossy fibers, pyramidal cells in the subiculum-CA1 zone and interneurons scattered in strata oriens and radiatum. PMID- 2720426 TI - Double-pulse stimulation of startle-like responses in rats: refractory periods and temporal summation. AB - A startle-like response was evoked by electrical stimulation with one pulse in several brainstem sites of the primary acoustic startle circuit. If a second pulse was delivered 0.4-10 ms after the first pulse, a stronger response or a decreased current threshold resulted. The facilitatory effect of the second pulse increased as interpulse (C-T) interval increased from 0.4 to 2.0 ms in cochlear nucleus or ventral lateral lemniscus sites. In caudal pontine reticular formation sites, the effect of the second pulse increased sharply from 0.3 to 0.5 ms. These results suggest that very short refractory period axons mediate electrically elicited startle in reticular formation, and that longer refractory period axons mediate startle in cochlear nucleus or ventral lateral lemniscus. In reticular formation sites, the effect of the second pulse declined nearly exponentially from 2.0 to 50 ms with a time constant of about 4 ms. Stimulation of similar reticular formation sites in cats evokes monosynaptic EPSPs in spinal motoneurons with an almost identical time course, as reported by other investigators. This suggests that the startle response evoked from the reticular formation results from monosynaptic activation of spinal motoneurons. Temporal summation declined more slowly and irregularly in cochlear nucleus and ventral lateral lemniscus sites, suggesting that these sites are not monosynaptically connected with spinal motoneurons, a conclusion consistent with anatomical data. In reticular formation sites near the facial nerve, a second peak in the two-pulse curve was observed at a C-T interval of 10 ms. The second peak was blocked by local anesthesia of the face ipsilateral to the stimulating electrode, suggesting that a single twitch of facial muscles facilitates startle. PMID- 2720428 TI - Sensitization of cat dorsal horn neurons to innocuous mechanical stimulation after intradermal injection of capsaicin. AB - Intradermal injection of 100 micrograms of capsaicin in cats excited dorsal horn spinal neurons classified as either 'high threshold' or 'wide dynamic range'. Capsaicin enhanced their responses to innocuous mechanical stimulation. A role for these neurons in mechanical hyperalgesia is suggested. PMID- 2720429 TI - The geniculohypothalamic tract in monkey and man. AB - The intergeniculate leaflet (IGL) of the lateral geniculate complex in rodents contains neuropeptide Y-immunoreactive (NPY-IR) neurons which project to the suprachiasmatic nucleus (SCN) of the hypothalamus. In the macaque monkey and human brain, a large portion of the pregeniculate nucleus contains NPY-IR neurons indicating that this is the primate homologue of the rodent IGL. The monkey SCN has a dense plexus of NPY-IR axons identical in location and appearance to that in rodents. As in other mammals, no NPY-IR neurons are found in the monkey SCN. In contrast, in the human SCN, the NPY-IR plexus is less dense than in the monkey and there are numerous NPY-IR neurons. This suggests that the human SCN differs in organization from that of other mammals and that the functional homologue of the mammalian geniculohypothalamic tract is local circuit NPY+ neurons within the nucleus. PMID- 2720430 TI - Oestrogen and noradrenaline modulate endogenous GABA release from slices of the rat medial preoptic area. AB - Endogenous gamma-aminobutyric acid (GABA) release from the rat medial preoptic area (MPOA) was measured in an in vitro slice technique with sensitive HPLC analysis. Oestrogen is demonstrated to increase GABA activity in the ovariectomised, oestrogen-primed (OVX-EB) rat prior to the luteinising hormone (LH) surge compared with ovariectomised (OVX) animals. Noradrenaline (NA) at a concentration of 10 microM was found to significantly enhance GABA release in response to 30 mM potassium stimulation in both OVX and OVX-EB animals. A significantly greater response to NA was observed in the OVX-EB animal. No effect of NA on basal GABA release was detected. The effects of NA were blocked by the alpha-adrenergic receptor blocker phenoxybenzamine (PB). These data suggest that GABA activity is modulated both by oestrogens and noradrenergic-mediated input in the MPOA. PMID- 2720431 TI - An evidence of 'post-seizure excitation' in feline-kindled seizures. AB - We assessed the post-seizure effects on the seizure threshold and the seizure duration using low-frequency kindling technique. The number of stimulating pulses required for a triggering of epileptic afterdischarge (pulse-number threshold; PNT) was used for the indicator of seizure threshold. PNT increased significantly at 2 and 4 h inter-stimulation intervals, whereas it decreased significantly with an increase of seizure duration at 16 and 24 h intervals. It appears from these data that a post-seizure excitation occurs after a post-seizure inhibition. PMID- 2720432 TI - Activity-induced depression of synaptic inhibition during LTP-inducing patterned stimulation. AB - In the hippocampus, patterns of electrical stimulation that approximate bursting neuronal activity during theta rhythm have been shown to induce a long-term potentiation (LTP) of excitatory synapses. In this study, a single subthreshold stimulus applied to one set of Schaffer/commissural fibers affected the response to a second stimulation delivered 200 ms later to a separate set of Schaffer/commissural fibers in the CA1 field of rat hippocampal slices. The first (priming) stimulus caused a prolongation of the synaptic response elicited by the second (primed) stimulus. In addition, the priming stimulation facilitated the induction of LTP by bursts of stimulation (4 pulses at 100 Hz) of the second afferent pathway. Analysis of the shape of the synaptic responses indicates that the prolongation is due to the removal of an inhibitory component rather than the addition of a novel excitatory component. Blockade of GABAA-ergic transmission with picrotoxin mimicked the priming effect in that it also widened synaptic responses and facilitated burst-induced LTP. We suggest that these patterns of stimulation result in a transient loss of inhibition during the primed stimulation. This, in turn, brings about a prolongation of the synaptic response that allows short bursts of excitatory synaptic activity to depolarize postsynaptic cells sufficiently to trigger LTP. PMID- 2720433 TI - Natriuretic action of central angiotensin II in conscious rats. AB - The effects of intracerebroventricular (i.c.v.) injections of angiotensin II (ANG II, 10 pg, 100 pg and 10 ng) on renal sodium excretion were investigated in conscious rats instrumented with a chronic urethral catheter. ANG II increased renal sodium excretion dose-dependently with a threshold i.c.v. dose of 10 pg. Only after the highest dose was a concomitant increase in arterial blood pressure and urinary flow observed. The ANG II-induced natriuresis began within 5 min of the i.c.v. injection and lasted for more than 1 h. The angiotensin receptor antagonist saralasin (1 ng, i.c.v.) largely prevented the natriuretic effect of i.c.v. injected ANG II (100 pg). Our results lend further support to the hypothesis that brain ANG II by its potent natriuretic actions may be instrumental in central osmotic control. PMID- 2720434 TI - Single-unit activity in the bed nucleus of the stria terminalis during fever. AB - Arginine vasopressin, released from nerve terminals in the septal region, probably exerts endogenous antipyretic activity. A major source of vasopressin to this area is the bed nucleus of the stria terminalis (BST). In order to characterize electrophysiologically the BST-septal pathway and its potential role in the control of fever, single-unit, extracellular recordings were made from neurons in the BST of anesthetized rats. Afferent and efferent connections were identified by electrical stimulation of the medial amygdaloid nucleus and the ventral septal area (VSA). BST neurons received both inhibitory and excitatory synaptic input from the amygdala and VSA. Efferents to the VSA were identified by stimulus-evoked antidromic spike invasion. Some BST neurons were responsive to peripheral skin temperature (thermoresponsive). The activity of putative vasopressin neurons was studied during prostaglandin E1-induced fever. Although a majority of BST units was unaffected by fever, a proportion of the cells examined increased their firing rates in accordance with reported release of vasopressin in the VSA during fever. PMID- 2720435 TI - Long-term effects of chronic methamphetamine administration in rhesus monkeys. AB - Biochemical and neuropathological effects of exposure to a high dose regimen of methamphetamine were evaluated in rhesus monkeys approximately 4 years after the last drug injection. Concentrations of dopamine and serotonin in caudate were below control levels as were concentrations of serotonin in several other brain regions. These changes were more severe in a monkey that was exposed twice to the drug regimen. A decrease in caudate synaptosomal uptake of both neurotransmitters as well as neuropathological changes were evident in that monkey. Although it is possible that partial recovery occurred, these results strongly suggest that methamphetamine-induced neurotoxicity may be permanent. PMID- 2720436 TI - Ionic currents on type-I cells of the rabbit carotid body measured by voltage clamp experiments and the effect of hypoxia. AB - Type-I cells (from rabbit embryos) in primary culture were studied in voltage clamp experiments using the whole cell arrangement of the patch-clamp technique. With a pipette solution containing 130 mM K+ and 3 mM Mg-ATP, large outward currents were obtained positive to a threshold of about -30 mV by clamping cells from -50 mV to different test pulses (-80 to 50 mV). Negative to -30 mV, the slope conductance was low (outward rectification). The outward currents were blocked by external Cs+ (5 mM) and partially blocked by TEA (5 mM) and Co2+ (1 mM). The initial part of the outward currents during depolarizing voltage pulses exhibited a transient Ca2+ inward component partially superimposed to a Ca2+ dependent outward current. Inward currents were further characterized by replacing K+ with Cs+ in the intra- and extracellular solution in order to minimize the outward component and by using 1.8 mM Ca2+, 10.8 mM Ca2+ or 10.8 mM Ba2+ as charge carrier. Slow-inactivating inward currents were recorded at test potentials ranging from -50 to 40 mV (holding potential -80 mV). The maximal amplitude, measured at 10 mV in the U-shaped I-V curve, amounted to 247 +/- 103 pA (n = 3). This inward current was insensitive to 3 microM TTX, but blocked by 1 mM Co2+ and partially reduced by 10 microM D600 and 3 microM PN 200-100. In contrast to outward currents, the inward currents exhibited a 'run-down' within about 10 min. Lowering the pO2 from the control of 150 Torr (air-gassed medium) to 28 Torr had no apparent effect on inward currents, but depressed reversibly outward currents by 28%. In conclusion, it is suggested that type-I cells possess voltage-activated K+ and Ca2+ channels which might be essential for chemoreception in the carotid body. PMID- 2720437 TI - [Results of using high porosity aortofemoral bifurcation prostheses]. AB - The authors report on their four-year experience with the use of extremely highly porous vascular polyester prostheses of Czechoslovak provenience, whose wall was sealed with fibrin. Aortofemoral bifurcated prostheses with a permeability of 6 100 ml/cm2/min were implanted in 102 patients. The method of fibrination appears to be simple and safe. No hemorrhage through the prosthetic wall was observed. The authors expect the high porosity of the prostheses to result in longer lasting patency of the grafts and thus in improvement of long-term results. PMID- 2720438 TI - [The effect of dietary proteins on the fluorescence of Nile red in the aortic arch in guinea pigs]. AB - The purpose of the paper was to investigate the effect of soy and casein protein, present in the diets in various ratios, upon cholesterolemia and intensity of Nile red fluorescence (as indicator of lipoproteins) from the wall of the arch of aorta in guinea pigs. A special optoelectronic device was constructed to allow objective quantitative measurement of fluorescence from histologic sections. Administration of soy protein, compared to cassein protein, resulted in significantly lower cholesterolemia values and lower fluorescence intensity. The study has verified the effect of the two dietary proteins tested also at the level of the vessel wall. PMID- 2720439 TI - [Transmural differences between damaged cardiomyocytes due to post-ischemic reperfusion and calcium paradox]. AB - Normothermic 3 min lasting perfusion of the isolated rat heart by Krebs- Henseleit solution in which Ca2+ was replaced by EDTA and subsequent perfusion with a Ca2+ containing medium induced structural and metabolic changes demonstrated electron microscopically and histochemically. In contrast to the ischemic reperfusion damage, in calcium paradox, the histochemically studied enzymes alpha-glucan-phosphorylase, lactate dehydrogenase, succinic dehydrogenase, beta-hydroxybutyric dehydrogenase, and ATPases were better preserved in the subendocardial region of the left ventricle. Ultrastructural analysis of this phenomenon showed good correlation with histochemical findings. A large portion of cardiomyocytes in the subendocardial layer exhibited but small changes. On the other hand, myocytes in the subepicardial region and in the midmyocardium were markedly damaged and all characteristic signs of calcium paradox were present, including hypercontraction bands with myofilament fusion, extrusion and accumulation of edematous mitochondria with occurrence of electron dense material in mitochondrial cristae, ruptures of the sarcolemma in all its layers, separation of intercalated discs, etc. The better preservation of the subendocardial region in experiments with calcium paradox is attributable to inadequate perfusion of this region by calcium free medium due to transmural anatomic inhomogeneity of capillary supply whose insufficiency in the subendocardial region results in a better protection of these myocytes from Ca2+ paradox. PMID- 2720440 TI - [The effect of diltiazem manufactured by Lachema on the calcium paradox in the isolated rat heart]. AB - The calcium paradox known as irreversible damage of the metabolism, structure, and function of the heart was used as model for testing the efficacy of diltiazem (Lachema) in the concentrations of 0.4 and 4.0 mumol.l-1. On the isolated rat heart perfused by Langendorff's method, the calcium paradox induced by 2.5 min depletion and subsequent 10 min repletion of calcium was manifested by loss of electric and contractile activity, by drop of coronary flow, and by significant decrease of ATP and ADP content, as well as of the total content of adenine nucleotides in the tissue. Diltiazem (Lachema) in the tested concentrations of 0.4 and 4.0 mumol.l-1 effectively reduced the damage of cardiac function. Its effect was demonstrated by improvement of the hemodynamic and metabolic parameters studied. PMID- 2720441 TI - Graphic representation of deviations of the cardiac electric field. AB - The first part of the paper presents a survey of mapping methods in electrocardiography and discusses the present possibilities of graphic representation of individual types of maps of the cardiac electric field (CEF). In the second part of the paper, the authors describe their own method of constructing complete departure maps. The mode of determining the matrix of the departure map surface is given. Four spatial maps--CEF surface, projection of CEF surface, threedimensional departure map, contour departure map--yield in one graphic output the complete departure map. The value of personal computers for diagnostic methods in medicine is being emphasized. The paper is supplemented by graphic outputs performed on the computer EC 1045 and represented by the plotter DIGIGRAF. PMID- 2720442 TI - [Temporary disappearance of EEG activity during reversible respiratory failure in rabbits and cats]. AB - The dynamics of changes of EEG activity was studied on the model of reversible respiratory failure in rabbits and cats in pentobarbital anesthesia. During N2 inhalation, apnea of 60 second duration, and subsequent resuscitation the electrocorticogram in bifrontal and bioccipital connection was recorded. Evaluation of 19 episodes of apnea in 7 rabbits and of 25 episodes in 8 cats yielded the following results: 1. During hyperventilation induced by N2 inhalation a certain activation of the EEG was observed (spindles more pronounced, increased occurrence rate of discharges of the reticular activation system). 2. At the onset of apnea the EEG was still distinct, suggesting that primary apnea is presumably not caused by anoxia and the accompanying electric silence of the structures that control respiration. 3. Disappearance of EEG occurred within 50 seconds from the onset of apnea in rabbits and within 30 seconds in cats. 4. After repeated episodes of apnea lasting for 60 sec., artificial ventilation mostly resulted in normalization of EEG. PMID- 2720443 TI - [The effect of diltiazem (Lachema) on transmural non-homogeneity of histochemical changes due to the Ca-paradox]. AB - Calcium paradox was induced by 2.5 min perfusion of the rat heart (Langedorf's system) at 37 degrees C with calcium-free Krebs--Henseleit solution and subsequent 10 min reperfusion with the same solution containing calcium. Ca2+ depletion itself did not affect the activities of the histochemically studied enzymes (succinate dehydrogenase, lactate dehydrogenase, beta-hydroxybutyric dehydrogenase, phosphorylase, and ATPases). Ca paradox was histochemically characterized by decrease and even disappearance of activities of the given enzymes and by marked transmural nonhomogeneity of these changes exhibiting a decreasing trend towards the endocardium. Diltiazem in the concentration of 0.4 and particularly of 4.0 mumol.l-1 exerted a protective effect manifested by a better preservation of the enzymatic activities. PMID- 2720444 TI - [The effect of smoking and alcohol on oxidative phosphorylation in mitochondria in the myocardium]. AB - The simultaneous effect of passive smoking and alcohol on oxidative phosphorylation was studied in rabbits after 14 day exposure. The results were compared with those obtained in previous studies on the isolated noxious effect of smoking or alcohol. The authors conclude that under the given experimental conditions the combined effect of ethanol and smoking doses not affect oxidative phosphorylation of mitochondria: energy production and respiration of mitochondria were preserved. The protective effect of ethanol upon the harmful effect of smoking on mitochondrial oxidative phosphorylation is accounted for by potential interaction of nicotine and ethanol in the microsomal fraction of the liver. PMID- 2720445 TI - [Age-dependent effect of non-steroidal anti-inflammatory agents on the phagocytic activity of leukocytes in mice]. AB - In experiments on mice of five different age groups (representing important stages of ontogenetic development) the phagocytic activity of polymorphonuclear leukocytes in peripheral blood was studied after short-term administration of phenylbutazone, indomethacin, ibuprofen, and diclofenac sodium. In six-week-old mice (period of sexual maturation) administration of phenylbutazone and indomethacin resulted in statistically significant increase of phagocytic activity. After administration of phenylbutazone to 18-month-old mice (old), phagocytic activity was reduced. In the groups of 3-week-old and 3- and 12-month old mice phenylbutazone and indomethacin did not significantly affect phagocytic activity. Administration of ibuprofen resulted in statistically significant decrease of phagocytic activity of leukocytes in three age groups, i.e. in 3-week , 6-week- and 18-month-old rats. In the other two age groups ibuprofen failed to be effective. No effect of diclofenac sodium on phagocytic activity of leukocytes could be established in comparison with the control group of mice in any of the age groups studied. The finding that phagocytic activity of leukocytes can be diminished even after short-term administration of ibuprofen is considered important, since it is currently one of the most frequently used anti inflammatory drugs. PMID- 2720446 TI - [Comparison of the results of a study on superstitiousness in patients with schizophrenia and in a control group]. AB - A high occurrence of magical contents is usually described as one of the characteristic manifestations of schizophrenic thinking. In the literature there is no agreement on the question whether quantitative intensification of the norm or qualitatively different magic contents are involved. The authors selected five best known superstitions and elaborated a 15-item examination implement affecting magical manifestations in three components of the psyche, i.e. in the cognitive, behavioral and affective one. The results obtained in a group of 45 patients affected with schizophrenia were compared with those obtained in the control group of 189 subjects. A significantly higher production was recorded in the control group. Contrary to the behavioral and affectivity components, no significant differences were found in the number of positive responses in the cognitive component. The obtained results corroborate the justification of distinguishing categories of magical thinking in normal and pathologic conditions. PMID- 2720447 TI - [Nutrition in the prevention of ischemic heart disease]. AB - The survey presents current knowledge on the role of nutrition in prevention of hypercholesterolemia and ischemic heart disease. From the standpoint of their role in atherogenesis, nutritional factors can be divided into protective and risk factors. The group of protective factors includes n-3 and n-6 polyunsaturated fatty acids, oleic acid, plant sterols, plant lecithins, some fiber components (e.g. pectin), plant proteins (e.g. soybean), vitamin C, vitamin E, magnesium, potassium, calcium, chromium, and selenium. The group of risk factors comprises saturated fatty acids, cholesterol, sucrose, sodium, vitamin D, and ethanol. After World War II the development of food consumption in Czechoslovakia resulted in an imbalanced state persisting for some decades now which is characterized by a high involvement of risk factors (high consumption of meat, sausages, animal fats, eggs, common salt, and alcoholic beverages) and by a low involvement of protective factors (low consumption of vegetables, fruit, potatoes, legumes, fish, and roughly milled grain). The imbalance of risk and protective factors in nutrition is conceivably one of the main causes of the extremely high mortality from cardiovascular diseases in Czechoslovakia. The current unfavorable trend in the rate of ischemic heart disease and in life expectancy of the population in Czechoslovakia can not be reversed without substantial changes in the composition of nutrition. PMID- 2720448 TI - [Molecular basis for the action of thyroid hormones]. AB - The mode of action of thyorid hormones at molecular level is described. The hormone reaches the target cell presumably by active transport and then it binds specifically to the plasma membrane, cytosol and mitochondria. Yet from the standpoint of its action, the most important binding is that to the cell nucleus. The nucleus receptor was partially isolated and its physico-chemical properties were determined. The hormone-receptor complex induces gene expression involving generation of specific ribonucleic acids and subsequent production of specific proteins (enzymes). The latent time interval for protein production is of varying length. Triiodothyronine induces in the liver the production of a specific protein which plays a role in the synthesis, metabolism, and storage of lipids. PMID- 2720449 TI - Abnormalities of serum proteins following thermal injury. AB - Suppressive factors were found to be present in serum and considered to be one of the causes of the suppression of body defences following thermal injury. The purpose of this study was to find out any abnormality of the postburn serum proteins by the comparison of burned and normal sera using immunoprecipitation in gel. The results of SDS-polyacrylamide gel electrophoresis, crossed immunoelectrophoresis, tandem crossed immunoelectrophoresis, and fused rocket immunoelectrophoresis showed that differing precipitation bands or peaks existed between burned and normal sera, and abnormal constituents with relatively low molecular weight were present in the burned serum. PMID- 2720450 TI - Burn injuries in native Canadians: a 10-year experience. AB - Between 1977 and 1986, 1598 patients were admitted to the Firefighters' Burn Unit of the University of Alberta Hospital in Edmonton, Alberta. One hundred and twenty-five (7.8 per cent) of these patients were Treaty Indians or Metis compared to 4.2 per cent of the general population in the same given area. The data show native people suffered larger total body surface area (TBSA) burns, were hospitalized on average 16.9 days longer and required 0.7 more operations than their non-native counterparts. Natives are also three times more likely to remain within the health care system as inpatients for rehabilitation after acute burn management has been completed. Mortality rates as a result of these burns were similar for natives (4.8 per cent) and non-natives (4.3 per cent). This review indicates that the native population is at higher risk of suffering burn injury even after adjusting for certain demographic variables, consequently impacting the utilization of the health care system. PMID- 2720451 TI - Frequency of use and rated effectiveness of cognitive and behavioural coping responses to burn pain. AB - Cognitive and behavioural pain control coping techniques were studied in a sample of burn clinic outpatients. Forty-four subjects of generally low socioeconomic status were recruited for the study. TBSA average 8 per cent, the mean subject age was 38.1 years, and subjects reported experiencing pain during half their waking hours the previous week. The Burn Pain Questionnaire (BPQ) was used to assess the reported frequency of use and effectiveness of eight behavioural and seven cognitive coping strategies for average and severe levels of pain. The BPQ was also used to assess pain duration as a correlate of the efficacy of coping techniques. The results indicated that three behavioural techniques (listening to TV/radio/stereo, sleeping, talking about pain) and one cognitive technique (thinking about something else) were rated as effective by the majority of subjects for average levels of pain. None of the techniques were rated by subjects as useful with sever pain. Use of two behavioural approaches (use of TV/radio/stereo, talking) and two cognitive approaches (concentrating attention, imagining self elsewhere) were significantly correlated with increased pain duration. Results are discussed in terms of tailoring psychological pain control techniques to the individual needs of the patient. PMID- 2720452 TI - Analysis of 100 patients with thermal injury treated in a new burn unit in Amman, Jordan. AB - This paper describes the treatment of patients with thermal injury in Jordan University Hospital. Between 1976 and 1980 inclusive 338 patients were treated in general surgical wards. More recently a new specialized burn unit has been built and between April 1985 and July 1986, 100 patients have been treated in this new unit. Compared with the earlier study there has been an increase in the number of patients admitted with more severe burns. Among these 100 patients scalds and fire-burn injury have a nearly equal incidence. Small children are especially vulnerable. The mortality rate, the incidence of disability and the duration of stay in hospital has decreased compared with the previous study. PMID- 2720453 TI - Evidence that 1 per cent Meshushit ointment prevents progressive dermal ischaemia of experimental deep partial skin thickness burns: a preliminary, quantitative controlled study. AB - This study quantitatively assessed the topical effects of Meshushit, a new herbal compound, on the healing process of experimental deep partial skin thickness burns over 27 days. To symmetrical circular burns were inflicted on the back of 15 animals by aluminium templates. The Meshushit and its control vehicle containing 0.1 per cent gentamycin or the control vehicle plus antibiotic alone, were applied topically to randomly selected burns at equal time intervals. Epithelialization and contraction were assessed on postburn days 6, 10, 15, 18, 22 and 27 using a computerized planimeter. The newly formed granulation tissue was assessed histologically on postburn day 27, while the hair follicles were counted in the same sections. Student's t test was used to differentiate the rates of contraction and epithelialization; hair follicle counts and the thickness of the newly formed granulation tissue. None of the animals died during the experiment. The epithelialization and contraction rates did not differ significantly between the test groups. The Meshushit-treated wounds showed a significantly thicker granulation tissue layer as compared to its control (828.72 +/- 46.39 microns vs. 540.78 +/- 37.81 microns, P less than 0.01). The count of hair follicles was significantly higher in the Meshushit-treated burns (23.38 +/- 1.84 vs. 3.76 +/- 0.35, P less than 0.001). It is concluded that the herbal Meshushit ointment enhanced the newly formed granulation tissue and preserved better the hair follicles in the present burn wound model. It is suggested that these findings are due to the preservation of the dermal microcirculation. PMID- 2720454 TI - 'Sabbath' electric plate burn: a ritual hazard. AB - This report describes the burns caused by an electric hot plate which is used by orthodox Jews for keeping food and liquids warm during the Sabbath (Saturday). An illustrative case is presented and the preventable aspects of this particular burn are discussed. PMID- 2720455 TI - Severe thermal hand burns--factors affecting prognosis. AB - This paper presents the results of the analysis of clinical data from a series of 132 thermally injured patients with 214 burned hands. The objective was to identify the factors affecting the pathogenesis of postburn hand deformities. The study indicates that deep burns have the worst prognosis and that circumferential burns are always followed by secondary sequelae. The incidence of secondary hand deformity rises sharply when the burn affects more than 25 per cent of the total body surface area (TBSA). Given the same physical therapy programme, early tangential excision and immediate grafting yield better results than conservative treatment. The results underline the role of patient motivation in maximal hand rehabilitation. PMID- 2720456 TI - Burns management and junior staff--what do they know? AB - This study examines the ability of junior doctors to initiate the management of burned patients. One hundred and twenty-four junior doctors were assessed using a questionnaire. Eighty per cent of the sample had had undergraduate lectures on the subject and 43 per cent had experience of managing patients with major burns. Despite this only 3 per cent could correctly carry out all the steps necessary to estimate the fluid requirements of a burned patient. Theoretical knowledge of the 'Rule of Nines' was adequate but 10 per cent of the sample made mathematical errors when supplied with a burns formula and the appropriate values. We suggest that postgraduate instruction be given to junior staff and that burns charts include details of a burns formula and an illustrative example of the calculation required. PMID- 2720457 TI - Comparison of E-Z Derm and Jelonet dressings for partial skin thickness burns. AB - A prospective, randomized trial of 32 patients with partial skin thickness burns is reported comparing E-Z Derm with Jelonet as a burn dressing. The bacterial colonization rate, need for surgical treatment, time for spontaneous healing, analgesic requirements and frequency of dressing changes were assessed in each group. No statistically significant differences were found between the two groups, for any of these factors. PMID- 2720458 TI - Severe electrical injury. AB - From January 1979 to January 1987, 125 patients were treated in our Centre for various electrical injuries. Among them, 85 patients were over 15 years of age (89.4 per cent were males and 10.6 per cent females) and 40 patients were below 15 years of age (92.5 per cent were males and 7.5 per cent females). Electricians were the most frequently injured in the over 15-year-old age-group, whereas most patients under 15 years old were students. We focused our study on five patients with multiple and severe electrical injury. Two of these patients were injured while erecting TV aerials, two were injured at work and the other one was working on a house roof. Despite all our efforts extensive limb amputations were required. Following complete healing, we fitted prostheses to the amputation stumps. All the patients have now returned to society as capable individuals, two of them to their previous occupations and the other three with new occupations. Our experience with five patients showed that patients with severe electrical injury and multiple amputations have a reasonable chance of recovery. Rehabilitation therapy must be given as early as possible after the electrical injury so that the patients may return to their normal place in society. PMID- 2720459 TI - Image analysis of restriction enzyme fingerprint autoradiograms. AB - A genome mapping system has been developed that reads and assembles data from clones analysed by restriction enzyme fragmentation and polyacrylamide gel electrophoresis. Input data for the system can be most effectively obtained by the use of a scanning densitometer and image-processing package, such as that described in this article. The image-processing procedure involves preliminary location of bands, cooperative tracking of lanes by correlation of adjacent bands, a precise densitometric pass, alignment of the marker bands with the standard, optional interactive editing, and normalization of the accepted bands. PMID- 2720460 TI - A new interactive protein sequence alignment program and comparison of its results with widely used algorithms. AB - A computer program that allows interactive sequence comparison is described. It graphically displays a search matrix using residue physiochemical characteristics and multilength segmental comparisons. The user selects through a mousing device and screen pointer the sequence spans to be matched. The results of this method are compared with those of ALIGN and BESTFIT. PMID- 2720461 TI - A fast and sensitive multiple sequence alignment algorithm. AB - A two-step multiple alignment strategy is presented that allows rapid alignment of a set of homologous sequences and comparison of pre-aligned groups of sequences. Examples are given demonstrating the improvement in the quality of alignments when comparing entire groups instead of single sequences. The modular design of computer programs based on this algorithm allows for storage of aligned sequences and successive alignment of any number of sequences. PMID- 2720462 TI - A test for the statistical significance of DNA sequence similarities for application in databank searches. AB - A method is developed, based on word-searching, which provides a rapid test for the statistical significance of DNA sequence similarities for use in databank searching. The method makes allowance for the lengths and dinucleotide compositions of the sequences being compared. A way is also described to calculate the power of the test, i.e. the probability of detecting a given similarity as being statistically significant. The effects on the power of the test of the scoring method, word length, sequence length, and sequence composition are examined. A novel scoring method is shown to be superior to the method currently used in most word-searching algorithms. PMID- 2720463 TI - A BASIC program for the removal of noise from reaction traces using Fourier filtering. AB - Software for the removal of noise from reaction curves using the principle of Fourier filtering has been written in BASIC to execute on a PC. The program inputs reaction traces which are subjected to a rotation-inversion process, to produce functions suitable for Fourier analysis. Fourier transformation into the frequency domain is followed by multiplication of the transform by a rectangular filter function, to remove the noise frequencies. Inverse transformation then yields a noise-reduced reaction trace suitable for further analysis. The program is interactive at each stage and could easily be modified to remove noise from a range of input data types. PMID- 2720464 TI - Fast and sensitive multiple sequence alignments on a microcomputer. AB - A strategy is described for the rapid alignment of many long nucleic acid or protein sequences on a microcomputer. The program described can handle up to 100 sequences of 1200 residues each. The approach is based on progressively aligning sequences according to the branching order in an initial phylogenetic tree. The results obtained using the package appear to be as sensitive as those from any other available method. PMID- 2720465 TI - GELENT: a sequence gel entry program for keyboard and sonic digitizer input. AB - A program is described for sequence data entry which allows flexible program control by responding to both the keyboard and a sonic digitizer concurrently. Simplification of the initialization stage of each gel reading has been achieved, in comparison with other programs. PMID- 2720466 TI - ANTHEPROT: IBM PC and Apple Macintosh versions. PMID- 2720467 TI - A BASIC microcomputer program for data analysis of limiting dilution assays. PMID- 2720468 TI - Methods for calculating the probabilities of finding patterns in sequences. AB - This paper describes the use of probability-generating functions for calculating the probabilities of finding motifs in nucleic acid and protein sequences. Equations and algorithms are given for calculating the probabilities associated with nine different ways of defining motifs. Comparisons are made with searches of random sequences. A higher level structure--the pattern--is defined as a list of motifs. A pattern also specifies the permitted ranges of spacing allowed between its constituent motifs. Equations for calculating the expected numbers of matches to patterns are given. PMID- 2720470 TI - Gerontologic considerations. PMID- 2720469 TI - New analytical tool for analysis of splice site sequence determinants. AB - A new analytical method has been used to examine the set of 40 exon/intron boundaries within the rat embryonic myosin heavy chain (MHCemb) gene. It has also been applied to an additional set of 850 splice sequences selected from GenBank. Strong evidence is obtained for the involvement of 3' ends but not 5' ends of exon sequences in splice site recognition. It can be determined that signal sequences of 5' intron ends concentrate near the splice borders, while the distributions of the 3' intron ends have a diffuse character. The possibility of re-interpreting some known features, in terms of the absence of certain elements rather than the presence of elements forming sequence determinants, is discussed. The analysis undertaken enabled us to work out a more detailed set of recognition sequence requirements for the splicing of nuclear pre-mRNA. In addition to requirements which have already been established we suggest the following: the 'AG-absence' in the immediate 3' terminal intron sequences; and a minimal match between a particular sequence and the known exon/intron consensus sequence of 5' splice junctions. PMID- 2720471 TI - Physical environment of the intensive care unit and elderly patients. PMID- 2720472 TI - The decision-making process in critical care of the aged. AB - Nurses in a critical care setting are challenged daily to provide safe, effective quality care for elderly patients. The decision process underlying this care is complex because of the amount, diversity, and uncertainty of information that must be processed. Some variables associated with the client, the nurse, and the critical care environment are irrelevant to the decision process, yet continue to influence nurses' decision making. Suboptimal and erroneous diagnoses and interventions may result. Awareness of factors that adversely affect decision making should assist nurses in enhancing their information processing. Use of objective and systematic decision-making techniques also can improve the efficiency and quality of decision making in the critical care of aging people. PMID- 2720474 TI - Essential features of successful epidemiology. PMID- 2720473 TI - Ration or rescue: the elderly patient in critical care. AB - 1. Persons who require the intensive interventions of critical care units enter with a contract of trust. They place their well-being, and often their lives in the hand of caregivers. To respect that trust by the most vigorous effort is a moral responsibility. 2. It is not the task of the practitioner in critical care to evaluate the social worth of the patient. Judgments as to the quality of life of individual patients are inappropriate and unsupportable and should never be used as a rationale for withholding or withdrawing essential care. 3. The decisions for introducing treatments should be based (as they have been historically) on the physician's evaluation of the patient's condition and the consequent appropriate interventions. The interference of third party payers in this clinical relation in which therapeutic decisions are dictated by cost or any other extraneous factors is morally repugnant. 4. Life or death decisions are not properly those of caregivers and should never be left to those whose mission is to protect life and relieve suffering. Decisions to use extraordinary means of sustaining life processes should be made in advance of the actual events by the informed wisdom of the physician whenever possible. The caregivers--physicians and nurses-should bring all their skills to bear to alleviate suffering, but that does not include hastening the death of another human being. PMID- 2720475 TI - Sex differences in the periodontal status of Hong Kong adults aged 35-44 years. AB - Epidemiological studies on periodontal diseases conducted in many countries employing different indices have generally shown advanced periodontal destruction to be more prevalent in adult males than in adult females. The 1984 Hong Kong survey of adult oral health, using the Community Periodontal Index of Treatment Needs (CPITN) to determine periodontal status, revealed that in males aged 35 to 44 years the prevalence of deep pockets was 23 per cent, compared with 9 per cent in females (P less than 0.01). Males had a mean of 0.4 sextants with deep pockets whereas females had a mean of only 0.1 sextants so affected (P less than 0.01). Females were found to have a significantly larger proportion of healthy sextants (P less than 0.01). The observed sex difference in disease prevalence may have been influenced by the fact that fewer teeth were present in the females, but it could not be explained by differences in reported oral hygiene measures and practices. PMID- 2720476 TI - The number of children, use of oral contraceptives and menopausal status in relation to the number of remaining teeth and the periodontal bone height. A population study of women in Gothenburg, Sweden. AB - A representative sample of urban women in Gothenburg, Sweden was examined for proximal periodontal bone heights and the number of teeth remaining. The results were studied in relation to the number of children borne, the use of oral contraceptives and the menopausal state. There was an increased risk of being edentulous with an increased number of children borne. This was also obvious when socio-economic status was taken into consideration. Edentulousness was most common among those women in the lowest socio-economic group who had given birth to many children. No significant difference in the number of remaining teeth was observed between current or previous users of oral contraceptives on the one hand and women who had never used them on the other. No significant differences were observed between premenopausal and postmenopausal women as regards the number of remaining teeth. The values for proximal periodontal bone heights showed no statistically significant differences for any of the conditions studied. PMID- 2720477 TI - Potential benefits of toothpaste advertising on dental health. AB - This paper considers the effect of advertising on the sales of various brands of toothpaste. It has attempted to investigate the relationship between the level of sales of a brand and those of its competitors. Econometric estimations of the demand-function for toothpaste have been made and the authors have tried to determine the interrelationships between advertisement and toothpaste sales. The findings cast doubt upon the efficiency of the present system of competitive advertisement and suggest a possible alternative approach to the marketing of toothpaste which could increase sales and, at the same time, beneficially influence dental health. PMID- 2720478 TI - CNA candidates' statements of interest. PMID- 2720479 TI - Repair of a false aneurysm of the aortic arch. AB - A 66-year-old man having previously undergone repair of aneurysms of the ascending, transverse and infrarenal aorta, presented with a large false aneurysm of the aortic arch. Successful repair of the aneurysm was achieved under a state of profound hypothermia and circulatory arrest. The patient remains well and free from aortic aneurysmal disease two years after surgery. PMID- 2720480 TI - Atrioventricular nodal tachycardia in the absence of retrograde conduction. AB - A patient with atrioventricular (AV) nodal reentrant tachycardia assessed by electrocardiographic and electrophysiological criteria is described. During ventricular pacing, retrograde conduction was absent at the longest cycle length tested with the site of block determined to be the AV node by concealed conduction criteria. These findings localize the tachycardia circuit above the His bundle and exclude a His-atrial bypass tract as the retrograde limb of the tachycardia circuit in this patient. PMID- 2720481 TI - Death following coronary angiography in a young woman with isolated left coronary ostial stenosis. AB - A 35-year-old woman with angina of five years duration underwent elective cardiac catheterization and coronary angiography which revealed left main stenosis. Immediately afterwards, the patient became distressed, hypotensive and bradycardic. She died despite emergency percutaneous transluminal coronary angioplasty and resuscitative efforts. Autopsy confirmed isolated left coronary ostial stenosis due to the combination of a congenital abnormality of the ostium and initial segment of left main coronary artery, together with a superimposed myointimal flap bridging the ostium. A unique association was an abnormal configuration of the ostia of the branches of the aortic arch. PMID- 2720483 TI - School nurses and their computers. PMID- 2720482 TI - Oxidant injury to isolated heart cells. AB - Recent evidence suggests that free radicals are generated in the heart during the reperfusion which follows ischemia. Intracellular accumulation of calcium has been postulated to be an important pathogenic factor in a number of disease states, including reperfusion injury. Therefore, in this study, the effects of various oxidants on calcium uptake by isolated rat heart cells were investigated. Ammonium persulphate, t-butyl hydroperoxide and phenazine methosulphate increased the number of cells in contracture in both a concentration dependent and time dependent manner, while 45Ca content of cardiomyocytes was decreased by oxidant in proportion to its concentration. Carbonyl cyanide m-chlorophenyl-hydrazone (CCCP) dependent (mitochondrial) and CCCP independent (sarcoplasmic reticulum) 45Ca contents in chemically skinned myocytes were reduced by the oxidants. By contrast, hydrogen peroxide raised 45Ca content of cardiomyocytes and did not reduce sarcoplasmic reticulum 45Ca content, although mitochondrial 45Ca content was decreased. Release of 45Ca from mitochondria and sarcoplasmic reticulum in saponin treated myocytes was accelerated by hypochlorous acid and hydrogen peroxide. The authors conclude that oxidants other than hydrogen peroxide inhibited intracellular uptake of calcium and accelerated calcium release, thus raising the cytosolic calcium concentration and causing cell contracture. The net influx of calcium across sarcolemmal membrane was decreased by these oxidants. PMID- 2720484 TI - One nurse's transfer to hospital information services. AB - This first article of a series details a personal account of a career change within the nursing profession. Through her own reflections and analysis, the evolution of a psychiatric clinical nurse specialist into an information services nurse liaison is traced and detailed from its beginning. The motivation for and difficulties in seeking such a drastic change are explored. Readers are invited to share the experiences of a nurse who takes a risk and ventures into the complex and completely different world of data processing while trying to maintain her identity as a nurse. PMID- 2720485 TI - Transferring documents from one system to another. AB - This article describes the technical and practical problems and advantages of transferring documents from one computer operating system to another. Nurses who are placed in situations that demand the use of different computers will find this information useful. The article provides general guidelines and suggests troubleshooting procedures. PMID- 2720486 TI - Use of a statewide Maternal and Child Health Information Network. AB - The Maternal and Child Health Information Network (MATCH) contains numerous data elements. The process of converting these data into information is an essential component of comprehensive management information system planning. This process must address not only the end-user mechanics of data retrieval, but also the framework for how data can be used in program administration. Although potential data use contributes to and may in fact drive system design, the reality of integrating computer and data usage into daily activities presents a different set of challenges in system implementation. For both state and local end-users, barriers to system use had to be addressed. In terms of directing system use, it was helpful to provide a format for categorizing data needs. The broad categories of data needs identified for program administration were planning, research, evaluation, management, and collaboration. Numerous initiatives have evolved for each of these categories. PMID- 2720487 TI - Graduate specialization in nursing informatics. AB - This article describes the need and rationale for developing nursing informatics as a new area of graduate level specialization. Included are the results of a comprehensive needs assessment study that was conducted to determine the employment opportunities for graduates of such a program of study as well as the potential student applicant pool. The findings clearly indicate the immediate and future demand for master's prepared nurses in this field and the importance of a timely academic response. PMID- 2720488 TI - Desktop publishing. PMID- 2720489 TI - A comparison of the methyl reductase genes and gene products. AB - The DNA sequences encoding component C of methyl coenzyme M reductase (mcr genes) in Methanothermus fervidus, Methanobacterium thermoautotrophicum, Methanococcus vannielii, and Methanosarcina barkeri have been published. Comparisons of transcription initiation and termination sites and of the amino acid sequences of the mcr gene products are presented. Structural features conserved within the amino acid sequences are identified and a comparison of methyl reductase with other disulfide bond synthesizing enzymes is presented. PMID- 2720490 TI - Origin of the eukaryotic nucleus: eukaryotes and eocytes are genotypically related. AB - The origin of the eukaryotic nucleus is difficult to reconstruct. While eukaryotic organelles (chloroplast, mitochondrion) are eubacterial endosymbionts, the source of nuclear genes has been obscured by multiple nucleotide substitutions. Using evolutionary parsimony, a newly developed rate-invariant treeing algorithm, the eukaryotic rRNA genes are shown to have evolved from the eocytes, a group of extremely thermophilic, sulfur-metabolizing, anucleate cells. The deepest bifurcation yet found separates the reconstructed tree into two taxonomic divisions. These are a proto-eukaryotic group (karyotes) and an essentially bacterial one (parkaryotes). Within the precision of the rooting procedure, the tree is not consistent with either the prokaryotic--eukaryotic or the archaebacterial--eubacterial--eukaryotic groupings. It implies that the last common ancestor of extant life, and the early ancestors of eukaryotes, very likely lacked nuclei, metabolized sulfur, and lived at near boiling temperatures. PMID- 2720492 TI - Biosynthesis of pseudomurein: isolation of putative precursors from Methanobacterium thermoautotrophicum. AB - In aqueous trichloroacetic acid extracts of Methanobacterium thermoautotrophicum the following compounds, which are supposed to be precursors in the biosynthesis of the glycan strand of the pseudomurein, were isolated and identified: (i) a disaccharide (compound II) composed of uridine 5'-diphosphate, N acetylglucosamine and N-acetyltalosaminuronic acid with N-acetylglucosamine at the reducing end, (ii) uridine 5'-diphospho-N-acetylglucosamine, and (iii) uridine 5'-diphospho-N-acetylgalactosamine. However, the corresponding monomeric derivative of N-acetyltalosaminuronic acid could not be detected. It is assumed that N-acetyltalosaminuronic acid may be formed from N-acetylgalactosamine by epimerisation and oxidation at the disaccharide level. These findings indicate that the biosynthetic pathways of murein and pseudomurein are quite different. PMID- 2720491 TI - The expression of the superoxide dismutase gene in Halobacterium cutirubrum and Halobacterium volcanii. AB - The gene encoding the Mn-containing superoxide dismutase (SOD) from Halobacterium cutirubrum has been cloned and sequenced. The deduced amino acid sequence is homologous to the sequences of Fe and Mn SODs from eubacteria. The high degree of amino acid identity between the archaebacterial and eubacterial proteins suggests that a SOD gene may have been laterally transferred between eubacteria and archaebacteria sometime after the accumulation of atmospheric oxygen. Consensus elements of halobacterial promoters are found upstream of the coding region, however, the spacing between them and the transcription start site is greater than in other genes. Termination of transcription occurs in five consecutive T residues that are preceded by a GC-rich sequence that has short inverted repeats. In addition to the authentic SOD gene, H. cutirubrum also contains a putative pseudogene. The SOD levels and growth rates of H. cutirubrum and Halobacterium volcanii were tested in response to treatment by paraquat, an intracellular generator of superoxide. In H. volcanii the growth rate slowed, and SOD was strongly induced throughout prolonged treatment with paraquat. In H. cutirubrum the same effects were noticed initially, but after 48 h exposure to the drug, the growth rate increased and the SOD level decreased. Production of paraquat resistant mutants of H. cutirubrum may play a part in this process, however, some type of physiological adaptation is also probably required. PMID- 2720493 TI - Expression and regulation of Halobacterium halobium phage phi H genes. AB - In this paper we describe five distinct modes of phi H gene expression: (i) transcription of phage phi H during lytic growth on the sensitive host bacterium (Halobacterium halobium strain R1); (ii) transcription of the circularized prophage phi H1 in strain R(1)24; (iii) transcription of the L region of phi H present as 12-kilobase-plasmid in the immune strain R1L; (iv) transcription during the lytic growth of phage mutants containing an ISH23/50 in the immune strain R1L; (v) transcription during lytic growth of ISH23/50-insertion mutants in the sensitive host bacterium R1 showing enhancement of early transcripts. The sequential expression of the phage genome is described together with a detailed analysis of the transcription of early lytic, constitutive, and immune genes that map in the L region. The putative promoter sequences determined for several phage genes were compared with the upstream sequences of the H. halobium DNA-dependent RNA polymerase large subunit genes and with the gene for the ribosomal protein S12 homolog of H. halobium. The similarity of these putative promoter elements revealed conserved motifs that are discussed in relation to the TATA-box motif recognized by the eukaryotic DNA-dependent RNA polymerase II. PMID- 2720494 TI - Halobacterium sp. GRB: a species to work with!? AB - The properties of the halobacterial isolate Halobacterium sp. GRB are discussed, especially in relation to its use as a laboratory strain. Experimental results on this species are described, including the isolation of point mutants in the bacterioopsin gene leading to single amino acid replacements in bacteriorhodopsin, the application of a selection procedure for the isolation of different types of mutants, the genetic stability of Halobacterium sp. GRB and the possibility of isolating a set of isogenic mutants, the conditions for transformation experiments with this species, and specific features of Halobacterium sp. GRB, such as halocin production and the absence of a restriction system, as well as DNA adenosine methylation. PMID- 2720495 TI - Characterization of the small endogenous plasmid of Halobacterium strain SB3 and its use in transformation of H. halobium. AB - To study the molecular biology of the halophilic archaebacterium Halobacterium halobium, the introduction of DNA engineered in vitro is desirable. As a first step in developing a cloning vector, the complete 1736 base pair nucleotide sequence of the natural, high copy number, Halobacterium plasmid pHSB1 has been determined. The plasmid was found to show homology to the small plasmids of Halobacterium strains GRB and GN101. Plasmid pHSB1 encodes a 317 amino acid protein of unknown function. The related halophile, H. halobium, could be transformed by pHSB1, demonstrating its utility as the basis of a cloning vector. PMID- 2720496 TI - Isolation and partial characterization of plasmids found in three Halobacterium volcanii isolates. AB - Three new isolates of Halobacterium volcanii were screened for the presence of plasmids. Each of the different isolates was found to contain one plasmid. These plasmids do not show any homology to each other, nor to the previously isolated plasmid pHV2. Partial restriction maps of these plasmids were determined. One of the plasmids contains chromosomal repetitive sequences as judged by the existence of homologous sequences in the chromosomal DNA of the three isolates. Using the protoplast fusion technique, we showed that at least one of the newly isolated plasmids is compatible with pHV2. PMID- 2720497 TI - Medicolegal issues in CPR. PMID- 2720498 TI - Euthanasia in the Netherlands. PMID- 2720499 TI - UFOs and cancer? PMID- 2720500 TI - Fitness to drive and emotional disorders. PMID- 2720501 TI - Disparaging capital account. PMID- 2720502 TI - Tobacco use in health care institutions. PMID- 2720503 TI - Treatment of premenstrual syndrome. PMID- 2720504 TI - Medicine in Uganda. PMID- 2720505 TI - Low-risk obstetrics. PMID- 2720506 TI - Waterbeds and dyspepsia. PMID- 2720507 TI - Acute pancreatitis associated with HIV infection [correction]. PMID- 2720508 TI - Licensure: competence to do what? [correction]. PMID- 2720509 TI - Parkinson's disease. PMID- 2720510 TI - Treatment of parasitic infections: Canadian versus US recommendations [correction]. PMID- 2720511 TI - The crisis in staffing neonatal intensive care units: a taste of things to come? PMID- 2720512 TI - Medical devices labelled for single use: the reuse of permanent cardiac pacemakers. PMID- 2720513 TI - A vision of health in the 21st century: medical response to the greenhouse effect. PMID- 2720514 TI - Case-control study of hydrocarbon exposures in patients with renal cell carcinoma. AB - A retrospective case-control study tested the hypothesis that exposure to hydrocarbon combustion products is associated with the development of renal cell carcinoma. One control per case, matched for sex, date of birth (within 5 years) and urologist, was chosen. Controls were patients who presented with hematuria and were shown not to have a urinary tract tumour. A total of 164 cases and 161 controls responded to mailed questionnaires and telephone interviews. Smoking more than 20 cigarettes per day was associated with the presence of metastatic renal cell carcinoma (p less than 0.001). Exposure to burning coal was associated with an increased relative risk of the disease but only when the exposure occurred between the ages of 10 and 24 years (p less than 0.05). Dose-response relations were demonstrated for intensity of exposure (p less than 0.025) and duration of occupational exposure (p less than 0.05). The distribution of latent periods from first exposure to diagnosis was bimodal, with one mode at 21 to 30 years and another at 41 to 50 years. Occupational exposure to tar or pitch or both was also associated with an increased relative risk of renal cell carcinoma (p less than 0.05). PMID- 2720516 TI - Parasitology: diagnostic yield of stool examination. AB - To assess the need for routinely submitting three stool samples per patient for recovery of enteric parasites, we reviewed the records of our parasitology laboratory for 1985-87 to determine the number of parasites that would not have been detected if only one or two samples had been submitted. A total of 16% of all stool samples were positive. For each sample that was positive for a parasite (index sample) a search was done for other stool samples, positive or negative, received from the same patient within 6 days of reception of the index sample. We identified 676 sets of two (276) or three (400) samples of which at least 1 was positive. A total of 93% of the enteric parasites were detected in the first sample in the two-sample sets. Among the three-sample sets 90% of the parasites were detected in the first sample, 8% in the second and 2% in the third. We recommend waiting for the result from the first stool sample rather than routinely submitting three samples for recovery of enteric parasites. PMID- 2720515 TI - Medical staffing in Ontario neonatal intensive care units. AB - Advances in technology have improved the survival rates of infants of low birth weight. Increasing service commitments together with cutbacks in Canadian training positions have caused concerns about medical staffing in neonatal intensive care units (NICUs) in Ontario. To determine whether an imbalance exists between the supply of medical personnel and the demand for health care services, in July 1985 we surveyed the medical directors, head nurses and staff physicians of nine tertiary level NICUs and the directors of five postgraduate pediatric residency programs. On the basis of current guidelines recommending an ideal neonatologist:patient ratio of 1:6 (assuming an adequate number of support personnel) most of the NICUs were understaffed. Concern about the heavy work pattern and resulting lifestyle implications has made Canadian graduates reluctant to enter this subspecialty. We propose strategies to correct staffing shortages in the context of rapidly increasing workloads resulting from a continuing cutback of pediatric residency positions and restrictions on immigration of foreign trainees. PMID- 2720517 TI - Non-OI vibrio cholerae septicemia associated with a motor vehicle accident. PMID- 2720518 TI - Canadian Indians to have own AIDS-education strategy. PMID- 2720519 TI - Quebec's hunger-striking MDs: do FMGs automatically have right to practise? PMID- 2720520 TI - In the Barakai camp there is little life, little hope. PMID- 2720521 TI - Physician-authors: doctors take aim at a healthy market. PMID- 2720522 TI - A portrait of the doctor and his word processor. PMID- 2720523 TI - Memorial's dramatic dean: can drama help medical students learn? PMID- 2720524 TI - Washington Basic Health Plan a first in US health insurance. PMID- 2720525 TI - Eligibility for CPR: is every death a cardiac arrest? PMID- 2720526 TI - Determinants of practice patterns. PMID- 2720527 TI - Iodine in the diet. PMID- 2720528 TI - Sterilization: Canadian choices. PMID- 2720529 TI - Residents' workloads: whose responsibility? PMID- 2720530 TI - Cyclosporine-induced deterioration in patients with AIDS. AB - Eight patients with AIDS (acquired immune deficiency syndrome) but free of life threatening infection were treated with the immunosuppressive drug cyclosporine for a mean of 53.9 days. The serum cyclosporine levels were maintained in the desired therapeutic range. All eight patients experienced severe toxic symptoms, which necessitated discontinuation of cyclosporine therapy in six. The serum levels of creatinine, urea and potassium rose during treatment and fell after therapy was stopped. The total leukocyte count, hemoglobin level, platelet count, total T-cell count, and T4- and T8-cell counts all fell markedly during treatment. The total leukocyte count, platelet count, and T4- and T8-cell counts rose after therapy was stopped, but the hemoglobin level remained low. No patient experienced resolution of symptoms during therapy, and the condition of all patients improved after treatment was stopped. The results of this pilot study indicate that cyclosporine does not alleviate, and may worsen, the symptoms and laboratory findings in patients with AIDS. PMID- 2720531 TI - Atherosclerosis and diabetes mellitus. PMID- 2720532 TI - US health care: another Canadian sends a message home. PMID- 2720533 TI - Contracts of employment for locums: the legal implications. PMID- 2720534 TI - Forty years of federal support for public health research through the Department of National Health and Welfare. AB - This paper traces: (a) the development, to the present day, of federal support for public health research in Canada, from its early beginnings under the Public Health Research Grant in 1948, and since 1975 through the National Health Research and Development Program (NHRDP); and (b) the influence that "New Perspectives" (1974) and "Achieving Health For All" (1986) have had on the evolution of the program. Other initiatives taken by the federal government during the past 40 years related to health/medical research in Canada are also indicated. Current NHRDP programs and policies are described, as are the mechanisms used by the NHRDP to fulfill its mandate for stimulating research in areas related to national health objectives. PMID- 2720535 TI - Hospital bed availability: developing accurate estimates. AB - Bed population ratios have long been used by health planners as a method of estimating resource availability to community residents. In Canada's tertiary care urban centres, it is recognized that these bed population ratios are misleading because so many beds in both tertiary care and community hospitals are occupied by patients referred from other areas. This paper illustrates a method for calculating bed population ratios based on actual number of hospital beds used by area residents, regardless of where this usage takes place, and regardless of whether this usage is based on in-patient or out-patient admissions. Since the information required for making these calculations is available to provincial insurance systems across Canada, this technique should have wide applicability. PMID- 2720536 TI - Nurses' preparedness for health promotion through linkage with mutual-aid self help groups. AB - This descriptive study of a sector of the Canadian nursing population aimed to identify attitudes, knowledge, and roles regarding mutual-aid self-help groups. Questionnaires were mailed to 200 randomly selected hospital nurses and to all 177 community health nurses working in the Nova Scotia metropolitan centre; 74 completed questionnaires were returned. Only half of the respondents considered themselves educationally well prepared for work with self-help groups. Almost all respondents viewed their relevant level of knowledge as only fair, and the most commonly cited reason for non-referral was lack of information. Most desired pertinent inservice training, a directory and continuing-education sessions. Twice as many nurses attended group meetings to increase their familiarity with groups as served initiator, speaker, consultant or non-professional member roles. The majority held positive attitudes regarding the effectiveness, merits and functions of lay help groups, professional linkage with self-help groups and future personal involvement. Reoriented educational mechanisms were recommended to overcome knowledge deficits. PMID- 2720537 TI - Referral continuity between private and public health care for the patient under 18 in the Montreal metropolitan region. AB - One of the objectives of the health and social services reform launched in Quebec in the early 70s was to achieve continuity between the public and the private sector. This study focuses on specific aspects of continuity, namely referral continuity as measured by the degree to which physicians refer to public health resources in the care they provide to patients under 18, as well as their perception of these resources. A telephone survey conducted in February, 1984 gathered information on the way Montreal general practitioners and pediatricians use other medical, paramedical and public health resources. The findings indicate that the objective of continuity has not been fully achieved. Among the factors which explain such results are the lack of communication between the two sectors and the perception by physicians that these other resources, especially CLSCs, offer competitive rather than complementary services. Such a view constitutes a major constraint to the effective and efficient coexistence of the private and public sectors in a medical care system. PMID- 2720538 TI - Sex-specific trends in suicide method, Canada, 1971-1985. AB - Between 1971 and 1985, sex-specific suicide rates in Canada have diverged, with male rates increasing and female rates decreasing. Using linear regression techniques, we examined changes in sex- and method-specific rates and their association with changes in overall sex-specific rates. 92% of the variability in the overall female rates was explained by the declining rate for poisoning by solid or liquid substances. The most important change for males was the increasing rate for hanging, strangulation and suffocation which explained 65% of the change in the overall rate. PMID- 2720539 TI - [The Anti-Tobacco Law in the hospital: perception of employees]. PMID- 2720540 TI - The use of chewing tobacco and snuff in Canada, 1986. AB - This paper reviews current data relating to the use of smokeless tobacco products in Canada. Sources of data include production, disposition, and sales statistics; special population surveys, and estimates obtained from the 1986 Labour Force Survey smoking supplement. In Canada, the use of smokeless tobacco products is confined to the male population. About 0.7% of males over age 15 use chewing tobacco and 0.4% use snuff. The pattern of use is similar to that of the United States in the early 70s. Prevalence rates for both substances tend to be higher in older age groups. Men employed in outdoor occupations are more likely to use chewing tobacco or snuff. Chewing tobacco use tends to be more prevalent in eastern Canada and snuff use in western Canada. The low national prevalence estimates conceal the relatively high usage rates among sub-populations. Among Inuit youth in the Northwest Territories in 1982, 25% of the 10-14 age group used smokeless tobacco. PMID- 2720541 TI - Assessment of Ontario's Geriatric Preventive Dentistry Program. AB - Ontario's Geriatric Preventive Dentistry Program (mandated under the Health Protection and Promotion Act) is assessed using the rational comprehensive approach. Policy options are examined, taking into account population characteristics, the nature of the health problem, current service delivery policy and resources, and barriers to access. Examining the 1974 Task Force recommendations, sets of draft guidelines issued in 1982, 1983, and 1984, and the revised 1985 guidelines as implemented, one can note changes in the benefits offered and in eligibility for coverage. The final program appears to be largely a symbolic policy response, which is unlikely to have major implications for either efficiency or community effectiveness. Implications of the current program, including the possibility it may be a precursor to more effective policies, are noted. PMID- 2720542 TI - Estimating the burden of illness in an Ontario community with untreated drinking water and sewage disposal problems. AB - The Hamilton-Wentworth regional health department was asked by one of its municipalities to determine whether the present water supply and sewage disposal methods used in a community without piped water and regional sewage disposal posed a threat to the health of its residents. Three approaches were used: assessments by public health inspectors of all households; bacteriological and chemical analyses of water samples; and completion of a specially designed questionnaire by residents in the target community and a control community. 89% of the 227 residences in the target community were found to have a drinking water supply that, according to the Ministry of Environment guidelines, was unsafe and/or unsatisfactory. According to on-site inspections, 32% of households had sewage disposal problems. Responses to the questionnaire revealed that the target community residents reported more symptoms associated with enteric infections due to the water supply. Two of these symptoms, diarrhea and stomach cramps, had a relative risk of 2.2 when compared to the control community (p less than 0.05). The study was successfully used by the municipality to argue for provincial funding of piped water. PMID- 2720543 TI - Age, period and cohort effects on suicide: a reply. PMID- 2720544 TI - Dental knowledge and behaviour in native children living in northern Saskatchewan. PMID- 2720545 TI - Community empowerment: the need for political analysis. PMID- 2720546 TI - The changing role of nurses: the perspective of Medical Services Branch. PMID- 2720547 TI - Acid haze air pollution and breast and colon cancer mortality in 20 Canadian cities. AB - Sulfur dioxide absorbs ultraviolet light in the region of the spectrum which is most active in forming vitamin D on the skin. Sulfate particles reflect light at this wavelength. High concentrations of these pollutants (acid haze) may lead to vitamin D deficiencies in exposed populations. Epidemiologic and laboratory evidence suggests that vitamin D plays a role in reducing risk of colon and breast cancer. We examined the association between sulfur dioxide and ultraviolet light-blocking aerosols in 20 Canadian cities, and age-adjusted breast and colon cancer mortality rates in the census divisions encompassing these cities. Statistically significant positive associations were found between these two measures of air pollution and age-adjusted mortality rates for colon cancer in women (multiple r = +.74, p = 0.003), and men (multiple r = +.61, p = 0.03), and breast cancer in women (multiple r = +.69, p = 0.007). Mortality rates for all other reported cancer sites were also examined, and no statistically significant positive associations were found consistently in both sexes. The ecological nature of this study is emphasized, and the possibility that an indirect association could explain these findings is discussed. PMID- 2720548 TI - Immunobiology of IgE. PMID- 2720549 TI - Suicide notes in adolescence. AB - Suicide rates for adolescents have shown a substantial increase over the past 30 years, but there is little information regarding the clinical status of adolescents who end their lives. In the adult literature, one avenue to understanding the psychologic condition immediately prior to the self-destructive act has been the study of suicide notes, and the present study constitutes the first systematic investigation of notes left by children or adolescents. Records of death were examined in the Office of the Coroner, City of Montreal, and all suicides between ages 10 and 20 were identified for the years 1978 to 1982. Seventeen individuals who left notes were identified, comprising 10% of the population of suicides. Suicides who left notes did not differ from the total group in age and sex distribution but were more likely to choose shooting as a method. The content of the notes was studied in terms of 11 variables which had proven characteristic of suicide notes in the adult literature, and the results were compared to those reported for adults. In general, our results support a psychoanalytic perspective which understands suicide as resulting from an ambivalent attachment to an object, loss of the object, internalization, and the direction of aggression against the self. Cases appeared to fall into two clusters. Older adolescents were more concrete, left specific instructions, did not address the note, did not give a reason for the act, and tended to choose intoxication as a method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720550 TI - Psychiatry training and research. AB - There is a growing concern that residents in psychiatric training programs may not be receiving an adequate exposure to the principles of research. This paper examines the need for such exposure and outlines a framework wherein the fundamentals of clinical research could be demonstrated to the resident physician. PMID- 2720551 TI - The homeless mentally ill and the need for a total care environment. AB - The dual conditions of homelessness and Serious mental illness are examined in a group of 132 former patients of a state hospital. A naturalistic approach was used in a six-month longitudinal Study that focused on the uniqueness and distinctiveness of a homeless existence. A more total care environment that recognizes a continuous service approach is necessary to meet the challenges presented by this population. PMID- 2720552 TI - Violent behaviour and psychiatric diagnosis in female offenders. AB - This retrospective study attempts to describe a cohort of female offenders admitted to the Forensic Unit at St. Thomas Psychiatric Hospital between January 1981 and December 1985. During this period there were 91 female admissions; 47 were sent from courts on a Warrant of Remand for psychiatric assessment, 30 under the Warrant of the Lieutenant Governor, 5 under Probation Orders, and the remaining 9 were sent from prison or a detention centre after assessment by a physician. The study has yielded some interesting findings with respect to the relationship between violent crime and particular psychiatric diagnoses, age at admission and type of crime committed, and age at admission and psychiatric diagnoses. We found that an early age of onset of criminal behaviour tends to be associated with personality disorder, while women over 30 were often diagnosed as having a psychotic disorder. We did not, however, find any association between age at first crime and age at index admission with the type of crime committed. PMID- 2720553 TI - A psychiatric intensive care unit in a psychiatric hospital. AB - This paper describes the operation of a psychiatric intensive care unit in a provincial psychiatric hospital. Its introduction led to a decrease in staff and patient accidents, a decrease in constant observation and seclusion hours, and a decrease in the number of nursing hours lost to injuries at work. It had no effect on nursing absenteeism. The ICU was well liked by nursing staff who preferred to work in its more consistent and controlled environment. In addition, it was also felt that the ward environment in other parts of the hospital became more therapeutic. We therefore conclude that psychiatric ICU's are useful additions to psychiatric settings with important cost and patient care implications. PMID- 2720554 TI - The inability to name a child. AB - A patient, whose presenting complaint is the inability to decide on a name for her child, is presented. A review of the literature on the significance of names is included, and comments are made on panelists from psychoanalytic and phenomenological perspectives. Management of the patient's depression is discussed. PMID- 2720555 TI - Rebound psychoses following the discontinuation of a high potency neuroleptic. AB - Increased familiarity with the effects of psychotropic medications has led to modifications in both prescribing habits and length of treatment. The case of a 34 year old woman is presented, in whom the return of psychotic symptoms following the discontinuation of neuroleptic medications is attributed to a rebound phenomena as opposed to a relapse of an underlying chronic illness. The author cites parallel situations previously described in the medical literature and outlines a conceptual framework for the understanding of this phenomenon. PMID- 2720556 TI - Sexual exploitation of patients. The position of the Canadian Psychiatric Association. PMID- 2720557 TI - [Psychiatric consultations in a general hospital (III): Positions of the consultant]. AB - Various clinical situations are described to illustrate the specific psychological assumptions toward which the psychiatric consultant is drawn in the course of daily liaison work in the general hospital. The purpose is to stress the usefulness and relevance of hitherto known models of consultation and models of patient-doctor relationships. PMID- 2720558 TI - Psychiatric acute observation unit. PMID- 2720559 TI - Hyperzincuria and hypozincemia in patients treated with cisplatin. AB - The effect of cis-diamminedichloroplatinum (DDP) on plasma and urinary zinc was studied in fifteen patients with squamous cell carcinoma. A decrease in plasma zinc accompanied by an increase in urinary zinc excretion was observed. Pretreatment plasma or urinary zinc did not correlate with tumor size or site, nor was there a correlation between changes in these measurements and a response to therapy. The enhanced excretion of urinary zinc may be related to a decrease in amino acid resorption in the proximal tubule. It is concluded that DDP administration may result in hyperzincuria and could potentially precipitate a symptomatic zinc deficiency state. PMID- 2720560 TI - Hepatic arterial infusion of human recombinant tumor necrosis factor-alpha. An experimental study in dogs. AB - Local and systemic toxicities associated with hepatic arterial infusion of human recombinant tumor necrosis factor (rTNF) were studied in healthy adult mongrel dogs. The animals received saline containing human serum albumin with or without rTNF (0.02, 0.2, or 2.0 mg/m2). Arteriograms were made, and blood samples were collected for hematologic and biochemical analyses at regular intervals. The dogs were killed at 1, 3, and 7 days postinfusion and complete necropsies were performed. Specimens were obtained from various tissues for histopathologic evaluation. Results indicated that all but the highest dose of rTNF were well tolerated. Severe histopathologic changes were found in the liver, spleen, and kidneys of the animals receiving 2.0 mg/m2 rTNF. In addition, focal tubular degeneration was found in one dog administered 0.2 mg/m2 rTNF. These data suggest that the upper dose limit for hepatic arterial infusion of rTNF is between 0.2 and 2.0 mg/m2 and that renal function should be closely monitored after infusion. PMID- 2720561 TI - Therapy-induced drug resistance in a human leukemia line (LALW-2). A clinically relevant model. AB - A human leukemic T-cell line, LALW-2, established by xenografting in nude mice, has been maintained through 14 serial passages. The cells display consistent morphologic features, immunophenotype, and karyotypic aberrations (including an 11;14 translocation) and exhibit rearrangement of the T-cell receptor beta-chain gene. The growth rate of LALW-2 xenografts was differentially affected by drugs administered to host mice, the cells being resistant to cytotoxic agents (particularly methotrexate and doxorubicin) used in treatment of the donor patient. In short-term in vitro culture, LALW-2 cells exhibited extreme resistance to methotrexate and were also resistant to vincristine, vinblastine, dactinomycin, and doxorubicin. The findings differ from those obtained with laboratory-derived methotrexate or multidrug-resistant cell lines. The response of LALW-2 cells, in both the nude mouse model and in vitro, is consistent with acquisition of drug-resistance as a result of clinical treatment. PMID- 2720563 TI - Prognostic factors and results of therapy for adult thalamic and brainstem tumors. AB - This report is a retrospective analysis of 83 adults (greater than 16 years of age) with histologically proven or presumed primary neoplasms of the thalamus, hypothalamus, midbrain, pons, and medulla. Patients were treated with combined surgery and postoperative irradiation or with irradiation alone at the Washington University Medical Center (St. Louis, MO) from January 1950 through December 1984. Histologic analysis confirmed the diagnosis of tumor in 21, including nine with well-differentiated astrocytoma, four with astrocytoma with anaplasia, and eight with glioblastoma multiforme. Overall and disease-free survivals at 5 years were 28.7 and 23.2%, respectively. A statistical analysis was performed to ascertain the prognostic importance of the following variables: age, race, gender, duration of symptoms, cranial nerve paresis, primary site, extent of surgery, histology, and irradiation dose. The only factor identified by univariate analysis to be critical for survival was primary location of disease. Patients with supratentorial (thalamus/hypothalamus, midbrain) tumors had a 10 year disease-free survival of 15.4% compared to 29.6% for those with infratentorial (pons, medulla) tumors (P = 0.07). Patients with lesions of the pons had a 5-year disease-free survival of 35.8% compared to 13.8% for those with tumors of the thalamus (P = 0.05). Increasing irradiation dose was not correlated with superior survival. Factors evaluated but established to be insignificant were age (P = 0.27), race (P = 0.63), gender (P = 0.27), duration of symptoms (P = 0.19), cranial nerve paresis (P = 0.71), histologic type (P = 0.16), and extent of surgery (P = 0.94). Follow-up for 13 surviving patients ranged from 2.6 to 28.7 (mean, 12.0) years. Neurologic deficits in surviving patients were absent in 15% (two of 13), mild in 62% (eight of 23), and moderate in 23% (three of 13). One case of brain radionecrosis was identified (6000 cGy, 200 cGy daily). PMID- 2720562 TI - Recovery of sperm production after chemotherapy for osteosarcoma. AB - Because treatment with surgery and combination chemotherapy produces a high cure rate in young men with osteosarcoma, their subsequent reproductive function is an important concern. Semen analyses of osteosarcoma patients, therefore, were performed before, during, and after treatment with the PADIC regimen consisting of cisplatin, Adriamycin (doxorubicin), and dacarbazine or, in some cases, the PADIC regimen plus additional drugs. Results showed that semen volume was not affected and that sperm motility was reduced only during treatment. Although nearly all patients were rendered azoospermic during treatment, sperm production resumed in 30 of 32 patients examined at least 2 years after treatment. Analysis with correction for censored data indicates that, in 78% of treated men, sperm counts will return to more than 10 million/ml. The percentage of men whose sperm counts recovered to normal was lower for those receiving cisplatin dosages greater than or equal to 600 mg/m2; no trends were observed with Adriamycin and dacarbazine dosages. The inclusion of additional drugs such as methotrexate, bleomycin, dactinomycin, or cyclophosphamide (less than 4 g/m2) did not significantly affect the recovery of spermatogenesis. We conclude that the risk of long-term infertility from treatment with the PADIC regimen is low. PMID- 2720564 TI - The N-myc gene product in primary retinoblastomas. AB - The N-myc gene product in retinoblastomas was examined using the antisera against the N-myc gene product, which was produced as a fusion protein by Escherichia coli. The N-myc gene product was detected not only in the retinoblastoma cell line Y79 but also in primary retinoblastomas as a pair of bands of approximately 62 kilodaltons (KD) by immunoblotting. Immunohistochemical analysis showed positively stained cells with the antibody against the N-myc gene product in a few rosettes or fleuretts containing area of the tumor. The nuclei of the cells were positively stained. The N-myc gene product was not detected in the normal part of the retina or in other parts of the eye. The results suggested that the level of the N-myc gene product may be inversely correlated with the differentiation of retinoblastoma cells and that the detection of the N-myc gene product may be useful in the diagnosis of retinoblastoma. Because the undifferentiated form of retinoblastoma carries a worse prognosis than the differentiated forms, the level of the N-myc gene product may be related to the aggressiveness of the tumor cells. It remains to be seen whether metastatic retinoblastoma has a higher concentration of the N-myc gene product. PMID- 2720565 TI - The effect of sex hormones and tamoxifen on the growth of human gastric and colorectal cancer cell lines. AB - The authors studied the effect of serial concentrations of estradiol, 4 hydroxytamoxifen with estradiol, and 5-dihydrotestosterone on cell lines derived from human gastric and colorectal cancers. Significant stimulation of the gastric and 2 colorectal cell lines occurred at physiologic concentrations of estradiol. Addition of the active metabolite of the estrogen-receptor blocker/partial agonist 4-hydroxytamoxifen had a stimulating effect on the growth rate of the gastric cell lines. The androgen, 5-dihydrotestosterone, had a modest inhibitory effect on the two gastric cell lines and two of the colorectal cell lines, and a stimulating effect on two further cell lines. PMID- 2720566 TI - Correlation between nuclear cytomorphometric parameters and estrogen receptor levels in breast cancer. AB - The authors studied the relationships existing between various cytomorphonuclear parameters recorded on 25 primary breast cancers and their estrogen receptor (ER) content. Cell image analyses of Feulgen-stained imprint smears, allowing determination of morphologic, densitometric, as well as textural parameters, were assessed by using the SAMBA 200 system (TITN, France). The ER levels were measured by the conventional dextran-coated charcoal assay. The authors then divided the 25 cancers into three categories: (1) "ER-negative or poorly positive tumors," i.e., those having less than 50 fmol ER/mg protein; (2) "ER-positive tumors," i.e., those containing between 50 and 150 fmol ER/mg protein; and (3) "ER highly positive tumors," i.e., those having more than 150 fmol ER/mg protein. The authors' results show that ER-negative or poorly positive breast cancers possess cells with bigger nuclei and higher DNA content, related to higher proliferation index than ER-rich tumors. Furthermore, the chromatin pattern of cells from ER-negative or poorly positive breast cancers is significantly more condensed than the thinly textured chromatin of ER highly positive tumors. Cell image analysis of Feulgen-stained imprints is proposed as an additional tool for grading malignancy. PMID- 2720567 TI - Prognostic significance of epidermal growth factor receptor in esophageal squamous cell carcinomas. AB - The prognostic value of epidermal growth factor (EGF) receptor level was studied in 32 patients with esophageal squamous cell carcinoma. The EGF receptor levels of tumors were measured by iodine 125 (125I)-EGF binding assay, and the patients subsequently were divided into two groups: a group with high EGF binding capacities (greater than or equal to 2.5% of input), and a group with low EGF binding capacities (less than 2.5% of input). The cumulative survival rates for the two groups were calculated by the Kaplan-Meier method. The generalized Wilcoxon test indicated that the survival rate of the high EGF binding group was significantly lower than that of the low EGF binding group (P less than 0.05). In tumors from two patients with the highest EGF receptor levels, EGF receptor gene amplification was observed. These patients developed mediastinal lymph node metastasis and died 4 and 11 months after surgery, respectively. These results suggest that elevated EGF receptor level is a significant prognostic indicator for esophageal squamous cell carcinoma. PMID- 2720568 TI - Human T-cell leukemia virus-I and hematologic malignancies in Panama. AB - Serum samples were obtained in a 2-year period (November 1, 1984-December 31, 1986) from 136 Panamanian patients with hematologic malignancies identified by a population-based registry designed for studies investigating human T-cell lymphotropic virus (HTLV)-I. Only three patients had clinical and serologic findings of HTLV-I-associated adult T-cell leukemia/lymphoma (ATLL). The authors conclude that although classical HTLV-I-associated ATLL occurs in the Panamanian population, it is not as prevalent as in other Caribbean populations. PMID- 2720569 TI - Participation of high-risk subjects in colon cancer screening. AB - Siblings of colorectal cancer patients are estimated to be three times more likely to develop colorectal cancer. Although these high-risk siblings are appropriate candidates for colon cancer screening, the factors that affect their participation in screening programs are not known. A study was conducted to examine the factors that might influence participation in fecal occult blood test (FOBT) screening by high-risk siblings of recently diagnosed colon cancer patients and nonhigh-risk control siblings. Siblings were mailed a sample FOBT card, a letter informing them of their risk status, and an invitation to participate in the FOBT screening program. They were later interviewed by telephone about their intention to participate in FOBT screening. FOBT cards were returned by 52.2% of high-risk siblings compared with 37.7% of control siblings (P less than 0.005). Only 24.8% of the cancer siblings thought they were more likely to get colon cancer compared with others their own age, and 27.8% thought they were less likely. Perceived risk of cancer and demographic and health related factors did not predict compliance beyond membership in the high-risk group. Siblings of colon cancer patients are more likely to participate in screening, and efforts to screen them could have a substantial impact on colorectal cancer. More work is needed to identify the factors responsible for compliance so that effective interventions can be developed. PMID- 2720570 TI - Malignant schwannoma of the clitoris in a 1-year-old child. AB - A 1-year-old infant with von Recklinghausen's neurofibromatosis was seen because of increasing clitoral enlargement over a 7-month period. The mother, who also had neurofibromatosis, was treated 2 years beforehand for an acoustic neuroma. The child was treated by radical clitorectomy. Pathologic examination revealed malignant schwannoma, a tumor not previously described in this site. Vincristine, dactinomycin, and cyclophosphamide chemotherapy was given for 2 years to prevent local recurrence and metastatic spread. The child remains tumor free 2.5 years after diagnosis. PMID- 2720571 TI - Radical hysterectomy and tailored postoperative radiation therapy in the management of bulky stage 1B cervical cancer. AB - Ninety-two patients with Stage IB cervical cancers having a diameter equal to or greater than 4.0 cm were treated with radical surgery. Thirty-two patients received postoperative radiotherapy because of operative findings suggestive of high risk of pelvic recurrence. All 32 irradiated patients were treated with a standard pelvic field. Four patients also received paraaortic radiotherapy, and ten received intravaginal brachytherapy. Postoperative complications were seen in five patients (two nonirradiated, three irradiated). Projected 5-year survival is 79% (71% 5-year survival in irradiated patients, and 83% 5-year survival in nonirradiated patients). Preoperative evaluation of tumor volume was not found to reliably predict histologic high risk factors such as depth of stromal invasion, risk of lymph node metastases, or presence of extracervical/uterine involvement. A primary surgical approach in this group of patients with large-diameter Stage IB cervical cancers allows definition of those patients who might benefit from a combined surgical and radiotherapeutic approach to treatment based on findings at operation. PMID- 2720572 TI - Stage I serous papillary carcinoma of the endometrium. AB - From 1973 to 1987, 16 patients with International Federation of Gynecology and Obstetrics (FIGO) Stage I serous papillary endometrial carcinoma were evaluated and treated at the University of Kentucky Medical Center (Lexington, KY). All patients were 60 years of age or older, and all were postmenopausal. Patients were treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and paraaortic lymph node sampling, and 38% were noted to have more extensive disease than appreciated clinically. Nine patients were given adjuvant postoperative radiation. Seven patients (44%) developed recurrent cancer with liver, lung, and upper abdomen being the most common sites of spread. Prognosis was most directly related to the presence of lymph vascular space invasion and the depth of myometrial penetration. No patient with serous papillary carcinoma confined to the endometrium developed recurrent cancer. In contrast, the recurrence rate of patients having myometrial invasion was 70% (P less than 0.03). Hormonal therapy was of limited value in the treatment of recurrent disease. This data suggests the need for adjuvant systemic therapy in the treatment of patients with Stage I serous papillary carcinoma of the endometrium who have myometrial invasion. PMID- 2720573 TI - Breast masses associated with adenocarcinoma of the prostate. AB - A breast mass in a man with carcinoma of the prostate may represent metastatic disease or, less often, a primary carcinoma of the breast. Advances in the differentiation of these lesions and a comparison of treatment regimes are discussed. PMID- 2720575 TI - Management of cancer pain. Fort Lauderdale, Florida, April 14-17, 1988. PMID- 2720574 TI - An epidemiologic assessment of cancer risk in oral precancerous lesions in India with special reference to nodular leukoplakia. AB - A cohort of 12,212 tobacco users was followed up annually to assess malignant potential of oral precancerous lesions in the Ernakulam district in Kerala, India. A total of 19 new oral cancers were diagnosed over a period of 8 years, and 15 (79%) of these arose from some preexisting precancerous lesion or condition. Nodular leukoplakia showed highest rate of malignant transformation (16% per year) as six of 13 nodular leukoplakia underwent malignant transformation over a mean follow-up period of 2.8 years. The relative risk (3243.2) compared with individuals with tobacco habits but without any precancerous oral lesion was also the highest for nodular leukoplakia. In addition, nodular leukoplakia was associated with submucous fibrosis in two patients, which progressed to oral cancer and was the clinical diagnosis for four lesions that turned out to be malignant on histopathologic examination. Nodular appearance was noted in two other precursor lesions as well. Thus, 14 of 19 oral cancers (74%) were either preceded by nodular leukoplakia and with lesions showing a distinct nodular appearance, or had the clinical appearance of nodular leukoplakia. PMID- 2720576 TI - Pharmacokinetics and clinical efficacy of oral morphine solution and controlled release morphine tablets in cancer patients. AB - Twenty-three adult patients with chronic pain due to cancer completed a double blind, randomized, two-phase crossover trial comparing plasma morphine concentrations and analgesic efficacy of oral morphine sulfate solution (MSS) and controlled-release morphine sulfate tablets (MS Contin [MSC], Purdue Frederick, Inc., Toronto, Ontario, Canada). MS Contin was given every 12 hours to all patients except those whose daily morphine dose could not be equally divided into two 12-hour doses with the tablet strengths available. MSS was given every 4 hours. Patients received both of the test drugs for at least 5 days, and, on the final day of each phase, peripheral venous blood samples for morphine analysis were obtained. Eighteen patients received MSC every 12 hours, and five received it every 8 hours. The same total daily morphine dose was given in both phases. In the 18 patients who received MSC every 12 hours, the daily morphine dose was 183.9 +/- 140.0 mg (mean +/- SD). In this group, the mean area under the curve (AUC) with MSC was 443.6 +/- 348.4 ng/ml/hour, compared with 406.8 +/- 259.7 ng/ml/hour for MSS (P greater than 0.20). Mean maximum morphine concentrations (Cmax) for MSC and MSS were 67.9 +/- 42.1 and 58.8 +/- 30.3 ng/ml, respectively (P greater than 0.05). Mean minimum morphine concentrations (Cmin) were 17.0 +/- 17.7 and 18.3 +/- 15.0, respectively (P greater than 0.30). There was a significant difference (P less than 0.001) between the two drugs in time required to reach maximum morphine concentration (Tmax). Mean Tmax after MSC occurred at 3.6 +/- 2.3 hours. After MSS, it occurred at 1.3 +/- 0.4 hours. In the five patients who received MSC every 8 hours, the findings paralleled those in the principal group, with no significant differences between MSC and MSS in Cmax or Cmin and a highly significant difference between the two in Tmax. However, in this small group of patients, the AUC with MSC was significantly (P = 0.04) greater than that with MSS. All patients had very good pain control throughout the study and both formulations were well tolerated. There were no significant differences between MSC and MSS in pain scores or side effects. Under the conditions of this study there was no clinically significant difference in bioavailability between MSC and oral MSS. When given on a 12-hourly basis in individually titrated doses, the MSC provided therapeutic plasma morphine concentrations throughout the dosing interval. PMID- 2720577 TI - Oral controlled-release morphine sulfate. Analgesic efficacy and side effects of a 100-mg tablet in cancer pain patients. AB - Fifty-one cancer pain patients with limited opioid exposure participated in a randomized, double-blind, repeated-dose, parallel-group comparison of two dosage strengths of the controlled-release morphine preparation, MS Contin tablets (The Purdue Frederick Company, Norwalk, CT). The patients were first stabilized on immediate-release oral morphine 30 mg every 4 hours, with 15 mg available every 2 hours as needed for breakthrough pain ("rescue" dose). Each patient then received either one 100 mg MS Contin tablet or three 30-mg MS Contin tablets every 12 hours, with rescue medication as needed, for 3 days. Analysis of study power revealed sufficient sensitivity to detect clinically relevant differences in pain intensity and use of rescue medication. The two tablet strengths yielded similar pain relief, use of rescue medication, and frequency of side effects. In addition, pain and use of rescue medication did not change from the beginning to the end of the 12-hour dosing intervals in either group. In the study population as a whole, pain intensity was lower and total morphine intake higher during the period on controlled-release morphine. These data establish comparable analgesic efficacy and side effect potential of these two dosage strengths and confirm a 12 hour duration of effect for both. The improved analgesia on the controlled release morphine may be attributable to increased consumption of drug resulting from improved compliance. PMID- 2720578 TI - Analgesic response to single and multiple doses of controlled-release morphine tablets and morphine oral solution in cancer patients. AB - Immediate-release oral morphine, given every four hours in individually titrated doses, is effective in the control of severe cancer pain. To evaluate the analgesic efficacy of a controlled-release morphine sulfate preparation, MS Contin tablets (MSC, Purdue Frederick, Toronto, Ontario, Canada), after a single dose and under steady-state conditions, the authors compared MSC administered every 12 hours with morphine oral solution (MOS) administered every 4 hours in 17 adult cancer patients with chronic severe pain. In the single-dose evaluation, in which the patients were randomly assigned to receive MSC or MOS, there were no significant differences in analgesic efficacy or requirement for supplemental morphine between the two treatments. With both preparations, pain severity ratings increased toward the end of the 12-hour, single-dose observation period and were higher than the pain scores reported after dose titration. In the steady state evaluation, which was a randomized crossover comparison, both preparations provided effective pain control with minimal side effects. There was no significant difference between MSC and MOS in overall pain scores or in pain scores analyzed by time of day and day of therapy. In conclusion, that an individualized twice-daily regimen of MSC is as effective as 4-hourly MOS for the control of chronic severe cancer pain. The twice-daily regimen has several advantages: it allows an uninterrupted night's sleep, it is substantially more convenient, and it can be expected to reduce both medication errors and noncompliance. PMID- 2720579 TI - Quality of life as an outcome variable in the management of cancer pain. AB - Valid measurement tools are needed by oncology researchers to help in the evaluation of the effectiveness of pain relief methods used in the treatment of cancer patients. A study was conducted to assess the validity and reliability of a tool designed to evaluate quality of life as a measure of pain management outcome in the individual patient. Items in the tested quality of life survey represented the areas of psychologic well-being, physical well-being, general and specific symptom control, and degree of social support. Using the test instrument, two oncology nurses interviewed subjects in three groups, each consisting of 50 subjects: cancer patients with pain, cancer patients without pain, and subjects with no cancer. Statistical analysis of the interview results revealed that the instrument has test-retest reliability, internal consistency, and interrater reliability, as well as content and construct validity for the major factors, psychologic well-being, worry, and nutrition. Further revision of the instrument is needed to restructure its subscales. The quality of life tool will enable researchers to evaluate a treatment regarding not only its effect on pain intensity but also its impact on the total individual. PMID- 2720580 TI - The United States experience with oral controlled-release morphine (MS Contin tablets). Parts I and II. Review of nine dose titration studies and clinical pharmacology of 15-mg, 30-mg, 60-mg, and 100-mg tablet strengths in normal subjects. AB - The results of nine US multicenter, sequential crossover, dose titration studies of controlled-release oral morphine (MS Contin 30 mg tablets [MSC], Purdue Frederick, Norwalk, CT) are reviewed in Part I. The studies demonstrated the prolonged analgesic efficacy of the preparation in the treatment of patients with moderate to severe cancer-related pain. Approximately 93% of the patients achieved satisfactory to excellent analgesia on a 12-hour regimen when appropriate dose titration was allowed. The remaining patients were successfully maintained on an 8-hour regimen. The preparation was well-tolerated and comparable in safety to immediate-release oral morphine. In global evaluations, MSC was judged to be significantly (P less than 0.05) more effective, and with significantly (P less than 0.05) fewer side effects than both the prestudy opioid analgesics and 4-hour immediate-release oral morphine. Patients had a broad range of morphine requirements (mean daily MSC dose, 240 mg; range, 60 mg/day to 1800 mg/day); therefore various MSC tablet strengths were developed. Part II presents three studies in which the MSC formulations (15-mg, 60-mg, and 100-mg tablets) were compared to the 30-mg tablet within three randomized, single-dose, two-way crossover, analytically blinded bioavailability protocols, to determine bioequivalence and dose proportionality. The maximum morphine concentration, time of maximum morphine concentration, and area under the plasma morphine versus 12 hour and 24-hour time curve (AUC 0.12; AUC 0.24) were determined in each study. There were no significant differences between the values associated with MSC 1 X 30 mg tablet and 2 X 15 mg tablets (study 1), MSC 2 X 30 mg tablets and 1 X 60 mg tablet (study 2), and MSC 3 X 30 mg tablets and 1 X 100 mg tablet (study 3, values adjusted to dose of 90 mg), except for one marginally significant difference in study 3 (AUC 0.24; P = 0.04) which was not clinically or biopharmaceutically significant. The results showed that MSC 15-mg, 30-mg, 60-mg, and 100-mg dosage strengths are bioequivalent and dose proportional, and, therefore, therapeutically interchangeable. It was concluded that with routine assessment of the patient and adherence to the principles of analgesic dosing, MSC can be successfully used to control cancer-related pain. Furthermore, the availability of various MSC tablet strengths can be expected to facilitate the analgesic management of a patient population with widely differing opioid requirements. PMID- 2720581 TI - Evaluation of a cancer pain model for the testing of long-acting analgesics. The effect of MS Contin in a double-blind, randomized crossover design. AB - A double-blind, double-dummy, crossover study compared oral controlled-release morphine sulfate (MS Contin tablets [MSC], Purdue Frederick, Norwalk, CT) every 12 hours, and immediate-release morphine sulfate (IRMS) tablets, every 4 hours, in 14 evaluable patients with chronic cancer pain. The test model described showed assay sensitivity for steady-state analgesia, requiring relatively few subjects to yield statistical significance in pharmacologic potency estimates. Initial doses were the calculated equivalents of about one third the previous opioid requirements or at least 30 mg MSC every 12 hours or 15 mg IRMS every 4 hours. This was generally subtherapeutic; hence, additional IRMS was available for break-through pain. Doses of MSC and IRMS were titrated upwards until the requirement for rescue IRMS was less than 20% of the total daily amount of morphine. In both study phases, the total dose of morphine increased significantly from the first day to the last, on which it was significantly (34%) higher for IRMS than MSC. Pain was significantly less intense and frequent in the last 24 hours of each treatment arm than in the first, and equally well controlled by both regimens. The two treatments were equipotent in a pharmacologic assay using dosages and pain scores. The requirement for rescue analgesia was similarly comparable for both treatments, decreasing significantly with upward dose titration. The few side effects experienced (one with MSC and three with IRMS) did not include serious reactions such as respiratory depression. It is concluded that MSC, 12-hourly, controls cancer pain as effectively and safely as IRMS on a 4-hour schedule. MS Contin exhibits a 12-hour duration of action as previously shown in other well-controlled trials. A problem of pain exacerbation at the start of each study phase was found to be associated with the design of this study. It may be resolved with a higher initial study dose and/or use of a patient-controlled analgesia device for parenteral rescue doses. PMID- 2720582 TI - Evaluation of dosing guidelines for the use of oral controlled-release morphine (MS Contin tablets). AB - Based on clinical studies with the oral controlled-release morphine preparation, MS Contin tablets (MSC, Purdue Frederick, Norwalk, CT), a series of guidelines had been previously developed to help in titration of the medication. A multiinvestigator study was undertaken to prospectively evaluate these guidelines. Thus far, 66 patients have been enrolled and 47 have completed the study. Only three patients (5%) discontinued because of drug-related side effects. One group of patients (n = 28) as transferred to MSC from weak opioids because of inadequate pain control. The other group (n = 19) had previously received strong opioids. Each patient received MSC every 12 hours in accordance with specific dosing procedures designed to arrive at doses that would provide acceptable analgesia without unacceptable side effects. By the end of the study, approximately 75% of the patients achieved pain intensity scores indicating no or slight pain. However, since there were no dose-limiting side effects, it is probable that more patients could have achieved excellent analgesia if upward dose titration had continued. There was a broad range of individual total daily morphine requirements. The average daily morphine dose in the groups who had previously received weak and strong opioids was 110 mg and 200 mg, respectively. Side effects, although generally mild and few in number, appeared to have been inadequately treated in many cases. The results show that adherence to the guidelines results in effective pain management in the majority of patients. Additional issues include placing more emphasis on both rapid and complete dose titration and aggressive treatment of side effects, as well as exploration of the option of patient-controlled dose titration with MSC. PMID- 2720583 TI - Rocket research and Pony Express delivery. PMID- 2720584 TI - The safe and effective use of postoperative radiation therapy in modified Astler Coller Stage C3 rectal cancer. AB - Locoregional recurrence in patients with Stage C3 (adjacent organ invasion) rectal carcinoma approaches 100% when surgery is not followed by adjuvant radiation therapy. The advent of the intestinal sling procedure (use of an absorbable polyglycolic acid mesh to suspend the small bowel out of the pelvis) has allowed tumoricidal doses (5000 cGy) of radiation therapy to be delivered to the pelvis without incurring radiation associated small bowel injury (RASBI). This surgical technique has allowed us to readdress the question, "what is the effectiveness of postoperative radiation therapy when tumoricidal doses can be safely administered to patients with Stage C3 rectal cancer?" Nineteen consecutive patients with Stage C3 rectal carcinoma underwent resective procedures and simultaneous use of the intestinal sling procedure. Postoperatively, all patients underwent contrast simulation studies that documented the small bowel above the sacral promentory. Tumoricidal doses ranging from 5200 to 5800 cGy (mean, 5600 cGy) were administered in fractionated doses. No patient demonstrated obstruction, infection, nausea, vomiting, cramps, diarrhea, or acute RASBI. There have been two locoregional recurrences in a mean follow-up period of 33 months (range, 12 to 54 months) in patients evaluated by physical examination, carcinoembryonic antigen (CEA) levels, computed axial tomography (CAT) scans, endoscopy, and reoperation or autopsy (P = 0.01). There have been ten distant recurrences (eight liver, one brain, and one lung). Three patients were reoperated on to rule out recurrence at 16, 17, and 24 months. All mesh was resorbed and there were no adhesions and no recurrent tumor. When the intestinal sling procedure is used, tumoricidal doses of radiation therapy can be safely administered without incurring RASBI. Postoperative high-dose radiation therapy can suppress locoregional recurrences in Stage C3 rectal carcinomas over and above what would be expected. PMID- 2720585 TI - Radiotherapy alone and chemoradiation for nonmetastatic esophageal carcinoma. A critical review of chemoradiation. AB - Sixty-five patients with nonmetastatic (Stages I, II, and III) esophageal cancer (EC) were treated with radiotherapy (RT) alone (56.00 to 61.00 Gy in 6 to 7 weeks) or synchronous combinations of radiotherapy and chemotherapy (RT-CT). RT CT consisted of 41.40 to 50.40 Gy in 4.5 to 8 weeks with continuous infusion 5 fluorouracil 5-FU (1000 mg/m2/d for 4 days in weeks 1, 4, and 8), mitomycin C (10 mg/m2 intravenously [IV] in weeks 1 and 8), cisplatin (75 mg/m2 IV in week 4). Maintenance CT consisted of methotrexate (200 mg/m2 IV), leucovorin (10 mg/m2 orally every 6 hours for 5 doses), and 5-FU (600 mg/m2 IV) in weeks 10, 12, and 14. Thirty-five patients treated by RT alone (Group A) were comparable in terms of age, sex, AJC staging, histologic condition, and location of primary with 30 patients treated by RT-CT (Group B). In Group A (range, 2- to 144+ months), two patients (42 and 144 months) are alive and well. In Group B (range, 2- to 59+ months), 12 patients (7 to 59 months) are alive and well. Median survival in Group A is 8 months, compared with 15 months for patients achieving a complete response (CR) in Group B. Patients in Group B achieved a 77% CR rate by endoscopy biopsy, whereas 30% of the patients in Group A achieved a CR (P = 0.0001). The recurrence rates at the primary site/regional nodes were 77% and 27% in Groups A and B, respectively (P = 0.0001). The incidences of distant metastases were 29% and 20%, respectively (P = 0.423). In Group A, the 1-year and 2-year cumulative survival rates were 27% and 13%, respectively. In Group B, the cumulative survival rates were 53% at 1 year and 29% at 2 years (P = 0.023). Aside from reversible myelotoxicity, the incidences of pulmonary fibrosis, esophagitis, and fistulae formation were less frequent in the combined technique treatment group. A compilation of reported chemoradiation protocols for EC indicates consistently improved 1-year and 2-year survival rates, compared with surgical and RT series. The key to further improvement in the treatment of EC appears to lie in increasing the biologic response (RT fractionation and endocavitary RT) and optimal use of multiple effective CT agents with nonadditive toxicities. PMID- 2720586 TI - Incidence of cerebral infarction after radiotherapy for pituitary adenoma. AB - The incidence of cerebral infarction was studied in 156 patients irradiated for treatment of pituitary adenomas. Seven patients experienced strokes at intervals of 3.2 to 14.6 years after irradiation. The observed incidence was not significantly greater than the expected value of 3.5 strokes (P = 0.078). Six strokes occurred in patients receiving equivalent doses (ED) of 1070 ret or more (observed to expected ratio 3.87, significantly elevated; P less than 0.001). Univariate log-rank analysis showed that the risk of stroke was significantly higher (P = 0.010) in patients receiving an ED of 1070 ret or more (4180 cGy/22 fractions) than those receiving lower doses. Multivariate analysis, however, demonstrated that the increased risk of stroke was associated only with increasing age (P less than 0.0001), not ED (P = 0.148). Due to these inconsistent statistical results, no definitive conclusions could be reached about the relationship between radiation dose to the pituitary and subsequent cerebral infarction. PMID- 2720587 TI - I-125 interstitial implantation for prostate cancer. What have we learned 10 years later? AB - From 1975 to 1984, 120 patients were treated at Eastern Virginia Medical School with iodine-125 (I-125) interstitial implantation and pelvic lymphadenectomy as the definitive therapy for stage A2-C prostatic carcinoma. As might be expected, a higher incidence of local recurrence was seen with tumors at a more advanced stage but also with tumors of moderate and poor differentiation. Local tumor control in these groups did not compare favorably with patients externally irradiated during this period, of which 246 patients were available for study. Only 57% of recurrences with I-125 were clinically evident by 5 years follow-up with failures detected at up to 10 years, as opposed to the development of 91% of local recurrences by 5 years with external beam irradiation (P = 0.001), suggesting a later incidence of local recurrence with I-125 therapy. Major complications attributable to local tumor recurrence were also more frequent in implanted patients (20% vs. 8%; P = 0.006). The incidence of distant metastasis increased significantly in patients who experienced local recurrences, i.e., 83% versus 18%, with the expected adverse affect on survival. Disease-free survival by grade and stage showed a particular disadvantage for patients with moderately well and poorly differentiated tumors and stage C disease treated by I-125 therapy. In conclusion, then, it appears that I-125 interstitial implantation is well suited to only a select group of prostate cancer patients with well differentiated, early stage disease and in most cases does not provide results comparable with external beam irradiation. PMID- 2720588 TI - Prognosis in patients with local recurrence after definitive irradiation for prostatic carcinoma. AB - Of 414 patients with Stage A2-C disease, all with a minimum follow-up period of 3 years, who have been definitively irradiated by external beam therapy or iodine 125 (I-125) implantation for biopsy-proven prostatic adenocarcinoma, 83 patients (20%) have experienced local recurrences. The incidence of distant metastasis was significantly higher in patients with local tumor recurrence (56 of 83; 68%), as compared with those with local control (64 of 331; 19%; P less than 0.001). This difference remained significant within each tumor grade and stage. Subsequently, survival in patients with local recurrence was significantly shorter than in those with local tumor control (66% vs. 89% at 5 years; P = 0.001). Of the 83 patients with local tumor recurrence, 56 had local recurrence and distant metastasis, and 27 had local failure alone, with a median follow-up of 76 months for the latter group. Fifteen of 83 patients with local recurrence (18%) developed major complications secondary to local disease. Three of the 83 (4%) patients were known to die of prostatic recurrence alone and another 11 of 83 (13%) as a result of some combination of local and distant disease. Therefore, in reference to the entire group of definitively irradiated patients, only 0.72% expired solely of complications associated with local tumor recurrence and an additional 2.7% expired of a combination of both local and distant disease. PMID- 2720589 TI - Olfactory neuroblastoma. AB - Fifteen patients with olfactory neuroblastoma were treated during the 17-year period of 1969 to 1986. Data was analyzed with respect to age at presentation, sex, presenting signs and symptoms, stage, and results of treatment. Age ranged from 4 to 67 years with the median age being 27 years. Median follow-up was 8 years. Local control was achieved in nine of nine patients or 100% with successful surgical resection, i.e., minimal residual disease, followed by postoperative radiation therapy (45 to 65 Gy) was employed. There were no distant failures when the primary site was controlled. Regional lymph node metastases were infrequent: only 13% (two of 15 patients) presented with positive nodes. Three of four patients treated initially with surgery alone had a local recurrence, two of which were successfully salvaged by combined therapy. There were four patients treated with radiation therapy alone: three had persistent disease after radiation therapy, and one patient was controlled with 65 Gy. Olfactory neuroblastoma has a propensity to recur locally when treated with surgery alone. The authors' experience suggests excellent local control can be achieved with surgery immediately followed by radiation therapy. Thus the authors recommend planned combined treatment for all resectable lesions. PMID- 2720590 TI - Primary tumors of the trachea. Results of radiation therapy. AB - From 1959 to 1986, 24 patients with primary malignant tumors of the trachea received radiotherapy as all or part of treatment. Common presentations included respiratory symptoms in 20 patients and hemoptysis in 15. Thirteen patients had squamous carcinomas with undifferentiated and adenoid cystic cancers in five and four patients, respectively. Overall actuarial survival was 45% at 1 year, 25% at 5 years, and 13% at 10 years. Survival was significantly correlated to histologic type (adenoid cystic versus squamous, P less than 0.03), but not to tumor extent or to patient age or sex. Local control was attained in 10 of 24 patients overall and was more frequent for patients with tumors localized to the trachea and for patients who were treated with combined surgery and radiotherapy. For the 18 patients treated with radiotherapy alone, complete response (CR) was seen to be significantly (P less than 0.001) related to dose: six of seven (86%) patients receiving greater than or equal to 6000 cGy attained CR versus one of 11 (9%) receiving less than 6000 cGy. Three patients developed complications related to radiotherapy. Radiotherapy can provide durable local control of localized tracheal tumors and should be considered for medically inoperable patients with localized tumors and for patients with high risk of recurrence after resection. PMID- 2720591 TI - Intraperitoneal P-32 after negative second-look laparotomy in ovarian carcinoma. AB - Thirty-one patients underwent a negative second-look laparotomy between 1976 and 1986. Fourteen patients received intraperitoneal chromic phosphate (P-32) after a negative second-look laparotomy. There has been no local recurrence (zero of 14) and no deaths attributable to recurrent disease. Local control and disease-free survival are 100%, with a minimum follow-up of 2 years and a mean follow-up of 4 years. Seventeen patients received no further therapy because of patient refusal, poor diffusion, or other contraindications to P-32 installation. Four of 17 patients undergoing negative second-look procedures without the addition of P-32 have subsequently recurred. This difference is highly suggestive (P = .076). There have been no major complications with the addition of P-32. The use of intraperitoneal P-32 after negative second-look laparotomies on ovarian carcinoma is well tolerated and effective in preventing recurrence. PMID- 2720592 TI - Primary radiation therapy in the treatment of squamous cell carcinoma of the soft palate. AB - From 1970 to 1986, 45 patients received primary radiation therapy for squamous cell carcinoma of the soft palate at the University of California Los Angeles (UCLA) Center for the Health Sciences and Wadsworth Veteran's Administration Hospital. Seven patients were lost to follow-up or had prior irradiation, and were excluded. Thirty-eight patients received a median dose of 70 Gy (62.5 to 80 Gy) to the primary site. After a median follow-up of 48 months, initial control of disease at the primary site was accomplished in 74% of the patients. The initial control by stage was as follows: TI, 83%, T2, 67%; and T3, 63%. After surgical salvage, local control increased to 92%, 80% and 75% for stages T1, T2, and T3, respectively. Twenty-nine percent (11 of 38) of the patients had cervical node metastases at presentation. Radiation provided regional control in 96% (26 of 27) with N0 disease and 86% (six of seven) with N1 disease at diagnosis. Sixteen patients (42%) had an additional malignancy of the upper aerodigestive tract. Because the incidence of second malignancies after treatment is high and surgical salvage of treatment failures is possible, close follow-up is essential in the management of this tumor. We conclude that radiation therapy is an effective modality for the treatment of squamous cell carcinoma of the soft palate. Primary radiation therapy may offer many patients the chance to avoid surgical procedures that are both cosmetically and functionally debilitating without compromosing treatment outcome. PMID- 2720593 TI - Hemibody irradiation. An effective second-line therapy in drug-resistance multiple myeloma. AB - The authors report the results of treatment of 41 patients with melphalan resistant multiple myeloma using single half-body irradiation (HBI) or double half-body irradiation (DHBI). Patients were grouped using prognostic classification reported by the Medical Research Council. Patients in group I and II showed the best response to therapy with reduction in serum of urinary paraprotein and improvement in symptoms, most notably a marked reduction in bone pain. In these groups five patients have survived over 2 years after therapy. The therapeutic response appeared better in those patients who received DHBI as opposed to those whom treated with single HBI. Patients in group III did not achieve prolonged survival but effective relief of bone pain was a consistent finding in these patients also. Thus HBI represents an alternative to combination chemotherapy as second-line treatment of patients with melphalan-resistant multiple myeloma. A comparative study of HBI versus combination chemotherapy is now indicated to establish which therapeutic approach is most effective. PMID- 2720594 TI - Hyperfractionation decreases the deleterious effects of conventional radiation fractionation on vertebral growth in animals. AB - Craniospinal axis irradiation in the treatment of pediatric tumors is associated with serious long-term sequelae including decreased bone growth (short sitting stature). In this study, an animal model was used to determine the effects of smaller incremental doses of radiation on bone growth. Sprague-Dawley weanling rats were given 25 Gy to the spine in 8 to 9 days, with fraction sizes ranging from 1.0 to 1.8 Gy. The animals receiving smaller doses per fraction (1.0 or 1.25 Gy) showed significantly more growth of the vertebral bodies in the treated fields than animals given larger incremental doses (1.5 or 1.8 Gy). These findings indicate a protective effect on bone growth for hyperfractionated irradiation of vertebral bodies. PMID- 2720595 TI - Cytofluorometric analysis of the DNA content in ovarian carcinoma and its relationship to patient survival. AB - Forty-one patients with epithelial malignancies of the ovary treated at the Medical College of Wisconsin Affiliated Hospitals from 1976 to 1984 had paraffin embedded tissue available for review. Of the 41 patients, 40 had adequate material to provide 50 micron sections that were evaluated with flow cytometry to determine DNA content. Tumor- and patient-related parameters were then correlated with the results of flow cytometry. Overall survival at 5 years in these patients was 43%, and relapse-free survival was 50%. Forty percent of the tumors were diploid, and 60% were aneuploid. Five-year survival for diploid patients was 74% with a relapse-free survival of 71%. Corresponding overall and relapse-free survivals for aneuploid patients were 22% and 35%, respectively. Distribution of the patients by histology, stage, and grade was equal between the diploid and aneuploid groups. All patients were treated with whole abdominal plus concomitant pelvic boost irradiation; total doses to the whole abdomen ranged from 10 Gy to 46 Gy (1000 to 4600 cGy) with the median dose being 37.5 Gy. Approximately 40% of the patients received chemotherapy, which usually consisted of a single agent (Alkeran, Burroughs Welcome, Research Triangle Park, NC). This retrospective study of patients with ovarian cancer treated with radiation therapy suggests the possibility that determinations of DNA ploidy may be useful in selecting patients whose poor prognosis dictates that a more aggressive therapy be used. PMID- 2720596 TI - Accelerated hyperfractionation radiation therapy for carcinoma of the nasopharynx. Techniques and results. AB - Experience using accelerated hyperfractionation radiation therapy (twice-a-day) in the treatment of 60 patients with squamous cell carcinoma of the nasopharynx is presented. The local control rate at the primary sites was significantly improved statistically as compared with 58 patients with the same disease and stages treated by once daily (once-a-day) radiation therapy at the Massachusetts General Hospital (MGH) 5 years before twice-a-day radiation therapy. For the T1-2 lesions, the 5-year actuarial local control rates were 89% after twice-a-day and 55% after once-a-day radiation therapy, with a P value of 0.0021. For the T3-4 lesions, the corresponding rates were 77% and 45%, with a P value of 0.026. The improved local control rates occurred in patients with N2-3 disease and among male and female patients, and were reflected in patient survival. Although our study is not randomized, the improved local control and survival rates after twice-a-day radiation therapy are encouraging. However, the final answer will require a clinical randomized trial in the management of carcinoma of the nasopharynx. PMID- 2720597 TI - External beam radiotherapy for carcinoma of the prostate. AB - Five hundred nineteen patients with prostate cancer were seen in the Radiation Oncology Division of the State University of New York (SUNY) Health Science Center, Syracuse, New York, between 1969 and 1981. The results for the 239 patients treated with radical intent are reported here. All patients received 60 to 70 Gy to the prostate with megavoltage beam irradiation; 142 with a small field (10 X 10 cm) 360 degrees rotational technique for Stage A, B, or C disease and 69 with a four-field pelvic brick technique (followed by a boost to the prostate) for Stage A through C and D1 disease. Twenty-eight patients were treated postoperatively for residual disease after radical prostatectomy or for recurrent tumor. The minimum follow-up time was 5 years. Actuarial 5-year and 7 year survival rates for Stage A (n = 34), B (n = 100), C (n = 63), and D1 (n = 14) were 91% and 76%, 86% and 75%, 67% and 40%, and 46% and 36%, respectively. The corresponding 5-year and 7-year relapse-free survival rates were 72% and 65%, 77% and 60%, 46% and 28%, and 38% and 25%. The local tumor control rates at 5 years were 91%, 85%, 77%, and 62% for Stage A, B, C, and D1, respectively. In our experience, there was no significant difference in relapse-free survival rates for patients who underwent transurethral resection (TURP) versus those who did not (67% versus 78% for Stage B [P greater than 0.25] and 38% versus 47% for Stage C [P greater than 0.25], respectively). Also there was no significant difference in relapse-free survival rates between large and small field techniques (64% versus 77% for Stage B [P greater than 0.25] and 56% versus 41% for Stage C [P greater than 0.25], respectively). The 5-year and 7-year actuarial survival rates were 90% and 71%, respectively, for the 15 patients with residual tumor and 58% and 33%, respectively, for the 13 patients treated for postprostatectomy recurrence. Severe complications were documented in only nine patients (3.7%) and mild to moderate complications in 53 patients (22%). Larger fields did not cause a higher rate of complications, although small fields were tolerated better than large fields; the significant acute reaction rate was 27% for large field techniques versus 11% for small field techniques (P greater than 0.01). These results confirm that external beam irradiation is an effective treatment for prostate cancer. PMID- 2720598 TI - "Eight-drugs-in-one-day" chemotherapy administered before and after radiotherapy to adult patients with malignant gliomas. AB - Thirty-one adult patients with malignant glioma (23 with glioblastoma multiforme, six with anaplastic astrocytoma, and two with brainstem glioma) were treated with up to ten cycles of "eight-drugs-in-one-day" chemotherapy (methylprednisolone 300 mg/m2, vincristine 1.5 mg/m2 [maximum of 2 mg/cycle], CCNU 75 mg/m2, procarbazine 75 mg/m2, hydroxyurea 3000 mg/m2, cisplatin 90 mg/m2, cytosine arabinoside 300 mg/m2, and imidazole carboxamide 150 mg/m2). Chemotherapy was planned as two cycles before and eight cycles after 60 Gy of involved brain irradiation. A total of 117 cycles of chemotherapy was administered. There was one treatment-related death. Myelosuppression was the most frequent toxic effect (leucopenia was less than 1000/mm3 in 9% of cycles and 1000-2500/mm3 in 25%; thrombocytopenia was less than 100,000/mm3 in 33% of cycles). Sixteen patients developed infections requiring treatment, two of which were life-threatening. Five patients suffered ototoxicity. Nausea and vomiting were observed in 35% of patients. A reversible rise in creatinine was observed in five patients. One patient developed a severe motor neuropathy, and three patients developed mild peripheral neuropathies. Three patients had episodes of atrial fibrillation. One new bundle branch block with supraventricular tachycardia was observed in a patient with pulmonary embolus. Five patients developed thrombophlebitis, three of whom had pulmonary emboli. Two patients suffered strokes in areas anatomically separate from their tumor. Eleven patients declined to continue therapy after receiving an average of three cycles. Two had complete, and five had partial responses. The median survival time was 47 weeks. The responses and survival times observed are comparable to less toxic treatment protocols for adults with malignant gliomas. PMID- 2720599 TI - Effects of isoferritins on human granulocytes. AB - Serum ferritin levels are often elevated in patients with certain cancers and these elevations are, in part, derived from the tumors. In such patients, the increased levels of serum ferritin are associated with a poor prognosis. This association may be explained in part by biological effects of ferritin on lymphocytes: inhibition of E-rosette formation, masking of cell surfaces and suppression of lymphocytes' response to mitogens in vitro. The authors hypothesized that ferritins from tumor tissues also exert adverse effects on human granulocytes that are involved in tumoricidal activity. Three granulocyte functions were tested: nitroblue tetrazolium test, phagocytosis, and production of hydrogen peroxide. The results supported the authors' hypothesis: NBT reduction and phagocytosis are decreased in granulocytes exposed to ferritins, more so with tumor ferritins, than normal ferritin, and H2O2 production is less in granulocytes previously exposed to ferritins from tumor and nontumor tissues than cells not exposed to ferritins. However, the inhibitory effects of ferritins on H2O2 production can be reversed if granulocytes are further stimulated by phorbol myristate acetate (a membrane stimulant). If the elevated serum ferritin in cancer patients impairs granulocyte functions, in vivo, then it may increase the risk of infection, decrease tumoricidal host responses, and, thereby, contribute to the poor prognosis of these individuals. PMID- 2720600 TI - Favorable cytogenetic abnormalities in secondary leukemia. AB - The authors report on five patients with secondary leukemia (SL) and one of the "specific" chromosomal rearrangements usually encountered in de novo acute nonlymphoblastic leukemia: inv(16), t(15;17), t(8;21), and t(9;11). They were characterized by solid tumor as the primary malignancy in four of five cases, absence of preleukemic phase in all cases, and myelodysplastic features in one of five cases only. All patients achieved complete remission (CR) with aggressive chemotherapy. Only two relapsed, but follow-up is still limited in the three remaining cases. Cytogenetic analysis is important in all younger patients with SL, especially if unusual features (such as absence of preleukemic phase or myelodysplastic features) are found. Aggressive chemotherapy appears to be indicated in those patients if a "specific" rearrangement is found. PMID- 2720601 TI - Appearance, site of occurrence, and physical and clinical characteristics of oral carcinoma in Torino, Italy. AB - The appearance, site of occurrence, and selected physical and clinical characteristics are reported for 102 symptomatic carcinomas diagnosed during a 30 month period in Torino, Italy. Erythroplasia was a more significant visual component than leukoplakia, confirming the results of a previous study on asymptomatic cancer in a US population. Floor of the mouth, oral tongue, and soft palate complex accounted for 75% of all sites and 84% of sites if posterior pillar is excluded. Seventeen percent of the lesions were T1, 60% T2, and 23% larger than T2. Size of the lesion was associated with anterior or posterior position and the mobility of the structure, as well as with ulceration, bleeding, and lymphadenopathy (55% of cancers had no nodal involvement). Tumefaction, burning, and pain were the most frequently reported symptoms. About 50% of patients experienced a time lapse between onset of symptoms and final diagnosis of less than 3 months, and this proportion was higher among patients with T1 cancers. PMID- 2720602 TI - Age and race related changes in mammographic parenchymal patterns. AB - The relationship between breast parenchymal patterns and age was examined in a nonselected, nonreferred group. The three major racial-ethnic subgroups represented have markedly different incidences of breast cancer, with Anglos (nonHispanic caucasians), Hispanics, and American Indians having higher to lower incidence rates of breast cancer, respectively. Mammograms were performed in 519 victims of nonhospital, nonnatural or unexplained deaths in New Mexico. The percentage of dense breast patterns (DY + P2) decreased with age for all groups. American Indian women showed a much earlier shift to a lower density parenchymal pattern than Anglo or Hispanic women. At older ages Indian women continued to have a slightly lower percentage of dense breast patterns than the other groups. The changes in breast parenchymal pattern with age and ethnic groups may reflect factors related to risk of breast cancer. PMID- 2720603 TI - Resection of pulmonary metastases in osteosarcoma. A retrospective analysis of 44 patients. AB - Between 1977 and 1985, 44 patients with osteosarcoma and pulmonary metastases were treated at Institut Curie and Marie-Lannelongue. Twenty patients were able to undergo operations according to our criteria. Of 17 patients who immediately after surgery were clinically and radiologically free of disease, six are alive with no evidence of disease and one suffered recurrent pulmonary disease; their 5 year survival is 37%. In 24 patients, various schemes for aggressive chemotherapy for measurable lung disease could be assessed. Only one patient had a complete response; there was one partial response, and three patients experienced stabilization of their disease for 6 to 8 months. Of five patients who had second line postoperative adjuvant chemotherapy, four relapsed within 2 months of stopping treatment. Surgical resection of lung metastases appears definitely to improve the outcome in osteosarcoma patients. Chemotherapy offers no advantage in treating bulk disease, but the prevention of new micrometastatic disease remains a possibility and should be assessed in randomised multicenter trials. PMID- 2720604 TI - Prognostic variables in recurrent limb melanoma treated with hyperthermic antiblastic perfusion. AB - Between October 1969 and December 1986, 136 patients with recurrent limb melanoma were treated with hyperthermic antiblastic perfusion (HAP). This retrospective analysis is aimed at identifying tumor-related and treatment-related variables likely to influence tumor response, locoregional control, disease-free survival, and overall survival. Independent factors predicting a complete response (CR) were the number of lesions (P less than 0.0001) and the minimum tumor temperature (minT) (P = 0.03). Only a positive trend was observed for the drug dose (P = 0.08). However, the proportion of CR was significantly higher (57.7%; P = 0.02) in patients who had a minT of 41.5 degrees C or greater and who were given a dose equal to or greater than the standard dose than in patients treated with lower temperatures and/or lower drug doses. The occurrence of a CR significantly increased the rates of locoregional control (77%; P = 0.007), disease-free survival (55.6%; P = 0.006), and overall survival (68.6%; P = 0.03). Treatment optimization may provide further therapeutic improvements by increasing the incidence of CR. However, the overall survival rates also were influenced by the number of lesions (P = 0.0014), sex (P = 0.04), and the number of previous relapses (P = 0.01). Therefore, tumor aggressiveness also is crucial in determining the outcome of the disease, and only early treatment with HAP can reduce the risk of distant metastases. PMID- 2720606 TI - American College of Surgeons/American Cancer Society Workshop on Quality Assurance in Cancer Care. Chicago, Illinois, August 25-27, 1988. Proceedings. PMID- 2720605 TI - Cancer of the breast in poor black women. AB - The authors carried out a retrospective analysis of 708 patients (94% blacks) with breast cancer who were diagnosed, treated and/or followed at Harlem Hospital Center (New York) between 1964 and 1986: nearly all patients were of low economic status with almost 50% having no medical coverage. Surgical treatment was implemented in 512 patients (72%). Radiotherapy and/or chemotherapy alone were used in 94 patients (13%); 102 patients (14%) refused treatment or died before its initiation. The 5-year and 10-year survival rates for those treated surgically were 39% and 27%, respectively. For those patients undergoing surgery (47% of whom were in Stages III and IV), 5-year and 10-year survival rates were analyzed according to stage of the disease. They were 54% and 54%, respectively, for Stage I; 56% and 35%, respectively, for Stage II; 41% and 18%, respectively, for Stage III; and 11% and 0%, respectively, for Stage IV. There was significant difference in the 5-year survival rates between patients with pathologically negative lymph nodes (64%) and a single positive lymph node (71%), compared to those with multiple positive lymph nodes (33%; P = 0.001). The 10-year survival rates were 39%, 34%, and 15% (P = 0.001), respectively. The authors conclude that breast cancer survival in this population of poor black women is low compared to the survival rate of black women nationally and very low compared to white women. PMID- 2720607 TI - Scope of quality of care for cancer patients. PMID- 2720608 TI - Patient evaluation studies of the Commission on Cancer of the American College of Surgeons. PMID- 2720609 TI - Quality assurance in cancer care. Pathology. PMID- 2720610 TI - Cytology. Accuracy of diagnosis. PMID- 2720611 TI - Quality assurance procedures in mammography. PMID- 2720612 TI - State-of-the-art assessment. Diagnostic oncologic imaging. AB - This review has summarized the status of organ site cancer imaging as applied to tumor detection, staging, and posttreatment follow-up. More general questions which have not been addressed include those related to the following: (1) the problem of providing more adequate training of radiologists in the specific challenge of cancer imaging; (2) how to increase the awareness of oncologists as to the specific indications and applications of tumor imaging procedures and enhance joint communication between radiologists and clinicians in the planning of the imaging procedures; and (3) how to stimulate the radiology and oncology communities to establish imaging standards and recommended procedures for specific tumor imaging challenges. Hopefully, an appreciation of the complex challenge of cancer imaging will result from these and subsequent discussions. PMID- 2720613 TI - Quality assurance. The use of endoscopy in cancer care. PMID- 2720614 TI - Problems of detection and referral. AB - To provide optimal quality of care for the nation's cancer patients, it is important that the individual identify the cancer early either through screening practices in an asymptomatic state or present themselves with early symptoms to the medical community. The primary care practitioner is an equal partner in this early detection of cancer and certainly needs to have significant incentives in place to perform quality screening services, as well as health counseling services for their asymptomatic patients and to investigate appropriately symptoms that could indicate early cancer. Perhaps of equal importance is the impact on cancer management outcome from the referrals of primary care practitioners to the oncology community. This area of cancer management is far less well studied and additional information would be of great help in determining where to place emphasis in professional and community education programs. PMID- 2720615 TI - Pretreatment staging of cancer. PMID- 2720616 TI - Multidisciplinary treatment planning. Tumor boards. AB - A brief review of the current status of cancer treatment based on hospital consultations, cancer treatment plans, and cancer management protocols is presented. Some potential for the development of clinical indicators around these various consultation activities are explored. The utilization of hospital tumor conference and tumor boards as a mechanism for multidisciplinary treatment planning and consultation is reviewed and possible utilization of a measure of such activities as potential clinical indicators is presented. PMID- 2720617 TI - Quality assurance issues in oncology nursing. AB - Oncology nursing has been given the challenge to determine if oncology patients are provided with the highest quality nursing care. Inherent in this challenge is the development of indicators to measure clinical excellence in oncology nursing practice as well as organizational excellence. The Standards of Oncology Nursing Practice by the Oncology Nursing Society (ONS) and the American Nurses' Association (ANA) provides the framework for the development of specific clinical indicators to measure oncology nursing practice. These standards contain structure, process, and outcome criteria to measure oncology nursing practice. Within these practice standards, emphasis is placed on 11 high-incidence problem areas that can occur in cancer patients at any stage of the disease process, regardless of the care setting. These problem areas should serve as the broad basis for the development of specific clinical indicators to measure the quality of nursing care provided to the oncology patient. This report provides suggestions for possible clinical indicators based on the ONS/ANA Standards and the scope of care provided by nursing to oncology patients. This report also discusses problems and issues related to quality assurance in cancer nursing, i.e., (1) the diversity of the patient populations that are cared for by oncology nurses; (2) the lack of research on clinical indicators in oncology nursing practice; and (3) the lack of a national data base on cancer nursing practice to aid in the establishment of "thresholds of acceptable performance." Possible solutions and recommendations for action are given. PMID- 2720618 TI - Continuity of care issues for cancer patients and families. AB - As survival rates for cancer patients increase, there is a compelling need to recall Montaigne's words that the value of life does not rest on the number of days, but on the quality of it. The problems that arise for patients and their families require integrated acute care and community-based services that consider the networks that make up an individual's life: families, friends, work, school, and religious and social institutions. Coordinating efforts to provide home care, psychosocial and educational supports, and information to help those who are experiencing the disease can ultimately help them develop effective coping strategies to maximize their healthy functioning. If we are to heed we must continue to promote much-needed dialogue among various branches of the health care community and representatives of the public and private sectors to identify problems, fill gaps in services, then develop interventions and understanding which will address the increasing needs encountered by all persons affected by cancer. PMID- 2720619 TI - Patients' perception of their care. PMID- 2720620 TI - Methodologic approaches to quality care evaluation. AB - A number of problems inherent to quality of care evaluation have been described above. Although issues such as limited resources and clinical staff resistance may not be specific to cancer care, they certainly impact on the evaluation of the quality of care offered to cancer patients. Other issues such as complexity of care and the time span over which care can occur are more applicable to the cancer patient population alone. In response to these issues, I have offered a number of solutions, such as reorganizations of tasks, the use of statistical techniques such as sampling and power analysis, and various feedback mechanisms which have been implemented at MSKCC. The data presented indicate that these mechanisms have been at least partially successful; however, given the absence of a controlled environment, drawing firm conclusions about the relationship between cause and effect is not possible. I hope that in the future these results may be replicated at other institutions who elect to implement any of the suggestions I have made. PMID- 2720621 TI - A model for oncology clinical indicators. PMID- 2720622 TI - Joint Commission plans for clinical indicator development for oncology. PMID- 2720623 TI - Medical staff enforcement. Dilemmas and decisions. PMID- 2720624 TI - Caring for elderly cancer patients. Quality assurance considerations. PMID- 2720625 TI - The dying patient and dehydration. PMID- 2720626 TI - Welcome to community health. Brenda, Beth and Susan. PMID- 2720628 TI - Creating supernurses. PMID- 2720627 TI - Professional liability: a successful year of self-protection for Canadian nurses. PMID- 2720629 TI - [The elderly and their health]. AB - Health promotion aims to increase individuals' decision making toward their own health and help them control their quality of life through personal strategies. Seniors benefit from this process, says the author, who describes a collaborative health promotion and information program at the Ottawa-Carleton Regional Health Department--a program that involves seniors, professionals and volunteers. The needs of the seniors were identified, involvement of relevant organizations requested, then the program was tested with the help of pilot groups. After the program was successfully launched, seniors were also involved in its evaluation and revision. PMID- 2720630 TI - [Autonomy of the elderly]. AB - If individuals cannot change life events, at least they can change their attitude towards them. To do so, older people need autonomy; that is, the freedom and independence to accept what they cannot change. How to master life and enjoy the remaining years, and how to replace negative forces by positive ones are explored here with caring and sensitivity. Readers are challenged to accept death as well as life, and that happiness in the later years is embodied in one's capacity to embrace health or sickness as a powerful lesson. By living fully into old age, we can attain peace, serenity and joy. PMID- 2720631 TI - Radiation therapy. PMID- 2720632 TI - Radiotherapy departmental automation. AB - Cost-effective radiotherapy departmental information systems have been developed to answer a growing need for facility management and clinical research. These systems provide scheduling and management support to improve patient flow, facility utilization, charge capture, quality assurance and clinical studies. Typical data base definition, system utilization and costs are presented. PMID- 2720633 TI - Unified nomenclature for pathogenic Neisseria species. PMID- 2720634 TI - First European Workshop on Cytogenetics and Molecular Genetics of Human Solid Tumors. Dijon, France, October 13-15, 1988. Abstracts. PMID- 2720635 TI - Malformation syndrome with t(2;22) in a cancer family with chromosome instability. AB - A de novo unbalanced t(2;22)(q37;q11.2) [corrected], resulting in the deletion of the 22pter-q11 and 2q37-qter regions, was observed in a 12-year-old girl born with a congenital malformation syndrome and later displaying signs of neurologic impairment. Some of the clinical signs observed appear to overlap those found in subjects monosomic in the 22q11 region affected by the DiGeorge syndrome. The chromosomal rearrangement observed may be related to a familial cytogenetic instability that also gives rise to sustained cancer predisposition. PMID- 2720636 TI - Chromosomal rearrangement in choriocarcinoma cell lines. AB - Malignant trophoblastic cells from four choriocarcinoma cell lines were evaluated in detail using Q, G, and C banding at various passages. The modal chromosome numbers for BeWo, DoSmi, ElFa, and Jar were 73, 71, 77, and 72, respectively. All the four tumor cell lines exhibited extensive chromosomal rearrangements with several consistent marker chromosomes in each. The majority of these markers have not been previously recognized in this malignancy. Rearrangements of chromosomes 1, 7, 9, 10, and 12 were noted in all four cell lines, but abnormalities of chromosomes 1 and 12 were not consistently present in ElFa and Jar, respectively. Telomeric associations were observed in two cell lines involving chromosomes 11 and 21 as well as chromosomes 3 and 12, resulting in two consistent marker chromosomes. A total of 86 breakpoints were involved in the consistent rearrangements observed in all four cell lines. Most of these breakpoints were located on chromosomes 1, 3, 9, 13, 12, 7, and 21, in order of frequency. PMID- 2720637 TI - A genetic linkage study of familial breast-ovarian cancer. AB - Linkage analysis was conducted in 17 families identified by the familial occurrence of breast and ovarian cancer using a series of 17 serologic and biochemical markers. Lod scores suggestive of linkage of breast/ovarian cancer susceptibility to the RH blood group locus on chromosome 1p were obtained. When the presence of fibrocystic disease of the breast in a first-degree relative of an affected family member was added as an indicator of susceptibility, the evidence for linkage increased. No evidence of linkage to GPT or ABO, both previously suggested to be linked to breast cancer susceptibility, was seen in this study. PMID- 2720638 TI - A der(11)t(8;11) in two medulloblastomas. A possible nonrandom cytogenetic abnormality. AB - Cytogenetic analysis of tumor tissue from two patients with medulloblastoma is reported. Both showed the presence of an i(17q) and a der(11)t(8;11)(q11;p11). It is suggested that the t(8;11) may be a translocation associated with medulloblastoma. PMID- 2720639 TI - Nonrandom karyotypic changes in immortal and tumorigenic Syrian hamster cells induced by diethylstilbestrol. AB - Treatment of Syrian hamster embryo cells with diethylstilbestrol (DES) resulted in the induction of immortal cell lines that progressed and formed tumors in nude mice. Four independently treated cell lines were analyzed cytogenetically at several passages during neoplastic progression. The immortal cell lines at the early passages had no structural abnormalities but did have numerical changes. For example, gain of chromosome 11 was found in all immortal cell lines, and gain of chromosome 19 was found in two of four cell lines. Tumorigenic cells showed not only a variety of numerical abnormalities but also structural abnormalities. Loss of a sex chromosome and gain of chromosome 19 were found in six of seven tumors. Gain of chromosome 11, which was found in all immortal cell lines, disappeared in five of seven tumors. Structural abnormalities involving chromosomes 2 and 3 were found in three of seven tumors. Many marker chromosomes were also found in the tumors. These results support our hypothesis that DES induced nondisjunction is important in its ability to induce cell transformation and suggests that gain of chromosome 11 and/or 19 may play a role in DES-induced neoplastic progression. Furthermore, these results indicate that for the acquisition of tumorigenicity, additional numerical or structural changes are needed, suggesting that multiple genetic events are required in the multistep process of carcinogenesis. PMID- 2720640 TI - Sequence of centromere separation: kinetochore formation and DNA replication in dicentric chromosomes showing premature centromere separation in rat cerebral cells. AB - A subpopulation of rat cerebral endothelial cells, designated B1, exhibits an array of multicentric chromosomes. Because of the formation of bridges at anaphase, this cell population produced new types of multicentrics at every cell division. These chromosomes showed kinetochore proteins at every centromeric site and all centromeric regions replicated their DNA at the end of the S phase, more or less simultaneously. A new subpopulation of cells, designated B2, obtained from the original sample frozen at Wayne State University displayed several dicentrics. In contrast to B1 these chromosomes exhibit premature centromere separation as reported for mouse and human cell lines. These B2 dicentrics show only one site of kinetochore protein deposition. The timing of DNA replication around the centric region of prematurely separating centromere is also changed similar to the earlier reported premature DNA synthesis for mouse dicentrics. These observations suggest a universality of relationship between premature centromere separation, a lack of kinetochore formation, and early replication of the centric/pericentric DNA associated with these centromeres. The cause of sudden change from activity to inactivity of these chromosomes, though interesting, is not clear. PMID- 2720641 TI - t(6;9) in bone marrow cells in two patients with sarcoidosis and acute myeloid leukemia. AB - A t(6;9) was seen in bone marrow aspirates from two patients with sarcoidosis who developed acute myeloid leukemia. This is a new observation not previously reported. PMID- 2720642 TI - Tumor-specific antigens as altered growth factor receptors. AB - Most induced, as opposed to spontaneous, tumors possess tumor-specific transplantation antigens. Data suggest that the prevalence of these antigens, at least among tumors induced chemically in diffusion chambers, is dependent upon the density of the culture at the time of carcinogen application. Other data show that density inhibition of cell growth is mediated by the interaction of various "growth factors" with their respective cell surface receptors. The juxtaposition of these two observations leads me to hypothesize that the tumor-specific transplantation antigen is an altered growth factor receptor. Development of the hypothesis leads to rational explanations of some paradoxical features of tumor growth in nude mice, to a possible understanding of why spontaneous tumors are nonimmunogenic, and to an explanation of the phenomenon of facilitation of tumor growth by a weak immune reaction. PMID- 2720643 TI - Gastrin in human bronchogenic carcinomas: constant expression but variable processing of progastrin. AB - Using a library of radioimmunoassays against essential sequences of human progastrin and procholecystokinin, we have examined the occurrence of gastrin, cholecystokinin, and their precursors in bronchogenic adenocarcinomas, large cell, small-cell, and squamous-cell carcinomas (n = 17). Progastrin and some of its bioactive (i.e., alpha-carboxyamidated) products were present in all tumors, irrespective of histological classification. The concentration of progastrin varied from 0.2 to 21.9 pmol/g tissue; glycine-extended intermediates constituted less than 0.1 to 0.5 pmol/g; and bioactive, carboxyamidated gastrin ranged from less than 0.1 to 6.1 pmol/g. Chromatography showed that the bioactive gastrins were exclusively gastrin-17 peptides, half of which were tyrosine O-sulfated. Neither procholecystokinin nor its processing products were found in the tumor extracts. Six samples of nonneoplastic human lung tissue contained traces of progastrin (range, less than 0.1-0.8 pmol/g), but neither bioactive gastrins nor any cholecystokinin. The results show that the gastrin gene is expressed in all classes of bronchogenic carcinomas. Due to incomplete posttranslational processing measurement of progastrin may be necessary to detect such expression. PMID- 2720644 TI - In vivo characterization of combination antitumor chemotherapy with calcium channel blockers and cis-diamminedichloroplatinum(II). AB - We have examined nifedipine, a dihydropyridine class calcium channel blocker, for ability to overcome cis-diamminedichloroplatinum(II) (cisplatin) resistance in a murine tumor line variant, B16a-Pt, which we developed for resistance to cisplatin. Nifedipine significantly enhanced the antitumor actions of cisplatin against primary subcutaneous B16a-Pt tumors and their spontaneous pulmonary metastases. We have characterized, in vivo, the pharmacokinetics and dose response interactions between nifedipine and cisplatin. We now report our studies designed to compare, in vivo, the efficacy of nifedipine and other calcium active compounds including: (a) structurally similar calcium channel blockers (nimodipine, nicardipine) from the dihydropyridine class, (b) structurally different calcium channel blockers from the benzothiazepine (diltiazem) and the phenylalkylamine (verapamil) classes, and (c) calmodulin antagonists (trifluoperazine and calmidazolium) for ability to enhance the antitumor action of cisplatin. Nifedipine was included as the standard or reference compound. In these studies verapamil and diltiazem failed to enhance the antitumor actions of cisplatin as did both calmodulin antagonists. Our findings suggest that nifedipine has a greater degree of specificity for B16a-Pt cells than structurally different calcium channel blockers from other chemical classes (i.e., diltiazem and verapamil), or the two calmodulin antagonists (i.e., trifluoperazine and calmidazolium). We concluded that nifedipine interacts with specific target site(s) which are not accessible by verapamil, by diltiazem, or by the calmodulin antagonists. Surprisingly, the two dihydropyridine class calcium channel blockers, nimodipine and nicardipine, also failed to enhance cisplatin's antitumor actions despite the fact that their specificity and kinetics for binding to the dihydropyridine receptor component of the calcium channel favors them (nimodipine and nicardipine) over nifedipine. Therefore, we postulate that the synergism between cisplatin and nifedipine is independent of the latter's effect on the voltage sensitive, slow inward calcium channel. We suggest that cisplatin cytotoxicity is enhanced by nifedipine's interaction with an as yet unidentified specific "target site," as opposed to nonspecific interactions with the tumor cell plasma membrane or specific interactions with calmodulin or the P-glycoprotein (which is responsible for pleiotropic resistance). PMID- 2720645 TI - Antiprogestins, a new form of endocrine therapy for human breast cancer. AB - The antitumor, endocrine, hematological, biochemical, and side effects of chronic second-line treatment with the antiprogestin mifepristone (RU) 486) were investigated in 11 postmenopausal patients with metastatic breast cancer. We observed one objective response, 6 instances of short-term stable disease, and 4 instances of progressive disease. Mean plasma concentrations of adrenocorticotropic hormone (P less than 0.05), cortisol (P less than 0.001), androstenedione (P less than 0.01), and estradiol (P less than 0.002) increased significantly during treatment accompanied by a slight decrease of sex hormone binding globulin levels, while basal and stimulated gonadotropin levels did not change significantly. The increased basal cortisol levels could not be further stimulated by synacthen, nor suppressed by 1 mg of dexamethasone. Plasma estradiol concentrations were significantly correlated with both androstenedione (P less than 0.05) and cortisol levels (P less than 0.01). The percentage of eosinophilic white blood cells (P less than 0.02) and mean plasma creatinine concentration (P less than 0.05) increased significantly. Side effects frequently occurred during long-term treatment and appeared to be caused mainly by the antiglucocorticoid properties of the drug. It is concluded that antiprogestins form a new treatment modality in the endocrine treatment of human breast cancer. New antiprogestins with less antiglucocorticoid side effects might be especially of value as an adjunct to antiestrogenic treatment in view of our finding that combined antiestrogenic and antiprogestational treatment caused additive growth inhibitory effects in rat mammary tumors. PMID- 2720646 TI - Functional properties and effect on growth suppression of human neuroblastoma tumors by isotype switch variants of monoclonal antiganglioside GD2 antibody 14.18. AB - A complete family of IgG isotype switch variant hybridomas was generated from the anti-GD2 monoclonal IgG3-producing hybridoma, 14.18, with the aid of the fluorescence-activated cell sorter. The IgG1, IgG2b, and IgG2a monoclonal antibodies (Mabs) produced by respective isotype switch variant hybridomas 14G1, 14G2b, or 14G2a, have binding activities for the biochemically defined GD2 antigen and GD2-expressing neuroblastoma target cell lines identical to that of IgG3 Mabs produced by the 14.18 parent cell line. This permitted us to examine the relative in vitro and in vivo cytotoxic capacities of each of the anti-GD2 antibodies for GD2-expressing neuroblastoma cells independent of antibody binding affinity or specificity. Mabs produced by 14.18, 14G2a, or 14G2b, but not 14G1, can direct efficient complement-dependent cytotoxicity against neuroblastoma tumor cells in the presence of human complement. Mabs produced by the parent 14.18 or by 14G2a are more efficient in directing antibody-dependent cell mediated cytotoxicity than Mabs produced by 14G2b, and Mabs of 14G1 are inactive. However, despite these noted in vitro differences, antibodies produced by each member of this switch variant family suppress the growth of human neuroblastoma tumor cells in BALB/c athymic nu/nu mice. These studies suggest that a mechanism(s) other than Fc-directed complement-dependent cytotoxicity or antibody dependent cell-mediated cytotoxicity may account for the in vivo antitumor effects of these particular antibodies. PMID- 2720647 TI - Platinum concentrations and DNA adduct levels in tumors and organs of cisplatin treated LOU/M rats inoculated with cisplatin-sensitive or -resistant immunoglobulin M immunocytoma. AB - Female LOU/M rats, bearing either a cisplatin (cisDDP)-sensitive or -resistant IgM immunocytoma, were sacrificed at 1 or 24 h after cisDDP administration (i.v., 10 mg/kg of body weight). Platinum levels, determined with atomic absorption spectroscopy, were in the order kidney much greater than liver greater than tumor greater than spleen in the 1-h samples. In the 24-h samples, more platinum was found in spleens than in tumors; the levels in the kidneys were the same as those measured at 1 h, in the spleens they were higher, and in livers and tumors they were lower than at 1 h after the injection; the greatest decrease occurred in the resistant tumor. cisDDP-DNA adducts were detected after chromatography of digested DNA samples isolated from these tissues and from blood cells. The quantitation of the four cisDDP-DNA adducts (Pt-G, Pt-AG, Pt-GG, G-Pt-G, the same as found previously in cisDDP-reacted DNA) was performed with specific antibodies, in the competitive enzyme-linked immunosorbent assay. The cisDDP-DNA adduct levels in the various 1-h tissue samples showed the same ranking order as the platinum levels. The blood samples contained the lowest amount of adducts. Because of the high platinum level in the kidneys (26 mg/kg of wet tissue), the adducts in this organ also could be determined with atomic absorption spectroscopy (the four adducts comprised about 400 fmol/micrograms of DNA). Comparison of the atomic absorption spectroscopy and enzyme-linked immunosorbent assay data showed excellent agreement. Except for the kidney, all samples showed a decrease in adduct level between 1 and 24 h after cisDDP treatment. The data on the tumors indicated that the difference in susceptibility to cisDDP between the sensitive and resistant tumors is not due to a decreased platinum content or reduced DNA adduct formation in the resistant tumor. PMID- 2720648 TI - Identification and characterization of X-ray-induced proteins in human cells. AB - In order to investigate the biochemical events involved in potentially lethal DNA damage repair (PLDR), we have identified a pleiotropic protein expression response that is activated upon X-irradiation of confluence-arrested human malignant melanoma (U1-Mel) cells. Plateau-phase U1-Mel cells were selected because of their extraordinary capacity for PLDR. Eight major X-ray-induced polypeptides (XIPs) of Mr 126,000-275,000 (i.e., XIP126 through XIP275) were detected by resolving L-[35S]methionine-labeled whole cell extracts using two dimensional gel electrophoresis. XIPs were found in unirradiated, proliferating U1-Mel cells, shut off under plateau-phase conditions and resynthesized in response to X-irradiation. The expression of three classes of proteins was affected by X-irradiation. Class I proteins, XIP145 and XIP269, were induced linearly with increasing X-ray doses. The rate of synthesis of class II proteins, XIP126, XIP135, XIP138, XIP141, XIP147, and XIP275, increased linearly with low X irradiation doses, but plateaued at doses of 150-250 cGy. In contrast, the expression of class III proteins, 47,000 and 254,000 Mr proteins, decreased with increasing X-ray doses. Tumor, cancer-prone, and normal human cells, which represent a wide range of cells with varied repair capacities, were investigated to better understand the role of XIPs in DNA damage responses. X-irradiated normal and tumor cells induced the synthesis of XIP145 and XIP269. A strong correlation between the induction of XIP269 and PLDR capacity, as measured by delayed plating of plateau-phase cells, was noted. XIP269 was present in six of seven normal and tumor cells types, but was completely absent in cells from patients with Bloom's syndrome and ataxia telangiectasia. X-irradiated Fanconi's anemia and xeroderma pigmentosum cells synthesized low levels of XIP269. The majority of XIPs synthesized by X-irradiated cells from cancer-prone patients were of low molecular weights. A number of XIP expression characteristics suggest their role in either gross chromosomal PLDR and/or in X-ray adaptivity responses: (a) XIP expression was inhibited by 1 microgram/ml cycloheximide, a dose which decreased survival 6-fold during PLDR holding and resulted in greater than 80% inhibition of protein synthesis; (b) XIP expression was specific for ionizing radiation damage, since heat shock, hypoxia, and alkylating agents failed to induce their synthesis; (c) the time course of expression was long, with the first appearance of XIPs at 3 h and maximal expression at 4 h. PMID- 2720649 TI - Effects of aromatic isothiocyanates on tumorigenicity, O6-methylguanine formation, and metabolism of the tobacco-specific nitrosamine 4 (methylnitrosamino)-1-(3-pyridyl)-1-butanone in A/J mouse lung. AB - Phenethyl isothiocyanate (PEITC), benzyl isothiocyanate (BITC), and phenyl isothiocyanate (PITC) were tested for their abilities to inhibit lung tumorigenesis and O6-methylguanine formation in lung DNA induced by the tobacco specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in A/J mice. Pretreatment with PEITC for 4 consecutive days at daily doses of 5 or 25 mumol inhibited tumor multiplicity induced by a single 10-mumol dose of NNK by approximately 70% or 97%, respectively. The 25-mumol daily dose of PEITC also reduced the percentage of animals that developed tumors by 70%. In contrast, both BITC and PITC failed to significantly reduce tumor multiplicity or the percentages of mice that developed tumors. Using an identical dosing regimen, parallel results were observed in the effects of these isothiocyanates on O6 methylguanine formation in the lung, in which PEITC at either dose resulted in considerable inhibition at 2 or 6 h after NNK administration, while BITC or PITC had little effect. PEITC was further tested for its ability to inhibit lung microsomal metabolism of NNK. A single administration of PEITC (5 or 25 mumol) resulted in 90% inhibition of NNK metabolism. These results in conjunction with recent results obtained using F344 rats firmly establish PEITC as an effective inhibitor of NNK lung tumorigenesis and suggest that the basis of this inhibition is the reduction of DNA adduct formation caused by the inhibition of enzymes responsible for NNK activation. PMID- 2720650 TI - Metabolic activation of 6-nitrochrysene in explants of human bronchus and in isolated rat hepatocytes. AB - It has previously been shown that 6-nitrochrysene can be activated to electrophilic species capable of reacting with DNA through metabolic pathways that form N-hydroxy-6-aminochrysene or trans-1,2-dihydroxy-1,2-dihydro-6 aminochrysene as critical intermediates. Since the lung is a known target tissue for the carcinogenic action of polycyclic nitroaromatic hydrocarbons, we investigated the metabolism and DNA binding of [3H]6-nitrochrysene in 11 specimens of human bronchus. Analysis of medium from [3H]6-nitrochrysene-treated explants indicated the presence of trans-9,10-dihydroxy-9,10-dihydro-6 nitrochrysene (0.04-330 pmol/mg epithelial DNA), trans-1,2-dihydroxy-1,2-dihydro 6-nitrochrysene (12-1700 pmol/mg epithelial DNA), 6-aminochrysene (1.6-2200 pmol/mg epithelial DNA), and trans-1,2-dihydroxy-1,2-dihydro-6-aminochyrsene (3.6 610 pmol/mg epithelial DNA). Both the levels and the relative proportions of these metabolites varied widely in explants from different individuals. The amount of DNA recovered and the level of DNA modification were sufficient for adduct analysis in eight of the 11 cases for which metabolite data were obtained. Five additional bronchial specimens for which metabolite data were not obtained were also analyzed for carcinogen-DNA adducts. The levels of binding varied from 0.06 to 30.5 pmol [3H]6-nitrochrysene bound/mg DNA (two adducts per 10(8) nucleotides-10 adducts per 10(6) nucleotides). HPLC analyses of enzymatic hydrolysates of the explant DNA indicated that 11 of 13 cases contained adducts with retention times identical to those of adducts derived from trans-1,2 dihydroxy-1,2-dihydro-6-aminochrysene or N-hydroxy-6-aminochrysene. The adduct derived from trans-1,2-dihydroxy-1,2-dihydro-6-aminochrysene was the major adduct detected in eight of 13 cases. The reasons for the variation in metabolism and adduct formation observed in [3H]6-nitrochrysene-treated explants of bronchus from different donors are not known but may reflect differences in the activities of enzymes responsible for the metabolism of this compound. The influence of induction of drug metabolizing enzymes on the activation pathway of 6 nitrochrysene in an intact cell system was tested using rat hepatocytes. 6 Nitrochrysene was incubated with freshly isolated hepatocytes from rats that were either untreated or pretreated with phenobarbital, 3-methylcholanthrene or Aroclor 1254. Although the levels of adducts were similar in all cases, the pattern of DNA adducts formed in these hepatocytes was dependent on the nature of the pretreatment of the rats. As previously reported, hepatocytes from untreated rats contained adducts derived from N-hydroxy-6-aminochrysene.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2720651 TI - Comparison of activity of deferoxamine with that of oral iron chelators against human neuroblastoma cell lines. AB - The iron chelator, deferoxamine, has demonstrated cytotoxicity against neuroblastoma cells. In this study we examined the in vitro antineuroblastoma activity of several potentially less expensive oral chelating agents. On a mole for mole basis, 1-hydroxypyridine-2-thionine (omadine) had 100 times the cytotoxicity of deferoxamine. 1,2-Dimethyl-3-hydroxypyrid-4-one also caused demonstrable cell death but at considerably higher molar concentrations than those required for deferoxamine. 2,3-Dihydroxybenzoic acid had no effect on neuroblastoma cell viability over a range of concentrations. In contrast to the effect of both deferoxamine and 1,2-Dimethyl-3-hydroxypyrid-4-one, those due to omadine were permanent within 24 hours of incubation, were not significantly altered by the presence of ionic iron, and correlated with an increase in the percentage of cells in the S-G2-M phases of the cell cycle. On the basis of these in vitro studies, we believe that the use of omadine in particular and iron chelators in general, by themselves or as cell cycle-recruiting agents together with standard cell cycle specific drugs, is an approach to the treatment of cancer worth further investigation. PMID- 2720652 TI - Antitumor activity and mechanism of action of the novel marine natural products mycalamide-A and -B and onnamide. AB - Three novel heterocyclic compounds, mycalamide-A and -B and onnamide, were isolated from Mycale sp. and Theonella sp. sponges collected in New Zealand and Okinawan waters. Each exhibited potent in vitro toxicity and in vivo efficacy against murine and human tumor cells. Concentrations of each that inhibited replication of cultured murine lymphoma P388 cells by 50% were 5 nM or less. Mycalamide-A and -B were also potent inhibitors of HL-60, HT-29, and A549 human tumor cell replication (50% inhibitory concentration less than 5 nM), while values for onnamide were greater (50% inhibitory concentrations between 25 and 200 nM). Mycalamide-A (10 micrograms/kg) and -B (2.5 micrograms/kg) were moderately active against P388 leukemia (increase in life span, approximately 50%), while onnamide was inactive (40 micrograms/kg; increase in life span, 15%). Mycalamide-A was also active against B16 melanoma, Lewis lung carcinoma, M5076 ovarian sarcoma, colon 26 carcinoma, and the human MX-1, CX-1, and Burkitt's lymphoma tumor xenografts. Mechanism of action studies indicate that the three agents inhibited protein synthesis. For example, after 1-h exposures to 20 nM mycalamide-A and -B, the rates of [3H]leucine incorporation into acid precipitable material of cultured P388 cells were inhibited 54 and 99%, while the effects on incorporation of [3H]uridine and [3H]thymidine were less. The relative effects of 20 to 2000 nM mycalamide-A on protein, RNA, and DNA synthesis were consistent with those observed during exposure of P388 cells to 1 microM emetine, a known inhibitor of protein synthesis. Also, the three agents inhibited translation of RNA into protein in a cell-free lysate of rabbit reticulocytes. Although mycalamide-A disrupted DNA metabolism, the agent apparently did not intercalate into DNA, and a mixture of four deoxynucleosides (250 microM each) did not decrease the antiproliferative effects of the agent. Collectively, these data indicate that this class of compounds represents novel antitumor agents which should be further evaluated to define their potential. PMID- 2720653 TI - Active uptake and extravesicular storage of m-iodobenzylguanidine in human neuroblastoma SK-N-SH cells. AB - Radio-iodinated m-iodobenzylguanidine (MIBG), an analogue of the neurotransmitter norepinephrine (NE), is increasingly used in the diagnosis and treatment of neural crest tumors. Active uptake and subsequent retention of MIBG and NE was studied in human neuroblastoma SK-N-SH cells. Neuron-specific uptake of [125I]MIBG and [3H]NE saturated at extracellular concentration of 10(-6) M and exceeded by 20-30-fold that by passive diffusion alone. A minimum of 50% of accumulated MIBG remained permanently stored but the SK-N-SH cells were incapable of retaining recaptured [3H]NE. [125I]MIBG was displaced from intracellular binding sites by unlabeled MIBG with 10-fold higher potency than by unlabeled NE. MIBG stored in SK-N-SH cells was insensitive to depletion by the inhibitor of granular uptake reserpine (RSP) and was not precipitated in a granular fraction by differential centrifugation. Only few electron-dense granules were found in these cells by electron microscopy. In contrast, MIBG storage in PC-12 pheochromocytoma cells which contained many storage granules, was sensitive to RSP and part of accumulated drug was recovered in a granular fraction. Accordingly, storage of MIBG in the SK-N-SH neuroblastoma cells is predominantly extravesicular and thus essentially different from that of biogenic amines in normal adrenomedullary tissue or in pheochromocytoma tumors, while sharing with these tissues a common mechanism of active uptake. PMID- 2720654 TI - Influence of pituitary grafts or prolactin administrations on the hormone sensitivity of ovarian hormone-independent mouse mammary MXT tumors. AB - The sensitivity of MXT mouse mammary tumors to ovarian hormones was assessed by the following parameters: growth in vivo; presence or absence of estrogen receptors and progesterone receptors; and histological differentiation. A spontaneous evolution from hormone sensitivity (HS) to hormone independence (HI) was observed when the tumors underwent monthly transplantation onto intact recipient mice, with the tumors fulfilling the criteria of HI tumors after the 12th transplantation. In contrast, the tumors recovered most of the criteria of hormone sensitivity when pituitary isografts were placed under the kidney capsules of HI tumor-bearing animals or when these animals received daily administrations of prolactin over several months. Sensitivity to 17 beta estradiol, progesterone, or prolactin was further assessed by actinomycin binding on the nucleus and thymidine labeling index, both measured by autoradiography. These technical approaches revealed that 17 beta-estradiol and prolactin stimulated the thymidine labeling index of both HI (despite the lack of detectable estrogen receptors) and HS MXT tumors whereas progesterone influenced only that of HS cancers. The three hormones significantly stimulated [3H]actinomycin D binding within HS tumors but not within HI ones. However, such "HI" tumors were characterized by increased actinomycin binding and thymidine labeling index in comparison with HS neoplasms. Thus, all the data presently reported strongly suggest that prolactin is able to restore the hormone-sensitive phenotype within so-called MXT hormone-independent tumors. PMID- 2720655 TI - Selective chromosomal damage and cytotoxicity of 125I-labeled monoclonal antibody 17-1a in human cancer cells. AB - A monoclonal antibody, 17-1a, which reacts with antigen expressed in human colon cancers was radiolabeled in high specific activity with 125I. The combination of the antibody and this radionuclide was observed to elicit specific cellular damage after being internalized into cells of the SW1116 human colon cancer cell line. The degree of internalization was quantitatively measured and found to increase over time to 49% after a 48-h incubation period. During this period, significant chromosome aberrations were observed in the SW1116 cell line due to the Auger electrons of 125I. This damage was not observed using Na125I, a nonimmunoreactive radiolabeled antibody, or cells which did not contain the requisite antigen. The number of chromosomal aberrations increased with increasing radioactive concentration of 125I-17-1a. The nuclear damage resulted in specific cellular cytotoxicity and decreased cell survival of SW1116 cells exposed to various concentrations of 125I-17-1a. PMID- 2720656 TI - Role of the methylene backbone in the antiproliferative activity of polyamine analogues on L1210 cells. AB - The impact of the polyamine analogues, N1,N11-diethylnorspermine (DENSPM), N1,N12 diethylspermine (DESPM), and N1,N14-diethylhomospermine (DEHSPM) on the growth properties of L1210 murine leukemia cells is compared. The order of antiproliferative activity of the three compounds is shown to be DEHSPM greater than DESPM greater than DENSPM with average 96-h IC50 values of 0.06, 0.18, and 1.3 microM, respectively. Trypan blue exclusion suggests that the cytotoxic behavior of the compounds is not apparent until 96 h after exposure to the analogues. DEHSPM is shown to act more quickly and demonstrates the most profound cytotoxic effects at 144 h. Competitive uptake studies with spermidine reveal DESPM and DEHSPM to have essentially identical Ki values of 1.4 and 1.6 microM, respectively, while DENSPM indicates a substantially higher Ki value of 17 microM. Finally, although the analogues reduce the levels of putrescine, spermidine, and spermine in L1210 cells, if the concentration of polyamines in the cell, including analogues, is expressed on a nitrogen equivalence basis, the total cationic charge with which the polyamines are associated is conserved. PMID- 2720657 TI - Hydrogen ion-mediated enhancement of cytotoxicity of bis-chloroethylating drugs in rat mammary carcinoma cells in vitro. AB - Aerobic glycolysis, a metabolic characteristic of malignant cells, can be exploited to increase the concentration of lactic acid selectivity in tumor tissues in vivo by systemic administration of glucose (E. Jahde and M. F. Rajewsky, Cancer Res., 42: 1505-1512, 1982). To investigate whether a more acidic microenvironment can enhance the effectiveness of cytocidal drugs, we have analyzed the colony-forming capacity of M1R rat mammary carcinoma cells exposed to bis-chloroethylating agents in culture as a function of extracellular pH (pHe). At pHe 6.2 the cytotoxicity of 4-hydroperoxycyclophosphamide, as measured by inhibition of colony formation, was potentiated by a factor of approximately 200 as compared to pHe 7.4. Similar results were obtained with mafosfamide, nitrogen mustard, nornitrogen mustard, melphalan, and chlorambucil; not, however, with ifosfamide. As indicated by experiments using the ionophor nigericin for rapid equilibration of pHe and intracellular pH (pHi; measured with pH-sensitive microelectrodes), modulation of drug action by varying pHe primarily resulted from the concomitant decrease in pHi. The acidic microenvironment enhanced cytotoxicity most effectively during the phase of cellular drug uptake and monofunctional alkylation of DNA. DNA cross-link formation appeared to be less affected by pH, and lowering of pHe during the phase of cross-link removal was only marginally effective. PMID- 2720659 TI - Spontaneous olfactory neuroepithelioma in a domestic medaka (Oryzias latipes). AB - Tumors of the central nervous system in fish are rare, and only six cases of spontaneous olfactory neuroepithelioma have been reported. This is the seventh case, found in a medaka, Oryzias latipes. The tumor was noted near the right olfactory orifice and finally measured 1.5 mm in diameter. Histologically the tumor consisted of undifferentiated neuroblasts forming a few true rosettes. Mitosis was frequently observed. Tumor cells stained diffusely for neuron specific enolase and sporadically for neurofilament proteins by immunohistochemical procedures. Additionally a few large tumor cells were positively stained for S-100 protein. Electron microscopy revealed that the tumor cells had extended cytoplasm in which parallel neurotubules and a few neuroendocrine granules were noted. In the perinuclear region, bundles of intermediate filaments and neuroendocrine granules were seen. Single cilia and a pair of centrioles were occasionally found, but no ciliated cells were found in this tumor. Some large tumor cells contained electron-dense intracytoplasmic inclusions which showed a crystalloid structure by high-magnification electron microscopy; however, this type of crystalloid has never been reported in neuronal tumors. PMID- 2720658 TI - Molecular basis for the sex-related difference in renal N-nitrosodimethylamine demethylase in C3H/HeJ mice. AB - Previous work with rat and rabbit liver enzymes has demonstrated that cytochrome P450IIE1 is responsible for the metabolism of N-nitrosodimethylamine (NDMA), a widely occurring carcinogen. The present study demonstrated that a similar enzyme also exists in the mouse kidney and is regulated by testosterone. These results can account for the reported sex-related difference in the renal metabolism of NDMA in mouse strains such as C3H/HeJ. NDMA demethylase activities (expressed as pmol/min/mg protein) in kidney microsomes of female and male C3H/HeJ mice were 3.0 +/- 0.7 and 51.9 +/- 11.2, respectively. After testosterone treatment (500 mg/kg b.w. in olive oil, s.c.) for 2 days, the renal NDMA demethylase activity of the female mice was elevated 17-fold. The difference and change in NDMA demethylase activity were accompanied by corresponding differences and changes in P450IIE1 as quantified by immunoblot analysis (using antibodies prepared against rat P450IIE1) as well as in the mRNA level for P450IIE1 as determined by Northern and slot blot analyses (using a cDNA probe containing the coding sequence of rat P450IIE1 gene). Based on gel electrophoresis, the molecular weight of mouse renal P450IIE1 was 52,000 and the size of mouse renal P450IIE1 mRNA was approximately 1.8 kilobases; both were similar to those found in rat liver and kidney. Renal P450IIE1 mRNA levels in female, male, and testosterone-treated female mice were at a ratio of 1:22:20. On the other hand, this testosterone-related difference was not observed in hepatic P450IIE1. In liver microsomes, there were no significant differences in NDMA demethylase activity, P450IIE1 content, and P450IIE1 mRNA level between male and female mice or between untreated and testosterone-treated female mice. The apparent Km value of NDMA demethylase in mouse kidney microsomes (22 to 27 microM NDMA) were similar to that in rat liver microsomes. Renal NDMA demethylase activity was inhibited by a monoclonal antibody prepared against rat P450IIE1. These results suggest that mouse renal P450IIE1 is similar to rat P450IIE1 and is responsible for the low Km form of NDMA demethylase activity. Nevertheless, only the mouse renal enzyme is regulated by testosterone. PMID- 2720660 TI - Nuclear distribution of the Ki-67 antigen during the cell cycle: comparison with growth fraction in human breast cancer cells. AB - It has been claimed that the commercially available Ki-67 monoclonal antibody recognizes a nuclear antigen which is solely expressed in cycling cells. Therefore, at present, Ki-67 is increasingly used as a tool in evaluating growth fractions (GFs) of human tumors. Here we describe specific patterns in the expression and topological distribution of this antigen during the cell cycle in MCF-7 human breast cancer cells. Our results support earlier findings that the antigen belongs to a class of antigens associated with the structural organization of meta- and anaphase chromosomes, and proteins located near the cortical regions of prenucleolar bodies and nucleoli. Using 5'-bromodeoxyuridine labeling technology, we show that the expression may be undetectably low at the onset of DNA replication. Comparison of Ki-67 fractions (KFs) and GFs as estimated from continuous 5'-bromodeoxyuridine-labeling curves revealed that KF was invariably higher than GF: in exponentially growing cov362.c14 human ovary cancer cells, KF was only 3.5% higher than GF; in MCF-7 cells, 11.3 +/- 4.6%. In MCF-7 cultures either growing under suboptimal conditions or treated with 10(-6) M tamoxifen, the difference was more pronounced. Furthermore, we evaluated the decrease of Ki-67-positive cells in nutritionally deprived and cell cycle specific, drug-treated cultures. Since the results indicate that nonproliferating cells may retain the antigen for a considerable period of time, KF may not always be a reliable indicator of GF. PMID- 2720661 TI - Development of resistance to 1-beta-D-arabinofuranosylcytosine after high-dose treatment in childhood lymphoblastic leukemia: analysis of resistance mechanism in established cell lines. AB - Cell lines PER-163 and PER-164 are derived from a patient with acute lymphoblastic leukemia who developed resistance to 1-beta-D arabinofuranosylcytosine (ara-C) after high-dose (HD) therapy. Both lines are highly resistant to ara-C and have maintained stable resistance for more than 18 mo. The resistance in PER-164 cells is the result of a selection process in vivo only, while PER-163 cells have in addition been exposed to ara-C in culture. Comparison with cell line PER-145, which is sensitive to ara-C and was established from the same patient before HDara-C therapy, revealed no differences with respect to surface markers, morphology, cytochemical stains, or requirements for growth in vitro. The leukemic origin of the three cell lines is indicated by the close similarities of all three cell lines to the patient's fresh cells. The analysis of the two resistant cell lines shows that resistance to ara-C is not due to lower ara-C transport capacity nor to cytokinetic reasons, since the percentage of cells in S-phase is similar in all three cell lines. In addition, the resistant cell lines do not show any increased cytidine deaminase activity. PER-164 cells show a markedly reduced deoxycytidine kinase activity, 4.8 nmol/h/mg of protein, compared to PER-145 cells with an enzyme activity of 21.48 nmol/h/mg of protein. In PER-163 cells, no deoxycytidine kinase activity could be detected. Furthermore, the two resistant cell lines show significantly different dCTP levels. The sensitive PER-145 cells generated 97.9 pmol of 1-beta-D arabinofuranosylcytosine triphosphate (ara-CTP)/10(7) cells during a 45-min incubation period in the presence of 10(-6) M ara-C. This contrasts with 0.16 and 12 pmol of ara-CTP/10(7) cells for PER-163 and PER-164 cells, respectively. These investigations suggest that cell phenotypes with distinct features can be generated after HDara-C treatment and that decreased deoxycytidine kinase activity appears to be one of the major mechanisms of resistance. PMID- 2720662 TI - Selenium-induced protection against cis-diamminedichloroplatinum(II) nephrotoxicity in mice and rats. AB - The influence of selenium on cis-diamminedichloroplatinum(II) (c-DDP) nephrotoxicity in mice and rats was assessed, using single doses of both compounds. Sodium selenite, 2 mg of selenium per kg, given 1 h before c-DDP, greatly reduced blood urea nitrogen and creatinine levels and morphological kidney damage in both BALB/c mice and Wistar rats, while administration 1 h after c-DDP did not. Liver toxicity of selenium was evaluated by measuring serum glutamic pyruvate transaminase and serum glutamic oxalate transaminase and by routine histology. No liver damage was observed in animals treated with sodium selenite, 2 mg of selenium per kg, and physiological saline or c-DDP. Pretreatment with sodium selenite did not reduce the antitumor activity of c-DDP against MPC 11 plasmacytoma or Prima breast tumor in BALB/c mice. The present results indicate that sodium selenite may provide protection against c-DDP nephrotoxicity, when it is given before c-DDP. Moreover, selenium has an antineoplastic activity against several tumors. The combination of these qualities may open new perspectives in cancer chemotherapy. PMID- 2720663 TI - Chromosomal analysis of a diethylnitrosamine-induced tumorigenic and a nontumorigenic rat liver cell line. AB - A chromosomal analysis was performed on two cell lines which were derived from the liver of two rats exposed to diethylnitrosamine in vivo. The cells were obtained by collagenase perfusion of the liver at an early stage of development of ATPase-deficient putative preneoplastic populations, and propagated from foci of epithelial cells which started growth in vitro. Cell line CL 38 proved to be tumorigenic after transplantation into nude mice, giving rise to hepatocellular carcinomas and metastases. Cell line CL 44 was nontumorigenic after transplantation into nude mice and was therefore considered preneoplastic. The diploid nontumorigenic line CL 44, with a modal number of 42 chromosomes, showed a deletion of chromosome 1 and a translocation of chromosomes 3 and 14 [t(3q12;14q21)]. The hyperdiploid neoplastic cell line CL 38 has a modal chromosome number of 52 and showed tri- or tetrasomy of chromosomes 3, 7, 9, 11, and 12 and a marker chromosome that might have originated from aberrant chromosome 1. One or two homologues of chromosome 3 showed terminal deletions (q42, q41, or q35). In both cell lines rearrangements of chromosome 11 were observed [rob(11q;?) or +11 or -11 or del(11)(q12)]. Some of these karyotype abnormalities are located on the same chromosome as described for transplantable hepatomas and for other chemically induced tumors of the rat. PMID- 2720664 TI - Physical association of base excision repair enzymes with parental and replicating DNA in BHK-21 cells. AB - The physical association of mammalian excision repair enzymes with DNA was examined as a function of cell proliferation. The molecular weight distribution of two nuclear base excision repair enzymes, the uracil DNA glycosylase and the hypoxanthine DNA glycosylase, were examined by sucrose step gradient analysis. The sedimentation of DNA polymerase activity as well as the distribution of parental and replicating DNA were determined simultaneously. In confluent BHK-21 fibroblasts, basal levels of both DNA glycosylases, DNA polymerase beta, and parental DNA sedimented to the 20%/40% sucrose border. In proliferating BHK-21 cells, induced levels of both DNA glycosylases, DNA polymerase alpha, and replicating DNA sedimented to the 40%/50% sucrose border. The physical association of the repair enzymes with DNA was demonstrated by detergent treatment and by DNase digestion. As defined by [35S] methionine pulse labeling analysis, newly synthesized DNA repair enzymes were localized with either parental or replicating DNA. These results suggested that the physical association of mammalian DNA repair enzymes with nuclear DNA was dependent on the proliferative state of the cell. PMID- 2720665 TI - Effect of coumarin on the normal rat prostate and on the R-3327H prostatic adenocarcinoma. AB - Coumarin, the parent compound of warfarin, has been observed to stimulate macrophages, increase phagocytosis, and induce changes in lymphocyte-mitogen responsiveness in cancer patients. Coumarin has been reported to have antitumor activity in human melanomas and renal cancer when used in conjunction with the H 2 antagonist, cimetidine. We have observed that coumarin has antiprostatic activity in rats. When coumarin was given to mature rats at a dose of 40 mg/kg, a significant decrease in the size of the prostate, seminal vesicles, and testes was observed. Testosterone levels were unchanged or slightly elevated, consistent with an antiandrogenic-like activity. Similarly, coumarin significantly inhibited the androgen-induced increase in prostatic size when administered to castrated rats receiving testosterone. Coumarin given to rats bearing the R-3327H androgen sensitive, prostate-derived tumor decreased the size of the primary tumor. The effect was greater than that produced by castration. Coumarin is worthy of further consideration as an agent for use in controlling the normal and abnormal growth of the prostate. PMID- 2720666 TI - Biodistribution of indium-111-labeled OC 125 monoclonal antibody after intraperitoneal injection in nude mice intraperitoneally grafted with ovarian carcinoma. AB - The purpose of this work was to study the biodistribution of 111In-labeled OC 125 monoclonal antibody (MAb) with known affinity for ovarian carcinomas in a nude mouse model grafted i.p. with a human ovarian cancer (NIH:OVCAR-3). Tumor uptake 24 h after i.p. injection was higher with intact 111In-labeled OC 125 MAb (28 +/- 7.44%ID/g) than with 111In-nonspecific immunoglobulin (6.86 +/- 1.35%ID/g). The kinetics of tumor uptake also differed, showing a plateau followed by a drop at Day 7 with 111In-OC 125 MAb and a decrease beginning at 24 h with 111In nonspecific immunoglobulin. Tumor-to-normal tissue ratios ranged between 29.91 +/ 11.85 and 0.68 +/- 0.15 with 111In-OC 125 MAb and between 4.50 +/- 1.06 and 0.53 +/- 0.04 with 111In-nonspecific immunoglobulin according to the normal tissues and the time points considered. Tumor uptake 2 h after injection was the same for F(ab')2 fragments as for intact MAb, whereas maximum uptake at 24 h (18.76 +/- 4.62%ID/g) was lower and was followed by a decrease at Day 4. Tumor-to-normal tissue ratios were in the same range, except for the tumor to blood ratio which was higher and the tumor to kidney ratio which was lower at 24 and 96 h. Maximum tumor uptake was higher after i.p. (30.77 +/- 4.76%ID/g) than i.v. (14.59 +/- 2.70%ID/g) injection. Instead of attaining the plateau noted after i.p. injection, tumor uptake after i.v. injection remained low at 2 h (2.11 +/- 1.66%ID/g), reaching its peak only after 96 h. 131I-OC 125 injected i.p., which reached maximum tumor uptake at 2 h (13.53 +/- 4.25%ID/g), showed tumor-to-tissue ratios ranging between 15.98 +/- 2.63 and 0.96 +/- 0.86, i.e., not very different from those with 111In. After i.p. injection of a radiolabeled colloid solution, maximum tumor uptake was reached at 96 h (20.22 +/- 5.35%ID/g), but with very high nonspecific uptake in liver (31.06 +/- 6.22%ID/g) and spleen (55.23 +/- 14.11%ID/g). These results indicate high, selective tumor uptake of 111In-OC 125 after i.p. injection and demonstrate the feasibility of i.p. radioimmunotherapy of ovarian carcinomas. PMID- 2720667 TI - Biodistribution of indium-111-labeled OC 125 monoclonal antibody intraperitoneally injected into patients operated on for ovarian carcinomas. AB - The biodistribution of 111In-labeled monoclonal antibody (MAb) OC 125 was studied after i.p. injection in 28 patients who underwent surgery for ovarian carcinoma. Group I (eight patients) received intact 111In-labeled OC 125 MAb, Group II (three patients) intact 111In-labeled irrelevant NS, Group III (five patients) intact 111In-labeled OC 125 MAb associated with 20 mg of the same unlabeled MAb and Group IV (12 patients) F(ab')2 fragments of 111In-labeled OC 125 MAb. The patients were operated on 1 to 3 days after i.p. injection, and the surgeon removed large tumor fragments and/or small tumor nodules and, in some patients, collected the residual perfusion fluid from which malignant cell clusters were isolated. Uptake by large tumor fragments at 24 h was low: 0.0031 +/- 0.0032% injected dose per gram (%ID/g) for Group I and 0.0024 +/- 0.0022%ID/g for Group IV. It was moderately higher than that of Group II (0.0014 +/- 0.0006%ID/g) and Group III (0.0015 +/- 0.0007%ID/g). Uptake by small tumor nodules (0.1302 +/- 0.0802%ID/g at 72 h for Group I) and malignant cell clusters (median: 0.3322, with a maximum value of 4.1614%ID/g at 24 h for Group IV) was markedly higher. Tumor-to-normal tissue ratios with OC 125 MAb [intact or F(ab')2 fragments] ranged between 0.1 and 8.5 for large tumor fragments and 2 and 8,700 for small tumor nodules and malignant cell clusters. It would thus appear that RIT is feasible if an appropriate radionuclide can be selected for antibody labeling. PMID- 2720668 TI - Relationship between the levels of serum thyroid hormones or estrogen status and the risk of breast cancer genesis in Japanese women. AB - For the purpose of investigating a possible correlation between the genesis of breast cancer and the levels of serum thyroid hormones or the estrogen status, which is one of the potential risk factors for breast cancer in Japanese women, we measured the percentage of free estradiol (E2) and the amounts of sex hormone binding globulin (SHBG) and thyroid hormones in serum samples from Japanese patients with breast cancer (N = 39) and normal controls (N = 36). The patients were found to have significantly higher free E2 and significantly lower SHBG than controls. Moreover, the serum levels of free triiodothyronine (FT3) and free thyroxine (FT4) were lower in the patients than in controls, while the serum levels of TSH and TBG in the patients were not significantly different from those in controls. The percentage of free E2 in serum was not significantly correlated with the level of any one of FT3, FT4, TSH, and TBG either in the patients or in controls regardless of menstrual status. These results suggest the possibility that the reduction in the serum FT3 and FT4 levels, which is independent of changes in the serum level of free E2, may be one of the risk factors for breast cancer in Japanese women. PMID- 2720669 TI - Endogenous nitrosation in relation to nitrate exposure from drinking water and diet in a Danish rural population. AB - Increasing levels of nitrate in drinking water is of concern due to the possibility of an associated increase in long-term exposure to endogenously formed carcinogenic N-nitroso compounds. Excretion of N-nitrosoproline in 12-h overnight urine after intake of 500-mg L-proline was used to quantify the rate of endogenous nitrosation in 285 individuals in an area in northern Denmark with large variation in nitrate concentration of the drinking water. Nitrate intake was measured in a 24-h duplicate diet sample. The crude association between nitrate concentration in drinking water and rate of endogenous nitrosation in individuals is only weakly positive and not quite statistically significant (P = 0.08). The risk of having detectable nitrosation increases significantly with total nitrate intake and tobacco smoking. In nonsmokers, nitrosation is determined by nitrate intake. Smokers have increased nitrosation which does not depend on nitrate intake. Effect modification through dietary factors was evaluated and indicated a protective effect of tea consumption, while the effect of eating vegetables was not clear-cut. The experimental design (12-h urine sample; proline dose taken in the evening) is likely to underestimate the effect of nitrate in drinking water relatively to nitrate in the diet. PMID- 2720670 TI - Immunological characterization and clinical implication of cobalamin binding protein in human gastric cancer. AB - Cobalamin (vitamin B12) binding protein was purified from gastric cancer extracts and from serum-free culture medium of cancer cell line KATOH-III. The molecular weight, determined by immunoprecipitation and sodium dodecyl sulfate polyacrylamide gel electrophoresis, was 70,000 and the pI was 2.8 to 3.2. From biochemical and immunological properties, this cobalamin binding protein was considered to be an isoprotein of cobalamin R binder. Monoclonal antibodies were produced against saliva R and cobalamin binding protein in culture medium to study their antigenic determinants. Monoclonal antibody 55-D reacted to an epitope of peptide in both binders, whereas WK-1 and H-12 reacted to determinants of a carbohydrate moiety, including sialic acid, in cancer cell-derived binder. In addition, we carried out an enzyme-linked immunoassay and examined plasma levels of immunoreactive R binder in patients with gastric cancer (n = 72), benign gastrointestinal disease (n = 30), and healthy individuals (n = 40). Even in patients without liver metastasis, the level of immunoreactive R binder detected by monoclonal antibody H-12 was elevated in some patients and decreased after excision of the tumor. R binder was also elevated in cancer tissue extract. Immunoreactive binder was histochemically detected in the cytosol of cancer cells and metaplastic cells of the gastric mucosa. The present findings suggest that cobalamin R binder is de novo synthesized in gastric cancer cells and that its plasma level increases in some patients. This binding protein may be a useful diagnostic and therapeutic parameter. PMID- 2720671 TI - A limited sampling strategy for cyclophosphamide pharmacokinetics. AB - A limited sampling strategy was developed to estimate the total area under the curve of plasma cyclophosphamide concentrations versus time (AUC). The strategy was developed with a training set consisting of 29 pharmacokinetic studies in 16 patients who received 1-h i.v. infusions of cyclophosphamide at a dosage of 1000 mg/m2. The strategy was developed by applying stepwise forward multiple regression analysis to cyclophosphamide concentrations observed at each time in the training set (independent variables) versus the AUC (dependent variable). It was confirmed by applying stepwise backward elimination regression analysis to the same data set. The final sampling strategy, which utilized three time points, was: AUC = 40.18C24 + 8.79C4 + 0.83C1 - 28 (dosage/1000), where C24, C4, and C1 represent plasma cyclophosphamide concentrations at 24, 4, and 1 h, respectively, and the dosage is in mg/m2 (r = 0.98). The strategy was validated prospectively with a test data set consisting of 14 pharmacokinetic studies in 11 patients who received 1-h i.v. infusions of cyclophosphamide at dosages of 300, 600, or 1200 mg/m2. The strategy proved highly predictive, with correlation coefficient between predicted and actual AUC of 0.94. The strategy also proved unbiased, with mean percentage of error (+/- SE) of 3.3 +/- 3.6%, and precise, with mean absolute percentage of error of 9.3 +/- 2.7%. The sampling strategy developed is being used in a multiinstitution trial of cyclophosphamide in an effort to relate cyclophosphamide pharmacokinetics, as expressed by AUC, with the toxic or therapeutic pharmacodynamic responses of the drug. PMID- 2720672 TI - Correspondence re: Mark J. Ratain et al., Limited Sampling Models for Amonafide (NSC 308847) Pharmacokinetics. PMID- 2720673 TI - Comparison of the synergistic potentiation of etoposide, doxorubicin, and vinblastine cytotoxicity by dipyridamole. AB - Dipyridamole (DPM) enhanced sensitivity to etoposide (VP-16), doxorubicin (DOX), and vinblastine (VBL) in a human ovarian carcinoma cell line that was already relatively sensitive to all three agents. This interaction was shown to be truly synergistic by median effect analysis over a 2 log cell kill. The combination index at 50% cell kill (CI50) was used to quantitate the extent of synergy. The CI50s were 0.42, 0.66, and 0.30 for VP-16, DOX, and VBL, respectively. We compared the effect of DPM on the cellular pharmacology of each chemotherapeutic drug. DPM increased the steady state cellular content of VP-16 by a maximum of 3.2-fold, and that of DOX and VBL by 1.7- and 3.7-fold, respectively. There was a good correlation between the CI50 and the DPM-induced increase in cellular drug content (r = 0.94). DPM had no effect on the initial influx VP-16 or DOX but did increase the initial influx of VBL by 3.5-fold. DPM inhibited the initial efflux of all three compounds. However, there was no relation between the extent of efflux inhibition and the magnitude of the DPM-induced increase in cellular drug content, indicating that DPM must have other effects as well. DPM has chemical characteristics similar to other known modulators of VP-16, DOX, and VBL sensitivity. When compared to verapamil, DPM was as efficacious but twice as potent in its synergistic enhancement of VP-16 sensitivity. These results demonstrate that DPM can markedly increase the cytotoxicity of VP-16, DOX, and VBL and suggest possible clinical applications. PMID- 2720674 TI - DNA alkylation in the hamster induced by two pancreatic carcinogens. AB - N-Nitrosobis(2-oxopropyl)amine (BOP) and N-nitroso(2-hydroxypropyl)(2 oxopropyl)amine (HPOP) alkylate DNA and other macromolecules in the liver, kidney, pancreas, and lungs when injected s.c. in the Syrian hamster. Two of the most abundant DNA adducts found were the N7-methylguanine and O6-methylguanine, which in the liver accounted for about 60% of total DNA alkylation. A third adduct which was invariably found in liver and kidneys, but could not always be detected in pancreas and lungs, was identified as N7-(2-hydroxypropyl)guanine. Quantitation of N7-methylguanine by its UV spectrum and radioactivity, following administration of single-labeled [1-14C]BOP or HPOP, showed that the specific activity of this adduct was one half that of the nitrosamine. This excludes participation of the gamma carbons of these nitrosamines in methylation reactions and indicates that intermediates in which scrambling of the alpha and gamma carbons is possible are not involved in yielding the ultimate methylating agent. Finally, a comparison of the alkylation levels caused by equivalent doses of BOP and HPOP showed that BOP targeted DNA and other cytoplasmic components of kidney, lungs, and pancreas more extensively than HPOP. Ratios of N7-methylguanine in BOP versus HPOP treated hamsters, at doses less than 40 mg/kg body weight, were 3.1 in the kidney, 7.0 in the pancreas, 3.9 in the lung, and only 3.5 in the liver. These ratios are in accordance with the greater carcinogenic potency of BOP compared to HPOP and also the different organotropic properties of the two carcinogens. PMID- 2720675 TI - Elevated protein kinase C expression in human breast tumor biopsies relative to normal breast tissue. AB - The Ca2+- and phospholipid-dependent protein kinase, protein kinase C (PKC), is a critical enzyme in the regulation of cell growth. In this report, we demonstrate elevated expression of PKC activity in surgical specimens of eight of nine spontaneous human breast tumors, as compared with the expression of PKC activity in normal breast tissue obtained from the same patients. The mean PKC specific activity in histologically normal breast tissue was 166 +/- 63 pmol 32P/min/mg, whereas the mean PKC specific activity in the breast tumors was 460 +/- 182 pmol 32P/min/mg (P = 0.0003; Student's t test). The low interpatient variability among the PKC levels observed in the histologically normal breast tissue specimens and the significant elevation of PKC levels observed in the tumors indicate that elevated expression of PKC activity in breast tissue is a potential marker for malignant disease in the breast. PMID- 2720677 TI - Comparison of effects of bryostatins 1 and 2 and 12-O-tetradecanoylphorbol-13 acetate on protein kinase C activity in A549 human lung carcinoma cells. AB - Activators of protein kinase C (PKC), such as 12-O-tetradecanoylphorbol-13 acetate (TPA) and bryostatins 1 and 2, inhibit the growth of A549 cells. At high concentrations the bryostatins do not affect cell growth. Here the hypothesis has been tested that modulation of A549 cell growth is the consequence of agent induced changes in location or extent of cellular PKC activity. PKC activity was measured after semi-purification with nondenaturing polyacrylamide gel electrophoresis in the cytosol and the particulate fraction of A549 cells. When cells were exposed to TPA or mezerein, PKC activity underwent rapid and concentration-dependent translocation from the cytosol to the membrane. TPA at 0.1 microM or mezerein at 1 microM caused almost complete translocation within 30 min. Incubation with bryostatins 1 or 2 also led to enzyme translocation, which was, however, much weaker than that observed with the tumor promoters. Neither 4 alpha-phorboldidecanoate nor the synthetic diacylglycerols 1,2-sn dioctanoylglycerol or 1-oleoyl-2-acetyl-sn-glycerol mimicked TPA in this way. Exposure of cells to TPA or the bryostatins for longer than 30 min caused the gradual disappearance of total cellular PKC activity. PKC downregulation was concentration dependent and complete after 24 h. A549 cells which had acquired temporary resistance toward the growth-arresting potential of TPA were completely devoid of any measurable PKC activity. The bryostatins were potent inhibitors of the binding of [3H]phorbol-12,13-dibutyrate to its receptors in intact cells, and the inhibition was dependent on bryostatin concentration. The results support the contention that PKC is involved in the mediation of growth inhibition caused by TPA or the bryostatins. However, the relationship between growth arrest and PKC translocation or downregulation seems to be a complex one. PMID- 2720676 TI - Differential effects of long-chain (sphingoid) bases on the monocytic differentiation of human leukemia (HL-60) cells induced by phorbol esters, 1 alpha, 25-dihydroxyvitamin D3, or ganglioside GM3. AB - Conditions were developed to prolong the ability of sphinganine, a potent inhibitor of protein kinase C, to block the phorbol ester-induced adherence of HL 60 cells beyond 24 h. The loss of inhibition after this time seen previously (A.H. Merrill, Jr., A.M. Sereni, V.L. Stevens, Y.A. Hannun, R.M. Bell, and J.M. Kinkade, Jr., J. Biol. Chem., 261: 12610-12615, 1986), which appeared to be due to metabolism of this long-chain base, was overcome by supplying sphinganine daily. After 4 days, phorbol myristate acetate-induced adherence was inhibited approximately 50% by sphinganine. Sphinganine significantly decreased the expression of nonspecific esterase induced by phorbol myristate acetate in the nonadherent cells, indicating that other aspects of maturation besides adherence were blocked. The effects of daily sphinganine treatments on the monocytic differentiation induced by 1 alpha-25-dihydroxyvitamin D3 or ganglioside GM3 were also investigated. The increases in nonspecific esterase expression, nitroblue tetrazolium reduction, and morphological maturation caused by either agent were unaffected by the long-chain base. In addition, the changes in several cell surface antigens caused by 1 alpha,25-dihydroxyvitamin D3 were unaltered by sphinganine. Although phorbol esters, 1 alpha,25-dihydroxyvitamin D3, and ganglioside GM3 all induce the maturation of HL-60 cells along the monocytic lineage, the finding that sphinganine only affected the differentiation initiated by phorbol esters, in which protein kinase C clearly is a major regulator, suggests that this enzyme does not play a major role in these other pathways of differentiation. PMID- 2720678 TI - Modulation of the metabolism and pharmacokinetics of 1-beta-D arabinofuranosylcytosine by 1-beta-D-arabinofuranosyluracil in leukemic mice. AB - The interaction between high concentrations of 1-beta-D-arabinofuranosyluracil (HiCAU) and 1-beta-D-arabinofuranosylcytosine (ara-C) was investigated in vivo with emphasis on cell kinetics, pharmacokinetics, and drug metabolism. Mice bearing L5178Y leukemia were given a 48-h s.c. infusion of high-dose ara-U (HiDAU) to achieve a plasma level of 0.5 to 1 mM. A total dose of 7.35 g/kg/day for 2 days was nontoxic; the mean survival of control (saline treated) leukemic mice was 12.2 +/- 1.8 days and 11.7 +/- 2.0 days for the HiDAU-treated leukemic mice. Using flow cytometry, cell cycle progression of L5178Y ascites cells was monitored during HiDAU infusion. At 48 h, the proliferative index (PI) percentage of the leukemic cells is significantly different (P less than 0.001) in HiDAU treated leukemic mice (mean = 50.8) versus control (mean = 45.6). A higher PI percentage is associated with accumulation of cells in S phase. This effect was highly variable in the ara-U-treated mice, and the ara-U "perturbed" group was defined as those mice whose cells had an increase in the PI to greater than or equal to 50%. The higher PI percentage in HiDAU-treated mice correlated with HiCAU in ascites fluid, leukemic cells, and kidney of perturbed mice. HiCAU in the "ara-U-perturbed" group altered the plasma pharmacokinetics of high-dose ara C (HiDAC, 1 g/kg), increased the cellular metabolism of ara-C to 1-beta-D arabinofuranosylcytidine triphosphate (ara-CTP) (3-fold), and increased ara-C-DNA synthesis (3-fold). In mice bearing the L5178Y leukemia, a 48-h infusion of ara-U followed by a 24-h s.c. infusion of 40 mg/kg resulted in a 260% increase in life span and seven 90-day survivors among 16 treated mice. In contrast, ara-U or ara C alone had a negligible therapeutic effect. ara-U-induced alterations in the systemic pharmacokinetics of ara-C are the result of inhibition of cytidine deaminase activity by HiCAU in liver and kidneys. This results in a decrease in ara-C catabolism and prolongs the plasma half-life of ara-C. The dual alteration of the pharmacokinetics of ara-C and cytokinetics of the leukemia cells by HiCAU results in enhanced survival of leukemic mice. These results may help explain the clinical utility of HiDAC treatment programs for patients with acute leukemia. PMID- 2720679 TI - Biological activity of hydroxylated chloroethylnitrosoureas. AB - 1-Nitroso-1-(2-hydroxyethyl)-3-(2-chloroethyl)urea (Compound I) and 1-nitroso-1 (2-hydroxypropyl)-3-(2-chloroethyl)urea (Compound II) display significantly reduced antitumor activity compared to the corresponding isomeric derivatives 1 nitroso-1-(2-chloroethyl)-3-(2-hydroxyethyl) urea (Compound III) and 1-nitroso-1 (2-chloroethyl)-3-(2-hydroxypropyl) urea (Compound IV). Their low therapeutic activity is paralleled by low toxicity while mutagenicity and carcinogenicity are high. A comparative investigation of the genotoxicity of Compounds I and III using primary cultures of fetal hamster lung cells revealed an about 14-fold higher rate of DNA single-strand breaks following exposure (100 microM, 1 h) to Compound I as compared to Compound III. The rate of DNA interstrand cross-links, on the other hand, was 11-fold higher following Compound III as compared to Compound I. The results underline that the therapeutic activity of chloroethylnitrosoureas is mainly attributable to their cross-linking potential while induction of DNA single-strand breaks plays a decisive role for mutagenicity and carcinogenicity but appears not to be relevant for antineoplastic effectiveness. PMID- 2720680 TI - Cross-linkage of nucleophosmin in tumor cells by nitrogen mustard. AB - Mouse leukemia (P388) cells were incubated in cell culture medium containing nitrogen mustard [2-chloro-N-(2-chloroethyl)-N-methylethanamine] for 4 h. The nucleophosmin immunoband with a molecular weight of 37,000 (p37; other molecular weights are similarly designated) was observed in both control and nitrogen mustard-treated cells. Three additional immunobands with molecular weights of 80,000 (p80), 120,000 (p120), and 230,000 (p230) were identified in the drug treated cells. The same results were observed with melphalan, but were not detected when mitomycin C, cis-platinum, Adriamycin, or actinomycin D were used. Treatments with DNase and RNase did not alter the molecular weights of these immunobands. These results indicate that the cross-linked products of nucleophosmin were not linked to DNA or RNA. The pI of p80, p120, and p230 is 5.1, which is the same as that of nucleophosmin (p37). The iodinated tryptic peptide map of p80 is identical to that of nucleophosmin. This result indicates that p80 is a dimer cross-linked by nitrogen mustard. The p80 and p120 immunobands were observed in Novikoff hepatoma and in hypertrophic rat liver, but were not detected in normal liver under the same conditions. These results indicate that tumor or proliferating cells have hexameric nucleophosmins which can be cross-linked by nitrogen mustards. PMID- 2720681 TI - Optimization of radioimmunotherapy using human malignant melanoma multicell spheroids as a model. AB - In vitro multicell spheroids from a human melanoma cell line and the human colon cancer cell line HT29, used as control, have been established as a model of poorly vascularized micrometastases in vivo. The antimelanoma monoclonal antibody 96.5 was radiolabeled with 131I at specific radioactivities from 1.85 to 3.96 GBq/mg. Cytotoxicity of 131I-96.5 to the spheroids, at an initial size of 300 microns in diameter, was investigated as a function of concentration of 131I-96.5 in the incubation medium, specific radioactivity, and treatment time. Spheroid growth delay and clonogenic survival of cells disaggregated from the spheroids at various times after treatment were used as end points. Therapeutic effects increased with the concentration of 131I-96.5 within the range 0.2 to 2 mg/liter (0.34 to 3.4 GBq/liter) at a fixed specific radioactivity. The effects increased with specific radioactivity at a fixed concentration of 131I-96.5. Difference in therapeutic effect was also observed between treatment times of 8 and 24 h. Radiation doses to the melanoma spheroids varied from 10 to 16 Gy. Unlabeled 96.5 at 2 mg/liter or 131I-iodide at 1.7 GBq/liter did not affect the growth of the melanoma spheroids. The HT29 spheroids, however, only suffered slight cytotoxicity at 1 or 2 mg/liter of 131I-96.5 and for a treatment time of 24 h despite comparable radiosensitivity of HT29 cells and melanoma cells to high-dose rate radiation. Similar cytotoxicity was observed in the HT29 group treated with 131I-iodide at 1.7 GBq/liter. Present findings therefore demonstrate preferential and adequate killing of the melanoma spheroids by 131I-96.5 at 0.5 mg/liter and 3.96 GBq/mg in 8 h. PMID- 2720683 TI - Effect of dose, molecular size, affinity, and protein binding on tumor uptake of antibody or ligand: a biomathematical model. AB - A mathematical model has been developed to determine the best approach to improving tumor targeting with antibody. The amount of antibody in the tumor (tumor content) and the tumor:normal tissue antibody concentration ratio (uptake ratio) were calculated over 12 days from injection, using the computer program FACSIMILE to solve the stiff nonlinear differential equations describing the system. Results indicate that success requires an optimal combination of dose, size, and binding affinity of antibody. Increasing the dose to 100 times that presently used for scanning increased both the percentage of injected antibody in the tumor and the uptake ratio by up to 2 orders of magnitude to maximal values determined by affinity. This result could be achieved by coinjecting unlabeled antibody. Increasing affinity from Keq = 10(9) to 10(13)M-1 increased the uptake ratio from 5 to 100 for whole antibody and to 550 for a small ligand, at the calculated optimal dose, but had no effect at the current scanning dose. With decreasing molecular size at average affinity, the same maximum tumor content and uptake ratio were achieved but progressively earlier. At high affinity there was a substantial advantage for a small ligand compared with whole antibody in terms of uptake ratio (550 versus 100) and tumor:normal tissue integral dose ratio (330 versus 60). The uptake of a small ligand was not increased by binding to plasma protein but with increasing time the tumor content was higher than without protein binding. PMID- 2720682 TI - Inhibition of methylnitrosourea-induced large bowel cancer development in rats by sarcophytol A, a product from a marine soft coral Sarcophyton glaucum. AB - An antitumorigenic effect of sarcophytol A (SaA), a simple monohydroxycembratetraene isolated from a marine soft coral Sarcophyton glaucum, was investigated in rat colon carcinogenesis. Three groups (26 rats each) of female CD-Fischer rats given an intrarectal dose of 2 mg of N-methyl-N nitrosourea 3 times weekly for Wk 1 to 3 were fed standard laboratory chow in the control group or the chow containing 0.01% SaA from Wk 1 or from Wk 4 in experimental groups. The body weight gain and the food intake were not different among all 3 groups, and SaA intake was similar in both experimental groups at a dosage of 6.18 and 6.14 mg/kg of body weight/day at Wk 5 and 3.87 and 3.90 mg/kg of body weight/day at Wk 25. At autopsy at Wk 26, the incidence of large bowel tumors was found to be significantly lower and the mean number of tumors per tumor-bearing rat to be insignificantly smaller in experimental groups than in the control group: 50% and 58% versus 85%, 1.8 and 1.8 versus 2.0. The tumors in both experimental groups were generally smaller. All the tumors except two signet ring cell carcinomas were well-differentiated adenocarcinomas. Induction of ornithine decarboxylase activity, a marker of tumor promotion, in the large bowel mucosa of rats which were fed the SaA chow for 1 wk, then received an intrarectal dose of 12, 6, or 1.2 mumol of deoxycholate, a tumor promoter in large bowel carcinogenesis, and were killed 4 h later was significantly lower than in control rats. Thus, it was concluded that SaA inhibited the development of large bowel cancer, probably through an antipromoting mechanism. PMID- 2720684 TI - Proliferation and responsiveness to estrogen of human endometrial cancer cells under serum-free culture conditions. AB - Studies of hormonal growth regulation in cultured human endometrial cancer cells are limited by the requirement of exogenous growth factors, usually supplied by addition of serum. The present report provides evidence that estradiol can stimulate proliferation of endometrial cancer cells of the Ishikawa line in the absence of serum or added growth factors. Mitogenic effects of estrogen were demonstrated in two different experimental systems, in cells attached to the substratum of mammalian tissue culture dishes, and in cells forming colonies in soft agar under anchorage-independent conditions. Addition of estradiol to a mixture of serum-free, phenol red-free Dulbecco's minimal essential medium and Ham's F-12 medium, supplemented with L-glutamine and 4-(2-hydroxyethyl)-1 piperazineethanesulfonic acid [basal medium: (BM)] significantly increased the proliferation of cells attached to culture dishes. Dose-response experiments revealed maximal estradiol stimulation at 10 nM; significant responses were also observed at 1 nM and at 100 nM concentrations. The mitogenic effect of 10 nM estradiol was comparable to that of 1% charcoal-treated fetal bovine serum and the two effects were additive. The presence of estradiol in serum-free BM resulted in a shortening of the doubling time of exponentially proliferating cells from 38 to 29 h. From the labeling index, measured after exposure to a pulse of [3H]thymidine, and from the mitotic index, both determined in exponentially proliferating cells, the lengths of the S and M phases were calculated to be 11 and 1 h, respectively. From these data it was estimated that estradiol shortened the G1 phase by approximately 40%, from 22 to 13 h. Estradiol doubled the colony formation efficiency of cells plated in BM containing 0.3% agar in the absence of serum as well as in the presence of 1% charcoal-treated fetal bovine serum. The stimulation of colony formation by estradiol was influenced by medium components, since no effects were observed in minimal essential medium. The colony formation efficiency was positively related to the serum concentrations and remained significantly lower in minimal essential medium than in BM at comparable serum levels. The observed positive relationship between colony formation efficiency and cell densities at plating suggests a cooperative mitogenic effect, likely due to autocrine and paracrine action of secreted growth factors. These results define a model to evaluate hormonal growth regulation mediated by autocrine mitogens in human endometrial cancer cells in the absence of interfering exogenous growth factors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2720685 TI - Heterogeneity in the induction and expression of carcinoembryonic antigen-related antigens in human colon cancer cell lines. AB - Sodium butyrate induces morphological and biochemical changes consistent with a more differentiated phenotype in some colon cancer cell lines. These changes include increased expression of carcinoembryonic antigen (CEA) and other oncodevelopmental markers. We utilized domain-specific probes and polyclonal antibodies against CEA-related antigens to study sodium butyrate-induced expression of the CEA gene family in a villous adenoma-derived cell line, which is nontumorigenic in nude mice (VACO 235), and two colonic carcinoma cell lines known to respond to sodium butyrate exposure by phenotypic differentiation (HT-29 and LS 174T). The induction begins as quickly as 24 h after exposure and occurs primarily at a transcriptional level, although some translational control is also evident. No evidence was found for gene amplification, rearrangement, or methylation to account for the mechanism of this transcriptional control. [35S]Cysteine pulse-labeled cell lysate immunoblots and polyadenylated RNA blot hybridization suggest that increases in mRNA transcript and CEA-related glycoprotein levels are primarily due to increased synthesis rather than decreased degradation. A considerable amount of heterogeneity is seen in the biosynthesis of the CEA-related glycoproteins, with each cell line showing a distinct pattern of CEA-related antigen expression from a limited number of mRNA transcripts. PMID- 2720686 TI - Interaction of hyperthermia and radiation in murine cells: hypoxia and acidosis in vitro, tumor subpopulations in vivo. AB - To better understand the effect of the level of oxygenation and pH on the heat radiation interaction, these factors were modeled in vitro using FSaIIC cells in monolayer and correlated with the response of Hoechst 33342 dye-defined FSaIIC tumor subpopulations treated in vivo. Exposure to both 42 degrees C and 43 degrees C for 1 h in culture prior to graded single fractions of radiation resulted in a striking decrease in the radiation oxygen enhancement ratio which was pH as well as temperature dependent. The oxygen enhancement ratio at 37 degrees C and pH 7.40 (or pH 6.45) was 2.9, but decreased to 1.4 at 42 degrees C at normal pH, 1.2 at low pH, and 1.0 at 43 degrees C at both pH values tested. This decrease in the oxygen enhancement ratio resulted from a far more marked decrease in Do values for the radiation survival curves of hypoxic cells compared to normally oxygenated cells at elevated temperatures. In addition, the shoulder region of the radiation survival curves was significantly decreased with increasing temperatures and the magnitude of the decrease was greatest in hypoxic cells at low pH. In vivo treatment followed by immediate tumor excision showed that bright cells (presumably oxygenated cells at normal pH) were approximately 2 fold more sensitive to 10 Gy of radiation than were dim cells (presumably hypoxic cells at low pH) but that dim cells were 2.5-fold more sensitive to 43 degrees C for 30 min hyperthermia. The combination of hyperthermia followed by radiation proved to be 1.8-fold more toxic to dim than to bright cells. Both hyperthermia alone and hyperthermia plus radiation, in contrast to radiation alone, were significantly more cytotoxic when tumors were left in situ for 24 h prior to excision as compared with immediate excision. These results indicate that hyperthermia markedly sensitizes hypoxic cells at low pH to the cytotoxic effects of radiation, as well as effectively killing cells in this tumor subpopulation. PMID- 2720687 TI - Model for the genetic evolution of human solid tumors. AB - A conceptual model is proposed for the genetic evolution of many human solid tumors that is based on the observations that cancer cells may spontaneously double their chromosome number; that cells with excessive chromosome numbers may be cytogenetically unstable, both losing chromosomes randomly during subsequent cell divisions, and often developing structural abnormalities in the chromosomes that are retained; and that some structural chromosome abnormalities may activate growth-promoting genes. The sequence of tetraploidization with chromosome loss can occur repeatedly in a given tumor. The available evidence supporting the model is reviewed. A computer simulation system that embodies these concepts is described and the model is used to generate distributions of chromosome number/cell under various simulated conditions and in a variety of simulated biological settings. A simulation of the time course of changes in chromosome number per cell that accompany the spontaneous neoplastic transformation of mouse fibroblasts in vitro is described. The best fit to the data was obtained when provision was made for the activation of at least two growth-promoting genes. The conditions for generating discrete aneuploid peaks in cytogenetic and flow cytometric studies were explored; our modeling studies suggest that the activation of a growth promoting gene is required in order to produce a discrete aneuploid peak. Our modeling studies suggest that the overrepresentation of individual oncogene-bearing chromosomes in aneuploid cell lines may require the activation of gene dose-dependent growth-promoting genes and is not likely to occur in cell lines in which at least two copies of each normal chromosome are required for cell survival. Overall, the results obtained using the model are consistent with a wide variety of flow cytometric and cytogenetic studies in human solid tumors. PMID- 2720688 TI - Karyotypic evolution of a human undifferentiated large cell carcinoma of the lung in tissue culture. AB - Serial cytogenetic studies were performed on a cell line derived from a pleural effusion from a patient with undifferentiated large cell carcinoma of the lung. The initial sample had a broad range of chromosome numbers per cell, with a hypodiploid/pseudodiploid stem line and a hypotetraploid sideline. A sequence consisting of a doubling of chromosome number per cell followed by chromosome loss was observed repeatedly during 40 culture passages. The presence of metaphase spreads showing evidence of endoreduplication suggested this as a likely mechanism for the doubling of chromosome number per cell. Eleven marker chromosomes were observed in the cells of the primary sample; these markers persisted through all subsequent passages. Chromosomes 1, 2, 6, 7, 8, 11, and 16 were consistently overrepresented; each of these chromosomes was involved in marker formation. Chromosomes 4, 5, 9, 10, 19, 21, and 22 were consistently underrepresented. Every chromosome, either in its normal form and/or as part of a marker, was represented on the average by at least one copy per diploid cell. Eighteen new marker chromosomes were observed during the course of cell cultivation; one of these evolved into a clonal marker over the course of six cell passages. Of the new marker chromosomes that were formed during the observation period, the majority were found in hypotetraploid cells. PMID- 2720689 TI - Circadian rhythm in toxicities and tissue uptake of 1,2-diamminocyclohexane(trans 1)oxalatoplatinum(II) in mice. AB - Mechanisms involved in the circadian rhythm in murine tolerance for the new platinum analogue, 1,2-diamminocyclohexane(trans-1)oxalatoplatinum(II) (1-OHP) were sought in 404 male C57BL/6 x DBA/2 F1 mice standardized by 12 h light-12 h dark. A potentially lethal dose of 1-OHP (17 mg/kg i.v.) resulted in 76% long term survival at 15 h after light onset (HALO) (activity span) as compared to 24% after treatment at 7 HALO (rest span) (chi 2 21.3; P less than 0.001). A total of 204 mice received the same dose of 1-OHP at one of three circadian stages (0, 8, or 16 HALO). No renal toxicity was encountered. Bone marrow and jejunal villi constituted the chief targets of 1-OHP toxicity at this dosage and schedule. Hematological tolerance as gauged by leukocyte counts was optimal when the drug was given at 16 HALO (P from analysis of variance, less than 0.001). Jejunal lesions were less severe after 1-OHP dosing at 16 HALO as compared to 8 HALO (P less than 0.001). Total platinum concentrations were determined in 18 tissues 24 h after 1-OHP dosing. The highest levels of platinum were found in the spleen on day 1 as well as on day 5 following 1-OHP treatment. Despite the fact that the highest platinum concentrations in tissues usually corresponded to drug dosing at 8 HALO, no correlation was documented between such variables and tissue toxicity. Tissue pharmacokinetics of 1-OHP contribute only in part if at all to the circadian rhythm in hematological and jejunal toxicity of this drug. PMID- 2720690 TI - Aberrant mitochondria in two human colon carcinoma cell lines. AB - Electron micrographs of CCL237 and FET cells (two slowly growing, differentiated human colon carcinoma lines) revealed enlarged mitochondria with few cristae. Polarographic measurement of respiratory activity in mitochondria isolated from these cell lines was compared to that of CV-1 cells (a normal monkey kidney epithelial line) and MIP101 cells (another human colon carcinoma line), both of which have mitochondria with a "normal" appearance. The respiratory control ratios of CCL237 and FET mitochondria were found to be considerably lower than those of CV-1 and MIP101 mitochondria (approximately 3 as compared to greater than 10, respectively), indicating that in CCL237 and FET mitochondria the processes of substrate oxidation and phosphorylation of ADP are only loosely coupled. In intact cells, differences in radiolabeled tetraphenylphosphonium uptake showed that the mitochondrial membrane potential in CCL237 and FET cells was less than that in CV-1 and MIP101 cells, and that nigericin failed to hyperpolarize the mitochondria of CCL237 and FET cells. In addition, FET mitochondria exhibited significantly lower ADP-stimulated and uncoupled respiratory rates than mitochondria isolated from the other cell types, indicating that in the former, the capacity for oxidative phosphorylation is somehow impaired. Selective toxicity of FET cells was obtained by treatment with 2-deoxyglucose, an inhibitor of glycolysis, suggesting the possibility of exploiting the phenotype of impaired oxidative metabolism for chemotherapy. PMID- 2720691 TI - Spontaneous mutation rates of tumorigenic and nontumorigenic Chinese hamster embryo fibroblast cell lines. AB - The genomic stability of a series of nontumorigenic, tumorigenic, and tumor derived Chinese hamster embryo fibroblastic (CHEF) cell lines was compared by examining their rates of spontaneous mutation at the hypoxanthine-guanine phosphoribosyl transferase (hprt) locus, using thioguanine resistance for selection of mutants. The spontaneous mutation rates were 1.1 x 10(-6) mutations/cell/generation in the non-tumor-forming CHEF/18 cell line and 4.9 x 10(-6) in the tumorigenic CHEF/16 cells. Three tumorigenic and tumor-derived CHEF cell lines derived from CHEF/18 (J132 3-2 T3L, focus 2, focus 3) and two lines (16-2 Tuk 4 and 204 Bu50 Tuk 2) derived from CHEF/16 were chosen on the basis of their karyotypes, which demonstrated a considerable level of chromosomal rearrangement. Mutation rates of four of these five lines ranged from 1.2 x 10( 6) to 8.9 x 10(-6) mutations per cell per generation. Only the fifth line, 16-2 Tuk 4, showed a significantly elevated rate of mutation as compared with the nontumorigenic CHEF/18 cell line. Thus, we have found no simple correlation between spontaneous mutation rate and the malignant phenotype, and we conclude that mutation rate per se is not a sensitive index of malignancy. In addition, we have compared three methods of calculating mutation rate and find that they rank the cell lines in the same order, but each stresses a different aspect of the distribution and therefore produces different estimates of the mutation rate. PMID- 2720692 TI - Direct diffusion of cis-diamminedichloroplatinum(II) in intraperitoneal rat tumors after intraperitoneal chemotherapy: a comparison with systemic chemotherapy. AB - Chemotherapy i.p. is increasingly being tested as a treatment modality for cancer limited to the peritoneal cavity. We have developed a rat tumor model in which penetration and distribution of cis-diamminedichloroplatinum(II) into intraperitoneal tumors have been studied. The platinum concentration in intraperitoneal tumor nodules, measured by two techniques, flameless atomic absorption spectroscopy and proton-induced X-ray emission, was always higher after i.p. treatment than i.v. Further, platinum concentrations were higher at the periphery of the tumor after i.p. administration than after i.v., while platinum concentrations in the center of the tumor nodules were identical. No difference was detected in platinum concentrations in s.c. tumors nor in the total area under the curve (plasma) after i.p. and i.v. administration of cis diamminedichloroplatinum(II), suggesting that the higher drug concentration measured in peritoneal tumors after i.p. administration is due to direct diffusion of the drug from the peritoneal cavity. PMID- 2720693 TI - Sensitivities of NIH/3T3-derived clonal cell lines to ionizing radiation: significance for gene transfer studies. AB - Rodent cells are frequently used as recipients in experiments involving gene transfer, isolation, and characterization. The present studies were designed to investigate the clonal responses to ionizing radiation of NIH/3T3 cells subjected to DNA-mediated gene transfer. Radiation sensitivity (D0) values were determined for the parental NIH/3T3 cell strain, six clonal cell lines transfected with DNA from radiation-resistant human tumor cells, and six nontransfected clonal cell lines. The radiation sensitivities of four transfected and two nontransfected clonal cell lines differed significantly from parental NIH/3T3 cells (P less than 0.05). Detailed karyotype analysis of two nontransfected clonal cell lines with differing radiation sensitivities showed variation in chromosomal composition. Specifically, a minute chromosome was observed to segregate consistently (in 49 of 50 metaphases) with the genome of one NIH/3T3 clone (D0 2.07 Gy) and was completely absent (from 50 metaphases) in another NIH/3T3 clone (D0 1.06 Gy). In the parental NIH/3T3 strain (D0 2.02 Gy) 10% of cells (3 of 30 metaphases) had such minute chromosomes. These findings demonstrate that the clonal cellular heterogeneity of NIH/3T3 cells is characterized by genotypic and phenotypic variations which must be considered in the experimental design involving gene transfer and expression. PMID- 2720694 TI - 131I-anticarcinoembryonic antigen therapy of LS174T human colon adenocarcinoma spheroids. AB - LS174T human colon adenocarcinoma multicell spheroids were used to study the radiobiological aspects of radioimmunotherapy. The spheroids were incubated in 131I-anticarcinoembryonic antigen (B7) at an antibody concentration of 0.5 microgram/ml and at 131I concentrations of 2.5 and 7.5 microCi/ml. After incubation times of 90 h, clonogenic cells per spheroid were reduced by 1400-fold and 23-fold at the high and low 131I concentrations, respectively. 131I Nonspecific antibody (PX63) resulted in 2- and 1.2-fold reductions. Spheroid diameter was not significantly affected by therapy but histological examination revealed that there had been a significant reduction in the cell density, particularly near the spheroid surface. Using a theoretical model to estimate radiation dose, a radiation survival curve was constructed. The resulting curve was somewhat concave suggesting the presence of a resistant population of cells. It is likely that this observation is primarily due to the fact that the inner cells received a lower dose than the outer cells. A population of radiobiologically hypoxic cells in the inner portion of the spheroids may also have contributed to the decreasing slope of the curve as well as ongoing cell division leading to new cells which receive a lower radiation dose per cell cycle. Because of the ability to estimate radiation dose for a given biological effect, these types of experiments may allow predictions of the efficacy of radiolabeled antibody therapy for micrometastatic disease. PMID- 2720695 TI - Expression of transforming growth factor alpha and epidermal growth factor receptor messenger RNA in neoplastic and nonneoplastic human kidney tissue. AB - Using Northern blot analysis, we have demonstrated that mRNA for transforming growth factor alpha (TGF-alpha) was expressed in five malignant kidney tissue specimens but was not detected in their autologous nonneoplastic homologues. In addition, the expression of epidermal growth factor (EGF) receptor mRNA in these malignant tissues was 2- to 3-fold greater than in nontransformed tissues. In two cases examined using immunohistochemistry, we were able to correlate the increased expression of the mRNA with an increase in protein expression. Since TGF-alpha is known to bind to the EGF receptor, the finding of an increased expression of both TGF-alpha and EGF receptor mRNA in kidney tumor tissue suggests that interaction between TGF-alpha and the EGF receptor may play a role in promoting transformation and/or proliferation of kidney neoplasms, perhaps by an autocrine mechanism. PMID- 2720696 TI - Phase I trial using adaptive control dosing of hexamethylene bisacetamide (NSC 95580). AB - Hexamethylene bisacetamide (HMBA), a potent differentiating agent, was administered to patients with refractory malignant tumors. Thirteen patients received 30 evaluable courses. HMBA was given by continuous i.v. infusion for 5 days. Therapy was repeated every 28 days, if patients had recovered from toxicity. The starting dose was 24 g/m2/day. Because our previous trial had shown wide interpatient variability in HMBA pharmacokinetics and excess toxicity at HMBA plasma concentrations greater than 2 mM (HMBA doses between 24 and 33.6 g/m2/day), we attempted to individualize each patient's dose based on a dosing scheme using an adaptive (feedback) control algorithm, which assumed linear clearance for HMBA. In all courses, a plasma sample was assayed daily and infusion rates were adjusted to achieve an HMBA plasma concentration of 1.5-2.0 mM (300-400 mg/liter). The patients included 12 men and 1 woman with a median age of 56 years (range, 34-76) and median Karnofsky performance status of 90% (range, 60-100). All patients had received prior chemotherapy and 9 patients had also received radiation therapy. The linear adaptive control algorithm was reasonably precise, with a mean absolute error of 0.28 (SE 0.04) mM. However, adjustments in infusion rate systematically overshot the desired change in steady state concentration, probably due to nonlinear clearance of HMBA. For levels within 24 h of a change in infusion rate, this resulted in significant bias, with a mean error of 0.24 (SE 0.09) mM. The mean absolute error was 0.40 (SE 0.06) mM. A second adaptive control algorithm, using a pharmacokinetic model with parallel first-order (renal) clearance and Michaelis-Menten (nonrenal) clearance and using Bayesian parameter estimation with a priori estimates based on our previous phase I trial, proved to be much more precise than the linear method and was unbiased when applied retrospectively to the same observations, with a mean error (within 24 h of a change in infusion rate) of 0.02 (SE 0.06) mM and a mean absolute error of 0.22 (SE 0.03) mM. Toxicity was reversible in all cases. Neurotoxicity, consisting of hallucinations, agitation, somnolence, or confusion, was seen in 2 patients. Four patients complained of insomnia or anxiety. Mild asymptomatic acidosis was seen in 3 patients. Other toxicity included grade 1-2 nausea and vomiting (10 patients), grade 2 diarrhea (2 patients), grade 3 thrombocytopenia (3 patients), grade 1-3 leukopenia (3 patients), and oral herpes simplex infection (4 patients). Mild reversible renal insufficiency (measured by creatinine clearance) was seen in 8 patients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2720697 TI - Carbamazepine-induced systemic lupus erythematosus. PMID- 2720698 TI - A metric for the evaluation of change in clinical trials. PMID- 2720699 TI - Pharmacokinetic and pharmacodynamic modeling of L-dopa plasma concentrations and clinical effects in Parkinson's disease after Sinemet. AB - Eleven parkinsonian patients participated in a pharmacokinetic/pharmacodynamic study in an attempt to model levodopa (L-DOPA) plasma concentrations to clinical effect. Carbidopa 25 mg/L-DOPA 100 mg (Sinemet 25/100) was given orally, and blood samples were obtained before and serially for 4 hours after the dose. Effect measurements were obtained with each blood sample and included tapping score, timed walking, and global assessment of motor function. Mean L-DOPA plasma concentrations were fitted to a one-compartment pharmacokinetic model. A time wise plot of modeled plasma L-DOPA concentrations versus mean effect measurements revealed a counter-clockwise hysteresis. Effect compartment concentrations were determined by a least squares approach, which determined elimination rate constants by minimizing hysteresis. Half-times for the equilibration between plasma and the effect compartment were 0.39 h for tapping, 0.36 h for walking, and 0.34 h for the global score. Pharmacodynamic data were fit best with an Emax model with baseline effect for tapping (Emax = 53.2 taps/60 s, EC50 = 0.58 microgram/ml) and global score (Emax set at 5.0 by limits of scale, EC50 = 2.53 micrograms/ml). A linear model best described the relationship between predicted effect site concentration and timed walking. L-DOPA plasma concentrations after oral Sinemet did not correlate well with clinical response because clinical response lags behind plasma concentrations. Half-times for equilibration between plasma and the effect site were similar for all of the effects measured. PMID- 2720700 TI - Falls and Parkinson's disease. AB - One hundred patients with Parkinson's disease (PD) and five patients with progressive supranuclear palsy were questioned about the frequency, circumstances, and consequences of falling. Parkinsonian symptoms were scored using the unified rating scale. Thirty-eight percent of parkinsonian patients fell, and 13% fell more than once a week. Broken bones (13%), hospitalization (18%), confinement to wheelchair (3%), and fear of walking occurred. Postural hypotension was uncommon and did not correlate to falling. Sensory loss, dementia, heart disease, and the use of antihypertensive medications were not related to falling. Falling did correlate with postural instability, bradykinesia, and rigidity but not with tremor. Falling was also related to age and duration of disease. The frequency of falling was correlated only to the severity of one parkinsonian symptom, postural instability. Progressive supranuclear palsy patients fell often and had marked postural instability. Factor analysis of parkinsonian characteristics yielded three groups, with tremor being an independent symptom. Frequent fallers and postural instability were not changed by dopaminergic therapy. Some fallers with gait difficulties and bradykinesia were improved with levodopa. Physical therapy was also of benefit to some patients. It is concluded that falling is a common problem in PD and may cause serious disability. Falling may be related to all the major motor signs except for tremor. Frequent falling is caused by postural instability, which is not reversible with dopaminergic therapy. PMID- 2720701 TI - Simple isolation of alpha-D-Neup5Ac-(2----3)-beta-D-Galp-(1----4)-D-Glcp(GM3o. s.) from bovine colostrum through lactonization. PMID- 2720702 TI - Isolation, purification, and characterization of fucose-containing sulfated polysaccharides from the brown seaweed Ecklonia kurome and their blood anticoagulant activities. AB - A sulfated polysaccharide fraction, obtained from the hot-water extract of the brown seaweed, Ecklonia kurome by removing laminaran and the major part of alginic acid, gave sulfated polysaccharides (B-I, B-II, C-I, and C-II) by both anion-exchange chromatography on a column of Ecteola-cellulose and by fractional precipitation with ethanol containing 0.3% calcium acetate, and then by gel filtration chromatography on a Sepharose 4B column. B-I and B-II are composed of fucose, galactose, mannose, xylose, glucuronic acid, and ester sulfate in the approximate molar ratios of 1.00:0.36:0.48:1.08:1.85:2.35 and 1.00:0.81:0.18:0.45:0.61:2.00, respectively. C-I and C-II are composed of fucose, galactose, glucuronic acid, and ester sulfate in approximate molar ratios of 1.00:0.03:0.03:1.61 and 1.00:0.19:0.07:1.48, respectively. Blood-anticoagulant activities with respect to activated partial thromboplastin time (APTT) were approximately 24, 19, 81, and 85% of that of heparin for B-I, B-II, C-I, and C II, respectively. All the polysaccharides showed slight antithrombin activity. No antifactor Xa activity was observed for any of the polysaccharides. PMID- 2720703 TI - 1H- and 13C-n.m.r. assignments for structural elements of xylose-containing N linked oligosaccharides, using 1D-and 2D-n.m.r. experiments. AB - 1H-N.m.r. and 13C-n.m.r. spectral assignments for synthetic beta-D-Xyl-(1----2) beta-D-Man-OMe, beta-D-Xyl-(1----2)-[alpha-D-Man-(1----3)]-beta-D-Man-OMe, beta-D Xyl-(1----2)-[alpha-D-Man-(1----6)]-beta-D-Man-OMe, and beta-D-Xyl-(1----2) [alpha-D-Man-(1----3)]-[alpha-D-Man-(1----6)]- beta-D-Man-OMe, which are structural elements of xylose-containing carbohydrate chains from N glycoproteins, have been made on the basis of 1D and 2D (DQF 1H-1H COSY, HOHAHA) 500-MHz 1H-n.m.r. spectroscopy and 1D 50-MHz 13C-n.m.r. spectroscopy, respectively. PMID- 2720704 TI - Synthesis of four structural elements of xylose-containing carbohydrate chains from N-glycoproteins. AB - The synthesis of the oligosaccharides beta-D-Xylp-(1----2)-beta-D-Manp-OMe (12), beta-D-Xylp-(1----2)-[alpha-D-Manp-(1----6)]-beta-D-Manp+ ++-OMe (17), beta-D Xylp-(1----2)-[alpha-D-Manp-(1----3)]-beta-D-Manp+ ++-OMe (21), and beta-D-Xylp (1----2)-[alpha-D-Manp-(1----3)] [alpha-D-Manp-(1----6)]-beta-D-Manp-OMe (25) is described. Methyl 3-O-benzyl-4,6-O-isopropylidene-beta-D-mannopyranoside (6) was prepared from the corresponding glucoepimer (4) by oxidation, followed by stereoselective reduction. Condensation of 6 with 2,3,4-tri-O-acetyl-alpha-D xylopyranosyl bromide in the presence of mercuric cyanide gave a 1:9 mixture of methyl 3-O-benzyl-4,6-O-isopropylidene-2-O-(2,3,4- tri-O-acetyl-alpha- (7a) and beta-D-xylopyranosyl)-beta-D-mannopyranoside (7), and then 7 was converted into the acetylated disaccharide-glycoside 11. Regioselective mannosylation, with 2,3,4,6-tetra-O-acetyl-alpha-D-mannopyranosyl bromide, at position 6 of deisopropylidenated 7 (8), using mercuric bromide as a promoter, afforded the trisaccharide-glycoside derivative 13, which was transformed into the acetylated trisaccharide-glycoside 16. The disaccharide derivative 10, obtained from 8, and the trisaccharide derivative 15, obtained from 13, were glycosylated at position 3 with O-(2,3,4,6-tetra-O-acetyl-alpha-D-mannopyranosyl)trichloroacetimidate (19), using trimethylsilyl triflate as a promoter, giving rise to acetylated tri- (20) and tetra-saccharide (24) derivatives, respectively. O-Deacetylation of 11, 16, 20, and 24 gave 12, 17, 21, and 25, respectively. PMID- 2720705 TI - Synthesis and reactions of O-acetylated benzyl alpha-glycosides of 6-O-(2 acetamido-2-deoxy-beta-D-glucopyranosyl)-N-acetylmuramoyl-L- alanyl-D isoglutamine esters: the base-catalysed isoglutamine in equilibrium glutamine rearrangement in peptidoglycan-related structures. AB - Condensation of benzyl 2-acetamido-6-O-(2-acetamido-3,4,6-tri-O-acetyl-2- deoxy-3 O-[(R)-1-carboxyethyl]-alpha-D-glucopyranoside (2) and its 4-acetate (4) with L alanyl-D-isoglutamine benzyl ester via the mixed anhydride method yielded N-(2-O [benzyl 2-acetamido-6-O-(2-acetamido-3,4,6-tri-O-acetyl-2-deoxy-beta-D- glucopyranosyl)-2,3-dideoxy-alpha-D-glucopyranosid-3-yl]-(R)-lacto yl)-L- alanyl D-isoglutamine benzyl ester (5) and its 4-acetate (6), respectively. Condensation by the dicyclohexylcarbodi-imide-N-hydroxysuccinimide method converted 2 into benzyl 2-acetamido-6-O-(2-acetamido-3,4,6-tri-O-acetyl- 2-deoxy-beta-D glucopyranosyl)-3-O-[(R)-1-carboxyethyl]-2-deoxy-alpha-D- glucopyranoside 1',4 lactone (7). In the presence of activating agents, 7 underwent aminolysis with the dipeptide ester to give 5. Zemplen O-deacetylation of 5 and 6 led to transesterification and alpha----gamma transamidation of the isoglutaminyl residue to give N-(2-O-[benzyl 2-acetamido-6-O-(2- acetamido-2-deoxy-beta-D glucopyranosyl)-2,3-dideoxy-alpha-D-glucopyr anosid-3- yl]-(R)-lactoyl)-L-alanyl D-isoglutamine methyl ester (8) and -glutamine methyl ester (9). Treatment of 6 with MgO-methanol caused deacetylation at the GlcNAc residue to give a mixture of N-(2-O-[benzyl 2-acetamido-6-O-(2-acetamido-2- deoxy-beta-D-glucopyranosyl)-4-O acetyl-2,3-dideoxy-alpha-D-glucopyra nosid-3- yl]-(R)-lactoyl)-L-alanyl-D isoglutamine methyl ester (11) and -glutamine methyl ester (12). Benzyl or methyl ester-protection of peptidoglycan-related structures is not compatible with any of the reactions requiring alkaline media. Condensation of 2 with L-alanyl-D isoglutamine tert-butyl ester gave N-(2-O-[benzyl 2-acetamido- 6-O-(2-acetamido 3,4,6-tri-O-acetyl-2-deoxy-beta-D-glucopyranosyl)-2,3-d ideoxy- alpha-D glucopyranosid-3-yl]-(R)-lactoyl-L-alanyl-D-isoglutamine tert-butyl ester (16), deacetylation of which, under Zemplen conditions, proceeded without side reactions to afford N-(2-O-[benzyl 2-acetamido-6-O-(2-acetamido-2-deoxy-beta-D- glucopyranosyl)-2,3-dideoxy-alpha-D-glucopyranosid-3-yl]-(R)-la cotyl)-L- alanyl D-isoglutamine tert-butyl ester (17). PMID- 2720706 TI - S-100 protein stimulates cellular proliferation. AB - S-100 protein (S-100p) is a small, acidic, calcium-binding protein that is present (predominantly) in the cytoplasm of many types of cells including those of neuroectodermal origin, such as glial cells, schwann cells and melanocytes. In human melanoma cells S-100p is abundant relative to the small quantities expressed by normal melanocytes. We investigated the possibility that this protein may be a growth factor. Purified S-100p from bovine brain or human melanoma cells was added exogenously to human melanoma cells and peripheral blood lymphocytes (PBL) and their growth in the presence of different concentrations of S-100p was determined using a [3H]dT-uptake proliferation assay. The growth of melanoma cells was stimulated by S-100p at concentrations of 1.95-31.25 micrograms/ml. Slight inhibition of cell proliferation occurred at high concentrations (125 micrograms/ml). Maximum stimulation of PBL was at 31.25 micrograms/ml. PBL were not inhibited even at high concentrations of S-100p (125 micrograms/ml). PBL stimulation by S-100p did not require the presence of monocytes/macrophages. Though stimulation by S-100p is not restricted to a specific cell type, when released by melanoma cells it may function as an "autocrine" tumor growth factor. Other cells, such as PBL, coming in contact with S-100p are also stimulated to proliferate. PMID- 2720707 TI - Phase I study of recombinant human tumor necrosis factor alpha in advanced malignant disease. AB - A phase I study with recombinant human tumor necrosis factor alpha (rhuTNF-alpha; Knoll AG, Ludwigshafen, FRG) in patients with advanced malignant disease was undertaken to evaluate drug toxicity (organ specificity, time course, predictability, reversibility, maximal tolerated dose), effectiveness, antigenicity and pharmacokinetics. TNF was administered as a test dose followed by daily i.v. infusions for 5 days, every 3 weeks (single i.v. infusion lasting 10 min, TNF dissolved in 50 ml 5% human albumin). Dosage was increased in groups of 3 or 4 patients from 0.04 mg/m2 to 0.28 mg/m2. A total of 19 patients with different cancers, including seven large-bowel carcinomas, three chronic myelogenous leukemias, three hypernephromas, two small-cell lung cancers, one malignant melanoma, one malignant lymphoma, one rhabdomyosarcoma and one fibrosarcoma were treated. Major side-effects were chills and fever (maximum 40.4 degrees C, median 38.7 degrees C, 19/19), headache (12/19), nausea and vomiting (12/19) and pronounced (greater than 20%) hypotension (4/19). Acute side-effects could be diminished by paracetamol or indomethacin pretreatment, and with one possible exception no tachyphylaxis to TNF was noted. Mild renal toxicity was seen during TNF treatment. Pharmacokinetic studies showed a serum half-life (t1/2) ranging from 11 min to 17 min for doses from 0.04 mg/m2 to 0.16 mg/m2 and prolonged clearance with t1/2 ranging from 54 min to 70 min in the 0.20-0.28 mg/m2 dose range. No objective antitumor effects were observed in this phase I study. PMID- 2720708 TI - Influence of low doses of an oxazaphosphorine on natural killer activity of human lymphocytes. AB - The influence of cis-4-sulfoethylthio-cyclophosphamide (mafosfamide) on natural killer cell activity was examined in vitro in order further to elucidate the possible immunological mechanisms of tumor regressions following low-dose oxazaphosphorine therapy. It was observed that cytotoxicity of human blood lymphoid cells was unchanged or reduced when the lymphocytes were pretreated for 24 h with mafosfamide or when the drug was present during incubation with K562 cells. However, when lymphoid cells were preincubated with human leukocyte interferon plus mafosfamide, natural killer activity was enhanced above the level caused by interferon alone. This enhancement was noted at mafosfamide concentrations of 1 nM-1 microM and was only present when the lymphocyte preparation was contaminated with monocytes. PMID- 2720710 TI - [Reliability of electrocardiographic criteria for the diagnosis of apical myocardial infarct]. AB - Electrocardiographic criteria for the diagnosis of apical myocardial infarction are still debated. Aim of the present study is to evaluate if there is an electrocardiographic pattern useful in the diagnosis of apical AMI using biplane ventriculography as "gold standard" technique. For this reason, we studied 75 patients at the first AMI with a-dyskinesis in the apical zone on biplane ventriculography (segments 3 and 7 according with CASS nomenclature). By the means of ventriculography we have selected 2 groups: a first group of 19 patients with a-dyskinesis confined to apical zone and a second group of 56 patients with a-dyskinesis in the apical zone and surrounding regions. In the 2 groups we found different electrocardiographic changes. In the first group (a-dyskinesis in the apical zone only) we found the ECG pattern of anterior AMI in 14 (73.7%), antero inferior AMI in 2 (10.5%), antero-lateral AMI in 1 (5.3%) and inferior-posterior AMI in 2 patients (10.5%), respectively; in the second group (a-dyskinesis in the apical and surrounding zones) we observed 31 (55.4%) anterior, 7 (12.5%) antero lateral, 7 (12.5%) antero-inferior and 11 (19.6%) inferior-posterior myocardial infarctions. Our study did not allow to recognize a "typical" ECG pattern associated with the "apical" infarction seen at ventriculography. PMID- 2720709 TI - Preferential homing of tumor-infiltrating lymphocytes in tumor-bearing mice. AB - In view of the current interest in the use of lymphoid cells in adoptive immunotherapy of patients with advanced cancer, we have studied the homing patterns of various lymphoid effector cells in mammary-tumor-bearing mice. Single cell suspensions of total splenocytes, natural killer (NK) cells, and lymphokine activated killer (LAK) cells were prepared from the spleens of C3H/OuJ mice. Tumor-infiltrating lymphocytes (TIL) were isolated from mammary adenocarcinomas excised from retired breeder females of the same substrain. Effector cells were labeled with indium-111 and injected via a tail vein into female C3H/OuJ mice bearing one or more mammary tumors. Twenty-four hours after administration, total splenocytes, NK cells, and LAK cells distributed themselves evenly between normal mammary tissue and mammary adenocarcinomas. Only TIL had a higher concentration in tumors than in corresponding normal mammary tissue. The ability of the different lymphocyte preparations to lyse YAC-1 cells was determined by means of a 4-h 51Cr-release cytotoxicity assay. Cells harvested from LAK cell cultures and further enriched by centrifugation through a discontinuous Percoll gradient and interleukin-2 (IL-2)-stimulated TIL demonstrated the highest levels of cytotoxicity, while total splenocytes and fresh TIL were characterized by the lowest levels. Since IL-2-stimulated TIL were highly cytotoxic and exhibited better tumor localization than both NK cells and LAK cells in this system, they may be the lymphoid effectors of choice for adoptive immunotherapy of advanced cancer. PMID- 2720711 TI - [Idiopathic dilated cardiomyopathy: clinical and prognostic significance of the morpho-functional involvement of the right heart]. AB - Aim of this study was to evaluate whether different severity of clinical and functional impairment of right heart in patients with idiopathic dilated cardiomyopathy (IDC) might condition distinct clinical features and prognosis. From 104 consecutive patients with hemodynamically assessed diagnosis of IDC studied between 1977 and 1987 in our Institute, 39 patients (28 males and 11 females, mean age 41 +/- 14 years) were selected on the basis of ejection fraction ranging from 35 to 50%, left ventricular end-diastolic pressure ranging from 13 to 20 mmHg and left ventricular end diastolic volume less than or equal to 150 ml/m2. A significant involvement of right heart (diagnosed according to a mean right atrial pressure greater than or equal to 9 mmHg, a right ventricular end-diastolic pressure greater than or equal to 9 mmHg and a right ventricular end-diastolic diameter greater than or equal to 30 mm) was assessed in 16 patients (41%), 11 males and 5 females, aged 40 +/- 15 years (Group A). On the contrary the remaining 23 patients (59%), 17 males and 6 females, aged 42 +/- 12 years, had a normal right heart (Group B). At entry into the study, clinical features appeared similar in the 2 groups of patients whereas patients of Group A had significantly higher incidence of atrial fibrillation (25% vs 4%, p less than 0.01) and complex ventricular arrhythmia (greater than or equal to 4 Lown class) (25% vs 4%, p less than 0.01) compared with patients of Group B. With respect to conduction defects no difference was found between Group A and Group B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720712 TI - [Abnormal coronary vasomotility in subjects with normal coronary arteries and reduced reserve of coronary flow]. AB - A reduced coronary flow reserve has been reported in patients with ischemia-like symptoms and normal coronary arteries. In 13 such subjects both coronary vasomotion and flow reserve were studied. The luminal area of the proximal and distal third of the left anterior descending and left circumflex artery were determined by biplane quantitative coronary arteriography using a computer assisted system. Subjects were studied at rest, during submaximal supine bicycle exercise (4.0 min, 116 W) and 5 min after sublingual administration of 1.6 mg nitroglycerin. Heart rate, mean pulmonary and aortic pressure as well as the percent change of both proximal and distal luminal area were determined. In 10 of the 13 subjects, coronary sinus blood flow was measured by coronary sinus thermodilution technique at rest and after dipyridamole infusion (0.5 mg/Kg in 15 min) 10 +/- 5 days after quantitative coronary arteriography. Coronary flow ratio (dipyridamole/rest) and coronary resistance ratio (rest/dipyridamole) were determined in these subjects. Subjects were divided into 2 groups according to the behaviour of the coronary vessels during exercise (vasodilation = Group 1, vasoconstriction = Group 2). Coronary vasodilation of the proximal (luminal area + 26%; p less than 0.001) and distal (+ 45%; p less than 0.001) artery was observed in 7 subjects (Group 1) during exercise and after sublingual nitroglycerin (+46%; p less than 0.001 and +99%; p less than 0.001, respectively). In Group 2 (n = 6), however, there was coronary vasoconstriction of the distal vessel segments (-24%; p less than 0.001) during exercise, whereas the proximal coronary artery showed vasodilation (+ 26%; p less than 0.001) during exercise. Following sublingual nitroglycerin, both vessel segments elicited vasodilation (distal coronary + 44%; p less than 0.001, proximal coronary artery +47%; p less than 0.001). Coronary flow ratio amounted to 2.5 in Group 1 and to 1.2 in Group 2 (p less than 0.05) and coronary resistance ratio to 2.7 in Group 1 and to 1.2 in Group 2 (p less than 0.05), respectively. Thus, among subjects with ischemia-like symptoms and normal coronary arteries there is a subgroup of patients (Group 2) with an abnormal dilator response of the distal coronary arteries to the physiologic dilator stimulus of exercise and a reduced dilator capacity of the resistance vessels after dipyridamole (= abnormal coronary vasodilator syndrome). The nature of this exercise-induced distal coronary vasoconstriction is not clear but might be due to an abnormal neurohumoral tone which may cause or contribute to the blunted vascular response during exercise. PMID- 2720713 TI - Non-invasive diagnosis of ischemic heart disease using stress thallium scintigraphy and digital exercise 2-dimensional echocardiography. AB - The introduction of computer technology has overcome many of the technical difficulties in performing and interpreting echocardiograms obtained from exercising individuals and has made stress echocardiography a potentially practical examination. Additional data, however, are necessary to establish the accuracy of exercise echocardiography. The purpose of this study is to compare exercise echocardiography and planar thallium studies for accuracy in detecting coronary artery disease. The study was performed on 50 patients, 41 of whom underwent coronary angiography. For the remaining 9 patients accuracy was defined as concordance of clinical information, treadmill ECG results, thallium data and the exercise echocardiogram. If there was any discrepancy among these tests, the patient was not included in the analysis. The sensitivity of exercise 2D digital echocardiography was comparable to stress thallium (0.86 vs 0.85) and was better than treadmill test alone (0.66). There were no false positive tests with echocardiographic study, while 1 false positive thallium examination was detected. The diagnostic accuracy of stress echocardiography was 0.90, stress thallium 0.85 and treadmill test only 0.75. In conclusion, exercise echocardiography appears to give results comparable to stress planar thallium studies. In addition, the ultrasonic procedure has several advantages: it is totally non-invasive, does not require a reperfusion study 4 hours later, avoids radiation and is less expensive. PMID- 2720714 TI - [Predictive value of myocellular hypertrophy in idiopathic dilated cardiomyopathy]. AB - The role of endomyocardial biopsy (EMB) in assessing of idiopathic dilated cardiomyopathy (IDCM) is a well-recognised one. On the contrary, the value of correlating histological features, such as myocellular hypertrophy, with functional evaluation and outcome is still controversial. It was the purpose of the present study to appraise the correlation with hemodynamic data and the predictive role of histological features in 32 consecutive patients affected by IDCM who underwent left ventricular EMB between January 1984 and December 1986. Light microscopy findings were graded by means of a semiquantitative score system. In comparison with the 19 patients with mild myocellular hypertrophy, the 13 patients with marked hypertrophy showed significantly lower right ventricular end-diastolic pressure (10.4 +/- 5.8 vs 6.6 +/- 3.6 mmHg, p less than 0.05) and left ventricular end-diastolic pressure (26.9 +/- 9.0 vs 16.5 +/- 8.8 mmHg, p less than 0.01). On the contrary, different degrees of interstitial fibrosis, as well as of the other morphologic findings, could not identify patients with distinct hemodynamic patterns. However, there was a direct correlation between the amount of myocellular hypertrophy and interstitial fibrosis (p less than 0.01). During a mean follow-up period of 32 +/- 11 months (range: 12-48 months), 6 patients died and 3 further patients underwent heart transplantation. Univariate analysis of histological features (log-rank test) showed a mild degree of hypertrophy alone to be significantly related to a poor outcome (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720715 TI - [Antiplatelet effects of combined therapy with ticlopidine and low doses of aspirin on patients with ischemic cardiopathy]. AB - The aim of study was to evaluate the effects on platelet function, in 8 patients with ischemic heart disease, of the following treatments administered consecutively: ticlopidine in a daily dose of 500 mg (10 days); aspirin in a daily dose of 50 mg (10 days); ticlopidine plus ASA, at the same dosages, for the last 10 days. Only ticlopidine plus ASA significantly inhibited EC 50 of ADP, collagen and arachidonate. Platelet activation and platelet sensitivity to prostacyclin was affected by ticlopidine and ticlopidine plus ASA but not by ASA alone. We conclude that in our ischemic heart disease patients the association of ticlopidine and low dose aspirin seems superior to each drug alone in inhibiting platelet activity. PMID- 2720716 TI - [Effectiveness of diltiazem in controlling ventricular response and improving exercise capacity in chronic atrial fibrillation. Double-blind, cross-over study]. AB - Although digoxin is often the drug of choice to control the ventricular response in chronic atrial fibrillation, it fails to control exercise-induced increase in heart rate. The efficacy of diltiazem to control ventricular response and to improve cardiovascular performance during maximal exercise was investigated in 13 digitalized patients with chronic atrial fibrillation. A placebo controlled prospective randomized double-blind study, was preceded by open titration phase. During the diltiazem treatment phase, mean ventricular response diminished at rest (85 +/- 12 versus 107 +/- 19 during digoxin therapy and versus 101 +/- 18 during digoxin and placebo therapy; p less than 0.001), as well as during maximal exercise (142 +/- 13 versus 159 +/- 17 during digoxin treatment and versus 160 +/ 14 during digoxin plus placebo treatment; p less than 0.001). During exercise (50 W), in a subgroup of 7 patients, mean ventricular rate dropped: 109 +/- 19 versus 142 +/- 21 during digoxin treatment and versus 143 +/- 17 during digoxin plus placebo treatment; p less than 0.001). In all patients, the mean rate at rest decreased about 19.3 +/- 6.9% and at maximal exercise about 10.3 +/- 4.9%. In the subgroup of the 7 patients ventricular mean rate at a load of 50 W decreased about 23.6 +/- 7.9%. In all the patients, maximal exercise capacity improved: the MET mean value increased from 3.59 +/- 1.3 to 4.52 +/- 1.18 (p less than 0.001); the mean value of the maximum exercise (MEC), according to the Redfords formula, increased from 65 +/- 48 to 132 +/- 70 (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720717 TI - [Treatment of recent atrial fibrillation with intravenous propafenone]. AB - Intravenous propafenone (1 mg/Kg in 3 min) has been administered to 14 patients with recent atrial fibrillation. The sinus rhythm was restored in 7 patients within 30 min after the injection. The left atrial size, evaluated by M-mode echocardiography, was no different in the group of responders, with respect to the non-responders. No adverse effect has been observed. One single patient manifested a long asystolic pause (3860 ms), at the restoration of sinus rhythm. Propafenone appears to be useful in the treatment of recent atrial fibrillation. PMID- 2720718 TI - [Transesophageal pacing in the diagnosis of accelerated atrioventricular conduction]. AB - The term "enhanced atrioventricular nodal conduction" (EAVN) is used to indicate an electrophysiologic condition characterized by subnormal conduction delay with reduced decremental properties in the AV node, which can be responsible for rapid ventricular rates in the event of fast atrial rhythms. Although identification of such an entity usually requires definition of the AV conduction intervals, some authors have suggested that EAVN can be diagnosed, by means of atrial pacing only, when 1:1 conduction with narrow QRS complexes occurs during atrial pacing at rate higher than 200 bpm. The use of incremental transesophageal atrial pacing (TAP) as a noninvasive tool for identification of EAVN was investigated in 19 patients. Fifteen had a history of supraventricular tachyarrhythmias (11 Wolff Parkinson-White syndrome; 2 Lown-Ganong-Levine syndrome; 1 intranodal AV reentry tachycardia; 1 sick sinus syndrome); 4 patients exhibited an electrocardiographic pattern of preexcitation without a history of tachyarrhythmias. Analysis of AV conduction at fast induced rates was hampered in 5 patients because of the easy occurrence of reciprocating tachycardia and/or atrial fibrillation during TAP, as well as because of the persistence of delta wave at cycle lengths (CL) shorter than 300 ms. Among the remaining patients, in 7 (50%, Group A), 1:1 AV conduction was present at pacing CL shorter than 300 ms. In 7 patients (50%, Group B), AV block occurred at pacing CL longer than 300 ms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720719 TI - Hypertrophic cardiomyopathy mimicking athlete heart: risk of progression and opportunity for a bioptical approach. AB - A case of hypertrophic cardiomiopathy (HCM) mimicking athlete heart, is reported. Performing competitive activity was followed by progression of HCM to cardiac dilation and hypokinesis so that transplant was needed at young age. The Authors suggest a more aggressive approach possibly inclusive of cardiac biopsy when doubtful cases of athlete heart require permission for competitive sports. PMID- 2720721 TI - Economics, Employment Commission a winner. PMID- 2720720 TI - [Sulodexide and defibrotide are not low molecular weight heparins]. PMID- 2720722 TI - Advances in diagnostic testing for vascular disease. PMID- 2720723 TI - NPH human insulin: does it work in a once-a-day regimen? AB - A clinical transfer trial was conducted to ascertain whether semisynthetic human NPH insulin has a full 24-hour duration of therapeutic effect comparable to that of NPH insulin from animal sources. Diabetic patients requiring insulin and stabilized on a once-a-day (QD) regimen of animal NPH insulin were enrolled and entered a two-week run-in period during which the constancy of their insulin requirements and the stability of their glycemic control were assessed. At the end of the run-in phase, baseline measurements were made of fasting blood glucose (FBG), hemoglobin A1 C, C-peptide, and insulin antibodies. Patients then were transferred to a QD regimen of semisynthetic human NPH insulin (Novolin N) in the same dose as the animal insulin. Glycemic control was reassessed after 1, 4, and 8 weeks of therapy, and a global assessment of overall glycemic control was made at the conclusion of the study. Efficacy variables were analyzed for 39 patients. Most had non-insulin-dependent diabetes mellitus (NIDDM) and most were transferred from mixed beef/pork insulin. Six (15%) patients required significant adjustments in insulin dose or regimen; the remaining 85% completed the eight weeks of treatment with minimal changes in insulin dose. Mean values for FBG and hemoglobin A1 C did not change significantly between baseline and the end of the study. The only statistically significant change was an increase in mean body weight (P less than or equal to 0.01). Results of the investigators' global assessments showed that 74% of the patients had unchanged or improved control of glycemia after transferring to semisynthetic human NPH insulin. The average frequency of hypoglycemic events was not significantly changed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720724 TI - Overall results of adjuvant chemotherapy and a chemosensitivity test for osteosarcoma. AB - Among 59 patients with long bone osteosarcoma without metastases at first diagnosis, the five-year cumulative survival rate was 51.7% following surgery and chemotherapy, and 14.4% in an historical control group. Preoperative combination chemotherapy with high-dose methotrexate, adriamycin, and vincristine was found to be effective in 60% (9/15) of the patients. Histopathological examination of the resected tumor indicated a necrosis rate of over 90%. Twenty tissue samples from 12 patients were tested for sensitivity to anticancer drugs using the human tumor clonogenic assay. Samples obtained by biopsy from four of five patients were found to be sensitive to methotrexate or cisplatin, as were five of six surgical specimens from primary lesions. Samples from pulmonary metastases, however, were either resistant or showed poor sensitivity to all anticancer agents tested. The predictability for methotrexate was 87.5% (7/8). Results indicate that combination chemotherapy improves patient survival. Further improvement in the overall prognosis may be achieved by using a reliable tumor sensitivity test to prepare an optimal chemotherapy program. PMID- 2720725 TI - Serum ferritin levels after multivitamin iron ingestion during teenage pregnancy. AB - The postabsorptive serum ferritin levels following normal dosages of prenatal multivitamin/multimineral supplements were studied in 17 pregnant teenagers, whose fetuses were between 16 and 20 weeks gestational age. The purpose of the study was to determine the effect of a single oral dose of differing prenatal multivitamin/multimineral tablets containing 60 or 65 mg of elemental iron on the postabsorptive serum ferritin levels. Each woman was randomly tested following the ingestion of one of three different tablets, both in a fed and a fasting state. Blood samples were obtained for ferritin measurement immediately prior to ingestion of the prenatal tablet, with or without a standard meal, and at 1, 3, 6, and 8 hours postabsorption. The group mean serum ferritin levels increased dramatically during the fasting state following ingestion of the Stuart Prenatal tablet and decreased when the Stuartnatal 1 + 1 or Materna 1.60 was ingested. The opposite results were observed when the tablets were ingested postprandially. The results of the study indicate that Stuart Prenatal was most suitable for consumption while fasting (ie, at the hour of sleep), and both Stuartnatal 1 + 1 and Materna 1.60 with a meal. PMID- 2720726 TI - Activity of ciprofloxacin in the treatment of experimental intra-abdominal abscesses in mice. AB - The therapeutic efficacy of ciprofloxacin in the treatment of experimental intra abdominal abscesses in mice caused by a strain of Staphylococcus epidermidis was compared with that of ampicillin and clindamycin. The abscesses were produced by intraperitoneal administration of a bacterial suspension obtained by bacterial culture of S epidermidis diluted to 10(8) CFU/ml mixed with sterilized rat feces and barium sulphate in male BALB/C mice. The following doses of antibiotics were given twice a day for seven days: ciprofloxacin, 1 microgram/100 microliters; clindamycin, 1.5 micrograms/100 microliters; and ampicillin, 3.6 micrograms/100 microliters. The antibiotic serum and pus concentrations were also determined by an agar well diffusion assay. The maximum serum concentrations were obtained 30 minutes after intraperitoneal administration (ciprofloxacin, 2.7 micrograms/ml; clindamycin, 9.0 micrograms/ml; ampicillin, 3.9 micrograms/ml). The penetration inside the abscess was also satisfactory (ciprofloxacin, 0.51 microgram/ml; clindamycin, 3.4 micrograms/ml; ampicillin, 3.8 micrograms/ml). A favorable clinical and bacteriologic response was obtained in 69% of the mice following the ciprofloxacin treatment and in 56% following ampicillin. The efficacy of ciprofloxacin was much higher than that of clindamycin and ampicillin, presumably because of its much higher intrinsic potency against the pathogen rather than for its pharmacokinetic characteristics and its penetration inside the abscess. PMID- 2720727 TI - Enhancement of cytocidal and antitumor effect of cisplatin by caffeine in human osteosarcoma. AB - A nontoxic dose of caffeine enhanced the cytotoxicity of cisplatin in human osteosarcoma cells (OST strain). Synergistic cytotoxicity was seen in vitro in OST cells when 2 mmol caffeine was added to a nontoxic dose of cisplatin (2 micrograms/ml). Caffeine reduced S-phase, G2/M-phase, and S-and-G2/M-phase accumulation by cisplatin on the DNA histogram, and nuclear fragmentation of tumor cells was frequently observed. Flow cytometric analysis appeared to be useful in assessing the efficacy of the combination of cisplatin and caffeine. The antitumor effect of the combination of cisplatin and caffeine was examined in OST transplanted to BALB/C athymic mice. Regression of the tumor was observed when cisplatin was given at a dose of 10 mg/kg. When 4 mg of caffeine was given once a day for three days after the administration of cisplatin, marked regression of the tumor was observed in groups treated with 5 or 10 mg/kg of cisplatin, without significant weight loss. These results indicate that caffeine enhances the antitumor effect of cisplatin on transplanted osteosarcoma in BALB/C athymic mice. PMID- 2720728 TI - [Detection of metabolic disorders as a cause of urolithiasis in clinical practice]. AB - Metabolic disorders are the most frequent risk factor for the development of urolithiasis. They are manigenic substances or deficiency of inhibitors of crystalgenic substances or deficiency of inhibitors of crystallization and aggregation. The authors use for their diagnosis a modification of Pak's procedure. It involves examination of 24-hour urine with the patient on a low calcium diet, supplemented by urine examination on fasting and after a 1000 mg calcium load. The procedure includes also examination of serum and bacteriological examination of urine. A total of 93% of patients with calcium lithiasis had a metabolic disorder, 42% suffered from idiopathic hypercalciuria, 32% from hyperuricosuria, 19% from hyperoxaluria, 15% from magnesium deficiency and 38% from hypocitraturia. On the other hand, patients with uric acid lithiasis had a detectable metabolic disorder only in 62%. Active detection of metabolic disorders is essential for the introduction of effective, specific metaphylaxis of urolithiasis. PMID- 2720729 TI - [Adverse effects of drug metaphylaxis of urolithiasis]. AB - The authors examined 133 patients with urolithiasis, treated with hydrochlorothiazide and 81 patients treated with allopurinol. In those treated with hydrochlorothiazide the calciuria and Ca/creat. index declined, and uricaemia rose. After treatment uricosuria increased significantly in 41% patients. The detection of diabetes did not exceed the prevalence in the population. In patients treated with allopurinol the uricaemia and uricosuria declined, a hepatic disorder with supraliminal rise of ALT was recorded in 23% of the patients and led to discontinuation of treatment in 15% of the patients. PMID- 2720730 TI - [Percutaneous extraction of concretions from the kidney]. AB - The authors submit a report on 225 patients operated by the percutaneous approach on the kidney during the period between March 1985 and February 1987. From 231 operations on account of lithiasis concrements were removed in 94.8%. No major complications were observed. The mean period which elapsed from operation to discharge was 8 days in one-stage operations and 19 days in multiple-stage operations. The authors discuss the indications and some technical conditions of the method. PMID- 2720731 TI - [Physical performance of patients on regular dialysis therapy]. AB - 1. Patients having regular dialyzation treatment have a 50% physical performance, as compared with the common population matched for age, already at the onset of treatment. 2. Physical performance does not depend on the level of residual glomerular filtration, on the mean urea concentration in the course of dialyzation treatment and the variations of urea concentrations during dialysis and intervals between dialysis. 3. Physical performance of patients having regular dialyzation treatment depends in a significant way on nutrition. 4. While during renal disease the performance of patients declined by 43%, in the course of ten years of regular dialyzation treatment it declined only by 21%. This fact indicates that already during the period of conservative treatment the patients should have an adequate diet and should engage in exercise to keep fit. Also during regular treatment, in addition to adequate dialysis, the patients should have an adequate diet and an opportunity to engage in physical exercise. PMID- 2720732 TI - [The Swiss program against AIDS]. PMID- 2720733 TI - [Development and conceptual program in the practice of rehabilitation medicine]. AB - The author draws attention to organizational short-comings in the development of rehabilitation in the CSSR, which are to a considerable extent due to the incorrect use of the term rehabilitation. It is used as a synonym of physiatrics, as regeneration or even recreation and as defined by WHO. Despite many satisfactory instructions and Government decrees quoted by the author, in practice the continuity of therapeutic and occupational rehabilitation is not satisfactory. The author mentions interrelations between assessment of work capacity, orthopaedic prosthetics and rehabilitation medicine. He explains the right to work ensured by the constitution with respect to rehabilitation. He expects favourable results which will ensure from the fusion of the health department and the department of labour and the department of labour and social affairs within the framework of economic reconstruction. PMID- 2720734 TI - [The role of prostanoids in malignant diseases]. AB - Prostanoids are substances which are of great regulatory importance for the organism. Recently not only their active participation in the metabolism of malignant tissue is discussed, but also the possibility of their use in the comprehensive treatment of malignant diseases. At present the effect on a reduction of metastases after prostaglandin I2 administration (= prostacycline) as well as of prostaglandin E2 is tested experimentally as they inhibit the capacity of primary tumours to form metastases. The possibility is also considered of using quantitative estimation of some prostanoids for evaluation of the severity of invasion of the organism by a malignant process. PMID- 2720735 TI - [Long-term administration of a low-protein diet with keto-analogs of essential amino acids and the metabolic status of patients with chronic kidney failure]. AB - To 12 patients with chronic renal failure (CHRI) for 12-22 months a diet containing 20 g high quality protein supplemented by keto analogues of essential amino acids (KA)--4.8 g/day--was administered. During the investigation period no significant change of the albumin, prealbumin or transferrin level was recorded, nor of Whitehead's quotient, immunoglobulin levels and haemoglobin concentration, serum iron and its binding capacity. However, there was decline of the C3 complement component (p less than 0.01). The investigated parameters of carbohydrate metabolism (fasting blood sugar, immunoreactive insulin, oral glucose tolerance test) did not change, similarly as total cholesterol and triglyceride levels. The originally reduced HDL-cholesterol level increased (p less than 0.05). The achieved results suggest that the long-term administration of a diet with 20 g protein supplemented by the minimal necessary dose of KA does not produce undesirable changes of the investigated metabolic parameters. PMID- 2720736 TI - [Evaluation of ovoscopic methods in the diagnosis of invasion with the tapeworm, Taenia saginata]. AB - During the period between 1979-1988 the authors examined 84 patients with the diagnosis of T. saginata by three ovoscopic methods to detect ova of tapeworms (Hein's method of faecal smears, Fust's method supplemented by examination of the sediment, and Graham-Brumpt's method of examination of the perianal area by means of an adhesive PVC tape. Of the mentioned methods Hein's method combined with Graham-Brumpt's method was most useful, as they detected ova of T. saginata during a single examination in 77 probands (91.7%). By Hein's method alone 8 positive (9.5%) cases were detected, by Graham-Brumpt's method alone 7 (8.3%) positive cases. Ovoscopic examination is recommended by the authors, in particular for workers engaged in animal farming and agriculture where the contact with the examined subjects is often difficult and they often do not report the excretion of segments in the faeces. PMID- 2720737 TI - [Simple chromatographic determination of the neopterin marker in immunopathies]. AB - Estimation of neopterin in urine has become part of examination in phenylketonuria, malignities, immunodeficiency incl. AIDS and HIV infection. The authors describe a simple chromatographic method for estimation of neopterin which does not call for highly efficient liquid chromatography nor imported kits. The di- and tetrahydro- forms of neopterin are oxidized with MnO2 and stable neopterin is obtained. The specimen is purified on a Dowex 50WX4 (Fluka) column in a H+ cycle and on PRESEPC18 (TESSEK) columns. Then thin-layer chromatography on Merck Kieselgel 60F254 plates is used in a system of ethyl acetate- isopropanol--1 N NH4OH (35:45:25). Fluorescence is assessed on a densitometer (Shimadzu CS-920 at 367.5 nm). The RF of neopterin is 0.214. The fluorescence is linear within the range of 5-200 ng. The method is sufficiently sensitive also for the estimation of normal neopterin excretion. The authors submit the results of estimations in controls, immunopathies and AIDS. PMID- 2720738 TI - [The effect of radiation on thyroid gland function]. AB - In the submitted review the authors discuss briefly the sequelae of irradiation of the thyroid gland. The most frequent postirradiation affection is usually latent hypothyroidism. The risk of the development of carcinoma in the irradiated gland is cca 200-700 cases per 1 million subjects per year per 1 Gy. The latent period is most frequently 15-30 years. Women and children are roughly twice as sensitive. The authors outline also the problem of 131I and its role in disasters of nuclear reactors. It is considered a 10 times weaker cancerogen than external radiation. In the conclusion the authors discuss possibilities of prevention with a more detailed account of the pharmacological block of the thyroid gland. The authors give also recommended doses to be used in the prophylactic administration of potassium iodide. PMID- 2720739 TI - [Renal function parameters in patients in intensive care]. AB - 82 patients treated at a ward of anaesthesiology and resuscitation had 330 renal function tests performed using a computerized programme. While glomerular functions were often preserve or even increased, tubular functions displayed a broad spectrum of disorders. --Nosocomial effects may have a significant role to play there. Extreme changes in regulation as regards impaired ADH involvement are nothing exceptional. Tubular osmotic diuresis and overflow osmotic diuresis are the most frequent types of diuresis, while lower frequency is seen in water diuresis, mixed water and tubular osmotic diuresis, and mixed overflow and tubular osmotic diuresis. The therapeutical effects of the incidence of overflow osmotic diuresis and wider use of aldosterone antagonists are discussed. PMID- 2720740 TI - [Risk factors for non-infectious diseases in health personnel at the District Institute of National Health in Pardubice]. AB - 1354 health workers of the District Institute of National Health in Pardubice were asked in a survey about the incidence of risk factors of non-infectious diseases in their life style. One quarter of the health workers live a healthy life by influencing risk factors in a favourable way. The results call for a more intense activity as regards elimination of risk factors in order to promote better health. PMID- 2720741 TI - [Holter monitoring of patients treated with cytostatic agents]. AB - After cytostatic treatment severe arrhythmias, the development of angina pectoris and even the development of acute myocardial infarction and sudden death were observed. Therefore we made in 42 patients with malignant haematological disease treated with cytostatics 96 Holter monitorings of the electrocardiographic signal. The monitoring was made during the administration of cytostatics as well as during the time interval between the administration of combinations of cytostatics. In both instances (during the administration and during the interval between administration) we recorded a surprisingly high, mean all-day as well as maximal, heart rate. In the group monitored during administration of chemotherapeutic drugs we observed 5-8 hours after administration of cytostatics serious ventricular arrhythmias [incl. ventricular tachycardia], denivelization of the ST segment, paroxysms of supraventricular tachycardia. In the group monitored during the interval between administration of cytostatics the sick sinus syndrome was recorded, as well as a passive nodal rhythm, disorders of the intraventricular conduction. The described changes are explained by the release of vasoactive substances after administration of cytostatics, by a change of the transmembrane calcium transport leading to an increased excitability of the heart muscle and possibly to coronary spasms and direct irreversible damage of the conduction system. PMID- 2720742 TI - [Findings from a socio-medical study of acute myocardial infarct]. AB - An investigation of the lifestyle of 80 patients with acute myocardial infarction was made in cooperation of Olomouc doctors and sociologists in 1987 and 1988. By means of questionnaires replies to 128 questions with 191 items were assembled. The findings were compared with a group of 378 people not treated on account of this disease and in some respects also with 89 patients treated in conjunction with a cerebrovascular attack. The investigation confirmed the great risk, in particular of men having responsible jobs, as well as the risk of subjects with prolonged traumas not compensated by adequate physical activities. The risk factor is work overload, prolonged mental strain, underrating of mental hygiene and psychotraining. The investigation confirmed also the negative role of a high blood pressure (frequently not treated), an unsuitable composition of the diet, overweight, diabetes. The factor of general satisfaction with professional achievements cannot balance the negative influence of these "destructive factors". As compared with a group of healthy subjects, patients had before the disease more frequently a very indifferent attitude to principles of a healthy lifestyle recommended by doctors. PMID- 2720743 TI - [Initial experience with modification of dosage of anti-arrhythmic agents using telephone transmission of the electrocardiogram]. AB - Despite the doubtless advances in the knowledge of cardiac electrophysiology, the mechanism of action of antiarrhythmia and the considerable clinical experience with these drugs, treatment of arrhythmia remains on a trial error basis. The authors tried to use the system serving the transmission of one lead electrocardiograms by telephone as a means of checking and correcting antiarrhythmia treatment. It is a method which despite its unpretentious character and reliability is used on a very limited scale. As compared with other contemporary means of the control of the effect of antiarrhythmia treatment, i.e. above all Holter's method or investigation of plasma levels of antiarrhythmia drugs, it is less time consuming and cheaper. The preliminary results of the authors, based on initial experience, are encouraging. PMID- 2720744 TI - [Non-invasive determination of the "anaerobic threshold" using heart rate kinetics]. AB - The functional parameters at the level of the "anaerobic threshold" (ANT) are used very frequently to characterize aerobic functions of the organism. For estimation of the ANT most frequently changes of the LA blood concentration in relation to an increasing load are used. The LA concentration depends to a considerable extent on the state of glycogen reserves in muscles which may change as a result of physical loads and as a result of dietary intervention. Ventilation parameters and values of the GR are practically independent on glycogen reserves. For the evaluation of mutual relationships between parameters at the level of the ventilation ANT and the level of ANT assessed by means of changes of the HR, both ANT values were assessed in a group of trained endurance runners on a treadmill and in a group of untrained young men on a bicycle ergometer. For practical use both ANT estimations can be considered identical, assuming that when using the HR for assessment of ANT we implement the following conditions: 1. The initial intensity of the load is at the level of 50 VO2max. or lower. 2. The duration of different grades of the load is 30-150 s. 3. Differences in the intensity of the load between different grades are 4-6 strokes. 4. The total number of loads varies between 7 and 12.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720745 TI - [The past and present of cardiac glycosides. II. Structure, physical and chemical properties. Pharmacodynamics]. AB - An outline is presented on the physical and chemical properties and structure of the most important cardiac glycosides, i.e. digoxin, digitoxin and g strophanthin. The overall effects of cardiac glycosides on the cardiovascular system not only are a composite of changes in the force of ventricular contraction and heart rate but also result from effects on the autonomic nervous system and on vascular smooth muscle. Furthermore reflex adjustments to the initial hemodynamic changes caused by the drug are also important. In the normal heart and circulation cardiac glycosides increase inotropy and decrease the chronotropy and dromotropy of the heart. They increase the peripheral vascular resistance and venous tone. Cardiac output remains unchanged or decreases slightly owing to increased peripheral vascular resistance and slowed heart rate. In patients with compromised cardiac inotropy the effects of the glycosides on the heart is essentially the same as in normal subjects, however by suppressing the enhanced sympathetic activity the negative chronotropic and dromotropic effects are more prominent. Peripheral vascular resistance is lowered, cardiac output and venous capacity are increased. PMID- 2720746 TI - [Long-term prognosis in patients with chronic postinfarct aneurysms. I. Conservative treatment of patients]. AB - Natural history of 99 patients with angiographically defined left ventricular aneurysm (LVA) has been studied. Congestive heart failure (CHF) was predominant in 52.5% patients. Mean follow-up was 94 months. The cumulative survival at 1, 5, 7, 10 years were 92, 65, 60 and 28% respectively. Left ventricular end-diastolic pressure averaged 2.8 kPa (LVEDP), ejection fraction (EF) 31%, contractile segment ejection fraction (CSEF) 45%, stroke work 6.7 mj. g-1, diastolic compliance 0.36 kPa-1 and passive elastic modulus 64.1 kPa. High risk groups of patients were those with LVEDP more than 3.3 kPa, CSEF less then 40%, EF less then 20% and with extent of LVA more then 40% of the diastolic area of the left ventricle. The Cox analysis of survival indicated following variables predicted outcome: functional impairment due to CHF, LVEDP, LVEDVI and number of vessels diseased. PMID- 2720747 TI - [Long-term prognosis of patients with chronic post-infarct aneurysms. II. Comparison of patients treated conservatively and surgically]. AB - Survival rates were determined for a group of 136 patients in whom left ventricular aneurysm was determined by angiography. They were treated medically (99 patients) or surgically (37 patients). Congestive heart failure was predominant in all patients. The two groups did not differ in regard to clinical and haemodynamic data except for a more extensive coronary artery disease in the surgical group. Survival rates at the 5, 7 and 9 years were 62.5%, 52.5% and 37.5% in the medicaly treated group and 50%, 40% and 32.5% in the surgical group. Functional improvement at least one Functional Class NYHA was present in 75% patients postoperatively, and in 27% of patients treated medically. CONCLUSION: In patients with left ventricular aneurysm with predominant congestive heart failure surgical treatment improved quality of life but did not increase long term survival. PMID- 2720748 TI - [The effect isometric exertion on left ventricular function in patients after myocardial infarct]. AB - 24 patients, after transmural cardiac infarction, were exposed to isometric exercise ("handgrip"). The haemodynamic response was checked by means of impedance plethysmography. The stroke volume decreased on average from 64 +/- 14 to 60 +/- 15 ml (p less than 0.05), cardiac output increased from 4.8 +/- 1.0 to 5.4 +/- 1.2 l/min. (p less than 0.01). Peripheral resistance significantly increased and left ventricular performance was non-significantly reduced. Compared with a group of healthy control, their stroke and cardiac output and cardiac work kept increasing during isometric exercise. Isometric exercise is an adequate means of checking left ventricular performance. PMID- 2720749 TI - [Relation between the surface ECG and the bundle of His electrogram in 200 patients]. AB - The relationship was assessed between different types of conduction disorders in surface ECG and pathological changes of intervals in electrograms of the His bundle during spontaneous cardiac action and during artificial right atrial stimulation in 200 patients (130 men, 70 women). For the detection of prognostically less favourable intra- and infraHisal conduction disorders it was found important to study the bundle of His electrographically in the following types of surface ECG: complete block of the right Tawara node with left posterior and left anterior hemiblock, complete block of the left Tawara node, left posterior hemiblock, atrio-ventricular block of the 1st degree (particularly when associated with intraventricular conduction disorder), IInd - degree atrio ventricular block 2:1 (3:1), less so atrio-ventricular block of the IIIrd degree. Even apparently normal surface ECG can sometimes conceal major damage to the His Purkinje system. Invasive electrophysiological tests are justified by the presence of syncopes or their equivalents due to unknown causes. PMID- 2720750 TI - [Personality characteristics of hypertensive patients]. AB - Essential hypertension, as well-known specialists believe, is due both to genetic and external environment factors. Apart from the steadily growing complexity of social life and various important life events, high-risk factors may also be seen in a certain way of behaviour and man's psychophysiological reactivity. Recent literature on this topic informs about some common characteristics found in the behaviour of hypertensive persons, for example: anxiety in social contacts, suppressed hostility, manifestations of perfectionism, suppression of emotions, exaggerated behavioral adaptability and defensive attitudes to stress stimuli. In accordance with literary data, the control group of hypertensive patients (N = 89) gave evidence of some identical characteristics. Their knowledge permits to carry out more specific attempts at influencing hypertension in a non pharmacological way. PMID- 2720751 TI - [The molecular structure of serum hemopexin and its role in the metabolism of hemoglobins]. AB - Human serum haemopexine together with albumin participates in the removal of haemoglobin released into the circulation during intravascular haemolysis by a haeme bond and in its transport into parenchymal liver cells. PMID- 2720752 TI - [Research fronts in medicine]. AB - Citation mapping of communicating structures of science and derived indices of the most active research fronts make it possible to adopt and create factographic bases for operative management and prognosis of fundamental medical research. Information data bases and printed registers for systematic use of these materials can be processed according to published analyses of priority trends of science, using methods of aggregated quotations or using networks of descriptors. The referred investigations pertain to the problem of allergy, AIDS, biomedical engineering, hyperthermia, hypnosis, risk pregnancy, epidemiology, modelling, bacterial bioluminescence, prostaglandins, aberrant genes, theory of immune systems, monoclonal antibodies, cholesterol metabolism, immunogenetics and neurobiology, incl. association to the work of Nobel prize winners. The science atlases for biochemistry, molecular biology, biotechnology and molecular genetics, and in new series for pharmacology, biochemistry, immunology, clinical and neurological and psychological disciplines provides a new type of standardized prognostic surveys with identification of the foremost world science fronts. PMID- 2720753 TI - [Experimental models of gastric ulcers. Changes in the secretion of gastric glycoproteins in selected types]. AB - The authors discuss possibilities of modelling of gastric ulcers in experiments on small laboratory animals. In four types of acute gastric ulcers and one type of chronic ulcer changes of glycoproteins in gastric mucus were investigated as to glycoproteins a protective effect on the gastric mucosa is ascribed. As indicator of secretion of these substances total hexose and total protein values were used. It was revealed that in homogenates the total hexose values were in all types of ulcers higher than in the control group. Total protein values were elevated in three types of ulcers. Elevated values of these substances were found also in gastric juice in ulcers after ligature of the pylorus. PMID- 2720754 TI - [Neuroretinopathy in dialyzed patients]. AB - Over the past 11 years, neuroretinopathy was seen in 26 hemodialyzed patients, in an average 5.3% of the patients receiving treatment. During the past 4 years, the rate of incidence had dropped to 1.6%. Neuroretinopathy is most likely to develop in the first two years of artificial kidney treatment. The mean survival time following an attack of neuroretinopathy in 16 decreased patients was 19.4 months. Three patients underwent successful kidney transplantation, 50% were normotensives. As part of the subsequent search for other pathogenetic factors, a high incidence of pathological values of nitrogenous substances was found (urea in 77%, creatinine in 76%, uric acid in 42%). 85% suffered from electric retinal function impairment. PMID- 2720755 TI - [Danol (danazol) in the treatment of fibrocystic breast disease with mastodynia]. AB - The author investigated in a group of 12 premenopausal women with fibrocystic mastopathy with mastodynia, confirmed on mammography, the effectiveness of a synthetic ethisterone derivative--danazole. An objective effect (reduction of the number and/or diminution of nodularities in the mammary parenchyma) was achieved in 67%, disappearance of mastodynia in 100%. As to side-effects only amenorrhoea was observed in 92%, spotting in 8%, an increase of body weight (1-6 kg) in 83% of the treated women. Danol will, with regard to its effectiveness and very good tolerance, if more widely available, substantially extend our therapeutic possibilities in the above indication. PMID- 2720756 TI - [The law and AIDS]. PMID- 2720757 TI - [Detection of specific antibodies to all classes, including IgE, against pollen allergens using the ELISA test]. AB - The authors describe a modification of the immunoenzymatic test suitable for estimation (sensitive dedection) of specific antibodies against pollen allergens of all classes of immunoglobulins, incl. specific IgE. When introducing the method, sera of experimental rabbits immunized with selected allergens were used. After elaboration of suitable conditions, the method was used to assess the presence of specific antibodies in sera of patients with the diagnosis of pollinosis. It was found that the most suitable concentration of pollen allergen combined with the solid phase for detection of specific IgE is 100 micrograms/ml, the optimal concentration of glutaraldehyde used to increase the amount of allergen combined with the solid phase by its polymerization and fixation is 0.25%. The use of the method does not call for special equipment and uses locally produced products. The method is useful for supplementing the diagnosis and its more accurate assessment under clinical conditions when biological tests cannot be used for diagnosis. The test makes monitoring during immunotherapy possible. PMID- 2720759 TI - The use of Fura-2 to estimate myoplasmic [Ca2+] in human skeletal muscle. AB - Fura-2 was used to estimate myoplasmic [Ca2+] in intact fibers and fiber segments from normal and diseased human muscles. Small muscle bundles (20-50 fibers) were loaded with the membrane-permeant form of the dye (Fura-2 AM). High-performance liquid chromatography was utilized to study the ability of these cells to hydrolyze Fura-2 AM. Immediately after the 30 min loading period, Fura-2 (the Ca2+ indicator) was the predominant form of the dye in all preparations and the concentration within these fibers remained stable for over 4 1/2 hours. In addition, the resting myoplasmic [Ca2+] in fiber segments from normal subjects and those susceptible to malignant hyperthermia were the same. However, halothane administration (1.5%) induced correlated increases in myoplasmic [Ca2+] and force only in fibers from the susceptible patients. In contrast, caffeine administration causes correlated increases in myoplasmic [Ca2+] and force in both types of muscle, but lower concentrations were needed to do so in the fibers from the susceptible patients. The effects of halothane and caffeine were reversible. We conclude that Fura-2 can be used successfully to estimate resting levels and changes in myoplasmic [Ca2+] in human skeletal muscle. PMID- 2720758 TI - Ionomycin releases calcium from the sarcoplasmic reticulum and activates Na+/Ca2+ exchange in vascular smooth muscle cells. AB - Ionomycin (1 microM) produced a large spike in cytosolic free Ca2+ [( Ca2+]i). The ionophore had no effect on [Ca2+]i if the sarcoplasmic reticulum had previously been Ca2+ depleted by stimulating neurohormone receptors. Ionomycin markedly increased 45Ca2+ efflux and decreased total cell Ca2+ by 60 to 70% in 1 min. Replacing extracellular Na+ [( Na+]o) with choline or N-methyl-D-glucamine strongly inhibited the effects of ionomycin on 45Ca2+ efflux and total Ca2+. Ionomycin caused similar peak increases in [Ca2+]i in the presence and absence of [Na+]o, but the exponential fall from the peak was faster in the presence of [Na+]o. Dimethylbenzamil, a potent blocker of Na+/Ca2+ exchange in these cells, strongly inhibited the effects of ionomycin on 45Ca2+ efflux and total cell Ca2+. We conclude that the increase in cytosolic free Ca2+ produced by ionomycin may be sufficient to activate the plasma membrane Na+/Ca2+ exchanger which removes Ca2+ from the cytosol and helps restore basal [Ca2+]i. PMID- 2720760 TI - Evidence of calmodulin involvement in cell volume recovery following hypo-osmotic stress. AB - An influx of Ca2+ into red blood cells of the bivalve mollusc Noetia ponderosa occurs immediately following a hypo-osmotic stress. The volume recovery response to the stress is dependent upon [Ca2+]o and is inhibited by phenothiazines. The action of these drugs is on the amino acid regulation portion of the recovery rather than on the ionic portion. Since the phenothiazines are non-specific in action, we have conducted several experiments to decide the site of phenothiazine action on the volume recovery response. The sulfoxide derivatives of both chlorpromazine and trifluoperazine have no effect on volume regulation at the same dose where the parent compound inhibits. At 50-100 times the concentration of the parent compound, the derivatives block both volume regulation and taurine efflux. The phorbol ester, TPA, an activator of protein kinase C, alters the volume recovery, but does so by affecting K+ rather than amino acid regulation. The only phenothiazine target that we can not rule out is calmodulin, which we also demonstrate to be present in the clam red cells. Thus, the data presented suggest that calmodulin is involved in the amino acid regulatory portions of the volume recovery in response to hypo-osmotic swelling. PMID- 2720761 TI - Measurement of cytoplasmic calcium concentration in cell suspensions: correction for extracellular Fura-2 through use of Mn2+ and probenecid. AB - 1321N1 astrocytoma cells loaded with Fura-2 were found to continuously transport Fura-2 to the extracellular medium. To correct for extracellular Fura-2 fluorescence a protocol was developed in which Mn2+ was added to duplicate cuvettes of cells to quench extracellular Fura-2 at the beginning and end of the experimental time course. Since the export of Fura-2 was linear with time, two separate quench determinations allowed the amount of fluorescence from extracellular Fura-2 fluorescence to be estimated at every point in the time course and subtracted from the data. The uncorrected and Mn2+-corrected basal cytoplasmic calcium concentrations averaged 153 nM and 72 nM, respectively. The peak intracellular calcium concentrations following muscarinic stimulation with 300 microM carbachol averaged 1159 nM (uncorrected) and 889 nM (Mn2+-corrected). Probenecid (2.5 mM) was found to block the export of Fura-2 from these cells and did not change the basal calcium concentration or the muscarinic calcium response. PMID- 2720762 TI - Coronary arteriography 1984-1987: a report of the Registry of the Society for Cardiac Angiography and Interventions. II. An analysis of 218 deaths related to coronary arteriography. AB - In a 42-month period, 218 deaths occurred in 222,553 patients undergoing coronary arteriography (0.098%). Age greater than 60 years, NYHA Class IV function, presence of left main coronary disease, and ejection fraction less than 30% all significantly increased the risk of the procedure. Sex and approach (brachial or femoral) used for the catheterization did not affect mortality. Since the SCAI report in 1982, the death rate has dropped significantly in high-risk patients. Low-risk patients (NYHA Class I or normal coronary arteries) who died generally were elderly or had associated valvular heart disease. PMID- 2720763 TI - Complications of cardiac catheterization and angiography in patients with valvular heart disease. VA Cooperative Study on Valvular Heart Disease. AB - Complications were surveyed prospectively in 2,029 catheterizations performed on 1,483 patients from the 13 centers participating in the VA Cooperative Study on Valvular Heart Disease. Complications were reported in 6.9% of 1,559 preoperative procedures of which 2.6% were major and 0.2% fatal. Clinical predictors of complications were hypertension and the precatheterization diagnosis of aortic stenosis. Nevertheless, patients with aortic stenosis successfully tolerated left ventriculography, which was routinely performed regardless of the magnitude of gradient. Procedural predictors of complication were brachial arteriotomy (vascular occlusion) and transseptal catheterization (tamponade). Among the 470 postoperative catheterizations performed solely for research purposes, there were six complications, of which five were bleeding events in patients taking warfarin. Transseptal catheterization was safer in postoperative patients with no cases of tamponade in 125 procedures. PMID- 2720764 TI - Left ventricular outflow obstruction by a mitral valve prosthesis: Doppler ultrasound and cardiac catheterization findings. AB - Left ventricular outflow tract obstruction by a mitral valve prosthesis was noted several years following surgery when symptoms of congestive heart failure occurred. The diagnosis was made using two-dimensional echocardiography and Doppler techniques and confirmed at heart catheterization, using micromanometer tipped catheters. PMID- 2720765 TI - Left main and right catheter-induced coronary artery spasm in a patient with vasospastic angina. PMID- 2720766 TI - Comparison of the frequency response characteristics of catheter-mounted piezoelectric and micromanometric phonotransducers. AB - This study compares the frequency response characteristics of catheter-mounted piezoelectric sound transducers with micromanometric transducers. The tip of a 8F catheter with two piezoelectric transducers and two micromanometers was inserted into a water-filled chamber that had a speaker fixed at one end. The speaker was driven by a power amplifier and sine wave generator. The outputs of the transducers were connected to a low-level amplifier. The piezoelectric transducer behaved as a tunable high-pass filter that could be modified by altering the input impedance of the low level amplifier; the frequency response characteristics were examined at five input impedances ranging from 0.96 to 11.8 megohms. The peak-to-peak outputs of the piezoelectric and pressure transducers were recorded at frequency ranges from DC to 1 kHz with a wide-band oscilloscope. The ratio of the outputs from the piezotransducer and micromanometer (Vph/Vpr) was plotted vs. frequency for each input impedance and analyzed to determine the piezotransducer's output resistance and equivalent capacitance; roll-off frequencies were then calculated. The equivalent capacitance of the piezo-element was determined to be 500-700 picofarads. Series capacitance acted with network resistance to produce a predictable frequency-dependent change in signal amplitude and phase angle. The inherent noise of the pressure transducer was found to be approximately 0.2 mm Hg, while the noise of the piezoelectric transducer was immeasurably low. The piezoelectric phonotransducers were superior to micromanometer transducers in their higher gain and lower noise, suggesting that these transducers may prove useful to physiologic and clinical studies for measuring intravascular sound. PMID- 2720767 TI - Coronary arteriography 1984-1987: a report of the Registry of the Society for Cardiac Angiography and Interventions. I. Results and complications. AB - This prospective series of results and complications of coronary arteriography from the Registry of the Society for Cardiac Angiography and Interventions is the largest ever reported. Since the initial report published in 1982, the results of coronary artery surgery and angioplasty have improved and therefore older and more symptomatic patients are referred for coronary arteriography. More patients are now studied by the femoral approach, and the major complications of the techniques are similar. Despite studying older and higher-risk patients, the complications are remarkably similar to those reported in the older series. Because of the sicker patients being studied, it is probably unlikely that the complication rate will decrease further in the future. The Society for Cardiac Angiography and Interventions will continue its Registry to follow complication rates of both established and new procedure. PMID- 2720768 TI - Single large-balloon percutaneous mitral valvuloplasty. AB - Successful percutaneous balloon mitral valvuloplasty was performed in six patients utilizing single large (up to 30 mm diameter) balloons. Mitral valve area increased from 1.1 +/- 0.1 to 2.5 +/- 0.3 cm2 (P less than 0.01), and there were no complications or significant increases in mitral regurgitation. Single large-balloon mitral valvuloplasty may be as effective as the currently used double-balloon technique and may allow the procedure to be performed more easily and quickly. PMID- 2720769 TI - Pointers on pericardiocentesis. PMID- 2720770 TI - Percutaneous balloon valvuloplasty for mitral stenosis complicated by fatal pericardial tamponade in a patient with extreme pulmonary hypertension. AB - A case of left ventricular perforation by straight-tipped balloon catheter during double-balloon mitral valvuloplasty with fatal outcome is presented. Technical considerations to prevent this complication are discussed. PMID- 2720771 TI - Use of pulmonary capillary wedge aspirates for the antemortem diagnosis of pulmonary microvascular tumor. AB - The diagnosis of pulmonary lymphangitic carcinoma usually requires fiberoptic bronchoscopy with transbronchial biopsy, percutaneous needle aspiration of the lung, and/or open lung biopsy. We performed right heart catheterization in three patients with adenocarcinoma, in whom the diagnosis of pulmonary lymphangitic carcinoma was made on the basis of cytologic examination of pulmonary capillary blood. PMID- 2720772 TI - Comparison of iced and room temperature injectate for thermodilution cardiac output. AB - Cardiac output estimation by thermodilution is carried out using room temperature or iced injectate, but the accuracy and variability of the two methods is not well documented. Room temperature and iced injectate were compared in 21 patients undergoing diagnostic cardiac catheterization. Dextrose injectate (10 ml) was administered in prefilled syringes left to stand either in iced water or in room air. Four injections were made sequentially with room temperature and iced injectate. Cardiac output by room temperature and iced injectate were not significantly different (4.70 +/- 1.22 for room temperature and 4.90 +/- 1.37 for iced injectate, n = 21, P = 0.155). There was a significant difference in the variance of the estimations by the two methods (room temperature = 0.296, iced = 0.120, P less than 0.005). From this variance the calculated number of measurements needed to estimate cardiac output to +/- 0.5 L/min with 95% confidence is seven for room temperature and four for iced injectate. For five patients with cardiac output less than 4.00 L/min with room temperature injectate, cardiac output with iced injectate was significantly higher (3.33 +/- 0.34 for room temperature vs. 3.69 +/- 0.49 for iced injectate, P = 0.05). Thus room temperature injectate generally gives a satisfactory cardiac output estimation but with significantly greater variability than iced injectate. Sample size for accurate cardiac output estimation must be greater with room temperature injectate. Iced injectate may over-estimate output when cardiac output is low. PMID- 2720773 TI - Simultaneous left ventricular and ascending aortic pressure measurements via single artery access for assessment of aortic stenosis. AB - In order to determine the reliability of a single arterial access technique for hemodynamic assessment of aortic stenosis, data obtained from this method was compared with that from dual arterial access in 13 patients. A 59 cm long, 8 Fr. Mullins Transseptal Sheath (MTS) was placed in the ascending aorta (AA) and a 5 Fr. pigtail catheter advanced through the MTS (using a hemostatic "Y" adapter) into the left ventricle for simultaneous pressure recordings. Another 5 Fr. pigtail catheter (PTC) was advanced in the AA from the contralateral femoral artery. Peak pressures, AA pressure-tracing characteristics, mean gradients, and the aortic valve area using tracings from the MTS and the PTC were compared. Peak pressures 120 +/- 8 vs. 119 +/- 8 mmHg (r = .998), "T" time .16 +/- .01 vs. .15 +/- .01 sec. (r = .913), "U" time .36 +/- .02 vs. .36 +/- .02 sec. (r = .983), mean gradients 38.4 +/- 6.1 vs. 39.6 +/- 6.9 mmHg (r = .990) and the AV area .78 +/- .08 vs. 79 +/- .08 cm2 (r = .994) were similar. Therefore, this single arterial technique provides data comparable to the traditional dual access system for hemodynamic assessment of aortic stenosis. PMID- 2720774 TI - Iatrogenic air embolism causing the adult respiratory distress syndrome. PMID- 2720775 TI - Isolation and characterization of two new drosophila protein kinase C genes, including one specifically expressed in photoreceptor cells. AB - We have isolated and characterized two new protein kinase C (PKC) genes from D. melanogaster. One, dPKC98F, maps to chromosome region 98F and displays over 60% amino acid sequence identity with members of a recently described "PKC-related" subfamily in mammals. The other, dPKC53E(ey), maps to region 53E4-7 on the second chromosome and lies within 50 kb of PKC gene previously characterized (dPKC). While dPKC98F transcripts are expressed throughout development, expression of the two genes mapping at cytogenetic location 53E is primarily in adults. dPKC98F and the previously reported 53E gene are transcribed predominantly in brain tissue. In contrast, dPKC53E(ey) is transcribed only in photoreceptor cells. We will discuss the significance of this tissue-specific localization with regard to phototransduction. PMID- 2720776 TI - Early and late periodic patterns of even skipped expression are controlled by distinct regulatory elements that respond to different spatial cues. AB - We have identified the regulatory sequences required for the periodic expression of the Drosophila pair rule gene even skipped (eve). We find that the gradually changing pattern of periodic eve expression during early embryogenesis is directed by two distinct regulatory programs. Initially, eve expression in individual stripes is established by different regulatory elements, each of which responds to nonperiodic spatial cues provided, at least in part, by the gap genes. Later, coordinate expression of eve in all seven stripes is directed by a single regulatory region that responds to periodic cues provided by primary pair rule genes, including eve itself. As a consequence of this two-step regulatory program, eve functions both in the establishment of the periodic pattern of gene expression and in the subsequent specification of parasegmental boundaries. PMID- 2720777 TI - Replication of RNA by the DNA-dependent RNA polymerase of phage T7. AB - The DNA-dependent RNA polymerase of bacteriophage T7 utilizes a specific RNA as a template and replicates it efficiently and accurately. The RNA product (X RNA), approximately 70 nucleotides long, is initiated with either pppC or pppG and contains an AU-tich sequence. Replication of X RNA involves synthesis of complementary strands. Both strands are also significantly self-complementary, producing RNA with an extensive hairpin secondary structure. Replication of X RNA by T7 RNA polymerase is both template and enzyme specific. No other RNA serves as template for replication; neither do other polymerases, including the closely related T3 RNA polymerase, replicate X RNA. The T7 RNA polymerase-X RNA system provides an interesting model for studying replication of RNA by DNA-dependent RNA polymerases. Such a mechanism has been proposed to propagate viroids and hepatitis delta, pathogenic RNAs whose replication seems to depend on cellular RNA polymerases. PMID- 2720778 TI - Steroid hormone receptors compete for factors that mediate their enhancer function. AB - Stimulation of transcription of reporter genes by the progesterone receptor (PR) was inhibited in transfected HeLa cells by co-expressing the estrogen receptor (ER) in an ER-dose- and estrogen-dependent manner. Both the N-terminal A/B region and the hormone binding domain of ER were involved in this inhibition, which was antagonized by antiestrogens and did not appear to involve direct interaction between ER and either reporter gene or PR. ER expression also inhibited activation by the glucocorticoid receptor (GR), and both PR and GR expression inhibited activation by ER, albeit to a lower extent. Similar transcriptional interference was observed between the endogenous PR and ER present in T47D and MCF-7 breast cancer cells transfected with an ER reporter gene. Moreover, transcription of the resident estrogen-induced pS2 gene was partially inhibited by exposing MCF-7 cells to progestins or glucocorticoids. We propose that these observations reflect competition for a functionally limiting transcription factor(s). PMID- 2720779 TI - Travels on the fraud circuit. PMID- 2720780 TI - On the specificity of BET-1 antibody. PMID- 2720781 TI - Characterization of an efficient coronavirus ribosomal frameshifting signal: requirement for an RNA pseudoknot. AB - The genomic RNA of the coronavirus IBV contains an efficient ribosomal frameshifting signal at the junction of two overlapping open reading frames. We have defined by deletion analysis an 86 nucleotide sequence encompassing the overlap region which is sufficient to allow frameshifting in a heterologous context. The upstream boundary of the signal consists of the sequence UUUAAAC, which is the likely site of ribosomal slippage. We show by creation of complementary nucleotide changes that the RNA downstream of this "slippery" sequence folds into a tertiary structure termed a pseudoknot, the formation of which is essential for efficient frameshifting. PMID- 2720782 TI - The protein encoded by a murine male germ cell-specific transcript is a putative ATP-dependent RNA helicase. AB - The murine PL10 cDNA corresponds to a transcript expressed only in the male germ line. Its expression is developmentally regulated, with high levels of transcripts being present during the meiotic and haploid stages of spermatogenesis. The deduced protein is shown to be highly homologous to the murine translation initiation factor eIF-4A and to other proteins that are also homologous to eIF-4A, including the Drosophila protein vasa. By consensus sequence conservation and comparison of secondary structure predictions, putative mononucleotide binding and DNA/RNA binding domains are proposed to be shared by all these proteins. Taken together, these results suggest a helicase function for PL10 protein similar to that of eIF-4A and suggests its possible role in a key step of the spermatogenic process. The possible significance of the similarity between the PL10 protein and the protein product of the maternal effect gene vasa is also discussed. PMID- 2720783 TI - A CCAAT box sequence in the adenovirus major late promoter functions as part of an RNA polymerase II termination signal. AB - Termination of transcription by RNA polymerase II has been shown in several cases to require a functional poly(A) addition site, although the actual termination event occurs further downstream. To define in more detail the sequences required for termination, we mapped the site at which transcription terminates on a chimeric plasmid template that contains the adenovirus MLP directing transcription of the SV40 early region. Termination in cells transfected with this plasmid occurs within a discrete promoter-proximal region that contains an inverted CCAAT-box sequence. This region of the MLP was also capable of directing termination, in an orientation-dependent manner, when inserted downstream of the poly(A) site in the plasmid template. In addition, in adenovirus-infected cells, transcription initiated from upstream promoters on the adenovirus chromosome terminates within the same MLP promoter-proximal region, both establishing the physiological relevance of the observed CCAAT-box dependent termination, and also suggesting a possible function for transcription termination in adenovirus infection. PMID- 2720784 TI - Fraud and the fabric of science. PMID- 2720785 TI - Sperm cells as vectors for introducing foreign DNA into eggs: genetic transformation of mice. AB - Mature mouse sperm cells incubated in an isotonic buffer with cloned DNA capture DNA molecules over a 15 min period. Spermatozoa incubated with pSV2CAT plasmid in either circular or linear form were used to fertilize mouse eggs in vitro. Sequences complementary to pSV2CAT were identified in approximately 30% of 250 progeny by Southern blotting. A genomic library was constructed from the DNA of a positive mouse. Three positive clones were identified and two adjacent HincII restriction fragments of 240 and 370 bp showed identical sequences to the corresponding fragments of the pSV2CAT plasmid. F1 progeny showed paternal and maternal transmission of the transgenes from founders. CAT gene expression was detected on tissues of adult F1 individuals, preferentially on tails and muscle. We conclude that transgenic mice can be obtained using sperm cells as foreign DNA vectors. PMID- 2720786 TI - Two different chromatin structures coexist in ribosomal RNA genes throughout the cell cycle. AB - The structure of ribosomal chromatin in exponentially growing Friend cells, in stationary cells, and in metaphase chromosomes was studied by psoralen photocrosslinking. It is shown that in intact cells, two distinct types of ribosomal chromatin coexist in Friend cells, one that contains nucleosomes and represents the inactive copies and one that lacks a repeating structure and corresponds to the transcribed genes. A single gene copy is either in one or the other chromatin state. The relative amounts of the two types of structures are similar in interphase and metaphase, however, their run-on activities differ significantly. This suggests that the two states of chromatin are maintained independently of the transcriptional process and that they are stably propagated through the cell cycle. PMID- 2720787 TI - The genes and transcripts of an antigen gene expression site from T. brucei. AB - The AnTat 1.3A antigen gene expression site of T. brucei was cloned from genomic libraries of the 200 kb expressor chromosome. In addition to the antigen gene, it contains seven putative coding regions (ESAGs, for expression site-associated genes), as well as a RIME retroposon. The polypeptide encoded by ESAG 4 shows homology to yeast adenylate cyclase, and possesses structural features of a transmembrane protein. The expression site is transcribed by a pol l-like polymerase in the parasite bloodstream form only, but sequences similar to ESAGs 5, 4, and 2 are also transcribed constitutively elsewhere, by a polymerase sensitive to alpha-amanitin. Ultraviolet irradiation, which seems to block RNA processing, allows the tentative mapping of a transcription promoter about 45 kb upstream of the antigen gene. PMID- 2720788 TI - Recovery of Agrobacterium tumefaciens T-DNA molecules from whole plants early after transfer. AB - A system for the analysis of independent T-DNA transfer events from Agrobacterium to plants is described. The complete T-DNA except for the 25 bp border sequences was replaced by one genome of a plant virus so that upon transfer to the plant, a viable replicon is produced by circularization. Rescue of virus from such infected plants allowed analysis of DNA sequences at or close to the ends of T DNA molecules. A rather conserved right border remnant of three nucleotides was found, whereas the sequences remaining at the left end were more variable. A point deletion in the left 25 bp sequence results in even less precise processing at the left end. In addition, many rescued T-DNA molecules carry small direct repeats between the joined T-DNA ends; linear T-DNA molecules are therefore transported to the plant. PMID- 2720789 TI - Natural killer cell regulation of murine embryonic pulmonary fibroblast survival in vivo. AB - We examined the role of the natural killer (NK) cell in controlling the survival of embryonic pulmonary fibroblasts in vivo. In vitro, both primary embryonic fibroblasts and an embryonic fibroblast line (10T1/2) were lysed by syngeneic C3H/HeN splenocytes threefold more efficiently than primary adult fibroblasts. The membrane phenotype of the effector cells was typical of NK cells. It was asialo GM1+, Lyt2.1-, Lyt 1.1-, Thy 1.2-. The cytotoxicity of the effector cell could be enhanced by IFN-alpha/beta but was deficient in the C3H/HeJ bg/bg mutant. Iododeoxyuridine (131I-dUrd)-labeled embryonic fibroblasts were injected intravenously into syngeneic mice with either enhanced or deficient NK function and their survival in the lung was quantitated. Enhanced fibroblast survival was detected in the NK deficient C3H/HeJ beige (bg/bg) mutant strain compared to its normal littermate C3H/HeJ (bg/+). A second method of NK depletion by pretreatment with rabbit anti-asialo GM1 antiserum also produced a striking increase in fibroblast survival. Poly(I:C) significantly enhanced the elimination of pulmonary fibroblasts from the lung between 4 and 24 hr after injection. Poly(I:C) did not enhance clearance of pulmonary fibroblasts in the C3H/HeJ (bg/bg) mutant, but did so in the normal littermate C3H/HeJ (bg/+). In conclusion, we have shown that the survival of embryonic pulmonary fibroblasts was inversely correlated with in vivo NK activity suggesting a possible role for this cytotoxic cell in the control of fibroblast growth in vivo. PMID- 2720790 TI - Tumor necrosis factor as a mediator of Mycoplasma orale-induced tumor cell lysis by macrophages. AB - We and other investigators have previously demonstrated that mycoplasmas induce macrophage-mediated lysis of tumor cells, but the mechanism responsible for this process had, thus far, not been clarified. We now report that addition of either viable or heat-killed Mycoplasma orale to murine macrophages induces a cytolytic activity which, due to its neutralization by a specific antiserum against murine cloned recombinant tumor necrosis factor (rTNF), was identified as TNF-mediated. Both thioglycollate-elicited peritoneal macrophages and the normal macrophages cloned from our JBM phi 1.1 bone-marrow-derived cell line effectively produced TNF at levels similar to, or higher than, those obtained in the presence of high concentrations of lipopolysaccharide (LPS). Four other mycoplasma species demonstrated a varied capacity to induce TNF production by macrophages. Elevated TNF levels were also observed during macrophage-mediated cytolysis of murine A9 fibrosarcoma cells in the presence of either M. orale or LPS. Addition of the specific antiserum against rTNF at a concentration which neutralized all TNF activity in the co-cultures partially inhibited concomitant A9 cell killing. We can, therefore, conclude that M. orale induces TNF production which is, at least partially, responsible for subsequent tumor cell killing. PMID- 2720791 TI - Effect of sulfate concentration on glycosaminoglycan synthesis in explant cultures of bovine articular cartilage. AB - The effects of the sulfate- and FCS concentration on the rate of synthesis and the biochemical properties of glycosaminoglycans, synthesized in bovine articular cartilage in vitro, were studied. 20% FCS in the culture medium stimulated the rate of synthesis. In media without FCS, the rate of synthesis decends from day 0 on. The differences in incorporation rates of [35S]-sodium sulfate and 1,6-[3H] glucosamine-HCl into glycosaminoglycans in serum free media containing 9 microM and 900 microM sulfate were used to discuss the inorganic sulfate concentration in cartilage. In 9 microM sulfate medium, the newly synthesized glycosaminoglycans contain higher levels of unsulfated disaccharides than the endogenous glycosaminoglycans. In each culture medium, the ratio 6-sulfated disaccharides to 4-sulfated disaccharides of the newly synthesized glycosaminoglycans becomes higher after 3 days in culture. The glycosaminoglycan synthesis is underestimated, when chondrocytes are cultured in media containing less than 200 microM sulfate. PMID- 2720792 TI - Lipid metabolism of rat adipocytes in culture. AB - Isolated differentiated rat adipocytes embedded in a collagen matrix were maintained in culture for 0, 4 and 14 days. Assessment of viability by either anabolic glucose metabolism or catabolic lipolytic metabolism can be misleading; both types of metabolism should be measured to establish the status of cells. Cells maintained morphological integrity even when not viable as judged by anabolic glucose metabolism. PMID- 2720793 TI - Studies of the mechanisms of nuclear control over the synthesis of mitochondrial DNA in sea urchin eggs. AB - We have studied the contribution of nuclear genomic activity and of the cytoskeletal integrity in the negative control operated by the nucleus over the mitochondrial genome. We have found that the nuclear control is exerted even in the presence of nuclei that have undergone heavy irradiation such as to block at least DNA replication and in the absence of intact microtubules. Data are presented which suggest some implication of ion (Ca++) movements in this negative control. PMID- 2720794 TI - Co-culture of fibroblasts and hepatic parenchymal cells induces metabolic changes and formation of a three-dimensional structure. AB - Co-culturing of tendon fibroblasts and liver parenchymal cells in Williams' medium E supplemented with fetal bovine serum, hormones, and L-ascorbic acid 2 phosphate, a long acting vitamin C derivative, resulted in formation of three dimensional structure. Both growth of fibroblasts and their production of collagen were inhibited, however production of albumin by the hepatocytes was much better preserved than when individual cells were cultured separately, indicating epithelial-mesenchymal interactions stimulate reorganization of the liver-like tissue from isolated cells. PMID- 2720795 TI - Collagen accumulation by human mammary epithelial cells in primary culture. PMID- 2720796 TI - Light response of cultured melanophores of a freshwater teleost, Zacco temmincki. AB - Melanophores in the skin of the freshwater teleost Zacco temmincki are light sensitive: Melanin granules, melanosomes, in the melanophores aggregate in darkness and disperse in light. Cultured melanophores of Zacco temmincki exhibited light sensitivity in the same manner as the melanophores in isolated scales. The dark-induced aggregation response became conspicuous after 2 days in culture. The appearance of the light response was later than that of the response to norepinephrine or melatonin, which induced rapid melanosome aggregation at one day in culture. The light sensitivity of the melanophores in isolated scales differed between individuals. A high correlation was observed between the degree of dark-induced aggregation in scale melanophores and that in cultured ones. PMID- 2720797 TI - Cellular sialic acid level and phenotypic expression in B16 melanoma cells: comparison of spontaneous variations and bromodeoxyuridine- and theophylline induced changes. AB - The relation of the total cellular content of sialic acid to phenotypic expression of B16 mouse melanoma cells was examined by using phenotype-modifying reagents and more than 10 cloned cell lines with spontaneous phenotypic variations. The sialic acid content changed in a growth phase-dependent manner with a peak in the early log phase of growth. This peak completely disappeared when cells were treated with 5-bromodeoxyuridine (BrdU), suggesting its relation to quasi-normal phenotypes of the treated cells. BrdU treatment also reduced the cellular sialic acid content itself and resulted in the suppression of the activity of tyrosinase, the key enzyme for melanogenesis, and a considerable increase in cell-to-substratum adhesiveness. Treatment with theophylline, in contrast, markedly elevated the sialic acid content, which was accompanied by dramatic increments in tyrosinase activity and pigmentation as well as a slight increase in adhesiveness. The results show a correlation of sialic acid level with tyrosinase expression but not with cell adhesion. From comparison of spontaneous phenotypic variations, the correlation of sialic acid level with tyrosinase activity was confirmed, while there was only a slight correlation with adhesiveness. It is thus suggested that sialylation/desialylation, being reflected as variations in cellular sialic acid content, is implicated in melanoma cell differentiation in terms of tyrosinase expression. PMID- 2720798 TI - An experimental study on the pathway of iron transfer from macrophages to erythrocytes in rat liver. AB - In order to reveal the pathway of iron release from macrophages, a 59Fe-labelled ferric hydroxide-potassium polyvinyl sulfate complex (Fe-PVS) was injected intravenously into anemic rats and the level of radioactivity in the liver, spleen, bone marrow, blood plasma and red blood cells (RBC) was estimated at various time intervals after the injection. Histochemical observation of ferric iron and ferritin in the liver was also made on anemic rats treated using unlabelled Fe-PVS. Fe-PVS injection promoted the recovery of anemia causing a rapid increase in the RBC number, with activated erythropoiesis occurring in the spleen and bone marrow. Soon after the injection, most of the radio iron was found in the liver with a small amount in the circulating erythrocytes, bone marrow and spleen. The iron level in the liver decreased gradually with a rapid increase in the iron level of the erythrocytes which reached a very high level 6 days after the 59Fe-PVS injection. Histochemical observations showed a heavy deposition of ferritin in the Kupffer cells 3 days after Fe-PVS injection. This deposition was minimized after 6 days with an increase in the level of ferritin in the parenchymal cells in the central area of acini. The level of radioferritin estimated biochemically in the nonparenchymal cell fractions of the liver revealed that the level dropped by about one third approximately 3.5 days after the Fe-PVS injection, showing the stimulated ferritin release at this stage. Results indicate that Kupffer cells in the liver play an important role in ferritin synthesis from the phagocytized iron compounds and that the iron is supplied for erythroid cell proliferation. PMID- 2720799 TI - Effect of dimethyl sulfoxide on cytosolic ionized calcium concentration and cytoskeletal organization of hepatocytes in a primary culture. AB - The addition of dimethyl sulfoxide (DMSO) to a chemically defined, serum free medium prolonged hepatocytes survival in primary culture. DMSO exposure had a remarkable effect on morphological change and F-actin filaments distribution of hepatocytes. When hepatocytes were cultured in a medium containing 2% DMSO, the cells showed a compact and cubical shape and intracellular F-actin filaments were mainly observed in a ring-like fashion around the intercellular space. After exposure to DMSO, fibronectin fibers in the interspace between cell and substratum were not apparent. Exposing the hepatocytes to DMSO also caused a sharp increase in cytosolic free ionized calcium ([Ca2+]). The initial increase in [Ca2+]i following the addition of DMSO was not attenuated by the chelation of extracellular Ca2+ with EGTA. The Ca2+ signal in the absence of extracellular Ca2+ was transient and returned to the basal levels within 1-2 min, while it was maintained at a high steady state in the presence of extracellular Ca2+. These results suggest that DMSO may be able to increase [Ca2+]i by two mechanisms, by the release of the ion from intracellular pools and, by the stimulation of influx across the plasma membrane. The increase in [Ca2+]i induced by DMSO treatment may play a role in prolonging hepatocyte survival in culture, since [Ca2+]i is one of the most important dynamic second messengers in various cellular metabolic processes. PMID- 2720800 TI - Wheat germ agglutinin, concanavalin A, and lens culinalis agglutinin block the inhibitory effect of nerve growth factor on cell-free phosphorylation of Nsp100 in PC12h cells. AB - It has been shown that in PC12 and its subclone PC12h treatment of the cells with nerve growth factor (NGF) induces a selective decrease in the incorporation of radioactive phosphate into a 100,000-dalton protein, designated in an earlier study as Nsp100, in the subsequent phosphorylation of soluble extracts from cells with (gamma-32P)ATP. In the present study, we show that plant lectins, wheat germ agglutinin (WGA), concanavalin A (Con A), and lens culinaris agglutinin (LCA), inhibit the action of NGF on Nsp100 phosphorylation in PC12h cells. Treatment of the cells with WGA, which binds to N-acetylglucosamine and sialic acid residues on glycoproteins, strongly blocked the inhibitory action of NGF on the protein phosphorylation. Con A and LCA, both of which recognize the same specific sugars (mannose, glucose), displayed only a moderate blocking effect. Unlike the native lectin, succinylated WGA, which has the ability to bind to N-acetylglucosamine but not to sialic acid residues, and other lectins examined in this study did not inhibit the action of NGF on Nsp100. WGA-mediated inhibition of NGF action was reversed by the addition of N-acetylglucosamine and by the addition of a much lower concentration of a sialoglycoprotein, mucin, into the culture. Since the binding of succinylated WGA to N-acetylglucosamine residues of cell-surface glycoconjugates is not sufficient to prevent the action of NGF, WGA might act on sialic acid residues of the NGF receptor molecule to effect the inhibition of biological actions of NGF. PMID- 2720801 TI - The isotopic effects of D2O in developing sea urchin eggs. AB - When developing sea urchin eggs were treated with sea water containing 40% D2O (D2O-SW) at the 8-cell stage, the micromere formation was delayed and micromeres were larger than those seen in the control. But eggs returned to normal artificial sea water (NASW) at the 16- to 32-cell stage did not form abnormal spicules in larvae of Pseudocentrotus depressus. Little effect on the spicule formation of Hemicentrotus pulcherrimus was also noted. If the culture period in D2O-SW was extended until the hatching stage, the number of plutei with abnormal spicules increased. Primary mesenchyme cells of Pseudocentrotus depressus larvae failed to make two aggregated spicule rudiments on the ventral side of the larva and developed a ring-like spicule. This ring-like spicule, however, only occasionally occurred in the larvae of Hemicentrotus pulcherrimus. The cell cycle was longer in the presence of D2O. However, blastomeres managed to divide throughout the development. Larvae reared in 20% D2O-SW after the hatching stage developed into quasi-normal plutei but smaller than control. We found no exogastrulation in these larvae. Exogastrulation was found only in larvae continuously cultured in 40% D2O-SW from the early development. These results are inconsistent with previous reports made by other authors. PMID- 2720802 TI - Botulism reference service for Canada. PMID- 2720803 TI - Botulism in Canada--summary for 1988. PMID- 2720804 TI - Botulism in Fort Chimo, Quebec. PMID- 2720806 TI - Influenza activity in Canada. PMID- 2720805 TI - Outbreak of staphylococcal foodborne illness related to consumption of lobster- Nova Scotia. PMID- 2720807 TI - Meningococcal disease in Canada. Surveillance summary to 1987. AB - Meningococcal disease continues to occur in Canada at endemic levels, with minor fluctuations. The incidence of the disease, in general, has changed very little over the past 3 decades. PMID- 2720808 TI - [Feminar with whey (serum) proteins prepared by thermal denaturation. Nitrogen and lipid balance in neonates with a low birth weight]. AB - For the newborn with low birth weights the Dairy Research Institute and Dairy Industry prepared an adapted dried milk--Feminar where most of the casein was replaced by whey proteins, prepared by thermal denaturation F-BTD. The results of the nitrogen and lipid balance made in low birth weight neonates fed this milk were compared with the results of balances in infants fed commonly prepared Feminar and Feminar where whey proteins were prepared by ultrafiltration F-BU. The balances were made in a total of 23 low birth weight neonates (always four balance days). The nitrogen and lipid retention after F-BTD was higher, and concurrent investigation of metabolites revealed lower blood urea concentration. PMID- 2720809 TI - [Gastroesophageal reflux in childhood asthma]. AB - Gastrooesophageal reflux (GER) may participate in the development and persistence of asthmatic complaints. For its detection various examination methods may be used such as oesophagography, oesophageal manometry and pH-metry, ultrasonography, isotope scintigraphy, oesophagoscopy. By means of these methods we detected GER in 27 children, i. e. 41% of a total number of 65 asthmatic children with a medium severe and severe form of the disease. Because of failure of conservative treatment of reflux and hitherto used anti-asthmatic therapy, in 1984 to 1986 in 11 children surgical treatment of reflux by Nissen's fundoplication was indicated. The group comprised 9 boys and 2 girls aged 2 to 14 years. The effect of the operation was evaluated after an interval of 1.5 to 3.5 years following operation. Surgical treatment was successful in four patients (36%) and partly successful in 5 patients (45%). Despite these encouraging results the indication surgery in GER in asthmatic patients still is strictly individual. PMID- 2720810 TI - [Roentgenologic phenotype in syndromes associated with congenital heart defects]. AB - In a group of children with congenital heart disease in 10.7% concurrently skeletal anomalies were observed (1085 children) and in 10.5% anomalies of the upper urinary pathways (1807 children). The authors describe X-ray findings in syndromes of anomalies most frequently associated with congenital heart disease. PMID- 2720811 TI - [How long does clinical death last? Case report of a 6-year-old girl]. PMID- 2720812 TI - [The physician and the computer. 22. Programming in the Prolog language]. AB - A modern tool of interaction with the computer is the programming language Prolog. The authors discuss its position among other languages, emphasize its different character (declarative programming). They outline basic structures of Prolog and its type of function. They also give examples of creating data bases of patients and the possibility to use this language in the creation of expert systems in medicine. PMID- 2720813 TI - [Development of demographic indicators in Czechoslovakia in 1987 and 1986 (1986- definitive data, 1987--preliminary data]. PMID- 2720814 TI - [Localized growth deviations in chronic juvenile arthritis]. PMID- 2720815 TI - [Contraindications for vaccination]. PMID- 2720816 TI - [Accidental heart murmur in children]. PMID- 2720817 TI - [Campylobacter pylori, its endoscopic detection in childhood]. PMID- 2720818 TI - [Inflammation of the urinary tract in a neonate infected with Chlamydia trachomatis. Case report]. PMID- 2720820 TI - [Experience with the treatment of enuresis]. PMID- 2720819 TI - [The status of neonates in women with surgery for congenital cardiac shunt defects]. PMID- 2720821 TI - [Atypical symptomatology and course of Wilson's disease. Case report]. PMID- 2720822 TI - [Changes in lymphocyte nucleoli in hypotrophic neonates]. PMID- 2720823 TI - [Myocarditis in childhood]. AB - In a group of 82 children followed up for prolonged periods the authors draw attention to some problems of virus myocarditis. They focused attention on the diagnosis of Coxsackie myocarditis for which they elaborated a scoring system. Based on this system they separated the prognostically most adverse group where cardiac decompensation was the dominant sign from the very beginning. They confirmed the theoretical assumption that in some children virus myocarditis develops into cardiomyopathy. This was proved in six children by histological examination and in 19 children by means of echocardiography. PMID- 2720824 TI - [Postgraduate education of pediatricians and its perspectives in Czechoslovakia]. PMID- 2720825 TI - [The physician and the computer. 26. Commercial software]. AB - The authors give an account of different types of commercially supplied programmes which can be used also in the health services. They discuss the properties and types of different software - data base programmes, text processors, graphic and statistical programmes and finally so-called integrated software along with data on possible mutual combinations. At the same time also general conditions for the application of these programmes within the framework of clinical informations systems are discussed incl. their advantages and short comings. PMID- 2720826 TI - [Long-term study of hepatitis B virus disease in children]. PMID- 2720827 TI - [Endogenous digoxin-like substance (nonspecific interference or a new hormone?)]. AB - The authors assessed changes of the serum level and urinary excretion of an endogenous digoxin-like substance in healthy neonates and parturient women who did not have digitalis therapy. Higher concentrations of the endogenous digoxin like substance (ESPD) found in the umbilical blood, as compared with parallel samples of venous blood of the mothers (n = 13; p less than 0.01), provide indirect evidence of the secretory autonomy of the neonatal organism. The highest ESPD concentrations in umbilical blood were found in neonates born before the 34th week of gestation (0.5-1.0 ng/ml), whereby with advancing gestational age the ESPD level declined significantly (n = 21; r = 0.62; p less than 0.01). This fact along with the positive correlation between the excretory fraction of sodium and renal ESPD excretion in the group of healthy 1-5-week-old premature babies (n = 10, r = 0.53; p less than 0.01) is consistent with the view on the identity of ESPD and the assumed natriuretic hormone, the circulating endogenous inhibitor of Na+, K+-ATPase. PMID- 2720828 TI - [Results of comprehensive care of infants with congenital and acquired defects of the central nervous system]. AB - The paper is the result of five years paediatric, neurological and neurosurgical care of 102 infants with inborn and acquired damage of the central nervous system. Early diagnosis, a suitably indicated neurosurgical operation, comprehensive paediatric and neurosurgical care ensure along with rehabilitation and psychic stimulation, optimum therapeutic results. So far only few reports on results of long-term studies of thus treated child patients were published. The paper is an example of interdisciplinary cooperation. PMID- 2720829 TI - [Foreign substances in maternal milk]. AB - In 1984-1985 72 specimens of human milk were examined for hexachlorobenzene, DDE and polychlorinated biphenyls and 69 specimens for lead and cadmium. The residual levels (expressed in mg.kg-1 milk fat) were as follows: hexachlorobenzene 1.97 (0.24-5.58), DDE 1.56 (0.17-5.80) and polychlorinated biphenyls 3.18 (1.28-9.08). All specimens were positive. The lead levels were 1.68 (less than 0.10-6.75), cadmium levels 0.31 (less than 0.05-1.08) ng.ml-1 milk. Lead was present in 94.2%, cadmium in 98.6% specimens. The results were compared with other areas of the CSSR, data from the literature and hygienic standards. The authors discuss limited or discontinued breastfeeding in high occupational exposure. Finally they emphasize advantages associated with breastfeeding and the justification of a prolactation programme. PMID- 2720830 TI - [Use of the Sevac Immunoskintest kit in children]. AB - The Immunoskintest SEVAC is a kit of antigens for skin tests to evaluate the state of cellular immunity. By means of this kit 591 children from birth to 15 years were examined: the children suffered from acute diseases of the CNS, respiratory diseases incl. relapsing ones, a malignant tumour, haematological disease, and there were children who were Mantoux II negative and healthy children from children's homes. The value of the index of the skin test was referred to the child's age and sex; the lowest values were recorded in children with immunosuppressive therapy and the highest values of the skin test were found in healthy children and those with acute disease; boys had higher values than girls. In none of the children undesirable side-reaction were recorded after administration of the antigens. PMID- 2720831 TI - [Graphic aids for the evaluation of growth in children]. AB - New values of basic anthropological parameters of children and adolescents aged 0 18 years (nation-wide survey of 120,000 children and adolescents in the CSR in 1981) made it possible to design graphic aids for paediatric practice. PMID- 2720832 TI - [Typing of districts for a study of the health status of the Czechoslovak population]. AB - The Institute of Social Medicine and Organization of Health Services is conducting at present the so far most extensive survey of the health status of the population in a sample comprising almost 20,000 subjects, i.e. subjects taking advantage of health services, as well as those who do not use the health services either because they are healthy or assume that they are healthy, or possibly for other reasons. For this survey a population sample is used which was previously used by the Federal Statistical Office for a survey of the class and social structure in the CSSR in 1984. This sample which is too large for our work had to be reduced. This reduction was made by selecting from the original sample, which comprised the entire territory of Czechoslovakia, only some districts where the survey was made. In order to make the selected districts representative for the entire territory of the country, we elaborated a typology of districts which contains demographic, economic, social and oecological parameters. For elaboration of the typology cluster analysi was used. PMID- 2720833 TI - [Computer technics in the system of preventive health examinations of the population]. AB - The authors describe possibilities regarding the use of computing technique in the sphere of preventive examinations. They present examples of typical sub systems and proposals for the whole system of preventive examinations. In the conclusion they describe the Czechoslovak medical computing technique which can be used for building a system of preventive examinations in this country. PMID- 2720834 TI - [Experience with screening for colorectal carcinoma using the Haemoccult Test]. AB - The authors submit their experience with the screening of colorectal cancer in 1985-1987 in the Bruntal district. Within the programme 9772 workers from industry and agriculture aged 45 years and more, regardless of sex, were examined. The return rate of tests was 93% and a total of 189 patients with a positive test of occult haemorrhage (1.93%) was detected. Adenomatous polyps or colorectal carcinoma were diagnosed in 91 patients (0.93%). The authors discuss demands which must be respected to make the screening successful. Attention is focused not only on the activity of health workers in this preventive programme but also to help leading workers in enterprises and the lay public. Only by coordination of the activities of all these bodies a favourable effects can be achieved. PMID- 2720835 TI - [Psycho-social and socio-medical problems with modern patients and diseases. II]. AB - The complexity of psychosocial diagnosis is closely linked with sociomedical problems of diagnosis and treatment of contemporary patients. Contemporary patients are a complicated complex as regards factors and conditions of the genesis and development of disease and its symptomatology. As to the main external factors which influence the development of disease, it is important to mention in particular neuropsychic strain, adynamia, unbalanced diet, undesirable habits and contaminants--allergens. What is characteristic of contemporary patients? Polymorbidity, an altered pathology of diseases as regards the character of external conditions in the present period, a considerable increase of the morbidity from neuroses and neurotic syndromes. A very urgent problem of contemporary patients is obesity and its complications. In conjunction with the development of disease we must take into account also the contemporary allergic background. Among patients there is a high rate of chronic foca diseases, undesirable habits, latent clinical symptomatology. PMID- 2720836 TI - [Self-help: new concepts in health care. I. The situation worldwide]. AB - In the first part of the paper devoted to the possibilities of self-help in health care the author gives an account of experience with self-help, in particular with mutual aid groups in the world. This concerns groups which have some common problem and which associate to tackle the problem. The author explains the basic terms of self-help (self-sufficiency, relying on its own strength, knowledge, abilities, experience) and functions of self-help groups (social and emotional support, defence against the feeling of isolation and loneliness; against stigmatization; source of information and practices pertaining to a given disease or state). The author emphasizes the importance of self-help in the sense of more active participation of patients or affected people in the protection and development of their health, i.e. greater responsibility for health. The author analyzes the relations between self-help and professional health services which should not be antagonistic but complementary and should lead to mutually useful collaboration. The author also mentions the importance ascribed to self-help in WHO documents, in particular in the programme "Health for all by the year 2000". PMID- 2720837 TI - [Approaches to evaluating the status and development of the health facility network]. AB - The author confronts the perspectives of demands on health care of the population in the CSSR with the contemporary state of the network of health facilities. From this confrontation he draws some conclusions and submits suggestions for the future function and organization of health care. PMID- 2720838 TI - Ethical decision-making models for nurses. PMID- 2720839 TI - Nursing's prescription for the assistive worker. PMID- 2720840 TI - Proton nuclear magnetic resonance study on the aromatic amino acid-guanine nucleotide system: effect of base methylation on the stacking interaction with tyrosine and phenylalanine. AB - The stacking interactions of tyrosine methylester (TyrOMe)-guanosine-5' monophosphate (GMP), TyrOMe-7-methylguanosine-5'-monophosphate (m7GMP), phenylalanine methylester (PheOMe)-GMP and PheOMe-m7GMP pairs in neutral buffer solution have been studied by proton nuclear magnetic resonance (1H-NMR). The H8 proton signal of GMP showed no noticeable temperature dependence, while the signals of other protons showed usual dependences arising from the ring stacking interaction with aromatic amino acids. The results can be interpreted in terms of the intramolecular C-H ... O hydrogen bonding and ring stacking. Complex formations in 1:1 molar ratio were deduced for all pairs from their Job plots. The association constant for each pair was obtained by analysis of the Scatchard plot. Further, the van't Hoff plot provided thermodynamic parameters of the complex structure. The analyses of these data suggested that albeit the N quaternization of GMP strengthens the stacking interaction with aromatic amino acid, the bulky methyl group in m7GMP facilitates the dissociation from the amino acid with small environmental change. The possible conformations of GMP and m7GMP in the interaction states are discussed on the basis of the coupling constants. PMID- 2720841 TI - Acrylamide derivatives as antiallergic agents. I. Synthesis and structure activity relationships of N-[(4-substituted 1-piperazinyl)alkyl]-3-(aryl and heteroaryl)acrylamides. AB - A new series of acrylamide derivatives (7-10) were synthesized. Antiallergic activity of these compounds was evaluated and their structure-activity relationships were examined. Compound 10d, N-[4-(4-diphenylmethyl-1 piperazinyl)butyl]-3-(3-pyridyl)acrylamid e, showed antiallergic activity equivalent or superior to that of ketotifen in the rat passive cutaneous anaphylaxis (PCA) test by oral administration. Compound 10d, unlike ketotifen, had more potent in vitro 5-lipoxygenase inhibitory activity than caffeic acid, whereas its in vitro antihistamine activity was weaker than that of ketotifen. In addition, its inhibitory activity against histamine release from rat mast cells was approximately two-thirds as potent as that of disodium cromoglycate (DSCG). Compound 10d is a promising agent for treating a variety of allergic diseases. PMID- 2720842 TI - A novel class of antiulcer agents. 4-Phenyl-2-(1-piperazinyl)quinolines. AB - The synthesis of a novel class of antiulcer agents, the substituted 4-phenyl-2-(1 piperazinyl)quinolines, and their pharmacological activities (inhibitory effects on hypothermia induced by reserpine and on gastric ulcers induced by stress or ethanol) are described. These compounds can be classified into three groups (a group predominantly effective on the stress-induced ulcer, one effective on both the stress- and ethanol-induced ulcers, and one selectively effective on the ethanol-induced ulcer), with regard to antiulcer activity. The inhibitory effect on stress-induced ulcer was found to be in close relation to the antagonism of hypothermia. The structure-activity relationships in these compounds are described. Among the compounds, 2-(4-ethyl-1-piperazinyl)-4-phenylquinoline dimaleate (9, AS-2646) showed a potent inhibition of stress-induced ulcer and gastric acid secretion, possively through action on the central nervous system, and it was selected for clinical evaluation. PMID- 2720843 TI - 20 Beta-hydroxysteroid dehydrogenase of neonatal pig testis: cofactor requirement and stereospecificity of hydrogen transfer from nicotinamide adenine dinucleotide phosphate, reduced form. AB - The cofactor requirement of purified 20 beta-hydroxysteroid dehydrogenase from cytosol fraction of neonatal pig testis, in the reduction of 17 alpha hydroxyprogesterone was investigated. The enzyme required beta-nicotinamide adenine dinucleotide phosphate, reduced form (beta-NADPH) as the preferred cofactor, with an apparent Km value of 17 microM. Furthermore, alpha-nicotinamide adenine dinucleotide phosphate, reduced form (alpha-NADPH), beta-3'-NADPH and beta-nicotinamide adenine dinucleotide (beta-NADH) were also utilized as hydrogen donors in the reduction at relatively high concentration with apparent Km values of 85.2 microM, 179.2 microM and 1.00 mM, respectively. The optimum pH was 5.5 when beta-NADPH was used as the cofactor, while it was 6.0 when beta-NADH was used. The hydrogen transfer from the beta-NADPH to the product, 17 alpha,20 beta dihydroxypregn-4-en-3-one catalyzed by 20 beta-hydroxysteroid dehydrogenase was stereospecific, and the 4-pro-S-hydrogen of the nicotinamide moiety was transferred to the product. PMID- 2720844 TI - Effect of water extracts of aloe and some herbs in decreasing blood ethanol concentration in rats. II. AB - Oral administration of ethanol to rats at a dose of 3 g/kg decreased alcohol dehydrogenase (ADH) activity and metabolism of lactate to pyruvate in the liver. The effects of water extracts of Aloe and some other herbs on blood ethanol concentration and on ADH activity in liver cytosol were examined. The water extracts of these herbs caused a faster elimination of ethanol from blood of normal rats when administered orally 30 min before oral administration of ethanol. The rapid elimination of ethanol seems to be due to a protection of ADH activity and the supply of nicotinamide dinucleotide, both of which are reduced by high ethanol concentration. The effects of ethanol in decreasing the enzyme activities relating to its own metabolism occur when high concentrations of ethanol pass through the liver, and thus may primarily appear during the absorption of alcohol from the gastrointestinal tract, when portal concentration of ethanol are very high. PMID- 2720845 TI - Novel computer optimization methodology for pharmaceutical formulations investigated by using sustained-release granules of indomethacin. AB - A modified optimization technique, based on the response surface methodology, was developed for selecting pharmaceutical formulations. In general optimization methods, it is difficult to insure that the optimum formulation is strictly obtainable. Thus, the combined use of random number techniques and Andrews' plots with general optimization methods was investigated for seeking the optimum formulation. The method developed in this study was applied to the optimization of a sustained-release formulation based on the interpolymer complex of polyvinylpyrrolidone with carboxyvinyl polymer. Indomethacin was selected as a model drug for which sustained-release formulations are desirable. Experimental results obtained for the optimum formulation agreed well with the predictions, indicating the usefulness of this approach. PMID- 2720846 TI - Characteristics of the gastrointestinal absorption of morphine in rats. AB - The absorption characteristics of morphine were investigated by using rat gastrointestine. Absorption and transport experiments were carried out by the in situ loop and the in vitro everted sac methods, respectively. Brush border membrane vesicles (BBMVs) were used for uptake experiments. Morphine and its metabolites, morphine-3-glucuronide (M-3-G), and morphine-6-glucuronide (M-6-G), in biological samples were simultaneously determined by high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection and electrochemical detection. In the in situ loop method, morphine was well absorbed in the order of jejunal site greater than duodenal site greater than ileal site greater than middle intestinal site greater than rectal site, but it was poorly absorbed from the stomach. In each of the everted duodenal and jejunal sacs, 2,4-dinitrophenol, a metabolic inhibitor, inhibited the transport of morphine from the mucosal side to the serosal side. Further, HgCl2 pretreatment reduced the absorption of morphine from the duodenal and the jejunal loops. The initial uptake of morphine by BBMVs was stimulated in the presence of an H+ gradient (inner pH 7.5 and outer pH 5.0) and an overshoot phenomenon was observed. The initial uptake showed concentration dependence, i.e., it was saturable. Results obtained in this study indicate that carrier-mediated transport stimulated by the H+ gradient is partly involved in the duodeno-jejunal absorption of morphine, although morphine is passively absorbed from other sites. PMID- 2720847 TI - Determination of sisomicin in eluate from dried blood spot on filter paper disc for monitoring of blood level in rat, by reversed-phase high-performance liquid chromatography after pre-column fluorimetric derivatization. AB - About 20 microliters of whole blood obtained by venipuncture from rat tail vein was spotted onto a filter paper and the blood spot was punched out (5 mm diameter). Sisomicin (SISO) in the dried blood spot (DBS) was extracted effectively into 0.5 M Na2HPO4 solution by ultrasonication and determined by reversed-phase high-performance liquid chromatography with pre-column derivatization using o-phthalaldehyde and beta-mercaptopropionic acid. This method could be used for the pre-clinical study of SISO blood levels of a number of mice or rats without killing. The results were identical with those for SISO in serum, if corrected for hematocrit values, and were used for the calculation of pharmacokinetic parameters for individual rats. The detection limit of SISO in DBS (10.1 microliters of whole blood) was 1.0 microgram per ml of whole blood. PMID- 2720848 TI - Synthesis and antiulcer activity of the metabolites of 2-(4-ethyl-1-piperazinyl) 4-phenylquinoline dimaleate (AS-2646), a novel gastric antisecretory and antiulcer agent. AB - The metabolites 3 and 4 of 2-(4-ethyl-1-piperazinyl)-4-phenylquinoline dimaleate (AS-2646, 1), a candidate as a gastric antisecretory and antiulcer drug, were synthesized to confirm the proposed structures. The effects of the metabolites 2 4 on ulcer induced by stress were determined. PMID- 2720849 TI - Determination of acetaldehyde in human blood by high-performance liquid chromatography using fluorometry. AB - A method was developed for the measurement of acetaldehyde in human blood by high performance liquid chromatography (HPLC). The method was based on a pre-column reaction; a fluorescent substance was formed by a coupling reaction between 2 mol of cyclohexan-1,3-dione and 1 mol of acetaldehyde with ammonium acetate. The coupling compound was analyzed by HPLC and the concentration of acetaldehyde was obtained from the calibration curve drawn from the results using standard solutions. The determination was sensitive and reproducible with a range of 0.2 10 microM and a precision (coefficient of variation) of 2.43%. PMID- 2720850 TI - Studies on the monoamine oxidase (MAO) inhibitory potency of TL-1, isolated from a fungus, Talaromyces luteus. AB - The compound tentatively named TL-1 was isolated from Talaromyces luteus as a metabolite having monoamine oxidase (MAO) inhibitory potency. TL-1 showed mixed type inhibition of MAO in mouse liver when kynuramine was used as a substrate, and the IC50 was 6.6 microM. The inhibition constants (Ki) for MAO-A and -B in mouse liver were 39.9 and 7.85 microM, respectively. On the other hand, the Ki values for MAO-A and -B in mouse brain were 74.0 and 0.71 microM, respectively. Despite the marked structural resemblance between TL-1 and 7-episclerotiorin, the latter compound had little inhibitory effect on MAO. PMID- 2720851 TI - External control of drug release. IV. Controlled release of 5-fluorouracil from a hydrophilic polymer matrix by microwave irradiation. AB - A polymeric system capable of delivering 5-fluorouracil (5-FU) at increased rates on demand by external microwave irradiation was developed. Sustained-release systems were made by incorporating 5-FU into an ethylene-vinyl alcohol copolymer. When exposed to release medium, the delivery systems released the drug slowly and continuously. Upon exposure to microwave irradiation, the drug was released at a much higher rate. Release rates returned to base line levels when the microwave irradiation was discontinued. This study demonstrated that release rates of 5-FU from a polymer matrix can be increased at desired times by external microwave irradiation. PMID- 2720852 TI - Effect of the interaction of drug-beta-cyclodextrin complex with bile salts on the drug absorption from rat small intestinal lumen. AB - This investigation was concerned with the change of the bioavailability of a drug owing to the interaction of the drug-beta-cyclodextrin complex with bile salts in rat intestinal lumen. The absorption of sulfamethizole (SMZ) from rat intestinal lumen after administration of SMZ-beta-cyclodextrin complex was determined by a closed-loop method in the presence or absence of bile. The blood level of SMZ after administration of SMZ-beta-cyclodextrin complex was significantly decreased in comparison with that after administration of SMZ alone in bile duct-ligated rats. On the other hand, the blood level of SMZ after SMZ-beta-cyclodextrin administration in intact rats (bile duct non-ligated) or on the addition of sodium cholate was similar to the level in the case of SMZ alone. Thus, bile salts were found to act as a competing agent in the gastrointestinal tract. PMID- 2720853 TI - Effect of extracts of Zingiberaceae herbs on gastric secretion in rabbits. AB - Some of the Zingiberaceae herbs are known to be useful as stomachics. Water extracts and methanol extracts of eight such herbs were examined in intact unanesthetized rabbits for their effect on gastric secretion. Oral administration of either water extracts or methanol extracts caused a significant decrease in gastric secretion. A significant effect of these extracts appeared at 3 h after administration. The effect of water extracts on gastric secretion was very similar to that of cimetidine, with a significant decrease in acid output. The effect of the methanol extracts was primarily observed as decreased pepsin output. PMID- 2720854 TI - Binding of glycyrrhizin to human serum and human serum albumin. AB - The binding of glycyrrhizin (GLZ) to human serum and human serum albumin (HSA) was examined by an ultrafiltration technique. Specific and nonspecific bindings were observed in both human serum and HSA. The association constants (K) for the specific bindings were very similar: 1.31 x 10(5) M-1 in human serum and 3.87 x 10(5) M-1 in HSA. The number of binding sites (n) and the linear binding coefficient (phi) in HSA were 1.95 and 3.09 x 10(3) M-1, respectively. When the human serum protein concentration was assumed to be 4.2% (equal to the measured serum albumin concentration), n in human serum was 3.09, which is similar to the n value in HSA, and phi in human serum was 0.71 x 10(3) M-1, which is reasonably close to that for HSA. The binding pattern of GLZ with human serum protein on Sephadex G-200 column chromatography showed that GLZ binds to only the albumin fraction. It was concluded that the GLZ-binding sites in human serum exist mainly on albumin and GLZ binds to specific and nonspecific binding sites at lower and higher concentrations than approximately 2 mM, respectively. PMID- 2720855 TI - Amino acids and peptides. XXIII. Synthesis of N alpha-protected amino acid 6 chloro-2-pyridyl esters and their evaluation for peptide synthesis. AB - 6-Chloro-2-pyridyl esters (OPyCl) of N alpha-benzyloxycarbonyl and tert butyloxycarbonylamino acids were synthesized by the N,N'-dicyclohexylcarbodiimide (DCC) method from the acids and 6-chloro-2-hydroxypyridine in dimethylformamide (DMF). The reactivity of the 6-chloro-2-pyridylester with amino group is much higher than that of the corresponding 2-pyridyl ester (OPy) and p-nitrophenyl esters (ONp) in dioxane and DMF, and a peptide bond is formed without acylation at the side chain hydroxyl group of amino acids. Z-Asp(OBzl)-OPyCl reacted with amino acid methyl esters in dioxane to give the corresponding dipeptide without any detectable aspartimide formation. PMID- 2720856 TI - The structure of nephritogenoside. AB - Nephritogenoside is a minor component of the basement membrane of normal animals (including humans). It is a glycopeptide with the ability to induce chronic progressive glomerulonephritis (end stage kidney) when administered as a single footpad injection, and contains a novel carbohydrate-peptide linkage. The total chemical structure was investigated. It was revealed that nephritogenoside is a simple glycopeptide composed of three glucose residues [alpha-Glc-(1----6)-beta Glc-(1----6)-Glc] and twenty-one amino acids [1Asn-Pro-Leu-Phe-5Gly-Ile-Ala-Gly Glu-10Asp-Gly-Pro -Thr-Gly-15Pro-Ser-Gly-Ile-Val-20Gly-21Gln], and that the glucose residues are linked alpha-N-glycosidically to the N-terminal amino acid. PMID- 2720857 TI - Fluorocinnoline derivatives. II. Synthesis and antibacterial activity of fluorinated 1-alkyl-1,4-dihydro-4-oxocinnoline-3-carboxylic acids. AB - Chemical modification of cinoxacin was studied with the aim of improving its antibacterial activity and spectrum. Alkylation of ethyl 6,7,8-trifluoro- and 6,7 difluoro-4-hydroxycinnoline-3-carboxylates (1 and 7) with alkyl iodide or dialkyl sulfate gave ethyl 1-alkyl-6,7,8-trifluoro- and 6,7-difluoro-1,4-dihydro-4 oxocinnoline-3-carboxylates (2 and 8), together with the isomeric anhydro-bases 3 and 9 of 2-alkyl-3-ethoxycarbonyl-6,7,8-trifluoro- and 6,7-difluoro-4 hydroxycinnolinium hydroxides, respectively. Acid-catalyzed hydrolysis of the 1 alkyl derivatives 2 and 8 gave the corresponding carboxylic acids 4 and 10. The same treatment of 3 and 9, accompanied with decarboxylation of the inner salts 5 and 11, afforded the anhydro-bases 6 and 12 of 2-alkyl-4-hydroxycinnolinium hydroxides, respectively. Displacement reactions of 4 and 10 with nucleophiles such as amine, alkoxide and thiolate gave 7-substituted 1-alkyl-6,8-difluoro- and 6-fluoro-1,4-dihydro-4-oxocinnoline-3-carboxylic acids (13 and 17-35). Antibacterial activities of these compounds were evaluated and compared with those of cinoxacin and norfloxacin. Some compounds showed a broader spectrum and more potent activity than cinoxacin, but were considerably inferior in activity to norfloxacin. PMID- 2720858 TI - Effect of propylgallate on a dipalmitoylphosphatidylglycerol and calcium mixture. AB - Effect of propylgallate (PrG) on the thermotropic behavior of mixtures of dipalmitoylphosphatidylglycerol (DPPG) and Ca2+ was studied by means of differential scanning calorimetry (DSC). In the case of DPPG or DPPG/Ca (molar ratio, 15 : 1), the transition temperature (Tm) of the main transition and the subtransition decreased from 40 degrees C to 29 degrees C and from 29 degrees C to 20 degrees C, respectively, with an increase in the concentration of PrG. The addition of PrG to the DPPG/Ca mixture induced a shoulder on the high temperature side in the reheating scan. Neither PrG nor low concentrations of Ca2+ bind to the Lc phase of DPPG. When the molar ratio of DPPG to Ca was 1 : 1, the subtransition did not occur, that is, only the main transition (Tm = 90 degrees C) appeared. The Tm of the main transition was slightly affected by PrG. On the addition of PrG, another metastable endothermic transition peak (Tm = 78 degrees C) appeared. It is concluded that Ca2+ and PrG inhibit each other's binding. PMID- 2720859 TI - Development of equilibrium domain shapes in phospholipid monolayers. AB - Fluorescence micrographs of monolayers of L-alpha-dipalmitoylphosphatidylcholine (DPPC) at the air water interface are analyzed. Ordered phase domains in coexistence with the fluid lipid phase change their shapes with time and with lateral pressure. With domains fixed under an electrode and well separated from their neighbours a peculiar instability of the boundary lines is observed. It is ascribed to the onset of an electrostatically induced shape transition. Elaborating the boundary regions where domain fusion and fission, respectively, are observed leads to a model on in-plane dipole orientation. PMID- 2720860 TI - Inhibitors of sterol synthesis. Metabolism of [2,4-3H]5 alpha-cholest-8(14)-en-3 beta-ol-15-one after oral administration to a nonhuman primate. AB - 5 alpha-Cholest-8(14)-en-3 beta-ol-15-one is a potent inhibitor of cholesterol biosynthesis which has significant hypocholesterolemic activity upon oral administration to rodents and nonhuman primates. In the present study the metabolism of the 15-ketosterol has been investigated after the oral administration of a mixture of [2,4-3H]5 alpha-cholest-8(14)-en-3 beta-ol-15-one and [4-14C]cholesterol to 8 baboons. Blood samples were obtained at 4, 8, 12, 16, and 24 h after administration of the labeled sterols. Clear differences in the time courses of the levels of 3H and 14C in plasma were observed. 3H in plasma showed maximum values at 4 to 8 h, whereas maximum values for the levels of 14C were observed much later. 3H in plasma was shown to be primarily in the form of its metabolites, i.e. esters of the 15-ketosterol, cholesterol, and cholesteryl esters. The levels of the 15-ketosterol and of each of these metabolites showed different changes with time. The labeled cholesterol (and the cholesterol moiety of the cholesteryl esters), formed from the [2,4-3H]-15-ketosterol, was characterized by chromatography and by purification by way of its dibromide derivative. At 24 h after the administration of the labeled sterols, the distribution of 3H in plasma lipoprotein fractions paralleled that of 14C, with most of the 3H and 14C in high density lipoprotiens (HDL) and low density lipoproteins (LDL). Almost all of the 3H in HDL and in LDL was found as cholesterol, cholesteryl esters and esters of the 15-ketosterol. The distribution of 3H in HDL and in LDL of the free 15-ketosterol, esters of the 15-ketosterol, cholesterol, and cholesteryl esters was similar to that of plasma, thereby indicating no unusual concentration of any of the 3H labeled components in HDL or LDL. PMID- 2720861 TI - X-ray diffraction studies of lipid phase transitions in hydrated mixtures of cholesterol and diacylphosphatidylcholines and their relevance to the structure of biological membranes. AB - Previous X-ray diffraction data on the effects of temperature on hydrated cholesterol/dimyristoylphosphatidylcholine mixtures have been confirmed and equivalent new data on cholesterol/stearolyoleoylphosphatidylcholine obtained. Molecular interpretations are discussed and related to previous studies of cholesterol/dioleoylphosphatidylcholine and of cholesterol-rich biological membranes. PMID- 2720862 TI - Atracurium, pharmacokinetics and metabolites. PMID- 2720863 TI - Reactivity and toxicity of atracurium and its metabolites in vitro. AB - Cytotoxicity of atracurium and of its metabolites was tested in vitro. Exposure of isolated rat hepatocytes to atracurium produced cellular damage evidenced by extrusion of an intracellular enzyme, lactate dehydrogenase (LDH), into the incubation medium. Leakage of LDH was directly related to the concentration of atracurium in the medium (250 to 800 microM). If the spontaneous degradation of atracurium (presumably via Hofmann elimination) was first carried out in vitro and the degradation products subsequently added to the isolated hepatocytes, the leakage of LDH was also dose-dependent but larger than that observed after the addition of the parent drug. When l-cysteine was admixed to the products of the spontaneous degradation of atracurium prior to their addition to the liver cells, no leakage of LDH was observed. The results are compatible with the working hypothesis that atracurium itself and, even more so, acrylates formed in Hofmann elimination of atracurium, are reactive toward nucleophiles and damage the cells by alkylating nucleophiles present in cellular membranes. Antecedent covalent binding of acrylates to the nucleophile cysteine, i.e., the formation of acrylate cysteine adducts, saturated the reactive capacity of acrylates for nucleophiles and thus prevented the reactive metabolites from alkylating the endogenous nucleophiles. Possible clinical consequences resulting from in vivo generation of reactive metabolites are not clear at the present time but are projected to be related to (a) the dose of atracurium administered, (b) the amount of acrylates generated, (c) the functional importance of the endogenous nucleophiles alkylated, and (d) the pathway and the speed of detoxification of atracurium and its metabolites. PMID- 2720864 TI - Nifedipine attenuates the intraocular pressure response to intubation following succinylcholine. AB - Forty patients without eye disease, undergoing elective nonophthalmic surgery, were studied to evaluate the efficacy of sublingual nifedipine in attenuating the intraocular pressure response to succinylcholine administration, laryngoscopy and intubation. The patients were randomly given either nifedipine 10 mg or placebo sublingually 20 minutes before induction of anaesthesia. Intraocular pressure (IOP) and systolic blood pressure (SBP) were recorded before and after induction of anaesthesia. The IOP response to succinylcholine administration, laryngoscopy and intubation was significantly less in patients receiving nifedipine (P less than 0.01). The mean maximum rise in IOP above basal level at one minute post intubation was 7.82 mmHg in the control group compared with 0.15 mmHg in the nifedipine pre-treated group. These results suggest that sublingual nifedipine is effective in attenuating the IOP response after succinylcholine administration, laryngoscopy and intubation. PMID- 2720865 TI - Consequences of fluid absorption during transurethral resection of the prostate using distilled water or glycine 1.5 per cent. AB - This prospective and randomized study compared the consequences of two irrigating fluids, distilled water and glycine for transurethral prostatectomy. Forty-nine consecutive unselected patients undergoing transurethral resection of the prostate with spinal anaesthesia were investigated. The irrigating fluid was either distilled water (group A, 24 patients) or glycine 1.5 per cent (group B, 25 patients). The absorption of irrigating fluid was measured, all surgical events and any clinical signs of TURP syndrome during and after surgery were recorded. Early signs of TURP syndrome were observed in one patient in group A and in four in group B without further consequence. From all the biological variables, only plasma protein concentration, haematocrit, free plasma haemoglobin and free bilirubin concentrations were found to have changed. Plasma protein concentration and haematocrit decreased significantly during and after surgery in the two groups. Free plasma haemoglobin increased significantly with time: a significantly higher concentration was observed in group A than group B. Free bilirubin concentration increased with time in the two groups and was statistically greater in group A. With the two irrigating fluids, we observed a significant amount of haemolysis and haemodilution without clinical consequences. A low irrigating fluid pressure, a short resection time, and the use of spinal anaesthesia seems to us to be essential. Close observation of patients following transurethral prostatectomy is needed but the choice of the irrigating fluid does not seem to be important. PMID- 2720866 TI - Effects of halothane on arrhythmias induced by myocardial ischaemia. AB - The effect of halothane on arrhythmias induced by ischaemia was investigated in rats, isolated perfused rat hearts, and pigs. Responses to the occlusion of the left anterior descending coronary artery were determined in groups (n = 9) of chronically prepared rats treated with no halothane, 0.5, or 1.0 per cent halothane immediately after occlusion; in isolated rat hearts (n = 10) treated with no halothane, 0.5, 1.0, 2.0, or 4.0 per cent halothane for 15 min before and after occlusion; and 20-25 kg pigs (n = 11) anaesthetised with halothane or pentobarbital. The ECG, arrhythmias, blood pressure (BP), heart rate (HR) and extent of infarction were determined in each model. In pigs, left ventricular pressure, dp/dtmax and cardiac output were also measured. In chronically prepared rats, halothane anaesthesia started after occlusion was antiarrhythmic and decreased the incidence of ventricular fibrillation and resulting mortality. In isolated rat hearts, 0.5 or 1.0 per cent halothane had little effect on occlusion induced arrhythmias. The highest concentration of halothane increased the incidence of ventricular fibrillation both before and after occlusion. Halothane decreased developed ventricular pressure in a dose-dependent manner. In acutely prepared pigs, halothane pre-treatment had no appreciable effect upon occlusion induced arrhythmias when compared with pentobarbital anaesthesia. Thus, halothane is antiarrhythmic when treatment is initiated after occlusion in the rat but this action is not seen in isolated hearts or intact pigs. The antiarrhythmic action of halothane is, therefore, species and model dependent. PMID- 2720867 TI - Haemodynamic effects of atropine during halothane or isoflurane anaesthesia in infants and small children. AB - In this study, two-dimensional and pulsed Doppler echocardiography were used to measure cardiovascular changes before and after IV atropine in 31 infants and small children during halothane (n = 15) or isoflurane (n = 16) anaesthesia. Prior to induction of anaesthesia heart rate (HR), mean blood pressure (MBP), and two-dimensional echocardiographic dimensions of the left ventricle and pulmonary artery blood flow velocity were measured by pulsed Doppler echocardiography. Cardiovascular measurements were repeated while anaesthesia was maintained at 1.5 MAC halothane (n = 15) or isoflurane (n = 16). Atropine 0.02 mg.kg-1 IV was then administered and two minutes later, a third set of cardiovascular data was obtained. Heart rate decreased during halothane anaesthesia but did not change significantly during isoflurane anaesthesia. Mean blood pressure, cardiac output (CO) and stroke volume (SV) decreased similarly during 1.5 MAC halothane or isoflurane anaesthesia. Ejection fraction (EF) decreased and left ventricular end diastolic volume (LVEDV) increased significantly in both groups, but decreases in EF (32 +/- 5 per cent vs 18 +/- 5 per cent) and increases in LVEDV (18 +/- 7 per cent vs 7 +/- 5 per cent) were significantly greater during halothane than during isoflurane anaesthesia. Following atropine, HR increased more in the patients maintained with halothane (31 +/- 6 per cent), than during isoflurane anaesthesia (18 +/- 5 per cent). Atropine increased CO in both groups of patients, but SV and EF remained unchanged. When compared with awake values, HR increased similarly and significantly (18 +/- 4 per cent) following atropine in both groups, and CO returned to control levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720868 TI - Intravenous regional anaesthesia (Bier block): review of 20 years' experience. AB - Our experience with intravenous regional anaesthesia (IVRA) in 1,906 patients over a period of 20 years has confirmed that this technique is safe and effective. IVRA may be used to provide anaesthesia for surgery involving both the upper and lower extremities. The need for supplemental medication is ordinarily minimal, so the technique is particularly suitable for short procedures in an ambulatory surgery centre. Yet, prolonged surgery may be performed using a "continuous technique." Although various local anaesthetic agents may be used to induce IVRA no drug has been demonstrated to be superior to lidocaine. The major cause of failure of the technique or serious adverse effects is technical error. A specific protocol for avoiding technical error is presented. Significantly, over a period of 20 years, there has not been any mortality or major morbidity. The incidence of adverse reactions was 1.6 per cent and consisted of minor events such as transient dizziness, tinnitus or mild bradycardia. PMID- 2720869 TI - Anaesthetic experience with paediatric interventional cardiology. AB - Anaesthetic and sedation techniques, complications and outcomes were reviewed in 176 children undergoing 184 interventional cardiologic procedures. Techniques included sedation only, and ketamine, inhalational or narcotic anaesthesia. Ketamine infusion was the technique most frequently used. Ketamine was associated with a higher incidence of respiratory complications (P less than 0.05) than the other techniques. The higher incidence of hypercarbia (15.6 per cent), which did not affect outcome, may be attributable to the use of supplemental sedatives. The incidence of upper airway obstruction (7.8 per cent) was similar to that of previous studies. Vascular compromise resulted from the procedure in 33 patients, necessitating surgical correction in 16. Cardiac perforation occurred in four cases, causing one death. Pulmonary valve stenosis was most amenable to balloon dilatation and aortic valve stenosis least amenable. ketamine was the anaesthetic agent preferred by cardiologists for use in the catheterisation suite when general anaesthesia was required. Vigilant monitoring by anaesthetic staff is necessary during the procedure, and avoidance of concomitant narcotics is recommended if a ketamine technique with spontaneous ventilation is used. PMID- 2720870 TI - Haemodynamic decompensation during caesarean section. PMID- 2720871 TI - Anaesthesia for caesarean delivery in a patient with May-Hegglin anomaly. AB - The anaesthetic management for Caesarean delivery is described in a patient with May-Hegglin anomaly. The condition, which is inherited as an autosomal dominant characteristic, has features of thrombocytopenia and a bleeding diathesis. Labour was induced and she received type specific platelet transfusion. Spinal anaesthesia, using five per cent lidocaine, 75 mg, with epinephrine and 0.5 mg morphine sulphate produced satisfactory operating conditions, excellent postoperative analgesia, and uncomplicated initial recovery. PMID- 2720872 TI - An armoured endotracheal tube obstruction in a child. AB - The case of a child whose tracheal tube became obstructed intraoperatively 30 minutes after intubation is reported. It appears that this obstruction was related to the development of bubbles within the walls which expanded upon exposure to nitrous oxide and diffusion of that gas into the bubbles. The authors want to point out the risk of gas diffusion into the walls of the tube and the possibility that repeated sterilization may enhance the development of bubbles. PMID- 2720873 TI - Tracheal tear during laryngopharyngectomy and transhiatal oesophagectomy: a case report. AB - A case is reported of a tracheal tear developing during laryngopharyngectomy and transhiatal oesophagectomy. Ventilation and oxygenation were managed by removing the tracheostomy tube and advancing a straight cuffed armoured tube via the tracheostomy into one main stem bronchus and applying CPAP to the other bronchus via a Foley catheter. Following gastrointestinal reconstruction, the membranous tracheal tear was repaired via a right lateral thoracotomy. PMID- 2720874 TI - Pulling versus guiding: a modification of retrograde guided intubation. AB - We describe a modification of retrograde guided intubation. With the help of a gliding knot fixed around the side hole of the tracheal tube, we use the catheter to pull and guide the tracheal tube down the larynx and trachea. The technique offers several advantages: it is surprisingly fast, relatively atraumatic, easy to perform, and eliminates most causes of failure. PMID- 2720875 TI - Difficult tracheal extubation. AB - We describe a case of nasotracheal tube fixation with a screw. A second case is described in which a broken drill bit was found to impinge on the wall but not penetrate into the lumen of a nasotracheal tube. Possible sequelae of this complication include airway leak, aspiration, tube obstruction, and trauma from attempts at forceful extubation. We recommend the routine intraoperative testing for tracheal tube movement and routine fibreoptic bronchoscopy through the tube when blind surgical procedures occur in the vicinity of a tracheal tube. PMID- 2720876 TI - Vessel dilator cricothyrotomy for transtracheal jet ventilation. AB - Needle cricothyrotomy is a safe, relatively easy procedure and has been described to enable pulmonary ventilation for patients in both elective and emergency situations. Conventional IV cannulae are short, thin-walled, and easily kinked and, therefore, do not provide a secure system to jet oxygen into the trachea. The vessel dilators of most 7-9 French introducer kits are firm, pliable, resist kinking, and can be passed easily into the tracheal lumen. We describe our experience with the use of vessel dilator cricothyrotomy to oxygenate and ventilate the lungs of patients in emergency and elective situations. PMID- 2720877 TI - Sterilization of anaesthetic equipment. PMID- 2720878 TI - Eliminating needle stick injuries. PMID- 2720879 TI - Mechanical airway maintenance. PMID- 2720880 TI - Anaesthetic research. PMID- 2720881 TI - Early ether anaesthesia. PMID- 2720883 TI - Blood pressure monitoring during mediastinoscopy. PMID- 2720882 TI - Safety of anaesthetic machines. PMID- 2720884 TI - Nasal sensor attachment. PMID- 2720885 TI - Epidural block during labour in hereditary angioneurotic oedema. PMID- 2720886 TI - Refresher Course outlines and abstracts of scientific papers. Annual meeting of the Canadian Anaesthetists' Society. June 9-13, 1989, Ottawa, Ontario. PMID- 2720887 TI - Preclinical toxicity and pharmacology of liposome-entrapped cis-bis-neodecanoato trans-R,R-1,2-diaminocyclohexane platinum(II). AB - Liposome-entrapped cis-bis-neodecanoate-trans-R,R-1,2-diaminocylohexane platinum(II) (L-NDDP) is a new lipophilic cisplatin derivative formulated in a liposomal carrier currently in phase I clinical trials. The preclinical toxicity and pharmacology of L-NDDP were studied in mice and dogs. At the LD50 dose (i.v. bolus) in mice (60.5 mg/kg or 181.5 mg/m2), a tenfold decrease in the granulocyte and platelet counts was observed in the absence of renal toxic effects. In dogs, the maximum tolerated dose (MTD) of L-NDDP given i.v. over a period of 45-60 min was 150 mg/m2. This dose produced significant vomiting (6-18 episodes), minimal renal dysfunction, a maximal decrease in granulocyte and platelet counts of from 30% to 70%, and acute and transient elevation of liver enzymes. Higher doses (225 and 300 mg/m2) resulted in severe gastrointestinal (GI) toxicity in one animal and the death of two others within 48 h. Autopsy results showed multifocal hemorrhages in the lungs, GI tract, kidney, and liver. Three dogs were treated monthly with the MTD up to a cumulative dose of 637.5-712.5 mg/m2 with excellent tolerance. No cumulative myelosuppression or liver dysfunction was observed, whereas a slight increase in the creatinine baseline level was detected in all three animals. Autopsy results at the end of the study showed mild changes limited to the liver, kidney, and GI tract. Pharmacologic studies showed that the drug was cleared, fitting a two-compartment model with a mean t1/2 alpha of 7.1 min and a t1/2 beta of 87.8 h. These studies show that L-NDDP can safely be given at therapeutic doses to animals and that the dose-limiting toxic effects consists of myelosuppression in mice and a multiorgan hemorrhagic syndrome related to vascular injury in dogs. PMID- 2720888 TI - Ionic titanocene complexes: a new type of antitumor agent. AB - Five ionic cyclopentadienyltitanium (IV) derivatives were investigated for their activity against fluid Ehrlich ascites tumor. Four compounds were built up by the intact bis(cyclopentadienyl)titanium(IV) ("titanocene") unit, forming the cationic moiety together with two covalently bound ligands, with certain anions being bonded via electrostatic forces: the acetonitrile complex [(C5H5)2TiCl(NCCH3)]+[FeC14]- (I), the 2'2'-bipyridyl derivative [(C5H5)2Ti(bipy)]2+[CF3SO3]2 (II), the o-phenanthroline complex [(C5H5)2Ti(phen)]2+[CF3SO3]2 (III), and the N-methyl-o-aminothiophenolate derivative [(C5H5)2Ti[o-S(NACH3)C6H4]]+I- (IV). Another ionic cyclopentadienyltitanium derivative investigated was the five-coordinate bis(dithiolene) chelate (C5H5)Ti(1,2,4-S2C6H3CH3)2]-N(C2H5)4)+ (V), the cyclopentadienyltitanium moiety representing the anionic part of the complex salt. All complexes were ionic, salt-like compounds, distinguished by good water solubility. Whereas complexes I, III, and V, given at optimal dose levels, effected maximal cure rates of only 70%-80%, all animals were cured after receiving complexes II and IV at dose ranges of 200-220 and 240-300 mg/kg, respectively. The antitumor activity of complex I was confirmed against solid experimental tumor systems B16 melanoma, colon 38 carcinoma, and Lewis lung carcinosarcoma. Because of their improved solubility in water and pronounced antitumor activity (especially that of II and IV against fluid Ehrlich ascites tumor), ionic cyclopentadienyl titanium complexes are considered to be an interesting new type of antitumor agent. PMID- 2720889 TI - Initial and early effects of adriamycin in murine sarcoma 180 cannot be restored in a resistant subline by increasing the uptake and external concentration of the drug. AB - We demonstrate the early effects (1 day) of Adriamycin (ADM) on proliferation stimulated and quiescent sensitive, and ADM-resistant cells of the murine tumor sarcoma 180 (S 180). By investigating cell-cycle distribution and thymidine labeling, it can be shown that sensitive cells are strongly affected by the drug, even in a proliferationarrested state. A remarkable but slow DNA synthesis is the prominent effect of this drug treatment on sensitive cells, even under nonstimulating conditions. In resistant cells, neither an increase in concentration nor a variation in drug uptake can induce effects that could be compared with those observed in the sensitive line. From these results we conclude that the early effects of ADM are not modulated by drug uptake. PMID- 2720890 TI - Phase II study of adriamycin with sequential methotrexate and 5-fluorouracil (AMF) in gastric carcinoma. AB - The purpose of this study was to evaluate the response rate, methotrexate plasma levels, and toxicity of a three-drug regimen in patients with gastric carcinoma. A total of 37 patients with advanced measurable adenocarcinoma of the stomach were treated with Adriamycin, methotrexate, and 5-fluorouracil (AMF). Adriamycin and methotrexate were given as i.v. infusions on day 1; 24 h following methotrexate administration, patients received an i.v. infusion of 5-fluorouracil concomitantly with oral leukovorin factor (given over 48 h). Methotrexate levels were monitored regularly in all patients, and courses were repeated every 3 weeks. The median dose levels per course were 50 mg/m2 (range, 40-60 mg/m2) for Adriamycin, 1,000 mg/m2 (range, 650-1,250 mg/m2) for 5-fluorouracil, and 500 mg/m2 (range, 160-625 mg/m2) for methotrexate. Of 36 evaluable patients, 8 (22%) achieved an objective response, including 1 complete remission. Stable disease was noted in 11 patients and a minor tumor regression occurred in 1. The median survival duration of all patients was 6 months (range, 2-31+ months). AMF was well tolerated; toxicities were mild to moderate, most frequently involving nausea and vomiting, mucositis, and neutropenia with or without fever. There was no death directly attributable to chemotherapy. Although the AMF regimen used a well-documented preclinical concept of synergism between methotrexate and 5 fluorouracil, response and survival results suggest a modest activity of this combination in patients with gastric cancer. Better preclinical models are necessary for the development of effective combination chemotherapy. PMID- 2720891 TI - Effect of ether lipids on mouse granulocyte-macrophage progenitor cells. AB - In this study we determined the potential bone marrow toxicity of the ether lipid derivatives 1-0-octadecyl-2-0-methyl-rac-glycero-3-phosphocholine (OcMe-G-3-PC), 1-0-hexadecyl-propanediol-2-phosphocholine (He-Pr-2-PC), and hexadecylphosphocholine (He-PC). OcMe-G-3-PC inhibited the proliferation of mouse granulocyte-macrophage progenitor cells (GM-CFCs) at a dose of 1 micrograms/ml, whereas He-Pr-2-PC and He-PC started to inhibit the growth of hemopoietic precursors at 5 micrograms/ml. In contrast to this finding, NMRI mice given 10 mg/kg i.v. daily for 4 weeks and 20 or 30 mg/kg for 5 days showed no bone marrow toxicity. We conclude that the dose-dependent toxic effects observed in vitro are within the physiological tolerance in vivo. PMID- 2720892 TI - Experience with intermediate-dose (110-120 mg/m2) epirubicin. AB - A total of 23 patients with advanced malignancies received escalating doses of epirubicin (100-120 mg/m2) i.v. at 3-week intervals; 15 had received previous chemotherapy. In all, 46 courses of chemotherapy were given. Mucositis (grade II or III) occurred in 47% of courses at 120 mg/m2, but in only 15% of courses at 115 mg/m2. Myelotoxicity was manifest as leucopenia, with a median white blood count nadir of 1.9 (range, 0.8-7.0) x 10(9)/l. Nausea and vomiting were generally well controlled by prophylactic antiemetic therapy. Alopecia was WHO grade 0 in 2 patients, grade I in 1, grade II in 5 and grade III in 14. No renal or hepatic toxicity was noted, and there were no episodes of congestive cardiac failure. One fatal coronary thrombosis (proven at post-mortem examination) occurred 48 h after a dose of 115 mg/m2. Four patients developed thrombophlebitis at the injection site that was not dose-related; it occurred at doses between 100 and 120 mg/m2. Two patients who had been given chemotherapy in the past had complete responses (one penile carcinoma, one gastric carcinoma). Six patients had partial responses, including two with breast cancer, one with gastric cancer and three with sarcoma. Intermediate-dose epirubicin was well tolerated up to 120 mg/m2, when mucositis became a significant clinical problem. Preliminary data suggest promising activity in gastric cancer, breast cancer and a variety of sarcomas. PMID- 2720893 TI - Treatment of advanced malignant melanoma with coumarin and cimetidine: a pilot study. AB - Based on previous results demonstrating that coumarin and cimetidine render objective tumor regressions in renal cell carcinoma, we conducted a pilot study to determine whether these drugs possess activity against malignant melanoma. A total of 22 patients with advanced melanoma received 100 mg coumarin p.o. daily for 14 days; on day 15, cimetidine was added at an oral dose of 300 mg four times daily. Both drugs were continued until progression of disease. In all, 12 patients had previously been treated, but all patients had a favorable performance status. No response was observed in 19 patients. Two patients with a low tumor burden achieved a partial response and a third showed a minor response. There was no toxicity from this regimen. Although coumarin and cimetidine at this dose and schedule did not display significant activity in this study population, further studies are warranted to explore higher doses and focus on patients with relatively low tumor burdens. PMID- 2720894 TI - Sequential moderate-dose methotrexate and 5-fluorouracil in advanced gastric adenocarcinoma. AB - A total of 23 patients with advanced gastric adenocarcinoma were treated with a combination of moderate-dose methotrexate (MDMTX), 250 mg/m2 i.v., with folinic acid rescue and 5-fluorouracil (5-FU) 600 mg/m2 i.v. Therapy was given every 7 days for 4 courses and then at 14-day intervals. All patients were evaluable for response. No complete responses occurred, but five patients (22%) had partial remissions (95% confidence limit, 5%-39%). The median duration of remission was 6 months, with a median survival of 11 months amongst responding patients. In all, six patients (26%) had stable disease for a median period of 5 months. The overall median survival was 6 months. Therapy was generally well tolerated, with principal toxicities consisting of neutropenia, nausea and vomiting, mucositis and diarrhoea. In terms of activity or survival in advanced gastric carcinoma, the combination of moderate-dose MTX and 5-FU does not appear to offer an advantage over single-agent therapy. PMID- 2720895 TI - Nail toxicity due to the combination adriamycin-mitoxantrone. PMID- 2720896 TI - Use of oral uridine as a substitute for parenteral uridine rescue of 5 fluorouracil therapy, with and without the uridine phosphorylase inhibitor 5 benzylacyclouridine. AB - Initial clinical trials have demonstrated that uridine (Urd) rescue given i.v. over at least 3 days can ameliorate 5-fluorouracil (FUra) toxicity; to avoid Urd induced phlebitis in the peripheral veins of patients, a central vein is used. The latter necessity, along with the need for 3 days of i.v. administration, makes Urd rescue by parenteral means a cumbersome and complicated clinical procedure. It would appear preferable to use oral Urd; however, the oral Urd dose in the clinic is limited, as high doses cause diarrhea. Therefore, using a tumor bearing murine model we investigated as to whether low doses of oral Urd coupled with a Urd phosphorylase inhibitor benzylacyclouridine (BAU), would effect safe rescue of FUra toxicity with preservation of antitumor activity. A high-dose FUra containing drug combination that included parenteral Urd rescue was used as a control; other groups of tumor-bearing mice received the same drug combination, except that p.o. Urd was substituted for i.p. Urd. In the absence of BAU, p.o. Urd could effect rescue while maintaining an antitumor effect comparable to that obtained with i.p. Urd. When given concomitantly with BAU, a 50% reduction in the oral Urd dose (i.e., from 4,000 to 2,000 mg/kg) enabled the achievement of a comparable therapeutic index. Intraperitoneal Urd produces very high (6-8 mM) plasma and tissue Urd levels, which remain above 100 microM for at least 6 h. In contrast, neither oral Urd nor oral BAU alone raised plasma Urd concentrations above about 50 microM. However, the combination of oral Urd plus oral BAU gave a peak plasma Urd level of about 300 microM, and the level was maintained above 100 microM for 6 h. Following oral Urd administration, gut tissue levels of Urd were in the mM range and those of BAU were in the range of 10-20 micrograms/g tissue, a level sufficient to result in substantial inhibition of Urd phosphorylase. Oral Urd plus oral BAU appears to be a promising clinical alternative to parenteral administration of Urd for selective rescue of FUra toxicity. PMID- 2720897 TI - O6-substituted-2'-deoxyguanosine-3'-phosphate adducts detected by 32P post labeling of styrene oxide treated DNA. AB - 32P post-labeling of DNA reacted with styrene oxide resulted in the detection of six adducts. In order to determine which of these corresponded to modification at the O6 position of guanine, O6-substituted styrene oxide-deoxyguanosine-3' monophosphate derivatives were synthesized. The two synthetic isomers were purified by HPLC and the structures were confirmed by mass spectrometry and 1H NMR. 32P post-labeling and co-chromatography with the DNA-styrene-7,8-oxide reaction products resulted in the assignment of adduct number 4 as O6-(2-hydroxy 2-phenylethyl)-2'--deoxyguanosine-3',5'-bisphosphate and adduct number 5 as O6-(2 hydroxy-1-phenylethyl)-2'-deoxyguanosine-3',5'-bisphosphate. PMID- 2720898 TI - Sensitivity of rat and mouse peripheral blood lymphocytes to BaP adduction and SCE formation. AB - Both mice and rats were injected i.p. with doses of benzo[a]pyrene (BaP) ranging from 10 to 100 mg/kg to compare species sensitivity to and the relationship between sister chromatid exchange (SCE) induction and DNA adduct formation. Twenty-four hours after injection, blood was removed by cardiac puncture and the peripheral blood lymphocytes (PBLs) were analyzed for both DNA adduct formation by 32P-postlabeling and SCE induction following lymphocyte culture. BaP induced similar, but not identical, SCE dose-response curves for each species. After BaP administration, the major DNA adduct, N2-[10 beta-(7 beta,8 alpha,9 alpha trihydroxy-7,8,9,10- tetrahydrobenzo[a]pyrene)yl]deoxyguanosine (BPDEI-dGuo), was approximately 10-fold more prevalent in the PBLs of the mouse than those of the rat. Thus, for equivalent amounts of BPDEI-dGuo, a greater number of SCEs are induced in the rat than the mouse. PMID- 2720899 TI - o-phenanthroline protects mammalian cells from hydrogen peroxide-induced gene mutation and morphological transformation. AB - The radiomimetic agent hydrogen peroxide is known to produce DNA strand breaks, chromosome damage and cell death. It has also been identified as one of the cytotoxic agents formed during certain drug metabolism and by phagocytic cells in the respiratory burst. Our laboratory recently identified the ultimate reactive species responsible for the DNA-damaging and cytotoxic effect of H2O2 as being hydroxyl radical. This was achieved by the use of the specific iron chelator o phenanthroline, which prevents the occurrence of a Fenton reaction between H2O2 and chromatin bound ferrous ions. In this paper we show that H2O2 is able to induce mutation at the HGPRT locus in V79 cells and morphological transformation of C3H/10T1/2 cells. o-Phenanthroline abolishes both effects, indicating that hydroxyl radical is directly involved in mutation and carcinogenesis. PMID- 2720900 TI - Influence of smoking parameters on the delivery of tobacco-specific nitrosamines in cigarette smoke--a contribution to relative risk evaluation. AB - The influence of the smoking parameters (puff profile, puff duration, puff volume, puff frequency) on the delivery of tobacco-specific nitrosamines (TSNAs) in mainstream smoke was investigated for six different cigarette brands, including filter cigarettes with very low to medium smoke yields and non-filter cigarettes with high and very high smoke yields. The puff profile did not influence the TSNA yields. The puff duration also had no remarkable influence on the TSNA delivery with the exception of a non-filter cigarette made of dark tobaccos. The puff volume and the puff frequency significantly influenced the TSNA yields. Increasing puff volume and frequency resulted in increasing TSNA values. The total volume drawn through a cigarette was calculated. The dependency of the TSNA delivery on the total volume was almost linear at least up to a total volume of approximately 500 ml/cigarette. The TSNA yield was the same for the same total volume no matter whether the total volume was due to a changing puff volume or a changing puff frequency. The total volume drawn through a cigarette is the main responsible factor for the TSNA delivery in mainstream smoke. Total volume data from smokers of low- and medium-tar cigarettes are used to calculate TSNA intake. The different smoking behaviour observed for smokers of low-tar and low-nicotine cigarettes as compared to standard smoking conditions is discussed with respect to the TSNA dependency on smoke parameters. PMID- 2720901 TI - Evaluation of dichloromethane as an inducer of DNA synthesis in the B6C3F1 mouse liver. AB - The potential of the mouse hepatocarcinogen dichloromethane (DCM) to induce hepatocellular division, as monitored by increased DNA synthesis, has been evaluated using B6C3F1 mice--the strain in which it is carcinogenic but not apparently genotoxic. Male mice were exposed to DCM either by oral gavage in corn oil (1000 mg/kg) or by inhalation of an atmosphere containing 4000 p.p.m. DCM for 2 h. Cells undergoing DNA synthesis (S-phase) were radiolabelled by means of four consecutive i.p. injections of tritiated thymidine at hourly intervals prior to killing. No evidence of S-phase activity was observed in the gavage studies. The inhalation studies resulted in some weak, but statistically significant increases in S-phase incidence, but the biological significance was unclear due to similar increases being observed in some control groups. It is concluded that DCM does not share the mitogenic properties of such presumed non-genotoxic mouse liver carcinogens as trichloroethylene, polybrominated biphenyls and carbon tetrachloride, and as such its carcinogenicity to the mouse liver remains mechanistically obscure. PMID- 2720902 TI - Structure of a mutagen from roasted seeds of Moringa oleifera. AB - A mutagenic compound was isolated from roasted seeds of Moringa oleifera Lam. Its structure has been elucidated by spectral analysis as 4(alpha-L rhamnosyloxy)phenylacetonitrile. The results of the Micronucleus Test, an in vivo method, showed that the number of micronucleated polychromatic erythrocytes (PCE)/1000 PCE for this compound is higher than that of the solvent control, dimethylsulfoxide, and approximates that of the positive control, tetracycline. This indicates that 4(alpha-L-rhamnosyloxy)phenylacetonitrile is a genotoxic compound. PMID- 2720903 TI - Enhanced metabolic activation of chemical hepatocarcinogens in woodchucks infected with hepatitis B virus. AB - The metabolism of chemical carcinogens was investigated in liver preparations from 28 captive woodchucks (Marmota monax). Of these, 23 were naturally infected with the woodchuck hepatitis virus (WHV), and eight also had primary hepatocellular carcinoma (PHC). Twenty-nine parameters were investigated in liver subcellular fractions, including cross-reactivity with HBsAg, and biochemical parameters, such as gamma-glutamyl transpeptidase, cytochrome P-450 and microsomal monooxygenases (aryl hydrocarbon hydroxylase, ethoxycoumarin and ethoxyresorufin deethylases, aminopyrine and dimethylnitrosamine demethylases, and testosterone 7 alpha-, 16 alpha- and 6 beta-hydroxylases), uridine 5' diphosphoglucuronosyl transferase, GSH and related enzymes (peroxidase, reductase and S-transferase), as well as other cytosolic enzyme activities (glucose 6 phosphate and 6-phosphogluconate dehydrogenases, NADPH- and NADH-dependent diaphorases, and DT diaphorase). In addition, liver preparations were used in order to quantify the metabolic activation into bacterial mutagens of five procarcinogens (aflatoxin B1, the pyrolysis products Trp-P-2 and MeIQ, 2 aminofluorene and dimethylnitrosamine) and the decrease of potency of three direct-acting mutagens (sodium dichromate, ICR 191 and 4-nitroquinoline 1-oxide). WHV infection produced a significant stimulation of carcinogen metabolism, as shown by the simultaneous change in detoxification parameters (GSH depletion) and activation indices (enhancement of microsomal monooxygenases and of procarcinogen activation into mutagenic metabolites). There were no significant differences between WHV-positive samples from animals without PHC and the noncancerous tissue of PHC-bearing animals, whereas a decrease of both activation and detoxification indices was recorded in the tumorous tissue. There was a considerable interindividual variability among WHV carriers, which was tentatively ascribed to genetic factors. Pregnancy was the only known factor influencing the results in WHV carriers. However, even by excluding pregnant animals, the effects on carcinogen metabolism produced by WHV infection were still statistically significant. These results, together with previous data obtained in humans, revealed that metabolic factors may play a role in the synergism between viral hepatitis and chemical hepatocarcinogens in the etiopathogenesis of PHC. PMID- 2720904 TI - Hepatocarcinogenic heterocyclic aromatic amines that induce cytochrome P-448 isozymes, mainly cytochrome P-448H (P-450IA2), responsible for mutagenic activation of the carcinogens in rat liver. AB - Male F344 rats were treated with hepatocarcinogenic heterocyclic aromatic amines such as amino acid- and protein-pyrolysate components (Trp P-1, Trp P-2, Glu P-1, Glu P-2, A alpha C, MeA alpha C, IQ and MeIQx) and changes in microsomal cytochrome P-450 isozymes in the livers were examined by means of immuno-Western blotting using anti-rat cytochrome P-450 monoclonal antibodies. The results suggested that all chemicals tested induce cytochrome P-448 isozymes, particularly cytochrome P-448H (P-450IA2), which efficiently mediate mutagenic activation of the carcinogens. This was substantiated by the enzymatic analyses with the substrates showing different characters to rat cytochrome P-450 isozyme mediated mutagenesis. PMID- 2720905 TI - Pancreatic acinar cell tumors in rats induced by 3,2'-dimethyl-4-aminobiphenyl. AB - Pancreatic acinar cell lesions, including foci, nodules, adenomas and in situ carcinomas, were found in male F344 rats given s.c. injections of 3,2'-dimethyl-4 aminobiphenyl (DMAB) at doses ranging from 50 to 167 mg/kg body weight in two 60 week experiments. The pancreatic lesions induced by DMAB were essentially the same as those reported in rats treated with 4-hydroxyaminoquinoline-1-oxide and azaserine. DMAB at high doses induced pancreas acinar cell as well as fat necrosis, and tumorigenicity for the pancreas was most effective at high necrogenic levels of carcinogen exposure. Mean labeling indices in basophilic foci, acidophilic foci, nodules and adenomas assessed by bromodeoxyuridine incorporation were elevated to approximately 0.69, approximately 2.17, approximately 1.43 and approximately 0.96% respectively, in contrast to the value of 0.39% observed for the surrounding normal acinar cells. The increase was significant in the acidophilic foci and nodules and the fact that these lesions had very high labeling indices suggests that they may have potential for progression to tumors. PMID- 2720906 TI - Computational analysis of structural and energetic consequences of DNA methylation. AB - The conformational and energetic consequences of cytosine methylation in eukaryotes related to transcription or formation of chromatin structure are not well understood. Structures of methylated and unmethylated DNA sequences from biologically relevant sources were studied by theoretical methods under different ionic conditions and demonstrate that cytosine methylation produces a localized pattern of steric, hydrophobic, energetic, conformational and electrostatic alterations in DNA. These findings suggest how this modification may influence protein-DNA interactions and support current hypotheses. The results reveal previously unrecognized potential effects of cytosine methylation which could critically affect normal and neoplastic cellular processes by altering transcriptional events, histone binding, chromosomal stability and cellular differentiation. PMID- 2720907 TI - Covalent binding of hexachlorobutadiene metabolites to renal and hepatic mitochondrial DNA. AB - The covalent binding of [14C]hexachlorobutadiene (HCBD) metabolites to DNA was investigated in mouse liver and kidney after application of a single oral dose of 30 mg/kg. A low level of binding of [14C]HCBD metabolites to nuclear DNA (nDNA) from kidney with a covalent binding index (CBI) of 27 was detectable, whereas nDNA from liver did not retain radioactivity significantly exceeding background activity (background CBInDNA = 6 and CBImtDNA = 60). Considerably higher binding of metabolites to mitochondrial DNA (mtDNA) from liver (CBI = 500) and kidney (CBI = 7500) could be demonstrated. Enzymatic hydrolysis followed by HPLC fractionation of mtDNA from mouse kidney revealed the presence of three radioactive compounds which may represent DNA bases altered by HCBD metabolites. The observed binding of HCBD metabolites to DNA constituents in vivo suggests that genotoxic mechanisms are operative in initiating HCBD nephrocarcinogenesis. PMID- 2720908 TI - DNA adduct formation and removal in specific liver cell populations during chronic dietary administration of 2-acetylaminofluorene. AB - The concentration of DNA adducts in specific hepatic cell types has been determined in F344 rats fed 0.02% 2-acetylaminofluorene (AAF) for 28 days followed by control diet for an additional 28 days. In animals killed at 28 days of AAF feeding, the major DNA adduct, N-(deoxyguanosin-8-yl)-2-aminofluorene, was present in each cell type in the order: hepatocytes (282 +/- 28 fmol/micrograms DNA) greater than whole liver (232 +/- 33 fmol/micrograms DNA) greater than nonparenchymal cells (128 +/- 30 fmol/micrograms DNA) greater than bile duct fraction (60 +/- 12 fmol/micrograms DNA). After an additional 28 days on control diet, the adduct level in each cell fraction was 30-40 fmol/micrograms DNA. Adduct removal was biphasic in whole liver, hepatocytes and nonparenchymal cells, with a fast phase apparent until the adduct concentration reached approximately 60 fmol/micrograms DNA. In whole liver and hepatocytes this level was obtained in approximately seven days, and in nonparenchymal cells the fast phase was complete in about two days. Adduct removal in the bile duct fraction exhibited only a single slow phase. At the end of the AAF feeding, hepatocytes accounted for 86% of the total liver DNA adducts. After an additional 28 days on control diet, hepatocyte adducts still contributed a major fraction (67%) of the total persistent adduct population. Thus, hepatocytes, the target cell for AAF-induced hepatic tumors, dominate the adduct formation and removal profile observed in whole liver. PMID- 2720909 TI - Inhibitor production by normal rat tracheal epithelial cells influences the frequency of spontaneous and X-ray-induced enhanced growth variants. AB - A cell culture model was used to assay for the induction of cell populations with enhanced growth capacity in culture in irradiated normal rat tracheal epithelial cells (NTEC). When cultures were maintained in minimally enriched Ham's F-12 plus 5% fetal bovine serum, it was noted that increasing the seeding density from 1 to 100 colony forming units per 60 mm dish decreased the frequency of proliferating epithelial foci (PEF) scored 5-6 weeks after seeding, from 2.5 to 0.07% in controls and from 5 to 0.9% in irradiated cultures. When low density (50 colonies per dish) control cultures were fed medium conditioned by higher density control cultures (300 colonies per dish) the observed frequency of PEF was 10-fold lower than that observed in cultures fed fresh medium or cultures fed medium conditioned by a carcinogen-induced tracheal cell line. These data suggest that some factor(s) present in conditioned medium derived from higher density normal cell cultures inhibits the emergence of many PEF. If cultures are maintained in serum-free enriched Ham's, many (17-21%) PEF were observed in both control and irradiated cultures. Medium harvested from high density cultures maintained in minimally enriched Ham's F-12 (5% FBS) was found to maximally inhibit normal cell thymidine uptake and growth as well as induce cornified envelope formation (terminal differentiation) in proliferating normal cell cultures. Medium harvested from normal cultures maintained in serum-free enriched Ham's was not inhibitory to normal cells and did not induce cornified envelope formation. Subcultured PEF-derived populations and PEF in 4 to 5-week primary cultures also did not produce inhibitor(s). In addition, subcultured PEF-derived cells were not induced to form cornified envelopes in the presence of inhibitory conditioned medium. The data suggest that the elaboration of an inhibitor(s) by normal epithelial cells affects the emergence of PEF. Irradiated cells appear to have some growth advantage over spontaneous PEF in that they are more likely to survive and form PEF under growth conditions associated with higher levels of inhibitor(s) in the medium. PMID- 2720910 TI - DNA repair synthesis in isolated rainbow trout liver cells. AB - Isolated trout liver cells were treated with lysolecithin to produce an in situ system for characterizing DNA repair in teleosts. In this preparation, the integrity of the plasma membrane is altered, nuclei remain intact, and the concentrations of dNTPs and nucleotide analogs, which normally do not penetrate intact plasma membranes, can be controlled. Following lysolecithin treatment, 50% of the total cellular protein and nearly 75% of total lactate dehydrogenase activity was released from the liver cells. Microscopic examination indicated that the integrity of the plasma membrane of trout hepatocytes was disrupted by lysolecithin; however, smaller nonhepatocytic liver cells were resistant to the disrupting effects of this detergent. Bleomycin induced DNA repair synthesis in lysolecithin-treated cells, as demonstrated by CsCl gradient analysis of 5-bromo, 2'-deoxyuridine, 5'-triphosphate-labeled DNA. Optimal conditions for bleomycin induced DNA repair synthesis in lysolecithin-treated trout liver cells were considerably different from that in lysolecithin-treated mammalian cells. Bleomycin-induced DNA repair synthesis was lower in lysolecithin-treated trout liver cells than in lysolecithin-treated mammalian cells at identical concentrations of 2'-deoxyribonucleoside, 5'-triphosphates (dNTPs), suggesting the decreased sensitivity of trout cells in unscheduled DNA synthesis assays can be attributed to factors other than differences in dNTP pools. Bleomycin-induced DNA repair synthesis in trout hepatocytes was shown to be very sensitive to inhibition by 2', 3'-dideoxythymidine, 5'-triphosphate and was resistant to inhibition by cytosine arabinoside, 5'-triphosphate, butylphenyldeoxyguanosine, 5'-triphosphate and aphidicolin. These observations indicate repair of bleomycin induced DNA damage in trout cells occurs through a mechanism similar to that in mammalian cells, utilizing DNA polymerase beta. PMID- 2720911 TI - Twelfth Annual Conference on Shock. Marco Island, Florida June 9-12, 1989. PMID- 2720912 TI - Chronotropic responsiveness of developing sinoatrial and ventricular rat myocytes to autonomic agonists following adrenergic and cholinergic innervation in vitro. AB - The chronotropic responses of isolated sinoatrial node and ventricular muscle cells to neurotransmitters were compared in vitro with and without selective adrenergic and cholinergic innervation. Explants of either thoracolumbar sympathetic ganglion or sacrococcygeal spinal cord were added to cultures of newborn rat sinus node regions or ventricular apexes harvested before the onset of autonomic innervation in vivo. Catecholamine synthesis was detected by glyoxylic acid histofluorescence. Acetylcholine synthesis was indicated by monoclonal antibody labeling of choline acetyltransferase. After electrical or pharmacological stimulation of neurons, the chronotropic response of individual myocardial cells confirmed the presence of neuroeffector transmission; the nature of the myocyte response identified the stimulated neuron as either adrenergic or cholinergic. Chronotropic responses of all myocardial cells to norepinephrine or acetylcholine were transcribed on a recorder coupled to a video photoconductive cell monitor. Isolated sinoatrial node cells were supersensitive to norepinephrine and acetylcholine; thresholds were 3 x 10(-16) M and 6 x 10(-15) M, respectively. These sinoatrial node cells remained sensitive to both norepinephrine and acetylcholine after the development of innervation in vitro. Ventricular cells also were sensitive with thresholds of 3 x 10(-11) M and 6 x 10(-14) M to norepinephrine and acetylcholine, respectively. However, following in vitro innervation, ventricular cells were significantly less sensitive to norepinephrine and acetylcholine (thresholds 3 x 10(-9) M and 6 x 10(-11) M). These data are the first to demonstrate that neurotrophic modulation is not homogeneous throughout the myocardium and that it may be dependent on the specific myocardial cell innervated. PMID- 2720913 TI - Aortic impedance and hydraulic power in the chick embryo from stages 18 to 29. AB - Little is known about the hemodynamic properties of the rapidly expanding arterial bed during embryonic development. Using a servo-null pressure system and 20-MHz pulsed Doppler velocity meter, we recorded simultaneous dorsal aortic pressure and velocity waveforms. The waveforms were digitized at 3-msec intervals and subjected to Fourier analysis. We calculated hydraulic energy and the impedance spectrum to 10 Hz. From stages 18 to 29, heart rate (148 +/- 3 to 193 +/- 9 beats/min), systolic pressure (1.14 +/- 0.12 to 3.04 +/- 0.10 mm Hg), and mean dorsal aortic blood flow (21 +/- 2 to 214 +/- 19 mm3/min) increased. Peripheral vascular resistance (Z0: 30.4 +/- 4.8 to 6.4 +/- 0.7 dyne x sec/mm5), and the impedance moduli (Z1: 6.5 +/- 1.0 to 1.7 +/- 0.2 dyne x sec/mm5; Z2: 6.1 +/- 1.2 to 1.7 +/- 0.1 dyne x sec/mm5; Z3: 7.3 +/- 1.1 to 1.7 +/- 0.2 dyne x sec/mm5) decreased. Total hydraulic power increased from 48 +/- 7 to 2,606 +/- 96 nW, while the proportion of oscillatory energy increased from 29 +/- 2% to 65 +/- 4%. With development hydraulic load decreases, total external work increases and the dorsal aorta and embryonic vascular bed becomes more compliant. A greater proportion of total energy is expanded in pulsatile blood flow, suggesting that ventricular-arterial coupling is less efficient later in development. PMID- 2720914 TI - Consequences of regional inotropic stimulation of ischemic myocardium on regional myocardial blood flow and function in anesthetized swine. AB - Determination of the effect of inotropic stimulation on regionally ischemic and hypokinetic myocardium is complicated when intravenous administration of the inotropic agent also causes stimulation of nonischemic adjacent and distant regions, thereby altering global ventricular hemodynamics. To obviate such events, 16 anesthetized swine were studied during regional inotropic stimulation by infusion of dobutamine hydrochloride (2.5 +/- 1 microgram/min) into the cannulated left anterior descending coronary artery. Coronary inflow was controlled by a pump in an extracorporeal circuit. Two groups of swine with different degrees of ischemia were studied. In the first group of animals (n = 8), reduction in coronary inflow to produce a fall in coronary artery pressure (CAP) from 114 +/- 7 mm Hg to 62 +/- 2 mm Hg caused a decrease in percent systolic wall thickening (%WTh) from 34.6 +/- 8.1% to 25.4 +/- 5.8% (p less than 0.005). In the second group of animals (n = 8), CAP was decreased to 46 +/- 5 mm Hg (control: 115 +/- 8 mm Hg) and % WTh decreased from 34.1 +/- 16.4% to 10.4 +/- 6.9% (p less than 0.001). Subendocardial blood flow was reduced from 1.41 +/- 0.38 ml/min/g to 0.65 +/- 0.13 ml/min/g (group 1, p less than 0.001) and from 1.08 +/- 0.22 ml/min/g to 0.24 +/- 0.08 ml/min/g (group 2, p less than 0.001). Regional infusion of dobutamine caused asynchronous ventricular contraction with early systolic augmentation in wall thickening followed by late systolic thinning. Therefore, during hypoperfusion regional myocardial function assessed by %WTh remained unchanged (26.2 +/- 5.8%, p = NS) in group 1 and decreased significantly to 1.6 +/- 5.1% (p less than 0.041) in group 2. Subendocardial blood flow decreased to 0.44 +/- 0.15 ml/min/g in group 1 (p less than 0.005) and to 0.15 +/- 0.07 ml/min/g in group 2 (p less than 0.012). To account for the augmented early systolic thickening that occurred during asynchronous contraction, a myocardial work index was developed in which the sum of the instantaneous left ventricular pressure-wall thickness product was calculated for estimation of regional myocardial work. Increases in this work index were apparent with the addition of dobutamine at both levels of hypoperfusion. This significant enhancement in regional myocardial function in group 2 caused a significant increase of 16% (p less than 0.009) in overall left ventricular power during ejection. Thus, regional inotropic stimulation with dobutamine caused enhancement of maximum work of the ischemic myocardium in the steady state despite a further decrease in subendocardial blood flow. PMID- 2720915 TI - Transendothelial transport and metabolism of adenosine and inosine in the intact rat aorta. AB - This study was aimed at defining the role of vascular endothelium in the transport and metabolism of adenosine. For this purpose, endothelium-intact and endothelium-denuded isolated rat aortas, perfused at constant flow (2 ml/min), were prelabeled with 3H-adenosine or 3H-inosine for 10 minutes at concentrations of 0.012-100 microM. Sequestration of adenosine by endothelium was determined from radioactivity recovered during selective endothelial cell removal with deoxycholic acid (0.75% for 15 seconds). In the physiological concentration range of adenosine (0.012-1 microM), fractional sequestration by endothelium was 90-92% of the total adenosine incorporation by the aorta. Endothelial sequestration of inosine at 0.1 microM was 85%. At 100 microM adenosine or inosine, fractional sequestration by aortic endothelium was 33% and 39%, respectively. Analysis of the specific radioactivity of adenine nucleotides extracted from prelabeled aortas indicated that most of the adenosine was incorporated into endothelial adenine nucleotides. Incorporation of inosine into endothelial ATP was approximately 15% that of adenosine. Inhibition of aortic adenosine deaminase with erythro-9-(2-hydroxy-3-nonyl)adenine (EHNA) did not influence sequestration of 0.1 microM adenosine, but resulted in a 49% reduction of total endothelial incorporation at 100 microM adenosine. Transfer of radioactive purines from the endothelium to underlying smooth muscle after prelabeling was equivalent to only 1%/hr of total endothelial radioactivity. Our findings suggested that 1) macrovascular endothelium of the aorta constitutes a highly effective metabolic barrier for circulating adenosine and inosine; 2) transfer of labeled adenine nucleotides from endothelium to underlying smooth muscle is rather small and most likely proceeds via dephosphorylated purine compounds; and 3) measurement of adenosine trapping in endothelial and smooth muscle compartments overestimates the transendothelial adenosine concentration gradient. PMID- 2720916 TI - Low Ca2+ reperfusion and enhanced susceptibility of the postischemic heart to the calcium paradox. AB - This study was designed to define the effect of postischemic low Ca2+ perfusion on recovery of high-energy phosphates, intracellular pH, and contractile function in isolated rat hearts. Phosphorus-31 nuclear magnetic resonance spectroscopy was used to follow creatine phosphate, adenosine triphosphate, intracellular inorganic phosphate, and intracellular pH during control perfusion (15 minutes), total ischemia (30 minutes), and reperfusion (30 minutes). In Group I the perfusate [Ca2+] was 1.3 mmol/l throughout the experiment, whereas in Group II the perfusate [Ca2+] was reduced to 0.05 mmol/l during the first 10 minutes of reperfusion. Hearts from Group III were not made ischemic but were subjected to 10 minutes of low Ca2+ perfusion followed by 20 minutes of normal Ca2+ perfusion. During low Ca2+ reperfusion (Group II) recovery of high-energy phosphates and pH was significantly better than in controls (Group I). However, after reexposure to normal Ca2+, metabolic recovery was largely abolished, coronary flow was suddenly impaired, and contracture developed without any rhythmic contractions. These observations indicated the occurrence of a calcium paradox rather than postponed ischemia-reperfusion damage. On the other hand, normoxic hearts (Group III) tolerated temporary perfusion with 0.05 mmol/l Ca2+ very well with respect to left ventricular developed pressure, coronary flow, and metabolic parameters. In conclusion, postischemic low Ca2+ (0.05 mmol/l) perfusion may reduce reperfusion damage, but at the same time ischemia appears to enhance the susceptibility of the heart to the calcium paradox. PMID- 2720917 TI - Reflex modulation of lymphatic pumping in sheep. AB - Lymphatic pumping activity was examined in halothane-anesthetized sheep. A doubly cannulated preparation of the mesenteric lymph duct was "isolated" from lymph input, other than that from a constant pressure reservoir of artificial lymph attached to its inflow cannula, but had its blood supply and innervation intact. A cerebral ischemic response, evoked by injection of 2 ml air into the common carotid artery, increased both mean arterial pressure and fluid propulsion by the lymphatic. The latter rose from a control value of 45 microliters/min to a peak of 74 microliters/min. When 10(-4) M phentolamine was introduced into the lymphatic lumen, there was a transient increase followed by a sustained fall in lymph pumping. Repetition of the air injection while phentolamine was present in the duct lumen produced no increase in lymph pumping. In adrenalectomized animals, resting lymph propulsion by the mesenteric duct was depressed, and the response to air injection was attenuated but remained significantly greater than control. These results suggest that reflex activation of the sympathetic nervous system can increase lymph propulsion and that this may be augmented by the release of circulating catecholamines. PMID- 2720918 TI - Improved safety factor for triphasic defibrillator waveforms. AB - Newly developed biphasic waveforms improve defibrillation efficacy both by reduction of defibrillation threshold and by amelioration of shock-induced dysfunction depending on the relative shape of the first and second pulses. Each of these independent effects improves the waveform's safety factor, the ratio between the shock intensity that produces a specific degree of postshock dysfunction and the shock intensity that produces defibrillation (or cellular excitation). Symmetrical waveforms reduce defibrillation threshold to about 60% that of the corresponding monophasic waveform, probably by reduction of excitation threshold for ischemic cells, but increase postshock arrhythmias. Biphasic waveforms with 10% "tails" reduce postshock arrhythmias. This study tests the hypothesis that these independent mechanisms for improvement of defibrillation efficacy can be combined into a single triphasic waveform that will have a higher safety factor than either of the two biphasic waveforms of which it is composed. Cultured myocardial cells were subjected to high-intensity electric-field stimulation with a control monophasic rectangular waveform, a symmetrical biphasic waveform, and a triphasic waveform consisting of the biphasic waveform with an added 10% "tail." Each waveform portion was 5 msec in duration. Photocell mechanograms monitored contractile activity. We found that the duration of postshock arrest of spontaneous contractile activity increased with stimulus intensity for all waveforms. The voltage gradient producing a 4 second arrest after the biphasic waveform shock was 80.6 +/- 1.3% that of the control waveform (100%), while the voltage gradient for the triphasic waveforms was 87.1 +/- 0.73% of control. The difference between biphasic and triphasic waveforms was significant (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720919 TI - Thromboxane A2 mediates increased pulmonary microvascular permeability following limb ischemia. AB - Lower torso ischemia and reperfusion lead to respiratory dysfunction characterized by pulmonary hypertension and increased lung microvascular permeability. This is associated with lung leukosequestration and thromboxane (TX) generation. This study tests the role of elevated TX levels following muscle ischemia in mediating remote lung injury. Anesthetized sheep prepared with chronic lung lymph fistulae underwent 2 hours of bilateral hind limb tourniquet ischemia. In untreated controls (n = 7), 1 minute after reperfusion there was a transient increase in plasma immunoreactive (i)-TXB2 levels from 211 to 735 pg/ml (p less than 0.05), and at 30 minutes, lung lymph i-TXB2 levels rose from 400 to 1,005 pg/ml (p less than 0.05). At 1 minute, the mean pulmonary arterial pressure (MPAP) increased from 13 to 38 mm Hg (p less than 0.05) and pulmonary microvascular pressure (Pmv) from 7 to 18 mm Hg (p less than 0.05). Lung lymph flow (QL) rose from 4.3 to 8.3 ml/30 min (p less than 0.05), the lymph/plasma (L/P) protein ratio was unchanged from 0.6, and the lymph protein clearance increased from 2.6 to 4.6 ml/30 min (p less than 0.05). Two hours after reperfusion, neutrophils were observed sequestered in lung capillaries and proteinaceous exudates were found in alveoli in contrast to sham-operated animals (n = 3). To maximize lung vascular surface area and achieve a pressure independent L/P protein ratio a left atrial balloon was inflated during one group of ischemia-reperfusion experiments (n = 5). This resulted in a baseline rise in MPAP to 20 mm Hg (p less than 0.05); a 4.3-fold increase in QL (p less than 0.05), a decrease in the L/P ratio from 0.70 to 0.28 (p less than 0.05) and a protein reflection coefficient (sigma d) of 0.72. During reperfusion the L/P ratio rose to 0.49 (p less than 0.05) and the sigma d decreased to 0.51 (p less than 0.05), documenting an increase in lung microvascular permeability. In contrast to untreated ischemic controls, inhibition of TX synthetase with OKY 046 (n = 6) reduced plasma i-TXB2 levels to 85 pg/ml (p less than 0.05) but also increased i-6-keto-PGF1 alpha levels to 78 pg/ml relative to 15 pg/ml in untreated controls (p less than 0.05). OKY 046 prevented the increase in MPAP, Pmv, QL, and lymph protein clearance (p less than 0.05). Lung histology was normal in distinction to the leukosequestration in untreated ischemic controls.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2720920 TI - A new protocol for removal of the endothelium from the perfused rat hind-limb preparation. AB - A new protocol has been developed for selective removal of the endothelium from the arteries of the perfused rat hind-limb preparation. The hind limb was perfused with oxygenated Krebs-Ringer bicarbonate solution with a combination of high flow and timed air bubbles (2 minutes at high flow followed by 5 minutes of air bubbles, followed by a further 2 minutes at high flow). Representative vessels at different diameters of the arterial tree--the femoral artery, the artery supplying the extensor hallucis proprius muscle, and the arteries, arterioles, and capillaries within the hallucis proprius muscle--were taken for examination by transmission and scanning electron microscopy. A graded degree of damage occurred along the length of the hind-limb vasculature, with endothelial cells having been completely removed from the femoral artery, removed from or severely damaged in the artery supplying the hallucis proprius muscle, and partially damaged in arteries within the hallucis proprius muscle. However, no damage occurred to the endothelial cells of the arterioles and capillaries within the hallucis proprius muscle. The integrity of the vascular bed after endothelial removal according to the above protocol was confirmed by the demonstration of no diminution, but in fact an increase, in contractile responses to bolus injections of alpha,beta-methylene ATP, resulting in a shift to the left of the dose response curve. The viability was further confirmed by the fact that the conductance (flow/perfusion pressure) of the preparation during the periods of high flow was no different before and after removal of the endothelium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720921 TI - Macromolecular transport within heart valves. AB - The present study documents the permeability characteristics of heart valvular endothelium to low-density lipoprotein (LDL), albumin, and horseradish peroxidase (HRP). Using quantitative autoradiography, LDL and albumin concentrations were measured within aortic valves of squirrel monkeys and rabbits after 30 minutes of in vivo circulation. The valvular concentration profiles were analyzed using theoretical mathematical models based on fundamental transport principles. In vivo transvalvular concentration profiles of LDL and albumin displayed the highest tissue concentrations immediately beneath the endothelium and displayed the lowest concentrations near the midline of the valve. Tissue concentrations of LDL and albumin displayed large differences in magnitudes between different regions of individual valve leaflets suggesting marked spatial variation in the permeability properties of the valvular endothelium to LDL and albumin; this was also seen visually with HRP. The results of the theoretical analysis showed that 1) the aortic valvular endothelium limits the uptake of LDL and albumin into the valvular tissue, 2) the permeability of the valvular endothelium differs widely from one region of a valve to another and even from one side of the valve to the other within a single valvular region, and 3) intramural diffusion is the predominant mode of transport for LDL and albumin within the aortic valve, even in valvular regions exposed to large pressure differences across the valve. PMID- 2720922 TI - Angiotensin II causes formation of platelet activating factor in cultured rat mesangial cells. AB - Angiotensin II may contribute to the progression of renal glomerular diseases. Beneficial effects of converting enzyme inhibition in models of renal disease are, however, not always explicable by hemodynamic consequences of angiotensin II inhibition. Angiotensin increases intracellular calcium in glomerular mesangial cells and activates phospholipase A2, factors required for the formation of the lipid mediator of inflammation platelet activating factor (PAF). We therefore examined whether angiotensin II could stimulate PAF production in cultured rat mesangial cells. During a 15-minute incubation angiotensin II caused formation of PAF in a dose-dependent manner with a threshold around 10(-9) M. In four experiments PAF formation in response to angiotensin II (10(-8) M) occurred within 5 minutes and was 29 +/- 8 pmol PAF/mg protein. The amount of PAF detected then declined to 9 +/- 2 and 13 +/- 3 pmol after 15 and 30 minutes of incubation with angiotensin II. More than 90% of the PAF remained cell-associated. The PAF formation was confirmed by negative ion chemical ionization mode of mass spectrometry. A single species of PAF was detected and identified as hexadecyl PAF. We speculate that part of the detrimental effects of angiotensin II in progressive renal disease may relate to PAF formation. The PAF generated may in turn influence glomerular function, platelets, and eicosanoid synthesis, all factors implicated in renal disease. Furthermore, we speculate that angiotensin II-induced PAF formation may contribute to microvasculature pathology in general. PMID- 2720923 TI - Long-term results of catheter ablation of a posteroseptal accessory atrioventricular connection in 48 patients. AB - Forty-eight patients with a posteroseptal accessory atrioventricular (AV) connection underwent catheter ablation of the accessory AV connection with 200 400 J shocks delivered by a standard defibrillator. Cathodal shocks were delivered through the proximal pair of electrodes of a 6F quadripolar electrode catheter positioned in the coronary sinus such that the proximal electrodes straddled the ostium (12 patients) or the third electrode from the tip was at the ostium (36 patients). A 16-cm patch electrode positioned on the back or anterior chest served as the anode. Two to 4 shocks were delivered (total, 635 +/- 198 J, mean +/- SD). The cathether ablation procedure was clinically successful in eliminating symptomatic tachycardias in in 32 of 48 patients (67%) during a mean follow-up of 26 +/- 19 months. A long-term follow-up electrophysiology study was performed in 27 of the 32 patients who had a successful clinical outcome, and this showed that conduction through the accessory AV connection was completely absent in 25 patients and present but impaired in two patients. The success rate was significantly higher in patients with a concealed accessory AV connection (13 of 13, 100%) than in patients with manifest preexcitation (19 of 35, 54%; p less than 0.001). Among the 12 patients in whom the proximal electrodes of the ablation catheter straddled the ostium of the coronary sinus, one patient developed cardiac tamponade requiring needle pericardiocentesis; there were no instances of cardiac tamponade among the 36 patients in whom the third electrode from the tip was at the ostium of the coronary sinus. Other complications were AV block requiring a permanent pacemaker and transient atrial tachycardia in one patient each and an asymptomatic pericardial effusion in three patients. In conclusion, with the catheter ablation technique described in this study, a successful clinical outcome may be achieved in approximately two thirds of patients who have a posteroseptal accessory AV connection, and the risk of serious complications is low. This technique is particularly well suited to patients with a concealed posteroseptal accessory AV connection, in whom the success rate is higher than in patients with manifest preexcitation. PMID- 2720924 TI - Cardiac conduction abnormalities during percutaneous balloon mitral or aortic valvotomy. AB - To evaluate the electrophysiologic changes in the cardiac conduction system that occur during percutaneous mitral or aortic balloon valvotomy, we prospectively studied the conduction system in 19 patients (10 mitral, 8 aortic, and 1 both) undergoing this procedure. A His bundle electrogram was recorded in all patients, and when sinus rhythm was present, the atrioventricular (AV) node effective refractory period was measured. Holter monitoring was performed during and for 24 hours after the procedure. Follow-up electrocardiograms (ECG) were available in 11 patients 2.3 +/- 1.5 months after the procedure. The AV node effective refractory period before (276 +/- 86 msec) and after valvotomy (298 +/- 85 msec) were not significantly different. The maximum His-Purkinje conduction time (HV interval) observed during valvotomy (66 +/- 20 msec) was significantly longer (p less than 0.01) than that measured before (57 +/- 10 msec) or after (60 +/- 18 msec) valvotomy. The mean HV intervals before and after valvotomy were not significantly different. The mean QRS complex duration increased from 95 +/- 28 to 112 +/- 28 msec during valvotomy and remained significantly prolonged (109 +/- 26 msec) 24 hours after the procedure (p less than 0.01). A new intraventricular conduction defect (QRS complex duration greater than 100 msec) or bundle branch block occurred in five of 13 patients who had normal QRS duration before the procedure. The change in HV interval did not correlate with the change in QRS complex duration. In four patients, the newly acquired intraventricular conduction defect was still present on follow-up ECG tracing. Complete heart block was not observed in any patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720925 TI - Left ventricular contractility and function in Kawasaki syndrome. Effect of intravenous gamma-globulin. AB - To investigate the effect of Kawasaki syndrome on myocardial function, as well as the influence of high-dose intravenous gamma-globulin therapy on resolution of functional abnormalities, we studied 98 patients with Kawasaki syndrome during five time intervals from onset of illness: 1) 10 days or less, 2) 11-31 days, 3) 1-3 months, 4) 3-12 months, and 5) 1-3 years. Normal controls included 48 children under age 8 years, without known cardiovascular disease. Using two dimensional directed M-mode echocardiograms, we obtained chamber dimensions, fractional shortening, rate-corrected velocity of shortening (Vcfc) adjusted for end-systolic wall stress, and early diastolic function parameters that included adjusted peak rates of left ventricular dimension change, wall thinning, and their respective timing. Left ventricular systolic and diastolic dimensions were larger (both p less than 0.01) in patients than in normal subjects in period 1. Stress-adjusted Vcfc was much lower in patients in the 3 months after disease onset; by period 5, contractility was comparable in patients and normal subjects. Adjusted indexes of early diastolic function did not differ significantly between patients and normal subjects. To investigate the effect of gamma-globulin, we analyzed data on 47 patients prospectively randomized to therapy with aspirin alone (n = 19, 40%) or to aspirin plus gamma-globulin, 400 mg/kg/day for 4 consecutive days (n = 28, 60%). In period 1, before treatment, the two groups had mean fractional shortening and stress-adjusted Vcfc comparable to each other but much lower than those of normal subjects (p less than or equal to 0.001). Patients treated with aspirin alone continued to have diminished fractional shortening and Vcfc compared with normal subjects in periods 2, 3, and 4 (all p less than or equal to 0.05). In contrast, fractional shortening and Vcfc in gamma globulin-treated patients in these periods were comparable to those of normal subjects. By period 5, no difference was detected in systolic function or contractility between either treatment group and normal subjects. We conclude that early abnormalities of left ventricular contractility and myocardial function, as assessed by echocardiography, generally resolve by 1-3 years after disease onset and that recovery is accelerated by administration of IVGG in the acute phase. PMID- 2720926 TI - Assessment of ventricular contractile state and function in patients with univentricular heart. AB - To elucidate the ventricular contractile state and function in patients with univentricular heart, the ventricular volume, mass, ejection phase index, and wall stress were evaluated with biplane ventriculography and pressure measurement in 41 patients: 18 with left ventricular (LV) type (age, 6.4 +/- 6.1 years) and 23 with right ventricular (RV) type (age, 5.7 +/- 4.1 years), and data from patients with univentricular heart were compared with data from 19 normal control subjects (age, 7.2 +/- 4.3 years). Although the end-diastolic and end-systolic volumes were significantly greater in both types of univentricular heart than in the normal control group, the volumes for the LV and RV type patients did not differ from each other. The ejection fraction (EF) was depressed in both patient types of univentricular heart and was significantly (p less than 0.005) lower in the RV type than in the LV type patients (0.56 +/- 0.05 for LV type, 0.50 +/- 0.07 for RV type, and 0.64 +/- 0.03 for the control group). The ventricular mass was larger in both patient types of univentricular heart than in that of the control group, whereas the ratio of ventricular mass to end-diastolic volume was significantly (p less than 0.001) lower in the RV type patients than in the LV type patients and the control group (0.79 +/- 0.18 g/ml for LV type, 0.51 +/- 0.10 for RV type, and 0.82 +/- 0.13 for control group). End-systolic stress was significantly elevated in both types of univentricular heart (241 +/- 45 for LV type, 328 +/- 52 for RV type, and 205 +/- 26 kdynes/cm2 for the control group) and significantly (p less than 0.001) greater in the RV type than in the LV type patients. There was a significant inverse correlation (p less than 0.001) between end-systolic stress and the ratio of mass to end-diastolic volume in all the patients. In 27 patients (12 patients for LV type, 15 for RV type) the mean normalized systolic ejection rate corrected for heart rate (MNSERc) clearly fell below the 95% confidence limit of the normal end-systolic stress-MNSERc relation. The end-systolic stress:end-systolic volume ratio was also significantly depressed in both patient types of univentricular heart (3.49 +/- 1.77 for LV type, 4.07 +/- 2.13 for RV type, and 7.20 +/- 1.32 for the control group). In these variables, however, there were no significant differences between LV and RV type patients of univentricular heart.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2720927 TI - Amiloride. Antiarrhythmic and electrophysiologic actions in patients with inducible sustained ventricular tachycardia. AB - This study assessed the antiarrhythmic activity of amiloride in 35 patients with inducible sustained ventricular tachycardia. Patients had failed to respond to 3.6 +/- 1.0 antiarrhythmic drugs. Ventricular tachycardia was reproducibly induced by programmed electrical stimulation in all patients at the baseline study. Amiloride was given at 10 and 20 mg/day p.o. on a twice-daily schedule that achieved serum concentrations of 21 +/- 17 and 36 +/- 18 ng/ml, respectively. The mean left ventricular ejection fraction was unchanged from 36 +/- 14% at baseline to 37 +/- 17% during amiloride treatment. Amiloride significantly increased serum potassium from 4.6 +/- 0.4 to 5.1 +/- 0.4 mM. Four patients failed amiloride therapy with spontaneous nonsustained ventricular tachycardia. The remaining 31 patients were assessed by repeat programmed stimulation. Six patients had complete antiarrhythmic response, and an additional six patients had less than 15 beats of ventricular tachycardia induced. Therefore, amiloride was an efficacious antiarrhythmic treatment in 12 of 35 (34%) patients. Amiloride concentrations were significantly higher (52 +/- 20 ng/ml) in patients that responded than in patients that did not respond (30 +/- 15 ng/ml). The only electrophysiologic measurement that changed significantly was the ventricular functional refractory period (from 269 +/- 24 to 283 +/- 25 msec, p less than 0.05). Amiloride also suppressed frequent, spontaneous ventricular premature beats in eight of 15 patients (53%). No somatic side effects occurred. Two of the five patients discharged on amiloride therapy developed asymptomatic nonsustained ventricular tachycardia, and this prompted a change in antiarrhythmic therapy. Both died suddenly of arrhythmia during substitute empiric antiarrhythmic drug therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720928 TI - Quantification of mitral regurgitation with amplitude-weighted mean velocity from continuous wave Doppler spectra. AB - Amplitude-weighted mean velocity from continuous wave (CW) Doppler spectra was used to measure aortic flow (QAo) and left ventricular mitral inflow (QLVin). These flows were used to quantify mitral regurgitation fraction: RFm = (QLVin QAo).QLVin-1.100(%).QLVin was calculated from the diastolic time integral of amplitude-weighted mean velocity that was derived from CW spectra with the transducer placed in the apical window and the CW beam directed toward the left ventricular inflow tract. QAo was obtained from the systolic time integral of amplitude-weighted mean velocity by using the same apical window and directing the CW beam toward the left ventricular outflow tract. In 20 normal subjects, RFm ranged between -6.2% and +8% (mean, -0.8%). In 25 patients with pure mitral regurgitation, RFm obtained by Doppler (y) was compared with RFm calculated from biplane left ventriculography and the Fick method (x). The correlation was r = 0.96, SEE = 6.1% of the mean or 12% of the angio-Fick mean; the regression line was y = 0.96x + 0.18; mean y = 49%, mean x = 51%. It is concluded that RFm can be determined accurately by using amplitude-weight mean velocities from CW Doppler spectra. The advantages of this method are its independence from the measurement of the left ventricular inflow or outflow tract area. PMID- 2720929 TI - Effects of aspirin and prostaglandin E1 on in vitro thrombolysis with urokinase. Evidence for a possible role of inhibiting platelet activity in thrombolysis. AB - The formation of thrombi in vivo includes the activation of both platelets and the coagulation cascade. Conventional thrombolytic therapy is primarily directed toward the dissolution of fibrin. To evaluate the possibility that platelet activity impairs the lysis of thrombi, we studied the effects of aspirin and platelet-deaggregating prostaglandin E1 on thrombolysis with urokinase. Combined platelet and fibrin thrombi were produced in vitro by adding CaCl2 and collagen (1 microgram/ml) to citrated platelet-rich plasma (250,000 platelets per microliters). Urokinase (500-10,000 units/ml) caused a dose-dependent weight loss of the thrombi that was maximal at 2,000 units/ml. The addition of aspirin (10 200 micrograms/ml) to platelet-rich plasma before thrombus formation markedly enhanced thrombolysis with urokinase. This effect was most pronounced at 20 micrograms/ml aspirin. However, when aspirin was added after completion of thrombus formation, no significant effect on thrombolysis was noted. Prostaglandin E1 (1-100 mumol/l) improved the lysis with urokinase of the combined platelet and fibrin thrombi. This effect was maximal at 20 mumol/l prostaglandin E1. When pure fibrin thrombi were produced in platelet-free plasma, prostaglandin E1 was without effect on lysis. Thus, in vitro lysis with urokinase of combined platelet and fibrin thrombi was enhanced by the addition of platelet deaggregating prostaglandin E1 and by pretreatment with aspirin. PMID- 2720930 TI - Myocardial inotropic responses to aggregating platelets and modulation by the endocardium. AB - Ventricular mural thrombi complicate many cardiac diseases. The endocardial endothelium can modulate the mechanical performance of subjacent myocardium and mediate responses to certain physiopharmacologic agents. We studied the effects of aggregating platelets on the contractile performance of isolated cardiac muscle. The role of the endocardium was investigated by selectively damaging it by very brief (1 second) exposure to 1% Triton X-100 in some muscle preparations before experiments. Cat papillary muscles (n = 54) were attached to an electromagnetic length-tension transducer in organ baths containing Krebs-Ringer solution (1.25 mM Ca2+, 35 degrees C), and stimulated electrically at 0.2 Hz. Homologous washed platelets (final concentration 3 x 10(11)/l) aggregated spontaneously on addition to baths. Mechanical performance increased significantly more in muscles with damaged endocardium than in intact muscles (p less than 0.05); total peak isometric twitch tension increased by 31.8 +/- 7.8% (with damaged endocardium) and 11.8 +/- 2.6% (with intact endocardium), and peak isotonic twitch shortening increased by 36.7 +/- 7.8% (with damaged endocardium) and 9.6 +/- 2.0% (with intact endocardium). Increases in maximum velocity of unloaded shortening were similar in both muscle groups. Time to half isometric twitch tension decline decreased in intact muscles (3.6 +/- 1.0%) but increased in Triton-treated muscles (2.5 +/- 1.3%, p = 0.003 for difference between groups). The inotropic response to platelets in muscles with intact endocardium was unaltered by pretreatment of muscles with indomethacin (10 microM) or by stimulation of platelet aggregation with thrombin (0.1 unit/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720931 TI - Vasopressin and the mature coronary collateral circulation. AB - In isolated vascular rings, we have shown that mature coronary collateral vessels are highly responsive to the vasoconstrictor effects of vasopressin. The purpose of the present study was to determine the effect of concentrations of vasopressin encountered in pathophysiologic states on the collateral circulation in vivo. We studied eight open-chest anesthetized dogs with mature coronary collateral vessels 3-6 months after placement of an ameroid constrictor on the left circumflex coronary artery. The left anterior descending coronary artery was perfused at constant pressure, and peripheral coronary pressure was monitored continuously throughout each experiment. At baseline and during intracoronary infusion of vasopressin, which resulted in concentrations ranging from 8 +/- 3 to 1,340 +/- 327 microM/ml, we measured regional myocardial perfusion with radiolabeled microspheres. At baseline, regional myocardial perfusion to the collateral-dependent myocardium and to the normally perfused myocardium was similar; however, during vasopressin infusion, collateral-dependent zone flow decreased by 49 +/- 14% whereas normal zone flow decreased by only 9 +/- 9% (p less than 0.0005, normal zone perfusion vs. collateral perfusion). Vasopressin increased transcollateral resistance by 242 +/- 95% above baseline but produced a more modest increase in normal zone resistance (15 +/- 10%). The subendocardial to subepicardial perfusion ratio increased by 28 +/- 12% in the normal zone in response to vasopressin but decreased by 18 +/- 11% in the collateral-dependent zone. These data show that mature coronary collateral vessels are responsive to the vasoconstrictor effects of vasopressin at concentrations encountered in various pathophysiologic states.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2720932 TI - Organ blood flow and somatosensory-evoked potentials during and after cardiopulmonary resuscitation with epinephrine or phenylephrine. AB - Pure alpha-adrenergic agonists, such as phenylephrine, and mixed alpha- and beta adrenergic agonists, such as epinephrine, raise perfusion pressure for heart and brain during cardiopulmonary resuscitation (CPR). However, with the high doses used during CPR, these drugs may directly affect vascular smooth muscle and metabolism in brain and heart. We determined whether at equivalent perfusion pressure, continuous infusion of phenylephrine (20 micrograms/kg/min) or epinephrine (4 micrograms/kg/min) leads to equal organ blood flow, cerebral O2 uptake, and cerebral electrophysiologic function. During 20 minutes of CPR initiated immediately upon ventricular fibrillation in anesthetized dogs, left ventricular blood flow was similar with epinephrine (45 +/- 9 ml/min/100 g) or phenylephrine (47 +/- 8 ml/min/100 g) infusion. The ratio of subendocardial to subepicardial blood flow fell equivalently during CPR with either epinephrine (1.23 +/- 0.06 to 0.70 +/- 0.05) or phenylephrine (1.32 +/- 0.07 to 0.77 +/- 0.05) administration. At similar levels of cerebral perfusion pressure (44 +/- 3 mm Hg), similar levels of cerebral blood flow were measured in both groups (27 +/ 3 ml/min/100 g). Cerebral O2 uptake was maintained at prearrest levels in both groups. Somatosensory-evoked potential amplitude was modestly reduced during CPR, but it promptly recovered after defibrillation. During CPR and at 2 hours after resuscitation, there were no differences between drug groups in the level of regional cerebral or coronary blood flow, cerebral O2 uptake, or evoked potentials. Therefore, with minimal delay in the onset of CPR and with equipotent pressor doses of phenylephrine and epinephrine, we found no evidence that one agent provides superior coronary or cerebral blood flow or that epinephrine by virtue of its beta-adrenergic properties adversely stimulates cerebral metabolism at a critical time that would impair brain electrophysiologic function. Moreover, epinephrine did not preferentially impair subendocardial blood flow as might be expected if it enhanced the strength of fibrillatory contractions. PMID- 2720933 TI - A new method for noninvasive quantification of valvular regurgitation based on conservation of momentum. In vitro validation. AB - The noninvasive Doppler assessment of regurgitant volume from jet size is limited by the fundamental inequality of jet volume and regurgitant volume and by the dependence of jet dimensions on driving pressure and instrument settings for a given flow volume. Therefore, this study addresses the hypothesis that an equation could be derived from basic physical principles to quantify regurgitant volume with velocities that can be directly measured by Doppler echocardiography. The principle of conservation of momentum for free turbulent jets resembling many cardiac lesions yields an equation for regurgitant volume as a function of maximum jet velocity, a distal centerline velocity, and the intervening distance. This theory was tested throughout a range of physiologic flow rates and pressures (orifice velocities) in steady flow for 0.08-0.40 cm2 circular orifices and a noncircular orifice and in physiologic pulsatile flow for 0.08 and 0.20 cm2 circular orifices. Plots of centerline velocities versus axial distance coincided with those expected for such jets. Calculated and actual volumetric flows agreed well by linear regression in the turbulent jet: for steady flow rates, y = 0.98x + 0.09 (r = 0.99, SEE = 0.14 l/min), with similar correlations for circular and noncircular orifices; for pulsatile flow, y = 1.02x + 0.03 for peak flow rate (r = 0.98, SEE = 0.18 l/min) and y = 1.02x + 0.58 for total regurgitant volume (r = 0.95, SEE = 0.81 ml). There was no significant effect of orifice size or location of velocity measurement within the turbulent jet. Therefore, for free jets resembling many clinical lesions, regurgitant flow rate and volume can be calculated noninvasively from Doppler velocities without planimetry of jet area. Because the required information is intrinsic to the jet, this method should apply regardless of associated valvular lesions. It should also apply to orifices of variable shape because turbulent eddies obliterate the details of flow at the orifice. The special case of jets impinging on walls must be considered separately for both this technique and flow mapping. PMID- 2720934 TI - Catheter ablation of atrioventricular bypass tracts. Still an investigational procedure. PMID- 2720936 TI - Granulocytes, platelet-activating factor, and myocardial injury. PMID- 2720935 TI - Myocarditis in Kawasaki syndrome. A minor villain? PMID- 2720937 TI - State-of-the-Art Symposium on Coronary Arterial Surgery. Dallas, Texas, May 9-10, 1988. Proceedings. PMID- 2720938 TI - Surgical therapy for left ventricular aneurysms. A ten-year experience. AB - We reviewed retrospectively the surgical results of left ventricular aneurysm reduction in 197 consecutive patients operated on in 1977-1987. There were 19 hospital deaths (9.6%) and 38 late deaths. The cumulative 5- and 10-year survival probabilities were 79% and 67%. Of the 140 late survivors, 130 underwent follow up study in 1988 (mean, 5 years postsurgery). We analyzed preoperative, perioperative, and postoperative variables to evaluate the efficacy of surgical therapy. The risk of early mortality was increased by worsening preoperative New York Heart Association class, operation within 30 days of myocardial infarction, combinations of ventricular arrhythmia and congestive heart failure, renal failure, and preoperative cardiogenic shock. There was a trend toward increased early mortality with multivessel coronary artery disease. Late mortality and length of survival were not predicted by any variable examined. PMID- 2720939 TI - Surgery for left ventricular aneurysm. Early survival with and without endocardial resection. AB - In the past 3 years, 86 patients had left ventricular aneurysms resected or plicated. Sixty-eight had recurrent sustained ventricular tachycardia as the indication for surgery and had preoperative and intraoperative electrophysiologic mapping. There were 14 hospital deaths (16%). Eight preoperative potential risk factors for early hospital mortality were analyzed by multivariate analysis. Only acute myocardial infarction within 30 days before surgery correlated with hospital death at the p less than 0.05 level. History of previous heart surgery and advanced New York Heart Association functional class were important risk factors at the p less than 0.1 level. Hospital mortality was 17.6% for patients who had intraoperative mapping and endocardial resection and 11.1% for the others. Patients who had aneurysm repair for ventricular tachycardia had a significantly higher incidence of low cardiac output early after surgery (p less than 0.025). PMID- 2720940 TI - A critique of emergency and urgent operations for complications of coronary artery disease. PMID- 2720941 TI - Risk stratification and management of patients with recurrent ventricular tachycardia and other malignant ventricular arrhythmias. AB - Clinical results are reviewed in 269 patients who underwent subendocardial resection for recurrent sustained ventricular tachycardia secondary to ischemic heart disease. Operative mortality is 15%. Factors increasing operative mortality rates are ejection fraction less than 20%, emergency operation, and history of previous heart operation. Use of amiodarone preoperatively does not alter operative risk. Clinical control of ventricular tachycardia is achieved in 93% of operative survivors. Two thirds of these patients do not need antiarrhythmic agents. Five-year actuarial survival is approximately 60%. Patient results with the automatic internal cardioverter defibrillator at the Hospital of the University of Pennsylvania and nationwide are also reviewed. As of June 1987, almost 1,500 patients had one or more devices implanted. Most patients had a prior documented cardiac arrest. Coronary artery disease is the cause of heart disease in over 70% of patients. Operative mortality is low (0.8-3.9%). Approximately 50% of patients have had therapeutic discharge of the device; however, asymptomatic discharge occurs in up to 45% of patients. Incidence of sudden death is 1.5% at 1 year and 5% at 5 years. Five-year actuarial survival is approximately 60%. Long-term mortality is primarily from heart failure. PMID- 2720942 TI - A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. AB - The purpose of the study was to devise a method of stratifying open-heart operations into levels of predicted operative mortality, using objective data that are readily available in any hospital. Following univariate regression analysis of 3,500 consecutive operations, 14 risk factors were chosen that met these conditions. A few factors were excluded because they were insufficiently objective or not always available. An additive model was constructed, using the factors chosen, to calculate the probability of mortality within 30 days. The method was then tested prospectively in 1,332 open-heart procedures at the Newark Beth Israel Medical Center. Patients were categorized in five groups of increasing risk: good (0-4%), fair (5-9%), poor (10-14%), high (15-19%), and extremely high (greater than or equal to 20%). The correlation coefficient of anticipated and observed operative mortality, using the additive model, was 0.99. The operative mortality also correlated closely with complication rates and length of hospital stay. The additive model was compared with a second model based on logistic multiple regression; the resulting correlation coefficient was 0.85. The method was also tested at two other hospitals; although their sample sizes were smaller, the outcomes in each risk group were comparable with those at this institution. The collection of data proved to be acceptably simple for all three centers. This study demonstrates that it is possible to design a simple method of risk stratification of open-heart surgery patients that makes it feasible to analyze operative results by risk groups and to compare results in similar groups between institutions. Wider application of the system is recommended. PMID- 2720943 TI - Ventricular aneurysm resection. Trends in surgical risk. AB - From 1972 to 1987, 1,183 patients underwent ventricular aneurysm resection. At 4 year intervals, this series was divided into four subsets that differed in patient and management-related variables. Comparison of patients seen from 1972 to 1975 with those seen in 1984-1987 shows a significant increase in mean age to 59.4 years, with 31.6% older than 65 years, an increase to 43.4% of patients with congestive heart failure, and a decrease to 42.8% of patients with angina. In the most recent interval, 30.7% of patients had mammary grafts, 81.1% had associated grafts, and 47.2% of patients were completely revascularized. Mortality rate, however, increased to 8%. Deaths were attributed to cardiac causes in 59.7% of cases. Multivariate analysis identified emergent procedures, advancing age, left main trunk disease, and history of congestive heart failure as risk factors. We conclude that the incidence of aneurysm resection is decreasing and operative risk has been constant despite advancing patient age and more extensive operative procedure. PMID- 2720944 TI - Disposable lenses. PMID- 2720945 TI - A morphologic and fluorophotometric analysis of the corneal endothelium in long term extended wear soft contact lens wearers. AB - Eleven extended wear soft contact lens wearers with an average of 4 years of wear underwent corneal fluorophotometry and quantitative specular microscopy. Compared to age-matched controls, a significant increase in mean endothelial permeability was found in the contact lens group, indicating a defect in their endothelial barrier function. A significant increase in the mean endothelial pump rate was also noted in the contact lens group. In addition, mean corneal thickness was significantly greater in the contact lens group. No significant difference was noted between the two groups in mean cell area and figure coefficient; however, the coefficient of variation was significantly higher in the contact lens group. Duration of contact lens wear correlated positively with coefficient of variation. An inverse correlation was noted between contact lens oxygen transmissibility and cell area, as well as corneal thickness. These data suggest both a morphologic and functional defect in the corneal endothelium of long-term extended wear soft contact lens wearers. PMID- 2720946 TI - Evaluation of variation in oxygen transmission in rigid contact lens extended wear. AB - Variation in thickness is known to affect the Dk/L of rigid gas permeable contact lenses. Our study was designed to evaluate the variability of central and average thickness of Oxyflow EW lenses. In addition, the relationship between overnight swelling of the central cornea and Dk/L was examined to determine whether Dk/L calculated with central lens thickness correlated better with lens-induced edema than Dk/L calculated with average lens thickness. The results showed marked variation among lens center thicknesses for all powers (-6 D, -2 D, +2 D, +6 D) examined, and, as expected, more variation for centrally calculated Dk/L with high minus lenses. Average Dk/L did not vary significantly with power. Average and central Dk/L values had a near 1:1 relationship for -2 D lenses for the base curve (7.8 mm) ordered; but only when power was kept constant was a good correlation seen between central and average Dk/L. A one-patient study evaluating the overnight central swelling response to three +6 D and three -6 D (high, medium, and low center thickness) lenses showed that central Dk/L correlated better with lens-induced edema than average Dk/L. Thus, specifying central thickness on lens orders appears to be a primary variable influencing extended wear edema at night. Peripheral Dk/L, however, may influence corneal physiological variables other than central edema and warrants further study. PMID- 2720947 TI - Paraperm EW lens for extended wear. AB - This paper reports the results of 372 patients fit with the Paraperm EW rigid gas permeable lens for extended wear. This lens material is a copolymer derived from siloxane and methylmethacrylate with an oxygen permeability (Dk) of 56 X 10(-11) at 37 degrees C. At the end of 1 year, 270 patients had completed the study with 94.8% achieving 20/25 or better vision. Complications included a 12.3% incidence of superficial limbal keratitis with staining, a 3.1% incidence of conjunctival injection, and a 1.5% incidence of observable corneal edema. The lens appears to be a significant addition to the possibilities available for fitting extended wear patients or those who desire occasional overnight lens wear. PMID- 2720948 TI - Disinfection associated spoilage of high water content ionic matrix hydrogels. AB - Chemical analysis was carried out on clinically obtained hazy white hydrogel lenses that had been exposed to hydrogen peroxide disinfection. Analysis revealed that hazing was a surface phenomenon limited to high water content ionic matrix hydrogels (type IV), the type associated with the deposition of large amounts of lysozyme. We subjected unworn lenses to cycling studies involving doping in a variable artificial tear solution followed by exposure to disinfectant; this allowed us to duplicate the clinical situation and to derive a mechanism for this phenomenon. Hazing proved independent of the presence of hydrogen peroxide but dependent on the interaction of lens-bound lysozyme and stannate anion, the latter derived from sodium stannate present in the disinfectant as a stabilizing agent. Hazing is restricted to the type IV hydrogels because only these polymers have a sufficient number of anionic binding sites and are of sufficient porosity to allow the penetration and binding of a thick layer of lysozyme. Lysozyme is essential to hazing. No other tear protein is small enough to penetrate the hydrogel matrix or basic enough to have a marked affinity for the lens and to provide binding sites for stannate anion. These findings highlight the unique vulnerability of the type IV hydrogel to interaction with trace or transient ionic constituents in tears and lens care solutions. PMID- 2720949 TI - The theory of corneal curvature change with the Intrastromal Corneal Ring. AB - The Intrastromal Corneal Ring (ICR) is a new corneal implant designed to alter anterior corneal curvature. After insertion into the peripheral corneal stroma, the ring may be mechanically expanded or constricted. We constructed a mathematical model to assess the amount of corneal flattening or steepening that might result from ICR expansion or constriction, respectively. The model predicted increased corneal flattening with increasing expansion of the ICR circumference. Progressive corneal steepening with increasing constriction of ICR circumference was predicted. Incremental reductions in initial ring diameter sizes resulted in increased degrees of predicted corneal flattening or steepening. The mathematical model of the ICR function illustrates the potential of the ICR to correct myopia or hyperopia. PMID- 2720950 TI - The politics of homemade saline. PMID- 2720951 TI - Pediatric epileptology. Proceedings of the 1988 Cleveland Clinic International Epilepsy Symposium. PMID- 2720952 TI - GAP-43 gene expression during development: persistence in a distinctive set of neurons in the mature central nervous system. AB - GAP-43 is a rapidly transported axonal protein most prominently expressed in regenerating and developing nerves. However, the low level persistence of GAP-43 in the adult CNS where growth and regenerative capacity are minimal may additionally indicate a role for this molecule in neuronal remodeling. Previous studies have revealed GAP-43 immunoreactivity in neurites throughout many regions of the CNS. To identify the CNS neurons that express GAP-43 at different stages of development, we utilized in situ hybridization and immunocytochemistry; the latter was performed with an antibody that recognizes GAP-43 immunoreactivity in both perikarya and neurites. In the perinatal period GAP-43 is expressed in all neurons. Subsequently its expression becomes progressively restricted such that by maturity most neurons no longer express detectable levels, although GAP-43 expression is still moderately high in the adult entorhinal cortex, and strikingly high in the adult hippocampus and olfactory bulb. In light of current notions about the function of GAP-43, it is tempting to speculate that this anatomy denotes neurons engaged in structural remodeling and functional plasticity. PMID- 2720953 TI - Proconvulsant effects of aminophylline during amygdala kindling in developing rats. AB - Aminophylline (A) is a proconvulsant in adult rats. We studied the effect of A on amygdala kindling in 15-day-old rat pups. Production of generalized seizures was significantly promoted by A at doses ranging from 10 to 100 mg/kg. Terminal status epilepticus (TSE) was produced in 33% of pups receiving 25 mg/kg A, 75% of pups receiving 50 mg/kg A, and 100% of pups receiving 100 mg/kg A. The number of stimuli needed to produce a stage 4-5 generalized seizure was significantly smaller in animals receiving 10 mg/kg A (5.7 +/- 3.4), 25 mg/kg A (3.4 +/- 2.4), 50 mg/kg A (1.9 +/- 1.4), or 100 mg/kg A (1.9 +/- 1.6) than in saline-treated controls (12.3 +/- 3.7) (P less than 0.001). In addition, 16% of pups receiving 50 mg/kg and 33% of pups receiving 100 mg/kg A and never stimulated developed TSE. These seizure-promoting effects of A in rat pups undergoing amygdala kindling are far more dramatic and occur at far lower doses than those previously reported in adults. PMID- 2720954 TI - The development of laminar staining for neuron-specific enolase in the rat somatosensory cortex. AB - The expression of the enzyme neuron-specific enolase (NSE) in the central nervous system (CNS) has been used as a developmental marker based on observations that it is expressed shortly after the arrival of afferent inputs. The immunostaining pattern of NSE was examined in the laminae of the somatosensory cortex of the rat and the relationship of this staining pattern with previous data on the timing of afferent and efferent arrival was determined. Male rat pups were sacrificed on postnatal days 1 (24 h after birth), 3, 5, 8, 10, 12, 15 and 20, and as an adult (over 90 days of age). Sections were stained with an anti-NSE antibody using the avidin-biotin immunocytochemical method. Sections from day 1 animals revealed stained cells in the subplate layer and cortical plate, presumably in cells destined to form layers VI and V. By day 8 there was staining in layers II, III, V and VI, the same layers that exhibited staining in the adult rat. This appears consistent with the arrival of afferents and efferents which is completed by approximately postnatal day 7. On day 10, there was a change in the staining pattern: cell staining in layer VI was decreased and then increased gradually up to adult levels by day 20. A stable pattern of NSE staining was not observed previous to day 20. These results suggest that changes in NSE expression following the initial arrival of afferents may relate to maturation of the neurons. PMID- 2720955 TI - Ontogeny of cholecystokinin gene expression in the rat thalamus--a hybridization histochemical study. AB - We examined the ontogeny of cholecystokinin (CCK) gene expression in the rat thalamus using hybridization histochemistry. Maturation of CCK gene expression occurred over the course of a month, beginning in the medial geniculate nucleus on the 17th day of gestation. CCK mRNA was found in the caudal nuclei first, later in the rostral; the ventral were followed by the dorsal; and the lateral by the medial. In some nuclei, such as the medial geniculate, CCK mRNA was present prior to the full differentiation of the neurons; whereas in others, such as the mediodorsal, the neurons differentiated to almost adult morphology before CCK mRNA was detected. PMID- 2720956 TI - On the distribution and morpho-functional characteristics of 5-HT-immunoreactive cells in the hypothalamus of fetuses and neonatal rats. AB - This study attempted to visualize serotonin (5-HT)-immunoreactive (IR) neurons in the hypothalamus of intact fetuses (E18) and neonatal rats (P9) as well as after their pretreatment with some drugs interfering with the 5-HT metabolism and uptake in the serotoninergic neurons (L-tryptophan, pargyline, 5 hydroxytryptophan, fluoxetine). The 5-HT-IR cells were not observed in the hypothalamus of normal, untreated fetuses and neonatal rats. However, two large accumulations of 5-HT-IR neurons appeared in the anterolateral hypothalamus and in the dorsomedial nucleus after the subsequent injections of the monoamine oxidase inhibitor, pargyline, and the amino acid precursor of the 5-HT synthesis, L-tryptophan. A significantly less intensive reaction was observed after injections either of the second precursor of the 5-HT synthesis, 5 hydroxytryptophan instead of L-tryptophan, or pargyline only. Immunostaining, provoked by the pargyline and L-tryptophan pretreatment, was completely blocked by the injection of the specific 5-HT uptake inhibitor, fluoxetine. It means that the 5-HT immunostaining of the hypothalamic neurons may be accounted for by their capacity to take up specifically 5-HT from the environment rather than by its intraneuronal synthesis from L-tryptophan. Nevertheless, the 5-HT synthesis from 5-hydroxytryptophan in these cells cannot be excluded. The uptake of extracellular 5-HT into catecholaminergic neurons can be excluded as nomifensine, the specific inhibitor of the uptake to these neurons, did not modify the immunostaining. PMID- 2720957 TI - Alterations in the microenvironment during spreading depression associated with epileptiform activity in the immature neocortex. AB - Local changes in extracellular ion concentrations were measured with ion sensitive microelectrodes in slices of mature (greater than 40 days of age) or immature (16-30 days of age) rat neocortex maintained in vitro. Repetitive stimulation resulted in increases in extracellular potassium ([K+]o) to levels of 8.85 +/- 2.1 mM in slices from adult animals and 12.77 +/- 1.8 mM in slices from immature animals. During exposure to picrotoxin, maximum levels were 11.3 +/- 2.6 and 14.8 +/- 2.5 mM in the mature and immature groups, respectively. Picrotoxin (50 microM) induced spontaneous bursts of repetitive spiking, followed by a slow, negative field potential, associated with spreading depression (SD), in slices from immature animals. [K+]o levels increased to 10.2 +/- 3.9 mM during repetitive spike discharges and reached 30.3 +/- 18.5 mM during SDs. Variations in the size of the extracellular space (ES) were examined during SD. The ES was found to reversibly decrease by 39 +/- 4.5%. Clusters of repetitive spikes were associated with 0.1-0.2 mM decreases in [Ca2+]o, whereas 1.12 +/- 0.06 mM decreases were observed during SDs. Decreases in [Na+]o and [Cl-]o of 56 +/- 10 mM and 41 +/- 9 mM, respectively, were observed during SDs suggesting that a net transmembrane movement of water occurred during SDs. These results indicate that changes in [K+]o associated with epileptiform activity in the immature nervous system are quantitatively different from those observed in the mature brain. These large increases in [K+]o may contribute to the prolonged nature of epileptiform discharges in the developing nervous system. PMID- 2720958 TI - Androgen regulation of an antigen expressed in regions of developing brainstem monoaminergic cell groups. AB - To examine the regulation of brain development by gonadal steroids we are using monoclonal antibodies obtained with neonatal rat brain homogenates as immunogens. One antibody, 3D10, binds selectively in regions of identified monoaminergic neuronal cell groups in the brainstem. Characterization of 3D10 immunoreactivity was carried out using free-floating 50 microns tissue sections from perinatal rats. The strongest reactivity was seen on postnatal day 1 in the locus coeruleus (A6) and in the regions of the A4 (dorsal) and A5 (ventral) noradrenergic cell groups. Immunoreactivity was also seen in the raphe magnus, pallidus and obscuris. Faint immunoreactivity was seen in the more rostral and median raphe nuclei and in the midbrain dopaminergic cell groups of the ventral tegmentum and substantia nigra. The number of 3D10 immunoreactive cells in all groups was greatest perinatally and decreased with age. The number of immunoreactive cells in the A4 region of males decreased at an earlier age than in females. Female offspring treated prenatally with testosterone propionate also had fewer immunoreactive cells in the A4 region at earlier ages, approximating the time course in the male. Thus, changes in the number of 3D10 immunoreactive cells reveal hormonal control of the time course of a developmental process in a selective population of neurons. PMID- 2720959 TI - Postnatal ontogeny of enkephalin fibers in spinal sympathetic nuclei. AB - The postnatal distribution of enkephalin (Enk) fibers is described in preganglionic containing sympathetic nuclei in the rat thoracolumbar spinal cord. In high thoracic spinal cord, at birth, Enk fibers are present in moderate numbers in the intermediolateralis nucleus, pars principalis (ILp), and nucleus intercalatus spinalis (IC). Enkephalin fibers first appear in the dorsal commissural nucleus (dcn) on postnatal day 2. Postnatal day 6 represents a pivotal timepoint when the basic Enk innervation pattern is established. From postnatal day 11 through day 20 there is a gradual accumulation of Enk fibers within each of the sympathetic nuclei such that the density and distribution of immunoreactive fibers approaches the adult appearance by postnatal day 20. An adult pattern is achieved by postnatal day 30. There is a rostral-caudal gradient in the developmental appearance of Enk fibers in sympathetic nuclei such that the ILp nucleus contains Enk fibers on postnatal day 0 in the high thoracic spinal levels compared to postnatal day 6 in low thoracic-high lumbar spinal levels. Examination of the location of Enk fibers during ontogeny highlighted several additional features of the distribution of Enk fibers in the adult animal. Enkephalin fibers delineate two subdivisions of the IC nucleus; a thin dense core of Enk fibers contained within a broader band of moderate numbers of Enk fibers. We also report variations in the general overall pattern of the Enk fiber distribution in high thoracic, middle thoracic, and lwo thoracic-high lumbar spinal cord levels. PMID- 2720960 TI - Sexually dimorphic behavioral and brain asymmetries in neonatal rats: effects of prenatal alcohol exposure. AB - Behavioral and neuroanatomical asymmetries were assessed in 3-day-old male and female rat pups chosen from litters whose dams had received one of 3 prenatal treatments: 35% ethanol-derived calories, pair-fed control, or lab chow control. Behavioral laterality was assessed by observing the preferred tail bias on postnatal (PN) day 1. On PN day 3, brains were sectioned and morphometric analyses conducted for total brain volume, left and right neocortical volumes, and left and right hippocampal volumes. Prenatal alcohol exposure altered the population proportions of left, right and neutral tail biases in male pups on PN day 1. Female pups were affected by both prenatal alcohol exposure and maternal undernutrition/stress of pair-feeding. Prenatal alcohol exposure decreased body weight and total brain volume, but increased the brain volume/body weight ratio compared to both control groups. Prenatal alcohol exposure also reduced the volumes of the hippocampus and neocortex, with the greatest proportional reduction found in the volume of the anterior neocortex. A left-right anterior neocortical asymmetry was observed, with tail bias, prenatal treatment and sex all significant factors. Alcohol-exposed males showed a 'feminized' asymmetry. These results demonstrate that a sexually dimorphic cerebral asymmetry can be detected at birth in rats; this asymmetry appears to be related to a postural position bias. The reversal of normal interhemispheric relations by prenatal alcohol exposure in male offspring suggested that the in utero hormonal milieu modulates the development of cerebral lateralization. PMID- 2720961 TI - Periodic feeding of SCN-lesioned pregnant rats entrains the fetal biological clock. AB - Destruction of the maternal suprachiasmatic nuclei (SCN) early in gestation disrupts maternal communication of time-of-day information to the rat fetus. In the present study, we demonstrated that periodic feeding (food cue) to SCN lesioned pregnant rats entrains the fetal biological clock. The phase of the drinking behavior rhythm was examined in pups reared in constant darkness, beginning at weaning. In several control (uncued) litters, pup phases at weaning were scattered. In other control litters where within-litter coordination of phase was observed, the average litter phase was unpredictable. In contrast, drinking rhythms of pups whose dams had received food cue during gestation were synchronized within- and between-litters, suggesting that prenatal food cue entrained the fetuses. The effect of food cue occurs prenatally, as similar results were obtained when offspring of SCN-lesioned, cued dams were fostered to lesioned, uncued dams on the day of birth. The present results, along with data from this and other laboratories, suggest that redundant mechanisms communicate time-of-day information to the fetus. PMID- 2720962 TI - Callosal projection neurons in area 17 of the fetal rhesus monkey. AB - We have studied the distribution of callosal projection neurons in area 17 of a fetal rhesus monkey which received large injections of horseradish peroxidase into the contralateral occipital cortex. In comparison to other cortical areas, area 17 contains few callosal projection neurons. Most of these cells are confined to a region extending tangentially about 2.5 mm from the 17/18 border, although a few neurons were noted as much as 5 mm from the border. Comparing the distribution of callosal projection neurons in the fetal monkey with what has been described in newborn and adult macaques, it is apparent that although some degree of refinement in striate callosal connections may occur during in utero development, the prenatal development of callosal connections in the macaque is inherently adult-like. PMID- 2720963 TI - Alkaline phosphatase isoenzymes in rheumatic diseases. AB - Serum alkaline phosphatase isoenzymes were determined quantitatively by electrophoresis on cellulose acetate in 168 patients with rheumatic diseases subgrouped for disease activity. Median values of total alkaline phosphatase and bone isoenzyme activity, as well as frequency of patients showing pathological values, increased gradually and significantly corresponding to disease activity in rheumatoid arthritis and ankylosing spondylitis, from 0% in inactive to 90% in very active forms. Bone isoenzyme was much more sensitive than total alkaline phosphatase in moderate disease activity and was also correlated to the number of involved extravertebral joints and pain in ankylosing spondylitis. No correlation was found with stage or duration of disease, age, sex, and erythrocyte sedimentation rate. Additional to bone isoenzyme, liver isoenzymes were elevated in some patients, but with only a weak correlation with disease activity. The intestinal isoenzymes were always normal. We conclude that quantitative determination of serum alkaline phosphatase bone isoenzyme activity is a major indicator for the assessment of disease activity and therapeutic monitoring in rheumatoid arthritis and ankylosing spondylitis. PMID- 2720964 TI - Isoelectric focusing of creatine kinase MM isoforms and its application for diagnosis of acute myocardial infarction. AB - CK MM isoforms (MM 3 having the highest isoelectric point, followed by MM 2, MM 1, and MM X) were measured in 35 patients with acute myocardial infarction (AMI) by isoelectric focusing on agarose gel. Blood samples were analysed every 2 h for the first 12 h, then every 4-8 h until 72 h after AMI. In the first sample, obtained 2.1 h after the onset of chest pain, the ratio of the isoforms MM 3:1 was 0.7 (range 0.2-1.8), equivalent to a normal value. Before the total CK exceeded normal, in 86% of the patients the ratio MM 3:1 rose to 2.2 (range 0.3 3.3). The maximal individual ratio MM 3:1 was 4 (range 0.9-12) after 7 h. It fell below 1 again after 27 h. Thus, the ratio MM 3:1 was useful in the early diagnosis of AMI by enzymatic methods and to estimate the time elapsed since the onset of infarction. Twenty patients with an open infarct vessel (angiographic data after thrombolytic therapy) showed similar peak enzyme activities as ten non reperfused patients. They differed significantly in the time to the peak activity, mostly for CK MM 3 and CK MB (p less than 0.0005). A higher ratio CK MM 3:1 and a shorter time to the maximum CK MM 3 activity in reperfused patients helps to assess the success of thrombolytic therapy. PMID- 2720965 TI - Elevated serum CK-BB levels in patients with cerebral transtentorial herniation after ischemic stroke. AB - We examined the time course of CK and its isoenzymes in 15 patients with severe ischemic stroke. Patients with cerebral transtentorial herniation (n = 7) had the highest CK-BB activity during herniation (1.54 +/- 0.6 U/L, mean +/- SD; range: 1.0-2.6 U/L). These values were distinctly above the values of a control group of 20 patients with non-neurological diseases (0.39 +/- 0.2 U/L, mean +/- SD). In patients with smaller lesions without herniation (n = 8) the maximum CK-BB increase was lower (0.56 +/- 0.26 U/L, mean +/- SD). PMID- 2720966 TI - Adenosine deaminase in body fluids: a useful diagnostic tool in tuberculosis. AB - The performance of a colorimetric ADA determination in body fluids other than serum in the diagnosis of tuberculosis was assessed in 1063 patients from whom pleural (600), peritoneal (136), pericardial (77), or cerebrospinal (250) fluids were obtained. In exudative pleuroperitoneal and pericardial effusions, an ADA decision level of 0.71 mu kat/L displayed a sensitivity of 1.00, and was higher than those of histologic (0.83) and bacteriologic (0.62) studies. At this level, ADA reached a specificity of 0.92 and efficiency of 0.94. In cerebrospinal fluid, an ADA catalytic concentration above 0.15 mu kat/L strongly suggests tuberculous meningitis in patients older than 7 years (sensitivity 1.00, specificity 0.99 and efficiency 0.99). ADA results obtained with a UV-method were closely correlated with those of the colorimetric method in pleuroperitoneal effusions (r = 0.989) and in cerebrospinal fluids (r = 0.905). Sample blanks should be processed, otherwise false positive results may be found in non-tuberculous cerebrospinal fluids (5.3%) and pleuroperitoneal effusions (3.8%). PMID- 2720967 TI - ELISA for human pancreatic elastase 1. AB - A sandwich-type ELISA for human pancreatic elastase 1 was developed and assessed for clinical feasibility. Using highly purified reagents, the test seems to be as sensitive and specific as the well-documented Radio-immunoassay (RIA) for the detection of elevated elastase 1 serum levels and, consequently, would have the same indications described for the RIA. In addition, the ELISA could be valid as a screening test for cystic fibrosis. Because ELISA reagents are relatively stable, the assay is always ready to use and can be performed without special equipment. PMID- 2720968 TI - Elastase 1 and chymotrypsin B in pancreatic juice and feces. AB - A chymotrypsin-like protease was detected along with elastase 1 in pancreatic secretion and stool. This enzyme was isolated from necrobiotic human pancreas, purified, partially characterized and designated as chymotrypsin B. Quantitative studies by rocket immunoelectrophoresis indicated that neither elastase 1 nor chymotrypsin B was degraded during intestinal passage. On the basis of a clinical study, both enzymes were found to reflect pancreatic function. PMID- 2720969 TI - Reliability of the determination of whole-blood oxygen affinity by means of blood gas analyzers and multi-wavelength oximeters. AB - Determination of the oxygen affinity of human whole blood with the help of blood gas analyzers and multi-wavelength oximeters is compared with an accurate method for recording hemoglobin oxygen dissociation curves (Clin Chem 1982;28:1287-92). P50 (oxygen tension at half saturation; So2 = 50%) and Hill's n (delta log [So2/(1-So2)]/delta log Po2) were determined in blood of 24 healthy donors. Three slightly different procedures were used for determination of P50 on the basis of Po2, pH, Pco2, and So2 measured with each of four different blood-gas analyzer/oximeter combinations. These methods were not able to discriminate between high and low values for P50 within the normal reference interval, but never failed to detect the high oxygen affinity of blood stored for 12 days, reflected in low values of P50. The methods thus proved suitable for detecting clinically significant deviations in oxygen affinity such as occur in patients with, e.g., abnormal hemoglobins, anemias, or carbon monoxide poisoning. Determination of Hill's n by these methods did not produce useful results. PMID- 2720970 TI - Isolation and characterization of myoglobin and its two major isoforms from sheep heart. AB - We isolated myoglobin from sheep heart by homogenizing cardiac muscle in 70% saturated ammonium sulfate, followed by chromatography on a column containing carboxymethyl(CM)-Sephadex gel. Two major isoforms of myoglobin, designated Mb 7.9 and Mb 8.1, were separated by chromatofocusing and were distinguished by their different patterns seen on either isoelectrofocusing or on electrophoresis on polyacrylamide gel. The isoelectric points of the major bands of Mb 7.9 and Mb 8.1 were 7.4 and 7.16, respectively. Both isoforms were identical in size when examined by gel filtration chromatography but differed slightly when analyzed by polyacrylamide gradient gel in the presence of sodium dodecyl sulfate. The Mr of Mb 7.9 (15,900 Da) is slightly smaller than that of Mb 8.1 (18,400 Da). When reacted against rabbit anti-sheep myoglobin, two isoforms also appeared as two nonidentical precipitin lines on agarose gel. PMID- 2720971 TI - Biological variability of 26 clinical chemistry analytes in elderly people. AB - Analytical, within-subject, and between-subject components of variation were estimated for 26 clinical chemistry analytes from duplicate analyses of 10 specimens collected from 27 healthy elderly subjects over a period of 20 weeks. Within-subject variations were similar to those generated previously by us in younger subjects. We conclude, therefore, that homeostasis is not compromised by age alone, and biological variability does not increase simply with age. All analytes except serum water had marked individuality, showing that conventional population-based reference values are of limited utility. The critical differences required for two results to be significantly (P less than or equal to 0.05) changed are not the same as those that prompt action by clinicians. Although heterogeneity of within-subject variation does exist, we believe that the critical differences generated will be useful in routine clinical decision making. PMID- 2720972 TI - Direct determination of four sulfates and seven glucuronides of 17-oxosteroids in urine by fluorescence "high-performance" liquid chromatography. AB - We describe a direct method for determining four sulfates and seven glucuronides of 17-oxosteroids (17OS) in urine without hydrolysis, by use of "high performance" liquid chromatography (HPLC) with fluorometric detection. After pretreatment of urine samples with a Sep-Pak C18 cartridge, four 17OS sulfates and seven 17OS glucuronides in the pretreated urine samples were reacted with tetrapentylammonium ions to form ion pairs. Ion-paired 17OS sulfates were extracted with benzene. By adding sodium sulfate to the remaining sample, we could then extract ion-paired 17OS glucuronides with dichloromethane. Each extract was labeled with dansyl-hydrazine in an acetic acid-acetonitrile solution. The labeled steroids were separated by HPLC on a reversed-phase Capcell Pak C8 (silicon-polymer-coated silica gel modified with octyl groups). We monitored each effluent with a fluorometric detector (330 nmexcitation, 535 nmemission). PMID- 2720973 TI - Phospholipid surface tension: the diagnostic utility of amniotic fluid and its lipid extract, an analysis of the value of precipitation with cold acetone. AB - In prevention of the respiratory distress syndrome (RDS), measurements of surface tension values (a biophysical property) of amniotic-fluid samples are correlated with their lecithin/sphingomyelin (L/S) ratios (a biochemical property). According to some authors, precipitation of phospholipid with cold acetone is essential for determining the L/S ratio, because it separates surfactant and nonsurfactant phospholipidic fractions. Here we report the first study of the ability of three amniotic-fluid components to decrease surface tension: The complete lipid extract (without precipitation), and the fractions precipitated and (or) remaining soluble after addition of cold acetone. Addition of increasing aliquots of lipid extracts to these three samples showed that: (a) measurement of surface tension rapidly and reliably indicates fetal lung maturity, and (b) both precipitated and soluble phospholipid fractions decrease surface tension similarly, making it unlikely that the precipitation step in fact separates surfactant and nonsurfactant material. PMID- 2720974 TI - Composition of very-low-density lipoproteins in non-insulin-dependent diabetes mellitus. AB - We studied the characteristics of very-low-density lipoproteins (VLDLs) composition in patients with non-insulin-dependent diabetes mellitus. VLDLs were isolated from 28 diabetics and 33 nondiabetics with a wide range of plasma lipid concentrations, so we could compare VLDL composition between the two groups at similar lipid concentrations. The mean cholesterol and triglyceride concentrations in plasma of diabetic subjects were 2170 (SD 570) and 2510 (SD 2230) mg/L, respectively, and 2230 (SD 560) and 2210 (SD 1830) mg/L in nondiabetics. Diabetic subjects showed positive correlations between plasma triglyceride concentrations and either preprandial blood glucose or glycated hemoglobin values (P less than 0.02 and less than 0.01, respectively). Concentrations of triglycerides, cholesterol, and apolipoproteins (apo) B, CII, CIII, and E in VLDL were not significantly different between diabetics and nondiabetics. At comparable triglyceride concentrations, the chemical compositions of the VLDL in the two groups were still very similar. Dividing the concentration of each component by the VLDL-apo B concentrations yielded similar contents of each component per unit of VLDL for the two groups. We conclude that the composition of VLDLs in diabetics is much the same as that in nondiabetics at comparable concentrations of triglycerides in plasma. PMID- 2720975 TI - Concentrations of lipids and apolipoproteins in patients with clinically well controlled insulin-dependent and non-insulin-dependent diabetes. AB - The triglyceride and cholesterol content of total, very-low-, intermediate-, low , and high-density lipoproteins, and of apolipoproteins (apo) Al, All, B, Cll, Clll, and E were determined in plasma from 107 patients with clinically well controlled diabetes and from 66 age- and weight-matched healthy normal subjects. The diabetic patients were separated into two groups: those with insulin dependent diabetes mellitus (IDDM, type 1, n = 24) and those with non-insulin dependent diabetes mellitus (NIDDM, type 2, n = 83). The latter group contained two subgroups: those treated by diet (type 2d, n = 42) or by insulin (type 2i, n = 41). High-density lipoprotein cholesterol was increased in IDDM patients, and decreased in NIDDM patients relative to control subjects. Mean apo Al values in IDDM patients were higher than in their respective controls and in NIDDM patients. Concentrations of apo B, Clll, and E were higher in all diabetic patients than in the healthy controls, but those of apo Cll did not differ statistically between diabetics and nondiabetics. Although total plasma cholesterol and triglyceride concentrations were apparently near normal values in patients with good glycemic control, we found a persistent increase of intermediate-density lipoproteins (remnants) in all the diabetic groups studied. This factor may be related to the perceived increased cardiovascular risk in these individuals. PMID- 2720976 TI - Enzymatic determination of potassium in serum. AB - This is a kinetic assay for measuring K+ in serum, based on the activation of pyruvate kinase (EC 2.7.1.40) by K+. We eliminated interference from Na+ and NH4+ ions, which also activate this enzyme, by including Na+-binding and NH4+ consuming reagents in the reaction mixture. The assay was developed with and evaluated in the Cobas Fara centrifugal analyzer (and has been used in other kinetic analyzers). Within-run and between-run CVs were less than 1.4% and less than 1.6%, respectively. The reaction rate per millimole of K+ per liter (0.05 delta A/min) was more than double that of the reagent blank (0.02 delta A/min). Results correlated well with those by flame photometry, and interference from bilirubin, hemoglobin, lipids, heparin, and other cations was negligible. This method, in conjunction with a previous method we have reported in which beta galactosidase is used for measuring Na+ in serum, offers a practical alternative to the use of ion-selective electrodes and flame photometry for measuring these clinically important monovalent cations in high-throughput or "stat" biochemical analyzers. PMID- 2720977 TI - Determination of the alkyl lysophospholipid derivative ET-18-OCH3, a new antineoplastic drug, in plasma. AB - We describe a sensitive method for measuring the concentration of the new antineoplastic drug ET-18-OCH3 in plasma. After plasma lipids are extracted, ET 18-OCH3 is separated from the excess of endogenous lipids by thin-layer chromatography and specific enzymatic hydrolysis of sphingomyelin by the action of sphingomyelinase. Analytical recovery after the complete isolation was 73.5% (CV = 9.8%, n = 15). [3H]-ET-18-OCH3 is used as internal standard. A densitometric method in which 8-anilino-1-naphthalenesulfonate, Mg salt, is used as fluorescent agent (excitation at 367 nm and emission greater than 390 nm) allows the sensitive determination of ET-18-OCH3 down to 0.1 mg/L (CV greater than 30%). The day-to-day CV is 25% for concentrations of 0.15 to 0.625 mg/L, 12% for 1.5 to 5.0 mg/L. Preliminary pharmacokinetic data reveal gastrointestinal absorption of ET-18-OCH3 after multiple oral administration. PMID- 2720978 TI - A simplified strategy for testing thyroid function. AB - We assessed a new strategy for thyroid-function testing that involves simultaneous measurement of free thyroxin and thyrotropin, both in singletons, with chemiluminescent assays. Using our current strategy of measuring free thyroxin as a first-line test with selected back-up testing, the results show that, of 810 patients without previous thyroid disease, 445 received back-up tests. Of these, 345 were euthyroid, whereas 63 classified as euthyroid and not selected for further testing in fact had abnormal back-up test results. Evidently the simultaneous measurement of free thyroxin and thyrotropin with the "Magic Lite" technology greatly improves diagnostic efficiency compared with this current strategy. PMID- 2720979 TI - An automated procedure for measuring biotinidase activity in serum. AB - In this automated procedure for quantifying biotinidase activity in human serum, a manual colorimetric method that measures conversion of the enzyme's artificial substrate N-biotinyl p-aminobenzoate was modified for use with a Technicon AutoAnalyzer II. The intra-run replicate precision (CV) was 2.1% and the day-to day CV was 4.6% for quality-control sera. Results were linearly related to biotinidase activity in serum over the complete range of clinically relevant values, 0.2 to 11.0 U/L. Moreover, results of the automated assay were not significantly different from those of the manual assay. Because the automated procedure is faster and more precise, we recommend it for population-based studies and some screening studies. PMID- 2720980 TI - Statistical interpretation of concentrations of magnesium, zinc, calcium, potassium, cholesterols, and creatine kinase isoenzymes in men at different stages of ischemic heart disease. AB - We present a statistical interpretation of plasma (Pl) and (or) erythrocyte (Erc) concentrations of magnesium, zinc, calcium, potassium, and total high-density lipoprotein (HDL) cholesterol, as well as of the activity of total creatine kinase (CK) and its CK-MB isoenzyme, in 26 men with pre-infarction syndrome (PIS) and 34 men with acute myocardial infarction (MI). Discriminant analysis allowed overall comparison of both groups and determination of the most significant variables: CK and Pl-Zn. By non-hierarchical cluster analysis we defined three homogeneous subgroups among MI men, with CK, CK-MB, and Pl-Zn differing significantly between the groups. In PIS men, Pl-Zn was correlated with Pl-Ca, whereas in MI men Pl-Zn was correlated with Pl-Mg. Stepwise regression indicated that Pl-Zn was the most significant regressor of CK in PIS men and of CK-MB in MI men. All these statistical interpretations support a special role of Pl-Zn in diagnosis and perhaps prognosis. After MI, interleukin-1 release may possibly mediate observed hypozincemia via formation of a heart Zn-metallothionein. PMID- 2720981 TI - Unreliable visual estimation of the incidence and amount of turbidity, hemolysis, and icterus in serum from hospitalized patients. AB - We examined the frequency of occurrence for turbidity, hemolysis, or icterus in 2599 serum samples submitted for chemistry testing in an acute-care general hospital. Each specimen was compared visually with full-color photographs of adulterated serum, and designated as either "0" (containing no interferent), or trace, 1+, 2+, 3+, 4+, or 5+. Visible interferents (1+ or greater) were thought to be present in 838 (31%) of the specimens (icterus, 525; hemolysis, 244; lipemia, 69). To assess the accuracy of such visual grading, we determined the concentration of triglycerides, hemoglobin, or bilirubin in the specimens considered to be contaminated. There was little agreement between the actual concentration of each interferent and the assigned grade of turbidity, hemolysis, or icterus, confirming the unreliability of human visual estimation of these potentially interfering substances. PMID- 2720982 TI - Correction of instrument- and reagent-based differences in determination of the International Normalized Ratio (INR) for monitoring anticoagulant therapy. AB - As recommended by the World Health Organization, standardization of prothrombin time assays involves conversion of prothrombin times into International Normalized Ratios (INR). We investigated the effect of two different methods (Nycomed's Thrombotest, and Instrumentation Laboratory's PT-fibrinogen) and three coagulation instruments (Schnitger & Gross, KC-10, and ACL) on calculations of INR. The INR plots showed considerable scatter of individual values around the regression lines when the two different methods were compared. Systematic differences in the outcome of INR calculation were related to the use of the different coagulation instruments. Prothrombin times obtained with the different instruments were linearly correlated. We used the bias of these lines to correct results for both the patients' samples and the reference samples. This correction yielded INR values from the different instruments that agreed well. PMID- 2720983 TI - Concentrations of some trace elements (Se, Zn, Cu, Fe, Mg, K) in blood and heart tissue of patients with coronary heart disease. AB - We measured Se, Zn, Fe, Cu, Mg, and K in blood and heart tissue of patients with coronary heart disease. Such patients have subnormal selenium concentrations in serum, whole blood, and (calculated per gram of hemoglobin) erythrocytes. Concentrations of zinc and copper in serum were also subnormal in these patients. Heart tissue collected from these patients during bypass surgery was analyzed for Se, Zn, Fe, Cu, Mg, and K; results are expressed in terms of wet weight and in relation to nitrogen and phosphorus content. Concentrations of these elements in blood are correlated with those in heart tissue. Selenium concentrations in serum correlated positively with those in tissue but not with those in erythrocytes. We found no association between concentrations of zinc, iron, copper, magnesium, and potassium in serum and the corresponding concentrations in heart tissue. There was a moderately positive correlation between the concentration of ferritin in serum and that of iron in tissue. We conclude that the turnover rate for selenium in tissue is similar to that in serum but greater than that for erythrocyte selenium. The concentrations of these six elements in heart tissue are partly correlated with the ejection fraction of the left ventricle. PMID- 2720984 TI - Fluorescence polarization immunoassay of gentamicin or netilmicin in blood spotted on filter paper. AB - In this improved simple method for determination of aminoglycoside antibiotics in dried-blood spots on filter paper, gentamicin or netilmicin is recovered from the blood spot most effectively by incubation for 60 min in an ultrafiltration tube containing 500 microL of 0.5 mol/L Na2HPO4 buffer. The eluates from the paper are centrifuged, then transferred to an Abbott TDx cartridge for measurement of gentamicin or netilmicin by fluorescence polarization immunoassay. The dried sample on paper is stable for about eight days at ambient temperature. Intra assay CVs for gentamicin and netilmicin are less than 8.5% and less than 6.1%, respectively. Analytical recovery of gentamicin and netilmicin from the paper exceeded 90%. This method permits simple blood collection and monitoring of the therapeutic concentration of gentamicin or netilmicin in serum, particularly that of newborn infants and small children. PMID- 2720985 TI - Lactate dehydrogenase isoenzyme patterns in serum of patients with metastatic liver disease. AB - Total lactate dehydrogenase (LD, EC 1.1.1.27) and LD isoenzymes were determined in serum of 170 patients with metastatic liver disease, 35 of whom had multiple metastatic sites. Overall, values of LD were above normal for 78% of the 170 patients. Half of the patients had an isomorphic pattern of LD isoenzymes (i.e., relative increase in all five isoenzymes); the other half had an increased LD-4,5 pattern, mostly a solitary increase in LD-5 only. Of those patients with normal LD values, 92% had the increased LD-4,5 pattern, whereas 70% of patients with LD values greater than 350 U/L had an isomorphic pattern of LD isoenzymes. All 35 patients with multiple metastatic sites had LD activity greater than 350 U/L; in the majority of them (74%) it was greater than 500 U/L; in 31 (89%), the increase was isomorphic. The diagnostic efficiency of the combined LD greater than 225 U/L (upper limit of normal) and increased LD-4,5 test results was much better than that of LD greater than 225 U/L alone (93% vs 74%). We conclude that serum LD and LD isoenzymes should be determined in every patient with suspected liver metastatic disease. The isomorphic pattern of LD isoenzymes is apparently associated with higher values for total LD and was common among the patients with multiple metastatic sites. PMID- 2720986 TI - Determination of trans-phylloquinone in children's serum. AB - By optimizing the conditions for determining trans-phylloquinone and its metabolite, K-2,3-epoxide, in serum through a two-step HPLC process combined with fluorometric detection after coulometric reduction, we have been able to develop a method applicable to small volumes of serum (200 to 500 microL). The limit of detection (signal-to-noise ratio of 3) was 15 ng/L for trans-phylloquinone, 30 ng/L for K-2,3-epoxide. The trans-phylloquinone concentrations measured by this method in serum from 82 children, ages one to six years, whose results were normal for overall coagulation tests, ranged from 40 to 880 ng/L (median 175 ng/L). We discuss these findings and compare them with vitamin K1(20) values reported for adults. PMID- 2720987 TI - Proficiency testing on drugs of abuse: one year's experience in Spain. AB - The need for external quality control for drugs-of-abuse urinalysis has long been recognized. Based on experiences in other countries, a proficiency testing program has been introduced recently in Spain. Sterile urine samples containing different concentrations of drugs and metabolites are analyzed by participating laboratories four times a year. Comprehensive educational reports reviewed by an advisory committee are released after each batch analysis. The first year's results verify (a) a beneficial influence of the program in regard to reducing errors when adequate techniques are used, (b) the need for using confirmatory techniques, and (c) the importance of experience and laboratory resources for optimizing results. The educational aspects of the program for the second year are stressing especially the in situ training of analysts and the supply of solutions of drugs and metabolites to be used as reference standards. PMID- 2720988 TI - Indirect measurement of desferrioxamine and its chelated compounds aluminoxamine and ferrioxamine by Zeeman atomic absorption spectrometry. AB - This indirect method for determination of desferrioxamine (DFO, deferoxamine, Desferal) and its chelated compounds ferrioxamine (FO) and aluminoxamine (AIO) in biological fluids involves metal chelate formation and solvent extraction, the metal being determined by Zeeman atomic absorption spectrometry (Zeeman-AAS). Special attention was paid to the pH and recovery of extraction, iron-aluminum interactions, extraction times and volumes, centrifugation rates, and instrument settings. Precautions were taken to avoid contamination with aluminum and iron and to prevent co-extraction of iron and aluminum not chelated to DFO. The addition calibration technique was used for standardization. Mean +/- SD recoveries of AIO and FO after extraction were respectively 98.3% +/- 3.7% and 101% +/- 3.7%. Sensitivity was 45 pg/0.0044 A.s for aluminum and 10 pg/0.0044 A.s for iron. Detection limits were 0.22 mumol/L for AIO, 0.06 mumol/L for DFO and FO. PMID- 2720989 TI - Bladder catheters and zinc contamination of urine. PMID- 2720990 TI - Albuterol: transdermal absorption and fingerprick blood-sample contamination from nebulizers. PMID- 2720991 TI - Monoject Amber samplette free of bilirubin photolysis. PMID- 2720992 TI - Status of drugs-of-abuse testing in urine under blind conditions: an AACC study. AB - We report results of a blind study designed to determine the accuracy of drugs-of abuse testing in urine as done in 31 laboratories across the United States. The drugs studied were amphetamines, cannabinoids, cocaine, opiates, and phencyclidine. These laboratories confirmed all positive drug results with a different analytical method. Ten urine samples were sent to each laboratory, which resulted in 1486 trials. There were no false-positive results. The overall accuracy rate was 97%. Our study demonstrates that urine drug testing can be accurate when performed by qualified staff, using up-to-date screening and confirmation methods, appropriate quality-assurance measures, and a chain of custody. PMID- 2720993 TI - Effect of storage temperature on concentrations of digoxin-like immunoreactive factor(s) in plasma. PMID- 2720994 TI - Creatine kinase MB isoenzyme in rhabdomyosarcoma. PMID- 2720995 TI - Benign transient hyperphosphatasemia in an adult with malignant lymphoma. PMID- 2720996 TI - More on ornithine decarboxylase. PMID- 2720997 TI - Increase of hypoxanthine during cardiac surgery, as measured by an indirect automated enzymatic assay. PMID- 2720998 TI - Indocyanine green interference in the Kodak Ektachem determination of total bilirubin. PMID- 2720999 TI - Sensitivity of CYCLO-Trac-SP (specific monoclonal immunoassay for cyclosporin A) PMID- 2721000 TI - The CV at the detection limit. PMID- 2721001 TI - Metabolism of androstenedione by placental microsomes in pregnancy hypertension. AB - The metabolism of [19-3H3]androstenedione by human placental microsomes was studied in vitro by radiometric analysis which distinguishes between 19 hydroxylation and elimination of the C-19 carbon. The ratio of the metabolic products tritiated water/tritiated formic acid is significantly greater for microsomes from patients with pregnancy hypertension when compared with normotensive pregnant women. This indicates that aromatization (2-hydroxylation) is deficient in pregnancy hypertension. PMID- 2721002 TI - Reversed-phase high-performance liquid-chromatography of 2,8-dihydroxyadenine in serum and urine with electrochemical detection. PMID- 2721003 TI - Alterations of acidic phospholipids in bronchoalveolar lavage fluids of patients with pulmonary alveolar proteinosis. AB - We analyzed phospholipids, especially the acidic phospholipids, i.e. phosphatidylglycerol (PG) and phosphatidylinositol (PI), of bronchoalveolar lavage (BAL) fluids from patients with pulmonary alveolar proteinosis. A significant decrease in PG and a concomitant increase in PI were found in the phospholipid of the patient's BAL fluids compared to that of normal subjects. Thus, the PG to PI ratio was significantly decreased in pulmonary alveolar proteinosis. These changes in the acidic phospholipids in BAL fluids of patients with pulmonary alveolar proteinosis appear to indicate that a switch-over in the synthesis of both acidic phospholipids from a same precursor CDP-diacylglycerol (CDP-DG) in alveolar Type II cells occurs in a such diseased state. However, since the molecular species profiles of PG and PI in the patient's BAL fluids were distinctly different from each other, the PG and PI present in the alveoli of the patients appeared to be derived from different pools of CDP-DG in alveolar Type II cells. PMID- 2721004 TI - Lymphocytes are the preferred cells for the measurement of blood coproporphyrinogen oxidase activity. PMID- 2721005 TI - Glycan microheterogeneity of alpha 1-acid glycoprotein in sera and dialysates of patients on continuous ambulatory peritoneal dialysis. AB - Total concentration and concanavalin (Con A) dependent microheterogeneity of alpha 1-acid glycoprotein (AGP) were studied in sera of eight chronic renal failure patients before the start of continuous ambulatory peritoneal dialysis (CAPD), and in sera and dialysate fluids for up to 6 months of CAPD. The glycan heterogeneity of AGP in the samples was expressed as a reactivity coefficient, i.e. the ratio of the Con A-reactive AGP components to the Con A non-reactive AGP component. Concentrations of AGP in serum and reactivity coefficients were markedly elevated in non-dialysed uraemic patients. AGP concentrations in serum increased further during the first week on CAPD, and then gradually decreased to pre-dialysis values, which were reached after 1 to 6 mth. The reactivity coefficients did not change significantly during the CAPD treatment. Dialysate AGP concentrations were low in comparison to those in serum, and there was a good correlation between the reactivity coefficients in the dialysate fluids and those in the corresponding sera. The effect of peritonitis was evaluated in a separate group of eight CAPD patients. Serum and dialysate AGP concentrations were significantly higher during than after peritonitis while the corresponding reactivity coefficients were only slightly elevated. PMID- 2721006 TI - Aberrant free radical activity in cystic fibrosis. AB - It has been suggested that the molar ratio of octadeca 9,11 dienoic acid to linoleic acid in biological material provides an index of activity along the non peroxide pathway of a free radical attack on polyunsaturated fatty acids. In 17 adults with cystic fibrosis the 'molar ratio' in nasal epithelial cells--a recognised target of the disease--exceeded that in 20 controls (median 2.09%, range 1.70-3.01% versus 1.56, 0.92-2.23%, p = 0.0002). The difference was also apparent, although less stark, upon analysis of serum in a further 22 CF patients (2.48%, 1.60-5.24%) and 25 controls (1.96%, 0.81-3.90%, p = 0.0348). There was no correlation between the 'molar ratio' and blood white cell count or erythrocyte sedimentation rate, severity of lung or liver disease, indicating that the raised values are a primary feature, rather than reflecting disease severity. Aberrant free radical activity may underlie cellular dysfunction in cystic fibrosis. PMID- 2721007 TI - Uptake of trihalomethanes by patients during hemodialysis. AB - Trihalomethanes (THM) present in tap water were also found in dialysis fluid because they were not eliminated by water treatment. THM, absorbed through the dialyser membranes, increased considerably in blood and in expired air of patients on hemodialysis during the dialysis sessions. The uptake of THM during each dialysis session was about 1 mg. PMID- 2721008 TI - Serum unconjugated bile acids in patients with small bowel bacterial overgrowth. AB - Concentrations of total and unconjugated bile acids in serum were measured fasting and 2 h postprandially in 9 patients with a positive [14C]glycocholate breath test consistent with small bowel bacterial overgrowth and in 13 controls. Gas-liquid chromatography-mass spectrometry (GLC-MS) and enzymatic-fluorometric assays were both used. In contrast to previous work, total serum bile acids were only occasionally elevated in patients with bacterial overgrowth. Total 2 h postprandial unconjugated bile acids, however, were elevated in 7/9 patients when measured by GLC-MS and in 6/9 when measured by the enzymatic-fluorometric method. The best separation between patients and controls was achieved by GLC-MS determinations of 2 h postprandial unconjugated cholic acid or primary bile acids, which were abnormal in 8/9 patients. This study indicates that measurement of serum bile acids may be a useful approach to the diagnosis of bacterial overgrowth, but would require accessible methods for separating and measuring cholic acid or unconjugated primary bile acids in post-prandial sera. PMID- 2721009 TI - Squamous cell carcinoma of the oral cavity: a retrospective analysis of treatment and prognosis. AB - A retrospective study of 267 patients with an oral cavity squamous cell carcinoma is presented. It includes all patients from a geographically well-defined area during an 11 and one-quarter year period. Thirty-five percent of the patients were treated with radical surgery, 40% with curative-dosage radiotherapy and 22% with combined therapy. One-year survival with No Evidence of Disease (NED) was 48%. Almost all recurrences were within the first year following completion of the initial treatment. Treatment results were especially ineffective in large local tumour cases (T3 and T4) and in instances with extensive regional lymph node metastases (N2 and N3). The observed 5-year survival ('crude survival') was 44%. All parameters for the course of disease following diagnosis and treatment were significantly correlated to disease stage. PMID- 2721010 TI - Conductive hearing loss assessment in children with otitis media with effusion. A comparison of pure tone and BERA results. AB - A comparison between pure-tone audiometry and brainstem electric response audiometry was made in 25 children with a conductive hearing loss due to otitis media with effusion. Pure-tone audiometry, including bone and air-conduction thresholds, was recorded using standard procedures. BERA was used to construct a latency-intensity function and from this the conductive hearing loss could be estimated. For all frequencies except for 2000 Hz a good correlation was found between the conductive loss in the pure-tone audiogram and the conductive loss as estimated by BERA. The moderate correlation for 2000 Hz is due to a 'Carhart' notch-like phenomenon in the pure-tone audiogram. PMID- 2721011 TI - Anatomical and functional reconstruction of old radical mastoidectomy cavities by obliteration tympanoplasty. AB - One hundred and seventeen patients who had previous radical mastoidectomies, atticotomies or Bondy operations were operated on between 1973 and 1984. An open technique with obliteration and traction meatoplasty was used in one stage in 19 ears (normal mucosa in mesotympanum) and in 2 stages in 98 ears (poor mesotympanum which needed to be dissected and covered with silastic sheeting). The second stage was performed 12 to 18 months later. Closure of the tympanic membrane was achieved in 93% of ears at the first stage. In 6 ears out of 81 second stages, residual cholesteatoma was found in the mesotympanum. No residual cholesteatoma was subsequently observed behind the flap but only 4 ears were checked behind the flap at the second stage. An air-bone gap within 20 dB was achieved in 85% of ears if the stapes was intact and surgery was performed in one stage, and in 55% of ears of the stapes was intact and surgery performed in 2 stages. If the crura were missing, an air-bone gap within 20 dB was achieved in 57% of ears in 2 stages. PMID- 2721012 TI - The effect of submucous resection of the nasal septum on mucociliary transport and nasal airway. AB - This paper reports changes in ciliary function following submucous resection of the nasal septum in 36 adult patients assessed by measuring mucociliary clearance time with a saccharine particle using the method described by Andersen et al. The alterations in mucociliary clearance time were compared with active anterior rhinomanometry. Following surgery, changes in symptoms of nasal obstruction as recorded by questionnaire were largely consistent with changes in mucociliary function and to a lesser extent with rhinomanometry. It is suggested that patients with a mucociliary clearance time of less than 10 min in the more blocked nostril may be less likely to benefit from surgery. PMID- 2721013 TI - Digital and mirror assessment of the adenoids at operation. AB - The size of an adenoid is generally considered to be a significant factor in the causation of Eustachian tube dysfunction and glue ear in children. We studied 120 consecutive cases of children undergoing adenoidectomy. Our aim was to assess the accuracy of the digital and mirror examinations in identifying adenoid size. Two surgeons of 1 and 2 years' experience in the speciality were found to have a statistically significant correlation between mirror examination and the amount of adenoid removed at operation. One surgeon of 4 years' experience was found to have a higher degree of correlation for both mirror and digital examinations. PMID- 2721014 TI - Carcinoma of the tonsillar region: surgical complications relative to the type of reconstruction. AB - The local and general complications in a series of 122 patients treated surgically for carcinoma of the tonsillar region are reported. Eighty-five of these patients were submitted to reconstruction with local or distant flaps, and in the remaining 37 patients primary closure was achieved. 28.2% of the flaps underwent marginal necrosis, and 11.8% total necrosis. Infection and the proportion of general complications were significantly higher in those patients submitted to reconstruction with flaps, whereas fistulae, necrosis of the cervical skin, rupture of the carotid artery and common general complications were not. Significant differences were not observed with respect to viability nor to complications between the different types of flaps, so that the choice of flaps should be based exclusively on other properties inherent in each flap. PMID- 2721015 TI - Cross-match requirements in head and neck surgery. AB - An audit of blood-ordering practices was carried out to compare the number of units of blood cross-matched and the number transfused during elective head and neck surgery. Routine cross-matching of blood for laryngectomy or radical neck dissection was found to be unnecessary, and it is suggested that a preoperative policy of blood grouping, screening for irregular antibodies and saving patients' serum be adopted. Should blood then be required, this procedure enables un crossmatched ABO-Rh(D) group specific blood to be released in an emergency with a high degree of safety. The routine cross-matching of blood can be supported for the remainder of the major head and neck operations, and guidelines as to the number of units that should be cross-matched are suggested. Implementation of these policies will reduce the number of units of blood unecessarily cross matched, decrease the amount of time-expired blood, and lead to increased efficiency of blood utilization. PMID- 2721016 TI - Sonotubometry: its role in childhood glue ear. AB - Sonotubometry is a relatively new technique for the measurement of Eustachian tube function. Two groups of children were studied: an abnormal group with a diagnosis of glue ear, and a control group of normal children. Sonotubometry testing showed tubal function to be normal in 80% of the control group compared with only 29% in the abnormal group. This difference is statistically significant. Furthermore, the reliability of sonotubometry testing as a predictor of glue ear was assessed and compared with the current methods of pre-operative assessment (pure tone audiometry, tympanometry, and otoscopy). Sonotubometry compares well, giving a correct prediction rate of 85%. In addition it has been shown that, unlike the other tests, sonotubometry testing was possible on all children studied. PMID- 2721017 TI - An objective method of assessing nasality: a possible aid in the selection of patients for adenoidectomy. AB - We present an appraisal of an objective technique for assessing nasality, or the nasal component of speech. Evidence suggests that a subjective impression of hyponasal speech is related to the adenoid volume and the radiographic palatal airway, although clinical assessments may have poor inter- and intra-observer agreement. Determination of the oral and nasal acoustic ratio or 'Nasalance' is quick, painless, and non-invasive. There was good agreement and reproducibility within normal subjects when test phrases were used. Words such as 'bananas' which contain nasal consonants showed large reductions in the Nasalance score when the nostrils were occluded and are of use in clinical assessment. This method may be of use in refining the selection of children for adenoidectomy. PMID- 2721018 TI - Local versus general anaesthesia in tonsillectomy. AB - Thirty-eight patients, suitable for tonsillectomy under local anaesthesia, were randomized and operated on under either local or general anaesthesia. The following parameters were compared: time in the operating room, duration of the operation, peroperative haemorrhage, number of ligatures required for haemostasis, postoperative haemorrhage, infection and weight loss. Post-operative discomfort was assessed using a visual analogue scale and a water drinking test. The total consumption of analgesic drugs in the post-operative period was recorded. The investigation shows that tonsillectomy under local anaesthesia, in suitable patients, is a safe alternative to tonsillectomy under general anaesthesia, and that considerable resources can be saved if the operation is performed with local anaesthesia. PMID- 2721019 TI - X chromosome instability associated with familial Turner syndrome. AB - A family with two members (two generations) exhibiting Turner syndrome is described. Cytogenetic studies on these individuals showed the presence of multiple X chromosome changes. Evidence is presented to show that the maternally inherited X chromosome is the chromosome involved in the structural alterations observed. The effect of a tendency of the maternal X chromosome to break at specific sites on the development of the Turner phenotype and abnormal karyology is discussed. PMID- 2721020 TI - Ehlers-Danlos syndrome: a new oculo-scoliotic type with associated polyneuropathy? AB - Two siblings born to consanguineous Bedouin parents and grandparents are reported with the phenotypic features of Ehlers-Danlos Syndrome (EDS), type VI. In addition, the affected individuals have a polyneuropathy as confirmed by nerve conduction velocity, electromyographic and muscle biopsy studies. We propose that this clinical combination represents a distinct type of EDS. PMID- 2721021 TI - Hutchinson-Gilford progeria syndrome: report of a Libyan family and evidence of autosomal recessive inheritance. AB - A Libyan family with the Hutchinson-Gilford progeria syndrome affecting three children of two sisters is described. The proband was ascertained because of repeated unhealing fractures. The pattern of inheritance appeared autosomal recessive. PMID- 2721022 TI - Chromosomal abnormalities in amniotic fluid cell cultures: a comparison of apparent pseudomosaicism in Chang and RPMI-1640 media. AB - The finding of chromosome mosaicism is one of the most difficult problems in fetal chromosome analysis. Whether the finding indicates true mosaicism or pseudomosaicism must be investigated. Studies detailing the incidence of true mosaicism and pseudomosaicism have been reported (Hsu & Perlis 1984, Bui et al. 1984, Worton & Stern 1984) but do not correlate pseudomosaicism with any particular type of culture media. Benn & Hsu (1985) compared cell growth and chromosome abnormalities in amniotic fluid cell cultures grown in Chang medium and RPMI-1640 medium and found no statistically significant difference in the rate of abnormalities in the two media. We have previously shown that Chang medium exhibited more abnormalities which were not verified in second and third cultures (Masia et al. 1986). In the current study we examined 212 cases grown in both Chang and RPMI-1640 media, and compared apparent single and multiple cell pseudomosaic abnormalities to medium type. The number of observed abnormalities was 22, occurring in 19 of the cases studied. Apparent pseudomosaic chromosome anomalies were observed in 18 Chang cultures and in 4 RPMI-1640 cultures. Statistical analysis found significant correlation between medium type and the degree of observed pseudomosaic cells. We conclude that the rate at which pseudomosaic cells are observed is partly a function of medium type, and in our laboratory Chang medium caused apparent pseudomosaicism at a greater level than RPMI-1640 medium. PMID- 2721023 TI - Dual porphyria in double heterozygotes with porphobilinogen deaminase and uroporphyrinogen decarboxylase deficiencies. AB - A coexistent dual deficiency of porphobilinogen deaminase (PBG-D; EC 4.3.1.8) and uroporphyrinogen decarboxylase (EC 4.1.1.37) in erythrocytes was recognized in five individuals, four males and one female. Clinically, the female and one male were diagnosed as suffering from acute intermittent porphyria (AIP), and the other two males were diagnosed as having porphyria cutanea tarda (PCT). Biochemically, the excretion pattern of urinary and fecal heme precursors exhibited a complex constellation with signs characteristic for both AIP and PCT. A coexistent dual enzyme deficiency of PBG-D and URO-D could be confirmed by repeated studies over 10 years. Clinical courses of both disease manifestations were observed. Family investigations have shown that the two disorders do not consistently segregate together. The findings suggest that the dual porphyria reflects a double heterozygous condition of coexistent AIP and PCT genes in the same individual. PMID- 2721024 TI - Autosomal dominant lamellar ichthyosis exhibits an abnormal scale lipid pattern. AB - Autosomal dominant lamellar ichthyosis (ADLI) is a recently recognized genetic skin disorder. Clinically and histologically, it cannot be distinguished with certainty from the more frequent autosomal recessive lamellar ichthyosis (ARLI), which in itself may still be heterogeneous. By ultrastructural examination of ADLI a prominent transforming zone between the stratum granulosum and stratum corneum and lipid inclusions in the stratum corneum have been observed. Using sequential high-performance thin-layer chromatography, we studied the plantar scale lipid pattern of two patients, mother and daughter, affected with ADLI. We found a distinctive alteration in the relative composition of the scale lipid pattern characterized by excessive amounts of free fatty acids, triglycerides, elevated n-alkanes, reduced free sterols and decreased total ceramides. This scale lipid profile clearly differs from that of the erythrodermic and non erythematous variants of ARLI and confirms that this disorder is a distinct entity of the heterogeneous group of lamellar ichthyoses. PMID- 2721025 TI - Phenotype variability in the Miller acrofacial dysostosis syndrome. Report of two further patients. AB - In this report we present two unrelated patients with the postaxial dysostosis syndrome (Miller syndrome) and document further the phenotypic variability of the craniofacial stigmata and of the postaxial (and preaxial) upper and lower limb reduction anomalies. PMID- 2721026 TI - Bloom's syndrome. XIV. The disorder in Japan. AB - Fourteen persons have been diagnosed Bloom's syndrome in Japan, with cytological verification in 11. Widely separated birthplaces throughout Honshu, Shikoku, and Kyushu and a parental consanguinity incidence greater than in the general population suggest that the Bloom's syndrome mutation, although very rare, is distributed widely throughout the Japanese population. The locus mutated is the same as in Jews and persons of Western European extraction. The phenotype differs somewhat from most cases recognized elsewhere, in that dolichocephaly is a less constant feature, the facial skin lesion is less prominent, and life-threatening infections are less common. The characteristic predisposition to neoplasia exists, however, as probably does that to diabetes mellitus. PMID- 2721027 TI - Evidence that increases in circulating catecholamines of adrenal origin are not involved in pressor response to bilateral carotid occlusion in anaesthetized dogs. AB - 1. We studied whether or not circulating catecholamines of adrenal origin play a major role in cardiovascular responses evoked by bilateral carotid artery occlusion (3 min) in anaesthetized dogs. 2. In the control group, the following parameters increased significantly (P less than 0.05) during bilateral carotid occlusion: aortic systolic pressure, heart rate, net adrenal catecholamine output, net renal noradrenaline output, and plasma catecholamine concentrations in aortic blood. Similar responses were obtained during the second occlusion performed approximately 25 min after the first occlusion. 3. After functional adrenalectomy (ADRX: diversion of adrenal venous blood flow), the increase in aortic adrenaline concentration observed during bilateral carotid occlusion was abolished. The increase in aortic noradrenaline concentration during the occlusion was significantly attenuated by approximately 60% (P less than 0.01) after ADRX. 4. The increase in net renal noradrenaline output during bilateral carotid occlusion after ADRX was not different from that observed before ADRX. Similarly, the response of aortic systolic pressure and heart rate during the occlusion was unaffected by ADRX. Furthermore, the increase in net adrenal catecholamine output during the occlusion was not affected by ADRX itself. 5. From these results, we conclude that the increase in circulating catecholamines of adrenal origin during bilateral carotid occlusion is not a major determinant for the increases in aortic pressure and heart rate. The results suggest that these cardiovascular responses during the occlusion are mediated principally by neuronal noradrenaline released from peripheral sympathetic nerve terminals. PMID- 2721028 TI - Inhibition of vasoconstriction by platelet activating factor in the in situ blood perfused rat mesentery. AB - 1. Perfusion pressure was measured in the in situ mesentery of anaesthetized rats perfused with blood at a constant 2 mL/min. 2. Increases in perfusion pressure were produced by mesenteric peri-arterial nerve stimulation at 10 Hz for 5 s at 2 min intervals and by bolus intra-arterial injections of the vasoconstrictors noradrenaline, angiotensin II and 5-hydroxytryptamine. 3. The intra-arterial infusion of platelet-activating factor (PAF) to produce a blood concentration of 3 X 10(-10) mol/L inhibited all responses to a similar extent. Intra-arterial prazosin (1-5 X 10(-9) mol/L), however, preferentially reduced responses to nerve stimulation and noradrenaline. 4. PAF at concentrations from 3 X 10(-11) to 10( 9) mol/L produced increasing inhibition of vasoconstrictor responses to nerve stimulation. The dose-response to PAF was shifted to the right by the concomitant intra-arterial infusion of the PAF antagonist SRI 63-441. 5. PAF at very low concentrations in vivo inhibits mesenteric vasoconstriction, produced by sympathetic nerve stimulation or various agonists, by a PAF-receptor mediated vasodilatation of the mesenteric vasculature. PMID- 2721029 TI - Effects of subacute opioid administration during late pregnancy in the rat on the initiation, duration and outcome of parturition and maternal levels of oxytocin and arginine vasopressin. AB - 1. The effects, on parturition in the rat, of subacute and acute opioid administration were studied. Further experiments investigated the role of modulation of maternal plasma and pituitary oxytocin (OXY) and arginine vasopressin (AVP) levels in these effects. 2. Subacute opioid (M320, buprenorphine or bremazocine) administration prolonged the gestation of rats. This was accompanied by toxic effects on the offspring. Acute subcutaneous (s.c.) M320 (10 micrograms/kg) administration was accompanied by prolonged gestation without toxic effects. 3. Subacute M320 (10 micrograms/kg, s.c., twice daily) treatment was accompanied by increased interbirth intervals in parturient rats. 4. Maternal OXY but not AVP release, as assessed by measurement of plasma and pituitary immunoreactivity, was elevated during and up to 1 h after the completion of parturition. Subacute M320 treatment did not inhibit this elevated OXY release. PMID- 2721030 TI - Characterization of single heart cell contractility by rapid imaging. AB - 1. A rapid imaging technique with temporal resolution of about 1 ms was employed to describe cell-length changes during the isotonic contraction cycle of adult rat ventricular myocytes at 22 degrees C. 2. Parameters of cell contraction and relaxation were defined and values obtained under control conditions and after treatment with 5 mumol/L verapamil. 3. Over 15 min, verapamil dramatically reduced the maximum shortening attained. This was associated with delay in both excitation-contraction coupling latency and the time at which maximum rate of shortening occurred. However, peak shortening was recorded earlier in the contraction cycle. Total cell-cycle time was abbreviated under the influence of verapamil and maximum rates of shortening and lengthening were depressed in a similar manner. 4. The results highlight the value of improved temporal precision in describing myocyte contractility and validate the use of the parameters defined in the single-cell model for the study of the mechanisms of action of cardiotonic agents. PMID- 2721031 TI - Natriuretic and hypotensive effects of brain natriuretic peptide in anaesthetized DOCA-salt hypertensive rats. AB - 1. Both natriuretic and hypotensive effects of brain natriuretic peptide (BNP), a novel peptide identified in porcine brain, were investigated in anaesthetized DOCA-salt rats and control rats. 2. An intravenous injection of two different doses (0.5 and 5.0 nmol/kg) of BNP produced a rapid and marked natriuresis and hypotension in DOCA-salt rats. 3. In particular, significant differences of responsiveness were observed between DOCA-salt and control rats when administered the lower dose of BNP. 4. It was suggested that DOCA-salt rats might be relatively more susceptible to BNP. PMID- 2721032 TI - Digoxin enhances the pressor response to aldosterone administration in conscious sheep. AB - 1. This study examined the hypothesis that inhibition of Na,K ATPase with digoxin would enhance the pressor response to aldosterone infusion in conscious sheep. 2. While intravenous infusion of digoxin (10 micrograms/kg per day for 5 days) had no effect on blood pressure and aldosterone infusion (6 micrograms/kg per day for 5 days) increased blood pressure by 7 mmHg, combined infusion of digoxin and aldosterone increased blood pressure by 17 mmHg. 3. The metabolic effects of the combined digoxin and aldosterone infusion were similar to those for aldosterone alone, suggesting that digoxin did not enhance the mineralocorticoid action of aldosterone. 4. The results of this study suggest that changes in Na influx (aldosterone-dependent) and efflux (digoxin-dependent) are important in the genesis of aldosterone-induced hypertension. PMID- 2721033 TI - Glomerular and serum immunoglobulin G subclasses in IgA nephropathy. AB - The distribution of human IgG subclasses among mesangial glomerular deposits of 11 patients with IgA nephropathy (IgA-N) was examined by indirect immunofluorescence with subclass-specific mouse monoclonal antibodies (mAb). A subclass restriction was observed with mesangial deposits containing almost exclusively IgG1 (81% of the studied biopsies) and IgG3 (64%). IgG2 was present in only 1 out of the 11 cases studied and IgG4 was never found to be present, although seven different anti-IgG4 mAb were used. In addition, serum levels of total IgA and IgG, as well as serum IgG subclass levels, were measured in 27 patients with IgA nephropathy by an indirect competitive immunoenzymatic assay using mAb. It was noted in IgA-N patients, but not in normal individuals, that there was significant positive correlation between total IgA and IgG serum levels which was entirely due to a positive correlation between total serum IgA and IgG2 levels. This study provides no explanation for the subclass restrictions observed but suggests that (i) the presence of IgA-IgG1-IgG3 in mesangial deposits may be secondary to an antigenic stimulation, possibly viral, and (ii) the positive correlation between IgA and IgG2 serum levels may result from an increased T helper function. PMID- 2721034 TI - Augmentation of natural cytotoxicity by leucine enkephalin in cultured peripheral blood mononuclear cells from patients infected with human immunodeficiency virus. AB - Natural Killer (NK) activity of lymphocytes from acquired immunodeficiency syndrome (AIDS) patients is frequently below normal and declines as disease progresses. We studied the potential of leucine enkephalin (leu-enkephalin) to restore this immune parameter by incubating nylon wool nonadherent mononuclear cells from 14 patients in the presence or absence of leu-enkephalin, and measuring NK cytolysis in a standard 51Cr release assay. The NK activity of human immunodeficiency virus antibody positive (HIV+) individuals with some remaining NK lytic ability was significantly augmented by leu-enkephalin concentrations of 10(-10) and 10(-8) M (n = 7). HIV+ patients with no measurable basal level of NK activity (n = 3) were not responsive to stimulation with leu-enkephalin. Human immunodeficiency virus antibody negative (HIV-) individuals (n = 4) responded in a pattern similar to normals. In addition, naloxone, an antagonist of alkaloid and peptide opiates including leu-enkephalin, displayed the properties of an antagonist/agonist, reflecting the immunoregulatory capacities of the endogenous opiate system. PMID- 2721035 TI - Serologic response against cardiolipin and enterobacterial common antigen in young patients with acute myocardial infarction. AB - Elevation of anticardiolipin antibodies has been observed in myocardial infarction and in many infections. To elucidate this topic, paired serum specimens from 40 patients with acute myocardial infarction were tested for anticardiolipin antibodies (solid-phase enzyme immunoassay) and enterobacterial common antigen antibodies (indirect hemagglutination test). Forty-one randomly selected individuals and 30 patients with chronic coronary heart disease served as controls. All individuals were males whose maximum age was 50 years. In patients with acute myocardial infarction the levels of anticardiolipin antibodies in paired sera rose significantly in all immunoglobulin classes (18% in the IgG class, 26% in the IgA class, and 43% in the IgM class), whereas no elevations occurred in the other groups. Fifteen of the acute myocardial infarction patients also showed at least a fourfold increase in enterobacterial common antigen antibodies, as compared with only one such increase in the two other groups combined. The increases were less marked than those seen in pronounced enterobacterial infections. These two reactions were closely associated. PMID- 2721036 TI - Department of Army lymphocyte immunophenotyping quality assurance program. AB - With the emergence of the human immunodeficiency virus (HIV) epidemic, lymphocyte immunophenotyping has become the single most important laboratory test for clinical management of HIV-infected subjects. To meet this challenge, the department of Army instituted a multicenter lymphocyte immunophenotyping quality assurance (QA) program in March 1986. An integral part of the QA program has been the development of a monthly proficiency testing program to survey the degree of precision and reproducibility of lymphocyte subset determinations within the Army. After 15 months of proficiency testing, the multicenter cumulative average standard deviation for the percentage of positive CD2 was 3.3, CD3 was 4.4, CD4 was 3.3, CD8 was 3.6, CD8*CD3 was 2.8, CD19/20 was 2.9, and 3.0 for natural killer (NK) cells. The cumulative average coefficient of variation for the percentage of positive CD2 was 3.9%, CD3 was 4.9%, CD4 was 6.6%, CD8 was 11.4%, CD8*CD3 was 9.4%, CD19/20 was 18.8%, and 26.5% for NK. Five survey shipments were also shipped to an additional 49 laboratories outside the Department of Army. The difference of the mean Army percentage positive values from the mean overall percentage positive values ranged from zero to 9.6, with an average difference of 1.6. The interlaboratory variability of flow cytometrically-derived percentage values presented in this report are almost half that cited by other multicenter lymphocyte comparative studies. PMID- 2721037 TI - Multicenter clinical trials: an optimistic view of their worth. PMID- 2721038 TI - Pericardial effusion early in acute myocardial infarction. AB - The incidence and significance of pericardial effusions early in acute myocardial infarction remain unclear. Using two-dimensional echocardiography, 172 patients with an acute myocardial infarction were evaluated within 72 h of presentation. Thirty patients (17%) had a pericardial effusion (29 small, 1 moderate) while 142 (83%) did not. No patient developed cardiac tamponade or required pericardiocentesis. Patients with pericardial effusions had higher peak creatine kinase as compared to patients without effusions (2036 +/- 1466 vs. 1483 +/- 1241, p less than 0.05) and a greater number of aneurysms (20% vs. 6%, p less than 0.05). In-hospital mortality was higher in the patients with pericardial effusions (10% vs. 2%, p less than 0.05). In conclusion, pericardial effusions are common in the early AMI period but are generally small and hemodynamically insignificant. They are associated with larger infarcts and greater mortality. PMID- 2721039 TI - Does ergometric stress test induce a procoagulative condition in patients with previous myocardial infarction? AB - A regularly scheduled physical training program seems to have antithrombotic effects. Moreover, the hemostatic changes occurring in patients with coronary artery disease during acute exercise have not been clearly elucidated. Since stress testing is routinely performed in clinical cardiology, it would be helpful to assess whether patients with coronary artery disease are exposed to acute coronary thrombosis during or soon after sustained physical exercise. This study was designed to evaluate the effect of acute physical exercise (stress test by bicycle ergometer) on blood coagulation in a group of patients with previous myocardial infarction, and to determine whether the antithrombotic therapy commonly administered favorably influences hemostatic equilibrium. Our results suggest that exercise testing is not harmful to patients with previous myocardial infarction in regard to hemostasis and fibrinolysis and that antithrombotic therapy reduces postexercise increase in platelets. PMID- 2721040 TI - Inadvertent permanent ventricular pacing from the coronary vein: an electrocardiographic, roentgenographic, and echocardiographic assessment. AB - The incidence of inadvertent permanent ventricular pacing from the coronary vein is not known. In a retrospective analysis of 69 patients in whom transvenous pacemakers were implanted between 1979 and 1986, 12 patients were discovered to have right bundle-branch block pattern to the paced complexes on electrocardiogram. In this group, three patients were considered to have inadvertent placement of pacing lead in the coronary vein by two-dimensional echocardiographic criteria. No complications were noted in follow-up of 2-79 months. Monitoring of surface electrocardiogram, frontal and lateral fluoroscopy, and pacing threshold and sensing parameters (during implantation of pacemaker) were found to offer no absolute protection against malplacement of the lead. Placement of the lead into the lung field via the main pulmonary artery and then withdrawing with eventual positioning into the right ventricular apex will avoid malposition into the coronary vein. Two-dimensional echocardiography is useful for the diagnosis of pacing lead malplacement and should be performed in any patient with right bundle-branch block pattern in the surface electrocardiogram following pacemaker implantation. PMID- 2721041 TI - Peripheral white matter lesions of the spinal cord with changes in small arachnoid arteries in systemic lupus erythematosus. AB - The spinal cords of two autopsy cases of systemic lupus erythematosus (SLE) (case 1, 34-year-old woman; case 2, 40-year-old woman) showed lesions restricted to the periphery and frequent changes in small arteries in the spinal subarachnoid space. There had been clinical cord involvement in both cases, for two months (case 1) and six years (case 2) before death, respectively. The spinal cord of case 1 had circumferentially located, multiple, round, spongy, sometimes necrotic, lesions, containing many swollen axons. Even the apparently spared peripheral regions showed moderate axon loss. Observation of serial sections of the cord revealed the direct connection of some occluded subarachnoid small arteries with vessels within the spongy lesions, indicating the responsibility of the vascular changes for the cord lesions. In case 2, the whole length of the spinal cord showed marked axonal loss in the entire circumferential white matter. Groups of old axonal retraction balls and localized spongy changes were occasionally observed at the periphery. The affected peripheral zone coincided with the region supplied by marginal arteries. These observations suggest that primary vascular lesions, followed by secondary degeneration of axons, played fundamental roles in the development of this unique lesion in case 2, and that localized changes such as those observed in case 1 gradually develop into the continuous lesion seen in case 2. PMID- 2721042 TI - Neuropathologic findings in three cases of profound hypoglycemia. AB - Three clinical cases of profound hypoglycemia are described with survival periods ranging from 2 1/2 months to 6 years. Although prolonged clinical coma was present in all cases, only subtle evidence of neuronal loss was found. The value of immunohistochemical examination of the grey and white matter of the telencephalon in detecting evidence of neuronal loss in such cases is demonstrated. Infarcts were uniformly absent, as would be expected from the lack of cerebral acidosis in hypoglycemia. In addition to the usual absence of infarction, the pathologic findings in hypoglycemia distinguish themselves from hypoxic/ischemic encephalopathy in that the cerebellum is regularly spared, and that there is sometimes a characteristic involvement of the dentate gyrus, a structure relatively resistant to hypoxic/ischemic damage. PMID- 2721043 TI - A new case of Ullrich's disease. AB - A new case of congenital, hypotonic-sclerotic muscular dystrophy is presented. The patient showed congenital hyperlaxity and looseness of distal joints, muscle weakness, and spur-like protrusion of the calcaneus. Afterwards rapid progressive contractures of both knees and hip joints developed. Muscle biopsies revealed unequivocal dystrophic abnormalities and small atrophic fibers with numerous foldings of basal lamina suggestive of a neurogenic lesion. The disease presents clinical variability but the diagnosis is possible when a newborn shows: no dominant family history, slender body, marked distal joint laxity and hyperflexibility, proximal joint contractures and normal or slightly increased serum enzymes. PMID- 2721044 TI - Early progressive supranuclear palsy: pathology and clinical presentation. AB - Progressive supranuclear palsy (PSP) is a syndrome of supranuclear ophthalmoplegic palsy, pseudobulbar palsy, rigidity of the limbs, nuchal dystonia, and dementia in which the gaze palsy is the hallmark of the disease. Most neurologists are reluctant to consider the diagnosis unless visual problems exist. Since the earliest complaints of PSP are said to be variable and subtle, accurate diagnosis is often delayed and initial pathologic changes of the disease not well studied. Two patients came to autopsy with dementia, gait disturbances, and/or dysarthria but no eye findings by history or physical exams. Symptoms had been attributed to metastatic cancers. At autopsy prominent globose neurofibrillary tangles with variable cell loss, microglial nodules, and neuronophagia were found in the locus ceruleus, third cranial nerve complex, nucleus supratrochlearis, nucleus centralis superior, and nucleus basalis of Meynert with mild pallor of the globus pallidus, mild cell loss in the dentate nucleus of the cerebellum, and sparing of the superior colliculus. The diagnosis of early PSP was made. These cases serve to 1) detail the more limited neuropathologic changes in early PSP, 2) reemphasize that the earliest clinical symptoms of PSP are not gaze palsies, and 3) remind clinicians to consider PSP in their differential diagnosis in patients with gait disturbances, dementia, and/or dysarthria, and 4) document PSP in association with carcinoma in two cases. PMID- 2721045 TI - Brain morphology in the Galloway syndrome. AB - The Galloway syndrome is a rare autosomal recessive disease consisting of congenital microencephaly associated with congenital nephrotic syndrome, and in some cases with hiatus hernia [Galloway and Mowatt, 1968]. The case presented is that of a microencephalic infant with the nephrotic syndrome who died at 11 3/4 months after a course characterized by convulsions, developmental delay, hypotonia and hyperreflexia. Brain weight was 270 g. The frontal, parietal, and rostral temporal cortex was pachygyric. Microscopically there was lack of cortical stratification, immature cortical neurons, improper orientation of cortical neurons (seen in the Golgi stained sections), and glioneuronal ectopias in the leptomeninges. There was hypomyelination in the brain stem and spinal cord, and no myelin in the hemispheres. There was also complete absence of the internal granular layer of the cerebellum. The dentate gyrus within the hippocampal formation was absent and the inferior olivary nuclei were hypoplastic. The mechanism of neuronal migration abnormalities and the significance of associated nephrosis is discussed. PMID- 2721047 TI - The severely traumatized lower limb: reconstruction versus amputation. PMID- 2721046 TI - Choroid plexus hemangioma with glial nodules in a premature stillborn study. AB - An unruptured hemangioma (vascular malformation) of the choroid plexus of the lateral ventricle in a premature stillborn baby is described. Along the flattened choroid plexus epithelium covering the hemangioma there were small, discrete glial nodules which stained strongly and diffusely for glial fibrillary acidic protein (GFAP). The glial nodules were devoid of surface epithelium and confined within the basement membrane region of the choroid plexus epithelium. GFAP positive cells were not present elsewhere in the choroid plexus. The histogenesis of the glial nodules, whether they have resulted from glial differentiation of reactive choroid plexus epithelium or represented glial heterotopia, remains uncertain. PMID- 2721048 TI - Anatomy of the axillary nerve and its relation to inferior capsular shift. AB - Axillary nerve injury is a recognized complication of the capsular slide procedure for multidirectional instability of the shoulder. Axillary nerve dissection followed by an anterior or posterior capsular shift procedure was carried out on 12 autopsy subjects to observe: (1) the normal relationships of the nerve; (2) its proximity to structures dissected in the procedure; and (3) the effects upon it of both anterior and posterior capsular shift procedures. The axillary nerve arises immediately posterior to the coracoid process and conjoint tendon. It crosses the inferolateral border of the subscapularis 3 to 5 mm medial to its musculotendinous junction, and it lies in intimate contact with the inferior capsule as it passes through the quadrilateral space. The nerve should be visualized prior to transecting the subscapularis tendon. During detachment of the inferior capsule from the humeral neck, the humerus should be gradually externally rotated, and the nerve should be gently retracted with a small flat instrument. Sutures reattaching the flap should be carefully placed to avoid injuring the nerve. The tendinous insertion of the teres minor is preserved from a posterior approach. The nerve can be visualized and protected during capsular detachment. PMID- 2721049 TI - Failed anterior acromioplasty. A review of 51 cases. AB - This report is a retrospective review of 51 patients, each of whom had a failed acromioplasty that was performed after presumptive diagnoses of impingement tendinitis. The purpose of the review is to analyze the failures, define their causes, and make recommendations regarding further management. Average age at time of initial surgery was 40 years (range, 20-64 years), and the follow-up period averaged 5.5 years (range, three to nine years). Thirty-four patients were found to have symptoms and signs that corresponded to a recognized clinical diagnosis and were thought to be sufficient to be a major cause of their pain. Twenty-three had a diagnosis other than continuing impingement. Success of a second surgical procedure was significantly greater in nonworker's compensation (WC) patients than in WC patients. Repeat acromioplasties in WC patients have poor results and are not recommended. Seventeen patients had no clear cause for their continuing shoulder tendinitis; however, time and supportive therapy allowed five patients to improve over an average 18-month period. In all categories, WC patients fared poorly, so prognosis must be guarded in this group. Non-WC patients may be helped with repeat surgery following an appropriate diagnosis for the cause of failure. PMID- 2721050 TI - Percutaneous cannulated screw coracoclavicular fixation for acute acromioclavicular dislocations. AB - In 1941, Bosworth introduced a new method of repairing acute complete acromioclavicular dislocations in which a noncannulated coracoclavicular lag screw was inserted by a blind technique. The author reintroduces the percutaneous coracoclavicular fixation concept. A cannulated screw was specially designed, and the technique of percutaneous insertion under fluoroscopic image control was developed. Fifty-three acromioclavicular dislocations were treated by this method. There were 40 Type III, five Type IV, and three Type V dislocations with distal clavicle fractures in conjunction with complete coracoclavicular ligament tears. Technical failures, which occurred in 17 of 53 patients (32%) included: failed percutaneous insertion in two; early screw pullout in three; late screw pullout in four; subluxation after screw removal in six; and malreduction of Type IV dislocation in two. There was no screw breakage or evidence of migration. Serous drainage occurred in two patients. PMID- 2721051 TI - The glenoid-labral socket. A constrained articular surface. AB - An anatomic study was designed to test the hypothesis that the articular surface of the glenoid fossa and labrum produces a composite socket of significant depth. Measurements were obtained from 25 anatomic specimen shoulders. The glenoid articular surface and labrum combine to create a socket that is approximately 9 mm deep in the superoinferior (SI) direction and 5 mm deep in the anteroposterior (AP) direction. The circular, pliable, fibrous labrum contributes approximately 50% of the total depth of the socket. Detachment of the labrum anteriorly, as in a Bankart lesion, may reduce the depth of the socket in the AP direction from approximately 5.0 to 2.4 mm. These anatomic observations provide some evidence that the socket may be an important factor in shoulder stability. Further in vivo kinematic studies of shoulders will be needed to better define the stabilizing role of the glenoid-labral socket. PMID- 2721052 TI - Classification and management of acetabular abnormalities in total hip arthroplasty. AB - Total hip arthroplasty, for both primary and revision operations, frequently involves bony abnormalities of the acetabulum. No standard nomenclature currently exists for the definition of acetabular deficiencies. A classification system is presented to assist in the preoperative evaluation and to provide a treatment protocol for these defects. PMID- 2721054 TI - The survival of the cemented femoral component of a total hip replacement. AB - A series of 1321 total hip arthroplasties including 238 primary revisions (18%) were evaluated to identify intrinsic factors of the femoral canal that might influence the success of a cemented total hip replacement. A survival analysis was used to compare the success rates of cemented femoral components. These were classified into five groups according to the condition of the medullary canal at the time of surgery: primary surgery, aseptic cemented loosening, failed noncemented hemiarthroplasty, previous septic failure, or fractured femoral prosthesis with rigid distally fixed cement. The overall survival rates of the five groups were found to be significantly different (p less than 0.01). Specifically, the success rates of recemented revisions for aseptic loosening were significantly lower than those for primary total hip replacements (p less than 0.01). No statistical difference was found between the success rates of primary surgeries and the revision success rates for septic failure or for a fractured femoral component. PMID- 2721053 TI - The use of somatosensory evoked potential during revision or reoperation for total hip arthroplasty. AB - Somatosensory evoked potential (SSEP) was used to continuously monitor the sciatic nerve intraoperatively during revision or reoperation for total hip arthroplasty. Of 25 cases monitored, eight patients (32%) exhibited 12 instances of SSEP deterioration, indicating neurologic compromise. These neurologic problems were due to retraction in seven cases and limb positioning in five. No postoperative neurologic deficits were noted in this group. Two of 35 patients (5.7%) not monitored had postoperative neurologic deficits. SSEP monitoring is a useful method for minimizing the intraoperative risks of clinical neurologic deficits during revisions or difficult reoperations. PMID- 2721055 TI - Evaluation of patients for high tibial osteotomy. AB - Fifty-one osteoarthritic knees evaluated by arthroscopic, roentgenographic, and clinical examinations prior to high tibial valgus osteotomy were reevaluated roentgenographically and clinically after a minimum follow-up period of five years (average, 6.2 years; range, 5-8.3 years). The number of good and excellent results decreased over time but was unrelated to the preosteotomy condition of the lateral and patellofemoral compartments as documented by arthroscopy. Knees with 7 degrees to 13 degrees of valgus angulation at the follow-up evaluation had significantly better results than knees with less than 7 degrees of valgus, regardless of the arthroscopic findings. Preosteotomy arthroscopic findings had no predictive value in evaluating patients for this procedure. PMID- 2721056 TI - Steroid-induced bilateral avascular necrosis of the lateral femoral condyles. A case report. AB - Osteonecrosis of both lateral femoral condyles was observed in a 42-year-old black woman under treatment with oral prednisone. She was treated by arthrotomy and debridement on the right side and conservative management on the left side. Lateral compartment osteonecrosis is most frequently associated with steroid therapy, but bilateral involvement is infrequent. PMID- 2721057 TI - Hemophilus parainfluenzae complicating total knee arthroplasty. A case report. AB - Infections are an unfortunate but well-known complication of prosthetic joint replacements. Prophylactic antibiotics have been prescribed to help combat infections in total joint arthroplasties. A 78-year-old woman with a cemented total knee replacement developed a Hemophilus parainfluenzae infection following routine root canal dental surgery. The infection was successfully treated with arthroscopic irrigation and antibiotic therapy. PMID- 2721058 TI - Overview of the severely traumatized lower limb. Reconstruction versus amputation. PMID- 2721059 TI - Medial displacement metatarsal osteotomy for treatment of painful bunionette. AB - A medial displacement metatarsal osteotomy was performed in 23 feet of 16 patients who had painful bunionette deformities. The mean follow-up period was 22 months. Relief of symptoms, e.g., lateral forefoot pain, plantar pain, toe deformity, functional limitation, and shoewear limitation, was achieved. Lateral forefoot tenderness also was relieved. Forefoot width and intermetatarsal four-to five, intermetatarsal two-to-five, and metatarsophalangeal five angles were consistently decreased. Overall results based on objective and subjective criteria were good in 88%, fair in 4%, and failure in 8%. Complications were superficial wound infection in one case and possible nonunion in one case. This operation is appropriate for the painful bunionette with metatarsal splaying or outflaring with or without intractable plantar keratosis and varus toe deformity. PMID- 2721060 TI - Correction of metatarsus primus varus with the Chevron metatarsal osteotomy. An analysis of corrective factors. AB - A trigonometric evaluation of the amount of correction of metatarsus primus varus obtainable via lateral displacement of the first metatarsal head in a Chevron osteotomy technique revealed that approximately 1 degree of correction may be obtained for each millimeter of lateral shift. This calculated correction was correlated with the actual correction obtained in ten feet. Narrowing of the metatarsal head associated with removal of the medial eminence was an additional corrective factor. PMID- 2721061 TI - Stress fractures of the sacrum following strenuous activity. AB - Three military recruits developed stress fractures in the sacral wing during rigorous elite basic training. Stress fractures in the sacrum have previously not been reported in a healthy population. Sacrum, like every bone of the pelvis and the lower limb that participates in weight bearing, may be susceptible to stress fracture following sustained excessive physical activity. PMID- 2721062 TI - Experimental spiral fractures. An in vitro biomechanical comparison of lag-screw fixation to plate fixation. AB - The rigidity and strength of fixation of experimental spiral fractures in canine tibias with triple lag-screw osteosynthesis were compared with fixation by six hole dynamic compression plating (DCP). Lag-screw fixation was 71% to 77% as stiff in bending and 69% as stiff in torsion as plate fixation. When evaluated by torsion to failure, lag-screw specimens were 68% as strong as plate specimens. Although the difference in energy to failure in torsion was not statistically significant between the two methods, both fell considerably short of control values. The lag preparation was 9% as strong as intact controls, and the plate preparation was 21% as strong as intact controls. Long spiral fractures without comminution are amenable to triple lag-screw osteosynthesis with some loss of rigidity and strength when compared to single-plate fixation. This decrease in rigidity and strength may be outweighed by the avoidance of the stress protection phenomenon noted under rigid plates. PMID- 2721063 TI - Occult fracture-subluxation of the midtarsal joint. AB - In four women with occult fracture-subluxation of the midtarsal joint incurred in trivial accidents, the correct diagnosis was made promptly, assisted in one case by bone scintigraphy. Treatment was conservative, consisting of cast immobilization for six to eight weeks and a weight-bearing restriction. At the minimum follow-up time of 24 months, the functional results were rated good in three patients and fair in one. In the patient with a fair result, a compression fracture of the posterior facet of the calcaneus was diagnosed retrospectively. An occult fracture-subluxation of the mid-tarsal joint can be treated effectively by conservative means. PMID- 2721064 TI - Initial care of massively traumatized lower extremities. AB - From July 1985 through July 1987, 19 patients with 20 massively traumatized lower limbs were treated using a standardized protocol, including early consultation with microvascular and plastic surgeons and a nurse-practitioner. This early consultation allowed for timely reconstruction as well as patient and family counseling. Thirteen of these 20 limbs (65%) were salvaged. Of the seven amputations, one patient died and two patients were lost to follow-up study. The results of the 16 remaining patients with 17 affected limbs were reviewed. Seventy-five percent were ambulatory in less than one year following surgery. All were ambulatory without external aids or orthoses at final follow-up examination. A rapid return to previous activities was a direct result of early decision making. PMID- 2721065 TI - High-energy, low-dose radiation therapy for aneurysmal bone cyst. Report of a case. AB - Whereas curettage and bone grafting of aneurysmal bone cysts (ABC) are generally accepted, recurrence is not uncommon and surgery is hazardous when the lesion is large and adjacent to the growth plate. High-energy, low-dose radiation in an eight-year-old girl with this lesion of the distal tibia was successful with no recurrence at the three-year follow-up examination. No complications have ensued, and excellent function has been sustained. Further evaluation of this form of radiation treatment is important in similar situations in which surgical excision of ABC may carry high risks. PMID- 2721066 TI - Skeletal metastases in liposarcoma detectable only by magnetic resonance imaging. AB - Diffuse, asymptomatic skeletal metastases occurred in a 46-year-old patient with liposarcoma. These metastases were detected by magnetic resonance imaging (MRI) but not by roentgenograms or radionuclide scans. Pathologic confirmation from the MRI-detected area was obtained. This observation suggests a possible explanation for the present discrepancy between the incidence of skeletal involvement in antemortem and postmortem studies in metastatic liposarcoma. MRI may be an extremely sensitive tool for detection of bone and bone marrow metastasis. PMID- 2721067 TI - Malignant neuroepithelioma (peripheral neuroblastoma). A case report. AB - Malignant neuroepithelioma is a rare neoplasm arising within the peripheral nervous system. It usually occurs in the lower extremities and may involve patients in any age group. In children younger than the age of five years, the tumor must be differentiated from a metastatic neuroblastoma; in adolescents and adults the tumor must be distinguished from other malignant round-cell tumors. The poor prognosis and the need for aggressive, combined surgical and chemotherapeutic modalities in treating this tumor necessitate a prompt and accurate diagnosis. PMID- 2721068 TI - Nondiaphyseal osteoid osteomas in the pediatric patient. AB - Nondiaphyseal osteoid osteomas lack the classic roentgenographic appearance of diaphyseal lesions. This may delay diagnosis and treatment. This paper reports on seven children with nondiaphyseal osteoid osteoma seen consecutively. Delay in making the diagnoses, once the children were examined by orthopedic surgeons, averaged six months. Absence of the classic roentgenographic appearance led to the delay in these cases. The difficulty in diagnosing the lesion on routine roentgenograms derives from the specific reaction to the lesion by cancellous bone as compared to cortical bone. Bone scans proved to be sensitive at locating a focal area of intense uptake but lacked the specificity to make the diagnosis. Computed tomography (CT) was quite specific at making the diagnosis and localizing the lesion for biopsy. How to differentiate between osteoid osteoma and osteomyelitis by CT is described. When osteoid osteoma is suspected in nondiaphyseal locations, CT is likely to aid in the diagnosis and localization of the lesion for biopsy. PMID- 2721069 TI - Augmentation of spinal fusion with bone morphogenetic protein in dogs. AB - Bone morphogenetic protein (BMP) induces mesenchymal cells to differentiate into cartilage and bone. To investigate the action of BMP on the growth of host bed derived bone in experimental spinal fusions, posterior intervertebral spinal fusions of the lower thoracic spine were performed in 13 mature mongrel dogs. Four different fusion methods were used at single intervertebral levels within each dog. Three levels in each dog were used as controls for the BMP level. The spinal columns were examined by radiohistomorphometric methods at three weeks, six weeks, and 12 weeks and showed the BMP level to have two to three times more new bone than control levels. At the BMP level, an increase in the amount of new bone was observed in the interval from three to 12 weeks, in contrast to a decrease seen at the control levels. Fusion was present in five of seven of the BMP levels compared with zero of seven, one of seven, and two of seven in the control levels. The BMP level exhibited an increased number and volume of areas of de novo cartilage and woven bone formation at all time intervals compared to all control levels. The polylactic acid polymer carrier was not resorbed and partially retained in the fusion site. The preliminary observations suggest that BMP may serve as a useful adjunct in spinal fusions, but research is required to find a rapidly degradable delivery system. The objective of BMP research is to augment the host bed capacity for bone generation and regeneration and to spare children and adults the pain and complications involved in removing excessive volumes of iliac crest bone grafts. PMID- 2721070 TI - The study of Maquet dome high tibial osteotomy. Arthroscopic-assisted analysis. AB - A review of 118 Maquet valgus high tibial osteotomies, secured with Charnley's external compression fixator, included 110 cases of primary osteoarthritis, six cases of osteonecrosis, and two cases of traumatic arthritis. Preoperatively, the mechanical axis of alignment showed varus deformity with an average of 9.6 degrees, while the final follow-up evaluation demonstrated valgus alignment with an average of 4.7 degrees. According to the criteria of Insall et al. the knee scores improved from 63.3 preoperatively to 88.8 postoperatively. The results were excellent or good in 84.8% of 118 knees followed an average of 27 months (range, 12-84 months). A significant relationship existed between the success of the correction of the mechanical axis and the knee's functional result. Also, the severity of the preoperative coronal angular deformity of the knee joint had a negative relationship with the final knee function. There were 39 (33.1%) complications, including 13 recurrences of varus deformity, 13 pin-tract infections, five peroneal nerve palsies, and two paralyses of the extensor hallucis longus. Preoperative arthroscopic grading according to the criteria of Fujisawa et al. and the additional point-counting method did not adequately predict the knee's functional outcome, but postoperative arthroscopic grading was of some prognostic value. PMID- 2721071 TI - Contrasting microanatomy of idiopathic and corticosteroid-induced osteoporosis. AB - Previous studies of microanatomic changes in normal bone with age have suggested that underlying differences in bone remodeling between male subjects and female subjects give rise to different patterns of bone loss. The relationship between microanatomic and histologic levels of organization are herein examined in two groups of osteoporotic subjects, one with idiopathic and the other with corticosteroid-induced osteoporosis. Using tissue from the iliac crest, total trabecular surface and trabecular width and number were measured, together with bone volume and static and dynamic indices of formation (osteoid surface, seam width, mean wall thickness, lamellar thickness, calcification fronts, and mineralization rate) and resorption (total resorption cavities and osteoclast incidence). The results suggest that while a similar loss of trabecular bone volume is common to both groups, there is a marked distinction in the distribution of the remaining bony tissue and indices of remodeling. A decline in trabecular number accompanied by a relative increase in resorption characterized both sexes with primary osteoporosis, whereas a decline in trabecular width associated with depressed formation was the predominant feature in the secondary disease. Thus trabecular attenuation is principally the manifestation of depressed formation, while trabecular discontinuity is primarily the manifestation of bone resorption. PMID- 2721072 TI - Effects of gonadectomy and estrogen administration on rat skeletal muscle. AB - The effects of sex hormones on rat soleus and caudofemoralis muscles were examined histochemically. The fiber diameter of three types of fibers, Types 1, 2A, and 2B, was larger in the adult male rat than in the female rat. The size of all three types of fibers was increased by ovariectomy, but the effect was most prominent on Type 2A. Orchiectomy resulted in a decrease in the size of Type 2B, but caused no change in Types 1 and 2A. Estrogen administration resulted in a decrease in the size of all types of fibers in both male and female gonadectomized rats. The total number and composition of each fiber type were not affected by gonadectomy or estrogen administration. Thus, the sex hormones exerted their effects on muscle fiber diameter, with female sex hormones having an inhibitory effect and testosterone having a promotive effect, but the fiber type profiles and the total number of fibers were not affected. PMID- 2721073 TI - Factors influencing infection rate in open fracture wounds. AB - Seventy-seven infections in 1104 open fracture wounds were evaluated to identify those factors that predisposed to infection. Factors could be placed into three categories: (1) increased risk, (2) no effect, and (3) inconclusive. The single most important factor in reducing the infection rate was the early administration of antibiotics that provide antibacterial activity against both gram-positive and gram-negative microorganisms. In this study, surgical debridement was performed on all open fracture wounds. PMID- 2721074 TI - Open joint injuries. Classification and treatment. AB - Experience with wounds involving the major joints of the lower extremity suggests that the extracapsular soft tissues and the intracapsular structures should be considered individually to assess accurately the magnitude of injury and to provide a prognosis. A classification scheme is proposed to characterize the areas and types of injury. Type I open joint injuries are single penetrations without extensive soft-tissue damage, permitting uncomplicated joint and wound closure. Type II injuries are single or multiple penetrations with extensive soft tissue disruptions (flaps, avulsions, degloving), often requiring secondary operations to attain closure. Type III injuries are open periarticular fractures with extension through the adjacent intraarticular surface. Type IV injuries are open dislocations or those with associated nerve or vascular injury requiring repair. The extent of intraarticular injury further subdivides Types I, II, and III. The prognosis for functional impairment correlates with the severity of injury. The cornerstones for successful management are debridement, antibiotic therapy, properly timed and performed joint closure, and aggressive treatment of the associated bony injury. PMID- 2721075 TI - Acute gangrenous cholecystitis due to metastatic melanoma detected by cholescintigraphy. AB - A case of acute gangrenous cholecystitis due to cystic duct obstruction by a metastasis from malignant melanoma detected by cholescintigraphy is presented. PMID- 2721076 TI - Uptake and kinetics of Tc-99m hexakis 2-methoxy isobutyl isonitrile in benign and malignant lesions in the lungs. AB - Kinetics of Tc-99m MIBI uptake was studied in 19 patients with lung lesions (6 benign, 13 malignant). Two dynamic studies were acquired after the I.V. injection of 10-15mCi (370-550 MBq); the first was every second for 60 seconds, followed by a second one every minute for 30 minutes. Delayed images were acquired at two and three hours. By assigning regions of interest (ROI) over the lung lesions (TR), contralateral normal lung (NL) and the heart (Ht), time activity curves (TAC) were generated and time to peak activity was calculated as well as the ratios of TR/NL, Ht/TR and Ht/NL. The Ht/NL ratio was also assessed in five patients referred with diagnosis of ischaemic heart disease (IHD) for myocardial imaging. There was a localized increase of Tc-99m MIBI uptake in ten patients with untreated malignant tumours of the lung. No localized uptake was found in one patient with untreated poorly differentiated squamous cell carcinoma, two treated lung cancer and four patients with non-malignant lesions of the lungs. Two patients with fibrosing alveolitis showed diffuse increase lung uptake. In all positive studies peak tumour was reached within the first minute. There was no statistical difference in the ratio of Ht/NL between all groups except in patients with fibrosing alveolitis. There was no significant difference between the ratios TR/NL, Ht/TR and Ht/NL at 5-10 minutes and 25-30 minutes. The ratio of TR/NL at 25-30 minutes was 1.58 +/- 0.36 in the positive cases versus 1 +/- 0.22 in the negative ones.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721077 TI - Iodine-131 metaiodobenzylguanidine uptake in infantile myofibromatosis. AB - I-131 MIBG scintigraphy was performed on a neonate who presented with a left neck mass and brachial palsy. Increased uptake of the tracer was apparent in the mass, initially suspected as being a neuroblastoma, but later diagnosed as infantile myofibromatosis. Since MIBG is principally taken up by neuroendocrine tumors, this finding suggests caution be used when interpreting studies in this age group. PMID- 2721078 TI - Results of hepatobiliary imaging using Tc-99m EHIDA. AB - Tc-99m labelled 2,6-diethylphenylcarbamoylmethyliminodiacetic acid (EHIDA) is a non-toxic radiopharmaceutical that was found to undergo rapid biliary excretion in a normal human, with accumulation of radioactivity in the gall bladder and intestine. Images in normal subjects and nonjaundiced patients showed rapid concentration of tracer by the liver and the passage of the same into the intestine within 15 to 40 minutes, with or without visualization of the gall bladder. In the jaundiced patient, the tracer blood clearance was delayed and urinary excretion was increased. Tc-99m EHIDA has been extensively investigated in 1634 patients to evaluate its performance in the diagnosis of hepatobiliary disorders. PMID- 2721079 TI - Failure of indium-111 leukocyte scanning to detect nodal involvement with Mycobacterium avium-intracellulare infection in the acquired immunodeficiency syndrome. AB - An In-111 leukocyte scan was used to evaluate fever of unknown origin in a patient with the AIDS rather than Ga-67. The scan was normal despite an impressively positive Ga-67 scan performed 48 hours later. In-111 should not be used to evaluate fever in patients with AIDS where mycrobacterium avium intracellular infection is a diagnostic possibility. PMID- 2721080 TI - Tc-99m MDP uptake by metastatic chondrosarcoma in the lung. PMID- 2721081 TI - Multidisciplinary imaging of Budd-Chiari syndrome. PMID- 2721082 TI - Atypical scintigraphic pattern of liver hemangioma. PMID- 2721083 TI - Cephalosporin-induced diffuse pulmonary inflammation depicted by Ga-67 scintigraphy. PMID- 2721084 TI - Myocardial scintigraphy with Tc-99m TBI in a 6-month-old infant with myocardial infarction after Mustard operation. PMID- 2721085 TI - Pericholecystic hepatic activity in a postcholecystectomy patient. PMID- 2721086 TI - Tc-99m serum albumin lymphoscintigraphy of upper limbs. PMID- 2721087 TI - Lack of effect of influenza vaccine on the pharmacokinetics of antipyrine, alprazolam, paracetamol (acetaminophen) and lorazepam. AB - 31 healthy male (n = 17) and female (n = 14) volunteers, aged 20 to 45 years, were divided into 4 groups and received on 3 separate occasions either: paracetamol (acetaminophen) 650mg intravenously (n = 9); alprazolam 1mg orally (n = 7); antipyrine (phenazone) 1g intravenously (n = 8); or lorazepam 2mg intravenously (n = 7). Doses were administered prior to influenza vaccine (0.5ml, intramuscularly) and at 7 and 21 days post-vaccination. The overall differences among the 3 trials in clearance of antipyrine were of borderline significance (p less than 0.0611), with a trend towards reduced clearance in both of the post vaccination trials. There were no overall differences observed in the elimination half-life of antipyrine, nor were there significant differences between trials in cumulative urinary excretion or fractional recovery of intact antipyrine, 4 hydroxyantipyrine, norantipyrine, or 3-hydroxymethyl antipyrine. For paracetamol and alprazolam, there were no significant differences among the 3 trials in any of the kinetic variables. The elimination half-life of lorazepam varied significantly among trials, but differences were small and not systematic. Lorazepam clearance did not vary significantly among trials. Thus, clearance of drugs which undergo hepatic conjugative reactions such as glucuronidation and sulphation are unlikely to be affected by the coadministration of influenza vaccine. Furthermore, not all drugs which are biotransformed by hepatic microsomal oxidation necessarily have impaired clearance due to coadministration of influenza vaccine. PMID- 2721088 TI - Tianeptine and its main metabolite pharmacokinetics in chronic alcoholism and cirrhosis. AB - The effect of chronic alcoholism (with or without associated moderate cirrhosis) on the disposition of the antidepressant tianeptine, which is devoid of substantial first-pass metabolism, was examined in 21 patients and 11 age-matched controls. Pharmacokinetic parameters for tianeptine and its C5 acid analogue metabolite (MC5 metabolite) were estimated by non-compartmental analysis. The area under the curve (AUC) for tianeptine, following a 12.5mg single oral dose, was decreased by 31% in chronic alcoholics and increased by only 14% in cirrhotics, compared to controls. These changes did not attain statistical significance. The trend of changes in the AUC for the MC5 metabolite was similar to that observed for the parent drug. No statistical difference was found in the terminal half-life for both tianeptine and its MC5 metabolite between patients and controls. On the basis of this study, it appears unnecessary to modify the proposed dosage regimen used in clinical trials (tianeptine sodium salt 12.5mg 3 times daily) in chronic alcoholics with or without associated moderate cirrhosis. PMID- 2721090 TI - Work-related risk factors for hepatitis B virus infection in personnel of a children's hospital. AB - Seroprevalence of hepatitis B virus markers was examined in employees participating in patient care at The Children's Mercy Hospital in Kansas City, Missouri. Of 377 workers tested in 1985-86, 36 (9.6%) were seropositive for any marker. Among 285 employees who presumably have only work-related hepatitis B exposure, 14 (4.9%) were seropositive. Age 50 years and older, black race, and education no more than 12 years were associated with seropositivity among workers with work-related exposure. Employees in the clinics, laboratories, emergency room, and operating room had an increased prevalence of hepatitis B markers compared to those in other work locations (8 vs. 2%, p less than 0.05). Traditional risk factors for infection were not predictive of seropositivity. Although the risk of acquiring hepatitis B infection from employment in a children's hospital is low, this study does identify work-related risk factors. Possible reasons for this association are discussed. PMID- 2721089 TI - Phenytoin dosage predictions in paediatric patients. AB - Phenytoin dosing in paediatric patients is complicated both by alterations in patient requirements due to growth and maturation changes and by the capacity limited characteristics of phenytoin metabolism. This study examines 2 pharmacokinetic methods to adjust phenytoin dosage based on a single dosing rate/steady-state serum phenytoin concentration pair. A Bayesian forecaster and a fixed parameter [rate of metabolism (Vmax)] method were examined with previously published sets of a priori parameter estimates. The fixed Vmax method was utilised with the parameter derived from native Japanese (method 1), US Caucasian (method 2) and European (method 3) patients. The Bayesian forecaster used a priori parameter estimates obtained from native Japanese (method 4) and European (method 5) patients. Each method was examined retrospectively in 34 paediatric patients with a total of 48 predictions possible. Measures of absolute predictability, bias (mean error, % dose) and precision (root mean squared error, % dose), were -3.58/12.2, -1.51/12.2, 4.06/9.96, -4.38/13.2, and -3.10/11.5, for methods 1, 2, 3, 4 and 5, respectively. There was no significant difference among the 5 methods. However, the Bayesian algorithm tended to be more robust over a broad range of situations, providing predictions in all cases. The fixed Vmax methods could not provide predictions in every case. Finally, all methods had a significant number of overpredictions of dosage. Poorer results were observed when prediction of steady-state serum concentrations were performed, partly due to the retrospective nature of the study. We conclude that close monitoring of patients, regardless of the method chosen to adjust dosage, is recommended. PMID- 2721091 TI - Pediatric bronchoscopy. A report of methodology and results. AB - Data for this article were obtained from a retrospective analysis of 386 pediatric bronchoscopies from 1979 through 1986. Endoscopic procedures were carried out under general anesthesia using a rigid open bronchoscope. There were 235 boys (61%) and 151 girls (39%). The mean age was 2 years, 3 months. Eight percent of the girls were under 1 month of age, compared with only 4 percent of the boys. The lightest patient weighed 650 g. In children under 1 year of age, the most common indications were dyspnea (32%) and anomaly or suspicion of anomaly (20%). In children over 1 year of age suspected foreign body (32%) and recurrent respiratory infections (30%) were the most common indications. In 15 percent of patients, laryngomalacia and/or an abnormal epiglottis was confirmed. Subglottic stenosis, congenital or acquired, was confirmed in 9 percent and tracheal compression in 12 percent of cases. Seventeen percent of the children showed totally normal findings. There were only eight complications in the whole series and no death or cardiac arrest. The authors confirm the safety of bronchoscopy when careful attention is paid to preoperative investigations, selection of the instruments used, and postoperative care. PMID- 2721092 TI - Therapy of acute bronchospasm. Complicated by lactic acidosis and hypokalemia. AB - Hypokalemia and lactic acidosis developed following correction of respiratory acidosis in a 5-year-old child who presented with respiratory failure secondary to severe asthma and treated with theophylline, inhaled albuterol, and parenteral methylprednisolone. Calculation of the "anion gap" that provided the clue to presence of lactic acidosis was confirmed by the measurement of serum lactate level. PMID- 2721093 TI - A case of indolent meningococcal infection. PMID- 2721094 TI - Toxic manifestations of cinnamon oil ingestion in a child. PMID- 2721095 TI - Coaches' goals for young children in a recreational sports program. AB - Almost all children participate in sports at some time, and programs are being established for even younger children. Adults who coach the children largely determine what the children's sports experience will be. Coaches' perceptions of what is important for the young children they instruct have not yet been carefully investigated. This study was designed, therefore, to determine coaches' goals for young children. Data were gathered by use of an attitude questionnaire administered to 29 coaches of a recreational basketball program of children ranging in age from 6 to 10 years old. Of the 12 goals, feeling part of a team, learning to do my best, and having fun and excitement were most highly rated as extremely important, while becoming popular was lowest rated as not important. Results revealed that coaches in general are able to clearly define their goals and priorities, and these goals seem developmentally appropriate for the children. However, coaches make little differentiation in goals based on age. PMID- 2721096 TI - Teenage pregnancy. Caring for adolescent mothers with their infants in pediatric settings. PMID- 2721097 TI - HIV-related beliefs, knowledge, and behaviors among high school students. PMID- 2721098 TI - Neonatal surgery. PMID- 2721099 TI - Management of esophageal atresia and tracheoesophageal fistula. AB - We can draw several conclusions from an analysis of our series: 1. Although prematurity remains to be an important factor in the survival of infants with major surgical or medical disease, the more important risk factor in esophageal atresia and tracheoesophageal fistula concerns: a. Severity of associated anomalies that are uncorrectable and fatal b. Associated complication from the disease or surgery (especially in infants less than 1500 gm). Complications such as tracheal perforation and gastric perforation are not tolerated well and can be fatal (the case in two of our patients). 2. Premature infants weighing even less than 1500 gm tolerate a major thoracotomy well with correction of an esophageal anomaly. In this series, the smallest weighed 1220 gm. This infant had an uneventful recovery with a good outcome. 3. Simultaneous correction of associated anomalies also is well tolerated by these patients. Judgment, however, should be exercised as to the extent and length of operative procedures performed. 4. Staged reconstruction is still an excellent alternative when one is dealing with a premature infant with concomitant surgical procedures, although lengthening operations with primary anastomosis for the most part have replaced the need for staging esophageal reconstruction. 5. Radiographs indicating a high upper pouch lesion also require bronchoscopic identification of the fistula prior to operative intervention to provide a guide to the proper surgical approach to the lesion. 6. Acute anastomotic leaks should be treated aggressively by antibiotics and immediate thoracotomy, with cervical esophagostomy, closure of the distal esophagus, drainage of the mediastinum, and gastrostomy placement. immediate intervention will result in better survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721100 TI - Neonatal intestinal obstruction. AB - Our experience in the management of 138 infants with various causes of intestinal obstruction has provided us with important principles of diagnosis and treatments that we adhere to in the course of our practice. 1. The overall mortality of neonates suffering from intestinal obstruction should be fewer than 5 per cent. The high survival rate is accounted for by improved care these patients receive in specialized units. 2. Prematurity did not appear to play a significant factor in the outcome of these infants with intestinal obstruction. Our experience shows that premature infants tolerate operative procedures well, even in those instances in which an associated surgically correctable lesion is simultaneously repaired. 3. The major risk factor in any neonate with intestinal obstruction is the delay in diagnosis and operative intervention, especially in infants diagnosed to have midgut volvulus. The additional second risk factor is the association of chromosome abnormality. 4. Traditional diagnostic studies such as plain films of the abdomen supplemented by either an upper GI or lower GI contrast study for specific indications have been very effective in obtaining an accurate diagnosis of intestinal bowel obstruction. 5. Hirschsprung's disease can be diagnosed in the neonatal period if the index of suspicion for this is high. 6. Special surgical techniques as described should be used whenever indicated to minimize morbidity. 7. The traditional Wangensteen-Rice evaluation of a patient with imperforate anus is accurate, and specialized studies should be deferred for the postoperative period. Collaborative care provided by the neonatologist, pediatric anesthesiologist, and pediatric surgeon for these patients is the key to a favorable outcome. PMID- 2721101 TI - Read my lips.... PMID- 2721102 TI - Maturational changes of theophylline pharmacokinetics in preterm infants. AB - The pharmacokinetics of theophylline were studied at steady state by stable isotope methodology in nine individual preterm infants. Maturational variables such as postnatal age, postconceptional age, gestational age, duration of treatment, and body weight at the time of the study were analyzed for their influence on theophylline kinetics during the first 6 months of life. The strongest statistical correlations were found between the logarithm of theophylline half-life (t1/2) and the postnatal age (r = 0.98; p less than 0.001) and the postconceptional age (r = 0.96; p less than 0.001). Step-wise multiple regression analysis revealed postnatal age as the most powerful predictor for theophylline t1/2 in the neonatal period (partial correlation coefficients were 0.78 for postnatal age, 0.19 for postconceptional age, and 0.10 for gestational age). Gestational age, duration of treatment, and weight did not correlate significantly with any pharmacokinetic parameters. We propose that theophylline metabolizing function of the liver increases in a logarithmic fashion during the first 6 months of life. PMID- 2721103 TI - Dose-dependent inhibition of theophylline metabolism by disulfiram in recovering alcoholics. AB - The influence of disulfiram on theophylline metabolism was studied in 20 recovering alcoholics. Ten of the patients, who were selected at random, received 250 mg of disulfiram daily. The other 10 patients received 500 mg of disulfiram daily. Two single-dose studies of theophylline kinetics were performed--one as a baseline control and the other after 1 week of treatment with disulfiram. With disulfiram pretreatment, the plasma clearance of theophylline was decreased from 105.7 +/- 10.2 (mean +/- SEM) to 83.1 +/- 8.1 ml/kg per hour (p less than 0.001) in the 250 mg group and from 94.3 +/- 13.3 to 65.4 +/- 10.7 ml/mg per hour (p less than 0.001) in the 500 mg group. The elimination half-life was prolonged significantly in both groups. The percent reduction in theophylline clearance was greater in the 500 mg group (32.5 +/- 3.1; range, 21.6 to 49.6) than it was in the 250 mg group (21.2 +/- 1.7; range, 14.6 to 29.6; p less than 0.01). Disulfiram decreased the formation of all theophylline metabolites in smokers in both treatment groups. In each group, the hydroxylation pathway was affected more than the demethylation pathway. These data indicate that at therapeutic doses disulfiram exerts a dose-dependent inhibitory effect on theophylline metabolism. Depending on the dose of disulfiram, a dose reduction of theophylline by as much as 50% may be necessary to minimize the risk of toxicity. PMID- 2721104 TI - S-mephenytoin hydroxylation phenotypes in a Swedish population determined after coadministration with debrisoquin. AB - Mephenytoin (100 mg) and debrisoquin (10 mg) were administered orally, both separately and together, to 41 healthy subjects. The ratios between the S and R enantiomers of mephenytoin and between debrisoquin and 4-OH-debrisoquin in urine were determined by use of GC. These ratios were used as measures of drug hydroxylation. There was no change in the phenotypic trait values of the two drugs when they were coadministered. Mephenytoin and debrisoquin then were coadministered to 253 healthy Swedish subjects, before bedtime, and urine samples were collected at periods of 0 to 8, 8 to 24, and 24 to 32 hours after drug administration. In the first sample, seven of the 253 subjects (2.8%, 95% confidence interval 0.8% to 4.8%) had an S/R ratio of greater than 0.8; this indicated that they were poor hydroxylators of S-mephenytoin. In the two consecutive samples, the S/R ratios of mephenytoin did not change in these seven persons, whereas it decreased to less than 0.2 in the third sample in the extensive hydroxylators. As was reported before, there was no relationship between the mephenytoin S/R ratio and the debrisoquin metabolic ratio (rs = 0.01). Coadministration of debrisoquin and mephenytoin before bedtime and urine collection during two consecutive nights allow for an accurate determination of both phenotypes in the population. PMID- 2721105 TI - Probenecid-induced changes in the clearance of carprofen enantiomers: a preliminary study. AB - Probenecid inhibits the elimination of several acidic drugs. In this study, the influence of probenecid on the pharmacokinetics of carprofen was investigated in three healthy volunteers after single peroral administration of 150 mg of RS-(+/ )-carprofen. Carprofen enantiomers and their glucuronides (after cleavage with sodium hydroxide) were measured by use of a stereospecific procedure. The plasma concentrations of S-(+)-carprofen were higher than those of R-(-)-carprofen at most of the sampling points. Probenecid reduced apparent total and renal clearances for both enantiomers. It also reduced the clearances of the carprofen enantiomers to their glucuronides and the renal clearances of the glucuronides. The differences caused by probenecid were significant, but few stereoselective effects were observed. PMID- 2721106 TI - The disposition and placental transfer of diazepam in cesarean section. AB - The disposition parameters and placental transfer of diazepam were determined from blood and both plasma total and free concentration data in five women who had not undergone labor and who received diazepam (5 mg intravenously for 2 minutes) 1 1/2 to 3 hours before cesarean section at term. All patients exhibited smooth log plasma free concentration-time profiles. In contrast, marked increases in plasma total (approximate 50% increase) and blood (approximate 40% increase) diazepam concentrations occurred at delivery. The plasma total and blood concentration fluctuations were associated with reciprocal variations in diazepam percent free in plasma. For each patient there was a substantial increase in plasma nonesterified fatty acid (NEFA) concentration during the surgical period. There was a significant correlation (p less than 0.02) between diazepam percent free and plasma NEFA concentration on the day of delivery, suggesting that the fluctuations in percent free, and hence plasma total and blood diazepam concentrations, were mediated in part by variations in plasma NEFA concentration. Disposition parameters were calculated for four of the patients; the mean free plasma clearance of diazepam was 42.5 ml/min/kg, similar to the mean value reported previously for nonpregnant women of comparable age. For each mother infant pair at delivery the ratio of total plasma diazepam concentration in umbilical vein plasma to that in maternal vein plasma was considerably greater than unity (mean +/- SD = 1.73 +/- 0.47), whereas the corresponding ratio for free plasma diazepam concentration was near unity (0.92 +/- 0.09).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721107 TI - Sublingual versus subcutaneous buprenorphine in opiate abusers. AB - To compare the pharmacologic profiles of sublingually and subcutaneously administered buprenorphine, 10 healthy male subjects with histories of opiate abuse were given sublingually administered buprenorphine (1, 2, and 4 mg), subcutaneously administered buprenorphine (1 and 2 mg), and placebo in a double blind, double-dummy, placebo-controlled study. All active buprenorphine dosages produced a significant degree of miosis but no significant changes in body temperature, blood pressure, or respiratory or heart rate. Buprenorphine produced varying degrees of euphoria related to dose and route of administration but little dysphoria and sedation, as assessed by subscales of the Addiction Research Center Inventory. Subject "liking" for buprenorphine was reported by both observers and subjects. The relative potency of sublingually to subcutaneously administered buprenorphine was calculated for both physiologic and behavioral parameters and found to be approximately two thirds. The results indicated that both sublingual and subcutaneous buprenorphine have a similar profile of effects in opiate abusers. PMID- 2721108 TI - Influence of coadministration on the pharmacokinetics of mezlocillin and cefotaxime in healthy volunteers and in patients with renal failure. AB - The pharmacokinetic disposition of cefotaxime, desacetyl cefotaxime, and mezlocillin after the administration of each drug singly and in combination was examined in eight healthy volunteers and in five anuric patients with end-stage renal disease (ESRD). In the presence of ESRD, the total body clearance of cefotaxime decreased from 256.7 +/- 41.5 to 65.4 +/- 42.0 ml/min, and its elimination half-life (t1/2) increased from 1.1 to 3.6 hours as compared with healthy volunteers. Concomitant administration of mezlocillin in healthy volunteers decreased the total body clearance of cefotaxime by 42% and increased its steady-state volume of distribution. This reduction in clearance was reflected by a decrease in both renal and nonrenal clearances. In the presence of ESRD, coadministration of mezlocillin increased the t1/2 of cefotaxime to 5.8 hours. Desacetyl cefotaxime accumulated in ESRD with a prolongation of its elimination t1/2 to 18.7 hours from 1.7 hours in healthy volunteers. Desacetyl cefotaxime peak plasma concentrations occurred later with the combination regimen in the presence of ESRD. The clearance of mezlocillin was reduced and t1/2 prolonged in ESRD from 194.6 +/- 31.9 to 76.4 +/- 38.8 ml/min and 1.4 to 2.3 hours, respectively. Concomitant administration of cefotaxime did not alter the pharmacokinetics of mezlocillin. These data suggest that in the presence of normal renal function, lower doses of cefotaxime may be adequate to maintain similar cefotaxime plasma concentrations when mezlocillin is coadministered compared to when cefotaxime is given alone. Additional pharmacodynamic and clinical studies with this combination are warranted to further elucidate the clinical impact of this pharmacokinetic interaction. PMID- 2721109 TI - Pharmacokinetic and pharmacodynamic evaluation of propafenone in patients with ventricular arrhythmia. Propafenone Research Group. AB - Propafenone, a class IC antiarrhythmic agent, is metabolized into two active metabolites: 5-hydroxypropafenone (5-OHP) and N-depropylpropafenone (NDPP). In a placebo-controlled, double-blind study, we examined trough plasma concentrations of propafenone and its two metabolites in 169 subjects. Patients were randomized to one of five parallel treatment groups: placebo and 337.5, 450, 675, or 900 mg/day propafenone with 24-hour ambulatory ECG monitorings, 12-lead ECGs, and plasma samples obtained at frequent intervals. Nonlinear kinetics were noted for propafenone and NDPP but not for 5-OHP. The ratio of NDPP to propafenone was about 10% at all doses, but the ratio of 5-OHP to propafenone decreased from 33% at 337.5 mg/day to 18% at 900 mg/day. Propafenone suppression of ventricular ectopy was dependent on concentration, with pairs and VT beats selectively suppressed at lower concentrations than VPBs. The PR interval and QRS duration increased significantly at propafenone concentrations above 100 ng/ml, while minimal heart rate slowing was noted at concentrations above 1,000 ng/ml. PMID- 2721110 TI - Concentration-response relationships of disopyramide in patients with ventricular tachycardia. AB - The protein binding of disopyramide is altered when concentration is increased within the therapeutic range. A wide range of free concentrations may be produced at a given total concentration. The present study assessed whether intracardiac electrophysiologic responses to disopyramide related better to free or to total concentration. Intravenous infusions of disopyramide were evaluated in 17 patients with inducible sustained ventricular tachycardia. The first maintenance infusion produced total serum concentrations of 11.7 +/- 2 mumols/L, and no significant increase occurred at higher-dose infusions. However, free concentrations during the first and second maintenance infusions were significantly different at 5.3 +/- 1 mumols/L and 6.8 +/- 1 mumols/L, respectively. Free fraction also increased significantly, from 45% +/- 8% to 50% +/- 7%. Overall change in QTc interval and ventricular tachycardia cycle length correlated with free concentration but not with total concentration. This study showed that some intracardiac measurements correlate with free concentration but that none correlate with total concentration. PMID- 2721111 TI - Dextromethorphan and caffeine as probes for simultaneous determination of debrisoquin-oxidation and N-acetylation phenotypes in children. AB - The feasibility and reliability of simultaneously determining debrisoquin oxidation and N-acetylation phenotypes was assessed in children with use of two innocuous substrate probes given by mouth, 30 mg dextromethorphan (Pertussin ES) and 25 to 46 mg caffeine (Coca-Cola beverage). Twenty-six children and adolescents (aged 3 to 21 years) were studied three times, once with each substrate given alone and once with the two substrates given together. Urine was collected for 4 hours, and the molar urinary metabolic ratios for dextromethorphan:dextrorphan and for two caffeine metabolites (AFMU:1X) were determined by HPLC ultraviolet assays. The urinary metabolic ratios for both substrates were not significantly different when the substrates were given alone compared with when they were given together. There also was no difference in either the oxidation or acetylation phenotype assignments when the two substrates were given alone and when they were given together. No adverse effects were observed. We conclude that dextromethorphan and caffeine can be given together to simultaneously determine oxidation and acetylation phenotypes and can thereby provide an innocuous, noninvasive method for the assessment of polymorphic drug metabolism in various pediatric populations. PMID- 2721112 TI - Regulation of alpha- and beta-myosin heavy chain messenger RNAs in the rat myocardium by amiodarone and by thyroid status. AB - 1. A number of the cardiovascular effects of amiodarone resemble those of hypothyroidism, prompting examination of the relationship between the actions of the drug and thyroid hormones. Amiodarone treatment of the rat was used as a model to determine the influence of the drug on thyroid hormone-regulated gene expression in the myocardium and liver; interactions between amiodarone and thyroid status were examined in hypothyroid and tri-iodothyronine (T3)-treated animals. 2. Myocardial levels of alpha- and beta-myosin heavy chain (MHC) messenger RNAs (mRNAs) were measured by dot hybridization to specific oligonucleotide probes; myocardial actin mRNA was measured in parallel by hybridization to a complementary DNA (cDNA) probe. Hepatic levels of Spot 14 and thyroxine-binding prealbumin mRNA were similarly determined by dot hybridization to radiolabelled cDNAs. 3. Amiodarone treatment of the rat resulted in specific increases in both alpha- and beta-MHC mRNAs in the myocardium, as well as hepatic Spot 14 mRNA, changes reversed by T3 administration. 4. Hypothyroidism resulted in a reduction in myocardial alpha-MHC and hepatic Spot 14 mRNAs, in contrast to amiodarone, whilst hypothyroidism and amiodarone both exerted stimulatory influences on beta-MHC mRNA. Treatment of hypothyroid rats with amiodarone had no significant effect on beta-MHC or Spot 14 mRNAs, but a further reduction in alpha MHC mRNA, compared with the untreated hypothyroid state, was evident. 5. The demonstrated influence of amiodarone on both alpha- and beta-MHC mRNAs and interactions between amiodarone and thyroid status in regulating MHC gene expression may be relevant to its therapeutic effect in man. PMID- 2721113 TI - Autoradiographic study of smooth muscle cell proliferation in spontaneously hypertensive rats. AB - 1. The rate of smooth muscle cell proliferation in age-matched 1-4-week-old spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rats was compared using autoradiography. 2. Labelling index, defined as labelled cells/sum of labelled and unlabelled cells x 1000, was obtained from perfusion-fixed superior mesenteric and large mesenteric arteries. 3. In the large mesenteric arteries, the smooth muscle cell labelling indices were similar between the SHR and WKY at all age groups, except at 1 week of age when the smooth muscle labelling index was higher in the SHR. 4. In the superior mesenteric arteries, labelling indices were similar between the rat strains at all age groups. 5. We conclude that, in the SHR, a rapid proliferation of smooth muscle cells in the large mesenteric arteries occurred during the first week of life. This resulted in a higher number of smooth muscle cell layers in the media of muscular arteries. 6. The increased proliferation may play a role in the subsequent development of hypertension in the SHR. PMID- 2721114 TI - Regional and time-dependent effects of inflammatory mediators on airway microvascular permeability in the guinea pig. AB - 1. Airway oedema resulting from increased microvascular permeability is a characteristic pathological finding of asthma. The regional effects of putative mediators involved in asthma on airway microvascular permeability have been studied. 2. The effects of histamine, leukotriene (LT) D4 and platelet-activating factor (PAF) on microvascular permeability in the nasal mucosa, larynx, trachea, main bronchi and intrapulmonary airways of the guinea pig were assessed by measuring the extravasation of intravenously administered Evans Blue dye. 3. PAF and LTD4 caused increased microvascular leakage throughout the respiratory tract, although their effects were maximal in different regions. Histamine had no significant effect on intrapulmonary airways. PAF was more potent than LTD4 and histamine at all airway levels. For example, in the trachea the doses required to cause leakage of 50% of maximal (ED50) were 10.4 nmol/kg, 138 nmol/kg and 11.2 mumol/kg, respectively, for PAF, LTD4 and histamine. 4. The effect of the three mediators was maximal 5 min after intravenous administration. Histamine, but neither LTD4 nor PAF, still caused significant leakage 30 min after administration. 5. The increased microvascular leakage induced by the mediators was inhibited by their respective specific receptor antagonists, suggesting that the effect was mediated via specific receptors. 6. Histamine, LTD4 and PAF have varying potencies in increasing microvascular permeability in the guinea-pig respiratory tract, exert their maximal effect in different regions and have varying durations of action. PMID- 2721115 TI - Effects of smoking on changes in respiratory resistance with increasing age. AB - 1. The oscillation method for measuring total respiratory resistance (Rrs) is a simple method of assessing airway dimensions which can be applied in epidemiological surveys and potentially might be useful for detecting mild airway disease in smokers. However, it is not known whether abnormalities in Rrs are only present when there are also abnormalities in simple spirometric tests. 2. We have compared values of Rrs and its frequency-dependence (fR) using the oscillation technique applied over the frequency range 6-26 Hz in 42 healthy, non asthmatic men who were never-smokers (aged 26-61 years) and in 41 male cigarette smokers (aged 32-64 years). The results were compared with those for spirometry and the single-breath N2 test which are the most commonly used techniques in epidemiological surveys for detecting the effects of smoking on the lungs. 3. There was a strong trend for Rrs (especially at lower oscillation frequency) and fR to increase with increasing age in smokers. Increases in Rrs and fR were usually present when forced expiratory volume in 1 s was less than 80% of predicted and the forced expiratory volume in 1 s/vital capacity ratio was less than 65%, but abnormal fR was present in some smokers whose spirometry was within conventional normal limits. 4. Abnormalities in Rrs and fR were weakly associated with abnormality of the single-breath N2 manoeuvre.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721116 TI - The thyroid hormone analogue SKF L-94901: nuclear occupancy and serum binding studies. AB - 1. We studied a brominated thyroid hormone analogue, SKF L-94901, which has the potential to lower serum cholesterol without adverse cardiovascular effects. This compound is about 50% as active as tri-iodothyronine (T3) in liver nuclear receptor binding in vivo but only 1% as active in vitro and has nearly 200 times more enzyme-inducing activity in liver than in heart. Our aim was to examine the interaction of SKF L-94901 with [125I]T3 binding to the intact nuclei in whole cells, isolated nuclei and nuclear extracts of human HeLa cells and to investigate the binding of this compound to human serum. 2. Relative to thyroxine (T4), the affinity of this compound for T4-binding globulin was 0.0035%, for transthyretin 1.66% and for albumin 1.26%. Low affinity for serum proteins, with a relatively high circulating free fraction, could explain why SKF L-94901 is more potent in vivo than in vitro. 3. Human HeLa cell nuclei, isolated after whole-cell incubations, bound [125I]T3 with high affinity (Kd = 78 +/- 8 pmol/l, mean +/- SEM), which was displaceable by T3 analogues in the order Triac [( 4-(4 hydroxy-3-iodophenoxy)-3,5-di-iodophenyl]acetic acid) greater than T3 greater than T4 much greater than reverse T3. Similar high-affinity (Kd = 58 +/- 6 pmol/l, mean +/- SEM) and identical specificity was observed in high-salt (0.4 mol/l KCl) nuclear extracts. In nuclei of whole cells incubated with [125I]T3 and SKF L-94901, the analogue was 0.8% as potent as T3, whereas in experiments with nuclear extract, the analogue was 7.7% as potent as T3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721117 TI - Direct and indirect measurement of the hepatic extraction ratio of indocyanine green in the rat. AB - 1. In order to estimate liver blood flow in the rat, the extraction ratio of Indocyanine Green was determined using a two-compartment model fitted to the plasma concentration time data after a single intravenous bolus dose and compared with values obtained directly by transhepatic sampling, both in the intact rat and in an isolated perfused rat liver preparation. 2. There was no agreement between estimates of the extraction ratio obtained by using the kinetic model and the directly measured values. 3. Elimination curves for Indocyanine Green were simulated to yield varied clearance values. Despite a 250% variation in clearance, extraction ratios derived using the two-compartment model were all greater than 0.9 and varied by less than 6%. 4. Estimates of liver blood flow obtained by deriving a value of the extraction ratio of Indocyanine Green using the two-compartment model are inaccurate. PMID- 2721118 TI - Metabolic characteristics of human adipose tissue in vivo. AB - 1. A method was developed for sampling the venous drainage from the subcutaneous adipose tissue of the anterior abdominal wall. This is a large depot in many subjects, and seems well suited to such studies as it is completely separated from the venous drainage of the underlying muscle by the aponeurosis of the external oblique muscle. 2. Eight normal subjects were studied after an overnight fast, and for 120 min after ingestion of 75 g of glucose. Concentrations of substrates in the abdominal wall drainage were compared with those in arterialized blood and in forearm muscle drainage. 3. Non-esterified fatty acid and glycerol concentrations in the abdominal wall drainage were high (three to four times the arterial level) after overnight fast. After glucose ingestion, arterial and abdominal venous levels fell and the arteriovenous differences narrowed. The forearm showed uptake of non-esterified fatty acids when fasting but not after glucose ingestion, with no significant arteriovenous difference for glycerol at any time. 4. The abdominal wall tissues showed a small arteriovenous difference for glucose uptake during fasting, which increased after glucose ingestion. Although lactate was produced throughout, its molar ratio to glucose uptake was less than that reported for other superficial sites, suggesting only a minor contribution of skin metabolism. Forearm muscle showed a larger and more prolonged increase in arteriovenous difference for glucose uptake after the glucose load, but no consistent release or uptake of lactate. 5. We conclude that the tissue studied by this technique is predominantly adipose. This technique may have wide application in studies of the metabolic basis for body weight regulation in man. PMID- 2721119 TI - Pitfalls in the assessment of cardiovascular reflexes in patients with sympathetic failure but intact vagal control. AB - 1. Two patients are described who presented with orthostatic hypotension as the main symptom. The diagnosis was sympathetic failure with intact vagal control. 2. Unusual test results were obtained. Assessment of the integrity of the total baroreflex arc by the Valsalva manoeuvre measuring only heart rate changes proved impossible, since the magnitude and time course of the heart rate response were normal notwithstanding the presence of a blood pressure response typical of sympathetic failure. 3. Sustained handgrip, cold pressor test and mental stress test all could induce a rise in blood pressure, despite the presence of sympathetic vasomotor lesions, but only when accompanied by a rise in heart rate. Efferent parasympathetic blockade by atropine, resulting in an increase in heart rate, was also accompanied by a substantial rise in blood pressure. These findings seem to result from a heart rate rise dependent increase in cardiac output unopposed by reflex vasodilatation. 4. In these patients the only baroreflex way to control blood pressure is by varying heart rate. This condition can be evaluated only if blood pressure and heart rate are measured on a beat-by beat basis. PMID- 2721120 TI - Acute effects of thiazides, with and without carbonic anhydrase inhibiting activity, on lithium and free water clearance in man. AB - 1. The acute effects of chlorothiazide and bendroflumethiazide on renal Li+ clearance (CLi) were studied in Na+-restricted healthy humans during maximum water diuresis. 2. Chlorothiazide, which has marked carbonic anhydrase inhibiting activity, increased CLi by about 25%. The concomitant rise in uric acid clearance, maximum urine flow and bicarbonate excretion suggests that this drug suppressed proximal reabsorption through carbonic anhydrase inhibition, which would also explain the observed fall in glomerular filtration rate (increased glomerulotubular feedback activity). 3. Bendroflumethiazide, which lacks carbonic anhydrase inhibiting activity, did not affect CLi or any of the other above mentioned variables. 4. It is concluded from the lack of an effect of bendroflumethiazide on CLi that Li+ is not reabsorbed in thiazide-sensitive segments of the human distal nephron. The rise in CLi after chlorothiazide is most likely due to suppressed Li+ reabsorption in the proximal tubules resulting from carbonic anhydrase inhibition. 5. The results of this study are compatible with the concept that CLi is an index of Na+ and water delivery from the proximal tubules in humans. PMID- 2721121 TI - Possible effects of diet and other factors on 31P-nuclear-magnetic-resonance measurement of intracellular magnesium in hypertension. PMID- 2721122 TI - Discontinuation of the physician-patient relationship. PMID- 2721123 TI - Changes to watch for in the tax laws--maybe the only really certain thing in life is change.... PMID- 2721124 TI - HCFA establishes "special reasonable charge" allowances for physician services. PMID- 2721125 TI - Relation of running distance to plasma HDL-cholesterol level in middle-aged male runners. AB - This study examined the relation of training distance to plasma high density lipoprotein cholesterol (HDLC) concentration in runners. Forty-eight male endurance runners, aged from 30 to 57 years, were classified into three groups according to training distance (Grade I: n = 12, 30 km/week; Grade II: n = 22, 60 km/week; Grade III: n = 14, 100 km/week in average running distance), with 12 non lean and 12 lean subjects as age-matched untrained controls. There were no significant differences in plasma total cholesterol among the groups (194-208 mg/dl on average). HDLC level was significantly higher in the untrained, lean group than in the untrained, non-lean men (63 +/- 13 vs. 46 +/- 8 mg/dl, mean +/- SD). HDLC levels in all the runner groups were significantly higher than in untrained, lean subjects, and no differences were observed among Grade I, II and III runner groups (76 +/- 15, 76 +/- 13, 77 +/- 11 mg/dl, respectively). This study suggests that further increases in HDLC could not occur in response to further elevation of training distance in well-trained runners. PMID- 2721126 TI - Diet-induced thermogenesis in patients with liver cirrhosis. AB - Diet-induced thermogenesis after ingestion of a mixed meal was investigated in eight patients with documented liver cirrhosis and in eight age- and sex-matched healthy controls. Respiratory gas exchange was measured continuously for one hour in the basal state and for three hours after ingestion of a mixed liquid meal, consisting of 17% kJ protein, 28% kJ lipids and 55% kJ carbohydrates and dispensed to correspond to 60% of the individually computed energy expenditure. Arterial substrate and hormone concentrations were determined before and at timed intervals for three hours after the meal. Urine was collected for determination of nitrogen excretion. The patients' oxygen uptake, energy expenditure and respiratory quotient were similar to those of the controls in the basal state. After the meal, pulmonary oxygen uptake and energy expenditure rose markedly in both groups during the first hour and were subsequently stable. The average increase in oxygen uptake above basal during the whole study period was 21.2 +/- 1.8% and 22.3 +/- 1.2% (NS) in patients and controls, respectively. The corresponding increase in energy expenditure was 24.8 +/- 2.0% in the patients and 24.9 +/- 1.4% in the controls (NS). The respiratory quotient was elevated throughout the postprandial period in both groups but the quotient was significantly higher in the patients (P less than 0.05-0.001), suggesting a greater proportion of carbohydrate oxidation. The basal arterial concentrations of insulin and glucagon were significantly higher in the patients. After the meal the insulin level increased 10- to 20-fold in both groups. Glucose concentration rose significantly in both groups to a maximum of 8.82 +/- 1.00 and 8.03 +/- 0.95 mmol/l in patients and controls, respectively, at 60 min after the meal. This was accompanied by a fall in the levels of glycerol and ketone bodies in both groups, indicating decreased lipolysis. It is concluded that both the basal energy expenditure and the thermogenic response to a mixed meal are similar in patients with liver cirrhosis and in healthy controls. The patients' carbohydrate oxidation rose to a greater extent after the meal, probably as a consequence of excessive increases in insulin concentration, demonstrating that insulin resistance in these patients may be compensated for by postprandial hyperinsulinaemia. PMID- 2721127 TI - Pulmonary vascular resistance rises with lung volume on exercise in obstructed airflow disease. AB - There has been experimental evidence that lung distension produces an increase in pulmonary vascular resistance (PVR). To study this effect in patients, we measured functional residual capacity (FRC) by helium dilution at rest and during low-load supine exercise in 30 patients with chronic obstructive pulmonary disease. Pulmonary haemodynamics were studied in these patients under the same conditions. FRC increased from rest (4.32 +/- 0.21 l) to exercise (4.71 +/- 0.20, P less than 0.001) but the change was smaller in the patients with the highest FRC at rest: there was a significant negative correlation between FRC change and FRC at rest (r = -0.38, P less than 0.01). There were seven patients with a small FRC change (less than 0.2 l) with exercise and 10 patients with a marked increase (greater than 0.5 l). Exercise was of the same load on average. FRC at rest was 5.1 l in the first group and 4 l in the second (P less than 0.05). Blood gases were almost identical at rest, and almost unchanged during exercise. PVR decreased from rest to exercise by 33 dyn.s.cm-5 in the first group and increased by 24 in the second (P less than 0.01). There was a significant correlation (P less than 0.05) between PVR and FRC changes from rest to exercise. These results suggest that lung distension may play a role in the PVR increase seen in some COPD patients with exercise. PMID- 2721128 TI - Evaluation of intermittent drainage of the renal pelvis as seen in the isotope renogram. AB - Intermittent drainage (ID) of the renal pelvis is probably due to episodes of aperistalsis in the pelvo-calyceal system. The incidence of ID in adult patients referred for renography for various nephro-urological conditions was found to be 4.5%. Presence of ID was not related to sex or age but more common at a low urine flow. It was then usually bilateral and interpreted as a normal phenomenon. If the urine flow at the renographic examination exceeded 2 ml min-1, ID was typically unilateral and there was often a history of obstructive uropathy and dilatation of the renal pelvis. However, there were no signs of obstruction or flank pains in connection with the recording of ID and follow-up studies did not disclose any deterioration of renal function. It is concluded that ID seen at renography during diuresis should not be regarded as evidence of obstruction of pelvic outflow but merely as an indication of a dilated upper urinary tract. PMID- 2721129 TI - The veno-arteriolar reflex in free skin flaps. AB - The veno-arteriolar reflex was measured in 10 subjects in whom an area of denervated skin was present in the lower limb following free flap transfer of skin and subcutaneous tissue 3 weeks to 2 years previously. The vasoconstrictor response to dependency was measured in the skin of the flap, in adjacent innervated skin and after chemical dilatation of cutaneous vessels in the skin of the flap. This veno-arteriolar reflex resulting in a reduction of blood flow of 30-40% was present and equal in both normal and denervated skin. The response was abolished by chemical vasodilatation. The results indicate that sympathetic innervation is not essential for the veno-arteriolar reflex, and suggest that myogenic mechanisms may be more important than previously believed. PMID- 2721130 TI - A modified method of curve analysis in foot volumetry and its reference values. AB - Foot volumetry was introduced by Norgren & Thulesius in 1973 as a non-invasive method of functional evaluation of venous insufficiency. In the following paper we suggest a slightly different method of curve analysis, thus showing the possibility of reducing the methodological error by 30-40%. Based on healthy men and women between 15 and 75 years, new reference values are presented. PMID- 2721131 TI - Age-dependency of left ventricular filling dynamics and relaxation as assessed by pulsed Doppler echocardiography. AB - Left ventricular diastolic function was assessed from transmitral flow velocity curves as measured by Doppler echocardiography in healthy individuals aged 21-69 years, each decade comprising 12 subjects. By ageing, progressive changes in the various filling parameters were observed. When comparing the youngest and oldest age groups, the ratio between peak velocities in early and late diastole decreased from 2.0 +/- 0.3 to 1.2 +/- 0.3 (P less than 0.001). The filling fraction of first third of diastole decreased from 54 +/- 5% to 45 +/- 4% (P less than 0.001). Isovolumic relaxation time increased from 61 +/- 11 ms to 77 +/- 12 ms (P less than 0.01). Correlation coefficients of velocity ratio, filling fraction and isovolumic relaxation time vs. age were r = -0.71 (P less than 0.001), r = -0.56 (P less than 0.001) and r = 0.44 (P less than 0.001), respectively. When isovolumic relaxation time and age were used together in multivariate regression analysis, only age was an independent predictor of velocity ratio and filling fraction. Stroke volume, peak velocity in left ventricular outflow tract, heart rate and systolic blood pressure were similar in all age groups. Thus, velocity ratio and filling fraction indicated a relative filling shift towards late diastole by ageing and were more sensitive than systolic parameters in reflecting age-related changes in cardiac function. The changes could be explained neither by delayed relaxation nor by change in systolic parameters. When using Doppler echocardiography for evaluation of left ventricular filling, age-matching of reference groups is necessary. PMID- 2721132 TI - Believability and syllogistic reasoning. AB - In this paper we investigate the locus of believability effects in syllogistic reasoning. We identify three points in the reasoning process at which such effects could occur: the initial interpretation of premises, the examination of alternative representations of them (in all of which any valid conclusion must be true), and the "filtering" of putative conclusions. The effect of beliefs at the first of these loci is well established. In this paper we report three experiments that examine whether beliefs have an effect at the other two loci. In experiments 1 and 2 subjects drew their own conclusions from syllogisms that suggested believable or unbelievable ones. In the third experiment they evaluated conclusions that were presented to them. The data show that beliefs both affect the examination of alternative models and act as a filter on putative conclusions. We conclude by showing how some types of problem and some problem contents make the existence of alternative models more obvious than others. PMID- 2721133 TI - Methodological problems in cross-cultural studies of linguistic relativity. AB - Bloom (1981) tested a weak version of the linguistic relativity hypothesis (i.e., "Language affects thinking though it does not determine thinking") in a series of cross-cultural experiments. According to Bloom, Chinese lacks two linguistic devices that are present in English and supposed to be critical in performing theoretical thinking. It was found that the Chinese subjects were outperformed by American counterparts in all the tests designed to assess the ability of theoretical thinking. The results were taken as evidence for the weak version of the linguistic relativity hypothesis. A methodological consideration has revealed, however, that all of his experiments except one are uninterpretable because of the lack of necessary control conditions. In addition, three experiments in the present study have demonstrated that the findings in Bloom's sole interpretable experiment were artifacts due to a methodological flaw. Further theoretical considerations reveal the inadequacy of Bloom's basic methodology and the limitation in the effects of linguistic relativity that may be possible at least theoretically. PMID- 2721134 TI - Closed-class immanence in sentence production. AB - The closed-class hypothesis asserts that function words play a privileged role in syntactic processes. In language production, the claim is that such words are intrinsic to, identified with, or immanent in phrasal skeletons. Two experiments tested this hypothesis with a syntactic priming procedure. In both, subjects tended to produce utterances in the same syntactic forms as priming sentences, with the structures of the self-generated sentences varying as a function of differences in the structures of the primes. Changes in the closed-class elements of the priming sentences had no effect on this tendency over and above the impact of the structural changes. These results suggest that free-standing closed-class morphemes are not inherent components of the structural frames of English sentences. PMID- 2721135 TI - Social support and life stress: a mental health consumers perspective. AB - This paper presents the results of an exploratory study of the relationship between two conceptualizations of social support and the experience of stress, frustrations and use of leisure time. A correlational study was conducted with over 200 clients of community support services in a large mid-western state. For these mental health consumers, no meaningful relationship was found between social support variables and the criterion variables. The long term mentally ill were found to have small social networks. The authors argue that reducing loneliness by itself is a valuable outcome of service for this population. PMID- 2721136 TI - Evaluating the effectiveness of countywide mental health care systems. AB - This study evaluates the effectiveness of eight (four urban and four rural) Community Support Program (CSP) delivery systems located in a state in the northwest United States. Data were collected from 364 respondents: 156 service organization directors, 49 case managers, 77 family members, and 82 seriously mentally ill clients. Four measures of effectiveness were used: comprehensiveness (number of key services for the seriously mentally ill available), coverage (proportion of persons served who needed services), quality of services on a six point scale, and services coordination (six-item scale). The four performance measures were found to significantly differentiate the eight counties. In five of six cases the measures were positively intercorrelated thereby confirming CSP claims that the key services are an integrated set and that it is feasible to provide a full range of services without sacrificing quality or hindering coordination. PMID- 2721137 TI - Managing local government opposition to community-based residential facilities for the mentally disabled. AB - "Prior Notification" policies have elicited fears of community opposition from agencies who have adopted a "low profile" approach in locating community-based residential facilities. Nevertheless, data from a survey of New Jersey community care providers indicate that local government officials express less opposition when informed of the proposed location and invited to meet with the provider. Arranging to meet with local officials is most important when neighbors have leadership, since officials express more intense opposition when neighbors invite them to a meeting. The literature has already established the fact that meeting with neighbors can facilitate mobilization and thereby engender more intense opposition, both from neighbors and from local officials. Hence, the available evidence suggests that providers should meet with local officials to discuss the community care program but should attempt to deal with neighbors individually. This strategy is compatible with the policy of "prior notification" adopted in New Jersey. PMID- 2721138 TI - Ethics training at mental health centers. AB - Eighteen (78.26% response rate) mental health centers in Colorado responded to a survey about the nature of ethics training. Mental health centers spent an average of 1.27 hours during the previous year on ethics training. Centers rated their staff as less prepared to deal with ethical issues than programs rated their students, representing a split between classrooms and applied settings. There may be some confusion of ethical and legal issues. Several recommendations are made, including interdisciplinary and continuing ethics training, and teaching a process of thinking rather than merely cases and rules. PMID- 2721139 TI - Low-income blacks in community mental health: forming a treatment relationship. AB - Sociodemographics, psychological symptom distress, and global adjustment were related to perceived quality of the therapeutic relationship at a community mental health center serving a predominantly low-income and black clientele. Data were collected at intake describing 56 clients; additional data were collected after two sessions of treatment, recording therapist perceived quality of the therapeutic relationship. Results indicated that with all else controlled, three factors predicted a favorable therapist evaluation: having ever been married; reporting more symptoms of psychological distress; having been rated as better adjusted. Apart from symptoms of hostility and somatization, the type of symptom distress suffered appeared less important than the number of symptoms and their severity. In this little studied but increasingly prevalent population of clients, it is possible to predict the formation of a promising therapeutic relationship by means of a relatively straightforward model of symptoms and adjustment. PMID- 2721140 TI - The psychiatric services in Cremona: a case study of the Italian reform law. AB - Italy's mental health law of 1978 provided for the gradual phasing out of psychiatric hospitals (PH) and the creation of comprehensive community-based systems. However, these changes have taken place at different times and in different forms. There are now three different organizational and care models operating in Italy: in the first, common in Southern Italy, the former PH and the new general hospital general wards (GHPW) coexist; in the second, outpatient departments complement the above facilities, but the hospital activity remains central; in the third model, a community model has been given priority--the so called "community priority." While many reports have been published describing the activity of some of the services adhering to the third model, no report has been published specifically describing the activity of services which work according to the second model, such as Cremona. In this paper, the activity of the Cremona psychiatric services is described, and the consequences of the reform law and the problems related to an hospital-based activity are emphasized. PMID- 2721141 TI - Patient reactions to a no smoking policy in a community mental health center. AB - The prevalence of cigarette smoking in a CMHC population was surveyed and patient attitudes and affective reactions regarding the implementation of a no smoking policy were assessed. The prevalence of smoking (80-84%) was in line with previous reports which have suggested that an extraordinarily high percentage of psychiatric patients engage in cigarette smoking. Significant differences were observed between smokers' and nonsmokers' reactions to the no smoking policy which resulted partially from negative reactions by smokers but also from positive reactions by nonsmokers. Although a slight decrease in client satisfaction was observed, the emotional reactions of smokers were generally not clinically substantive. A 16 month follow-up survey of clinicians further supported the idea that the negative reactions of smokers were not of major magnitude and were probably transitory. The authors conclude that the primary effects of a mental health center smoking policy may be the protection of the service environment and improvements in the well-being of nonsmoking patients and staff who would otherwise be at risk for the effects of second hand smoke. PMID- 2721142 TI - Accuracy of death certificates in neonatal deaths. AB - Death certificates of neonates were compared with detailed clinical and pathological information provided for a national neonatal mortality survey. The systematic method of assigning the cause of death to one of seven broad categories in the survey found complete agreement with the underlying cause of death on the death certificate in 83 per cent of cases (274/330). There was only a minor disagreement involving clinical opinion in a further 6.7 per cent (22). The reasons for disagreement in the remaining 10.3 per cent (34) were examined. In the majority of instances, 6.0 per cent (20), the fault lay with the certifying doctor who provided inadequate or inaccurate information on the death certificate or who, in providing all the information, appeared to be ignorant of coding rules. In 1.2 per cent (4) the fault lay with coding inaccuracies or misapplication of coding rules in failing to select the underlying cause in a correct sequence of clinical events. In the remaining 3.0 per cent (10) of cases the rules governing the survey did not follow the WHO coding rules. PMID- 2721143 TI - A census of patients waiting for treatment or consultation in surgical specialties in an English health region. AB - A census of waiting lists in five surgical specialties within the Northern Region has been carried out. In addition to enumerating those patients waiting for inpatient treatment and outpatient consultation, the census characterized lists in terms of the age and sex structure of those waiting; the length of time people had waited; their district of residence and (for inpatients only) the numbers waiting for certain specified operations or procedures. Patients waiting for inpatient treatment were older, overall, than the general population and, within specialties, ophthalmology lists contained a higher proportion of the very elderly whilst ear, nose and throat surgery lists had a younger age-structure. Three-quarters of ophthalmology inpatient lists were made up of patients waiting for cataract surgery, 14 per cent of patients awaiting orthopaedic inpatient treatment were waiting for hip joint replacement and 32 per cent of gynaecology lists comprised women needing sterilization. These data on age-structure and case composition are broadly similar to recent work carried out by Yates's group who restricted their study to longer waiting lists in the West Midlands Region and Wales. When data in the present study were related to the population from which the cases arose, it was found that the prevalence of outpatient waiting was greater than inpatient waiting except for general surgery (where a higher proportion of the population was awaiting inpatient treatment) and in gynaecology (where outpatient and inpatient waiting was equally common).2+ Standardized waiting list ratios (SWLRs) have been calculated to allow comparisons between districts and specialties, free of distortions produced by differing age structure of populations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721144 TI - Care in the community--elderly people living alone at home. AB - A study carried out in East Anglia identified a number of aspects of the lives of elderly people living alone and some of these are reported here. A sample of 2000 elderly people from 20 general practitioner practices was selected for interview. Overall, there was a response rate of 88 per cent. Of those age 75 and over, 43 per cent lived alone, this proportion being higher in urban areas, in council, privately rented and sheltered housing and amongst women. There is a high level of informal support for elderly people living alone, although there is also a large number who do not have regular frequent visitors. Of the statutory services, home helps visit nearly a quarter of those aged 75 and over living alone, on a weekly basis. In terms of at least one activity of daily living, shopping, those living alone exhibit a higher level of independence than those living with others, but nearly a quarter of those aged 75 and over living alone do rely on someone else entirely to do their shopping for them. The study identified a number of aspects of ill health in elderly people. There was a substantial proportion with urinary incontinence and, amongst those aged 75 and over living with others, a significant proportion with a degree of faecal incontinence. There was also a high proportion of people unable to cut their own toenails.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721145 TI - Drugs affecting postural stability and other risk factors in the hip fracture epidemic--case-control study. AB - A parallel rise in hip fracture incidence and the rate of prescription of drugs affecting postural stability have been investigated by a case-control study. Other risk factors were also considered. One hundred and seventy-three cases and 134 hospital emergency surgical controls were interviewed and briefly examined, and drug data were corroborated by letter to general practitioners. The analysis revealed no significant difference between consumption of benzodiazepines in cases and controls, major tranquillizers, diuretics or other anti-hypertensives. However, they differed significantly in their average body weight and incidence of stroke. It is suggested that hip fractures on the whole occur in a particularly frail group of elderly people and that the increased fracture incidence over the last 20 years results from the survival of a more frail or less active group than hitherto. PMID- 2721146 TI - Medical student projects in practical health promotion. AB - This paper describes a programme of projects on health promotion policy carried out by students of St Mary's Hospital Medical School as part of the community medicine course. The programme of work draws together three themes which have recurred in recommendations on the future of medical education: the need to locate health within its social and economic context, the importance of training doctors in health promotion, and the educational value of project work. From a practical service perspective, the information gained thereby has been extremely valuable in assisting the development, implementation and monitoring of local health promotion policies. PMID- 2721147 TI - Analysis of secular trends in surgery for glue ear in the North Western Region (1975-1984). AB - Hospital Activity Analysis (HAA) data relating to operations for glue ear and tonsillectomy performed on residents of the North Western Region, aged 0-9 years during the period 1975-1984 were studied. The rate of surgery for glue ear has risen from 45/10,000 to 107/10,000 representing an increase of 137 per cent. The tonsillectomy rate by comparison has undergone a more modest increase of 19 per cent. The study casts doubt on a 'vacuum effect', as has been argued by Black. Marked variation in rates of surgery between Districts in the Region were noted, and the possible explanations discussed. A review of the literature revealed considerable controversy concerning the management of glue ear and the need for a definitive trial is highlighted. PMID- 2721148 TI - Outcome indicators for diabetes services--what do we have and what do we need? AB - Minimizing the need for hospital admissions for hyperglycaemic coma, hypoglycaemic coma and amputation of the lower limbs in patients with diabetes can be regarded as some of the legitimate objectives of a local diabetes service. Routinely collected data are available to calculate rates for such admissions for health service districts and for regions or their equivalents. East Anglian regional rates for admissions mentioning hyperglycaemic coma fell between 1981 and 1986 while rates for those mentioning hypoglycaemic coma rose. Amputation rates remained steady. Between-district variation for all rates was considerable and certain districts showed consistently high rates from year to year for hyperglycaemic coma with others having consistently high rates for amputations. Lack of standardization of case definition and uncertainty about the validity of routinely collected hospital admission data are the most important drawbacks of this approach. With careful interpretation, however, these data provide a possible source for the measurement of the effectiveness of local diabetes services. PMID- 2721149 TI - The meaning of information on GP referral rates to hospitals. AB - Research shows consistently wide variations in all aspects of general medical practice. Extreme variations in rates of referral to hospital have recently been highlighted, but remain largely unexplained. New information systems now make it possible to identify GPs with very high or very low rates of referral so that their behaviour can be reviewed. Before using this information politicians, managers and doctors should give careful thought to what it means and its limitations. The rate of referral provides no indication of the appropriateness of referrals. Any intervention designed to improve the referral mechanism should aim to increase the proportion of people who are appropriately referred to hospital and to reduce the proportion who are inappropriately referred. This is unlikely to be achieved by focusing attention on GPs with high or low rates regardless of how they are made up. PMID- 2721150 TI - Communicable disease report July to September 1988. From the PHLS Communicable Disease Surveillance Centre. AB - The most important events of the quarter were the preparations for the new childhood immunization programme with the official introduction of measles/mumps/rubella (MMR) vaccine on 1 October 1988, and the revision of the list of the notifiable infectious diseases on the same date. PMID- 2721151 TI - Isolation and characterization of histones from Anopheles albimanus Weidemann. AB - 1. Histones from Anopheles albimanus adults were prepared by a combination of techniques including chromatin isolation and selective extractions. 2. The anopheline histones were identified on acid urea gels by comparing their electrophoretic profile with that of calf thymus histones and histones isolated from other tissue. 3. Excellent separation of histones was obtained after the extractions by a single electrophoretic run. 4. In addition to the five major classes of histones found in eukaryotes, a sixth class was detected and tentatively identified as histone H5. 5. This is the first report of histone H5 and its function in insects. PMID- 2721152 TI - Comparison of protein constituents between atria and ventricles from various vertebrates by two-dimensional gel electrophoresis. AB - 1. Protein constituents of cardiac muscles of 23 species were examined by two dimensional gel electrophoresis in order to find the difference in protein components between atria and ventricles. 2. Protein compositions of atria were similar to those of ventricles, however, differences were found in myosin and some other proteins in most species. 3. A major protein with molecular weights of 12,000-15,000 daltons was distributed only in atria from mammals. 4. The atrioventricular difference suggested that the ventricular tissue was more specialized in mammals than in birds, as compared with the atrial tissue. PMID- 2721153 TI - Purity of Glycera dibranchiata monomer hemoglobin components III and IV determined by isoelectric focusing. AB - 1. The Glycera dibranchiata monomer hemoglobin components III and IV display behavior upon high voltage isoelectric focusing which is similar, but not identical to the behavior demonstrated by monomer hemoglobin component II (Constantinidis and Satterlee (1987). Biochemistry 26, 7779-7786). 2. Both components III and IV show multiple line behavior and formation of significant amounts of apoprotein when solutions of each holoprotein are focused on polyacrylamide gels. 3. The apoprotein of each component focuses as a single line, indicating that this is the most unambiguous estimate of purity for these proteins. 4. The purity of the component III and IV preparations can be estimated to be at least 95%. PMID- 2721154 TI - Quantification and kinetics of purine catabolism in Dalmatian dogs at low and high purine intakes. AB - 1. In eight Dalmatian dogs low and high purine intakes resulted in plasma urate levels from 25 to 185 mumol/l. 2. The relationship between purine intake and excretion of uric acid and allantoin per day was described by linear regression equations. 3. The elimination of endogenous purines was 1.8 mmol/day for urate and 1.7 mmol/day for allantoin. Exogenous purines increased renal excretion by 0.57 mmol/mmol. 4. Kinetic measurements with [2(-14)C]uric acid infused continuously into each of two dogs on low and high purine revealed increases of plasma pool (urate + allantoin) of 3.3 fold and entry rate of 4.0 fold. Conversion of urate into allantoin increased from 20 to 36%. 5. Renal elimination of catabolites increased 3.3 fold and exhalation rate of purine-CO2 379 fold. Extra-renal elimination at high purine intake was quantitatively similar to humans and closely related to pool size. PMID- 2721155 TI - Lipolytic enzymes of the digestive organs of the crown-of-thorns starfish (Acanthaster planci): comparison of the stomach and pyloric caeca. AB - 1. Stomach and pyloric caeca homogenates from the crown-of-thorns starfish hydrolysed p-nitrophenyl esters, alpha-naphthyl esters, cholesteryl oleate and tributyrin. The pyloric caeca contained the highest activities. 2. The p nitrophenyl acetate hydrolytic activity eluted at 0.23 M NaCl on ion exchange chromatography while the p-nitrophenyl palmitate hydrolytic activity eluted between 0.2 and 1.0 M NaCl. 3. Polyacrylamide gel zymograms for alpha-naphthyl acetate hydrolytic activity revealed one major band and several minor bands of activity for both tissues. 4. Isoelectric focusing zymograms revealed one major band with a pI = 4.2 for both tissues, with an additional band at pI = 3.5 for pyloric caeca. 5. The pyloric caeca contained twice as much lipid as the stomach. Lipid extracts contained mixtures of steroids and steroid-esters; a cholesterol like sterol was tentatively identified. PMID- 2721156 TI - Enzymatic deacylations of esterified saccharides--III. Comparison of de esterifications by serum esterases from different sources. AB - 1. 14C-labelled methyl 2,6-di-O-pivaloyl-alpha-D-glucopyranoside (1) was used as a substrate for esterases from rabbit, guinea pig, mouse, donkey, pig, horse, sheep and human sera. 2. Stepwise de-esterification of the diester substrate 1 occurred with rabbit, guinea pig and mouse serum. Data on time-course experiments and kinetic data are reported. 3. The use of donkey, pig, horse, sheep and human serum led to the migration of the 2-O-pivaloyl group in substrate 1 to the position 4- in the sugar molecule, followed by stepwise de-esterifications of both 1 and the newly formed methyl 4,6-di-O-pivaloyl-alpha-D-glucopyranoside (4). A report is given on the time-course experiments. PMID- 2721157 TI - Evidence of myristylated disulfide-linked dimer of variant surface glycoprotein of Trypanosoma brucei-brucei. AB - 1. Variant surface glycoprotein (VSGs) of Trypanosoma brucei-brucei may exist as a disulfide-linked dimer in both forms: myristylated (mfVSG) and non-myristylated (sVSG), as judge by fluorography and immunoblotting of SDS-PAGE under non reducing conditions. 2. The dimeric VSG form is labeled with [3H]-myristic acid in our incorporation conditions. 3. AnTat 1.1 trypanosomes preincubated with tunicamycin and incubated with [3H]-myristic acid synthesized a labeled molecule that has an apparent molecular weight slightly smaller than the native form, and that also corresponds to a disulfide-linked dimer. PMID- 2721158 TI - Physico-chemical characteristics of superoxide dismutase in Ascaris suum. AB - 1. Three SOD isoenzymes obtained from purified extracts of Ascaris suum were characterized. 2. The physico-chemical characteristics studied were: optimum pH, methods of preservation of enzymatic activity, molecular weight, and the u.v. and visible light absorption spectra. 3. The optimum pH for the Cu, Zn SOD I and II was 10.2 and 10.1 for the Mn SOD. 4. The extracts retained their levels of activity longer at -70 degrees C, and after lyophilization. The Mn SOD was more labile than the Cu, Zn SOD I and II. 5. The molecular weights obtained by filtration through Sephadex G-75 were: 73,000 for Mn SOD; 42,600 for Cu, Zn SOD I; and 39,800 for the Cu, Zn SOD II. 6. Both the u.v. and visible light spectra were similar to other dismutases from other sources. PMID- 2721159 TI - Integral lipids of mammalian hair. AB - 1. It has been demonstrated that hair contains lipids which cannot be removed by extensive extraction with chloroform-methanol mixtures. These integral lipids can be extracted only after the hair has been subjected to alkaline hydrolysis. 2. Integral hair lipids include cholesterol sulfate (0.7-2.9 mg/g hair), ceramides (0.6-1.4 mg/g), cholesterol (0.3-1.4 mg/g), fatty alcohols (trace-0.2 mg/g) and fatty acids (2.3-4.0 mg/g). 3. One of the major integral hair lipids, representing 38.4-47.6% of the total fatty acids, is the anteisobranched 18 methyleicosanoic acid. 4. The species examined included human (Homo sapiens), pig (Sus scrofa), dog (Canis familiaris), sheep (Ovis ammon aries) and cow (Bos taurus). PMID- 2721160 TI - Metabolism of aldosterone in the colostomized duck (Anas platyrhynchos): partial characterization of urinary metabolites. AB - 1. Chronically colostomized ducks were injected with [4-14C]-aldosterone to study the metabolism of aldosterone and the pattern of metabolite excretion via the kidney. 2. Nearly half of the injected dose was excreted as radiometabolites during the first 24 hr; the largest amounts being excreted during the first 3 hr after injection. 3. Ion-exchange chromatography showed that monosulfate, disulfate, glucuronide, acidic, and neutral metabolites were excreted during each collection period, and that their relative proportions changed with time after injection of [4-14C]-aldosterone. 4. HPLC analysis of the neutral radiometabolites revealed 15 major peaks with retention times corresponding to both polar and reduced derivatives of aldosterone. 5. Only small quantities of unaltered labelled aldosterone were excreted. 6. Treatment of the birds with SKF 525-A caused a decrease in the total quantity of radiometabolite excreted and a change in the proportions of neutral and acidic metabolites in the cloacal fluid. 7. The decreases that occurred in the absolute amounts of some of the polar metabolites excreted by the birds treated with SKF-525A suggests that they may be hydroxylated and at least part of the aldosterone metabolizing system in the duck is cytochrome P450 dependent. PMID- 2721161 TI - Oxidative metabolism of rabbit and rat intestine with short chain fatty acids and glucose: an evaluation of data analysis. AB - 1. Glucose sustained VO2 of rabbit ileum, caecum, and distal colon better than SCFAs. 2. In rabbit proximal colon, while VO2 was stimulated in the presence of butyrate it was not sustained. 3. Rat caecum utilized glucose but it was not necessarily the best substrate for either the ileum or colon of this species and SCFAs appeared to stimulate VO2 of rat ileum and inhibit VO2 in rat caecum and colon. 4. It was concluded from the comparison of the two methods of data analyses that curve-fitting the data by a negative exponential equation provides for a more clear and in depth interpretation of such studies. PMID- 2721162 TI - The global extrapolation of numerical methods for computing concentration profiles in percutaneous drug absorption. AB - A family of numerical methods is developed and analyzed for the numerical solution of the parabolic partial differential equation together with the associated initial and boundary conditions, which arise in a mathematical model of the transient stage of percutaneous drug absorption. Two global extrapolation procedures are described, the first in time only, the second in both space and time, for improving the accuracy of the computed concentration profiles. The behaviours of two members of the family of methods, before and after extrapolation, are examined by repeating a number of experiments reported in the literature. Modifications to the algorithms, which are necessary in computing concentration profiles after the ointment is removed at the steady state, are outlined. PMID- 2721163 TI - A program package for self-assessment and examination in biochemistry. AB - A BASIC program has been developed for self-evaluation and testing of an individual's knowledge of main categories in biochemistry. The computer tests permit sequential or random distribution of items, random distribution of answers in each item at each new run, effective feedback control with the student, use of a program clock to determine different time allowance, precise and quick analysis and grading of student's answer thus saving the time and labour of examiners. Editing, deleting and appending of new items is easily achieved. Information is obtained for verifying the quality of the test itself. Examination versions of tests in ten categories have been combined into an annual computer test in biochemistry. PMID- 2721164 TI - New noninvasive computerized method for the area measurement of the dicrotic notch. AB - Measurement of the area of the dicrotic notch is an important noninvasive diagnostic procedure in cardiocirculatory evaluation. The methodology for measuring the magnitude of the dicrotic notch has varied considerably, ranging from visual inspection to the use of microcomputer technology. The current computerized method provides a quantitative exactitude when compared to polar planimetry. Coefficients of correlation (r) were 0.89 and highly significant (p less than 0.01). Furthermore, the current method circumvents densitometric placement variation between repeated measurements. PMID- 2721165 TI - Software interface between SAS and the GDDM interactive chart utility. AB - Data from temporary or permanent SAS-data-sets on disk are transferred to the GDDM Interactive Chart Utility (ICU). Within the ICU these data can be displayed graphically, including all features of modification, supported by the ICU. The transfer is accomplished by a user written SAS procedure, which transforms the data from SAS internal format to the structure required to call the ICU from a PL/1 program. The interface provides interactive menu driven graphics from SAS data-sets without the need to use SAS control language. The implementation refers to the CMS operating system. PMID- 2721166 TI - On the optimal choice of the electrode number and locations in body surface mapping. AB - The problem of choosing the number and the thoracic locations of the leads needed for reconstructing body surface maps of heart potentials is considered. In a previous work (P. Barone, In "Computers in Cardiology" (K. L. Ripley, Ed.), pp. 491-494. IEEE Computer Soc. Press, Washington, DC, 1985) the problem was solved, provided that the user is able to give a threshold below which the information content of two leads is considered equal. In this paper a sensitivity analysis that can help the user in choosing the optimal threshold, or, equivalently, the optimal number of leads, is performed. The problem is reduced to the dynamic search of spanning forests of an undirected graph. An example using real data is also discussed. PMID- 2721167 TI - Stochastic Petri net modeling of wave sequences in cardiac arrhythmias. AB - We describe a methodology for modeling heart rhythms observed in electrocardiograms. In particular, we present a procedure to derive simple dynamic models that capture the cardiac mechanisms which control the particular timing sequences of P and R waves characteristic of different arrhythmias. By treating the cardiac electrophysiology at an aggregate level, simple network models of the wave generating system under a variety of diseased conditions can be developed. These network models are then systematically converted to stochastic Petri nets which offer a compact mathematical framework to express the dynamics and statistical variability of the wave generating mechanisms. Models of several arrhythmias are included in order to illustrate the methodology. PMID- 2721168 TI - Computer model of cardiac repolarization processes and of the recovery sequence. AB - A computer model simulating both excitation and recovery processes within a block of heart muscle tissue has been developed and implemented on different IBM PC AT compatible computers. The model incorporates blocks of tissue consisting of several thousand elements and introduces phenomena which are completely or partly omitted in other existing cardiac electrophysiology models. These phenomena include the electric anisotropy of the tissue, different durations of repolarization in different layers of tissue, and the different shapes of action potential which correspond to cells excited when not fully recovered. Implementation of the model on small personal computers requires the use of a special data structure management and an effective algorithmic background. The program of the model is written in PASCAL and uses dynamically allocated data structures and the asynchronous simulation technique of event planing. These techniques are described in detail. The model has been used in various experiments. Results of simulation studies are presented in the form of modeled three-lead electrocardiographic records. The experimental series which are described include basic patterns of regular activation sequences, modeling of premature beats, simulation of effects due to fast pacing, models of ischemia and infarction, simulation of reentry mechanisms with a special reference to the initiation of ventricular fibrillation, and models of late potentials. The future development of more realistic models of the cardiac recovery process is also discussed. PMID- 2721169 TI - NERVTRACK--a neuroanatomical data bank. AB - To provide the neurologist with a detailed and easily accessible neuroanatomical reference, we have developed a data bank including all relevant efferent and many afferent neuroanatomical pathways. NERVTRACK contains 4000 anatomical data items arranged in a tree-like manner reflecting structural and functional relationships. The program is able to address problems like the following: (1) What is the spinal, radicular, and peripheral innervation of a given muscle? (2) Which muscles are affected by a lesion of a given peripheral nerve, a root, or a segment of the spinal cord? (3) For a given muscle, what are synergists and antagonists, and which clinical test is applicable to evaluate its strength? NERVTRACK runs on IBM-compatible microcomputers, even on lap tops. It is a fast and comfortable reference for clinical practice and serves as a readily accessible teaching aid. PMID- 2721170 TI - A semi-Markov model for the average length of stay in transient states and its application. AB - The purpose of this paper is to develop a methodology that can be used to study the length of stay distribution of the patient in various states of the disease. The treatment data on cancer of cervix patients are used to illustrate its application. PMID- 2721171 TI - Comparison of electrocardiographic data (P waves): test of a shape-based approach. AB - We tested a method for comparing ECG signals (P waves), in a sample of 10 normal males. In each subject, sets of 219 body surface ECGs were simultaneously recorded during tidal respiration. Only beats at end expiration and peak inspiration were considered. The beats of each group were subdivided into two subgroups of the same size (about 30 beats) and separately averaged. The two averaged beats at end expiration, assumed to be equal, were compared in order to estimate the noise variance (sigma2), i.e., the lowest value of variance at which the beats were statistically similar (P less than 0.05). At the same value of sigma2, the beat at end expiration significantly differed from that at peak inspiration. By considering the individual leads, significant differences were found in more than 50% of the 219 ECGs, in specific thoracic areas. The data indicated that the method can reveal differences between P waves occurring during tidal respiration and provide information on the topographical distribution of the differences. PMID- 2721172 TI - Frequency characteristics of the heart rate variability produced by Cheyne-Stokes respiration during 24-hr ambulatory electrocardiographic monitoring. AB - Spectral analysis of heart rates during 24-hr ambulatory electrocardiographic monitoring has been carried out to characterize the heart rate spectral components of Cheyne-Stokes respiration (CSR) by using fast Fourier transformation (FFT). Eight patients with congestive heart failure were selected for the study. FFT analyses have been performed for 614.4 sec. Out of the power spectrum, five parameters were extracted to characterize the CSR. The low peak frequencies in eight subjects were between 0.0179 Hz (56 sec) and 0.0081 Hz (123 sec). The algorithms used to detect CSR are the followings: (i) if the LFPA/ULFA ratios were above the absolute value of 1.0, and (ii) the LFPP/MLFP ratios were above the absolute values of 4.0, then the power spectrum is suggestive of CSR. We conclude that the automatic detection of CSR by heart rate spectral analysis during ambulatory ECG monitoring may afford a tool for the evaluation of the patients with congestive heart failure. PMID- 2721173 TI - Applying expert system techniques to human genetics. AB - Although expert systems have been developed in a variety of medical areas, there has been very little application of expert system techniques to the field of human genetics. The purpose of the research project described in this paper was (1) to experiment with different types of knowledge representation for data and knowledge structures in human genetics and (2) to explore the applicability of different inference mechanisms for various genetic problems. We present an object oriented and a fact-based model for the representation of genealogical information and describe two prototype systems. PMID- 2721174 TI - Automatic landmarking of cephalograms. AB - This paper presents an algorithm for automatically locating certain characteristic anatomical points called landmarks on cephalograms (skull X-rays). These landmarks are used by orthodontists in diagnosis and treatment planning. The algorithm uses digital image processing and feature recognition techniques to locate the landmarks. A resolution pyramid of the digitized cephalogram is first created. The algorithm works on the smaller, lower resolution images to locate features of interest and moves to the bigger, higher resolution images if greater location accuracy is required. Prefiltering using the median filter, contrast enhancement using histogram equalization, and edge enhancement using different gradient operators are performed on the images. The algorithm uses anatomical knowledge of the human facial structure to search for features containing the landmarks. The accuracy of the algorithm in locating the landmarks is compared with values obtained from human experts. At present the algorithm attempts to locate 10 landmarks of 27 needed for a complete analysis. All 10 landmarks have been successfully located on five cephalograms of varying quality. PMID- 2721175 TI - Application of the general linear model for smoothing gas exchange data. AB - The precision of an interpretation of gas exchange records in progressive exercise is limited by the typical breath-to-breath variation in the data. Recently, two procedures have been proposed for minimizing the "noise" in the estimates of alveolar gas exchange time series data. One approach utilizes an estimate of pulmonary blood flow (Q) for smoothing purposes. The other approach utilizes an estimate of effective lung volume (V'L) for smoothing purposes. In this paper, we formulate the smoothing problem as a general linear model and demonstrate the concurrent estimates of both V'L and Q. Furthermore, we investigate the interaction between V'L and Q. Specifically, when a high value of lung volume is used (such as the subject's resting functional residual capacity) in the alveolar gas exchange algorithm, the estimate of Q is biased low and the result is a less effective smoothing of the data. In addition, we demonstrate how the Q estimate can be improved by utilizing more appropriate estimates of arterial carbon dioxide tension. PMID- 2721176 TI - Size polymorphism of the erythrocyte complement receptor type 1 (CR1) in systemic lupus erythematosus induced by hydralazine. AB - The human erythrocyte complement receptor type 1 (CR1) is polymorphic with respect to molecular weight. Size variants with molecular weights of 190,000 (type A), 220,000 (type B) and 160,000 (type C) daltons have been detected in normal individuals (22 individuals), patients with hydralazine (Hz) lupus (n = 27), a group of Hz controls (n = 30) and the relatives of both Hz groups (27 and 11 individuals, respectively). The method of detection was SDS-polyacrylamide gel electrophoresis of erythrocyte membranes on low-percentage cross-linked gels followed by Western blotting using polyclonal rabbit anti-CR1 antibodies. In normal individuals, 77% had the A allotype and 26% carried the B allotype; amongst Hz lupus patients 67% carried the A allotype, 31% carried the B allotype, and 3% (1 individual) had the C allotype. Amongst the patients who had been on Hz but did not develop SLE, 83% carried the A allotype and 17% carried the B allotype. The AA phenotype was only found in 44% of Hz SLE patients but in 64% of normals and 70% of the Hz control group. Although not statistically significant, the results indicate a relative underrepresentation of the AA phenotype in patients with Hz-induced SLE. In addition, an equal or greater relative amount of the C allotype was detected in an Hz SLE patient with the AC phenotype. This is in contrast to lower relative amounts of the C allotype found in normal individuals with this phenotype. PMID- 2721177 TI - [Definition of psychiatry--establishment of scientific psychiatry (14)]. PMID- 2721178 TI - [Question on modern medicine. 4. I. Critique on Guyton's physiology]. PMID- 2721179 TI - [Case study series: nursing report and discussion. Various approaches to a nursing situation and the development of understanding of patients]. PMID- 2721180 TI - [In search of logic in awareness of a child--a theory of awareness in child care]. PMID- 2721181 TI - Interaction of cinnamaldehyde (a sensitizer in fragrance) with protein. AB - Formation of a cinnamaldehyde-protein conjugate in the skin by reaction of cinnamaldehyde with nucleophilic groups in proteins is considered to be responsible for the observed immunogenicity. The kinetics of the reaction of bovine serum albumin with cinnamaldehyde in aqueous solution at 30 degrees C have been investigated, and the rate of formation of conjugate over the pH range 6.4 10.5 showed a first-order dependence on cinnamaldehyde concentration. The cinnamaldehyde binding sites on the protein appeared mostly or exclusively to be the thiol groups of cysteine residues. PMID- 2721182 TI - Penetration of the fragrance compounds, cinnamaldehyde and cinnamyl alcohol, through human skin in vitro. AB - The delivery of cinnamaldehyde and cinnamyl alcohol in fragrance through human skin has been investigated by in vitro penetration studies using full thickness human skin. Cinnamaldehyde was transformed to cinnamyl alcohol and cinnamic acid in the skin. The transformation took place in model protein solution, bovine serum albumin, as well as in skin homogenates. After conjugation of cinnamaldehyde with the protein, a lag time was observed after which cinnamyl alcohol and cinnamic acid were released. On the other hand, cinnamyl alcohol was not transformed in detectable amounts to either cinnamaldehyde or cinnamic acid during penetration of the skin. PMID- 2721183 TI - Hyposensitizing therapy with standard antigenic extracts: an important source of thimerosal sensitization. AB - The frequency of thimerosal sensitization was determined in 5 groups of subjects: military recruits; healthy subjects; patients with asthma or rhinitis undergoing hyposensitizing therapy with thimerosal-preserved antigenic extracts; patients with allergic contact dermatitis; patients with allergic contact conjunctivitis. Our patients with allergic contact dermatitis have a higher incidence of positive patch tests to thimerosal than healthy subjects. The source of thimerosal sensitization in this group remains obscure, their history of exposure to this or to other mercury derivatives being comparable to that of the healthy population. Patients with allergic contact conjunctivitis and patients receiving immunotherapy for asthma or rhinitis present a significantly higher frequency of thimerosal sensitization than the other groups, indicating that ophthalmic solutions and thimerosal-preserved allergen extracts are an important source of thimerosal sensitization. The clinical relevance of thimerosal sensitization was definitively established only in patients with allergic contact conjunctivitis, even though patients receiving immunotherapy frequently presented local reactions at the site of allergen inoculation. PMID- 2721184 TI - Contact allergy to surgeons' gloves in their patients. PMID- 2721185 TI - Dynamics of the pattern of contact sensitivity in Sofia. PMID- 2721186 TI - Seasonal influence on patch test results. PMID- 2721187 TI - Contact dermatitis from plants in a geriatric nurse. PMID- 2721188 TI - Nickel sulphate in the treatment of alopecia areata. PMID- 2721189 TI - Irritant contact dermatitis due to the herbal oil, black man oil. PMID- 2721190 TI - Patch test results in 1987 compared to trends from the period 1977-1983. PMID- 2721191 TI - Phosgene (2,5-dichlorophenyl)hydrazone, a new strong sensitizer. PMID- 2721192 TI - Patch testing with fragrance mix at 16% and 8%, and its individual constituents. PMID- 2721193 TI - The percutaneous electrocoagulation vasectomy technique--a comparative trial with the standard incision technique at Marie Stopes House, London. AB - One-hundred-and-one men requesting vasectomy in 1985 for the purpose of limiting family size were admitted to a study of standard incision and monopolar diathermy, and a new percutaneous electrocoagulation vasectomy procedure. Semen specimens were tested at 10 and 12 weeks after surgery. Men were telephoned at 2, 12 and 24 weeks post-surgery to elicit complications and complaints. Half of the men having the standard incision procedure and about one-third of the men undergoing the percutaneous procedure complained of discomfort during the surgery. At the two-week telephone contact, 23% of those having the standard incision and 66% of those having the percutaneous procedure reported complications. There were few complications or complaints reported at the long term follow-up contacts with either method; although twice as many men in the percutaneous group were not declared sterile by the end of the study period. Failure rates were 2.0% for the standard incision procedure and 7.8% for the percutaneous approach. PMID- 2721194 TI - The reliability of surrogate information about oral contraceptive use, smoking, height and weight collected from men about their wives. AB - Ninety-nine female hospital patients and their husbands were asked to complete separate questionnaires about the woman's history of using oral contraceptives as well as her height, weight and cigarette smoking habits. The questionnaires were completed in the presence of a research nurse to ensure that there was no discussion. Reports of height, weight and smoking status showed a good agreement between the women and their husbands. Husbands usually reported accurately on whether the woman was a current or past user of oral contraceptives, but most of them were unable to name the brand of oral contraceptive that was used, or give an estimate of the duration of use. PMID- 2721195 TI - Effects of a new indole derivative on guinea pig reproduction. AB - The effect of a new indole derivative, (1,1,3-trimethyl-3-(3'-indolyl)-1,2,3,4 tetra-hydrocyclopent[b]-in dole) denoted 1 related to indomethacin and yeuhchukene 2 were tested on guinea pig reproduction. In mating experiments ten females were given compound 1 p.o. from cycle day 14 and onwards throughout pregnancy. Two groups of ten females each were used as controls. Conception occurred significantly (p less than 0.001) faster in the treatment group. The litter size was significantly (p less than 0.001) smaller after treatment with the indole derivative. Dams and pups did not seem to have been adversely affected by the treatment as judged by their exterior, behavior and survival. The results are suggested to be due to a reduction in the number of ova available for conception (litter size) in combination with improved conditions for ovum implantation and/or a facilitated sperm migration in the female genital tract. These effects are discussed in relation to known effects of arachidonic acid metabolites on reproduction. PMID- 2721196 TI - Sustained azoospermia in squirrel monkey, Saimiri sciureus, resulting from a single intratesticular glycerol injection. AB - Previous studies in rats had shown that a single intratesticular injection of glycerol resulted in long-term suppression of spermatogenesis without marked alterations in hormone levels. Studies were undertaken to determine the effect of similar treatment in squirrel monkeys (Saimiri sciureus). Ten monkeys received an intratesticular injection of saline (controls) and ten of glycerol solution (treated). Semen and blood samples were obtained on a weekly or bi-weekly basis one month prior to, during the 8 months following and at 22 months after the injection. Sperm numbers in the semen samples of controls remained at 160-435 x 10(6) per ml throughout the experiment. Sperm numbers in treated animals declined to near zero within two months and remained at zero. Serum testosterone and progesterone levels were not significantly different between control and treated animals. Serum LH and FSH levels were not significantly different between control and treated animals except during months 6-8 after the injection, when levels in the treated were higher. At termination (22 months), the weights and sperm contents of epididymides of the glycerol-treated animals were highly significantly reduced. Steroidogenesis (based on amounts and kinds of steroids formed from 14C-progesterone) by testicular tissue was not altered by the glycerol treatment when measured on a per testis basis. This is the first evidence that a single intratesticular injection of glycerol results in long-term suppression of spermatogenesis in primates, without altering testicular steroidogenesis and serum hormone levels. PMID- 2721197 TI - Breast cancer and oral contraceptives: patterns of risk among parous and nulliparous women--further analysis of the Swedish-Norwegian material. AB - A Swedish-Norwegian case-control study comprising 473 women less than 45 years old with newly diagnosed invasive breast cancer diagnosed in 1984-85, and 722 age matched control women, was reanalyzed to evaluate if nulliparous women who had used oral contraceptives (OCs) were at particular risk for breast cancer. The relative risk for nulliparous women who had used OCs for eight years or more was 4.3 (95% confidence interval, 1.4-13.1), and parous women with the same duration of use had relative risk 1.7 (0.7-4.2) as compared to nulliparous and parous women, respectively, who had never used OCs. Parous women who had used OCs for twelve years or more after their first full-term pregnancy had a relative risk of 3.0 (1.3-7.4). The findings from the study suggest that nulliparous women may be particularly susceptible to the risk for breast cancer with long-term OC use. PMID- 2721198 TI - The effect of some of the polyphenolic compounds on sperm motility in vitro: a structure-activity relationship. AB - Many of the common polyphenolic compounds which are naturally present in abundance in plant extracts, exercise inhibitory effects on mammalian sperm motility in vitro, which could be the cause of the antifertility effects of the crude plant extracts. The action of these polyphenolic compounds seems to be structure-dependent. Their activity was found to be dependent on the positions of hydroxyl groups and modulated by the positions of methyl groups on the benzene ring. Carbon-carbon double bond on the side chain of cinnamic acid series compounds was essential for their activity. One of the plausible actions of polyphenols on spermatozoa seems to be the augmentation of the generation of superoxide radicals by them, which might be involved in the inhibition of their motility in vitro. PMID- 2721199 TI - Effect of norgestrel on development of mouse pre-embryos. AB - The effect of synthetic progestins found in oral contraceptives has potential implications for developing embryos in women who receive oral contraceptives during early pregnancy. We assessed the effect of the progestin norgestrel on the developing pre-embryo. B3C6F1 mice were given 5 IU PMSG followed by 5 IU hCG 48h later. Studies were performed on pre-embryos recovered and pooled at both 24h (Group A) and 48h (Group B) post hCG. At each time period, they were randomly assigned to control or norgestrel (4.0 ng/ml) treatment. In a third study, pre embryos collected 24h post hCG were cultured in the absence or presence of 8.0, 80.0, or 800 ng/ml norgestrel. Cultures were performed in Ham's F-10 media with 10% fetal calf serum at 37 degrees C in an atmosphere of 5% CO2, 5% O2 and 90% N2 with 15-30 embryos per 1 ml of culture fluid. At 24h, 48h and 72h post recovery, cultures were viewed, the appearance of embryos noted, and number of blastomeres recorded. Compared to control groups, analysis demonstrated no significant difference in the rate of development of control and norgestrel pre-embryos in any group at any time period (24h, 48h, or 72h post recovery). We conclude that norgestrel at the dose tested has no acute adverse morphological effects on development of mouse pre-embryos. This observation has potential clinical implications with regard to inadvertent use of norgestrel-containing oral contraceptives during early days of pregnancy, as well as consideration of the mechanism of action of norgestrel-containing "morning after" pills. PMID- 2721200 TI - Morphological changes in human spermatozoa as examined under scanning electron microscope after in vitro exposure to saponins isolated from Sapindus mukorossi. AB - Saponins isolated from Sapindus mukorossi have potent spermicidal activity. Morphological changes in human ejaculated spermatozoa after exposure to these saponins were evaluated under Scanning Electron Microscope. The minimum effective concentration (0.05% in spot test) did not affect the surface topography after exposure for 1 minute. However, incubation of spermatozoa for 10 minutes resulted in extensive vesiculation and disruption of plasma membrane in the head region. Higher concentrations (0.1%, 1.25%, 2.5% and 5.0%) caused more or less similar changes which included vesiculation, vacuolation, disruption or erosion of membranes in the head region. These findings suggest that the morphological changes observed are due to alterations in the glycoproteins associated with the lipid bilayer of plasma membrane of spermatozoa. PMID- 2721201 TI - The entry of gossypol across the blood-testis barrier in rats. AB - This paper presents the experimental data about how different formulations of gossypol enter the blood-testis barrier following intravenous administration in acute experiments on rats. It was found that gossypol encapsulated by liposomes crossed the blood-testis barrier more readily than free gossypol, without affecting its pharmacokinetic pattern in the circulating blood, suggesting that liposomes may be useful as drug carriers and may facilitate the entry of encapsulated gossypol into the seminiferous tubule from the blood. PMID- 2721202 TI - Contraception and AIDS prevention. PMID- 2721203 TI - Cardiac rhythm disorders in various types of hypertrophic cardiomyopathies. AB - The aim of the study was to provide a detailed characterization of patients with hypertrophic cardiomyopathy who are at increased risk of severe cardiac rhythm disorders and, thus, also sudden death. The group, made up of 64 patients, was subjected to 24-hour ECG Holter monitoring. The patients were examined by echocardiography and myocardial hypertrophy distribution was studied in detail. A significantly higher incidence of severe ventricular arrhythmias was found in patients with hypertrophy involving large areas of the myocardium and with increased myocardial wall thickness. Patients with a positive history of syncopes were found to have a high incidence of severe supraventricular and ventricular cardiac rhythm disorders. No relationship was established between the incidence of arrhythmias and the presence or extent of obstruction. Patients with extensive hypertrophy (both in terms of the area involved and myocardial thickness) as well as those with a history of syncopes represent a risk group as regards the development of potentially lethal arrhythmias. PMID- 2721204 TI - Surgical treatment of infective endocarditis in the active stage. AB - The study summarizes the results of surgical treatment of active infective valvular endocarditis (IE) in two cardiac surgical centres in Hungary and the Soviet Union between 1969-1987. Most (92.9%) of the 241 patients operated on were in severe condition pre-operatively (NYHA Class III and IV), their mean age was 38.2 years. The infectious process was localized predominantly on the aortic valve (169 patients), and developed on previously normal valves in 151 patients. Hospital mortality was 17%, the underlying cause of death was often heart failure, sometimes associated with sepsis. Late mortality was 12.5% (25 patients), only six of these patients died of recurrent infection. The authors stress the high efficacy of surgical treatment of active valvular IE. PMID- 2721205 TI - Surgical treatment of dissecting aneurysm of the ascending aorta: immediate and late results. AB - The authors describe experience gained with surgical treatment of dissecting aneurysm of the ascending aorta in the period from 1978 to 1987. 30 patients were operated on using the techniques proposed by Bentall, De Bono and Carbrol. All patients exhibited the presence of annulo-aortic ectasia. Hospital mortality in the past four years was 20%. On the basis of an analysis of immediate and late results the authors come to the conclusion that Bentall's, De Bono's and Cabrol's technique is the method of choice for surgical corrections of annulo-aortic ectasia and Marfan's syndrome. PMID- 2721206 TI - Endothelial lesion in hypertension. AB - A method for indicating latent endothelial lesion based on circulating endothelial cell count after methionine challenge was used in a group of hypertensives and in healthy controls. A significantly increased cell count was found in hypertensives. PMID- 2721207 TI - The effect of sympathetic and parasympathetic activity on QT duration. Clinical study in patients with normal and prolonged QT time. AB - The effect of parasympathetic and sympathetic pharmacologic blockade (atropine and propranolol) on QT duration was studied in 26 patients. Of this number 17 had a normal QT time, while in 9 patients the QT interval was prolonged (greater than 460 ms). QT time was determined before and after the pharmacologic blockade with sinus rhythm (under a non fixed cycle length) and with atrial pacing (with a fixed cycle length). Atropine administration did not change QT duration significantly. On the effect of beta receptor blockade in normal patients only the corrected QT time shortened, while in long QT syndrome a very pronounced shortening in QT time, independent of the changes in the cycle length, could be observed. In QT prolongation an overactivity in the sympathetic tone can be supposed. PMID- 2721208 TI - Plasma tumor necrosis factor and mortality in critically ill septic patients. AB - Tumor necrosis factor (TNF) cachectin has been implicated as an important host mediator responsible for shock and multiple organ failure (MOF) observed during sepsis. Using a sensitive enzyme-linked immunosorbent assay, we measured plasma TNF levels in 43 septic patients suffering from a broad range of diseases. Measurements were taken on the day that sepsis was diagnosed. Eleven patients had detectable TNF plasma levels ranging from 10 to 100 pg/ml (TNF-positive group); in 32 patients circulating TNF could not be detected (TNF-negative group). The groups did not differ significantly as to age, underlying disease, percentage positive bacteremia and bacteriologic profile, sepsis score, and extent of MOF. Eight (73%) of 11 TNF-positive patients died from sepsis during ICU stay, vs. 11 (34%) of 32 TNF-negative patients (p less than .05). This study demonstrates that sepsis is accompanied by detectable circulating TNF in 25% of the cases, and for these patients mortality is twice that for comparable TNF-negative patients. PMID- 2721209 TI - Open management of the septic abdomen: therapeutic and prognostic considerations based on APACHE II. AB - We analyzed the results of open treatment in 30 patients with abdominal sepsis (11 patients after trauma [group 1], five patients with pancreatic abscess [group 2], and 14 patients with acute GI pathology [group 3]) uncontrolled by conventional methods as evidenced by continuing fever with leukocytosis and worsening organ functions. APACHE scores at the time of initial laparotomy and at the time of open management, respectively, were: group 1, 19.8 and 16.6; group 2, 8.4 and 12.4; and group 3, 14.2 and 15.0. Twenty-seven patients had multiple system failure. Sixteen (53%) of the 30 patients survived, 73% in group 1, 60% in group 2, and 36% in group 3. Survival correlated well with age less than 50 yr and the absence of multiple organ failure. The technique was easily performed and many of the pitfalls previously reported were not observed. In patients requiring fascial prosthesis, the absorbable polyglycol acid (Dexon) mesh was found to be superior to the nonabsorbable polypropylene. We conclude that the open technique is feasible, effective, and worthy of consideration in patients with extensive wound necrosis and uncontrolled abdominal sepsis. PMID- 2721210 TI - Pulmonary hypertension in acute respiratory failure. AB - In order to examine the prognostic value of pulmonary arterial hypertension (PAH) in patients with moderate and severe acute respiratory failure (ARF), 225 patients with ARF who had been treated with mechanical ventilation and admitted to our ICU during a 3-yr period (January, 1983 to January, 1986) were prospectively studied. All 70 (31%) patients with moderate and severe ARF also had some form of hemodynamic or pulmonary instability, and were monitored with a pulmonary artery catheter. Of these 70 patients, 38 (54%) had PAH (mean BP 29 +/- 6 mm Hg); their mortality was 79% (30/38). The rest of the patients (n = 32) did not have PAH (mean BP was 15 +/- 3 mm Hg) and their mortality was 44% (14/32) (p less than .01). Thirty patients met all the criteria for adult respiratory distress syndrome (ARDS), and their mortality was 70% (21/30); all of them were included among the 38 PAH patients. ARDS patients who died had a significantly higher pulmonary vascular resistance and a significantly lower cardiac index than patients who survived (p less than .001). We conclude that PAH (present in all our ARDS patients) is a good predictor of mortality in ARF of diverse causes. PMID- 2721211 TI - Terminal events in the intensive care unit: review of 258 fatal cases in one year. AB - The last events before death were analyzed in 258 patients who died in our ICU. Deepening coma (104 patients) and acute circulatory failure (90 patients) were the most common events preceding death. Catastrophic events accounted for only 12% of deaths. In 168 (65%) of 258 patients, death was considered inevitable and CPR was not performed. Furthermore, 22 (9%) patients were allowed to die after withdrawal of intensive care support. These observations indicate that most deaths are expected in the ICU and that "do-not-resuscitate" orders can be reasonably given in the majority of fatal cases. Moreover, complete withdrawal of intensive care support should be considered as a reasonable option in hopeless patients. Since circulatory shock was identified as the most common potentially reversible problem, better prevention and management of acute circulatory failure are needed to improve survival. PMID- 2721212 TI - Continuous arteriovenous hemofiltration in premature infants. AB - Five critically ill premature infants with acute renal failure (ARF) and hypervolemia were treated by continuous arteriovenous hemofiltration (CAVH). Prostacyclin was used to prevent hemofilter clotting. Mean treatment duration was 53.6 +/- 14 h. Mean blood flow rates of 1.6 +/- 0.22 ml/min and filtration fractions of 17.2 +/- 3.7% produced mean ultrafiltration rates of 8.3 +/- 3.1 ml/kg.h. Fluid overload was easily corrected by means of CAVH. The mean prehemofiltration serum creatinine and urea levels were 2.3 +/- 0.4 and 77 +/- 29.7 mg/dl; the mean posthemofiltration levels were 2.38 +/- 0.43 and 92 +/- 34.4 mg/dl, respectively. Hemofilter clotting occurred every 14 h. Urinary output was restored in three infants. Three of the five infants died, but none of the deaths was related to ARF or CAVH. CAVH is a safe and simple method to control fluid and metabolic imbalances in critically ill premature infants. PMID- 2721213 TI - Renal oxygenation in endotoxin shock in dogs. AB - Renal hemodynamics and oxygen metabolism were studied in eight adult beagle dogs during shock induced with an iv infusion of Escherichia coli endotoxin. Renal blood flow (RBF) and renal cortical PO2 decreased profoundly during the 15-min endotoxin infusion. RBF increased sharply immediately after cessation of infusion, but soon declined and remained depressed throughout the rest of the 4-h experiment. The renal cortical PO2 remained depressed for approximately 2 h and then gradually increased toward the baseline level. Endotoxin infusion was followed by an increased renal PvO2 and a decreased renal arteriovenous oxygen difference. Renal oxygen consumption declined abruptly during endotoxin infusion, but increased toward the end of the experiment. These results suggest impaired tissue oxygenation and possibly increased oxygen shunting in the kidney during endotoxin shock. PMID- 2721214 TI - Feasibility of noninvasive physiologic monitoring in resuscitation of trauma patients in the emergency department. PMID- 2721215 TI - Inverse ratio ventilation in a 6-year-old with severe post-traumatic adult respiratory distress syndrome. AB - We successfully employed inverse ratio ventilation on a 6-year-old multiple trauma victim with severe adult respiratory distress syndrome after conventional ventilation modes using volume ventilation with high positive peak inspiratory pressure and PEEP had failed to improve oxygenation. PMID- 2721216 TI - Tumor necrosis factor. PMID- 2721217 TI - Reversal of intractable septic shock with norepinephrine therapy. PMID- 2721218 TI - Weaning failure due to acute neuromuscular disease. PMID- 2721219 TI - Percutaneous approach to tracheostomy. PMID- 2721220 TI - Do periodic hyperinflations improve gas exchange in patients with hypoxemic respiratory failure? PMID- 2721221 TI - Massive doses of midazolam infusion for delirium tremens. PMID- 2721222 TI - Recommendations for intensive care unit admission and discharge criteria. PMID- 2721223 TI - Illness from fright or soul loss: a North Balinese culture-bound syndrome? AB - The paper examines kesambet, a common cause of child mortality and adult sickness in North Bali, by placing it in the context of cultural conceptions of body, person and spirit, as well as interpersonal praxis. Emotions, virtue, and the covert intentions of others are salient preoccupations in the construction of kesambet. The analysis thus serves to question Geertz's classical account of Balinese personhood, which interprets the Balinese concern with grace and composure as aesthetically motivated. Kesambet is also analysed in comparative perspective, especially in relation to susto; and Good and Good's distinction between etiological and descriptive criteria is utilized. PMID- 2721224 TI - A light microscopic and autoradiographic study of non-irradiated and irradiated ocular wounds. AB - Focal gamma irradiation was used to limit the intraocular extension of scar tissue which typically occurs after posterior perforating injury to the eye. Standard posterior perforating injuries were created in the right eye of forty eight rabbits, half of which had the site of perforation focally irradiated using a Cobalt 60 ophthalmic plaque. Non-irradiated wounds healed with profuse formation of highly cellular and vascularised granulation tissue which invaded the vitreous to form contractile vitreo-retinal membranes. In irradiated eyes vitreo-retinal membrane formation was infrequent; the wounds showing only sparse granulation tissue with little or no extension into the vitreous cavity. Autoradiographic studies carried out in a second group of 40 animals showed that the episclera was the main source of the proliferating fibroblasts, and cell counts confirmed that the inflammatory and repair responses in irradiated wounds were both delayed and attenuated. PMID- 2721225 TI - Glucose consumption in cultured corneal cells. AB - The rate of glucose consumption in cultured epithelium, endothelium, and keratocytes was measured; and the effect of reduced glucose availability on the consumption rate of these three cell lines was delineated. All three cell types exhibited an asymptotic decrease of glucose over time while being incubated in Krebs-Ringers solutions of varying glucose concentrations. At a concentration resembling that of the aqueous, epithelium (EPI), endothelium (ENDO), and keratocytes (K) consumed 6.7, 7.4, and 9.0 micrograms/cm2/hr respectively. Each cell type consumed glucose at a rate that was related to the amount of available glucose. As glucose concentration was reduced from 90 to 30 mg%, which was a 66% reduction in available glucose, the consumption of EPI, ENDO, and K dropped 74%, 61%, and 44% respectively. PMID- 2721226 TI - A correlative electron microscopic and freeze-fracture examination of cat corneal endothelial wound repair. AB - In an attempt to create a model for sustained corneal edema in humans, the present study has examined wounded cat corneal endothelium. Small central (7 mm) wounds or large 90 percent debridement wounds were created with an olive tipped cannula and corneas sampled from 1 to 75 days post-wounding were processed for light and transmission electron microscopy and freeze-fracture. In small wounds, wound closure was complete by 14 days and corneal edema was absent. During wound closure, leading edge cell membranes had decreased intramembrane particles, numerous vesicle fusion sites and lacked cell junctions. Endothelium behind the wound margin was multilayered with fragmented cell junctions. After wound closure, endothelium returned to the morphology of non-wounded endothelium except that an abnormal posterior collagenous layer (PCL) was present. Wound closure was greatly retarded in large wounds and corneas remained edematous at 75 days. The morphology of the endothelial cells was similar to that in small wounds except for the presence of large multinucleated cells and a thicker PCL. These large wound findings are similar to those observed in chronically stressed dysfunctional human corneal endothelium and in this animal model may represent a similar response to injury. PMID- 2721227 TI - The effect of temperature on the renaturation of alpha-crystallin. AB - The effects of variations in temperature and protein concentration on the renaturation of bovine alpha-crystallin have been examined using gel permeation chromatography, sedimentation analysis, fluorescence spectroscopy and electron microscopy. High protein concentration (3-53 mg/ml) were found to generate heterogenous populations of aggregates. It was concluded that concentrations above 3 mg/ml were inappropriate for renaturation of alpha-crystallin. Aggregates with molecular masses gradually increasing from 461,000 to 695,000 Da were produced with increasing temperature over the range 6-39 degrees C. Electron microscopy demonstrated that the reaggregates were composed predominantly of particles with circular cross-sections and mean diameters of 13-14 nm. As the renaturation temperature increased, increasing amounts of sheet-like structures were observed. Tryptophan accessibility to acrylamide quenching decreased in these aggregates as the size increased. These observations are consistent with the concept that there is no unique quaternary structure, or set of structures, for alpha-crystallin but that the protein can exist in a variety of forms containing different numbers of subunits. PMID- 2721228 TI - Expression of c-myc protooncogene in primary cultures of human corneal stromal cells. AB - We have determined steady-state levels of c-myc mRNA in quiescent and serum stimulated human corneal stromal cells. Steady-state levels of c-myc mRNA increased 6-fold following 2 hours of serum stimulation over levels observed at quiescence. A parallel increase in the rate of c-myc gene transcription was observed in serum-stimulated cells as compared to quiescent cells, indicating that the abundance of c-myc transcripts in corneal stromal cells during the transition from quiescence to proliferation is regulated mainly at the transcriptional level. These findings indicated that the expression of c-myc gene in human corneal stromal cells is regulated in a cell growth dependent manner in response to serum induction. PMID- 2721229 TI - Cell cycle specific effects of selenium on the lens epithelium studied in vivo by the direct chemical approach. AB - We attempted to separate S phase from post-S phase effects of selenium upon the lens epithelium by exposing the lens in vivo to selenium either during S phase synthesis of DNA or immediately after completion of DNA synthesis. Incorporation of 3H-thymidine into lens epithelial cell DNA is complete within about 3 hours after intraperitoneally injecting this substrate. Young rats were given selenium either 5 hours before injecting 3H-thymidine (selenium present at the time of labeled-DNA synthesis) or 5 hours after 3H-thymidine (selenium present immediately after completion of S phase). By measuring changes in the distribution of 3H-DNA between the epithelium and lens body for 14 days after injection we estimated migration times and rates of differentiation of the labeled cell population. When selenium was present during DNA synthesis, DNA labeling was decreased by 70%, net migration time (movement from the germinative zone to the equator) was markedly prolonged and the rate of differentiation was slightly accelerated. Selenium had little affect on these parameters if first present immediately after S phase. We conclude that selenium insult to the lens epithelium is largely confined to germinative epithelial cells in S or pre-S phases of the cell cycle. PMID- 2721230 TI - Osteoporosis: impact on the elderly societal concerns, and the role of radiology. AB - Osteoporosis has recently become a concern in both the medical and lay communities. Osteoporosis may be defined as a decrease in bone mass with maintenance of normal bone composition. The increase in bone fragility results in an increased incidence of fractures. The disease most commonly affects postmenopausal women, particularly Caucasians. It is estimated that 1.2 million fractures per year can be attributed to osteoporosis. These fractures cost the health care system approximately $18.1 billion per year. Given the magnitude of the health and attendant financial problems, osteoporosis deserves the attention of clinicians and researchers. This article will deal with the pathophysiologic processes, techniques for bone mineral determination, therapeutic regimens and the advisability of mass screening. The relationship between bone mineral content and fracture risk has not been clearly defined. If every American woman between the ages of 40 and 54 years were given a single bone mineral screening examination, the cost would be approximately $187.5 million/year. At this price and in the absence of accepted treatment programs, it does not seem prudent for radiologists or other physicians to recommend expensive mass screening. PMID- 2721231 TI - Peptide YY-induced inhibition of pancreatic exocrine secretion is not neurally mediated. PMID- 2721232 TI - Lymphocyte responsiveness after irradiation in canine and human intestinal allografts. PMID- 2721233 TI - The preoperative staging of malignant tumors of the stomach by computed tomography and liver function tests. PMID- 2721234 TI - The effects of acute sleep deprivation on level of resident training. PMID- 2721235 TI - Determinants of weld strength in laser-assisted microvascular anastomosis. PMID- 2721237 TI - An introduction to human skin aging. PMID- 2721236 TI - The effect of portal hypertension on gastric emptying of liquids. PMID- 2721238 TI - Permanent loss of fingernails due to allergic reaction to an acrylic nail preparation: a sixteen-year follow-up study. PMID- 2721239 TI - Borrelia burgdorferi infections. PMID- 2721240 TI - Histopathologic characteristics and ultrastructure of aging skin. AB - Histologic and ultrastructural examination of skin biopsy specimens from younger compared to older persons documents age-related structural alteration in the epidermis, dermal-epidermal junction, dermis, and the epidermal appendages including hair follicles, sebaceous glands, and sweat ducts and glands. The fine, regular epidermal surface patterns change to coarser and less regular ridges with aging. Epidermal projections into the dermis are retracted and the dermal epidermal junction is flattened. The dermis becomes thinner; there is less fibrous collagen and less elastic fiber in older skin, but the elastic component may appear increased compared to collagen. Elastic fibers may become frayed, porous, and matted together. The density of blood vessels is reduced and, in particular, there are fewer capillary loops in the papillary dermis. There are fewer as well as structurally altered hair follicles, sebaceous glands, and sweat glands with increasing age. PMID- 2721241 TI - Physiological consequences of human skin aging. AB - The expression and treatment of cutaneous disease in the elderly differ from those applicable to younger adults. Anatomical changes in aging skin result in altered physiological behavior and susceptibility to disease. Decreased epidermal renewal and tissue repair accompany the aging process. The rate of hair and nail growth declines, as well as the quantity of eccrine, apocrine, and sebum secretion. There are alterations in immune surveillance and antigen presentation with aging. The cutaneous vascular supply is decreased, leading to decreases in inflammatory response, absorption, and cutaneous clearance. Impaired thermal regulation, tactile sensitivity, and pain perception occur as one ages. We summarize the major changes that occur during the intrinsic aging process of the skin to facilitate the recognition and treatment of skin disease in the older patient. PMID- 2721242 TI - Skin aging: lessons from cutis laxa and elastoderma. AB - Several lines of evidence suggest that elastic fibers provide resilience to normal human skin, and that abnormalities in elastin may be the primary event leading to the clinical appearance of aged skin. Innately aged skin exhibits a paucity and fragmentation of elastic fibers, while actinically damaged skin consists of an abnormal accumulation of elastotic material within the dermis. Cutis laxa and elastoderma are two cutaneous diseases that manifest as selective alterations in elastic fibers. Clinical and histopathologic findings in these diseases are similar to those found in cutaneous aging. Thus, it appears that alterations in the quantity and/or quality of the elastic fibers may contribute to age-associated cutaneous changes. PMID- 2721243 TI - Topical tretinoin and photoaged skin. AB - Topical tretinoin has been proposed for the treatment of photoaged skin in recent years. In both open and double-blind trials, it has been successful in reversing some of the histologically and clinically apparent changes of photoaging. Many patients will experience a dermatitis due to retinoids during therapy, but are usually able to tolerate the treatment. Although clinical improvement may be modest, most patients are pleased with the result. We have found that optimal improvement is achieved by using tretinoin 0.1 percent cream to the limit of tolerance. By carefully instructing the patient on the application of the medication, the occurrence of initial dermatitis with therapy, and the type of improvement to expect, compliance with and tolerance of tretinoin therapy are greatly enhanced. PMID- 2721244 TI - Prevention of skin cancer in xeroderma pigmentosum with oral isotretinoin. AB - To confirm reports that skin cancer can be prevented with retinoid treatment, a three-year controlled prospective study was conducted of oral isotretinoin in five patients with xeroderma pigmentosum who had a history of multiple cutaneous basal cell or squamous cell carcinomas. Patients were treated with isotretinoin, 2 mg/kg per day for two years, and then evaluated for an additional year without using the drug. Before, during, and after treatment, biopsy specimens of all suspicious lesions were examined, and skin cancers were removed surgically. The patients had a total of 121 tumors in the two years before treatment. During two years of treatment with isotretinoin, there were twenty-five tumors, with an average reduction in skin cancers of 63 percent (p = 0.019). After use of the drug was discontinued, the tumor frequency increased a mean of 8.5 times over the frequency during treatment (p = 0.007). Although all patients experienced mucocutaneous toxic effects, and abnormalities in triglyceride levels, results of liver function tests, or skeletal findings occurred in some, high-dosage oral isotretinoin was effective in the chemoprophylaxis of skin cancers in patients with xeroderma pigmentosum. PMID- 2721245 TI - Psychological aspects of skin disorders in the elderly. AB - The aged have many skin problems. However, these are not the "high-visibility" diseases that are the stuff of geriatric textbooks. Skin diseases are not disabling, do not hamper self-care, and are not fatal. Nonetheless, they are important for reasons that geriatricians are usually unaware of: they spoil the quality of life. An aged, degraded skin is uncomfortable to live in. It is also unattractive and leads to aversive reactions by others. The unhandsome aged have trouble maintaining self-esteem when they recollect the smooth, unmarked, turgid skin that was the clothing of their youth. All this is conducive to a lessening of contact between the aged and potential providers of support, including health care providers. Enhancing appearance provides a psychological boost that may lead to positive thoughts and actions. "Looking good is feeling better" is a sound maxim for improving health at all ages. PMID- 2721246 TI - New modes of mechanical ventilation for ARDS. How should they be evaluated? PMID- 2721247 TI - Is Levophed lethal? PMID- 2721248 TI - Roentgenologic diagnosis of emphysema. Accurate or not? PMID- 2721249 TI - Serious infectious complications of corticosteroid therapy for COPD. AB - We report seven elderly patients with COPD who developed serious infectious complications during prolonged treatment with high doses of corticosteroids. Infections included invasive pulmonary aspergillosis, Herpes simplex stomatitis and esophagitis, cytomegalovirus pneumonia, bacterial sepsis, fungemia and meningitis due to Cryptococcus neoformans. Each of the three patients who developed invasive aspergillus pneumonia died. The efficacy of prolonged therapy with high doses of corticosteroids in patients with COPD is not proven. These cases illustrate the potential for serious infections in patients with COPD treated with corticosteroids. PMID- 2721250 TI - Vasodilators and primary pulmonary hypertension. Variability of long-term response. AB - Long-term response to vasodilator therapy was assessed in six patients with PPH. Following an acute trial, each patient was restudied after (1) two months of drug administration, (2) one month of abstinence from therapy, and (3) an additional two months of therapy. Three of six patients had no long-term reduction of PVR after treatment; one showed a progressive increase. Of the three patients whose PVR was still reduced at the end of the second therapy period none showed a return of PVR to baseline during the abstinence phase, which may suggest that long-term reduction of pulmonary vascular tone may modify the vasoconstrictive component of this disease. The heterogeneous response of this small number of patients to sequential drug administration and withdrawal demonstrates the difficulty of interpreting previously reported clinical trials and underscores the need for a well-designed controlled study of vasodilator administration in these patients. PMID- 2721251 TI - Use of mycobacterial smears in the diagnosis of pulmonary tuberculosis in AIDS/ARC patients. AB - Pulmonary tuberculosis in AIDS/ARC patients is an increasing problem. To assess the utility of acid-fast smears of pulmonary secretions in this patient population, we evaluated 38 AIDS/ARC patients with culture-positive pulmonary infection. A control group consisted of 57 non-AIDS/ARC patients, who also did not belong to an AIDS risk group, diagnosed during the same period. The number of culture-positive sputum samples evaluated per patient was similar in both groups (3.82 +/- 3.11 AIDS/ARC vs 4.47 +/- 2.83 control group). Significantly fewer AIDS/ARC patients, 45 percent, however, had a positive acid-fast smear compared with the control group, 81 percent (p less than 0.001). The initial sputum smear submitted was positive in only 29 percent of the AIDS/ARC group compared with 61 percent of control subjects (p less than 0.01). Further, greater than or equal to 5 negative smears were found in 60 percent of the evaluable AIDS/ARC patients compared with just 13 percent of control subjects (p less than 0.01). More extensive findings on chest roentgenograms were not associated with a significantly higher yield of smear positivity in the AIDS/ARC group. We conclude that acid-fast smears on sputum specimens are a relatively insensitive test for pulmonary tuberculosis in AIDS/ARC patients. PMID- 2721252 TI - Predictors of objective level of daytime sleepiness in patients with sleep related breathing disorders. AB - Excessive daytime sleepiness, the most prevalent symptom associated with the OSAS, is hypothesized to result from either fragmentation of sleep or hypoxemia during sleep. Measures of nocturnal sleep, respiration during sleep, and daytime sleepiness in 466 patients with apnea were collected to evaluate these two hypotheses. The various parameters were submitted to correlation and multiple regression analyses to predict daytime sleepiness as measured by the MSLT. The RAI, which measures the number of arousals from sleep associated with respiratory disturbances (best fragmentation correlation), produced a higher correlation with MSLT scores than did TMES (best hypoxemia correlation); however, the measures were highly intercorrelated, and multiple regression analyses to determine which parameters independently predicted MSLT showed the single best predictor to be the RAI. Additional independent variance in MSLT score was explained by TST and PSG1. Measures of hypoxemia provided little or no independent predictive information. These data support the hypothesis that sleep fragmentation is an important determinant of daytime sleepiness in patients with apnea. PMID- 2721253 TI - Effect of intentional hemodilution on platelet survival in secondary pulmonary hypertension. AB - Platelet regeneration time was assessed in 13 young adults with pulmonary hypertension and polycythemia secondary to congenital heart defects who underwent isovolemic hemodilution to improve clinical status and coagulation defects. The estimated platelet half-life in patients with Eisenmenger's complex was significantly shortened in comparison with normal subjects (3.8 +/- 1.9 vs 4.8 +/ 1.0 days, p less than 0.05). Hemodilution was carried out with no adverse effects, using low molecular weight dextran solutions. Lowering hematocrit from 61 to 50 percent resulted in a significant increase in platelet half-life from 3.8 +/- 1.9 to 5.7 +/- 1.8 days (p less than 0.02), which was followed by a marked rise in platelet count from 149 +/- 31 to 209 +/- 47 x 10(9) platelets/L (p less than 0.003). Arterial oxygen tension did not change significantly. These observations indicate that high hematocrit levels may have accounted for the shortened platelet survival and thrombocytopenia in these patients. Significant hemodilution may lead to a marked improvement in platelet abnormalities in patients with Eisenmenger's complex. PMID- 2721254 TI - Acute anterior wall myocardial infarction presenting with positive T waves and without ST segment shift. Electrocardiographic features and angiographic correlation. AB - Eighteen patients with a first AMI, who during the acute ischemic phase did not develop ST segment elevation, but only positive or peaked T waves, are described. Patients who do not develop ST segment elevation during evolving anterior AMI represent a subgroup with a high probability of total obstruction of the LAD artery with retrograde filling via collateral vessels and a small degree of left ventricular dysfunction. We assume that during the period of total obstruction there was preexisting adequate collateral circulation in order to prevent transmural ischemia, which explains the absence of ST segment elevation. PMID- 2721255 TI - Comparison of central-venous to mixed-venous oxygen saturation during changes in oxygen supply/demand. AB - Because central venous O2 saturation (superior vena cava, ScvO2) can be monitored with less patient risk than mixed venous O2 saturation (pulmonary artery, SvO2), we examined the correlations between SvO2 and ScvO2 over a broad range of cardiorespiratory conditions, including hypoxia, hemorrhage, and resuscitation in anesthetized dogs. The correlation coefficient (r) between SvO2 and ScvO2 in 179 simultaneously drawn blood samples from 22 dogs was 0.97. In another nine dogs, the two sites were continuously and simultaneously monitored with fiberoptic catheters; r was 0.96 with a mean difference of 3.7 +/- 2.9 percent (SD) saturation. In each dog the changes in ScvO2 closely paralleled the changes in SvO2. Although absolute values of ScvO2 are not sufficiently identical to SvO2 to calculate O2 uptake or pulmonary shunt precisely, close tracking of changes in the two sites across a wide range of hemodynamic conditions warrant further consideration of ScvO2 for patient monitoring of trends in O2 supply/demand. PMID- 2721256 TI - Effectiveness of open-circuit and oxyhood delivery of helium-oxygen. AB - The combination of helium with oxygen is less dense than air and as such has been beneficial to patients with airflow obstruction within the large airways. The purpose of this study was to evaluate the effectiveness of delivering He-O2 by open-circuit systems by measuring DD50 in five adult volunteers. The mean (+/- SD) DD50 with a nonrebreathing mask was 1.32 +/- 0.89, with a simple mask was 1.21 +/- 0.87, and with a nasal cannula was 1.00 +/- 0.13; the DD50 with the nonrebreathing mask and the simple mask was statistically greater than with the cannula (p less than 0.05). Two infant oxygen hoods were assessed by measuring the nitrogen concentration at different locations in the hoods. The N2 concentration increased progressively from top to bottom, indicating that the helium was concentrated at the top. We conclude that the nonrebreathing mask and simple masks are probably satisfactory He-O2 delivery systems, that the infant oxyhood may be suboptimal, and that the nasal cannula is ineffective. PMID- 2721257 TI - Effect of azelastine, an antiasthmatic drug, on bronchial responsiveness in patients with bronchial asthma. AB - This study was designed to clarify whether azelastine, an antiasthmatic drug, could favorably alter bronchial responsiveness in patients with bronchial asthma. To estimate bronchial responsiveness, methacholine challenge was performed in 21 patients with bronchial asthma. After the first examination, all patients were treated for eight weeks with azelastine, 2 mg twice daily. After four and eight weeks' treatment, methacholine challenge was repeated. After eight weeks' treatment, Dmin, an index of bronchial sensitivity, was increased significantly, and after four weeks an insignificant increase was observed. The RrsC, SGrs/GrsC, indices of respiratory resistance and bronchial reactivity, respectively, did not change significantly during eight weeks' treatment. Recently various chemical transmitters, especially leukotrienes, were shown to be closely related to the genesis of bronchial asthma. Accordingly, the effect of azelastine observed here might be ascribed to its antagonizing action on leukotriene. Since bronchial hyperresponsiveness is a critical etiologic factor in bronchial asthma, long-term administration of azelastine might help to modify the disease's basic pathophysiologic conditions. PMID- 2721258 TI - Prevalence of chronic bronchitis and respiratory function in a group of dairy farmers in the French Doubs province. AB - We used a questionnaire combined with medical history and spirometric studies to compare symptoms and respiratory function in two groups of subjects living in the French province of Doubs. A group of 250 dairy farmers was compared with 250 control subjects, matched with regard to sex, age, height, and smoking habits. The prevalence of acute bronchial infections and dyspnea was identical in the two groups. Among dairy farmers, 30 (12 percent) had chronic bronchitis vs 15 (6 percent) in the control group (p less than 0.05). Chronic bronchitis was more common in patients aged over 40 years (p less than 0.001) and in nonsmokers (p less than 0.001). All respiratory function parameters measured (expressed as a mean percentage of values measured in comparison with theoretic values) were lower in the dairy farmer group than in the control group. With regard to degree of bronchial obstruction, the difference between the two groups was more marked in patients aged 40 years and over and in nonsmokers. Dairy farmers' occupation is a risk factor of chronic bronchitis and bronchial obstruction, in particular in patients aged 40 years and over and in nonsmokers. PMID- 2721259 TI - Effects of oral terbutaline in chronic airflow limitation. AB - A randomized, double-blind, crossover study was conducted to assess the efficacy of five weeks' treatment with terbutaline, 15 mg daily, compared with placebo in 17 evaluable patients with moderate to severe chronic airflow limitation (CAL) with a minor reversible component. A significant improvement after terbutaline treatment compared with placebo was observed in subjective assessments of breathlessness after two of the activities of daily living, and in daily peak flow measurements recorded in patient diaries. At the clinical assessment after five weeks' terbutaline therapy, 12 of 17 patients had improved pulmonary symptom scores compared with placebo, and a slight increase in FEV1 was observed relative to placebo (0.09 L, p less than 0.05). Thus, five weeks' treatment with oral terbutaline in patients with CAL resulted in significant improvements in several subjective assessments, despite a lack of effect on the majority of the objective variables. PMID- 2721260 TI - Clinical pharmacokinetics of theophylline and levels of alpha 1-acid glycoprotein in smokeless tobacco users. AB - Elimination half-life and apparent volume of distribution of theophylline were determined in ten healthy volunteers who used smokeless tobacco (snuff or chewing tobacco) regularly but did not smoke cigarettes. Serum concentrations of the acute phase reactant alpha 1-acid glycoprotein (AAG) were also measured. The elimination half-life of theophylline was 9.32 +/- 3.40 hours (mean +/- standard deviation), the apparent volume of distribution was 0.45 +/- 0.03 L/kg, and AAG concentrations were 63.8 +/- 15.76 mg/dL. All these values are comparable to values reported for nonsmokers. These results suggest that nonsmoking users of ST should be considered to be tobacco nonusers for purposes of planning theophylline dosing and monitoring strategies. PMID- 2721261 TI - HLA and sarcoidosis in the Japanese. AB - One hundred fourteen patients with sarcoidosis, who were diagnosed as having sarcoidosis histologically, have been typed for HLA class 1 (A, B, and C) and class 2 (DR and DQ) antigens. Controls consisted of 478 healthy Japanese subjects. The frequencies of HLA-A1, HLA-Bw46, HLA-Cx46, HLA-DRw8, HLA-DRw9, and HLA-DRw52 were significantly increased in sarcoidosis compared to control subjects, but only four patients were positive for HLA-A1. Increased frequencies of HLA-Bw46 and HLA-Cx46 were thought to be attributable to linkage disequilibrium with HLA-DRw8. Patients with HLA-DRw52 were the most frequent (84 cases of 113). No significant differences were observed between HLA-DRw52 positive and HLA-DRw52-negative patients in their clinical features, but all of the patients with muscular involvement (six cases) were positive for HLA-DRw52. Among patients positive for HLA-DRw52, those with HLA-DR5 showed a significantly better clinical course and earlier onset of the disease than those with HLA-DRw8. These results suggest that HLA antigens may play an important role in the pathogenesis of sarcoidosis. PMID- 2721262 TI - Roentgenographic evidence for predominant left-sided location of unilateral pleural plaques. AB - The roentgenographic prevalence and anatomic distribution of pleural plaques were studied in the US Navy Asbestos Medical Surveillance Program population (105,064 individuals as of July 17, 1985). "Definite" or "probable" pleural plaques were noted in 4.4 percent of films. These were unilateral in 19.3 percent of roentgenograms with "definite" pleural plaque and 33.9 percent of films with "probable" pleural plaque. Unilateral findings were more often left-sided than right-sided; a ratio of 287:82 in the "definite" group and 625:287 in the "probable" group. Left-sided predominance of unilateral plaque is a consistent and unexplained epidemiologic finding that may provide clues to pleural pathogenesis following asbestos exposure. PMID- 2721263 TI - Airway secretory IgA concentrations in patients with lung cancer. Evaluation of the uninvolved lung. AB - To determine whether concentrations of the primary airway immunoglobulins (SIgA, IgG) are altered in the uninvolved lung of patients with lung cancer, we determined concentrations of SIgA and IgG in bronchial washings recovered from a proximal airway of the uninvolved lung in 24 patients with lung cancer and in ten patients with benign lung disease. When standardized for the amount of total protein recovered (SIgA/TP, IgG/TP), bronchial washings recovered from the uninvolved lung of lung cancer patients demonstrated a significantly decreased SIgA/TP ratio compared to control subjects (.14 +/- .02 vs .31 +/- .05, SEM, p less than 0.05). There were no differences in the IgG/TP ratios. Lung cancer patients with a decreased serum albumin (less than 3.2 g/dl) had a significantly decreased SIgA/TP ratio in bronchial washings compared to patients with a higher serum albumin (.08 +/- .03 vs .18 +/- .04, SEM, p less than 0.05). The decreased relative concentration of airway SIgA in lung cancer patients may adversely affect airway defenses against bacterial colonization. PMID- 2721264 TI - Influence of age, sex, and obesity on blood pressure of Hutterites in South Dakota. AB - Anthropometric and blood pressure data were evaluated in 724 male and female Hutterites and 273 randomly sampled male and female subjects in southeastern South Dakota who served as the control group. Hutterite males and females showed significant age-dependent increases of both weight and obesity (p less than 0.001) not seen in the control group. Both systolic and diastolic blood pressures (SP and DP) of the Hutterites were higher than those of the control subjects (p less than 0.001). There were highly significant correlations between age, weight, obesity (all p less than 0.001), and SP and DP of the Hutterites. Correlations between the weight and SP and DP were significant (p less than 0.001) in the control groups. The prevalence of systolic blood pressures greater than or equal to 140 mm Hg among Hutterite males ranged from 34.6 to 79.3 percent in age groups by decade vs 8.7 to 34.2 percent in age-matched control males. The prevalence of diastolic blood pressure levels greater than or equal to 90 mm Hg ranged from 0 percent in the youngest (less than or equal to 29 years) to 7.9 percent oldest age group (60+ years) of control males. The prevalence of elevated DP among male Hutterites ranged from 5.9 to 37.9 percent in corresponding age groups. A similar age-dependent trend of prevalence rates of elevated DP and SP were noted in female Hutterites but to a lesser extent than in control subjects. Elevated blood pressure levels among Hutterites may be an important contributing risk factor to the younger mean age of death of Hutterites compared to the control population. PMID- 2721265 TI - Two cases of myocardial infarction in type 4 Ehlers-Danlos syndrome. AB - Ehlers-Danlos syndrome is an inherited connective tissue disorder. Clinical manifestations of this syndrome are due to fragile connective tissue. Though many cardiovascular disorders in association with it have been reported, myocardial infarction is quite rare. In this report, two cases with type 4 Ehlers-Danlos syndrome and myocardial infarction are described. Patient 1 was a 30-year-old woman. She was diagnosed as having myocardial infarction on the basis of typical changes in electrocardiograms and serum enzymes (CPK, SGOT and LDH). The diagnosis of type 4 Ehlers-Danlos syndrome was made by the microscopic examination of her connective tissue. Patient 2 was a 32-year-old man. He was also diagnosed as having acute myocardial infarction. His fibroblasts were cultured and they could not synthesize type 3 collagen. Type 4 Ehlers-Danlos syndrome was diagnosed. It was likely that myocardial infarction might have resulted from the fragility of their coronary arteries in type 4 Ehlers-Danlos syndrome. PMID- 2721266 TI - Hemodynamic and gas exchange alterations during Intralipid infusion in patients with adult respiratory distress syndrome. AB - Hemodynamic and pulmonary gas exchange consequences of 20 percent intravenous fat emulsion infusion (3.0 +/- .3 mg/kg/min) were evaluated in 19 patients who demonstrated ARDS. Lipid infusion precipitated a significant reduction in PaO2/FIO2 from 241 +/- 50 to 184 +/- 41 (mean +/- SD) and increased MPAP from 26.0 +/- 5.1 to 31.8 +/- 4.8 mm Hg, pulmonary vascular resistance from 149 +/- 78 to 179 +/- 61 dyne.s/cm5 and pulmonary venous admixture (Qva/Qt) from 20.7 +/- 15.2 to 30.6 +/- 8.6 percent. Further analysis revealed that the magnitude of increased Qva/Qt was greater in patients who manifested septicemia (N = 10) compared to those who did not (N = 9): 12.3 vs 7.3 percent, respectively. We conclude that intravenous lipid administration was associated with increased MPAP and Qva/Qt in patients with ARDS, particularly when accompanied by septicemia. Although these alterations resolved after the lipid infusion was terminated, we suggest that prudent measures should be taken to guarantee adequate oxygenation during intravenous fat emulsion therapy in patients suffering from ARDS. PMID- 2721267 TI - Effect of dopamine vs norepinephrine on hemodynamics in septic shock. Emphasis on right ventricular performance. AB - The effects of continuously infused dopamine and norepinephrine on hemodynamics, oxygen metabolism, and right ventricular (RV) performance were studied by crossover design in ten patients with septic shock who needed treatment with vasoactive drugs after fluid replacement. Standard hemodynamic measurements were obtained and RV performance assessed before and 1 h after the start of the infusion. All but one patient had pulmonary hypertension, and in seven the RV ejection fraction (RVEF) was lower than 50 percent at baseline. Drugs were titrated to a systolic arterial blood pressure of mean 106 +/- 18 mm Hg for dopamine and 116 +/- 20 mm Hg for norepinephrine (NS). Dopamine infusion increased the cardiac index (CI) 16 percent (p less than 0.02), but heart rate and systemic and pulmonary vascular resistances were unchanged. With norepinephrine CI was unchanged, a heart rate decreased 7 percent (p less than 0.05), and systemic and pulmonary vascular resistance increased 35 and 26 percent, respectively (p less than 0.05). With both drugs, RV volumes and RVEF remained unchanged, and systemic oxygen consumption increased equally (by 19 percent for dopamine and 22 percent for norepinephrine, p less than 0.05); systemic oxygen delivery rose by 17 percent during dopamine infusion and was unchanged during norepinephrine infusion. Norepinephrine increased oxygen extraction vs dopamine (p less than 0.05). There were no differences in urinary output. Norepinephrine may improve the RV oxygen supply/demand ratio, but this potentially beneficial effect on RV ejection fraction may be offset by a concomitant increase in pulmonary vascular resistance and RV afterload. Norepinephrine may not adversely affect the peripheral circulation. In short-term treatment of volume-resuscitated, severe septic shock complicated by pulmonary hypertension and impaired RV performance, norepinephrine may be at least as effective as dopamine. PMID- 2721268 TI - Relationship between mixed venous oxygen saturation and cardiac index in patients with chronic congestive heart failure. AB - The use of mixed venous oxygen saturation (SvO2) in patients with chronic congestive heart failure (CHF) has been advocated to analyze the action of therapy on cardiac index (CI). To evaluate the relationship between CI and SvO2, ten CHF patients (mean age 65 years) were studied before and one, two, three, four (T4), six, eight and 24 hours after oral administration of an angiotensin converting enzyme (ACE) inhibitor (perindopril, 4 mg). At T4, a 12 percent increase in CI (p less than 0.01) was associated with a 16 percent decrease in arteriovenous oxygen difference (p less than 0.01), a 13 percent increase in mixed venous oxygen pressure (PvO2) (p less than 0.01), and a 9 percent increase in SvO2 (p less than 0.05) with no significant change in arterial oxygen pressure. There was no correlation between CI and SvO2 (r = 0.22) and between CI and PvO2 (r = 0.23). Individual analyses were performed and patients were divided into two groups based on CI versus SvO2 r value; group 1, n = 6, r greater than 0.65 (0.65-0.90), group 2, n = 4, r less than 0.65 (0.14-0.20). The lack of correlation in group 2 was due to a drug-dependent increase in oxygen consumption (VO2) +18 percent vs -3 percent in group 1 (p less than 0.05) associated with a lack of increase in PvO2 +3 percent vs +14 percent in group 1 (p less than 0.05) despite a similar increase in oxygen availability +19 percent versus +16 percent. It was concluded that (1) a correlation between CI and SvO2 is not found in every patient with CHF; (2) the lack of correlation in four out of our ten patients was due to an associated and significant increase in CI and VO2 in group 2; (3) group 2 patients probably had an important oxygen debt before treatment; (4) SvO2 cannot be used instead of CI to determine the hemodynamic consequences of the use of cardiovascular drugs. PMID- 2721269 TI - Pharmacokinetics of a 3 mg/kg body weight loading dose of gentamicin or tobramycin in critically ill patients. AB - We evaluated the pharmacokinetics and adequacy of gentamicin or tobramycin after administration of a loading dose of 3 mg/kg body weight in 14 critically ill patients with presumed sepsis. Therapeutic blood levels after loading dose were obtained in 13 of the 14 patients. Measured volume of distribution, serum half life, and elimination rate constant were significantly different from values calculated by using standard formulae. All the patients tolerated the dose well without significant deterioration in renal function. Based on the present study, we conclude that administration of 3 mg/kg body weight loading dose of gentamicin or tobramycin in critically ill patients with sepsis would result in earlier therapeutic drug levels. PMID- 2721270 TI - Psychological defenses and coping styles in patients following a life-threatening attack of asthma. AB - Twenty-five patients who have suffered a near miss asthma death (NMAD) have undergone a comprehensive psychiatric evaluation on average 13 months following this event. Forty percent of the patients were judged to have psychiatric disorders at the time of assessment. All patients had very high levels of denial and following the NMAD, patients appeared to either decompensate psychiatrically, usually exhibiting symptoms of anxiety disorders, or further increase their levels of denial. Those patients who had psychiatric illnesses at the time of the study were more constitutionally vulnerable towards developing these disorders and had a reduced perception of their quality of life compared with the patients who increased their levels of denial following the NMAD. The effects of the NMAD on patients and their families ranged from mutual anger and anxiety, although the anger was often repressed, to mutual overinvolvement and overdependence. The presence of high levels of denial of asthma and a history of psychiatric illness in the patient appear to be factors that may increase the likelihood of death from asthma. PMID- 2721271 TI - Teaching models for Nd:YAG laser bronchoscopy. AB - A number of groups have demonstrated the efficacy of neodymium:yttrium-aluminum garnet (Nd:YAG) laser bronchoscopy for treatment of patients with selected tracheobronchial disorders. This therapy involves a new technology, the laser, and new adaptations of conventional rigid and flexible bronchoscopy that are unfamiliar to many bronchoscopists. We describe two teaching models for laser bronchoscopy that have been employed successfully in our laser courses. Using these models, bronchoscopists can become familiar with laser bronchoscopic equipment and appreciate the interaction of laser and soft tissue in a controlled setting in the laboratory before applying this therapy to patients. PMID- 2721272 TI - The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism. AB - Autologous blood clot was injected into six dogs to produce a graduated decrease in cardiac output (CO). The effects of an infusion of norepinephrine, titrated to specific end points, were recorded before embolization and at two levels of pulmonary hypertension. Simultaneous measurements of systemic and renal hemodynamics were made. Sequential blood clot injection increased (p less than .01) pulmonary vascular resistance (PVR) from 1.3 to 13 to 33 mm Hg.L-1.min and reduced CO 45 percent and 75 percent (p less than .01). Norepinephrine increased both stroke volume and CO (p less than .01) in each condition and did not increase PVR. Since the biventricular filling pressures remained constant or fell slightly with norepinephrine, the increase in CO is best explained by an improvement in pump performance. There was no deterioration in renal blood flow or creatinine clearance with norepinephrine. The data suggested that in this model of right ventricular dysfunction, norepinephrine consistently improved myocardial performance without provoking further vasoconstriction in either the pulmonary or renal circulations. PMID- 2721273 TI - Diffuse panbronchiolitis preceding ulcerative colitis. AB - To expand the clinical spectrum of ulcerative colitis-associated lung disease, we describe a patient with panbronchiolitis associated with ulcerative colitis. In addition to his having a distinctive pulmonary manifestation of this bowel disease, other noteworthy aspects of this patient's course include the onset of pulmonary symptoms several years prior to bowel manifestations and the partial resolution of his pulmonary symptoms following colectomy. PMID- 2721274 TI - Severe bronchospasm followed by respiratory arrest during thallium-dipyridamole imaging. AB - We describe the occurrence of sudden severe bronchospasm and respiratory arrest following dipyridamole infusion in a patient with chronic obstructive pulmonary disease predominantly of the emphysematous type. The severe reaction was unexpected because the patient had tolerated well withdrawal of aminophylline derivatives for 48 hours and was receiving chronic prednisone 20 mg qd. Although the diagnostic and prognostic gains from dipyridamole imaging far outweigh the small risk associated with the test, patients with chronic pulmonary obstructive disease must be closely monitored during thallium-dipyridamole imaging. PMID- 2721275 TI - Bronchiectasis and progressive respiratory failure following smoke inhalation. AB - A 49-year-old man who sustained inhalational injury in a fire 23 years ago developed bronchiectasis 12 years later and hypercapnic respiratory failure with cor pulmonale 20 years following the injury. Delayed onset of chronic respiratory failure should be considered among the long-term complications of inhalational injury. PMID- 2721276 TI - Fatal pneumopericardium caused by SF6 gas infusion into the pleural space after pneumonectomy and pericardial resection. AB - A 63-year-old man with lung carcinoma underwent a right pneumonectomy and combined resection of the pericardium. Postoperatively, SF6 gas was introduced into the empty pleural space for the protection of excessive shift of heart and mediastinum, but a fatal pneumopericardium occurred. A rare but possible complication of cardiac tamponade after inert gas infusion in patients undergoing combined resection of pericardium is reported. PMID- 2721277 TI - Hemothorax and hemopericardium in a patient with Bean's blue rubber bleb nevus syndrome. AB - A patient with Bean's blue rubber bleb nevus syndrome presented with a hemothorax, and 18 years earlier had presented with "idiopathic" hemopercardium and tamponade. Typical hemangiomas were found in the pleura and skin. This is the first report of intrathoracic bleeding with this disorder. PMID- 2721278 TI - Reinforcement of the anastomosis between the fragile arterial vessel and the prosthetic graft. A headband method. AB - A new method of anastomosis was devised, intended for the reinforcement of the anastomosed area between the fragile vessel of the patient and the prosthetic graft in cardiovascular surgery. This method, which may be called a headband method, consists of suturing a small prosthetic graft wrapping the anastomosed area together with the arterial vessel in the manner of a headband. Fourteen cases have been evaluated at follow-up periods ranging from 24 to 40 months. All cases proved successful without noteworthy complications. PMID- 2721279 TI - Fatal pericarditis due to Mycobacterium avium-intracellulare in acquired immunodeficiency syndrome. AB - A 27-year-old white male homosexual with AIDS presented 19 months after the initial diagnosis with persistent fever, marked dyspnea at rest, and severe substernal pain in the chest. A pericardial friction rub was auscultated, and an effusion was demonstrated echocardiographically. Pericardiocentesis yielded 220 ml of serosanguinous fluid. Special stains of the fluid for microorganisms were negative. A mycobacterial infection was suspected, and therapy with multiple antimycobacterial agents was initiated. Cultures of the fluid eventually yielded MAI. Despite therapy, cardiac function declined, and the patient died two months after presentation. Autopsy confirmed the diagnosis of chronic pericarditis due to MAI. Pericarditis due to MAI should be included in the differential diagnosis of cardiac dysfunction in patients with AIDS. PMID- 2721280 TI - Pleural effusion in Churg-Strauss syndrome. AB - A 33-year-old man with a two-year history of asthma and sinusitis presented with wheezing, pleuritis, bilateral pleural effusions, and patchy basilar infiltrates on chest roentgenogram. Laboratory studies revealed peripheral blood eosinophilia, and pulmonary function studies showed an obstructive pattern which was bronchodilator responsive. Thoracocentesis yielded an acidotic exudative effusion with low glucose, low C3, eosinophilia, and a markedly increased rheumatoid factor. Open lung biopsy revealed extensive eosinophilic interstitial pneumonitis with necrotizing eosinophilic vasculitis. Although pleural effusions are present in 29 percent of Churg-Strauss patients, these effusions have not been well described. This report describes the pleural fluid findings in a case of Churg-Strauss syndrome. PMID- 2721281 TI - Pericardial effusion and tamponade due to Kaposi's sarcoma in acquired immunodeficiency syndrome. AB - We describe a 29-year-old homosexual man with acquired immunodeficiency syndrome who developed pericardial effusion and tamponade. Pericardiocentesis resulted in clinical improvement. All diagnostic tests on pericardial fluid were negative. At autopsy, extensive plaques and nodules of Kaposi's sarcoma were found studding the epicardium, and no other cause of effusion was found. To our knowledge there has been no previous case of Kaposi's sarcoma associated with pericardial effusion and tamponade reported in patients with AIDS. Kaposi's sarcoma should be considered in the differential diagnosis of pericardial effusion in these patients. PMID- 2721282 TI - Hypomagnesemia in intensive care. Correction of units. PMID- 2721283 TI - Mortality in sleep apnea. PMID- 2721284 TI - Vigorous cleaning of Inspirease Reservoir Devices. PMID- 2721285 TI - Severe reactive airways disease induced by propafenone. PMID- 2721286 TI - High output congestive heart failure in septic shock. PMID- 2721287 TI - A unique case of catamenial pneumothorax. PMID- 2721288 TI - Multivariate analysis of aminoglycoside levels in hemodialysis patients. AB - Multivariate discriminant analysis was performed on data for 50 consecutive hemodialysis patients who had received aminoglycoside treatment because of severe bacterial infections. The 10 of the 60 clinical parameters considered to be most important were survival of patients (28/50 patients), success of treatment (27/50 patients), acute or chronic renal failure (15 vs. 35), age (54 +/- 17 years), creatinine level (675 +/- 298 mumol/l), artificial ventilation (21/50 patients), need for catecholamines (19/50 patients), continuous arteriovenous hemofiltration (9/50 patients), duration of therapy (12 +/- 8 days) as well as aminoglycoside peak (7.5 +/- 2.7 mg/l) and trough levels (3.6 +/- 1.3 mg/l). The 4 of the 10 parameters investigated by multivariate analysis significantly contributing to survival of patients were clinical success of aminoglycoside treatment (p = 0.0001), no need for catecholamines (p = 0.0001), duration of dosage (p = 0.003) and aminoglycoside peak levels (p = 0.009). PMID- 2721289 TI - Effect of ciprofloxacin and ofloxacin on human polymorphonuclear leukocyte activity against staphylococci. AB - The interaction of ciprofloxacin and ofloxacin with the bactericidal capability of human polymorphonuclear leukocytes against staphylococci was investigated. Exposure of Staphylococcus aureus and Staphylococcus epidermidis to subinhibitory concentrations of ciprofloxacin and ofloxacin did not significantly affect the uptake and killing by human polymorphonuclear leukocytes. In our assay, ciprofloxacin and ofloxacin in concentrations of one time the minimal inhibitory concentration induced a significant reduction in viable intraphagocytic S. aureus (percentages of survival: 43 and 51%, respectively) compared to the controls without antibiotic (percentage of survival: 65%). In contrast, both antimicrobials failed to produce a reduction in viable intraphagocytic S. epidermidis. PMID- 2721290 TI - Anticancer chemotherapy accelerates scalp hair loss with no androgenic involvement. AB - The involvement of plasma testosterone in patients associated with scalp hair loss accelerated by anticancer drugs including aclarubicin and cisplatin was investigated. Scalp hair loss observed was minor in 12 and severe in 2 out of 31 patients. In patients without significant hair loss, the combination of aclarubicin and cisplatin produced a significant decrease in the plasma testosterone concentration in male patients and a significant increase in female patients 3 days after the anticancer chemotherapy. Six days after the chemotherapy, however, these concentrations returned to pretreatment values. Similar changes were observed in patients with minor or severe scalp hair loss induced by these drugs. These results suggest that aclarubicin and/or cisplatin may accelerate scalp hair loss with no androgenic involvement. PMID- 2721291 TI - Penetration of monobactam antibiotics (aztreonam, carumonam) into human prostatic tissue. AB - Concomitant concentrations of monobactam antibiotics were measured in plasma and in prostatic tissue obtained by transurethral resection in 25 patients, 60-120 min after dosage. A 1-gram single intravenous injection of aztreonam or carumonam yielded mean prostatic concentrations of 6.0 mg/kg in 20 patients. Five patients who received a 2-gram dose of carumonam demonstrated average prostatic levels of 10 mg/kg. These concentrations significantly exceed MIC values for most common gram-negative urinary tract pathogens. PMID- 2721292 TI - Fostering intergenerational relationships for at-risk youth. PMID- 2721293 TI - Taming the wild things. PMID- 2721294 TI - Sexuality: a neglected component of child sexual abuse education and training. AB - Human sexuality is defined broadly as a function of total personality, especially to feelings of personal worth. A rationale, specific content, and teaching methodologies are suggested for the integration of sexuality content in the preparation of child welfare workers concerned with the prevention, intervention, and treatment of child sexual abuse. PMID- 2721296 TI - [Primary extranodal non-Hodgkin lymphoma of the stomach. Value of surgery within the scope of a multimodality treatment concept]. AB - The clinical course of 22 patients was analyzed in a retrospective study; all of these were suffering from malignant lymphoma of the stomach and most underwent radical resection as the only therapeutic measure. A unrelated effect on the survival rate was found in a high-grade malignancy metastatic disease of celiac lymph nodes (stage II2E) and tumor size. On the basis of the presented data we assume that low-grade malignant lymphomas stages IE can be cured by radical resection. In stage II1E and II2E we recommend multi-disciplinary treatment strategy with radical resection followed by radiation therapy in low-grade malignancy or chemotherapy in high-grade malignancy. PMID- 2721295 TI - Adolescent sexuality: promoting the search for hidden values. AB - Adolescent pregnancy and AIDS, and their implications for health risk, warrant a reexamination of professional values of child welfare workers toward adolescent sexuality. This article presents an exercise designed to assist practitioners in understanding the hidden values that influence intervention. PMID- 2721297 TI - [Results of 10 years' experience with peranal Parks and Stuart extirpation of villous and tubulo-villous adenomas of the rectum]. AB - From 1973 to 1983 68 patients with villous and tubulovillous adenomas were operated by the peranal technique of Parks and Stuart. Seven patients had a circumferential adenoma and in ten patients (14.7%) an invasive cancer was found, four patients with Dukes A and six patients with Dukes B. The lethality of the 68 patients was 1.5% and the morbidity 4.5%. By a follow-up between 5 and 15 years the recurrence rate was 20.9%. There was no recurrence of cancer, especially not in the two patients with primary excision of an invasive carcinoma. PMID- 2721298 TI - [Stomach rupture--a rare complication of resuscitation]. PMID- 2721299 TI - [Comment on the contribution by H. V. Zuhlke et al.: Endotoxinemia and bacteremia in manual oral decompression in ileus]. PMID- 2721300 TI - [Interdisciplinary treatment of gallstones: surgery, endoscopy, lithotripsy. Report of experiences after 4 years]. AB - Today, several methods of treatment for gall stone disease exist besides standard surgical procedures: endoscopy, lithotripsy, litholysis or a combination of the above. During the last four years 1786 patients were treated using an interdisciplinary approach. Cholecystectomy was still the most frequent method of treatment for symptomatic cholecystolithiasis (n = 1369) with low morbidity (4.3%) and lethality (0.28%). Probably less than 20% of all cases fulfill the strict selection criteria for extracorporeal shock wave lithotripsy (ESWL). All alternative methods of treatment in which the gallbladder is preserved have an increased risk for gall stone recurrence. Only after the long-term follow-up results of ESWL are known, the recurrence rate can be assessed. In most cases, bile duct stones (n = 417) were removed by endoscopy, if necessary in combination with ESWL (n = 310, stone removal: 95%, lethality: 0.3%). However, in low risk patients with concurrent cholecystolithiasis surgery was still the method of choice (n = 107, stone removal: 96%, lethality: 0/107). It seems not so important as to who performs the non-surgical procedures in the treatment of gall stones - the surgeon, internist or radiologist. Moreover, an interdisciplinary approach should be sought. PMID- 2721301 TI - [The surgical anatomy of the genital nerves of the male and their preservation in excision of the rectum]. AB - Studies of the fetus and new-born were undertaken to determine the exact localization of the nn. erigentes in the lower pelvis. The particular topography was visualized using histological slides and a special digital imaging technique. The nn. erigentes were found to be bundled along the diaphragmatic part of the urethra before entering the two cavernous bodies of the penis. These findings suggest that a small anterior patch of rectal muscle covering the diaphragmatic part of the urethra should be left behind in male patients undergoing total proctocolectomy in order to preserve potency. This operative technique cannot be employed for carcinomas extending to the anterior rectal wall. Since 1980, the new technique has been used in 18 male patients with rectal carcinoma and sexual function was preserved in all cases. PMID- 2721302 TI - [Arguments for a revised concept in the therapy of acute pancreatitis. On the indications for conservative, endoscopic and surgical procedures]. AB - From January 1, 1973 to October 31, 1987 we treated 271 patients suffering from acute pancreatitis at the Department of General Surgery at the University Munster, Westphalia. 159 (58.7%) presented with stage I, 75 (27.7%) with stage II, and 39 (13.6%) with stage III disease according to the Mainz classification for acute pancreatitis. In 147 cases an endoscopic sphincterotomy (EST) was performed. At a low method-specific morbidity (5.4%) we observed a mortality rate of 0% for stage I, 8% for stage II, and 22% for stage III. Altogether, a mortality rate of 13.3% was calculated for the necrotizing forms of acute pancreatitis after EST, compared to 36.5% for a conventionally (conservative therapy, operation) treated group. PMID- 2721303 TI - [Segment-oriented liver resection. Principles--technic--status]. AB - Complete surgical resection represents the only treatment for malignant tumors of the liver which offers the chance of long-term tumor-free survival. The segment orientated approach appears to be a fundamental improvement in preventing incomplete tumor removal as well as wastage of non-involved hepatic tissue. This resection technique is particularly based on a detailed knowledge of intrahepatic vascular anatomy and its variations. The use of modern diagnostic and surgical aids such as intraoperative ultrasound and liver transsection using the "ultrasonic-aspirator" expedites such technically sophisticated types of liver resection and permits their save and low risk implementation. The clinical relevance of this approach is analyzed on 452 hepatic resections consecutively performed from October, 1984, through December, 1988. 312 patients suffered from malignant disease, 224 of them from metastatic tumor. There were 159 segment orientated procedures as opposed to 167 common hepatectomies, and 126 non anatomical resections. In 235 patients the procedure was restricted to the liver, whereas in 48 cases a perihepatic extension, and in 169 distant extrahepatic procedures were performed as well. The overall 30 days mortality was 4.4%, ranging from 50% in 8 trauma cases to 2% in 204 elective procedures restricted to a non-cirrhotic liver. Segment orientated modifications reduced the risk of hepatic failure and consecutive mortality particularly associated with right lobectomy and hepatectomy, respectively. In turn, non-radical tumor removal was significantly diminished if compared to both common as well as non-anatomical resections. PMID- 2721304 TI - [The mobile cecum syndrome: appendectomy and cecopexy or only appendectomy?]. AB - 1159 patients underwent appendectomy via a McBurney incision from 1972 to 1983 at our institution. 115 patients (10%) had a mobile cecum syndrome (CMS) as defined by Nicole, without evidence of appendicitis or other pathologic findings at operation. 102 patients were followed up to 15 years after the operation. 82% of the 102 patients were free of symptoms at assessment. 36 patients underwent appendectomy and 63 appendectomy and cecopexy. The two cohorts were comparable with respect to sex, age at operation, duration of right lower abdominal pain, operative findings and length of follow-up. There was no significant difference in the postoperative result of patients with appendectomy alone and those with appendectomy and cecopexy. Moreover, we were not able to identify patients who may benefit from an additional cecopexy, on the basis of patient related factors or intraoperative findings. PMID- 2721305 TI - [Femoro-crural in situ bypass]. AB - During a period of 21 months from April 1986, 108 in situ femoro-crural bypass procedures were performed. The indication for surgery was in all cases a limb threatening ischemia. Always the technique described by Leather et al. was used. All the patients had obstructive disease of the crural arteries, thus the distal anastomosis was performed in a single crural or pedal artery for 102, and for 40 at the level of the ankle or foot. 97 per cent of the patients were discharged from the hospital with a salved limb, the one year patency was 76 per cent and one year limb survival 90 per cent. In our hands the in situ technique has shown much better results than the reversed vein technique. PMID- 2721306 TI - [Post-traumatic soft tissue defects of the heel]. AB - Trauma induced soft tissue defects of the heel are likely to develop recurrent ulcerations along with osteitis of the calcaneus even after years of conservative treatment. Biomechanical as well as plastic surgical, traumatological and orthopedical shoe device problems which must be taken into consideration to manage the functional demands, are discussed. PMID- 2721307 TI - [Tongue necrosis as a complication of giant cell arteritis]. PMID- 2721308 TI - [Tongue necrosis following subtotal struma resection caused by Horton giant cell arteritis]. PMID- 2721309 TI - [Primary adenocarcinoma of the duodenum in combination with pancreas anulare]. PMID- 2721310 TI - Sex chromosome pairing patterns in male mice of novel Sxr genotypes. AB - The influence of the sex-reversal factor (Sxr) on X and Y chromosome pairing was examined by comparing males with "novel" and "standard" Sxr genotypes. The novel Sxr males were exceptional in carrying Sxr on their X rather than their Y chromosome, or homozygously on both their X and Y chromosomes, or on a Y chromosome of different origin to that on which the factor arose. Regardless of its chromosomal location, Sxr was found to elevate the frequency of X-Y separation. Univalent X and Y chromosomes were observed to undergo self association in a variable proportion of spermatocytes of all Sxr-carrying males. There was a suggestion that chromosomal location of the factor could influence the frequency of univalent self-association. Our observations do not support the published hypothesis of Y self-pairing as the cause of the elevated rate of X-Y separation at pachytene in Sxr-carrying males. Rather, they suggest that heterozygosity due to the presence of Sxr in the XY pairing region may be sufficient to disrupt pairing and cause univalence, or alternatively, that Sxr is an inefficient promoter of X-Y pairing initiation. PMID- 2721311 TI - From "acta diurna" to "Chronobiologia". PMID- 2721312 TI - Magnetic resonance spectroscopy and ambulatory cardiovascular monitoring noninvasively gauge timing of phosphate metabolism and circulation. AB - Circadian changes in high-energy phosphate metabolism of the human forearm and the relative independence of these metabolic changes from the circulation were noninvasively demonstrated and quantified by combining nuclear magnetic resonance spectroscopy (MRS), ambulatory blood pressure and heart rate monitoring and chronobiologic time series analysis. PMID- 2721313 TI - Internal desynchronization of circadian rhythms and tolerance of shift work. AB - Fifteen male subjects including 12 shift workers (oil refinery operators) volunteered to document circadian rhythms in sleep-wake, grip strength of both hands, peak expiratory flow, heart rate, self-rated drowsiness, fatigue and attention. Each of these variables was measured 4 to 6 times/day for 2 to 3 weeks. In addition, both axillary temperature (with a shielded probe) and wrist activity were almost continuously recorded at 15 min intervals during the same time span. Individual time series were analyzed according to several statistical methods (power spectrum, cosinor, chi 2, etc.), in order to estimate the prominent circadian period tau and to evaluate both individual and subgroup differences with regard to tolerance of shift work, age, duration of shift work. The present study confirms for continuously recorded temperature and wrist activity, grip strength of both hands, heart rate and peak expiratory flow that intolerance of shift work is frequently associated with an internal desynchronization. However, this conclusion cannot be extended to circadian rhythms in self-rated drowsiness, fatigue and attention. The internal desynchronization among several circadian rhythms supports the hypothesis that these latter are driven by several oscillators, with presumable differences between right and left hemispheres as suggested by unequal values of tau in rhythms of both hand grip strength. Since an internal desynchronization can be observed in tolerant shift workers having no complaint, it is likely that symptoms of intolerance are related to the subject's sensitivity to internal desynchronization rather than to the desynchronization itself. PMID- 2721314 TI - Rhythms in the ovulatory cycle. 1st: Prolactin. Chronobiological Research Group on Synthetic Peptides in Medicine. AB - Circadian and circatrigintan profiles of prolactin (PRL) in young normally cycling women at 4 well characterized times of the ovulatory cycle have been compared. Circadian patterns of PRL (collected at 2-h intervals for 24h at each phase selected) change during the 4 phases, being higher in the luteal phase. In a consistent percentage of individuals, serum PRL rises notably during the night; in one half of the subjects a peak is located also in the afternoon or early evening. The statistically significant circatrigintan rhythm of PRL shows the acrophase approximately in the mid-luteal phase. PMID- 2721315 TI - Circadian activity rhythms in hamsters and rats treated with imipramine in the drinking water. AB - Circadian rhythms of locomotor activity were recorded in 15 male golden hamsters and in 15 rats. The animals were exposed alternatingly to a variety of conditions with either light-dark cycles (LD) or continuous illumination (LL). The hamsters were split into two groups: 7 animals received plain water, and 8 animals water together with imipramine hydrochloride. The rats received plain water or water with imipramine in alternation. In all animals the addition of imipramine resulted in a reduction of water uptake and in a concomitant reduction of the daily amount of activity. Otherwise, no significant effects of imipramine could be observed: in LD, the phase-angle differences between rhythm and zeitgeber were not changed by imipramine, and, in the hamsters, the upper limits of entrainability and the rates of re-entrainment were identical in the two groups of animals; in LL, the period of the free-running rhythm was slightly lengthened by imipramine in the hamsters, but remained unchanged in the rats. PMID- 2721316 TI - Estradiol and testosterone levels in patients undergoing partial hepatectomy. A possible signal for hepatic regeneration? AB - In five adult male patients undergoing a 40-60% partial hepatectomy, serum sex hormone levels before and after hepatic resection were determined. Blood was drawn immediately prior to each surgical procedure and at specified time points postoperatively. Compared to hormone levels found prior to surgery, following major hepatic resection, estradiol levels increase at 24 and 48 hr, while testosterone levels decline, being significantly reduced at 96 and 144 hr. These data demonstrate that adult males who undergo a 40-60% partial hepatectomy experience alterations in their sex hormone levels similar to those observed in male rats following a 70% hepatectomy. These changes in sex hormone levels have been associated in animals with an alteration of the sex hormone receptor status of the liver that is thought to participate in the initiation of the regenerative response. These studies suggest, but do not prove, that in man, as in the case of the rat, sex hormones may participate in the initiation of or at least modulate in part the regenerative response that occurs following a major hepatic resection. PMID- 2721317 TI - Aging and pancreatic exocrine function. Studies in female conscious rats. AB - Basal pancreatic exocrine functions as well as responses to endogenous (BPJ diversion) and exogenous (injection of CCK-8 or secretin) stimulations were examined in young (6- and 12-month-old) and old (24- to 26-month old) female Fischer 344 rats. Basal secretions were not significantly different between young and old rats. BPJ diversion significantly stimulated pancreatic secretions of fluid, bicarbonate, and protein in all animals. The pancreatic protein response (mg/kg/hr) to BPJ diversion was significantly attenuated with respect to age [57.59 +/- 16.16, 43.73 +/- 6.94, and 20.75 +/- 3.95, for 6-, 12-, 24- to 26 month-old rats, respectively, mean +/- SE, F(2,20) = 3.49, P less than 0.05]. The pancreatic responses to secretin (0.086, 0.432, and 1.728 nmol/kg) were not significantly different between young and old rats. Intravenous injection of CCK 8 (0.033, 0.167, and 0.667 nmol/kg) produced a significant increase in protein output in all age groups. In young animals, stepwise increases in protein output were observed, whereas, in old rats, increments in response to the larger two doses of CCK-8 (0.167 and 0.667 nmol) were smaller than that produced by 0.033 nmol/kg of CCK-8. In conclusion, the basal secretions in old rats were comparable with those in young ones, but the reserve capacity for protein secretion appears to decrease in old compared to young rats. PMID- 2721319 TI - Serious systemic toxicity resulting from use of tetracaine for pharyngeal anesthesia in upper endoscopic procedures. AB - Three cases of serious systemic toxicity from tetracaine pharyngeal anesthesia for upper endoscopic procedures are described. The pathophysiologic basis for systemic toxicity is discussed and a recommendation for preendoscopic anesthesia is provided. PMID- 2721318 TI - CCK receptors in release of pancreatic polypeptide (PP) in dogs. AB - Pancreatic polypeptide (PP) is released after ingestion of protein-fat meals and following administration of some gut hormones (CCK and bombesin), but the hormonal contribution to the physiological release of PP has not been elucidated. We used specific and potent CCK-receptor antagonist, L-364,718, administered intravenously in a dose of 0.5 mumol/kg or intraduodenally in a dose of 2 mumol/kg to assess the role of CCK in the release of PP. Exogenous CCK-8 infused intravenously in gradually increasing doses (12.5-400 pmol/kg/hr) caused a dose dependent increase in plasma PP from basal 28 +/- 4 pM to 136 +/- 18 pM, and this PP increase was completely suppressed by both intravenous and intraduodenal administration of L-364,718. Meat feeding caused a dramatic increase in plasma PP from a basal level of 26 +/- 4 pM to a peak of about 190 +/- 32 pM, and the pretreatment with intravenous or intraduodenal L-364,718 reduced this PP increase by about 60%. Duodenal perfusion with oleate (0.12-4.0 mmol/hr) or L-Trp (0.12 4.0 mmol/hr) also increased plasma PP, reaching, respectively, 180 +/- 28 pM and 76 +/- 6 pM. Pretreatment with intravenous or intraduodenal L-364,718 completely abolished the plasma PP responses to oleate and L-Trp. Bombesin (100 pmol/kg/hr) raised plasma PP to the level similar to that achieved by meat feeding and L 364,718 given intravenously or intraduodenally blocked completely these plasma PP increments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721320 TI - Endoscopic biopsy is diagnostic in gastric antral vascular ectasia. The "watermelon stomach". AB - Gastric antral vascular ectasia was endoscopically diagnosed in seven patients. Pathologic characteristics of this entity were defined retrospectively, by studying endoscopic pinch biopsy slides from these seven patients and antrectomy specimens from five patients. A scoring system was developed, and the seven patients were compared prospectively with various control groups. Abnormalities of mucosal vessels (fibrin thrombi and/or ectasia) consistently distinguished patients from control antrectomies, normal biopsies, acute gastritis biopsies and atrophic gastritis biopsies (P = 0.02, all comparisons). Spindle cell proliferation into mucosa also was characteristic of gastric antral vascular ectasia, distinguishing this disease from normals, acute gastritis, and atrophic gastritis (P less than or equal to 0.039, each comparison). The presence of abnormal mucosal vessels (fibrin thrombi and/or ectasia) and spindle cell proliferation was similar in patient antrectomies compared to patient endoscopic biopsies. Therefore, we conclude that endoscopic biopsies can reliably diagnose gastric antral vascular ectasia, a vascular disorder characterized by abnormal mucosal vessels and spindle cell proliferation. PMID- 2721321 TI - Clinicopathological features and natural history of gastric hamartomatous polyps. AB - The clinicopathological features, chromoendoscopic findings, and natural history of hamartomatous polyps of the stomach were compared with those of gastric hyperplastic polyps. Hamartomatous polyps were found significantly more frequently in adult females than adult males, and all were found significantly more frequently in adult females than adult males, and all were located in the gastric body or the fundus. In general, the number of polyps per patient was less in older patients. Histologically, all these polyps were formed of cystically dilated oxyntic glands and irregularly deformed oxyntic glands. Chromoendoscopic examinations using Congo red showed that the polyps were associated with extensive acid-secreting areas, were all located in acid-secreting areas, and had an acid-secreting function. Colonoscopy and/or radiologic examinations showed that one or a few polyps were frequently also present in the colons of these patients, but none of the families of the patients had a history of gastrointestinal polyposis. One to 11 years after the initial endoscopy, in seven (50.0%) of 14 patients with hamartomatous polyps followed up, the number of polyps decreased significantly. PMID- 2721322 TI - Detection of esophageal motor disorders by radionuclide transit studies. A reappraisal. AB - Radionuclide measurement of esophageal transit has been proposed as a screening test for esophageal motor dysfunction. In this study we evaluated the radionuclide esophageal transit test in 49 consecutive patients undergoing esophageal manometry for esophageal motor disorders. Esophageal transit was assessed using a 10-ml water bolus labeled with 250 microCi technetium-99m sulfur colloid. In preliminary studies in 14 healthy controls, mean transit time was 9.6 +/- 2.1 (SD) sec. Prolonged transit (greater than 15 sec) was observed in two of 28 swallow sequences in the control subjects. Transit times were prolonged in all patients with achalasia or diffuse esophageal spasm, and in five of seven patients with nonspecific abnormalities of peristaltic progression. The test was abnormal in only three of seven patients with high-amplitude peristalsis (nutcracker esophagus) and in none of three patients with hypertensive lower esophageal sphincter. Additionally, prolonged transit was seen in two of 18 patients with normal manometry. We conclude that the radionuclide transit test using a liquid bolus successfully identifies motor disorders characterized by defective peristaltic progression but not disorders in which peristalsis is intact. A major limiting factor appears to be the small number of swallow sequences tested. The test may not, therefore, be accurate enough to consider adopting as a sensitive and noninvasive screening test in the evaluation of patients with suspected esophageal motor disorders. PMID- 2721323 TI - Preliminary report on isolation of mycobacteria from patients with Crohn's disease. AB - Several investigators have recently described the isolation of slow growing mycobacteria from the tissues of patients with Crohn's disease (CD). The primary purpose of this study was to culture and identify mycobacteria from the intestines of patients with CD and other intestinal diseases (control tissues). The culture methods were designed to eliminate most rapid-growing mycobacteria and to enhance the isolation of slow growing mycobacteria. Eighty-two surgically resected intestinal tissue samples were cultured over a four-year period: 27 tissues were from CD patients and 55 from patients with other intestinal diseases. After 4-12 months of culture, five mycobacteria were isolated, but only two have been identified thus far. Both of these organisms appeared to have initially grown as spheroplasts, but revertant bacteria were cultivated after transfer into fresh media. Four of the mycobacteria were from CD tissues, and one isolate was from a control tissue. Two of the isolates have been identified as M. chelonei subsp. abscessus, strain 390 and M. paratuberculosis strain 410. This M. paratuberculosis is similar to the previously identified M. paratuberculosis strains isolated from other human intestinal tissues from patients with CD. Both strains 390 and 410 were inoculated into neonatal goats, but they failed to reproduce a CD-like disease. The isolation of four mycobacteria from 27 CD tissues and only one from 55 control tissues strengthens the findings of previous investigators and supports the hypothesis that mycobacteria may be etiologically associated with some cases of Crohn's disease. PMID- 2721324 TI - Causes and consequences of hypochlorhydria in the elderly. PMID- 2721325 TI - Micronodular cirrhosis after thiabendazole. AB - Hepatotoxicity secondary to the administration of thiabendazole has been rare since this drug was produced in 1964. In 14 of 15 patients reported previously in the literature, severe intrahepatic cholestasis resolved within seven months of the onset of illness. A recent report documented the progression to cirrhosis in a 15th patient. We report the second case of a patient with intrahepatic cholestasis that developed after treatment with thiabendazole and progressed to severe micronodular cirrhosis. PMID- 2721326 TI - Sucralfate effects. PMID- 2721327 TI - Acute pancreatitis associated with Campylobacter enteritis. PMID- 2721328 TI - Meaning of measurement of bound sialic acid output in human gastric juice. PMID- 2721329 TI - Ascitic cholesterol: accurate parameter to the differential diagnosis of ascites? PMID- 2721330 TI - Protein binding characteristics of bumetanide. AB - The association constants (k) and binding capacities (np) of bumetanide were determined in pooled venous blood obtained from adults, venous cord blood of healthy full-term infants, and critically ill neonates using ultrafiltration. Bumetanide was highly bound to plasma proteins (approximately 97%) in all three populations studied. Two classes of binding sites were identified, a high affinity, low-capacity site with k and np in the order of 10(3) M-1 and 10(-3) M, respectively, and a low-affinity, high-capacity site with k and np in the order of 10(2) M-1 and 10(-2) M, respectively. Binding capacities were similar between the three groups studied and were larger than the 'presumed' therapeutic concentration following intravenous administration of the drug, which is on the order of 10(-6) M (less than or equal to 0.5 microgram/ml). PMID- 2721331 TI - Activity of alcohol dehydrogenase and aldehyde dehydrogenase in maternal liver, fetal liver and placenta of the near-term pregnant ewe. AB - The activity of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) was determined in the near-term pregnant ewe. There was little ADH activity in fetal liver (4.4%) and placenta (0.2%) compared with maternal liver. Low KM (microM acetaldehyde) ALDH activity was similar in the three tissues. High KM (mM acetaldehyde) ALDH activity was less in fetal liver (57%) and placenta (16%) compared with maternal liver. These data and the pharmacokinetics of ethanol and its proximate metabolite, acetaldehyde, in the near-term pregnant ewe indicate that ethanol elimination from the maternal-fetal unit is regulated primarily by maternal hepatic ADH-catalyzed biotransformation of ethanol, and low KM ALDH activity in the fetal liver and placenta protects the fetus from exposure to ethanol-derived acetaldehyde, which is produced primarily in the maternal compartment. PMID- 2721332 TI - Effect of chronic maternal drug addiction on placental drug metabolism. AB - Microsomes were prepared from the term placentas of 5 drug-dependent and 4 normal (control) mothers and from the livers of 3 normal fetuses (gestational age = 22 24 weeks) to determine if chronic maternal drug addiction can induce metabolic pathways in the placenta which are utilized in the biotransformation of drugs of abuse. Using as model substrates aminopyrine for demethylation, aniline for hydroxylation, and bilirubin for conjugation, we observed little to none of substrate biotransformation in both drug-dependent and control placentas. Similarly, such enzymatic activity in the fetal liver was also low. We conclude that chronic maternal addiction does not induce metabolic pathways in the placenta for the biotransformation of drugs of abuse. PMID- 2721333 TI - Neonatal bilirubin production after preterm labor tocolysis with nifedipine. AB - We studied the in vivo total bilirubin production, as indexed by the carboxyhemoglobin level (HbCO), of infants whose mothers had ritodrine (RIT) tocolysis or underwent tocolysis with the calcium channel blocker, nifedipine (NIF). No difference in HbCO between the infant groups was detected: NIF 0.67 +/- 0.31% saturation and RIT 0.88 +/- 0.47% saturation. We conclude that NIF is unlikely to cause a clinically important increase in total bilirubin production when used at doses sufficient for tocolysis. PMID- 2721334 TI - Effects of acute administration of naltrexone on cardiovascular function, body temperature, body weight and serum concentrations of liver enzymes in autistic children. AB - The effects of acute, orally administered naltrexone (0.5, 1.0, 1.5 and 2.0 mg/kg), a potent opiate receptor antagonist, on auscultated heart rate, systolic blood pressure and axillary body temperature were investigated before and about 1 h postdrug in 5 autistic children (4-12 years of age). In addition, an electrocardiogram was recorded on each child before and about 3 h after placebo or 2.0 mg/kg of naltrexone. Finally, the serum concentrations of the liver enzymes glutamic-oxaloacetic transaminase (SGOT) and glutamic-pyruvic transaminase (SGPT) were measured 24 h following placebo or naltrexone administration. Naltrexone had no statistically significant effects on any of these measures in comparison with baseline or placebo levels. Thus, these data provide preliminary evidence for the safety of acute administration of naltrexone in children. PMID- 2721335 TI - Mechanisms of developmental increase in the sensitivity to ouabain. AB - In the present study we examined (1) the arrhythmogenic toxicity of ouabain (5 micrograms/kg/min intravenously) in anesthetized guinea pigs of 1-5 days and 3 months of age, and (2) the state of Na+-Ca2+ in the sarcolemmal vesicles isolated from these age groups. Guinea pigs of 1-5 days old tolerated 75% more ouabain than the young adults without significant alteration in the maximal inotropic response. Sodium-dependent 45Ca2+ uptake was substantially lower in the vesicles isolated from hearts of 3-day-old animals, which was characterized by a lower rate of 45Ca2+ uptake (60% Vmax), as compared to the young adults. There was no significant difference in the affinity for 45Ca2+ (Km). The apparent rate of Na+ dependent 45Ca2+ efflux was also lower in the vesicles from 3-day-old guinea pigs. However, the percent extrusion of 45Ca2+ appeared to be unchanged. PMID- 2721336 TI - Effect of in utero cocaine exposure on startle and its modification. AB - The effect of prenatal cocaine on acoustic sensorineural reactivity was assessed using reflex modification procedures in infants born to mothers with cocaine abuse (C-exposed). Reflex modification was tested using a controlled eyeblink eliciting tap to the glabella presented either alone or with a 90-dB SPL tone. The results from 19 C-exposed infants were compared to 19 healthy matched drug free infants. ANOVA comparison of the two groups showed C-exposed infants were more reactive in general, as indicated by a larger glabellar reflex, and more responsive to auditory stimuli, as indicated by an increased blink when the tone accompanied the tap (p less than 0.05). These data suggest that in utero cocaine exposure may have a direct effect on sensorineural processing and may place these infants at risk for cognitive and/or neurological sequelae. PMID- 2721337 TI - Perinatal opiate exposure. Effects on metabolism of xenobiotics and steroids in adult rat liver. AB - The effects of perinatal or neonatal morphine exposure on the hepatic steroid and xenobiotic metabolism in adult rats were studied. Early morphine exposure did not affect the 16 alpha-hydroxylation or 5 alpha-reduction of androstenedione in either sex, but decreased the 7 alpha- and 6 beta-hydroxylations in both sexes. Morphine exerted a suppressive effect on the ethoxyresorufin-O-deethylase activity and increased the ethoxycoumarin-O-deethylase activity in both sexes. Morphine exposure did not significantly affect its own N-demethylation or the total cytochrome P-450 content in the liver. Neonatal morphine exposure caused a significant decrease in body and testes weight in the adult male rat. We conclude that the effects of morphine are not confined to sex-differentiated pathways and are similar in both sexes. PMID- 2721338 TI - Effects of prenatally administered thyroid hormones or glucocorticoids on maturation of kidney function in newborn rats. AB - Influences of treatment with thyroid hormones or dexamethasone during pregnancy on development of kidney function were studied in newborn rats. Treatment of dams for 3 days is followed by a higher rate of urine production in newborn rats. A statistically significant raise of sodium/potassium ratio in tetraiodothyronine- or dexamethasone-treated rats indicates a higher degree of maturation of kidney function. Treatment of dams with dexamethasone is followed by an increase of absolute excreted quantities of sodium and potassium in newborn rats. Treatment of dams with triiodothyronine can increase renal excretion of p-aminohippurate in newborn rats. PMID- 2721339 TI - Relationship of skin thickness to duration of diabetes, glycemic control, and diabetic complications in male IDDM patients. AB - Skin thickness is primarily determined by collagen content and is increased in insulin-dependent diabetes mellitus (IDDM). We measured skin thickness in 66 IDDM patients aged 24-38 yr and investigated whether it correlated with long-term glycemic control and the presence of certain diabetic complications. With univariate analysis, skin thickness was increased and significantly related to duration of diabetes (P less than .001), previous glycemic control (P less than .001), retinopathy (P less than .001), cheiroarthropathy (P less than .001), and vibration-perception threshold (P less than .05). There was a negative correlation between forced expiratory volume at 1 s (P less than .05) and vital capacity (P less than .05) with duration of diabetes. Neither skin thickness nor ankle arteriomedial wall calcification correlated with abnormal autonomic function tests. When corrected for duration of diabetes, there was a weak correlation between skin thickness and glycemic control (P less than .05) but no correlation with retinopathy, cheiroarthropathy, and vibration-perception threshold. This study confirms that there are widespread connective tissue changes in diabetes mellitus, although the biochemistry needs further elucidation. PMID- 2721340 TI - Effects and correlates of blood glucose awareness training among patients with IDDM. AB - Whereas self-monitoring of blood glucose (SMBG) is the recommended source of information on which to make self-care decisions, patients frequently use estimates of their own blood glucose (BG). This study evaluated whether patients with insulin-dependent diabetes mellitus (IDDM) could learn to improve accuracy of BG estimations and whether this would lead to improved metabolic control. Subjects in BG awareness training improved both their BG-estimation accuracy and glycosylated hemoglobin (HbA1) compared with the control group. Initial BG estimation accuracy was marginally associated with pretreatment HbA1 and months of previous SMBG experience. Posttreatment improvement was associated with pretreatment BG-estimation accuracy and the ability to counterregulate to insulin induced hypoglycemia. PMID- 2721341 TI - Quantitative relationship between plasma lipids and glycohemoglobin in type I patients. Longitudinal study of 212 patients. AB - Plasma cholesterol, triglycerides, glycohemoglobin, and other covariates were measured in 212 type I (insulin-dependent) diabetic subjects on entry into a longitudinal study of diabetes and again after an average interval of 3.7 yr. Changes in individual cholesterol and triglyceride values over time were significantly correlated with changes in glycohemoglobin. After adjustment for potentially confounding covariates, plasma cholesterol declined by 2.2% (0.1 mM) for each percentage-point reduction in glycohemoglobin and plasma triglycerides declined by 8% (0.08 mM) per percentage point glycohemoglobin. Increased insulin dose was independently associated with increased plasma triglycerides, after adjusting for glycohemoglobin level and other covariates. However, insulin dose diabetic metabolic control, measured as declining glycohemoglobin, is the variable most closely associated with reduced plasma lipids in a population of typical type I diabetic patients. PMID- 2721342 TI - Metabolic effects of fructose supplementation in diabetic individuals. AB - With new diabetes diet guidelines recommending high carbohydrate intake, questions arise regarding acceptable intake of simple sugars. Whereas several short-term studies report flattened glycemic and insulin response to fructose consumption, some also report increased serum triglyceride levels. Few studies examine the effects of long-term fructose consumption. We evaluated the long-term safety of fructose consumption in 14 middle-aged men with diabetes. Subjects followed an ambulatory high-fiber high-carbohydrate control diet at home for 8 wk, entered the hospital for 5 days on this diet, and spent the next 7 days on a similar diet supplemented with 50-60 g fructose. They continued the fructose diet at home for 23 wk, then resumed a postcontrol diet for an additional 16 wk. In the hospital, glycemic control improved significantly on the fructose supplemented diet compared with the hospital control diet. In the ambulatory setting, no significant differences in plasma glucose, glycohemoglobin, serum cholesterol, triglycerides, lactate, or urate occurred between precontrol, fructose, or postcontrol periods. Fasting serum lactate was higher by 0.5 meq/L during the ambulatory fructose period than during the precontrol period. Body weight also increased during the ambulatory fructose period due to higher calorie intake. Adherence to fructose consumption was excellent and improved adherence to carbohydrate and fat recommendations. If total calorie intake is controlled to promote desirable body weight, crystalline fructose used with a high-carbohydrate high-fiber low-fat diet appears to be safe and acceptable for diabetic individuals. PMID- 2721343 TI - Clinical evaluation of computer-assisted self-monitoring of blood glucose system. AB - The Glucometer M Diabetes Management System includes a glucose-reflectance meter with memory that can interface with a microcomputer for data manipulation and analysis. We evaluated the system in a short-term randomized control trial to determine its impact on metabolic control, self-monitoring of blood glucose (SMBG) testing behaviors, regimen self-adjustment, understanding of insulin dependent diabetes mellitus (IDDM) treatment, attitudes about SMBG, and perceived quality of patient-physician interaction. Twenty-nine adolescent subjects (experimental) with IDDM were randomly assigned the Glucometer M system for 4 mo. Twenty-eight control subjects used meters without memory. All subjects returned twice to the clinic at 2-mo intervals during the study. At clinic visits, both groups reviewed their SMBG data with their physician. Reviews on experimental subjects were conducted with computer-generated data formats. Control subject reviews used traditional logbooks. Both groups showed a significant drop in glycosylated hemoglobin during the study period (P less than .001); however, there were no between-group differences. There were also no differences in SMBG testing behavior or self-reported regimen self-adjustment between groups or within groups compared with baseline. Compared with control subjects, experimental subjects indicated a significant increase in self-reported understanding of IDDM treatment (P = .002), perceived importance of testing (P = .006), and the quality of interaction with their physician (P less than .001). These data suggest that use of computer-assisted SMBG systems in the outpatient setting does not improve metabolic control over 4 mo. It may, however, contribute to improving communication between the patient and health-care providers. PMID- 2721344 TI - Perceived and actual level of knowledge of diabetes mellitus among nurses. AB - The purpose of this study was to survey staff nurses on their perceived and actual level of knowledge of diabetes mellitus. A convenience sample of 184 professional staff nurses from both inpatient and outpatient settings of a large research-teaching hospital was surveyed. The Diabetes Self-Report Tool (Cronbach's alpha = .91) was used to assess staff nurses' perceptions of knowledge of diabetes mellitus. The Diabetes: Basic Knowledge Test (DBKT; Cronbach's alpha = .79) was used to measure the actual level of knowledge of diabetes mellitus. The data were analyzed with Pearson's correlation coefficients. A moderately low negative correlation (r = -.36, P less than .001) indicated that the staff nurses' perceived knowledge of diabetes mellitus was inversely related to actual knowledge. Subjects were found to have a mean score of 64% on the DBKT. Study findings raise questions as to the adequacy of staff nurse knowledge of diabetes and the ability of staff nurses to assess themselves for knowledge deficits. PMID- 2721346 TI - Reduced albuminuria and improved insulin sensitivity after dietary protein restriction in IDDM patients. PMID- 2721345 TI - Standards of medical care for patients with diabetes mellitus. PMID- 2721347 TI - A bill of rights. PMID- 2721348 TI - 1988: a year of change in cytopathology. PMID- 2721349 TI - Recruitment of individuals to the field of cytotechnology: a regional society's efforts. PMID- 2721350 TI - Metaplastic carcinoma of the breast: fine-needle aspiration cytology of seven cases. AB - We describe the cytomorphology of seven cases of metaplastic carcinoma of the breast studied by fine-needle aspiration cytology and by histology. All seven cases contained foci of ductual adenocarcinoma. This finding was combined with heterologous mesenchymal elements in four cases, a spindle-cell pattern of growth in one case, and extensive squamous-cell metaplasia in two cases. Both carcinomatous and metaplastic components were present on smears in four cases (57%). Thus in three cases (43%), the diagnosis was not possible on smear material alone. Differential diagnostic considerations are discussed. PMID- 2721351 TI - Bronchoalveolar lavage in the diagnosis of lipoid pneumonia. AB - Lipoid pneumonia (LP) is an uncommon entity with the characteristic radiographic features and histologic findings of alveoli filled with vacuolated, lipid-laden histiocytes. We questioned whether bronchoalveolar lavage (BAL) could be useful in the confirmation of LP. We examined lipid stains (oil-red O) in BAL specimens from 18 cases, representing a variety of pulmonary disease states, and compared them with an index case of confirmed LP. The index case of LP had a history of chronic intranasal use of mentholated petrolatum with subsequent x-ray findings of progressive air bronchograms. Positive histochemical confirmation (oil-red O) performed on frozen sections of transbronchial lung biopsy was obtained. Eleven of the non-LP cases had no intracellular staining of BAL macrophages with oil-red O stain, whereas the index case of LP exhibited markedly positive intracytoplasmic staining of macrophages for lipid. The remaining seven cases showed minimal to mild lipid staining with only one other case having moderate staining. This study demonstrates that BAL macrophages from patients with a variety of pulmonary states and without suspected LP do not demonstrate significant staining for intracellular lipids, in contrast with the expected strong positivity of LP. Lipid staining of BAL specimens, although not entirely specific, may be a preferred method for confirming the diagnosis of LP, thereby avoiding more invasive procedures. PMID- 2721352 TI - Fine-needle aspiration of the liver: out of the ivory tower and into the community. AB - This study of 160 consecutive fine-needle aspirates of localized hepatic masses analyzed the efficacy of the technique when extended into a multicenter setting. The aspirates were processed and interpreted by a single cytology service, but they were performed, under radiographic imaging, in eight different hospitals by at least 20 radiologists, few of whom had had the opportunity to acquire long term experience. Of 108 malignancies, 101 were correctly sampled (sensitivity, 93.5%), including 30 primary hepatocellular carcinomas, 70 metastatic tumors, and 1 lymphoma. Specific benign pathologic lesions in 12 cases were amenable to cytodiagnosis. The problem of the remaining 47 samples, which contained exclusively blood, necrotic material, or normal and reactive hepatic constituents, was addressed at length. These were considered "nondiagnostic" samples in the context of aspirating focal masses. The majority had benign lesions on further study, but tumors were found in seven, all of which had been sampling errors, resulting in a negative predictive value of 82.5%. Fine-needle sampling of localized lesions, particularly neoplasms, can thus perform well in transition from single-center studies to more widespread usage in daily practice. Confident reliance on the procedure can be maintained if appropriate radiologic and cytologic facilities exist, provided that the limitations of nonneoplastic aspirates are fully understood. PMID- 2721353 TI - Fine-needle aspiration cytology of pheochromocytoma-ganglioneuroma of the organ of Zuckerkandl. AB - Fine-needle aspiration (FNA) cytologic and immunocytochemical findings of a rare combined pheochromocytoma-ganglioneuroma developing in a 48-yr-old Japanese man in the organ of Zuckerkandl are described. This is the first report of a combined pheochromocytoma-ganglioneuroma of the organ of Zuckerkandl. FNA cytology showed typical cytologic findings of these two components similar to those described individually in fine-needle aspirates of these neoplasms. The neoplastic cells showed positive reactions for vasoactive intestinal polypeptide, neuron-specific enolase, and S-100. PMID- 2721354 TI - Mesenteric fibromatosis: cytologic, histologic, and ultrastructural findings in a case. AB - The cytologic findings in a case of mesenteric fibromatosis initially suggested the diagnosis of a benign spindle-cell soft-tissue tumor. Subsequent histology and electron microscopy were performed on the resected mass, and the definitive diagnosis was established. The patient had a history of previous abdominal surgery, but no features of Gardner's syndrome. The difficulties associated with the diagnosis of mesenteric fibromatosis and the cytologic diagnosis of benign and spindle-cell soft-tissue tumors and low-grade sarcomas in general are discussed. PMID- 2721355 TI - Epithelioid hemangioendothelioma: cytomorphology and histological features of a case. AB - A case of epithelioid hemangioendothelioma involving the left lung, the 10th thoracic vertebra, and paravertebral soft tissues is presented. Preoperative sputum cytology was thought to show adenocarcinoma. Histologic examination demonstrated an intravascular bronchioloalveolar tumor; immunohistochemical staining for factor VIII-related antigen revealed strongly positive tumor cells. The cytomorphology of this rare neoplasm is discussed. PMID- 2721356 TI - Adenosquamous-cell carcinoma of the ovary: report of a case with positive peritoneal fluid cytology. AB - Cytologic examination of peritoneal fluid showed only malignant squamous cells, without revealing adenocarcinomatous cell components, in a patient who had an endometrioid adenosquamous-cell carcinoma of the ovary. Histologic examination of the ovary demonstrated diffuse squamous-cell carcinoma with rare foci of endometrioid and abortive malignant glands, as well as isolated mucin-positive cells. The cytologic differential diagnosis of malignant squamous cells in peritoneal fluid and the pathogenesis of squamous-cell carcinoma of the ovary are discussed. PMID- 2721357 TI - Fine-needle aspiration cytology of angiolymphoid hyperplasia with eosinophilia: a case report with electron microscopy and immunohistochemistry. AB - Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon vascular inflammatory lesion usually involving the dermis or subcutaneous tissue of the head-neck region of middle-aged women. Histologically, this lesion shows a florid proliferation of vessels lined by particular endothelial cells and an inflammatory infiltrate composed of lymphocytes and eosinophils. The fine-needle aspiration (FNA) cytology of a nodular lesion in the retroauricolar region of a 18-yr-old woman showed spindle-shaped and polygonal cells with vesicular nuclei and deeply eosinophilic cytoplasm containing well-defined vacuoles in a background of eosinophils and lymphocytes. These features were consistent with a proliferation of epithelioid endothelial cells, and a diagnosis of ALHE was suggested. The histology confirmed the preoperatory diagnosis, and ultrastructural and immunohistochemical studies further demonstrated the endothelial nature of epithelial-appearing cells. Because the clinical appearance of the lesion may mimic a large number of benign and malignant diseases, a preoperatory diagnosis of ALHE is rarely made. The FNA cytology may represent a simple and reliable method with which to study and diagnose proliferations of epithelioid endothelial cells. PMID- 2721358 TI - Urine and semen cytomorphology in patients with testicular tumors. AB - Our original technique of preparing urinary and seminal sediment was modified in order to identify neoplastic cells in cases of testicular malignancies. In a series of 24 patients with testicular tumor-like conditions, 18 tumors were diagnosed, 12 cytologically. In one case, the result of cytological examination was falsely positive since histopathology revealed necrosis of the testicle only. The morphology of neoplastic cells in the seminal sediment is demonstrated. PMID- 2721359 TI - Identification of features of metaplastic cells in sputum for the detection of squamous-cell carcinoma of the lung. AB - Digitized images of 1,556 squamous metaplastic cells from the sputum of 15 patients with confirmed squamous-cell carcinoma of the lung and 13 subjects without apparent neoplasia were analyzed to determine if features existed within these relatively normal cells that could be used to differentiate between the two populations. Results indicate that such marker features do exist. A cross validation study using an additional 465 cells confirmed the conclusion that squamous metaplastic cells from patients with squamous-cell carcinoma of the lung do differ from those of subjects without cancer. While such marker features alone are not reliable enough to assist pathologists in the diagnosis of squamous-cell carcinoma of the lung, they might, in sufficient numbers, be used to identify patients for whom follow-up testing would be advised. PMID- 2721360 TI - Implementing the Commission recommendations. PMID- 2721361 TI - Closing critical care beds. PMID- 2721362 TI - Symbion acute ventricular assist device: nursing challenge. AB - A cardiac patient is rapidly deteriorating and facing imminent death. The medical team decides to insert an experimental ventricular assist device (VAD) to perform the work of the dying heart. How can the critical care nurse best care for a patient with this challenging and unyielding diagnosis? PMID- 2721363 TI - Replication: key to research application. AB - Replication of research is critical to expanding the sample size and demonstrating applicability of research findings for different critical care patients or units. This author describes several options for developing a replication study in critical care. PMID- 2721364 TI - Legal commentary on substance abuse. PMID- 2721365 TI - QA in continuous arteriovenous hemofiltration. AB - As new treatment modalities pervade the clinical setting, quality monitoring tools must be developed to assess compliance with standards. Continuous arteriovenous hemofiltration, an alternative treatment of patients in renal failure, is becoming common in intensive care units. Because of the increased emphasis on specialization and in order to fulfill their responsibility to provide quality care, critical care practitioners can conduct concurrent evaluations for patients receiving this form of therapy. PMID- 2721366 TI - Ketoacidosis and lactic acidosis. PMID- 2721367 TI - Pituitary-specific factor binding to the human prolactin, growth hormone, and placental lactogen genes. AB - The human genes coding for growth hormone (GH), chorionic somatomammotropin (placental lactogen, CS), and prolactin (Prl) are related evolutionarily but are expressed in phenotypically distinct cell types despite their nucleotide sequence homology. We show here that the promoters of the human Prl and CS genes contain cis-acting sequences that confer pituitary-specific expression in a cell-free transcription assay. Similar data are obtained with the human GH gene, consistent with earlier work by others. Footprinting analysis shows that neighboring sequences in each of these three promoters are protected from deoxyribonuclease I digestion by rat pituitary cell extracts. Footprinting competition experiments and gel retardation assays with synthetic oligonucleotides suggest that a single factor is responsible for the pituitary-specific footprints seen on the human Prl, CS, and GH genes. They also suggest that this factor is identical or closely related to the trans-acting factor GHF-1/Pit-1. Similarities with and differences from the rat GH and Prl genes are discussed. PMID- 2721368 TI - Characterization of the gene corresponding to bovine placental prolactin-related cDNA I: evolutionary implications. AB - We have previously characterized a family of transcripts, isolated from bovine placental tissue, that are related to prolactin (PRL) and are distinct from placental lactogen (PL). Here we describe a PRL-related gene that corresponds to one of these placental transcripts, bPRC-I. Restriction endonuclease mapping and sequence analysis of this gene reveal that it is distributed among five exons spanning approximately 9.2 kb. The site of transcription initiation was determined and repetitive sequences were localized in the first two introns. The nucleotide sequence of the coding region is 64% homologous to the bPRL gene and 44% homologous to the bovine growth hormone (bGH) gene. The 5'-flanking region shows no detectable homology to that of bPRL or bGH. Genomic Southern blot analysis indicates that this gene is a member of a family of PRL-related genes. PMID- 2721369 TI - Expression and characterization of recombinant TGF-beta 2 proteins produced in mammalian cells. AB - Recombinant DNA plasmids coding for transforming growth factor beta 2 (TGF-beta 2) precursor and a hybrid TGF-beta 1(NH2)/beta 2(COOH) molecule consisting of the amino-terminal precursor portion of transforming growth factor-beta 1 (TGF-beta 1) linked in phase to the carboxyl terminus of mature TGF-beta 2 were constructed and transfected into COS cells. Both plasmids directed the synthesis of active TGF-beta 2 which was secreted into the supernatants of transfected cells. The TGF beta 2 was secreted in a latent form, as an acidification step was required to demonstrate optimal biological activity. Using site-specific anti-peptide antibodies, we show that precursor and mature forms of TGF-beta 2 are produced. A stable Chinese hamster ovary (CHO) cell line expressing the hybrid TGF-beta 1(NH2)/beta 2(COOH) protein was isolated. This cell line secreted both precursor and mature forms of TGF-beta 1(NH2)/beta 2(COOH); acidification was required to demonstrate biological activity. Protein sequence analysis of recombinant TGF beta 2 produced by this CHO clone demonstrated that correct proteolytic cleavage had occurred, suggesting that the processing signals contained within the TGF beta 1 amino portion can function in producing mature TGF-beta 2. Receptor binding studies showed that TGF-beta 2 specifically bound predominantly to type III receptors on the surface of human palatal mesenchymal cells. The availability of active TGF-beta 2 should aid in determining its potential therapeutic use as a growth modulator. PMID- 2721370 TI - Height at onset of insulin-dependent diabetes mellitus in high- and low-risk countries. Japan and Pittsburgh Childhood Diabetes Research Groups. AB - The relative height at the onset of insulin-dependent diabetes mellitus was recorded in 340 cases from Japan and 191 cases from Pittsburgh, U.S.A. In Pittsburgh, the children diagnosed after puberty were shorter than normal whereas those diagnosed prior to puberty were much taller than normal. However, in Japan, there was no association between age at onset and relative height; at every age the newly diabetic children had similar relative heights to the non-diabetic population. This discrepancy may be related to the 18-fold incidence difference between the two countries. PMID- 2721371 TI - The development of the fetal rat intestine and its reaction to maternal diabetes. I. Morphometrical analysis in normal conditions. AB - In rodents, the fetal intestine develops rapidly during the last 5 days of gestation. The present investigation describes the events which occur in the duodenum, jejunum and ileum of fetal Wistar rat from day 16.5 to 21.5. The first villi and microvilli as well as endocrine cells already appear at 17.5 days in the duodenal mucosae. Goblet cells are detected at 18.5 days. The structure of the intestinal mucosa at 21.5 days is similar to that of adults. The evolution was quantified by morphometric analysis. The external and inner circumference, the length of the villi profile and the increased absorption area due to the villi profile were measured. We demonstrated that the total enlargement of the luminal surface area due to the villi and the microvilli in the duodenum of the fetus at 21.5 days is similar to that in the adult duodenum. This morphometric analysis could be used to detect possible disturbances in the development of the fetal intestine. PMID- 2721372 TI - The development of the fetal rat intestine and its reaction to maternal diabetes. II. Effect of mild and severe maternal diabetes. AB - Diabetes during pregnancy induces specifically structural and functional changes in the fetal endocrine pancreas. Other organs are affected as well. In this study, the fetal intestinal tract which is in close connection with the endocrine pancreas was analysed during diabetic gestation. The disease was induced by two different doses of streptozotocin which led to a mild or severe diabetic state in the mother. In fetuses from mildly diabetic as well as from severely diabetic rats, the time sequence in the appearance of the differentiated cells was identical and similar to that of controls. However, morphometric analysis of the intestine of fetuses from severely diabetic rats revealed a decrease in each of the parameters measured which led to a general hypotrophy of the intestine. In the fetuses from mildly diabetic rats, the values of the morphometric parameters of the duodenal mucosa remained unchanged and comparable to those of the control group. The vascularisation of the duodenum is modified in these fetuses because the volume density of the blood vessels is significantly increased. In conclusion, both diabetic states of the mother induce various alterations in the fetal intestine, including the blood vessels. The nature of the structural changes observed in the intestine could lead to modifications in the function of the entero-pancreatic system in these fetuses. PMID- 2721373 TI - 2-D electrophoresis distribution of stable 14C-glycation products from pig lens crystallins in relation to diabetic cataract formation. AB - We incubated pig lens crystallins with 14C-glucose and eliminated the unstable glycation products with posterior dialysis. All five soluble protein classes separable by Sepharose CL-6B column chromatography were radioactive, but the alpha-H fraction was five times more so than any of the others (14.2 vs. 3.1, 3.2, 1.6, and 2.3 x 10(3) cpm/mg protein, for alpha-H, alpha-L, beta-H, beta-L, and gamma proteins, respectively). However, the autoradiographs of our two dimensional electrophoresis patterns revealed glycosyl adducts in all the soluble protein subunits except for gamma-a, and showed no evidence of preferential glycation of the alpha-H fraction subunits. We conclude that stable glycation products find their way into the alpha-H fraction but that the components of this fraction do not undergo unusually extensive glycation. This is consistent with the theory that senile diabetic cataracts arise from the hyperaggregation of proteins due to glycation. PMID- 2721374 TI - [Synergism of action of growth and differentiation factors]. PMID- 2721375 TI - [Domain structure of myosin subfragment 1]. PMID- 2721376 TI - [Comparative evaluation of the effect of immobilization stress on the dynamics of resistance to induction of lipid peroxidation in internal organs and brain]. PMID- 2721377 TI - Cosmetic allergy to the UV-absorber bornelone. AB - Two cases of contact allergy to the UV-absorber bornelone in cosmetic products are presented. The literature on (photo)contact allergy to sunscreens is reviewed. PMID- 2721378 TI - [Contact allergy to a new preservative]. AB - A 43 year old woman with no previous skin disease developed contact eczema on the face and neck after application of a lotion used for "smoothing wrinkels", available as a non-prescription item. Patch testing of the product and of one of its ingredients, Euxyl K 400, revealed strong positive reactions. Upon testing of the individual components of the preservative Euxyl K 400, the substance 1,2 dibromo-2,4-dicyanobutane showed a positive reaction even in the concentration of 0.004%. Due to the increasing use of Euxyl K 400 inclusion of the preservative in the patch test battery should be considered. PMID- 2721379 TI - Contact allergy to colour developing agents. Analysis of test preparations, bulk chemicals and tank solutions by high-performance liquid chromatography. AB - Colour developing agents which are derivatives of p-phenylenediamine can cause contact allergy. This study was done to perform if the observed simultaneous test reactions between different colour developing agents could be explained by common contaminants, reaction products or impurities. High-performance liquid chromatography (HPLC) was used for the separation of p-phenylenediamine, 1,4 benzoquinone, hydroquinone, Metol and the colour developing agents CD-2, CD-3 and CD-4. The stability in water solutions and in petrolatum mixtures was examined for the last three substances. Samples of test preparations drawn at different stages of guinea pig maximization tests (GPMT) with colour developing agents were analysed, as well as patch test preparations for clinical use and tank solutions from developer machines. No contaminants or reaction products in common were shown in the bulk chemicals, tank solutions or test preparations of CD-2, CD-3 and CD-4. These findings and the GPMT studies imply that the simultaneous test reactions reflect cross-sensitization. The colour developing agents were stable in petrolatum mixtures, but unstable in water solutions. Therefore, fresh solutions for intradermal induction and petrolatum mixtures for topical induction and challenge were used in the final GPMT's. PMID- 2721380 TI - [Evaluating skin tolerance. Study of skin cleansing agents in modifications of the Duhring chamber test]. AB - Towards Elucidation of the Problems of Skin-compatibility Testing/An investigation of hand-cleansing products using a modified Duhring chamber test The irritant potential of commercially available liquid syndets was investigated in a repetitive Duhring chamber test using a modified test procedure. Instead of regularly testing over a period of five days, the test was conducted only as long as it took for the first signs of irritation to appear. Among those products tested, substantial differences were found with respect to irritation and possible application time, and, as a result, to skin compatibility. Some of them produced skin irritation with the same intensity and just as quickly as the control substance, sodium lauryl sulfate (0.5%). These differences are not observed in a simple 24-hour epicutaneous test. For this reason, the latter, as opposed to the repetitive Duhring chamber test, appears to be unsuitable for comparative skin compatibility studies of syndets. The skin compatibility of special hand cleaners containing solvents was also investigated in a modified Duhring chamber test. In addition to the modification introduced above for the liquid syndets, here the maximum cumulative application time was reduced from 48 to 30 h. In this manner different degrees of skin compatibility to various special hand cleaners can be ascertained and taken into account when developing new products. PMID- 2721381 TI - ["The standard epicutaneous test"]. PMID- 2721382 TI - [Initial symptoms of malignant thyroid tumors: the effect of age and sex in an iodine-deficient region. Experiences with 1116 patients]. AB - Initial symptoms of thyroid cancer were collected and analysed for 1116 patients with thyroid cancer in an iodine-deficient region, retrospectively for the period 1960-80 (604 patients), prospectively for 1981-87 (512). Using the WHO classification, 56.1% of patients had papillary, 32.7% follicular, 4.8% C-cell, 3.7% anaplastic and 2.7% various other malignant tumours. In 40% of all patients the initial sign had been a solitary intrathyroid nodule. Cervical lymph node swelling as initial sign had been significantly more frequent in men (21.1%) than in women (10.3%; P less than 0.003). In patients aged under 40 years the cervical lymph node signs were three times as common as among those over 50 years. Distant metastases as initial sign of papillary carcinoma were seen only in those over 60 years. Tumour stages T3 and T4 were seen significantly more frequently in over 60 year-old (42.2%) than under 40-year-old (25.1%; P less than 0.001), independent of histological type. Composition and initial signs of this patient cohort in an iodine-deficient region differed only slightly from those in an iodine-rich region. PMID- 2721383 TI - [Acute multifocal placoid pigment epitheliopathy with inflammatory CSF findings. A special form of borreliosis?]. AB - A 24-year-old woman with acute multifocal placoid pigment epitheliopathy in both eyes had no signs or symptoms other than the impaired vision. Visual evoked potentials demonstrated prolonged latency. Lumbar CSF showed inflammatory changes. Serum antibody titres against Borrelia burgdorferi were markedly elevated. Cortisone treatment was without success, but intravenous penicillin quickly brought about improvement in vision. Borrelia infection may thus have been the cause of the multifocal placoid pigment epitheliopathy. PMID- 2721384 TI - [The handing over of hospital documents on deceased patients to relatives]. PMID- 2721385 TI - [Side effects of a cartilage extract]. PMID- 2721386 TI - [Protracted blood sugar increase in type 1 diabetics after brief but exhausting muscular exercise]. AB - In eight type I diabetics-three of them under intensified insulin therapy and five on continuous subcutaneous insulin infusion (CSII)-blood-glucose concentrations fell significantly during 20-minute isometric and dynamic muscle work at about 50% of individual maximal work capacity and subsequent intensive exercise of five minutes until exhaustion. However, 6 1/2 hours later blood glucose levels (221 +/- 39 mg/dl after isometric exercise and 219 +/- 24 mg/dl after dynamic exercise) were clearly above the mean level measured at the same time of day on the three preceding days of 138 +/- 12 mg/dl (P less than 0.05). No hypoglycaemia occurred. This blood-sugar profile can be explained by a significant rise in cortisol and growth hormone and their long-lasting blood sugar raising effect. PMID- 2721387 TI - [Lambliasis: a cause of malabsorption and diarrhea?]. AB - Multiple biopsies from the lower duodenum were obtained during endoscopy of 171 patients with dyspepsia, diarrhoea and/or suspected malabsorption. Histological evidence of lambliasis was obtained in six (3.5%). Antibiotic treatment with metronidazole, 250 mg two or three times daily for seven to 11 days (which had to be repeated in two cases), improved symptoms in four. In most of the patients "functional upper-abdominal symptoms" had been diagnosed after extensive examinations. In case of unclear upper-abdominal symptoms, chronic or chronic recurrent diarrhoea and/or malabsorption lambliasis should be considered and histological examination of the duodenal mucosa undertaken. PMID- 2721388 TI - [Acute water intoxication]. PMID- 2721389 TI - [Patient behavior and length of the prehospital phase in myocardial infarction]. AB - 120 of 272 consecutive patients (44%) with confirmed myocardial infarction reached hospital within three hours of onset of symptoms. Important delays were caused by the patients "treating" themselves with drugs (delay of 6.8 +/- 14.9 h) and/or other measures (11.1 +/- 15.7 h), and in 50 of 144 (35%) patients, who consulted a doctor, time-consuming diagnostic tests and therapeutic measures (10.9 +/- 12.6 h). On the other hand, severity of pain shortened the prehospitalization phase significantly (P less than 0.025). Age, time of day, infarct site or whether first-time or recurrent infarct had no influence on the time elapsed until admission to the intensive care unit. Thus advice to patients and instruction to doctors may be the most effective means of shortening the prehospital phase in patients with myocardial infarction. PMID- 2721390 TI - [Diagnosis and therapy of asymptomatic adrenal tumors]. AB - Adrenal tumours had been discovered incidentally (since 1981) in 32 patients (23 females and nine males; mean age 54 [25-73] years) who had had computed tomography (CT) or ultrasonography for other reasons: none had a history or symptoms of such tumour. Tumours were bilateral in eight, right or left-sided in 12 each: all had been confirmed by CT. Average tumour size was 3 cm (1-9 cm). Three patients had cortisol-producing adrenal tumours, and there was one benign phaeochromocytoma (abnormally high adrenaline and noradrenaline excretion). Fine needle biopsies in two patients revealed a benign histology. An adrenalectomy was performed in eight patients (the one phaeochromocytoma, six adenomas and one ganglioneuroma). Follow-up CT in 11 of the non-operated patients 6-48 months later (mean of 14 months) did not demonstrate any increase in tumour size so that a waiting attitude seems justified: benign tumours are clearly much more frequent than malignant ones. However, if the tumour diameter is greater than 6 cm, an adrenalectomy is indicated because of the danger of malignancy. PMID- 2721391 TI - [Adenomatosis of the bile ducts as a rare cause of cholestasis]. AB - Biliary obstruction of uncertain aetiology in a 69-year-old women led to a cholecystectomy and exploration of the bile tract: a nearly complete cast of the hepatic ducts and intrahepatic bile ducts was extracted. Histological examination of the gall bladder and liver biopsy failed to provide a diagnosis, but a bile duct biopsy taken at the time of an endoscopic retrograde cholangiography revealed the diagnosis of papillomatosis. This disease has a poor prognosis because there is no known cure. PMID- 2721392 TI - [Nimodipine for subarachnoid hemorrhage]. PMID- 2721393 TI - [Cardiac rhythm disorders following the intravenous injection of toluidine blue]. PMID- 2721394 TI - [Polyneuropathy in Churg-Strauss syndrome]. AB - An acute polyneuropathy with fever and blood eosinophilia (69%) developed in a 72 year-old woman with chronic bronchial asthma and weight loss for a few months. A muscle biopsy revealed necrotizing vasculitis with numerous eosinophilic granulocytes and neurogenic atrophy. The vasculitic changes were only minor in the sural nerve and limited to the epineurium. Signs of acute nerve-fibre disintegration were marked, while some fascicles were only affected in some sectors. The clinical and histological diagnosis suggested Churg-Strauss syndrome. The polyneuropathy, eosinophilia and abnormal erythrocyte sedimentation rate quickly disappeared on administration of initially 80 mg prednisolone and 100 mg azathioprine. PMID- 2721395 TI - [Central venous catheters]. PMID- 2721397 TI - [The HIV infection risk at emergency outpatient departments]. PMID- 2721396 TI - [Molecular genetics and diagnostic certainty--the example of cystic fibrosis]. PMID- 2721398 TI - [Arctic regions and their populations]. PMID- 2721399 TI - [Herniography]. PMID- 2721400 TI - [Cytophagic histiocytic panniculitis]. PMID- 2721402 TI - [The riddle of asthma]. PMID- 2721401 TI - [Gynecologic examination of young women]. PMID- 2721403 TI - [Disturbances in cerebral circulation]. PMID- 2721404 TI - [East Bothnian treatment modalities of spinal manipulation and limb correction]. PMID- 2721405 TI - [Retinoid treatment of pediatric skin diseases]. PMID- 2721406 TI - [Unusual manifestations of tuberculosis]. PMID- 2721407 TI - Eagle's syndrome: an atypical cause of dysphonia. AB - We report an unusual case of dysphonia secondary to Eagle's syndrome. Despite documentation of the stylohyoid syndrome in the literature, the appropriate diagnosis in this case eluded several clinicians. Once the diagnosis was made, surgical therapy rendered the patient completely free of her symptoms. Although the patient's pain was somewhat atypical for the stylohyoid syndrome, we believe that this case underscores the importance of the head and neck surgeon's need for familiarity with the various causes of head and neck pain. PMID- 2721408 TI - Neurilemmoma of the vagus nerve in the neck. AB - Two cases of vagal neurilemmoma are presented and are added to the 64 such cases previously reported. Current management is discussed, with emphasis on diagnostic procedures, which include preoperative CT scanning and exploration of the neck, with careful definition of the tumor under general anesthesia. The operative techniques used are discussed. Attention is also drawn to severe transient bradycardia that may occur during removal of these tumors. PMID- 2721409 TI - Facial presentation of disseminated superficial actinic porokeratosis. AB - A case of disseminated superficial actinic porokeratosis (DSAP), an autosomal dominant genodermatosis possessing a pathognomonic cornoid lamella, is presented. Exclusively facial disseminated superficial actinic porokeratosis is an unusual clinical presentation, although 15% of patients having the condition in the typical generalized form have facial lesions. There is no specific treatment. In selected cases, lesions may be excised, electrodesiccated, or sprayed with liquid nitrogen. Topical steroids and topical 5-fluorouracil have been reported to be beneficial in some instances. Sunscreens should be tried as a preventive measure, especially in family members of patients with known DSAP. PMID- 2721410 TI - Chondrosarcoma of the larynx. AB - Two cases of laryngeal chondrosarcoma are described. The first exhibited a fibrosarcomatous differentiation, which is a rare finding in chondrosarcoma and usually indicates poor prognosis. The second was found in a larynx six years after Teflon injections for the treatment of vocal cord paralysis. The possibility of Teflon as a tumorigenic factor in this case is raised. PMID- 2721411 TI - Osteoma of the tongue. AB - Osteomas are benign bony neoplasms commonly found in long bones and in the skull and facial bones. Osseous growths within soft tissue structures of the head and neck are rare. Review of the English literature reveals only 31 cases of osteomas within the soft tissues of the tongue and 2 in the buccal mucosa. We report on a patient with a bony hard asymptomatic mass at the base of the tongue, which was found to be an osteoma by biopsy. Complete removal was declined by the patient. There was no progression during a six-month period of follow-up. PMID- 2721412 TI - AIDS and the otolaryngologist. PMID- 2721413 TI - Nerve sheath tumors of the head and neck. PMID- 2721414 TI - Surgical treatment of submandibular salivary gland enlargement. AB - The anatomy of the submandibular salivary gland and common conditions that cause gland enlargement are described. We also describe a simple technique for removal of a calculus from Wharton's duct and a method for submandibular gland excision. PMID- 2721415 TI - Surgical approach to the parotid gland. AB - The key to surgical treatment of the parotid gland is adequate exposure and careful identification and protection of the facial nerve. The superficial and deep lobes of the gland can be removed from external approaches with little or no damage to the facial nerve if a careful and thoughtful surgical technique is employed. PMID- 2721416 TI - Salivary disease in childhood. AB - Salivary disease in childhood is uncommon. Clinical features are much the same as in adult disease, however, congenital, inflammation, and functional disease is more common. Management is governed by the same general principles in all age groups. Congenital abnormalities are rare. Inflammation, either bacterial or viral, is the most common disease. Chronic sialadenitis usually resolves at puberty. Neoplasia is rare, and the majority of tumors are benign and occur in the parotid gland. Malignancy is suggested by rapid growth, pain, skin fixation, and lymphadenopathy. Surgical treatment of sialorrhea should only be considered after careful assessment. Relocation of the submandibular ducts is the treatment of choice. PMID- 2721417 TI - An approach to the diagnosis and management of salivary gland disease. PMID- 2721418 TI - Carnitine concentration during the development of human tissues. AB - The different carnitine storage patterns in developing human tissues (skeletal muscle, liver and brain) were demonstrated. The carnitine concentration was high in the skeletal muscle and liver relative to other tissues during preterm gestation, and the skeletal muscle carnitine concentration increased with growth. On the other hand, the brain carnitine concentration was low. The brain contained a larger proportion of acylcarnitine than of free carnitine from midgestation, while the skeletal muscle and liver contained larger concentrations of free carnitine than of acylcarnitine. These different carnitine concentrations and composition patterns in the skeletal muscle, liver and brain may be related to maturation of the potential carnitine reserve and to metabolic functions, such as fatty acid utilization and the reservoir of acetyl units, in each developmental tissue. PMID- 2721419 TI - Renal conservation of carnitine by infants and adults: no evidence of developmental regulation. AB - To determine the efficiency of renal conservation of carnitine in infants, urinary carnitine excretion was measured at intervals in 10 infants while plasma carnitine concentration was manipulated by supplementing carnitine-free formula with 0 microM, 140 microM and 280 microM L-carnitine. As carnitine supplementation increased from 0 microM to 280 microM, fractional excretion of free carnitine increased tenfold from 0.6% to 6.0%; fractional excretion of acylcarnitine esters increased to a lesser degree (10.5-15.6%). At all supplementation levels fractional excretion of acylcarnitine esters was significantly greater than fractional excretion of free carnitine. We conclude that free and esterified carnitine are handled differently in the infant kidney. Results in infants were compared to previously reported data for adults. Mean fractional excretions of total, free and esterified carnitine by infants (7.2%, 5.4% and 12.7%, respectively) were similar to those by adults (6.5%, 5.0% and 15.0%). Thus, renal losses of carnitine apparently do not account for the low plasma carnitine concentrations observed in infants fed carnitine-free formulas. PMID- 2721420 TI - Laterality of arm movement in full-term newborn. AB - We have investigated 20 healthy full-term newborns between the 4th and the 6th day of life in standard conditions for laterality of arm movements, before and after introduction of a target. The durations of recording were: (a) 5 min continuously before target introduction; (b) five 1-min units during target presentation. The movements studied were extension, flexion, movement with semiflexed arm with hand half-open or open toward the midline of the body, and total movements. Each of these items were counted separately and the counts were compared within and between sides. Spontaneous movements showed no side preference whereas in the presence of the target, movements toward the midline (target directed movements) showed a significant right-hand preference. PMID- 2721421 TI - Human milk fat content: within-feed variation. AB - Changes in milk fat content during individual breast-feeds were studied using a modification of the interrupted feed technique (Woolridge et al. (1982): Early Human Dev., 6, 265-272). Each feed was interrupted once, for weighing the baby and obtaining a small milk sample; weighing and milk sampling were also done at the start and end of the feed from that breast. Mathematical analysis of 52 feeds from the first breast offered at a feeding episode, and 39 second-breast feeds, showed a similar pattern on both types. The fat content rose in line with (Vi/Ve)1.35 (V being the volume consumed since the feed from that breast began). However, first-breast feeds showed sharp initial and final rises in fat content. The authors propose a mechanism to explain the difference in pattern between first- and second-breast feeds. PMID- 2721422 TI - The effect of (induced) maternal emotions on fetal behaviour: a controlled study. AB - In ten healthy near-term pregnant women the effect of induced maternal emotions on fetal motor behaviour was studied. Emotions were induced by showing a film of a normal delivery. Fetal behaviour was recorded by means of real-time ultrasound observations of general movements and eye movements and by fetal heart rate monitoring. The observations had a duration of 2 h. The data were compared with those obtained during a 2-h control period, which took place the day before (n = 5) or after the study period (n = 5). Maternal emotions (induced) were measured by means of psychological tests. No effects on fetal motor activity or on behavioural state organization could be found as a result of this film. There was, however, a significant positive correlation (P less than 0.01) between the mean level of anxiety of the women and the motor activity of the fetuses. PMID- 2721423 TI - [Prospective analysis of nursing education]. PMID- 2721424 TI - [Uruguay: methods for a simulation model of future medical supply]. PMID- 2721425 TI - [Brazil: the problem of human resources in the health district]. PMID- 2721426 TI - Silent period in spinal cord pathology. AB - The silent period evoked by the electrical stimulus of the abductor pollicis brevis and the triceps surae muscles was studied in both normal subjects and in patients affected by spinal compression, by multiple sclerosis and by familial degenerative myelopathy. In normal subjects, the duration of the silent period is shorter in the upper limbs than in the lower limbs. In patients with spinal compression and multiple sclerosis, the duration of the silent period in the lower limb is significantly greater. On the contrary, the duration in familial degenerative myelopathy is significantly longer, recording from the abductor pollicis brevis. The authors conclude that this technique is useful in the diagnosis of spinal lesions from compression and demyelination. PMID- 2721427 TI - A retrospective electrodiagnostic evaluation of footdrop in 303 patients. AB - In this retrospective study the authors have analysed the results of electrophysiologic examinations in patients with paresis or paralysis of the foot dorsiflexors. Two groups have been distinguished. A first group consists of 217 patients, investigated between April 1st 1986 and September 30th 1987. Several etiologic categories have been recognized and the relative frequency of each of them in the group as a whole has been described. Footdrop has been found to be either of central neurogenic origin (31%) or of peripheral neurogenic origin (68%). The latter group has been further subdivided, the most important subgroups being common peroneal nerve lesions (30.6%), L5-radiculopathies (19.7%) and polyneuropathies (18.3%). In a second group, the authors have studied the results of 34 electrophysiologic examinations for footdrop due to a sciatic nerve lesion and of 109 examinations for footdrop due to common peroneal nerve palsy. The period covered was from January 1st 1980 to September 30th 1987 The authors have been able to draw a parallel between these two categories of footdrop patients; 76.5% of the sciatic nerve lesions and 67.0% of the common peroneal nerve lesions are traumatic in origin; in both groups there is a striking preponderance of young male patients, which is even more pronounced when only the traumatic lesions are considered. In the majority of cases with sciatic nerve damage the peroneal portion is involved. In the common peroneal nerve lesions, the deep structures are more frequently injured than the superficial aspect.2= PMID- 2721428 TI - Sympathetic skin response in diabetic neuropathy. AB - Sympathetic function test was undertaken using the sympathetic skin response (SSR), a technique for assessment of sudomotor activity, in 67 diabetics, and the results were compared with those from 45 age-matched normal subjects. The SSR was readily elicitable in normal subjects, but absent in six patients with diabetes. In 28 patients, the SSR was preserved, but their amplitude was below the normal range. The decrease in the SSR amplitude correlated well with a fall in motor and sensory conduction velocity. The SSR magnitude correlated well to the impaired R R interval variation during deep breathing and the heart rate increase and the blood pressure change on standing, indicating a close correlation between the disturbance of sudomotor function and that of other sympathetic and parasympathetic functions. Most of the patients with clinical evidence of dysautonomia and with insulin treatment revealed diminished or absent SSR. PMID- 2721429 TI - Electromyography of stair locomotion in elderly men and women. AB - The electromyographic activity of five lower limb muscles during stair locomotion was examined in ten men and women aged 76-83 years. Phasic activity patterns were compared with those in previous studies of young adults to determine differences indicative of an enhanced need to provide joint stability. The temporal patterning of the stair gait cycle showed no evidence of an increase in weight bearing time to aid balance control. There was a high level of consistency between phasic activity patterns in the present and previous studies in all muscles with the exception of biceps femoris. Factors contributing to its increased level of activity in our elderly subjects are discussed. There was evidence of modifications to muscular activity to provide additional joint stability at both the knee and ankle. This was most apparent in stair descent during the transition to, and the early weight acceptance period. PMID- 2721430 TI - Neurophysiological characteristics of spinal arteriovenous malformations. AB - The aim of the study was to identify the clinical and neurophysiological pattern of deficits in spinal arteriovenous malformations (AVM) to allow an early diagnosis which is the prerequisite for effective treatment by early surgery or embolization. Among 26 patients with myelographic signs of a spinal AVM, selective spinal angiography disclosed 20 cases with a dural AV-fistula (dAVF) and 6 patients with an intradural AV-malformation (iAVM). Although the main pathogenetic factor in both disorders may be different, clinical and neurophysiological findings proved to be of limited value in differential diagnosis. Clinical symptoms presented by the patients were a variable combination of lower motor neuron lesion, sphincter disturbance, sensory transverse lesion and partly additional signs of upper motor neuron involvement. Electromyography invariably showed an increased rate of polyphasia and frequently pathological spontaneous activity usually in several myotomes. Normal sensory conduction velocity of the sural nerve contrasted with almost regularly pathological SEP's after tibial nerve stimulation. The distribution if clinical and neurophysiological findings suggests rather widespread lesions of the lower cord and/or cauda equina, frequently at a lower level than the angiographically localized shunt. This suggests a vascular myelopathy on the basis of insufficient venous drainage at least for the frequent dural AV-anomaly. PMID- 2721431 TI - Comparison among various movement tasks of cerebral motor potential preceding voluntary movement. AB - We examined the relationship between the movement potential (MP) and various movement tasks. We found that the MP amplitudes were the highest for the hand grip movement among various movement tasks. Furthermore, the present results indicated that a significant correlation was found between the MP latencies and prereaction time. The present experiments showed that there were changes in the latency and amplitude of the MP in rapid movements from a slightly sustained contraction and in fast reaction movements. Therefore, we noted that the MP amplitudes and latencies change corresponding to the type of movement tasks. Accordingly, it may be concluded that there is a close relationship between the MP and central motor output, namely physical factors (force and speed). PMID- 2721432 TI - Relationship between the location of the ground electrode and size of electrical stimulus artifacts. AB - In simulated electrophysiologic recordings, electrical stimuli were applied to the upper limbs of ten subjects. Then, stimulus artifacts were recorded using different ground locations, while all other technical parameters were kept constant. Stimulus artifacts were relatively large (often reaching a maximum amplitude) when stimulating electrodes were between ground and recording electrodes. Artifacts were relatively small (commonly arriving at a minimum and never at a maximum value) when recording electrodes were between ground and stimulus sites. When the ground was situated between stimulating and recording electrodes, the stimulus artifacts had about an even chance (40-50%) of achieving either a maximum or a minimum amplitude value. These findings do not seem to support the traditional belief that the best ground location to reduce the size of the stimulus artifacts is between points of stimulation and recording. PMID- 2721433 TI - [Schizophrenia and family-expressed emotions. Study of an Italian population]. AB - Expressed Emotion (EE) is a method of assessing the emotional make-up of a family, widely used in English-speaking countries, with particular reference to schizophrenia. This research programme arose out of a trial application of EE to a group of Italian families. Data are given here relative to a sample of 19 families with a schizophrenic member (according to DSM III criteria). The results confirm the hypothesised correlation between family EE and recidivist symptomatology of schizophrenic subjects: "high family EE" is associated with the most serious and habitual schizophrenic cases. The necessary adaptations which had to be made in order to apply EE assessment methods to Italian families are also discussed. PMID- 2721434 TI - [Mood and insulin-dependent diabetes. Value of the Von Zerssen test]. AB - At the end of a week of education, 120 diabetics (I.D.D.M.) checked the list of items from the Von Zerssen's test. This self evaluation test classifies the mood in to depression (13%), anxiety (27%), normal (39%) and euphoria (21%). The ages of the patients and the duration of their diabetes were irrelevant to the results. But, according the type of diabetes, the results become: discovery of I.D.D.M.: depression (4%), anxiety (35%), normal (35%), euphoria (26%); I.D.D.M. (former N.I.D.D.M.): depression (16%), anxiety (28%), normal (31%), euphoria (25%); I.D.D.M. ancient: depression (15%), anxiety (23%), normal (45%), euphoria (17%). PMID- 2721435 TI - [Lithium and sensory analysis]. AB - Despite our extensive knowledge regarding the biochemical and physiological actions of lithium, we have so far been unsuccessful in linking this information to the clinical actions of lithium in a unified model. It may be that a psychological/behavioural approach may allow us to achieve this objective. The present paper presents an outline of some studies on the behavioural actions of lithium in rats and mice and suggests how the data from such work can lead to a model of lithium action and of manic-depressive disorder couched in terms of information-processing mechanisms. Recent work in manic-depressive patients, using a signal detection task, is also described: the results are broadly confirmatory of the information-processing model of lithium effects. PMID- 2721436 TI - [Action of PMA (phorbol myristate acetate), scopolamine, propranolol, and oxotremorine on memorization of an active or passive avoidance test]. AB - The role of various second messengers in the learning and retention of a passive or active avoidance has been investigated in mice. Scopolamine at 3 mg/kg i.p. inhibits muscarinic M1 and M2 receptors and thus acetylcholine activation of the phosphoinositide cycle. This results in amnesia of passive avoidance but has no effect on active avoidance learning. Oxotremorine at 0.05 mg/kg i.p., whose preferential M2 muscarinic action limits acetylcholine release and also inhibits adenylate cyclase activity, causes amnesia of the retention of a passive avoidance and antagonizes the learning of an active avoidance. DL-propranolol at 40 mg/kg i.p., which inhibits cAMP formation, does not affect retention of a passive avoidance but antagonizes that of an active avoidance. Similarly, phorbol myristate acetate a 0.1 mg/kg i.p., which activates protein kinase C, has no effect on the retention of a passive avoidance but antagonizes that of an active avoidance. The results tend to show a distinct role for cAMP-dependent protein kinase, which would participate in memorization processes of an active avoidance, and for protein kinase C, which would participate in that of a passive avoidance. The authors discuss the involvement of different neurophysiological mechanisms as a function of the type of behavior, depending on whether or not it is related to the control of environmental situations. PMID- 2721437 TI - [Mechanism of action of clonidine in the forced-swimming test in mice]. AB - Clonidine displays immobility-reducing effects in the mouse swimming model at doses (0.06-16 mg/kg IP) which decrease spontaneous motility. Tricyclic antidepressants evoke a similar dissociation in motor activity. The immobility reducing effect of clonidine (1 mg/kg at 30 min pretesting) was reversed by yohimbine (4 mg/kg) but was unaffected by prazosin (2 mg/kg) or alpha-methyl paratyrosine (100 mg/kg), and was enhanced by reserpine (2.5 mg/kg). Mediation by alpha-2 postjunctional receptors was thus suggested. However, two 5-HT receptor blockers--methysergide (2 mg/kg) and ketanserin (8 mg/kg)--increased this effect of clonidine whereas the non selective agonist 5-MeODMT (1 mg/kg) reduced clonidine action. Conversely, pretreatment with a subthreshold dose of clonidine (0.06 mg/kg at 45 min pretesting) made effective subthreshold doses of three 5-HT uptake inhibitors (citalopram 2 mg/kg, indalpine and fluvoxamine 4 mg/kg) and of the 5-HT1 receptor agonist 8-OH-DPAT (0.5 mg/kg). According to these data, the mouse swimming model would trigger functional relationships between central alpha noradrenergic and serotonergic mechanisms. PMID- 2721438 TI - [Calcium channel modulators as antidotes in fatal imipramine poisoning]. AB - Calcium entry modulators were tested as antidotes to imipramine lethal toxicity. 42 rats were administered intraperitoneally 85 mg/kg of imipramine. In 6 control rats, hypotension and bradycardia were observed. Survival time was 15' +/- 5'. Survival time of rats treated with intraarterial nitrendipine was 21' +/- 11'. Survival time of 5 out of 6 rats treated by intraarterial verapamil or diltiazem was respectively 19'00" +/- 14'30" and 40'30" +/- 32'00". 5 out of 6 rats treated by intraarterial nimodipine, as well as all of the rats treated by flunarizine or nicardipine survived and were alive and active 48 hours later. Intoxication with imipramine may induce life threatening complications for which there are no specific medication. Nicardipine might be considered in the treatment of acute poisoning by imipramine and related tricyclic compounds. PMID- 2721439 TI - Bimodal nuclear estrogen receptor binding: synchrony in athymic mouse uterus and human breast tumor xenografts. AB - Human MCF-7 tumors were transplanted into ovariectomized female athymic nude mice supplemented with estradiol pellets. Ten days after hormone pellet removal, the animals were treated with 10 micrograms/kg estradiol, and the nuclear estrogen receptor (ERn) profile was assessed by the exchange assay. The pattern in the tumors was qualitatively similar to that in the uterus. A bimodal pattern of ERn was seen, with peaks at 1 and 8 h. Further biochemical analysis of uterine samples showed that both peaks were comprised of similar levels of salt-resistant ERn forms. Scatchard plot analysis of estradiol binding demonstrated high affinity receptors (Kd = 0.73-0.86 nM) as components of both peaks. In the ovariectomized adult rat there was also a bimodal pattern of ERn 1 and 13-14 h after the injection of 20 micrograms/kg estradiol. Direct hormone stimulation of the uterus was achieved with intraluminal (IL) injection of estradiol. IL injections of estradiol (100-800 pg/horn) stimulated uterine DNA synthesis compared to IL saline injections in the contralateral horn. IL injection of 200 pg/horn estradiol resulted in a bimodal pattern of ERn at 3 and 9 h. These data indicate that a bimodal pattern of ERn is present in estrogen target tissues exhibiting a growth response. PMID- 2721440 TI - Peptidylarginine deiminase in rat pituitary: sex difference, estrous cycle related changes, and estrogen dependence. AB - We have found notable sex difference in peptidylarginine deiminase (EC 3.5.3.15) in rat pituitaries. Pituitaries collected from 3-week to 6-month-old male rats, and those from 3-week-old females showed negligible enzyme activities. The enzyme activity of female pituitaries increased markedly by 2 months, and even further by 6 months of age. Measurements of the enzyme activity around the estrous cycle revealed its characteristic change, being high in the proestrus and estrus, and low in the metestrus and diestrus. These changes of the enzyme activity were shown to reflect changes of the actual amount of a single type of peptidylarginine deiminase by immunoprecipitation and immunoblotting analyses using an antiserum raised to an enzyme sample purified from rat skeletal muscle. The amount of pituitary enzyme was impoverished by ovariectomy. Repeated injections of 17 beta-estradiol to ovariectomized rats substantially restored the pituitary enzyme level. The above data suggest involvement of peptidylarginine deiminase in the female pituitary function. PMID- 2721441 TI - Insulin-like growth factor I gene expression in the rat ovary is confined to the granulosa cells of developing follicles. AB - The in vivo intraovarian synthesis of insulin-like growth factor-I (IGF-I) has been studied in the rat by Northern blot, dot blot hybridization, and in situ hybridization histochemistry. Ovarian IGF-I mRNA transcript sizes (7.0 kilobases (kb), 1.6 kb, and a group from 0.4-0.9 kb) were similar to those in liver and other tissues. The proportion of ovarian IGF-I to tubulin messenger RNA (mRNA) was increased to 176% of control values by treatment with diethylstilbestrol, while the ratio in liver was decreased to 64.4%. In situ hybridization identifies the major in vivo site of IGF-I synthesis in the ovary as the granulosa cells of developing follicles. IGF-I mRNA was present in the granulosa cells of developing preantral and antral follicles, but was not seen in atretic follicles or corpora lutea. In preovulatory follicles high levels of IGF-I mRNA were confined to the antral cell layers and to the cells of the cumulus oophorus. High levels of tubulin gene expression within follicles were seen in a similar distribution to that for IGF-I but 80-90% of corpora lutea also strongly expressed the tubulin gene. Interstitial cells, including thecal cells, express the tubulin gene at low levels but do not express the IGF-I gene. The distribution of IGF-I mRNA is the same as that previously observed for mitotically active granulosa cells, and therefore offers strong support for the view that IGF-I in the ovary acts by an autocrine-paracrine mechanism to promote granulosa cell replication. PMID- 2721442 TI - Distribution and regulation of 5 alpha-androstane-3 beta,17 beta-diol hydroxylase in the rat central nervous system. AB - 5 alpha-Androstane-3 beta,17 beta-diol hydroxylase (3 beta-diol OHase), a form of cytochrome P-450 whose main function is thought to be the elimination of dihydrotestosterone (DHT) from its target tissues, was found in the central nervous system (CNS) of both male and female rats at a level which is at least 300-fold higher than any other P-450 catalyzed steroid hydroxylase in the brain. In order to gain some insight into the physiological function of this enzyme we have studied its distribution throughout the CNS as well as the effects of age and hormonal manipulations of rats. We have also partially purified the enzyme from the brain and compared it with the 3 beta-diol OHase in the prostate. 3 beta Diol OHase activity was distributed throughout the CNS of adult male and female rats with levels between 70-153 nmol products formed/g tissue.h. The products were identified as 5 alpha-androstane-3 beta,7 beta,17 beta-triol,5 alpha androstane-3 beta,6 alpha,17 beta-triol and 5 alpha-androstane-3 beta,7 alpha,17 beta-triol. The ratio of these three triols was 1:9:3. Catalytic activity was not affected by castration or adrenalectomy of male rats, or during late pregnancy or lactation in females. In the brains of 14-day-old fetuses and 2-day-old rats, the level of 3 beta-diol OHase was 30% of that of adults and it increased to adult levels by day 28. Cytochrome P-450 was partially purified from microsomes of whole brain, hypothalamus, and prostate and 3 beta-diol OHase activity reconstituted. On the basis of the ratios of the three triols formed from 3 beta diol, it can be concluded that the 3 beta-diol OHase in the brain is similar to that in the prostate. From a comparison of the turnover numbers in reconstituted systems with P-450 prepared from the prostate, brain, and hypothalamus, it can be estimated that up to 50% of the P-450 in the hypothalamus and 10% in whole brain is 3 beta-diol OHase. Supportive evidence for this relative distribution of 3 beta-diol OHase in the hypothalamus was obtained by comparing the sodium dodecyl sulfate electrophoretic profiles of P-450 obtained from the hypothalamus and prostate microsomes. PMID- 2721443 TI - Multiple forms of peptidyl alpha-amidating enzyme: purification from rat medullary thyroid carcinoma CA-77 cell-conditioned medium. AB - Conditioned medium from cultures of rat medullary thyroid carcinoma CA-77 cells was used as a source for purification of the secreted forms of peptidyl alpha amidating enzyme. The alpha-amidating enzyme activity was partially purified using a combination of weak anion exchange and gel filtration chromatography. Subsequent strong anion exchange chromatography at pH 6.0 resolved this partially pure enzyme into four distinct peaks of activity, termed Ia, Ib, II, and III. Peaks Ia and Ib exhibited broad pH optima between pH 6.0-8.5, whereas peaks II and III both exhibited pH optima at approximately pH 5.0. The peak III activity was further purified to electrophoretic homogeneity using hydrophobic interactive chromatography followed by strong anion exchange chromatography at pH 8.0. The enzyme exhibited an apparent molecular mass of 75K, a pH optimum of approximately pH 5.0, and a maximal turnover number of 580 min-1 in the presence of L ascorbate. Kinetic studies demonstrated that the enzyme probably functions through a ping-pong mechanism with respect to the binding of the glycine-extended peptide substrate and the L-ascorbate cofactor. The peak III enzyme exhibits several distinctive characteristics compared to amidating enzymes isolated and characterized by other laboratories. PMID- 2721444 TI - Insulin-like growth factor I messenger ribonucleic acids with alternative 5' untranslated regions are differentially expressed during development of the rat. AB - Solution hybridization/RNase protection assays were used to study the developmental expression of insulin-like growth factor I (IGF-I) mRNA levels in rats. In liver, heart, and kidney, total IGF-I mRNA levels were low at birth and increased during the 50-day postnatal period, with liver levels increasing by over 100-fold. In contrast, stomach, muscle, and testicular IGF-I mRNA levels were highest at the earliest stages examined (late fetal or early neonatal) and declined thereafter to the levels observed in 50-day-old rats. In brain, IGF-I mRNA levels rose 2-fold during the first week of life and declined over the next 6-7 weeks. Lung IGF-I mRNA levels were highest in 20-day-old fetuses and exhibited some fluctuation during the postnatal period. Alternative splicing in the 5'-untranslated region of the primary rat IGF-I transcript gives rise to three transcripts, classes A, B, and C, which have divergent 5'-untranslated region sequences associated with a common region that encodes the mature IGF-I peptide. These sequences contain upstream in-frame translation initiation codons and may, therefore, encode alternate IGF-I prepropeptides. The class C variant was the predominant mRNA species at all stages of development studied and was the only IGF-I transcript in brain, heart, and muscle. In tissues where multiple 5' untranslated region splicing variants occurred, therefore, changes in total IGF-I mRNA primarily reflected changes in this splicing variant. However, the class C and class A (as well as class B in liver) transcripts exhibited temporally divergent changes over some developmental intervals. Class A transcripts in the liver, stomach, testes, and lung as well as class B transcripts in liver, exhibited sustained increases from 15 or 22 postnatal days to maximal levels at 50 postnatal days. In kidney, class A transcripts also increased steadily, but beginning at an earlier stage, i.e. at 8-15 days of postnatal life. These results demonstrate that the temporal expression of total IGF-I mRNA in the developing rat occurs in a tissue-specific manner, and additionally, that IGF-I mRNA variants are differentially expressed during development. PMID- 2721445 TI - Human testosterone-binding globulin is a dimer composed of two identical protomers that are differentially glycosylated. AB - Affinity-purified human testosterone-binding globulin (hTeBG) is composed of two subunits [mol wt (Mr), 52,200 and 48,600], as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), electrophoretic transfer, and immunochemical localization with a monoclonal antibody raised against rat androgen-binding protein. Fluorography of SDS-PAGE gels on which photoaffinity labeled hTeBG was analyzed yielded essentially identical results. Enzymatic deglycosylation of hTeBG with neuraminidase to remove sialic acid led to the production of two subunits of 50,800 and 47,300 Mr when assessed by SDS-PAGE. Treatment of hTeBG with an optimal concentration of N-glycanase to remove Asn linked oligosaccharides produced a single subunit of 44,100 Mr. When hTeBG was treated with neuraminidase and O-glycanase to remove O-linked oligosaccharides, three subunits were seen, two of which had Mr not clearly different from those obtained with neuraminidase treatment alone plus a subunit of 40,900 Mr. Treatment of hTeBG with a combination of all three enzymes produced a single subunit of 42,900 Mr. Chemical deglycosylation with trifluoromethane-sulfonic acid produced a single subunit with a Mr identical to that produced by treatment with all three enzymes. We concluded that this is the Mr of completely deglycosylated hTeBG. Based on this Mr, carbohydrates contribute 18% and 12% to the apparent Mr of the heavy and light subunits of hTeBG, respectively. Two dimensional PAGE analysis of hTeBG with its oligosaccharides intact indicated that the heavy subunit was composed of seven isoelectric variants with pI values of 5.87-6.55, while the light subunit was composed of four charge variants with pI values of 6.14-6.55. Treatment of hTeBG with the enzymes resulted in a shift in the pH values to a more basic pH range, indicating that carbohydrate removal also removed charged species from the protein. The greatest cathodal shift occurred when hTeBG was treated with a combination of the three enzymes (pI 7.33 7.77) or when it was chemically deglycosylated (pI 6.37-7.02). Despite the apparent removal of all carbohydrates, the single subunit was still composed of multiple isoforms. This finding suggests that other charged species remain on the hTeBG molecule. PMID- 2721446 TI - Type I, 5'-monodeiodinase activity in the lactating mammary gland. AB - Mammary homogenates from lactating, weaned, pregnant, and nonpregnant rats were analyzed for 5'-monodeiodinase activity (5'-MA). Only lactating glands exhibited significant enzyme activity. Competitive analysis showed that mammary 5'-MA is not inhibited by high (10 microM) concentrations of T4 or T3, but is highly sensitive to prophythiouracil (5 mM). Kinetic parameters demonstrate an acompetitive bisubstrate enzymatic mechanism known as the ping-pong type. The Km and maximum velocity for rT3 were 0.40 microM and 1.42 nmol/mg.min, respectively. These results provide the first evidence that 5'-MA is present in the lactating mammary gland and suggest that this enzymatic activity corresponds to type I enzyme. PMID- 2721447 TI - The effects of sulfhydryl-modifying reagents on cholecystokinin-receptor interactions in guinea pig gastric glands. AB - The effects of a number of different sulfhydryl agents on cholecystokinin (CCK) binding sites in isolated fundic gastric glands and gastric mucosal membranes from guinea pigs were evaluated. [125I]CCK octapeptide binding was significantly reduced when gastric glands were pretreated with iodoacetamide (IA; 10 mM), p chloromercuribenzoate (PCMB; 0.1 mM), or N-ethylmaleimide (NEM; 0.1 mM) at 24 C, but not by dithiothreitol (DTT; 1.0 mM) or dinitrothiobenzoic acid (DTNB; 10 mM). In contrast, inclusion of DTT or IA during binding led to significant increases in the amount of radioligand bound, while in the presence of DTNB binding was significantly reduced. Glycine-HCl wash of gastric glands pretreated with these agents indicated that NEM and IA reduced radioligand internalization by about 80% (P less than 0.001) and increased surface binding by 20% (P less than 0.01) and 76% (P less than 0.001), respectively. PCMB inhibited radioligand binding to surface sites by more than 90% and completely inhibited radioligand internalization. Gastric mucosal membranes bound significantly less radioligand after PCMB (80%) and NEM (26%) treatment compared to controls, and significantly more after IA treatment (162%). Scatchard analysis of the CCK-receptor interaction indicated two binding sites with dissociation constants of 0.71 and 11.7 nM, and binding capacities of 3.6 and 15.8 nmol/mg DNA, respectively. NEM and IA significantly increased the Kd of the high affinity site without affecting the binding parameters of the low affinity site; the low affinity site was eliminated by PCMB treatment, and the affinity and capacity of the high affinity site were significantly reduced. In the presence of DTT, [125I]CCK octapeptide binding to gastric glands was enhanced with a significant increase in the amount of radioligand in the internalized pool (39%; P less than 0.001) and no increase in binding to gastric mucosal membranes. These results suggest that sulfhydryl groups play an important role in CCK-receptor interactions. PMID- 2721448 TI - Effect of age on calcium uptake in isolated duodenum cells: role of 1,25 dihydroxyvitamin D3. AB - Uptake of Ca2+ in cells isolated from rat duodenum declined in the senescent rats. This age-related change was not due to an alteration in the rate of Ca2+ efflux or in the size of the cell. The decrease appeared specific, as alpha methyl glucoside uptake was not altered. Cell population, as monitored by sucrase activity for villus cells, was not different between duodenal cells isolated from 6- and 24-month-old rats. Kinetic analysis shows the Vmax, the apparent maximum uptake capacity, decreased in the cells from senescent rats whereas the Km, the apparent affinity to Ca2+, was unchanged. Serum levels of 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D [1,25-(OH)2D] were determined as a function of age; the levels of 25OHD were not significantly different in 3-, 6-, 12-, and 24-month-old rats. On the other hand, serum 1,25-(OH)2D decreased throughout the age range studied. Since duodenal Ca2+ uptake is closely regulated by 1,25 (OH)2D3, we tested the hypothesis that low serum 1,25-(OH)2D in the senescent rats may have contributed to the decline in duodenal Ca2+ uptake. In vivo administration of 1,25-(OH)2D3 to senescent rats significantly enhanced Ca2+ uptake activity in the isolated duodenal cells. After 1,25-(OH)2D3 treatment, Ca2+ uptake activity in cells isolated from senescent rats was only slightly less than that in cells from adult rats. We conclude that duodenal Ca2+ uptake declined in the senescent rats, and this age-related change was most likely due to the low serum level of 1,25-(OH)2D and not the result of a decrease in any duodenal response to 1,25-(OH)2D3. PMID- 2721449 TI - Serum and monohydroxytamoxifen inhibit progesterone receptor concentrations in primary rat uterine cells grown in serum-free medium. AB - Uterine cells dispersed from immature rat uteri were grown in culture in serum free medium supplemented with insulin (5 micrograms/ml), transferrin (5 micrograms/ml), and selenous acid (5 ng/ml; ITS). Cells were grown to a confluent monolayer and had a fibroblastic appearance, similar to cells cultured in the presence of 10% serum [horse-fetal calf (6:1), stripped three times with dextran coated charcoal]. However, estrogen receptor and progesterone receptor (PgR) concentrations were higher in cells grown in serum-free medium than in cells grown in serum. Uterine cells grown in ITS contain PgR levels that are near maximum (927 +/- 168 fmol/mg protein), and estradiol (0.1 nM; 24 h) causes a 10 50% increase in PgR. Addition of serum or monohydroxytamoxifen for 24 h decreases PgR levels by about 50%, and estrogen can completely overcome the inhibition caused by either serum or monohydroxytamoxifen. Our data suggest that PgR levels may be down-regulated by a component of serum. PMID- 2721450 TI - Cytosolic 3,5,3'-triiodo-L-thyronine (T3)-binding protein (CTBP) regulation of nuclear T3 binding: evidence for the presence of T3-CTBP complex-binding sites in nuclei. AB - Effect of cytosolic 3,5,3'-triiodo-L-thyronine (T3)-binding protein (CTBP) on [125I]T3 binding to nuclei was investigated in vitro. CTBP and nuclei were prepared from rat kidney. CTBP was inactivated by incubating with charcoal and activated by incubating with NADPH or with NADP and dithiothreitol. Two complexes of CTBP and T3 [CTBP-T3(NADPH) and CTBP-T3(NADP)] were separately prepared, and the functions of these complexes were estimated. [125I]T3 binding to nuclei was not influenced by the inactive form of CTBP. NADP or NADPH alone did not modify [125I]T3 binding to the nuclei. However, the binding was markedly inhibited by NADPH in the presence of the inactive form of CTBP, but it was not inhibited by NADP in the presence of the inactive form of CTBP. The ability of nuclei to bind [125I]T3 was markedly diminished by pretreatment of the nuclei with 10(-8) M unlabeled T3. The diminished activity was not modified by adding NADPH or NADP. However, [125I]T3 bound to these nuclei in the presence of NADP and the inactive form of CTBP. Binding of [125I]T3 to these nuclei was not observed in the presence of NADPH and the inactive form of CTBP. When the nuclei that had previously been saturated with 10(-6) M unlabeled T3 were incubated with [125I]T3 CTBP(NADP) complex, radioactivity bound to the nuclei. The binding of radioactivity, however, was not observed when these nuclei were incubated with [125I]T3. The [125I]T3-CTBP(NADPH) complex did not bind to these nuclei. When the nuclei that had previously been treated with T3-CTBP(NADP) complex were incubated with [125I]T3, radioactivity bound to the nuclei. The binding of radioactivity, however, was not observed when these nuclei were incubated with [125I] T3 CTBP(NADP) complex. The [125I]T3-CTBP(NADPH) complex did not bind to these nuclei. These results suggested that 1) CTBP activated by NADP plays a role as a carrier protein for T3 from cytoplasm to nucleus; 2) there are binding sites for T3-CTBP(NADP) complex in rat kidney nuclei; and 3) these binding sites are different from nuclear T3 receptors. PMID- 2721451 TI - Regional specificity of testosterone regulation of proopiomelanocortin gene expression in the arcuate nucleus of the male rat brain. AB - Endogenous opioid peptides have been implicated as mediators in the negative feedback action of gonadal steroids on GnRH secretion. We have previously demonstrated that testosterone stimulates POMC gene expression in neurons of the arcuate nucleus. However, the wide distribution and variety of actions attributed to the numerous arcuate POMC neurons suggest that these cells may be heterogeneous in their responsiveness to steroid hormones. We tested the hypothesis that testosterone modulates a select population of POMC neurons within the arcuate nucleus of the adult male rat by comparing POMC mRNA signal levels throughout the arcuate nucleus of intact, castrated, and castrated testosterone replaced adult males. Adult male rats were castrated and implanted (sc) with a Silastic capsule (30 mm) that was either empty (n = 6) or filled with crystalline testosterone (n = 5). Control sham-operated animals (n = 6) were left intact. In each animal the arcuate nucleus was divided into four equal rostral-caudal areas within which we measured POMC mRNA content in individual cells. We report that the effects of castration and testosterone replacement are observed in POMC neurons located in the most rostral region of the arcuate nucleus. After castration, POMC mRNA content was reduced in cells of the most rostral arcuate area (intact, 152 +/- 5 grains/cell; castrate, 119 +/- 2 grains/cell; P less than 0.0005), and replacement with physiological levels of testosterone prevented the decline in POMC mRNA levels so that they remained equivalent to that of the intact animal (castrated testosterone-replaced, 153 +/- 6 grains/cell). There was no significant difference in POMC mRNA signal between intact and castrated testosterone-replaced animals in the most rostral area. POMC neurons in the more caudal aspect of the arcuate (75% of the nucleus) were unaffected by the treatments; alternatively, it is possible that a real change in POMC message content in a subpopulation of cells was obscured by larger numbers of nonresponding cells within the same tissue sections. Based on these observations we conclude that there is a heterogeneous population of POMC neurons in the arcuate nucleus and that testosterone regulates POMC gene expression in a select group of these cells located in the rostral portion of the arcuate nucleus. PMID- 2721452 TI - Characterization of the circulating form of porcine relaxin: biological activity and terminal amino acids. AB - Relaxin is structurally related to insulin, and it induces pregnancy-related changes in the reproductive tract of several mammalian species. Relaxin isolated from the ovaries of pregnant sows has been used for primary structure determination, for much of the biological characterization of the hormone, and for the development of RIAs. Immunoreactive (IR) relaxin is found in peripheral blood during pregnancy in pigs and other species, but it has not been established that the substance identified by RIA is structurally or biologically equivalent to the native ovarian hormone. IR relaxin was, therefore, isolated from peripheral plasma of late pregnant gilts (days 112-114) for bioassay and determination of terminal amino acid residues. IR relaxin was monitored by a specific homologous RIA during fractionation of plasma by gel filtration, cation exchange, and hydrophobic binding to octadecysilica. IR relaxin circulates unbound and is equipotent with ovarian relaxin in the mouse pubic ligament bioassay. Amino acids released from IR relaxin by pyroglutamic aminopeptidase and carboxypeptidase-Y were converted to their 4-dimethylamino-azo-4'-sulfonyl derivatives for identification by HPLC. The B-chain of IR relaxin had an amino terminal pyroglutamic acid. Amino acids sequentially released from the carboxy terminal indicated a chain length of 28-30 amino acids, suggesting a heterogeneity reminiscent of that of ovarian relaxin isolated by other methods. Arginine was released from the free amino-terminal by dimethylaminozaobenzene isothiocyanate degradation, indicating an intact A-chain of 22 amino acids. Blood immunoreactive relaxin in pigs is, therefore, a secreted biologically active form of relaxin with an amino acid composition similar to that of the form stored in the corpus luteum. PMID- 2721453 TI - Characterization and charge distribution of the asparagine-linked oligosaccharides on secreted mouse thyrotropin and free alpha-subunits. AB - Mouse hemipituitaries in vitro secrete TSH, composed of an alpha-beta heterodimer, as well as excess (free) alpha-subunits. By dual metabolic labeling with [35S]sulfate and [3H]mannose, we have characterized oligosaccharides from secreted TSH alpha, TSH beta, and free alpha-subunits released from the apoprotein by enzymatic deglycosylation. Oligosaccharides from each subunit displayed a distinct anion exchange HPLC profile due to a specific pattern of sialylation and sulfation. Six species were obtained from TSH alpha (with two glycosylation sites), including neutral oligosaccharides as well as those with one or two negative charges. For TSH beta (with one glycosylation site) at least eight oligosaccharide species were noted, representing nearly every permutation of sialylation and sulfation; approximately 30% contained three or more negative charges. Analysis of [3H]mannose-labeled oligosaccharides on Concanavalin-A agarose showed 85% binding for those from TSH alpha, 70% for free alpha, and 50% for those from TSH beta. These data demonstrate that oligosaccharides from secreted TSH beta were more sialylated and sulfated, consistent with a more complex branching pattern, than those from TSH alpha. Oligosaccharides from free alpha-subunit were more sialylated than those from TSH alpha, and the net negative charge was intermediate between those of TSH alpha and TSH beta. Although great microheterogeneity is present even at the single glycosylation site on the beta-subunit of secreted TSH, a pattern of sialylation and sulfation could be discerned. If one assigns probabilities of sialylation [p(N)] and sulfation [p(S)] based on the observed distribution within monoacidic (charge -1) species, the proportion of diacidic (charge -2) oligosaccharides could be predicted for each subunit by [p(N)]2, 2[p(N)] [p(S)], [p(S)]2, corresponding to species containing two sialic acid, one sialic acid and one sulfate, and two sulfate residues, respectively. This suggests that the probability of sialylation or sulfation at a second site on these oligosaccharides is similar to that at the first and that anionic oligosaccharides in secreted TSH and free alpha are distributed binomially with regard to sialic acid and sulfate residues. PMID- 2721454 TI - In vivo stimulation of bone formation by transforming growth factor-beta. AB - The effect of transforming growth factor-beta (TGF beta) on bone in vivo was examined. Twelve daily injections of 1 microgram TGF beta directly onto the periostea of parietal bones of neonatal rats stimulated the formation of periosteal woven bone. The thickness of the treated parietal bones increased at least 2-fold in a dose-dependent manner. This TGF beta effect was localized at the sites of injection, and no change was observed in contralateral parietal bones and tibiae. The body weight in these growing rats was not affected by TGF beta 1. TGF beta 2 had effects similar to those of TGF beta 1 on the parietal bones in vivo. These results reveal for the first time that TGF beta stimulates bone formation in vivo and indicate its anabolic role in local bone metabolism. PMID- 2721455 TI - Tissue-specific differences in the levels of proglucagon-derived peptides in streptozotocin-induced diabetes. AB - The synthesis and secretion of proglucagon-derived peptides are regulated in a tissue-specific manner in pancreas, intestine, and brain. We have examined the plasma and tissue levels of these peptides during the first 3 weeks of streptozotocin (STZ)-induced diabetes in the rat. Plasma glucose levels were markedly elevated (P less than 0.0001) within 24 h of STZ administration. The plasma levels of glucagon-like immunoreactive (GLI) peptides were significantly elevated on days 8-22 of diabetes (P less than 0.05-0.001). Ileal GLI peptide concentrations rose in parallel with the plasma levels (r = 0.39; P less than 0.006) to 250% of control levels (P less than 0.001); however, pancreatic GLI peptide content increased only transiently on day 1 (P less than 0.05). No significant differences in the posttranslational processing of proglucagon in normal or diabetic rats could be detected. The increment in ileal GLI peptide content was not associated with increases in intestinal proglucagon mRNA transcripts. In contrast, pancreatic, but not intestinal, somatostatin mRNA levels were increased on day 22 of diabetes. Diabetic rats were found to have small but significant changes in GLI and immunoreactive glucagon peptide content of the hypothalamus and medulla oblongata (P less than 0.05). These observations suggest that STZ-induced diabetes may produce tissue-specific perturbations in the biosynthesis and secretion of the proglucagon-derived peptides. PMID- 2721456 TI - Fasting-associated changes in serum thyrotropin in the rat are influenced by gender. AB - Studies in the male rat have demonstrated that fasting is associated with a decrease in serum TSH concentrations. The present studies were performed to determine if gender influenced the serum TSH changes associated with fasting. In 8 of 10 experiments in male rats, serum TSH concentrations were significantly reduced in fasted compared to fed groups. In contrast, in none of the 9 experiments in female rats were serum TSH concentrations significantly reduced in the fasted groups. When all experiments were pooled, the decrease in the serum TSH concentration in the fasted rats compared to that in the fed rats was 55 +/- 4% (mean +/- SE) in males and 10 +/- 7% in females (P less than 0.001). In female rats ovariectomy did not result in a pattern in which fasting was associated with a decrease in serum TSH concentrations. Testosterone (T) was administered to male rats during fasting, but this treatment did not prevent the fasting-induced decrease in serum TSH concentrations. In gonadectomized male rats serum TSH concentrations were unchanged by fasting. However, if T was administered to gonadectomized male rats before and during fasting, serum TSH concentrations were significantly decreased in the fasted compared to the fed rats. These studies indicate that there is a sex difference in the serum TSH response to fasting in rats. The decline in serum TSH with fasting in the male rat is not mediated by a decline in serum T concentrations. Rather, T appears to maintain a process which increases the serum TSH concentration, and it is this process that is susceptible to inhibition by fasting. PMID- 2721457 TI - Insulin-like growth factor type I (somatomedin-C) stimulates high density lipoprotein (HDL) metabolism and HDL-supported progesterone biosynthesis by swine granulosa cells in vitro. AB - Type I insulin-like growth factor (IGF-I) stimulated high density lipoprotein (HDL)-promoted progesterone production by swine granulosa cells cultured under serum-free conditions in vitro. In the presence of pure human IGF-I (50 ng/ml), the half-maximally effective concentration of swine HDL was 16 micrograms/ml (67% confidence limits; 15-17 micrograms/ml) after 2 days of exposure to this growth factor, 5.4 (2.6-9.8) micrograms/ml after 4 days, and 3.8 (1.2-4.8) micrograms/ml after 6 days. Maximal progesterone production increased approximately 10-fold in the presence of IGF-I and HDL on day 2, 125-fold on day 4, and 330-fold on day 6. The facilitative action of IGF-I on HDL-supported progesterone biosynthesis was accompanied by time-dependent stimulatory effects of IGF-I on trypsin-releasable HDL, trypsin-resistant cell-associated HDL, and degraded HDL (P less than 0.01). Moreover, incubation of swine granulosa cells with [3H]cholesteryl oleate-labeled HDL demonstrated that IGF-I exerted a time-dependent stimulatory effect on [3H]free cholesterol and [3H]cholesteryl ester accumulation in granulosa cells, and significantly augmented the secretion of [3H]progesterone (separated by two dimensional TLC). In addition to the ability of IGF-I to amplify the cellular acquisition of radiolabeled sterol, this growth factor also increased the total mass of cellular cholesteryl ester and total cellular cholesterol as measured by microfluorometric assay (P less than 0.01). We conclude that IGF-I facilitates the effective delivery of HDL-derived sterol substrate into the steroidogenic pool of ovarian cells. Such observations offer an additional role for the differentiative actions of this somatomedin in the expression of full steroidogenic potential by granulosa-luteal cells. PMID- 2721458 TI - Effects of insulin-like growth factors I and II on growth and differentiation of transplanted rat embryos and fetal tissues. AB - The objective of our study was to obtain comparative information on the roles of insulin-like growth factors (IGFs) I and II in the growth and differentiation of rat embryos and fetuses in an in vivo experimental system. Ten-day-old rat embryos or 16-day-old fetal rat paws were transplanted under the capsule of both kidneys of syngeneic hosts, where they grew rapidly, and tissue differentiation occurred in an essentially normal manner. Infusion of a rabbit antiserum to human (h) IGF-I for 6 days into the renal artery of one kidney caused only a slight inhibition (approximately 20%) of growth of transplanted embryos on that kidney. However, 9 days of treatment with the antiserum caused highly significant growth retardation of transplanted embryos by 40-45%. Exposure of fetal paws to the same antiserum for 9 days inhibited their growth by 27%. Infusion of synthetic hIGF-II or partially purified rat IGF-II [(MSA)multiplication-stimulating activity], for 6 days stimulated the growth of embryo transplants directly, and MSA was more effective than hIGF-II. By contrast, infusion of purified natural hIGF-I did not promote their growth. Growth of fetal paw transplants in hypophysectomized (HX) hosts was reduced by 70% compared to that in intact hosts. In the HX hosts infusion of the MSA was more effective than the hIGF-I at promoting the growth of paw transplants. Both MSA and IGF-I promoted ossification in the fetal paws in the HX hosts. These results suggest that both IGFs could be involved in regulating the growth and differentiation in prenatal rats, and IGF-II may be the more effective of the two factors as a growth-promoting agent in utero. PMID- 2721459 TI - Glucocorticoid endangerment of hippocampal neurons does not involve deoxyribonucleic acid cleavage. AB - Glucocorticoids (GCs) are highly pathogenic if secreted in excess. Recent work shows that such deleterious consequences include damage to the hippocampus, a principal neural target site for GCs. Excessive chronic exposure to GCs accelerates senescent hippocampal neuron loss, while the presence of GCs at the time of neurological insults, such as seizure or hypoxia-ischemia, exacerbates hippocampal damage. The present study determines whether GCs endanger hippocampal neurons through the same mechanism by which they damage lymphocytes. GC-induced lymphocytolysis involves cleavage of chromosomal DNA, most likely through steroid induction of a nuclease that produces a characteristic ladder of fragmented DNA. Moreover, inhibition of DNA repair using the poly(ADP-ribose) synthetase inhibitor benzamide exacerbates GC-induced lymphocytolysis. We replicated this GC induced fragmentation of DNA in thymocytes, but observed the absence of a similar fragmentation in DNA from primary hippocampal cultures under conditions in which GCs exacerbate the toxic effects of the excitotoxin kainic acid. Furthermore, under such conditions benzamide did not worsen the GC/kainic acid toxicity. These observations suggest that GCs endanger hippocampal neurons through a different mechanism, one that seems likely to be less sterotyped and simple than this cascade of apoptosis in lymphocytes. PMID- 2721460 TI - Circadian rhythm of vasopressin levels in cerebrospinal fluid of the fetus: effect of continuous light. AB - We have measured the concentrations of vasopressin in sequential samples of cerebrospinal fluid (CSF) obtained from fetal lambs between 108 and 130 days gestation. There was a clear and significant (F = 4.46; P less than 0.005) rhythm in vasopressin concentrations in the CSF of nine fetuses, characterized by a mean trough value of 19.4 +/- 6.4 pg/ml (mean +/- SD) at 0200 h and a peak value of 41.1 +/- 28.0 pg/ml at 1400 h. The mean cycle length was 23.2 +/- 1.7 h, with the majority (greater than 80%) of peak concentrations found during daylight hours. There were no concurrent fluctuations in concentrations of vasopressin in plasma or Na, K, Cl, or osmolality in CSF. To examine the relationship between environmental cycles of light and darkness and rhythm of vasopressin concentrations in CSF, pregnant animals were maintained in a constant light environment. In the five fetuses of ewes maintained under these conditions, the rhythm of vasopressin in CSF was markedly damped or not apparent (F = 1.50; P greater than 0.15). These results demonstrate that prominent circadian rhythm of vasopressin in the CSF of the fetus in utero. Despite the fact that the fetus is sequestered from direct influences of the environment, exposure of the pregnant ewe to constant light disrupts the fetal pacemaker that generates the circadian rhythm of vasopressin in CSF. Studies of this rhythm in the fetal lamb, therefore, provide a means to examine the mechanisms of entrainment and assess prenatal influences on circadian organization of the fetus. PMID- 2721461 TI - Conservation of free but not total or non-sex-hormone-binding-globulin-bound testosterone in serum from Nagase analbuminemic rats. AB - Nagase analbuminemic rats have normal reproductive capacity, normal apparent libido, and normal serum concentrations of LH and FSH. Therefore, it is reasonable to assume that intracellular sex steroid hormone concentrations are normal or at least adequate to maintain normal reproductive function in these rats. To test whether intracellular testosterone concentrations in these rats are maintained by the circulating concentration of free or free-plus-weakly-bound testosterone, we measured the concentrations of total testosterone, free testosterone, and non-sex-hormone-binding-globulin-bound testosterone in sera from five adult male Nagase analbuminemic rats and from five age- and sex-matched controls. We found that the analbuminemic rats had markedly decreased serum concentrations of total and non-sex-hormone-binding-globulin-bound testosterone, but normal serum concentrations of free testosterone. These results suggest that intracellular concentrations of testosterone in biologically relevant organs of the rat are maintained by the concentration of free rather than free-plus-weakly bound testosterone in plasma, in accord with the free hormone hypothesis. PMID- 2721462 TI - Ontogeny of peptidylglycine alpha-amidating monooxygenase activity in rapidly mineralizing bone from neonatal mouse. AB - Peptidylglycine alpha-amidating monooxygenase is hormonally, developmentally, and nutritionally regulated. In several tissues concomitant changes in enzyme activity and the level of expression of a known amidated peptide have been demonstrated. We report that neonatal mouse calvarium, a rapidly mineralizing bone, has detectable amidation enzyme activity. The level of activity varied 3-10 fold during the first 9 d of life. Production of one or more amidated peptides by bone may be coordinately regulated. PMID- 2721463 TI - Developmental study of hippocampal kindling. AB - The critical susceptibility to seizure in immature hippocampus of rat brain was investigated using the kindling model of epilepsy. Hourly electrical low intensity stimulations applied to the left dorsal hippocampus of suckling rats induced longer initial AD duration (p less than 0.01) with faster development of kindling seizure than in that of adult rats. In contrast to the marked reduction of wet dog shakes (WDS) in adult rats, in suckling rats persistent and prolonged WDS were observed as kindling progressed. The faster development of hippocampal kindling in suckling rats than in adult rats was explained by the different excitability of the stimulated brain site and the different extent of neural connections in many brain structures, which participate in generalization of seizures arising from a stimulated site. PMID- 2721464 TI - Tolerance to anticonvulsant effects of diazepam, clonazepam, and clobazam in amygdala-kindled rats. AB - Benzodiazepines are effective anticonvulsants, but long-term clinical usefulness is limited by development of tolerance. Tolerance to the actions of three prototype anticonvulsant benzodiazepines (BZDs)--diazepam (DZP), clonazepam (CZP), and clobazam (CLB)--was studied in amygdala-kindled rats. Fully kindled rats were dosed three times daily for 2 or 4 weeks. Amygdala stimulation was given 30 min after drug administration on days 1, 2, 3, 5, and 7 of chronic treatment and then three times weekly. During treatment, tolerance was observed as a loss of drug effect to suppress behavioral and EEG manifestations of seizure activity. Seizure activity remained stable in rats treated with vehicle. Tolerance to the anticonvulsant effects developed most rapidly during CLB treatment and most slowly during CZP treatment. Tolerance to the motor impairment caused by the drugs developed more rapidly. Assay of the amount of drug in brain extracts, using a BZD receptor assay, showed that tolerance was functional, not metabolic. Doubling the dose did not readily restore full anticonvulsant activity. The response to amygdala stimulation 24 h after treatment was stopped showed no residual BZD effect, but there was a rebound in duration of some seizure measures in rats that had been treated with CLB or DZP. Retesting 48 h after treatment was stopped showed that rats were still tolerant. The amygdala kindled rat is a reliable and sensitive model for studying long-term actions of anticonvulsant BZDs. PMID- 2721465 TI - Prognostic significance of independent auras in temporal lobe seizures. AB - We performed a retrospective study of auras that occurred independently of complex partial seizures in patients undergoing continuous EEG monitoring with stereotactically implanted depth electrodes placed in mesiotemporal structures. Forty of 54 patients had a history of independent auras, and 32 of these individuals had independent auras while being monitored. Two hundred ninety-two independent auras were recorded, and EEG characteristics and subjective symptoms were analyzed with regard to surgical outcome. Most patients had ictal EEG changes with all or some of their auras. Four patients had nonlocalized or multifocal complex partial seizures despite the presence of well-localized auras, indicating that if intracranial ictal recording is used as a gold standard for localization, complex partial seizures must be recorded. Presence or absence of EEG change with auras did not affect prognosis nor did variability of ictal EEG pattern, spatial extent of initial field potential, aura duration, or character of symptoms correlate with prognosis or postoperative persistence of auras. PMID- 2721466 TI - Depression, locus of control, and the effects of epilepsy surgery. AB - The purposes of this investigation were (a) to determine the relationship between interictal depression and a potential psychosocial risk factor (locus of control), (b) to examine changes in self-reported depression after anterior temporal lobectomy (ATL), and (c) relate postoperative changes in depression to alterations in surgical outcome and locus of control. Thirty-seven patients with intractable seizures of temporal lobe origin were administered measures of depression and locus of control both preoperatively and 6 months postoperatively. Results revealed a significant preoperative relationship between depression and an external locus of control, but this relationship no longer existed postoperatively. Postoperative declines in depression were independent of any alterations in locus of control. Further analyses revealed that depression declined significantly only in patients rendered completely seizure-free by ATL, whereas patients who were significantly improved (greater than or equal to 75% reduction in seizure frequency) but continued to experience some seizure activity showed no changes in self-reported depression. Finally, a wide variety of neurologic and seizure-related variables were shown to be unrelated to depression. The clinical and theoretical significance of these findings is discussed. PMID- 2721467 TI - Factors affecting the outcome of MMPI and neuropsychological assessments of psychogenic and epileptic seizure patients. AB - The literature reveals conflicting information regarding the extent to which psychogenic seizure patients have emotional disorders and neuropsychological deficits as compared with patients with epileptic seizures. Among groups matched for numbers of subjects, age, sex, and years of education, we observed that patients who had solely psychogenic seizures with either a major component of affectual expression or relatively minor motor activity were more disturbed emotionally than epileptic patients with partial seizures. In contrast, the personality characteristics of psychogenic seizure patients whose attacks had either little affectual display or prominent motor expression could not be distinguished from those of epileptic patients with convulsive generalized seizures. Closely matched groups of patients with solely psychogenic seizures, partial seizures, or generalized seizures did not differ in neuropsychological performance. However, psychogenic seizure patients performed much better on neuropsychological measures than a less-well-educated, but otherwise matched group of patients with generalized epileptic seizures. PMID- 2721468 TI - Risk of age-related fractures in patients with unprovoked seizures. AB - The incidence of age-related fractures was determined in a cohort of 467 Rochester, Minnesota residents with unprovoked seizures. The 30 initial hip fractures observed were significantly more than the 13.19 expected [standardized morbidity ratio (SMR) = 2.3; 95% confidence interval (CI) 1.5-3.3]. The overall incidence of distal forearm (Colles) fractures was not significantly increased (SMR = 1.6; 95% CI 0.9-2.5), based on 17 cases. Hip fracture incidence was increased during the first 10 years after seizure diagnosis but was not related to anti-epileptic drug (AED) use. In contrast, the increase in Colles' fracture incidence was associated with duration of therapy, as the SMR for greater than or equal to 10 years of AED use was 2.4 (95% CI 1.0-5.0). The incidence of vertebral fractures was slightly higher among treated patients but was not associated with duration of AED use. Thus, there was no consistent pattern to support the contention that fracture incidence is greatly increased by long-term AED use. PMID- 2721470 TI - Chromosomal aberrations in peripheral lymphocytes of cotton field workers exposed to pesticides. AB - Fifty-two pesticide sprayers in cotton fields were selected for the analysis of chromosomal aberrations in peripheral lymphocytes. Twenty-five samples were collected from healthy males who were not exposed to pesticides. Statistical analysis revealed that there was a significant increase in chromosomal aberrations in the exposed population compared to controls. Total chromosomal aberrations increased irrespective of duration of exposure. PMID- 2721469 TI - Cytogenetic effects of phenytoin and/or carbamazepine on human peripheral leukocytes. AB - The cytogenetic effects of phenytoin (PHT) and/or carbamazepine (CBZ) were studied to determine clastogenic potential. Comparative analysis of chromosome breakage and sister chromatid exchange (SCE) was performed between 18 patients with epilepsy receiving PHT and/or CBZ and 10 healthy nontreated controls. These studies failed to detect a significant increase in chromosome aberrations or SCEs in groups of treated individuals as compared with controls. No correlation was observed between the rate of either chromosome damage or SCEs and age, sex, drug blood level, or daily dose. The results indicate no detectable chromosome damaging effects of PHT alone, CBZ alone, or a combination of these two antiepileptic drugs (AEDs). PMID- 2721471 TI - Relationship of cadmium accumulation to zinc or copper concentration in horse liver and kidney. AB - The concentrations of Cd, Zn, Cu, and metallothionein (MT) in the liver, renal cortex, and renal medulla were determined in 24 male and 15 female younger thoroughbreds (age 27 to 97 months) and two old male horses (age 154 months and 190 months). High correlations were found between Zn and MT in the liver (partial correlation coefficient 0.836), between Cd and MT in the renal cortex (partial correlation coefficient 0.786), and between Cd and Zn in the renal cortex (partial correlation coefficient 0.675), while the correlation between Cd and MT in the liver was low (partial correlation coefficient 0.124). In the renal medulla, high correlations were found between Cd and Zn (partial correlation coefficient -0.631), between Zn and Cu (partial correlation coefficient 0.881), and between Cd and Cu (partial correlation coefficient 0.785). Therefore, in the liver, the MT concentration is the most highly correlated with the Zn concentration and is not correlated with the CD concentration unless artificially exposed to Cd. In the renal cortex, the MT and Cd concentrations are very highly correlated with each other. The Zn concentration is about 20 micrograms/g when the Cd concentration in the renal cortex is the lowest. PMID- 2721472 TI - Blood mercury concentrations following methyl mercury exposure in adult and infant monkeys. AB - Female monkeys (Macaca fascicularis) were dosed chronically with the equivalent of 10, 25, or 50 micrograms/kg/day methyl mercury until at least 90% of estimated blood equilibrium was reached and were then bred to untreated males. Infants were dosed with the same dose their mothers had received. An additional group of infants was dosed with 50 micrograms/kg/day beginning at birth. Infants exposed in utero were born with higher (1.7x) mercury levels than their mothers, but blood mercury levels of the offspring decreased to less than one-half that of the mothers. The steady-state blood levels of the group exposed postnatally were not different from steady-state levels of the group exposed in utero plus postnatally. When dosing was discontinued, the rate coefficient of elimination from blood did not differ between the adults (mothers) and the in utero plus postnatally exposed group, while that of the group exposed postnatally only was lower. There was no indication of a relationship in the rate of elimination for mother-infant pairs. These results suggest that the kinetics of methyl mercury in blood are complicated and may depend on the age of the individual when exposure begins. PMID- 2721473 TI - Biochemical validation of self-reported exposure to environmental tobacco smoke. AB - Biochemical validation of reported exposure to environmental tobacco smoke (ETS) lends credibility to epidemiological studies investigating the association of passive inhalation of smoke to respiratory disease or lung cancer. In the current study, a series of questions regarding ETS exposure was self-administered to nonsmokers and self-reported intensity of exposure was compared with cotinine levels in urine samples obtained on site. The target population of this study was a group of municipal workers who reported exposure in a domestic setting and/or in the workplace. When asked if they were exposed to ETS on social occasions, both males and females who responded positively had higher urinary cotinine levels (P less than 0.02) than those who gave a negative response. Mean urinary cotinine concentrations were found to be elevated in both men and women who reported that they lived with a smoker. Cotinine levels in the urine of those reporting exposure were over twice as high as those in the urine of respondents who denied having been exposed. ETS exposure in the home was the greatest contributor to increased urinary cotinine levels in both men and women. Among individuals who were exposed at work only, the reported degree of exposure agreed well with the mean urinary cotinine values. Those findings emphasize that the validation of exposure status with a biomarker is an essential prerequisite for epidemiological studies investigating passive smoking. PMID- 2721474 TI - Lead in soil: recommended maximum permissible levels. AB - Lead in soil has been recognized as a public health problem, particularly among children. In recent years, attention has been directed to cumulative adverse effects of lead at low levels of intake. Lead-contaminated soil and dust have been identified as important contributors to blood lead levels. Based on available data on blood lead and lead in soil, an approach has been developed to suggest a permissible level of lead in soil, below which there will be reasonable certainty that adverse health effects will not occur. An acceptable level of 600 ppm of lead in soil suggested as a "safe" level would contribute no more than 5 micrograms/dl to total blood lead of children under 12 years of age. Maximum permissible levels of lead in soil have been recommended based on the dose response relationship of lead in soil and blood lead in children. PMID- 2721475 TI - Respiratory health effects associated with ambient sulfates and ozone in two rural Canadian communities. AB - A cross-sectional epidemiological study investigating the respiratory health of children in two Canadian communities was conducted in 1983-1984 in Tillsonburg, Ontario, located in a region of moderately elevated concentrations of transported air pollutants, and in Portage la Prairie, Manitoba, situated in a low pollution area. There were no significant local sources of industrial emissions in either community. Seven hundred and thirty-five children aged 7-12 were studied in the first town and 895 in the second. Respiratory health was assessed by the measurement of the forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1.0) of each child, and by evaluation of the child's respiratory symptoms and illnesses using a parent-completed questionnaire. Sulfur dioxide (SO2), sulfate, and particulate nitrate levels were significantly higher in Tillsonburg than in Portage la Prairie (P less than 0.05), but nitrogen dioxide (NO2) and inhalable particles (PM10) differed little between the communities. Historical data in the vicinity of Tillsonburg indicated that average annual levels of sulfates, total nitrates, and ozone (O3) did not vary markedly in the 9-year period preceding the study. The results show that Tillsonburg children had statistically significant (P less than 0.001) lower levels of 2% for FVC and 1.7% for FEV1.0 as compared with children in Portage la Prairie. These differences could not be explained by parental smoking or education, the use of gas cooking or wood heating fuels, pollution levels on the day of testing, or differences in age, sex, height, or weight. The differences persisted when children with cough with phlegm, asthma, wheeze, inhalant allergies, or hospitalization before age 2 for a chest illness were excluded from analysis. With the exception of inhalant allergies, which occurred more frequently in Tillsonburg children, the prevalence of chronic respiratory symptoms and illnesses was similar in the two communities. PMID- 2721476 TI - Chronic exposure of sheep to a zinc smelter in Peru. AB - Liver levels of arsenic, cadmium, copper, lead, manganese, and zinc were assessed in adult female sheep living in the vicinity of a zinc smelter in Peru. The study was conducted on a large sheep-raising cooperative divided into seven management units, operated under a standardized husbandry system. Soil samples were analyzed for the same metals at varying distances from the smelter. A gradient of concentration of heavy metals in soil was found between 1 and 56 km from the smelter. Soil concentrations for all metals except manganese decreased significantly with increasing distance from the smelter. The strongest correlations were found for copper, lead, and zinc (P less than 0.001). Topographic features and prevailing wind direction appeared to play a role in the dispersion of pollutants. Liver samples were obtained from 153 sheep on five units of the cooperative. The centers of the units sampled were between 13 and 56 km from the smelter. Hepatic concentrations of arsenic, lead, manganese, and zinc decreased significantly with increasing distance from the smelter. Liver arsenic and liver zinc were significantly related to soil concentrations. Liver levels of arsenic, cadmium, lead, and manganese in sheep from the cooperative were significantly higher than those detected in control sheep from southern Peru. Sheep populations may serve as biological monitors for heavy metal accumulation and environmental carcinogenesis. PMID- 2721477 TI - The influence of inhaled formaldehyde on rat lung cytochrome P450. AB - The effect of formaldehyde (HCHO) inhalation on total cytochrome P450 in the lungs of Sprague-Dawley rats was assessed after single and repeated exposures to 0, 0.5, 3, and 15 ppm HCHO. Whole-body exposures were conducted in dynamic, monitored exposure systems for 6 hr/day, 5 days/week, for periods of exposure of 1 day, 4 days, 12 weeks, or 24 weeks. Lung microsomal fractions were prepared and total protein and cytochrome P450 were measured 18 hr after the end of exposure at each time point. Two separate sets of exposure studies were conducted, thus duplicating all measurements for each dose group and at each time point. There were no detectable levels of total lung P450 in any of the rats that received a single 6-hr exposure to all three HCHO doses, while control lung P450 levels were similar to that found for 4-day and 12-week control rats. After 4 days of repeated exposures, however, there was a highly significant, reproducible, and dose-dependent increase in lung P450 levels relative to controls, with the 0.5, 3, and 15 ppm groups demonstrating 387, 1026, and 1123% of control values, respectively. Lung P450 levels remained elevated at all HCHO concentrations through 12 and 24 weeks of exposure, although the percentage difference between exposed and control rats continually dropped throughout the course of long-term repeated exposures. While HCHO-exposed rats did have decreased total body weight relative to controls, lung microsomal protein and lung weight of nearly all of the HCHO-exposed rats was not significantly different from the controls. The initial inactivation of lung P450 after a single HCHO exposure is apparently a transient phenomenon, with dose-dependent induction of the total P450 levels in the lung as the pattern of response to repeated exposures to inhaled HCHO. PMID- 2721478 TI - Effects of sulfur dioxide or ammonium sulfate exposure, alone or combined, for 4 or 8 months on normal and elastase-impaired rats. AB - Normal and lung-impaired rats were compared after exposure to SO2 and/or (NH4)2SO4 for 4 or 8 months, or for 8 months plus 3 months recovery. Young adult male Sprague-Dawley rats were pretreated intratracheally with either physiologic saline (normal lungs) or porcine pancreatic elastase (impaired lungs). Rats from each pretreatment group were exposed to filtered air (control), to SO2 (1 ppm) or (NH4)2SO4 (0.5 mg/m3), or to combined SO2 + (NH4)2SO4 for 5 hr/day, 5 days/week. Morphologic, physiologic, and immunologic criteria were evaluated. At 4 months cellular immunologic responsiveness was not impaired, but physiologic changes were detected. Morphologic changes were apparent in all time periods. Elastase induced changes included greater lung volumes, emphysema, and alveolar interstitial fibrosis. Pollutant effects included bronchiolar epithelial hyperplasia and changes in alveolar mean chord length (MCL). Relative to controls, bronchiolar epithelial hyperplasia and MCL increased in saline/pollutant groups, but decreased in elastase/pollutant rats at 4 months. The pretreatment/pollutant interaction was not observed at 8 months. Elastase effects persisted throughout the recovery period. Pollutant effects were more transitory, although alveolar septal fibrosis was greater in saline/(NH4)2SO4 rats at 8 months. Pulmonary function changes associated with elastase included increases in residual volume, functional residual capacity, and the residual volume/total lung capacity ratios. The alveolar plateau of single-breath washout (N2 slope) was significantly steeper in elastase-treated rats but less steep in animals exposed to SO2 or to (NH4)2SO4 than in those exposed to air only. PMID- 2721479 TI - C3c concentrations in sera of persons living in areas with different levels of air pollution in Northrhine-Westphalia (Federal Republic of Germany). AB - A number of air pollutants is known to affect the immune system resulting in alterations of the complement activity in serum. We determined the levels of C3c, one of the activation products of the component C3, in serum samples obtained from various population groups living in areas with different levels of air pollution in Northrhine-Westphalia (FRG). The results show that the serum C3c levels tend to be increased in subjects living in areas with elevated levels of air pollution. By applying a linear regression model it can be demonstrated that a significant part of the variance of the C3c concentrations is explained by the residence area factor after making allowance for the effect of various confounders. The increase of the serum C3c concentrations appears to result from an increased activation of the complement component C3. The underlying mechanisms as well as the pathophysiological significance of these findings are unknown. PMID- 2721480 TI - Metabolic enhancement and increase of alveolar macrophages induced by ozone. AB - Male Wistar rats were exposed to 0.2 ppm ozone (O3) for 14 days and at intervals alveolar macrophages were collected by bronchoalveolar lavage to examine the effects of O3. The specific activities of glucose-6-phosphate dehydrogenase and glutathione peroxidase of alveolar macrophages increased to 1.6-fold (on the 3rd day) and 1.5-fold (on the 5th day), respectively, those of the control values. Similarly, the specific activities of pyruvate kinase, lactate dehydrogenase, and hexokinase also increased to 1.6-fold, 1.4-fold, and 1.2-fold, respectively, those of the control values on the 3rd day. The activities of all enzymes tested were maintained at significantly higher levels until the 14th day. Furthermore, the incorporation of [14C]thymidine into alveolar macrophages increased twice the control values on the 1st and 3rd days and was almost completely inhibited by the addition of 1.23 x 10(-4) M aphidicolin, a competitive inhibitor of DNA polymerase alpha. The number of alveolar macrophages collected from exposed animals also increased to 1.5-fold that of the control value on the 3rd day and was maintained at significantly higher level until the 14th day. It was noted that alveolar macrophages of small size preferentially increased between the 5th and 14th days. These results show that exposures to 0.2 ppm O3 induced a metabolic enhancement of the peroxidative metabolism, glycolysis, and DNA synthesis in alveolar macrophages and increased the macrophages of small size. PMID- 2721481 TI - Effects of alcohol consumption on mitochondrial aldehyde dehydrogenase isoenzymes in rat liver. AB - The effects of long-term and short-term exposure of rats to ethanol on aldehyde dehydrogenase (ALDH) activity in the liver mitochondria were investigated. The specific activities of mitochondrial high Km ALDH and low Km ALDH after the prolonged administration of ethanol were both increased to levels about 2.5 times that of the control group. In contrast, high Km and low Km ALDH showed maximum activity 12 h after administration of a single large dose of ethanol, increasing 21 and 4.4 times, respectively, over the level in the control group. When ethanol was administered for a long time, the two ALDH isoenzyme levels showed approximately the same increase, while the high Km ALDH level was more significantly increased than the low Km ALDH level after a single large dose. These results suggest that the high Km ALDH level of the outer membrane was increased as a result of a transient increase in the level of acetaldehyde around the liver mitochondria after a single large dose of ethanol, and that high Km ALDH plays an important role in acetaldehyde metabolism. However, when ethanol was administered for a long time, the mitochondria were exposed to low concentrations of acetaldehyde over a long time, leading to an increase in levels of low and high Km ALDH in the matrix. PMID- 2721482 TI - Effects of arginine-free diet on urea cycle enzymes in young and adult ferrets. AB - Young ferrets develop hyperammonemia soon after eating an arginine-free diet, whereas adult ferrets do not develop hyperammonemia after an identical treatment. Earlier reports indicate that young or adult rats do not develop hyperammonemia and encephalopathy after a single meal of an arginine-free diet. The effects of a single feeding of an arginine-free diet on the urea cycle enzyme activities in the liver of young and adult ferrets is reported. Ornithine carbamyl transferase, carbamyl phosphate synthetase and ornithine aminotransferase activities in the livers of adult ferrets were significantly higher than those in the livers of young ferrets. A single meal of an arginine-free diet did not alter the urea cycle enzyme activities in the liver of young or adult ferrets. The levels of urea cycle enzymes in the liver and kidney of young ferrets were comparable to those in rat liver and kidney. The results suggest that the hyperammonemia observed in young ferrets following a single meal of an arginine-free diet may not be due to the deficiency of enzyme activities. PMID- 2721483 TI - Effects of some S-blocked glutathione derivatives on the prevalent glyoxalase II (a form) of rat liver. AB - The prevalent glyoxalase II (S-2-hydroxyacylglutathione hydrolase, EC 3.1.2.6, a form) of rat liver cytosol has been studied with a series of seven S-blocked glutathione derivatives. At pH 7.4 and 20 degrees C, only p-nitrobenzyl-S glutathione was found completely inactive. All the other derivatives are linear competitive inhibitors of the enzyme. Ki values using S-D-lactoylglutathione as substrate are reported. Alkyl-S-glutathiones are weak inhibitors and their inhibition increases with the decrease of the length of the alkyl chain. The best inhibitors are those glutathione derivatives which contain a thioester bond (carbobenzoxy- and p-nitrocarbobenzoxy-S-glutathione) or a carbonyl group (p chlorophenacyl-S-glutathione). Inhibition by carbobenzoxy-S-glutathione seems to be more complex since the double reciprocal plot shows deviation from linearity at low substrate concentration. PMID- 2721484 TI - Wheat dwarf virus, a geminivirus of graminaceous plants needs splicing for replication. AB - By analysing mRNAs with the polymerase chain reaction (PCR) and by studying in vitro generated mutants we have identified an intron in the genome of wheat dwarf virus (WDV), a geminivirus of cereals. Polypeptides whose expression is essential for the replication of the viral DNA have been defined. They are encoded by two distinct overlapping open reading frames (ORFs). The joining of these two ORFs by deletion of the intron as well as the introduction of a frameshift mutation within the intron do not prevent replication of the viral genome in suspension culture cells. In contrast to WDV, the geminiviruses of dicotyledonous plants possess a single continuous ORF, highly homologous to the two individual ones of WDV. We propose that mRNA splicing is a common feature of all geminiviruses of the Gramineae and might contribute to their host class specificity. The existence of a functional intron is a novel finding for the plant viruses. PMID- 2721485 TI - The contact site A glycoprotein of Dictyostelium discoideum carries a phospholipid anchor of a novel type. AB - The contact site A glycoprotein, a cell adhesion protein of aggregating Dictyostelium cells, was labeled with fatty acid, myo-inositol, phosphate and ethanolamine in vivo, indicating that the protein is anchored in the membrane by a lipid. This lipid was not susceptible to phosphatidyl inositol specific phospholipase C. When cleaved with nitrous acid or when subjected to acetolysis, the anchor released lipids which were different from those released from Trypanosoma variant cell surface glycoprotein, a protein with a known phosphatidyl inositol-glycan anchor. Resistance to weak and sensitivity to strong alkali indicated that the fatty acid in the contact site A glycolipid anchor was in an amide bond. On incubation with sphingomyelinase, a lipid with the chromatographic behavior of ceramide was released. These results suggest that the contact site A glycoprotein is anchored by a ceramide based lipid glycan. PMID- 2721486 TI - Differential exon usage involving an unusual splicing mechanism generates at least eight types of NCAM cDNA in mouse brain. AB - The murine neural cell adhesion molecule (NCAM) is known to exist in three isoforms of different size, NCAM-180, -140 and -120 coded for by four transcripts of 6.9, 6.1, 4.8 and 2.7 kb in length. Since the differences between these isoforms are due to alternative splicing in the coding region for the transmembrane and cytoplasmic domains, the extracellular, N-terminal portion of NCAM seemed to be shared by all three protein forms. Here we report that the coding region for N-terminal domains of NCAM also contains at least two sites of alternative splicing, termed alpha and pi. Short additional sequences of 3, 18 and 30 nt in length can be introduced at these sites, which are located in the membrane-proximal 'stem' between the Ig-like domains and the membrane attachment site and within the Ig-like domain IV, respectively. Proof for at least eight different mRNAs has been found by sequencing and S1 nuclease protection assays of selected independent cDNA clones, and Northern blot analyses. If most combination of the splice patterns identified so far in mouse brain occurred, 24 different mRNAs could be generated coding for 18 different proteins. The shortest extra sequence found inserted at splice site alpha consisted only of the trinucleotide AAG, raising questions about the mechanism of this particular insertion. PMID- 2721487 TI - Localization and heterogeneity of agonist-induced changes in cytosolic calcium concentration in single bovine adrenal chromaffin cells from video imaging of fura-2. AB - Temporal and spatial changes in the concentration of cytosolic free calcium ([Ca2+]i) in response to a variety of secretagogues have been examined in adrenal chromaffin cells using digital video imaging of fura-2-loaded cells. Depolarization of the cells with high K+ or challenge with nicotine resulted in a rapid and transient elevation of [Ca2+]i beneath the plasma membrane consistent with Ca2+ entry through channels. This was followed by a late phase in which [Ca2+]i rose within the cell interior. Agonists that act through mobilization of inositol phosphates produced an elevation in [Ca2+]i that was most marked in an internal region of the cell presumed to be the site of IP3-sensitive stores. When the same cells were challenged with nicotine or high K+, to trigger Ca2+ entry through voltage-dependent channels, the rise in [Ca2+]i was most prominent in the same localized region of the cells. These results suggest that Ca2+ entry through voltage-dependent channels results in release of Ca2+ from internal stores and that the bulk of the measured rise in [Ca2+]i is not close to the exocytotic sites on the plasma membrane. Analysis of the time courses of changes in [Ca2+]i in response to bradykinin, angiotensin II and muscarinic agonists showed that these agonists produced highly heterogeneous responses in the cell population. This heterogeneity was most marked with muscarinic agonists which in some cells elicited oscillatory changes in [Ca2+]i. Such heterogeneous changes in [Ca2+]i were relatively ineffective in eliciting catecholamine secretion from chromaffin cells. A single large Ca2+ transient, with a component of the rise in [Ca2+]i occurring beneath the plasma membrane, may be the most potent signal for secretion. PMID- 2721488 TI - Dose-dependent regulation of macrophage differentiation by mos mRNA in a human monocytic cell line. AB - The proto-oncogene c-mos was expressed during differentiation of the human monocytic cell line U937 into macrophages. To investigate a possible role of the mos oncogene, we introduced the v-mos gene under an inducible promoter, MT-I, into U937 cells. The v-mos transformed cells expressed mos mRNA at an amount proportional to the concentration of Zn2+ ions. The induction of the v-mos gene caused growth inhibition and macrophage differentiation in these cells. The differentiation of v-mos transformed monocytes into macrophages required continuous expression of the v-mos gene. The extent of expression of phenotypic characteristics of macrophages, such as phagocytosis, cell surface antigens and typical morphology, depends on the amount of mos mRNA present. We were therefore able to demonstrate that the expression of only one oncogene, mos, determines monocyte differentiation into macrophages. PMID- 2721489 TI - Molecular characterization of a new immunoglobulin superfamily protein with potential roles in opioid binding and cell contact. AB - A purified opioid-binding protein has been characterized by cDNA cloning. The cDNA sequence predicts an extracellularly located glycoprotein of 345 amino acids. This protein does not possess a membrane-spanning domain but contains a C terminal hydrophobic sequence characteristic of membrane attachment by a phosphatidylinositol linkage. It displays homology to the immunoglobulin protein superfamily, featuring three domains that resemble disulfide-bonded constant regions. More specifically, the protein is most homologous to a subfamily of proteins which includes the neural cell adhesion molecule (NCAM) and myelin associated glycoprotein (MAG) and one subgroup of the tyrosine kinase growth factor receptors comprising the platelet-derived growth factor receptor (PDGF R), the colony-stimulating factor 1 receptor (CSF-1 R) and the c-kit protooncogene. These sequence homologies suggest that the protein could be involved in either cell recognition and adhesion, peptidergic ligand binding or both. PMID- 2721490 TI - Dominant and specific repression of Xenopus oocyte 5S RNA genes and satellite I DNA by histone H1. AB - The genome of Xenopus laevis contains two large families of class III genes (oocyte 5S RNA and satellite I DNA) that are repressed in somatic cells. Both gene families are actively transcribed in a soluble extract of X.laevis oocyte nuclei, using chromatin deficient in histone H1 as a template. The addition of histone H1, to this transcriptionally active chromatin, results in the dominant and selective repression of oocyte 5S RNA genes and satellite I DNA. Somatic 5S RNA genes remain active following histone H1 addition. Changes in chromatin structure could have a dominant role in the regulation of class III gene expression during Xenopus embryogenesis. PMID- 2721491 TI - In vivo and in vitro expression of U7 snRNA genes: cis- and trans-acting elements required for RNA polymerase II-directed transcription. AB - Three of five genes coding for U7 small nuclear (sn) RNA of the sea urchin Psammechinus miliaris were shown to be expressed during early embryogenesis by microinjection into sea urchin eggs followed by fertilization. Both in vivo and in nuclear extracts of blastula embryos, a minimal promoter of 80 bp of 5' flanking sequence is essential for their expression. Sequences upstream of position -80 enhance transcription in vivo, but not in vitro, approximately 5 fold. In vitro, transcription initiates at nucleotide +1 of the U7 snRNA and is directed by RNA polymerase II. Protein-DNA binding studies and site-directed mutagenesis demonstrate the presence of multiple proteins interacting with sequences between -57 and -26, which are essential for selection of the correct initiation site and for efficient in vitro transcription. Three of these factors recognize a TATA-like regulatory element between positions -53 and -45, suggesting a role for TATA-binding proteins in the initiation of sea urchin U7 snRNA transcription. PMID- 2721492 TI - Pre-mRNA splicing mutants of Schizosaccharomyces pombe. AB - A collection of temperature sensitive (ts-) mutants was prepared by chemical mutagenesis of a wild type Schizosaccharomyces pombe strain. To screen the ts- mutants for pre-mRNA splicing defects, an oligodeoxynucleotide that recognizes one of the introns of the beta-tubulin pre-mRNA was used as a probe in a Northern blot assay to detect accumulation of intron sequences. This screening procedure identified three pre-mRNA splicing mutants from 100 ts- strains. The three mutants are defective in an early step of the pre-mRNA splicing reaction; none accumulate intermediates. The precursors that accumulate at 37 degrees C are polyadenylated. Analysis of the splicing of another pre-mRNA showed that the mutations are not specific for beta-tubulin. The total RNA pattern in the three splicing mutants appears to be normal. In addition, the amounts of the spliceosomal snRNAs are not drastically changed compared to the wild type and splicing of pre-tRNAs is not blocked. Genetic analyses demonstrate that all three splicing mutations are tightly linked to the ts- growth defects and are recessive. Crosses among the mutants place them in three complementation groups. The mutants have been named prp1, prp2 and prp3. PMID- 2721493 TI - Induction and repression of the Drosophila Sgs-3 glue gene are mediated by distinct sequences in the proximal promoter. AB - The normal developmental expression of the Drosophila salivary gland secretion protein gene Sgs-3 requires the interaction of a distal and proximal regulatory element. A deletion/replacement analysis of the proximal promoter in stably transformed lines shows that induction of an Sgs-3/Adh fusion gene is normal if sequences from +10 to -50 are replaced by those of the hsp70 gene. Sequences between -98 and -50 are necessary for this expression but there is internal redundancy within this region as two distinct upstream sequences of 18 and 22 bp respectively are sufficient for stage- and tissue-specific expression, albeit at reduced levels. A point mutation at -53 eliminates the ecdysone-mediated repression of the Sgs-3 promoter at pupariation. We report mosaicisms of expression within the salivary gland for a number of stably transformed lines. PMID- 2721494 TI - Genetic and structural analysis of the ColE1 Rop (Rom) protein. AB - Repressor of primer (Rop) is a small dimeric protein that participates in the mechanism that controls the copy number of plasmid of the ColE1 family by increasing the affinity between two complementary RNAs. The Rop dimer is a bundle of four tightly packed alpha-helices that are held together by hydrophobic interactions. We have systematically altered, by site directed mutagenesis, most of the solvent exposed amino acids of the Rop bundle and we have identified the alterations that cause a decrease of the activity of the regulatory molecule. We conclude that Rop folding is rather insensitive to amino acid substitutions and to other mutations as drastic as deletions and insertions. Looking along the 2 fold symmetry axis the amino acid side chains whose alterations affect the function of Rop are all located on one side of the molecule. Furthermore they are clustered at the extremities of the alpha-helix bundle, the only exception being the aromatic ring of Phe-14. PMID- 2721495 TI - Methyl-accepting taxis proteins in Halobacterium halobium. AB - Methyl-accepting taxis proteins were identified and characterized in Halobacterium halobium, an archaebacterial species that is both chemotactic and phototactic. The data suggest direct involvement of methylation and demethylation in mechanisms of both chemotaxis and phototaxis and identify adaptation as the sensory process in which those reactions are likely to be involved. Analysis by electrophoresis and fluorography revealed methyl-accepting species, of apparent Mr between 90,000 and 135,000, that exhibited characteristics of sensory components. Those methyl-3H-labeled species were absent in a mutant blocked in taxis. Methylation of specific bands increased after positive chemostimuli and decreased after negative stimuli. Other methyl-3H-labeled bands, from 17 to 29 kd, exhibited features of biosynthetic intermediates, not of sensory components. Assay of rates of demethylation by measuring release of volatile forms of radiolabeled methyl groups revealed transient changes following chemo- or photostimuli that persisted for periods roughly equivalent to adaptation times. Negative chemostimuli induced increased rates of demethylation, as expected from fluorographic analysis, but positive chemostimuli also resulted in an increase. Photostimuli of either sign were followed by increases in rates of demethylation of shorter duration and lesser magnitude than chemostimuli-induced increases, a relationship that corresponded to differences in adaptation time. PMID- 2721496 TI - Characterization of double-stranded RNA genetic elements associated with biological control of chestnut blight: organization of terminal domains and identification of gene products. AB - We have determined the organization within the terminal domains of the major large double-stranded RNA genetic elements associated with the hypovirulent strain EP713 of the chestnut blight pathogen Cryphonectria (Endothia) parasitica. Only the polyadenylated strand contained long open reading frames. Furthermore, only RNA of the same polarity as the polyadenylated strand was detectable in a single-stranded form, indicating that the polyadenylated strand is the coding or plus strand. The organization of the 5'-proximal portion of the plus strand consisted of a 495 nucleotide non-coding leader sequence followed by two overlapping open reading frames. The first, ORF1, extended 957 nucleotides while the second, ORF2, began 68 nucleotides upstream of the ORF1 termination codon and extended at least 1412 nucleotides. No open reading frames of significant size were detected within 0.8 kb of the poly(A) tail. In vitro translation of synthetic transcripts containing ORF1 yielded a polypeptide of Mr 29 kd. The ORF1 product was also detected in lysates of the hypovirulent strain but was absent in lysates of the isogenic virulent strain. It represents the first protein to be identified as a gene product encoded by a hypovirulence-associated double stranded RNA genetic element. PMID- 2721497 TI - Interaction of nuclear factors with the upstream region of the alpha-subunit gene of chicken muscle acetylcholine receptor: variations with muscle differentiation and denervation. AB - The region lying between nucleotides (nt) -110 and -45 of chicken acetylcholine receptor alpha-subunit gene 5' upstream sequence confers developmental control of expression in primary cultures of chicken myotubes. This region interacts with several nuclear factors present in muscle cells as shown by DNase I footprinting and gel-retardation experiments. An Sp1-like factor and a guanine stretch-binding protein were found to bind to overlapping sites immediately upstream of the TATA box. Several factors interacting in the same region with a domain similar to the SV40 enhancer core appeared during in vitro differentiation of myoblasts into myotubes. The concentration of some of these factors increased also after denervation of leg muscle in newborn chickens. The specific interaction of nuclear factors with this domain may thus play a critical role in the regulation of alpha-subunit gene expression by muscle differentiation and electrical activity. PMID- 2721498 TI - A novel human muscle factor related to but distinct from MyoD1 induces myogenic conversion in 10T1/2 fibroblasts. AB - We have isolated the cDNA encoding a novel human myogenic factor, Myf-5, by weak cross-hydridization to the mouse MyoD1 probe. Nucleotide sequence analysis and the identification of the corresponding gene indicate that human Myf-5 is a member of a small gene family which also contains the human homologue to MyoD1. Although structurally related to the mouse factor, the human Myf-5 constitutes a different protein which nevertheless is capable of inducing the myogenic phenotype in embryonic C3H mouse 10T1/2 'fibroblasts'. The existence of more than one MyoD1-like protein in human skeletal muscle is further suggested by the detection of several similar but distinct cDNA clones. The phenotypic conversion of 10T1/2 cells by the human factor is recognized by the capacity of the cells to form multinucleated syncytia and synthesize sarcomeric myosin heavy chains. Moreover, transient expression of Myf-5 in 10T1/2 cells leads to the activation of a co-transfected muscle-specific CAT reporter gene which by itself is transcriptionally silent in the non-muscle cell background. The deduced amino acid sequence of clone Myf-5 reveals a region which is highly similar to myc proteins and the developmental factors from Drosophila encoded by the achaete scute locus and the twist gene. The myc homology region and a preceding cluster of basic amino acids are located in a larger sequence domain with strong similarity to the mouse myogenic factor MyoD1. Two additional short segments with high serine and threonine content are conserved between the two proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721499 TI - Molecular cloning and characterization of the novel, human complement-associated protein, SP-40,40: a link between the complement and reproductive systems. AB - The cDNA sequence encoding the human complement-associated protein, SP-40,40, is reported. The two chains of SP-40,40 are coded in a single open reading frame on the same mRNA molecule, indicating the existence of a biosynthetic precursor protein which matures post-synthetically by the proteolysis of at least one peptide bond. The precursor is preceded by a signal sequence for vectorial export and contains six N-linked glycosylation sites distributed equally between the two chains of the structure. The sequence of the SP-40,40 precursor bears a 77% identity to a rat sulphated glycoprotein-2 (SGP-2) which is the major secreted product of Sertoli cells. The presence of SP-40,40 within human seminal plasma at levels comparable to those in serum was demonstrated, indicating that SP-40,40 and SGP-2 are serum and seminal forms of the same protein. A sequence of 23 amino acids within the beta-chain of SP-40,40 exhibited significant homology to corresponding segments located within complement components C7, C8 and C9. The short cysteine-containing motif represented the only evidence of a possible vestigial relationship between SP-40,40 and other complement components. The precise role of SP-40,40 is not known in either blood or semen but the present findings document an intriguing link between the immune and the reproductive systems. PMID- 2721500 TI - Evidence for the involvement of pim-2, a new common proviral insertion site, in progression of lymphomas. AB - We have compared proviral integrations near (putative) proto-oncogenes in Moloney murine leukemia virus-induced primary and transplanted T cell lymphomas. We previously found proviruses integrated near c-myc, pim-1, and N-myc in primary tumors (Selten et al., 1984; Van Lohuizen et al., 1989a; Van Lohuizen et al., 1989b). We have now identified an additional common proviral integration site, called pim-2, that carries somatically acquired proviruses in the majority of transplanted tumors. In primary tumors integration near pim-2 is usually undetectable or present in only a minor fraction of the tumor cells. This subpopulation selectively grows out upon transplantation. Insertion near pim-2 is a relatively late event in tumorigenesis and is often preceded by proviral insertions in other common insertion sites, yielding tumor clones which carry proviruses in up to three different common insertion sites within the same cell (c-myc, pim-1 and pim-2). The data suggest that pim-2 plays an important role in tumor progression. PMID- 2721501 TI - Human immunodeficiency virus type 1 LTR TATA and TAR region sequences required for transcriptional regulation. AB - The human immunodeficiency virus (HIV) type 1 LTR is regulated at the transcriptional level by both cellular and viral proteins. Using HeLa cell extracts, multiple regions of the HIV LTR were found to serve as binding sites for cellular proteins. An untranslated region binding protein UBP-1 has been purified and fractions containing this protein bind to both the TAR and TATA regions. To investigate the role of cellular proteins binding to both the TATA and TAR regions and their potential interaction with other HIV DNA binding proteins, oligonucleotide-directed mutagenesis of both these regions was performed followed by DNase I footprinting and transient expression assays. In the TATA region, two direct repeats TC/AAGC/AT/AGCTGC surround the TATA sequence. Mutagenesis of both of these direct repeats or of the TATA sequence interrupted binding over the TATA region on the coding strand, but only a mutation of the TATA sequence affected in vivo assays for tat-activation. In addition to TAR serving as the site of binding of cellular proteins, RNA transcribed from TAR is capable of forming a stable stem-loop structure. To determine the relative importance of DNA binding proteins as compared to secondary structure, oligonucleotide-directed mutations in the TAR region were studied. Local mutations that disrupted either the stem or loop structure were defective in gene expression. However, compensatory mutations which restored base pairing in the stem resulted in complete tat-activation. This indicated a significant role for the stem-loop structure in HIV gene expression. To determine the role of TAR binding proteins, mutations were constructed which extensively changed the primary structure of the TAR region, yet left stem base pairing, stem energy and the loop sequence intact. These mutations resulted in decreased protein binding to TAR DNA and defects in tat-activation, and revealed factor binding specifically to the loop DNA sequence. Further mutagenesis which inverted this stem and loop mutation relative to the HIV LTR mRNA start site resulted in even larger decreases in tat-activation. This suggests that multiple determinants, including protein binding, the loop sequence, and RNA or DNA secondary structure, are important in tat-activation and suggests that tat may interact with cellular proteins binding to DNA to increase HIV gene expression. PMID- 2721502 TI - Overlapping sites for constitutive and induced DNA binding factors involved in interferon-stimulated transcription. AB - A 14 bp interferon (IFN)-stimulated response element (ISRE) from 6-16, a human gene regulated by alpha-IFN, confers IFN inducibility on a heterologous thymidine kinase promoter. A 39 bp double-stranded oligonucleotide corresponding to a 5' region of 6-16 which includes the ISRE competes for factors required for gene expression by alpha-IFN in transfected cells and a single base change (A-11 to C) within the ISRE (GGGAAAATGAAACT) abolishes this competition. Band-shift assays performed with whole-cell extracts and the 39 bp oligonucleotide reveal specific complexes formed by rapidly induced and constitutive factors, both of which fail to bind to the A-11 to C oligonucleotide. A detailed footprinting analysis reveals that these two types of factors bind to overlapping sites within the ISRE, but in very different ways. These data were used to design oligonucleotides which decreased the formation of the inducible complex without affecting the constitutive one. Changes at the 5' margin of the ISRE and upstream of it markedly decrease formation of the induced but not the constitutive complex and also abolish the ability of the 39 bp sequence to function as an inducible enhancer with the thymidine kinase promoter. Thus, induction of 6-16 transcription in IFN-treated cells is likely to be stimulated by binding of the induced factor to the ISRE and upstream sequences, while the subsequent suppression of transcription may involve competition for the ISRE by the other class of factors. PMID- 2721503 TI - Gene replacement in Dictyostelium: generation of myosin null mutants. AB - The eukaryotic slime mold Dictyostelium discoideum has a single conventional myosin heavy chain gene (mhcA). The elimination of the mhcA gene was achieved by homologous recombination. Two gene replacement plasmids were constructed, each carrying the G418 resistance gene as a selective marker and flanked by either 0.7 kb of 5' coding sequence and 0.9 kb of 3' coding sequence or 1.5 kb of 5' flanking sequence and 1.1 kb of 3' flanking sequence. Myosin null mutants (mhcA- cells) were obtained after transformation with either of these plasmids. The mhcA cells are genetically stable and are capable of a variety of motile processes. Our results provide genetic proof that in Dictyostelium the conventional myosin gene is required for growth in suspension, normal cell division and sporogenesis, and illustrate how gene targeting can be used as a tool in Dictyostelium. PMID- 2721504 TI - The integrated conjugative plasmid pSAM2 of Streptomyces ambofaciens is related to temperate bacteriophages. AB - Streptomyces ambofaciens ATCC23877 and derivatives contain the 11-kb element pSAM2 present in an integrated state or as a free and integrated plasmid. This element, able to integrate site-specifically in the genome of different Streptomyces species, is conjugative and mobilizes chromosomal markers. Besides these plasmid functions, we have shown that the site-specific recombination system of pSAM2 presents strong similarities with that of several temperate phages. The integration event is promoted by a site-specific recombinase of the integrase family. The int gene encoding this integrase is closely linked to the plasmid attachment site (attP). A small open reading frame (ORF) overlaps the int gene and the predicted protein exhibits similarities with Xis proteins involved in phages excision. The integrated copy of pSAM2 in strain ATCC23877 is flanked by att sequences (attL and attR). Another att sequence (attX) is present in this strain and attX and attL are the boundaries of a 42-kb fragment (xSAM1) absent, as well as pSAM2, from S.ambofaciens DSM40697. Sequences partially similar to pSAM2 int gene are found near the chromosomal integration zone in both S.ambofaciens strains. The possible origin of pSAM2, an element carrying plasmid as well as phage features, is discussed. PMID- 2721506 TI - Anaesthesia of tomorrow. PMID- 2721505 TI - Outcome from intensive care. II. A 5-year study of 1308 patients: short-term outcome. AB - All patients (n = 1308) admitted to a multidisciplinary intensive care unit (ICU) during a 5-year period (1979-83) were followed prospectively. The in-unit mortality was 18% and the in-hospital mortality (mortality during ICU-stay plus mortality during the ensuing hospital stay) was 29%. Increasing age was associated with increasing in-hospital mortality, up to 40% mortality rate in patients aged 80 years and older. Using multiple logistic regression analyses, prognostic factors for mortality were identified. Risk factors for death in the ICU included age, cardiovascular diseases, sepsis, adult respiratory distress syndrome and acute renal failure. Cancer did not appear as a risk factor. The mortality during the ensuing hospital stay, however, was significantly influenced by cancer as well as the aforementioned risk factors. When controlled for severity of illness, expressed by the level of organ system failure after 48 h of ICU treatment, only sex, sepsis and severity of illness showed significant influence on the mortality in the ICU, and only sex and severity of illness significantly influenced mortality during the ensuing hospital stay after discharge from the ICU. PMID- 2721507 TI - A reflection filter for isoflurane and other anaesthetic vapours. AB - A new way of saving anaesthetic vapours is described. The method is analogous to the heat-moisture exchanger principle: the vapour is trapped in a filter during expiration and is returned to the patient during the subsequent inspiration. Fresh vapour is supplied on the patient side of the filter. A small container with 60 ml of a hydrophobic zeolite (an inorganic material) was used as filter. In model lung tests, this reduced the isoflurane consumption by 51% at a tidal volume of 300 ml, by 57% at 600 ml and by 51% at 930 ml. Neither isoflurane nor halothane yielded any degradation products when brought in contact with the zeolite. PMID- 2721508 TI - Comparison of intravenous and endobronchial atropine: a pharmacokinetic and dynamic study in pigs. AB - In an experimental animal study using adolescent pigs we compared the pharmacokinetics and -dynamics of atropine following intravenous injection (0.25 mg, n = 6) or endobronchial instillation (2 mg, n = 6). Results showed that endobronchial atropine is rapidly absorbed by the pulmonary circulation, resulting in a peak plasma concentration of 48.8 +/- 25.9 ng ml-1 (mean +/- SD) after 2 min, compared to 46.3 +/- 16.7 ng ml-1 in the first min after intravenous injection. A first increase in heart rate could be observed within 1 min after both routes of drug administration. Significant changes in heart rate were found 9-30 min after endobronchial and 12-15 min after intravenous medication, with a maximum after 9 min (+57%) and 12 min (+24%), respectively. Mean bioavailability of atropine following the endobronchial route reached only 23% during the first 6 h when compared to intravenous administration. In light of this reduced bioavailability, we suggest an adult dosage in humans of atropine 2 mg diluted in 5-10 ml of saline administered endobronchially to attain a reliable increase in heart rate during a cardiac emergency when, in an intubated individual, no intravenous line is readily available. PMID- 2721509 TI - Left ventricular segmental wall motion score as a criterion for selecting patients for direct surgery in the treatment of postinfarction ventricular tachycardia. AB - No indisputable criteria for selecting candidates for direct surgery in postinfarction ventricular tachycardia are yet available. We prospectively tested the result of surgery in patients showing normokinesia or slight hypokinesia in at least 3 of 9 segments of the left ventricle as determined on two oblique projections of the left ventricular angiogram. Sixty consecutive patients with recurrent symptomatic ventricular tachycardia were stratified on the basis of this criterion; 50 candidates were thus eligible for surgery. Direct surgery (endocardial resection and/or cryoablation) was performed in 23 patients (after a mean of 4.1 antiarrhythmic drug trials), while 27 patients were maintained on drug treatment (at discharge, a mean of 3.7 drug trials). Surgery was map-guided in 19 patients and non-map-guided in four emergency cases. No patients died in the immediate postoperative phase, but two (9%) died during follow-up. The actuarial survival at 12 months was 93%; the surgery-alone cure rate for ventricular tachycardia was 78%. Of the 27 non-operated surgical candidates, two died during in-hospital drug testing and five after discharge (total 26%). Actuarial survival at 12 months was 78% and did not differ significantly from that of the operated patients. After discharge, 80% of the non-operated surgical candidates still using the drug at discharge remained free of recurrence. In the 10 drug-treated non-surgical candidates (at discharge, a mean of 3.8 drug trials), survival and the number of arrhythmia-free patients were markedly lower than in surgical candidates. This study shows that the segmental wall motion score is of great clinical value and can be applied for stratification of patients with ventricular tachycardia after myocardial infarction for either surgery or medical therapy. PMID- 2721510 TI - Spectral mapping of the electrocardiogram with Fourier transform for identification of patients with sustained ventricular tachycardia and coronary artery disease. AB - In time domain analysis, detection of late potentials is limited by high pass filtering, noise interference and the necessity to exclude patients with bundle branch block. We therefore used frequency analysis with Fourier transform of multiple segments of the surface electrocardiogram (25 segments, size 80 ms, time shift 3 ms) during sinus rhythm after signal averaging. Thirty-two post myocardial infarction patients with sustained ventricular tachycardia (VT), 19 post-myocardial infarction patients without VT and 17 healthy subjects were studied. A total of 18 patients had bundle branch block. In 24 out of 32 patients with VT, three-dimensional spectral plots were characterized by spectral peaks greater than 10 dB in the range of 40-200 Hz in segments only at the end of QRS and the early ST wave, but not far outside the QRS. In only 2 out of 19 patients without VT and in 1 out of 17 healthy subjects could such peaks be observed. Noise caused spectral peaks throughout all segments. Sixteen out of 18 patients with bundle branch block were correctly classified with spectral mapping. With the Simson method, patients with bundle branch block had to be excluded, abnormal results were found in 10 out of 19 patients with VT, but also in 5 out of 15 patients without VT and in 3 out of 16 healthy subjects. Thus, spectral mapping of the electrocardiogram offers promise for better identification of patients prone to sustained VT in the presence of coronary artery disease. PMID- 2721511 TI - Interobserver and echo-angio variability of two-dimensional colour Doppler evaluation of aortic and mitral regurgitation. AB - Colour Doppler flow mapping (CD) has proved to be a very sensitive and specific means of diagnosing valvular regurgitation and obtaining a rapid semiquantitative estimation of the severity of regurgitation itself. We tried to compare a semiquantitative evaluation of aortic and mitral regurgitation, without time consuming calculations of regurgitant jet areas, with the conventional visual semiquantitative angiographic estimation. We have also evaluated in detail the interobserver variability of this type of semiquantitation. Two independent observers (OB) have reviewed CD studies of a selected group of 47 consecutive patients who underwent both cineventriculography and aortography for aortic regurgitation (AR) and/or mitral regurgitation (MR), then graded as mild, moderate or severe. At CD, AR and MR were classified as present or absent and graded as mild, moderate or severe. The following interobserver percentage agreements were noted for AR presence or absence, AR grade, MR presence or absence, MR grade, respectively: 96%, 83%, 96%, 83%. Likewise, the respective echo-angio agreements were 90%, 58%, 80%, 70%. Agreement was significant (P less than 0.001) in all cases. Thus, good interobserver and echo-angio agreement was found in the CD assessment of AR and MR. However, under- or overestimation of CD vs. angio was noted in several cases (mostly by one grade). Underestimation of CD vs. angio was 27% for AR and 18.5% for MR; overestimation of CD vs. angio was 15% for AR and 11.5% for MR. CD has proved to be a useful technique not only for the qualitative but also for the semiquantitative evaluation of aortic and mitral regurgitation, as assessed in the same subjects, with good interobserver agreement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721512 TI - Relationship of QRS amplitude to left ventricular dimensions after acute blood volume reduction in normal subjects. AB - The relationship between the acute reduction in left ventricular dimensions induced by intravenous frusemide and scalar electrocardiographic QRS amplitude was studied in 14 normal subjects. The major electrocardiographic change was a significant increase in QRS voltages inversely proportional to the changes in left ventricular dimensions. This effect was opposite to the change predicted by the Brody effect. Surface electrocardiographic voltages are greatly influenced by myocardial cell orientation and the effective dipoles of the wave of activation are parallel to the long axes of cardiac fibres. As in the normal ventricle the arrangement of fibres is mainly circumferential, the body surface potentials are strongly affected by longitudinal wave front voltages. We suggest that during acute reduction of blood volume the inverse relationship of left ventricular volume and QRS amplitude can be explained by a reduced short-circuiting effect of blood mass on a longitudinally directed wave of activation. PMID- 2721513 TI - What is the ideal orientation of a mitral disc prosthesis? An in vivo haemodynamic study based on colour flow imaging and continuous wave Doppler. AB - Doppler colour flow imaging demonstrates normal laminar flow to enter the left ventricle in diastole through the mitral inflow tract located posteriorly in the left ventricle. Laminar flow then passes around the left ventricular apex to the anteriorly located outflow tract. As this is the normal physiologic flow pattern, it would seem appropriate that in the surgical implantation of a mitral tilting disc prosthesis the greater orifice should be directed posteriorly to mimic the normal native valve flow pattern. To determine whether variable positioning of the greater orifice had any significant haemodynamic consequences, intracavitary blood flow patterns were studied in 30 patients with mitral Bjork-Shiley prostheses variously orientated in the mitral orifice. The orientation of the greater orifice (OGO) of the prosthesis was determined by fluoroscopy and the pattern of the left ventricular inflow from Doppler colour flow imaging. Twelve patients had their OGO and inflow directed towards the inflow tract (orientation I): nine patients had their OGO and inflow directed anteriorly towards the outflow tract (orientation II) and nine patients had their prosthesis with OGO and inflow in an intermediate position (orientation III). The mean prosthetic diastolic gradient, calculated using continuous wave Doppler, averaged 2.8 mmHg (+/- 0.5 mmHg) for the 25-mm prosthesis in orientation I, but 6.0 mmHg (+/- 0.7 mmHg) for the same size prosthesis in orientation II and 5.8 mmHg (+/- 0.9 mmHg) with a 25-mm prosthesis in orientation III. Similarly, for prostheses of 27 mm and 29-31 mm the lowest mean diastolic gradient was found in orientation I (2.7 mmHg +/- 0.8 and 2.8 mmHg +/- 0.5, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721514 TI - Unorthodox diagnostic procedure in a rare case of intrapericardial malignant schwannoma. AB - To establish preoperatively the cytology of a large right atrial tumour, an echoguided transcutaneous thin needle aspiration using a transhepatic approach was performed. Cytology suggested myxoma, which had been mimicked by regressive changes within the tumour, while the histologic examination of the removed specimen revealed a malignant pericardial Schwannoma. In spite of this discrepancy we think that solid tumours located at the free atrial wall are accessible to ultrasound guided puncture without great risk. PMID- 2721515 TI - Latent functional duality in an accessory pathway. AB - Accessory atrioventricular pathways classically possess neither decremental conduction nor functional duality. This report details an accessory pathway in which functional longitudinal dissociation, with decremental ventriculoatrial conduction in each component, was observed after, but not before, administration of the antiarrhythmic drug recainam. PMID- 2721516 TI - The methods and results of uterine body cancer: a twenty-year experience of treatments at the Tbilisi Oncological Center. AB - In the period 1968-1987 at the Oncological Scientific Center of Tbilisi 1100 Endometrial Cancer were observed. All patients were treated surgically and in particular 89.9% cases with total hysterectomy and adnexectomy; 9.8% with hysterectomy, adnexectomy and lymphadenectomy; 0.3% with Wertheim's operation. The Author suggests a pathological staging system with in the first stage (cancer limited to the uterus) in order to better select the treatment and prognosis of patients. According to his classification 5 years survival was 88.1% when tumour was absent in the operative specimen; 82.6% when the tumor was less 2 cm; 67.5% for tumour more than 2 cm; 60.3% when less than half of the myometrium was involved and 40.8% with more than half of the myometrium. The Author confirms the validity of surgical therapy in endometrial cancer eventually associated with hormonal and/or radiotherapy for the cases more at risk. PMID- 2721517 TI - Second neoplasm: a complication of cancer treatment. AB - Two cases of second tumors induced by chemo and/or radiotherapy used in the treatment of gynecological neoplasms, are described. A comparison with data reported in the Literature was performed. PMID- 2721518 TI - Early results of local application of 13-cis retinoic acid in the treatment of leukoplakia of the vulva. AB - A group of 35 patients with leukoplakia of the vulva was treated with 13-cis retinoic acid applied topically. Complete or partial remission occurred in 17 patients. Parallel determination of retinol level in sera revealed its increased value as compared to healthy persons. PMID- 2721519 TI - Complications of pelvic lymphadenectomy in patients with endometrial adenocarcinoma. AB - The complications of surgical treatment in 193 cases of endometrial adenocarcinoma, subdivided into two groups, were analyzed: 58 without lymphadenectomy and 135 with systematic pelvic lymphadenectomy before total abdominal hysterectomy and bilateral salpingo-oophorectomy with vaginal cuff. The only significant differences concern the number of patients requiring transfusions and the length of the postoperative stay. It is suggested that lymphadenectomy should always be performed when an abdominal approach is chosen. PMID- 2721520 TI - Simultaneous appearance of ovarian and endometrial carcinoma: a therapeutic challenge. AB - We have analyzed 37 cases of simultaneous appearance of carcinoma in the ovary and endometrium. This paper deals with the question of whether they should be considered stage III endometrial carcinomas, stage II ovarian carcinomas or independent primary tumors. The cases were grouped according to their histology as endometrioid ovarian carcinomas with endometrial carcinoma (group A), same carcinoma, but not of endometrial origin in both organs (group B) and histologically different concomitant carcinomas of ovary and endometrium (group C). Although our series was small, the survival was better than could have been expected either for stage III endometrial carcinoma, or stage II ovarian carcinoma. This supports the view that many of those tumors should be considered independent stage I carcinomas. Another fact in favour of this hypothesis is the strong correlation between myometrial invasion and prognosis in these cases, which is comparable to that found in endometrial carcinoma alone. PMID- 2721521 TI - A cytoplasmatic estrogen receptor related protein (ER-D5 Ag) in breast cancer. AB - A monoclonal antibody against an Estrogen Receptor Related Protein (EG-D5 AG by Amersham) was analyzed in evaluating hormone dependence in 188 breast cancers, in addition to current index of steroid receptors. The Authors observed that the concentration of this new Antigen is not related with PgR but with ER concentration. In fact, increasing the ER values, increases the concentration of ER-D5 Ag, showing a good correlation between these two tumoral markers. In regard to Progesterone Receptor ranges, the ER-D5+ves were equally distributed between PgR-ves and PgR+ves Our experience suggests the application of ER-D5 Ag as R-ves tumor screening marker and emphasizes the importance of a second level in determining therapy and prognosis in breast cancer. PMID- 2721522 TI - Can the uterine cervix grow a moustache? AB - The exceptional founding of a sebaceous gland in the squamous epithelium of the uterine cervix are described. The possible embriologic origin are discussed. PMID- 2721523 TI - Correlation between cervical intraepithelial neoplasia and invasive cervical carcinoma on the basis of their frequency in the Province of Trieste (1977-1986). AB - The Authors report the results of a study on the diffusion of CIN and of invasive carcinoma of the portio in the Trieste population over the 1977-1986 decade. In order to achieve this aim all the bioptical specimens analyzed in the Institute of Pathological Anatomy and Histology of Trieste University were reviewed. Over this period 313 cases of CIN 1-2, 314 cases of CIN 3 and 289 of invasive carcinoma were diagnosed. The average age for CIN 1-2 lesions was 33.5 (range 17 78), for CIN 3 39.9 (range 18-81) and for invasive carcinoma 58.6 (range 26-89). The distribution by age group was markedly different in the three types of lesion dealt with, showing a substantial presence of preinvasive lesions under the age of 50. During the period considered a significant decrease in the incidence of invasive carcinoma was not recorded, in contrast with other reports. This datum may be explained by the fact that the number of women undergoing cyto-oncological screening has not increased over the last decade. PMID- 2721524 TI - Serum calcium level in patients with carcinoma of the cervix in relation to menstrual status. AB - Serum levels of calcium and phosphorous were evaluated in patients with carcinoma of the cervix between pre- and post-menopausal women and compared the same with various normal female populations of different physiological status, involving premenopause, postmenopause and third trimester of pregnancy. Hypercalcemia was noted both in premenopausal and postmenopausal cervix cancer patients although this is more marked in the latter. No definite relationship was observed between serum calcium and phosphorous (inorganic) level. The discordance in serum calcium level assumes significance in the light of hormonal status between the pre- and postmenopausal state of cancer patients. PMID- 2721525 TI - The influence of perimenopausal age on estrogen receptor status and estradiol and DNA content in human breast cancer. AB - In 25 cases of breast cancer occurring in perimenopausal age, estrogen receptor (ER) content was determined by the dextran-coated charcoal (DCC) assay and both endogenous-bound estradiol and nuclear DNA concentrations were measured by computerized quantitative analysis on formalin-fixed paraffin-embedded tissue samples. No statistically significant relationship (p greater than 0.05) was found within these parameters. The high incidence (64%) of ER-negative cases in this menopausal age was mainly due (62.5%) to interference of high levels of endogenous estradiol occupying the receptor sites in-vivo. The prevalence of hormone-insensitive and aneuploid cell clones accounted for the remaining true ER negative tumours (37.5%). PMID- 2721526 TI - Advanced ovarian cancer: urinary tract resection as a part of cytoreductive surgery. AB - Maximum surgical effort to minimize residual tumor following primary surgery has been shown to increase mean survival in patients with epithelial ovarian cancer. From September, 1983 to November, 1987, 22 patients underwent resection of the urinary tract as a part of cytoreductive surgery. Seven patients underwent partial cystectomy, four underwent partial cystectomy with ureteroneocystotomy, five patients underwent ureteroneocystotomy while an additional four patients underwent ureteroureteral anastomosis. One patient underwent primary transverse colon conduit while another underwent a similar procedure after developing urinary leakage. All anastomoses were protected with indwelling stents while the urinary bladder was drained with an indwelling Foley catheter for ten days. Both patients requiring conduits had undergone prior radiation therapy in addition to chemotherapy. Nine major and two minor complications occurred in seven patients. One patient died six weeks postoperatively after concurrent hepatic resection. Optimal cytoreduction was possible in 59% of the patients, and was associated with a mean survival of 15.2 months. Optimal cytoreduction including resection of the urinary tract was associated with longer survival and acceptable morbidity and it appears to be justified in patients with ovarian cancer. PMID- 2721527 TI - The clinical value of lymphography in cervical cancer, FIGO-stage Ib-IIa. AB - We report the limited value of lymphography in detecting lymphnode-metastases in 54 patients with operable cervical cancer, FIGO-stage Ib-IIa. A low predictive value of the positive lymphogram and low sensitivity of lymphography were found. This was not affected by the use of strict criteria in assessing the lymphograms. Analysis of the sensitivity of lymphography showed poor ability of the radiologist in localising a metastasis in a patient. High accuracy of lymphography and high specificity were found relatively easy to achieve. They are of minor clinical importance. Only 29 percent of patients with proved lymphnode metastases had lymphographical evidence at the site of these metastases. It was decided not to continue the routine use of lymphography in this group of patients. PMID- 2721528 TI - Complications of uterine cervix treatments: proposal for a glossary for a uniform classification. AB - Complications and inevitable sequelae or side effects of Uterine Cervix Cancer Treatments are reported in many Papers. Some Authors simply describe the observed complications, others use some kind of Classification. The major problem is that, as complications are often a very soft endpoint, reporting criteria and classifications used vary from one Author to another, in such a way that no comparison is possible between data reported by different Authors. Sometimes the same Author uses different classifications and reporting criteria in different papers. Moreover no comparison is possible between complications arising from different treatment modalities like Surgery, Radiotherapy or combined Radio Surgical treatment. In this paper a classification encompassing virtually all the complications that can be observed with any possible treatment of uterine cervix cancer is proposed. Complications, divided by anatomical site and classified in different degrees according to their severity, are gathered into a glossary. General rules for the use of the glossary are given. PMID- 2721529 TI - Early stromal invasion of the vulva. AB - 151 vulvectomy operation specimens and 154 biopsies from the vulva were examined. They represented either dysplasias, carcinomata in situ or invasive squamous cell carcinomas. 17.4% of the cases showed early stromal invasion as well in dysplasias and carcinomata in situ as in the margins of the invasive carcinomas. On the other hand the early stromal invasion of the vulva does not show such striking alterations as does that of the cervix uteri. PMID- 2721530 TI - Effective treatment of chronically progressive multiple sclerosis with low-dose cyclophosphamide with minor side-effects. AB - Twenty-one multiple sclerosis (MS) patients with a chronically progressive course were treated with a low dose of cyclophosphamide (CY). The control group consisted of 21 MS patients with a chronically progressive course who received the standard treatment (ACTH or cortisone). The control group consisted of patients who preferred the standard therapy because of its beneficial effects. In contrast, the patients of the CY group wanted to try a new therapy because the standard therapy was not effective. Thus before starting the study the progression of the disease was faster in the CY group than in the standard therapy group. As regards age, sex and degree of disability, the two groups were comparable. For 20 of the 21 patients in the CY group the degree of disability (Kurtzke scale) remained stable over 1 year; for 2 of the 20 stable patients there was even an improvement. In the standard therapy group, 7 out of 21 patients were stable over 1 year, while 14 showed progressive disability. A quantitative neurological score at the beginning and 1 year after the therapy showed a nearly identical difference between the CY group and the control group. The changes of the patients' abilities in daily-life activities (which were observed and recorded by the nurses) were similar to the Kurtzke scale data obtained by the physicians. The beneficial effect of CY in chronically progressive MS was thus highly significant (P less than 0.001). The side-effects of low-dose CY were fewer than those of ACTH. PMID- 2721531 TI - Pituitary adenoma and meningioma in the same patient. Report of three cases. AB - Three patients are presented in whom both pituitary adenoma and meningioma were found. The pituitary tumour was a prolactinoma in one case and non-secreting adenoma in the other two. In one case the meningioma originated from the planum sphenoidale and was seperate from the pituitary adenoma. Another patient had a parasellar meningioma, which was suspected preoperatively by different enhancement on the CT scan. In the third case, both tumours were mainly infradiaphragmatic and could not be differentiated preoperatively or intraoperatively. This appears to be the first case with both tumours below the diaphragm. The clinical, radiological and histopathological findings are presented. PMID- 2721532 TI - The influence of age on the natural history of unipolar depression when treated with electroconvulsive therapy. AB - The influence of age on the natural history of unipolar depression when treated with electroconvulsive therapy (ECT) was studied using a naturalistic/archival study design. A sample of 125 patients who received no somatic treatment were compared with 128 patients who all received a course of ECT with at least four treatments. Patients were separated according to age at admission. Treated patients, aged 40 or older, who were clearly remitters showed no differences in previous episodes, subsequent episodes, subsequent hospitalizations, or likelihood of experiencing a period of full recovery when compared with a similar group of untreated patients. Hospitalization greater than 1 year and chronicity were significantly more common in the untreated older subjects. Treated patients aged 39 or younger, who also were clearly remitters, showed significant increases in subsequent episodes and subsequent hospitalizations when compared with a group of depressed patients of similar age who received no somatic treatment. Hospitalization greater than 1 year was also more common in the untreated younger patients. ECT clearly reduces the rate of chronicity in older patients but may be associated with an increase in episodes after treatment in the younger population. PMID- 2721533 TI - Conversion disorder (DSM-III 300.11): symptomatology and course in childhood and adolescence. AB - The incidence, age and sex distribution, symptomatology, psychosocial stress factors and course of conversion symptoms in a child and adolescent psychiatric patient sample were studied. Under the age of 10 conversion symptoms are comparatively rare and consequently require careful diagnosis, particularly regarding visual and hearing defects. Predominant conversion symptoms are seizures, gait problems and paralysis. PMID- 2721534 TI - The validity of the French version of the GHQ-28 and PSYDIS in a community sample of 20 year olds in Switzerland. AB - The 28-item GHQ (General Health Questionnaire) and the 43-item PSYDIS (Psychic Distress) were translated into French and administered to a community sample of 233 young adults. Of the two tests, the GHQ was shown to have the better correlation with the clinical assessment. For PSYDIS, specificity was 72.8, sensitivity was 64.2, but the misclassification rate rose to 29.2. The GHQ misclassified 18.5% of the respondents at the best cut-off point (5/6), with a specificity of 91.1 and a sensitivity of 49.1. The corrections C-GHQ (Goodchild and Duncan-Jones method of scoring) and simple Likert scoring improved sensitivity, although this was still unsatisfactory with males. Considering the lability of troubles in a young population, the GHQ should be applied with caution for epidemiological purposes. PMID- 2721535 TI - Symptoms in the first two years of life. A preliminary population study of infantile autism. AB - A population sample of autistic children (n = 26) were compared retrospectively with age- and sex-matched mentally retarded children (n = 20) and age- and sex matched population-representative children (n = 25) on a 130-item questionnaire to the mother concerning characteristic features of the child's behaviour in the first 2 years of life. Thirteen items discriminated clearly between the groups. The results are discussed in the context of early screening for autism. PMID- 2721536 TI - Lipid peroxidation and superoxide dismutase activity in muscle and erythrocytes in adult muscular dystrophies and neurogenic atrophies. AB - Lipid peroxidation (LP) and superoxide dismutase (SOD) activity were determined in erythrocytes and skeletal muscle obtained from patients with limb-girdle and facioscapulohumeral muscular dystrophies, neurogenic atrophies and from age matched control subjects. Neither lipid peroxidation nor SOD activity in erythrocytes of patients differed from control values. SOD activity and LP in muscle specimens were also normal in types of neurogenic atrophy. Lipid peroxidation in the muscle from patients with adult types of muscular dystrophy had a tendency to be increased. The values were widely scattered, the highest being obtained in the older patients with long duration of disease. PMID- 2721537 TI - Cardiovascular regulation and lipoprotein profile during administration of co dergocrine in essential hypertension. AB - Co-dergocrine has recently been demonstrated acutely to lower plasma norepinephrine (NE) and blood pressure (BP) in patients with essential hypertension, and similar results have been obtained during chronic administration of co-dergocrine to healthy men. The present study investigated the effect of 3 weeks of treatment with co-dergocrine 4 mg/day on BP, plasma catecholamines, certain other BP-regulating factors and serum lipoproteins in patients with essential hypertension. Compared to placebo conditions, co dergocrine decreased supine BP and heart rate by -7% and the upright plasma NE level by -24%. Supine plasma NE also fell (-24%). Total cholesterol and the LDL + VLDL-cholesterol lipoprotein fraction were lowered by -6%. No significant change was observed in plasma renin activity, angiotensin II, aldosterone and epinephrine levels, whole blood and plasma volume, exchangeable sodium, and the cardiovascular responsiveness to NE, angiotensin II and isoproterenol. The findings suggest that in patients with essential hypertension, chronic treatment with co-dergocrine may slightly decrease sympathetic outflow and, at least in the short-term, lower the potentially atherogenic serum LDL + VLDL - cholesterol fraction. PMID- 2721538 TI - Effect of N-acetylcysteine on plasma cysteine and glutathione following paracetamol administration. AB - The effect of oral N-acetyl-L-cysteine (NAC) on plasma sulphhydryls has been studied in healthy volunteers. Following NAC 30 mg.kg-1, total NAC in plasma (i.e. free NAC and NAC as disulphides) reached a median peak concentration of 67 nmol.ml-1 within 45 to 60 min, and disappeared with an apparent half-life of 1.3 h. Only a fraction of total NAC (AUC 163 nmol.ml-1.h) was in the form of free NAC (AUC 12 nmol.ml-1.h, peak concentration 9 nmol.ml-1). Free cysteine was markedly increased (peak increment 49 nmol.ml-1; AUC 80 nmol.ml-1.h). Total cysteine and free and total glutathione in plasma were unchanged. Following the administration of 2 g paracetamol plasma cysteine and glutathione decreased (median decrement in AUC over 3 h was 5.1 nmol.ml-1.h and 3.8 nmol.ml-1.h, respectively). In contrast, the administration of 2 g NAC together with paracetamol resulted in an increase in the AUC of cysteine (+29.2 nmol.ml-1.h) and glutathione (+4.6 nmol.ml-1.h). The data show that NAC leads to a marked increase in circulating cysteine, in part by reacting with cystine and thereby forming mixed disulphides with cysteine and releasing free cysteine as shown in vitro. NAC had no effect on plasma glutathione in the absence of increased stress on the glutathione pools. However, NAC supports glutathione synthesis when the demand for glutathione is increased, as during the metabolism of paracetamol. PMID- 2721539 TI - Renal clearance of theophylline and its major metabolites: age and urine flow dependency in paediatric patients. AB - The renal clearance of theophylline (TH) and its metabolites 1,3-dimethyluric acid (1,3-DMU), 3-methylxanthine (3-MX), and 1-methyluric acid (1-MU) has been studied in 10 children aged 8 months to 14 years. Individual renal clearances were calculated from serum levels and amounts excreted in urine after i.v. administration of the parent drug. The clearance of 1,3-DMU was found to depend both upon urine flow rate and age, which are interrelated. An effect of urinary pH was expected, but was not studied. Consistent age-dependent changes in the relative quantities of metabolites excreted were not observed. PMID- 2721540 TI - Acetylator phenotype and congenital malformations. AB - The hypothesis has been tested that an unusual maternal acetylator phenotype can predispose to congenital malformations in the fetus. The acetylator phenotype of normal caucasian control women and of mothers of malformed children was established by measuring urinary sulphadimidine and its acetylated metabolite. A further control group was the fathers of the malformed newborn. The malformations studied were facial-cleft, spina-bifida and congenital heart disease. The acetylator phenotype was shown not be modified by pregnancy. 49 of 100 (49%) control women were rapid acetylators. Amongst the 108 mothers of malformed babies, 56 (52.8%) were slow acetylators and 52 (47.2%) were fast acetylators, 42 out of 83 (50.5%) of the fathers of malformed were slow acetylators and 41 (49.5%) were fast acetylators. Thus, the acetylator phenotype of the mothers of malformed children is no different from the acetylator phenotype of controls. PMID- 2721541 TI - Influence of renal failure, rheumatoid arthritis and old age on the pharmacokinetics of diflunisal. AB - The single-dose plasma kinetics of diflunisal was studied in healthy young and old subjects, in patients with rheumatoid arthritis, and in patients with renal failure. The plasma and urine kinetics of the glucuronidated metabolites of diflunisal were studied in the healthy elderly subjects and in the patients with renal failure. In addition, the multiple-dose plasma kinetics of diflunisal was assessed in healthy volunteers and in patients with rheumatoid arthritis. After a single dose of diflunisal the terminal plasma half-life, mean residence time and apparent volume of distribution were higher in elderly subjects than in young adults. No difference was observed in any pharmacokinetic parameter between age matched healthy subjects and patients with rheumatoid arthritis. The elimination half-life of unchanged diflunisal was correlated with the creatinine clearance (r = +0.89) and its apparent total body clearance exhibited linear dependence on creatinine clearance (r = +0.78). In patients with renal failure, the terminal plasma half-life and mean residence time of diflunisal were prolonged. The renal and apparent total body clearances were lower, the mean apparent volume of distribution was higher and the mean area under the concentration-time curve extrapolated to infinity (AUC) was greater in the renal failure patients than in controls. The plasma concentration of the glucuronidated metabolites rapidly rose to levels above those of unchanged drug in renal patients, whereas they were lower than those of unchanged diflunisal in controls. The AUC (0-96 h) of diflunisal glucuronides in the patients was four-times that in controls, and the terminal elimination half-life of the glucuronides was prolonged in them. The renal excretion and clearance of diflunisal glucuronides were reduced when renal function was impaired. After multiple dosing, the pre-dose steady-state plasma concentration increased with decreasing creatinine clearance (r = -0.79). When the plasma concentration exceeded 200 mumols.l-1, the elimination half-life was doubled, due to partial saturation of diflunisal conjugation. This finding suggests that lower doses could be used in long-term treatment. Thus, old age and arthritic disease appear to have little influence on the kinetics of diflunisal in the absence of renal functional impairment. Ordinary doses can be given for short term treatment of elderly patients with or without RA. In patients with renal failure, however, reduced doses of diflunisal are recommended. PMID- 2721542 TI - Inhibitory effect of free fatty acids on plasma protein binding of disopyramide in haemodialysis patients. AB - The plasma (or serum) protein binding of disopyramide (DSP) in five haemodialysis patients was studied using an ultrafiltration technique. There was an increase in the free fraction of DSP in the plasma on dialysis days in comparison to the levels on interdialysis days, which was associated with an elevation of the free fatty acid levels in the plasma together with the increase of the free fraction of DSP. The inhibitory effect of free fatty acids on DSP binding in an in vitro study was enhanced in proportion to their concentrations, and was shown to be due to competition at one binding site by experiments with oleic acid as a representative displacer. Certain endogenous organic acids, such as indoxyl sulphate, 2-hydroxyhippuric acid and hippuric acid, which are characteristically elevated in chronic renal failure, scarcely affected the protein binding of DSP. The findings indicate that free DSP should be monitored in patients with elevated plasma free fatty acid levels, such as those on haemodialysis therapy. PMID- 2721543 TI - Dose equivalence of midazolam and triazolam. A psychometric study based on flicker sensitivity, reaction time and digit symbol substitution test. AB - The pharmacodynamic potency of oral midazolam, a new ultrashort-acting hypnotic benzodiazepine, has been evaluated relative to a standard dose of triazolam, a well established oral benzodiazepine with a similar pharmacological profile. In a balanced design, double-blind cross-over study 6 healthy volunteers received 3.75, 7.5, and 15 mg midazolam and 0.25 mg triazolam orally, at 8 a.m., at weekly intervals. Drug effects were repeatedly measured over 8 h by a new psychometric method, the threshold amplitude for perception of flickering light (TPF) assessed at 5 and 30 Hz. Auditory reaction time, digit-symbol substitution test (DSST), and self-rating by subjects served as reference standards. Median midazolam doses equivalent to 0.25 mg triazolam, interpolated on dose-response curves for peak effects, were 5.2 mg (TPF 30 Hz), 6.4 mg (TPF 5 Hz), 6.5 mg (DSST), and 7.4 mg (reaction time), respectively. Alternative methods of data analysis gave similar results. Introduction of TPF as a highly reproducible and sensitive measure of the effect of benzodiazepines on the CNS offers new opportunities to compare the relative potencies of different benzodiazepines in man. Since clinical experience has shown 0.25 mg triazolam to be safe and effective, it is concluded that the corresponding single oral dose of midazolam is between 5 and 8 mg. PMID- 2721544 TI - Effects of buprenorphine on motor activity of the sphincter of Oddi in man. AB - Buprenorphine, (Temgesic), a N-cyclopropylmethyl derivative of oripavine, is both an agonist and antagonist of morphine. Its effect on the motility of the sphincter of Oddi (SO) in humans have been investigated by endoscopic manometry (EM). Buprenorphine leads to a significant decrease in the amplitude of SO contraction waves without altering other parameters. Thus, it has no morphine like effect on SO motility, but it does act like a partial antagonist of morphine in reducing the amplitude of SO contraction waves. PMID- 2721545 TI - Transcutaneous absorption of naproxen gel. AB - The kinetics of naproxen was studied in healthy volunteers after cutaneous application of gels containing 5 and 10% of the drug. Bioavailability was estimated from serum concentration and cumulative urinary metabolite excretion data, both determined up to 96 hours after drug administration. The mean bioavailability after the 10% gel was 1.1% (serum data) and 1.0% (urine data), and after the 5% gel it was 2.1% (serum data) and 1.8% (urine data). Despite the small amount of naproxen absorbed, a potential pharmacological effect, due to cutaneous accumulation of the drug following topical administration, may be suggested from the course of the serum concentration-time curves. PMID- 2721546 TI - Intraventricular self-administration of heroin in the rat: reward seems dissociated from analgesia and physical dependence. AB - Experimentally naive rats were implanted with a cannula in the lateral ventricle of the brain and were allowed to self-administer heroin in doses of 0.125, 0.25, 0.5, 1 or 2 micrograms/infusion or placebo for five daily sessions of 3 h. The number of self-injections was related to the unit dose in an inverted U-shaped manner: the 0.5 microgram/infusion dose induced the highest infusion rate. The total heroin intake was proportionally related to the unit dose. A hot-plate test performed immediately after the fourth session revealed no analgesic effects in any of the groups that self-administered heroin. A naloxone (10 mg/kg) challenge given immediately after the fifth session induced very mild withdrawal signs only in the group that administered the highest dose of heroin. The results indicate that rats readily acquire intraventricular heroin self-administration behaviour and suggest that the rewarding effects of heroin can be dissociated from its analgesic and physical dependence-inducing effects. PMID- 2721547 TI - N alpha-acetyl-[Arg8]vasopressin antagonizes the behavioral effect of [Cyt6]vasopressin-(5-9), but not of vasopressin. AB - It has been found recently that N alpha-acetyl-[Arg8]vasopressin (Ac-VP) is present in the brain of rats. The physiological significance of this peptide is as yet unknown. Therefore, the central nervous system effects of this peptide were investigated, namely, its effects on passive avoidance behavior, exploratory behavior and body temperature. The interaction of Ac-VP with the central nervous system effects of vasopressin (VP) was also studied. Ac-VP had a slight agonistic effect on passive avoidance behavior, i.e. it facilitated passive avoidance behavior at a dose 100 times higher than that of VP. Relatively low doses (3-10 ng) of Ac-VP attenuated passive avoidance behavior, which suggests that Ac-VP interfered with an endogenous compound involved in the control of passive avoidance responding. Ac-VP was also able, albeit in higher doses (30 ng), to competitively antagonize the effect of [Cyt6]VP-(5-9), a highly potent, putative endogenous metabolite of vasopressin in the rat brain. This antagonism could be due to an interaction of Ac-VP with sites other than the V1 vasopressin receptor. Ac-VP had no significant influence on other central nervous system effects of the hormonally active nonapeptide VP, such as exploratory behavior and body temperature. These effects were readily antagonized by the V1 vasopressin receptor antagonist d(CH2)5Tyr(Me)VP. Ac-VP may be competitive antagonist of behaviorally active vasopressin metabolite(s) in the brain. PMID- 2721548 TI - Cardiac and hemodynamic effects of the selective bradycardic agent KC 8857 during exercise-induced myocardial ischemia. AB - The effects of an in vitro bradycardic agent without negative inotropism, KC 8857 (3,7-di-(cyclopropylmethyl)-9,9-tetramethylene-3,7-diazabicyclo-[3.3.1]- nonane dihydrochloride), were tested in chronically instrumented dogs in a model of exercise-induced myocardial ischemia. KC 8857 was i.v. infused during critical stenosis of the circumflex branch of the left coronary artery which led to exercise-induced myocardial dysfunction. KC 8857 caused a decrease in heart rate, left ventricular dp/dtmax and calculated myocardial oxygen demand at rest and during exercise. Since positive dp/dtmax values at a given heart rate were not altered by KC 8857 it may be assumed that myocardial function was restored mainly by the decrease in heart rate. PMID- 2721549 TI - Roles of mast cells and PMN leukocytes in cardiotoxin-induced rat paw edema. AB - Cardiotoxin, isolated from the venom of Naja naja atra, was found to cause rat hind-paw edema in a dose-dependent manner. This edematous response was significantly suppressed by pretreatment with diphenhydramine, methysergide or compound 48/80, which reduced the tissue histamine content. Polymorphonuclear (PMN) leukocyte infiltration appeared within 1 h and had accumulated markedly in the rat paw 3-6 h after subplantar injection of cardiotoxin. Methotrexate pretreatment significantly reduced not only the peripheral leukocyte count but also cardiotoxin-induced paw edema. Captopril, a kininase inhibitor, potentiated the edematous response caused by a low dose of cardiotoxin. The initial phase, occurring within 3 h, of paw edema induced by cardiotoxin was suppressed by trasylol, [Thi5,8,D-Phe7]bradykinin, or by cellulose sulfate pretreatment which greatly reduced plasma kininogen levels. Both mast cells and PMN leukocytes possess kinin-forming activities, but with different properties. The kinin forming activity of mast cells but not of PMN leukocytes was inhibited by trasylol. In isolated mast cells, cardiotoxin caused a dose-dependent release of histamine, beta-glucuronidase, lactate dehydrogenase and kinin-forming activity. These observations suggest that mast cells and PMN leukocytes are involved in cardiotoxin-induced paw edema, and that inflammatory mediators such as histamine, serotonin and kinins were supplied directly or indirectly by mast cells, at least in the initial phase. PMID- 2721550 TI - The effects of adenosine triphosphate and related purines on arterial resistance vessels in vitro and in vivo. AB - The distribution of P2-purinoceptors in pre-capillary resistance vessels was studied in vitro, using Krebs perfused rabbit ears and in vivo, in autoperfused hindquarters, intestinal and renal vasculatures of pentobarbitone anaesthetised cats. ATP (10(-10)-10(-6) mol i.a.) caused dose-dependent vasodilatation which, in the rabbit ear, was antagonised by reactive blue 2 (10(-5)-10(-4) M). At the highest concentration of reactive blue 2, ATP responses were reversed and a dose dependent vasoconstriction was seen. Reactive blue 2, also reduced the vasodilator responses to carbachol and to a lesser extent papaverine which suggests that the antagonist has limited selectivity. The rank order of potency of ATP analogues as vasodilators, 2-methylthio ATP greater than ADP greater than ATP greater than alpha,beta-methylene and beta,gamma-methylene ATP, suggests P2y purinoceptors are involved. The selective P2x-purinoceptor agonist, alpha,beta methylene ATP, caused pronounced vasoconstriction in the rabbit ear and cat intestinal vasculature which was not antagonised by phenoxybenzamine. In contrast, alpha,beta-methylene ATP had little effect in the autoperfused hindquarters and renal vasculatures suggesting a very heterogeneous distribution of P2x-purinoceptors in the cat. The results are consistent with the proposal that two distinct types of P2-purinoceptors are present on blood vessels. PMID- 2721551 TI - Airway hyperreactivity follows anaphylactic microshock in anaesthetized guinea pigs. AB - Actively sensitized guinea-pigs were challenged with a dose of ovalbumin aerosol (300 micrograms ml-1, 5 s) that caused submaximal bronchoconstriction (anaphylactic microshock). Airway reactivity to i.v. 5-hydroxytryptamine (5-HT), i.v. acetylcholine (ACh) and aerosolised 5-HT was assessed subsequently. In addition, histological studies were carried out to investigate possible pulmonary recruitment of inflammatory cells following anaphylactic microshock. Following antigen challenge, there was a significant (P less than 0.05) increase in airway reactivity. This phenomenon was temporally separated (60-120 min) from the initial anaphylactic bronchoconstriction, but occurred in the absence of detectable lung pathology other than minor epithelial necrosis. Whilst histamine aerosol (100 micrograms ml-1, 5 s) did not induce airway hyperreactivity, pretreatment with the histamine H1 receptor antagonist mepyramine (2 mg kg-1 i.v.) prevented that occurring following antigen challenge. These observations suggest that in the pathogenesis of airway hyperreactivity, mediator release from resident leukocytes is initially more important than pulmonary infiltration of circulating cells. Depletion of a putative epithelium-derived relaxant factor may also play a contributory role. The anaphylactic release of histamine may modulate the release of secondary mediators of airway hyperreactivity. PMID- 2721552 TI - Heterologous desensitization of bradykinin-induced phosphatidylinositol response and Ca2+ mobilization by neurotensin in NG108-15 cells. AB - The heterologous desensitization of the bradykinin (BK)-induced increase in intracellular Ca2+ concentration ([Ca2+]i) by neurotensin was studied in neuroblastoma x glioma hybrid NG108-15 cells. The addition of neurotensin to the cells resulted in an increase in [Ca2+]i and an increase in the formation of inositol phosphates in Ca2+-free medium. Pretreatment of the cells with neurotensin resulted in 43% decrease in the BK-induced increase of [Ca2+]i. The increase in [Ca2+]i induced by ionomycin, which causes Ca2+ release from the intracellular pool, was not decreased by pretreatment with neurotensin. This indicates that the inhibitory effect of neurotensin on the BK-induced increase of [Ca2+]i was not due to depletion of the intracellular Ca2+ pool. Pretreatment with neurotensin also caused a 47% decrease in the BK-induced formation of inositol trisphosphates (IP3). This decrease was not due to depletion of phosphatidylinositol bisphosphates. Neurotensin did not inhibit [3H]BK binding to cell membranes. These results show that neurotensin desensitizes the BK responses of NG108-15 cells, heterologously, perhaps by changes in phospholipase C and/or guanine nucleotide-binding protein (G-protein). PMID- 2721553 TI - Study into the role of cholecystokinin in bombesin-stimulated pancreatic growth in rats and hamsters. AB - The effects of cholecystokinin and bombesin on growth of the exocrine pancreas have been studied extensively in rats but not in hamsters. Since hamsters are frequently used for studying pancreatic carcinogenesis it seems highly relevant to determine the effects of these peptides on growth of the hamster pancreas as well. In order to determine whether or not bombesin stimulates pancreatic growth in hamsters and to investigate the role of cholecystokinin in mediating this effect, we conducted a 2-week experiment in which cholecystokinin and bombesin were administered to both rats and hamsters, either with or without lorglumide (CR-1409; a specific cholecystokinin receptor antagonist). Rats were included in the study for comparison. Cholecystokinin and bombesin were found to stimulate pancreatic growth and DNA synthesis in both species. Lorglumide did not significantly influence the effect of bombesin on pancreatic weight but did significantly inhibit DNA synthesis in both species. The effect of cholecystokinin on pancreatic weight was greater in hamsters than in rats. This effect was significantly inhibited by lorglumide in hamsters but not in rats, whereas a significant decrease in DNA content was attained in both species. Thus, this study shows marked differences between rats and hamsters in the pancreatic growth response to cholecystokinin and bombesin. PMID- 2721554 TI - UH-AH 37, an ileal-selective muscarinic antagonist that does not discriminate between M2 and M3 binding sites. AB - The novel antimuscarinic compound UH-AH 37 (6-chloro-5,10-dihydro-5-[(1-methyl-4 piperidyl)acetyl]-11H- dibenzo-[b, e][1,4]diazepine-11-one hydrochloride) showed a 14-fold higher affinity for ileal than for atrial muscarinic receptors. In receptor binding studies UH-AH 37 showed no marked selectivity for either atrial, glandular or ileal muscarinic binding sites. Moreover, it did not reveal binding heterogeneity in membranes from ileal smooth muscle. These result indicate that UH-AH 37 possesses a unique and novel selectivity profile. PMID- 2721555 TI - Effects of some antidepressant drugs on the activity of glial cell enzymes in culture. AB - An oligodendrocyte-enriched culture was incubated with the antidepressant drugs, amitriptyline, desipramine, mianserin and citalopram, in a concentration of 3 X 10(-6) M for 24 h and 14 days. The activity of glycerol-3-phosphate dehydrogenase (G3PDH), lactate dehydrogenase (LDH), pyruvate carboxylase (PC) and the incorporation of [3H]thymidine was measured. An increase in both the incorporation of [3H]thymidine into DNA and the activities of G3PDH and PC was observed. However, LDH activity decreased after a 2-week incubation. The above results indicate that the antidepressant drugs change the metabolism of glial cells. PMID- 2721556 TI - Effects of dilazep (Comelian) on the central purinergic system: inhibitory effects on clonidine-induced aggressive behavior. AB - Mice given clonidine (20-50 mg/kg i.p. and 5 micrograms i.c.v.) exhibited aggressive behavior. Dilazep as well as N6-(L-phenylisopropyl) adenosine (adenosine agonist) inhibited this behavior. Dilazep combined with N6-(L phenylisopropyl) adenosine markedly inhibited the behavior at low doses that were without effect when given alone whereas the inhibitory effect of dilazep on the behavior was reversed by caffeine and 8-phenyltheophylline, which are adenosine antagonists. The results suggest that the inhibitory action of dilazep on clonidine-induced aggressive behavior can be substantially attributed to central purinoceptor stimulation. PMID- 2721557 TI - Enhanced acetylcholine release from denervated atria: intrinsic neural supersensitivity. AB - Atrial tissue from denervated dog hearts was incubated with [3H]choline. When compared with controls, nicotine released more acetylcholine (ACh) from denervated atria at 10(-5) and 2 x 10(-5) M, but not at 5 x 10(-5) M. In parallel contractility studies using tissue from these same atria, the negative inotropic response to nicotine was enhanced at 5 x 10(-6) and 10(-5) M, but not at 2 x 10( 5) or 5 x 10(-5) M nicotine. These results indicate that denervation (i.e. decentralization) supersensitivity of the intrinsic cardiac nerves of canine hearts is characterized by enhanced release of ACh. PMID- 2721558 TI - Antagonism of central and peripheral anorectic effects of caerulein by L-364,718. AB - The reduction in food intake induced by i.p. injections of the cholecystokinin (CCK) analogue caerulein was antagonised by a low dose (0.25 mumol/kg s.c.) of the selective CCK antagonist L-364,718. To block the anorectic effect of centrally administered caerulein a dose of 25 mumol/kg of L-364,718 was required, demonstrating that central CCK receptors can be blocked effectively in the rat by choosing appropriate doses of L-364,718. PMID- 2721559 TI - The imidazoline preferring receptor: binding studies in bovine, rat and human brainstem. AB - The binding of [3H]clonidine to brainstem membrane preparations was studied in an attempt to characterize imidazoline-sensitive, catecholamine-insensitive receptors. Human samples and samples from two animal species were used. [3H]Clonidine binding was always saturable, reversible and specific with a KD value of 6-7 nM. The Bmax values were 45.5 +/- 5.5, 145 +/- 34 and 65 +/- 33 fmol/mg protein in the whole rat medulla oblongata, the nucleus reticularis lateralis region of bovine and that of human, respectively. In the whole rat brainstem we could not demonstrate the presence of [3H]clonidine binding sites that were insensitive to catecholamines. In bovine and human nucleus reticularis lateralis (NRL) preparations, the amount of specifically bound labelled clonidine that was not displaced by an excess of (-)-norepinephrine was 25 and 100%, respectively. Substances that had a structure similar to that of clonidine were able to compete with [3H]clonidine binding within the human NRL. Cirazoline was the most potent to inhibit [3H]clonidine binding although yohimbine was also able to displace binding in the human NRL but with lower apparent affinity. Competition assays with idazoxan stereoisomers clearly showed that this binding was stereospecific. Therefore the human NRL region provides the first model of an homogenous population of imidazoline-preferring, non-alpha-adrenergic membrane receptors. PMID- 2721560 TI - Antagonism by tubocurarine and verapamil of the regenerative acetylcholine release from mouse motor nerve. AB - The role of presynaptic acetylcholine receptors and Ca2+ channels in the regenerative acetylcholine release was studied in the cut muscle preparation of mouse phrenic nerve hemidiaphragm. The regenerative release shown as a prolonged endplate depolarization was evoked by stimulation of the nerve with a train of pulse at 75-300 Hz when acetylcholinesterase activity was depressed with neostigmine or by lowering temperature. Tubocurarine, cobratoxin, verapamil, diltiazem and nifedipine at low concentrations, which had a negligible effect on the endplate potential, shortened the duration of regenerative depolarization while leaving the amplitude unaffected. In contrast, Mn2+ at concentrations that markedly reduced the amplitude of single endplate potentials caused little suppression of the regenerative depolarization though intensive stimulation was needed to trigger the response. On the other hand, atropine inhibited the regenerative depolarization only at high concentrations which also depressed endplate potentials. These results indicate that the mechanism for evoking the regenerative release involves the activation of acetylcholine receptors and Ca2+ channels which are sensitive to tubocurarine and Ca2+ channel blockers. The Ca2+ channel concerned, however, appears to differ from that involved in the normal quantal release of acetylcholine. PMID- 2721561 TI - Chronic haloperidol treatment with low doses may enhance the increase of homovanillic acid in rat brain. AB - Homovanillic acid (HVA) levels were determined by high performance liquid chromatography with electrochemical detection in the striatum and prefrontal cortex of rats that had received single or repeated injections of various doses of haloperidol. Haloperidol increased the HVA concentrations in both brain regions after both acute and chronic treatment with doses of 0.01-1 mg/kg. The increase in the HVA concentrations in the striatum was blunted after repeated haloperidol injections with doses of 0.5-1 mg/kg, suggesting that haloperidol pretreatment results in a decreased responsiveness to the drug at high doses (tolerance). Tolerance also developed to the effect of long-term haloperidol treatment on the HVA concentrations in the prefrontal cortex at the highest dose used (1 mg/kg). This suggests that the differences in the development of tolerance between the striatum and prefrontal cortex are not qualitative but quantitative. However, repeated haloperidol injections at doses of 0.01-0.05 mg/kg enhanced the increase in HVA concentrations. This suggests that tolerance does not develop after chronic haloperidol treatment with low doses. Decreased HVA concentrations were also found after withdrawal from chronic haloperidol treatment (rebound decrease). However, this rebound decrease was much smaller than the decrease in response of the HVA concentrations to repeated haloperidol injections, suggesting that different mechanisms are involved. PMID- 2721562 TI - Acute and chronic effects of methylphenidate on cortical adrenoceptors in the rat. AB - The effects of acute and chronic treatments with methylphenidate were examined on cortical adrenoceptors. A single dose of methylphenidate increased the affinity of [3H]prazosin and [3H]idazoxan binding sites. Acute and chronic methylphenidate treatments caused a down-regulation of alpha 1-adrenoceptors. There were no changes in cortical beta-adrenoceptors measured with [3H]dihydroalprenolol nor in endogenous monoamine levels. The alterations in alpha-adrenoceptors can be attributed to an indirect action of methylphenidate possibly through an accrued release of noradrenaline or tyramine. PMID- 2721563 TI - GM1 ganglioside counteracts cholinergic and behavioral deficits induced in the rat by intracerebral injection of vincristine. AB - The intracerebroventricular injection of 0.5 mg of vincristine sulphate in adult male Wistar rats caused within 11 days the impairment of motor and reflexive behavior, evaluated by the elevated platform and hanging wire tests, a decrease in food consumption and loss of body weight, a 45% decrease in hippocampal choline acetyltransferase (ChAT) activity and a 35% decrease in the rate of high affinity choline uptake (HACU) in the injected side. The latter effects are due to the death of neurons in the respective hemiseptum. Intrafimbrial injection of vincristine caused the same decrease in ChAT activity without behavioral alterations. Daily i.p. administration of GM1 ganglioside, beginning immediately after the vincristine injection, prevented dose dependently the decrease in ChAT activity and HACU rate. Prevention was complete with the 60 mg/kg dose. The same dose was equally active on ChAT activity when given s.c. but was inactive p.o. The ChAT decrease was also prevented when GM1 treatment began 5 days after vincristine. GM1 60 mg/kg i.p. also reduced the behavioral toxicity of vincristine. The possibility that GM1 might prevent vincristine toxicity by antagonizing its disruption of neurofilaments and axonal flow is discussed. PMID- 2721564 TI - The effect of strontium on the drug-receptor interaction on cholinergic drugs. AB - The effect of replacing calcium with strontium in the perfusion fluid was qualitatively and quantitatively studied in the isolated longitudinal muscle of the guinea-pig ileum. In the presence of strontium hyoscine could be considered a competitive antagonist of acetylcholine for the acetylcholine receptor of the longitudinal muscle of the guinea-pig ileum; dibenamine still blocked this receptor in an irreversible way. The equilibrium constants for acetylcholine (KA) and hyoscine (KI) were obtained in the presence of calcium (KA = 3.16 +/- 0.63 microM; KI = 0.38 +/- 0.07 nM), and strontium (KA = 7.00 +/- 0.89 microM; KI = 0.93 +/- 0.16 nM). The results show a decrease in the affinity of both drugs for the muscarinic receptor in the presence of strontium. PMID- 2721565 TI - Hypothalamic prostaglandin E2 receptors coupled to an adenylyl cyclase. AB - We show that the effect of prostaglandin (PG) E2 on luteinizing hormone-releasing hormone (LHRH) release involves a receptor-mediated process coupled to an adenylyl cyclase system. The adenylyl cyclase activity in rat hypothalamus synaptic membrane preparations was stimulated by PGE2 and this stimulation was directly related to the presence of guanine nucleotide (GTP). PGE2 specifically bound to P2 membranes from rat and porcine hypothalami with similar characteristics. Computer-fitted saturation curves provided evidence for two binding components which may be two states of the same receptor (RH and RL). Experiments with Gpp(NH)p, a non-metabolizable analogue of GTP, suggested the interconversion of RH and RL. These results may reflect different states of the ternary complex (hormone-receptor-guanine binding protein). Magnesium (Mg2+) can modify the RH and RL binding parameters, but seems to act directly on the PGE2 receptor site. PMID- 2721566 TI - 5-Hydroxytryptamine evokes three distinct responses on the rat superior cervical ganglion in vitro. AB - In addition to the 5-HT3-mediated fast depolarisation, 5-hydroxytryptamine (5-HT) evoked two additional responses on the rat superior cervical ganglion: a hyperpolarisation and a slow depolarisation. These responses appeared to be direct actions on 5-HT receptors since they were present in a low calcium medium containing tetrodotoxin and were not abolished by a variety of non-serotonin antagonists. The hyperpolarisation was not antagonised by 5-HT3 or 5-HT2 antagonists. The 5-HT1 ligands 5-carboxamidotryptamine (5-CT) and 8-OH-DPAT also evoked a hyperpolarisation. The hyperpolarisation was antagonised by six 5-HT1A antagonists including WB-4101 and spiroxatrine. It was therefore concluded to be mediated by a 5-HT1A receptor. The slow depolarisation was only evoked by 5-HT. The receptor involved in this response, however, could not be determined. We conclude that in addition to 5-HT3 receptors the rat superior cervical ganglion possesses 5-HT1A receptors and another uncharacterised 5-HT receptor. PMID- 2721567 TI - A new potent and selective non-peptide gastrin antagonist and brain cholecystokinin receptor (CCK-B) ligand: L-365,260. AB - L-365,260 (3R(+)-N-(2,3-dihydro-1-methyl-2-oxo-5-phenyl-1H-1,4- benzodiazepin-3 yl)-N'-(3-methylphenyl)urea), interacted in a stereoselective and competitive manner with guinea pig stomach gastrin and brain cholecystokinin (CCK) receptors. The affinity of L-365,260 for both gastrin (Ki = 1.9 nM) and brain CCK-B (Ki = 2.0 nM) receptors was greater than 2 orders of magnitude higher than its affinity for peripheral pancreatic CCK-A receptors or various other receptors. L-365,260 exhibited a similar high affinity for brain CCK-B receptors of rats, mice and man. A somewhat lower affinity for gastrin and brain CCK-B (IC50 = 20-40 nM) receptors was observed in dog tissues. In vivo, oral administration of L-365,260 antagonized gastrin-stimulated acid secretion in mice (ED50 = 0.03 mg/kg), rats (ED50 = 0.9 mg/kg) and guinea pigs (ED50 = 5.1 mg/kg). L-365,260 did not affect basal acid secretion and did not antagonize histamine- or carbachol-stimulated acid secretion in mice. L-365,260 represents a potentially powerful new tool for investigating gastrin and brain CCK-B receptors, and possibly their role in physiology and disease. PMID- 2721568 TI - Comparison of the anticonvulsant efficacy of primidone and phenobarbital during chronic treatment of amygdala-kindled rats. AB - In amygdala-kindled rats, single-dose administration of primidone did not reduced seizure activity 2 h after i.p. injection, i.e. when plasma levels of the drug were highest, but significant anticonvulsant effects were found 24 h after administration, when the drug was almost completely eliminated. During chronic treatment with primidone, marked anticonvulsant efficacy was determined after 3 15 days of three times daily treatment with 50 mg/kg i.p., indicating that this effect was due to the accumulation of metabolites, especially phenobarbital. Maximum anticonvulsant activity attained during chronic primidone medication was almost equal to that found during chronic treatment of kindled rats with phenobarbital, 30 mg/kg once daily. However, drug plasma level determinations during both treatments showed that on days when both treatments were about equieffective, levels of metabolically derived phenobarbital in the primidone group were significantly lower than levels in rats treated with phenobarbital alone, thus indicating that primidone potentiated the anticonvulsant effect of metabolically derived phenobarbital. Additional evidence for potentiation of the anticonvulsant effect of phenobarbital by primidone was found in single dose experiments with combined injection of both drugs, whereas side-effects, such as ataxia and muscle relaxation, induced by phenobarbital were not increased by combined treatment with primidone. Accordingly, side-effects occurring during chronic primidone treatment were less pronounced than side-effects found during chronic phenobarbital medication. In both treatment groups, tolerance to the anticonvulsant effect developed during the 2nd week of administration, while attenuation of side-effects took place already in the first week. Following cessation of treatment, signs of physical dependence, such as withdrawal hyperexcitability and weight loss, were observed. The data indicate that, at least in kindled rats, the anticonvulsant activity of primidone during chronic treatment is due to the combined and possibly synergistic actions of primidone and metabolically derived phenobarbital. PMID- 2721569 TI - Post-receptor-mediated increases in adenylate cyclase activity after chronic antidepressant treatment: relationship to receptor desensitization. AB - Administration to rats of chronic electroconvulsive shock (ECS) or chronic desipramine (DMI, 10 mg/kg daily i.p. for 3 weeks) did not affect either basal or forskolin-stimulated adenylate cyclase activity in membranes prepared from the caudate nucleus. In cerebellar membranes prepared from rats which had received chronic ECS, forskolin-stimulated activity was significantly increased compared to activity in sham- or single ECS treated rats. Forskolin-stimulated adenylate cyclase was increased in both hippocampal and cerebellar membranes from rats which received chronic DMI, compared to saline-treated animals. In cerebellar membranes, increases comparable to those with forskolin were also obtained with guanylyl-5'-imidodiphosphate (GppNHp) after both treatments, while with Mn2+ ions, either alone or in the additional presence of forskolin, the changes observed were similar to those previously reported in cortical membranes. A possible mechanism for these effects was investigated by studying antidepressant induced and in vitro desensitization of the cyclic AMP response in slice preparations from the various brain areas. In slices from caudate nucleus, chronic DMI did not alter stimulation of cyclic AMP formation by either noradrenaline or forskolin, while in cerebellar slices the noradrenaline response was significantly reduced, and in hippocampal slices both responses were reduced (heterologous desensitization). In vitro incubation of cortical slices with noradrenaline also resulted in a reduction in the response to both agents. However, in membranes prepared from the desensitized cortical slices, there was no change in the degree of activation of adenylate cyclase by either NaF or forskolin. Thus, the increase in these activities, observed in certain brain areas after chronic antidepressant treatment may not necessarily be related to beta-adrenoceptor desensitization. PMID- 2721570 TI - The cardiovascular effects of centrally administered taurine in anaesthetised and conscious rats. AB - The effects of pentobarbitone anaesthesia on the cardiovascular changes induced by centrally administered taurine have been investigated in spontaneously hypertensive (SHR) and normotensive rats. Administration of taurine (100-400 micrograms) into the lateral cerebral ventricle (i.c.v.) of anaesthetised SHR and normotensive rats induced a dose-related fall in systemic blood pressure and heart rate, which tended to be of a greater magnitude in the SHR. In anaesthetised rats attached to a ventilator, taurine was not as potent at inducing a fall in systemic blood pressure, approximately double the dose being required to produce the same cardiovascular changes as that which occurred in anaesthetised rats without a ventilator. In conscious normotensive rats taurine had no effect on blood pressure until a dose of 800 micrograms was administered i.c.v., whereas in conscious SHR, a small, but significant depressor response was evident with 400 micrograms. These findings demonstrate that pentobarbitone anaesthesia sensitises the rats to the cardiovascular effects of taurine, partially through a mechanism which involves respiratory depression. Conversely in conscious rats a much higher dose of taurine is required to induce a fall in arterial pressure and heart rate per se. PMID- 2721571 TI - Evaluation of adenosine agonists as potential analgesics. AB - Adenosine agonists, N6-cyclohexyladenosine (CHA), N6-cyclopentyladenosine (CPA), N6-phenylisopropyladenosine (PIA), 5'-N-ethylcarboxamidoadenosine (NECA), 5'-N methylcarboxamidoadenosine (MECA) and 2-chloroadenosine (CADO), produced a dose related inhibition of acetylcholine (ACh)-induced writhing in mice. The antinociceptive potency of adenosine agonists was comparable to that of morphine. Adenosine agonists were 10-1000 times more potent when given i.c.v. than p.o., suggesting a central site of action. Theophylline antagonized the antinociceptive activity of R-PIA in the writhing assay, suggestive of an adenosine receptor mediated event. The sedative/ataxic properties of adenosine agonists were evaluated using a rotorod assay. Adenosine agonists impaired performance on the rotorod in doses comparable to and in some cases lower than those active in the ACh writhing assay. The results of the present study suggest that adenosine agonists attenuate nociceptive responding to a chemical stimulus through a central purinergic mechanism. The ability of adenosine agonists to inhibit ACh induced writhing may be secondary to their sedative/ataxic properties. PMID- 2721572 TI - Biphasic dose-response curve to muscarine on the rat superior cervical ganglion. AB - The dose-response curve for the muscarine-induced depolarisation of the rat isolated superior cervical ganglion, studied over the concentration range of 3 nM 1 mM, was biphasic. An apparent maximum was obtained at around 1-3 microM muscarine, but this was only a plateau between the two parts of the curve. Two cardioselective antagonists, gallamine (10 microM) and AF-DX 116 (1 microM) had a complex action on this dose-response curve. The dose-response curve between 0.01 and 0.3 microM was shifted to the right, the responses around 3 microM muscarine were enhanced, but the dose-response curve over 30 microM muscarine was unaffected. The M1-selective antagonist pirenzepine (0.05 microM) depressed all parts of the dose-response curve, but it still appeared biphasic. Pretreatment of the ganglion with pertussis toxin (1 microgram/ml) enhanced the depolarisation to muscarine 0.01-1000 microM and the dose-response curve became less biphasic. Like gallamine and AF-DX 116, pertussis toxin abolished the muscarinic M2-mediated hyperpolarisation of the ganglion recorded in 0.3 microM pirenzepine. It is concluded that the presence of an underlying M2-mediated hyperpolarisation contributes to the biphasic nature of the dose-response curve to muscarine. PMID- 2721573 TI - Pertussis toxin sensitivity of drug-induced potentials on the rat superior cervical ganglion. AB - We have investigated the action of pertussis toxin on a range of receptor mediated responses of the rat superior cervical ganglion in vitro. The ganglia were treated with pertussis toxin for 24 h at 37 degrees C using an in vitro method. Appropriate controls were also carried out. Pertussis toxin (1 microgram/ml) reduced ganglionic hyperpolarisations mediated by adenosine, alpha 2, 5-HT1A, M2 and GABAB receptors. The GABAB-mediated hyperpolarisation of this preparation, evoked by baclofen and GABA in a bicuculline-resistant manner, has not previously been reported. Pertussis toxin did not reduce ganglionic depolarisations evoked by potassium chloride and 5-HT3, GABAA and nicotinic receptors. Depolarisations to muscarine and noradrenaline, probably mediated by M1 and beta-receptors, also appeared to be resistant to pertussis toxin. The similar sensitivity of the various ganglionic hyperpolarisations to pertussis toxin indicates that they may all be mediated by similar G-proteins. PMID- 2721574 TI - Effects of ONO-3708, an antagonist of the thromboxane A2/prostaglandin endoperoxide receptor, on platelet aggregation and thrombosis. AB - The beneficial effects of an antagonist of the thromboxane A2/prostaglandin endoperoxide receptor, 7-[2 alpha,4 alpha-(dimethylmethano)-6 beta-(2-cyclopentyl 2 beta- hydroxyacetamido)-1 alpha-cyclohexyl]-5(Z)-heptenoic acid (ONO-3708) on thrombosis were examined. ONO-3708 at 0.1-3 microM inhibited the human platelet aggregation induced by thromboxane A2, prostaglandin H2, collagen, ADP (secondary phase) and epinephrine (secondary phase) without affecting prostanoid synthesis and the content of cyclic AMP in platelets. The in vivo effects, on coronary thrombosis in this case, were examined in two canine models. ONO-3708, 3 to 300 micrograms/kg i.v., prevented dose dependently the coronary thrombosis induced by partial obstruction of the coronary artery. ONO-3708, 3 micrograms/kg per min i.v., significantly prevented electrically stimulated coronary thrombosis without affecting systemic blood pressure and heart rate. These results indicate that the thromboxane A2/prostaglandin endoperoxide receptor could play an important role in the pathogenesis of thrombosis and that ONO-3708 may have therapeutic advantages in preventing thrombosis. PMID- 2721575 TI - M2 muscarinic receptors on the iris sphincter muscle differ from those on iris noradrenergic nerves. AB - The pre- and postjunctional affinity constants of a series of muscarinic antagonists were determined in guinea pig and rabbit irises. Field stimulation evoked [3H]noradrenaline release from superfused isolated irises was concentration dependently inhibited by (+/-)-methacholine, confirming the presence on the iris noradrenergic nerves of prejunctional inhibitory muscarinic receptors. The affinity constants of the antagonists at the pre- and postjunctional receptors are compatible with the coexistence in the iris of two different M2 receptors: the cardiac (M2 alpha) subtype on the noradrenergic nerves and the smooth muscle (M2 beta) subtype on the iris sphincter muscle. The rank order of potency of the antagonists studied at the prejunctional site was: atropine greater than himbacine greater than AF-DX 116 greater than pirenzepine greater than hexahydrosiladifenidol. The order of potency at the postjunctional receptors mediating the methacholine-induced isotonic contraction of the isolated rabbit iris sphincter was: atropine greater than hexahydrosiladifenidol greater than pirenzepine greater than himbacine greater than AF-DX 116. PMID- 2721576 TI - Evoked release of endogenous amino acids from rat striatal slices and its modulation. AB - The release of endogenous gamma-aminobutyric acid (GABA), glutamate and aspartate stimulated by high K+ was studied by superfusing rat striatal slices. Stimulation with 5 min of 30 mM K+ was applied twice (S1 and S2) at a 20 min interval. The maximum release of GABA following stimulation was 40 (at S1) and 26 (at S2) times greater than the basal release. S1 and S2 each produced a maximum release of almost same magnitude for both glutamate and aspartate (about 2.5 times basal release). The removal of Ca2+ from the perfusion medium reduced the maximum release of these amino acids by more than 80% without affecting basal release significantly. Striatal slices were next stimulated in the same way after the addition of apomorphine or haloperidol to the perfusion medium. Apomorphine, 10 or 100 microM, reduced the K+-evoked release of GABA (by 24% at S1 and 35% at S2 with 10 microM; by 37% at S1 and 47% at S2 with 100 microM) but failed to affect the simultaneous release of glutamate and aspartate. Haloperidol (1 microM) reduced the S1-induced release of GABA but had no significant effect on the subsequent S2-induced release. The evoked release of aspartate or glutamate did not respond significantly to haloperidol, but there was a tendency to a decrease in aspartate release similar to the decrease seen for GABA release, particularly with S1. Based on these results, we discuss the property of GABA, aspartate and glutamate as neurotransmitters and the possible dopaminergic regulation of the release of these amino acids. PMID- 2721577 TI - Diltiazem enhances and flunarizine inhibits nimodipine's antiseizure effects. AB - The dihydropyridine calcium channel antagonist, nimodipine has antiepileptic and anticonvulsive properties that are thought to be mediated through neuronal calcium channel blockade. The dihydropyridine binding site can be positively and negatively allosterically regulated by the benzothiazepines and the phenylalkylamines/piperazines, respectively. We investigated this binding interaction at the physiologic level by examining the effects of diltiazem (a benzothiazepine) and flunarizine (a piperazine) on the antiseizure activity of nimodipine. Seizures were induced with pentylenetetrazole in awake rats with chronically implanted EEG electrodes. Calcium channel antagonists were administered intracerebroventricularly 30 min after pentylenetetrazole at doses given at 15 min intervals. Diltiazem and flunarizine alone lacked antiseizure properties. The calculated ED50 values for nimodipine were: nimodipine alone = 135 micrograms; nimodipine + diltiazem (100 micrograms) = 67 micrograms. Nimodipine + flunarizine (10 micrograms) completely suppressed nimodipine's antiseizure activity. These findings may reflect the interaction observed among these agents at binding sites associated with the calcium channel and supports the idea that dihydropyridines mediate their antiseizure actions through neuronal calcium channel antagonism. PMID- 2721578 TI - 9-Amino-1,2,3,4-tetrahydroacridine (THA) blocks agonist-induced potassium conductance in rat hippocampal neurones. AB - The actions of 9-amino-1,2,3,4-tetrahydroacridine (THA) were studied on rat CA1 pyramidal neurones under voltage-clamp in transverse slices of hippocampus maintained in vitro. As previously reported, THA reduced the resting conductance of cells; THA also suppressed inward rectification activated by hyperpolarization by up to 75% (The dose of THA which reduced the response by 50% (IC50) was 300 microM). More sensitive to the action of THA was the outward K+ current activated in CA1 neurones by 5-HT, adenosine and baclofen. This was completely blocked by THA (IC50 = 28 microM). The cooperativity of this latter action of THA with its well-known anticholinesterase activity is discussed in relation to the therapeutic effects of THA in treating Alzheimer's disease. PMID- 2721579 TI - Inhibitory histamine H3-receptors on cholinergic nerves in human airways. AB - The histamine H3-agonist, (R)-alpha-methylhistamine (alpha-MeHA) caused a dose dependent inhibition of cholinergic contractile responses to electrical field stimulation in human bronchi without affecting the basal tone. alpha-MeHA, but, did not alter the response to acetylcholine. Blockade of H1- and H2-receptors, or alpha- and beta-adrenoceptors failed to prevent the inhibitory effect of alpha MeHA, whereas the specific H3-antagonist, thioperamide, was effective. Our results indicate that H3-receptors modulate cholinergic neurotransmission in human airways. PMID- 2721580 TI - Methoctramine, a selective M2 alpha muscarinic receptor antagonist, does not inhibit carbachol-induced drinking in the rat. AB - Methoctramine, a selective M2 alpha muscarinic receptor antagonist, was examined for its ability to inhibit carbachol-induced drinking in the rat. Intracerebroventricularly (i.c.v.) administered methoctramine was devoid of activity up to a dose of 100 nmol/rat, whereas higher doses were toxic under our experimental conditions. 4-DAMP, pirenzepine and hexahydrosiladifenidol were also tested. The rank potency order for the compounds (4-DAMP greater than pirenzepine = hexahydrosiladifenidol) was similar to that for their affinity at M1 receptors, as found in experiments in vitro. The putative M1 agonist McN-A-343 was inactive up to doses of 13.9 micrograms/rat. Our data suggest that M2 alpha receptors do not mediate cholinergic drinking in the rat. The question whether M1 or M2 beta muscarinic receptors are involved in this response still awaits a firm answer. PMID- 2721581 TI - Antidepressant interactions with 5-hydroxytryptamine3 receptor binding sites. PMID- 2721582 TI - Endothelial muscarinic receptors in the rabbit aorta. PMID- 2721583 TI - Reduced endothelium-dependent relaxation of cystic fibrosis pulmonary arteries. PMID- 2721584 TI - Effects of centrifugation on the degradation of short-lived proteins in exponentially growing cultured cells. AB - The degradation mechanisms of short-lived proteins in cultured cells are unknown, probably due to the lack of procedures which specifically affect the degradation of these proteins. We found that centrifugation of cultured cells, growing either in monolayer or in suspension, between 5000 and 25,000g for 30 min, inhibits (more than 50%) the degradation of short-lived proteins but not of long-lived proteins. Protein synthesis or cell viability is not affected. Centrifugation also disorganizes the Golgi apparatus, as checked by routine electron microscopy, and inhibits the degradation of endocytosed proteins (a lysosomal process which is controlled by the Golgi apparatus). Using different centrifugation speeds, a good correlation was found between alteration of the Golgi apparatus and inhibition of protein degradation. PMID- 2721585 TI - Growth-stimulating effect of transferrin on a hybridoma cell line: relation to transferrin iron-transporting function. AB - The relation of the growth-stimulating capacity of transferrin to its iron transporting function was investigated in mouse hybridoma PLV-01 cells cultivated in a chemically defined medium. The cells were precultivated in protein-free medium supplemented either with ferric citrate (cells with a high intracellular iron level) or with iron-saturated transferrin (cells with a low intracellular iron level). Iron uptake was monitored after the application of 59Fe-labeled ferric citrate or pig transferrin. Cultivation of the cells at the optimum growth stimulating concentration (500 microM) of ferric citrate resulted in an intracellular iron level about 100-fold higher than that of cells cultivated at the optimum transferrin concentration (5 micrograms/ml). Replacement of pig transferrin with bovine transferrin resulted in similar intracellular iron levels, but the growth-stimulating effect of bovine transferrin was more than one order of magnitude lower. Cells with a high intracellular iron level grew equally well when cultivated with iron-saturated transferrin or with apotransferrin + deferoxamine (2 micrograms/ml). On the other hand, cells with a low intracellular iron level required iron-saturated transferrin for further growth and apotransferrin + deferoxamine was ineffective. The results suggest that transferrin can act as a cell growth factor only in the iron-saturated form. However, several findings of this work indicate that supplying cells with iron cannot be accepted as the full explanation of the transferrin growth-stimulating effect. PMID- 2721586 TI - Factors influencing the differentiation of embryonal carcinoma and embryo-derived stem cells. AB - The effects of aggregation, retinoic acid, and medium conditioned by Buffalo rat liver (BRL) cells, alone and in combination, on the differentiation of PSA4TG12 embryonal carcinoma and E14 embryonal stem cells are reported. The observations indicate that BRL-conditioned medium has more than one effect on the differentiation process, that retinoic acid has at least two effects which operate in different concentration ranges, and that both agents influence the choice of differentiation pathway as well as the extent of differentiation. PMID- 2721587 TI - Mechanisms responsible for long-term survival of adult rat hepatocytes in the presence of phenobarbital in primary culture. AB - The mechanisms, by which phenobarbital (PB) supports the survival of adult rat hepatocytes in primary culture, were investigated. PB altered the shape of rat erythrocytes to produce cup-formed cells and protected them from hypotonic hemolysis. Anesthetics (ketamine, lidocaine, mepivacaine, and bupivacaine) and an anti-inflammatory agent (indomethacin), which are also known to protect erythrocytes from hypotonic hemolysis by stabilizing their membranes, efficiently supported the survival of hepatocytes in primary culture. Furthermore, the well known biological membrane stabilizers, such as cholesterol and vitamin E, also showed the maintenance effect on primary cultured hepatocytes. PB effectively reduced the leakage of lactate dehydrogenase from hepatocytes caused by chenodeoxycholic acid in primary culture. Rotenone and amobarbital, which act repressively on the PB-sensitive site in the respiratory chain and are known to inhibit the mitochondrial formation of active oxygen species with NAD-linked substances, effectively prolonged the hepatocyte survival in primary culture. Elevation of oxygen tension in primary culture remarkably decreased the hepatocyte survival rate, which was preserved by addition of antioxidant substances, such as vitamin C, vitamin E, bifemelane, selenite, and superoxide dismutase. On the other hand, in the presence of PB, the hepatocyte survival rate hardly changed with the elevation of oxygen tension. From these findings, it seems that PB stabilizes the hepatocyte membranes and reduces the mitochondrial formation of active oxygen species and that the stabilized functions of membrane and the reduction of oxidative stress result in the prolonged survival of hepatocytes in primary culture. PMID- 2721588 TI - Isolation and analysis of nuclear bodies from estrogen-stimulated chick liver. AB - The target cells of most steroid hormones contain prominent structures termed nuclear bodies (NB). Estrogen (ES) responsive tissues have very distinctive NB, whose development has been associated with both the level of ES receptors and their retention times in nuclei. It has been suggested that these NB may be large scale ES binding centers at transcriptionally hyperstimulated sites. We examined the formation of NB in ES-stimulated rooster liver, after primary induction of vitellogenesis and during subsequent decay of this response. Distinct NB appear 6 h postinduction, initially as compact spheroids with ring-like profiles and later on as more complex morphotypes. Nuclei average 15-17 NB each at peak induction (24-48 h), but this declines again gradually as the hormonal response abates. This transient pattern is paralleled closely by the [3H]ES binding capacity of nuclei in vitro and the calculated number of specific hormone receptors present. There is no direct numerical correspondence, however, between the NB and the ES receptors, either on a one-to-one basis or as some simple ratio. Hence any links between ES binding activity in nuclei and the NB must be both complex and indirect. Nuclear bodies were isolated following lysis of nuclei by sonication and separation of subfractions on discontinuous sucrose gradients. The resultant NB-enriched fraction consisted primarily of protein, with traces of DNA and RNA. Analysis of proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed a complex pattern of polypeptides, some apparently unique and probably NB-derived. PMID- 2721589 TI - Analysis of supra-nucleosome particles from unfertilized eggs of sea urchins. AB - Two discrete supranucleosomal particles that differ in their electrophoretic migration on 1% agarose gels were isolated from unfertilized sea urchin eggs. Both particles contain the same complement of cleavage stage (CS) chromosomal proteins, which is identical to the complete set of basic proteins isolated directly from chromatin by extraction with 0.25 N HCl. DNA fragments between 210 and 1500 bp were found in both particles, and the basic unit of DNA repeat length determined by micrococcal nuclease digestion was 126 +/- 3 bp. The isolated nucleoparticles are electrophoretically stable over a wide range of DNA sizes (126-1500 bp) indicating that their structure is maintained by internal interactions among the CS chromosomal proteins, previously designated CS A through CS G. Based on these results we conclude that the CS chromosomal proteins are functionally equivalent to classical histones in their ability to direct higher ordered structures of chromatin. PMID- 2721590 TI - The recycling of a secretory granule membrane protein. AB - We have used N-hydroxysuccinimido-d-biotin as a reagent for labeling proteins exposed at the surface of cultured bovine adrenal chromaffin cells during Ba2+ stimulated secretion. A specific secretory granule membrane constituent, dopamine beta-hydroxylase (DBH), has been investigated using immunoprecipitation followed by electrophoresis. Within 30 min of stimulation, exposed DBH had been cleared from the cell surface. Nevertheless, quantitation of labeled DBH using [125I] streptavidin suggested that it remained undegraded over a period of 24 h, a time during which secretory granule stores of catecholamines were being replenished. Subcellular fractionation of the cultured cells suggested that, after 3 or 4 h, the biotinylated DBH, which was still membrane-bound, was located in particulate material that also contained cytochrome b561, another major secretory granule membrane component. PMID- 2721591 TI - Evidence that a nuclear matrix protein participates in premessenger RNA splicing. AB - The role of nuclear matrix proteins in premessenger RNA splicing has been investigated using antibodies raised against isolated rat liver nuclear matrix and cross-reactive with a 65-kDa HeLa cell nuclear matrix protein (IGA-65). IGA 65 is an internal nuclear matrix component which can be solubilized as a component of nuclear splicing extracts, by the action of endogenous ribonucleases, EDTA, and DTT during extract preparation. Preincubation of splicing extract with antibodies against IGA-65 (anti-IGA-65) inhibited in vitro splicing of exogenous adenovirus precursor RNA. Furthermore, assembly of precursor RNA into active spliceosome complexes was inhibited by pretreatment of extracts with anti-IGA-65, suggesting a role for IGA-65 during early spliceosome assembly. The IGA-65 present in splicing extracts was distinguishable from known U-snRNP and hnRNP proteins on protein gels. Furthermore, electrophoresis of splicing extract on native gels indicated that IGA-65 was present in protein complexes different from those containing U-snRNPs or hnRNP C protein. The data support identification of complexes containing IGA-65 as nuclear factors involved in pre-mRNA splicing and, by extension, suggest a role for the nuclear matrix during processing in vivo. PMID- 2721592 TI - Genetic analysis of metabolic cooperation in mammalian cell lines. AB - Metabolites can be exchanged between cells in culture by direct transfer from the cytoplasm of one cell to that of another in a process known as metabolic cooperation. Most mammalian cell lines are able to transfer small molecules directly between adjacent cells in this way and are consequently mec+; however, a small number are defective in this ability (mec-). Results obtained from somatic cell hybrids formed between combinations of these cells have shown that the four different cell lines examined in this study can be divided into at least two different complementation groups on the basis of their ability to transfer 3H labeled nucleotides to adjacent cells. Two of the cell lines clearly fall into a single complementation group. PMID- 2721593 TI - Extracellular matrix organization modulates fibroblast growth and growth factor responsiveness. AB - To learn more about the relationship between extracellular matrix organization, cell shape, and cell growth control, we studied DNA synthesis by fibroblasts in collagen gels that were either attached to culture dishes or floating in culture medium during gel contraction. After 4 days of contraction, the collagen density (initially 1.5 mg/ml) reached 22 mg/ml in attached gels and 55 mg/ml in floating gels. After contraction, attached collagen gels were well organized; collagen fibrils were aligned in the plane of cell spreading; and fibroblasts had an elongated, bipolar morphology. Floating collagen gels, however, were unorganized; collagen fibrils were arranged randomly; and fibroblasts had a stellate morphology. DNA synthesis by fibroblasts in contracted collagen gels was suppressed if the gels were floating in medium but not if the gels were attached, and inhibition was independent of the extent of gel contraction. Therefore, growth of fibroblasts in contracted collagen gels could be regulated by differences in extracellular matrix organization and cell shape independently of extracellular matrix density. We also compared the responses of fibroblasts in contracted collagen gels and monolayer culture to peptide growth factors including fibroblast growth factor, platelet-derived growth factor, transforming growth factor-beta, and interleukin 1. Cells in floating collagen gels were generally unresponsive to any of the growth factors. Cells in attached collagen gels and monolayer culture were affected similarly by fibroblast growth factor but not by the others. Our results indicate that extracellular matrix organization influenced not only cell growth, but also fibroblast responsiveness to peptide growth factors. PMID- 2721594 TI - Frequent derepression of G6PD and HPRT on the marsupial inactive X chromosome associated with cell proliferation in vitro. AB - X chromosome dosage compensation in Marsupials is like that in eutherian mammals except that the paternal X chromosome is always inactive, and silence of this chromosome is not well maintained. We previously showed that the unstable inactivation of the paternal G6PD allele is associated with the lack of DNA methylation in the 5' CpG cluster. Even though this CpG island is unmethylated, the paternal allele (marked by an enzyme variant) is at least partially and often severely repressed in most tissues of the opossum, so that factors other than methylation must inactivate the locus. Here we report that when cell cultures are established from these tissues, the silent G6PD locus is depressed. Although often complete, the extent of derepression differs among tissues and within different cell types in the same tissue, and is not accompanied by obvious changes in the pattern of chromosome replication. Studies of the HPRT locus in these cells show that the paternal HPRT allele also derepresses in cultured cells. These observations suggest that without DNA methylation to maintain the silence of the locus, tissue or cell-specific factors act to repress the silent locus, but are unable to maintain inactivity through cell division, or are lost as cells proliferate in culture. PMID- 2721595 TI - The differentiation of normal and transformed human fibroblasts in vitro is influenced by electromagnetic fields. AB - We studied the effect of symmetric, biphasic sinusoidal electromagnetic fields (EMF) (20 Hz, 6 mT) on the differentiation of normal human skin fibroblasts (HH 8), normal human lung fibroblasts (WI38), and SV40-transformed human lung fibroblasts (WI38SV40) in in vitro cultures. Cells were exposed up to 21 days for 2 x 6 h per day to EMF. Normal mitotic human skin and lung fibroblasts could be induced to differentiate into postmitotic cells upon exposure to EMF. Concomitantly, the synthesis of total collagen as well as total cellular protein increased significantly by a factor of 5-13 in EMF-induced postmitotic cells. As analyzed by two-dimensional gel electrophoresis of [35S]methionine-labeled polypeptides, EMF-induced postmitotic cells express the same differentiation dependent and cell type-specific marker proteins as their spontaneously arising counterparts. In SV40-transformed human lung fibroblasts (cell line WI38SV40) the exposure to EMF induced the differentiation of mitotic WI38SV40 cells into postmitotic and degenerating cells in subpopulations of WI38SV40 cell cultures. Other subpopulations of WI38SV40 cells did not show any effect of EMF on cell proliferation and differentiation. These results indicate that long-term EMF exposure of fibroblasts in vitro induces the differentiation of mitotic to postmitotic cells that are characterized by differentiation-specific proteins and differentiation-dependent enhanced metabolic activities. PMID- 2721596 TI - The s phase is discrete and is controlled by the circadian clock in the marine dinoflagellate Gonyaulax polyedra. AB - Cloned cultures of the dinoflagellate Gonyaulax polyedra grown in a 12-h light-12 h dark cycle (LD 12:12) were synchronized to the beginning of G1 by a two sequential filtration technique. After the second filtration, with the cultures growing in LD 12:12, not many cells had divided after 1 day, but approximately half underwent cell division after 2 days. Flow cytometric measurements of the cells revealed that there is one unique S phase starting about 12 h prior to cell division and lasting for less than 4 h. A majority of cells in cultures synchronized in the same way but maintained in continuous light (LL) after filtration also divided synchronously after 2 days. Just as for the cultures in LD 12:12, those in LL have a similar discrete DNA synthesis phase prior to division. It is concluded that the circadian control of cell division acts before the S phase, giving rise to a discontinuous DNA synthesis phased by the circadian clock. PMID- 2721597 TI - Protein phosphorylation during 1-methyladenine-induced maturation of Asterias oocytes. AB - Maturation was induced in Asterias oocytes with 1-methyladenine (1-MA) at a final concentration of 2 microM. At 5, 10, and 30 min of treatment, oocytes were homogenized and the cytosolic fraction was prepared. The cytosol was incubated with [gamma-32P]ATP and [gamma-32P]GTP. The phosphorylated proteins were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the radioactivity in the gels was determined by autoradiography. The cytosol prepared from 1-MA-treated oocytes incubated with [gamma-32P]ATP showed a marked increase in the radiolabeling of proteins with estimated molecular weights of 70,000 and 62,000 Da. With [gamma-32P]GTP a 56,000-Da protein showed increased radiolabeling. The present finding suggests that an early biochemical event of 1 MA-induced oocyte maturation in Asterias is the stimulation of phosphorylation of specific proteins. PMID- 2721598 TI - The collagen recognition sequence for fibroblasts depends on collagen topography. AB - We found that the peptide Gly-Arg-Gly-Glu-Ser-Pro (GRGESP) inhibited spreading of human fibroblasts inside collagen gels and markedly decreased gel contraction, but this peptide had no effect on cell spreading on collagen-coated surfaces. On the other hand, the peptide Gly-Arg-Gly-Asp-Ser-Pro (GRGDSP), which inhibited cell spreading on collagen-coated surfaces, did not inhibit cell spreading within collagen gels and was a less effective inhibitor of collagen gel contraction than GRGESP. Based on these findings, we conclude that human fibroblasts can interact with different collagen cell recognition sequences depending upon topographical organization of the collagen. PMID- 2721599 TI - The biosynthetic pathway of pyrimidine (deoxy)nucleotides: a sensor of oxygen tension necessary for maintaining cell proliferation? AB - Culture experiments on Ehrlich ascites tumor cells revealed that a low oxygen tension (about 20% in normoxic atmosphere) induced an increase in the length of the growth cycle. The relative growth of aerobic control cells after transfer to the second in vitro passage was 145% within 24 h, and reduced to 50% at 1% O2 and about 30% at 0.1% O2. The increase in protein and DNA content of these hypoxic cultures was equally impaired. Also, the cell cycle traverse as analyzed by flow cytometry was affected predominantly at the G1/early S stage. Uptake of labeled thymidine into acid-insoluble material of hypoxic cells was below that of controls whereas incorporation of uridine exceeded that of normoxic controls. Supplementation of cells cultured under 0.1 and 1% O2 with 0.1 mM uridine or 0.1 mM deoxycytidine + 0.01 mM deoxyadenosine and deoxyguanosine improved all growth parameters; deoxynucleosides were more effective than uridine in cells under 0.1% O2 whereas in cells cultured under 1% O2 similar effects of both were observed. This points to an insufficient supply of nucleic acid precursors even under moderate limitations of oxygen tension and not only under strict hypoxia. Whereas a 12-h cultivation time at 0.1% O2 hardly impaired cell growth after reoxygenation, a cultivation time of 24 h considerably reduced the cellular capability to recover. This was alleviated by addition of (deoxy)nucleosides from the beginning of hypoxic culture. The results are interpreted as supporting the concept that the biosynthetic pathway of pyrimidine (deoxy)nucleotides--because of two oxygen-dependent enzymes, dihydroorotate dehydrogenase and ribonucleotide reductase--is a potential transducer of environmental limitations in oxygen tension to the proliferative capacity of cells. PMID- 2721600 TI - Decreased accuracy of protein synthesis in extracts from aging human diploid fibroblasts. AB - The accuracy of protein synthesis has been measured in extracts from human diploid fibroblasts of different ages. Extracts were supplied with purified mRNA for the coat protein of the cowpea variant of tobacco mosaic virus (CcTMV), which lacks codons for cysteine and methionine. The presence of 35S-cysteine in CcTMV coat protein synthesized during translation reactions therefore represents translational error. Translation reactions were performed with extracts from young fibroblasts (less than 50% of life span completed) and old fibroblasts (more than 90% of life span completed), and the translation products were purified by immunoprecipitation and analyzed by polyacrylamide gel electrophoresis. The error frequency increased from 4.2 x 10(-5) cysteines/amino acid in young cell extracts to 2.9 x 10(-4) cysteines/amino acid in old cell extracts. Cysteine incorporation was not due to nonspecific binding, and could be increased approximately sixfold by the addition of the misreading antibiotic, paromomycin. It is concluded that translational accuracy is not stable during aging in vitro, and it is proposed that this decrease in the fidelity of information transfer could be responsible for the variety of changes observed in aging cultured human cells. PMID- 2721601 TI - Effects of a vitamin-A-free diet on tissue vitamin A concentration and dark adaptation of aging rats. AB - Changes in serum, hepatic, and ocular vitamin A levels were followed in 9-month old Long Evans rats fed either a vitamin-A-free or vitamin-A-sufficient diet for up to 18 months. After 18 months, hepatic total vitamin A fell exponentially from 2542 +/- 433 to 48 +/- 12 micrograms/g wet weight, but these stores maintained normal serum retinol and ocular total vitamin A concentrations in vitamin-A deprived rats. However, retinal dark-adaptation time, a functional indicator of photoreceptor integrity, was prolonged in elderly vitamin-A-deprived rats as compared to vitamin-A-sufficient controls (p less than 0.05). Aging appeared to be the most important factor that depressed the rate of dark adaptation, with vitamin A status having a secondary effect. The proportion of total ocular retinaldehyde decreased (p less than 0.05) and the concentration of retinyl ester increased (p less than 0.05) in the eyes of 27-month-old vitamin-A-deprived rats compared to age-matched vitamin-A-sufficient animals. Possible mechanisms of visual dysfunction include abnormal retinal rhodopsin recycling caused by a dependence on newly absorbed dietary vitamin A (e.g., chylomicron). Alternatively, in the vitamin-A-deprived rat, decreased hepatic oxidation of pentobarbital (used for electroretinographic anesthesia) could prolong retinal anesthetic exposure and either directly depress neural transmission or indirectly alter transmission by affecting rhodopsin recycling. PMID- 2721602 TI - Relationship between aging, drug treatment and the cerebral enzymatic antioxidant system. AB - Four different brain regions (parieto-temporal cortex, caudate-putamen, substantia nigra, and thalamus) were examined in rats aged 5, 10, 15, 20, 25, 30, and 35 months. The following enzyme activities related to the antioxidant system were measured: glucose-6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase, glutathione peroxidase, glutathione reductase, and superoxide dismutase (as total). Specific enzyme activities vary markedly with age, according to the various regions studied, indicating nonhomogenous vulnerability of different brain regions to aging. In general, both superoxide dismutase and glutathione reductase tended to decline during the last half of life, while glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase tended to increase slightly with age. In rats of 10, 20, or 30 months, chronic treatment for two months with a vasodilator (papaverine) or a calcium-blocker (nicardipine) indicated that the antioxidant enzyme activities are partially influenced according to the exogenous agent used, the brain region tested, and the age of the animals. PMID- 2721603 TI - Age-related changes in the motor response to environmental novelty in the rat. AB - To examine age-related changes in responsiveness to environmental novelty, 3-, 12 , and 24-month-old male Fischer 344 rats were maintained on a restricted diet and exposed to a modified open field for 10 min on each of 10 consecutive days. On the first day of testing, animals of all groups showed equal amounts of rearing. While the 3-month animals continued to show approximately the same levels of rearing until the 8th day, by day 5, the older groups (12- and 24-month) had significantly reduced their rearing. Conversely, grooming was initially highest among the 24-month-old animals. While 3- and 12-month rats showed habituation of grooming, the oldest animals failed to habituate their grooming response by day 5. By day 10, there were no significant differences among the groups in either rearing or grooming. Although food was available in the center of the modified open field, there was little eating and there were no differences among groups. However, all animals did eat quickly when food was made available in their home cages. Thus, all animals displayed a profile of stress-related responses to open field exposure. Plasma corticosterone levels likewise were elevated in the modified open field. Some, but not all, components of this response profile habituated over the 10 days of exposure. Three-month-old animals responded to the novelty predominantly by rearing and 24-month animals predominantly by grooming. This suggests that with aging, locomotor responses to stress are replaced by a more self-directed form of displacement activity. PMID- 2721604 TI - Doxorubicin toxicity and pharmacokinetics in old and young rats. AB - Doxorubicin (Dx) toxicity was compared in old (24 months) and young (6 weeks) Crl:CD(SD) BR male rats, and a clear age-related increase was found. The mortality of all animals receiving a single i.v. Dx dose was followed for 270 days. Old rats died after doses of 2.5 mg/kg, while young animals died after doses two times higher, 5 mg/kg. In old rats body weight loss started 10 to 15 days after Dx, compared to 50 to 80 days for young animals. In young and old rats pharmacokinetic and metabolic studies of Dx were conducted in vivo and in the liver perfusion model. Peak levels of Dx and areas under the time/concentration curves (AUC) in serum and in several tissues of old rats were 1.5 to 2 times higher than in young rats. Concentrations of Dx metabolites in serum and tissues (doxorubicinol, Dxol, and doxorubicinone, Dxone) in young and old rats were not noteworthy. However, higher percentages of Dxone than Dxol were found in both groups in vivo and in vitro. Old livers appeared to produce more Dxone as a percentage, particularly in the bile, which was higher. Urinary elimination of Dx markedly slowed with age; only small amounts of the metabolites were eliminated in urine. In vivo and in vitro availability of Dx and its metabolites is discussed in view of their possible role in the greater toxicity observed in 24 month-old rats. PMID- 2721605 TI - The waste-product theory of aging: transformation to unlimited growth in cell cultures. AB - A differential equation governing intracellular waste content is solved numerically to determine the circumstances under which the growth of an in vitro cell population is limited. Parameter values derived from data on human glial cell cultures are employed. It is assumed that a) waste accumulation depresses the rate of cellular reproduction and b) intracellular waste is diluted by cell division, but is not otherwise eliminated. Population size depends upon two parameters: the rate of waste production and the rate of cell division in the absence of waste. If the rate of waste production is sufficient, the population size approaches an asymptote as in phase III growth in vitro. If a lower rate of waste production allows the cells to outmultiply the waste, growth is unlimited as in a transformed cell population. The asymptotic population size and the threshold for unlimited growth are remarkably sensitive to small changes in the values of the two rate parameters unless the ratio of their values is constant. This suggests that there may be a cellular mechanism that relates the waste production and cell division rates. PMID- 2721606 TI - Abstracts. International Society for Experimental Hematology, XVIIIth annual meeting. 16-20 July 1989, Paris, France. PMID- 2721607 TI - Visual cancellation of the torsional vestibulo-ocular reflex in humans. AB - Using the eye-coil/magnetic field method, we measured the torsional vestibulo ocular reflex (VOR) in ten subjects during active head rotations in roll at about 0.5 Hz. In the dark, regardless of instructions or mental effort, the gains (eye velocity/head velocity) had a mean value of around 0.61. When they viewed a visual display that was stationary, gains rose to 0.72. When viewing a visual display that moved in roll with their heads, subjects could decrease their gains to a mean of 0.46. Separate experiments showed that, as expected at this frequency, the optokinetic system made only a weak contribution. It has been proposed that the horizontal VOR is cancelled by the smooth pursuit system. Since there is no torsional pursuit system, some other mechanism must be used to augment or partially cancel the torsional VOR. Attempts to show that imagination could change this gain showed only weak effects. When asked to imagine an earth fixed scene, gains were around 0.63; when asked to imagine a subject-fixed scene, gains decreased to only 0.60. When allowed to use a tactile contribution to aid the imagination in cancelling the VOR, the gain dropped further but only to 0.57. We conclude that mental effort in the dark has little influence on the torsional VOR but vision does by a mechanism that is not optokinetic or pursuit. PMID- 2721609 TI - Trajectory control in targeted force impulses. VI. Independent specification of response amplitude and direction. AB - The preceding study of this series (Hening, Favilla and Ghez 1988) examined the time course of the processes by which human subjects use information from a target to set the amplitude of an impulse of isometric elbow force. In that study, subjects were provided with separate cues to time response initiation and to inform them of the required amplitude of the response. When the time between target presentation and response initiation was too brief for them to incorporate information from the target, subjects produced default responses whose amplitudes reflected their prior experience. At longer latencies, subjects specified response amplitude with a gradual time course, starting earlier and ending later than an average reaction time. The present study now examines how two distinct response features, amplitude and direction, are specified following presentation of a target. We sought to answer three main questions. What are the features of responses that are produced before target information is available? Are direction and amplitude specified serially or in parallel? Does the specification of one response feature interfere with the specification of the other? Six normal subjects were studied. They were trained to initiate impulses of isometric elbow force in synchrony with the last of a predictable series of regular tones. The amplitudes and directions were to match those of visual targets requiring flexions or extensions with one of three amplitudes. The targets were presented at random times (0-400 ms) before the last tone. Target directions and amplitudes were either predictable (simple condition) or unpredictable (choice condition). In the simple condition, response amplitudes and directions were independent of the interval between target presentation and response onset (S-R interval). In the choice condition, both amplitude and direction varied with the S-R interval. At short S-R intervals (less than 100 ms), the direction of the subjects' responses was not related to that of the target. The amplitudes of the responses were near the centers of the two target ranges. With increasing S-R intervals, the proportion of correct direction responses gradually increased. Over the same range of S-R intervals, the amplitudes of both right and wrong direction responses to the different targets separated and converged on their respective target amplitudes. Specification of both direction and amplitude was complete at S-R intervals greater than 300 ms. The time course of amplitude specification in this bidirectional paradigm was prolonged over that in a paradigm where response direction was predictable.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2721608 TI - Projections from the rostral mesencephalic reticular formation to the spinal cord. An HRP and autoradiographical tracing study in the cat. AB - Eye and head movements are strongly interconnected, because they both play an important role in accurately determining the direction of the visual field. The rostral brainstem includes two areas which contain neurons that participate in the control of both movement and position of the head and eyes. These regions are the caudal third of Field H of Forel, including the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal with adjacent reticular formation (INC-RF). Lesions in the caudal Field H of Forel in monkey and man result in vertical gaze paralysis. Head tilt to the opposite side and inability to maintain vertical eye position follow lesions in the INC-RF in cat and monkey. Projections from these areas to extraocular motoneurons has previously been observed. We reported a study of the location of neurons in Field H of Forel and INC-RF that project to spinal cord in cat. The distribution of these fiber projections to the spinal cord are described. The results indicate that: 1. Unlike the neurons projecting to the extra-ocular muscle motoneurons, the major portion of the spinally projecting neurons are not located in the riMLF or INC proper but in adjacent areas, i.e. the ventral and lateral parts of the caudal third of the Field H of Forel and in the INC-RF. A few neurons were also found in the nucleus of the posterior commissure and ventrally adjoining reticular formation. 2. Neurons in caudal Field H of Forel project, via the ventral part of the ventral funiculus, to the lateral part of the upper cervical ventral horn. This area includes the laterally located motoneuronal cell groups, innervating cleidomastoid, clavotrapezius and splenius motoneurons. At lower cervical levels labeled fibers are distributed to the medial part of the ventral horn. Projections from the caudal Field H of Forel to thoracic or more caudal spinal levels are sparse. 3. Neurons in the INC-RF, together with a few neurons in the area of the nucleus of the posterior commissure, project bilaterally to the medial part of the upper cervical ventral horn, via the dorsal part of the ventral funiculus. This area includes motoneurons innervating prevertebral flexor muscles and some of the motoneurons of the biventer cervicis and complexus muscles. Further caudally, labeled fibers are distributed to the medial part of the ventral horn (laminae VIII and adjoining VII) similar to the projections of Field H of Forel. A few INC-RF projections were observed to low thoracic and lumbosacral levels.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2721610 TI - Environmentally-specified patterns of movement coordination in normal and split brain subjects. AB - Rhythmic movement patterns between the hands in response to environmental signals are studied in normal (musicians and nonmusicians) and split-brain subjects. Only two phase-locked states - in-phase and anti-phase - are shown to be stable for all subjects. Split-brain subjects show an even greater attraction to these patterns, thus providing no support for the notion that reduced cortical interaction between the hemispheres allows for independent visuomotor control of the hands in such tasks. Moreover, differences in trajectories produced by normal individuals and those without an intact corpus callosum are remarkable. The resultant patterns of coordination afford 1) a generalization of previous results on intrisincally generated rhythmic behavior to environmentally-specified movement patterns; and 2) a discussion of neural mechanisms underlying stable phase relations. PMID- 2721611 TI - Human fetal spinal cord xenografts survive in the eye of athymic nude rat hosts. AB - Human fetal spinal cord tissue was recovered from elective abortions and grafted to the anterior chamber of the eye of adult athymic nude rats. The transplants slowly became vascularized from the host iris during the first months. There was a clear cut stage-dependent survival and growth along a more "human" time-table. Fetal spinal cord tissue from embryos younger than gestational week 8 showed a much better survival and growth than tissue from older stages. Using laminin immunohistochemistry blood vessels could be visualized in the grafts. The pattern of vascularization was, however, clearly abnormal; there were fewer vessels which had abnormally thick walls as compared to those in the normal spinal cord. Similar to rat spinal cord allografts the human spinal cord xenografts displayed a relative gliosis and were surrounded by a glial layer visualized with antibodies against glial fibrillary acidic protein. Neurofilament-immunoreactive fibres were found inside the glial layer. A variety of neurons were found including large polygonal motoneuron-shaped cells, albeit with CGRP and AChE negative cell bodies. Both Substance P and enkephalin-immunoreactive cells and fibres were found. It is concluded that xenografted fetal human spinal cord survives, grows and may provide a useful model for experimental studies of human spinal cord development and connectivity. PMID- 2721612 TI - Characterization of input synapses on intracellularly stained neurons in hippocampal slices: an HRP/EM study. AB - This study describes the fine structure of input synapses on identified neurons in slices of the guinea pig hippocampus. For morphological identification, granule cells of the fascia dentata and pyramidal neurons of regio inferior of the hippocampus were impaled and intracellularly stained with horseradish peroxidase (HRP). Input synapses on the HRP-stained neurons were identified in the electron microscope by the location of the synapses in inner or outer zones of the dentate molecular layer, as in the case of the synaptic contacts on injected granule cells, or by unique fine structural characteristics, as in the case of the giant mossy fiber boutons on CA3 pyramidal cells. As in tissue fixed in situ by transcardial perfusion, a large number of terminals arising from the different afferents in inner and outer zones of the dentate molecular layer were well preserved and formed synaptic contacts with small spines, large complex spines, and dendritic shafts of the HRP-filled granule cells. Mossy fiber synapses on the stained CA3 neurons were densely filled with clear vesicles, contained a few dense-core vesicles, and formed synaptic contacts with large spines or excrescences. Occasionally electrondense degenerating boutons were also found impinging on the stained dendrites and spines. The significance of the present findings for electrophysiological and pharmacological studies on brain slices is discussed. PMID- 2721613 TI - Neck muscle activation patterns in humans during isometric head stabilization. AB - A musculoskeletal system with more muscles than there are motions could be programmed in alternative ways to produce a single movement. In this case, the muscles would have the potential to be maximally responsive in multiple directions rather than responding preferentially in a single direction. To determine the response patterns of muscles in the head-neck motor system, the simultaneous activation of four of the 23 neck muscles acting on the head was recorded with both surface and intramuscular electrodes. Fifteen human subjects were tested during an isometric head stabilization task. When the EMG response patterns were plotted, each muscle demonstrated a preferred direction of activation. This preferred activation direction was consistent in all of the subjects for three of the muscles tested. The fourth muscle, splenius, was preferentially activated during neck flexion in half of the subjects and during neck extension in the other half. Increasing the force parameters of the task suggested a linear relationship between force and the EMG output in the preferred response directions. Responses in the nonpreferred directions were produced by a nonlinear change in EMG activation of the muscle. This finding could have implications for theories of how reciprocal activation and cocontraction patterns of response are elicited. Results from this study, that the CNS programs neck muscles to respond in specific orientations rather than generating an infinite variety of muscle patterns, are in agreement with our findings in the cat. PMID- 2721614 TI - Seizure-induced damage in the substantia nigra pars reticulata: lesions in the frontal cortex prior to the seizure period mitigate the damage. AB - Flurothyl-induced status epilepticus in the rat causes a hypermetabolic necrosis in the substantia nigra pars reticulata (SNPR). We studied if cortically generated excitatory input into the SNPR was causative of the structural damage. Rats were subjected to a unilateral frontal cortex lesion prior to induction of 40 min status epilepticus. A distinct mitigation in the size of the necrotic region in the ipsilateral SMPR was noted when compared to the contralateral side of the same animals (N = 10). No side difference was noted in animals where a lesion of similar size was placed in the parietal cortex region (N = 2) or in unlesioned animals subjected to seizures (N = 4). Neither analyses of energy metabolites in the cerebral cortex nor EEG revealed any side differences during seizures in the animals with lesions in the frontal cortex. This suggests that difference in seizure intensity was not the explanation for the mitigation of SNPR damage. It is suggested that the excitatory input from the frontal cortex was necessary for development of neuronal necrosis in the SNPR due to seizures. PMID- 2721615 TI - Distribution of galanin-binding sites in the monkey and human telencephalon: preliminary observations. AB - Using X-ray film autoradiography the distribution of 125I-galanin binding sites was studied in the forebrain of monkey and man. In the monkey a high density was found in all areas of the neocortex, especially layer 4, and in certain subfields in the hippocampal region. Also in the human brain high activity was seen in neocortex, mainly layer 6 and in hippocampal areas, as well as in amygdala, piriform cortex and hypothalamus. These results suggest that the 29-amino acid peptide galanin may be involved in the regulation of higher cortical functions in primates. PMID- 2721616 TI - Response properties and tonotopical organization in the dorsal cochlear nucleus in rats. AB - Pure tone burst stimulation was used to study discharge properties and tonotopic organization in the dorsal cochlear nucleus (DCN) of rats anesthetized with alpha chloralose urethane. An animal's head was fixed with a fine nail embedded in the skull in order to prevent the head from moving. Unit discharges of DCN neurons were recorded with micropipettes filled with fast green dye. Free field pure tone bursts were presented using a ribbon tweeter; it delivered stimuli at a maximum SPL of 96 dB. Electrode tracks were reconstructed through subsequent histological examinations. A total of 429 units were sampled in 51 animals. Of these, 230 units (54%) responded to tone bursts higher than 20 kHz with a mean latency of 6.3 ms. Tonotopical organization was clearly evident throughout the mediolateral axis of the DCN; high frequencies were represented medially and low frequencies laterally. Nearly constant frequencies were represented along the dorso-ventral axis and no systematic organization was observed along the rostrocaudal extension of the DCN. When tuning curves were measured in DCN neurons with excitatory and inhibitory responses, we found that inhibitory sidebands were usually located in a frequency range higher or lower than the excitatory response area and sometimes partially overlapped with it. PMID- 2721617 TI - The effects of cryogenic blockade of the centrifugal, bulbopetal pathways on the dynamic and static response characteristics of goldfish olfactory bulb mitral cells. AB - The responses of single goldfish olfactory bulb mitral cells were studied by extracellular recordings before and during cryogenic blockade of the efferent, centrifugal pathways in the ipsilateral olfactory tract. In each experiment the same odour was presented 40 times before and then 40 times during cooling. Each stimulus period (at least 30 s) was preceded by a stimulus-free interval (at least 30 s), during which a steady stream of tap water was applied. These procedures allow the investigation of activity changes of single neurons and of cell ensembles using statistical methods. i) In comparison with the pre-cooling activity, cooling of the efferent pathways did not cause a generalized disinhibition in mitral cell responses. Significant disinhibitory, significant inhibitory and indifferent effects occurred in about the same proportion during repetitive water and odour applications. ii) Abrupt or slow changes of single mitral cell discharge patterns during the 40 water and odour applications were observed before and during blocking of the efferent fibre systems: These pattern changes are therefore not necessarily a consequence of the efferent signals, and may thus have been a result of intrabulbar plasticity. iii) The most notable effect of efferent fibre blockade across all experiments was a significant (Wilcoxon-rank-test, P = 0.01) decrease of the signal to noise ratio i.e., the ratio between the activity during the "spontaneous" (water) and the stimulus (odour) phase, which could be demonstrated for both the phasic (immediately after stimulus onset) and tonic (during long term stimulation) components of the mitral cell responses. PMID- 2721618 TI - Projections from the medial septum and diagonal band of Broca to the dorsal and central superior raphe nuclei: a non-cholinergic pathway. AB - The anatomical organization of projections from the medial septal nucleus (MS), and the vertical (VDB) and horizontal limb (HDB) of the diagonal band of Broca to the dorsal raphe nucleus (NRD) and the central superior raphe nucleus (RCS) of the rat were studied by anterograde [3H]-leucine, and True Blue and Fluoro Gold fluorescent retrograde tracing. Projections from the MS were found to enter the basal mesencephalon at the rostro-medial aspect of the pontine nuclei, curve dorsally and terminate throughout the RCS and in the caudal portion of the NRD. Fibers from the VDB were found to enter these raphe nuclei by two separate routes; some fibers reached the basal mesencephalon, curved dorsally and terminated in the RCS and NRD. Other fibers entered the pedunculopontine nucleus, curved medially and reached the NRD. Presumed terminal labelling was found overlaying the RCS and NRD throughout their rostro-caudal extensions. The brain stem projections from HDB entered the mesencephalon by the same routes as those from VDB, but the labelling over RCS was sparse, and the NRD labelling was preferentially distributed to the rostral portion of the nucleus. The present data indicate a crude topographic organization of the projections from the septal region to the NRD and RCS. In general, the distribution of presumed terminal labelling appeared to be more closely associated with the distribution of NRD and RCS 5-HT immunoreactive cell bodies, than with the cytoarchitectonically defined extensions of these raphe nuclei. By sequential evaluation of the distribution of retrogradely labelled and acetylcholine esterase-stained cells on the same section, and by selective tracing with radiolabelled choline, it appears that the vast majority, if not all, of the neurons in MS and diagonal band which project to the rostral raphe are non-cholinergic. PMID- 2721619 TI - Object-centered encoding by face-selective neurons in the cortex in the superior temporal sulcus of the monkey. AB - Neurophysiological studies have shown that some neurons in the cortex in the superior temporal sulcus and in the inferior temporal cortex respond to faces. To determine if some face responsive neurons encode stimuli in an object-centered coordinate system rather than a viewer-centered coordinate system, a large number of neurons were tested for sensitivity to head movement in 3 macaque monkeys. Ten neurons responded only when a head undergoing rotatory movements was shown. All of these responded to a particular movement independently of the orientation of the moving head in relation to the viewer, maintaining specificity even when the moving head was inverted or shown from the back, thereby reversing viewer centered movement vectors. This was taken as evidence that the movement was encoded in object-centered coordinates. In tests of whether there are neurons in this area which respond differently to the faces of different individuals relatively independently of viewing angle, it was found that a further 18 neurons responded more to one static face than another across different views. However, for 16 of these 18 cells there was still some modulation of the neuronal response with viewing angle. These 16 neurons thus did not respond perfectly in relation to the object shown independently of viewing angle, and may represent an intermediate stage between a viewer-centered and an object-centered representation. In the same area as these neurons, other cells were found which responded on the basis of viewer-centered coordinates. These neurophysiological findings provide evidence that some neurons in the inferior temporal visual cortex respond to faces (or heads) on the basis of object-centered coordinates, and that others have responses which are intermediate between object-centered and viewer-centered representations. The results are consistent with the hypothesis that object-centered representations are built in the inferior temporal visual cortex. PMID- 2721620 TI - Neurochemical correlates of conditioned circling within localized regions of the striatum. AB - Two experiments were conducted to determine the effects of conditioned circling on the concentrations of dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) within discrete regions of the striatum (STR). The first study assessed the inherent regional distributions of these compounds with respect to the three primary axes: anterior-posterior, dorsal-ventral and medial lateral. Concentrations of DA, DOPAC and HVA and the ratios of each metabolite to DA were found to vary across each dimension. However, the topographical distribution of each compound was unique. The results of the first experiment confirm that the STR is not a homogeneous structure. It is possible that the regional variations in dopamine metabolism underly the diverse functions which the STR is thought to modulate. The second experiment determined whether specific regions of the STR were differentially involved in the mediation of conditioned circling. DA metabolism, as estimated by metabolite concentrations and metabolite to DA ratios, was bilaterally increased within the anterior dorsomedial and dorsolateral STR, relative to noncircling, water-deprived controls. DOPAC and the corresponding ratio were enhanced selectively within the dorsomedial region, whereas HVA and its ratio to DA were increased preferentially within the dorsolateral STR. The ratio of DOPAC to DA was also enhanced within the anterior ventromedial STR. No other significant neurochemical effects were detected. These results support the hypothesis that the dorsal STR critically subserves circling. Moreover, it is possible that the medial and lateral regions of the dorsal STR are differentially involved in circling. These results also confirm previous reports of bilateral augmentation of striatal DA metabolism in association with high rates of conditioned circling. PMID- 2721621 TI - Mossy fiber synapses on glutamate decarboxylase-immunoreactive neurons: evidence for feed-forward inhibition in the CA3 region of the hippocampus. AB - Mossy fibers are known to form excitatory synapses on pyramidal neurons in regio inferior of the hippocampus. This study demonstrates that the mossy fibers also establish synaptic contacts with glutamate decarboxylase-immunoreactive, supposedly GABAergic inhibitory neurons in the CA3 region. The observed connection provides a morphological basis for feed-forward inhibition of the pyramidal cells. PMID- 2721622 TI - Nonradioactive detection of vasopressin mRNA with in situ hybridization histochemistry. AB - In situ hybridization histochemistry has been used successfully by many laboratories to detect mRNAs within single cells in the CNS. The detection of these hybrids in CNS tissue sections has been accomplished mainly with radioactive probes. However, radiolabeled probes have intrinsic limitations, including the long exposure time required for high resolution autoradiography and the inability to detect multiple RNA species within the same neuron. Here we report a new method to detect mRNA in situ using a synthetic DNA probe conjugated to alkaline phosphatase (AP). The probe was synthesized to be complementary to the glycoprotein coding region of vasopressin mRNA. Under normal hybridization conditions high resolution detection of vasopressin mRNA within individual neurons was routinely obtained within 8 h. The distribution of hybridization signal obtained with the AP-conjugated probe was identical to that observed with the same probe radiolabeled with [35S]dATP. Hybridization-positive neurons were found in all regions of the CNS that have been previously reported to synthesize vasopressin, including magnocellular neurons in the paraventricular nucleus (PVN) and the supraoptic nucleus. Small diameter neurons were also observed in the suprachiasmatic nucleus, the accessory PVN, the bed nucleus of the stria terminalis, and a cell group along the ventral surface of the optic tract. These results suggest that nonradioactive detection of neuropeptide mRNA in situ can be easily accomplished within 24 h. Furthermore, the improved resolution with AP conjugated oligonucleotide probes should enhance efforts to study the regulation of gene expression in the nervous system. PMID- 2721623 TI - Spatial learning in rats: correlation with cortical choline acetyltransferase and improvement with NGF following NBM damage. AB - Rats display an acquisition deficit in a circular water maze following excitotoxic lesions of the nucleus basalis magnocellularis (NBM). Experiments were therefore performed to determine if acquisition behavior on this task could predict the degree of cortical cholinergic deafferentation and if the acquisition deficit could be pharmacologically reversed. Performance on acquisition was highly correlated with the lesion-induced reduction in cortical choline acetyltransferase (ChAT) activity. Accuracy of spatial behavior was highly correlated to percentage ChAT depletion (r = 0.75). Neither lesioned rats nor controls displayed a retention deficit after a 9-day interval, nor did either group display a passive-avoidance retention deficit. To test the causal relationship between cholinergic dysfunction and spatial behavior, the central nervous system cholinergic enhancer nerve growth factor (NGF) was intraventricularly infused for 4 weeks. NGF infusion resulted in improved acquisition of the water maze task compared to NBM-lesioned rats receiving vehicle infusion and untreated rats with NBM lesions. These studies indicate that the decrease in cortical ChAT activity is likely to be responsible for the observed acquisition deficit and that pharmacological manipulations can be successfully used to improve behavior following NBM lesions. PMID- 2721624 TI - Decreased adrenal medullary catecholamines in adrenal transplanted parkinsonian patients compared to nephrectomy patients. AB - Adrenal medullary catecholamines were measured in tissue samples from eight patients who underwent autologous transplantation of the adrenal medulla to the caudate nucleus as a treatment for Parkinson's disease. These adrenal catecholamine levels were compared to a group of patients of similar age who underwent unilateral nephrectomy for renal cell carcinoma. The levels of each catecholamine, expressed as nanomoles per milligram wet weight tissue, were significantly lower (P less than or equal to 0.005) in the parkinsonian patients than in the nephrectomy patients. These observations support data reported previously from autopsy specimens and suggest that the adrenal medullae of parkinsonian patients may be a compromised source of dopamine-producing tissue; this may limit its effectiveness in eliciting maximum clinical improvement following transplantation. PMID- 2721625 TI - Absence of linkage of ABO blood group locus to familial tuberous sclerosis. AB - A mutation leading to tuberous sclerosis was linked to the ABO blood group locus (9q34) on the long arm of chromosome 9. In an effort to confirm this assignment, nine multigenerational families with tuberous sclerosis, comprising 126 sampled individuals, were assessed for linkage of the ABO locus to tuberous sclerosis. Two-point linkage analysis and multilocus linkage analysis were used to evaluate linkage between tuberous sclerosis and the markers ABO, MCT136, and AblK2. Linkage of ABO to tuberous sclerosis was excluded for a distance of 20 centimorgans (cM) encompassing the region of the ABO locus. There was no evidence for genetic heterogeneity within this data set. Using 23 polymorphic markers, exclusion mapping demonstrated only a 1% probability that the tuberous sclerosis locus was on the distal short arm of chromosome 9 and provided no evidence in support of a tuberous sclerosis locus on the remainder of chromosome 9 including the area of the ABO locus. PMID- 2721626 TI - Sweat gland reinnervation by sudomotor regeneration after different types of lesions and graft repairs. AB - Clinical and experimental investigations have shown that recovery of motor and sensory functions after a nerve lesion varies with the type of lesion and the repair technique. We report a study on regeneration of sudomotor axons to sweat glands (SGs) in the mouse paw following different sciatic nerve injury procedures: freezing, crushing, and sectioning. After sectioning, repair was by primary suture or by grafting with the resected section or with conduits of plastic or collagen. Successful regeneration was marked by the reappearance of SG reactivity to pilocarpine. After a freezing or crushing lesion, SGs activated by pilocarpine reappeared by 17 days postoperation and then increased progressively in number until the preoperative number of SGs were again active at 41 days. Cutting the nerve followed by primary repair resulted in a short delay and a significant deficiency in reinnervation. Results obtained with a graft of a segment of resected nerve were similar to primary repair after nerve section and better than when grafts of plastic or collagen tubes were used. This suggests that substances provided by the grafted nerve segment and the type of conduit provided play important roles in the regeneration of unmyelinated axons. PMID- 2721627 TI - The effects of tones on PGO waves in slow wave sleep and paradoxical sleep. AB - Ponto-geniculo-occipital (PGO) waves are macropotential waveforms occurring spontaneously during paradoxical sleep (PS) in the pons, the lateral geniculate body (LGB), and the occipital cortex of the cat. In our earlier work (6, 20) tones elicited waves in the LGB and the occipital cortex during both slow wave sleep (SWS) and PS that resembled PGO waves in form and amplitude. Using a limited and variable number of trials, we observed that these elicited waveforms, which we term elicited PGO waves (PGOE), seemed to decline rapidly in amplitude and probability during SWS but not during PS. The present two experiments served as a more rigorous test of the hypothesis that the rate of habituation of PGOE would be more rapid in SWS. In a first experiment seven cats were studied in up to four sessions in PS and four in SWS; each session consisted of 32 1000-Hz, 90 dB SPL tones lasting 90 ms. We found that (i) the number of PGOE was significantly greater in PS; (ii) the mean amplitude of the waves was greater in PS; (iii) the probability of eliciting a wave tended to decline faster in SWS, but some decline also occurred in PS; and (iv) on the first trial, PGOE were more easily produced in SWS. Results of a second experiment with five cats suggested that the decline in the probability of PGOE in PS was not accounted for by differences in the ease of eliciting them at different times into a PS episode. The role of the dorsal raphe nucleus (DRN) in modulating state-dependent differences in PGOE is discussed. PMID- 2721628 TI - Simultaneous catecholamine histofluorescence and thymidine autoradiography of the sexually dimorphic nucleus of the preoptic area in the rat. AB - The sexually dimorphic nucleus of the preoptic area (SDN-POA) in the rat represents a morphological substrate in which the influence of gonadal hormones on the process of sexual differentiation of the brain can be seen. Since the medial preoptic area (MPO) is a region rich in catecholamine (CA) terminals, it is possible that catecholamines may play a role either in the differentiation of the perinatal SDN-POA or in the function of this nucleus in the adult. It is not known whether catecholamine terminals exist within the SDN-POA or whether they can directly influence the activity of SDN-POA neurons. The present study was conducted to determine the extent to which catecholamines innervate this nucleus and further to elucidate the possibility of a potential sexual dimorphism in the innervation pattern. In order to determine which of the neurons in the MPO are within the SDN-POA we have utilized the fact that the SDN-POA has a prolonged period of neurogenesis in comparison to other neurons of the MPO. Thus, tritiated thymidine-labeled neurons can be used as a detection criterion for the SDN-POA. To conduct this experiment, timed pregnant Sprague-Dawley females were given a single injection of [3H]thymidine on Day 18 of gestation. Pups were killed as adults and prepared for fluorescence histochemistry of monoamines. Sections adjacent to those examined for catecholamine fluorescence were treated for autoradiographic localization of [3H]thymidine. Fluorescence innervation patterns were plotted within the boundaries of the nucleus following its identification from Nissl sections as well as from adjacent autoradiograms simultaneously viewed in a comparator bridge microscope with dark-field illumination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721629 TI - Reduction of paired pulse inhibition in the CA1 region of the hippocampus by pilocarpine in naive and in amygdala-kindled rats. AB - Subconvulsant doses (20 mg/kg) of pilocarpine administered to a kindled rat convert a kindled seizure to status epilepticus. The hippocampus is involved in such status epilepticus. Furthermore, evidence is accumulating that GABA-mediated inhibition in the hippocampus is chronically diminished by kindling. The studies presented here compared the electrophysiologic effects of pilocarpine in vivo in the CA1 region of the hippocampus in naive and amygdala-kindled rats. A paired pulse paradigm previously shown to quantify the potency of GABAergic inhibition was employed. Stimuli were delivered in the CA3 region of urethane-anesthetized rats and population spikes were recorded in the contralateral CA1 region. In naive rats, pilocarpine (6-60 mg/kg) caused a left shift in the input-output curve measuring stimulus intensity vs population spike amplitudes, indicating an increase in neuronal excitability. In addition, paired pulse inhibition was reduced for interpulse intervals less than 70 ms. In amygdala-kindled rats, neuronal excitability was also enhanced following pilocarpine administration. The potency of baseline paired pulse inhibition was decreased in kindled rats compared to naive controls. Following pilocarpine, inhibition for interpulse intervals less than 70 ms was further reduced, but to a lesser extent than in naive rats. These findings suggest that the ability of subconvulsive doses of pilocarpine to change a discrete kindled seizure triggered by one stimulus to status epilepticus depends on the suppression of GABAergic inhibition below a critical level. PMID- 2721630 TI - Effects of prolonged retinal ganglion cell inactivity on superior colliculus glucose metabolism in the mature hooded rat. AB - Previous work utilizing the 2-deoxyglucose (2-DG) technique demonstrated that denervation, both direct (enucleation) or indirect (retinal receptor destruction, leaving ganglion cells intact), resulted in a depression followed by an increase in glucose metabolism in the superior colliculus (SC) of the mature hooded rat. Both enucleation and receptor loss result in (1) cessation of ganglion cell activity and (2) disruption of connections between visual system neurons. To examine the relative importance of these two factors to the metabolic depression "recovery" sequence, retinal ganglion cells were silenced without denervation for periods ranging from 24 h to 2 months by means of repeated intraocular tetrodotoxin (TTX) injections. SC metabolic activity fell to levels comparable to those seen after enucleation or receptor damage, but no recovery was detected. A more sensitive within-animal comparison was carried out to detect any small shifts in metabolic activity which might have occurred during retinal blockade; after 1 or 2 months of monocular TTX treatment, either binocular enucleation or binocular TTX injections were performed 24 h before 2-DG, depriving both sides of the SC of retinal input. Metabolic activity was slightly higher in the SC that had received no retinal input for 1 or 2 months, indicating that physiological changes had occurred within the SC during the afferent blockade. A second group of rats was allowed to recover from the effects of long-term TTX for from 1 to 12 days and binocularly exposed to visual stimuli during 2-DG uptake to determine whether damage had resulted from the TTX injections and to assess the time course of the effects of retinal blockade on SC functional activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721631 TI - Vascular morphology and permeability in fetal CNS grafts to the renal capsule. AB - According to conventional neovascularization concepts, due to local tissue factors, a viable graft of central nervous (CNS) tissue should be expected to retain a complete blood-brain barrier (BBB) in its new site. In order to determine if grafted CNS would alter the phenotype of ingrowing peripheral vessels we have used an uncomplicated model. Rat fetal cortex, which already has a BBB to protein, was grafted to the subcapsular space of the host rat kidney. After postoperative times between 4 weeks and 3 months, horseradish peroxidase was injected systemically for periods between 90 s and 4 min. Correlative electron microscopy depicted vascular morphology. Each graft contained protein exudation particularly around large vessels in the neuropil. At the EM level some of the vascular endothelia had fenestrations, were invested with collagen, and were not contacted by astroglia. Capillaries indigenous to the CNS grafts and related normally to astroglial end feet were also prominent. The presence of non CNS vessels with peripheral ultrastructural and permeability characteristics would appear to contradict conventional theory in that CNS grafts can be vascularized by vessels of a different phenotypic and physiologic nature. PMID- 2721632 TI - Litomosoides carinii: mode of action in vitro of benzothiazole and amoscanate derivatives with antifilarial activity. AB - It is suggested that the recently developed benzothiazole and amoscanate derivatives with antifilarial activity exert their action in vitro by an inhibition of mitochondrial-derived respiration. It was confirmed that the drugs CGP 20376, 21835, 20308, 21306, and 6140 cause a rapid immobilization in vitro of the adult filarial worm, Litomosoides carinii, the time required being similar to rotenone at the same concentration. The other drugs investigated, CGPs 20309, 21833, 24589, 23518, and 13231, were also effective; however, they required much longer incubation times. Submitochondrial particles (SMP) were prepared from Ascaris muscle and rat liver. The concentration of drug causing 50% inhibition of respiration (IC50) was calculated. It was found that the drugs most rapidly inhibiting respiration have IC50s for NADH oxidase of less than 25 microM in both Ascaris and rat liver SMP. This effect on SMP respiration could be overcome by using succinate as a substrate, indicating the site of inhibition to be within complex I of the mitochondrial respiratory chain. Further experiments showed that whereas the respiratory chain's NADH:ferricyanide reductase was unaffected by these drugs, there were pronounced effects on both Ascaris and rat liver NADH:quinone reductase activity. This suggests that the inhibition within complex I occurs after the flavoprotein dehydrogenase, but before the site of the quinone reduction. The other compounds examined, which had a slower effect on motility, also showed inhibition of the NADH oxidase, but not to as great an extent as the aforementioned compounds. The compounds most active against motility were also most effective at inhibiting respiration in intact adult L. carinii. Analysis of the aerobic end products produced by L. carinii showed that acetate production was greatly reduced even in the presence of low concentrations of the drugs. There was also a slight decrease in lactate production. However, a direct effect on the glycolytic pathway was ruled out by two observations. One, that the production of lactate from cell-free extracts of L. carinii is unaffected by the presence of the drugs, and secondly, that a protozoan, Giardia lamblia, reliant on glycolysis for energy production, can survive for long periods of time in the presence of high concentrations of the drugs. A correlation can be observed between the time for immobilization of the filarial worm and the strength of inhibition of mitochondrial respiration. Therefore, it is suggested that, at least in vitro, the mechanism of toxicity of these antifilarials in L. carinii is due to the blocking of the respiratory chain at a site similar to that of rotenone. PMID- 2721633 TI - Angiostrongylus cantonensis: role of eosinophils in the neurotoxic syndrome (Gordon-like phenomenon). AB - The role of eosinophils in the pathophysiology of Angiostrongylus cantonensis infections was investigated in nonpermissive (guinea pig) and permissive (rat) hosts. Neurological symptoms similar to the Gordon phenomenon (ataxia, tremor, paralysis) together with a loss of Purkinje cells in the cerebellum were observed after intracraneal injection of human eosinophil extracts or after infection with A. cantonensis, only in guinea pigs and not in rats. Blood eosinophilia as well as eosinophil numbers present in the cerebellum and in the cerebrospinal fluid were higher in guinea pigs than in rats, at all times after infection with A. cantonensis. Increased levels of cytotoxicity toward L3 larvae in vitro were obtained in the presence of guinea pig eosinophils and IgE antibodies, rather than with the corresponding rat effector system. The detection of one eosinophil granule component, the eosinophil peroxidase, in the cerebrospinal fluid from infected guinea pigs but not from rats suggested that in nonpermissive hosts, neurological disorders, similar to the previously described Gordon phenomenon, might be due to eosinophil neurotoxins released after interaction of eosinophils with the parasites. PMID- 2721634 TI - Leishmania amazonensis: involvement of cysteine proteinases in the killing of isolated amastigotes by L-leucine methyl ester. AB - L-leucine-methyl ester (Leu-OMe) kills Leishmania mexicana amazonensis amastigotes by a mechanism which requires proteolytic cleavage of the ester. N Benzyloxycarbonyl-phenylalanyl-alanyl diazomethane (Z-Phe-AlaCHN2), a specific and irreversible inhibitor of cysteine proteinases, was used to characterize the enzymes involved in parasite destruction. It was shown that (1) amastigotes preincubated with micromolar concentrations of Z-Phe-AlaCHN2 survived challenge with Leu-OMe concentrations lethal to control parasites; (2) the proteolytic activity of 25- to 33-kDa cysteine proteinases in parasite lysates subjected to electrophoresis in gelatin-containing acrylamide gels was selectively inhibited in parasites pretreated with Z-Phe-AlaCHN2 and chased in inhibitor-free medium; and (3) cysteine proteinase activity was also inhibited in gels incubated with amino acid and dipeptide esters, possibly because the compounds were acting either as substrates (e.g., Leu-Leu-OMe) or as inhibitors (e.g., Ile-OMe) of the enzyme. The results support the involvement of low molecular weight cysteine proteinases in the destruction of amastigotes by Leu-OMe. Characterization of the structure and substrate specificity of the enzymes may permit the rational development of more selectively leishmanicidal amino acid derivatives. PMID- 2721635 TI - Subcutaneous transposition of the spleen enhances the survival rate following 90% hepatectomy in rats. AB - The effects of subcutaneous transposition of the spleen (STS) on the survival rate following 90% hepatectomy were investigated in rats. The survival rate was significantly higher in the STS group than in the non-STS group. Light microscopy enabled us to note that congestion in the terminal portal veins and sinusoids occurred either slightly earlier or to a higher degree in the non-STS group. PMID- 2721636 TI - VLDL substrate properties and efficiency of their metabolic transformation by LPL. AB - A study was made of the regulation of the triglyceride hydrolysis catalysed by LPL from bovine milk, by the apoproteins from human plasma VLDL. Both isolated apolipoproteins, and those found on the surface of plasma VLDL particles, were investigated. A concentration-dependent activating action of apo C-II on the hydrolysis of emulsified triolein, and uncompetitive inhibition of VLDL triglyceride hydrolysis by apo C-III were found. It is suggested that VLDL lipolysis might be controlled in vivo through the variation of the relative surface content of these enzymatic activity modulators. PMID- 2721637 TI - Purification of alpha-ketoaldehyde dehydrogenase from the human liver and its possible significance in the control of glycation. AB - Alfa-ketoaldehyde dehydrogenase, which was extracted and purified from human livers, may act on carbonyl compounds, such as 3-deoxyglucosone, and be involved in the control of glycation (Maillard reaction) in the body. PMID- 2721638 TI - Solubilization and characterization of a ouabain-sensitive protein from transverse tubule membrane-junctional sarcoplasmic reticulum complexes (TTM-JSR) in cat cardiac muscle. AB - A new glycoprotein of 31,500 dalton, which has a high affinity for ouabain, and is independent of (Na+-K+)-ATPase, was solubilized from transverse tubule membrane and junctional sarcoplasmic reticulum complexes (TTM-JSR) of cat cardiac muscle. This protein could be extracted only in small amounts from sarcolemma plasma membrane (SLM-PL) fragments, suggesting that it indeed originates from the TTM-JSR. PMID- 2721639 TI - Cycles of juvenile hormone esterase activity during the juvenile hormone-driven cycles of oxygen consumption in pupal diapause of flesh flies. AB - During diapause O2 consumption in fly pupae is a cyclic event (4-day periodicity at 25 degrees C) driven by cycles of juvenile hormone activity. Levels of juvenile hormone esterase activity change systematically during the cycle, with highest activity observed at the nadir of the O2 consumption cycle. PMID- 2721640 TI - Decreased number of asialoglycoprotein receptors in diabetic BB Wistar rat. AB - The binding of asialoglycoproteins by hepatic binding protein was studied in freshly isolated hepatocytes from genetically diabetic BB Wistar rats. The number of cell surface asialoglycoprotein receptors was dramatically decreased (58,000 +/- 38,000 for diabetic rats compared to 267,000 +/- 70,000 for normal rats), while the association equilibrium constant was not changed. These results parallel those obtained with streptozotocin-diabetic rats and support the hypothesis that insulin deprivation is responsible for the decrease in the receptor number. PMID- 2721641 TI - Colcemid effects on homologue pairing and crossing over during fetal mouse oogenesis. AB - Colcemid was administered to gestational day 13 female mice to test effects on homologue pairing, synapsis and recombination of fetal oogenesis. Pairing abnormalities were detected in pachytene oocytes by light and electron microscopy examination of bivalents and synaptonemal complexes. Reduction of total chiasmata per treated diplotene oocyte (22.74) compared to controls (31.07) was found. PMID- 2721642 TI - Effects of ethanol and acetaldehyde on cultured pre-implantation mouse embryos. AB - Pre-implantation 2-cell stage mouse embryos, obtained from superovulated CF-1 mice, were exposed to ethanol and acetaldehyde through the culture medium for 60 min followed by a 105-h incubation period. Control and ethanol exposed embryos survived equally well in ethanol concentrations as high as 800 mg/100 ml medium and acetaldehyde levels up to 10 mg/100 ml medium. PMID- 2721643 TI - Morphological and functional modifications of rat liver peroxisomal subpopulations during cold exposure. AB - A report is made (during cold exposure) of: a) the morphometric-stereologic analysis both on the whole rat liver peroxisomal population, and on 2 peroxisomal subpopulations having a diameter greater than 0.5 microns, and less than 0.5 microns, called Pe (Peroxisomes) and sPe (small Peroxisomes), respectively; b) the uricase and palmitoyl-coenzyme A oxidase activity assay on 2 classes of rat liver peroxisomes, sedimenting at 10,000 g and 27,000 g and containing Pe and sPe, respectively. The peroxisomal volume and number densities increase during cold exposure, reaching a maximum (+67% and +130%, respectively, P less than 0.05) at 10 days. These modifications are accompanied by an appreciable reduction of the average peroxisome volume (from 0.27 +/- 0.05 microns 3 to 0.19 +/- 0.02 microns 3) due to a major percentage increase of sPe during cold exposure. At a qualitative level, the formation of "clusters" and a stricter association between mitochondria and peroxisomes is also observed. Cold exposure increases the oxidative capacity of the whole peroxisomal compartment; in the Pe fraction the palmitoyl-CoA oxidase and uricase specific activity ratio is constant (about 0.1), during cold exposure, but in the sPe fraction this ratio increases significantly (from 0.05 to 0.09). The results indicate that the peroxisomal population is influenced during cold exposure, with the formation of a new peroxisomal population which is on average smaller and more specialized for the beta-oxidative activity. The possible involvement of peroxisomes in thermoregulatory thermogenesis during cold exposure is also discussed. PMID- 2721644 TI - Effects of 3,5,3'-triiodothyronine (T3) on rat liver peroxisomal compartment during cold exposure. AB - In this study, by enzymatic assays and morphometric-stereologic analyses, we show that the remodelling of the rat liver peroxisomal compartment, occurring during cold exposure, is largely influenced by the thyroid state of the animal. The research was performed both on the whole rat liver peroxisomal population and on 2 peroxisomal subpopulations: one having a diameter greater than 0.5 microns, sedimenting at 10,000 g and called Pe (Peroxisomes); and the other having a diameter less than 0.5 microns, sedimenting at 27,000 g and called sPe (small Peroxisomes). The increase in the peroxisome number and in the peroxisome volume densities, elicited by cold exposure, is greatly reduced in hypothyroid cold exposed animals (-63% and -40% respectively, P less than 0.01), while triiodothyronine (T3) administration to these rats restores the values observed in normal cold-exposed animals. The "clusters" and the strict association between mitochondria and peroxisomes, more frequently found in cold-exposed rats, are rarely observed in hypothyroid cold-exposed animals. At peroxisomal enzymic level, the thyroid hormone inhibits, during cold exposure, the uricase activity ( 29% in Pe and -40% in sPe), and stimulates the palmitoyl-coenzyme A oxidase activity (+44% in Pe and +88% in sPe). The results also demonstrate that T3 exerts all these effects by acting principally on sPe. PMID- 2721645 TI - Aromatase activity in the brain of the three-spined stickleback, Gasterosteus aculeatus. III. Effects of castration under different conditions and of replacement with different androgens. AB - Non-breeding stickleback males were gonadectomized or sham-operated in winter. They were then exposed to a high temperature and either a short photoperiod which did not induce breeding or to a longer, stimulatory, photoperiod. In the latter experiment empty Silastic capsules or capsules filled with the aromatizable androgen, androstenedione or the non-aromatizable androgen, 11 ketoandrostenedione were implanted intraperitoneally in the operated fish. Furthermore, males that were already in breeding condition were gonadectomized or sham-operated in late spring. Brains were freeze-sectioned and punches from the nucleus preopticus-nucleus anterioris periventricularis region were incubated with [19-3H]-androstenedione. After extraction of steroids with CH2CI2, the tritium activity remaining in the water phase gives a measure of aromatization as tritiated water and formic acid are formed when [19-3H]-androstenedione is aromatized to oestrogens. The aromatase activity was higher in sham-operated than in castrated fish in all three experiments. Both androstenedione and 11 ketoandrostenedione abolished the effect of gonadectomy on aromatization. PMID- 2721646 TI - Cardiovascular responses to hypoxia in the Atlantic cod, Gadus morhua. AB - The cardiovascular responses to hypoxia (oxygen tension in inspired water, PiO2 = 30-40 mmHg) was investigated in the cod before and after bilateral sectioning of the glossopharyngeal (IX) and the pretrematic ramus of the vagus (X) innervating the first pair of gill arches. The study demonstrates in the cod two distinct mechanisms of responses to environmental hypoxia. The first mechanism involves oxygen receptors located in the areas of the gills innervated by the nerves sectioned in the experiments. Hypoxic stimulation of these receptors produced slowly (approximately 6 min) developing bradycardia, and despite a 30%-50% decrease in heart rate, cardiac output remained virtually constant due to a concomitant increase in cardiac stroke volume. The second mechanism involves oxygen receptors located elsewhere, and these receptors trigger a rapidly (within approximately 2 min) developing increase in both ventral and dorsal aortic blood pressure, caused by an increase in the systemic vascular resistance. PMID- 2721647 TI - Potassium transport in rabbit erythrocytes. AB - The aim of the present investigation is to study the nature of the ouabain resistant tracer fluxes of K in rabbit erythrocytes. The data show that the rabbit red cell membrane has a high-capacity, chloride-dependent K transport which is stimulated by osmotic swelling, and which is relatively insensitive to inhibition by loop diuretics, compared to the Na-dependent K transport systems of human and avian red cells. It resembles a system first described in the "LK" (low potassium) sheep erythrocyte, and it is probably the pathway behind the net K efflux which accompanies the regulatory K loss seen in rabbit erythrocytes following osmotic swelling, first recognised by Davson (1937). Further, the rabbit red cell does not show NaKCl cotransport or paradoxical temperature dependence of the "passive leak". PMID- 2721648 TI - Potassium transport in monkey erythrocytes. AB - K transport in Rhesus and Cynomolgus monkey erythrocytes has been characterised and compared to that in human erythrocytes. Transport due to the NaK pump, residual (diffusional) leak, volume-, pressure- and N-ethyl-maleimide-stimulated KCl system and internal Ca2+-stimulated K channel were similar to that in man but in the monkey it differed, in lacking the loop-diuretic-sensitive NaKCl cotransport system. PMID- 2721649 TI - Ovarian and body weight responses of female redheaded bunting to ultra-short photoperiods: demonstration of circadian involvement. AB - Ultra-short photoperiods, of 3 h less than the threshold photoperiodic demand of female redheaded bunting, when used in variable time cycles (T cycles) cause ovarian growth and an increase in body weight depending upon the period of the cycle. The cycles of period 24 h or close to that (22 h and 26 h) were non stimulatory whereas 18 h, 20 h, 28 h and 30 h were photo-stimulatory. These results indicate the presence of a circadian component within the bird which regulates their photoperiodic responses. PMID- 2721650 TI - Hemodynamic and electrophysiological effects of mercury in intact anesthetized rabbits and in isolated perfused hearts. AB - Using intact anesthetized rabbits and isolated perfused hearts, the hemodynamic and electrophysiological effects of mercury (Hg) were examined in order to assess the role of cardiovascular dysfunction in Hg intoxication. The most consistent and prominent cardiovascular effect was a significant reduction in blood pressure. This cardiodepressive action was probably brought about by the primary action of Hg on the heart rather than by altered sympathetic activity, as evidenced by normal renal nerve activity at times when the hemodynamic actions of Hg were clearly manifest. Although the principal target organ for the toxic actions of inorganic Hg is the kidney, chronic exposure to both inorganic and organic Hg frequently results in signs and symptoms of CNS dysfunction. The profound hemodynamic effects of Hg that we have observed emphasize the potential importance of Hg cardiotoxicity and indicate the need to differentiate between the primary and the secondary effects of Hg intoxication on CNS tissues for evaluation of the toxic effects of Hg compounds. PMID- 2721651 TI - Increased sarcolemmal membrane permeability of cardiac muscle cells in rats fed grains cultivated in a Keshan disease endemic area: a study with horseradish peroxidase as a tracer. AB - The alteration of sarcolemmal membrane permeability of cardiac muscle cells in rats fed grain from a Keshan disease (KD) endemic area was studied with horseradish peroxidase (HRP) as a tracer. Weanling male rats were divided at random into three groups and fed the following three diets, respectively, for 3 months: a diet with grain from a KD endemic area (Group A), a diet with grain from a KD nonendemic area (Group B), and standard laboratory chow (Group C). At the end of the experiment, HRP was injected intravenously and localized in the ventricular myocardium by light microscopy. The experimental results showed that the percentage of cardiac muscle cells containing HRP reaction product in rats fed grain from the KD endemic area was significantly greater than that in rats fed grain from nonendemic area and standard laboratory chow. This suggests that the sarcolemmal membrane permeability of cardiac muscle cells in rats of Group A was markedly increased. The distribution of cardiac muscle cells with increased sarcolemmal membrane permeability was similar to that seen in the myocardium of KD patients. The present study suggests that the abnormal membrane permeability of cardiac muscle cells may play an important role in the pathogenesis of myocardial necrosis in KD. PMID- 2721652 TI - Comparison of lipid accumulation and metabolism in carrageenan-induced granulomas to aorta and blood monocytes of normal and cholesterol-fed rabbits. AB - New Zealand rabbits (six each) were either maintained on a standard chow diet (ND) or the chow diet supplemented with cholesterol/peanut oil (HD) for 2 weeks. After 2 weeks, each animal had 15 ml of a 1% carrageenan gel injected subcutaneously into the midabdominal area. Rabbits were maintained on the diets for an additional 4 weeks. At sacrifice, blood was collected both for serum and for monocyte isolation and granulomas and aorta were excised. Tissues were assayed for lipid composition and lipid metabolism. Electron and light microscopies were performed on granuloma tissue. Granulomas from ND animals did not stain with oil red O. Granulomas from HD animals had homogenous oil red O staining indicating lipid accumulation. Granulomas from both ND and HD animals consisted of macrophages. Macrophages from ND rabbits accumulated follicular carrageenan but not lipid, while HD macrophages had the appearance of foam cells. Granuloma lipid content and metabolism closely paralleled the aorta and blood monocytes. The HD tissue had increased acylCoA:cholesterol acetyltransferase (ACAT) activity and lipid composition changes reflective of the atherosclerotic process. ND granulomas had no elevation of lipid content or ACAT. The carrageenan induced granulomas provide a useful model for studying the biochemical and morphologic changes characteristic of arteries undergoing atherogenic change. PMID- 2721653 TI - Low-density lipoproteins isolated from the blood of patients with coronary heart disease induce the accumulation of lipids in human aortic cells. AB - Smooth muscle cells cultured from the intima of unaffected human aorta accumulate lipids during incubation with the blood serum of patients with coronary heart disease (CHD). Blood sera of most healthy subjects fail to induce the deposition of lipids in cultured cells. Very-low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins of two subclasses (HDL2 and HDL3) were isolated from the blood of healthy subjects and CHD patients. LDL from the blood of healthy individuals did not raise intracellular lipid levels within 24 hr of cultivation (the maximal concentration used, 1000 micrograms/ml). During the same incubation period, LDL obtained from the blood of CHD patients (200 to 1000 micrograms/ml) caused a 2- to 5-fold rise in cholesteryl esters as well as a 1.5- to 3-fold rise in free cholesterol and triglycerides, whereas intracellular phospholipid levels remained unchanged. There was a direct correlation (r = 0.95) between cholesterol accumulation in the cells incubated with whole sera of CHD patients and cholesterol level in the cells incubated with LDL isolated from these sera. In one of the three cases, the ability to raise the intracellular level of cholesteryl esters was demonstrated by VLDL (500 micrograms/ml) derived from CHD patients' blood. HDL2 and HDL3 did not affect lipid levels in smooth muscle cells cultured from unaffected intima. HDL3 from the blood of CHD patients and healthy subjects (50 to 250 micrograms/ml) reduced cholesteryl ester levels in cells cultured from atherosclerotic plaques 1.5- to 2-fold. HDL2 also decreased the content of cholesteryl esters in plaque cells, though less effectively than HDL3. The data obtained suggest that circulating LDL and, possibly, VLDL in the blood of CHD patients are capable of inducing the accumulation of fat in vascular wall cells. PMID- 2721654 TI - Orotic acid overproduction in experimental cirrhosis of rats. AB - Ammonia clearance, portal blood ammonia, and amino acid concentrations were studied during induction of cirrhosis by carbon tetrachloride in rats. Exposure to CCl4 vapors twice weekly for 7-16 weeks doubled orotic acid excretion. If exposure was discontinued for 7 days, the orotic acid excretion decreased despite the presence of cirrhosis proven histologically. Replacement of dietary casein with soybean protein eliminated the CCl4-induced orotic aciduria in growing rats but not in adults. Supplementation of casein with 1.5% arginine did not prevent CCl4-induced orotic aciduria. [14C]Orotate uptake into RNA and DNA of liver was not impaired. Perfusion of livers of cirrhotic animals with ammonia concentrations between 0.2 and 3.0 mM revealed no significant decreases in urea synthesis rates due to cirrhosis and no increase in the tendency to make orotic acid at a given ammonia concentration. However, ammonia uptake by cirrhotic livers was significantly reduced, resulting in higher ammonia concentrations in the effluent when there was moderate-to-severe cirrhosis. Portal blood samples taken from rats exposed to CCl4 had higher ammonia concentrations as cirrhosis worsened. The results lend support to the "intact hepatocyte" hypothesis of cirrhosis which attributes metabolic abnormalities to intrahepatic shunts. PMID- 2721655 TI - Ultrastructural alterations in ovaries from nifurtimox or benznidazole-treated rats: their relation to ovarian nitroreductive biotransformation of both drugs. AB - Chagas' disease is a parasitic chronic condition affecting several million people in Latin America. Two drugs are used in the chemotherapy of Chagas' disease: nifurtimox (Nfx) and benznidazole (Bz). Both are nitroderivatives whose deleterious effects are related to their reductive biotransformation. In this work we report that rat ovaries exhibited Bz and Nfx nitroreductase activity. The Bz nitroreductase was only found in the mitochondrial fraction and was partially inhibited by CO. The Nfx nitroreductase activity was maximal in ovarian mitochondria but was also present in microsomes and in the cytosol. The microsomal enzyme was completely inhibited by CO while that in mitochondria was only partially inhibited by CO. The cytosolic activity only proceeded using hypoxanthine as substrate and was inhibited by allopurinol. The cytosolic activity was able to proceed in part under oxygen. All the other Bz or Nfx nitroreductases were completely inhibited by atmospheric oxygen. The potential participation of cytochrome P450, flavoenzymes, iron-sulfur-protein, and xanthinooxidase in both nitroreductive processes is discussed. The administration of either Nfx or Bz to female rats produced ultrastructural degenerative effects in the different cell types of ovaries. Specific alterations such as swelling, disruption, disorganization, and loss of matrix components were observed in ovarian mitochondria. These alterations occurred irrespectively of the ovarian cycle stage. The potential reproductive toxicological consequences of Bz or Nfx administration are analyzed. PMID- 2721656 TI - A biochemical and morphological investigation of the early development of genetic emphysema in tight-skin mice. AB - The tight-skin (Tsk) mouse has recently been proposed as a genetic model of emphysema. In the present study, the development of emphysema was investigated in these mice with histological, biochemical, and ultrastructural methods at 4 days and at 1 and 2 months of life. At 4 days after birth, histological examination of the lungs revealed only a mild enlargement of the primary sacculi. Neither biochemical nor ultrastructural changes were seen however at this time. At 1 month of age, the histological examination showed marked emphysema-like changes, characterized by enlargment of air spaces accompanied by destruction of alveolar walls. Biochemical analysis showed a marked decrease in insoluble elastin content and a significant increase in salt-extractable collagen. Ultrastructural investigation revealed edema fluid in the interstitium and broken and disorganized elastic fibers. All these findings strikingly resemble the changes which occur in the lungs early after an instillation of elastase. In the 2-month old Tsk mice the histological lesion progressed in severity. The ultrastructural findings were similar to those observed at 1 month, and the biochemical changes showed no signs of recovery. Thus, in these mice, the emphysematous lesion develops very rapidly between 4 days and 1 month of life and shows the characteristics of an elastolytic process which is still ongoing at 2 months of age. PMID- 2721657 TI - Spontaneous erythroid colony formation in the differential diagnosis of erythrocytosis. AB - Erythroid colony formation in vitro was studied in 80 patients with erythrocytosis. 43 of the patients had polycythaemia vera (PV), 18 patients had secondary erythrocytosis, 6 had normal red cell mass, and 13 patients were regarded as unclassified. Spontaneous erythroid colony formation, in the absence of exogenous erythropoietin in the cultures, was discovered in all patients with PV, whereas no patient with secondary erythrocytosis or with normal red cell mass showed this phenomenon. 8 of the 13 patients with unclassified erythrocytosis spontaneously formed erythroid colonies. 7 patient with unclassified erythrocytosis have been followed for 5 yr. 3 of the 4 patients with spontaneous colony growth but none of the 3 without it can now be classified as PV. Thus, spontaneous erythroid colony formation indicates PV even in early and atypical cases. Therefore, the culture of erythroid progenitors is very useful in the differential diagnosis of problematic cases with erythrocytosis. PMID- 2721658 TI - HIV-disease and bone marrow changes: a study of 60 cases. AB - We report our experience of peripheral blood and bone marrow changes in patients with HIV disease. Abnormalities were most commonly seen in patients with advanced disease. In AIDS group IV patients (CDC classification) anaemia (92%) neutropenia (85%) monocytopenia (75%) and thrombocytopenia (61%) have their highest incidence, the reason being a combination of factors such as infection, myelosuppressive drugs and HIV infection itself. Bone marrow examinations were performed most commonly for microbiological culture (25%) and the investigation of anaemia (16%). Morphological changes in the bone marrow were non-specific and not pathognomic; however erythroid hypoplasia was found to be a distinctive feature associated with MAI infection. The procedure provided a high yield for microbiological culture, particularly in MAI infection. PMID- 2721659 TI - Gallium scanning in the management of mediastinal Hodgkin's disease. AB - Gallium-67 scanning was performed pre- and post-therapy in 25 patients with Hodgkin's disease and a mediastinal mass. At restaging after therapy, radiographs (or CT scans) did not predict the presence of active disease whereas gallium scans did with a high degree of accuracy. Gallium-67 determined disease activity in those patients who had a residual mediastinal mass predicting outcome in 11 out of 12 patients; one had a late relapse at 7 years. In patients without a residual mass gallium scanning was again accurate, predicting outcome in 11 of 13 patients. Two patients with negative gallium scans but subsequent active disease were scanned too soon after chemotherapy. The results suggest that gallium scanning has an important role in the management of mediastinal Hodgkin's disease and is superior to all current methods of assessing disease activity irrespective of the presence of a residual mediastinal mass. PMID- 2721660 TI - Genetic and other influences on red-cell flavin enzymes, pyridoxine phosphate oxidase and glutathione reductase in families with beta-thalassaemia. AB - In 18 beta-thalassaemia families from the Ferrara area the incidence of an inherited low flavin mononucleotide (FMN)-dependent pyridoxine phosphate (PNP) oxidase activity, a sensitive indicator of red-cell FMN deficiency, is higher in related members in these families than in the unrelated spouses and controls subjects without family history of thalassaemia. This suggests slower red-cell riboflavin metabolism in thalassaemia families, which may have resulted from selection in combination with thalassaemia by malaria. However, there was a markedly higher incidence of red-cell flavin adenine dinucleotide (FAD) deficiency in thalassaemia heterozygotes than in their normal relatives. This was indicated by higher stimulation of FAD-dependent glutathione reductase (GR) activity by FAD and lower GR activity per red cell, and suggests a marked additive effect by thalassaemia on the red cell FAD deficiency that results from the inherited slow riboflavin metabolism. There is evidence that diversion of FAD to other FAD-dependent enzymes might be an important factor. PMID- 2721661 TI - Colony formation by megakaryocyte progenitors in myelodysplatic syndromes. AB - In vitro megakaryocytic colony formation by progenitors from the bone marrow was studied in 40 myelodysplastic syndrome patients. Megakaryocytic colonies were decreased in number or absent in 30 patients; only 10 showed normal colony growth. The growth correlated to some extent with the FAB-class. Patients with normal colony formation had either RA or RARS, but also in these two FAB-types half of the patients showed reduced megakaryocytic colony formation. Only 1 out of 15 patients with RAEB or RAEBt had normal megakaryocyte growth. The patients with CMML did not show any megakaryocytic colonies. The growth of erythroid colonies was normal in 3 patients and reduced or absent in the others. All 3 with normal erythroid colony formation also showed normal megakaryocyte growth, and all patients with normal megakaryocyte colony formation also had normal granulocyte-macrophage colony growth. Granulocyte-macrophage colony and cluster formation was normal in 17 patients. Defective formation of megakaryocytic, erythroid, and granulocyte-macrophage colonies was seen in 22 patients, compatible with a defect in a pluripotent stem cell. Megakaryocytic colony formation had no obvious correlation with any specific chromosome abnormality, and the distribution of the growth patterns was almost similar in patients with a normal and those with an abnormal karyotype. PMID- 2721662 TI - Thymidylate synthesis and utilization via the de novo pathway in normal and megaloblastic human bone marrow cells. AB - We have measured the thymidylate synthetase activity of intact bone marrow cells using a 3H2O release assay. The mean thymidylate synthetase activity of vitamin B12- or folate-deficient megaloblastic marrow cells was reduced only in severely anaemic patients. There was a correlation between thymidylate synthetase activity and RBC in patients with megaloblastic haemopoiesis. The mean rate of incorporation into DNA of 6-3H deoxyuridine was similar in megaloblastic and normoblastic marrows. The rate of thymidylate synthesis exceeded its incorporation into DNA in all marrows, and the mean ratio between synthesis and incorporation was similar in normoblastic and megaloblastic patients, being independent of both thymidylate synthetase activity and RBC. Thus de novo thymine nucleotides were not utilized more efficiently in megaloblastic marrow cells. These data suggest that impaired thymidylate synthesis may not be the central defect in megaloblastic haemopoiesis, and that there is only a single pool of thymidine triphosphate in human bone marrow cells. PMID- 2721663 TI - Respiratory insufficiency in acute leukemia following treatment with cytosine arabinoside and septicemia with streptococcus viridans. PMID- 2721664 TI - Serum thymidine kinase in polycythaemia vera. PMID- 2721665 TI - Spontaneous splenic rupture in myelodysplastic syndrome. PMID- 2721666 TI - Evidence that the anti-coagulant and lethal properties of a basic phospholipase A2 from snake venom are unrelated. AB - The basic phospholipase A2 (PLA2) from venom of the African elapid Naja nigricollis was previously shown to have anti-coagulant and lethal properties, both of which were abolished by treatment with p-bromophenacyl bromide (pBP). In the present paper we first report that pBP-treated PLA2 is capable of inhibiting the anti-coagulant activity but not the lethal activity of native PLA2, thus suggesting that both properties might be independent. We then confirm this evidence using PLA2-specific monoclonal immunoglobulins. One of these, called HSF, neutralized the lethal activity but not the anti-coagulant activity, whereas another antibody, called HSP2, inhibited the anti-coagulant activity but not the lethal activity of the PLA2. The data presented in this paper are taken as evidence that the anti-coagulant activity is not implicated in the lethal effects of basic PLA2 from Naja nigricollis. PMID- 2721667 TI - Immunological evidence for the role of phosphoprotein p68/pI = 7.3 in premessenger RNA splicing. AB - A 68 kDa (pI = 7.3) nuclear phosphoprotein has been previously characterized as a component of transcriptionally active chromatin. Two-dimensional PAGE Western blotting and radioimmunoassay with monoclonal antibodies have identified this protein in nuclear extracts used for in vitro RNA splicing. In vitro splicing activity could be quantitatively inhibited by preincubating nuclear extracts with the antibodies, but the assembly of 60 S spliceosomes could not. PMID- 2721668 TI - The mechanism of action of the cytotoxic lectin from Phoradendron californicum: the RNA N-glycosidase activity of the protein. AB - A toxic lectin from Phoradendron californicum (PCL) was found to inactivate catalytically 60 S ribosomal subunits of rabbit reticulocytes, resulting in the inhibition of protein synthesis. To study the mechanism of action of PCL, rat liver ribosomes were treated with the toxin and the extracted rRNA was treated with aniline. A fragment containing about 450 nucleotides was released from the 28 S rRNA. Analysis of the nucleotide sequence of the fragment revealed that the aniline-sensitive phosphodiester bond was between A4324 and G4325 of the 28 S rRNA. These results indicate that PCL inactivates the ribosomes by cleaving an N glycosidic bond at A4324 of 28 S rRNA in the ribosomes as does ricin A-chain. PMID- 2721669 TI - Affinity labeling of forskolin-binding proteins. Comparison between glucose carrier and adenylate cyclase. AB - An [125I]iodoazidosalicylic acid derivative of forskolin was synthesized for identification of the diterpene's binding sites on the catalytic subunit of adenylate cyclase and on glucose transport proteins. The affinity label was selectively incorporated into proteins of Mr 40,000-60,000 in membranes from human erythrocytes and from various other tissues. The iodoazidosalicylic acid derivative also specifically labeled the catalytic moiety of adenylate cyclase from rabbit myocardial membranes. However, the structural requirements of the two forskolin-binding sites must be different, since the affinity of the photolabel for the glucose carriers is much higher than that for the cyclase catalyst. Furthermore, the label is readily competed with by D-glucose and cytochalasin B for its binding site on the glucose carrier but not on adenylate cyclase. PMID- 2721670 TI - Primary structure of rat liver elongation factor 2 deduced from the cDNA sequence. AB - A number of cDNA clones in summary encoding 700 amino acid residues from the N end of rat liver elongation factor 2 (EF-2) and including 49 nucleotides of the 5'-untranslated mRNA region have been obtained. EF-2 cDNA clones were isolated from gradually constructed small (1000-5000 clones) specific cDNA libraries using the primer extension method for synthesis of the first cDNA chain. The complete primary structure of cDNA and protein EF-2 from rat liver was derived taking into account the primary structure of the 3'-terminal region EF-2 cDNA previously reported [(1986) Proc. Natl. Acad. Sci. USA 83, 4978-4982]. Comparison of this cDNA with hamster cDNA has shown that (i) the base sequences had a 89.7% homology while that of the 5'-untranslated region was 73%; (ii) there are two amino acid replacement in rat liver EF-2 as compared with hamster EF-2. PMID- 2721671 TI - Characterization of purinoceptors present on human liver plasma membranes. AB - Using ATP alpha 35S as radioligand, we have detected the presence of specific purinoceptors on human liver plasma membranes. They are characterized by a Kd value of 0.19 microM and a Bmax of 24 pmol/mg membrane protein. These purinoceptors belong to the P2Y subclass as demonstrated by the high degree of similarity with rat liver purinoceptors, previously shown to be P2Y [(1986) Biochem. J. 240, 367-371] and known to be involved in the control of liver glycogenolysis. PMID- 2721672 TI - Forskolin decreases sensitivity of brain adenylate cyclase to inhibition by 2',5' dideoxyadenosine. AB - The effects of forskolin on the sensitivity of adenylate cyclase to 'P'-site mediated inhibition were studied. Stimulation of crude and purified preparations of adenylate cyclase by forskolin led to decreased sensitivity to inhibition by 2',5' dideoxyadenosine with enzyme from rat and bovine brain. This is in contrast with the enhancement of P-site sensitivity induced by calmodulin, divalent cations, and stable GTP analogs and is in contrast with behavior seen with enzyme from liver and S49 cyc membranes. The effect of forskolin on P-site sensitivity of the brain adenylate cyclase was not dependent on the presence of G-proteins or calmodulin. It was not the consequence of proteolysis nor was it due to an obvious artifact in the assay procedures. This distinct behavior of the brain enzyme is most likely due to a structural difference in the catalytic subunit. PMID- 2721673 TI - The cysteine proteinase inhibitor chicken cystatin is a phosphoprotein. AB - Peptide maps obtained by reversed-phase HPLC of tryptic digests of isoelectric form 1 (pI = 6.5) and 2 (pI = 5.6) of chicken egg white cystatin revealed that the difference was located only in a single peptide (residues Ser-74-Lys-91). Ser 80 of cystatin 2 was subsequently identified as being modified by phosphorylation. Moreover, alkaline phosphatase treatment of a mixture of native cystatin forms 1 and 2 was shown by ion-exchange chromatography to cause the disappearance of isoelectric form 2 with a concomitant increase in form 1. Thus, the existence of two isoelectric forms of chicken cystatin is due to the phosphorylated form 2 and non-phosphorylated form 1. PMID- 2721674 TI - Inhibition of target cell mitochondrial electron transfer by tumor necrosis factor. AB - Using digitonin permeabilization to assay mitochondrial electron transfer, we have found that respiratory activity (succinoxidase and cytochrome oxidase) in three mouse fibroblast lines is completely eliminated by incubation with human recombinant tumor necrosis factor-alpha (hrTNF). As with cytotoxicity, hrTNF induced mitochondrial dysfunction occurs in resistant cells upon inhibition of protein synthesis, whereas sensitive cells exhibit spontaneous respiratory inhibition. In C3HA cells, inhibition is detectable 1.5-2 h after hrTNF addition, preceding cell lysis by at least 5 h (as measured by dye exclusion), and is approximately coincidental with morphological changes we have previously reported for this cell line. LM cells also exhibit inhibition of electron transfer, coincidental with morphological changes. These results suggest that bioenergetic dysfunction may be involved in the cytotoxic mechanism of TNF. PMID- 2721675 TI - Mitochondrial metabolism of guanine nucleotides. Possible role of guanosine. AB - The catabolism of intramitochondrial guanine nucleotides was examined. During 30 min incubation of rat liver mitochondria at 37 degrees C in the presence of oligomycin and carboxyatractyloside, guanine and xanthine were formed and appeared in the medium. Under these conditions, the direct conversion of GMP to guanine by hypoxanthine-guanine phosphoribosyltransferase is suggested to be the main catabolic route within the organelles. Only very small amounts of guanosine were produced and detected both inside and outside the organelles. [14C]Guanosine and [14C]inosine were taken up by the mitochondria. Therefore, guanosine is suggested to be a precursor of intramitochondrial guanine nucleotides. PMID- 2721676 TI - Predominant localization of phosphoenolpyruvate carboxykinase mRNA in the periportal zone of rat liver parenchyma demonstrated by in situ hybridization. AB - In rat liver parenchyma, expression of the phosphoenolpyruvate carboxykinase (PEPCK) gene was studied by Northern blot analysis with a biotinylated cRNA probe and the zonal localization of PEPCK mRNA was demonstrated by in situ hybridization with a radiolabelled cRNA probe. During the feeding period at night, overall PEPCK mRNA levels were low and PEPCK mRNA was detected only in small areas of the periportal zone. At the beginning of the light period (7 am) the overall PEPCK mRNA level began increasing and the periportal areas containing PEPCK mRNA broadened. The maximum of the total abundance and of the area with high levels of PEPCK mRNA was reached at noon. Fasting for 24-72 h did not cause further significant alterations in the level or localization of PEPCK mRNA. The present data are in line with previous findings of the predominant localization of PEPCK activity and enzyme protein in periportal hepatocytes. They suggest that the heterogeneous expression of the PEPCK gene in rat liver is regulated at the pretranslational level. PMID- 2721677 TI - Interaction of benz[a]pyrene diol epoxide with chromatin studied by flow linear dichroism. AB - Chromatin isolated from Ehrlich ascites cells was incubated with the tumourigenic compound (+)-7 beta,8 alpha-dihydroxy-9 alpha,10 alpha-epoxy-7,8,9,10- tetrahydrobenz[a]pyrene [(+)-anti-BPDE] at low ionic strength and the modified chromatin was analysed using flow linear dichroism (LD). The results confirm that (+)-anti-BPDE preferentially binds to the DNA in the linker regions, and furthermore show that the long axis of the bound pyrenyl chromophore is oriented parallel or close to parallel to the average orientation of the chromatin fiber axis. The data indicate that the binding geometry of (+)-anti-BPDE in chromatin is similar to that in pure DNA and deoxyguanosine-containing double-helical oligonucleotides. PMID- 2721678 TI - Resonance Raman characterization of hog thyroid peroxidase. An SERRS study. AB - Resonance Raman (RR) spectra of hog thyroid peroxidase (TPO) were observed for the first time and compared with those of lactoperoxidase (LPO) and horseradish peroxidase (HRP). Since TPO purified by monoclonal antibody-assisted immunoaffinity chromatography was strongly fluorescent, the surface enhancement technique using Ag colloid adsorption was used for the oxidized form, but ordinary RR spectra could be obtained for the reduced form. The RR spectra of TPO were distinct from those of HRP in both the oxidized and reduced states and indicated the presence of six-coordinated iron-protoporphyrin. PMID- 2721679 TI - Reductive chain separation of botulinum A toxin--a prerequisite to its inhibitory action on exocytosis in chromaffin cells. AB - Cleavage of the disulfide bond linking the heavy and the light chains of tetanus toxin is necessary for its inhibitory action on exocytotic release of catecholamines from permeabilized chromaffin cells [(1989) FEBS Lett. 242, 245 248; (1989) J. Neurochem., in press]. The related botulinum A toxin also consists of a heavy and a light chain linked by a disulfide bond. The actions of both neurotoxins on exocytosis were presently compared using streptolysin O permeabilized bovine adrenal chromaffin cells. Botulinum A toxin inhibited Ca2+ stimulated catecholamine release from these cells. Addition of dithiothreitol lowered the effective doses to values below 5 nM. Under the same conditions, the effective doses of tetanus toxin were decreased by a factor of five. This indicates that the interchain S-S bond of botulinum A toxin must also be split before the neurotoxin can exert its effect on exocytosis. PMID- 2721680 TI - Down-regulation of fast-twitch skeletal muscle fiber with cardiac troponin-C and recombinant mutants. Structure/function studies with site-directed mutagenesis. AB - Structure/function relationships in troponin C are studied with vertebrate fast twitch fibers by exchanging the skeletal troponin C with two bacterially synthesized recombinant proteins designed by site-directed mutagenesis of cardiac troponin C. One mutant (CBM1) contained an additional active site, by deleting Val-28 and converting Leu-29, Gly-30, Ala-31 and Glu-32 to Asp, Ala, Asp and Gly, respectively, in the normally inactive trigger site 1 in the N-terminus. In another mutant (CBM2A), the normally active site 2 was inactivated by conversion of Asp-65 to Ala. The fibers were found to be down-regulated with recombinant cardiac troponin C (CTnC3), as with tissue-cardiac-troponin-C. With mutants, in one case (CBM1) the regulation was unmodified despite Ca2+ coordination by all sites. In contrast, regulation was found to be completely blocked with the mutant (CBM2A) where both trigger sites were inactive. The results provide the first indication that structural specification of the entire EF-hand motif of site 1, and not just Ca2+ coordination, is needed to operate fully the Ca2+ switch in fast-twitch fibers. PMID- 2721681 TI - Muramyl peptides bind specifically to rat brain membranes. AB - The capability of immunoactive muramyl peptides to bind specifically to rat brain membranes has been discovered. The reaction of an N-acetylglucosaminylmuramyl dipeptide analog having an additional C-terminal lysine residue (GMDP-Lys) with Bolton-Hunter reagent or N-hydroxysuccinimidyl-4-azidosalicylate afforded two acylated derivatives, GMDP-Lys-(Hp) and GMDP-Lys(Azs). Their iodination resulted in radioactive derivatives (spec. act. approximately 2000 Ci/mmol) whose binding to rat brain membranes is characterized by Kd approximately 3 nM and Bmax approximately 10 fmol/mg membrane protein. Binding could be inhibited by muramyl dipeptide (MDP), GMDP-Lys, and GMDP, while fragments of the latter, N acetylglucosamine dipeptide and disaccharide, were ineffective. PMID- 2721682 TI - S-100a0 protein stimulates the basal (Mg2+-activated) adenylate cyclase activity associated with skeletal muscle membranes. AB - S-100a0 protein, the alpha alpha isoform of the S-100 family, stimulates basal (Mg2+-activated) adenylate cyclase (AC) activity associated with the sarcolemma, longitudinal tubules and terminal cisternae of rat skeletal muscle cells. The stimulatory effect of S-100a0 on AC activity is maximal around 5 microM S-100a0 and half-maximal around 0.2 microM S-100a0. Also, the stimulatory effect is greatest on the AC activity associated with the terminal cisternae than on the other membrane fractions studied. These data are discussed in relation to the subcellular localization of S-100a0 in muscle cells. PMID- 2721683 TI - Structure of the rat liver ribosome 40 S subunit: freeze-drying and high resolution shadow casting. AB - Small ribosomal subunits from rat liver have been studied by electron microscopy using freeze-drying and high-resolution shadow casting. The absolute hand of the asymmetric subunit has been determined and its three-dimensional model with a 'right' location of the side protuberance has been constructed. The results evidence that pro- and eukaryotic ribosomes have a unique and principally similar structural organization. PMID- 2721684 TI - DNA polymerase I (Klenow fragment): role of the structure and length of a template in enzyme recognition. AB - The values of Kd and Gibbs energy (delta G degrees) have been measured for complexes of the template site of DNA polymerase I Klenow fragment with the homo oligonucleotides d(pC)n, d(pT)n, and d(pA)n and hetero-oligonucleotides of various structures and lengths. These parameters were evaluated from the protective effect of the oligonucleotide on enzyme inactivation by the affinity reagents d(Tp)2C[Pt2+ (NH3)2OH](pT)7 and d[(Tp2)C(Pt2+(NH3)2OH)p]3T of the template site. The present results and previously reported data [(1985) Biorg. Khim. 13, 357-369] indicate that the nucleoside components of the template form complexes as a result of their hydrophobic interactions with the enzyme. Only one template internucleotide phosphate forms an Me2+-dependent electrostatic contact and a hydrogen bond with the enzyme. The 19-20-nucleotide fragments of the template appear to interact with the protein molecule. PMID- 2721685 TI - The primary structure of rat ribosomal protein L34. AB - The amino acid sequence of rat ribosomal protein L34 was deduced from the nucleotide sequence in a recombinant cDNA and confirmed from the NH2-terminal amino acid sequence of the protein. Ribosomal protein L34 contains 117 amino acids (the NH2-terminal methionine is removed after translation of the mRNA) and has an Mr of 13,498. Hybridization of the cDNA to digests of nuclear DNA suggests that there are 7-9 copies of the L34 gene. The mRNA for the protein is about 630 nucleotides in length. PMID- 2721686 TI - Effect of DNA supercoiling on in vitro transcription from the adenovirus early region 4. AB - The effect of DNA supercoiling on in vitro transcription from the early region 4 (E4) promoter of adenovirus type 5 (Ad5) has been investigated by using a cell free transcription system that maintains supercoiled DNA templates. The supercoiled DNAs yield several-fold higher levels of E4 transcripts and more faithfully reflect the regulation of in vivo transcription than the linear DNAs. PMID- 2721687 TI - Tissue-specific expression of profilin. AB - Expression of profilin and profilin:actin ratios in vertebrates were determined with polyclonal antibodies against profilin and actin. Profilin was detected in a wide variety of bovine tissues and was enriched in smooth muscle of bovine, porcine and avian origin. The protein was purified from pig stomach muscle tissue. Smooth muscle profilin was found to be more effective in inhibiting the polymerization of skeletal muscle actin than thymus profilin purified by the same method. PMID- 2721688 TI - Comparative analysis of viral cysteine protease structural models. PMID- 2721689 TI - Three actin-binding proteins are developmentally regulated in rat liver plasma membranes. AB - Actin-binding membrane proteins (linking microfilaments to the cell membrane) are involved in cytoskeleton-membrane interactions which are supposed to undergo profound changes during cell proliferation and development. In this study 8 polypeptides were shown to bind F-actin directly in the liver cell membranes of mature rats. From these, the abundance of three polypeptides, of 130, 50 and 36 kDa, was observed to increase considerably during postnatal development, which indicates a developmental change in the cytoskeleton-membrane interactions. PMID- 2721690 TI - In vitro translation of cytosolic and peroxisomal epoxide hydrolase and catalase on liver polyribosomes from untreated and clofibrate-treated C57B1/6 mice. AB - Free and membrane-bound polyribosomes were isolated from the livers of untreated and clofibrate-treated male C57B1/6 mice. The in vitro translation products were investigated in a rabbit reticulocyte cell-free system by immunoprecipitation of cytosolic epoxide hydrolase, catalase and albumin. The soluble forms of epoxide hydrolase present in cytosol and in peroxisomes were found to be synthesized on free polyribosomes and could not be distinguished from each other, since only one primary translation product was found with the methods used. Clofibrate treatment was found to increase total protein synthesis, synthesis of soluble epoxide hydrolase and translational efficiency of the isolated polyribosomes. PMID- 2721691 TI - [Dispensary care of gynecological patients]. PMID- 2721692 TI - [Prevention of tuberculosis in rural localities]. PMID- 2721693 TI - [The epidemiology and prevention of viral hepatitis A]. PMID- 2721694 TI - [Amniotic fluid embolism]. PMID- 2721695 TI - [Organizational aspects of the dispensary care of women]. PMID- 2721696 TI - [Chlamydial infection in obstetrics and gynecology]. PMID- 2721697 TI - [Cardiomyopathies]. PMID- 2721698 TI - [Electrosleep in the treatment of patients with periodontal diseases]. PMID- 2721699 TI - [Vinegar essence poisoning]. PMID- 2721700 TI - [Health education in protecting nature]. PMID- 2721701 TI - [Dispensary care of pregnant women]. PMID- 2721702 TI - [Smoking and the organ of vision]. PMID- 2721704 TI - [Static gymnastics while wearing a plaster cast in fractures]. PMID- 2721703 TI - [Neurological disorders in pregnant women]. PMID- 2721705 TI - [Dispensary care of women following labor]. PMID- 2721706 TI - [The daily regimen in a rural preschool institution]. PMID- 2721707 TI - [Acute inflammatory diseases of the adnexa uteri]. PMID- 2721708 TI - [Iron-deficiency anemia in children]. PMID- 2721709 TI - [Liver cirrhosis]. PMID- 2721710 TI - [Primary hyperparathyroidism]. PMID- 2721711 TI - [Clicking or snapping fingers]. PMID- 2721712 TI - [The clinical picture of the most acute period of myocardial infarct]. PMID- 2721713 TI - [Electrocardiographic diagnosis of organophosphate insecticide poisoning]. PMID- 2721714 TI - [First aid in chemical burns of the eyes]. PMID- 2721715 TI - [Prophylactic medical exams of adolescents for vocational guidance purposes in railway transport]. PMID- 2721716 TI - [Therapeutic physical exercise in hip fractures]. PMID- 2721717 TI - [Therapeutic physical exercise in arthrosis deformans of the knee joint]. PMID- 2721718 TI - Does transient hyperprolactinemia during ovarian hyperstimulation interfere with conception or pregnancy outcome? AB - The significance of transiently increased serum prolactin (PRL) levels on pregnancy rates in in vitro fertilization (IVF) is unknown. The aim of this study was to evaluate PRL levels in IVF patients who conceived and in matched controls who did not. Thirty-seven IVF cycles resulting in pregnancy and 74 nonpregnant cycles were compared. Prolactin was measured before ovarian stimulation with clomiphene citrate, and human menopausal gonadotropin and estradiol (E2) and PRL were measured 8 hours after human chorionic gonadotropin (hCG) administration at midcycle. Before ovarian stimulation, serum PRL levels were not different in the pregnant and nonpregnant women (11.1 +/- 0.6 [mean +/- standard error] micrograms/l and 10.1 +/- 0.4 micrograms/l, respectively). After hCG, PRL levels were significantly higher in the pregnant women than in the nonpregnant women (20.8 +/- 1.6 and 16.0 +/- 0.9 micrograms/l, respectively; P less than 0.005) and more pregnant than nonpregnant women had elevated PRL levels (49% versus 28%, respectively; P less than 0.05). There was no correlation between PRL and E2 in either group. The abortion rate was not different between the women with elevated PRL (22.2%) and the normoprolactinemic women (31.6%). These results do not support treatment of transient hyperprolactinemia with dopamine agonists in IVF patients. PMID- 2721719 TI - Relationship of within-patient semen variability to outcome of intrauterine insemination. AB - To define the subpopulation of infertility patients who would benefit from intrauterine insemination (IUI) with swim-up homologous sperm, the relationship of within-patient semen variability to outcome of IUI was studied. The 61 women in the study had negative workups. Men had at least one semen sample with greater than or equal to 20 x 10(6) sperm/ml. The 6-month cumulative pregnancy rate for all patients was 31.8%. Patients with original sperm motilities consistently greater than or equal to 30% had a higher cumulative pregnancy rate (62.9%) than patients with one or more motility less than 30% (22.0%, P = 0.0015, log-rank test). Patients with post-swim-up motilities consistently greater than or equal to 70% had a cumulative pregnancy rate (51.2%) significantly greater than patients inconsistent for this parameter (15.6%, P = 0.0116). Consistency of sperm motility is a useful parameter for defining the subpopulation of patients who would benefit from IUI. PMID- 2721720 TI - Circannual rhythms of sperm parameters of fertile men. AB - Mean monthly values for ejaculate volume, sperm density, and percentage of motile sperm were calculated from semen analyses performed on volunteered donors to the laboratory from 1979 to 1986. The data of 4,196 ejaculates were computerized by the single Cosinor method for searching on circannual rhythms of the parameters. The study does not detect circannual rhythms, neither of the ejaculate volume nor of the percentage of motile sperm. A statistically significant high-amplitude seasonal variation was detected in sperm court, the highest values being recorded in late winter and early spring, the lowest values being recorded in late summer. PMID- 2721721 TI - Isolation of a human seminal plasma peptide with bombesin-like activity. AB - Bombesin (BN) and BN-like peptides such as gastrin-releasing peptide (GRP) belong to the growing group of regulatory peptides. Bombesin and GRP share the same carboxyl-terminal heptapeptide sequence that is essential for receptor recognition and biologic activity. Immunohistochemical findings have indicated the presence of a BN-like peptide in the neuroendocrine cells of the human prostate. These findings, together with the high concentrations of different regulatory peptides recently found in seminal plasma, prompted us to characterize a BN-like peptide in human semen by gel-filtration chromatography, reverse-phase high-pressure liquid chromatography, and in vitro bioassay. Here we demonstrate that human semen contains high levels (mean +/- standard deviation, 288.9 +/- 114.39 pg/ml) of a substance that closely resembles the 14-27 carboxyl-terminal fragment of GRP (GRP 14-27). The partially purified peptide obtained from this source, examined on an in vitro bioassay that is especially useful for testing BN like activities, elicits a contractile response of the rat uterus that is indistinguishable from that stimulated by standard BN and GRP 14-27. The GRP 14 27 present in human seminal plasma may be involved in some aspect of the process of fertilization. PMID- 2721722 TI - Anaphylactic shock from intracavitary 32% Dextran-70 during hysteroscopy. PMID- 2721723 TI - Karyotype analysis of blighted ova in pregnancies achieved by in vitro fertilization. AB - Pregnancies achieved by IVF and resulting in blighted ovum were karyotyped. The rate of aneuploidy was found to be 38% (5/13). In vitro fertilization does not appear to be a risk factor for chromosome anomaly in live births or miscarriages, and the data reported so far may suggest that aneuploid rates are actually lower for pregnancies achieved by IVF. PMID- 2721724 TI - Spontaneous abortions in women with endometriosis. PMID- 2721725 TI - Fertility after ectopic pregnancy. PMID- 2721726 TI - Gore-Tex surgical membrane. PMID- 2721727 TI - Videolaseroscopy for endometriosis. PMID- 2721728 TI - Microscopic peritoneal endometriosis. PMID- 2721729 TI - Benign deception: fragmentation, overlapping publications, and loose authorship. PMID- 2721730 TI - Diagnosis and management of out-of-phase endometrial biopsies among patients receiving clomiphene citrate for ovulation induction. AB - Eighty-seven patients who underwent a late secretory phase endometrial biopsy while taking clomiphene citrate (CC) for ovulation induction were studied. Of the endometrial biopsies, 21 (24%) showed an endometrium greater than 2 days out of phase (OOP) with respect to the subsequent menstrual cycle. All 87 patients were categorized by age, weight, CC dosage, and underlying disease entity. The patients then were evaluated by these categories in relation to the incidence of an OOP biopsy while taking CC. Patients with a diagnosis of hypothalamic amenorrhea were statistically more likely to have an OOP endometrium. No other subgroup showed an increased or decreased incidence of OOP biopsies. Conception and spontaneous abortion rates were similar among patients with in-phase biopsies and those with out-of-phase biopsies, which subsequently were corrected with further medical therapy. An aggressive approach to the diagnosis and treatment of luteal phase insufficiency in patients who receive CC for ovulation induction is recommended. PMID- 2721731 TI - Luteal cytoplasmic estradiol and progesterone receptors in human endometrium: in vitro fertilization and normal cycles. AB - Luteal cytoplasmic estradiol (E2) and progesterone (P) receptor levels were measured from the 22nd to the 25th days of the menstrual cycle in endometrial samples obtained from seven patients in an in vitro fertilization (IVF) program who received no embryo replacement after ovarian stimulation with clomiphene citrate/human menopausal gonadotropin/human chorionic gonadotropin, and from seven normally menstruating women. Serum levels of E2, P, follicle-stimulating hormone, luteinizing hormone, and prolactin (PRL) were measured in blood samples collected at the time of biopsy. The E2 (P less than 0.01) and PRL (P less than 0.001) levels were higher in stimulated than in spontaneous cycles. The level of cytoplasmic P receptor was decreased in endometrium in stimulated cycles, but cytoplasmic E2 receptor remained unchanged. These alterations in the luteal phase of cytoplasmic P receptor in the endometrium could be involved in the low rate of success following the IVF program. PMID- 2721732 TI - Marital break-up among couples raising families by artificial insemination by donor. AB - The separation rate for Norwegian women who had given birth to children after artificial insemination by donor (AID, n = 227) was compared with the separation rate among all Norwegian women that met certain demographic criteria for equality (controls, n = 6,689). The criteria included identical year of maternal birth, similar age at marriage, and equally long period between marriage and birth of the first child. Mean duration of marriage at first delivery was 7.4 years, and mean age of the first child was 3.6 years at registration of the data. The incidence of marital break-up in the AID group was 1.8%, as compared with 3.0% to 3.7% in the control group. The difference is not significant (P approximately 0.15). The authors conclude that the separation rate in AID families does not differ significantly from the observed separation rate in a demographically matched population. The study highlights the importance of selecting a proper control group before statements of the magnitude of separations in AID families are made. PMID- 2721733 TI - The surplus human embryo: its potential for growth, blastulation, hatching, and human chorionic gonadotropin production in culture. AB - Early embryos that were unsuitable for transfer to patients or for cryopreservation were cultured either in a human tubal fluid (HTF) or a minimum essential medium (MEM). A significantly higher proportion of embryos developed to blastocysts in MEM (26.8%) than in HTF (14.5%). Approximately similar proportions of embryos formed blastocysts in MEM in the presence or absence of serum. The rate of embryo growth to blastocysts was similar in all media. Blastocyst hatching occurred in MEM + or - serum, but it failed to occur in HTF with serum. Released human chorionic gonadotropin (hCG) from hatched and intrazonal blastocysts was detected by day 8 after fertilization. The mean amount of hCG produced by day 14 was 19,500 mIU from hatched and 1,550 mIU from intrazonal blastocysts. Serum stimulated the output of hCG. PMID- 2721734 TI - Chromosome analysis of human oocytes failing to fertilize in vitro. AB - To assess the contribution of chromosome anomalies to the high failure of in vitro fertilization (IVF), 94 unfertilized eggs from 43 women participating in the IVF program were cytogenetically investigated. The mean age of the oocyte donors was 33.6 years. Chromosome karyotypes were obtained in 65 of 94 oocytes: 34 oocytes (52.3%) had a normal haploid chromosome complement; 10 (15.4%) were hypohaploid; 7 (10.8%) were hyperhaploid; 8 were diploid; and 6 were hypodiploid or hyperdiploid (from 36 to 53). Eleven eggs showed prematurely condensed chromosomes of the G1-phase from sperm, as well as a set of maternal metaphase II chromosomes. These results are compared to similar reports in the literature. PMID- 2721735 TI - [Effect of prostaglandin E2 on the development of myocardial damage in rats with various resistance to hypoxia]. AB - Experiments conducted on male rats with congenital high and low resistance to hypoxia (HH and LH, respectively) have revealed, that injection of prostaglandin E2 (PHE2) 15 min before the injection of adrenalin essentially decreases the activity of lipid peroxidation in myocardium as compared with animals which have been injected to only adrenalin. This modulative effect (PHE2) on the action of adrenalin was more pronounced in LH-rats. Consequently, the activity of the prostaglandin stress-limiting system determines to a great extent the organism resistance to hypoxia. PMID- 2721736 TI - [Changes in quantitative characteristics of mitochondria of the cortical tubules of the kidneys with compensatory hypertrophy in the blocking of autonomic mediation]. AB - To elucidate the significance of neuromediators in ergotrophic provision of duct cells of the compensatory-hypertrophying kidney mitochondrial apparatuses of cortical nephron segments epithelium in a single kidney of Wistar rats have been morphometrically studied under conditions of continuous 90-day blockade of vegetative nerves by administration of both guanetidine and atropine. It is shown that distal duct mitochondria have undergone the most pronounced regressive changes in the experimental series that is accounted for by specificity and power capacity of the transport processes in this segment. Lagging of the principal morpho-functional mitochondrial characteristics in other cortical nephron portions behind those of a single kidney is a direct evidence of the active trophic influence of the vegetative nervous system mediators on adaptive reconstruction of compensatory-hypertrophying kidney metabolism. PMID- 2721737 TI - [Seasonal fluctuations of the testicular androgenic function in rats]. AB - Testicular steroid-delta 5-3 beta-ol-dehydrogenase activity and plasma testosterone level in pubertal Wistar rats in spring and summer are 2-4 times higher than in autumn and winter. On the contrary the weight of the ventral prostate and seminal vesicles is lower in summer as compared with that in other seasons. This divergence is probably caused by fluctuations of the glandular secret content. PMID- 2721738 TI - [Characteristics of the mobilization of psychophysiologic functions in various degrees of effectiveness in occupational activity]. AB - Central nervous, neuromuscular, cardiovascular systems and high psychic functions: thinking, attention and memory in assemblers of electric equipment have been studied in complex. These studies have revealed that high labour productivity is achieved due to the high functional stress of physiological systems of the organism. In this case functions both specific and nonspecific for the local physical work are activated. High-efficient activity is followed by mobilization of the psychophysiological functions, interfunctional relations being intensified. PMID- 2721739 TI - [The role of adrenergic receptors in the realization of hypothalamic effects on the motor function of the digestive tract in hypophysectomized dogs]. AB - Chronic experiments on hypophysectomized dogs with gastric and small intestinal fistulas as well as with hypothalamus-implanted electrodes have shown that blockade of alfa-adrenoreceptors by phentolamine increases the number of the excitatory motility responses while stimulating hypothalamic structures during rest of the gastrointestinal tract and decreases inhibitory effects of the stomach while stimulating hypothalamic structures during work of the digestive tract. The blockade of beta-adrenoreceptors by obsidan induces weakening of excitatory responses of the digestive tract and intensification of inhibitory ones while stimulating hypothalamic structures in hypophysectomized dogs. PMID- 2721740 TI - [Effect of successive lesions of the hippocampus and amygdaloid body on conditioned-reflex alimentary reactions in rabbits]. AB - Bilateral electrolytic lesions of the dorsal hippocamp and basolateral amygdalar complex impede the differential and extinctive inhibition. The damage of the corticomedial amygdala against a background of the dorsal hippocamp deficiency facilitates differentiation and extinction of alimentary reflexes induced by a decrease of the alimentary motivation and by weakening of alimentary conditioned reflexes. Lesions of the dorsal hippocamp after the corticomedial amygdala damage facilitates the training of positive alimentary reflexes, but weakens inhibitory conditioned reflexes. PMID- 2721741 TI - [Inotropic effect of chlorpromazine on the frog atrium]. AB - The chlorpromazine, a calmodulin inhibitor, has been studied for its action on the contraction force and calcium current of the frog atrium fibres. Chlorpromazine (10(-5) mol/l) was observed to induce maximal increase of the contraction force that 30 min after the agent action amounted to (47.3 + 9.3)% of control. The high concentration of chlorpromazine (10(-4) mol/l) produced irreversible decrease in the contraction force. Chlorpromazine (10(-5) mol/l) increased the calcium current by (27.5 +/- 4.8)%. It is supposed that chlorpromazine increases contraction force and calcium current through the inhibition of calmodulin-dependent phosphodiesterase activity. PMID- 2721742 TI - [Bioelectric activity of various parts of the upper urinary tract]. AB - Experiments on 50 dogs carried out by the method of in vivo electromyography have confirmed the localization of the pacemaker of the pyeloureter in the proximal end of the renal pelvis at the pelvicalyceal border. It is determined that the pacemaker biopotentials are characterized by higher frequency, low-voltage rhythmic amplitude, special form and the highest stability of parameters to the diuresis changes and adrenalin influence. Biopotentials are spreading in the distal direction with an increasing speed, amplitude and decreasing frequency. Pyeloureteral junction is the main rhythmoregulator of the bioelectric activity of the ureter. Synchronization of the bioelectric activity of different parts of the pyeloureter depends on the level of its excitability. PMID- 2721743 TI - [Effect of papaverine on monosaccharide and glycine transport in the small intestine in vitro]. AB - Papaverin is shown to have a significant inhibitory effect on the intestinal transport systems for glucose, galactose and glycine but not for fructose. In vitro experiments have revealed that the inhibitory effect of papaverin on the glucose transport take place under mucosal application, nevertheless the serosal one is of a stimulatory character. Papaverin inhibits only the active component of the glucose transport. PMID- 2721744 TI - [Characteristics of thermograms of the skin of the anterior surface of the trunk in persons with various tonus of the sympathetic and parasympathetic nervous system]. AB - Vegetative regulation is shown to affect the heat pattern of the trunk skin. Two types of thermograms are found in men: "monotonous" and "spotted", the first thermogram being characterized by prevalence of the parasympathetic and the second one-by sympathetic tonus. In women "spotted" thermograms and sympathicotonic direction of the vegetative regulation are registered. PMID- 2721745 TI - [Carbohydrate and lipid metabolism in rats during adaptation to cold]. AB - Cold adapted rats are shown to have glucose and fatty acids concentration in blood inchanged, lactate concentration increased and triglyceride concentration decreased against the control level. Glucose utilization rate in the tolerance test grows. Glycogen content falls, hexokinase and succinate dehydrogenase activity increases, glucose-6-phosphatase and NAD+-isocytratedehydrogenase activity decreases in the liver of experimental animals. The results indicate that utilization of carbohydrate and lipid substrates for thermogenesis is intensified in cold-adapted rats. The hypothesis is supported by the data of tests dealing with IPNA injection or with bringing the animals back under thermocomfortable conditions. PMID- 2721746 TI - [Age-related characteristics of cholinergic regulation of the biomechanical function of the rat heart in hypoxia]. AB - Hypoxia is shown to decrease chronotropic and inotropic responses of the isolated heart of mature rats to stimulation of M-choline receptors. In aged tissue hypoxia has no influence on the inotropic response to carbocholine effect. The results permit a conclusion to be made on the higher resistance of cholinergic mechanisms that regulate the cardiac function to hypoxic effects in aged animals. PMID- 2721747 TI - [The role of riboflavin and pantothenic acid in the reproductive function of swine]. AB - Results of the experiment have shown that in order to increase multiple pregnancy and quality of piglets the ration of sows during pubescence and in the reproductive period must contain not less than 5-6 mg of riboflavin and 20-22 mg of pantothenic acid per one feed unit. That level can be ensured either by addition of synthetic preparation of riboflavin (4-4.5 mg) and calcium d pantothenate (10-15 mg), or by inclusion of about 5% of the fodder yeast mass into complete-ration combined feed. PMID- 2721748 TI - [Topography of catecholamine-containing neurons of the locus coeruleus in the cat]. AB - Topography of catecholamine-containing (CA) neurons of the cat locus coeruleus was studied using a combination of the catecholamine histofluorescence method and rapid embedding of the brain tissue into the paraffin wax. The distribution of CA neurons was examined at frontal and sagittal sections of the brain stem. Unlike that shown previously the quantity of CA neurons in the rostral pole of the locus coeruleus was somewhat higher while at the frontal level of P--2.0-P--4.0 the significant number of CA cells of the locus coeruleus was localized more ventromedially. PMID- 2721749 TI - [Effect of ovarian hormones on mast cells in the denervated uterus of rats]. AB - In adult rats estradiol was found to enhance functional activity of mast cells, whereas progesterone inhibited substantially this effect. The experiments with denervated uterus revealed that the stimulating estrogen effect on mast cells in its tissues was in part associated with activated neuromediation induced by these hormones. PMID- 2721750 TI - [Characteristics of the differentiation of hematopoietic stem cells of the bone marrow in experimental lesions of the liver]. AB - The liver lesion in the CBA mice has been induced by administration of one of three agents five times every day; gamma-globulin fraction of antihepatocytotoxic serum in doses of 4.8 and 7.7 mg of protein per 100 g of body mass; gamma globulin fraction of normal rabbit serum and bovine serum albumin in a dose of 4.8 mg of protein; three- four- or five-fold introduction of carbon tetrachloride in a dose of 0.5 ml per 100 g of body mass with oil (1:1) each three days; calibrated stenosis of the portal vein was produced. The total number of hemopoietic stem cells in the bone marrow was estimated by the colony-forming unit/spleen assay. Histological analysis of the colony-forming units was applied. The liver lesion was accompanied by a decrease in the ratio of the erythroid/granulocytic colonies. PMID- 2721751 TI - [Effect of the natriuretic factor obtained from arterial blood of dogs on cardio- and hemodynamics in experimental studies]. AB - The natriuretic factor, inhibiting Na-K-ATPase, exerts a stable positive inotropic and negative chronotropic effect as a result of its single administration in a dose stimulating the natriuretic activity of the kidneys. It also decreases the overall peripheral vascular resistance. The mean arterial pressure slightly changes. PMID- 2721752 TI - [Effect of helium and argon on the oxygen uptake by lymphocytes]. AB - The effect of inert helium and argon gases on the tissue respiration has been studied on lymphocyte suspensions of white rats. It is shown that normoxic helium oxygen mixture induces almost a two-fold increase of the O2 uptake by lymphocytes as compared with the control (air). No deviations in the value of the studied parameter are revealed in case of replacement of nitrogen from air by argon. Significance of the membrane structure in realization of effects of inert gases is under discussion. PMID- 2721753 TI - [Antibody-producing ability of splenic cells of the progeny of female rats with chronic lesions of the liver]. AB - Spleen antibody-forming function in the offspring of female rats with experimental chronic autoimmune liver affection has been studied for its specificities. The data obtained testify to that these animals are characterized by the increased immunoreactivity at all the stages of investigation, that is confirmed by an increase in the number of antibody-forming cells in their spleen. Besides, the splenocytes of immunized animals have an immunostimulating effect on the productive phase of antibodygenesis and has no such effect on the inductive phase. PMID- 2721754 TI - [In vitro study of the marginal closure in adhesive fillings]. AB - The margin closure of Dentin Adhesit composit fillings made in vitro in the dentin cavity is not the best after the cavity cleaning prescribed by the factory. After a cavity cleaning by propiol acid of 1.22% during 10 seconds better marginal closure could be obtained than by using industrial cavity cleanser (Ahydron). PMID- 2721755 TI - [Distribution of caries according to teeth and dental surfaces in youths 14-18 years of age]. AB - Caries data of 489 health vocational secondary schoolgirls between the age of 14 18 was recorded according to teeth, and toothsurfaces. The surfaces with caries and filling were expressed in percent, as the ratio of examined surfaces. The prevalence of extractions was also registered. The caries prevalence on occlusal and approximal surfaces of the individual teeth was analysed, and the similarity and increasing caries prevalence of the approximal surfaces in the upper second distribution of the approximal surfaces was analysed between the mesial and distal surfaces. The most important findings were: the high extraction of the first molars, the increase of occlusal caries rate in the second molars, the high and increasing caries prevalence of the approximal surfaces in the upper second premolars, and lower first molars respectively in the upper incisors. PMID- 2721756 TI - [Reconstruction of the branches of the trigeminal nerve using microsurgery methods]. AB - The cause and pathomechanism of injuries of the n. trigeminus branches are described. The diagnostics and prognostics of the injuries are discussed in detail and a system of classification employed by the author is disclosed. After describing the microsurgical technique employed for treating the injuries successful treatment of 210 patients is reported on. PMID- 2721757 TI - [The effect of composite filling materials on the diameter of the blood vessels of the dental pulp in rat teeth]. AB - The authors tested the effect of some of the characteristic types of composite filling materials in a vital-microscope test. The results show that all the four tested filling materials (Biogloss, Evicrol, Isomolar, Isopast) significantly widened the pulpal arteriola; the Biogloss was ineffective for the diameter of the venula, but employing Evicrol, Isomolar and Isopast it was significantly increased. Between the tested materials compared to each difference was observed only during the development of their effect. The hyperaemia observed by us is important in case of short-time inspections as the indicator of acute reactions. Further test is required whether is there any connection between the tested hyperaemia and the toxic effect. PMID- 2721758 TI - [Functional reorganization in the system of corticotectal connections after unilateral deafferentation of the cortex]. AB - The responses of the cat's collicular neurons to direct stimulation (DCR) of contralateral neocortex were studied in various periods after unilateral dissection of cortico-subcortical connections. The data obtained suggest that, in intact cat's brain, during early hours of postoperative period, and within 1-2 years after the operation, functional specifics of contralateral motor and sensory projections to superior colliculus played a major part in determining basic features of compensatory shifts of the impulse activity of collicular neurons. PMID- 2721759 TI - [Comparative study of the discharges of sympathetic and parasympathetic nerves during stimulation of the visceral field of the limbic cortex]. AB - Comparative characteristics of parasympathetic responses in pelvic nerve and sympathetic responses in lumbar white communicating rami to stimulation of dorsal and ventral parts of anterior, visceral area of limbic cortex were studied in anesthetized and immobilized cats. Single shocks or short trains of stimuli of the area 25 in limbic cortex evoked a complex response in pelvic nerve, consisting mostly of three waves: the late waves II and III of the parasympathetic discharge with a mean latency of 63.3 and 180.4 msec, and a mean magnitude of 11.0 and 16.7 microV, resp. A short latency component was rarely observed and its latency was about 15.9 msec. The EPs in pelvic nerve and white rami had the lowest threshold in stimulation of the ventral part of area 25. Comparative study of the excitability-recovery properties of cingulo parasympathetic and cingulo-sympathetic responses revealed a long-lasting inhibition of the test responses for 2000 and 900 msec, resp. PMID- 2721760 TI - [Compensation of gait disorders after left-sided removal of a portion of the motor cortex in the white rat]. AB - Spatial quantitative aspects of walking are described prior to and after partial extirpation of left motor cortex in rats. Symmetry of the gait returned to normalcy within over three months after the operation. Length and width of the steps did not return to the prior-to-operation level within 12 months. PMID- 2721761 TI - [Effect of various doses of ethanol on the structure of the wakefulness-sleep cycle in cats]. AB - I.p. administration of 25% ethanol solution with a gradual increase of the dose from 1 to 2 g/kg prolonged the wakefulness, reduced the slow-wave sleep, inhibited the paradoxical phase, and caused a fragmentation of the sleep wakefulness cycle. The above disorders preserved during a few days after the cessation of ethanol administration. PMID- 2721762 TI - [Active and passive mechanical properties of the wall of the lymphangion]. AB - The modules of elasticity of circular stripes of lymphangion wall were 3.5.10(4) N.m-2, and those of longitudinal stripes were 1.5.10(5) N.m-2. The module of elasticity of intact lymphangions ranged from 1.2.10(4) to 5.2.10(4) N.m-2. The volume-pressure relationship in intact lympangions were similar to length-force relationship in circular stripes. Spontaneous contractions were only evoked by distention of circular stripes. These findings suggest that smooth muscle of circular layer of lymphangion's wall seems to play a basic role in pumping function of lymphangions. PMID- 2721763 TI - [Compensatory mechanisms regulating oxygen transport and erythropoiesis during an alteration in the erythrocyte composition of the blood in rats]. AB - The data obtained revealed that the level of 2,3-DPH in erythrocytes and that of erythropoietin in the blood plasma were important compensatory mechanisms for regulation of the oxygen transport and the erythropoiesis in alteration of the blood erythrocyte composition in rats. PMID- 2721764 TI - [Effect of starvation on respiratory reactivity in inbred rats]. AB - The 5-day starvation, with water ad libitum, decreased the reactivity of the respiration system to acute hypoxic hypoxia (11% O2) in spontaneously hypertensive (SH) rats and had no such effect in Krushinskii-Molodkina (KM) rats. The difference in the responses of KM and SH rats to starvation and the action of hypoxic gas mixture shows that the respiratory system reactivity has an obvious genetic component. PMID- 2721765 TI - [Characteristics of the evacuatory function of the stomach when fat is added to the food]. AB - In dogs with fistulas in fundal and antral parts of the stomach and in the duodenum, the influence of adding fat (margarine) to carbohydrate food (bread) on the stomach evacuation was studied. Progressive increase of fat (25, 50 and 75%) in the food stimuli delayed the stomach evacuation, the delay assuring no stability of caloric transport to the duodenum. Destroying of pyloric sphincter led to an acceleration of the stomach evacuation. The latter finding suggests that the pyloric sphincter plays a major role in the regulation of stomach emptying from the fat food. PMID- 2721766 TI - [Effect of ethanol on the inhibitory pause in the discharge of cerebellar Purkinje cells in rats]. PMID- 2721767 TI - [Aconitine-induced arrhythmia in animals with various learning speeds]. PMID- 2721768 TI - [Amygdala influences on the pulmonary surfactant system in rats]. PMID- 2721769 TI - [The mechanism of "spontaneous" gastric secretion in laboratory rats]. PMID- 2721770 TI - [A universal electrode for recording infraslow physiological processes in the visceral organs of the rabbit]. PMID- 2721771 TI - [A method for studying the electrical potential of the cerebrospinal fluid from the subarachnoid space of the ventral surface of the medulla oblongata]. PMID- 2721772 TI - [A new modification to an indirect method of recording the arterial pressure in the tail artery of rats]. PMID- 2721773 TI - Ethical decisions for the future. PMID- 2721774 TI - Clinical nursing ethics. PMID- 2721775 TI - Bioethics. How to manage conflicting values. PMID- 2721776 TI - Bioethics--resolving ethical issues through caring, sharing and nursing knowledge. PMID- 2721777 TI - Ethics: the fundamental nature of caring. PMID- 2721778 TI - Bioethics. A philosophical view of humanness. PMID- 2721779 TI - [Biochemical characteristics of nuclear 5 alpha-reductase and cytosol 3 alpha hydroxysteroid dehydrogenase in rat submandibular gland]. AB - Biochemical studies of testosterone 5 alpha-reductase and 3 alpha-hydroxysteroid dehydrogenase (3 alpha-HSD) in rat submandibular gland (SMG) were performed. 14C labeled testosterone or dihydrotestosterone (DHT) was incubated with subcellular fractions from rat SMG in the presence of 0.2 mM NADPH at 37 degrees C for 20 min in an atmosphere of 95% O2 and 5% CO2. Among the subcellular fractions, the high 5 alpha-reductase activity was detected in the nuclear fraction and 3 alpha-HSD in cytosol. Nuclear 5 alpha-reductase was efficiently solubilized in 2 mg digitonin per mg protein and 0.3 M KCl solution at 4 degrees C for 30 min. The maximum velocities (Vmax) of nuclear and solubilized 5 alpha-reductase activity for testosterone were 71.4 pmol/mg protein per min and 25.4 pmol/mg protein per min. Apparent Michaelis constant (Km) of nuclear and solubilized enzymes for testosterone were calculated as 11.1 microM and 16.7 microM by the Lineweaver Burk plot, respectively. The activity of solubilized 5 alpha-reductase from nuclei was stable by NADPH and KCl, and the molecular weight of the enzyme was estimated as 158 K.D approximately 200 K.D by Bio-Gel A-1.5 m column chromatography. The column chromatography also showed a peak of 3 alpha-HSD activity in cytosol, revealing the molecular weight of approximately 50 K.D. However, the elution peak of the 3 alpha-HSD was effectively decreased by KCl in Tris-HCl buffer. The molecular weight of 5 alpha-reductase and 3 alpha-HSD in SMG were similar to those in prostate. A stable and extractable 5 alpha-reductase was demonstrated in nuclei of rat SMG with possessing a considerable affinity for testosterone and also high 3 alpha-HSD activity for DHT was revealed in cytosol of the tissue. PMID- 2721780 TI - [Serum concentrations of delta 5C21 steroids during pregnancy and at delivery]. AB - In order to study the changes of C21-steroid levels which included Pregnenolone (P5), 20 alpha dihydropregnenolone (20P5), 16 alpha hydroxypregnenolone (16P5), progesterone (P4) and 20 alpha dihydroprogesterone (20P4) in maternal peripheral blood during pregnancy and at delivery, these steroids were measured by GC-MASS with application of deuterated steroids as internal standard. The accuracy of GC MASS method of these steroids was satisfactory with C.V. value of less than 6%. Total delta 5C21 steroid concentrations in course of pregnancy and at delivery were as follows; P5 (mean +/- S.D. ng/ml): 66.6 +/- 36.2 (1st trimester), 80.9 +/ 24.6 (2nd trimester), 147.7 +/- 30.1 (3rd trimester) and 299.7 +/- 178.3 ng/ml (at delivery), 20Ps: 212.6 +/- 102.5, 143.4 +/- 53.9, 248.9 +/- 58.8, 563.4 +/- 198.2 ng/ml, 16P5: 8.6 +/- 8.6, 8.1 +/- 5.2, 124.3 +/- 40.3, 378.5 +/- 180.0 ng/ml, respectively. P4 (43.0 +/- 28.0 ng/ml) and 20P4 (8.0 +/- 4.0 ng/ml) in 1st trimester showed gradual increase to maximum level (P4: 138.2 +/- 30.1 ng/ml, 20P4: 105.4 +/- 21.6 ng/ml) at pre-pain period, afterward decreased rapidly (P4: 70.9 +/- 23.2 ng/ml, 20P4: 59.8 +/- 19.3 ng/ml) at delivery. P5, 20P5 and 16P5 levels were found to be significantly higher in umbilical artery (UA) as well as in umbilical vein (UV) than those in maternal vein (MV) regardless of labor pain. P4 and 20P4 did not show any differences in MV regardless of labor pain. P4 in UV (pain+) and 20P4 in UA (pain-), however, showed significantly higher than P4 in UV (pain-) and 20P4 in UA (pain+). P5, 20P5, 16P5 and 20P4 levels were significantly lower in the case of anencephalic pregnancy (ANC) at 3rd trimester than in normal pregnancy, especially 16P5 levels (22.2 +/- 5.0 ng/ml) showed 1/5 of those in normal pregnancy. From the results obtained above, it is suggested that these delta 5C21 steroids are actively produced in the feto-placental unit in the course of pregnancy. The levels of these steroids reached maximum at delivery, but the levels of P4, 20P4 decreased toward delivery after maximum levels were shown in the stage of pre-labor pain. No significant difference of P4 level in the case of ANC suggested that P4 production correlated with placenta as well as maternal and fetal precursor. Decreasing of 20P4 and P4 level after the stage of pre-labor pain suggested that activity of 3 beta hydroxysteroid dehydrogenase was reflected by uterine contraction during labor. PMID- 2721781 TI - The structural identification of a secondary dye produced from the reaction between sunset yellow and sodium metabisulphite. AB - The stability of sunset yellow FCF (E110) was investigated in a model soft drinks system, with and without the addition of sodium metabisulphite. The rate of dye degradation was monitored by spectrophotometry and HPLC. In samples containing both sunset yellow and sodium metabisulphite, the formation of a lemon-yellow coloured compound was clearly demonstrated. Isolation and subsequent analysis by NMR and FAB-MS showed the structure of the compound to be that resulting from sulphonation at carbon 4 of the sunset yellow molecule. Examination of a stored commercial soft drinks sample indicated the presence of the same lemon-yellow compound. PMID- 2721782 TI - A study of the contamination by ochratoxin A of green and roasted coffee beans. AB - A study was performed to evaluate the contamination by ochratoxin A in coffee beans. Twenty-nine samples of green coffee were collected from large lots of material by representative sampling. The analyses of green coffee samples showed a significantly high contamination percentage (58%) ranging from 0.2 to 15 micrograms/kg. Naturally and artificially contaminated samples were roasted at different operation times (5-6 min) to verify the percentage of destruction of the mycotoxin. The percentage ranged from 48% to 87% and from 90% to 100% in artificially and naturally contaminated samples respectively. The beverages prepared from artificially contaminated coffee using the most common types of coffee makers showed no residues of ochratoxin A. PMID- 2721783 TI - A procedure for the determination of lead in green vegetables at concentrations down to 1 microgram/kg. AB - An accurate and highly sensitive dry ashing/graphite furnace atomic absorption spectrometry (GFAAS) procedure has been developed for the measurement of lead in green vegetables. The accuracy of the method was established by analysis of standard reference materials and confirmed by isotope dilution using an inductively coupled plasma-mass spectrometer (ICP-MS). The limit of detection (wet weight) of the technique is 1-3 micrograms/kg with relative standard deviations ranging from 6% for a sample of kale containing 500 micrograms/kg to 20% for cabbage containing 3.0 micrograms/kg. PMID- 2721784 TI - Influence of hexacyanoferrate(II) based treatments upon the elimination of heavy metal traces in wine. I. The case of lead. AB - An investigation was undertaken to determine whether the wine treatments for elimination of iron and copper used in Western Europe--with tetrapotassium hexacyanoferrate(II): K4[Fe(CN)6]--and in the United States--with iron(II) and potassium hexacyanoferrate(II) ('Fessler compound')--are suitable for lowering the concentration of lead to within legal limits. In both series of experiments the decrease in lead concentrations remained very poor. It was concluded that the treatments using hexacyanoferrates lowered lead levels but not sufficiently to reduce completely lead contamination in wines. PMID- 2721785 TI - Serum selenium and gastric cancer in two regions of Norfolk. AB - Selenium concentrations were measured in the serum of 244 patients attending the Norfolk and Norwich Hospital, and 246 attending the James Paget Hospital in Gorleston, Norfolk. Both the mean and the median serum selenium concentration was lower in Gorleston than in Norwich, the difference being much greater in women than in men. Whereas the selenium concentrations were normally distributed about the mean for the Norwich area, there was a skewed distribution for the Gorleston area. The results are discussed in relation to the previously observed high risk of intestinal type gastric cancer in the Gorleston area. PMID- 2721786 TI - Determination of acrylamide in sugar by capillary GLC with alkali flame ionization detection. AB - A method for the determination of acrylamide traces as a residue of anti incrustation agents in sugar was developed. Acrylamide was extracted into ethyl acetate after derivatization by bromination to 2,3-dibromopropionamide (2,3 DBPA). The extract was cleaned up on a silica gel column and analysed by gas liquid chromatography with an alkali flame-ionization detector (AFID). A glass capillary column with OV-1 stationary phase was used for this analysis. The recovery of the method determined in model experiments was 70.0% and 77.1% at 100 micrograms kg-1 and 20 micrograms kg-1, respectively. The limit of detection of acrylamide in sugar is 1-10 micrograms kg-1. Parameters of the described method are compared with other published methods. PMID- 2721787 TI - Investigation of ethyl carbamate levels in some fermented foods and alcoholic beverages. AB - An analytical procedure has been developed for the determination of trace amounts of ethyl carbamate in fermented foodstuffs and alcoholic beverages. Concentrations were generally below the 1-5 micrograms/kg detection limit in bread, cheese, yoghurt, beer, gin and vodka. Higher concentrations were found in the other alcoholic beverages examined, which included whisky, fruit brandy, liqueur, wine, sherry and port. PMID- 2721788 TI - Ebstein's anomaly: unusual presentation and surgical repair. AB - Ebstein's anomaly is the most significant congenital anomaly involving the tricuspid valve. This lesion may present in a simple form or may be complicated by other lesions. Patients with this anomaly may vary from mildly symptomatic to severely debilitated. The role of surgical treatment is not uniformly agreed upon, and the optimal procedure for correction or palliation is not clearly defined. Because of the wide spectrum of morphologic abnormalities which may be present in Ebstein's anomaly, no one particular operation may always be satisfactory. We and other groups continue to search for optimal procedures and feel strongly that individualization must be carried out to optimize the result in each patient. We encountered a patient with Ebstein's anomaly in an almost atretic tricuspid valve. In addition, there was severe right ventricular outflow tract obstruction and pulmonary valve stenosis. In this patient the "Fontan Principle" was successfully applied in his management. PMID- 2721789 TI - Health planning in Delaware: physician participation. PMID- 2721791 TI - Assuming responsibility for Delaware's AIDS patients. PMID- 2721790 TI - Uganda safari (American surgeon visits east Africa). PMID- 2721792 TI - Esthetic dentistry. PMID- 2721793 TI - Examining your smile. AB - The future of cosmetic dentistry is boundless. The creativity and the ingenuity of the dental practitioner supplemented by computer technology is opening new vistas of treatment possibilities. The dentist of the 1990s will restore and enhance the natural beauty of the human smile more than ever in the past. PMID- 2721794 TI - Smiling and facial exercise. AB - The exercise program presented uses exercises to quickly build up the patient's facial muscles and confidence. It is an active process, and the patient must be encouraged to do the exercise to get the full and satisfactory effect. The dental office staff should be encouraged to follow this program too. The results will be noticed, and they can support the patients in doing these exercises. Smiles do much to improve the environment we work and live in. PMID- 2721795 TI - Esthetic principles; concepts, and practices in pediatric and adolescent dentistry. AB - The foundation of all dental esthetics is health. A beautiful dentition only occurs in supporting structures free of disease and inflammatory responses. Beyond health, the desire for manipulation of the oral cavity for esthetics in pedodontics is guided by the expectations of the dentist and the parents. When treatment planning for young children and adolescents, it is imperative that the dentist helps to distinguish procedures performed for the health and functional needs of the child from techniques performed to meet cultural standards of esthetics. PMID- 2721796 TI - Esthetic orthodontic appliances for the adult. AB - There is no malocclusion in the adult that cannot be treated as well with esthetic appliances as with the conventional metal brackets. In a study about adult orthodontic patients. Breece and Nieberg found that most people wait until they are adults to start treatment because no one recommended it previously. It is essential that the dental practitioner understand the positive psychological impact of esthetic appliances upon the attitude of the adult and recommend that the adult needing orthodontic treatment enjoy the benefits of these technologic advances in esthetics and comfort. PMID- 2721797 TI - The role of bleaching in esthetics. AB - Bleaching discolored teeth must be considered a viable treatment modality. Although it does not offer the predictability of many cosmetic options, its simplicity and economics demands attention. Combining bleaching with selected bonding and contouring can return a smile to the not-so affluent, conservative, or apprehensive patient who does not wish to face tooth reduction and full coverage. PMID- 2721798 TI - [CHILD syndrome--a case report for understanding this rare genetic dermatosis]. AB - CHILD syndrome in a 4 6/12 years old girl with manifestation of the typical unilateral ichthyosiform erythroderma and hypoplasia of the left arm and leg after birth is reported. The symptoms are listed in a table for comparison to other publications. The moderate shortening of the mother's left arm has significance to the unclear mode of heredity. Local therapy with vitamin A acid brought a satisfactory result. Finally, a short reference is given to a new case from another kindred. PMID- 2721799 TI - [Occupationally-induced skin tumors in East Germany. Increased risk of basalioma in furriers and hide processors?]. AB - The percentage of occupational cancer is only 0.5% of all tumors in the German Democratic Republic. International estimations are higher (4 to 38%). From 1981 to 1985 49 skin tumors (32 squamous cell tumors and 17 basal cell cancers) were accepted as occupationally induced disease in 47 patients. No tumors were registered in 5 of the 15 counties of the GDR. The occupational histories were analysed in 300 basalioma patients and 600 citizens of the same sex and age. The risk of getting a basalioma was significantly higher in the group of furriers than in the control population. It is recommended to accept a basalioma as occupational cancer in case of contact with carcinogens in furriers. PMID- 2721800 TI - [Reaction and effectiveness of prednisolone in zinc oxide containing dermatologic agents]. AB - The ions of prednisolone and zinc are reacting in a mole proportion of 2:1, and are forming a defined compound according to the formula ZnL2 (L = prednisolone anion). This was proven by potentiometrical equilibrium investigations. Therefore the application of prednisolone within zinc oxide containing dermatics is less indicated. The limited usability and reduced effectiveness of prednisolone containing zinc oxide-dermatics forbid a central production and storage for a longer time. PMID- 2721801 TI - [Dependence of spermatozoa motility on other ejaculate parameters]. AB - 1852 ejaculate specimens were investigated to determine the sperm motility subjectively, and by the motility performance coefficient (Ishii). Statistical analysis shows that motility changes significantly with sperm density. PMID- 2721802 TI - What is new on sweat glands. PMID- 2721803 TI - Idiopathic acquired generalized anhidrosis: electron-microscopic and immunohistochemical studies and analysis of lectin-binding pattern of the cell membrane. AB - Idiopathic acquired generalized anhidrosis with sudden onset is rare and its pathogenesis is not known. We report a patient with this condition, and the results of electron-microscopic and immunohistochemical studies as well as an analysis of the lectin-binding pattern of the cell membrane. Electron microscopically, the cells of the eccrine sweat gland showed vacuolar changes. Besides their cytoplasmic changes, the results of a deficient lectin-binding pattern of the glandular cells suggest that there are disturbances in the formation of glycoproteins on their membrane. PMID- 2721804 TI - Acetylator phenotype in psoriasis. AB - Acetylator phenotype has been determined with sulfamethazine in 64 psoriatic patients and in 157 normal control subjects. Forty patients (62.5%) versus 90 control subjects (57.3%) were slow acetylators (p = NS). However, 81% of the 27 patients with psoriatic siblings were slow acetylators (p less than 0.05). Slow acetylator phenotype may be a genetic risk factor for the development of psoriasis. PMID- 2721805 TI - Peroxidase activity in mast cell granules in urticaria pigmentosa. AB - The morphology of mast cells in the skin lesion from a case of urticaria pigmentosa was observed using light and electron microscopy. Furthermore, the IgE deposition on mast cells in the lesion was studied with immunoelectron microscopy. Diaminobenzidine reaction and 4-chloro-naphthol reaction were used to detect endogenous peroxidase activity in mast cells in the lesion. Ultracytochemical techniques were applied to clarify the localization of peroxidase activity in the mast cells. Morphologically, neither blast-like cells nor intermediate cells between basophils and mast cells were found in the lesion. No mast cells in the lesion did exhibit IgE deposition on their plasma membrane. By light microscopy, granular stains of diaminobenzidine reaction and 4-chloro naphthol reaction were observed in the cytoplasm of mast cells in the lesion. By electron microscopy, a finely stippled peroxidase staining was observed in some granules of the mast cells. Perinuclear cisterna and endoplasmic reticulum appeared devoid of enzymatic activity. These findings suggest that the infiltrating mast cells in this case were immature. PMID- 2721806 TI - Stratum corneum lipids in skin xerosis. AB - Lipids of the stratum corneum are implicated in cohesion and desquamation of the stratum corneum as well as in the maintenance of normal barrier function. Evidence linking the intercellular lipids to such processes has mainly been derived from studies on acquired or inherited diseases of lipid metabolism manifesting abnormalities in the structure and the function of the stratum corneum. We have studied the composition of stratum corneum lipids in clinically normal individuals with typical xerosis or 'winter dry skin' in order to establish if the lipid composition differs from that of normal individuals, showing no signs of xerosis. The amount of total stratum corneum lipids was not related to xerosis (22.0 +/- 1.8 micrograms/cm2 for normal skin, and 26.3 +/- 2.9 micrograms/cm2 for severe xerosis), and no correlation was evident between polar lipids, cholesterol sulfate (2.8 +/- 0.5% for normal skin, and 1.6 +/- 0.2% for severe xerosis), or ceramides types I-VI, and dry skin. It therefore appears that dramatic changes in stratum corneum lipids are not detectable in normal 'winter dry' skin. However, a decreased proportion of neutral lipids (sterol esters, triglycerides), coupled to increased amounts of free fatty acids, were found associated to the severity of dry skin. Apart from a decline in the sebaceous function and in esterases activity, winter dry skin does not appear to be associated to dramatic changes in polar stratum corneum lipids. PMID- 2721807 TI - Clear-cell syringoma. Immunohistochemistry and electron microscopy study. AB - Clear-cell syringoma is a histologic variant of syringoma that is otherwise clinically indistinguishable from ordinary syringoma. This variant is formed by cells that have pale or clear cytoplasm as a result of glycogen accumulation. There is a high association of clear-cell syringoma and diabetes mellitus. A case of clear-cell syringoma associated with diabetes mellitus is described. Electron microscopic examination revealed that periluminal cells showed intra- and extracytoplasmic multivesicular bodies that may be characteristic of the clear cell variant. Immunohistochemistry for carcinoembryonic antigen (CEA) showed ordinary syringomas as in the presence of CEA within and surrounding duct-like spaces. PMID- 2721808 TI - Atypical scleroderma associated with multiple myeloma. AB - A case of atypical scleroderma associated with multiple myeloma is reported. The patient was a 50-year-old male; morphea-like plaques with brownish pigmentation were scattered on the whole body and sclerodactylia-like changes, contracture of fingers and polymyositis were observed. Histological findings in the sclerotic lesions were consistent with scleroderma. One year later, M-protein (IgG, kappa chain) appeared in the serum and 3 years from the onset, the patient was diagnosed as multiple myeloma by bone marrow examination. It is speculated that abnormal immunological reactions related to multiple myeloma caused scleroderma like lesions. PMID- 2721809 TI - Skin dimples in hypophosphatasia. PMID- 2721810 TI - Obesity is associated with increased post-prandial GIP levels which are not reduced by dietary restriction and weight loss. AB - Obesity is characterised by fasting and post-prandial hyperinsulinaemia. One factor which may contribute to this is overactivity of the enteroinsular axis. Glucose tolerance, beta-cell response and GIP profiles were therefore compared during oral glucose (OGTT), mixed meal (MTT) and intravenous glucose tolerance tests (IVGTT) in both lean (IBW less than 120%) and obese (IBW greater than 120%) healthy subjects. The tests were repeated in the obese group after a period of dietary restriction and weight loss. Fasting GIP concentrations were similar, but postprandial levels were significantly greater in the obese subjects during both the OGTT and MTT. Glucose profiles were similar but associated with basal and stimulated hyperinsulinaemia in the obese subjects indicating insulin resistance. GIP levels did not change during the IVGTT and were similar in the two groups throughout the test. Following diet and weight-reduction there was a significant decrease in both fasting and post-prandial insulin levels in the obese subjects but there were no significant changes in glucose or GIP concentrations. In conclusion the endogenously stimulated plasma GIP response is exaggerated in obese healthy subjects but this increased response is not decreased by short term diet and weight loss. The increased GIP concentrations may contribute the observed hyperinsulinaemia in obesity, but its contribution is likely to be small in view of the decrease in insulin concentrations following diet and weight-loss which was independent of any change in GIP. PMID- 2721811 TI - Some keys factors in the clinical diagnosis of non insulin-dependent diabetes: a multinational comparison. PMID- 2721812 TI - Effects of chronic atenolol therapy on cardiovascular response to isometric exercise in essential hypertension. AB - Cardiovascular response to 2 min of isometric handgrip exercise at 50% of maximum voluntary contraction was studied echocardiographically in 10 essential hypertensives, before and during treatment with atenolol for a mean of 2 months. The patients responded with increases in heart rate, systolic and diastolic blood pressures, cardiac output and calculated triple product, no changes in stroke volume and total peripheral resistance, and decreases in ejection fraction, mean velocity of circumferential shortening and mean diastolic posterior wall velocity of the left ventricle before treatment. Chronic atenolol therapy attenuated the increases in heart rate, blood pressure and triple product, and the decreases in ejection fraction, mean velocity of circumferential shortening and mean diastolic posterior wall velocity of the left ventricle but resulted in a marked increase in total peripheral resistance. The pressure response and triple product rise in response to isometric handgrip exercise were also decreased. This suggests an obvious advantage to hypertensive patients who may, therefore, be protected from the risk of cardiovascular complications following isometric exercise. PMID- 2721813 TI - Mechanism of action of the antitumour effect of K18. AB - K18 is an anticancer drug for oral administration comprising about five molecules of melphalan, an alkylating drug, covalently bonded to human immunoglobulin G. This study measured the in vitro antitumour activity of K18, melphalan and immunoglobulin G on human myeloma cells (RPMI-8226) and the in vivo antitumour effects of K18 and melphalan in BALB/c nude mice bearing human lung cancer cells (LC-10). The relative tumour-inhibitory effect, in vitro, was found to be: immunoglobulin G less than K18 less than melphalan. This activity of K18 was about half the theoretical value indicating that melphalan molecules are not released easily from the conjugate. K18 showed strong antitumour activity in vivo which continued after stopping administration. On the other hand, the effects of melphalan did not continue after administration was stopped. The distribution of [125I] K18 and [14C]melphalan was examined in BALB/c nude mice 14 days after implantation of LC-10 cells. Radioactivity levels in the major organs showed a transient rapid increase followed by a gradual decline. In tumours, [14C]melphalan levels increased transiently and then decreased, whereas [125I]K18 levels persisted following intravenous administration. PMID- 2721814 TI - Amoxycillin and clavulanic acid in the treatment of urinary tract infections in children. AB - The efficacy of amoxycillin-clavulanic acid combination in the treatment of urinary tract infections resistant, in vitro, to amoxycillin was studied in 42 children. Of the 24 children with urinary tract infection for the first time, combination therapy, dosing twice daily for 5 days (40 mg/kg.day), cleared the infection in 23 (96%) cases. Relapse occurred in four (17%) cases within 30 days. Of the 18 children who presented with recurrent urinary tract infections therapy, as above, cleared the infection in 16 (89%) cases. In these cases, long-term therapy was performed at a dosage of 20 mg/kg once daily. Tolerance was good; gastro-intestinal disorders in five (12%) cases which regressed by dosing at 8 h rather than 12 h intervals. In conclusion, amoxycillin-clavulanic acid can be considered a first choice treatment of urinary tract infections in children. PMID- 2721815 TI - The use of a hand-held computer to record clinical trial data in general practice: a pilot study. AB - A system has been developed to collect and process clinical trial data in general practice using a hand-held computer in the patient's presence. It was based on a Psion Organiser II (model XP) computer using software produced for the trial. The major advantages are: (a) avoidance of protocol violations and other incorrect data entries; and (b) saving of time for investigators and company personnel. The present coding of symptoms was found to be the only major drawback, but this problem could be remedied for future studies. PMID- 2721816 TI - Nursing interaction of Wistar rats is modified by prior experience of altered nursing bout length. AB - We tested the capacity of 2 week postpartum Wistar rat litters and their dams to adapt to experimental shortening and lengthening of the time available for nursing while maintaining the frequency of bouts constant, using manual transfer between cage compartments. In 8-hr and 24-hr experiments, the short bout group (10 min/hr) gradually came to show normal litter weight gain, short latency milk ejections, and increased high arched nursing position, while the 40-min/hr group showed increased latency to attachment and longer latency to ME compared to the 20 min/hr control group. Pup body temperature did not vary between groups. Although pups in the 10-min group showed increased dam-directed behaviors in the first 8h, this difference vanished thereafter. In a twenty-fifth cycle, after dams and litters were exchanged, the prior experiences of the dams and not of the litters were found to determine the dynamics of milk exchange. PMID- 2721817 TI - Relative importance of experience, social facilitation, and availability of milk in weaning of rats. AB - These studies investigated the role that social facilitation, availability of the dam, and milk play in the maintenance of suckling behavior. Beginning at Day 20, rat pups' suckling experiences were restricted to testing with an anesthetized dam. In the first experiment, nipple attachment was abandoned by about Day 25 in rats that were tested alone with an anesthetized dam for 1 hr per day. When tested in groups of four, nipple attachment was maintained until about Day 27. Increasing exposure to an anesthetized dam to 2 hr per day prolonged nipple attachment about another 4 days. In the second experiment, pups were given either one or two daily 1-hr attachment tests and tested with either an anesthetized dam or an anesthetized dam in which the milk letdown reflex was reinstated. Both increasing the daily exposure to an anesthetized dam and reinstating milk letdown significantly prolonged suckling. Pups given two daily exposures to an anesthetized, milk-laden dam attached until about Day 47, long past the normal age of weaning. PMID- 2721818 TI - Effects of hand-rearing on the behavioral development of infant and juvenile gorillas (Gorilla g. gorilla). AB - Nineteen hand-reared and seven mother-reared infant and juvenile gorillas were observed for a period of 3 years. Almost all hand-reared individuals developed stereotyped behaviors during the first months. In most cases these behaviors disappeared in the first or second year. Social behaviors, solitary play, nest building and grooming developed at about the same age in hand-reared and mother reared infants. Hand-reared immatures showed significantly more solitary play, more aggression and less social play than mother-reared ones, especially when raised in pairs. When young gorillas were kept in groups, the frequencies of these behaviors came nearer to those of mother-reared immatures. No significant differences were noted in social play. When introduced to conspecifics, hand reared infants sometimes reacted with indiscriminant aggression. Gorillas should thus preferably be reared in peer groups and be introduced to adults not later than one year of age. PMID- 2721819 TI - Ontogenetic differences in short-term retention of Pavlovian conditioning. AB - In the present series of studies 16- and 21-day-old rats acquired an aversion to a black compartment (CS+) paired with footshock, only if given preconditioning exposure to a white chamber (CS-) not paired with footshock. The strength of conditioning was inversely related to the length of the retention interval in both age groups. However, the rate of forgetting was accelerated in the 16-day old subjects, indicating infantile amnesia for the conditioned aversion. Strength of conditioning was also inversely related to the length of the CS-/CS+ interval in both age groups, indicating that expression of the aversion is critically dependent on an active memory of the CS- at the time of conditioning. Additionally, there was an ontogenetic decrease in the rate of forgetting of the CS-, indicating infantile amnesia for elements of the conditioning episode that did not predict occurrence of US. PMID- 2721820 TI - Uterine positions and schedules of urination: correlates of differential maternal anogenital stimulation. AB - Lactating Mongolian gerbils, like lactating Norway rats, reliably lick some pups in their litters more than they lick others. Male gerbil pups are licked more by their dams than are their sisters and some males and some females within each litter are licked more often than are their sibs of the same sex. In the present article, we explore the characteristics of same-sex littermates that are correlated with elicitation of extreme amounts of maternal anogenital licking. We found that both the male pup and the female pup in a litter of gerbils that received the most maternal anogenital licking: (1) released greater quantities of urine and (2) exhibited longer latencies to begin to urinate in response to artificial anogenital stimulation than did the male pup and the female pup in a litter that received the least amount of maternal anogenital licking. We also found that foster mothers rearing Caesarean-delivered litters spent more time licking the anogenital areas of: (1) those male pups that, as fetuses, had occupied uterine locations adjacent to relatively few females and (2) those female pups that, as fetuses, had occupied uterine locations adjacent to relatively many males. We discuss implications of these findings for understanding of how maternal behavior may mediate hormonal effects on the development of young gerbils. PMID- 2721821 TI - Anterior and posterior, but not cheek, intraoral cannulation procedures elevate serum corticosterone levels in neonatal rat pups. AB - Implantation of intraoral cannulas is a procedure that has been typically assumed to be relatively unstressful in neonatal rat pups. To test this assumption, endocrine responses to such implantations were compared with those of other standard procedures. In Experiment 1, corticosterone and growth hormone (GH) levels were assessed in 4-day-old rat pups placed in an incubator for 15 or 60 min following either: no treatment, subcutaneous (sc) injection of 0.9% NaCl, anterior or posterior intraoral cannulation, ice anesthesia or ether anesthesia. Corticosterone levels were elevated relative to nontreated controls 15 min after all treatments except sc injection. These levels remained elevated after 60 min in both cannulation groups and the ice anesthesia group. In Experiment 2, the ability of ether anesthesia to reduce the hormonal response to the cannulation procedures was assessed in addition to examining the hormonal response to intraoral cannulations through the cheek in 4-day-old rat pups. Ether did not attenuate the corticosterone response to either anterior or posterior cannulations. Pups subjected to the cheek cannulation procedure did not exhibit any significant alterations in serum corticosterone levels when compared with nontreated control pups. GH levels were found to differentiate less among the various procedures than corticosterone levels, with GH levels generally being low in all groups, including nontreated control animals. These data suggest that a cheek placement is less stressful than anterior and posterior placements and may provide a viable alternative in studies necessitating the implantation of cannula into the buccal cavity during the early postnatal period. PMID- 2721822 TI - Effect of carbohydrate intake on kidney function and structure in SHR/N-cp rats. A new model of NIDDM. AB - The SHR/N corpulent (cp) rat is a genetically obese rat that develops hyperglycemia, hyperinsulinemia, and proteinuria. This study was designed to evaluate the effects of high carbohydrate (CHO) intake on renal function and structure in this animal model and to determine whether the renal effects are related to the type of CHO ingested. Two groups of 5-wk-old obese male SHR/N-cp rats and lean male littermates were fed diets containing 54% CHO in the form of sucrose or starch. After 12 wk, renal function parameters, including creatinine clearance, urinary glucose excretion, and urinary protein excretion, were measured. Renal morphology was evaluated by semiquantitative light and electron microscopy. On either diet, obese rats had significantly higher urinary glucose and protein excretions than their lean littermates. Mean creatinine clearance (ml/min) in obese rats did not differ significantly from values observed in lean rats. When corrected for body weight, creatinine clearance (ml.min-1.kg-1) tended to be lower in obese than in lean rats, but the difference was significant (P less than .02) only for obese and lean sucrose-fed animals. Obese rats fed sucrose compared with their obese counterparts fed starch had higher body weight (+8%, P less than .05), glucose excretion (+63%, P less than .02), and protein excretion (+242%, P less than .005). In obese rats, protein excretion correlated with glucose excretion (r = .71, P less than .01). Glomerular lesions consisting of mesangial expansion and intercapillary nodules were found in obese but not in lean rats. Moreover, obese rats fed sucrose had a significantly greater number of involved glomeruli than obese rats fed starch.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721823 TI - Nutritional and hormonal regulation of articular collagen production in diabetic animals. AB - Although changes in collagen production probably play a major role in the connective tissue defects of diabetes, we do not know to what extent these changes are attributable to hormonal/metabolic versus nutritional alterations. To study collagen production as influenced separately by nutrition versus hormonal/metabolic factors, rats were given 50 mg/kg i.v. streptozocin (STZ) (mild weight-gaining diabetes) or 100 mg/kg STZ (severe weight-losing diabetes) and compared with nondiabetic food-restricted rats to match weight changes in diabetic animals. Articular cartilage was incubated with [3H]proline, and uptake of [3H]proline into both collagen and noncollagen proteins was determined with purified bacterial collagenase. Collagen decreased to 49% in mildly diabetic rats and 16% in severely diabetic rats, compared with control rats fed ad libitum and decreased to 85 and 73%, respectively, in food-restricted rats (both P less than .01 vs. diabetes). Diabetes induced a greater defect in collagen production than food restriction and a greater decrease in collagen than noncollagen protein production within each group, suggesting a specific effect on collagen. With comparable levels of metabolic severity (glucose, beta-hydroxybutyrate), diabetic animals that lost weight produced significantly less collagen than animals that gained weight, suggesting separate mechanisms. Quantitation of the impact of undernutrition on collagen production in diabetes demonstrated that approximately 31 to 32% of the defect was due to undernutrition, leaving approximately 68-69% of the defect due to the diabetic state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721824 TI - Auditory brain stem responses in preterm infants: evidence of peripheral maturity. AB - This study explored further the relationship between peripheral and central auditory maturation on the basis of the auditory brain stem response. Auditory brain stem responses were recorded in preterm infants and adults to rarefaction and condensation click stimuli transduced through insert Tubephones. Infant recordings presented a triphasic waveform preceding wave I similar to that of the cochlear receptor potentials seen with adults during electrocochleography. Wave I latency and amplitude were found to be equivalent to those of adult subjects. Moreover, neither latency nor amplitude variability among infant wave I responses was found to be any greater than adults. Latencies of waves III and V, however, exhibited the expected differences relative to the adult comparison group. When the indirect evidence of cochlear receptor potentials in the infant are viewed adjacent to the observations that their ABR wave I latency, amplitude, and variability were entirely consistent with those of young adults, the data lend strong support for peripheral auditory electromaturity. These data are discussed relative to previously published reports of prolonged wave I latency in the infant which was attributed either to middle ear effects or immaturity of the cochlea and first order VIIIth nerve neurons. PMID- 2721825 TI - Analysis of auditory evoked potentials by magnitude-squared coherence. AB - Evoked potentials are usually analyzed in the time domain (voltage versus time). The most familiar frequency-domain measure, the power spectral density function, displays power as a function of frequency but doesn't distinguish signal power from noise power. The coherence function estimates, for each frequency, the ratio of signal power to total (signal plus noise) power and, thus, indicates the degree to which system output (scalp potential) is determined by input (acoustic stimulus). Coherence ranges from 0 to 1; values above specified critical values can be accepted as demonstrating statistically significant system response. In this paper, we present coherence analysis of human scalp responses to clicks and amplitude-modulated tones. In both cases, this analytic method provides insight into the spectral character of the response (for example, assisting in specifying desirable filter characteristics). Threshold sensitivity is also improved: statistically significant responses can be detected at lower intensity by coherence analysis than by inspection of time-domain waveforms. PMID- 2721826 TI - The dichotic rhyme task: results in split-brain patients. AB - Monosyllabic rhyme words were dichotically presented to normal and complete split brain subjects. In the normal adult population, only one of the words in the dichotic condition was identified. Hence, normal performance was about 50%, with a small but significant right-ear advantage. The split-brain patients yielded the expected marked left deficit, as seen on other dichotic speech tests, and demonstrated a right-ear enhancement, producing a large interear difference. This right-ear enhancement on the dichotic rhyme task (DRT) may suggest a release from central auditory competition in the left hemisphere. The dichotic rhyme task's normative data results and sensitivity to lack of callosal transmission make it worthy of further clinical and basic research. PMID- 2721827 TI - Identification of synthetic vowels by patients using the Symbion multichannel cochlear implant. AB - In this report we describe the vowel identification ability of eight patients who scored above 70% correct on a test of spondee word identification. The stimuli were 12 synthetic vowels in "bVt" format. The vowels differed in the frequency of F1, F2, and F3. The mean identification accuracy was 60% correct. Front vowels and dipthongs, (3), and (u) were relatively well identified. The vowels in "but," "bought," and "bout," which were characterized by high F1s and low F2s were not well identified. The results are consistent with a model of recognition in which F1 is specified, with relatively good accuracy, by a rate code and in which extreme values of F2 are specified by a rate/place code. PMID- 2721828 TI - Word recognition by 50 patients fitted with the Symbion multichannel cochlear implant. AB - We describe the word recognition ability of 50 patients who use the multichannel cochlear implant manufactured by Symbion, Inc. The median scores for open set tests involving auditory stimulation alone were: 14% correct (range 0 to 60) for monosyllabic words, 44% correct (range 0 to 100) for spondees, and 45% correct (range 0 to 100) for words in the Everyday CID Sentences. In the visual stimulation condition of the Everyday CID Sentences, the median score was 64% correct (range 0 to 100). In the visual plus auditory stimulation condition, the median score was 99% correct (range 46 to 100). These results demonstrate that relatively good speech understanding can be achieved using a cochlear implant which employs only a few channels of stimulation and which simultaneously activates monopolar electrodes. PMID- 2721829 TI - Assessing speech recognition in noise for listeners with a signal processor hearing aid. AB - Hearing aids with signal processors use advanced circuitry to enhance speech recognition in noise. The effectiveness of these processors has not been well established. The purpose of this study was to evaluate performance on a speech recognition in noise task for listeners wearing a Zeta signal processor aid with the processor turned on and with the processor turned off. In addition, comparisons were made to performance while unaided and aided with a conventional hearing aid. A simple adaptive procedure and a psychometric function were the procedures used. Results for normal-hearing subjects indicate performance was usually better without a hearing aid. Performance when aided was similar for the processor on and the conventional aid. Performance in both of these conditions was clearly better than with the signal processor off. Although results for the hearing-impaired subjects varied widely, there was a trend for better performance with the conventional aid and with the signal processor on than for the signal processor off condition. PMID- 2721830 TI - Transfer functions and correction factors used in hearing aid evaluation and research. AB - In hearing aid research and application it is often necessary to transform the sound pressure level or acoustic gain measured at one physical point (e.g., 2 cc coupler) to an equivalent value at another physical point (e.g., tympanic membrane). Results of currently available studies on various transformations are summarized in this report. When no data were available, the desired transfer function was calculated as a linear combination of known contributing transfer functions. Values are given for the center frequencies of 1/3 octaves and critical bands. PMID- 2721831 TI - Speech sound discrimination pre- and posttympanostomy: a clinical case report. PMID- 2721832 TI - Neurotologic findings of a patient with acquired immune deficiency syndrome. AB - A Caucasian male contracted acquired immune deficiency syndrome (AIDS) following a blood transfusion during heart surgery. Four years later he developed dizziness, dysequilibrium, and emotional disturbances. Neurotologic evaluation implicated central vestibular and auditory dysfunction. Electronystagmographic findings showed ataxic pursuit and optokinetic nystagmus, with a total loss of caloric excitability. The auditory brain stem response indicated delayed absolute and interpeak latencies, and the synthetic sentence identification test yielded abnormally reduced scores bilaterally. Psychological tests suggested organic brain disease with severe anxiety and depression. At autopsy, the AIDS retrovirus was found in mononuclear and multinucleated giant cells in the cortical and subcortical gray matter, cerebral and cerebellar white matter, and throughout the brain stem. Pathologic changes were consistent with the patient's neurotologic profile. PMID- 2721833 TI - Multifacility management and the MIS Guidelines. PMID- 2721834 TI - Joint initiatives offer institutional options. PMID- 2721835 TI - MUMS: can they grow in rural areas? PMID- 2721837 TI - From retrenchment to action. PMID- 2721836 TI - Psychogeriatric inpatients and group work. PMID- 2721838 TI - Quality indicators should emphasize outcomes. PMID- 2721839 TI - Mortality in a cohort of diabetic patients. Causes and relative risks. AB - In a prospective study of mortality in a large group of Scottish diabetic patients, ischaemic heart disease was responsible for 51% of deaths, with the diabetic relative risks of death being 3.8, 2.7 and 2.2 for the age groups 45-64, 65-74, and 75 years and over, respectively. The diabetic relative risks for mortality from all causes were 5.5, 2.3, 1.7, 1.3 for age ranges 15-44, 45-64, 65 74, and 75 and over, respectively. The all cancer mortality rate is not reduced in diabetic individuals. PMID- 2721840 TI - Meetings of directors of World Health Organization collaborating centres in the field of diabetes. PMID- 2721841 TI - Serum fructosamine assay: influence of serum protein concentration. PMID- 2721842 TI - Increasing incidence of diabetes mellitus in Norwegian children 0-14 years of age 1973-1982. AB - A retrospective technique was used to register all newly diagnosed cases of diabetes mellitus in Norwegian children 0-14 years of age during the ten-year period 1973-1982. A total of 1,914 newly diagnosed cases were detected, from an average population of 932,037 children. The degree of ascertainment was near to 99%. The male incidence exceeded the female incidence by 12% (p less than 0.02). The mean yearly incidence for the ten-year period was 20.5 per 100,000. Comparing the two five-year periods 1973-1977 and 1978-1982, the mean yearly incidence increased from 18.5 to 22.7 per 100,000 (p less than 0.0001). There was a marked geographic variation with the highest incidence in the south-east and lower incidence in the northern part of the country. However, in the northern part of the country, there was a remarkable increase of the annual incidence from the first to the second five-year period (12.9 vs 19.3 per 100,000). The highest numbers of new cases were detected in the months of January and October, and the lowest numbers in May and July. The seasonal pattern was significantly different from a uniform distribution of new cases throughout the year (p less than 0.001). The age-specific incidence increased towards a peak at 12 years for both sexes. In conclusion, Norway has a high and apparently increasing incidence of childhood diabetes. The geographic variation and secular trend present challenging clues for a search of etio-pathogenic factors. PMID- 2721844 TI - Health promotion: what is the role of family physicians. PMID- 2721843 TI - Microangiopathy in human diabetic neuropathy: relationship between capillary abnormalities and the severity of neuropathy. AB - Clinical, electrophysiological and ultrastructural morphometric observations were made in 5 diabetic non-neuropathic patients, 5 diabetic patients with mild neuropathy and 11 diabetic patients with severe neuropathy. Capillary abnormalities were assessed in simultaneous nerve, muscle and skin biopsies and compared with results from 6 age-matched, non-diabetic control subjects. Nerve capillaries demonstrated markedly greater pathology than skin and muscle capillaries. Endoneurial capillary density was significantly reduced in severely neuropathic diabetic patients (p less than 0.01) when compared with control subjects. Capillary basement membrane (p less than 0.002), endothelial cell (p less than 0.003) and total diffusion barrier (endothelial cell, pericyte, basement membrane) (p less than 0.001) thickness were significantly increased, and oxygen diffusing capacity was significantly reduced (p less than 0.001) in the nerves of patients with severe diabetic neuropathy when compared to control subjects. Endothelial cell profile number and luminal perimeter were significantly increased in asymptomatic (p less than 0.01), (p less than 0.05) and severely neuropathic (p less than 0.001), (p less than 0.05) diabetic patients respectively. However, endothelial cell outer perimeter, a measure of capillary size, showed no significant increase in diabetic patients when compared with control subjects. An association was observed between neurophysiological and neuropathological measures of neuropathic severity. There was no significant correlation between the duration of diabetes and HbA1 levels with capillary pathology or with neuropathic severity. Very few abnormalities of muscle and skin correlated with neuropathic severity. However, all measures of nerve capillary pathology correlated significantly with neurophysiological and neuropathological measures of neuropathic severity. PMID- 2721845 TI - Educational research in family medicine. PMID- 2721846 TI - An experimental study of two methods for teaching sexual history taking skills. AB - The purpose of this study was to test two distinct components of a sexual history taking training program in a controlled, randomized experiment. Twenty-four family practice residents were divided into two groups. One group received skills oriented training and the other received sexual awareness oriented training. Both groups received active listening skills training and general information about sexual dysfunction. The effects of the two treatment groups were assessed by residents' performance in videotaped simulated sexual history interviews. Results strongly suggested that the skills oriented method was more effective than the awareness oriented method for teaching residents to take a sexual history. No residents elicited information about sexual orientation. These results are discussed in terms of their implications for teaching and research in sexual history taking skills. PMID- 2721847 TI - A supervised training program in flexible sigmoidoscopy: evaluating skills from residency training to clinical practice. AB - To assess the effectiveness of a training program in flexible sigmoidoscopy for family practice residents, we prospectively studied the performance of four residents during their training and after graduation. One hundred and four training exams performed with the assistance of an experienced gastroenterologist were compared with 118 unassisted post-training, post-residency exams. The mean depth of insertion for the post-training period was 51.1 +/- 1.2 cm, which was significantly greater (P less than .05, Student's t test) than the mean training period depth of 47.6 +/- 1.2 cm. There was no significant difference in the identification of polyps or cancer between the training and post-training periods. The mean duration of an exam was 17.3 +/- 0.6 minutes in the post training period. No significant complications were encountered in either period. The residency trained family physicians obtained results similar to those reported by trained endoscopists in depth of examination and pathology detected, although their examinations required more time. We conclude that this model of training was effective in the development of flexible sigmoidoscopy procedural skill for family practice residents. PMID- 2721848 TI - Family practice obstetrics: style of practice. AB - Prevalent birth practices reflecting a family-centered, minimally invasive style of obstetrical practice were surveyed among 235 family physicians practicing obstetrics in Michigan. Respondents older than 35 years and those without an academic affiliation reported fewer "family-centered" and more "intrusive" practices than did younger or academically affiliated respondents. Compared to published data on California obstetricians, Michigan family physicians were more likely to report practices that appear family centered and, particularly for more recent graduates, ones less likely to routinely involve obstetrical interventions. PMID- 2721849 TI - Assessing the functional status of older patients with chronic illness. AB - The purpose of this study was to investigate the value of using a validated functional assessment instrument, the Sickness Impact Profile (SIP), with older, chronically ill patients seeking care at the family physician's office. The SIP was completed by the patient and the family physician on patients 55 years of age or older who were seen at a family practice residency clinic. The study used stratified, random assignment in an experimental design to compare physician and patient reaction to the SIP. Both physicians (residents and faculty) and patients felt the SIP was useful in detecting disabilities. Approximately half of the physicians felt the SIP was helpful in patient management. Patients reported twice as many disabilities as were reported by physicians. Half of the clinic physicians had the opportunity to review a patient's SIP immediately prior to a visit. They recognized more disabilities and agreed more often with the patients about the presence of a disability. The physicians felt the SIP was too lengthy to assimilate easily into the clinic setting. Use of a functional assessment instrument is advocated because of its ability to increase both physician awareness and physician-patient communication regarding the presence of a functional deficit. PMID- 2721850 TI - Disarming the family ghost: a family of origin experience. AB - A training method based on family of origin theory was designed to improve health care providers' interactions with difficult patients. The training is divided into five phases. First, leaders introduce participants to basic family of origin issues and the goals and format of the process. Second, participants discuss a difficult case, and, third, construct a family of origin genogram. Fourth, participants analyze the similarities between the two emotional systems. Leaders conclude with a discussion of the symptoms of fusion and develop strategies to avoid fusion during the therapeutic process. Within each phase, leaders present case examples and the participants in dyads proceed through the same process. By going through this process, participants will be better able to understand how family of origin dynamics affect the care they provide patients and why certain patients often prove to be difficult cases. PMID- 2721851 TI - Physician compliance with mammography guidelines: a retrospective chart review. AB - Annual mammography is recommended by the American Cancer Society as an effective technique for the early detection of breast cancer in women aged 50 and older. This paper reports on a study conducted in a large group family practice in an urban academic setting to examine the frequency with which physicians were ordering mammograms for one age-appropriate group of female patients. The charts of a random sample of 88 females over age 55 who had been patients in the practice for at least five years were abstracted for information on mammography and breast examination as well as background clinical history. Within this sample, 56% had no mammograms recorded over the five-year study period, and only 19% had a mammogram within the most recently completed year. The average interval between mammograms over five years for subjects with one or more mammograms was 3.5 years. For 18% of all ordered mammograms the results could not be located in the chart. These findings suggest that family physicians need to improve adherence to recommended guidelines for mammography and to improve documentation of screening activities in the medical record. PMID- 2721853 TI - Engel reexamined. PMID- 2721852 TI - The Beck Depression Inventory: normative data and problems with generalizability. AB - A frequency distribution of Beck Depression Inventory (BDI) scores for 484 adult family practice patients was generated to assist researchers with cutoff score decisions and sample size calculations. The question of generalizability was addressed by comparing three primary care BDI studies. Large between-study differences in the frequency of elevated BDI scores remind us that the use of normative data from another setting is second choice to standardization using the population in question. PMID- 2721854 TI - David Baltimore responds. PMID- 2721855 TI - Meal-induced peptide tyrosine tyrosine inhibition of pancreatic secretion in the rat. AB - In the present studies we examined the distribution, release, and biological actions of peptide tyrosine tyrosine (PYY) in the rat. The concentration and distribution of PYY was highest in the ileum and colon as determined by both radioimmunoassay of rat tissue extracts and immunocytochemistry. An ultrastructural comparison of rat and dog colonic PYY cells revealed a bipolar distribution of peptide-containing secretory granules in both species. Serum PYY and pancreatic exocrine secretory responses were monitored after presentation of a meal to meal-trained rats (n = 12). A significant increase in PYY concentrations was not observed until 120 min after meal presentation, a delayed response similar to that previously observed in the dog. PYY responses were also observed in rats after perfusion of the intestine at the level of the duodenum and ileum with an 80 mOsm micellar solution of sodium oleate. Duodenal instillations of the fatty acids resulted in a maximum PYY response after 120 min, whereas rats subject to ileal perfusion of fat exhibited maximum PYY release within the first hour. In other experiments, infusion of exogenous PYY at 100 pmol.kg-1.h-1, which reproduced plasma PYY levels observed after a meal and perfusion of the gut with fat, significantly inhibited CCK-stimulated bile pancreatic volume (P less than 0.02), protein (P less than 0.01), and amylase (P less than 0.01) output. These studies demonstrate a bipolar distribution of PYY containing secretory granules in cells of the jejunal, ileal, and colonic mucosa, and show that PYY is released in response to a meal in amounts sufficient to inhibit cholecystokinin-stimulated pancreatic secretion. Evidence is presented that PYY may mediate the delayed inhibition of pancreatic secretion that is observed in the rat after ingestion of a meal. PMID- 2721856 TI - Anticachectin/tumor necrosis factor-alpha antibodies attenuate development of cachexia in tumor models. AB - C57BL/6 mice bearing either a transplantable methylcholanthrene-induced sarcoma or Lewis lung adenocarcinoma were passively immunized every other day with a rabbit immunoglobulin fraction raised against murine cachectin/tumor necrosis factor-alpha. Mice bearing methylcholanthrene-induced sarcoma developed tumor associated hypophagia that was attenuated by anticachectin immunoglobulin treatment. In the same tumor-bearing animals, anticachectin treatment also significantly reduced the extent of carcass protein and fat loss, and reduced tumor weight. Mice bearing Lewis lung adenocarcinoma did not develop significant anorexia or carcass lean tissue depletion as tumor growth progressed, but they lost carcass lipid. Treatment of Lewis lung adenocarcinoma bearing mice with anticachectin antibodies diminished the degree of carcass lipid depletion and prevented plasma hypertriglyceridemia. However, in both tumor models, anticachectin treatment did not affect either the development of anemia, hypoalbuminemia or the increase in serum amyloid P concentrations seen with increasing tumor burden. We conclude that an endogenous cachectin response, inhibitable by exogenously administered antibody, contributes to anorexia and to changes in body fat and protein metabolism in these tumor-bearing animals. Neutralizing endogenous cachectin production with antibodies offers the potential to reduce tissue wasting that is frequently associated with neoplastic disease, but it does not appear to affect all of the hematologic and acute phase responses in these murine tumor models. PMID- 2721857 TI - Phosphosugars are potent inhibitors of central nervous system inflammation. AB - Adoptively transferred allergic encephalomyelitis can be inhibited by various phosphosugars, particularly mannose-6-phosphate. The sugar specificity suggests that inhibition may be due to depletion of lymphocyte cell-surface lysosomal enzymes, which are essential for the passage of lymphocytes across the vascular endothelium and the entry of lymphocytes into the central nervous system parenchyma. PMID- 2721858 TI - Rating intervals: an experiment in peer review. AB - The National Institute of Health (NIH) peer review process for research grant applications is one of the largest and most respected systems of its kind in the world. Recently, however, the distribution of raw priority scores voted by NIH study sections has been skewed, and the rating behavior of individual review groups has been quite variable. These phenomena have made funding decisions more difficult. To achieve greater uniformity of rating behavior and a broader description of scores, an experiment was conducted involving 24 study sections. Standard adjectival descriptors and standard rating scales were used. On a random basis, half of the study sections were instructed to vote in units of 0.1 while the other half used an interval of 0.5. The results of this study have now been translated into standard practice at NIH. PMID- 2721859 TI - NIH funding. PMID- 2721860 TI - The mystery of nursing. PMID- 2721862 TI - [7th national continuing education seminar on hepato-gastroenterology. Geneve, Palexpo, 15-16 April 1989]. PMID- 2721861 TI - Mother, aseptic technique, and me. PMID- 2721864 TI - Importance of an alkaline microenvironment for rapid restitution of the rabbit duodenal mucosa in vitro. AB - Rapid epithelial restitution after superficial damage of the gastroduodenal mucosa consists of the migration of remaining intact epithelial cells beneath a necrotic layer of mucus and shed cells. Complete reepithelialization occurs within 60 min (rat stomach) to 7 h (rabbit duodenum) and does not involve cell division. The present study investigated rapid restitution of the acid-damaged rabbit duodenal mucosa in vitro under various conditions. Alkaline flux and transmucosal potential difference were measured simultaneously, and computerized morphometry was performed. Rapid restitution was nearly completed 5 h after damage at neutral luminal pH, but it was retarded when the luminal pH (pHL) was kept at 3. Removal of the necrotic layer did not impair restitution at neutral luminal pH but caused delay at acidic pH (pHL = 3.0). Removal of nutrient bicarbonate slightly delayed restitution at pHL = 7.4 and caused complete inhibition at pHL = 3.0. Alkaline secretion was usually stable but was nearly totally abolished after removal of nutrient bicarbonate. The potential difference decreased after acid damage and showed a tendency to recover in parallel with mucosal restitution. This gradual recovery correlated directly with morphometry. The authors assume that rapid restitution of the duodenal mucosa at an acidic luminal pH depends on the presence of a protective necrotic layer and sufficient alkaline secretion to maintain an optimal environment adjacent to the mucosa. Disturbance of this alkaline microenvironment could be important for the development and healing of duodenal ulcer. PMID- 2721863 TI - Measurement of the surface hydrophobicity of human gastrointestinal mucosa. AB - A technique has been developed for assessing the surface hydrophobicity of human gastrointestinal mucosa by measuring the plateau contact angle of saline drops applied to endoscopic biopsy specimens. The plateau contact angle was not affected by the mode of drying. The intraobserver and interobserver coefficient of variation was less than 5%. The gastric mucosal surface had a higher mean contact angle than the submucosal surface (69 degrees vs. 47 degrees, p less than 0.001). Glycerol drops gave lower contact angles than saline drops (55 degrees vs. 69 degrees) but gave the same derived values for surface free energy (42 vs. 41 mJ/m2). Regional values for contact angle were as follows: gastric body 70 degrees, antrum 70 degrees, duodenal bulb 62 degrees (p less than 0.01 vs. stomach), distal duodenum 50 degrees (p less than 0.001 vs. stomach and p less than 0.01 vs. bulb), and rectum 57 degrees (p less than 0.001 vs. stomach). We conclude that it is feasible to measure the surface hydrophobicity of human endoscopic biopsy specimens and that the stomach is relatively more hydrophobic than the duodenum and rectum. PMID- 2721865 TI - Effect of sialoadenectomy on adaptive cytoprotection in the rat. AB - In the present study we have investigated the effect of sialoadenectomy in the rat on adaptive cytoprotection induced by intragastric instillation of an irritant concentration of ethanol (10% wt/vol). Gastric mucosae were examined 1 h after oral administration of 100% ethanol. In animals with intact salivary glands, pretreatment with saline was followed 15 min later by 100% ethanol. This treatment was associated with a significant degree of mucosal damage. However, prior administration of 10% ethanol in place of saline reduced the area of ulceration. In sialoadenectomized rats, the irritant concentration of ethanol did not protect the gastric mucosa from the damaging actions of absolute ethanol. The effect was partially restored if sialoadenectomized rats were treated for 3 days with an aqueous extract of rat salivary gland tissue. Histologic examination revealed no differences in the extent of epithelial damage or adherent mucus between rats with intact salivary glands and sialoadenectomized rats following pretreatment with either saline or 10% ethanol. Although adaptive cytoprotection in animals with intact salivary glands was not associated with increases in mucosal capacities for prostaglandin E2 or 6-keto prostaglandin F1 alpha biosynthesis, sialoadenectomy resulted in a reduction in the mucosal biosynthetic capacities for both prostanoids. Salivary gland extract administration to sialoadenectomized rats did not significantly alter mucosal prostaglandin biosynthesis levels. These data suggest that salivary gland factors affected adaptive cytoprotection induced by an irritant dose of ethanol. Although endogenous prostaglandin biosynthesis capabilities do not appear to be altered in adaptive cytoprotection, salivary factors appear to influence mucosal generation of prostaglandins. PMID- 2721866 TI - Impaired internal anal sphincter in a subgroup of patients with idiopathic fecal incontinence. AB - During multiport manometric recordings of the anorectum, 35 of 140 patients with idiopathic fecal incontinence had abnormally weak sphincters that did not relax during rectal distention, suggesting impaired function of the internal anal sphincter. This study documents this finding and compares anorectal function in these 35 patients with 25 matched normal subjects and the remaining 105 incontinent patients. Basal and squeeze pressures were significantly lower in the incontinent study group than in the other two groups. During rectal distention, 25 of 35 patients showed no anal relaxation at any volume, whereas 10 patients showed some relaxation after 60-ml distention because of the postinflation rebound in internal anal sphincter tone. The electrical responses of the external anal sphincter to rectal distention and to increases in intraabdominal pressure were greater in patients than in normal subjects, but the anal pressures were lower and anal leakage was common. Rectal sensations were not significantly different from normal subjects. These results indicate that 25% of patients with idiopathic fecal incontinence have markedly impaired function of the internal anal sphincter, but these patients also have extremely weak external sphincters. PMID- 2721867 TI - Fat-storing (Ito) cells of rat liver synthesize and secrete apolipoproteins: comparison with hepatocytes. AB - Fat-storing cells of the liver store most of the vitamin A of the body. Vitamin A is present in a few large fat droplets within the cell. The aim of our study was to investigate apolipoprotein biosynthesis in isolated fat-storing cells from rat liver during the time in culture. Isolated rat hepatocytes were studied for comparison. Proteins were biosynthetically labeled and further identified by immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis. Apoproteins in culture supernatants were identified by density gradient ultracentrifugation and by one- and two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis of aliquots of the gradient. Rat plasma was processed in the same way and used for comparison. Fat-storing cells synthesized and secreted apoprotein E, apoprotein A-I, apoprotein A-IV, and low amounts of apoprotein C. The synthesis of these proteins increased during the culture time, reaching a maximum at the fifth day after isolation. The proteins were identified mostly as apoproteins of high-density lipoprotein. Hepatocytes synthesized and secreted apoproteins of all classes of lipoproteins. The distribution of high-density lipoprotein apoproteins was similar to that of fat storing cells but hepatocytes produced larger amounts of the apoproteins. PMID- 2721868 TI - Subunit interactions and physical properties of bovine gallbladder mucin. AB - In this study the interaction of gallbladder mucin subunits was examined by gel permeation chromatography, quasielastic laser light scattering, and viscometry. Purified mucin eluted primarily in the void volume of a Sepharose 2B-Cl column, indicating a molecular weight above 2 x 10(6). Disaggregation of the mucin polymer resulted in the elution of glycoprotein in the included volume of the Sepharose 2B-Cl column. Gallbladder mucin had a hydrodynamic radius of 630 A that was independent of mucin concentration below 2 mg/ml. At mucin concentrations above 2 mg/ml, a concentration-dependent increase in both hydrodynamic radius and apparent viscosity of gallbladder mucin was observed. Mucin demonstrated a strong pH dependence in hydrodynamic radius and viscosity with the maximum occurring at approximately pH 5.5. These findings suggest that noncovalent interactions participate in bovine gallbladder mucin subunit associations. Furthermore, changes that occur in the physicochemical environment of the gallbladder during periods of stasis may enhance the viscoelastic properties of mucin and promote the accumulation of biliary sludge in the gallbladder. PMID- 2721869 TI - Removal of common bile duct stones by the combination of percutaneous balloon dilatation and extracorporeal shock-wave lithotripsy. AB - Endoscopic papillotomy may not be possible in patients who have previously undergone gastric surgery. We describe the successful treatment of such a patient with ultrasound-guided, percutaneous transhepatic biliary drainage, followed by balloon dilatation of the sphincter of Oddi and extracorporeal shock-wave lithotripsy. Combinations of new treatment forms may be necessary and effective when single forms of treatment fail. PMID- 2721870 TI - Spontaneous rupture of nonparasitic cyst of the liver. AB - A case of spontaneous rupture of a nonparasitic liver cyst, documented by serial computed tomography scans, is reported. The patient was closely followed clinically after the rupture of the cyst and was treated conservatively, without surgical intervention. No peritonitis developed. This unusual complication of nonparasitic simple liver cysts may not always require surgery. PMID- 2721871 TI - Stimulation of G2-arrested rat liver and pancreas cells by fasting. AB - The present study complements earlier work that revealed a mitogenic effect of fasting on G2-blocked hepatocytes, demonstrating that the release of hepatocytes from the G2 arrest is maximal at 3 h of fasting and that the phenomenon lasts for 12 h. The mitogenic effect of fasting is not restricted to the liver, as similar results were obtained with the pancreas--suggesting a possible action on other organs as well. A simple physiologic stimulus such as fasting can thus be used in further studies on the properties of G2 cell populations and their possible role in the regulation of normal and abnormal growth processes. PMID- 2721872 TI - Mitochondrial aspartate aminotransferase in nonalcoholic cirrhosis. PMID- 2721873 TI - Ethanol-induced intestinal mucosal injury. PMID- 2721874 TI - The manpower position: is the expense too immense to make sense? PMID- 2721875 TI - Fecal lipid excretion in pancreatic insufficiency. PMID- 2721876 TI - Technetium 99m phagocyte scanning in inflammatory bowel disease. PMID- 2721877 TI - Studies of intestinal lymphoid tissue. XII. Epithelial lymphocyte and mucosal responses to rectal gluten challenge in celiac sprue. AB - The immunopathologic, structural, and functional changes within rectal mucosa of known celiac sprue subjects were quantitated during local challenge with a peptic tryptic digest of gluten. In the celiac sprue patients challenged with 2 g of digest, major effects occurred in lamina propria, submucosa, and local microvasculature. The lamina propria swelling was biphasic, starting 1-2 h after challenge with widespread extravascular deposition of fibrinogen, indicative of increased microvascular permeability, receding by 24 h postchallenge. A rapid fall in mast cells together with granule discharge suggested their involvement in this response. The late-phase swelling (48-72 h) was preceded by a rapid influx of neutrophils and basophils, the latter showing evidence of degranulation beyond 72 h. Reestablishment of vessel lumina, a rise in mast cells, and loss of neutrophils indicated tapering of the inflammatory cellular cascade by 96 h. Lymphocytes, first seen to enter the lamina by 2 h postchallenge, increased progressively, thereby resulting in substantial infiltration between 36 and 96 h. A marked rise in epithelial lymphocytes, maximal at 6-8 h, waned by 24 h. Volumes of surface and crypt epithelium remained constant throughout. In another challenge series with 4 g of gluten digest, electrical potential difference across rectal mucosa decreased significantly 12 h postchallenge, but the associated decreases in net sodium and chloride absorptive fluxes were insignificant. It is concluded that rectal mucosa is sensitized to gluten in celiac sprue disease and thus offers a promising and convenient in vivo substrate for investigative and diagnostic purposes. PMID- 2721878 TI - Regional differences in the vascular response of the canine esophagus to vasodilators. AB - The basal blood flow of the proximal and distal body of the esophagus, and that of the lower esophageal sphincter, and the vascular response of these sites to intravenous infusion of nifedipine (1.0 microgram/kg.min) and isoproterenol (0.1 microgram/kg.min) were studied. The basal blood flow of the mucosa plus submucosa, muscularis propria, and the whole wall was significantly higher in the lower esophageal sphincter than in the proximal or the distal body. Intravenous nifedipine caused a similar decrease in vascular tone of the mucosa and the muscularis propria in all sites of the esophagus. Isoproterenol infusion significantly decreased the vascular tone of the mucosa with columnar epithelium (i.e., mucosa overlying the lower esophageal sphincter), but not of the mucosa with squamous epithelium (i.e., mucosa overlying the body). In the muscularis propria the vasodilatory effect of isoproterenol and nifedipine was significant at all sites, but this effect was greater in the striated muscle of the body than in the smooth muscle of the lower esophageal sphincter (p less than 0.05). Thus, not only do different vasodilators have different effects on the vasculature of the esophagus, but also a single agent may have differing effects on the various sites and layers of this organ. PMID- 2721879 TI - Developmental profile of chromogranin, hormonal peptides, and 5-hydroxytryptamine in gastrointestinal endocrine cells. AB - In this immunocytochemical study, we have analyzed the developmental profile and phenotypic expression of the endocrine cell antigens chromogranin, 5 hydroxytryptamine, gastrin/cholecystokinin, cholecystokinin (9-20), somatostatin, somatostatin 28 (1-14), somatostatin cryptic peptide, glucagon, glucagonlike peptides 1 and 2, glicentin, peptide YY, glucose-dependent insulinotropic peptide, secretin, neurotensin, and substance P in human fetal stomach and intestine. All currently identifiable endocrine cell types were detected by 10 wk of gestation. Immunostaining for the endocrine cell marker chromogranin revealed abundant endocrine cells in the earliest specimens (8 wk of gestation) with a relatively higher frequency in both proximal duodenum and distal colon/rectum compared with other areas. Quantification of endocrine cells showed an increase with age that was roughly parallel to the growth of the gut as a whole. These studies show that the diversity of the endocrine component of the gut appears to be established by 10 wk of gestation and that gut activity is preceded by the development of a fully differentiated endocrine component, which may subserve or even initiate the onset of functional maturity. PMID- 2721880 TI - Effects of streptozotocin-diabetes on rat intestinal mucin and goblet cells. AB - Intestinal mucin and goblet cells were examined in streptozotocin-diabetic rats and age-matched controls. Mucin (tissue content and secretion) was measured using a highly specific enzyme-linked immunoassay. In contrast to the increased protein to deoxyribonucleic acid ratio, an absolute decrease was observed in the mucin to deoxyribonucleic acid ratio in mucosal homogenates of the diabetic intestine. This was not due to a loss of goblet cells as their numbers per crypt-villus unit increased in diabetic rats (in proportion to the rise in enterocyte numbers and crypt-villus length). Histochemically, goblet cell mucin was unchanged in diabetes. After a 90-min incubation of everted intestinal segments in Krebs' buffer, pH 7.4, at 37 degrees C, the amount of mucin released into the medium was the same in diabetic and control rats when expressed relative to tissue deoxyribonucleic acid. However, secreted mucin represented a significantly larger proportion of the total tissue mucin content in diabetic animals. Thus, to maintain mucin output at normal levels, the rate of mucin secretion is apparently increased in the diabetic intestine, despite (or perhaps causing) a large decrease in the tissue mucin content. PMID- 2721881 TI - Pyloric motor response to intraduodenal dextrose involves muscarinic mechanisms. AB - The delivery of dextrose solutions to the duodenum is associated with the stimulation of phasic and tonic pyloric contraction. In this study, the effects of intravenous atropine on the antropyloroduodenal motor responses to intraduodenal infusions of 25% dextrose were assessed in 10 normal volunteers. Antropyloroduodenal pressures were recorded with a manometric assembly incorporating a sleeve sensor spanning the pylorus, and sideholes in the antrum and duodenum. In each experiment, three intraduodenal infusions of 25% dextrose were given at a rate of 4 ml/min, for a median duration of 19 min (range 17-20). During the second dextrose infusion, intravenous atropine was given as a bolus (15 micrograms/kg) followed by an infusion (4 micrograms/kg.min), which was continued until the end of each experiment. Before atropine was given, the pyloric motor response to the second dextrose infusion was not significantly different from the response to the first infusion, but after administration of atropine there was a rapid decrease in the rate of isolated pyloric pressure waves, from 0.8 to 0.1 per minute (p less than 0.05). The isolated pyloric pressure wave response to the third dextrose infusion was completely blocked, and there was a much smaller maximum increase in basal pyloric pressure compared with the first infusion (p less than 0.01). This study indicates that intraduodenal dextrose reproducibly stimulates isolated pyloric pressure waves and increases basal pyloric pressure by mechanisms that involve muscarinic receptors. PMID- 2721882 TI - Anatomic, motor, and clinical assessment of vertical banded gastroplasty. AB - The aim of this study was to assess gastric anatomy, motility, and emptying after vertical banded gastroplasty and to correlate the anatomic and physiologic results with clinical outcome. Eleven patients were studied at least 7 mo after operation, by which time they had lost 31% +/- 4% (mean +/- SEM) of their excess body weight. Stomal diameter, volume, and distensibility of the proximal gastric pouch were determined by a balloon distention technique. Gastric emptying was monitored scintigraphically both with and without distention of the proximal pouch. Stomal diameters ranged from 10 to 15 mm (mean +/- SEM = 11 +/- 1 mm), and pouch capacity ranged from 20 to 150 ml (76 +/- 9 ml). Mean intrapouch pressure was 13 mmHg before distention, increased to 22 mmHg with distention to half maximal capacity, and then changed little with further distention to maximum capacity. Near maximal pouch distention during gastric emptying of a 300-ml test meal decreased antral contractile activity and speeded the initial rate of emptying (t25 with distention = 14 +/- 3 min vs. 24 +/- 3 min without distention, p less than 0.03), but did not alter the later rate of emptying. No clear-cut relationship was present between weight loss and stomal diameter, pouch volume, or gastric emptying. The conclusion was that distention of the proximal gastric pouch created by vertical banded gastroplasty inhibited antral contractions and increased the initial rate of gastric emptying, but no clear-cut correlation was found in this cohort between weight loss after the operation and stomal diameter, pouch size, and gastric emptying. PMID- 2721883 TI - [Maternal plasma concentrations in multiple oral fenoterol treatment]. AB - Reports on the clinical effectiveness of oral treatment with beta-sympathomimetic fenoterol are quite divergent in their conclusions. The aim of this study was to determine the plasma levels of fenoterol in steady state during tocolytic treatment with high oral doses. Nine pregnant women with clinically indicated tocolysis were given a 5 mg dose of fenoterol in tablet form eight times per day at prescribed hours. During the first four days, in the late afternoon just before and again one hour after the intake, a blood sample was taken to determine the fenoterol concentration by radioimmunoassay. In addition, uterine activity, blood pressure, heart rate, and tremor were periodically checked while the patient was under observation. The fenoterol levels in the plasma ranged from 130 to 200 pg/ml; the steady state concentration remained relatively constant throughout the observation period. It is not certain, that by taking the blood sample one hour after the tablet was swallowed, the maximal concentration was found. However, with the given doses, nearly the same fenoterol levels were measured in the blood as with low doses of intravenously administered fenoterol. PMID- 2721884 TI - [Therapy of sterility from the viewpoint of females]. AB - 361 gynecological out-patients were questioned by means of a standardised questionnaire concerning their attitude towards the following possibilities of therapy procedures in case of sterility: 1. Artificial Insemination by Husband (AIH) 2. Artificial Insemination by Donor (AID) 3. In Vitro Fertilization (IVF) 4. Surrogate motherhood 5. Microsurgery Clearly positive was their attitude towards microsurgery, AIH and IVF. The patients would, in case of a corresponding sterility problem, accept such therapy for themselves. Negative, however, was their attitude towards AID and surrogate motherhood. Acceptance turned out to be significantly higher in regard to the medically and psychologically more precarious procedures like IVF, AID and surrogate motherhood, when asked whether they would tolerate such therapy for other involuntarily childless couples. Acceptance and valuation of procedures repeatedly followed the same order: microsurgery was judged "most moral" and "most natural", then AIH, IVF, AID and last surrogate motherhood. So traditional ideas of standards and values are decisive factors of acceptance. Emotionally the experience of sexuality, the progenitive act and pregnancy seem to belong together. The more a medical technical procedure will interfere with their privacy the less it will be accepted. No difference in attitude was to be detected in regard to demographic criterions like age or religion. Sterile women, however, were far more prepared to undergo a physically as well as emotionally strenuous therapy in order to have their childwish come true. Personal involvement plays a decisive role in the acceptance of medically and psychologically more precarious procedures like IVF and AID. In comparison the extent of medical-technical efforts, and health risks, seem to be of minor importance. PMID- 2721885 TI - [Spermatozoal antibodies in cervical mucus and in the luminal fluid of the uterus in sterile patients]. AB - Poor postcoital tests in infertile patients may be due to dysmucurrhoea, low sperm count, or specific antibodies against spermatozoa. Using a latex agglutination test ("Sperm-antibody-slide-test", Fa. Biotec, Hannover), we examined the cervical and uterine secretions of the patients for sperm antibodies. The results showed a close correlation between a positive sperm antibody-test and a poor postcoital test, especially in those couples with regular sperm quality. Also in cases with normal postcoital tests, positive sperm antibody titers can be observed. Therefore, the sperm-antibodies may disturb fertilization in infertile patients even without causing immobilization or agglutination of the spermatozoa in the female genital tract fluids. The determination of the spermatozoa-antibody content in the cervical and uterine secretions must be regarded as an improvement in the diagnostic procedure in human infertility. PMID- 2721886 TI - [Labor without prenatal care--an unnecessary challenge]. AB - A group of 431 patients who had given birth, but had not attended regular check ups during their pregnancy, are compared with a cumulative comparative group. The data is from a databank, belonging to the Swiss gynaecological working group. The following results are striking: Very young women, relatively older childbearing women, a noticeably high number of unmarried women and women from the Mediterranean countries. The number of women with heavy nicotine abuse is significant. The general progress of the pregnancy is however not noticeably different from the comparative group. The premature birth rate is higher in the group without pregnancy check-ups, as are birth deficiences and clinical foetal distress. Particularly noticeably is the high number of perinatal deaths. The pointlessness and the possible reasons for lack of regular pregnancy check-ups are discussed. PMID- 2721887 TI - [Inhibition of spontaneous uterine contractions by gestagens]. AB - So far, in spite of the well known pregnancy maintaining effect of progesterone, not one of the many trials could succeed, in using progesterone or synthetic gestagens for tocolytic purposes. Therefore we have investigated the tocolytic effect of gestodene, which is supposed to be the most potent gestagene available at this time and which has, in addition, properties very similar to natural progesterone. In 26 uterine strips, obtained during cesarean section, we found a highly significant decrease of spontaneous uterine activity 10, 20 and 60 minutes after application of gestodene 10(-6) M. PMID- 2721888 TI - [SCC (squamous cell carcinoma) antigen as a tumor marker in cervix cancers]. AB - The TA-4 antigen obtained from squamous cell carcinoma of the uterine cervix has a subunit, the SCC antigen, which can be measured in serum with a polyclonal antibody in a radioimmunoassay. SCC values less than or equal to 1.5 ng/ml were found in 96% of 48 clinically healthy women. This concentration was then set as the cut off value. Of the 122 patients with untreated squamous cell carcinoma of the cervix, 76% had SCC concentrations above 1.5 ng/ml. The CEA was raised in 50% of the cases. In stages III and IV, 89% of the SCC values was raised and 65% of the CEA. Among the 50 patients with recurrent or progressive cervical carcinoma elevated levels of SCC were found in 78% and raised CEA concentrations in 52%. Only in 25% of the cases were both tumour markers raised at the same time. Complete remission was clinically established in 48 patients with cervical carcinoma who had had increased SCC values prior to therapy. The SCC values were in the normal range in 71% of the patients, the CEA values were normal in 81%. The increase in SCC concentration often preceded the tumour recurrence by months. Up to 70% of the patients with vaginal or vulvar carcinoma had elevated SCC levels. SCC proved to be a valuable tumour marker for the follow up of cervical, vaginal, and vulvar cancer. PMID- 2721889 TI - [The nuclear surface area as a malignancy parameter in breast cancer]. AB - For better characterisation of the degree of malignancy of breast cancers, we have attempted to establish a correlation between nuclear size and prognosis in breast cancer. Karyometric investigations were carried out on biopsies from 200 primary breast cancers. On the basis of the nuclear areas determined, we were able to distinguish three groups of carcinomas: group I: carcinomas with small nuclear areas (n = 33), mean value 97.76 microns 2, group II: carcinomas with intermediate nuclear areas (n = 98), mean value of the nuclear areas 146.5 microns 2, group III: carcinomas with large nuclear areas (n = 69), mean value 190.8 microns 2. After five years, 6% of the patients in group I had died, as compared to 35% in group II and 48% in group III. The median survival time was 45 to 48 months in group I, as compared to 37 months in group II and 28 months in group III. There was a direct correlation between axillary lymph node status and nuclear size: the carcinomas with the small nuclear sizes showed the least involvement. A comparison of the prognostic relevance of nodal status and nuclear area size, reveals a good relevance for the nuclear area similar to that of the nodal status. The results of the biopsy cytology are already available to the surgeon before the operation. PMID- 2721890 TI - [The prognostic value of lymphangiosis carcinomatosa and malignancy grading in T1/T2-N0 cancers of the breast using 10 or fewer examined axillary lymph nodes]. AB - In 270 cases of T1 and T2 carcinomas of the breast with ten or less axillary lymph nodes having been examined, the prognostic relevance of the histopathological statement of nodal negativity was assessed in a retrospective study. In this collective study, the mean number of lymph nodes examined was 4.1 +/- 1.9 for the 153 N0 carcinomas and 4.4 +/- 2.2 for the 117 cases with axillary lymph node metastases, respectively. The patients with N0 carcinomas were grouped according to the number of lymph nodes examined, thus resulting three subgroups, those with 1-2, 3-6, and 7-9 lymph nodes having been sampled and subjected to histopathologic evaluation. There was an approximately equal distribution in these three groups with respect to tumor size and tumor types; a correlation between the patients' age and the number of lymph nodes examined could not be found. A comparison of the three groups revealed conspicuous differences among the N0 carcinomas regarding both the disease-free survival time (DFS) and the overall survival time (OS), whereas a higher representativity of the determination of the nodal state, correlating with the number of lymph nodes examined, could not be confirmed. The disease-free survival time, the rate of disease recurrence as well as the median survival time and the 5-year survival rate, however, could be shown to be significantly dependent on tumor-related conditions, especially the grade of malignancy in connection with the presence or absence of peritumoral lymphatic or blood vessel invasion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721891 TI - [Psychosomatic aspects of females in the climacteric. The climacteric- psychosomatics--personality structure]. AB - In this experimental study, the feelings of climacterium in two groups of menopausal women were compared (a test group with climacteric complaints vs a control group without complaints). 70 patients were given a questionnaire: EWL by Janke and Debus, FPI and Giessen-test. The evaluation of the socio-economic data exhibited the fact, that patients in the group with complaints took more drugs than the other group and were more inclined to weight gain. Gynecological data showed significant differences in the beginning and the experience of menstruation. Psychological tests of the group with complaints showed a lack of self-assurance and increased anxiety. These women had also a tendency toward psychosomatic disorders and were less assertive in their social contacts. The discriminant analysis of menopausal and personality variables classified the women equally into the group with complaints compared to the control group. PMID- 2721892 TI - [Atmocausis vaporization. Most severe internal burns following intrauterine use of steam]. AB - The article gives a brief historical review of the now obsolete method of atmocausis and reports on two cases of very deep internal burns after direct intrauterine application of superheated steam; one of the patients died as a result of this procedure. In the thirties this method was used especially to arrest intrauterine perimenopausal bleeding, but has since been abandoned. PMID- 2721893 TI - [Prenatal diagnosis of severe tricuspid valve insufficiency in Ebstein anomaly with pulmonary valve atresia by 2-dimensional color coded Doppler echocardiography]. AB - By the application of all methods of fetal echocardiography the prenatal diagnosis and a prognostically correct assessment was reached in a severe case of Ebstein's anomaly of tricuspid valve associated with pulmonary atresia, severe tricuspid regurgitation, and a hypoplastic main pulmonary artery. It is demonstrated that only the application of two-dimensional color-coded Doppler echocardiography followed by a spectral-Doppler-echocardiography can result in an accurate evaluation of hemodynamical alterations and thus in the prognostic assessment in the reported case. PMID- 2721894 TI - [Giant cell sarcoma: a rare breast tumor]. AB - This is a case report on a giant cell sarcoma or malignant osteoclastoma of the mammarian gland. Clinical diagnosis of this very rare tumor was of an exulcerating breast carcinoma. Histologically, this tumor shows epulis-like giant cells. Pathogenetically, a metaplasia of stromal cells, and of the glandular epithelium, is discussed. A simple mastectomy with extirpation of the axillary lymph nodes was performed. No metastases were found. PMID- 2721895 TI - [Excimer laser cold section technic for surgical gynecology]. PMID- 2721896 TI - [Bacteriotherapy of intestinal dysbacteriosis in patients with acute leukemia]. AB - The results have been presented of correcting intestinal microflora in 127 patients with acute leukemia by preparations containing Bacillus bifidus and acidophilus: dried and milk bifidum-bacterin, biofructolact, acidophilic milk. PMID- 2721897 TI - [Ph'-positive acute leukemia]. AB - A comparative study of Ph'-positive and Ph'-negative blast cells of patients with acute leukemia (12 and 63, respectively) has revealed certain differences between them: Ph'-positive elements were more often characterized by a mixed immunological phenotype, they could grow in agar culture. The therapy of Ph' positive leukemia was less effective than that of Ph'-negative disease. PMID- 2721898 TI - [Effect of endothelial and smooth muscle cells and the extracellular matrix produced by them on hematopoiesis]. AB - The influence of endothelial and smooth muscle cells and their extracellular matrices on hemopoiesis in long-term bone marrow cultures was investigated. In contract to smooth muscle cells, the enrichment of adherent cell layer with endothelial cells led to the stimulation of hemopoietic cell and granulocyte macrophage progenitor (CFU-GM) production. The extracellular matrices of both smooth muscle and endothelial cell origin also produced a stimulating effect on the culture, although they were not so effective as endothelial monolayers. The cultures from cryopreserved bone marrow could be established only with the help of endothelial cells or any types of extracellular matrices. PMID- 2721899 TI - [Experimental study of hemodynamics and oxygen regimen in the body during replacement of massive blood loss with a suspension of erythrocytes in a solution of modified deionized gelatin]. AB - In experiments on dogs with acute massive hemorrhage the effectiveness has been studied of red blood cell suspension in glucose-saline solution N 8 prepared in the Central Research Institute of Hematology and Blood Transfusion, and in a preservative based on gelatin developed in the Leningrad Research Institute of Hematology and Blood Transfusion. The advantage of the colloid preservative has been proved by the parameters of macro- and microdynamics of the blood, oxygen basic state, oxygen budget and rheologic properties of the blood. PMID- 2721900 TI - [Treatment of patients with acute nonlymphoblastic leukemia with low doses of cytarabine]. AB - The analysis has been presented of the treatment of 35 patients (mainly middle aged) with acute non-lymphoblastic leukemia, 27 of them untreated. Repeated 2-3 week courses of subcutaneous injections of cytarabine were used (10 mg/m2, twice a day). A total of 5 complete and 4 partial remissions were recorded. The frequency of complete remissions among the patients who received 2 and more courses of the drug therapy comprised 38.8%. Complete remissions were observed in primary patients with initially lowered or normal leucocyte count in the blood, with partially retained granulocytopoiesis, and a relatively slow progressing of the disease. The mechanisms of action of low doses of cytarabine has been considered. PMID- 2721901 TI - [Influence of agents of infusion-transfusion therapy on the status of kidney function in hemorrhagic shock]. AB - The influence of autologous blood, rheopolyglucinum with mannitol and of two combined blood corrigents on tubular secretion (with respect to 131I-hippuran excretion) and glomerular filtration (with the use of 169Yb-DTPA) was studied in experiments on white mice with "irreversible" hemorrhagic shock. It was established that autoblood transfusion led to an insignificant recovery of tubular secretion and glomerular filtration in shock. Rheopolyglucinum with mannitol improved, to some extent, the kidney function, while the combined blood corrigents including rheopolyglucinum, mannitol, crystalloids and sodium succinate contributed to more complete recovery of the kidney function. The highest effect was recorded when the blood corrigent was supplemented by a compound resuming the electron transport along the mitochondrial respiratory chain. The use of the autoblood with combined blood corrigents (1:4) in severe hemorrhagic shock led to the same degree of recovery of tubular secretion and glomerular filtration as combined blood corrigents alone. PMID- 2721902 TI - [Anti-ischemic protection of the liver using perfluorocarbon emulsion]. AB - Anti-ischemic effectiveness of a Soviet perfluorocarbon emulsion (PFE) was studied in 43 experiments on rabbits with 90-min constriction of the hepatoduodenal ligament and under hypothermic perfusion of the liver during ischemia in the open contour. It has been established that PFE perfusion to a great extent promotes the retention of the ischemized liver function. PMID- 2721903 TI - [Improvement of the blood preservative citroglucophosphate]. PMID- 2721904 TI - [Individual resistance of erythrocytes to the processes of cryopreservation as a function of the features of iron metabolism in donors]. PMID- 2721905 TI - [Effectiveness of donor immunization with adsorbed tetanus anatoxin depending on several factors]. PMID- 2721906 TI - [Low doses of cytarabine in the treatment of acute non-lymphoblastic leukemia in adults]. AB - Low doses of cytarabine were used in the therapy of 33 adult patients with non lymphoblastic leukemia. A total of 37.5% of complete remissions were recorded in the group of primary patients, and 36% of complete remissions--in the group of resistant patients and in those with relapses. Indications have been determined, and an opinion on the mechanism of action of low doses of cytarabine has been expressed. PMID- 2721907 TI - [Signs of hypoxia in patients with post-transfusion complications]. AB - Altogether 65 patients with acute renal failure induced by blood transfusion were examined for the clinical and biochemical manifestations of hypoxia according to the determination of hemoglobin affinity for oxygen, of 2,3-DPH, ATP and creatine in red blood cells and for acid-base balance. It has been shown that both clinical and biochemical manifestations of hypoxia are most pronounced in oligoanuria and particularly during hemodialysis. PMID- 2721908 TI - [Resistance of erythrocytes of different ages to oxidants in persons with hereditary glucosephosphate dehydrogenase deficiency]. PMID- 2721909 TI - [Rheological properties of preserved blood stored in polymer containers and glass vials]. PMID- 2721910 TI - [Electric and rheological properties of erythrocytes during storage of preserved blood]. PMID- 2721911 TI - [Rapid analysis of HbC beta 6Glu----Lys]. PMID- 2721912 TI - [Problem of the expediency of studying a new biological phenomenon "emperipolesis"]. PMID- 2721913 TI - Phosphate regulation of ACV synthetase and cephalosporin biosynthesis in Streptomyces clavuligerus. AB - Cephalosporin production by Streptomyces clavuligerus was reduced sharply by 60 mM phosphate added to a chemically-defined medium. All the four synthetases in the pathway examined, i.e., ACV synthetase, cyclase, epimerase and expandase, were repressed by phosphate, with ACV synthetase being the main repression target and expandase the next. ACV synthetase activity was inhibited by phosphate to a lesser extent than expandase and cyclase, and this inhibition could be reversed by adding Fe2+. Fe2+ itself was inhibitory to ACV synthetase action. PMID- 2721914 TI - Effects of pertussis toxin and indomethacin on murine lymphocytes in the bronchoalveolar lavage fluids. AB - The total number of lymphocytes in the bronchoalveolar lavage (BAL) fluids significantly increased in mice injected intravenously with pertussis toxin (PT), while the absolute number of alveolar macrophages markedly decreased. This finding probably reflects the lymphocyte accumulation in interstitial spaces as we previously observed in mice injected with PT. In addition, indomethacin, at lower dosage (0.5 mg/kg) prevented peripheral lymphocytosis and lymphocyte accumulation in the alveolar spaces of the lungs of mice injected with PT. These results provide evidence that PT is responsible for lymphocyte accumulation together with a marked decrease of alveolar macrophages in the lungs of treated mice; moreover, indomethacin is effective in preventing bronchoalveolar changes caused by PT. PMID- 2721915 TI - Influence of substrate carbon on the metabolism of Clostridium thermohydrosulfuricum. AB - The concentration of carbon sources has a significant influence on the growth, carbohydrate uptake and metabolite distribution in Clostridium thermohydrosulfuricum. The growing concentrations of glucose or starch increase the production of ethanol and lactate, the intracellular fructose-1,6-diphosphate (FDP) and the specific activity of lactate dehydrogenase (LDH), but decrease the ethanol/lactate ratio. PMID- 2721917 TI - Purification of a TDH-related hemolysin produced by a Kanagawa phenomenon negative clinical isolate of Vibrio parahaemolyticus 06: K46. AB - A hemolysin produced by a clinical isolate of Kanagawa phenomenon-negative Vibrio parahaemolyticus 06: K46 was purified by 55% ammonium sulfate fractionation and successive column chromatographies on DEAE-cellulose, hydroxyapatite, Sepharose 4B and Mono Q. The purified hemolysin was physicochemically and immunologically identical with the Vp-TRH (V. parahaemolyticus thermostable direct hemolysin related hemolysin) recently described in V. parahaemolyticus 03: K6 (Honda et al. Infect. Immun. 56: 961-965, 1988). This indicates that V. parahaemolyticus of Kanagawa-negative clinical isolates possessing not only 03: K6 but also different serotypes such as 06: K46 produce Vp-TRH. Production of Vp-TRH by most clinical isolates of Kanagawa-negative V. parahaemolyticus was also demonstrated. These results suggest the importance of Vp-TRH among clinical isolates of Kanagawa negative V. parahaemolyticus. PMID- 2721916 TI - The serotype distribution of Campylobacter in patients with diarrhoea in Kuwait. AB - Fifty one strains of Campylobacter jejuni/coli isolated from patients with diarrhoea, at the Amiri Hospital, Hawally, Kuwait were classified on the basis of the heatstable-HS-antigens and the heat-labile-HL-antigens, by using 20 and 23 hyperimmune antisera for the two methods, respectively. The ages of the patient ranged from 3 months to 60 years, and 72.6% of the strains were from children less than 4 years. With the number of antisera used 78.4% of the HS antigens and 96.1% of the HL antigens could be identified. About half of the strains had one of five HS antigens (4, 8, 13, 5 or 25) and 70.5% of the strains had one of five HL antigens (1, 36, 2, 6, or 21). The study shows that the most common HS and HL antigens among Campylobacter strains from Kuwait also are the most frequent antigens of strains from other parts of the world. A limited number of antisera are sufficient to identify the majority of the strains. PMID- 2721918 TI - Streptomycetes can grow through small filter capillaries. AB - Streptomycetes are Gram-positive bacteria growing as branching filaments. The filaments are able to deform. This ability allows the cells to squeeze through capillaries as small as 0.2 micron in diameter. After passage through the capillaries, numerous hyphae are morphologically altered to a helical structure. PMID- 2721919 TI - Enterococcus raffinosus sp. nov., Enterococcus solitarius sp. nov. and Enterococcus pseudoavium sp. nov. AB - Deoxyribonucleic acid base composition, deoxyribonucleic acid-deoxyribonucleic acid hybridization, and biochemical studies were performed on some enterococci from clinical sources of uncertain taxonomic position. Our results indicate that 6 human strains, a single clinical isolate and a strain from bovine mastitis are genetically distinct from each other and all other previously described Enterococcus species and constitute three new species, for which the names Enterococcus raffinosus, Enterococcus solitarius and Enterococcus pseudoavium are proposed. PMID- 2721920 TI - Low heat resistance of Bacillus sphaericus spores correlated with high protoplast water content. AB - The low heat resistance (D100 = 0.554 min, z = 13.4 degrees C) of dormant lysozyme-sensitized spores of Bacillus sphaericus 9602 was correlated with a low protoplast wet density (1.305 g/ml) equivalent to a high protoplast water content (61.0%, wet weight basis). These values for these unusual spores were consistent with those correlated previously in 28 spore types of seven other species. PMID- 2721921 TI - The structure of the lipopolysaccharide core region of Citrobacter 027. AB - The structure of Citrobacter 027 lipopolysaccharide core has been established using sugar and methylation analyses and 1H-NMR spectroscopy, and was shown to be identical to the core described recently in PCM 1487 strain which represents a separate serotype in Citrobacter genus. PMID- 2721922 TI - Construction of shuttle vectors useful for transforming Clostridium acetobutylicum. AB - Plasmids pIM13, pT127 and pBC16 delta 1, introduced by transformation into Clostridium acetobutylicum N1-4081, were shown to replicate in, and to confer antibiotic resistance upon this new host. Recombinant plasmids were constructed by inserting erythromycin-resistant plasmid pIM13 into the unique ClaI site of pBR322 or by ligating a tetracycline-resistant determinant of plasmid pT127 to HindIII-linearized pIM13. The hybrid plasmids replicated and expressed erythromycin resistance in C. acetobutylicum strain N1-4081 and in Escherichia coli or Bacillus subtilis, indicating that they might be useful as shuttle vectors for transferring genes between these strains. The efficiency and stability of different replicons in C. acetobutylicum were compared. PMID- 2721923 TI - Profiles of enterotoxin and cytotoxin production in Campylobacter jejuni and C. coli. AB - Enterotoxin and cytotoxin production of 10 strains of Campylobacter spp. were examined by ELISA and HeLa cells assay, respectively. Both toxins were produced in high concentrations by strains freshly isolated from patients. The maximum enterotoxin activity was found to be at 24 h after incubation, at which time cell growth reached the stationary phase. On the other hand, production of cytotoxin increased after the logarithmic phase of the growth. PMID- 2721924 TI - Degradation of intestinal glycoproteins by Bacteroides vulgatus. AB - Bacteroides vulgatus, isolated from a patient with Crohn's disease, produced in gnotobiotic rats 7 constitutive enzymes that might be concerned with the degradation of intestinal glycoproteins. Furthermore Bacteroides vulgatus caused an almost complete loss of blood group antigenicity of the intestinal glycoproteins. Enzymes with the potency to release toxic compounds from hepatic conjugates and plant glycosides, beta-glucuronidase and beta-glucosidase, respectively, were only detectable in small amounts. These findings indicate that Bacteroides vulgatus, which accounts for 40% of the total flora of patients with Crohn's disease, may play a role in the pathogenesis of Crohn's disease, by increasing the break-down of the mucus layer and therefore damaging its protective function. PMID- 2721925 TI - Multiple forms of carboxylesterase activity in Acinetobacter calcoaceticus. AB - A carboxylesterase activity (E.C.3.1.1) was found in all four strains of Acinetobacter calcoaceticus tested. The activity was present in both 2 X 10(4) gav h-1 supernatant and bacterial wall-membrane fractions. The activity in the supernatant was in two molecular weight forms, the predominant form with a Mr of about 10(3) K and a minor form Mr approximately 600 K. The activity was inhibited by phenylmethylsulfonyl fluoride. SDS-PAGE showed that in A. calcoaceticus NCIB 8250 the activity was composed of three components of Mr 43, 40 and 38 K. The individual components showed different activities with 1- or 2-naphthyl esters. Of the other strains used, one showed a nearly identical pattern of component activities, while the other two showed only two component activities. PMID- 2721926 TI - Phenotypic effects of apolipoprotein structural variation on lipid profiles. I. APO H and quantitative lipid measures in the healthy women study. AB - Apolipoprotein H (APO H), also known as beta 2-glycoprotein I, has been identified as a protein component of the major lipoprotein density fractions in human plasma. Recently, genetically determined structural polymorphism in white and black populations has been documented for this apolipoprotein. There are three common alleles in whites and blacks and a fourth allele found mainly in blacks. Family data confirm the autosomal codominant pattern of inheritance for the APO H structural gene. Little is known about the function of APO H, but it has demonstrated both lipid and platelet involvement. In this study we investigate the effect of APO H phenotypes on quantitative lipid measures in a group of 443 white women being followed through menopause for changes in cardiovascular risk. At baseline all women were premenopausal. None of the APO H phenotypes showed a statistically significant effect on lipid measures in this population. PMID- 2721927 TI - Estimation of genetic model parameters: variables correlated with a quantitative phenotype exhibiting major locus inheritance. AB - A major locus that is detected through its effect on one phenotype (a primary trait) may also affect other quantitative phenotypes or qualitative disease endpoints (secondary traits). The pattern of effects of the major locus on a set of primary and secondary traits suggests candidate defects for the mutant allele. The effects are directly estimable when "measured genotypes" or a tightly linked marker allow unambiguous assignment of major locus genotypes. When genotypes assignments are ambiguous for a major locus detected through its effect on a quantitative primary trait, we propose estimators using genotypic probabilities. Making certain reasonable assumptions, we demonstrate asymptotic unbiasedness of these genotypic probability estimators of the genotypic means and variances for either the quantitative primary or secondary traits, of the covariances between quantitative primary and secondary traits, and of prevalences for the secondary qualitative traits. An important application of genotypic probability estimators is to define an effect of a major locus that cannot be detected upon analysis of the variable; for example, major locus effects may be defined for hypertension or blood pressure as secondary traits, but not detected as primary traits. PMID- 2721928 TI - Repeated-measures model for the investigation of temporal trends using longitudinal family studies: application to systolic blood pressure. AB - A contemporary path model for the analysis of familial resemblance is extended to incorporate repeated measurements on the entire pedigree over time, in order to assess age-related changes in familiality. The parameters of the model can be defined as arbitrary functions of the ages, age differences, or cohabitation times of the family members at the exact time of measurement. Tracking of the phenotypes is decomposed into a familial and a nonfamilial component, which varies with both the time span between measurements and the ages at measurement. Some of the family members may have data missing on one or more visits, and the visits may be unequally spaced both within and across families. The method incorporates all measurements available from all visits into a single model. The model is applied to longitudinal data on systolic blood pressure in 490 East Boston families measured two times at 3-year intervals. Evidence for some nonfamilial tracking is found. Additionally, significant temporal trends are demonstrated in the familiality as a function of age, t2(A), which appears to be near zero at birth, grow to a maximum of about 40% at around age 30, and then appears to monotonically decrease again. No evidence was found for temporal trends in marital resemblance or residual sibling environmental effects. This model provides an objective method of investigating developmental changes in the correlational structure of families over time using repeated-measures and of estimating continuous changes in familiality with age. PMID- 2721929 TI - Robust methods for the detection of genetic linkage for quantitative data from pedigrees. AB - The robust method for detecting linkage developed by Haseman and Elston [The investigation of linkage between a quantitative trait and a marker locus. Behav Genet 2:3-19, 1972] for data from sib pairs is extended to any type of noninbred relative pair. The regression of the squared relative-pair trait difference on the estimated proportion of genes identical by descent (i.b.d.) at a marker locus is shown to depend upon the recombination fraction between the two loci; the regression coefficient is negative if the trait and marker loci are linked. A test for linkage based on data from any informative type of relative pair can thus be obtained by testing that this regression coefficient is less than zero. Formulae for the asymptotic power of such tests for linkage based upon independent relative pairs are developed. Results are also given for the special case in which the proportion of genes shared i.b.d. for relative pairs is known. Finally, a general algorithm is described that will incorporate all available pedigree data to calculate an estimate of the proportion of genes that a relative pair shares i.b.d. at a marker locus. PMID- 2721930 TI - Path analysis under generalized marital resemblance: evaluation of the assumptions underlying the mixed homogamy model by the Monte Carlo method. AB - Path analysis of nuclear family data has been widely applied to resolve genetic and environmental sources of familial resemblance. Here we report the results of a systematic evaluation of the effects of departures from five modeling assumptions often made when analyzing nuclear family data; i) the observed environmental index is unaffected by the genotype, ii) the basis of marital resemblance is correctly specified in the model, iii) there are no intergenerational differences in either the genetic or cultural heritability, iv) there is no genetic dominance, and v) there is no genotype by family environment interaction. "Deterministic simulations" identified various situations where model misspecification could lead to substantial bias in the estimation of the heritabilities. For these situations, "stochastic simulations" were performed to determine whether the "goodness-of-fit" test used in path analysis would correctly reject the misspecified model. In samples of 500 nuclear families, each comprising two parents and two children, the goodness-of-fit test was found to be sensitive to misspecifications of the source of marital resemblance and the existence of intergenerational differences in heritabilities, although reduced power would make the test less sensitive in smaller samples. The test was largely insensitive to misspecifications of possible genetic effects on the environmental index, and to the existence of multiplicative interaction between the genotype and familial environment. When genetic effects on the index are ignored, the genetic heritability (h2) is underestimated, the cultural heritability (c2) is overestimated, but h2+c2 remains unchanged. Neglecting the interaction was found to result in an overestimate of h2. PMID- 2721932 TI - Recombination between small X chromosome duplications and the X chromosome in Caenorhabditis elegans. AB - Twelve new X chromosome duplications were identified and characterized. Eight are translocated to autosomal sites near four different telomeres, and four are free. Ten include unc-1(+), which in wild type is near the left end of the X chromosome, and two of these, mnDp72(X;IV) and mnDp73(X;f), extend rightward past dpy-3. Both mnDp72 and mnDp73 recombined with the one X chromosome in males in the unc-1-dpy-3 interval at a frequency 15- to 30-fold higher than was observed for X-X recombination in hermaphrodites in the same interval. Recombinant duplications and recombinant X chromosomes were both recovered. Recombination with the X chromosome in the unc-1-dpy-3 interval was also detected for five other unc-1(+) duplications, even though their right breakpoints lie within the interval. In hermaphrodites, mnDp72 and mnDp73 promoted meiotic X nondisjunction and recombined with an X chromosome in the unc-1-dpy-3 interval at frequencies comparable to that found for X-X recombination; mnDp72(X;IV) also promoted trisomy for chromosome IV. A mutation in him-8 IV was identified that severely reduced recombination between the two X chromosomes in hermaphrodites and between mnDp73 and the X chromosome in males. Recombination between the X chromosome and duplications of either the right end of the X or a region near but not including the left end was rare. We suggest that the X chromosome has one or more elements near its left end that promote meiotic chromosome pairing. PMID- 2721931 TI - Caenorhabditis elegans mutants defective in the functioning of the motor neurons responsible for egg laying. AB - We have isolated and characterized 45 Caenorhabditis elegans mutants presumed to be defective in the functioning of the hermaphrodite-specific neurons (HSNs). Like hermaphrodites that lack the HSN motor neurons, these mutants are egg-laying defective and do not lay eggs in response to exogenous imipramine but do lay eggs in response to exogenous serotonin. Twenty of the 45 mutations define 10 new egl genes; the other 25 mutations are alleles of five previously defined genes, four of which are known to affect the HSNs. Seven mutations in three genes cause the HSNs to die in hermaphrodites, as they normally do in males. These genes appear to be involved in the determination of the sexual phenotype of the HSNs, and one of them (egl-41) is a newly identified gene that may function generally in sex determination. Five of the 15 genes are defined only by mutations that have dominant effects on egg laying. One gene egl(n1108), is defined by a temperature sensitive allele that has a temperature-sensitive period after HSN development is complete, suggesting that egl(n1108) may be involved in HSN synaptic transmission. Four of the genes are defined by single alleles, which suggests that other such genes remain to be discovered. Mutations in no more than 4 of the 15 genes specifically affect the HSNs, indicating that there are few genes with functions needed only in this single type of nerve cell. PMID- 2721934 TI - A building block model for quantitative genetics. AB - We introduce a quantitative genetic model for multiple alleles which permits the parameterization of the degree, D, of dominance of favorable or unfavorable alleles. We assume gene effects to be random from some distribution and independent of the D's. We then fit the usual least-squares population genetic model of additive and dominance effects in an infinite equilibrium population to determine the five genetic components--additive variance sigma 2 a, dominance variance sigma 2 d, variance of homozygous dominance effects d2, covariance of additive and homozygous dominance effects d1, and the square of the inbreeding depression h--required to treat finite populations and large populations that have been through a bottleneck or in which there is inbreeding. The effects of dominance can be summarized as functions of the average, D, and the variance, sigma 2 D. An important distinction arises between symmetrical and nonsymmetrical distributions of gene effects. With symmetrical distributions d1 = -d2/2 which is always negative, and the contribution of dominance to sigma 2 a is equal to d2/2. With nonsymmetrical distributions there is an additional contribution H to sigma 2 a and -H/2 to d1, the sign of H being determined by D and the skew of the distribution. Some numerical evaluations are presented for the normal and exponential distributions of gene effects, illustrating the effects of the number of alleles and of the variation in allelic frequencies. Random additive by additive (a*a) epistatic effects contribute to sigma 2 a and to the a*a variance, sigma 2/aa, the relative contributions depending on the number of alleles and the variation in allelic frequencies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2721933 TI - Localization of murine X and autosomal sequences homologous to the human Y located testis-determining region. AB - Recently a candidate gene for the primary testis-determining factor (TDF) encoding a zinc finger protein (ZFY) has been cloned from the human Y chromosome. A highly homologous X-linked copy has also been identified. Using this human sequence it is possible to identify two Y loci, an X and an autosomal locus in the mouse (Zfy-1, Zfy-2, Zfx and Zfa, respectively). Suprisingly ZFY is more homologous to the mouse X and autosomal sequences than it is to either of the Y linked loci. Both Zfy-1 and Zfy-2 are present in the Sxr region of the Y but Zfy 2 is absent in the Sxr deletion variant Sxrb (or Sxr") suggesting it is not necessary for male determination. Extensive backcross analyses map Zfa to mouse chromosome 10 and Zfx to a 5-cM interval between anonymous X probe MDXS120 and the tabby locus (Ta). We also show that the mouse androgen receptor locus (m-AR) believed to underlie the testicular feminization mutation (Tfm) shows complete linkage to Zfx. Comparative mapping indicates that in man these genes lie in separate conserved DNA segments. PMID- 2721935 TI - Spatial autocorrelation analysis of migration and selection. AB - We test various assumptions necessary for the interpretation of spatial autocorrelation analysis of gene frequency surfaces, using simulations of Wright's isolation-by-distance model with migration or selection superimposed. Increasing neighborhood size enhances spatial autocorrelation, which is reduced again for the largest neighborhood sizes. Spatial correlograms are independent of the mean gene frequency of the surface. Migration affects surfaces and correlograms when immigrant gene frequency differentials are substantial. Multiple directions of migration are reflected in the correlograms. Selection gradients yield clinal correlograms; other selection patterns are less clearly reflected in their correlograms. Sequential migration from different directions and at different gene frequencies can be disaggregated into component migration vectors by means of principal components analysis. This encourages analysis by such methods of gene frequency surfaces in nature. The empirical results of these findings lend support to the inference structure developed earlier for spatial autocorrelation analysis. PMID- 2721936 TI - Linkage disequilibrium and genetic variances under mutation-selection balance. AB - I determine the contribution of linkage disequilibrium to genetic variances using results for two loci and for induced or marginal systems. The analysis allows epistasis and dominance, but assumes that mutation is weak relative to selection. The linkage disequilibrium component of genetic variance is shown to be unimportant for unlinked loci if the gametic mutation rate divided by the harmonic mean of the pairwise recombination rates is much less than one. For tightly linked loci, linkage disequilibrium is unimportant if the gametic mutation rate divided by the (induced) per locus selection is much less than one. PMID- 2721937 TI - Models of quantitative variation of flux in metabolic pathways. AB - As a model of variation in a quantitative character, enzyme activity variation segregating in a population is assumed to affect the flux in simple metabolic pathways. The genetic variation of flux is partitioned into additive and nonadditive components. An interaction component of flux variance is present because the effect of an allelic substitution is modified by other substitutions which change the concentrations of shared metabolites. In a haploid population, the the proportion of interaction variance is a function of the gene frequencies at the loci contributing to the flux variation, enzyme activities of mutant and wild type at variable loci and activities at nonvariable loci. The proportion of interaction variance is inversely related to the ratio of mutant to wild-type activities at the loci controlling the enzyme activities. The interaction component as a function of gene frequencies is at a maximum with high mutant allele frequencies. In contrast, the dominance component which would apply to a diploid population is maximal as a proportion of the total when mutant alleles are at low frequencies. Unless there are many loci with large differences in activity between the alleles, the interaction component is a small proportion of the total variance. Data on enzyme activity variation from natural and artificial populations suggest that such variation generates little nonadditive variance despite the highly interactive nature of the underlying biochemical system. PMID- 2721938 TI - Critical issues in the review of diagnostic criteria for "adjustment disorders" and "psychological factors affecting physical condition". PMID- 2721939 TI - A psychocutaneous profile of psoriasis patients who are stress reactors. A study of 127 patients. AB - Psoriasis is a chronic, relapsing, cutaneous condition with a 1%-2% prevalence in the general population. About 40% of psoriatics report that psychosocial stress significantly exacerbates their condition. However, the clinical characteristics of the subgroup of psoriatic patients who are stress reactors have not been delineated. At a practical clinical level it is therefore difficult to implement specific psychosocial treatments among the psoriatic population. In this study, we compared the psychocutaneous characteristics of patients who reported that stress exacerbated their psoriasis, i.e., the high stress reactors (N = 64) to the subgroup who reported no significant association between stress and their psoriasis, i.e., the low stress reactors (N = 63). The high stress reactors had more disfiguring disease clinically (p less than 0.02); psychologically they tended to rely more upon the approval of others (p less than 0.05) and experienced more psoriasis-related daily stress (p less than 0.005). The high stress reactors also reported more flare-ups of their psoriasis during the 6 months prior to admission (p less than 0.05). We have shown that the high stress reactors can be clinically delineated from the low stress reactors. Certain psychosocial interventions will most likely decrease the morbidity associated with psoriasis among the high stress reactors, and may possibly even result in a decline in the number of major flare-ups of the psoriasis. PMID- 2721940 TI - Consultation on the medical frontier. A preliminary survey of the attitudes of infant intensive care nurses. AB - Advancing medical technology presents problems to medical professionals previously unforeseen. Psychiatric consultants are frequently called upon to assist staff, patients, and families in addressing these issues. The nursing staff of an infant intensive care unit was surveyed as to their perceptions of their work and their coping strategies. The results confirmed that in this technologically novel environment, staff were still attempting to acquire coping strategies to effectively meet demands placed upon them. The present study indicates that consultants need to be cognizant of such concerns to effectively assist such staff. PMID- 2721941 TI - Who gets treated where. A study of patients transferred and not transferred from a consultation-liaison service to a general hospital psychiatry unit. AB - The decision to transfer a patient from a general hospital unit to a psychiatric unit is multifactorial. The most salient patient characteristics include the degree of dysfunctional behavior, the absence of social supports, and the presence of Axis II pathology. Severity of medical illness does not discriminate between the two groups. Awareness of these characteristics could aid physicians in formulating transfer decisions. PMID- 2721942 TI - The initial presentation of depression in family practice and psychiatric outpatients. AB - Most reports characterizing the initial presentation of depression are based on patients seen in psychiatric settings. It is not clear whether the difficulty in identifying depression in medical clinic outpatients is due to physician unfamiliarity with the diagnostic criteria or because the psychiatric syndrome is not the same in early, mild cases that present with somatic symptoms. In this study, depressed patients choosing the medical clinic for care presented the same somatic symptoms as nondepressed medical patients. In comparison to depressed patients who presented to the psychiatric clinic, depressed medical patients' chief complaints were more somatic, obscure, and less psychologically focused. Depressed psychiatric patients had more symptoms on a medical review of systems checklist than did medical patients with an equivalent level of depression. When DSM-III criteria were applied, depressed patients from each clinic tended to fulfill the major and minor criteria in a similar pattern. However, the prevalence of depression in the medical setting was much lower and milder than was that presenting to the psychiatry clinic. Once present at a diagnosable stage, however, the syndrome appeared to be the same in both patient groups. PMID- 2721943 TI - Effects of medical illness and somatic symptoms on treatment of depression in a family medicine residency practice. AB - The specific aims of this pilot study were to describe the treatment received by depressed patients in a family practice residency setting and to compare treatment modalities and intensity of treatment between patients with and without medical illnesses. A 12-month chart audit of a cohort of 340 patients randomly sampled from a family practice waiting room for a previous study revealed a 1 year period prevalence for diagnosed depression of 10.3% (35 patients). No patient met DSM-III-R criteria for major depressive disorder and yet 57% received tricyclic antidepressant therapy and 60% were eventually referred for specialist mental health care. Tricyclic therapy and follow-up visits for depression were less likely to take place for patients with more severe medical illnesses or high levels of somatic symptoms. These findings suggest that patients in primary care settings may have depressive symptoms severe enough to provoke tricyclic therapy or referral but do not meet current diagnostic criteria. Furthermore, medical illness and somatic symptoms may deleteriously affect treatment in primary care patients. Additional prospective research is needed to determine appropriate criteria for treatment of depressive symptoms in primary care patients and to evaluate the effects of medical illness and somatic symptoms on treatment by primary care physicians. PMID- 2721944 TI - Management of general medical patients with symptoms of depression. AB - This article describes the management of depressive symptoms in a group of ambulatory patients in general medical care during a 1-year period. It also examines patient outcomes by types of management and aggressiveness of treatment. Subjects are 112 male patients longitudinally enrolled in a V.A. General Medical Clinic who screened positively on both the Zung Self-rating Depression Scale and the DSM-III criteria. Medical records were abstracted to obtain information on mental health management. During the follow-up year, 48% of the moderately depressed patients received some form of mental health management compared to 92% of the severely depressed patients. Of the treatment modes, only patients who had a mental health clinic visit and/or psychiatric consultation were significantly more improved than those not so treated--but only at 6 months (p = 0.09) and 9 months (p = 0.02). Actual treatment experience was then classified into three levels based on intensity, duration, and combinations of treatments. Of the three levels, only those patients in the moderately aggressively treated condition were significantly more improved at 3 months (p = 0.02) and at 6 months (p = 0.04) than those in the no-treatment condition. PMID- 2721945 TI - Treating depression in primary care practice. An application of decision analysis. AB - Decision analysis approaches complex treatment issues by considering alternative strategies in an explicit and logical manner, and examining their outcomes in the face of varied assumptions. Significant data gaps impede full application of this framework to the treatment of depressed primary care patients. Nevertheless, decision analysis already can be useful in emphasizing needed clinical information in treating these patients and highlighting future directions for research. PMID- 2721946 TI - Meiotic chromosome segregation in human t(11;22)(q23;q11) carriers: a theoretical consideration. AB - The t(11;22)(q23;q11) translocation is the most frequently encountered familial reciprocal translocation in humans. In the majority of reported cases ascertainment has been through the birth of a child with the chromosomal constitution 47,XX,+der(22) or 47,XY,+der(22), i.e., tertiary trisomy. Previous segregation analysis of familial cases showed a number of interesting features. Thus, euploid unbalanced genotypes resulting from adjacent segregation are absent in the progeny, and only tertiary trisomic offspring are recovered. To explain this unusual progeny output we present here a model for the meiotic behavior of this translocation in the carriers based on an analysis of cytogenetic data of progeny of carriers. This model predicts the formation of a chain trivalent with chromosome order 11-der(11)-22 during prophase I and its predominant alternate orientation at metaphase I. PMID- 2721947 TI - Psychogeriatric services--a special case. PMID- 2721948 TI - Clubbing it. PMID- 2721950 TI - Safe prescribing. PMID- 2721949 TI - Pet therapy--animal house. PMID- 2721951 TI - Prime ingredients. PMID- 2721952 TI - The caring business. PMID- 2721953 TI - Choice for change. PMID- 2721954 TI - Private function. PMID- 2721955 TI - Food, glorious food. PMID- 2721956 TI - Sore point. PMID- 2721957 TI - What a waste. PMID- 2721958 TI - A single erythroid-specific DNase I super-hypersensitive site activates high levels of human beta-globin gene expression in transgenic mice. AB - Erythroid-specific DNase I super-hypersensitive (HS) sites that are normally located far upstream of the human beta-globin locus were inserted immediately upstream of a 4.1-kb fragment containing the human beta-globin gene. These constructs (HS beta) and a construct containing the beta-globin gene alone (beta) were microinjected into fertilized mouse eggs, and expression was analyzed in erythroid fetal liver and brain of day-16 embryos that developed. Only 7 of 23 animals that contained the beta gene alone expressed human beta-globin mRNA in erythroid tissue, and the average level of expression per gene copy was 0.3% of endogenous mouse beta-globin mRNA. In contrast, 50 of 51 transgenic mice that contained various HS beta constructs expressed the transgene specifically in erythroid tissue. The average level of expression per gene copy for constructs containing all five upstream HS sites was 109% of endogenous mouse beta-globin mRNA. Constructs that contained a single super-hypersensitive site (HS II beta) expressed 40% as much human beta-globin as mouse beta-globin mRNA per gene copy. These results demonstrate that the HS VI site, normally located downstream of the human beta-globin locus, is not required for high-level expression. Furthermore, the results demonstrate that high levels of human beta-globin gene expression can be obtained in transgenic mice even when a relatively small fragment of DNA (1.9 kb) containing erythroid-specific super-hypersensitive site II (HS II) is inserted upstream of the human beta-globin gene. PMID- 2721959 TI - Temporally modular gene expression during cotyledon development. AB - The regulation of cotton embryogenesis has been addressed by measuring the abundance of 47 mRNAs in cotyledons from the late cotyledon stage through early germination. There are at least 11 distinct classes of coordinately expressed mRNAs. Their expression patterns appear to result from unique combinations of five temporal abundance components. These are associated with the cotyledon stage, the endogenous concentration of free abscisic acid, maturation (reserve accumulation), ovule abscission, and germination. This modularity suggests that only a few global regulatory factors orchestrate gene expression with many genes responding to several of them. Significant expression associated only with postabscission or free abscisic acid is restricted to that of the Lea mRNAs earlier suggested to be a component of the embryo's preparation for desiccation. PMID- 2721960 TI - A nucleoprotein complex mediates the integration of retroviral DNA. AB - The integration of viral DNA into the host genome is an essential step in the retrovirus life cycle. To understand this process better, we have examined the native state of viral DNA in cells acutely infected by murine leukemia virus (MLV), using both a physical assay for viral DNA and a functional assay for integration activity (Brown et al. 1987). The viral DNA and integration activity copurify during velocity sedimentation, gel filtration, and density equilibrium centrifugation, indicating that viral DNA is in a large (approximately 160S) nucleoprotein complex that includes all functions required for integration activity in vitro. Analysis by immunoprecipitation shows that the viral capsid protein is part of the active nucleoprotein complex, but recognition of the complex by only a subset of anti-capsid sera implies that the protein is constrained conformationally. The viral DNA within this structure is accessible to nucleases; the effects of nucleases on the integrity of the complex suggest that the integration-competent particle is derived from and similar to the core of extracellular virions. PMID- 2721961 TI - Nuclear factor E2F mediates basic transcription and trans-activation by E1a of the human MYC promoter. AB - Transcription from one of the two initiation sites, P1 and P2, of the dual human MYC promoter seems to be essential in all proliferating cells. To identify proteins and target structures for MYC regulation, a DNA region was analyzed that is critical for P2 promoter activity. Here, we show that a nuclear factor binds to a DNA element within P2, which is conserved perfectly between mouse and man and displays a striking homology to the E1a-inducible E2 promoter of adenovirus type 5 (Ad5). We demonstrate that the same transcription factor, defined recently as E2F, which plays an essential role in the activation of adenovirus early promoters and enhancers, also interacts as a dominant nuclear factor with the MYC promoter. The presence of an intact E2F binding site is required for basic expression and for trans-activation of the P2 promoter by E1a proteins. The human MYC promoter is the first cellular target described for E2F. The results suggest that expression of MYC might be regulated via modulation of E2F by cellular 'E1a like' factors. PMID- 2721963 TI - 'Deliberate releases' in Europe: over-regulation may be the biggest threat of all. PMID- 2721962 TI - xlgv7: a maternal gene product localized in nuclei of the central nervous system in Xenopus laevis. AB - The Xenopus oocyte nucleus (GV) is a storehouse for a large number of proteins that are used during early development. We have cloned and characterized a cDNA coding for a maternal gene product that is localized in the GV and then becomes highly enriched in the nuclei of the central nervous system (CNS) of tadpoles and adult frogs. This cDNA (xlgv7) is 2.1 kb and hybridizes to a 2.4-kb RNA species on Northern blots. Southern blots of genomic DNA suggest that this gene is a member of a multigene family. The cDNA sequence reveals a long open reading frame (ORF) of 1773 nucleotides, with a putative nuclear targeting signal (Glu Arg Arg Lys Lys Lys Thr) at the extreme carboxyl terminus and an internal histidine (His) rich region with a repeated conserved amino acid sequence between His pairs. The significance of this region is unclear, but the protein is a DNA-binding protein, and it is possible that this region is involved in this function. The xlgv7 protein also possesses a putative nucleotide-binding consensus sequence that is similar to the bacterial RecA and RecB and yeast RAD proteins. Protein xlgv7 exists as several isotypes that exhibit developmental and cell-specific changes during development. Northern blot analysis of the abundance of the xlgv7 mRNA shows an accumulation following neural induction at stages 15-16. There is a transient expression of the mRNA in the gut of tadpoles. In the adult, the mRNA is highly enriched in the brain and is absent or in very low abundance in other tissues. Immunohistochemical analysis of the protein shows that the protein is localized in the nuclei of the brain cells. We conclude that the xlgv7 gene product is a maternal protein that may serve several important functions, one of which may be in the development and maintanance of the CNS. PMID- 2721964 TI - Very rapid nucleotide sequence analysis of improved, double-stranded minipreps. AB - Recently, the combination of double-stranded sequencing and Sequenase has been used to accomplish rapid, high-performance sequencing. This combination is relatively resistant to the usual compression effects of palindromes seen with sequencing enzymes such as Klenow fragment of DNA polymerase I or reverse transcriptase. However, for optimal results the method has still relied on plasmids purified by centrifugation through CsCl gradients. The preparation of large-scale cultures, CsCl gradients, and subsequent dialysis are time-consuming processes. The present report describes an improved, miniprep procedure which eliminates the need for CsCl gradients or single-stranded vectors. The effectiveness of the procedure is due to increased ampicillin concentration which amplifies the plasmids, destruction of contaminating enzymes by diethylpyrocarbonate treatment, and vortexing to facilitate rapid sample handling. Sequences of the resulting minipreps are equal in resolution and quality to sequences of CsCl-gradient-purified plasmids. PMID- 2721965 TI - Actin, tubulin and H4 histone genes in three species of hypotrichous ciliated protozoa. AB - In hypotrichous ciliated protozoa, genes are transcribed in the macronucleus where the genome consists of 'gene-sized' linear DNA molecules. We have isolated clones of actin, tubulin and H4 histone macronuclear genes from Oxytricha nova, Stylonychia lemnae and Euplotes crassus in an effort to determine if they possess molecules of similar size for a given coding function, and also to determine the size range of non-coding DNA present on these molecules. Our results indicate that while the length of their non-coding DNA can vary slightly, both between different hypotrichs and within the gene family of a single organism, actin and tubulin macronuclear molecules are similarly sized. The sizes observed for these molecules support the hypothesis that each macronuclear molecule encodes a single gene. However, the H4 histone macronuclear molecules show a much wider size range and generally are much longer than necessary to encode the H4 histone. We therefore sequenced a 1700-bp H4 histone macronuclear molecule from O. nova to determine if it might possibly encode additional gene products. Sequence data reveals the presence of nine open reading frames (ORFs) greater than 100 bp in length; however, Northern hybridization analysis of the products of this DNA molecule reveals only a single transcript. PMID- 2721966 TI - Alert physicians can break the elder abuse cycle. PMID- 2721967 TI - Geriatric assessment in the office setting. AB - Attention to functional limitations must be incorporated into the routine care of the elderly. Several brief, validated functional assessment instruments are now available for office use. Routine screening of the elderly population typically uncovers unknown concerns in one third to one half of patients, even if those patients are well known to their physician. Functional assessment instruments have been developed with specific site and populations in mind. Therefore, physicians should evaluate which instrument best matches the population to be tested. Functional measures should be viewed as an adjunct to improving care, not as a stand-alone diagnostic test. PMID- 2721968 TI - Detecting elder abuse: a guide for physicians. AB - Abuse and neglect of the elderly is not a new phenomenom, however, it recently has become recognized as a social problem throughout the United States. Much like child abuse, detection of elder abuse is contingent upon physicians' awareness of this problem and an understanding of the risk factors that often appear before a crisis occurs. Understanding elder abuse detection and risk factors will enable the practicing physician to identify and treat abuse. The purpose of this article is to provide physicians with detection and intervention strategies, with the hope that physicians will utilize their unique relationship with their patients to further the investigation of this growing social problem. PMID- 2721969 TI - What is the nutritional status of the elderly? AB - Recent surveys have assessed the nutritional status of the elderly in the United States. One of the most consistent findings is an age-dependent decline in energy intake. Clinical protein deficiency among free-living elderly in the country is unusual despite reported lower serum albumin levels. The percentage of people with vitamin and mineral intakes below 2/3 of the RDA was common. Low nutrient intakes included vitamins A, D, thiamin, riboflavin, folic acid, calcium, and zinc. One unresolved problem is whether the nutrient needs of older adults are different from younger adults. Improvement in our understanding of the interaction of nutrition and related aging problems may improve and enhance the quality of nutritional care for the elderly. PMID- 2721970 TI - Breast cancer in older women: trends in diagnosis. AB - Breast cancer is a disease of elderly as well as middle-aged women. Even in patients of advanced age, breast cancer shortens life expectancy. Early diagnosis, through preventative screening with mammography and physical examination, offers the best hope of cure. Deterrents to use of mammography have included radiation risk, unnecessary biopsies, and cost. However, current low radiation doses minimize radiation risks; test specificity is much better in older women, leading to fewer unnecessary biopsies; and new Medicare guidelines lower out-of-pocket patient cost. With increased education of older women and health care providers, methods to decrease mortality from breast cancer in the elderly can become widespread. PMID- 2721971 TI - Basic principles of prescribing for geriatric outpatients. AB - Use of drugs in the elderly is associated wih increased risk of adverse side effects and morbidity. This is partly because the elderly have more chronic medical conditions and decreased homeostatic reserve. Pharmacotherapy must be individualized, since the elderly are widely variable, and drugs must be carefully monitored to minimize risk of poor outcomes. The clinician must remember that drugs are only one of the available interventions in geriatric care and that their use entails not only potential for benefit but also considerable risk. It is the clinician's responsibility to practice in such a way that this risk is minimized. PMID- 2721972 TI - Physical work capacity of older women and men living in rural communities of eastern Ontario, Canada. AB - The physical work capacity of a population of older men and women living in rural municipalities of Eastern Ontario, Canada, was similar to the one observed on a group of Swedes living in the urban district of Uppsala. The physical work capacity test determined at 150 heart frequency per minute (PWC-150) in older men and women did not appear to be heart rate/age-related. There appeared to be no relationship between physical stature and heart rate response to physical exercise in the men and women tested. PMID- 2721973 TI - Heart rate and blood pressure reactivity during active coping with a mental task in healthy 18- to 73-year-old subjects. AB - Alterations with aging in the responses of heart rate (HR) and blood pressure (BP) reactivity were investigated during mild mental stress induced by undergoing a psychometric test, in 52 women and men aged 18-73 years, with no history of cardiovascular, renal or neurological deficits. HR and BP responses were measured before, during and after the test. Resting HR and diastolic BP (DBP) were not age related while resting systolic BP (SBP) was. HR and SBP were increased during test performance. HR reactivity, measured during task execution as well as during recovery, was significantly decreased in older subjects. DBP recovery variation was lowered with age. These results indicate that age is an important determinant of the magnitude of cardiovascular adjustment during minor mental stress in women and men. PMID- 2721974 TI - Age and blood cell rheology. AB - The identification of the rheological variables responsible for alterations in capillary blood flow caused by the aging process could help explain why the incidence of vascular disease increases with age. Using new techniques for the separation and micropore filtration of the haemocellular subpopulations in 110 subjects aged 21-84 years, the aim of this study was to show to what extent, if any, age influences blood cell deformability. The filterability of mononuclear leucocytes decreased with age (r = 0.25; p less than 0.001), whereas the filterability of polymorphonuclear leucocytes or erythrocytes did not change significantly with age. PMID- 2721975 TI - Rise in plasma noradrenaline with age results from an increase in spillover rate. AB - Venous plasma noradrenaline (NA) kinetics, determined using steady-state intravenous infusions of subpressor doses of [3H] NA, were measured in 8 young, 13 middle-aged and 8 elderly subjects. Plasma NA concentrations were 0.71 nmol/l (0.25-0.98) in the young, 1.90 nmol/l (0.98-3.65) in the middle-aged and 3.03 nmol/l (1.15-3.85) in the elderly (young vs. elderly, p less than 0.001). NA spillover rates were 2.07 nmol/l/m2 (1.05-4.91) in the young, 3.91 nmol/l/m2 (1.62-9.44) in the middle-aged and 7.57 nmol/l/m2 (4.38-24.0) in the elderly (young vs. elderly, p less than 0.001). Plasma NA clearance was similar in young and elderly subjects. NA spillover was positively correlated with age (r = 0.58; p less than 0.01) and was not independently related to blood pressure. The rise in plasma NA with age results from an increase in spillover rate rather than any alteration in clearance. PMID- 2721976 TI - Silicone oil in the anterior chamber. AB - A total of 42 cases (42 eyes) with silicone oil in the anterior chamber after pars plana vitrectomy (PPV) and after silicone oil injection into the vitreous cavity (SIV) were analyzed. The main complications caused by silicone oil were corneal endothelial cell damage and secondary glaucoma. Specular microscopy showed decreased cell density, apparent pleomorphism of endothelial cells, and increased corneal thickness. In some cases, edematous and necrotic endothelial cells were found. The characteristic optical artifacts resulting from silicone oil coming into contact with the endothelium, such as a bright reflex, reversed pattern of illumination, and interference fringes, were also observed. There was a definite correlation between elevated intraocular pressure (IOP) and the presence of silicone oil in the anterior chamber; the IOP dropped significantly on removal of the oil. The treatment and prevention of conditions involving silicone oil in the anterior chamber are briefly discussed. PMID- 2721977 TI - The glaucoma suspect: differentiation of the future glaucoma eye from the non glaucomatous suspect eye. 2. Visual field decay. AB - Visual-field areas to a I2e stimulus were measured planimetrically using an X-Y digitizer and a computer program. Sampling of normal subjects and patients suspected of having glaucoma was done at two points in time. Calculations of eye wall stress were done using ultrasonic data and intra-ocular pressure (IOP) measurements from patient records. For those suspected of having glaucoma who developed chronic open-angle glaucoma (COAG), the time of transition was the second point in time. The visual field area was regressed against patient age at the two points in time. No difference in the regression slopes was found for the normal subjects and unchanged patients. The patients who did develop glaucoma were significantly different. The mean annual rate of visual-field change (rate of decay) was calculated and found to be 28.5 mm2/year for the normals, 153.5 mm2/year for the suspects, and 376.4 mm2/year for those patients who developed glaucoma. The rate of visual-field decay only correlated with patient age (P = 0.03) and eye-wall stress (P less than 0.01) in the patients who developed glaucoma. PMID- 2721978 TI - Plasma fluorescein and fluorescein glucuronide in patients with selected eye diseases. AB - Systemically administered fluorescein (F) is rapidly transformed to the fluorescent metabolite fluorescein glucuronide (FG). Little is known about how diseases can influence the synthesis or disposition of FG. We studied F and FG in the plasma ultrafiltrate of 75 people who were normal or had diabetes, retinitis pigmentosa, or idiopathic rhegmatogenous retinal detachment. F and FG were determined by high-performance liquid chromatography. The concentration of FG was comparable to F 1 h after an intravenous injection of F, both in normal subjects and in patients with retinitis pigmentosa, which suggests that FG may not be an important contributor to the vitreous fluorescence at that time. At later times FG substantially exceeded F. The concentration of FG was significantly higher in diabetics than in the other groups 14 h after an oral dose of F. Accordingly, the possible effect of disease on plasma dye concentrations should be considered in studies measuring F by fluorescence hours after systemic F administration, since this could influence the intraocular fluorescence irrespective of any alteration in ocular function. PMID- 2721979 TI - The pattern-evoked electroretinogram (PERG): age-related alterations and changes in glaucoma. AB - Pattern-onset electroretinograms (PERGs) were studied in 147 normal subjects of different ages (14-79 years) and in 110 eyes of 65 patients with glaucoma or ocular hypertension. The responses showed an increase (P less than 0.001) in peak latency with increasing age and a decrease (P less than 0.001) in amplitude which approximately parallels the loss of ganglion cells estimated by other authors. Many glaucoma eyes showed a loss of the normally present spatial tuning. In the age group above 50 years 50% of the onset responses were significantly diminished and the peak latencies were not significantly different. A negative correlation (P less than 0.001) was found between the size of the PERG and the cup/disc ratio and a positive correlation (P less than 0.001) with the area of the neuroretinal rim of the optic disc. The PERG decreased (P less than 0.01) with increasing visual field losses. PMID- 2721980 TI - Incomplete Wolfram syndrome: clinical and electrophysiologic study of two familial cases. AB - Wolfram, or DIDMOAD, syndrome is a genetic disorder characterized by diabetes insipidus, diabetes mellitus, optic atrophy and deafness. We studied a family in which only diabetes mellitus and primary optic atrophy were present in three female siblings. Two of these patients, fraternal twins, were subjected to a complete electrophysiologic examination. The possibility of an incomplete clinical expression of Wolfram syndrome, hypotheses of its genetic transmission, and diagnostic problems are discussed. PMID- 2721981 TI - Posterior chamber intraocular lens implantation during pars plana lensectomy and vitrectomy for diabetic complications. AB - Ten eyes had posterior chamber lenses implanted in the ciliary sulcus in front of the anterior lens capsule during diabetic pars plana lensectomy and vitrectomy. Six months later, nine eyes had improved vision and one had the same vision as compared with preoperative acuity levels. Two eyes had 0.5 and eight eyes had 0.1 or better acuity. None of the eyes developed iris or angle neovascularization or glaucoma, and all ten eyes had clear vitreous cavities with attached maculas. The posterior chamber lenses were well tolerated and provided good visual rehabilitation. PMID- 2721982 TI - Influence of artificial tears on corneal epithelium in dry-eye syndrome. AB - The corneal epithelium of patients with dry-eye syndrome is stressed by both tear film insufficiency and the frequent use of eye drops (artificial tears). In order to quantify corneal epithelial damage, the permeability of corneal epithelium to sodium fluorescein was determined in 40 consecutive patients with dry eyes (BST less than 10 mm), who did not exhibit visible corneal lesions upon slit-lamp examination. The corneal epithelial permeability of dry-eye patients was shown to be 2.8 times greater than that of individuals without ocular disease. Corneal epithelial permeability of patients using artificial tears containing benzalkonium chloride was increased 3.1 times and that of patients using drops preserved with chlorobutanol only 1.7 times. PMID- 2721983 TI - Impairment of corneal epithelial barrier function in diabetics. AB - Corneal epithelial permeability was determined using an automatic fluorophotometer in 80 consecutive diabetic patients. The corneal epithelium, which is the most important part of the corneal diffusion barrier, showed a significant increase of permeability to watery, ionic substances (natrium fluorescein). The permeability was increased 5.4 times in comparison with nondiabetic individuals and a distinct correlation of increased permeability with the presence and duration of retinal nonperfusion areas was observed. PMID- 2721984 TI - Video fluorescein angiography: method and clinical application. AB - Video fluorescein angiography, combined with a picture analyzing system, is a clinically applicable, objective method of evaluating the retinal blood-flow parameters. Optical density measurements were performed on videorecordings of fluorescence angiograms by means of a picture-analyzing system in order to determine the circulation parameters of the retina. These included: the arm retina time (ART), the arteriovenous passage time (AVP), and the mean arterial dye-bolus velocity (MDV). Normal values for these parameters were derived from measurements in 75 healthy volunteers. The mean arm-retina time (ART) was 11.2 +/ 3.3 s, the mean arteriovenous passage time (AVP) 1.45 +/- 0.4 s and the mean arterial dye-bolus velocity (MDV) 6.39 +/- 1.7 mm/s. No significant correlation could be shown between pulse or blood pressure and one of the retinal circulation parameters. A group of ten healthy volunteers was examined twice in order to obtain the intraindividual variation for the measuring parameters. The coefficient of variation for the ART was 18%, 10% for the AVP, and 26% for the MDV. PMID- 2721985 TI - Alterations in the shape of the automated perimetric profile arising from cataract. AB - The attenuation of the perimetric response arising from cataract was investigated and related to the degree of cataract quantified by glare sensitivity. Visual fields were measured with the Octopus and Dicon automated perimeters out to an eccentricity of 30 degrees. Nuclear and non-nuclear cataracts differed in their effect on the perimetric profile. Non-nuclear cataracts exhibited the same qualitative characteristics as a model developed in previous studies, whereby the overall pattern of perimetric attenuation was dependent upon target configuration. For these subjects, perimetric sensitivity was depressed to a greater extent at an eccentricity of 30 degrees compared with fixation when measured with the large projected stimuli, whereas the reverse was true when sensitivity was measured with the small LED stimuli. Conversely, nuclear cataracts depressed perimetric sensitivity to a greater extent at the fovea compared with more peripheral regions for both the large projected and small LED stimuli. PMID- 2721986 TI - Fucosidosis: ultrastructural study of the eye in an adult. AB - The ocular histopathological and ultrastructural features of fucosidosis in a man who survived to the age of 25 years are reported. Virtually all of the cells of the eye contained cytoplasmic, membrane-bound, and confluent areas of fibrillogranular and multilaminated material. The most striking accumulations were present within the endothelial cells lining blood vessels and corneal endothelium, and the least amount was present in the uveal melanocytes. PMID- 2721987 TI - Sorbitol metabolism in retina studied in vitro. AB - A new method is described which allows study of the retinal sorbitol metabolism in vitro. Bovine retinal tissue was incubated in tissue culture medium for 24 h and after this time showed only small morphological changes. The sorbitol content doubled at a glucose level of 5.5 mM compared with freshly prepared noncultured retina. Increasing glucose concentrations led to a gradual increase of the sorbitol content. Supplementation of the culture medium with fructose likewise enhanced the retinal sorbitol accumulation. An aldose reductase inhibitor (ICI 128436; Statil) significantly decreased the sorbitol content. PMID- 2721988 TI - Comparison of different models for the testing of pilocarpine eyedrops using conventional eyedrops and a novel depot formulation (nanoparticles). AB - An objective in the development of ophthalmic formulations is the use of in vitro or animal models that closely resemble the clinical situation. For this reason, experiments with conventional pilocarpine nitrate eyedrops and a depot formulation of pilocarpine nitrate sorbed to poly (butylcyanoacrylate) nanoparticles were carried out. In vitro, the diffusion of pilocarpine through bovine cornea was measured using Edelhauser cells. In vivo, the rabbit aqueous humor concentration of pilocarpine and miosis were determined after application of the above formulations. In addition, intraocular pressure was measured. Since pilocarpine has little influence on intraocular pressure in healthy rabbits, the pressure had to be increased artificially. Three models were employed that are described in the literature, namely, the betamethasone model, the alpha chymotrypsin model, and the water-loading model. Pilocarpine could be loaded onto nanoparticles by 15% but was rapidly released from the nanoparticles based on the bovine corneal experiment. Nanoparticles only enhanced the aqueous humor concentration at 30 min; this increase, however, led to a considerably extended period of miosis as well as a reduction in intraocular pressure. The duration of the action and the intensity of the response were different among the three models tested. According to the present results, the betamethasone model seems to represent the best correlation to the clinical situation. PMID- 2721989 TI - Effect of beta-irradiation by a 106 ruthenium plaque on the rabbit eye choroid. AB - Fourteen Chinchilla gray rabbit eyes were treated with a ruthenium plaque, receiving 200, 400, or 800 Gy, to assess the effect of beta-irradiation on the normal rabbit choroid. Radiation effects were evaluated using fundus photography, fluorescein angiography, fluorophotometry, and histology. Fluorophotometry showed a fluorescein leakage into the vitreous 1 day after irradiation. Leakage values returned to normal within 1 month after irradiation. Fluorescein angiography showed nonperfusion of the choroid after beta-irradiation; the time between irradiation and the onset of nonperfusion was found to be dose dependent. Five months after 200 Gy irradiation, choroidal atrophy had developed but some vessels still stained with fluorescein; 400 Gy irradiation induced subtotal choroidal nonperfusion within 3 months and 800 Gy within 1 week. PMID- 2721990 TI - [Effect of transportation noise on the status of the cardiovascular system of the population]. AB - The results of a multipronged study of noise effect on the state of the cardiovascular system of the urban population are presented. The study of regular noise effect on various population groups has been conducted under natural and laboratory conditions. A complex of appropriate investigation techniques has been used. The population of noise-exposed regions has higher rates and more distinct forms of disorders in myocardium, vessel elasticity, hemodynamics, extracardial regulation and higher risk of cardiovascular disease than those living under more quiet conditions. PMID- 2721991 TI - [The role of sanitary and bacteriologic examination of water in the prevention of acute intestinal infections in the Estonian S.S.R]. AB - Extension of a complex of sanitary, hygienic, antiepidemic and technical measures carried out in Estonia since the 60s assisted in reducing significance of the water factor in the prevalence of acute intestinal infections. PMID- 2721992 TI - [Public health authorities of the Ukraine discuss the objectives of perestroika]. PMID- 2721993 TI - [Determining the levels of toluene, benzene and xylene in hand washings from the skin of workers by a method of vapor-phase chromatographic analysis]. PMID- 2721994 TI - [Blood electrolytes after exposure to organochlorine- and organophosphate insecticides]. PMID- 2721995 TI - [Physical development of students at vocational and secondary schools]. PMID- 2721996 TI - [Presence of Salmonella in surface water reservoirs in Cuba]. PMID- 2721997 TI - [Substantiation of the maximum permissible level of 4-chlorophenol in reservoir water]. PMID- 2721998 TI - [Toxicity of inorganic mercury derivatives]. PMID- 2722000 TI - [Cytotoxicity of the pesticide romucide]. PMID- 2721999 TI - [Evaluation of the combined effect of sherp and sintamide 5 in acute experiments]. PMID- 2722002 TI - [Survival of microorganisms in soil contaminated with diesel fuel]. PMID- 2722001 TI - [Functional state of animals after inhalation of electrolysis oxygen obtained from distilled water]. PMID- 2722003 TI - [Toxicologic evaluation of Fokaptam E after its cutaneous administration]. PMID- 2722004 TI - [The 19th Party Conference and the tasks in the field of industrial hygiene and protection]. PMID- 2722005 TI - [The working conditions of microscope operators and the ways for their sanitary improvement in the manufacture of microelectronic devices]. AB - The investigation of microelectronic devices showed that the working conditions of microscope operators in general satisfy the sanitary and hygienic requirements with the exception of lighting of places of work and the conditions of objects' illumination in the field of microscope view, this being the main reason of visual fatigue. The earliest and most distinct fatigue signs involve the changes in color discrimination acuity, adaptation time to darkness, response time to light stimulus. The measures intended for optimization of working conditions of microscope operators are proposed. PMID- 2722006 TI - [Characteristics of the physiological functions in the operators of foundry transfer lines in the course of the work day and week]. AB - The correlation analysis covered the state of the cardiovascular, hemodynamic, thermoregulatory, vegetative nervous systems, the characteristics of strength, endurance, attention, readiness to action among operators of transfer foundry lines during working days and weeks. It was shown that the main physiologic changes occurred at the initial stage, i. e., on the first day before the dinner break. To the end of the working week correlational links were established among temperature, arterial pressure, characteristics of strength, endurance, the time necessary for response and attention, thus higher intensity of the thermoregulatory system functioning being evidenced. PMID- 2722007 TI - [Dependence of the levels of morbidity with temporary loss of work capacity on the body functional state of those working in hypokinesia]. AB - The study was designed to analyze the relation of body functioning and temporary disability rates in order to identify physiologic indices characterizing health status and its possible variations. As illustrated by the data on health status of female workers engaged in precision assembly work and exposed to hypokinesia it was established that the indices of general physical work capacity could be used for predicting possible changes in workers' health state. The workers with high levels of physical capacity for work had lower morbidity rates, that tendency being especially revealed in workers of older age groups. PMID- 2722008 TI - [Function of the respiratory system in miners with chronic regional hypobaric hypoxia and hypothermia]. AB - The role of meteotropic factors (low atmospheric pressure and cold climate) in the development of functional disorders of respiratory system was studied for miners of the North-East region of the USSR. Regularities in forming external respiration dysfunctions during adaptation of migrating population and development of dust pathology are demonstrated. It was found that general adaptation syndrome in miners exposed to chronic hypobaric hypoxia and hypothermia is characterized by development of hyperventilation syndrome, leading to increase in dust load and moderate mobilization of respiratory tissue. Early failure of compensatory processes and forming of marked hyperventilation syndromes, an increase in pulmonary elastic draught and mobilization of respiratory tissue are observed in dust pathology in the analyzed conditions. PMID- 2722009 TI - [Latent fatigue]. AB - Fatigue prevention determines the expediency of taking account of the signs of the so-called latent fatigue when assessing intensity of modern work load. Physiologic data on the signs and mechanisms of latent fatigue are described. These signs include an increase of physiologic work load and appearance of selective resistance to occupational fatigue while under other conditions the capacity for work decreases. PMID- 2722010 TI - [Immunological monitoring and correction of the immune disorders in allergic diseases in poultry growers]. AB - It was established that allergic diseases of poultry farmers were characterized by the shifts in immunoregulation expressed in terms of the decrease of the number of T-lymphocyte-suppressors, precursors of effectory and immunoregulatory T-lymphocytes, reduction of functional actifity of T- and B-cells along with an increase in the content of B-lymphocytes with antibody-dependent killers' sensitization and suppression of nonspecific protective factors. The results suggested that the use of immunomodulatory drugs helped to improve clinicoimmunologic indicators. PMID- 2722011 TI - [The classification of industrial chemical allergens]. AB - The classification of industrial chemical allergenic compounds has been developed. The criterion of noxious effect of allergenic chemicals is described not only by experimentally valid allergenic signs of the compound but also by clinical manifestations of allergosis in workers and sanitary diagnostic reliability of occupational allergic diseases. Numerous allergens are classified according to the chemical systematization of compounds. The classification contains 2 classes: the 1st class involves inorganic and elementoorganic compounds, the 2nd one--organic compounds. The first class has 7 subclasses, each of them covers compounds of one of the series of the 2nd-6th periods of Mendeleeff's periodic table. The second class has 3 subclasses, combining the compound derivatives of acyclic (2.1), aromatic and alicyclic (2.2), and heterocyclic hydrocarbons (2.3). PMID- 2722012 TI - [The late sequelae of occupational vinyl chloride poisoning]. PMID- 2722013 TI - [Evaluation of the efficacy of a stay in a preventorium for miners with cardiovascular pathology and the residual manifestations of craniocerebral injury]. PMID- 2722014 TI - [A method for plotting calibration graphs and assessing measurement error by using a microcomputer]. PMID- 2722015 TI - [A method for determining ammonium alum-based aerosol-forming dusts in mine air]. PMID- 2722016 TI - [Ventilation of the PNSh-I4 continuous spinning machine]. PMID- 2722017 TI - [The sexual functions of persons in contact with chromium compounds during manufacture]. PMID- 2722018 TI - [Local and skin resorptive action of N,N-diethylchloracetamide]. PMID- 2722019 TI - [The use of high-performance liquid chromatography for the prediction of toxicity]. PMID- 2722020 TI - Protection by desferrioxamine against histopathological changes of the liver in the post-oligaemic phase of clinical haemorrhagic shock in dogs: correlation with improved survival rate and recovery. AB - Haemorrhagic shock was produced in anaesthetized dogs, by rapid arterial bleeding to mean arterial blood pressure 35 mmHg, and maintained oligaemic for 4 h followed by return of withdrawn blood(ROWB). Dogs were observed for 72 h after ROWB for survival and recovery, and, for histopathological (HP) studies on liver, dogs were sacrificed 2 h after ROWB in non-survival experiments. Desferrioxamine mesylate (25 mg/kg) was administered intra-muscularly at 2,3 and 4 h after blood loss in survival experiments and for HP studies the drug was given at 4 h in one group and at 2 h plus 4 h after blood loss in the second group. With the drug given at 3 or 4 h, survival was 70% and 100% while in the 2 h and the untreated groups it was 50%. Recovery was rapid in all the drug treated survivors, few became conscious within 30 min, showed slight activity by 4-6 h, all were almost normally active by 24 and fully so by 72 h after ROWB. All the 5 control survivors remained unconscious/drowsy upto 24 h; 3 were sluggish at 72 h. By group analysis, serum iron elevation during the oligaemic and at the end of the post-oligaemic phase was less in the drug-treated animals. HP changes of shock in the liver studied by light microscopy, were markedly reduced in severity and were less prevalent in the drug-treated dogs. The salutory effects of desferrioxamine may be due to inhibition of iron catalyzed free-radical production and tissue damage, through its strong iron chelating action. It may have a therapeutic advantage in this emergency condition without the disadvantages of toxicity inherent in prolonged use. PMID- 2722021 TI - Electrochemical characteristics of nitro-heterocyclic compounds of biological interest. IV. Lifetime of the metronidazole radical anion. AB - Electrochemical studies on metronidazole using mixed aqueous/dimethylformamide (DMF) solvents have allowed us to generate the one-electron addition product, the nitro radical anion, RNO2(-.). Cyclic volt-ammetric techniques have been employed to study the tendency of RNO2-.to undergo further chemical reaction. The return to-forward peak current ratio, ipr/ipf, was found to increase towards unity with increasing DMF content of the medium, indicating the extended lifetime of RNO2( .). Second order kinetics for the decay of RNO2-were established at all DMF concentrations examined. Extrapolation has allowed the rate constant and a first half-life of 8.4 x 10(4) dm3/mol-sec and 0.059 seconds respectively, to be determined for the decay of RNO2-in a purely aqueous media. This is impossible by direct electrochemical measurement in water, due to a different reduction mechanism, giving the hydroxylamine derivative in a single 4-electron step. The application of the technique to other nitro-aromatic compounds is discussed. PMID- 2722022 TI - Continuous monitoring of in vitro oxidation of human low density lipoprotein. AB - The kinetics of the oxidation of human low density lipoprotein (LDL) can be measured continuously by monitoring the change of the 234 nm diene absorption. The time-course shows three consecutive phases, a lag-phase during which the diene absorption increases only weakly, a propagation phase with a rapid increase of the diene absorption and finally a decomposition phase. The increase of the dienes is highly correlated with the increase of MDA or lipid hydroperoxides. The duration of the lag-phase is determined by the endogenous antioxidants contained in LDL (vitamin E, carotenoids, retinylstearate). Water-soluble antioxidants (ascorbic acid, urate) added in micromolar concentrations prolong the lag-phase in a concentration-dependent manner. The determination of the lag-phase is a convenient and objective procedure for determining the susceptibility of LDL from different donors towards oxidation as well as effects of pro- and antioxidants. PMID- 2722023 TI - [Results of laboratory and clinical tests on the new Soviet heart valve model LIKS-2]. AB - LIKS-2 rotatable disk prostheses were tested in laboratories for wear, atraumatic performance, and hemodynamic efficacy. Accelerated tests on testing units demonstrated their high reliability and lasting performance. The values of drops in, pressure and regurgitation volumes were negligible. The late-term results (of up to 5 years) of using LIKS-2 prostheses for correcting mitral and aortic valvular diseases were studied in the department of heart surgery of the All Union Scientific Centre of Surgery. The prostheses showed high thrombo resistance, mechanical reliability, and atraumatic performance in patients in the late-term follow-up periods. PMID- 2722024 TI - [Comparative evaluation of the results of surgery in closing ventricular septal defects using transventricular and transatrial approaches in young children]. AB - The results of operations for correction of ventricular septal defects (VSD) in 97 young children (from 12 to 48 months of age) were evaluated. In 57 children the operation was conducted through a transventricular (group 1) and in 40- through a transatrial approach (group 2). The results of the operations in the two groups did not differ in essence. Essential differences were revealed in the cardiac index (CI) value and the requirements in cardiotonics: the CI was much lower and the doses of adrenalin higher in group 1 than in group 2. A more pronounced stability of hemodynamics on the first postoperative day and lesser possibility of the development of acute cardiac failure are important advantages of the transatrial approach and allow the authors to recommend it as the method of choice in closure of perimembranous VSD, particularly if they are complicated by high pulmonary hypertension. PMID- 2722025 TI - [Mitral commissurotomy in children and adolescents]. AB - The article analyses the results of operations on 184 children and adolescents with rheumatic mitral stenosis. "Pure" mitral stenosis was diagnosed in 48.4% of patients, valvular stenosis in combination with relative tricuspid insufficiency- in 23.4%, mitral valvular disease with I degree regurgitation--in 26%, and mitral stenosis combined with aortic valvular diseases which did not need surgical correction--in 2.2% of patients. Transventricular instrumental commissurotomy was performed in 73.9% of patients, digital commissurotomy--in 7.1%, open mitral commissurotomy under conditions of extracorporeal circulation--in 3 patients. Adequate distention of the mitral orifice was achieved in 84% of patients, incomplete separation--in 16%. Complications occurred after the operation in 29.7% of patients. Traumatic mitral insufficiency developed in 38 patients. The immediate results were good in 84.2%, satisfactory--in 9.9%, and poor--in 3.2% of patients. Hospital mortality was 2.7%. PMID- 2722026 TI - [The status of the adaptation system and hemodynamics in patients with chronic post-embolic pulmonary hypertension]. AB - The article discusses the results of biochemical, hemodynamic, and angiographic studies in 33 patients with chronic post-embolic pulmonary hypertension of various degree. The authors show that prolonged occlusion of the pulmono-vascular channel causes predominant activity of the sympathoadrenal, hypophyseal-adrenal, and renin-angiotensin-aldosterone systems, which maintains and aggravates pulmonary hypertension. The degree and character of these changes are directly dependent on the volume of the affection of the pulmonary vascular channel. PMID- 2722027 TI - [Objective and subjective evaluation of the rehabilitation of patients following heart valve prosthesis]. AB - Some aspects of the character of life of 71 patients after prosthetics of the heart valves were studied in a complex according to a medico-psychological program. The functional condition improved as the result of the operation in most of them, but many neuro-psychic complaints, poor self-appraisal, and dissatisfaction due to many limitations remained. An unfavourable tendency in return to work was revealed, which corresponded to subjective appraisal of rehabilitation and not to functional restoration. PMID- 2722028 TI - [Cooling of the myocardium: clinical comparison of 2 methods of administering the cardioplegic solution]. AB - The authors studied the dynamics of changes in myocardial temperature in injection of an oxygenated cardioplegic solution through the root of the aorta (group 1 of patients) and through the right atrium (group 2) during prosthetic repair of the heart valves. Retrograde injection of the cardioplegic solution through the right atrium ensured adequate cooling of the hypertrophied myocardium of both ventricles and did not yield to antegrade infusion. It proved possible to attain a safe level of right-atrial hypothermia only when the cardioplegic solution was infused through the right atrium. This is due to the fact that the method combined the features of perfusion and local hypothermia. PMID- 2722030 TI - [Temporary occlusion of the bronchi in the treatment of complex suppurative destruction of the lungs]. AB - In the period from 1984 to 1987 the authors had under observation 179 patients with acute pulmonary destruction following various courses. Variants of temporary occlusion of the fistula-carrying bronchus were performed in 54 patients in whom the disease was complicated by bronchopleural fistula and pyopneumothorax. Occlusion of a lobar or segmental bronchus (51 patients) was preceded by preliminary flow cleansing of the affected bronchopulmonary areas and intrapleural hydrolavage of the lung with alternating pressure. In 3 patients temporary occlusion of the bronchus was conducted with a hollow obturator according to the method suggested by the authors; the method allows cleansing of the affected lung with the occluded bronchus to be combined with its gradual re expansion. Four among the 54 treated patients died, 50 recovered. PMID- 2722029 TI - [Preoperative plombage of damaged bronchi in children with bronchiectases using a biopolymeric compound for cupping endobronchitis]. AB - The authors discuss their experience in the use of a biopolymeric composition of a biological glue KL-3 and an antiseptic for preoperative filling of bronchiectatic cavities in 28 patients with bronchiectases. The filling is performed before the operation during bronchoscopy conducted under anaesthesia. As a result endobronchitis is relieved, the time needed for preoperative management is shortened, and the number of possible postoperative complications is reduced to minimum. PMID- 2722031 TI - [A 1-stage surgical treatment of bilateral bullous disease of the lungs using trans-sternal organ-preserving surgery]. AB - Experience in the use of the trans-sternal approach in surgical treatment of bilateral bullous disease of the lungs in 16 cases is generalized. The results of organ-preserving operations in periods of 6 months are analysed. The technical aspects of surgery for bilateral bullous disease are discussed. Hemorrhage and paresis of the right diaphragmatic dome were the postoperative complications. There were no fatal outcomes. The experience of other surgeons on the treatment of this pathological condition is discussed. PMID- 2722032 TI - [The CO2 laser in the surgical treatment of suppurative processes in the lungs]. AB - Operations were carried out on 58 patients with suppurative processes in the lungs. The authors worked out a method of thoracotomy by means of a laser with layer-by-layer division of the muscles during compression with special clamps, as well as a method of economical resection consisting in cutting the pulmonary tissue with a laser scalpel, electrocoagulation of small vessels, and stitching through the large vessels and bronchi with a suturing instrument. The use of a CO2 laser in operations for suppurative processes in the lungs makes it possible to conduct economical operations and reduce the number of complications. PMID- 2722033 TI - [Hemosorption in the complex therapy of severe forms of acute pneumonia and infectious destruction of the lungs]. AB - The article deals with the results of treatment of 60 patients with severe pneumonia and acute infectious destructions of the lungs. Hemosorption improved the results of treatment of patients with this pathological condition due to rapid recovery from the state of toxicosis, stimulation of immunity, and improvement of microcirculation. The dynamics of changes of the immunological values are discussed, the indications for conducting hemosorption in patients with severe pneumonia and infectious destructions of the lungs and the criteria of its efficacy are determined. PMID- 2722034 TI - [Intraoperative histologic verification of focal diseases of the lungs]. AB - The article deals with the results of histological study of material of emergency biopsies and subsequent scrupulous examination of lung resectates obtained from 50 patients with focal diseases of the lungs which were not identified precisely and unverified morphologically before the operation. Inflammatory pseudotumors of two types and in different phases were revealed in 19 patients, different forms of active tuberculosis--in 9, different forms of primary carcinoma of the lungs- in 8, proliferative processes bordering on malignancy--in 5, silicosis and silicotuberculosis--in 4, and suppurative and sclerotic changes--in 4 patients. The results confirm the importance of close cooperation of the surgeon and morphologist at all stages of the diagnosis. PMID- 2722035 TI - [The use of a mathematical method in evaluating the severity of the condition of patients with pyopneumothorax]. AB - The course of pyopneumothorax in 427 patients, among whom 310 were subjected to temporary occlusion of the bronchus, was appraised by means of the severity index based on consideration of deviations of the values of hemodynamics, external respiration, blood, and acid-base equilibrium from the normal level. In a favourable course of pyopneumothorax the severity index was found to be within the ranges of the confidential interval. The method makes it possible to appraise the compensatory properties of the organism and prognosticate the course of the disease. PMID- 2722036 TI - [The highest permissible levels of resection of the esophagus in cancer during surgery with intrathoracic or cervical esophagogastric anastomoses]. AB - The levels of esophageal resection for squamous carcinoma were determined in 84 patients by measuring the distance from the incisors to the ring of the esophagogastric anastomosis during esophagoscopy. The radicalism of the operations was evaluated from the difference in the distance between the incisors and the upper border of the tumor and the distance between the incisors and the anastomosis. The mean levels of the highest possible resections of the esophagus were at a distance of 33.5 +/- 2.8, 23.6 +/- 2.0, and 20.4 +/- 2.0 cm from the incisors, respectively, in Garlock's operation, Lewis' operation, and Dobromyslov Torek's operation with esophagoplasty using an antiperistaltic gastric pedicle. It is suggested that the choice of the method of surgical treatment should be based on comparison of the determined levels of the highest possible resection of the esophagus with the endoscopic assessment of the level of the upper border of the tumor in the esophagus. PMID- 2722037 TI - [Ensuring the viability of gastric transplants used in esophagoplasty using hemomotordynamic monitoring]. AB - A new method of hemomotordynamic monitoring of an isoperistaltic gastric graft in esophagoplasty was evaluated in the clinic in 27 patients. The method was found to be adequate in determining and ensuring viability of the grafts. The presence of an intramural pulse in all parts of the graft is the criterion of its viability. Monitoring allows early diagnosis and timely surgical and drug correction of reparable ischemic disorders. The change of the surgical tactics during the operation consists in abandoning one-stage formation of the anastomosis and placing the graft in a subcutaneous bed. PMID- 2722038 TI - [Radical correction of Fallot's tetralogy following 2 earlier operations, transventricular pulmonary valvulotomy and cavopulmonary anastomosis]. PMID- 2722039 TI - [Successful reimplantation of a conduit 7 years after radical correction of a persistent truncus arteriosus]. PMID- 2722040 TI - Lady in a nursing home. PMID- 2722041 TI - Drugging elders. PMID- 2722042 TI - 33-day laceration stay. PMID- 2722043 TI - Dementia? Or delirium? PMID- 2722044 TI - Listening. PMID- 2722045 TI - Guide to changing lab values in elders. PMID- 2722046 TI - Getting a handle on patient mobility. PMID- 2722047 TI - Where's discharge planning on your list? PMID- 2722048 TI - Follow-up study of 232 patients with stage Ia1 and 411 patients with stage Ia2 squamous cell carcinoma of the cervix (microinvasive carcinoma). AB - This report retrospectively analyzes 643 patients with microinvasive squamous cell carcinoma of the cervix who were followed-up for 3-17 years. The cases were classified according to the FIGO definition adopted in 1985 which includes a subdivision into Stage Ia1 and Stage Ia2. It is concluded that the new FIGO system has definite advantages for the decision of therapy in microinvasive carcinoma. Unnecessary radical treatment can be avoided. PMID- 2722049 TI - Pelvic exenteration for recurrent or persistent gynecologic malignancies: a 10 year review of the Memorial Sloan-Kettering Cancer Center experience (1972-1981). AB - From January 1, 1972 to December 31, 1981, sixty-five patients underwent pelvic exenteration as treatment for recurrent or persistent gynecologic malignancy at Memorial Sloan-Kettering Cancer Center. Cervical carcinoma was the disease most commonly treated by exenteration. The operative mortality of 9.2% represents an improvement over previous reports from this institution. After routine use of prophylactic minidose heparin, no cases of thrombophlebitis or pulmonary embolus occurred postoperatively. A 5-year survival rate of 23% warrants continued use of exenteration in carefully selected patients. The significant mortality and morbidity associated with pelvic exenteration preclude its use as a palliative procedure. PMID- 2722050 TI - Extraperitoneal versus transperitoneal selective paraaortic lymphadenectomy in the pretreatment surgical staging of advanced cervical carcinoma (a Gynecologic Oncology Group study). AB - Two-hundred and eighty-eight patients with predominately stage IIB or IIIB cervical carcinoma underwent pretreatment surgical staging including selective paraaortic lymphadenectomy (SPAL), followed by pelvic irradiation with or without paraaortic irradiation (RT). Four patients were excluded from analysis (two received no RT and two were insufficiently documented). Of the remaining 284 patients, 128 underwent extraperitoneal (EP) SPAL and 156 transperitoneal (TP) SPAL procedures. Age, race, and stage (clinical and surgical), cell type, paraaortic nodal status, and peritoneal cytology findings were similar in both groups. Complications presumed to arise from operative staging were infection, which was similar for both groups, and vascular injury, which was higher in the TP group, although not statistically significant. Complications subsequent to RT fell into two categories: local-pelvic necrosis, vesicovaginal and rectovaginal fistulas, proctitis, etc., and regional-enterovaginal fistula, bowel obstruction, enteritis, bowel perforation, etc. The frequency of local complications was similar for both EP and TP patients. Utilizing univariant analysis, among regional complications, both bowel obstruction and nonobstructive enteric injuries were observed significantly more often in TP patients than in EP patients (11.5% vs 3.9%, P = 0.03, for both types). Multivariant analysis confirmed these observations. This report supports the conclusions that in advanced cervical carcinoma (1) EP- and TP-SPAL are of similar sensitivity in detecting nodal spread, (2) no significant differences in the frequency of surgical complications could be detected between EP- and TP-SPAL groups, and (3) TP-SPAL is associated with a higher frequency of certain postirradiation regional enteric complications. PMID- 2722051 TI - Clinical stage I and II endometrial carcinoma treated with surgery and/or radiation therapy: analysis of prognostic and treatment-related factors. AB - This is an analysis of 266 patients with clinical stage I and II endometrial carcinoma treated with curative intent at the University of Florida between October 1964 and December 1980. There was a minimum 5-year follow-up. Thirty-nine patients who died of intercurrent disease less than 5 years from treatment were excluded from analysis of pelvic disease control and determinate disease-free survival. All patients were included in the analysis of complications. Pelvic disease control and determinate disease-free survival rates at 5 years were 91 and 88%, respectively, for stage I and 84 and 68% for stage II. There was no apparent difference in the rates of local control and survival or in the incidence of complications when comparing preoperative with postoperative radiation therapy. Tumor grade, stage, depth of myometrial invasion, and history of exogenous estrogen use or abnormal estrogen balance were of prognostic significance. Data on pelvic disease control, survival, and treatment complications are outlined, and management guidelines are discussed. PMID- 2722052 TI - Cerebral metastases in patients with ovarian cancer treated with chemotherapy. AB - Cerebral metastases are considered an uncommon complication of ovarian carcinoma. In a series of 52 patients treated with platinum, Adriamycin, and cyclophosphamide combination chemotherapy, 6 patients developed cerebral metastases, an incidence (11.6%) higher than that reported by others. The median age of the patients with cerebral metastases was similar to that of patients without this complication. Cerebral metastases occurred as site of first relapse in three of six patients. Only one patient had extraperitoneal disease prior to chemotherapy and four of the six patients had attained a complete response following chemotherapy. Cerebral relapse occurred at 0, 21, 27, 30, 34, and 36 months from original diagnosis of ovarian carcinoma and 0, 9, 11, 19, 25 and 29 months following first treatment with combination chemotherapy. The median survival was 33 months from diagnosis and 28.5 months from first treatment with chemotherapy. This compares with a median survival from diagnosis for the entire series of 30 months (28 months from first treatment). The result of treatment of established metastases was poor. Survival from diagnosis of cerebral metastases was 2, 2, 3, 6, 10, and 41 + months. If other series confirm these findings consideration may need to be given to prophylactic central nervous system radiotherapy for patients achieving complete remission after systemic chemotherapy. PMID- 2722053 TI - Establishment and characterization of a human cell line from a serous papillary endometrial carcinoma. AB - The cell line SPEC-1, derived from a human serous papillary endometrial carcinoma (SPEC), has been established and repetitively subcultured for over 18 months. SPEC is a clinically aggressive histologic variant of endometrial adenocarcinoma with a significantly poorer prognosis. The SPEC cells exhibit morphologic and ultrastructural characteristics of transformed epithelial cells. The cells were further characterized with regard to growth kinetics, histochemistry, karyotype, and tumorigenicity. These studies indicate that several properties of the SPEC cells in culture contrast markedly with those of both typical endometrial adenocarcinoma cell lines and normal endometrial epithelia, as described in the literature. The most significant of these differences concern cytogenetic and ultrastructural features. The implications of these unique characteristics are discussed with regard to the relationship they may have to the unusually aggressive biological behavior of this tumor cell type in vivo. This SPEC cell line should prove useful in future studies designed to determine important factors in the biological behavior of human tumor cells. PMID- 2722054 TI - Vascular access in gynecologic cancer using the Groshong right atrial catheter. AB - From December 1986 through July 1987, forty-one Groshong catheters were inserted in 38 patients with invasive gynecologic cancer for a cumulative total of 4170 days of patient use. (mean catheter indwelling time: 93 days; range: 3-300 days). A supraclavicular approach was used to cannulate the brachiocephalic vein in 31 patients. In 6 patients, the subclavian vein was cannulated via an infraclavicular approach, while 4 patients had the catheters placed via external jugular venous cutdown. Thirty-seven catheters were inserted at the bedside without fluoroscopy using the Seldinger technique and a peel-away catheter introducer sheath. A chest x-ray was used to confirm the right atrial position of the catheter. Major complications included two pneumothoraces, and three catheter related cases of sepsis. A unique feature of the Groshong catheter is a pressure sensitive two-way valve at the intravascular end, minimizing the potential for air embolism and back-bleeding. This eliminates the need for a heparin flush or external clamping, but permits blood sampling. Catheter insertion and maintenance procedures at bedside are simple, time saving, and cost effective. With the increasing use of continuous chemotherapy infusion protocols, use of vesicant drugs, hyperalimentation, and the need for outpatient therapy, we recommend early placement of the Groshong catheter in the oncology patient. PMID- 2722055 TI - Primary carcinoma of the vagina: a study of 29 cases. AB - Twenty-nine cases of primary carcinoma of the vagina were reviewed. Vaginal carcinoma produced symptoms in 26 cases and postmenopausal bleeding was the most frequently observed symptom. Squamous carcinoma was the dominating histologic type (83%). Twelve patients had previously been treated for invasive or preinvasive cervical disease. Six patients had previously received pelvic irradiation. The median time from cervical carcinoma to vaginal carcinoma was 20 years, and from pelvic irradiation to vaginal carcinoma, 25 years. Two factors significantly influenced the results of treatment: the mode of delivery of radiation therapy and the total tumor dose. Clinical staging did not significantly influence the results of treatment although stage I patients did better than stage II-IV patients. Combination of external pelvic irradiation and brachytherapy, with a total tumor dose of 7000 R or more, was necessary to prevent local recurrence. PMID- 2722056 TI - Evaluation of the hearing loss associated with cis-platinum treatment by high frequency audiometry. AB - The effect of cis-platinum treatment on the hearing of 23 ovarian cancer patients was evaluated using standard and high-frequency audiometry. Twenty-two percent of the patients developed a hearing loss of at least 15 db, 13% in the range 125 8000 Hz and 9% only in the high-frequency area above 8 kHz. However, due to the high-frequency hearing loss (presbyacusis) in older patients high-frequency audiometry was often unobtainable. Hearing screening using standard pure-tone audiometry is recommended for cis-platinum patients as a routine procedure. PMID- 2722057 TI - Serum squamous cell carcinoma antigen levels in patients with invasive squamous vulvar and vaginal cancer: a preliminary report. AB - Pretreatment serum squamous cell carcinoma antigen (SCC) levels were obtained in 12 patients with invasive vulvar and 5 patients with invasive vaginal squamous cancer. Only 4 of 12 (33%) patients with vulvar cancer and 1 of 5 (20%) patients with vaginal cancer, usually those with more advanced disease, had elevated serum SCC levels at the time of diagnosis. PMID- 2722058 TI - Ovarian carcinoma during pregnancy: a study of 23 cases in Israel between the years 1960 and 1984. AB - Data from a study on malignant ovarian tumors in pregnancy in Israel are presented. During the 25-year period of the survey, 23 new cases of malignant ovarian tumors during pregnancy were diagnosed, representing an incidence of 0.12/100,000 females over the age of 14; over half of the patients were in their third decade of life at the time of diagnosis of the tumor. Ovarian malignant tumors during pregnancy are more prevalent in Jewish women of European-American origin than in those of Asian-African descent. Borderline carcinomas were found in 35% of our patients; epithelial invasive tumors were found in 30%; the other tumors were dysgerminoma (17%), granulosa cell tumor (13%), and undifferentiated carcinoma (5%). Most of the patients (74%) were diagnosed in stage I. In three cases, ovarian cancer was diagnosed during surgery for tubal pregnancy, and in two during cesarean section at term. In early-stage disease and low-potential malignancy tumors, surgery can be conservative; thus, 14 of 23 bore a live child. In advanced disease, aggressive surgery, chemotherapy, and/or radiotherapy should be instituted. Factors affecting prognosis were age of patient, histologic type of tumor, and clinical stage of disease. Overall, the survival is much better than that for ovarian tumors in general, because most of the tumors are of low potential malignancy and are diagnosed at an early stage. PMID- 2722059 TI - Scalene lymph node biopsy in the preoperative evaluation of patients with recurrent cervical cancer. AB - From 1982 to 1987, 24 patients with recurrent carcinoma of the cervix underwent scalene lymph node biopsy prior to exploration for exenteration. Patients with palpable nodes were excluded from the study. There was no significant morbidity associated with the procedure. None of the 24 patients was found to have metastases to the scalene lymph nodes. From this study it would seem unjustifiable to perform this procedure on all patients undergoing evaluation for exenteration. PMID- 2722060 TI - Synchronous primary neoplasms of the female reproductive tract. AB - A histopathologic review of synchronous primary neoplasms of the female reproductive tract is presented. During a 30-year period, 3863 patients with female genital malignancies were accessioned to the UCLA Tumor Registry: 958 had ovarian cancer, 776 endometrial cancer, 1556 cervical cancer, and 573 other gynecologic malignancies. Twenty-six (0.7%) patients with invasive synchronous primary cancers were identified. The most frequent synchronous genital lesions were ovarian and endometrial cancers in 11 patients (0.3%). No association was documented between genital and extragenital cancers. Patients with synchronous ovarian and endometrial cancers each were low stage and low grade, and the prognosis was excellent. Their detection in a relatively early stage suggests diagnosis may be facilitated by early symptoms from the endometrial carcinoma, and that these lesions are biologically of relatively low grade. These data support the conclusion that there is an association between low-stage epithelial carcinoma of the ovary and endometrial carcinoma. PMID- 2722061 TI - Comparison of the pattern of metastatic spread of squamous cell cancer and adenocarcinoma of the uterine cervix. AB - Retrospective review of medical records and autopsy findings in patients dying of squamous cell cancer or adenocarcinoma of the uterine cervix was undertaken to evaluate for possible differences in biologic behavior between these tumor types. Twenty-one patients with each tumor type were evaluated. Patients with adenocarcinoma were found to have a higher incidence of tumor involvement of the paraaortic lymph nodes (13/21 vs 6/20, P less than 0.05), uterine corpus (17/17 vs 12/20, P less than 0.05), and adrenal gland (7/21 vs 0/21, P less than 0.005). Presence of ascites (9/21 vs 2/21, P less than 0.05) and hydrothorax (9/21 vs 3/21, P less than 0.05) was also significantly more frequent in patients with adenocarcinoma. These findings suggest that this tumor may behave differently in regard to pattern of metastatic spread or response to therapy. The therapeutic implications of these findings deserve further study. PMID- 2722062 TI - Fallopian tube carcinoma: a clinicopathological study of 17 cases. AB - From 1969 through 1986, 17 patients with primary adenocarcinoma of the fallopian tube were treated at the Loma Linda University Medical Center. Stages I, II, and III of the disease were present in 6, 5, and 6 patients, respectively. The mean age of the patients was 59.9 years. Vaginal bleeding or discharge (57%), followed by abdominal pain or discomfort (29%), was the most common symptom in our patients. A palpable pelvic mass was detected in two-thirds of the patients. One case of carcinosarcoma, one case of mixed mesodermal tumor, and one case of endometrioid carcinoma are included. No patient in this series had a correct preoperative diagnosis. Therapy consisted of surgical resection, usually followed by various combinations of adjuvant radiation therapy and/or chemotherapy. The overall 5-year survival rate was 31%. Five patients (29%) are alive without evidence of disease. This study supports the need for collaboration among large centers to define the optimal adjuvant therapy of this disease. In the absence of the desired treatment protocols, such lesions should be approached in a manner similar to that used for ovarian cancers. PMID- 2722063 TI - DNA flow cytometry, clinical and morphological parameters as prognostic factors for advanced malignant and borderline ovarian tumors. AB - Patients with malignant ovarian (n = 111) and borderline (n = 8) tumors (FIGO stage III/IV) underwent surgery and chemotherapy and were analyzed clinically (age, residual tumor after surgery) and morphologically (type, grade, psammoma body content), and by means of flow cytometry (DNA ploidy, S-phase fraction). Follow-up was 12-72 months for investigation of survival. Patients under 60 years of age (n = 18) with malignant tumors showed longer survival than patients over 60 (n = 93) (P = 0.078). Residual tumor was relevant for prognosis in malignant tumors only if macroscopically there was no residual disease (n = 13). There were no significant differences between residual tumors less than or equal to 2 cm (n = 61) and greater than 2 cm (n = 37). WHO typing was of little importance for survival analysis. Compared to borderline tumors (n = 8), serous (n = 65), endometrioid (n = 13), nonclassifiable (n = 12), mucinous carcinomas (n = 8), and nonepithelial tumors (n = 12) had a poor prognosis. Psammoma bodies were found in 25 patients with serous carcinomas, 7 of them had a high content. The prognosis for these 7 patients was much better than that for patients with a moderate or low psammoma body content (P = 0.006). Twenty-three epithelial tumors were graded G1, 28 were G2, and 47 were G3. However, grading was considered only as a prognostic factor in serous carcinomas (n = 65) (P = 0.028). A total of 199 DNA histograms from 119 patients were analyzed by flow cytometry (FCM). There were no correlations between tumor type and DNA ploidy or S-phase fraction. Seven of eight borderline tumor and all serous carcinomas with a high content of psammoma bodies were diploid combined with a low (less than or equal to 4%) S-phase fraction. DNA ploidy and S-phase fraction were excellent prognosticators. Of 99 epithelial malignant tumors, 35 were diploid and 64 were aneuploid. An S-phase fraction less than or equal to 4% was found in 39 patients, 4.1-10% in 73 patients, and greater than 10% in 23 patients. Diploid tumors and tumors with a low S-phase fraction showed the best survival (P = 0.007, resp. 0.0001). Our study emphasizes the importance of an accurate histology, including information on psammoma body content, and the importance of DNA flow cytometry. The advantage of FCM is that the results are simple, reproducible, and objective. PMID- 2722064 TI - Treatment of locoregional recurrence of carcinoma of the cervix by radiotherapy after primary surgery. AB - Eighteen patients with locoregional recurrence after primary surgery for carcinoma of the cervix and treated by radiotherapy were analyzed. An overall complete response of 88%, 16 of 18, was achieved. Five of sixteen patients (31%) developed a second locoregional recurrence. Response to radiotherapy seemed to correlate strongly with tumor volume. The overall 5-year survival for all 18 patients was 44%, and the disease-free survival, 39%. Only 22%, 4 of 18, had distant metastases in the subsequent course of the disease. PMID- 2722065 TI - Use of angio computed tomography to evaluate extent of endometrial carcinoma. AB - Patients with endometrial carcinoma underwent angio computed tomography (CT) prior to surgery to evaluate the extent of the carcinoma. The subjects of the study were 87 patients operated on at the Cancer Institute Hospital during the period 1983 to 1986. After preoperative bilateral internal iliac angiography, angio CT was performed using the already inserted catheters. Although the intact uterine wall was enhanced by the angio CT, the cancerous lesion was not, which permitted easy recognition of the cancerous lesion as a low-density area. To evaluate the degree of myometrial invasion, the minimal thickness of intact uterine wall was measured in the CT image, and was compared later with findings from the operative materials. The comparison showed that for all the patients, the minimal thickness of the intact uterine wall as shown in the CT image was comparable to the actual minimal thickness of the operative materials. Because depth of myometrial invasion is known as an important prognostic factor, measurement of the minimal thickness of the intact uterine wall as shown in the CT image is useful as an objective prognostic factor. Angio CT facilitates recognition of myometrial invasion preoperatively. PMID- 2722066 TI - Methotrexate-induced erythema multiforme. AB - The folic acid antagonist, methotrexate, has many applications in the treatment of neoplastic disease. While methotrexate produces several well-recognized toxic effects, cutaneous reactions are rare. A patient who developed classical erythema multiforme while receiving low-dose methotrexate as treatment of nonmetastatic gestational trophoblastic neoplasia is presented. Erythema multiforme has been associated with a variety of pharmacologic agents. It typically presents as a pruritic papular dermatitis of the extensor surfaces of the extremities and may require multiple skin biopsies to establish the diagnosis. Spontaneous reversal usually occurs with discontinuation of therapy. Patients developing erythema multiforme related to antineoplastic agents should be switched to an alternate regimen. PMID- 2722067 TI - Posthysterectomy carcinoma of the fallopian tube presenting as vaginal adenocarcinoma: a case report. AB - The clinical and pathological features of a case of adenocarcinoma of the fallopian tube with a unique presentation are described. The 68-year-old patient presented with vaginal bleeding 25 years after a vaginal hysterectomy. Pelvic examination revealed a 0.5-cm nodule of tumor involving the mucosa of the vaginal apex. At laparoscopy, the left fallopian tube was dilated and adherent to the vaginal vault. Pathological examination of the upper vaginectomy and bilateral salpingo-oophorectomy specimen revealed a primary papillary adenocarcinoma of the left fallopian tube that had invaded directly into the mucosa of the vaginal apex. Vaginal involvement, either at the time of presentation or subsequently in the course of the disease, is very rare in patients with carcinoma of the fallopian tube. PMID- 2722068 TI - Advanced ovarian dysgerminoma with cure of tumor persistent in meninges. AB - Isolated meningeal recurrence of ovarian cancer is uncommon. It is generally assumed that such cases are not accompanied by prolonged survival. We report the cure of a patient with advanced ovarian dysgerminoma who developed febrile carcinomatous meningitis 2 weeks after receiving her fifth course of combination chemotherapy (5 months after initiation of chemotherapy). No parenchymal brain disease was identified. The persistence of disease in the leptomeninges is related to the ability of the blood-brain barrier to exclude chemotherapeutic agents. The patient responded to craniospinal radiation and remains free of disease 2 years after completion of treatment. PMID- 2722069 TI - [Relation of uteroplacental hemodynamics and fetal respiratory behavior in pregnancy with threatened premature labor or intrauterine retardation]. AB - The results of uteroplacental hemodynamics obtained by nuclear medicine were correlated with the corresponding antepartal and intrapartal cardiotocographic findings in 52 patients with preterm labor and in 53 patients with intrauterine growth-retarded fetuses. With the existence of continued disturbance in pregnancy the relationship between primary maternal hemodynamic disorders and decreased fetal respiratory performance is already evident antepartum and unambiguously intrapartum. The dependence of the antepartal cardiotocographic findings on therapeutical improvements in perfusion is of clinical relevance. PMID- 2722070 TI - [Maternal lipoproteins post partum. Qualitative and quantitative studies of the effect of lactation]. AB - Quantitative and qualitative examinations of serum lipoproteins separated by use of discontinuous ultracentrifugation were performed in 17 lactating and 13 non lactating healthy women 5 days and 5 weeks after delivery. In general a normalisation of the lipid parameters, which are increased during gestation, was observed during this period. Within 5 weeks after delivery all single parameters were in levels of normal non-pregnant women. A significant effect of lactation on the decrease of pregnancy-induced hyperlipoproteinemia after delivery could not be detected. PMID- 2722071 TI - [Impedance cardiography in labor: clinical significance of several hemodynamic parameters]. AB - The authors evaluated some cardiac parameters at the end of the 3rd trimester of pregnancy, during labor and immediately post partum, by means of a new noninvasive technique: impedance cardiography. Results demonstrated the effectiveness of this method for the study of the cardiac function in the pregnant woman. PMID- 2722072 TI - [Continuous subcutaneous opiate infusion]. PMID- 2722073 TI - [Carotid endarterectomy]. AB - Carotid endarterectomy was performed 77 times in 73 symptomatic patients. In 67 of them there had been 1 or more transient ischemic attacks (TIA), in 4 transient atypical symptoms, and in 2 mild persistent neurological deficits. After operation 1 died of a stroke and 1 had a nonfatal myocardial infarction. In 3.3% of 33 low-risk patients (Sundt's classes 1 and 2) there was mild postoperative neurological deficit. The rate of neurological complications was much higher in 40 high-risk patients (classes 2 and 3), including 5 with postoperative stroke. Followup averaged 21.5 months (longest 54 months), the 5-year survival (by extrapolation from a life table analysis curve) was 87%, and there was only 1 fatal stroke. Those who recovered from operation without complications had an 86% chance of having no further neurological problems. PMID- 2722074 TI - [Hospitalization policy following minor head injuries]. AB - Of 44 patients admitted with head injuries during 1980-84, 316 (72%) arrived fully conscious with normal neurological status and no X-ray evidence of skull fracture. These cases were admitted for observation, but in none was there any untoward development. On analysis of the cases that developed complications and in the light of the literature, we conclude that it is possible to define a group at low risk for developing complications following head injury. These patients could safely be discharged from the emergency room without admission for observation. This group included 176 (40%) of those admitted and fulfilled the following criteria. They arrived fully conscious, there was no recurrent vomiting, neurological examination was normal, there was no X-ray evidence of skull fracture, and they were between 16-70 years of age. However, these cases should only be discharged from the emergency room after a physician gives oral and written instructions to a responsible adult who accompanies the patient. Such a policy would result in considerable saving of resources by reducing admissions for observation of those at low risk for developing complications. PMID- 2722075 TI - [Combat stress reaction]. AB - The case of an atypical combat reaction in a 32-year-old soldier is presented. The initial phenomenon was a self-inflicted gunshot wound of the foot, while the post-traumatic symptoms appeared after a latent period 10 months. The combat stress reaction itself was identified during psychotherapy as the reactivation of trauma experienced in a previous war. Dimensions highlighted by this case include functional versus clinical measures used in diagnosis, and therapeutic considerations, such as the principles of immediacy, proximity and expectancy involved in the immediate combat stress reaction and thereafter. PMID- 2722076 TI - [Is iris melanoma really a nevus?]. AB - In recent years several investigators have reached the conclusion that the prognosis of melanoma of the iris is related to the cell type of the tumor. Overall mortality ranges from 3.0-3.6%, but there is no correlation between the clinical manifestation of the tumor, its microscopic appearance, or the results of angiography. The clinical behavior of histologically benign tumors may be malignant, with penetration through the trabeculum into the ciliary body and sclera, and there may even be recurrence following excision of the tumor. We present 2 women, 20 and 59 years old, respectively, with melanoma of the iris with malignant behavior. However, in 1 of them the microscopic picture was completely benign, although the tumor had penetrated into the angle of the anterior chamber and had caused severe secondary glaucoma. PMID- 2722077 TI - [A process audit of stillbirths in a rural family medical practice]. AB - A process audit was undertaken of 5 stillbirths recorded in a rural family medical practice between 1985-1987. The stillbirth rate for this practice was 81/1000, as opposed to a national rate of only 4.5/1000 (p less than 0.015). The clinic records of the women, both before and during the affected pregnancies were reviewed in detail. In each case the family and hospital physicians involved were interviewed, as were 3 of the 5 patients. In 2 cases fetal death was recorded when the women were admitted to hospital after fetal movements had already been absent for more than 48 hours. The other 3 women were admitted while the fetus was still alive. The stillbirth occurred in the first of them at 38 weeks of a pregnancy complicated by maternal viral hepatitis A (no fetal monitoring for technical reasons), in the second at 39 weeks after continual fetal monitoring for 48 hours, and in the third at 41 weeks in a pregnancy complicated by pre eclamptic toxemia. It was concluded that probably all 5 fetal deaths could have been prevented had there been more intensive instruction of the women in the correct interpretation of fetal movements, or if management after admission to hospital had been different. PMID- 2722078 TI - [Spermatic cord hematoma simulating torsion of testis in Henoch-Schonlein syndrome]. AB - Henoch-Schonlein syndrome (HSS) is a systemic disease of young children characterized by colicky pain, with melena, vomiting and damage to the joints, kidneys and other organs. Surgical problems involving the gastrointestinal tract include bleeding, intussusception and perforation. Uncommon complications, caused by bleeding into brain tissue and into the scalp, muscles, chest and scrotum, are real challenges for the physician. Spermatic cord hematoma is a rare complication of HSS. Other complications of HSS mentioned in the literature which affect the male genital system include edema of the spermatic cord or testis, epididymitis, orchitis, bleeding, Morgagni cyst, or hematoma surrounding the testis. Considering the low incidence of testicular torsion in HSS, we believe that when a patient with HSS develops acute testicular pain, noninvasive diagnostic procedures such as Doppler, ultrasound and radioisotope scans should be performed in the hope of avoiding unnecessary surgical interventions. A 2-year-old boy with HSS in whom torsion of the testis developed is reported. PMID- 2722079 TI - [Acute severe myositis due to bezafibrate treatment]. AB - The second generation fibric acid derivative, bezafibrate (Bezalip, Norlip) is widely used as a hypolipemic agent throughout Europe and Israel. Its side-effects are well documented, and include myositis, which is considered very rare. We report a 55-year-old diabetic woman with hypertension who had mild renal dysfunction (creatinine 2.0 mg/dl) who received 400 mg/d bezafibrate because of combined (Type IIb) hyperlipoproteinemia. She developed acute myositis, with extreme muscle weakness, pain and CPK levels of up to 3500 units. On discontinuation of the drug all clinical and biochemical features ceased and complete cure followed. No other symptoms have appeared during 2 years of followup. The few reports of such cases in the German literature point to a greater prevalence of myositis in those with renal dysfunction. Early diagnosis of bezafibrate-induced myositis is crucial, a discontinuation of the drug results in cure. PMID- 2722080 TI - [Physician-initiated smoking cessation program]. AB - The detrimental effects of smoking are well-known, but physicians have generally been unsuccessful in eliminating this serious public health problem. It has been suggested that the family physician is the ideal person to give antismoking advice and to initiate a treatment program. The aim of this study was to examine intervention by family physicians in cigarette smoking. 93 smokers who presented for routine medical treatment at their family medical clinic were assigned alternately to a study or control group. The study group participated in a 10 minute antismoking counselling session given by their family physician, while the control group did not. After 15 months, 55% of the treated group had decreased their daily cigarette intake or stopped smoking completely, as compared to 39% of the control group. 5 (11%) of those who participated in the counselling session reported that they had stopped smoking completely, compared with 2 (4.3%) in the control group. We suggest that antismoking advice by the family physician is essential in the fight against the smoking epidemic and would significantly reduce the degree of smoking. PMID- 2722081 TI - [Harmful effects of smoking]. PMID- 2722082 TI - [Relationships between the immune system, ultraviolet light and skin cancer]. PMID- 2722083 TI - [Lowering high blood pressure--to what extent?]. PMID- 2722084 TI - [Effect of propiverine hydrochloride on the function of the bladder in dogs]. AB - Propiverine hydrochloride (P-4) is a new derivative of benzilic acid. The effect of P-4 on the function of the bladder in anesthetized dogs was studied in comparison with flavoxate, which is clinically used for the treatment of pollakiuria. P-4 (4 mg/kg, i.v.) caused a significant increase in maximum vesical volume (Vmax), which was estimated by a cystometrogram. A similar effect was also observed following intravenous administration of verapamil (1 mg/kg), while flavoxate (4 mg/kg, i.v.) caused no significant changes in Vmax. P-4 significantly decreased the frequency of rhythmic bladder contractions at doses higher than 1 mg/kg, i.v., whereas flavoxate first revealed a significant decrease at 4 mg/kg, i.v. Thus the inhibitory effect of P-4 on the micturition movements of the bladder is more potent than that of flavoxate. These findings indicate that P-4 is a useful drug for the treatment of pollakiuria. PMID- 2722085 TI - [Effects of 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) on the unimpeded eruption rate and the dental hard tissue formation in rat mandibular incisor]. AB - To understand the mechanism of eruption in continuously growing teeth, the relationship between the rate of eruption and formation of dental hard tissues was examined following administration of 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP), an inhibitor of hard tissue formation. Three experimental groups of rats received daily subcutaneous injections of 9, 18 or 36 mg P of HEBP/kg, respectively, for 7 days. Tetracycline was also injected to mark the dentine in some animals. To maintain an unimpeded state, all four incisors in each rat were shortened repeatedly during the experimental period. Eruption rates of the mandibular incisors were measured by a photographic method. Transverse sections of the mandibles were cut and histological, microradiographic and fluorescent micrographic examinations were done. Significant decreases of the eruption rates were found in all experimental groups following the administration of HEBP. However, differences were not marked among the three experimental groups. It was also shown that matrix formation and calcification of the dentine were markedly inhibited following the administration of HEBP. Matrix formation and calcification of the enamel were also inhibited by the drug administration. It is assumed that the eruption of the rat incisor is not closely associated with the formation of dental hard tissues and their calcification. PMID- 2722086 TI - [Recent comparative statistical correlation studies on predicting the space requirement of the cuspid and bicuspid region using multiple regression comparisons]. AB - The purpose of the investigation was to develop multiple regression equations to calculate the space requirements in the canine and premolar regions. The investigation was based on study models from a group of 63 (36 males and 27 females) patients with an ideal Angle class I occlusion. The mesiodistal width of unerupted incisors and the buccolingual and mesiodistal width of first molars were used as independent variables. A test group of 64 study models (32 males and 32 females) from orthodontically treated patients was used to represent the malocclusions typically present in an orthodontic clinic or practice. The space requirement can be predicted from three variables in both upper and lower jaws. The inclusion of more variables does not significantly improve the prediction. The correlation coefficient for the buccolingual width of the first lower molar was significantly higher than that for the mesiodistal width. The combination of 22, 32 and 36 (buccolingual) achieved the highest correlation coefficient in both groups. Further, if at the time of analyses, one of the canines or premolars (33, 34 or 24) has erupted their width may be included as an additional independent variable. The correlation and regression coefficients for males and females showed no significant difference. PMID- 2722087 TI - [Consultation for patients with cheilognathopalatoschisis and their family members. Cooperation between orthodontists and human geneticists]. AB - In children with a cleft lip and palate the question of aetiology always arises. This is the case in particular when the neonatologist discovers or suspects additional malformations. Since newborn children with cleft lip and palate are now usually brought for initial treatment to an orthodontist, it is his responsibility to inform the parents about the possibility and necessity of genetic counselling and possibly, to initiate contact with the appropriate institute. This is always the case when the wish for further children is expressed. If the orthodontist recognizes microsymptoms in the parents or finds indications of their occurrence in the family, he will strongly recommend such a consultation, with cleft lip and palate patients, the orthodontist should discuss a genetic consultation as part of his confidential relationship with the patient so that the young patients understand the possible risk for the next generation. This consultation can bring enormous psychological relief for the patient if there is only a slight risk of recurrence. PMID- 2722088 TI - [Odontogenesis and dentition development following irradiation of pediatric tumors of the maxillofacial area]. AB - A case involving a 13-year-old patient who was found to have an embryonal rhabdomyosarcoma of the middle pharynx at the age of six and a half years will present the consequences of radiotherapy to the head of a growing child. The clinical examination and the X-rays show the effects of radiation: delayed development of the teeth, root dwarfism, caries and general growth disturbance. PMID- 2722089 TI - [Functional study of the temporomandibular joint in new orthodontic cases using the hinge axis recorder]. AB - The temporomandibular joint function of 66 children (mean: 11.5) with malocclusion was investigated with help of axiographic tracings. Besides other parameters of the tracings we studied the relationship between centric occlusion, centric relation and their positions in regard to the axiographic tracing line of the protrusion movement with a gauge between the front teeth. The distance between CR and CR measured as a vector was 0.7 mm (+/- 0.4 mm). Though we investigated a group with serious malocclusions the distance of CO measured perpendicular to the gauge protrusive tracing was 0 (+/- 0.4 mm). In 60 joints the CO tracing point did not coincide with the gauge protrusive line: On account of these measurements the terms compression and distraction of the joint have a graphic meaning. In 4% of the children we found tracings which were typical for joint pathology: reciprocal clicking. In 21% of the patients we found "disturbed" tracings, but their prognostic value is still unknown. PMID- 2722090 TI - [Periodontal reaction to orthodontic measures]. AB - In twelve rats, the right maxillary first molar was moved mesially by means of a fixed appliance. It was not possible to find any histopathological differences with forces of 10 N, 20 N and 30 N. We also found no different cellular reactions in the tension and pressure zones between the periods of three, six, ten and 14 days. In the treated rats the first molar was tilted. The mesial root was intruded. Local pressure zones were regularly formed around the mesial root and distal aspect of the alveolar crest of the bifurcation. It could be shown by vital polyfluorochrome staining that there was no mesial tooth movement; rather distal drifting was delayed. PMID- 2722091 TI - [The importance of the choice of materials and their design for the efficacy of orthodontic appliances]. AB - The aim of this study is to stress the importance of correct selection of materials for orthodontic appliances, and thereby emphasize the functional relationship between choice and use of material. The outlined state of the art is the result of carefully-conducted research, the development of which has been briefly mentioned; however, the type of problem resulted from critical observations by orthodontic practitioners who apply the research results for the benefit of their patients. PMID- 2722092 TI - [Secondary implantation of posterior chamber lenses]. AB - In 27 eyes, secondary implantation of posterior chamber lenses was performed. The precondition was the existence of a part of the posterior lens capsule with zonular fibers. After cleaning of the capsule surface by means of irrigation/aspiration as well as lysis of posterior synechiae and if necessary, anterior vitrectomy, the lens was fixated in the ciliary sulcus using air and healon. Postoperatively, the visual acuities were found to be the same or better in comparison with the preoperative readings. The two main complications were decentralization of the intraocular lens and further opacification of the posterior lens capsule. PMID- 2722093 TI - [Protective effect of the anterior lens capsule: corneal endothelial cell loss following intercapsular phacoemulsification compared with phacoemulsification with large open capsulotomy]. AB - In an experimental study using rabbits, the intercapsular technique was performed in 20 eyes to make a small anterior capsulotomy. A large, "can opener" capsulotomy was performed in 20 eyes, and ten eyes (five non-operated animals) served as controls. Endothelial cell loss was determined by vital staining with Trypan blue and Alizarin red S. Average endothelial cell loss with the intercapsular technique was 1.2%; with the can opener technique the cell loss was 6.6%. This difference was statistically significant (p less than 0.01). The percentage in the control eyes was 0.05%. Positive relations between endothelial cell loss related to phacoemulsification time and/or the amount of irrigating fluid used existed for the can opener group only (p less than 0.01). These results demonstrate that the presence of an almost intact anterior lens capsule during removal of lens substance is protective to the corneal endothelium. PMID- 2722094 TI - [Principles of the practical use of viscoelastic substances in eye surgery]. AB - The different rheological properties of viscous and viscoelastic substances indicate different uses in surgical practice. Purely viscous substances solve manly surface-tactical problems. The stronger the elastic component, the better the substances are suitable also for space-tactical and tissue-tactical purposes. A new field of interest is the neutralization of the buoyancy of silicone oil and gas bubbles. The latter can be used for the insertion of posterior chamber lenses in cases where the lens capsule is lacking (air sandwich). The main disadvantage is the postoperative rise of intraocular pressure: but this can be managed by a release of the substance through a preplaced keratotomy. PMID- 2722095 TI - [Natural fluorescence of nuclear cataract lenses and melanomas of the eye]. AB - For various reasons, it is desirable to have an objective cataract classification system that does not depend on either the opinion of the physician or the patient. Since both highly molecular protein aggregates and chromophores are formed in cataractous lenses, which fluoresce under suitable stimulation, we have developed a fluorescence apparatus that illuminates the lens with five monochromatic wavelengths between 350 and 500 nm in situ. The fluorescence spectrum is recorded up to 100 ms with an optical multi-channel analyzer. This fluorescence method is non-invasive and does not harm the eye; it also uses the native fluorophore. The set of fluorescence spectra obtained by this method describes the condition of the cataractous lens both quantitatively and qualitatively. Because of the sensitivity of the method, it can also be used to assess the disease objectively in the early stages and to test and determine the effectiveness of anti-cataract drugs. Another use was discovered by using the fluorescence measurements for the diagnosis of malignant melanomas. With this equipment, melanomas in the eye and the surrounding area can be diagnosed both rapidly and precisely. PMID- 2722096 TI - [Radiation cataract following injection of radium 224]. AB - The Spiess Ra-224 series ist presented. It consists of 900 patients who were repeatedly injected intravenously with known dosages (microCi/kg) of the alpha particle emitter Ra-224 for the intended treatment of tuberculosis and ankylosing spondylitis between 1943 and 1952/1965. 682 patients had been treated as adults after the age of 20 years, and 218 hat been injected as "juveniles" aged 20 years or younger. All 218 "juvenile" patients except one who had suffered from ankylosing spondylitis, had been injected for tuberculosis. Among the 218 patients 91 have died leaving 127 alive. Of the "juvenile" patients 9 were examined at the Eye Hospital of the Universitat Munchen including histopathology of an autopsy eye in one case. Of the 9 patients 8 proved to have some cataracts and 2 appeared morphologically similar to age-related cataract. In 6 patients there was a posterior subcapsular cataract which was a dense round plaque with a clear subcapsular zone of about 0.5 to 0.6 mm. This clear zone corresponds well to newly deposited lens fibres during the period of about 40 years from treatment to examination. PMID- 2722097 TI - [The effect of Co-60 irradiation on the monomer fraction of intraocular PMMA lenses]. AB - Sterile inflammatory reactions of varying degree are a rare, but not uncommon complication after intraocular lens implantation. At present we still do not know the cause of these processes, but we consider two chemical substances at least as risk factors for them: the lens content of monomeric methyl methacrylate, which is present in any lens made from polymethyl methacrylate (Perspex), and the lens content of ethylene oxide, an extremely toxic agent, which is absorbed by the lens during sterilization with this gas. Gaschromatographic investigations show that under sterilization of intraocular lenses by Co60-radiation the lens content of monomeric methylmethacrylate can be reduced drastically. Also, any contamination of the lens by ethylene oxide is avoided. Therefore at least two important arguments speak in favour of this alternative sterilization technique. PMID- 2722098 TI - [Laser scan microscopy: a new imaging procedure in quality assessment of artificial lenses]. AB - Laser-scan microscopy permits the evaluation of surfaces and deeper layers of an object by computer-assisted scanning with a laser beam. The reflected helium-neon or argon laser light is transmitted to a photodetector and after signal processing, to a frame store and a TV monitor. Imaging is realized by synchronous scanning and modulation of light intensity. Laser-scan microscopy revealed a smooth surface of both PMMA and HEMA lenses, whereas tears were detected in folded silicone implants. The physical and chemical homogeneity inside the three different materials was optimal. Compared to scanning electron microscopy, the quality of imaging is not as good with laser-scan microscopy. Nevertheless, one decisive advantage of the latter method is an analysis free of processing and artifacts, which permits a routine control of brand new and folded intraocular lenses. PMID- 2722099 TI - [Retinotoxicity of intravitreous injection of cefmenoxime]. AB - The semisynthetic third generation cephalosporin cefmenoxime was injected through the pars plana into the mid-vitreous in seven rabbit eyes. The drug dosage varied between 0.5 and 15 mg. Seven control eyes were injected only with 0.9% NaCl solution. Electroretinography was performed before injection and 1 week post injection. The rabbits were anesthetized by intramuscular application of ketanine (Ketanest). Immediately after the second ERG the eyes were enucleated and prepared for both light and electron microscopy. Light microscopy showed only slight retinotoxic effects. Electron microscopy revealed beginning toxic necrosis of the outer segments of the photoreceptors following drug doses equal to or greater than 2 mg. Significant changes in the ERG were not noted in any of the treated eyes. The toxicity of cefmenoxime and other cephalosporins reported in the literature is discussed together with the clinical relevance of the findings. PMID- 2722100 TI - [Organization of the retina: structure/function relations and a species comparison of retinal ganglion cells]. AB - The retina contains a range of ganglion cell types that differ in morphology and in their response to visual stimuli. They extract different image parameters and transmit them to the brain in independent parallel channels. One type, the alpha cells, shows a phasic response to light stimuli and covers a relatively large retinal area of about 1 degree to 3 degrees diameter. They are important for the detection of movement and global form, but not for high visual acuity. In a comparative study, alpha cells were found in all mammalian species investigated. They comprise only 1%-4% of all ganglion cells. However, with their large dendritic fields and regular soma spacing they provide complete coverage of the retina and contribute to image analysis at each retinal location. As alpha cells are a consistent component of mammalian retinae, they are most likely also a functional constituent of the human retina. The functional properties of different ganglion cell types have a bearing on the clinical diagnosis, because retinal damage (e.g., in glaucoma patients) may be specific to the cell type. PMID- 2722101 TI - [Pattern electroretinography and pattern visual evoked potentials in maculopathy: a comparison with sensory tests]. AB - The retinal and cortical potentials for pattern reversal were recorded in 58 eyes of 30 patients afflicted with macular disease. The highest incidence of abnormality (79%) was found for the amplitudes P-ERG and P-VECP. Total field EOG and L-ERG were affected less frequently (41% and 25%). The P-ERG amplitude correlated significantly with the sensitivity of the central 10 degrees visual field (static perimetry). The P-VECP threshold check size showed a close correlation with visual acuity. Thus, the recording of pattern-evoked retinal and cortical potentials serves as a supplementary means of assessing types of maculopathy. PMID- 2722102 TI - [Round table discussion of contraindications for contact lenses]. PMID- 2722103 TI - [Management of unilateral refractive errors with contact lenses]. AB - The degree of aniseikonia with the correction of unilateral aphakia is mathematically and clinically much greater with glasses than with contact lenses. It is not possible to estimate the resulting aniseikonia on an individual basis from calculating the right-to-left difference between the retinal image sizes. However, both calculation of the differences between the retinal image sizes and the aniseikonia point out the advantage of contact lenses. Unilateral axial myopia (more than 90% of anisomyopias are axial) shows the smallest differences between retinal image sizes for glasses; however, measuring the aniseikonia with the phase difference haploscope shows the smallest amount of aniseikonia for contact lenses. This apparent contradiction can be explained by the "expansion" of the "granularity of perception" of the more myopic eye. Because the amount of "expansion" varies widely between individuals and is not known in particular cases, aniseikonia cannot be calculated but must be measured. Aniseikonia proved to be one of the most important factors in the development of amblyopia of the more myopic eye. Contact lenses are the best means of reducing the amount of aniseikonia in patients suffering from axial anisomyopia. In cases with minor anisomyopia it may be also possible to obtain a minor degree of aniseikonia with glasses. Exceptions such as "useful" and "malignant" anisomyopia must be taken into consideration. PMID- 2722104 TI - [Accommodation-convergence coupling using the stereomicroscope]. AB - The term "instrument myopia" means an accommodative effort caused by the view into the microscope. This accommodation may be connected with the convergence position of the eye. Heterophoria should be developed if accommodation-induced convergence of the eyes does not harmonize with convergence of the ocular axes of a stereomicroscope. In 16 probands, an accommodation of 1.1 +/- 0.72 dpt and esophoria of +11.1 +/- 8.5 pdpt were measured at parallel ocular axes. The accommodation increased by 0.12 dpt/degree convergence with increasing convergence angle of the ocular axes. When the visual field was unrestricted, this line intersected the accommodation convergence line at 6.7 degrees. The esophoria decreased with increasing convergence angle and passed over to exophoria. At 8 degrees convergence, heterophoria amounted to -0.2 +/- 2.9 pdpt, and at 16 degrees exophoria was -12 +/- 9.5 pdpt. The minor degree of heterophoria and especially the very minor heterophoria at 8 degrees convergence support the view that the optimum convergence of the ocular axes is near where both accommodation convergence lines intersect. PMID- 2722105 TI - [AIDS. New models disclose the pathophysiology]. PMID- 2722106 TI - [Patients with craniocerebral injuries and their reintegration into vocational life. The effect of parameters independent of the accident on expert assessment]. AB - A prospective study of 60 patients with head injuries who received both primary care and an assessment at our Department, the influence of various parameters on the assessment was investigated. Catamnestically, the insurance-relevant results actually achieved are shown. It can be seen that at a 40 per cent incapacitation, reintegration into the work-a-day world is hardly possible. PMID- 2722107 TI - [Bing-Neel syndrome. Polyneuropathy within the scope of paraproteinemia]. AB - A rare cause of polyneuropathy, first described in 1936, is the Bing-Neel syndrome. This polyneuropathy develops on the basis of a paraproteinemia. Five patients in whom the symptom constellation presented, were examined. All patients complained of motor or sensory deficiencies affecting the limbs, but had no evidence of malignant disease. Four patients had IgM paraprotein, one an IgG paraprotein in the serum. In two patients, the bone marrow revealed lymphocytic infiltration in the sense of an immunocytoma, in one other patient, a plasmacytoma was detected in the bone marrow. Three patients were treated in accordance with the Knospe regimen, the patient with the plasmocytoma with the Alexanian regimen. In one case satisfactory regression of the symptoms was observed, in the other two cases a moderate improvement occurred. PMID- 2722108 TI - [Personal experiences with naturopathy. Therapeutic possibilities in diseases of the paranasal sinuses]. PMID- 2722109 TI - [Propafenone on the way into a new world. Profile of the anti-arrhythmia agent]. PMID- 2722110 TI - [Recovery of heart muscle. Weaning from the heart-/lung machine is often a problem--new pump systems for temporary cardiovascular assistance]. PMID- 2722111 TI - [HIV infection. Cardiologic diseases in AIDS patients]. PMID- 2722112 TI - [Exemplary tumor after-care. Clinic talkshows as psycho-oncologic management--20 years of the Bad Trissl clinic]. PMID- 2722113 TI - [Anamnestic and psychopathologic studies of obsessive-compulsive patients]. AB - Twenty-eight patients, that is 0.8% of all 3,225 patients admitted between 1981 and 1986 in the Free University of Berlin, Department of Psychiatry, had a primary diagnosis of obsessive-compulsive disorder (ICD-9: 300.3). These patients were compared with random samples of equal size (N = 28) of schizophrenic psychoses paranoid type (ICD 295.3), manic depressive psychoses depressed type (ICD 296.1) and neurotic depressions (ICD 300.4) using an AMDP-based multiaxial diagnostic description. It turned out, that although obsessive-compulsive patients were best discriminated from the other clinical groups by their typical symptoms, they were characterized likewise by other psychopathological, especially depressive symptoms. In view of the course of obsessive-compulsive disorder, the findings were compatible with those of other reports. Beyond it, a subgroup of patients with relatively unfavourable course could be described by AMPD-items. PMID- 2722114 TI - [Regulation of cytosolic calcium concentrations in vascular smooth muscle cells]. PMID- 2722115 TI - Contractile responses to hypoxia of isolated rings from the left branch of rabbit pulmonary artery. AB - Contractile responses of left extrapulmonary artery segments with either intact or damaged endothelium were examined with changes in PO2 at constant pH. Hypoxia consistently reduced noradrenaline-induced contractions. This hypoxia-induced relaxation was sometimes followed by a contraction and a second relaxation. Hypoxia-induced relaxations were also obtained if precontraction was elicited with KCl (40 mM), but no triphasic response was observed. Relaxations faded away with time and only contractions were then observed. Relaxations were more considerable in rings from young animals and, although always present, decreased with the age of the animal. Endothelium damage reduced hypoxia-induced relaxations. Indomethacin, a potent blocker of cyclooxygenase, increased hypoxia induced contraction and reduced relaxation in segments with intact endothelium. Without endothelium the indomethacin effect was less significant. It is concluded that the response to hypoxia of the pulmonary artery is similar to that of systemic vessels. Endothelium seems to play a modulatory role in the hypoxia induced response in extrapulmonary artery. Prostaglandin metabolism seems to play a minor role in this modulation. PMID- 2722116 TI - Effect of turpentine-induced inflammation on the disposition kinetics of propranolol, metoprolol, and antipyrine in the rat. AB - Plasma concentrations after oral administration of the high extraction drug propranolol are increased in patients and animals with inflammation. This could be due to increased serum propranolol binding, but also to decreased first-pass metabolism. We studied the pharmacokinetics of 3 drugs in control rats and in rats with turpentine-induced inflammation: propranolol, which is bound extensively to alpha 1-acid glycoprotein (alpha 1-AGP); metoprolol, another high extraction drug, but which is negligibly bound to alpha 1-AGP; and antipyrine, a low extraction drug, not bound to serum proteins. After IV administration of propranolol in rats with inflammation, systemic clearance, volume of distribution, and free fraction decreased, and the area under the curve (AUC) increased, whereas the half-life did not change. As the systemic clearance of a high extraction drug such as propranolol depends on hepatic blood flow only, a fall in hepatic blood flow or transition to a low extraction situation should be postulated. After oral administration of propranolol, the AUC was increased 20 fold in rats with inflammation; as the decrease in free fraction was only 4-fold, it can be concluded that a considerable decrease in hepatic intrinsic clearance was present. For metoprolol, in contrast to propranolol, after IV administration, no changes in pharmacokinetic parameters as a result of inflammation were observed. After oral administration, the AUC was increased about 4 times in rats with inflammation; as metoprolol is only negligibly bound to serum proteins, the increase in AUC can be attributed to a decrease in hepatic intrinsic clearance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722117 TI - Is monitoring plasma levels of netilmicin necessary in neonates? AB - Thirty-two neonates were treated with netilmicin 3 mg/kg every 12 h by IV infusion for 30 min for suspected infections, colonization, or proven infections. Pharmacokinetic studies were performed in order to define the situations in which monitoring of plasma levels would be appropriate. Mean plasma levels were within the therapeutic range and did not differ in fullterms and preterms. In the 4 children who had 2 successive pharmacokinetic studies, plasma levels were increased between H1 and H5 at the second evaluation due to netilmicin accumulation. Plasma half-life was longer in proven infections and seemed to decrease in preterms with increased gestational age. These results suggest that the dosage schedule should be left inchanged, but that administration time should be reduced from 30 to 20 min and that peak and trough plasma levels should be measured only in proven infections, in very premature babies (gestational age less than 33 wk), and during netilmicin treatment longer than 5 d. PMID- 2722118 TI - Pharmacokinetics of lidocaine and bupivacaine in retrobulbar and facial block. AB - Analgesia can be obtained during ophthalmic surgery by regional anesthesia using local anesthetic agents. As in other indications, neurological complications may occur, especially because the site of injection is close to the central nervous system. In order to evaluate the risk of retrobulbar and facial block obtained after 40 mg lidocaine and 20 mg bupivacaine injection, pharmacokinetics of both drugs was evaluated in plasma obtained from 11 patients. In addition, 3 cerebrospinal fluid samples were analyzed. Maximal plasma concentration was 0.73 +/- 0.33 micrograms.ml-1 for lidocaine and 0.19 +/- 0.06 micrograms.ml-1 for bupivacaine, obtained 24.7 +/- 23.0 min and 12.0 +/- 3.7 min after the end of injection, respectively. CSF/plasma ratio was in the range 0.05-0.26 for lidocaine and 0.56-1.33 for bupivacaine. In all patients, regional anesthesia was sufficient to perform surgery without any other analgesic drug. No sign of cardiovascular or respiratory toxicity was observed during the study. PMID- 2722119 TI - Failure of spermatozoa from T/t mice to fertilize in vitro is overcome by zona drilling. AB - Failure of epididymal spermatozoa from T/t mutant mice, but not from t/t individuals, to fertilize oocytes in vitro was partially overcome by opening a small aperture in the zona pellucida with acidified Tyrode's solution to permit direct access of the spermatozoon to the vitellus. This study provides a model system to evaluate requirements for successful zona drilling in the treatment of human infertility and further insights into the effects of the t complex on sperm fertility. PMID- 2722120 TI - Modification of the zona-free hamster ova bioassay of boar sperm fertility and correlation with in vivo fertility. AB - These studies were designed to evaluate the ability of the zona-free hamster ova bioassay to detect differences in fertility of boar sperm. In the first study, sperm from two previously infertile boars were compared to sperm from seven previously fertile boars. The percentage of zona-free hamster ova penetrated by sperm from the previously infertile boars was significantly lower than the percentage of ova penetrated by sperm from previously fertile boars (18% of ova penetrated vs. 83%, P less than .001). In the 14 ejaculates from the previously infertile boars that had ejaculate motilities of 50% or greater, the percentage of zona-free hamster ova penetrated continued to be lower than in ejaculates from the fertile boars. One of the two previously infertile boars consistently had a normal semen analysis. The only two observed manifestations of his reduced fertility were his zero conception rate and the limited ability of his sperm to penetrate zona-free hamster ova. In the second study, females were inseminated with equal numbers of sperm from two previously fertile males and the paternity of offspring determined at birth. The experiment was replicated with four combinations of six boars. A high correlation was observed between the percentage of offspring sired and the ability to penetrate zona-free hamster ova (R = .89). Neither morphology nor the ability of the sperm to undergo an acrosome reaction during in vitro incubation was correlated with fertility in the competitive mating situation. These results suggest the zona-free hamster ova bioassay can improve the in vitro fertility assessment of fresh boar semen. PMID- 2722121 TI - Differentiation of binuclear spermatozoa in mice. AB - In an electron microscopy study of abnormal spermatogenesis in mice, we have found that two discrete haploid nuclei may be located in a single spermatid cytoplasm after the second meiotic division. The spermatid continues to differentiate and forms a binucleate spermatozoon with both nuclei separately packaged within the sperm head. The Golgi apparatus of the double spermatid forms a single proacrosome that attaches to both nuclei. Apparently, one acrosomal structure differentiates to cover and compartmentalize the two haploid nuclei within the sperm head. Chromatin condensation appears normal. The head morphology and number of flagella vary in mature spermatozoa produced by this process. This work demonstrates one pathway by which polyploid spermatids continue to differentiate to spermatozoa after failure of cytoplasmic division or possibly cellular fusion. PMID- 2722122 TI - Distribution and role of microfilaments during early events of sheep fertilization. AB - The distribution of actin was studied during early events of sheep fertilization by fluorescence microscopy after staining with 7-nitrobenz-2-oxal-1.3 diazole (NBD)-phallacidin and anti-actin antibody and by electron microscopy after heavy meromyosin labelling. unfertilized and fertilized eggs exhibited a continuous band of fluorescence with both NBD-phallacidin and anti-actin antibody. Unlike in mice, no high concentration of actin overlying the spindle was detected in ovulated sheep oocytes. At the site of sperm head incorporation, the fertilization cone developed above the decondensing male chromatin and was underlined by a submembranous area rich in microfilaments. A similar actin network was observed in the cortex of the second polar body. Cytochalasin D was used to investigate the role of actin during the fertilization process. This drug did not prevent sperm fusion and incorporation but inhibited polar body abstriction and fertilization cone development and retarded sperm tail incorporation. Moreover, in the presence of the drug, the anchorage of the metaphase II spindle at the surface of the egg was destroyed. The role of microfilaments in these early events is discussed. PMID- 2722123 TI - Development of single blastomeres from four- and eight-cell mouse embryos fused into the enucleated half of a two-cell embryo. AB - Single blastomeres from four- and eight-cell mouse embryos were fused into the enucleated halves of two-cell embryos, and the ability of these reconstituted embryos to develop in vitro and in vivo was examined. The proportion of these reconstituted embryos developing to blastocysts was 74% (60/81) when four-cell embryo blastomeres were used as nuclei donors and 31% (57/182) when eight-cell embryo blastomeres were used. Eight complete sets of the quadruplet-reconstituted embryos developed to blastocysts, and five live young (9%, 5/57) were obtained after transfer; however, none of the live young were clones. Although when using blastomeres from eight-cell embryos no complete set of eight developed to blastocysts, sextuplets were obtained. The blastocysts, however, failed to produce live young after transfer. In assessing the outgrowths, it was found that 43% of those derived from reconstituted embryos using blastomeres from four-cell embryos had an inner cell mass (ICM); however, outgrowths derived from reconstituted embryos using blastomeres from eight-cell embryos lacked an ICM. These results suggest that the genomes of four- and eight-cell nuclei introduced into the enucleated halves of two-cell embryos are reversed to support the development of the reconstituted embryo. PMID- 2722124 TI - Effects of non-24-hour days on reproductive efficacy and embryonic development in mice. AB - ICR female mice were exposed to either 22 (L11, D11) or 26 hour day (L13, D13) light/dark cycles for at least 2 weeks before mating and/or during pregnancy. The mating rates of these animals decreased considerably. When pregnant females were examined at gestation days 12.0 or 17.5, resorption rates were increased, the embryos weighed less, and development was retarded in the experimental groups with preconceptional exposure to non-24-hour days. We speculate that in mice maternal and paternal pre- and periconceptional environment of daily light/dark cycles is important for normal reproductive efficacy and normal embryonic development during pregnancy. PMID- 2722125 TI - [Penetration of antibiotics into second degree burned skin in rabbits]. AB - This study was designed to determine the concentration of antibiotics administered systemically in second degree burned skin in rabbits. I: Penetration of Sulfobenzyl-penicillin (SBPC) into Deep Dermal Burn (DDB). The concentration of SBPC was determined in the skin and serum of four groups. One group acted as control and the other three had DDB. The rabbits in each were administered 100 mg/kg of SBPC by 2 hour drip infusion. In burn groups SBPC was given on the 1st, 4th and 7th post burn day, respectively. In the control group, peak concentration in the serum and skin was obtained at the end of the drip administration decreasing quickly thereafter. In every burn group, SBPC was detected in the skin and peak concentration was obtained at the end of the drip administration. After drip infusion, the SBPC level in the skin remained longer in the burn groups than in the control group. In the first day burn group, SBPC could not be detected until 1 hour after the initiation of the drip, while in the other two burn groups, SBPC could be detected a little at 30 minutes. The SBPC skin to serum ratio at the end of the drip administration in each burn group was half the value of that in the control group. II: Penetration of Cefpiramide (CPM) into Superficial Dermal Burn (SDB). The concentration of CPM was determined in the skin and serum of five groups. One group acted as control and the other four had SDB. The rabbits in each group were administered 20 mg/kg of CPM intravenously by bolus injection. In burn groups CPM was given at 8, 16, 24 and 48 hours, respectively, after burn inducement. As in the control group, CPM was detected in the SDB at every stage after burn inducement. However, CPM remained in the burned skin longer than in the non-burned skin. In the 16-hour-after-burn-group the CPM level reached its peak at 30 minutes after injection, while in the other three burn groups, the maximum level was achieved at 15 minutes. The CPM concentration in the skin of each burn group was the same or higher than that of the control group. III: Antibiotics systemically administered were determined in second degree burned skin. However, the degree of penetration was different according to the degree of burn.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2722126 TI - [Comparative effects of inhalation anesthetics on atrioventricular conduction with and without calcium entry blockers]. AB - Calcium entry blockers have been used during general anesthesia in order to control hypertension and tachyarrhythmias. It is well known that both calcium entry blockers (CEBs) and inhalation anesthetics have depressant effects on atrioventricular (AV) conduction and sinus automaticity. Therefore, this study was designed to evaluate combined effects of either halothane, enflurane, isoflurane, or sevoflurane and CEBs (verapamil, diltiazem, or nifedipine) on AV conduction. The following 3 sets of experiments were performed using 90 mongrel dogs anesthetized with ketamine 100-150 mg im, thiamylal 25 mg/kg iv and nitrous oxide with 50% oxygen. Experiment 1: to evaluate the effects of ketamine and thiamylal on AV conduction. Experiment 2: to evaluate drug interactions of halothane with CEBs. Experiment 3: to evaluate the combined effects of four different inhalation anesthetics at equipotent concentrations (0.8% halothane, 1.6% enflurane, 1.2% isoflurane, and 1.7% sevoflurane) and verapamil. The following variables were measured utilizing His bundle electrocardiogram: Sinus cycle length (SCL), AV conduction time (AH interval), His Purkinje conduction time (HV interval), effective and functional refractory period of AV node (ERP and FRP). It was confirmed that ketamine im and thiamylal iv used for induction of anesthesia did not change AV conduction time from experiment 1. The combined effects of either verapamil (0.1 mg/kg) or diltiazem (0.15 mg/kg) and 0.8% halothane were additive on AV conduction. Although nifedipine (0.01 mg/kg) did not affect AV conduction, there was the significant prolongation of SCL with halothane compared to without halothane. In experiment 3, 0.8% halothane and 1.6% enflurane were stronger than 1.2% isoflurane and 1.7% sevoflurane concerning inhibitory effects on AV conduction. Verapamil had some deleterious effects in 1.6% halothane or 3.2% enflurane anesthesia because of extreme inhibitory effects on AV conduction and sinus automaticity. In conclusion, caution must be exercised in usage of CEBs if inhalation anesthetics are used in higher concentrations. PMID- 2722127 TI - [Significance of anaerobic threshold in the assessment of functional state in patients with chronic heart disease]. AB - The value of anaerobic threshold measurement in the assessment of aerobic capacity was evaluated in 14 athletic and 62 normal subjects, as well as in 165 patients with chronic heart disease. Anaerobic threshold was defined as the oxygen consumption at which pulmonary ventilation began to increase non-linearly in relation to oxygen consumption during symptomatic maximal graded treadmill exercise. Anaerobic threshold was detectable in most of the cardiac patients as well as in athletic and normal subjects, and correlated well with individual lactate threshold. It was highly reproducible in subjects in whom measurements were repeated. Anaerobic threshold decreased as age progressed in normal subjects as well as other exercise parameters. In cardiac patients, anaerobic threshold was significantly lower than in athletic or normal subjects, and decreased progressively as New York Heart Association classification advanced. Anaerobic threshold correlated loosely with pulmonary wedge pressure and cardiac index in patients, and increased after successful cardiac surgery reflecting improved cardiac function. Thus, determination of anaerobic threshold by respiratory measurements is an accurate and objective method to assess aerobic capacity in cardiac patients as well as in athletic and normal subjects. PMID- 2722128 TI - [Radioimmunoassay for the determination of glycated hemoglobin and its clinical significance]. AB - The glycosylated hemoglobin (Hb) is a useful marker for monitoring blood glucose concentrations over the prior one or two month period. A variety of method has been described for the determination of glycated Hb, but many of them have serious pitfalls. In this report, a radioimmunoassay for glycated Hb was developed and its clinical significance was described. The antiserum was obtained by immunizing guinea pigs with reduced glycated human serum albumin. This antiserum was capable of identifying glucitollysine residues on glycated Hb of normal and diabetic individuals after reduction with NaBH4. The RIA described here had satisfactory reproducibility as judged by the intra-assay (1.6-3.7%) and inter-assay (1.7-5.4%) precision. To evaluate the usefulness of this RIA method, HbAlc values measured by HPLC method were compared with values by this RIA method. According to the criteria of the WHO Expert Committee on Diabetes Mellitus, 80 subjects were divided into normal group (N), impaired glucose tolerance group (IGT), and diabetic group(DM). Average of glycated Hb values obtained by this RIA in 20 IGT subjects was significantly higher (p less than 0.001) than that of 30 normals and 17 IGT subjects exceeded upper normal range (mean + 2SD). But there was no significant difference between N and IGT in the levels of HbAlc by HPLC and all IGT subjects remained normal range. In a patient treated with continuous subcutaneous insulin infusion therapy failure of normalization of the glucose balance was discernible by an elevation of glycated Hb values by RIA. In contrast, HbAlc values fell within the normal range in this patient. From these results it appears that determination of glycated Hb by this RIA represents a more sensitive parameter for long-term than HbAlc by HPLC and is suitable for monitoring even small fluctuation of blood glucose. PMID- 2722129 TI - Direct evidence that the insulin receptor mediates a mitogenic response in cultured human fibroblasts. AB - To define the role of the insulin receptor in mediating a mitogenic response in cultured human fibroblasts, the effects of specific monoclonal antibodies against the insulin and the type I IGF receptor on insulin-stimulated [3H]thymidine incorporation were investigated. Insulin stimulated [3H]thymidine incorporation in a biphasic fashion. In the first phase, a half-maximal effect was observed at 20 ng/ml, and a seemingly maximal effect was obtained at 100-1000 ng/ml. With 10 micrograms/ml insulin, a secondary increase in [3H]thymidine incorporation was seen which was similar to the maximal effect of IGF-I. These [3H]thymidine incorporation results were corroborated with cell replication studies. MC-51, a highly specific monoclonal antibody for the insulin receptor, inhibited the stimulation of [3H]thymidine incorporation by 25 ng/ml of insulin. AlphaIR-3, a monoclonal antibody specifically directed against the type I IGF receptor, had no significant effect on insulin-stimulated [3H]thymidine incorporation at low (10 1000 ng/ml) concentrations of insulin. However, alpha IR-3 interfered with the incremental increase in [3H]thymidine incorporation observed at 10-100 micrograms/ml insulin. These data demonstrate that insulin, at low concentrations, is capable of stimulating DNA synthesis and replication of human fibroblasts through interaction with its own receptor, while at supraphysiological concentrations, much of insulin's mitogenic effect is mediated through the type I IGF receptor. PMID- 2722130 TI - A study of hepatic metabolism of thyroxine in BB/W rats treated with L-thyroxine. AB - The effect of thyroxine (T4) on T4 conversion to triiodothyronine (T3) and reverse T3 (rT3) was studied in BB/W rats. A colony of 38 BB/W rats was obtained and half were treated with thyroxine (T4), 1 mg per liter of drinking water. At 106 days of age the following groups were identified: nondiabetic, no T4 treatment, 8 rats; nondiabetic, T4 treated, 8 rats; diabetic, no T4 treatment, 10 rats; diabetic, T4 treated, 7 rats. All animals with diabetes were treated with insulin. T4 conversion to T3 and rT3 was assessed in liver homogenates in 0.1 M Tris-HCl buffer, pH 7.4, with or without 5 mM dithiothreitol (DDT). Serum T4 and rT3 were significantly elevated in both T4-treated groups (P less than 0.001), while serum T3 was not affected in either. Basal T4 deiodination to T3 by the liver homogenate did not change on treatment with T4; the addition of DTT increased T3 production in the homogenate from T4 treated nondiabetic animals (P less than 0.05). In both nondiabetic and insulin-treated diabetic rats there was no effect of T4 on the rate of rT3 production. Since, in the rat, 30-40% of circulating T3 is a direct contribution of thyroid gland secretion, and that would be absent in our T4-suppressed animals, the normal serum T3 may reflect increased absolute peripheral T3 production from the greater concentration of circulating T4. PMID- 2722131 TI - The role of serum fructosamine as a screening test for gestational diabetes mellitus. AB - The serum fructosamine concentration indicates the degree of glycation of serum proteins, particularly albumin, and reflects an average blood glucose level over the previous 1-3 weeks. Serum fructosamine, glycated haemoglobin (HbA1c), total serum protein, serum albumin, fasting plasma glucose and oral glucose tolerance test (OGTT) have been measured in 127 healthy control subjects, 102 type 1 and 152 type 2 diabetes mellitus patients and 106 nondiabetic pregnant women. Fructosamine concentration of 2.24 +/- 0.16 and 3.21 +/- 0.41 mmol/l (mean +/- S.D.) has been found in control subjects and diabetics respectively (P less than 0.001). During the second trimester a significantly lower fructosamine level (1.92 +/- 0.21 mmol/l) has been found in pregnant women, most likely due to the low serum albumin concentration (31.35 +/- 3.97 g/l). None of them had a fructosamine level above the normal limit of 2.55 mmol/l. On the other hand, 12 pregnant women showed a disturbed OGTT with normal fructosamine. If the serum fructosamine concentration was adjusted for 40 g/l albumin, then a mean fructosamine of 2.16 +/- 0.24 mmol/l was found in patients with gestational diabetes. Our results show that serum fructosamine has a similar diagnostic value as HbA1c for non-pregnant adults, but neither can replace OGTT for the diagnosis of gestational diabetes. PMID- 2722132 TI - Serum levels of type III procollagen peptide in diabetes mellitus. AB - Serum levels of type III procollagen peptide (P-III-P) were investigated in 19 patients with type 1 (insulin-dependent) and in 48 (25 orally treated, 23 insulinized) patients with type 2 (non insulin-dependent) diabetes mellitus. Among patients with type 2 diabetes, 16 orally treated and 14 insulin-treated subjects had macrovascular complications. P-III-P levels were not correlated with the duration of diabetes and with glucose control, nor were there any significant sex and age differences in the levels. P-III-P values were significantly higher in the sera of insulin-treated non insulin-dependent diabetic patients with macroangiopathy. These high values (18.5 +/- 10.8 ng/ml) were in contrast with normal values in healthy subjects (8.5 +/- 2.5, P less than 0.001), insulin dependent diabetics (9.9 +/- 3.4 ng/ml, P less than 0.01), non insulin-dependent diabetics treated with oral agents (8.2 +/- 2.6 ng/ml, P less than 0.001) and insulin-treated non insulin-dependent patients without macroangiopathy (8.2 +/- 4.9 ng/ml, P less than 0.001). Although this study does not demonstrate that an increase in type III collagen synthesis is responsible for the pathogenesis of macroangiopathy, it suggests that insulin-dependent fibroblast sensitization may play a role in the acceleration and progression of macroangiopathy. PMID- 2722133 TI - The influence of Guar gum on absorption of metformin from the gut in healthy volunteers. AB - Dietary fibre and biproducts of some vegetable extracts (Guar etc.) are advocated to reduce postprandial hyperglycaemia but there is some evidence that these may disturb the absorption kinetics of orally administered drugs. The effect of Guar gum on the digestive absorption of metformin was tested in 6 healthy subjects given 1700 mg of metformin with a standardised meal. Metformin blood levels showed that when given together with Guar there was a reduction in the absorption rate over the first 6 hours. These findings suggest that combination therapy may diminish the anti-hyperglycaemic action of metformin. PMID- 2722134 TI - Heterogeneity of big-big hPRL in hyperprolactinemia. AB - Sera from a patient with macroprolactinoma (case 1) and from a hyperprolactinemic woman with regular menstruation (case 2) were analyzed for prolactin activity by gel filtration using Sephadex G-100, Sephadex G-200 and TSK G3000SW columns. The chromatographic profile by Sephadex G-100 showed that the percentage of immunoreactive big-big hPRL was 10.7% in case 1 and 64.1% in case 2. On Sephadex G-200 and TSK G3000SW columns, the molecular weight of big-big hPRL was estimated to be more than 500,000 daltons (big-big1 hPRL) in case 1 and approximately 250,000-300,000 daltons (big-big2 hPRL) in case 2. Big-big1 hPRL in case 1 was converted to big and little hPRLs when the serum was treated with 2 mercaptoethanol (2-ME), but part of the big-big2 hPRL in case 2 was converted to a larger molecule. Radioactive big-big hPRL generated by mixing labeled hPRL with the serum from case 1 was eluted with the void volume on Sephadex G-100 column and was not converted to the other molecular forms after 2-ME treatment. There were two radioactive big-big hPRL on TSK G3000SW column and these estimated molecular weights were more than 300,000 daltons. The data demonstrated the existence of at least two forms of big-big hPRL in the serum and indicated that radioactive big-big hPRL may be different from these hPRLs in the serum. PMID- 2722136 TI - Neuroendocrinology 1988. 31st International Henri-Pierre Klotz Days of Clinical Endocrinology. Paris, May 26-27, 1988. PMID- 2722135 TI - Urinary calcium and oxalate excretion during oral fructose or glucose load in man. AB - We studied urinary calcium and oxalate excretion in response to oral fructose load and to oral glucose load each on two different randomized mornings in twelve healthy subjects. Oral fructose load provoked an increase in calciuria and a decrease in oxaluria while oral glucose load induced an increase in both calciuria and oxaluria. These results suggested that in healthy subject, the decrease in oxaluria observed during fructose load reduced the product urinary [calcium] x [oxalate] which was the main factor in the genesis of urinary calcium oxalate stones while glucose load increased the risks of urolithiasis by means of the rise in both calciuria and oxaluria. PMID- 2722137 TI - Abnormal dopamine sensitivity in some human prolactinomas. AB - In most of human prolactin (PRL)-secreting adenomas, dopamine and dopamine agonists normally suppress the excessive PRL secretion. Nevertheless, a subpopulation of such patients presents a relative insensitivity to the ergot derivative bromocriptine. Six patients with a macroadenoma (n = 5) or microadenoma (n = 1) were considered resistant to bromocriptine which, at a daily dose of 15-60 mg, did not normalize high plasma PRL levels. Culture studies of these adenoma cells showed that: (1) 10(-8) M bromocriptine produced a 32 +/- 16% inhibition of PRL release versus 65 +/- 12% obtained in the same conditions with normal human pituitary cells; (2) sulpiride (10(-6) M) reversed the inhibitory effects of bromocriptine, and (3) the bacterial endotoxins, cholera toxin (10( 11) M) and pertussis toxin (250 ng/ml), respectively, produced a 45-500% increase and a total abolition of bromocriptine-induced PRL inhibition. These observations and recent data of the literature allow to discuss the possibility of receptor or postreceptor defects in such tumors. PMID- 2722138 TI - Changing hypothalamopituitary function: its role in aging of the female reproductive system. AB - Changes in female reproductive function occur relatively early during the life span in many mammalian species. Therefore, this physiological system is an excellent model system in which to study the effects of age on specific endocrine relationships since changes occur prior to the occurrence of multiple pathologies associated with later stages of aging. Data from several laboratories suggest that changes in hypothalamic, pituitary and ovarian function may contribute to age-related deterioration of fertility in females. We will focus our attention on the role of hypothalamic changes in the cascade of events that eventually lead to acyclicity and infertility. Data suggest that changes in the diurnal rhythmicity of catecholaminergic neurotransmitters and their receptors occur during middle age. These changes may regulate the pattern of release of GnRH since alterations in the pulsatile pattern of LH secretion also become detectable at this age. Some age-related changes in hypothalamic and pituitary function are not irreversible or absolutely determined. Instead it appears that the ovarian steroidal milieu modulates the rate of aging of several aspects of hypothalamohypophysial function. In summary, changes in hypothalamic and pituitary function appear to contribute to the aging of the female reproductive system. PMID- 2722139 TI - Increased basal plasma vasopressin-neurophysin in mania. AB - Basal plasma vasopressin-neurophysin (hNpI) was estimated in 50 drug-free neuropsychiatric patients classified according to the Research Diagnostic Criteria. The hNpI concentration was higher in the 5 manics (0.76 +/- 0.15 ng/ml) than in the 16 schizophrenics (0.53 +/- 0.08), 12 minor depressed (0.54 +/- 0.06) and 17 major depressed (0.48 +/- 0.10; p less than 0.05). Thus, those results confirm our initial observation of an increased vasopressinergic function in the manic compared to the depressed phase in one bipolar patient. Whether this increase in the vasopressin release is a consequence of the neuropsychiatric disorders or initiates and/or participates in their pathophysiology remains to be elucidated. The hypothetic consequence on water metabolism of such an increase remains also to be defined. PMID- 2722140 TI - Thyroid-thymus interactions during development and aging. AB - A good body of experimental and clinical evidences suggests that bidirectional interactions do exist between the neuroendocrine system and the thymus activity. In particular, thymic endocrine activity seems to be strongly influenced by neuroendocrine signals. In this context, studies performed in hyper- and hypothyroid subjects and in the low triiodothyronine (T3) syndrome, which affects premature infants, have clearly shown that thyroid hormones and in particular T3 physiologically modulate thymic peptide secretion. In vitro experiments, with thymic whole-organ cultures, have demonstrated that thyroid hormones exert their action on the epithelial cells of the thymus deputed to synthesize and secrete thymic peptides and that such an effect does not seem to depend on the known permissive action of thyroid hormones. PMID- 2722141 TI - Stress and auto-immune endocrine diseases. AB - Auto-immunity may occur in all endocrine tissues, with a particular prevalence in thyroid and pancreatic islets. The most demonstrative clinical expressions of this auto-immunity are Graves' disease and insulin-dependent diabetes. In the former, extensive data are available upon the immunological disorders seen in peripheral blood as well as in the thyroid itself. The predisposal profile of such diseases is quite well delineated (genetic markers in HLA system, organ specific T suppressive deficiency). On the other hand, the mechanisms implicated in the onset of auto-immunity are still questioned, the classical viral infection being scarcely demonstrated. Clinical observation registers frequent stressful life events just before the onset of these diseases, but there are few convincing data in the literature. The recent findings on the close relations between the immune system and the central nervous system lead to conceive an actual psychoneuro-endocrine-immune axis. This axis might explain the eventual priming effect of stress in patients predisposed for an organ-specific auto-immunity. PMID- 2722142 TI - The tyranny of irresponsible freedom. PMID- 2722143 TI - Psychosocial issues in dealing with AIDS. PMID- 2722144 TI - National forum addresses need to enhance training in treating the seriously mentally ill. PMID- 2722145 TI - Coordinating inpatient and outpatient treatment for a chronically suicidal woman. PMID- 2722146 TI - Medication refusal and the rehospitalized mentally ill inmate. AB - Records of all inmates committed to a state forensic hospital in fiscal year 1982 (N = 472) were studied to examine the inmates' hospital utilization between September 1977 and April 1984 and the reasons for their admissions. Medication refusal, hallucinations and delusions, and threatened or potential violent behavior toward others were the most frequently documented reasons for admission. Medication refusal was associated with a greater number of hospitalizations, shorter hospitalizations, diagnoses of paranoid schizophrenia or schizophreniform disorders, longer prison sentences, and convictions for more serious felonies. Inmates admitted for medication refusal were also likely to be referred concurrently for threatened or potential violent behavior toward others. The study demonstrates the particularly violent nature of a large proportion of the hospitalized mentally ill inmates and the important role of medication refusal in their rehospitalization. PMID- 2722148 TI - AIDS anxiety among health care professionals. AB - House staff physicians and nurses at a major New York City teaching hospital completed a 79-item questionnaire designed to assess AIDS anxiety, fear of contagion, and personal attitudes about homosexuality. Sixty-three percent of respondents were skeptical of or did not believe assurances by experts that health care workers who observe safety guidelines are at minimal risk of contracting AIDS from patients. Respondents from minority groups were significantly less trusting of experts' reassurances of their safety and were more uncomfortable working with homosexual patients. Twenty-six percent of all respondents feared that they would become victims of AIDS if they continued their present work, yet 97 percent expressed a firm commitment to caring for AIDS patients throughout their illness and the dying process. The author suggests that AIDS training and educational programs for health care professionals should consider their cultural background and psychosocial needs. PMID- 2722147 TI - Effects of a smoking ban on a general hospital psychiatric service. AB - After a private general hospital announced plans to ban smoking inside the hospital, the authors initiated a study on the psychiatric units to identify anticipated and actual patient-related problems associated with the ban and to assess staff and patient attitudes toward the ban. Data were obtained through pre and post-ban surveys of medical and nursing staff and predischarge interviews with patients. The findings showed that staff anticipated more smoking-related problems than actually occurred and that patients who smoked were able to reduce their tobacco use during their hospital stay. No evidence was found to suggest that hospitalized psychiatric patients are less capable of cutting down on smoking than the general population. PMID- 2722149 TI - Management of HIV-positive psychiatric patients who fail to reduce high-risk behaviors. AB - The authors describe clinical and legal dilemmas faced by staff involved in providing inpatient psychiatric treatment to two HIV carriers who continued to practice high-risk behaviors after learning of their HIV infection. Staff were unsure of their obligation to report the patients under a state law giving the commissioner of health broad discretion to limit the freedoms of HIV-infected individuals who continue to practice high-risk behaviors. Treatment of the patients also raised concerns about the appropriateness of treating noncompliant HIV-infected patients in traditional psychiatric settings and the lack of suitable aftercare facilities. The authors advocate developing a specialized treatment approach for noncompliant HIV-infected patients and provide a series of recommendations that might serve as the foundation for such an effort. PMID- 2722150 TI - Use of a holding technique to control the violent behavior of seriously disturbed adolescents. AB - Therapeutic holding is a treatment technique in which a violent patient is physically contained by people rather than by mechanical or chemical restraints or seclusion. Episodes of therapeutic holding that took place on an inpatient adolescent psychiatric unit over an 18-month period were examined retrospectively through chart review and review of written audits of each episode. During that period, 22.8 percent of the patient population experienced at least one episode of therapeutic holding. Patients requiring this intervention were more likely to be younger and, when day at risk were controlled, to be male and to have had longer stays on the unit. The technique enabled patients to regain behavioral control after a mean of 21.2 minutes, a much shorter period of containment than the four to 16 hours reported in studies of seclusion. PMID- 2722151 TI - A smoke-free psychiatric unit. PMID- 2722152 TI - Evolution of smoking policies in Oregon psychiatric facilities. PMID- 2722153 TI - Security safeguards in community rehabilitation of forensic patients. PMID- 2722154 TI - A partially computerized treatment plan. PMID- 2722155 TI - An intensive community-based treatment alternative to state hospitalization. PMID- 2722156 TI - Patient or client? PMID- 2722158 TI - Drug errors: dangerous, costly, and avoidable. PMID- 2722157 TI - Patient credit checks help hospitals minimize bad debt. PMID- 2722159 TI - Competition stiff for available psychiatrists. PMID- 2722160 TI - Psych: PPS may be out, but the pressure is on. PMID- 2722161 TI - Keeping the lid on the cost of legal services. PMID- 2722162 TI - Freshman CEO: new perspectives yield innovation. Interview by Alden Solovy. PMID- 2722163 TI - Deep marketing cuts are unfair, unwise. PMID- 2722164 TI - Merged provider groups take on Kaiser. PMID- 2722165 TI - CEOs can make it easier to drive a hard bargain. PMID- 2722166 TI - Research makes medical devices easier to use. PMID- 2722167 TI - Computer virus prescription: 'safe computing'. PMID- 2722168 TI - Do medical staff problems exist on the new job? PMID- 2722169 TI - A reason for living in the past: a better time. PMID- 2722170 TI - Image analysis in anatomic pathology: what are the issues? PMID- 2722171 TI - Prognostic value of morphometry in papillary thyroid carcinoma. AB - The value of morphometric analysis in addition to standard prognostic indicators was studied in 28 cases of papillary thyroid carcinoma. Standard features included age, sex, lymph node status, tumor size, and encapsulation. The mean follow-up was 47 months (maximum, 140 months). Recurrences were documented in six patients at a mean time of 34 months; five patients recurred with distal metastases and one patient recurred with local disease. Univariate analysis most closely associated tumor recurrence with nuclear anisotropism (the standard deviation of the estimated nuclear area [ENASD]) and tumor size. With forward stepwise incremental analysis, the value of tumor size was lost and only the ENASD and the cellularity mean index (CMI), defined as the percentage of tumor volume composed of tumor cells, significantly correlated with recurrence. Fifty five percent of patients with an ENASD greater than 17 microns2 and a CMI greater than 40% developed recurrence as compared with 5% of patients with lesser values (P = .0001). Morphometric analysis may significantly contribute to the role of histopathology in the evaluation of papillary thyroid carcinoma and may also provide information regarding prognosis not obtained by standard methods. PMID- 2722172 TI - A comparative morphometric and cytophotometric study of endometrial hyperplasia, atypical hyperplasia, and endometrial carcinoma. AB - The DNA content and nuclear measurements of five groups of endometrial proliferations--proliferative endometrium (PE), simple hyperplasia (SH), atypical hyperplasia (AH), well-differentiated carcinoma (WDC), and poorly differentiated carcinoma (PDC)--were compared using 14 descriptors in a stepwise discriminant analysis. Classification using the discriminant rules agreed with the pathologic interpretation for 78% of the specimens. All PEs were assigned to the correct group, and 97% of benign endometria and carcinomas were correctly classified as benign or malignant. Only two of 39 hyperplasias (5%) were misclassified as malignant, and only one of 36 carcinomas was classified as benign. In the difficult distinction between AH and WDC, using all descriptors for the five groups, only 68% of the AH and 60% of the WDC classifications were in agreement with the pathologist of record. However, when discriminant rules addressing only AH and WDC were used, 37 of 39 AHs and WDCs were in concordance. This suggests that a morphometric distinction between AH and WDC is feasible. PMID- 2722173 TI - Neoplasms of endometrial stroma: histopathologic and flow cytometric analysis with clinical correlation. AB - Ten neoplasms of endometrial stroma (one stromal nodule, four endolymphatic stromal myoses, and five stromal sarcomas) were compared using clinical data as well as histopathologic and flow cytometric parameters. None of the patients with stromal nodules or endolymphatic stromal myosis had extrauterine disease at presentation or tumors displaying a mitotic rate greater than 10/10 hpf (high power fields), nuclear pleomorphism, atypical mitotic figures, DNA aneuploidy, or a high proliferative index (greater than 10% S phase cells). The stromal nodules were circumscribed and behaved in a benign fashion. The patients with endolymphatic stromal myosis had infiltrative tumors that behaved as low-grade cancers with good responses to therapy. Four of the five patients with stromal sarcoma had extrauterine disease at presentation as well as tumors characterized by a mitotic rate much greater than 10 mitoses/10 hpf, nuclear pleomorphism, atypical mitotic figures, DNA aneuploidy, and a high proliferative index. These four patients had aggressive disease with poor response to therapy. The fifth of the stromal sarcomas had a high mitotic rate, but lacked the other features linked with aggressive behavior; this patient has responded well to treatment. The mitotic count may not be the most useful criterion for predicting biologic behavior in endometrial stromal tumors since it does not always reflect an increased rate of cell turnover as demonstrated by the percentage of cells in the S phase. DNA analysis by flow cytometry yields a more accurate picture of tumor behavior. PMID- 2722174 TI - The use of DNA flow cytometry in the diagnosis of triploidy in human abortions. AB - The ploidy of placental tissue from 59 abortions was determined using DNA flow cytometry. The specimens were also screened histologically for features considered to be characteristic of a partial mole. Triploidy was found in six cases; three of these cases presented histologically as partial moles. From the four specimens histologically classified as partial moles, three appeared to be triploid. The most specific histologic features of triploidy were cystic change of the placental villi and trophoblastic hyperplasia with vacuolation of the syncytiotrophoblast; however, these changes were also found in some of the nontriploid abortions. Irregularity of villous contours was less specific. PMID- 2722175 TI - Intravascular lipoleiomyomatosis: a report of two cases. AB - Two cases of intravascular leiomyomatosis (IVL) with histologic features of a lipoleiomyoma (LPL) are reported. Both tumors arose from preexisting uterine leiomyomata. One tumor was found incidentally in a uterus removed for leiomyomata. The other tumor extended up the inferior vena cava into the right side of the heart and presented as a cardiac mass. Although LPL is considered to be a benign lesion, IVL recurs in approximately 10% of reported cases, and must be distinguished from low-grade endometrial stromal sarcoma and leiomyosarcoma with vascular invasion. The combination of features in these cases lends support to the theory that IVL may arise by intravascular extension of a preexisting leiomyoma. PMID- 2722176 TI - Primary mucosal malignant melanoma: an immunohistochemical study of 12 cases with comparison to cutaneous and metastatic melanomas. AB - Immunohistochemical analysis of 40 formalin-fixed, paraffin-embedded malignant melanomas (12 primary mucosal, 16 primary cutaneous, and 12 metastatic cutaneous) was performed to study the possible differences in immunostaining profiles according to location. The majority of melanomas were reactive with a polyclonal antibody to S100 protein (P-S100; 85%), a monoclonal melanoma-specific antibody (HMB-45; 88%), and a monoclonal antibody to vimentin (90%), and there were no differences in staining profiles for these antibodies by anatomic location. In contrast, while 13 of 16 cutaneous melanomas (81%) and ten of 12 metastatic melanomas (83%) were reactive with a monoclonal antibody to S100 protein (MoAb 079), only five of 12 mucosal tumors (42%) showed positive staining for MoAb-079. Similarly, 14 cutaneous melanomas (88%) and 11 metastatic melanomas (92%) showed positive staining for neuron specific enolase (NSE), while only four mucosal melanomas (33%) were NSE-positive. Of the 40 melanomas, all but two were reactive with either P-S100, MoAb-079, or HMB-45. These findings suggest that MoAb-079 and NSE may be less sensitive markers than P-S100 and HMB-45 for routinely processed mucosal melanomas as compared with cutaneous and metastatic tumors. PMID- 2722177 TI - A protective device for performing cranial autopsies. AB - An effective device for performing cranial autopsies is described. This device prevents the aerosolization of potentially infectious particulate material while opening the cranial vault. PMID- 2722178 TI - Bulbar encephalitis complicating trigeminal zoster in the acquired immune deficiency syndrome. AB - A 30-year-old homosexual man with the acquired immune deficiency syndrome and a recent history of zoster involving the mandibular division of the right trigeminal nerve was found at autopsy to have a predominantly demyelinating lesion restricted to the ipsilateral spinal trigeminal tract and nucleus. Cowdry A inclusions were readily apparent in the nuclei of numerous glia and isolated neurons, and inclusion-bearing cells were immunoreactive with an antiserum to the varicella zoster virus (VZV). This represents the first demonstration that zoster associated trigeminal encephalitis is the result of brainstem invasion by VZV. The restricted topography of this lesion implicates axonal transport in its pathogenesis. PMID- 2722179 TI - Progressive lymph node histology and its prognostic value in patients with acquired immunodeficiency syndrome and AIDS-related complex. AB - Seventy-four sequential lymph node biopsies from 30 acquired immunodeficiency syndrome (AIDS)/AIDS-related complex (ARC) patients showed temporal histologic progression from explosive follicular hyperplasia (EFH) to mixed follicular hyperplasia/involution (mixed) to follicular involution (FI) to lymphocyte depletion (LD). This histologic progression correlated with symptoms, development of opportunistic infections (OI), and mortality. At initial biopsy, only 50% of the AIDS/ARC patients with EFH/mixed compared to 100% with FI/LD were symptomatic with weight loss, night sweats, diarrhea, fever, or fatigue. 31% of ARC patients with EFH and 63% with FI developed an OI in a median of 69 months and 5 months, respectively; 86% with LD had a concurrent or previous OI. Ninety percent of ARC patients progressing to FI/LD died; 85% of those persisting with EFH/mixed remained alive 18 to 50 months after initial biopsy. AIDS patients with EFH lived twice as long as those with FI/LD. Progressive histology did not correlate with lymphoma. The number of ARC patients developing Kaposi's sarcoma was too small to draw definitive conclusions. PMID- 2722180 TI - Angiosarcoma of the left atrium mimicking myxoma: case report. AB - The case of a 65-year-old female patient with a pedunculated left atrial angiosarcoma is presented. Histologically, the tumor was composed of vascular spaces lined by atypical cells with similar cells in the solid portion of the tumor. Immunohistochemical stain for factor VIII-related antigen was positive in the cells forming vascular spaces. Immunoperoxidase stain for Ulex Europaeus I lectin was positive in cells lining vascular lumina and in individual cells in the solid portion of the tumor. Cardiac angiosarcomas characteristically occur in men, arise in the right atrium, are large mural masses that infiltrate widely at the time of presentation, and are usually rapidly fatal. Review of the literature reveals that this case of cardiac angiosarcoma is unusual by virtue of its occurrence in a female, left atrial location as a polypoid lesion, and prolonged symptom-free survival after surgical resection alone. Cardiac angiosarcoma may clinically and radiologically simulate myxoma. PMID- 2722181 TI - Acute and chronic pericholangiolitis in association with multifocal hepatic lymphangiomatosis. AB - Multifocal, lymphangiomatous lesions were found in the right lobe of the liver of a 9-year-old girl who died seven days after head trauma. We believe the lesions represent a cystic and pseudoneoplastic dilatation of liver lymphatics secondary to a posttraumatic complication, acute and chronic inflammation primarily of small bile ducts, and canaliculi (pericholangiolitis). The findings provide new evidence that inflammation and fluid overload, in the absence of a congenital malformation, are cardinal factors in the pathogenesis of some forms of lymphangiomatosis. PMID- 2722182 TI - Toxoplasma-induced occlusive hypertrophic arteritis as the cause of discrete coagulative necrosis in the CNS. PMID- 2722183 TI - Pulmonary scar cancers. PMID- 2722184 TI - Molecular defects of type III procollagen in Ehlers-Danlos syndrome type IV. AB - Fibroblasts from most patients with Ehlers-Danlos syndrome (EDS) type IV, a disorder characterized by fragility of skin, blood vessels, and internal organs, secrete reduced amounts of type III procollagen. In 7 of 8 cell strains analyzed, we found evidence of structural defects in half of the type III procollagen chains synthesized, such as deletions or bona fide amino acid substitutions, which cause delayed formation and destabilization of the collagen triple helix and, as a consequence, reduced secretion of the molecule. The data suggest that EDS type IV is often caused by heterozygosity for mutations at the COL3A1 locus, which affect the structure of type III procollagen. The triple-helical region of the molecule, like the homologous region of type I procollagen, appears to be particularly vulnerable. PMID- 2722185 TI - Radioresistant DNA synthesis and human genetic diseases. AB - Sixty-eight human fibroblast cell strains were assayed for radioresistant DNA synthesis (RDS), which is defined here as the absence of a steep component of inhibition of DNA synthesis in a dose-response curve when rate of DNA synthesis is plotted against radiation doses from 0 to 20 Gy or more. Twenty-seven strains from patients who were previously diagnosed to have ataxia-telangiectasia (AT) were positive for this feature. Among the cell strains that did not show RDS were two from AT obligate heterozygotes (i.e., the parents of AT patients), two from patients with Alzheimer disease, two from patients with Friedreich ataxia, one from a patient with Bloom syndrome, one from a patient with Down syndrome, and six from patients with various immunodeficiencies. Four strains demonstrated RDS that was less pronounced than in most AT cells: one was from a patient with Nijmegen breakage syndrome, one was from a patient without ataxia but with choreiform movement disorder, telangiectasia, and elevated concentrations of alpha-fetoprotein in the blood, and two were from AT patients. RDS therefore is not a necessary trait of human genetic diseases that involve radiosensitivity or immunodeficiency. Although recent reports suggest that some AT patients do not exhibit RDS, we found RDS in all the AT cells we tested. PMID- 2722186 TI - Genetic studies of human apolipoproteins. VIII. Role of the apolipoprotein H polymorphism in relation to serum lipoprotein concentrations. AB - Apolipoprotein H (APO H) has recently been identified as a structural component of chylomicrons, very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Although the precise metabolic function of APO H in lipid metabolism is not certain, it has been suggested that APO H may be involved in triglyceride (TG) metabolism. In addition to the previously described quantitative polymorphism, we have recently detected a common qualitative polymorphism at the APO H structural locus. To test the role of APO H genetic variation in determining lipoprotein and lipid levels, we have estimated the allelic effects of APO H variation on TG, VLDL, LDL, HDL, HDL3, and total cholesterol on 356 Nigerian blacks (189 males, 167 females). While no significant effect of phenotype was observed on lipoprotein levels, the effect of interaction between phenotype and gender was significant. Therefore, data on males and females were analyzed separately using analysis of variance after adjusting for age and body mass index. Logarithmic transformation of pertinent variables was done to bring the distribution of the variables closer to normality. A statistically significant effect of phenotype was observed on triglyceride levels in females only (P less than 0.05). Further analysis of this phenotypic effect revealed that it is due to the impact of the APO H*3 allele, which raises triglycerides by 9.92 mg/dl as compared to the common allele, APO H*2. These findings are in accordance with the postulated role of APO H in triglyceride metabolism. On the basis of its sex-specific effect, we propose a hypothesis that may explain the combined influence of the quantitative and qualitative polymorphisms at the APO H locus on triglyceride levels in females. PMID- 2722187 TI - Cytogenetic studies on three pheochromocytomas derived from patients with von Hippel-Lindau syndrome. AB - Chromosomal analyses of three pheochromocytomas from patients with von Hippel Lindau syndrome are reported. One pheochromocytoma revealed a normal karyotype, another tumor showed a trisomy 7 as the only chromosomal abnormality, whereas in a further sample a polyclonal chromosome constitution was detected. In addition to a normal 46,XX cell line, four distinct chromosomally abnormal cell lines could be identified. One cell line revealed partial trisomy for the long arm of chromosome 1 and additionally exhibited the phenomenon of telomeric association. Most interestingly, three further cell clones showed rearrangements of chromosome 3 including the region where the von Hippel-Lindau gene was mapped; three rearrangements resulted in a partial or total trisomy of 3p. Our findings are discussed in relation to previously reported cytogenetic and molecular results regarding von Hippel-Lindau syndrome. PMID- 2722188 TI - A linkage group with FRA16B (the fragile site at 16q22.1). AB - Polymorphic DNA markers located in bands 16q13, 16q21 and 16q22 were examined for recombination with FRA16B, the fragile site at 16q22.100. A tight linkage cluster D16S10-FRA16B-D16S4-HP was established. There were no recombinants (theta = 0.0, z = 8.3) between D16S10 and D16S4, which flank FRA16B. The markers D16S10 and D16S4 are in close proximity on the genetic map and delineate a small chromosomal segment, which contains the distamycin A-inducible fragile site. PMID- 2722189 TI - Newborn screening by DNA analysis of dried blood spots. AB - Amplification of DNA recovered from a dried blood spot was used to genotype individuals with sickle cell disease, sickle cell carriers, and controls. A single 200-microliters blood spot applied to a filter paper provides sufficient material for more than 20 genetic analyses. In addition, the stability of the DNA is such that adequate material for amplification can be isolated from dried blood spots up to a year following collection. The DNA analysis methods described in this study could be applied to large-scale screening of newborns for genetic disorders. PMID- 2722190 TI - Nucleolar structures in chromosome and SC preparations from human oocytes at first meiotic prophase. AB - We describe a comparative study of the behavior of nucleolar structures and their relationship with nucleolar chromosomes and synaptonemal complexes at first meiotic prophase of human oocytes in an attempt to elucidate the nature of this cellular organization and to learn more about maternal nondisjunction. The number of main nucleoli varies along the different stages of prophase I and is usually low. It shows an increase from leptotene to pachytene and a decrease from pachytene to diplotene related to a decrease and an increase of main nucleoli volume, respectively. The methodology employed has enabled us to analyze in detail dark bodies, round bodies, dense bodies, and main nucleoli in chromosome or synaptonemal complex spreads. The relationship between nucleolar chromosomes or synaptonemal complexes and the nucleoli implies the existence, in a very reduced space, of chromosomal regions that contain homologous sequences and that are often unpaired. This situation may facilitate the production of heterologous pairing and chromosomal exchanges between nonhomologous chromosomes and finally result in aneuploidy. Thus, the situation explained above together with the differences between the oocyte and spermatocyte NOR cycles could be one of the reasons for the higher incidence of aneuploidies of maternal origin at meiosis I. PMID- 2722192 TI - Determining informativity of marker typing for genetic counseling in a pedigree. AB - For the situation of a Mendelian disease linked to a genetic marker, a new method is described that allows evaluating for genetic counseling the information potentially available from the linked marker before the marker data are actually obtained, that is, prior to drawing blood for marker typing. For a consultand in a family pedigree, the method determines the risk distribution (small families) or an approximation to it (larger families) and calculates the probability that the risk will deviate beyond certain limits from its a priori value, which exists without marker data, for example, that the risk will be smaller than 0.10 or larger than 0.90. The method was applied here to a pedigree of 15 individuals for which analytical calculations would be difficult to carry out. PMID- 2722191 TI - Centromeric alpha satellite DNA amplification and translocation in an unusually large chromosome 14p+ variant. AB - We report cytogenetic and molecular studies on a family that carries, in the father, an unusually large chromosome 14p+ variant [WSi-var(14)(p+)] and, in one of his children, a translocation [DSi-der(14)] involving the variant chromosome. Increase in the size of WSi-var(14)(p+) was estimated to be approximately 35% that of a normal chromosome 14. Presence of extra chromosomal material in this variant chromosome was demonstrated by G-banding using trypsin and staining with Leishman, G-banding using bromodeoxyuridine (BrdU) and Giemsa, and R-banding using BrdU and Giemsa. This material was positive using C-banding with BaOH and staining with Giemsa and negative in DAPI/distamycin staining, suggesting that it contained repetitive DNA but probably not of the types found in the heterochromatic regions of chromosomes 1, 9, 15, 16, and Y. Staining of the nucleolus organiser region (NOR) with AgNO3 indicated the retention of the NOR in WSi-var(14)(p+) but not in DSi-der(14). In situ hybridisation of metaphase cells with an alpha satellite DNA probe specific for human acrocentric chromosomes demonstrated a significantly increased amount of centromeric alpha sequences in WSi-var(14)(p+). Most or all of the extra alpha sequences were retained in DSi der(14), indicating translocation near the very distal end of the enlarged region. The extra alpha satellite DNA material may have originated through amplification of some centromeric segments. The possible role of the amplified DNA in chromosomal translocations is discussed. PMID- 2722193 TI - Myotonia congenita (Thomsen's disease) excluded from the region of the myotonic dystrophy locus on chromosome 19. AB - Linkage analysis has been carried out in six German families with autosomal dominantly inherited myotonia congenita (Thomsen's disease) using five chromosome 19 markers known to be linked to the gene for myotonic dystrophy (DM). Two of the markers, APOC1 and APOC2, are tightly linked to DM. Close linkage between these markers and myotonia congenita (MC) has been excluded to a distance of 9 cM (z = 2.158). These data support the clinical suggestion that MC and DM are non-allelic disorders. PMID- 2722194 TI - Brachytelephalangic chondrodysplasia punctata: a possible X-linked recessive form. AB - The author describes four cases of chondrodysplasia punctata with an hypoplasia of the distal phalanges of the fingers. In these cases, growth disturbance is moderate without asymmetry of the limbs, and the facial dysmorphism is similar to that found in Binder's maxillo-facial dysostosis. The phalangeal anomaly is very important for the diagnosis of chondrodysplasia punctata at an age when epiphyseal stippling is no longer present. The relationship of this form of chondrodysplasia with cases in which there is a deletion of the terminal short arm of the X chromosome is discussed. A possible hypothesis is that this form, which is always observed in males, is secondary to an isolated mutation of the Xp localized gene. PMID- 2722195 TI - Characterization of a panel of somatic cell hybrids for subregional mapping along 11p and within band 11p13. Subdivision of the WAGR complex region. AB - The short arm of chromosome 11 carries genes involved in malformation syndromes, including the aniridia/genitourinary abnormalities/mental retardation (WAGR) syndrome and the Beckwith-Wiedemann syndrome, both of which are associated with an increased risk of childhood malignancy. Evidence comes from constitutional chromosomal aberrations and from losses of heterozygosity, limited to tumor cells, involving regions 11p13 and 11p15. In order to map the genes involved more precisely, we have fused a mouse cell line with cell lines from patients with constitutional deletions or translocations. Characterization of somatic cell hybrids with 11p-specific DNA markers has allowed us to subdivide the short arm into 11 subregions, 7 of which belong to band 11p13. We have thus defined the smallest region of overlap for the Wilms' tumor locus bracketed by the closest proximal and distal breakpoints in two of these hybrids. The region associated with the Beckwith-Wiedemann syndrome spans the region flanked by two 11p15.5 markers, HRAS1 and HBB. These hybrids also represent useful tools for mapping new markers to this region of the human genome. PMID- 2722196 TI - Amplification of satellite III DNA in an unusually large chromosome 14p+ variant. AB - A phenotypically normal male (WSm) was found to have an unusually large short arm of chromosome 14. Increase in the size of this variant chromosome [Wsm-var(14)] was estimated to be approximately 30% that of a normal chromosome 14 by G-banding using trypsin and staining with Leishman. The extra chromosomal material was positive in CBG staining (C-banding using BaOH and staining with Giemsa), suggesting the presence of repetitive DNA. In situ hybridisation using repetitive probes demonstrated this material to be strongly positive for satellite III DNA, and negative for Y-specific heterochromatic DNA. Hybridisation with an alpha DNA probe specific for human acrocentric chromosomes indicated the retention of the centromere, and the absence of alpha DNA in the extra chromosomal material. We propose the origin of the extra chromosomal material in WSm-var(14) to be a result of amplification of contiguous satellite III DNA that is normally present in the short arm of chromosome 14. This variant chromosome does not appear to be associated with the abnormal phenotype in WSm's daughter who is mentally retarded and carries a t(1;?)(q41;?) translocation of chromosome 1. PMID- 2722197 TI - Family study of common fragile sites. AB - The frequency of folate-sensitive common fragile sites (1p31, 1q44, 3p14, 3q26.2, 6q26, 16q23, Xp22.3) was determined in 19 healthy individuals from four families. The individuals consisted of 12 males and 7 females from 1 to 59 years of age. The frequency showed intrafamilial variation, but we were unable to demonstrate that the frequency was inherited in a Mendelian codominant fashion. In eight subjects whose chromosome 3 homologues could be distinguished by Q-band polymorphism, breakages at 3p14 occurred with equal frequencies on the homologues. Our study suggests that common fragile sites are a part of normal chromosome structure, and the frequency of their expression largely depends on environmental factors. PMID- 2722198 TI - Demonstration of spontaneous XX/XY chimerism by DNA fingerprinting. AB - The M13 bacteriophage probe, which makes possible the establishment of DNA fingerprints, was used to study a phenotypically normal woman with a 46XY karyotype and her twin brother. Identical fingerprints and positive hybridization with a series of Y-specific probes were obtained on blood samples from the siblings. DNA from a skin biopsy of the woman yielded a clearly different pattern and displayed no Y-specific hybridization, indicating that she is a spontaneous chimera. This study illustrates the use of DNA fingerprinting as a powerful and simple aid to the diagnosis of natural chimerism. PMID- 2722199 TI - Partial trisomy of distal 8q derived from mother with mosaic 8q23.3----24.13 deletion, and relatively mild expression of trichorhinophalangeal syndrome I. AB - A 17-month-old girl with a partial trisomy of distal 8q derived from her mother, who has a mosaic 8q23.3----q24.13 deletion, was studied. Both showed a relatively mild phenotype of trichorhinophalangeal syndrome I. The karyotype of the proposita was designated as: 46,XX,-8,+der(8),inv ins(8;8)(p23.1;q24.13q23.3)mat. Her phenotype was considered similar to that of her mother despite the trisomies of distal 8q. She seems to be the first example of a partial trisomy of distal 8q derived from a parent with an interstitial deletion of a distal 8q segment and trichorhinophalangeal syndrome I. PMID- 2722200 TI - Use of linkage disequilibrium data in prenatal diagnosis of cystic fibrosis. PMID- 2722201 TI - Medical applications of artificial intelligence and information systems. PMID- 2722202 TI - Medical application of artificial intelligence and information systems. PMID- 2722203 TI - Sleep staging automaton based on the theory of evidence. AB - This paper addresses sleep staging as a medical decision problem. It develops a model for automated sleep staging by combining signal information, human heuristic knowledge in the form of rules, and a mathematical framework. The EEG/EOG/EMG events relevant for sleep staging are detected in real time by an existing front-end system and are summarized per minute. These token data are translated, normalized, and constitute the input alphabet to a finite state machine (automaton). The processed token events are used as partial belief in a set of anthropomimetic rules, which encode human knowledge about the occurrence of a particular sleep stage. The Dempster-Shafer theory of evidence weighs the partial beliefs and attributes the minutes sleep stage to the machine state transition that displays the highest final belief. Results are briefly presented. PMID- 2722204 TI - Knowledge-based approach to sleep EEG analysis--a feasibility study. AB - A knowledge-based approach to automated sleep EEG (electroencephalogram) analysis is described. In this system, an object-oriented approach is followed in which specific waveforms and sleep stages ("objects") are represented in terms of frames. The latter capture the morphological and spatio-temporal information for each object. An object detection module ("frame matcher"), operating on the frames, is employed to identify what features need to be extracted from the EEG and to trigger the appropriate "specialist"--specialized signal processing modules--to obtain values for these features. This leads to an opportunistic approach to EEG interpretation with quantitative information being extracted from the signal only when needed by the reasoning processes. The system has been tested on the detection of K complexes and sleep spindles. Its performance indicates that the approach followed is feasible and can become a powerful tool for automated EEG interpretation. PMID- 2722205 TI - OVERSEER: a prototype expert system for monitoring drug treatment in the psychiatric clinic. AB - This paper describes the development of OVERSEER: a prototype knowledge-based system that monitors the drug treatment of psychiatric patients in real time. Using treatment protocols developed by the expert clinician, OVERSEER monitors the drug treatment process and issues alerts when standard clinical practices are not followed or when laboratory results are abnormal. Written in Prolog, OVERSEER is designed to interface directly with the hospital's database, and, thereby, utilizes all available pharmacy and laboratory data. Moreover, unlike the interactive expert systems developed for the psychiatric clinic, OVERSEER does not require extensive data entry by the clinician. Consequently, the chief benefit of OVERSEER's monitoring approach is the unobtrusive manner in which it evaluates psychopharmacological treatment and provides information regarding patient management to the hospital. PMID- 2722206 TI - Monitor: an expert system that validates and interprets time-dependent partial data based on a cystic fibrosis home monitoring program. AB - The use of health diaries to monitor patients with chronic diseases has often been complicated by difficulties encountered in data quality assurance and interpretation. An expert system, Monitor, has been developed to predict the health status of cystic fibrosis patients based on daily home measurements of pulse, respiratory rate, weight, inspired vital capacity, and a check list of symptoms of acute illness. This system ensures data reliability beyond what can be achieved in most current automatic error detection procedures by validating inputs against patient-specific expectations. Its explicit representation of the time dimension and the hierarchical structure of its knowledge base facilitate the abstraction of trends and relationships among the time-dependent data. Dynamically imposed expectations also lend flexibility to the interpretation process by allowing the processing of partial (incomplete) data. Monitor correctly classified 86 percent (three-category classification) and 94 percent (two-category classification) of 111 cases. This demonstrates that expert systems can be a feasible approach in building more robust diary monitoring systems. PMID- 2722207 TI - ESTER: an expert system for management of respiratory weaning therapy. AB - The withdrawal of mechanical ventilation generally presents no problems if carried out when the values of certain predictive physiological variables suggest that the patient will be able to breathe for him or herself. In certain cases, however, a more gradual weaning procedure is necessary, in which the amount of mechanical assistance provided is in some way reduced little by little. One of the usual means of achieving this gradual reduction is by intermittent mandatory ventilation (IMV), in which short bursts of mechanical ventilation are separated by progressively longer periods of "ventilator silence" which stimulate the patient's endogenous respiration. ESTER is an expert system in which the most widely accepted criteria are systematically called upon to supply advice to the clinician who has to prescribe a respiratory therapy regime suited to the needs of the patient. After effecting a preliminary prognosis of the patient's condition, ESTER asks for certain physiological parameters to be keyed in. Analysis of these parameters reveals the patient's condition and allows a recommended respiratory therapy to be designed. PMID- 2722208 TI - Production and characterization of murine monoclonal antibody to human alpha lactalbumin. AB - Human alpha-lactalbumin (alpha-LA), a milk protein normally produced by, and restricted to, functionally differentiated breast epithelial cells has been shown immunohistochemically to be a good marker for breast cancer. Antibodies with specificity only for human alpha-LA have not previously been reported. The present study documents the production and characterization of an IgG1 murine monoclonal antibody with specificity restricted only to human alpha-LA. This monoclonal antibody, designated ET-1, was purified by affinity chromatography using human alpha-LA. Specificity of ET-1 for human alpha-LA was established by enzyme linked immunosorbent assay (ELISA), absorption studies, immunoprecipitation and by immunoblotting. ET-1 binds to human alpha-LA with a KD of 7.41 x 10(-8) mol/l and does not cross-react with bovine alpha-LA. This unique reactivity of ET-1, which is not inherently shared by polyclonal antisera, should enable the antibody to be used for the development of a sensitive immunoassay for circulating human alpha-LA. PMID- 2722209 TI - Effect of Santoquin on humoral immune function in mice: lack of interference with selenium utilization. AB - Santoquin (0.25% by weight) in the diets of mice receiving adequate dietary selenium (1.0 parts/10(6] reduced the humoral immune response, as monitored by the plaque-forming cell assay, to levels exhibited by mice maintained on selenium deficient diets (0.005 parts/10(6)). Mice exhibiting this suppression of immunity had levels of blood glutathione peroxidase, serum selenium, and liver DNA, RNA and protein similar to mice receiving selenium only. Therefore, it was concluded that Santoquin is not immunosuppressive by interfering with selenium metabolism or general tissue function, but by other unknown mechanisms. PMID- 2722210 TI - The role of immunology in the development of clinical transplantation. PMID- 2722211 TI - Efficacy of serum sialoglycoproteins as a biomarker of the disease activity & treatment monitoring in patients with base tongue malignancy. AB - Serum levels of sialoglycoprotein constituents i.e., sialic acid, seromucoid hexoses, and mucoid proteins were determined in 34 patients with base tongue malignancy and 15 controls matched for age and sex. All three constituents were found to be significantly raised; however, only sialic acid levels increased with the severity of the disease. More than 92 per cent of the patients in each clinical stage showed abnormal values of hexoses and mucoid proteins in seromucoids. Electrophoretic separation showed a split in alpha-2-glycoprotein at pretreatment time in 67.6 per cent of the patients. On administration of radiotherapy, all three fractions decreased while alpha-2- split disappeared in 61.8 per cent patients and gamma glycoprotein peak emerged at the end of the protocol with a parallel decrease in these three constituents. It may be concluded from the data that serum sialoglycoproteins can be useful to monitor therapy in base tongue malignancy patients. PMID- 2722212 TI - Diagnostic value of carcinoembryonic antigen assay of pleural & peritoneal effusions in malignancy. AB - Carcinoembryonic antigen (CEA) assays were performed on effusion fluid and plasma samples of 55 patients; 38 with malignant and 17 with benign disease. Sensitivity of plasma CEA was 60.5 per cent while specificity was 76.5 per cent. Sensitivity of effusion fluid CEA was 52.63 per cent but specificity was 100 per cent. Sensitivity of the cytological examination of the fluid was 60.5 per cent and no false positive diagnosis was made. Detection rate of malignancy increased to 81.6 per cent (31 of 38) when cytology and effusion fluid CEA were used in adjunction for diagnosis, with 100 per cent specificity. PMID- 2722213 TI - Aminopyrine-N-demethylase activity of rat liver after administration of crude cannabis extract. AB - The effect of cannabis extract, on the hepatic aminopyrine-N-demethylase activity was studied in rats. Daily administration of cannabis extract for 15 consecutive days increased the aminopyrine-N-demethylase activity which was significant on day 15 post-treatment at 2 and 10 mg/kg doses. At 20 mg/kg, a significant increase was observed from day 7 which continued up to day 15. These findings suggest that cannabis extract can induce hepatic aminopyrine-N-demethylase activity. PMID- 2722214 TI - Prevalence of haemoglobin D in Uttar Pradesh. AB - Haemolysates from 1098 unrelated individuals residing at Lucknow were investigated for haemoglobin variants by cellogel electrophoresis. Haemoglobin 'D' trait was found in 16 subjects (1.5%). The prevalence of Hb-D trait in Khatris was 3.1 per cent compared to 0.5 per cent in other Hindus. One case of Hb D trait with thaiassaemia was also seen in a Muslim girl. PMID- 2722216 TI - Effect of chronic opioid administration on glycosylated haemoglobin levels in heroin addicts. AB - Levels of stable form of HbA1 in blood were estimated in 20 male heroin addicts, so as to assess the effect of chronic opioid use on glucose metabolism. No significant difference in the levels of stable form of HbA1 was observed in the heroin addicts as compared to controls, indicating absence of any long-term impairment of glucose tolerance in heroin addicts. PMID- 2722215 TI - Structural changes in human cervical mucus. AB - The crystallization phenomenon of human cervical mucus was investigated with the help of scanning electron microscope. Changes in the conformation of crystals and ferning patterns were studied on different days of the menstrual cycle in both normally ovulating women and those using oral contraceptives. No crystalline structure was found on day 5 in both categories of women, whereas square crystals were observed on day 21 in normal woman. Nature and type of ferning pattern changes seen from days 11 to 14 in normal women were not seen during this period in women who were on oral contraception, instead a thick, viscous mucus was found during the entire period of the cycle. PMID- 2722217 TI - Lipids changes in alcoholic & non-alcoholic cirrhotics. AB - Fasting plasma samples from 29 patients of cirrhosis were analysed for cholesterol and triglycerides and their lipo-protein fractions. The patients included 11 alcoholic cirrhotics consuming over 130 g/day of absolute ethanol and 18 non-alcoholic cirrhotics. The difference in lipid values between the two patient groups was not significant except that VLDL cholesterol was raised in alcoholic cirrhotics (P less than 0.05). However, in comparison to normal healthy controls, the values were significantly altered. The dietary intake, in the two groups showed no difference, except that non-alcoholic cirrhotics consumed more animal proteins. Low intake of exogenous fat and reduced synthesis of endogenous cholesterol in cirrhotic patients seemed to influence the total lipid values. PMID- 2722218 TI - Cardiac sarcolemma enzymes & liver microsomal cytochrome P450 in isoproterenol treated rats. AB - In the heart sarcolemma and sarcoplasmic reticulum of rat there was significant decrease in cholesterol and phospholipid levels in isoproterenol treated rats. The membrane enzymes lipoprotein lipase and Ca-ATPase decreased due to myocardial necrosis. Lipid peroxide and xanthine oxidase were significantly enhanced, whereas superoxide dismutase was markedly decreased in ischemic heart produced by isoproterenol. Cytochrome P450, b5 and heme were found to be degraded in myocardial cell damage. Guggulsterone showed a marked protective effect on the cardiac enzymes and cyt P450 system against myocardial necrosis induced by isoproterenol. PMID- 2722219 TI - Protein synthesis in human foetal brain & liver. AB - Anthropometric measurements were carried out on 772 normal human foetuses in Medical Termination of Pregnancy Clinics in Calcutta. Foetal brain constituted 14 per cent of body weights from 9 to 24 wk of gestation. The protein content/g of the foetal livers increased during 9-24 wk of gestation whereas that of the brain decreased slightly during this period. The rate of incorporation of 14C-leucine into 16,000 x g supernatant fractions of human foetal liver increased with progress of gestation. In foetal cerebrum and midbrain, the incorporation rate increased from 13 to 20 wk of gestation and then decreased. 16,000 x g pellet fractions of human foetal liver showed an increase of leucine incorporation with progress of gestation. However, the rate of incorporation in the foetal cerebrum was nearly the same at different periods of gestation. PMID- 2722220 TI - Effect of an Ayurvedic compound preparation on the ability of rat urine to influence mineral phase formation. AB - Rat urine could inhibit not only the in vitro initial precipitation of calcium and phosphate/oxalate ions as mineral phase but also the subsequent growth of the preformed mineral phase. Oral administration of the aqueous extract of a commercially available Ayurvedic compound preparation to rats, was found to significantly increase the ability of the urine samples to inhibit both the initial mineral phase formation and its subsequent growth. PMID- 2722221 TI - Synergistic promoter effect of diethylstilbesterol & phenobarbitone in diethylnitrosamine induced hepatic neoplasia in rats. AB - An experimental model was designed to study the role of both diethylstilbesterol (DES) and phenobarbitone (PB) singly or in combination, in diethylnitrosamine (DEN) induced hepatic neoplasia. Experimental and control rats were injected DEN (200 mg/kg) or saline, ip. Acute morphological changes were studied at days 1, 2 and 3; and at weekly intervals for 3 wk. Four weeks after DEN pretreatment the experimental and control rats were randomized into various groups and fed DES (T1), PB (T2) or a combination of both DES and PB (T3). Five rats from each experimental group were sacrificed at 10, 20 and 30 wk. Group T3 showed gross nodules with a mean nodule score of 20.5 mm at 20 wk. Nodule score in T1, T2 and T3 at 30 wk were 7, 9 and 34.5 mm respectively. The sequential morphological lesions encountered were clear cell and acidophilic foci; acidophilic, basophilic and mixed nodules. Haemorrhage within the nodules was frequent when DES was administered either alone or in combination with PB. Oval cell proliferation and cholangiocellular lesions were produced in all experimental groups. Foci and nodules generally showed loss of glucose-6 phosphatase, adenosine triphosphatase and invariable presence of gamma-glutamyl transpeptidase and glycogen. A combination of DES and PB as promoter yielded earliest and highest nodule score. This suggests that DES and PB acted synergestically as promoters or that PB caused enzyme induction thereby enhanced the promotive effect of DES. PMID- 2722222 TI - Cardiovascular regulatory functions in elderly patients with hypertension. AB - To dissociate the effects of an elevated blood pressure on the cardiovascular regulatory functions from those of aging in the hypertensive elderly individual, resting hemodynamic measurements and circulatory autonomic functions in 30 elderly (mean age, 66 years) hypertensive (World Health Organization stages I and II) patients were compared with those in 30 healthy elderly (mean age, 65 years) normotensive volunteers. The elderly hypertensive group showed a significantly lower cardiac index and higher total peripheral resistance. beta-Receptor sensitivity, as determined by chronotropic dose of infused isoproterenol, and baroreceptor reflex sensitivity index, derived from phase II, but not phase IV, of Valsalva's maneuver, were only slightly but significantly reduced in the hypertensive group. The variability of heart rate at rest as an index of parasympathetic control of heart was similar between these two groups. Plasma norepinephrine level was significantly inversely related to resting mean blood pressure (r = -0.31, p less than 0.05) when analyzed as a whole group. Plasma renin activity, but not plasma aldosterone, was significantly decreased in the hypertensive group. To define the effects of age itself, these parameters in normotensive elderly subjects were also compared with those in 12 young normotensive subjects (mean age, 23 years). Although resting hemodynamic measurements did not differ, various circulatory autonomic functions were significantly different between these two age groups. The variability of heart rate in 24-hour ambulatory monitoring, beta-receptor responsiveness, resting vagal cardiac activity, and baroreceptor reflex sensitivity derived from phase IV of Valsalva's maneuver were significantly depressed in the elderly. Resting plasma norepinephrine level was elevated and renin-aldosterone system decreased in the elderly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722223 TI - Sodium-lithium countertransport and blood pressure: the Gubbio Population Study. AB - The relation of red blood cell sodium-stimulated lithium countertransport to blood pressure (BP) and prevalence of hypertension was assessed in univariate and multivariate analyses for 2,748 men and women aged 25-74 years who participated in the baseline examination of the Gubbio Population Study in north central Italy. Since age-specific countertransport values were consistently higher for men than women, all analyses were done for men and women separately. In simple correlation analyses, countertransport was significantly related to systolic and diastolic BP in both sexes (r values 0.107-0.163). In age-adjusted analyses, countertransport was significantly related to BP level of both men and women not receiving antihypertensive treatment; mean levels were high for hypertensive persons receiving antihypertensive therapy compared with normotensive persons. Age-adjusted prevalence rates of hypertension were progressively higher for both sexes in successively higher quintiles of countertransport, almost twice as high for those in the highest quintile compared with those in the lowest quintile. Correspondingly, age-adjusted logistic regression analyses showed countertransport to be related significantly to prevalence of hypertension for both men and women (p less than 0.001). Since age, body mass index, plasma total cholesterol, uric acid, glucose, urinary sodium/potassium excretion, pulse, and (for men) daily alcohol intake also were significantly correlated with BP, and in some instances with countertransport, relation of countertransport to BP was also assessed in multivariate analyses with control for these variables.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722224 TI - Hydrocortisone-induced hypertension in humans: pressor responsiveness and sympathetic function. AB - Oral hydrocortisone increases blood pressure and enhances pressor responsiveness in normal human subjects. We studied the effects of 1 week of oral hydrocortisone (200 mg/day) on blood pressure, cardiac output, total peripheral resistance, forearm vascular resistance, and norepinephrine spillover to plasma in eight healthy male volunteers. Although diastolic blood pressure remained unchanged, systolic blood pressure increased from 119 to 135 mm Hg (SED +/- 3.4, p less than 0.01), associated with an increased cardiac output (5.85-7.73 l/min, SED +/- 0.46, p less than 0.01). Total peripheral vascular resistance fell from 15.1 to 12.2 mm Hg/l/min (SED +/- 1.03, p less than 0.05). Resting forearm vascular resistance remained unchanged, but the reflex response to the cold pressor test was accentuated, the rise in resistance increasing from 10.5 mm Hg/ml/100 ml/min (R units) before treatment to 32.6 R units after treatment (SED +/- 6.4, p less than 0.025). The rise in forearm vascular resistance accompanying intra-arterial norepinephrine (25, 50, and 100 ng/min) was also significantly greater after hydrocortisone, increasing from an average of 14.9 +/- 2.4 R units before treatment to 35.1 +/- 5.5 R units after hydrocortisone (SED +/- 6.0, p less than 0.05). A shift to the left in the dose-response relation and fall in threshold suggested increased sensitivity to norepinephrine after treatment. Measurement of resting norepinephrine spillover rate to plasma and norepinephrine uptake indicated that overall resting sympathetic nervous system activity was not increased. The rise in resting blood pressure with hydrocortisone is associated with an increased cardiac output (presumably due to increased blood volume).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722225 TI - Lipid alterations in renal membrane of stoke-prone spontaneously hypertensive rats. AB - Phospholipase A2 activity, phospholipids, and phospholipid fatty acids were investigated in renal membrane of male stroke-prone spontaneously hypertensive rats (SHRSP) and age-matched Wistar-Kyoto rats. Renal phospholipase A2 activity increased and membranous phospholipids especially phosphatidylcholine and phosphatidylethanolamine, decreased with age in SHRSP. Arachidonate in phospholipid also decreased with age in SHRSP. To determine the effect of pressure load on the lipid alterations in renal membrane, SHRSP that received antihypertensive treatment with hydralazine, enalapril, or nicardipine for 5 weeks were compared with those without treatment. Antihypertensive treatments prevented phospholipid degradation and increased arachidonate in phospholipid relative to the control group. Phospholipase A2 activity in each group treated with antihypertensive drugs did not differ from that in the control group. These results suggest that the course of hypertension causes renal membranous phospholipid degradation and increases phospholipase A2 activity. Antihypertensive treatments may prevent these lipid alterations in SHRSP. These renal membranous structural changes may provide an explanation not only for functional abnormalities such as decreased membrane fluidity but also for the progress of hypertension. PMID- 2722226 TI - Ploidy in mesenteric vessels of aged spontaneously hypertensive and Wistar-Kyoto rats. AB - Long-term regulation of blood pressure in a hypertensive rat may be mediated by elevated DNA content of smooth muscle cells of resistance vessels. This study explores DNA changes represented by an increased frequency of polyploid cells in multiple levels of the mesenteric arterial tree of spontaneously hypertensive rats (SHR) and age-matched Wistar-Kyoto (WKY) control rats. Two ages were examined: 45 and 78-80 weeks of age. SHR and WKY rats did not differ in frequency of polyploid cells at any mesenteric branch level at either age. Although hypertension per se seemed not to be a factor, both species showed increased numbers of polyploid cells with aging at certain branch levels of the mesenteric arterial tree. The data in the current study support the idea that hypertension and aging may result in similar and possibly additive changes in DNA in the vessel wall. PMID- 2722227 TI - Effects of perfusion pressure on energy and work of isolated rat hearts. AB - A chemomechanical study of hypertrophied hearts of 6-month-old spontaneously hypertensive rats (SHR) and that of age-matched Wistar-Kyoto (WKY) rats was carried out, analyzing the response of the heart to steady-state changes in coronary perfusion pressure. The ratio of heart (dry)-to-body (wet) weight of WKY rats was 0.37 +/- 0.02 (10(-3] and for SHR was 0.58 +/- 0.03 (10(-3] (p less than 0.01). In the apex-ejecting, isolated, pyruvate-perfused working hearts of WKY rats and SHR, coronary flow was constant when coronary perfusion pressure was set between 140 and 190 cm H2O (range of autoregulation). Coronary flow was perfusion pressure dependent when the coronary perfusion pressure was set below 110 cm H2O for both WKY rats and SHR. Cardiac output, developed pressure, rate of pressure development (dP/dt), and oxygen consumption were constant in the range of autoregulation but decreased in the direction of coronary flow when coronary flow was reduced by a drop in perfusion pressure. Similarly, the phosphorylation potential, phosphocreatine, adenosine triphosphate, and cyclic adenosine monophosphate were constant in the range of autoregulation but decreased directionally with coronary perfusion pressure below 110 cm H2O for both SHR and WKY rats. There was a significantly lower phosphorylation potential in SHR as compared with WKY rats when coronary perfusion pressure was reduced to 80 cm H2O. In the region of autoregulation, coronary flow and oxygen consumption were significantly less in SHR, although developed pressure was significantly greater at both high and low workloads.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722228 TI - [40 years of nursing care; a history of the future]. PMID- 2722229 TI - [Approach to the dying. Role of the family and of the caregiver]. PMID- 2722230 TI - [The survivors after a suicide]. PMID- 2722231 TI - [Education at your service]. PMID- 2722232 TI - [High-risk patients taking NSAIDs are threatened with dangerous complications]. PMID- 2722233 TI - [Your obligation to educate and to inform]. PMID- 2722234 TI - [Liking one's profession, a question of balance]. PMID- 2722235 TI - Subunit structure of the variable V-1 antigen of Mycoplasma pulmonis. AB - It was previously shown that multiple structural variants of the V-1 antigen (variable antigen 1) of Mycoplasma pulmonis could be found within a single strain. This antigen is unusual in that it produces a ladder pattern after sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The present study showed that some variants of V-1 could be extracted into the aqueous phase of a phenol-H2O system. Analysis with anti-V-1 monoclonal antibodies showed that the phenol-H2O-extracted V-1 had a regular spacing of 3.1 kilodaltons (kDa) between bands and trypsinization of this extracted V-1 resulted in the gradual symmetrical collapse (2.9-kDa increments) of the ladder into a single band, suggesting the presence of multiple identical subunits within the V-1 structure. The upper band from the phenol-H2O-extracted V-1 was isolated and analyzed by SDS polyacrylamide gel electrophoresis immunoblotting, resulting in the regeneration of the original ladder pattern with 3.1-kDa spacing between bands. When V-1 was boiled for increasing times in the presence of SDS, the staining intensity of the upper band decreased with the concurrent appearance of additional lower-molecular weight bands. Finally, by using whole cells, it was found that the lower molecular-weight species of the ladder pattern selectively partitioned into the hydrophobic phase of a Triton X-114 phase partitioning system, and the higher molecular-weight bands were found in the aqueous phase. These data indicate that the V-1 bands are composed of subunits which may aggregate via hydrophobic interactions and that these aggregates at least partially dissociate when exposed to harsh denaturing conditions, resulting in the characteristic ladder pattern of V-1. PMID- 2722236 TI - Plasmid-influenced changes in Mycobacterium avium catalase activity. AB - A virulent Mycobacterium avium strain, LR25, which carries three plasmids (18, 28, and 165 kilobases) and grows at 43 degrees C was compared with its plasmid free, avirulent segregant, strain LR163, to identify the basis for the latter's inability to grow at 43 degrees C. The failure of mid-log-phase cultures of strain LR163 to grow at 43 degrees C was dependent on the presence of high levels of culture aeration. In addition, highly aerated cultures of strain LR163 failed to grow at 37 degrees C. Mid-log-phase cultures of strain LR163 had 30% of the catalase activity of strain LR25 and were more hydrogen peroxide (0.08%, wt/vol) susceptible. Catalase activity of strain LR25 was higher in cultures grown with high aeration than in those grown with almost no aeration. These data support the contention that plasmid-encoded genes influence M. avium catalase activity. PMID- 2722237 TI - Dependence of proliferation of Bacteroides forsythus on exogenous N-acetylmuramic acid. AB - Bacteroides forsythus is the first wild-type or mutant bacterium found to require exogenous N-acetylmuramic acid for proliferation and maintenance of cell shape. This implies so far unknown pathways for peptidoglycan synthesis and a strict dependence of B. forsythus on other bacteria in its oral habitat. Addition of N acetylmuramic acid to conventional bacteriological media allows routine cultivation of this fastidious organism. PMID- 2722238 TI - Immune response to dimeric subunits of the pertussis toxin B oligomer. AB - Immunization of mice with the dimeric subunits of pertussis toxin (S2-S4 and S3 S4) induced an antibody response detectable by enzyme-linked immunosorbent assay and immunoblot techniques. These antibodies were able to neutralize the ability of pertussis toxin to alter the morphology of Chinese hamster ovary cells. Mice immunized with the dimers were also protected against the leukocytosis-promoting effects of toxin. Based on these data, the dimers of pertussis toxin may be considered for further study as potential vaccine candidates. PMID- 2722239 TI - Retention of bacterial lipopolysaccharide at the site of subcutaneous injection. AB - The tissue distribution of Klebsiella pneumoniae O3 lipopolysaccharide (KO3 LPS) was studied in mice injected subcutaneously (s.c.) or intraperitoneally (i.p.) with 125I-labeled KO3 LPS. Marked retention of KO3 LPS radioactivity could be found at the site of s.c. injection for several weeks. On the other hand, about 85% of the radioactivity rapidly disappeared from the peritoneal cavity within 6 h after i.p. injection. The long-term presence of KO3 LPS at the injection site was also supported by experiments with 51Cr-labeled KO3 LPS and immunoblotting and immunofluorescence staining methods. The R-form LPS lacking the O-specific polysaccharide chain of KO3 LPS and the lipid A fraction of KO3 LPS seemed to remain at the site in larger amounts and for longer times than KO3 LPS. There were no marked differences in the retention pattern at the injection site among KO3 LPS, Escherichia coli LPS, Salmonella typhosa LPS, and Salmonella enteritidis LPS. However, much less radioactivity accumulated in the livers and spleens of mice injected with either KO3 LPS or S. typhosa LPS compared with the other LPS preparations. It was suggested that retention of LPS at the site of s.c. injection may play an important role in the development of various biological actions of s.c. injected LPS. PMID- 2722240 TI - Vibrio cholerae expresses cell surface antigens during intestinal infection which are not expressed during in vitro culture. AB - Vibrio cholerae O1 bacteria harvested directly from ligated or nonligated intestines of rabbits with experimental cholera expressed at least 7 to 8 novel, in vivo-specific cell envelope (env) proteins that were not found on vibrios after in vitro culture in various ordinary liquid media. At the same time, several of the env proteins ordinarily expressed in vitro had disappeared or become much reduced. The infection-induced novel env protein were immunogenic. In immunoblot analyses, antisera raised against in vivo-grown vibrios and then absorbed with in vitro-grown bacteria of the same strain specifically stained at least eight infection-induced antigens ranging from 62 to approximately 200 kilodaltons; absorption with washed in vivo-grown bacteria, on the other hand, removed the antibodies reacting with these antigens, indicating that the antigens were present on the bacterial cell surface. Conversely, antiserum against in vitro-grown bacteria reacted with several env antigens in in vitro-grown bacteria that were missing in the infection-derived vibrios. These adaptational changes were strikingly similar for different strains of cholera vibrios of both classical and El Tor biotypes. Most of the in vivo-specific proteins (with apparent molecular masses of approximately 200, approximately 150, approximately 140, 92, 68, 62, 43, and 29 kilodaltons) were not induced during cultivation of bacteria in iron-depleted medium and are probably not related to the iron regulated env proteins known to be involved in iron transport systems. PMID- 2722241 TI - Two-dimensional gel electrophoresis and immunoblotting of Campylobacter pylori proteins. AB - Whole-cell, outer-membrane protein, flagellum-associated antigens and partially purified urease of Campylobacter pylori were analyzed by two-dimensional gel electrophoresis. C. pylori strains were readily distinguished from strains of Campylobacter jejuni, C. coli, and C. fetus by absence of major outer membrane proteins with Mrs of 41,000 to 45,000. C. pylori strains also lacked the acidic surface-array proteins at Mr 100,000 to 149,000 identified previously in serum resistant strains of C. fetus. Surface labeling of intact C. pylori cells with 125I revealed two common major proteins, which we have designated protein 2 (pI 5.6 to 5.8, Mr 66,000) and protein 3 (pI 5.2 to 5.5, Mr 63,000). Proteins 2 and 3 were also the major components (subunits) observed in partially purified urease. Partially purified preparations of flagella consistently contained proteins 2 and 3. Thus, urease appears to be associated with both outer membranes and flagella of C. pylori. C. pylori strains also possessed an antigen at Mr 59,000 which was cross-reactive with antiserum against flagella of C. jejuni. However, the antigen did not appear to be associated with flagella per se in C. pylori. Protein 2 was unique to C. pylori among the Campylobacter species studied. It was not recognized by antibody against whole cells of C. jejuni or C. fetus or flagella of C. jejuni. Protein 3 was cross-reactive with antiserum against whole cells of C. jejuni and C. fetus, as were several other major protein antigens. Because protein 2 is a major outer membrane protein that is apparently unique to C. pylori, development of monospecific antibodies against this antigen may be useful for the identification of C. pylori in tissues, and purified antigen may be useful for serologic tests for specific diagnosis of C. pylori infections. PMID- 2722242 TI - Enhancement of immunoglobulin G responses in mice against hepatitis B virus surface antigen, influenza virus hemagglutinin vaccine, and tetanus toxoid by 6-O acylated muramyl dipeptides. AB - The adjuvant activity of chemically synthesized 6-O-acylated muramyl dipeptides (MDP) was tested in aqueous form. The activity was assessed by determining immunoglobulin G (IgG) titers in sera of mice immunized with hepatitis B virus surface antigen, influenza virus hemagglutinin (HA) vaccine, or tetanus toxoid with an enzyme-linked immunosorbent assay. Administration of 6-O-acyl-MDP analogs with antigens induced marked enhancement of primary and secondary IgG antibody responses and maintained high antibody levels for at least 7 weeks. Among the analogs tested, an MDP methyl ester carrying a 6-O-3-hexadecanoyl oxytetradecanoyl group (compound 309) exhibited the most intensive adjuvant activity. Its activity was stronger than that of 6-O-2-tetradecylhexadecanoyl (B3O)-MDP used as a positive control. However, accumulation of peritoneal cells and activation of peritoneal macrophages by compound 309 was weaker than that by 6-O-B30-MDP, suggesting that 309 as an immunoadjuvant is more suitable for vaccination in terms of its stronger enhancement of antibody formation and lower induction of inflammatory response than 6-O-B30-MDP. PMID- 2722243 TI - Lectinlike properties of pertussis toxin. AB - We have examined the lectinlike properties of pertussis toxin by binding inhibition assays and affinity chromatography of goose erythrocyte membranes. Although pertussis toxin and wheat germ agglutinin apparently recognize similar sugar sequences on glycoproteins, the binding activities of the two lectins are not identical. PMID- 2722244 TI - Effect of a purA mutation on efficacy of Salmonella live-vaccine vectors. AB - We made delta aroA, delta purA, and delta aroA delta purA derivatives of a strain of Salmonella dublin and isolated a nalidixate-resistant mutant of each construct. An inoculum of each of the nearly isogenic nalidixate-resistant auxotrophs was administered to BALB/c mice by gavage. The ability of each strain to colonize, invade, persist in tissues, and evoke serum and mucosal antibody responses to the lipopolysaccharide of the parent strain was examined. Only the delta aroA strain colonized, invaded, persisted, and (more importantly) evoked sustained significant serum and mucosal antibody responses. Neither the delta purA nor the delta aroA delta purA strain showed any of these abilities. These observations demonstrate that the purA defect, which causes a requirement for adenine, reduces the live-vaccine efficacy of attenuated Salmonella strains and may limit the effectiveness of Salmonella strains as carriers of heterologous antigens. These findings may be important in the selection of attenuated S. typhi strains for use in humans either as antityphoid live vaccines or as vectors for antigens of other pathogens. PMID- 2722245 TI - Characterization of the selective inhibition of growth of virulent Legionella pneumophila by supplemented Mueller-Hinton medium. AB - The phenotypic difference between virulent and avirulent Legionella pneumophila with regard to growth on supplemented Mueller-Hinton (SMH) agar was investigated. Defined populations of virulent and avirulent L. pneumophila were inoculated onto hybrid growth media containing the combination of SMH agar components with potassium phosphate-buffered charcoal-yeast extract agar. The casein acid hydrolysate component of SMH agar was found to be inhibitory to the growth of virulent but not avirulent cells. The selectively inhibitory component of the casein acid hydrolysate was identified as NaCl. PMID- 2722246 TI - Neck-shoulder loading in wordprocessor use. Effect of learning, gymnastics and armsupports. AB - The loading of wordprocessor workers was followed over a four month period of a re-education course with the aid of electromyography of the trapezius and frontalis muscles in order to study the effect of learning. Working with the word processor increased the electrical activities in both muscles. The increase did not diminish with the learning of the work. On the contrary the electrical activity increased significantly in the frontalis muscle. Intervening gymnastics during work decreased the electrical activities. The screen (on/off) did not affect the activity. Most effective in lowering the myoelectrical activity in both muscles were the armsupports. A significant positive linear correlation was observed in the electrical activities of the trapezius and frontalis muscles both at rest and during wordprocessor work. PMID- 2722247 TI - Experimental human exposure to ethylene glycol monomethyl ether. AB - The uptake of EGME and the urinary excretion of its major metabolite (MAA) was studied in seven male volunteers during experimental exposure to EGME at rest. The exposure concentration was set at 16 mg/m3, the present Threshold Limit Value. A high retention (0.76) remained unchanged during the 4-h exposure period. In combination with a constant pulmonary ventilation and a fixed exposure concentration this resulted in an uptake rate that showed no significant variation in time. The total amount of EGME inhaled corresponded to a dose of only 0.25 mg/kg. During and up to 120 h after the start of the exposure, MAA was detected in the urine. The elimination half-life was on average 77.1 h. The total amount of MAA excreted was calculated by extrapolation and averaged 85.5% of the inhaled EGME. The pharmacokinetic data are compared with those obtained from other human exposure studies to ethylene glycol ethers (EGEE and EGBE). PMID- 2722248 TI - An improved method for the determination in urine of alkoxyacetic acids. AB - A sensitive and specific method for the determination in urine of alkoxyacetic acids, the metabolites of ethylene glycol monoalkyl ethers, was developed by combining the advantages of two previously described methods. The acids were determined gas chromatographically as their pentafluorobenzylesters. The alkylation with pentafluorobenzylbromide was performed after dissolving the dry residue of lyophilized urine in methanol. Quantitative derivatization was obtained when the urinary pH was adjusted to pH 7.0, when the reagent concentration was 5% v/v, and when the reaction mixture was heated at 90 degrees C for 3 h. Sample clean-up was performed by adding bidistilled water and the esters were extracted with methylene chloride with high yields (95%). Alkoxyacetic acid concentrations in the range of 0.1 to 200 mg/l could be determined with an average imprecision of +/- 3.5%. PMID- 2722249 TI - Mortality study of cancer risk among oil refinery workers. AB - The mortality experience of 1595 male workers employed in one of the largest Italian refineries in the period from 1949-1982 was examined. From the comparison with national and local death rates, increases in mortality owing to lung and kidney cancers, brain tumors, and leukemias emerged. No definite trends according to duration of exposure and years since first exposure were apparent. The increases regarding cancer of the lung, kidney and brain appeared to be associated with the early period of operations. Analysis by exposure category suggested an association of the increased mortality from leukemias with working in production (observed = 2; expected = 0.61). Kidney cancer mortality was elevated among maintenance workers (obs. = 2; exp. = 0.18). Small numbers prevented firmer conclusions. Workers in the moving department had a significantly increased mortality from all cancers (obs. = 22; exp. = 11.7), and lung cancer (obs. = 11; exp. = 3.6). Confounding by smoking could be excluded as sufficient explanation of the three-fold increase in lung cancer deaths. It was in moving that highest airborne levels of polynuclear aromatic hydrocarbons had been discovered in an independent environmental investigation. PMID- 2722250 TI - Osteopenia in inhabitants with renal dysfunction induced by exposure to environmental cadmium. AB - Bone density was measured in 28 women with itai-itai disease, 92 men and 114 women with cadmium-induced renal dysfunctions and 44 men and 66 women living in the three different non-polluted areas using a microdensitometer. The values of both indices corresponding to cortical width and bone mineral content were significantly lower in itai-itai disease patients than the cadmium-exposed women with renal dysfunctions and the non-exposed subjects. The cadmium-exposed women also showed a decrease in bone density compared with the non-exposed subjects. A significant decrease in bone density was also observed between cadmium-exposed men and the non-exposed subjects, although the difference was not as clear as in the women. The present study indicates that exposure to cadmium could cause marked osteopenia, particularly in the women. PMID- 2722251 TI - Urinary vanadium as a biological indicator of exposure to vanadium. AB - Vanadium was determined in urine and blood of two workers (Worker Nos. 1 and 2 with direct exposure to vanadium pentoxide) and 13 fellow workers (with indirect or no vanadium exposure), and the results were compared by means of personal and stationary sampling of vanadium in air. Worker No. 1, a foreman with the heaviest exposure to vanadium, had a green tongue, complained of frequent productive coughing, and excreted 47 to 124 ng/ml vanadium in his late morning and mid afternoon urine. Worker No. 2, a helper to the foreman with less exposure, had no green tongue or subjective complaints, and excreted no vanadium at a measurable level even in his mid-shift urine. No vanadium was detected in urine samples from other workers, nor in blood from all workers including Worker Nos. 1 and 2. Application of inductively coupled plasma emission spectrometry to measurement of vanadium in biological materials is discussed. PMID- 2722252 TI - Determination of nickel in lung specimens of thirty-nine autopsied nickel workers. AB - Lung specimens from 39 nickel refinery workers autopsied during the period from 1978 to 1984 were analyzed for nickel. Fifteen of the workers were employed in the Roasting and Smelting Department, where exposure to nickel was predominantly in the form of nickel-copper oxides, Ni3S2 and metallic dust. The remaining 24 men worked in the Electrolysis Department. Exposure in this group was considered to be mostly to the water-soluble compounds, NiSO4 and NiCl2, but also to a lesser degree to water-insoluble nickel compounds such as nickel-copper oxides and sulphides. The arithmetic mean +/- SD for nickel concentration in lung tissues expressed in micrograms g-1 dry wt for the 39 workers was 150 +/- 280. In the workers employed in the Roasting and Smelting Department, the average nickel concentration was 330 +/- 380; for those who worked in the Electrolysis Department it was 34 +/- 48. Lung tissue from 16 autopsied persons not connected with the refinery had an average nickel concentration of 0.76 +/- 0.39. Statistical analysis based on log-normal distributions of the measured nickel concentrations allowed three major conclusions to be formulated: (1) nickel refinery workers exhibit elevated nickel levels in lung tissues at autopsy; (2) workers of the Electrolysis Department and the Roasting Smelting Department constitute distinct groups with respect to the accumulation of nickel in lung tissue; (3) workers who were diagnosed to have lung cancer had the same lung nickel concentrations at autopsy as those who died of other causes. PMID- 2722253 TI - Anesthesia for dental and oral surgery. PMID- 2722254 TI - Release of allergens from Cladosporium conidia. AB - Sugars and proteins are released from conidia of Cladosporium cladosporioides after incubation in various chemical solutions. Ultrastructural studies demonstrated that these exudates contained components from the outer wall layer and from internal compartments (inner wall and cytoplasm). The allergenicity of the extracts was evaluated using a passive cutaneous anaphylaxis test and radioallergosorbent test. Spore exudates obtained with Tris, NaOH or NaCl displayed the highest allergenic potency. The amount of allergens released was dependent on the incubation media, on the extraction time and on the spore concentration. PMID- 2722255 TI - Serum antibodies to Pseudomonas pseudoalcaligenes in metal workers exposed to infected metal-working fluids. AB - Metal workers exposed to aerosol from metal-working fluid were examined with respect to serum antibody to the lipopolysaccharide (LPS) of Pseudomonas pseudoalcaligenes. During 1 year of observation this species grew at high concentrations in the fluid (approximately 10(8) CFU/ml), and the air surrounding the metal-working machines sometimes contained more than 10(5) CFU/m3. The levels of antibody belonging to the IgG and IgA classes were significantly higher than in blood donors and in workers newly employed. Comparison with employees not working in the machine hall showed a significantly higher IgG, but not IgA, antibody level. For IgM antibody no such difference was found. Among the exposed workers, non-smokers had significantly higher IgG antibody levels than smokers, whereas no such difference was established for IgA and IgM antibodies. In smokers the IgG antibody level seemed to decline in the long-range time, since there was a negative correlation between the time of employment with exposure to metal working fluids and IgG antibody level. The antibody data indirectly demonstrate that P. pseudoalcaligenes grown in metal-working fluid penetrated the body surface of metal workers to yield an immune response most probably after inhalation of aerosol containing bacteria. In the metal workers this long-term exposure did not lead to any acute or chronic respiratory discomfort. PMID- 2722256 TI - Experimental drug-induced allergic nephritis mediated by antihapten antibody. AB - Experimental drug-induced allergic nephritis (DIAN) was mediated by an antihapten antibody. It has been postulated that DIAN is induced by cellular and humoral mechanisms. We tried to induce DIAN in mice, where the mechanism depends on humoral immunity. The first attempt was made in mice actively producing antibodies against cephem antibiotics, i.e. cephalothin (CET). Acute interstitial nephritis (AIN), morphologically similar to human disease, was obtained by injection of a CET-protein conjugate into the renal cortex in mice producing anti CET-IgE and IgG antibodies. AIN could also be induced when normal mice, passively given anti-CET IgG antibody, received a subsequent intrarenal challenge with CET protein conjugate. These preliminary results indicate that IgG antibody has an important role in the genesis of DIAN. Further experiments were performed with monoclonal antibodies directed against haptens instead of antibiotics in order to clarify the Ig isotype concerned. In mice passively given anti-Dansyl-IgG2a or anti-NP-IgG2a monoclonal antibodies, a challenge with an appropriate hapten protein conjugate into the renal cortex resulted in AIN. However, transfer of anti-Dansyl-IgE or anti-DNP-IgE monoclonal antibodies, followed by challenge, did not induce AIN. In the experimental systems described, the involvement of a cellular immune mechanism is excluded. The results suggest that IgG, but not IgE antibody, is essential for the induction of DIAN by humoral immune mechanism. PMID- 2722257 TI - Increased hyaluronan (hyaluronic acid) levels in bronchoalveolar lavage fluid after histamine inhalation. AB - Hyaluronan (hyaluronic acid) appears in low concentrations in bronchoalveolar lavage fluid from healthy individuals, while increased amounts have been reported in lavage fluid from patients with interstitial lung diseases and allergic asthma. We have earlier reported a strong correlation between the appearance of lavage fluid mast cells and hyaluronan in patients with sarcoidosis and extrinsic allergic alveolitis. The central role of the mast cell in allergic asthma is well documented. In this study we have investigated if challenge with inhaled histamine, a major mast cell component, could influence the appearance of hyaluronan in bronchoalveolar lavage fluid. A more than twofold increase of hyaluronan was seen 24 h after challenge with histamine. This increase correlated with a less pronounced increase of albumin in lavage fluid. Histamine challenge also induced an increase of mast cells, lymphocytes, and granulocytes in the lavage fluid. The observed histamine effect on the hyaluronan recovery during lavage might be explained by a histamine-mediated leakage of interstitial fluid, rich in hyaluronan, to the alveolar space. Mast cell degranulation of histamine may partly underlie the appearance of increased amounts of hyaluronan in lavage fluid from patients with interstitial lung diseases and allergic asthma. PMID- 2722258 TI - Budesonide reduces sensitivity to antigen but does not alter baseline tone or responsiveness to carbachol, terbutaline, and enprofylline in IgE-sensitized guinea-pig tracheae. AB - In vitro incubation of IgE-sensitized guinea-pig tracheal rings with 10(-7) M budesonide for 24 h significantly shifted the concentration-response curve to antigen by 5-fold to the right. Smooth muscle characteristics such as baseline tone, muscarinic contraction or relaxation to beta 2-receptor agonists and xanthines were not or only marginally affected by this exposure of airway tissue to a glucocorticoid drug. It is concluded that budesonide reduced anaphylactic IgE-driven release of contractile mediators. PMID- 2722259 TI - Human seminal plasma suppresses delayed-type hypersensitivity responses to intravaginally deposited sheep red blood cells and sperm: separation of immunosuppressive factors. AB - Although significant progress has been made in identifying the immunosuppressive factors in seminal plasma (SP) and their possible action in vitro, the potential role of SP in naturally occurring normal immune responses in vivo is less certain. Human SP or its fractions, administered 5 or 10 times at 3-day intervals into the mouse vagina simultaneously with washed human sperm or sheep red blood cells, suppressed the delayed-type hypersensitivity reactions to footpad injection of the antigens. However, SP failed to suppress antibody formation to these antigens in the applied experimental conditions. In an in vitro study, SP suppressed the proliferation of human peripheral blood mononuclear cells to phytohemagglutinin. This suppression of in vitro proliferation by SP was mediated by materials of both low (LMW) and high molecular weight (HMW). Among the HMW materials, a factor with approximately 1,500 kilodaltons, partially purified by DEAE-cellulose chromatography and gel filtration, exhibited the most potent suppressor activity in vitro and in vivo. The suppressive activities of SP or its fractions were not abolished by treatment with both heat (95 degrees C for 10 min) and trypsin (1.0 mg/ml, 37 degrees C for 4 h). These findings indicate that SP could contribute to the development of suppressed cellular immunity to sperm; immunosuppressive actions of SP are mediated by at least two distinct factors in vivo as well as in vitro. PMID- 2722260 TI - Potentiation of the stimulatory capacity of pokeweed mitogen via its binding to autologous erythrocytes. AB - The effect of human erythrocytes (E) on blastogenesis and immunoglobulin (Ig) production induced by pokeweed mitogen (PWM) in cultures of human peripheral blood mononuclear cells (PBMC) was investigated. The stimulation of PBMC with PWM was markedly enhanced in the presence of E, and PWM bound to E, followed by thorough washing (E-PWM), was even more effective in inducing blast cell formation and Ig production. Blast cell responses after stimulation with E-PWM were on average two times higher than those seen after stimulation with comparable dilutions of fluid-phase PWM. The PWM that remained in solution after incubation with E (Sup E-PWM) had little mitogenic capacity and inhibited the blast cell response induced by fluid-phase PWM. Transwell culture experiments demonstrated that the enhancement of the blast cell response of PBMC by E-PWM could be induced by PWM that was released from E-PWM, whereas the enhancement of Ig production was found to be dependent on the presence of PWM on E. Both for blast cell formation and Ig production, it was found that the enhanced stimulation with E-PWM depended on the presence of monocytes. PMID- 2722261 TI - Serum neopterin patients with X-linked and acquired 'common variable' hypogammaglobulinaemia. AB - Serum neopterin was measured in patients with acquired 'common variable' hypogammaglobulinaemia (CVH), X-linked agammaglobulinaemia (XLA) and healthy subjects. There was a highly significant increase in neopterin levels in the CVH patients as compared with that of the other groups, particularly in those CVH patients with non-A non-B or granulomatous hepatitis. There was no association between raised neopterin levels and chronic infective lung disease. Since chronic viral infections are associated with raised serum neopterin, this data add some support to a viral aetiology for CVH. PMID- 2722262 TI - Effect of systemic and orally administered iota-carrageenan on ovalbumin-specific antibody response in the rat. AB - Iota-carrageenans are high molecular weight polygalactans commonly used in the food industry. Their immunomodulating effects were examined on the reaginic and IgG ovalbumin-specific responses after systemic or oral administration to Brown Norway rats. Intraperitoneal injection of ovalbumin with either iota-carrageenan or alum induced both a reaginic and IgG response. Reaginic antibodies were detected in the primary response with alum, but only in the secondary response with iota-carrageenan. Oral tolerance to ovalbumin was similarly induced whether the protein was given alone or admixed in solution with iota-carrageenan. These results confirmed the systemic adjuvant action of iota-carrageenan described earlier, and showed that this effect did not take place when orally administered. PMID- 2722263 TI - Mourning and reminiscence: parallel psychotherapeutic processes for elderly people. AB - Mourning and reminiscence are therapeutic processes common in therapeutic work with the elderly. However, a theoretical explanation of why they are effective has been lacking. Personal construct theory accounts for both in terms of the search of elderly persons for validation of their construct systems. In this article, this explanation of the parallel psychotherapeutic processes is explored, together with relevant information from the literature on mourning and reminiscence. Therapeutic case studies illustrate the characteristics of the two processes and the relationship between them. PMID- 2722264 TI - The impact of religious orientation in conjugal bereavement among older adults. AB - Despite the importance of religious faith to many older adults and the predictability of spousal death as an extremely distressful life experience, only a few studies have seriously focused on the relationship between religious commitment and adaptation to widowhood. The present study addressed this issue by surveying 159 elderly widowed involved in southern Californian support groups. Grief, depression, and intrinsic-extrinsic religiousness were assessed and then analyzed via hierarchical multiple regression procedures. Higher extrinsicness was found with higher levels of distress across sex, suggesting that an extrinsic orientation may set the stage for a poorer adjustment. Widowers tending to be more indiscriminately proreligious also showed higher distress levels. Greater distress was associated with poorer health after spousal death for widows and before spousal death for widowers. PMID- 2722265 TI - Delivery of services in rural settings to the elderly mentally retarded-mentally ill. AB - A number of controversial arguments exist regarding the ability of sparsely populated areas to adequately provide for their elderly mentally retarded; the elements of distance, education, and capital are said to effectively obstruct access to psychiatric and social support. Yet several facts speak soundly for the necessity to overcome these obstacles: a five-fold increase in the life spans of the mentally retarded in recent decades, and the amply demonstrated reality that individuals with mental retardation are nearly twice as likely as the general population to develop severe behavioral disorders. This article examines both the methods and the reasons for ensuring that rural populations of elderly mentally retarded citizens receive modern psychiatric assistance and community support. PMID- 2722266 TI - Life satisfaction of elderly individuals in regular community housing, in low cost community housing, and high and low self-determination nursing homes. AB - Numerous studies have found that giving nursing home residents more control or self-determination in their daily lives increases their life satisfaction. However, it is not known if elderly people living in high self-determination nursing homes are as satisfied with life as elderly people living in the community. In this study, it was found that elderly persons living in regular community housing, in low-cost community housing, and in high self-determination nursing homes reported similar levels of life satisfaction, and more life satisfaction than elderly people living in low self-determination nursing homes. Health and sociodemographic variables could not account for these findings. The common assumption that nursing homes have detrimental effects on life satisfaction appears unwarranted in the case of those that provide opportunities for self-determination. PMID- 2722267 TI - Do past experiences predict agitation in nursing home residents? AB - The relationships between the three syndromes of agitated behavior aggressive, physically nonaggressive, and verbally agitated) and three aspects of past personality (exposure to stress, history of a mental disorder, and leisure habits) were examined in 408 nursing home residents. Results showed that residents who had experienced the following stressful events during their lives-a life-threatening experience, separation from spouse, retirement, financial problems, and immigration-exhibited more physically nonaggressive behaviors (such as, pacing). Residents who had not experienced the stressful event of relocation manifested more aggressive (e.g., hitting) and physically nonaggressive behaviors. Neither history of a mental disorder nor past preferences for leisure activities were found to be related to agitated behaviors manifested by nursing home residents. Possible explanations for these results are discussed. PMID- 2722268 TI - Observed changes in the functioning of nursing home residents after relocation. AB - This study investigated the effects of environmental changes on the functioning of nursing home residents who were relocated to a newly built facility. Assessment via a multidimensional observation scale revealed that the physical functioning and orientation of the relocated residents were not affected. A stabilizing effect on mood was noted along with a relative increase in withdrawn behavior. Mortality rate showed a decline. These apparent positive and negative effects are discussed in relation to the conditions surrounding the move, the extent of change, and the relative quality of the new environment. PMID- 2722269 TI - Effect of nursing home staff training on quality of patient survival. AB - This study tests the effects of nursing home staff training in care for the dying on the quality of life of terminally ill patients. Ten matched community nursing homes were assigned randomly to experimental (training) or control (no training) conditions Patients (N = 306) admitted to the homes were assessed at admission, one month, and three months concerning quality of life as measured by depression, alienation, self-esteem, and locus of control. Satisfaction with care was also measured at one and three months. Patients in trained homes had less depression and greater satisfaction with care than patients in control homes at one and three months. Training effects were similar in all of the five homes. The study shows that a favorable impact on patient care can be achieved when staff in nursing homes are trained to work with dying patients. PMID- 2722270 TI - Antisperm antibodies are more prevalent in men with low sperm motility. AB - Fifty-six men with low sperm motility (less than or equal to 40% of sperm with forward progression) who attended our infertility clinic were tested for antisperm antibodies (IgG and IgA) using the indirect immunobead test. Nineteen (34%) of these men were found to be positive (greater than 10% binding). This was significantly higher (P less than 0.01) than the incidence (5%) of antibodies in men who attended our infertility clinic with high sperm motility (greater than 40% of sperm with forward progression). It is concluded that significantly more men with low sperm motility have antisperm antibodies. The functional significance of these antibodies warrants further investigation. PMID- 2722271 TI - Fertilization of human oocytes in vitro by spermatozoa from oligozoospermic and normospermic men. AB - Sperm were isolated from the semen of oligozoospermic (less than 20 x 10(6) sperm/ml) and normospermic (greater than or equal to 20 x 10(6) sperm/ml) men in an in-vitro fertilization (IVF) programme. Oocytes from the female partners were inseminated with either 75 or 100 x 10(3) motile sperm and checked for fertilization after 16-20 h. A significant reduction in the overall fertilization rate of oocytes was seen for the oligozoospermic group compared to the normospermic group, at both insemination concentrations. In the oligozoospermic group, a fertilization rate of 31% (19/61) was achieved when oocytes were inseminated with 75 x 10(3) sperm, and 38% (9/24) when inseminated with 100 x 10(3) sperm. This compared with rates of 57% (397/696) and 64% (650/1018), respectively, for normospermic cases at both insemination concentrations. No evidence of fertilization was seen in 36% (4/11) and 67% (4/6) of oligozoospermic cases when 75 or 100 x 10(3) sperm were used, compared with values of 13% (17/133) and 9% (20/212), respectively, in normospermic cases. After excluding zero cases, the fertilization rate of oocytes for the oligozoospermic group (75%; 9/12) was similar to the normospermic group (70% 650/935) when 100 x 10(3) sperm were used. However, when 75 x 10(3) sperm were used, the fertilization rate for the oligozoospermic group (41%; 19/46) was significantly lower than that of the normospermic group (62%; 397/645). Following the transfer of embryos into the female partner, clinical pregnancies were diagnosed in 2/7 (29%) oligozoospermic cases and 27/267 (10%) normospermic cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722272 TI - Detection of immunosuppressive activity in human seminal plasma by an immunobioassay. AB - Recent evidence has shown that under in-vitro conditions human seminal plasma can interfere directly or indirectly with the function of cells of the immune system. It is however, questionable whether the results generated in vitro can be related directly to in-vivo activity. We have therefore standardized an in-vivo immunobioassay to detect the immunosuppressive property of human seminal plasma using adoptive transfer of contact sensitivity to a specific antigen such as dinitrofluorobenzene. Our results indicate that when sensitized lymphoid cells were incubated in vitro with human seminal plasma, their ability to transfer the delayed hypersensitivity in non-sensitized mice was suppressed or inhibited in comparison with the controls. The percentage suppression varied with different samples but the results indicate clearly that the immunosuppressive properties of human seminal plasma can be demonstrated using an in-vivo immunoassay. PMID- 2722273 TI - True hermaphroditism with bilateral ovotestis: a case report. AB - A true hermaphrodite with a 46 XX/47 XXY karyotype, gynaecomastia, hypospadia and scrotal gonads was investigated. Gonadectomy performed at 14 years of age revealed bilateral ovotestes. The ovarian portion contained follicles of all developmental stages. The testicular portion was immature consisting of seminiferous cords with Sertoli cells at various steps of differentiation and few germ cells within massive aggregates of collagenous connective tissue. Leydig cells as well as germ cells remained in an embryonic stage of development. Sections of a differentiated Wolffian duct (ductuli efferentes, epididymis, vas deferens) as well as of a Mullerian duct (hypoplastic fallopian tube) were found adjacent to both gonads. Postoperative treatment consisted of androgen substitution therapy leading to progression of puberty. PMID- 2722274 TI - Effects of male accessory sex glands on sperm transport, fertilization and embryonic loss in golden hamsters. AB - This study was performed to determine the cause of reduced fertility after selective or complete ablation of the male accessory sex glands (ASG) in the golden hamster. The ASG (ampullary gland, coagulating gland, dorsal prostate, ventral prostate and seminal vesicle) were removed bilaterally. The following results were observed in matings involving such surgically-treated males. (1) Fertilization rate was not changed. (2) Total removal of all ASG resulted in significantly fewer sperm reaching the oviduct 1.5 h after mating and a higher rate of embryonic death at day 9 of pregnancy in the mated females. (3) Absence of the ampullary gland and ventral prostate led to higher rates of embryonic death by day 9 of pregnancy. (4) Compared with the controls, fewer oviductal sperm were found in post-ovulatory matings involving males in which the seminal vesicles had been removed. (5) No relationship could be established between the size (weight) of sperm plugs and the number of sperm found in the uterus. PMID- 2722275 TI - The role of free oxygen radicals and sperm function. PMID- 2722276 TI - The incidence and influence upon fertility of antisperm antibodies in seminal fluid following vasectomy reversal. AB - Seminal plasma samples from men undergoing vasovasostomy were analysed for antisperm antibodies using the indirect immunobead test. A pre-operative assessment showed antisperm antibodies of either IgA or IgG class to be present in 9/27 (33.3%) men. A significant increase (P less than 0.05) in the post operative incidence of the antibodies was seen in the men who achieved patency (27/45, 60%) but not in those men for whom no sperm were seen in the ejaculate (4/10, 40%). After follow-up for a minimum of 1 year, conception rates for couples in which the male partner had achieved patency were similar in the groups with no antibodies detected post-operatively (12/18, 66.7%) or with IgA alone (2/3, 66.7%), but was reduced significantly in the presence of IgG (1/9, 11.1%; P less than 0.05) or IgA + IgG (3/15, 20.0%; P less than 0.01). PMID- 2722277 TI - Radiological features of dialysis amyloid spondyloarthropathy. AB - Nine patients undergoing regular dialytic treatment (RDT) for more than 60 months (mean 125 +/- 33 months) showed clinical and radiological evidence of non infective destructive spondyloarthropathy (DSA). The cervical spine was the skeletal segment most affected (100% of cases). Three patients were found also to be suffering from discal and bone alterations of the dorsal column, and in two other patients the vertebral bodies L4-L5 were changed. Typical radiological pictures showed a narrowing of intervertebral spaces with the destruction or sclerosis of adjacent subchondral bones, erosions of vertebral body plates and cavitations. CT studies of the altered spines confirmed discal lesions and osteolytic areas with bone condensation at each level. Ligamentous lesions resulting in severe disorders of spinal statics were discovered during autopsy of three patients. Histological study of disc and peridiscal ligaments indicated the presence of large amyloid deposits containing beta-2-microglobulin (B2-m). It is possible that the minor biocompatibility of the cuprophan membrane of dialyzers is the most significant factor responsible for the hyperproduction of B2-m and thus of the osteo-articular deposition of a new type of amyloidosis. PMID- 2722278 TI - Prerequisites to salvage profound biventricular failure patients with ventricular assist devices. AB - We conducted chronic experiments to determine how to treat profound biventricular failure systematically with ventricular assist devices (VADs) and to analyze the factors that affect prognoses for this condition. Anoxic arrest was induced in ten goats by aortic cross-clamping under normothermic conditions (38.5 degrees C) for 30 (n = 3), 45 (n = 1), and 60 (n = 6) minutes. A left ventricular assist device (LVAD) was implanted in eight animals, and a biventricular assist device (BVAD) was used in two. Three goats--two of which had undergone anoxic arrest for 30 minutes and one for 60 minutes--whose right atrial pressure (RAP) was approximately 18 mm Hg during the acute stage, recovered in two to three weeks, and the pumps were successfully removed. Pathological findings in these animals showed scattered areas of surviving myocardium, with connective tissue replacing the degenerated myocardium. The remaining five LVAD goats required higher RAPs to maintain circulation and died from various causes. Maintaining circulation without volume loading, even in the presence of arrhythmias, was easier with the BVAD. One BVAD animal that underwent 45 minutes of anoxic arrest recovered from right ventricular failure, and the right pump was removed. The second goat (anoxic arrest, 60 min) on the BVAD failed to recover. Autopsy of the myocardium revealed a thin ventricular wall. Our studies show that the use of VADs allows time for a failing heart to recover, but the potential for healing is affected by the severity of myocardial damage prior to VAD application.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722279 TI - Parameters and methods for testing artificial heart valves. AB - The report describes the development of heart valve test standards. The aim is comprehensive quality assurance by in vitro tests. The project includes three test fields: general basis, development and definition of test methods and test devices and comparative in vitro assessment of valves for the definition of minimum requirements. A preliminary list of test parameters and test steps has been defined: geometrical, flow, deformation, force, and conditioning parameters. A system of geometrical parameters has been developed for standardized aortic models. Geometrical parameters of 31 valves of six types and different sizes underline a close correlation between geometrical and hemodynamic parameters. The relative ostium cross-section Ae/AT increases with valve size and lies between 0.3 and 0.5. Two new measurement devices with quasi-steady flow are proposed as quick testers for leakage flow and pressure loss. PMID- 2722280 TI - Velocity and shear stress distribution downstream of mechanical heart valves in pulsatile flow. AB - Ten mechanical valves (TAD 27 mm): Starr-Edwards Silastic Ball, Bjork-Shiley Standard, Bjork-Shiley Concave-Convex, Bjork-Shiley Monostrut, Hall-Kaster (Medtronic-Hall), OmniCarbon, Bicer Val, Sorin, Saint-Jude Medical and Hemex (Duromedics) are investigated in a comparative in vitro study. The velocity and turbulent shear stress profiles of the valves were determined by Laser Doppler anemometry in two different downstream axes within a model aortic root. Depending on the individual valve design, velocity peaks up to 1.5 m/s and turbulent shear stress peaks up to 150 N/m2 were measured during the systolic phase. These shear stress peaks mainly occurred in areas of flow separation and intense momentum exchange. Directly downstream of the valves (measuring axis 0.55.dAorta) turbulent shear stress peaks occurred at peak systole and during the deceleration phase, while in the second measuring axis (1.5.dAorta) turbulence levels were lower. Shear stress levels were high at the borders of the fluid jets. The results are discussed from a fluid-dynamic point of view. PMID- 2722281 TI - Endothelial cell seeding on PTFE vascular prostheses using a standardized seeding technique. AB - A standardized method was developed for seeding endothelial cells (EC) in tubular vascular grafts. A rotational cell seeding device for tubular prostheses is presented and parameters influencing the kinetics of cell adhesion (rotation speed, graft diameter, cell suspension level, inoculated cell number) are reported. Seeding EC in 14 mm ID PTFE vascular grafts with rotation rate of 10 rph gave an adhesion rate of 80% in a homogeneous monolayer. PMID- 2722282 TI - Plasma vasoactive intestinal peptide in uremic patients. PMID- 2722283 TI - Topical issues--a U.S. viewpoint. PMID- 2722284 TI - Validation of a coronary prognostic index for the Chinese--a tale of three cities. AB - In order to confirm the efficacy of a new coronary prognostic index for the prediction of mortality of acute myocardial infarction in the Chinese in general, this index was applied to 886 patients from six general hospitals in Hong Kong (435 patients), Guangzhou (212 patients) and Shanghai (239 patients), respectively. They could be successfully stratified into seven clinical subsets with stepwise increasing mortality. The overall mortality tallied with that predicted by the original coronary prognostic index. The efficacy of this prognostic index for the prediction of mortality from acute myocardial infarction among the Chinese is verified and its application in the objective assessment of patients with acute myocardial infarction is recommended. PMID- 2722285 TI - Restenosis is a common feature of the angiographic follow-up after balloon valvoplasty of calcified aortic stenoses. AB - Balloon dilatation of calcified aortic stenosis was attempted in 12 patients, 6 men and 6 women, aged 38-82 years. Two patients underwent emergency surgery because of myocardial injury or pericardial tamponade. One patient with severe depressed left ventricular function in whom the procedure was attempted in cardiogenic shock died during the procedure. One patient experienced severe aortic insufficiency after dilatation. The remaining pressure gradient was higher than 50 mm Hg in another patient. Seven dilatations were considered to be successful with a remaining pressure gradient below 50 mm Hg and a mean gradient reduction of 53 mm Hg. In one of these 7 patients, who suffered from severe heart failure, valvoplasty had been carried out to make aortic valve replacement possible. The operation was performed 2 weeks later without complications. Five of 6 patients treated medically after successful valvoplasty had restenosis within 3 to 12 months. One of them exhibited a good result at 3 months but severe restenosis after one year. It is concluded that balloon valvoplasty of calcified aortic stenosis cannot be considered an alternative to surgery. If, however, left ventricular function improves after successful valvoplasty, valve replacement will then carry less risk. PMID- 2722286 TI - Rate-dependent change in dispersion of repolarisation during ventricular pacing in man. AB - The difference between the end of monophasic action potentials recorded in the outflow tract of right ventricle and the T-wave on the surface electrocardiogram was measured as an estimate for disparity of termination of repolarisation. It was measured during right ventricular pacing at three basic cycle lengths 500, 600 and 700 msec and programmed stimulation with single extra stimuli in 15 patients with coronary arterial disease. The disparity of termination of repolarisation was rate dependent, showing increased values when stimulated at cycle length of 700 ms compared to 600 msec (P less than 0.005) and 500 ms (P less than 0.001). Premature stimulation revealed three different modes in changes of dispersion: in six patients the premature dispersion was increased at the shortest coupling intervals from the effective refractory period. It was unchanged compared to basic values in four, and in the rest of the patients the premature dispersion was reduced at the shortest coupling intervals. These results show that the dispersion of recovery of repolarisation increases at the lower stimulation frequencies. Premature dispersion is not always increased in the closest proximity to V-ERP during programmed ventricular stimulation in patients with ischemic heart disease. PMID- 2722287 TI - Recording of the electrocardiogram from the sinus node and direct measurement of the sinuatrial conduction time in children. AB - Using a simple technique, the electrocardiogram from the sinus node, which had been previously recorded in adults, was for the first time derived successfully in 27 of 31 children (87%). The values of the sinuatrial conduction time were then precisely measured directly according to the electrocardiogram from the sinus node. The sinuatrial conduction time measured directly was significantly longer in 6 children with sick sinus syndrome (138.3 +/- 10.3 msec, mean +/- standard deviation) than in 21 normal children (66.9 +/- 14.4 msec, mean +/- standard deviation). No overlap was found between them. Furthermore, comparison was made between the children and the adults (7 cases with sick sinus syndrome, 32 cases with normal sinus nodal function). The results suggested that the electrocardiogram recorded from the sinus node may be a valuable and promising technique for the evaluation of sinus nodal function and in the accurate diagnosis of the sick sinus syndrome in children. PMID- 2722288 TI - Intravenous diltiazem in patients with paroxysmal re-entrant supraventricular tachycardia. AB - The electrophysiologic effects and efficacy of diltiazem were evaluated with programmed electrical stimulation of the heart in 12 patients with supraventricular re-entrant tachycardia (five with atrioventricular nodal tachycardia and seven with circus movement tachycardia the accessory pathway being concealed in 4). Diltiazem was infused over 1 minute at the dose of 0.25 mg/kg and the electrophysiologic parameters were evaluated at 5 and 30 minutes. Diltiazem prolonged the AH interval from 83.5 +/- 58 to 99 +/- 55 msec (P less than 0.05), effective and functional refractory periods of atrioventricular node from 244 +/- 40 to 268 +/- 56 msec (P less than 0.05) and from 432 +/- 124 to 468 +/- 130 msec (P less than 0.005) respectively, lowered the atrial pacing rate inducing second-degree atrioventricular block from 159 +/- 32 to 134 +/- 33 beats/min (P less than 0.005) and decreased systolic and diastolic blood pressure from 143.5 +/- 33 to 132.5 +/- 22 mm Hg (P less than 0.05) and from 90 +/- 15 to 82.5 +/- 9 (P less than 0.05), respectively. Diltiazem prevented the reinduction of the tachycardia in 4 of 5 patients with atrioventricular nodal tachycardia and in 4 of 7 with circus movement tachycardia. The mechanism of action of diltiazem consisted of depression of conduction in atrioventricular node in anterograde fashion while there were no effects on refractoriness of the accessory pathway. The drug was well tolerated with no adverse effects. Diltiazem, therefore, appears an effective and safe drug in the acute treatment of re-entrant supraventricular tachycardia. PMID- 2722289 TI - Semiquantitative grading of mitral regurgitation by color-coded Doppler echocardiography. AB - We evaluated patients with mitral regurgitation by color-coded Doppler echocardiography using a semiquantitative score system, which is useful in the clinical setting, by providing rapid discrimination between mild, moderate and severe regurgitation. The study was performed in 42 patients (19 female, 23 male) mean age 58 years, range 23-75 years with mitral regurgitation of different etiology. Color-coded Doppler measurements were compared to angiographic findings using a three point score system. In addition to such parameters as maximal jet length, area and the ratio jet area/left atrial area, we also considered the duration of regurgitant flow. The best correlation was obtained for the maximal area of the jet multiplied by the duration of regurgitant flow/cycle length (r = 0.88), determined in the apical plane where the jet was best visualized. For the parameter area of jet alone, the correlation coefficient was 0.81, for the length of the jet the value was r = 0.65 and comparison of the areas of jet and left atrium gave a coefficient of 0.77. A clear separation between mild and severe regurgitation was observed only for the parameter calculated by multiplying the area of the jet by the duration of mitral regurgitation. In only 7% of the patients with moderate and severe regurgitation could we observe an overlap. This parameter, therefore, represents a useful method for estimating in a semiquantitative manner the severity of mitral regurgitation by color-coded Doppler echocardiography. PMID- 2722290 TI - Flow patterns of mitral regurgitation due to different etiologies: analysis by color-coded Doppler echocardiography. AB - We have used cross-sectional real time color-coded Doppler echocardiography to characterize the patterns of the regurgitant jet seen in mitral valvar disease of different etiologies. We studied 118 patients with mitral regurgitation due to rheumatic valve disease (n = 26), hypertrophic obstructive cardiomyopathy (n = 22), dilated cardiomyopathy (n = 35) and prolapse of the leaflets of the mitral valve (n = 35). We analyzed the origin, spatial distribution, extent and duration of the regurgitant jet. A semiquantitative grading system was used to evaluate the extent of the jet by measuring its maximal area and the duration of regurgitant flow. Typical flow patterns could be observed in hypertrophic obstructive cardiomyopathy, (in which the crescent shaped jet was elongated in midsystole and directed posteriorly) in dilated cardiomyopathy (in which oval shaped jets were observed throughout systole) and in prolapse of the leaflets (in which early or late systolic regurgitant jets occurred with an eccentric "drop like" pattern, being directed posteriorly in patients with a prolapse of the aortic leaflet and anteriorly in those with a prolapse of the mural leaflet of the valve). A large variety of patterns was found in rheumatic disease due to the individual deformation of the leaflets. A comparison of the measured area of the jet revealed no significant differences between regurgitation caused by rheumatic valve disease and dilated cardiomyopathy. The regurgitation in 80% of these patients was of moderate to severe degree. In contrast, regurgitation due to prolapse of the leaflets or hypertrophic obstructive cardiomyopathy appeared to be of mild to moderate degree in 90% of cases. PMID- 2722291 TI - Aneurysm of the pulmonary trunk in association with minimal pulmonary stenosis. AB - We report a rare instance of aneurysm of the pulmonary trunk (maximum diameter 6.8 cm) in association with trivial valvar pulmonary stenosis (peak gradient 18 mm Hg). The relevant literature is briefly reviewed. PMID- 2722292 TI - Absence of the leaflets of the aortic valve in DiGeorge syndrome. AB - A newborn infant is described with complete absence of the leaflets of the aortic valve, interruption of the aortic arch and DiGeorge syndrome. This association has not previously been reported, nor has absence of the leaflets of the aortic valve without other features of left ventricular dysplasia. We discuss the possible influence of severe intra-uterine aortic regurgitation on development of the aortic arch. PMID- 2722293 TI - Myocardial bridges at multiple sites over the left coronary artery in a patient with hypertrophic cardiomyopathy. AB - In a 47-year-old male with hypertrophic cardiomyopathy, coronary angiography revealed three myocardial bridges associated with significant systolic narrowing of the left coronary artery. Measurements during pacing and exercise demonstrated no sign of myocardial ischemia. Ten-year follow-up was uneventful. Thus, the prognosis of myocardial bridges, even when located at multiple sites across the left coronary artery, seems benign. PMID- 2722294 TI - Balloon pulmonary valvuloplasty in a child with Ebstein's anomaly and valvar pulmonary stenosis. AB - We performed a balloon pulmonary valvuloplasty in a child with Ebstein's anomaly using the standard technique. The procedure reportedly has not been performed in the face of this defect and, although difficult, was safely and successfully accomplished. In patients with Ebstein's anomaly and right ventricular outflow obstruction compounded by pulmonary valve stenosis, application of this technique may delay the need for surgical intervention. PMID- 2722295 TI - Aneurysm of atrial septum associated with rheumatic mitral stenosis simulating tumour of right atrium. AB - We present a case of aneurysm of interatrial septum associated with rheumatic mitral stenosis, which supports the theory that claims that the pressure gradient between the atriums plays an important part in its aetiology. The angiographic image of a filling defect in the right atrium may cause an erroneous diagnosis of atrial tumour. The levophase of right angiography and cross-sectional echocardiography confirmed the diagnosis of aneurysm of interatrial septum. PMID- 2722296 TI - Haemopericardium in rheumatoid arthritis. AB - We report two cases of haemopericardium presenting as tamponade in patients with rheumatoid arthritis. Pericardial aspiration produced a good clinical response with no reaccumulation. We suggest that, although rare, haemopericardium can be a feature of rheumatoid disease and may be associated with significant haemodynamic disturbance. PMID- 2722297 TI - Percutaneous balloon dilatation of stenotic truncal valve in a newborn. AB - We describe the use of percutaneous balloon angioplasty of a stenotic truncal valve in a newborn with a common arterial trunk. A 12 mm balloon catheter was chosen, this representing 80% of the diameter of the ventriculo-truncal junction. The peak systolic gradient dropped from 45 to 15 mm Hg. The procedure can avoid, or certainly delay, surgical treatment of the stenotic truncal valve. PMID- 2722298 TI - Echocardiographic diagnosis of a left atrial thrombus in a patient with normal prosthetic mitral valve. AB - A 20-year-old male with a Bjork-Shiley mitral valve prosthesis on optimal anticoagulation and antiplatelet drug therapy presented with systemic embolization 11 months after mitral valve replacement. Cross-sectional and Doppler echocardiography revealed a left atrial thrombus attached to the posterior wall of the left atrium and normal function of the prosthetic valve. The findings were confirmed at surgery. PMID- 2722299 TI - Fantasy proneness, hypnotizability, and absorption--a re-examination: a brief communication. AB - In a previous study (Lynn & Rhue, 1986) of fantasy-prone persons, "fantasizers" participated in an 8-10 hour, multi-session study. Group selection was based on scoring in the upper 4% of the college population on the Inventory of Childhood Memories and Imaginings (ICMI) of Wilson and Barber (1981) and conforming to the fantasy-prone personality syndrome (Wilson & Barber, 1981) during an interview. Fantasizers differed from nonfantasizers (lower 4% of population) and medium range scorers on measures of hypnotizability (Harvard Group Scale of Hypnotic Susceptibility, Form A, Shor & E. Orne, 1962) and absorption (Tellegen Absorption Scale, Tellegen, 1976). In the current study, Ss were selected on the basis of their ICMI scores and participated in a 1-session experiment. As in our first study (Lynn & Rhue, 1986), fantasizers differed from both comparison groups on the measure of absorption and from the nonfantasizers on the measure of hypnotizability. Further, the correlations among fantasy proneness, absorption, and hypnotizability were stable across studies. Fantasy proneness and absorption were not found to be truly discriminable constructs. Unlike our initial study (Lynn & Rhue, 1986), fantasy-prone and medium range Ss were equally hypnotizable. Methodological differences across studies provide a plausible explanation for the disparate results obtained. PMID- 2722300 TI - Return of the repressed: hypnoanalysis of a case of total amnesia. AB - A case study is presented of a woman suffering from global amnesia so profound that she had lost all sense of personal identity. Hypnotherapy was used to establish, through imagery, a solid inner core on which to rebuild a sense of self. From the image of a strong column on which rested a book with a golden lock (her history), to reading about other lives, books and stories were utilized to establish a safe external environment in which the reawakening of repressed memories was no longer perceived as dangerous. A discussion of relevant literature on the subjects of global amnesia, loss of personal identity, and post traumatic stress is offered as a basis for discussing the present case. PMID- 2722301 TI - Pushing the limits of recovery: hypnotherapy with a stroke patient. AB - Hypnotherapy was used to assist recovery of left arm function following stroke in a 66-year-old woman. Treatment protocol is described, and results are discussed in terms of how hypnosis may facilitate voluntary motor movement. Recent literature on cortical changes in hypnosis and motor improvement during hypnosis is discussed in relation to the present results. PMID- 2722302 TI - Hypnosis and transference: a measure of archaic involvement. AB - 20 Likert-type items were derived directly from Shor's theoretical propositions concerning the occurrence of transference-like experiences among hypnotic Ss. In 3 separate experiments, this 20-item Archaic Involvement Measure (AIM) was administered to a total of 452 Ss following termination of both group and individually administered hypnosis procedures. Results suggest that: (a) AIM is internally consistent, and is significantly correlated with hypnotizability; (b) among high hypnotizable Ss, AIM scores assess an important aspect of hypnotic experience which is relatively unrelated to behavioral response to hypnotic suggestions; (c) there is no change in AIM scores associated with the sex of the hypnotist or S; and (d) there are 3 clusters of AIM items: perceived power of the hypnotist, positive emotional bond to the hypnotist, and fear of negative appraisal. Possible validational and clinical research applications of AIM are presented, along with a plea for further empirical examination of the relational dimensions of hypnosis. PMID- 2722303 TI - The hypnotic relationship: an investigation of compliance and resistance. AB - The purpose of this investigation was to assess the ability of hypnotic Ss to voluntarily resist a neutral suggestion when a monetary reward is offered for resistance. 19 of 40 Ss (47.5%) successfully resisted after money was offered by the "resistance instructor." The correlation between resistance/compliance and hypnotizability was -.44 (high hypnotizables were more likely to comply). Ss' impressions of the hypnotist tended to be positive; impressions of the resistance instructor tended to be neutral. There was a tendency for nonresistors to have a more positive view of the hypnotist but it is not as marked as was found in an earlier study (Levitt & Baker, 1983). PMID- 2722304 TI - Hypnosis and autonomy: a moderator analysis. AB - The study focused on autonomy as a moderator variable in the prediction of subjectively reported hypnotic depth. Ss in the experimental part of the study were 56 undergraduate psychology and education majors classified as either high or low in autonomy. Ss who were equated on capacity for absorption were individually administered 1 of 3 hypnotic inductions: an authoritarian induction, a permissive heteroinduction, or a self-hypnosis induction. The study had a double-blind design. The data suggest that situational manipulation has greater impact on low than on high autonomy Ss. Individual-difference variables such as absorption, have greater impact on hypnotic depth for high than for low autonomy Ss. The data indicate that the hypnotic behavior of high autonomy Ss is more likely to be self-congruent and less likely to be demand-congruent. A factor analytic inquiry of absorption confirmed the importance of affective/regressive capacity for hypnotic functioning for high autonomy Ss. The study supported the alternate-path perspective of hypnosis. PMID- 2722305 TI - Hypnosis and rational-emotive therapy--a de-stressing combination: a brief communication. AB - It has been suggested that teacher stress might be reduced through cognitive restructuring which is aimed at improving the rationality of their thinking. To test this hypothesis, 40 high school teachers were paired on their level of reasonable thinking, operationalized in terms of scores on the Teacher Idea Inventory (Bernard, Joyce, & Rosewarne, 1983), and allocated at random to one of 2 groups. They also completed the Face Valid Stress Test. The experimental group participated in 4 weekly treatment sessions involving a hypnotic induction and suggestions derived from key elements of Rational-Emotive Therapy. These focused on the reduction of what Ellis (Ellis & Grieger, 1977), the originator of this treatment, calls "irrational thinking." The control group spent the same amount of time discussing stress reduction methods. Both the Face Valid Stress Test and the Teacher Idea Inventory were re-administered at the end of this period and again 12 months after conclusion of the experiment. Results indicated that both the experimental and control groups significantly reduced their levels of irrational thinking and stress, although the former's improvement was more marked, particularly at the 12-month follow-up. PMID- 2722306 TI - Comparison of digoxin and dobutamine in patients with severe dilatative cardiomyopathy. AB - The hemodynamic effects of dobutamine were compared with those of digoxin in seven patients with severe diffuse dilatative cardiomyopathy. Dobutamine (7.5 micrograms per kg of body wt per min) was given intravenously for 30 min and then discontinued until hemodynamics returned towards base line. Digoxin (12.5 micrograms per kg) was then given intravenously and hemodynamics were recorded for 120 min. Thereafter, dobutamine was again given at the previous dose. Dobutamine increased cardiac and stroke volume index and decreased pulmonary occlusive (wedge) pressure and systemic vascular resistance without changing heart-rate or arterial pressure. Digoxin also increased cardiac and stroke volume index and decreased pulmonary wedge pressure and systemic vascular resistance with digoxin without changing arterial pressure. In contrast to dobutamine, heart rate was decreased with digoxin indicating reduced myocardial oxygen demand. Re infusion of dobutamine did not have any notable hemodynamic effect, with the exception of an increase in heart-rate-systolic pressure production. These data indicate that the positive inotropic properties of digoxin and dobutamine are not additive. Furthermore, concerning the effect of digoxin on the heart-rate, its use seems preferable to the use of sympathomimetic agents such as dobutamine, in patients with diffuse chronic dilatative myocardiopathy. PMID- 2722307 TI - Concentrations of flurithromycin in serum and tonsils. AB - The concentrations of flurithromycin in serum and palatine tonsils of eleven adult male patients undergoing tonsillectomy were determined. Each patient received 500 mg t.i.d., in all ten doses, before tonsillectomy. Flurithromycin concentrations were measured by a microbiological method. Mean serum levels (+/- SE) were 0.72 microgram/ml (+/- 0.19) after 8 h from the 9th dose and 0.67 microgram/ml (+/- 0.13) after 4 h from the 10th dose. Average concentrations (+/- SE) in tonsils were: 1.43 +/- 0.20 microgram/g (right) and 1.32 +/- 0.21 (left) 4 h after the last administration. Therefore, the mean tissue/serum ratio was about 2:1. These results indicate a good diffusion of flurithromycin from serum to tonsillar tissue. PMID- 2722308 TI - Reduction of hyperlipidemia with 3-sn-polyenyl-phosphatidylcholine in dialysis patients. AB - Hyperlipidemia is of particular concern in dialysis patients due to the high incidence of ischemic cardiovascular complications. Two groups of 10 patients with at least one year of dialysis and a residual glomerular filtration rate less than 1 ml/min, serum cholesterol greater than 260 mg/dl, LDL cholesterol greater than 180 mg/dl and triglycerides greater than 200 mg/dl were admitted to the study. The patients received either 3 x 450 mg 3-sn-polyenyl-phosphatidylcholine (PPC) mornings and evenings (2.7 g daily, 6 capsules) or placebo during the double-blind, randomized study. Six weeks treatment was followed by a two-week wash-out phase. Lipid parameters including total cholesterol, triglycerides, HDL and LDL cholesterol were determined 14 days before treatment, at treatment begin, at 2, 4 and 6 weeks during treatment and 14 days after treatment cessation. PPC caused a significant decrease in total cholesterol (-37.8 mg/dl) two weeks after treatment begin (2 p less than 0.001). This decrease remained constant during the duration of treatment. Two weeks after PPC application a decrease in LDL cholesterol had occurred (-32.0 mg/dl) (2 p less than 0.01) as compared to stable placebo values. Significant PPC induced decreases in triglycerides occurred four (-58.2 mg/dl; 2 p less than 0.001) and six weeks (-43.3 mg/dl; 2 p less than 0.01) after initiation of treatment, as compared to the placebo group (four weeks: +5.7 mg/dl and six weeks: -11.4 mg/dl). Side effects in the PPC group were equivalent to those reported in the placebo group. This study shows that PPC is an effective antihyperlipidemic agent in dialysis patients. PMID- 2722309 TI - Biliary elimination of ticarcillin plus clavulanic acid (Claventin): experimental and clinical study. AB - The aim of the present study was to assess the biliary elimination and disposition of Claventin, a combination of clavulanic acid (CA), a beta-lactamase inhibitor, with ticarcillin (TIC), resulting in an enhancement of the activity of the antibiotic and broadening of its antibacterial spectrum. This work was done experimentally and in humans. Assays of both molecules were performed by HPLC. During a 3 h perfusion of five isolated rabbit liver preparations, 1.3 +/- 0.2% and 0.4 +/- 0.1% of TIC and CA added to the circulating blood were eliminated in the bile. At the same time, 31.8% of TIC and 50.5% of CA were submitted to a hepatic biotransformation. In healthy subjects (n = 5), after a single i.v. injection of 3.2 g of Claventin (TIC: 3 g + CA: 0.2 g) mean peak concentrations of 66.8 +/- 31.9 micrograms/ml (TIC 4th h) and 0.3 +/- 0.1 microgram/ml (CA, 2nd h) were observed in the aspirated duodenal fluid where 0.07% and 0.01%, respectively, of the administered dose were recovered during the 4 h investigation period. In cholecystectomized patients (n = 10) provided with a T tube, i.v. administration of Claventin, 3.2 g, resulted in biliary maximal levels of 177 +/- 49 micrograms/ml (TIC: 2nd h) and 2.7 +/- 0.5 microgram/ml (CA 1st h). Total amount of each derivative eliminated in bile over 12 h averaged 0.28% (TIC) and 0.05% (CA) of the given dose. Hepatobiliary clearance was 20.5 ml/h (TIC) and 4.4 ml/h (CA). In intra-operative simultaneously sampled specimens of serum, choledochal bile, gallbladder bile and gallbladder wall, the following concentrations were measured 1 h after i.v. administration of Claventin: TIC: 105 +/- 10; 386 +/- 66; 72 +/- 20 micrograms/ml and 36 +/- 11 micrograms/g, CA: 3.5 +/- 0.7; 5.9 +/- 1.5; 0.3 +/- 0.3 microgram/ml and 0.1 +/- 0.1 microgram/g. The biliary pharmacokinetics determined in humans makes it possible to consider favourably the prophylactic use of Claventin in surgery of the biliary tree and constitute a good prerequisite for a possible beneficial treatment of biliary tract infections. PMID- 2722310 TI - The variability in oro-cecal transit time assessed using a bean-based test meal and its use in the study of the effect of metoclopramide and BRL 24924 on transit time. AB - The inter and intra subject variation in the oro-cecal transit time assessed using the bean/breath hydrogen method was studied and analyzed to allow estimation of the number of patients/subjects required to show a drug-induced difference for given levels of statistical significance and power. Thus at the conventional 5% level of significance and for a test with 90% power, a dozen subjects should be sufficient to show a drug-induced change which is 25% or greater. Two crossover studies are described using 20 mg metoclopramide and 2 mg BRL 24924, orally, against placebo to investigate their action on oro-cecal transit time. Metoclopramide, 20 mg, produced a 45% reduction in the transit time compared with placebo. BRL 24924, 2 mg, in a similar study showed a 71% reduction. PMID- 2722311 TI - Homologous meniscus transplantation. Experimental and clinical results. AB - The increase in severe ligament injuries of the knee has led to consideration of the need for meniscal transplantation in reconstructive operations for chronic rotational instability. Transplantation of the medial meniscus was carried out in two groups of 15 sheep. In one group lyophilised, gamma-sterilised allogenic menisci were transplanted and these underwent a complete remodelling in 48 weeks. In the other group, deep frozen allogenic menisci were used and these remained fully functional without remodelling. We then carried out meniscal transplantation in 22 patients who were followed-up for a mean of 14 months. Arthroscopy was possible in two-thirds of the cases at an average of 8 months after operation. Both types of transplanted menisci, lyophilised and deep frozen, decreased in size, as small as a regenerated meniscus in some cases. In general the deep frozen menisci showed better results. PMID- 2722312 TI - The cruciate ligaments in knee replacement. AB - The cruciate ligaments were resected with their bony insertions during total knee arthroplasty carried out in 12 patients with severe rheumatoid or osteoarthritis. The ligaments were examined histologically and biomechanically, using ten specimens from healthy adults as a control. A significant difference was found in the tensile stiffness and viscoelastic properties of the ligaments between the arthritic and the control group. The ligaments in the rheumatoid knees had a distinctly inferior tensile strength compared with the osteoarthritic knees. Total knee replacement, which also replaces ligament function, should therefore be considered in severely damaged rheumatoid knees. PMID- 2722313 TI - Arthroscopic versus open synovectomy in the rheumatoid knee. AB - We report the clinical and radiological results after arthroscopic synovectomy (41 knees) and open capsulosynovectomy (26 knees) in patients with rheumatoid arthritis, with an average follow-up of more than ten years. The clinical outcome was much the same in both groups, but there was gradual deterioration, especially after eight years. Radiological changes of osteoarthritis were worse in the knees treated by open capsulosynovectomy compared with the arthroscopic group. Arthroscopic synovectomy has many advantages and we believe that it is better than open capsulosynovectomy for patients with rheumatoid arthritis of the knee. PMID- 2722314 TI - Spring alloplasty in the treatment of fractures of the thoracic and lumbar spines. A correlation of the results of treatment with the mechanism of injury. AB - We describe 270 patients with spinal injuries who were treated by spring alloplasty between 1971 and 1985. The radiological results were compared with the mechanism of injury. The best outcome was obtained in patients with a spinal dislocation or flexion fracture. The technique is also recommended in compression fractures with wedging of the vertebral body, where there is a smaller proportion of good radiological results, but a gratifying improvement in neurological and functional outcome. The method is only cautiously advocated in cases of facet joint fracture and is generally contraindicated in massive compression fractures. PMID- 2722315 TI - A comparison of myelography and computer tomography in lumbar disc herniation. AB - We report a retrospective study of 219 patients with lumbar disc lesions in whom the operative findings were compared with the results of computer tomography (CT) and myelography. When used alone each method achieved virtually the same degree of accuracy (87.8% and 87.4%). Particular attention was paid to 70 "problem" cases in whom the initial CT diagnosis suggested herniations at different levels which were not in keeping with the clinical symptoms or signs. The operative findings showed that CT had produced 10.4% false positives and 4.4% false negatives. The corresponding results for myelography were 5.9% and 8.9%. Myelography is, therefore, a more exact method of diagnosis for segmental and lateral herniations. After initial computerised tomography, myelography is indicated when there is a discrepancy between CT and the clinical findings. PMID- 2722316 TI - The Neer II replacement for rheumatoid arthritis of the shoulder. AB - Thirty-eight patients had a Neer II replacement for rheumatoid arthritis of the shoulder. The average age at operation varied from 23 to 68 years. The average follow-up was 20.9 months. Forty shoulders were free of pain and function was reasonable in 21. Overall evaluation showed an excellent or satisfactory result in 15, 16, were acceptable and 10 poor. The most frequent radiological finding was upward subluxation which was present in 20 shoulders. An incomplete radiolucent zone was found around the glenoid component in 32% and around the humeral in 5%; there was no gross loosening. PMID- 2722317 TI - Clavicular osteotomy in shoulder arthroplasty. AB - We present an approach to the shoulder which is easily performed, offers unrivalled exposure for the accurate placement of prostheses or reconstruction of complicated fractures and is easily closed. We have used this approach since 1977 and report our results in 128 patients. PMID- 2722318 TI - The mechanical effects of femoral shaft perforation at total hip replacement. AB - Perforation of the femoral shaft at total hip arthroplasty is a complication which is being reported more frequently. It has been suggested that the presence of bone cement in the perforation decreases the weakening effect of the perforation, but the mechanical basis for this belief is dubious. The anatomy of perforation was studied by cadaver dissection and its mechanical consequences were assessed in two models using Pedilen, a polyurethane foam, and pig femora. It was found that cement in a hole in bone decreased the weakening effect of the hole to tensile stress. PMID- 2722319 TI - Calcium homeostasis and exercise. AB - Calcium homeostasis is altered by strenuous physical exercise. The mechanism is unclear. Our study was designed to investigate this relationship, particularly any associated changes in the calcium regulating hormones. Six subjects carried out a strenuous exercise programme for 10 min on a bicycle ergometer. Blood samples were analysed for ionized calcium, total calcium, calcitonin and pH. Plasma parathormone was assayed using a new and very sensitive N-terminal assay. Serum ionized calcium was significantly elevated by exercise at 50% of maximum aerobic capacity (VO2 max). The rise persisted until the late recovery phase, when it fell significantly below resting levels. Plasma parathormone levels were initially depressed by moderate exercise (50% VO2 max.) but were significantly elevated during and immediately after severe exercise. Our results suggest that exercise stimulates the hormonal, osteolytic influences acting on the skeleton, with increases in plasma parathormone and mobilisation of calcium stores. These changes may provide a supply of raw material allowing the osteogenic mechanical forces initiated by exercise to produce a positive skeletal balance. In view of the possible relevance of these findings to the understanding and management of osteoporosis we feel that this area merits further study. PMID- 2722320 TI - Solitary metastasis of the patella as the first manifestation of lung cancer. A case report. AB - A man of 71 was seen with a solitary metastasis in the patella as the first presentation of carcinoma of the lung. PMID- 2722321 TI - Monomelic macrodystrophia lipomatosa. A case report. AB - There are many reports of macrodystrophia lipomatosa involving the hands or feet, but here we report an unusual case where the whole of the left lower limb was affected. PMID- 2722322 TI - Automated systems for measurement of oxygen uptake during exercise testing. AB - We evaluated three automated systems for measurement of O2 uptake and compared them with the conventional Douglas bag method. One system (9000 IV Ergometric system) was only tested with respect to its oxygen kinetics, the other two (MMC Horizon and EOS-Sprint) were tested during three exercise programs: (1) steady state exercise at 50-W steps from 0 to 200 W, (2) progressive increasing exercise to maximal load, and (3) single-step exercise from 0 to 250 W. The regression lines of mean O2 uptake and load for six subjects were different for intercept (MMC-Horizon) or slope (EOS-Sprint) compared with the conventional method. The maximal O2 uptake values of six subjects were not significantly different for the two systems when compared with the Douglas bag method. The time constants of the exponential function describing oxygen kinetics during repeated (6 times) step changes in load in two subjects were different for the three systems. MMC-Horizon and 9000 IV Ergometric system had lower (51.8 s and 55.1 s, respectively, vs 62.5 s) and EOS-Sprint higher time constant (94.6 vs 47.7 s) than the conventional method. The automated systems were convenient and efficient for measurement of O2 uptake during steady-state and maximal exercise. When O2 uptake kinetics are essential, one has to take into account the response time of the system. PMID- 2722323 TI - Prospective study of concentric and eccentric leg muscle torques, flexibility, physical conditioning, and variation of injury rates during one season of amateur ice hockey. AB - Twenty-three male ice hockey players in a third division amateur ice hockey team were prospectively studied during the 1987-1988 season. O2 uptake, muscle flexibility, and isokinetic concentric and eccentric leg muscle strength were measured before and after the season. All injuries were recorded by one and the same physician attending all the games: 68 injuries occurred altogether but only six of these led to absence from training or matches. O2 uptake and muscle flexibility were unchanged during the season, but a significant drop of both concentric and eccentric quadriceps and hamstring torques occurred in spite of the fact that the team played two games and trained twice per week during the entire season. No correlation between the fall in muscle strength and the injury rate was found. Although many injuries occur in ice hockey, the majority are minor ones that do not lead to absence from playing. PMID- 2722324 TI - Effect of chronic endurance exercise on retention of dietary protein. AB - On two separate occasions, five well-trained endurance runners (VO2max = 71 +/- 5 ml/kg/min; means +/- SD) consumed a meat-free diet for 6 days. For one trial the subjects consumed the recommended dietary allowance (RDA) of protein (REC-PRO = 0.86 +/- 0.23 g/kg body wt/day). Protein intake for the other trial was 1.7 times higher (HI-PRO = 1.49 +/- 0.29 g/kg body wt/day). Each subject followed his regular training program (12-16 km running/day), and on day 5 of each diet completed a treadmill run at a similar intensity and duration (75 min at 72% VO2max). Seventy-two hour urinary urea N loss (days 4, 5, and 6 of each diet) and day 5 exercise sweat urea N excretion were measured. Serum urea N and creatinine increased significantly during the treadmill run under both dietary conditions (P less than 0.05). No significances between diet differences were observed in sweat or urinary urea N excretion; however, excretion of both tended to be higher on the REC-PRO diet than on the HI-PRO diet. The differences in protein intake combined with the nitrogen excretion measures resulted in significant differences in estimated whole-body nitrogen retention between the two treatments. Nitrogen retention (means +/- SE) remained positive during the HI-PRO trial (2.41 +/- 1.99 g/day) but was significantly (P less than 0.005) reduced to -5.29 +/- 2.58 g/day during the REC-PRO trial. These results suggest that the current protein RDA may be inadequate for athletes engaging in chronic high-intensity endurance exercise. Future studies are needed to confirm this observation. PMID- 2722325 TI - Complement and immunoglobulin levels in athletes and sedentary controls. AB - Eleven marathon runners (42.7 +/- 2.1 yrs, 54.2 +/- 1.8 ml.kg-1.min-1) and nine sedentary controls (44.2 +/- 1.2 yrs, 33.3 +/- 1.1 ml.kg-1.min-1) were studied during 30 min of rest, a graded maximal treadmill test using the Balke protocol, and 45 min of recovery to determine the effects of training and acute exercise on complement and immunoglobulin levels. Three baseline and five recovery blood samples were obtained in addition to repeated 5-min samples during exercise. Data for the exercise period were analyzed using a multiple regression approach to repeated measures ANOVA to allow comparison between groups on a percent VO2max basis. Groups did not differ during any of the three phases for IgG, IgA, or IgM. Resting levels of complement C3 (0.89 +/- 0.05 vs 1.27 +/- 0.10 g/L, P less than 0.001) and C4 (0.19 +/- 0.02 vs 0.29 +/- 0.03 g/L, P less than 0.001) were significantly lower in athletes than in controls. Exercise complement C3 [F(1,18) = 14.1, P = 0.001] and C4 [F(1,18) = 7.6, P = 0.013], and recovery complement [F(1,18) = 19.4, P less than 0.001] and C4 [F(1,18) = 13.5, P = 0.002] were also lower in the athletes than in sedentary controls. Acute increases during exercise were not associated with changes in catecholamines or cortisol. These data suggest that blood concentrations of C3 and C4, but not IgG, IgA, or IgM, are decreased during rest, graded maximal exercise, and recovery in marathon runners in comparison with sedentary controls. PMID- 2722327 TI - A comparison of two noninvasive methods in the determination of the anaerobic threshold in children. AB - Seventy children, ranging in age from 7 to 14 years, performed a maximal exercise test on a treadmill with determination of the anaerobic threshold (AT) by two methods: (1) with the gas exchange method the ventilatory anaerobic threshold (VAT) was identified by the increase in the ventilatory equivalent for O2 uptake without a concomitant increase in the ventilatory equivalent for CO2 output and (2) with the method proposed by Conconi, the AT was taken at the point beyond which the increase in work intensity exceeded the increase in heart rate and the linearity of the work rate/heart rate relationship was lost. The AT values measured with the two methods were correlated (r = 0.80, P less than 0.001). This result confirms, also in children, the validity of the simple Conconi method: It can be used particularly for the determination of the individual optimal intensity of training. PMID- 2722326 TI - Natural killer cell activity in peripheral blood of highly trained and untrained persons. AB - Natural killer (NK) cell activity and concentration of CD16+ cells (NK cells) and CD20+ cells (monocytes) in peripheral blood were measured in highly trained racing cyclists and in age- and sex-matched untrained controls. Median NK cell activity was 38.1% (range 20.0%-57.1%) in trained vs 30.3% (range 19.7%-43.1%) in untrained (P = 0.008). Median %CD16+ cells was 17% (range 7%-33%) in trained vs 11% (3%-29%) in untrained (P = 0.007). Indomethacin in vitro enhanced the NK cell activity in both groups. There was, however, no significant difference between the NK cell activity in trained and untrained after exposure to indomethacin in vitro. Indomethacin-enhanced NK cell activity was 45.9% (range 24.4%-67.5%) in trained and 40.0% (range 23.9%-68.5%) in untrained (P = 0.138). Mean %CD14+ cells was 8.3% (range 2%-15%) in trained vs 3.8% (2%-8%) in untrained (P less than 0.0001). The increased NK cell function thus demonstrated in highly trained persons might result in better resistance against infectious disease. PMID- 2722328 TI - Effects of clinostatism and orthostatism on blood viscosity. AB - The present study was planned to study the magnitude of the effects of body position upon blood viscosity. We compared blood rheological properties in nine healthy subjects after 1 h in a horizontal position and after 1 h in a vertical position. After orthostatism, blood viscosity was 38%, 41%, and 22% higher at 0.05, 1, and 20 s-1 shear rates, respectively. This result was the consequence of the increase of hematocrit (41.2% +/- 2.3% vs 44.2% +/- 2.7) and plasma viscosity (1.55 +/- 0.09 mPa.s vs 1.67 +/- 0.08 mPa.s) induced by orthostatism in all the subjects. The rise of the different plasma proteins and fibrinogen was the cause of the plasma viscosity increase. Blood viscosity at standard hematocrit (45%) was not significantly altered by orthostatism. Rheological studies at standard hematocrit showed that body position did not modify red cell deformability and aggregability. As suggested by the increase in hematocrit and plasma proteins and by the absence of alteration of blood rheological properties at standard hematocrit, the large effect of body position upon blood viscosity is the consequence of the hemoconcentration without alteration of erythrocyte deformability and aggregability. PMID- 2722329 TI - One- and two-dimensional echocardiography in body builders and endurance-trained subjects. AB - The object of the study was to investigate possible myocardial adaptations to intensive body building training and to differentiate them from the athlete's heart resulting from high intensive endurance training. Seven top-level body builders (BB) were examined by one- and two-dimensional echocardiography and bicycle ergometer step test. They were compared with seven highly endurance trained athletes (E) using the matched pair procedure. BB showed normal blood pressure at rest and during ergometric exercise; their ergometric performance was in the normal range of sedentary subjects. Absolute left ventricular muscle mass (LVMM) as well as one-dimensional measurements of wall thickness and internal diameters were found to be similar in BB and E, while body weight and surface related values were clearly higher in E. The ratios between LV myocardial thickness and internal diameter (M-mode) as well as between LVMM and LV volume (combined one- and two-dimensional method) were not statistically different between BB (0.356 +/- 0.077 and 1.10 +/- 0.16) and E (0.436 +/- 0.062 and 1.26 +/ 0.21). LV contractility was similar in both groups. Diastolic parameters showed only a slight tendency toward slower isovolumetric relaxation in BB. A significant correlation existed between lean body mass and LVMM in BB but not in E. The findings suggest that intense body building over a period of several years does not induce any form of concentric hypertrophy. Analogously to the increase in body dimensions, body building also causes an increase in heart size with an unchanged mass/volume ratio. There is no evidence of an enlargement of the heart in relation to body weight, as occurs in endurance athletes. PMID- 2722330 TI - Sports-related injuries in children. AB - Within a 3-year period, from 1980 to 1982, 1124 sports injuries of children aged 6-15 years were treated in the Turku University Central Hospital casualty department. Two-thirds (69%) of the injuries were sustained by boys. Sports injuries represented 21% of the diagnoses related to accidents in this age group. Half of the sports accidents occurred during the 4 winter months. Boys were injured most commonly in ice hockey (36%) and football (20%) and girls in skating (18%) and riding (18%). One quarter (26%) of the injuries were located in the head and neck, 36% in the upper extremities, 33% in the lower limbs, and 4% in the trunk. The most common types of injuries were fractures (26%), sprains and strains (24%), contusions (22%) and wounds (17%). The proportional occurrence of fractures increased with age in boys (P less than 0.001) and decreased in girls (P less than 0.001), luxations (P less than 0.05) and sprains (P less than 0.001) increased with age in girls; skull injuries (P less than 0.01) and contusions and wounds (P less than 0.001) decreased in boys. Girls had more sprains (P less than 0.001) but fewer contusions and wounds (P less than 0.001). Most of the injuries were mild; 9% of the cases were hospitalized. Minor surgery was performed in 16% and reconstructive surgery in 2% of all injuries. About 70% of the injuries occurred in nonorganized sports. PMID- 2722331 TI - Growth and pubertal development of young female gymnasts and swimmers: a correlation with parental data. AB - Whereas intensive and regular physical training is known to alter female reproductive function, its potential role in growth is still controversial. At the beginning of a longitudinal growth study of young elite female gymnasts (n = 34, 15-25 h/wk training) and moderately trained swimmers (n = 19, 5-15 h/wk), patterns of recalled parental growth and pubertal maturation were compared with those of parents of 25 sedentary school girls. These data were also correlated to the height, weight, pubertal development as well as adult height prognosis of their daughters. Bone age was estimated using the methods of Greulich-Pyle and Tanner (RUS score) and adult height prognosis using the methods of Bayley-Pinneau (BP), Roche-Wainer-Thissen (RWT), and Tanner et al. (TW2). Parents of gymnasts were significantly lighter (fathers: P = 0.027; mothers: P = 0.038) and shorter (fathers: P = 0.034; mothers: P less than 0.001) than those of swimmers and controls. Consequently, target heights of gymnasts were also significantly shorter (P less than 0.001). Recalled menarche occurred significantly later (P = 0.030) in mothers of gymnasts who, in turn, grow much alike their mothers. At the first visit, the gymnasts were shorter and lighter for age than swimmers and controls. Their bone age (11.0 +/- 1.3 years, mean +/- SD) was retarded (P less than 0.001) when compared with chronological age (12.6 +/- 1.2 years). Adult height prognosis was lower for gymnasts than for other girls (BP: P less than 0.001; RWT: P = 0.023, TW2: P less than 0.001), but adequate for target height range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722332 TI - Longitudinal changes in distance-running performance of young males. AB - Longitudinal studies of adolescent males have shown that absolute maximal aerobic power (VO2max) and distance-running performance improve with age, while VO2max expressed relative to body mass remains stable. These earlier studies used subjects that were engaged in distance-run training; therefore, it was not possible to assess the relative importance of growth and/or run training to improved performance. The purpose of this study, therefore, was to quantify longitudinal changes in VO2max, running economy (RE), and distance-running performance in non-run-trained young males. Six subjects were tested at mean ages of 9.9 (T1) and 16.8 years (T2). Statistical tests of mean values revealed that over the 7-year period, relative VO2max remained unchanged (T1, 48.9 ml.kg-1.min 1; T2, 47.8 ml.kg-1.min-1) and RE improved (T1, 234.2; T2, 202.8 ml.kg-1.km-1), 9 min run distance increased (T1, 1637 m; T2, 2115 m), and the estimated percent of VO2max incurred during the 9-min run increased from 85.8% (T1) to 99.5% (T2). It was concluded that the improvement in distance-running performance observed in adolescent boys was not dependent upon run training. In view of the fact that maximal aerobic power remained stable, this change appears to be attributable to better running economy and an ability in runs of a fixed duration to perform at a higher relative work load. PMID- 2722333 TI - Psychological effects during reduced training in distance runners. AB - Reduced training is most frequently employed by swimmers prior to an important competition. To investigate what occurs during reduced training in runners, ten well-trained adult male distance runners trained for 4 weeks at their baseline training distance (BT), followed by a 3-week period of a 70% reduction in training volume (RT). At the same time each week the subjects completed the Profile of Moods States (POMS) and Physical Self-Efficacy Scale (PSES). Overall and leg ratings of perceived exertion (RPE) were given each week while running at two consistent speeds on a motor-driven treadmill. Responses to the POMS, PSES, and Sport Competition Anxiety Test were also obtained prior to 5-km races during BT and RT. Pre-race and weekly global mood state was improved (less negative) during RT. Pre-race vigor decreased significantly (P less than 0.01) at RT week 2 as compared with BT, and then increased significantly (P less than 0.01) at RT week 3 as compared with week 2. Pre-race tension decreased significantly (P less than 0.05) at RT week 3. A significant (P less than 0.01) drop in testing day fatigue occurred at RT week 1 as compared with BT. Reduced RPEs were also noted during RT weeks 2 and 3 at the slower running speed. No differences were found for competition anxiety or physical self-efficacy. Racing performance remained constant throughout the study. These results suggest that the subjects were unaccustomed to RT, but maintained a positive mood state particularly when it was realized that performance capability was unaltered. PMID- 2722334 TI - Action in international medicine. PMID- 2722335 TI - Actinic prurigo at sea level in Colombia. PMID- 2722336 TI - Wax models of the skin. PMID- 2722337 TI - Ichthyosis. Reliability of clinical signs in the differentiation between autosomal dominant and sex-linked forms. AB - The reliability of clinical signs to differentiate between autosomal dominant ichthyosis (ADI) or sex-linked ichthyosis (SLI) were assessed. SLI was defined as ichthyosis in combination with steroid sulphatase deficiency. Age of onset and format of the scales were found to be reliable signs to ascertain the diagnosis of ADI or SLI. The ADI-like appearance in histopathology seems to be of little diagnostic value. PMID- 2722338 TI - Peripheral neural involvement in cutaneous leishmaniasis. A pathologic study of human and experimental animal lesions. AB - Peripheral neural involvement in cutaneous leishmaniasis has recently been recognized. A man presented with several tender hyperesthetic skin nodules. Histopathologic examination confirmed the diagnosis of cutaneous leishmaniasis. Of most interest was the presence of a striking lymphohistocytic inflammatory infiltrate around and within cutaneous nerves in addition to demonstrable leishmania organisms in the perineural space. This observation led to a detailed histopathologic evaluation of leishmanial skin lesions that developed in 13 mice after subcutaneous injection with leishmania major promastigotes. Varying degrees of neural involvement was noted in skin lesions from nine animals. In some lesions, in addition to inflammatory cells in the nerves, organisms were demonstrable within probable schwann cells. Three pathologic stages of dermal neural involvement were identified, namely, an early, intermediate, and late stage, depending on the severity of damage; however no correlation was found between the pathologic stage and the duration of the leismanial skin lesion of a specific animal. PMID- 2722339 TI - Dissemination in cutaneous leishmaniasis. 3. Lymph node involvement. AB - In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients (12%), two lymph node areas were involved. The affected lymph nodes were typically solitary, firm, mobile, nontender, only moderately enlarged, and appeared to persist beyond the clinical healing of the associated skin lesions. The results of pathologic and immunopathologic studies carried out on eight lymph nodes obtained from this group of patients supported the leishmanial etiology. Although amastigotes were only demonstrated in two lymph nodes, the leishmanial antigen was found in all eight specimens. The lymph node involvement is another manifestation of dissemination in infection with a dermotropic leishmania. It appears that in some cases, instead of the parasite, it may be the leishmanial antigen that disseminates and produces lymphadenitis. PMID- 2722340 TI - Familial Becker's nevus. PMID- 2722342 TI - Reactive perforating collagenosis. PMID- 2722341 TI - Positive Weil-Felix reactions in a case of rickettsialpox. PMID- 2722343 TI - Palisading granuloma after typhoid-paratyphoid immunization. PMID- 2722344 TI - Hyperpigmentation of the nail from lead deposition. PMID- 2722345 TI - Use of occlusive membrane in the treatment of prurigo nodularis. PMID- 2722346 TI - Should dermatologists read their own slides? PMID- 2722348 TI - Mortality from nonmelanotic skin cancer. PMID- 2722347 TI - Three siblings with extensive aplasia cutis congenita of the scalp and underlying bone defect: autosomal recessive inheritance. PMID- 2722349 TI - Topical corticosteroids. PMID- 2722350 TI - Ethnic differences in blood pressure level between Japanese school children in Bolivia and native Bolivians. AB - Blood pressure levels were measured in 626 children (138 Japanese, 477 Bolivian and 11 of mixed blood) in a Japanese agricultural settlement in Bolivia. Systolic (SBP) and diastolic (DBP) blood pressure was higher in Japanese children than in Bolivian children at each measured age by 4.09 mmHg (P = 0.0001) and 2.25 mmHg (P = 0.0038), respectively, using analysis of covariance. Although the slope of the regression line both for SBP and for DBP with age tended to be greater in Japanese, this was not statistically significant. There were no ethnic differences in height, weight or body mass index, however, which are usually indicators that correlate well with blood pressure. Ethnic differences in blood pressure were also shown at each of the measured values of height (SBP: 3.93, DBP: 2.19) and weight (SBP: 4.03, DBP: 2.23). Factors causing these ethnic differences are discussed in relation to cultural and genetic considerations. PMID- 2722351 TI - Oral contraception, smoking and inflammatory bowel disease--findings in the Royal College of General Practitioners Oral Contraception Study. AB - Data from the Royal College of General Practitioners Oral Contraception Study have been examined to determine whether oral contraceptive use was associated with the development of Crohn's disease or ulcerative colitis. Over a 17 year period Crohn's disease developed in 42 women and ulcerative colitis in 78. The incidence of both diseases was greater in oral contraceptive users compared to non-users with the rate ratio for Crohn's disease being 1.7 (95% confidence limits, 0.88, 3.2) and for ulcerative colitis being 1.3 (95% confidence limits 0.82, 2.0). For both diseases incidence was unrelated to parity or social class, but women smoking at recruitment had a greater incidence of Crohn's disease (rate ratio 1.8, 95% confidence limits 0.93, 3.3) and a reduced incidence of ulcerative colitis (rate ratio 0.68, 95% confidence limits 0.41, 1.1). Although these results are based on small numbers and could be chance findings, they are consistent with other studies showing associations between oral contraceptive use, smoking and the development of Crohn's disease and ulcerative colitis. PMID- 2722352 TI - Risk factors for endometrioid, mucinous and serous benign ovarian cysts. AB - To evaluate the risk factors for serous, mucinous and endometrioid ovarian cysts, data were collected in a case-control study conducted in the greater Milan area based on 202 women with benign cysts (114 endometrioid and 88 serous or mucinous) of the ovary and 1127 controls. Questions were asked about menstrual and reproductive characteristics, marital status, education, history of various diseases, and lifetime use of oral contraceptives and other hormonal treatments. Higher social class, earlier menarche and longer interval between age at first marriage and first birth, a likely indicator of subfertility, were associated with an increased risk of serous, mucinous and endometrioid cysts. Women with endometrioid cyst were characterized by low parity, less frequent irregular or long menses, more frequent oral contraceptive use and low body mass index, while the most relevant risk factor associated with serous and mucinous cysts was greater age at first birth. The present data point out the epidemiological differences between endometrioid and serous or mucinous cysts. Further, they suggest that analyses of risk factors for epithelial ovarian cancer subdivided by various histotypes may be of interest in order to confirm possible heterogeneities in the aetiology of ovarian epithelial neoplasms. PMID- 2722353 TI - Risk factors for sudden infant death syndrome in the US Collaborative Perinatal Project. AB - Risk factors for sudden infant death syndrome (SIDS) were studied among infants born to the nearly 56,000 women enrolled in the US Collaborative Perinatal Project from 1959 through 1966. The 193 SIDS cases identified in the cohort were compared with 1930 controls randomly selected from infants who survived the first year of life. The previously documented excess risk associated with black race disappeared after adjusting for maternal education and family income. Maternal smoking, maternal anaemia during pregnancy, and lack of early prenatal care were all positively associated with SIDS. After adjustment for gestational age, infants with low weight and length at birth were still at increased SIDS risk, suggesting that intrauterine growth retardation may be a risk factor. Neurological abnormalities diagnosed before death were associated with SIDS, but much of the association was removed by adjusting for birthweight. The negative association of breastfeeding with SIDS was much reduced upon adjustment by maternal education and birthweight. These findings may have important implications in our understanding of the epidemiology of SIDS. PMID- 2722354 TI - Sudden infant death and immunization: an extensive epidemiological approach to the problem in France--winter 1986. AB - In March 1986 five sudden infant deaths were reported, following the diphtheria tetanus toxoids-pertussis and inactivated poliomyelitis virus (DTP-IPV) immunization of the infants concerned. An epidemiological study was carried out in order to investigate the possibility of a relationship between this immunization and sudden infant death syndrome (SIDS). A detailed examination of the five cases had been carried out by a doctor. An exhaustive survey of all postneonatal deaths occurring between January and March 1986 was conducted and also a matched case-control survey. No significant differences were found in the immunization rates between SIDS and other causes of death, nor between SIDS and living controls. These results are compared with the results from previously published studies on the topic. PMID- 2722355 TI - Ethnic determinants of perinatal statistics of Chinese: demography of China, Hong Kong and Singapore. AB - Despite limited health resources, the Chinese have achieved reasonably good perinatal and neonatal mortality rates comparable to those of many developed countries. China, Hong Kong and Singapore, areas with different socioeconomic structures, have shared the same favourable ethnic determinants of perinatal mortality. The Chinese have much lower incidence of very low birthweight babies (less than 1000 g) and lethal congenital anomalies. The former is probably related to the rarity of teenage pregnancy, maternal smoking and alcohol consumption. Asphyxia remains a major contributor to perinatal deaths. The perinatal mortality rate in mainland China has remained relatively unchanged in contrast to the dramatic falling trend in Hong Kong and Singapore in the past two decades. This may be accounted for by differences in socioeconomic conditions despite their identical ethnic origin. Studying the Chinese sociocultural pattern may have a great impact on perinatal mortality by preventing low birthweight babies. PMID- 2722356 TI - Video display terminal use and spontaneous abortion risk. AB - A matched case-control study investigated the potential effects of video display terminal (VDT) use on risk of spontaneous abortion in pregnancy. Structured interviews were administered to 334 cases immediately following a miscarriage. For each case, two age and parity-matched controls were enrolled, the first being a woman still pregnant (less than 25 weeks' gestation), and the second a woman in the postpartum ward of the same participating hospital. Separate analyses were carried out for each comparison group due to potential and observed differences in recall loss and selection bias. The overall exposure to VDT's during the period of interest (three months preceding the last menstrual period [LMP] to four months post-LMP) did not indicate an increased risk for either control group comparison (OR = 1.14, p = 0.47 with postnatal controls; OR = 0.80, p = 0.20 with prenatal controls). Furthermore, when exposure data were re-classified to remove women with distant or single exposures, no significant odds ratios were found. While several socioeconomic and obstetric variables were significantly associated with VDT use, multivariate analysis did not alter the lack of association of VDT use with case-control status. Finally, evidence for recall bias in postnatal control reporting, evidenced by underreporting of trivial exposures in this group, is examined. PMID- 2722357 TI - Epidemiology and cause of deaths among women in rural Bangladesh. AB - A total of 542 women aged 15 to 44 years died during the 10-year period 1976 to 1985 in the control area of Matlab, an area with a population of 90,000, representative of many other rural areas of southern Bangladesh. The corresponding age-specific mortality rate was 290 per 100,000 women 15-44 years. These deaths have been analysed retrospectively, using information collected through the Demographic Surveillance System set up by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and verbal autopsies conducted in the homes. Of these deaths, 175 (32%) were due to infectious diseases, 163 (30%) to direct obstetric complications, 67 (12%) to injuries, and the remaining 26% to other causes. Cause-specific and proportionate mortality rates showed a positive association with age for deaths due to infectious diseases, non-infectious diseases and unspecified causes, and an inverse association with age for deaths due to injuries. These rates showed a peak in the intermediate age group 25 to 34 years for deaths due to direct obstetric causes. No consistent trends were visible when annual rates were studied over time. Prior to death, 42% of the women were attended by traditional practitioners, and 33% were not attended at all. Demographic impact is discussed, emphasizing the contribution of obstetric causes to overall mortality. Priorities for health policy implications are proposed, focusing upon a strong maternity care programme, and improved availability of female health personnel, in the context of the socio-cultural constraints imposed on women in poor rural areas. PMID- 2722358 TI - Mortality among farmers in Iceland. AB - A retrospective cohort study was performed to determine the cause of death among 5923 farmers in Iceland. Information on deaths occurring between 1977 and 1985 was obtained through the Statistical Bureau of Iceland. The vital status could be ascertained for all subjects in the study. Expected death rates were calculated, based on the national rates for males in the corresponding age groups and calendar years. The number of deaths from all causes, malignant neoplasms, lung cancer, ischaemic heart disease, respiratory diseases and accidents was less than expected in the total cohort and in nearly all subcohorts. There was no statistically significant excess risk, however: SMR for skin cancer was 2.30, SMR for Hodgkin's disease was 1.71, for leukaemia SMR was 1.60, and for brain cancer SMR was 1.23 in the total cohort. The results are in agreement with those of most previous studies of farmers, but because of the short follow-up time, the excess risk found for deaths from skin and haematological malignancies did not reach statistical significance. Further follow-up is planned in the future. PMID- 2722359 TI - Changes in mortality among Cubans in the United States following an episode of unscreened migration. AB - This paper discusses the effect of the Mariel migration, a massive boatlift from Cuba to the United States in 1980, on mortality among Cuban Americans. Estimates of the Cuban-born population in the US were made for 1979 and 1981, the years prior to and following the boatlift. A comparison of age-adjusted rates showed that while general mortality did not change greatly (an increase of only about 5%), there was a 151% increase in homicide mortality. The increase in the homicide rate among Cubans in metropolitan Miami (Dade County), the major area of concentration, was 109%; it was still greater among Cubans elsewhere (240%). The demographic differences between the Mariel migrants who settled in Dade and those who were settled elsewhere are discussed. PMID- 2722360 TI - Social ties and survival among the elderly in Tampere, Finland. AB - The association between social ties and survival was assessed using a stratified sample of 1060 elderly aged 60-89 years in the city of Tampere, Finland. During the 6.5-year follow-up, 240 men and 153 women died. Compared with married men, the death rate ratio among unmarried men was 1.7 and among widowers 1.2. The respective ratios for women were 1.2 and 1.2. Vicinity of children, living alone, loneliness, social contacts, and social participation were used as indicators of social ties. Men and women were analysed separately. None of the indicators were significant predictors of survival in proportional hazard analyses, after adjusting for age, perceived health, functional ability and occurrence of a disabling disease at baseline. The relative hazards ranged between 0.85 and 1.38, and all 95% confidence intervals included unity. However, when social participation was entered into the models as a continuous variable, it was strongly associated with increased survival in both sexes. Social participation is probably not protective as such, but it may rather reflect way-of-life, which is characterized by social competence or 'control of destiny'. PMID- 2722361 TI - Cancer mortality of Chinese in Canada. AB - Cancer deaths determined from national vital statistics in Canadian ('Chinese') immigrants who were born in mainland China, Hong Kong or Taiwan were compared with those in the Canadian-born population. Standardized mortality ratios (SMR) based on 1981 census data and on 755 deaths among 81,740 Chinese males and 586 deaths among 83,965 females during 1980-1984, showed that the overall cancer mortality in Chinese males (SMR 141), and females (SMR 116), was significantly higher than in the Canadian-born. Moreover, SMR varied by cancer site and showed a pattern of risks similar to those reported for foreign-born Chinese in the USA: strikingly high SMR for nasopharynx and liver or gallbladder in males and females; high ratios for stomach, intestines or colon, rectum, and lung, but a low ratio for prostate in males; and high ratios for lung and cervix uteri but low ratios for breast and ovary in females. These findings indicate that useful studies on cancer mortality could be carried out in Canadian Chinese. PMID- 2722362 TI - Lead, IQ and social class. AB - Social class (SC) conveys information about a child's potential lead exposure (PB) as well as other, independent determinants of cognition (IQ). Thus, depending on the way in which SC is handled in statistical analyses, the PB-IQ association may be either 'overadjusted' or 'underadjusted' for SC. Two assumptions that underlie the inclusion of SC in correlation/regression analyses of the PB-IQ relationship are: 1) SC is an interval scale and 2) the PB-IQ relationship is homogeneous in all social strata. Simulation analyses are presented to illustrate the impact that different values of the bivariate correlations PB-SC, IQ-SC, and PB-IQ have on the estimate of the PB-IQ adjusted for SC. Alternative approaches to addressing these issues are discussed. PMID- 2722363 TI - Short-term effects of sulphur dioxide pollution on mortality in two French cities. AB - To assess the short-term effects of sulphur dioxide (SO2) atmospheric pollution on mortality a study was conducted in two large French cities, using daily measures of pollution and mortality. A statistically significant association between daily SO2 pollution and respiratory deaths up to 10 days later was shown in both cities for both male and female populations together in the age group 65 years and over. No coherent results were found between SO2 pollution and cardiovascular deaths, or between suspended particulates and either respiratory or cardiovascular deaths. Particular emphasis was put on the use of correct statistical procedures using time series analysis and on the comparison of the part played by SO2 or suspended particulates on mortality. PMID- 2722364 TI - Epidemiological significance of microbiological pollution criteria for river recreational waters. AB - A retrospective follow-up study was conducted during the summer of 1986 in the French Ardeche basin in order to assess the relationship between swimming-related morbidity and the bacteriological quality of the recreational water. 5737 tourists in eight holiday camps were questioned as to the occurrence of illness and their bathing habits during the week preceding the interviews. The rate-ratio contrasting swimmers and non-swimmers for total morbidity is 2.1 (1.8-2.4) = 95% confidence interval); gastrointestinal illness is the major type of morbidity and differs significantly between the two groups (RR = 2.4 (1.9-3.0) for total gastrointestinal cases; RR = 2.3 (1.7-3.2) for 'objective' gastrointestinal cases). Faecal streptococci (FS) are best correlated to gastrointestinal morbidity, using direct linear regression models. Faecal coliforms (FC) are not as good predictors of the risk. The concentration of faecal streptococci above which the 'objective' gastrointestinal morbidity among bathers is significantly greater than among non-bathers is 20 FS/100 ml. Swimmers suffer skin ailments much more frequently than non-swimmers (RR = 3.7 (2.4-5.7]; although the relationship may be artefactual, this type of morbidity is well correlated with the concentration of faecal coliforms, aeromonas and pseudomonas. This study provides epidemiological data on which to base microbiological standards for river recreational waters dependent on what might be considered as an 'acceptable' risk. PMID- 2722365 TI - Nitrate exposure from drinking water and diet in a Danish rural population. AB - Increasing levels of nitrate (NO3-) in drinking water in Denmark is of concern due to the possibility of an associated increase in long-term exposure to endogeneously formed N-nitroso compounds. Using a duplicate portion technique in combination with a qualitative description of diet and other background variables, the total nitrate intake in a Danish rural population and the contribution of drinking water to the total nitrate exposure is estimated. People drinking nitrate-free water have an intake of 37 mg NO3- per day. At 47 mg NO3- per litre, the exposure is increased to 89 mg, about 60% of which originates from the water. At 84 mg NO3- per litre, the daily exposure is 123 mg, 70% of which originates from the drinking water. These crude comparisons between three groups of people are supplemented with quantitative modelling of nitrate exposure at individual level. Apart from drinking water, consumption of vegetables is a major source of nitrate in this population. Using nitrate in overnight urine samples to quantify exposure is less accurate than the duplicate dietary portion technique and tends, in the present study, to underestimate the contribution of water derived nitrate to total nitrate intake. PMID- 2722366 TI - Injuries and risk factors for injuries from the 29 May 1982 tornado, Marion, Illinois. AB - On 29 May 1982, a tornado struck Marion, Illinois. As a result, ten people were killed, 38 were hospitalized, and 196 were examined in hospital emergency rooms. In order to describe injuries and to identify risk factors that might have increased or reduced the risk of injuries, we (1) conducted a telephone survey of all persons we could identify who were in the path of the tornado and (2) reviewed the emergency room logs and records and admission files of hospitals that provided initial care. Overall, 19.3% of people who were in the path of the tornado were injured during the impact. Only 39.0% of people examined in emergency rooms were injured as a direct result of the impact. The remainder were injured while rescuing, cleaning up, or just walking in the disaster area. Behaviours that were most protective were being in a house on the lowest floor, staying underground in a basement, protecting one's body with something like a blanket, and staying away from windows. Neither lying down nor opening doors or windows seemed to decrease the risk of being injured. Our results emphasize the need for early warnings and public education about protective behaviours. PMID- 2722367 TI - Cancer incidence among native Americans of western Washington. AB - The incidence of cancer among Native Americans in Alaska, Canada, and the south western United States has been reportedly low relative to the Caucasian populations in these areas. We investigated the incidence of cancer among the Native Americans of Western Washington for the time period 1974-1983 and compared it to that of the Caucasian population using two types of analyses, age standardized incidence ratios (SIR) and proportional cancer incidence ratios (PIR). Native Americans of this area were found to be at lower risk of cancer than Caucasians at almost all ages. The age-standardized incidence ratio (SIR) for all cancer sites was 0.4 (p less than 0.01) for males and 0.6 (p less than 0.01) for females. A relative excess of cancer of the cervix (SIR = 1.6, PIR = 2.1, p less than 0.05) was found among Native American females. Significant deficits were found for corpus uterine cancer among females (SIR = 0.2, PIR = 0.5, p less than 0.05) and cancer of the prostate among males (SIR = 0.2, PIR = 0.5, p less than 0.05). A suggestive increase in the risk of cancer of the gallbladder was discovered for males and females. This is the first report on cancer incidence among Native Americans in Western Washington. PMID- 2722368 TI - Epidemiological surveillance in Peace Corps Volunteers: a model for monitoring health in temporary residents of developing countries. AB - In 1985, the US Peace Corps developed a computerized epidemiological surveillance system to monitor health trends in over 5500 Peace Corps Volunteers working in development projects in 62 countries worldwide. Data on 31 health conditions and events are collected monthly from each country; quarterly and annual incidence rates are then calculated, and the analysed data are distributed. In 1987, the most commonly reported health problems were diarrhoea (unclassified), 48 cases per 100 volunteers per year; amoebiasis, 24 per 100 volunteers per year; injuries, 20 per 100 volunteers per year; bacterial skin infections, 19 per 100 volunteers per year; and giardiasis 17 per 100 volunteers per year. Tracking each of these common problems, as well as other selected health conditions, guides design of more specific studies and disease control efforts. Health problems with very low rates (less than 1.0/100 volunteers/year) include hepatitis, schistosomiasis, non-falciparum malaria, and filariasis. The epidemiological surveillance system provides the health data needed to plan, implement, and evaluate health programmes for Peace Corps Volunteers, and provides a model for surveillance in other groups of temporary and permanent residents of developing countries. PMID- 2722369 TI - Would a healthier population consume fewer health service resources? A life-table analysis using hospital in-patient enquiry (HIPE) bed-usage statistics as a proxy for hospital treatment costs. AB - The long-term effects upon acute-care hospital costs of reductions of morbidity and mortality from various causes are explored. The daily number of beds used per million population for all diagnostic categories is suggested as a proxy measure of hospital costs. An index of lifetime bed usage for a hypothetical cohort of persons living out their lives under specified age-specific mortality and morbidity patterns is derived. Examples of the application of this index are given for differing assumptions about mortality and morbidity in males. It is shown that reducing ischaemic heart disease or cancer morbidity will lead to increased overall hospital costs whereas reductions in the rate of occurrence of accidents, injuries and poisonings would reduce overall costs. The assumptions underlying the use of the index are discussed and extensions to the population model are proposed. PMID- 2722370 TI - Nutrient misclassification: bias in the odds ratio and loss of power in the Mantel test for trend. AB - The effect of misclassification by one-, two-, or seven-day food records on the apparent magnitude of results was quantified for two hypothetical models of association of diet with disease. For each of 106 women, classification to quintiles of intake was calculated from 37 to 72 one-day records and compared to classification by one- to seven-day records. In analyses based on few records per subject, odds ratios were biased toward unity and results from models differing in strength of association of diet with disease were more similar. Loss of power in a test for trend was especially important for associations of the magnitude probable for diet and disease relationships (odds ratios of 3.00 or less) and for samples of 100 cases and 100 controls or fewer. The measurement error associated with diet measures currently in use can obscure relatively strong associations even without biased or confounded measures. PMID- 2722371 TI - Prevalence of antibodies to human immunodeficiency virus among intravenous drug users in Israel--association with travel abroad. AB - A serological survey of 400 Israeli intravenous drug users showed a 2% prevalence of antibodies to human immunodeficiency virus (HIV). No difference was found between seropositive and seronegative subjects regarding mean age, duration of intravenous drug use, and needle sharing. Seropositivity was, however, significantly associated with travel abroad since 1980 (P less than 0.001), and with intravenous drug injection abroad (P = 0.04). These data indicate that Israel is a pre-endemic area for HIV infection, and transmission of the virus among Israeli intravenous drug users seems to be infrequent at the current level of exposure. PMID- 2722372 TI - Mothers' personal and domestic hygiene and diarrhoea incidence in young children in rural Bangladesh. AB - This study examines the effect of maternal personal and domestic hygiene on the incidence of diarrhoea in children aged 6-23 months from rural areas around Teknaf, Bangladesh. The intervention area received augmented water supply through handpumps and health education while the control area received no project inputs. From July 1980 to June 1983, diarrhoea incidence was recorded weekly while mothers' personal and domestic hygiene was observed yearly. Annual incidence of diarrhoea in 314 children from the intervention area and 309 children from the control area was analysed in relation to maternal personal and domestic hygiene, controlling for education and occupation of household head and household size. Results show that, in both areas, use of handpump water for drinking and washing, removal of child's faeces from the yard, and maternal handwashing before handling food and after defaecation of self and child, observed together, decreased yearly diarrhoea incidence in children by more than 40% compared to children living in households where none or only one of these practices was observed. PMID- 2722373 TI - The risk of infection from Giardia lamblia due to drinking water supply, use of water, and latrines among preschool children in rural Lesotho. AB - Stool samples were collected from 267 rural, preschool children in four districts in Lesotho during October-November, 1984. Sixty-three children (23.6%) were tested positive for Giardia lamblia, the most commonly recovered parasite from stool samples. The use of low amounts of water for personal hygiene was associated significantly with having G. lamblia (OR = 2.42), but the use of traditional, non-improved drinking water sources (OR = 1.38) or lack of latrines (OR = 0.94) was not. Although G. lamblia may be primarily waterborne in developed countries, the amount of water that is used for personal and domestic hygiene may be more important than the quality of drinking water in developing countries. Other risk factors that were identified to be associated significantly with having or not having Giardia were child older than 24 months (OR = 6.79), mother less than 20 years of age (OR = 5.18), residing in Mohales Hoek district (OR = 2.33), and possessing several agricultural tools (OR = 0.70). PMID- 2722374 TI - Chlamydial antibodies and tubal infertility. AB - Prevalence of Chlamydia trachomatis antibodies was studied in infertile women with and without tubal obstruction, and in a control group of pregnant women in a Central-African country with a high infertility rate. In comparison with the control group, tubal infertility patients were significantly more likely to have serum antibodies of 1:64 or greater with an age-adjusted odds ratio of 7.8 (95% confidence interval (CI) 3.2-19.1). Infertile women without tubal obstruction had antibody titres similar to the control group with an odds ratio of 1.1 (95% CI: 0.6-1.9). In the tubal infertility group there was a kind of dose-response relationship between chlamydial antibodies and the severity of tubal damage and pelvic adhesions on laparoscopy, with odds ratios of 3.2 (95% CI: 0.7-14.8), 6.2 (95% CI: 1.9-21.6) and 18.1 (95% CI: 6.0-68.5) in the group with mild, moderate and severe pelvic adhesions respectively. This survey adds more evidence to the hypothesis that C. trachomatis is a major agent responsible for tubal infertility in Central Africa. PMID- 2722375 TI - Loss of maternal measles antibody during infancy in an African city. AB - Measles epidemics with 20% of the cases under nine months of age continue to occur in Brazzaville, Congo, even though measles vaccination coverage was 77% in the 12- to 23-month age group in 1986. In order to estimate the duration of passive immunity against measles, we conducted a serologic survey of infants aged 2 to 9 months. Measles antibody was measured from capillary blood with the plaque inhibition test. An antibody titre of 40 milli-International Reference Units per ml of serum (mIRU/ml) or less was defined as seronegative. Among the 252 infants studied, the proportion with detectable antibody dropped from 95.8% at 2 months of age to 48.5% at 4 months of age, and to 8.2% in the 7-8 month age group. A simple logistic model with age as the only variable provided an excellent fit to the observed values. Between the ages of 8 and 28 weeks, there was an almost steady decline of approximately 4.7% per week in the proportion of infants who were seropositive. These findings suggest that loss of maternal measles antibody during infancy might be faster than reported in other African populations. Giving measles vaccine to infants before the age of nine months currently recommended by the Expanded Programme on Immunization may be useful in some populations. Further studies of seroconversion and impact on measles are needed. PMID- 2722376 TI - An 'electronic' extramural course in epidemiology and medical statistics. AB - This article describes an extramural university course in epidemiology and medical statistics taught using a computer conferencing system, microcomputers and data communications. Computer conferencing was shown to be a powerful, yet quite easily mastered, vehicle for distance education. It allows health personnel unable to attend regular classes due to geographical or time constraints, to take part in an interactive learning environment at low cost. This overcomes part of the intellectual and social isolation associated with traditional correspondence courses. Teaching of epidemiology and medical statistics is well suited to computer conferencing, even if the asynchronicity of the medium makes discussion of the most complex statistical concepts a little cumbersome. Computer conferencing may also prove to be a useful tool for teaching other medical and health related subjects. PMID- 2722378 TI - A situation in which age-adjustment by covariance analysis may be inappropriate. PMID- 2722377 TI - Alcohol consumption and breast cancer: a cross-national correlation study. AB - The authors examined the cross-national correlation of alcohol consumption (based on food availability data) and breast cancer. Weighted correlation coefficients for alcohol and breast cancer were 0.31 for mortality and 0.65 for incidence; the corresponding unweighted coefficients were 0.50 and 0.45. Correlation coefficients for fat consumption and breast cancer ranged from 0.69-0.89. After adjustment for fat consumption in multiple regression models, the positive alcohol-breast cancer association disappeared, while the fat-breast cancer correlation remained positive and strong. These findings do not support the positive alcohol-breast cancer association that has been suggested by analytical epidemiological studies. The multivariate results, however, should be interpreted with caution due to the potential variation in the extent to which national alcohol data reflect consumption among females. PMID- 2722379 TI - Linear Index of Mortality as a measure of health status. PMID- 2722380 TI - Autoimmune disorders and multiple myeloma. PMID- 2722381 TI - Menthol cigarette smoking and oesophageal cancer. AB - Oesophageal cancer incidence and mortality among American blacks is over three times the rate for whites. Between 1950 and 1977 the age-adjusted oesophageal cancer mortality rate approximately doubled in non-whites while remaining virtually unchanged in whites. Between World War II and the 1970s menthol cigarette sales dramatically increased, roughly paralleling the increase in oesophageal cancer among blacks. The present study uses existing data from a large hospital-based case-control study to test whether menthol cigarette smoking is related to oesophageal cancer. Oesophageal cancer cases were current smokers. Controls were matched to the cases on age (+/- 5 years) and sex, had conditions thought not to be related to tobacco use, and were also current smokers. Tabular analyses showed no change in risk for males ever-smoking menthol versus those never smoking menthol cigarettes. For women, however, there was an increased risk. Results of logistic regression analyses performed to account for potential confounding factors showed a marginally significant (P = 0.08) decrease in risk among male short term (less than 10 years) menthol smokers versus male never menthol smokers (OR = 0.50, 95% Cl: 0.23-1.07) but no increased risk for menthol smoking of longer duration. Duration of menthol smoking fitted as a continuous variable showed no increased risk (P = 0.9) after accounting for non-menthol cigarette smoking duration (about 2% per year increase, P = 0.02). For females, the logistic analysis produced a marginally significant (P = 0.07) increased risk for longer menthol use (OR = 2.30, 95% Cl: 0.93-5.72).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722382 TI - Prediagnostic serum selenium in a case-control study of thyroid cancer. AB - Sera from 43 persons who developed thyroid cancer on an average 4.8 years after blood sampling were compared with sera from controls. Three controls per case matched for sex, age, place of residence and year of blood sampling, with regard to serum selenium and serum copper. Cases were significantly lower in serum selenium than controls, and the estimated odds ratio of thyroid cancer increased from 1 for levels greater than or equal to 1.65 mumol/l, to 6.1 for levels 1.26 1.64 mumol/l, to 7.7 for levels less than or equal to 1.25 mumol/l. When time from blood sampling to diagnosis of the case was considered, it could be shown that the protective effect of high serum selenium concentrations was restricted to the last (less than 7) years prior to the diagnosis of thyroid cancer. The serum selenium concentration of cases tended to decrease relative to controls the shorter time was from blood sampling to the diagnosis. There was no difference between cases and controls with regard to serum copper. PMID- 2722383 TI - Gallstone growth, size, and risk of gallbladder cancer: an interracial study. AB - To investigate gallstone size, growth, and the relation between stone size and gallbladder cancer we have used cholecystectomy reports from 1676 female subjects (169 Whites, 531 Blacks, and 976 Native American Indians). Although the prevalence of gallstones differs markedly in these groups it appears that the estimated growth rate of gallstones in younger subjects, 2.0 mm per year (95% confidence interval: 1.7-2.3 mm) is homogeneous for all three groups. In both Indian and non-Indian populations the proportion of small stones diminished and the proportion of large stones increased over time. We found a strong relationship between gallstone size and gallbladder cancer. Large stones (greater than or equal to 3 cm) were found in 40% of patients with gallbladder cancer but in only 12% of all subjects of similar age. The relative risk for gallbladder cancer in subjects with stones greater than or equal to 3 cm was 9.2 compared with subjects with stones less than 1 cm. (95% confidence interval: 2.3-37). We estimate that one-third of all gallbladder cancers in subjects with calculi will be associated with large (greater than or equal to 3 cm) stones. We believe that stone size might be used to determine the risk of gallbladder cancer in patients with gallstones. PMID- 2722384 TI - Case-control studies of cancer in New Zealand electrical workers. AB - A series of reports, including a New Zealand case-control study, have suggested that electrical workers are at increased risk of leukaemia. We report here a further series of case-control studies based on the New Zealand Cancer Registry. These involved 19,904 male patients registered with cancer for the period 1980 1984 who were aged 20 years or more at time of registration. For each cancer site, the registrations for other sites formed the control group. Three main findings emerged. First, there is an elevated leukaemia risk in New Zealand electrical workers (odds ratio (OR) = 1.62, 95% confidence interval (Cl) 1.04 2.52), but little evidence of increased risks for other cancer sites. Second, contrary to other published studies, the increased risk was primarily for chronic leukaemia (OR = 2.12) rather than acute leukaemia (OR = 1.25), and for lymphatic leukaemia (OR = 1.73) rather than myeloid leukaemia (OR = 1.22). Third, the increased risk was strongest for certain categories of electrical work including radio and television repairers (OR = 7.86, 95% CI 2.20-28.09), electricians (OR = 1.68, 95% Cl = 0.75-3.79), linemen (OR = 2.35, 95% Cl 0.97-5.70) and power station operators (OR = 3.89, 95% Cl 1.00-15.22). PMID- 2722385 TI - Brain tumour mortality in immigrants. AB - All Canadian deaths due to malignant brain tumour for the years 1970-73 were identified and analysed for country of birth. The years 1970-73 were chosen since in later years country of birth was no longer available for each death. The brain tumour population consisted of 1551 male and 1058 female deaths and matched controls were chosen from deaths due to other causes. Americans who died of brain tumour in Canada had a standardized mortality ratio (SMR) of 1.0 compared to their fellow Americans in the USA. Italian, German, Dutch and British immigrants had SMR between 1.5 and 2.6 compared to rates in their home countries and between 1.24 and 2.09 when compared to Canadian rates. A series of graphs shows the increased risk for male immigrants quite dramatically, and indicates that for females the increases were less pronounced. Further analysis showed that the excess risk is confined to those who were born in Western Europe while their Canadian-born children experienced the same rates as all Canadians. Based on the limited information available, occupation could not be shown to play a role in establishing risk. An attempt was made to pinpoint the years of immigration which showed the greatest risk. It is concluded that the determination of risk of brain tumour has a strong environmental component. The possibilities for identification of this component are discussed. PMID- 2722386 TI - Breathlessness, chronic bronchitis and reduced pulmonary function as predictors of cardiovascular disease mortality among men in England, Scotland and the United States. AB - Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of chronic bronchitis, and pulmonary function are investigated among men in two employed populations (17,717 London civil servants and 4904 Scottish workers) and in two communities (844 men in Tecumseh, Michigan and 6859 men in Renfrew and Paisley Burghs, Scotland). Men are aged 40-64 years at entry in all studies except Renfrew-Paisley, where they are aged 45-64 years. Length of follow up ranges from 6 to 16 years. Age and smoking habits were controlled for in all analyses. Chronic phlegm production is not significantly associated with CVD mortality, and 'chronic bronchitis' is significantly associated with mortality only in the employed populations. Low FEV1 is significantly associated with CVD mortality only in the Whitehall study; however, the rate ratios are above one in all studies. Breathlessness is significantly associated with CVD mortality in all studies. These associations between CVD mortality and 'chronic bronchitis', low FEV1, and breathlessness persist after also controlling for employment grade, systolic blood pressure, antihypertensive medication, ECG changes, plasma cholesterol level, body mass index and diabetes. Only the associations between breathlessness and mortality persist after further controlling for low FEV1 and myocardial ischaemia. The rate ratios between breathlessness and mortality are about two for all studies. It is concluded that in these populations, breathlessness is an independent and major predictor of CVD mortality. PMID- 2722387 TI - The prevalence and risk factors of hypertension in Klong Toey slum and Klong Toey government apartment houses. AB - We have investigated the prevalence and factors associated with hypertension in 976 residents of Klong Toey Slum and 909 residents of government apartment houses, aged 30 and above, selected by probability sampling after systematic household surveys with an average response rate of over 80%. Hypertensives were those who had, on at least three measurements, average diastolic blood pressure equal to or above 95 mmHg and/or systolic blood pressure equal to or above 160 mmHg or had blood pressure below 160/95 mmHg but were currently on antihypertensive medication. The prevalence of total hypertensives were found to be 17.3% and 14.0% for residents of slum and government apartment houses respectively. Men and women had more or less equal mean blood pressure and similar prevalence of hypertension. The mean systolic blood pressure increased with age while the mean diastolic blood pressure, after an initial rise with age in lower age groups, tended to level off from the age group 55-64 years upwards. Only one quarter to one third were aware of their illness and less than 15% were receiving treatment. Significant risk factors include age, duration of smoking, duration of alcohol intake, high body mass index, high Cholesterol, high Triglyceride, high Low Density Lipoprotein Cholesterol (LDLC), low High Density Lipoprotein Cholesterol (HDLC), high Total Cholesterol (TC) to High Density Lipoprotein ratio (TC/HDLC), high LDLC to HDLC ratio and diabetes mellitus. The data suggested that hypertension was an important public health problem in low socioeconomic groups in Bangkok. Some of the risk factors were related to an unhealthy lifestyle which should receive due consideration in planning for appropriate control. PMID- 2722388 TI - Isolated systolic hypertension in Dutch middle aged and all-cause mortality: a 25 year prospective study. AB - In the early 1950s, the blood pressure of 3901 Dutch civil servants and their spouses aged 40-65 years was measured in a general health survey. Isolated systolic hypertension (systolic pressure greater than 160 mmHg, diastolic pressure less than 90 mmHg) was observed in 6.3% of the women and 3.0% of the men. The prevalence increased with age and it was more common in women in all age groups. Using logistic regression, with adjustment for potential confounders (age, smoking, serum cholesterol, Quetelet index, alcohol consumption, haemoglobin level, pulse rate and diastolic blood pressure) the association of 15 and 25-year total mortality with isolated systolic hypertension was determined. Compared to normotensive people (systolic pressure less than or equal to 135 mmHg, diastolic pressure less than 90 mmHg), the risk of death from all causes was significantly higher for men with isolated systolic hypertension after 15 and 25 years of follow-up (odds ratio OR = 2.4, 95% confidence interval (CI) 1.2-4.8 and OR = 3.2, 95% CI 1.3-8.0). For women 15-years mortality risk was strongly associated with isolated systolic hypertension (OR = 3.7, 95% CI 1.4-9.7). The increased risk was less pronounced after 25 years of follow-up (OR = 1.7, 95% CI 0.96-3.0). Our results support those of other studies and indicate that isolated systolic hypertension is an important independent risk factor for all-cause mortality. Since isolated systolic hypertension may be an indicator for the early onset of ageing, it is important to study its determinants and to pay more attention to its diagnosis and treatment in middle-aged populations. PMID- 2722389 TI - A preliminary evaluation of factors affecting an experimental system for vaccination-and-challenge with Haemonchus contortus in sheep. AB - A preliminary evaluation of factors affecting an experimental system for vaccination-and-challenge with Haemonchus contortus in sheep. International Journal for Parasitology 19: 169-175. Studies were made with Haemonchus contortus in sheep to ascertain the influence of a range of factors in the domain of the host, the parasite or the vaccine on the formulation of protocols for vaccination and-challenge to be used in identifying protective immunogens. The results corroborate earlier findings that protective immunity can follow vaccination with homogenates of parasites and show that initial processing of parasites for a vaccine leaves protective immunogen in a functional state. Sonicates of adult worms produced protective immunity and were identified as raw stock in which to prospect for candidate immunogens. By contrast, sonicates of infective larvae and exsheathing fluid invoked no significant protection and were not accredited for the same purpose. In an experiment unaccompanied by protective immunity, ewes contained lower worm burdens than castrate males indicating that vaccination experiments should be made with hosts of one sex only. Again in an experiment unaccompanied by protective immunity, Freund's complete adjuvant increased susceptibility to infection compared with Freund's incomplete adjuvant or no adjuvant implying a profound and persistent interference from killed mycobacteria on resistance against H. contortus. PMID- 2722390 TI - The effects of immunization of sheep with Trichostrongylus colubriformis larvae on worm burdens acquired during grazing. AB - The effects of immunization of sheep with Trichostrongylus colubriformis larvae on worm burdens acquired during grazing. International Journal for Parasitology 19: 177-181. Romney sheep, reared helminth-free in pens to 5 months of age, were immunized against Trichostrongylus colubriformis by giving two doses of 200,000 T. colubriformis infective larvae at 15 day intervals to assess protection from natural challenge during grazing. Five immunized sheep and five unimmunized sheep were grazed on infested pasture for 4 weeks, and were then returned to the pens for 4 weeks before slaughter. Worm burdens, gastrointestinal histology and mucus antiparasite activity were examined at slaughter. Faecal egg counts and haematological examinations were carried out at regular intervals throughout the trial. Significant protection (P less than 0.05) was afforded immunized sheep against adult T. colubriformis (87%), T. axei (67%), Nematodirus spathiger (91%) and Ostertagia spp. (42%). Greater numbers of immature Nematodirus spp. and Ostertagia spp. were present in immunized sheep Overall, a significant (P less than 0.05) 42% reduction in total nematode burdens was afforded by immunization of the sheep with T. colubriformis larvae. Immunized sheep had significantly (P less than 0.05) more globule leukocytes, mast cells and eosinophils in gastrointestinal tissue and significantly (P less than 0.05) higher levels of mucous antiparasite activity than unimmunized sheep. Haematological observations showed some sheep had transient eosinophilia during immunization or grazing. Both immunized and unimmunized sheep showed depressed (P less than 0.05) total leukocyte counts during grazing which returned to pre-grazing levels within 1 week of return of the sheep to the pens. Overall, haematological parameters reflected parasite challenge and were unrelated to worm burdens acquired. PMID- 2722391 TI - Giardia intestinalis: electrophoretic evidence for a species complex. AB - The technique of allozyme electrophoresis was applied to 29 Australasian stocks and 48 clones of Giardia intestinalis from humans as a means of increasing the number of genetic markers currently available for identification and classification. Fifty different enzymes were examined and of these 26 loci were found to be suitable for use as genetic markers. The data indicate the presence of four discrete genetic groups within the sample of G. intestinalis examined. The groups had fixed genetic differences at 23-69% of loci established. The evidence suggests that G. intestinalis is a species complex. The results have important implications for the systematics of human isolates of Giardia, as well as for studies on the epidemiology and demography of giardiasis in Australia and elsewhere. PMID- 2722392 TI - Polyamine metabolism in Ancylostoma ceylanicum and Nippostrongylus brasiliensis. AB - Spermidine was detected as the major polyamine of Ancylostoma ceylanicum as well as Nippostrongylus brasiliensis. Spermine was present in lower amounts whereas the level of putrescine was even less. S-Adenosylmethionine decarboxylase, a rate limiting enzyme in the biosynthetic pathway of polyamines, was demonstrated at low levels in both parasites. Decarboxylation of lysine and arginine was absent or negligible and that of ornithine questionable, as the enzyme activity was not inhibited by alpha-difluoromethylornithine while RMI 71,645, an irreversible inhibitor of ornithine aminotransferase, strongly inhibited the liberation of CO2 from ornithine. High activity of ornithine aminotransferase was observed in both the parasites and may interfere with the assay for ornithine decarboxylase. Adults of A. ceylanicum were found to rapidly take up spermidine and spermine from incubation medium while uptake of putrescine was very low. These results indicate that hookworms depend on uptake and interconversion rather than de novo synthesis for their polyamine requirement. PMID- 2722393 TI - Eosinophil responses in sheep selected for high and low responsiveness to Trichostrongylus colubriformis. AB - A breeding programme, based on selection for faecal egg counts, has produced lines of sheep which demonstrate either increased resistance (high responder) or susceptibility (low responder) to challenge infection with T. colubriformis after vaccination with irradiated larvae. Circulating blood eosinophilia, a hallmark of helminth infections, was examined in third generation lambs from two separate selective matings and random bred control lambs. Numbers of eosinophils were higher in high responder lambs when compared to low responders after vaccination and challenge infections. Analysis of eosinophil counts confirmed a strong line effect and there was no evidence of a sex effect. Random bred lambs showed wide individual variations in eosinophil numbers and their response to infection. It was concluded that peripheral eosinophilia was more a measure of host responsiveness to infection than an indicator of helminthiasis. As such the eosinophil may serve as an indicator of the hosts ability to respond to T. colubriformis vaccination and infection. PMID- 2722394 TI - Quantitative determination of anti-hydatid antibodies by ELISA without a colorimetric reading. AB - A simple and sensitive immunoenzymatic technique for titration of anti-E. granulosus antibodies is described. The method employs the Diffusion-In-Gel-ELISA (DIG-ELISA) technique that needs no plate reader and thus could be widely used in endemic areas. Seventy five human sera, including patients with hydatid disease (26), other parasitic diseases (20), infectious diseases (9), non-infectious diseases (4) and healthy donors (16), were assayed to evaluate diagnostic specificity. The results obtained indicate that DIG-ELISA exhibits sensitivity and specificity similar to other serological techniques for hydatid diagnosis, and in addition improves simplicity. PMID- 2722395 TI - Neuropeptide Y and neuropeptide Y18-36. Structural and biological characterization. AB - Neuropeptide Y (NPY), a 36-residue peptide amide, has been shown by numerous studies to be a potent vasoconstrictor. In order to gain an appreciation of the structural requirements for this action, we have previously synthesized a number of fragments of NPY. It had been shown that sequential deletions from the N terminus resulted in peptides with decreasing hypertensive activity. In the present study we present data supporting the unexpected finding of two fragments, NPY17-36 and NPT18-36 with substantial hypotensive action in vivo. This action was dose dependent (data not shown) and was also observed to a lesser extent with NPY19-36 but not NPY16-36 or NPY20-36. It was, however, slower in onset and of longer duration than the hypertensive action of NPY. These differing kinetics of action may suggest that NPY and NPY18-36 act through different mechanisms. Structural studies using circular dichroism were performed. While NPY was found to assume an ordered helical structure in both aqueous buffer and trifluoroethanol (TFE), 30% TFE in aqueous buffer was required to induce substantial helicity for NPY18-36. This structural investigation suggests that both NPY and NPY18-36 assume an ordered conformation upon reaching the lipid rich receptor environment. PMID- 2722396 TI - Analogs of oxytocin containing a pseudopeptide Leu-Gly bond of cis and trans configuration. AB - Analogs of deamino-oxytocin wherein the Leu-Gly peptide bond has been replaced by a tetrazole moiety or by a double bond of trans configuration were synthesized and their biological activities evaluated. Trans double bond was found to be the most appropriate substitution for the amide bond (uterotonic activity 24% of the deamino-oxytocin). In the case of all three analogs low but prolonged galactogogic activity was found and the ratio of uterotonic in vitro and in vivo activity was surprisingly high (ranging from 4.5 to 20). PMID- 2722397 TI - Hormonotoxins. I. Strategy for synthesis of ovine luteinizing hormone--gelonin conjugate bearing the toxin in the beta-subunit. AB - The amino groups in the beta-subunit of ovine luteinizing hormone (oLH) were modified by thiolation using N-succinimidyl-3-(2-pyridyldithio) propionate so that it may be coupled in a disulfide linkage to similarly modified ribosome inactivating protein, gelonin. The modified beta-subunit was able to hybridize with free LH alpha-subunit and the complex retained full biological activity. However, when gelonin was coupled to the beta-subunit, the resulting conformational changes masked or eliminated the sites necessary for intersubunit recognition of the free alpha-subunit. This has important implications for the design in the synthesis of gonadotropin-toxin/drug conjugates. PMID- 2722398 TI - Ostrich MSEL-neurophysin belongs to the class of two-domain "big" neurophysin as indicated by complete amino acid sequence of the neurophysin/copeptin. AB - Mammalian neurohypophyseal hormones, oxytocin and vasopressin, are known to be synthesized as part of two larger precursors containing, respectively, a VLDV neurophysin and a MSEL-neurophysin together with its associated glycopeptide. Starting from ostrich neurohypophyses, a "big" neurophysin was isolated and chemically characterized. Following sequence determination of the CNBr-derived fragments and of peptides obtained from trypsin and V8-protease digestion of the oxidized protein, this "big" neurophysin was found to contain an MSEL-neurophysin moiety (94 residues) still covalently associated with the COOH-terminal glycopeptide (38 residues, copeptin). This study demonstrates that the ostrich MSEL-neurophysin sequence closely resembles all known MSEL-neurophysin sequences and that, furthermore, it does not contain the single amino acid insertion shown previously in the ostrich VLDV-neurophysin. It is also shown that the stretch of amino acids, linking the MSEL-neurophysin and the copeptin, is clearly different from its mammalian homologues and lacks the Arg residue normally recognized by the cleaving enzyme. This study also demonstrates that the ostrich copeptin is more closely related to the amphibian copeptin sequence than to its mammalian homologue, leading to the hypothesis that two families of copeptin molecules might exist. Thus, the ostrich MSEL-neurophysin-copeptin molecule is the first "big" neurophysin reported in birds and, together with the guinea pig and amphibian homologues, represents the third example of partial or no neurophysin copeptin cleavage. PMID- 2722399 TI - Isolation and characterization of a gonadotropin receptor binding inhibitor from porcine follicular fluid. AB - The presence of a gonadotropin receptor binding inhibitor in pooled porcine follicular fluid has been demonstrated. Porcine follicular fluid fractionation on DE-32 at near neutral pH, followed by a cation exchange chromatography on SPC-50 and Cibacron blue affinity chromatography, yielded a partially purified gonadotropin receptor binding inhibitor (GI-4). The partially purified GI binding inhibitor inhibited the binding of both 125I labelled hFSH and hCG to rat ovarian receptor preparation. SDS electrophoresis of radioiodinated partially purified GI followed by autoradiography made it possible to identify the binding component as a protein of molecular weight of 80,000. Subjecting 125I labelled GI-4 to chromatography on Sephadex G-100 helped obtain a homogeneous material, GI-5. The 125I labelled GI-5 exhibited in its binding to ovarian membrane preparations characteristics typical of a ligand-receptor interaction such as saturability, sensitivity to reaction conditions as time, ligand and receptor concentrations and finally displaceability by unlabelled inhibitor as well as FSH and hCG in a dose dependent manner. This material could bind ovarian receptors for both FSH and LH, its binding being inhibited by added FSH or hCG in a dose dependent manner. PMID- 2722400 TI - Primary structure of elephant pituitary prolactin. AB - Tryptic digests of elephant pituitary prolactin (elePRL) were separated by reverse phase high performance liquid chromatography (HPLC) and paper electrophoresis. From the amino acid composition, the amino acid sequencing of selected peptides, and from their alignment with expected tryptic peptides from ovine prolactin (oPRL), the primary sequence of elePRL is proposed. PMID- 2722401 TI - Primary structure of fox pituitary growth hormone. AB - Tryptic digests of fox growth hormone (fGH) were separated by reverse phase high performance liquid chromatography (HPLC) and by paper electrophoresis. From the amino acid composition of these tryptic peptides and from their alignment with the expected tryptic peptides from bovine growth hormone (bGH), the primary structure of fGH is proposed. There are only 17 amino acid residues which are different in these two growth hormone molecules. PMID- 2722402 TI - Utilization of medical resources in persons with DSM-III personality disorders in a community sample. AB - A community survey of 401 randomly selected subjects yielded 249 responders, of which twenty-six had DSM-III criteria personality disorders (PDs), and 167 had no personality disorder traits (controls). More PDs than controls were medically hospitalized during the last year (38% vs 17%, p = .006). A number of significant associations was found between the number of DSM-III personality trait questions answered in a positive fashion and medical utilization. These associations varied by gender. Most striking was the .50 correlation for females between flamboyant personality disorder scores and visits to the family doctor for mental health reasons. PMID- 2722403 TI - The Child Consultation Rating Scale. AB - A consultation psychopathology rating scale is described for use in assessing psychopathology in pediatric patients and their families in a tertiary care general teaching hospital setting with high acuity and rapid patient turnover. The scale is composed of twelve consultation variables, thirty patient variables, and fourteen parent variables. It includes a global rating and a DSM-III-R diagnosis for both parent and child. Pilot findings using the scale are described for sixty pediatric patients and thirty controls. Interrater reliability using Kendall nonparametric correlations between raters was obtained for each variable and achieves significance ranges from p less than .05 to p less than .001. Applications to training pediatric and psychiatry residents in the systemic observation of child psychopathology are discussed. PMID- 2722404 TI - Childhood's enuresis in the history of women with hyperprolactinemic amenorrhea. AB - Hyperprolactinemia, or elevated levels of prolactin in blood, is a normal physiologic post-partum response in lactating women. Non-lactating women with hyperprolactinemia often present during the reproductive years since they may have amenorrhea, galactorrhea, or both. Hypersecretion of prolactin is most commonly due to pituitary adenomas. Women with hyperprolactinemic amenorrhea are often quite anxious, depressed and hostile. It has been hypothesized that these psychological symptoms might antecede the onset of hyperprolactinemia and that hyperprolactinemia may be associated with early developmental problems and may be psychogenic in origin. Twenty patients with hyperprolactinemic amenorrhea and twenty-one normoprolactinemic patients with amenorrhea had an interview covering psychiatric history in order to establish whether they had ever met DSM-III criteria for functional nocturnal enuresis at one time during their childhood. While seven out of twenty (35%) patients with hyperprolactinemic amenorrhea were found to have had functional enuresis during their childhood, only two out of twenty-one (9.5%) normoprolactinemic amenorrheic women reported having had functional enuresis. The difference between the two groups was statistically significant (chi-squared: 3.88; p less than 0.05). We postulate that early stress and developmental problems may present in children as psychological distress and functional enuresis and in women as psychological symptoms (e.g., anxiety and depression) and hyperprolactinemic amenorrhea. PMID- 2722405 TI - Psychotic states associated with disorders of thyroid function. AB - Thyroid-related psychoses continue to pose diagnostic and treatment challenges for clinicians. Two case histories illustrate diverse clinical states associated with hyper- and hypo-thyroidism respectively and highlight the need to consider the possibility of thyroid disorder in all patients presenting with acute psychotic mental disorder. They also demonstrate treatment methods directed at control of psychotic symptoms and restoration of an euthyroid state. PMID- 2722406 TI - Depression and magnesium deficiency. AB - The psychiatric symptoms of magnesium deficiency are unspecific, ranging from apathy to psychosis, and may be attributed to other disease processes associated with poor intake, defect absorption, or excretion of magnesium. Serum magnesium should be determined when there are symptoms consistent with magnesium deficiency and/or in conditions which can lead to a deficiency, e.g., malabsorption, malnutrition, alcoholism and diuretic treatment. A low serum value suggests magnesium deficiency, but the diagnosis is reinforced with analyses of magnesium in the urine and a loading test with magnesium. Magnesium can be given orally or intramuscular/intravenously. PMID- 2722407 TI - Effect of pregnancy on psychosis: life circumstances and psychiatric symptoms. AB - As part of an ongoing prospective study to correlate mother and infant outcome with social isolation during pregnancy, the Schedule for Affective Disorders, SADS-C, was administered to twenty-seven psychotic patients late in pregnancy. Extensive standardized evaluation of life stresses and social supports included a Prenatal Interview with sixty items relating to demographics, drug use, health and obstetrical history, family involvement and development expectations of the infant, and a thirty-item Difficult Life Circumstances questionnaire. In this sample the patients' previous life adjustments were stabilized by their pregnancy unless the pregnancy itself created personal stress for the patient. Higher scores on Difficult Life Circumstances were found to be associated with more psychiatric symptomatology. Symptoms of pregnancy confounded SADS-C items measuring vegetative signs of depression. One group of items on the SADS-C appeared to selectively identify a subset of women whose underlying affective symptomatology was potentiated by pregnancy. A second group of items identified women whose symptoms appeared to be reactive to current situational strains. PMID- 2722408 TI - Emotional aspects of cataract surgery. AB - A retrospective study of fourteen elderly patients, all of whom had undergone cataract extractions with lens implantation was undertaken. Issues pertaining to pre-, post-, and intraoperative anxiety were investigated as were questions about changes in mood, energy level, activity, and severity of non-ophthalmologic medical conditions. Also, an investigation was made into the accuracy of the patient's perception of the technical aspects of the procedure and the extent to which they found technical information on the procedure either desirable or anxiety provoking. Little effect was found in terms of changes in mood, general perceptions of health, or activity. Issues somewhat peripheral to the actual surgical procedure were found to be the most anxiety provoking while confidence in the surgeon and reassurance from friends who have had the procedure were found to be the most anxiety relieving. The well-educated patients seemed to lack any technical knowledge of the procedure itself and in many cases found this information to be anxiety provoking. PMID- 2722409 TI - Microvascular flow distribution and transcapillary diffusion at the forefoot in patients with peripheral ischemia. AB - Transcapillary diffusion of Na-fluorescein injected by the intravenous route was measured by a videomicroscopy system in the skin of the dorsum of the forefoot in healthy controls (n = 21) and in patients with moderate (n = 35) and severe (n = 29) ischemia secondary to lower extremity arterial occlusive disease. Systolic ankle blood pressure and transcutaneous PO2 at the forefoot were significantly decreased in both groups of patients according to the severity of ischemic disease (p less than 0.001). The difference of the mean filling times between the first and last capillaries was used as a parameter for inhomogenous microvascular perfusion. It was significantly increased in moderate and severe ischemia (p less than 0.05). Transcapillary diffusion measured with a large window densitometer in a skin area of 2.8 mm2 was significantly enhanced in both groups of patients. The increase was more pronounced in the patients with severe ischemia (p less than 0.001) than in those with moderate ischemia (p less than 0.05). Among the patients with severe ischemia the diabetics exhibited significantly higher mean values of pericapillary fluorescence light intensity than the non-diabetics (p less than 0.001). At high magnification (550 times) distinct sites of increased transcapillary diffusion were detected in both groups of patients. They were most often localized at the apex of the capillary loops ("candle light phenomenon") and were more frequent in patients with severe than with moderate ischemia. In conclusion microvascular blood flow distribution is inhomogeneous and transcapillary diffusion increases at the level of single capillaries and skin areas in patients with moderate and especially severe foot ischemia. PMID- 2722410 TI - Dynamic compliance of single perfused frog mesenteric capillaries and rat venules: a filtration coefficient correction. AB - The compliance of microvessels produces a potential source of error in the measurement of hydraulic conductance, regardless of which method is used. The compliance characteristics of rat and frog microvessels, in vivo, was studied using a two oil technique capable of measuring changes in radius of 0.01 micron at intervals of 0.02 seconds. Two water insoluble immiscible oils were micro injected into occluded segments of the vessel. Since the volume of the oil remained constant the position of the interface at different times, following a sudden change in applied pressure, could be used to determine the time course of changes in vessel diameter. It was found that approximately 90% of the compliance response had occurred within 0.4 seconds of applying a step change in pressure. This compliance response coincides with the initial change in fluorescence used in the measurement of fluid with the initial change in fluorescence used in the measurement of fluid filtration by the densitometric technique. PMID- 2722411 TI - The effect of long-term activity on the microvasculature of rat glycolytic skeletal muscle. AB - Long-term electrical stimulation of a fast skeletal muscle (rat tibialis anterior, TA), at 10 Hz, 8 hours/day for 7 days, caused an increase in capillarity, determined both as capillary density/mm2 and as capillary to muscle fibre ratio (C/F), and an increase in the weight of corrosion cast of the entire vascular bed. Chronic muscle activity caused a greater linear velocity of RBCs (Vrbc) in the capillaries supplying predominantly glycolytic fibres of the resting TA. During contractions imposed acutely, the absolute value attained was greater than in control TA, but the increase over resting Vrbc was not as great. Factors which did not change with long-term electrical stimulation were the individual capillary dimensions and the intermittency of flow; those remained similar to control values. It was calculated from capillary dimensions and density, and from the increase in corrosion cast/muscle wet weight ratios, that capillary neoformation alone could account for the growth of the microvasculature in the predominantly glycolytic surface layers of TA, but not necessarily in the oxidative core or in other mixed skeletal muscles. PMID- 2722412 TI - Visual half-field tests of lateralized letter presentations: differences between preliterate and literate children. AB - In the present study, hemispheric differences in global and analytic processing were investigated in preliterate and literate children, using the "dual-letter" matching task paradigm (Navon, 1977). The stimuli consisted of lateralized visual presentations of large uppercase letters made up of small uppercase letters. The task of the subject was to decide on each trial if the large or small letters were the same or not. Vocal reaction time (VRT) and error-frequency were used as dependent measures. In Experiment 1, 28 right-handed 8-years old children participated. The children were split into a preliterate and a literate group depending on teachers evaluations, and on scores on a reading test. The results showed longer VRTs for the preliterate children when the stimuli were initially presented to the right hemisphere and especially when the subjects were required to match the small letters. These results were followed up in Experiment 2, where the preliterate subjects were split into "fast" and "slow" readers. The results showed that the "slow" readers were more impaired in processing the letter stimuli when the stimuli were initially presented to the right hemisphere. It is concluded that hemispheric asymmetry for letter processing interacts with the development of normal reading ability in children. PMID- 2722414 TI - Right and left hand skill in left-handers: distribution, learning, and relation to nonverbal intelligence. AB - The relation of hand skill to nonverbal intelligence (spatial reasoning) tested by Cattle's Culture Fair Intelligence Test was studied in left-handed subjects. Hand skill was assessed by the peg moving test, which revealed that some of the left-handers (Geschwind scores and self-reports) were ambidexters. The distribution for right hand skill fitted to Gaussian data better than that for left hand skill. The R-L difference between the hands in peg moving times could also be described by normal distributions in the total sample, ambidexters, and left-handers. The right and left hands of ambidexters were as fast as the left handers. In left-handers, the right hand was significantly slower than the left hand. In males, right-hand skill fitted to Gaussian data better than left-hand skill. In males and females, right and left-hand skill fitted to Gaussian data. Left-hand skill fitted to Gaussian data better in females than males. The difference between right- and left-hand peg-moving times was found to be larger in females than males. There was no significant difference between the right- and left-hand peg moving times of the male and female left-handers. The mean peg moving times for the right and left hands linearly decreased at each successive trial (N = 10). This motor learning was found to be better in left-handers with high IQs than those with low IQs. The right hand of left-handers with high IQs was faster than that with low IQs. The motor learning of the left hand was not different in left-handers with high and low IQs. The regression line for ambidexters exhibited less learning than that for left-handers. It was suggested that right hand skill is associated with nonverbal intelligence in left-handers, indicating the importance of left hemispheric processing in this kind of cognitive performance. PMID- 2722413 TI - Handedness, cerebral lateralization, and measures of "latent left-handedness". AB - Two surveys were conducted to investigate the relationship between handedness and various variables that have been considered to be either more fundamental indices of an underlying laterality than handedness or have been proposed as moderating the relationship between handedness and cerebral lateralization. In the first survey (N = 686), sighting eye dominance was found to be related to handedness. In the second (N = 799), arm folding and leg crossing, but not hand clasping or spreading the fingers, were found to be related to handedness. Although these variables are correlated with handedness, they do not have the properties that would make them likely to improve prediction of cerebral lateralization. PMID- 2722415 TI - Extension of the analysis of the time structure of behavioral acts. AB - A parameter known as the K-function has previously been used to analyze the temporal structure of behavioral acts. In earlier work the study of these acts or of the joint relationship of separate acts has used a restricted list of activities whose definitions are difficult to explicate. In the present study this technique has been extended to a more extensive list of acts, each meaning of which is intuitively clear. As with the earlier work, the bootstrap method has been used to estimate the uncertainty in these measures, and the usefulness has been examined using data from studies of rats exposed to phenytoin or nitrous oxide. PMID- 2722416 TI - Hemisphericity and personality. AB - Hemisphericity was originally defined with regard to cognitive processes only. This paper describes a brief personality questionnaire derived from work on personality changes in temporal lobe epilepsy as a method of demonstrating the existence of hemisphericity as a personality characteristic. A factor analysis of the Personal Inventory (Bear & Fedio, 1977) in a normal sample suggests the existence of a right and a left hemisphere component to the personality traits tapped by the scale. Three separate validity studies of a questionnaire developed from the factor analysis, utilizing cognitive, affective and general personality measures provide confirmation. Left hemisphericity types are characterized as possessing greater control over their impulses, experiencing less generalized tension, being more trusting and imaginative and viewing themselves in a positive light. Right hemisphericity types are characterized as possessing less control over their impulses, being tense, suspicious, shy and pragmatic and viewing themselves in a negative light. PMID- 2722418 TI - Short-latency somatosensory and brainstem auditory evoked potentials in patients with Parkinson's disease. AB - Short-latency somatosensory evoked potentials (SSEPs) and brainstem auditory evoked potentials (BAEPs) were recorded in 44 patients with Parkinson's disease (mean age 67.3 years) and 23 normal subjects (mean age 69.3 years). Patients with Parkinson's disease and normal subjects did not show any significant difference with regard to the interpeak latencies between N13 and N20 central conduction time (CCTs). Likewise, there were no significant differences in CCTs between patients with and without dementia. The interpeak latencies between waves I and V (I-V IPLs) in patients with Parkinson's disease were significantly longer than those of the normal subjects (p less than 0.05). In particular, patients with dementia revealed significant prolongation of I-V IPLs compared to patients without dementia and normal subjects (p less than 0.01, p less than 0.001) although no significant differences were observed between patients without dementia and normal subjects. These results show that auditory brainstem pathways are involved in Parkinson's disease patients with dementia. PMID- 2722417 TI - Recurrence of complex motor and vocal tics in an elderly woman responsive to opiates. AB - A 73-year-old woman experienced recurrence of complex and motor tics in late adult life. Involuntary vocalizations that had a cough-like quality constituted the most distressing feature of her tick disorder. The latter was unresponsive to diverse pharmacological agents including neuroleptics, clonazepam, baclofen, phenytoin, and various nonnarcotic antitussive agents. Low dose oxycodone produced almost complete abolishment of the cough-like involuntary vocalizations. This report implicates derangement in the activity of the endogenous opioid system in the pathophysiology of Tourette's syndrome, and suggest that opiates may be prescribed in the therapy of TS patients otherwise recalcitrant to administration of haloperidol or other dopamine blocking agents. PMID- 2722419 TI - Collective modes in neural networks. AB - A theoretical model, based on response of a neural network to an external stimulus, was constructed to determine its collective modes. It is suggested that the waves observed in EEG records reflect the cooperative electrical activity of a large number of neurons. Further, an actual EEG time series was analyzed to deduce two dynamic parameters, dimension d of phase space of the neural system and the minimum number of variables nc necessary to describe the EEG pattern. We find d = 6.2 and nc = 11. PMID- 2722420 TI - Dehydrogenase activities of the pentose phosphate pathway in erythrocytes of healthy non iron-deficient subjects. PMID- 2722421 TI - Nutritional status, grip strength, and immune function in institutionalized elderly. AB - The effects of vitamin supplementation on grip strength and immune function was studied in a group of institutionalized elderly with a relatively higher prevalence of low and below acceptable biochemical parameters of vitamin C, pyridoxine, folic acid, riboflavin, iron and zinc nutriture. The vitamin supplementation has resulted in a statistically significant increase in the level of biochemical parameters related to added vitamins, and the number of subjects with inadequate vitamin values was reduced to zero. The improved vitamin status had a positive and statistically significant effect on the delayed cutaneous hypersensitivity one of the parameters of cellular immunity. The calculation of multiple correlation after inclusion of all biochemical parameters into the stepwise regression analysis has shown that the coefficient of multiple regression between examined biochemical parameters of nutrition status and delayed cutaneous hypersensitivity was R = .599 (p less than 0.001) which indicates that about 36% of the variability in the cellular immunity would be affected by the vitamin and mineral nutrition status. PMID- 2722422 TI - Retinol, beta-carotene and alpha-tocopherol status in a French population of healthy children. AB - The serum of 392 French healthy children aged 1-16 years was analysed for vitamin A, vitamin E, beta-carotene and cholesterol contents. The study group consisted in 185 females and 207 males, living in the area of Tours, France. The mean serum values are 42.05 +/- 12.0 micrograms/dl for vitamin A, 572 +/- 381 micrograms/l for beta-carotene and 9.5 +/- 2.5 mg/l for vitamin E. According to sex distribution, mean values of studied micronutrients levels are higher in boys than in girls, but not significantly. Vitamin A and vitamin E serum levels increased with age. Vitamin E peripheral level is strongly correlated with total cholesterol serum value. The results are compared to those of underdeveloped countries children groups studies. At least, decreased vitamins levels are observed among five per cent of children and are examined as being at risk to develop a deficiency. PMID- 2722423 TI - Effect of vitamin E on lipid components of atherogenic rats. AB - Rats were made atherogenic by feeding a synthetic diet containing high fat (20%) and cholesterol (2%) for two, three or four weeks. For alpha-tocopherol acetate supplementation studies, the rats on atherogenic diet for two weeks received alpha-tocopherol acetate 5 mg or 20 mg/100 g body weight once daily, orally for two weeks along with the atherogenic diet. Atherogenic diet fed rats showed elevated plasma cholesterol, hepatic total lipids, triglycerides and cholesterol and the increase in the constituents paralleled the period of feeding the diet. Administration of alpha-tocopherol acetate lowered the plasma cholesterol and hepatic lipid components in a dose-dependent manner. Supplementation with alpha tocopherol acetate reduced the elevated osmotic fragility of erythrocytes from atherogenic diet fed rats to that of control levels. Thus alpha-tocopherol acetate administration to experimental atherogenic rats could normalize the altered lipid profile of atherogenesis and thereby reduce the risk for infarction. PMID- 2722424 TI - Comparison of methods for thiamin and riboflavin nutriture in man. AB - Thiamin and riboflavin nutriture were assessed in 127 apparently healthy individuals aged between 20 and 82 yr, living in small villages near the town of Gubbio. The methods of erythrocyte transketolase activity and HPLC determination of thiamin pyrophosphate (TPP) for thiamin and erythrocyte glutathione reductase and HPLC determination of flavin adenine dinucleotide (FAD) for riboflavin were used. A significant correlation between enzymatic and HPLC methods was found. This was not the case for the correlation between status test and vitamin intake, particularly for thiamin. The vitamer determination in blood by HPLC can be considered a reliable, fast and reasonably accurate method for long-term thiamin and riboflavin nutritional status assessment. PMID- 2722425 TI - The vitamin B1 status among young Egyptian males in relation to infection with parasites. AB - Erythrocytic transketolase activity and thiamin pyrophosphate effect (TPP%) were used to define the nutritional thiamin status of an age stratified sample of 66 young males with parasitic infection. The results revealed that 6% of the control group were biochemically deficient in vitamin B1 compared with a percentage incidence of 42% among the parasitized subjects. Intestinal infection with Entamoeba histolytica, Hymenolepsis nana or with more than one parasite had the most depleting effect on the tissue thiamin status. PMID- 2722426 TI - The vitamin B1 status among young Egyptians from the oasis in relation to glucose 6 phosphate dehydrogenase deficiency. AB - Erythrocyte transketolase activity was assayed and %TPP effect was calculated to define the vitamin B1 status among 63 young boys and girls from the Oasis with normal or G6PD-deficiency. Based on the mean %TPP values; 15.6, 75 and 60% of the studied normal, G6PD-deficient males and females; respectively were deficient in B1. PMID- 2722427 TI - Biotin bioavailability from protein supplements and cereal grains for growing broiler chickens. AB - A 21d growth bioassay was conducted with broiler chicks to estimate the availability of biotin from canola meal (CM), cereal grains and CM-supplemented cereal diets. A standard biotin response curve was generated with biotin supplemented diets, using growth rate (g/d) as the dependent variable (X) and biotin intake (micrograms/d) as the independent variable (Y), as follows: Y = 2.28X + 9.76, r = 0.946 (P less than 0.01). Other groups of chicks were fed diets containing CM, soybean meal (SBM), cereal grains or CM + grain as a source of biotin. Results indicated that biotin bioavailability (%) was low in most cereal grains, i.e. wheat 17, triticale 20, barley 21, and sorghum 39; moderate in CM, 66; and high in SBM, 98, and maize, 114. Plasma and liver biotin concentrations in excess of 4000 ng/L and 3000 ng/g, respectively, were indicative of adequate biotin status. PMID- 2722428 TI - Biotin assessment in foods and body fluids by a protein binding assay (PBA). AB - The biotin content of plant and animal food samples as well as of human plasma and urine specimens was assessed by a modified protein binding assay (PBA). Protein bound biotin in samples was released by digestion with papain, food samples were in addition treated previously with liquid nitrogen. Comparing analyses by use of the conventional microbiological test with L. plantarum resulted in slightly enhanced biotin values, in case of plasma by 9.2% and in case of urine by 10.3%, but the results obtained by both methods correlated well (r = 0.926 for plasma and 0.934 for urine). Regarding food analysis the additional comparison of different disintegration procedures led to best reproducible results by using the PBA with preceding papain digestion. PMID- 2722429 TI - Studies on bioavailability of oral biotin doses for humans. AB - Single biotin doses (600 micrograms and 900 micrograms) orally administered to male and female volunteers were very rapidly eliminated from plasma after absorption leading to a remarkable increase of urinary excretion. A prolonged enhancement of plasma levels occurred only after continuous supplementation with 300 micrograms biotin/day for 1 week and following 900 micrograms biotin/day for another week. From the diurnal turnover of the plasma level after oral stimulation with 600 micrograms biotin some biokinetic indices, such as the constants of invasion and elimination rate as well as the elimination half life time were determined. The median of the invasion constant was calculated to 2.068 h-1, that one of elimination constant to 0.3867 h-1 suggesting no indication of diminished body stores. The elimination half life time of the administered biotin dose from plasma amounted to 1 hour, 50 minutes. PMID- 2722430 TI - Effect of dietary ascorbic acid on levels of serum mineral nutrients in guinea pigs. AB - The effect of dietary ascorbic acid on the serum mineral nutrients, Ca, Cu, Fe, K, Mg, Mn, Na and Zn in guinea pigs has been studied. Large amounts of ascorbic acid were administered to experimental animals in their drinking water. The daily ascorbic acid intake from the diet for the control animals was 10 mg/kg body weight. The mean ascorbic acid intakes for the two groups of experimental animals were 366 (37 times control) and 722 (72 times control) mg/kg body weight/day. In the ascorbic acid-treated animals, there was a significant increase in serum ascorbic acid levels in comparison with the controls. No substantial differences were observed in the body weights. The large quantities of dietary ascorbic acid did not influence serum levels of all eight minerals studied when the experimental and control values were compared using the two-tailed Student's t test. However, serum level of copper in the guinea pigs ingesting a daily dose of 722 mg of ascorbic acid per kg body weight was slightly below control value when one-tailed Student's t-test was used. PMID- 2722431 TI - Mineral elements in unrefined sugar, and rat reproduction. AB - Male and female Sprague-Dawley rats were fed purified diets in which the carbohydrate component was either starch or refined sugar (sucrose). The addition to these diets of the ash prepared by the incineration of unrefined muscovado sugar prevented the deficiencies of Factor R seen in the offspring when the diets were not supplemented with ash. Analysis by neutron activation showed that the ash from the unrefined sugar significantly increased the proportion of iron, cobalt, manganese, caesium and rubidium in the diets. The addition of chlorides of all five mineral elements to the diet containing refined sugar also prevented the development of signs of deficiency of Factor R in the pups. However the addition of cobalt chloride alone, or of cobalt and manganese chlorides, did not prevent the deficiency. It is likely that what we have called reproductive Factor R is iron, caesium or rubidium. PMID- 2722432 TI - Nutrition of the elderly in a Mediterranean city in Spain: effects of life-style patterns. AB - We studied the food intake in a representative sample (121 males, 202 females) of the elderly people (greater than 60 years) of the city of Reus (Spain) living at home. The analysis of the consumption of nutrients revealed an energy intake lower than recommended but similar to that found in other surveys dealing with the same age group. We observed that in our elderly people, the major food sources of caloric intake were different in relation to those of adults of the same population. The distribution of energy percentage derived from several macronutrients is different in the elderly in relation to adults (35-64 yr) and children (3-4 yr) of the same population. In younger people there was a remarkably energy excess derived from lipids if compared with the recommended allowances, which does not occur in the elderly group. Among all the sociocultural characteristics of the individuals, the type of life-style is revealed as the major explanation of the differences in intake. The elderly males who live with younger people consume more energy (p less than 0.01), lipids (p less than 0.001) and carbohydrates (p less than 0.05) than those who live only with other old people. In elderly people living with younger ones, the energy sources become unbalanced in the same way as in the young people. We have not found any differences in the biotype of the elderly men in relation to the patterns of life-style which may explain the different intakes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722433 TI - Dietary animal proteins and cholesterol metabolism in rats. AB - The effects on cholesterol metabolism in rats of diets containing various animal proteins or soy protein were studied. The animal proteins tested were casein, whey protein, fish protein, hemoglobin, plasma proteins, ovalbumin, egg-yolk protein, beef protein and chicken-meat protein. The semi-purified diets were isonitrogenous and balanced for residual fat and cholesterol in the protein preparations. The nature of the dietary protein had no effect on serum cholesterol concentration. Group mean liver cholesterol concentration was increased and fecal excretion of bile acids was decreased by all animal proteins when compared with soy protein. This study suggests that carefully balancing diets for components other than protein in the protein preparations prevents protein effects on serum cholesterol in rats but not on liver cholesterol and bile acid excretion. PMID- 2722435 TI - Adult vernier thresholds do not increase with age; vernier bias does. AB - Vernier acuity and vernier bias were examined in persons aged 20 to 79 years using a method of adjustments. Vernier bias (mean error) showed a sharp increase between 35 and 45. Vernier acuity (standard deviation or precision of alignment) did not vary significantly with age. These different results indicate the importance of separate evaluation of acuity and bias. Vernier acuity is little affected by minor optical changes that occur with age. Therefore, normal vernier acuity in older persons suggests that the neural substrates which underlie fine grain discrimination of object location are unaffected by aging over the range investigated. PMID- 2722434 TI - A new in vitro assay for quantitating tumor cell invasion. AB - The attachment to and penetration of basement membranes by tumor cells is required to complete the metastatic cascade which culminates in the establishment of secondary tumor foci. Therefore, basement membranes are critical barriers to the passage of disseminating tumor cells. We have developed a simple, in vitro model using matrigel-coated transwell chambers (Costar) for use in a tumor cell invasion assay. Two variants of the K1735 UV-induced murine melanoma cell line were assayed for their invasive capabilities and compared with their ability to colonize the lung in an experimental metastasis assay. The K1735-M2 cells, which are highly metastatic in vivo, invaded through basement membrane matrigel at a significantly higher rate than the low metastatic cells, K1735-16, in a 72-hour assay. As a negative control, normal murine fibroblasts were incapable of penetrating the barrier. Tumor cell invasion in vitro correlated with lung colonization in vivo. Therefore, this model may provide a valuable tool to study the mechanisms involved in the pathogenesis of tumor cell invasion during hematogenous dissemination. PMID- 2722436 TI - How normal are "normal" square wave jerks? AB - Fifty normally sighted young subjects underwent horizontal electro-oculographic (EOG) examination to investigate fixation stability of the saccadic system. The number of square wave jerks (SWJ) and saccades per minute were calculated in three clinically used test conditions: (1) with a fixation point; (2) in darkness; and (3) with eyes closed. SWJ were recorded in all conditions. The highest number of SWJ per minute were found in darkness and with closed eyes. The analysis of the findings shows a range of normalcy for these three clinically used EOG conditions from which pathology can be inferred. PMID- 2722437 TI - Early abnormal visual experience induces strabismus in infant monkeys. AB - We measured ocular alignment in the horizontal direction for 17 monkeys reared under deprivation paradigms that involved monocular defocus, monocular occlusion and optically corrected aphakia coupled with continuous or partial occlusion of the fellow eye. Alignment was measured at 3 and 7 months with a photographic corneal light reflex method. Results showed that a majority of the monkeys in each paradigm developed strabismus following deprivation rearing, the common factor being early abnormal visual experience. Results also indicated a trend in which many of the deviations seen at 3 months of age were exotropic while all of the animals with deviations at 7 months of age were esotropic. These results on deprivation-induced strabismus, which are the first reported in monkeys, are consistent with previous findings in cats and humans, providing further evidence that deprivation affects not only sensory, but motor systems as well. These findings provide evidence that infant monkeys are a good model for studies of the possible relationships between amblyopia and strabismus that are often noted in children with early visual deprivation. Furthermore, it raises the prospect that some of the findings in previous animal studies that have been attributed to the direct effects of deprivation may actually be secondary to the induced misalignment. PMID- 2722438 TI - Retinal light damage in rats exposed to intermittent light. Comparison with continuous light exposure. AB - Visible light-induced photoreceptor cell damage resulting from exposure to multiple intermittent light-dark periods was compared with damage resulting from continuous light in albino rats maintained in a weak cyclic-light environment or in darkness before light treatment. The time course of retinal damage was determined by correlative measurements of rhodopsin and visual cell DNA at various times after light exposure, and by histopathological evaluation. The effect of intense light exposures on rhodopsin regeneration and on the level of rod outer segment docosahexaenoic acid was also determined. For rats previously maintained in weak cyclic light, 50% visual cell loss was measured 2 weeks after 12 1 hr light/2 hr dark periods, or following 24 hr of continuous light. A comparable 50% loss of visual cells was found in dark-reared rats after only 5 hr of continuous illumination or 2-3 hr of intermittent light. As judged by histology, cyclic-light-reared rats incurred less retinal pigment epithelial cell damage than dark-reared animals. In both experimental rat models intermittent light exposure resulted in greater visual cell damage than continuous exposure. Visual cell damage from intermittent light was found to depend on the duration of light exposure and on the number of light doses administered. Measurements of rhodopsin and DNA 2 hr and 2 weeks after light exposure of up to 8 hr duration revealed that visual cell loss occurs largely during the 2 week dark period following light treatment. The loss of docosahexaenoic acid from rod outer segments was also greater in rats exposed to intermittent light than in animals treated with continuous light. It is concluded that intermittent light exposure exacerbates Type I light damage in rats (involving the retina and retinal pigment epithelium) and the schedule of intense light exposure is a determinant of visual cell death. PMID- 2722439 TI - Characterization of uveal melanoma cell lines that grow as xenografts in rabbit eyes. AB - Two cell lines, OCM-1 and OCM-2, were established from biopsied specimens of choroidal melanomas of spindle B and mixed cell type morphologies. Both cell lines were phenotypically malignant. Karyotypic analyses revealed human chromosomes with a modal number of 95 and 85, respectively. These cell lines have been passaged for over 2 years and are essentially immortal. The cells grew without contact inhibition as monolayers in liquid culture or as clones in soft agar. Electron microscopy revealed melanoma cells containing premelanosomes and cultures free from contamination by fibroblasts. To categorize the morphologies of these cultured cells better by the Callender classification, they were grown as xenografts in the anterior chambers of rabbits immunosuppressed with daily i.m. doses of Cyclosporin A (10 mg/kg). Tumor plaques were detected after 10 days. The eyes were enucleated and fixed in formalin and stained with hematoxylin and eosin for histopathological evaluation. The xenograft from OCM-1 was found to consist predominantly of spindle B-type melanoma cells. In contrast, the xenograft from OCM-2 contained epithelioid, spindle B and clear cell ("balloon") melanoma cells. The ability of these cell lines to grow as xenografts confirmed their neoplastic origin. In fact, the types of the uveal melanoma cells in the xenografts resembled those in the original biopsied tumors. This suggests that the morphology of human uveal melanoma cells is an inherited trait and may be genetically fairly stable. PMID- 2722440 TI - The effects of ultrasonically induced hyperthermia on experimental tumors in the rabbit eye. AB - Greene's melanomas, implanted in the anterior chamber of 31 eyes of 19 Dutch rabbits, were treated with hyperthermia induced by high intensity focused ultrasound (HIFU). The percentage necrosis 24 hr after treatment (N) as a function of steady-state intratumor temperature (T) could be described with N(T) = -181.5 + 4.7T (P less than 0.05). The most frequent side effect was a local hemorrhagic keratitis. The acoustic absorption coefficient and thermal conductivity of the tumor tissue were 0.08 cm-1 X MHz-1 at 36 degrees C and 0.011 W, cm-1 X degrees C-1, respectively. With these parameters a simple thermal model was established that enabled us to predict the ultrasonic intensity needed to reach a desired intratumor temperature. PMID- 2722441 TI - Relating the surface properties of intraocular lens materials to endothelial cell adhesion damage. AB - Relationships between corneal endothelial cell adhesion and intraocular lens (IOL) surface properties were studied to develop a lens surface with a lower potential to damage the corneal endothelium. The surfaces examined were poly(methyl methacrylate) (PMMA) and four types of plasma-deposited coatings on PMMA. These four films were prepared from perfluoropropane, ethylene oxide, 2 hydroxyethyl methacrylate (HEMA), and N-vinyl-2-pyrrolidone (NVP). These "monomers" were chosen to produce surfaces with a range in surface chemistry and surface energy. Each type of coating was characterized by electron spectroscopy for chemical analysis (ESCA) and contact angle techniques. In addition, these surfaces were contacted with rabbit corneal endothelium over a force range of 4000-20,000 dynes. The extent of endothelial cell damage was measured. Over the force range investigated, each modified surface was found to induce a significantly different degree of cell adhesion than that caused by PMMA. The perfluoropropane plasma film induced a constant lower degree of adhesion damage than the PMMA for all forces of contact. Although the HEMA and NVP hydrogel surfaces also induced lower adhesion damage than PMMA, the cell loss associated with each did increase as a function of force. The ethylene oxide film caused a significant increase in cell loss compared to the PMMA-induced losses. Based upon the correlation between the surface analysis data and the cell-surface contacting results, we suggest that a "soft" high-energy surface or a "rigid" low-energy surface is favorable for reduced cell adhesion. Also, the results indicate that cell adhesion increases for materials with increased hydrocarbon enrichment and for materials with lower (ether bonding)/(ester and ketone linkages) ratios. PMID- 2722442 TI - Pyridine nucleotides and phosphorylation potential of rabbit corneal epithelium and endothelium. AB - In order to validate in situ corneal redox fluorometry, the redox state and phosphorylation potential of freeze trapped rabbit corneal epithelium and endothelium were studied using quantitative histochemical methods. The results were compared with noninvasive measurements using an optically sectioning fluorometer microscope. Enucleated rabbit eyes were either frozen in Freon-12, cooled by liquid nitrogen or exposed for 1 hr in 1 mM NaCN to block oxidation and then freeze trapped. Corneas were sectioned, freeze-dried, samples of individual layers dissected, weighed, and analyzed for: NADH, NAD+, NADPH, NADP+, ATP, ADP, and Pi. The aerobic epithelium showed a ratio for NAD+/NADH of 1.85 +/- 0.08 (9). In anoxia this ratio decreased to 1.06 +/- 0.07 (8). The NAD+/NADH ratio of aerobic endothelium was 3.25 +/- 0.28 (6); in anoxia this ratio was 0.68 +/- 0.14 (5). The values of phosphorylation potential ATP/(ADP X Pi)M-1 were: 447.9 +/- 40.2 (9) in aerobic epithelium, 378.2 +/- 24.7 (5) in anoxic epithelium; 308.4 +/ 25.2 (7) in aerobic endothelium and 225.4 +/- 19.1 (5) in anoxic endothelium. Aerobic-anoxic transitions alter the concentrations of NADH and NAD+ but did not affect the concentration of NADPH and NADP+. The microhistochemical data indicate that the redox state of rabbit epithelium is less sensitive to hypoxia than the endothelium. This difference between the two limiting layers is reflected in alterations of phosphorylation potential induced by hypoxia. The similarly high efficiencies of both layers in maintaining relatively high ATP levels during histotoxic hypoxia is most likely a result of compensatory ATP generation by enhanced glycolysis. PMID- 2722443 TI - Experimental formation of 100 nm periodic fibrils in the mouse corneal stroma and trabecular meshwork. AB - The so-called long-spacing collagen that exhibits approximately 100 nm periodicity has been observed in the interstitial connective tissue of various organs under normal and pathological conditions. Although we, as well as many other investigators, have reported an increasing amount of these structures with age in the human trabecular meshwork, the pathological significance and the mechanism of its formation are still unknown. We incubated mouse ocular tissues in culture medium containing 20 mM ATP and prepared them for electron microscopic observation according to the method of Bruns et al (J Cell Biol 103:393, 1986). After the incubation, abundant 100 nm periodic fibrils were observed in the corneal stroma and the region of the trabecular meshwork, both of which show no structure of 100 nm periodicity under normal conditions. For the experimental formation of 100 nm periodic fibrils, ATP, acidic condition and temperature around 37 degrees C are necessary. The 100 nm periodic fibrils observed in our experiment were very similar to long-spacing collagen, in that the dark transverse bands have 100 nm intervals and very fine filaments of 6-7 nm diameter axially connect the bands. Long-spacing collagen is not usually observed in the human cornea, even in aged persons. The results of our study suggest that the occurrence of long-spacing collagen is related to special conditions developing in the trabecular meshwork with age but not in the corneal stroma. Experimental studies of 100 nm periodic fibril formation in mice offer a useful model for the age-related increase of long-spacing collagen in the trabecular meshwork of the human eye. PMID- 2722444 TI - Cyclic nucleotide-dependent phosphorylation of proteins in rabbit ciliary processes. AB - Cyclic nucleotide-dependent protein phosphorylation in albino rabbit ciliary processes was studied in particulate and soluble fractions of the tissue by the technique of SDS-polyacrylamide gel electrophoresis and autoradiography. In the presence of gamma-32P-ATP, the soluble fraction showed increased phosphorylation of proteins of 200, 32 and 16 kDa molecular weight when 10 microM cAMP was added. Protein phosphorylation increased with time up to 5 min. No significant augmentation of phosphorylation was observed in the presence of 10 microM cGMP compared to control. In the particulate fraction, proteins with molecular weights of 200, 160, 105, 72, 58, 32 and 16 kDa showed increased phosphorylation in the presence of 10 microM cAMP. Phosphorylation caused by the addition of cAMP was maximal between 30 sec and 1 min for the particulate membrane fraction, but with longer incubation times the incorporation of phosphate residues decreased. The same molecular weight proteins of the membrane fraction that were phosphorylated in a cAMP-dependent manner were phosphorylated in the absence of exogenous cAMP by addition of either the catalytic subunit of cAMP-dependent protein kinase or activators of membrane-bound adenylate cyclase such as l-isoproterenol, vasoactive intestinal peptide, aluminum fluoride or forskolin. A cAMP-dependent dephosphorylation of a 56 kDa protein was observed in the membrane fraction. Cyclic GMP did not cause observable changes in the pattern of protein phosphorylation in the particulate fraction of rabbit ciliary processes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722445 TI - Effect of acetylcholine on membrane potential of cultured human nonpigmented ciliary epithelial cells. AB - Human nonpigmented ciliary epithelial cells (NPE) were grown in tissue culture after transformation with an origin-defective mutant of SV-40 DNA. In these cells membrane potentials (V) were measured using the microelectrode technique. Addition of 10(-4) M acetylcholine led to a bisphasic voltage response. An immediate, transient hyperpolarization was followed by a sustained depolarization below the steady state level. These responses were irreversibly blocked by 10(-5) M atropine. In Ca2+-free media the initial addition of acetylcholine resulted in an unchanged voltage response. A second application of acetylcholine in Ca2+-free solution evoked only an abortive response of V, and further addition had no effect on V. In the presence of Ca2+ channel blockers (10(-5) M verapamil, 1 mM Co2+) the acetylcholine-induced response of the membrane potential was not changed. The initial hyperpolarization induced by acetylcholine was reduced by 33 +/- 3% (n = 6) in the presence of 2 mM Ba2+ and by 79 +/- 6% (n = 6) in the presence of 1 mM quinidine. Moreover, the amplitude of the hyperpolarization was dependent on the extracellular K+ concentration. With increasing extracellular K+ concentration (and decreasing transmembrane K+ gradient) the acetylcholine induced hyperpolarization was reduced. To further elucidate the role of Ca2+ in the acetylcholine-induced responses, we measured cytoplasmic Ca2+ activity using the fluorescence of intracellularly trapped Fura-2. Cytoplasmic Ca2+ activity increased immediately and transiently upon addition of acetylcholine. We conclude that acetylcholine transiently hyperpolarizes V in cultured human NPE by activation of K+ channels mediated by mobilization of Ca2+ from intracellular stores. PMID- 2722446 TI - Pattern-evoked potentials and optic nerve fiber loss in monocular laser-induced glaucoma. AB - ERG and VEP responses to counterphase checkerboard stimuli were obtained from cynomolgus monkeys with monocular glaucoma induced by laser photocoagulation of the trabecular meshwork. The glaucomatous eyes showed reductions of PERG amplitude that were directly related to the histologically defined nerve damage. VEP amplitudes were also reduced in the glaucomatous eyes, but were more variable and less affected by damage than the PERG responses. An acute increase in eye pressure to 40 mm Hg in eyes without damage had no detectable effect on PERG amplitudes. PMID- 2722447 TI - Parapapillary chorioretinal atrophy in normal and glaucoma eyes. I. Morphometric data. AB - Glaucomatous optic nerve damage is associated with alterations of the intra- and parapapillary optic disc area. We measured and compared the parapapillary region in 582 eyes of 321 patients suffering from chronic primary open-angle glaucoma and in 390 eyes of 231 normal subjects. Only one randomly assessed eye per patient and subject was taken for statistical analysis. Highly mopic eyes with a myopic refractive error of more than -8.00 diopters had been excluded. The parapapillary chorioretinal atrophy was divided into a peripheral zone "Alpha" with irregular hyper- and hypopigmentation, and a more central zone "Beta" characterized by whitish colour, visible large choroidal vessels and visible sclera. In the normal eyes both zones were significantly (P less than 0.001) largest and most common in the temporal horizontal sector, followed by the inferior temporal sector, the superior temporal sector and finally the nasal sector. In the glaucoma group both zones were significantly larger (P less than 0.0001; Mann-Whitney test) and more frequent than in the normal eyes (0.40 +/- 0.32 mm2 versus 0.65 +/- 0.49 mm2 for zone Alpha, 0.13 +/- 0.42 mm2 versus 0.79 +/- 1.17 mm2 for zone Beta). The differences were significant also for the earliest glaucoma stage of this study. They were most marked for the nasal parapapillary sector. Significant differences (P less than 0.001) between the normal group and the earliest glaucoma stage were: zone Alpha larger than 0.20 mm2 or broader than 0.20 mm in the temporal horizontal sector, total area of zone Alpha larger than 0.30 mm2, occurrence of zone Alpha in the nasal sector, and occurrence of zone Beta anywhere. PMID- 2722448 TI - Parapapillary chorioretinal atrophy in normal and glaucoma eyes. II. Correlations. AB - The parapapillary chorio-pigment-epithelio-retinal atrophy in glaucomatous eyes is significantly larger than in normal eyes. In a previous study its area and frequency have been measured in 582 eyes of 321 patients with chronic primary open-angle glaucoma and in 390 eyes of 231 normal subjects. In the current study the parapapillary changes were correlated with intrapapillary morphometric data and with perimetric indices. The parapapillary chorioretinal atrophy was significantly correlated with the neuroretinal rim area, the horizontal and vertical cup/disc ratios, the quotient of horizontal to vertical cup/disc ratio, the retinal nerve fiber layer score, and the mean visual field loss. It was larger in the same sector where the neuroretinal rim loss was more marked. The correlation coefficients were generally higher for zone "Beta," characterized by complete chorioretinal atrophy with visible large choroidal vessels and sclera, than for zone "Alpha," which showed irregular hypo- and hyperpigmentation. The parapapillary chorioretinal atrophy was correlated in location and time with the intrapapillary glaucomatous changes. It deserves attention in glaucoma diagnosis and follow-up. Its evaluation is especially valuable in eyes with small optic nerveheads (disc size less than 1.6 mm2) in which the intrapapillary glaucomatous changes occur later than the parapapillary ones. PMID- 2722449 TI - The relationship between secretion of retinol and protein by the lacrimal gland. AB - Secretion of retinol and protein by the rabbit lacrimal gland appear to be closely related, suggesting that they are secreted by the same mechanism. Pilocarpine and vasoactive intestinal peptide (VIP) both stimulate protein and retinol secretion rate in a dose-dependent manner, but the concentrations of retinol and protein in the lacrimal gland fluid are independent of fluid flow at flow rates in excess of 1 microliter/min. Under all conditions of stimulation with pilocarpine and VIP that were studied, the retinol:protein ratio in lacrimal gland fluid of normal rabbits remained constant at 3.3 ng retinol/mg protein. This correlation between retinol and protein secretion by the lacrimal gland suggests that retinol is protein-bound in lacrimal gland fluid. To identify this protein, vitamin A-deficient rabbits were treated orally with 3H-retinyl acetate. Lacrimal gland fluid was collected and analyzed for 3H-retinol and protein. The 3H-retinol in lacrimal gland fluid was identified by reverse-phase HPLC and analysis of protein by gel filtration chromatography showed that this 3H-retinol was associated with protein which eluted from the columns in the 20 kD range. PMID- 2722450 TI - A fluorescence-quenching assay for measuring permeability of reconstituted lens MIP26. AB - A sensitive fluorometric assay for measuring permeability of liposomes containing bovine lens MIP26 has been developed and characterized. Lens membrane proteins were isolated and incorporated into artificial membranes composed of bovine brain phospholipids, sphingomyelin and the fluorescent probe, N-4-nitrobenzo-2-oxa-1,3 diazole phosphatidylethanolamine (NBD-PE). Quenching of the probe with cobalt chloride allowed the measurement of liposome permeability in the presence and absence of lens membrane proteins. Liposomes containing the putative gap junctional polypeptide known as Major Intrinsic Protein 26 (MIP26) were shown to be more permeable than those not containing the MIP26 protein. Permeability was shown to be positively correlated with the amount of MIP26 in the liposomes and with increasing purity of the protein. This method offers a sensitive assay for channel function of the putative junction protein, and provides further evidence that MIP26 from lens membranes is a gap junctional polypeptide. PMID- 2722451 TI - Optical constancy of the chick lens during pre- and post-hatching ocular development. AB - Embryonic and post-embryonic development of the ocular lens is associated with the continual production of new secondary lens fibers by the mitotic activity of equatorial epithelial cells. This continual development affects lens size and shape and refractive index distribution. Study of embryonic lens optical function has been largely ignored. The optical characteristics of the developing chick lens, including paraxial and eccentric focal lengths, were measured during the embryonic period of development and up to 15 days after hatching. Measurements were made with an automated scanning laser system in which the video image of a helium-neon laser beam refracted by an excised lens in solution is digitized. Focal length is measured for beams moving in small steps on either side of that center. Measurements were made on excised lenses as well as with the lens in situ within the anterior segment of the eye. The results, collected from a study of a total of 80 lenses, indicates that embryo lenses at 6-7 days of incubation have long and very variable focal lengths. At the tenth embryo day, focal length drops by more than one-half and focal variations, between lenses and for different beam positions within a single lens, is reduced. Further measures for 14- and 17-day embryo lenses, as well as for lenses from hatchling and 5-, 10- and 15-day-old chicks, indicate that there is little change in focal length, either paraxially or for eccentric beam positions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722452 TI - Distribution of gap junctions and square array junctions in the mammalian lens. AB - The morphology of membrane specializations of the cortex and nucleus of bovine lenses has been analyzed for both isolated membrane fractions and intact tissue fragments. Fractions of fiber cell membranes isolated from the outer cortex and the inner nucleus of lenses have been compared using x-ray diffraction, electron microscopy, SDS polyacrylamide gels and Western blots. Each fraction has distinctive structural characteristics. In x-ray experiments, the cortical fraction gives no sharp equatorial reflections (from the plane of the membrane), whereas the nuclear fraction gives sharp equatorial reflections which index on a square lattice of 6.6 nm. In thin-section electron micrographs, the cortical fraction is composed primarily of closed vesicles and flat membrane sheets, some of which contain pentalamellar structures similar in appearance to the 16-18 nm thick gap junctions found in other tissues. The nuclear fraction contains mostly undulating membrane pairs which often show 11-14 nm pentalamellar profiles and occasionally thicker junctions. In freeze-fracture images the cortical membranes display irregular clusters of intramembrane particles which resemble gap junctions, whereas the nuclear membranes contain numerous large square arrays with a 6.6 nm repeat and few irregular clusters or individual intramembrane particles. Images of fragments of intact lenses used in the membrane isolations give similar results; in the cortex the area covered by gap junctions is over 50 times the area covered by square lattices, whereas nuclear fiber cell membranes contain large square arrays. Thus, cortical and nuclear fiber cell membranes have quite different morphologies. In particular, the size of the square arrays of protein increases as the fiber cells mature. SDS polyacrylamide gels from cortical and nuclear fractions are similar in that they both contain MP26 as the major band. However, Western blot analysis shows increasing quantities of lower molecular weight, 25 kD and 22 kD, cleavage products as one progresses from the cortex to the nucleus. These data indicate that MP26 and/or its cleavage products form square crystalline arrays in nuclear fibers. The morphology of these arrays suggests a role for MP26 in cell-to-cell adhesion. PMID- 2722454 TI - College of Medicine CME activities. AB - The author provides an update on the extensive continuing medical education activities undertaken by the University of Iowa College of Medicine. PMID- 2722453 TI - Experimentally induced ocular chlamydial infection in infant pig-tailed macaques. AB - Four Macaca nemestrina monkeys were inoculated in the conjunctiva with Chlamydia trachomatis (strain E) at 6 weeks of age. A fifth monkey was inoculated with HeLa cell materials only. Ten weeks later, all monkeys were reinoculated with either strain E or strain C. All inoculated monkeys were susceptible to infection with C. trachomatis as documented by fluorescent antibody staining of smears and reisolation of the organism from conjunctival and nasopharyngeal swab specimens. Rectal and vaginal swab specimens remained negative throughout the study. Three of four inoculated animals responded with IgM titers reaching a peak of 1:16 (M#3) and 1:32 (M#1, M#4) 2 weeks after the primary inoculation. IgG appeared in all inoculated animals and titers rose to peak levels of 1:64 (M#2), 1:128 (M#1, M#3), and 1:256 (M#4). Histopathology documented a dramatic difference in immunological response following secondary inoculation. Primary inoculation elicited a typical inflammatory response characterized by moderate stromal infiltration of polymorphonuclear and mononuclear leukocytes. Plasma cells appeared by week 3 postinoculation (pi). Following a secondary inoculation, classic follicle formation was evident by 1 week pi. Mononuclear markers identified a germinal center composed of B cells and a T cell cap. Epithelial thinning near the cap of the follicle was accompanied by a complete loss of goblet cells. This model may be useful for studying the immunopathology of infant chlamydial infections. PMID- 2722455 TI - University hospitals reach out. AB - University of Iowa Hospitals and Clinics extends its services throughout Iowa to support community physicians and the hospitals in which they serve their patients. PMID- 2722456 TI - VA cooperation strengthens vets' care, education. AB - A unique partnership between the University of Iowa College of Medicine and 3 Veterans Administration hospitals is described. PMID- 2722458 TI - Education of medical students. PMID- 2722457 TI - Today's medical students and the Iowa curriculum. AB - Physicians are naturally interested in the following generation. Charles M. Helms, M.D., associate dean, student affairs and curriculum, University of Iowa College of Medicine, offers comments on students and what they are taught. PMID- 2722459 TI - Cost accounting for clinics. PMID- 2722460 TI - Drugs in pregnancy. PMID- 2722461 TI - Iowa Department of Public Health. Working together. PMID- 2722462 TI - Giardiasis in Iowa. AB - The author discusses transmission and case distribution of the parasitic disease giardiasis and why it should be made reportable. PMID- 2722463 TI - Informed consent: procedure specific. AB - The Iowa Supreme Court recently set forth guidelines concerning informed consent. The authors discuss formulation of procedure specific surgical consent forms which comply with Iowa Code requirements. PMID- 2722464 TI - Hospitals and health care. PMID- 2722465 TI - Selling a medical practice. PMID- 2722466 TI - Ionic and non-ionic contrast media and reactions. PMID- 2722467 TI - Chimpanzee adenoviruses are related to four subgenera of human adenoviruses. AB - Nine adenovirus strains isolated from chimpanzees were studied with regard to their relatedness to each other and to human adenovirus prototypes by neutralization and hemagglutination inhibition. The strains belonged to six serotypes, and all of them were clearly related to, but not identical to human adenoviruses of subgenus A, B, C, or E respectively. DNA restriction analysis corroborated these relationships. PMID- 2722468 TI - Interactions between citrus exocortis and potato spindle tuber viroids in plants of Gynura aurantiaca and Lycopersicon esculentum. AB - Plants of Gynura aurantiaca and tomato (Lycopersicon esculentum) were inoculated with severe strains of citrus exocortis viroid (CEV) and potato spindle tuber viroid (PSTV). The progeny of both viroids was analyzed by two systems of PAGE which allowed discrimination between CEV and PSTV on the basis of their different sizes. When inoculated separately to G. aurantiaca CEV and PSTV induced severe and very mild symptoms, respectively, with CEV accumulating to a higher level than PSTV, whereas when tomato was the host, each viroid induced severe symptoms (although the reaction caused by PSTV was more intense) with PSTV reaching a higher steady-state concentration than CEV. The simultaneous inoculation of both viroids induced in G. aurantiaca the characteristic symptomatology of CEV, which was the only viroid that could be detected, whereas the response observed in tomato was that typical of PSTV, and only this viroid could be recovered. On the other hand, when G. aurantiaca plants were first inoculated with PSTV and later challenged with CEV, part of the plants displayed the characteristic severe reaction of CEV and both viroids were present in the corresponding extracts, but the other part showed the mild symptomatology induced by PSTV, and only this viroid could be isolated. However, when the protected plants were topped the new shoots exhibited severe symptoms and only CEV could be detected. These results suggest that CEV and PSTV compete for a limiting host factor needed for their replication, transport or accumulation, with CEV and PSTV having the highest affinity for the G. aurantiaca and tomato factors, respectively. PMID- 2722469 TI - Relationship of lychnis ringspot virus to barley stripe mosaic virus and poa semilatent virus. AB - Barley stripe mosaic virus (BSMV), poa semilatent virus (PSLV), and lychnis ringspot virus (LRSV) have previously been assigned to the hordeivirus group because of similarities in their particle morphology, physicochemical properties and serological analyses. However, the serological relationships of the three viruses have not been determined by direct comparison. The present study evaluated the relatedness of these viruses by Western and dot immunoblotting and by nucleic acid hybridizations. Serological analyses of the coat proteins separated by gel electrophoresis and of intact virus particles bound to nitrocellulose membranes revealed that BSMV and PSLV are distantly related, but that they are more closely related to each other than to LRSV. The genomic RNAs of the viruses failed to cross-hybridize in northern hybridization tests conducted at different temperatures. These comparisons showed that BSMV, PSLV and LRSV are distinct viruses with little nucleotide sequence relatedness. Thus our data provide additional support for their inclusion as separate members of the hordeivirus group. PMID- 2722470 TI - Evolutionary relationship of three southern African maize streak virus isolates. AB - The aligned restriction endonuclease maps of three sequenced maize streak virus isolates, three restriction-mapped southern African maize streak virus isolates, and two other sequenced geminiviruses were used as a means of calculating the sequence divergence between these viruses. The degree of divergence was used to construct a phylogenetic tree for the viruses; this tree agrees well with predictions from sequence comparisons, and so the method can be used to study the relationship of geminivirus isolates without the labor and expense of sequencing each one. PMID- 2722471 TI - The Moshe Prywes lecture in medical education. New pathways for medical education. PMID- 2722473 TI - Cardiovascular, skeletal and ophthalmologic manifestations in patients with Marfan's syndrome. AB - Cardiovascular, skeletal and ophthalmologic manifestations of Marfan's syndrome were evaluated in 36 patients with Marfan's syndrome, including 22 females and 14 males whose ages ranged from 3 to 70 years. The patients complained mainly of palpitations and chest pain. Mitral clicks and/or systolic murmurs were heard in 31 patients (86%); skeletal findings were found in 35 patients (97%) and ECG T wave changes in 11 (30%). Chest X-rays showed cardiac enlargement in six patients (17%) and dilatation of the aorta in two (6%). Holter monitoring performed in 21 patients showed only a few premature atrial and ventricular beats in 4, although prolapse of the mitral valve was found in 18 patients. Echocardiography revealed mitral valve prolapse in 32 patients (89%), 21 females (95% of females) and 11 males (79% of males). Aortic root dilatation was found in 19 patients (53%). 11 males (79% of males) and 8 females (36% of females). This study demonstrates the variable clinical expression of Marfan's syndrome and the importance of clinical and noninvasive methods, mainly echocardiography, for its evaluation. PMID- 2722472 TI - Seasonal variation in blood cholinesterase activity. AB - Blood cholinesterase activity was determined in 482 people to establish the range of enzyme values in residents of our area. A decrease in activity was noted during the summer, which recurred the following summer. This was due to a selective decrease in plasma pseudocholinesterase activity. The seasonal variation may be explained by the ingestion of pesticide residues found in fruit and vegetables. PMID- 2722475 TI - Algodystrophy and nerve lesions. PMID- 2722474 TI - Necrotizing tracheobronchitis following mechanical ventilation of the newborn. AB - Mechanical ventilation of newborn infants with respiratory distress is associated with diverse pathology of the lung. Recent reports have focused on a distinct lesion pattern of the tracheobronchial system--necrotizing tracheobronchitis. While many advanced cases of the disease proved fatal secondary to airway obstruction, others were successfully treated by removal of the occlusion. We describe two neonates with necrotizing tracheobronchitis, one of whom had a complete occlusion of the right main stem bronchus that was relieved by curettage during bronchoscopic examination. PMID- 2722476 TI - A case of tungiasis in Israel. PMID- 2722477 TI - Intrapleural instillation of streptokinase in the treatment of organizing empyema. PMID- 2722478 TI - Annual meeting of the Israel Endocrine Society. 16 to 17 January 1989, Jerusalem, Israel. Abstracts of papers. PMID- 2722479 TI - Comparison of the activity of polyanions and polycations on the classical and alternative pathways of complement. AB - Polyanions and polycations inhibit activity of the alternative and classical pathways of complement. We compared polyanions (commercial porcine heparin, chondroitin sulfate A, chondroitin sulfate B (dermatan sulfate), chondroitin sulfate C and heparatin sulfate) with polycations (salmon sperm protamine sulfate, poly-L-lysine, poly-L-arginine, polybrene and a synthetically prepared portion of platelet factor 4) for ability to inhibit alternative and classical pathway activity. The polyanions had considerably more activity on the alternative than on the classical pathway, whereas the polycations more profoundly inhibited classical than alternative pathway activity. For example, heparin, a polyanion, at 1.0 micrograms (7.7 x 10(-7) M based upon an Mr average of 13000)/10(7) cellular intermediates, inhibited alternative pathway activity and classical pathway activity by 77 and 14%, respectively, whereas protamine sulfate, a polycation, at 0.25 micrograms/10(7) cellular intermediates, inhibited these two pathways by 34 and 98%, respectively. These studies suggest that the capacity to inhibit complement activity is a common feature of highly charged substances and the polyanions preferentially inhibit the alternative pathway while polycations preferentially inhibit the classical pathway. In vivo these highly charged substances could play an important role in the tissues in regulating the activity of both pathways of complement. PMID- 2722480 TI - Prompt elevations of PGE2 and thromboxane A2 metabolites in peripheral node efferent lymph of sheep following drainage area immunization. AB - In the past decade, the main interest in the involvement of prostaglandin E2 (PGE2) in the immune response has been concerned with its role in immunomodulation (suppression) both in vitro and in vivo. Comparatively little attention has been devoted to its immunostimulatory role. It has been suggested that PGE2, like histamine, may function as a 'double agent', initially triggering, facilitating and augmenting a stimulatory immune response and later modulating, limiting and contributing to the turning off of this response. We here report an early (within minutes) immunostimulatory involvement of PGE2 (and thromboxane A2) in the sheep, with prompt elevations in levels of PGE2 and thromboxane B2 in popliteal lymph node efferent lymph following drainage area immunization with killed Salmonella muenchen bacteria. These elevations were associated with an increase in efferent lymph flow and an equally prompt but limited depression of lymphocyte outputs into efferent lymph ('shutdown', 'recruitment'). Local increases in blood flow and vascular permeability probably play important roles in these events. PMID- 2722481 TI - Fatal knowledge? Prenatal diagnosis and sex selection. AB - Moral and social arguments weigh heavily against performing medical procedures solely for purposes of sex selection. The medical profession has a responsibility to abandon its posture of ethical neutrality and take a firm stand now against sex selection. PMID- 2722482 TI - At law. Crack, symbolism, and the constitution. PMID- 2722483 TI - What's a pharmacist to do? PMID- 2722484 TI - On the pragmatics of sharing. PMID- 2722485 TI - Surrogacy revisited. PMID- 2722486 TI - The "multidisciplinary approach". PMID- 2722487 TI - Supraomohyoid neck dissection: rationale, indications, and surgical technique. AB - The supraomohyoid neck dissection is a selective cervical node dissection that removes the contents of the submental and submandibular triangles (lymph node level I), the jugulodigastric and jugulo-omohyoid lymph node groups, and the lymph node-bearing tissues located anterior to the cutaneous branches of the cervical plexus and above the omohyoid muscle (lymph node levels II and III). The sternocleidomastoid muscle, the spinal accessory nerve, and the internal jugular vein are preserved. This type of neck dissection is indicated in the surgical management of the neck in patients with large T2, T3, and T4 squamous cell carcinomas of the oral cavity in whom the cervical lymph nodes are either clinically negative (N0) or single, discrete, and less than 3 cm in diameter (N1). In this paper, we discuss the rationale for this operation, its staging, and its therapeutic value, and present a detailed description of the surgical technique. PMID- 2722488 TI - Twice-a-day radiotherapy for T3 squamous cell carcinoma of the glottic larynx. AB - Between March 1978 and April 1986, 21 previously untreated patients with T3 squamous cell carcinoma of the true vocal cord received radical courses of twice a-day radiotherapy (120 cGy twice daily) to total doses of 7,440-7,680 cGy. The rate of local control at the primary site was 67% after radiotherapy. The ultimate control rate after salvage surgery was 83%. Five-year absolute and cause specific survival rates were 59% and 81%, respectively. It is concluded that radiotherapy is a rational approach for many patients with T3 glottic cancer. PMID- 2722489 TI - Radiotherapy after excisional biopsy of carcinoma of the oral tongue/floor of the mouth. AB - This is an analysis of 16 patients with excisionally biopsied (TXN0) squamous cell carcinoma of the oral tongue (nine patients) and floor of mouth (seven patients) treated with radiotherapy. All patients had a minimum 2-year follow-up and 81% had at least 5 years of follow-up. One patient died of intercurrent disease 16 months after treatment and was excluded from analysis of local control. All patients were evaluable for analysis of survival and complications. Local control was achieved in 14 of 15 patients; one patient with local recurrence underwent a surgical salvage procedure, which was unsuccessful. No patients developed recurrent disease in the neck or in distant sites. Five-year absolute and cause-specific survival rates were 10 of 13 and 10 of 11, respectively. PMID- 2722490 TI - Effect of prior radiotherapy on postsurgical wound infection. AB - Radiotherapy causes both epithelial and endothelial damage acutely with the subsequent development of interstitial and perivascular fibrosis. These effects may lead to decreased blood flow, delayed wound healing, and a delay in achieving normal wound tensile strength. In a retrospective study of wound infections that developed in 23 of 354 patients (6%) accrued in a series of prospective, randomized antibiotic trials, the incidence of wound infection in patients receiving prior radiotherapy (7.6%) was not statistically different from the incidence of wound infection observed in patients who had had no prior radiotherapy (6.3%). Wound infection that developed in patients after radiotherapy tended to be associated with increased hospitalization, an increased rate of fistulization, and more frequently required secondary surgical repair. It is concluded that major head and neck procedures can be accomplished without an absolute increase in the incidence of wound infection. However, when postoperative complications occur, it may result in a significant increase in morbidity. PMID- 2722491 TI - Effects of general anesthesia on the human blink reflex. AB - The blink reflex was studied in 10 patients undergoing elective procedures under general anesthesia. Anesthetic agents were isoflurane, halothane, nitrous oxide, methohexital, and thiopental in various combinations. At induction, blink reflexes were diminished by low-dose thiopental (1-1.5 mg/kg) and abolished by high-dose thiopental (4-8 mg/kg) and methohexital (1.5 mg/kg). Blink reflexes were absent during halogenated volitile inhalational anesthesia and did not return until patients were in the recovery room, well after end-tidal anesthetic levels were zero by mass spectroscopy. Recovery of consciousness and the ability to blink on command often preceded return of any blink reflex activity, indicating that the blink reflex is not useful as a postoperative test of facial nerve function in the operating room after anesthesia. In six patients, blink reflexes were still diminished 2-3 hours after cessation of anesthesia, at a time when patients were fully oriented and corneal and eyelid reflexes were clinically normal. This finding suggests that the blink reflex might be a sensitive test of subtle CNS dysfunction after inhalational anesthesia and potentially could serve as a useful objective indicator of recovery from anesthesia for outpatient surgery. PMID- 2722492 TI - Postanginal sepsis. AB - Postanginal sepsis is a septicemia resulting from an antecedent pharyngitis that causes an internal jugular vein thrombophlebitis. Because of the severity of the disease and the difficulty in its diagnosis, familiarity with all aspects of the disease is essential. We present three cases and review the literature on postanginal sepsis. The clinical course of the disease is described and its evaluation and treatment are outlined. PMID- 2722493 TI - Vascular ring anomaly. AB - Congenital vascular ring anomalies frequently present to the pediatric otolaryngologist with symptoms of tracheoesophageal compression. One such case is reported and the literature reviewed. The role of the otolaryngologist in the diagnosis and management of congenital vascular ring anomalies is discussed. PMID- 2722494 TI - Plasma cell granuloma of the thyroid gland. AB - Plasma cell granuloma is a tumor-like lesion consisting of mature plasma cells, sometimes with Russell bodies and reticuloendothelial cells, supported by a stroma of granulation tissue. These tumors are most common in the lungs and were sporadically reported in extrapulmonary sites. A rare case of plasma cell granuloma of the thyroid is reported. The value of immunohistochemical staining is demonstrated. PMID- 2722495 TI - Recurrent squamous cell carcinoma of the lower lip. PMID- 2722496 TI - Lateral arm free flap in oral cavity reconstruction: a functional evaluation. AB - By use of sophisticated techniques now available from the science of Speech Pathology, we can now document, quantify, and critically analyze the surgeon's reconstructive efforts in the oral cavity. Using these methods, we have evaluated the neurotized lateral arm free flap in six patients receiving oral reconstruction. Two of these are reported in detail. This study has provided a protocol that results in the objective analysis of swallowing, articulation, and range of tongue motion and sensation. All of these tests can be routinely performed by a speech pathologist to document both operative performance as well as patient progress in speech and swallowing. It would appear that we have quantified evidence that the neurotized lateral arm free flap may represent a significant step forward in reducing the morbidity of total and subtotal glossectomy by providing a truly functional reconstruction. PMID- 2722497 TI - Retinoic acid inhibition of a head and neck multicellular tumor spheroid model. AB - The effects of retinoic acid (RA) on multicellular tumor spheroids (MTS) derived from a head and neck squamous carcinoma cell line, MDA 886Ln, were studied. Growth of MTSs was shown to be inhibited by 10(-5) to 10(-7) M RA; dose response studies demonstrated that by 10(-10) M RA, MTS growth was inhibited by less than 20%. MTSs treated with RA for 10 days had a decreased labeling index (15% compared with 23% for controls). Histologic studies at 10 days showed both an alteration in tissue-like architecture and an inhibition of squamous differentiation in RA-treated spheroids. Morphologic inhibition of differentiation was confirmed by immunohistochemical staining for involucrin. Histologic sections were also probed with a series of biotinylated lectins to search for RA-induced changes in glycosylation. Changes in staining occurred with two lectins, soybean agglutinin and peanut agglutinin. This study showed that RA induced perturbations in biological processes such as growth and differentiation in a new model system for squamous carcinomas of the head and neck, MDA 886Ln MTS. PMID- 2722498 TI - Tracheotomy in children with recurrent respiratory papillomatosis. AB - Fifty-eight patients with laryngeal papillomatosis were managed at Children's Hospital Medical Center, Cincinnati, OH, between January 1978 and December 1987. Twelve of these patients (21%) had tracheotomies. A retrospective review of these 12 cases was undertaken to determine the incidence, pattern, timing, and clinical risk factors for tracheal spread after tracheotomy. Six of 12 patients (50%) developed tracheal papillomas after tracheotomy. Peristomal mucosa was consistently the site of initial involvement followed by progressive distal spread along the length of the tracheotomy tube. Stomal involvement followed tracheotomy by an average of 14 weeks, occurring as early as 7 weeks postoperatively. Mid-tracheal spread followed stomal involvement by an average of 10 weeks. Risk factors for tracheal spread included the presence of subglottic disease at the time of tracheotomy and prolonged cannulation. Whenever possible, tracheotomy should be avoided in patients with recurrent respiratory papillomatosis. When unavoidable, every effort should be made to keep the duration of cannulation as short as possible. PMID- 2722499 TI - Trumpet maneuver for visual and CT examination of the pyriform sinus and retrocricoid area. AB - The trumpet maneuver, a technique to inflate the hypopharynx with air, allows visualization of the pyriform sinuses and retrocricoid area during both fiberoptic examination and CT scanning. The technique is useful in delineating both normal and abnormal anatomy, and is especially useful in the evaluation of patients with hypopharyngeal symptoms in whom there is a low suspicion of anatomic disease. The methods, endoscopic photographs, and CT scan images are presented. PMID- 2722500 TI - Metastatic papillary carcinoma of the thyroid: the significance of extranodal extension. AB - A retrospective study of patients with papillary carcinoma of the thyroid was conducted at The University of Texas M. D. Anderson Cancer Center to determine the significance of cervical nodal metastases in which the cancer has extended beyond the capsule of the node. The survival of 25 patients with extracapsular invasion was compared to 63 controls. There was no statistically significant difference in regional recurrence, distant metastases, death from cancer, or recurrence-free survival between the two groups. Surgically resectable extrathyroid extension of tumor at the primary site and the clinical stage of cervical metastases also had no prognostic significance. The most important prognostic factors for differentiated thyroid carcinoma remain the age and sex of the patient, the histology of the cancer, and the presence of distant metastatic disease. PMID- 2722501 TI - Hereditary carcinoma syndromes associated with benign head and neck tumors. AB - Hereditary forms of carcinoma may be associated with benign head and neck tumors. Many of these hereditary carcinoma syndromes present first to the otolaryngologist. Two unusual cases of Gardner's and Muir--Torre's syndromes illustrate the hereditary carcinoma syndromes associated with head and neck lesions. We describe the use of new genetic markers and propose a diagnostic algorithm. PMID- 2722502 TI - Management of laryngeal radionecrosis: animal and clinical experience. AB - Radiation necrosis of the laryngeal cartilages is an uncommon complication of radiotherapy for laryngeal carcinoma. It is a devastating process for which there is no one acceptable treatment. Medical management offers only temporary, symptomatic relief, which further necessitates surgical treatment. Surgical management may start with a tracheotomy; however, it often ends with a total laryngectomy. Physiologically, the necrotic cartilages are the source of the problem. It is a general surgical principle that nonviable tissue must be excised to promote healing. Therefore, if the affected laryngeal cartilages were removed, the larynx should heal. Total or near total removal of the thyroid and cricoid cartilages with preservation of the endolaryngeal soft tissues has not been reported in the literature. Theoretically, if the entire cartilaginous framework is removed, there would be no structural support for the airway. We have found using animal models, that submucosal resection of the laryngeal cartilages, leaving the perichondrium and endolaryngeal soft tissues intact can result in a competent airway. Animal and clinical experience will be presented. PMID- 2722503 TI - DNA ploidy in oral cavity carcinomas, with special reference to prognosis. AB - Single-cell DNA cytofluorometry was performed on paraffin-embedded tissue of 140 patients with squamous cell carcinomas of the oral cavity. Half of the tumors (71 of 140) were DNA nondiploid. Well-differentiated carcinomas were more often DNA diploid than moderately well-differentiated ones (P less than 0.001; chi-square). The aneuploid tumors responded better to preoperative radiotherapy than did the DNA diploid (P less than 0.001) and polyploid tumors (P less than 0.05; chi square). Using the multivariate Cox's regression analysis multiploid type tumor, age of the patients and presence of lymph node metastases were the only significant factors influencing survival. DNA diploid tumors in stages I and II had a better prognosis than DNA nondiploid (P less than 0.01; Kaplan-Meier). The reverse was true for stages III and IV, where DNA nondiploid tumors had a better prognosis (P less than 0.05; Kaplan-Meier). Tumor stages (P less than 0.001; Kaplan-Meier) and especially lymph node metastases (P less than 0.0005; Kaplan Meier) were major prognostic factors. Tumor DNA ploidy may be a complement to clinical and morphologic parameters as a prognostic predictor in squamous cell carcinoma of the oral cavity. PMID- 2722504 TI - Carcinoma of the lip in Auckland, New Zealand, 1969-1987. AB - We have retrospectively reviewed the case notes of 180 patients with carcinoma of the lip seen in Auckland between 1969 and 1987. The greater Auckland region is a geographically unique area as it comprises a modest European population (800,000 people) coupled with the largest Maori and Pacific Islander populations in the world (each of approximately 70,000 people). There were 158 patients with T1 lesions, 20 with T2 lesions, and 1 with T3 disease. Only one patient had nodal metastases at presentation. Management was primarily surgical in 138 patients, primarily radiotherapy in 25, and 14 patients received adjuvant radiotherapy after surgical excision. Primary surgical excision was associated with a 20% treatment failure rate (local recurrence and/or development of nodal metastases). Radiotherapy alone as primary therapy was followed by an 80% recurrence rate. When adjuvant radiotherapy was used after excision the failure rate was 21%. In those patients treated with local excision, the major factor predisposing to disease recurrence was the presence of a positive margin, and recurrence in cervical lymph nodes markedly worsened the prognosis. Overall, 83% of patients were alive and well at the time of the review, 7% were either dead of disease or alive with recurrent disease, and 10% were dead of other causes. We conclude from our data that good results can be achieved after surgery for lip cancer, providing negative margins are obtained, and that positive margins require early re-excision. Regional nodal disease infrequently follows complete excision of the primary lesion, but when it occurs it has an ominous significance. PMID- 2722505 TI - Magnetic resonance imaging of paranasal sinus tumors for craniofacial resection. AB - Computerized tomography (CT) has been shown to be 78% accurate with respect to anatomic extent of tumor when correlated with operative findings and histology in patients undergoing craniofacial resection. To determine whether preoperative evaluation could be improved by the combination of CT and magnetic resonance imaging (MRI), 26 patients with tumor of the paranasal sinuses had undergone MRI before surgery in addition to CT. Ten patients also received Gadolinium-DTPA as a contrast-enhancement agent during MRI. The radical approach offered by craniofacial resection allows accurate evaluation of imaging techniques and when these are compared with histologic findings, a 94% correlation is found. The use of Gadolinium further improves the accuracy of tumor delineation to 98%. Despite the intrinsic disadvantage of absent bone detail, MRI demonstrates the extent of tumor better than CT and can distinguish it from inflammed mucosa, retained secretions, and normal mucosa provided the correct sequences are used. PMID- 2722506 TI - Symptomatology of acute radiation effects in humans after exposure to doses of 0.5-30 Gy. AB - This article distills from available data descriptions of typical human symptoms in reaction to prompt total-body ionizing radiation in the dose range 0.5 to 30 Gy midline body tissue. The symptoms are correlated with dose and time over the acute postexposure period of 6 wk. The purpose is to provide a symptomatology basis for assessing early functional impairment of individuals who may be involved in civil defense, emergency medical care and various military activities in the event of a nuclear attack. The dose range is divided into eight subranges associated with important pathophysiological events. For each subrange, signs and symptoms are designated including estimates of symptom onset, severity, duration and incidence. PMID- 2722507 TI - Chelation of 238Pu(IV) in vivo by 3,4,3-LICAM(C): effects of ligand methylation and pH. AB - The linear tetracarboxycatecholate ligand, 3,4,3-LICAM(C) (N1,N5,N10,N14 tetrakis(2,3-dihydroxy-4-carboxybenzoyl-tetraaza tet radecane, tetra sodium salt) injected within 1 h after injection of Pu(IV) citrate, removes about the same fraction of Pu from animals as CaNa3-DTPA (diethylenetriaminepentaacetate, calcium, sodium salt) but removes less inhaled Pu than CaNa3-DTPA and leaves a Pu residue in the renal cortex. However, the formation constant of the expected Pu 3,4,3-LICAM(C) complexes are orders of magnitude greater than that of Pu-DTPA, and 3,4,3-LICAM(C) is 100 times more efficient than CaNa3-DTPA for removing Pu from transferrin in vitro. Because the formation constants of their actinide complexes are central to in vivo actinide chelation, ligand design strategies are dominated by the search for ligands with large Pu complex stabilities, and it was necessary to explain the failure of 3,4,3-LICAM(C) to achieve its thermodynamic potential in vivo. All the batches of 3,4,3-LICAM(C) prepared at Berkeley or in France [Euro-LICAM(C)] were found by high-pressure liquid chromatography to be mixtures of the pure ligand [55% in Berkeley preparations, 8.5% in Euro-LICAM(C)] and its four methylesters. A revised synthesis for 3,4,3-LICAM(C) is appended to this report. All of the incompletely hydrolyzed 3,4,3-LICAM(C) preparations and the pure ligand were tested for removal of Pu from mice [238Pu(IV) citrate intravenous, 30 mumol kg-1 of ligand at 1 h, kill at 24 h, radioanalyze tissues and separated excretal]. The presence of methylesters did not significantly impair the ability of the ligands to remove Pu from mice, and it did not alter the fraction of injected Pu deposited in kidneys. Temporary elevation (reduction) of plasma and urine pH of mice by 0.5 mL of 0.1 M NaHCO3 (NH4Cl) injected before or simultaneously with pure 3,4,3-LICAM(C) somewhat improved (significantly reduced) Pu excretion but had little influence on Pu deposition in kidneys. Review of the investigations of Pu removal from animals by 3,4,3-LICAM(C) revealed that the fractional renal Pu deposit was characteristic of the species and that it could be reduced by vigorous alkalinization which indicated the need to examine the details of the pH dependence of Pu complexation by 3,4,3 LICAM(C).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2722508 TI - A microcomputer algorithm for solving first-order compartmental models involving recycling. AB - A general algorithm for solving first-order compartmental models including recycling systems has been developed and its implementation on a microcomputer is described. Matrix algebra is used to obtain for any compartmental model an analytical solution, which is expressed as the exponential of a matrix of rate constants. A special technique is used in the algorithm to enable this exponential to be evaluated with a rapidly converging series. Truncation errors incurred in this process are estimated automatically. Thus, in an extreme case, where these errors may be significant, the appropriate action can be taken. Given a particular model, the user enters the model parameters into a rate matrix according to a simple rule. The algorithm then uses this matrix to solve the model, and thus no specialized mathematical knowledge is needed. The algorithm is given in a short BASIC program (60 lines) listed in an appendix. No additional software is required. By running this program on a standard microcomputer, the user can solve models of any complexity: those up to 15 compartments in seconds and those up to 30 compartments within a minute. The algorithm is thus ideally suited to solve kinetic models describing the transport of radionuclides in the environment or the translocation of elements in biological systems such as the metabolic models recommended by the International Commission on Radiological Protection (ICRP). Given the initial amount of material in each compartment at time t = 0, together with its radioactive decay constant, the algorithm gives both the amount in each compartment at any future time t and the number of disintegrations that will have occurred in each compartment up to time t. The computer program, shown in an appendix, could easily be used to calculate disintegrations over any time interval of interest, or to predict the quantities or fractions of an intake expected to be present in any in vivo or excretion compartments of interest. Thus, the algorithm can be useful in both the design and conduct of bioassay and internal dose assessment procedures. PMID- 2722509 TI - Dose-modification factor for accumulated dose to cell nucleus due to protein bound 3H. AB - The purpose of this work was to estimate the dose-modification factor for accumulated dose in the cell nucleus due to protein-bound 3H in animal organs. The animal tissues were modeled to make a simplified theoretical estimation of the extent of dose modification due to the differential distribution of proteins between the cell nucleus and the extranuclear region. The results of theoretical calculation were applied to the case of mouse organs for which various cytological factors were determined experimentally. It was found that the dose modifying factor (f) for mouse organs was between about 0.8 and 1.5, indicating that dose modification due to protein localization is of minor importance for the dosimetry of internally retained 3H. PMID- 2722510 TI - Cancer mortality around La Hague nuclear facilities. AB - Cancer death rates from the Beaumont-Hague "canton," where a nuclear facility is located, were compared with those for the Manche "departement." No significant increase was found in cancer deaths during 1970-1982 for leukemias and in 1975 1982 for all other types of malignant tumors. PMID- 2722511 TI - Estimation of the quality factor on the basis of multi-event microdosimetric distributions. AB - The measurement of microdosimetric distributions for the purpose of estimating the quality factor, Q, may be encumbered in pulsed radiation fields--as produced, for instance, by accelerators with low duty cycle--because of a signal pile-up. We propose a method of estimating Q from the first several moments of multi-event distributions. In addition to overcoming the high dose-rate problems, the measurement of such distributions can be performed in significantly smaller volumes than conventional microdosimetry, thus raising the possibility of reducing the site diameter (presently 1 micron) for which y in the function Q(y) is specified. PMID- 2722512 TI - Technique-dependent decrease in thyroid absorbed dose for dental radiography. AB - A LiF thermoluminescent dosimetry (TLD) system, calibrated in the tissue of interest with the beam used for experimentation, was employed to investigate dosages (muGy) to the thyroid region of an anthropomorphic phantom resultant from two dental complete-mouth radiographic procedures. Both techniques were compared in terms of dosages associated with combinations of lead apron and thyroid collar shielding while using a 70-kVp or 90-kVp x-ray beam for a 20-film complete-mouth series. Lead shielding significantly decreased the dose to the thyroid using both techniques (p less than 0.05). The use of the 90-kVp beam resulted in a significant reduction in the thyroid absorbed dose when using the bisecting angle technique (p less than 0.05) but caused a significant increase in the thyroid absorbed dose when the paralleling technique was used (p less than 0.05). The implementation of higher kilovoltage techniques in dental offices must therefore be dependent on the radiographic technique employed. PMID- 2722513 TI - Doses to patients from dental radiology in France. AB - In France, a national study was undertaken to estimate both dental radiology practices (equipment and activity) and the associated population collective dose. This study was done in two steps: A nationwide survey was conducted on the practitioner categories involved in dental radiology, and dosimetric measurements were performed on patients and on an anthropomorphic phantom by using conventional dental x-ray machines and pantomographic units. A total of 27.5 x 10(6) films were estimated to have been performed in 1984; 6% of them were pantomographic and 94% were conventional. Most of the organ doses measured for one intra-oral film were lower than 1 mGy (100 mrad); pantomogram dose values were generally higher than intra-oral ones. The collective effective dose equivalent figure was 2,000 person-Sv (2 x 10(5) person rem) leading to a per head dose equivalent of 0.037 mSv (3.7 mrem). The study allowed authors to identify ways to reduce the patient dose in France (e.g., implementing the use of long cone devices and controlling darkroom practices). PMID- 2722514 TI - Effectiveness of skin absorption of tincture of I in blocking radioiodine from the human thyroid gland. AB - Topical application of tincture of iodine (I) was found to be effective in blocking the thyroid uptake of orally administered 131I in humans. Abdominal skin application of tincture of I resulted in an approximately 82% reduction in the uptake of 131I by the thyroid gland. The effectiveness varied among individuals and may have depended on the quantity applied and on the application site. In each study group, elevated levels of serum I were observed. PMID- 2722516 TI - How science can contribute to the legal process. PMID- 2722515 TI - Health physics measurement of Princeton Tokamaks, 1977-1987. AB - The Princeton Plasma Physics Laboratory (PPPL) began fusion experiments in 1951. In the early years, the major health physics concerns were associated with x radiation produced by energetic electrons in the plasma. Within the past year, neutron and 3H production from 2H-2H (represented hereafter as D-D) reactions has increased significantly on the larger fusion devices. Tritium retention noted in graphite tiles underscores the significance of material selection in present and future 3H-fueled fusion devices. This paper reports on operational health physics radiation measurements made on various PPPL machines over the past 10 y. PMID- 2722517 TI - The effect of dose rate on radiation injury. PMID- 2722519 TI - Neutron dose equivalent outside the lateral shielding of an electron linear accelerator operating at 0.48-2.15 GeV. PMID- 2722518 TI - An empirical model for x-ray attenuation in Pb and mild steel. PMID- 2722520 TI - Dose levels of medical exposure from diagnostic x-ray procedures in Beijing, China. PMID- 2722521 TI - Radiation cancer risks: who is ordained to speak for science? PMID- 2722522 TI - Peer review and scientific consensus in radiation cancer assessment. PMID- 2722523 TI - New data inconsistent with 'scientific consensus' on low-level radiation cancer risks. PMID- 2722524 TI - Use of liquid vs. capsule form 131I. PMID- 2722526 TI - Proposed change to the IRPA 1985 guidelines on limits of exposure to ultraviolet radiation. International Non-ionizing Radiation Committee of the International Radiation Protection Association. PMID- 2722525 TI - The effect of low-level radiation. PMID- 2722527 TI - A survey of Scottish Health Boards and English Health Authorities. The extent of computerisation in health visiting records. AB - There is a wide variation in how computer technology has been used with regard to child health records and allied services. A survey of health boards in Scotland was extended to English health authorities (HAs) to ascertain if information was collected from health visitor records for computer analysis. The results showed Greater Glasgow Health Board uses a record which is coded for a computer. Fife Health Board also used part of this system. In England, ten of the individually described health authorities have just or are in the process of redesigning their records for health visitors. There is a wide variation of how computer technology has been used with regard to health visiting. For an overall picture of family and child most records either relied on the manual part of the record or did not require this information to be recorded. Developments in health visiting which try to ensure a service to the family as well as the child would therefore remain hidden or, more worryingly, untouched. PMID- 2722528 TI - Research projects in community nursing care of the elderly. AB - Concern has been expressed about the lack of research taking place in community nursing. There are difficulties in monitoring who does what; some of the difficulties are to do with defining research and deciding whether a research project involving nurses in the data collection is a nursing project or not. Nursing research projects sponsored by DHSS have been well documented as have projects specifically concerned with children. There are anomalies in funding the community based research and nursing research in particular. To gain some idea of the kinds of funding and research in community nursing in relation to the elderly, a national survey was carried out by this research centre over 1986 and 1987. PMID- 2722529 TI - Some impressions of community health care from Australia and Canada. AB - In this article a health visitor with Coventry Health Authority describes her experiences over a period of 12 months whilst visiting the state of New South Wales, Australia and the province of Ontario, Canada and observing the community health services in action. Some personal comments are offered regarding the health visiting facilities available in both countries and an assessment is made of the effectiveness of those alternative systems of community health care. PMID- 2722530 TI - Pendle syndrome? PMID- 2722531 TI - 45 Cope Street: working in partnership with parents. PMID- 2722532 TI - Social security reforms one year on. PMID- 2722533 TI - American Association of Critical-Care Nurses Demonstration Project: profile of excellence in critical care nursing. AB - The American Association of Critical-Care Nurses developed a Demonstration Project to document fiscal costs and patient care effectiveness of critical care nursing in a unit characterized by valued organizational attributes. Data were collected by interview, observation, and written surveys from 42 nurses, 68 physicians, and 192 patient admissions. Decentralized administration, participatory management, high rate of CCRN certification, all-registered nurse staff, and high nurse-physician collaboration were present. Organizational and clinical outcomes were positive: high satisfaction, low turnover, low mortality ratio, no new complications, high patient satisfaction. The proportion of charges for nursing-controlled factors was low compared with proportion of total stay spent in the unit. Aspects of structure, process, and outcome can be measured simultaneously in critical care; these measurements indicate that positive organizational and clinical outcomes coexist with valued aspects of the organizational environment. PMID- 2722534 TI - Observations of a support group for automatic implantable cardioverter defibrillator recipients and their spouses. AB - We studied the use of an 8-week group support intervention with recipients of automatic inplantable cardioverter-defibrillators (AICDs) and evaluated the effect of this treatment on both patients and spouses. Patients attending the Rhode Island Hospital Arrhythmia Clinic formed the study population. Six patients and their spouses formed the treatment group. Six patients living a distance (greater than 25 miles) from the hospital who were not able to attend the sessions formed a natural comparison group. Outcome was reported by a descriptive analysis of the group experience and assessment of changes in role functioning and psychologic adaptation after the intervention. Study results supported our hypothesis that group therapy was an effective treatment modality in promoting positive adjustment of patients to the AICD device. Furthermore, trends emerged suggesting positive shifts in both role functioning and psychologic adjustment in patients attending group sessions. These findings suggest that group therapy is a useful method of providing support and education for individuals receiving the AICD device. PMID- 2722535 TI - Why are so many critical care nurses unable to recognize ventricular tachycardia in the 12-lead electrocardiogram? AB - We submitted the 12-lead electrocardiogram of an easily recognized ventricular tachycardia to more than 2500 critical care nurses for diagnosis. Seventy-eight percent of these failed to diagnose ventricular tachycardia, opting for supraventricular tachycardia with ventricular aberration. It was clear that only 0.5% of 2500 experienced nurses knew the three clues available for diagnosing ventricular tachycardia. PMID- 2722536 TI - Alternating atrial transport. PMID- 2722537 TI - Airway obstruction from overinflation and herniation of tracheostomy tube balloon. PMID- 2722538 TI - Promoting the young child's development in the intensive care unit. AB - Young children are much more emotionally vulnerable to hospitalization than are adults. The admission of a child to an intensive care unit (ICU) is stress producing and can affect the child's ability to develop at an optimal level. This article provides the ICU nurse with a working knowledge of normal growth and developmental patterns of infants and toddlers. Internal strengths of the child, external supports, and environmental manipulation that the nurse can use to promote the critically ill child's growth and development and support the child in coping with hospitalization are presented. Discussion centers on the child experiencing an acute crisis that requires long-term intensive monitoring, rather than on the chronically ill child. PMID- 2722539 TI - Hemofiltration: an alternative to dialysis. AB - Continuous arteriovenous hemofiltration (CAVH) is a relatively new procedure designed to relieve fluid overload. It has proved useful in many patients whose ability to maintain fluid homeostasis is compromised. Burn victims, patients with acute renal failure, patients with pulmonary edema, and trauma patients have all received benefit from CAVH. CAVH is an extracorporeal circuit in which blood is propelled by the force of the patient's blood pressure through a filter, ultrafiltered, and returned to the patient. CAVH removes fluid and solutes more slowly than hemodialysis, eliminating the danger of rapid fluid and electrolyte shifts. There are several ways to perform the procedure but all require intense and sophisticated medical and nursing care. Strong knowledge of fluid, electrolyte, and acid/base balance, hemodynamics, and assessment skills is required. The ability to intervene quickly and appropriately if trouble arises is a necessity. The dynamics of the treatment are discussed in detail in this article. How to deliver a safe and efficient treatment, troubleshooting guidelines, and suggestions for accurate documentation are also included. PMID- 2722540 TI - NTI research abstracts. Sixteenth annual National Teaching Institute. Atlanta, Ga., May 15 to 18, 1989. PMID- 2722541 TI - Pseudoappendicitis caused by Salmonella heidelberg. PMID- 2722542 TI - Moral distress and the shortage of critical care nurses. PMID- 2722543 TI - Personality factors of critical care nurses. PMID- 2722544 TI - Thinking aloud. PMID- 2722545 TI - Effects of music on patient anxiety in coronary care units. PMID- 2722546 TI - Home health education revisited: a violation of state nursing practice acts? PMID- 2722547 TI - Discharge of a patient with chronic respiratory failure: Part I. PMID- 2722548 TI - Personal power and the home healthcare nurse. PMID- 2722549 TI - Myocardial infarction: assessing the patient in the family setting. PMID- 2722550 TI - The supervisory shared home visit tool. PMID- 2722552 TI - Growing up. PMID- 2722551 TI - Oral health and hygiene for the elderly. A shared learning experience. PMID- 2722553 TI - Long-term oxygen therapy: indications and guidelines for use (continued education credit). PMID- 2722554 TI - Coping with fears of caring for HIV-positive patients. PMID- 2722555 TI - Identifying roles of hospice volunteers. PMID- 2722556 TI - Attitudes of community health nurses toward their role in rehabilitation of aging patients. PMID- 2722557 TI - Structure of rDNA in the mosquito Anopheles gambiae and rDNA sequence variation within and between species of the A. gambiae complex. AB - The structure of the rDNA repeating unit of Anopheles gambiae (Diptera: Culicidae) was determined by restriction endonuclease mapping and hybridization analyses on four independent clones obtained from a genomic library of a colony (G3) from the Gambia (West Africa). rDNA gene coding sequences are conserved, but much intragenomic and intraspecific (geographic) variation occurs in the intergenic spacer. Hybridization of subclones from spacer and coding sequences to genomic DNA that was isolated from single mosquitoes from laboratory colonies of four other A. gambiae complex species reveals conservation of coding sequences but concerted evolution in the intergenic spacers. PMID- 2722558 TI - Histochemical detection of monoamine oxidase and alcohol dehydrogenase activities in the Syrian hamster Harderian glands: existence of a sexual dimorphism. AB - Monoamine oxidase (MAO) and alcohol dehydrogenase (AD) activities were studied histochemically in the Syrian hamster Harderian gland using tryptamine as substrate and Nitroblue Tetrazolium as the final electron acceptor. No dark: light-related changes were observed. Male type I secretory cells showed an intense MAO reaction. Female type I cells exhibited a moderate MAO activity. Both male and female glands showed a moderate/intense AD-positive reaction. Male type II cells were lacking MAO and AD activities. MAO activity found in the hamster Harderian glands corresponded mainly to MAO type A since treatment with chlorgyline (0.01, 0.1 and 0.5 mM) totally inhibited it. The possible role of these two enzymes in Harderian gland indolalkylamine metabolism is discussed. PMID- 2722559 TI - A multiple-staining ultrastructural procedure simultaneously detecting three membrane antigens on suspended cells by monoclonal antibodies and pre-embedding immunogold labelling. AB - A triple ultrastructural immunogold staining method for the simultaneous demonstration of three surface antigens of peripheral blood mononuclear cells at the electron microscope level is described. A six-step pre-embedding immunoelectron microscopy procedure was developed, using commercially available reagents. The CD11b antigen was first detected, through a two-step (indirect) method with 40 nm-sized gold particles; after a blocking step, the HLA-DR surface antigen was subsequently detected, through a two-step (biotin-streptavidin) method with 20 nm-sized gold particles; the CD4 antigen was finally detected, through a one-step (direct) method, using 5 nm-sized gold particles. Electron microscopic examination revealed firstly the presence of a triple-labelled cell subpopulation, which showed gold granules of the three sizes simultaneously decorating the cell membrane. Thus, the cells of such a subset simultaneously expressed the three antigens investigated. In contrast, either gold particles of only one size or no gold particles were observed on the cell surface of other subpopulations. This technique is a model demonstrating the importance of varying the size of particles in pre-embedding gold immunoelectron microscopy for a better analysis of the expression of surface antigens in isolated cells. PMID- 2722560 TI - Endocytotic pathways across the human gall-bladder mucosa: permeability studies using horseradish peroxidase. AB - Human gall-bladder epithelium obtained straight from the operating theatre was incubated in an Ussing chamber with the fluid phase marker, horseradish peroxidase (HRP), for up to 60 min. When the marker was presented on the apical surface, within 30 min it had moved readily across the apical cytoplasm in transport vesicles to receptosomes and into the lateral intercellular space, extending across the basement membrane into the lamina propria. When HRP was presented at the basal aspect, within 30 min it had moved through the lamina propria, across the basement membrane and into the lateral intercellular space. By 60 min, only small amounts had been taken up by the epithelial cells and transported to receptosomes. These data indicate a rapid transmucosal endocytotic pathway for blood- or bile-borne macromolecules. PMID- 2722561 TI - Use of poly(vinylpyrrolidone) and poly(vinyl alcohol) for cryoultramicrotomy. AB - Specimens infused with or suspended in a mixture of 10-30% poly(vinylpyrrolidone) and 2.07-1.61 M sucrose can often be more easily frozen-sectioned than those infused with sucrose alone. The pH of such a mixture can be efficiently adjusted to neutrality by using Na2CO3. Use of poly(vinylpyrrolidone) causes little or no increase in the background level of immunolabelling. Adsorption staining of ultrathin frozen sections with a mixture of uranyl acetate and poly(vinyl alcohol), i.e. a simple thin-embedding of the sections in such a mixture, produces positive staining effects that are often enough to delineate structures of many organelles. When OsO4-treated frozen sections are stained with uranyl acetate and further adsorption-stained with a mixture of lead citrate and poly(vinyl alcohol), the overall staining effects are similar to those observed in double-stained conventional sections. PMID- 2722562 TI - Immunohistochemical study of the biological fate of a subcutaneous bovine collagen implant in rat. AB - The biological fate of a bovine collagen implant (Zyderm Collagen Implant ZCI), injected subcutaneously into rats, was studied by the immunoperoxidase technique using specific antibodies against the bovine implant and against types I, III, IV, V collagens, fibronectin and elastin. The implant remained in the animals until the end of the experiment (90 days), with no visible modification, as demonstrated by immunoperoxidase labelling and scanning electron microscopy. A slight inflammatory reaction was visible around the implant 24 h after injection and within the implant 3 days after injection. Fibroblast invasion began 7 days after injection. The chronology of the deposition in the implant of the host (rat) extracellular matrix components was as follows: by 24 h after injection, fibronectin was observed throughout the implant; types I and V collagens appeared on the 7th day, and, in contrast to surrounding connective tissue, type V collagen labelling was obtained without acid pretreatment of the section. Types III and IV collagens were detected inside the implant only 30 days after injection. At the end of the experiment (90 days), there was abundant types I and IV collagens after fibroblast migration, and abundant type IV collagen demonstrating an important vascularization. No elastic fibres could be detected inside the implant but they appeared as a dense network around the implant in host connective tissue. PMID- 2722563 TI - Cytochemical localization of DNA loop attachment sites to the nuclear lamina and to the inner nuclear matrix. AB - The rat liver nuclear matrix, obtained by endogenous nuclease digestion and extraction with low and high ionic strength media, contains residual DNA fragments that are considered to represent the attachment sites of the chromatin domains to the nucleoskeleton. These sites, protected against nuclease digestion by their binding with the nucleoskeleton proteins, should be either mainly linked to the peripheral lamina or to the inner nuclear matrix. The DNA fragment distribution at the level of the different components of the nuclear matrix has been evaluated in samples embedded in Epon and in hydrophilic resins by means of the DNase-gold technique. The labeling obtained suggests that the chromatin loops are prevailingly associated with the interior of the matrix; in fact about twice of the label is present in the inner matrix with respect to the peripheral lamina area. These results confirm the hypothesis that in interphase the chromatin maintains an organization similar to that of chromosomes, with loops radiating from a central scaffold, instead of being mainly attached to the lamina as otherwise suggested. PMID- 2722564 TI - Immunohistochemical study of cells positive for glial fibrillary acidic protein (GFAP) in the human pituitary gland, with special reference to folliculo-stellate cells. AB - The cytology and the distribution of cells which contain glial fibrillary acidic protein (GFAP) were studied immunohistochemically in thick frozen sections of human pituitary glands. Immunoreactive cells were constantly demonstrated in both neuro- and adenohypophysis. In the neural lobe, an irregular network of long GFAP positive pituicyte processes was revealed. Within this network, some asymmetric pituicytes became visible. A variable number of cells was stained in cell cords and follicles of the pars distalis and the intermediate zone. The morphology of these cells could be studied in detail, providing strong evidence to support the hypothesis that adenohypophyseal GFAP-immunoreactive cells belong to the folliculo-stellate (FS) cell system. Cells with similar cytological features in the pars distalis or the intermediate zone were found to share common immunoreactivities against GFAP and the presumable FS cell markers vimentin and S 100 protein. Our results corroborate the notion that, in the human pituitary, GFAP can be regarded as a marker protein of pituicytes and FS cells, which is expressed at varying degrees. PMID- 2722565 TI - Secretory component in differentiating normal epithelium, benign lesions and malignancy in the human breast as monitored by monoclonal antibodies. AB - An immunohistochemical study of the expression of the secretory component (SC) in human mammary gland epithelium at various stages of differentiation, as well as in benign and malignant breast tumours, was undertaken using three mouse monoclonal antibodies. Antibody RICEO-SC-05 (SC-05), raised against a partially purified preparation of human SC, and reacting with a reduction-resistant epitope present in both free and polymeric immunoglobulin-bound SC, was compared in immunoperoxidase and immunofluorescence studies on a diverse range of normal tissues, to 2 reference anti-SC antibodies (LICR-LONLC28 and RICEO-MFG-12). All three antibodies reacted with secretory epithelia only, consistent with known patterns of expression of SC in tissues, although there was an unexpected reaction by all anti-SC antibodies with some Hassal's corpuscles of the thymus. Staining patterns seen in the normal resting, pregnant, lactating and regressing (after weaning) breast provide evidence for differentiation-associated changes in the production of SC, and support the concept of terminal ductal lobular units (TDLUs) as functional compartments of the mammary gland. SC was detected in all but one benign breast lesion (n = 53) as compared to only 24% positive cases with heterogeneous expression of SC found among 176 primary and metastatic breast carcinomas examined. In a series of 40 primary breast carcinomas and their corresponding lymph node metastases, a good overall correlation was found between the expression of SC in the matched specimens; aside from 3 heterogeneously SC positive carcinomas whose metastatic counterparts were SC-negative. Our results demonstrate a potential application for monoclonal antibodies to SC in the study of human mammary gland differentiation, but suggest that the value of an assay for SC in the diagnosis of breast carcinomas is questionable due to the generally low expression of SC by either primary or metastatic breast lesions. PMID- 2722566 TI - Histochemical demonstration of GABA-like immunoreactivity in cobalt labeled neuron individuals in the insect olfactory pathway. AB - Individual olfactory neurons in the antennal lobes of Periplaneta americana were investigated for their morphological and neurochemical properties by means of intracellular cobalt injection and indirect peroxidase-antiperoxidase immunohistochemistry. GABA-like immunoreactivity was demonstrated in many local interneurons but not in uniglomerular projection neurons. PMID- 2722567 TI - Cytochemical observations of the coiled bodies in neurons of rat sympathetic ganglia. AB - Coiled bodies were investigated by means of ultrastructural cytochemistry. Preferential staining methods for localization of various proteins (ribonucleoproteins, basic proteins, phosphoproteins and glycoproteins) and DNA were applied. The results of cytochemical tests revealed that coiled bodies have a proteinaceous nature. They are composed of ribonucleoproteins, probably of nucleolar origin. They also contain phosphoproteins and glycoproteins but lack cytochemically detectable DNA. Coiled bodies present ultrastructural and cytochemical characteristics similar to the fibrillar part of the nucleous and to the interchromatin granules. The origin and possible functional role of coiled bodies are briefly discussed. PMID- 2722568 TI - [Model investigations on the structure of the purple dye complex of Giemsa staining]. AB - Nuclei of Giemsa stained cells show a purple coloration, which is generated by a complex of DNA, azure B (AB) and eosin Y (EY). The structure of this complex is unknown. Its absorption spectrum shows a sharp and strong band at 18,100 cm-1 (552 nm), the so called Romanowsky band (RB). It is possible to produce the complex outside of the cell, but it is cubersome to handle. Easier to handle is a purple complex composed of chondroitin sulfate (CHS), AB and EY, which also shows a sharp and strong RB at 18,100 cm-1 in the absorption spectrum. This CHS-AB-EY complex is a model for the DNA-AB-EY complex of Giemsa stained cell nuclei. We tried to investigate its structure. In the first step of the staining procedure CHS binds AB cations forming a stable CHS-AB complex. In the case of saturation each anionic SO4- and COO- -binding site of CHS is occupied by one dye cation and the complex has 1:1 composition. It has a strong and broad absorption band with its maximum at ca. 18,000 cm-1 (556 nm). In the second step the CHS-AB complex additionally binds EY dianions forming the purple CHS-AB-EY complex with its RB at 18,100 cm-1. This band can be clearly distinguished from the broad absorption of the bound AB cations. RB is generated by the EY chromophore, whose absorption is shifted to longer wavelength by the interaction with the CHS-AB framework. PMID- 2722569 TI - Evidence that dopaminergic sympathetic axons supply the medullary arterioles of human kidney. AB - The ability of the kidney to excrete sodium appears to depend on release of dopamine from intrarenal sources. In the present study, we have used immunohistochemistry to examine the possibility that renal dopaminergic nerves constitute one of these sources. We found that the sympathetic axons supplying cortical structures in human kidney contain tyrosine hydroxylase-like immunoreactivity but lack DOPA decarboxylase-like immunoreactivity. By contrast, the vasa recta arterioles of the renal medulla are supplied by varicose tyrosine hydroxylase-positive nerve fibres, some of which also contain DOPA decarboxylase. As DOPA decarboxylase has been demonstrated in other situations to be a selective marker for dopaminergic terminal axons, our results suggest the innervation of renal medullary blood vessels in man by both noradrenergic and dopaminergic sympathetic nerves. PMID- 2722570 TI - Intranuclear and cytoplasmic hemoglobin in human erythroblasts during maturation. Electron microscopic immunocytochemistry. AB - Changes in the hemoglobin level in human bone marrow erythroblasts associated with cell maturation were studied by the electron microscopic immunocytochemical technique using protein A-gold. Intense reaction of gold to hemoglobin was observed diffusely in the cytoplasm, but the reaction was weak in the Golgi zone. No reaction was observed in mitochondria or granules. Cytoplasmic hemoglobin was noted in basophilic erythroblasts and increased with maturation. Hemoglobin was also noted in the nucleus, especially in the euchromatin, though in smaller amounts than in the cytoplasm. Since intranuclear hemoglobin tended to increase in the euchromatin but to decrease in the heterochromatin with erythroblast maturation, the ratio of the amount of hemoglobin in the euchromatin to that in the heterochromatin increased with maturation. PMID- 2722571 TI - Polarized distribution of binding sites for concanavalin A and wheat-germ agglutinin in the zona pellucida of goodeid oocytes (teleostei). AB - Zonae pellucidae of the viviparous goodeid teleosts Girardinichthys viviparus, Xenoophorus captivus, and Xenotoca eiseni were investigated ultrastructurally, and binding sites for ConA and WGA were localized on cross-sections using a colloidal gold technique. In late stages of development, the oocytes are surrounded by a three-zonated acellular matrix multiply perforated by pore canals allowing long microvilli of the oocyte to penetrate interstices of the follicle epithelium. Together, the surface of the microvilli and zona pellucida is coated by a thin layer of homogeneous slightly electron-dense material. In early oogenesis, the thin acellular layer is entirely packed with binding sites for WGA, whereas those for ConA occur only sparsely. Three-zonated zonae pellucidae amply contain both WGA and ConA receptors. The asymmetric labelling pattern obtained with both lectin protein gold preparations indicates a polarized organization of the different glycoconjugates. WGA receptors are concentrated within the outer region of the zona pellucida. Labelling with ConA-HRP-Au complexes produced heavy deposits of marker beads within the inner two thirds of the zona pellucida and weak labelling of the superficial coat. After prolonged digestion with neuraminidase, WGA binding sites were no longer detectable. PMID- 2722572 TI - Histochemistry of glycoconjugates in the gallbladder epithelium of ten animal species. AB - A battery of seven lectins and several conventional mucin histochemical techniques were used to identify the epithelial mucins of the gallbladder of ten species: man, rabbit (Oryctolagus cuniculus, mammalia), hamster (Mesocricetus auratus, mammalia), chicken (Gallus gallus, bird), sparrow (Passer domesticus, bird), moorish gecko (Tarentola mauritanica, reptilia), ladder snake (Elaphe scalaris, reptilia), lake frog (Rana perezi, amphibia), natterjack toad (Bufo calamita, amphibia) and gilthead sea bream (Sparus auratus, fish). Glycogen was found in the epithelial lining of the reptilian and amphibian gallbladders. Sulphate and carboxyl groups were frequently found in the same species, except in the ladder snake and natterjack toad gallbladders where only sulphate groups were identified. Sialic acid residues were detected in man, rabbit, bird, T. mauritanica, R. perezi and fish gallbladders. ConA binding pattern was similar in the ten species studied. In the human gallbladder only PNA failed to label the luminal surface, while the glands were only unreactive to DBA. The human gallbladder showed a large variety of saccharides. The present results suggest that no relation exists between the composition of the gallbladder mucins and the situation of the species in the phylogenetic scale. PMID- 2722573 TI - [Orbital pseudotumor]. AB - The orbital pseudotumour is an inflammatory infiltration, which ranges from a lymphoid, through a granulomatous to a sclerosing type, depending on its stage of maturity. Its simulataneous appearance with autoimmune-reaction-induced diseases might indicate an immune-allergic aetiology. After clinical diagnostic procedures including imaging techniques (of which magnetic resonance is particularly important) as much of the tissue as possible should be removed by orbitotomy. Therapy with cortisone and/or radiation is indispensable, but seems to be effective only in the early stages. The case histories of three patients over periods of 1.5-12 years are analysed and compared with the currently available results in the literature. PMID- 2722574 TI - [Submicroscopic changes in the jejunum in ectopic sites. A scanning and transmission electron microscopy study following free, microvascular jejunum transfer]. AB - Biopsies of the jejunal epithelium were analysed by scanning and transmission electron microscopy of specimens taken from patients at least 1 year after reconstruction of defects from resection of oro-hypopharyngeal cancer by free microvascular anastomized jejunum graft. The villi were compressed and flattened, their surface uneven due to calibre changes of columnar cells. The microvilli were rarefied and grossly altered. In the subapical area there was a distinct enhancement of desmosomal connections. Paneth cells and endocrine cells were unaltered. Autonomic nerves were intact, though the muscularis mucosa seemed to be denervated. PMID- 2722575 TI - [Catheter implantation for intra-arterial chemotherapy of malignant tumors of the head and neck]. AB - Tumors of the head and neck are mainly squamous cell carcinomas of varying differentiation. If the tumor is advanced (T3-T4) or distant metastases are present, the tumor is often to be regarded as inoperable. If cure is unlikely or substantial functional impairment is to be expected, surgery may no longer seem reasonable, even for tumors limited to one side. Since either radiotherapy or chemotherapy alone or in combination are often disappointing or have considerable side-effects, it seems reasonable to try to inhibit malignant cell growth by administering a cytostatic agent by intra-arterial "superselective" chemotherapy using an implantable catheter. The method is simple, and the patients may also receive combined radiotherapy if necessary. Furthermore, ambulant treatment is possible, with a substantially reduced risk of infection. This is an advantage compared with other catheter techniques, particularly in view of the restricted expectation of life of patients with advanced tumor. The disadvantage of "A-port implantation" is that chemotherapy can only start after complete wound healing. PMID- 2722576 TI - [The lymphocyte transformation test for detecting immunologic inner ear deafness]. AB - The basis and performance of the lymphocyte transformation test for proving an immunologically induced inner ear hearing loss are described and documented. In 6 out of 14 patients with inner ear hearing loss of unknown origin an immunological etiology could be elaborated by using this test. The relevance of this test as well and its further application by using collagen type II as antigen are discussed. PMID- 2722577 TI - [Prognosis of peripheral facial paralysis in Lyme borreliosis (Garin-Bujadoux, Bannwarth meningopolyradiculitis)]. AB - Meningopolyradiculitis (Garin-Bujadoux syndrome, Bannwarth syndrome) is the second stage of Lyme disease, a tick-borne Borrelia infection. Almost 60% of these patients develop an acute peripheral facial paresis. The disease can be differentiated from Bell's palsy only by finding the specific Borrelia antibodies in serum and CSF. Other cranial nerve lesions can be found besides facial paresis. The follow-up of seven Borrelia-infected patients is described: one showed bilateral, the others unilateral, facial paresis. High dosage of penicillin or tetracycline for 10-14 days is the appropriate therapy. The prognosis of facial paresis in tick-borne Borrelia infection is considered to be good. All our patients showed complete recovery of motor nerve function. PMID- 2722578 TI - [Extracranial meningioma: a rare differential diagnosis of an intranasal tumor]. AB - Meningiomas are common intracranial neoplasms, making up 19.5 per cent of all intracranial tumours. Meningiomas occurring outside the central nervous system are uncommon. In this report should be presented an extradural meningioma of the left nasal cavity, which was diagnosticated in an 78-year-old female. These slowly growing non-infiltrating tumours have no characteristical clinical symptoms, they cause nasal obstruction and sinusitis. The origin of these tumours is uncertain. Obviously intranasal meningiomas take their origin from the arachnoideal meningocytes which accompany the olfactory filaments through the lamina cribrosa to the extradural site. PMID- 2722579 TI - [Acrodysostosis: an autosomal inherited form of peripheral dysostosis]. AB - We report a 13-year-old boy with peripheral dysostosis, nasal hypoplasia, brachydactyly and a tracheal stenosis of unknown origin. Acrodysostosis is usually caused by an autosomal gene, but in this case it was probably due to a new mutation. The frequently described mental retardation is not essential feature. Ectopic calcification has not been previously reported. PMID- 2722580 TI - [Angioedema in ENT practice]. AB - Angioedema is characterized by subcutaneous or submucosal swelling, which often affects the lips, tongue and oral or pharyngeal sites. Laryngeal oedema can be potentially life-threatening. The pathogenesis of angioedema is thought to involve the release of histamine and other mediators with subsequent extravasation of fluid. Over 90% of cases of chronic angioedema are clinically idiopathic. The known causes are allergic and more commonly pseudo-allergic (IgE independent) reactions, especially drug or food hypersensitivity. Pseudo-allergic angioedemas are mainly evoked by a direct release of mediators or activation of the complement system. At the Department of Otolaryngology (Medizinische Hochschule Hannover) we performed a retrospective evaluation of the clinical histories of inpatients with angioedemas. The most common was swelling of the tongue, with laryngeal edema noted in five cases. Only one patient, whose case is reported, required a tracheostomy. In seven patients the causes of angioedema were determined as drug or food intolerance. The treatment of acute attacks is outlined. PMID- 2722581 TI - [The status of galvanic assessment of equilibrium]. AB - The galvanic test is the only method of localising the site of the disease in the differential diagnosis between a vestibular endorgan or neuronal lesion. The galvanic nystagmus persists even after complete destruction of the inner ear but is impaired as soon as the peripheral vestibular neurone is damaged. We investigated 30 normal subjects, 10 patients with Meniere's disease and 20 patients with an acoustic neuroma. The patients had a reduced caloric response on one side. All subjects were stimulated monaural-unipolar. The photoelectronystagmograms were analysed by determining slow phase velocity. For interpretation we used the "relationship of excitability" as described recently by Mulch and Scherer for the thermal test. This procedure seems to be more accurate than the calculation of side difference of excitability as a proportion of total reaction. Furthermore we suggest basing the evaluation of galvanic test by calculating expectation regions for the logarithmic values obtained by right left stimulation. This method assumes a two dimensional symmetric normal distribution. The parameters lay within the normal range in all patients with Meniere's disease whereas they were abnormal in every subject with an acoustic neuroma. PMID- 2722582 TI - [Diffuse idiopathic skeletal hyperostosis as a cause of dysphagia. A case report]. AB - Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory stiffening disease of the vertebral spine due to extensive bone formation, often causing complete bridging of neighbouring intervertebral spaces. Except for the spine, other parts of the skeleton are rarely affected. Although in 78% of all cases the cervical spine is involved, dysphagia is rare (17%), being caused either by mechanical obstruction or by para-oesophageal inflammation due to irritation at the osteophyte processes. The diagnosis may be established by conventional X-ray of the spine, oesophagogram or CT. The paper describes a patient presenting with dysphagia caused by spondylophyte blockage of the cervical spine. PMID- 2722583 TI - [Dysontogenetic cysts of the mouth floor]. AB - Congenital cysts of the floor of the mouth are rarely seen. We investigated in the years 1987 and 1988 four patients with swellings in the floor in the mouth. The histological examination results dermoid and epidermoid cysts. A teratoma was not seen. Sonographic investigation and computertomography were both helpful by getting the correct diagnosis of these cysts and their location. The treatment was the exstirpation from the outside of the throat because all cysts were located under the geniohyoid muscle. PMID- 2722584 TI - Development of computer algorithms for radiation treatment planning. AB - As a result of an analysis of data relating tissue response to radiation absorbed dose the ICRU has recommended a target for accuracy of +/- 5 for dose delivery in radiation therapy. This is a difficult overall objective to achieve because of the many steps that make up a course of radiotherapy. The calculation of absorbed dose is only one of the steps and so to achieve an overall accuracy of better than +/- 5% the accuracy in dose calculation must be better yet. The physics behind the problem is sufficiently complicated so that no exact method of calculation has been found and consequently approximate solutions must be used. The development of computer algorithms for this task involves the search for better and better approximate solutions. To achieve the desired target of accuracy a fairly sophisticated calculation procedure must be used. Only when this is done can we hope to further improve our knowledge of the way in which tissues respond to radiation treatments. PMID- 2722585 TI - Prognostic factors and results of surgery and postoperative irradiation in the management of pituitary adenomas. AB - Prognostic factors and results of therapy were analyzed in a retrospective examination of 121 patients with pituitary adenomas treated with surgery and postoperative irradiation (RT) from January 1954 through December 1982 at the Radiation Oncology Center, Mallinckrodt Institute of Radiology. The 10-year overall and disease-free survival for all patients was 85.1 and 89.4%. The expected survival for an age-, gender-, and race-matched population was not significantly distinct at 85.3% (p = 0.72). Follow-up of 94 surviving patients ranged from 3.4 to 29.5 years (mean, 11.7). Statistical analysis was performed for multiple prognostic factors including age, race, gender, disease bulk, visual field symptoms, disease type, surgical approach, and irradiation dose and volume. The only prognostic variable identified by univariate analysis to significantly alter disease-free survival was irradiation dose. Patients receiving 5000-5400 cGy had a tumor control rate of 94.1% (64/68) compared to 85.0% (17/20) for 4000 4999 cGy, 75.0% (18/24) for 3000-3999 cGy, and 28.6% (2/7) for less than 3000 cGy (p = 0.000059). Factors evaluated but established to be insignificant were age, race, gender, disease bulk, visual field symptoms, disease type, surgical approach, and irradiated volume. The 10-year disease-free survival by classification was 93.3% for patients with amenorrhea/galactorrhea, 89.9% for non functioning adenomas, and 76.4% for acromegaly (p = 0.21). Overall improvement in visual field defects subsequent to treatment occurred in 48.4% (44/91) of those with visual field defects before RT and was significantly correlated with RT dose. The median time to progression of disease was 10.2 years with the last failure occurring at 25 years following the fulfillment of RT. Severe complications related to RT were apparent in 1.7% (2/121). None were known to have endured brain radionecrosis. Serious surgical complications occurred in 9.9% (12/121). PMID- 2722586 TI - Treatment of supratentorial high grade gliomas with split course high fractional dose postoperative radiotherapy. AB - Ninety-two patients with malignant supratentorial gliomas diagnosed from 1977 to 1983 received split course external beam radiotherapy. The initial course of radiation consisted of 3000 cGy whole brain in ten fractions 5 days a week. After a 2-week rest, treatment was continued to a portal restricted to the computerized tomography scan demonstrated abnormality plus a margin for an additional 2100 cGy (total 5100 cGy/17 fx/36 days). The optic chiasm and hypothalamus were excluded from the high dose region. Following review of all pathologic specimens, three patients with grade II glioma, three lacking histologic confirmation, two unbiopsied and eleven not receiving the prescribed treatment were excluded from the survival analysis. No patients were lost to follow-up. Surviving patients were followed 85 months (median); range 68-125 months. All remaining patients were followed until death. The median actuarial survival for 73 grade III and IV patients was 12.5 months. The 5-year actuarial survival was 10%. The median survival for 54 grade IV patients was 10 months. The 5-year survival was 4%. For 19 grade III patients the median survival was 22.5 months. The 5-year survival was 26%. There was one long-term grade IV survivor (68 mos.) and four long-term grade III survivors (76, 85, 108, 125 mos). No patient developed optic nerve or chiasm injury. One patient, an 85 months survivor, had biopsy documented radionecrosis and hemiparesis. The incidence of necrosis among 62 patients alive 6 months or more (and therefore at risk of brain necrosis) is 1/62 (2%). The incidence among survivors is 1/5. The nominal standard dose for this regimen is 1749 ret. The predictive value of the "nominal standard dose" and "equivalent dose" formulae for brain necrosis is explored. We conclude (a) that this regimen provides a survival probability equivalent to conventional treatment for grade III and IV supratentorial gliomas, (b) that neither the equivalent nor nominal standard doses predicted the incidence of brain necrosis, (c) that the time dose schedule is well tolerated and has an acceptable risk-benefit ratio, (d) that its advantage to the patient is decreased time requirement and cost. PMID- 2722587 TI - Analysis of independent variables affecting survival after recurrence of prostate cancer. AB - Two hundred and sixty-six patients developed recurrence after external beam radiation therapy for Stage B or C prostate cancer. The median survival from the time of recurrence was 30 months, the 5-year actuarial survival was 22% and the 8 year actuarial survival was 13%. The original stage influences survival after recurrence. Median survival is 35 months for Stage B and 27 months for Stage C. Five-year actuarial survivals are 31% for Stage B and 16% for Stage C. The site of recurrence (infield or metastatic) influences survival after recurrence. Median survival is 33 months for infield and 25 months for metastatic. Five-year actuarial survival is 30% for infield and 17% for metastatic. The time of recurrence influences survival after recurrence, comparing survival in patients recurring in the first year after treatment, to patients recurring in the second or later years after treatment. Median survival after recurrence is 14 months for those who recur in the first year, 32 months for those who recur later. Histologic grade influences survival after recurrence. Median survivals are 49 months for well differentiated, 31 months for moderately differentiated, and 23 months for poorly differentiated. Cox regression analysis indicates that original stage, site of recurrence (local vs. metastatic), time of recurrence after therapy, and histologic grade are all independent variables influencing survival after recurrence (p = less than .01). This study supports the aggressive treatment of prostate cancer to prevent recurrence and provides a means of estimating prognosis for patients who suffer a recurrence of their prostate cancer after treatment. PMID- 2722588 TI - Prognostic factors in limited rectal cancer treated with intracavitary irradiation. AB - At the Centre Georges-Francois Leclerc of Dijon, 91 limited rectal tumors received a complete intracavitary 50 kV contact radiotherapy alone or associated with interstitial brachytherapy according to the guidelines of J. Papillon. Nineteen had a villous adenoma and 72 a well or moderately differentiated rectal adenocarcinoma. The majority of patients had contra-indications for major surgical procedures. The median age was 70 years. Seventy-six percent (69/91) of the rectal tumors remained free from local recurrence. After salvage therapy, the local control was 91% (83/91). Sphincter preservation was obtained in 85% (77/91). "De novo" adenocarcinomas developed on pre-existing benign pathology and villous adenomas were not significantly different with regard to local control (76% resp. 75% versus 59.5%; p = 0.22). According to the Dijon clinical staging system, the local relapse-free survival at 5 years was 97% for CS T1A, 77% for CS T1B, 65% for CS T2A, and 60% for CS T2B. Tumors of the anterior rectal wall had a better local control rate than lateral and posterior primaries (100% versus 63% versus 67%). For the middle rectum, the local relapse-free survival was 94% compared to 54% of the upper and 77% of the lower rectum. Four additional patients had a preoperative intracavitary therapy and salvage surgery for incomplete tumor regression; the complete remission rate is 96% (91/95). Intracavitary radiotherapy alone is an effective treatment for limited rectal cancers. Contact X ray therapy can be used alone in CS T1A whereas a combination of contact X ray therapy and interstitial brachytherapy is often the optimal approach in CS T1B and CS T2A. In CS T2B, our data do not support the use of intracavitary techniques alone. In these cases, the sequence external irradiation followed by an interstitial implant seems of interest and deserves further evaluation with more patients and follow-up. PMID- 2722589 TI - Management of subdiaphragmatic early-stage Hodgkin's disease. AB - Twenty-six patients with Stage IA-IIB Hodgkin's disease confined below the diaphragm were treated at the Mayo Clinic over a 9-year period (1974-1982). Ten of the twenty-six patients presented with intra-abdominal disease alone, and the remaining 16 patients presented with palpable inguinal-femoral adenopathy. One hundred thirty patients with pathologically staged supradiaphragmatic disease were treated over the same period and serve as a comparison group. The median age of 52 years among patients with subdiaphragmatic disease was significantly higher than the median age of 27 years in supradiaphragmatic group. There was no difference in sex distribution between the two groups. One-fifth of the subdiaphragmatic patients presented with B symptoms compared to one-tenth in the supradiaphragmatic group. No significant histological differences were seen. The majority of patients were treated with radiation therapy alone. The overall failure rate was 42% in the subdiaphragmatic group versus 22% in patients with supradiaphragmatic disease. All of the failures occurred in patients treated with radiotherapy alone. Stage and the presence of B symptoms were the most important prognostic factors. The type of subdiaphragmatic presentation (intra-abdominal versus inguinal-femoral) did not influence the outcome. Despite decreased 5-year recurrence-free survival (57% subdiaphragmatic vs. 79% supradiaphragmatic, p = 0.03), the overall 5-year survival rate of 85% is comparable to that of patients with supradiaphragmatic disease. It appears that inverted Y irradiation alone is sufficient for patients with Stage IA disease, but that patients with B symptoms or Stage II disease require more aggressive initial therapy if recurrence-free survival is to be improved. PMID- 2722590 TI - The effect of arterial oxygen content on the results of radiation therapy for epidermoid bronchogenic carcinoma. AB - Anemia is believed to be an important prognostic factor in treating cancer patients by radiation therapy. One possible explanation for this is tumor oxygenation. With respect to tumor oxygenation, the arterial oxygen content (CaO2) may be of more importance than the hemoglobin (Hb) level. This study shows the relationship between the CaO2 and tumor response to radiation therapy. Forty two patients with epidermoid bronchogenic carcinoma, treated by irradiation alone between April 1982 and March 1986, were reviewed. Regression of the tumor after radiation therapy was calculated as a percent change in the tumor area. Arterial oxygen partial pressure (PaO2), Hb level, and percent oxygen saturation of Hb in arterial blood (SaO2) were measured within 2 weeks of commencement of radiation therapy and the CaO2 was calculated. The rank correlation coefficients between the maximum percent regression of the tumor and the PaO2, the Hb level and the CaO2 were 0.36, 0.34, and 0.46, respectively. Statistical analyses of the data indicate that the group of patients with CaO2 over 14.5 ml/dl exhibited greater tumor regression and longer survival periods than the group of patients with CaO2 below 14.5 ml/dl. Similarly patients with PaO2 over 90 mmHg or Hb level over 11 g/dl, exhibited significantly greater tumor regression and longer survival periods than those with PaO2 below 90 mmHg and Hb level below 11 g/dl. There were no significant differences in the length of survival periods with respect solely to the Hb level or the PaO2. It was concluded that the CaO2 is more important than the Hb level in determining tumor response to radiation therapy. This is considered as important indirect evidence of the existence of hypoxic fractions of cells in human tumors. PMID- 2722591 TI - Lack of a differential radiation response for proliferative and non-proliferative rat thyroid cells (FRTL-5) in vitro. AB - FRTL-5 rat thyroid epithelial cells maintain normal thyroid function and morphology in vitro, exhibit an absolute requirement for thyroid stimulating hormone (TSH) for proliferation and display radiation dose response characteristics indistinguishable from those of rat thyroid epithelial cells in vivo (Rad. Res. 105:138-146, 1986). In TSH-free medium cells remain in a non proliferative, yet viable, state for prolonged periods of time and respond to TSH re-stimulation by a return to exponential growth. Flow cytometric analysis using two-step acridine orange (AO) staining revealed an accumulation of cells in the G1 phase of the cell cycle accompanied by a pronounced reduction in red fluorescence (indicative of RNA content) in FRTL-5 cells cultured in the absence of TSH. The response of proliferative and non-proliferative FRTL-5 cells to single dose, split dose and fractionated radiation was compared to determine whether proliferative status was an important response determinant. The response of FRTL-5 cells was not influenced by proliferative status at the time of irradiation. Additionally, dose response was not altered by variable (12 hr-8 days) non-proliferative intervals before or after irradiation. As revealed by split dose experiments, the rate and extent of sublethal damage repair was likewise similar for proliferative and non-proliferative cells. Multifraction experiments employing three fractions separated by 6 hr intervals indicate that non-proliferative FRTL-5 cells completely repair sublethal damage between fractions. These results indicate that the radiation response of FRTL-5 cells is not influenced by the proliferative status of the cells prior to or post irradiation. PMID- 2722592 TI - Nephropathy in the mature pig after the irradiation of a single kidney: a comparison with the immature pig. AB - The right kidney of 11 mature 10-month-old Large White female pigs was irradiated with single doses of 9.8-14.0 Gy of 60Co gamma rays. Individual kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured using 99mTc-DTPA and 131I-hippuran renography for periods up to 24 weeks after irradiation. Renal function was assessed either as a functional index, FI (FI = irradiated/unirradiated kidney function), or as the individual kidney GFR and ERPF. The radiation-induced changes after the irradiation of a single kidney (unilaterally irradiated--UI) of mature pigs were compared with those previously observed in 14-week-old immature pigs. Irradiation resulted in a dose-dependent reduction in the FI for both GFR and ERPF. However, these reductions were significantly less than those previously seen in immature pigs. Within 2 weeks of irradiation GFR increased in both the irradiated and the unirradiated kidneys in each animal, compared with unirradiated age-matched control kidneys. No marked changes in renal hemodynamics were seen in mature animals after a single dose of 9.8 Gy. This was in marked contrast to the pronounced reduction in the GFR and ERPF in the irradiated kidney previously observed in immature animals irradiated with an equivalent single dose of X rays. After higher doses, the irradiated kidney in mature pigs showed a dose-dependent reduction in GFR and ERPF. However, the extent of this reduction was significantly less than that seen in immature animals. There was no apparent difference in the response of the unirradiated kidneys in mature or immature pigs. The ED50 values, based on a probit fit to the data for the proportion of functional tests in which the irradiated kidney showed a greater than or equal to 50% reduction in GFR or ERPF, were higher in the mature animals; for example for ERPF the ED50 values were 11.76 +/- 0.28 Gy and 7.67 +/- 0.34 Gy for mature and immature animals, respectively. Thus, the UI kidney in mature pigs appears to be less radiosensitive than the UI kidney in immature animals. PMID- 2722593 TI - Multiple fractions of gamma rays induced resistance to cis-dichloro diammineplatinum (II) and methotrexate in human HeLa cells. AB - Previous irradiation could induce changes in the cell-sensitivity to additional cytotoxic agents. In this study we examined whether the sensitivity to additional cytotoxic agents was affected in cells irradiated with multiple fractions of gamma rays if these agents were given at the time when the lesions induced in DNA by radiation have already been repaired. Human cervix carcinoma HeLa cells were irradiated daily with 0.5 Gy of gamma rays five times a week for 6 weeks. When the fractionation regimen was completed, that is when the cells had accumulated the total dose of 15 Gy of gamma rays, the sensitivity of these cells to gamma rays, UV light, cis-dichlorodiammineplatinum (II) (cis-DDP), methotrexate (MTX), and hydroxyurea (HU) was examined and compared to control cells. Results revealed that preirradiated cells did not change sensitivity to gamma rays and UV light, but that they increased the resistance to cis-DDP, and MTX (especially for higher concentrations of MTX), and increased sensitivity to HU (for lower concentrations of HU). The increased resistance to cis-DDP was also measurable up to 30 days after the last dose of gamma rays. The results indicate that preirradiation of HeLa cells with multiple fractions of gamma rays could change their sensitivity to additional cytotoxic agents, and that this is a relatively long-lasting effect. Our results suggest that caution is needed in medical application of radiation combined with chemical treatment. PMID- 2722594 TI - A comparison of thermal enhancement of cis-diamminedichloroplatinum (II) induced renal and intestinal toxicities by whole body hyperthermia in the rat. AB - Thermal enhancement of cis-diamminedichloroplatinum (II) (DDP) induced renal and intestinal toxicities by whole body hyperthermia (WBH) were compared using a F344 rat model. Thermal enhancement ratios (TER) for DDP-induced nephrotoxicity were calculated using renal functional assays and morphological techniques. TER values for gastrointestinal (G.I.) toxicity were calculated using "severity of diarrhea" and jejunal crypt cell survival as assays. TER's for renal damage varied between 3 and 3.4, whereas the TER measured for G.I.-toxicity was 1.8. Physiological changes caused by WBH or intrinsic differences in the sensitivities of normal tissues to DDP +/- WBH may be responsible for the differences in thermal enhancement of DDP-induced renal and intestinal toxicities. PMID- 2722595 TI - Thermal conduction effects associated with temperature measurements in proximity to radiofrequency electrodes and microwave antennas. AB - The smearing effects due to thermal conduction along various, nonenergized, interstitial devices were quantified in a flow cell-thermal step gradient. An insulated cylindrical flow cell with a high (ca 45 degrees C, 1.12 cm i.d., 1.6 cm o.d.) temperature region surrounded by a low (ca 37 degrees C) temperature region was used to compare temperature profiles measured with a thermocouple sensor inside a Stanford radiofrequency (RF) hyperthermia/brachytherapy catheter, a BSD instrumented microwave (MW) antenna (i.e., thermistor integrated into a dipole antenna) and a Dartmouth MW antenna with a juxtaposed optical sensor. Two parameters were used to quantify the thermal smearing of each interstitial device in the flow cell: (a) the maximum temperature difference (MTD) and (b) the full- width- half-maximum (FWHM) of the high temperature region. The "true" temperature maximum (45.4 degrees C) and distribution (FWHM = 1.65 +/- 0.06 cm) were measured with an optical sensor. These data indicate that the BSD instrumented MW antenna significantly smeared the true temperature profile (MTD = 2.7 degrees C, FWHM = 2.1 cm), as did the Dartmouth MW antenna (MTD = 1.5 degrees C, FWHM = 1.7 cm). The Stanford RF catheter, when insulated, resulted in minimal smearing (MTD = 0.3 degrees C, FWHM = 1.9 cm). Moreover, when the insulation was removed so the RF electrode was exposed to the thermal step gradient, smearing was again minimal (MTD = 0.3 degrees C, FWHM = 1.9 cm). PMID- 2722596 TI - Temperature dependence of binding of a fluorescent hypoxia probe. AB - The rate of binding of a fluorescent probe for hypoxia, AF-2, is dependent upon cell temperature as well as oxygenation. Aerobic cells bind AF-2 about 5 times less rapidly at 37 degrees C than at 45 degrees C. Below 42 degrees C, the rate of AF-2 binding by aerobic cells increases by a factor of about two for each 10 degrees C, but above 42 degrees C, the rate increases 10-fold for each additional 10 degrees C. However, for cells incubated under nitrogen, these biphasic kinetics were not observed, and the rate of metabolism and binding increased only two-fold per 10 degrees C from 28 degrees to 45 degrees C. These differences in binding kinetics cannot be explained by a decrease in the rate of auto-oxidation of the nitro anion radical, but might involve differences in the available reducing equivalents in cells heated under air or nitrogen. The possibility of using fluorescent probes to measure temperatures of individual tumor cells during hyperthermic treatment is discussed. PMID- 2722597 TI - Variation in the technical support of radiation oncology in different practice settings. AB - Two surveys of radiation therapy practice in the United States have been analyzed to reflect the technical support and processes of patient evaluation in different types of facilities. A 1986 random sample of facilities including single treatment unit free standing, single treatment unit hospital based, multiple treatment unit free standing, and multiple unit hospital based facilities have been surveyed to assess procedures, support, services, and equipment. The single treatment unit free standing and the single treatment unit hospital based facilities have the fewest support services, lower energy equipment, infrequent electron capability, and less than half are able to simulate complex disease processes with a dedicated simulator. A separate survey of practice in 1983 assessed compliance with important aspects of patient evaluation and treatment. In this survey single unit facilities showed greater variability above and below the national average than facilities with multiple treatment units and free standing facilities showed greater variation above and below the national average than hospital based facilities. This study identifies specific areas for improvement in the structure and practice of radiation oncology. It is still true that one can not indict broad categories of practice but must evaluate the individual facility. PMID- 2722598 TI - Phase I/II study of Fluosol-DA and 100% oxygen as an adjuvant to radiation in the treatment of advanced squamous cell tumors of the head and neck. AB - Fluosol-DA 20% (Fluosol) is an emulsion of perfluorodecalin and perfluorotripropylamine, which has the ability to carry oxygen and has been shown to enhance the ability of radiation to control tumors in animal studies. Since November 1984, patients with unresectable squamous cell carcinomas of the head and neck have been enrolled in a study to evaluate the safety and potential efficacy of this adjuvant therapy. Forty-six patients were entered of which 37 completed radiation and are evaluable. Patients were infused weekly with Fluosol and then breathed 100% oxygen for a minimum of 30 minutes prior to and during radiation. Eleven patients received 5 infusions of 8 mL/Kg, four patients 6 infusions of 8 mL/Kg, five patients 5 infusions of 9 mL/Kg, seven patients 7 infusions of 7 mL/Kg and eight patients 8 infusions of 7 mL/Kg. Nine patients had Stage III disease, 20 patients Stage IV disease and 8 patients had failed previous therapy with chemotherapy and/or surgery. The radiation doses delivered ranged from 6600 cGy to 7500 cGy. The overall complete response rate for this group was 76%. All 9 Stage III patients were complete responders, 13 of 20 Stage IV responded and 6 of 8 with previous therapy were complete responders. The survival rate at 1 year was 67% for absolute and 78% as determinant. Of those patients achieving a complete response, 75% continued free of disease 1 year after therapy. Out of 254 total test doses, 11 patients experienced a reaction to the test dose of Fluosol. Of 235 total infusions 6 patients experienced a reaction during the Fluosol infusion with 7 patients experiencing post infusion reactions. These were readily controlled with diphenhydramine or acetominophen. Elevated liver enzymes were observed in some patients with a mean time to normalization of 102 days for alkaline phosphatase, 39 days for SGOT, and 46 days for SGPT. PMID- 2722599 TI - Calculation of complication probability factors for non-uniform normal tissue irradiation: the effective volume method. AB - An estimation of normal tissue complication probability factors is important, particularly for evaluating 3-dimensional treatment plans. A method has been developed to calculate complication probability factors for non-uniformly irradiated normal organs using dose volume histograms and complication probabilities for uniform partial organ irradiation. In the effective volume method each volume element of the histogram is considered independently and subject to a power law dose volume relationship. Thus, a non-uniform dose volume histogram is reduced to a uniform one with an effective volume, and a dose equal to the maximum dose to the organ. The complication probability is then obtained from known complication probabilities for uniform partial organ irradiation. The effective volume histogram transformation method is shown to obey various boundary conditions, and is illustrated by comparing probability calculations for alternative 3-dimensional treatment plans for the pelvis. In addition, the limitations of this histogram reduction method are discussed and compared to other calculational techniques. The use of probability factor calculations in treatment plan evaluation, and their role in numerical scoring is explored. PMID- 2722600 TI - Computer-assisted conformation radiotherapy with a variable thickness multi-leaf filter. AB - A new computer-assisted conformation radiotherapy with a variable thickness multi leaf filter system was developed. Each wedgeshaped compensating filter (aluminum, tan theta = 0.1) travels against the movement of the ipsilateral leaf and according to defined parameters. By using our filter, a homogenous dose distribution in the target area was obtained and high-dose levels outside the target area decreased significantly. PMID- 2722601 TI - Alopecia associated with unexpected leakage from electron cone. AB - Excessive irradiation due to unexpected leakage was found on a patient receiving electron beam therapy. The cause of this leakage was analyzed and the amount of leakage was measured for different electron beam energies. The highest leakage occurred with a 6 x 6 cm cone using a 12 MeV electron beam. The leakage dose measured along the side of the cone could be as great as 40%. Until the cones are modified or redesigned, it is advised that all patient setups be carefully reviewed to assure that no significant patient areas are in the side scatter region. PMID- 2722602 TI - A non-contacting intraoperative electron cone apparatus. AB - Aluminum tubes, 20 cm long, of various diameter and face angle have been used to collimate electron beams for intraoperative radiotherapy. The tubes placed in a body cavity are clamped to the treatment couch. A thin rod is fixed coaxially to a disc which is placed on the entrance face of the tube. A stepwise procedure involving couch translation, rotation, and gantry rotation is used to align the central axis of the beam with the axis of the cone. Further collimation is provided by an aperture mounted in an assembly which slides into the standard accessory holder of the machine and is separated by a 10 cm air gap from the tube in the patient. Careful adjustment of this aperture diameter results in a relatively uniform dose across the treated area. The use of 3 mm wall thickness aluminum tube provides for minimal leakage outside of the cone. A camera has been mounted to a plate that also mounts in the standard accessory holder and is used to document the area treated. PMID- 2722603 TI - Cisplatin and external beam radiation in patients with invasive bladder cancer. PMID- 2722604 TI - Calibration of SR-90 ophthalmic applicators. PMID- 2722605 TI - Radiotherapy and cisplatin for invasive bladder cancer: criteria of "complete response". PMID- 2722606 TI - Radial dose function (RDF) PMID- 2722607 TI - Hypo-fractionation. PMID- 2722608 TI - Occasional case reports/communications from the international radiation oncology community. PMID- 2722609 TI - Fraction size or accelerated repopulation? PMID- 2722610 TI - Psychoanalysis and eating disorders. PMID- 2722611 TI - The process of recovering from anorexia nervosa. AB - The authors describe the process of recovering from anorexia nervosa as it is revealed by 13 women who have recovered from the illness. Emphasizing the patient's perspective, the paper reviews the perceived causes of the disorder, helpful and harmful therapy-related and life experiences, features hardest to change, the defensive function of anorexia nervosa and residual traits. Generally, the movement toward health entails forming a therapeutic relationship in which the anorexic can identify and express feelings, experience the empathic, nonjudgmental understanding of another person, separate from a pathological family system, resolve hostile dependent attachment to parents, assuage primitive guilt, and engage in the trials of adolescent psychosexual development to enter adulthood with the beginnings of a firm, cohesive sense of self. PMID- 2722612 TI - Integrating treatments for bulimia nervosa. PMID- 2722613 TI - Obesity: a psychoanalytic challenge. PMID- 2722614 TI - The parents' relationship and the child's illness in anorexia nervosa. AB - The authors examine the impact on the preanorexic child of the parents' relationship with one another, particularly the models they present of mature male/female relationships. The authors suggest that patterns of maternal perfectionism and self-sacrifice combined with paternal entitlement makes sexual maturity particularly threatening for female children in these families, and may partially explain the greater incidence of anorexia nervosa in women, and its explosive incidence in adolescence. PMID- 2722615 TI - Self psychological reflections on the origins of eating disorders. PMID- 2722616 TI - Sexuality, pregnancy, and parenting in anorexia nervosa. PMID- 2722617 TI - Anorexia nervosa in the congenitally blind: theoretical considerations. PMID- 2722618 TI - AIDS and adolescents: exploring the challenge. First national conference. New York City, March 27-28, 1988. PMID- 2722619 TI - AIDS prevention and education. Recommendations of the Work Group. PMID- 2722620 TI - Services and treatment issues. Recommendations of the Work Group. PMID- 2722621 TI - Adolescents and AIDS. Excerpts from address. PMID- 2722622 TI - AIDS policies on youth. Recommendations of the Work Group. PMID- 2722623 TI - AIDS testing and epidemiology for youth. Recommendations of the Work Group. PMID- 2722624 TI - Adolescents and AIDS. Excerpts from address. PMID- 2722625 TI - Borrelia burgdorferi infection in horses. PMID- 2722626 TI - Chemical restraint for true evaluation of hip status in dogs. PMID- 2722627 TI - The ominous spread of Borrelia burgdorferi infection. PMID- 2722629 TI - Closing the information gap: problem formulation as the critical first step. PMID- 2722628 TI - Preview of AVMA-funded drug residue study. PMID- 2722630 TI - Changing environments and external factors that may impact veterinary medicine. PMID- 2722631 TI - Enrollment decline continues in 1988-1989. PMID- 2722632 TI - Hagglers, slow payers, and no payers. PMID- 2722633 TI - Breath sound terminology in the veterinary literature. PMID- 2722634 TI - Bovine fetal infection with Mycobacterium paratuberculosis. AB - In utero transmission of Mycobacterium paratuberculosis, the causative agent of paratuberculosis in cattle, has been suggested. Tissue specimens were obtained at a packing plant from pregnant dairy cows and their fetuses and from cows with clinical signs of paratuberculosis and from their fetuses. Specimens were processed according to methods described for isolating M paratuberculosis from bovine tissues and were incubated on Herrold egg yolk medium for 16 weeks. Presumed positive specimens were confirmed to be M paratuberculosis, using acid fast staining and subculturing. Of 407 lymph nodes from cows, 34 (8.4%) were culture positive for M paratuberculosis; 9 of 34 (26.4%) of these culture positive cows had fetuses from which specimens were also culture positive. The results estimated the risk of fetal infection with M paratuberculosis to be 26.4% (95% confidence interval between 11.3 and 40.7%). PMID- 2722635 TI - Side effects of etomidate in dogs. AB - Intravenous administration of etomidate, a nonbarbiturate sedative hypnotic, induced excitement, myoclonus, pain on injection, vomiting, and apnea during induction of anesthesia in 20 experimental dogs and 70 hospitalized dogs. The dogs had excitement and purposeless muscle movements during recovery from anesthesia. The frequency and severity of the side effects were markedly attenuated or eliminated by the administration of diazepam, acepromazine, or morphine prior to etomidate administration. PMID- 2722636 TI - Treatment of proliferative colitis in ferrets. AB - Proliferative colitis associated with intracellular Campylobacter sp was diagnosed in 10 ferrets. The ferrets had a history of diarrhea (often blood tinged or mucoid), dehydration, and chronic weight loss. Additional clinical signs included rectal prolapse, lethargy, fever, and a palpably thick colon. In 5 ferrets, the diagnosis was confirmed by colonic biopsy, via endoscopy. Supportive treatment in 5 ferrets did not alleviate the clinical signs or the proliferative intestinal disorder. oral chloramphenicol treatment (50 mg/kg of body weight, q 12 h for 10 to 21 days) resulted in marked clinical improvement and eradication of proliferative intestinal lesions in 5 ferrets. PMID- 2722637 TI - Zygomatic salivary gland mucocele in a ferret. AB - A zygomatic salivary gland mucocele was diagnosed in a 1-year-old female domestic ferret with exophthalmos. A T-shaped incision from near the lateral canthus to the base of the ear and continuing ventrally to the level of the commissure of the mouth was made to expose the mucocele. Surgical removal was complicated by the large open orbit of the ferret, adjacent cellulitis, extension ventromedial to the globe, and difficulty in identifying important motor nerves. Vision was maintained, but slight postoperative enophthalmos and mild upper eyelid paresis developed. PMID- 2722638 TI - Cerebrospinal nematodiasis in a goat herd. AB - During the fall of 1985, 4 Angora goats, from a herd of 40, were examined on a farm in central Michigan. Affected goats were alert but had neurologic deficits consistent with upper and lower moto neuron involvement. Eosinophilic pleocytosis in a cerebrospinal fluid sample from one goat was consistent with cerebrospinal nematodiasis. Parelaphostrongylosis was confirmed in 3 goats by identification of Parelaphostrongylosis tenuis larvae in spinal cord sections. Ivermectin may have influenced the herd's susceptibility to new parasitic infections. Control of parelaphostrongylosis probably is best achieved by removal of susceptible animals from treed swamps coinhabited by white-tailed deer from late summer until after the first killing frost. PMID- 2722639 TI - Triploidy (117,XXX) in a stillborn canine pup conceived with frozen semen. AB - Analysis of skin fibroblast cultures from a deformed stillborn female Alaskan Malamute pup revealed a 3n = 117,XXX (normal, 2n = 78,XX) chromosome count. The triploid pup was delivered by cesarean section 5 days after estimated date of parturition, because the bitch failed to start labor. The bitch had been inseminated with thawed frozen semen deposited into the lumen of the uterus approximately 4 days after ovulation. Gross anatomic abnormalities of the pup included omphalocele, diaphragmatic hernia, persistent right aortic arch, atresia ani, and no right forelimb distal to the scapula. The pup also had arthrogryposis of the left carpus, kyphosis of the thoracic vertebrae, widely separated cranial sutures, open fontanelles, hydrocephalus, and cleft palate. Suspected cause of the triploidy was dispermy of an aged oocyte after intrauterine deposition of the thawed frozen semen. Numeric chromosome abnormalities may be causes of fetal deformity or death that can be detected by fetal karyotype. PMID- 2722640 TI - Obstructed portal venous flow and portal vein thrombus in a dog. AB - A young adult Doberman Pinscher had clinical signs and laboratory data consistent with the copper-associated hepatopathy commonly found in Doberman Pinschers. Hepatic biopsy and hepatic copper analysis did not support this diagnosis. Furthermore, changes seen in the hepatic biopsy specimen did not explain the acquired portosystemic shunting or the portal hypertension that the dog had. A mesentery venoportagram revealed markedly delayed filling of one portal vein, and necropsy revealed a small thrombus partially occluding that hepatic vein. It was not determined whether obstructed portal venous flow caused the portal vein thrombus or vice versa; however, it was theorized that the portal vein thrombus, once formed, contributed to further portal hypertension and/or delayed portal vein filling. PMID- 2722641 TI - Extraskeletal osteosarcoma in two dogs. AB - Extraskeletal osteosarcoma (ESOS) of the spleen and jejunum was diagnosed in 2 dogs. As an extremely uncommon type of tumor that has proven difficult to treat, ESOS is associated with high rate of local recurrence and metastatic disease. Extraskeletal osteosarcoma principally affects older dogs, has no apparent breed predilection, and may develop more frequently in males. The cause of ESOS is unknown, but may involve malignant metaplasia of pluripotential mesenchymal cells into osteoblasts. Macroscopically, ESOS usually is observed as a hard mass and may appear similar to calcified hematoma or myositis ossificans. The classic radiographic appearance of ESOS is a soft tissue mass with focal mineralization and without adjacent bone involvement. PMID- 2722642 TI - Thrombocytosis associated with a myeloproliferative disorder in a dog. AB - A dog with a myeloproliferative disorder and thrombocytosis had clinical signs that were consistent with a diagnosis of essential thrombocythemia. The dog was treated with aspirin, radioactive phosphorus, and melphalan. Eighteen months after referral, the disorder progressed to chronic granulocytic leukemia, and treatment was switched to hydroxyurea. Fourteen months later, the dog was euthanatized because of uncontrollable atrial fibrillation. PMID- 2722643 TI - Prognostic factors and survival after radiotherapy for intranasal neoplasms in dogs: 70 cases (1974-1985). AB - Survival time and 31 prognostic factors were analyzed for 70 dogs undergoing radiotherapy for intranasal tumors at the Veterinary Hospital of the University of Pennsylvania between 1974 and 1985. At the time of analysis (January 1987), 14.3% (10 of 70) of the dogs were alive. Of the remaining dogs, 34 died because of tumor recurrence, 14 died because of intercurrent disease, and 12 were lost to follow-up evaluation. Pretreatment prognostic factors that were significantly correlated with disease-free interval or long-term survival could not be identified. Notably, presence of a facial mass was not prognostically significant, suggesting that extensive disease should not preclude treatment. Median survival time of dogs with all tumor types was 16.5 months, with a 1-, 2-, and 3-year survival of 54%, 43%, and 35%, respectively. Median survival time of dogs with carcinoma was 13.5 months, with 1-year survival of 51%, 2-year survival of 37%, and 3-year survival of 31%. Orthovoltage radiation was efficacious in the treatment of canine intranasal tumors. PMID- 2722644 TI - Clinical features of salmonellosis in cats: six cases (1981-1986). AB - Of 6 cats with salmonellosis, only cats 1, 4, and 5 manifested clinical signs of gastroenteritis. In cats 2 to 5, salmonellosis was characterized by fever, a left shifted leukogram, and vague nonspecific signs of illness. Salmonellae were isolated from blood and feces of cats 1 to 4, and from extraintestinal sites as part of a mixed gram-negative bacterial flora in cats 5 and 6. Of 4 cats with Salmonella bacteremia, cats 2, 3, and 4 were successfully treated with trimethoprim-sulfadiazine, amoxicillin, and/or chloramphenicol; treatment with cephapirin was ineffective in 3 cats. In some cats, salmonellosis was observed as a chronic febrile illness without specific gastrointestinal signs or as a localized tissue infection. PMID- 2722645 TI - Trends in veterinarians' incomes, 1980 to 1987. PMID- 2722646 TI - What is your diagnosis? Fractures of the sixth cervical vertebra in a Quarter Horse colt. PMID- 2722647 TI - Use of altrenogest in mares. PMID- 2722648 TI - Safety in radiography. PMID- 2722649 TI - Changing environments and external factors that may impact veterinary medicine. PMID- 2722650 TI - Committee looks at veal calf welfare. PMID- 2722651 TI - Auditing hospital bills. PMID- 2722652 TI - Exotic Newcastle disease from smuggled birds remains threat to domestic poultry. PMID- 2722653 TI - Manpower: a surplus in supply or demand? PMID- 2722655 TI - Study warns of greenhouse effect. PMID- 2722654 TI - Horses like night-lights. PMID- 2722656 TI - Cat cases. PMID- 2722657 TI - Developing standards in animal research review. AB - Thirty-two institutional animal care and use committees reviewed 4 hypothetic protocols involving experimental procedures frequently conducted on animals. Committees were in general agreement on the need to refine hypothetic protocols to minimize pain, distress, and other harm to laboratory animals. All but 2 committees sought modifications in each protocol, and in numerous instances, committees would not approve a protocol without major modifications. The committee responses delineated emerging standards governing specific areas of animal use, such as antibody production, induced disease, surgery, physical restraint, and behavioral conditioning. Committees had less consensus in their approach to assessing the justification for laboratory animal use. Apparently, this component of committee responsibilities presented the major conceptual and practical difficulties for committees engaged in animal research review. PMID- 2722658 TI - Plasma concentrations of oxytetracycline in swine after administration of the drug intramuscularly and orally in feed. AB - Four pigs were used in a 2 X 2 crossover study to determine plasma oxytetracycline (OTC) concentration and OTC pharmacokinetic variables after IM administration of 2 OTC preparations--long acting OTC and a 100-mg of OTC/ml solution (OTC-LA and OTC-100, respectively)--at a dosage of 20 mg/kg of body weight. In a second study, 3 additional pigs were given ad libitum access to feed containing pure OTC (0.55 g/kg of feed). The mean (+/- SD) peak plasma OTC concentration after OTC-LA administration was 6.0 +/- 2.2 micrograms/ml at 30 minutes; the mean peak plasma OTC concentration after OTC-100 administration was 6.7 +/- 3.4 micrograms/ml at 90 minutes. Mean plasma OTC concentration after oral OTC administration in feed peaked at 0.4 micrograms/ml 48 hours after access to OTC-medicated feed and decreased to 0.25 micrograms/ml by the end of that study. Mean plasma OTC concentration was maintained at greater than 0.5 micrograms/ml for less than 48 hours after OTC-LA administration and for less than 36 hours after OTC-100 administration. Mean plasma OTC concentration decreased to less than 0.2 micrograms/ml by 72 hours after IM administration of either product. Calculation of area under the plasma OTC concentration-time curve (AUC) did not reveal significant difference between the 2 OTC formulations. There also was not significant difference (between OTC-LA and OTC-100) in the value of the disappearance rate constant after administration of either OTC formulation. The data did not indicate significant pharmacologic advantage of OTC-LA, compared with OTC-100, when either formulation was administered IM at a dosage of 20 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722659 TI - Thermopsis montana-induced myopathy in calves. AB - Six heifer calves were administered the dried and ground whole plant of Thermopsis montana by gavage once daily for 2 to 4 days at an initial dosage rate of 1 g/kg of body weight. Two of the 6 heifers died after the second dose, and the remaining 4 calves were humanely killed and their tissues were examined. Serum creatine kinase and aspartate transaminase activities were significantly (P less than 0.05) increased after initiation of plant administration. All calves had skeletal muscular degeneration or evidence of regeneration and repair of damaged myofibers in all skeletal muscle groups examined. Myoglobinuria and cardiac muscle degeneration were not detected in any of the calves. PMID- 2722660 TI - Description of an epizootic and persistence of Streptococcus equi infections in horses. AB - The age-specific attack rates of Streptococcus equi infections of the upper respiratory tract and lymph nodes (strangles) in horses for the different age groups were 17.6% for broodmares, 47.5% for 1-year-old horses, and 37.5% for foals. Streptococcus equi was isolated from nasal, pharyngeal, or lymph node specimens in 31 (60.8%) of 51 sick horses. A male 1-year-old horse, shipped from Kentucky to farm A, was considered to be the index case. Six (19.4%) of 31 horses with strangles remained as shedders of S equi after clinical signs of the disease had ended. Shedders of S equi were not identified from horses that were exposed to infected horses but never developed strangles. PMID- 2722661 TI - Comparison of bronchodilators in alleviating clinical signs in horses with chronic obstructive pulmonary disease. AB - A representative of each of 3 types of bronchodilators was given iv to horses with clinical signs of chronic obstructive pulmonary disease. We used atropine (0.01 mg/kg of body weight) as an anticholinergic, isoproterenol HCl as a beta adrenergic, and aminophylline, the soluble salt of theophylline, as a methylxanthine. Response to these drugs was evaluated by measuring maximal change in intrathoracic pressures (delta Ppl) and observing clinical signs. Atropine caused a significant (P less than 0.01) reduction in delta Ppl, compared with that caused by aminophylline. Atropine caused the delta Ppl to decrease an average of 83 +/- 15% toward normal. Clinical improvement was noticed in 87% of the cases. Maximal changes in pleural pressures were reduced by an average of 21 +/- 14 mm of Hg, with 27% returning completely to normal. Isoproterenol helped 77% of horses clinically, and caused delta Ppl to decrease an average of 68 +/- 31% toward normal. The average reduction in delta Ppl was 16 +/- 10 mm of Hg. Aminophylline helped alleviate clinical signs of 50% of the horses and caused delta Ppl to decrease an average of 41 +/- 36% toward normal. The average reduction in delta Ppl was 10 +/- 11 mm of Hg. PMID- 2722662 TI - Epidural analgesia with 0.75% bupivacaine for laparotomy in goats. AB - Epidural nerve block with 0.75% bupivacaine (1 ml/4 kg of body weight) was performed in 17 goats tranquilized by IM administration of acetylpromazine (0.07 mg/kg). For comparison, epidural nerve block with 2% lidocaine containing 1:100,000 epinephrine (1 ml/5 kg) was performed in 7 goats. Transient signs of CNS stimulation were observed during injection of bupivacaine in 5 goats and of lidocaine in 2 goats. Analgesia of the flank was inadequate for laparotomy in 4 goats given bupivacaine (including 1 goat given a two-thirds dose) and in 2 goats given lidocaine. Analgesia for these goats was provided by local infiltration of the operative site with lidocaine. With bupivacaine, the onset of analgesia was up to 40 minutes, and the duration of analgesia was several hours; most goats were unable to stand for at least 11 hours. In comparison, epidural nerve block with lidocaine had a more rapid onset and much shorter duration. For both anesthetic drugs, despite adequate analgesia for laparotomy, response to manipulation of abdominal viscera was observed in 12 goats. Arterial blood pressure and blood gas tensions were measured in 8 goats given bupivacaine; 3 goats had mean arterial blood pressure less than 70 mm of Hg. Seven goats had normal PaCO2 but 2 goats had low PaO2; 1 goat sedated with xylazine had increased PaCO2 and hypoxemia. PMID- 2722663 TI - Serologic diagnosis of toxoplasmosis in cats fed Toxoplasma gondii tissue cysts. AB - Serum samples derived from 7 cats 3 to 950 days after cats were fed tissue cysts of Toxoplasma gondii were evaluated using Sabin-Feldman dye, modified agglutination, indirect hemagglutination, and latex agglutination tests. The modified agglutination test, using whole formalin-preserved tachyzoites, was more sensitive for diagnosis of toxoplasmosis than were other tests. Titers from the modified agglutination test that used formalin-preserved tachyzoites were higher than those from the modified agglutination test that used acetone-preserved tachyzoites. Although cats had no clinical signs of toxoplasmosis, T gondii antibody titers remained high (greater than 1:1,000) for up to 29 months. PMID- 2722664 TI - Preputial foreign body in a bull. AB - A preputial foreign body caused severe preputial swelling and depression in a 4 year-old Shorthorn bull. Disruption of the preputial epithelium by the foreign body resulted in abscess formation lateral to the prepuce. A patent urethral fistula, probably a complication of prior fibropapilloma excisional surgery, was also detected on the distal portion of the glans penis. Foreign body removal, antimicrobial administration, and warm hydrotherapy resolved the swelling and abscess. Electroejaculation was used to extend the penis and to minimize preputial adhesions. Breeding soundness examinations were used to evaluate breeding potential. PMID- 2722665 TI - Bilateral chorioretinitis, centripetal optic neuritis, and encephalitis in a llama. AB - Blindness characterized by dilated, unresponsive pupils and ophthalmoscopic evidence of optic nerve atrophy and retinal degeneration developed in a 5-year old llama. Lesions were not progressive during 2 months of observation. The llama was euthanatized and necropsied. Histopathologic findings included chorioretinitis, optic neuritis, and encephalitis characterized by mononuclear perivascular infiltration. Attempts to prove an infectious cause were unsuccessful. PMID- 2722666 TI - Repair of fracture of the proximal portion of the radius and ulna in a llama. AB - Repair of a comminuted fracture of the proximal portion of the radius and ulna in a 4-month-old llama was achieved by use of internal fixation. An 8-hole narrow dynamic compression plate was applied to the lateral aspect of the radius and a 7 hole narrow dynamic compression plate was applied to the cranial aspect of the radius. One year after surgery, the llama had a normal gait and the cosmetic appearance of the limb was excellent. PMID- 2722667 TI - Surgical management of duodenal obstruction in an adult horse. AB - A 3-year-old Standardbred stallion was admitted for treatment of acute enterocolitis. The horse improved in response to empiric treatment, but subsequently developed ventral edema, scrotal abscessation, and severe laminitis. Improvement again was seen, but on day 29 of hospitalization, the horse developed rapid heart rate and signs of abdominal pain. Exploratory celiotomy revealed complete obstruction of the descending portion of the duodenum, 20 cm caudal to the duodenal sigmoidal flexure. Three-tier duodenojejunostomy and jejunojejunostomy were performed to bypass the duodenal obstruction. PMID- 2722668 TI - Osteomyelitis of the calcaneus in horses: 28 cases (1972-1987). AB - Medical records of 28 horses with osteomyelitis of the calcaneus were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long term follow-up information. Trauma was the most commonly reported cause (24). Physical examination revealed lameness in 27 horses, and 22 (79%) had a wound or draining tract over the plantar aspect of the calcaneus. Radiography of all horses was done prior to the initiation of treatment, and follow-up radiography was done on 20 horses. The most common radiographic findings were soft tissue swelling (25), bony lysis of the calcaneus (17), bone fragments or sequestra from the tuber calcis (13), and periosteal new bone production or bony lysis of the sustentaculum tali (5). Association could not be found between initial radiographic findings and eventual outcome of the case. Positive bacterial cultures were obtained from 13 horses. A wide variety of gram-positive, gram negative, and anaerobic organisms were isolated. Fourteen of the 15 isolates, for which susceptibilities were reported, were susceptible to penicillin, gentamicin, or trimethoprim sulfamethoxazole. Twenty-six of the 28 horses diagnosed as having osteomyelitis of the calcaneus were treated; 16 horses were treated with surgical debridement in addition to antimicrobial treatment, and 10 horses were treated with antimicrobial agents, anti-inflammatory drugs, or supportive wound care. There was no significant difference in survival rate of horses treated surgically and those treated conservatively. Six horses that were treated were later euthanatized for problems associated with chronic osteomyelitis, and 2 horses died or were euthanatized for unrelated problems. Eighteen horses (64%) were alive at last follow-up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722669 TI - Ulceration in the proximal portion of the urethra as a cause of hematuria in horses: four cases (1978-1985). AB - Sudden onset of hematuria was associated with mucosal ulceration of the proximal portion of the urethra in 1 stallion and 3 geldings. Hematuria was observed characteristically and consistently at the end of urination. Mucosal ulceration was identified endoscopically in the proximal portion of the urethra at the level of the ischial arch. Biopsy of an ulcerated area of the proximal urethra in one gelding revealed transitional cell carcinoma. Treatment regimens varied from systemic antimicrobial and/or vasoactive therapy to diversion of urinary flow via a temporary perineal urethrostomy. Hematuria resolved in 14 to 24 days (average, 20 days) after treatment was begun, except in one gelding that died of undetermined causes during an initial examination. In the 3 remaining horses, hematuria had not recurred for up to 9 years (average, 1 year). PMID- 2722670 TI - A42867, a novel glycopeptide antibiotic. AB - A42867 is a new glycopeptide antibiotic of the ristocetin-vancomycin class active against aerobic and anaerobic Gram-positive bacteria. A42867 is produced by a strain of Nocardia nov. sp. ATCC 53492. A42867 was isolated during a screening program aimed at the discovery of new members of this glycopeptide class of antibiotics, by affinity chromatography based on an acyl-D-alanyl-D-alanine probe. The structure of A42867 was elucidated by fast atom bombardment MS, high field 2D 1H NMR spectroscopy, and HPLC analysis of the hydrolyzed carbohydrates. A42867 differs from vancomycin in the sugar portion and in the presence of only one chlorine atom in the peptide core. Its biological activity on Gram-positive aerobic and anaerobic bacteria is similar to that of other antibiotics of this group. PMID- 2722671 TI - Calicheamicins, a novel family of antitumor antibiotics: taxonomy, fermentation and biological properties. AB - A novel family of antitumor antibiotics, the calicheamicins, were isolated from the fermentation broth of Micromonospora echinospora subsp. calichensis. These antibiotics exhibited significant activity against Gram-positive and Gram negative bacteria in vitro. Calicheamicin gamma 1I demonstrated antitumor activity against P388 leukemia and B16 melanoma in vivo. PMID- 2722672 TI - UCN-01 and UCN-02, new selective inhibitors of protein kinase C. I. Screening, producing organism and fermentation. AB - In the course of continued screening program for new selective inhibitors of protein kinase C (PKC), fermentation broths from over 5,000 soil isolates were screened for their inhibitory activity of PKC. HPLC analysis of active cultures revealed that five different strains (N-71, N-115, N-126, N-128 and N-139) of Streptomyces isolated from various local soil samples were found to produce staurosporine and related compounds. Of these strains, N-126, a high producing strain, was found to produce new selective inhibitors of PKC, UCN-01 and its stereoisomer, UCN-02. The pH control of fermentation resulted in an increase of the production of UCN-01 and UCN-02. PMID- 2722673 TI - Production of new polyene antibiotics by Streptomyces cellulosae after addition of ethyl (Z)-16-phenylhexadec-9-enoate. AB - Ethyl (Z)-16-phenylhexadec-9-enoate (3), an analog of ethyl oleate (2), was synthesized and added to cultures of Streptomyces cellulosae ATCC 12625 which normally produce fungichromin (1) as the principal polyene antibiotic. These cultures showed drastic reduction of fungichromin biosynthesis but afforded four new polyene antibiotics with a truncated four carbon side chain which are designated as isochainin (11) (an isomer of chainin (10], 14-hydroxyisochainin (12), 1'-hydroxyisochainin (13), and 1',14-dihydroxyisochainin (14). The close correspondence of 13C NMR chemical shifts between these compounds and fungichromin suggests that the stereochemistry at every site is exactly analogous. PMID- 2722674 TI - Cyclosporins--new analogues by precursor directed biosynthesis. AB - Cyclosporin A (ciclosporin), a potent and clinically important immunosuppressive drug (Sandimmun), represents the main component of a group of over 25 closely related, cyclic undecapeptides produced by the fungus Tolypocladium inflatum. By feeding experiments using DL-alpha-allylglycine as precursor, specific incorporation in position 2 was attained leading to [Allylgly2]cyclosporin A. Exogenously supplied L-beta-cyclohexylalanine results in the almost exclusive production of [MeCyclohexylala1]cyclosporin A (replacement of methylbutenyl methylthreonine-1). D-Alanine in position 8 can be successfully substituted by D serine. The new [D-Ser8] analogues of the cyclosporins A, C, D and G as well as [Allylgly2]cyclosporin A exhibit high immunosuppressive effects. PMID- 2722675 TI - MM 47755, a new benz[a]anthracene antibiotic from a streptomycete. PMID- 2722676 TI - The structure of hidamicin, a polyether antibiotic. PMID- 2722677 TI - Oxidation processes in the biosynthesis of the tetracenomycin and elloramycin antibiotics. PMID- 2722678 TI - Anti-hepatitis B virus activities of purine derivatives of oxetanocin A. PMID- 2722679 TI - New glutarimide antibiotics, S-632-B1 and B2. I. Taxonomy of producing strain, fermentation and biological properties. AB - Strain S-632 was found to produce new glutarimide antibiotics, S-632-B1 and B2, which were isolated from the culture fluid. A taxonomic study on strain S-632 was carried out, and the taxonomic characterization demonstrated that it belonged to the species Streptomyces hygroscopicus. The strain was given the name S. hygroscopicus S-632. These antibiotics were active against Saccharomyces sp., but inactive against filamentous fungi and bacteria, and had cytotoxic activity against KB tissue culture cells. PMID- 2722680 TI - New glutarimide antibiotics, S-632-B1 and B2. II. Isolation, physico-chemical properties and chemical structure. AB - Antifungal antibiotics S-632-A1,A2,B1 and B2 were extracted with ethyl acetate from the filtered broth of Streptomyces hygroscopicus S-632 and isolated through a combination of conventional and reversed-phase silica gel column chromatography. On the basis of the spectral data, S-632-B1 and B2 were found to be new members of the glutarimide family of antibiotics. The chemical structures of these components were elucidated as two stereo-isomers of 3-(5,7-dimethyl-8,9 epoxy-2-hydroxy-4-oxo-6-decenyl)glutarimide. PMID- 2722681 TI - New antitumor antibiotic, FR-900462. I. Taxonomy of the producing strain. AB - A new species of the genus Streptomyces, the proposed name of which is Streptomyces tokashikiensis sp. nov., is described. Soil isolate, strain No. 7124, produces a new antitumor antibiotic FR-900462. The organism is characterized by the presence of spores on the substrate hyphae. Strain No. 7124 is closely related to Streptomyces spiralis in morphological and cultural characteristics, but there are differences in spore surface, growth-permissible temperature, and carbohydrate utilization pattern. Therefore, it was decided to designate strain No. 7124 as a new species within the genus Streptomyces. PMID- 2722682 TI - New antitumor antibiotic, FR-900462. II. Production, isolation, characterization and biological activity. AB - FR-900462 is a new antitumor antibiotic produced by Streptomyces tokashikiensis No. 7124. It was highly active against leukemia P388 and melanoma B16. Furthermore, it has weak antimicrobial activity against some Gram-positive bacteria. PMID- 2722683 TI - Structural elucidation of aculeximycin. I. Further purification and glycosidic bond cleavage of aculeximycin. AB - A new insecticidal antibiotic, aculeximycin (ACM), was produced by an actinomycete identified as Streptosporangium albidum. ACM has been successfully isolated from culture filtrate by a combination of Diaion HP-20, Amberlite CG-50, reversed phase silica gel and Sephadex LH-20 chromatographies. It was found that ACM is a basic glycosidic antibiotic with a molecular weight of 1,672 including five monosaccharide units, three double bonds and a hemiketal ring by preliminary spectral analyses. Treatment of ACM with 1,8-diazabicyclo[5,4,0]undecene-7 caused a glycosidic bond cleavage to give aculexitriose, pseudoaglycones I and II. PMID- 2722684 TI - Structural elucidation of aculeximycin. II. Structures of carbohydrate moieties. AB - Treatment of aculeximycin with 2% 1,8-diazabicyclo[5,4,0]undecene-7 (DBU) methanol yielded three products, aculexitriose, pseudoaglycones I and II. The structural elucidation of aculexitriose was carried out by spectral analyses (MS, NMR (1H-1H 2D NMR spectroscopy, nuclear Overhauser effect] and chemical degradations of aculexitriose and its derivatives. The structure of aculexitriose was established to be a branched trisaccharide, O-6-deoxy-beta-D-glucopyranosyl (1----2)-O-[3-amino-2,3,6-trideoxy-beta- D- arabino-hexopyranosyl-(1----3)]-6 deoxy-D-glucopyranose. On the other hand the pseudoaglycones I and II were stereoisomers with respect to a chiral center newly formed by the DBU reaction. The pseudoaglycones contain one neutral sugar and one amino sugar, which turned out to be D-mannose and L-vancosamine, respectively. PMID- 2722685 TI - Metabolic products of microorganisms. 254. Structure of the new nikkomycins pseudo-Z and pseudo-J. AB - Two new nikkomycins were isolated from the fermentation broth of Streptomyces tendae Tu 901/PF 53+-3. These new metabolites, nikkomycins pseudo-Z (psi-Z,1) and pseudo-J (psi-J, 2) differ from the corresponding nikkomycins Z and J by a C glycosidic bond between C-5 of uracil and C-1' of 5-amino-5-deoxy-D-allo furanuronic acid instead of an N-glycosidic bond. The structure elucidation was achieved by two-dimensional NMR techniques and mass spectrometry. PMID- 2722686 TI - Chemical modification of hitachimycin. II. Synthesis and antitumor activities of carbonate derivatives. AB - Several carbonate derivatives of hitachimycin have been synthesized and evaluated their activities including antibacterial, cytocidal against HeLa cells and in vivo antitumor against Sarcoma 180. Some of these derivatives showed higher antitumor activity than hitachimycin. Among the derivatives, 11,15-di-O methoxycarbonylhitachimycin (2), 11,15-di-O-ethoxycarbonylhitachimycin (3) and 15 O-methoxycarbonylhitachimycin (9) were most effective in in vivo assay. PMID- 2722687 TI - Synthesis and biological activity of analogues of diazaquinomycin A, a new thymidylate synthase inhibitor. AB - Diazaquinomycin A (1), a new thymidylate (TMP) synthase inhibitor, is poorly soluble in various solvents and exhibits no antitumor activity, while a series of the analogues prepared from 1 are more soluble in water and chloroform than 1, and some of them exhibit antitumor activity in mice. Some analogues in which the lactam rings are replaced by pyridine rings did not inhibit TMP synthase. The diethoxy analogue 25 is a 10-fold more potent inhibitor of TMP synthase than 1. The diacetoxy analogue 23 exhibits significant antitumor activity (T/C: 175%) against Meth-A fibrosarcoma in mice. PMID- 2722688 TI - Structure-activity relationships for unsaturated dialdehydes. 3. Mutagenic, antimicrobial, cytotoxic, and phytotoxic activities of merulidial derivatives. AB - The mutagenic activity in the Ames' Salmonella assay, the antimicrobial activities against bacteria, fungi, and algae, the cytotoxic activities against Ehrlich ascitic tumor cells and L1210 cells, and the phytotoxic activities against Lepidium sativum and Setaria italica, of the unsaturated dialdehyde merulidial and six acetylated, hydroxylated, and cyclopropane ring isomerized derivatives of merulidial, are compared. Some possible structure-activity relationships are discussed. PMID- 2722689 TI - Biosynthetic similarity between Streptomyces tenjimariensis and Micromonospora olivasterospora which produce fortimicin-group antibiotics. AB - The profile of bioconversion products of istamycin (IS) components by a blocked IS mutant of Streptomyces tenjimariensis that lost IS-productivity suggested a possible biosynthetic pathway of IS similar to that of fortimicin (FT) by Micromonospora olivasterospora. Both organisms are resistant to the antibiotics produced by each other. Based on these similarities, they were examined for their capability to convert an FT-intermediate (FT-B) and IS-intermediates (IS-A0 and B0) through their biosynthetic pathways. S. tenjimariensis formed 1-epi-FT-B, 2'' N-formimidoyl-FT-A (= dactimicin) and 1-epidactimicin (a new antibiotic) from FT B. On the other hand, M. olivasterospora converted IS-A0 and -B0 to 2''-N formimidoyl-IS-A (= IS-A3) and -B (= IS-B3), respectively. Thus, the similarity in antibiotic biosynthesis was confirmed between these FT-group antibiotic producing organisms. It was also found that the major fermentation product of M. olivasterospora is not FT-A (astromicin) but dactimicin. PMID- 2722690 TI - Oxidases involved in biosynthesis of macrolide antibiotic patulolides from Penicillium urticae S11R59. AB - Patulolides are a group of 12-membered macrolide antibiotics produced by Penicillium urticae S11R59. An enzyme involved in the conversion of patulolide C to patulolide A was purified from P. urticae S11R59 and characterized. The enzyme showed a single band on SDS-PAGE and molecular sieve HPLC both of which indicated a Mr of 86,000, indicating that the enzyme is monomeric. However, the enzyme was separated into two bands of very similar pI's (pI 4.2 and 4.3) by isoelectric focusing. Both bands catalyzed the conversion of patulolide C to patulolide A, as demonstrated by activity staining. The two isoenzymes were proved to be oxidases by the simultaneous production of H2O2 during the conversion of patulolide C to patulolide A. The molar ratio for patulolides C, A and H2O2 was determined to be 1:1:1. The optimum pH and temperature were determined to be 7 and 35-40 degrees C, respectively, and the enzymes were stable at pH 6-9 and 4-40 degrees C. The oxidases showed characteristic absorption at 345 and 450 nm, indicating the presence of flavin as coenzyme. Among several analogues of patulolide C tested, the oxidases showed very narrow substrate-specificity; only patulolide C was oxidized to patulolide A. No enzyme activity for the reverse reaction, i.e. from patulolide A to patulolide C, was present in the cell-free extract of P. urticae S11R59. Patulolide C oxidases therefore play a key role in the biosynthesis of patulolides. PMID- 2722691 TI - Enzymic inactivation of lincosaminide and macrolide antibiotics: divalent metal cation and coenzyme specificities. PMID- 2722692 TI - 1-Epidactimicin, a new aminoglycoside antibiotic converted from fortimicin B by a blocked mutant of istamycin-producing Streptomyces tenjimariensis. PMID- 2722693 TI - Effects of creep feeding, zeranol implants and breed type on beef production: I. Calf and cow performance. AB - A 2-yr study was conducted to evaluate the effects of a high-energy creep feed, preweaning zeranol implants and breed type on calf and cow performance. Two hundred calves sired by Brahman and Romana Red bulls out of Angus and Angus x Brown Swiss reciprocal crossbred (F1) dams were stratified by breed type and sex to three creep treatments: no creep feed (NC); long-term creep (LC), creep-fed from 56 to 210 d of age (weaning); and short-term creep (SC), creep-fed from 146 to 210 d of age. Alternate calves within sex, breed type and creep treatment were implanted with 36 mg of zeranol at an average of 56 d and reimplanted 90 d later. The LC and SC calves had heavier (P less than .001) 210-d weights than NC calves (264 and 257 vs 231 kg, respectively), and the LC calves were heavier (P less than .001) at 146 d than NC calves. The LC calves had higher (P less than .001) ADG from 118 to 210 d of age and higher 146 and 210-d condition scores than did NC calves. Pregnancy rate was not affected (P greater than .46) by creep treatment of calf. Zeranol implants increased (P less than .01) 146- and 210-d weights (184 vs 175 kg and 259 vs 243 kg) and ADG during all periods to weaning. Brahman-sired calves had higher (P less than .005) 146- and 210-d weaning weights and frame scores than Romana Red-sired calves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722694 TI - Effects of creep feeding, zeranol implants and breed type on beef production: II. Reproductive development and fat deposition in heifers. AB - Effects of preweaning creep feeding and zeranol implants on reproductive tract development and udder and s.c. fat deposition were studied in 24 weanling heifers (7 mo of age) with Brahman and Romana Red sires and Angus and Angus x Brown Swiss F1 reciprocal crossbred dams. Creep treatment did not affect (P greater than .19) ovarian weight, ovarian size, uterine horn diameter or follicle number. Heifers from the three creep treatments did not differ (P greater than .25) in udder weight, total lipid or percentage of lipid in the udder. Noncreep-fed (NC) heifers had a greater (P less than .02) number of adipocytes/gram of udder tissue than did the long-term creep-fed (LC) and short-term creep-fed (SC) heifers. The LC heifers had larger udder (166.0 vs 152.7 m) and s.c. adipocytes (166.7 vs 148.8 m) than NC heifers. Heifers implanted with zeranol at 56 and 146 d of age had a greater (P less than .03) uterine horn diameter and heavier (P less than .02) uterine weight than unimplanted heifers. Percentage of lipid in the udder was lower (P less than .02) in heifers implanted with zeranol. Implanted heifers had smaller (P less than .10) s.c. adipocytes than unimplanted heifers. Breed of dam did not effect (P greater than .17) development of the reproductive tract of weanling heifers. Heifers from Angus dams had smaller (P less than .08) udders and less (P less than .10) total fat in the udder than those from F1 dams, and the heifers from F1 dams tended (P less than .12) to have larger udder adipocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722695 TI - Effect of vitamin C and space allowance on performance of weanling pigs. NCR-89 Committee on Confinement Management of Swine. AB - The influence of space allowance and vitamin C supplementation on rate and efficiency of weight gain and mortality of weanling pigs was investigated in a cooperative study that involved 11 experiment stations in the North Central Region (NCR-89). The factorially arranged treatments were .124 vs .248 m2 of floor space/pig and 0 vs 625 ppm vitamin C added to a corn-soybean meal-dried whey diet. The 1,296 pigs (36 replications) averaged 27 d of age and 6.9 kg at the start of the 28-d feeding trial. Crowded pigs (.124 m2/pig) consumed 11.2% less (P less than .01) feed and grew 11.0% slower (P less than .01) than those allowed twice as much space (.248 m2/pig). Crowding did not affect (P greater than .05) gain/feed ratio. Neither vitamin C supplementation nor the interaction between space allowance and vitamin C influenced (P greater than .05) performance or mortality. None of the treatments influenced (P greater than .05) body weight variation between pigs within pens. There were station effects (P less than .01) for all criteria, except mortality, but there were no station x treatment interactions (P greater than .05). In the environments represented at 11 experiment stations, dietary vitamin C was not necessary for optimum performance of weanling pigs. PMID- 2722696 TI - Effect of fenbendazole and pyrantel tartrate on the induction of protective immunity in pigs naturally or experimentally infected with Ascaris suum. AB - An experiment was conducted with 96 weanling pigs (avg initial wt 18.5 kg) divided into six treatment with two replicates of eight pigs each. Pigs in Treatments 1, 2 and 3 were penned in outside pens with dirt lots that previously were contaminated with A. suum ova to induce a natural ascaris infection. Pigs in Treatments 4, 5 and 6 were penned in an open-front building with solid concrete floors and were experimentally infected with 2,000 embryonated A. suum. ova on d 1, 15 and 29 of the experiment. Pigs in Treatments 1 and 4 were medicated with fenbendazole (FBZ, 3 mg/[kg BW.d]) for three consecutive days during three consecutive time periods. Pigs in Treatments 2 and 5 were medicated with pyrantel tartrate (PT, 106 mg/kg feed) for 28 d. Pigs in Treatments 3 and 6 served as infected, unmedicated controls. All pigs were challenged with 100 A. suum eggs 7 d after termination of the final FBZ treatment. All pigs were killed 66 d after challenge and worms were recovered. Fenbendazole treatment resulted in greater (P less than .07) average daily gain than PT treatment in pigs penned outside. Among inside pigs, FBZ treatment resulted in better (P less than .02) feed utilization than in controls. The FBZ and PT treatments reduced (P less than .03) the total number of A. suum, the length and weight of female ascarids and the length of male ascarids compared with controls. A natural continual infection with A. suum was less effective than experimental infection in inducing protective immunity in pigs. PMID- 2722697 TI - Effect of birth and fraternal litter size and cross-fostering on growth and reproduction in swine. AB - Twelve hundred fifty-one pigs from six farrowings (FGRP) were classified within a FGRP by their birth litter size (BL- = below average and BL+ = above average), randomly allotted to nursing litter sizes of 6 or 12+ pigs/sow (NL- vs NL+) and reared by their own or foster dams (XF- vs XF+). Pigs were weighed at birth, 21 d and when near 105 kg. A random sample of 40 gilts per FGRP was retained for observation of pubertal age and primipara conception. Twenty-four gilts per FGRP were farrowed and rebred for a second parity. Pigs born in large litters were younger at 105 kg than those born in small litters (189 vs 196 d +/- 1.4); no other differences (P greater than .05) were observed for BL. Pigs reared in larger litters had lower survival rate from birth to weaning (79 vs 86% +/- 1), had slower weight gains to 21 d of age (5.3 vs 6.6 kg +/- .17) and were older at 105 kg (195 vs 190 d +/- 1.4) than those reared in small litters (P less than .04). Cross-fostered pigs were slower gaining to 21 d (5.9 vs 6.1 kg +/- .14) and were older at 105 kg (195 vs 191 d +/- 1.4) than pigs not cross-fostered pigs (P less than .02). Growth beyond 105 kg and pubertal age were unaffected by any factor studied (P greater than .05). Although size of birth litter did not affect (P greater than .05) any reproductive trait, an interaction between litter size and farrowing group was detected.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722698 TI - The relationships of birth weight, preweaning gain and postweaning gain with the bovine major histocompatibility system. AB - A total of 739 cattle from nine breeds maintained at the Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska were tested for 42 class I antigens of the bovine major histocompatibility system (BoLA). Each antigen appears to be the product of a distinct co-dominant allele of the BoLA-A locus. The number of antigens present in each breed ranged from a minimum of 10 in Hereford to a maximum of 21 in Charolais cattle. There were large differences among breeds in the frequencies of antigens. The effect of each antigen on birth weight, preweaning weight gain and postweaning weight gain was estimated in a gene substitution model. Each breed was analyzed separately. There were significant effects of some BoLA antigens on birth weight, preweaning weight gain and postweaning weight gain, which is consistent with previous reports showing associations between the major histocompatibility system and growth parameters in mice, rats and pigs. However, further research is necessary to confirm these findings and to determine the biological mechanisms underlying these associations. PMID- 2722699 TI - Interrelationships of exogenous porcine growth hormone administration and feed intake level affecting various tissue levels of iron, copper, zinc and bone calcium of growing pigs. AB - Trace mineral status was evaluated in a 2 x 3 factorial treatment array with a total of 34 barrows growing from 25 to 55 kg live weight. Treatments included three levels of feed intake (100, 80 and 60% of ad libitum intake) and exogenous pituitary growth hormone (pGH) therapy (0 and 100 micrograms/kg BW daily). Blood was collected prior to slaughter for the determination of hematocrit and serum trace metal concentrations; tissues (liver, heart, kidney, bone and muscle) were obtained when pigs were slaughtered at 55 kg. Hematocrits and serum Fe were lower in pGH-treated pigs than in controls at all levels of feed intake. Serum Cu was increased by feed restriction but was not altered by pGH therapy. The concentration of serum Zn was not affected by either treatment. Concentrations of hepatic Fe and Cu were lower in pGH-treated pigs than in controls but were higher in feed-restricted pigs than in ad libitum-fed pigs. However, the total amounts of hepatic Fe and Cu were similar in pGH-treated pigs to concentrations in controls. The concentration of hepatic Zn was not influenced by either pGH treatment or feed intake. Femur weights were marginally greater in pGH-treated pigs, probably due to elevated water content. Iron concentration in bone was higher in pGH-treated pigs than in control pigs, whereas Ca, Cu and Zn were not influenced by pGH treatment or feed restriction. Feed intake and pGH treatment did not influence the concentrations of Fe, Cu or Zn in muscle. These findings indicate that pGH therapy affects the metabolism of Fe but has little impact on the overall composition of body ash. PMID- 2722700 TI - Dietary protein-induced changes in porcine muscle respiration, protein synthesis and adipose tissue metabolism. AB - Growth rate, physically separable tissues of the ham and loin, heat production, skeletal muscle respiration and protein synthesis, and lipogenesis and lipolysis in s.c. adipose tissue were measured in a single experiment in which pigs were offered a 13 (n = 8), or 21% (n = 6) protein diet from 20 to 100 kg live weight. Pigs that were fed the 13% protein diet gained body weight slower, ate less, converted feed less efficiently and took 31 d longer to reach 100 kg live weight. Fat depth (cm) was greater (P less than .05) and loin eye area (cm2) was less (P less than .01) in pigs fed the 13% protein diet (2.6 vs 2.3 and 29.8 vs 35.3). Pigs that were fed the 13% protein diet had lower (P less than .05) ham and loin separable muscle and greater (P less than .05) ham and loin separable fat. The mean heat production was less (P less than .05) in pigs offered the 13% (22.49) vs 21% (24.63 MJ/d) protein diets. In the intercostal muscle preparation, total and Na+,K+-ATPase-dependent respiration (microliter O2.mg-1.h-1) were lower (P less than .05) in pigs offered the 13% (2.39 and .41) vs the 21% (3.89 and .68) protein diets. The energy used for the support of Na+ transport across membrane accounted for approximately 17% of muscle respiration. Absolute rates of protein synthesis in the muscle preparations were lower (P less than .01) at 13 than at 21% dietary protein. Lipogenesis in s.c. adipose tissue was not affected by dietary protein level. There was no difference in basal and norepinephrine stimulated lipolysis between the two dietary protein levels. PMID- 2722701 TI - Relationships among intramuscular collagen, serum hydroxyproline and serum testosterone in growing rams and wethers. AB - Concentration and maturation of collagen and serum concentrations of hydroxyproline and testosterone were determined in growing rams and wethers to characterize developmental changes in collagen associated with a representative testicular steroid. Groups of eight rams and eight wethers were slaughtered at 12, 18, 24 and 30 wk of age. Concentrations of collagen in longissimus, supraspinatus and infraspinatus muscles and serum hydroxyproline were greater (P less than .05) in rams than in wethers at all ages. Collagen stability, as measured by collagen solubility and thermal shrinkage temperature, was greater (P less than .05) in wethers than in rams. Differences in collagen stability and serum hydroxyproline concentration indicated that collagen synthesis and turnover were more rapid in rams than in wethers. Serum hydroxyproline decreased (P less than .05) and collagen solubility decreased (P less than .05) with age, indicating that collagen turnover was occurring most rapidly in 12-wk-old lambs and that collagen maturation was predominant in 24- to 30-wk old lambs. Testosterone parameters measured in rams were unrelated within groups to collagen characteristics, possibly reflecting the high variability in testosterone secretion and the slow development of collagen. However, rams as young as 12 wk of age were under the influence of testosterone, and differences in collagen between rams and wethers were apparent at that time. PMID- 2722702 TI - Serum zinc, iron and copper status during early gestation in sows fed a folic acid-supplemented diet. AB - The purpose of this trial was to determine whether an addition of folic acid to a commercial diet would affect serum Zn, Fe and Cu status in sows between weaning and 30 d of gestation. At weaning, 162 sows were assigned randomly to six groups and housed in individual cages fitted on a slatted floor. There were six treatments according to a 2 X 3 factorial arrangement: two levels of supplementary folic acid (0 and 5 mg/kg of diet) and three treatments to stimulate ovulation (none, flushing and pregnant mare serum gonadotropin [PMSG] i.m. injection). Control groups were fed a commercial-type diet, and folic acid treated groups were fed the same diet supplemented with 5 mg/kg of pteroylglutamic acid. All sows were mated twice within 7 d after weaning. Of the 162 animals originally selected, 123 sows were pregnant and used in this trial. Serum folates, Zn, Cu and Fe were measured at weaning, mating and 30 d of gestation. Serum Cu, Zn and folates increased between weaning and mating, and then decreased to 30 d of gestation. Supplementing the commercial diet with folic acid elevated serum folates between weaning and d 30 of gestation (P less than .001). Folic acid supplementation also was associated with a higher level of serum Zn at 30 d of gestation. Supplemental folic acid had no effect on the pattern of serum Cu and Fe throughout the experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722703 TI - Utero-placental transfer of octanoic, palmitic and linoleic acids during late gestation in gilts. AB - The transfer across the swine uterus and placenta of [1-14C]octanoic acid, [9,10(n)-3H]palmitic acid and [1-14C]linoleic acid was studied in five gilts and their fetuses during late gestation following a single bolus injection. Only trace amounts of labeled fatty acids were found in fetal plasma lipid. The highest fetal plasma lipid values were less than 1.2% of the peak maternal values. The concentration of plasma free fatty acids (FFA) and fatty acid profiles in the umbilical artery (FA) and vein (FV) and uterine artery (UA) and vein (UV) were compared. There were no measurable umbilical arterio-venous differences. Concentrations of FFA in FA and FV were about 40% of the UA and UV values (187, 194, 73, 82 microEq/liter for UA, UV, FA and FV, respectively). Fetal plasma contained larger amounts of 14:0, 16:1, 18:1 and 20:4, whereas maternal plasma contained larger amounts of 18:0 and 18:2. There was difference between fetal and maternal plasma for 16:0 and 18:3; the latter was present only in minute amounts. In conclusion, only trace amounts of FFA cross the swine placental tissues during late gestation; therefore, their contribution to fetal energy supply or lipid storage appears limited. PMID- 2722704 TI - The effect of feeding different protein-free diets on the recovery and amino acid composition of endogenous protein collected from the distal ileum and feces in pigs. AB - Nine barrows with an average initial weight of 60 kg were fitted with simple T cannulas at the distal ileum. The animals were fed four different protein-free diets according to an incomplete latin square design. Diet 1 (control diet) consisted of 79.7% cornstarch, 10% sucrose, 3% Alphafloc (a source of cellulose), 3% canola oil and a vitamin-mineral premix. Diets 2, 3 and 4 contained, respectively, 4% pectin, an additional 7% cellulose and an additional 10% canola oil, each included at the expense of cornstarch. Feces were collected during 3 d following a 7-d adaptation period. Thereafter, digesta were collected during two 24-h periods with a 24-interval between periods. The pigs were fed 800 g of feed twice at 0800 and 2000. Added pectin increased (P less than .05) the recovery of endogenous protein in ileal digesta from 19.8 diet (diet 1) to 24.0 g per kg dry matter intake. This increment was largely due to increases (P less than .05) in glycine and proline from 1.9 to 2.4 and from 6.2 to 8.4 g per kg dry matter intake, respectively. In feces, only added cellulose increased (P less than .05) excretion of endogenous protein (8.4 vs 11.1 g/kg DM intake) and of most amino acids. Including additional fat did not affect the quantity of endogenous protein and amino acids recovered in ileal digesta or feces. Small but significant differences (P less than .05) were observed in the amino acid composition of endogenous protein recovered in ileal digesta when the different protein-free diets were fed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722705 TI - The effect of protein status of the pig on the recovery and amino acid composition of endogenous protein in digesta collected from the distal ileum. AB - Barrows with an average initial weight of 55 kg were fitted with simple T cannulas at the distal ileum. The animals were fed a protein-free diet that consisted of 79.7% cornstarch, 10% sucrose, 3% Alphafloc (a source of cellulose), 3% canola oil and a vitamin-mineral premix. The pigs were fed 700 g of diet twice each day, at 0800 and 2000. A balanced amino acid mixture or a saline solution was administered intravenously while the protein-free diet was fed. Ileal digesta were collected for 24 h following a 7-d adaptation period. The administration of amino acids reduced (P less than .05) the recovery of endogenous protein from 18.5 to 12.7 g per kg dry matter intake. For the amino acids, the reduction was only significant (P less than .05) for proline, from 3.6 to .6 g per kg dry matter intake. If the total endogenous protein losses are assumed to be constant and the differences in the amino acid composition of non-reabsorbed endogenous protein, as observed in this study, are used to calculate true ileal digestibilities, differences in the digestibilities of the indispensable amino acids are large (up to 7.4 percentage units for threonine). The amino acid composition of endogenous protein determined in pigs fed a protein-free diet and parenterally administered with amino acids should provide a better estimate for the calculation of true amino acid digestibilities when based on the determination of true protein digestibility by the 15N-isotope dilution technique. PMID- 2722706 TI - Effect of elevated ambient temperatures on puberty in gilts. AB - Effects of elevated ambient temperature on puberty and related physiological responses were studied in 40 gilts. Group 1 (n = 20) gilts were born in September and Group 2 (n = 20) gilts were born in March. Gilts were placed in environmentally controlled chambers at 140 d of age. After a 10-d acclimation period at 20 degrees C, 35% relative humidity (RH), and 12 h light (L)/12 h dark (D), gilts within each group were randomly assigned to one of two treatments: control (C; 15.6 degrees C, 35% RH, 12 h L/12 h D) or heat stress (HS; 33.3 degrees C, 35% RH, 12 h L/12 h D). Daily detection of estrus with a boar began at 180 d of age and continued for 50 d. All gilts not reaching puberty by 230 d of age received 1,000 IU pregnant mare serum gonadotropin (PMSG) and 7 d later were examined by laparotomy. Rectal temperatures (REC) and respiration rates (RESP) were taken twice daily. Food intake (FI) and water usage (WC) were recorded daily. Blood samples were collected weekly and BW recorded at 150, 190, and 230 d of age. No differences (P greater than .05) were observed due to season of birth. Heat-stressed gilts had greater (P less than .001) REC and RESP and consumed more (P less than .01) water than C gilts. Food intake and ADG were not different between treatments (P greater than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722707 TI - Modulation of luteal activity in postpartum beef cows through changes in dietary lipid. AB - Studies were conducted to evaluate the normal changes in lipid metabolism occurring in the suckled Brahman crossbred female during the postpartum period (Exp. 1) and to examine the function of induced corpora lutea (CL) in postpartum cows fed diets with normal (2.8%) lipid or elevated (8%) lipid content (Exp. 2). Multiparous and primiparous females (n = 20), maintained on pasture without energy or protein supplementation, were used in Exp. 1. A linear increase (P less than .001) in plasma lipid metabolites was observed between the 1st and 8th wk after calving, reaching a plateau of 221 +/- 18.3 and 74 +/- 3.4 mg/dl for total cholesterol and triglycerides, respectively. Seventy percent of all postpartum females exhibited luteal activity within 50 d (x = 34.7 d), and 59% of these animals exhibited short luteal phases (less than 12 d). In Exp. 2, primiparous and multiparous females (n = 32) were assigned to receive a control (n = 16) or high-lipid (HL) diet (n = 16; 30% whole cottonseed) between d 1 and d 38 after calving. The HL diet increased (P less than .001) total cholesterol and triglycerides 1.7- and 1.4-fold, respectively, relative to controls, and increased (P less than .05) the spontaneous occurrence of low-level progesterone elevations. Forty-eight-hour calf removal and gonadotropin-releasing hormone (GnRH; .22 mg/kg BW i.v.) were employed between d 21 and 26 after calving to induce ovulations. Mean concentrations of progesterone in the HL group were markedly higher (P less than .01) than in controls between d 5 and 8 of the induced cycle, and average lifespan of induced CL was approximately twice that of controls (P less than .01). PMID- 2722708 TI - Effects of copper and molybdenum supplements on the copper and selenium status of pregnant ewes and lambs. AB - The aim of this work was to investigate whether Cu, alone or in combination with Mo, reduces the Se status of sheep. Thirty-six Hampshire ewes were separated prior to mating into four treatment groups of nine sheep each. The four groups consisted of 1) basal (alfalfa hay or legume-grass low-moisture silage, corn, oats), 2) basal plus 10 mg Cu/kg diet, 3) basal plus 10 mg Mo/kg and 4) basal plus Cu and Mo (each 10 mg/kg). Copper and Mo were added to both ewe and lamb diets. Treatments continued until lambs were weaned at 10 wk postpartum. The basal ewe diet contained, in mg/kg, 5.6 Cu, .05 Se and 1.0 Mo. The basal lamb diet contained, in mg/kg, 6.1 Cu, .07 Se and less than 1.0 Mo. Sulfur concentrations in the ewe and lamb diets were .24% and .20%, respectively. Copper supplements increased, and Mo supplements decreased, the concentration of Cu in the livers of ewes and lambs (P less than .05). Despite this, there were no effects of treatment on Se concentration or glutathione peroxidase activity in blood or tissues. Selenium levels in plasma of all ewes declined throughout pregnancy and lactation, indicating that .05 mg/kg Se was insufficient for the maintenance of Se status during pregnancy in Hampshire ewes. Copper and Se levels (mg/kg fresh weight) in the liver of lambs at weaning for Treatments 1 through 4 were 48 and .13, 158 and .10, 11 and .11, and 136 and .13, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722709 TI - Effect of dietary protein level on nitrogen metabolism in the growing bovine: I. Nitrogen recycling and intestinal protein supply in calves. AB - Eight Angus heifer calves (234 kg) were assigned to either a high (HP; 126 g N/d) or low (LP; 66.5 g N/d) protein intake. Calves received 4.8 kg DM/d consisting of 30% cottonseed hulls and 70% corn-soybean meal in equal portions at 4-h intervals. Single doses of 14C- and 15N-urea and 15N-ammonium sulfate were injected into the blood urea-N (BUN) and ruminal NH3-N (RAN) pools, respectively, to measure rate of flux through, and transfer of N between, these and bacterial N. Nitrogen balance was greater (P less than .05) for HP than for LP (56.9 vs 25.1 g N/d), but abomasal N flow as a percentage of N intake was greater (P less than .05) for LP than for HP (124 vs 71.1%). Pool size and net synthesis rate for both RAN and BUN pools were greater (P less than .05) for HP than for LP. Calves fed HP degraded more (P less than .05) BUN in the gastrointestinal tract than calves fed LP (37.4 vs 14.0 g N/d). Quantities of RAN absorbed from the rumen also were greater (P less than .05) for HP than for LP (14.2 vs 2.8 g N/d). The proportion of total gastrointestinal BUN degradation occurring in the rumen averaged 53 and 26% for LP and HP. Data are interpreted to suggest that net incorporation of BUN into bacterial protein (urea recycling) is inversely related to level of protein intake. PMID- 2722710 TI - Effect of dietary protein level on nitrogen metabolism in the growing bovine: II. Diffusion into and utilization of endogenous urea nitrogen in the rumen. AB - Six Angus heifer calves (234 kg) were assigned to either a high (HP; 126.1 g N/d) or low (LP; 66.5 g N/d) protein intake to evaluate ruminal criteria associated with movement of blood urea-N (BUN)-derived NH3-N from the rumen wall into interior ruminal digesta. Calves received 4.8 kg DM/d of diets containing 30% cottonseed hulls and 70% cornsoybean meal in equal portions at 4-h intervals. Following single i.v. injections of 15N-urea, ruminal fluid was collected serially for 4 h postinjection from digesta located adjacent to the rumen wall (wall-proximate digesta; WPD) and from the center of the rumen digesta mass after manual agitation (center mixed digesta; CMD). Mean ruminal NH3-N (RAN) concentrations were higher (P less than .05) for HP than for LP, but were not affected (P greater than .05) by digesta sampling site. Ruminal urease activity was higher (P less than .05) for LP than for HP and tended (P = .14) to be higher for WPD than for CMD. Area under the 15N enrichment curve (AUC) ratios between sampling sites (WPD/CMD x 100) for RAN were greater (P less than .05) for LP than for HP. However, AUC ratios for bacterial N were not affected (P greater than .05) by protein level. Whereas BUN-derived 15NH3 appeared to thoroughly equilibrate with RAN in interior ruminal digesta with HP, there appeared to be a declining enrichment gradient for RAN from the rumen wall to the interior ruminal digesta with LP. Data are interpreted to suggest that bacteria at or near the rumen wall may preferentially utilize some BUN-derived NH3-N entering through the rumen wall in calves fed LP diets. PMID- 2722711 TI - Effects of a salivary stimulant, slaframine, on ruminal fermentation, bacterial protein synthesis and digestion in frequently fed steers. AB - Slaframine (SF), a parasympathomimetic salivary stimulant, was administered i.m. (10, 15 or 20 micrograms SF/kg BW) to ruminally and abomasally fistulated steers at 12-h intervals for 18-d periods in a latin square-designed experiment. Steers were fed semicontinuously (12 times daily) a 40:60 roughage:concentrate diet at twice their net energy requirement for maintenance. Ruminal digestion coefficients for DM, ADF and starch were 10 to 16% lower and linearly related in an inverse manner to the level of SF administered (P less than .05). Postruminal digestion of DM, ADF and starch increased as much as 46.7, 9.5 and 44.0%, respectively, in a fashion linearly related (P less than .05) to the level of SF administered. Total tract digestion of DM and ADF were not affected by SF; however, total tract starch digestion was increased as much as 5% and was related linearly (P less than .05) to SF treatment. With SF administration, as much as 13% more bacterial protein exited the rumen, resulting in a 16.5% linear improvement (P less than .1) in the efficiency of ruminal bacterial protein production per 100 g of OM fermented. Ruminal concentrations of VFA, ammonia and pH were not affected by SF. These results demonstrate a positive relationship between salivation and ruminal bacterial protein synthesis and suggest that feed utilization by ruminants may be improved by pharmacological stimulation of salivary secretions. PMID- 2722712 TI - Zinc methionine for ruminants: relative bioavailability of zinc in lambs and effects of growth and performance of growing heifers. AB - Studies were conducted to evaluate zinc methionine (ZnMet) as a source of Zn for ruminants. Experiment 1 compared the availability of Zn in ZnMet and zinc oxide (ZnO) in lambs fed a semi-purified diet deficient in Zn. Based on growth rate and animal performance, plasma Zn and plasma alkaline phosphatase activity, no differences in Zn availability were detected between the two Zn sources. Apparent absorption of Zn also was similar, but Zn retention was higher (P less than .01) in lambs fed ZnMet because of a tendency for lower urinary Zn excretion (P less than .19) in this group. Zinc absorption and retention by lambs were similar for the two Zn sources in Exp. 2 when 20 mg Zn/kg was added to an orchardgrass hay based diet containing 30 mg Zn/kg. In Exp. 3, lambs were dosed orally with 300 mg of Zn as ZnO or ZnMet, and the increase in plasma Zn following dosing was monitored. The increase in plasma Zn above predosing values was similar at 6 h but was higher at 12 (P less than .10) and 24 h (P less than .05) postdosing in lambs given ZnMet. Thirty-six Hereford x Simmental heifers (271 kg) were used in Exp. 4 to determine the influence of supplementing Zn (25 mg/kg) as ZnO or ZnMet of growth performance and Zn status. Heifers were fed a corn silage-based diet that contained 23.1 mg Zn/kg during the 126-d study. Zinc supplementation to the basal diet increased (P less than .05) gain and feed/gain during the first 56 d, but not for the entire 126-d study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2722713 TI - Postprandial variations in the activity of polysaccharide-degrading enzymes in microbial populations from the digesta solids and liquor fractions of rumen contents. AB - The diurnal variations in the specific activities of polysaccharide-degrading enzymes after feeding were monitored in adherent and non-adherent microbial populations separated from bovine rumen liquor and digesta solids. There were marked differences in the activity profiles of the enzymes within the subpopulations. Enzymes involved in the degradation of soluble carbohydrates were more active in the non-adherent populations, and in the liquor phase subpopulation activities increased in the 1-2 h post-feed period. The muralytic enzymes were most active in the adherent population. Specific activities increased by up to 20-fold over the 24 h period, with an initial five-fold increase occurring between 8 h and 12 h after feeding. Enzyme levels in the three non-adherent populations were similar at the end of the postprandial period. In the population recovered from the liquid associated with the digesta particles, however, the activities did not increase until the latter stages of the period, whereas in the non-adherent population from the digesta solids the activities varied little during the diurnal cycle. The numbers of micro-organisms associated with the digesta solids were similar at 2 h and 20 h after feeding; the variations in enzyme levels did not occur as a result of a population increase but were due to increased activities in an established population. The plant cell wall structural polysaccharides were degraded at different rates. There was no appreciable cellulose digestion during the first 8 h of the postprandial period and although hemicellulosic constituents were removed continuously the rate of loss of both polymers was increased in the later stages of the diurnal cycle when enzyme activities were maximal. PMID- 2722714 TI - A biotinylated DNA probe to detect bacterial cells in artificially contaminated foodstuffs. AB - A biotin-labelled DNA probe was used in a dot-blot hybridization test to demonstrate the presence of Escherichia coli in a variety of artificially contaminated foodstuffs. Positive hybridization was detected by using a streptavidine/polyalkaline phosphatase conjugate to generate an insoluble coloured precipitate in the presence of an appropriate dye. The colour intensity was measured with a computer-controlled image analysis system which assessed objectively the hybridization signal produced by each sample. The method was capable of distinguishing positive hybridization at cell concentrations exceeding 10(4) cells/dot-blot, equivalent to 2 x 10(7) cells/g food, and had none of the drawbacks normally associated with the use of radioactively labelled DNA in hybridization techniques. The procedure is highly specific and takes less than 30 h. Many samples can be screened simultaneously and the procedure can be used to detect any species for which a suitable DNA probe is available. PMID- 2722715 TI - Vibrio parahaemolyticus and other halophilic vibrios associated with seafood in Hong Kong. AB - The summer prevalence of Vibrio parahaemolyticus and other halophilic vibrios in seafood from Hong Kong markets was investigated. Halophilic vibrios were isolated from all seven types of seafood examined, and comprised 9.1%, 8% and 6.1% of contaminating aerobic heterotrophic bacteria from mussels, clams and oysters respectively. Sucrose-positive vibrios were more common than sucrose-negative varieties. Vibrio alginolyticus was the most frequently isolated species, followed by V. parahaemolyticus, V. harveyi, V. fluvialis, V. vulnificus, V. pelagius, V. campbellii, V. spendidus and V. marinus. Mussels contained the highest concentration of V. parahaemolyticus (4.6 x 10(4)/g); oysters and clams contained 3.4 x 10(4)/g and 6.5 x 10(3)/g respectively. The ubiquity and relatively high concentrations of V. parahaemolyticus and other pathogenic vibrios in shellfish is a potential public health hazard in Hong Kong and other subtropical Asian countries. PMID- 2722717 TI - Cefmetazole: a clinical appraisal. Based on a symposium. Long Beach, California, 22 October 1988. PMID- 2722716 TI - Enhanced resistance of anaerobic rumen fungi to the ionophores monensin and lasalocid in the presence of methanogenic bacteria. AB - The presence of Methanobrevibacter smithii altered the susceptibility of the anaerobic fungi Neocallimastix frontalis and Piromonas communis to the carboxylic ionophores monensin and lasalocid. The ionophores depressed growth (measured by chitin accretion), the uptake of glucose and the production of H2, formate and acetate by the fungi growing axenically in semi-solid medium. In the presence of M. smithii, the sensitivity of the fungi to monensin and lasalocid was decreased. For example, the uptake of glucose by N. frontalis strain RE1 in the culture was reduced to 50% of the control value by monensin at 0.5 microgram/ml. In the presence of M. smithii strain PS, approximately three times as much monensin was needed to bring about the same effect. In similar tests, the sensitivity of strain RE1 to lasalocid was decreased about nine-fold in the presence of M. smithii. The effect was not observed if the methanogens were killed by autoclaving before inoculation. It is suggested that the enhanced resistance to ionophores in the presence of M. smithii is a consequence of changes in the energy metabolism of the fungi growing in co-culture. PMID- 2722718 TI - The effects of cefmetazole and latamoxef on platelet function in healthy human volunteers. AB - This study has compared the effects of normal saline (placebo), cefmetazole, and latamoxef (moxalactam) on platelet function in healthy human volunteers. Twenty nine volunteers were randomized to receive placebo (n = 10), cefmetazole 2 g (n = 9) or latamoxef 2 g (n = 10) intravenously every 6 h for six days. Under double blind conditions template bleeding time and ex-vivo adenosine diphosphate (ADP) induced platelet aggregation were measured before drug dosing, after the first, ninth, and last drug doses and one and three days after the last drug dose. Latamoxef caused progressive impairment of platelet function with statistically significant increases in the mean bleeding time to 7.4 +/- 3.7 min (P = 0.02) and the amount of ADP (0.2 mM) required to induce 50% platelet aggregation to 77.3 +/ 91.1 microliters (P = 0.03) on day 6 of treatment compared with values before drug administration (4.2 +/- 0.7 min; 3.7 +/- 22 microliters, respectively). These changes were reversible following discontinuation of drug dosing. Cefmetazole and placebo had no significant effects on either measure of platelet function at any time during the study. PMID- 2722719 TI - Preclinical safety studies of cefmetazole. AB - In order to assess the safety of cefmetazole, preclinical multiple-dose parenteral studies, varying from one to three months in length, were conducted in Sprague-Dawley rats and beagle dogs. Although the largest doses used were in multiples of several times the weight-adjusted doses intended for humans, cefmetazole was generally well tolerated. The principal adverse effect noted in the adult rats receiving the largest doses (2000 and 2500 mg/kg/day) of cefmetazole was slight elevation of serum alanine aminotransferase. Infant rats injected subcutaneously with 300 mg/kg/day or more of cefmetazole for 35 consecutive days had reversible reductions in testicular weight and maturation of spermatogenesis, but not lasting discernible effect on reproductive function. The most consistent effects of longterm multiple dosing with cefmetazole in dogs consisted of vomiting and retching during dosing and reversible haematological changes (mild regenerative anaemia, positive Coombs' test, clinically-silent thrombocytopenia) in a number of the dogs. These findings supported the interpretation that cefmetazole was acceptably safe for clinical studies in humans. PMID- 2722720 TI - Interaction of cephalosporins with penicillin-binding proteins of methicillin resistant Staphylococcus aureus. AB - The binding affinity of cefmetazole for penicillin binding proteins (PBPs) of methicillin resistant Staphylococcus aureus (MRSA) was compared with the affinities of cefazolin, cefotetan, and cefoxitin for these same sites. Overall, cefmetazole was found to have comparable or higher affinity for PBP1, PBP2, and PBP3 than cefoxitin or cefotetan; its affinity for these PBPs is lower than that of cefazolin. Interestingly, the antibiotic showed a somewhat greater affinity for PBP2' (PBP2a) than cefazolin, cefotetan, and cefoxitin. These results suggest that the somewhat lower MICs detected with cefmetazole for MRSA may be a consequence of the interaction of the antibiotic with PBP2'. PMID- 2722721 TI - Cefmetazole postmarketing surveillance in Japan. AB - The Sankyo Company Ltd had conducted a postmarketing surveillance programme on cefmetazole sodium since its marketing introduction in Japan. Two data collection approaches were used: a survey in which participating physicians provided complete information on all their patients who received cefmetazole for treatment of infection, and two voluntary reporting systems--one sponsored by Sankyo and the other by the Japanese Ministry of Health and Welfare. Eight years' data from this programme are presented. The survey allowed quantitative determination of estimated incidence rates of adverse drug reactions (ADRs) in the overall population. A total of 118,318 patients were enrolled in the survey; this resulted in a sensitivity adequate to detect ADRs that occur in only one of 10,000 patients. Two per cent of the survey patients reported ADRs (either clinical events or laboratory abnormalities or both). The most frequent clinical ADRs were cutaneous reactions, followed by gastrointestinal symptoms. The most common laboratory abnormalities were in hepatic function tests. Rare and potentially serious events reported in the voluntary systems included anaphylactic shock, pseudomembranous colitis, and haemorrhagic tendency. Disulfiram-like reactions associated with alcohol ingestion were also reported rarely. With appropriate monitoring, cefmetazole is safe and well tolerated for the treatment of infection. PMID- 2722722 TI - A comparison of cefmetazole, and cefoxitin for the treatment of patients hospitalized with acute urinary tract infections. AB - This study evaluates the safety and efficacy of cefmetazole in comparison with cefoxitin in the parenteral treatment of patients hospitalized with acute urinary tract infections. Of the 49 evaluable patients, 27 were randomized to cefmetazole and 22 to cefoxitin. There was clinical success in 26 (96%) patients and bacteriological cure in 22 (81%) patients receiving cefmetazole. This compares with clinical success in 21 (95%) patients and bacteriological cure in 17 (77%) patients randomized to cefoxitin. There were no adverse reactions associated with either antibiotic. This study indicates that the clinical and bacteriological outcome was similar. PMID- 2722723 TI - Cefmetazole treatment of intra-abdominal infection. AB - Seventy-nine patients were enrolled in a study comparing cefmetazole and cefoxitin as single agent antibiotic therapy for intra-abdominal infection. Thirty-seven patients had appendicitis, 16 patients had perforated peptic ulcer while 26 patients had a variety of other infectious processes. The clinical response to both antibiotics was good and tolerance was equivalent. Four patients with Pseudomonas aeruginosa isolated from the initial culture experienced microbiological failure. Three patients treated with cefmetazole had prolongation of the prothrombin time. PMID- 2722725 TI - Single-dose cefmetazole versus multiple dose cefoxitin for prophylaxis in abdominal surgery. AB - One hundred and ninety-five patients undergoing abdominal surgical procedures completed a multicentre, randomized, open-label study comparing the safety and efficacy of cefmetazole and cefoxitin for the prevention of postoperative wound infection. Cefmetazole was administered iv in a single 2 g dose given within 90 min of the operation. Cefoxitin was administered in a single 2 g, similarly timed, preoperative dose and two additional doses given at 6 h intervals after surgery. For operations that exceeded 2-4 h duration an additional dose of each agent was administered. Patients undergoing colorectal operations received oral neomycin and erythromycin as bowel preparation. Colorectal operations were performed most frequently (49% of patients) followed by cholecystectomies (26%) and gastroduodenal procedures (21%). The operative site infection rate was 6.5% for cefmetazole and 7.7% for cefoxitin (P greater than 0.05). Serious drug related adverse effects were not observed. This study demonstrates that administration of single-dose cefmetazole is as effective as a standard three dose regimen of cefoxitin for prophylaxis with abdominal operations. PMID- 2722726 TI - A randomized prospective study of antibiotic prophylaxis during abdominal surgery. AB - The safety and efficacy of intravenous cefmetazole for prophylaxis before abdominal operations were compared with those of intravenous cefoxitin in a randomized, prospective clinical study. Eighty-nine evaluable patients were enrolled. These patients underwent primarily clean/contaminated (56%) and contaminated (39%) operations. A total of three (3%) patients developed postoperative wound infections. Two patients (2%) developed non-life-threatening adverse drug reactions. There were no life-threatening adverse drug reactions. There were no significant differences between the cefmetazole and cefoxitin study groups. Cefmetazole appears to be as safe and as efficacious as cefoxitin antibiotic in prophylaxis for intra-abdominal operations. PMID- 2722724 TI - Treatment of skin and soft tissue infections: a comparative study of cefmetazole and cefoxitin. AB - In this comparative study, both cefmetazole and cefoxitin were found to be safe and effective in the treatment of skin and soft tissue infections. Greater activity of cefmetazole against some strains of Staphylococcus aureus, Streptococcus pneumoniae, beta-haemolytic streptococci and aerobic Gram-negative bacilli was confirmed. A 90% or better cure rate was achieved with both drugs. At late follow up, three patients treated initially with cefmetazole had recurrent signs and symptoms. However, these three patients had vascular insufficiency which predisposed them to infection. Since cefmetazole has a longer half-life than cefoxitin, it may prove to be more convenient, or more cost effective, or both, in these and other infections. PMID- 2722727 TI - Cefmetazole versus cefoxitin in prevention of infections after abdominal surgery. AB - Patients undergoing elective abdominal surgery were randomized to receive cefmetazole or cefoxitin in a three-dose perioperative prophylactic regimen. There were three infections in 89 evaluable patients receiving cefmetazole. There were six infections in 39 patients receiving cefoxitin. Both regimens were acceptable with minimal toxicity. PMID- 2722728 TI - Comparative intraoperative concentrations of two cephalosporins with activity against anaerobic bacteria. AB - We determined the intraoperative concentrations of cefmetazole and cefoxitin in serum and muscle from the wound of 30 patients who were undergoing cholecystectomies. The study employed an open-label design in which all patients randomly received cefoxitin sodium (30 mg/kg) or cefmetazole sodium (15 or 30 mg/kg) intravenously with the induction of anesthesia. Total serum and wound muscle concentrations achieved with cefmetazole 30 mg/kg were significantly greater than those achieved with a similar dose of cefoxitin. Cefmetazole in a 15 mg/kg dose was comparable with cefoxitin 30 mg/kg in achieved concentrations. The elimination half-life for cefoxitin was much shorter than that for cefmetazole (41 min v. 64-68 min, respectively) and this relates to a shorter duration of action for the former. The choice of agent for surgical prophylaxis should incorporate factors relating to drug pharmacokinetic properties as well as microbiological factors. PMID- 2722730 TI - The ethics of veterinary biophotography. PMID- 2722729 TI - Prophylaxis in caesarean section with cefmetazole and cefoxitin. AB - A prospective, randomized, open comparison of three 1 g doses of cefmetazole with three 2 g doses of cefoxitin for non-elective Caesarean section was performed. Sixty-nine patients were evaluated. The two groups were comparable with respect to labour characteristics that might influence risk of postoperative infectious morbidity. Similarly, the nature of the bacterial contamination/infection of the amniotic fluid at the time of Caesarean section was comparable in the two groups. The only infectious morbidity noted was endomyometritis. The incidence was the same in both groups, 5/50 (10%) in the cefmetazole group and 2/19 (10.5%) in the cefoxitin group. Febrile morbidity, as reflected in the fever index, was not significantly different between the groups, 10.2 +/- 18.5 degree hours in the cefmetazole group and 7.5 +/- 11.7 degree hours in the cefoxitin group. Cefmetazole appeared to be equivalent to cefoxitin in reducing post-Caesarean section endomyometritis. PMID- 2722731 TI - Architectural photography for the biophotographer. Part I: Exteriors. PMID- 2722732 TI - An all-purpose photo utility belt. PMID- 2722733 TI - Understanding accommodative response. PMID- 2722734 TI - R.I.T. internships: expectations vs. realities. PMID- 2722735 TI - Portraiture, a simplified approach. PMID- 2722736 TI - Purification and characterization of a novel form of 20 alpha-hydroxysteroid dehydrogenase from Clostridium scindens. AB - We have purified a steroid-inducible 20 alpha-hydroxysteroid dehydrogenase from Clostridium scindens to apparent homogeneity. The final enzyme preparation was purified 252-fold, with a recovery of 14%. Denaturing and nondenaturing polyacrylamide gradient gel electrophoresis showed that the native enzyme (Mr, 162,000) was a tetramer composed of subunits with a molecular weight of 40,000. The isoelectric point was approximately pH 6.1. The purified enzyme was highly specific for adrenocorticosteroid substrates possessing 17 alpha, 21-dihydroxy groups. The purified enzyme had high specific activity for the reduction of cortisone (Vmax, 280 nmol/min per mg of protein; Km, 22 microM) but was less reactive with cortisol (Vmax, 120 nmol/min per mg of protein; Km, 32 microM) at pH 6.3. The apparent Km for NADH was 8.1 microM with cortisone (50 microM) as the cosubstrate. Substrate inhibition was observed with concentrations of NADH greater than 0.1 mM. The purified enzyme also catalyzed the oxidation of 20 alpha dihydrocortisol (Vmax, 200 nmol/min per mg of protein; Km, 41 microM) at pH 7.9. The apparent Km for NAD+ was 526 microM. The initial reaction velocities with NADPH were less than 50% of those with NADH. The amino-terminal sequence was determined to be Ala-Val-Lys-Val-Ala-Ile-Asn-Gly-Phe-Gly-Arg. These results indicate that this enzyme is a novel form of 20 alpha-hydroxysteroid dehydrogenase. PMID- 2722737 TI - Thermus thermophilus 16S rRNA is transcribed from an isolated transcription unit. AB - A cloned 16S rRNA gene from the extreme thermophilic eubacterium Thermus thermophilus HB8 was used to characterize the in vivo expression of the 16S rRNA genes in this organism by nuclease S1 mapping. The gene represents an isolated transcription unit encoding solely 16S rRNA. Under exponential growth conditions, transcription was initiated at a single promoter, which represents the structural equivalent of Escherichia coli rrn P2 promoters. The promoter-leader region was very similar to the E. coli rrn P2 promoter-leader segment that is responsible for antitermination. The T. thermophilus leader region was approximately 85 nucleotides shorter than its E. coli P2 counterpart. Potential processing intermediates were correlated with a proposed secondary structure of T. thermophilus pre-16S rRNA. PMID- 2722738 TI - Concentration-dependent repression of the soluble and membrane components of the Streptococcus mutans phosphoenolpyruvate: sugar phosphotransferase system by glucose. AB - Growth of Streptococcus mutans Ingbritt in continuous culture (pH 7.0, dilution rate of 0.1 h-1) at medium glucose concentrations above 2.6 mM resulted in repression of the sugar-specific membrane components, enzyme IIGlc (EIIGlc) and EIIMan, of the phosphoenolpyruvate:sugar phosphotransferase system (PTS). In one experiment, significant repression (27-fold) was observed with 73 mM glucose when the glycolytic capacity of the cells was reduced by only 2-fold and when the culture was still glucose limited. In a more comprehensive experiment in which cells were grown in continuous culture at eight glucose concentrations from 2.6 to 304 mM, in addition to repression of specific EII activities for glucose, mannose, 2-deoxyglucose, and fructose, synthesis of the general protein, EI, was repressed at all glucose levels above 2.6 mM to a maximum of 4-fold at 304 mM glucose when the culture was growing with excess glucose (i.e., nitrogen limited). The other PTS general protein, HPr, was less sensitive to the exogenous glucose level but was nevertheless repressed fourfold under glucose-excess conditions. The Km for glucose for EIIGlc increased from 0.22 mM during growth at 3.6 mM glucose (glucose limited) to 0.48 mM at 271 mM glucose (glucose excess). The shift from heterofermentation to homofermentation during growth with increasing glucose levels suggests the involvement of glycolytic intermediates, ATP, or another high-energy phosphate metabolite in regulation of the synthesis of the PTS components in S. mutans. PMID- 2722739 TI - Anaerobic oxidation of p-cresol mediated by a partially purified methylhydroxylase from a denitrifying bacterium. AB - Anoxic cell extracts of a denitrifying bacterial isolate (PC-07) were shown to oxidize p-cresol to p-hydroxybenzoate. Oxidation of the substrate was independent of molecular oxygen and required nitrate as the natural terminal electron acceptor. Two enzyme activities were implicated in the pathway utilized by PC-07. A p-cresol methylhydroxylase mediated the oxidation of p-cresol to p hydroxybenzaldehyde, which was further oxidized to p-hydroxybenzoate by an NAD+ dependent dehydrogenase. The PC-07 methylhydroxylase was partially purified by anion-exchange chromatography. The protein appeared to be a multifunctional flavocytochrome, which first oxidized p-cresol to p-hydroxybenzyl alcohol, which was then oxidized to p-hydroxybenzaldehyde. The identity of the aldehyde was confirmed by mass spectroscopy. The PC-07 methylhydroxylase had a limited substrate range and required an alkyl-substituted phenolic ring with a hydroxyl group in the para position. From the available evidence, p-cresol, a naturally occurring phenol, exhibited the greatest affinity to the enzyme and therefore may be its natural substrate. PMID- 2722740 TI - Transport of glutamine by Streptococcus bovis and conversion of glutamine to pyroglutamic acid and ammonia. AB - Streptococcus bovis JB1 cells energized with glucose transported glutamine at a rate of 7 nmol/mg of protein per min at a pH of 5.0 to 7.5; sodium had little effect on the transport rate. Because valinomycin-treated cells loaded with K and diluted into Na (pH 6.5) to create an artificial delta psi took up little glutamine, it appeared that transport was driven by phosphate-bond energy rather than proton motive force. The kinetics of glutamine transport by glucose energized cells were biphasic, and it appeared that facilitated diffusion was also involved, particularly at high glutamine concentrations. Glucose-depleted cultures took up glutamine and produced ammonia, but the rate of transport per unit of glutamine (V/S) by nonenergized cells was at least 1,000-fold less than the V/S by glucose-energized cells. Glutamine was converted to pyroglutamate and ammonia by a pathway that did not involve a glutaminase reaction or glutamate production. No ammonia production from pyroglutamate was detected. S. bovis was unable to take up glutamate, but intracellular glutamate concentrations were as high as 7 mM. Glutamate was produced from ammonia via a glutamate dehydrogenase reaction. Cells contained high concentrations of 2-oxoglutarate and NADPH that inhibited glutamate deamination and favored glutamate formation. Since the carbon skeleton of glutamine was lost as pyroglutamate, glutamate formation occurred at the expense of glucose. Arginine deamination is often used as a taxonomic tool in classifying streptococci, and it had generally been assumed that other amino acids could not be fermented. To our knowledge, this is the first report of glutamine conversion to pyroglutamate and ammonia in streptococci. PMID- 2722741 TI - Evidence for posttranslational modification and gene duplication of Campylobacter flagellin. AB - A gene encoding a flagellin protein of Campylobacter coli VC167 has been cloned and sequenced. The gene was identified in a pBR322 library by hybridization to a synthetic oligonucleotide probe corresponding to amino acids 4 to 9 of the N terminal sequence obtained by direct chemical analysis (S. M. Logan, L. A. Harris, and T. J. Trust, J. Bacteriol. 169:5072-5077, 1987). The DNA was sequenced and shown to contain an open reading frame encoding a protein with a molecular weight of 58,945 and a length of 572 amino acids. The deduced amino acid sequence was identical to the published N-terminal amino acid sequence of VC167 flagellin and to four internal regions whose partial sequences were obtained by direct chemical analysis of two tryptic and two cyanogen bromide peptides of VC167 flagellin. The C. coli flagellin protein contains posttranslationally modified serine residues, most of which occur within a region containing two 9-amino-acid repeating peptides separated by 34 unique amino acids. Comparisons with the sequences of flagellins from other bacterial species revealed conserved residues at the amino- and carboxy-terminal regions. Hybridization data suggest the presence of a second flagellin copy located adjacent to the first on the VC167 chromosome. PMID- 2722742 TI - Cloning and sequencing of the gene encoding the 72-kilodalton dehydrogenase subunit of alcohol dehydrogenase from Acetobacter aceti. AB - A genomic library of Acetobacter aceti DNA was constructed by using a broad-host range cosmid vector. Complementation of a spontaneous alcohol dehydrogenase deficient mutant resulted in the isolation of a plasmid designated pAA701. Subcloning and deletion analysis of pAA701 limited the region that complemented the deficiency in alcohol dehydrogenase activity of the mutant. The nucleotide sequence of this region was determined and showed that this region contained the full structural gene for the 72-kilodalton dehydrogenase subunit of the alcohol dehydrogenase enzyme complex. The predicted amino acid sequence of the gene showed homology with sequences of methanol dehydrogenase structural genes of Paracoccus denitrificans and Methylobacterium organophilum. PMID- 2722743 TI - Streptomyces lipmanii expresses two restriction systems that inhibit plasmid transformation and bacteriophage plaque formation. AB - Bacteriophage host range studies suggested that several beta-lactam-producing streptomycetes express similar restriction-modification systems. Streptomyces lipmanii LE32 expressed two restriction-modification systems, designated SliI and SliII. A mutant strain, PM87, was defective only in SliI restriction but expressed both SliI and SliII modification. Streptomyces sp. strain A57986, a natural isolate partially deficient in the expression of SliI and SliII restriction, nevertheless modified bacteriophage DNA for both SliI and SliII specificities. Protoplasts of PM87 and A57986 were transformed by several plasmids, and the modified plasmids isolated from these strains transformed wild type S. lipmanii efficiently. PMID- 2722744 TI - Construction and characterization of an Azotobacter vinelandii strain with mutations in the genes encoding flavodoxin and ferredoxin I. AB - Flavodoxin and ferredoxin I have both been implicated as components of the electron transport chain to nitrogenase in the aerobic bacterium Azotobacter vinelandii. Recently, the genes encoding flavodoxin (nifF) and ferredoxin I (fdxA) were cloned and sequenced and mutants were constructed which are unable to synthesize either flavodoxin (DJ130) or ferredoxin I (LM100). Both single mutants grow at wild-type rates under N2-fixing conditions. Here we report the construction of a double mutant (DJ138) which does not synthesize either flavodoxin or ferredoxin I. When plated on ammonium-containing medium, this mutant had a very small colony size when compared with the wild type, and in liquid culture with ammonium, this double mutant grew three times slower than the wild type or single mutant strains. This demonstrated that there is an important metabolic function unrelated to nitrogen fixation that is normally carried out by either flavodoxin or ferredoxin. If either one of these proteins is missing, the other can substitute for it. The double mutant phenotype can now be used to screen site-directed mutant versions of ferredoxin I for functionality in vivo even though the specific function of ferredoxin I is still unknown. The double mutant grew at the same slow rate under N2-fixing conditions. Thus, A. vinelandii continues to fix N2 even when both flavodoxin and ferredoxin I are missing, which suggests that a third as yet unidentified protein also serves as an electron donor to nitrogenase. PMID- 2722745 TI - Plasmid dependence of Pseudomonas sp. strain NK87 enzymes that degrade 6 aminohexanoate-cyclic dimer. AB - A bacterial strain, Pseudomonas sp. strain NK87, that can use 6-aminohexanoate cyclic dimer as the sole source of carbon and nitrogen was newly isolated from wastewater of a factory which produces nylon-6. Two responsible enzymes, 6 aminohexanoate-cyclic-dimer hydrolase (P-EI) and 6-aminohexanoate-dimer hydrolase (P-EII), were found in the NK87 strain, as is the case with Flavobacterium sp. strain KI72, another 6-aminohexanoate-cyclic-dimer-metabolizing bacterium (H. Okada, S. Negoro, H. Kimura, and S. Nakamura, Nature [London] 306:203-206, 1983). The P-EI enzyme is immunologically identical to the 6-aminohexanoate-cyclic-dimer hydrolase of KI72 (F-EI). However, antiserum against the 6-aminohexanoate-dimer hydrolase purified from KI72 (F-EII) did not react with cell extracts of NK87, indicating that the F-EII and P-EII enzymes are immunologically different. Restriction endonuclease analyses show that the NK87 strain harbors at least six plasmids ranging in size from 20 to 80 kilobase pairs (kbp). The P-EI and P-EII genes were cloned in Escherichia coli. Both the P-EI and F-EI probes strongly hybridized with a 23-kbp plasmid in Southern hybridization analyses. The P-EII probe hybridized specifically with an 80-kbp plasmid, but the F-EII probe hybridized with none of the plasmids harbored in NK87. These results indicate that the P-EI gene and P-EII gene are encoded on the 23-kbp and 80-kbp plasmids, respectively. PMID- 2722746 TI - High homology between 6-aminohexanoate-cyclic-dimer hydrolases of Flavobacterium and Pseudomonas strains. AB - The nucleotide sequences of the genes for 6-aminohexanoate-cyclic-dimer hydrolases of Flavobacterium sp. strain K172 (F-nylA) and Pseudomonas sp. NK87 (P nylA), enzymes essential for the degradation of a by-product of the nylon-6 industry, were obtained by the dideoxynucleotide chain-termination method. A 1,479-base-pair open reading frame starting at a GTG and terminating at a TGA was found for the both of the genes. The P-nylA and F-nylA genes encoded polypeptides of 493 amino acids and had only 10 base substitutions in the coding region, which caused seven amino acid substitutions. PMID- 2722747 TI - Biochemical evidence that starch breakdown by Bacteroides thetaiotaomicron involves outer membrane starch-binding sites and periplasmic starch-degrading enzymes. AB - Bacteroides thetaiotaomicron can utilize amylose, amylopectin, and pullulan as sole sources of carbon and energy. The enzymes that degrade these polysaccharides were found to be primarily cell associated rather than extracellular. Although some activity was detected in extracellular fluid, this appeared to be the result of cell lysis. The cell-associated amylase, amylopectinase, and pullulanase activities partitioned similarly to the periplasmic marker, acid phosphatase, when cells were exposed to a cold-shock treatment. Two other enzymes associated with starch breakdown, alpha-glucosidase and maltase, appeared to be located in the cytoplasm. Intact cells of B. thetaiotaomicron were found to bind 14C-starch. Binding was probably mediated by a protein because it was saturable and was decreased by treatment of cells with proteinase K. Results of competition experiments showed that the starch-binding proteins had a preference for maltodextrins larger than maltohexaose and a low affinity for maltose and maltotriose. Both the degradative enzymes and starch binding were induced by maltose. These findings indicate that starch utilization by B. thetaiotaomicron apparently does not involve secretion of extracellular enzymes. Rather, binding of the starch molecule to the cell surface appears to be a first step to passing the molecule through the outer membrane and into the periplasmic space. PMID- 2722748 TI - Genetic evidence that outer membrane binding of starch is required for starch utilization by Bacteroides thetaiotaomicron. AB - Mutagenesis of Bacteroides thetaiotaomicron with the transposon Tn4351 produced five classes of mutants that were not able to grow on amylose or amylopectin. These classes of mutants differed in their ability to grow on maltoheptaose (G7) and in the level of starch-degrading enzymes produced when bacteria were grown on maltose. All of the mutants were deficient in starch binding. Since one class of mutants retained normal levels of starch-degrading enzymes, this indicates that binding of the starch molecule by a cell surface receptor is necessary for starch utilization by B. thetaiotaomicron. Analysis of a starch-negative mutant that grew on G7 indicated that B. thetaiotaomicron possessed two starch-binding components or sites. One component (site A), apparently missing in this mutant, had an absolute preference for larger starch oligomers, whereas the other component (site M) also had a high affinity for maltodextrins (G4 through G7). Mutants not able to grow on maltodextrins (greater than G4) probably lacked both of these binding components. Only one class of mutants did not grow normally on maltose, but instead had a 4- to 5-h lag on maltose and a slower growth rate than the wild type. This class of mutants did not produce any of the starch-degrading enzymes or bind starch, even when growing on maltose. Such a phenotype probably resulted from transposon inactivation of a central regulatory gene or a gene encoding an enzyme that produces the inducer. The fact that both the degradative enzymes and the starch-binding activity were affected in this mutant indicates that genes encoding the cell surface starch-binding site are under the same regulatory control as genes encoding the enzymes. PMID- 2722749 TI - Purification and properties of L-alanine dehydrogenase of the phototrophic bacterium Rhodobacter capsulatus E1F1. AB - In the phototrophic nonsulfur bacterium Rhodobacter capsulatus E1F1, L-alanine dehydrogenase aminating activity functions as an alternative route for ammonia assimilation when glutamine synthetase is inactivated. L-Alanine dehydrogenase deaminating activity participates in the supply of organic carbon to cells growing on L-alanine as the sole carbon source. L-Alanine dehydrogenase is induced in cells growing on pyruvate plus nitrate, pyruvate plus ammonia, or L alanine under both light-anaerobic and dark-heterotrophic conditions. The enzyme has been purified to electrophoretic and immunological homogeneity by using affinity chromatography with Red-120 agarose. The native enzyme was an oligomeric protein of 246 kilodaltons (kDa) which consisted of six identical subunits of 42 kDa each, had a Stokes' radius of 5.8 nm, an s20.w of 10.1 S, a D20,w of 4.25 x 10(-11) m2 s-1, and a frictional quotient of 1.35. The aminating activity was absolutely specific for NADPH, whereas deaminating activity was strictly NAD dependent, with apparent Kms of 0.25 (NADPH), 0.15 (NAD+), 1.25 (L-alanine), 0.13 (pyruvate), and 16 (ammonium) mM. The enzyme was inhibited in vitro by pyruvate or L-alanine and had two sulfhydryl groups per subunit which were essential for both aminating and deaminating activities. PMID- 2722750 TI - Two nifA-like genes required for expression of alternative nitrogenases by Azotobacter vinelandii. AB - Two nifA-like genes, designated anfA and vnfA, have been identified in Azotobacter vinelandii. The anfA gene is located upstream from the nitrogenase-3 structural gene cluster (anfHDGK) and is preceded by a sequence that is potentially part of a ntrA-dependent promoter. The product of anfA appears to be required for expression of nitrogenase-3, since cells of the anfA deletion strain CA66 were unable to synthesize this nitrogenase when derepressed in N-free, Mo- and V-deficient medium. The vnfA gene was identified after determination of the nucleotide sequence of DNA flanking the Tn5 insertion in mutant strain CA46. Two open reading frames (ORF1 and ORF2) were found located upstream from the vnfA gene, and a nifE-like ORF, preceded by a possible ntrA-dependent promoter, was found downstream from this gene. It is not known whether vnfA is expressed only under N2-fixing conditions. However, potential ntrA-dependent promoters were found immediately upstream from vnfA (within the 3' end of ORF2) and immediately downstream from ORF1. The region spanning ORF1 and ORF2 contained an A + T-rich sequence that was also found immediately upstream from the potential ntrA dependent promoter of anfA. The product of vnfA appears to be required for the synthesis of nitrogenase-2, since cells of strain CA46 synthesized only nitrogenase-1 and -3 but not nitrogenase-2 when grown in the presence of vanadium. The product of nifA, which is required for synthesis of nitrogenase-1, is not required for synthesis of either nitrogenase-2 or nitrogenase-3. However, growth data indicate that nifA is required for a factor (or factors) necessary for maximal diazotrophic growth under Mo- and V-deficient conditions. PMID- 2722751 TI - The central domain of Rhizobium meliloti NifA is sufficient to activate transcription from the R. meliloti nifH promoter. AB - The Rhizobium meliloti nifA product (NifA) shares extensive homology in its central region and at its C-terminal end with Rhizobium leguminosarum DctD and with NtrC from several species. All three proteins are transcriptional activators of NtrA (RpoN)-RNA polymerase-dependent promoters. Several large deletions of R. meliloti NifA were constructed to investigate the role of the conserved and divergent domains of NifA in transcriptional activity and posttranscriptional regulation by oxygen. The ability of NifA expressed from the Escherichia coli lacZ promoter to activate the R. meliloti nifH promoter in E. coli and R. meliloti was tested under a range of defined atmospheric oxygen partial pressures. Deletion of the divergent N-terminal domain of NifA had little effect on NifA activity and no effect on oxygen sensitivity. Deletion of the conserved C terminal helix-turn-helix motif of NifA did not eliminate NifA-dependent activation of the nifH promoter, although it did decrease NifA activity about twofold in E. coli and 10-fold in R. meliloti. A NifA carrying both the N terminal and C-terminal deletions and consisting of only the central highly conserved domain and 50 divergent amino acids retained the ability to activate transcription from the nifH promoter. The transcriptional activity of the conserved central domain is consistent with the prediction that the core domain is the part of NifA which interacts with the transcriptional machinery to stimulate transcription. PMID- 2722752 TI - Replication origins of single-stranded-DNA plasmid pUB110. AB - The two replication origins of plasmid pUB110 have been characterized. The site of initiation of DNA replication at the plus origin was mapped to within an 8 base-pair sequence. DNA synthesis initiated at the origin was made to terminate precociously in an inserted sequence of 18 base pairs that is homologous to a sequence in the origin. This suggests that pUB110 replicates as a rolling circle. The minus origin of plasmid pUB110 has been characterized, and the minimal sequence required for function has been determined. As with other minus origins, activity is orientation specific with respect to the direction of replication. Its activity is sensitive to rifampin in vivo, suggesting that RNA polymerase catalyzes single-strand to double-strand conversion. Unlike all other plasmids of gram-positive bacteria thus far described, the pUB110 minus origin is functional in more than one host. PMID- 2722753 TI - Recruitment of a chromosomally encoded maleylacetate reductase for degradation of 2,4-dichlorophenoxyacetic acid by plasmid pJP4. AB - When Pseudomonas aeruginosa PAO1c or P. putida PPO200 or PPO300 carry plasmid pJP4, which encodes enzymes for the degradation of 2,4-dichlorophenoxyacetic acid (TFD) to 2-chloromaleylacetate, cells do not grow on TFD and UV-absorbing material with spectral characteristics of chloromaleylacetate accumulates in the culture medium. Using plasmid pRO1727, we cloned from the chromosome of a nonfluorescent pseudomonad, Pseudomonas sp. strain PKO1, 6- and 0.5-kilobase BamHI DNA fragments which contain the gene for maleylacetate reductase. When carrying either of the recombinant plasmids, pRO1944 or pRO1945, together with pJP4, cells of P. aeruginosa or P. putida were able to utilize TFD as a sole carbon source for growth. A novel polypeptide with an estimated molecular weight of 18,000 was detected in cell extracts of P. aeruginosa carrying either plasmid pRO1944 or plasmid pRO1945. Maleylacetate reductase activity was induced in cells of P. aeruginosa or P. putida carrying plasmid pRO1945, as well as in cells of Pseudomonas strain PKO1, when grown on L-tyrosine, suggesting that the tyrosine catabolic pathway might be the source from which maleylacetate reductase is recruited for the degradation of TFD in pJP4-bearing cells of Pseudomonas sp. strain PKO1. PMID- 2722754 TI - Identification of cyclic intermediates in Azorhizobium caulinodans nicotinate catabolism. AB - In wild-type Azorhizobium caulinodans ORS571, nicotinate served both as anabolic substrate for NAD+ production and as catabolic substrate for use as the N source. Catabolic enzyme activities were greatest from cultures grown with nicotinate as the N source and least when cultures were grown with ammonium as the N source. Vector insertion mutants unable to catabolize nicotinate (nic::Vi mutants) still required micromolar quantities of this compound for growth. Therefore, A. caulinodans wild type is NAD+ auxotrophic. As the first two intermediates in A. caulinodans nicotinate catabolism, two cyclic compounds, 6-hydroxynicotinate and 1,4,5,6-tetrahydro-6-oxonicotinate, were identified. These compounds were purified from the growth medium of strain 61009 (a nic::Vi mutant) by high performance liquid chromatography; their identities were subsequently confirmed by UV absorbance, nuclear magnetic resonance, and mass spectra. The conversion of 1 mol of nicotinate to 6-hydroxynicotinate consumed 0.5 mol of O2. From 18O isotopic incorporation experiments, water was the hydroxyl-equivalent source. A nicotinate hydroxylase activity proved to be cell wall-membrane associated; this activity served as direct electron donor (not indirect via NADP+) to O2 via membrane electron transport. These catabolic reactions have not previously been witnessed together in the same organism. A. caulinodans nicotinate catabolism seems coupled to N2 fixation, although the explicit mechanism of this coupling remains to be determined. PMID- 2722755 TI - Chemical basis of rough and smooth variation in mycobacteria. AB - Rough and smooth colony variants of Mycobacterium kansasii were compared with respect to surface glycolipid composition. Thin-layer chromatography of the native glycolipid antigens, gas chromatography of the constituent sugars, and in situ probing with an appropriate monoclonal antibody by colony dot blot enzyme linked immunosorbent assay and immunogold labeling demonstrated that all M. kansasii strains of smooth colony morphology contain on their surfaces the recently described trehalose-containing lipooligosaccharides, whereas all rough variants were devoid of such surface antigens. Yet all strains, rough and smooth, contained another glycolipid, the M. kansasii-specific phenolic glycolipid. Previous studies by others had shown that the rough forms of M. kansasii persist longer than smooth variants in experimentally infected mice. Therefore, this study may provide some insight into the question of the chemical basis of pathogenesis in certain mycobacteria. PMID- 2722756 TI - Isolation and characterization of the rRNA gene clusters of Halobacterium marismortui. AB - Two rRNA operons of Halobacterium marismortui were identified and cloned into plasmid pBR322 as 10- and 20-kilobase-pair (kbp) HindIII fragments, respectively. Restriction maps of the 10-kbp clone (pHH10) and an 8-kbp HindIII-ClaI subclone (pHC8) of the other operon were established. Southern hybridization of 16S, 23S, and 5S rRNA probes to the clones demonstrated that both operons code for the three rRNA species. By S1 nuclease analysis, the transcription initiation sites, some of the processing sites within the primary transcripts, and the boundaries of the mature 16S and 23S rRNA molecules were determined. Both operons are transcribed in vivo. Comparison of the two operons indicated that they are not identical. The most striking difference between the operons is the existence of three putative transcription initiation sites in one operon (HC8) and only one such site in the other operon (HH10). The regions surrounding these 5' transcript end sites share a high level of sequence similarity to each other and to the rRNA promoter regions of other halophilic archaebacteria. Analysis of the proximal 130 nucleotides of the two 16S rRNA genes indicated greater-than-expected sequence heterogeneity. There are a 2-base-pair insertion in the HC8 16S gene and 10 additional sites of nucleotide sequence heterogeneity. PMID- 2722757 TI - Calcofluor- and lectin-binding exocellular polysaccharides of Azospirillum brasilense and Azospirillum lipoferum. AB - Extracellular polysaccharides synthesized by Azospirillum brasilense and A. lipoferum were shown on agar plates and liquid flocculating cultures. The six strains used in this work expressed a mucoid phenotype, yielding positive calcofluor fluorescence under UV light. The calcofluor-binding polysaccharides were distributed between the capsular and exopolysaccharide fractions, suggesting exocellular localization. No calcofluor fluorescence was observed in residual cells after separation of the capsular and exopolysaccharide fractions. Cellulose content was significantly higher in flocculating than in nonflocculating cultures. Failure to induce flocculation by addition of cellulose (100 mg/ml) to nonflocculating cultures, together with the sensitivity of flocs to cellulase digestion, suggested that cellulose is involved in maintenance of floc stability. Different A. brasilense and A. lipoferum strains bound to a wheat lectin (fluorescein isothiocyanate-wheat germ agglutinin), indicating the occurrence of specific sugar-bearing receptors for wheat germ agglutinin on the cell surface. The biochemical specificity of the reaction was shown by hapten inhibition with N acetyl-D-glucosamine. All six strains failed to recognize fluorescein isothiocyanate-soybean seed lectin under our experimental conditions. We conclude that azospirilla produce exocellular polysaccharides with calcofluor- and lectin binding properties. PMID- 2722759 TI - Interspecific complementation analysis by protoplast fusion of Candida tropicalis and Candida albicans adenine auxotrophs. AB - A protocol employing inositol starvation was used to isolate proline and adenine auxotrophs of Candida tropicalis. Interspecific hybrids between red adenine auxotrophs of C. tropicalis and Candida albicans were formed by protoplast fusion. These C. tropicalis red adenine auxotrophs were shown to fall into two complementation groups by crossing them with a known C. albicans ade1 tester strain. It is suggested that these two groups correspond to the ade1 and ade2 mutants of Saccharomyces cerevisiae and C. albicans and that these defined mutants may be useful in attempts to develop transformation systems for C. tropicalis. PMID- 2722758 TI - Overproduced bacteriophage T4 gene 33 protein binds RNA polymerase. AB - Bacteriophage T4 gene 33 protein (gp33), which is required for viral late transcription, has been overproduced. The purified gp33 binds to RNA polymerase core from uninfected or T4-infected Escherichia coli, but the major E. coli transcription initiation factor, sigma 70, competed effectively for this binding. PMID- 2722760 TI - Diagnosis of affective disorders and schizophrenia in the U.S.: a 1984 survey of psychiatrists and graduating residents. AB - During a 5-month period in 1983 and 1984, the authors surveyed a random sample of U.S. psychiatrists and all psychiatric residents graduating in 1984, with response rates of 56.1% and 51.9% respectively. They report the diagnostic classifications and subtypes used by the clinicians as well as the clinical features required by the clinicians to diagnose affective disorders and schizophrenia. When diagnosing schizophrenia, the graduating residents differed from their senior colleagues by giving more importance to the course of illness, duration of symptoms, and exclusion of affective disorder. These findings are discussed in light of past surveys and the development of new diagnostic systems. PMID- 2722761 TI - Ca2+-sensitive transition in the molecular conformation of molluscan muscle myosins. AB - Filament assemblies of myosin molecules purified from scallop adductor muscles were stabilized by Ca2+ in the presence of ATP or ADP. Electron micrographs showed that the tail part of monomeric myosin molecules was folded in the absence of Ca2+, but was extended in the presence of Ca2+ at physiological ionic strength. PMID- 2722762 TI - Molecular cloning and sequence analysis of cDNA containing the entire coding region for human fetal liver cytochrome P-450. AB - From a human fetal liver cDNA library, a cDNA clone (lambda HFL33) containing the entire coding region for a form of cytochrome P-450 related to P-450 HFLa was obtained. The clone was 1,971 bp long and had an open reading frame of 1,509 nucleotides coding for a 503 amino acid polypeptide. The nucleotide and the deduced amino acid sequences of lambda HFL33 were very similar to but clearly distinct from those of NF25 and HLp cDNAs, which code for forms of cytochrome P 450 in adult human liver. The deduced N-terminal amino acid sequence of the HFL33 protein was identical to that of P-450 HFLa. PMID- 2722763 TI - Effect of polyamines on globin synthesis in a rabbit reticulocyte polyamine-free protein synthetic system. AB - A polyamine-free protein synthetic system, established from components of rabbit reticulocytes, consisted of globin mRNA, salt-washed ribosomes, partially purified initiation factors, and pH 5 enzymes. Spermidine added to this system not only lowered the optimal magnesium concentration required for globin synthesis, but it also stimulated the globin synthesis 6- to 8-fold. The optimal spermidine concentration was 0.4 to 0.6 mM, a concentration similar to that in intact rabbit reticulocytes. The ratio of alpha to beta globin chains synthesized in the presence of spermidine and Mg2+ was approximately 1.0, while the ratio in the presence of only Mg2+ was approximately 1.5. Formation of methionyl puromycin was stimulated 4- to 6-fold by spermidine. This indicates that the stimulation is mainly at the level of initiation. PMID- 2722764 TI - Ether phospholipid molecular species in human platelets. AB - Molecular species of diacyl, alkenylacyl, and alkylacyl subclasses in human platelet phospholipids were quantitatively analyzed. Dinitrobenzoyldiradylglycerol derivatives prepared from phosphatidylcholine and phosphatidylethanolamine were separated into subclasses by TLC or normal-phase HPLC. Each subclass consisting of more than 20 molecular species was quantified by reverse-phase HPLC with the eluting solvent of acetonitrile-2-propanol (80 : 20). The retention times of molecular species in the alkenylacyl and alkylacyl subclasses were approximately 1.24 and 1.56 times as long as that of the diacyl type. Phosphatidylcholine contained mostly diacyl subclass (94.5%) and small amounts of alkenylacyl (0.8%) and alkylacyl (4.7%) subclasses, while phosphatidylethanolamine was comprised of 44.2% diacyl, 54.4% alkenylacyl, and 1.4% alkylacyl subclasses. The diacyl subclass of phosphatidylcholine mainly consisted of monoenoic and dienoic molecular species, whereas the other subclasses of phosphatidylcholine and all subclasses of phosphatidylethanolamine were mostly comprised of polyenoic molecular species. The distribution of arachidonic acid-containing molecular species in the diacyl, alkenylacyl, and alkylacyl subclasses were 18.7, 48.2, and 47.9%, respectively, in phosphatidylcholine, and 60.1, 63.0, and 46.9% in phosphatidylethanolamine. Hence, the alkylacyl and alkenylacyl subclasses of phosphatidylcholine seem to play physiological roles different from the diacyl subclass in human platelets. PMID- 2722765 TI - Comparison of the cytoskeleton fractions of rat red blood cells prepared with non ionic detergents. AB - The characteristics of cytoskeleton fractions prepared from rat red cell ghosts with four non-ionic detergents were studied. One percent (w/v) solutions of Triton X-100, Emulgen 911, MEGA-9 (nonanoyl-N-methylglucamide), and octylglucoside solubilized 78, 68, 80, and 92% of the ghost phospholipid, while they solubilized 82, 78, 72, and 62% of the ghost band 3, a transmembrane protein, respectively. There was no correlation between the solubilization percentages of phospholipid and band 3. Phospholipids retained in cytoskeleton fractions were shown to exist as blebs on the surface by electron microscopic observation. The cytoskeleton fraction prepared with octylglucoside retained about two-fold more band 3 than that with Triton X-100 (Triton shells). However, cytoskeleton fractions prepared from p-chloromercuribenzoate-treated ghosts with the two detergents retained almost equal amounts of band 3, less than 5% of that in the ghosts. Under this condition, most of band 2.1, a protein linking band 3 to the spectrin-actin network, was released from the cytoskeleton fractions. The band 3 solubilized with octylglucoside sedimented faster in a linear sucrose gradient and had a larger Stokes' radius than that with Triton X-100, which is known to exist as dimer. These results strongly suggest that octylglucoside does not disturb the association of tetrameric band 3 with the spectrin-actin network, while Triton X-100 dissociates tetrameric band 3 to the dimer, resulting in the difference in the amount of band 3 retained in cytoskeleton fractions. In conclusion, octylglucoside can produce a more native cytoskeleton fraction of red cell membranes than Triton shells. PMID- 2722766 TI - The immunological homology between two filamentous cross-linker phosphoproteins, connectin and cross-bridge region of neurofilament-H, is not affected by the phosphorylation state. AB - It has recently been shown that a monoclonal antibody SM 1-36-2 against connectin, an elastic filament of striated muscles, binds to the "elastic" domain of the molecule, and that the H subunit of neurofilament (NF-H), an intermediate filament of nerve cells, shares a homologous domain (Shimizu, T. et al. (1988) Biomed. Res. 9, 227-234 and Itoh, Y. et al. (1988) J. Biochem. 104, 504-508). In order to characterize (1) the intramolecular localization of the domain in the NF H and (2) the effect of the phosphorylation state on the immunoreactivity, the homologous domain in the NF-H was analyzed by Western blotting after limited digestion with trypsin or alpha-chymotrypsin and dephosphorylation with E. coli alkaline phosphatase. It was found that (1) the epitope was located not in the core region but in the carboxyl-terminal peripheral (cross-bridge) region of NF-H and (2) the epitopes in connectin and NF-H were not affected by the phosphorylation state. PMID- 2722767 TI - Leukotriene A4 hydrolase from guinea pig lung: the presence of two catalytically active forms. AB - Leukotriene A4 hydrolase was purified to apparent homogeneity from the guinea pig lung. The molecular weight was determined to be 70 kDa by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The enzyme exhibited two active forms with different pI values (5.7 and 5.4) depending on the presence or absence of SH reducing reagents during purification procedures. No significant differences were observed between both forms of the enzyme as regards the catalytic properties. The N-terminal 20 amino acid sequence (PEVVDTXSLASPATVXRTKH) showed a 90% identity to the human enzyme with a constitutive substitution of Ile-3 and Ser-14 (human) by Val-3 and Thr-14 (guinea pig), respectively. PMID- 2722768 TI - Detection of 10 variants of biliverdin reductase in rat liver by two-dimensional gel electrophoresis. AB - We have identified and characterized multiple forms of biliverdin reductase (BVR) in control rat liver cytosol. Two-dimensional electrophoresis of the purified BVR resolved a minimum of 10 discrete protein zones. All 10 proteins were BVR as judged by immunological cross-reactivity toward rabbit anti-rat BVR. Based on the isoelectric focusing pattern of separation, the BVR variants could be organized into five net-charge groups designated as BVR-IEF1 to BVR-IEF5 and three molecular mass groups designated as BVR-MW1-BVR-MW3, respectively. The pI values of the net-charge groups were: BVR-IEF1, 6.23; IEF2, 5.91; IEF3, 5.76; IEF4, 5.61; IEF5, 5.48. The Mr values of the molecular mass groups were: BVR-MW1, 30,400; MW2, 30,700; MW3, 31,400. Single dimension slab gel isoelectric focusing offered greater resolution of the net charge variants, and BVR-IEF3 was further resolved into two variants, IEF3a and IEF3b, with pIs of 5.77 and 5.75, respectively. The six net-charge variants also resolved on a preparative chromatofocusing column and were designated as BVR-CF1-BVR-CF6. The pH values of the peak fractions were: BVR-CF1, 6.91; CF2, 6.33; CF3, 6.03; CF4, 5.82; CF5, 5.45; CF6, 5.27. Correspondence between the isoelectric focusing net-charge variants and the chromatofocusing net-charge variants was established. The Mr and net-charge variants did not represent partially degraded forms of biliverdin reductase produced during purification since the pattern of resolution of variants on slab gel isoelectric focusing or two-dimensional electrophoresis did not change by purifying the proteins in the presence of protease inhibitors and 5 mM EDTA. BVR-CF2 and BVR-CF4 were purified and examined for pH-dependent cofactor requirements for activity. Both net-charge variants and two pH optima that were cofactor-dependent; maximum activity with NADPH, however, was at pH 8.5 and with NADH at pH 6.7. With both variants, however, a higher catalytic rate was observed with NADH than with NADPH at their respective pH optima. Furthermore, BVR-CF2 exhibited a higher catalytic rate than did BVR-CF4 with either cofactor throughout the pH range of 5-9. PMID- 2722769 TI - Role of water in the energy of hydrolysis of phosphoanhydride and phosphoester bonds. AB - The observed equilibrium constants for hydrolysis (Kobs) of a phosphoester and a phosphoanhydride bond were measured under a variety of conditions likely to alter the interactions of reactants and products with water. These included increasing the pH of the medium from 5.0 to 10.0, increasing the MgCl2 concentration form 0 to 200 mM, and decreasing the water activity of the medium by adding either dimethyl sulfoxide (50%, v/v) or polyethylene glycol 6,000-8,000 (50%, w/v). The Kobs for phosphoesters such as phosphoserine, glucose phosphate, glycerol phosphate, and ethylene glycol phosphate varied little over this wide range of conditions, the extreme values of Kobs being 12 and 200 M. In contrast, the Kobs for the phosphoanhydride bond of pyrophosphate varied from a value greater than 20,000 to 0.1 M. In totally aqueous media at a pH between 7.0 and 8.0 and in the presence of 0.5-1.0 mM MgCl2, the energy of hydrolysis of pyrophosphate was 1.2 4.0 kcal/mol greater than that of phosphoserine. However, when the water activity was decreased by adding polyethylene glycol to the medium within the same pH and MgCl2 concentration range, the energy of hydrolysis of phosphoserine became 2.0 2.5 kcal/mol greater than that of pyrophosphate. The results suggest that for phosphoesters, the solvation energies of reactants and products, unlike the case of phosphoanhydride bonds, are not the major factors in determining the energy of hydrolysis. PMID- 2722770 TI - Axial coordination of ferric Aplysia myoglobin. AB - Resonance Raman spectra of ferric Aplysia myoglobin in the ligand-free and the azide-bound forms have been studied over a wide pH range to determine the coordination states of the heme iron atom. In the hydroxide form at high pH (approximately 9) the iron is six-coordinate and is in a high/low spin equilibrium. As the pH is lowered below the acid/alkaline transition (pKa = 7.5), the heme becomes five-coordinate. When the pH is lowered even further no other changes in the resonance Raman spectrum are detected; thus, the heme remains five coordinate down to pH 4, the lowest value studied. For ferric azide-bound Aplysia myoglobin, the iron is six-coordinate in a high/low spin equilibrium at all pH values (4.8-9). These data indicate (i) that the unusual reactivity toward azide previously observed at neutral pH is indeed related to the absence of a coordinated water molecule, and (ii) that causes other than the heme coordination are responsible for the spectral differences and the ligand-binding kinetics differences observed below pH 6. PMID- 2722771 TI - The molecular structure of the left-handed Z-DNA double helix at 1.0-A atomic resolution. Geometry, conformation, and ionic interactions of d(CGCGCG). AB - The structure of d(CGCGCG) crystallized in the presence of magnesium and sodium ions alone is compared to that of the spermine form of the molecule. The very high resolution nature of these structure determinations allows the first true examination of an oligonucleotide structure in fine detail. The values of bond distances and angles are compared to those derived from small molecule crystal structures. In addition, the interactions of cations and polyamines with the Z DNA helix are analyzed. In particular, multiple cationic charges appear to offer enhanced stabilization for the Z-DNA conformation. The location of spermine molecules along the edge of the deep groove and also spanning the entrance to the groove emphasizes the importance of polyamines for stabilizing this left-handed structure. On averaging, we obtained very similar structural parameters for the two different structures with standard deviations generally smaller than the deviations of the crystallographic model from ideal values. This indicates a high degree of accuracy of the two structures, which have been refined using different data and different refinement methods. The derived bond lengths and angles may thus be more representative of this polymeric DNA structure than those derived from mono- and dinucleotide structures at a similar accuracy. PMID- 2722772 TI - The fatty liver dystrophy (fld) mutation. A new mutant mouse with a developmental abnormality in triglyceride metabolism and associated tissue-specific defects in lipoprotein lipase and hepatic lipase activities. AB - An autosomal recessive mutation, termed fatty liver dystrophy (fld), can be identified in neonatal mice by their enlarged and fatty liver (Sweet, H. O., Birkenmeier, E. H., and Davisson, M. T. (1988) Mouse News Letter 81, 69). We have examined the underlying metabolic abnormalities in fld/fld mice from postnatal days 3-40. Serum and hepatic triglyceride levels were elevated 5-fold in suckling fld/fld mice compared to their +/? littermates but abruptly resolved at the suckling/weaning transition. Blot hybridization analysis of liver and intestinal RNAs revealed a liver-specific increase in apolipoprotein (apo) A-IV and C-II mRNA concentrations (100- and 6-fold, respectively) that was limited to the suckling and early weaning stages in fld/fld mice. Resolution of these differences during the weaning period could not be delayed by prolonging suckling to the 20th postnatal day nor could the mutant phenotype be elicited in young adult animals with a high fat diet. Lipoprotein lipase (LPL) activity was reduced 16-fold in the white adipose tissue of fld/fld mice until the onset of weaning. Heart activity was decreased less than 2-fold, but there were no deficits in brown adipose tissue or liver. Hepatic lipase (HL) mRNA levels and activity were significantly reduced in fld/fld livers and sera, respectively, during the suckling period. Mapping studies show the fld locus to be distinct from loci encoding LPL, HL, and apoA-IV, and those responsible for the combined lipase deficiencies in cld/cld and W/Wv mice. These data suggest that the fld mutation is associated with developmentally programmed tissue-specific defects in the neonatal expression of LPL and HL activities and provide evidence for a new regulatory locus which affects these lipase activities. This mutation could serve as a useful model for (i) analyzing the homeostatic mechanisms controlling lipid metabolism in newborn mice and (ii) understanding and treating certain inborn errors in human triglyceride metabolism. PMID- 2722773 TI - Inhibition by bestatin of a mouse ascites tumor dipeptidase. Reversal by certain substrates. AB - Bestatin, [(2S,3R)-3-amino-2-hydroxy-4-phenyl-butanoyl]-L-leucine, a known inhibitor of aminopeptidases, is shown to be a potent linear competitive inhibitor (KI,2.7 nM) of a dipeptidase purified from Ehrlich-Lettre hyperdiploid mouse ascites tumor cells. This inhibition can be classified as "slow binding" but not as "tight binding." Substrate protects the enzyme from bestatin inhibition when enzyme and inhibitor are in approximately equimolar concentrations. Addition of substrate (6 mM) partially (by about 20%) reverses dipeptidase inhibition by bestatin, but the time required for maximum recovery depends on the nature of the substrate. Substrates with lower Km (0.28-1.4 mM) values that exhibit substantial substrate inhibition require longer times (23-65 min) than those with higher Km values that show little substrate inhibition. Substrates with Km values higher than 1.5 mM do not reverse inhibition. The inhibition of the tumor dipeptidase by bestatin has been compared with inhibition by a variety of inhibitors of other Zn-metallo-proteolytic enzymes. These inhibitors were far less potent (KI, 0.063-10 mM), indicating a difference between the tumor dipeptidase and other enzymes of that class. Our results are discussed in terms of a postulated model of the bestatin molecule in the active site of the tumor dipeptidase, an enzyme which has not been studied by x-ray crystallographic means. The phenyl group of bestatin is placed in a hydrophobic pocket that is external but adjacent to the active site of the tumor dipeptidase. The shape of this pocket, as it appears from our results plus modeling, is such that only certain R groups of substrate can fit. The existence of such a pocket might explain the differential effect of substrates in the reversal of bestatin inhibition of the dipeptidase and also might explain substrate inhibition by misalignment of R groups into this pocket. PMID- 2722774 TI - KMnO4 as a probe for lac promoter DNA melting and mechanism in vivo. AB - The reagent potassium permanganate is used to probe lac transcription complexes by primer extension-probing analysis. A series of strongly hyperreactive bands, corresponding to the known melted region, is observed when open complexes are formed in vitro. A nearly identical pattern occurs in vivo, the signal intensity of which increases when open complexes are trapped with rifampicin. Quantitative comparison of the signal intensity obtained under steady-state conditions with that obtained in the presence of rifampicin indicates that transcription from each of three lac promoter variants is limited in vivo principally by the slow rate of open complex formation. The slow-start lac L8:UV5 promoter is also limited somewhat by slow RNA chain initiation. Slightly different patterns of KMnO4 reactivity at each promoter variant in the absence of RNA polymerase in vitro suggest that DNA sequence dictates the ultimate pattern of melting, with the polymerase acting principally to stabilize the melted state specified by the DNA sequence. PMID- 2722775 TI - Phosphatidylethanolamine N-methyltransferase in human red blood cell membrane preparations. Kinetic mechanism. AB - The successive methylations of phosphatidylethanolamine to form phosphatidylcholine were measured using exogenously added intermediates and membrane preparations from human red blood cells. The addition of phosphatidylethanolamine resulted in no increase in methylation rate over that with endogenous substrate; however, the addition of monomethylphosphatidylethanolamine (PME) and dimethylphosphatidylethanolamine (PDE) markedly increased the reaction rate and allowed studies into the kinetic mechanism for the second and third methylation reactions. The data are consistent with catalysis of the last two methylations being by a single enzyme with a random Bi-Bi sequential mechanism. Analysis of PDE:phosphatidylcholine product ratios indicates that the enzyme can conduct multiple methylations of enzyme bound phospholipid. The nature of the acyl chain (16:0 versus 18:1) of the phospholipid had only a small effect on the value of the kinetic constants. The maximal velocities obtained with the 18:1 substrate were less than 5% lower than those obtained with the 16:0 substrate. The Km values for the two phospholipids were 20-45 and 10-14 microM for the methylation of PME and PDE, respectively. The Km for S-adenosylmethionine (AdoMet) was 5-9 microM with PME and 4 microM with PDE as substrates. Depending on the acyl chain and the phospholipid, the Ki(AdoMet) varied from 8 to 19 microM, the Ki(PME) from 41 to 82 microM, and the Ki(PDE) from 35 to 61 microM. The Ki for S-adenosylhomocysteine (AdoHcy) was between 1.0 and 1.4 microM depending upon the variable substrate. The endogenous concentrations of PME and PDE in red blood cell membranes were estimated to be 0.49 and 0.24 mumol/liter packed cells, respectively. The product from the utilization of AdoMet, S-adenosylhomocysteine (AdoHcy), was shown to be a competitive inhibitor of its precursor, AdoMet, and a noncompetitive inhibitor of the two phospholipid substrates. PMID- 2722776 TI - Cholesterol heterogeneity in bovine rod outer segment disk membranes. AB - Rod outer segment disk membranes have been used to study visual transduction events. Numerous studies have also focused on protein-lipid interactions in these membranes. The possible heterogeneity of the disk membrane composition has not been addressed in such studies. Freeze fracture studies (Andrews, L. D., and Cohn, A. I. (1979) J. Cell Biol. 81, 215-220; Caldwell, R., and McLaughlin, B. (1985) J. Comp. Neurol. 236, 523-537) suggest a difference in cholesterol content between newly formed and old disks. This potential heterogeneity in disk membrane composition was investigated using digitonin. Osmotically intact bovine rod outer segment disk membranes prepared by Ficoll flotation were separated based on the cholesterol content of the disks. The addition of digitonin to disk membrane suspensions in a one-to-one molar ratio with respect to cholesterol produced an increase in the density of the membranes in proportion to the amount of cholesterol present. The digitonin-treated disks were separated into subpopulations using a sucrose density gradient. Disks were shown to vary in cholesterol to phospholipid ratio from 0.30 to 0.05. The ratio of phospholipid to protein remained constant in all disk subpopulations at approximately 65 phospholipids per protein. No significant change in the fatty acid composition of the disks was observed as a function of change in cholesterol content. This work demonstrates compositional heterogeneity in disk membranes which may ultimately affect function. PMID- 2722777 TI - Primary structure of the rat kidney band 3 anion exchange protein deduced from a cDNA. AB - A rat kidney cDNA library was screened using an oligonucleotide hybridization probe derived from an amino acid sequence of the mouse erythrocyte Band 3 Cl /HCO3- exchanger. Ten cDNAs representing a single class of mRNA and encoding the kidney Band 3 anion exchanger were isolated. Analysis of the deduced amino acid sequence revealed that kidney Band 3 is a truncated version of erythrocyte Band 3. The 848-amino acid rat kidney protein is virtually identical to mouse erythrocyte Band 3 except that it lacks the first 79 amino acids of the N terminal cytoplasmic domain. Exons 1, 2, and 3 of the Band 3 gene, which are included in erythrocyte Band 3 mRNA, are not present in the kidney cDNA. The 5' untranslated regions of kidney Band 3 transcripts contain sequences from the third intron and exons 4 and 5 of the Band 3 gene. The sequences from exons 4 and 5 that serve as untranslated sequences in the rat kidney mRNA have the potential to encode amino acids 46-79 of erythrocyte Band 3 but are not part of an open reading frame; the apparent translation initiation site corresponds to codon 80 of mouse erythrocyte Band 3 mRNA. Northern blot hybridization studies indicate that two additional Band 3 mRNAs, which differ in size from the major 4.5 kilobase pair transcript in kidney, are expressed at low levels in kidney and brain. PMID- 2722778 TI - Cloning, structure, and expression of the mitochondrial cytochrome P-450 sterol 26-hydroxylase, a bile acid biosynthetic enzyme. AB - The conversion of cholesterol into bile acids in the liver represents the major catabolic pathway for the removal of cholesterol from the body. In this complex biosynthetic pathway, at least 10 enzymes modify both the ring structure and side chain of cholesterol, resulting in the formation of the primary bile acids, cholic acid, and chenodeoxycholic acid. To gain insight into the details and regulation of this pathway, we have used protein sequencing and molecular cloning techniques to isolate and characterize a cDNA encoding the rabbit mitochondrial sterol 26-hydroxylase. This enzyme catalyzes the first step in the oxidation of the side chain of sterol intermediates in the biosynthesis of bile acids. The structure of the sterol 26-hydroxylase, as deduced by both DNA sequence analysis of the cDNA and protein sequence analysis, reveals it to be a mitochondrial cytochrome P-450. A signal sequence of 36 residues precedes a coding region of 499 amino acids, predicting a molecular weight of 56,657 for the mature protein. The identity of the 26-hydroxylase cDNA was further confirmed by expression in monkey COS cells employing a versatile eukaryotic expression vector. Blotting experiments revealed that the mRNA for this enzyme is expressed in many tissues and that it is encoded by a low copy number gene in the rabbit genome. PMID- 2722779 TI - Isolation of a cDNA clone coding for a putative second potassium channel indicates the existence of a gene family. AB - A putative second potassium channel expressed in rat brain is identified by cloning and characterization of cDNA clones. Two cDNA clones, isolated from rat brain libraries, encode a 499-residue protein that is 80% identical with a previously described rat brain potassium channel and 68% identical with a Drosophila potassium channel. This new potassium channel is called BK2 to distinguish it from the previously described potassium channel (BK1). The BK2 gene, unlike the Drosophila potassium channel gene complex, appears to produce a single, large (approximately 9.5-kilobase) RNA transcript. Southern analysis of rat genomic DNA indicates that the BK1 and BK2 transcripts are the products of independent genes. Analysis of the distribution of BK2 transcripts in rat brain by in situ hybridization histochemistry suggests that the BK2 gene is ubiquitously expressed by central nervous system neurons. Identification of this putative second mammalian potassium channel cDNA indicates the existence of a potassium channel gene family, confirming electrophysiological data on the diversity of potassium channels expressed in rat brain. PMID- 2722780 TI - Platelet-activating factor acetylhydrolase increases during macrophage differentiation. A novel mechanism that regulates accumulation of platelet activating factor. AB - Monocytes and macrophages produce bioactive lipids, such as platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine, PAF), that mediate inflammation. These cells synthesize PAF following their activation, but not constitutively. Previous studies have demonstrated that PAF accumulation is regulated by the activity of the synthetic enzymes. We observed that the accumulation of PAF in stimulated human monocytes decreased by 90% as they differentiated into macrophages. There was no decrease in the activities of the synthetic enzymes; however, the activity of the degradative enzyme, PAF acetylhydrolase, increased 260-fold. The increase in PAF acetylhydrolase activity appeared to result from a net increase in the synthesis of a new enzyme. These studies demonstrate a novel mechanism in which an increase of the degradative enzyme regulates the accumulation of PAF. This may be an important mechanism by which macrophages modulate inflammatory responses. PMID- 2722781 TI - Complete intron/exon organization of DNA encoding the alpha' chain of human C3. AB - The third component of human complement (C3), a central molecule in both the classical and alternative pathways of complement, is comprised of two polypeptides, termed the alpha and beta chains. Activation of C3 cleaves the alpha chain into two fragments, C3a, an inflammatory peptide, and the alpha' chain which remains covalently linked to the beta chain. Proteolytic fragments derived from the alpha' chain during activation and regulation of complement play a significant role in host defense and regulation of the immune response. Two cosmid clones covering the alpha' chain region were used to characterize the structure of this portion of the C3 gene. The alpha' chain is encoded by 24 exons, which range in size from 52 to 213 base pairs (bp) with an average size of 115 bp. The splice donor sequence at the beginning of intron 12 has a rare sequence variant of GC instead of the usual GT sequence. Ten introns have been completely sequenced and were surprisingly short, ranging in size from 85 to 242 bp with an average of 140 bp. Other introns range in size from 250 bp to over 4 kilobases in length. The gene size for this portion of C3 is estimated to be 23 24 kilobases. Comparison of exon structure with protein domains and with peptide mapping studies demonstrates that several binding sites on C3 are encoded by single exons. These data support the hypothesis that individual exons can code for functional protein domains. PMID- 2722782 TI - Three states for the formyl peptide receptor on intact cells. AB - Three distinct states of the formyl peptide receptor have been described. These are: 1) the ternary complex of ligand, receptor, and G protein (LRG); 2) the rapidly dissociating occupied receptor (ligand-receptor complex (LR]; and 3) a desensitized slowly dissociating guanine nucleotide-insensitive receptor (desensitized ligand-receptor complex ("LRX"]. During cell activation there is a rapid interconversion among receptor states from a rapidly dissociating form (t 1/2 approximately 10 s) to a slowly dissociating form (t 1/2 greater than or equal to 2 min). Neither the dynamics of the states nor their interconversion is influenced by ribosylation of G protein in the presence of pertussis toxin. In contrast to ribosylation, treatment of cells with either 2-deoxyglucose or fluoride ion, both of which lead to a loss of adenine and guanine nucleotides, causes a time-dependent change in ligand dissociability. After short periods of treatment (5-15 min) rapid dissociation is observed; after longer times (30-60 min), slow dissociation is once again detected. When intact cells are first ribosylated and then energy-depleted, only a rapidly dissociating receptor is detected. These results are discussed in terms of a model with the following elements: 1) intact cell dynamics during cell activation are dominated by an energy-dependent interconversion from LR to LRX; 2) under activation conditions, LRG appears and disappears too rapidly to be detected; 3) in cells depleted of energy and guanine nucleotide, LRG is stabilized; 4) in cells both ribosylated and depleted of energy, LR is stabilized. PMID- 2722783 TI - Expression of the mammalian mitochondrial genome. Stability of mitochondrial translation products as a function of membrane potential. AB - Polypeptide decay has been measured as a function of membrane potential. Mitochondrial translation products were pulse-labeled in vitro with [35S]methionine using isolated rat heart mitochondria in the presence of an energy-generating system. The relative rate of protein degradation was estimated from the specific activity (counts/min/mg of protein) of the labeled translation products following the addition of unlabeled methionine (chase). To modulate membrane potential, inhibitors of oxidative phosphorylation were used singly or in combination; their effect was monitored by following uptake of the nonmetabolizable lipophilic cation triphenylmethylphosphonium. When the potential was dissipated, the rate of polypeptide decay increased and vice versa. These results suggest that the stability of mitochondrial translation products is linked to a process(es) that is dependent upon delta psi; likely candidates include synthesis and/or assembly of mitochondrial gene products. PMID- 2722784 TI - Evidence that the 59-kDa protein synthesis initiation factor from wheat germ is functionally similar to the 80-kDa initiation factor 4B from mammalian cells. AB - The results of this investigation show that the 59-kDa protein synthesis initiation factor from wheat germ, designated eukaryotic initiation factor (eIF) 4G by Browning et al. (Browning, K.S., Maia, D.M., Lax, S.R., and Ravel, J.M. (1987) J. Biol. Chem. 262, 539-541), cross-links to the 5'-terminal cap of oxidized mRNA in the presence of eIF-4A, eIF-4F, and ATP, stimulates the RNA dependent ATPase activities of eIF-4A and a mixture of eIF-4A and eIF-4F, and stimulates the unwinding activities of eIF-4A, eIF-4F, and a mixture of eIF-4A and eIF-4F. These findings strongly suggest that the 59-kDa factor from wheat germ is the functional equivalent of the 80-kDa protein synthesis initiation factor, eIF-4B, from mammalian cells. Recent reports indicate that the wheat germ initiation factor which contains two subunits of 80 and 28 kDa and which was given the designation "eIF-4B" by Lax et al. (Lax, S.R., Lauer, S.J., Browning, K. S., and Ravel, J.M. (1986) Methods Enzymol. 118, 109-128) is an isozyme form of eIF-4F and not the functional equivalent of mammalian eIF-4B. On the basis of functional characteristics we propose that the designation for the wheat germ factor containing the 80- and 28-kDa polypeptides be changed from eIF-4B to eIF (iso)4F and the designation for the 59-kDa factor be changed from eIF-4G to eIF 4B. PMID- 2722785 TI - Removal of tropomyosin overlap modifies cooperative binding of myosin S-1 to reconstituted thin filaments of rabbit striated muscle. AB - Cooperative binding of myosin S-1.ADP to regulated F-actin was previously reported and has been interpreted by a two-state model in which an important source of cooperativity is nearest neighbor interactions between the 7 actin.tropomyosin (TM).troponin units (functional units) (Hill, T.L., Eisenberg, E., and Greene, L. (1980) Proc. Natl. Acad. Sci. U.S.A. 77, 3186-3190). It has been postulated that the head-to-tail overlap between adjacent TM molecules is the structural basis of the nearest neighbor interactions. We tested the hypothesis by examining S-1.ADP binding to reconstituted regulated F-actin containing either intact TM or nonpolymerizable TM from which the COOH-terminal 11 residues were removed. In the absence of Ca2+, substitution of nonpolymerizable TM for TM reduced significantly the slope of the steeply rising phase of the sigmoidal S-1.ADP binding curve. Nevertheless, considerable residual cooperativity remained. Analysis of the data using the two-state model of Hill et al. suggests that removal of TM overlap abolishes nearest neighbor interactions, while the concerted change of the state of 7 actins in a functional unit can account for the residual cooperativity. PMID- 2722786 TI - Cross-linking of nitrogenase components. Structure and activity of the covalent complex. AB - The nitrogenase complex from Azotobacter vinelandii is composed of the MoFe protein (Av1), an alpha 2 beta 2 tetramer, and the Fe protein (Av2), a gamma 2 dimer. During turnover of the enzyme, electrons are transferred from Av2 to Av1 in parallel with the hydrolysis of MgATP. Using the cross-linking reagent, 1 ethyl-3-(3-dimethylaminopropyl)carbodiimide, we have identified some of the properties of the complex between the two components. The cross-linking reaction was highly specific yielding a single apparent Mr = 97,000 protein. The amount of cross-linked product was essentially independent of whether MgATP or MgADP were in the reaction. Also, the amount was maximum at high ratios of Av2 to Av1. The Mr = 97,000 protein was characterized by amino acid analysis and Edman degradation and was found to be consistent with a 1:1 complex of an Av2 gamma subunit and an Av1 beta subunit (the amino terminal serine subunit). The complex was no longer active in the nitrogenase reaction which supports, but does not prove, the requirement for dissociation of the complex after each electron transferred. Nitrogenase activity and cross-linking were inhibited in an identical way by NaCl, which suggests that electrostatic forces are critical to the formation of the electron transfer complex. PMID- 2722787 TI - Protein kinase C activity can desensitize the gonadotropin-responsive adenylate cyclase in Leydig tumor cells. But hCG-induced desensitization does not involve protein kinase C activation. AB - The murine Leydig tumor cell line, MLTC-1, contains a gonadotropin receptor coupled adenylate cyclase. Although the binding of human choriogonadotropin (hCG) initially causes cells to accumulate cAMP, in time, the response to hCG is attenuated by desensitization. Treating intact cells with the tumor promoter, 12 O-tetradecanoyl-phorbol-13-acetate (TPA), or with diacylglycerol also causes desensitization of the hCG response. These compounds are activators of calcium/phospholipid-dependent protein kinase (PKC). Treating MLTC-1 cells with TPA or dioctanoylglycerol increased the portion of PKC in the cell membrane fraction. This phenomenon is associated with activation of PKC. Treating isolated membranes with purified PKC desensitize the hCG response. Thus, desensitization caused by TPA or dioctanoylglycerol is probably mediated by PKC. PKC is normally activated when phosphoinositides are metabolized to diacylglycerol and inositol phosphates. There was no significant accumulation of inositol phosphates when cells were treated with hCG. hCG did not increase the portion of PKC in the cell membrane fraction. However, hCG could desensitize isolated membranes, but TPA could not. We conclude that although protein kinase C activity can desensitize the gonadotropin response, hCG does not cause desensitization by activating PKC. The implications of this observation are discussed. PMID- 2722788 TI - Binding of recA protein to Z-form DNA studied with circular and linear dichroism spectroscopy. AB - Binding of RecA to poly(dG-m5dC) and poly(dG-dC) under B- and Z-form conditions was studied using circular dichroism (CD) and linear dichroism (LD). LD revealed a quantitative binding of RecA to Mg2+-induced Z-form poly(dG-m5dC) with a stoichiometry of 3.1 base pairs/RecA monomer, which is slightly larger than the 2.7 base pairs observed for the B-form. The LD spectra indicate a preferentially perpendicular orientation of DNA bases and a rather parallel orientation of the tryptophan residues relative to the fiber axis in both complexes. The association rate of RecA to Z-form DNA was found to be slower than to B-form. CD measurements showed that the polynucleotide conformation is retained upon RecA binding, and CD and LD confirm that RecA binds to both forms of DNA. The Mg2+-induced Z-form is shown to be retransformed into B-form, both in free and in RecA-complexed polynucleotides by addition of NaCl, whereas the B----Z transition cannot be induced by addition of Mg2+ when the polynucleotide is complexed with RecA. From this it is inferred that RecA does not stabilize the Z-conformation of the polynucleotide but that it can kinetically "freeze" the polynucleotide in its B conformation. On all essential points, the same conclusions were also reached in a corresponding study of unmethylated poly(dG-dC) with the Z-form induced by Mn2+. PMID- 2722789 TI - Thyroid hormones inhibit platelet function and myosin light chain kinase. AB - We examined the extranuclear effects of thyroid hormones on human platelets. Pretreatment with DL-thyroxine or DL-triiodothyronine inhibited collagen-induced aggregation, in a dose-dependent manner, but other derivatives of thyroid hormone had no significant effects. In contrast to collagen, 12-O-tetradecanoylphorbol-13 acetate-induced aggregation was not affected by thyroid hormones at the same concentration range. Thyroxine also inhibited the release of [14C] serotonin from collagen-stimulated platelets, with a marked reduction in the phosphorylation of 20,000-dalton protein. Thyroxine and triiodothyronine had inhibitory effects on myosin light chain kinase purified from human platelets and inhibited more markedly the myosin light chain kinase than protein kinase C (Ca2+/phospholipid dependent enzyme) and cAMP-dependent protein kinase. In addition, L-thyroxine behaved as a competitive inhibitor of myosin light chain kinase toward calmodulin, and the Ki value was calculated to be 2.6 microM. To determine whether or not thyroxine directly binds myosin light chain kinase, we prepared an affinity column, using L-thyroxine as the ligand. Myosin light chain kinase was selectively bound to the column while calmodulin passed through. We also designed a procedure for the purification of myosin light chain kinase from human platelets, using L-thyroxine-affinity chromatography. A markedly increased purification was thus achieved, and DEAE-cellulose and L-thyroxine-affinity chromatography were made feasible. These results suggest that thyroxine can serve as a pharmacological tool for elucidating the biological significance of myosin light chain kinase-mediated reactions and is a pertinent ligand which can be used to purify myosin light chain kinase from platelets as a substitute for calmodulin. PMID- 2722790 TI - Evidence for the formation of the 4a-carbinolamine during the tyrosine-dependent oxidation of tetrahydrobiopterin by rat liver phenylalanine hydroxylase. AB - In the presence of phenylalanine and molecular oxygen, activated phenylalanine hydroxylase catalyzes the oxidation of tetrahydrobiopterin. The oxidation of this tetrahydropterin cofactor also proceeds if the substrate, phenylalanine, is replaced by its product, tyrosine, in the initial reaction mixture. These two reactions have been defined as coupled and uncoupled, respectively, because in the former reaction 1 mol of phenylalanine is hydroxylated for every mole of tetrahydrobiopterin oxidized, whereas in the latter reaction there is no net hydroxylation of tyrosine during the oxidation of the tetrahydropterin. During the course of the coupled oxidation of tetrahydrobiopterin, a pterin 4a carbinolamine intermediate can be detected by ultraviolet spectroscopy (Kaufman, S. (1976) in Iron and Copper Proteins (Yasunobu, K. T., Mower, H. F., and Hayaishi, O., eds) pp. 91-102, Plenum Publishing Corp., New York). Dix and Benkovic (Dix, T. A., and Benkovic, S. J. (1985) Biochemistry 24, 5839-5846) have postulated that the formation of this intermediate only occurs when the oxidation of the tetrahydropteridine is tightly coupled to the concomitant hydroxylation of the aromatic amino acid. However, during the tyrosine-dependent uncoupled oxidation of tetrahydrobiopterin by phenylalanine hydroxylase, we have detected the formation of a spectral intermediate with ultraviolet absorbance that is essentially identical to that of the carbinolamine. Furthermore, this absorbance can be eliminated by the addition of 4a-carbinolamine dehydratase, an enzyme which catalyzes the dehydration of the 4a-carbinolamine. Quantitation of this intermediate suggests that there are two pathways for the tyrosine-dependent uncoupled oxidation of tetrahydrobiopterin by phenylalanine hydroxylase because only about 0.3 mol of the intermediate is formed per mol of the cofactor oxidized. PMID- 2722791 TI - Lipid-lipid interactions as regulators of carboxylester lipase activity. AB - The hydrolysis of 1,3-dioleoylglycerol and related substrates by mammalian pancreatic carboxylester lipases was studied. Mixed lipid films of substrates with 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine at the argon-buffer interface were exposed to relatively high levels of monomeric porcine pancreatic carboxylester lipase for a brief period. With either 1,3-dioleoylglycerol, 1,2 dioleoylglycerol, trioleoylglycerol, or oleoylmethanol as a substrate, the percentage of substrate hydrolysis increased abruptly from near zero to near 100% with increasing proportion of substrate in the film. The phospholipid was not hydrolyzed. Using 1,3-dioleoylglycerol as the substrate with either the dimeric, porcine pancreatic carboxylester lipase, human pancreatic carboxylester lipase, or human milk bile salt-stimulated lipase gave results identical to those obtained with the porcine monomer. Hydrolysis of 1,3-dioleoylglycerol by porcine monomeric carboxylester lipase was independent of the initial surface pressure of the film. However, a strong correlation was observed between hydrolysis and interfacial lipid composition at all surface pressures, even if bulk 1,3 dioleoylglycerol was also present. The ultrasensitive dependence of hydrolysis on interfacial lipid composition, i.e. lipid-lipid interactions, suggests that such "switching" may contribute to the regulation of diacylglycerol levels in cells where they function in signal transduction. PMID- 2722792 TI - Lecithin:retinol acyltransferase in retinal pigment epithelial microsomes. AB - Microsomal preparations from retinal pigment epithelium carry out phosphatidylcholine synthesis upon incubation with 1 palmitoyllysophosphatidylcholine and fatty acyl-CoA. Phosphatidylcholine synthesized in situ in this manner is an acyl donor for retinyl ester synthesis, demonstrating the existence of lecithin:retinol acyltransferase. Although acyl transfer to retinol is from the 1-position of phosphatidylcholine, the fatty acid in the 2-position is important in substrate recognition. The finding of this novel enzyme activity in retinal pigment epithelial microsomes suggests that phosphatidylcholine is the endogenous acyl donor in CoA-independent retinol esterification observed in these preparations. PMID- 2722793 TI - Conformation of NAD+ bound to allosteric L-lactate dehydrogenase activated by chemical modification. AB - On modification of arginine residues with 2,3-butanedione, the Thermus caldophilus L-lactate dehydrogenase is converted to an activated form that is independent of an allosteric effector, fructose 1,6-bisphosphate (Fru-1,6-P2). The conformation of NAD+ bound to the modified enzyme in the absence of Fru-1,6 P2 was investigated by means of proton NMR, analyzing the time dependence of the transferred nuclear Overhauser effect (TRNOE) and TRNOE action spectra. The inter proton distances determined on TRNOE analysis indicated that both the nicotinamide riboside moiety and the adenosine moiety of NAD+ were in the anti conformation, the ribose rings being in the C3'-endo form. This conformation was almost the same as that of NAD+ bound to the native enzyme-Fru-1,6-P2 complex, rather than that of NAD+ bound to the free native enzyme. These results suggest that the C3'-endo-anti form of the enzyme-bound NAD+ is essential for the activation of the T. caldophilus L-lactate dehydrogenase. PMID- 2722794 TI - Anticoagulant activity of synthetic hirudin peptides. AB - Synthetic peptides based on the COOH-terminal 21 residues of hirudin were prepared in order to 1) evaluate the role of this segment in hirudin action toward thrombin, 2) define the shortest peptide derivative with anticoagulant activity, and 3) investigate the role of tyrosine sulfation in the peptides' inhibitory activities. A hirudin derivative of 20 amino acids, Hir45-64 (derived from residues 45-64 of the hirudin polypeptide), was found to effect a dose dependent increase in the activated partial thromboplastin time (APTT) of normal human plasma but to have no measurable inhibitory activity toward thrombin cleavage of a tripeptidyl p-nitroanilide substrate. Anticoagulant activity in hirudin derivatives was comparable in peptides of 20, 16, and 12 residues truncated from the NH2 terminus. Additional truncated peptides prepared by synthesis and carboxypeptidase treatment reveal that the minimal sequence of a hirudin peptide fragment with maximal anticoagulant activity is contained within the sequence: NH2-Asn-Gly-Asp-Phe-Glu-Glu-Ile-Pro-Glu-Glu-Tyr-Leu-COOH. The 12 residue derivative thus identified was reacted with dicyclohexylcarbodiimide in the presence of sulfuric acid to yield a Tyr-sulfated peptide, S-Hir53-64. By comparison to unsulfated peptide, S-Hir53-64 was found to contain a specific inhibitory activity enhanced by one order of magnitude toward increase in APTT and to effect a dose-dependent increase in thrombin time of normal human plasma to yield a 4-fold increase in thrombin time with 2.5 micrograms/ml peptide using 0.8 units/ml alpha-thrombin. Comparison of S-Hir53-64 to hirudin in thrombin time and APTT assays reveals a 50-fold difference in molar specific activities toward inhibition of thrombin. Comparison of antithrombin activities of S-Hir53-64 using a variety of animal thrombins demonstrates greatest inhibitory activity toward murine, rat, and human enzymes and a 10-fold reduced activity toward bovine thrombin. PMID- 2722795 TI - Studies of the fatty acid-binding site of rat liver fatty acid-binding protein using fluorescent fatty acids. AB - Rat liver fatty acid-binding protein (FABP) is a 14.3-kDa cytosolic protein which binds long chain free fatty acids (ffa) and is believed to participate in intracellular movement and/or distribution of ffa. In the studies described here fluorescently labeled ffa were used to examine the physical nature of the ffa binding site on FABP. The fluorescent analogues were 16- and 18-carbon ffa with an anthracene moiety covalently attached at eight different points along the length of the hydrocarbon chain (AOffa). Emission maxima of all FABP-bound AOffa were found to be considerably blue-shifted with respect to emission of phospholipid membrane-bound AOffa, suggesting a high degree of motional constraint for protein-bound ffa. Large fluorescence quantum yields and long excited state life-times indicate that the FABP-binding site for ffa is highly hydrophobic. Analysis of rotational correlation times for the FABP-bound AOffa suggest that the ffa are tightly bound to the protein. Variation of the quantum yield with attachment site suggests that the carboxylic acid group of the fatty acyl chain is located near the aqueous surface of the FABP. The rest of the ffa hydrocarbon chain is buried within the protein in a hydrophobic pocket and is particularly constrained at the midportion of the acyl chain. PMID- 2722796 TI - Alpha-secondary tritium kinetic isotope effects for the hydrolysis of alpha-D glucopyranosyl fluoride by exo-alpha-glucanases. AB - alpha-Secondary tritium kinetic isotope effects ranging from 1.17 to 1.26 were measured for the hydrolysis of alpha-D-glucopyranosyl fluoride (forming beta-D glucose) catalyzed by several glucoamylases and a glucodextranase. These results indicate that cleavage of the C-F bond is slow and that the enzymic transition state has significant oxo-carbonium ion character. Strong support for this conclusion is provided by the agreement found in the case of Rhizopus niveus glucoamylase (alpha-TV/K 1.26; Km 26 mM) between measured values of the alpha secondary deuterium kinetic isotope effects (alpha-DV/K 1.16; alpha-DV 1.20) and those calculated from the tritium isotope effect. The data are consistent with the promotion of an intramolecular elimination of fluoride by the present exo alpha-glucanases based on their ability to stabilize, perhaps with a counter ion, the development of a carbonium ion-like transition state. Although the oxo carbonium ion is formally denoted as an intermediate it could represent a transition state along a reaction pathway to a covalent glucosyl intermediate. PMID- 2722797 TI - The cyclic nucleotide specificity of eight cAMP-binding proteins in Dictyostelium discoideum is correlated into three groups. AB - cAMP is a mediator of inter- and intracellular events in Dictyostelium discoideum and is thought to act through specific receptors. Eight forms of cAMP-binding proteins have been described in this organism: four forms of a cell surface receptor, a cell surface and extracellular phosphodiesterase, an intracellular cAMP-dependent protein kinase (CAK), and a recently identified cAMP-binding protein (CABP1) that is present on the cell surface, in the cytoplasm, and in the nucleus. In this study we have analyzed the cyclic nucleotide specificity of these cAMP-binding proteins using 13 derivatives of cAMP with modifications in the adenine, ribose, and phosphate moiety. The results suggest that the cAMP binding proteins belong to three groups: (i) four forms of the cell surface receptor, (ii) two forms of an intracellular receptor (CABP1 and CAK), and (iii) cell surface and extracellular phosphodiesterase. cAMP is probably bound to the surface receptors in the anti conformation in a hydrophobic cleft of the receptor with essential interactions at N6H2' and O3'. In contrast, cAMP is probably bound to CAK and CABP1 in the syn conformation with essential interactions at O2', O3', O5', and exocyclic oxygen. Finally, binding of cAMP to phosphodiesterase involves only O3' and exocyclic oxygen. The cyclic nucleotide specificity of cAMP-induced processes in D. discoideum indicates that the cell surface receptors participate in the transduction of the cAMP signal during chemotaxis and cell differentiation. Functions for CABP1 and CAK in these processes are presently elusive. PMID- 2722798 TI - Lowering extracellular pH evokes inositol polyphosphate formation and calcium mobilization. AB - Changing extracellular pH (pHo) from 7.4 to 6.1 increased [3H]inositol bis- and trisphosphates approximately 10- and 5-fold, respectively, in 15 s in human fibroblasts. [3H]Inositol phosphate increased less rapidly than the polyphosphates. Bradykinin similarly increased [3H]inositol phosphates. Shifting pHo from 7.4 to 6.0 evoked a large spike in cytosolic free Ca2+ [( Ca2+]i) which was primarily caused by the release of stored Ca2+. Changing pHo from 7.4 to 6.0 decreased cytoplasmic pH to approximately 7.0. Moderate decreases in intracellular pH had no effect on [Ca2+]i or 45Ca2+ efflux. Decreasing pHo strikingly increased 45Ca2+ efflux and decreased total cell Ca2+ similarly to bradykinin. Changing pHo from 7.4 to approximately 6.4 produced half-maximal effects on [Ca2+]i, 45Ca2+ efflux, and total Ca2+. Cycling pHo between 7.4 and 6.0 produced repetitive decreases and increases in total Ca2+. Bradykinin released the Ca2+ which was reaccumulated after an acid pulse indicating that Ca2+ had returned to the hormone-sensitive pool. Decreasing pHo also released stored Ca2+ from coronary endothelial, neuroblastoma, and umbilical artery muscle cells, but not from rat aortic smooth muscle or human epidermoid carcinoma (A431) cells. We suggest that lowering pHo stimulates a phosphoinositidase-coupled receptor by protonating a functional group with a pKa near 6.5. PMID- 2722799 TI - Primary structural determinants essential for potent inhibition of cAMP-dependent protein kinase by inhibitory peptides corresponding to the active portion of the heat-stable inhibitor protein. AB - PKI-(5-24)-amide is a 20-residue peptide with the sequence, Thr5-Thr-Tyr-Ala-Asp Phe-Ile-Ala-Ser-Gly-Arg-Thr-Gly-Arg-Arg-Asn-A la-Ile-His- Asp24-NH2, that corresponds to the active portion of the heat-stable inhibitor protein of cAMP dependent protein kinase (Cheng, H.-C., Kemp, B. E., Pearson, R. B., Smith, A. J., Misconi, L., Van Patten, S. M., and Walsh, D. A. (1986) J. Biol. Chem. 261, 989-992). Amino acid residues in PKI-(5-24)-amide responsible for the potent inhibition (Ki = 2.3 nM) of the catalytic subunit of protein kinase were further investigated using deletion and substitution analogs of the synthetic peptide. Residues 5, 23, and 24 were not required for activity since the 17-residue PKI-(6 22)-amide retained full potency. Sequential removal of the first seven amino acids from the NH2 terminus of PKI-(5-24)-amide caused a progressive 50-fold loss of inhibitory potency. In contrast, substitution of either Thr6, Asp9, or Ile11 with alanine, or Ala8 by leucine, in PKI-(5-22)-amide produced less than 3-fold decreases in potency. Of the 2 aromatic residues in PKI-(5-22)-amide, the individual substitution of Phe10 and Tyr7 by alanine caused, respectively, 90- and 5-fold decreases in inhibitory potency, demonstrating important roles for each. This NH2-terminal portion of the peptide is believed to contain a significant portion of alpha-helix. Many recognition or structural determinants are also essential in the COOH-terminal portion of PKI-(5-22)-amide. In addition to the basic subsite provided by the three arginines, several other of the residues are critical for full inhibitory potency. Substitution of Ile22 by glycine in either PKI-(5-22)-amide or PKI-(14-22)-amide lowered the inhibitory potency by 150- and 50-fold, respectively. Separate replacement of Gly17 or Asn20, in either PKI-(5-22)-amide or PKI-(14-22)-amide, caused 7-15-fold decreases in potency. Substitution of both Gly17 and Asn20 together (in PKI-(14 22)-amide) produced a synergistic loss of inhibitory activity. [Leu13,Ile14]PKI (5-22)-amide, a doubly substituted analog exhibited a 42-fold increase in Ki value. We conclude that Ser13 and/or Gly14, Gly17, Asn20, and Ile22 each contribute important features to the binding of these inhibitory peptides to the protein kinase, either by providing recognition determinants, inducing structure, and/or allowing essential peptide backbone flexibility.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2722800 TI - Replication of baboon endogenous virus in human cells. Kinetics of DNA synthesis and integration. AB - For the baboon endogenous virus to infect human cells a specific region on chromosome 6 is required for viral DNA replication and integration. In studying the kinetics of baboon endogenous virus DNA replication we show that linear DNA was synthesized as the predominant species after infection and that unintegrated DNA persisted after many cell passages. Examination of integrated DNA revealed the failure of the virus to integrate at early passages. With continuous replication, however, virus integration was observed, but at multiple sites in the host cell. PMID- 2722801 TI - Effect of inhibiting N-glycosylation on the stability and binding activity of the low density lipoprotein receptor. AB - Tunicamycin, a specific inhibitor of N-glycosylation, was used to study the function of asparagine-linked oligosaccharides of the low density lipoprotein (LDL) receptor in cultured human skin fibroblasts. When cells were preincubated in the presence of 0.5 micrograms/ml of the drug the incorporation of [3H]mannose into the receptor was completely prevented and that of [3H]glucosamine was reduced to approximately 41% of the control value. The [35S]methionine radioactivity detected in receptor core protein of tunicamycin-treated cells was about 52% of that measured in the receptor of control cells. The decrease in the radioactivity was similar in both the mature receptor as well as in its precursor form, and it was significantly greater than that found in total protein. The rates of receptor degradation in control- and tunicamycin-treated cells were comparable. Neither cell surface appearance of the newly synthesized LDL receptor nor its recycling were affected by tunicamycin. However, the LDL receptor produced in tunicamycin-treated cells was smaller in molecular size, and it exhibited an about 50% lower binding capacity when compared with its counterpart synthesized in control cells. This indicates that there is a relationship between N-glycosylation and the ligand binding activity of the LDL receptor. The possible role of asparagine-linked oligosaccharides in optimizing the biological activity of the LDL receptor is discussed. PMID- 2722802 TI - The effect of podophyllotoxin on microtubule dynamics. AB - We have investigated the effects of podophyllotoxin on the dynamic properties of microtubules assembled from pure tubulin dimer. Excess podophyllotoxin causes the complete disassembly of microtubules, through formation of a tubulin-GTP podophyllotoxin ternary complex with a dissociation rate constant of 160 s-1 at 37 degrees C, similar to that found upon extensive isothermal dilution in this buffer system. Addition of substoichiometric concentrations of podophyllotoxin causes partial disassembly of microtubules through production of an equivalent amount of the ternary complex. Microtubule length measurements and incorporation of [3H]GTP-tubulin dimer show that podophyllotoxin can suppress the dynamic instability of tubulin dimer microtubules and that it acts substoichiometrically in so doing. We interpret the action of substoichiometric podophyllotoxin on microtubule ends in terms of effects on interconversion of growing and shrinking microtubules in a dynamic system in which tubulin-GTP-podophyllotoxin is kinetically analogous to tubulin-GTP in addition and to tubulin-GDP in dissociation. The ability to suppress dynamic instability may be one way in which drugs such as podophyllotoxin, acting at relatively low concentrations, are able to arrest cell growth and development in a selective way, without necessarily affecting the integrity of the major part of the cytoskeletal microtubule network. PMID- 2722803 TI - P2-purinergic agonists stimulate phosphodiesteratic cleavage of phosphatidylcholine in endothelial cells. Evidence for activation of phospholipase D. AB - The effects of purinergic agonists on phosphatidylcholine (PC) breakdown and prostacyclin synthesis were investigated in cultured bovine pulmonary artery endothelial cells (BPAEC) prelabeled with [3H]choline and [14C]myristic acid. Both labels were selectively incorporated into PC. In BPAEC prelabeled with [3H]choline, ATP stimulated a rapid 5-fold increase in intracellular free [3H]choline. [3H]Choline formation was associated with a concomitant loss of 3H from PC, and it was not preceded by an increase in the 3H content of other PC degradation products. In BPAEC prelabeled with [14C]myristic acid, ATP stimulated a rapid increase in [14C]phosphatidic acid and [14C]diacylglycerol. These changes were associated with a loss of 14C from PC but not from phosphatidylinositol. In permeabilized BPAEC prelabeled with [3H]choline, ATP and guanosine 5'-O-(3 thiotriphosphate) (GTP gamma S) stimulated an increase in [3H]choline but not [3H]phosphocholine. The effects of ATP and GTP gamma S were synergistic at low GTP gamma S concentrations. Permeabilized BPAEC did not convert exogenous [3H]phosphocholine to [3H]choline. These data are consistent with the notion that purinergic agonists stimulate PC breakdown by a phospholipase D mechanism. This suggestion was supported by the observation that in the presence of ethanol, ATP stimulated the formation of [14C]phosphatidylethanol in BPAEC prelabeled with [14C]myristic acid. Several adenine nucleotides and related purine derivatives were compared for their effectiveness in stimulating PC breakdown and prostacyclin synthesis. The chemical specificity observed for the two responses indicated that both were mediated by the P2Y purinoceptor subtype. PC breakdown stimulated by ATP occurred prior to the maximum rate of release of prostacyclin into the medium. Taken together these data indicate that PC breakdown in endothelial cells stimulated with purinergic agonists is due, at least in part, to the activation of a phospholipase D that is coupled to purinoceptors by a guanine nucleotide-binding protein. In conjunction with previous data on the effects of bradykinin, these findings suggest an important role for PC breakdown in the mechanism of signal transduction in endothelial cells stimulated with Ca2+ mobilizing agonists. PMID- 2722804 TI - Characterization of the complete human elastin gene. Delineation of unusual features in the 5'-flanking region. AB - Genomic clones encompassing the entire human elastin gene, including 11 kilobases flanking the ATG translation initiation codon, have been obtained and characterized by restriction enzyme analysis and extensive DNA sequencing. These analyses demonstrated that functionally distinct hydrophobic and cross-linking domains of the protein are segregated into separate exons throughout the gene. All exons are multiples of three nucleotides, and exon:intron borders always split codons in the same way which permits cassette-like alternative splicing. The 5'-flanking region lacks a canonical TATA sequence, is G + C-rich, and contains several SP1 binding sites and an AP2 binding site. Primer extension and S1 nuclease protection experiments indicate that transcription is initiated at multiple sites in the gene. PMID- 2722805 TI - Cloning and sequence analysis of a rat liver cDNA encoding acyl-peptide hydrolase. AB - Acyl-peptide hydrolase catalyzes the removal of an N alpha-acetylated amino acid residue from an N alpha-acetylated peptide. Two overlapping degenerate oligonucleotide probes based on the sequence of a CNBr tryptic peptide, derived from purified rat acyl-peptide hydrolase, were synthesized and used to screen a rat liver lambda gt11 cDNA library. A 2.5-kilobase cDNA was cloned and sequenced. This clone contained 2364 base pairs of rat acyl-peptide hydrolase sequence but lacked a translational initiation codon. Using a 220-base pair probe derived from near the 5'-end of this almost full-length cDNA to rescreen the library, full length clones were isolated, which contained an in-frame ATG codon at nucleotides 6-8 and encoded the NH2-terminal sequence, Met-Glu-Arg-Gln.... The DNA sequence encoded a protein of 732 amino acid residues, 40% of which were confirmed by protein sequence data from 19 CNBr or CNBr tryptic peptides. The isolated enzyme is NH2-terminally blocked (Kobayashi, K., and Smith, J. A. (1987) J. Biol. Chem. 262, 11435-11445), and based on the NH2-terminal protein sequence deduced from the DNA sequence and the sequence of the most NH2-terminal CNBr peptide, it is likely that the NH2-terminal residue is an acetylated methionine residue, since such residues are frequently juxtaposed to glutamyl residues (Persson, B., Flinta, C., von Heijne, G., and Jornvall, H. (1985) Eur. J. Biochem. 152, 523 527). The RNA blot analysis revealed a single message of 2.7 kilobases in various rat tissues examined. Although this enzyme is known to be inhibited by diisopropyl fluorophosphate and acetylalanine chloromethyl ketone (Kobayashi, K., and Smith, J. A. (1987) J. Biol. Chem. 262, 11435-11445), no strong similarity in protein sequence has been found with other serine proteases. This result suggests that acyl-peptide hydrolase may be a unique serine protease. PMID- 2722806 TI - Regulation of expression of the alternative mRNAs of the rat alpha-thyroid hormone receptor gene. AB - The rat alpha-thyroid hormone receptor gene encodes through alternative splicing at least three protein isoforms with different functions, and three mRNA species (2.6, 5.4, 6.8 kilobase (kb) in size) are detected using alpha gene-specific probes (Mitsuhashi, T., Tennyson, G. E., Nikodem, V. M. (1988) Proc. Natl. Acad. Sci. U. S. A. 85, 5804-5808). In the present study, the identities of these mRNAs were analyzed by Northern analysis, and it was demonstrated that in rat brain the receptor protein is encoded by the minor 5.4- and 6.8-kb mRNAs and the variant proteins are encoded by the major 2.6-kb mRNA. Relative quantities of these mRNAs were determined by RNase protection assay, and the ratio of the receptor mRNAs to the variant mRNAs was estimated to be 1:6 in adult brain. The ratio between the mRNAs was regulated in both a tissue-specific and developmental stage-specific manner. The receptor mRNA levels were also regulated by the thyroid state of the animal showing an increased level in hypothyroid rat liver while those in brain were not affected. Analysis of the alpha-thyroid hormone receptor gene suggested that the choice between two poly-adenylation sites and subsequent RNA processing appear to generate the 3' heterogeneity of these alternative mRNAs. PMID- 2722807 TI - Macrophage differentiation inducing factor from human monocytic cells is equivalent to murine leukemia inhibitory factor. AB - Human macrophage differentiation inducing factor (DIF) can induce differentiation of human myeloid leukemic cells into macrophage-like cells in vitro. A procedure is described for purification of DIF from serum-free human monocytic leukemia THP 1 cell-conditioned medium. The procedure included concentration of a conditioned medium by ultrafiltration, lentil lectin-Sepharose affinity chromatography, and fast protein liquid chromatography using Mono S and Mono Q. DIF-A of pI 9.0 and DIF-B of pI 8.8 were obtained after a final purification with a Mono Q column, and both DIF gave a single peak with a molecular weight of approximately 51,000 determined by gel chromatography. NH2-terminal amino acid analysis of DIF-A showed a noticeable homology with murine leukemia inhibitory factor. Human DIF-A was found to induce maturation of human and murine leukemic cells into both macrophage-like cells with nitro blue tetrazolium reducing activity and phagocytic cells, but was found to suppress proliferation of these leukemic cells. PMID- 2722808 TI - Conformational changes in the alpha- and beta-subunits of the insulin receptor identified by anti-peptide antibodies. AB - The structure of the insulin receptor was studied with polyclonal antibodies obtained from rabbits which were immunized with synthetic peptides having a sequence identity to three regions of the alpha-subunit and five regions of the beta-subunit. None of the alpha-subunit antibodies including alpha-Pep8 (residues 40-49 (Ullrich, A., Bell, J.R., Chen, E.Y., Herrera, R., Petruzzelli, L.M., Dull, T.J., Gray, A., Coussens, L., Liao, Y.-C., Tsubokawa, M., Mason, A., Seeburg, P.H., Grunfeld, C., Rosen, O.M., and Ramachandran, J. (1985) Nature 313, 756 761), alpha-Pep7 (12 amino acid C-terminal extension (Ebina, Y., Ellis, L., Jarnagin, K., Ederly, M., Graf, L., Clauser, E., Ou, J.-H., Masiar, F., Kan, Y.W., Goldfine, I.D., Roth, R.A., and Rutter, W.J. (1985) Cell 313, 747-758], or alpha-Pep6 (residues 1-7, 9) immunoprecipitated the human insulin receptor solubilized from IM-9 lymphocytes; however, alpha-Pep8 immunoprecipitated the dithiothreitol-reduced receptor. Antibodies prepared against the N terminus of the beta-subunit (alpha-Pep5, residues 780-790) and the ATP binding site (alpha Pep3, residues 1013-1022) did not react with the intact receptor under any conditions; however, antibodies to the C terminus of the beta-subunit (alpha Pep1, residues 1314-1324) and to the juxta-membrane region (alpha-Pep3, residues 952-962) immunoprecipitated the solubilized receptor in both its phosphorylated and nonphosphorylated forms. In contrast, the antibody reactive with the regulatory region of the beta-subunit which contains the major autophosphorylation sites (alpha-Pep2, residues 1143-1154) only precipitated the phosphorylated form. Thus the conformation of the extracellular domain of the receptor is rigid and stabilized by disulfide bonds, whereas several regions of the intracellular domain are accessible to antibodies and undergo conformational changes during autophosphorylation. PMID- 2722809 TI - Hyaluronic acid stimulates protein kinase activity in intact cells and in an isolated protein complex. AB - The addition of hyaluronate to intact chick embryonic heart fibroblasts enriched with a hyaluronate-binding protein (HABP) stimulated phosphorylation of tyrosine and serine/threonine residues in cellular proteins. A protein complex containing a hyaluronate-binding protein (cell-HABP) was isolated from the cultured heart fibroblasts. The isolated complex (Mr approximately 1 x 10(6] contained phosphoproteins that exhibited protein kinase activity specifically stimulated by hyaluronate. Both tyrosine and serine residues in the protein complex were phosphorylated in response to this glycosaminoglycan. The hyaluronate-stimulated protein kinase activity was tightly associated with cell-HABP in vitro; enzyme activity co-immunoprecipitated with cell-HABP using a monospecific anti-HABP antibody and co-eluted with cell-HABP when chromatographed on a column of Sephacryl S-1000 in 2.0 M guanidine hydrochloride. The uniqueness of the cell HABP-associated protein kinase activity was suggested by both its specific response to hyaluronate, relative to related glycosaminoglycans such as heparin and chondroitin sulfate or to growth factors such as epidermal growth factor or insulin, and its antigenic distinction from other protein kinases such as growth factor receptors. These results point to a new mechanism by which glycosaminoglycans, such as hyaluronate, may modify cell behavior. PMID- 2722810 TI - Properties of a Drosophila RNA polymerase II elongation factor. AB - We have purified from nuclear extracts of Drosophila Kc cells a 36-kDa protein, DmS-II, which has an effect on the elongation properties of RNA polymerase II. DmS-II stimulates RNA polymerase II during the transcription of double-stranded DNA templates when the nonphysiological divalent cation manganese is present. In the presence of physiological mono- and divalent cations, the factor reduces the tendency of RNA polymerase II to pause at specific sites along a dC-tailed template including the major pause encountered after 14 nucleotides have been incorporated. Based on its size and chromatographic properties, as well as its ability to stimulate RNA polymerase II activity in the presence of manganese, the protein seems to be analogous to a factor S-II purified from mouse cells (Sekimizu, K., Kobayashi, N., Mizuno, D., and Natori, S. (1976) Biochemistry 15, 5064-5070). We have used a completely defined system and show that the properties of DmS-II are intrinsic to the factor and not mediated through other factors. PMID- 2722811 TI - Increased translatable mRNA and decreased lipogenesis are responsible for the augmented secretion of lipid-deficient apolipoprotein E by hepatocytes from fasted rats. AB - We examined the mechanism through which fasting selectively increases the secretion of apoE while it decreases the secretion of all lipoprotein lipids (Davis, R. A., Boogaerts, J. R., Borchardt, R. A., Malone-McNeal, M., and Archambault-Schexnayder, J. (1985) J. Biol. Chem. 260, 14137-14144). Livers were obtained from rats that were fed chow plus drinking water (control) and drinking water only (fasted) for three days. Livers were extracted for both total and poly(A) RNA. Using full length, nick-translated 32P-labeled cDNA probes for both apoE and beta-actin, the relative abundance was determined by slot blot hybridization assays. There was 2-fold more apoE mRNA in the livers of fasted rats. Furthermore, translation of poly(A) RNA using a reticulocyte lysate showed a similar 2.3-fold increase in the synthesis of immunoprecipitable [35S]methionine-labeled apoE. The 2-fold increase in translatable apoE mRNA correlates with a similar increase in apoE secretion. We also characterized the form of apoE secreted by hepatocytes from fasted cells. Cells were labeled with [35S]methionine, and the medium was separated by agarose 0.5m column chromatography. The majority of the apoE secreted cells from both control and fasted rats eluted in fractions that contained no detectable lipid. Furthermore, almost all of the increased apoE secreted by fasted cells was in these lipid deficient fractions. The isoform distribution of apoE secreted by cells from both groups consisted of six major apoE isoforms. Consistent with previous results, treatment with neuraminidase transformed the acidic forms into the three most basic, suggesting that the three most acidic isoforms contain varying amounts of sialic acid. The isoform pattern of apoE secreted by cells from fasted rats was significantly enriched in two acidic isoforms, while it was significantly decreased in the major basic isoform. Moreover, when oleic acid (1 mM) was added to the culture medium to stimulate lipogenesis, the amount of apoE secreted with lipid increased as did the more basic isoforms. These data suggest that the secretion of lipid-deficient apoE by cells from fasted rats is the result of increased mRNA and a concomitant reduction in lipogenesis. Furthermore, the parallel shift of both the amount of apoE secreted associated with lipid as well as its isoform pattern to a more basic one by oleic acid suggests that the lipid availability plays a role in determining the lipid complement and sialic acid content of apoE secreted by the hepatocyte. PMID- 2722812 TI - Intracellular thionins of barley. A second group of leaf thionins closely related to but distinct from cell wall-bound thionins. AB - Leaf thionins of barley have been identified as a novel class of cell wall proteins, toxic to plant pathogenic fungi, and possibly involved in the defense mechanism of plants (Bohlmann, H., Clausen, S., Behnke, S., Giese, H., Hiller, C., Reimann-Philipp, U., Schrader, G., Barkholt, V., and Apel, K., (1988) EMBO J. 7, 1559-1565). In the present work a second subfraction of thionins has been detected within the leaf cell, mainly in the vacuole. Thionins of both groups are closely related to each other. They are toxic to phytopathogenic fungi as well as to plant protoplasts, they share similar amino acid sequences, and their synthesis in etiolated seedlings of barley is down-regulated by light. Despite these similarities each of the two subfractions of thionins could be clearly distinguished by its subcellular distribution. In ultrathin sections of embedded etiolated leaf material, cell wall thionins could be immunogold labeled specifically by an antiserum raised against a fusion protein of Escherichia coli beta-galactosidase and the 15,000 Mr precursor polypeptide of thionins. This antiserum did not react with intracellular thionins. Inversely, intracellular thionins were recognized specifically by an anti-serum raised against soluble leaf thionins. The possible function of intracellular thionins as part of a defense mechanism has been discussed. PMID- 2722813 TI - Purification of erythrocyte dematin (protein 4.9) reveals an endogenous protein kinase that modulates actin-bundling activity. AB - A partially purified preparation of human erythrocyte protein 4.9, consisting of 48-, 52-, and 55-kilodalton polypeptides, is capable of bundling rabbit muscle actin in vitro (Siegel, D. L., and Branton, D. (1985) J. Cell Biol. 100, 775 785). Purification schemes, peptide mapping, antibody cross-reactivity, and chemical cross-linking techniques show that the 48- and 52-kDa polypeptides are sequence-related phosphorylated components, whereas the 55-kDa polypeptide is not. Purified protein 4.9 (dematin), consisting of 48- and 52-kDa polypeptides, effectively bundles actin in vitro; under similar conditions, the isolated 55-kDa polypeptide does not bundle actin. In fact, when added back to purified dematin, fractions containing the 55-kDa polypeptide can completely abolish dematin's actin-bundling activity. The basis for this inhibitory activity is an endogenous protein kinase that phosporylates both the 48- and 52-kDa isoforms of dematin, thus abolishing dematin's actin-bundling activity (Husain-Chishti, A., Levin, A., and Branton, D. (1988) Nature 334, 718-721). Although the endogenous kinase often co-purifies with the 55-kDa polypeptide, it can be separated from the 55-kDa polypeptide and has the characteristics of a catalytic subunit of a cyclic AMP dependent protein kinase. PMID- 2722814 TI - The alkali light chains of human smooth and nonmuscle myosins are encoded by a single gene. Tissue-specific expression by alternative splicing pathways. AB - Human smooth muscle and nonmuscle cells express closely related myosin alkali light chains which are different from the isoforms present in striated muscle tissues. To date no information on the amino acid sequence of these mammalian nonstriated muscle isoforms has been available. We have isolated full-length cDNA clones encoding the nonmuscle (lym4) and smooth muscle (GT6) myosin light chains (MLCs) from cultured human lymphoblasts and heart aorta smooth muscle cells, respectively. Here we present the complete nucleotide sequences for both cDNA clones, together with the deduced amino acid sequences for the peptides. Both cDNAs contain the same open reading frame for 151 amino acids with 5 amino acid differences located in the C terminus. These differences are encoded by a block of 44 nucleotides which is present only in the smooth muscle (SM) mRNA. To identify the human gene coding for the two MLC isoforms, we have isolated and sequenced the nonmuscle (NM)/SM MLC gene, together with several intronless pseudogenes. A single functional gene was found containing 7 exons which are utilized for the coding information of the SM MLC mRNA. In contrast, the NM MLC mRNA does not contain sequences encoded by exon 6 which corresponds to the 44 nucleotides expressed in SM mRNA. This genomic configuration suggests that both the smooth muscle and nonmuscle MLCs in man are generated from the identical primary transcript by alternative splicing pathways taking place in a tissue dependent manner. PMID- 2722815 TI - Rat ornithine decarboxylase gene. Nucleotide sequence, potential regulatory elements, and comparison to the mouse gene. AB - Expression of ornithine decarboxylase is regulated by a variety of hormonal and other stimuli in rat cells and tissues. To study this phenomenon at the molecular level, we isolated and sequenced a cDNA-encoding rat ornithine decarboxylase and deduced its amino acid sequence. The cDNA clone was used to isolate a clone from a rat genomic library which contained the sequence of the entire rat ornithine decarboxylase gene. The gene comprised 12 exons and 11 introns and spanned 7.7 kilobases. Two polyadenylation signals (AATAAA) were located 310 and 697 base pairs 3' to the translational termination codon and were responsible for the occurrence of two hybridizing mRNA species in Northern blots of rat cells and tissues. S1 nuclease mapping suggested that there were multiple transcriptional start sites; the major one appeared to be located 2269 base pairs of genomic sequence 5' to the ATG translational initiation site, representing 274 bases of mRNA. Several potential regulatory elements were identified in the 5'-promoter regions or in the first intron: a TATA box, GC boxes, AP-1 and AP-2 binding sites, a cAMP-responsive element, a glucocorticoid regulatory element, and RNA polymerase III promoter sequences. The 5'-noncoding region of the mRNA was extremely rich in G + C; secondary structure predictions suggested that almost this entire region could form stable secondary structures, with an overall free energy of formation (delta G) of -114 kcal/mol. The potential regulatory elements identified in both the promoter region of the gene and the 5'-untranslated region of the mRNA may be involved in the complex regulation of rat ornithine decarboxylase expression. PMID- 2722816 TI - Studies on the expression of genes encoding apolipoproteins B100 and B48 and the low density lipoprotein receptor in nonhuman primates. Comparison of dietary fat and cholesterol. AB - African green monkeys were fed diets containing low and moderate cholesterol concentrations with either polyunsaturated or unsaturated fat as 40% of calories. Plasma total cholesterol, low density lipoprotein (LDL) cholesterol, and apoB concentrations generally were higher in animals fed (a) the higher dietary cholesterol concentration and (b) saturated fat. At necropsy, liver and intestine were removed, and measurement of mRNAs for LDL receptors (liver) and for apolipoprotein B (liver and intestine) was done. Monkey small intestine mucosa made exclusively apoB48 while the liver made only apoB100, although apoB mRNA in both tissues was the same size (14 kilobases). No dietary cholesterol or fat effects were found for apoB mRNA abundance in the liver, while the animals fed the higher dietary cholesterol level had 50% lower levels of hepatic LDL receptor mRNA. In a separate group of animals, livers were perfused and the rate of apoB secretion was measured. No dietary fat effect on apoB secretion rate was found, and no relationship between plasma LDL cholesterol concentration and the rate of hepatic apoB production existed. These findings support the idea that the dietary factors that increase LDL concentrations act by reducing clearance of apoB containing particles rather than by increasing production of these lipoproteins. Hepatic LDL receptor mRNA was similar in abundance in polyunsaturated fat and saturated fat-fed animals, suggesting that the difference in plasma cholesterol concentration between these groups is not mediated via effects on LDL receptor mRNA abundance. The level of intestinal apoB mRNA was about 30% higher in animals fed the moderate dietary cholesterol concentration. Earlier studies have shown that more cholesterol is transported in chylomicrons from the intestine when dietary cholesterol levels are higher, and the increased intestinal apoB mRNA abundance may reflect increased intestinal cholesterol transport and chylomicron apoB48 production. PMID- 2722817 TI - Purification of oxysterol binding protein from hamster liver cytosol. AB - We have purified to apparent homogeneity an oxysterol binding protein from cytosol of hamster livers. This protein, which corresponds to the protein described by Taylor and Kandutsch (Taylor, F. R., and Kandutsch, A. (1985) Chem. Phys. Lipids 38, 187-194), binds oxysterols such as 25-hydroxycholesterol but does not bind cholesterol or steroid hormones in vitro. It may participate in the feedback repression of enzymes of cholesterol biosynthesis and the low density lipoprotein receptor. The protein was purified more than 40,000-fold with a series of ion exchange chromatography steps. The final preparation contained a doublet of peptides with molecular weights (Mr) of 101,000 and 96,000, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. These components formed a complex that migrated on gel filtration with an apparent Mr of 280,000 in the absence or presence of 25-hydroxycholesterol. The amino acid sequence of a tryptic peptide from this protein complex was obtained, and a monoclonal antipeptide antibody was prepared. The antibody stained both the 101,000- and 96,000-Da proteins on immunoblots, suggesting that these two components are closely related and that one may be a modified or proteolyzed form of the other. With the purified protein now available, it should become possible to determine the role, if any, that this protein plays in the regulation of intracellular cholesterol metabolism. PMID- 2722818 TI - Protease secretion by Erwinia chrysanthemi. Proteases B and C are synthesized and secreted as zymogens without a signal peptide. AB - The gene encoding the secreted 53-kDa metalloprotease (protease B) and the 5' end of the gene encoding the secreted 55-kDa metalloprotease (protease C) of the Gram negative bacterium Erwinia chrysanthemi have been sequenced. The predicted sequences of the two proteases do not have typical signal sequences at their NH2 termini. Both proteases are synthesized as inactive higher molecular weight precursors (zymogens proB and proC) which are secreted into the external medium where divalent cation-mediated activation occurs. The activation of proB occurs with a t1/2 of less than 5 min at 37 degrees C in Luria broth medium, whereas that of proC occurs with a t1/2 of about 150 min. The NH2 termini of purified proteases B, proB, and C were sequenced. ProB starts at the initiator methionine whereas B and C start, respectively, at residues +16 and +18 of the sequence deduced from the nucleotide sequence. A short NH2-terminal extension is therefore removed during the activation process, most likely by an autocatalytic mechanism. Protease B shows a high degree of sequence homology with the secreted 50-kDa metalloprotease of Serratia marcescens, which also lacks a signal peptide and for which an inactive higher molecular weight form has been reported. PMID- 2722819 TI - Gly-Gly-X, a novel consensus sequence for the proteolytic processing of viral and cellular proteins. AB - Three African swine fever virus structural proteins of relative molecular weights 150,000, 37,000, and 34,000 (p150, p37, and p34) are derived from precursors with relative molecular weights 220,000, 60,000, and 39,000 (pp220, pp60, and pp39) by proteolytic cleavage after the second Gly residue in the sequence Gly-Gly Ala/Gly. A search of the National Biomedical Research Foundation Data Bank revealed that several adenovirus proteins, ubiquitin, and an interferon-induced 15-kDa protein are also derived from precursors that are cleaved at the sequence Gly-Gly-X, where X is often an amino acid residue with a hydrophobic side chain. The sequence Gly-Gly-X together with other physical properties of the protein seems to be a recognition sequence for the processing of a variety of viral and cellular proteins. PMID- 2722820 TI - Bacterial lipopolysaccharide regulates the phosphorylation of the 68K protein kinase C substrate in macrophages. AB - Bacterial lipopolysaccharide (LPS) potentiates protein kinase C (PKC)-dependent responses such as the activation of arachidonic acid metabolism in macrophages (Aderem, A. A., Cohen, D. S., Wright, S. D., and Cohn, Z. A. (1986) J. Exp. Med. 164, 165-179). Concomitantly, LPS promotes the myristoylation of a 68K PKC substrate, shown to be equivalent to the 80/87K PKC substrate found in brain and fibroblasts (Aderem, A. A., Albert, K. A., Keum, M. M., Wang, J. K., Greengard, P., and Cohn, Z. A. (1988) Nature 332, 362-364). We have now examined the effect of LPS on the phosphorylation of this 68K PKC substrate. We report here that LPS modifies the kinetics and extent of phosphorylation of the 68K protein. While treatment with LPS alone induces low level phosphorylation of the 68K protein, it markedly increases the rate of subsequent phorbol 12-myristate 13-acetate (PMA) dependent phosphorylation of this protein. Phosphorylation in LPS-treated macrophages was maximal 1-2 min after administration of PMA, while maximal phosphorylation in macrophages not exposed to LPS was only achieved 6 min after addition of PMA. In addition to increasing the rate of PMA-dependent phosphorylation of the 68K protein in macrophages, LPS also promoted the phosphorylation of a novel peptide on the 68K protein. Thus while PMA stimulated the phosphorylation of two thermolytic phosphopeptides (phosphopeptides 1 and 2), the low level of phosphorylation observed with LPS alone was found to occur on phosphopeptides 1 and 2 as well as on a novel phosphopeptide (phosphopeptide 3). Furthermore, LPS treatment of macrophages potentiated phosphorylation of all three phosphopeptides when the cells were subsequently stimulated with PMA. While phosphorylation stimulated by LPS and PMA was slightly more than additive for phosphopeptides 1 and 2, it was markedly synergistic (increased 14.5-fold) for phosphopeptide 3. Phosphorylation of all three phosphopeptides occurred exclusively on serine. It is possible that LPS-induced myristoylation of the 68K protein directs it to the membrane where its phosphorylation is enhanced by its close association with PKC. PMID- 2722821 TI - A synthetic peptide-directed antibody as a probe of the phosphorylation site of pyruvate dehydrogenase. AB - A synthetic peptide, corresponding to the 14-amino acid tryptic fragment containing phosphorylation sites one and two of bovine mitochondrial pyruvate dehydrogenase, was coupled to Limulus polyphemus hemocyanin and used to produce rabbit polyclonal antibodies. A positive signal was observed when Western blots of bovine, porcine, or yeast mitochondrial pyruvate dehydrogenase complexes were probed with the antibodies but not with blots of bacterial, cellular slime mold, plant mitochondrial, or plant plastid pyruvate dehydrogenase complexes. The antibodies also gave a positive signal when used to probe blots of the bovine kidney branched chain 2-oxo acid dehydrogenase complex. The ATP-dependent phosphorylation/inactivation of rat liver mitochondrial pyruvate dehydrogenase complex could be inhibited by prior incubation with the anti-peptide antibodies. PMID- 2722822 TI - Cell-specific expression of mouse albumin promoter. Evidence for cell-specific DNA elements within the proximal promoter region and cis-acting DNA elements upstream of -160. AB - Regulation of albumin gene expression is believed to be mediated by multiple nuclear factors that interact with cis-acting DNA sequences within the first 160 base pairs (bp) of the promoter. The minimal promoter sequence required to generate tissue-specific expression has not been clearly defined. We have constructed a series of transient expression vectors containing progressive deletions of the mouse albumin gene 5'-flanking sequence fused to the bacterial chloramphenicol acetyltransferase (CAT) gene and include the Moloney murine leukemia viral (Mo-MuLV) enhancer. Promoter activity was determined in mouse hepatoma and fibroblast cell lines by chloramphenicol acetyltransferase and S1 nuclease analyses. All constructions were compared with -623 Albcat-Mo-MuLV which contains all the sequence homology between the rat and mouse promoters. Low levels of expression were observed with -60 Albcat-Mo-MuLV (10%) in hepatoma but not fibroblast cells. Addition of promoter sequence to -208 bp progressively increased activity to 190% in the hepatoma cells, while -308 and -1612 Albcat-Mo MuLV had activity similar to the -623 Albcat-Mo-MuLV level, and -3000 Albcat-Mo MuLV showed a 2-fold reduction in transcriptional activity. The inclusion of promoter sequences upstream of -60 generated low levels of expression in the fibroblasts. We also show that factors from mouse liver nuclear extracts protect at least five regions of the albumin promoter upstream of -160. Our results indicate that tissue specificity is established within the proximal promoter region and that additional cis-acting elements that may have a functional role in the efficiency of albumin gene expression are located upstream of -160 bp. PMID- 2722823 TI - The effects of mevinolin on the thiol/disulfide exchange between 3-hydroxy-3 methyglutaryl-coenzyme A reductase and glutathione. AB - The feeding of mevinolin plus cholestyramine to rats results in the production of a form of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR-CM) having thiol/disulfide redox properties different from those of 3-hydroxy-3 methylglutaryl-CoA reductase isolated from animals which had been given only cholestyramine (HMGR-C). The second-order rate constant for the inactivation of HMGR-CM by GSSG is 7-fold slower than for HMGR-C, while the second-order rate constant for the reactivation of oxidized enzyme by GSH is 100-fold slower. However, in the presence of saturating concentrations of both substrates, the rate constants for thiol/disulfide exchange are similar for both forms of the enzyme. HMGR-CM behaves as if a protein-glutathione mixed disulfide having a Kox of 27 +/- 4 is formed at equilibrium. In contrast, HMGR-C has previously been shown to form a protein-protein disulfide (Cappel, R. E., and Gilbert, H. F. (1988) J. Biol. Chem. 263, 12204-12212). Both forms of the enzyme are more difficult to oxidize thermodynamically in the presence of saturating levels of both substrates. For HMGR-CM, NADPH alone has no effect on the equilibrium constant for oxidation, but hydroxymethylglutaryl-CoA alone makes the enzyme approximately twice as difficult to oxidize. Under physiological conditions, HMGR CM is thermodynamically more difficult to oxidize than HMGR-C. HMGR-C can be converted to HMGR-CM by in vitro treatment with mevinolinate. A direct or indirect interaction of mevinolin with HMGR-C results in some persistent, as yet undefined, structural alteration which inhibits the formation of a protein-SS protein disulfide upon oxidation by glutathione disulfide. PMID- 2722824 TI - Synthetic amphipathic peptides resembling apolipoproteins stimulate the release of human placental lactogen. AB - Previous studies from our laboratory demonstrated native high density lipoproteins and apolipoproteins AI, AII, and CI, stimulate the release of human placental lactogen (hPL) from trophoblast cells in culture. To examine the mechanisms by which these apolipoproteins stimulate hPL release, we have studied hPL secretion in response to several synthetic peptide analogs of the amphipathic helical structure of the apolipoproteins. The magnitude of the stimulation of hPL release in response to the analog peptides correlated with the ability to displace apolipoproteins from high density lipoprotein and with other measures of phospholipid binding affinity such as the increase in alpha-helicity and the size of complexes formed between the peptide and phospholipid. The correlation of stimulatory ability and lipid affinity suggests that the action of the apolipoproteins on hPL release may be mediated through an interaction with plasma membrane phospholipids. PMID- 2722825 TI - Peroxisomal bile acid-CoA:amino-acid N-acyltransferase in rat liver. AB - Bile acid-CoA:amino-acid N-acyltransferase activity was measured in subcellular fractions of rat liver homogenate. The conversion of [14C]choloyl-CoA and [14C]chenodeoxycholoyl-CoA into the corresponding [14C]tauro- and glyco-bile acids was calculated after isolation of the product by high performance liquid chromatography. There was an enrichment of bile acid-CoA:amino-acid N acyltransferase activity in the light mitochondrial (L) fraction and to a lesser extent in the microsomal fraction. Surprisingly, no enrichment was found in the cytosolic fraction. Subfractionation of the L-fraction by Nycodenz gradient centrifugation, showed that the activity of the N-acyltransferase had a bimodal distribution and co-sedimented with peroxisomes (particulate catalase) and microsomes (esterase). The highest specific amidation activity of both choloyl CoA and chenodeoxycholoyl-CoA was always found in the most peroxisome-rich fractions. [14C]Taurocholate formation in the peroxisomal fraction was 2.2 mumol/mg of protein/min. Striking differences were observed in the Km values and the saturation concentrations for glycine and taurine. The peroxisomal amidation of [14C]choloyl-CoA had a Km for taurine of 0.9 x 10(-3) M and for glycine of 17 x 10(-3) M. The results are consistent with the possibility that most of de novo synthesized bile acids conjugate to taurine by a peroxisomal bile acid-taurine N acyltransferase in rat liver. The bile acids deconjugated in the gut and recirculating to the liver may be activated and amidated by the microsomal enzyme system prior to biliary secretion. PMID- 2722826 TI - Involvement of protein kinase C in platelet-activating factor-stimulated diacylglycerol accumulation in murine peritoneal macrophages. AB - Incubation of murine peritoneal macrophages with platelet-activating factor (PAF; 1-O-alkyl(C16 + C18)-2-acetyl-sn-glycerol-3-phosphorylcholine) results in the rapid accumulation of [3H]inositol phosphates and sn-1,2-diacylglycerol (DAG) and mobilization of intracellular calcium (Prpic, V., Uhing, R. J., Weiel, J. E., Jakoi, L., Gawdi, G., Herman, B., and Adams, D. O. (1988) J. Cell Biol. 107, 363 372). We have further investigated the relationship of phosphoinositide metabolism to accumulation of DAG and the possible involvement of protein kinase C in the accumulation of DAG in response to PAF. DAG accumulation proceeds at a slower rate than the accumulation of either [3H] inositol 1,4,5-trisphosphate or total [3H]inositol phosphates. Accumulation of DAG from additional precursors is suggested from both an estimation of the mass of total inositol phosphates produced and the accumulation of [3H]choline in response in PAF. Down-regulation of protein kinase C by prolonged pretreatment with phorbol ester or inhibition of the enzyme with sphingosine inhibited the PAF-generated accumulation of DAG at 10 min by approximately 80%. Under the same conditions, no inhibition of PAF stimulated generation of [3H]inositol 1,4,5-trisphosphate was observed. Similar inhibition was observed when 10 microM ionomycin or 0.1 microM phorbol 12 myristate 13-acetate were used to stimulate accumulation of DAG. The results suggest that PAF stimulates the accumulation of DAG from source other than phosphatidylinositol metabolism in peritoneal macrophages and that this occurs subsequent to the activation of protein kinase C. PMID- 2722827 TI - Solubilization and partial purification of retinyl ester synthetase and retinoid isomerase from bovine ocular pigment epithelium. AB - Studies reported previously from this laboratory have demonstrated that membranes from the pigment epithelium of the vertebrate eye can transform free all-trans retinol to 11-cis-retinol as well as 11-cis- and all trans-retinyl esters (Bernstein, P. S., Law, W. C., and Rando, R. R. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 1849-1853; Bernstein, P. S., Law, W. C., and Rando, R. R. (1987) J. Biol. Chem. 262, 16848-16857; Fulton, B. S., and Rando, R. R. (1987) Biochemistry 26, 7938-7945). The congeneric retinals are also formed under conditions where retinol redox activity is present. Here we report the successful solubilization of both the retinyl ester synthetase and isomerase activities from the pigment epithelium membranes of the bovine eye. The zwitterionic detergent Zwittergent 3 14(N-tetradecyl-N,N-dimethyl-3-ammonio-1-propanesulfonate; cmc 0.012%) gave optimal solubilization of both activities. Three initial criteria for successful solubilization were used. First, high speed centrifugation (greater than 150,000 x g) left the activities in the supernatant. Second, the solubilized enzymatic activities were found in the included volume upon gel filtration. Finally, the solubilized activities were quantitatively passed through a 0.22-microns filter. Employing anion exchange and gel filtration chromatography results in a partial purification of the retinyl ester synthetase (approximately 189-fold). The solubilized retinoid isomerase is also partially purified (approximately 10-14 fold) following anion exchange chromatography. It is also shown that the membrane bound and solubilized ester synthetase catalyzes the esterification of retinol using added lecithins as exogenous acyl donors. In addition, evidence is provided indicating that there is a positional selectivity for the acyl group transfer from the lecithin to retinol. The transfer occurs largely, if not entirely, from the 1-position of the lecithin. PMID- 2722828 TI - The crystal structure of erabutoxin a at 2.0-A resolution. AB - The three-dimensional structure of erabutoxin a, a single-chain, 62-residue protein neurotoxin from snake venom, has been determined to 2.0-A resolution by x ray crystal structure analysis. Molecular replacement methods were used, and the structure refined to a residual R = 0.17. The sites of 62 water molecules and 1 sulfate ion have been located and refined. The structure of erabutoxin a is very similar to that established earlier for erabutoxin b. These toxins from venom of the same snake differ in sequence only at residue 26, which is Asn in erabutoxin a and His in erabutoxin b. The substitution leads to only minor variations in intramolecular hydrogen bonding. Furthermore, the distribution of thermal parameters and the implied regional mobilities are similar in the two structures. In particular, the highly mobile character of the peripheral segment Pro44-Gly49 in both structures supports the specific role proposed for this segment in neurotoxin binding to the acetylcholine receptor. Forty-eight of the solvent sites determined are first surface positions; approximately one-half of these are equivalent to solvent sites in erabutoxin b. PMID- 2722829 TI - Stabilized isoporphyrin intermediates in the inactivation of horseradish peroxidase by alkylhydrazines. AB - The reaction of horseradish peroxidase with alkylhydrazines results in delta-meso alkylation of the prosthetic heme group and enzyme inactivation (Ator, M. A., David, S. K., and Ortiz de Montellano, P. R. (1987) J. Biol. Chem. 262, 14954 14960). As reported here, enzyme inactivation is associated with the accumulation of intermediates that absorb at approximately 835 nm. The properties of these intermediates, including their collapse to give meso-alkylhemes, identify them as isoporphyrins. The t1/2 values for inactivation and formation of the isoporphyrin intermediate at 25 degrees C are, respectively, 11.6 and 12.5 min for methylhydrazine (2.0 mM), 8.7 and 7.2 min for ethylhydrazine (1.0 mM), and 30 and 25 s for phenylethylhydrazine (50 microM). The isoporphyrin intermediates are surprisingly long-lived, with half-lives (35 degrees C, pH 7.0) of 9, 28, 96, and 450 min for, respectively, the phenylethyl, methyl, n-butyl, and ethyl analogues. pH studies show that protonation of a group with pKa = 5.0-6.5 accelerates isoporphyrin decay and decreases steady state isoporphyrin accumulation. Horseradish peroxidase reconstituted with delta-meso-methylheme, unlike horseradish peroxidase with a heme that has a larger meso-substituent, is catalytically active but is more sensitive to H2O2-mediated degradation of the prosthetic group than is the native enzyme. The delta-meso-methylheme prosthetic group is converted in the reaction with H2O2 to a biliverdin-like product. The results implicate highly stabilized isoporphyrin intermediates in the inactivation of horseradish peroxidase by alkylhydrazines and indicate that inactivation by the meso-alkyl groups is due to steric interference with electron delivery to the heme edge rather than to intrinsic electronic consequences of meso-alkylation. The structural features that stabilize the cationic isoporphyrins may also be involved in stabilization of the Compound I porphyrin radical cation. PMID- 2722830 TI - Amino acid sequences in fibrinogen mediating its interaction with its platelet receptor, GPIIbIIIa. AB - Platelet membrane GPIIbIIIa is a member of the family receptors named integrins that recognize RGD sequences in their ligands. GPIIbIIIa interacts with at least three different adhesive ligands: fibrinogen, fibronectin, and von Willebrand factor. These interactions are inhibited by RGD-containing peptides and by peptides corresponding to a sequence unique to fibrinogen in the COOH-terminal domain of its gamma chain (HLGGAKQAGDV). Two RGD sequences are present in fibrinogen A alpha chain: an RGDS sequence at A alpha 572-575, and an RGDF sequence at A alpha 95-98. Polyclonal antibodies raised against the RGDF sequence and the gamma COOH-terminal domain both reacted specifically with fibrinogen in solid phase enzyme-linked immunosorbent assays and immunoprecipitated the protein in solution. The Fab fragments prepared from these antibodies inhibited fibrinogen-platelet interaction and aggregation. These results demonstrate that these two sequences are both accessible within the fibrinogen molecule and are both implicated in ligand binding and cell-cell interaction. In addition, by further examining the interaction of the gamma chain peptide with platelets, it was found that RGDF and the gamma peptide produced a similar dose-dependent inhibition of the binding of the labeled gamma peptide to ADP-stimulated platelets. These results provide evidence that the RGDF sequence present at the A alpha 95-98 constitutes with the gamma 401-411 sequence two recognition sites interacting with the same site or with mutually exclusive sites on GPIIbIIIa. PMID- 2722831 TI - High affinity divalent cation binding to actin. Effect of low affinity salt binding. AB - Monomeric actin labeled with the fluorescent probe N-iodoacetyl-N'-(5-sulfo-1 naphthyl)ethylenediamine (1,5-I-AEDANS-actin) displays a fast fluorescence intensity increase immediately upon addition of salt and then a slow fluorescence intensity change concurrent with Ca2+/Mg2+ exchange at the high affinity divalent cation binding site on actin. The fast change appears to reflect competitive binding of K+ at low affinity (nonspecific) sites and of Mg2+ or Ca2+ at low and intermediate affinity sites. Binding of cation at the low affinity sites (but apparently not at the intermediate affinity sites) results in an increase in k-Ca and k-Mg and thus a decrease in affinity for divalent cations at the high affinity site. The effect of Mg2+ on k-Ca is twice that of K+ for equal fractional saturations of the low affinity binding, and the effect of K+ and Mg2+ together on k-Ca reflects competitive binding at the low affinity sites. Thus the affinity and kinetics of divalent cation binding at the high affinity site of actin are significantly affected by concurrent cation binding at low affinity sites. PMID- 2722832 TI - Identification of D-sorbitol 3-phosphate in the normal and diabetic mammalian lens. AB - The 31P NMR spectra of mammalian lenses show, in addition to previously identified compounds such as ATP, Pi, glycerophosphorylcholine, and alpha glycerophosphate, an unusual phosphorylated metabolite resonating at 6.5 ppm. The concentration of this compound increases manyfold in the lenses of diabetic rats concomitant with activation of the aldose reductase pathway. We have purified this material and have identified it as D-sorbitol 3-phosphate. It appears likely that this unusual metabolite of sorbitol may reflect or be part of the metabolic aberration of diabetes in the lens. PMID- 2722833 TI - A new core tetrasaccharide component from the lipopolysaccharide of Rhizobium trifolii ANU 843. AB - A second core oligosaccharide fragment has been isolated and characterized from the lipopolysaccharide (LPS) of Rhizobium trifolii ANU 843. The oligosaccharide is a tetrasaccharide composed of galactose, galacturonic acid, mannose, and 3 deoxy-D-manno-2-octulosonic acid. The mannose residue is alpha-linked to the 4 position of 3-deoxy-D-manno-2-octulosonic acid and the galacturonic acid residue is alpha-linked to the 6-position of mannose. The galactose residue, which is acetylated at the 4-position, is attached to the 4-position of mannose by an alpha-linkage. All of the aldoses are in the pyranose form. The composition of the tetrasaccharide was determined by gas-liquid chromatography of the alditol acetate derivatives of the component monosaccharides. The configuration of anomeric linkages was determined by 1H NMR spectroscopy. Fast atom bombardment mass spectrometry (FAB-MS) was performed on acetylated, per(trideutero)acetylated and underivatized tetrasaccharide giving sequence information in addition to information on the residue which was acetylated. Similar studies were performed on the oligosaccharide after reduction with sodium cyanoborohydride and peracetylation with labeled and unlabeled acetic anhydride as before. Further linkage and sequence analysis was obtained from methylation analysis, and from electron impact mass spectrometry of the per(trideutero)acetylated oligosaccharide and from collision-induced dissociation fast atom bombardment tandem mass spectrometry using linked scans at constant B/E on the cyanoborohydride-reduced, per (trideutero)acetylated oligosaccharide. The exact location of the acetyl group was deduced from 1H NMR double resonance experiments in conjunction with mass spectrometric data. PMID- 2722834 TI - 27-Hydroxyoctacosanoic acid is a major structural fatty acyl component of the lipopolysaccharide of Rhizobium trifolii ANU 843. AB - A new hydroxylated, very long-chain fatty acid has been isolated and characterized from the lipopolysaccharide (LPS) of Rhizobium trifolii ANU 843. The lipid A of the organism was degraded by mild alkali and borohydride and the products methylated, peracetylated, and fractionated on a C18 reverse-phase column. The major lipid fraction was reduced with lithium triethylborohydride, methylated, peracetylated, and subjected to thin layer chromatography. The methylated peracetylated acid and the reduced diacetylated diol (1,27 dihydroxyoctacosane diacetate) were isolated and characterized by mass spectrometry and 1H NMR spectroscopy using homonuclear decoupling. The identity and linkage of the new fatty acid in the lipopolysaccharide was confirmed by 1H NMR spectroscopy of purified lipid A fractions and similar NMR studies of lipid A after acylation by phenylisocyanate. In the native LPS, the 27-hydroxy C-28 fatty acid is acylated at the 27-hydroxy position by other 3-hydroxy fatty acids. About 50% of the total fatty acid content of the LPS of R. trifolii ANU 843 is 27 hydroxyoctacosanoic acid. This oxyacyloxy structure involving 27 hydroxyoctacosanoic appears to be the major structural feature of the lipid A of this organism. PMID- 2722835 TI - Purification of hepoxilin epoxide hydrolase from rat liver. AB - Hepoxilin epoxide hydrolase activity was demonstrated in rat liver cytosol using as substrate [1-14C] hepoxilin A3, a recently described hydroxy epoxide derivative of arachidonic acid. The enzyme was isolated and purified to apparent homogeneity using conventional chromatographic procedures resulting in 41-fold purification. The protein eluted during isoelectric focusing at a pI in the 5.3 5.4 range. The specific activity of the purified protein was 1.2 ng/microgram protein/20 min at 37 degrees C. On sodium dodecyl sulfate-polyacrylamide gel electrophoresis, under denaturing conditions, a molecular mass value of 53 kDa was observed. Using native polyacrylamide gel electrophoresis, enzyme activity corresponded to the main protein band. The purified protein used hepoxilin A3 as preferred substrate converting it to trioxilin A3. The enzyme was marginally active toward other epoxides such as leukotriene A4 and styrene oxide. The Mr, pI, and substrate specificity of the hepoxilin epoxide hydrolase indicate that this enzyme is different from the recently reported leukotriene A4 hydrolase from human erythrocytes and rat and human neutrophils and constitutes a hitherto undescribed form of epoxide hydrolase with specificity toward hepoxilin A3. Tissue screening for enzyme activity revealed that this enzyme is ubiquitous in the rat. PMID- 2722836 TI - Structure and activity dependence of recombinant human insulin-like growth factor II on disulfide bond pairing. AB - The complete peptide map of purified folded recombinant human insulin-like growth factor II (rhIGF-II) was determined to verify its sequence and disulfide bonding scheme. Each peptide generated by digestion with pepsin was purified and characterized by amino acid analysis, amino acid sequence analysis, and fast atom bombardment/mass spectrometry. Some peptides were also sequenced using tandem mass spectrometry. The rhIGF-II peptide map was compared to that of rat insulin like growth factor II and to that of a disulfide-bonded isomer of rhIGF-II. The data obtained in these studies are consistent with the conclusion that the rhIGF II obtained from Escherichia coli has the correct amino acid composition, sequence, and the native disulfide-bonded structure. The binding affinities of these forms of recombinant IGF-II for IGF carrier proteins were measured in an IGF binding protein assay. The disulfide isomer of rhIGF-II was 160-fold less potent than native rhIGF-II in the competitive protein binding assay. These studies illustrate the need to characterize recombinant polypeptides containing disulfide bonds to allow the native structure to be verified before characterizing the biological properties of such molecules in hopes of elucidating their physiologic functions. PMID- 2722837 TI - A quantitative model for the kinetics of cAMP-dependent protein kinase (type II) activity. Long-term activation of the kinase and its possible relevance to learning and memory. AB - Using computer simulation we have modeled the kinetics of cAMP-dependent protein kinase, type II, following transient pulses of cAMP. We show that under the appropriate physiological conditions, the kinase can remain activated 20 min or longer after the cessation of adenylate cyclase activation, in a process we term long-term activation. Long-term activation depends in part on the state of phosphorylation of the regulatory subunit, because phosphorylation of the regulatory subunit regulates the affinity of this subunit for the catalytic subunit. We have used our model to simulate experiments that have been performed on the kinetic and steady state activities of cAMP-dependent protein kinase and have found good agreement between the simulations and the experimental data. The effects of the activity of phosphodiesterase, adenylate cyclase, and protein phosphatase on the kinetics of cAMP-dependent protein kinase have been modeled, as have the effects of different ratios of regulatory subunit to catalytic subunit. We have also simulated the activation of the cAMP-dependent protein kinase in Drosophila learning and memory mutants having primary or secondary defects in the cAMP cascade. We make predictions regarding the behavior of different mutants, which are in line with the experimental data. The model corroborates the assumption that the cAMP cascade may play a role in learning and short-term memory. PMID- 2722838 TI - Purified human erythrocyte pyrroline-5-carboxylate reductase. Preferential oxidation of NADPH. AB - Pyrroline-5-carboxylate reductase catalyzes the final step in proline synthesis by NAD(P)H-dependent reduction of pyrroline-5-carboxylate. We have purified and characterized this enzyme from human erythrocytes. Purification to homogeneity (approximately 600,000-fold) was accomplished by sonication, ultracentrifugation, 2',5'-ADP-Sepharose affinity chromatography, and DEAE-Sephacel ion exchange chromatography. The enzyme runs as a single band of 30,000 Mr on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Sizing chromatography under nondenaturating conditions demonstrates activity in the 300,000-350,000 Mr range, suggesting that the native enzyme exists as a 10- to 12-mer. The purified enzyme exhibits kinetic characteristics similar to those previously described for whole red cell homogenates. The Vmax is 10-fold higher and the Km for pyrroline-5 carboxylate is 7-fold higher with NADH versus NADPH as cofactor. The affinity for NADPH is 15-fold higher than that for NADH. Erythrocyte pyrroline-5-carboxylate reductase is competitively inhibited by NADP+. Unlike the enzyme from some other sources, erythrocyte pyrroline-5-carboxylate reductase is not inhibited by proline or ATP. Double label studies using [14C]pyrroline-5-carboxylate and [3H]exNADPH in the presence of both NADH and NADPH were performed to determine the preferred source of reducing equivalents. In the presence of physiologic concentrations of pyrroline-5-carboxylate and both pyridine nucleotides, all of the reducing equivalents came from NADPH. We suggest that, in some cell types including human erythrocytes, a physiologic function of pyrroline-5-carboxylate reductase is the generation of NADP+. PMID- 2722839 TI - Further characterization and immunochemical studies on the carbohydrate specificity of jackfruit (Artocarpus integrifolia) lectin. AB - The lectin from jackfruit (Artocarpus integrifolia) seeds has been purified by Rivanol (6,9-diamino-2-ethoxyacridine lactate) treatment. The specific activity, molecular weights of parent lectin and its subunit, its glycoprotein nature, and hemagglutination-inhibition assays suggest that this preparation is identical to that obtained by affinity chromatography on melibiose-agarose adsorbent (Ahmed, H., and Chatterjee, B. P. (1986) in Lectins, Biology, Biochemistry, Clinical Biochemistry (Bog-Hansen, T. C., and van Driessche, E., eds) Vol. 5, pp. 125-133, Walter de Gruyter, New York). The lectin strongly agglutinates human and several animal erythrocytes. The lectin contains five isolectins of pI values 7.1, 6.85, 5.5, 5.3, and 5.1. It is thermally stable and loses its activity above 75 degrees C. The hemagglutinating activity remains unchanged in the presence of bivalent cations viz., Ca2+, Mg2+, Mn2+, etc. It is a metalloprotein. The lectin retains its activity by dialysis with acetic acid followed by EDTA. It agglutinates Ehrlich ascites cells. Equilibrium dialysis of lectin with melibiose and quenching of fluorescence of 4-methylumbelliferyl-alpha-D-galactopyranoside by the lectin show that homotetrameric jackfruit lectin has two sugar-binding sites. The lectin precipitates well several galactomannans and glycoproteins having terminal D-Gal-alpha-(1----6)- or D-Gal-beta-(1----3)-D-GalNAc residues. It hardly or does not precipitate polysaccharides having terminal D-Gal-alpha-(1--- 3) residues. Quantitative precipitin-inhibition studies using various haptens suggest that the -OCH2- group at C-1 and -OH groups at C-4 and partially at C-6 in the alpha-glycoside of D-galactose configuration are important for lectin sugar interaction. PMID- 2722840 TI - Structures and metabolism of inositol tetrakisphosphates and inositol pentakisphosphate in bovine adrenal glomerulosa cells. AB - In adrenal glomerulosa cells, angiotensin II stimulates rapid increases in inositol 1,4,5-trisphosphate (Ins-1,4,5-P3) and inositol 1,3,4,5 tetrakisphosphate (Ins-1,3,4,5-P4), followed by slower increases in two additional inositol tetrakisphosphate (InsP4) isomers. One of these InsP4 isomers was previously identified as Ins-1,3,4,6-P4 and shown to be a precursor of inositol pentakisphosphate (InsP5). Analysis of the third InsP4 isomer, purified from cultured bovine adrenal cells labeled with [3H]inositol and stimulated by angiotensin II, revealed that the polyol produced by periodate oxidation, borohydrate reduction, and dephosphorylation was [3H]iditol. This finding is consistent with precursor structures of either Ins-1,4,5,6-P4 or Ins-3,4,5,6-P4 (= L-Ins-1,4,5,6-P4) for the third InsP4 isomer. The [3H]iditol was readily converted to [3H]sorbose by the stereospecific enzyme, L-iditol dehydrogenase, indicating that it originated from Ins-3,4,5,6-P4. Chicken erythrocytes labeled with [3H]inositol also contained high levels of Ins-1,3,4,6-P4 and Ins-3,4,5,6 P4, as well as InsP5, but only small amounts of Ins-1,3,4,5-P4. Both [3H]Ins 1,3,4,6-P4 and [3H]Ins-3,4,5,6-P4, but not [3H]Ins-1,3,4,5-P4, were phosphorylated to form InsP5 in permeabilized bovine glomerulosa cells. In addition, InsP5 itself was slowly dephosphorylated to Ins-1,4,5,6-P4, indicating that its structure is Ins-1,3,4,5,6-P5. These results demonstrate that the higher inositol phosphates are metabolically interrelated and are linked to the receptor regulated InsP3 response by the conversion of Ins-1,3,4-P3 through Ins-1,3,4,6-P4 to Ins-1,3,4,5,6-P5. The source of Ins-3,4,5,6-P4, the other precursor of InsP5, is not yet known but its elevation in angiotensin II-stimulated glomerulosa cells suggests that its formation is also influenced by agonist-regulated processes. PMID- 2722841 TI - Activation of phospholipase D by the fucose-sulfate glycoconjugate that induces an acrosome reaction in spermatozoa. AB - We report for the first time that phospholipase D activity in sea urchin spermatozoa can be regulated by a component of egg jelly known to induce an acrosome reaction. The fucose-sulfate glycoconjugate (FSG) of egg jelly that induces an acrosome reaction in spermatozoa caused Ca2+-dependent increases in 1,2-diacylglycerol and phosphatidic acid. Diacylglycerol concentrations were increased 2-fold, and phosphatidic acid concentrations were elevated up to 10 fold 2 min after the addition of FSG to spermatozoa. FSG also caused increases in choline, but not in choline phosphate concentrations. Neither phosphorylation of diacylglycerol nor de novo synthesis from glycerol were significant routes of synthesis of phosphatidic acid during the acrosome reaction. When spermatozoa were incubated with FSG in the presence of ethanol, phosphatidylethanol was produced. As ethanol concentrations in the extracellular medium were increased from 0.1 to 2.5%, the amount of phosphatidylethanol increased, whereas phosphatidic acid concentrations decreased, suggesting a competitive transphosphatidylation reaction catalyzed by phospholipase D. Furthermore, when a phosphatidylcholine pool in spermatozoa was radiolabeled using [3H]1-O-alkyl-2 lyso-glycerol-3-phosphorylcholine, the subsequent addition of FSG caused a 4-fold accumulation of [3H]phosphatidic acid. FSG-induced elevations in [3H]phosphatidic acid were positively correlated with the percent of cells that had undergone an acrosome reaction. PMID- 2722842 TI - Xenopus laevis contains two nonallelic preproinsulin genes. cDNA cloning and evolutionary perspective. AB - We undertook the cloning of preproinsulin cDNAs from the South African clawed toad, Xenopus laevis, in order to study the role of insulin during embryogenesis in this species. We found that X. laevis contains two different preproinsulin cDNAs, both of which code for peptides containing 106 amino acids of typical structure but which differ by eight amino acids: one in the signal peptide, two in the B-chain, four in the C-peptide, and one in the A-chain. Southern blot analysis indicates that the two preproinsulin cDNAs identified correspond to two different nonallelic genes which we believe arose through a recent gene duplication within the amphibian radiation possibly during the development of tetraploidy in this species. Both genes are expressed, since we have recently identified the two corresponding insulins in pancreatic extracts of adult toads (Shuldiner, A.R., Bennett, C., Robinson, E.A., and Roth, J. (1989) Endocrinology, in press). These cDNAs represent the first amphibian preproinsulin sequences to be elucidated. PMID- 2722843 TI - Identification of 1-alkyl-2-acyl-3-(2',3'-diacylglycerol)glycerols, a new type of lipid class, in harderian gland tumors of mice. AB - A new class of alkyl glycerolipids, 1-alkyl-2-acyl-3-(2',3' diacylglycerol)glycerols, was identified in lipid extracts prepared from harderian gland tumors of mice. After saponification, this lipid class yielded 1 alkyl-3-(1'-glycerol)glycerols. Identification was based on mass spectrometry, proton nuclear magnetic resonance spectroscopy, infrared spectroscopy, and chromatography of various derivatives and appropriate standards that were synthesized. The alkyl moieties of this unique lipid class consisted of saturated aliphatic chains with chain lengths of 14 to 20 carbon atoms. The acyl moieties were mostly saturated and monounsaturated aliphatic chains ranging from 14 to 24 carbon atoms. The alkyl and acyl moieties of 1-alkyl-2-acyl-3-(2',3' diacylglycerol)glycerols were similar to those of alkyldiacylglycerols present in the same tissue, except for the presence of monounsaturated alkyl moieties in the latter. 1-Alkyl-2-acyl-3-(2', 3'-diacylglycerol)glycerols were only found in trace amounts in the normal harderian glands of mice. The total quantity of the alkyl and acyl moieties with a chain length greater than 20 carbon atoms in the alkyldiacylglycerols from tumors were considerably lower than those found in normal harderian glands of mice. This is the first report of the presence of bisglyceryl ether lipids in mammalian tissue; its unique chemical structure is consistent with the type of ether-linked lipid products that could be synthesized in the reaction catalyzed by alkyldihydroxyacetone-P synthase. PMID- 2722844 TI - Purification of a new, calcium-independent, high molecular weight phospholipase A2/lysophospholipase (phospholipase B) from guinea pig intestinal brush-border membrane. AB - A phospholipase A2 activity directed against phosphatidylcholine was previously described in brush-border membrane from guinea pig intestine (Diagne, A., Mitjavila, S., Fauvel, J., Chap, H., and Douste-Blazy, L. (1987) Lipids 22, 33 40). In the present study, this enzyme was solubilized either with Triton X-100 or upon papain treatment, suggesting a structural similarity with other intestinal hydrolases such as leucine aminopeptidase, sucrase, or trehalase. The papain-solubilized form, which is thought to lack the short hydrophobic tail responsible for membrane anchoring, was purified 1800-fold to about 90% purity by ion exchange chromatography on DEAE-Sephacel, gel filtration on Ultrogel AcA44, and hydrophobic chromatography on phenyl-Sepharose. Upon polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, a main band with an apparent molecular mass of 97 kDa was detected under reducing and nonreducing conditions. In the latter case, phospholipase A2 activity could be recovered from the gel and was shown to coincide with the 97-kDa protein detected by silver staining. The enzyme activity was unaffected by EGTA and slightly inhibited by CaCl2. The purified enzyme displayed a similar activity against phosphatidylcholine and phosphatidylethanolamine, whereas 1-O-alkyl-2-acyl-sn glycero-3-phosphocholine hydrolysis was reduced by 50% compared to diacylglycerophospholipids. Using phosphatidylcholine labeled with either [3H]palmitic acid or [14C]linoleic acid in the 1- or 2-positions, respectively, the purified enzyme catalyzed the removal of [3H]palmitic acid, although at a lower rate compared to [14C]linoleic acid. This resulted in the formation of sn glycero-3-phosphocholine, but only 1-[3H]palmitoyl-sn-glycero-3-phosphocholine was detected as an intermediary product. In agreement with this, 1-acyl-2-lyso-sn [14C]glycero-3-phosphocholine was deacylated at almost the same rate as the sn-2 position of phosphatidylcholine. Since upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the two hydrolytic activities were detected at the same position as 97-kDa protein, the enzyme is thus considered as a phospholipase A2 with lysophospholipase activity (phospholipase B), which might be involved in phospholipid digestion. PMID- 2722845 TI - A defective intramolecular autoactivation cascade may cause the reduced kinase activity of the skeletal muscle insulin receptor from patients with non-insulin dependent diabetes mellitus. AB - The insulin receptor purified from skeletal muscle of patients with non-insulin dependent diabetes mellitus (NIDDM) displayed a 25-55% reduction in insulin stimulated autophosphorylation and tyrosyl-specific phosphotransferase activity relative to controls. This decrease was not explained by alterations of muscle fiber composition, insulin binding affinity or capacity, or the Km values for ATP; the lower kinase activity was entirely attributed to a decrease in the Vmax of the enzyme. Phosphorylation sites in the beta-subunit of the control and diabetic receptor were identified by tryptic digestion and reverse-phase high performance liquid chromatography. Autophosphorylation occurred primarily in two regions of the beta-subunit: the regulatory region containing Tyr-1146, Tyr-1150, and Tyr-1151, and the C terminus containing Tyr-1316 and 1322. Autophosphorylation of the regulatory region at all three tyrosyl residues (tris phosphorylation) appears to be necessary to activate the receptor kinase (White, M. F., Shoelson, S. E., Stepman, E. W., Keutmann, H. & Kahn, C. R. (1988) J. Biol. Chem. 263, 2969-2980). The receptor from NIDDM patients showed a decreased level of tris-phosphorylation of the regulatory region which was closely associated (r2 = 0.97) with the decreased kinase activity. In contrast, weak associations were found between kinase activity and the bis-phosphorylated forms of the regulatory region (r2 = 0.51) and the C terminus (r2 = 0.35). Therefore, the reduced formation of the tris-phosphorylated regulatory region in the diabetic receptors suggests that a defective autophosphorylation cascade leading to tris-phosphorylation of the regulatory region may cause, in part, the reduced insulin-stimulated kinase activity of the insulin receptor in muscle of NIDDM patients. PMID- 2722846 TI - Cloning of the cDNA of a human neutrophil bactericidal protein. Structural and functional correlations. AB - The bactericidal permeability increasing protein (BPI) is a 50-60-kDa membrane associated protein isolated from granules of polymorphonuclear leukocytes. A full length cDNA clone encoding human BPI has been isolated and the derived amino acid sequence reveals a structure that is consistent with previously determined biological properties. BPI may be organized into two domains: the amino-terminal half, previously shown to contain all known antimicrobial activity, contains a large fraction of basic and hydrophilic residues. In contrast, the carboxyl terminal half contains more acidic than basic residues and includes several potential transmembrane regions which may anchor the holoprotein in the granule membrane. The cytotoxic action of BPI is limited to many species of Gram-negative bacteria; this specificity may be explained by a strong affinity of the very basic aminoterminal half for the negatively charged lipopolysaccharides that are unique to the Gram-negative bacterial envelope. The amino-terminal end of BPI exhibits significant similarity with the sequence of a rabbit lipopolysaccharide binding protein, suggesting that both molecules share a similar structure for binding lipopolysaccharides. PMID- 2722847 TI - Purification and characterization of glycosphingolipid-specific endoglycosidases (endoglycoceramidases) from a mutant strain of Rhodococcus sp. Evidence for three molecular species of endoglycoceramidase with different specificities. AB - Two molecular species of endoglycoceramidase (designated as endoglycoceramidases I and II) were purified 32,700 and 43,000 times with overall recoveries of 4.8 and 2.9%, respectively, from a culture fluid of the mutant strain M-750 of Rhodococcus sp., cultivated in the absence of inducers (ganglioside). After being stained with Coomassie Brilliant Blue or a silver-staining solution, each purified enzyme showed a single protein band on polyacrylamide gel electrophoresis in the presence and absence of sodium dodecyl sulfate. The apparent molecular weights, as estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, were 55,900 for endoglycoceramidase I and 58,900 for endoglycoceramidase II, and their pIs were 5.3 and 4.5, respectively. both were capable of hydrolyzing the glucosylceramide linkage of ganglio-type, lacto-type, and globo-type glycosphingolipids to afford intact oligosaccharides and ceramides. Globo-type glycosphingolipids were strongly resistant to hydrolysis by endoglycoceramidase II in comparison with endoglycoceramidase I. Neither could hydrolyze gala-type glycosphingolipids, cerebrosides, sulfatides, glycoglycerolipids, or sphingomyelins. In addition to these two enzymes, the strain M-750 produced a third minor molecular species of endoglycoceramidase designated as endoglycoceramidase III. It was found capable of specifically hydrolyzing the galactosylceramide linkage of gala-type glycosphingolipids that were not hydrolyzable at all by endoglycoceramidases I or II. The molecular weights of the oligosaccharide and ceramide released from asialo GM1, incubated either in normal H2O or H2(18)O with the enzyme, were compared by fast atom bombardment-mass spectrometry. The result clearly indicated that both endoglycoceramidases I and II hydrolyze the glycosidic linkage between the oligosaccharide and ceramide. Thus, a systematic name of the endoglycoceramidase should be glycosyl-N-acyl-sphingosine 1,1-beta-D-glucanohydrolase. PMID- 2722848 TI - Stoichiometric binding of low density lipoprotein (LDL) and monoclonal antibodies to LDL receptors in a solid phase assay. AB - The current paper describes a solid phase ligand binding assay for the low density lipoprotein (LDL) receptor that takes advantage of the domain structure of the protein. An antibody directed against one domain, e.g. the cytoplasmic tail, is adsorbed to a microtiter well. A detergent solution containing the LDL receptor is added, and the receptor is allowed to bind to the antibody. The wells are then washed, and one of the following radioiodinated ligands is added: 125I LDL or an 125I-labeled monoclonal antibody directed against a different domain than the antibody adsorbed to the well. Under these conditions, the human LDL receptor shows high affinity for 125I-LDL and for 125I-IgG-HL1, a monoclonal antipeptide antibody directed against a 10-amino-acid "linker" between repeats 4 and 5 in the ligand binding domain. The binding affinity is the same at 4 degrees C and 37 degrees C. The binding of 125I-LDL and 125I-IgG-HL1 occurs with 1:1 molar stoichiometry, suggesting that the human LDL receptor binds 1 mol of LDL per mol of receptor. The acid-dependent dissociation of 125I-LDL and 125I-labeled monoclonal antibody from LDL receptors that is observed in intact cells was also shown to occur in the solid phase binding assay. We used the solid phase assay to demonstrate the secretion of LDL receptors from monkey cells that have been transfected with a cDNA encoding a truncated form of the human receptor that lacks the membrane-spanning domain. This assay may be useful in measuring the relative amounts of the intact LDL receptor in tissue extracts and the secreted receptor in transfected cells. PMID- 2722849 TI - The beta actin promoter. High levels of transcription depend upon a CCAAT binding factor. AB - Although beta actin mRNA is down-regulated during myogenesis, the beta actin promoter confers constitutive expression when joined to heterologous genes transfected into a variety of different cell backgrounds, including differentiated muscle. Normal promoter activity is dependent upon the binding of a ubiquitous factor to the CCAAT-box element. Loss or reduction in factor binding correlates with a major reduction in promoter activity both in vivo and in vitro. The binding domain covers approximately 23 base pairs as determined by DNase footprinting. Methylation of A and G residues in and adjacent to the CCAAT box results in the loss of factor binding. Mutations across the binding domain indicate that the sequence GCCAATCAG within the domain is sufficient as a recognition sequence for factor binding. This binding is not competed by the alpha cardiac actin CCAAT sequence. Bandshift experiments demonstrate a predominant single band of similar mobility in nuclear extracts from various cells and tissues, with the exception of HeLa cells. The prevalence of the factor and its recognition sequence in a variety of promoters suggests that this factor has a common role in the transcriptional activation of several eukaryotic promoters. PMID- 2722850 TI - Synthetic transit peptides inhibit import and processing of mitochondrial precursor proteins. AB - We have demonstrated that a synthetic peptide corresponding to the rat mitochondrial malate dehydrogenase (mMDH) transit peptide (TP-28) inhibits the binding of pre-mMDH to isolated mitochondria. Synthetic peptides derived from chloroplast transit peptide sequences, which have a similar net charge, did not inhibit import. In addition, this peptide (TP-28) inhibits import of ornithine transcarbamylase, another mitochondrial matrix protein, thus suggesting that common import pathways exist for both mMDH and ornithine transcarbamylase. A smaller synthetic peptide corresponding to residues 1-20 of the mMDH transit peptide (TP-20) also inhibits binding. However, several substitutions for leucine 13 in the smaller peptide relieve import inhibition, thus providing evidence that this neutral residue plays a crucial role in transit peptide binding to the mitochondrial surface. Proteolytic processing of pre-mMDH by a mitochondrial matrix fraction to both the mature and intermediate forms of mMDH was also inhibited by TP-28. The ability of synthetic peptides to inhibit distinct steps in the import of mitochondrial precursor proteins corresponds precisely to their ability to interact with the same components used by transit peptides on intact precursors. Furthermore, inhibition at multiple points along the import pathway reflects the functions of several independent structures contained within transit peptides. PMID- 2722851 TI - Disulfide bond formation in the regulation of eIF-2 alpha kinase by heme. AB - The inhibition of the autophosphorylation of the heme-regulated eukaryotic initiation factor (eIF)-2 alpha kinase (HRI) by hemin is very similar to that produced by thiol oxidation by diamide. The results obtained from the analysis of sodium dodecyl sulfate-polyacrylamide gel electrophoresis of unphosphorylated and phosphorylated HRI under reducing and nonreducing conditions indicate that hemin promotes disulfide formation in HRI. Hemin-promoted disulfide formation in HRI occurs under quasi-physiological conditions, i.e. 30 degrees C, 10 min at hemin concentrations of 5-10 microM. Under nondenaturing conditions, unphosphorylated HRI, phosphorylated HRI, hemin-treated unphosphorylated HRI, and hemin-treated prephosphorylated HRI are all eluted identically on Sephacryl S-300 column chromatography with an apparent molecular mass of 290,000 daltons. It appears, therefore, that the disulfide formation promoted by hemin occurs within the unit of 290,000 daltons. In addition, hemin treatment of phosphorylated HRI results in the appearance of a disulfide-linked form of higher molecular mass when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under nonreducing conditions. A similar high molecular mass form is observed when HRI is treated with 1,6-bismaleimidohexane, a double sulfhydryl cross-linker agent, and the autophosphorylation of HRI and the phosphorylation of eIF-2 alpha by HRI are greatly diminished; these effects are similar to the effects of hemin on HRI. We conclude that disulfide formation by hemin provides a likely mechanism by which hemin prevents the activation and inhibits the activity of HRI. PMID- 2722853 TI - Phosphorylation modulates the activity of glycine N-methyltransferase, a folate binding protein. In vitro phosphorylation is inhibited by the natural folate ligand. AB - Glycine N-methyltransferase (EC 2.1.1.20) was recently identified as a major folate binding protein of rat liver cytosol (Wagner, C., and Cook, R. J. (1984) Proc. Natl. Acad. Sci. U.S.A. 81, 3631-3634). Activity of the enzyme is inhibited when the natural folate ligand, 5-methyltetrahydropteroylpentaglutamate (5-CH3 H4PteGlu5), is bound. It has been suggested that glycine N-methyltransferase plays a role in regulating the availability of methyl groups in the liver. Purified transferase was phosphorylated in vitro by the catalytic subunit of cAMP dependent protein kinase. If 5-CH3-H4PteGlu5 was first bound to the transferase, phosphorylation was inhibited. Phosphorylation of glycine N-methyltransferase in vitro increased its activity approximately 2-fold. 5-CH3-H4PteGlu5 inhibited the activity of newly phosphorylated enzyme as well as native enzyme. Freshly isolated rat hepatocytes incorporated 32P-labeled inorganic phosphate into this folate binding protein. Chemical analysis of purified enzyme showed about 0.55 mol of phosphate present per mol of glycine N-methyltransferase subunit. These results indicate that phosphorylation of glycine N-methyltransferase may provide a mechanism for modulating the activity of this enzyme and support its role in regulating the availability of methyl groups. PMID- 2722852 TI - Chylomicron-chylomicron remnant clearance by liver and bone marrow in rabbits. Factors that modify tissue-specific uptake. AB - The metabolism of [14C]cholesterol- and [3H]retinol-labeled chylomicrons obtained from canine thoracic duct or rabbit mesenteric lymph was investigated in normal fasted rabbits. Typically, 70-80% of the chylomicrons injected into the rabbits were cleared from the plasma in 20 min, and their uptake was accounted for principally by the liver and the bone marrow. Surprisingly, the bone marrow was a major site of uptake; the uptake ranged from about half that of the liver to a nearly equal amount. The importance and specificity of chylomicron-chylomicron remnant uptake by the bone marrow were established by demonstrating that (a) bone marrow throughout the body accumulated these lipoproteins, (b) the level of uptake was consistent regardless of how the values were calculated or how the chylomicrons were prepared, (c) the uptake represented specific binding, and (d) radiolabeled intestinal lipoproteins induced in vivo delivered cholesterol and retinol to the marrow. Electron microscopic examination of the rabbit bone marrow established that perisinusoidal macrophages uniquely accounted for the uptake of the chylomicrons. Whereas liver cleared a variety of both triglyceride-rich lipoproteins (chylomicrons, chylomicron remnants, and very low density lipoproteins) and cholesterol-rich lipoproteins (beta-very low density lipoproteins and high density lipoproteins containing apolipoprotein E), bone marrow uptake appeared to be restricted to the triglyceride-rich lipoproteins. More chylomicron remnants (generated in a hepatectomized rabbit) were cleared by the liver than by the bone marrow, and the addition of excess apolipoprotein E to chylomicrons resulted in their preferential uptake by the liver. The role of chylomicron-chylomicron remnant delivery of lipids or lipid-soluble vitamins to rabbit bone marrow is open to speculation, and whether triglyceride-rich lipoprotein uptake occurs to a significant extent in the bone marrow of humans remains to be determined. PMID- 2722854 TI - Changes in glycosylation alter the affinity of the human transferrin receptor for its ligand. AB - When transferrin receptors of human erythroleukemic cells were pulse-labeled with [35S]methionine and then chased in the absence of radioactive precursor, the first detectable immunoprecipitable form of the receptor had a molecular mass of 85 kDa. This form of the receptor was converted to the mature form of 93 kDa with a half-time of about 40-60 min. Both the immature (85 kDa) and mature (93 kDa) receptors associated as dimers, the native form of the receptor. The 85-kDa, as well as the 93-kDa, receptors bound to a monoclonal antibody raised against the transferrin receptor or to transferrin-Sepharose. In order to determine whether glycosylation was necessary for ligand binding, purified receptors were isolated from cells grown in the presence of tunicamycin. When K562 cells were grown in the presence of tunicamycin, an 80-kDa nonglycosylated form of the receptor was synthesized. This nonglycosylated receptor was also capable of dimer formation; however, much less of it reached the cell surface than the fully glycosylated form, although both untreated and tunicamycin-grown cells appeared to synthesize transferrin receptors at similar rates. Although the number of receptor molecules/cell was similar in control and tunicamycin-treated cells, the nonglycosylated receptors exhibited a much lower affinity for transferrin than those of untreated cells; in contrast, when receptors were purified by immunoprecipitation and digested with bacterial alkaline phosphatase, no difference was observed between the affinity of these receptors and undigested immunoprecipitated receptors. These results suggest that glycosylation is not necessary for specific binding of transferrin to its receptor, but the affinity of this binding can be influenced greatly by the presence or absence of carbohydrate residues. PMID- 2722855 TI - Osteopontin, a transformation-associated cell adhesion phosphoprotein, is induced by 12-O-tetradecanoylphorbol 13-acetate in mouse epidermis. AB - A murine mRNA (provisionally called 2ar) is described whose abundance is greatly increased by the tumor promoter 12-O-tetradecanoylphorbol 13-acetate both in JB6 epidermal cells in vitro and in epidermis in vivo. We have previously shown induction of 2ar in epidermal or fibroblast cell lines by tumor promoters, growth factors, and transformation with H-ras. The 2ar mRNA appears to be derived from a single copy gene. It encodes the mouse homolog of rat osteopontin, a 41.5-kDa glycosylated bone phosphoprotein that binds to fibroblasts and osteosarcoma cells and to hydroxylapatite (bone matrix). The rat and mouse sequences are 84% identical at the amino acid level and 87% identical at the nucleotide level. Many of the primary structural features are conserved, including a run of 9-10 aspartic residues and a Gly-Arg-Gly-Asp-Ser cell adhesion sequence. Antiserum raised against portions of the predicted polypeptide immunoprecipitated proteins of apparent Mr 55,000-70,000 both from reticulocyte lysates containing the translation products of hybrid-selected mRNA and from cell culture medium containing metabolically labeled proteins secreted by JB6 cells. The results presented here demonstrate that osteopontin is identical to a transformation associated phosphoprotein whose level of expression by cultured cells and abundance in human sera has been correlated with tumorigenicity. These results suggest a role for osteopontin in carcinogenesis. The murine version of osteopontin has been given the formal name "secreted phosphoprotein 1" and the designation spp. PMID- 2722856 TI - Antithrombin III-dependent anti-prothrombinase activity of heparin and heparin fragments. AB - Heparin and heparin fragments in the molecular mass range 1,700-20,000 Da were examined for their ability to accelerate the antithrombin III (AT III)-dependent inhibition of human factor Xa and the prothrombin converting complex (prothrombinase) during human prothrombin activation. The prothrombinase reaction was modeled by a 3-parameter 2-exponential equation to determine the initial rate of prothrombin activation and the pseudo-first order rate constants of inhibition of prothrombinase and in situ generated thrombin activity. The catalytic specific activities of the heparins increased with increasing molecular size for both the inhibition of prothrombinase and factor Xa. A 10-fold increase over the entire Mr range was found. In contrast to results obtained by others (Ellis, V., Scully, M. F., and Kakkar, V. V. (1986) Biochem. J. 233, 161-165; Barrowcliffe, T. W., Havercroft, S. J., Kemball-Cook, G., and Lindahl, U. (1987) Biochem. J. 243, 31 37), all the heparins showed a 5-fold higher rate of inhibition of factor Xa when compared with the inhibition of prothrombinase, indicating that the factor Va mediated protection of factor Xa from inhibition by AT III/heparin is independent of the molecular size of the heparin. Our original approach has also revealed a hitherto unrecognized phenomenon, namely, in addition to the accelerating effect of the heparins on the rate of formation of the inactive AT III-factor Xa complex, heparins with Mr greater than 4,500 reduce the initial rate of thrombin generation in the presence of AT III in a concentration-dependent way. We hypothesize that the formation of the dissociable ternary AT III-heparin-factor Xa complex results in a (partial) loss of factor Xa activity towards its natural substrate prothrombin. PMID- 2722857 TI - Immunoaffinity purification, partial sequence, and subcellular localization of rat liver phospholipase A2. AB - Monoclonal antibodies against rat liver mitochondrial phospholipase A2 were used to develop a rapid immunoaffinity chromatography for enzyme purification. The purified enzyme showed a single band upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The sequence of the N-terminal 24 amino acids was determined. This part of the sequence showed only 25% homology with that of rat pancreatic phospholipase A2 but was 96% identical to that of rat platelet and rat spleen membrane-associated phospholipase A2. These enzymes are distinguished from pancreatic phospholipases A2 by the absence of Cys-11. In rat liver phospholipase A2 activity has been reported in various subcellular fractions. All of these require Ca2+ and have a pH optimum in the alkaline region, but little is known about the structural relationship and quantitative distribution of these enzymes. We have investigated these points after solubilization of the phospholipase A2 activity from total homogenates and crude subcellular fractions by extraction with 1 M potassium chloride. Essentially all of the homogenate activity could be solubilized by this procedure indicating that the enzymes occurred in soluble or peripherally membrane-associated form. Gel filtration and immunological cross reactivity studies indicated that phospholipases A2 solubilized from membrane fractions shared a common epitope with the mitochondrial enzyme. The quantitative distribution of the immunopurified enzyme activity among subcellular fractions followed closely that of the mitochondrial marker cytochrome c oxidase. Rat liver cytosol contained additional Ca2+-dependent and -independent phospholipase activities. PMID- 2722858 TI - Differences in redox and kinetic properties between NAD-dependent and O2 dependent types of rat liver xanthine dehydrogenase. AB - Reductive titrations of a NAD-dependent type (type-D) and an O2-dependent type (type-O) of rat liver xanthine dehydrogenase showed that only the type-D enzyme formed a pronounced stable FAD semiquinone (FADH*). The FAD semiquinone was less stabilized in the presence of NAD. The Vmax value for xanthine-NAD activity of type-D enzyme was close to that for xanthine-O2 activity of type-O enzyme, while the Vmax value for xanthine-O2 activity of type-D enzyme was about one-fourth of that of type-O enzyme. The Km value for O2 of type-D enzyme was about five times as large as that of type-O enzyme. The absorbance spectrum of type-D enzyme during turnover with xanthine and O2 as substrates showed a considerable amount of FADH* formation, but that with xanthine and NAD as substrates showed only a negligible one. Low xanthine-O2 activity of type-D enzyme, as compared with that of type-O enzyme, seems to be explained by the conformational change occurring in conversion from type-O to type-D enzyme, which results in different reactivity of FAD to molecular oxygen and a higher fraction of FADH* during turnover. The binding of NAD may possibly increase the fraction of FADH2, resulting in a Vmax value of xanthine-NAD activity almost as high as that of xanthine-O2 activity of type-O enzyme. PMID- 2722859 TI - A possible role of inorganic phosphate as a regulator of oxidative phosphorylation in combined urea synthesis and gluconeogenesis in perfused rat liver. A phosphorus magnetic resonance spectroscopy study. AB - Metabolic control of oxidative metabolism was studied in perfused rat liver by means of phosphorus magnetic resonance spectroscopy. Oxygen consumption, ATP, and Pi were measured with different rates of gluconeogenesis and urea synthesis by varying concentrations of the substrates in the perfusate. Five levels of oxygen consumption (VO2) were obtained: an average control value of 1.94 +/- 0.14 and 2.93 +/- 0.25, 3.29 +/- 0.46, 3.85 +/- 0.26, and 4.18 +/- 0.56 mumol/min/g liver (mean +/- S.D., n = 6). The corresponding ATP concentrations were 2.51 +/- 0.20, 2.39 +/- 0.08, 2.24 +/- 0.09, 2.13 +/- 0.12, and 1.91 +/- 0.13 mM. Pi increased stoichiometrically with the decrease in ATP. Free Pi (Pif) was calculated as NMR visible Pi in control plus -delta ATP (1.94 mM + (-delta ATP]. The kinetic relationship of oxidative phosphorylation as a function of Pif followed a Michaelis-Menten type of equation: VO2 = 5.55/(1 + 0.24/[( Pif] - 1.81]. The observed Km value for Pi of 0.24 mM approximates the reported Km value in isolated mitochondria of 1 mM. The free Pi concentration of 1.94 mM is in the range of the Km value, while the free ADP concentration of 200 microM exceeds the Km value of 20 microM. Therefore, it is suggested that Pi play a major role in the regulation of mitochondrial oxidative phosphorylation in combined urea synthesis and gluconeogenesis. PMID- 2722860 TI - Isolation and characterization of cDNA clones derived from the divergently transcribed gene in the region upstream from the human dihydrofolate reductase gene. AB - Transcripts initiated in the region immediately upstream from the human dihydrofolate reductase gene but transcribed from the opposite strand have been identified in human cells. These divergent upstream transcripts are polyadenylated, start at 89 base pairs upstream from the dihydrofolate reductase major initiation site, and are composed of two species of 5.0 and 3.8 kilobases in length. We have isolated complementary DNA clones derived from the divergent transcripts and identified a 3.5-kilobase open reading frame in one of these clones. Computer-assisted sequence analyses have shown that there is no significant sequence homology between the putative amino acid sequence and known protein sequences. This arrangement of two divergent transcriptional units suggests that the expression of these two genes may be regulated by a bidirectional promoter with common sequence elements. PMID- 2722861 TI - DNA primase-DNA polymerase alpha assembly from mouse FM3A cells. Purification of constituting enzymes, reconstitution, and analysis of RNA priming as coupled to DNA synthesis. AB - The mouse DNA primase-DNA polymerase alpha complex can be resolved with buffer containing 50% ethylene glycol (Suzuki, M., Enomoto, T., Hanaoka, F., and Yamada, M. (1985) J. Biochem. (Tokyo) 98, 581-584). The dissociated primase and DNA polymerase alpha have been purified sufficiently that there was no cross contamination with each other. By the use of thus isolated DNA primase and DNA polymerase alpha in addition to DNA primase-DNA polymerase alpha complex, we have studied primer RNA synthesis and DNA elongation separately as well as the coupled reaction of the initiation and elongation of DNA chains. In the absence of deoxyribonucleoside triphosphates, the isolated primase synthesized oligoribonucleotides of an apparent length of 7-11 nucleotides (monomeric oligomer) and multiples of a modal length of 9-10 nucleotides (multimeric oligomer) and fd phage single-stranded circular DNA. Monomeric and dimeric oligomers were synthesized processively, and trimeric and larger oligomers were produced by repeated cycles of processive synthesis. The primase complexed with DNA polymerase alpha mainly synthesized monomeric and a small amount of dimeric oligomers. In the presence of deoxyribonucleoside triphosphates at concentrations above 10 microM, the DNA primase-DNA polymerase alpha complex exclusively synthesized monomeric oligomers only, which were utilized as primers for DNA synthesis. On the other hand, the products synthesized by the isolated primase were qualitatively unchanged as compared with those synthesized in the absence of DNA precursors. When the synthesis of oligomers by the isolated primase was coupled with DNA elongation by the addition of the primase-free DNA polymerase alpha, the synthesis of dimeric oligomers was inhibited as a result of efficient DNA elongation from monomeric oligomers. PMID- 2722862 TI - Cloning and regulation of a mRNA specifically expressed in the preadipose state. AB - A cDNA library of Ob1771 preadipocytes was constructed, and a cDNA clone designated pOb24 was isolated by differential screening. The pOb24 mRNA, 6 kilobases in length, rose sharply in early differentiating Ob1771 and 3T3-F442A cells and decreased thereafter. In mouse adipose tissue, it was present at a high level in stromal-vascular cells (containing adipose precursor cells) and at a low level in mature adipocytes. Thus, pOb24 mRNA appears to be both in vitro and in vivo an unique marker of the preadipose state, i.e. of cell commitment during adipose cell differentiation. In contrast to glycerol-3-phosphate dehydrogenase mRNA, the emergence of pOb24 mRNA in Ob1771 cells required neither growth hormone or triiodothyronine as obligatory hormones nor insulin as a modulating hormone. Comparative studies of the expression of pOb24 and dihydrofolate reductase genes during the cell cycle suggest that arrest at the G1/S boundary was critical for the entry into the preadipose state. Tumor necrosis factor and transforming growth factor-beta were able to induce a large decrease of pOb24 mRNA level in growth-arrested Ob1771 cells. This decrease was shown to be only confined to early differentiating, glycerol-3-phosphate dehydrogenase negative cells as no decrease of pOb24 mRNA level was observed in glycerol-3-phosphate dehydrogenase positive cells. This result suggests that signals generated by tumor necrosis factor and transforming growth factor-beta have no effect on a commitment-related gene in late differentiated cells. PMID- 2722863 TI - Primary structure and transcriptional regulation of rat pepsinogen C gene. AB - The entire rat pepsinogen C gene has been isolated from a rat genomic library, using the rat pepsinogen C cDNA as a probe. Southern blot analysis showed that there exists at least two rat pepsinogen C genes. The nucleotide sequences of the coding regions and the 5'- and 3'-flanking regions of one of the rat pepsinogen C genes have been determined. This gene is split into 9 exons interrupted by eight intervening sequences. The 5'-flanking region is similar to that of the human pepsinogen C gene, but only the former has the core sequence of the Sp1 binding site. The amount of transcripts of the rat pepsinogen C genes was found to increase during development, and a similar increase was shown to be induced by injection of hydrocortisone. As a candidate of a factor which regulates the transcription, we found a 25-kDa protein by Southwestern blotting. It binds to a specific site in the 5'-flanking region of the gene only in the presence of Mg2+ ion, and it is present in the nuclear fraction of the gastric mucosa but not of the liver. PMID- 2722864 TI - A novel amino acid substitution in the reactive site of a congenital variant antithrombin. Antithrombin pescara, ARG393 to pro, caused by a CGT to CCT mutation. AB - Antithrombin is a plasma protein inhibitor that can be grouped within a serine proteinase inhibitor superfamily. Antithrombin Pescara is a functional variant of antithrombin found in a family with a high incidence of thrombosis. Preliminary functional analysis has suggested that the abnormality resides in the reactive site rather than in the heparin binding domain of the molecule. Accordingly, we have isolated the variant from plasma using heparin-Sepharose chromatography, followed by chromatography upon thrombin-Sepharose to remove the normal antithrombin that is present (the propositus is heterozygous for the variant). The variant protein was reduced, S-carboxy-methylated, and fragmented with CNBr. A pool ("CNBr pool 4") containing the reactive site region was isolated by reverse-phase high performance liquid chromatography and sequentially treated with trypsin and V8 protease. Fast atom bombardment-mass spectrometric analysis of this subdigest identified a novel peptide of mass 1708. Four steps of Edman degradation together with further analysis by fast atom bombardment-mass spectroscopy identified the NH2-terminal sequence of this peptide as Ala-Ala-Ala Ser. The mass of the novel peptide and its changing mass in response to Edman degradation are only compatible with its identity as Ala382-Arg399, with the reactive site Arg393 replaced by Pro. Using specific oligonucleotide hybridization, we demonstrated that the molecular defect of antithrombin Pescara is caused by a CGT to CCT mutation in codon 393. These findings may be of broad interest, as other members of the serine protease inhibitor superfamily contain arginine at their reactive sites and may be expected to undergo a similar mutation. PMID- 2722865 TI - Purification and properties of a new enzyme, NG,NG-dimethylarginine dimethylaminohydrolase, from rat kidney. AB - A new enzyme, NG, NG-dimethylarginine dimethylaminohydrolase which plays a role in the metabolism of NG,NG-dimethyl-L-arginine, has been purified to homogeneity from rat kidney. The enzyme consists of a single polypeptide and its molecular weight is about 33,000. The isoelectric point of the enzyme is at pH 5.2. The enzyme catalyzes the hydrolytic liberation of the dimethylamino moiety of NG,NG dimethyl-L-arginine and forms L-citrulline and dimethylamine. It is highly specific for NG,NG-dimethyl-L-arginine and NG-monomethyl-L-arginine, and the Km values for these amino acids are 0.18 and 0.36 mM, respectively. The enzyme shows the maximum activity at pH 6.5 and requires no cofactor. The activity is strongly inhibited by SH-blocking reagents (e.g. p-chloromercuribenzoate and HgCl2) and divalent metal ions (e.g. Cd2+, Cu2+, and Zn2+). PMID- 2722866 TI - Transcriptional control of the rat heme oxygenase gene by a nuclear protein that interacts with adenovirus 2 major late promoter. AB - Induction of rat heme oxygenase is mediated by at least two factors: its substrate heme and heat shock (Shibahara, S., Muller, R.M., and Taguchi, H. (1987) J. Biol. Chem. 262, 12889-12892). We have identified the cis-acting element of the rat heme oxygenase gene (HO gene), that was specifically bound by a nuclear protein prepared from rat glioma cells. We have termed this protein as heme oxygenase transcription factor (HOTF), whose estimated molecular weight is about 40,000. The element identified is CCACCACGTGACTCGAG (-51/-35) located just upstream of TATA-like sequence. The functional studies indicate that this sequence is required for the accurate and efficient initiation of transcription from the HO gene promoter. Since the HOTF-binding element is similar to the upstream promoter sequence (UPS) of the adenovirus 2 major late promoter (Ad2MLP), we examined whether rat HOTF is homologous to the upstream stimulatory factor (USF) or major late transcription factor previously identified in HeLa cells, which interacts with the UPS and activates the transcription from the Ad2MLP. HOTF specifically binds to the UPS of Ad2MLP, whereas HOTF failed to form a stable complex with the mutated HOTF-binding element lacking a GTGA sequence ( 44/-42 of the HO gene), the sequence of which is identical to a core sequence of the USF-binding sites. Moreover, we show that like USF, HOTF is heat stable. These results suggest that HOTF may be homologous to USF or the major late transcription factor. Since USF is present in uninfected cells, it is conceivable that the expression of the HO gene is regulated at least in part by USF. PMID- 2722867 TI - Crystallization of a synthetic analog of calcium-binding site III of rabbit skeletal troponin C. AB - Single crystals of the calcium-binding peptide AcA98STnC (90-123)amide, which is a synthetic fragment analog of rabbit skeletal troponin C calcium-binding site III, have been grown in the tetragonal crystal system. Crystals were developed to a maximum size of 0.60 x 0.60 x 0.75-mm by the technique of washing and reseeding. The space group is I41 with a = 40.21(1) A, c = 34.07(1) A; there is 1 polypeptide fragment/crystallographic asymmetric unit, and the solvent content is estimated to be 29%. The crystals diffract to at least 1.8-A d spacings and are stable in the x-ray beam for 1 week. PMID- 2722868 TI - Lipoprotein abnormalities associated with lipopolysaccharide-induced lecithin: cholesterol acyltransferase and lipase deficiency. AB - Density gradient ultracentrifugation was used to isolate and characterize the plasma lipoproteins from African green monkeys before and 24 and 48 h after subcutaneous injection of 300 micrograms/kg lipopolysaccharide (LPS) to induce an acute phase response. Compared with 0 h values, reductions occurred in plasma cholesterol (39%), high density lipoprotein (HDL) cholesterol (54%), lecithin:cholesterol acyltransferase (LCAT) activity (55%), and post-heparin plasma lipase activity (68%) 48 h after LPS injection while plasma triglyceride concentrations increased 700%. Cholesterol distribution among lipoproteins shifted from 7 to 41% in very low density lipoproteins (VLDL), 65 to 38% in low density lipoproteins (LDL), and 28 to 21% in HDL after LPS injection. At 48 h after LPS injection, all lipoprotein classes were relatively enriched in phospholipid and triglyceride and depleted of cholesteryl ester. The plasma concentration of all chemical constituents in VLDL was increased 3-9-fold within 48 h after LPS injection. By negative stain electron microscopy, HDL were discoidal in shape while VLDL and LDL appeared to have excess surface material present. Even though total HDL protein concentration in plasma was unaffected, the plasma mass of the smallest HDL subfractions (HDL3b,c) doubled while the mass of intermediate-sized subfractions (HDL3a) was dramatically decreased within 24 h after treatment. HDL became enriched in apoE, acquired apoSAA, and became depleted of apoA-I, A-II, and Cs by 48 h after LPS injection while apoB-100 remained the major apoprotein of VLDL and LDL. We conclude that administration of LPS to monkeys prevents normal intravascular metabolism of lipoproteins and results in the accumulation of relatively nascent forms of lipoproteins in plasma. These immature lipoproteins resemble those isolated from the recirculating perfusion of African green monkey livers, which are relatively deficient of LCAT activity and those isolated from the plasma of patients with familial LCAT deficiency. PMID- 2722869 TI - A new method for cell permeabilization reveals a cytosolic protein requirement for Ca2+ -activated secretion in GH3 pituitary cells. AB - Ca2+ is a major regulator of exocytosis in secretory cells, however, the biochemical mechanisms underlying regulation remain to be identified. To render the secretory apparatus accessible for biochemical studies, we have developed a cell permeabilization method (cell cracking) which utilizes mechanical shear. GH3 pituitary cells subjected to cracking were permeable to macromolecules but retained a normal cytoplasmic ultrastructure including secretory granules. Incubation of the permeable cells at 30-37 degrees C with 0.1-1.0 microM Ca2+ and millimolar MgATP resulted in the release of the secretory proteins, prolactin (PRL) and a proteoglycan, but not lysosomal enzymes. Extensively washed permeable cells were incapable of releasing PRL in response to Ca2+ and MgATP addition. However, addition of cytosol was found to restore Ca2+-activated, MgATP-dependent PRL release. The cytosolic factor responsible for activity was thermolabile and protease sensitive. The protein was partially purified, and its molecular mass was estimated to be equivalent to that of a globular protein of 200-350 kDa by molecular sieve chromatography. Inhibitors of calmodulin or protein kinase C (trifluroperazine, calmidazolium, H-7) failed to inhibit Ca2+-activated PRL release, and the required cytosolic protein could not be replaced by purified calmodulin, calmodulin-dependent protein kinase II, protein kinase C, or calpactin I. Further purification and characterization of the cytosolic protein should reveal the nature of biochemical events involved in regulated secretory exocytosis. PMID- 2722870 TI - Vaccinia specific kinase inhibitory factor prevents translational inhibition by double-stranded RNA in rabbit reticulocyte lysate. AB - Mouse L-cells infected with vaccinia virus produce a specific kinase inhibitory factor (SKIF) which inhibits the activation of the interferon-induced, double stranded (ds)RNA-dependent, eukaryotic initiation factor (eIF)-2 alpha-specific protein kinase in L-cell extracts (Whitaker-Dowling, P., and Younger, J. S., (1984) Virology 137, 171). The effects of a partially purified preparation of SKIF have been examined in cell-free extracts of rabbit reticulocytes. Both the phosphorylation state of eIF-2 and protein synthetic activity have been determined. SKIF inhibits the phosphorylation of the alpha subunit of eIF-2 by dsRNA-dependent eIF-2 alpha-kinase in reticulocyte lysate, but does not affect phosphorylation of eIF-2 by the heme-sensitive kinase. In addition to its effects on eIF-2 alpha-PKds activity, SKIF prevents dsRNA-induced inhibition of protein synthesis in reticulocyte lysate. In contrast, SKIF does not prevent the translational inhibition caused by hemin depletion. These data provide a direct correlation between the effects of SKIF on eIF-2 alpha phosphorylation and on protein synthetic activity and demonstrate the specificity of SKIF. The results also show that SKIF does not abolish dsRNA sensitivity, but increases the concentration of dsRNA required to activate the kinase and phosphorylate eIF-2. PMID- 2722871 TI - Agonist-dependent phosphorylation and nuclear dephosphorylation of glucocorticoid receptors in intact cells. AB - Phosphorylation and dephosphorylation has been suggested to influence the function of glucocorticoid receptors, but evidence for hormone-dependent changes in the phosphorylation state under physiological conditions is lacking. Here we show that in intact WEHI-7 mouse thymoma cells, labeled for 18-20 h with [32P]orthophosphate and [35S]methionine, glucocorticoids rapidly increase the average number of phosphates on the steroid-binding protein approximately from three to five. This stimulation is agonist-dependent since the antiglucocorticoid RU 486 (17 beta-hydroxy-11 beta,4-dimethylaminophenyl-17 alpha-propynyl estra-4,9 diene-3-one) has no effect by itself and blocks the cortisol-induced phosphorylation. Furthermore, the salt-unextractable nuclear bound receptors lose at least two phosphates compared to cytosolic and nuclear extractable forms. These results show for the first time that these hormone-dependent transcription regulators undergo agonist-induced phosphorylation and dephosphorylation which may affect their activity. PMID- 2722872 TI - Identification of two types of smooth muscle myosin heavy chain isoforms by cDNA cloning and immunoblot analysis. AB - We previously reported the characterization of a rabbit uterus cDNA clone (SMHC29) which encoded part of the light meromyosin of smooth muscle myosin heavy chain (Nagai, R., Larson, D.M., and Periasamy, M. (1988) Proc. Natl. Acad. Sci. U. S. A. 85, 1047-1051). We have now characterized a second cDNA clone (SMHC40) which also encodes part of the light meromyosin but differs from SMHC29 in the following respects. Nucleotide sequence analysis demonstrates that the two myosin heavy chain mRNAs are identical over 1424 nucleotides but differ in part of the 3'-carboxyl coding region and a portion of the 3'-nontranslated sequence. Specifically, SMHC40 cDNA encodes a unique stretch of 43 amino acids at the carboxyl terminus, whereas SMHC29 cDNA contains a shorter carboxyl terminus of 9 unique amino acids which is the result of a 39-nucleotide insertion. Recent peptide mapping of smooth muscle myosin heavy chain identified two isotypes with differences in the light meromyosin fragment that were designated as SM1 (204 kDa) and SM2 (200 kDa) type myosin (Eddinger, T. J., and Murphy, R.A. (1988) Biochemistry 27, 3807-3811). In this study we present direct evidence that SMHC40 and SMHC29 mRNA encode the two smooth muscle myosin heavy chain isoforms, SM1 and SM2, respectively, by immunoblot analysis using antibodies against specific carboxyl terminus sequences deduced from SMHC40 and SMHC29 cDNA clones. PMID- 2722873 TI - Cyanide and azide behave in a similar fashion versus cuprozinc-superoxide dismutase. AB - The 1H NMR spectra of the cyanide adduct of Cu2Co2-superoxide dismutase have been remeasured at pH 7.5. The exchange rate of CN- is slow on the NMR time scale. The correlation with the spectrum of the unligated enzyme has been established through saturation-transfer techniques of the system in which 50% of the cyanide adduct is formed and through comparison with the spectrum of a Cu2Co2-superoxide dismutase-CN- sample in which the histidines have been deuterium labeled at the position epsilon 1. The similarities between the spectra of the CN- and N-3 derivatives are stressed, in particular with respect to the removal from copper coordination of the same histidine, assigned as His-46. PMID- 2722874 TI - A male accessory gland peptide with protease inhibitory activity in Drosophila funebris. AB - Male accessory glands of Drosophila funebris synthesize and secrete a peptide that shows a protease-inhibiting activity. Amino acid sequencing of the purified peptide revealed that the peptide consists of 63 amino acid residues. It is a serine protease inhibitor belonging to the pancreatic trypsin inhibitor (Kunitz) family. The inhibitory function and the kinetic characteristics of the inhibition have been examined with various substrates. The peptide possibly plays a role as an acrosin inhibitor involved in Drosophila reproduction. PMID- 2722875 TI - Enzymatic in situ determination of stereospecificity of NAD-dependent dehydrogenases. AB - Amino acid racemases inherently catalyze the exchange of alpha-hydrogen of amino acids with deuterium during racemization in 2H2O. When the reactions catalyzed by alanine racemase (EC 5.1.1.1) and L-alanine dehydrogenase (EC 1.4.1.1), which is pro-R specific for the C-4 hydrogen transfer of NADH, are coupled in 2H2O, [4R 2H]NADH is exclusively produced. Similarly, [4S-2H]NADH is made in 2H2O with amino-acid racemase with low substrate specificity (EC 5.1.1.10) and L-leucine dehydrogenase (EC 1.4.1.9), which is pro-S specific. We have established a simple procedure for the in situ analysis of stereospecificity of C-4 hydrogen transfer of NADH by an NAD-dependent dehydrogenase by combination with either of the above two couples of enzymes in the same reaction mixture. When the C-4 hydrogen of NAD+ is fully retained after sufficient incubation, the stereospecificity of hydrogen transfer by a dehydrogenase is the same as that of alanine dehydrogenase or leucine dehydrogenase. However, when the C-4 hydrogen of NAD+ is exchanged with deuterium, the enzyme to be examined shows the different stereospecificity from alanine dehydrogenase or leucine dehydrogenase. Thus, we can readily determine the stereospecificity by 1H NMR measurement without isolation of the coenzymes and products. PMID- 2722876 TI - Formation of large, sedimentable transcription complexes with VARNA genes and other related genes. AB - We have used an Eppendorf centrifuge for isolation of transcription complexes assembled on VARNA genes and other related genes with NTP-depleted cell-free extracts. Similar to the 5 S rRNA gene, sedimentable, stable transcription preinitiation complexes could be assembled from two VARNA genes, two EB virus specific EBER genes, four human tRNA genes, and one human Alu-family RNA gene, suggesting that the 5 S rRNA-specific transcription factor, TFIIIA, was not required for formation of these sedimentable, stable preinitiation complexes. Parameters affecting assembly of these complexes were sequences in circular DNA templates, sizes and sequences of linear DNA templates, temperature and incubation time. These complexes were stable at from 4 to 37 degrees C, and somewhat stable to salt wash. From results of effects of various mutations on assembly of these sedimentable complexes, we concluded that they were transcription machineries. Addition of the supernatant and partially purified factors to salt-washed complexes stimulated their transcription, we concluded that these sedimentable complexes were minimal transcription machineries containing suboptimal quantities of loosely bound transcription factors, TFIIIB, and RNA polymerase III. DNase 1 footprints of these sedimentable preinitiation complexes showed that two regions were protected, from +34 to +80 including the B block promoter element, and from +98 to +105. Similar DNase 1 footprints were also obtained from salt-washed complexes and stable preinitiation complexes isolated by molecular sieve column chromatography. PMID- 2722877 TI - Elements modulating the block of transcription elongation at the adenovirus 2 attenuation site. AB - We have previously reported that a block of transcription elongation is functioning in vivo and in vitro within the leader sequences of SV40 and the adenovirus 2 major late transcription units and in the regulation of transcription of the P4 promoter of minute virus of mice. In the present study using the HeLa whole cell extract-Sarkosyl system with adenovirus 2 major late promoter as a template we have analyzed several basic parameters that can contribute to our understanding of the mechanism that regulates the elongation block at the adenovirus 2 attenuation site. We show that the elongation block is augmented at elevated temperatures (40-45 degrees C). The elongation block can be reversed by the addition of 0.2 M NaCl to the transcription reaction and the reversibility is temperature-dependent. Furthermore, while at 30-35 degrees C the elongation block is reversible with dilution of the Sarkosyl, at 40-45 degrees C it is only partially reversible. These results may indicate that a factor(s) is involved in the regulation of the elongation block and/or that the conformation of the transcription complex is temperature dependent. Finally, we show that the extent of the elongation block is dependent on the consecutive T residues at the attenuation site and we discuss the involvement of RNA secondary structure in eliciting the elongation block. PMID- 2722878 TI - A block of transcription elongation by RNA polymerase II at synthetic sites in vitro. AB - We have previously suggested that transcription elongation by RNA polymerase II can be blocked when the nascent RNA is folded into a stem-and-loop structure followed by polyuridines. As an approach to test this suggestion in vitro, several GC-rich deoxyoligonucleotides with dyad symmetries were chemically synthesized and inserted following the adenovirus 2 major late promoter. These constructs were transcribed in vitro using HeLa whole cell extract. The transcripts of the synthetic inserts can potentially form stem-and-loop structures with destabilization energy from 0 to -48 kcal followed by 3, 5, and 8 U residues. The results obtained show that transcription elongation is blocked by these synthetic inserts and that the extent of the elongation block is directly correlated to the stabilities of the potential stem-and-loop structure and the proceeding number of U residues. Three levels of elongation blocks were observed: a brief pause of the polymerase occurs when the RNA could be folded into a secondary structure or when there were 5-6 T residues on the sense DNA strand. An extended pause occurred when the number of T residues on the sense DNA strand was increased to 8. Transcription termination, with a partial release of the attenuated transcript occurred when a stable RNA secondary structure (delta G = 48 kcal) was followed by 8 U residues. The relevancy of these in vitro results to the in vivo mechanism of a transcription elongation block is discussed. PMID- 2722879 TI - Effect of zinc(II) and other divalent cations on binding of 3,5,3'-triiodo-L thyronine to nuclear receptors from cultured GC cells. AB - The effect of Zn(II) in 3,5,3'-triiodo-L-thyronine (T3) binding to nuclear receptors was studied in dialyzed 0.4 M NaCl extracts of nuclei from cultured GC cells. Addition of ZnCl2 to nuclear extracts resulted in a time- and concentration-dependent dissociation of T3 from nuclear receptors. Half-maximal dissociation occurred at 6 microM ZnCl2. Addition of ZnCl2 also resulted in a concentration-dependent inhibition of binding of T3 to nuclear receptors. Half maximal inhibition of binding occurred at 1-3 microM ZnCl2. Scatchard analysis indicated that Zn(II) addition decreased kA and did not alter receptor concentration. These effects of Zn(II) were prevented when ZnCl2 was added to nuclear extracts in the presence of 5 mM EDTA or 5 mM dithiothreitol. Moreover, Zn(II)-induced inhibition of T3 binding was reversed by the addition of 5 mM EDTA. The inhibitory effect of Zn(II) on T3 binding seemed specific for nuclear receptors; no effect of Zn(II) on the binding of T3 to proteins in rat serum or GC cell cytosol or to rabbit anti-T3 serum was observed. Cd(II) had a similar concentration-dependent inhibition of T3 binding to nuclear receptors which was reversible. Our findings suggest that Zn(II) may play a role in T3 binding to nuclear receptors as well as its putative role in the binding of receptor to DNA. PMID- 2722880 TI - Hydrolysis of dolichyl esters by rat liver lysosomes. AB - Dolichyl ester hydrolase activity is broadly distributed among the organs of the rat. The highest activity was found in spleen, brain, lung, and thyroid tissues, whereas this activity is very low in stomach and intestine. The esterase involved is localized to the lumen of lysosomes and, to some extent, in the plasma membranes. Hydrolysis occurs with both alpha-saturated and alpha-unsaturated polyisoprenes esterified with different fatty acids, but the rate of hydrolysis is strongly dependent on the nature of the substrate. The enzyme involved is inhibited by divalent cations, EDTA and EGTA and also by one of the products, dolichol. The esterase is activated by 3-[(3-cholamidopropyl) dimethylammonio]-1 propranesulfonic acid and taurodeoxycholate and inhibited by Triton X-100. Dolichyl esterase activity is completely inhibited by alpha- and beta-naphthyl acetate, phenylmethylsulfonyl fluoride, and beta-chloromethylmercurisulfate. These inhibitors, as well as the pH optimum for dolichyl ester hydrolysis, clearly differentiate the enzyme involved from cholesteryl esterase and triglyceride lipase. Microsomal phospholipase A hydrolyzes dolichyl esters at a slow rate only. In vivo labeling experiments with [3H]mevalonate demonstrated that newly synthesized dolichol is transported in esterified form to the lysosomes, where this lipid is slowly hydrolyzed by the esterase. The possibility is raised that the role of the fatty acyl moiety may be to target dolichol to its final location in the cell. PMID- 2722882 TI - Thermodynamics of the hydrolysis of sucrose. AB - A thermodynamic investigation of the hydrolysis of sucrose to fructose and glucose has been performed using microcalorimetry and high-pressure liquid chromatography. The calorimetric measurements were carried out over the temperature range 298-316 K and in sodium acetate buffer (0.1 M, pH 5.65). Enthalpy and heat capacity changes were obtained for the hydrolysis of aqueous sucrose (process A): sucrose(aq) + H2O(liq) = glucose(aq) + fructose (aq). The determination of the equilibrium constant required the use of a thermochemical cycle calculation involving the following processes: (B) glucose 1-phosphate2 (aq) = glucose 6-phosphate2-(aq); (C) sucrose(aq) + HPO4(2-)(aq) = glucose 1 phosphate2-(aq) + fructose(aq); and (D) glucose 6-phosphate2-(aq) + H2O(liq) = glucose(aq) + HPO4(2-)(aq). The equilibrium constants determined at 298.15 K for processes B and C are 17.1 +/- 1.0 and 32.4 +/- 3.0, respectively. Equilibrium data for process D was obtained from the literature, and in conjunction with the data for processes B and C, used to calculate a value of the equilibrium constant for the hydrolysis of aqueous sucrose. Thus, for process A, delta G0 = -26.53 +/- 0.30 kJ mol-1, K0 = (4.44 +/- 0.54) x 10(4), delta H0 = -14.93 +/- 0.16 kJ mol-1, delta So = 38.9 +/- 1.2 J mol-1 K-1, and delta CoP = 57 +/- 14 J mol-1 K-1 at 298.15 K. Additional thermochemical cycles that bear upon the accuracy of these results are examined. PMID- 2722881 TI - Reversible folding of rhodanese. Presence of intermediate(s) at equilibrium. AB - For the first time completely reversible unfolding was achieved for guanidinium chloride-denatured rhodanese using a systematically defined protocol. These conditions included beta-mercaptoethanol, lauryl maltoside, and sodium thiosulfate. All components were required to get more than the previous best reactivation with lauryl maltoside of 17% (Tandon, S., and Horowitz, P. (1986) J. Biol. Chem. 261, 15615-15681). Non-coincidental transition curves were obtained by monitoring different parameters including: (i) variation in the activity, (ii) shifts of the fluorescence wavelength maximum, and (iii) variation in ellipticity at 220 nm. The transition followed by the fluorescence wavelength maximum was asymmetric and resolvable into two separate transitions. A thermodynamic analysis was used to define the energetics of the two processes. Studies with the fluorescent "apolar" probe 1,8ANS are consistent with the appearance of organized hydrophobic surfaces following the first transition. Near UV CD measurements indicated that the first transition is associated with a loss of dyssymmetry around at least some of the tryptophans. Thus, the unfolding of rhodanese is complex, and there are detectable intermediate(s) during the process. These results suggest that reversible unfolding occurs in two discrete stages: 1) loss of tertiary interactions and activity, with retention of secondary structure, and 2) loss of secondary structure. The available x-ray structure suggests that the first transition can be associated with changes in the domain interactions, which may modulate the effectiveness of helix dipoles in lowering the pKa of the active site sulfhydryl. PMID- 2722883 TI - Regulation of rat growth hormone receptor gene expression. AB - A cDNA encoding the growth hormone (GH) receptor was cloned from rat liver. Both the nucleotide and translated amino acid sequence share greater than 70% similarity with the GH receptors from rabbit and human. An RNA probe was generated from this sequence for use in a solution hybridization assay to quantitate GH receptor mRNA expression in rat tissues. Expression was detected in 9/12 tissues examined, with the highest levels observed in the liver. Expression in liver, kidney, heart and muscle was developmentally regulated, being low at birth and rising to adult levels in 5 weeks. No difference was observed between hepatic expression in males and females, although livers from pregnant rats had elevated levels. Hypophysectomy and GH treatment did not affect hepatic GH receptor mRNA levels. PMID- 2722884 TI - Uracil-DNA glycosylase in insects. Drosophila and the locust. AB - It has been reported that Drosophila lacks a uracil-DNA glycosylase but that a direct incising activity on uracil-containing DNA appeared developmentally only in third instar larvae. In contrast we have found by two independent assays, that uracil-DNA glycosylase exists in both Drosophila eggs as well as in third instar larvae. The first assay shows the liberation of [3H] uracil from a d(AT)n polymer randomly substituted with [3H]uracil by its synthesis in the presence of [3H] dUTP. The second fluorometric assay for uracil-DNA glycosylase depends on the unique topological properties of circular DNAs and has the advantage of detecting apyrimidinic/apurinic (AP) endonuclease activity as well. To test one other insect, locust eggs were also assayed for uracil-DNA glycosylase. The amount of uracil-DNA glycosylase correlated well with the amount of DNA in actively replicating cells. PMID- 2722885 TI - Conformational properties of streptokinase. AB - The conformational properties of streptokinase (SK) have been assessed by the techniques of differential scanning calorimetry, circular dichroism (CD), and through a combinational approach employing several algorithms which are predictive of secondary structural characteristics. In low ionic strength buffers, SK undergoes a reversible two-state thermal transition with a temperature of maximum heat capacity (Tm) of 46.1 +/- 0.9, a delta Hcal of 98 +/- 11 kcal/mol and a delta Hcal/delta HvH of approximately 1. In high ionic strength buffers, similar calorimetric properties were obtained with the exception that the delta Hcal/delta HvH values were considerably less than 1, indicating the existence of an additional irreversible thermally induced alteration in the molecule, most likely resulting in its aggregation. The effect of pH on the thermal unfolding properties of SK was determined. The results demonstrated that single two-state thermal transitions were obtained, with progressively decreasing Tm values, as the pH was reduced from 6.4 to 3.4, indicating a destabilization of the entire molecule at reduced pH. In the alkaline region, between pH 8.4 and 9.4, stabilization of a separate region of the molecule was obtained, as evidenced by an increase in the delta Hcal/delta HvH to values approximating 2. CD analysis was performed in order to estimate secondary structural characteristics of SK. The best fit of secondary structural parameters to the experimental CD spectrum provided estimates of 17% helices, 28% beta-sheet, 21% beta-turns, and 34% disordered structures. Both the intensity of the spectral band at 208 nm and the level of antiparallel beta-sheet strongly suggest that SK is an alpha + beta protein. PMID- 2722886 TI - Identification of two distinct isoforms of stathmin and characterization of their respective phosphorylated forms. AB - Stathmin is a ubiquitous soluble protein (Mr approximately 19,000, pI approximately 6.2-5.5) whose phosphorylation is associated with the intracellular mechanisms involved in the regulations of cell differentiation and functions by extracellular effectors. Its purification from rat brain and the preparation of specific antibodies allowed us to identify a set of immunologically related unphosphorylated (N1, N2) and phosphorylated (P1, P2a, P2b, P3) proteins of decreasing isoelectric points. All these proteins yielded identical silver stained or 32P-radioactive peptide maps with the protease V8 from Staphylococcus aureus, indicating that they are also structurally related. In vitro phosphorylation with the exogenous catalytic subunit of the cAMP-dependent protein kinase, as well as dephosphorylation with alkaline phosphatase, indicated that P1, P2, and P3 derived from N1 and N2 by progressive phosphorylation. Phosphorylation of individual proteins extracted from semi-preparative two dimensional polyacrylamide gels demonstrated the existence of two distinct isoforms of stathmin, alpha and beta: N1 and N2 are their respective unphosphorylated forms (alpha O and beta O), whereas proteins P1-P3 could be resolved as at least three increasingly phosphorylated forms of both alpha and beta stathmin (alpha 1, alpha 2, alpha(3) and beta 1, beta 2, beta(3]. In intact pituitary GH4C1 cells, hormones like thyrotropin-releasing hormone and vasoactive intestinal peptide induced a similar conversion from N1 and N2 to P1, P2, and P3. The phosphorylation of both alpha and beta isoforms of stathmin is therefore a physiologically significant response to specific extracellular regulatory agents. In conclusion, stathmin represents a family of at least two distinct protein isoforms, whose respective phosphorylation and expression might play a role in its likely function as an intracellular relay of various converging extracellular signals. PMID- 2722887 TI - Post-translational isoprenylation of cellular proteins is altered in response to mevalonate availability. AB - Cells incorporate isoprenoid products derived from mevalonate (MVA) into several unique proteins. The aim of this study was to delineate the effects of blocking MVA synthesis on the covalent isoprenylation of these proteins in murine erythroleukemia cells. Inhibition of protein synthesis with cycloheximide prevented the incorporation of [3H]MVA into proteins, suggesting that isoprenylation normally occurs immediately after synthesis of the polypeptides. However, incubation of cells with lovastatin, a competitive inhibitor of 3 hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, for as little as 1 h prior to addition of cycloheximide rendered the isoprenylation step insensitive to cycloheximide. Lovastatin had no apparent effect on the stability of the isoprenylated proteins, but the development of cycloheximide insensitivity during the lovastatin preincubation was dependent on synthesis of new protein during that period. Addition of 50-200 microM MVA to the culture medium eliminated the effects of preincubation with lovastatin. Preincubation of cells with 25 hydroxycholesterol, which suppresses the synthesis and enhances the degradation of HMG-CoA reductase but is not a competitive enzyme inhibitor, did not induce cycloheximide-insensitivity of the isoprenylation reaction. The results suggest that blocking MVA synthesis with lovastatin causes a rapid depletion of isoprenoid groups available for protein modification. Consequently, there is an accumulation of non-isoprenylated substrate proteins. Shifts in the ratio of modified vs. unmodified proteins in response to MVA availability may have implications for the changes in cell morphology, cell proliferation and HMG-CoA reductase gene expression that occur when cells are subjected to MVA deprivation. PMID- 2722888 TI - The interaction between Cu(I) superoxide dismutase and hydrogen peroxide. AB - The interaction between superoxide dismutase (SOD) and peroxide, under anaerobic conditions in the presence of an OH radical scavenger, formate, and an indicator, nitro blue tetrazolium, involves five reactions and an equilibrium: (table; see text) Reaction 3 occurs at a rate that is proportional to both peroxide and enzyme with no kinetic evidence for any intermediate peroxide-enzyme complex. Rate studies as a function of pH corroborate previously published work (Fuchs, H. J. R., and Borders, C. L., Jr. (1983) Biochem Biophys. Res. Commun. 116, 1107 1113; Blech, D. M., and Borders, C. L., Jr. (1983) Arch. Biochem. Biophys. 224, 579-586) suggesting that HO2-, and not H2O2, is the active species in this system: k(HO2- + superoxide dismutase-Cu+) = 2.6 x 10(3) M-1 s-1. Evidence is presented which suggests that HO2-, like O2-, reacts at rates that are affected by the electrostatic forces of the enzyme. PMID- 2722889 TI - Structural heterogeneity among unique sulfated L-galactans from different species of ascidians (tunicates). AB - The sulfated polysaccharides that occur in the tunic of ascidians differ markedly in molecular weight and chemical composition. A high molecular weight fraction (F 1), which has a high galactose content and a strong negative optical rotation, is present in all species. Several structural differences were observed among the F 1 fractions obtained from three species of ascidians that were studied in detail. Large numbers of alpha-L-galactopyranose residues sulfated at position 3 and linked glycosidically through position 1----4 are present in F-1 from all three ascidians. However, alpha-L-galactopyranose units, 1----3-linked and partially sulfated at position 4, comprise about half of the sugar units in the central core of F-1 from Ascidian nigra. In addition, L-galactopyranose nonreducing end units occur in F-1 from Styela plicata and A. nigra, but comprise only a minor fraction of F-1 from Clavelina sp. The combination of these various component units gives a complex structure for F-1 from S. plicata and A. nigra, whereas F-1 from Clavelina sp. possesses a simpler structure. The structures of these ascidian glycans are unique among all previously described sulfated polysaccharides, since they are highly branched (except that from Clavelina sp), sulfated at position 3, and contain large amounts of L-galactose without its D enantiomorph. These data show unusual examples of polyanionic glycans with structural function in animal tissues. PMID- 2722890 TI - An application of beam theory to determine the stress and deformation of long bones. AB - We present a generalized beam theory in which deformation and load are determined simultaneously, in order to analyze statically indeterminant problems involving long bones. We regard a long bone as a beam curved in three dimensions for which the cross-sectional properties vary continuously along its length. The theory is used to determine the force, moment, deflection and twist along the fifth metatarsal when it is subjected to both a pointwise and a distributed load. PMID- 2722891 TI - Modelling of the heart and pericardium at end-diastole. AB - Herein we present a refined version of Vito's two-sphere static model of the heart with pericardium and discuss its possible applications. The improvements we make on Vito's model are: (i) Vito assumed that the elastic materials which constitute the model 'heart' and 'pericardium' are isotropic; we relax this assumption to that of transverse-isotropy. (ii) Our analysis, which does not assume the existence of stored-energy functions, links the model directly to empirical stress-strain relations of suitable biaxial uniform-extension tests; two such stress-strain relations (one for the pericardium, one for the myocardium, both of which may be described by the same equation except for difference in the values of response parameters) now define the model completely, so we avoid altogether the difficult task of determining full-fledged constitutive equations for the pericardium and myocardium. As for applications, we contend that the concentric spheres in static equilibrium can be taken as a model of the left ventricle and pericardium at end-diastole. We show that the model when equipped with suitable stress-strain relations does give good fit to the pressure-volume data which Spotnitz et al. (1966, Circulation Res., 18, 49 66) obtained from excised canine left ventricles and to the pericardium data which Pegram et al. (1975, Circulation Res., 9, 707-714) obtained from closed chest, anaesthetized dogs. Three different empirical formulae were tried in the data-fitting as the equation that describes the requisite stress-strain relations. The 'exponential law' gave the best results. PMID- 2722892 TI - An evaluation of a micropolar model for blood flow through an idealized stenosis. AB - In this paper, the behavior of a viscous fluid described by Newtonian constitutive theory is compared with that predicted by a model based on micropolar continuum theory. The geometry chosen for this comparative analysis is a stenosis in which gradient effects should be pronounced. A range of boundary conditions for fluid microspin are considered. Although velocities and streamlines are found to be similar for the two continuum models, striking differences in shear stresses are revealed. These differences may be as high as 50% for vanishing microspin boundary conditions. Such significant discrepancies highlight the need for further study of higher order modeling of blood flow. PMID- 2722893 TI - Trunk muscle electromyography and whole body vibration. AB - By measuring the electromyographic (EMG) activity of the paraspinal muscles, we have estimated the average and peak-to-peak torque imposed on the spine during whole body vibration. Six subjects had surface electrodes placed on their erector spinae muscles at the L3 level. The EMG-torque relationship was estimated by having each subject perform isometric horizontal pulls in an upright seated posture. The subject was then vibrated vertically and sinusoidally in a controlled, flexed, slightly lordotic seated posture, in 1 Hz increments from 3 to 10 Hz at a 0.1 g RMS seat acceleration level. Between vibration readings taken at each frequency, a static reading was also taken with the subject maintaining the same posture. The entire vibration-static 3-10 Hz test was repeated for reliability purposes. Specialized digital signal processing techniques were developed for the EMG signals to enhance the measured cyclic muscle activity and to allow automatic measurement of the time relationship between the mechanical displacement and the estimated torque. We found significantly more average and peak-to-peak estimated torque at almost all frequencies for vibration vs static sitting. PMID- 2722894 TI - Relationships between loading history and femoral cancellous bone architecture. AB - A theory relating bone maintenance to mechanical loading history has been applied to successfully predict the distribution of bone density and trabecular orientation in the adult proximal femur. The loading history was simulated by determining the stress fields in a two-dimensional finite element model exposed to various discrete loading cases and making assumptions about the relative number of loading cycles associated with each load case. The total stimulus to bone maintenance was then calculated by a linear superposition of the stimulus of each loading case. Based on the calculated total stimulus, the apparent density and material properties of each element were changed and the stress solutions were again determined. Using this iterative technique, the bone apparent density and orientation characteristics were predicted. The results indicate that the trabecular morphology of the femur can only be explained by considering the joint loadings from multiple directions. Contrary to the 'trajectorial theory' promoted by Wolff (The Law of Bone Remodelling, 1892), trabecular orientations predicted from our multiple-load analyses are not necessarily perpendicular and do not correspond to the principal stress directions of any one loading condition. Our predicted orientations correspond better to the drawing of bone trabecular morphology by von Meyer (Archs Anat. Physiol. wiss. Med. 34, 615-628, 1867) than to the classic drawing by Wolff and suggest that further study of the trajectorial theory is warranted. PMID- 2722895 TI - Identification of knee joint models for varus-valgus and internal-external rotations: snow skiing experiments. AB - Sprains at the knee are the most frequent of the severe injuries occurring during alpine snow skiing. This paper discusses the development of analytical models describing rotations across the knee joint caused by varus-valgus and internal external moments applied at the foot during skiing. Identification of an ARMAX model requires simultaneous measurements of the rotations across the knee and the moments at the foot during skiing. As the models only relate the measured input (moment) and output (rotation) data, they also identify components of apparent rotation resulting from imperfect fixation of the rotation measuring instrument on the test subject and resulting from other inputs. The models identified for all subjects are of order four or five for both varus-valgus and internal external rotation, and they describe modes with oscillatory and exponentially decaying components. Application of the models to prediction of rotation across the knee from the measured moment at the foot is illustrated by example. A new, and virtually mechanically uncoupled, six degrees-of-freedom, strain gauge dynamometer is developed to record the moments at the foot during skiing. The concept of the dynamometer design has general application. PMID- 2722896 TI - Dynamics of left ventricular wall and mitral valve mechanics--a model study. AB - The relation between global left ventricular pumping characteristics and local cardiac muscle fiber mechanics is represented by a mathematical model of left ventricular mechanics in which the mitral valve papillary muscle system is incorporated. The wall of the left ventricle is simulated by a thick-walled cylinder. Transmural differences in fiber orientation are incorporated by changing the direction of material anisotropy across the wall. The cylinder is free to twist. The upper end of the cylinder is covered by a thin, flexible sheet, representing the base of the left ventricle. The mitral valve is incorporated in this sheet. The tips of the mitral leaflets are connected by chordae tendineae to the papillary muscles which are attached to the bottom of the cylinder. Canine cardiac cycles were simulated for various end-diastolic values of left ventricular volume (25-120 ml, control 60 ml), left atrial pressure (0-2.7 kPa, control 0.22 kPa) and aortic pressure (5-11 kPa, control 11 kPa). In this wide range of preload and afterload mechanical loading of the muscle fibers appeared to be distributed quite evenly (SD: +/- 5% of control value) over all muscular structures of the left ventricle, including the papillary muscles. PMID- 2722897 TI - Quantitation of human shoulder anatomy for prosthetic arm control--I. Surface modelling. AB - Anatomical data and models for the human shoulder musculo-skeletal system are developed with the intent of quantifying physiological subcomponents of a model based multi-axis prosthetic limb control scheme which has heretofore been implemented empirically. Part I presents the controller formulation, the surface descriptions of the muscles (and bones), and the centroidal trajectory data of the muscles. The data partially quantify the muscle modelling components of the controller, and set the stage for the analysis of the force-to-moment anatomical conversion factors of Part II. PMID- 2722898 TI - Cardiac 3,4-dihydroxyphenylethylene glycol (DHPG) and catecholamine levels during perindopril therapy of chronic left ventricular failure in rats. AB - 1. Left ventricular myocardial infarction was induced in female Wistar rats by ligation of the left anterior descending coronary artery. 2. One month following operation, rats with infarcts developed marked cardiomegaly compared to sham operated rats, indicating the presence of chronic left ventricular failure. 3. The ratio of the noradrenaline metabolite 3,4-dihydroxyphenylethylene glycol (DHPG) to noradrenaline (NA) was elevated in the right ventricle of rats with heart failure one month following infarction, suggesting a chronic increase in cardiac sympathetic activity. 4. Perindopril therapy for one month commenced 4 weeks after infarction returned cardiac weights to normal and significantly reduced right ventricular DHPG/NA ratios. 5. The results suggest that ACE inhibition with perindopril reduces elevated levels of cardiac sympathetic activity in rats with chronic left ventricular failure and leads to regression of cardiomegaly. PMID- 2722899 TI - Vascular smooth muscle responses in normo- and hypertensive rats to sympathetic nerve stimulation and putative transmitters. AB - 1. Using changes in perfusion pressure as a measure of end organ response, the effects of field stimulation (0.5 ms supramaximal voltage), noradrenaline (NA, 10(-5)-10(-3) M), adrenaline (ADR, 10(-6)-10(-4) M) and adenosine triphosphate (ATP, 10(-4)-10(-2) M) on the tail artery and mesenteric bed preparations in both normotensive (WKY) and spontaneously hypertensive (SHR) rats were examined. 2. The pressor responses in both preparations from SHR rats to field stimulation, NA and ADR were significantly (P less than 0.05) greater than those from age-matched WKY controls. Responses of both preparations to ATP in normo- and hypertensive rats did not differ significantly. 3. In both preparations from either WKY or SHR rats, pressor responses to ATP (10(-4)-10(-2) M) were inhibited by alpha,beta methylene ATP (alpha,beta MeATP, 1 x 10(-6) M) while those to field stimulation were not. Phentolamine (2 x 10(-6) M) and prazosin (1 x 10(-7) M) each inhibited the pressor responses to both field stimulation, NA and ADR. 4. [3H] was released by field stimulation from tail arteries pre-incubated with either [3H]-NA or [3H] adenosine in both normotensive and hypertensive rats. Release in each case was abolished by tetrodotoxin (1 x 10(-6) M). 5. There was no significant difference in the stimulation-evoked [3H]-NA overflow between SHR & WKY rats, alpha,beta MeATP had no significant inhibitory effect on the overflow of [3H] following incubation with [3H]-NA from either group of animals. 6. In the presence of diltiazem (2 x 10(-6) M) and prazosin (5 x 10(-7) M) to abolish any squeezing effect of muscle contractions on ATP release, there was no significant difference in the [3H] overflow between tail arteries from SHR and WKY rats following incubation with [3H]-adenosine. 7. The results confirm the increased response to nerve stimulation in hypertensive animals, an effect probably mediated postsynaptically via alpha-adrenoreceptors. There was no evidence for the involvement of ATP in the hypertensive state. PMID- 2722900 TI - Effects of short-term ketanserin treatment on the QT interval and vagal function in healthy subjects. AB - 1. The serotonergic type-2 (5HT2) antagonist ketanserin was given in a dose of 40 mg twice daily for 3 days to eight healthy subjects in a double-blind placebo controlled randomized crossover study. 2. The QTc interval was prolonged slightly but significantly (P less than 0.01) by a mean of 29 +/- 7 milliseconds after ketanserin compared to placebo. 3. Ketanserin reduced both mean arterial pressure and heart rate (P less than 0.05), by 5.7 +/- 1.8 mmHg and 3.5 +/- 1.5 beats minute-1 respectively, when compared to placebo. 4. There was a tendency (not statistically significant) for cardiac vagal outflow to be reduced after ketanserin (assessed by the heart rate responses to standing, deep breathing and the Valsalva manoeuvre). 5. In healthy man, ketanserin causes prolongation of the QTc interval and a reduction in heart rate. These changes do not appear to be due to enhanced cardiac parasympathetic activity. PMID- 2722901 TI - A testing technique allowing cyclic application of axial, bending, and torque loads to fracture plates to examine screw loosening. AB - Orthopaedic internal fracture fixation plates are subjected to combined axial, bending, and torsional loads in vivo which can cause screw loosening and implant failure. This paper outlines a relatively simple technique which allows controlled application of combined axial, bending, and torsional loading to examine the loosening rate of cortical screws used to attach these plates. Fiber reinforced polycarbonate rods with a tensile strength similar to that of cortical bone were cut at half their length to simulate fractured tibii. These were compression plated using a standardized technique and placed in a loading fixture. Joint loads at the knee determined from force plate analysis and statics were applied to a plated fixture during testing. The design of the fixture allowed adjustment of the proportion of bending and torsional loads applied to the test samples. It also allowed a reproducible means of applying a predetermined axial, bending, and torsional load. Screw loosening following cyclical loading was evaluated by measuring the amount of angular displacement required to retighten screws to a prescribed torque value. A torque wrench was modified to allow the measurement of these displacements. PMID- 2722902 TI - Biomechanics of curved surgical needle bending. AB - Because needle bending resistance is such an important factor in the selection of surgical needles, a standard quantitative test of needle bending has been devised to study the biomechanics of deformation of needles from three different commercial manufacturers. The superior resistance to deformation of needles made by one manufacturer has been related to the specific alloy, ASTM 45500 stainless steel, employed in its production. The needles produced from ASTM stainless steel 45500 have stronger tensile and yield strengths than those of the other alloys, accounting for their greater resistance to bending. PMID- 2722903 TI - Porosity of surgical mesh fabrics: new technology. AB - A new method using an image processing system developed in our laboratories is used to measure the pore size in Mersilene, Marlex, and Teflon surgical meshes. All three meshes appear to have sufficiently large pores and should facilitate tissue growth/attachment. Results obtained in this study are compared to results of an earlier paper. PMID- 2722904 TI - Ectopic induction of cartilage and bone by water-soluble proteins from bovine bone using a collagenous delivery vehicle. AB - A controlled-release delivery vehicle for water-soluble osteogenic proteins from demineralized bone matrix was constructed using purified type I collagen. The water-soluble proteins were isolated from a 4 M GdnHCl extract of bone matrix. Although the water-soluble proteins were capable of inducing cartilage formation in vitro, they were incapable of inducing cartilage or bone in vivo when implanted intramuscularly into mice in the absence of an appropriate delivery vehicle. The collagen-based delivery vehicle alone was also incapable of inducing osteogenesis in vivo. However, when the water-soluble proteins were incorporated into the delivery vehicle, the combination was capable of inducing cartilage and bone 76% of the time. These results demonstrate that it is possible to formulate a controlled-release delivery vehicles for soluble bioactive factors which upon release interact with local responsive cells. PMID- 2722905 TI - The regulation of orthopaedic devices in France. PMID- 2722906 TI - Clinical-pathological analysis of failed central nervous system fluid shunts. AB - Clinical failures of central nervous system fluid shunts remain a vexing problem. Attributed largely to infectious and technical etiologies, it has been hypothesized recently that inflammatory mechanisms may play a role in this clinical phenomenon. In order to obtain morphologic evidence for this hypothesis, a study of failed shunts was performed. Twenty-five of 57 sequentially removed CNS fluid shunt assemblies or components over the course of 18 months contained sufficient intraluminal tissue to allow a histomorphologic assessment. Tissue was removed from either the intraventricular or intraperitoneal portion and examined with routine light microscopical and histochemical techniques to assess the degree of cellularity, composition of the cells, presence of debris, and organisms. Morphologic findings were correlated with the clinical courses and microbiological cultures. Data were analyzed nonparametrically using the chi 2 test. There was a substantially significant association between repeated failures and non-infectious obstructions. Eight demonstrated evidence of active inflammatory processes; and although not statistically significant, the presence in 3 cases of giant cells, macrophages, lymphocytes, and eosinophils all suggestive of a hypersensitivity reaction correlated with the occurrence of culture negative clinical failures. These morphologic findings will stimulate further experimental and clinical research into possible inflammatory mediators of shunt failure. PMID- 2722907 TI - Preparation and surface characterization of PEO-grafted and heparin-immobilized polyurethanes. AB - Surfaces of commercial polyurethanes (PUs) were modified by poly(ethylene oxide) (PEO) grafting and/or heparin immobilization for long-term biomedical applications. PU surfaces were treated with diisocyanate and then reacted with PEO or heparin. The heparin immobilized by various methods on the PU surface was very stable, with concentrations of 1.45-1.84 micrograms/cm2. Surface structure and characteristics of each modified PU were examined by performing the following surface analyses: attenuated total reflection infrared (ATR-IR), electron spectroscopy for chemical analysis (ESCA), scanning electron microscopy (SEM), and dynamic contact angle measurements. The reaction scheme and surface chemical structure of modified PUs were confirmed by ATR-IR and ESCA, respectively. SEM results showed that the PU-PEO surface was very smooth and that the smoothness of the heparinized PU surfaces varied, depending upon the solvent and coupling agent used in the process. The hydrophilicity of the surface was significantly increased after PEO grafting or heparin immobilization. Increase in the chain length of the grafted PEO resulted in significant increases in hydrophilicity and surface mobility. PMID- 2722908 TI - Applied biomaterials standards report. AB - The purpose of my column is to provide readers with current information on biomaterials-related standards produced by both private groups and government agencies, and standards-related activities. Standards are descriptive documents given official status by their producers and, in the case of biomaterials, they are generally intended to provide formalized descriptions of (a) materials used in the construction of medical devices, (b) materials used directly in surgical repairs, (c) test methods to evaluate materials for such applications, and (d) methods for handling or processing such materials. Please consider this column not only a place to obtain biomaterials standards information but also a place to submit news of biomaterials standards developments in order to get the information before the public. This invitation extends to all members of any and all professional organizations and government agencies in the United States and abroad who are active in standards development and would like specific activities or standards publicized. I will present the information in this column to the extent that allotted space allows. And last, a caveat--since this is a column, it contains both factual information and opinions. I will make every effort to make it clear which is which. Also, as a frame of reference, please note that this column was written and submitted in January, 1989. PMID- 2722909 TI - Polygamy and fertility in Somalia. AB - The 1983 Somali Family Health Survey showed that polygamy and monogamy selected women with different social characteristics. Wives in polygamous unions were prone to be younger at first martial cohabitation and to have previous marital disruptions. Since a young age at first cohabitation and number of previous marriages have opposite effects on the cumulative fertility rate of women, the difference in this rate between wives in polygamous and monogamous unions vanished when both factors were controlled in a multivariate analysis. PMID- 2722910 TI - Determinants of cumulative fertility in Kenya. AB - This paper analyses the effects of age at first marriage, level of education, place of residence, marriage disruption, religion, contraceptive use, and work status on cumulative fertility in Kenya, using data from the 1977-78 Kenya Fertility Survey. Age at first marriage is the main determinant of cumulative fertility, but there are significant effects of level of education and marriage disruption. Place of residence is only significant for the Coast province. The implication of the findings is that to promote any real decline in fertility, emphasis should be placed on providing higher education and work opportunities for young women as an alternative to early marriage. PMID- 2722911 TI - Nursing behaviour and its relation to duration of post-partum amenorrhoea in an Andean community. AB - Nunoa is a high altitude rural Peruvian community characterized by socioeconomic stratification and differential access to the market economy. Nursing practices and the effects of nursing are also stratified; this translates into a risk of menses at 12 months post-partum nearly seven times greater in wealthier than in poorer women. Most nursing occurs in the morning, among those who practice on demand breast-feeding. Nursing episodes are clustered into sessions; the amount of breast-feeding is regulated by varying the number of episodes per session rather than by changing the duration of suckling episodes or the frequency of sessions per hour. Thus, resumption of ovulation is not dependent on the variable spacing of nursing episodes or sessions. The components of nursing activity most likely to be responsible for variation in the duration of post-partum amenorrhoea in these nursing women are mean session duration and mean number of episodes per session. The mean duration of morning nursing sessions is negatively associated with infant's age, reflecting the greater reliance of younger children on breast milk. The mean duration of afternoon nursing sessions is positively associated with mother's age, independent of infant's age, possibly reflecting maternal age related variation in milk production capabilities. Baby minding by older daughters may also help to explain variation in afternoon nursing. PMID- 2722912 TI - Predicting contraceptive use in Bangladesh: a logistic regression analysis. AB - Family planning knowledge, attitude and practice surveys typically assess respondents' reproductive attitudes and intentions to use contraception. Longitudinal observation of individual respondents nevertheless shows that such questions are not strongly predictive of subsequent behaviour. This study examines 3 years' data which show that a set of such responses to questions are nevertheless substantially superior in predicting behaviour than any single indicator. Thus statistical techniques which bring into account the apparent multidimensionality of contraceptive motivation can greatly improve upon the estimation of future practice of family planning in a population. PMID- 2722913 TI - Age at first intercourse. AB - In 1984-85 a representative sample of 286 Danish women and 336 men aged 16-20 years were interviewed about their sexual debut. Seventy-four females (25.9%) and 101 males (30.1%) had not yet experienced sexual intercourse. A maximum likelihood estimation method was used to establish the age distribution at sexual debut. This takes into account knowledge of age at interview among the non experienced respondents and of the few who did not report age at sexual debut. The median age at first sexual intercourse was close to 16.8 years for both females and males. This appeared to be a consequence of age at debut declining among women and remaining unchanged among males during the preceding 20 years. PMID- 2722915 TI - The consequences of heterogamy and homogamy on the similarity between spouses. AB - Humans in many societies are known to mate, or marry, assortatively for a number of characters such as eye colour, height, IQ and place of birth. In this assortment an element of active choice may be involved. It is not known whether this choice is genetic. Two models of human mate choice are examined in which both males and females can express a mating preference. In the first, 'sexual' preferences can be expressed for any phenotype not necessarily one's own; in the second, preferences are only expressed for an individual's own phenotype. The results of the examination indicate how much active choice would be needed to account for the observed correlations between human mates, and suggest whether human mating preferences are more likely to be sexual or assorting. PMID- 2722914 TI - Menarche, menopause and reproduction in the Kipsigis of Kenya. AB - Among the Kipsigis, a population of south-western Kenya who do not use contraception, age at menarche and age at last live birth could be determined for a cohort of post-menopausal women, through reference to clitoridectomy ceremonies that can easily be dated. While a woman's age at last live birth was strongly associated with the length of her reproductive lifespan, completed family size was better predicted by age at menarche. The demographic implications of variation in menarcheal age are discussed. PMID- 2722916 TI - Son preference and child replacement in Bangladesh: a new look at the child survival hypothesis. AB - Birth history data from women in the 1975-76 Bangladesh Fertility Survey were used to search for intentions to replace dead children. The median intervals between successive births of orders (i) and (i + 1) were not shorter when some siblings of orders below (i) had died. Nor was the median duration between the death of a child and the first posthumous birth shorter when the dead child was a boy or when it was survived by fewer than two brothers. The median intervals were generally shorter when the mother lived in an urban rather than a rural area but this difference was attributable only to the shorter duration of breast-feeding by urban women. These results disputed the notions that the timing of births was deliberately quicker to replace a dead child, that attempts at replacement were sex-selective, or that child replacement intentions were stronger in urban than in rural populations. PMID- 2722917 TI - Biological influence of infant death on fertility. AB - This study examines the biological influence of infant death on subsequent fertility in three Asian countries--Indonesia, Nepal and Sri Lanka, comparing the birth interval between two consecutive births up to the sixth birth by survival status of the preceding infant among breast-feeding women not using contraception. There is consistent evidence of biological influence in each of the three countries. Infant death shortens birth intervals by up to 30%, though its influence varies between the countries. PMID- 2722918 TI - Ethnic differentials in early childhood mortality in Nepal. AB - This paper investigates the association of early childhood mortality (between birth and second birthday) with ethnicity in Nepal, based on data from the 1976 Nepal Fertility Survey, which was part of the World Fertility Survey. The approach is through a series of hazard models, which incorporate ethnicity, year of birth, mother's illiteracy, father's illiteracy, rural-urban residence, region, sex, maternal age, survival of previous birth, previous birth interval, and breast-feeding as covariates. Ethnic differentials in early childhood mortality are not explained by the other socioeconomic and demographic covariates, except for a modest effect of illiteracy, but the remaining covariates explain a great deal of variability in early childhood mortality itself. Analysis using an improved specification of breast-feeding as an age varying covariate indicates, on average, that breast-feeding, relative to not breast-feeding, reduces age-specific mortality risks during the first 2 years of life by 76%, a very large effect. PMID- 2722919 TI - Determinants of intrauterine growth retardation: evidence against maternal depletion. AB - This analysis examines the relationship between length of preceding birth interval and risk of intrauterine growth retardation using data on Swedish infants from the 1973 World Health Organization study of perinatal mortality. Results of a multivariate logit analysis demonstrate that the lower than average mean birth weight of infants born after short birth intervals cannot be completely attributed to their shorter mean gestation length. Infants born after birth intervals of 12 months or less are 30% more likely to be small for gestational age (SGA) than infants born 18-59 months after the previous birth, even when the effects of maternal age and parity are controlled. The results obtained here do not support maternal depletion as an explanation for the association between short birth intervals and elevated risk of SGA, since there is no evidence of an attenuation of the risk of SGA with increasing length of interval in the under 18 month birth interval range. PMID- 2722920 TI - Life expectancy in less developed countries: socioeconomic development or public health? AB - Various studies have enquired into the influence of socioeconomic development or public health measures on life expectancies in less developed countries. Analysis of the effect of these two groups of factors upon life expectancy, using data for 95 less developed countries, indicates that mortality is primarily influenced by such socioeconomic development measures as urbanization, industrialization, and education, and secondarily by such public health measures as access to safe water, physicians, and adequate nutrition. PMID- 2722921 TI - Rotator cuff function in the impingement syndrome. AB - Thirty-three patients with impingement syndrome of the rotator cuff were studied before and at operation. It was shown that the rotator cuff lengthens and twists during elevation of the arm. Elevation is achieved by early glenohumeral abduction and continuous flexion and external rotation. The range of free rotation at the glenohumeral joint diminishes progressively during elevation. Rotator cuff impingement occurs towards the end of the early glenohumeral abduction. Excision arthroplasty of the acromioclavicular joint and anterior acromioplasty is highly effective for impingement under the acromion, but only moderately effective where impingement is under the acromioclavicular joint. PMID- 2722922 TI - Dupuytren's contracture. Fine structure in relation to aetiology. AB - The fine structure of palmar fascia from patients with Dupuytren's contracture (DC) was compared with that from patients with carpal tunnel syndrome (CTS). In contrast to previous assumptions, the ultrastructure of fibroblasts both in vivo and in vitro from DC and CTS appeared identical, indicating that myofibroblasts are not specific to DC. The major differences between DC and CTS were: 1) a sixfold and fortyfold increase in fibroblast density in cord and nodular areas of DC compared with CTS; 2) a more disorganised pattern of collagen fibrils in DC; and 3) markedly narrowed microvessels surrounded by thickened, laminated basal laminae and proliferating fibroblasts in DC compared with CTS. To account for these morphological changes a hypothesis is presented which proposes that oxygen free radicals cause pericytic necrosis and fibroblastic proliferation. This hypothesis provides a potential avenue for therapy of DC and other fibrotic conditions. PMID- 2722923 TI - Bone changes in the vascularised fibular graft. AB - We report a retrospective review of 62 consecutive patients who had a vascularised fibular transfer to reconstruct a large skeletal defect. We were particularly interested in the bone dynamics of the vascularised graft, since fractures occurred in 25% of the cases at an average time of eight months after surgery. Hypertrophy was more common when the limb was mechanically loaded; it was enhanced where the graft was not bypassed by internal fixation. The length of the graft and the use of additional bone graft material had no influence on the incidence of stress fracture or on hypertrophy. We conclude that a vascularised graft should be protected against fatigue fracture during the first year, and that a gradual increase in mechanical loading will enhance remodelling and hypertrophy. PMID- 2722924 TI - A new operation for the prevention and treatment of amputation neuromas. AB - A stump neuroma is caused by the disorganised growth of axon cylinders into proliferating granulation tissue, but this is stopped by an undamaged epineural sleeve. We report experiments in the rat in which the epineural sleeve of the stump of the sciatic nerve was freed from nerve fascicles for about 5 mm and then sealed with a synthetic tissue adhesive. Neuroma formation was largely prevented in comparison with the results of other methods. This new technique has been used to treat 68 painful neuromas in 36 patients. All but three of the patients were cured or improved and none were made worse. PMID- 2722926 TI - Operation for collateral ligament ruptures of the metacarpophalangeal joints of the fingers. AB - Ten cases of complete rupture of the collateral ligaments of the metacarpophalangeal finger joints are reported. The nature of this injury, the pre-operative morbidity and the intra-operative pathology are analysed. In all cases surgery was performed with satisfactory results. Operation is indicated for joint stability, grip and pinch strength, pain control and early functional recovery. PMID- 2722927 TI - Teratoma of the spinal cord. A case report with CT scans. AB - Teratomas in the spinal cord are rare. We report a case in a 54-year-old man. CT scans revealed tumours of different densities within the spinal canal; this heterogeneity may help to differentiate teratoma from other spinal cord tumours. After resection of the tumours under microscopy, the result was excellent. Histological examination showed a variety of tissues, including elements of all three germinal layers. PMID- 2722925 TI - Free tendon grafting to repair the metacarpophalangeal joint of the thumb. Surgical techniques and a review of 70 patients. AB - We report the use of a free tendon graft in 70 patients to repair lesions of the capsuloligamentous complex of the metacarpophalangeal joint of the thumb. Of these 37 had a lesion of the ulnar collateral ligament, 18 of the radial collateral and 11 of the volar plate. Four patients had combined lesions. We outline our techniques and review 51 of the patients. Of those 47 (92%) were satisfied, and all but one had regained full stability. Pinch grip strength was normal in 48. About one-third of the patients had some loss of flexion/extension; this was seldom noticed by the patients and caused no significant disability. Free tendon graft reconstruction is indicated for severe fresh lesions, for old lesions with chronic disability and for lesions which have not responded to conservative management. PMID- 2722928 TI - The prognosis of surgery for cervical compression myelopathy. An analysis of the factors involved. AB - We have studied the morphometry of the spinal cord in 50 patients with cervical compression myelopathy. Computed tomographic myelography (CTM) showed that the transverse area of the cord at the site of maximum compression correlated significantly with the results of surgery. In most patients with less than 30 mm2 of spinal cord area, the results were poor; the cord was unable to survive. Several factors, such as chronicity of disease, age at surgery and multiplicity of involvement are said to influence the results of surgery, but the transverse area of the cord at the level of maximum compression provides the most reliable and comprehensive parameter for their prediction. PMID- 2722929 TI - The deformity of idiopathic scoliosis made visible by computer graphics. AB - We present a method of visualising spinal deformities in three dimensions using conventional radiographs and computer graphics. The shape of the spinal column can be determined from the anteroposterior and lateral radiographs and displayed in any projection. In patients with adolescent idiopathic scoliosis, the fundamental lesion, an abnormal lordosis, can be demonstrated without the need for additional views. The method is applicable to other spinal deformities and may help to elucidate their three-dimensional shape. PMID- 2722930 TI - Torticollis due to a combination of sternomastoid contracture and congenital vertebral anomalies. AB - We report four children with sternomastoid contracture combined with torticolis secondary to congenital vertebral anomalies. Two had features of Klippel-Feil syndrome and a proximal release of the contracted sternomastoid produced good cosmetic correction initially. Progression of the deformity occurred subsequently without recurrence of sternomastoid contracture. One child had such mild deformity that it was merely observed. The fourth child was born with torticollis without sternomastoid tightness and a vertebral anomaly was later recognised. He slowly developed a sternomastoid contracture and his condition was considerably improved by sternomastoid release. This combination of causes of torticollis has not, as far as we know, been previously reported. The clinician should be aware of it and should also realise that radiographs of the very immature spine may not disclose the bony anomalies. PMID- 2722931 TI - The three-dimensional anatomy of the proximal femur in Perthes' disease. AB - A new method of recording the three-dimensional anatomy of the proximal femur from a single anteroposterior radiograph is described. This technique shows that in Perthes' disease the femoral head and neck are in significant anteversion and true varus. This anatomical configuration may be important in the pathogenesis and treatment of this disorder. PMID- 2722932 TI - Arthrography of early Perthes' disease. Swelling of the ligamentum teres as a cause of subluxation. AB - Hip arthrography was performed in 19 patients in the initial stage of Perthes' disease. Sphericity and subluxation were measured and it was found that subluxation was independent of the femoral head deformity. We therefore tried to identify the cause of early subluxation: in seven patients a swollen ligamentum teres was thought to be responsible, and was associated with medial pooling of the contrast medium. A swollen ligamentum teres was seen in another seven cases; the other five arthrograms were normal. These findings were further clarified by enhanced CT scans, which confirmed that ligament swelling may be an important cause of early subluxation. PMID- 2722933 TI - Acetabular fractures in children and adolescents. AB - A retrospective study of 23 acetabular fractures in patients up to 17 years of age is presented, with an average follow-up of eight years. Good or excellent functional results were achieved in 21 patients; radiographic results were good or excellent in 16. Conservative treatment gave consistently good results in fractures with minimal initial displacement, stable posterior fracture dislocations and Salter-Harris type 1 and 2 triradiate cartilage fractures. Less favourable results were seen in type 5 triradiate cartilage fractures and in comminuted fractures, but operation was no better. Unstable posterior fracture dislocations and irreducible central fracture-dislocations need operative treatment but the results may still be unsatisfactory. PMID- 2722934 TI - Aggressive osteoblastoma. A case previously reported as a recurrent osteoid osteoma. AB - We review the case of a 58-year-old man with a benign osteoblastic lesion. This originated in the base of the right second metacarpal and eventually involved several adjacent bones, persisting for at least 27 years despite 11 operations. It was originally reported in the literature as a recurrent osteoid osteoma, but we believe it is more properly diagnosed as an aggressive osteoblastoma, since the histological pattern did not change over the years. The lesion has remained locally aggressive with no evidence of malignant characteristics. PMID- 2722935 TI - Soft tissue recurrence of osteoclastoma. AB - We report a case of osteoclastoma of the distal radius originally treated by curettage, then by resection and bone replacement. There was a soft tissue recurrence of the tumor 13 years later. PMID- 2722936 TI - Cystic degeneration of fibrous dysplasia masquerading as sarcoma. AB - An area of fibrous dysplasia of bone may undergo rapid enlargement which may be due to either cystic degeneration or malignant transformation. These complications may be clinically and radiologically indistinguishable and, unless both are borne in mind, incorrect management may follow. Magnetic resonance imaging was used in one of our cases and was the only imaging modality to demonstrate the true nature of the condition. PMID- 2722937 TI - Hallux varus. AB - We reviewed 12 patients with congenital hallux varus who had had operations on 20 feet to enable them to wear normal shoes and to improve the appearance. After an average follow-up of 12.7 years the results of soft tissue procedures were satisfactory in 12 of 17 feet. Arthrodesis of the first metatarsophalangeal joint, performed primarily in one foot and secondarily in two others was also satisfactory, but metatarsal osteotomy in two feet gave unsatisfactory results leading to local amputation. The unsatisfactory results were generally due to the appearance of shortness of the first metatarsal and rarely because of symptoms or recurrent deformity. PMID- 2722938 TI - Dislocation of the hip in cerebral palsy. Natural history and predictability. AB - To determine the natural history of dislocation of the hip in cerebral palsy, and to evolve methods to predict dislocation, the notes and radiographs of 462 patients with cerebral palsy were reviewed. Dislocation occurred in 10% of patients by progressive migration and subluxation of the proximal femur in the presence of acetabular dysplasia. Statistical analysis identified the radiographic features that helped to predict dislocation. Measurement of acetabular index, by a method that allows for rotation of the acetabulum, was the most powerful single predictor. Measurement of this index at two and four years of age could identify patients who would dislocate unless effective treatment was undertaken, those at risk of dislocation only if scoliosis developed, and those who would not dislocate. On the basis of this method of screening for dislocation, a logical system of surgical prophylaxis is proposed. PMID- 2722939 TI - Measurement of acetabular erosion. The effect of pelvic rotation on common landmarks. AB - Using dried bones which could be tilted and rotated, we assessed the accuracy of published radiographic methods for measuring the migration of prosthetic acetabular components and compared the results with a new method. The new line linking acetabular margins was significantly more accurate for proximal migration than the teardrop, the sacroiliac line or the sacroiliac-symphysis line. For medial migration, a new line tangential to the brim and through the horizontal mid-point of the obturator foramen was more accurate than Kohler's line, the ilio ischial line or the iliopubic line. In combination, the two new lines can give a more accurate assessment of acetabular erosion than previous methods, since they are less affected by the differences in rotation commonly found in a series of radiographs. PMID- 2722940 TI - Torsional stability of the femoral component of hip arthroplasty. Response to an anteriorly applied load. AB - Torsional instability of femoral components has not received much attention, and is difficult to detect in conventional radiographs. To test this we designed a system to apply a load in an anteroposterior direction to the head of a femoral component, implanted into a cadaveric femur. Rotation within the bone was measured, using a purpose built transducer, with and without preservation of the neck, with and without cement, and with longitudinal ridges but no cement. The results show that torsional instability may be a problem in uncemented replacement. Preservation of the femoral neck and the use of a ridged prosthesis increases resistance to rotation. Rotational movements occurring in vivo during such activities as climbing stairs and rising from the seated position may contribute to mechanical loosening. PMID- 2722941 TI - Total replacement of the hip for avascular necrosis in sickle cell disease. AB - Total hip replacement was performed in 27 hips of patients who had sickle cell anaemia with avascular necrosis of the femoral head. The disease was bilateral in 11 patients. Considerable medical problems were encountered although most of the patients had exchange transfusion before surgery (86%), which prevented postoperative sickle cell crises in all but two cases. At the primary operation hard sclerotic bone was seen in nine femora with complete obliteration of the femoral canal. There were four femoral fractures, three following perforation of the shaft due to this hard bone. There was a very high morbidity due to loosening in both cemented and uncemented prostheses. With a rate of 59% over a cumulative 5.5 year period, revision was being performed at an average of only 43 months. Surgeons should be aware of these problems. PMID- 2722942 TI - Rehabilitation after hip fractures. Home and hospital management compared. AB - The rehabilitation of elderly patients after hip fractures is important: we report a prospective study which compares supported home rehabilitation with management in hospital in two similar groups of patients. Our results show that early discharge from hospital and home rehabilitation produces substantial savings in bed days, and also provides quicker and more effective recovery. PMID- 2722943 TI - Morphology of the femur in proximal femoral fractures. AB - We studied the morphology of the contralateral femur in 10 patients with subcapital fractures, 10 with trochanteric fractures and 10 with unilateral osteoarthritis. We found that the patients with trochanteric fractures had a significantly shorter femoral neck (4.5 +/- 0.5 cm) than patients with subcapital fractures or osteoarthritis (5.4 +/- 0.4 cm). It may be that this difference in femoral neck length is related to the site at which a proximal femoral fracture occurs. PMID- 2722944 TI - Treatment of displaced subcapital fractures with the Charnley-Hastings hemiarthroplasty. AB - Between December 1982 and June 1986, 98 displaced subcapital femoral neck fractures were treated using the Charnley-Hastings bipolar hemiarthroplasty. Although the patients were elderly, often with associated medical problems, the operation was well tolerated and the mortality at one and six months was 14.4% and 24.5% respectively. Fifty-four hips were reviewed after an average follow-up of 33 months; 64.8% of patients had a good or excellent result. The fair or poor results were seen mainly in patients with poor pre-operative mobility and multiple medical problems. A significant cause of morbidity was dislocation (two interprosthetic) which occurred in six hips. There were two cases of deep sepsis but neither patient was fit for further surgery. There were no cases of acetabular erosion requiring revision surgery. PMID- 2722945 TI - Repair of calcaneal tendon ruptures. A safe technique. AB - A new method of repair of the calcaneal tendon, which uses a small transverse skin incision, is described. In 41 patients, there was only one minor wound problem and the clinical results were satisfactory. PMID- 2722946 TI - Needlestick injuries at operations for trauma. Are surgical gloves an effective barrier? AB - Surgeons are at risk from both hepatitis B and human immunodeficiency viruses. While vaccines have been developed against the former, barrier methods remain the mainstay of protection. Puncture wounds of the hand are a potential source of contamination; the protection afforded by surgical gloves has been investigated. Gloves from 280 orthopaedic operations for trauma were tested for perforations; one or more was found after 30% of the operations in gloves worn by the surgeon or scrub nurse. About 60% of the perforations were noticed at the time of penetration and most affected the dominant thumb and index finger. Puncture was more common during operations lasting more than one hour. The incidence of perforation was 19% for the outer of double gloves, 14% for a single glove and 6% for the inner of double gloves. These results indicate that surgical gloves function poorly as a protective barrier, especially in difficult, lengthy, fracture surgery. The practice of double-gloving confers increased but not absolute protection. PMID- 2722947 TI - Arthroscopic management of synovial chondromatosis of the knee. Findings and results in 18 cases. AB - We report the results of arthroscopic removal of loose bodies and abnormal synovium from 18 knees with primary synovial chondromatosis. After a mean of three years, six months (range one to 10 years), 14 knees were either symptom free or had only minor symptoms. Three of these had required two arthroscopic operations. Three patients were improved but not cured and there was one failure. The results were better than the published results of open operation for this condition. Three patterns of macroscopic appearances were noted: four knees had large lesions covered by normal synovium, 10 had small fragments of cartilage lying in or on the synovium and four had only free fragments of cartilage in the joint cavity but none in, on, or under, the synovium. These three appearances may represent three different disease processes. PMID- 2722948 TI - A follow-up study of an uncemented knee replacement. The results of 312 knees using the Kodama-Yamamoto prosthesis. AB - The Kodama-Yamamoto knee is an uncemented surface replacement which has been used since 1970. The design has been improved twice and this present report concerns the results of the Mark II model. Between 1980 and 1984, 350 knees were replaced in 225 patients. In 1987, a survey of 335 of these knees was conducted at two to seven years after operation. The results were excellent or good in 83% of patients. Many of the failures were because of general disorders unrelated to the operation, but in 5.4% of the knees there were local complications which continue to present problems. PMID- 2722949 TI - Osteochondritis dissecans and other lesions of the femoral condyles. AB - We reviewed lesions of the femoral condyles seen in 5,000 knee arthroscopies, recording the findings and the age and sex of the patients. We were able to distinguish the characteristics of developing and late osteochondritis dissecans, acute and old osteochondral fractures, chondral separations, chondral flaps and idiopathic osteonecrosis, and suggest that these are separate distinct conditions. Haemarthrosis was associated only with acute osteochondral fractures. The characteristic feature of osteochondritis dissecans was an expanding concentric lesion at the 'classical' site on the medial femoral condyle which appeared during the second decade of life and progressed to a concave steep-sided defect in the mature skeleton. Caffey's (1958) classification of epiphyseal dysplasias could not be applied to osteochondritis dissecans, which appeared to have a gradual onset without acute trauma. Much of the controversy about the cause of osteochondritis dissecans is the result of imprecise nomenclature. PMID- 2722950 TI - Re-attachment of the un-united trochanter in Charnley low friction arthroplasty. AB - In a prospective study, a double crossover wire with a compression spring was used to re-attach 52 un-united trochanters at revision operations on total hip arthroplasties. Bony union was achieved in 42 (81%) and was not influenced by the duration of the nonunion or the separation gap. The new method compared favourably with earlier revisions at which other methods of trochanteric re attachment had been used. PMID- 2722951 TI - Incomplete ruptures of the anterior cruciate ligament. AB - In a prospective study, 41 consecutive patients with a partial tear of the anterior cruciate ligament, diagnosed by arthroscopy, were reviewed after an average of 17 months, having been in plaster for six weeks after injury. Their average age was 29 years and review included clinical examination, measurement of anterior and posterior laxity with the Stryker knee laxity tester as well as evaluation of knee function and activity level. Twenty-one patients had unstable knees at follow-up; the mean total anteroposterior laxity for these patients was 12.6 +/- 3.9 mm compared with 7.1 +/- 4.3 mm for the normal knee. Most patients had few symptoms, but there was a significant reduction in the mean level of activity in the unstable group. PMID- 2722952 TI - Madura foot or plantar fibromatosis. PMID- 2722953 TI - The extensor hallucis brevis muscle flap. PMID- 2722954 TI - A modified technique for subtalar arthrodesis. PMID- 2722955 TI - Arthroscopic drilling of osteochondral lesions of the knee. PMID- 2722956 TI - Iliotibial band contracture after using the Pavlik harness. PMID- 2722957 TI - Systemic mastocytosis affecting the skeletal system. PMID- 2722958 TI - Correcting rotational displacement of femoral neck fractures. PMID- 2722959 TI - Aluminium-induced hip fractures: a hypothesis. PMID- 2722960 TI - Late fracture associated with retained internal fixation. PMID- 2722961 TI - Septic arthritis following arthroscopy and intra-articular steroids. PMID- 2722962 TI - Arthroscopic surgery in the very young. PMID- 2722963 TI - Reconstructive surgery after extensive paralysis of the upper limb II. PMID- 2722964 TI - Postirradiation lesions of the brachial plexus. Results of surgical treatment. AB - In a series of 103 cases of postirradiation lesions of the brachial plexus operated on between 1978 and 1986--of which 60 patients have been reviewed with a follow up from 2 to 9 years--the surgical results are analyzed according to an anatomic classification, a clinical classification, and the surgical procedures. We conclude that the radiation plexitis should be treated surgically and at the earliest possible time after the onset of paresthesias. Also, the surgical procedure which gives the best results is neurolysis with pedicled omentoplasty. PMID- 2722965 TI - Surgical indications in children with cerebral palsy. AB - We have presented our approach to the surgical consideration for the upper extremities of a child with cerebral palsy. This is basically a coordinated approach involving many team members, and is the only way to achieve predictable postoperative results. PMID- 2722966 TI - Neoplastic modulation of extracellular matrix: stimulation of chondroitin sulfate proteoglycan and hyaluronic acid synthesis in co-cultures of human colon carcinoma and smooth muscle cells. AB - Previous studies have shown that human colon carcinomas contain elevated amounts of chondroitin sulfate proteoglycan (CS-PG) and hyaluronic acid, and that the major site of synthesis of these products is the host mesenchyme surrounding the tumor. These findings have led to the proposal that the abnormal formation of the tumor stroma is modulated by the neoplastic cells. The experiments of this paper were designed to explore further this complex phenomenon in an in vitro system using co-cultures of phenotypically stable human colon smooth muscle (SMC) and carcinoma cells (WiDr). The results showed a 3-5-fold stimulation of CS-PG and hyaluronic acid biosynthesis in the co-cultures as compared to the values predicted from the individual cell type cultured separately. The increase in CS PG was not due to changes in specific activity of the precursor pool, but was rather due to a net increase in synthesis, inasmuch as it was associated with neither a stimulation of cell proliferation nor with an inhibition of intracellular breakdown. These biochemical changes were corroborated by ultrastructural studies which showed a marked deposition of proteoglycan granules in the co-cultures. Several lines of evidence indicated that the SMC were responsible for the overproduction of CS-PG: i) SMC synthesized primarily CS-PG when cultured alone, in contrast to the WiDr, which synthesized exclusively heparan sulfate proteoglycan; ii) only the SMC in co-culture stained with an antibody raised against the amino terminal peptide of a CS-PG (PG-40), structurally and immunologically related to that synthesized by the SMC; iii) the stimulation of CS-PG in SMC could be reproduced, though to a lesser extent, using medium conditioned by WiDr, whereas medium conditioned by SMC had no effects on WiDr. In conclusion this study has reproduced in vitro a tumor-associated matrix with a proteoglycan composition similar to that observed in vivo and provides further support to the concept that production of a proteoglycan-rich extracellular environment is regulated by specific tumor-host cell interactions. PMID- 2722967 TI - The role of Asp-49 and other conserved amino acids in phospholipases A2 and their importance for enzymatic activity. AB - The role of aspartic acid-49 (Asp-49) in the active site of porcine pancreatic phospholipase A2 was studied by recombinant DNA techniques: two mutant proteins were constructed containing either glutamic acid (Glu) or lysine (Lys) at position 49. Enzymatic characterization indicated that the presence of Asp-49 is essential for effective hydrolysis of phospholipids. Conversion of Asp-49 to either Glu or Lys strongly reduces the binding of Ca2+ ions, in particular for the lysine mutant, but the affinity for substrate analogues is hardly affected. Extensive purification of naturally occurring Lys-49 phospholipase A2 from the venom of Agkistrodon piscivorus piscivorus yielded a protein that was nearly inactive. Inhibition studies showed that this residual activity was due to a small amount of contaminating enzyme and that the Lys-49 homologue itself has no enzymatic activity. Our results indicate that Asp-49 is essential for the catalytic action of phospholipase A2. The importance of Asp-49 was further evaluated by comparison of the primary sequences of 53 phospholipases A2 and phospholipase homologues showing that substitutions at position 49 are accompanied by structural variations of otherwise conserved residues. The occurrence of several nonconserved substitutions appeared to be a general characteristic of nonactive phospholipase A2 homologues. PMID- 2722968 TI - Type I protein kinase C isozyme in the visual-information-processing pathway of monkey brain. AB - Previously using PKC isozyme-specific antibodies for immunoblot analysis, we demonstrated the heterogeneous distribution of PKC isozymes in various regions of monkey and rat brains and that type I PKC was most abundant in cerebellum, hippocampus, amygdala, and cerebral cortex (Huang et al.: J Biol Chem 262:15714 15720, 1987). Using these antibodies, we have also demonstrated that type I, II, and III PKC are products of PKC genes gamma, beta, and alpha, respectively (Huang et al.: Biochem Biophys Res Commun 149:946-952, 1987). By immunocytochemical analysis, type I PKC-specific antibody showed strong reactivity in various types of neuron in hippocampal formation, amygdala, cerebellum, and neocortex. In hippocampal formation, granule cells of dentate gyrus and pyramidal cells of hippocampus were heavily stained. By immunoblot analysis, relative levels of PKC isozymes in several areas of monkey cerebral cortex involved in the visual information processing and storage were determined. Both type II and III PKCs appeared to be evenly distributed and at moderate levels, type I PKC formed a gradient of increasing concentration rostral along the cerebral cortex of occipital to temporal and then to the limbic areas. Neurobehavioral studies have demonstrated that the neocortical and limbic areas of the anterior and medial temporal regions participate more directly than the striate, prestriate, and posterior temporal regions in the storage of visual representations and that both hippocampus and amygdala are important in the memory formation. As type I PKC is present at high levels in hippocampus, amygdala, and anterior temporal lobe, we predict that the type I protein kinase C may participate in the plastic changes important for mnemonic function. PMID- 2722969 TI - Modulation of mitogenic activity and cellular binding of basic fibroblast growth factor by basic proteins. AB - Polycationic molecules were studied either for their ability to displace the binding of basic fibroblast growth factor (bFGF) to high- and low-affinity membrane interaction sites and/or to modulate bFGF-induced proliferation of fibroblasts. Heparin-binding polypeptides, such as polylysine, protamine, histones, and thrombin-displaced [125I]bFGF bound to bovine brain membrane receptors. The most displacing polypeptides were those with the strongest affinity to heparin. Two of these polypeptides, protamine and polylysine, inhibited (at 5 microM) by more than 90% the mitogenic effect induced by bFGF on Chinese hamster lung fibroblast cells (CCL39). At the same dose, no effect was observed with basic proteins that do not bind to heparin, such as cytochrome C and lysozyme. An interesting observation was that protamine at 1 microM potentiated by 1.5-fold the mitogenic activity of bFGF, while it acted as an inhibitor at higher concentration. PMID- 2722970 TI - Growth factor modulation of melanoma growth stimulatory activity mRNA expression in human malignant melanoma cells correlates with cell growth. AB - This report demonstrates that the expression of melanoma growth stimulatory activity (MGSA) mRNA can be modulated in a positive fashion in the Hs294T human melanoma cell line by PDGF and MGSA. There is close correlation between MGSA expression and the pattern of cell growth in Hs294T cells. PMID- 2722971 TI - Cascade of autophosphorylation in the beta-subunit of the insulin receptor. AB - Insulin stimulated autophosphorylation of the beta-subunit of the insulin receptor purified from Fao hepatoma cells or purified from Chinese hamster ovary (CHO/HIRC) or Swiss 3T3 (3T3/HIRC) cells transfected with the wild-type human insulin receptor cDNA. Autophosphorylation of the purified receptor occurred in at least two regions of the beta-subunit: the regulatory region containing Tyr 1146, Tyr-1150, and Tyr-1151, and the C-terminus containing Tyr-1316 and Tyr 1322. In the presence of antiphosphotyrosine antibody (alpha-PY), autophosphorylation of the purified receptor was inhibited nearly 80% during insulin stimulation. Tryptic peptide mapping showed that alpha-PY inhibited autophosphorylation of both tyrosyl residues in the C-terminus and one tyrosyl residue in the regulatory region, either Tyr-1150 or Tyr-1151. Thus, a bis phosphorylated form of the regulatory region accumulated in the presence of alpha PY, which contained Tyr(P)-1146 and either Tyr(P)-1150 or 1151. In intact Fao, CHO/HIRC, and 3T3/HIRC cells, insulin stimulated tyrosyl phosphorylation of the beta-subunit of the insulin receptor. Tryptic peptide mapping indicated that the regulatory region of the beta-subunit was mainly (greater than 80%) bis phosphorylated; however, all three tyrosyl residues of the regulatory region were phosphorylated in about 20% of the receptors. As the phosphotransferase was activated by tris-phosphorylation but not bis-phosphorylation of the regulatory region of the beta-subunit (White et al.: Journal of Biological Chemistry 263:2969-2980, 1988), the extent of autophosphorylation in the regulatory region may play an important regulatory role during signal transmission in the intact cell. PMID- 2722972 TI - Ligand-induced association of epidermal growth factor receptor to the cytoskeleton of A431 cells. AB - Recently, we have obtained evidence in favor of a structural interaction between the epidermal growth factor (EGF) receptor and the Triton X-100-insoluble cytoskeleton of epidermoid carcinoma A431 cells. Here we present a further analysis of the properties of EGF receptors attached to the cytoskeleton. Steady state EGF binding studies, analyzed according to the Scatchard method, showed that A431 cells contain two classes of EGF-binding sites: a high-affinity site with an apparent dissociation constant (KD) of 0.7 nM (7.5 x 10(4) sites per cell) and a low-affinity site with a KD of 8.5 nM (1.9 x 10(6) sites per cell). Non-equilibrium binding studies revealed the existence of two kinetically distinguishable sites: a fast-dissociating site, with a dissociation rate constant (k-1) of 1.1 x 10(-3) s-1 (1.0-1.3 x 10(6) sites per cell) and a slow dissociating site, with a k-1 of 3.5 x 10(-5) s-1 (0.6-0.7 x 10(6) sites per cell). The cytoskeleton of A431 cells was isolated by Triton X-100 extraction. Scatchard analysis revealed that approximately 5% of the original number of receptors were associated with the cytoskeleton predominantly via high-affinity sites (KD = 1.5 nM). This class of receptors is further characterized by the presence of a fast-dissociating component (k-1 = 2.0 x 10(-3) s-1) and a slow dissociating component (k-1 = 9.1 x 10(-5) s-1). The distribution between fast and slow sites of the cytoskeleton was similar to that of intact cells (65% fast and 35% slow sites). Incubation of A431 cells for 2 h at 4 degrees C in the presence of EGF resulted in a dramatic increase in the number of EGF receptors associated to the cytoskeleton. These newly cytoskeleton-associated receptors appeared to represent low-affinity binding sites (KD = 7 nM). Dissociation kinetics also revealed an increase of fast-dissociating sites. These results indicate that at 4 degrees C EGF induces the binding of low-affinity, fast dissociating sites to the cytoskeleton of A431 cells. PMID- 2722973 TI - TGF beta gene transcription in normal and neoplastic liver growth. AB - TGF beta is a potent, nontoxic inhibitor of mitogen-induced DNA synthesis in primary cultures of adult rat hepatocytes. Using a cDNA probe, we investigated TGF beta gene expression in quiescent, regenerating, and neoplastic liver, and several hepatoma lines by Northern gel analysis. We found that regenerating liver had increased TGF beta gene transcripts beginning at about 8 h, with a broad peak of 48-120 h and return to normal after 9 days. Separation of the regenerating liver into its constituent cell types, followed by RNA extraction and reprobing, revealed that increased TGF beta gene transcripts were confined to the enriched endothelial-cell population and not the hepatocytes. Increased hepatic TGF beta expression was also found in fetal liver and in rats immediately after birth. Elevated TGF beta mRNA levels were also found in primary cultures of oval cells and an established bile ductular cell line, as well as in carcinogen-altered liver epithelial cell lines. Transcripts were undetectable in normal human liver but were abundant in the human hepatoma lines Hep G2, Hep 3B, PLC/PRF/5, and SK Hep-1. Elevated levels were also found in the normal rat liver-derived lines BRL 3A and clone 9 and the H4IIE rat hepatoma, but not in the HTC, MH1C1, and MH7777 rat hepatomas. The hepatocarcinogen diethylnitrosamine induced high transcript levels after single injections in a time- and dose-dependent manner. These results suggest that the liver may be a paracrine organ with respect to TGF beta gene expression, which can be induced by carcinogens and by growth stimulation. PMID- 2722974 TI - Bioequivalency of ranitidine tablets. AB - The bioavailability of two brands of ranitidine tablets was studied in 10 healthy volunteers. Formulation factors were compared by performing disintegration, dissolution and content uniformity tests. Plasma concentrations of ranitidine were measured using a sensitive and precise high pressure liquid chromatographic (HPLC) procedure. Pharmacokinetic parameters were determined for both formulations and included: Cmax, AUCt, AUC infinity, tmax, t1/2 and the terminal rate of elimination (k). Statistical analysis revealed that differences between the brands were not significant. The two formulations can be considered to be bioequivalent. PMID- 2722975 TI - Performance of two predictive methods for calculation of the key pharmacokinetic parameters for gentamicin dosage individualization. AB - Performance of two methods for determination of the apparent volume of distribution (Vd) and the elimination half-life (t1/2) for gentamicin was evaluated in 20 non-obese acutely ill patients. The patients had varying degrees of renal function. Initial creatinine clearance ranged from 22.7-103.1 ml/min, with a mean value (+/- SEM) of 63.26 (+/- 5.74) ml/min, and serum creatinine concentration was 1.37 (+/- 0.13) mg/dl, with a range of 0.70-3.0 mg/dl. The total daily dose of gentamicin ranged from 1.85-4.71 mg/kg. Two different methods were used for Vd calculation: the Hull-Sarubbi method and Chiou midpoint-back extrapolation method. For t1/2 estimation, the Hull-Sarubbi and Cutler methods were used. These values were compared with the values obtained by the Sawchuk Zaske method. Mean predicted error (ME), mean absolute error (MAE), and root mean squared error (RMSE) were calculated for each method. Prediction bias and precision were compared statistically between each method by calculating the 95% confidence intervals of the delta MA and delta MAE, respectively. The MAEs revealed that the precision of Vd predictions were within 1.04 litre and 0.62 litre for the Hull-Sarubbi and Chiou methods, respectively. For the elimination half-life, none of the methods performance exhibited substantial bias. The Hull Sarubbi method, however, was less biased and more precise than the Cutler method. PMID- 2722976 TI - Comparison of fluorescence polarization immunoassay and HPLC for the determination of theophylline in serum. AB - Theophylline in serum was measured by fluorescence polarization immunoassay (FPIA) and by high-performance liquid chromatography (HPLC). Within-run precision studies using control samples in the subtherapeutic, therapeutic and toxic concentrations, resulted in coefficients of variation in the range of 2.86-3.12% (FPIA) and 2.1-3.66% (HPLC), respectively. Between-run precision ranged from 2.76 6.2% for FPIA and from 2.51-6.0% for HPLC. The mean recovery for three spiked controls was 98.9% for FPIA and 98.8% for HPLC. Comparison of 60 patients' samples, assayed with both methods, indicated an extremely good analytical correlation (r = 0.990). The FPIA method displayed a slight but consistent positive bias in relation to the concentration of theophylline present in patients sera. Caffeine was found to exhibit a positive bias to 13%, over a caffeine concentration range of 10-40 micrograms/ml. The HPLC method offers an advantage for measurements of both caffeine and theophylline simultaneously. The FPIA offers significant advantages in speed of analysis and turnover-time, while maintaining accuracy and precision compared with those of established HPLC procedures. PMID- 2722977 TI - Influence of food on bioavailability from two controlled-release granules of theophylline. AB - The bioavailability and absorption pattern of theophylline from Theolong granule and Theodur-G were studied in five healthy volunteers both in fasting conditions and after taking two different meals. In all the subjects, no dose-dumping effect was observed with a standard- or a fat-rich breakfast on these preparations. Postprandial administration delayed the absorption of theophylline and a fat-rich breakfast significantly reduced the area under the curve (AUC0-26) for both preparations. The mean AUC decreased by 14.0% for the former and 19.7% for the latter when the fat-rich breakfast was administered. Intake of a standard breakfast resulted in a decrease in the AUC0-26 by 10.6% for Theolong granules but there was little effect observed with the Theodur-G granules. PMID- 2722978 TI - The behaviour of bioadhesive betamethasone tablets in the mouth. AB - Disk-shaped adhesive tablets, for treatment of mouth lesions, were prepared by direct compression of a mix of high viscosity sodium carboxymethyl-cellulose and 0.061% betamethasone valerate. They were evaluated in six healthy volunteers. The tablets hydrated rapidly, increased their wet weight fourfold in 15 min and maintained contact with the oral mucosa for at least 4 h. Erosion of the tablets was variable with only minor losses in one subject at all times tested, whereas over 80% tablet weight loss occurred in two subjects after 2.5 h. These differences were not solely related to differences in salivary flow. Loss of betamethasone occurred in parallel with the loss of weight from the tablet suggesting that drug release was mainly by erosion of the gelled polymer and not by diffusion from the matrix. The tablets provided prolonged contact with the mucosa but the intersubject variability and drug loss should be addressed to improve the formulation. PMID- 2722979 TI - Adverse drug reaction reporting and pharmacists. PMID- 2722980 TI - Selection of high-performance liquid chromatographic methods in pharmaceutical analysis. IV. Selection of most applicable separation system. AB - Different analytical tasks in the pharmaceutical analysis can be classified according to the separation problems into three main groups: trace analysis, assay methods and separation of closely related compounds including isomers. The most important requirements of high-performance liquid chromatographic (HPLC) methods with respect of the separation problems are summarized. Considerations and recommendations for the selection of the most applicable HPLC system to solve particular analytical problems are discussed. HPLC methods can be compared on the basis of the system resolution (SR) and system selectivity (SS). Criteria developed for the characterization of HPLC methods considering the difficulties created by the different analytical problems are established. The principles of the selection of the most applicable separation systems are demonstrated through some practical examples in pharmaceutical analysis. PMID- 2722981 TI - Chiral recognition by biological macromolecules. Partial resolution of racemic enones by albumin. AB - A novel approach to the optical resolution of racemic enones has been introduced by using the binding properties of the transport protein albumin, which chemically binds preferentially one antipode of some alpha, beta-unsaturated cyclic enones in a reversible manner. Simple separation of the macromolecules by ultrafiltration leads to partial resolution of racemates. PMID- 2722982 TI - Ion-pair, anion-exchange and ligand-exchange high-performance liquid chromatography of tenuazonic acid and 3-acetyl 5-substituted pyrrolidine-2,4 diones. AB - The ion-pair, ligand-exchange and anion-exchange chromatography of the fungal metabolic tenuazonic acid (TA) and its related 3-acetyl 5-substituted pyrrolidine 2,4-diones were studied. Ion-pair chromatography was performed on a C18 column with a mobile phase composed of cetrimide, phosphate buffer in water-methanol and a metal complexant (ethylenediamine) to improve the peak sharpness. Addition of the same metal complexant to the mobile phase of the anion-exchange chromatographic system also improved its efficiency. TA and its 5-substituted analogues derived from valine and leucine were separated with the ion-pair and anion-exchange chromatographic systems. With ligand-exchange chromatography, TA could only be separated from its valine analogue. These chromatographic systems were used for the detection of TA in the culture filtrates of the fungus Pyricularia oryzae and in infected rice leaves. Deproteinated culture filtrates could be rapidly analysed for their TA content by anion-exchange chromatography. However, this system was not suitable for the detection of TA in the infected rice leaf as interfering compounds were coeluted with TA. Ion-pair and ligand exchange chromatographic systems allowed the efficient quantification of TA in infected leaves. PMID- 2722983 TI - Size fractionation of oligosaccharides by liquid chromatography on a cation exchange column. AB - Oligosaccharides, labelled with 2-aminopyridine at their reducing ends, were satisfactorily fractionated according to the sugar sizes on Shodex RSpak DC-613, a cation-exchange resin column (Na+ form), with water-acetonitrile as the eluent in the presence of sodium acetate or triethylammonium acetate buffer. For the fractionation of sugar samples, dextran hydrolyzates, chitin oligomers and oligosaccharide moieties of ovomucoid were used. The oligosaccharides were strongly adsorbed to the resin column with solvents containing less water and at lower temperature, and were eluted in order of increasing molecular size above the critical concentration of acetonitrile. Baseline separation of a dextran hydrolyzate up to oligomers having 20 glucose units was observed by gradient elution. The separation efficiency and elution pattern were investigated by changing the buffer concentration, mobile phase pH and temperature. PMID- 2722984 TI - Determination of amphetamine-related compounds by high-performance liquid chromatography with chemiluminescence and fluorescence detections. AB - High-performance liquid chromatography with chemiluminescence detection has been established for the determination of trace levels of amphetamine-related compounds (APs) after fluorigenic derivatization. Bis(2,4,6-trichlorophenyl) oxalate and hydrogen peroxide in acetonitrile was used as a post-column chemilumigenic reagent. As derivatization reagents, dansyl chloride (Dns-Cl), 4 fluoro-7-nitrobenzoxadiazole (NBD-F) and naphtalene-2,3-dicarbaldehyde (NDA) were compared. Dns-Cl was the most suitable of the three for the simultaneous determination of both primary and secondary amino APs. The on-column detection limits for Dns-derivatives were 3.10(-15) - 4.10(-15) mol. NDA gave the most sensitive derivatives (cyanobenz[f]isoindole, CBI derivatives) with only primary amino APs. The detection limits for CBI derivatives were as low as 2.10(-16) mol. The present method was applied to the determination of methamphetamine in human urine. Only diethyl ether extraction was necessary as a clean-up treatment before Dns derivatization, because diethyl ether extracted methamphetamine quantitatively from urine at strong alkaline pH and the extract showed few interfering peaks around the retention time of methamphetamine after the derivatization. Methamphetamine concentrations as low as 1.10(-7) M in urine were determined after the above treatments. PMID- 2722985 TI - High-performance anion-exchange chromatography of homogeneous D-gluco oligosaccharides and -polysaccharides (polymerization degree greater than or equal to 50) with pulsed amperometric detection. AB - High-performance anion-exchange chromatography under alkaline conditions with pulsed amperometric detection was applied to the analyses of (1----2)-, (1----3) , (1----4)- and (1----6)-linked homogeneous alpha- or beta-D-gluco oligosaccharides and -polysaccharides up to a degree of polymerization (DP) of greater than or equal to 50. Each series of homogeneous D-gluco-oligomers and polymers showed a linear relationship between log k' and DP in isocratic elution using 150 mM sodium hydroxide solution containing 100 mM sodium acetate as the eluent. An effective separation of individual members of an homologous series of linear glucans was achieved using gradient elution, accomplished by maintaining the sodium hydroxide concentration at 150 mM and increasing the sodium acetate concentration during the analysis. The detector response per HCOH group in D gluco-oligomers (DP 2-7) was almost the same. PMID- 2722986 TI - Determination of limonin in grapefruit juice and other citrus juices by high performance liquid chromatography. AB - A method has been developed for the quantitation of the bitter component limonin in grapefruit juice and other citrus juices. The sample clean-up consisted of centrifugation, filtration and a selective, rapid and reproducible purification with a C2 solid-phase extraction column. The limonin concentration was determined by high-performance liquid chromatography on a C18 column with UV detection at 210 nm. A linear response was obtained from 0.0 to 45 ppm limonin. The minimum detectable amount was 2 ng. The minimum concentration which was detected without concentration with good precision was 0.1 ppm. The method was also used for the determination of limonin in different types of oranges, including navel oranges, mandarins, lemons, limes, pomelos and uglis. PMID- 2722987 TI - High-performance liquid chromatographic determination of free formaldehyde in cosmetics. AB - An improved, sensitive method for the determination of formaldehyde in cosmetics and other commercial products is reported. The procedure is based on dilution of the sample with tetrahydrofuran-water (9:1), followed by precolumn derivatization with 2,4-dinitrophenylhydrazine and direct reversed-phase high-performance liquid chromatography. The formaldehyde derivative is stabilized in the reaction medium by addition of phosphate buffer and neutralization and detected in less than 10 min by the standard additions methods. The method also appears to be suitable for the direct evaluation of the formaldehyde donors used in cosmetics as preservatives. PMID- 2722988 TI - Optimization of mobile phase composition for high-performance liquid chromatographic analysis of eleven priority substituted phenols. PMID- 2722989 TI - Determination of sun-screen agents in cosmetic products by reversed-phase high performance liquid chromatography. Part II. PMID- 2722990 TI - High-performance liquid chromatographic determination of some psychotropic indole derivatives. PMID- 2722991 TI - Rapid determination of isomer ratios of butylated hydroxyanisole by high performance liquid chromatography. PMID- 2722992 TI - Reversed-phase high-performance liquid chromatographic separation of lutein and lutein fatty acid esters from marigold flower petal powder. PMID- 2722993 TI - Reversed-phase thin-layer chromatography of homologues of antimycin A and related derivatives. PMID- 2722994 TI - Separation of the molecular species of diacyl and alkenylacyl subclasses of the methyl ester of dinitrophenylethanolamine glycerophospholipid by high-performance liquid chromatography. AB - A high-performance liquid chromatographic (HPLC) procedure for the separation of the molecular species of alkenylacyl and diacyl subclasses after the derivatization of ethanolamine glycero-phospholipids (EGP) to the methyl ester of the dinitrophenylated lipids is described. Methyl esters of dinitrophenylethanolamine glycerophospholipids were first separated into alkenylacyl, alkylacyl and diacyl subclasses by thin-layer chromatography, then each subclass was separated into individual molecular species by reversed-phase HPLC. By converting the EGP into UV-absorbing derivatives, it proved possible to utilize the specificity of spectrophotometric detection for the determination of the individual molecular species. Alkenylacyl and diacyl derivatives were resolved into fifteen to twenty different species in a single HPLC run. The method should facilitate studies on the metabolism of the polar head group of both molecular species of alkenylacyl and diacyl glycerophosphoethanolamine in a variety of tissues using radioactive precursors. PMID- 2722995 TI - Sensitive ferrocene reagents for derivatization of amines for high-performance liquid chromatography with electrochemical detection. AB - Six reagents possessing ferrocene as an electrophore were prepared and evaluated for pre-column derivatization of amino compounds for their determination by high performance liquid chromatography with electrochemical detection. The utility of these reagents was investigated employing phenethylamine as a model compound. Among these six, N-succinimidyl 3-ferrocenylpropionate was the best with respect to reactivity, stability and electrochemical properties. The developed method was applied to the determination of putrescine formed from ornithine by ornithine decarboxylase. PMID- 2722996 TI - Alpha 1-acid glycoprotein high-performance liquid chromatography column (EnantioPAC) as a screening tool for protein binding. AB - An attempt was made to correlate retention behavior on a high-performance liquid chromatographic (HPLC) system employing an immobilized alpha 1-acid glycoprotein (AAG) column with AAG binding behavior for various compounds. Protein binding was assessed by propranolol displacement studies in an equilibrium dialysis system using isolated AAG. HPLC retention behavior poorly correlated with propranolol displacement from AAG. This system is not suitable for use as a screening tool for AAG affinity. PMID- 2722997 TI - Quantitation of hemoglobins Bart's, H, Portland-I, Portland-II and constant spring by anion-exchange high-performance liquid chromatography. AB - We introduce a new high-performance liquid chromatographic procedure that uses a specific anion-exchange column for the separation of hemoglobin (Hb) Bart's (gamma 4), Hb H (beta 4), Hb Portland-I (zeta 2 gamma 2), Hb Portland-II (zeta 2 beta 2), and the abnormal Hb Constant Spring (alpha 2 extended beta 2) in cord blood and adult red cell lysates. The method provides quantitative data for Hb Bart's in cord blood that correlate well with the alpha-globin gene status of the babies and can be used for an initial identification of alpha-thalassemic conditions. Quantitation of Hb Bart's from cord blood samples that are collected on filter paper and submitted as dried blood spots is unreliable. The separation of Hb H and Hb Bart's allows an evaluation of the synthesis of these two hemoglobin components in patients with Hb H disease. PMID- 2722998 TI - Capillary gas chromatographic-mass spectrometric method for the identification and quantification of some benzodiazepines and their unconjugated metabolites in plasma. AB - A gas chromatographic-mass spectrometric method for the identification and/or quantification of diazepam, clobazam, flunitrazepam, triazolam, midazolam, oxazepam and lorazepam and some of their desmethylated and hydroxylated metabolites in plasma is described. Benzodiazepines were extracted from plasma with butyl acetate at pH 9; the hydroxylated compounds were then silylated with N,O-bis (trimethylsilyltrifluoroacetamide). Analysis was performed using a compact mass-selective detector operating in the electron-impact mode. Depending on the concentration, identification was performed either by direct comparison of the observed mass spectra with reference spectra or by the relative intensities of the most intense and characteristic ions in the selected-ion monitoring (SIM) mode. Quantification was performed in the SIM mode using the most intense ion. The intra-assay precision and accuracy were better than 5-6%; linearity was satisfactory up to 1-2 micrograms/ml. The detection limit was 1-5 ng/ml for most of the benzodiazepines. This method can be easily used in clinical situations when a safe and rapid response is essential for patient treatment. PMID- 2722999 TI - Gas chromatographic-mass spectrometric assessment of the pharmacokinetics of amineptine and its main metabolite in volunteers with liver impairment. AB - A pharmacokinetic study of amineptine (Survector) and its C5 metabolite, resulting from a beta-oxidation of the heptanoic acid side-chain, was undertaken with ten human volunteers, who received a single 100-mg tablet of amineptine orally. They were affected with liver impairment in order to determine if this situation would alter greatly the pharmacokinetic parameters. The internal standard was the octanoic acid homologue. Analyses were carried out by gas chromatography (GC) and GC-mass spectrometry using TMS ester derivatives. Plasma samples were extracted using a C18 reversed-phase cartridge at pH 4.0. Mass fragmentographic measurements on the plasma samples were performed on the m/z ions (M + H)+ and (base peak)+ using ammonia chemical ionization. The global evaluation of precision was good and the coherence between the two modes of measurements, (base peak)+ and (M + H)+ ions, gave a regression factor r close to unity. For amineptine the total body clearance and mean residence time were accurate and precise with eight volunteers, but only four volunteers showed such coherent data for the slope of the elimination curve, beta, and half-life. However, the beta value, half-life and mean residence time of the C5 metabolite were accurate and precise with seven, eight and ten volunteers, respectively. It is concluded that the drug was still detoxified at normal levels. PMID- 2723000 TI - Determination of the antihypertensive drug 1-[2-ethoxy-2-(3'-pyridyl)ethyl]-4-(2' methoxyphenyl) piperazine (IP/66) in rat and human plasma by high-performance liquid chromatography and isotope dilution mass spectrometry. AB - In connection with pharmacokinetic studies on the antihypertensive drug 1-[2 ethoxy-2-(3'-pyridyl)ethyl]-4-(2'-methoxyphenyl)piperazine (IP/66) (I), appropriate high-performance liquid chromatographic (HPLC) and gas chromatographic-mass spectrometric isotope dilution (GC-MS-ID) methods for its determination in rat and human plasma, respectively, were developed. In both techniques, deproteinized and basified plasma samples were extracted and purified by adsorption on an Extrelut-1 column, then the drug was eluted with dichloromethane. Quantitative HPLC analysis was performed on a C8 reversed-phase column. The mobile phase was phosphate buffer (0.02 M, pH 2.8)-acetonitrile (65:35), with UV detection at 208 nm. The internal standard was 1-[2-butoxy-2-(3' pyridyl)ethyl]-4-(2'-methoxyphenyl)piperazine, a homologue of I. The inter-assay coefficient of variation (C.V.) was 9.9% for a drug level of 2 micrograms/ml. Quantitative GC-MS-ID analysis was performed with a DB-17 fused-silica capillary column using the selected-ion monitoring technique. The deuterated form of I, 1 [2-ethoxy-2-(3'-pyridyl)ethyl]-4-2'-trideuteromethoxyphenyl)pipe razine, utilized as internal standard, was synthesized. The inter-assay C.V. was 7.36% for a drug level of 1 ng/ml. PMID- 2723001 TI - Determination of methandrostenolone and its metabolites in equine plasma and urine by coupled-column liquid chromatography with ultraviolet detection and confirmation by tandem mass spectrometry. AB - Monitoring steroid use requires an understanding of the metabolism in the species in question and development of sensitive methods for screening of the steroid or its metabolites in urine. Qualitative information for confirmation of methandrostenolone and identification of its metabolites was primarily obtained by coupled-column high-performance liquid chromatography-tandem mass spectrometry. The steroids and a sulphuric acid conjugate were isolated and identified by their daughter ion mass spectra in the urine of both man and the horse following administration of methandrostenolone. Spontaneous hydrolysis of methandrostenolone sulphate gave 17-epimethandrostenolone and several dehydration products. This reaction had a half-life of 16 min in equine urine at 27 degrees C. Mono- and dihydroxylated metabolites were also identified. Several screening methods were evaluated for detection and confirmation of methandrostenolone use including thin-layer chromatography and high-performance liquid chromatography. Coupled-column liquid chromatography was used for automated clean-up of analytes difficult to isolate by manual methods. The recovery of methandrostenolone was 101 +/- 3.3% (mean +/- S.D.) at 6.5 ng/ml and both methandrostenolone and 17 epimethandrostenolone were quantified in urine by ultraviolet detection up to six days after a 250-mg intramuscular dose to a horse. The utility of on-line tandem mass spectrometry for confirmation of suspected metabolites is also shown. PMID- 2723002 TI - Sensitive high-performance liquid chromatographic determination of ionic drugs in biological fluids with short-wavelength ultraviolet detection using column switching combined with ion-pair chromatography: application to basic compounds. AB - A highly sensitive and selective high-performance liquid chromatographic method with short-wavelength UV detection is described for the determination of ionic compounds in biological fluids, which was applied to two basic compounds, 2-(3-[4 (4-fluorophenyl)-1-piperazinyl]propyl)-6,7,8,9-tetrahydro-2H-nap htho [2,3 b][1,4]oxazin-3(4H)-one (I) and methyl 2-(4-diphenylmethyl-1-piperazinyl)ethyl (+/-)-1,4-dihydro-2,6-dimethyl-4-(m-nitrophenyl)-3,5-pyridinedicarboxyla te (II), in human serum. The method is based on the combination of the column-switching technique and ion-pair chromatography. In the first ODS column, the analyte is pre-separated from endogenous substances in serum by ion-pair chromatography. After column switching, in the second ODS column the heart-cut fraction containing the analyte is further separated by non-ion-pair chromatography from coeluted endogenous substances from the first ODS column. The proposed method offered high sensitivity and selectivity with UV detection at 215 nm for I and 230 nm for II. The detection limits were 0.2 ng/ml for both I and II using 1 ml of serum. The principle of the proposed method would be applicable to both acidic and basic compounds in biological fluids with a suitable ion-pair reagent. PMID- 2723003 TI - High-performance liquid chromatographic method for the radiometric determination of [14C] bucromarone in human plasma utilizing non-radiolabeled bucromarone as an internal standard. AB - A novel radiometric high-performance liquid chromatographic (HPLC) method was developed for the determination of [14C]bucromarone in human plasma. The procedure involved the addition of non-radiolabeled bucromarone hydrochloride to each plasma sample as an internal standard; the plasma sample was then extracted, and the bucromarone was separated from its metabolites and endogenous compounds by reversed phase HPLC. The concentration of [14C]bucromarone in each plasma sample was calculated from the ratio of the amount of radioactivity in the eluate fraction corresponding to bucromarone and the peak height of the ultraviolet absorbance (210 nm) of the non-radiolabeled bucromarone used as an internal standard. The lower limit of quantitation for bucromarone free base in this assay was 8 ng/ml when [14C]bucromarone succinate had a specific activity of 0.5 microCi/mg. The coefficients of variation for the experimentally determined concentrations of bucromarone in spiked plasma samples were 6.8 and 14.3% at concentrations of 80 and 20 ng/ml, respectively. This method was used to determine concentrations of bucromarone in the plasma of healthy volunteers who were given intravenous infusions of [14C]bucromarone succinate. In general, the methodology should be applicable to any radiolabeled compound that possesses appreciable ultraviolet absorbance. PMID- 2723004 TI - Enantioselective drug monitoring of (R)- and (S)- propranolol in human plasma via derivatization with optically active (R,R)-O,O-diacetyl tartaric acid anhydride. AB - A sensitive high-performance liquid chromatographic method was developed for the stereoselective assay of (R)- and (S)-propranolol in human plasma. The method involves diethyl ether extraction of the drugs and a racemic internal standard, N tert.-butylpropranolol, followed by derivatization of the compounds with the chiral reagent (R,R)-O,O-diacetyl tartaric acid anhydride. The resulting diastereomeric derivatives were separated isocratically on a reversed-phase column. Quantitation was achieved by the peak-height ratio method with reference to the internal standard. The assay was accurate and reproducible in the concentration range 1-100 ng of (R)- and (S)-propranolol per ml plasma, using fluorescence detection at lambda ex 290 nm and lambda em 335 nm. The applicability of this method was demonstrated for the determination of concentration-time profiles of propranolol enantiomers in the course of comparative pharmacokinetic studies. PMID- 2723005 TI - Identification of 9-hydroxylamine-1,2,3,4-tetrahydroacridine as a hepatic microsomal metabolite of tacrine by high-performance liquid chromatography and electrochemistry. AB - Amperometric detection using a dual-electrode thin-layer cell in the series configuration can aid in the identification of unknown components in complicated samples by voltammetric characterization. This is shown by studying the metabolism of tacrine by rat hepatic microsomes using high-performance liquid chromatography with electrochemical detection. The major metabolite detected in microsomal incubations did not co-elute with any standard acridine available and was produced in too small a quantity for mass spectral characterization. Tentative identification of this metabolite as 9-hydroxylamine-1,2,3,4 tetrahydroacridine was made by electrochemical characterization. The electrochemistry of the metabolite was compared to that of the hydroxylamine produced and studied by cyclic voltammetry. PMID- 2723006 TI - Rapid and specific method for the determination of vancomycin in plasma by high performance liquid chromatography on an aminopropyl column. AB - A high-performance liquid chromatographic method has been developed for the quantitative analysis of vancomycin in plasma. The method involves protein precipitation with acetonitrile, followed by normal-phase chromatography on an aminopropyl column. The clear supernatant was injected after centrifugation, and the eluent was monitored at 240 nm. No interference was found either with endogenous substances or with many currently used drugs, indicating a good selectivity for the procedure. The standard curve was linear between 0.1 and 100 micrograms/ml, and the detection limit was 0.01 microgram/ml of plasma. The mean intra- and inter-assay coefficients of variation were 2.4 and 4.0%, respectively, in the 10-50 micrograms/ml range. Application of the method to the study of vancomycin pharmacokinetics in a rabbit after a single intravenous dose is also reported. PMID- 2723007 TI - Micro-method for measurement of branched-chain keto acid concentrations in plasma from sheep and man. PMID- 2723008 TI - Rapid method for the determination of hippurate in biological fluids by high performance liquid chromatography. PMID- 2723009 TI - Analysis of term human milk concentrations of 3,5,3'-triiodo-L-thyronine by high performance liquid chromatography and radioimmunoassay: correlation with circulating serum levels in lactating women. PMID- 2723010 TI - Separation of peptides from sodium dodecyl sulphate by high-performance liquid chromatography. PMID- 2723011 TI - Determination of reduced folate derivatives in tissue samples by high-performance liquid chromatography with fluorimetric detection. PMID- 2723012 TI - Liquid chromatographic determination of common water-soluble antioxidants in biological samples. PMID- 2723013 TI - Quantitative determination of buprenorphine and its active metabolite, norbuprenorphine, in human plasma by gas chromatography--chemical ionization mass spectrometry. PMID- 2723014 TI - Rapid quantitation of methotrexate and its metabolites in human serum, urine and bile, using solid-phase extraction and high-performance liquid chromatography. PMID- 2723015 TI - Application of high-performance liquid chromatographic analysis of scoparone and its metabolites in the study of cytochrome P450 differentiation in vitro. PMID- 2723016 TI - DNA probes bind non-specifically to eosinophils during in situ hybridization: carbol chromotrope blocks binding to eosinophils but does not inhibit hybridization to specific nucleotide sequences. AB - Eosinophils were found to bind radiolabelled DNA probes non-specifically during in situ hybridization. Pretreatment of cells with carbol chromotrope blocked non specific binding without interfering with the recognition of specific nucleotide sequences. PMID- 2723017 TI - A microscale procedure for isolating and sequencing the viroid RNA present in one gram of infected leaf tissue. AB - A microscale procedure for the isolation and purification of viroid RNA from one gram of viroid-infected leaf tissue and for its subsequent sequencing at the cDNA level is described using potato spindle tuber viroid (PSTV) as model system. Total nucleic acids are phenol-extracted and salt-fractionated with 2 M LiCl. The viroid-containing fraction is then subjected to bidirectional polyacrylamide gel electrophoresis. This removes all co-fractionated cellular RNAs from the circular viroid RNA which is finally recovered from the gel in pure form by isotachophoresis. Thus, from one gram of PSTV-infected tomato leaf tissue, about 100-250 ng of circular PSTV RNA can be obtained and used as template for several DNA primer-directed reverse transcription reactions. From the primer-extended overlapping cDNAs the entire sequence of the viroid progeny synthesized in an individual plant or plant leaf can thus be established by Maxam-Gilbert sequencing. This renders the procedure especially suited for the routine analysis of the in vivo fate of viroid mutants constructed in vitro. PMID- 2723018 TI - Differentiation of rinderpest and peste des petits ruminants viruses using specific cDNA clones. AB - The morbilliviruses which infect ruminants, rinderpest (RPV) and peste des petits ruminants (PPRV), are difficult to distinguish serologically. They can be distinguished by differential neutralisation tests and by the migration of the major virus structural protein, the nucleocapsid protein, on polyacrylamide gels. Both these methods are time consuming and require the isolation of live virus for identification; they are not suitable for analysis of material directly from post mortem specimens. We describe a rapid method for differential diagnosis of infections caused by RPV or PPRV, which uses specific cDNA probes, derived from the mRNAs for the nucleocapsid protein of each virus, which can be used to distinguish unequivocally the two virus types rapidly. PMID- 2723019 TI - Biotinylated RNA probes for the detection of potato spindle tuber viroid (PSTV) in plants. AB - Diseases caused by potato spindle tuber viroid (PSTV) are of significant agronomic importance, and early detection is vital. The objective of this paper was to synthesize biotinylated RNA probes in order to develop a specific, sensitive, and reliable assay system for detection of PSTV in infected plants. RNA probes were prepared by in vitro transcription of cloned PSTV, and were labelled with either biotin-11-UTP or [32P]UTP. Partially purified total RNAs from healthy and from PSTV-infected plants were spotted onto nitrocellulose filters and hybridized with either biotin-labelled or 32P-labelled probes. Our results showed that the sensitivity of biotinylated probes was similar to that for the 32P-labelled probes. PMID- 2723020 TI - Anomalous electrophoretic behavior of the major potato virus X RNA translation product. AB - The major potato virus X (PVS) RNA translation product migrates in Laemmli's electrophoresis system as a 210 kDa polypeptide ('p210'). If a Tris-phosphate-SDS buffer system is used instead of a Tris-glycine-SDS one, the mobility of p210 is higher than that of the largest TMV RNA translation product, the 183 kDa protein. It is suggested that anomalous electrophoretic behavior of the largest PVX polypeptide during SDS-electrophoresis is due to its primary structure, namely to the presence of hydrophilic domains. PMID- 2723021 TI - A simple method for detection of viral satellite RNAs in small plant tissue samples. AB - A procedure is described that allows extraction and can estimate the total amount of single-stranded and double-stranded viral satellite RNAs and viral RNA present in a minimal amount of infected plant tissue, and is capable of distinguishing different cucumber mosaic viral and nepoviral satellites by polyacrylamide gel electrophoresis under semi-denaturing or fully-denaturing conditions. PMID- 2723022 TI - Avidin-biotin enhanced reverse passive hemagglutination method for detection of HIV antigens. AB - A new assay for HIV antigens, the avidin-biotin enhanced reverse passive hemagglutination (AB RPHA) test is described which is suitable for detection of infection in cell culture experiments. This assay is simple to perform and economical, and has sensitivity equal to or greater than that of commercial ELISA assays. The coated red cells used for this assay may be stored in the frozen or lyophilized state. PMID- 2723023 TI - The calcium channel blocker diltiazem lowers serum parathyroid hormone levels in vivo and in vitro. AB - PTH secretion is inversely related to the extracellular and cytosolic calcium (Ca2+) concentrations and, therefore, might be affected by calcium channel blockers such as diltiazem. To investigate the effects of diltiazem on parathyroid function in vivo, 15 subjects were treated with diltiazem (120-360 mg/day), and 15 subjects were treated with the nonspecific vasodilator hydralazine (75-150 mg/day). Diltiazem lowered serum PTH levels from 1.07 +/- 0.07 to 0.87 +/- 0.07 pg/L (P = 0.001), and increased urinary calcium and decreased urinary phosphate excretion (P less than 0.001 and P less than 0.01, respectively). The hydralazine-treated subjects had no significant differences in any of these parameters. To investigate this effect further, dispersed bovine parathyroid cells were incubated for 2 h with or without diltiazem. Regression analysis of PTH released vs. the concentration of diltiazem (10(-7)-10(-4) mol/L) revealed a significant negative relationship (P less than 0.01) with 40% inhibition of PTH release at 10(-4) mol/L (P less than 0.01). The cytosolic Ca2+ concentration, measured using the Ca2+-sensitive fluorescent dye fura-2, was significantly increased in the presence of 10(-4) mol/L diltiazem (P less than 0.01). In summary, diltiazem lowered PTH levels in vivo and in vitro, perhaps acting as a Ca2+ channel agonist in the parathyroid cell and inhibiting PTH release through a rise in the cytosolic Ca2+ concentration. PMID- 2723024 TI - Fasting alters pulsatile and rhythmic cortisol release in normal man. AB - The effect of a 5-day fast on integrated, pulsatile, and periodic cortisol release was studied in 10 normal men by measuring serum cortisol concentrations every 20 min for 24 h before (day 0) and during the fifth day of fasting (day 5). Serum concentration profiles were analyzed for integrated cortisol release (area under the curve), pulsatile hormone release by an objective, statistically based pulse detection algorithm (cluster analysis), and periodic hormone release (circadian and ultradian rhythms) by Fourier expansion time series analysis. Urinary cortisol excretion per 24 h was measured in 5 men. The mean 24-h integrated serum cortisol concentration increased 1.7-fold during fasting (P = 0.0006). This increase resulted from a 2-fold increase in the serum cortisol concentrations between pulses (valley mean; P = 0.0004), an increase in the pulse height (P = 0.001), and an increase in pulse increment above baseline (P = 0.01). There were no changes in the number of pulses per 24 h, the interval between pulses, the width of the pulses, or the area of the pulses during fasting. Twenty four-hour urinary cortisol excretion increased in all men, and the mean urinary cortisol (nanomoles per L)/creatinine clearance (milliliters per s) ratio increased from 119 on day 0 to 187 on day 5 (n = 5; P = 0.05). The pattern of periodic hormone release also changed during fasting; the mean (+/- SE) circadian rhythm (24-h) amplitude decreased from 160 +/- 14 nmol/L on day 0 to 102 +/- 105 nmol/L on day 5 (P = 0.06), and the amplitude of the 12-h rhythm increased from 68 +/- 11 to 99 +/- 11 nmol/L. There also were significant increases in the amplitudes of rhythms with periodicities of 8.1, 4.1, 2.4, 1.6, and 1.3 h (P = 0.02-0.008). Fasting in normal men results in distinct changes in the amount and pattern of pulsatile, circadian, and ultradian cortisol release. PMID- 2723025 TI - Persistence of large molecular weight prolactin secretion during pregnancy in women with macroprolactinemia and its presence in fetal cord blood. AB - Two hyperprolactinemic women with marked increases in circulating 150K PRL were studied from conception throughout pregnancy and delivery. The serum PRL increase during pregnancy in these women was considerably less than that in normal pregnant women (2- and 3.5-fold vs. 10- to 20-fold increases, respectively). The 150K PRL species persisted as the predominant circulating form of PRL throughout each trimester of pregnancy in these women. In contrast, the predominant form of PRL in serum from normal pregnant women was the 22K PRL form. Gel filtration analysis of the umbilical venous cord serum of infants of the macroprolactinemic women demonstrated excessive concentrations of 150K and 50K PRL compared to the molecular species of PRL in the cord serum of normal infants. Repeat analysis of the PRL species in one infant at age 3 yr continued to reveal excessive secretion of 150K PRL (11% vs. less than 6% in normals). These data suggest that genetic influences may be operative in determining PRL heterogeneity. PMID- 2723026 TI - Treatment of orthostatic hypotension with octreotide. AB - The purpose of this study was to evaluate the therapeutic potential of the somatostatin analog octreotide in patients with orthostatic hypotension. Octreotide was administered sc, and its pressor effect was assessed while the patients were semirecumbent and on the tilt table. We also studied the effect of octreotide on blood pressure while patients walked. The efficacy of therapy was assessed by measuring the duration of walking (walking time) before the onset of hypotension. Low doses of octreotide (0.2-0.4 micrograms/kg) had a pressor effect in all patients with progressive autonomic failure (n = 7), multiple system atrophy (n = 7), and diabetic autonomic neuropathy (n = 8), but not in patients with sympathotonic orthostatic hypotension (n = 6). Larger doses (0.4-1.6 micrograms/kg) resulted in a sustained (greater than or equal to 50 min) increase in blood pressure during walking in four of six patients with progressive autonomic failure and in one of six patients with multiple system atrophy. Some patients in whom octreotide failed to stabilize upright blood pressure had a satisfactory response to the drug after pretreatment with dihydroergotamine (10 micrograms/kg, sc). Patients with diabetic autonomic neuropathy, although sensitive to the pressor effect of octreotide, often developed nausea or abdominal cramps after moderate doses (greater than 1.0 micrograms/kg). These results indicate that the pressor effect of octreotide is sufficiently potent to prevent orthostatic hypotension in some patients with autonomic neuropathy. Others require treatment with both dihydroergotamine and octreotide to achieve a stable upright blood pressure. PMID- 2723027 TI - Regulation of thyroid peroxidase and thyroglobulin gene expression by thyrotropin in cultured human thyroid cells. AB - cDNAs for thyroid peroxidase (TPO) and thyroglobulin (Tg) have been cloned and sequenced. Using such cDNAs, we investigated the regulation of TPO and Tg gene expression by various agents in cultured human thyroid cells. Unstimulated human thyroid cells contained a major RNA species [3.2 kilobases (kb) in length] and several minor RNA species (less than 3.2 kb mRNA) of TPO, but no detectable Tg transcripts. However, TSH-stimulated thyroid cells contained four distinct TPO mRNA species (4.0, 3.2, 2.1, and 1.7 kb) and a single Tg mRNA species (8.5 kb). TSH stimulated the TPO and Tg mRNA levels in a dose- and time-dependent manner. The same results were obtained with 8-bromo-cAMP, a cAMP analog, but not with insulin or insulin-like growth factor I. Furthermore, inductions of these mRNAs by TSH and 8-bromo-cAMP were almost completely blocked by cycloheximide, a protein synthesis inhibitor. These results suggest that human thyroid cells contain four distinct TPO mRNAs and a single species of Tg mRNA, and the levels of all mRNAs are increased by TSH/cAMP stimulation. These increases are blocked by inhibiting protein synthesis, indicating that TSH stimulation of TPO and Tg mRNA levels may be mediated by newly synthesized protein(s). PMID- 2723028 TI - Sex hormone-binding globulin response to the anabolic steroid stanozolol: evidence for its suitability as a biological androgen sensitivity test. AB - Both the androgen-induced decline in serum sex hormone-binding globulin (SHBG) levels during puberty and the anabolic effect of exogenous testosterone are absent in patients with androgen insensitivity (testicular feminization). To determine whether the androgen-induced decline in serum SHBG could be used as a test of androgen sensitivity, we studied the effect of the anabolic-androgenic steroid stanozolol (17 beta-hydroxy-17 alpha-methyl-5 alpha-androstano-[3,2 c]pyrazol) on serum SHBG in 25 control subjects, 3 patients with complete androgen insensitivity, and 4 patients with partial androgen insensitivity. Stanozolol was administered orally for 3 days (0.2 mg/kg.day); blood samples were taken before and 5, 6, 7, and 8 days after the beginning of the test for measurements of serum SHBG. The lowest value (i.e. the peak response) in each subject was used as the measure of the response to stanozolol. In the control subjects the mean nadir serum SHBG level was 51.6 +/- 5.9% (+/- SD) of the initial value (P less than 0.001). In the 4 patients with partial androgen insensitivity the nadir serum SHBG ranged from 73-89%, and in the 3 patients with complete androgen insensitivity it ranged from 93-97% of the initial value. Thus, the decrease in serum SHBG after short term administration of stanozolol reflects androgen responsiveness and, thus, may be used to differentiate patients with androgen insensitivity syndromes from those with other causes of male pseudohermaphroditism. PMID- 2723029 TI - Clinical and molecular studies of a thyrotropin-secreting pituitary adenoma. AB - A 40-year-old woman, who had previously received radioactive iodine for hyperthyroidism, presumably due to Graves' disease, subsequently was found to have inappropriately elevated serum TSH and alpha-subunit levels and a pituitary adenoma. Detailed clinical studies revealed marked serum TSH elevations (approximately 100 mU/L) with no circadian variation, but with 7 pulses/24 h. Serum alpha-subunit levels averaged 2.5 micrograms/L, with 13 pulses/24 h. Neither serum TSH nor alpha-subunit responded to TRH stimulation, nor did serum TSH change during dopamine infusion, but alpha-subunit levels did decline slightly. In contrast, during somatostatin infusion, serum TSH declined to 30% of baseline levels, while alpha-subunit levels did not change. Pituitary adenoma tissue obtained at the time of transsphenoidal surgery immunostained weakly with anti-TSH beta serum and strongly with anti-alpha-subunit serum. Northern blot analysis of RNA isolated from the tumor revealed TSH beta and alpha-subunit mRNA levels of normal length, while primer extension analysis showed a major initiation site for the TSH beta gene that appeared to be identical in the tumor and normal pituitary tissue. A second minor upstream start site was detected in the tumor, but it represented less than 1% of transcription compared to the major downstream start site. We conclude that the tumor secreted TSH and alpha-subunit in an abnormal and discordant fashion, but that the TSH gene initiation site appeared to be normal and, therefore, did not explain the observed secretory abnormalities. PMID- 2723030 TI - Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism. AB - Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status. PMID- 2723031 TI - Absence of monocyte procoagulant activity during the immune response to influenza virus. AB - The ability of mononuclear phagocytes (MPh) to manifest procoagulant activity (PCA) resulting in the formation of fibrin is thought to be a key MPh effector function in tissue repair. The present study addresses the question of whether monocyte PCA is confined to tissue hypersensitivity reactions or is a general correlate of all immune responses. We show here that PCA is not the obligate outcome when the immune system is stimulated. In particular, under in vitro conditions in which a mitogen (phytohemagglutinin) or an antigen (purified protein derivative of tuberculin) elicits good PCA responses, incubation with influenza virus does not result in the generation of PCA, although other parameters of response to the virus appear to be intact. Moreover, influenza virus can cause suppression of PCA when cultures are stimulated with either phytohemagglutinin, purified protein derivative of tuberculin, or endotoxin, conditions which would otherwise result in good PCA responses. This lack of PCA persists throughout the culture period and is not caused by an effect of influenza virus on the viability of either MPh or leukocytes in general. PMID- 2723032 TI - Functional capacity of immunoglobulin G preparations and the F(ab')2 split product. AB - Five immunoglobulin G preparations, including one 5S F(ab')2 split product, were compared for activity against common bacterial, viral, and protozoan pathogens. Standard assays were used to quantitate antibodies to tetanus, diphtheria, cytomegalovirus, herpes simplex virus types 1 and 2, rubella virus, and Toxoplasma gondii. Opsonization and killing of bacteria were examined by chemiluminescence methods using Streptococcus pneumoniae types 5, 12F, and 14 and Staphylococcus aureus. Antibodies to the viral pathogens and T. gondii were not detectable for the 5S immunoglobulin even at high concentrations (50 mg/ml) but were present in all 7S preparations at immunoglobulin concentrations of 10 mg/ml. Relatively lower activities for tetanus and diphtheria antibody were also seen with the F(ab')2 product. Opsonizing capacity against all pneumococcal serotypes and Staphylococcus aureus was lowest for the 5S product and highest for the commercially available intravenous immunoglobulin product that is purified by using a pH 4.25 formulation. These data do not support potential clinical usefulness of immunoglobulin G split products and suggest wide variations of specific antibody among commercial intravenous immunoglobulin preparations. PMID- 2723033 TI - Evaluation of DNA colony hybridization and other techniques for detection of virulence in Yersinia species. AB - The virulence of yersiniae varies according to (i) species and biotype and (ii) possession of a 67- to 72-kilobase virulence plasmid. Y. pestis, Y. pseudotuberculosis, and biotypes 1B, 2, 3, 4, and 5 of Y. enterocolitica are inherently virulent but express full virulence only when in possession of a virulence plasmid. Other Yersinia species and biotypes 1A and 3B of Y. enterocolitica are seldom implicated in disease. In this study, we prepared DNA probes from eight nonoverlapping regions of the virulence plasmid of a strain of Y. enterocolitica and from the inv and ail chromosomal loci responsible for the invasive capacity of Y. enterocolitica and Y. pseudotuberculosis. The probes were used in colony hybridization experiments to investigate 156 yersiniae of various species and biotypes and of differing virulence. Probes prepared from the inv gene of Y. pseudotuberculosis hybridized with Y. pseudotuberculosis and Y. pestis only, whereas an analogous probe prepared from Y. enterocolitica hybridized with all species and biotypes of yersiniae (but not with other bacteria) regardless of virulence or potential virulence. Probes prepared from the ail region of Y. enterocolitica reacted almost exclusively with Y. enterocolitica strains of pathogenic biotypes. Probes prepared from the virulence plasmid of a serogroup O:8, biotype 1B isolate of Y. enterocolitica identified virulent yersiniae in all species with a high degree of sensitivity and specificity. These probes did not react with yersiniae of avirulent biotypes or species. Of the other assays of virulence evaluated (calcium dependence, binding of crystal violet, and pyrazinamidase activity), binding of crystal violet provided a simple means for identifying plasmid-bearing strains. PMID- 2723034 TI - "Campylobacter upsaliensis" isolated from blood cultures of pediatric patients. AB - Seventeen campylobacters isolated from cultures of blood samples of 16 bacteremic patients were susceptible to cephalothin and were either catalase negative or had only weak catalase activity (CNW strains) and were classified as "Campylobacter upsaliensis" (K. Sandstedt and J. Ursing, XIV Int. Congr. Microbiol., p. B8-17, 1986). All of the patients had predisposing conditions, and 10 patients were less than or equal to 12 months old, indicating that "C. upsaliensis" is an opportunistic pathogen of humans. PMID- 2723035 TI - Direct isolation of atypical thermophilic Campylobacter species from human feces on selective agar medium. AB - Campylobacter upsaliensis is the name which has been proposed for a new group of thermophilic campylobacter strains which differ from C. jejuni and C. coli in having a negative or weak catalase reaction. Primary isolation of these strains from human feces has been achieved only by use of filtration techniques. We report here direct isolation of strains corresponding to C. upsaliensis from stools of six children. The strains were isolated on a newly described campylobacter-selective medium. The strains were oxidase positive, hippurate negative, nitrate positive, negative for H2S in triple sugar iron, and susceptible to cephalothin (30-micrograms disk) and nalidixic acid (30-micrograms disk), and they grew at 37 and 43 degrees C, but not at 25 degrees C. The selective medium used was a blood-free, charcoal-based medium consisting of Columbia agar base, activated charcoal, cefoperazone (32 micrograms/ml), vancomycin (20 micrograms/ml), and cycloheximide (100 micrograms/ml). The medium supported the growth of the weakly reacting or catalase-negative strains, with colony counts equivalent to those obtained on antibiotic-free horse blood agar. These strains could not be isolated directly from stool on Skirrow medium, and colony counts confirmed that this medium could not support a low inoculum of these organisms. The clinical significance of these strains is unknown. We conclude that C. upsaliensis can be isolated directly from stool by using a selective medium, without the need for filtration. PMID- 2723036 TI - Production of bacteriocin-like antagonism by clinical isolates of Yersinia enterocolitica. AB - Fourteen clinical isolates of Yersinia enterocolitica serotype O:3 and four well documented virulent strains of serotypes O:3, O:8, and O:9 were biotyped and examined for plasmid-associated autoagglutination and calcium dependency and for epithelial cell adherence. These strains were tested for the production of bacteriocin-like antagonism by using tryptone soya blood agar at room temperature and at 37 degrees C. By using the cross-streaking method, three clinical isolates produced inhibitory substances at room temperature. These substances were active against a variety of clinical isolates and their plasmid-cured derivatives at both room temperature and 37 degrees C. The inhibition was easier to read after incubation of the cross-streaked plate at 37 degrees C. The inhibition patterns indicate that two of the three producer strains appear to recognize potentially virulent O:3 strains, with or without the virulence plasmid. PMID- 2723037 TI - Identification of gram-positive coccal and coccobacillary vancomycin-resistant bacteria. AB - A total of 84 of 150 vancomycin-resistant (defined as no inhibition of bacterial growth around a 30-micrograms vancomycin disk placed on 5% sheep blood-Trypticase soy agar [BBL Microbiology Systems, Cockeysville, Md.]) bacteria were definitively identified by determining the phenotypic criteria. The identity of representatives was also confirmed by DNA-DNA hybridizations. The following strains were identified: 1 Enterococcus faecium, 18 Leuconostoc mesenteroides, 15 Leuconostoc citreum, 9 Leuconostoc pseudomesenteroides, 2 Leuconostoc lactis, 20 Pediococcus acidilactici, 5 Pediococcus pentosaceus, and 14 Lactobacillus confusus. The remaining vancomycin-resistant strains were identified as probable Leuconostoc (6 strains), probable Pediococcus (1 strain), and probable lactobacilli (28 strains). A total of 32 strains of gram-positive coccobacillary bacteria remained unidentified. Tests used for the phenotypic identification of strains to the genus level included a Gram stain of bacteria grown in thioglycolate broth, gas production in Lactobacillus Mann, Rogosa, and Sharpe broth, hydrolysis of pyrrolidonyl-beta-naphthylamide, bile-esculin reaction, demonstration of streptococcal group D antigen, and growth at 10 and 45 degrees C and in 6.5% NaCl broth. Strains were identified to the species level by hydrolysis of esculin, reactions in litmus milk, slime production on 5% sucrose agar, acidification of maltose, melibiose, and raffinose broths, deamination of arginine, and growth at 42 degrees C and in 6.5% NaCl broth. PMID- 2723038 TI - Antigenic and genetic variation in Legionella pneumophila serogroup 6. AB - Legionella pneumophila subsp. pneumophila serogroup 6 is second in importance only to L. pneumophila serogroup 1 as a cause of legionellosis. Monoclonal antibody (MAb) reactivity and multilocus enzyme electrophoretic analyses were used to subtype serogroup 6 isolates as a potential aid for epidemiologic and virulence studies. Forty-eight serogroup 6 isolates submitted to the Centers for Disease Control from 1980 to 1985 were examined by these methods. The isolates were divided into two groups based on differential reactivity with two MAbs. Thirty-two of the isolates were of a single electrophoretic type (ET) and were reactive with both MAbs. The remaining 16 isolates were distributed among 10 ETs and were reactive with one or both MAbs. The mean genetic diversity for serogroup 6, as determined from the degree of variability at 20 enzyme loci, was found to be essentially the same as that for L. pneumophila subsp. pneumophila as a whole. The ETs of serogroup 6 isolates were unique but closely related genetically to the ETs of L. pneumophila subsp. pneumophila serogroups 1 to 5, 7, and 8. The range of serogroup 6 subtypes distinguished by MAbs and enzyme electrophoresis suggests that the combination of these two methods can be useful as a typing system. PMID- 2723039 TI - Suicide phenomenon in mesophilic aeromonads as a basis for species identification. AB - The acetic acid-mediated suicide phenomenon in mesophilic aeromonads in conjunction with tests for aerogenicity and esculin hydrolysis served as the basis for species identification. Of 210 Aeromonas isolates tested at 30 degrees C, 88 were identified as Aeromonas hydrophila (nonsuicidal, aerogenic, esculin positive), 52 were identified as A. sobria (suicide variable, aerogenic, esculin negative), and 70 were identified as A. caviae (suicidal, anaerogenic, esculin positive). These identifications paralleled those achieved by biochemical criteria. PMID- 2723040 TI - Monoclonal antibodies against the main immunogenic region of the acetylcholine receptor. Mapping on the intact molecule. AB - About two-thirds of the antibodies to the nicotinic acetylcholine receptor (AChR) in myasthenic patients, and in rats immunized with intact AChR, bind to the main immunogenic region (MIR) on the alpha-subunit. We tested all available anti-MIR monoclonal antibodies (mAbs) by competition experiments for binding on the intact AChR from Torpedo electric organ and human muscle. Practically complete competition between all possible paired combinations of anti-MIR mAbs was found. As a consequence, the MIR must be a very concrete and small region. Furthermore, the location of the MIR relative to some other less immunogenic regions was also determined. PMID- 2723041 TI - Tumor necrosis factor alpha (TNF alpha) and neurological diseases. Failure in detecting TNF alpha in the cerebrospinal fluid from patients with multiple sclerosis, AIDS dementia complex, and brain tumours. AB - The presence of tumor necrosis factor alpha (TNF alpha)/cachectin was investigated in 180 paired cerebrospinal fluid (CSF) and serum samples from patients with neurological diseases, and in five paired CSF and serum samples of Macaca cynomolgus monkeys with acute monophasic experimental autoimmune encephalomyelitis (AMEAE). TNF alpha was never detected in human CSF, even when an extensive demyelination was documented (active multiple sclerosis, acquired immunodeficiency syndrome (AIDS) dementia complex). Only one Macaca with AMEAE had detectable levels of TNF alpha in CSF but not in serum, suggesting an intrathecal synthesis of this cytokine in AMEAE. PMID- 2723042 TI - Search for nicotinic acetylcholine receptors on human leukocytes: absence of alpha-bungarotoxin binding in studies of healthy individuals and myasthenia gravis patients. AB - To investigate whether nicotinic acetylcholine receptors might be present on blood mononuclear cells we studied the binding [125I]alpha-bungarotoxin to mononuclear cells from three normal controls and seven myasthenia gravis patients. The medulloblastoma cell line, TE671, which expresses a functional nicotinic acetylcholine receptor having pharmacological properties similar to that of skeletal muscle receptor, was used as a positive control for alpha bungarotoxin binding. None of the mononuclear cell samples studied exhibited specific binding of alpha-bungarotoxin. PMID- 2723043 TI - Time-dependent effects of isolation on lymphocyte and adrenocortical activity. AB - Individual housing of previously group-housed animals was found to result in time dependent changes in mitogen-induced lymphocyte proliferation and plasma corticosterone concentrations. During the first week of isolation, both B and T lymphocyte responses were depressed. However, within 2 weeks at least a 2-fold enhancement was observed. The increased lymphocyte response was still present after 35 days of isolation. Within the first day of isolation and continuing for 2 weeks, plasma corticosterone levels were found to be significantly decreased in isolated animals compared to those of continuously housed animals. No significant differences in steroid levels were observed by 35 days. These data demonstrate that isolation is accompanied by a depressed adrenocortical activity and suggest that the immunosuppression associated with short-term exposure is mediated by factors other than corticosterone. PMID- 2723044 TI - In vitro modulation of lymphocyte proliferation by prednisolone and interferon alpha in patients with HTLV-I-associated myelopathy (HAM). AB - One of the hallmarks of human T-lymphotropic virus type I (HTLV-I) infection is the proliferation in vitro of peripheral blood lymphocytes (PBLs) in the absence of growth factors. This phenomenon, the autologous proliferative response (APR), involves spontaneous growth of HTLV-I-infected T-cells and proliferation of T cells in response to the infected cells. We studied the modulating effect of prednisolone (PSL) and interferon-alpha (IFN) on APR of PBLs obtained from five patients with HTLV-I-associated myelopathy (HAM). APR was significantly inhibited by PSL and IFN suggesting that APR is important in the pathogenesis of HAM. PMID- 2723045 TI - Ground reaction forces on the plantar surface of the foot after talectomy in the myelomeningocele. AB - Results of talectomies in 19 patients with severe foot deformities secondary to myelomeningocele were evaluated with an average follow-up of 12 years, 7 months. Although an apparently plantigrade foot was usually obtained, talectomy rarely succeeded in distributing weightbearing forces uniformly over the plantar surface. Photoelastic force-plate analysis incorporating three-dimensional contour mapping clearly identified areas of high ground-foot reaction forces (GFRs) and high-pressure gradients. We suggest that such high-pressure areas predispose these patients to neurotrophic ulceration. PMID- 2723046 TI - Energy cost of walking in normal children and in those with cerebral palsy: comparison of heart rate and oxygen uptake. AB - The rate of oxygen uptake can be used to assess energy expenditure during walking, but the necessary instrumentation is cumbersome, expensive, and usually unavailable in the clinical setting. Heart rate is an easily measured parameter, but its use as an index of energy expenditure in children has not been validated previously. We found that the relationship between oxygen uptake and heart rate was linear throughout a wide range of walking speeds for both children with cerebral palsy and normal children. There was no significant difference between the slope or the gamma-intercept of the lines for the two groups. These findings validate the use of heart rate as an index of energy expenditure for normal children and for children with cerebral palsy. PMID- 2723047 TI - Transporting children in body casts. AB - Automotive restraint systems for children in body or hip spica casts, who cannot be accommodated by conventional child restraints or seat belts, were investigated. A car bed restraint and a harness vest restraint were subjected to simulated 30-miles/h crash tests to assess their effectiveness. The successful systems were then tried by patients and their families and found to be convenient as well. Details of the testing, potential limitations of the systems, and a subsequent actual crash experience are reported. PMID- 2723048 TI - Elevated growth velocity in children with Perthes' disease. AB - Sequential measurements of height and weight from diagnosis to maturity in 44 children with Perthes' disease are presented. Both boys and girls have an increased growth velocity after the age of 6 years. In boys diagnosed prior to the age of 6 years, the pubertal growth spurt occurs early but is not sustained. Girls have a delayed but rapid pubertal growth spurt. Abnormal growth patterns are further evidence for the concept of "the susceptible child" and increased growth velocity may contribute to trabecular failure and subsequent epiphyseal infarction. PMID- 2723049 TI - Slipped upper femoral epiphysis: internal fixation using single central pins. AB - Eighteen patients with slipped upper femoral epiphyses were treated by internal fixation using single pins in the centre of the femoral head. In 15 patients, prophylactic pinning of the unaffected side was performed; therefore, 33 hips were pinned. Results were encouraging in that no slip progressed following fixation, no pins broke, and no late reslips occurred. The optimum position for a pin is in the centre of the femoral head, with subsequent pins in suboptimal sites. The method of single pinning is simple and, theoretically, minimizes the risk of joint penetration. PMID- 2723050 TI - Latissimus dorsi and teres major tendons: separate or conjoint tendons? AB - Latissimus dorsi and teres major are used for tendon transfer about the shoulder in treating weakness that results from brachial plexus palsy. Anatomy textbooks describe separate insertion sites for these two tendons. During a surgical procedure, which included releasing these two tendons off the humerus from a posterior approach, they appeared to be joined together. Cadaver shoulders were subsequently dissected to determine if the tendons had conjoint or separate insertions. We found that although the two tendons do have separate insertion sites, they were joined to one another and difficult to separate. For this reason, when performing releases or transfers with these muscles, surgeons should consider the two as one structure in order to avoid damage to the important surrounding neurovascular structures (axillary and radial nerves, posterior humeral circumflex artery). PMID- 2723051 TI - Plastic deformation in pediatric fractures: mechanism and treatment. AB - The plastic deformation often observed in children's long bone fractures is due largely to the complex nature of the molecular and histologic aspects of pediatric bone. Pediatric cortical bone has a lower mineral content than adult bone, accounting in part for its different material properties. Although plasticity allows children's long bones to absorb more energy prior to fracture, a significant deformity may persist after injury. An algorithm and technique for treatment of plastic deformation of the radius and ulna, the two most commonly involved bones in plastic deformation, are reviewed. PMID- 2723052 TI - Fractures and rickets in very low birth weight infants: conservative management and outcome. AB - Fractures and rickets (F/R) often occur in very low birth weight (VLBW less than 1500 g) infants who are acutely ill. However, there are no prospective longitudinal studies of the clinical course of F/R in these infants. In a prospective study of 78 VLBW infants during the first year after birth, radiographic evidence of healing and remodeling of F/R was noted in affected infants (n = 25) concurrent with increased enteral intake and physical growth, and regardless of whether specific orthopedic treatment was initiated. Skeletal maturation as indicated by the development of ossification centers at the wrists was directly related to weight gain, and was similar to term infants by 1 year. No infant had skeletal deformities on follow-up examination. We suggest that VLBW infants with F/R can be managed "conservatively," with emphasis on nutritional intake to achieve weight gain. PMID- 2723053 TI - Recurrent voluntary anterior dislocation of the hip: case report and review of the literature. AB - Recurrent dislocation of the hip is uncommon in children, and anterior dislocation, as in the case reported, is extremely rare. Terminology is often confusing, with "recurrent," "voluntary," and "habitual" dislocations described. The causative pathology of the dislocation must be determined before appropriate treatment can be selected; computed tomography can be helpful in making this decision. PMID- 2723054 TI - Superficial femoral pseudoaneurysm and arterial thromboembolism caused by an osteochondroma. AB - A 13-year-old boy with a symptomatic distal femoral osteochondroma was found to have a pseudoaneurysm of the superficial femoral artery caused by the tumor and occlusion of the anterior tibial artery due to arterial thromboembolism. Excision of the exostosis followed by saphenous vein grafting resulted in an excellent clinical recovery. PMID- 2723055 TI - Occipitoatlantal instability in a child with Kniest syndrome. AB - A case report of occipitoatlantal instability in a 3-year-5-month-old child with Kniest syndrome is presented. Upper cervical spine instability has not previously been reported in Kniest syndrome. Presenting symptoms are similar to those of atlantoaxial instability, which has been reported in patients with skeletal dysplasia. Our patient was effectively treated with occipito-C2 fusion and halo cast immobilization. PMID- 2723056 TI - Intraoperative excision of metal prominences: a technical note. AB - In situ modification of metal rods can be difficult. High-speed cutting discs are effective in cutting metal prominences which cause soft tissue irritation and bony erosion. Water-soluble jelly can effectively trap the metal debris generated during this cutting process. PMID- 2723057 TI - Klippel-Feil syndrome with neck pain. PMID- 2723058 TI - Acquired C1 inhibitor (C1-INH) deficiency type II. Replacement therapy with C1 INH and analysis of patients' C1-INH and anti-C1-INH autoantibodies. AB - The response of two patients with autoantibody-mediated C1-inhibitor (C1-INH) deficiency to replacement therapy with C1-INH was studied over a period of 3 d. In patient 1 an acute attack of angioedema was successfully managed by infusion of 1,000 U of C1-INH concentrate. C1-INH function returned to normal levels within 30 min, while CH50 and C4 peaked after 6-7 h and C1 hemolytic activity reached 50-60% of normal after 3 d. Immediately after the injection an increase in C1-INH-anti-C1-INH complexes was observed. Based on NH2-terminal sequence analysis of the patients' Mr 96,000 C1-INH, it is concluded that this fragment is generated after cleavage of C1-INH in its active site by one of its target proteases without generating a covalent C1-INH-enzyme complex. In a second patient with a four to five times higher anti-C1-INH antibody titer, the infusion of 500 ml of plasma or of 2,000 U of C1-INH concentrate influenced neither the severity of the patient's angioedema nor the tested parameters, except for an increase in the amount of C1-INH-anti-C1-INH complexes. Analysis of patients' anti-C1-INH antibodies revealed that the antibodies recognize different epitopes within the C1-INH. This suggests that patients with acquired angioedema type II are a heterogenous group with respect to the C1-INH autoantibodies. PMID- 2723059 TI - Effects of exogenous free radicals on electromechanical function and metabolism in isolated rabbit and guinea pig ventricle. Implications for ischemia and reperfusion injury. AB - Oxygen-derived free radicals have been implicated in the pathogenesis of cardiac dysfunction during ischemia, postischemic myocardial "stunning," and reperfusion injury. We investigated the effects of oxygen-derived free radicals on cardiac function in intact isolated rabbit hearts and single guinea pig ventricular myocytes. In the intact rabbit ventricle, exposure to free radical-generating systems caused increased cellular K+ efflux, shortening of the action potential duration, changes in tension, and depletion of high energy phosphates similar to ischemia and metabolic inhibition. In patch-clamped single ventricular myocytes, free radical-generating systems activated ATP-sensitive K+ channels, decreased the calcium current, and caused cell shortening by irreversibly inhibiting glycolytic and oxidative metabolism. The results suggest that free radicals generated during ischemia and reperfusion may contribute to electrophysiologic abnormalities and contractile dysfunction by inhibiting glycolysis and oxidative phosphorylation. Inhibition of metabolism by free radicals may be an important factor limiting functional recovery from an ischemic insult after reestablishment of effective blood flow. PMID- 2723060 TI - Immune system control of rat and rabbit colonic electrolyte transport. Role of prostaglandins and enteric nervous system. AB - The role of the immune system in controlling intestinal electrolyte transport was studied in rat and rabbit colon in Ussing chambers. A phagocyte stimulus, the chemotactic peptide FMLP, and a mast cell stimulus, sheep anti-rat IgE, caused a brief (less than 10 min) increase in short-circuit current (Isc). Products of immune system activation, platelet-activating factor (PAF) and reactive oxygen species (ROS), caused a sustained, biphasic increase in the Isc. Ion replacement and flux studies indicated that these agonists stimulated electrogenic Cl secretion and inhibited neutral NaCl absorption; responses that were variably inhibited by the cyclooxygenase blockers indomethacin and piroxicam. Lesser degrees of inhibition by nordihydroguaiaretic acid could be accounted for by decreased prostaglandin synthesis rather than by lipoxygenase blockade. Tetrodotoxin, hexamethonium, and atropine also inhibited immune agonist stimulated Isc, but had no effect on immune agonist-stimulated production of PGE2 or PGI2. These results indicate that immune system agonists alter intestinal epithelial electrolyte transport through release of cyclooxygenase products from cells in the lamina propria with at least 50% of the response being due to cyclooxygenase product activation of the enteric nervous system. The immune system, like the enteric nervous system and the endocrine system, may be a major regulating system for intestinal water and electrolyte transport in health and disease. PMID- 2723061 TI - Production of GAWK (chromogranin-B 420-493)-like immunoreactivity by endocrine tumors and its possible diagnostic value. AB - GAWK (chromogranin-B 420-493) is a 74 amino acid peptide recently isolated from human pituitaries. Using two different antibodies (directed against GAWK [1-17] and [20-38] fragments) GAWK-LI was measured in tumors from 194 patients and in the plasma of 434 patients by RIA. The highest tissue concentrations of GAWK-LI were found in pheochromocytoma (GAWK [1-17]-LI, 18,173 +/- 3,915; GAWK [20-38] LI, 17,852 +/- 2,763 [mean +/- SEM] pmol/g wet wt tissue; n = 9), which were at least ten times higher than any other tumors producing GAWK-LI. High concentrations of GAWK-LI were also found in other types of endocrine tumors including carcinoid, medullary carcinoma of thyroid, pancreatic, and ACTH producing lung tumors. On the other hand, low concentrations of GAWK-LI were found in nonendocrine tumors. Plasma concentrations of GAWK-LI were found to be elevated in patients with endocrine tumor, but more so in those with pancreatic tumors than with pheochromocytomas. Plasma concentrations returned to normal after successful tumor removal. Chromatographic profiles of GAWK-LI in extracts of pheochromocytomas and normal adrenals showed high molecular weight peaks that were absent in the extracts of other endocrine tumors and normal pancreas, suggesting differential tissue-specific processing. Thus GAWK-LI is produced by a variety of endocrine tumors and may serve as a plasma tumor marker, especially in patients with pancreatic endocrine tumors. PMID- 2723062 TI - Failure of postnatal adaptation of the pulmonary circulation after chronic intrauterine pulmonary hypertension in fetal lambs. AB - To determine the effects of chronic intrauterine pulmonary hypertension on the perinatal pulmonary circulation, we induced chronic elevations of pulmonary artery pressure in 24 late-gestation fetal lambs by maintaining partial compression of the ductus arteriosus with an inflatable vascular occluder. Pulmonary artery pressure was increased from 44 +/- 1 to 62 +/- 3 mmHg for 3-14 d. Although left pulmonary artery blood flow initially increased during acute partial ductus compression, the increase in flow was not sustained during chronic ductus compression despite persistent elevations of pulmonary artery pressure (P less than 0.01). Chronic hypertension decreased the slope of the pressure-flow relationship from 3.4 +/- 0.3 (initial) to 0.9 +/- 0.1 ml/min per mmHg, and blunted the fetal pulmonary vascular response to small increases in PO2 (P less than 0.0001). Pulmonary hypertension for greater than 8 d increased the wall thickness of small pulmonary arteries (P less than 0.001). Compared with controls, hypertensive animals had higher pulmonary artery pressure, lower pulmonary blood flow, and predominant right-to-left ductus shunting after cesarean-section delivery (P less than 0.0001). We conclude that chronic pulmonary hypertension in utero, in the absence of hypoxemia or sustained increases in blood flow, causes abnormal fetal pulmonary vasoreactivity, structural remodeling, and the failure to achieve the normal decline in pulmonary resistance at birth. PMID- 2723063 TI - Type I C1 inhibitor deficiency with a small messenger RNA resulting from deletion of one exon. AB - The molecular genetic basis of C1 inhibitor (C1 INH) deficiency in a patient with type I hereditary angioneurotic edema was studied. This patient was found to have an abnormally short C1 INH mRNA together with a normal message. Restriction fragment length polymorphism of the C1 INH gene was detected by Southern blot analysis of the patient's DNA after digestion with Pst I or Sac I, and hybridization with a full-length C1 INH cDNA. Hybridization of the same blot with three different fragments of the full-length cDNA suggested that exon VII and portions of both flanking introns were deleted in the C1 INH gene. Northern blot analysis of RNA from cultured monocytes, using a probe corresponding to exon VII, also indicated that the abnormal C1 INH mRNA had a deletion of these nucleotides. To confirm the hypothesis that the short C1 INH mRNA contained a deletion, the involved segment of the patient's C1 INH mRNA was amplified using the polymerase chain reaction (PCR). PCR amplification yielded two C1 INH DNA fragments of different lengths (380 and 160 bp). Southern blot and sequence analysis of both DNA fragments clearly revealed that the smaller 160-bp DNA was derived from the abnormal message and had a deletion of nucleotides corresponding to exon VII. PMID- 2723064 TI - RNA fingerprinting of respiratory syncytial virus using ribonuclease protection. Application to molecular epidemiology. AB - We have used the technique of ribonuclease protection to define genomic variation among circulating isolates of subgroup A respiratory syncytial (RS) virus. RNAs extracted from HEp-2 cells infected with strains to be analyzed were hybridized with a 32P-labeled RNA probe corresponding to the RS virus G glycoprotein (A2 strain). Areas of nonhomology were detected by cleavage with ribonuclease A. Using this technique, multiple distinct RNA cleavage patterns could be distinguished among viral isolates recovered from infants residing in the same metropolitan area and infected during the same epidemic season. Epidemiologically related isolates (from coinfected twins, from infants infected during a nosocomial outbreak at an extended care facility, and from institutionalized adults infected during an outbreak) yielded identical patterns. In two separate outbreaks, differences in cleavage patterns among certain isolates corresponded to epidemiologically significant differences among the individuals from whom the isolates were recovered. We conclude that substantial genomic heterogeneity exists among circulating isolates of subgroup A RS virus. Ribonuclease protection can be used as a molecular fingerprinting tool for expanded studies of the molecular epidemiology of this virus. PMID- 2723065 TI - 17-beta-estradiol increases mitogenic activity of medium from cultured preadipocytes of massively obese persons. AB - Having reported that omental preadipocytes from massively obese persons release into the culture medium proteins mitogenic for preadipocytes, this study aimed to determine whether estrogens contribute to the production of these factors. Sub cultured omental preadipocytes from 13 massively obese women were grown in the presence or absence of 17-beta-estradiol, and during the last 24 h the conditioned medium was prepared in the absence of serum. Media from cells of 8 of 13 subjects contained significantly higher mitogenic activity when grown in the presence of 17-beta-estradiol. 17-Alpha-estradiol was not effective. The bioassay system involved rat perirenal preadipocytes, since these have been well characterized. Partial purification by gel filtration chromatography indicated that the estrogen-dependent factors had Mr greater than 250,000 and approximately 30,000. Thus, estrogens might contribute to the development of massive obesity in genetically susceptible subjects by promoting the production of paracrine/autocrine principles by adipose cells. PMID- 2723066 TI - Androgen regulation of rat renal angiotensinogen messenger RNA expression. AB - Renal angiotensinogen (ang-n) mRNA concentration in the male WKY rat increases significantly during puberty. Furthermore, renal angiotensinogen mRNA level in the adult female WKY rat is considerably lower than in the male. The present study investigates the role of androgen in differential renal ang-n mRNA expression. Northern and slot blot analyses with alpha-32P labeled ang-n cDNA (pRang 3) demonstrated that castration lowered ang-n mRNA levels in the male kidney by greater than or equal to 60% compared with control, suggesting that androgen may be involved with renal ang-n gene regulation. Moreover, male WKY rats castrated as weanlings and normal adult female WKY rats each implanted with testosterone displayed significant (P less than 0.05) increases in renal ang-n mRNA levels. Our observations, taken together with previous reports that androgen influences proximal tubule morphology and the tubular expression of transport proteins (e.g., Na+/H+ antiporter), may have important physiological implications for understanding the relationship between androgen and angiotensin in the regulation of tubular function. PMID- 2723067 TI - Atherosclerosis influences the vasomotor response of epicardial coronary arteries to exercise. AB - We studied the vasomotion of epicardial coronary arteries during exercise and tested the hypotheses that abnormal vasoconstriction is related to the presence of atherosclerosis and may be related to endothelial dilator dysfunction. During cardiac catheterization quantitative coronary angiography was performed in 21 patients during supine bicycle exercise. 21 of 28 smooth, angiographically normal vessel segments dilated (14.0 +/- 1.8%) during exercise; four smooth segments did not change whereas only three constricted. In contrast, 15 of 16 vessel segments with irregularities constricted in response to exercise (17.0 +/- 0.1%) with only one segment dilating. All 10 stenotic segments constricted to exercise (23 +/- 4%). Six patients also received intracoronary acetylcholine before exercise to test endothelium-dependent dilator function. In five of six patients all nine vessel segments showed the same directional response to acetylcholine and exercise. Three irregular and two stenotic segments constricted with acetylcholine (51 +/- 21%) and exercise (9.0 +/- 0.6%). In contrast, four smooth segments dilated to acetylcholine (19 +/- 6%) and exercise (9 +/- 1%). Both exercise and acetylcholine generally dilated smooth but constricted irregular and stenosed coronary segments. It appears likely that atherosclerosis plays an important role in the abnormal vasomotion of diseased coronary arteries during exercise and the pattern of abnormality suggests impairment of vasodilator function. PMID- 2723068 TI - Formyl peptide-induced chemotaxis of human polymorphonuclear leukocytes does not require either marked changes in cytosolic calcium or specific granule discharge. Role of formyl peptide receptor reexpression (or recycling). AB - We examined the role of intracellular and extracellular calcium on the ability of human polymorphonuclear leukocytes to migrate chemotactically and reexpress (or recycle) formyl peptide receptors when challenged with the synthetic chemotactic peptide, N-formyl-methionyl-leucyl-phenylalanine (FMLP). Extracellular calcium was not required for either optimal chemotactic responses or receptor reexpression. Depletion and chelation of intracellular calcium resulted in significant diminution in the ability of polymorphonuclear leukocytes to release the specific granule constituents lactoferrin and vitamin B12-binding protein during the process of chemotaxis, but had no effect on the capability of these cells to respond chemotactically. Similarly, chelation of intracellular calcium did not affect the ability of these cells to reexpress a population of formyl peptide receptors. Inhibition of receptor reexpression, by a nonagglutinating derivative of wheat-germ agglutinin, was associated with inhibition of chemotactic responses to FMLP. Thus, it appears that large changes in cytosolic free calcium are not necessary for formyl peptide-induced polymorphonuclear leukocyte chemotaxis. In contrast, continuous reexpression (or recycling) of formyl peptide receptors is required for polymorphonuclear leukocyte chemotactic responses to FMLP, a process that appears to be independent from specific granule fusion with plasma membrane. PMID- 2723069 TI - Characterization and histologic localization of human growth hormone-variant gene expression in the placenta. AB - The human growth hormone-variant (hGH-V) gene is one of five highly similar growth hormone-related genes clustered on the short arm of chromosome 17. Although the pattern of expression of the adjacent normal growth hormone (hGH-N) and chorionic somatomammotropin (hCS) genes in this cluster are well characterized, the expression of the hGH-V gene remains to be defined. In previous studies, we have demonstrated that the hGH-V gene is transcribed in the term placenta and expressed as two alternatively spliced mRNAs: one is predicted to encode a 22-kD hormone (hGH-V), the other retains intron 4 in its sequence resulting in the predicted synthesis of a novel 26-kD hGH-V-related protein (hGH V2). In the present report, we document the expression of both of these hGH-V mRNA species in the villi of the term placenta, demonstrate an increase in their concentrations during gestation, and directly sublocalize hGH-V gene expression to the syncytiotrophoblastic epithelium of the term placenta by in situ cDNA-mRNA histohybridization. The demonstrated similarity in the developmental and tissue specific expression of the hGH-V gene with that of the related hCS gene suggests that these two genes may share common regulatory elements. PMID- 2723071 TI - Molecular cloning and chromosomal mapping of DNA rearranged with the parathyroid hormone gene in a parathyroid adenoma. AB - Parathyroid adenomas are common benign neoplasms for which no chromosomal defects have been described. We recently found two parathyroid adenomas bearing clonal restriction fragment abnormalities involving the PTH locus, and now show that in one of these tumors: (a) a DNA rearrangement occurred at the PTH locus; (b) the rearrangement separated the PTH gene's 5' flanking region from its coding exons, conceivably placing a newly adjacent gene under the influence of PTH regulatory elements; (c) the DNA that recombined with PTH normally maps to 11q13, the known chromosomal location of several oncogenes and the gene for multiple endocrine neoplasia type I; and (d) the rearrangement was a reciprocal, conservative recombination of the locus on 11q13 (Human Gene Mapping Library assignment D11S287) with PTH (on 11p15). These data provide molecular cytogenetic evidence for the clonal occurrence of a major chromosome 11 aberrancy in this benign parathyroid tumor. The D11S287 clone could prove useful in genetic linkage analyses, in determining precise 11q13 breakpoints in other neoplasms, and in identifying a gene on chromosome 11 that may participate in parathyroid tumor development. PMID- 2723070 TI - Inhibition of cholesteryl ester transfer protein activity by monoclonal antibody. Effects on cholesteryl ester formation and neutral lipid mass transfer in human plasma. AB - We have employed a neutralizing monoclonal antibody, prepared against the Mr 74,000 cholesteryl ester transfer protein (CETP), to investigate the regulation of lecithin:cholesterol acyltransferase (LCAT) activity by cholesteryl ester (CE) transfer, and also to determine which lipoproteins are substrates for LCAT in human plasma. The incubation of normolipidemic plasma led to transfer of CE from HDL to VLDL, and of triglycerides from VLDL to LDL and HDL. This net mass transfer of neutral lipids between the lipoproteins was eliminated by the monoclonal antibody. However, CE transfer inhibition had no effect on the rate of plasma cholesterol esterification in plasma incubated from 10 min to 24 h at 37 degrees C. In the absence of CE transfer, HDL and LDL exhibited cholesterol esterification activity, whereas VLDL did not. The rate of CE formation in HDL was three to four times greater than in LDL during the first hour of incubation, but CE formation in HDL decreased after 6-8 h, while that in LDL continued. Thus, (a) the Mr 74,000 CETP is responsible for all neutral lipid mass transfer in incubated human plasma, (b) the rate of CE formation in plasma is not regulated by CE transfer from HDL to other lipoproteins, and (c) HDL is the major initial substrate for LCAT; LDL assumes a more significant role only after prolonged incubation of plasma. PMID- 2723072 TI - A gene conversion located 5' to the A gamma gene in linkage disequilibrium with the Bantu haplotype in sickle cell anemia. AB - Cloning and sequencing of the gamma-globin gene of a sickle cell anemia patient homozygous for the Bantu haplotype has revealed a gene conversion that involves the replacement of an A gamma sequence by a G gamma sequence in the promoter area of the A gamma gene. This event is similar to another gene conversion believed to be responsible for the very high homology between gamma-globin genes, suggesting that the promoter area of these genes is prone to this type of genetic rearrangement. Further analysis demonstrated that the chromosome bearing this gene conversion has a very high frequency among Bantu chromosomes and a very low or nil frequency in other haplotypes linked to the beta s gene. No correlation was found between the G gamma/A gamma ratio and the presence of the gene conversion among Bantu haplotype patients, thus excluding a portion of the gamma gene sequence in the determination of this ratio. PMID- 2723075 TI - Irrational thinking and negative emotionality in college students and applicants for mental health services. AB - Although Rational-Emotive Therapy (RET) would posit that greater levels of irrationality and negative emotionality will be found in distressed persons, this basic hypothesis has never been examined. In this study, 60 normal university students and 45 new client applicants for mental health services completed the Survey of Personal Beliefs to assess irrational ideation and the Beck Depression Inventory, the State-Trait Anxiety Inventory, the State-Trait Anger Inventory, the Problematic Situations Questionnaire, and the Profile of Mood States to assess negative emotionality. As predicted, the clinical group was found to be more anxious (p less than .01), more depressed (p less than .01), more confused (p less than .01), less vigorous (p less than .05), and to report lower frustration tolerance (p less than .05) as compared to the normal group. Overall, clinical subjects did not show higher levels of irrational thinking. However, clinical subjects with high depression scores had significantly higher overall irrational ideation in contrast to those in the normal group with low depression scores (p less than .05). Finally, significant correlations were found between overall irrational ideation and Trait Anger (p less than .01) and between overall irrational ideation and Total Guilt (p less than .05). Because the clinical group was significantly older by 10 years, replication with a larger number of subjects of equal ages is recommended. PMID- 2723073 TI - High concentrations of catecholamines in human hypothalamic-hypophysial blood. AB - While the hypothalamic-hypophysial portal system has been extensively studied in laboratory animals, equivalent studies have not been performed in humans. Here, we present an experimental procedure for collecting suprapituitary blood in man. To solve the question on the origin of such blood we investigated specific markers of hypothalamic secretory activity: the catecholamines (CAs). We found (a) norepinephrine (NE), dopamine (DA), and epinephrine (E) concentrations from approximately 1.5 to 2.5, 3.5 to 4.5, and 6- to 10-fold higher, respectively, in suprapituitary than peripheral blood, (b) different NE/DA and NE/E ratios in favor of DA and E in suprapituitary blood, and (c), a complete (100%) group separation (suprapituitary vs. peripheral) when discriminant analysis included only DA and E. These data indicate that suprapituitary blood composition is different from that of the peripheral blood, and is particularly rich in CAs and claimed differences between DA and E release on one hand and NE release on the other in suprapituitary blood also are observed. We advance the hypothesis of a hypothalamic source of such amines draining via median eminence into portal vasculature, and name this blood "hypothalamic-hypophysial blood." Besides serving as "classical" neurotransmitters, CAs may also have a direct neurohormonal role in the regulation of the human hypothalamic-hypophysial function. PMID- 2723074 TI - Intravenous infusion of apolipoprotein E accelerates clearance of plasma lipoproteins in rabbits. AB - Plasma cholesterol levels in cholesterol-fed rabbits were markedly reduced by the intravenous infusion or bolus injection of recombinant human apo E or rabbit plasma apo E. Administration of 6-70 mg of apo E resulted in an approximately 20 40% acute reduction in plasma cholesterol levels within 2-3 h. Plasma cholesterol levels remained reduced for 4-8 h after the administration of apo E. Furthermore, the intravenous injection of apo E reduced the plasma cholesterol levels in Watanabe heritable hyperlipidemic rabbits. The addition of apo E to [14C]cholesterol-labeled canine thoracic duct lymph or [14C]cholesterol-labeled chylomicrons resulted in accelerated plasma clearance of these diet-induced lipoproteins in normal rabbits, with the uptake occurring primarily in the liver. This study suggests that the amount or availability of apo E in the plasma of cholesterol-fed rabbits may be rate limiting for the normal clearance of diet induced remnant lipoproteins. PMID- 2723076 TI - Social desirability response tendencies in psychiatric inpatient children. AB - This study examined the substantive features of children's social desirability (SD) tendencies that could influence the nature and severity of psychopathology. Examinations of substantive features of SD responding in an inpatient child psychiatry unit (N = 76) suggested that higher scores on the Children's Social Desirability questionnaire were associated strongly with (1) lower mental age; (2) higher scores on self-reported social competence; (3) lower scores on self reported anger; and (4) lower scores on parent-reported externalization behavioral disturbance. Results were interpreted as suggesting that SD responding for child inpatients may reflect a mixed picture of negative features of cognitive and social immaturity that could affect adversely their ability to judge their own and others' social behavior and of positive features of less external behavioral disturbance and more prosocial attitudes and behaviors. PMID- 2723078 TI - A comparison of MMPI profile types across standard and contemporary norms. AB - Changes in mean elevation, dispersion, overall configuration, and code type of well-defined MMPI profiles derived from diagnostic groups with known clinical correlates were examined after transformation using contemporary norms developed by Colligan, Osborne, Swenson, and Offord (1983). A total of 34 MMPI profiles from both Gilberstadt and Duker (1965) and Marks, Seeman, and Haller (1974) were analyzed using contemporary normalized T scores. Results yielded the expected reduction in mean elevation and dispersion about the mean upon transformation to contemporary norms. Linear and contemporary normalized T-score profiles correlated highly with each other and manifested a similar pattern of correlation with Skinner and Jackson's (1978) three modal MMPI types. Similarity in the code types of 94% of the profiles was found. However, the substantial number of order changes in the scales that comprise the code type evident upon transformation highlights the caution and care necessary when one is interpreting MMPI profiles based on contemporary norms. Continued use of original norms together with contemporary norms appears indicated until the full implications of profile and code type differences upon transformation to contemporary norms are understood. PMID- 2723079 TI - Criteria for assessing inconsistent patterns of item endorsement on the MMPI: rationale, development, and empirical trials. AB - The concepts nonresponsivity (stimulus avoidance) and content responsive faking (dissimulation) are reviewed and sharply distinguished for their implications for MMPI validity. Although conventional validity scales and indices may be sensitive to content responsive faking, these measures are poorly suited for assessing content nonresponsivity, which is better evaluated with reference to the consistency of item endorsements. A set of rationally derived decisions rules for evaluating content nonresponsivity is presented and investigated empirically. In three studies, each of which compares psychiatric patients with a different set of computer-generated data, the performance of the decision rules and the consistency measures that comprise them was generally superior to traditional measures. The use of consistency-based invalidity criteria is recommended for both clinical and research purposes. PMID- 2723077 TI - Life events and psychopathology severity: comparisons between psychiatric outpatients and inpatients. AB - Relationships between life events stress variables and seven indices of psychopathology severity for a group of 97 never-hospitalized outpatients were compared with those of a previously studied group of 217 first-admission functional disorder psychiatric inpatients from the same geographical catchment areas. The hypotheses tested were that degree of life events stress would be correlated positively with indices of psychopathological severity and that the magnitudes of association would be higher for the outpatients. Bivariate correlations and stepwise multiple regression with other potential demographic and prognostic moderator variables provided evidence for significant, but somewhat differing, patterns in outpatient vs. inpatient stress/pathology relationships. Contrary to prediction, the magnitudes of significant and near significant associations between life events and pathology severity were not different in the two samples. PMID- 2723080 TI - MMPI F-K index among hospitalized Vietnam veterans. AB - The F-K index of the MMPI has been used as a marker of symptom overreporting. One population for which previous research has shown this pattern is Vietnam in country veterans with PTSD. This study assessed the F-K index on 515 inpatients: 329 Vietnam in-country and 186 Vietnam-era patients. Normative data on psychiatric inpatients were presented. Also, a special MMPI subscale (MMPI-PTSD), a measure to identify PTSD among these veterans, was used. Results showed that all Vietnam veterans, especially in-country veterans, overreport symptoms to a high degree. The overall mean for in-country vets was 7.3. Also, when the special MMPI-PTSD subscale was used, a vast majority of in-country veterans who were in the PTSD range had high F-K index scores. Dissimulation as a symptom of PTSD was discussed. PMID- 2723081 TI - Measuring personal values that are specific to eating: reliability, factors, and eating pattern correlates. AB - Eating disorders, particularly weight control disorders, appear resistant to long term modification. While personal values have been shown to influence long-term behavior, their influence on eating patterns has not been studied because of the lack of an instrument to measure those values that are specific to eating. The Eating Values Survey (EVS) was created to measure priorities given to 21 eating related values, such as sensory qualities of food, the experience of hunger, socializing with others, body appearance, nutritional contribution to health, etc. Responses of 109 male and 99 female university students to the EVS were found stable over a 2-week period and revealed five factors, identified as Gusto, Easy Necessity, Orderliness, Gourmet, and Social Approval. EVS scores also correlated significantly with such self-reported eating disorder variables as being overweight and self-induced vomiting. Sex differences in eating values appeared matters of emphasis rather than of distinction. PMID- 2723082 TI - Frequency of reported premenstrual changes in normal and self-selected populations. AB - Premenstrual Assessment Form (PAF) data are presented on the prevalence of premenstrual syndrome subtypes in self-referred women (N = 60) who were requesting an evaluation for premenstrual difficulties. These data are compared to the normative data of Halbreich and Endicott (1982). The PAF offers the advantages of comprehensive symptom coverage and criteria for non-mutually exclusive subtypes of premenstrual disorder. Although the PAF relies on retrospective accounts of premenstrual difficulty, it allows the exploration of the relationships between perception of premenstrual symptoms and sample selection criteria. The present data suggest that sample characteristics such as their manner of selection for study will influence significantly the prevalence of PAF subtypes. PMID- 2723083 TI - Effects of mode of presentation on head-injured patients' recall of narrative information. AB - A 2 x 3 x 3 factorial design was used to examine the recall of units of verbal information by head-injured (n = 12) and hospitalized controls (n = 12) under three modes of presentation and three recall times. Presentation of three instruments commonly used in memory assessment was counterbalanced among overt passive (standard administration), covert active (silent reading), and overt active (reading aloud) modes. Information recall was taken immediately after presentation, 20 minutes, and 48 hours later. Analysis of variance revealed a significant main effect for group, but no main effect for either mode of presentation or recall time. Confirmatory nonparametric analysis supported initial results. Findings are discussed with regard to potential implications for clinical assessment on brain-injured patients and further research in memory assessment on this population. PMID- 2723084 TI - Rey-Auditory Verbal Learning and Rey-Osterrieth Complex Figure Design performance in Alzheimer's disease and closed head injury. AB - Performance on the Rey-Auditory Verbal Learning (R-AVL) and Rey-Osterrieth Complex Figure Design (R-O CFD) tests was examined in patients (N = 94) with dementia of the Alzheimer's type (DAT) and closed head injury (CHI). On the R AVL, DAT patients demonstrated considerably greater impairment than CHI patients, along with a flat learning/retention curve that showed negligible improvement with repeated trials, recency effects only, and an excessive number of word intrusions (confabulation) on the recognition trial. CHI patients demonstrated both a recency and primacy effect along with improvement over repeated trials (positive slope learning curve). Both groups demonstrated impairment R-O CFD recall; the DAT group again displayed substantially greater copying and recall deficits. Clinical guidelines are given for the use of the R-AVL and R-O CFD for these two patient populations. PMID- 2723085 TI - The latent factor structure of the WAIS-R: a factor analysis of individual item responses. AB - Factor analytic examination of a 166 x 166 intercorrelational matrix that represents individual item scores from the 11 subtests of the WAIS-R provided evidence of five interpretable factors (N = 409). Two of these were identified as the Verbal and Performance factors previously encountered in traditional WAIS-R subtest-based factor analyses. The other three factors were characterized readily as involving (1) Advanced Vocabulary skills; (2) Basic Responsivity and (3) Advanced Computational ability. All three of these "new" factors accounted for at least 10% of the total variance, and comments are made with regard to the possible significance of their discovery to such topics as subtest variation and profile psychodiagnostics, theories that pertain to the nature and structure of human intellectual functioning, and subtest-based personality measurement theories. PMID- 2723086 TI - Counselors' reports of their use of self-disclosure with clients. AB - Ninety-six counselors indicated the frequency of their use of 11 types of self disclosure, which varied in intimacy from incidental information (age, race) to personal weaknesses. Positive emotional responses to clients were used most frequently, and opinions/attitudes were used least frequently. A factor analysis showed three factors to describe the data best. Factor 1 was represented by information related to the personal identify and experiences of the therapist. Factor 2 involved the emotional responses of the therapist to the client. Factor 3 was principally the disclosure of professional experiences and identity. Implications are considered. PMID- 2723087 TI - Object representations and symptomatology: preliminary findings in young adult psychiatric inpatients. AB - This study was designed to contribute to the empirical clarification of the object representation construct by assessing the relationships (a) among the levels of cognitive representation of four distinct and relevant individuals; and (b) among those cognitive object representations and dimensions of symptomatology. Subjects were 30 long-term inpatients of a private psychiatric hospital in Connecticut. Cognitive-developmental level of object representation was assessed according to the system described by Blatt, Brenneis, Schimek, and Glick (1976) and symptom dimensions via the SCL-90. Object representations all were interrelated significantly and tended to be related to depressive, but not other, symptomatology. Results could not be accounted for by variation in subjects' verbal production. Findings are discussed in terms of expected developmental increases in object-representation consistency; the potential influence of psychotherapy on object representations; the relative salience of different objects; unknown test-retest reliability of the instrument; and methodological and sampling issues. It is recommended that future empirical research investigate more systematically the nature of developmental level of object representation. PMID- 2723088 TI - A comparison of cognitive-behavioral and hypnotic treatments of chronic pain. AB - Twenty-seven chronic pain patients were assigned to one of three treatment groups: hypnosis, cognitive-behavioral, and an attention control. Hypnosis and cognitive-behavioral treatments were identical with the exception of the hypnotic induction. Scores on the McGill Pain Questionnaire (MPQ) and the Activity Log (Fordyce, 1976) were collected at pretreatment, posttreatment, and follow-up intervals. Analyses of changes showed significant increases in activity and decreases in pain intensity for the cognitive-behavioral treatment. Changes for the hypnosis treatment were noted only on the MPQ. Changes for both groups were sustained on the 1-month follow-up. Results of ANCOVAs showed that the cognitive behavioral treatment resulted in significantly lower pain rating scores than those in the control treatment, but no significant differences were observed between the behavior and hypnosis groups. Findings support the superiority of the cognitive-behavioral treatment on behavior measures and equivalence to hypnosis on subjective measures. PMID- 2723089 TI - Wife abuse as it affects work behavior in a center for mentally retarded persons. AB - This study examined differences between conjugally abused and nonabused female employees at a state-supported ICF/MR residential facility in relation to the potential for client abuse, absenteeism rates, and performance ratings. The research was conducted at a rural institution for mentally retarded persons at which approximately 72% of the workforce was female. A survey package composed of demographic questions, the Child Abuse Potential Inventory (Milner, 1980), and other self-report questions that concerned abuse was distributed to all permanent female employees. The survey return rate was 31.7%. Analysis of the data indicated a significant difference between CAP scores for emotionally and physically abused women and their nonabused counterparts (p less than .01). When a CAP score of 215 was used as a cut-off, 44% of the abused women were classified into the potential abuser category. No significant differences were revealed between categories of abuse and measures of absenteeism or performance appraisal scores. PMID- 2723090 TI - Temperament as a predictor of psychological adjustment in female adult incest victims. AB - Multiple regression analysis was used to examine the relation between temperament and psychological adjustment in a sample of female adult incest victims (N = 57). Several dimensions of temperament, including activity level, mood, approach/withdrawal, flexibility (adaptability), and rhythmicity were significant predictors of various indicators of adjustment and self-esteem. The findings suggest that temperamental characteristics may moderate the effects of childhood incest on adult adjustment. PMID- 2723091 TI - The Children of Alcoholics Screening Test: relationship to sex, family environment, and social adjustment in adolescents. AB - The Children of Alcoholics Screening Test (CAST), the Family Environment Scale (relationship scales only), and the Social Maladjustment Scale were administered to 494 male and female adolescents with a mean age of 16.6 years. High CAST scores were found to be related significantly to low family cohesion, high family conflict, and low overall family support. CAST scores were not related significantly to family expressiveness or to social maladjustment. Internal consistency reliability estimates for the CAST for both males and females were in the mid .90s. Finally, CAST scores of male and female adolescents were found to differ significantly, which indicates the need for separate validation studies to determine screening cut-points for the two groups. PMID- 2723092 TI - Content bias of the MacAndrew's Alcoholism Scale in seizure disorder patients. AB - The possibility of content bias in the MacAndrew's Alcoholism Scale (MAC) from the MMPI was examined in groups of seizure disorder (n = 35), general medical (n = 25), and psychiatric patients (n = 20). Scores above criteria on the MAC were associated with reported alcohol problems only for the psychiatric patients. Almost 50% of the seizure patients with no such history had scores above criteria on the MAC. This classification inaccuracy is even greater than that reported recently in contemporary normal samples. The results suggest that caution should be used when one is administering the MAC to seizure disorder patients and that further investigation of possible content bias in other MMPI scales or subscales should be pursued. PMID- 2723093 TI - Differences in the Symptom Check List-90 profiles of black and white methadone patients. AB - The Sympton Check List-90 (SCL-90) scores of 900 methadone patients were compared by sex and race using a two-way multivariate analysis of variance. The mean profiles did not differ with respect to sex, but did for race. White methadone patients were more obsessive-compulsive and depressed than the Black patients. However, the magnitudes of the mean differences were less than 2.5, and such small mean differences indicate that the employment of separate sex- or race based normative values for the interpretation of the SCL-90 is unnecessary with methadone patients. PMID- 2723094 TI - Assessment of cognitive functioning in poly-substance abusers. AB - Neuropsychological deficits of memory and spatial perception have been associated with substance abuse. The present study assessed the degree to which verbal abstraction is impaired in substance abusers because this function typically is reduced in diffuse cerebral disorders. Test scores of 100 consecutively admitted substance-abusing patients indicated that performance on the Similarities test of the WAIS was actually higher than Vocabulary scores. This finding was replicated with the WAIS-R on a second sample of 100 patients who demonstrated impaired memory and psychomotor speed. These findings indicated that verbal abstraction was unimpaired in two large samples of poly-substance abusers. Further, the superiority of Similarities over Vocabulary scores suggests that in poly substance abusers, Similarities scores may be a better index of premorbid intellectual competence than the more typically used Vocabulary scores. PMID- 2723095 TI - Reliability theory and clinical psychology. AB - Psychologists who report test results usually ignore the published data on the reliability of the test. When reliability is taken into account, the standard error of measurement is used to estimate the magnitude of the range around the observed score in which the true score is most likely to occur. It is assumed that the observed score is the best available estimate of the true score and that the standard error of measurement is the standard deviation of possible true scores around this observed score that could result from errors of measurement. Most textbooks of psychometrics notwithstanding, neither of these popular beliefs is correct. The correct procedure for estimating the most probable true score and the range of error associated with it is described, and the implications for psychological report writing are discussed. PMID- 2723096 TI - Inter- and intra-examiner variability using standard and constant force periodontal probes. AB - Current methods of measuring periodontal probing depths at specified sites by clinical means are subject to wide variation both within and between examiners. This paper reports an investigation into the influence of a constant-force periodontal probe on intra- and inter-examiner variability when measuring probing depths. 30 sites in 10 patients with untreated chronic adult type periodontitis were examined by 2 operators, firstly using a standard periodontal pocket probe then with a constant force probe. Neither examiner was aware of the others readings and were thus blind in relation to one another. Comparison of the recordings of the 2 operators using the standard probes showed significant differences between the operators (p less than 0.01) but this difference became insignificant when the constant force probe was used. One operator had a significant variation between his standard and constant force measurements (p less than 0.01), but the other did not. Overall there was a maximum variation of +/- 1 mm in 79.9% of recordings using the standard probe and this agreement was increased to 100% with the use of the constant pressure probe. PMID- 2723097 TI - The use of repeated measures analysis of variance for plaque and gingival indices. AB - Clinical trials for anti-gingivitis and anti-plaque agents commonly use the mean of Silness and Loe plaque indices and Loe and Silness gingival indices as response variables. The aim of this report is to determine if data from anti plaque and anti-gingivitis clinical trials using Silness and Loe plaque indices and Loe and Silness gingival indices satisfy conditions necessary for the use of the univariate or multivariate approach to repeated measures. These conditions are multivariate normality, homogeneity of variance-covariance matrices, and for the univariate approach, a type-H variance-covariance matrix. Data from 5 separate clinical trials representing a wide range in sample size, pretreatment mean gingival and plaque indices and treatment effects were used to test these conditions. Either the univariate or multivariate approach to repeated measures was found to be appropriate for both responses of the 5 clinical trials. Thus, means of Silness & Loe and Loe and Silness gingival indices meet the necessary conditions for use of either the univariate and/or multivariate approach to repeated measures. However, significant time-treatment interactions are a common occurrence in these types of clinical trials and must be evaluated carefully. The analyses in this study were carried out using SAS. Other mainframe statistical software packages and many micro-computer statistical software packages have routines to analyze repeated measures experiments with analysis of variance methods. However, some of the packages may omit the multivariate approach to repeated measures or may not include interactions between within-subject and between-subject effects. These packages should be used with caution. PMID- 2723098 TI - Guided tissue regeneration in the treatment of furcation defects in mandibular molars. A clinical study of degree III involvements. AB - The present investigation was designed to evaluate the regenerative potential of the periodontal tissues in degree III furcation defects at mandibular molars using a treatment procedure based on the principle of guided tissue regeneration. The patient sample included 21 patients, 26-65 years of age, who presented periodontal lesions in the right and left molar regions including "through and through" furcation defects. After an initial examination, each patient was subjected to a series of full-mouth scaling and root planing. 2-3 months later, they were recalled for a baseline examination. The furcation-involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of muco-periosteal flaps at the buccal and lingual aspects of the molars. Granulation tissue was removed and the exposed root surfaces were debrided and planed. The width and the height of the entrance openings to the furcation defects were assessed. A teflon membrane was adjusted to cover the entrances to the defects (buccal and lingual) and was retained in the manner described by Pontoriero et al. (1988). The flaps were repositioned on the outer surface of the membrane and secured by sutures which were removed after 10 days. Following surgery, the patients were instructed to rinse the mouth twice daily for 4 weeks with chlorhexidine gluconate. The membranes were removed after a healing period of 1-2 months. A surgical procedure identical to the test procedure was performed in the control tooth regions with the exception of the placement of membranes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723100 TI - Is early plaque growth rate constant with time? AB - Early plaque growth and plaque topography were studied in 15 young adults with a healthy periodontium during a 4-day period of no oral hygiene. After perfect tooth-cleaning, the recolonisation of the buccal surfaces of 48 teeth (front teeth and premolars) was recorded at the start and after 6, 12, 24, 30, 36, 48, 54, 60, 72, 84 and 96 h. At each visit, reproducible colour slides of the buccal tooth surfaces were taken after plaque disclosure. Plaque extension was calculated planimetrically as a % of the total surface area of the tooth. At the end of the experimental period, an average of 27.7% of the surface area was covered by plaque. The early plaque growth followed an exponential curve with a slight tendency for saturation at 96 h. During the night, the plaque growth rate decreased by up to 50%. Clear differences in plaque growth rate were observed between types of teeth, and the plaque growth pattern seemed to be closely correlated to irregularities of the tooth surface. The discontinuity in plaque growth and the influence from the tooth surface roughness have important implications for oral hygiene planning. PMID- 2723099 TI - Periodontal disease and oral microbial successions during myelosuppressive cancer chemotherapy. AB - Factors contributing to the succession of opportunistic pathogens at oral sites, including the periodontium, during myelosuppressive chemotherapy are poorly understood. This study examined the relation of periodontal disease to qualitative and proportional shifts in the oral microflora of 21 acute nonlymphocytic leukemia patients (7 male and 14 female, mean age (range) = 51.0 (25-81 years) observed during standardized myelosuppressive regimens. Supra- and subgingival microbial plaque specimens were individually collected from 2 contralateral oral sites (distobuccal of teeth 1-6 and 3-6) in each participant at hospital admission (day 1) and during point of maximal myelosuppression (day 14). Periodontal disease indices obtained at day 1 included site-specific measures of attachment loss and clinical assessment of disease status. Using a residualized change score analysis, periodontal disease status and attachment loss were positively correlated with increases in the proportional recovery of Staphylococcus sp. from supragingival sites and total yeast from supra- and subgingival sites. When age-related covariation in the microbial shifts was controlled in the analysis, periodontal disease status and attachment loss demonstrated no significant correlation with increases in total yeast at supragingival sites. These findings suggest that host factors such as periodontal disease may contribute to patterns of oral microbial successions during cancer chemotherapy. PMID- 2723101 TI - Clinical effects of local application of collagen film-immobilized tetracycline. AB - Tetracycline-containing cross-linked collagen film (TC film), or tetracycline free placebo film, were locally applied 4 times, at 1-week intervals, to 33 teeth with periodontal pockets larger than 4 mm, in 11 patients with periodontal disease. The clinical and microbiological effects are summarized, as follows. In the group treated with the TC film, (1) the clinical indices were significantly decreased at the 4th and 7th weeks in comparison with those at the beginning of treatment. In particular, this group showed a significant decrease in the incidence of bleeding as compared with the placebo group at the 4th week. (2) Total counts of bacteria in the periodontal pockets showed an obvious tendency to decrease with time. The proportion of black-pigmented bacteroides was significantly decreased at the 4th and 7th weeks when compared with the pretreatment value. The extent of decrease in the proportion of spirochetes at both the 4th and 7th weeks was significant compared with the placebo group and the pretreatment value. PMID- 2723102 TI - Criteria for assessment of interproximal bone loss on bite-wing radiographs in adolescents. AB - The present study was performed to determine radiographically the normal distance between the cemento-enamel junction (CEJ) and the alveolar bone crest (AC) as a background for diagnostic decision on bone loss in adolescents. For this purpose, the normal appearance of the alveolar crest was studied in 30, 18-year-olds reported to have had a clinically healthy gingiva at the age of 16 years. A clinical examination was performed and 4 posterior bite-wing radiographs were taken. Sites with bleeding on probing, loss of probing attachment, defective fillings and calculus were excluded from the analysis. At the remaining 737 sites, the distance CEJ-AC was measured on radiographs. Also, the appearance of the marginal bone (normal, sclerotic, notched and/or irregular image, widening of the periodontal ligament space) was recorded. The mean distances CEJ-AC for the separately-recorded maxillary surfaces amounted to 0.9 or 1.0 mm. In the mandible, the distances amounted to 0.7 or 0.8 mm except for the mesial surface of the mandibular first premolar, where a mean distance of 0.5 mm was noted. At maxillary surfaces, 84-90% of the sites showed a distance of 1 mm or less and 94 100% a distance of 1.5 mm or less. At mandibular surfaces, 93-100% of the sites showed a distance of 1.0 mm or less and 100% a distance of 1.5 mm or less. At 4 sites, located at the mesial surface of the first and second premolars in the maxilla, the CEJ-AC distance was recorded as 2 mm. One site was classified as not having a normal appearance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723103 TI - Chemotherapeutic inhibition of supragingival dental plaque and gingivitis development. AB - A 6-month double-blind, controlled clinical study was conducted on 107 healthy adult subjects to determine the efficacy of a mouthrinse used as a supplement to regular oral hygiene measures on supragingival dental plaque and gingivitis. 115 healthy adult patients were recruited for the study. Following screening examinations for minimal entry levels of existing gingivitis and plaque in patients with a minimum of 20 sound natural teeth, extrinsic tooth stain, gingivitis and plaque index scores were recorded. Soft tissues were evaluated. All subjects then received a complete dental prophylaxis, removing plaque, calculus and extrinsic stain. Utilizing their normal oral hygiene, subjects began a regimen of rinsing with 20 ml of the randomly assigned rinse, twice daily for 30 s for 6 months. 7 days after prophylaxis, gingivitis was again scored (baseline 2). Soft tissue, gingivitis, plaque area and extrinsic stain were evaluated again at 3 and 6 months. Results demonstrated that after 6 months, listerine produced a 34% inhibition of both plaque and of gingivitis compared to a hydroalcohol control (p less than 0.001). PMID- 2723104 TI - Periodontal condition and microbiology of healthy and diseased periodontal pockets in type 1 diabetes mellitus patients. AB - On the basis of glycosylated hemoglobin (HbA1c) values, 22 type 1 (insulin dependent) diabetic adults were grouped into patients with near normal (HbA1c less than or equal to 7.7%) and poor (HbA1c greater than or equal to 9.9%) metabolic control. A total of 44 subgingival sites were examined for Actinobacillus actinomycetemcomitans, black-pigmented Bacteroides species and Capnocytophaga species. No significant difference could be demonstrated between patients in the 2 test groups with regard to periodontal condition. Neither age of diabetic patients nor duration of diabetes mellitus influenced the periodontal parameters. In both test groups, pocket depth of 4 mm or more (greater than or equal to 4 mm) was found to be significantly associated with increased swelling, bleeding after probing and amount of marginal plaque. Proportionally high %s of cultivable A. actinomycetemcomitans (mean 4.3%; range 2.8-5.8%), Bacteroides gingivalis (33.2% and 34.6%) and Bacteroides intermedius (mean 4.2%; range 0.001 13.5%) were isolated from diseased periodontal pockets. In diabetic patients with poor metabolic control, B. intermedius was isolated from diseased periodontal pockets with a mean % of 7.2%, range 0.3-12.5%. Independent of the degree of metabolic control, low %s of Capnocytophaga species were isolated from diseased and healthy periodontal pockets, mean 0.9% (range 0.003-3.9%) and mean 1.4% (range 0.04-4.9%), respectively. It was concluded from this study that metabolic control seems to have no direct effect on the periodontium. Furthermore, the role of Capnocytophaga species in the pathogenesis of infectious periodontal disease in type 1 diabetic patients seems to be overestimated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723105 TI - The retention of newly-acquired brushing and flossing skills. AB - Brushing and flossing ability increased dramatically 3 weeks following 2 sessions of oral hygiene instructions. At the same time, the plaque index for these patients decreased significantly. 1 year after the oral hygiene instruction, the plaque index for these patients returned to the pre-intervention levels. However, these patients were able to maintain their 3-week post-intervention brushing and flossing scores. We conclude that increased levels of plaque 1 year later, was not due to loss of brushing and flossing skills. PMID- 2723106 TI - Treatment of diet-resistant polygenic hypercholesterolaemic patients with a new nicotinate derivative; in vivo and in vitro low density lipoprotein metabolic studies. AB - Six patients (four women and two men) with mild to moderate hypercholesterolemia, but with no clinical evidence of the disease being monogenic familial hypercholesterolaemia and who, over the previous 3 months on a rigidly controlled hypolipidaemic diet therapy, showed no reduction in plasma cholesterol levels, were recruited into a study to assess the metabolic effects of Pirozadil, a new nicotinic acid derivative. After a 3 month treatment period, a significant reduction in plasma cholesterol from 299.8 +/- 31.2 mg/dl (mean +/- SD) to 256.8 +/- 18.1 mg/dl (P less than 0.02) and Low Density Lipoprotein (LDL) cholesterol from 211.7 +/- 44.9 mg/dl to 168.8 +/- 19.0 mg/dl (P less than 0.05) was observed. Although there was a trend toward decreased plasma and Very Low Density Lipoprotein (VLDL) triglyceride, the differences did not reach statistical significant. High Density Lipoprotein (HDL) cholesterol was unchanged. The drug was well tolerated with no side effects noted. To assess the mode of action, autologous125I-labelled LDL was injected and apoprotein B (apo B) kinetic parameters were measured; production rate (PR) and fractional catabolic rate (FCR). An in vitro measurement of the in vivo catabolism (LDL-apo B receptor activity in freshly isolated lymphocytes) was also measured pre- and post treatment. The pharmacological intervention resulted in a significant decrease of 19.9% in PR from 10.5 +/- 1.81 mg/kg/d to 8.41 +/- 1.13 mg/kg/d (P less than 0.05) while the FCR remained relatively unchanged (0.260 +/- 0.042 vs 0.248 +/- 0.040 pools/d) as did the LDL receptor activity (78.2 +/- 20.9 vs 69.3 +/- 21.4 ng LDL/mg cell protein/hr).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723107 TI - Obesity and beta-blockers: influence of body fat on their kinetics and cardiovascular effects. AB - Beta-blockers are among the most widely used antihypertensive drugs. They differ from each other in regard to several factors such as: beta-agonist activity, beta 1-selectivity and solubility. Aim of this work was to evaluate the influence of obesity on the kinetics and the antihypertensive effect of two Beta-blockers with different solubility such as: the water-soluble, atenolol and the liposoluble, metoprolol. The study was carried out according to an open randomized cross-over design. Eight obese hypertensive patients, after a two week washout period, were randomly allocated to a four week treatment. After a two week intermediate washout period, each patient switched to the other treatment for an additional four week period. On the first and the last day of each treatment the subjects were hospitalized to collect blood samples for the assay of the two drugs and to measure cardiovascular parameters. Obesity does not exert any effect on the kinetics of the water-soluble beta-blocker, atenolol, while markedly interferes with that of the liposoluble, without any apparent influence on its anti hypertensive effect. These findings extend to obese hypertensives the concept that the plasma concentrations of beta-blocking agents are not reliable predictors of their therapeutic effect. PMID- 2723108 TI - Effects of liver disease on the disposition of ciramadol in humans. AB - To determine the effects of liver disease on the disposition of ciramadol, an analgesic that undergoes ether glucuronidation, we studied its plasma pharmacokinetics in 10 patients with stable cirrhosis, 8 with acute viral hepatitis, and 16 age-matched healthy controls. Renal excretion of the glucuronides was also determined. In healthy controls given a single intravenous dose of the drug the t 1/2 was 3.4 +/- 0.3 hrs and the systemic clearance was 668 +/- 109 ml/min of which renal clearance was 320 +/- 73 ml/min and non-renal clearance 349 +/- 74 ml/min. The corresponding values after an oral dose were similar. Renal clearance was related directly to the estimated creatinine clearance. Moreover, the renal clearance of ciramadol exceeded creatinine clearance, suggesting that the drug was excreted not only by glomerular filtration but also by tubular secretion. The systemic clearance of intravenous ciramadol was diminished by 40% in cirrhosis, P less than 0.05, due to a reduction in renal clearance, while non-renal clearance remained normal. Renal clearance of the inactive glucuronides, on the other hand, was not affected. In patients with acute viral hepatitis, systemic clearance was unchanged, but renal clearance of ciramadol tended to increase during the acute phase of the disease and to return toward normal after recovery. Renal excretion of the inactive glucuronides was decreased by 48% (P less than .05). These findings suggest that the non-renal ether glucuronidation of ciramadol remains intact in patients with stable cirrhosis or acute viral hepatitis. However, the renal clearance of the drug may be impaired in cirrhosis, but tends to be enhanced in acute hepatitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723109 TI - Correction of blood drug levels for changes over the day. AB - A graph-based method is presented to compensate for the influence of variations in drug dosage schedules and blood sampling times upon the blood concentrations of drugs whose elimination half-life is between 7 and 48 hours. This method permits the clinician to interpret blood drug levels drawn at nonstandard times, and to correct blood drug levels for how the daily dose was divided. This method is expected to improve the convenience of monitoring blood drug levels. PMID- 2723110 TI - Saturable first-pass kinetics of propranolol. AB - Reduced bioavailability (F) due to hepatic first-pass extraction of an oral dose (D) is a well-known pharmacokinetic phenomenon. An integrated solution for Michaelis-Menten kinetics of the first-pass effect is derived from the maximal metabolic rate (Vm), volume of distribution (Vd), first order absorption rate constant (ka), Michaelis constant (Km), and liver blood flow (Q). F = 1 - VmVd/kaD ln (1 + kaD/QKm) This equation for single dosage can also be extended to steady state kinetics after multiple dosing in which the amount of a drug present in the hepatic circulation is considered. According to the literature, the bioavailability of a single 80 mg oral dose of propranolol (F = 0.22) increases after multiple doses Fss = 0.36). Based on the first pass equations for single dosage and multiple dosing, the maximal metabolic rate (Vm = 0.043 mg l-1 h-1) corresponding to 310 mg per day and the Michaelis constant (Km = 0.10 mg/l) were calculated for propranolol. Incorporation of nonlinear plasma protein binding in this concept may explain the lack of threshold phenomenon for a single dose of less than 40 mg propranolol. Zero order absorption kinetics could explain why cumulation kinetics seem linear even at an excessive dosage of 960 mg propranolol per day. From these derivations it may be concluded that multiple dosing, increase in plasma protein binding, high absorption rate, and increased portal venous blood flow will increase bioavailability, whereas slow release formulations, fractional drug dosage, and saturable absorption kinetics will decrease bioavailability of first-pass drugs like propranolol. PMID- 2723111 TI - Acetylator phenotypes of Saudi Arabians by a simplified caffeine metabolites test. AB - The authors examined acetylator phenotypes of 296 Saudi subjects of Arabic origin by measuring the molar concentration ratio of two caffeine metabolites, 5 acetylamino-6-formylamino-3-methyluracil (AFMU) and 1-methylxanthine (1MX), using a simplified version of a previously reported high-performance liquid chromatographic method. Spot urine samples were collected from the subjects who regularly drink coffee, tea, or other caffeinated beverages. The subjects were originally from different regions of Saudi Arabia but currently live primarily in the capital city of Riyadh. The day-to-day reproducibility of the molar concentration ratio of AFMU/1MX was established in 14 randomly selected subjects. These metabolites were stable in urine at 4 degrees and -20 degrees, but AFMU was unstable at room temperature (23 degrees). The frequency distribution data indicate that 72.3% of the subjects are of slow acetylator phenotype. PMID- 2723112 TI - Pharmacokinetics of oral nifedipine: relevance of the distribution phase. AB - Pharmacokinetics of oral Nifedipine was studied in 12 Mexican young healthy volunteers, six men and six women, who received a 10 mg capsule. Plasma levels were determined by a nifedipine specific HPLC assay. Experimental data were fitted and pharmacokinetic parameters were calculated using an open two compartment model. No statistically significant difference was detected between men and women, thus both sexes were considered as a single population. Nifedipine plasma levels rose rapidly (ka = 8.46 +/- 1.96 h-1) reaching a maximum concentration of 145 +/- 23 ng/ml in 0.61 +/- 0.07 h. Plasma levels then decayed with a distribution phase (alpha = 1.98 +/- 0.40 h-1, t1/2 alpha = 0.46 +/- 0.06 h) and a terminal elimination phase (beta = 0.17 +/- 0.03 h-1, t1/2 beta = 4.98 +/- 0.55 h). AUC was 384 +/- 41 ng h/ml. Values of AUC and t1/2 beta were higher than those reported by other authors. Differences in the AUC could be due to ethnic origin, environmental factors or nutritional habits. Ten subjects presented plasma concentration-time curves in which the distribution phase was clearly distinguishable, having a ka/alpha relationship higher than 1.5. For the other two subjects, the distribution phase was not apparent and ka/alpha was lower than 1.5. The results show that an adequate characterization of the distribution phase is required if one pretends to use pharmacokinetic data for dosage regimen design. PMID- 2723113 TI - Doxylamine and diphenhydramine pharmacokinetics in women on low-dose estrogen oral contraceptives. AB - Thirteen women chronically using low-dose estrogen-containing oral contraceptives (50 micrograms or less of ethinyl estradiol or its equivalent for a minimum of 3 months) and 12 age-matched drug-free control women received a single 25 mg oral dose of doxylamine succinate in the fasting state. Ten women taking oral contraceptives and ten controls received a single 50 mg oral dose of diphenhydramine hydrochloride. Multiple plasma samples drawn during 30 hours following the dose of doxylamine, and 12 hours after diphenhydramine dosage, were analyzed by gas chromatography using nitrogen-phosphorus detection. Mean pharmacokinetic variables for doxylamine in control and oral contraceptive groups were: peak plasma concentration, 103 vs 100 ng/ml; time of peak, 2.40 vs 1.87 hours after dosage, elimination half-life, 10.1 vs 10.2 hours; and total clearance, 3.70 vs 3.88 ml/min/kg. Mean pharmacokinetic variables for diphenhydramine in control and oral contraceptive groups were: peak plasma concentration, 63.7 vs 73.8 ng/ml; time of peak, 2.7 vs 2.2 hours after dosage; elimination half-life, 6.0 vs 5.1 hours; and total clearance, 21.8 vs 25.5 ml/min/kg. None of these differences were statistically significant. Thus, low dose estrogen-containing oral contraceptives do not significantly influence the pharmacokinetics of the antihistamines doxylamine or diphenhydramine. PMID- 2723114 TI - Influence of demographic factors on cyclosporine pharmacokinetics in adult uremic patients. AB - The causes of variability in cyclosporine (CS) clearance (CL) are mostly unknown. The pharmacokinetics of CS were studied in 30 adult uremic patients after single intravenous and oral doses by analyzing serial concentrations in serum by radioimmunoassay (SR) and in whole blood by radioimmunoassay (WR) and high pressure liquid chromatography (WH). Bioavailability (F) and CL were calculated by noncompartmental models and were significantly different depending upon the assay method except for FSR = FWR: FSR = 43.2 +/- 21.7%; FWR = 43.5 +/- 18.5%; FWH = 36.4 +/- 17.3%; CLSR = 849 +/- 363 ml/min; CLWR = 380 +/- 156 ml/min; CLWH = 559 +/- 174 ml/min. The age of the patients and parameters describing body size such as weight, surface area and percent of ideal weight were not correlated with CL. The height of the patients correlated with CLWH but not CLSR or CLWR. Parameters responsible for CS binding in blood such as cholesterol, triglyceride, hemoglobin concentration or hematocrit did not explain variability in CL. Of the factors indicative of liver function alanine transaminase activity but not aspartate transaminase, lactate dehydrogenase, alkaline phosphatase activity nor total bilirubin concentration in serum was correlated with CL. F was not correlated with any of the demographic factors except for alanine transaminase. None of the significant correlations explained enough of the variability to afford a reliable prediction of CL or F. PMID- 2723115 TI - Pharmacokinetics of midazolam following intravenous and oral administration in patients with chronic liver disease and in healthy subjects. AB - To study the effects of cirrhosis of the liver on the pharmacokinetics of midazolam single IV (7.5 mg as base) and p.o. (15.0 mg as base) doses of midazolam were administered to seven patients with cirrhosis of the liver and to seven healthy control subjects. One cirrhotic patient did not receive the oral dose. The distribution of midazolam in both study groups was alike as indicated by similar values of t1/2 alpha, V1 and Vss. Also the plasma protein binding of midazolam was unchanged in the patients with cirrhosis. The elimination of midazolam was significantly retarded in the patients as indicated by its lower total clearance (3.34 vs. 5.63 ml/min/kg), lower total elimination rate constant (0.400 vs. 0.721 h-1), and longer elimination half-life (7.36 vs. 3.80 h). The bioavailability of oral midazolam was significantly (P less than 0.05) higher in patients than controls (76% vs. 38%). The antipyrine-half-life was 32.4 h in the patients and 11.8 h in the controls. There were statistically significant (P less than 0.01) correlations between the clearances of the two drugs (r = 0.680) and between their half-lives (r = 0.755). The hypnotic effects of midazolam were similar in both groups. However, on a pharmacokinetic basis a reduced dosage of midazolam to patients with advanced cirrhosis of the liver is recommended. PMID- 2723116 TI - Single dose safety, tolerance, and pharmacokinetics of HP 029 in healthy young men: a potential Alzheimer agent. AB - 1,2,3,4-tetrahydro-9-aminoacridin-1-ol maleate (HP 029) is a new cholinergic compound that has been shown to enhance memory in animals and therefore may be potentially effective in humans for the treatment of Alzheimer's disease (AD). The initial safety, tolerance, and pharmacokinetics of HP 029 after single oral doses were assessed in a randomized, double-blind, placebo controlled study in 70 healthy young men (eight dose groups). The test doses ranged from 5 to 200 mg. There were 9 subjects per dose group, 6 on HP 029 and 3 on placebo. The 5 and 100 mg dose groups had only 8 subjects. Plasma and urine samples were analyzed for nonconjugated HP 029 using an HPLC assay with a detection limit of 1 ng/ml. HP 029 was rapidly absorbed after oral dosing with mean peak plasma levels occurring between 0.75 and 1.2 hours. The mean peak levels ranged from 12.7 and 234.7 ng/ml after the 10 and 200 mg doses, respectively. There were dose related increases in peak plasma levels, AUCs, and the amounts of drug excreted in the urine. The mean plasma half-life was about 2.0 hours and was not affected by dose. About 6 to 11% of the dose was eliminated in the urine. HP 029 was renally cleared at a high rate and independent of dose. There were no clinically important or drug-related changes in any of the physical examinations, audiograms, or ophthalmologic examinations. There were only minor within-subject fluctuations in vital signs, ECGs, and laboratory values, none of which were clinically meaningful or drug related after any of the doses of HP 029.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723117 TI - The drug regulatory process in Finland. PMID- 2723119 TI - Pharmacokinetics of mexiletine in the elderly. AB - The effect of advancing age on the kinetics of the antiarrhythmic agent mexiletine was studied by comparing various kinetic parameters calculated after administration of a single oral dose of mexiletine hydrochloride to seven elderly and eight young healthy volunteers. The rate of absorption of the drug from the gastrointestinal tract was significantly slower in the elderly (1.37 +/- 0.51 hr 1) than in the young group (2.25 +/- 0.79 hr-1). The mean values for elimination half-life and oral clearance were 12.3 +/- 3.7 hr and 10.3 +/- 5.4 mL/min/kg respectively in the young group and 14.4 +/- 4.5 hr and 8.5 +/- 2.9 mL/min/kg respectively in the elderly group. Neither of these parameters was significantly different between the two groups. The amount of mexiletine eliminated in urine up to 48 hours postdose was identical in both groups and represented less than 5% of the administered dose. It is concluded that the age-related modifications in the kinetics of mexiletine are not clinically important during chronic administration of the drug. PMID- 2723118 TI - Extension of the serum digoxin concentration--response relationship to patient management. AB - The purposes of this investigation were to demonstrate how computer simulations may be employed to extrapolate data obtained from a single intravenous digoxin dose to multiple oral dosing patterns and how these simulations may apply to clinical situations. The intravenous data were obtained from a previous study of the pharmacokinetics of serum digoxin and its inotropic response (derived from systolic intervals) in 12 normal male volunteers. The simulations were applied to various clinical situations including variations in oral dosing, alternate loading doses, no loading versus loading dose, and intravenous versus oral dosing. A nonlinear relationship was found between response and the post distribution serum digoxin concentration in the therapeutic range. Thus, the increase in inotropic response is less than proportional to the increase in digoxin concentration in serum. This nonlinear relationship has several important clinical implications for loading and maintenance dosing protocols. Such concepts may be important relative to more rational clinical use of digoxin and to decreasing digoxin toxicity. PMID- 2723120 TI - Pharmacokinetics and antihypertensive effects of low dose clonidine during chronic therapy. AB - Using a sensitive and specific radioimmunoassay the pharmacokinetic disposition of clonidine was determined in hypertensive patients after a single dose and then after 5, 28 and 56 days of chronic dosing with 75 micrograms bd. Following a single dose of clonidine maximal plasma concentrations of 0.34 +/- 0.06 ng/ml were achieved after 3.6 +/- 1.2 hours. After 5 days of repetitive dosing the maximal concentration was significantly higher, 0.66 +/- 0.06 ng/ml and remained so throughout chronic therapy (P = 0.018). The AUC, Tmax and T1/2 did not differ significantly between the acute dose and the chronic dosing pharmacokinetic studies. Clonidine also produced a significant fall in blood pressure. Supine diastolic blood pressure fell from 106 +/- 5 mmHg predose to 99 +/- 6 mmHg 2 hours after the first dose (P less than 0.05). The corresponding values after cyclopenthiazide alone were 108 +/- 8 and 105 +/- 8 mmHg (P = 0.13). Similar falls in blood pressure were produced during chronic therapy. PMID- 2723121 TI - Effects of traxanox sodium on blood pressure and serum uric acid in hypertensive patients: a preliminary study. AB - The effects of chronic administration of traxanox sodium (traxanox) on blood pressure and serum uric acid level were investigated in 15 patients who had mild to moderate hypertension. Traxanox or its placebo was orally administered in a single-blind protocol. Blood pressure was significantly reduced from baseline after treatment with traxanox. The serum uric acid level after drug administration was significantly lower than with placebo whereas urinary uric acid excretion was significantly greater and uric acid clearance tended to be greater. These results indicate that chronic administration of traxanox reduces serum uric acid level as well as blood pressure in patients with mild to moderate hypertension. This reduction in serum uric acid is due in part to a traxanox induced elevation of urinary uric acid excretion. PMID- 2723122 TI - Bioavailability of citrate from two different preparations of potassium citrate. AB - The bioavailability of citrate from two different preparations of potassium citrate was examined in eighteen normal volunteers during three phases of study. After stabilization on a constant metabolic diet, subjects took a single dose of placebo, "slow-release" potassium citrate tablets (60 meq) or rapid-release liquid potassium citrate preparation (60 meq). Timed urine specimens were collected for 24 hours and analyzed for citrate, potassium, and pH. Similar biochemical findings were observed following administration of the two different preparations with the onset and decline of changes being slightly more rapid for the liquid potassium citrate than the tablet preparation. These equivalent bioavailability data indicate that the liquid preparation is a comparable therapeutic alternative to the tablet form. PMID- 2723123 TI - Spironolactone metabolism: steady-state serum levels of the sulfur-containing metabolites. AB - Metabolism of spironolactone in man is extensive and complex. For many years the dethioacetylated metabolite, canrenone, was assumed to be the major metabolite. However, recent studies using specific high performance liquid chromatography (HPLC) have demonstrated the presence of spironolactone and the sulfur-containing metabolites 7 alpha-thiomethylspirolactone (IV) and 6 beta-hydroxy-7 alpha thiomethylspirolactone (V), in addition to canrenone, in the serum after a single oral dose of spironolactone. The importance of spironolactone and metabolites IV and V relative to canrenone at steady state remains unknown and was the subject of the present investigation. Twelve healthy males received 100 mg spironolactone, once daily, for 15 days. Repeated blood samples were taken on days 1, 8 and 15 for estimation of spironolactone and its metabolites. Peak serum levels [mean (SD)] of spironolactone, canrenone, and sulfur-containing metabolites IV and V were 72 (45), 155 (43), 359 (106) and 101 (26) ng/ml, respectively on day 1 and 80 (20), 181 (39), 391 (118) and 125 (24) ng/ml, respectively on day 15. The AUC (0-24) values of these compounds on day 15 were 231 (50), 2173 (312), 2804 (777) and 1727 (367) ng.hr/ml, respectively and the post-steady state elimination half-life (t1/2) values were 1.4 (0.5), 16.5 (6.3), 13.8 (6.4), and 15.0 (4.0) hours, respectively. It was concluded that unmetabolized spironolactone is present in the serum and that the sulfur containing metabolite IV rather than canrenone is the major metabolite in serum following single or repeated doses of spironolactone. PMID- 2723124 TI - Pimobendan increases calcium sensitivity of skinned human papillary muscle fibers. AB - The calcium sensitizing effects of the cardiotonic agent pimobendan on force production were investigated on chemically skinned human papillary muscle fibres. The papillary muscles were obtained from patients undergoing mitral valve replacement operations. Tension was produced by different free calcium concentrations and 100 mumol/l of pimobendan shifted the pCa-tension relationship significantly to the left. The effects of pimobendan were concentration dependent (10-300 mumol/l) but additionally also correlated with the state of left ventricular performance of the patients. Skinned papillary muscle fibres obtained from patients with reduced ventricular performance were more sensitive to calcium as well as pimobendan compared with fibres from patients with normal left ventricular performance. No differences in response to pimobendan were observed between fibres from NYHA II and NYHA III heart failure patients. PMID- 2723125 TI - An evaluation of the effect of repeated doses of oral activated charcoal on salicylate elimination. AB - The authors investigated the effect of repeated doses of oral activated charcoal on salicylate elimination in six healthy volunteers. On two occasions (phase I and phase II; separated by one week) each subject received 1300 mg of aspirin as an aqueous solution. On the second occasion (phase II) each subject also received a total dose of 55 g of aqueous activated charcoal initiated 4 hours after salicylate administration (25 g initial dose, followed by three 10 g doses at two hour intervals). Serum salicylate levels were measured from one to twelve hours post aspirin ingestion. The pharmacokinetic analysis showed no significant change between phase I and phase II for either the salicylate elimination half-life or the area under the concentration versus time curve from 4-12 hours post aspirin ingestion. Reasons for the lack of effect of repeated doses of charcoal on salicylate elimination are discussed and, these results cannot necessarily be extrapolated to the overdose situation. Further investigation is warranted to assess the effect of repeated doses of activated charcoal in the salicylate overdosed patient. PMID- 2723126 TI - Olfaction in prolonged administration of pyridostygmine. PMID- 2723127 TI - Naloxone suppresses buprenorphine stimulation of plasma prolactin. AB - The effects of parenterally-administered buprenorphine and simultaneous injection of naloxone was evaluated in six healthy adult males. Each subject was studied on six occasions, an average of 10 days apart, and received either two simultaneous intramuscular injections of saline, buprenorphine 0.3 mg and saline, or buprenorphine 0.3 mg and 0.6 mg, 0.45 mg, 0.3 mg, or 0.15 mg of naloxone. Simultaneous injection of buprenorphine 0.3 mg and saline resulted in an average increase in plasma prolactin above baseline levels of approximately 10 and 25 ng/ml, 30 and 55 minutes after injection. Buprenorphine-induced stimulation of plasma prolactin levels was statistically significantly greater than basal prolactin values (p less than 0.01). When 0.6 mg of naloxone was simultaneously injected with 0.3 mg buprenorphine, peak plasma prolactin levels were significantly lower (p less than 0.05) than prolactin values after administration of 0.3 mg buprenorphine and saline. Simultaneous injection of 0.45 mg naloxone and 0.3 mg buprenorphine also resulted in a significant attenuation (p less than 0.05) of buprenorphine-stimulated prolactin levels. Injection of 0.3 mg or 0.15 mg of naloxone did not inhibit prolactin stimulation produced by buprenorphine 0.3 mg. These findings demonstrate a dose-effect relationship between naloxone concentration and suppression of the increase in plasma prolactin levels produced by administration of buprenorphine 0.3 mg. As prolactin stimulation occurs shortly after opioid agonist administration and is temporally concordant with the rapid induction of pharmacologic reinforcement associated with opiate abuse, naloxone added to buprenorphine parenteral preparations may reduce the abuse potential of buprenorphine. PMID- 2723128 TI - Validation of a therapeutic plasma level range in amitriptyline treatment of depression. AB - In the course of a double-blind study, 29 depressed patients received amitriptyline 150 mg/day for 4 weeks. Scores on the Hamilton Depression Rating Scale were assessed before treatment and after 2 and 4 weeks, and plasma levels of amitriptyline, nortriptyline, and (E)-10-hydroxynortriptyline were monitored weekly. Response reflected by percent reduction of Hamilton Depression Rating Scale score and by final score was better at steady-state amitriptyline + nortriptyline concentrations of 125-210 ng/ml than at lower and higher plasma levels. This applied to the total group and to the subgroup of 22 female patients. The data confirm the results of a previous study performed in the same hospital. An influence of the (E)-10-hydroxynortriptyline concentration in plasma on therapeutic outcome was not discernible. The results suggest that plasma level monitoring may be helpful when patients do not respond to conventional amitriptyline doses. PMID- 2723129 TI - Clinical effect of buspirone in autistic children. AB - Buspirone is a novel antianxiety agent with no chemical similarity to other psychotropic medications. Pharmacological effects include inhibition of serotonin neurons, decrease of striatal levels of serotonin and metabolites, and reduction in serotonin binding sites. Buspirone also has effects on dopamine, norepinephrine, and the GABA systems. To pursue an antiserotonergic treatment rationale for autistic disorder, an open-blind 4-week trial comparing buspirone to fenfluramine or methylphenidate was conducted. Hyperactivity was a target symptom in three children with improvement noted in two with buspirone. Behavioral toxicity was encountered in one of two autistic subjects treated with methylphenidate and very mild improvement in another subject on fenfluramine. An autistic child with obsessive ideation was unchanged. No adverse reaction to buspirone was encountered. Further investigation in a double-blind trial of buspirone is warranted for treatment of symptoms of autism, especially aggression and hyperactivity. PMID- 2723130 TI - Pemoline-induced abnormal involuntary movements. AB - Plasma pemoline levels were measured in 6- to 12-year-old, severely hyperactive males coincident with onset of abnormal involuntary movements. Acute exposure to pemoline (2 mg/kg orally) was associated with choreoathetoid movements of face, limbs, and trunk in five of 20 subjects in an acute study of pemoline pharmacokinetics. Also reported is a series of four chronically treated patients who developed choreiform movements and dyskinesias after variable periods of exposure from 3 weeks to 3 months with pemoline (1.5-2.0 mg/kg/day). Abnormal movements following acute or chronic exposure to pemoline cleared after pemoline discontinuation. Pemoline pharmacokinetics does not seem to be a primary determinant in the development of abnormal involuntary movements after chronic exposure. Total amount of pemoline absorbed may play a role in the development of choreoathetoid movements following acute exposure. PMID- 2723132 TI - View from the Nation's Capital. Combating research misconduct. PMID- 2723131 TI - Buspirone: effects on prolactin and growth hormone as a function of drug level in generalized anxiety. AB - Certain evidence suggests that buspirone, a novel nonbenzodiazepine anxiolytic, may be a 5-HT1A serotonergic agonist and may antagonize postsynaptic dopaminergic receptors. The latter property raises questions regarding a dyskinesia- or extrapyramidal symptom-inducing potential. We monitored serum prolactin and growth hormone in 10 subjects with generalized anxiety disorder and 10 matched controls before and after 4 weeks of pharmacotherapy. A drug effect upon serotonin-modulated prolactin release or on the tubero-infundibular dopamine axis (prolactin; growth hormone) was negligible at clinically effective dosages of buspirone. Concomitant buspirone levels also failed to demonstrate any significant relationships. PMID- 2723133 TI - Melatonin mediates the antidyskinetic effects of naloxone in tardive dyskinesia. PMID- 2723134 TI - Actual medication versus therapist guesses: in a blind study, how blind is blind? PMID- 2723135 TI - Buspirone-induced mania. PMID- 2723136 TI - Buspirone treatment of anxiety in a patient dependent on alprazolam. PMID- 2723137 TI - Lorazepam monotherapy for catatonic stupor. PMID- 2723138 TI - Children's 24-hour serum lithium level after a single dose predicts initial dose and steady-state plasma level. PMID- 2723139 TI - Errors in science versus scientific fraud. PMID- 2723140 TI - Intersubject variation in the pharmacokinetics of haloperidol and reduced haloperidol. AB - Single oral doses (5 mg) of haloperidol were administered to 36 healthy men (26 black, 10 white) of whom 28 (22 black, 6 white) completed the study. Plasma samples harvested over 96 hours were analyzed for haloperidol and reduced haloperidol by means of a new high performance liquid chromatographic method. Reduced haloperidol was detectable in the plasma of only six of the 28 subjects (five blacks, one white). In these individuals reduced haloperidol plasma concentrations were generally much lower than those of the parent drug. This finding in the present single-dose study is in contrast to literature reports that have described levels of reduced haloperidol higher than those of the parent drug in some patients chronically mediated with haloperidol. There was wide intersubject variation in area under the plasma concentration versus time curve and apparent oral clearance values for haloperidol. The distributions of these pharmacokinetic parameters about their respective means were each leptokurtotic and skewed toward higher values. In each case the geometric mean gave a better estimate of central tendency than the arithmetic mean. Wide intersubject variation prevented the detection of significant differences in these pharmacokinetic parameters between black and white subjects or between smokers and nonsmokers. PMID- 2723141 TI - Effects of listener sophistication on judgements of tracheoesophageal talker intelligibility. AB - The purpose of this project was to provide preliminary data on comparative judgments of tracheoesophageal (TE) speech intelligibility by two groups of listeners who varied in their listening sophistication. Four highly proficient TE talkers produced the stimuli for the study. Stimuli represented all consonant manner classes in both pre- and postvocalic contexts. The two listener groups were composed of 10 naive listeners and 10 experienced speech pathologists. Data from each listener group was analyzed for overall intelligibility and intelligibility by pre- and postvocalic phonetic position. Scores were also quantified by phonetic manner class. Statistically significant differences were identified between judgments of the two listener groups for prevocalic stops and fricatives. Experienced listeners did, however, generally judge talkers to exhibit higher intelligibility compared to naive listeners. The potential clinical implications of these data are discussed. PMID- 2723142 TI - A fundamental frequency investigation of children ages 6-10 years old. AB - The fundamental frequency characteristics of 30 children between the ages of 6 and 10 years were investigated in a variety of speech tasks. The results indicated that average fundamental frequency across tasks for the boys is approximately 262 Hz, and for girls approximately 281 Hz. Statistical analysis indicated that there was no significant difference in the fundamental frequency of boys and girls in this age range. High vowels were found to have higher fundamental frequency values than low vowels. Sustained vowels had higher fundamental frequency values than either spontaneous speech or reading for both groups of speakers. The results of this investigation are discussed in terms of maturational processes, and in comparison to corresponding adult information. PMID- 2723143 TI - Harsh voice: vocal effort perceptual ratings and spectral noise levels of hearing impaired children. AB - This study investigated the relationship between spectral noise levels and ratings of perceived vocal effort in the voices of severely to profoundly hearing impaired children as compared to normal-hearing children, aged 6-11. Spectral noise levels served as an index of the inharmonic (noise) components present from 100 to 2500 Hz for sustained vowels. A nine-point perceptual rating scale was devised as the subjective measure of vocal effort. The severely to profoundly hearing-impaired children could be differentiated on the basis of significantly higher ratings for perceived vocal effort in addition to higher physical measurements of spectral noise levels. Tentative therapeutic implications are discussed. PMID- 2723144 TI - The influence of adaptive seating devices on vocalization. AB - This study examined the relationship between receipt of adaptive seating devices (ASD) and sophistication of early vocalizations/verbalizations. Eight nonverbal children with cerebral palsy were studied prior to and following receipt of an ASD. Total speech tokens increased for 7 of the 8 subjects and diversity of speech sounds increased for 6 subjects. A concomitant improvement in feeding independence was observed for those subjects who demonstrated the greatest increase in speech sound diversity. PMID- 2723145 TI - Adolescents' attitudes toward peers who wear visible hearing aids. AB - The purpose of this study was to determine how adolescents are likely to react to peers who wear visible hearing aids. Forty high school juniors and seniors rated a photograph of a male peer on an 81-scale semantic differential. One-half rated a copy of the photograph in which a hearing aid was visible and the others rated a copy in which one was not visible. Analyses of the ratings suggest that adolescents are likely to react negatively to peers who wear visible hearing aids. Clinical implications are discussed. PMID- 2723146 TI - The effect of pictured visual cues on elicited sentence imitation. AB - In one experiment language-normal 6 1/2-year-old and 4 1/2-year-old children (N = 68) were asked to imitate sentences with or without pictured visual cues. In a second experiment groups of language-disordered children (N = 43) also 4 1/2 and 6 1/2 years of age were asked to imitate sentences with and without pictured visual cues. In both experiments there was no significant difference in the syntactical and grammatical quality of elicited imitations between conditions. Older children performed better than young children in both experiments. It was concluded that pictured visual cues do not affect the syntactical and grammatical quality of language-normal and language-disordered children's elicited sentence imitations. PMID- 2723147 TI - A preliminary comparison of flat affect schizophrenics and brain-damaged patients on measures of affective processing. AB - Flat affect is a major component of schizophrenia and is often also seen in neurological disorders. A preliminary set of comparisons were conducted to delineate neuropsychological mechanisms underlying flat affect in schizophrenia, and new measures are described for the assessment of affective deficits in clinical populations. Subjects were schizophrenic with flat affect (SZs), right brain-damaged (RBD), Parkinson's Disease (PDs), and normal control (NC) right handed adults. Subjects were administered affective measures of expression and perception in both facial and vocal channels. For both perceptual and expressive tasks the SZs performed significantly less accurately than the NCs and the PDs but did not differ from the RBDs. This was the case for both face and voice. This finding lends support to the speculation that right hemisphere mechanisms, especially cortical ones, may be compromised among schizophrenics with flat affect. PMID- 2723148 TI - Functional subdivisions in the auditory cortex of the guinea pig. AB - The auditory fields in the cortex of the guinea pig were investigated with microelectrode mapping techniques. Pure tones of varying frequencies and amplitudes were used as acoustic stimuli. Mainly, multiunit activity was recorded. A large tonotopic area is found in the anterior half of the auditory cortex. This area is named the anterior field (field A). Frequency tuning curves of multiunits in field A are generally narrow. Responses to tone stimuli are strong, and latencies are short. Low best frequencies are represented rostrally, high best frequencies caudally. The tonotopy is continuous and quite regular. Field A is narrow dorsally and becomes gradually broader ventrally. Correspondingly, the isofrequency lines slightly diverge from dorsal to ventral. Caudal to the first field, there is a second, smaller tonotopic area. It lies in the dorsal half of the posterior auditory cortex and is therefore named the dorsocaudal field (field DC). The frequency specificity of the cell clusters in this area is as strong as in field A, but the tonotopy is discontinuous: In the dorsal half of field DC, high best frequencies (16-32 kHz) are represented rostrally; the low frequencies (0.5-2.8 kHz) are represented immediately caudal to the high frequencies, while the intermediate frequencies are missing. Ventrally in field DC, the frequency representation is more complete. Except for this discontinuous map, we did not notice any differences between fields A and DC. A third tonotopic field was found rostral to field A. This field extends over a surface of less than 1 mm2 and was named the small field (field S). It contains a complete representation of the frequency range; high best frequencies are located rostrally, low frequencies caudally. The response latencies are slightly longer in field S than in fields A or DC, and the tuning curves are broader. A broad strip of nontonotopic cortex (auditory belt) surrounds fields A and DC caudally. We subdivided this area into the dorsocaudal and the ventrocaudal belt region. In both areas, tuning curves are often broad, and response latencies are longer than in the tonotopic cortex. In the dorsocaudal belt, most multiunits react with a phasic on-response to pure tones; in the ventrocaudal belt, tonic responses occur more frequently. Another nontonotopic region is located in the anterior auditory cortex, rostral to the tonotopic fields, and was therefore named the rostral belt. Tuning curves in this area are broad, latencies are short, and response thresholds are often high. In the discussion, the guinea pig is compared with other mammalian species.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723149 TI - Anatomy of the auditory thalamocortical system of the guinea pig. AB - We investigated the projection from the medial geniculate body (MG) to the tonotopic fields (the anterior field A, the dorsocaudal field DC, the small field S) and to the nontonotopic ventrocaudal belt in the auditory cortex of the guinea pig. The auditory fields were first delimited in electrophysiological experiments with microelectrode mapping techniques. Then, small quantities of horseradish peroxidase (HRP) and/or fluorescent retrograde tracers were injected into the sites of interest, and the thalamus was checked for labeled cells. The anterior field A receives its main thalamic input from the ventral nucleus of the MG (MGv). The projection is topographically organized. Roughly, the caudal part of the MGv innervates the rostral part of field A and vice versa. After injection of tracer into low or medium best-frequency sites in A, we also found a topographic gradient along the isofrequency contours: the dorsal (ventral) part of a cortical isofrequency strip receives afferents from the rostral (caudal) portions of the corresponding thalamic isofrequency band. However, it is not so obvious whether such a gradient exists also in the high-frequency part of the projection. A second, weaker projection to field A originates in a magnocellular nucleus that is situated caudomedially in the MG and was therefore named the caudomedial nucleus. The dorsocaudal field DC receives input from the same nuclei as the anterior field, but the location of the labeled cells in the MGv is different. This was demonstrated by injection of different tracers into sites with like best frequencies in fields A and DC, respectively. After injection of HRP into the 1-2 kHz isofrequency strip in field A and injection of Nuclear Yellow (NY) into the 1 2-kHz site in field DC, the labeled cells in the MGv form one continuous array that runs from caudal to rostral over the whole extent of the MGv. The anterior part of this array consists of NY-labeled cells; i.e., it projects to field DC. The caudal part is formed by HRP-labeled cells; i.e., it innervates field A. These findings indicate that there is only one continuous tonotopic map in the MGv. This map is split when projected onto the cortex so that two adjacent tonotopic fields (A and DC) result. The cortical maps are rotated relative to the thalamic map in that rostral portions of the MGv project to caudal parts of the tonotopic cortex and vice versa.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723150 TI - Afferent connections of the oculomotor nucleus in the chick. AB - Horseradish peroxidase was injected into the oculomotor nucleus of the chick in order to locate and characterize the neurons projecting to this nucleus. In the rostral mesencephalon, 120-180 neurons were labelled in the medial area of the ipsilateral nucleus campi Foreli; 190-220 in the interstitial nucleus of Cajal (most of them contralateral); and smaller numbers bilaterally in the medial mesencephalic reticular formation, the nucleus of the basal optic root complex, and the central grey matter. More caudally, numerous neurons were labelled in the contralateral abducens nucleus and the vestibular complex and a few in the nucleus reticularis pontis caudalis. Labelled neurons appeared ipsilaterally in the caudal region of the nucleus vestibularis superior and in the rostral tip of the nucleus descendens just lateral to the tractus lamino-olivaris. In the contralateral vestibular complex, a group of labelled cells observed in the dorsolateral area may be homologous to the mammalian cell group Y. At the level of the contralateral abducens nucleus, the most numerous group of cells (625-700) projecting to the oculomotor nucleus formed a lateromedial fringe that affected the nucleus tangentialis, the rostral tip of the nucleus descendens, and the ventrolateral region of the nucleus medialis. Only a few labelled neurons were seen in the contralateral nucleus vestibularis superior, the ipsilateral cell group A, and the ipsilateral nucleus vestibularis medialis. PMID- 2723151 TI - Effects of very early monocular and binocular enucleation on primary visual centers in the tammar wallaby (Macropus eugenii). AB - The role of retinal afferents and their binocular interactions in the development of mammalian primary visual centers has been studied in the marsupial wallaby. Monocular and binocular enucleation was performed prior to any retinal innervation of the visual centers. After monocular enucleation retinal projections were traced by horseradish peroxidase histochemistry and compared with those in normal animals and those during development. The topography of retinal projections to the superior colliculus and the dorsal lateral geniculate nucleus after monocular enucleation was determined by making retinal lesions and tracing the remaining projections with horseradish peroxidase. The position and nature of the filling defects in terminal label were compared with controls with similarly placed lesions. The superior colliculus and dorsal lateral geniculate nucleus ipsilateral to the remaining eye were shrunken. Projections to the ipsilateral superior colliculus, ipsilateral accessory optic nuclei, and ipsilateral suprachiasmatic nucleus, although enlarged, never approached the density contralaterally, as was also the case during normal development. The expanded projection in the ipsilateral superior colliculus came primarily from temporal and ventral retina. In the dorsal lateral geniculate nucleus, terminal bands and cellular laminae, although not identical to normal, did develop. During normal development overlap of afferents from the two eyes occurs in the binocular region. The decrease in volume of the nucleus ipsilateral to the remaining eye after monocular enucleation suggests that the monocular region disappears in the absence of appropriate input and the binocular region survives. Contralaterally there was no decrease in volume, compatible with this idea. The topography of retinal projections supports this interpretation. It was normal contralaterally while ipsilaterally it was appropriate for the normal binocular region. There was an expansion of the projection along the lines of projection in what would normally be binocular regions of the nucleus, where retinal afferents failed to segregate in the absence of binocular competition. After binocular enucleation the alpha and beta segments of the dorsal lateral geniculate nucleus were still recognizable but cell-sparse zones were absent, as was the characteristic orientation of primary dendrites of geniculocortical cells. There are rigid developmental constraints operating on the innervation of territory by retinal afferents from the two eyes, and many features of the mature pattern arise without binocular interactions during development. PMID- 2723152 TI - Structure and histogenesis of the principal sensory nucleus of the trigeminal nerve: effects of prenatal exposure to ethanol. AB - Clinical and experimental evidence shows that prenatal exposure to ethanol causes craniofacial malformations, microcephaly, and abnormal development of the central nervous system. This study describes the effects of ethanol on the development of the principal sensory nucleus of the trigeminal nerve (PSN). The offspring of two groups of rats were examined. Pregnant females in one group were fed a liquid diet containing 6.7% (v/v) ethanol (Et) and rats in the other group were fed an isocaloric liquid control diet (Ct). Each pregnant rat was administered [3H]thymidine on one day during the period from gestational day (G) 10 to G22. After pups grew to 30 days of age, they were killed and their brains were processed by an autoradiographic procedure. Qualitatively, the PSN of Ct- and Et treated rats appeared similar; they were composed chiefly of small neurons and a few scattered large neurons. On the other hand, quantitative analyses revealed significant differences between both groups. Although the volume of the PSN of Et treated rats was not significantly different (-3.2%) than that for Ct-treated rats, the PSN of Et-treated rats had significantly (P less than 0.01) fewer (30.0%) neurons than did the PSN of Ct-treated rats. The number of the small neurons, but not of the large neurons, was affected most by the ethanol exposure. Prenatal exposure to ethanol also altered the generation of PSN neurons. Most neurons in the PSN of Ct-treated rats were born between G12 and G15, the small neurons being generated before the large neurons. In Et-treated rats, too, small neurons were born before the large neurons; however, the time frame of neuronogenesis was delayed as it occurred between G13 and G16. Thus, prenatal exposure to ethanol produces profound developmental abnormalities that lead to permanent alterations in the structure of the mature central nervous system. PMID- 2723153 TI - Topography of cones and rods in the tree shrew retina. AB - The topographical distribution of cones and rods in the tree shrew retina was analysed quantitatively in whole-mounted retinae and horizontal semithin sections stained with cresyl violet or toluidine blue. The outer nuclear layer consists of a single layer of photoreceptor nuclei with the rod nuclei slightly displaced towards the outer plexiform layer. This facilitated quantification of the photoreceptor populations. The density of cones ranges from 12,000/mm2 in the peripheral retina to a maximum of 36,000/mm2 in the inferior retina. Unlike ganglion cell density, the density of cones does not peak in the temporal retina. Rod density, between 500/mm2 and 3,500/mm2, also peaks in the inferior retina, but not in the same region as cone density. Rods constitute from 1 to 14% of the photoreceptor population, depending on retinal location, and have a local minimum at the central area. Amongst the cones a regularly arrayed subpopulation of presumed blue-sensitive cones is distinguished by its special staining properties. These cones constitute between 4 and 10% of the cone population depending on retinal location. A second, irregularly spaced, subpopulation of possibly pathological cones is also described. PMID- 2723154 TI - Structural and functional properties distinguish two types of multipolar cells in the ventral cochlear nucleus. AB - We distinguish two types of large multipolar cells designated sustained (CS) and onset (OC) choppers in the anterior posteroventral cochlear nucleus (A PVCN)/nerve root region on the basis of certain anatomical and physiological features. CS axons head into the trapezoid body, while OC axons use the intermediate acoustic stria of Held. At the electron microscopic (EM) level, collateral terminals of OC axons contain pleomorphic vesicles; CS terminals contain small round vesicles. CS dendritic trees tend to be distributed in a stellate fashion while OC dendritic trees tend to be elongated. At the EM level the sustained chopper somata are sparsely innervated while the proximal dendritic tree receives considerably more input. The OC somata are highly innervated and this heavy innervation continues out onto the proximal dendrites. Distally the dendritic innervation falls off considerably for both categories. Physiologically, members of the OC population have wider dynamic ranges at the characteristic frequency (CF), wider response areas that are typically not flanked by inhibitory sidebands, and responses to short tones that do not show the same form of regularity expressed by sustained choppers. Intracellularly the sustained choppers exhibit sustained depolarization to short tones for the duration of the stimulus with resultant regular spiking at a rate that is stimulus level dependent. The response to swept tone shows this same level dependent regularity. In response to tones, the OC cells also show a sustained depolarization whose amplitude is stimulus-level dependent but whose range is much greater and whose onset is initiated more abruptly. Although the onset component of the OC spike output is reliably initiated by these levels of depolarization, regular firing to the sustained depolarization is not initiated at levels of depolarization that would surely generate regular firing in sustained choppers. This regularity is also absent in the swept tone response despite marked levels of excitation. PMID- 2723155 TI - Survey of noncortical afferent projections to the basilar pontine nuclei: a retrograde tracing study in the rat. AB - The retrograde transport of the conjugate wheat germ agglutinin-horseradish peroxidase (WGA-HRP) was used in the rat to identify the cell bodies of origin for all subcortical projections to the basilar pontine nuclei (BPN). A parapharyngeal surgical approach was used to allow the injection micropipette to enter the BPN from the ventral aspect of the brainstem and thus avoid any potential for false-positive labeling due to transection and injury-filling of axonal systems located dorsal to the basilar pontine gray. A surprisingly large number of BPN afferent cell groups were identified in the present study. Included were labeled somata in the lumbar spinal cord and a large variety of nuclei in the medulla, pons, and midbrain, as well as labeled cells in diencephalic and telencephalic nuclei such as the zona incerta, ventral lateral geniculate, hypothalamus, amygdala, nucleus basalis of Meynert, and the horizontal nucleus of the diagonal band of Broca. Quite a number of cell groups known to project directly to the cerebellum also exhibited labeled somata in the present study. To explore the possibility that such neurons were labeled because their axons were transected and injury-filled as they coursed through the BPN injection site to enter the cerebellum via the brachium pontis, a series of rats received complete, bilateral lesions of the brachium pontis followed 30-60 minutes later with multiple, diffuse injections of WGA-HRP (12-16 placements per animal) throughout the cerebellar cortex. In another series of animals, the massive cerebellar WGA HRP injections were not preceded by brachium pontis lesions. In the latter cases, each of the cell groups in question that were known to project directly to the cerebellum exhibited labeled somata. However, when the cerebellar HRP injections were preceded by brachium pontis lesions, each of the cell groups in question continued to exhibit labeled somata in numbers comparable to that observed in the nonlesion cases. This implies that such neurons project to the BPN and the cerebellar cortex and that the axons of these particular neurons do not project to the cerebellum via the brachium pontis. PMID- 2723156 TI - Accumulation of pigment granules in lacrymal gland epithelium in practolol treated beagle dogs. AB - A 6-month oral toxicity test of practolol was carried out in beagle dogs as a reference control for a newly developed beta blocker. No significant drug-induced changes were detected in any animals by various ophthalmological examinations such as ERG, tear flow, lysozymal activity in tears, etc. However, an unusual pathological change was detected in the lacrymal gland of all five dogs treated with practolol and not in control animals. Macroscopically, the lacrymal glands assumed a blackish brown to deep black colour on both the outside and the cut surface. Microscopically, fine, dark-brown pigment granules were present in the apical and supra-nuclear portion of the cytoplasm of predominantly serosal type epithelial cells. These pigments reacted positively to Schmorl's method for lipofuscin, but gave a negative PAS reaction for polysaccharide, Prussian blue for iron and Ziehl-Neelsen method for ceroid pigment. They were detected as membrane-bound electron-dense bodies by electron microscopy. Similar pigments were also deposited in the cytoplasm of the apocrine sweat gland. Although the mechanism of the accumulation of these granules is far from clear, concentration of practolol in the lacrymal gland is considered to be very closely related to the presence of these granules. A possible mechanism for ocular toxicity by practolol, involving this change, is discussed. PMID- 2723157 TI - Radial and tibial nerve pathology of two lactating ewes with "kangaroo gait". AB - Radial and tibial nerves of two ewes with clinical signs of chronic "kangaroo gait" were examined by qualitative and quantitative techniques and compared to the same nerves of a clinically normal ewe in late lactation. In affected ewes, there was extensive axonal degeneration of myelinated fibres in the radial nerve. Large and small myelinated fibres were affected equally and unmyelinated fibres were normal. Nerve fibre regeneration was present. In contrast, tibial nerve changes in the "kangaroo gait" ewes were minimal. The chronic nature of the radial nerve pathology was consistent with the clinical time course of "kangaroo gait". Regeneration may account for gradual improvement with eventual recovery in most chronically affected ewes. An episode of bilateral severe compression of a proximal radial nerve site is proposed as an explanation for the neuropathy, although the specific mechanism of this trauma is not known. PMID- 2723158 TI - Oestrogen and progesterone receptors and their relationship to histological grades of epithelial tumours of the magnum region of the oviduct of the domestic fowl. AB - Tumours of the proprial tubular glands of the magnum region of the oviduct of the domestic fowl (Gallus domesticus) were found to contain receptors for oestrogen and progesterone. The distribution of the receptors in the cytosol and nucleus of the tumour cells was similar to that of the normal magnum under oestrogen stimulation. Receptor content showed a positive correlation with increasing clinical stage and histological grade, i.e., malignancy and undifferentiation of the tumours. These tumours are unusual for hormonally responsive tumours in that their receptor mechanism remains intact with loss of differentiation. PMID- 2723159 TI - Persistence of carbadox-induced adrenal lesions in pigs following drug withdrawal and recovery of aldosterone plasma concentrations. AB - This study was performed to investigate the persistence of carbadox-induced adrenal lesions in pigs after withdrawal of the drug. Six groups (N = 13) received 0 (control group), 25, 50, 100 and 200 ppm carbadox. After 10 weeks, carbadox was withdrawn from the feed. Five and 11 weeks after withdrawal, two pigs per group were necropsied and the adrenals were examined histologically. Five weeks after withdrawal, recovery of lesions was seen in the 25 and 50 ppm groups. In the 100 and 150 ppm groups, adrenal changes were still present. After 11 weeks an incomplete recovery occurred in the 100 ppm group and in one of the pigs from the 150 ppm group; the second pig of this group still demonstrated moderate changes. Pigs from the 200 ppm group showed severe changes and absence of a clear zonal differentiation. Plasma aldosterone values started to recover 2 weeks after withdrawal of carbadox. Histological examination suggested stimulation of the aldosterone-producing glomerular zone, eventually resulting in regressive changes. The mechanisms that possibly induced this continuous stimulation are discussed. PMID- 2723160 TI - Choroid plexus carcinoma in a dog. AB - Choroid plexus carcinoma was diagnosed in a 5-year-old female mixed breed dog which was euthanized due to progressive neurologic disease. Diagnosis of the tumour was based on gross and light microscopic findings following a complete necropsy. The chemical staining patterns in the case are compared with human choroid plexus tumours. The criteria for the distinction between benign and malignant variants of choroid plexus tumours are discussed. PMID- 2723161 TI - Polycystic disease of the kidney and liver in an adult Persian cat. AB - Polycystic disease of the kidney and liver was diagnosed in a 10-year-old spayed female Persian cat. Previous reports of renal and hepatic polycystic disease in dogs and cats have described only juvenile forms, with death at an early age. The cat of this report had large, fluid-filled kidney and liver cysts, compared with the relatively small, spongiform cysts of puppies and kittens. The clinicopathological findings in this adult Persian cat are comparable to the adult form of renal and hepatic polycystic disease of man. PMID- 2723162 TI - Bilateral colobomas in a horse. AB - Bilateral true colobomas with retrobulbar cysts located over the optic nerves are described in an 8-year-old Quarterhorse mare with a history of progressive blindness. Colobomas result from the failure of an embryonic fissure to close and retrobulbar cysts result from eversion of the neuroectoderm through the colobomas. It could not be determined whether the small optic nerves and the scars, rosettes and disorganization of the cell layers in the retina were the result of concurrent dysplasia or were secondary to degeneration. PMID- 2723163 TI - Teratoma of the pituitary gland in a young male rat. AB - A pituitary teratoma was found in a 5-week-old (37-day-old) male Donryu rat. The tumour (10 x 11 x 9 mm) was round in shape and white in colour. The cut surface was solid without haemorrhagic or cystic change. Histologically, it was composed of various kinds of tissue components including mature and immature elements derived from the three embryonic germ layers, i.e., nervous tissue, cartilage, bone, squamous epithelial element, glandular element lined by one or more layers of ciliated columnar or cuboidal epithelial cells, striated muscle tissue, adipose tissue and connective tissue. Neuroepithelial rosettes and immature or embryonal epithelium as well as immature cartilage were intermingled with mature somatic tissues. PMID- 2723164 TI - A testicular seminoma in a rabbit. AB - The histological, ultrastructural and biological features are described of a spontaneously occurring seminoma in the testis of a male domestic rabbit. The tumour was structurally similar to seminomas in other animal species. PMID- 2723165 TI - Hyperintense signal of the posterior pituitary on T1-weighted MR images: an experimental study. AB - The origin of the hyperintense signal (HIS) of the pituitary gland posterior lobe (PL) on T1-weighted magnetic resonance (MR) images was investigated. Six rabbits were imaged on a 1.5 T device before and after 2 weeks' feeding of hypertonic saline solution (phase I). Two were killed soon after the second imaging; the pituitary gland was examined histochemically for neurosecretory granules containing antidiuretic hormone (ADH). The other four rabbits were given regular water for another 2 weeks (phase II) and then were again imaged. The plasma ADH level was monitored at each imaging session. In all subjects, the signal intensity of the PL decreased at the end of phase I, and the HIS reappeared at the end of phase II. The neurosecretory granules in the PL significantly diminished in number in phase I. Plasma ADH levels significantly increased in phase I and returned to their normal range in phase II. These clear correlations between MR findings and hormonal and histochemical results strongly suggest that the source of the HIS of the PL is the neurosecretory granules containing ADH. PMID- 2723166 TI - Gadolinium-DOTA enhanced MR imaging of intracranial lesions. AB - Gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N",N"'-tetraacetic acid (Gd-DOTA) is the first of a new class of macrocyclic paramagnetic magnetic resonance (MR) contrast agents (gadolinium cryptelates) to be used in clinical practice. Gadolinium-DOTA possesses relaxation properties similar to those of gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). We report our initial clinical experience in 38 patients with intracranial lesions studied with MR before and after injection of Gd-DOTA. Diseases included primary and metastatic brain tumor, cerebral infarct, vascular malformation, meningioma, hemangiopericytoma, schwannoma, and pituitary macroadenoma. Gadolinium-DOTA was administered intravenously in a dosage of 0.1 mmol/kg body weight. All studies were performed on a superconductive 0.5 T system. As compared to noncontrast T1- and T2-weighted images (WI), Gd-DOTA enhanced T1 WI were useful in defining the anatomy of malignant intraaxial tumors (high-grade glioma, metastasis) and in tumor versus edema differentiation. Low-grade gliomas did not enhance; in these cases the precontrast T2-weighted sequence was found to be more informative. In post operative patients, Gd-DOTA allowed us to demonstrate residual tumor or tumor recurrence. Extraaxial tumors (meningioma, hemangiopericytoma, neuroma) enhanced markedly, presumably reflecting tumor vascularity. In our experience, the use of Gd-DOTA improves the anatomic definition of cerebral lesions and in some cases increases both MR sensitivity and specificity. We found Gd-DOTA to be a well tolerated and effective paramagnetic contrast agent. Gadolinium-DOTA can be considered as an alternative water-soluble MR contrast agent to Gd-DTPA. PMID- 2723167 TI - Xenon-CT cerebral blood flow evaluation of cerebral ischemia in children and young adults. AB - Xenon-CT cerebral blood flow determinations in 20 children and young adults (age less than 40) who presented with cerebral ischemia were retrospectively reviewed for evidence of unifocal or multifocal ischemic disease. These results were compared with the findings of conventional CT and magnetic resonance (MR) examinations in the same patients. Xenon-CT revealed additional lesions or added significant pathophysiological information in 80% of patients scanned by noncontrast CT, 89% scanned by postcontrast CT, and 58% scanned by MR. Xenon-CT is a useful adjunct to MR and conventional CT in the evaluation of cerebral ischemia in children and young adults. PMID- 2723168 TI - MR imaging of white matter lesions in uncomplicated chronic alcoholism. AB - Chronic alcoholics may have CNS lesions, such as microvasculitis or glial, neural, and myelin degeneration, as documented in postmortem studies on subjects who had Wernicke encephalopathy, corpus callosum degeneration, or central pontine myelinolysis. One may also expect the presence of early white matter disease in patients who do not have neurologic complications of alcoholism. Thirty-five chronic alcoholics (Diagnostic and Statistical Manual III criteria) and 35 normal control subjects were studied by means of magnetic resonance (MR) imaging. Subjects greater than 60 years old, or those with CNS involvement, or clinically evident systemic disorders were excluded. Of the remaining asymptomatic alcoholics, MR detected multiple round hyperintense areas in the white matter of 14 patients, in addition to aspecific corticosubcortical and cerebellar atrophies. None of the normal control subjects showed such a finding. These results suggest an early involvement of the brain in asymptomatic alcoholic patients. PMID- 2723169 TI - MR imaging of compressive myelomalacia. AB - The authors studied retrospectively 42 patients with the magnetic resonance (MR) diagnosis of myelomalacia. Depending on MR findings, the patients were grouped into early, intermediate, and late stages of myelomalacia. Early stage myelomalacia patients presented with high intensity signal changes on T2-weighted images involving the width of the affected cord. The intermediate stage patients were characterized by varying degrees of cystic necrosis of the central gray matter, better seen on T2-weighted images. Central cystic degeneration, syrinx formation, and atrophy were prominent features of the late stage of myelomalacia. Ten patients had follow-up MR examinations within 6 months of initial imaging. Two of the four early stage myelomalacia patients showed improvement in the repeat studies. The follow-up scans of the six intermediate and late stage myelomalacia patients showed either no change or progression of disease. Early stage myelomalacia may be reversible, depending on the severity of the initial spinal cord injury. Magnetic resonance can serve as a useful tool in the assessment and management of myelomalacia patients. PMID- 2723170 TI - Computed tomography in pulmonary sarcoidosis. AB - We studied the high resolution CT (HRCT) scans of 15 patients with biopsy-proven sarcoidosis and correlated the findings with pulmonary function tests (12 patients), 67Ga scans (10 patients), bronchoalveolar lavage (five patients), recent transbronchial biopsy (six patients), and recent open lung biopsy (three patients). The HRCT features included small nodules, thickened interlobular septa, patchy focal increase in lung density, honeycombing, and central conglomeration of vessels and bronchi. Active alveolitis was present by gallium scanning criteria in 5 of 10 cases. By bronchoalveolar lavage criteria, activity was present in three of five cases. Patchy increase in density may correlate with active alveolitis as seen on 67Ga scanning. High resolution CT was better than chest X-radiography for demonstration of patchy increase in density and for distinguishing nodules from septal thickening. Both nodules and patchy density were partly reversible following therapy. Nodular densities seen on CT correlated with the presence of granulomata on histology. Resting pulmonary function tests correlated poorly with presence and extent of lung disease on HRCT. The presence on HRCT of focal fine nodules, patchy focal increase in lung density, and central crowding of bronchi and vessels should suggest the diagnosis of sarcoidosis. In some patients, HRCT can identify unsuspected parenchymal lung disease and document the reversible components of sarcoid lung disease. PMID- 2723171 TI - Computed tomography of inflation-fixed lungs: the beaded septum sign of pulmonary metastases. AB - Radiographic identification of pulmonary metastases has proved to be a challenging problem. We applied high resolution CT (HRCT) to 180 post-mortem lung specimens prepared by a method that allows for direct one-to-one pathologic radiologic correlation. Of the 180 lungs, 32 had pulmonary metastases. The location, number, size, and interstitial changes were evaluated in 32 cases with pulmonary metastases. The pulmonary metastases were peripheral lesions in 94% of these 32 patients, and multiple tumors were found in 91% of these cases. The metastases were less than 1 cm in diameter in 78%. Twenty-two of the 32 cases (69%) had obvious interstitial changes. In 19 of these 22 cases the interstitial change was characterized by the appearance of a "beaded septum" on HRCT. This beaded septal change corresponded directly to tumor growth in pulmonary capillaries and lymphatics and the septal interstitium. This sign was not noted in any of the specimens with pulmonary edema or fibrosis or in normal lungs. We believe that detection of the beaded septum sign on HRCT is highly suggestive of pulmonary metastases. PMID- 2723172 TI - Pulmonary contusion: CT vs plain radiograms. AB - In experimentally induced pulmonary contusions, CT (n = 27) and chest X-ray (n = 24) findings were compared with the findings at autopsy. Twenty-seven of 27 (100%) pulmonary contusions were visible by CT immediately after trauma compared with 9 of 24 (37.5%) in the chest X-ray. After 30 min follow-up, 18 of 24 (75%) lesions were seen on the plain film. Five of 24 (21%) contusions escaped detection on conventional radiographs. Computed tomography underestimated lesion size in 5 of 60 (8%) measurements, conventional radiographs in 21 of 36 (58%) measurements. Pathological examination never revealed a pulmonary contusion that was not demonstrated by CT. Therefore, pulmonary contusion seems unlikely in a trauma patient with normal pulmonary CT. PMID- 2723173 TI - CT signs of duodenal perforation secondary to blunt abdominal trauma. AB - Two cases of duodenal perforation secondary to blunt abdominal trauma demonstrate CT findings of focal bowel wall thickening, interruption of progress of bowel contrast medium, and extraluminal gas and fluid. PMID- 2723174 TI - Computed tomography in abdominal Castleman's disease. AB - Three patients with abdominal Castleman disease studied by CT are presented. Two cases corresponded to localized mesenteric disease and the third to a systemic form of the process. The CT findings are nonspecific, although a dense enhancement of the lesions can be demonstrated sometimes on dynamic CT. PMID- 2723176 TI - CT appearance of right gonadal vein. AB - The CT appearance of the right gonadal vein was studied. It is usually first seen 1 cm below the bifurcation of the inferior vena cava (IVC) and empties into the IVC laterally or anterolaterally 4 cm below the union of the right renal vein and IVC. Occasionally, it empties into an accessory right renal vein rather than the IVC. The right gonadal vein was visualized partially or completely in 80% of patients, and generally measured less than or equal to 4 mm in maximum diameter. It was enlarged in a patient with portal hypertension and in a post-partum woman. Knowledge of its typical CT appearance should prevent confusion with abdominopelvic lymph nodes. PMID- 2723175 TI - Gadolinium-DTPA enhanced dynamic MR imaging in the evaluation of cisplatinum nephrotoxicity. AB - Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced dynamic magnetic resonance (MR) imaging was used to monitor the nephrotoxic effects of cis-platinum (cis-diamminedichloroplatinum; CDDP), a chemotherapeutic agent that produces damage in the proximal convoluted tubule. Ten New Zealand white rabbits (NZWs) were divided into two groups and were evaluated at two clinically relevant doses of CDDP. Group 1 (four NZWs) received CDDP intravenously at 125 mg/m2 over 1 h. Rabbits in Group 2 (six NZWs) were infused with CDDP at 40 mg/m2 each day for 5 consecutive days. Dynamic MR images were performed in the axial plane at 1.5 T using a gradient recalled acquisition in the steady state sequence with an echo time of 11 ms, a repetition time of 20 ms, and a flip angle of 10 degrees after a bolus injection of Gd-DTPA 0.1 mmol/kg. Thirty-two sequential post Gd DTPA images (5.12 s/image) were obtained over 2 min 45 s at a single location. All rabbits underwent baseline normal and serial post CDDP Gd-DTPA enhanced dynamic MR scans. Analysis of the alterations in the normal pattern of renal enhancement caused by CDDP was facilitated by using a stacked profile image and quantitative region of interest measurements of signal intensity. Normally, after the injection of Gd-DTPA, a dark band promptly appears in the outer cortex of the kidneys and migrates centripetally toward the papilla, reflecting the tubular concentration of Gd-DTPA. In Group 1 rabbits, nephrotoxicity due to CDDP was observed as early as 9 h after administration of the drug, with a complete disappearance of the dark band by 7 days. In Group 2 rabbits, the band disappeared gradually and reappeared 2-10 days after the completion of CDDP treatment, indicative of tubular damage and recovery with return of the concentrating ability of the kidney. These results illustrate the feasibility of using Gd-DTPA dynamic MR as a sensitive monitor of drug induced alterations of renal function. PMID- 2723178 TI - Comparison of CT and MR imaging in musculoskeletal neoplasms. AB - Magnetic resonance (MR) and CT of 50 musculoskeletal neoplasms were compared to investigate the relative values of these modalities in the assessment and staging of musculoskeletal neoplasms and to determine how often they are complementary and when they are redundant. The material included 25 benign and 25 malignant neoplasms, of which 33 were skeletal and 17 were of soft tissue origin. Magnetic resonance was superior to CT with respect to all morphologic criteria except for cortical bone destruction, calcification, ossification, and the assessment of lytic and sclerotic changes in flat bones. Magnetic resonance was found to be complementary to CT in 48% of the cases (30% malignant, 18% benign). Use of both MR and CT was considered redundant in 52% of the cases (20% malignant, 32% benign). Magnetic resonance was found to be the modality of choice for all benign and malignant soft-tissue neoplasms. Both modalities are complementary and necessary for complete evaluation of malignant skeletal tumors. Benign skeletal tumors should be considered for evaluation by CT, MR, or both on an individual case basis. PMID- 2723177 TI - Fatty replacement of spinal bone marrow due to radiation: demonstration by dual energy quantitative CT and MR imaging. AB - Dual energy CT and quantitative magnetic resonance (MR) imaging were used to evaluate marrow changes due to radiation. The bright signal intensity seen on MR was shown by the two quantitative techniques to be due to a threefold increase in the marrow fat content compared with nonradiated levels and to a normal control. Fat estimates by MR and dual energy CT were in excellent agreement. Single energy CT overestimates the amount of bone loss in the radiation field. Dual energy CT and quantitative MR can be used to correct this error. PMID- 2723179 TI - MR fat suppression technique in the evaluation of normal structures of the knee. AB - The chopper fat suppression (CFS) pulse sequence, which is a phase sensitive implementation of the Dixon fat suppression method and the spin echo (SE) pulse sequence, was used in the evaluation of anatomic structures of the normal knee using 48 sets of imaging sequences in six volunteers using a repetition time/echo time combination of 1,500/30, 60 ms. A demonstration of the CFS technique in 10 patients with suspected knee pathology is also presented. A semiquantitative grading scale was established to rate anatomic visualization and used to compare CFS and SE pulse sequence techniques. The results in normal subjects demonstrate that hyaline cartilage is significantly better visualized by fat suppression pulse sequence than by conventional SE pulse sequence in the coronal and sagittal planes of imaging (p less than 0.001). The preliminary results from patients studies suggest that CFS imaging may be useful in the evaluation of meniscal tears, in the differentiation of hyaline cartilage from joint fluid, and in the detection of both soft tissue and bone injuries. PMID- 2723180 TI - Achilles tendon injuries: the role of MR imaging. AB - Eight magnetic resonance (MR) examinations were performed in seven patients with Achilles tendon injuries and correlated with physical examination and surgical and clinical follow-up. The MR examinations depicted the Achilles tendon in excellent detail and Achilles tendon abnormalities with greater accuracy than physical examination. Of five tendons shown to be at least partially torn on MR, palpable tendinous defects were found in only one, and plantarflexion weakness was found in four. The MR and surgical findings precisely correlated in one case. Magnetic resonance proved valuable in the evaluation of clinically equivocal Achilles tendon tears and may ultimately play a greater role as a research tool in the determination of optimal forms of therapy for specific Achilles tendon injuries. PMID- 2723181 TI - Fidelity of three-dimensional CT imaging for detecting fracture gaps. AB - Simulated femoral neck fractures with varying amounts of distraction were studied using four modifications in a volumetric, three-dimensional CT reconstruction program to allow an objective comparison of volumetric versus surface (thresholded) rendering. Binary classification caused spurious fusion of gaps less than 2.0 mm or, at settings preserving these gaps, produced false holes in adjacent bone. Fracture gaps were visible to 0.0 mm using volumetric CT image rendering technique. PMID- 2723182 TI - Assessment of phase and amplitude effects due to susceptibility variations in MR imaging of the brain. AB - Susceptibility effects due to the presence of hemorrhage have been observed in a substantial number of patients and are a potential source of artifact in in vivo spectroscopy. The studies so far have concentrated on observations of phase differences, but amplitude variations also exist. This article reviews the degree to which the two are independent and suggests that at least three different pulse sequences are necessary to characterize effects due to local field inhomogeneities arising in clinical studies. PMID- 2723183 TI - Intraventricular central neurocytoma: CT and MR findings. AB - Primary cerebral neuroblastoma occurring within the ventricles has been called intraventricular central neurocytoma. This lesion is usually calcified and tends to have a better prognosis than primary cerebral neuroblastoma occurring in the hemispheres. This entity must be considered when an intraventricular calcified lesion is encountered. We report the CT and MR findings in a case of this unusual neoplasm. PMID- 2723184 TI - MR imaging of perineural metastasis along the vidian nerve. AB - The perineural space is a well recognized pathway of tumor spread of head and neck cancer. We report a case of perividian metastasis studied with magnetic resonance imaging. PMID- 2723185 TI - Mucocele of the anterior clinoid process: CT and MR findings. AB - A patient with biopsy-proven primary mucocele of the anterior clinoid process is presented. Gadolinium-DTPA enhanced magnetic resonance imaging revealed a nonenhancing lesion isointense to gray matter. Computed tomography revealed well corticated bony margins without direct involvement of the sphenoid sinus. PMID- 2723186 TI - Lumbar epidural chordoma: MR findings. AB - Chordomas derive from persistent nests of notochordal cells that do not regress. They usually arise from the midline within bone of the skull base or spinal column. Typical radiographic findings of chordomas include midline location and bony destruction. We report an unusual epidural chordoma of the lumbar spine. PMID- 2723187 TI - Cauda equina syndrome complicating ankylosing spondylitis: MR features. AB - A case of cauda equina syndrome complicating long standing ankylosing spondylitis is presented. Bony erosions were demonstrated on CT. Magnetic resonance showed arachnoid diverticula filling the erosions. Magnetic resonance obviated the need for intrathecal contrast medium injection. PMID- 2723188 TI - Computed tomography of benign mesenchymoma of the neck. AB - Mesenchymoma is a tumor composed of two or more mesenchymal components along with fibrous tissue. We describe the CT findings in a case of benign mesenchymoma that presented as an unusual neck mass in an elderly woman. PMID- 2723189 TI - MR imaging of primary thyroid lymphoma. AB - Magnetic resonance (MR) images of a patient with primary malignant lymphoma of the thyroid gland and Hashimoto thyroiditis are presented. On T1-weighted images the intensity of the thyroid lymphoma was similar to that of Hashimoto thyroiditis. On T2-weighted images the thyroid lymphoma was seen as a homogeneous area of high intensity compared with Hashimoto thyroiditis. Magnetic resonance was equal to CT in diagnosing and staging of primary thyroid lymphoma. Direct coronal images of MR were useful in planning the radiation port. PMID- 2723190 TI - CT appearance of lunate trachea. AB - Computed tomography provides excellent visualization of the trachea, but there have been only limited descriptions of variations in tracheal shape. The normal tracheal cartilage is U shaped. Lunate shaped trachea is uncommon and is characterized by a coronal/sagittal diameter ratio (tracheal index) greater than 1. We present the CT appearance of a lunate shaped trachea with corresponding pathologic sections. Destruction of the membranous septum caused marked increase in the tracheal index in this patient. PMID- 2723191 TI - CT diagnosis of traumatic pericardium rupture. AB - A case of traumatic rupture of the pericardium secondary to a motor vehicle accident is presented. Diagnosis of this condition was made prior to surgery by CT. PMID- 2723192 TI - Leukemic infiltrates of the heart: CT findings. AB - Although primary cardiac tumors are rare, metastatic disease to the heart is not uncommon. This is particularly true of the leukemias. Because of increased patient survival, cardiac leukemic infiltrates may assume a larger role in the gamut of leukemic complications. We present a case of massive cardiac leukemic infiltrates in which CT was instrumental in diagnosis and patient management. Relevant pathologic and radiologic features are reviewed. PMID- 2723193 TI - CT findings of perforated duodenal diverticulitis. AB - The diagnosis of duodenal diverticulitis is rarely made preoperatively by upper gastrointestinal series or plain abdominal films. We describe a case of perforated duodenal diverticulitis diagnosed by CT. PMID- 2723194 TI - Computed tomography of acute jejunogastric intussusception. AB - A case of acute retrograde jejunogastric intussusception occurred 31 years after a Billroth II partial gastrectomy. Gastroscopy was nondiagnostic. The CT features allowed a correct diagnosis. PMID- 2723195 TI - Renal lymphoma in ataxia-telangiectasia: CT contribution. AB - Ataxia-telangiectasia (AT) or the Louis-Bar syndrome is a familial, multisystem disorder. Patients with the disease are at high risk for malignancy, in particular lymphoreticular neoplasms, and immunodeficiency, rendering them susceptible to infection. We present a 17-year-old girl with AT and a history of lymphoma who developed a persistent fever. An isolated renal mass was discovered by abdominal ultrasound and CT. Although the diagnosis of renal lymphoma is strongly suggested by these modalities, other types of renal mass lesions, including renal infection, may occur in patients with AT and ultimately a definitive diagnosis may only be established by biopsy. PMID- 2723196 TI - Hemispherical spondylosclerosis: MR appearance. AB - We present a case of hemispherical spondylosclerosis (HSS) in a middle-aged woman with low back pain. The plain radiographic findings, CT and MR appearance, and pathological examination are described, and the difficulties encountered in differentiating HSS from malignancy and infection are discussed. PMID- 2723197 TI - Mesothelioma of the pericardium: CT and MR findings. PMID- 2723198 TI - Three-dimensional FLASH imaging: applications with gadolinium-DTPA. AB - Sixteen patients with a variety of brain and spine tumors were examined with T1 weighted spin echo and three-dimensional (3D) fast low-angle shot (FLASH) (60 degree flip angle) techniques before and after administration of Gd diethylenetriamine pentaacetic acid (DTPA) to assess the utility of volume imaging in parenchymal and dural disease. Reconstructions were performed on a Kontron MIP magnetic resonance (MR) workstation and compared with the corresponding spin echo images. Good 3D FLASH examinations (n = 9) were seen with a variety of echo times (6-17 ms) and repetition times (40-100 ms). Fair (n = 4) and poor (n = 3) examinations were usually associated with motion artifact, especially the coronal acquisitions. Spin echo images were all considered of good quality. An increase in confidence of diagnosis was seen in nine cases following contrast medium administration, based on either enhancement of an abnormality (n = 7) or failure of enhancement (n = 2). Three-dimensional FLASH imaging combined with Gd-DTPA holds promise to develop into a clinically valuable sequence allowing good patient throughput and ability to reconstruct in any plane and sensitivity to abnormalities of the blood-brain barrier or vascularity. However, some problems remain, including motion and susceptibility artifacts, long reconstruction time, and loss of resolution in reconstruction due to anisotropic volume. PMID- 2723199 TI - An allergy to local anesthetics? The consequences of a misdiagnosis. AB - In this case, inappropriately labeling the child as "allergic to local anesthetics", resulted in her inability to receive appropriate dental care. It was a major disservice to her and led to the potentially serious consequences of neglecting the dental disease present. The small caries lesions that would have required amalgam restorations at five years of age progressed to painful toothaches requiring stainless steel crowns and pulpal treatment. Although adverse reactions to local anesthetics are uncommon, most dentists can anticipate encountering a patient who will have an adverse reaction to a local anesthetic. This case ilustrates the need for dentists to be knowledgeable regarding the signs and symptoms of the potential adverse reactions and their appropriate management. Most importantly, prevention is based upon knowledge of anatomy, dose determination, and the use of proper armamentarium and technique, which are key factors in making a safe and effective drug even safer. PMID- 2723201 TI - The marvelous third. PMID- 2723200 TI - Effects of trauma to the primary incisors on their permanent successors: multidisciplinary treatment. AB - Dental trauma can often be a factor in developing a malocclusion. Although the prevalence of severely affected permanent teeth following trauma to their predecessors is relatively low, each case may present a variety of sequelae. The purpose of the following report was to present the problems confronting the dentist when treating children after serious injury to their primary incisors. A brief summary of the sequelae of trauma to the primary dentition as found in a longitudinally followed sample, as well as in the representative case of a ten year-old girl, are presented. The need for prolonged follow-up, originality in the solution, and a multidisciplinary treatment approach are stressed. PMID- 2723202 TI - Emergence of morality: understanding. PMID- 2723203 TI - The ingestion of fluoride dentifrice by young children. AB - Through the fluoridation of drinking water, fluorides are becoming an increasing part of the human environment in industrialized countries. Fluoridated toothpastes are widely used in the United States and Canada. The younger a subject is, the greater proportion of toothpaste he or she tends to swallow. PMID- 2723204 TI - Radiographic evaluation of pulpal therapy for primary anterior teeth. AB - A total of 144 anterior primary incisors with formocresol pulpotomies or pulpectomies comprised the study sample. Although the former had a moderately high success rate, those incisors treated with the latter procedure had a better prognosis. It may be the preferred treatment when the extent of pulpal involvement cannot be determined. PMID- 2723205 TI - The relationship of parental dental anxiety and child's caries status. AB - The objective was to determine whether parental dental anxiety is associated with the caries status of their children. A higher level of dental anxiety was found among caries-active children, probably due to their more negative experiences in treatment. Also, fathers from the lower socioeconomic group who had a high level of dental anxiety had children with lower df-scores. PMID- 2723206 TI - The clinical diagnosis of occlusal caries: a problem. AB - The problem of the diagnosis of occlusal caries is discussed on the basis of a pilot study. Out of twenty-six selected molars and premolars with a virtually intact enamel cover, twenty were found to be affected by occlusal caries extending into the dentine. In six cases in which the enamel was covered by a sealant, dentinal caries could not be excluded. Two teeth had a sound enamel surface in spite of the presence of much dentine caries. The bitewing radiographs of these cases showed a distinct radiolucency. Until it becomes possible to diagnose occlusal caries more effectively, the combination of bitewing radiograph and clinical examination with mirror, light, and probe is to be regarded as optimal. The dentist in general practice should keep in mind that even a tooth classified as clinically sound may contain extensive dentinal caries. The prevalence of this form of caries should be investigated further, and the search for better diagnostic aids should continue. PMID- 2723207 TI - Residual contamination of toothbrushes by microorganisms. AB - Procedures for maintaining the cleanliness of oral cleaning instruments have been discussed infrequently. S. mutans and pathogenic microorganisms can be transferred readily when a toothbrush is used, increasing the risk of dental caries and infectious diseases. It is suggested that sterilization equipment or specific detergents be used. PMID- 2723208 TI - Relationships between DEF, demographic and behavioral variables among multiracial preschool children. AB - In general, the data produced in this study suggest that children's dental health is related to certain practices begun during the infant and preschool years. Specific interventions (e.g., early weaning, parent-assisted toothcleaning, and diets high in milk and low in sugar) will decrease the incidence of caries in children. PMID- 2723210 TI - Sports dentistry. PMID- 2723211 TI - Selected proceedings of the Workshop on Anesthesia Education. March 1-2, 1989, Chicago, Illinois. PMID- 2723209 TI - Continuing potential for pediatric dental services in nonurban areas. AB - Recently published pediatric dental-use-pattern data (into the second half of the 1980s), based on a distribution by urban vs nonurban residents, permit a review of the proposal for pediatric dentists to increase practice activities in nonurban areas. Despite a major concentration of the population in metropolitan areas of the country, there are 13.4 million children (between two and seventeen years of age) living in nonmetropolitan areas. PMID- 2723212 TI - Keynote address. PMID- 2723213 TI - The role of the dental school in teaching conscious sedation. PMID- 2723215 TI - Advanced education for sedation and anesthesia in dentistry. PMID- 2723214 TI - Undergraduate education in the use of intravenous conscious sedation for dentistry. PMID- 2723216 TI - Rationale for an advanced education program in dental anesthesiology. PMID- 2723217 TI - A summary of pharmacosedation training in postdoctoral general practice programs. PMID- 2723218 TI - Expanding educational opportunities in continuing education for anesthesiology and sedation. PMID- 2723219 TI - Issues of pain and anxiety control training and continuing education. PMID- 2723220 TI - Pharmacologic consideration in the training of dentists in anesthesia and sedation. PMID- 2723221 TI - Guidelines for teaching the Comprehensive Control of Pain and Anxiety in Dentistry. Council on Dental Education, American Dental Association. PMID- 2723222 TI - Curriculum guidelines for geriatric dentistry. PMID- 2723223 TI - Oral condyloma acuminatum. AB - Fifty-one cases of oral condyloma acuminatum are reported, bringing the total number in the English medical/dental literature to approximately 156 cases. Ninety-five percent of the 59 new cases were in males. Eight-one percent occurred in the age range of 21-40 years. The most common locations were upper lip, lingual frenum, dorsum of the tongue, and lower lip. Thirty-four percent presented with multiple lesions. PMID- 2723224 TI - Treatment of multiple apocrine hidrocystomas with the carbon dioxide (CO2) laser. AB - The apocrine hidrocystoma tends to occur as a solitary facial cystic lesion. We report an unusual patient in whom there were multiple apocrine hidrocystomas scattered over the periorbital region and ears. Although solitary apocrine hidrocystomas are easily treated with excision, we had good results employing carbon dioxide laser vaporization in the treatment of numerous hidrocystomas. PMID- 2723225 TI - Vermilionectomy using the W-plasty technique. AB - We describe a variation of the conventional vermilionectomy consisting of incisions using the W-plasty technique, which allows a more distensible scar with better cosmetic and functional results. Its primary indications are actinic cheilitis and leukoplakia of the lower lip. It is a more complicated technique than the classic one, and requires a larger loss of skin, but the benefits largely outweigh the drawbacks. PMID- 2723226 TI - Treatment of Pseudomonas aeruginosa auricular perichondritis with oral ciprofloxacin. AB - Pseudomonas aeruginosa auricular perichondritis can be a serious and expensive postoperative infection requiring prolonged hospitalization and intravenous administration of antibiotics. Oral antimicrobial agents have not been effective in the treatment of serious P. aeruginosa infections. Recently completed clinical trials have shown that oral ciprofloxacin, one of the new fluoroquinolone antimicrobials, is effective in the treatment of certain P. aeruginosa infections. We report two cases of P. aeruginosa auricular perichondritis successfully treated as outpatients with oral ciprofloxacin. This article also reviews the salient features of the new fluoroquinolones and their impact on antimicrobial therapy of serious skin and skin-structure infections. PMID- 2723227 TI - Red tattoo reactions: treatment with the carbon dioxide laser. AB - Cutaneous reactions to red tattoo pigment occurred in two patients who developed erythema, swelling, and severe pruritus in the area of red coloration within their tattoos. Carbon dioxide (CO2) laser vaporization of the red portions of the tattoos led to complete resolution of symptoms with an excellent cosmetic result and preservation of the tattoo design. A step-by-step guide to the use of the CO2 laser for this treatment is described. PMID- 2723228 TI - Anesthesia for outpatient dermatologic cosmetic surgery: midazolam--low-dosage ketamine anesthesia. AB - Cardiovascular, respiratory, CNS, and postoperative effects of using low-dose ketamine and midazolam combined with local anesthesia during 40 outpatient cosmetic procedures are reviewed. This method of anesthesia is safe, effective, and well-tolerated by patients. PMID- 2723229 TI - Pseudolymphoma of the earlobes due to ear piercing. AB - Keloids are commonly seen as a complication of earlobe piercing. As biopsies are usually not performed routinely in many instances, some of the lesions might, in fact, represent other entities, such as cutaneous pseudolymphoma. Contrary to keloids, for which surgery alone is not recommended, a simple excision or superficial x-ray is sufficient in such cases. PMID- 2723230 TI - Treatment of perifolliculitis capitis abscedens et suffodiens with the carbon dioxide laser. AB - We describe the successful use of the carbon dioxide (CO2) laser for localized surgical therapy in a patient with perifolliculitis capitis abscedens et suffodiens that was refractory to conservative treatment. PMID- 2723231 TI - Allergic reactions to Sotradecol. PMID- 2723232 TI - Cosmetic varicectomy versus sclerotherapy. PMID- 2723234 TI - Reviewing research findings for application to ET clinical nursing practice. PMID- 2723233 TI - Pressure point measures in the operating room. PMID- 2723235 TI - Patch testing. PMID- 2723236 TI - Alternatives in gastrostomy management: the button. PMID- 2723237 TI - Use of a pressure-reducing cushion in a neonatal setting. PMID- 2723238 TI - Education of state officials in dermal ulcer care. PMID- 2723239 TI - President's message--networking saves money and enhances patient care by consolidating resources. PMID- 2723240 TI - IAET strategic planning report: chapter I. PMID- 2723241 TI - The place of a pediatric intensivist in our society. PMID- 2723242 TI - Proceedings of the III International Symposium on Pediatric Surgical and Neonatal Intensive Care. PMID- 2723243 TI - Oxygen free radicals and lungs. AB - Some of the metabolites resulting from the monovalent reduction of O2, superoxide anion and hydroxyl radical, are O2, radicals, whereas H2O2, which is not a radical since having no unpaired electron, is also an active O2 intermediate. These O2 metabolites are formed intracellularly as a result of normal metabolism. Their production can increase following exposure to high O2 concentration, radiations or certain drugs. An increased amount of extracellular O2 metabolites occurs after activation of certain inflammatory cells or during the course of the hypoxanthine-xanthine oxidase reaction. To counteract this oxidative stress, antioxidant defenses exist, whether enzymatic (superoxide dismutase, glutathione peroxidase, catalase, etc.) or nonenzymatic (GSH, vitamin E and C, etc.). Oxidative injury can result from an imbalance between oxidative stress and the defense mechanisms. The main targets are protein, DNA and lipids. The cellular response of the lung is stereotyped and involves cell injury (especially endothelial cells and type I pneumocytes), inflammatory reaction and repair processes. PMID- 2723244 TI - Hemodynamic monitoring in childhood. AB - Hemodynamic monitoring is indicated in children with impending or manifest cardiocirculatory failure. Since cardiocirculatory failure is characterized by an imbalance between oxygen delivery and oxygen demand due to perfusion failure, the parameters monitored should aid in the assessment of these oxygen variables. Oxygen delivery depends on oxygen content and cardiac output. Cardiac output is determined by heart rate and stroke volume; stroke volume by preload, afterload and contractility. Since the direct measurement of oxygen consumption routinely is almost impossible, global oxygen utilization represented by mixed venous oxygen saturation may be used to quantify the relationship between oxygen delivery and oxygen consumption. Justification of invasive hemodynamic monitoring depends among other things on an optimal balance between usefulness of information and complications associated with the techniques used. In future, the development of further noninvasive techniques and the scientific evaluation of recommended monitoring techniques are prospects in cardiovascular monitoring in childhood. PMID- 2723245 TI - Stress-induced disturbances of the gastro-intestinal tract in children. AB - The gastrointestinal tract is particularly sensitive to stress, especially in children. The specificity of the gastric, intestinal and colonic microcirculation explains the high risk of ischemia during septic and hemorrhagic shock. The consequences of digestive ischemia vary from mucosal ulceration to transmural necrosis. Tissue hypoxia, the production of superoxide radicals and luminal factors explain these lesions. Some drugs are proposed which may limit the extent of these ischemic lesions; however to prevent them the author advises, on anticipating stress and complete hemodynamic monitoring of infants at risk. PMID- 2723246 TI - Measurement of post-operative pain and narcotic administration in infants using a new clinical scoring system. AB - We developed a clinical neurologic and behavioral scoring system composed of 10 items to measure the post-operative pain levels in infants: (1) sleep during preceeding hour, (2) facial expression of pain, (3) quality of cry, (4) spontaneous motor activity, (5) Spontaneous excitability, (6) flexion of fingers and toes, (7) sucking, (8) global evaluation of tone, (9) consolability and (10) sociability. Using this system, a group of infants ranging from one to seven months in age and undergoing minor surgical procedures was studied. The infants were randomly assigned to two groups: Group I received Fentanyl intravenously (3 micrograms/kg) prior to surgery, and Group II received a placebo. The infants then were studied post-operatively in the recovery room at 30, 60, 90 and 120 min intervals. Over the entire post-operative observation period, 54% of the infants in Group I had satisfactory analgesia compared to 18% in Group II. There were no significant differences in Group I and Group II in oxygenation, carbon dioxide elimination, blood pressure, heart rate or temperature. PMID- 2723247 TI - Regional analgesia on pediatric medical and surgical wards. AB - Regional anesthetic approaches to pain management were examined in 72 children and young adults (ages 3 weeks to 31 years) who were observed on the surgical or medical wards of a children's hospital separate from intensive care areas. A protocol was devised to permit safe conduct of these techniques on the ward. Full resuscitation supplies were kept at each bedside. All patients receiving epidural narcotics had an apnea monitor, hourly counting of respiratory rates, and restriction of systemic analgesics. All bolus re-injections into the catheters were performed by an anesthesiologist who monitored the patient for 20 min. Minor side-effects, including pruritus, nausea, and urinary retention were common, but manageable. Significant complications included: one case of decubitus ulcers requiring skin-grafting, one episode of mild hypotension in a patient with terminal malignancy, requiring ephedrine and phenylephrine, and one mild toxic reaction on test dosing due to presumed intravascular migration of a lumber sympathetic catheter. Regional analgesic techniques can provide excellent analgesia on the wards for selected children and young adults, provided precautions are taken. Further study is required to define specific indications, risks and benefits relative to simpler techniques. PMID- 2723248 TI - The ontogeny of the metabolic and endocrine stress response in the human fetus, neonate and child. AB - Evidence of an endocrine and metabolic response to stress is evident from the mid trimester of fetal life. The ontogeny of this response is seen in the different patterns of response evident in the fetus, neonate, infant and child. These data raise important issues concerning the management of pain and stress in early life. PMID- 2723249 TI - Anaesthetic technique and pain in the newborn. AB - This paper reviews the approach to pain during surgery in the newborn under five general headings: (1) current attitudes to pain in the newborn during anaesthesia and intensive care; (2) current evidence on the response of the newborn to pain; (3) current approaches to the management of pain in the newborn; (4) the complications of these approaches; (5) the resultant principles of the management of anaesthesia in the newborn. PMID- 2723250 TI - A model: systems management of life threatening injuries in children for the state of Maryland, USA. AB - In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been charged with the responsibility of developing national standards of emergency care for children and are currently at work on such a landmark document. We have had a functioning statewide system for the management of life threatening injuries in children for the past 10 years. In 1985, 320 children were admitted to our trauma center. The evolution, organization, and current status of the Maryland system is described in this report. Hopefully it may serve as one successful model which could be modified for use in other regions of the country. PMID- 2723251 TI - Harvesting organs for paediatric transplantation: medical features. AB - The progress in organ transplantation has led to a rise in the demand for organs. Paediatric intensive care units are the main source for obtaining organs. Every "brain dead" patient should be regarded as a potential donor. General contraindications to organ donation are: systemic viral or bacterial infections and extra-cerebral malignancy. They are also organ-specific contraindications. The criteria for the diagnosis of "brain death" have been widely studied and defined. Care of brain dead donors consists of maintenance of cardiac, pulmonary and renal function. Monitoring requires control of central venous and arterial blood pressure, core temperature, urine flow, heart rate and biological data on both urine and blood. A 5% dextrose infusion is maintained with added potassium and sodium chloride according to the urine flow, detectable water loss, and blood and urine composition. Hypotension due to hypovolaemia requires immediate treatment with blood, colloid or albumin infusion. Persistent hypotension with cardiac pump failure is treated with inotropic agents: dopamine and/or dobutamine. Raised urine flow due to diabetes insipidus requires desmopressin (dDAVP). Progress in organ collection requires the consent of the parents and highly motivated medical teams. PMID- 2723252 TI - Organ procurement in children--surgical, anaesthetic and logistic aspects. AB - To cover the need in paediatric organ transplantation, every potential donor should be considered as a multi-organ donor. Successful transplantation may be performed with kidneys retrieved from very young infants, even anencephalic neonates if the en-bloc technique using both kidneys is used. Regarding the liver, paediatric donors can be accepted from one month of age while livers harvested from older children and even young adults can be transplanted into small children after ex-vivo reduction of the size of the graft. Multi-organ procurement from the same donor provides valuable organs if the anaesthetic management of the donor is appropriate. Active transplant programs needs international cooperation which is made possible by the organ exchange organizations. PMID- 2723253 TI - Regulation of the pulmonary circulation in the perinatal period and in children. AB - In the fetus, the pulmonary circulation is actively maintained in a constricted state due to low oxygen environment and perhaps leukotrienes. Pulmonary blood flow represents about 8% of fetal cardiac output. Shortly after birth, pulmonary vascular resistance (PVR) and pulmonary arterial pressure fall rapidly, whereas pulmonary blood flow reaches systemic levels. The exact mechanisms by which the dramatic changes in PVR occur with the onset of ventilation at birth are extensively reviewed. They include: oxygen environment and release of vasoactive substances such as bradykinin, PGI2 or PGD2. Thus, regulation of the fetal and immediate postnatal pulmonary circulation reflects a balance between factors producing active pulmonary vasoconstriction and those producing vasodilatation. PMID- 2723254 TI - Sex and sexually transmitted disease on campus: perspective and challenge. PMID- 2723255 TI - Sex and anxiety on the campus: thirty-five years thereof. PMID- 2723256 TI - College students' knowledge and health beliefs about AIDS: implications for education and prevention. AB - A questionnaire designed to measure the application of the dimensions of the Health Belief Model (HBM) to AIDS prevention and to practicing safer sex was administered to 139 undergraduates aged 22 years and under. Students generally had good knowledge about the facts of AIDS, which was consistent with other studies. We found an important difference between students' beliefs about practicing safer sex to prevent AIDS depending on whether their level of knowledge was high or low. The HBM posits that all of its dimensions must be present in order for belief to be followed by action. However, students with low knowledge indicated that the perceived barriers to practicing safer sex were higher than did students with high knowledge about AIDS. These results suggest that special efforts need to be made to teach students with low knowledge more about AIDS and that the barriers to safer sex can and should be overcome. There were no differences between students known to be sexually active compared with those who may or may not have been sexually active. One explanation was a possibly high number of students in the group identified as "perhaps sexually active" who actually were sexually active. Similarly, there were no differences between college students who did or did not know someone with AIDS, but this may have been due to the small number of students who did know such a person. Students' preferences for the format and methodology of AIDS education also were presented. In general, the students preferred small-group discussions and formats such as movies or panel discussions where they could remain "anonymous."(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723257 TI - The efficacy of educational movies on AIDS knowledge and attitudes among college students. AB - University students from five classes were randomly assigned to seeing either a movie on AIDS or a movie on first aid. Six weeks later, both groups of students filled out a questionnaire measuring their knowledge of AIDS, attitudes toward AIDS, and attitudes toward homosexuals. In general, the differences between the two groups on the knowledge and attitudes measures were slight. In particular, there was little effect on social attitudes. The showing of one educational movie on AIDS (particularly the movie that was used in this experiment) appears to be insufficient to educate students on this issue. PMID- 2723258 TI - Effect of instructional videotapes on AIDS knowledge and attitudes. AB - The effectiveness of four commercial videotape presentations in changing AIDS knowledge and attitudes among 584 college students was evaluated in a pre-post design with control group and follow-up. AIDS knowledge and attitudes were measured prior to, immediately after, and 4 to 6 weeks following presentation of the informational videotapes. In addition, subjects rated each videotape on several specific dimensions, including overall quality. The effects of age, sex, prior exposure to AIDS information, and presence v absence of post-presentation discussion were measured as covariates. In general, there was a significant immediate increase in AIDS knowledge attributable to all four videotapes (p less than .001). These gains persisted until follow-up, with no erosion for three of the four tapes. With the exception of perceived effectiveness of AIDS prevention methods (p less than .001), attitudes toward AIDS showed no change as a result of exposure to any of the videotapes (p greater than .05). Viewer ratings showed two of the videotapes to be superior in terms of perceived overall quality (p less than .05). There were also differences in ratings of videos on other dimensions. Among the covariates, there was no relationship at time of follow-up between post presentation discussion v no discussion and either knowledge gain or attitude change. Sex was related to one attitude component, with women perceiving the AIDS epidemic as more severe than men (p less than .001). PMID- 2723259 TI - Condom sales at public universities in California: implications for campus AIDS prevention. AB - Public health officials have called for increased use of condoms to protect Americans from sexually acquiring human immunodeficiency virus (HIV) infection. To investigate the availability of condoms for sale on college campuses, we asked student union directors and bookstore managers from all 28 public universities in California, with a combined enrollment of half a million students, to complete a detailed questionnaire in August and September 1987. Two thirds of the campuses reported having condoms for sale in either their bookstores or convenience stores; one third said condoms were available in the men's and women's restrooms in their student unions. On most campuses, sales were instituted in the past year in response to the AIDS (acquired immune deficiency syndrome) epidemic. However, very few campuses provided AIDS education at the point of sale, and condoms were not easily available outside of store hours. Respondents felt that the most important obstacles to increasing the distribution of condoms on campus included concern about presenting a negative image of the university and the low priority assigned to this issue by the university administration and others on campus. This study suggests that although condom availability has improved in the past year, the opportunity exists at most California public universities to increase the distribution of condoms and improve associated AIDS-related health education efforts. PMID- 2723260 TI - Management of the abnormal Papanicolaou smear. AB - Since 1943, Papanicolaou (Pap) smears have been widely used to screen for cervical cancer. Over the past 25 years, new understanding of the natural history of cervical epithelial neoplasia has defined the existence and importance of dysplasia, also termed cervical intraepithelial neoplasia (CIN), and more recently, its probable link to human papilloma virus (HPV). Inflammatory atypia (IA) is a common cytological diagnosis whose significance is less understood. Current gynecological opinion strongly supports a practice of colposcopic evaluation for all women with cytology showing any degree of CIN. Data from studies in our health service and elsewhere establish that 15% to 30% of patients with IA will have CIN if evaluated by colposcopy. Although clinicians may choose to follow such patients with repeated Pap smears, there are strong arguments for offering colposcopic evaluation to patients with IA. Potential problems with false-positive cervical biopsy reports, however, may limit the utility of colposcopy in patients with IA cytology. PMID- 2723261 TI - Classification, management, and tracking of abnormal Papanicolaou smears. AB - A system of classifying, managing, and tracking abnormal Papanicolaou (Pap) smears was used at a California university where 3,289 patients were tested. Classification was based on use of the latest cytopathological techniques for identifying characteristics associated with dysplasia and human papilloma virus (HPV). The follow-up success rate was determined for 6-month repeat Pap smears, colposcopy patient contact, and biopsy results. Pathology report correlations were determined for the noncolposcopy group by using repeat Pap smear results. Biopsy results were correlated with Pap smear readings for accuracy and yielded significant statistical information for the program. PMID- 2723262 TI - Screening for chlamydia by university health centers: is it necessary and feasible? PMID- 2723263 TI - Hepatitis B--the latest sexually transmitted disease. PMID- 2723264 TI - Coronary arteriographic analysis and angiographic morphology. PMID- 2723265 TI - Ischemia--silent or manifest: does it matter? PMID- 2723266 TI - Effects of successful intravenous reperfusion therapy on regional myocardial function and geometry in humans: a tomographic assessment using two-dimensional echocardiography. AB - This study tested the hypothesis that reperfusion therapy might provide benefit at two levels: 1) by arresting infarct migration at the endocardial level, such that partial or complete recovery of regional function occurs; and 2) if the former is not achieved, by preventing complete or near complete transmural migration and subsequent infarct expansion. To test this hypothesis, 24 patients who received intravenous streptokinase therapy within 4 h of chest pain were studied prospectively. All patients underwent two-dimensional echocardiography at the time of admission and 1, 2, 3 and 10 days later. The patients also underwent coronary angiography 2 h after completion of streptokinase therapy. Although 18 (75%) of the 24 patients had a patent infarct-related artery, only 8 (45%) of the 18 patients with this finding showed improvement in regional function. Improvement was not evident until 3 to 10 days after streptokinase therapy. In addition to the presence of an open infarct-related artery, the interval between chest pain and onset of streptokinase therapy (2.5 +/- 0.5 versus 3.2 +/- 0.7 h, p = 0.02) differed significantly between patients who did or did not show improved regional function. Of the 15 of 16 patients with no improvement in regional function, 4 showed infarct expansion, and all had a closed infarct related artery compared with only 2 of the 11 not showing expansion (p = 0.01). In conclusion, intravenous streptokinase given within 4 h of chest pain results in improvement in regional function in about 33% of the patients, presumably by arresting the infarction within the endocardium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723267 TI - Left ventricular thrombus incidence and behavior studied by serial two dimensional echocardiography in acute anterior myocardial infarction: left ventricular wall motion, systemic embolism and oral anticoagulation. AB - Serial two-dimensional echocardiography was performed to detect left ventricular thrombus in 92 consecutive patients with a confirmed first acute anterior myocardial infarction. Thirty left ventricular thrombi were diagnosed in these 92 patients. The cumulative percent of identified thrombus in each echocardiographic examination in the surviving patients was 27% at less than 24 h; 57% at 48 to 72 h; 75% at 1 week and 96% at 2 weeks. The thrombus shape was defined as mural in 53% and protruding in 47% of patients. Systemic embolism (stroke) was noted during hospitalization in two patients with a protruding thrombus. At 12 weeks of follow-up, patients with thrombus had poorer (and almost unchanged from baseline) global left ventricular function as expressed by wall motion score compared with that of patients without thrombus, who exhibited significant improvement. Global left ventricular wall motion in patients with persisting or resolved thrombus was similar during follow-up. Apical wall motion worsened in 70% of the patients with persisting thrombus and in 25% of the patients with resolved thrombus (p less than 0.1). In the 22 surviving patients with thrombus, resolution or change in thrombus shape or size was noted in 14 of the 15 patients receiving anticoagulant therapy and in 4 of the 7 untreated patients. Six of the 18 patients with an early- (48 to 72 h) and none of the 12 patients with a later-formed thrombus died. Maximal serum enzyme levels, percent with Killip functional class III to IV and left ventricular wall motion score were higher in the patients with an early- than in those with a later-formed thrombus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723268 TI - Determinants of exercise capacity in hypertrophic cardiomyopathy. AB - Exercise capacity in hypertrophic cardiomyopathy is thought to relate to elevated left atrial pressure as a consequence of impaired diastolic function, but this assumption has not previously been evaluated. Twenty-three patients with hypertrophic cardiomyopathy underwent hemodynamic assessment during symptom limited maximal exercise with objective measurement of exercise capacity by respiratory gas analysis. Maximal oxygen consumption and anaerobic threshold were 28.1 +/- 7.5 and 21.5 +/- 6.1 ml/kg per min, respectively (the lower limit of reference range in our laboratory is 39 and 27 ml/kg per min, respectively). Maximal oxygen consumption was reduced in 11 of 13 patients who were in New York Heart Association functional class I and who denied limitation of exercise capacity and in all 10 patients who were in functional class II or III. Maximal oxygen consumption and anaerobic threshold were related to peak cardiac index (r = 0.650, p less than 0.001 and r = 0.459, p = 0.03, respectively) and to the increase in cardiac index on exercise (r = 0.677, p less than 0.001 and r = 0.509, p = 0.016, respectively), but not to cardiac index at rest, peak and rest pulmonary capillary wedge pressure, pulmonary capillary wedge pressure at an oxygen consumption of 15 ml/kg per min or the rise in pulmonary capillary wedge pressure on exercise. These findings are not consistent with the hypothesis that elevated left atrial pressure is the major determinant of exercise capacity in patients with hypertrophic cardiomyopathy and they suggest that, as in patients with chronic cardiac failure, other mechanisms should be considered. PMID- 2723269 TI - Noninvasive diagnosis of coronary artery fistula by Doppler color flow mapping. AB - Sixteen patients with coronary artery fistula proved by coronary angiography or surgery were studied using two-dimensional echocardiography and Doppler color flow mapping. The coronary artery fistula drained into the right atrium in 4 patients, the right ventricle in 2 and the pulmonary artery in 10. The dilated coronary artery was visualized in 7 of the 16 patients with a fistula, as compared with none of the 40 control subjects. These 7 patients included 5 of 6 patients with a fistula draining into the right atrium or right ventricle and only 2 of 10 patients with a fistula draining into the pulmonary artery. Abnormal flow signals in the dilated coronary artery were visualized with Doppler color flow mapping in five of these seven patients. Color flow imaging visualized abnormal flow signals with mosaic appearance in the pulmonary artery in eight patients, the right atrium in four and the right ventricle in two. The chamber in which abnormal signals were detected corresponded with the entry site of the fistula by angiography. Intraoperative imaging during surgical repair was needed in two cases to confirm ligation of all arteries feeding into the fistula network. In conclusion, Doppler color flow imaging is diagnostically useful to visualize shunt flows originating from the opening or exit of a coronary artery fistula. Furthermore, intraoperative use of this technique may provide confirmation of successful surgical ligation of the fistula. PMID- 2723270 TI - Assessment of right ventricular performance by pulsed Doppler echocardiography in patients after intraatrial repair of aortopulmonary transposition in infancy or childhood. AB - The purpose of this study was to determine whether measurement of aortic blood flow velocity and acceleration by pulsed Doppler ultrasound can be used to assess the global performance of the systemic right ventricle noninvasively in young patients who have undergone intraatrial repair of aortopulmonary transposition. The effect of age at surgery on right ventricular performance in these patients was also studied. Pulsed Doppler velocity profiles of aortic blood flow were analyzed at a mean age of 5.5 years in 24 patients who had undergone intraatrial repair of aortopulmonary transposition either in early infancy (mean age 3.4 +/- 1.3 weeks) or later (mean age 8.5 +/- 6.5 months). Velocity and acceleration variables in these patients were compared with the same variables in 24 age matched normal subjects and with the performance of their own right ventricle as assessed by two-dimensional echocardiographic measurement of ejection fraction. The 12 patients who underwent early repair had a higher ejection fraction than did the 12 who underwent later repair (mean +/- SD 0.60 +/- 0.07 versus 0.42 +/- 0.10; p less than 0.001). Aortic flow velocity was similar in all patients. Aortic acceleration was normal in patients after early intraatrial repair of aortopulmonary transposition (20.8 +/- 2.3 m/s2), but was abnormally slow in patients after late repair (11.1 +/- 1.8 m/s2; p less than 0.001), thus suggesting that the latter group had diminished right ventricular performance. Concomitantly, acceleration time and ratio of acceleration time to ejection time were increased in patients after late repair.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723271 TI - Cardiac malformations in trisomy-18: a study of 41 postmortem cases. AB - The cardiac malformations in 41 karyotyped and autopsy cases of trisomy-18 are presented in detail. The salient findings were a ventricular septal defect in all cases; tricuspid valve anomalies in 33 cases (80%); pulmonary valve anomalies in 30 (70%); aortic valve malformations in 28 (68%); mitral valve anomalies in 27 (66%); polyvalvular disease (that is, malformations of more than one valve) in 38 (93%); a subpulmonary infundibulum (conus) in 40 (98%); a bilateral conus with a short subaortic infundibulum in 1 case with double outlet right ventricle (this being the only documented case of bilateral infundibulum in trisomy-18); double outlet right ventricle in 4 cases (10%), three having a subpulmonary infundibulum only and all 4 having mitral atresia; tetralogy of Fallot in 6 cases (15%), 2 having pulmonary atresia; and a striking absence of transposition of the great arteries and inversion at any level (visceral or cardiac), findings that appear to be characteristic of all trisomies. These data suggest that excessive chromosomal material (as in trisomies) may result in situs solitus at all levels. The malformations of the atrioventricular and semilunar valves were characterized by redundant or thick myxomatous leaflets, long chordae tendineae and hypoplastic or absent papillary muscles. The ventricular septal defect was associated with anterosuperior conal septal malalignment in 25 cases (61%). On the basis of the characteristic valvular lesions, the type of ventricular septal defect and the absence of transposition or inversions, two-dimensional echocardiographic diagnosis of trisomy-18 in the fetus may become possible. PMID- 2723272 TI - Comparison of immediate versus day to day variability of ventricular tachycardia induction by programmed stimulation. AB - The use of programmed stimulation to assess long-term oral antiarrhythmic drug efficacy for ventricular tachycardia is complicated by the fact that mode of ventricular tachycardia induction varies from day to day in the absence of drug therapy. The purpose of this prospective study was to assess whether mode of ventricular tachycardia induction is more reproducible within one study than from day to day. Thirty-nine consecutive patients with documented sustained ventricular tachyarrhythmias secondary to coronary artery disease underwent three inductions of ventricular tachycardia at 15 min intervals in the absence of drug therapy. A stimulation protocol in which the only major variable was the number of extrastimuli required for tachycardia induction was used. Subsequent day to day variability in mode of tachycardia induction was also assessed in the same patients at two further drug-free inductions at intervals of 5 +/- 2 days. The number of extrastimuli required for tachycardia induction was significantly more reproducible at the immediate repeat studies than from day to day (69% of patients versus 31%, p less than 0.01). From these data, probability tables were derived that show the likelihood that changes in inducibility at subsequent tachycardia inductions are due to chance. The QRS configuration of induced ventricular tachycardia was also more reproducible at the immediate studies (64% versus 26%, p less than 0.01). Basic electrophysiologic and stimulation variables differed over a significantly wider range from day to day than at the immediate studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723273 TI - Comparison of endocardial and epicardial programmed stimulation for the induction of ventricular tachycardia. AB - Twenty-seven patients who had pairs of stainless steel wire electrodes placed on the right and the left ventricle during cardiac surgery underwent both epicardial and endocardial programmed ventricular stimulation to assess the inducibility of ventricular tachycardia. Twenty-six of the patients had coronary artery disease and were studied to evaluate map-guided surgery for treatment of ventricular arrhythmias. Burst ventricular pacing and up to three ventricular extrastimuli coupled to two drive train cycle lengths were delivered from the right and left ventricular epicardial wire electrodes and from endocardial catheter electrodes placed at the apex and outflow tract of the right ventricle. Ventricular tachycardia was reproducibly induced in three patients by both endocardial and epicardial stimulation. In one patient ventricular tachycardia was reproducibly induced by epicardial stimulation, but nonreproducible, nonsustained ventricular tachycardia was induced by endocardial stimulation. Ventricular tachycardia remained inducible by both endocardial and epicardial stimulation in three instances (two patients) during drug therapy. A negative study (less than 10 consecutive ventricular beats induced) was obtained in 23 patients by both endocardial and epicardial stimulation. The patients were followed up for 12 to 43 months (average 31). Sudden death or documented ventricular tachycardia occurred in two of the three patients with a positive study by both endocardial and epicardial stimulation. Nineteen (83%) of the 23 patients with concordantly negative studies remained free of arrhythmias. On the basis of concordant results of endocardial and epicardial stimulation (p = 0.001) these results suggest that epicardial stimulation of the right and the left ventricle is an acceptable method to assess the postoperative inducibility of ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723274 TI - Hemodynamic benefit of atrioventricular synchrony: prediction from baseline Doppler-echocardiographic variables. AB - The purpose of this study was to determine if baseline Doppler-echocardiographic variables of systolic or diastolic function could predict the hemodynamic benefit of atrioventricular (AV) synchronous pacing. Twenty-four patients with a dual chamber pacemaker were studied. Baseline M-mode and two-dimensional echocardiograms were obtained and Doppler-echocardiographic measurements of mitral inflow and left ventricular outflow were made in VVI mode (single rate demand) and in VDD (atrial synchronous, ventricular inhibited) and DVI (AV sequentially paced) modes at AV intervals ranging from 50 to 300 ms. Forward stroke volume and cardiac output were determined in each mode at each AV interval from the left ventricular outflow tract flow velocities, and the percent increase in cardiac output over VVI mode was determined. M-mode measurements, including left ventricular end-diastolic dimension, shortening fraction and left atrial size and Doppler measurement of diastolic filling, including peak early velocity and percent atrial contribution, did not correlate with the percent increase in cardiac output during physiologic pacing. The stroke volume in VVI mode correlated significantly with the percent increase in cardiac output during physiologic pacing (r = -0.61, p less than 0.005 for VDD mode and r = -0.55, p less than 0.05 for DVI mode). Five of the 15 patients with VVI stroke volume less than 50 ml but none of the 9 patients with stroke volume greater than 50 ml had ventriculoatrial (VA) conduction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723276 TI - Prospects for transpulmonary contrast echocardiography. PMID- 2723275 TI - Left heart opacification with peripheral venous injection of a new saccharide echo contrast agent in dogs. AB - Opacification of the left heart chambers after venous injection of echo contrast agents with transpulmonary capabilities has been difficult to achieve because of a lack of availability of a biodegradable nontoxic agent that produces uniformly small microbubbles. SHU-508 is a new saccharide echo contrast agent that produces bubble sizes from 2 to 8 microns in diameter, capable of traversing the pulmonary capillary bed and resulting in left heart contrast. The echo intensity produced by this agent was compared with that of agitated saline solution, indocyanine green and SHU-454 (another experimental saccharide agent for right-sided contrast) during 136 injections in eight dogs. Videotaped two-dimensional echographic images were digitized and analyzed with the use of videodensitometry for peak right and left ventricular intensity, pulmonary transit times and time of persistence of contrast. The highest right ventricular intensity value (3,594 +/- 1,393) was achieved with SHU-508 (p less than 0.05 compared with the other agents). The right ventricular contrast seen with SHU-508 also persisted for a longer period (22.8 +/- 12 s) than with the standard agents (p less than 0.001). Left ventricular contrast with SHU-508 was visually evident in all 42 injections, whereas the peak left ventricular intensity was 35% as bright as that produced in the right ventricle by the same agent. Peak left ventricular intensity values from SHU-508 were compared with those from agitated saline solution injected from the pulmonary capillary wedge position in four dogs. SHU-508 produced brighter left ventricular intensity (1,281 +/- 607) compared with that obtained with the saline-wedge technique (p les than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723277 TI - Sources of variability for Doppler color flow mapping of regurgitant jets in an animal model of mitral regurgitation. AB - To determine whether Doppler color flow mapping could be used to quantify changing levels of regurgitant flow and define the technical variables that influence the size of color flow images of regurgitant jets, nine stable hemodynamic states of mitral insufficiency were studied in four open chest sheep with regurgitant orifices of known size. The magnitude of mitral regurgitation was altered by phenylephrine infusion. Several technical variables, including the type of color flow instrument (Irex Aloka 880 versus Toshiba SSH65A), transducer frequency, pulse repetition frequency and gain level, were studied. Significant increases in the color flow area, but not in color jet width measurements, were seen after phenylephrine infusion for each regurgitant orifice. For matched levels of mitral regurgitation, an increase in gain resulted in a 125% increase in color flow area. An increase in the pulse repetition and transducer frequencies resulted in a 36% reduction and a 28% increase in color flow area, respectively. Jet area for matched regurgitant volumes was larger on the Toshiba compared with the Aloka instrument (5.2 +/- 3.1 versus 3.2 +/- 1.2 cm2, p less than 0.05). Color flow imaging of mitral regurgitant jets is dependent on various technical factors and the magnitude of regurgitation. Once these are standardized for a given patient, the measurement of color flow jet area may provide a means of making serial estimates of the severity of mitral insufficiency. PMID- 2723278 TI - Factors influencing the structure and shape of stenotic and regurgitant jets: an in vitro investigation using Doppler color flow mapping and optical flow visualization. AB - To evaluate factors influencing the structure and shape of stenotic and regurgitant jets, Doppler color flow mapping and optical flow visualization studies were performed with use of a syringe model with a constant rate of ejection to simulate jets of valvular regurgitation and a pulsatile flow model of the right heart chambers to simulate jets of mild, moderate and severe valvular pulmonary stenosis. Ink-(0 to 40%) glycerol-water jets (viscosity 1 to 3.5 centiPoise) were produced by injecting the fluid at a constant rate into a 10 gallon rectangular reservoir of the same still fluid through 1.4 and 3.4 mm needles. The Doppler color flow scanners imaged the laminar jet length within 3 mm of actual jet length (2 to 6 cm) and the jet width within 2 to 3 mm of the actual jet width. Jet flows with Reynolds numbers ranging from 230 to 1,200 injected into still fluid yielded jet length/width ratios that decreased with increasing Reynolds numbers and leveled off to a length/width ratio of 5-6:1 at a Reynolds number near 600. When the fluid reservoir was swirled to better mimic the effect of flow entering the same cardiac chamber from a second source, the jets showed diminution of the jet length/width ratio and a clearly defined zone of turbulence. Studies of the pulsatile flow model were performed at cardiac outputs of 1 to 6 liters/min for the normal and each stenotic valve. Mild stenosis had an orifice area of 2.8 cm2, moderate stenosis an area of 1.0 cm2 and severe stenosis an area of 0.5 cm2. Laminar jet length represented the length of the total jet, which had a symmetric width and was measured from the valve opening to a region where the jet exhibited a spray effect. Laminar jet lengths (0.2 to 1.1 cm) were imaged by Doppler color flow mapping and optical visualization only in the moderate and severely stenotic valves and only at flows less than or equal to 3 liters/min (mean Reynolds numbers less than or equal to 3,470). Beyond this flow rate the jets exhibited a spray effect. Laminar jet length/width ratio approached unity with an increased amount of valvular stenosis and higher flow volumes (cardiac output). Proximal aliasing was present in each valve studied. the length of aliasing (0 to 3.2 cm) proximal to the valve was longer with increased flow rates and increased amounts of stenosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723279 TI - Clinical significance of in vitro and in vivo experimental findings regarding Doppler flow velocity recordings. PMID- 2723280 TI - The American College of Cardiology, cardiovascular research and research careers. PMID- 2723281 TI - What is the role of vagal tone in the genesis of life-threatening ventricular tachyarrhythmias in humans? PMID- 2723282 TI - Erratum in coding of fat avoidance scale. PMID- 2723283 TI - Metric mix-up in rice flour muffin formulation. PMID- 2723284 TI - National Dairy Council and National Dairy Board. PMID- 2723285 TI - Southeast Asian renal exchange list: correction in table heading. PMID- 2723286 TI - Weight gain and pregnancy outcome in underweight and normal weight women. AB - The relationship of antenatal weight gain to pregnancy outcome was studied in 362 pairs of underweight women (less than 90% Metropolitan Relative Weight) and normal weight (90% to 110%) women who were matched for age, occupation, height, parity, race, and smoking habits. The mothers, selected from a study of pregnancy outcome in 1,080 middle-class women, had early and regular prenatal care. Regression analyses within each initial weight category revealed that there was no relationship between initial weight of mothers and birth weight of their infants, but birth weight increased significantly with antenatal weight gain (p less than .0001). A 1-kg maternal increase in weight was associated with a 12.85 gm increase in birth weight in offspring of underweight women and an 8.59-gm increase in offspring of normal weight women. Underweight women had significantly larger prenatal weight gains (9.3 vs. 8.5 kg), but there were no statistically significant differences in mean birth weight, gestational age, or Apgar scores between infants of women in the two weight groups. Very underweight women (less than 80% MRW) had lower-birth-weight infants, more preterm infants, and more infants with medical complications. Antenatal weight gain accounted for the greatest variation in birth weight among infants of underweight and normal weight women. When underweight mothers gained less than 9 kg, their infants had mean birth weights 361 gm less than the mean birth weights of infants of underweight women who gained more weight. PMID- 2723287 TI - Weight gain patterns during twin gestation. AB - Few data are available about desirable weight gain during twin gestation. The present study addresses this issue through retrospective evaluation of 217 women pregnant with twins who delivered at Swedish Hospital Medical Center, Seattle, between 1982 and 1986. The purpose of the study was to identify an optimum total weight gain and an optimum weight gain pattern for normal twin gestation. A mean prenatal weight gain of 20 kg (44 lb) was associated with "optimum" outcome; optimum outcome was defined as a pregnancy lasting at least 37 weeks with the delivery of two living infants weighing greater than or equal to 2,500 gm each with 5-minute Apgar scores greater than or equal to 7. A weight gain curve for twin gestation was generated and compared with the standard curve for singleton pregnancy. While the weight gain curve during twin gestation was similar to the standard curve during the first half of pregnancy, increased weight gain began in the second trimester and continued to term. The weight gain pattern of twin gestations with less-than-optimum outcome paralleled that of the optimum outcome group until about 30 weeks' gestation, at which time weight gain slowed in women in the former group, whose mean total weight gain was 16.8 kg (37 lb). PMID- 2723288 TI - Dietary cravings and aversions in the postpartum period. AB - Although food cravings and aversions are commonly experienced by pregnant women, the degree to which they persist in the postpartum period is unknown. This study examines this issue in both lactating and nonlactating women. A random sample of 463 subjects was selected from all prenatal patients receiving care at a large health maintenance organization (HMO). Even though almost all of the subjects reported craving some food or beverage during the last trimester of pregnancy and half reported some aversion, those phenomena dropped markedly in the postpartum period. Evaluation of dietary quality as related to food cravings revealed no clear association; that is, the data provided no evidence to support the hypothesis that cravings are caused by dietary deficiencies or that they result in significantly augmented intake of key nutrients found in those foods. Overall, food cravings and aversions do not continue into the postpartum period at a higher rate than one would expect in the adult female population; manifestation of food cravings/aversions is not related to dietary quality. PMID- 2723289 TI - Nutritional elements in U.S. diets: results from the Total Diet Study, 1982 to 1986. AB - Through the Food and Drug Administration's Total Diet Study, the levels of 11 nutritional elements (sodium, potassium, calcium, phosphorus, magnesium, iron, zinc, copper, manganese, selenium, and iodine) in the diets of eight age-sex groups were determined for the 4 years between 1982 and 1986. The 234 Total Diet Study foods, which are representative of the U.S. food supply, were purchased, prepared for consumption, and analyzed for the elements four times each year. The results were combined with national food consumption data to estimate intakes for 6- to 11-month-old infants, 2-year-old children, 14- to 16-year-old boys and girls, 25- to 30-year-old men and women, and 60- to 65-year-old men and women. Six elements (calcium, magnesium, iron, zinc, copper, and manganese) were low (less than 80% of the Recommended Dietary Allowance or below the low end of the Estimated Safe and Adequate Daily Dietary Intake range) for three or more of the age-sex groups. Six elements were of concern for teenage girls and adult women, five for older women, three for 2-year-old children, two for teenage boys and older men, and only one for infants and adult men. Sodium levels (which did not include discretionary salt) were elevated for 2-year-old children and teenage boys, and iodine was elevated for all age-sex groups. A significant trend was noted only for iodine, the intake of which decreased during the 4-year period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723290 TI - Distributional shape of nutrition data. AB - Nutrition data from 111 undergraduate college students (51 males and 60 females, ranging in age from 17 to 24) were studied with respect to the shape of the underlying probability distributions. Three-day averages for total energy, percent protein, percent saturated fat, percent unsaturated fat, percent complex carbohydrates, percent refined carbohydrates, cholesterol, sodium, vitamin C, and iron (measured in milligrams) were computed, and their distributions were compared with the normal (Gaussian) distribution. The distribution of values of sodium for females and, to a lesser extent, cholesterol for females and of cholesterol and vitamin C for males, differed from the normal distribution. The remaining distributions appeared to be reasonably close to normal in shape. It is recommended that nutrition researchers verify the normal distribution assumptions prior to applying parametric techniques to their data and that they use nonparametric (distribution-free) techniques to analyze their data whenever those assumptions are not valid. PMID- 2723291 TI - Mean proportion and population proportion: two answers to the same question? AB - Two different, but equally correct, answers can be given to a question such as "What proportion of the cholesterol that is consumed comes from eggs?" This is because the question can have two different meanings, depending on whether one is referring to the mean proportion of cholesterol from eggs or the population proportion. The mean proportion of cholesterol from eggs for a group of persons is determined by first calculating the proportion of cholesterol from eggs for each person and then taking an arithmetic mean of all the proportions. The population proportion is calculated by summing the amount of cholesterol from eggs for all persons and then dividing that by the sum of the cholesterol from all foods for all persons. These two different formulas often yield similar results. Sometimes, however, the results can be quite different because of variation in the ratio, variation in the denominator, and/or the correlation between the ratio and the denominator. Each of these formulas is designed to answer a specific question: the mean proportion addresses the question about the average per person and the population proportion addresses the question of population intakes. But because either may be used to answer the same general question, confusion may result. This article discusses the factors influencing differences between the two formulas and the implications of those differences for reporting and interpreting dietary intake data. PMID- 2723292 TI - Using evaluation strategies within a hospital-based dietetic education program: a case study. AB - A case study is presented to describe evaluation strategies used to document educational outcome resulting from a consortium-based hospital dietetic education program. Six supporting hospital facilities and 56 graduates were surveyed by questionnaire in June 1985. Within hospitals, results showed dietetic student time was defined as service-based for 46% of reported hours in foodservice experiences and for 54% in clinical experiences. A 71% graduate survey return revealed that 95% of the graduates sought and obtained employment after training, and 93% were employed in 1985 (classes 1974 to 1984). PMID- 2723293 TI - Water-soluble vitamin intakes of infants consuming mixed diets. PMID- 2723294 TI - Effects of microwaving human milk: changes in IgA content and bacterial count. AB - On the basis of this study, IgA was best preserved in frozen human milk by thawing either overnight in the refrigerator or under warm running water. If either of those procedures are to be used, it is suggested that bacterial monitoring should be performed. Because current technology does not allow for accurate low internal temperature monitoring of liquids, it is concluded that use of the microwave oven for the treatment of human milk is inappropriate. However, because microwaving is as effective as holder pasteurization in killing bacteria, and because it would be less expensive and is faster, this process should be further investigated. PMID- 2723295 TI - Nutrition knowledge and attitudes and menu planning skills of family day-home providers. PMID- 2723296 TI - Reimbursement for nutrition services: profile of third-party payers in Utah. PMID- 2723297 TI - Dietetic internship formats: director and intern perceptions. PMID- 2723298 TI - What is on the menu at the child care center? PMID- 2723299 TI - Validation of a nutrient adequacy score for use with women and children. AB - The purpose of this study was to develop and validate a nutrient adequacy score to be used by nutrition programs for women and children. The study population included 1,431 children, teenagers, and pregnant and lactating women. A dietary score was developed to be limited if certain targeted subgroups of major food groups were not included. Scores were related to Mean Adequacy Ratios (MARs), truncated indexes of the percent of the Recommended Dietary Allowances for protein, calcium, iron, magnesium, phosphorus, vitamin A, thiamin, riboflavin, vitamin B-6, vitamin B-12, and vitamin C through the use of correlation/regression analysis. Separate analyses were run for each of nine different population segments. Regression coefficients were used to generate predicted MAR values that were, in turn, used to categorize individuals according to certain cut-off points. Individuals were also categorized by their actual MARs, according to the same cut-off points. These categorizations provided the basis for validating the score. The score correctly classified 69% to 98% of the persons in each population segment. The score was most sensitive for population segments that have a large proportion of persons below a particular cut-off. Just as important, the score was simple to implement, requiring just three steps from assessing the food frequency to determining risk. PMID- 2723300 TI - Recall of a child's intake from one meal: are parents accurate? AB - Although the accuracy of dietary intake information for children has previously been studied, methodological issues make the results of those studies difficult to interpret. In order to address one of the major methodological issues, unobtrusive observations were performed on the lunch meal of 34 children. These children ranged in age from 4.0 to 9.5 years (mean = 5.8 years, standard deviation = 1.6 years). Each child was accompanied by both parents. Dietary recalls were obtained the following day from (a) the mother alone, (b) the father alone, and (c) the mother, father, and child reporting as a group (consensus recall). Recalls were analyzed with nutrition software that yields information on energy, protein, carbohydrate, sugar, total fat, cholesterol, sodium, iron, and calcium. Strong correlations were seen between each recall and the observation (mean r = .86). However, the group accuracy in correctly reporting different types of foods varied from the fathers' under-reporting of breads (-27%) to fathers' over-reporting of fruit (+50%). When regression analyses were used, only the consensus recall resulted in a regression line not significantly different from 1.0 for the majority of the nutrients analyzed. Thus, it appears that the consensus recall produced a better estimate of the observed intake from one meal than did recalls obtained from mother or father. PMID- 2723301 TI - Weight loss and senile dementia in an institutionalized elderly population. AB - The purpose of this study was to determine whether patients with Alzheimer's disease or senile dementia have a higher incidence of underweight and weight loss than non-demented patients. In a retrospective study, the admission weight and height and the current weight of 36 patients with Alzheimer's disease and senile dementia of the Alzheimer's type were compared with those of 31 non-demented patients. Patients with Alzheimer's disease or senile dementia were significantly (p less than .05) further below minimum acceptable body weight on admission and were significantly (p less than .05) further below minimum acceptable body weight after an average of 17 months in the institution in comparison with the control group. Additional research is needed to determine whether the weight loss seen in patients with Alzheimer's disease or senile dementia is due to a metabolic aberration inherent in the disease or to management issues in feeding those patients. PMID- 2723302 TI - Effect of household size on nutritional patterns among the Dutch elderly. AB - Elderly persons are vulnerable to nutritional risks. Factors such as living alone make the elderly prone to poor nutritional status as a result of inadequate diets. The results of a Dutch national nutrition survey of food consumption and nutritional status among 539 independently living, apparently healthy elderly persons, aged 65 to 79 years, show that in general the intake of macronutrients deviates from the Dutch recommendations. In particular, saturated fat intake and P:S ratio were unfavorable, especially for the solitary elderly persons (saturated fat intake 19.0 +/- 3.2% and 17.7 +/- 3.3% total energy for men and women, respectively). Except for vitamin B-6 (about 92% of the recommendation on a group level for men and 78% for women), the intake of micronutrients studied is considered to be adequate. Elderly women living alone had a higher calcium:phosphorus ratio (0.76 +/- 0.12), lower meat consumption (90 +/- 31 gm), and a lower mean HDL-cholesterol concentration (1.22 +/- 0.28 mmol/L) in serum than non-solitary elderly women (Ca:P ratio 0.73 +/- 0.12, meat consumption 100 +/- 36 gm, HDL-cholesterol concentration 1.45 +/- 0.38 mmol/L). Potatoes, vegetables, and meat were more often prepared for more than one day at a time by elderly persons living alone than by the non-solitary elderly. PMID- 2723303 TI - Food habits and dietary change of Southeast Asian refugee families living in the United States. AB - Food habits and changes in food consumption patterns were assessed among 60 Southeast Asian refugee families (Cambodian and Hmong) living in the United States. With the use of a structured interview schedule, in-home interviews were conducted by a Hmong or a Cambodian bilingual staff person with the adult having primary responsibility for family meal preparation. Results indicated that while food buying practices have changed drastically in the U.S., Southeast Asian refugee families have maintained strong ties to their native foods and traditional diets. In the U.S., as in Southeast Asia, rice remains the staple food in their diet. High status foods in Cambodia and Laos, such as fruits, meats, and soft drinks, remain highly preferred foods in the U.S. and are consumed frequently. Although most adults prefer eating their native foods, their children prefer both American and native foods. Thirty percent of the adolescents in the home had major responsibility for evening meal preparation. PMID- 2723304 TI - The cholesterol/saturated fat index of the food supply and nutrient intake in an Israeli community compared with the general population. AB - The average annual death rate from--as well as incidence of--myocardial infarction in the kibbutzim of the Upper Galilee, Northern Israel, is twice that of the general Israeli population. Since dietary habits probably have a role in the etiology of this chronic disease, we compared the food supply in two kibbutzim with the average Israeli consumption. Food supply and a sample of nutrient intake were computed and calculated per person. Energy, protein, and fat (including cholesterol and saturated fat) consumption in the kibbutzim was higher than the average Israeli intake. Similarly, the cholesterol/saturated fat index was 1.4 and 2.8 times higher in kibbutz A and 1.3 and 2.6 times higher in kibbutz B than the average for the Israeli population and the recommended value, respectively. These findings may explain the high morbidity and mortality related to ischemic heart disease found in the kibbutzim. PMID- 2723305 TI - The cholesterol-saturated fat index for coronary prevention: background, use, and a comprehensive table of foods. AB - The potential of a food or a diet to raise the plasma level of total and low density-lipoprotein cholesterol and to promote atherosclerosis is directly related to its cholesterol and saturated fat content. A new formula that indicates the concentrations of cholesterol and saturated fat in foods, termed the cholesterol-saturated fat index (CSI), has been devised. A low CSI indicates low saturated fat and/or cholesterol content and thus hypocholesterolemic and low atherogenic potential. Guidelines are provided for using the CSI to evaluate or plan low-fat diets, for comparing a food or a mixed dish with others, and for evaluating a day's food intake. A comprehensive table of foods is presented. PMID- 2723306 TI - "Dine to Your Heart's Content": an assessment of the program in Virginia. AB - The "Dine to Your Heart's Content" program in Virginia was examined from the perspectives of both patrons and restaurateurs. Both groups were tested on knowledge of food composition relative to fats and oils. Additionally, restaurateurs responded to questions concerning the need for nutrition education for their personnel. Eighty-eight percent of the 178 patrons expressed an interest in following a heart-healthy diet: 55% maintained that they always or often were motivated by health-related considerations when selecting menu items. The most important characteristics of the menu items (5-point scale, 1 = least important) were reported to be low cholesterol (3.85 +/- 1.01), low saturated fat (3.77 +/- 1.05), low total fat (3.76 +/- 1.03), low sodium (3.69 +/- 1.15), and low calorie (3.57 +/- 1.13). Fifty-seven percent of the patrons were aware of the program, but most of them dined in participating restaurants less than half of the time they dined out. There were no significant differences between the scores of patrons and restaurant personnel regarding knowledge of fat and oil content of foods. The overall mean score for the entire group was 6.09 +/- 3.4 points out of a possible 13 points. Restaurateurs cited nutrition education for waitstaff and assistance in the identification of appropriate menu items as aspects of the program most in need of further development. The major disadvantage of the program cited was potential negative attention drawn to some menu items. Overall, however, restaurateurs concurred that the advantages of participation in the program outweighed the disadvantages. All of them stated that the major advantage of the program was the ease with which a public service could be provided to their patrons while, simultaneously, the image of the restaurant was enhanced. PMID- 2723307 TI - Extension of health and nutrition services via advanced telecommunications. AB - The present and future technology of telecommunications will revolutionize the promotion and dissemination of health and nutrition services. Telecommunications can extend health and nutrition services because of its communicating and tracking capability. The University Affiliated Cincinnati Center for Developmental Disorders' Federal Project and other selected projects and programs using telecommunications technology illustrate the promotion and dissemination of nutrition and health services and the economic and efficient aspects of teleconferencing, electronic mail, and video imaging. This technology must be incorporated into the field of nutrition and health to meet the changing advances in the world and to improve the nutrition and health of individuals--particularly those who are at high risk, such as children with developmental disorders and chronic diseases. PMID- 2723308 TI - Assessing productivity of foodservice systems in nutrition programs for the elderly. AB - A pilot study was conducted to develop a monitoring instrument for the measurement of productivity in nutrition programs for the elderly. Observations of foodservice activities were collected for 3 days in each of three senior centers utilizing cook/serve production models. Direct work activity categories included processing, service, transportation, clerical, cleaning, and receiving. Delay activities included personal delay and idle time. Information was gathered on the number of meals served. A method to recognize the equivalent work of senior citizen volunteers was developed. Productivity ratios were calculated as average labor minutes in each activity per meal served. Labor time was consistent within centers, and productivity varied with number of meals served. Average productivity ranged from 12.95 to 19.30 labor minutes per meal. PMID- 2723309 TI - Dietary fat intake: demographics. PMID- 2723310 TI - Calculation of aspartame intake in children. PMID- 2723311 TI - Pleasantness perception of salt in young vs. elderly adults. PMID- 2723312 TI - Dietary intake of calcium, iron, folacin, alcohol, and fat for college students in central Michigan. PMID- 2723313 TI - Position of The American Dietetic Association: nutrition intervention in the treatment of human immunodeficiency virus infection. PMID- 2723314 TI - Caring for caregivers: a woman's issue. PMID- 2723315 TI - Mothers in medical school. PMID- 2723316 TI - Sexist language: should we be concerned? AB - What is sexist language? It is inherently discriminatory language, either written or spoken, that implies an unjustified sexual bias against a group or an individual, usually women, but sometimes men. The identification of sexist language and the need for a change to nonsexist forms have long been topics of controversy. In this article we review the history of the debate as well as the evidence that this form of discriminatory language causes harm. The latter point is important, since the whole question is often dismissed as insignificant. The relevance of the issue to scientific and, particularly, medical writing is explored. Finally, a survey of journal writing is presented to help answer first, the question of how much of a problem still exists, and second, if so, what recommendations are needed to ameliorate it. PMID- 2723317 TI - Gender equity. PMID- 2723318 TI - Reflections on geriatrics in Great Britain. PMID- 2723319 TI - Maternal/fetal rights: two views. AB - The autonomy of a pregnant woman is seriously compromised if she is pressured, threatened, or forced to submit to medical or surgical treatment to which she does not consent. The missionary zeal of physicians, judges, and society to save the at-risk fetus at times violates the competent woman's right to make decisions about the integrity of her body. All avenues must be explored to preserve the health of the fetus, but at the same time, the mother's need for self determination must be respected. Inevitably, clinical emergencies requiring a choice between the life of the fetus and that of the mother will arise. In crisis situations the pregnant woman has a right to choose. PMID- 2723320 TI - Three cheers for elective hysterectomy. PMID- 2723321 TI - Quality of glass and polycarbonate bifocal dress lenses. AB - A survey of the quality of bifocal glass and polycarbonate dress lenses was conducted to determine how well these lenses conform to the ANSI (American National Standards Institute) Z80.1 standard and to identify processing operations that need improvement. Eight different prescriptions were filled with polycarbonate and glass dress lenses by different laboratories. Conformance to the ANSI Z80.1 standard was determined for seven characteristics of individual lenses and one characteristic (vertical prism imbalance) of the pairs of lenses in prescriptions. The results show that 78% of the glass lenses and 43% of the polycarbonate lenses conformed to ANSI Z80.1 for the seven characteristics of individual lenses. For pairs of lenses, 88% of the glass pairs and 71% of the polycarbonate pairs have acceptable vertical prism imbalance. Glass lenses that did not conform failed for a variety of reasons, none of which dominated. Incorrect add power and excessive prism were the major causes of polycarbonate lenses not conforming. PMID- 2723322 TI - Clinical objective assessment of the accommodative response. AB - Objective assessments are often needed in a visual examination, and are often more reliable, and therefore helpful, in the decision-making process of patient care. One visual function that is generally evaluated subjectively is accommodation. In those patients that cannot respond properly, an objective assessment is needed. This paper discusses a procedure for the objective assessment of the amplitude of accommodation, the status of the accommodative response of each eye, and the facility of accommodation. PMID- 2723323 TI - A normative study of step vergence in elementary schoolchildren. AB - The purpose of this study was to develop normative data for step vergence testing in children age 6-12. Such data are not currently available for this age group. Base-in and base-out step vergence testing with a prism bar was performed on 386 elementary schoolchildren who had all passed a modified clinical technique (MCT) screening. A new polarized target was developed which enabled us to detect suppression, as well as diplopia or blur. The findings suggest significant differences from normative data previously reported for adults. Because the data for 6-year-olds were different from the rest of the group, we suggest that lower norms be used for this age group. This study provides expected findings for step vergence testing outside the phoropter, which can be used clinically for the assessment of disparity vergence ranges in young children. PMID- 2723324 TI - Ocular manifestations of Lyme disease. AB - The incidence of Lyme disease has been increasing at alarming rates in recent years. Being the most commonly reported tickborne bacterial disease in the United States, it now outnumbers Rocky Mountain spotted fever by a ratio of almost 2:1. It is a multisystem illness and can manifest itself with dermatologic, neurologic, cardiac and rheumatologic involvement. The ocular complications of Lyme disease can present as one of the more ominous signs during the course of the illness. The detection of the disease and proper referral by the optometrist may permit more appropriate treatment, and thus, a better prognosis of the illness. PMID- 2723325 TI - Instrument accommodation compensation of single lens reflex camera viewfinders. AB - An instrument accommodation compensation is built into the viewfinders of single lens reflex cameras. The extra accommodation required when using these cameras can cause difficulty for some patients. This paper presents a simple method for measuring the instrument accommodation compensation of reflex cameras and presents the results of such measurements for several cameras. PMID- 2723326 TI - Coats' disease. AB - Coats' disease is an ocular condition characterized by telangiectatic vessels, microaneurysms, and intraretinal and subretinal exudates. This disease entity is usually uniocular, occurs in young males in their first decade of life, and has a prevalence for the temporal retina. A case report of Coats' disease is presented along with a discussion of its management and treatment. PMID- 2723327 TI - Posterior scleritis with secondary ciliochoroidal effusion. AB - Posterior scleritis is a granulomatous inflammation occurring either within the scleral tissue or in the vascular networks adjacent to it. This inflammatory process can cause leakage of fluid from the choroid into the suprachoroidal space leading to ciliochoroidal effusion and an exudative retinal detachment. The following is a case report of a 64 year old white male, who presented with an acute angle closure attack and myopic shift in one eye, and later developed an exudative choroidal and retinal detachment. Posterior scleritis was diagnosed based on ultrasonography and the orbital CT scan findings. The acute angle closure attack, myopic shift and exudative detachments completely resolved with the use of oral steroids and cycloplegics. PMID- 2723328 TI - Methyldopa-related convergence insufficiency. AB - A case report of convergence insufficiency related to the use of methyldopa is presented. Methyldopa is a systemic antihypertensive agent. It has sympatholytic properties which lower blood pressure by decreasing peripheral vascular resistance. The proposed effects of methyldopa on binocular vision are reduced accommodative convergence and increased demand on fusional convergence. These effects would create a susceptibility to convergence insufficiency. To my knowledge, an association between methyldopa and convergence insufficiency has not been previously reported. PMID- 2723329 TI - Now it can and should be told. PMID- 2723330 TI - The use of fluorescamine as a detection reagent in protein microcharacterization. AB - With recent advances in protein microchemistry, compatible methods for the preparation and quantitation of proteins and peptides are required. Fluorescamine, a reagent which reacts with primary amino groups has been used successfully to detect amino acids, peptides, and proteins in various micromethods. This article discusses these methods which include (1) amino acid analysis of protein and peptide hydrolysates with postcolumn fluorescamine derivatization; (2) purification and characterization of proteins and peptides by reversed-phase HPLC with postcolumn fluorescamine derivatization; (3) purification of peptides by two-dimensional chromatography and electrophoresis on thin-layer cellulose with fluorescamine staining; and (4) electroblotting of protein bands from SDS-PAGE to glass fiber filters and polyvinylidene difluoride (PVDF) membranes with fluorescamine staining. In addition, this article also compares a postcolumn fluorescamine detection system with a UV detection system in the applications of amino acid analysis and reversed-phase HPLC protein/peptide analysis. PMID- 2723331 TI - On the evaluation of data from flow-dialysis experiments. AB - Flow dialysis can be used to measure (i) ligand binding to macromolecules and (ii) the size of transmembrane ion gradients. Generally an approximate method is used to calculate the binding or gradient parameters from the raw data. Here we present a simple but exact method and evaluate the errors that may arise when the approximate method is used to calculate the magnitude of ion gradients. In addition, equations are presented that allow for a correction for sampling from or additions to the upper compartment of a flow-dialysis vessel during the measurements. Setty and Hendler [(1982) J. Biochem. Biophys. Methods 7, 35-46] have reported artifacts in the measurement of ion-gradients caused by the addition of electron donors to the upper compartment of a flow-dialysis cell. Here we extend their observations and suggest additional methods to prevent such artifacts. PMID- 2723332 TI - Isoelectric focusing of tryptic peptides from hemoglobin subunits by immobilized pH gradients. AB - The technique of isoelectric focusing on immobilized pH gradients (IPG) has been applied to the analysis of tryptic digests of alpha- and beta-chains of human hemoglobin. Using peptides purified by RP-HPLC as a reference, it was possible to create a peptide map in the single IEF dimension. Unfortunately, it was not possible to find experimental conditions (medium for migration and staining) which would allow the detection of peptides of less than 10-12 residues. Almost all the bands visible on the gel could be assigned to known peptides. In order to obtain these results the IPG runs were performed in 8 M urea containing 0.5% carrier ampholytes and the gel stained with colloidal Coomassie brilliant blue G 250, in the presence of a high-salt concentration and at acidic pH. PMID- 2723333 TI - Effects of carotid sinus nerve stimulation at different times in the respiratory and cardiac cycles on variability of heart rate and blood pressure of normotensive and renal hypertensive dogs. AB - It was the purpose of the present study to determine (1) whether or not there exists a common respiratory and cardiac cycle time effect of the baroreceptor control of heart rate (HR) and blood pressure (BP) in spontaneously breathing anaesthetized dogs and (2) whether this effect, if present, is abnormal in dogs with renal hypertension. The baroreflex responses were evoked by brief low intensity electrical carotid sinus nerve stimulation (CSNS) triggered by the R wave in the electrocardiogram with an adjustable delay (0-210 ms) and positioned in either inspiration or expiration. All baroreceptor afferent nerves were intact. Brief CSNS had no noticeable effect on breathing. The responses of means of HR, respiratory sinus arrhythmia (RSA), and systolic and diastolic respiratory blood pressure waves (RBPWsyst, RBPWdiast) to CSNS were not different for normotensive and hypertensive dogs. No cardiac, but a small respiratory cycle time effect on means of HR, BPsyst and BPdiast was observed. The magnitude of RSA and RBPWdiast was markedly enhanced for expiratory CSNS at each delay after the R wave. Inspiratory CSNS diminished the magnitude of RSA and RBPW only if applied during systole, and become ineffective for delays greater than 200 ms after the R wave. During both respiratory phases, CSNS was elevated at times of central presentation of the natural sinoaortal baroreceptor discharges (120 ms and 70 ms, respectively). The magnitudes of RSA and RBPW were influenced simultaneously and in the same way by CSNS throughout. It is concluded that, under the present experimental conditions, RSA and RBPW have a common central origin. PMID- 2723334 TI - Effects of superior mesenteric and coeliac ganglionectomy on peptide-producing cells of the small intestinal mucosa in the Hanford mini pig. II. Immunohistochemical study. AB - Superior mesenteric and coeliac ganglionectomy was performed in 5 Hanford mini pigs and cholecystokinin (CCK)-immunoreactive I-cells, neurotensin (NT) immunoreactive N-cells, glucagon (Glu)-immunoreactive L-cells, glicentin (Glic) immunoreactive L-cells and somatostatin (Som)-immunoreactive D-cells were quantitatively evaluated in the duodenum, the upper, middle and lower jejunum and the ileum before, 3 weeks and 6 months after ganglionectomy. Three additional animals served as controls. After ganglionectomy, I-cell numbers increase by 110% in the upper jejunum and duodenum; N-cells increase by 86% in the lower jejunum. Glu- and Glic-immunoreactive L-cells decrease slightly in the jejunum. In contrast, D-cells decrease in all sections of the small intestine by 44-76% (P less than 0.05 and P less than 0.001). All the examined entero-endocrine cells, except the D-cells in the duodenum and upper jejunum, develop hypertrophy after ganglionectomy. No changes either in number or size are found in the ganglia and neurons of the myenteric plexus. From these and the recently described increase in villus height and absorptive cells and absorptive cell enzymes after ganglionectomy (Holle, G.E. et al. Effects of superior mesenteric and coeliac ganglionectomy on the mucosa of the small intestine in the Hanford mini pig. I. Histological and enzymhistochemical study, J. Auton. Nerv. Syst., 26 (1988) 135 145), we conclude that the extrinsic nervous system takes suppressive influence on structure and probably function of the small intestinal mucosa by modifying its cellular organization. PMID- 2723335 TI - Interactive responses to stimulation of the amygdaloid central nucleus and baroreceptor afferent activation in the rabbit. AB - Recent evidence suggests that the amygdaloid central nucleus (ACE) may contribute to the regulation of arterial baroreceptor-vagal reflex sensitivity. To obtain additional data relevant to this suggestion, interactions between stimulation of the ACE and arterial baroreceptor afferent activation were examined. New Zealand rabbits were anesthetized with alpha-chloralose and a stimulating electrode was implanted stereotaxically in the ACE. In the first series of experiments, cardiovascular responses to stimulation of the ACE were assessed during periods in which blood pressure was decreased using sodium nitroprusside or increased in the rostral arterial compartment by inflating the tip of a Swan-Ganz catheter positioned in the descending aorta. It was found that the magnitude of bradycardia to stimulation of the ACE was correlated with the level of arterial blood pressure at the onset of stimulation, such that higher blood pressures were associated with larger bradycardic responses. These data suggest that arterial baroreceptor afferent activity may be an important factor in the elicitation of bradycardia from the ACE. In the second series of experiments, the aortic nerve was isolated, and cardiovascular responses to stimulation of the aortic nerve and to low frequency (5 Hz) stimulation of the ACE were assessed both alone and in combination. Stimulation of the aortic nerve during low frequency stimulation of the ACE was found to produce bradycardia of a significantly larger magnitude than the sum of the responses produced by each stimulus presented alone. These data demonstrate that bradycardia to stimulation of baroreceptor afferent fibers is augmented significantly during low frequency stimulation of the ACE. Taken together, these results are consistent with the notion that the ACE may contribute to the sensitivity of the arterial baroreceptor-vagal reflex. PMID- 2723336 TI - Evidence that blood vessels in guinea-pig lung are supplied by both noradrenergic and dopaminergic axons. AB - Assay of catecholamines in guinea-pig lung showed that the amount of dopamine in this tissue is 3-4 times greater than that predicted to be associated only with noradrenergic nerves, and is depleted by animal treatment with 6-hydroxydopamine. Fluorescence microscopy after formaldehyde condensation did not reveal any non neuronal stores of catecholamines within the lung. The pulmonary and bronchial arterial vessels are accompanied by numerous fine nerve fibres that exhibit immunoreactivity for tyrosine hydroxylase, and are therefore presumed to be catecholaminergic. A small proportion of these fibres are also immunoreactive for DOPA decarboxylase. The results are consistent with innervation of pulmonary and bronchial resistance vessels by dopaminergic as well as noradrenergic sympathetic axons. PMID- 2723337 TI - Autonomic nervous reflexes in respiration elicited by mechanical stimulation of the velopharyngeal region in rabbits. AB - Reflex increases in peak activity of the diaphragm and expiratory pharyngeal muscles were recorded in lightly anesthetized and vagotomized rabbits by gentle mechanical stimulation of the nasal surface of the soft palate and of the posterior wall of the nasopharynx. No noticeable change in diaphragmatic activity was evoked by gentle mechanical stimulation of the oral surface of the soft palate and of the posterior wall of the oropharynx. The present results suggest that afferent signals from mechanoreceptors of the velopharyngeal region may contribute to reflex augmentation of respiration. PMID- 2723338 TI - Plasma levels of catechols after fasting in intact or adrenal-demedullated rats. AB - We compared arterial plasma levels of catechols after a 24-h fast with levels after 24 h of an ad libitum diet in conscious rats. Epinephrine concentrations were significantly decreased after the fast; levels of norepinephrine, dopa, and dihydroxyphenylglycol were unaffected. Adrenal-demedullated rats had decreased levels of dopa regardless of dietary intake and lower levels of norepinephrine after fasting than during the usual diet. The results indicate that fasting decreases adrenomedullary activity in intact animals, with little or no effect on sympathoneural activity. PMID- 2723339 TI - Adrenergic and VIP-ergic relaxatory mechanisms of the feline extrahepatic biliary tree. AB - Relaxatory mechanisms of the extrahepatic biliary tree were investigated in anesthetized cats allowing separate recordings of the sphincter of Oddi, gallbladder and duodenal wall. Regional intra-arterial administration of vasoactive intestinal peptide (VIP) elicited dose-dependent relaxatory motor responses, which were not influenced by blockade of cholino- or beta adrenoceptors, but were most probably due to activation of VIP receptors at the smooth muscle membrane. Efferent electrical vagal nerve stimulation unmasked relaxatory motor responses after previous blockade of muscarinic cholinoceptors. The neural transmission did not involve beta-adrenoceptors but was effectively antagonized after additional blockade with hexamethonium. Since both nerve terminals and ganglion cells with VIP-like immunoreactivity were abundant in the feline sphincter of Oddi, VIP is one possible transmitter candidate of the postganglionic inhibitory neurons. Non-selective activation of beta-adrenoceptors by isoprenaline or selective activation of beta 2-adrenoceptors by terbutaline also induced a dose-dependent relaxation of these regions. On a molar basis, relaxation via beta-adrenoceptors was 40-50 times less potent than via VIP. Both types of beta-adrenergic relaxation were antagonized by propranolol. The terbutaline-induced responses were selectively antagonized by beta 2-adrenoceptor blockade. To evaluate the role of beta 1-adrenoceptors, non-selective stimulation with isoprenaline was given; this relaxation was little influenced by blockade of beta 2-adrenoceptors but was completely antagonized by propranolol. In all experiments using beta-adrenoceptor antagonists these drugs each increased the basal tone of the preparation suggesting release of tonic inhibition exerted via beta-adrenoceptors. PMID- 2723340 TI - Immunoreactive thyroglobulin in sera and saliva of patients with various thyroid disorders: role of autoantibodies. AB - The present study was designed to assess the transfer of thyroglobulin (Tg) and anti-Tg antibodies (TgAb) to saliva in subjects with positive TgAb in their sera. Group I consisted of normal euthyroid control subjects (n = 10). Group II were patients with various thyroid disorders and no TgAb in their sera (n = 6). Group III were patients with thyroid disorders and TgAb in their sera (n = 31). The mean serum Tg level (+/- SE) and mean TgAb level [mean % binding +/- SE (range)] were as follows: Group I, Tg: 22.0 ng/ml +/- 1.64 (n = 10); TgAb 1.91% +/- 0.34 (range 0.6% to 4%). Group II, Tg: 119.8 ng/ml +/- 28.0 (n = 6) TgAb 1.59% +/- 0.34 (0.64% to 2.7%). Group III Tg 167.9 ng/ml +/- 41.0 (n = 31) TgAb 23.2% +/- 3.87 (4.2% to 67.5%). The mean salivary Tg level (SaTg) and mean TgAb binding (% +/- SE range) in saliva were as follows: Group I SaTg 2.07 ng/ml +/- 0.39 (n = 10) SaTgAb 1.13% +/- 0.38 (0% to 3.1). Group II SaTg 3.41 ng/ml +/- 0.67 (n = 6), SaTgAb 0.55% +/- 0.29 (0-1.9%). Group III SaTg 5.22 ng/ml +/- 0.96 (n = 31), SaTgAb 3.1% +/- 1.58 (0 to 47.7%). Salivary TgAb were only present in 4 out of 31 cases of Group III. Mean serum Tg in group IV-A was 75.01 ng/ml +/- 52.1 (n = 11). Mean serum TgAb in group IV-A was 1.94% +/- 0.31 (n = 11).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723341 TI - Possible association of aldosterone producing adenoma and non-functioning adrenal tumor. AB - A 37-year-old woman presented with hyperaldosteronism, suppressed renin levels, and a left adrenal mass on CT scanning. Selective adrenal venous sampling indicated a marked rise of the aldosterone level in the right adrenal vein, while the level in the left vein was low. On laparotomy, an aldosterone producing adenoma (APA) of 12x10x5 mm in size was found in the right adrenal gland and was resected, while the left mass was left in situ. The post-operative course showed normalization of both the clinical and biochemical features of primary aldosteronism, with no sign of recurrence or of enlargement of the remaining adrenal mass in 2.5 years of follow up, suggesting the possible coexistence of a "non-functioning" tumor. This case demonstrates the importance of adrenal venous sampling for the localization of APA particularly since the presence of the APA may be masked by a visualized but unrelated adrenal mass. PMID- 2723342 TI - Clinical nurse practitioners. Identifying their roles. AB - 1. The functions of GCNS may be vague and therefore difficult to implement. A GCNS with a secondary role, such as in discharge planning, can make the GCNS more visible. 2. The secondary role of discharge planning is complimentary to the role of GCNS and allows the GCNS easy access to the geriatric patients. 3. To provide the GCNS with more visibility, a specific plan including education and community programs was needed. 4. Because of the wide spectrum of information in gerontological nursing, GCNS must define their limitations. PMID- 2723343 TI - Geropharmacology treatment: behavioral problems extend nursing responsibility. AB - 1. Assessment of older adults with behavior problems considers factors contributing to the behavior; potential psychosocial interventions; patient characteristics influencing medication action; and medication characteristics influencing therapeutic and adverse effects. 2. Anxiety, agitation, and other behavioral problems in demented patients might arise from their inability to verbally express complaints such as pain and discomfort. 3. Although constant blood levels of medication are most effective for ongoing management of behavior problems, as needed doses can be used to establish the optimal dosing schedule. 4. Medications in low doses can be used to improve the patient's response to psychosocial interventions for behaviors such as anxiety, agitation, depression, and sleep disorders; but they should not be used as the only intervention. PMID- 2723344 TI - Making a difference: the gerontological CNS. AB - 1. While the role components and the activities of CNSs may be common to them all, what differentiates the gerontological CNS from others is the target population. 2. There are some data to support the claim that these nurses reduce the severity and incidence of complications, prevent readmissions, and facilitate timely discharges. 3. Researchers have found that with a nurse practitioner on staff, four out of five employers reported significantly improved patient care and improved staff nurse performance. 4. While the prevention of injury to elders is crucial from a nursing perspective, it is also extremely beneficial from a fiscal perspective. PMID- 2723345 TI - [Cervical smears in general medicine. Evaluation of the regular performance of cervical smears among the patients of general practitioners in the Rhone-Alpes region]. AB - Cervical smears in the area of "Rhone Alpes" are evaluated through a population examined by general practitioners. Among 10,000 examined women, aged from 15 to 69 years, 20% had never been smeared. In 8% of the remaining 8,000 cases, the smear was realized since more than 5 years. Absence or prolonged delay was more frequently met with more aged women, from unfavorable or rural area; or foreigner (from South of Europe or from North-West Africa). These results are discussed and compared with those of other studies whether inside or outside France. Certainly, they are under-estimated as regards the general population. In fact, this study considers an already mostly medicalized population together with volunteer general practitioners. However, it's always less medicalized than in most of French studies considering this subject. PMID- 2723346 TI - [Role of Chlamydia trachomatis in tubal pathology (acute salpingitis and tubal sterility). Microbiological study of 175 samples of peritoneal fluid]. AB - The study was carried out on 175 patients who underwent laparoscopy together with search for chlamydia in the peritoneal fluid when they were having investigations for sterility or for pelvic pain. These patients are classified into three groups according to the clinical and laparoscopic features: 50 cases of acute salpingitis. 104 cases of tubal sterility and 21 control cases who were normal on laparoscopy. The mean age was 25.7 years for acute salpingitis and 30.4 years for tubal sterility. The purpose of this study was to work out the role played by chlamydia trachomatis in tubal phatology and two techniques were used at the same time: The identification of chlamydia trachomatis in 175 samples of peritoneal fluid taken during a laparoscopy; Research for anti-chlamydia antibodies in serum using an indirect micro-immunofluorescent technique. Cell cultures were performed after the peritoneal fluid had been centrifuged. It had been in transport medium 2 SP and frozen. Our technical methods for isolating chlamydia (microplaque culture on Hela lines, incubation in the presence of cycloheximide and research for chlamydial inclusion bodies using direct immunofluorescence with monoclonal antibodies and 2 successive passages of the cells) have allowed us to confirm that chlamydia was present in 44% of cases of acute salpingitis and in 37% of cases of tubal sterility. The search for anti-chlamydial antibodies in the serum in indirect immunofluorescence with a single antigen (of L2 serotype) gave positive results which were comparable to those in other studies, i.e. 50% of positive serological results in acute salpingitis and 63% in tubal sterility.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723347 TI - [Angiosarcoma of the breast]. AB - Angiosarcoma of the breast is a rare connective tissue tumour, there having been fewer than 100 cases described. It occurs practically only in women and presents as a phylloid tumour of rapid growth in a young woman. There may be inflammatory phenomena; local trauma is often mentioned. The diagnosis is difficult and relies on the histological examination of biopsy specimens or of the whole specimen removed. The microscopic appearance may be very similar to that of a benign haemangioma. It is necessary to make several cuts and to remember the essential feature of a haemangioma of the breast, namely that it is subclinical and therefore usually discovered microscopically by chance. Treatment consists of simple mastectomy without usually needing to clear the axilla. It is necessary to give polychemotherapy. There is still no agreement on radiotherapy and hormone therapy. The prognosis is very serious because the mean length of survival is around 22 months. We report a recent case of angiosarcoma of the breast in which diagnostic steps were taken in order, and for which expert histological opinion made it possible to diagnose the condition in less than one month. A 37 year old woman had been complaining of the recent appearance of a tumour in her right breast which was growing rapidly because at the first consultation, within one month after her first signs, it measured 50 mm in diameter. It was poorly outlined, multinodular and non-inflammatory.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723348 TI - [Abdominal pregnancy. Apropos of 7 cases collected between 1978 and 1986]. AB - The authors point out, following a study of 7 cases of abdominal pregnancy, how necessary it is to make a diagnosis early and to use ultrasonography routinely whenever there is the slightest abnormality in the progress of the pregnancy, such as absence of strong fetal movements or failure of the abdominal contents to grow rapidly. The treatment is surgical and the placenta should as far as possible be removed completely because serious complications both of infection and haemorrhage can occur if the placenta is only partially removed. These complications can pose a great threat to the mother. PMID- 2723349 TI - [Simultaneous intra- and extra-uterine pregnancies. Apropos of 6 cases]. AB - Six cases of simultaneous intra- and extra-uterine pregnancies are described by the authors. The rate of 1/5000 deliveries is considerably higher than described in the literature. The association of the two conditions is seldom thought of and has never been diagnosed before the extra-uterine pregnancy has ruptured. The initial picture seems to be that of an intra-uterine pregnancy with a threatened abortion in 83% of the cases. Only 33% of the intra-uterine pregnancies reached term. The prognosis could be improved if the doctor were to think of the possibility more often. PMID- 2723350 TI - [The obstetrical outlook in uterine malformations]. AB - The authors start with an anatomical description which makes it possible to distinguish from one another septate, bicornuate unicornuate and pseudo-cornuate uteri. The diagnosis is often suggested by the clinical features and is made by using complementary examinations such as ultrasound, hysterography, hysteroscopy and laparoscopy. Although it is difficult to be sure of the incidence of the condition it is thought to be around 1%. In the 10 years from 1978 to 1987 the authors have studied 296 pregnancies occurring in 109 patients who were not operated on and 34 pregnancies occurring in 21 patients who had plastic operations on their uteri. They show that the condition has an effect at all stages of pregnancy and delivery and in the first category of patients (abortion in 38%, extra-uterine pregnancy in 8%, prematurity, pre-eclampsia and malpresentation in 28%, with a high rate for caesarean section in 37%). The prognosis was quite different in patients who had been operated on. The published literature confirms these findings. The authors discuss the different ways of carrying out surgical treatment (simple section or excision of the septum, or Bret-Palmer's plastic operation on the uterus with treatment of the associated vaginal abnormalities), plus the medical treatment (with rest and the use of vasodilatators and drugs for anti-platelet aggregation) to be used during the pregnancy. They conclude that it is necessary to make a diagnosis of what type of malformation is present, to decide which surgical procedures to carry out as this does improve the prognosis greatly. PMID- 2723351 TI - [Anencephaly in underdeveloped countries. Apropos of 22 cases in Kinshasa, Zaire]. AB - There were 22 cases of anencephaly found out of 70,450 live births registered between 1973 and 1985 in the University Teaching Hospital of Kinshasa. The very low frequency of this abnormality (31 p. 100,000) is in contrast with that published for industrialised countries (180 to 590 p. 100,000). Is this difference due to feeding habits or to racial and geographical influences? Without either routine ultrasound or alphafetoprotein estimations and acetylcholinesterase levels, the diagnosis of anencephaly could only be made by X raying cases with hydramnios (64%), and in the remaining cases on delivery. The pregnancies lasted on an average 36.8 weeks. All the deliveries were normal but only 23% of the babies were born alive and all of these died within the first hour of life. There was no case of postmaturity. In fact, 50% of the births were premature. PMID- 2723352 TI - [Pregnancy and delivery after the age of 40]. AB - When pregnancy occurs in a woman who is more than 40 years of age there are certain risks, ranging from the risks of chromosome abnormalities to those associated with grand multiparity and the syndrome of "the precious baby", when it is a first pregnancy. We have looked at the case notes of 52 patients who delivered after the age of 40. This was a total of 59 pregnancies which occurred in our service between the 1st January 1981 and the 31st December 1986. Of these patients 6 were primiparous, which was 1.17% of all those women delivered in the service. 83% delivered vaginally, with or without the help of forceps. In this group hypertension as well as vein troubles and fatness are more common. Prematurity was of a low order (3.4%), as was perinatal mortality as compared with other series in the literature. We only had one case of trisomy and this was very upsetting for us because we could not get across to our patients the importance of antenatal screening in more than one third of all cases. PMID- 2723353 TI - [Prognosis in ovarian cancer as a function of the results of the second-look laparatomy]. AB - Second-look laparotomy (SLL) was performed after chemotherapy in 106 patients with epithelial ovarian cancer. Thirteen were stage I and II and 93 stage III and IV. Seventy-eight patients received cisplatin-based regimens. Median follow-up was 60 months. Negative SLL was found in 32 patients who had a 5-year survival rate of 43.4% after SLO. Microscopy residual disease was present in 9 patients whose 5-year survival rate was 25%. Maximum residual tumor of 2 cm or less was found in 13 patients with 5-year survival rate of 30%. Residual tumor larger than 2 cm after secondary cytoreduction was present in 21 patients, their 3-year survival rate was 18.3%. Eighteen patients with bulky residual disease who did not have cytoreduction were all dead within 17 months. Patients with initial residual tumor at first laparotomy less than 2 cm had a near significant advantage in survival rate over patients with residual disease greater than 2 cm and stage IV (p = 0.07). Non-responders to initial chemotherapy had a survival rate similar to that of partial-responders. These findings justify discontinuation of conventional systemic chemotherapy for patients showing residual disease after SLL and secondary tumor removal in case of residual tumor at SLL. Therapeutic trials are needed in advanced ovarian cancer testing initial aggressive surgery or early debulking to avoid bulky residual disease and consolidation therapy in patients who achieved complete pathological response or minimal residual intraperitoneal disease. PMID- 2723354 TI - [Variation in plasma progesterone induced by the vaginal administration of Utrogestan]. AB - The authors of this article have been trying to find out how natural progesterone contained in Utrogestan tablets are absorbed by the body when these tablets are placed in the vagina. To do this they conducted their studies on genitally active young women who had volunteered, who were not pregnant and who were not taking hormones. Several therapeutic protocols were tested. Vaginal administration of 100 mg of progesterone (1 Utrogestan tablet) resulted in an increase in blood progesterone levels within an hour. It reached its maximum level after 2 to 6 hours and lasted for 24 hours on an average. The average level was 3.7 ng/ml with a dose of 100 mg/day and 9.7 ng/ml with a dose of 200 mg/day. One capsule every 12 hours ensures that the least variation between individuals occurs. It is the most worth-while dosage and the one recommended by the authors of this article. PMID- 2723355 TI - [When should peridural analgesia be started in induced labor? Result of a randomized prospective study]. AB - Two groups of women who had labours induced were compared in a prospective randomised trial: The first group of 41 patients (group 1) in whom the epidural was started at the beginning of induction. A second group of 47 patients (group 2) in whom the epidural was only started when labour became "active" and induction had been effective. The length of labour and the obstetrical results were identically the same in both groups: at least there was no significant difference. There was no special benefit from waiting until labour started properly before injecting the epidural. This result made us look retrospectively to women whose labours had been induced and who might have benefited from the epidural being started late. The only significant difference was found apparently between primipara and multipara, and this was quite independent of the state of the cervix and the lower segment at the onset: it would appear to be better to put the epidural analgesia in once the labour has started in primiparous patients where as in multiparous ones on the other hand there seems to be a better effect if the epidural is started as soon as induction is started. PMID- 2723356 TI - [Shoulder dystocia]. AB - In this study, 49 cases of shoulder dystocia have been examined. These cases took place in Athens University Second Gynecological and Obstetrics Department, over a period of ten years, from 1975 to 1985. In 23 cases, the delivery was normal, in 20 cases it was necessary to use a vacuum extractor and in 6 cases a forceps. In none of the above cases was there a Cesarean Section, because the cases were not regarded as a fetopelvic disproportion, but as cases which justify normal delivery. There follows a general outline of the treatment to be applied in cases of shoulder dystocia, including a generous episiotomy, the application, if possible, of a muscular relaxation by inhalation anesthesia, and the application of certain obstetric manipulations. In our cases, we applied general anesthesia in 7 cases and local in 39, whereas in 3 was no anesthesia at all. The obstetric manipulations we applied were those of McRoberts in 15 cases, of Jacquemier in 10 cases, of Wood in 15 cases, of Barnum in 5 cases, of Hibbard in 8 cases and of Couder in 6 cases. Our results also appear in tables I and II. In 36 cases, out of 49, (73.49%), the fetal weight was over 4,000 g. In 23 cases (47%) the mother had gained 12 kg during pregnancy. Also, in our study, 20% of the cases (10 mothers) were multiparous and 45% (22 mothers) had a prolonged second stage of labour by more than one hour. Class A (by White) diabetes was found in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723357 TI - Diagnosis and treatment of injury to the second and third carpometacarpal joints. AB - We describe the diagnosis, treatment, and follow-up of a group of 13 patients with hand pain traced to pathologic conditions of the second or third carpometacarpal joints. Missed diagnosis was universal. With suspicion raised by history of injury or repeated stress and point tenderness on examination, diagnosis was confirmed by complete pain relief after injection of 1% lidocaine locally. In management of patients with occult pain in the hand, attention should be directed to the second or third carpometacarpal joints. Arthrodesis with use of an inverted triangular graft from the base of the metacarpal provides predictable and lasting relief. PMID- 2723358 TI - Treatment of open fracture of the forearm in osteogenesis imperfecta. AB - An open fracture of the forearm in a patient with osteogenesis imperfecta is reported. Immediate operative debridement and open reduction, combined with rigid external fixation, provided the patient with an excellent functional result. PMID- 2723359 TI - Sural nerve grafts for delayed repair of divided posterior interosseos nerves. AB - Sural nerve grafts were used in three patients to bridge gaps measuring 2 1/2 to 4 1/2 cm in previously transected but not repaired posterior interosseous nerves. The grafts were done at 4, 5, and 7 months after injury. Extension was weaker in all three than on the uninjured side, but the range of motion was complete, with the exception of a slight lag of index finger extension and partial return of extension of the extensor carpi ulnaris in the same patient. All three patients recovered full function of the involved hand 1 year after grafting. The properties of the posterior interosseous nerve (pure motor and short distance to the muscle) contribute to good results with nerve grafts in delayed nerve repairs. We believe that these results are better than tendon transfers, at least in young patients. PMID- 2723360 TI - Fluctuation in grip and pinch strength among normal subjects. AB - Grip and pinch strength testing are commonly used to evaluate hand strength for disability ratings and to assess responses to various forms of therapy. This study determined the variations in grip and pinch strength in normal individuals. Ninety-five healthy subjects--61 women and 34 men--were examined prospectively by use of a Jamar dynamometer and a Preston pinch gauge. Grip and pinch were measured in the morning and afternoon twice a week for 3 weeks, giving a total of 12 testing periods. Mean grip strength fluctuated between 5.1 and 8.4 kg, or between 19.2% and 23.7%. Mean lateral pinch strength fluctuated between 2.6 and 3.8 pounds, or between 13.8% and 17.6%. There were no differences between the morning and afternoon values. Grip and pinch strength fluctuate over time. Repeat testing is necessary to accurately assess hand strength. Grip and pinch strength do not vary from morning to afternoon. PMID- 2723361 TI - Giant cell tumor of metacarpal treated by cryosurgery. AB - We report the case of a 44-year-old woman with a giant cell tumor of the fourth metacarpal head of her dominant left hand that was treated with cryoprobe freezing, curettage and bone grafting. Three years after operation the metacarpophalangeal joint remained normal both functionally and radiologically. The tumor has not recurred. Cryoprobe killing of giant cell tumors of the hand can offer effective direct tumor eradication, as well as maintaining normal bone architecture and preserving full function. PMID- 2723362 TI - An unusual case of dermatofibrosarcoma protuberans. AB - A dermatofibrosarcoma protuberans involving the thumb of a nondominant hand is reported and represents the first case reported in this location. Dermatofibrosarcoma protuberans is a soft tissue neoplasm. It is a slow growing, locally aggressive fibrous tumor that occurs with equal frequency on the chest, abdomen, back, and proximal aspect of the extremities. Only two cases involving the hand are reported in the literature. PMID- 2723363 TI - Subungual keratoacanthoma in the hand. AB - A subungual keratoacanthoma of the thumb with a 5-year follow-up is reported. Recurrence after initial curettage necessitated amputation of the terminal phalanx as definitive treatment. The 22 subungual keratoacanthomas of the hand reported in the literature are reviewed. Although conservative treatment sparing the digit in the form of excision and curettage is recommended as the initial treatment of choice, this uncommon benign, but aggressive, lesion of the nail bed may require amputation of the involved phalanx as definitive treatment. PMID- 2723364 TI - Replantation and revascularization of hands: clinical analysis and functional results of 261 cases. AB - During the past 4 years we performed 261 replantations and revascularizations on amputated digits and hands in 153 patients. The overall survival rate was 82%. Clean-cut proximal level amputations and hypothermically preserved amputation parts had the highest survival rate. A higher survival rate and more satisfactory results with accelerated return of sensory function correlated with repair of both digital arteries and two veins rather than only one. All patients experienced intolerance to cold, but this was more troublesome in patients with digital replantation in whom only a single artery was repaired. Digital sensibility and joint motion after replantation were better in these patients who had sharp amputations and on whom repairs were carried out in zone III. Return of intrinsic muscle function after hand replantation was poor; however, patient satisfaction with the procedures remained high. PMID- 2723365 TI - Elective cross-hand transfer: a case report with a five-year follow-up. AB - The elective free microvascular cross-hand transfer of the right hand to the left distal carpus was successfully performed in a 35-year old professional photographer. Traumatic loss of the left hand with preservation of a useful thumb and concomitant right upper extremity injury leaving the right hand with an amputated thumb, but paralyzed and insensate from a brachial plexus palsy 5 years before transfer, set the stage for such a reconstruction. Multiple immediate tendon transfers and primary nerve grafting provided for finger flexion and extension plus functional sensibility in this first reported case of an elective cross-hand microvascular transfer. Five years follow-up demonstrates useful and powerful flexion, and functional extension of digits in the reconstructed left hand and right upper extremity function has been improved with a below-elbow prosthesis. PMID- 2723366 TI - Results of flexor tendon tenolysis after replantation in the hand. AB - Thirty-seven replanted digital units and four thumb replantations had a flexor tendon tenolysis at an average of 10 months after replantation. The results were assessed by measuring total active motion, potential active motion, and by the formula of Strickland and associates. The total active motion increased from a mean pretenolysis of 72 degrees to 130 degrees. The potential active motion increased from a mean of 43% to 70% after tenolysis. Both of these improvements were statistically significant (p less than 0.001). The formula of Strickland and associates rated 13 excellent, 11 good, 6 fair, and 11 poor. The thumbs had two fair results and two poor results. Poor results were also seen in crush or avulsion amputations, hands with more than two digits amputated, and those requiring a proximal interphangeal joint capsulotomy. Little difference was found related to the number of arteries or tendons repaired. Complications included tendon rupture and infection. No digits were lost. The results of this study would support flexor tendon tenolysis after replantation of fingers but not replanted thumbs. PMID- 2723367 TI - The UNILINK system for mechanical microvascular anastomosis in hand surgery. AB - A new mechanical anastomotic device--the UNILINK system--for small vessels, designed for work under the operating microscope was used in four patients for microvascular, hand surgical operations. All procedures were successful with regard to tissue survival and wound healing. Basal skin temperature and systolic blood pressure distal to the mechanical anastomoses were normal 12 to 26 months after the operation. Doppler investigation also confirmed that all mechanical anastomoses were patent. At the time of this report, 32 to 45 months after the operations, no adverse effects of the method have been found. The device offers increased safety and speed in microvascular operations. PMID- 2723368 TI - Restoration of sensibility in fingers repaired with free sensory flaps from the toe. AB - The sensibility of 25 fingers reconstructed with three different types of free sensory flaps from the toe was evaluated. The relationships between sensory restoration and the patient's age, type of sensory flap, selection of sutured nerves, and circulatory complications in the flap were analyzed. Wrap-around flaps were used in 5 fingers, hemipulp flaps in 11, and toe-to-finger transfers in 9. The follow-up period ranged from 16 to 79 months. Restoration of sensibility in the flap was closely related to the patient's age and vascular insufficiency of the flap. Therefore, establishing and maintaining and adequate circulation in the flap at operation is essential for good sensory restoration. PMID- 2723369 TI - Comparative study of vascularized and nonvascularized tendon grafts for reconstruction of flexor tendons in zone 2: an experimental study in primates. AB - Vascularized tendon grafts were compared with nonvascularized tendon grafts in a primate experimental model. In four monkeys, seven vascularized extensor hallucis longus grafts were placed in the foot's digital fibroosseous canal and these were compared with eight nonvascularized tendon grafts similarly placed in the opposite extremities. The juncture techniques and postoperative protocols were identical for both tendon groups. All tendons were explored 5 months after insertion. The vascular pedicle was patent in all vascularized tendons. Three tendon ruptures occurred in nonvascularized tendons and only one rupture occurred in a vascularized tendon. The digits with vascularized tendons demonstrated a significantly better simulated total active motion (117 degrees versus 128 degrees, p less than 0.05) than digits with nonvascularized tendons. The difference was even more significant when a localized tenolysis of the proximal juncture of the tendon graft was performed (215 degrees versus 138 degrees, p less than 0.01). This study supports the concept that vascularized tendon grafts may be advantageous in scarred tendon beds. PMID- 2723370 TI - Human flexor tendon participation in the in vitro repair process. AB - This work demonstrates that human flexor tendon segments have the same capabilities to survive culturing and to mobilize an intrinsic healing response as previously described animal models. Segments of human flexor profundus tendons from the flexor tendon sheath were cultured in vitro and analyzed at 1, 2, and 4 weeks by scanning and transmission electron microscopy. The epitenon area thickened during the first week of culture. Fibroblasts migrated over the cut surface of the collagen bundles until they encapsulated the cut end by the second week when new collagen fibrils were seen in the extracellular spaces. By the fourth week, cells in multiple layers covered the cut end of the tendon, both collagen fibrils and new mature collagen bundles were seen. End encapsulation was accomplished by fibroblasts migrating from the outer surface and the interstices of the tendon. The encapsulating cells were active in phagocytosis and collagen synthesis during the entire incubation period. PMID- 2723371 TI - Early dynamic splinting for extensor tendon injuries. AB - Extensor tendon injuries are traditionally splinted with no motion for 3 to 4 weeks after repair. This may result in limitation of flexion because of extensor tenodesis at the site of repair. To prevent this, we used a dynamic splinting program opposite to the one that is used for flexor tendon repair, with an outrigger splint holding the fingers in extension and allowing full active flexion. Fifty-two patients who had extensor tendon repairs in the area from the wrist to the middle of the proximal phalanx were treated. Motion was begun 2 to 5 days after repair and was continued for approximately 5 weeks. No tendon ruptures occurred, and all patients recovered full flexion. PMID- 2723372 TI - Management of chronic lunotriquetral ligament tears. AB - Treatment of chronic disruptions of the lunotriquetral (LT) ligament is not well defined. Eleven patients treated by LT fusion with use of a compression screw are reported. The injury frequently resulted from hyperextension of the wrist. Pain on the ulnar side of the wrist, limited motion, and tenderness over the LT joint exacerbated by ballottement were present. Standard radiographs were normal. Arthrography showed the ligamentous tear in all cases. After operation, immobilization was continued until fusion was apparent radiographically. Fusion was achieved in all cases between 2 and 5 months. Four patients were free of pain, four patients had pain only at the extremes of motion, and three patients had persistent pain. Mean wrist motion was as follows (preoperative/postoperative): flexion (53 degrees/45 degrees), extension (60 degrees/49 degrees), radial deviation (17 degrees/21 degrees), and ulnar deviation (25 degrees/18 degrees). Maximum grip strength as a percentage of the uninjured side was 73% preoperatively and 59% postoperatively. LT tears can exist de novo or as part of the ulnar impaction syndrome; a method for differentiation is presented. PMID- 2723373 TI - Replacement of the trapeziometacarpal joint with a cemented (Caffiniere) prosthesis. AB - Between 1978 and 1985, 31 Caffiniere prostheses were implanted in the first carpometacarpal joints of 28 patients for treatment of degenerative osteoarthritis (26 patients) or rheumatoid arthritis (2 patients). At follow-up an average of 48 (13 to 77) months after operation, four hands had reoperation, with the replacement of six components, five cups and one metacarpal component. In addition, there were x-ray signs of component loosening in three other cases. Of the 29 thumbs that could be evaluated with regard to pain, 27 had no pain at all or only slight pain, and two patients had moderate pain. No patient suffered from severely disabling pain. Mobility and strength were satisfactory. PMID- 2723375 TI - Year 2024--an ironical view of SocioLiza and what led to it/journal staff changes. PMID- 2723374 TI - Triquetral-lunate arthritis secondary to synostosis. AB - Until recently the problem of painful, symptomatic arthritis of the wrist secondary to congenitally incomplete separation of carpal bones has been infrequently recognized. Five patients with either excessive stress loading or trauma had eight symptomatic wrists with congenitally incomplete separation of the triquetral-lunate joint. Three of these patients had bilateral symptoms. Six of the wrists had been treated by a limited wrist arthrodesis of the triquetral lunate joint resulting in asymptomatic wrists and improved range of motion. It appears that patients with this congenital condition poorly tolerate stress loading or trauma secondary to deficient intra-articular cartilage formation resulting in a clinical and anatomic state similar to degenerative arthritis. We suggest a limited wrist arthrodesis as definitive treatment for symptomatic congenitally incomplete separation of the triquetral-lunate joint, with possible application in incomplete separation of the other intercarpal joints. PMID- 2723376 TI - Divorce, family conflict, and adolescents' well-being. AB - The relative effects of family conflict and divorce on the well-being of adolescents were examined in a longitudinal study of a heterogeneous community sample. Higher levels of family conflict were associated with increases in adolescents' depressed mood, anxiety, and physical symptoms over time. In contrast, neither recent divorce nor earlier divorce was associated with longitudinal changes in any health outcomes. Also, adolescents living in intact families with high conflict had significantly poorer well-being than those living in families of divorce with low conflict. Finally, the longitudinal effects of divorce and family conflict did not differ by age and sex, but Hispanic adolescents experienced more negative effects of family conflict than non Hispanic whites, and the well-being of Asian adolescents was influenced more strongly by recent divorce. PMID- 2723377 TI - Psychiatric diagnosis as reified measurement. AB - Throughout the 1980s, psychiatry has promoted diagnosis--with its language of categories--as the preeminent measure of psychological problems. In clinical psychiatry, the decade opened with the publication of the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III). In psychiatric epidemiology, the decade saw the development of the Diagnostic Interview Schedule (DIS) and its use in the large-scale Epidemiologic Catchment Area (ECA) surveys. Proponents of the diagnostic approach herald the DIS as a breakthrough. We argue, on the contrary, that diagnosis as a form of measurement hinders understanding. If the ECA studies provide new insight into the patterns and causes of psychological problems, they will do so despite the use of diagnostic measurement. We present here a critical analysis of the inherent weaknesses of diagnosis as a form of measurement, particularly as a means of representing psychological problems. First, we describe the weaknesses: diagnosis treats attributes as entities; it reduces the signal but not the noise; and it collapses the structural relationships. Second, we offer an interpretation of why psychiatry promotes a form of measurement poorly suited to its subject: the linguistic legacy of nineteenth-century biology and epidemiology; the social construction of the need for mental health services; and the enclosure of a scientific and professional domain. Third, we conclude that diagnostic measurement impedes understanding. We recommend eliminating diagnosis from research on the nature, causes, and consequences of mental, emotional, and behavioral problems. PMID- 2723378 TI - Sex differences in psychosocial consequences of alcohol and drug abuse. AB - This paper reports analyses of the 1985 National Household Survey on Drug Abuse to evaluate three perspectives on sex differences in the relationship of psychosocial problems to levels of substance use. The results are more consistent with a styles of deviance perspective than with either the generalized feminine vulnerability or the convergence theses. Compared to women, men report higher levels of alcohol and drug abuse during the past year and are more likely than women to have experienced each of 17 psychosocial problems resulting from alcohol or drug use. Significant sex by substance use interaction tests for problem indices and for individual problems suggest that substance abuse is related more strongly to intrapsychic problems among women and to problems in social functioning among men. Decompositions of the sex differences in mean levels of psychological and social/behavioral problems suggest that most of the differences can be explained by males' greater frequency of intoxication and drug use. PMID- 2723379 TI - Race, socioeconomic status, and psychological distress: an examination of differential vulnerability. AB - Using data from a 1985 epidemiological survey of 2,115 adults in Florida, this research has two goals: it tests the proposition that race and SES jointly influence mental health, and it examines the contribution of undesirable life events and economic problems to psychological distress across SES groups. Using multiple indicators of SES and mental health, we found that the evidence for a model of joint influence of race and SES on mental health varied with the measures being used. The most general conclusion is that SES interacts with race to increase psychological symptoms of distress. Partitioning the sample into three SES categories (low, middle, high), we examined the contribution of stressors to the greater distress among lower-SES blacks compared to other blacks and lower-SES whites. Lower-SES blacks are more vulnerable than lower-SES whites to the impact of undesirable events, but they are less vulnerable than lower-SES whites to the impact of economic problems. Lower-SES blacks are more vulnerable than middle-SES blacks to the impact of both discrete events and economic problems. Limitations of the study indicate a need for future longitudinal studies with measures of coping resources and support networks to further our understanding of the race, social class and psychological distress relationship. PMID- 2723380 TI - Fertility and fertility-related behavior among Mexican-American and non-Hispanic white female adolescents. AB - Ethnic differences in fertility-related behavior are examined in a community based probability sample of 706 Mexican-American and 317 non-Hispanic white females aged 13 through 19 years. Mexican-Americans are more likely than whites to have had a live birth, but are no more likely to have been pregnant and are less likely to have had sexual intercourse. Sexually experienced Mexican Americans, however, are twice as likely as whites to have been pregnant. Among those ever pregnant, Mexican-Americans are more likely to have had a live birth, while whites are more likely to have had an abortion. Ethnic differences remain strong when socioeconomic status and indicators of social instability are controlled statistically, lending more support to the "minority status" hypothesis than to the "characteristics" hypothesis concerning the fertility related behavior of minority group members. PMID- 2723381 TI - The effects of women's employment: personal control and sex differences in mental health. AB - Married women have been found consistently to have higher rates of anxious and depressive symptoms than married men. Power explanations for this difference predict that employment for women, which is associated with greater power in the family, would reduce women's symptoms to approximate men's more closely. Results on the effects of women's employment, however, are inconsistent. One explanation for this inconsistency concerns role overload, or the greater demands experienced by women with employment. This paper proposes that overload creates greater symptoms for the same reason as low power; that is, through lowering individuals' sense of personal control. Thus employment for women is not consistently positive because it often trades one source of low control for another. We test a personal control explanation for the effects of women's employment, using community surveys of mental health. Results indicate that issues of personal control underlie the effects of both high demands and low power on sex differences in anxious and depressive symptoms. PMID- 2723382 TI - Dynamics of the intramolluscan larval development of Schistosoma haematobium: replication of daughter sporocysts and cercarial production. AB - During the intramolluscan larval development of Schistosoma haematobium (Algerian strain) in Bulinus truncatus, two replication processes of daughter sporocysts occur. Replication by direct sporocystogenesis appears more important than sporocystogenesis post cercariogenesis. These mechanisms assure a periodic renewal of the sporocyst stock in the snail host and seem to be synchronized with the development of cercarial generations. The succession of several generations of cercariae is responsible for the alternation of high and low periods of productivity. The scheme proposed for the intramolluscan development of S. haemtobium is compared with those described for S. mansoni and S. bovis and interpreted in terms of demographic strategies adapted to a better exploitation of the snail host. PMID- 2723383 TI - Hymenolepis murissylvatici: humoral response in intestinal lavages of the mouse. AB - Hymenolepis murissylvatici elicits a humoral response in serum and in the intestine of the mouse from which it is immunologically rejected. In serum, significant differences were recorded 3 days after reinfection, while in intestinal lavages it takes place from day 9 after reinfection. In serum the response is largely the result of IgG and IgM antibodies whereas in the intestine, IgA is the most abundant antibody. Although specific IgE could not be demonstrated in serum, it was present in intestinal lavages, although rather late (i.e. day 14 after reinfection). Treatment of young worms in vitro both with immune serum or intestinal lavages had no apparent effect on their viability. Immune serum produced a complement independent precipitation on the surface of the worms in vitro. This reaction did not affect viability or infectivity of the parasite, as demonstrated by the successful implantation of treated worms in recipient mice. The above-mentioned results, together with the knowledge that the Hymenolepis model has no tissue stages and causes no tissue damage, make it probable that further study of this model will reveal some specific intestinal immunological reactions. PMID- 2723384 TI - A survey of intestinal helminths of well-cared-for dogs in Jamaica, and their potential public health significance. AB - This study investigates the level of helminthic infestation in better-cared-for dogs in a middle-class community in suburban Kingston. A canine zoographic study was conducted, and fresh faecal deposits were collected and analysed for helminth life-cycle stages. The survey indicated that 73% (n = 93) of households in the study area owned one dog or more (mean = 1.4). Resident's attitudes towards canine management suggested that the dog population was, in general, restricted to the residential estate, and most owners claimed to have dewormed their dogs at least as young animals. Of 141 faecal specimens, 58% contained eggs or larvae of one or more of eight helminths: Uncinaria stenocephala (26%), Ancylostoma sp. (23%), Trichuris vulpis (9%), Toxocara canis (8%), Spirocerca lupi (6%), Strongyloides sp. (6%), Apophallus sp. (4%) and taeniids (1%). There was a high level of multiple infection in the host animals, with approximately one fifth of the infected samples containing three or more helminth types. Infection intensity was apparently low, but some dogs harboured heavy worm loads. PMID- 2723385 TI - Observations on the suitability and importance of the domestic intermediate hosts of Echinococcus granulosus in Uttah Pradesh, India. AB - The present study investigated the suitability and importance of buffaloes, camels, sheep, goats and pigs in maintaining the life-cycle of Echinococcus granulosus in Aligarh, India. A total of 565 (36%) of 1556 buffaloes, 20 (2%) of 1208 goats, 5 (1%) of 559 pigs, 6 (6%) of 109 sheep and two of three camels were found to harbour hydatid cysts. The frequency distribution of the hydatid cysts in each intermediate host species was over-dispersed and in buffaloes cyst fertility increased with increasing cyst size. Of 2171, 95 and four buffalo, goat, and camel cysts examined 327 (15%), two (2%) and three cysts respectively were fertile. No pig or sheep cysts were found to contain protoscoleces. The unfenced buffalo abattoir and the large number of dogs allowed access to the abattoir coupled to the number of buffalo slaughtered in comparison to the other potential hosts, indicates that the buffalo is the most significant host for maintaining the life-cycle of the parasite in this area of India. Applicable control measures for the region are suggested. PMID- 2723386 TI - Leukocyte accumulation in sparganosis: further characterization of an eosinophil chemotactic factor of the plerocercoid of Spirometra erinacei. AB - An eosinophil chemotactic (ECF) was partially purified from plerocercoids of Spirometra erinacei by a combination of anion-exchange chromatography on DE52 and gel filtration on Sephacryl S-200. The molecular weight of ECF was estimated to be 25,000-45,000 by high-pressure liquid chromatography. The ECF was bound with concanavalin A-Sepharose. The ECF was sensitive to periodate oxidation and to heating (56 degrees C, 30 min). On isoelectric focusing, eosinophil chemotactic activity was clearly revealed at pI 4.1. These results suggest that ECF of S. erinacei plerocercoid is an acidic glycoprotein. An intradermal injection of ECF eosinophil attractions in the normal guinea pig skin. PMID- 2723387 TI - In vitro effect of ivermectin on Pseudoterranova decipiens survival. AB - Third larval stages (L3) removed from fish fillets, fourth larval stages (L4) raised in in vitro culture, and adults of Pseudoterranova decipiens, collected from grey seal (Halichoerus grypus) stomachs, were exposed to the broad spectrum anthelmintic, ivermectin. L3 and L4 parasites were exposed, in vitro, to 500, 100, 50, 20, 5 and 1 micrograms/ml concentrations of the drug, in culture media. Adult P. decipiens were exposed in vitro to a concentration of 500 micrograms/ml ivermectin, only. Controls consisted of parasites placed in culture media alone or culture media plus drug vehicle. These three developmental stages of P. decipiens were all found to be susceptible to the effects of ivermectin. PMID- 2723388 TI - Inorganic elements in the adults of Ascaridia galli (Schrank, 1788). AB - Inorganic analysis of Ascaridia galli has shown the levels of sodium, potassium, copper, magnesium, calcium, zinc, iron, nitrogen, phosphorus, sulphur, chlorine and cobalt (expressed as percentage of dry weight) to be higher in females than in males. PMID- 2723390 TI - Malpractice cap increase moves to Senate. PMID- 2723389 TI - A simple method for the collection of Necator americanus larvae. AB - A simple method for the collection of third-stage larvae of Necator americanus has been described. This technique provides repeated recovery of very clean larvae from cultures in moderate numbers. PMID- 2723391 TI - A review of infections in day-care centers. PMID- 2723392 TI - Radiology clinic: ulcerated, swollen finger: rule out osteomyelitis. PMID- 2723393 TI - Advantages of split-funded medical insurance. PMID- 2723394 TI - Computer systems for patient accounting. PMID- 2723395 TI - Fraud and abuse in health care joint ventures. PMID- 2723396 TI - Let robots do the work. PMID- 2723397 TI - Depression, etc. PMID- 2723398 TI - Histochemical demonstration of prolactin binding sites. AB - We have developed a new probe for histochemical demonstration of prolactin binding sites. Ovine prolactin (oPRL) was conjugated with the N-hydroxy succinimide ester derivative of the fluorochrome 7-amino-4-methylcoumarin-3 acetic acid. Under mild reaction conditions the ester derivative reacted with available NH2 groups of the prolactin molecule to form stable bonds. The coupling reaction yielded products that co-migrated with oPRL but had slightly decreased isoelectric points. The receptor binding and bioactivity of the flurochrome hormone derivatives were decreased essentially proportional to the extent of conjugation. The derivatives were further tested for their ability to label PRL binding sites, using frozen sections of mammary gland and brain tissue of lactating rats. The results presented in this report describe the validation of this probe with regard to labeling of PRL binding sites at the light microscopic level in known target organs (mammary gland and choroid plexus). In addition, this fluorescent probe was used to demonstrate the presence of PRL binding sites at a novel site, the ependymal lining of the third ventricle. PMID- 2723399 TI - Expression of the neural cell adhesion molecule NCAM in endocrine cells. AB - We examined the expression of the neural cell adhesion molecule NCAM in a number of endocrine tissues of adult rat and in an endocrine tumor cell line. NCAM was found by immunoelectron microscopy to be present on the surface of all endocrine cells in the three lobes of the hypophysis, although staining was relatively less intense in the intermediate lobe, and in pancreatic islets. Pituicytes, hypophyseal glial cells, were also labeled for NCAM. A rat insulinoma cell line (RIN A2) also expressed NCAM as judged by immunocytochemistry. Analysis of NCAM antigenic determinants (Mr 180, 140, and 120 KD) revealed large variations in the relative proportions of NCAM polypeptides present in the different tissues. Although all tissues and cell lines expressed NCAM-140, NCAM-180 was not detected in the adenohypophysis, pancreas, or adrenal medulla, and NCAM-120 was found in none of the endocrine tissues or cell lines except at low levels in the neurohypophysis. The tumor cell line expressed significant levels of NCAM-180, which was most abundant in the neurohypophysis. These results show that NCAM expression appears to be a general property of endocrine cells, although the antigenic composition differs markedly from that in brain tissue. These data are discussed with regard to the embryological origins of the different endocrine tissues, and possible functional implications are suggested. PMID- 2723400 TI - Distribution of the calcium-binding protein SPARC in tissues of embryonic and adult mice. AB - SPARC (Secreted Protein that is Acidic and Rich in Cysteine), a Ca++-binding glycoprotein also known as osteonectin, is produced in significant amounts by injured or proliferating cells in vitro. To elucidate the possible function of SPARC in growth and remodeling, we examined its distribution in embryonic and adult murine tissues. Immunohistochemistry on adult mouse tissues revealed a preferential association of SPARC protein with epithelia exhibiting high rates of turnover (gut, skin, and glandular tissue). Fetal tissues containing high levels of SPARC included heart, thymus, lung, and gut. In the 14-18-day developing fetus, SPARC expression was particularly enhanced in areas undergoing chondrogenesis, osteogenesis, and somitogenesis, whereas 10-day embryos exhibited selective staining for this protein in Reichert's membrane, maternal sinuses, and trophoblastic giant cells. SPARC displayed a Ca++-dependent affinity for hydrophobic surfaces and was not incorporated into the extracellular matrix produced by cells in vitro. We propose that in some tissues SPARC associates with cell surfaces to facilitate proliferation during embryonic morphogenesis and normal cell turnover in the adult. PMID- 2723401 TI - Production and characterization of a novel monoclonal antibody against neurotensin: immunohistochemical localization in the midbrain and hypothalamus. AB - We developed a mouse monoclonal antibody against neurotensin (NT), termed NT8, for applications in immunohistochemistry and for ELISA analysis of NT. The antibody's paratope was determined by competitive ELISA using several peptide fragments of NT. That paratope requires intact peptide bonds between NT residues proline-7, arginine-8, and arginine-9. The antibody is of the IgG2B sub-isotype, having an IC50 for intact NT of approximately 3 nM when measured by competitive ELISA. Light microscopic immunohistochemical studies in the periaqueductal gray (PAG) and hypothalamus demonstrated staining patterns that agreed well with previous reports. Neuron perikarya were visualized even in the absence of colchicine pre-treatment, indicating that NT8 antibody is very sensitive in immunohistochemical applications. At the EM level, the antibody stained axon terminals, dendrites, and perikarya in the PAG. In lightly immunoreactive perikarya, rough endoplasmic reticula were visualized, suggesting that biosynthetic precursors to NT might be recognized by NT8. PMID- 2723402 TI - A new cytochemical method for ultrastructural detection of liposomes in tissues in vivo. AB - Multilamellar vesicles (MLVs) have been used as drug carriers to increase efficacy or decrease toxicity of a variety of therapeutic agents, including antineoplastics, antibiotics, and immunomodulators. Although analysis of the disposition of encapsulated materials is relatively simple using radiolabels or single enzymes, determining the cellular and subcellular disposition of intact MLVs, i.e., those that still retain their encapsulated materials, is much less straightforward. We have developed a technique that allows demonstration of the uptake of intact MLVs by Kupffer cells. The method is based on co-localization of paired enzymes, glucose oxidase (GO), and horseradish peroxidase (HRP). The rationale for the localization is that H2O2 generated from glucose and oxygen by GO acts as the substrate for the HRP-mediated oxidative polymerization of diaminobenzidine. Therefore, only sites of co-localization of GO and HRP should stain. Mice were injected IV with phosphatidyl choline MLVs encapsulating HRP and GO. Encapsulated enzymes were separated from non-encapsulated by passing the MLVs over a Sepharose 2B column. Control mice were injected with equivalent amounts of free GO. Mice were sacrificed 30 min after injection and liver tissue was fixed in 3% cacodylate-buffered glutaraldehyde for at least 18 hr. Tissues were washed in buffer, then stained in medium containing glucose, diaminobenzidine HCl, and dimethylsulfoxide in 0.1 M cacodylate buffer. In animals injected with MLV encapsulated GO and HRP, vacuoles in Kupffer cells and some endothelial cells contained electron-dense reaction product. No other cell type, including polymorphonuclear leukocytes, was stained. In control animals no staining was seen. Our results indicate that encapsulation of paired enzymes may be a feasible method to demonstrate the cellular and subcellular disposition of intact liposomes. PMID- 2723403 TI - Ultrastructural distribution of histones within Ehrlich tumor cell nucleoli: a cytochemical and immunocytochemical study. AB - We investigated the ultrastructural distribution of histones within Ehrlich tumor cell nucleoli by means of three cytochemical methods and by a Lowicryl post embedding immunogold labeling procedure involving anti-histone (H2B, H3, H4) antisera as well as antibodies to synthetic peptides of histones. With the two technical approaches, labeling was particularly concentrated over the perinucleolar chromatin and over its intranucleolar invaginations which penetrate the nucleolar body and come in close contact with the fibrillar centers. Furthermore, the high-resolution immunocytochemical technique revealed the presence of a small amount of the three histones in the fibrillar centers, preferentially located towards their peripheral regions. In addition, colocalization of DNA at all the histone-positive sites could be visualized after double immunogold staining using a monoclonal anti-DNA antibody and the anti histone antisera. These results appear to indicate that all the DNA detected within the nucleolus was associated with histones. This finding suggests that the ribosomal DNA, including transcriptionally active genes, is bound to histones. PMID- 2723404 TI - Heterogenous distribution of type IV collagen, entactin, heparan sulfate proteoglycan, and laminin among renal basement membranes as demonstrated by quantitative immunocytochemistry. AB - Type IV collagen, entactin, heparan sulfate proteoglycan, and laminin antigenic sites were revealed on various rat renal basement membranes by use of protein A gold immunocytochemistry. The basement membranes of the proximal and distal convoluted tubules, those of Bowman's capsule and glomerulus, and the mesangial matrix were labeled for all the antigens but to differing extents. Control experiments confirmed the specificity of these labelings. Quantitative evaluation revealed an important heterogeneity for each antigen among the various basement membranes. This heterogeneity suggests that the basement membrane components must arrange themselves in different ways, possibly to account for differences in functional properties of the various renal structures. PMID- 2723405 TI - Solid-phase adsorption method for removing undesired antibodies from polyclonal antiserum. AB - We have developed a novel and simple method, requiring only a small amount of antigen, for removal of undesired antibodies from antiserum. The method was established using a well-characterized antiserum against rat luteinizing hormone (anti-rLH). Wells of polystyrene tissue culture plates were coated with rat LH (rLH). Anti-rLH diluted 1:3000 was added to rLH-coated wells and shaken to remove LH antibodies. Control anti-rLH was treated in a similar manner in non-rLH-coated wells. Both antisera were tested by immunocytochemistry on rat pituitaries. Antiserum from rLH-coated wells stained no cells, whereas the control serum stained cells that were morphologically typical of LH cells. The effectiveness of this antibody removal was also confirmed in a modified ELISA. In another experiment, anti-rLH and anti-hTSH beta sera were mixed. The final dilution of both antisera was 1:10,000. Anti-rLH was removed by the purification method described. Completeness of antibody removal was confirmed by a double immunohistochemical staining of rat pituitary in which sections were first stained by the PAP method and then stained with an immunofluorescence procedure after elution of the first antigen-antibody complex. The mixed antiserum incubated in rLH-coated wells did not stain LH cells. There was no co localization between the LH immunopositivity demonstrated by an anti-rLH serum using immunofluorescence and cells immunostained with the purified antiserum using the PAP method. As indicated in ELISA, the titer of the TSH beta antiserum was not decreased compared to that of the untreated, mixed control antiserum, and the LH antibodies were eliminated by the treatment. This new purification method has four distinct advantages: (a) antiserum is not treated chemically; (b) it requires only a small amount of antigen compared with the amount required for affinity chromatography; (c) neither the undesired antigen-antibody complex(es) nor an excess amount of antigen is present in the purified antiserum; and (d) removal of undesired antibodies can be monitored by ELISA. PMID- 2723406 TI - Is aromatic L-amino acid decarboxylase immunoreactivity a marker for noradrenergic sympathetic axons? PMID- 2723407 TI - Do the same subdivisions of the nucleus reticularis tegmenti pontis project onto longitudinal zones of the paramedian lobule? An anatomical study in the rabbit with retrograde tracing technique (HRP). AB - Rabbits were subject to iontophoretic injections of HRP into various sites of mediolateral extent of the cerebellar paramedian sublobules (PML). The distribution of retrogradely HRP-labelled neurons was mapped within the subdivisions of the pontine reticular tegmental nucleus (NRTP). Clear evidence for absence of correlation between the distribution of labelled cells within the NRTP longitudinal subdivisions and mediolateral location of HRP injection sites in PML has been obtained. The present findings suggest that there is no longitudinal compartmentalization of the NRTP-PML connectivity and the same NRTP longitudinal subdivisions project onto several sagittal zones of the PML. PMID- 2723408 TI - Nigrostriatal projections in the rat as demonstrated by retrograde transport of horseradish peroxidase. I. Projections to the rostral striatum. AB - The distribution of nigral neurons projecting to the rostral part of the striatum was studied in 12 rats using the horseradish peroxidase or the wheatgerm lectin bound horseradish peroxidase labelling techniques. Labelled neurons localized in the substantia nigra pars compacta (SNc) were demonstrated throughout the anteroposterior extent of the nucleus. Most of the labelled neurons were localized in the medial half of the SNc, predominantly in its basal part. Labelled neurons localized in the substantia nigra pars reticulata (SNr) predominated in the caudal half of the nucleus where they were found in its medial, central and lateral parts. A quantitative evaluation of the shape and size of the labelled neurons showed no statistically significant differences between the SNc and SNr as to the shape of the labelled perikarya. In contrast, nigrostriatal neurons in the SNc were found to have larger perikarya than their counterparts in the SNr. PMID- 2723409 TI - [Comparative studies of the anatomy of the brain in three species of Agnatha: Petromyzon marinus, Lampetra fluviatilis and Lampetra planeri]. AB - This study has been carried out upon 3 species of Petromyzonts: Petromyzon marinus, Lampetra fluviatilis and Lampetra planeri. According to the values of the index of encephalization (whole brain) and to these of the structures indices (brain subdivisions), similarities as well as differences have been pointed out. Other detail are brought by the relative volume of these subdivisions expressed by a per cent value of the entire brain volume (the ventricular volumes being removed). 1. The indices of encephalization show that the Sea Lamprey is the less encephalized species amongst Vertebrates (with an arbitrary value of 10); but the 2 other lampreys stay at a higher level (respectively 44 and 38) while the Hagfish reaches 54 and the average encephalization index of bony fishes locates at the 100 value. 2. The relative volumes lead to a quantified brain pattern which characterizes the both 3 Lampreys with regard to the other species of Vertebrates: olfactory bulbs are well developed, more than the cerebral hemispheres; at the same time the so-called structure Tegmentum + Medulla oblongata holds about 50% of the entire brain volume. This dual pecularity may be considered as the expression of a primitive status. 3. The structure indices (each of it being fixed at 10 for the Sea Lamprey) are uniformly higher in the 2 Lampetra (with a step of 20 to 30 unities of index). It seems to be, this time, the expression of an inner evolution in Petromyzonts, but remaining the basic pattern of the group. Some examples taken amongst other Vertebrates emphasize this pecularity: Polypterus possess high indices for the cerebral hemispheres (595: processus of telencephalization) and cerebellum (1250). On the other hand the Sturgeon shows low values for all the subdivisions, except cerebellum (549). Finally, the Hagfish withdraws from the brain pattern of Lamprey because its indices are clearly higher for olfactory lobes (141) and diencephalon (113). PMID- 2723411 TI - The effects of amphetamine on synaptic plasticity in rat's medial prefrontal cortex. AB - Morphometric analysis of medial prefrontal cortex (layer VI) of rats treated daily with amphetamine in a dose of 2.5 mg/kg during 3 weeks was performed on the electron microscopic level. The efficacy of the amphetamine dosage was tested on behavioral observation. Synapses on dendritic shafts and spines were studied. The density of axo-dendritic synapses increase on 74%, while the density of synapses on spine's neck decreased on 53%. Most synaptic parameters measured in axo dendritic (1) and axo-spinous (2) synapses increased significantly under the influence of 2.5 mg/kg dose of AMPH: area of presynaptic terminal increased on 35% (1) and 21% (2), length of postsynaptic density increased on 13% (1) and 12% (2), area of spine increase on 25%. But the density of synaptic vesicles near the active zone decrease (1-on 16.5%, 2-on 20%). PMID- 2723410 TI - Cells of origin of spinothalamic, spinotectal, spinoreticular and spinocerebellar pathways in the pigeon as studied by the retrograde transport of horseradish peroxidase. AB - The cells of origin of spinal neurons projecting to the thalamus, the midbrain, the reticular formation, and the cerebellum in the pigeon were studied with the method of retrograde transport of horseradish peroxidase (HRP). Only few spinal cells project up to the thalamus and to the tectum and their location is at the base of the dorsal horn (lamina V) and in the intermediate or ventral spinal grey matter (most contralateral). However, many cells in the dorsal column nuclei (including external cuneate nucleus) project up to these brain areas. Many spinal neurons project to the caudal brainstem and reticular formation. With medioventral injections of HRP labeled cells were found in lateral lamina I (bilateral) and laminae V-VIII (most contralateral) with a concentration in lateral lamina V/VI and lamina VIII. With dorsolateral brainstem injections there was a predominance of lamina I neurons, located bilaterally at the dorsolateral corner of the dorsal horn near Lissauer's tract. These results show that spinal cells, which in mammalian species project up to the thalamus, predominantly end in the caudal brainstem. Injections into the cerebellum disclosed that not only cells of Clarke's column but also sofar not known "spinal border cells", located dorsal to and in part intermingled with the motoneurons, are cells of origin of spinocerebellar tracts and that both groups of cells occur at the cervical and at the lumbar enlargement. PMID- 2723412 TI - The histology of the cerebral neurosecretory system in several representatives of Cleroidea (Coleoptera, Insecta). AB - In Thymalus sp. (Peltidae), Melambia tekkensi (Trogositidae), Trichodes apiarius and Thanasimus formicarius (Cleridae), the composition of cerebral neurosecretory cells (NSC) is similar to that found earlier in Meloidae (Panov 1985a) and Tenebrionidae (Melnikova and Panov 1981; Melnikova 1983). 20 type I NSCs, 16 type II NSCs, 4 type III NSCs, several type IV NSCs and 4 type V NSCs are characteristic of their pars intercerebralis. On the other hand, a reduction of type I and II NSC number to 10 and 12 cells, respectively, was revealed in Malachius affinis, Malachius viridis and Malachius bipustulatus (Melyridae). There are 6 large dorsolateral NSCs and 2 lateral ones in each brain hemisphere of most Cleroidea studied. Their retrocerebral endocrine complex is similar to that of most polyphagous coleopterans: a single nervus corporis cardiaci leaves each brain side, the corpora cardiaca are fused with lateral aorta walls and corresponding corpora allata. PMID- 2723413 TI - The effects of haloperidol on synaptic plasticity in rat's medial prefrontal cortex. AB - Morphometric analysis of Medial prefrontal cortex (layer VI) of rats treated daily with haloperidol in a dose of 0.1 mg/kg during 3 weeks was performed on the electron microscopic level. The efficacy of the haloperidol dosage was tested on the amphetamine psychosis model. Synapses on dendritic shafts and dendritic spines were studied. The density of synapses on dendritic shafts increased on 51%, while on spine's neck it decreased on 19%. There were significant changes of some synaptic parameters only in axo-dendritic synapses: area of presynaptic terminal decreased on 13% (p less than 0.05), length of postsynaptic density decreased on 15% (p less than 0.05), but the density of synaptic vesicles near the active zone increased on 10% (p less than 0.05). PMID- 2723414 TI - [Volumetric analysis of the principal subdivisions of the brain of Gobioidei (Teleosts, Perciformes)]. AB - The coral reef Gobioidei have very small olfactory bulbs. Compared to other teleost fishes, Gobioidei are all microsmic. The forebrain shows little variation; its size is the same as that of other perciform fishes, giving a good idea of the phylogenetic level of the Gobioidei. The mesencephalic tectum is very important in Gobioidei but very small in Trypauchen vagina, which is a burrowing species that is almost blind. The cerebellar body is small as in all other benthic fishes. The cerebellar valvula is also always small, especially the reflex lamina. The medulla oblongata is very large; the size of the vagal and facial lobes is correlated with the gustatory sense, an important feature of most Gobioidei. PMID- 2723415 TI - The fine structure of the inferior colliculus in the cat. I. Neuronal perikarya in the central nucleus. AB - The fine structure of the neurons in the ventrolateral and the dorsomedial parts of the central nucleus of the inferior colliculus has been studied. 318 neurons, followed in serial ultrathin sections were examined. On the basis of the cell size, four major types of neuronal perikarya were identified: large (greater than 22 microns), medium-large (18-22 microns), medium-small (12-18 microns), and small (less than 12 microns). According to the shape of the perikarya, the ultrastructural features of their organelles, the occurrence and number of axosomatic synaptic contacts, the main neuronal types were subdivided in more discrete varieties. The large neurons have three varieties (oval, irregular, and fusiform). The nucleocytoplasmic ratio of these cells is usually above 1:1.8. They possess voluminous cytoplasm, that is rich in organelles. The granular endoplasmic reticulum is organized in NISSL bodies. Extremely numerous axosomatic synapses are present. These neurons represent the large stellate and disc-shaped projection (efferent) neurons, described in GOLGI studies. The medium-large neurons have two varieties. The nucleocytoplasmic ratio is 1:1.6-1:1.3. They possess a lesser amount of cytoplasm. Only the first variety possess discrete NISSL bodies. These cells are moderately afferented. The medium-small neurons display distinct differences in the number and pattern of cell organelles, and might be splitted in four varieties. The nucleocytoplasmic ratio is 1:1.4-1:1.1. Some of the medium-small neurons (especially--the first and the second variety) are probably projection cells, whilst others (especially--the third variety) might be interneurons. The small neurons display relatively large nucleus, small amount of cytoplasm (nucleocytoplasmic ratio approx. 1:1.2), general paucity of organelles, and extremely few axosomatic synapses. The both varieties of the small neurons, in all probability, represent local circuit neurons. From the total number of 318 neurons, 250 cells were followed in long rows of serial sections, that allowed distinct discrimination. From the latter, 18.4% were classified as large, 27.2%-medium-large, 44.4%-medium-small, and 10.0%-small neurons. The remaining 68 perikarya do not offer reliable electron microscopic criteria that could allow an unequivocal identification. The description of the cell somata in the central nucleus of the inferior colliculus, and its synaptic organization (to be published) will provide a basis for future studies on the connectivity, synaptic events, and neurotransmitter interactions in the relay nuclei of the auditory system. PMID- 2723416 TI - [Synaptic ribbons in pinealocytes of olfactory bulbectomized rats under experimental conditions]. AB - In previous studies it has been suggested that the increase in the number of synaptic ribbons is parallel to the melatonin forming activity of the pineal gland. The presence of synaptic ribbons in the pinealocytes of rats subjected to experimental manipulations known as enhancers of pineal actions (blindness, blindness + olfactory bulbectomy, blindness + underfeeding and blindness + cold exposure) has been studied. We found a significantly lower number of synaptic ribbons in the pinealocytes of control rats as compared with rats subjected to enhanced pineal actions. Since the latter showed a pineal-dependent gonadal atrophy and low serum estradiol levels, a direct relationship between the number of synaptic ribbons and the functional status of the pineal gland may be established. Thus, our results suggest that the number of synaptic ribbons might be an indicator of pineal activity. PMID- 2723417 TI - Autoimmunity and central nervous system regeneration in urodele amphibians. AB - Spinal cord lesion in newt is followed by complete cell and fibre regeneration. Previous observations showed that the presence of a granuloma due to a foreign substance (talcum) in the vicinity of the cut spinal cord slows down and/or prevents regeneration. The present experiments, while confirming previous evidence, show that, in animals with a paraspinal granuloma or a subcutaneous granuloma containing an autoplastic and homoplastic spinal cord implant, immunocomplexes appear on the cut ends as has been observed by the same authors in animals in which spinal cord regeneration does not occur (Mammals). The authors discuss the results in view of their theory of the autoimmune nature of the absence of axonal regeneration. PMID- 2723418 TI - Bioaccumulation of metals from nickel smelter waste in P and F1 generations of exposed animals. I. Dynamics of metal distribution in the organs and AM activity. AB - A group of female Chinchilla rabbits was exposed respiratory to metal aerosol originating from dumped wastes of a nickel smelter. The experiment was carried out in a biomonitoring station situated 4 km away from the dump in the direction of prevailing winds. Metals (Fe, Cr, Ni) introduced by inhaled waste particles were found in the increased amount in the body organs of exposed (P and F1) animals. Following a 3-months exposure of female rabbits (P), the elevated level of Cr in liver and kidneys was found, and after 6-month exposure also in the heart and thigh muscles. The Ni content proved to be increased in the lungs, heart and thigh muscles following 3-month period and in the liver after the 6 month exposure. Concerning the Fe content, it was already elevated in all the organs investigated except the lungs after 3-month exposure. The alveolar macrophage (AM) count was increased significantly in the exposed female rabbits (P) only after 6 months (P less than 0.05) and rose continually till the end of 9 month exposure (P less than 0.01). The enzyme activity of lysosomes was enhanced after 9-month exposure. In F1 rabbits 6 weeks of age elevated levels of chromium were found in the liver, kidneys, heart and thigh muscles. The Fe content was increased in the liver and thigh muscle, while the Ni content was enhanced only in the brain. The increased mucus secretion was observed on the tracheal mucous relief of F1 rabbits in response to the noxious effect of needle-shaped metal particles using an electron scanning microscope, despite the short duration (6 weeks) of postnatal exposure. The reported findings emphasize the effects of metal particles originating from the waste of a nickel smelter in an environment where the mean value of the dust fallout was only 4 g.m-2.30 days-1. PMID- 2723419 TI - Dose effect relationship for some specific effects of dithiocarbamates. AB - The effect of zinc ethylenebisdithiocarbamate (zineb) and manganese ethylenebisdithiocarbamate (maneb) has been studied in a chronic experiment (4.5 months) on albino rat thyroid gland and gonads. A complex of biochemical, morphological (histological, histochemical and electronmicroscopic), radiological, functional and biological methods has been employed. Different groups of rats were subjected to inhalatory poisoning with zineb in concentrations 110, 50, 10 and 2 mg.m-3 and maneb in concentrations 135, 12 and 2 mg.m-3. It was established that both compounds provoke toxic irritative changes in the lung and the trachea, more strongly expressed with maneb. A correlation of the dose and the effect was determined. At a zineb dose 0.1 LD50 and 0.01 LD50 applied twice weekly an increased 131l uptake (rebound phenomenon) was found and signs of increased activity of the thyroid gland. At doses 0.1, 0.02 and 0.01 LD50 both for zineb and maneb and an additional dose 0.002 LD50 for maneb, a decrease in the fertile capacity resulting from the damage of the germinative was determined (atrophic changes in Sertoli cells, deserted tubuli seminiferi because of disturbed maturation of the spermatozoa; small number or lack of differentiated forms of spermatogenesis; suppressed ovopoiesis, increased number of atretic follicles, with the domination of the relative part of the growing follicles) and endocrinoactive structures (destruction to disappearing of Leydig's cells; injured cells of Theca interna, granulosa and interstitium). These data as well as the data for teratogenicity give us grounds to recommend a higher security coefficient in hygiene standardization. PMID- 2723420 TI - Monoclonal antibodies against hepatitis B virus surface antigen: preparation and characterization. AB - Hybridomas secreting HBsAg antibodies were obtained by fusing murine myeloma cell line P3-X63-Ag8 to spleen cells of BALB/c mice sensitized with HBsAg. The surface antigen used for immunization of mice was prepared by purification from pooled human plasma specimens. Resulting monoclonal antibodies were detected by the SPRIA method. Clones producing highest anti-HBs titres were used to prepare mouse ascitic fluids. Monoclonal antibodies in ascitic fluid reached a titre of 10(6) to 10(7) at a protein concentration of 1 mg per ml. Two of the prepared monoclonal antibodies, HBS-01 and HBS-02, both belonging to IgG1 subclass of immunoglobulins, were selected for further study in order to assess their potential useability in the commercial ELISA kit. The pI values for HBS-01 ranged from 6.60 to 6.85, for HBS-02 from 5.6 to 6.1. In solid phase ELISA test the use of HBS-01 antibody improved accuracy of the assay by increasing its detection sensitivity for HBsAg subtypes adw and ayw in the reference serum; this sensitivity was evidently much better than that seen with the commercially available rabbit polyclonal anti-HBsAg antibody. The monoclonal antibody HBS-01 is specific to the determinant "a", which makes it suitable for use in ELISA test aimed at HBsAg detection. The antibody HBS-02 showed a markedly better reaction with HBsAg subtype adw than subtype ayw and can thus be used with advantage for their discrimination. PMID- 2723421 TI - The immune profile of contact allergy patients. AB - Nonspecific parameters of antibody-related and cellular immune responses were studied in a group of 30 patients treated for manifest contact allergy to metals (chromium, cobalt, nickel) or non-metals (epoxy resin, rubber) confirmed in each of them by specific patch test positivity. In addition, every patient was tested for the pattern of skin reactivity to the Immunoskintest (USOL, Prague) antigens administered intradermally. The group of 20 metal allergy patients had decreased suppressor index values, enhanced formation of immediate active rosettes and an elevation of serum IgM and IgA immunoglobulins. The remaining 10 patients reacted by a reduced ability of neutrophils to exert phagocytic action on HEMA particles and a decrease in levels of alpha-2-macroglobulins in serum. This may help select a series of suitable immune parameters to be used as prediction tests in the secondary prevention of cases of occupational contact dermatitis. PMID- 2723422 TI - Suncus murinus. Observations on ecology, distribution, status to plague in Bombay. AB - The common house shrew Suncus murinus has been shown to play an important role in maintenance and perpetuation of plague infection by earlier plague workers. With the control of human plague there is no knowledge about foci of plague in small mammals associated with man. Present study was carried out to fill in this Lacuna. Studies carried out in the present paper reveal that S. murinus does not harbour any plague infection in Bombay. This species is widely distributed in Bombay and is found to be associated with man throughout the year. The principal species of fleas harboured by this mammal is Xenopsylla cheopis. The insectivore mainly feeds on tine animals and insects and breeds throughout the year. PMID- 2723423 TI - Comparison of indirect and sandwich ELISA for the identification of ECHO viruses. AB - An indirect enzyme linked immunosorbent assay (ELISA) was standardized for the identification of ECHO viruses isolated in buffalo green monkey (BGM) kidney cell culture on inoculation of 113 sewage samples. Comparable results were obtained with both indirect and sandwich ELISA for the identification of ECHO viruses in respect of 15 out of 34 sewage samples which showed 75-100% CPE in BGM monolayers. PMID- 2723424 TI - Fatty acid composition of lipopolysaccharides of the strains of different species of Yersinia. AB - The fatty acid composition of lipopolysaccharides of the strains of Y. enterocolitica, Y. intermedia, Y. frederiksenii and Y. ruckeri studied during cultivation on meat-peptone agar is characterized by the predominance of 3 hydroxytetradecanoic and dodecanoic acids. Closely related to the mentioned bacteria is the strain of Y. kristensenii which is distinguished only by its higher level of hexadecanoic acid. The strains of Y. pseudotuberculosis and the vaccine strain of Y. pestis have a uniform fatty acid composition of lipopolysaccharides with predominance of 3-hydroxytetradecanoic acid. Their relatively low level of dodecanoic acid conditions the characteristic fatty acid spectrum of lipopolysaccharides which differs from that of the above mentioned group of Yersinia. The peculiarities of the fatty acid composition of lipopolysaccharides of both groups of Yersinia are preserved during growth on meat-peptone broth, but the increase in the level of hexadecanoic acid balances the differences between Y. kristensenii, the other Y. enterocolitica-like bacteria and Y. ruckeri. The obtained results confirm close relationship of Y. pseudotuberculosis and Y. pestis, and also of Y. enterocolitica and Y. enterocolitica-like bacteria, showing propinquity of Y. ruckeri to the latter. PMID- 2723425 TI - Serological survey of measles in Yemen in 1985. AB - The HI assay for measles was used to evaluate the sera of 191 children of preschool age (1-6 ys) from five regions of South Yemen: highland, coastal, Vadi Hadramot, the agricultural area Abijan and the capital city Aden. The serum positivity rate was 47.5% in 1-2-year-old children, 75.5% in 3 year-old and 88.5% in 4-6 year-old children. The geometric mean of HI titres was 4.8 log2 in preschool children. An optimal strategy of vaccination against measles in Yemen is discussed. PMID- 2723426 TI - Acanthamoeba culbertsoni and Naegleria fowleri: occurrence of antibodies in man. AB - Serum samples of 1,054 inhabitants of Bohemia (Czechoslovakia) were examined by means of indirect haemagglutination test with antigens from Naegleria fowleri and Acanthamoeba culbertsoni. With N. fowleri antigen the frequency of positive reactions did not exceed 3.5 per cent in lowest serum dilutions only. N. fowleri could not be identified as a possible causative agent in any chronic form of disease in man. Significant accumulation of positive findings with A. culbertsoni antigen was observed in hepatitis A patients and convalescents (52 per cent). The potential interpretations of this phenomenon are discussed. PMID- 2723427 TI - Platelet deactivation by 5HT2-receptor blockade parallels the antihypertensive response to ketanserin. AB - Serotonin (5HT) has been implicated in thromboembolic complications and blood pressure elevation and both may be reduced with the 5HT2-receptor blocker ketanserin. In 17 patients with essential hypertension (WHO I and II, diastolic pressure V greater than or equal to 100 mmHg) blood pressure, platelet 5HT uptake, content and release as well as 5HT-induced shape change and aggregation were measured before and immediately after 8 weeks oral ketanserin at 20-40 mg twice daily. During ketanserin therapy, platelet 5HT release, shape change reaction and aggregation to 5HT were significantly reduced by more than 50%. These platelet effects were more pronounced in patients responsive to ketanserin (greater than or equal to 10% decrease of diastolic pretreatment pressure) and the fall in diastolic pressure correlated with the inhibition of 5HT-induced aggregation as well as the change in 5-hydroxy-indoleacetic acid (5HIAA) in platelet-rich plasma (PRP; P less than 0.05). Serotonin-receptor-independent platelet events were not affected by ketanserin. Ketanserin corrects 5HT2 receptor-mediated platelet function along with the reduction of blood pressure. PMID- 2723428 TI - Malignant pheochromocytoma: diagnosis and treatment in fifteen cases. AB - This study reviews the diagnosis and treatment of 15 patients with malignant pheochromocytoma (MP) between 1958 and 1986 in Shanghai Rui-jin Hospital. The main clinical features consisted of sustained elevation of arterial blood pressure, obviously increased catecholamine secretion and a sustained positive phentolamine test. Out of 15 patients only seven survived, two of whom suffered from paraplegia due to metastatic cordal compression. Compared with some earlier results, the prognosis was unsatisfactory. There were several factors which may have been responsible: (1) late diagnosis; (2) incomplete operation, and (3) no regular post-operative assessment of urinary biochemical changes. Because MP is a tumour with a low degree of malignancy, noting the above three factors and using 131I-MIBG to obtain accurate diagnosis and effective treatment enables a better prognosis of this disease. PMID- 2723429 TI - Abnormal structure and function of isolated subcutaneous resistance vessels from essential hypertensive patients despite antihypertensive treatment. AB - The morphological and functional characteristics of isolated subcutaneous resistance vessels (about 230 microns internal diameter) from 13 patients treated for essential hypertension for a median period of 14 months and from 15 matched normotensive controls were examined. The blood pressure of the patients and the controls were not significantly different at the time of examination. However, although compared with the controls, the lumen diameter of the vessels from the patients was not significantly different, the media thickness to lumen diameter ratio was 19% greater. Furthermore, although there was no difference in the active pressure response of the vessels from the two groups, the vessels from the patients had a lower sensitivity to calcium, relaxed faster after a contraction and the sensitivity to exogenous noradrenaline shifted more to the left with cocaine. Since the abnormalities found here have previously also been found in vessels from patients with untreated essential hypertension, the study suggests that despite antihypertensive treatment to normotensive levels for about 1 year, some morphological as well as functional characteristics of the resistance arteries are not fully normalized. This could have consequences for the prognosis of essential hypertension. PMID- 2723430 TI - Disparate effects of mental stress on plasma noradrenaline in young normotensive and hypertensive subjects. AB - The response of blood pressure, heart rate and plasma catecholamines to a mental arithmetic and a cold pressor test was studied in 70 patients with mild essential hypertension and in 41 age- and sex-matched normotensives. Each group consisted of three prospectively stratified age classes: 20-29, 30-39 and 40-55 years. During mental arithmetic, hypertensives showed only a higher increment of systolic blood pressure (+17-19%) than normotensives (+12-15%). Plasma noradrenaline in the youngest normotensives (20-29 years) showed a small but significant decrease (-0.20 +/- 0.07 nmol/l) whereas the youngest hypertensives showed a small but significant increase of plasma noradrenaline (+0.14 +/- 0.04 nmol/l). The difference between both groups was highly significant (P less than 0.001). In the two older age classes there was no difference in plasma noradrenaline response between normo- and hypertensives. During the cold pressor test both the cardiovascular and plasma noradrenaline response were of the same magnitude in normo- and hypertensives. These data reinforce the concept that the increased sympathetic reactivity to mental stress in hypertensives may be restricted to the younger age. PMID- 2723431 TI - Twenty-four-hour blood pressure is not dependent on endogenous circadian rhythm. AB - The effects of shifted working and sleeping phases on the diurnal blood pressure rhythm were investigated in 15 physically working industrial shift workers at a slowly rotated three-shift system. Ambulatory 24-h blood pressure monitoring was performed during the morning and night shifts. In the two shifts the mean 24-h blood pressure was identical. There were no differences in the blood pressure levels in the sleeping phases or in the working periods between the two 24-h cycles. Diurnal blood pressure fluctuations had equal amplitudes. Corresponding to the lag between the working period there was a phase difference of 8 h between the 24-h blood pressure curves. At this lag, there was a high correlation between the mean hourly blood pressure values (r = 0.683). Twenty-four-hour blood pressure curves during the first and last day of a night shift were nearly equal. Thus the effects of shift rotation on the 24-h blood pressure profile were fully expressed within the first 24 hours. The immediate and complete adaptation of the 24-h blood pressure curve to shifted activity and sleeping phases indicates that activity determines the diurnal blood pressure profile. The blood pressure is largely independent of internal circadian rhythm. PMID- 2723432 TI - Modulation of tumor necrosis factor-alpha gene expression. Desensitization of prostaglandin E2-induced suppression. AB - PGE2, an immune mediator, is an inhibitor of LPS-stimulated TNF production and gene transcription. In the present study we determined whether pretreatment with PGE2 could desensitize the suppressive function of PGE2 for the production of macrophage (MO)-derived TNF. CFA-elicited MO were incubated with PGE2 or medium only, washed, and then challenged with graded doses of LPS (0.001 to 1000 ng/ml) in the presence or absence of new PGE2. The concomitant addition of PGE2 with LPS shifted the LPS concentration-effect curve 16-fold to the right with a 52% decrease in the maximum LPS response, while MO pretreated with PGE2, washed, and incubated with LPS plus new PGE2 were desensitized to TNF regulation. These latter conditions resulted in a complete loss of the ability of PGE2 to inhibit MO TNF production as demonstrated by no significant change in the EC50 of LPS. In addition, the PGE2 concentration effect curve was shifted to the right after pretreatment of MO, suggesting a desensitized PGE2 receptor system. At the transcriptional level, pretreatment of MO with PGE2 attenuated the ability of new PGE2 to inhibit LPS-dependent TNF mRNA expression. Further studies demonstrated that, although the concomitant addition of the cyclooxygenase inhibitor indomethacin plus LPS could increase TNF production, MO pretreated with indomethacin, washed, and then challenged with LPS demonstrated an inhibition of TNF expression. MO pretreated with indomethacin also demonstrated an increased sensitivity for exogenous PGE2-induced suppression of TNF mRNA and bioactivity. These investigations further support the role of PGE2 as an immunomodulating compound that may effectively regulate the local concentration of specific monokines needed to maintain an inflammatory lesion. PMID- 2723433 TI - Mechanism of lysis by large granular lymphocyte granule cytolysin: generation of a stable cytolysin-RBC intermediate. AB - The effect of ionic strength and pH on the hemolytic activity of large granular lymphocyte granule cytolysin was examined in detail. Cytolysin-mediated lysis of RBC was inhibited by either low ionic strength or low pH. Under these conditions a nonlytic cytolysin-RBC intermediate was formed as revealed by hemolysis when cytolysin pretreated cells were washed and resuspended at physiologic ionic strength and pH. Formation of the cytolysin-RBC intermediate at low ionic strength (250 mM sucrose), pH 7.3, required greater than 0.1 mM calcium. In contrast, formation of the intermediate at physiologic ionic strength (150 mM NaCl), pH 6.0, was calcium independent. Both types of intermediates were stable at 37 degrees C and required calcium to induce subsequent lysis. The degree of lysis of the intermediate generated at low ionic strength was similar to that measured under standard conditions with the use of either whole granule preparations or purified cytolysin. However, lysis of intermediates formed at pH 6.0 was much less efficient. Our data indicate that a stable cytolysin-RBC intermediate can be formed in which cytolysin is present in an unreactive state on the RBC surface; under conditions of physiologic ionic strength and calcium concentrations this intermediate rapidly lyses. PMID- 2723435 TI - Variations in protein expression related to human eosinophil heterogeneity. AB - In hypereosinophilic patients, eosinophil heterogeneity has been assessed mainly according to morphologic and biologic criteria. In order to investigate the molecular basis of such heterogeneity, biochemical analysis was performed on various eosinophil subpopulations fractionated on metrizamide gradients. Whole cell extracts from purified eosinophils disrupted with a nonionic (NP-40) detergent were successively analyzed by SDS-PAGE and two-dimensional electrophoresis (isoelectric focusing or nonequilibrium pH gradient electrophoresis in the first dimension). Hypodense eosinophils that sediment in the lightest density gradients (18 to 22% metrizamide solution) differed from other purified eosinophils (intermediate and normodense eosinophils respectively collected in 22 to 23% and 23 to 25% metrizamide solutions). Comparative analysis of protein patterns on both monodimensional and bidimensional electrophoresis showed that a basic protein of Mr 51 kDa, present on normodense or intermediate eosinophils, was poorly detected in the case of hypodense eosinophils. In contrast, two other proteins with apparent Mr of about 23 kDa and 41 kDa were exclusively or predominantly identified in these latter cell fractions. Immunochemical analysis with polyclonal antibodies against eosinophil basic proteins and enzymatic assays revealed that the 51-kDa polypeptide could be related to an eosinophil peroxidase-like molecule. In addition, the two proteins detected only in hypodense eosinophils might be related to proteins newly synthesized by in vivo activated eosinophils. Our results suggest that variations in protein expression might represent a good marker of in vivo activation. PMID- 2723434 TI - Depression of polymorphonuclear leukocyte functions by purified influenza virus hemagglutinin and sialic acid-binding lectins. AB - Infection of polymorphonuclear leukocytes (PMNL) with influenza virus causes depression of PMNL metabolic and bactericidal activities. The studies reported here were undertaken to determine whether the hemagglutinin (HA) glycoprotein of influenza virus mediates this depression. PMNL were incubated with purified HA and the oxidative responses to exogenous stimuli were measured. The results indicate that HA, in either liposomes or protein aggregates referred to as rosettes, depressed PMNL oxidative responses. Depression was observed within 2 min of initial interaction of HA with PMNL and lasted more than 2 h. The membrane fusion activity of HA requires proteolytic cleavage of the HA, whereas the receptor binding activity does not. There was no difference in the ability of virions with cleaved or uncleaved HA to depress PMNL responses suggesting that the fusion event is not required for PMNL dysfunction. Inasmuch as the HA glycoprotein binds to sialic acid-containing receptors on the surface of the PMNL, we tested whether other sialic acid-specific binding proteins can mediate the reduction of PMNL responses. Sialic acid-specific lectins from Limulus polyphemus or Limax flavus were incubated with PMNL before measuring their responses to secondary stimulus. Depression was observed upon incubation with the lectins similar to that seen upon incubation with the HA or influenza virus. These results suggest that attachment of influenza virus to sialic acid containing receptors is responsible at least in part, for suppressing PMNL oxidative responses. PMID- 2723436 TI - Functional role of human IgG subclasses in eosinophil-mediated killing of schistosomula of Schistosoma mansoni. AB - Although IgG antibodies and eosinophils have been shown to kill schistosomula of Schistosoma mansoni in vitro, very little data exist that describe the role of each IgG antibody isotype in this event. This study was designed to test the role of each IgG subclass in the eosinophil-dependent killing reaction. IgG antibodies purified by protein G or protein A affinity chromatography demonstrated a killing effect only in the presence of eosinophils activated in vivo or normal eosinophils activated in vitro by eosinophil activating factor. Purification of each IgG isotype allowed confirmation of these results and demonstrated that the killing effect was associated with IgG1 and IgG3 antibodies. IgG2 antibodies expressed a dual function: 1) an effector function with activated eosinophils and 2) a blocking function with normal eosinophils. IgG4 antibodies, whatever the source of eosinophils, blocked the killing mediated by IgG effector antibodies. These findings are discussed in relation to immunity and susceptibility to reinfection in human schistosomiasis. PMID- 2723437 TI - Human tumor infiltrating lymphocytes. Analysis of lymphokine mRNA expression and relevance to cancer immunotherapy. AB - Tumor infiltrating lymphocytes (TIL) isolated from 12 patients with metastatic malignant melanoma, renal cell carcinoma, or breast adenocarcinoma were expanded in rIL-2 for 22 to 45 days (median 33 days) and analyzed for lymphokine mRNA expression and patterns of TCR gene rearrangement. All TIL cultures were significantly enriched for T cells, with CD3+ CD8+ cells predominant in 8 of 10 cases tested, and demonstrated an oligoclonal (rather than polyclonal) pattern of TCR gene rearrangement. Nine of 12 cultures could effectively lyse the autologous targets in short term chromium release assays. IL-2 expanded-TIL expressed mRNA for TNF-alpha and TNF-beta (lymphotoxin) and, in 5 of 9 (41%) cases, granulocyte/macrophage-colony stimulating factor mRNA but not IL-1 beta or IL-2 transcripts. Cultured TIL deprived of rIL-2 for 4 days did not constitutively express mRNA for any of the lymphokines tested. One long term TIL line in culture was followed and periodically tested for lytic activity and TNF-mRNA expression. Loss of the specific cytolytic but not proliferative activity at day 85 was associated with disappearance of TNF mRNA. Profiles of lymphokine secretion may provide a useful marker for functionally characterizing different T cell subsets and may provide correlates of the in vivo anti-tumor effects of these cells when TIL are adoptively transferred into cancer-bearing patients. PMID- 2723438 TI - Role of tumor necrosis factor-alpha in E1A oncogene-induced susceptibility of neoplastic cells to lysis by natural killer cells and activated macrophages. AB - NIH-3T3 cells transfected with adenovirus E1A oncogene cDNA were found to exhibit cytolytic susceptibility to murine NK cells and activated macrophages associated with a threshold level of oncogene product expression exceeding that required for morphological transformation. A similar correlation was observed between threshold levels of E1A gene product expression and target cell susceptibility to direct cytotoxicity by rTNF. Inhibition of splenic NK cell and peritoneal macrophage cytolysis by antisera specific for murine rTNF confirmed the importance of E1A-induced TNF susceptibility as one determinant of target cell cytolytic susceptibility. Anti-TNF antibody was, however, unable to block killing of E1A-expressing targets by the NK cell line, NKB61A2. These results suggest a direct link between the functions of E1A oncogene products and cellular mechanisms of action of TNF elaborated by host effector cells and indicate that E1A expression also affects target cell susceptibility to TNF-independent cytolytic mechanisms. PMID- 2723439 TI - Fast ELISA for measuring serum antibody responses. AB - A method which speeds up the enzyme-linked immunosorbent assay (ELISA) is described. The procedure uses a modified Falcon fast assay screening system (Becton Dickinson Labware, Lincoln Park, NJ) and Falcon round-bottom 96-well plates. Antigen is adsorbed onto beads which extend from a lid and fit into 96 well plates. The beads are washed in a trough and reacted to antibody in the round-bottom plate. The labor required to wash the plates after coating with antigen, antibody or conjugate is thereby reduced. Greater flexibility and accuracy result, especially with the use of more than one 96-well plate. In this study, naturally occurring human IgG antibody responses to two isolated bacterial antigens were measured in over 200 subjects. It was found that numerical taxonomy could be used to split out the high IgG responders. The IgM response to one of the antigens was less variable and not significantly related to the IgG response. The fast ELISA is as useful to operate as the standard ELISA, but less stressful on the operator and more rapid. PMID- 2723440 TI - Purification of uteroglobin using monospecific antibodies coupled to divinylsulphone-activated agarose. AB - As a model for the isolation of a labile or trace protein, the purification of uteroglobin (UGL) by immunoaffinity chromatography is described. Antibody was isolated from sheep antiserum by immunoprecipitation, and coupled to divinylsulphone-activated agarose (Mini Leak). For the immunoabsorption stage rabbit uterine mucosal scrapings were defatted and incubated directly with the immunosorbent. After washing and desorption, the UGL preparation contained relatively few high molecular weight impurities and these were removed by gel chromatography. Purification was monitored at each step by two-dimensional SDS polyacrylamide gel electrophoresis and immunoelectrophoresis. Furthermore, affinity-purified UGL was tritiated with N-succinimidyl[2,3-3H]propionate and assayed by fluorography. In order to determine absolute UGL concentrations a competitive ELISA was developed. PMID- 2723441 TI - The ability of normal human monocytes to phagocytose IgG-coated red blood cells is related to the number of accessible galactosyl and mannosyl residues in the Fc domain of the anti-red blood cell IgG antibody molecules. AB - The percentage of normal human monocytes (MCs) that are able to form rosettes with, and subsequently phagocytose, IgG-coated red blood cells (RBCs) has been determined in vitro using five batches of anti-RBC IgG antibodies. These antibodies differed from each other by their capacity to bind to lectins recognizing two of the oligosaccharide structures of the Fc domain, namely, peanut agglutinin (PNA) and concanavalin A (ConA) which specifically bind to beta galactosyl and alpha-mannosyl residues, respectively. The threshold between high (H) and low (L) binding capacities (BC) was arbitrarily fixed at 15% of mean specific binding. For each level of RBC sensitization tested (1500-6000 Ab molecules/one RBC), the percentage of MCs binding at least three IgG-RBCs was similar whatever the IgG Ab preparations used. In contrast, the percentage of MCs capable of phagocytosing at least three IgG-RBCs coated with 3000, 4500 and 6000 IgG/cell, as well as the phagocytosis index (number of IgG-RBCs ingested/100 MCs) of IgG-RBCs coated with 1500, 3000, 4500 and 6000 IgG/cell, were significantly lower (P less than 0.01 at least) using IgG Ab molecules with either [(PNA H)(ConA-H)] BC, [(PNA-L) (ConA-H)] BC or with [(PNA-L)(ConA-L)] BC than the corresponding values measured using RBCs coated with IgG Ab molecules exhibiting [(PNA-H)(ConA-L)] BC. The binding to MCs of 125I-labelled anti-RBC IgG Ab molecules exhibiting different binding profiles to PNA and to ConA was studied by Scatchard plot analysis. A single class of binding sites was observed in each case. MCs bound a mean of 23,000 IgG molecules with a mean association constant (Ka) for IgG binding of about 1.4 X 10(8) M-1. These data indicate that terminal (and/or accessible) galactosyl and mannosyl residues of IgG Ab molecules play a role in the ingestion of IgG-RBCs by human MCs, despite the fact IgG Ab binding to IgG(Fc) receptors is not significantly affected. Thus, when studying the phagocytosis of IgG-coated RBC by human MC monolayers, the assay should be performed not only using similar RBC/MC ratios and IgG coating values, but also with IgG antibodies having comparable mean PNA and ConA binding capacities. PMID- 2723442 TI - Rat monoclonal antibodies. VII. Enhancement of ascites production and yield of monoclonal antibodies in rats following pretreatment with pristane and Freund's adjuvant. AB - The effect of intraperitoneal injections of pristane, incomplete Freund's adjuvant (IFA) and a v/v mixture of pristane and IFA (called PIFA) on ascites production and the yield of monoclonal antibodies has been studied in Louvain rats. The best results were obtained following injection of 2 ml PIFA at the moment of i.p. transfer of hybridoma or immunocytoma cells. Ascites production was increased by as much as 4.7 times and monoclonal antibody production by more than six times compared with untreated control rats. PMID- 2723443 TI - The immunocross test. An immunoelectrophoretic method based on the difference between the isoelectric points of antigens and immunoglobulins. PMID- 2723444 TI - Overall study of the in vitro plasma clotting system in an invertebrate, Liocarcinus puber (Crustacea Decapoda): considerations on the structure of the Crustacea plasma fibrinogen in relation to evolution. AB - An overall study of the in vitro plasma coagulation system in the crab Liocarcinus puber has been carried out using various analytical methods, namely thromboelastography, spectrophotometrical examination, and a new one based on changes of the mechanical impedance of the developing clot. From the results reported here the clotting pattern in this species appears surprisingly complex for an invertebrate and unexpectedly closer to that of the vertebrates. Indirect evidences suggest that the fibrinogen polypeptide chains in this species and very likely in the other crustacean, are very different from those of the vertebrates. This would imply that crustacean and vertebrate fibrinogen would have diverged from one another in a far remote past, far beyond the individualization of the vertebrate alpha chain, that is, over 1.5 million years ago. PMID- 2723445 TI - Thuricin: the bacteriocin produced by Bacillus thuringiensis. AB - Bacillus thuringiensis serovar, thuringiensis (HD-2) demonstrated antibacterial activity against 48 of 56 strains of B. thuringiensis and against some other Gram positive species but not against Gram-negative species. The antibacterial activity was not inducible by mitomycin C or by ultraviolet irradiation, and additional activity was not liberated from cells by sonication. Upon dilution of the antibacterial substance, zones of inhibition diminished without the appearance of plaques. Gel filtration chromatography indicated an Mr greater than 950,000 for the bacteriocin (thuricin) in its native form. The native thuricin was sedimented by ultracentrifugation, but electron microscopy of the pellet failed to reveal phage particles or phage components. Nondenaturing polyacrylamide gel electrophoresis (PAGE) of thuricin demonstrated the association of bacteriocin activity with a protein band which migrated only slightly into a 5% gel. Sodium dodecyl sulfate (SDS)-PAGE of partially purified thuricin revealed five major bands. Thuricin activity was substantially reduced by treatment with chymotrypsin, pronase, subtilisin, trypsin, and heat at 96 degrees C but not by treatment with lysozyme, phospholipase C, papain, peptidase, or organic solvents. It exhibited a bactericidal and bacteriolytic effect on a sensitive strain, B. thuringiensis serovar, canadensis (MF4). Partially purified preparations of thuricin had phospholipase A activity which was adsorbed by sensitive cells but not by cells which were insensitive to thuricin. Antibacterial activity was blocked by preincubation of thuricin with phospholipid. Loss of a 150-mDa plasmid was correlated with loss of thuricin production. PMID- 2723446 TI - Factors influencing the leukocyte concentration of the freshwater snail Bulinus africanus. PMID- 2723447 TI - Activity of commercial Bacillus thuringiensis preparations against Trichostrongylus colubriformis and Nippostrongylus brasiliensis. PMID- 2723448 TI - Impaired defense mechanisms in bay mussels, Mytilus edulis, with hemic neoplasia. AB - Immunocompetence of bay mussels, Mytilus edulis, with hemic neoplasia was investigated with an in vitro yeast phagocytosis assay and by in vivo clearance from the blood of injected Cytophaga sp. bacteria. The yeast phagocytosis assay was conducted with hemocytes maintained in 90% plasma. Neoplastic hemocytes, characterized by enlarged nuclei and scant cytoplasm, failed to phagocytose yeast cells. In contrast, greater than 90% of hemocytes from unaffected animals and morphologically normal hemocytes from mussels with the disease phagocytosed yeast. Substitution of normal plasma with that from a mussel with advanced disease (essentially 100% neoplastic hemocytes) did not affect the phagocytic capability of normal hemocytes. Conversely, normal plasma did not enhance the phagocytic capabilities of neoplastic cells. Mussels with advanced disease showed reduced bacterial clearance; control or lightly affected mussels (less than 11% neoplastic hemocytes) cleared greater than 90% of injected bacteria in 4 hr, while mussels with advanced disease cleared 44-83%. These experiments indicate that mussels with advanced hemic neoplasia have compromised defense systems. This may account for the reported mortality in mussels and other bivalve molluscs with hemic neoplasia. PMID- 2723449 TI - Electrical determination of water content and concentration profile in a simulation model of in vivo stratum corneum. AB - Because of its efficient water-holding capacity, healthy stratum corneum (SC) can stay soft and flexible under any environmental conditions. There may be, however, a great difference in water content within the SC between the lowermost layer that faces the wet underlying living tissue and the superficial portion of the SC that is exposed to the relatively dry ambient atmosphere. To better understand the water profile of the SC and also to verify the accuracy of measurements of high frequency conductance used to evaluate the hydration state of the skin surface, we devised a simple and convenient in vitro model of the SC that stimulates the in vivo setting of the SC. It consists of an isolated sheet of SC whose lower surface covers a pad of water-saturated filter paper, and its upper surface is exposed to the ambient atmosphere. By placing this model in environments with different relative humidities (RH), we confirmed that the recorded conductance values correlated well with the actual water content of the SC (r = 0.94). Using a model having five layers of SC sheets, the water content of the innermost portion of the SC was estimated to be equivalent to about 90% of its dry weight; this level of water content remaining relatively constant over a wide range of ambient RH except in extraordinarily humid environments above 90% RH when water began to accumulate excessively in the whole SC. Using this five SC sheet model, it was clearly demonstrated that there was an almost straight water concentration gradient from the lowermost layer to the uppermost layer of the SC. We also confirmed that the skin conductance of the high frequency current correlated well with the water content of the superficial portion of the SC as well as with that of the whole SC, therefore, it is a good parameter of the hydration state of the superficial layer of the SC. PMID- 2723450 TI - Optimization of an in vitro lymphocyte blastogenesis assay for predictive assessment of immunologic responsiveness to contact sensitizers. AB - Current methods for the predictive and diagnostic assessment of contact sensitization rely on the visual scoring of skin reactions. Predictive animal tests, generally using guinea pigs, require a relatively large number of animals to produce a sufficient database for interpreting skin reaction scores. In vitro assays have the potential of being more quantitative than skin testing and, if so, would require fewer animals. However, although in vitro assays are commonly used to study the cellular immune response to strong contact sensitizers, there has been little effort to validate them for predictive assessment purposes. We have optimized an in vitro lymphocyte blastogenesis assay for detecting the response of mouse lymphocytes to strong contact sensitizers with the eventual objective of applying this assay to moderate and weak sensitizers as well. Lymph node lymphocytes from mice sensitized to the strong contact allergens, dinitrochlorobenzene (DNCB), dinitrofluorobenzene (DNFB), or trinitrochlorobenzene (TNCB), responded [greater than or equal to 12,000 counts per minute (CPM) above background] when cultured with water soluble chemical analogues, di- or trinitrobenzene sulfonic acid (DNBS or TNBS). However, the strong sensitizer, oxazolone (OXAZ), has no water soluble analogue and lymphocytes from mice sensitized to OXAZ responded poorly in vitro (less than 2000 CPM) to an ethanol-solubilized OXAZ preparation in spite of very strong in vivo sensitization (ear swelling assay). To increase the assay sensitivity, for OXAZ, we modified the antigen presentation conditions by using 1) solubilized antigen-modified adherent spleen cells, 2) dendritic cells from the draining lymph nodes of antigen painted mice, and 3) antigen-modified Langerhans cell enriched cultured epidermal cells (EC). These approaches increased OXAZ-directed responses to greater than 7000, greater than 20,000, and greater than 100,000 CPM, respectively, under culture conditions optimized for cell density, responder: stimulator cell ratio, culture duration, and responder cell type. Our results represent a first attempt to directly modify cultured epidermal cells with OXAZ and use these cells to stimulate OXAZ-directed blastogenesis in microtiter plate cultures. This optimized assay is now under evaluation for predictive assessment of contact sensitizers relevant to occupational and consumer exposures. PMID- 2723451 TI - Action spectrum of vascular specific injury using pulsed irradiation. AB - It has been clearly demonstrated that cutaneous blood vessels will be selectively damaged by a laser whose wavelength matches one of the three absorption spectral peaks of the chromophore, oxyhemoglobin, for example, 577 nm. A restriction in the application of this wavelength for the treatment of benign cutaneous vascular tumors, such as portwine stains, has been the penetration depth of 577 nm irradiation of approximately 0.5 mm from the dermal epidermal junction (DEJ). This study was undertaken to establish whether it was possible to increase the penetration depth from 0.5 mm by changing the wavelength to beyond 577 nm in albino pig skin. Results from this study confirm that penetration depth increases from 0.5 to 1.2 mm by changing the wavelength from 577 to 585 nm at 4 J/cm2, while maintaining the same degree of vascular selectivity as that previously described after 577 nm irradiation. This occurred in spite of a mismatch in the wavelength between 585 nm and the oxyhemoglobin absorption peak of 577 nm. Unlike 585 nm irradiation and in contrast with theoretical predictions, 590 nm laser light did not penetrate as deeply as 585 nm. Not only was there a reduction in the penetration depth of the laser beam from 1.2 mm at 585 nm to 0.8 mm at 590 nm, at 4 J/cm2, but there was also a decrease in vascular selectivity in albino pig skin exposed to 590 nm irradiation. PMID- 2723452 TI - HTLV-1 infection in Papua New Guinea: evidence for serologic false positivity. AB - Serum samples from 557 individuals participating in studies from four separate lowland and highland populations in Papua New Guinea exhibited consistently false positive results for human T lymphotropic virus (HTLV) type 1 (10%) and human immunodeficiency virus (HIV) type 1 (5%) antibody in direct antiglobulin and agglutination assays. All serum samples were negative in competitive ELISAs and radioimmunoassays for HTLV-1 and HIV-1; selected samples of reactive sera were negative in an HTLV-2 competitive ELISA. Immunofluorescent antibody tests using HTLV-1 infected cells correlated poorly with ELISA results. None of the sera from Papua New Guinea neutralized vesicular stomatitis virus pseudotypes of HTLV-1. By Western blot analysis, only three serum samples were weakly reactive to HTLV-1 gag proteins. These studies suggest there is as yet no firm evidence of HTLV-1, HTLV-2, or HIV-1 infection in Papua New Guinea, although there may be a low prevalence. PMID- 2723453 TI - Biologic potential of amantadine-resistant influenza A virus in an avian model. AB - Amantadine has been accepted for both the treatment and prophylaxis of influenza A virus infections. Although amantadine-resistant mutants have been shown to be readily generated both in the laboratory and in children treated with rimantadine, little is known about their biologic properties, such as genetic stability, transmissibility, or pathogenicity, compared with the parental virus. This study examined these properties using an avian influenza virus, A/chicken/Pennsylvania/1370/83 (H5N2). Variants that were amantadine-resistant, virulent, and capable of competing with wild-type virus for transmission to susceptible hosts in the absence of the drug were selected. These amantadine resistant variants were also genetically stable, showing no reversion to wild type after six passages in birds over a period of greater than 20 d. Thus, these virus variants had no detectable biologic impairment. The mutations conferring drug resistance were in the M2 polypeptide and were identical to mutations previously described in human amantadine-resistant virus. These results suggest that resistant mutants may have the potential to threaten the effective use of amantadine and rimantadine for the control of epidemic influenza. PMID- 2723454 TI - Oral ciprofloxacin and a monoclonal antibody to lipopolysaccharide protect leukopenic rats from lethal infection with Pseudomonas aeruginosa. AB - To study the treatment of infection with Pseudomonas aeruginosa, a leukopenic rat model was developed that closely mimics the pathogenesis of Pseudomonas infection in man. This model achieved approximately 90% mortality within 10 d of infection. Pseudomonas organisms were inconsistently shed from the feces despite gastrointestinal colonization (9 fecal v. 23 cecal cultures positive for challenge strain in 28 rats). Treatment of rats with oral ciprofloxacin at 40 mg/kg afforded complete protection. A suboptimal dose of ciprofloxacin (20 mg/kg), achieving peak levels of 0.31 micrograms/mL in serum and 26.3 micrograms/mL in stool, resulted in survival of 8 (40%) of 20 rats. Intraperitoneal administration of a monoclonal antibody directed at the lipopolysaccharide of the challenge strain of Pseudomonas resulted in survival of 5 rats (26%). The combination of the two increased the survival to 75% (15 of 20, P less than 0.05 compared to either treatment alone). Thus, the combination of suboptimal doses of ciprofloxacin and a monoclonal antibody appears to protect leukopenic rats from lethal infection better than either treatment alone. PMID- 2723455 TI - Inducible resistance to vancomycin in Enterococcus faecium D366. AB - Strain D366, a clinical isolate of Enterococcus faecium, is resistant (minimum inhibitory concentration [MIC] 32 mg/L) to vancomycin. When exponential-phase cultures were exposed to half the MIC of vancomycin, a lag of 3-4 h occurred before growth resumed. Cells preexposed to 1/2 MICs of vancomycin did not show any lag. Pregrowth of D366 with vancomycin caused resistance to all glycopeptides tested. Pregrowth in vancomycin resulted in synthesis of a 3.95-kDa cytoplasmic membrane-associated protein. This protein was correlated with resistance in mutants with high-level resistance, in the presence of NaCl, which inhibited the activity of vancomycin, and when several glycopeptides with varying activities were tested. Vancomycin-grown cells appeared abnormal and lysed at a much slower rate than did normal cells. We conclude that (1) vancomycin resistance in D366 is inducible; (2) resistance is correlated with the synthesis of 39.5-kDa cytoplasmic membrane protein; and (3) this protein play an additional role in the inhibition of normal lytic functions. PMID- 2723456 TI - The activity of isoxazolyl penicillins in experimental staphylococcal infection. PMID- 2723457 TI - The efficacy of ivermectin in the chemotherapy of gastrointestinal helminthiasis in humans. PMID- 2723458 TI - Surrogate markers for HIV incidence among homosexual men. PMID- 2723459 TI - First isolates of Rickettsia conorii in Spain using a centrifugation-shell vial assay. PMID- 2723460 TI - Osteoarticular infection due to Coxiella burnetii. PMID- 2723462 TI - Burroughs Wellcome AIDS training program for IDSA members. PMID- 2723461 TI - Cryptosporidiosis in a rural community in central Mexico. PMID- 2723463 TI - Removal of peripheral blood monocytes by phenylalanine methyl ester has no effect on the colony growth of hematopoietic progenitor cells. AB - Purification of hematopoietic cells often includes an adherence step for the removal of monocytes. Recent studies have shown that some hematopoietic cells are adherent and that plastic adhesion might activate monocyte/macrophage for cytokine production. We investigated the possibility of using L-phenylalanine methyl ester (PME) as an alternative approach to monocyte removal, particularly for large-scale cell separations. Cell yield, extent of monocyte removal and cloning efficiency of colony-forming progenitor cells were compared to that produced by plastic adhesion. Starting with mononuclear cells (MNC) from adult peripheral blood, cell recovery after PME treatment was higher than that achieved with adherence and fewer monocytes were present. Cloning efficiency of the granulocyte-monocyte colony-forming progenitor cells (CFU-gm) was not affected by the PME treatment. PME treatment and plastic adhesion of low-density cord blood cells produced comparable cell recovery, monocyte depletion and cloning efficiencies for CFU-gm and burst forming units for erythroid progenitor cells (BFU-e). The PME procedure was optimized for the purification of hematopoietic cells from large quantities (less than 1 x 10(9)) of low density. T cell-depleted peripheral blood MNC containing 60% to 85% monocytes. Compared to two cycles of plastic adhesion, PME treatment permitted higher cell recovery (5.9% vs. 1.3%), lower monocyte contamination (4.5% vs. 10.7%) and substantial cost, time and labor savings without compromising CFU-gm growth. PMID- 2723464 TI - Human long-term bone marrow cultures in aplastic anemia. AB - Long-term bone marrow cultures (LTMC) were initiated with marrow from five normal subjects and eight patients with aplastic anemia (AA). Near confluent to confluent adherent layers developed in all cultures from normal subjects and AA patients. When present, the 'cobblestone' areas in LTMC from AA subjects were smaller than those observed in the LTMC from normal subjects. The decline in total and viable cell numbers in the LTMC was similar for both normal subjects and AA patients. Granulocyte-macrophage colony-forming units (CFU-gm) were present in nonadherent cells (NAC) from normal LTMC for a mean of 5.2 weeks. CFU gm were present in the NAC of only two of the eight AA cultures for one week. The absent or small 'cobblestone' areas and the absence of CFU-gm production in AA LTMC suggest a decrease in the reproductive potential of adherent hematopoietic stem cells, which may be the result of either an abnormal hematopoietic stem cell or an abnormal stromal microenvironment or both. PMID- 2723465 TI - Histogenesis of early preneoplastic lesions induced by N-nitrosobis(2 oxopropyl)amine in exocrine pancreas of hamsters. AB - The histogenesis of early putative preneoplastic lesions, arising in exocrine pancreas of Syrian hamsters after treatment with N-nitrosobis(2-oxopropyl) amine (BOP), was evaluated using electron microscopy and immunohistochemistry. Electron microscopical examination of pseudoductular lesions, present in hamster pancreas 2-4 mo after treatment with BOP, demonstrated that acinar cells forming part of these lesions frequently lose their zymogen granules. However, convincing evidence of dedifferentiation of acinar cells to proliferating ductal/ductular cells was not found. Most ductal/ductular cells of the BOP-induced pseudoductular lesions stained positively with cytokeratins specific to ductal/ductular cells. Acinar cells were all negative and, moreover, those lining the pseudoductular lesions were frequently surrounded by cytoplasmic processes of adjacent cells that stained strongly positive with the cytokeratin antibody. The present findings indicate that the early pseudoductular lesions, induced in exocrine pancreas of hamsters by BOP, originate from proliferating ductal/ductular rather than proliferating dedifferentiated acinar cells. PMID- 2723466 TI - Caerulein stimulates pancreatic secretory response in conscious newborn rats. AB - The aim of our study was to measure age-dependent, caerulein-stimulated pancreatic enzyme secretion of conscious CFY suckling rats without pancreatic duct cannulation. Pancreatic secretory response was expressed as the decrease in specific enzyme (trypsin, amylase) activity compared to saline-injected control. The study was performed in three phases. In 10-d-old conscious newborn rats, single 1 and 3 micrograms/kg sc doses of caerulein induced significant decreases in specific trypsin (42 and 47%) and amylase (34 and 33%) activity 15 min after the caerulein injection; the same doses injected at 0 and 30 min evoked a similar decrease 90 min after the first injection. The 0.5 microgram/kg dose was ineffective. In 10-d-old anesthetized rats, the 90-min-decrease in total pancreatic trypsin activity, induced by graded doses (1,3,10, and 30 micrograms/kg) of caerulein, was compared to the 90-min output of trypsin in their bile-pancreatic juice. Each of the applied doses induced significant change in the total trypsin activity both in the pancreas (-33-57%) and juice (+21 +/- 49%) and its decrease in the gland corresponded quantitatively well (r = 0.52; p less than 0.01) to the increase in the simultaneous 90-min trypsin output. The age- and dose-dependent pancreatic response of 3-, 5-, 10-, and 20-d-old conscious rats was investigated under the effect of 1,3,10, and 30 micrograms/kg sc doses of caerulein injected at 0 and 30 min. In 3-d-old rats, the 10 and 30 micrograms/kg and in 20-d-old rats, the 1 and 3 micrograms/kg doses were effective, whereas in 5- and 10-d-old rats each caerulein dose applied evoked a significant decrease in pancreatic-specific trypsin activity. CONCLUSION: The pancreas of newborn rats is in vivo less sensitive to caerulein between postnatal d 3 and 10 than in already weaned rats. PMID- 2723467 TI - Progressive changes in pancreatic vasculature accompanying copper deficiency induced glandular atrophy. AB - Pancreatic vasculature was studied in rats treated with a dietary copper deficient regimen to assess and characterize changes in the exocrine angioarchitecture of the gland. The deficient state is known to induce progressive acinar degeneration, atrophy, and subsequent replacement with noninflammatory lipomatosis. This study was carried out since little information exists regarding changes in the vasculature that accompany acute glandular necrosis. Corrosion casts produced from Mercox injected deficient rats were studied using scanning electron microscopy and compared to injected preparations studied by light microscopy. Results show that with initial atrophy of degenerative acini (6-8 wk), pancreatic lobules decreased in size and the volume of the vascular bed reduced. From wk 8 onward, the accumulation of fat cells expanded the configuration of lobules to more normal dimensions. Although vascular interconnectivity within lobules remained reduced, its basic angioarchitecture remained intact and served to vascularize fat cells in lieu of acini. No acute angiopathic changes indicative of vascular disorganization were found. These observations support the hypothesis that the vasculature of the atrophied pancreas, although modified in regions of the gland most severely targeted by acinar necrosis, remains intact and its basic structural features preserved. Preliminary evidence also supports the observation that preservation of the basic elements of lobular angioarchitecture may form the basis for subsequent regeneration of acinar tissue in the reversed deficient state. PMID- 2723468 TI - Influence of bile flow obstruction vs bile diversion on pancreatic secretion in the conscious rat. AB - Changes in pancreatic exocrine functions were compared between conscious rats with bile duct ligation and bile diversion from the duodenum on the first, third, fifth, and seventh postoperative days. Body weight was significantly decreased with time in both groups. Basal secretions of fluid, bicarbonate, and protein remained unchanged throughout the experimental period in bile duct ligated rats, whereas in bile diverted rats, the basal bicarbonate secretion with returning of pancreatic juice to the duodenum increased on the third postoperative day, and the basal protein output significantly increased with time. Basal secretions with returning of pancreatic juice to the duodenum in both groups were higher than that in control (bile and pancreatic juice returned to the intestine) rats. Stepwise increases in fluid and bicarbonate outputs responding to the graded doses of secretin were observed in bile duct ligated rats on the first and third postoperative days, as has been observed in bile diverted rats. However, on the fifth and seventh postoperative days, stepwise responses to graded doses of secretin were no longer observed in bile duct ligated rats. The pancreatic response to cerulein was greater in bile diverted rats than in bile duct ligated rats. Plasma CCK concentration in 7-d bile duct ligated rats (4.7 pM) was significantly higher than that in 7-d bile diverted rats (1.6 pM), although the pancreatic wet weight, protein concentration, and total content were comparable for the two groups. It was suggested that the presence of bile in the duodenum is required to maintain normal pancreatic secretion, and that the removal of bile from the intestine has quite different effects, depending on whether the bile flow is obstructed or diverted. PMID- 2723469 TI - Loosely coupled coaxial TEM applicators for deep-heating. AB - The development of a coaxial TEM (transverse electromagnetic) deep-heating, non contacting applicator employing two axially spaced concentric sleeves is described which has electrostatic characteristics and has been named the ESA. Thermal data obtained with the FDA/CDRH elliptic-shaped human torso phantom (with fat overlay) showed nearly uniform heating (+/- 10%) throughout the inner cross section. Saline tank measurements on a torso cross-section confirmed similar SAR uniformity. Animal experiments with a pig, both with and without blood flow, verified deep-heating and suggested that some preferential central heating occurred. The absence of excessive surface heating indicated that the major portion of the E-field excitation is axially aligned. The non-contacting applicator does not require a water bolus, and experiments showed that moderate patient movement had minor effect on performance. PMID- 2723470 TI - Comparative thermal dosimetry of interstitial microwave and radiofrequency-LCF hyperthermia. AB - Steady-state temperature distributions induced by commercial radiofrequency localized current field (RF-LCF) and microwave (MW) interstitial heating systems were compared in dog thigh muscle in vivo using repeated 15-min heating experiments in the same implant site. Control experiments consisting of up to nine successive, identical heat trials with either modality verified that induced temperature distributions could be duplicated reliably. For all comparative dosimetry experiments a square array of parallel heat sources and thermometry probes was inserted percutaneously through a 5 mm grid Plexiglas template to a depth of 7.0-8.0 cm. Metal trocar electrodes were left at the corners of square arrays for two or three successive RF-LCF heat trials. After the metal trocars were removed, two or three more heat trials were performed using dipole microwave antennas in Teflon catheters at the same four positions. The three-dimensional temperature distributions within the array boundaries were characterized by mapping up to 11 fibre optic temperature probes in 1 cm increments during the steady-state plateau of each trial. The distributions were analysed quantitatively in terms of the percentage of measured points which achieved at least 50 per cent of the maximum array temperature increase above baseline (delta Tmax). Results showed that the RF-LCF technique heated more uniformly with depth along the bare metal electrodes and more consistently within the array boundaries than the microwave dipole antennas. For all array spacings studied (1.0-3.5 cm), the RF electrodes heated approximately 10-20 per cent more of the array volume to greater than 50 per cent of delta Tmax. PMID- 2723471 TI - Temperature distributions, microangiographic and histopathologic correlations in normal tissue heated by ferromagnetic needles. AB - Rabbit hind limb musculature implanted with nine ferromagnetic nickel-copper alloy needles was inductively heated in a 120 kHz oscillating magnetic field. Rabbits were heated every third day for a total of three 30 min heating periods. Ferromagnetic needles with Curie points of 42 degrees C, 45 degrees C, and 48 degrees C were used. Fourteen days following the third heating the animals were sacrificed and the tissues processed for microangiography and histopathology. Implanted muscle heated rapidly and achieved a stable temperature within 10 min. Two weeks after heating for three 30 min heat cycles at temperatures above 47.1 degrees C, both vasculature destruction and muscle necrosis were noted. However, at temperatures below 45.5 degrees C, histopathologic and microangiographic findings were indistinguishable from unheated, implanted controls. Myocentric granuloma formation surrounding the thermoseed tracks with vascular preservation characterized tissue at a steady-state temperature between 45.5 degrees C and 47.1 degrees C. Nickel-copper alloy thermoseeds were effective at producing reproducible, localized interstitial hyperthermia. Chronic vascular and histopathologic alterations correlated closely with previous steady-state temperatures. PMID- 2723472 TI - Ultrastructural changes induced by hyperthermia in Chinese hamster V79 fibroblasts. AB - The effects of hyperthermic treatment on some intracellular components and on the general morphology of Chinese hamster V79 fibroblasts have been studied. After 1 h of heating at 42 degrees C cells show small interruptions of the plasma membrane, dilation of the mitochondrial cristae and dissociation of the polyribosomes. These modifications become progressively more pronounced after 1 or 3 h treatment at 43 degrees C. Severe alterations in the general morphology of the cells are evident after 1 h heating at 45 degrees C. PMID- 2723473 TI - Phosphorus NMR study of the response of a murine tumour to hyperthermia as a function of treatment time and temperature. AB - Evaluating the response of tumours to therapy promises to become one of the major applications of in vivo phosphorus (31P) nuclear magnetic resonance spectroscopy. Decreases in the levels of organic phosphates in favour of inorganic phosphate (Pi) as occur in murine tumours after hyperthermia treatment, can be quantified by the ratio ATP/Pi. In this study the relationship between the time of heating (15, 30 and 60 min) and the temperature (43 and 44 degrees C) was investigated in mice with NU-82 tumours by considering the changes in ATP/Pi ratio as a function of both variables. After 30 min treatment at 43 degrees C the percentage decrease in ATP/Pi ratio was similar to that observed after 15 min at 44 degrees C (42 +/- 9 vs. 48 +/- 9); after 60 min at 43 degrees C the decrease was similar to that after 30 min at 44 degrees C (75 +/- 7 vs. 74 +/- 4). These results give further evidence for the validity of a current working definition of thermal dose: thermal dose = t integral of 0 2T-43 dt. In addition this study shows that in vivo 31P NMR spectroscopy can be a useful means for assessment of thermal dose. PMID- 2723474 TI - Reduced thermal sensitivity of the vasculature in a slowly growing tumour. AB - The thermal sensitivity of a slowly growing murine mammary carcinoma has been studied, and correlated with several vascular parameters. This tumour, CaRH, had previously been shown to be particularly resistant to hyperthermia when applied as 1 h immersion in a 42.8 degrees C water bath, with or without added X-rays. In the present study water bath temperatures of 43, 44 and 45 degrees C were used as well as a more complex system of water bath plus radiofrequency currents which produced a uniform intratumour temperature of 43 degrees C. Following treatment the tumour blood volume and relative capillary perfusion were estimated using radioactive tracer techniques. Only the treatments which gave at least 60 per cent reduction in blood perfusion yielded significant growth delays or thermal radiosensitization. These data have been compared with values for six other murine tumours. If, instead of comparing the exposure temperature, we compare the blood flow reduction, it is seen that all of the tumours are similar in their thermosensitivity. A higher temperature may be needed to cause vascular shutdown in more slowly growing tumours, but it is achieved with an intratumour temperature of 43 degrees C for 1 h. This may correlate with endothelial cell proliferation rates, which are similar in CaRH to the values measured in human tumours. The more rapid vascular expansion of the fast-growing tumours may result in a more fragile and thermosensitive capillary network. The hypoxic fraction, which is a measure of vascular inadequacy, also correlates with thermal sensitivity. PMID- 2723475 TI - Thermosensitization by step-down heating in mouse testis. AB - Step-down heating (SDH) was investigated in mouse testis by giving an initial treatment of 3 min at 43.0 degrees C followed immediately by a treatment in the temperature range 38.0-42.0 degrees C. The dose-response curves for testis weight loss as a function of duration of hyperthermia were compared with those obtained using single-temperature treatments. In all cases the curves were linear, allowing the use of Arrhenius analysis. For single-temperature treatments the Arrhenius relationship showed an inflection at approximately 41 degrees C with a small, but significant, increase in activation energy for hyperthermal temperatures below the transition. SDH increased the thermal sensitivity in this lower range, by approximately 1 degree C, but the activation energy was not significantly altered. The results support the view that in vivo thermosensitization by SDH is not due solely to inhibition of development of thermotolerance. PMID- 2723476 TI - Re-induction of hsp70 synthesis: an assay for thermotolerance. AB - Of the many heat shock proteins (HSPs), hsp70 appears to correlate best with heat resistance, either permanent or transient. We have investigated various approaches to quantify the concentration of hsp 70, and examined the relationship between hsp70 and cells' thermal sensitivity during the development and decay of thermotolerance in model systems. Here, experiments were performed to determine the possibility of using the rate of synthesis of hsp70 after a second test heat shock to predict the kinetics of thermotolerance. Specifically, we studied the relationship between the retained thermotolerance in a murine tumor cell line SQ 1 and a human tumor cell line, HCT-8, after fractionated heat doses and the cells' ability to re-initiate synthesis of hsp70 in response to an additional test heat dose in vitro. Monolayers of cells were exposed to a first heat treatment (e.g., 41 degrees C, 4 h) and then incubated at 37 degrees C for 0-72 h. At various times after the first heat treatment, cells were either challenged with a 45 degrees C, 45 min heat shock to assess the residual thermotolerance by colony formation, or labelled with [35S]methionine before or after an additional test heat dose (e.g. 43.5 degrees C, 15 min). We found that the cells' ability to re-initiate hsp70 synthesis in response to the test heat shock inversely correlated with retained thermotolerance. Our data suggest the level of hsp70 in thermotolerant cells regulates the rate of synthesis of additional hsp70 in response to the subsequent heat challenge. Furthermore, the results showed that the rate of re-induction of hsp70 synthesis after a test shock can be used as a rapid measure of retained thermotolerance. This study suggests an approach for quantifying the level of retained thermotolerance during a course of fractionated hyperthermia. PMID- 2723477 TI - Cell cycle progression during chronic hyperthermia in S phase CHO cells. AB - S phase CHO cells chronically exposed to 41.5 degrees C exhibited an apparent resistance to further cell killing after 4-6 h. During the treatment interval, cells were observed to progress out of S phase and into G2, mitosis, and the next cell cycle. Progression through S was delayed by about 2 h and an equivalent mitotic delay was observed. After entry into mitosis, heated cultures showed an altered nuclear morphology, presumably as the result of abnormal division occurring during the treatment. Tritium suicide experiments at this temperature showed that clonogenic, as well as nonclonogenic, cells progressed during this period. When S phase cultures were chronically heated at 42 degrees C, however, the delay in transit through S phase was 8-10 h, and an accumulation in G2 phase was observed. Therefore, our results show that, in S phase cultures heated at 42 degrees C, cell killing continues while cells progress through S, suggesting that chronic thermotolerance cannot be expressed in S phase. Furthermore, at 41.5 degrees C, cells which progress out of S during the treatment express resistance to heat killing in subsequent cell cycle phases. In summary, our results indicate that, although chronic tolerance is not expressed during heating in S phase, it is expressed after the cells progress out of S phase. PMID- 2723478 TI - [Studies of the treatment of recurrent abortion with husband's lymphocytes]. AB - Thirty-two primary habitual aborters who had more than 3 abortions during the early stages of pregnancies without any known causes of habitual abortions were studied. The degree of HLA-DR compatibility of the patient couples was similar to that of 70 control couples. The patients were treated with intra-dermal injections of their husbands' lymphocytes 4 times every 2 weeks. The skin reactions at the sites of the injection were estimated 24 hours and 48 hours after the first and fourth injections. The mixed lymphocyte reaction (MLR) after the last injection decreased in the patients whose skin reaction was weaker following the last injection than the first (p = 0.007), and these patients had a good prognosis for subsequent pregnancies (p = 0.010). On the other hand, the MLR after the last injection did not weaken in the patients whose skin reaction did not become weaker (p = 0.007), and in these patients abortion resulted in subsequent pregnancies (p = 0.010). The HLA-DR compatibility of the patient couple and anti-HLA-DR antibody induced by the treatment did not affect the prognosis for subsequent pregnancies. PMID- 2723479 TI - [Somatic cell hybrids used in cytogenetic analysis of transformation mechanism of uterine endometrial cell]. AB - 6-Thioguanine and Neomycin resistant human endometrial carcinoma cells were established from parental HHUA 95 cells in the present study. The karyotype was 46,XX although chromosome abnormalities had been observed occasionally. Cell hybrids between 6-TGr neor 95 and rat immortalized, non-tumorigenic 3Y1 cells were formed to analyze for cosegregation of chromosomes and tumorigenicity. However, the morphology of 3 hybrid clones was a spindle form, similar to the 3Y1 cells. In spite of the consistent presence of human chromosomes, negative anchorage independent growth in these clones suggested that none of the chromosomes involved in fused cells was associated with tumorigenicity of endometrial carcinoma. Loci on a few human chromosomes of a normal cell cause suppression in several hybrid systems. Cell fusion between 6-TGr 95 and normal human fibroblasts (HF) was performed to confirm whether this is also true in endometrial carcinoma. Hybrid cells had four copies of homologous chromosomes (two from each of the parent cells). These had a polygonal appearance, being similar to the HHUA 95 cells. Both anchorage independence and tumorigenesis were negative. Those results suggested that malignant transformation of endometrial cells was the result of multiple genetic changes. In this respect, the loss of genes implicated in the suppression plays an important role in endometrial carcinogenesis. PMID- 2723480 TI - [The evaluation of ultrasonic oocyte collection techniques for IVF-ET--comparing the transabdominal and transvaginal methods]. AB - In order to evaluate the effectiveness and safety of ultrasonic oocyte collection for IVF-ET, a comparative study was performed on the results of IVF-ET by the transabdominal and transvaginal methods in 145 cycles of 51 patients. The oocyte collection rate for the transvaginal method was significantly higher than that for the transabdominal method (77.1% vs. 68.7% per follicle, p less than 0.01). The majority of the oocytes were collected in three follicular flushings. The fertilization rate for oocytes collected by the transabdominal method was significantly higher than that for those collected by the transvaginal method in cases of tubal damage and endometriosis (81.1% vs. 65.6% per oocyte, p less than 0.01). There was no significant difference between the signs of complications seen with the two methods. Six successful pregnancies were obtained by IVF-ET in our hospital (4 cases by the transabdominal method, and 2 cases by the transvaginal method). Two of these cases have already delivered full term healthy male infants. In conclusion, these results indicate that ultrasonic oocyte collection has been established as the most effective method for IVF-ET by means of either the transabdominal or the transvaginal methods. PMID- 2723481 TI - [The study on the human placental L-lactate transport mechanism (using placental microvillous membrane vesicles)]. AB - To elucidate the human placental L-lactate transport mechanism, we investigated L lactate uptake by microvillous membrane vesicles (MMV) prepared from full termed human placenta using the rapid filtration technique. 1. The transport of L lactate into the MMV was not dependent on the Na+ electrochemical gradient (extravesicular greater than intravesicular). 2. The transport of L-lactate into the MMV was dependent on the H+ gradient (extravesicular greater than intravesicular) and this H+ dependent L-lactate uptake showed a tendency to overshoot. This overshoot disappeared with the addition of H+ ionophore (FCCP). 3. The initial rate of this H+ dependent L-lactate transport into the MMV exhibited saturation kinetics with respect to the L-lactate concentration: An apparent Km of 4.35mM and Vmax of 2.78n mol/mg protein/20sec were calculated. These results indicated that there existed a H+ and L-lactate transport system in human placental MMV. PMID- 2723482 TI - [A study on the production of CA125 antigen using tissue culture of eutopic and heterotopic endometrium]. AB - The possibility of the endometrial production of CA125 and the effect of P4, MPA, and E2 were investigated using tissue cultures of eutopic endometrium (uterine endometrium obtained from uterine myoma) and heterotopic endometrium (uterine myometrium obtained from adenomyosis). CA125 was detected in eutopic endometrium before culture, its concentration being significantly higher in tissues obtained during the early proliferative phases than in those obtained during the early secretion. On the other hand, no significant changes in the tissue concentrations of CA125 before culture were found in heterotopic endometrium during a menstrual cycle. In the heterotopic endometrium, in the production of CA125 in the medium was higher than that in the eutopic one. The data on CA125 in the culture medium also indicated that the production was significantly higher during the proliferative phases than during secretion. Cycloheximide significantly decreased the concentrations of CA125 in the medium and in tissues of the eutopic and heterotopic endometrium. The production of CA125 was not affected by the addition of P4, but MPA significantly inhibited the in-vitro production of CA125, which could no longer be observed when E2 was simultaneously added to the medium. These results indicated that not only the eutopic but also the heterotopic endometrium could produce CA125, and this ability seems to be more marked in the heterotopic than that in the eutopic endometrium, especially during the secretory phases. This study demonstrated one of the causes of increased serum CA125 in patients with adenomyosis. PMID- 2723483 TI - [Study on hypoosmotic swelling test for infertile male patients]. AB - The hypoosmotic swelling test was done on 74 infertile men, 7 patients who achieved pregnancy by AIH (AIH group) and 10 fertile men and the usefulness of its test was assessed. 1) The rate of total swollen sperm and that of g type swollen sperm from infertile men were significantly lower than rates in the patients in the AIH group and fertile men. 2) There were significant but weak positive correlations between semen analysis (total sperm concentration, motility, motile sperm concentration) and hypoosmotic swelling test results (total swollen sperm, g type swollen sperm). 3) When the cut off value of the rate of total swollen sperm and g type swollen sperm was set at 42% and 14%, respectively, rates were above the cut off value except for g type swollen sperm in patients in the AIH group. PMID- 2723484 TI - [Establishment and characterization of human ovarian endometrioid carcinoma cell line]. AB - A new cell line, designated as HOC-I, was established from a recurrent region of ovarian endometrioid carcinoma. HOC-I was subcultivated more than 55 times. 1) The monolayer culture cells showed a pavement like arrangement with polygonal cells and had a tendency to pile up. PAS positive substance could be seen in the cytoplasm. Desmosomes, microvilli and well developed cell organelles could be found by electron microscopy. 2) The population doubling time was about 75 hours. The chromosomal number showed pseudodiploidy of which the mode was 46. 3) By heterotransplantation to the nude athymic mouse, the tumor easily developed. 4) The effects of estradiol and progesterone on the cellular growth were assessed by the 3H-TdR uptake test. Estradiol increased 3H-TdR uptake of HOC-I but progesterone decreased it. These data suggested that HOC-I had sex-steroid hormone dependency. 5) Estrogen receptor was not detected in HOC-I by the ER-EIA method or the ER-ICA method. 6) The HOC-I cells produced CA125 and TPA in culture media. PMID- 2723485 TI - [Role of sperm passage through cervical mucus: fertilizing capacity tested by in vitro fertilization with zona-free hamster eggs]. AB - The effect of sperm passage through cervical mucus (CM) on the fertilizing capacity of human spermatozoa was examined in the in vitro fertilization system of zona-free hamster eggs. Each drop of ejaculated semen and BWW culture medium was connected by a small capillary tube filled with preovulatory CM, egg white or BWW medium under liquid paraffin oil in a plastic petri dish. After 2 hours, zona free hamster eggs were added to the drop of BWW culture medium containing spermatozoa which had passed through the capillary tube and the mixture was incubated for various lengths of time at 37 degrees C under 5% CO2 in air. Human spermatozoa, which were washed and preincubated for 2 hours in BWW medium, were capable of fertilizing zona-free hamster eggs but needed a longer incubation time than spermatozoa which had passed through CM. Fertilization rates of spermatozoa which had passed through CM and egg white were very similar, but no fertilization occurred in the drop containing spermatozoa which had passed through BWW medium, presumably because of the contamination with seminal plasma. These results indicate that the most important role of CM may be to separate motile spermatozoa from seminal plasma components hostile to fertilization. PMID- 2723486 TI - [The synergistic abortive effect of anti-progestogen RU 38486 and aromatase inhibitors for pregnant rat]. AB - We examined whether or not aminoglutethimide (AG) and miconazole (MCZ), as aromatase inhibitors, increase the abortive activity of RU38486 (RU) in pregnant rats. RU (2.5 mg/kg) alone or with an aromatase inhibitor (10 mg/kg) was administered orally to day 6-, 9- and 12-pregnant rats. After 24 hr, the ovaries, uterus and placental tissues were resected. Aromatase activity in the 800 x g supernatant fraction of the tissue homogenate was measured. Serum levels of progesterone (P), estradiol-17 beta (E2), prolactin (PRL) and testosterone (T) were also measured by RIA. In addition, the ovarian aromatase activity and the serum hormone levels in day 6-pregnant rats were measured 0, 3, 6, 12 and 24 hr after the oral administration on. The mean abortive rates in RU-treated day 6-, 9 and 12-pregnant rats were 75%, 62.5% and 50%, respectively. Although AG or MCZ alone did not induce abortion, they significantly increased the abortive effects of RU. The serum concentrations of P and E2 in day 6- and day 9-pregnant rats treated with RU and an aromatase inhibitor were decreased. There was no significant change in the serum concentrations of PRL and T during the experiment. Although no aromatase activity was detected in the uterus or placenta, the activity in ovarian tissue increased with the gestation period. The ovarian aromatase activity was suppressed by RU and an aromatase inhibitor, but not by RU alone. These results demonstrate that both RU and aromatase inhibitor enhance the abortion effects of RU in rats. PMID- 2723487 TI - Fetal Doppler echocardiographic assessment of cardiac blood flow velocity in normal fetuses and in those with congenital heart disease. AB - Ninety fetal Doppler echocardiographic examinations were performed on 72 normal fetuses and 5 with congenital heart disease [2 pulmonary stenosis (PS), 1 pulmonary atresia (PA), 1 tetralogy of Fallot (TOF) and 1 endocardial cushion defect (ECD)] at 16 to 40 weeks of gestational age. The maximum transmitral (MVMax), transtricuspid (TVMax), transaortic (AVMax) and transpulmonary blood flow velocity waveforms (PVMax) were assessed. The detection rates for MVMax, TVMax, AVMax and PVMax in normal fetuses were 69.4%, 68.2%, 77.6% and 43.5%, respectively. MVMax, TVMax, AVMax and PVMax correlated well with gestational age, in the normal fetuses. However, there was no correlation between MVMax, TVMax, AVMax, PVMax and heart rate, in the normal fetuses, respectively. The TVMax/MVMax ratio was one and over in 53 of 55 normal fetuses (96.4%), and the PVMax/AVMax ratio was one and over in 11 of 25 normal fetuses (44%). In cases of PS, the TVMax was relatively low, but the PVMax was definitely high. The TVMax/MVMax ratios in cases of PS were 0.8 and 1.0, respectively. AVMax in a fetus with TOF was definitely low and markedly decreased in the case of ECD. Therefore, fetal Doppler echocardiography is a pertinent diagnostic tool which can be used to analyze cardiac hemodynamics in all fetuses, in utero. PMID- 2723488 TI - [A case of pregnancy complicated with Cushing syndrome]. PMID- 2723489 TI - Transactions of the Thirteenth International Leprosy Congress. The Hague, The Netherlands, 11-17 September 1988. PMID- 2723490 TI - Clinical and roentgenological studies on malalignment disorders of the patello femoral joint. Part III: Lesions of the patellar cartilage and subchondral bone associated with patello-femoral malalignment. AB - This study was aimed at clarifying what mechanism of patello-femoral malalignment causes cartilage lesions and how the lesions are related to the symptoms. The study was composed of a laboratory experiment and clinical observations on 127 joints of 123 patients. In the clinical observations, cartilage lesions on the patella as well as on the groove and condyles of the femur were studied by performing either arthroscopy or open surgery. Changes of the subchondral bone of the patella were also examined through sky-line view roentgenograms to determine their relationship with cartilage lesions. From these observations, it was concluded that cartilage lesions are caused by shearing stresses produced by the abnormal motion of the patella due to malalignment, often accompanied by open or closed (to the joint cavity) subchondral lesions. The experiment showed that various types of cartilage-bone damage could be brought about depending on various combined factors of velocity and energy of the stressing force. Based on our theory, a reasonable treatment is presented. PMID- 2723491 TI - [The influence of parathyroid hormone on the process of fracture healing]. AB - The influence of parathyroid hormone (PTH) on the process of fracture healing was examined using the fractured rats which were parathyroidectomized or given synthetic PTH. The biochemical and histological changes were studied. The results were as follows: I) Parathyroidectomized rats (PTX rats) showed decreased serum Ca, increased serum P and decreased serum PTH as observed in hypoparathyroidism. The fracture healing was impaired due to delay of both chondroclasis at the phase of endochondral ossification and secondary remodeling of primary cancellous bone. II) In rats treated with PTH (PTH rats) both serum Ca and P levels were increased at the early stage. Bone resorption as well as formation was also promoted at the early stage. At the late stage only bone formation remained good with poor bone resorption, indicating that secondary bone remodeling is decreased. The union of callus was impaired. Fracture healing was consequently delayed in both PTX and PTH rats. It is therefore suggested that PTH may be one of the important factors in fracture healing. PMID- 2723492 TI - [Studies on experimentally induced malformations of the spine and spinal cord: neuropathology of lumbosacral agenesis]. AB - The neuropathology of rats with sacral agenesis were studied. On day 8 of gestation, Donryu rats were given an intraperitoneal injection of trypan blue (40 mg/kg), and the offspring were raised. Sixty (23.1%) out of 260 offspring showed abnormalities in the lower half of the body, tail of hind limbs, and the six-week survival rate of the rats with these abnormalities was 38.3%. The grown malformed rats showed complete or incomplete lumbosacral agenesis. In these rats, the spinal level of motor paralysis corresponded to the vertebral level of malformation, and the average spinal level of sensory disturbance was 4.1 segments lower than that of motor paralysis. In the lumbar enlargement of the spinal cord, the ventral horns and the ventral roots were more hypoplastic than the dorsal horns and the dorsal roots, which seemed to be the cause of the difference in the levels of motor paralysis and sensory disturbance. Rats displayed mirror movements of their hind limbs induced by a similar method, which might have resulted from dysplasia of the ventral region of the lumbar spinal cord. PMID- 2723493 TI - [Changes in the spinal evoked potential induced by lateral compression of the spinal cord in dogs]. AB - The paper deals with the changes of the spinal evoked potential during and after lateral compression of the spinal cord in mongoloid dogs along with the motor recovery seen for a two week period. METHOD: Lateral compression was applied to the spinal cord extradurally at a speed of 1 mm per five seconds using a specially designed apparatus after laminectomy. A stimulating electrode was placed at the L5 level on the dorsum of the dura along the midline. Three recording electrodes were placed: one at the T6 level (R1), and the other two just cranially (T12, R2) and caudally to the compression level (L1, R3). The compression was released right after the R1 potential became flat. The dogs were kept alive for two weeks, during which time the evoked potentials were monitored at 1 day, 1 week, and 2 weeks. RESULTS: 1) In the recovery of amplitude, the first potentials were generally better than the second potentials. 2) The latency showed good recovery in 24 hours. 3) Many dogs showed good recovery in their motor function. PMID- 2723494 TI - [Sports injuries of the ankle]. PMID- 2723495 TI - [Congenital dislocation of hip--problems after the initial treatment]. PMID- 2723496 TI - [A study of trunk muscle in idiopathic scoliosis]. AB - Isometric and isokinetic parameters related to trunk muscle function in patients with idiopathic scoliosis were measured by Cybex dynamometer with a trunk stabilization system. Activities of the paraspinal muscles were also determined by electromyographic observations. In scoliotic patients some parameters, especially endurance in lateral bending to the concave side of the trunk, were predominant. In electromyographic analysis, neurogenic changes were observed in 25.9% of patients with idiopathic scoliosis. In nonprogressive scoliosis, the mean amplitude of EMG did not differ between the convex and the concave. In progressive scoliosis, however, the mean amplitude of EMG was higher on the convex side than on the concave side. Thus, the compensatory reaction on the curvature of the spine caused higher amplitude of action potential of the back muscles on the convex side than in the concave side. These data suggest that the trunk muscle imbalance is one of the most important factors in the onset and progression of idiopathic scoliosis. PMID- 2723497 TI - [A clinical study evaluating bone mineral mass in the radius during skeletal growth--single photon absorptiometry]. AB - Using 125-I single photon absorptiometry, bone mineral measurements were performed on 206 healthy Japanese children (2 to 19 years of age). Bone mineral content (BMC), bone width (BW) and BMC/BW values were determined for the radius at distal 1/6 site (metaphysis) and distal 1/3 site (diaphysis). BMC/BW values at both sites correlated well with body height and weight. Bone mass in the diaphysis (distal 1/3 site) increased linearly during the 2-19 years of skeletal growth, but bone mass in the metaphysis (1/6 site) increased steeply during the pubertal period. In children receiving glucocorticoid therapy, bone mass was reduced in proportion to the duration of drug administration. In children under anticonvulsant therapy, the yearly increase in bone mass was significantly low especially in those patients with poor physical activity levels. Bone mineral decrease in the radius occurred in the children with hypopituitalism, hypothyroidism (cretinism), hyperthyroidism and Turner's syndrome. PMID- 2723498 TI - Maturation of autogenous tendon grafts in anterior cruciate ligament reconstruction of the human knee--an arthroscopic study. AB - Fifty-six arthroscopic observations on 53 knees at various intervals after anterior cruciate ligament (ACL) reconstruction using the autogenous quadriceps and patellar tendon were analyzed to clarify the morphological maturation process of the grafts in human patients. Arthroscopic observations of the grafts were divided into four types, except for one rerupture case. In type I, thick synovial tissue with abundant capillary blood vessels filled the intercondylar fossa. In type II, synovial tissue mass was decreased and ligamentous tissue showed through the thin synovial tissue. In type III, relatively thick synovial tissue with many folds and abundant capillary blood vessels enveloped thick ligamentous tissue. In type IV, thin synovial tissue with relatively few blood vessels enveloped thick ligamentous tissue. Correlation between these graded types and intervals after reconstruction was significant (chi-square test, p less than 0.001). These four types of arthroscopic findings are thought to represent four phases of the maturation process of autogenous grafts after ACL reconstruction in human patients. PMID- 2723499 TI - [Impact absorbing properties of the human knee joint]. AB - A biomechanical study has been carried out on 20 cadaveric knee joints to investigate the load absorbing mechanism of the knee. The impact load was applied using a falling weight onto the transected proximal femur and the force transmitted through the knee joint was measured at the transected distal tibia using a load transducer. The transmitted peak force applied through the joint was first measured through the intact knee (100%). After the lateral and medial menisci were cut radially the transmitted peak force increased to 113% and it reached 121% after the meniscus and all the soft tissues had been removed. Next the articular cartilage and subchondral bone were removed and this resulted in the transmitted peak force increasing to 135%. When a knee joint replacement was then carried out, the peak transmission force was found to increase to 180%. These results show that the knee joint has an impact absorbing property in each segment and comparison of the results reveals that osteoarthritic joint is capable of less shock absorption than the normal knee. The high impact force in an implanted knee suggests micro-fractures of the cancellous bone might be expected and may produce long term loosening. PMID- 2723500 TI - [Functional anatomy of the long head of biceps brachii--a comparative study between normal and torn rotator cuff shoulders in cadaver specimens]. AB - In order to clarify the function of the tendinous portion of the long head of biceps brachii, intra-articular lesions of the glenoid labrum and the bicipital long head were investigated on 100 shoulder joints in 50 cadavers. From the point of anatomical features, the glenoid cavity is deepened and widened by the glenoid labrum, and the bicipital long head, which arises from the superior glenoid labrum, covers the humeral head anterosuperiorly and stabilizes the humeral head in the glenoid cavity. The pathological changes of the glenoid labrum with cuff tear (46 joints) included hypertrophy, fraying and erosion, while the bicipital long head was widened and flattened. These pathological changes progressed in company with the extension of the cuff tear. From these results, it is concluded that the intra-articular elements, such as the glenoid labrum and the bicipital long tendon play significant roles as glenohumeral stabilizers. PMID- 2723501 TI - English abstracts of proceedings of the twenty-sixth Congress of the Japan Society for Cancer Therapy. Niigata, Sept. 29, 30, Oct. 1, 1988. PMID- 2723502 TI - Spontaneous zona reaction in the mouse as a limiting factor for the time in which an oocyte may be fertilized. AB - This study evaluated the effect of ovum aging on the in vitro fertilizability of mouse ova. Over 1347 ova were evaluated. Serial trypsin digestion of in vitro and in vivo aged ova revealed an increase in zona digestion time (0.25% trypsin) beginning at 40 hr, which increased over a 40-hr period and resulted in the unfertilized zona becoming as "hard" as the fertilized embryo zona. In vitro fertilizability showed a rapid decrease as zona hardening occurred with loss of cortical granules as assessed by electron microscopy. These data suggest that the window of fertilizability is "closed" by a spontaneous zona reaction occurring at about 55 hr post-human chorionic gonadotropin with loss of cortical granules and zona hardening as manifested by increasing zona digestion time with 0.25% trypsin. PMID- 2723503 TI - Swim-over: an alternative method for harvesting motile spermatozoa. AB - An alternative method for harvesting motile spermatozoa has been developed. Two plastic chambers, one with human semen and one with Earle's medium, were connected by a glass tube filled with cervical mucus. Semen samples were obtained from 18 men. Mid-cycle, sperm-free cervical mucus was provided by 18 women. During incubation aliquots were drawn from the culture chamber every hour for analysis of sperm characteristics. A pronounced increase in motility was observed. The number of penetrated sperms averaged 1 million after 3 hr. The percentage normal morphology increased from 42 +/- 11 to 73 +/- 15 (mean +/- SD). It is suggested that "swim-over" should prove useful for obtaining sperm of high quality. Further studies for refinement and evolution of the method are currently in progress. PMID- 2723504 TI - Choice of needle for ovum pickup. PMID- 2723505 TI - Establishment of a visiting provincial in vitro fertilization (IVF) service. PMID- 2723506 TI - Clinical results of the in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT) program at Birmingham Maternity Hospital, Birmingham, United Kingdom. PMID- 2723507 TI - Return to the natural cycle for in vitro fertilization (alleluia! alleluia!) PMID- 2723508 TI - The influence of handling procedures during mouse oocyte and embryo recovery on viability and subsequent development in vitro. AB - The effect on mouse oocyte and embryo viability of prolonging the time that they spend in the oviduct prior to flushing has been investigated. Oocytes and embryos from oviducts that were flushed quickly and with as little temperature variation as possible were compared with oocytes and embryos flushed from oviducts that had been left for 30 min, either at 37 degrees C in saline or in the intact dead mouse before dissection. It was found that retention of the eggs and embryos in the oviducts leads to a lower viability at recovery and also affects the subsequent developmental potential of embryos in culture. PMID- 2723509 TI - Correlation of follicular diameter with oocyte recovery and maturity at the time of transvaginal follicular aspiration. AB - Forty-four consecutive patients undergoing transvaginal follicular aspiration for in vitro fertilization underwent ultrasonic measurement of follicular diameter at the time of oocyte retrieval to determine the correlation of follicular size with recovery rates and oocyte maturity. Based on the results of 412 follicles aspirated, the data were grouped by size (less than or equal to 11, 12-14, 15-17, 18-20, and greater than or equal to 21 mm) and oocyte maturity. Recovery rates were significantly higher in 18- to 20-mm follicles (P less than 0.01) and lower in those less than or equal to 11 mm (P less than 0.001). The probability of retrieving a metaphase I or II oocyte was significantly lower in follicles less than or equal to 11 mm (P less than 0.001), somewhat higher in 12- to 14-mm follicles (P less than 0.01), and equally high among the other groups. There were no differences in the incidence of fractured zonas. We conclude that follicles greater than or equal to 15 mm provide the highest probability of retrieving mature oocytes and the low recovery rates of mature oocytes from follicles less than or equal to 11 mm suggest that, in selected circumstances, the operating surgeon may choose not to aspirate them. PMID- 2723510 TI - Effects of prolactin during preincubation of mouse spermatozoa on fertilizing capacity in vitro. AB - In the present study, some beneficial effects of mouse prolactin (PRL) on spermatozoa were demonstrated in mice. The motility rate of spermatozoa is well maintained during incubation in modified Krebs-Ringer bicarbonate solution (mKRB) containing PRL (10 or 100 ng/ml) for up to 120 min. When spermatozoa that had been preincubated in the same PRL-containing mKRB were incubated with oocytes in mKRB, significantly more spermatozoa attached to the zona pellucida of each oocyte. When spermatozoa that had been preincubated in mKRB with PRL (50 and 100 ng/ml) for only 15 or 30 min were used for in vitro fertilization (IVF), significantly higher fertilization rates were yielded by those spermatozoa than by control spermatozoa preincubated without PRL for the same periods. The prolongation of the preincubation period did not result in increased fertilization rates. Thus, PRL demonstrated biological effects on spermatozoa by shortening the optimal preincubation period for spermatozoa to acquire capacitation and by maintaining their motility and ability of the attachment to the oocyte during IVF. The results are relevant to clinical application of PRL for infertile patients with oligozoospermia or asthenozoospermia. PMID- 2723511 TI - A prospective randomized comparison of single- and double-lumen needles for transvaginal follicular aspiration. AB - Patients undergoing ultrasound-directed transvaginal follicular aspiration in a large in vitro fertilization (IVF) program were randomized for retrieval with either a single-lumen needle (SLN; N = 22) or a double-lumen needle (DLN; N = 22) to compare recovery rates and the technical aspects of their use. Two hundred ten and two hundred two follicles were aspirated with each needle, respectively. Follicular diameters were measured ultrasonically at the time of aspiration and recorded. One or more washes were performed when using the DLN and the SLN was withdrawn each time to recover the fluid in the dead space of the needle. The distribution of follicular sizes was the same for both needles. Oocyte recovery rates (SLN = 65.7%; DLN = 63.9%) and the incidence of fractured zonae (SLN = 9.1%; DLN = 6.4%) were the same for both needles (alpha greater than 0.50; beta less than 0.01). Although there were no differences between the two needles in the number of oocytes provided for IVF, there were technical differences. The DLN needle was more flexible and frequently deviated from the projected path as observed by ultrasound. The SLN may be preferable because it is technically easier to use; however, there may remain specific indications for the use of the DLN. PMID- 2723512 TI - Parameters influencing the response time of volatile anesthetics monitors. AB - In a given inhalational anesthetic analyzer, response (RT) is usually thought to be a constant value, however, several factors may influence RT. RT's measured under ideal conditions for the Beckman LB 2, the Normac (Datex), the Servo S 120 (Siemens) and the Irina (Drager) were 107 +/- 5, 589 +/- 14, 538 +/- 30, and 166 +/- 15 msec, respectively. In addition, we investigated the RT of a Beckman LB 2 analyzer under conditions which may occur in clinical practice (non ideal conditions). Increasing aspirating flow (AF) resulted in shorter RT's, the effect being most pronounced when AF was below 200 ml/min. Interposing a filter prolonged RT by 80%. The type of the inhalational anesthetic (halothane or isoflurane), humidity and temperature of the carrier gas as well as size and direction of the concentration step change did not influence RT. Increasing length or internal diameter (ID) of the sample tube resulted in longer RT's. Changing the sample tube material from glass to Teflon or polyethylene resulted in a slight increase of RT, but the increase was dramatic when rubber or silicone tubes were used. The partition coefficient of halothane in the material of a particular sample tube was directly correlated to the corresponding RT in this sample tube. The influence of different sampling places was studied by interposing copper or corrugated rubber tubing between the place where the concentration step change occurred and the place where the gas was sampled, the measured time was called total response time (TRT). Using corrugated rubber tubes instead of copper tubes increased TRT two to four times. More distal gas sampling and/or lower flow rates caused longer TRT's. Compared with sampling in its center, gas sampling near the walls of the tube resulted in an increase in TRT of 13-45%. It is concluded that the response time of an infrared inhalational anesthetic analyzer is not a constant parameter, but varies between 100 and 4000 msec depending on the characteristics of the analyzer, the sample line, and the place of gas sampling. PMID- 2723513 TI - Development and evaluation of a dual-pump microcomputer-based closed-loop arterial pressure control system. AB - Hypertension after cardiac surgery is common and is associated with increased morbidity. It is usually managed by the infusion of short acting vasodilators. The use of a closed-loop computer system to control the infusion of a vasodilator has been shown to compare favourably with manual control. We have developed a closed-loop system for the ATARI 1040ST microcomputer to control arterial pressure by the simultaneous infusion of two vasodilators. The control program is based on a proportional-integral-derivative algorithm which has been adapted to allow control of two IMED 929 infusion pumps from one RS-232 port. All communication between the user and computer is carried out with a 'mouse', thus increasing acceptability of the system to ward staff. Cardiovascular data are collected on-line from the patient monitor via a custom-built analogue to digital convertor. This system was used to study glyceryl trinitrate and sodium nitroprusside in 24 patients requiring vasodilators after cardiopulmonary bypass. The study showed that in 14 of the patients hypertension was controlled by GTN alone and 10 required supplementary SNP. We have demonstrated that this dual-pump automatic arterial pressure control system is a satisfactory and safe method of administering two vasodilators simultaneously. It is suitable for both routine clinical and research uses. PMID- 2723514 TI - Work of IEEE P1157 Medical Data Interchange committee. AB - The Institute of Electrical and Electronics Engineers (IEEE) has been working for several years to develop medical system communication standards, under sponsorship of the Engineering in Medicine and Biology Society (EMBS). The work of the IEEE P1157 Medical Data Interchange committee is surveyed in this paper. By 1990 the IEEE P1157 Medical Data Interchange committee plans to have a draft standard ready for ballot, with an initial focus on the interface transactions needed to support a patient care information system. Eventually, the IEEE P1157 Medical Data Interchange committee will develop standards with a wider scope, including the transfer of electronic medical records between different vendor systems. PMID- 2723515 TI - What is sex? PMID- 2723516 TI - Bronchopulmonary sequestration. AB - Bronchopulmonary sequestration is a rare lesion making up less than 10% of all congenital pulmonary malformations. The two classic types, extralobar and intralobar, can be distinguished by whether or not the sequestered pulmonary tissue is enclosed by a separate visceral pleural lining. A case of intralobar bronchopulmonary sequestration is presented. At present, aortography is necessary to establish the diagnosis, but other imaging modalities including computed tomography, ultrasound, and magnetic resonance imaging offer the potential for additional useful information. PMID- 2723517 TI - A proposal for care for the medically indigent in the New Orleans area. AB - The medical care of the indigent in the New Orleans area is an acute problem because of growing deficiencies of funding support, an aging plant, limited equipment, and difficult working conditions at the Charity Hospital (New Orleans). This is the second part of a presentation dealing with the problems and opportunities for the Charity System both in New Orleans and in Louisiana. I have expressed opinions about the choices for the responsible entity, the planning, the location, the organization, the finance of care, and the continuing relationship of medical care to medical education. I propose to continue the Charity Hospital in a new facility. If a new facility is impossible close Charity Hospital over a five- to seven-year period, care should be delivered in various community hospitals in Orleans and Jefferson parishes. Outpatient and emergency care should be decentralized. Louisiana State University is the preferred choice as the planning and operating authority. I believe the continuing interrelationship of the care of the medically indigent and medical education (faculty, residents, and students) is important. PMID- 2723518 TI - ECG of the month. Read my blips. Ventricular bigeminal rhythm. PMID- 2723519 TI - Respiratory failure associated with the post-polio syndrome. AB - The recent medical literature documents the occurrence of progressive muscle weakness 30 to 40 years after apparent recovery from poliomyelitis. We present a patient whose respiratory failure was attributed to the late effects of poliomyelitis on the respiratory muscles via spinal cord impairment. We examine the characteristics and proposed causes of the "postpolio syndrome." PMID- 2723520 TI - What about mandatory AIDS testing? AB - Mandatory testing for AIDS is controversial. Such screening has been suggested for prisoners, immigrants, prostitutes, military personnel, and persons contemplating marriage or pregnancy. Quarantining and even tatooing have also been recommended for persons with AIDS. The advent of mass testing raises the issues of (1) proper allocation of scarce AIDS resources; (2) the need for confidentiality of examination reports; (3) the value of this assessment without the existence of a definitive treatment; (4) the possibility of both false positive and false negative results; and (5) the provision of counseling for people with positive testing. Other concerns involve public health needs versus individual rights, and the confidentiality of the doctor-patient relationship. Past epidemics serve as paradigms for the role of mandatory screening and quarantine in a public health crisis. As testing for AIDS is expanded, anticipate that adverse reactions such as panic, depression, grief, compulsive behavior, and suicide attempts will increase. The physician must provide counsel on such matters as "safe sex" practices, avoidance of needle sharing, and early warning signs of AIDS and ARC. PMID- 2723521 TI - Maternal mortality. A report of the KMA Maternal Mortality Study Committee. AB - This maternal mortality report delineates the course of a myocardial infarction subsequent to a cesarean section. A brief discussion of this entity is presented. PMID- 2723522 TI - Pancreatitis following aneurysmectomy. PMID- 2723523 TI - Unmet geriatric need in Kentucky. PMID- 2723524 TI - Sensitivity, specificity, predictive value and accuracy of film/screen mammography. A three-year experience. AB - Mammographic and pathologic findings of 312 breast lesions biopsied at the University of Kentucky Medical Center over a three-year period (Jan 1, 1984 through Dec 31, 1986) were correlated. Each of the 312 mammographic examinations was classified as a true positive, true negative, false positive, or false negative interpretation based on the final pathologic diagnosis. The data on 88 wire directed biopsies for clinically occult mammographic lesions and data on 224 biopsies of palpable lesions performed without wire localization were evaluated separately and in combination. From this data the sensitivity, specificity, predictive value, and accuracy of mammography for detecting breast cancer were calculated. Results of all breast biopsies 1984-1986 gave a sensitivity of 84%, specificity of 59%, positive predictive value of 40%, negative predictive value of 92%, and an accuracy of 65% for film-screen mammography. Wire directed biopsies increased the false positive diagnosis from 22 to 96 but also accounted for the detection of 14 clinically occult breast cancers, of which 84% had negative lymph nodes. PMID- 2723525 TI - CT of aortic and mitral valve calcification. AB - In a retrospective study of 100 patients 40 years of age or older, routine CT of the thorax demonstrated calcification of the aortic valve in five and mitral valve in five. The prevalence of valvular calcification increased with increasing age; calcification was present in 36% of patients over 70 years of age and 75% over 80. None had a history of rheumatic fever; in nine of 10 cases valvular calcification appeared to be degenerative in etiology. In one younger patient, aortic valvular calcification occurred in a congenitally bicuspid valve. Aortic valvular calcification on CT is specific for aortic stenosis; CT also demonstrates the calcification earlier than either plain radiographs or echocardiography. In the elderly, mitral valve calcification on CT seems to occur as a manifestation of degenerative changes in the mitral valve and anulus and may be associated with mitral insufficiency, mitral valve prolapse, or conduction abnormalities. Two-dimensional echocardiography and doppler interrogation of the valves should be done in any patient in whom CT demonstrates aortic or mitral valvular calcification. PMID- 2723526 TI - A return to altruism. PMID- 2723527 TI - Risk of the practice of medicine. PMID- 2723528 TI - Maternity leave and job security: a prescription for improved quality of life in the U.S.A. PMID- 2723529 TI - Winds of change--Part II. PMID- 2723530 TI - Vibrio vulnificus sepsis after eating raw oysters. AB - Vibrio vulnificus, a marine vibrio found in coastal waters of the United States, may contaminate certain seafoods, particularly raw oysters. Patients with underlying liver disease are particularly susceptible to severe illness. Unexplained febrile diseases in patients who have eaten raw oysters may be caused by Vibrio vulnificus. A fatal and a nonfatal case are reported in two such patients. These patients are the first two reported cases of Vibrio vulnificus infection in Kentucky. PMID- 2723531 TI - Perceptions and utilization of hyperbaric oxygen therapy for carbon monoxide poisoning in an academic setting. AB - The routine use of hyperbaric oxygen as therapy for carbon monoxide intoxication is being critically reexamined nationally. There are no controlled prospective clinical studies that show this modality to clearly be superior to the more traditional use of high concentrations of supplemental oxygen. Proponents of hyperbaric therapy often claim that such studies would now be unethical, would violate the accepted standard of care for this medical emergency, and would place the treating physician in an indefensible medical-legal position. In an attempt to determine the status of hyperbaric oxygen in our community as treatment for significant carbon monoxide exposure, we surveyed physicians practicing at the university regional trauma center to determine their perception of the indications for hyperbaric oxygen therapy for carbon monoxide poisoning. We then audited the medical records of all patients treated during a four-year period with the diagnosis of carbon monoxide poisoning or smoke inhalation to determine the actual utilization of this therapeutic modality. The results of our study indicate that hyperbaric referral is not the standard treatment for significant carbon monoxide intoxication in this academic setting. PMID- 2723532 TI - Endobronchial Nd:YAG laser surgery. AB - Thirty-six malignant and four benign endotracheal and endobronchial lesions were treated using Nd:YAG laser through flexible bronchoscope from November 1985 to July 1987 at the University Hospital in Louisville, Kentucky. Progressive dyspnea and hemoptysis were primary indications for the procedures. The majority of patients were treated under general anesthesia using intravenous agents. Most patients required two treatment sessions for complete endobronchial tumor ablation. The mean hospital stay was 48 hours. Two patients died postoperatively; one died of myocardial infarction and another of progressive respiratory failure. The mean survival was 13 weeks. Sixty-three percent of patients treated were improved as measured by Karnofsky Performance Status. Mean change in Performance Status between pre- and post-laser treatment was 100% (from 30 to 60). We conclude that therapeutic laser bronchoscopy is a useful adjunctive treatment in selected patients with obstructing or bleeding lung tumors. PMID- 2723533 TI - A surgical approach to the management of severe esophageal caustic injuries in childhood. PMID- 2723534 TI - Together--we can make a difference! PMID- 2723535 TI - Study of mitochondrial organization in living resident and activated macrophages using the laser dye rhodamine 123. AB - Rhodamine 123, a fluorescent laser dye that labels metabolically active mitochondria of living cells, was used to analyse the pattern of distribution of mitochondria in resident and activated mouse peritoneal macrophages kept in culture for 4 or 24 hr. Activated macrophages kept for 4 hr in culture showed abundant small mitochondria distributed throughout the cell. This pattern changes to a situation in which the mitochondria are filamentous and radiate from the perinuclear region when these cells are kept in culture for 24 hr, acquiring a pattern similar to that observed in resident macrophages. After treatment with phorbol myristate acetate, resident macrophages presented a mitochondrial distribution similar to that observed in activated macrophages. PMID- 2723536 TI - Guinea pig lung eosinophil: purification and prostaglandin production. AB - Guinea pig lung eosinophils have been purified from bronchoalveolar lavage (BAL) fluid, and the production of prostaglandin E2 (PGE2), thromboxane B2 (TXB2), and 6-keto-PGF1 alpha was measured after stimulation with phorbol myristate acetate (PMA), platelet-activating factor (PAF), and formyl-methionyl-leucyl phenylalanine (fMLP). A combination of plating and discontinuous Percoll gradient centrifugation was used to purify eosinophils. The purity of eosinophils in fraction E (interface between Percoll density 1.057-1.068) was around 96%, and the viability was 99%, with a mean yield of 2.7 x 10(6) cells per guinea pig. Similarly, in fraction D (interface between Percoll density 1.047-1.057), the mean purity of eosinophils was 76% and the viability of cells was 99%, with a mean yield of 1.1 x 10(6) cells per guinea pig. Purified eosinophils produced TXB2 predominantly after stimulation with PMA, fMLP, and PAF. The 6-keto-PGF1 alpha was slightly increased in cell supernatants after stimulation with PMA and fMLP, but PGE2 was not elevated with any stimulus. The highly purified eosinophils of fraction E generated amounts of TXB2 and 6-keto-PGF1 alpha similar to the amount generated by eosinophils contaminated with some macrophages (fraction D). These results suggest a role for eosinophils in the production of TXA2 by guinea pig lung. PMID- 2723537 TI - Thermal regulation of FMLP receptors on human neutrophils. AB - Polymorphonuclear leukocytes (PMNs) from subjects diagnosed as having juvenile periodontitis (JP) have been categorized on the basis of their chemotactic (CTX) response to f-met-leu-phe (FMLP) when assayed concurrently with PMNs from periodontally healthy subjects (HP). When PMNs from JP groups demonstrating depressed CTX were assayed for lysosomal enzyme secretion (LES) in response to FMLP, there were no significant differences with respect to rate or amount. Significant differences were observed between HP and chemotactically depressed JP cells when assessed for FMLP receptor ligand binding at 23 degrees C, but not at 4 degrees C. Receptor differences observed at 23 degrees C in HP cells included an increase in amount of total binding, number of receptors, and available displaceable binding sites, compared with the chemotactically depressed JP PMNs, whereas the receptor affinities were similar. These data suggest that differences in FMLP receptor density in JP PMN that are chemotactically depressed may be related to processes that modulate receptor mobility and/or expression. PMID- 2723538 TI - Hydrolysis of phosphatidylcholine during LDL oxidation is mediated by platelet activating factor acetylhydrolase. AB - Degradation of phosphatidylcholine to lysophosphatidylcholine occurs during oxidative modification of low density lipoproteins (LDL). In this study, we have shown that this phospholipid hydrolysis is brought about by an LDL-associated phospholipase A2 that can hydrolyze oxidized but not intact LDL phosphatidylcholine. The chemical nature of the oxidized phospholipids that can act as substrates for this enzyme was not fully characterized, but we hypothesized that the specificity of the enzyme for oxidized LDL phosphatidylcholine might be explained by fragmentation of polyunsaturated sn-2 fatty acyl groups in LDL phosphatidylcholine during oxidation. To facilitate characterization of this enzyme, we therefore selected a fluorescent phosphatidylcholine substrate that had a short-chain, polar residue in the sn-2 position: 1-palmitoyl 2-(6-[7-nitrobenzoxadiazolyl]amino) caproyl phosphatidylcholine, (C6NBD PC). This substrate was efficiently hydrolyzed by LDL, but the dodecanoyl analogue of C6NBD PC, which differed only in that a 12 carbon rather than a 6-carbon acyl derivative was present in the sn-2 position, was not hydrolyzed. The phospholipase activity was heat-stable, calcium independent, and was inhibited by the serine esterase inhibitors phenylmethylsulfonyl-fluoride and diisopropylfluorophosphate, but was resistant to p-bromophenacylbromide and dithiobisnitrobenzoic acid. The phospholipid hydrolysis could not be attributed to the action of lecithin:cholesterol acyltransferase or lipoprotein lipase. Nearly all of the activity in EDTA anticoagulated normal plasma was physically associated with apoB-containing lipoproteins, but this apoprotein was not essential as enzyme activity was present in plasma from abetalipoproteinemic patients. These properties are very similar to those recently reported for human plasma platelet-activating factor (PAF) acetylhydrolase. In the present study, we found that acylhydrolase activity against C6NBD PC, PAF, and oxidized phosphatidylcholine copurfied through gel filtration and ion-exchange chromatography. Substrate competition was demonstrated between C6NBD PC, PAF, and oxidized 2-arachidonyl phosphatidylcholine, suggesting that a single enzyme was active against all three substrates. The enzyme had an apparent molecular weight of 40,000-45,000 by high pressure gel exclusion chromatography. Inhibition of this activity with disopropyfluorophosphate prior to oxidative modification of LDL prevented phospholipid hydrolysis but did not affect the production of thiobarbituric acid reactive compounds or the change in electrophoretic mobility. In addition, this inhibition of phospholipase did not prevent the rapid degradati PMID- 2723539 TI - A bile alcohol sulfate as a major component in the bile of the small skate (Raja erinacea). AB - The nature of bile alcohols and bile acids in gall-bladder and hepatic bile from perfused livers of the small skate (Raja erinacea) has been investigated. The main bile alcohol sulfate was isolated by thin-layer chromatography and analyzed by fast atom bombardment mass spectrometry and 13C NMR. Following solvolysis and purification on Lipidex-DEAP, the bile alcohol profile was measured by capillary gas-liquid chromatography-electron impact mass spectrometry. Based on these studies and on comparison with authentic scymmnol sulfate and scymnol, the main bile alcohol was identified as 5 beta-cholestane-3 alpha,7 alpha,12 alpha,24 xi,26,27-hexol sulfate. The mean +/- SD concentration in gallbladder bile from five different skates was 24.6 +/- 8.7 mmol/l. Only 0.1 mmol/l of cholic acid and its conjugates was found in a pool of skate bile. The main bile alcohol sulfate in the bile of the small skate seems to be a metabolic end product, present in a concentration comparable to that of bile salts in mammals. PMID- 2723540 TI - Transepidermal water loss: the signal for recovery of barrier structure and function. AB - Previous studies have demonstrated that perturbations in barrier function stimulate epidermal lipid synthesis and that this increase can be prevented by occlusive membranes. These observations suggest that epidermal lipid synthesis might be related to barrier function and raised the question whether transcutaneous water flux might regulate epidermal lipogenesis. In the present study we first abrogated the barrier with acetone, and then compared the rate of repletion of stainable lipids, barrier recovery, and epidermal lipogenesis in animals covered with occlusive membranes or vapor-permeable membranes versus uncovered animals. Acetone treatment of hairless mice removed stainable neutral lipids from the stratum corneum, with repletion evident both biochemically and histochemically within 48 hr in uncovered animals. In contrast, when the animals were covered with an occlusive membrane, the usual return of stratum corneum lipids was aborted. Since application of vapor-permeable membranes allowed normal lipid repletion, occlusion alone is not responsible for the inhibition of lipid repletion. Acetone treatment also perturbed epidermal barrier function, which returned to normal in uncovered animals in parallel with the reappearance of stratum corneum lipid. However, when animals were covered with an occlusive membrane, barrier function did not recover normally. In contrast, occlusion with vapor-permeable membranes allowed barrier function to recover normally. Finally, whereas occlusive membranes prevented the characteristic increase in epidermal lipid synthesis that follows barrier perturbation, epidermal lipid synthesis was increased in animals covered with a vapor-permeable membrane. These results point to transepidermal water flux itself as the signal that regulates epidermal lipid synthesis, which is associated first with the redeposition of stratum corneum lipids and then the normalization of stratum corneum barrier function. PMID- 2723541 TI - Interaction of the high density lipoprotein conversion factor with recombinant discoidal complexes of egg phosphatidylcholine, free cholesterol, and apolipoprotein A-I. AB - An HDL conversion factor which promotes the conversion of HDL3 to populations of larger and smaller particles has recently been identified in human plasma. In the present report a partially purified preparation of this factor has been used to examine the conversion of 79:0:1, 77:5:1, and 74:10:1 (mol:mol:mol) egg phosphatidylcholine-free cholesterol-apolipoprotein A-I (apoA-I) recombinant discoidal complexes. The study was carried out in order to ascertain whether the conversion process is regulated by the concentration of free cholesterol in the complexes. The complexes comprised one major and two minor populations of particles with respective Stokes' diameters of 96 A, 84 A, and 78 A. The 74:10:1 complexes also contained a population of particles 112 A in diameter. The 79:0:1 and 77:5:1 complexes contained two molecules of apoA-I per particle. The 74:10:1 complexes comprised two classes of particles with two or three molecules of apoA I. When the 74:10:1 complexes were incubated with the conversion factor, the 96 A and 84 A particles were converted to a population of particles 78 A in diameter that contained two apoA-I molecules. In the case of the 79:0:1 and 77:5:1 complexes, the 96 A particles were converted to 78 A particles but the concentration of 84 A particles did not change. The rate of conversion of 96 A particles to 78 A particles was dependent on the concentration of free cholesterol in the complexes. When the 74:10:1 complexes were incubated for 24 hr with the conversion factor, the 96 A particles were completely converted to particles 78 A in diameter. In the case of the 77:5:1 complexes, complete conversion was achieved by 48 hr. Conversion of the 79:0:1 complexes did not proceed to completion, even when the incubation was extended beyond 48 hr. The rate of conversion of 96 A particles to 78 A particles was also dependent on the concentration of the conversion factor in the incubation mixtures. The previous incubations contained equivalent concentrations of apoA-I and conversion factor. When the concentration of the conversion factor relative to apoA-I was reduced, there was a concomitant decrease in the rate of conversion of 96 A particles to 78 A particles. Conversion was not evident when the concentration of the conversion factor was reduced to one-tenth that of apoA-I.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723542 TI - A novel explanation for the reduced LDL cholesterol in severe hypertriglyceridemia. AB - When [3H]cholesteryl ester-labeled low density (LDL) and intermediate density lipoproteins (IDL) from a normotriglyceridemic, hypercholesterolemic rabbit were injected into severely hypertriglyceridemic, hypercholesterolemic rabbits, 60% of the label appeared in very low density lipoproteins (VLDL) at 3 hr. A similar experiment showed that 40% of injected 131I-protein-labeled LDL appeared in the IDL fraction at 4 hr. Taken together, these data suggest that the exchange of LDL cholesteryl ester for VLDL triglyceride results in a density shift of injected LDL to the IDL density range. Furthermore, the percent of injected 131I-labeled LDL from normotriglyceridemic rabbits that appeared in the IDL fraction increased in rabbits with increasing levels of plasma triglyceride. This LDL density shift was reproduced in vitro by incubating iodinated LDL from normotriglyceridemic, hypercholesterolemic rabbits with concentrations of VLDL from hypertriglyceridemic, hypercholesterolemic rabbits similar to those in plasma. With such a system, it was shown that the percentage of LDL that appeared in the IDL fraction increased with time, was enhanced fourfold by the addition of plasma lipid transfer protein, increased with increasing molar ratio of triglyceride to cholesteryl ester in VLDL, but apparently did not increase with increasing VLDL particle number. These studies suggest that a pronounced decrease in density of lipoproteins that would normally appear in the LDL density range, resulting from loss of cholesteryl ester in exchange for VLDL triglyceride, may explain, at least in part, the reduced LDL levels in severe hypertriglyceridemia. PMID- 2723543 TI - Metabolic behavior of hepatic VLDL and plasma LDL apoB-100 in African green monkeys. AB - Recently, evidence has accumulated suggesting that significant amounts of plasma low density lipoproteins (LDL) may be derived by direct production. These plasma very low density lipoprotein (VLDL)-independent sources include the production and secretion of LDL-like particles directly by the liver, and/or a small pool of nascent precursor particles that are converted rapidly to LDL. The current studies were designed to test the hypothesis that hepatic VLDL represent a rapidly turning over precursor pool to plasma LDL in African green monkeys. Livers from African green monkeys were perfused with serum-free medium containing [3H]leucine or 3H-labeled amino acids for 4-6 hr. Hepatic [3H]VLDL and autologous plasma 125I-labeled LDL were injected simultaneously into recipient animals and density gradient ultracentrifugation and gel filtration were used to characterize the distribution of 3H and 125I radioactivity at selected times after injection. These studies show that 4 to 66% of the injected dose of hepatic VLDL [3H]apoB 100 was metabolized extremely rapidly into particles that resembled the recipient's plasma LDL by size and density. Based on the kinetic model developed to describe the metabolic behavior of hepatic VLDL [3H]apoB-100, the estimated maximal pool size of hepatic VLDL apoB-100 in these animals was very small (0.042 and 0.112 mg) and represented, at best, approximately 10% of the average plasma VLDL apoB-100 mass found in cholesterol-fed African green monkeys. In addition, the radiolabeled hepatic LDL appear to be metabolized similarly to plasma LDL. That is, the rapid conversion of hepatic VLDL as well as the direct production of hepatic particles within the LDL density range appear to contribute to plasma LDL. Metabolic heterogeneity was also seen within the LDL class. The more buoyant subfraction (LDL1) had a higher turnover rate than the more dense subfraction (LDL2) and hepatic VLDL-derived [3H]LDL1 had a slower final rate of plasma disappearance than the plasma-derived 125I-labeled LDL1 in most animals. The results from these studies suggest that a small pool of hepatic VLDL can be converted very rapidly to plasma LDL and may contribute significantly to the large plasma pool of LDL seen in cholesterol-fed African green monkeys. This pathway may be analogous to the pathway in some human subjects in which a portion of human plasma VLDL is converted rapidly into LDL without passing through a delipidation cascade, often referred to as direct LDL production. PMID- 2723544 TI - Inhibition of acylcoenzyme A:cholesterol acyltransferase activity in CaCo-2 cells results in intracellular triglyceride accumulation. AB - The activity of acylcoenzyme A:cholesterol acyltransferase (ACAT) in CaCo-2 cells was inhibited by the ACAT inhibitor, 58-035. The inhibitory effect of this acylamide was specific for cholesterol esterification catalyzed by ACAT; the rates of triglyceride, phospholipid, and cholesterol synthesis were not inhibited by this agent. Cholesteryl esters were depleted in CaCo-2 cells 24 hr after inhibition of ACAT activity, whereas the unesterified cholesterol content increased by 56% after 96 hr. Moreover, inhibiting ACAT activity with 58-035 resulted in a time-dependent 2.5-fold increase in intracellular triglycerides. This accumulation of triglycerides in CaCo-2 cells was associated with a 37% increase in triglyceride synthesis by 96 hr in the presence of 58-035. Triglyceride-rich lipoprotein secretion (d less than 1.006 g/ml) was not affected by inhibiting ACAT activity for up to 6 hr. However, triglyceride-rich lipoprotein secretion was significantly decreased in CaCo-2 cells that were preincubated with 58-035 for 24 to 96 hr. Lipoproteins of density less than 1.006 g/ml that were isolated from CaCo-2 cells incubated with the ACAT inhibitor were deficient in cholesteryl esters and triglycerides compared to lipoproteins isolated from control cells. The data suggest that triglycerides accumulate in CaCo-2 cells in which ACAT activity has been inhibited by 58-035. This accumulation of triglycerides is associated with a modest increase in triglyceride synthesis and a decrease in triglyceride secretion. Altering intracellular cholesterol pools by regulating ACAT activity in the gut could result in the decrease of triglyceride transport and/or the secretion of triglyceride-rich lipoprotein particles of abnormal composition. PMID- 2723545 TI - Genetic analysis of total cholesterol and triglycerides in a pedigree of St. Thomas rabbits. AB - A pedigree consisting of 103 New Zealand White hyperlipidemic and normal rabbits was used in a genetic analysis of total cholesterol and triglyceride levels to test for Mendelian control of hyperlipidemia. The founder male of this pedigree was identified through hypercholesterolemia and evidence suggested vertical transmission of a hypercholesterolemic phenotype in this pedigree, although a combined hyperlipidemia phenotype (elevated cholesterol and triglycerides) also occurred in many descendents of the original founders. Segregation analysis of quantitative measures of total cholesterol and triglycerides in this pedigree was employed to test hypotheses about Mendelian control in the presence of substantial inbreeding. A simple Mendelian model was the best explanation for triglycerides in these animals. This best fitting model was essentially co dominant with genotypic specific variances, where the heterozygote was hypertriglyceridemic and the mutant homozygote showed even more extreme values. The observed distribution of total cholesterol was also compatible with a mixture of distinct genotypic distributions, but there was evidence of non-Mendelian transmission in this pedigree. The observed hypertriglyceridemia in these animals may reflect an abnormality of very low density lipoprotein metabolism described previously. Further studies will be required to elucidate the genetic control of hypercholesterolemia and the associated combined hyperlipidemia in these rabbits. PMID- 2723546 TI - Incorporation of deuterium-labeled fatty acids into human milk, plasma, and lipoprotein phospholipids and cholesteryl esters. AB - Fatty acid metabolism and the contribution of dietary fatty acids to milk cholesteryl ester (CE) and phospholipid (PL) were investigated in normal lactating mothers. The approach used was to feed mixtures of triglycerides containing deuterium-labeled palmitic acid (16:0-2H2), oleic acid (18:1-2H6), and linoleic acid (18:2-2H4). Milk and plasma samples were collected for 72 hr. Triglyceride (TG), CE, and PL fractions from milk, plasma, and lipoprotein were isolated and analyzed by gas-liquid chromatography and mass spectrometry. Data for the milk CE and PL fractions showed a definite selectivity for incorporation of 16:0-2H2 and 18:1-2H6 relative to 18:2-2H4. Based on the ratios of the deuterated fatty acids incorporated into the milk CE and PL samples, their incorporation times and isotopic enrichment data, it appears that these fatty acids are supplied mainly by the TG derived from chylomicrons and very low density lipoproteins. Plasma and lipoprotein CE data showed a progressive increase in 18:2-2H4 content, with 16:0-2H2 and 18:1-2H4 remaining relatively constant over the collection period. Plasma and lipoprotein PL data showed a higher rate for incorporation of 18:2-2H4 than 16:0-2H2 and 18:1-2H6 over the course of the sampling period. Comparison to previous data from adult males indicates lactation does not have a major effect on the general metabolism of these fatty acids. An increase with time in the isotopic enrichment of 18:2-2H4 in the plasma and lipoprotein CE and PL samples was observed which is consistent with in vitro selectivities reported for lecithin:cholesterol acyltransferase and phosphatidylcholine acyltransferase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723547 TI - Quantification and regulation of apolipoprotein E expression in rat Kupffer cells. AB - Apolipoprotein E (apoE) is synthesized by a wide variety of cells including cells of the monocyte-macrophage lineage. In order to assess the quantitative significance of apoE synthesis in a mature tissue macrophage, apoE synthesis was compared in Kupffer cells and hepatocytes isolated from rat liver. Immunoreactive apoE synthesized by both cell types exhibited identical isoform patterns when examined by high-resolution two-dimensional gel analysis. ApoE synthesis was not detected in hepatic endothelial cells. Northern blot analysis using a rat apoE cDNA probe demonstrated a single mRNA species of approximately 1200 nucleotides in freshly isolated hepatocytes and Kupffer cells. The absolute content of apoE mRNA in each cell type was determined with a DNA-excess solution hybridization assay. The apoE mRNA content (pg/microgram RNA) for Kupffer cells and hepatocytes was 35.7 and 98.8, respectively. Accounting for cellular RNA content and the population size of each cell type in the liver, Kupffer cells were calculated to contain about 0.7% of liver apoE mRNA; hepatocytes account almost quantitatively for the remainder. These results suggest that Kupffer cells are not major contributors to the plasma apoE pool. After intravenous injection of bacterial endotoxin, apoE mRNA was decreased in freshly isolated Kupffer cells whereas whole liver showed no change in apoE mRNA. Endotoxin treatment had no effect on the apoE mRNA content in several peripheral tissues. These results indicate that apoE expression in vivo is differentially regulated by endotoxin in Kupffer cells as compared to hepatocytes or apoE-producing cells in peripheral tissues. PMID- 2723549 TI - One-step rapid extractive methylation of plasma nonesterified fatty acids for gas chromatographic analysis. AB - The present report describes a one-step method for the derivatization and extraction of nonesterified fatty acids in plasma with subsequent analysis by conventional capillary gas-liquid chromatography or gas-liquid chromatography mass spectrometry. The procedure requires 200 microliters of citrated plasma, dilution with 200 microliters of methanol containing a suitable internal standard, and rapid methylation (10 min) with ethereal diazomethane. An aliquot (60%) of the ether layer is subsequently removed, taken to dryness with nitrogen gas, and the residue is dissolved in a small volume of hexane (usually 50 microliters) for chromatographic analysis (taking 1 microliter for on-column injection). Samples are ready for analysis within 15 min after initial preparation of the plasma. The method has been found to be simple and rapid, providing clean fatty acid profiles. Although the method has been tested with 200 microliters of rat and human plasma, it can easily be adapted to a 40 microliters plasma sample if the esterified plasma extract is suspended in a smaller volume of hexane and/or a larger aliquot of the extract were to be injected into the gas chromatograph through use of a splitless injector. PMID- 2723548 TI - Lipoprotein lipase and hepatic lipase mRNA tissue specific expression, developmental regulation, and evolution. AB - Lipoprotein lipase (LPL) and hepatic lipase (HL) enzyme activities were previously reported to be regulated during development, but the underlying molecular events are unknown. In addition, little is known about LPL evolution. We cloned and sequenced a complete mouse LPL cDNA. Comparison of sequences from mouse, human, bovine, and guinea pig cDNAs indicated that the rates of evolution of mouse, human, and bovine LPL are quite low, but guinea pig LPL has evolved several times faster than the others. 32P-Labeled mouse LPL and rat HL cDNAs were used to study lipase mRNA tissue distribution and developmental regulation in the rat. Northern gel analysis revealed the presence of a single 1.87 kb HL mRNA species in liver, but not in other tissues including adrenal and ovary. A single 4.0 kb LPL mRNA species was detected in epididymal fat, heart, psoas muscle, lactating mammary gland, adrenal, lung, and ovary, but not in adult kidney, liver, intestine, or brain. Quantitative slot-blot hybridization analysis demonstrated the following relative amounts of LPL mRNA in rat tissues: adipose, 100%; heart, 94%; adrenal, 6.6%; muscle, 3.8%; lung, 3.0%; kidney, 0%; adult liver, 0%. The same quantitative analysis was used to study lipase mRNA levels during development. There was little postnatal variation in LPL mRNA in adipose tissue; maximal levels were detected at the earliest time points studied for both inguinal and epididymal fat. In heart, however, LPL mRNA was detected at low levels 6 days before birth and increased 278-fold as the animals grew to adulthood.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723550 TI - 31P NMR of tissue phospholipids: a comparison of three tissue pre-treatment procedures. AB - Extracted tissue phospholipid 31P NMR profiles, obtained from individual porcine lenses subjected to two preservation procedures (acetone desiccation and freeze drying) and a perchloric acid-extraction procedure, were compared to those from freshly excised lens specimens. Each profile yielded quantitative data on 12 lens phospholipids: PC, LPC, PC plas, PE, LPE, PE plas, PS, SPH, PI, LPI, PG, and CL. A specimen group size of at least 9 lenses was required for secure statistical inter-group comparisons by the Scheffe procedure, due to specimen 31P NMR profile variability, interpreted as arising from specimen biological variability. The phospholipid profiles of lenses preserved by acetone desiccation were essentially identical to those from the freshly excised control lenses. Freeze-dried lens profiles differed significantly in four components, while profiles from perchloric acid-extracted lenses differed in six. It is concluded that specimen preservation by acetone disiccation is a useful method for preserving tissue phospholipids for subsequent 31P NMR profile analysis, while freeze-drying is not. Lipid extraction following a tissue acid extraction is also of little or no value in the determination of tissue phospholipid profiles. PMID- 2723551 TI - A competitive exclusion principle for pathogen virulence. AB - For a modified Anderson and May model of host parasite dynamics it is shown that infections of different levels of virulence die out asymptotically except those that optimize the basic reproductive rate of the causative parasite. The result holds under the assumption that infection with one strain of parasite precludes additional infections with other strains. Technically, the model includes an environmental carrying capacity for the host. A threshold condition is derived which decides whether or not the parasites persist in the host population. PMID- 2723552 TI - A renewal equation with a birth-death process as a model for parasitic infections. AB - A model is derived for the description of parasitic diseases on host populations with age structure. The parasite population develops according to a linear birth death-process. The parasites influence mortality and fertility of the hosts and are acquired with a rate depending on the mean parasite load of the host population. The model consists of a system of partial differential equations with initial and boundary conditions. From the boundary condition a renewal equation for the host population is derived. The model is then generalized to describe a multitype process. Existence and uniqueness of solutions are proved. Results concerning persistent solutions are indicated. PMID- 2723553 TI - Shake up in physician reimbursement: implications for American health care delivery. PMID- 2723554 TI - Educating people with congenital heart disease. PMID- 2723555 TI - Physician liability under the "borrowed servant" rule. PMID- 2723556 TI - The relationship of age, level of formal education, and duration of employment toward attitudes concerning the use of computers in the workplace. AB - The introduction of computer technology in the Canadian health care environment necessitates an adaptation by hospital employees in order to perform their jobs. One thousand twenty-two hospital staff were surveyed immediately following their initial orientation to computers. The survey identified attitudes toward change, and the use of computers in the workplace. Demographic data and job classifications of all respondents were tabulated. Hypotheses were tested regarding the relationships between age, formal education, and duration of employment, and attitudes toward computers and change. Results indicated a generally positive response toward the use of computers in the workplace and to change in general. However, statistically significant results were obtained indicating that age, level of education, and length of employment affect the degree of positive response to both computers and change. The results suggest that demographic variables such as age, level of education, and employment duration must be taken into consideration when planning for the implementation of computer systems in the health care setting. PMID- 2723557 TI - Reporting results from a clinical pharmacological laboratory using a microcomputer. AB - Responsibility lies with an analytical pharmacological laboratory to issue each result with an assessment of its validity for the corresponding patient. This is scarcely possible by the usual manual methods of data handling even when complete diagnostic and pharmacokinetic data are available, because of the staff time required. Use of a microcomputer running a suite of True Basic programs showing "artificial intelligence" solves the temporal difficulty and leads to the issue of more incisive, detailed reports. PMID- 2723558 TI - A PC-based system for visual evoked potential studies. AB - An interactive PC-based computer controlled system is described that can be used for collection and analysis of data of Visual Evoked Potentials (VEPs). Visual stimuli are generated on a high-resolution color monitor driven by an Enhanced Graphics Adaptor (EGA). The VEP waveforms are digitized by an A/D converter at a sampling rate of 1 KHz and stored on a hard disk for further analysis. The analysis software includes both time and frequency analysis routines as well as some innovative techniques for the use of the VEPs as a diagnostic measure for various diseases. PMID- 2723559 TI - Applications of staffing, scheduling, and budgeting methodologies to hospital ancillary units. AB - A computer-aided methodology for integrating the budgeting, staffing, and labor productivity systems of Ancillary Services using Respiratory Therapy as an example is presented. The data needed, staffing computations and schedules, and productivity analysis are presented and discussed. A summary of the predicted savings and other benefits for the application hospital are presented with comparisons to present productivity systems. PMID- 2723561 TI - Identification of fecal parasites in the quality assessment programme for the year 1984-1987, in Thailand. AB - Review of data from the quality assessment programme of the DHLQC for the years 1984-1987 shows that some laboratories still have difficulty identifying fecal parasites; particularly the protozoa and the rare parasites although percentages of correct identification have improved in recent years. Helminth ova or larvae in fecal specimens were correctly identified by approximately 55 per cent of the laboratories. Correct identification of intestinal protozoan cysts, however, was achieved by an average of only 29 per cent of the participants. PMID- 2723560 TI - Utilization of the eye health care in northern Thailand. PMID- 2723562 TI - Is routine pre-operative electrocardiogram necessary? AB - Among 3,371 ECG (electrocardiograms) performed at Hat Yai Municipal hospital in 1981, at least 424 were done presumably for a routine preoperative investigation. Analysing the data file of each patient, it was found that 14 per cent had definitely abnormal ECGs of the type that generally implies ischemic heart disease. Another 9 per cent had ECGs that were possibly abnormal and needed, at least, a medical evaluation. However, only a fifth (22 out of 100) of those with abnormal ECGs were eventually examined and of these, less than half (9 out of 22) had their management altered. These results suggest that routine preoperative ECG lacks the potential usefulness given constraints present in several health centers in this country. PMID- 2723563 TI - Two-dimensional echocardiographic detection of in-hospital complications in acute myocardial infarction. AB - The two-dimensional echocardiogram is an ideal noninvasive method for evaluation of the global and regional wall function of left ventricle particularly the apical part in the early phase of acute myocardial infarction. Apical dysfunction, right ventricular infarction, left ventricular thrombi can be detected by 2D-Echo. It is especially useful in the identification of a high risk group of patients with acute myocardial infarction, as a guideline for attempting different therapeutic modalities in these patients. PMID- 2723564 TI - Evaluation of training program for volunteer family planning communicators. AB - The objectives of the VFPCs training program are to develop the strategy for promotion of sterilization by contraceptive comsumers in the provinces. The program promoted coordination among government and the private sector. The project was planned to cover 12 provinces in Northeastern Thailand. The results indicated that the project had achieved readiness to some degree. Consequently, the significant differences between pre and post tests (p less than 0.01) indicated that the VFPCs had benefited by the training program. For the most part, the objectives of training were achieved. PMID- 2723565 TI - Facial paralysis following blunt head injury. AB - Schirmer's test is not a reliable test to localize the level of facial nerve damage. From our results of Schirmer's test (greater than 30%), 53.3 per cent of the cases had facial nerve damage below the geniculate ganglion. Conservative treatment is recommended for delayed palsy. PMID- 2723566 TI - Salient clinical features of Sheehan's syndrome. AB - The natural history of Sheehan's syndrome is chronic. There is a long delay between peripartum hemorrhage and diagnosis. The majority of patients delivered at home and resided in rural areas where modern obstetric care was not readily attainable. The syndrome should be suspected in patients who present with asthenia-weakness, adrenal crisis and secondary amenorrhea. The symptoms that the patients usually had were secondary amenorrhea, asthenia-weakness, loss of axillary and pubic hair and failure to lactate. The important physical signs were loss of pubic and axillary hair, dry skin, slow relaxation phase of deep tendon reflex, hypopigmented areolar and pallor. The common laboratory features of the patients were anemia, eosinophilia, hypoalbuminemia, elevation of serum SGOT but not SGPT, hyponatremia and low fasting plasma glucose. PMID- 2723567 TI - Pregnancy in Sheehan's syndrome. AB - This is the first report of pregnancy in a patient with Sheehan's syndrome in Thailand. Resumption of menstruation and pregnancy following massive postpartum hemorrhage although rare, can occur if there is selective hypopituitarism with normal gonadotropin level and are not against the diagnosis. Since the maternal and fetal mortality is far more common in unrecognized cases, therefore, early diagnosis is crucial. Physicians should consider this syndrome every patient who has a history of postpartum hemorrhage and symptoms and signs of hypopituitarism. PMID- 2723568 TI - Isoniazid-rifampicin-induced submassive hepatic necrosis. AB - A 58-year-old woman with tuberculosis received antituberculous drugs which included isoniazid, rifampicin, and ethambutol. Nausea and anorexia were initial symptoms while jaundice and abdominal pain were late manifestations. She became comatose and died 7 weeks after therapy. Autopsy revealed submassive necrosis of the liver and active advanced pulmonary tuberculosis. It is, thus, necessary for the physician to be alert for this serious complication in prescribing a combination of these antituberculous drugs. PMID- 2723569 TI - Gingival fibroblasts and tissues attachment to curetted cementum surface in periodontally involved teeth. AB - We examined whether or not gingival fibroblasts attach to curetted cementum surface in periodontally involved teeth. For in vitro experiment, superficial cementum in periodontally involved human teeth was curetted and cut into 3 X 3 mm fragments, put into a plastic plate and mixed with fibroblasts for 1 to 3 days. Numerous fibroblasts attached to the curetted cementum surfaces, while only a few fibroblasts could attach to the diseased cementum. For in vivo experiment, experimental periodontitis was induced in monkeys by leaving a resin plate in artificially created marginal bone crest for 3 months. In the flap surgery, only superficial cementum was curetted. Two- and 4-month biopsy specimens disclosed that the regenerated gingival tissues attached well to the curetted cementum surface. Both in vivo and in vitro results indicated subjacent cementum in periodontally involved teeth could be a suitable surface for fibrous attachment. PMID- 2723570 TI - In vitro interaction between gingival fibroblasts and various root surfaces. AB - The objective of the present in vitro study was to examine the effect of various root surface treatments on the initial attachment of gingival fibroblasts. Cultured fibroblasts were well spread and attached to demineralized dentin with citric acid, superficially curetted cementum, and root surface with periodontal ligament, while those on the planed dentin showed a poorly spread appearance. The first three root surfaces exhibited rough and irregular surface appearances with a well-developed filopodia and the latter root surface exhibited a smooth appearance, suggesting the texture of the root surface is closely associated with cell attachment. Interiorized collagen fibrils and numerous cytoplasmic vesicles were seen along the cell membrane of fibroblasts facing the root surfaces of the planed dentin, demineralized dentin, and superficially curetted cementum. Thus even the artificially exposed tooth surface with citric acid may be subjected to further alteration by fibroblasts. PMID- 2723571 TI - Quick-freeze, deep-etch visualization of the nuclear pore complex. AB - We have visualized the nuclear pore complex (NPCx) three-dimensionally by quick freeze, deep etching and suggest that NPCx is composed of four rings and associated filaments. The rings were located at the cytoplasmic side, at the nucleoplasmic side, and at the pore waist as well. Some of the filaments emanated toward the cytoplasm, some sprawled over the cytoplasmic face of the nuclear membrane, and some intervened the rings. The emanating filaments were considered to be vimentin filaments judging from the replica and thin-sectioned image. PMID- 2723572 TI - Cuticular ultrastructure of Paragonimus from Costa Rica. AB - The surface ultrastructure of eggs, metacercariae, and adults of Paragonimus endemic to Costa Rica were examined under the scanning electron microscope. Two different morphological types of parasites were found. The most commonly found form was the "first type" (86%) corresponding to the previous descriptions of P. mexicanus. The metacercariae of this type showed an oral sucker surrounded by papillae clustered on the dorsal lip, the ventral sucker showed six internal and from 30 to 35 external papillae. The most evident difference in the "second type" was observed on the ventral sucker, because it showed an intermediate row of five to six papillae located between the internal and external papillae. In conclusion, the Paragonimus species of Costa Rica is P. mexicanus. The morphological differences seen could be a variation of the same species or another species. PMID- 2723573 TI - Electron microscopic studies on the stretch-induced disordering of the myofilament lattice in tetanized frog skeletal muscle fibers. AB - To study the effect of stretch on the hexagonal myofilament lattice in frog skeletal muscle fibers, the fibers were fixed at rest and during the isometric tetanus with or without stretch, and their cross sections were examined electron microscopically. The degree of disorder of the myofilament lattice as estimated by the Fourier transform and rotation methods in the digital image analysis was found to be largest during the isometeric tetanus with stretch and smallest during the isometeric tetanus without stretch, supporting the view that the stretch-induced force enhancement results from the disordering of the myofilament lattice. PMID- 2723575 TI - The thirty-third symposium of the Japanese Society of Electron Microscopy. Fukuoka, Japan, October 13-14, 1988. Abstracts. PMID- 2723574 TI - Nuclear and nucleolar changes in preimplantation mouse embryos expressing numerous virus-like particles. AB - Preimplantation mouse embryos spontaneously arrested in development at the two cell and three-cell stages were obtained from a pregnant Slc: ICR mouse. Numerous intracisternal A-type virus-like particles were expressed in the cytoplasm of these abnormal mouse embryos. Several nuclear and nucleolar changes observed in these embryos, probably related to the hyperactive synthesis of virus-like particles, were reported. PMID- 2723576 TI - Abstracts of papers, twenty-ninth Hokkaido regional meeting of the Japanese Society of Electron Microscopy. Sapporo, February 6, 1988. PMID- 2723577 TI - Quantification of the effects of chlorpromazine on performance under delayed matching to sample in pigeons. AB - The effects of four doses of chlorpromazine (dose range 0.5 to 12.5 mg/kg) on performance under a delayed matching-to-sample procedure in pigeons was investigated, using the exponential model of memory (White, 1985). Performance was measured using a bias-free measure of discriminability, log d (Davison & Tustin, 1978), and negative exponential functions were fitted to individual subject and group data at each dose level. A decrease in matching accuracy was found to be caused by an increase in the rate of forgetting, b, and a decrease in the initial discriminability, log d0. Changes in rate of forgetting and discriminability occurred at doses that had no statistically significant effect on response latency. The exponential model of memory accounted well for the data and provided a useful way of quantifying the effects of chlorpromazine on the processes involved in delayed matching-to-sample performance. PMID- 2723579 TI - Selective utilization of serum vitamin A for visual pigment synthesis. AB - Two groups of goldfish (Carassius auratus) were subjected to light and temperature conditions known to promote a contrast in their scotopic visual pigment compositions. After 3 weeks, the porphyropsin/rhodopsin ratio in the neuroretina of these goldfish ranged from 99% porphyropsin in one group to 59% in the other. Samples of blood, liver and retinal pigment epithelium (RPE) were also removed from these animals and analysed by high-performance liquid chromatography (HPLC) for vitamin A composition. There was consistently more vitamin A2 than vitamin A1 (over 50% vitamin A2) in both vitamin A alcohol and vitamin A esters extracted from the liver and the RPE. In contrast, only 30% of all vitamin A extracted from the blood was vitamin A2. These observations suggest that it is mainly vitamin A1 that is transported in the blood, whereas vitamin A2 is selectively retained in the liver and in the RPE and used to form porphyropsin in the eye. PMID- 2723578 TI - Responding on concurrent-chains schedules in open and closed economies. AB - Pigeons' key pecks were reinforced according to concurrent-chains schedules of reinforcement. The programmed average time from the onset of the initial links to a terminal link entry was held constant across conditions while the value of variable-interval schedules in the terminal links was varied. Performance was assessed under two economic conditions: (a) an open economy in which session duration was limited to 1 hr and subjects were maintained at 80% of their free feeding body weights with postsession food when necessary; and (b) a closed economy in which sessions were 23.5 hr long and no deprivation regimen was in effect. In all cases, the relative rate of responding in the initial links matched the reduction in overall delay to primary reinforcement correlated with entry into one terminal link relative to the reduction in delay correlated with entry into the other terminal link. Although the sum of responses made in the initial links and terminal links was found to increase, then decrease, as the rate of food presentation decreased in the closed economy, there was no consistent effect of overall rate of food presentation on total responding in the open economy. The choice data suggest that relative delay reduction predicts choice accurately, regardless of economic context. PMID- 2723580 TI - Insect cardioactive peptides: neurohormonal regulation of cardiac activity by two cardioacceleratory peptides during flight in the tobacco hawkmoth, Manduca sexta. AB - The relationship between two cardioactive neuropeptides, the cardioacceleratory peptides (CAPs), and changes in heart rate during flight was investigated in the tobacco hawkmoth, Manduca sexta. In vivo heart recordings from intact, tethered adults revealed a marked increase in heart rate associated with flying. Both anterior-to-posterior and posterior-to-anterior contraction waves showed a measurable elevation in contraction frequency. These changes in heart activity were noted in animals engaged in short (20 min) or long (60 min) bouts of continuous flight. Bioassay of blood taken from flying animals revealed the presence of an activity-dependent, blood-borne cardioacceleratory factor(s). Biochemical analyses of the blood of flying insects on HPLC identified two cardioacceleratory factors which co-eluted with the two CAPs. A depletion in the ventral nerve cord levels of both CAPs was observed during flight. In vivo injections of an anti-CAP monoclonal antibody blocked the increase in cardiac activity associated with flight. These results confirm the hypothesis that both CAPs act as cardioregulatory neurohormones during flight in Manduca sexta. PMID- 2723581 TI - Assessment of bone turnover with biochemical markers. PMID- 2723582 TI - Prevalence of hereditary haemochromatosis in two Swedish urban areas. AB - The prevalence of hereditary haemochromatosis (HH) was studied in Stockholm and Goteborg, the two largest cities in Sweden, using screening with transferrin saturation in combination with serum ferritin and further clinical and laboratory examinations. In Goteborg, none of 1660 men aged 50 and 51 years, randomly selected from the census register, was found to have HH. In Stockholm, nine out of 11,920 male hospital inpatients were diagnosed as having HH. The calculated mean and 95% confidence ranges were consistent with earlier findings in two studies on men in Malmo, the third largest urban area in Sweden. Pooling results from these three main urban areas, the mean prevalence was 0.073% (17/23, 355), which is considerably lower than figures reported from one area in northern Sweden and from pedigree analyses in several other areas in the world. Screening of the US population in the N-HANES II study also showed much lower figures. The reasons for these discrepancies are discussed and it is suggested that the average prevalence of HH in Caucasian populations is probably around 0.1%. PMID- 2723583 TI - Changes of activated partial thromboplastin time during constant intravenous and fixed intermittent subcutaneous administration of heparin. AB - Marked circadian variations in the activated partial thromboplastin time (APTt) during continuous heparin infusions for thromboembolic episodes have been reported in a French study. The aim of the present study was to test if these variations could be reproduced in a Swedish population. The frequency spectrum variations in APTt values were analysed with the Prony and the statistical Pearson product momentum correlation coefficient methods. In seven patients with pulmonary embolism, APTt was checked every fourth hour during 48 h of continuous, constant heparin treatment. In only one patient was a distinct circadian variation of APTt values seen. In six patients with venous leg thromboses, treated with s.c. heparin, marked variations in APTt were noticed over periods of 12 h. These variations paralleled the regular s.c. injections of heparin every twelfth hour. The results of the present study could not confirm the marked circadian variations in APTt reported in an earlier French study during continuous heparin infusions, except in one patient. PMID- 2723584 TI - Doppler echocardiographic assessment of the valve area in patients with atrioventricular valve stenosis by application of the continuity equation. AB - The orifice area was non-invasively assessed in 19 patients with mitral or mitral and tricuspid stenosis by combined cross-sectional and Doppler echocardiography. Stroke volume was calculated as the product of aortic or pulmonic cross-sectional area and the time velocity integral of the flow across that valve, and the stenotic valve area was obtained as the stroke volume divided by the time velocity integral of the stenotic valve. In addition, the mitral valve area was estimated by the pressure half-time method of Hatle et al. The non-invasive determinations were compared with those calculated by the Gorlin formula at cardiac catheterization. The valve area obtained by combined cross-sectional and Doppler echocardiography showed a close correlation with the Gorlin area, r = 0.90, SEE = 0.13 cm2, n = 20. In contrast, the valve area estimated by the pressure half-time method showed only a moderate correlation with the Gorlin area, r = 0.68, SEE = 0.38 cm2, n = 18, and estimates by this method tended to significantly overestimate the Gorlin area. In conclusion, non-invasive valve area determinations based on combined cross-sectional and Doppler echocardiography can be used to accurately quantify the severity of the lesion in patients with atrioventricular valve stenosis, while determinations by the pressure half-time method may show errors of a magnitude that limits its clinical applicability. PMID- 2723585 TI - Primary biliary cirrhosis presenting as idiopathic thrombocytopenic purpura with deterioration after splenectomy. AB - A case of primary biliary cirrhosis (PBC) presenting as idiopathic thrombocytopenic purpura is described. The patient, a 59-year-old woman, had, at the time when thrombocytopenia was first observed, an asymptomatic PBC. She responded only temporarily to corticosteroids, and splenectomy had to be performed later. After this operation the platelet count was normalized, but a marked and rapid deterioration of her previously indolent PBC occurred. The time relationship indicates that the removal of the spleen may be considered the cause of the disease's progression. Possible mechanisms behind this adverse effect of the splenectomy are discussed. After initiation of azathioprine therapy a good response in clinical and laboratory features of the PBC was obtained, although the histological picture has remained unchanged. PMID- 2723586 TI - Free apolipoprotein (a) in abetalipoproteinaemia. PMID- 2723587 TI - IgD-lambda monoclonal gammopathy and axonal neuropathy. PMID- 2723588 TI - Radioimmunoassay of human pepsinogen A and pepsinogen C. AB - We describe the development of radioimmunoassays to measure both human pepsinogen A and pepsinogen C concentrations in serum. The antibodies were raised in goats by immunization with purified pepsinogen A or C. The affinity constants of the respective antibodies were 20.10(10) l/mol and 7.10(10) l/mol. Pepsinogens A and C were labeled with Na 125I by the chloramine T method. The binding between labels and antibodies was inhibited by 0.50 at 0.82 ng pepsinogen A per tube and 2.1 ng pepsinogen C per tube. The detection limits of the assay of pepsinogen A and C were 0.12 microgram/l and 1.8 micrograms/l, respectively. Pepsinogen A and C were purified and added to a patient serum, showing a good recovery in the radioimmunoassays. Serial dilution of another patient serum, which contained a high concentration of both antigens, showed curves parallel to the standard curves. The intra- and interassay variations of these radioimmunoassays were evaluated. The intra-assay coefficients of variation for pepsinogen A were found to vary from 0.03 to 0.102 at concentrations in serum in the normal range, while the inter-assay coefficient of variation ranged from 0.118 to 0.194 at the same concentrations in serum. For the pepsinogen C radioimmunoassay we found intra assay coefficients of variation between 0.126 and 0.147 at concentrations in serum in the normal range, while the inter-assay coefficient of variation ranged from 0.174 to 0.325 for the same sera. In 201 blood donors we found a mean serum concentration of pepsinogen A of 59 micrograms/l and a mean serum concentration of pepsinogen C of 15 micrograms/l. There was a significant relationship between these values (r = 0.779, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723589 TI - A candidate reference method for the determination of magnesium in serum. AB - A candidate reference method for the determination of magnesium in serum (analytical range 0.5 to 2.0 mmol/l) by flame atomic absorption spectrometry was commissioned. The relative standard deviation of the 4 replicates of each value ranged from 0.18 to 1.07%, and the standard error of the mean ranged from 0.63 to 8.34 mumol/l. In the analysis of 3 different standard solutions (prepared by weighing the analyte), which was performed in each of three different experiments the values recorded by the candidate reference method deviated by -0.15, 0.44 and 0.24%, respectively. The reference method value did not differ significantly from the definitive value. As the method seems to be as reliable as comparable reference methods for the determination of sodium, potassium or calcium, tests of transferability should now be undertaken. PMID- 2723590 TI - Evaluation of the automated haematology analyser Sysmex M-2000. AB - The automated Sysmex M-2000 was evaluated according to the ICSH (International Committee for Standardization in Haematology) protocol. After dilution of packed cells with cell-free plasma, blood cell counts were linear. The overall precision of the measured parameters was good; the CV's ranged between 0.64% and 2.06%. The carry-over was negligible; platelets showed the biggest carry-over with 0.25% in the Whole Blood Mode, while red blood cells (RBC) showed a carry-over of 0.55% in the Prediluted Mode. 300 clinical samples were measured on the Sysmex M-2000 and the Sysmex CC-700 with PL-100, and the results were compared. The coefficients of correlation for white blood cells (WBC), red blood cells (RBC), haemoglobin and haematocrit were greater than 0.99; platelets showed an r of 0.982. Comparison of the results from the Sysmex M-2000 trimodal leukocyte distribution with a manual 100 cell differentiation showed a close correlation for lymphocytes (r = 0.948), and neutrophils (r = 0.931). The middle cell fraction corresponding to monocytes, eosinophils and basophils showed a correlation with r = 0.703. Pathological samples showed no interference with the blood count. Leukocyte counts less than 1000 x 10(9)/l did not effect the measurement of haemoglobin. During the period of evaluation, no instrument malfunctions occurred. Because of its precision and reliability, the Sysmex M-2000 is well suited for routine work and stat analysis in medium-sized laboratories. PMID- 2723591 TI - Chlamydia infections during pregnancy. PMID- 2723592 TI - Community-oriented primary care. PMID- 2723593 TI - Office counseling of rape victims. PMID- 2723594 TI - Risks of overtreatment of hypertension. PMID- 2723595 TI - Visit frequency for essential hypertension: observed associations. AB - Data from the British Department of Health and Social Services Hypertension Care Computing Project were analyzed to study determinants of visit frequency in hypertension management. The 457 patients from five general practices made 7974 visits between 1971 and 1985 resulting in 7391 intervals on which evaluation could be based. The mean interval between visits was 113 days (SD = 110 days) with a median interval of 91 days. Visit interval was influenced by level of blood pressure and length of time in follow-up. For diastolic pressures less than 104 mmHg the mean visit interval was 4 months, contrasting with 2 months for diastolic pressures greater than 130 mmHg. Visit intervals became longer with increasing length of time in follow-up, independent of level of blood pressure. Shorter intervals reflected initial management and getting the blood pressure reduced; longer intervals may reflect patients' failure to keep scheduled appointments. Between practices, mean visit intervals ranged from 99 to 193 days (median 72 to 164 days). These differences were reduced after adjustment for length of time the patients had been in follow-up. Patient age, sex, body mass index, and the presence of angina pectoris were not associated with visit interval. The analyses illustrate how process and outcome may be linked in ambulatory care practice as a means of determining rational guidelines for optimal utilization of health services. PMID- 2723596 TI - Can the family physician avoid conflict of interest in the gatekeeper role? An affirmative view. PMID- 2723597 TI - Can the family physician avoid conflict of interest in the gatekeeper role? An opposing view. PMID- 2723598 TI - Analysis of resident and attending physician interactions in family medicine. AB - Clinical teaching does not fit neatly into traditional teaching-learning models. The interaction between a resident and an attending physician is of particular interest because it has several functions including education, supervision, socialization, and quality control. The purpose of this study was to observe, classify, and record verbal teaching and learning behaviors in the resident attending physician interaction. During a 12-month period, 125 observations of resident-attending physician interactions were recorded; the average length of the interactions was 4.27 minutes. The six most frequent resident verbal behaviors compared by postgraduate year level did not vary significantly. Only one of the six most frequent attending physician verbal behaviors varied significantly. In the average interaction of about 4 minutes, three fourths of the interaction was on patient care issues, leaving little time for teaching. There are many unanswered questions about the resident-attending physician interaction and its contribution to the training of a physician. PMID- 2723599 TI - Family physicians' involvement in obstetric care. Rural northeastern Minnesota and northwestern Wisconsin. PMID- 2723600 TI - Smoking cessation. PMID- 2723601 TI - Serum cholesterol and glycosylated hemoglobin. PMID- 2723602 TI - Seasonal variation in freeze tolerance and ice content of the tree frog Hyla versicolor. AB - Freeze tolerance and ice content of Hyla versicolor showed pronounced variation between summer (June) and winter (December). Summer frogs survived freezing at -3 degrees C for up to 9 hr and ice accumulation up to 50% of their total body water. A time course of ice formation indicated that an equilibrium level was reached in approximately 15 hr. Thus, the lethal ice content was less than the equilibrium ice content for these conditions (63.1%). A second group was induced to enter an overwintering condition by holding them through the summer and then subjecting them to a progressive reduction in temperature and photoperiod for 2 months. These frogs survived freezing for 48 hr at -3 degrees C. Their equilibrium ice content at this temperature was significantly lower (52.5%) than comparably treated summer animals. In the winter acclimatized group, frozen frogs had substantially higher blood glucose levels than unfrozen frogs (22.7 mumol/ml vs. 1.33 mumol/ml), but glycerol levels were not elevated after freezing. Freezing frogs conditioned for overwintering at -7 degrees C resulted in a higher equilibrium ice content (62.6%), but none survived. It is evident that in preparation for overwintering, frogs reduce the amount of ice formed at a given subzero temperature, but there is little indication of a substantial change in the total amount of ice tolerated. PMID- 2723603 TI - Chemical access to the vomeronasal organs of the lizard Chalcides ocellatus. AB - A functional association between tongue flicking and vomeronasal organ chemoreception in lizards has been assumed frequently, but never tested. To test this hypothesis, a cotton swab soaked in prey extract mixed with [3H]proline was touched ten times to the snouts of normal and tongueless lizards (Chalcides ocellatus), as well as normal lizards whose vomeronasal organ (VNO) ducts had been sealed with a tissue adhesive. Additionally, such a swab was held approximately 0.5 cm in front of the snout of normal and tongueless lizards for 1 min, which allowed no contact by tongueless animals and tongue contact only by normal lizards. Using autoradiography, substantial and comparable concentrations of labeled molecules were detected in the mouths, VNO ducts, and VNOs of normal subjects in both conditions, as well as tongueless lizards whose snouts made physical contact with swabs. No label was evident in VNOs of tongueless animals that did not contact swabs or normal animals with sealed VN ducts. Labeling was not apparent generally in the olfactory epithelium. These results suggest that: 1) the tongue is not required for, nor does it increase, chemical delivery to VNOs when snout contact occurs; 2) the tongue transfers molecules from the external environment to the oral region; 3) it is unlikely that nonvolatile chemicals reach the olfactory epithelium via an oral route; and 4) tissue adhesive is an effective means of preventing chemical access to the VN organs. PMID- 2723604 TI - Bromocriptine prevents the castration-induced rise in porphyrin concentration in the harderian glands of the male Syrian hamster, Mesocricetus auratus. AB - The Harderian glands in Syrian hamsters exhibit a striking sexual dimorphism. Male Harderian glands show two cell types and low levels of porphyrins and melatonin. Of the enzymes involved in the synthesis of melatonin, N acetyltransferase (NAT) and hydroxyindole-O-methyltransferase (HIOMT) show high and low activity levels, respectively. Female Harderian glands show but one cell type and have high porphyrin and melatonin levels, low NAT activity, and high HIOMT activity. In castrated males, the Harderian glands exhibit a female pattern of morphology, porphyrin levels, and indoleamine metabolism. In an attempt to determine whether prolactin in involved in this sexually dimorphic response of the Harderian glands, intact and castrated male and intact female hamsters were injected daily with 500 micrograms of bromocriptine, a dopamine agonist. Bromocriptine led to reduced serum prolactin levels in all groups. It had no apparent effect on the Harderian glands of intact males. In contrast, in castrated males bromocriptine prevented the postcastrational rise in porphyrin levels but had no effect on NAT or HIOMT activities. In females, bromocriptine treatment had no effect on porphyrin concentrations or HIOMT activity; it led to a statistically significant increase in NAT activity. We propose that testosterone inhibits Harderian porphyrin synthesis while dopamine or prolactin stimulates it. PMID- 2723605 TI - Cytogenetic analysis of ethanol-induced parthenogenesis. AB - The brief exposure of recently ovulated mouse oocytes to a dilute solution of ethanol in vitro for 1, 3, or 5 min induced a uniform high incidence of parthenogenetic activation. The majority of parthenogenones developed a single haploid pronucleus after the extrusion of a second polar body. The proportionate incidence of this parthenogenetic class was significantly reduced as the duration of ethanol exposure increased from 1 min to 5 min. There was a concomitant increase in the incidence of parthenogenones that developed two haploid pronuclei following failure of extrusion of the second polar body. Cytogenetic analysis of the ethanol-induced single-pronuclear haploid parthenogenones at metaphase of the first cleavage division clearly demonstrated that a significant proportion were aneuploid. The incidence of aneuploidy observed was directly related to the duration of ethanol exposure. G-band analysis of the aneuploid metaphases revealed that the chromosomes were not randomly involved in the malsegregation events. This observation may be a reflection of the relationship of particular chromosomes to the meiotic spindle apparatus rather than on any specific property of the agent to which they were exposed. It is believed that ethanol disrupts the organisation of cytoskeletal elements and, in particular, interferes with the processes of chromosome segregation at the second meiotic division. PMID- 2723606 TI - Interaction of proteins RSV IV and RSV V in rat seminal vesicle secretion. AB - The RSV IV polypeptide, molecular weight ratio (Mr = 10,000), which is produced by the rat seminal vesicle, has previously been suggested to be associated with another polypeptide in the gland secretion (Higgins et al., '76). This study provides that RSV IV is a component of a protein shown by immunoassays, electrophoresis, and amino acid composition analysis to contain, together with RSV IV, the seminal vesicle secretory RSV V polypeptide (Mr = 13,000). This RSV IV-RSV V complex (namely CFS protein) had an isoelectric point at pH 7.2 and an approximate molecular weight of 22,000 daltons. This complex inhibits the previously reported in vitro binding of the isolated RSV IV to epididymal sperm cells, thus suggesting a functional role for the RSV IV-RSV V interaction. PMID- 2723607 TI - Beta-adrenergic blockers prevent short photoperiod-induced gonadal regression, but not melatonin-induced regression in male Syrian hamsters. AB - Pineal melatonin synthesis is regulated by norepinephrine at beta-adrenergic receptors on pinealocytes. Melatonin released from the pineal is believed to be responsible for short photoperiod-induced gonadal regression. By blocking melatonin production at the beta-adrenergic receptor with beta-adrenergic antagonists, short photoperiod-induced gonadal regression was prevented. Propranolol or nadolol injected daily in the late afternoon prohibited short photoperiod-produced testicular regression in male Syrian hamsters. Likewise, propranolol and nadolol pellets were able to block short photoperiod-induced gonadal regression. Interestingly, in the presence of beta-adrenergic antagonists, gonadal regression was still produced by daily afternoon injections of melatonin. These results indicate that propranolol or nadolol can be used to "pharmacologically pinealectomize" hamsters and block the physiological action of the pineal. PMID- 2723608 TI - Development of porcine embryos from the one-cell stage to blastocyst in mouse oviducts maintained in organ culture. AB - Successful development of porcine embryos from the one-cell stage to the blastocyst stage has been accomplished using mouse oviducts in organ culture. One cell embryos were transferred to mouse oviducts maintained in organ culture and were cultured for 6 days. Control embryos from each donor pig were cultured in a modified Krebs-Ringer bicarbonate medium. Thus control and experimental embryos obtained from the same individual pig could be directly compared. At the end of the culture period, all embryos were scored for the stage of development attained and stained to allow the cell number of each embryo to be counted. In medium alone, only 35.7% of the one-cell embryos reached the morula or blastocyst stage, whereas 78.1% of the one-cell embryos transferred to mouse oviducts reached the morula or blastocyst stage. Of those embryos reaching the morula or blastocyst stage, cell numbers were similar for the two treatments (medium alone vs. oviduct culture). The procedure described for mouse oviduct organ culture provides a simple method for culturing early-stage pig embryos to the morula or blastocyst stage prior to embryo transfer. PMID- 2723609 TI - Effects of salts in promoting the adhesion of amphibian gastrula cells. AB - Presumptive ectodermal and endodermal cells were isolated from the gastrula of the newt Cynops pyrrhogaster, and the effects of salts on embryonic cell adhesion were examined. When the concentrations of NaCl, KCl, MgSO4 and Ca (NO3)2 in the culture medium were increased individually, they all effectively promoted ectodermal cell adhesion. MgSO4 and Ca(NO3)2 promoted endodermal cell adhesion, but NaCl and KCl did not. The culture medium containing increased NaCl (90 mM) nonspecifically promoted ectodermal cell adhesion to the four substrata studied- polystyrene dish, glass, collagen, and fibronectin. The effects of drugs that influence the membrane permeability of Na+ and Ca2+ and the replacement of Na+, Cl-, and Ca2+ with other ions were studied. The results show that the flow of Na+ and Ca2+ into the cytoplasm promotes ectodermal cell adhesion but exerts no influence on endodermal cell adhesion. PMID- 2723610 TI - Notochordal induction of cell wedging in the chick neural plate and its role in neural tube formation. AB - Cells in the median hinge point (MHP) of the bending chick neural plate are tightly apposed to the underlying notochord. These cells differ from those in adjacent lateral neuroepithelial areas (L) in that MHP cells are short and mainly wedge-shaped and line a furrow, whereas L cells are tall and mainly spindle shaped and do not line a furrow. Cell generation time also differs in these regions. These consistent differences are detectable only after the notochord has formed and established contact with the neural plate; it is unclear whether they result from self-differentiation or induction. Two experiments were performed to evaluate the hypothesis that MHP characteristics develop owing to inductive interactions between the notochord and overlying neuroepithelial cells. First, notochordless chick embryos were generated to determine whether midline neuroepithelial cells still developed typical MHP characteristics. In the absence of the notochord, such characteristics did not develop. Second, isolated segments of quail notochord were transplanted subjacent to L of chick hosts to ascertain whether the notochord is capable of inducing MHP characteristics in L cells. When transplanted notochordal segments established apposition with host L cells, the apposing L cells usually developed typical MHP characteristics. Collectively, these results provide strong evidence that the notochord plays an inductive role in the formation of MHP characteristics. This investigation further revealed that bending can occur in the absence of MHP characteristics, forming a neural tube with an abnormal morphology. Thus, the formation of such characteristics, particularly cell wedging, is not required for bending but plays a major role in generating the normal cross-sectional morphology of the neural tube. PMID- 2723611 TI - Physiological doses of epinephrine in the human: chronotropic but not hyperglycemic or catecholaminotropic. AB - Single physiological doses of epinephrine did not affect the blood sugar level of human volunteers though they caused a marked tachycardia that was accompanied by a strong transient sensation, typically described as fullness in the chest. Epinephrine did not cause the release of norepinephrine and/or dopamine in man, in contrast to three other vertebrates (lamprey, eel, and rat). In the human, as in the rat and cyclostomes, the glycemic effect of epinephrine occurs only during stress and/or unphysiological conditions, while the chronotropic effects are probably physiological from cyclostomes to man. PMID- 2723612 TI - A specific androgen-binding protein (ABP) in Necturus testis and its zonal distribution. AB - The urodele amphibian Necturus maculosus has a zoned testis, which is advantageous for separating Leydig cells from germinal elements and for studying stage-dependent biochemical changes. Using [3H]testosterone (T) in a standard binding assay and dextran-coated charcoal (DCC) or Sephadex LH-20 to separate free and bound steroids, we identified an androgen-binding protein (ABP) in Necturus testis cytosols. This protein was of high affinity (Kd = 10(-9) M) and was saturable (Bmax = 10(-9) M) and specific for androgen (T; 5 alpha dihydrotestosterone, DHT) but could be distinguished from the androgen receptor of Necturus testis by its relative abundance (300-550 fmol/mg protein), short half-time of dissociation (3 min at 22 degrees C), inability to adhere to DNA cellulose, and absence from nuclear extracts. Additionally, when analyzed on sucrose gradients, the ABP of Necturus testis sedimented at 6-7 S in both low or high ionic strength buffers. In that estradiol (E2) is a poor competitor for T binding, this protein resembles a sex steroid-binding protein previously identified in urodele serum but differs from the ABP and testosterone-estradiol binding globulin (TEBG) of rodents, humans, goldfish, and sharks. It is differentially distributed within the testis, with the highest levels in immature lobular regions composed of Sertoli cells and germ cells in premeiotic stages and lower levels in regions composed primarily of Leydig cells. The cellular source and function of this protein in Necturus testis remain to be determined. PMID- 2723613 TI - Protein and nucleic acid analysis of influenza B viruses isolated in Italy in 1984. AB - Genomic and phenotypic analysis of 30 influenza B viruses, isolated in Italy in 1984, antigenically closely related to the B/USSR/100/83 prototype virus, was carried out using T1-oligonucleotide fingerprinting of total RNA and one dimensional peptide mapping. The results of fingerprinting analysis indicated an oligonucleotide spot homology of 90-96%, corresponding to a nucleotide sequence variation of only 0.75-0.3%. All the strains appear to belong to the same evolutionary line. Nevertheless, heterogeneity was found at the structural and antigenic level, when the viruses were compared by peptide mapping and monoclonal antibody analysis. No correlation between the biochemical variability of the viruses and the epidemiological characteristics of the different strains was established, which is consistent with the hypothesis that distinct variants, arisen at different times from a parental strain, co-circulate during an epidemic, although the additional occurrence of random mutations during the evolution of the epidemic cannot be excluded. PMID- 2723614 TI - Immunoglobulin-class-specific immune response to respiratory syncytial virus structural proteins in infants, children, and adults. AB - The protein specificities of IgG, IgM, and IgA antibodies induced during respiratory syncytial virus (RSV) infection in 74 patients (4 weeks to 81 years of age) were investigated using the technique of immunoblotting. Although the pattern of antibody reactivity varied among patients, most of the humoral immune response in all age groups was directed against the 48, 42, 35, and 27 K proteins. An infant's own antibody response was discernible in 55 of the 57 children below 1 year of age, despite the presence of maternally derived antibodies. Antibody against the 90 K surface glycoprotein was not detectable in those less than 1 year of age. Primary RSV infection induced antibodies only against a subset of RSV proteins. Although a broadening of the antibody response occurred with increasing age and in the course of reinfection, an immune response to all the viral structural proteins was observed rarely. PMID- 2723615 TI - Measurement of avidity of specific IgG for verification of recent primary rubella. AB - Sixty-four subjects' serum samples, positive or equivocal by rubella IgM assays and containing rubella IgG, were examined for the avidity of rubella IgG. Four of the sera originated from rubella reinfections; others had false-positive IgM results due to interference by parvovirus infection or by other mechanisms; and the remaining were sera from the acute phase or convalescence of primary rubella. A novel IgG avidity test, avidity-ELISA, and a semiquantitative haemolysis typing assay were used. According to the avidity-ELISA, 29 subjects had recent primary rubella (low IgG avidity), and another 29 had previous rubella immunity (high IgG avidity), whereas 6 serum samples gave borderline avidity values. Comparison of these results with pre-existing clinical records and laboratory data showed that all samples with low IgG avidity were obtained during or shortly after acute primary rubella. All sera with high IgG avidity originated from the previously immune subjects; the rubella reinfections were confined within this group. Five of the six sera with borderline avidity values were obtained within 2 months from primary rubella. In conclusion, the measurement of IgG avidity is a powerful tool for the distinction of acute or recent primary rubella from pre-existing rubella immunity, including rubella reinfections. PMID- 2723616 TI - Inactivation of human hepatitis B virus DNA polymerase by pyridoxal 5'-phosphate. AB - Human hepatitis B virus (HBV) DNA polymerase activity was inhibited by pyridoxal 5'-phosphate (PLP) specifically and noncompetitively with respect to deoxythymidine triphosphate (DTTP). NaBH4 reduction of PLP-HBV core proteins resulted in the complete inactivation of HBV DNA polymerase, and PLP modification of the enzyme was though to be mediated through Schiff-base formation. HBV DNA polymerase has a Michaelis constant (Km) of 0.31 microM for dTTP and an apparent inhibition constant (Ki) of 0.2 mM for PLP. Its inactivation and modification by PLP may be useful in the study of not only the reaction mechanism of catalysis, but also the physicochemical nature of the enzyme. PMID- 2723617 TI - Pre-S proteins in hepatitis B. AB - Two reactive sequences of the pre-S regions of hepatitis B surface antigen were synthesized chemically and used in micro-ELISAs for the assay of pre-S1 and pre S2 antigens in serum from patients with acute and chronic hepatitis B. Pre-S1 antigen correlated well with the presence of HBV-DNA and was no longer detectable on cessation of viral replication, after natural recovery and after successful treatment with alpha-interferon. Pre-S2 proteins were also lost after treatment with alpha-interferon. The results show that the assay of pre-S1 and pre-S2 proteins in serum provides additional useful markers for assessing patients with acute and chronic hepatitis B infection and for monitoring the response to treatment with interferon. PMID- 2723618 TI - Protective effect of a synthetic peptide comprising the complete preS2 region of the hepatitis B virus surface protein. AB - A peptide was synthesized containing the entire 55 amino acid residue sequence of the hepatitis B virus (HBV) surface antigen preS2 region (ad subtype). The unconjugated peptide was inoculated into four chimpanzees. Following multiple injections, all of the animals developed specific antipeptide antibodies that reacted with intact surface antigen particles bearing the preS2 moiety. All four peptide-inoculated animals were found to be protected from infection after intravenous challenge with live HBV of either the ad or ay subtypes. PMID- 2723619 TI - The impact of a military air disaster on the health of assistance workers. A prospective study. AB - The worst peacetime disaster in United States Army history occurred on December 12, 1985 in Gander, Newfoundland. A charter airline carrying 248 soldiers home from peacekeeping duties in the Sinai Desert crashed after a refueling stop, killing all on board. After the crash, Army family assistance workers were appointed to help the surviving family members of each dead soldier. While substantial attention has been paid to the impact of sudden disasters on survivors and bereaved relatives, little is known about the health risks to those who perform helper roles. This study aimed to: a) identify the major stress areas for disaster family assistance workers; b) examine the relation between degree of exposure to these stressors and health; and c) locate risk factors, or resistance resources that might modulate any ill effects of exposure. A survey instrument assessed duration and intensity of family-helping activities and psychological well-being, psychiatric symptoms, major illness indicators, and social and personality variables at 6 months after the crash and again at the 1-year point for 131 family assistance officers. Results indicate a dose-response effect between exposure measured at time 1 and well-being, symptoms, and illness at time 2. Analysis of covariance findings also show that social supports (work supervisors, family, and friends) modulate the effects of exposure on symptoms and well-being. Social supports and the personality style of hardiness (or dispositional resilience) interact to modulate the effects of exposure on illness. These results demonstrate: a) a delayed negative impact of helper stress on family assistance workers, and b) a protective function of social supports and personality hardiness. Further research in this area should thus consider the potential influence of social/situational variables and personality dispositions in coping with disaster helper stress. PMID- 2723620 TI - Multiple diagnosis in posttraumatic stress disorder. The role of war stressors. AB - Prior studies have shown that posttraumatic stress disorder (PTSD) in Vietnam veterans is associated with various aspects of war stressors and that other diagnoses often co-occur with PTSD in this population. The present report examines the prediction of other diagnoses, in combination with PTSD, from a variety of war stressor experiences in a broad sample of veterans recruited from clinical and nonclinical sources. The results show that PTSD with panic disorder is better explained by war stressors than other diagnostic combinations and that high-risk assignments and exposure to grotesque deaths were more salient than other stressor experiences in accounting for different diagnostic combinations. Implications of the findings for PTSD's placement in the DSM-III-R and for psychological and pharmacological treatments were discussed. PMID- 2723621 TI - Validity and reliability of the DSM-III criteria for posttraumatic stress disorder. Experience with a structured interview. AB - The DSM-III criteria for posttraumatic stress disorder (PTSD) were operationally defined for use in a structured interview. Acceptable interrater and test-retest reliabilities were shown; diagnostic validity was demonstrated relative to a standard diagnostic interview procedure; construct validity was shown in relation to a PTSD self-rating scale and to degree of combat exposure; the structured interview score correlated significantly with observer symptom scales for depression and anxiety. PMID- 2723622 TI - Psychological sequelae of war. A 3-year prospective study of Israeli combat stress reaction casualties. AB - The long-term psychological sequelae of combat were assessed employing the Impact of Event Scale (IES) 1, 2, and 3 years after the 1982 Lebanon War. The following groups of Israeli veterans participated: combat stress reaction casualties (N = 213) and comparable controls (N = 116). For the purpose of the study, the subjects in each group were screened and further divided according to whether they did or did not suffer from posttraumatic stress disorder (PTSD). Results showed that elevated rates of distress were reported by both combat stress reaction and PTSD casualties at all three points in time. In both study groups the level of distress declined with time. Theoretical and methodological implications were discussed. PMID- 2723623 TI - Dimensions of war zone stress. An empirical analysis. AB - Responses of 142 Vietnam veterans on two frequently employed measures of combat stress were factor analyzed. Four factors emerged, each of which represented an aspect of participation in activities within the Vietnam war zone. One factor in particular, abusive violence, was significantly related to postservice problems of adjustment and was the most powerful predictor of a diagnosis of combat related posttraumatic stress disorder. Our data suggest that unidimensional models of war zone stress that focus exclusively on exposure to life threat in combat situations are inadequate for characterizing important features of the Vietnam theater that are related to subsequent psychopathology. PMID- 2723624 TI - Serum thyroxine levels in schizophrenic and affective disorder diagnostic subgroups. AB - Serum free thyroxine (FT4) and total thyroxine (TT4) levels were measured at 2 week intervals during the course of hospitalization in 29 male inpatients in the following four diagnostic groups: paranoid schizophrenia (PS); undifferentiated schizophrenia; bipolar I disorder, manic; and major depressive disorder, endogenous type. The most striking finding was a difference in the direction of both TT4 and FT4 change during clinical recovery in the PS group compared with the other three groups. Analysis of the delta values, representing the change between admission and discharge values, revealed significant differences between the mean rise in the PS group vs. the mean decreases in the other three groups for both TT4 (p less than .0003) and FT4 (p less than .003). For TT4, 75% of the PS group showed a rise during recovery in contrast to 4% of the remaining groups; for FT4, 50% of the PS group showed a rise compared with 14% of the other groups. A significant difference was also observed between the FT4 levels of bipolar I, manic vs. PS patients at the time of hospital admission, which may have potential usefulness in the differential diagnosis of these two disorders. This study emphasizes the importance of exploring more fully the psychiatric significance of thyroxine levels within the endocrinological normal range and of doing longitudinal assessments of thyroxine and symptom changes during clinical recovery in psychiatric disorders. PMID- 2723625 TI - Evidence for a menstrual-linked artifact in determining rates of depression. AB - This is the first empirical report suggesting a menstrual-linked artifact in determining rates of depression. We investigated the effects of perceived menstrual cycle phase, and premenstrual and postmenstrual timing in the cycle, on scores for a self-report measure of depression that is widely used in epidemiological studies, the Center for Epidemiologic Studies Depression Scale (CES-D). The first study used a cross-sectional design and the second used a follow-up design with repeated measures across the menstrual cycle. Both studies assessed a community-based sample of regularly menstruating women. In the second study, testing was also done at 2-week intervals in men for comparison purposes. Both studies supported the hypothesis of a significant menstrual cycle-related effect on CES-D scores. The menstrual-linked effect is greater than the test retest variability observed in men, such that women more often tend to meet the cut-off criteria for depression on the CES-D premenstrually, as compared with postmenstrually. Thus it is possible that cyclic variations in ratings on the CES D may elevate epidemiological estimates of depression, as defined by RDC criteria, for menstruating women. Further longitudinal assessment in randomly selected samples will be needed in order to clarify whether a menstrual-linked effect is substantial and specific enough to require correction, or documentation of cycle phase, in epidemiological studies of depression. PMID- 2723626 TI - Update on instruments to measure DSM-III and DSM-III-R personality disorders. AB - In the last 2 years, researchers have revised personality instruments to encompass the DSM-III-R criteria for personality disorders. More recent, innovative instruments undergoing validity work include a self-report instrument that rederives DSM-III personality categories from dimensional measures, a self report designed to be used in conjunction with a diagnostic interview, an interview designed to be given by trained lay people, and a family history measure of the DSM-III personality disorder clusters. The modifications of older instruments and those instruments more recently developed are described. Clearly instruments require additional validity testing and better test-retest reliability. Discrepancies between different measurement instruments also need to be addressed. PMID- 2723627 TI - Kinetic evidence for cooperative binding of two ortho-phenanthroline molecules to astacus protease during metal removal. AB - Kinetic evidence is presented that introduces a new possibility for a mechanism of metal removal from a protein by a chelator. Astacus protease is a 22,614 dalton zinc-metalloendopeptidase from the digestive tract of the freshwater crayfish. Recent studies have shown that it contains a single zinc atom and that removal of this metal yields inactive apo-enzyme, which can be reactivated upon readdition of zinc, cobalt, or copper. The enzyme is inactivated by metal chelators in a time and concentration dependent manner. The inactivation of Zn Astacus protease by 1,10-phenanthroline (OP) can be monitored continuously in the presence of substrate. The concentration of substrate was found to have no effect on the inactivation rate, indicating that the chelator binding during inactivation is of the noncompetitive type. First-order rate constants for the inactivation process are seen to depend on the concentration of chelator in a sigmoidal manner. Based on mathematics analogous to that for cooperativity in enzyme-substrate kinetics, the deduction is made that there are two OP binding sites on the protein and that the rate of inactivation is related to the saturation of both sites with ligand. If one uses this model, the limiting rate constant of inactivation upon saturation of both sites with ligand is 6.76 x 10( 3) sec-1, and the half maximal rate occurs at an OP concentration of 6.52 mM. A mechanism is proposed wherein both protein bound chelators can cooperate during metal removal either by direct chelation of the metal or by allosteric means. The proposed model and the noncompetitive binding of chelator and substrate are discussed in relation to a recently proposed metal binding site. PMID- 2723628 TI - A 1H NMR study of cobalt(II) arsanilazocarboxypeptidase A. AB - Cobalt(II) arsanilazotyrosine-248 carboxypeptidase A has been characterized through 1H NMR spectroscopy. The ability of the azoenzyme to form binary and ternary complexes with L- and D-phenylalanine and azide has been investigated. Comparison with the 1H NMR results obtained on unmodified cobalt(II) carboxypeptidase provides direct information on the specific effect of the presence of the azo group on the reactivity of the system. Marked differences in the interaction with D-phenylalanine have been observed, and structural inferences are drawn. PMID- 2723629 TI - Acetylcholine synthesis by a sympathetic ganglion in the presence of 2-(4 phenylpiperidino)cyclohexanol (AH5183) and picrylsulfonic acid. AB - The present experiments measured the release and the synthesis of acetylcholine (ACh) by cat sympathetic ganglia in the presence of 2-(4 phenylpiperidino)cyclohexanol (AH5183 or vesamicol) and/or picrylsulfonic acid (TNBS), two compounds known to have the ability to block the uptake of ACh by cholinergic synaptic vesicles in vitro. We confirmed that, in stimulated (5 Hz) perfused (30 min) ganglia, AH5183 depressed ACh release and ACh tissue content increased by 86 +/- 6% compared to contralateral ganglia used as controls. Preganglionic activity increased ACh release by a similar amount in the presence (19.9 +/- 1.0 pmol/min) or absence (20.5 +/- 2.4 pmol/min) of TNBS. The final tissue ACh content was also similar in the presence (1,668 +/- 166 pmol) or absence (1,680 +/- 56 pmol) of TNBS. However, the AH5183-induced increase of tissue ACh content (86 +/- 6%) was abolished completely when AH5183 was perfused with 1.5 mM TNBS (-3.0 +/- 1.0%). This inhibition of ACh synthesis, observed in TNBS-AH5183-perfused ganglia, was not dependent upon further inhibition of ACh release beyond that caused by AH5183 alone, because 14.0 +/- 1.9% of the transmitter store was released by preganglionic nerve stimulation in the presence of TNBS plus AH5183 and this was similar in the presence of AH5183 without TNBS (14.0 +/- 0.6%). Moreover, when ganglia were first treated with TNBS and then stimulated in the presence of AH5183, an increase of 64 +/- 6% of the ganglionic ACh content occurred, and this increase was not statistically different from the increase measured with AH5183 alone (86 +/- 6%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723630 TI - Phosphorylation of superior cervical ganglion proteins during regeneration. AB - The incorporation of radioactive phosphate into proteins of both normal and regenerating ganglia of the sympathetic nervous system of the rat is reported. The incorporation reactions were carried out in vitro by incubating homogenates of excised ganglia with [gamma-32P]ATP under various conditions. It was found that incorporation of phosphate into proteins of regenerating ganglia in the molecular mass range 10,000-100,000 daltons increased up to 40% over incorporation into proteins from control ganglia during the first 3 days following injury and returned to control levels after 14 days. Analysis of the proteins by two-dimensional electrophoresis revealed that only few, i.e., less than 20, became radioactively labelled in homogenates of superior cervical ganglia in the presence of Ca2+, and even fewer in the presence of cyclic AMP. Furthermore, all these proteins fell within a narrow pI range of 4-6. The growth associated protein, variously designated GAP-43, B-50, F-1, and pp46, has an enhanced level of expression and phosphorylation in regenerating ganglia compared with controls at day 3. Injury also caused consistently higher levels of incorporation into two other proteins with molecular masses at positions 55,000 and 85,000 and pI values of 5.1 and 4.5, respectively; the former protein most probably is beta-tubulin. The fact that both proteins are found in the 15,000 g pellet after the tissue has been solubilized in 0.5% nonionic detergent indicates that they may indeed by components of filament assemblies. Thus, the results suggest that protein phosphorylation is a mechanism involved in cytoskeletal function in regenerating nerve. PMID- 2723631 TI - Tyrosination state of tubulin and the activity of tubulin:tyrosine ligase and tubulin carboxypeptidase in the developing retina of the chick. AB - The tyrosination state of tubulin and the enzymes involved in the tubulin tyrosination/detyrosination cycle--tubulin:tyrosine ligase and tubulin carboxypeptidase--were determined in chick retina during development. The amount of tyrosinable (tyrosinated plus detyrosinated) tubulin increased approximately 110% from embryonic day 7 to 14. Then it decreased, and by day 19 it was similar to the value on day 7. This result did not change after hatching, at least up to day 20. The proportion of tyrosinated and detyrosinated tubulin significantly changed with the development of the animal. At embryonic day 7, these tubulin species were at a proportion of 70 and 30%, respectively, and after hatching, the values inverted, to 30 and 70%, respectively. This change did not correlate with the activity of the ligase relative to that of the carboxypeptidase, as measured in vitro. This observation suggested that a change in the turnover rate of microtubules, in the proportion of assembled and nonassembled tubulin pools, or in both had occurred. Coincident with the last possibility, the proportion of assembled tubulin was found to increase during the development of the animal. This finding suggests that the tyrosination state of tubulin may be determined, at least in part, by the assembly state. PMID- 2723632 TI - Isolation and characterization of secretory granules storing a vasoactive intestinal polypeptide-like peptide in Torpedo cholinergic electromotor neurones. AB - Previous immunocytochemical work showed that the cholinergic electromotor neurones of Torpedo marmorata contain a vasoactive intestinal polypeptide-like immunoreactivity (VIPLI) that is conveyed to the terminals by axonal transport from the cell bodies where it is presumably synthesized. In extension of this work, we have now succeeded in isolating the VIPLI storage granules from both the terminals and the axons of these neurones and characterizing them morphologically and biochemically. They were readily separated from synaptic vesicles but contained several components in common that had previously been regarded as specific for synaptic vesicles. Among these were a heparan sulphate type of proteoglycan, synaptophysin, and a Mg2+-dependent ATPase. The VIPLI concentration in lobe tissue and the amount of tissue available were both insufficient to permit the isolation of granules from the electromotor cell bodies by the same technique but it was possible to establish the presence of such granules by particle-exclusion chromatography, using the stable markers mentioned above. In contrast to the VIPLI-containing granules, axonal synaptic vesicles differed from their terminal counterparts in having a very low acetylcholine content relative to stable vesicle markers: they presumably fill up on reaching the terminal where they are exposed to higher concentrations of cytoplasmic acetylcholine. PMID- 2723633 TI - Determination of brain interstitial concentrations by microdialysis. AB - Microdialysis is an extensively used technique for the study of solutes in brain interstitial space. The method is based on collection of substances by diffusion across a dialysis membrane positioned in the brain. The outflow concentration reflects the interstitial concentration of the substance of interest, but the relationship between these two entities is at present unclear. So far, most evaluations have been based solely on calibrations in saline. This procedure is misleading, because the ease by which molecules in saline diffuse into the probe is different from that of tissue. We describe here a mathematical analysis of mass transport into the dialysis probe in tissue based on diffusion equations in complex media. The main finding is that diffusion characteristics of a given substance have to be included in the formula. These include the tortuosity factor (lambda) and the extracellular volume fraction (alpha). We have substantiated this by studies in a well-defined complex medium (red blood cell suspensions) as well as in brain. We conclude that the traditional calculation procedure results in interstitial concentrations that are too low by a factor of lambda 2/alpha for a given compound. PMID- 2723634 TI - Introduction of macromolecules into bovine adrenal medullary chromaffin cells and rat pheochromocytoma cells (PC12) by permeabilization with streptolysin O: inhibitory effect of tetanus toxin on catecholamine secretion. AB - Conditions are described for controlled plasma membrane permeabilization of rat pheochromocytoma cells (PC12) and cultured bovine adrenal chromaffin cells by streptolysin O (SLO). The transmembrane pores created by SLO invoke rapid efflux of intracellular 86Rb+ and ATP, and also permit passive diffusion of proteins, including immunoglobulins, into the cells. SLO-permeabilized PC12 cells release [3H]dopamine in response to micromolar concentrations of free Ca2+. Permeabilized adrenal chromaffin cells present a similar exocytotic response to Ca2+ in the presence of Mg2+/ATP. Permeabilized PC12 cells accumulate antibodies against synaptophysin and calmodulin, but neither antibody reduces the Ca2+-dependent secretory response. Reduced tetanus toxin, although ineffective when applied to intact chromaffin cells, inhibits Ca2+-induced exocytosis by both types of permeabilized cells studied. Omission of dithiothreitol, toxin inactivation by boiling, or preincubation with neutralizing antibodies abolishes the inhibitory effect. The data indicate that plasma membrane permeabilization by streptolysin O is a useful tool to probe and define cellular components that are involved in the final steps of exocytosis. PMID- 2723635 TI - Cysteine: depolarization-induced release from rat brain in vitro. AB - Compounds released on depolarization in a Ca2+-dependent manner from rat brain slices were screened to identify candidates for neuroactive substances. Lyophilized superfusates were analyzed by reversed-phase HPLC after derivatization with 9-fluorenyl N-succinimidyl carbonate. One of the compounds that showed an increase of concentration in superfusates in the presence of iodoacetamide was identified as the cysteine (Cys) derivative, S carboxamidomethylcysteine, by fast atom bombardment mass spectrometry and other methods. This stable Cys derivative originates from endogenous, extracellular Cys. The finding led to a method for quantification of Cys in superfusates by immediate cooling of the superfusates to 0 degrees C and reaction of Cys with N ethylmaleimide. Depolarization-induced Ca2+-dependent release of Cys was most prominent in the neocortex, followed by the mesodiencephalon, striatum, and cerebellum. This suggests that Cys is released from a neuronal compartment and might be involved in neurotransmission. PMID- 2723636 TI - Biosynthesis, development, and regulation of neuropeptide Y in superior cervical ganglion culture. AB - The biosynthesis of neuropeptide Y (NPY) and norepinephrine (NE) has been examined in dissociated neuronal cultures from newborn rat superior cervical ganglion (SCG). NPY synthetic rate was measured by immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis after incubation in medium containing a labeled amino acid. The authenticity of the NPY was confirmed by reverse-phase HPLC analyses of tryptic peptides. The NPY synthetic rate in cultures grown in complete serum free medium increased 30-fold after plating, in parallel to catecholamine synthesis; both NPY and the catecholamines reached the rate for adult SCG neurons. This development in culture is seen without spinal cord input, target organs, or significant numbers of glial cells. NPY synthesis was maintained in the face of a major decrease in the rate of NE production after cholinergic induction. PMID- 2723637 TI - Effect of dichloroacetate on regional energy metabolites and pyruvate dehydrogenase activity during ischemia and reperfusion in gerbil brain. AB - The objective of this study was to determine whether administration of dichloroacetate (DCA), an activator of pyruvate dehydrogenase (PDH), improves recovery of energy metabolites following transient cerebral ischemia. Gerbils were pretreated with DCA, and cerebral ischemia was produced using bilateral carotid artery occlusion for 20 min, followed by reperfusion up to 4 h. DCA had no effect on the accumulation of lactic acid and the decrease in ATP and phosphocreatine (PCr) during the 20-min insult, nor on the recovery of these metabolites measured at 20 and 60 min reperfusion. However, at 4 h reperfusion, levels of ATP and PCr were significantly higher in DCA-treated animals than in controls, as PCr exhibited a secondary decrease in caudate nucleus of control animals. PDH was markedly inhibited at 20 min reperfusion in both groups, but was reactivated to a greater extent in DCA-treated animals at 60 min and 4 h reperfusion. These results demonstrate that DCA had no effect on the initial recovery of metabolites following transient ischemia. However, later in reperfusion, DCA enhanced the postischemic reactivation of PDH and prevented the secondary failure of energy metabolism in caudate nucleus. Thus, inhibition of PDH may limit the recovery of energy metabolism following cerebral ischemia. PMID- 2723638 TI - Increased nigral iron content and alterations in other metal ions occurring in brain in Parkinson's disease. AB - Levels of iron, copper, zinc, manganese, and lead were measured by inductively coupled plasma spectroscopy in parkinsonian and age-matched control brain tissue. There was 31-35% increase in the total iron content of the parkinsonian substantia nigra when compared to control tissue. In contrast, in the globus pallidus total iron levels were decreased by 29% in Parkinson's disease. There was no change in the total iron levels in any other region of the parkinsonian brain. Total copper levels were reduced by 34-45% in the substantia nigra in Parkinson's disease; no difference was found in the other brain areas examined. Zinc levels were increased in substantia nigra in Parkinson's disease by 50-54%, and the zinc content of the caudate nucleus and lateral putamen was also raised by 18-35%. Levels of manganese and lead were unchanged in all areas of the parkinsonian brain studied when compared to control brains, except for a small decrease (20%) in manganese content of the medial putamen. Increased levels of total iron in the substantia nigra may cause the excessive formation of toxic oxygen radicals, leading to dopamine cell death. PMID- 2723639 TI - Is the augmentation of K+-evoked intrasynaptosomal Ca2+ concentration due to the influx of Ca2+ in rat brain synaptosomes? AB - Intraterminal free Ca2+ concentration modulates the subsequent release of neurotransmitters. Depolarization of synaptosomes with 29 mM K+ augments cytosolic free Ca2+ concentration, which is triphasic, the peak times being at 10, 60, and 180 s. We examined the characteristics of each elevation of cytosolic free Ca2+ concentration in rat brain synaptosomes which had been preincubated for 3 min with a Ca2+-channel blocker, such as La3+, diltiazem, nifedipine, or verapamil, and under conditions of hypoxia or acidosis. The concentration of free Ca2+ in the quin-2-loaded rat brain synaptosomes was detected fluorometrically. All these elevations were suppressed in the presence of 200 microM EGTA or 100 microM La3+. At the first phase, the elevation of cytosolic free Ca2+ concentration with high K+ stimuli was significantly inhibited by La3+ (20 microM) or by acidosis (pH 6.7). On the other hand, diltiazem, which is a more potent blocker of the release of Ca2+ from the mitochondria, inhibited the increasing cytosolic free Ca2+ concentration at the third phase in a concentration-dependent manner. Hypoxia also showed inhibition at the third phase. These results suggest that the augmentation of high K+-evoked cytosolic free Ca2+ concentration may be due to the influx of extracellular Ca2+. The increase in cytosolic free Ca2+ concentration at the third phase is no doubt linked to the mitochondrial function. PMID- 2723640 TI - Nonneuronal localization for steroid converting enzyme: 3 alpha-hydroxysteroid oxidoreductase in olfactory tubercle of rat brain. AB - 3 alpha-Hydroxysteroid oxidoreductase (EC 1.1.1.50) was localized in the rat brain by cryostat sectioning, microassay, and neurochemical lesions. Single 16 microns sections were cut, homogenized, and assayed. In the olfactory tubercle 3 alpha-hydroxysteroid oxidoreductase activity is high in the piaglial layer at the surface, 20-fold lower at a depth of 50 microns, and 50-fold lower at a depth of 200 microns. A similar pattern of activity was seen in the olfactory bulb, the interpeduncular nucleus, the frontal pole of the cortex, and the frontoparietal cortex. When kainic acid, a toxin that destroys neurons but leaves glia and axons of passage intact, was injected into the olfactory tubercle, 3 alpha hydroxysteroid oxidoreductase activity was undiminished whereas glutamic acid decarboxylase activity was reduced by 80%. This laminar distribution and insensitivity to kainic acid are consistent with a nonneuronal localization. The high concentration of astrocytes in the piaglial layer, where 3 alpha hydroxysteroid oxidoreductase activity is highest, lead us to suggest that this enzyme is localized to astrocytes. The presence of particular enzymes in some brain regions and not in others determines which products are synthesized and which are inactivated in those regions. Thus, the location of 3 alpha hydroxysteroid oxidoreductase and other steroid converting enzymes can affect the activity of neuronal circuits and the behaviours regulated by those circuits. PMID- 2723641 TI - Cloning of a cDNA encoding MAP1B in rat brain: regulation of mRNA levels during development. AB - This article describes the isolation of a microtubule-associated protein 1B (MAP1B) cDNA clone from a rat brain lambda gt11 library and the study of MAP1B mRNA expression during brain development. On Northern blots, the cDNA hybridized with an mRNA of greater than 10 kilobases which was present only in the brain. The identity of the cDNA was confirmed by the characterization of the antiserum against the fusion protein, and also by comparing both the original antibody and the anti-fusion protein antiserum with a panel of well-studied monoclonal antibodies against different forms of MAP1 and MAP2. The regulation of MAP1B mRNA during development was studied in whole brain, cerebral cortex, hypothalamus, brainstem, and olfactory bulbs. The steady-state levels of MAP1B mRNA in all tissues examined were relatively low in the adult compared to developing brains. This decrease varied in different brain regions, and its time course appeared to coincide with the pattern of postnatal developmental and morphological events. The developmental patterns of the MAP1B mRNA and protein in the brain were similar, suggesting that expression of this protein is under transcriptional control. The RNA blots were also probed with beta-actin and beta-tubulin to compare the levels of MAP1B mRNA with other cytoskeletal elements and as controls for the quality of the RNA. PMID- 2723642 TI - Solubilization of peripheral-type benzodiazepine binding sites from cat cerebral cortex. AB - The present study demonstrates for the first time the solubilization of peripheral-type benzodiazepine binding sites (PBS) from cat cerebral cortex. Of all detergents tested [digitonin, 3-[(3-cholamidopropyl)dimethylammonio]-1 propane sulfonate (CHAPS), Tween 20, deoxycholate, and Triton X-100] in the presence of NaCl, the best solubilization (15% of initial activity) was obtained using 0.5% of the zwitterionic detergent CHAPS plus 2 M NaCl. Specific binding of [3H]PK 11195 to membrane-bound and solubilized PBS was saturable, yielding equilibrium dissociation constants (KD) of 1.3 +/- 0.2 and 1.9 +/- 0.3 nM, respectively, and maximal numbers of binding sites of 1,435 +/- 150 and 980 +/- 126 fmol/mg protein, respectively. The KD value of PK 11195 binding to solubilized PBS obtained from experimental kinetic analysis was 0.95 +/- 0.09 nM. The relative potencies of various compounds (PK 11195, Ro 5-4864, diazepam, flunitrazepam, clonazepam, methyl-beta-carboline-3-carboxylate, and Ro 15-1788) in displacing [3H]PK 11195 specific binding from membrane-bound and solubilized PBS were similar. Most of the solubilized binding activity was destroyed by heating at 60 degrees C for 30 min or by treatment with 2 M guanidinium chloride, which indicates the presence of a protein-binding site in the solubilized preparation. Over 85% of the solubilized binding activity was retained after 1 week at 4 degrees C, which will enable future application of purification procedures without major concern for stability of the material. PMID- 2723643 TI - High-affinity cannabinoid binding site: regulation by ions, ascorbic acid, and nucleotides. AB - The high-affinity cannabinoid site in rat brain is an integral component of brain membranes that recognizes cannabinoids with inhibitory constants (Ki) in the nanomolar range. To clarify its physiological role, we studied the regulation of [3H]5'-trimethylammonium delta 8-tetrahydrocannabinol ([3H]TMA) binding. The site is inhibited by heavy metal ions, such as La3+, at low micromolar concentrations; divalent cations, such as Ca2+ and Mg2+, inhibit [3H]TMA binding, though at somewhat higher concentrations. In contrast, [3H]TMA binding is stimulated by Fe2+, Cu2+, and Hg2+ ions. Ascorbic acid and its analogs are also stimulators of cannabinoid binding at low micromolar concentrations. Stimulation of [3H]TMA binding by ascorbate or ions is dependent upon molecular oxygen, but is not inhibited by metabolic poisons. Metabolically stable nucleoside triphosphate analogs enhance [3H]TMA binding by different mechanisms, with hydrolysis of a high-energy phosphate bond apparently requisite for these influences. These results suggest that the cannabinoid binding site is associated with a nucleotide utilizing protein possessing multiple regulatory subsites. PMID- 2723644 TI - Sequence analysis of a proteolyzed site in Drosophila choline acetyltransferase. AB - The amino terminal sequence of the 13-kilodalton (kD) polypeptide present in purified Drosophila acetyl-CoA: choline-O-acetyltransferase (EC 2.3.1.6) was determined, and its position in the sequence of the intact enzyme was located. Enzyme polypeptides for sequencing were obtained from native enzyme protein by denaturation, followed by fractionation on reverse-phase HPLC. The 13-, 54-, and 67-kD polypeptides recovered from the separation were subjected to amino terminal sequencing. Only the 13-kD fragment yielded a sequence. The 67- and 54-kD polypeptides appeared completely blocked to gas-phase Edman sequencing. The location of the amino terminal sequence from the 13-kD polypeptide in the cDNA deduced enzyme sequence indicated that this fragment represents the carboxyl portion of the 67-kD enzyme, with the 54-kD polypeptide providing the amino terminal portion. The proteolysis that gave rise to the 13-kD polypeptide occurred at the carboxyl side of a monobasic lysine residue. An earlier comparison of the enzyme from Drosophila and pigs indicated that the cleaved lysine may be a conserved residue in the porcine enzyme. The cleaved enzyme region characterized in this study does not coincide with the regions of high homology found in the two enzymes, but hydrophilicity profiles generated for this area showed similarities. PMID- 2723645 TI - Protein kinase C activation enhances K+-stimulated endogenous dopamine release from rat striatal synaptosomes in the absence of an increase in cytosolic Ca2+. AB - The possibility that protein kinase C modulates neurotransmitter release in brain was investigated by examining the effects of 12-O-tetradecanoylphorbol 13-acetate (TPA) on Ca2+ transport and endogenous dopamine release from rat striatal synaptosomes. TPA (0.16 and 1.6 microM) significantly increased dopamine release by 24 and 33%, respectively, after a 20-min preincubation with TPA followed by 60 s of depolarization with 30 mM KCl. Depolarization-induced 45Ca2+ uptake, measured simultaneously with dopamine release, was not significantly increased by TPA. Neither 45Ca2+ uptake nor dopamine release was altered under resting conditions. When the time course of K+-stimulated 45Ca2+ uptake and dopamine release was examined, TPA (1.6 microM) enhanced dopamine release after 15, 30, and 60 s, but not 1, 3, or 5 s, of depolarization. A slight increase in 45Ca2+ uptake after 60 s of depolarization was also seen. The addition of 30 mM KCl to synaptosomes which had been preloaded with the Ca2+-sensitive fluorophore fura-2 increased the cytosolic free Ca2+ concentration ([Ca2+]i) from 445 nM to 506 nM after 10 s of depolarization and remained elevated after 60 s. TPA had no effect on [Ca2+]i under depolarizing or resting conditions. Replacing extracellular Ca2+ with 100 microM EGTA reduced K+-stimulated (60 s) endogenous dopamine release by 53% and decreased [Ca2+]i to 120 nM. In Ca2+-free medium, 30 mM KCl did not produce an increase in the [Ca2+]i. TPA (1.6 microM) did not alter the [Ca2+]i under resting or depolarizing conditions, but did increase K+-stimulated dopamine release in Ca2+-free medium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723646 TI - Acute and chronic effects of ethanol on transbilayer membrane domains. AB - Alcohols, including ethanol, have a specific effect on transbilayer and lateral membrane domains. Recent evidence has shown that alcohols in vitro have a greater effect on fluidity of one leaflet as compared to the other. The present study examined effects of chronic ethanol consumption on fluidity of synaptic plasma membrane (SPM) exofacial and cytofacial leaflets using trinitrobenzenesulfonic acid (TNBS) labeling and differential polarized fluorometry of 1,6-diphenyl-1,3,5 hexatriene (DPH). Mice were administered ethanol or a control liquid diet for 3 weeks. Animals were killed and SPM prepared. The exofacial leaflet of SPM was significantly more fluid than the cytofacial leaflet in both groups, as indicated by limiting anisotropy of DPH. However, differences between the two leaflets were much smaller in the ethanol-treated group. Ethanol at concentrations seen clinically had a greater effect in vitro on the more fluid exofacial leaflet. This asymmetric effect of ethanol was significantly diminished in the exofacial leaflet of the ethanol-treated mice. Chronic ethanol consumption has a specific effect on membranes. Membrane functions that may be regulated by asymmetry of fluidity and lipid distribution may be altered by chronic ethanol consumption. PMID- 2723647 TI - Characterization and regional distribution of individual gangliosides in goldfish central nervous system. AB - Gangliosides were partially purified from goldfish brain and fractionated by DEAE Fractogel column chromatography. Each fraction was then analyzed by HPTLC and also by HPLC after conversion of the gangliosides to 2,4-dinitrophenylhydrazides. The tetrasialoganglioside GQ1c was found to constitute more than 50% of the total gangliosides. Gangliosides in smaller quantities were also tentatively identified. These included GT1b, GT1c, GT2, GT3, GD1a, and several others. By using this information, the amounts of individual gangliosides in various regions of goldfish central nervous system were compared. Although all areas of brain examined contained similar concentrations of gangliosides, with GQ1c as the predominant component, retina and optic nerve contained significantly lower concentrations of GQ1c, and GM3 was the major component. PMID- 2723648 TI - Presence of proteolipid protein in coelacanth brain myelin demonstrates tetrapod affinities and questions a chondrichthyan association. AB - The protein and glycoprotein compositions of CNS myelin from the living coelacanth (Latimeria chalumnae) were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. An unglycosylated component of 25 kilodaltons showed substantially stronger immunoblot reactivity with antibodies against mammalian proteolipid protein (PLP) than lungfish glycosylated PLP. DM-20 (intermediate protein) was not detectable in either fish. The presence of unglycosylated PLP in CNS myelin of the actinistian coelacanth contradicts an association with cartilaginous fishes but supports tetrapod affinities closer than those of lungfish. PMID- 2723649 TI - Equilibrium binding analysis of neural cell adhesion molecule binding to heparin. AB - The kinetics of neural cell adhesion molecule (NCAM) binding to heparin were studied in a heparin-Sepharose-based solid-phase binding assay. The observed binding is time dependent and saturable. A binding constant of 5.2 +/- 1.4 X 10( 8) M is observed for binding of newborn rat NCAM to heparin. This is approximately 25 times lower than the binding constant determined for newborn rat NCAM homophilic binding. Both Scatchard and Hill plot analyses suggest the presence of only one binding site. Fab' fragments of antibodies to rat NCAM significantly inhibit binding, a result indicating that a specific site on NCAM is involved in binding to heparin. The binding is inhibited by heparin (IC50, approximately 5 micrograms/ml), whereas chondroitin sulfate is a less potent inhibitor (IC50, approximately 15 micrograms/ml). PMID- 2723650 TI - High-pressure extraction of membrane-associated protein kinase C from rat brain. AB - Extraction of rat brain membrane-associated protein kinase C with high specific activity was obtained by applying benzyl alcohol (a membrane fluidizer), EDTA, and high hydrostatic pressures. Approximately 50% of total brain-associated activity was extracted from membranes. The pressure-extracted activity had an eightfold enrichment in the lipid/protein ratio when compared with the cytosolic fraction. This may explain the inability of exogenous diacylglycerol to stimulate endogenous phosphorylation in pressure-extracted activity. The enzyme is extracted at greater than 1,300 atm, a result indicating it most likely has a portion inserted into the hydrophobic portion of the membrane bilayer. Perturbation of the native membrane induces a change in the membrane-associated protein kinase C-lipid interaction that permits extraction under conditions used for the cytosolic species. This is the first report of conversion of the endogenous membrane species to a cytosolic one and may be important in determining the role of protein kinase C in neuronal regulation. PMID- 2723651 TI - Mouse brain c-fos mRNA distribution following a single electroconvulsive shock. AB - The regional distribution of c-fos mRNA in the mouse brain has been investigated by in situ hybridization autoradiography after seizures induced by an acute electroconvulsive shock (ECS). ECS led to a widespread induction of the proto oncogene c-fos in the brain, with highest concentrations in discrete areas within the limbic system and also in the hypothalamus and cerebellum. The mild stress of sham treatment in earclipped animals induced a weaker and qualitatively different pattern of c-fos mRNA expression involving the cortex, hippocampus, and cerebellum. These data suggest the usefulness of c-fos in situ hybridization as a marker of neuronal stimulation and in mapping a range of effects from a mild stress to the robust changes of an electroconvulsive seizure. PMID- 2723652 TI - Possible involvement of polysialogangliosides in nerve sprouting and cell contact formation: an ultracytochemical in vitro study. AB - In Cichlid fish (Oreochromis mossambicus) primary cell cultures from whole brain and optic tectum, the differentiation-dependent distribution of polysialogangliosides on the outer cell surface has been followed on an ultrastructural level. For this, a two-step labeling technique with the monoclonal mouse antibody Q211, recognizing a polysialoganglioside-associated epitope, followed by a secondary IgM antibody, coupled to colloidal gold sols as an electron-dense marker, has been used. The gold grains are not uniformly distributed over the whole cell surface, but rather are clearly arranged clusters. In cells from freshly hatched larvae, both cell bodies and nerve fibers strongly exhibit the polysialoganglioside epitope on their surface. With progressing development, neuronal cell labeling is more and more restricted to nerve fibers and especially to cellular adhesion zones, including synaptic terminals, thus suggesting a functional involvement of polysialogangliosides in nerve sprouting and initiation of both cell-to-extracellular matrix and cell-to cell contacts. PMID- 2723653 TI - Ganglioside modulation of cyclic AMP-dependent protein kinase and cyclic nucleotide phosphodiesterase in vitro. AB - Purified cyclic AMP-dependent protein kinase (cAK) catalytic subunit phosphorylated 180-, 49-, 31-, 19-, and 14-kilodalton (kDa) proteins of rabbit sciatic nerve membranes. The ability of cAK to phosphorylate these membrane substrate proteins was inhibited by gangliosides GM1, GD1a, and GT1b with half maximal inhibitory concentration (I50) = 7-25 microM. Neutral glycolipids and lysophosphatidylcholine were much less effective. Cyclic AMP (cAMP) kinase phosphorylation of histone IIA was inhibited by GM1, GD1a, and GT1b (I50 = 115 microM, 75 microM, and 75 microM, respectively). Inhibition by GM1 was competitive with respect to histone (Ki = 108 microM). Autophosphorylation of cAMP kinase was inhibited by GM1 (I50 = 15 microM). GT1b, GD1a, and GM1 half maximally stimulated calmodulin-dependent cyclic nucleotide phosphodiesterase at 0.1 microM, 0.2 microM, and 0.3 microM, respectively. Although GT1b stimulated phosphodiesterase by increasing Vmax and decreasing Km (similar to calmodulin), GD1a and GM1 produced only an increase in Vmax. These results suggest that ganglioside can modulate the activity of cAMP kinase by both direct inhibition of the enzyme and indirect reduction of cAMP levels through activation of phosphodiesterase. Through these mechanisms, gangliosides may alter cAMP dependent protein phosphorylation and cell function within the nervous system. PMID- 2723654 TI - Transport of muscarinic cholinergic marker protein activities in regenerating sciatic nerve of rat. AB - The transport characteristics of choline acetyltransferase (ChAT; EC 2.3.1.6), acetylcholinesterase (AChE; EC 3.1.1.7), and the muscarinic acetylcholine receptors (mAChR) were studied in perineurally sutured, regenerating rat sciatic nerve. At different times after repair, the sciatic nerve was ligated for 24 h, and the activities of the cholinergic marker proteins, as well as the binding capacity, were measured proximally and distally from the ligature. The number of bidirectionally transported receptors increased linearly up to 5 months postoperatively (6.1-33.6% and 5.6-25.6% of the control level proximal and distal to the ligature, respectively). The quantity of anterogradely transported ChAT reached a plateau 3 months postoperatively (74.9% of the control level), whereas the retrogradely transported enzyme was then only 34.7% of the control value. The activity of AChE increased linearly during nerve regeneration, and exceeded the control level after 4 months (121.0% and 63.7% proximally and distally, respectively). The data indicate that the altered bidirectional transport of cholinergic marker proteins may be monitored quantitatively during nerve regeneration. This method might be suitable for studies of the nerve regeneration process. PMID- 2723655 TI - p-chloromercuribenzoate causes Ca2+-dependent exocytotic catecholamine secretion from cultured bovine adrenal medullary cells. AB - Incubation of cultured bovine adrenal medullary cells with p chloromercuribenzoate (50-500 microM), a sulfhydryl-reacting agent, caused an increase in the secretion of catecholamines, p-Chloromercuriphenyl sulfonate, a p chloromercuribenzoate analogue that poorly penetrates the cell membrane, caused a similar increase in catecholamine secretion. In both cases, catecholamine secretion was dependent on extracellular Ca2+. Furthermore, p chloromercuribenzoate caused both 45Ca2+ influx into the cells and an increase in the intracellular free Ca2+ concentration. The increases in catecholamine secretion and 45Ca2+ influx behaved similarly in relation to p chloromercuribenzoate concentration. The time courses of the increased secretion, 45Ca2+ influx, and intracellular free Ca2+ concentration by p chloromercuribenzoate were also quite similar. The stimulation of catecholamine secretion by p-chloromercuribenzoate was reversed by washing the cells with dithiothreitol-containing medium, but not by dithiothreitol-free medium. When the cells were treated with p-chloromercuribenzoate, dopamine-beta-hydroxylase, an enzyme present in the chromaffin granules along with catecholamines, was also released. However, p-chloromercuribenzoate did not cause release of phenylethanolamine-N-methyltransferase, an enzyme present in the cytoplasm. These results indicate that catecholamine secretion due to p-chloromercuribenzoate occurs by Ca2+-dependent exocytosis. PMID- 2723656 TI - Comparison of [125I]iodolysergic acid diethylamide binding in human frontal cortex and platelet tissue. AB - The human platelet contains a functional 5-hydroxytryptamine (5-HT) receptor that appears to resemble the 5-HT2 subtype. In this study, we have used the iodinated derivative [125I]iodolysergic acid diethylamide ([125I]iodoLSD) in an attempt to label 5-HT receptors in human platelet and frontal cortex membranes under identical assay conditions to compare the sites labelled in these two tissues. In human frontal cortex, [125I]iodoLSD labelled a single high-affinity site (KD = 0.35 +/- 0.02 nM). Displacement of specific [125I]iodoLSD binding indicated a typical 5-HT2 receptor inhibition profile, which demonstrated a significant linear correlation (r = 0.97, p less than 0.001, n = 17) with that observed using [3H]ketanserin. However, [125I]iodoLSD (Bmax = 136 +/- 7 fmol/mg of protein) labelled significantly fewer sites than [3H]ketanserin (Bmax = 258 +/- 19 fmol/mg of protein) (p less than 0.001, n = 6). In human platelet membranes, [125I]iodoLSD labelled a single site with affinity (KD = 0.37 +/- 0.03 nM) similar to that in frontal cortex. The inhibition profile in the platelet showed significant correlation with that in frontal cortex (r = 0.96, p less than 0.001, n = 16). We conclude that the site labelled by [125I]iodoLSD in human platelet membranes is biochemically similar to that in frontal cortex and most closely resembles the 5-HT2 receptor subtype, although the discrepancy in binding capacities of [125I]iodoLSD and [3H]ketanserin raises a question about the absolute nature of this receptor. PMID- 2723657 TI - Muscarinic agonists cause calcium influx and calcium mobilization in forebrain neurons in vitro. AB - We have examined the effects of the muscarinic agonist carbachol on the intracellular free Ca2+ concentration ([Ca2+]i) in primary cultures of neurons from rat forebrain using the Ca2+-sensitive fluorescent dye fura-2. Addition of carbachol increased the [Ca2+]i in approximately 60% of cells studied. Oxotremorine-M, but not pilocarpine, mimicked the effects of carbachol. The response was reduced by 60% on removal of extracellular Ca2+, a finding suggesting that muscarinic receptor activation causes Ca2+ influx in addition to intracellular Ca2+ mobilization. Tetrodotoxin and nitrendipine also significantly reduced the response to carbachol. These studies suggest that the changes in [Ca2+]i produced by activation of muscarinic receptors result in part from mobilization of intracellular Ca2+ and that influx through voltage-sensitive Ca2+ channels also provides a significant contribution to the net [Ca2+]i change observed. PMID- 2723658 TI - Enhanced brain cell proliferation following early adrenalectomy in rats. AB - We have previously demonstrated an increase in adult brain DNA content in rats adrenalectomized on postnatal day 11. The present studies examined cell proliferation in cerebral cortex, cerebellum, hippocampus, and midbrain diencephalon following adrenalectomy at this age. Compared to sham-operated controls, adrenalectomized animals showed increased [3H]thymidine incorporation into DNA (measured at 1 h following a pulse injection) in all brain regions at 7 and 14 days postsurgery. In some areas, the effect was already present as early as 2 days following adrenalectomy. Chronic replacement with corticosterone prevented this increase in DNA labelling in a dose-dependent manner. When cell proliferation in the cerebral cortex and cerebellum was independently assessed by measuring changes in thymidine kinase activity, enzyme activity was significantly elevated in both areas at 7 and 14 days postsurgery. Finally, histological examination of the cerebellar cortex suggested a delayed disappearance of the external granular layer in several cerebellar lobules of adrenalectomized animals. Overall, these findings indicate that day-11 adrenalectomy leads to a prolonged stimulation of mitotic activity in areas where cell formation at this time is exclusively glial (i.e., cerebral cortex and mid-brain-diencephalon) as well as in areas where postnatal neurogenesis is also occurring (cerebellum and hippocampus). It is hypothesized that this stimulation results from the removal of a tonic inhibitory effect exerted by circulating glucocorticoids in the normal intact animal. PMID- 2723659 TI - A kinetic analysis of kappa-opioid agonist binding using the selective radioligand [3H]U69593. AB - The interaction of the nonselective opioid ligand [3H]bremazocine and of the kappa-opioid [3H]U69593 with the kappa-receptor was investigated in guinea-pig cortical membranes. Each radioligand bound to a single population of high affinity sites, although [3H]U69593 apparently recognised only 70% of those sites labelled by [3H]bremazocine. Naloxone and the kappa-selective ligands U69593 and PD117302 exhibited full inhibition of the binding of both radioligands. Kinetic analysis demonstrated biphasic rates of association and dissociation for both [3H]bremazocine and [3H]U69593. Detailed analysis of the binding of [3H]U69593 revealed that the fast rate of association was dependent on radioligand concentration, in contrast to the slow rate, which was independent of ligand concentration. Guanylyl-5'-imidodiphosphate (GppNHp) inhibited binding of [3H]U69593; saturation analysis demonstrated that the inhibitory effects of GppNHp resulted in a decrease in affinity without any significant change in binding capacity. GppNHp attenuated the formation of the slow component of [3H]U69593 binding, while accelerating the fast component. The data are consistent with the formation of a high-affinity complex between the kappa receptor and a guanine nucleotide binding protein. Guanine nucleotides promote the dissociation of this ternary complex and the stabilisation of a lower affinity state of the receptor. PMID- 2723660 TI - Effects of pregnancy on the contents of water, taurine, and total amino nitrogen in rat cerebral cortex. AB - Plasma osmolality and the levels of water, taurine, and total amino nitrogen (detected as ninhydrin-positive substances) have been measured in the cerebral cortices of nonpregnant and 19-day pregnant Wistar rats. Plasma osmolality fell by 11 mosmol/kg during pregnancy. Brain water content remained unaltered, but levels of taurine and ninhydrin-positive substances fell by 48.5 and 21.9%, respectively. It is suggested that one way in which brain cells are prevented from swelling during the mild hypoosmolality of pregnancy is through loss of cellular amino nitrogen, particularly taurine. PMID- 2723661 TI - Serotonin 5-HT2 receptors: two states versus two subtypes. PMID- 2723662 TI - Determination of the deoxyglucose and glucose phosphorylation ratio and the lumped constant in rat brain and a transplantable rat glioma. AB - Mitochondrially bound hexokinase (ATP-D-hexose-6-phosphotransferase; EC 2.7.1.1) was dissociatively extracted from normal rat brains and intracerebral and subcutaneous implants of the 36B-10 glioma. At least 70% of the total hexokinase enzyme activity in normal and glioma tissue was associated with the mitochondrial fraction. Purification of the crude tissue extracts by ion-exchange and affinity chromatography followed by analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed a successive purification of the enzyme to homogeneity with a molecular size of 98 kilodaltons. Enzyme kinetics with glucose or 2-deoxyglucose (2-DG) as the substrate were measured spectrophotometrically by coupling the appropriate reactions to either NADPH or NAD+ formation. The Km of hexokinase with glucose as the substrate in the intracerebral glioma (0.138 mM) and subcutaneous glioma (0.183 mM) tissues was 2.1-2.7-fold higher than that observed in normal brain tissue (0.067 mM) (p less than 0.001). No significant differences were observed in the Km for hexokinase with 2-DG as the substrate in the glioma and normal brain tissue. The phosphorylation ratio for normal brain was 0.320 and was increased in the intracerebral glioma to 0.694 and in the subcutaneous glioma to 0.519. The ratios of deoxyglucose and glucose volumes of distribution in normal brain and intracerebral glioma tissues were 1.70 and 1.85, respectively. The lumped constants calculated directly from the phosphorylation ratios and the volumes of distribution of deoxyglucose and glucose were 0.517 in normal brain and 1.168 in intracerebral glioma. Our results indicate the lumped constant is increased 2.26-fold in intracerebral glioma compared with normal brain. PMID- 2723663 TI - Metabolism of prostaglandin D2 by human cerebral cortex into 9 alpha, 11 beta prostaglandin F2 by an active NADPH-dependent 11-ketoreductase. AB - In homogenates of rat cerebral neocortex prostaglandin D2 (PGD2) was found to be quantitatively the main PG biosynthesized by a cytosolic PGD synthetase from endogenously released arachidonic acid. Amounts of 628 ng/g wet weight were found after 30-min incubation periods compared with basal levels of 2.3 ng/g wet weight. In human cerebral cortex, whether obtained at biopsy or postmortem, only small amounts of PGD2 (4.5-11.7 ng/g wet weight/30 min) were formed. Furthermore, PGD2, added to homogenates of human biopsy temporal cortex, was converted efficiently into 9 alpha,11 beta-PGF2 by a NADPH-dependent 11-ketoreductase as has been reported in other human tissues (liver and lung). PGF2 alpha was determined directly as the n-butylboronate derivative. It became clear that 9 alpha,11 beta-PGF2 was formed in considerably greater amounts than PGF2 alpha and that other metabolites are also formed. These results can account for the low amounts of PGD2 found in incubations of human brain tissue. The rat brain does not contain 11-ketoreductase activity. The present results indicate that the 9 alpha,11 beta-PGF2 must be considered along with other eicosanoids in pathophysiological situations in brain. PMID- 2723664 TI - Phosphorylated thiamine derivatives and cortical activity in the baboon Papio papio: effect of intermittent light stimulation. AB - The effect of intermittent light stimulation (ILS) on the distribution of thiamine derivatives in three brain areas (occipital, motor, and premotor) was compared in photosensitive and nonphotosensitive baboons. ILS induces paroxysmal discharges in the motor and premotor areas of photosensitive animals only. In baboons submitted to ILS, thiamine triphosphate (TTP) decreases in both photosensitive and nonphotosensitive animals; thiamine monophosphate (TMP) increases in photosensitive animals, which present ILS-induced paroxysmal discharges, whereas it is unaffected in nonphotosensitive animals. The variations are the most significant in the occipital (visual) cortex. A consumption of TTP may result from electrical activity induced by light stimulation in the occipital area. No correlation between ILS-induced paroxysmal activity and a decrease in TTP contents was found. However, photosensitive animals are affected differently from nonphotosensitive animals, as their content of TMP in the cerebral cortex increases on stimulation. However, as long as the exact role of thiamine compounds in relation to membrane excitability in the nervous system remains unknown, it is impossible to conclude whether the differences observed in the metabolism of thiamine compounds are the cause or the consequence of the photosensitivity in the baboon Papio papio. PMID- 2723665 TI - The structure of eryloside A, a new antitumor and antifungal 4-methylated steroidal glycoside from the sponge Erylus lendenfeldi. AB - The structure of a new glycoside, eryloside A [1], isolated from the Red Sea sponge Erylus lendenfeldi, has been determined by 1D and 2D nmr techniques. PMID- 2723666 TI - Antifungal agents: in vitro and in vivo antifungal extract from the common daisy, Bellis perennis. PMID- 2723667 TI - Vacuum liquid chromatography and quantitative 1H NMR spectroscopy of tumor promoting diterpene esters. PMID- 2723668 TI - Pentagalloylglucose, a xanthine oxidase inhibitor from a Paraguayan crude drug, "Molle-i" (Schinus terebinthifolius). PMID- 2723669 TI - Identity of maprounic acid with aleuritolic acid. Revision of the structure of maprounic acid: X-ray crystal structure of p-bromobenzyl acetylmaprounate. PMID- 2723670 TI - Effects of cholinergic drugs on learning impairment in ventral globus pallidus lesioned rats. AB - The excitotoxin kainic acid (10 nmol/microliter) was used to produce bilateral lesions in the nucleus basalis magnocellularis (NBM) of rats which provides extensive cholinergic innervation to the cerebral cortex. The behavioral effects of physostigmine, THA (9-amino-1,2,3,4-tetrahydroacridine hydrochloride) and NIK 247 (9-amino-2,3,5,6,7,8-hexahydro-1H-cyclopenta[b]quinoline monohydrate hydrochloride) were investigated by observing locomotor activity, shock sensitivity and passive avoidance response in the NBM-lesioned rats. Evaluation of locomotor activity and shock sensitivity in the experimental animals did not reveal any sensorimotor disturbances caused by the lesions. Oral administration of 1 and 2 mg/kg physostigmine reduced the locomotor activity in the NBM-lesioned rats, while physostigmine (0.5 mg/kg), THA (1 or 3 mg/kg) and NIK-247 (1 or 3 mg/kg) had no effect on locomotor activity. Compared with the sham-operated controls, the NBM-lesioned rats exhibited a significantly lesser deficit in the retention of the passive avoidance response. THA (1 or 3 mg/kg) and NIK-247 (1 or 3 mg/kg) elicited good retention of the passive avoidance response. Rats with NBM lesions showed impaired acquisition of a passive avoidance response when trained repeatedly at 24-h intervals. Also, when post-training NBM lesions were induced, there was rapid extinction of the acquired passive avoidance response. THA or NIK 247 administered at doses of 3 mg/kg significantly increased response latencies of post-trained NBM-lesioned rats. THA or NIK-247 administered once a day in doses of 1 or 3 mg/kg p.o. produced a very significant increase of acetylcholine in the cerebral cortex of NBM-lesioned rats after the 21st administration. These finding suggest that THA and NIK-247 exert an ameliorating effect on memory disturbance induced by NBM lesions in rats. PMID- 2723671 TI - Different forms of brain acetylcholinesterase and muscarinic binding in Parkinson's disease. AB - Choline acetyltransferase (ChAT) activity, the sedimentation and solubility forms of acetylcholinesterase (AChE) as well as total (3H-quinuclidinyl benzilate, QNB) and M1 (3H-pirenzepine, PZ) muscarinic binding were investigated in the temporal cortex (TC) and nucleus caudatus (NC) of both non-demented and demented parkinsonian patients and controls. ChAT activity and low-salt-soluble and detergent-soluble AChE were lower in the TC of demented patients with Parkinson's disease than in controls. ChAT activity and the solubility forms of AChE in the NC did not differ between controls and parkinsonian patients. In the TC, the activity of the intermediate form of AChE was lower in parkinsonian patients, but the activity of the light form of AChE did not differ between controls and parkinsonian patients. In the TC of patients with Parkinson's disease the Bmax of 3H-QNB binding was slightly higher than in controls, but the Bmax of 3H-PZ binding did not differ between controls and parkinsonian patients. In the NC the Bmax of 3H-QNB binding was unchanged compared to that of the controls. The concomitant decrease of ChAT with soluble as well as membrane-bound tetrameric AChE suggests a close relationship between ChAT and tetrameric form of AChE. M1 receptors (3H-PZ binding sites) are not affected in the TC, but are decreased in the NC of demented parkinsonian patients. This decrease may be secondary to the loss of dopaminergic neurons projecting from the substantia nigra to the striatum. PMID- 2723672 TI - Autoantibodies to brain endothelial cells in the sera of patients with human T lymphotropic virus type I associated myelopathy and other demyelinating disorders. AB - We examined the sera of 21 cases of human T-lymphotropic virus type I (HTLV-1) associated myelopathy (HAM), 30 cases of neuro-Behcet (N-B) syndrome, and 36 cases of multiple sclerosis (MS) for the presence of autoantibodies to brain endothelial cells by enzyme-linked immunosorbent assay (ELISA) using cultured brain endothelial cells. The concentrations of immunoglobulin G (IgG) which bound to brain endothelial cells were significantly increased in the sera of patients with HAM before (P less than 0.001) and after (P less than 0.01) blocking Fc receptors compared to those of controls. The levels of IgG binding to brain endothelial cells were also significantly increased in the sera of patients with N-B syndrome (P less than 0.01), and MS (P less than 0.001) especially those in an exacerbation compared to those of controls regardless of blocking Fc receptors. These results suggest that IgG binding to brain endothelial cells may be mediated via an immunologically specific antigen-antibody interaction as a result of the blood-brain barrier (BBB) damage in cases of HAM, N-B syndrome and MS. PMID- 2723673 TI - Immunological studies on patients with optic neuritis without evidence of multiple sclerosis. AB - We studied 6 patients with idiopathic optic neuritis (ON) after a mean follow-up period of 12 years. No evidence of multiple sclerosis (MS) was found on clinical grounds, nor by magnetic resonance imaging (MRI) or evoked responses. Levels of spontaneous proliferation, serum gamma-interferon (IFN-gamma) and lymphocyte MHC locus II antigen were similar in ON and in 6 patients with progressive MS, but different in healthy controls. This suggests that similar immunological conditions in vivo prevail after an idiopathic ON and in MS. A normal PHA-induced interleukin-2 receptor expression and lymphocyte proliferation but a low IFN gamma secretion and MHC locus II antigen expression were observed. This suggests that an ON and MS defect is expressed after an interleukin-2 receptor ligand but before IFN-gamma secretion. Our findings also suggest that immunological factors do not explain the neuropathological confinement of the lesions in ON but the protective influence may rather be exerted by some as yet undefined genetic influence or may be explained by the different etiology of ON and MS. PMID- 2723674 TI - Age-related changes in the fibre composition of equine peripheral nerve. AB - Transverse sections of the lateral palmar nerve from a group of horses free from neuromuscular disease were assessed quantitatively, with emphasis on differences in the fibre population related to age. Morphometric analysis of the population of myelinated and unmyelinated fibres was performed. Changes were identified, there being a loss of larger myelinated fibres in older horses. The relationship of myelin thickness to axon diameter and the unmyelinated fibre population did not alter with age. The lateral palmar nerve is suitable for biopsy and electrophysiological study in the horse, but age related changes must be appreciated in the interpretation of results. PMID- 2723675 TI - Tuberculosis of the nervous system. A clinical, radiological and pathological study of 39 consecutive cases in Riyadh, Saudi Arabia. AB - Thirty-seven consecutive adults and 2 children with tuberculosis of the nervous system were studied. Twenty-eight patients (72%) had intracranial or intraspinal tuberculomas and only 11 patients (28%) had tuberculous meningitis. Of the 14 patients (36%) with intracranial tuberculomas 6 presented with epilepsy of late onset including convulsive status epilepticus(2). The 6 patients with multiple tuberculomas some of which were situated in the infratentorial compartment were surprisingly free of major neurological disability of systemic disturbance. Thirteen patients (33%) presented with spinal cord compression due to tuberculoma. Eight of these had associated bony abnormalities such as collapsed vertebrae and loss of pedicles usually regarded as characteristic of malignant disease and 2 presented with clinical features of acute transverse myelitis. Eleven patients (28%) had tuberculous meningitis. One of these died, 1 had a protracted illness with gait ataxia and hydrocephalus and 1 other patient was disabled by hemiplegia, dysphasia and epilepsy but the remaining 8 recovered fully. Tuberculosis outside the nervous system was found in 13 patients (33%) in 12 (31%) of whom it was pulmonary. Acid fast bacilli were demonstrated by Ziehl Neelsen stain in 16 patients (52%) out of 31 from whom specimens were available. Mycobacterium tuberculosis was eventually cultured from only 6 specimens. These data suggest that the clinical and radiological features of tuberculosis of the nervous system in Saudi Arabia may differ substantially from those reported from other countries. In our study there was low morbidity and low fatality rate. Two patients had infratentorial tuberculomas, and 8 patients had bony abnormalities in the vertebral column, typical of malignant disease. PMID- 2723676 TI - Role of histamine in traumatic brain edema. An experimental study in the rat. AB - The possibility that histamine plays a role in the formation of traumatic brain edema was investigated in the rat. A 3 mm deep and 3 mm long stab injury was performed in the right parietal cortex under urethane anaesthesia. The brain water content and histamine levels in plasma and brain were measured at the end of 1, 2 and 5 h periods after trauma. There was a 3.46% increase in brain water content in the traumatized hemisphere from the value in the control group at 5 h. The histamine content was increased by 107% in plasma and 51% in the traumatized brain hemisphere from the control value at this time period. The increased brain water content as well as the elevated plasma and brain histamine levels were prevented by prior treatment with the histamine H2-receptor antagonist cimetidine. Mepyramine (a histamine H1-receptor antagonist) failed to reduce the increased brain water content and the histamine levels in plasma and brain remained high. The results strongly indicate that histamine has a role in the formation of early traumatic brain edema and that this reaction can be influenced by pharmacological procedures. PMID- 2723677 TI - Wernicke's encephalopathy in non-alcoholics. An autopsy study. AB - In a 5-year autopsy material constituting 6,964 autopsies, there were 52 cases of Wernicke's encephalopathy of which 12 (23%) occurred in non-alcoholics. Among 18 cases with active (acute) disease, 7 cases (39%) were found in non-alcoholics. Only 4 cases of active Wernicke's disease were diagnosed clinically, all of them in alcoholics. The predominant clinical symptoms were disorientation and depressed levels of consciousness, whereas eye symptoms were recorded in only 3 cases. None of the non-alcoholics were given specific thiamine therapy, whereas some alcoholics received large doses of the vitamin as a routine procedure. However, the thiamine therapy was often instituted too late. It is concluded that active Wernicke's encephalopathy should be considered in all patients with prolonged malnutrition and that disorientation and depressed levels of consciousness may be the predominating symptoms of the disease. Even the slightest suspicion of Wernicke's encephalopathy should prompt immediate administration of large doses of thiamine parenterally. PMID- 2723678 TI - "Grumose degeneration" of the dentate nucleus. A light and electron microscopic study in progressive supranuclear palsy and dentatorubropallidoluysial atrophy. AB - So-called "grumose degeneration" (GD) of the dentate nucleus (DN) which is a unique alteration in progressive supranuclear palsy and dentatorubropallidoluysial atrophy was studied by light and electron microscope. Light microscopically, the presence of a large amount of eosinophilic granular and/or amorphous material around the neurons is the most conspicuous feature of GD. In addition, the number of neurons is decreased and some of them are swollen as with central chromatolysis. Electron microscopically, the granular and/or amorphous material mainly consists of the altered axon terminals of the Purkinje cells (Pax), which are relatively electron-dense and characteristically contain varying numbers of deformed lamellar bodies, highly electron-dense mitochondria and many vacuoles which are adherent to the astrocytic processes. GD is a unique histological change of both the chromatolytic DN neurons and the grumose appearance of the altered Pax. Possible mechanisms are discussed. PMID- 2723679 TI - Acute effects of low-dose cranial irradiation on regional capillary permeability in experimental brain tumors. AB - To determine the acute effects of low-dose cranial irradiation (CRT) on regional capillary permeability (RCP) of normal brain, brain tumor and damaged brain surrounding the tumor, we used quantitative autoradiography (QAR) to measure regional blood-to-tissue transport (K) of [14C]aminoisobutyric acid (AIB) in experimental C6 brain tumors 3-4 h after a single dose of 3 Gy CRT. K increased 63% in cortex, 30% in basal ganglia and 31% in brain surrounding the tumor (BST) vs. controls (P less than 0.005). K did not change in the tumor or in the brain adjacent to the tumor (BAT), suggesting that capillaries of normal parenchyma are more sensitive to the acute effects of CRT than capillaries of damaged parenchyma or tumor. PMID- 2723680 TI - Forebrain ischemia induced by temporary bilateral common carotid occlusion in normotensive rats. AB - Ischemic brain lesions were induced in adult Wistar and Fischer rats by temporary occlusion of the bilateral common carotid artery. The severity of ischemic lesions depended on the duration of carotid occlusion. While 2 h occlusion resulted in 15 deaths among 40 rats and the development of ischemic lesions in 16 of 25 asymptomatic survivors, none died after 0.5 h occlusion and yet 13 of 30 apparently asymptomatic rats had ischemic lesions when examined on day 7. Histological examination combined with immunohistochemistry of autologous albumin for assessing the integrity of the blood-brain barrier (BBB) revealed two distinct lesions: (1) ischemic neural damage with extensive tissue permeation of serum albumin, (2) death of individual neurons sparing other neural elements in the absence of the BBB breakdown. Ischemic neural damage with BBB breakdown was common in animals dying within 48 h after reflow. The lesions without BBB breakdown, on the other hand, were found solely in asymptomatic animals in which groups of severely degenerated neurons were preferentially located in the CA 1 region of the hippocampus, the caudoputamen and deeper layers of the neocortex. The sequential measurements of regional cerebral blood flow (rCBF) in the bilateral hippocampus by the hydrogen clearance method disclosed a steady decrease in rCBF after the occlusion, 51% of the pre-occlusion state at 10 min, 35% at 25 min and 32% at 40 min. The simplicity of procedure could make this model suitable for the study of the pathogenesis of ischemic neuronal damage in a critically low perfusion state. PMID- 2723681 TI - Myosin heavy chain expression in human muscle cocultured with mouse spinal cord. AB - Monoclonal antibodies which specifically recognise the neonatal or adult fast (type 2A and 2B) or slow myosin heavy chain (MHC) were used to investigate the myosin composition of human muscle which had regenerated in culture in the presence or absence of embryonic mouse spinal cord tissue. Adult fast MHC was found in an average of 75% of the cultured fibres, irrespective of the time in culture, the source of the muscle, the presence of neurones or modifications to the growth medium. It was not found alone but was always in association with the neonatal and/or slow myosin isoforms. The expression of fast MHC in human muscle therefore differs from that in mouse muscle in this culture system (Ecob-Prince et al. 1986), but is still strong evidence for the development of at least one aspect of an adult phenotype in culture. PMID- 2723682 TI - Influence of autograft size on peripheral nerve regeneration in cats. AB - A combination of electrophysiological and histological techniques has been used to study the extent to which the size of an autograft affects myelinated axon regeneration in damaged cat peripheral nerves. The length of the graft and the match between the number of axons and Schwann cell basement membrane tubes in the graft and the repaired nerve were investigated. No difference was found in the success of regeneration through 10, 20 and 30 mm autografts. Changing the number of Schwann cell tubes available to regenerating myelinated axons also had no detectable effect on the success of regeneration. PMID- 2723684 TI - Environmental litigation. PMID- 2723683 TI - Visuospatial problem solving, conceptual reasoning and sorting behaviour in multiple sclerosis out-patients. AB - Visuospatial problem solving, conceptual reasoning and shifting of set were studied in out-patients with definite and probable MS. The sample of MS patients was homogeneous with respect to 2 important dimensions. All were out-patients, leading a normal although handicap-restricted social life. Furthermore, in all patients relapse or obvious instability of the disease were absent for at least a month. On Raven's Progressive Matrices, the Category test and the Wisconsin Modified Card Sorting test, no significant differences were found between the group of MS patients and a control group of healthy volunteers. However, 18% of MS patients and 4% of controls were rated as performing slightly below the expected levels of cognition. Stepwise regression analysis failed to reveal effects of illness variables, and no difference between patients with definite and probable MS could be detected. Clearly, most socially integrated MS patients in stable disease stages are capable of normal visuospatial problem solving, abstract reasoning and shifting of set. PMID- 2723685 TI - Biomedical waste incineration. PMID- 2723686 TI - Applications of a method for setting air quality standards based on epidemiological data. AB - A method for setting air quality standards for long-term cumulative exposures of a population based on epidemiological studies has been developed. It uses exposure estimates interpolated from monitoring stations to zip code centroids, each month applied to zip code by month residence histories of the population. Two alternative cumulative exposure indices are used--hours in excess of a threshold, and the sum of concentrations above a threshold. The indices are then used with multiple logistic regression models for the health outcome data to form dose response curves for relative risk, adjusting for covariates. These curves are useful for determination of at what exposure amounts and threshold levels, effects which have both statistical and public health significance begin to occur. The method is applied to a ten year follow-up of a sub cohort of 7,343 members of the National Cancer Institute-funded Adventist Health Study. Up to 20 years of residence history was available. Analysis for prevalence of symptoms was conducted for four air pollutants--total oxidants, sulfur dioxide, nitrogen dioxide, and total suspended particulates. For each pollutant, cumulated exposures were calculated above each of five different thresholds. Statistically significant effects were noted for total suspended particulates, total oxidants, sulfur dioxide, past and passive smoking. PMID- 2723687 TI - Screening-level assessment of airborne carcinogen risks from uncontrolled waste sites. AB - This report presents screening-level estimates of the general level of cancer risks arising from air emission from uncontrolled waste sites. Twenty-five National Priorities List sites were chosen randomly and airborne cancer risks estimated for each site in terms of risk to the maximally exposed individual (MEI risk), average individual risk (AEI risk), and population incidence. The estimates were developed using the EPA Human Exposure Model using assumptions on the rate and toxicity of site emissions. MEI risks ranged from 4 X 10(-9) to 1 X 10(-6) with an average of about 5 X 10(-7). AEI risks for individuals residing within four miles of the sites average about 10(-8), declining significantly for individuals residing at longer distances. Population incidence was low at all sites ranging from 2 X 10(-4) to 1 X 10(-2) cancer cases expected within 60 miles of the sites. Due to the uncertainties in this type of analysis and the underlying study assumptions, these results must be viewed with caution. Nonetheless, some preliminary conclusions can be drawn from the analysis, principally that airborne cancer risks from uncontrolled waste sites are likely to be small in most cases, with the greatest concern being maximally exposed individuals rather than the number of cancer cases expected in the exposed population. PMID- 2723688 TI - Effects of oxidant air pollutants on pulmonary surfactant using two isolation procedures. PMID- 2723689 TI - Inference and decision in clinical trials. PMID- 2723690 TI - Models, methods, and goals. PMID- 2723691 TI - Inference and decision at the bedside. PMID- 2723692 TI - Performance of tests of significance based on stratification by a multivariate confounder score or by a propensity score. AB - Stratification by a multivariate confounder score or by a propensity score has been proposed for the multi-confounder situations that are commonly encountered in epidemiologic evaluations of the effects of a treatment or a triage decision. However, the use of these scores in clinical research has been limited, perhaps in part because of the concern that the stated level of statistical significance may be exaggerated when there is a high degree of correlation between the exposure and the set of confounders. We present a specific example and computer simulations to suggest that exaggeration of statistical significance occurs only under unusual circumstances when the correlation between the exposure and the confounders is extreme. Our simulations also suggest that an analysis based on stratification by a propensity score is less affected by high correlation between the exposure and the confounders than is an analysis based on a multivariate confounder score. PMID- 2723693 TI - Principles of nonexperimental assessment of excess risk, with special reference to adverse drug reactions. AB - The risk of a particular kind of adverse reaction to a particular agent must be thought of with reference to the contemplated type of exposure and the type of person potentially exposed, and critically important in the contemplated exposure is its duration. In the general case, a distinction has to be made between risk during exposure and that after its discontinuation. For both of these risks, modifications of their magnitudes especially by previous exposure to the same agent must be considered. These risks are studied by focusing on incidence densities specific to subintervals of the total periods of risk. Assessment of these densities is generally best accomplished by following a (very large) dynamic (open) population, not specified on the basis of exposure. Cases of the adverse event, without regard for their etiology, that occur in this source population over the period of follow-up need to be identified and classified, first as to whether they arose from the study population proper or from the extraneous segment of the source population. Those arising from the study population and characterized by "recent" exposure--implying potential causation by it--need to be classified according to the attained duration of exposure and, where applicable, time since its discontinuation at the time of the inception of the adverse event. An appropriate sample of the source population over its follow up needs to be obtained and classified in like manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723694 TI - Age, period and cohort effects on the risk of major depression: results from five United States communities. AB - Rates of major depression are presented from the recently completed Epidemiologic Catchment Area (ECA) Study based on probability samples of over 18,000 adults, 18 years of age and older, living in five U.S. communities. These rates were analyzed to describe simultaneously the changes affecting successive birth cohorts and the changes associated with the period in which the onset of the disorder occurred, using age-period-cohort (APC) models. The non-identifiability problem inherent in all APC models was resolved by assuming that the linear period effect and linear cohort effect were non-negative. This assumption is consistent with our a priori substantive knowledge of the disease. Under this assumption, as the linear period effect varies from its minimum to its maximum values, a family of curves representing the possible effects of a factor was generated for each of the time factors--age, period and cohort. The results of the analysis showed a sharp increase in rates of major depression among both men and women in the birth cohort born during the years 1935-1945. The rates among females, however, seemed to have stabilized in the generations born since 1945, while the rates in males continued to rise sharply among the cohorts born in the following decade, after which, in 1955, they also levelled off. In contrast, the rates associated with period of onset of major depression continued to increase between the years 1960-1980 among both men and women of all ages studied. These findings are considered in light of the persistent concentration of depression in women and in biologically related members of families of affected individuals. PMID- 2723695 TI - Methodology for measuring health-state preferences--I: Measurement strategies. AB - Values play a critical part in decision making at both the individual and policy levels. Numerous methodologies for determining the preferences of individuals and groups have been proposed, but agreement has not been reached regarding their scientific adequacy and feasibility. This is the first of a four-part series of papers that analyzes and critiques the state-of-the-art in measuring preferences, particularly the measurement of health-state preferences. In this first paper we discuss the selection of relevant attributes to comprise the health-state descriptions, and the relative merits of three measurement strategies: holistic, explicitly decomposed, and statistically inferred decomposed. The functional measurement approach, a statistically inferred decomposed strategy, is recommended because it simultaneously validates the process by which judges combine attributes, the scale values they assign to health states, and the interval property of the scale. PMID- 2723696 TI - A study of multiple causes of death in California: 1955 and 1980. AB - Multiple cause of death patterns in California for 1980 were compared to a similar study of deaths conducted in 1955. Primary underlying causes of death changed, mainly reflecting the emergence of respiratory cancer as a major cause of death in 1980. The number of causes reported per death increased from 1955 to 1980, in all age and sex groups. Diseases of the arteries and pneumonia, which are among the most common underlying causes of death, appeared more often on death certificates in both 1955 and 1980 as contributing causes than as underlying the death. Diabetes was studied in detail in the 1955 report, and comparisons were made in 1980 to show increases in the proportions of deaths with this disease and corresponding increases in its prevalence among the living population from the National Health Survey. Multiple cause of death data can provide further information on the prevalence of a fatal disease in a population and its relative role in contributing to mortality, and can also provide new information on diseases that contribute to deaths, which was not previously available in population-based studies of single cause of death. PMID- 2723697 TI - Comparison of surrogate and subject reports of dietary practices, smoking habits and weight among married couples in the Tecumseh Diet Methodology Study. AB - Agreement between surrogate and subject reports of current food frequencies and other eating habits, smoking behavior and weight was assessed in 1982-1983 for 180 husbands and wives, aged 45 through 64 years. Agreement was measured by per cent exact agreement and weighted kappa for frequencies of 30 itemized foods or food groups, and for surrogate- and subject-based quintiles of frequencies of eight broad food groups and of vitamin A and C consumption indexes. Surrogate and subject mean frequencies were generally similar, but at the individual level of analysis, agreement varied widely. Agreement was greatest, among the food items and groups, for alcoholic beverages, and among the other items, for smoking status. Extreme misclassification by quintile was very small, but only 40% of persons self-classified in either extreme quintile were similarly classified by their spouses. This level of misclassification may result in the dilution of real relationships between diet and health. PMID- 2723698 TI - The diagnostic process--some unwitting uses. PMID- 2723699 TI - Ethical dimensions of leadership in community health nursing. AB - This article deals with ethical leadership. Community health nurse (CHN) leaders are confronted with ethical problems in increasing numbers and complexity. To deal successfully with these dilemmas, nurse leaders must be aware of leadership qualities, know the ethical obligations of leaders, and use actions that produce the best decisions in tough financial times. The main purpose of the article is to present several helpful strategies for CHN leaders to use for ethical decision making. Types of ethical decisions that nurse leaders make are given. Six recommendations for action to be taken for ethical decisions in today's changing health-care climate are explored. PMID- 2723700 TI - Self-assessed health of Hispanic elderly persons. AB - The relationships between self-assessed health and physical and instrumental activities of daily living (IADL) scores were examined for 152 noninstitutionalized Hispanic elderly persons in the community. Self-assessed health was not related to either physical or instrumental activities, but was related to education. There were significant differences between men and women when the three measures were analyzed. Cultural explanations are offered for the findings of this study and the implications of these findings for community health nursing are discussed. PMID- 2723701 TI - An application of Johnson's behavioral model: a case study. AB - The utilization of Johnson's approach to assess clients' behavioral systems demonstrated that it is an effective way of determining the many factors that impinge on an individual's ability to cope with and adapt to change. Small (1980) used the Johnson model as a conceptual framework in assessing the needs of visually impaired children and found that for nursing practice, the Johnson model was a practical tool for implementing all phases of the nursing process encompassing the child's feelings, needs, and desires. Holaday (1980) combined the Johnson model and the Piagetian theory to assess the cognitive development of a 6-year-old, chronically ill child. She found that use of this model for assessment allows the nurse to describe objectively the patient's behavior, which serves to indicate the presence of any disequilibrium. The Johnson model can also be used successfully in a group situation such as a support group for Alzheimer's caregivers, where problem solving and making choices to adapt to lifestyle changes are a definite requirement. For professional nurses in clinical practice, the application of models for assessment of clients will allow them to categorize the phenomena they observe and to gain insight into the clinical situations with which they deal. PMID- 2723702 TI - Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting. AB - As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice. PMID- 2723703 TI - All visiting nurses are not alike: home health and community health nursing. AB - This article explores the differences between the practice of home health nursing and the practice of community health nursing which is suggested by the literature. Thirty-two nurses from three metropolitan home health agencies were surveyed; of these, 13 were randomly selected for interview in order to describe the current practice of home health-care nursing. As anticipated, home health nursing and community health nursing were found to differ significantly; the implications of this finding for nursing education are explored. PMID- 2723704 TI - Ethical decision making for community health nurses. AB - Modern health-care technology has complicated the ethical considerations of not only diagnosis and treatment, but also the social implications of diseases. Nurses are facing daily challenges as they struggle to protect and support confidentiality, justice, and beneficience for their clients. Community health nurses (CHNs), in light of their manner of primary care delivery, are often involved in these challenges. CHNs, due to their manner of primary care delivery, may find themselves in situations very different from those of other health-care workers. Often these situations have a moral component that cannot be addressed by the traditional problem-solving methods. Knowledge of ethical theories that offer frameworks for problem solving is essential as these CHNs struggle with ethical dilemmas. PMID- 2723705 TI - Dynamic response of the ROSE damping device. AB - Methods used in clinical practice to increase the damping of a transducer hydraulically coupled to an intraarterial blood-pressure monitoring system often decrease the undamped natural frequency of the system. This leads to spuriously high systolic and low diastolic pressure readings. The ROSE damping device is being marketed as a possible solution to the problem. We tested the dynamic response of three different catheter systems, with various pressure-tubing lengths of 1 to 7 feet (30.5 to 213.4 cm), with and without the ROSE damping device. The device was able to substantially increase damping and at the same time maintain the undamped natural frequency. Typically it increased the damping coefficient from a minimum of 0.17 +/- 0.01 to a minimum of 0.33 +/- 0.01, while never significantly decreasing the undamped natural frequency. In testing a sample of 25 devices we did observe, however, a wide variability in damping characteristics among different devices. Damping coefficients ranged between 0.19 and 1.20. PMID- 2723706 TI - Intraoperative monitoring of brainstem auditory evoked potentials following emergency evacuation of a cerebellar vascular malformation. AB - This case report highlights the use and value of monitoring the auditory brainstem response during emergency neurosurgery. The prompt on-line changes in the auditory brainstem response after evacuation of a cerebellar arteriovenous malformation provided objective evidence of improved brainstem function, which aided in the management of this patient's disorder. PMID- 2723707 TI - Delayed carotid shunt occlusion detected by electroencephalographic monitoring. AB - Little has been recorded in the anesthesia literature concerning the changes in the electroencephalogram (EEG) that may occur during carotid endarterectomy many minutes after shunt placement and restoration of flow and that may be attributed to "delayed" shunt occlusion or cerebral emboli. We describe a patient in whom EEG changes indicative of cerebral ischemia occurred at the time of carotid clamping. The changes resolved promptly after placement of a carotid shunt but recurred 11 minutes later. Because of the EEG changes, the carotid shunt was evaluated and found to have become occluded. EEG monitoring was crucial to the detection of shunt occlusion in the absence of other systemic changes or surgical difficulties. The rapidity and magnitude of the changes in the EEG suggest that, if the occlusion had not been discovered and the patency of the shunt restored, the patient would have been at increased risk for neurologic injury. PMID- 2723708 TI - Pulse oximetry: a "which" hunt? PMID- 2723709 TI - Errors in 14 pulse oximeters during profound hypoxia. AB - The accuracy of pulse oximeters from fourteen manufacturers was tested during profound brief hypoxic plateaus in 125 subject sets using 50 normal adult volunteers, of whom 29 were studied two to nine times. A data set usually consisted of 10 subjects, and 13 sets were collected between August 1987 and July 1988. In the first 6 sets, six 30-second hypoxic plateaus were obtained per subject at 55 +/- 6% oxyhemoglobin (O2Hb) (range, 40 to 70%). In the last 7 sets, three hypoxic plateaus were obtained at each of four levels, approximately 86, 74, 62, and 50% O2Hb, for the purpose of linear regression analysis. Inspired oxygen was adjusted manually breath by breath in response to arterial oxygen saturation computed on-line from end-tidal oxygen and carbon dioxide tensions. End-plateau arterial blood O2Hb was analyzed by a Radiometer OSM-3 oximeter, and plateau pulse oximeter saturation (SpO2) was read by cursor from a computer record of the analog output. Three to 13 instruments were tested simultaneously by using 1 to 3 duplicate instruments from each of one to seven manufacturers. Variations introduced by manufacturers were tested on subsequent sets in several instruments. An index of error, "ambiguity" (alpha) of oxygen saturation, was defined as the absolute sum of bias and precision (mean and SD of SpO2 - O2Hb) at O2Hb = 55.8 +/- 4.5%, preserving the sign when bias was significant at P less than 0.05. Ambiguity values for finger probes (unless specified) with latest data were: Physio-Control, 3.9 (ear, 3.3); Puritan-Bennett, -4.4; Criticare, 5.8 (forehead, 4.7); Kontron, 5.9 (infant probe) and 6.1 (ear, 5.8; forehead, 7.1); Biochem, -6.0; Datex 6.4 (ear, 6.9; forehead, 6.8); Critikon, 8.4; SiMed, 8.6; Marquest, 9.0; Novametrix, 10.2; Invivo, -12.2 (ear, -14.3); Nellcor, -15.1; Ohmeda, -21.2; and Radiometer, -21.2 (ear, -9.6). Linear regression slopes of 36 instruments from twelve manufacturers generally deviated from 1 in proportion to alpha. The data showed substantial differences in bias and precision between pulse oximeters at low saturations, the most common problems being underestimation of saturation and failing precision. PMID- 2723710 TI - Pulse oximetry for monitoring during ward analgesia: epidural morphine versus parenteral narcotics. AB - A pulse oximeter was used to monitor oxygen saturation in 20 women following cesarean delivery. The patients were randomly assigned to one of two groups. Group A received conventional parenteral narcotics for relief of postoperative pain and group B received epidural morphine. All patients were monitored overnight, and data were stored continuously. There were no statistically significant differences in the low saturation values between the two groups. However, the group A desaturation episodes occurred an average of 2.7 +/- 1.9 hours after the parenteral narcotics were administered, and the group B desaturation episodes occurred an average of 13.7 +/- 5.9 hours after the epidural morphine was administered. PMID- 2723711 TI - Prototype ventilator and alarm algorithm for the NASA space station. AB - An alarm algorithm was developed to monitor the ventilator on the National Aeronautics and Space Administration space station. The algorithm automatically identifies and interprets critical events so that an untrained user can manage the mechanical ventilation of a critically injured crew member. The algorithm was tested in two healthy volunteers by simulating 260 critical events in each volunteer while the volunteer breathed via the ventilator. Thirteen critical events were induced eight times in random order, for the five different modes of ventilation. These events included various ventilator tubing disconnects, leaks, and occlusions, as well as power and gas supply failures. The algorithm identified the critical events and generated alarms in response to 99.2% (516 of 520, total) of the events. The alarm textual messages were correct 98% (505 of 516 messages) of the time. The alarm algorithm is an improvement over current alarms found on most ventilators because its alarm messages specifically identify failures in the patient breathing circuit or ventilator. The system may improve patient care by helping critical care personnel respond more rapidly and correctly to critical events. PMID- 2723712 TI - New perspectives in the chemoprophylaxis of toxoplasmosis. AB - The usual chemoprophylaxis of toxoplasmosis consists of spiramycin or the combination of pyremethamine-sulfamide. This chemoprophylaxis can be used: 1 - In the pregnant woman: spiramycin avoids or has low fetal damage. In case of maternal contamination after 33 weeks of pregnancy, pyrimethamine-sulfadiazine combination should be used in spite of its potential toxicity. 2 - In the newborn infant, chemoprophylaxis prevents the emergence of retinochoroiditis. 3 - In congenital toxoplasmic retinochoroiditis, systematic repetitive cures of pyrimethamine-sulfamide reduce frequency of recurrences. 4 - In immunocompromised patients, the systematic use of pyrimethamine and sulfadoxine prevents neurotoxoplasmosis, in case of kidney, heart, and allogeneic bone marrow transplantations, and also in case of patients with malignant hemopathy or AIDS. PMID- 2723713 TI - Drug combinations in the treatment of malaria. AB - The knowledge of the plasmodium life-cycle is essential for the use of antimalarial drugs and their combinations. The antimalarial drugs currently available can act on one or more stages of parasitic development, but only on its proliferative phases. The combinations of drugs in the treatment of malaria aim at three distinct objectives: a) action on different stages of parasitic life cycle; b) enhancement of antiparasitic activity; and c) prevention of drug resistance. In this regard, complementary, additive and potentiating combinations have been used, sometimes on an empiric basis. The potentiating combinations seem the most logical and effective, but some of them are not rational due to pharmacokinetic differences between the proposed components. PMID- 2723714 TI - In vitro short-term chemosensitivity test in head and neck tumors. AB - A new method to test the sensitivity of human tumor cells has been developed. A suspension of mechanically dissociated tumor cells is kept in continuous incubation for 24h, in cultures with antineoplastic agents. Drug induced cell cycle perturbations are monitored by flow cytometric computer analysis and DNA distributions of the cells stained with propidium iodide are expressed in percentage. The test is used in 15 head and neck human solid tumors. The drugs tested were: VCR, EpiDx, CDDP, MTX, 5-FU, CPM, BLM. The results obtained reveal that tumor sensitivity varies independently from the stage and malignity grading. Therapeutic combinations are assigned by selecting the drugs on the basis of the individual in vitro response. PMID- 2723715 TI - Effects of spatial and temporal dispersion of synaptic input on the time course of synaptic potentials. AB - 1. As part of the ongoing studies on the time course of single-fiber synaptic potentials recorded in spinal neurons, a theoretical analysis of the effects of spatial and temporal dispersion of synaptic input to a neuronal cable model was undertaken. 2. Results were obtained using a simple R-C soma, equivalent dendritic cylinder cable model of a neuron. Synaptic input was represented by a current injection at various points on the dendritic cable. 3. Spatial dispersion of multiple inputs to the cable model generally produced somatic transients with smooth time courses that could be closely matched by a transient generated at a single input location, usually with a different current time course. 4. Temporal dispersion, representing nonsynchronous activation of multiple synaptic contacts at the same electrotonic location, generally resulted in somatic transients with an increased rise-time and a corresponding small increase in the half-width. The somatic transient generated by these temporally dispersed inputs could usually be well matched by a single input at a different location. 5. Addition of temporal dispersion to a spatially dispersed input produced variable results in which the rise-times and half-widths of somatically recorded transients could be either increased or decreased. 6. It is concluded that a detailed knowledge of both the spatial and temporal properties of synaptic input is essential to the interpretation of single-fiber synaptic potentials. Previous results on the amplitude and time course of single-fiber synaptic potentials recorded in spinal neurons are discussed in light of the present observations. PMID- 2723716 TI - Analysis of synaptic events in the opossum piriform cortex with improved current source-density techniques. AB - 1. The piriform cortex of the opossum was studied by current source-density (CSD) analysis of field potentials to determine the laminar and temporal distribution of synaptic currents evoked by lateral olfactory tract (LOT) stimulation. 2. Extracellular conductivity was measured as a function of depth at high resolution and incorporated into CSD computations. Inclusion of the conductivity term resulted in relatively subtle changes in the shapes of CSD profiles. Resolution and accuracy of CSD computations was further improved by use of a new smoothing approach and averaging of multiple potential profiles obtained at the same site. 3. The CSD depth profile resulting from LOT stimulation revealed six major synaptic events that were consistently present at anterior, middle, and posterior sites: one during the first (A1) peak of the initial surface negative dichrotic field potential component, three during the second (B1) peak, one during the surface positive field potential component (period 2), and one during the second surface negative component (period 3). In addition, CSD profiles were computed for the population spike generated by synchronous discharge of action potentials. Depths of the net inward and outward membrane currents underlying these events were correlated with the cortical lamination as determined histologically by placement of small dye marks. 4. In agreement with previous reports it is concluded that the large inward membrane current in layer Ia during the A1 wave underlies a monosynaptic EPSP evoked in distal apical dendritic segments of pyramidal cells by afferent fibers. This EPSP displays a marked paired shock facilitation. 5. Based on anatomic and physiological considerations it is concluded that the three spatially and temporally distinct inward membrane currents (sinks) that were observed in layers III, superficial Ib, and mid- to deep-Ib during the B1 wave, underlie disynaptic EPSPs resulting from direct synaptic interactions between pyramidal cells. It is postulated that the layer III sink is generated in basal dendrites largely via local axon collaterals, the superficial layer Ib sink in intermediate apical dendritic segments by association fibers originating in the anterior piriform cortex, and the deep Ib sink in proximal apical segments by association fibers originating largely in the posterior piriform cortex. 6. The latencies of the layer Ia and superficial layer Ib sinks (presumed mono- and large disynaptic EPSPs, respectively) increased from anterior to posterior. Amplitude of the superficial Ib sink relative to the Ia sink increased from anterior to posterior.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723717 TI - GABA- and glutamate-mediated synaptic potentials in rat dorsal raphe neurons in vitro. AB - 1. Synaptic potentials were recorded with intracellular electrodes from rat dorsal raphe neurons in a slice preparation. 2. Synaptic potentials were evoked by applying electrical pulses to bipolar stimulating electrodes positioned immediately dorsal to the raphe nucleus; these arose after a latency of 0.5-5 ms and had a duration of 20-200 ms. 3. The synaptic potential was biphasic (at the resting potential) when the recording electrodes contained potassium citrate; a depolarization was followed by a hyperpolarization. The hyperpolarization reversed in polarity at -70 mV and was blocked by bicuculline. 4. The depolarizing synaptic potential was reduced to 50-90% of control by kynurenate (1 2 mM) or 6-cyano-2,3-dihydroxy-7-nitro-quinoxaline (CNQX) (10 microM) and increased in amplitude and duration by magnesium-free solution. 5. In magnesium free solutions (with CNQX), the depolarizing synaptic potential was blocked by DL 2-amino-5-phosphonovaleric acid (APV, 50 microM). APV also blocked depolarization caused by adding N-methyl-D-aspartate (NMDA) to the superfusion solution. 6. The results indicate that raphe neurons display two synaptic potentials having a duration of 150-200 ms: one that is mediated by GABA and a second that is due to an excitatory amino acid. The component mediated by an excitatory amino acid involves, in part, a receptor of the NMDA type. PMID- 2723718 TI - Esophageal mechanoreceptors in the feeding system of the pond snail, Lymnaea stagnalis. AB - 1. We identify esophageal mechanoreceptor (OM) neurons of Lymnaea with cell bodies in the buccal ganglia and axons that branch repeatedly to terminate in the esophageal wall. 2. The OM cells respond phasically to gut distension. Experiments with a high magnesium/low calcium solution suggest that the OM neurons are primary mechanoreceptors. 3. In the isolated CNS preparation, the OM cells receive little synaptic input during the feeding cycle. 4. The OM cells excite the motoneurons active in the rasp phase of the feeding cycle. 5. The OM cells inhibit each of the identified pattern-generating and modulatory interneurons in the buccal ganglia. Experiments with a saline rich in magnesium and calcium suggest that the connections are monosynaptic. 6. Stimulation of a single OM cell to fire at 5-15 Hz is sufficient to terminate the feeding rhythm in the isolated CNS preparation. 7. We conclude that these neurons play a role in terminating feeding behavior. PMID- 2723719 TI - Membrane properties and synaptic responses of the guinea pig nucleus accumbens neurons in vitro. AB - 1. The membrane properties and synaptic responses of guinea pig nucleus accumbens neurons in vitro were studied with intracellular recording methods. 2. The population of neurons could be divided into groups of low (20-60 M omega, average 46.5 M omega) and high (60-180 M omega, average 96.5 M omega) input resistance. The resting membrane potential in both groups was approximately -70 mV. 3. Other membrane properties were quite similar in both groups. Inward rectification occurred at potentials more negative than -80 mV; this was blocked by Cs+ (2 mM). Membrane potential oscillations were observed at potentials between -65 and -55 mV; these were blocked by tetrodotoxin (TTX, 0.5 microM). Outward rectification occurred at potentials less negative than -45 mV; this was depressed by tetraethylammonium (TEA, 10 mM). 4. Action potentials elicited by small depolarizing current pulses (2-5 ms, 0.3-0.5 nA) were approximately 95 mV in amplitude and 1.0 ms in duration. The afterhyperpolarization following each action potential was less than 30 ms in duration, and no accommodation of action potential discharge was seen at frequencies up to 40 Hz. The action potentials were reversibly blocked by TTX (0.3 microM). In addition, TTX-insensitive, Ca2+ dependent spikes were evoked by passing larger and more prolonged current pulses (greater than 40 ms, greater than 0.5 nA) across the membrane. 5. Focal electrical stimulation of the slice surface with low intensity (1 ms, less than 10 V) elicited excitatory postsynaptic potentials (EPSPs) in neurons of both high and low-resistance groups. The reversal potential (+10.2 mV) for the EPSPs was close to the reversal potential (+7.7 mV) of the responses to glutamate applied in the superfusing solution. The N-methyl-D-aspartic acid (NMDA) receptor antagonists, D-alpha-aminoadipic acid (1 mM) and DL-2-amino-5-phosphonovaleric acid (DL-APV, 250 microM), reversibly depressed the EPSP; the glutamate uptake inhibitor, L-aspartic acid-beta-hydroxamate (50 microM), or removal of Mg2+ from the superfusate, augmented the EPSP. 6. When the intensity of the focal stimulus was increased (1 ms, greater than or equal to 10 V), a second larger depolarizing response (duration, 800 ms to 2 s) could be evoked in addition to the smoothly graded EPSP. This was seen only in cells of the high-resistance group (90-130 M omega).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723720 TI - Functional properties of monkey caudate neurons. I. Activities related to saccadic eye movements. AB - 1. We recorded single cell activities in the caudate nucleus of the monkeys trained to perform a series of visuomotor tasks. In the first part of this paper, we summarize the types and locations of neurons in the monkey caudate nucleus. In the second part, we report the characteristics of neurons related to saccadic eye movements. 2. Neurons were classified into two types in terms of spontaneous discharge pattern. A majority of the neurons (2,287/2,559, 89%) had very low frequency discharges (mostly less than 1 Hz). The rest (n = 272) showed irregular tonic discharges (3-8 Hz) with broad spikes. 3. Of 2,559 neurons tested, 867 showed spike activity related to some aspects of the tasks; 502 neurons showed discharges in response to environmental changes outside, not in relation to, the tasks. None of the neurons responsive in or outside the tasks belonged to the irregular-tonic type. 4. The task-related activities were classified as: Saccade related, Visual, Auditory, Cognitive, Fixation-related, and Reward-related. The activities detected outside the tasks were classified into: Visual, Auditory, Movement-related, Reward-related, and Other. Few neurons had both task-related and task-unrelated activities. 5. The locations of recorded neurons were determined using a coordinate system based on the anterior and posterior commissures. Task-related neurons were clustered longitudinally in the central part of the caudate. Neurons responsive outside the tasks were more widely distributed; specifically, auditory neurons were in the medial part, whereas movement-related neurons were in the lateral part. The irregular-tonic neurons were dispersed all over the caudate. 6. The monkey was trained to fixate on a spot of light on the screen and, when the spot moved, to follow it by making a saccade. A visually guided saccade occurred when the spot moved to another location without a time gap (saccade task). A memory-guided saccade occurred when the spot first disappeared and after a time gap reappeared at a fixed location (saccade with gap task). By delivering a cue stimulus while the monkey was fixating, a memory-guided saccade was elicited to a randomly chosen location (delayed saccade task).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723721 TI - Functional properties of monkey caudate neurons. II. Visual and auditory responses. AB - 1. Visual responses of caudate neurons were studied in monkeys trained to fixate on a small spot of light. A visual stimulus (another spot of light) was presented in various contexts of behavior using different behavioral paradigms. Visual receptive fields were usually large and centered on the contralateral hemifield. Among 217 neurons with visual responses, 184 were further classified into subtypes. 2. Visual responses in 64 neurons were not modulated by changing the paradigms (unconditional visual responses). In the other neurons, visual responses were dependent on the behavioral contexts in which the stimulus was presented. Three types of behavioral modulation were found. 3. A saccade-enhanced visual response (n = 37) was the one that was enhanced if the monkey made a saccade to the stimulus on its appearance. The enhancement was spatially selective: the response was depressed if the saccade was directed away from the stimulus. 4. Memory-contingent visual responses (n = 36) were present preferentially when the monkey remembered the location of the stimulus and a few seconds later made a saccade to the remembered location. Responses were greater when the location of the stimulus was randomized between trials. 5. Expectation contingent visual responses (n = 46) were present preferentially when the stimulus came on while the monkey was not fixating another spot, and the stimulus was related directly to a reward. Unlike the other types, its receptive field included both contralateral and ipsilateral hemifields without a particular preference. 6. A small number of neurons (n = 16) showed a visual response that easily habituated. 7. Latencies of visual responses were usually between 100 and 200 ms. The latencies of the memory-contingent, expectation-contingent, and habituated visual responses tended to be longer than the others and tended to be more variable between trials. 8. Among auditory responsive neurons only a small proportion were related to the tasks. The response was greater to a contralateral sound. It was enhanced if the monkey used the sound as the cue for the future target location. 9. The results suggest that sensory responses of caudate neurons could be used to guide a subsequent sequence of learned behaviors by confirming predicted environmental states, renewing memory, or establishing a motor set. PMID- 2723722 TI - Functional properties of monkey caudate neurons. III. Activities related to expectation of target and reward. AB - 1. The present paper reports complex neural activities in the monkey caudate nucleus that precede and anticipate visual stimuli and reward in learned visuomotor paradigms. These activities were revealed typically in the delayed saccade task in which memory and anticipation were required. We classified these activities according to their relationships to the task. 2. Activity related to expectation of a cue (n = 46) preceded the presentation of a spot of light (target cue) that signified the future location of saccade target. When the target cue was delayed, the activity was prolonged accordingly. The same spot of light was preceded by no activity if it acted as a distracting stimulus. 3. The sustained activity (n = 80) was a tonic discharge starting after the target cue as if holding the spatial information. 4. The activity related to expectation of target (n = 109) preceded the appearance of the target whose location was cued previously. It started with or after a saccade to the cued target location and ended with the appearance of the target. The activity was greater when the target was expected to appear in the contralateral visual field. 5. The activity related to expectation of reward (n = 57) preceded a task-specific reward. It started with the appearance of the final target and ended with the reward. In most cases, the activity was nonselective for how the monkey obtained the reward, i.e., by visual fixation only, by a saccade, or by a hand movement. The activity was dependent partly on visual fixation. 6. A few neurons showed tonic activity selectively before lever release and are thus considered to be related to the preparation of hand movements. 7. The activity related to breaking fixation (n = 33) occurred phasically if the monkey broke fixation, aborting the trial. 8. Activity related to reward (n = 104) was a phasic discharge that occurred before or after a reward of water was delivered. The activity was not simply related to a specific movement involved in the reward-obtaining behavior (eye, hand, or mouth movement). 9. Fixation-related activity (n = 72) was tonic activity continuing as long as the monkey attentively fixated a spot of light. It was dependent on reward expectancy in most cases. 10. The present results, together with those in the preceding papers, indicate that the activities of individual caudate neurons--sensory, motor, or cognitive--are dependent on specific contexts of learned behavior.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723723 TI - Peptidergic modulation of a multioscillator system in the lobster. I. Activation of the cardiac sac motor pattern by the neuropeptides proctolin and red pigment concentrating hormone. AB - 1. The cardiac sac motor pattern consists of slow and irregular impulse bursts in the motor neurons [cardiac sac dilator 1 and 2 (CD1 and CD2)] that innervate the dilator muscles of the cardiac sac region of the crustacean foregut. 2. The effects of the peptides, proctolin and red pigment-concentrating hormone (RPCH), on the cardiac sac motor patterns produced by in vitro preparations of the combined stomatogastric nervous system [the stomatogastric ganglion (STG), the paired commissural ganglia (CGs), and the oesophageal ganglion (OG)] were studied. 3. Bath applications of either RPCH or proctolin activated the cardiac sac motor pattern when this motor pattern was not already active and increased the frequency of the cardiac sac motor pattern in slowly active preparations. 4. The somata of CD1 and CD2 are located in the esophageal and stomatogastric ganglia, respectively. Both neurons project to all four of the ganglia of the stomatogastric nervous system. RPCH elicited cardiac sac motor patterns when applied to any region of the stomatogastric nervous system, suggesting a distributed pattern generating network with multiple sites of modulation. 5. The anterior median (AM) neuron innervates the constrictor muscles of the cardiac sac. The AM usually functions as a part of the gastric mill pattern generator. However, when the cardiac sac is activated by RPCH applied to the stomatogastric ganglion, the AM neuron becomes active in antiphase with the cardiac sac dilator bursts. This converts the cardiac sac motor pattern from a one-phase rhythm to a two-phase rhythm. 6. These data show that a neuropeptide can cause a neuronal element to switch from being solely a component of one neuronal circuit to functioning in a second one as well. This example shows that peptidergic "reconfiguration" of neuronal networks can produce substantial changes in the behavior of associated neurons. PMID- 2723724 TI - Sets of synaptic currents paired by common presynaptic or postsynaptic neurons. AB - 1. In the buccal ganglia of Aplysia, presynaptic neurons B4 and B5 produce similar inhibitory postsynaptic currents (PSCs) in several postsynaptic follower cells. Previous work has shown that both duration and amplitude of these PSCs vary, that each parameter may be altered transiently by manipulating presynaptic activity, and that these variations affect synaptic efficacy. 2. To permit synapse-to-synapse comparisons, the mean and coefficient of variation (CV) of both peak conductance (gpeak) and time constant of decay (tau) were determined for sets of synaptic currents evoked by direct intracellular stimulation of presynaptic neurons. For 56 synapses, gpeak = 0.40 +/- 0.33 (SD) microS for a CV of 0.83, and tau = 19.7 +/- 4.0 ms for a CV of 0.20. The synapse-to-synapse variability was within 5% of values obtained from a previous population. 3. The relative contributions of presynaptic and postsynaptic factors to efficacy and variability of PSCs were examined by recordings from two classes of three-cell networks and by comparing values of gpeak and tau at synapses sharing a common presynaptic or postsynaptic neuron. 4. In the first case, paired presynaptic inputs from B4 and B5 converged on a common postsynaptic cell. For 16 examples of this case, mean values of both gpeak and tau recorded in a single follower cell, but produced by different presynaptic neurons, were significantly closer than those recorded in different followers (P less than 0.001). The common postsynaptic cell did not constrain variability of these parameters; CVs for paired synapses were not significantly different from the population (P greater than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723725 TI - Physiological and pharmacological analysis of suppressive rod-cone interaction in Necturus retina [corrected]. AB - 1. Intracellular recordings were obtained from retinal neurons of the mudpuppy, Necturus, while superfusing the eyecup with various pharmacologic agents. In most experiments, the retina was continuously stimulated with a small spot of red light that was centered over the recording electrode and flickering at rates too fast for amphibian rods to follow. The retina was additionally stimulated intermittently with a dim, spatially diffuse background field of 520 nm wavelength. 2. In general, the dim background greatly enhanced flicker responsiveness. We (16) previously called this effect suppressive rod-cone interaction (SRCI) and showed it reflects a tonic suppressive influence on cone pathways that is removed by selective rod-light adaptation. 3. Lead chloride has been claimed to selectively block rod-related retinal responses (13, 35). While recording from horizontal cells lead chloride decreases responses to the dim, diffuse light flashes, enhances the frequency entrained response attributable to cones, and eliminates a background influence on flicker responses. 4. O-phospho-D serine (DOP), kynurenic acid (KyA), and piperidine dicarboxylic acid are known to act on horizontal cells as antagonists of the photoreceptor neurotransmitter (26, 32, 33). In both depolarizing and hyperpolarizing bipolar cells, these agents enhance flicker responsiveness with no background present and prevent background enhancement of flicker. 5. Mudpuppy cones were found to have a receptive-field surround, which under our stimulus conditions is attributable to rod input. KyA, which is unknown to have any direct influence on photoreceptors, totally blocks this surround mechanism. This indicates that the cone-surround mechanism is attributable to horizontal cell feedback. The influence of KyA on SRCI in cones is similar to that observed in recordings from depolarizing bipolar cells. 6. Most sustained third-order neurons demonstrate SRCI. In these cells, SRCI is blocked by DOP or KyA. Most ON-OFF neurons fail to demonstrate SRCI under control circumstances. The ON-response of these cells is blocked by 2-amino-4 phosphonobutyric acid (31) which leaves the OFF-response intact. While their ON response is blocked, ON-OFF neurons demonstrate SRCI. 7. The foregoing results indicate that SRCI reflects a tonic, inhibitory influence of horizontal cells on cone pathways that is removed by light-adapting rods. In part, SRCI must involve horizontal cell feedback onto cones. SRCI in third-order neurons appears to largely reflect distal retinal processing. PMID- 2723726 TI - Characteristics of vagal esophageal tension-sensitive afferent fibers in the opossum. AB - 1. Single-unit vagal afferent activity was recorded from 35 fibers that demonstrated evoked response to distension in the smooth muscle portion of the esophagus in anesthetized opossums. 2. The conduction velocities, measured in 22 fibers, varied from 1.0 to 21.33 m/s. Eight fibers (36%) had conduction velocities in the range of C-fibers (less than 2.5 m/s), whereas 14 (64%) had velocities in the range of A delta-fibers (3.16-21.33 m/s). All fibers were spontaneously active with an average discharge rate of 7.3 +/- 1.0 imp/s (mean +/ SE; range, 1.2-23 imp/s). 3. Esophageal distension produced a reproducible increase in discharge rate that adapted slowly to sustained distension. The average threshold pressure of the endings was 10 mmHg. The saturation pressure was 70 mmHg with cumulative, stepwise distension and 56 mmHg with graded, discrete distensions, respectively. 4. The discharge rate at the saturation pressure was 46 +/- 7 imp/s with cumulative, stepwise distensions and was 59 +/- 4 imp/s with graded, discrete distensions. The difference in maximum discharge between these two modes of distension was not statistically significant (P greater than 0.05). 5. Esophageal peristaltic contraction was associated with bursts of spike discharge with an average rate of 53.6 +/- 4.7 imp/s. 6. Two types of fibers were identified based on their duration of spike discharge associated with peristaltic contraction. The short-activity fibers showed a short duration of response consisting of approximately 3 s of spike bursts in response to swallows. These short-activity fibers were not activated by either stretch or contraction of the longitudinal esophageal muscle. The long-activity fibers showed a long duration of response consisting of approximately 10 s of activity in response to swallows. These long-activity fibers could be activated by longitudinal muscle stretch or contraction. 7. It is concluded that esophageal tension-sensitive mechano-receptors associated with vagal afferents are activated by physiological peristalsis and are present "in series" with either circular or longitudinal muscle layers. PMID- 2723727 TI - Lateral tegmental field neurons of cat medulla: a source of basal activity of raphespinal sympathoinhibitory neurons. AB - 1. We tested the hypothesis that sympathoinhibitory (SI) neurons in the lateral tegmental field (LTF) of the cat medulla exert their actions over a pathway that includes raphe neurons whose axons innervate the thoracic intermediolateral nucleus (IML). 2. We recorded from 32 LTF neurons with sympathetic nerve-related activity [as demonstrated with spike-triggered averaging of inferior cardiac sympathetic nerve discharge (SND)] whose firing rate increased during the inhibition of SND produced by baroreceptor reflex activation. These neurons were classified as SI in function. 3. Twenty-three of these 32 LTF-SI neurons were antidromically activated by microstimulation of the raphe nuclei, 2-4 mm rostral to the obex and 3-4.5 mm below the dorsal surface of the medulla. The threshold current for eliciting the longest-latency antidromic responses [18.9 +/- 2.4 (SE) ms] was increased when the stimulating microelectrode was moved more dorsally in the midline. With one exception, these neurons could not be antidromically activated by stimulation of sites either 1.5-2.0 mm lateral to the midline, contralateral to the site of unit recording or raphe sites caudal to the obex. Threshold stimuli applied 2-4 mm rostral to the obex and 1 mm lateral to the midline, ipsilateral to the site of unit recording, elicited antidromic responses whose onset latencies were shorter than those produced by raphe stimulation. These data support the view that the axons of LTF-SI neurons terminated in the region of the raphe that contains SI neurons whose axons innervate the IML. 4. We recorded from 32 raphe neurons with sympathetic nerve-related activity whose firing rate increased during baroreceptor reflex activation. These neurons were classified as SI in function. Twenty-five of the 32 raphe-SI neurons were antidromically activated by microstimulation of the third thoracic (T3) IML. Seven (including 5 with spinal axons) of 24 raphe-SI neurons tested were synaptically activated by microstimulation of the region of the LTF containing SI neurons. The modal onset latency of synaptic activation was 22.8 +/- 8.4 ms. This value is close to the difference in spontaneous firing times (26 ms on the average) of LTF-SI and raphe-SI neurons, relative to the peak of the cardiac related burst of SND. 5. Taken together, these data are consistent with the hypothesis that LTF-SI neurons are a source of the background discharges of raphespinal-SI neurons. 6. Thirteen raphe-SI neurons were antidromically activated by stimulation of both the medulla and T3 IML.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723728 TI - Effects of prolonged light exposure, GABA, and glycine on horizontal cell responses in tiger salamander retina. AB - 1. The effects of prolonged light exposure, gamma-aminobutyric acid (GABA), and glycine on the horizontal cell (HC) light responses were studied in the superfused flat-mounted isolated retinas of the larval tiger salamander. 2. Under prolonged dark-adapted conditions, the time-to-peak of the HC light response was approximately 2-4 s, and after the termination of prolonged (6-8 min) light exposure, the time-to-peak became approximately 0.5-1 s. 3. This prolonged light induced change in response rise time was not observed in either photoreceptors or bipolar cells, and thus the change in HC response rise time may occur postsynaptically in the HC membrane. 4. Application of 100 microM of GABA mimicked prolonged darkness and reversibly slowed down the HC response rise time, and application of 100 microM bicuculline mimicked prolonged light exposure and reversibly sped up the HC response rise time. 5. Glycine also slowed down the HC response rise course, but its effect was not observable until the concentration was raised to 1-3 mM. Strychnine did not exert any effect on HC responses when applied alone, but it could reverse the glycine actions. 6. The actions of glycine disappeared in the presence of bicuculline, indicating that the GABA and glycine pathways were probably not independent. Application of 5-10 mM glycine produced an increase of flow of preloaded 3H-GABA from the retina. 7. These results indicate that GABA may be the primary modulator that slows down the kinetics of the postsynaptic membrane proteins in the HCs. The extracellular concentration of GABA is probably high in prolonged darkness, and it is low after prolonged light exposure. Glycine, when applied at high dose, results in an increase of GABA release that slows down the HC response time course. 8. Prolonged darkness and light exposure appear to modulate the HC response in the time domain through GABA, and this change in HC response time course is probably responsible for shaping the bipolar cell responses and making the retinal signals more transient under light-adapted conditions. PMID- 2723729 TI - Innervation of vascular and cardiac muscle of Aplysia by multimodal motoneuron L7. AB - 1. The cardiovascular system of Aplysia has proven to be a useful preparation for study of the neural control of circulation. To better understand the neural integration of function in this system, we have attempted to gain a more complete picture of its morphology and innervation patterns, with particular emphasis on the abdominal aorta and heart. 2. The vasoconstrictor muscle fibers of the abdominal aorta were found by dye injection to be extensively branched, with many processes that are less than 1 micron in diameter. Because of the wide spacing between individual muscle fibers, these fine processes, which have relatively few contractile filaments, may be required to mediate the electrical coupling that is observed between muscle cells. 3. L7, an identified cell in the abdominal ganglion, had been shown by others to be an excitatory motoneuron for the gill, the siphon, and the sheath-contracting muscles of the pleuroabdominal connectives, and also to excite the gill motoneurons in the branchial ganglion (5, 43, 56). We have found that this multimodal motoneuron also directly excites the auricle of the heart and the vasoconstrictor muscle of the abdominal aorta. 4. The excitatory effect of L7 on the abdominal aorta interacts synergistically with that produced by the other known excitatory inputs to that structure, the LBVc vasoconstrictor motoneurons. 5. The abdominal aorta is also richly innervated by axons immunoreactive for serotonin and for the neuropeptide FMRFamide. Serotonin inhibits the contractions of the aorta elicited by firing either L7 or the LBVC cells. In contrast, FMRFamide selectively inhibits the contractions elicited by the LBVC cells. 6. Our results suggest that a significant amount of the functional integration of the cardiovascular and respiratory systems is achieved by the use of a motoneuron common to both systems, and that there is likely to be extensive peripheral inhibitory modulation of the vasoconstrictor inputs to the abdominal aorta. PMID- 2723730 TI - Participation of prefrontal neurons in the preparation of visually guided eye movements in the rhesus monkey. AB - 1. We recorded from 257 neurons in the banks of the posterior third of the principal sulcus of two rhesus monkeys trained to look at a fixation point and make saccades to stimuli in the visual periphery. Sixty-six percent (220/257) discharged or were suppressed in association with one or more aspects of the tasks we used. 2. Fifty-eight percent (151/257) of the neurons responded to the appearance of a spot of light in some part of the contralateral visual field. Cells did not seem to have absolute requirements for stimulus shape, size, or direction of motion. 3. Thirty-six percent (29/79) of visually responsive neurons tested quantitatively gave an enhanced response to the stimulus in the receptive field when the monkey had to make a saccade to the stimulus when its appearance was synchronous with the disappearance of the fixation point (synchron task). Twenty-nine percent (19/57) of the neurons gave an enhanced response to the stimulus when the monkey had to make a saccade to the stimulus some time after it appeared (delayed-saccade task). In general, enhancement in the synchron task correlated well with enhancement in the delayed-saccade task. 4. Enhancement was spatially specific. It did not occur when the monkey made a saccade to a stimulus outside the receptive field even though there was a stimulus within the receptive field. 5. Twenty-three percent (27/117) of neurons studied in the delayed-saccade task gave two bursts, one at the appearance of the stimulus and a second one around the saccade. This second burst generally did not occur when the monkey made the same saccade to a remembered target, but instead required the presence of the visual stimulus, and so we describe it as a reactivation of the visual response. Reactivation was also spatially specific. 6. The latency from reactivation to the beginning of the saccade ranged from 160 ms before the saccade to the beginning of the saccade. Reactivation usually continued for several hundred milliseconds after the saccade, sometimes for the duration of the trial. 7. Reactivation and enhancement are not the same mechanism. Although some cells showed both phenomena there was no correlation between enhancement and reactivation. 8. Cells that showed reactivation in the saccade task also showed reactivation at a weaker level in a suppressed-saccade task. In this task the monkeys had to hold fixation despite the disappearance of the fixation point and the continued presence of the peripheral stimulus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723731 TI - Amplifying role of convergence in olfactory system a comparative study of receptor cell and second-order neuron sensitivities. AB - 1. Extracellular unitary responses of receptor cells of second-order neurons identified as output cells were recorded in the frog. Four odorants of defined concentrations distributed over a wide range were delivered in the form of 2-s square pulses to the olfactory mucosa with a multistage dynamic flow dilution olfactometer. Bulbar responses were studied under two conditions, the stimuli being delivered either to the ventral or to the entire mucosa. 2. Overall responsiveness of the cells was compared. For the second-order neurons, the response ratio (excitation or inhibition) clearly depended on the condition of stimulation when the entire mucosa was stimulated, the bulbar response ratio was increased, as compared with that obtained when only the ventral mucosa received stimuli. Furthermore, when the stimuli were delivered to the whole mucosa, the bulbar excitation ratio was found to be similar to those of receptor cells and second-order neurons. 3. Response thresholds were determined from a comparison of the interspike interval values in the 30-s pre- and in the 12-s poststimulus time periods, using the Mann-Whitney U test (Table 2). The distribution of response thresholds of receptor cells as a function of stimulus concentration did not significantly differ from that of second-order neurons as excited by stimulating the ventral mucosa. These two distributions differed significantly from the distribution of second-order neurons as stimulated through the entire mucosa. In this last experimental condition, the bulbar neurons displayed an improved sensitivity. 4. The overall recruitment process, represented by the cumulative percentage of cells responding with excitation as a function of concentration, was found to be continuous over the entire concentration range. At the bulbar level, when the entire mucosa was stimulated, the recruitment occurred at lower concentrations than when only the ventral mucosa was stimulated. In this last case, the dynamics of the bulbar recruitment did not differ from that of receptor cells. 5. The recruitment process was further studied for each stimulus, for receptor cells as well as for second-order neurons. Differences in recruitment were found between stimuli and, as for the bulbar neurons, they depended on the condition of stimulation. 6. The main outcome of these results is the demonstration that the convergence of receptor cells onto second-order neurons is functionally implicated in an amplification process of the primary signal in olfaction.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723732 TI - Visually induced plasticity of postsaccadic ocular drift in normal humans. AB - 1. Five human subjects viewed binocularly the interior of a full-field hemisphere filled with a random-dot pattern. During training, eye movements were recorded by the electrooculogram. A computer detected the end of every saccade and immediately moved the pattern horizontally either in the same or, in different experiments, the opposite direction as the saccade. The motion was exponential, its amplitude was 25% of the horizontal component of the antecedent saccade, and its time constant was either 25, 50, or 100 ms in different experiments. Before and after 2-3 h of this experience, movements of both eyes were measured simultaneously by the eye-coil/magnetic-field method while subjects made saccades across the moveable pattern, looked between stationary targets, or made saccades in the dark, to see the effect of such adaptation on postsaccadic eye movements. 2. After 2-3 h (10,000-20,000 saccades) subjects developed a zero-latency, postsaccadic, ocular drift in the dark in the direction of the pattern motion. Three subjects were trained to backward drift, two to onward drift. Drift amplitude in the dark changed by 6% of the saccade size (range: 2-11%). The drift was exponential with an overall time constant of 108 ms. 3. After training, while viewing the adapting pattern motion, the change in the amplitude of the zero latency drift was approximately 10% (range: 6.5-14%). 4. Increasing the time constant of the pattern motion produced significant increases in the time constant of the ocular drift. 5. The incidence of dynamic overshoot (a tiny, backward saccade immediately following a main saccade) was idiosyncratic and went up in some subjects and down in others with adaptation. These changes did not seem related to modifications of postsaccadic drift. 6. Normal human saccades are characterized by essentially no postsaccadic drift in the abducting eye and a pronounced onward drift (approximately 4%) in the adducting eye. This adduction adduction asymmetry is largely preserved through adaptation. Thus the changes in drift were conjugate and conformed to Hering's law of equal (change of) innervation. 7. These results agree with those previously demonstrated in the monkey and can similarly be explained by parametric changes in the pulse, slide, and step of normal saccadic innervation. PMID- 2723733 TI - Dynamics of neuronal firing correlation: modulation of "effective connectivity". AB - 1. We reexamine the possibilities for analyzing and interpreting the time course of correlation in spike trains simultaneously and separably recorded from two neurons. 2. We develop procedures to quantify and properly normalize the classical joint peristimulus time scatter diagram. These allow separation of the "raw" correlation into components caused by direct stimulus modulations of the single-neuron firing rates and those caused by various types of interaction between the two neurons. 3. A newly developed significance test ("surprise") is applied to evaluate such inferences. 4. Application of the new procedures to simulated spike trains allowed the recovery of the known circuitry. In particular, it proved possible to recover fast stimulus-locked modulations of "effective connectivity," even if they were masked by strong direct stimulus modulations of individual firing rates. These procedures thus present a clearly superior alternative to the commonly used "shift predictor." 5. Adopting a model based approach, we generalize the classical measures for quantifying a direct interneuronal connection ("efficacy" and "contribution") to include possible stimulus-locked time variations. 6. Application of the new procedures to real spike trains from several different preparations showed that fast stimulus-locked modulations of "effective connectivity" also occur for real neurons. PMID- 2723734 TI - Synaptic effects of intercostal tendon organs on membrane potentials of medullary respiratory neurons. AB - 1. Stimulation of intercostal muscle tendon organs or their afferent fibers reduces medullary inspiratory neuron activity, decreases motor output to inspiratory muscles, and increases the activity of expiratory laryngeal motoneurons. The present study examines the synaptic mechanisms underlying these changes to obtain information about medullary neurons that participate in the afferent limb of this reflex pathway. 2. Membrane potentials of medullary respiratory neurons were recorded in decerebrate paralyzed cats. Postsynaptic potentials (PSPs) elicited in these neurons by intercostal nerve stimulation (INS) were compared before and after intracellular iontophoresis of chloride ions. After chloride injection, the normal hyperpolarization caused by inhibitory (I) PSPs is "reversed" to depolarization. 3. In inspiratory neurons, reversal of IPSPs by chloride injection also reversed hyperpolarization produced by INS when applied during any portion of the respiratory cycle. This observation suggests that increased chloride conductance of the postsynaptic membrane mediated the inhibition. Further, it is very likely that the last-order interneuron in the afferent pathway must be excited by INS and alter inspiratory neuron activity via an inhibitory synapse. The linear relationship between the amplitude of the INS induced PSP and membrane potential of inspiratory neurons provided evidence that neurons in the afferent pathway are not respiratory modulated. 4. The membranes of expiratory vagal motoneurons and post-inspiratory neurons were depolarized by INS during all portions of the respiratory cycle before IPSP reversal. Reversal of IPSPs affected neither this depolarization of expiratory vagal motoneurons during stage I and II expiration nor that of post-inspiratory neurons during stage I expiration. Thus this depolarization probably resulted from synaptic excitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723735 TI - Role of extracellular space in hyperosmotic suppression of potassium-induced electrographic seizures. AB - 1. Focal electrographic seizures arose in the CA1 region of rat hippocampal slices bathed in elevated (8.5 mM) external potassium [( K+]o). High [K+]o also induced spontaneous interictal bursts that originated in area CA3 and propagated to CA1. To examine the contribution to electrographic seizure initiation of excitatory mechanisms that are influenced by extracellular volume, we studied the effect of hyperosmotic expansion of interstitial volume on seizure occurrence, interictal bursts, and excitatory synaptic transmission. The tissue electrical resistance was also measured leading up to and during seizures. 2. Media made 5 30 mosmol/kg hyperosmotic by addition of agents restricted to the extracellular space (mannitol, sucrose, raffinose, L-glucose, dextran) rapidly and reversibly abolished [K+]o-induced spontaneous CA1 seizures in 86% of slices tested. However, similar increases in osmolality effected by agents that access the intracellular compartment (D-glucose, glycerol) did not influence electrographic seizure occurrence. Hyperosmotic changes with plasma membrane impermeable compounds, but not permeable compounds, produced significant concentration dependent decreases (1-10%) in the electrical resistance of CA1 stratum pyramidale. Because tissue resistance is proportional to extracellular volume, these results suggest that hyperosmotic suppression of electrographic seizures is associated with expansion of the extracellular space in hippocampal slices. 3. Measurement of electrical resistance of the CA1 stratum pyramidale during spreading depression and electrographic seizure revealed an increase in tissue resistance to 122% and 108% of control, respectively. Furthermore, a slight (approximately 2%) but significant increase in electrical resistance gradually occurred over the 20 s immediately preceding seizure generation. The observed increase in tissue resistance suggests extracellular space is decreased during these events. 4. Hyperosmolality did not alter CA3 interictal burst frequency. However, burst intensity, estimated from the total length of the burst waveform, was significantly reduced in both the CA3 (83% control) and CA1 region (67% control) when osmotic changes were imposed by plasma membrane impermeant compounds. Additionally, media made hypoosmotic by removal of 7.5 mM NaCl reversibly increased burst intensity. 5. High [K+]o potentiated excitatory synaptic transmission and excitatory postsynaptic potential (EPSP) spike coupling.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723736 TI - Two populations of rhythmically bursting neurons in rat medial septum are revealed by atropine. AB - 1. Previous findings, such as the sensitivity of the hippocampal theta rhythm to cholinergic manipulation, support a "pacemaker" role for the cholinergic cells of the medial septal nucleus and the vertical limb of the nucleus of the diagonal band (MSN-NDB). To explore the mechanism(s) of action of systemic antimuscarinic drugs in eliminating the theta rhythm, recordings of hippocampal EEG and rhythmic MSN-NDB neurons that fired in phase with the hippocampal theta rhythm were taken during the administration of atropine in urethane-anesthetized rats. 2. Twenty two of 33 rhythmic MSN-NDB cells continued to burst at the theta rhythm frequency after administration of a dose of atropine (25 mg/kg iv) that was sufficient to eliminate the theta rhythm (atropine-resistant cells). The remaining 11 cells lost their rhythmic firing pattern over the same time course as the loss of the theta rhythm (atropine-sensitive cells). 3. Both types of rhythmic MSN-NDB cells could be antidromically driven from the fimbria/fornix with similar latencies (range, 0.5-4.0 ms). The extracellularly recorded spike waveforms were not useful in predicting the atropine sensitivity of a given cell. Atropine-resistant cells frequently had higher firing rates than atropine-sensitive cells, but there was sufficient overlap of the two groups to make this a poor predictor of sensitivity. 4. Cooling the fimbria/fornix reversibly eliminated the hippocampal theta rhythm, but had no effect on 21/25 rhythmic MSN-NDB cells tested. This indicates that the atropine-sensitive MSN-NDB cells do not depend on the periodic output from the hippocampus for their rhythmic firing. Recordings from pairs of rhythmic MSN-NDB cells during cooling and/or atropine administration showed unchanged phase relations at the theta rhythm frequency. In rats in which the septohippocampal system was exposed by aspirating the overlying brain tissue, direct application of atropine (10 mg/ml) to the septal nuclei reversibly eliminated the hippocampal theta rhythm. 5. The rhythmic cells of the MSN-NDB are apparently composed of at least two distinct types, both of which potentially contribute to the production of the theta rhythm in the hippocampus. Elimination of hippocampal theta rhythm after local septal atropine application suggests that the loss of rhythmic activity in the group of atropine-sensitive septal cells is sufficient for the elimination of the theta rhythm. A model of the septohippocampal connections necessary for the theta rhythm is presented. PMID- 2723737 TI - Whole cell recording from lobster olfactory receptor cells: responses to current and odor stimulation. AB - 1. The basic electrical properties of olfactory (antennule) receptor cells were studied in an in situ preparation of the spiny lobster using whole cell patch clamp recording. 2. The current-voltage relationship of the cells was linear for membrane potentials between -150 and -40 mV and rectified at more positive membrane potentials. The input resistance at rest averaged 508 M omega. The cells displayed two time constants, with mean values of 29.8 and 8.2 ms. 3. Depolarizing current steps elicited fast, overshooting action potentials at a mean threshold of -32 mV from an imposed resting membrane potential of -65 mV. The action potentials were tetrodotoxin (TTX) and tetraethylammonium (TEA) sensitive, suggesting they are typical sodium/potassium action potentials. 4. Odor stimulation evoked slow, dose-dependent, depolarizing receptor potentials up to 50 mV in amplitude. In approximately 30% of cells tested, these led to repetitive spiking when the cells were depolarized beyond -45 to -30 mV. The amplitude of the receptor potential was graded as a linear function of the logarithm of the odor concentration. 5. The amplitude of the receptor potential varied linearly with the membrane potential between -70 and -30 mV. Extrapolated reversal potentials appeared to be normally distributed around a mean value of 3.6 mV. 6. The results collectively indicate that lobster olfactory receptor cells have electrical properties similar to, but not necessarily identical with, those currently envisaged for olfactory receptor cells in other species. PMID- 2723738 TI - Differential effects of fornix and caudate nucleus lesions on two radial maze tasks: evidence for multiple memory systems. AB - The present experiments were designed to examine the hypothesis that the mammalian brain contains anatomically distinct memory systems. Rats with bilateral lesions of caudate nucleus or fimbria-fornix and a control group were tested postoperatively on 1 of 2 versions of the radial maze task. In a standard win-shift version, each of the 8 arms of the maze was baited once, and the number of errors (revisits) in the first 8 choices of each trial was recorded. Fimbria fornix rats were impaired in choice accuracy, while caudate animals were unimpaired relative to controls. Different groups of rats with similar lesions were tested on a newly developed win-stay version of the radial maze, in which the location of 4 randomly selected baited arms was signaled by a light at the entrance to each arm, and which required rats to revisit arms in which reinforcement had been previously acquired within a trial. Rats with fimbria fornix lesions were superior to controls in choice accuracy on the win-stay radial maze task, while caudate animals were impaired relative to controls. The results demonstrate a double dissociation of the mnemonic functions of the hippocampus and caudate nucleus. Some implications of the presence of 2 memory systems in the mammalian brain are discussed. PMID- 2723739 TI - Studies of nerve-muscle interactions in Xenopus cell culture: analysis of early synaptic currents. AB - We have studied the spontaneous and nerve-evoked synaptic currents during the initial period of nerve-muscle contact in Xenopus cell cultures. The precise timing of the contact was achieved by physically manipulating embryonic muscle cells into contact with co-cultured spinal neurons. Previous studies have shown that physical contact of the muscle membrane induces pulsatile release of acetylcholine (ACh) from the growth cone of these neurons, resulting in spontaneous synaptic currents (SSCs) in the muscle cell within seconds following the contact. In the present work, we first showed that these SSCs at the manipulated nerve-muscle contacts are similar to those observed at naturally occurring synapses. We then examined the possible cellular mechanisms responsible for the marked variation in SSC amplitude and showed that it most likely results from differences in either the amount of ACh contained in each release event or the extent of close membrane apposition near the release sites. During the first 20 min following the nerve-muscle contact, there was an increase in the frequency and mean amplitude of the SSCs. During a similar period, the evoked synaptic currents (ESCs), which were induced by suprathreshold electrical stimulation of the neuronal soma, also showed an increase in the mean amplitude and a reduction in the delay of onset following the stimulus. These postcontact changes in the efficacy of synaptic transmission may be related to an increase in the total area of close membrane apposition between the nerve and muscle cells. This was suggested by the finding that neurite-muscle adhesion increases over a similar postcontact period. The transition from low- to high-efficacy transmission during the early phase of contact may reflect the process of selective adhesion between the cells, and thus signify the formation of specific synapse. Analysis of the fluctuation in the ESC amplitude at the early nerve-muscle contact suggests that evoked release of ACh occurs as multiples of a quantal unit. However, this unit is apparently related to only a small subpopulation of SSCs of relatively high amplitudes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723740 TI - Studies of nerve-muscle interactions in Xenopus cell culture: fine structure of early functional contacts. AB - We have studied the fine structure of nerve-muscle contacts during the first few hours of synaptogenesis in embryonic Xenopus cell cultures. The precise timing of contact was achieved by manipulating isolated spherical myocytes (myoballs) into contact with growth cones or neurites of co-cultured spinal neurons. The contacts were shown to be functional by whole-cell voltage-clamp recording of nerve-evoked synaptic currents in the muscle cell. The ultrastructure of these functional contacts was examined by thin-section electron microscopy. In total, 20 nerve muscle pairs were studied with contact periods ranging from 20 min to 12 hr, during which time a substantial increase in the amplitude of synaptic currents occurred. The structure of noncontacting cells and of nerve-muscle contacts formed between the cells by natural encounters in 1-d-old cultures were also examined in order to identify the features and the time course of morphological differentiation of early functional contacts. Prominent features of the contact area during the first few hours included: close apposition of the nerve and muscle membranes, greater frequency of coated pits and vesicles, and thickening of postsynaptic muscle membrane. Occasionally, clusters of clear vesicles occurred near presynaptic membrane, but no further sign of active zone differentiation was observed. In comparison, definitive active zone structure, well-formed extracellular basal lamina, and widened cleft were seen in natural contacts less than 24 hr old. This study of the identified functional contacts may help us to understand the structural basis for early nerve-muscle interaction and the functional significance of various synaptic specializations. PMID- 2723741 TI - The role of a modulatory neuron in feeding and satiation in Aplysia: effects of lesioning of the serotonergic metacerebral cells. AB - Food-induced arousal in Aplysia is characterized by a progressive increase in the speed and strength of biting responses elicited by a seaweed stimulus. Data from semi-intact and dissected preparations suggest that the identified, serotonergic, metacerebral cells (MCCs) of the cerebral ganglion contribute to food-induced arousal by enhancing the strength of buccal muscle contractions, and by modulating the output of the central pattern generator for biting movements. In order to test this hypothesis in intact, free-moving animals and to determine if the MCCs play a role in satiation of feeding, the behavior of animals that had their MCCs destroyed by intracellular injection of proteases was compared with that of B Cell-Lesion and Dye injection control animals (Experiment 1) or surgical control animals (Experiment 2). Nonfeeding behaviors such as defensive withdrawal responses, locomotion, and righting reflexes were unaffected by MCC lesioning. Also unaffected by MCC lesioning were appetitive feeding behaviors and the amount of food needed to satiate animals. Significant behavioral deficits in consummatory feeding behaviors, which remained stable for periods exceeding 10 d, were observed in the MCC-lesioned animals but not in controls. Lesioned animals exhibited a slowing of rate of repetitive biting responses by 40% of controls and had reduced magnitudes of repetitive bites, particularly at the end of a testing run of 10 consecutive bites. The deficit in bite magnitude was minimally evident in food-deprived animals (Experiment 1) but became more pronounced as animals were fed to satiation (Experiment 2). MCC-lesioned animals still exhibited a residual build-up of the rate and magnitude of biting responses at the onset of feeding behavior. This suggests that, in addition to the MCCs, there are other sources of modulation that contribute to plasticity of consummatory responses during the food-induced arousal state. PMID- 2723742 TI - Development and death of external granular layer cells in the weaver mouse cerebellum: a quantitative study. AB - Previous studies have identified the cerebellar granule cell as a primary site of gene action in the weaver mutant mouse. The temporal expression of the weaver mutant granule cell phenotype has not been fully investigated. To identify early postnatal expression of the weaver mutant phenotype, we quantitated 4 parameters of cerebellar development in postnatal day 0, 2, 4, 6, and 8 +/+, wv/+, and wv/wv mice: (1) cerebellar area, (2) cells in the external granule layer (EGL), (3) number of mitotic figures in the EGL, and (4) number of pyknotic figures in the EGL. Qualitative observations suggest a generalized retardation in the development of wv/wv and wv/+ EGL cells compared with the +/+ cells. Quantitatively, the earliest detectable mutant phenotype in wv/wv and wv/+ cerebella is the increased presence of cell death in the EGL, apparent at the day of birth. Degenerating cells in the EGL, the majority of which are found in the postmitotic zone of this layer, contain abnormally clumped heterochromatin, suggestive of "nuclear" cell death. Previous hypotheses concerning the mechanism of weaver gene action have suggested that granule cells die due to their inability to migrate from the EGL. The time course, mode, and spatial organization of cell death found in the present studies lead us to suggest that an earlier event in granule cell development, such as the exit of neuroblasts from the cell cycle or axonogenesis, is affected by the weaver gene. PMID- 2723743 TI - Selective elimination of cross-compartmental innervation in rat lateral gastrocnemius muscle. AB - The calf muscles of the rat hindlimb are composed of smaller entities, called neuromuscular compartments, which are the territories of muscle innervated by a single, naturally occurring primary (first-order) muscle nerve branch. While it is quite clear that a precise connectivity exists very early in development between motoneuron pools and individual muscles, the mechanisms responsible for producing the adult pattern of compartmental innervation are unknown. This study uses intracellular recording techniques to demonstrate that neuromuscular compartments are essentially established at birth and that postnatal synapse elimination has little role in establishing neuromuscular compartments. Our results demonstrate the existence of a small number of cross-compartmental connections in neonates which are not present in adults. Examining the removal of these cross-compartmental connections in both normal muscles and in muscles that have had synapse elimination delayed by tenotomy reveals that the synapses responsible for this innervation are eliminated in a selective manner. PMID- 2723744 TI - The "motion-blind" patient: low-level spatial and temporal filters. AB - The "motion-blind" patient previously described by Zihl et al. (1983) was investigated using standard psychophysical procedures with stimuli whose spatial and temporal properties could be separately manipulated. Detection experiments for sinewave grating stimuli of varying spatial and temporal frequency showed sensitivity in this patient to be only slightly impaired. Temporal integration for stimuli of varying spatiotemporal frequency exhibited the expected space-time covariation seen in normal vision. An examination of the suprathreshold discriminative capacity of this patient was undertaken for spatial frequency, contrast, and temporal frequency. Although all of these discriminative functions were impaired, those concerning temporal frequency or velocity were dramatically reduced. No similar loss was seen for spatial frequency discrimination for moving or temporally varying stimuli. No measurable temporal frequency discrimination was present above 6 Hz and no velocity discrimination above 6 degrees/sec. Experiments involving the direction discrimination of suprathreshold drifting gratings of arrays of random dots revealed an inability to perceive direction of movement above a velocity of about 6 degrees/sec. Contrast thresholds contingent on direction of motion of a drifting grating also showed a much greater deficit than simple detection. Apparent motion using 2-flash random dot kinematograms revealed that the residual motion vision of this patient corresponded to the "short-range" motion process of normal vision. This process originally defined by Braddick (1974) operates over restricted space and time intervals. Apparent motion could only be supported by a narrow range of intermediate spatial displacements. These results suggest that this patient does exhibit some residual motion perception, probably corresponding to a severely impaired "short-range" mechanism. The patient's relatively intact ability to perform simple types of discrimination but severe impairment of performance at making judgments relevant to the nature of motion of the same stimuli suggests that while the components necessary for the analysis of motion are intact their more global associations have been disrupted. This implicates an extrastriate locus of the brain damage. Alternative explanations for the nature of the deficit are discussed. PMID- 2723745 TI - Neurobehavioral deficit due to ischemic brain damage limited to half of the CA1 sector of the hippocampus. AB - It is well known that ischemia causes neuronal necrosis in selectively vulnerable sectors of the hippocampus. Since the hippocampus is involved in spatial navigation, learning, and memory, selective deficits in these areas may arise from ischemic brain damage. The objective of this study was to test whether a minimal ischemic insult, producing selective neuronal necrosis restricted to only a portion of the CA1 pyramidal cells of the hippocampus, could produce a detectable spatial navigation deficit. Male Wistar rats received 9 min of forebrain ischemia induced by carotid clamping and hypotension or sham operation with exposure of the carotid arteries. The rats were allowed to recover and were tested on a simple place task, a place learning-set task, and a pattern discrimination task in swimming pools paradigms. Subsequently, the rats were perfusion-fixed and their entire brains subjected to quantitative histopathologic analysis. Although both ischemic and sham-operated groups learned the simple place task, the learning-set task revealed defects in spatial navigation, reflected as increased errors and latency in the performance of the ischemic rats. In the subsequent pattern discrimination task, the ischemic group was superior to the control group, which perseverated by attempting to use a place strategy to solve the discrimination. Quantitative neuropathology revealed neuronal necrosis in the ischemia group limited to 50% of the CA1 zone of the hippocampus. Extrahippocampal damage consisted of rare cortical neuronal necrosis in 2 of 6 animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723746 TI - Hippocampal damage associated with prolonged and fatal stress in primates. AB - Sustained exposure to glucocorticoids (GCs), adrenal hormones secreted during stress, can cause neural degeneration in the rat. This is particularly so in the hippocampus, a principal neural target site for GCs, in which GCs can exacerbate the rate of neuron death during normal aging, as well as the severity of neuronal damage after various neurological insults. Thus, stress can be a potent modulator of hippocampal degeneration in the rat. The present report suggests a similar association in the primate. Eight vervet monkeys, housed in a primate center in Kenya, that had died spontaneously from 1984 to 1986, were found at necropsy to have multiple gastric ulcers; a retrospective, neuropathological study was then done of this opportunistic population. Compared with controls euthanized for other research purposes, ulcerated monkeys had marked hippocampal degeneration that was apparent both quantitatively and qualitatively, and both ultrastructurally and on the light-microscopic level. Minimal damage occurred outside the hippocampus. Damage was unlikely to have been due to an agonal or post-mortem artifact. Instead, ulcerated monkeys appear to have been subject to sustained social stress, perhaps in the form of social subordinance in captive breeding groups: most came from social groups, had significantly high incidences of bite wounds at necropsy, and had hyperplastic adrenal cortices, indicative of sustained GC release. Moreover, the specific hippocampal cell fields damaged in ulcerated animals matched those damaged by GCs in the rodent hippocampus. Thus, this represents the first evidence suggesting that sustained stress, via GC hypersecretion, might be neurodegenerative in the primate. PMID- 2723747 TI - Mechanisms of contour perception in monkey visual cortex. I. Lines of pattern discontinuity. AB - We have studied the mechanism of contour perception by recording from neurons in the visual cortex of alert rhesus monkeys. In order to assess the relationship between neural signals and perception, we compared the responses to edges and lines with the responses to patterns in which human observers perceive a contour where no line or edge is given (anomalous contour), such as the border between gratings of thin lines offset by half a cycle. With only one exception out of 60, orientation-selective neurons in area V1 did not signal the anomalous contour. Many neurons failed to respond to this stimulus at all, others responded according to the orientation of the grating lines. In area V2, 45 of 103 neurons (44%) signaled the orientation of the anomalous contour. Sixteen did so without signaling the orientation of the inducing lines. Some responded better to anomalous contours than to the optimum bars or edges. Preferred orientations and widths of tuning for anomalous contour and bar or edge were found to be highly correlated, but not identical, in each neuron. Similar to perception, the neuronal responses depended on a minimum number of lines inducing the contour, but not so much on line spacing, and tended to be weaker when the lines were oblique rather than orthogonal to the border. With oblique lines, the orientations signaled were biased towards the orientation orthogonal to the lines, as in the Zollner illusion. We conclude that contours may be defined first at the level of V2. While the unresponsiveness of neurons in V1 to this type of anomalous contour is in agreement with linear filter predictions, the responses of V2 neurons need to be explained. We assume that they sum the signals of 2 parallel paths, one that defines edges and lines and another that defines anomalous contours by pooling signals from end-stopped receptive fields oriented mainly orthogonal to the contour. PMID- 2723748 TI - Mechanisms of contour perception in monkey visual cortex. II. Contours bridging gaps. AB - We have studied the mechanism of contour perception by recording from neurons in the visual cortex of alert rhesus monkeys. We used stimuli in which human observers perceive anomalous contours: A moving pair of notches in 2 bright rectangles mimicked an overlaying dark bar. For control, the notches were closed by thin lines so that the anomalous contours disappeared or half of the figure was blanked, with a similar effect. Orientation-selective neurons were studied. With the receptive fields centered in the gap, 23 of 72 (32%) neurons tested in area V2 responded to the moving "bar" even though the stimulus spared their response fields, and when the notches were closed, their responses were reduced or abolished. Likewise, when half of the figure was removed, the neurons usually failed to respond. Neurons with receptive fields within 4 degrees of the fovea signaled anomalous contours bridging gaps of 1 degree-3.5 degrees. The anomalous contour responses were compared quantitatively with response field profiles and length-summation curves and found to exceed the predictions by linear-summation and summation-to-threshold models. Summation models also fail to explain the effect of closing lines which add only negligible amounts of light. In V1, only one of 26 neurons tested showed comparable responses, and only with a narrow gap. The others responded only when the stimulus invaded the response field and did not show the effect of closing lines, or failed to respond at all. The contour responses in V2, the nonadditivity, and the effect of closure can be explained by the previously proposed model (Peterhans et al., 1986), assuming that the corners excite end-stopped fields orthogonal to the contour whose signals are pooled in the contour neurons. PMID- 2723749 TI - Time course of structural changes at identified sensory neuron synapses during long-term sensitization in Aplysia. AB - We have used the gill- and siphon-withdrawal reflex of Aplysia californica to explore the morphological basis of the synaptic plasticity that underlies long term sensitization. In earlier studies (Bailey and Chen, 1983, 1988a), we described 2 classes of structural changes at identified sensory neuron synapses that occur following long-term sensitization: (1) increases in the number, size, and vesicle complement of active zones and (2) an overall increase in the total number of synaptic varicosities per sensory neuron. In the present study, we have begun to examine which of these anatomical changes might be necessary for the maintenance of long-term sensitization by exploring the time course over which they occur and, in particular, their duration relative to the persistence of the memory assessed behaviorally. Toward this end we have quantitated changes in both the total number of varicosities and their active zone morphology in single HRP labeled sensory neurons taken from long-term sensitized and control animals at different intervals (1-2 d, 1 week, and 3 weeks) following training. We have found that long-term sensitized animals examined within 48 hr after the completion of training demonstrate an increase in the total number of varicosities per sensory neuron as well as an increase in the incidence, size, and vesicle complement of their synaptic active zones compared with control animals. The increase in the number of varicosities and active zones persists unchanged for at least 1 week, and the increase in active zone number is only partially reversed at the end of 3 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723750 TI - Differential loss of neuromuscular connections according to activity level and spinal position of neonatal rabbit soleus motor neurons. AB - We have tested whether the ability of synapses to compete for occupancy of endplates during neuromuscular synapse elimination is affected by differences in the spinal position or in the activity level of the parent motor neuron. To test the role of spinal position, the relative sizes of motor units for motor neurons from middle and extreme (rostral/caudal) positions in the rabbit soleus motor pool were determined at 3 postnatal ages: 4-5 d ("early" ages, when the soleus is heavily polyinnervated), 8-9 d ("intermediate"), and 11-15 d ("late," when the soleus has just reached singly innervated state). Average motor unit sizes from extreme ventral roots were similar to those from middle ventral roots in early aged soleus muscles but were significantly smaller (by 18-27%) for both intermediate and late muscles. Thus, motor neurons from extreme positions evidently compete less effectively for retention of synapses than those from middle positions. To test the role of differential activity, inactive and active synapses were pitted directly against one another by implanting Silastic plugs laden with tetrodotoxin (TTX) into one of the spinal nerves containing a minority of the soleus motor axons. Differential activity was maintained during a period of extensive synapse loss, from the time of the implant at day 4 or 5 until the intermediate age (day 8-9). Motor unit twitch tensions were subsequently measured to determine the relative number of synapses retained by individual active and inactive motor neurons. The inactivated motor units were on average significantly larger (by more than 50%) than the corresponding group from normal and control implanted animals. The abnormally large size of inactivated motor units persisted in animals allowed to recover from the TTX block and examined after multiple innervation had disappeared. Hence, the effect of the TTX block cannot be attributed to a simple slowing of synapse elimination specifically among the inactive motor neurons. We conclude that complete presynaptic inactivity improves the chances of survival relative to that for normal activity during synapse elimination in the neonatal rabbit soleus muscle. This difference in competitive ability may contribute to the development of an important characteristic of adult muscles, the correlation between motor unit size and recruitment threshold. PMID- 2723751 TI - Characterization of a partial cDNA clone for the NILE glycoprotein and identification of the encoded polypeptide domain. AB - A partial cDNA clone [2.4 kilobase (kb)] for the nerve growth factor-inducible large external (NILE) glycoprotein was selected from a lambda gt11 expression library constructed using mRNA from PC 12 cells. A 0.2 kb subclone (pNILE-1B) was used for Northern blot analysis of NILE message present in 2 NILE-positive neuronal cell lines and 2 NILE-negative glial cell lines. pNILE-1B hybridizes with components of 6.8 and 2.0 kb in the 2 neuronal cell lines but fails to show hybridization with any components in the 2 glial cell lines. Only the 6.8 kb species would be large enough to code for the NILE polypeptide. A rabbit antiserum was prepared against the NILE-beta-galactosidase fusion protein produced by the NILE clone. This antiserum (anti-NILE-beta-gal) immunoprecipitates NILE glycoprotein from neuronal cell lines, further confirming the authenticity of the NILE cDNA clone. The epitope recognized by anti-NILE-beta gal is contained in an 85 kDa tryptic fragment from the phosphorylated carboxy terminus of NILE. The 160 kDa tryptic fragment containing the amino terminus is not recognized by anti-NILE-beta-gal. Both immunoprecipitation and immunofluorescence experiments indicate that the anti-NILE-beta-gal epitope is not exposed on the cell surface but is accessible only after cells are treated with detergent. The cytoplasmic nature of the determinant is also indicated by its absence on a truncated, soluble form of NILE released from cells (possibly by a proteolytic mechanism) into the medium. This released NILE is 15-20 kDa smaller than the detergent-extracted NILE and, in addition to lacking the anti-NILE-beta gal epitope, does not contain the cytoplasmic site(s) of phosphorylation. Nucleotide sequencing of the pNILE-1B subclone confirms the location of the anti NILE-beta-gal epitope in the cytoplasmic domain. The clone contains an open reading frame coding for a 79 amino acid segment of the polypeptide that differs in only 2 residues from the cytoplasmic domain of the L1 glycoprotein. PMID- 2723752 TI - Hippocampal neurons in the monkey with activity related to the place in which a stimulus is shown. AB - In order to analyze the functions of the hippocampus in the primate, and to advance the understanding of amnesia, the activity of 994 single hippocampal neurons in the monkey was analyzed during the performance of a task known to be affected by hippocampal damage in which both an object, and its position in space, must be remembered. The serial multiple object-place memory task required a memory for the position on a video monitor in which a given object had appeared previously. It was found that 9.3% of neurons recorded in the hippocampus and hippocampal gyrus had spatial fields in this and related tasks, in that they responded whenever there was a stimulus in some but not in other positions on the screen. We found that 2.4% of the neurons responded to a combination of spatial information and information about the object seen, in that they responded more the first time a particular object was seen in any position. Six of these neurons were found that showed this combination even more clearly, in that, for example, they responded only to some positions and only if it was the first time that a particular stimulus had appeared there. It is concluded that there are neurons in the primate hippocampus which (1) respond to position in space and (2) in some cases combine information about stimuli and their position in space, responding to a stimulus only the first time it is seen in a position in space, for example. Thus, not only is spatial information processed by the primate hippocampus, but it can be combined with information about which stimuli have been seen before. The ability of the hippocampus to form such conjunctions may be an important property for its role in memory. PMID- 2723753 TI - Synaptic ultrastructure of functionally and morphologically characterized neurons of the superficial spinal dorsal horn of cat. AB - Recordings of neuronal unitary discharges evoked by primary afferent input were made in the superficial part of the spinal cord's dorsal horn, the marginal zone and substantia gelatinosa (also known as laminae I and II), using fine micropipette electrodes filled with HRP. After physiological characterization with respect to primary afferent input, HRP was injected intracellularly iontophoretically into the recorded neuron. Following histochemical processing, the neurons so delineated were studied at the light and electron microscopic levels. No clear relationship between function and either general cellular configuration or synaptic ultrastructure appeared in these analyses, although the concentration of dendritic distribution could be related to the nature of primary afferent excitation. Nocireceptive cells had dendrites mostly branching and ending in lamina I and IIo, while the dendrites of innocuous mechanoreceptive cells arborized principally in lamina II and III. Glomerular synaptic complexes (large, complex arrays of axonic and dendritic profiles with synaptic interconnections) were found to contact a few neurons of both the nocireceptive and mechanoreceptive classes. All neurons received large numbers of simple axonic contacts (small axonic boutons with only 1 or 2 synaptic contacts with a single postsynaptic profile). A degree of specificity in the presynaptic articulations appeared to be reflected by the observations that (1) nocireceptive neurons were never found to receive synaptic contacts from boutons which resembled the known ultrastructure of peripheral innocuous mechanoreceptors, and (2) mechanoreceptive neurons were never seen to receive synaptic contacts from boutons which resembled the known ultrastructure of primary afferent nocireceptors. The axons of the labeled neurons of both nocireceptive and mechanoreceptive classes terminated in simple axonic synapses. All classes of neurons participated in dendrodendritic contacts; however, only some mechanoreceptive neurons had dendrites containing vesicles that were presynaptic to other profiles. No nocireceptive neurons, regardless of gross configuration, were found to have vesicles in their dendrites, but 3 nocireceptive neurons received synapses from presynaptic dendritic profiles. PMID- 2723754 TI - Acetylcholine in the crayfish optic lobe: concentration profile and cellular localization. AB - The crayfish optic lobe contains high levels of acetylcholine (ACh) and choline as measured with a chemiluminescent assay in small fragments of optic lobe tissue. The highest concentrations were found in the medulla externa and medulla interna (second and third optic neuromeres), which have ACh concentrations of 270 pmol/mg tissue. This concentration is about 16 times that measured in the photoreceptors and lamina ganglionaris (the first optic neuromere). Immunocytochemistry (based upon antisera to choline-glutaryl-BSA) revealed low levels of ACh-like reactivity in the lamina ganglionaris associated with the terminal arbors of centrifugal and/or tangential neurons. The most intense ACh like reactivity was observed in monopolar neurons of the medulla externa and medulla interna. One monopolar neuron/medullary column (or about 2500 neurons/medullary neuropile) exhibited reactivity and an estimated cytoplasmic concentration of 8.1 mM. PMID- 2723755 TI - Cholinergic synapses and the organization of contrast detection in the crayfish optic lobe. AB - The actions of acetylcholine (ACh) were examined on 4 classes of multicolumnar interneurons whose dendrites lie in close proximity to the putative cholinergic transmedullary neurons described in the companion report. ACh-elicited responses in each cell type resemble visually elicited synaptic events and persist following synaptic blockade with 20 mM CoCl2. Tangential cells exhibit a hyperpolarizing response to ACh that resembles the visual response in reversal potential and dependence on extracellular chloride. The visual response is potentiated by the anticholinesterase, neostigmine (0.1 mM). Visual and carbachol elicited responses are blocked by nicotinic ganglionic antagonists (e.g., 10(-6) M pempidine) that are 10-100 times more potent than D-tubocurarine. Medullary amacrine cells exhibit depolarizing responses to ACh (10(-6) M) and light with similar reversal potentials. The visual response is potentiated by neostigmine. Dimming fibers respond to light and ACh with a hyperpolarization that inhibits the maintained discharge. The sustaining fiber response to ACh reflects both direct responses and indirectly elicited synaptic actions. The direct action is a hyperpolarization possibly related to the visual "off-response." It is associated with an increased conductance and a reversal potential negative to the dark potential. The off-response is abolished by curare and pempidine and potentiated by neostigmine. ACh appears to orchestrate several aspects of the dual-channel contrast detection system of the optic lobe. The actions of ACh on tangential cells, amacrine cells, and dimming fibers are all consistent with the effects of a spatially localized increment in light intensity and a corresponding local release of ACh in the retinotopic columnar array. PMID- 2723756 TI - Dynamics of the endoplasmic reticulum and other membranous organelles in growth cones of cultured neurons. AB - The fluorescent lipophilic dye 3,3'-dihexyloxacarbocyanine iodide [DiOC6(3)] was used to examine the distribution of membrane-bound organelles in growth cones of cultured rat sympathetic neurons. Within chemically fixed growth cones, intense DiOC6(3) fluorescence was localized predominately to the base or central region of growth cones. However, in most growth cones several thin DiOC6(3)-fluorescent processes radiated from the base into the periphery, and double fluorescence imaging of single growth cones indicated that these processes were highly colocalized (approximately 79%) with microtubules. The distribution of DiOC6(3) fluorescence in living growth cones was examined using low light-level fluorescence video microscopy. We observed thin fluorescent processes within the periphery of growth cones to undergo length excursions (extension/retraction) and to change orientation (move laterally). During growth cone advance, processes became progressively thicker and were gradually engulfed by the advancing fluorescent mass. When growth cones were viewed with video-enhanced differential interference contrast microscopy, the position of the fluorescent processes correlated with thickened extensions of central-type cytoplasm through which vesiclelike organelle transport often occurred. These observations indicate several features concerning the organization and movement of membranous organelles (MOs) in growth cones: (1) MOs are highly compartmentalized, the majority being localized to the growth cone base; (2) MOs advance into the periphery along distinct pathways probably associated with microtubules; (3) one or more thin continuous MOs, which most likely represent a thin tubular component of the endoplasmic reticulum, generally precedes advance of vesiclelike MOs along individual transport pathways; and (4) transport pathways with their associated MOs are spatially and temporally dynamic. PMID- 2723757 TI - Lesions of the amygdala that spare adjacent cortical regions do not impair memory or exacerbate the impairment following lesions of the hippocampal formation. AB - Monkeys with stereotaxic lesions of the amygdaloid complex that spared the surrounding cortex (i.e., the periamygdaloid, entorhinal, and perirhinal cortices) performed normally on the delayed nonmatching to sample task, as well as on 3 other memory tasks (object retention, concurrent discrimination, and delayed response) administered during the 1 1/2 years after surgery. These animals also performed normally on pattern discrimination and motor-skill learning, 2 tasks analogous to ones amnesic patients perform well. A second group of monkeys with conjoint lesions that included both the amygdaloid complex, as just described, and the hippocampal formation were impaired on the same 4 memory tasks. However, the severity of impairment in this group was no greater than in monkeys with lesions of the hippocampal formation alone. Thus, circumscribed bilateral lesions of the amygdala did not impair performance on 4 different memory tasks, nor did they exacerbate the memory impairment that followed hippocampal formation lesions alone. These findings suggest that one must look to structures other than the amygdala to account for the severe memory impairment that follows large lesions of the medial temporal region. One possibility is that damage to the cortical regions that surround the amygdala contributes to memory impairment. PMID- 2723758 TI - Regulation of melatonin secretion in a photoreceptive pineal organ: an in vitro study in the pike. AB - The pineal organ (or pineal) of a teleost fish, the pike, contains typical (cone like) and modified photoreceptor cells. Both are involved in indole metabolism, including melatonin production. How photoperiod controls melatonin biosynthesis in organs containing mainly photoreceptor cells, remains unclarified. To tackle this question we have used cultured pike pineal organs to investigate the variations in (1) the activity of the arylalkylamine-N-acetyltransferase (NAT), which is involved in the biosynthesis of melatonin, in static culture and (2) melatonin release in a perifusion system. Serum melatonin was also quantified in pike kept under a 24 hr light/dark (LD) cycle. Under LD conditions, NAT activity, melatonin release, and serum melatonin levels were high during the scotophase and low during the photophase. High-amplitude rhythms in NAT activity and melatonin release were maintained during three 24 hr cycles in constant darkness and a low amplitude rhythm of NAT persisted in constant illumination. Midnight illumination induced a dramatic decrease of NAT activity and melatonin release. Darkness at midday did not induce a rise of the melatonin release, which occurred only at the onset of the subjective scotophase. From the present data it is strongly suggested that the pineal of the pike contains a circadian oscillator- synchronized by the photoperiod--which generates the rhythms of NAT activity and of melatonin release. Melatonin release, which reflects the rhythmic activity of NAT, might largely contribute to the melatonin circulating levels. The circadian oscillations observed under constant conditions suggest that the oscillator might behave differently in the pike, compared with intrapineal oscillators of 2 other species (lizard and chicken) under investigation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723759 TI - Sexually dimorphic polypeptides in developing antennal sensory neurons of an insect. AB - Many insects have sexually dimorphic antennae with sensilla peculiar to one sex specialized to detect sex pheromones released by the other sex. In the moth Manduca sexta, the axons of receptor cells in the male-specific sensilla as well as those common to both sexes terminate in the antennal lobes of the brain. We have used 2-dimensional electrophoresis (2DE) to study some of the proteins that are produced by sensory receptor cells in developing antennae and transported through their axons to the brain. Extracts of antennal nerves from mature male and female M. sexta yield nearly identical 2DE patterns of proteins after staining or fluorography. Gels prepared from antennal nerves of developing animals, however, exhibit a sexual dimorphism in the quantitative pattern of at least 2 classes of proteins. One class consists of four 49 kDa proteins of similar charge, designated 49a, 49b, 49c, and 49d in order of decreasing mobility on nonequilibrium pH gradient electrophoresis gels. The total amount and apparent rate of synthesis of 49b and 49d are ca. 4- to 7-fold greater in antennal nerves of developing males than in those of females. Protein 49c is comparably enriched in female antennal nerves, while 49a is enriched ca. 1.2-fold in females. The second class consists of a single polypeptide of 24 kDa, which is nearly undetectable in silver-stained gels but was shown to be ca. 9-fold enriched in males by fluorography. At the end of adult development, male and female moths have similar patterns of the 49 kDa polypeptides, and synthesis of the 24 kDa polypeptide is reduced to nearly undetectable levels. The patterns of sexual dimorphism thus appear to be associated with the growth and maturation of antennal sensory axons into the antennal lobes. Biosynthesis of the 24 kDa polypeptide was nearly undetectable in antennal lobes or fragments of antennal nerves incubated in vitro with radiolabeled methionine. The 49 and 24 kDa polypeptides appear to belong to separate classes of rapidly transported proteins. The 24 kDa polypeptide is among the most rapidly transported proteins; it is found exclusively in a particulate fraction and is associated with plasma membrane but apparently not mitochondria. The 49 kDa polypeptides are found in both the particulate and soluble fractions; the more basic 49a and 49b are enriched in the particulate fraction, while the more acidic 49c and 49d are enriched in the soluble fraction. PMID- 2723760 TI - Differential localization of microtubules in cerebellar cells. AB - The distribution and subcellular localization of microtubules in rat brain cerebellum was analyzed by immunohistochemistry with antibodies prepared against 3 synthetic peptides corresponding to the C-terminal region of beta-tubulin. The peptides used correspond to amino acid positions 416-425 (peptide 1), 416-431 (peptide 2), and 426-445 (peptide 4). The antibodies thus obtained displayed a remarkable specificity in reacting with different cell types in the rat cerebellum. Antibodies directed against peptide 1 primarily stained Purkinje cells and their dendrites and axons. Peptide 2 antibodies preferentially stained the glomeruli, while antibodies directed against peptide 4 preferentially stained Bergmann glial fibers. These results are discussed in terms of dissimilarities in microtubule organization and masking of epitopes by microtubule-associated proteins (MAPs) in individual cerebellar cells, which may be related to specific functional properties. PMID- 2723761 TI - Effects of DIDS on the chick retinal pigment epithelium. I. Membrane potentials, apparent resistances, and mechanisms. AB - While little is known about the transport properties of the retinal pigment epithelium (RPE) basal membrane, mechanisms for anion movement across the basal membrane appear to be present (Miller and Steinberg, 1977; Hughes et al., 1984; Miller and Farber, 1984). This work examines the electrophysiological effects of the anion conductance blocker, 4,4'-diisothiocyanostilbene-2,2'-disulfonate (DIDS) on the basal membrane of an in vitro preparation of chick retina-RPE choroid. DIDS (10-125 microM), added to the choroidal bath, decreased the transtissue potential by decreasing the potential across the RPE. Intracellular RPE recordings showed that DIDS affected the membrane potential in 2 phases, initially hyperpolarizing the basal membrane and then, after prolonged exposure, depolarizing the apical membrane. Resistance assessment by transtissue current pulses and intracellular c-wave recordings suggested that DIDS increased basal membrane resistance (Rba) during the first phase and increased apical membrane resistance (Rap) during the second phase. Measurements of intracellular Cl- activity (aiCl) showed that Cl- was actively accumulated by the chick RPE since it was distributed above equilibrium across both the apical and basal membranes. Perfusion of the basal membrane with 50 microM DIDS significantly increased aiCl . The DIDS-induced basal membrane hyperpolarization, apparent increase in Rba, and increase in aiCl- are all consistent with Cl- -conductance blockade. During the second phase, apical membrane responsiveness to the light-evoked decrease in subretinal [K+]o (Oakley, 1977) was reduced an average of 58%. This finding, given the second-phase apical membrane depolarization and apparent increase in Rap, is consistent with a decrease in apical membrane K+ conductance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723762 TI - Effects of DIDS on the chick retinal pigment epithelium. II. Mechanism of the light peak and other responses originating at the basal membrane. AB - 4,4'-diisothiocyanostilbene-2,2'-disulfonate (DIDS) appears to block a Cl- conductance in the basal membrane of the chick retinal pigment epithelium (RPE) (Gallemore and Steinberg, 1989). The present paper describes the effect of DIDS, as well as effects of anion movement blockade with other pharmacological agents, on 3 responses that originate as depolarizations of the RPE basal membrane: the light peak of the DC electroretinogram, the response to sodium azide, and the response to a small transtissue hyperosmotic gradient. Intracellular and extracellular potentials, and measurements of subretinal [K+]o were obtained from an in vitro preparation of chick retina-RPE-choroid. Choroidal perfusion with each of 4 anion transport and Cl- channel blockers (DIDS, 4-acetamido-4' isothiocyanostilbene, phenylanthranylic acid, and thiocyanate) suppressed the light peak. DIDS, the most potent agent, abolished the basal membrane light-peak depolarization. Choroidal perfusion with azide depolarized the basal membrane and decreased its apparent resistance, Rba, as in cat (Linsenmeier and Steinberg, 1987). The basal membrane depolarization, recorded extracellularly as an increase in the transtissue potential (TTP), was blocked by DIDS. Azide also increased RPE c-wave amplitude, which could be explained by the decrease in Rba, and it suppressed the light peak. As previously described (Shirao and Steinberg, 1987), a 25 mOsm transtissue hyperosmotic load (retinal side hyperosmotic) increased the TTP, increased the c-wave and decreased the transtissue resistance. DIDS suppressed each of these effects. We conclude that the light peak, the response to azide, and the response to a retinal hyperosmotic load may each originate as an increase in a basal membrane anion conductance that may be permeable to chloride.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723763 TI - Ultrastructural demonstration of a gastric monosynaptic vagal circuit in the nucleus of the solitary tract in rat. AB - Previous light microscopic work in the rat has demonstrated that many dendrites of vagal gastric motoneurons extend beyond the cytoarchitectural boundaries of the dorsal motor nucleus of the vagus (DMV) into the nucleus of the solitary tract (NST), where they overlap with the central terminal field of vagal gastric primary sensory neurons (Shapiro and Miselis, 1985a). In the present ultrastructural study, the synaptic relationship of vagal afferent terminals and vagal motor neurons and dendrites was examined. Following injection of cholera toxin-HRP conjugate (CT-HRP) into the dorsal and ventral musculature of the stomach wall, centrally transported tracer was visualized using tetramethylbenzidine or diaminobenzidine histochemistry. Light microscopy confirmed the presence of retrogradely labeled gastric DMV neurons whose dendrites extended into the overlying NST. The subnucleus gelatinosus of the dorsomedial NST at a level just rostral to the obex contained the highest density of vagal motoneuronal dendrites coextensive with transganglionically labeled vagal sensory afferents. Ultrastructural analysis of several NST subfields at this rostrocaudal level revealed many asymmetric synaptic contacts between labeled sensory afferents and labeled motoneuronal dendrites in the subnucleus gelatinosus but not elsewhere. Following CT-HRP injection into the cervical vagus nerve in separate animals, vagovagal synaptic contacts were again observed only in the subnucleus gelatinosus, despite extensive afferent labeling in other NST subnuclei. The demonstration of a monosynaptic gastric vagovagal circuit provides the anatomical substrate for the relay of gastric interoceptive information directly to gastric vagal motoneurons, which may play a unique role in the central regulation of gastric motility and secretion. PMID- 2723764 TI - Intracellular pH transients of mammalian astrocytes. AB - Intracellular pH (pHi) is an important physiologic variable that both reflects and influences cell function. Glial cells are known to alter their functional state in response to a variety of stimuli and accordingly may be expected to display corresponding shifts in pHi. We used fine-tipped, double-barreled, pH sensitive microelectrodes to continuously monitor pHi in glial cells in vivo from rat frontal cortex. Cells were identified as glia by a high membrane potential and lack of injury discharge or synaptic potentials. Continuous, stable recordings of pHi from astrocytes were obtained for up to 80 min but typically lasted for approximately 10 min. Resting pHi was 7.04 +/- 0.02 with a membrane potential of 73 +/- 0.9 mV (mean +/- SEM; n = 51). With cortical stimulation, glia depolarized and became more alkaline by 0.05-0.40 pH (n = 50). During spreading depression (SD), glia shifted more alkaline by 0.11-0.78 pH (n = 26). After stimulation or SD, glia repolarized and pHi became more acidic than at resting levels. Superfusion of the cortical surface with 0.5-2 mM Ba2+ caused glia to hyperpolarize during stimulation and completely abolished the intracellular alkaline response. The predominant pH response of the interstitial space during stimulation or SD was a slow acidification. With superfusion of Ba2+ an early stimulus-evoked interstitial alkaline shift was revealed. The mechanism of the intracellular alkaline shift is likely to involve active extrusion of acid. However, internal consumption of protons cannot be excluded. The sensitivity of the response to Ba2+ suggests that it is triggered by membrane depolarization. These results suggest that glial pHi is normally modulated by the level of local neuronal activity. PMID- 2723765 TI - Afferent basis of visual response properties in area MT of the macaque. I. Effects of striate cortex removal. AB - The middle temporal area (MT) of the macaque monkey is a region of extrastriate cortex involved in the analysis of visual motion. MT receives strong projections from striate cortex and from area V2, which is dependent on striate for visual responsiveness. Accordingly, the visual properties of MT neurons have been thought to reflect the further processing of its input from striate cortex. We examined the dependence of MT activity on pathways deriving from striate cortex by recording from MT neurons following removal of their striate input. Repeated recordings in area MT were made in 4 hemispheres of anesthetized macaques following either partial or total ablations of striate cortex. Cells in MT were tested for responsiveness, selectivity for direction of motion and direction tuning, and ocular dominance. Receptive fields were also plotted. In an additional animal, we recorded from MT neurons during reversible cooling of the central representation in striate cortex. We found that striate cortex removal or inactivation did not abolish the visual responsiveness of the majority of MT cells. Although the residual responses were generally much weaker than in the intact animal, direction selectivity and binocularity were still present. Moreover, receptive field size and overall topography appeared unaltered. PMID- 2723766 TI - High-affinity uptake of L-kynurenine by a Na+-independent transporter of neutral amino acids in astrocytes. AB - L-Kynurenine (KYN), an intermediary product in the kynurenine pathway of tryptophan metabolism, is the common precursor from which are formed both quinolinic acid, a potent endogenous "excitotoxin," and kynurenic acid, a nonselective antagonist of excitotoxins. The present work examines 3H-KYN transport in primary astrocyte cultures derived from the cerebra of newborn mice. Influx and efflux of 3H-KYN were attributable almost entirely to carrier-mediated transport. The tritium recovered in uptake experiments was identifiable as 3H KYN, indicating a low rate of KYN metabolism during incubations up to 30 min. KYN uptake decreased in the presence of extracellular Na+, at least in part because KYN efflux was accelerated. Marked trans stimulation of KYN efflux by extracellular KYN provided evidence of the exchanging nature of the carrier. Saturation curves for the initial velocity of KYN uptake conformed to a 1 component saturable system with Km of 32 microM and Vmax of 2.1 nmol mg-1 protein min-1. KYN was notably concentrated by the astrocytes, with an estimated steady state distribution ratio of 180-fold for 1 microM KYN. Analog inhibition studies showed that the KYN transporter exhibited a clear preference for large neutral amino acids; leucine, tryptophan, and phenylalanine were recognized with relatively higher affinity than KYN. In summary, KYN is concentratively transported into astrocytes by a Na+-independent exchanger with high affinity for branched-chain and aromatic neutral amino acids. The substrate specificity and high affinity of this transport system resemble the properties of neutral amino acid transport across the blood-brain barrier in the rat and human. PMID- 2723767 TI - A comparison of movement direction-related versus load direction-related activity in primate motor cortex, using a two-dimensional reaching task. AB - Shoulder joint-related motor cortex cells show continuously graded changes in activity, centered on a preferred movement direction, during active arm movements in 8 directions away from a central starting position (Georgopoulos et al., 1982). We demonstrate here that many of these cells show similar large continuously graded changes in discharge when the monkey compensates for inertial loads which pull the arm in 8 different directions. These load-dependent discharge variations are typically unimodal, centered on one load direction called the cell's load axis, and are often sufficiently continuous, symmetric, and broad as to show a good fit to a sinusoidal curve. A vectorial representation of cell activity indicates that the pattern of load-dependent activity changes in the population forms a signal whose direction is appropriate to compensate for the loads. The responses of single cells to different combinations of movement and load direction are often complex. Nevertheless, the mean activity of the sample population under any condition of movement direction and load direction can be described reasonably well by a simple linear summation of the movement related discharge without any loads, and the change in tonic activity of the population caused by the load, measured prior to movement. The strength of the load-dependent discharge variation differs among cells. Cells can be sorted into 2 phasic and 2 tonic groups that show differing degrees of sensitivity to loads. In particular, it was found that the greater the degree of cell discharge variation associated with different actively maintained limb postures, the greater the activity changes caused by loads. No similar correlation was found for the degree of discharge variation during movement. Preliminary evidence suggests that phasic and tonic cell groups may be spatially segregated in the motor cortex. These observations are consistent with the idea that there exists in the motor cortex activity encoding aspects of movement kinematics, as well as movement dynamics. These observations are in agreement with studies of more distal arm joints, showing that the activity of certain motor cortex cells varies with the patterns of muscle activity and output forces required to produce a movement. These experiments extend the description of the control of the direction of movement of a multiple degree-of-freedom joint into the spatial (direction) domain to a greater extent than previously achieved. PMID- 2723768 TI - Physiological and anatomical studies of the interactions between Purkinje cells and basket cells in the cat's cerebellar cortex: evidence for a unitary relationship. AB - Intracellular recordings have been obtained from neurons in lobule V of the cat's vermis, which were identified as basket cells following intracellular injections of HRP. Stimulation of the inferior cerebellar peduncle or peripheral nerves elicited an initial depolarizing and subsequent hyperpolarizing response. Neither potential could be graded with changes in stimulus intensity; both displayed all or-none properties at threshold levels of stimulation. The depolarization and hyperpolarization were confirmed as an excitatory postsynaptic potential and an inhibitory postsynaptic potential (IPSP), respectively, on the basis of their response to intracellular injections of hyperpolarizing and depolarizing currents into the cell body. A possible source of the unitary IPSP is the Purkinje cell, via its recurrent axonal collaterals. To test this hypothesis, an electron microscopic analysis was carried out to define the synaptic relationships between the recurrent collaterals of an HRP-filled Purkinje cell and 3 basket cells. Serial section analysis reveals that collaterals from a single Purkinje cell contact several basket cells, but each basket cell received somatic input from only one Purkinje cell. These data provide an anatomical substrate for the unitary IPSP observed during intracellular recording from basket cells. The unitary nature of the Purkinje cell-basket cell interaction indicates that a very limited population of cortical neurons may be involved in local circuits that integrate afferent information in the cerebellar cortex. PMID- 2723769 TI - Optical recordings of the cortical response to whisker stimulation before and after the addition of an epileptogenic agent. AB - Optical recording methods using voltage-sensitive dyes were used to monitor activity in rat somatosensory cortex. We measured evoked signals in response to whisker stimulation before (control) and after the addition of the epileptogenic agent, bicuculline, and also detected spontaneous interictal events that occurred after bicuculline. Bicuculline led to an increase in the size, duration, cortical extent, and, surprisingly, the latency of the evoked responses. These enhanced evoked responses appeared to originate in the region of the control response and propagate outward. In contrast, the spontaneous signals appeared to originate at random cortical positions and had a more variable cortical extent. A transition signal measured just after the addition of bicuculline was larger than the control response but localized and rapid in time course. In most cases, there was a good correlation between the optical recordings and field potential measurements made with a ball electrode on the cortical surface, but there were occasional instances where the optical signal disappeared while the ball electrode signal was unchanged. PMID- 2723770 TI - Rapid remodeling of sensory endings in the corneas of living mice. AB - The terminals of trigeminal neurons were followed over time in the corneas of living mice by repeated staining with a nontoxic fluorescent dye. The purpose of these observations was to evaluate remodeling of sensory nerve endings in an adult mammal. Video images of topically stained nerve endings within particular corneal regions were recorded initially, and then again after intervals ranging from 4 hr to 30 d. Comparison of the 2 sets of images showed that sensory endings in the corneal epithelium undergo continual rearrangement under normal circumstances. Substantial changes in terminal configuration occurred over periods as brief as a day. PMID- 2723771 TI - Quantitative structure-activity relationship study on some dihydropteridine reductase inhibitors. AB - The dihydropteridine reductase (DHPR) inhibitory potencies of some 4 phenyltetrahydropyridines, 4-phenylpiperidines, and 4-phenylpyridines, are analyzed in relation to their physico-chemical and molecular properties. They are found to have significant correlation with Hammett constant sigma and the van der Waals volume Vw. The correlation is linear with sigma and parabolic with Vw. Hence, it is argued that DHPR inhibition involves dispersion interaction and is enhanced by electron donation from the substituents but hindered by steric effects produced by large substituents. It is also found that these electronic and steric effects are significant only when they are produced by substituents being at specific position in the molecules. PMID- 2723772 TI - Inhibition of serine proteinases by p-carbethoxyphenyl esters of epsilon guanidino- and epsilon-amino caproic acid: thermodynamic and molecular modeling study. AB - The inhibitory effect of the clinically used p-carbethoxyphenyl ester of epsilon guanidino-caproic acid methanesulphonate (epsilon-GCA-CEP) on the catalytic properties of human LYS77-plasmin (EC 3.4.21.7), bovine factor Xa (EC 3.4.21.6), bovine alpha-thrombin (EC 3.4.21.5), ancrod (EC 3.4.21.28), crotalase (EC 3.4.21.30), bovine beta-trypsin (EC 3.4.21.4), porcine pancreatic beta-kallikrein B (EC 3.4.21.35), human urinary kallikrein (EC 3.4.21.35) and the Mr 54,000 species of human urokinase (EC 3.4.21.31) was investigated (between pH 2.0 and 8.5, I = 0.1 M; T = 21 +/- 0.5 degrees C), and analyzed in parallel with that of the homologous derivative p-carbethoxyphenyl epsilon-amino-caproate hydro chloride (epsilon-ACA-CEP). On lowering the pH from 5.5 to 3.0, values of the apparent dissociation inhibition constant (Ki) for epsilon-GCA-CEP and epsilon ACA-CEP interaction with the serine proteinases considered increase, reflecting the acidic pK-shift upon inhibitor binding of a single ionizing group. Over the whole pH range explored, (i) epsilon-GCA-CEP interacts with bovine factor Xa and bovine alpha-thrombin with an higher affinity than that observed for epsilon-ACA CEP binding; (ii) both inhibitors associate to bovine beta-trypsin with the same affinity; and (iii) epsilon-ACA-CEP inhibits human Lys77-plasmin and the Mr 54,000 species of human urokinase with an higher affinity than that reported for epsilon-GCA-CEP association, thus reflecting the known enzyme primary specificity properties. However, the affinity of epsilon-ACA-CEP for ancrod, crotalase, porcine pancreatic beta-kallikrein-B and human urinary kallikrein, all of which preferably bind arginyl rather than lysyl side chains at the primary position of substrates and/or inhibitors, is paradoxically higher than that displayed by epsilon-GCA-CEP. By considering the amino acid sequences, the X-ray three dimensional structures and/or the computer-generated molecular models of serine proteinase: inhibitor adducts, the observed binding behaviour of epsilon-GCA-CEP and epsilon-ACA-CEP to the enzymes considered has been related to the inferred stereochemistry of proteinase: inhibitor contact region(s). PMID- 2723773 TI - Comparative effects of ketoconazole on rat, dog and human testicular steroidogenesis. AB - Ketoconazole is an antifungal azole derivative which also inhibits the cytochrome P-450(17)alpha, catalyzing the conversion of progestins into androgens. The effects of ketoconazole on human, dog and rat testosterone biosynthesis were compared using short term incubations of dispersed testicular cells. The results showed that ketoconazole inhibited androgen biosynthesis at lower concentrations in dispersed human testicular cells (IC50: 0.08 mumol/l) than in canine (IC50: 0.1 mumol/l) and rat cells (IC50 greater than or equal to 0.2 mumol/l). Furthermore, they demonstrated that ketoconazole first inhibited the 17,20-lyase activity and then the 17-hydroxylation in rat and dog cells whereas only the 17 hydroxylation was affected in human cells. PMID- 2723774 TI - A strategic plan for implementing nursing diagnosis into daily practice. AB - Staff development educators are instrumental as change agents in identifying the need for change, developing and implementing a strategic plan to unfreeze, change, and refreeze learning behavior, and evaluating its effectiveness. This article examines an attempt at one facility to implement nursing diagnosis into daily practice through the use of Lewin's change theory. The impact of driving and restraining forces is discussed as they facilitated or hindered adaptation to change throughout the process. PMID- 2723775 TI - Simulations: their selection and use in developing nursing competencies. AB - Efficient and effective use of simulations for teaching or review requires that they be matched carefully to a target nursing competency. Guidelines are provided to assist nursing staff development educators in selecting and using simulations for psychomotor assessment and interpersonal skills as well as problem solving. PMID- 2723776 TI - A hospital-based approach to physical assessment. AB - This article describes a hospital-wide physical assessment workshop program for all licensed nursing personnel that was initiated, administered, and evaluated. The process, administration, statistical evaluations, conclusions, and recommendations for future endeavors are discussed. PMID- 2723777 TI - Developing a preceptor program: what are the ingredients? AB - Facilitating the orientation process has historically been the responsibility of staff development personnel. In recent years, hospitals have experienced the need to enhance the clinical orientation of new nurses; thus, the preceptor has emerged as a viable means of orienting nurses to the clinical setting and in socializing the graduate nurse to the role of a professional nurse. This article discusses the preceptor program for nurse orientation at The Cleveland Clinic Foundation. PMID- 2723778 TI - Learning needs assessment. Part 1. PMID- 2723780 TI - Investigation of post-course application of discharge planning information on the nursing unit. PMID- 2723779 TI - Educational offering design model. PMID- 2723781 TI - Utilization of a staff development department to promote the philosophy and goals of nursing management. PMID- 2723782 TI - Nursing resources and the delivery of patient care: the National Center for Nursing Research Perspective. AB - The nursing shortage has preoccupied nurse executives with daily crises about how to provide adequate staff resources to assure quality care and how best to plan for the future. This major societal concern affects all settings--but most particularly hospitals. The National Center for Nursing Research (NCNR) has been actively assessing this situation and has begun several targeted initiatives. Nurse executives have a vital role in this evolving research priority area focused on nursing resources and its effect on quality of care. PMID- 2723783 TI - Converting nursing care cost to revenue. AB - The authors describe the process that bridges the gap between concept and reality by developing a successful system of charging for nursing services. By determining the cost of nursing services and extracting the nursing charge from the traditional room rate, nursing units are converted to revenue producers, with the ability to negotiate for managed care contracts, justify budgets and staffing, equate nursing with other revenue producing centers, and eliminate opinion about perceptions of the cost of nursing services. PMID- 2723784 TI - A theory development role for nurse administrators. AB - Nurse administrators can formulate useful theories while solving the complex problems of practice. An awareness of the mental perspective that frames one's thoughts about experiences can aid in theory development. Examples are developed to illustrate how different mental perspectives lead to different theories, decisions, and outcomes. It is argued that a system perspective, when used as an aid for conceptualizing experiences, will assist nursing administrators in developing theories that address their comprehensive sphere of activity and influence. PMID- 2723785 TI - A nursing diagnosis based model: guiding nursing practice. AB - Fiscal uncertainty, anxiety about nursing retention, and public scrutiny characterize the hospital milieu. During times such as these, introducing a conceptual model may appear inpractical and untimely. However, the conceptual model at Robert Wood Johnson University Hospital has demonstrated many practical applications. It guides nursing practice and provides a framework for quality assurance, documentation of nursing care, and education of nurses in the hospital. Future plans include using the model as a basis for developing a computerized care planning system and a method for cost accounting for nursing. The authors describe how the model serves to unify, give direction, simplify, and improve nursing practice. PMID- 2723786 TI - Effecting change through the stream analysis process. AB - The growing nursing shortage requires immediate and compelling changes in the work environment for nurses. The author describes a method for effecting change that nursing administrators can use to plan and implement change within complex health care environments. Stream analysis ensures a comprehensive analysis of many interactive problems and a plan for change that is multidimensional, coordinated, and congruent with the goals of the institution and the professional goals for nursing practice. PMID- 2723787 TI - Epidemiology, resources, and collaboration: an international perspective. PMID- 2723788 TI - The crisis in graduate education for nursing administration. PMID- 2723789 TI - Absenteeism-retention links. AB - Absenteeism and its relationship to retention was explored using Price and Mueller's 1981 model of turnover. Data were obtained from 71 hospital professionals by two questionnaires comprised of established instruments. Absenteeism data then were collected for six months. An empirical model of absenteeism is proposed that demonstrates the linking variables with retention and also reflects complex associations of intent to stay with turnover and absenteeism. Recommendations for reduction of absenteeism are included. PMID- 2723790 TI - The unit service clerk. AB - The role of service clerk has been implemented at the Medical Center Hospital of Vermont to provide ancillary assistance to nursing staff. This support system has resulted in increased direct patient care by nurses, greater job satisfaction, and a more effective use of financial resources. PMID- 2723791 TI - Dual degree. Future preparation for nurse executives? AB - What is the best educational preparation for top-level nurse executives? Which educational degrees will improve marketability? These questions were asked of nurse executives and their chief executive officers in a national market survey. The authors discuss the results of the survey which provides information that may be useful in selecting educational programs and in planning and revising graduate curriculum. PMID- 2723792 TI - Patient classification system evaluation. Part 1: Essential system elements. AB - How can nurse executives assure optimum patient classification system performance? This two-part series advances a framework for patient classification system (PCS) evaluation. Using an expanded definition of a PCS, part one presents a discussion of the six system elements considered essential to a fully operational PCS. Part Two offers a description of PCS selection criteria as well as keys to successful system implementation. Application of this evaluation framework allows for rapid problem identification and remediation, assists with PCS selection, and enhances overall system performance. PMID- 2723794 TI - Agency nursing: the hospital's response. PMID- 2723793 TI - A guide to tax-exempt bonds. AB - Nursing administrators are actively involved in hospital credit ratings. We review sources of funding for capital investments, bond rating agencies, and hospital bond ratings. The questions frequently asked of nursing are outlined as well as steps to prepare for a facility visit. PMID- 2723795 TI - Agency nursing: costs and quality. PMID- 2723796 TI - Head nurses: leadership skills project. PMID- 2723797 TI - Developing new models of care, roles, and responsibilities. PMID- 2723798 TI - The Nursing Research Program at Children's Hospital, Boston. PMID- 2723799 TI - Study of local atomic order in amorphous materials in a computerized transmission electron microscope. AB - Experimental results obtained by electron diffraction (ED) and extended electron energy loss fine structure (EXELFS) techniques to study the local atomic order in amorphous materials such as carbon, silicon, and its oxides are described. Potential applications of ED and EXELFS techniques and their limitations are also discussed. PMID- 2723800 TI - Magnetic field emission gun with zirconiated emitter. AB - A magnetic-field-superimposed field emission gun with low aberrations and equipped with a zirconiated tungsten emitter has been developed for applications where very stable high probe currents are required. It has been tested on a conventional electron microscope at 10 kV and on an electron beam testing system at 1 kV. Probe current i = 250 nA in a probe size d = 0.4 micron is obtained at 10 kV; at 1 kV the resolution is 0.1 micron with i = 5 nA, and 0.4 micron with i = 30 nA. For these probe currents, the spatial broadening effect due to electron electron interactions in the beam is the preponderant factor limiting the probe size. PMID- 2723801 TI - Which image parameter(s) for the automation of the electron microscope? AB - Experiments on automating the transmission electron microscope rely on the search for minimum variance. This image parameter gives satisfactory results for automatic focusing, astigmatism correction, and beam alignment. We investigate here the different image descriptors that might also be used; we conclude that texture parameters, which are directional, would be better candidates correcting astigmatism and beam tilt. PMID- 2723802 TI - Examples of high-resolution electron microscopy (HREM) investigation of complex oxides related to perovskite. AB - The properties of oxides may be drastically influenced by their microstructures. Thus the knowledge of nonstoichiometric mechanisms is an essential tool for the conception of new inorganic compounds by solid-state chemist. Through three chosen examples of complex oxides with perovskite-related structure, these points are illustrated. The new families of phosphate tungsten bronzes, the antiferromagnetic AMn1-xFexO3-y, and the copper oxides LCuO3-x (L = Ba, Y, La) were studied by high-resolution electron microscopy (HREM) in order to analyze the mechanisms of nonstoichiometry, the defects of which can modify their physical properties (magnetism or electronic conductivity) and the factors that govern their stabilization. PMID- 2723803 TI - Electronic core level microanalyses and microcopies in multipurpose apparatus. AB - Using an instrument equipped with two electron guns, an electron analyzer, and a Si(Li) diode detector, we developed microanalytical techniques based on inner shell electron excitations by incident electrons and X-rays, that is, electron energy-loss spectroscopy (EELS) in the reflection mode; electron probe microanalysis (EPMA) and X-ray appearance potential spectroscopy (XAPS); electron induced Auger electron spectroscopy (e-AES); X-ray photoelectron spectroscopy (XPS), X-ray absorption spectroscopy (XAS); X-ray induced AES (XAES), X-ray fluorescence analysis (XRF), and scanning X-ray radiography (SXR). The corresponding characteristic images (including X-ray microradiography and X-ray photoelectron microscopy) were obtained in the scanning mode. The principle of the apparatus is described. Each spectroscopy and microscopy is illustrated by an example. Their performance and limits are discussed. PMID- 2723804 TI - Transmission electron microscopy studies in relation to production of solar cells from polycrystalline silicon sheets (R.A.D. process). AB - Ribbon against drop (R.A.D.) ribbons exhibit a polycrystalline texture similar to that of most melt-grown ribbons; we review here the defects of as-grown materials as well as after the solar cells' production. PMID- 2723806 TI - Electron crystallography of organic materials. PMID- 2723805 TI - An application of high-resolution transmission electron microscopy to the study of the fine structure of dislocations in potassium feldspars. AB - An application of high-resolution transmission electron microscopy (HRTEM) to the study of two types of dislocations in potassium feldspars (K-feldspars) is shown here. HRTEM images were submitted to a filtering in order to improve their interpretation. One type of dislocation--(010)[001]--appears to be dissociated, with (010)[001]/2 planar defect, whereas the other one--(010)[110]/2--is perfect. This result helps provide an understanding of dislocation activation in this material. PMID- 2723807 TI - Interpretation of electron diffraction data from organic microcrystals: a theoretical perspective. AB - The current framework for the quantitative analysis of transmission electron diffraction data from organic microcrystals is discussed. The appropriate formulation depends upon the crystal perfection: solution-grown material tends to be nearly perfect with regular elastic bends whilst the epitaxial samples are usually considerably less perfect with highly irregular bends. It is possible to obtain Bragg intensity data which are near-kinematical and thus amenable to ab initio structure analysis. Thereafter, the further refinement of the model proceeds with a consideration of dynamical and crystal bending effects. If both of these are small it is a good approximation to analyse them independently rather than use the correct description of dynamical scattering from a deformed foil. The analysis of three-dimensional data sets from tilt series is considered. Although the technique has been successfully demonstrated in several instances there are still details of the analysis that need further clarification. PMID- 2723808 TI - Dynamic focussing for recording images from tilted samples in small-spot scanning with a transmission electron microscope. AB - For three-dimensional electron microscopical structure research the specimen must be imaged in a tilted position. Specimen tilt is also often needed to achieve an optimal molecular packing orientation. The tilt with respect to the optical axis causes a defocus gradient alongside the imaged area and thus entails the following complications: 1) The phase-contrast transfer function fades for strong defocus; 2) the Fourier coefficients are split; and 3) the signal-to-noise ratio cannot be enhanced by simple averaging. An image procedure with small-spot scanning and simultaneous defocus compensation is proposed which helps to reduce these problems. PMID- 2723809 TI - Control of specimen orientation and environment. AB - Application of electron microscopy in a wide variety of fields of investigation has placed ever-expanding demands on the various components of the instrument. In situ specimen manipulation is one such demand and can often be critical to the success of an experiment. Control of specimen orientation is the most common manipulation, but control of a variety of other physical and chemical parameters may also be important. Temperature, gaseous and/or liquid environment, and mechanical operations are examples. Control and variation of these parameters in a small device (occupying a few cm3) operated in a strong magnetic field inside a vacuum system is often a considerable challenge. This must also be done at extreme stability: at least as good as the resolution limit of the microscope. Optimization of stage performance is too often sacrificed for optical performance or vice versa. The next generation of objective lenses and specimen stages are being designed in concert: an approach which should lead to an improved in situ laboratory, observed with optimum optics. PMID- 2723810 TI - Electron diffraction of synthetic polymers: the model compound approach to polymer structure. AB - X-ray fiber diffraction is a technique most often used to establish the structure of chemically regular crystalline polymers. However, this technique has many shortcomings. Some of them are: ambiguities regarding the choice of the space group, limited intensity data, often large diffraction spots, and overlapping intensities. Microsingle crystals of synthetic polymers, when they can be produced, happen to have dimensions that are well suited to being studied by electron diffraction. Electron diffraction data from microsingle crystals often complement the X-ray fiber data. Strictly speaking, one does not solve the crystal structure of a polymer in the conventional way but rather one chooses from among many potentially acceptable models the one which fits the X-ray and/or the electron diffraction data best. The various steps of model building, its placing within the unit cell, and structure refinement will be discussed. PMID- 2723811 TI - Electron crystallography of linear polysaccharides. AB - The present article illustrates how the use of electron diffraction data coupled with realistic molecular modeling can yield to unambiguous structural elucidation of linear polysaccharides in the crystalline state. The series of the original ab initio quantitative crystal structure analyses is presented, along with a description of the methods. Pertinent examples showing the unique ability and utility of electron crystallography to yield new structural insights for biologically interesting macromolecules are given. PMID- 2723812 TI - Electron diffraction and diffraction contrast imaging of thin organic films. AB - The applications of electron diffraction and diffraction contrast electron microscopy with which to study the structure and dynamics of organic thin films are discussed. The techniques of making thin film deposits on substrates and of forming free-standing thin films over holes on the substrate are described. Selected area electron diffraction and diffraction contrast imaging techniques for thin film studies are elaborated, and examples are given. Methods to reduce radiation damage and environmental protection of the thin film specimen are outlined. The interpretation of electron diffraction and imaging data is given for three cases: 1) The effects of film tilting and molecular tilting (with respect to the film plane) are examined. 2) The detection of phase transition is illustrated. 3) The use of labels to mark film domains is shown together with the measurement of dynamic movement. PMID- 2723813 TI - Packing of linear molecules: an electron microscope study of disorder in mesophases and binary solids. AB - With the aid of epitaxial orientation techniques originally designed for linear polymer crystallization, it is found that a large assortment of linear chain molecules can be prepared for electron diffraction study in a projection onto the molecular axes. This not only facilitates a study of ordered monodisperse molecular crystal structures but also of the disordered state as well, including thermotropic phase transitions and the structure of binary solids. Representative studies of monodisperse and polydisperse phase behavior based on electron diffraction and differential scanning calorimetry measurements are reviewed for n paraffins, glycerolipids, and cholesteryl esters. The importance of observing the microcrystalline state is readily apparent from these studies--not only because the symmetry of individual small crystals can be determined, but also because local structural variations not detectable in bulk measurements are readily observed. PMID- 2723814 TI - High-resolution imaging of organic crystals. AB - The history of high-resolution imaging of organic crystals is summarized, followed by a discussion of radiation damage which reflects current thinking. Methods of specimen preparation and the experimental techniques for high resolution imaging are described. The results show the application of these techniques to aromatic hydrocarbons, phthalocyanines, and linear-chain aliphatic molecules. Artefacts and image interpretation are also discussed. PMID- 2723815 TI - Direct observation of molecular images of lanthanide phthalocyanines: III. Structural defects. AB - The crystal imperfections in thin films of lanthanide phthalocyanines (LnPc2H, Ln = Nd, Tb, Er, Tm, Yb, and Lu) grown expitaxially on KCl have been observed by molecular imaging. Grain and twin boundaries, stacking faults, point defects, vacancies, mosaic structures, and sometimes even some amorphous islands exist in the well-crystallized specimens. Combined with the results reported earlier, the packing characteristics of planar LnPc2H molecules can be well understood. PMID- 2723816 TI - Patterns of lipogenesis in laying hens fed a high fat diet containing safflower oil. AB - Lipogenesis by liver and ovarian tissue in vitro, incorporation of lipids synthesized de novo into the egg yolk in ovo, and the fatty acid composition of liver and yolk triglycerides were studied in laying hens fed a low fat control diet or 30% safflower oil diet for 3 wk. The study was conducted to determine if reduced triglyceride synthesis and the fatty acid composition of dietary fat could account for the changes in the fatty acid composition of liver and egg yolk triglyceride from safflower oil feeding. Triglyceride synthesis was reduced by safflower oil feeding. Relative distribution of labeled carbon into liver triglycerides and phospholipids was also reduced. In vivo incorporation of labeled carbon from [1-14C]acetate into egg yolk triglycerides and phospholipids closely paralleled that in liver slices, suggesting that the liver controls the pattern of lipid incorporation into yolk. The fatty acid composition of liver and yolk triglycerides was markedly altered by safflower oil feeding. The changes in fatty acid composition of yolk triglycerides could not be accounted for by the reduction in triglyceride synthesis and the fatty acid composition of safflower oil. PMID- 2723817 TI - Effects of dietary beef and soy protein on tissue composition and low density lipoprotein uptake in young pigs. AB - To study effects of dietary protein source on plasma cholesterol homeostasis, six littermate pairs of 8-wk-old, castrated male pigs were assigned randomly to high fat diets containing either lean beef or soy protein isolate, with beef tallow as the major fat source in both diets. Diets were fed for 6 wk, with blood samples taken weekly and analyzed for lipid composition. At 6 wk, each pig was injected with [3H]cholesterol- and [14C]sucrose-labeled low density lipoproteins, and serial blood samples were taken. Pigs were then killed, and several tissues were sampled. Results show that dietary beef or soy protein, when fed with beef tallow as a fat source, has differential effects on rates of uptake of intact LDL by heart, M. sartorius muscle and subcutaneous adipose tissue, and on rates of uptake of LDL cholesterol by net free cholesterol exchange in subcutaneous and perirenal adipose tissues. Dietary protein source affected the composition of only two tissues analyzed. Pigs fed the beef-based diet had greater lipid concentrations in M. sartorius muscle, whereas pigs fed the soy protein-based diet had greater lipid concentrations in heart. Source of dietary protein did not influence in vivo kinetics of LDL cholesterol removal from blood plasma. PMID- 2723818 TI - Transport of selenoamino acids and their sulfur analogues across the intestinal brush border membrane of pigs. AB - Transport of selenomethionine (Se-Met) and its sulfur analogue, methionine (Met), across the pig jejunal brush border membrane (BBM) was investigated using isolated BBM vesicles. Experiments were also performed to gain insight into the transport mechanism(s) for selenocystine. Se-Met as well as Met were transported by a single, Na+-dependent, carrier-mediated process common for both amino acids. Evaluation of the kinetic parameters revealed no differences between Se-Met and Met in the maximal transport velocity (Vmax) or in the Michaelis constant (Km). Furthermore, transport of Se-Met and Met showed similar characteristics with respect to electrogenicity and substrate specificity. In addition, evidence was obtained for a competitive inhibition of cystine transport across the BBM by selenocystine and basic amino acids. PMID- 2723819 TI - Identification of N-beta-L-aspartyl-L-phenylalanine as a normal constituent of human plasma and urine. AB - A new beta-aspartyl dipeptide, N-beta-L-aspartyl-L-phenylalanine (beta-AP), has been isolated and identified in urine and plasma from normal human volunteers. beta-AP was isolated from urine samples by high performance liquid chromatography (HPLC). Its identity and stereochemistry were demonstrated by HPLC and gas chromatography/mass spectrometry (GC-MS). The mean urinary beta-AP concentration in the subjects was 0.63 +/- 0.14 microgram/mg creatinine when averaged over two consecutive days of urine collection. Daily beta-AP excretion, determined from two 24-h urine samples collected from five individuals, was 801 +/- 117 micrograms/d (2.7 mumol/d). No diurnal rhythm was evident within the 24-h collection periods. beta-AP was also isolated from human plasma by HPLC and identified by GC-MS. Plasma from subjects contained approximately 5 ng beta AP/ml. Furthermore, beta-AP was formed when asparagine and phenylalanine were incubated with an enzyme extract from human kidney. Thus, at least some of the beta-AP present in humans, and presumably other beta-aspartyl dipeptides as well, appears to be synthesized endogenously. PMID- 2723820 TI - Effects of baking hulless barley on the digestibility of dietary components as measured at the ileum and in the feces in pigs. AB - The effects of different baking conditions on the apparent digestibility of dietary components were examined in pigs with an ileal cannula. The pigs were fed a hulless barley-based diet that was 1) uncooked, 2) baked for 4 h using high moisture, low temperature (37% dry matter, 121 degrees C) conditions (HMLT), or 3) baked for 1 h using lower moisture, high temperature (48% dry matter, 204 degrees C) conditions (LMHT). Ileal digesta and fecal dry matter were not different between the three diets. Pigs fed the HMLT and LMHT diets had 4% and 2% higher starch digestibility at the ileum, respectively, than did pigs fed the uncooked diet (P less than 0.05). Total Klason lignin recovered at the terminal ileum was similar for all diets even though initial Klason lignin values for the LMHT diet were twice that of the uncooked or HMLT diet. Digestibility of non starch polysaccharides (NSP) as measured at the ileum and in the feces of pigs fed the baked diets was about 10% higher than in pigs fed the uncooked diet (P less than 0.1). The ratio of NSP ileal digestion:NSP digestion as measured in the feces was over 0.75 for all diets. Baking increased digestibility in the barley based diet by increasing the digestibility of starch and dietary fiber. Increasing the severity of baking (LMHT) tended to decrease digestibility compared to the mild baking (HMLT), but not significantly. PMID- 2723821 TI - Ability of juvenile white sturgeon (Acipenser transmontanus) to utilize different carbohydrate sources. AB - Juvenile white sturgeon were fed isonitrogenous diets containing 27.2% glucose, fructose, maltose, sucrose, lactose, dextrin, raw corn starch or cellulose for 8 wk. Growth, body composition, plasma chemistry (with the exception of glucose), and liver glucose-6-phosphate dehydrogenase (G6PDH, EC 1.1.1.49), malic enzyme (EC 1.1.1.40) and isocitrate dehydrogenase (ICDH, 1.1.1.42) activities of sturgeon were significantly (P less than 0.05) affected by the different dietary carbohydrate sources. Sturgeon fed either the maltose or glucose diets had the highest percent energy retained, followed by those fed either the dextrin, raw corn starch or sucrose diets, whereas those fed either the lactose, fructose or cellulose diets had the lowest. Sturgeon fed either the maltose or glucose diets were hyperlipidemic, having twice the amount of plasma total lipid, triacylglycerol and total cholesterol as fish fed the other carbohydrate sources. These two carbohydrate sources were also more lipogenic: maltose- or glucose-fed sturgeon had significantly higher body lipid and liver G6PDH, malic enzyme, and ICDH activities. The poor ability of sturgeon to utilize either sucrose or lactose appears to be due to low intestinal sucrase (EC 3.2.1.48) and lactase (EC 3.2.1.108) activities. Intestinal aminopeptidase (EC 3.4.11.11), maltase (EC 3.2.1.20), sucrase and lactase activities of sturgeon were not affected by feeding different carbohydrate sources for 8 wk. PMID- 2723822 TI - Relationship between dietary intake and tissue levels of reduced and total vitamin C in the nonscorbutic guinea pig. AB - The objective of this study was to determine the effect of a broad range of dietary intake levels of ascorbate on the distribution of both total and reduced ascorbate in guinea pig tissues. Young male Hartley guinea pigs were fed for 2 mo a modified Reid-Briggs purified diet containing five different levels of total ascorbate that provided 0.8-52 mg ascorbate/d. We also fed aged guinea pigs two different levels of ascorbic acid (1.5 or 60 mg/d) for 2 mo. Reduced and total ascorbate was measured in eye lens and aqueous humor, liver, kidney and plasma. The data indicate that it is possible to markedly enhance the level of ascorbate in tissues above that obtained by feeding a diet that contains only enough ascorbate to prevent scurvy. In all tissues, as the level of total ascorbate present in the tissue increased, so did the proportion present in the reduced form. In old guinea pigs, the eye lens was the only tissue in which both reduced and total ascorbate were significantly lower than in the young guinea pigs at both high and low intake levels. PMID- 2723823 TI - Vitamin D is necessary for reproductive functions of the male rat. AB - The effect of vitamin D deficiency on the fertility and reproductive capacity of male rats was investigated. Male weanling rats were fed vitamin D-deficient or vitamin D-replete diets until maturity, and mated to age-matched, vitamin D replete females. Vitamin D-deficient males were capable of reproduction. However, successful matings, i.e., presence of sperm in the vaginal tract of the female, by vitamin D-deficient males were reduced by 45% when compared to matings by vitamin D-replete males. Fertility (successful pregnancies in sperm-positive females) was reduced by 73% in litters from vitamin D-deficient male inseminations when compared to litters from females inseminated by vitamin D replete males. These results demonstrate that vitamin D and its metabolites are necessary for normal reproductive functions in the male rat. PMID- 2723824 TI - Pyridoxine uptake by rat renal proximal tubular cells. AB - Uptake of [3H]pyridoxine by freshly isolated rat renal proximal tubular cells was temperature dependent and exhibited saturation kinetics, with estimated Kt and Vmax of 1.3 microM and 14 pmol/(10(6) cells.0.5 min), respectively. Pyridoxamine, 4'-deoxypyridoxine and 5'-deoxypyridoxal were as effective as unlabeled pyridoxine in inhibiting tracer uptake, whereas pyridoxamine-5'-phosphate, pyridoxal and 4'-pyridoxic acid had no effect, and other vitameric forms and structural analogs caused intermediate inhibition of cellular vitamin uptake. After 30 min, 88% of accumulated radioactive vitamin B-6 in cell extracts had been metabolized to phosphorylated forms and pyridoxal, which supports metabolic trapping as a mechanism responsible for the cellular accumulation observed. Initial uptake was significantly decreased in the presence of ethionine and ouabain; however, carbonylcyanide-p-trifluoromethoxyphenylhydrazone had no effect. Partial to complete substitution of NH4Cl and LiCl for NaCl had no effect, while partial substitution with RbCl caused significant dose-related inhibition of initial pyridoxine uptake. Amiloride also significantly decreased initial uptake. These data are consistent with a facilitated uptake process for pyridoxine that has substrate specificity and may be modulated by sodium-hydrogen exchange and/or pH gradient effects. Cellular uptake is followed by intracellular metabolic trapping catalyzed by pyridoxal kinase. PMID- 2723825 TI - Changes in pyridoxal phosphate and pyridoxamine phosphate in blood, liver and brain in the pregnant mouse. AB - A decrease in plasma pyridoxal-5'-phosphate (PLP) occurs during pregnancy in humans and experimental animals for reasons that are not known. To determine if mice also develop decreased plasma PLP concentrations during pregnancy, and if plasma PLP levels in pregnancy reflect tissue levels of PLP and pyridoxamine-5' phosphate (PMP), we measured PLP concentrations in plasma, erythrocytes and whole blood, and liver and brain PLP and PMP in control and pregnant mice. Mice were fed a nonpurified diet containing 8.13 mg pyridoxine-HCl/kg. The PLP analyses were performed in our newly developed apotryptophanase method in which the substrate S-benzyl-L-cysteine is hydrolyzed to benzyl mercaptan, reacted with Ellman's reagent and measured spectrophotometrically. During pregnancy, plasma PLP levels decreased 50% below control levels, but erythrocyte and whole blood PLP levels increased 2.9- and 1.6-fold, respectively. Liver PLP and PMP decreased 25%, in parallel with plasma PLP, but brain PLP and PMP concentrations were unchanged during pregnancy. These results suggest that metabolism or utilization of vitamin B-6 is altered in pregnancy, and that plasma PLP concentrations alone may not be a good indicator of nutritional status in pregnancy. PMID- 2723826 TI - Ascorbate enhances copper transport from ceruloplasmin into human K562 cells. AB - Copper uptake from human ceruloplasmin (Cp) into cells of a human erythroleukemic cell line, K562, was investigated. The interaction between ascorbic acid and the copper atoms in ceruloplasmin was a focal point of the study. Nondenatured 67Cu labeled ceruloplasmin (67Cu-Cp) was prepared by an ascorbate-catalyzed exchange of Cp with 67CuCl2 in vitro. The complex was stable, even in the presence of 1.0 mM ascorbate. Adding K562 cells and incubating at 37 degrees C resulted in an immediate transfer of 67Cu from ceruloplasmin to the cells. At 37 degrees C the copper accumulated by the K562 cells resisted dissociation by mild acid washing. The rate of transfer of 67Cu was proportional to the Cp concentration in the medium. Ascorbate (100 microM) enhanced the uptake of 67Cu at least fourfold. D Isoascorbate worked as well as L-ascorbate, suggesting that the reducing potential of the vitamin (or its isomer) was important in the uptake of copper. Approximately 20% of the 67Cu absorbed into the cytosol was precipitable with antibodies to Cu-Zn superoxide dismutase (Cu-Zn SOD). Ascorbate, however, did not enhance the incorporation of radioactivity into Cu-Zn SOD, suggesting that copper may not be the only rate-limiting factor in the synthesis of this enzyme in K562 cells. The possible relevance of these observations to vitamin C deficiency is discussed. PMID- 2723827 TI - Short-term malnutrition in neonatal rabbits: effect on gastrointestinal epithelial proliferation. AB - We determined DNA synthesis, cell turnover and cell migration in 72-h fasted and control neonatal rabbits because acute neonatal malnutrition causes specific regional alterations in brush border structure and function. Decreased cell turnover and/or migration might partly explain these observations. We injected fed and fasted neonatal rabbits with [3H]thymidine. At 1 and 72 h after injection we assessed cell proliferation and migration. Villus height was less in proximal small bowel from fasted rabbits (PF) than in fed controls (PC). Villus height was lower in proximal than in distal small bowel from fasted rabbits (DF). DNA synthesis, as measured by incorporation of [3H]thymidine into DNA, was less in PF and DF than in PC and distal small bowel from fed rabbits (DC) whether expressed per microgram DNA or per intestinal segment. Similarly, thymidine kinase activity was lower in PF and DF than in PC and DC. For both fed and fasted rabbits, more cells were present in the proliferative zone from proximal small bowel than in that from distal. Small bowel labeling index was less in PC than in DC, and less in DF than in DC. The ratio of the number of cells in the proliferative zone to the number of cells in crypt was greater in PC than in DC and greater in DF than in DC. The migration zone was significantly greater in PC than in PF and greater in the fed group in the proximal small bowel than in the distal small bowel. Thus, a 72-h fast in neonatal animals resulted in decreased DNA synthesis and cell migration. Regional alterations in cell proliferation occurred.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723828 TI - Beta-carotene and aryl hydrocarbon hydroxylase in the rat: an effect of beta carotene independent of vitamin A activity. AB - Animal models demonstrate a cancer-protective effect of vitamin A. However, human epidemiologic studies correlate the intake of the precursor, beta-carotene, rather than active vitamin A, to a reduced risk for certain cancers. This suggests that beta-carotene may have cancer-protective properties independent of its vitamin A activity. In the present rat study, effects of beta-carotene or active vitamin A on carcinogen metabolizing enzyme activity were evaluated. The activity of intestinal aryl hydrocarbon hydroxylase (AHH, EC 1.14.14.1) was higher in rats fed a purified diet supplemented with beta-carotene than in rats fed the control diet containing adequate vitamin A as retinyl palmitate (165 +/- 30 vs. 90 +/- 18 pmol/min x mg), P less than (0.05). Supplementing the control diet with retinyl acetate had no effect. This AHH-enhancing effect of beta carotene on the activity of the intestinal mucosal enzyme was not seen on the hepatic enzyme, which is consistent with the nearly complete conversion of beta carotene to vitamin A prior to reaching the liver. These results demonstrate an effect of beta-carotene on carcinogen metabolism which is independent of its vitamin A activity. This may help explain human epidemiologic data, and may lead to further work which would allow for prudent dietary recommendations toward a reduction in cancer risk. PMID- 2723829 TI - Conversion of dietary choline to trimethylamine and dimethylamine in rats: dose response relationship. AB - Trimethylamine (TMA) and dimethylamine (DMA) are normal components of human urine and are precursors of dimethylnitrosamine, a potent carcinogen. In part, DMA and TMA are products of the metabolism of dietary choline by intestinal bacteria. Most TMA formed in the intestinal tract is later oxidized and excreted as trimethylamine oxide (TMAO). Humans treated with large doses of choline smell "fishy" (the odor of TMA). Humans ingest choline as part of foods, and yet rarely smell fishy, suggesting that TMA formation must depend upon the dose of choline ingested. We found that, in adult rats, at low doses of choline (1.5 mmol/kg body wt) only 9 mumol choline (6% of the dose) reached the part of the intestine which is colonized by bacteria (the cecum and colon). After administration of 15 mmol choline/kg body wt, 237 mumol (16% of the dose) reached the cecum and colon. At both doses, 64-65% of the administered choline was absorbed from the intestine by 3 h after the dose. We found that orally administered choline slightly increased TMA and TMAO excretion at doses of choline smaller than 7 mmol/kg body wt, but that there was a disproportionately large increase in TMA excretion per 24 h when larger doses were administered (from 11 mumol TMA and 100 mumol TMAO per kg body wt in controls to 226 mumol TMA and 3617 mumol TMAO per kg body wt in rats treated with 15 mmol choline/kg body wt).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723830 TI - Effects of dietary fish oil or pectin on blood pressure and lipid metabolism in the DOCA-salt hypertensive rat. AB - This study investigated the effects of diets containing fish oil or pectin on blood pressure and lipid metabolism in the deoxycorticosterone acetate (DOCA) salt hypertensive rat. Three groups (8 rats/group) of unilaterally nephrectomized rats were fed for 21 d one of three purified diets: a) 8% fish oil + 2% safflower oil + 5% alpha cellulose (fish oil diet), b) 10% safflower oil + 5% pectin (pectin diet), or c) 10% safflower oil + 5% alpha cellulose (control diet). Each of the diets contained 6% NaCl and all rats received DOCA (30 mg/kg body wt, subcutaneously) twice weekly. Systolic blood pressure of rats fed fish oil was significantly lower (P less than 0.05) than that of rats fed the control diet; there was no significant difference between the pectin and control groups. Plasma renin activity and net sodium and potassium balances were similar among the three groups. Plasma total cholesterol, LDL cholesterol and HDL cholesterol were significantly lower (P less than 0.05) in the group fed the fish oil diet than in the group fed the control diet. Total, LDL and HDL cholesterol did not differ between rats fed the pectin and rats fed the control diet. Plasma triglyceride concentration did not differ among the three groups. Thus, dietary fish oil attenuated the development of DOCA-salt hypertension, unrelated to alterations of net sodium balance. Fish oil feeding also lowered total, LDL and HDL cholesterol, but did not alter the HDL/LDL ratio. In contrast, dietary pectin exerted no effect on blood pressure or lipid metabolism. PMID- 2723831 TI - Methionine hydroxy analog (free acid) reduces avian kidney damage and urolithiasis induced by excess dietary calcium. AB - Urinary acidification previously was shown to be an effective treatment for calcium-induced urolithiasis in domestic fowl, but diuresis caused by the acidifying agent (ammonium chloride) was an undesirable side effect. Because supplemental dietary methionine reportedly acidifies mammalian urine, an experiment was conducted to evaluate the efficacy of the free acid form of methionine hydroxy analog (MHA) as an acidifying agent for treating avian urolithiasis. From 5 to 17 wk of age, immature Single Comb White Leghorns were fed diets containing normal calcium (1%) or high calcium (3.5%). Diets were supplemented with 0, 0.3 or 0.6% MHA. Relative to birds fed the normal calcium diets, birds fed the high calcium diet without added MHA were in a state of metabolic alkalosis and excreted more alkaline urine containing high levels of calcium. Birds fed the high calcium diet without MHA also had significantly higher kidney asymmetry ratios, a higher incidence of gross kidney damage, and a higher incidence of urolith formation when compared with birds fed normal calcium diets. When compared with the high calcium diet without MHA, the high calcium diet supplemented with 0.6% MHA significantly acidified the urine without causing detectable metabolic acidosis, significantly reduced kidney asymmetry and gross kidney damage, and reduced the incidence of urolith formation without increasing water consumption or urine flow. These data demonstrate that MHA effectively prevents calcium-induced kidney damage in domestic fowl without causing undesirable side effects. MHA did increase both fractional and absolute calcium excretion during calcium loading. PMID- 2723832 TI - The contributions of individual factors to thromboembolic stroke. AB - To determine the importance of individual factors to thromboembolic stroke (TES) risk, the authors performed a hospital-based case-control study. Ninety cases (56 men and 34 women, ages 15 to 65) discharged from the hospital between January 1981 and December 1984 with a diagnosis of TES supported by computed tomography were matched to 174 control patients (106 men and 68 women). Data on potential risk factors were obtained from the medical record and telephone interview. Using multivariate analysis, three variables were significantly associated with TES risk: hypertension (odds ratio [OR] = 3.4; 95% confidence interval [CI] 1.9-6.0), diabetes (OR = 4.0; 95% CI 2.0-8.3), and smoking (OR = 2.0; 95% CI 1.2-3.6). The data were also analyzed using a direct risk assessment method. This analysis describes the risk in patients with any one factor compared with patients without any of the factors. The direct estimates of risk increased by 71% for hypertension (OR = 5.8), 28% for diabetes (OR = 5.1), and 90% for smoking (OR = 3.8). The authors conclude that hypertension, diabetes, and smoking are the major risk factors for TES in patients 65 years old or younger. PMID- 2723833 TI - How accurate are faculty evaluations of clinical competence? AB - OBJECTIVE: To determine the degree and sources of variability faculty evaluations of residents for the American Board of Internal Medicine (ABIM) Clinical Evaluation Exercise (CEX). DESIGN: Videotaped simulated CEX containing programmed resident strengths and weaknesses shown to faculty evaluators, with responses elicited using the open-ended form recommended by the ABIM followed by detailed questionnaires. SETTING: University hospital. PARTICIPANTS: Thirty-two full-time faculty internists. INTERVENTION: After the open-ended form was completed and collected, faculty members rated the resident's performance on a five-point scale and rated the importance of various aspects of the history and physical examination for the patient shown. MEASUREMENTS AND MAIN RESULTS: Very few of the resident's strengths and weaknesses were mentioned on the open-ended form, although responses to specific questions revealed that faculty members actually had observed many errors and some strengths that they had failed to document. Faculty members also displayed wide variance in the global assessment of the resident: 50% rated him marginal, 25% failed him, and 25% rated him satisfactory. Only for performance areas not directly related to the patient's problems could substantial variability be explained by disagreement on standards. CONCLUSIONS: Faculty internists vary markedly in their observations of a resident and document little. To be useful for resident feedback and evaluation, exercises such as the CEX may need to use more specific and detailed forms to document strengths and weaknesses, and faculty evaluators probably need to be trained as observers. PMID- 2723834 TI - Access to medical care in a medically indigent population. AB - OBJECTIVE: To study nature and extent of barriers to access to medical care in a single county and to define the nature of the illnesses in a population affected by those barriers. DESIGN: Descriptive study of consecutive patients not able to obtain medical care because of financial or other barriers. Financial barriers and medical diagnoses were categorized and the severity of illness and impact of unavailability of medical services were judged by a panel of internists using consensus analysis. The likelihood of obtaining care after refusal of assistance was also evaluated. SETTING: A social services eligibility office on the grounds of an urban, university teaching hospital that serves a largely medically indigent population. PATIENTS: 200 patients who presented to eligibility workers seeking financial assistance. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Sixty percent could not obtain care because they were illegal aliens, 40% could not obtain care because they did not meet the strict criteria of the assistance programs. Sixty percent of patients had a moderate to high likelihood of long term disability from their illnesses; 38% of a subgroup were not able to find care four weeks after entering the study, and these patients appeared to have more severe disease than those who were able to find care. CONCLUSIONS: Many medically indigent persons with significant illnesses face serious financial barriers to access to medical care. PMID- 2723835 TI - The likelihood of remaining normotensive following antihypertensive drug withdrawal. AB - OBJECTIVE: To determine the proportion and characteristics of mild hypertensives who remain normotensive after withdrawal from drug treatment. DESIGN: Longitudinal descriptive study. SETTING: A university family practice unit (FPU) and a large steel company (DOFASCO) in Hamilton, Ontario. PATIENTS: Participants were 107 of 125 (86%) eligible hypertensives at the two sites; 103 (96%) subjects completed the study. INTERVENTION: Subjects discontinued antihypertensive medication and were followed until blood pressure (BP) became elevated or for 12 months, whichever was shorter. MEASUREMENTS AND MAIN RESULTS: BPs were monitored according to a predefined schedule and before, during, and after mental and physical stress tests. Thirty-eight (37%, 95% confidence interval [CI] 27-46%) subjects remained normotensive at 12 months. Predictors of remaining normotensive included lower medicated standing diastolic blood pressure (DBP) (87.6 versus 91.8 mm Hg, 95% CI for the difference 2.2-6.2, p less than 0.001) and longer duration of normotension on drugs (12.6 months versus 8.7, 95% CI for the difference 0.9-6.9, p = 0.012). There was no significant relationship between maintenance of normotension and age, medication potency, duration of hypertension, weight, lying BP, change in heart rate, or BP during mental or physical stress tests; the power to detect a clinically important difference in lying DBP was 99% but for other variables was lower (21-75%). CONCLUSIONS: The probability of hypertensives' remaining normotensive for one year after drug withdrawal increases as the medicated standing DBP decreases and as the number of months of BP control while on medication increases. Studies with larger sample sizes are warranted to determine whether other variables may be significant predictors. PMID- 2723836 TI - An analysis of the quality of research reports in the Journal of General Internal Medicine. AB - Forty-four "original articles" published in the Journal of General Internal Medicine were reviewed using a rating instrument with 13 items developed from previously published standards for the design, analysis, and presentation of medical research. Each item was rated on a four-point (poor-to-excellent) scale. Inter-rater agreement was good (86% agreement; kappa = 0.65). Seven items received excellent or good ratings in 80% or more of the articles, but six problem areas were identified: description of study scope (generalizability), informed consent procedures, reliability assessments, references for statistical procedures or computer programs, and the use of descriptive and comparative statistics. Guidelines for these and other criteria are offered to help researchers prepare clear and informative reports. PMID- 2723837 TI - Caring for the frail older patient: the doctor-patient-family caregiver relationship. AB - Much has been written about the complexities of the doctor-patient relationship and the myriad ways that both parties communicate. When patients become more frail, this relationship must expand to include their family caregivers. This addition of a third person complicates the situation in more than an additive fashion. It requires more time and energy on the part of physicians that are not without costs. Balancing both patient and caregiver needs in a time-driven and increasingly competitive world is not easy. Physicians not only need better preparation to meet the challenges of caring for frail older patients, but they also need changes in reimbursement policies so that they can afford to spend the time needed to manage the complexities inherent in the doctor-patient-family caregiver relationship. Although there is uncertainty about timing of these changes, there is no uncertainty about the complexity of the doctor-patient family caregiver relationship. To make its management easier, the following rules are worth remembering: 1. Carefully assess problems in all domains of patient function and develop plans for managing and monitoring these problems. 2. Recognize that the effects of patient disabilities cycle between patient and caregiver. 3. Pay attention to the needs and concerns of patients and of their caregivers. 4. Provide caregivers with as much information as possible and educate them about "when to worry." 5. Assure caregivers that you are available to answer questions and help them with handling problems that arise in the care of their elders. PMID- 2723838 TI - AIDS and the limits of confidentiality: the physician's duty to warn contacts of seropositive individuals. PMID- 2723840 TI - The certified internist. PMID- 2723839 TI - Surviving bereavement. PMID- 2723842 TI - Criticizing the Journal. PMID- 2723841 TI - Access, health, and the general internist. PMID- 2723843 TI - Who talks to physicians? PMID- 2723844 TI - Consulting and being consulted. PMID- 2723845 TI - Chest x-ray before vascular surgery. PMID- 2723846 TI - Principle of least wave change. AB - Fermat's principle of least time has some well-known limitations. It does not, for example, apply to diffraction gratings and holograms, because it does not include the concept of waves. The substitution of least number of waves in flight for least time of flight and the addition of a term that is a function of the grating frequency result in a generalized principle. It is easy to remember because it is based on only the number of waves minus the number of grooves, and it would be especially useful when refraction and diffraction are combined, as, for example, in some holographic optical elements. PMID- 2723847 TI - Why are some spatial discriminations independent of contrast? AB - The accuracy of some spatial discriminations, including spatial frequency and orientation, is independent of the contrasts of the stimuli discriminated except when contrasts are near the detection threshold. This fact is surprising because higher contrasts should improve signal-to-noise ratios and performance. Two alternative explanations of this puzzle are examined, using a signal-detection theory vector model: (1) noise increases with stimulus contrast in such a way that signal-to-noise ratios remain constant; (2) noise is constant, but the difference signal generated by each individual tuned mechanism is independent of contrast because the response function of the mechanism becomes compressive (approximately logarithmic) at a low contrast. The alternative explanations generate different predictions, which have been tested in several experiments. The results reject alternative (1) as a model of suprathreshold discrimination and give mixed support to alternative (2). PMID- 2723848 TI - A second look at the double degree. PMID- 2723849 TI - Duplication of the face. PMID- 2723850 TI - Selecting software for video imaging. PMID- 2723851 TI - Surgical treatment of salivary gland tumors. AB - Two hundred fifteen patients (74.14%) with benign tumors and 75 patients (25.86%) with malignant tumors of the salivary glands were analyzed. One hundred eighty five of these patients were followed for 1 to 20 years postoperatively. Of 150 benign tumors, recurrence was noted in 15 cases (9.75%). The 5-year recurrence rate was 7.82%. With the malignant tumors, recurrence was noted in 16 patients (51.6%). The 5-year recurrence rate was 27.75%. PMID- 2723852 TI - Incidence of cleft lip and palate in Sri Lanka. AB - In a prospective study that surveyed 51,542 live births and 5,263 still births in central Sri Lanka, cleft lip with or without cleft palate (CL +/- P) was found to have an incidence of 0.83 per 1,000 births, and isolated cleft palate (CP) an incidence of 0.19 per 1,000 births. Distribution by sex, type of cleft, and site was similar to that in whites. Family history was positive in 19.6% of CL +/- P and in 9.1% of CP subjects. Furthermore, the frequency of CL +/- P in relatives of subjects with CL +/- P was significantly greater than that of CP. Of the three major ethnic groups that inhabit Sri Lanka, the incidence was significantly greater in the Moors than in the Sinhalese and the Tamils. Social status was found to have no association with the occurrence of clefts. PMID- 2723853 TI - Intraosseous and extraosseous calcifying odontogenic cyst (Gorlin cyst). AB - This retrospective study of 15 central and five peripheral calcifying odontogenic cysts (COCs) was undertaken to compare the characteristics of these two lesions. The data reveal that the central COCs were more common than peripheral lesions by a 3:1 ratio and that they were usually diagnosed in the second decade of life, whereas the peripheral ones were usually noted after the age of 50. Seven of the 15 central COCs (47%) were associated with odontomas, and three (20%) with dentigerous cysts. Conservative enucleation or excision was the treatment of choice. PMID- 2723854 TI - Treatment of mandibular fractures by means of compression osteosynthesis. AB - This report is a retrospective study of 76 patients with mandibular fractures treated by compression osteosynthesis. Good results were achieved in 83% of the cases. The complications encountered were either soft tissue infections or minor malocclusions. It was concluded that the relatively low rate of complications can be further reduced by careful selection of patients and meticulous performance of the technique. PMID- 2723855 TI - Patient response to temporomandibular joint arthroscopy: preliminary findings in 24 patients. AB - A group of 24 patients who underwent TMJ arthroscopy with lysis of adhesions and lavage of 28 joints were evaluated for changes in symptoms and mandibular opening. The mean follow-up period was 7.5 months. The results revealed a general improvement in pain, joint noise, and hypomobility following TMJ arthroscopy. Measurement of mandibular opening revealed a mean increase of 5.9 mm. These results suggest that TMJ arthroscopy appears to be an excellent modality for the palliation of symptoms of TMJ pain, joint noise, and hypomobility. PMID- 2723857 TI - Intubation by use of the light wand: experience in 253 patients. AB - Use of the light wand for 253 intubations in a variety of clinical settings is described. Twenty patients were successfully intubated by the light wand method who had failed to be intubated by direct laryngoscopy. Three failures were noted on patients who weighed more than 350 pounds each. Both nasal and oral endotracheal intubations were accomplished with minimal morbidity. PMID- 2723856 TI - Survey of TMJ arthroscopy in oral and maxillofacial surgery residency programs. AB - A questionnaire was mailed to oral and maxillofacial surgery residency programs in February 1988 regarding their indications for arthroscopy, number of patients treated, acquisition of skills, success of therapy, and several other questions about arthroscopy. Of the 56 questionnaires returned, 38 (68%) reported experience with TMJ arthroscopy. Pain and decreased range of jaw motion were the most frequently listed indications for surgery. Neural injuries were the most frequently seen complication. Four auditory canal perforations were reported. The operation was deemed successful in 64.8% of the patients. The most frequent criteria given for success were pain relief and increased range of motion. The main sources chosen by the respondents of this survey for acquiring skill in a residency program were information from the literature and hands-on training. PMID- 2723858 TI - Radiographic and microscopic evaluation of subperiosteally implanted blocks of hydrated and hardened alpha-tricalcium phosphate in rabbits. AB - Tissue response to preformed tricalcium phosphate (TCP) blocks prepared from alpha-tricalcium phosphate (alpha-TCP) powder by hydration and hardening at 80 degrees C was studied by implanting them subperiosteally on the buccal aspect of the mandible in rabbits. X-ray diffraction of the alpha-TCP powder showed a typical pattern of TCP, whereas a mixed pattern of TCP and hydroxylapatite was obtained after hydration and hardening. The radiographic findings at 4 weeks showed a tendency to bony union of the TCP block with the underlying bone. Microscopically, new bone that was being formed extensively from the underlying bone surface and filling the space between the block and bone at 4 weeks gradually changed into lamellar bone. There was no evidence of resorption of the TCP block throughout the experiment. The tissue response was essentially consistent with that to hydroxylapatite particles studied under similar conditions in our laboratory. It was concluded that the hydration and hardening of alpha-TCP powder may provide an implant block with a desirable contour that does not interfere with bone formation. PMID- 2723859 TI - Flow cytometric analysis of benign and malignant tumors of the oral and maxillofacial region. AB - One hundred eight fresh tissue samples obtained from normal tissues, benign tumors, and malignant tumors of the oral and maxillofacial region were analyzed for nuclear DNA content and cell kinetics by flow cytometric analysis (FCM). Mean DNA indices for 22 normal tissues and 18 benign tumors were 1.00 and 1.02, respectively, and all samples but one showed diploid pattern. On the other hand, the value for 68 malignant tumors was 1.38, and 66% of them showed an aneuploid pattern. The S phase and G2 + M phase cell populations for malignant tumors were 17.2% and 7.0%, respectively. With the exception of G2 + M phase cell population, all values for malignant tumors were significantly higher than those of normal tissue and benign tumors. Although statistical differences were not observed in most of the values, they were higher in squamous cell carcinomas than in malignant salivary gland tumors. The incidence of aneuploidy and DNA index showed a tendency to increase with the increase of T classification, in N2 and N3 tumors, and in the group of patients with recurrence or who died. The DNA index and the type of DNA ploidy were well correlated to malignancy grade determined by six histologic parameters, whereas the S phase cell population was correlated to mitosis. The analysis by the two-dimensional diagnostic supporting system showed that more than 80% of malignant tumors can be correctly diagnosed by combined values of DNA index and S phase cell population. The results indicate that nuclear DNA analysis by FCM is quite useful as a supplement to histologic diagnosis and evaluation of malignancy grade. PMID- 2723860 TI - The fascicular structure of the lingual nerve and the chorda tympani: an anatomic study. AB - Damage of the lingual nerve is one of the most common problems in oral surgery, especially during removal of the third molar. After microsurgery of the lingual nerve, there is a lack of regeneration of the gustatory fibers in comparison with the sensory fibers. The histologic investigation of ten human lingual nerve preparations showed that the chorda tympani fibers distribute widely in the fascicles of the lingual nerve. Therefore, after microsurgical reconstruction of the lingual nerve in the third molar region, the chance of the gustatory fibers meeting and regenerating is very low. PMID- 2723861 TI - The future of oral and maxillofacial surgery. PMID- 2723862 TI - Primary malignant melanoma of the oral cavity: a case report. AB - A rare case of a primary malignant melanoma of the upper alveolus with rapid spread to the cervical lymph nodes and brain in a 47-year-old man is described. PMID- 2723863 TI - Familial florid osseous dysplasia: a case report. AB - Most cases of florid osseous dysplasia are asymptomatic and are found during routine radiographic examination. The radiographic spectrum is similar to that of other benign fibro-osseous lesions, beginning as a radiolucent lesion and becoming more radiopaque as the involved bone becomes more sclerotic. Many benign fibro-osseous lesions demonstrate similar histologic features, and without other radiographic and clinical information, a definitive diagnosis may be impossible. The dense bone of florid osseous dysplasia is very susceptible to infection and osteomyelitis, particularly with advancing years and in response to trauma. The disease may be self-limiting as reported by many authors, but as in this case, can be symptomatic for most of the person's lifetime. This presents a diagnostic and treatment dilemma for the clinician. Although this entity has a distinct predilection for black women, more reported cases should be evaluated before the mode of inheritance can be established and before a tendency for familial cases in individuals of Italian descent can be confirmed. PMID- 2723864 TI - Severe facial trauma after orthognathic surgery with rigid fixation. PMID- 2723865 TI - Brachial plexus injury occurring during oral and maxillofacial surgery: a case report. AB - A case of brachial plexus injury occurring during bilateral temporomandibular joint reconstruction is reported. Patient positioning during surgery is the key to prevention of such injuries. PMID- 2723866 TI - The management of hemorrhage from severe missile injuries using Foley catheter balloon tamponade. AB - Foley catheter tamponade is introduced as a method of arresting hemorrhage from maxillofacial wounds due to war missiles. Three cases representing severe casualties are presented and the technique described. PMID- 2723867 TI - An acrylic head appliance for craniomaxillary fixation. AB - An acrylic head appliance for the treatment of LeFort fractures is described. The appliance remains stable and effective during the course of treatment. When immobilization is no longer needed, it may be removed without anesthetizing the patient. PMID- 2723868 TI - Transoral placement of rigid fixation following sagittal ramus split osteotomy. PMID- 2723869 TI - The nursing shortage. PMID- 2723870 TI - From the president. PMID- 2723871 TI - Factors affecting compliance in the home i.v. antibiotic therapy client. AB - Home I.V. Antibiotic Therapy has been an accepted form of treatment for infections requiring parenteral forms of antibiotics since the late 1970s. Most clients successfully complete their course of therapy without complications, but for those who do not, interventions can be instituted to reach a successful completion of therapy. It takes the creativity and special skills of the I.V. Therapy nurse to overcome some of these obstacles. With proper training and identification of potential problems, most clients can finish their course of I.V. Antibiotics without incident. PMID- 2723872 TI - Peripherally inserted central catheters--use in home care. AB - Reliable vascular access is essential for any type of intravenous therapy. The movement of many intravenous therapies to the home setting has placed a greater burden on home care nurses to maintain reliable vascular access. In the past, when peripheral venous access became unmanageable, a central venous device such as a tunneled silastic catheter or a polyurethane subclavian line was placed. Peripherally inserted central venous catheters now offer an alternative to this type of device. These devices, nicknamed long-arm or long-line catheters, are providing reliable vascular access for many therapies. They are inserted by specially trained nurses in the home. They offer fewer complications, decreased cost and improved patient comfort. The phlebitis rate and other catheter-related complications are examined. Nurse training and insertion procedures are explored in this small pilot study. PMID- 2723873 TI - Performance skill evaluations for i.v. nurses. AB - The ability to evaluate and document the skills of the professional I.V. nurse can be more than an idealistic fantasy. It is essential to understand the purpose of evaluations and to provide an effective tool to reach the goals of improving performance and documenting the quality of care provided. Having accomplished these basic steps, one can apply the use of the evaluation tool in peer review processes such as quality assurance, skill validations, policy and procedure review and revision, and staff education. PMID- 2723874 TI - Fluid and electrolyte therapy: considerations for patient care. AB - In today's world of health care, the registered nurse who practices intravenous therapy must possess a thorough and up-to-date working knowledge of the intravenous fluids that are administered. This is not only necessary for safe nursing practice but is essential for excellent quality patient care. Due to the many types of intravenous fluids manufactured and administered today, it is extremely vital that the I.V. nurse be entirely familiar with each one before it is administered. This article will outline fluid, electrolyte and nutrient requirements as well as the most common I.V. fluids administered, their indications for use, complications and side effects. PMID- 2723875 TI - Evaluation and use of advanced i.v. technology. Part 2: Patient controlled analgesia. AB - Although many conflicting studies report different results with the use of PCA, it has proven to be a safe and effective alternative to controlling pain in many clinical settings. The patients perception of the care is improved with the feeling of having more control. PCA can also decrease the demand on nursing time required by the P.R.N. I.M. injections, allowing time to deal with other aspects of the patients care. The use of PCA does place greater responsibility on the I.V. nurse to maintain the integrity of the system and prevent I.V.-related complications. PMID- 2723876 TI - Hemodynamics and blood flow distribution in experimental shock. The effect of noradrenaline and isoproterenol. AB - Cardiac output, regional blood flow and other hemodynamic variables were observed on dogs in hemorrhagic and in endotoxin shock. In hemorrhagic shock, a redistribution of cardiac output from other vascular beds to the coronary circulation was seen. This was induced by vasoconstriction in all vascular regions except the coronary arteries. In endotoxin shock, vascular resistance increased in some regions and decreased in others. A redistribution in favor of the mesenteric and femoral regions was seen. The coronary circulation was relatively well maintained in either shock models. Increased oxygen extraction was seen in all vascular beds. Blood pH was decreased corresponding to the degree and duration of the shock. Only small regional variations were observed in these variables. Noradrenaline increases vascular resistance in all regions except the coronary arteries. Isoproterenol reduces vascular resistance in all areas. Both drugs have cardiotropic effects. The same response was seen in normal as well as in shocked dogs. In addition to principal shock treatment, there may still be a place for the judicious use of these drugs in shock therapy. PMID- 2723877 TI - Fatalities in a stroke unit. AB - During the first 4 years of the CV unit the mortality rate among 464 patients was 5.2 per cent. The records of the 24 fatalities were reviewed. In the 10 patients submitted to autopsy the clinician's opinion of the cause of death was confirmed in 6 cases. In 4 cases autopsy revealed brain abscess, pulmonary embolism, acute myocardial infarction and pneumonia, respectively. Other significant findings not registered clinically were made in 4 cases. Twenty-three patients underwent a cerebral CT scan which showed positive findings in 19 cases. In one patient a brain abscess was misinterpreted as a brain infarction and in 2 other patients with a negative CT scan, autopsy revealed a small pontine and hemispheric infarction, respectively. Apart from the misdiagnosis of the brain abscess the accuracy of the CT scan was acceptable. Extracranial complications as a cause of or contributing to death in stroke patients are common. Prevention, early detection and treatment of these complications are important. The findings underscore the importance of autopsy in the evaluation of stroke patients. PMID- 2723878 TI - [Stomal recurrence following total laryngectomy--a clinicopathological study]. AB - A clinicopathological study of 10 cases of stomal recurrence following total laryngectomy treated at Kurume University Hospital from 1971 to 1986 was completed. The results of this study are summarized as follows: 1) The frequency of stomal recurrence was 5.8%. 2) Of these 10 cases, 3 cases were supraglottic (3%), 5 cases were glottic (7%), and 2 cases were subglottic (29%) carcinomas. The incidence of stomal recurrence was higher in subglottic carcinomas. 3) Nine cases out of 10 extend to the subglottic region. 4) The incidence of stomal recurrence was higher in emergency tracheostomy case. 5) Average of period from total laryngectomy to stomal recurrence was 9.7 months. 6) It is suggested that the cause of stomal recurrence is metastasis to the paratracheal lymphnode. 7) In order to prevent stomal recurrence, it is important to dissect paratracheal soft tissues bilaterally in high risk cases. 8) With regard to treatment, it is better to remove surgically the tumor and paratracheal soft tissues as completely as possible and to do postoperative radiation. PMID- 2723879 TI - [Experimental study on the eye movements induced by the electrical stimulation of the cerebellar nucleus in the rabbit]. AB - The purpose of this study is to investigate the induced eye movements by the cerebellar nuclei stimulation in the rabbits. Forty-five pigmented rabbits were used in this experiments. The cerebellar nuclei, especially medial nucleus, were stimulated electrically and the induced eye movements were observed. The results were as follows. 1. The horizontal nystagmus was produced by the electrical stimulation of the medial, anterior interposed, or posterior interposed nuclei. 2. The horizontal nystagmus towards the ipsilateral to the stimulated side was observed when the caudal portion of the medial nucleus was stimulated. On the other hand, the horizontal nystagmus towards the contralateral to the stimulated side was observed when the rostral portion of the medial nucleus was stimulated. 3. The latency of the field potential in the vestibular nucleus by stimulating the medial cerebellar nucleus, and that in the reverse situation, were 0.7 to 1.1 msec. 4. After the destruction of the lateral vestibular nucleus, no nystagmus was elicited by the stimulation of the medial cerebellar nucleus. From these results, it can be concluded that there is the monosynaptic connection between the medial cerebellar nucleus and the lateral vestibular nucleus. This indicates that the stimulation of the medial cerebellar nucleus produces the excitation of the vestibular nucleus via the cerebello-vestibular fibers and produces the nystagmus in the pigmented rabbits. PMID- 2723880 TI - [A study on the mechanism of phleboid olfactory function]. AB - Phleboid olfactory test has wide clinical application for olfactory disturbance. Many unclarified aspects still remain concerning the mechanism of smell after an intravenous infusion of Alinamin. It is believed that when Alinamin is infused intravenously and byproducts are discharged from the blood into the alveoli, odorous substances reach the nasal cavity through exhalation. In order to clarify the mechanism of smell in more detail, we conducted the following experiments: 1) Cases of laryngectomy were examined to determine if intravenous infusion of Alinamin affected the olfactory organ. 2) Saliva specimens in healthy subjects were collected before and after intravenous infusion of Alinamin and examined for the presence of a secreted odorous substance using a functional test. 3) Healthy subjects who were inhibited in their sense of smell were examined for the presence of garlic odor after intravenous infusion of Alinamin. The results were as follows: 1) 80% of subjects of laryngectomy without cotton in the nares and 20% of subjects of laryngectomy with cotton in the nares perceived the garlic odor. 2) Garlic odorous substance was not recognized in saliva specimens collected before and after intravenous infusion of Alinamin. 3) The healthy subjects inhibited in their sense of smell and intravenously infused with Alinamin perceived the odor at the same time as exhalation. The above results indicated that the mechanism of smell after intravenous infusion of Alinamin occurred via exhalation, but not through the other routes. PMID- 2723881 TI - [Mucormycosis in paranasal sinuses]. AB - Paranasal sinus mucormycosis is a rare and often fatal condition that occasionally occurs in patients with debilitating disease. Five mucormycosis cases with paranasal sinus involvement are reported. Two also complicated diabetes mellitus. These diabetic patients rapidly developed meningitis after the onset of symptoms. One case was soon operated upon and necrotic masses with fungus were excised. Despite i.v. amphotericin B administration, two patients lost their consciousness in a few days, relapsed into coma and died. In these cases, the infection originated from the ethmoidal sinus and directly spread towards the orbit and brain. The remaining three cases with mucormycosis had operations after the initial diagnosis of sinusitis. All of the three patients are alive and well. The combination of an excisional operation and antifungal therapy resulted in favorable response. High resolution CT scanning is valuable both in planning treatment and monitoring the response to therapy. PMID- 2723882 TI - [Gelle test in patients of Meniere's disease and fluctuating low tone hearing loss]. AB - The threshold shift at 500 Hz bone conduction under positive and negative static pressure of 400 mmH2O applied to the external auditory canal was examined in 20 patients of Meniere's disease with fluctuating low tone hearing loss, 21 patients of sensorineural hearing loss without fluctuating and 24 normal controls. In contrast to the 10 to 15 dB threshold shift in the latter two groups (non fluctuating group, 14.8 +/- 5.1 dB at positive and 11.1 +/- 5.7 dB at negative; normal controls, 13.6 +/- 5.4 dB at positive and 9.3 +/- 5.3 dB at negative), the former showed a significantly smaller shift (3.2 +/- 6.1 dB at positive and 2.3 +/- 4.5 dB at negative) while hearing was depressed. However, when the hearing was improved, the pressure effect became greater even in the former group (11.3 +/- 5.3 dB at positive and 9.1 +/- 4.8 dB at negative). To understand further details of these phenomena, we performed electrophysiological animal experiments. Through a small hole made on the guinea pig's cochlear bony wall, 300 mmH2O pressure was applied to the scala tympani and the threshold of 500 Hz CM was examined in both endolymphatic sac obliterated ears and non-obliterated ears. In 14 non-obliterated ears 21.1 +/- 5.1 dB threshold shift was recorded, whereas it was only 1.6 +/- 2.6 dB in 9 obliterated ears at 4-6th postoperative days. These results seem to reflect that the endolymphatic pressure is great during the early stage of hydrops.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723883 TI - [Facial bone fracture--statistical analysis and clinical aspects]. AB - We experienced 102 cases of facial bone fracture during 16 months of 1986 to 1987. These cases were analyzed statistically concerning causes, age and locations of the fracture. These fractures have increased rapidly in number. The causes were classified into three types; occurrence during sport, traffic accident and fighting, which were equal in number. There were 85% males and 15% females in the patient cohort, which were concentrated at the ages of 10-20 years. A large part of the fractures was mostly consisted of maxillo-facial components (95%). These trends were similar to the previous report of our clinic (1972-1979). On the other hand, not only severe dysfunctioning cases but also complicated cases increased in number, so that the several clinical aspects were reported. Case 1: 17-year-old male presented with retraction of left cheek caused by Rugby foot ball, whose malar bone was dislocated backward and anticlockwise, was treated with oroantral reduction and with the intermaxillary packing of silicon blocks. Case 2: 10-year-old boy with complaint of double vision occurred by head blow to right eye. Pure type blowout fracture of the orbital floor was presented, which was reconstructed by silicon plate from the incision of the lower eyelid. Case 3: 59-year-old male presented with 6 month history of diplopia and retraction of left eye ball, had been under the conservative care by an eye doctor. X-ray examination showed the intraorbital soft tissue was blown out into the ethmoidal sinus. However the transethmoidal reduction was performed, the result was not satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723885 TI - [High-resolution computed tomography of posterior tympanum]. AB - A complex set of sinuses, eminences and ridges lies in the posterior border of the tympanic cavity (posterior tympanum). The facial nerve canal is located between the facial sinus and the sinus tympani. The posterior limit is the posterior semicircular canal. The posterior tympanum is often the site of residual collection of granulation tissue or cholesteatoma, and is not directly visualized by the usual surgical approaches. Thus preoperative knowledge of cholesteatoma in these area is of obvious importance. It has been accepted that high-resolution computed tomography (HRCT) has the significant advantage to provide specific information of the middle ear. Contribution of the HRCT for diagnosis of posterior tympanum was examined by three temporal bone specimens and one hundred subjects with normal middle ear. In the experiments using the temporal bone specimens, each structure in the posterior tympanum was labeled by a fine needle. HRCTs were subsequently obtained to confirm the labeled structure. In one hundred subjects, it was examined whether each structure was also confirmed by the routine HRCT. Results are as follows: (1) Axial HRCT sections provided essential informations for the preoperative evaluation of the posterior tympanum. (2) Such bony structures as the pyramidal eminence and the pyramidal ridge were the most prominent structures on the posterior wall. (3) Laterally close to the pyramidal eminence lies one sinus which was marked by the needle placed in the facial sinus proper or in the lateral tympanic sinus; It is the facial sinus in a wide sense.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723884 TI - [Retinotectal and tectopontine projection in the guinea pig: experimental, anatomical and electrophysiological study]. AB - The collicular organization of mammals such as the rabbit, cat, and monkey have been well studied. However, little anatomical or physiological information about the guinea pig has been available. Consequently, the author studied the descending and ascending projections of the superior colliculus in the guinea pig by using both anterograde horseradish peroxidase conjugated with wheatgerm agglutinin (WGA-HRP) tracing and electrophysiological techniques, and the following results were obtained. 1. Evoked potentials were recorded from the superior colliculus contralateral to the site of photic stimulation of the retina. Recordings from the superficial layer of the superior colliculus displayed negative waves, whereas recording from the deeper layer displayed positive waves. 2. After intraocular injection of WGA-HRP, anterograde labels were observed in the stratum griseum superficiale and stratum opticum of the superior colliculus contralateral to the injection site. 3. Eye movements with deviation toward the upward or contralateral side were elicited by electrical stimulation in the intermediate layer of the superior colliculus. 4. After injection of WGA-HRP into the superior colliculus, transported labels were observed in the dorsolateral basilar pons ipsilateral to the injection site, and the paramedian pontine reticular formation contralateral to the injection site. These studies suggested that the pathway through the superior colliculus observed in the guinea pig is similar to that in other mammals. However, some differences may exist with respect to the processing of light signals and the mechanism causing eye movement. PMID- 2723886 TI - [Partial oxygen tension of middle ear cavity in a normobaric environment]. AB - The present theory of eustachian tube function and middle ear ventilation posits that oxygen absorbed by the middle ear mucosa causes negative middle ear pressure which is relieved by periodic opening of the eustachian tube during swallowing and yawning. Measured by a PO2 sensor (Clark type) inserted into the middle ear cavity of normal adults through the eustachian tube, the partial oxygen pressure of the tympanic cavity was found 53.7 +/- 6.5 Torr (N:22). It was about one-third of ambient pressure (about 150 Torr), and showed no change when the eustachian tube was opened by swallowing. Our second study measured the effect of alterations in the systemic arterial blood oxygenation on middle ear gas exchange in 23 guinea pigs ventilated using 21% (room air), 50%, 70% and 100% oxygen at constant carbon dioxide blood gas tension. Partial oxygen tension (PO2) of middle ear cavity was measured by inserting a PO2 sensor into the tympanic bulla through a bore hole. The following results were obtained: (1) PO2 of the middle ear cavity was 39.3 +/- 2.2 Torr at room air, 42.2 +/- 0.84 Torr at 50%, 46.6 +/- 1.1 Torr at 70% and 54.5 +/- 3.7 Torr at 100% oxygen breathing. (2) There was a significant correlation between PO2 of the middle ear cavity and systemic arterial hyperoxygenation noted. Y = 30.79 + 0.056.X (r = 0.9440) (3) The rate of oxygen diffusion in the middle ear cavity was 2.665 x 10(-5) ml/min/cm2 and the rate of oxygen absorption in the middle ear space was 2.874 x 10(-5) ml/min/cm2. No significant difference between the rate of diffusion and that of absorption of oxygen in the middle ear cavity was noted. In our third study, electron microscopy shows that the submucosal capillaries of the human mastoid cells are structures which facilitate the intra- and extravascular transport of substances. It is known from these results that tympanic cavity pressure is kept equal to ambient pressure, or slightly higher to atmospheric pressure, by the respiratory function of the middle ear and mastoid cells so that outflow of air from the tympanic cavity to the pharyngeal orifice occurs during the ventilation of the eustachian tube at ambient pressure and inflow of air from the pharynx to the tympanic cavity is prevented in the absence of environmental pressure changes. The middle ear cavity has respiratory function, and in particular, such function of the mastoid cavity, which is larger in volume than the tympanic cavity, plays a significant role.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 2723887 TI - [High-voltage electron microscopic observations on mouse olfactory bulb neurons]. AB - The fine structures of Golgi-impregnated mitral, tufted and granule cells in the mouse olfactory bulb were investigated by a high-voltage electron microscope. Observation was focused exclusively on intraglomerular dendritic trees of mitral and tufted cells as well as granule cell spines. These structures could be precisely observed under high-voltage electron microscopy in contrast to the vague observation available by light microscopy. Intraglomerular dendritic tufts of mitral and tufted cells possess a similar structure. Their most characteristic feature is varicose branches, which are morphologically classified into two parts, relatively thick parts and thinner parts. The latter consist of bead-like varicosities and thin segments less than 0.35 microns, combination of which take on a thread and beads appearance. Another common structure is small, spine-like appendages which can be seen on all parts of the tufts. Granule cell spines can be individually observed with the aid of stereoscopy, even where they are closely clustered. As a result, many more spines could be recognized by high-voltage electron microscopy than by light microscopy. The width of terminal swellings of spines in the granule cell layer are, in most spines, shorter than 0.4 microns. On the other hand, in the mitral body and external plexiform layer, sizes of spines are much more variable; larger ones with a width of between 1.0 and 1.5 microns as well as smaller ones between 0.4 and 0.5 microns are usually found. Consequently, these findings described above proved to be useful for attaining a deeper understanding of both light and thin section electron microscopic findings of these structures. PMID- 2723888 TI - [Sequelae and transient sequelae-like symptoms in Bell's palsy]. AB - Four symptoms of sequelae of Bell's palsy, such as abnormal synkinesis, facial spasm, contracture, and crocodile's tear were examined with 351 patients with Bell's palsy. As a result, it was seen transient sequelae-like symptoms which disappeared in recovery process. These 4 symptoms were divided into the persistent symptoms which persisted or appeared (sequelae) after 6 months from onset and the transient sequelae-like symptoms which disappeared before 6 months from onset (transient symptoms). The relation between the sequelae and the transient symptoms were examined. Transient facial spasm were shown only in mild cases with early cure, and it was deemed that these had no relation to sequelae. Other transient symptoms were shown in the cases with moderate and severe palsy, and it was deemed that these had a close relation to sequelae. The incidence of sequelae was 19%, and that of transient symptoms was 23%. Therefore, in order to discuss the actual behavior of the sequelae, it is important to investigate the sequelae with rejection of transient symptoms. PMID- 2723889 TI - [Prognostication of sequelae in Bell's palsy]. AB - Four symptoms of sequelae (abnormal synkinesis, facial spasm, contracture, and crocodile's tear) which persisted or appeared after 6 months from onset were examined with 351 patients with Bell's palsy. The incidence of sequelae were 2% in the group having score (May-Hosomi's modified method, 90 points method) over 40 points within 1 months after onset. Other hand, the incidence of sequelae were 15% in the group having score under 40 points at 1 weeks from onset, 30% in the group having score under 40 points at 2 weeks, 57% in the group having score under 40 points at 3 weeks, and 76% in the group having score under 40 points at 1 month. From these findings, it was seen that the prognostication with a high accuracy was possible by the score. PMID- 2723890 TI - Identification of hallucinatory themes in the Late Neolithic art of Hungary. AB - A number of factors that coalesced in the Venus figurines of the Late Neolithic culture from Hungary have been identified with dominant hallucinatory themes, suggesting the crucial role of ecstatic religion in this culture. This article provides a review of the nature and role of hallucinogens in the ecstatic religion of contemporary and historical cultures in order to establish a background for analysis. Analysis of these Late Neolithic artifacts indicates the presence of a number of themes associated with hallucinogen use: the presence of iconographic elements similar to eidetic forms; the use of red color; anthropo- and theriopomorphic figurines in seated postures; and specific patterns of breakage with disposal. The discussion illuminates the crucial features as well as the role and significance of these factors in ecstatic cults. PMID- 2723891 TI - LSD and creativity. AB - The effects of lysergic acid diethylamide (LSD) on creativity were examined in a unique experiment in the late 1950's. In this project, artists were asked to draw and paint a Kachina doll both prior to and one hour after the ingestion of LSD. Evaluations of these artistic productions were analyzed by a professor of art history in order to investigate the impact of LSD on artistic creativity. Certain representative changes were found in the artists' predominant style. The most significant change was noted in those artists whose styles were intrinsically representational or abstract to more expressionistic or nonobjective. Other changes noted included the following: relative size expansion; involution; movement; alteration of figure/ground and boundaries; greater intensity of color and light; oversimplification; symbolic and abstract depiction of objects; and fragmentation, disorganization, and distortion. Many artists judged their LSD productions to be more interesting and aesthetically superior to their usual mode of expression. The above-mentioned changes contributed to the artists' convictions that they were fashioning new meanings to an emergent world. PMID- 2723892 TI - Psychoactive properties of !Kung Bushmen medicine plants. AB - This article addresses some of the recent controversy over the role of psychoactive substances in the !Kung Bushmen healing ceremonies and trance induction. Although some contemporary works on the !Kung and their healing ceremonies give no evidence of the use of psychoactive plants, an examination of the available biochemical and pharmacological literature on the properties of these plants indicates that most contain psychoactive or toxic substances that are likely to have trance-inducing properties. Almost half of the !Kung medicine plants contain psychoactive substances or have toxic properties, and a similarly large group of these plants has psychoactive or toxic properties in related species. Although recent reports have shown little concern with the use of psychoactive substances, the earlier literature illustrated a major concern with their use in !Kung Bushmen trance and healing. This contrast with more recent research suggests a decline in the use of psychoactive plants in the recent past. This decline is examined with respect to changes in the !Kung Bushmen society and how attitudes in the United States regarding drug use may have influenced investigators and their research reports. PMID- 2723893 TI - A modern-day shamanistic healer in the Peruvian Amazon: pharmacopoeia and trance. AB - The functions and successes of shamanistic healers are addressed in the context of psychoneuroimmunology, which allows a description of how therapeutic success is achieved via the symbolic manipulation of biological processes. These perspectives reinforce the continued importance of traditional shamanistic healers in the contemporary world. This is illustrated by the activities of a Peruvian healer who utilizes both psychoactive plant substances and a syncretic combination of modern and traditional symbolic therapies. The reliance on a wide range of psychoactive plants, including both psychoactive substances and nonhallucinogenic plants, is shown to be empirically effective in the treatment of disease. This demonstrates the pragmatic and adaptive approaches of these traditional healers and their positive functions in treating a variety of illnesses in today's world. PMID- 2723894 TI - Transient nonketotic hyperglycinemia in neonates. PMID- 2723895 TI - Surface colonization with coagulase-negative staphylococci in premature neonates. AB - To follow the emergence of surface colonization with coagulase-negative staphylococci in neonates, we sampled four surface sites (axilla, ear, nasopharynx, and rectum) in 18 premature infants during the first 4 weeks of life. Swabs were obtained on the first day of life, twice weekly for 2 weeks, and weekly thereafter. Isolates were characterized by species, biotype, antibiotic susceptibility patterns, and slime production. Over 4 weeks the percentage of infants with Staphylococcus epidermidis as the only surface coagulase-negative staphylococci rose from 11% to 100%. Predominance of a single S. epidermidis biotype increased from none to 89%. Multiple antibiotic resistance rose from 32% to 82% of isolates, and the prevalence of slime production increased from 68% to 95%. This microbiologic pattern was established by the end of the first week of life and persisted throughout the month of study. In three infants, S. epidermidis sepsis developed with organisms identical to their predominant surface isolate. We conclude that species, multiple antibiotic resistance, and slime production appear to confer a selective advantage for the surface colonization of premature newborn infants in the intensive care nursery environment. Infants so colonized may be at greater risk for subsequent infection with these strains of coagulase-negative staphylococci. PMID- 2723896 TI - Effect of blood transfusion on apnea frequency in growing premature infants. PMID- 2723897 TI - Bone mineralization in former very low birth weight infants fed either human milk or commercial formula: one-year follow-up observation. PMID- 2723898 TI - Role of Ureaplasma urealyticum in bronchopulmonary dysplasia. PMID- 2723899 TI - Neutrophil storage pool depletion in neonates with sepsis. PMID- 2723900 TI - Cow milk protein as a cause of infantile colic. PMID- 2723901 TI - Administration of measles-mumps-rubella vaccine to children allergic to eggs. PMID- 2723902 TI - Management of meconium-stained neonates. PMID- 2723903 TI - Renal calcifications in preterm infants. PMID- 2723904 TI - Communicability of Pseudomonas infections in patients with cystic fibrosis. PMID- 2723905 TI - Pediatricians' knowledge of meningomyelocele. PMID- 2723906 TI - Association of intralipid with retinopathy of prematurity. PMID- 2723907 TI - C-reactive protein in bacteremia. PMID- 2723908 TI - Human immunodeficiency virus type 1 antigenemia in children. AB - Human immunodeficiency virus type 1 (HIV-1) core antigen was assayed in the plasma of children at risk for infection with HIV to determine its usefulness in the diagnosis of infection and to correlate it with the clinical stage of disease. Antigen was detected in the plasma of all children less than 15 months of age with acquired immunodeficiency syndrome (AIDS). Two thirds of children with AIDS-related illnesses and half of children with asymptomatic infection had antigen. Although 53% of plasma specimens originating from HIV-infected children younger than 6 months of age contained antigen, only 25% of plasma specimens from children younger than 6 months who had no symptoms and none of the 10 specimens from HIV-infected newborn infants contained antigen. Half of the specimens containing core antigen also contained anticore antibody. Quantitative mean antigen levels were more likely to be elevated in children with AIDS (516 pg/ml) than in children with AIDS-related illnesses (295 pg/ml) or in those who had no symptoms (70 pg/ml). Antigen levels tended to increase over time in children with advancing clinical illness, but they tended to decrease over time after a diagnosis of AIDS was made. Antigen was detected in the plasma of 4 of 14 children without symptoms who subsequently reverted to an HIV seronegative state. We conclude that the detection of core antigen occurs with high frequency in children, even young infants, with symptomatic HIV infection. Plasma core antigen was less frequent in children without symptoms and was not detected in 10 infected children when they were tested at birth. PMID- 2723909 TI - Hypercalcitoninemia and hypocalcemia in acutely ill children: studies in serum calcium, blood ionized calcium, and calcium-regulating hormones. AB - We studied the hypotheses that serum calcium and blood ionized calcium would be low in acutely ill children and would rise with clinical improvement. In 15 children admitted to the pediatric intensive care unit, the blood ionized calcium level was 4.45 +/- 0.06 mg/dl (1.11 +/- 0.015 mmol/L) on entry versus 5.17 +/- 0.03 mg/dl (1.29 +/- 0.01 mmol/L) in control subjects (p less than 0.005), rose significantly on days 2 and 3, and was 5.12 +/- 0.04 mg/dl (1.28 +/- 0.01 mmol/L) at discharge (p less than 0.005). Changes in serum calcium level were similar, whereas serum magnesium and phosphorus levels were normal and did not change. Basal serum parathyroid hormone concentrations were elevated, rose further during the study, and were normal at discharge. Serum parathyroid hormone levels correlated inversely with blood ionized calcium levels, indicating that compensatory hyperparathyroidism occurs with low blood ionized calcium concentrations. Basal serum calcitonin values were evaluated on entry and decreased with clinical improvement. Serum calcitonin levels correlated significantly with low blood ionized calcium levels, indicating that hypercalcitoninemia may play a role in the pathogenesis of hypocalcemia in these children. Urine calcium excretion was not increased in the four children studied. We speculate that with clinical improvement, a rise in serum parathyroid hormone levels and a decline in serum calcitonin levels may help restore normocalcemia in these acutely ill children. PMID- 2723910 TI - Metabolic evaluation of obese and nonobese siblings. AB - OBJECTIVE: To test the hypotheses that obese adolescents have a lower resting metabolic rate and less aerobic endurance than their nonobese siblings. DESIGN: Case-referent study of obese and nonobese siblings from the same kindred. SETTING: Tertiary referral center. PARTICIPANTS: Telephone screening of community volunteers resulted in a consecutive sample of 16 kindreds. Obese and nonobese siblings were similar in age, height, and pubertal status. Significantly more female subjects were in the obese group (p less than 0.01). MEASUREMENTS AND MAIN RESULTS: Body composition studies revealed that the obese siblings had higher body fat (p less than 0.001) but that fat-free mass was similar to that of the lean siblings. Resting metabolic rates determined by indirect calorimetry for the obese and nonobese pairs did not differ. Although the obese siblings appeared less fit when maximal oxygen consumption was measured in relation to total weight, maximal oxygen consumption did not differ when values were standardized for fat-free mass. CONCLUSIONS: The obese adolescents did not have a reduced resting metabolic rate. As in adults, the relationship between resting metabolic rate and fat-free mass was similar for obese and nonobese children and adolescents. Any decreased sport participation by the obese siblings was not due to inherent reductions in aerobic capacity. PMID- 2723911 TI - Attenuation of spontaneous, nocturnal growth hormone secretion in children with hypothyroidism and its correlation with plasma insulin-like growth factor I concentrations. AB - To define further the alterations in growth hormone (GH) secretion that occur in childhood hypothyroidism, we quantified spontaneous nocturnal secretion in seven patients with primary hypothyroidism. We examined the relationship between plasma insulin-like growth factor I (IGF-I) and GH secretory profile in each patient before and during therapy with L-thyroxine. In contrast to the results of previous studies that used pharmacologic tests of GH release, spontaneous GH secretion was consistently attenuated in the hypothyroid state. Mean nocturnal GH levels were reduced by 58% (1.48 +/- 0.38 ng/ml, mean +/- SEM) in comparison with values obtained during L-thyroxine therapy (3.54 +/- 0.71 ng/ml, p less than 0.01). Coincident with the reduced levels of GH, plasma IGF-I concentrations were lower in patients before therapy (0.46 +/- 0.20 U/ml) compared with concentrations during therapy (1.50 +/- 0.34 U/ml, p less than 0.01). In treated, euthyroid patients, GH and IGF-I levels were equivalent to those of normal children. The excellent correlation (r = 0.77) between plasma IGF-I and mean nocturnal GH concentrations indicates that reduced plasma IGF-I levels in hypothyroidism probably result from suppressed GH secretion. PMID- 2723912 TI - Familial XX chromosomal maleness does not arise from a Y chromosomal translocation. AB - To determine the mechanism for the coexistence of XX chromosomal maleness and true hermaphroditism in the same family, we performed cytogenetic and molecular genetic analyses, using DNA probes from the short arm of the Y chromosome. These studies excluded the following possible mechanisms: (1) an inherited, mitotically unstable Y chromosome that results in chromosomal mosaicism, (2) an inherited Y to-X or Y-autosomal translocation, (3) recurrent Y-to-X translocation, and (4) incomplete inactivation of the X chromosomal homolog for the testicular determining factor. We conclude that the disorder of sexual differentiation observed in this family can be best explained by a dominant autosomal gene with variable expressivity. PMID- 2723913 TI - Glutaric aciduria type I: enzymatic and neuroradiologic investigations of two kindreds. AB - Two kindreds with glutaric aciduria type I were investigated. Of 20 family members who underwent neurologic examination and organic acid analysis of urine, 18 had glutaryl-coenzyme A dehydrogenase (GDH) activity determined in cultured skin fibroblasts and 12 had computed tomographic brain scans. Six homozygotes were identified who had undetectable GDH activity and identical biochemical profiles (consisting of glutaric and 3-hydroxyglutaric aciduria, reduced serum carnitine concentrations, and frontotemporal atrophy). Serial computed tomographic brain scans of one homozygous infant demonstrated the sequential postnatal development of this atrophy during 3 years before the development of clinical manifestations. In three of the six homozygotes, including the father in one kindred, there were no clinical manifestations of glutaric aciduria type I. These findings raise questions about the value of prenatal diagnosis in predicting clinical manifestations in homozygous newborn infants. PMID- 2723914 TI - Hypocalcemia and critical illness in children. PMID- 2723915 TI - Cephalosporins for bacterial meningitis: which one is best? PMID- 2723916 TI - Lupus nephritis in childhood: cyclophosphamide--yes or no? PMID- 2723917 TI - Childhood hypersensitivity pneumonitis (farmer's lung): four cases in siblings with long-term follow-up. PMID- 2723918 TI - Morphometric facial changes and obstructive sleep apnea in adolescents. PMID- 2723919 TI - Scrotal hair in infancy. PMID- 2723920 TI - Coccidian parasites (Apicomplexa: Eimeriidae) from two species of caimans, Caiman yacare daudin and Caiman latirostris daudin (Alligatoridae), from Paraguay. AB - From October 1986 to January 1987, feces from 119 Caiman yacare and 12 Caiman latirostris were collected in Paraguay and later examined for coccidian oocysts; 69 of 119 (58%) samples from C. yacare and 3 of 12 (25%) samples from C. latirostris contained coccidian oocysts. Two eimerians infected C. yacare and both are described as new species. Sporulated oocysts of Eimeria paraguayensis n. sp. are ellipsoid, 34.0 x 23.6 (26-38 x 20-29) microns with sporocysts ovoid, 14.0 x 7.1 (10-19 x 6-10) microns. Sporulated oocysts of Eimeria caimani n. sp. are spheroid, 22.4 (19-29) microns with sporocysts ovoidal, 12.9 x 6.5 (8-17 x 5 8) microns. Isospora jacarei infected C. latirostris and is redescribed. Sporulated oocysts of I. jacarei are sub-spheroid, 13.2 x 12.1 (10-18 x 10-15) microns with sporocysts ellipsoid, 10.4 x 5.8 (7-13 x 4-11) microns. To date, members of the Eimeriidae found in Crocodylia include 5 species of Eimeria and 2 of Isospora including the new species described here. PMID- 2723921 TI - Re-establishing a life cycle of Schistosoma mansoni from cryopreserved larvae. AB - To study the feasibility of re-establishing a life cycle of Schistosoma mansoni (NMRI strain) from cryopreserved larvae, schistosomules were suspended in the cryoprotectant 1,2-ethanediol and cryopreserved in liquid nitrogen. Mice were injected intramuscularly with samples thawed after 3 days, 3 wk, or 6 mo in liquid nitrogen storage. Two to 5% of the cryopreserved larvae and approximately 18% of corresponding unfrozen control larvae developed into adult worms. Infectivity did not decrease as a function of storage time. The adult worms showed no structural damage or changes in overall size and morphology when examined by light and transmission electron microscopy. Female worms derived from cryopreserved larvae had the same or slightly elevated egg production as controls, but tissue egg distributions were comparable. Subsequent passages through Biomphalaria glabrata snails and mice revealed no difference in snail prepatent death rate, percentage of snails infected, cercarial production per snail, or cercarial infectivity. PMID- 2723922 TI - Comparison of egg excretion and serum pepsinogen levels as measures of nematode worm burdens in calves with limited pasture exposure. AB - Four- to 6-mo-old calves raised on clean pastures were allowed to graze for about 30 days on pastures naturally contaminated with Ostertagia ostertagi, Cooperia spp., Haemonchus placei, and Nematodirus helvetianus. The calves were then housed on concrete for 3 wk before slaughter. At necropsy the eggs per gram of feces (EPG) and the total worm burdens from the abomasum and small intestine were determined. Blood samples were also obtained for serum pepsinogen (PEP) assays. A total of 44 calves was sampled over 27 mo. Adult worm totals were distributed more normally after logarithmic transformation (LOGTOTAL), and EPG and PEP were distributed more normally after square root transformation (SQRT--EPG; SQRT- PEP). Correlation between LOGTOTAL and either SQRT--EPG or SQRT--PEP was about 0.7. These correlations were higher than those obtained with nontransformed data, suggesting that either EPG or PEP are easily measured variables that explain a significant amount of the variation observed in total worm burdens. Polynomial regression models of a cubic order using the SQRT--EPG accounted for 78% of the variation observed in the LOGTOTAL, whereas SQRT--PEP accounted for 58% of the variance. Within the range of worm burdens observed, these results indicate that EPG has value in estimating total worm burdens of naturally infected calves, and that pepsinogen levels are of less value for analysis of total worm burden in calves with a limited previous exposure to trichostrongyle nematodes. PMID- 2723923 TI - Anti-filarial effects of nine quinoline-containing drugs on adult filariae in vitro. AB - The potencies and efficacies of 9 quinoline-containing anti-malarials including chloroquine, (bis)desethylchloroquine, SN6911, SN12108, amodiaquine, CN-2999-2K, primaquine, quinacrine, and quinine were examined in vitro against adult female Brugia pahangi. Parasite motility and lactate excretion were measured as indicators of drug effects. All of the agents tested showed time-dependent increases in potency over a 24-72-hr incubation period. SN12108 was the most potent at 72 hr, reducing motility by greater than or equal to 50% (IC50) at 1.0 x 10(-7) M. Chloroquine (IC50 2.3 x 10(-6) M), desethylchloroquine (IC50 7.0 x 10(-6) M), quinacrine (IC50 1.9 x 10(-6) M), and quinine (IC50 1.5 x 10(-5) M) were the least potent. All of the drugs caused time-dependent decreases in lactate excretion, except quinine; decreases were found to be dose dependent. A high correlation (r greater than 0.85) was seen between time-dependent effects on motility and lactate excretion. The effects of chloroquine (10 microM) on motility were also examined in female Acanthocheilonema viteae, Dirofilaria immitis, Onchocerca volvulus, and male Onchocerca gutturosa. Dirofilaria immitis was less sensitive to chloroquine than B. pahangi; A. viteae was equally sensitive. Species of Onchocerca were the most sensitive parasites studied. Adult O. gutturosa and O. volvulus were affected by 10 microM chloroquine within 4-6 hr; motility was reduced by 80% within 24 hr. Although the mechanism of anti filarial activity of the quinoline-containing drugs is not known, their in vitro activity against a variety of adult filariae at clinically relevant concentrations, as well as differential sensitivity seen between the different filariae examined, warrants further study of these compounds. PMID- 2723924 TI - Efficacy of ivermectin in hookworms as examined in Ancylostoma caninum infections. AB - Single oral doses of ivermectin were given to dogs with moderate or heavy infections of Ancylostoma caninum (egg counts ranging from 7,100 to 41,700 eggs/g feces) at 100, 50, 30, or 10 micrograms/kg body weight. Each of these dosages was effective in clearing the infection completely, so that numerous worms were passed in the feces on days 1-3, but no worm was recovered from the intestinal tract at necropsy on day 4 after treatment. In contrast, an average of 178 worms per dog was recovered at necropsy from the vehicle-treated control and the untreated animals. Albendazole, a known anti-hookworm agent, even in a dose of 400 mg, eliminated only 21-65% of the worms harbored by the infected animals. No untoward reaction to ivermectin or significant pathological change was noted in the experimental animals. In vitro experiments demonstrated that ivermectin: (1) was highly detrimental to actively motile adult worms in concentrations greater than 5.60 micrograms/ml; (2) was detrimental to eggs inside the uterine tissue of female worms in dosages at or greater than 10 micrograms/kg body weight; and (3) killed infected larvae in concentrations as low as 0.0025 micrograms/ml. PMID- 2723925 TI - Efficacy of hyperimmune bovine colostrum for prophylaxis of cryptosporidiosis in neonatal calves. AB - Twelve neonatal calves were experimentally infected with oocysts of Cryptosporidium parvum. Six calves in group A fed hyperimmune colostrum at birth had significantly less diarrhea and shed oocysts for less time than did 6 calves in group B fed colostrum from cows that were not hyperimmune. Calves in group A had diarrhea for 0-4 days (means = 2.3 days), whereas calves in group B had diarrhea for 4-6 days (means = 5.0 days). Calves in group A shed oocysts for 4-9 days (means = 6.2 days), whereas calves in group B shed oocysts for 7-11 days (means = 8.5 days). These findings indicate that passive lacteal immunity conferred partial protection against cryptosporidiosis. Whether such protection was provided by the immunoglobulins that were highly elevated in the colostrum (greater than 1:200,000 for IgG1, IgM, and IgA) and constituted a large part of the circulating antibody in the calves, or by other biologically active factors, such as cytokines, is undetermined. PMID- 2723926 TI - Effects of pyran copolymer on host resistance of mice to Plasmodium yoelii. AB - Female B6C3F1 mice treated with 25 mg/kg pyran intravenously (i.v.) on days -4 and -3 were more susceptible to nonlethal Plasmodium yoelii 17XNL or lethal Plasmodium berghei ATCC-30090 than untreated mice or mice treated intraperitoneally (i.p.). Female B6C3F1 mice treated with pyran i.p. displayed enhanced resistance to Listeria monocytogenes as compared to untreated mice or mice given pyran i.v. Peritoneal exudate cells (PEC) primed by pyran i.p. possessed enhanced ability to kill Listeria but impaired ability to destroy Plasmodium. Phagocytosis of Covaspheres by PEC was greater for mice given pyran i.p. than those given pyran i.v. Chemiluminescence evoked by zymosan was less for PEC from mice given pyran i.v. than for those from untreated mice or those given pyran i.p. Chemiluminescence was greater for adherent splenocytes from mice treated with pyran i.p. than for those from untreated mice or those from mice treated i.v. Pyran administered i.v. is less effective in modulating the host immune response than pyran administered i.p. Immunomodulatory agents such as pyran have adverse as well as beneficial effects depending upon the route of administration. PMID- 2723927 TI - Morphology of Leishmania braziliensis: changes during reversible heat-induced transformation from promastigote to an ellipsoidal form. AB - Leishmania braziliensis, growing axenically at 26 C and transferred to 34 C, changes within 3 hr from the long slender motile promastigote form to an ellipsoidal form with a nonmotile flagellum. This transformation is reversible for heat treatments of up to 12 hr. In this study we show by light microscopic measurements that the cells decrease in length and increase in diameter at constant volume. Quantitative morphometry of electron micrographs further demonstrates that: the distance between nucleus and kinetoplast decreases; the kinetoplast enlarges slightly; the distance between adjacent subpellicular microtubules decreases; and that after 3 hr of heat treatment there is no change in mitochondrial morphology, but after 6 hr of heat treatment the mitochondria lose their cristae and no longer possess a clearly defined double membrane. These observations are compared with the morphological changes that occur normally in the gut of a sandfly and in the in vivo transformation occurring during infection of the mammalian host and of macrophage cultures. PMID- 2723928 TI - Influence of Lernaeocera branchialis (Crustacea: Copepoda) on growth rate of Atlantic cod, Gadus morhua. AB - Influence of Lernaeocera branchialis, a hematophagous copepod, on the growth rate of Atlantic cod, Gadus morhua, was investigated in fish of various sizes. Initially, it appeared that growth, over a 16-mo period, was reduced when single or multiple infections were present. We then examined growth rate by comparing food consumption, weight gain, food conversion efficiency, and condition (k) factor over a 2-mo period and subsequently over a 4 wk in control and experimentally infected fish. Total body weight and length of each fish, controls and infected were determined before and after feeding known weights of food. Adults infected with young parasites consumed more food and gained more weight than controls, especially in the first month, but food conversion efficiency and k-factor were greater than those of controls after 2 mo, but food efficiency was still lower than in controls. In 2 groups of young infected fish, all values were consistently lower than those of uninfected fish of comparable size during the 2 mo period. Three additional trials on immature cod confirmed that infected fish consumed less food and exhibited less growth than infected controls. Our results suggest that only adult cod infected with immature parasites compensate for the infections by increasing food consumption, thus resulting in a transitory weight gain. Additionally, parasites that have completed their reproductive activities still produce subtle effects in the form of low food conversion efficiency in their hosts. PMID- 2723929 TI - Effect of testosterone on the susceptibility of C57BL/6 mice to infection with Brugia pahangi with reference to inflammatory cell response. AB - Effects of testosterone on the susceptibility and inflammatory cell responses of C57BL/6 mice infected intraperitoneally with Brugia pahangi larvae were examined. On day 15 postinfection, female mice showed significantly greater resistance than did males, and peritoneal cell responses (lymphocytes, macrophages, and eosinophils) were great in females. Castration of highly susceptible male mice increased their resistance and peritoneal cell responses to the level of female mice; whereas, castration of female mice did not affect the susceptibility and cell responses. Furthermore, testosterone treatment at a physiological dose in the castrated male mice or a pharmacological dose in female mice suppressed resistance and inflammatory cell responses. These results suggest that male sex hormone, testosterone, but not female sex hormone has a regulatory role in the susceptibility and cellular response of C57BL/6 mice to infection with B. pahangi, and it causes differences between sexes in susceptibility. PMID- 2723930 TI - Susceptibility of inbred mice to Paragonimus miyazakii infection. AB - Differences in the susceptibility among inbred strains of mice to Paragonimus miyazakii infection were examined. Recovery of worms varied among the strains used. More were recovered from BALB/c mice than from any of the other strains; whereas, the fewest were recovered from C57BL/6 and C57BL/10. No worm formed a cyst in the lung or matured in any of the strains. PMID- 2723931 TI - Orbital hydatid cyst of Echinococcus oligarthrus in a human in Venezuela. AB - This study reports the first known case of human hydatid disease caused by the larval stage of Echinococcus oligarthrus. The patient, a native Venezuelan female, presented a single cyst localized intraorbitally behind the left eye (retroocular), which was discovered by computed tomography. The cyst was removed by surgery, and after parasitological studies it was identified as an E. oligarthrus hydatid cyst. This is also the first case of intraorbital hydatid cyst in humans in Venezuela. PMID- 2723932 TI - Survival of Trichinella muscle larvae in frozen wolf tissue in Italy. AB - Living larvae were collected in central Italy from the masseters of a wolf frozen for 6 mo. These parasites were identified as a southern Palearctic species (Trichinella sp. 3) through gene-enzyme analysis. At the second passage in laboratory mice, the muscle larvae were unable to survive at - 10 C for 5 days. Biological and epidemiological implications are discussed. PMID- 2723933 TI - Schistosoma mansoni: egg morphology and hatchability. AB - Schistosoma mansoni eggs were isolated and staged microscopically according to size. The eggs were then allowed to hatch and were reexamined; the hatching percentage of mature eggs was calculated. The results show clearly that not only do immature eggs not hatch, but also mature eggs greater than 160 microns fail to hatch. PMID- 2723934 TI - Antibiotics and cholestyramine in the treatment of persistent diarrhea in infants. PMID- 2723935 TI - Crohn's disease lesions in the upper gastrointestinal tract: correlation between clinical, radiological, endoscopic, and histological features in adolescents and children. AB - The incidence of Crohn's disease (CD) lesions in the upper gastrointestinal (GI) tract of both adults and children is frequently underestimated. In this prospective study, a total of 31 children suspected of having Crohn's disease were systematically examined to identify upper digestive tract lesions. They all underwent barium transit endoscopy with multiple-level biopsies. Typical clinical symptoms suggestive of upper GI tract involvement were found in 5 children (16%), radiological signs in only one child (3%), endoscopic lesions in 13 children (42%), and specific granulomas in 12 children (39%). In eight of these 12 children, the biopsies were taken from macroscopically normal areas of the esophagogastroduodenal mucosa. One of the 31 children had no abnormal radiological and endoscopic features suggestive of CD on the distal small bowel and the colon. There was no correlation between the clinical, radiological, and histological data. Endoscopy plus biopsy provided a positive diagnosis in 39% of cases and a confirmation of the diagnosis in 87% of cases. Endoscopic and histological evidence of CD of the upper GI tract is often present despite an absence of clinical symptoms or radiological changes. Upper GI tract endoscopy with multiple biopsies may be important in the evaluation of this condition and even in some cases for the establishment of the diagnosis. PMID- 2723936 TI - Amyloidosis in children with inflammatory bowel disease. AB - Reactive systemic or secondary amyloidosis occurs in 1-29% of adults with Crohn's disease, but only sporadic cases of amyloidosis have been recognized in children with inflammatory bowel disease. We therefore have studied operative specimens (ileal, ileocolonic, and colonic) from 46 children (30 with Crohn's disease and 16 with ulcerative colitis) to determine the frequency of amyloid deposits. Sections of bowel, skin, and lymph nodes (n = 940) were stained by Congo red and examined by light microscopy and by polarized light. Amyloid deposits were found in only one of 46 subjects, an 18-year-old girl who had had Crohn's disease for 6 years. Intestinal amyloid deposits, present 16 months before the clinical diagnosis of amyloidosis, were patchy and seen predominantly in the intestinal mucosa. We conclude that amyloidosis is rare in children requiring surgery for Crohn's disease and ulcerative colitis. Examination of Congo red-stained sections can detect even subclinical amyloidosis. The amyloid deposits in our patient, which were both patchy and consistently mucosal, suggest that multiple endoscopic biopsy samples, not necessarily containing submucosa, are sufficient for diagnosis. PMID- 2723937 TI - Chronic inflammatory bowel disease in children in western Norway. AB - The incidence of Crohn's disease (CD) and ulcerative colitis (UC) in children in western Norway was estimated in a prospective epidemiological study during the years 1984 and 1985. The total population in the area was 807,000 and the child population was 198,570 (1984). There were 27 new cases of chronic inflammatory bowel disease (IBD) in children aged 15 years or less, 10 new cases of CD, and 17 of UC. The mean annual incidence of CD in the child population was 2.5/100,000/year, whereas the incidence of UC in the child population was 4.3/100,000/year. Nearly all the children had abdominal symptoms. In this study, we found an incidence of CD in children that is the highest hitherto reported, to our knowledge. To the contrary, the incidence of UC was considerably lower than previously reported from northern Europe. PMID- 2723938 TI - Early prediction of relapse during gluten challenge in childhood celiac disease. AB - Thirty-seven children, in whom celiac disease had been diagnosed because of flat mucosa on a gluten-containing diet and recovery on a gluten-free diet, were challenged with gluten powder, 10 g/day, in addition to an otherwise gluten-free diet. A small intestinal biopsy was performed before the challenge; clinical symptoms, a 1-h blood xylose test, and gliadin antibody measurement were used to establish the timing of the confirmatory biopsy. All but one case relapsed within 205 days (mode, 60 days). In no case was the relapse clinically evident. Raised levels of gliadin antibodies, a fall in xylose absorption, or both predicted the relapse in 37%, 7%, and 57% of cases, respectively. Evaluated individually, each test gave a considerable rate of false negative results. Discriminant coefficients produced for each test were used to compute a score that allowed the classification of patients into relapse/no relapse categories with a good degree of accuracy. The discriminant score rose sharply after only 15 days of challenge, indicating that it is possible to predict the relapse long before any clinical symptom appears. PMID- 2723939 TI - Tannin-rich carob pod for the treatment of acute-onset diarrhea. AB - Infants aged 3-21 months with acute diarrhea of bacterial and viral origin were treated as inpatients with oral rehydration fluid and randomly received for up to 6 days either a tannin-rich carob pod powder (40% tannins or 21.2% polyphenols and 26.4% dietary fiber), 1.5 g/kg/day (n = 21) to a maximum of 15 g, or an equivalent placebo (n = 20). The duration of the diarrhea from admission was 2.0 +/- 0.27 days in the test group and 3.75 +/- 0.30 days in the placebo group (p less than 0.001). Normalized defecation, body temperature, and weight and cessation of vomiting were reached more quickly by the patients who received the test substance. The test substance was well accepted and tolerated. PMID- 2723940 TI - Breast-milk fatty acids of rural Gambian mothers: effects of diet and maternal parity. AB - The influence of diet and maternal parity on the fatty acid composition of mature breast milk have been studied in 23 rural Gambian mothers. The subjects' habitual diet was low in fat (16% total energy), groundnuts (peanuts) constituting the principal fat source. The high abundance of oleic and linoleic acids in groundnut fat were reflected in the proportions of these fatty acids in breast milk (47.0 +/- 1.5 and 13.0 +/- 0.3 g/100 g fat, respectively), which were elevated compared with mothers in other African communities. Estimates of daily breast-milk fatty acid secretion indicated that there was little risk of essential fatty acid deficiency in Gambian infants. The proportions of fatty acids synthesized de novo (10:0, 12:0, 14:0) were less than expected from published studies of mothers consuming low-fat diets, averaging 16.8 +/- 1.4 g/100 g fat. As the study was conducted at a time of food shortage and high energy expenditure, it is argued that mobilisation of body fat during negative energy balance increased the availability of long-chain fatty acids to the breast. The proportion of endogenous fatty acids was markedly reduced in the milk of mothers of very high parity (parity 1 = 19.3 +/- 1.6 g/100 g fat; parities 10 + = 11.4 +/- 1.5 g/100 g fat; p less than 0.01). It is hypothesised that this represents an impairment of the ability to synthesise breast-milk fatty acids de novo in these mothers. PMID- 2723941 TI - Effects of two levels of intake of chloride, potassium, and calcium on mineral and acid-base metabolism in premature infants. AB - Growth (weight, length, mid-upper arm circumference), acid-base status, serum electrolyte levels, and selected parameters of urine (creatinine and electrolyte levels, urine pH, renal net acid excretion, levels of metabolites of aldosterone) were determined serially from the 10th to the 32nd days for 4 weeks in 21 premature infants (birth weight, 1,100-2,000 g) fed either formula A or formula B (formula B was formula A supplemented with chloride, potassium, and calcium). Premature infants fed formula B showed a higher weight gain (31 versus 28.2 g/day), a higher increment of middle-upper arm circumference (0.31 versus 0.24 cm/week), and a decreased renal net acid excretion (1.24 versus 1.92 mEq/kg/day). Almost all premature infants fed formula A and some with a high growth rate receiving formula B showed hypochloruria corresponding to chloride deficiency. Premature infants fed unsupplemented humanized formulas may have an inadequate intake of minerals. PMID- 2723942 TI - Small intestinal development in growth-retarded fetal sheep. AB - The functional maturity of the gastrointestinal system is essential for the survival of the neonate. The effects of reducing placental size and the ensuing fetal growth retardation on the development of the small intestine (SI) of the sheep fetus were investigated. At 140 days of gestation (term is 147 days), fetal body weight, gastrointestinal weight (from the abomasum to the rectum, i.e., the gut), SI weight, and SI length in the growth-retarded fetuses (n = 6) were significantly reduced (p less than 0.05) when compared with age- and breed matched control fetuses. The SI weight was disproportionately reduced as a fraction of the gut weight or SI length (p less than 0.01). The proximal SI showed marked reductions in the thickness of the wall, muscularis externa, mucosa, villus height, and crypt depth (p less than 0.003). Densities of villi and crypts were also reduced (p less than 0.02). The crypt-to-villus ratio was maintained. Glycogen was accumulated basally in the villus epithelial cells, and their nuclei were located apically. These characteristics are comparable to those of much younger fetuses. In the distal SI, interanimal variation was large; however, the mean thickness of the wall, the muscularis externa, the mucosa, and the villus height were all reduced (p less than 0.05). In this region, the density of villi and crypts, the pattern of glycogen accumulation, and the position of the nuclei did not markedly differ between growth-retarded and control fetuses. Villus cell density was increased (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723943 TI - Electrogenic sodium transport in the developing rabbit cecum. AB - The adult rabbit cecum absorbs Na by an electrogenic, Cl-independent process that is inhibited by the amiloride analogue phenamil. In the colon, this transport system is unique to the cecum. Because the developing colon exhibits many specialized functions, we have now examined the development of electrogenic Na transport in the newborn rabbit. Cecal tissue from animals between 7 and 38 days old was mounted in modified Ussing chambers for measurement of Na and Cl flux (J) and the short-circuit current (Isc). At 7-10 days, the (Isc) was only 0.8 +/- 0.18 microEq cm-2 h-1, but by 35-38 days it had increased to 4.6 +/- 0.79 microEq cm-2 h-1. The Na transport increased in parallel with Isc; JNanet = -0.49 +/- 0.33 microEq cm-2 h-1 at 7-10 and 4.7 +/- 1.6 microEq cm-2 h-1 at 35-38 days. The Na transport was not inhibited by phenamil (10-4 M) at 7-10 days, but by the 35 38-day period, phenamil reduced the JNanet to 1.6 +/- 0.37 microEq cm-2 h-1. The Cl secretion was not stimulated by theophylline in the 14-16-day-old cecum, nor was Na absorption stimulated by epinephrine. The rabbit cecum does not demonstrate electrogenic Na absorption until after the 4th week of life. PMID- 2723944 TI - Acute pancreatitis from a duodenal foreign body in a child. AB - A 14-month-old child was admitted to the hospital with acute pancreatitis, abdominal pain, and shock. An abdominal radiograph revealed a paper clip standing out at the duodenal level. The foreign body was removed by endoscopy, revealing an edematic and hemorrhagic duodenal papilla. The patient progressed favorably after the foreign body was removed. This observation underlines the necessity of digestive transit surveillance of a foreign body that has not been endoscopically removed and the relevancy of duodenal endoscopy for acute pancreatitis of indefinite etiology. PMID- 2723945 TI - Retrograde esophagoscopy for foreign body removal. AB - Foreign bodies of the esophagus may penetrate the wall and migrate extraluminally, requiring a thoracotomy for removal. We report two children who swallowed coins that went undetected for several months and slowly eroded into the esophageal wall. These coins could not be retrieved by upper endoscopy, because of proximal strictures and granulation tissue at the perforation sites. Following surgical gastrostomy and retrograde flexible endoscopy, the coins were successfully removed. Retrograde endoscopy should be considered for removal of foreign esophageal objects before undertaking a thoracotomy. PMID- 2723946 TI - Low breast milk phosphorus concentration in familial hypophosphatemia. AB - We report breast milk mineral concentrations in a mother with familial hypophosphatemia that was untreated due to poor compliance with medical advice. Milk phosphorus content was extremely low despite normal maternal serum phosphorus concentrations. Milk calcium concentrations were only modestly decreased so that the ratio of calcium to phosphorus was greatly elevated. It appears that mothers with this disorder who breast feed should have their milk mineral content carefully monitored during lactation. If milk mineral content is abnormal despite maternal therapy with phosphorus and vitamin D, infants may require supplementation of mineral intake. PMID- 2723947 TI - Absence of regression of Barrett's esophagus. PMID- 2723948 TI - Milk lactose malabsorption in Gabon measured by the breath hydrogen test. AB - It is usual to consider that the greatest part of the black African population is lactose intolerant. Also, milk lactose malabsorption was studied by a breath hydrogen technique in 87 Gabonese children and 20 Gabonese adults (central Africa). The prevalence of malabsorption was 64.2% in rural schoolchildren, 65% in the urban hospitalized, and 60% in adults. Twelve children and six adults had clinical symptoms after a lactose load. All subjects were Bantus, with no tradition of consuming dairy products. These data must be considered in programs of nutritional support in Africa. PMID- 2723949 TI - Propylthiouracil hepatotoxicity mimicking autoimmune chronic active hepatitis in a girl. PMID- 2723950 TI - Importance of the characteristics of gatekeepers in the design of effective alcohol education programs. AB - Community "gatekeepers" (N = 53) participated in an alcohol education workshop designed to increase identification, intervention, and referral of women with alcohol problems. Participants completed questionnaires before and after the workshop and, participated in a six-month follow-up. Results suggest that the higher the educational level and more salient the topic of alcoholism in women, as suggested by greater percent of women clients, the greater the actual gain in knowledge. Gatekeepers with no prior alcoholism training perceived themselves as having less knowledge about alcoholism before the workshop and showed greater pains in perceived knowledge as a result of the workshop than gatekeepers with prior training. PMID- 2723951 TI - Media manipulation of adolescents' personal level judgements regarding consequences of smokeless tobacco use. AB - Videotapes were developed to try to impact on personal level judgements of concern and risk in the context of smokeless tobacco use, a growing substance use problem in adolescents. In a within-and-between-subjects design, convincingness (i.e., dramatic portrayal) of the videotaped message (high and low) and perceived probability of consequences portrayed in the message (high and low) were manipulated. PMID- 2723952 TI - The impact of the "I'm Special" Program on student substance abuse and other related student problem behavior. AB - There has been a proliferation of school-based substance abuse prevention programs geared toward reducing or delaying the onset of student use of illegal drugs. But the field has shown a general absence of evaluation dealing with the behavior consequences of these practices. This article fills this gap by using the case of the "I'm Special" Program (ISP) targeted for fourth grade students. Using a quasi-experimental design, a comparison is made between the substance using and other problem behavior of students who have been exposed to the ISP and those who have not during their later school years in grades 5 through 12. At the aggregate level, the proportions of current substance users and the incidence of their related problem behavior were significantly lower among the ISP graduates than those who have not been exposed to the program. In particular, there were consistently lower proportions of current substance users among the ISP recipients than the non-recipients in grades 5-7. However, the impact of the ISP seems to diminish significantly in and around ninth grade. During the senior high level, the pattern revealed is almost random. And, in some drug categories, it has been speculated that the ISP students were trying to "catch up" with what they may have missed out on during earlier grade levels. PMID- 2723953 TI - Pediatric psychology training: an analysis of graduate, internship, and postdoctoral programs. AB - The field of pediatric psychology is in the early stages of formulating its own identity relative to other areas, such as clinical child and health psychology. This paper complements other recent efforts to delineate training practices and guidelines. Questionnaires regarding doctoral, internship, and postdoctoral training experiences were obtained from 89% of the membership of the Society of Pediatric Psychology. From this information, rankings of the most commonly attended programs at each training level were derived. Some overlap was apparent between doctoral programs that were conducive to training in pediatric and clinical child psychology; however, differences between programs in these areas also were noted. The most commonly attended internship and postdoctoral settings were those in major medical centers or children's hospitals. Suggestions for investigating the current status of predoctoral, internship, and postdoctoral programs that may be facilitative of training in pediatric psychology are discussed. PMID- 2723954 TI - Relation between severity of chronic illness and adjustment in children and adolescents with sickle cell disease. AB - Tested the relationship between illness severity and adjustment in 70 sickle cell patients, aged 8-16. Illness severity was measured by frequency of hospitalization and emergency room visits, frequency and intensity of pain crises, and duration of illness. Adjustment variables were IQ, self-esteem, social and personal adjustment, behavioral problems, school performance, and peer relations. Medical variables-associated illness patterns and type of hemoglobinopathy-were also considered. Sex and age were covariates. The hypothesis that illness severity would affect adjustment was generally not supported. Other factors such as SES, family structure, or support systems may affect adjustment and suppress the hypothesized relationship. The need for a more global intervention approach than using illness severity to measure need for psychotherapeutic assistance is suggested. PMID- 2723955 TI - The role of social modeling in unexplained pediatric pain. AB - Interviewed 20 children with recurrent unexplained pain (UP) and 20 children with recurrent explained pain (EP) secondary to sickle cell anemia and their parents to determine the presence of models of pain or illness behavior in the child's environment. The location, intensity, frequency, and environmental consequences of the children's and the models' pain were also assessed. The hypothesis that UP Ss would identify more models was supported. In addition, UP Ss identified more positive consequences of the child's pain behavior while EP Ss identified more negative consequences. Children perceived the frequency and intensity of their pain to be similar to their models', while parents did not report such a relationship. Body location data suggest that children may model either general illness behavior or exact symptoms. Implications for future research are discussed. PMID- 2723956 TI - Developmental trends in memory and metamemory in children with attention deficit disorder. AB - Examined the development of memory strategy knowledge and spontaneous use of strategy by 6- to 12-year-old boys with ADD-H. Metamemory knowledge of 12 ADD-H boys, unmedicated for study participation, and 12 matched control Ss was compared using a structured interview. Use of categorization was assessed using free recall of word lists differing in category composition (acoustic vs semantic categories) and list organization (clustered by category vs unclustered). Interview data indicated no difference between groups in development of metamemory knowledge. Analysis of free recall performance showed that ADD-H Ss were less likely than controls to benefit from that knowledge when strategy was less salient and involved effortful reorganization of stimuli (p less than .05). The results were consistent with a production deficiency. Developmental trends and implications for remediation are discussed. PMID- 2723957 TI - Factorial design based optimization of the formulation of albumin microspheres containing adriamycin. AB - The use of factorial design in the formulation of adriamycin-associated albumin microspheres, using the heat-stabilization technique, is illustrated. The effect of stabilization temperature, protein concentration and stabilization time on the entrapment and recovery of adriamycin in microspheres have been investigated using a 2 x 4 x 4 factorial design. The associated drug content in unwashed and four times washed microspheres was determined using HPLC. Maximum drug association and drug recovery were obtained from microspheres synthesised using 25 per cent w/v albumin solution and stabilized at 120 degrees C for 2.5 min. Under these conditions, the entrapped and total associated drug content of the microspheres was about 4 per cent and 12 per cent w/w respectively, and the drug recovery was about 75 per cent. The in vitro dissolution study carried out using dynamic dialysis revealed that the release of adriamycin from these particles follows a bi-phasic pattern. The results demonstrate that use of short stabilization time, low protein concentration and low stabilization temperature are required for the formulation of microspheres with high adriamycin content. PMID- 2723958 TI - Selective transfer of cyclosporin to thoracic lymphatic systems by the application of lipid microspheres. AB - To overcome some of the disadvantages of present cyclosporin A (CsA) therapy, lipid microspheres incorporating CsA (lipo-CsA) were designed and their selective transfer to thoracic lymphatic systems was evaluated in vivo. It was found that concentrations of CsA in lymph-ducts were about 46 times higher after 2 h and 9 10 times higher after 3 h following oral administration of lipo-CsA, compared with those of conventional CsA. The concentrations in plasma produced by lipo-CsA were also higher than those produced by conventional CsA. PMID- 2723959 TI - Immobilization of enzyme by microencapsulation and application of the encapsulated enzyme in the catalysis. AB - Microencapsulation of lipase (Pseudomonas fluorescens) was carried out using (W/O)/W two-phase emulsion technique. Polystyrene (PS) and Styrene-Butadiene Rubber (SBR) were utilized as wall materials either separately or in mixture. A particular composition of 2:1 PS-SBR yielded homogeneous and tough wall structure, resilient to the impact and tight confinement of enzyme macromolecules. Performance of the encapsulated enzyme was evaluated employing the hydrolysis of triacetin (triglyceride of acetic acid) as a model substrate of the enzyme catalysis. A mathematical model was developed to simulate the behaviour of hydrolysis, which was derived under the assumption that the diffusion of small molecules (substrate and products) through the wall of microcapsules plays a dominant role to the reaction rate. Inhibition of the reaction by the decreasing pH due to the release of acetic acid was also taken into account. The calculated values agreed quite well with the observed data. PMID- 2723960 TI - Liposomes as cyclosporin A carriers: positively charged lecithin-cholesterol liposomes associated with cyclosporin A do not inhibit biosynthesis of mitochondrial polyglycerophosphatides and microsomal phosphatidylinositol. AB - Phosphatidylcholine (from egg yolk)-cholesterol-stearylamine (7:2:2.25, molar ratio) liposomes when associated with cyclosporin A (phosphatidylcholine:cyclosporin A = 2:0.07, molar ratio) do not inhibit significantly the biosynthesis of [3H]polyglycerophosphatides and [3H]phosphatidylinositol in mitochondrial and microsomal membranes, respectively, isolated from rat liver. These results are explained by possible protection of the liposomes by cyclosporin A against phospholipase A2 hydrolysis. PMID- 2723961 TI - Methotrexate transport from the internal phase of multiple w/o/w emulsions. AB - Release rates of Methotrexate (MTX) encapsulated in the internal phase of w/o/w emulsions stabilized by the interfacial interaction between albumin and sorbitan mono-oleate(Tween 80) were measured as functions of two formulation variables- the oil phase and the secondary emulsifier composition. The release rate was significantly affected by the nature of the oil phase and decreased in the order isopropyl myristate greater than octadecane greater than hexadecane greater than dodecane greater than octane, which was a reflection of the increasing internal droplet size of the emulsions. The release rate data conform with first order kinetics. Comparison of the effective permeability coefficients calculated from the experimental apparent first-order rate constants, with the effective permeability coefficient of water in planar oil layers, containing non-ionic surfactants, determined by a microgravimetric method supported the hypothesis of diffusion of MTX in water loaded inverse micelles. Surfactants with high HLB values, used as the secondary hydrophilic emulsifier increased the release rates, primarily by increasing the rate of diffusion of MTX through the non-aqueous liquid membrane. PMID- 2723962 TI - Structure of hollow polystyrene microspheres: an SEM study. AB - Hollow polystyrene microspheres have been prepared by a modified interfacial polymer deposition technique. The hollow microspheres were characterized using scanning electron microscopy. The effects of polymer concentration and the quantity of the internal phase material (methanol) used on the microsphere size and their wall thickness were studied. Increase in polymer concentration causes increase in wall thickness while increasing internal phase material increases microsphere size and deforms them from a spherical shape. PMID- 2723963 TI - Evaluation of compressibility of pentaestergum coated aspirin microcapsules. AB - We have earlier reported the usefulness of the pentaerythritol rosin ester (pentaestergum) as a coating material, its dissolution kinetics and in vivo release studies in dogs. The present communication deals with the compressibility of the pentaestergum-coated aspirin microcapsules. The microcapsules were prepared by the pan-coating method described earlier. These were compressed into the tablets using a single punch machine. The tablets were evaluated for hardness, friability loss, disintegration time and dissolution studies. The results showed that there were significant differences in the release characteristics from the microcapsules and the compressed tablets. The effect of 5 per cent starch as a disintegrating agent in the tablet formulation was also studied. The results showed that the tablets can be a suitable dosage form for pentaestergum-coated microcapsules to give a delayed drug release. PMID- 2723964 TI - A study on the thermostability of microencapsulated glucose oxidase. AB - Glucose oxidase was microencapsulated within polyurea membranes by the interfacial polymerization method and the stability to heat of the encapsulated enzyme was examined. Thermostability of microencapsulated glucose oxidase was prominent and increased with increase in the amount of glucose oxidase entrapped. This stability, however, could not be ascribed to the peculiar properties of microcapsules but was suggested to be caused by the incorporation of glucose oxidase molecules in the membranes through chemical bonding. This stability revealed that the enzyme molecules in the microcapsules could not always exist in the dissolved form but a fairly large portion of the molecules participated in the polymerization reaction and changed their enzymatic properties. PMID- 2723965 TI - Microencapsulation of phenylpropanolamine to achieve sustained release. AB - Phenylpropanolamine HCl was initially microencapsulated with cellulose acetate butyrate, however, the microcapsules did not show acceptable sustained release. A reduction of the drug particle size prior to microencapsulation resulted in a reduction in drug release rate from the microcapsules. The desired drug release profile was attained only when the drug powder was replaced with a drug-resin complex in the microencapsulation process. The pH of the dissolution media had an effect on the drug release profile. PMID- 2723966 TI - Preparation of microspheres of water-soluble pharmaceuticals. AB - An emulsion-solvent evaporation procedure involving the dispersion of an alcoholic solution of an active in liquid paraffin was used to prepare microspheres of water-soluble pharmaceuticals using ethylcellulose as a carrier. The effects of surfactant, plasticizer, drug loading, and agitation speed on drug release rate from the microspheres were evaluated. The release rates of water soluble drugs from microspheres, ranging from 100 and 500 microns in diameter, were sustained over an extended time and were found to be related to the ratio of drug to polymer in the final product. PMID- 2723967 TI - Effect of particle size and film thickness on bioavailability and ulcerogenicity of encapsulated flufenamic acid. AB - Encapsulation of four batches of flufenamic acid (FFA) having mean particle diameters of 75, 130, 180 and 225 microns with cationic acrylic resin (Eudragit E) have been achieved using a fluidized-bed granulator (Glatt AG). The bioavailability and gastric ulcerogenic activity of the encapsulated and plain drug for each batch have been simultaneously assessed in rats subjected to physical restraint stress. Encapsulated batches of FFA showed significantly higher plasma levels and lower ulcerogenic activities than those of plain batches. Although encapsulated batches showed comparable plasma levels, compared with each other, they varied greatly as regards their ulcerogenic activities. The smaller the mean diameter of microcapsules of a batch the lower its ulcerogenic activity. A linear correlation was found between the film thickness of Eudragit in microcapsules and the ulcer indices of various encapsulated batches. Plain FFA batches, however, showed comparable plasma levels as well as comparable ulcer data, when compared with each other, within the size range studied. PMID- 2723968 TI - Radiopaque hydrogel microspheres. AB - Spherical, hydrophilic microspheres prepared from crosslinked poly(methyl methacrylate) (PMMA) by alkaline hydrolysis have been made radiopaque by impregnating with barium sulphate by the precipitation technique. Microspheres having carboxyl functions as their alkali metal salt were swollen in sodium sulphate solution and barium sulphate entrapment was effected by treating with barium chloride solution. The swelling characteristics of the microspheres could be controlled by acidification and further by anhydride formation thereby trapping the barium sulphate firmly inside the microspheres. Barium sulphate loading of up to 70 wt-per cent could be achieved by this technique. These microspheres have been found to possess excellent X-ray contrast properties and may find application as particulate emboli in endovascular embolization. PMID- 2723969 TI - Long-term results: botulinum for sixth nerve palsy. AB - Eight patients with intracranial malignancies or vascular lesions and sixth nerve palsies were treated with botulinum toxin chemodenervation of the antagonist medial rectus muscle. Primary deviation ranged from 20 to 75 prism diopters (pd) of esotropia. Six were treated acutely (within 3 months of onset) and two, which demonstrated partial recovery of lateral rectus function but with residual esotropia and diplopia, were treated after 6 months. After a mean follow-up of 20.6 months, seven were diplopia-free with excellent rotations. Five had complete resolution of the esotropia and diplopia, with near complete recovery of abduction. One had 6 pd residual esotropia, while another, whose sixth nerve had been resected, required a modified Jensen procedure, resulting in full rotations. The single case of bilateral sixth nerve palsy had a functional improvement but was lost to follow-up. One patient had a vertical strabismus induced with the injection and had a gradual return of the esotropia. PMID- 2723970 TI - Expanded binocular peripheral visual fields following surgery for esotropia. AB - We measured the horizontal extent of the binocular peripheral field of vision in ten adult esotropes using Goldmann perimetry before and after strabismus surgery. In every case there was expansion of the field by an amount approximately commensurate with the change in angle of strabismic deviation. This occurred regardless of the presence of amblyopia or recovery of binocular fusion. Subjective improvement in peripheral vision was appreciated by a number of patients. Visual field expansion should be recognized as a significant indication for correction of esotropia. PMID- 2723971 TI - Observations on the use of three different contrast sensitivity tests in children and young adults. AB - Forty-one children and young adults aged 4 to 25 years (mean 14.5 +/- 6.9, SD) with normal eyes were examined with three different contrast sensitivity tests: the Vistech distance and near test, the Cambridge Low Contrast Gratings test, and the LH-5 Contrast test. In different age groups, the youngest children aged 4 to 9 years had the lowest result values. The results of the older children aged 10 to 15 years and young adults aged 16 to 25 years were close to each other. The range of the results in all tests was large in every age group. The values of contrast sensitivity could not be compared from one test to another; in the Vistech tests the values varied from 10 to 200, in the Cambridge test from 170 to 560, and in the LH-5 test from 5 to 50. Most of the children liked the LH-5 test best, while most of the young adults preferred the Vistech distance test. It is useful to examine children and adults with different contrast sensitivity tests; however, the same test should be used in follow-up examinations. PMID- 2723972 TI - Regional uveal response to increased nutritional needs in the retinal zone of the developing eye demonstrated in an eye with retinoblastoma. AB - The outer layers of the normal retina depend on indirect nutrition originating in the choriocapillaris and supplied to the retina by way of the pigment epithelium. An eye with exophytic retinoblastoma is used to demonstrate increased vascularity and tissue substance in the adjacent choroid believed to be indirectly induced by a regional increase in nutritional requirements in the retinal zone of a developing eye. PMID- 2723973 TI - Sclerodermiform linear atrophy after the use of intralesional steroids for periorbital hemangiomas: a review of complications. AB - A 1-year-old girl developed a linear atrophy 3 months after a second injection of intralesional steroids for a periorbital hemangioma, followed by spontaneous resolution of the atrophy within 13 months. Reported and potential complications of intralesional steroids for periorbital hemangiomas are reviewed. PMID- 2723974 TI - Binocular function in human infants: correlation of stereoptic and fusion-rivalry discriminations. AB - Studies of stereopsis in infants have shown that the average age of onset is 3.5 months. This is the same age at which infants first show evidence of another binocular function, namely, preference for binocularly fusible patterns over rivalrous ones. We tracked the development, using two-alternative forced-choice preferential looking, of the two forms of binocular function in 17 infants, 11 male and six female. They were tested at regular intervals until they showed preferences for 1) a fusible pattern (vertical stripes presented to each eye) over a rivalrous one (vertical stripes presented to one eye, horizontal stripes to the other), and 2) a line stereogram of 32 min crossed disparity over a comparable stereogram with zero disparity. The correlation between the age of onset of the fusion preference (mean 12.4 weeks) and the age of onset of stereopsis (mean 11.0 weeks) was r = 0.79. Female infants showed a preference for the fusible stimulus at a mean age of 9.9 weeks, significantly earlier than the males at a mean age of 13.8 weeks. Similarly, females also showed evidence of stereopsis at an earlier age (9.1 weeks compared with 12.1 weeks for males). PMID- 2723975 TI - Gonioscopic findings in trabeculectomies in young children. AB - To discover why trabeculectomy often fails in children, we studied a series of 27 procedures, focusing on intraocular and scleral factors that prevent humoral drainage. Gonioscopy was performed under anesthesia with Fluothan (ICI, UK), and trabeculectomy was considered successful when values were equal to or lower than 20 mm Hg. Only ten procedures proved successful, and all had large basal iridectomies plus visible anterior scleral openings at gonioscopy. Possible causes for the 17 failures are listed, together with indications for revision surgery. PMID- 2723976 TI - Pediatric intermediate uveitis. AB - Clinical findings, course, treatment, and complications of intermediate uveitis in children is analyzed in a series of 60 patients. While generally a chronic indolent disease, in the pediatric age group acute anterior uveitis is the presenting symptom rather than the milder symptomatology characterized in the adult with a similar syndrome. The etiologic evaluation of these patients was unrewarding. The great majority of patients improved following the use of periocular corticosteroid injections and retinal cryopexy, and immunosuppressive agents were infrequently employed in the management of the disorder. Cataract formation, secondary glaucoma, band keratopathy, vitreous hemorrhage, and papillitis were seen as complications. A treatment algorithm is presented. PMID- 2723977 TI - Patient follow-up--cystinosis. PMID- 2723978 TI - Exercise induced esotropia. AB - A case of unusual intermittent esotropia and diplopia is reported. A 13-year-old boy experienced diplopia during vigorous exercise that resolved within 30 minutes after stopping the exercise. The symptoms had been present unchanged since age 6. Examination revealed orthophoria. After vigorous exercise an esotropia of 14 prism diopters in the distance developed, which gradually resolved over 30 minutes. Neurologic evaluation, CT scan, and magnetic resonance imaging scan have been normal. The symptoms have continued unchanged for 11 years. To my knowledge, no other similar case of exercise induced esotropia has been reported. PMID- 2723979 TI - Diffuse infiltrating retinoblastoma. AB - A young child was examined for unilateral hyphema of 1 month duration with a questionable history of blunt trauma. Ultrasonography was negative for tumefaction. Two months later the media cleared, revealing a diffusely abnormal retina. Computed tomography demonstrated a diffusely thickened posterior pole containing calcium. Histopathology of the enucleated globe was consistent with a diffuse infiltrating retinoblastoma. This is the first report of computed tomographic findings in diffuse infiltrating retinoblastoma. PMID- 2723980 TI - Preventable pediatric trauma deaths in a metropolitan region. AB - All pediatric trauma deaths occurring in metropolitan Toronto (population, 2.2 million) in 1986 were analyzed from the regional coroner's records. Injuries sustained were scored using the Abbreviated Injury Scale (1985; AIS) and Injury Severity Score (ISS). Victims with injuries graded AIS 6 (any region), AIS 5 head/neck (excluding acute epidural hematoma), or ISS greater than 59 were deemed unsalvageable. All other injuries were considered survivable and the deaths from them preventable. Use of these objective criteria indicated that 8/38 of the children (21%) who died from trauma had survivable injuries. Since in three cases medical aid was not sought because of social circumstances, 5/38 (13%) was considered a realistic estimate of preventable death rate (PDR). These results suggest that when objective criteria are used, the PDR in pediatric trauma may be less than that reported in adult trauma victims. Defining the PDR on the basis of objective criteria may prove useful in the conduct of further studies of this kind and permit valid comparisons to be made. PMID- 2723981 TI - Clinical outcome in children with acute cerebellar encephalopathy and neuroblastoma. AB - Acute cerebellar encephalopathy (ACE)--ataxia often associated with opsoclonus, polymyoclonus, and irritability--may be associated with neuroblastoma and should be suspected in a child who presents with ACE. The survival in ten children with ACE associated with neuroblastoma was 100%. Most of the tumors were ganglioneuroblastomas. The abdomen was the most common location for the tumor in this study although it also can be found in the mediastinum. All patients with this syndrome had a localized tumor. With ACTH therapy, ACE may resolve early postoperatively, but it tends to recur in most patients, continuing for as long as 3 years after the initial operation. Treatment with ACTH or prednisone modifies and rapidly clears the symptoms during the acute episode of recurrent ACE as well as helps to resolve subsequent neurologic sequelae. Significant neurologic sequelae persisted in seven of ten patients and included deficits in cognition or intellect, hyperactivity, impulsivity, emotional lability, and mild motor deficits. Seizures were seen in one patient. PMID- 2723983 TI - Splenic injury: nonoperative management in three patients with infectious mononucleosis. AB - Three patients with infectious mononucleosis and splenic injury were managed nonoperatively. Mechanisms of injury included significant left upper quadrant trauma during a football game in a 17-year-old boy, a minor fall in a 16-year-old girl, and no apparent trauma in the remaining patient, a 28-year-old man. All had significant abdominal pain and two were hypotensive upon admission. All had computerized tomographic scan documentation of splenic enlargement, significant injury, and free peritoneal blood. Paracentesis was not performed. Only the first patient received transfused blood. The hospitalization period ranged from nine to 14 days. Gradual and finally complete healing (return to normal size) was documented in all three patients. Follow-up is 66, 14, and 10 months. Although clearly controversial and not free from danger, successful nonoperative management of the injured enlarged spleen in select patients with mononucleosis is possible in an appropriate setting. PMID- 2723982 TI - Immune consequences of nonoperative treatment of splenic trauma in the rat model. AB - To investigate the immunologic consequences of non-operative management of splenic injury, three parameters were studied: survival following pneumococcal sepsis, clearance of blood-borne bacteria, following Hemophilus influenzae challenge, and antibody response to type III pneumococcal capsular polysaccharide. Two hundred twenty-five Sprague-Dawley rats were divided into three groups and subjected either to a splenectomy, a sham operation, or standard blunt trauma. A significant increase in mortality was noted in the splenectomized group as compared with both the traumatized and control groups when challenged with Streptococcus pneumoniae. In both the control and trauma groups, H influenzae cleared significantly within 18 hours. Blood-borne bacteria persisted at the same level for 72 hours in the splenectomized animals. Four and 11 days later, the antibody level in both traumatized and control groups was higher than in the splenectomized subjects (P less than .001). There was no difference in the serum antibody level between the control and trauma groups at four days. However, at 11 days the trauma group showed a significant decrease in the antibody level (P less than .05). It can be concluded that following spontaneously-healing splenic trauma in the rat model, survival, bacterial clearance, and antibody response were all superior to that observed in the splenectomized subjects. In addition, the healed splenic disruption did not impair clearance of blood-borne encapsulated bacteria. PMID- 2723984 TI - Splenic injury: a 5-year update with improved results and changing criteria for conservative management. AB - The policy of conservative nonoperative management of the injured spleen is reviewed, and recommendations are made to improve this mode of therapy. From 1981 to 1986, 75 patients were admitted with diagnosed splenic injury. Of thes, ten were operated on (four splenorrhaphies, three total splenectomies, one partial splenectomy; in two, the spleen had stopped bleeding spontaneously) and three died, all from causes unrelated to splenic trauma. Only 23% of the patients treated nonoperatively required blood transfusions, and the length of both hospital stay and time spent in the ICU was reduced. The results of this review show that, in comparison with our previous 5-year report, the number of patients treated without surgery increased from 70% to 87%, those receiving blood transfusions decreased from 36% to 23%, and the number undergoing a splenectomy decreased from 24% to 4%. These data suggest that almost all children with splenic injury can be successfully treated without an operation, those who are hemodynamically stable do not require ICU care, and the total hospital stay for uncomplicated splenic injury can be limited to seven days. A laparotomy can be safely reserved for patients with immediate massive hemorrhage or with transfusion requirements of greater than 40 mL/kg. PMID- 2723985 TI - Management of the brown recluse spider bite. AB - The objectives in the treatment of the brown recluse spider bite are to prevent skin necrosis and the need for reconstructive surgery. A simple technique that consists of curetting the subcutaneous tissue in the necrotic area of the lesion, to prevent the local destructive actions of the toxin, is described. From 1981 to 1987, 18 patients were treated with this technique. The wounds were generally curetted under local anesthesia in an outpatient setting. In all but one case, the erythema, edema, and pain resolved significantly in 24 to 48 hours, and the wounds healed primarily with minimal scarring. We consider curettage the treatment of choice for brown recluse spider bites when the lesions are noted in relatively early stages. It can be performed as an outpatient procedure; it controls the symptoms and prevents further necrosis, with excellent cosmetic results. PMID- 2723986 TI - Crotalid envenomation in children: selective conservative management. AB - Snake bites in children remain an uncommon injury. In general, there is a wide disagreement by knowledgeable authorities on a uniform approach to therapy. In the last 5 years, 29 children have been treated in our institution for snake bites, all with signs of envenomation. Treatment consisted of diagnostic laboratory studies, intravenous fluids, tetanus prophylaxis, antibiotics, bed rest, elevation, and observation. There were no deaths. A fasciotomy was required in three children. Cryotherapy initiated elsewhere resulted in tissue loss. Seven children received antivenin. All developed signs and symptoms to serum sickness. From this experience, it appears that the majority of snake bites in children, especially copperhead bites, can be treated selectively and conservatively. Care must be exercised in using antivenin as it is associated with a high rate of serum sickness. Cryotherapy adds to the morbidity of the bite and is not to be used. PMID- 2723987 TI - Management of the brown recluse spider bite. PMID- 2723988 TI - Congenital metastatic cervical teratoma: diagnostic and management considerations. AB - Cervical teratomas in the newborn are uncommon and difficult management problems, as their natural history and prognosis are not well defined. Existing or potential airway obstruction is usually the main concern in acute management of these patients. Total excision is essential to avoid local recurrence in benign lesions, and a small but present risk of malignancy can result in death from metastatic lesions which appear later. A unique case of neonatal malignant cervical teratoma with large congenital metastatic lesions present in liver, lung, and buttocks was successfully managed. Magnetic resonance imaging (MRI) was invaluable, both in delineating these lesions and in planning a four-stage curative resection of all macroscopic disease. Such a case has not been reported previously. PMID- 2723989 TI - Evaluation of high-intensity therapeutic ultrasound irradiation in the treatment of experimental hepatoma. AB - A study evaluating the efficacy of high-intensity therapeutic ultrasound (HITU) as a treatment modality in experimental hepatoma is reported. Morris hepatoma (3924) 1 x 10(6) cells were transferred subcutaneously into 40 male ACI rats (weight, 150 to 200 g). Animals were divided into four experimental groups: group 1 (n = 10) consisted of untreated controls; group 2 (n = 10) received intraperitoneal cyclophosphamide 50 mg/kg as a single dose; group 3 (n = 10) underwent HITU only; and group 4 (n = 10) received both chemotherapy (as in group 2) and HITU (as in group 3). HITU was administered with a 5.5-cm diameter 4-MHz quartz transducer creating a continuous wave with 400 W/cm2 focal intensity. The entire tumor was irradiated in 1-mm increments (horizontal and vertical) using treatment cycles of 4 seconds on and 11 seconds off. Total body weight and tumor volume were measured on the day of treatment, and 4 weeks later. At 4 weeks, the animals were killed, the tumor was excised and weighed, and tumor volume was determined. Tumor volume in all treated animals (groups 2, 3 and 4) was significantly smaller than in controls (P less than .001) at 4 weeks, and tumor volume for animals in group 4 was significantly smaller than for those in groups 2 and 3 (P less than .01). These data indicate that HITU significantly reduces tumor size when compared with control rats with Morris hepatoma. A synergistic effect of chemotherapy and HITU was observed and resulted in an enhanced tumor response and reduction of tumor size.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723990 TI - Cachectin/tumor necrosis factor production by fetal and newborn rat hepatic macrophages. AB - The capacity of fetal and newborn hepatic macrophages to produce cachectin/tumor necrosis factor (TNF) has not been previously examined. The role that TNF plays in newborn infection is also unknown. In the present report, fetal and newborn rat hepatic macrophages have been maintained in short-term tissue culture, and are shown to produce TNF in response to in-vitro endotoxin stimulation. Cells obtained are morphologically and antigenically consistent with macrophages, and are depleted of accessory cells and lymphocytes. In response to increasing doses of endotoxin, fetal and newborn hepatic macrophages produce TNF, and this production is suppressed fully by pretreatment with dexamethasone. The results demonstrate that fetal and newborn hepatic macrophages possess the capability to produce TNF in vitro. We propose that TNF may play a role in the response of the fetus and newborn to bacterial infection. PMID- 2723991 TI - The role of pediatric surgery in the medical school curriculum. AB - In most medical schools, exposure to pediatric surgery is presented as a subspecialty elective. We have offered it as an integral part of the surgical clerkship for 10 years in the belief that it provides an excellent educational environment. To confirm this concept, the quizzes (Q), final examinations (FE), and grades of students assigned to the pediatric surgical service were prospectively studied. All students (N = 139) in the surgical clerkship entered the study. Thirty-two students were randomly selected and assigned to the surgical service of a major pediatric hospital (P-Surg) for 50% of their clerkship. The other students (N = 107) were assigned to a variety of adult surgical services (G-Surg) and served as the control group. All students attended the same seminars, used the same educational materials, were examined with the same test items, and were evaluated by the same oral examiners. Test items were electronically scored and the database was analyzed on an IBM computer. The statistical analysis was performed using a Student's t test and chi 2 analysis. There was no significant difference in the demonstrated cognitive performance and grades awarded to the two groups of students. We conclude that a pediatric surgical service provides an atmosphere that is educationally comparable to the adult general surgical service. PMID- 2723992 TI - Gastroesophageal reflux following percutaneous endoscopic gastrostomy in children. AB - The frequency and clinical significance of gastroesophageal reflux (GER) in patients after percutaneous endoscopic gastrostomy (PEG) was determined. Ten children, aged 11 months to 15 years, who had normal preoperative extended esophageal pH monitoring were restudied after PEG. Of the ten patients, six developed GER with a pH score significantly higher than their initial one (40.5 +/- 3.3 pre-PEG v 129.5 +/- 24.2 post-PEG, P less than .005). Similarly, the mean post-PEG pH score was higher in patients with GER than in those without a change in score (129.5 +/- 24.2 v 33.8 +/- 2.8, P less than .005). None of these patients was symptomatic for GER immediately after the PEG, but within 10 months of surgery, three of six (50%) developed reflux-related symptoms. These data indicate that clinically significant GER is associated with PEG. PMID- 2723993 TI - Transthoracic Nissen fundoplication for gastroesophageal reflux in patients with severe kypho-roto-scoliosis. AB - Transthoracic Nissen fundoplication was used for the correction of gastroesophageal reflux in five mentally retarded patients with severe kypho-roto scoliosis. This deformity may result in a gastroesophageal junction so high above the left costal margin that transabdominal fundoplication is extremely difficult. Operative morbidity was minimal. One wrap disruption occurred that required reoperation. Results have been satisfactory 6 to 24 months postoperatively. PMID- 2723994 TI - Biliary atresia: early determination of prognosis. AB - Analyses of bile bilirubin during the first month after Kasai operations, and of the liver biopsies obtained at the time of initial surgery, were done in 67 patients with biliary atresia. Bilirubin excretion (milligrams per day) was determined as the product of the bile volume and its concentration. Operative liver biopsies were evaluated for fibrosis, bile duct proliferation, bile stasis, giant cell transformation, and parenchymal degeneration; the severity of each abnormality was graded on a scale of 0 to 4. A forward stepwise regression procedure using the Cox proportional hazards model identified the relationship between survival and covariants. Thirty-nine of 67 patients died. Of these, 38 excreted less than 6 mg of bilirubin per day during the first postoperative month. The other patient died of a coexisting anomaly. Nine other patients who excreted less than 6 mg of bilirubin per day are alive but are either jaundiced or awaiting transplantation. Nineteen patients who excreted greater than or equal to 6 mg of bilirubin per day are alive (mean follow-up, 61 months) with normal or near-normal liver function. The severity of liver fibrosis, bile duct proliferation, and bile stasis did not correlate with survival, whereas giant cell transformation and parenchymal degeneration were highly significant (P less than or equal to .000 and P less than or equal to .0003, respectively). Twenty six infants with grade 1-4 giant cell transformation or grade 2-4 parenchymal degeneration had a mean survival of 11 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723995 TI - Primary reexcision for patients with 'microscopic residual' tumor following initial excision of sarcomas of trunk and extremity sites. AB - Among 404 patients with primary tumors of extremity-trunk sites entered in the Intergroup Rhabdomyosarcoma Study (IRS) (1972 to 1984), 154 were placed in clinical group IIa, ie, with negative nodes but with "microscopic residual" (MR) disease, following the initial excisional (not biopsy) procedure. An elective reexcision of the area of the primary tumor (PRE) was performed in 41 of these patients within 35 days (mean interval, 14 days; SE, 0.9) with no intervening therapy. These procedures consisted of wider excision of the tumor "bed," resulting in a technical transfer of these patients from group IIa to group I, ie, complete excision. This reduced intensity of nonsurgical therapy (irradiation and chemotherapy). Among the 41 patients who underwent PRE, the 3-year survival estimate (Kaplan-Meier) was 91% (SE, 4%). This may be compared with the results in 113 patients who remained in group IIa, in which the 3-year survival estimate was 74% (SE, 4%). A second group for comparison consisted of the 73 patients with trunk/extremity tumors who were placed in group I after a single excisional procedure, ie, no PRE, in whom the 3-year survival estimate was 74% (SE, 5%). Recognized prognostic factors influencing survival in these groups were comparable, with the exception of tumor size, ie, the largest tumors (greater than or equal to 10 cm in diameter) were concentrated in groups I and IIa. When patients with tumors greater than or equal to 10 cm in diameter (9.7% of the total) were removed from all three study groups, patients undergoing PRE had longer survival duration estimates than patients in the control groups. PMID- 2723996 TI - Pancreas divisum, pancreatic pseudocyst, and choledochal cyst in an 8-year-old child. AB - An 8-year-old American Indian girl presented with acute pancreatitis. Ultrasonography and computerized tomography (CT) showed two large cystic masses near the head of the pancreas. During 4 weeks of complete bowel rest and total parenteral nutrition, she had multiple exacerbations of pancreatitis without resolution of the cysts. There were no symptoms of biliary ductal obstruction. Endoscopic cholangiopancreatography (ERCP) showed an 8-cm pancreatic pseudocyst, pancreas divisum, and a 10-cm choledochal cyst. The junction of the common bile duct and the pancreatic duct of Wirsung had a normal relationship. She underwent a Roux-en-Y pseudocyst-jejunostomy and an accessory sphincteroplasty. Three months later, a choledochal cyst excision was performed with biliary reconstruction. The patient is well and asymptomatic 1 year later. This case suggests that pancreatic juice reflux into the common bile duct may not be the only etiology of choledochal cyst formation. PMID- 2723997 TI - Surgical treatment of pancreas divisum causing pancreatitis in children. AB - Although controversial, pancreas divisum has been implicated as a cause of acute pancreatitis when there is stenosis of the accessory papilla that drains the duct of Santorini. Over the past 5 years, four children with pancreas divisum and recurrent pancreatitis were successfully treated surgically. The diagnosis was made by endoscopic retrograde cholangiopancreatography (ERCP) in each case. Surgical treatment included sphincteroplasty to the accessory papilla to improve drainage of the duct of Santorini, opening the ampulla of Vater to expose the ostium of the duct of Wirsung to enlarge it, and cholecystectomy. PMID- 2723998 TI - Decreased immunogenicity of fetal kidneys: the role of passenger leukocytes. AB - Early in gestation, fetal rat kidneys are less immunogenic than in later fetal stages, and also less immunogenic than early-gestation fetal hepatic tissue. The purpose of this study was to test this observation in an allogeneic model, and to explore the basis of the decreased immunogenicity of early-gestation fetal kidneys. Kidneys were harvested from Fischer (FSH) fetal rats on the 15th, 17th, 18th, and 19th gestational day (GD), and then grafted under the kidney capsule of incompatible Wistar/Furth (W/F) adult male rats. Fetal hepatic tissue was harvested from 15th-GD FSH fetal rats, and then grafted under the kidney capsule of W/F adult male rats. Each recipient received either one kidney or a 3-mm piece of liver. Graft biopsies were obtained 10, 20, 30, and 40 days posttransplantation, and evaluated histologically. The severity of rejection was divided into three grades according to the degree of mononuclear infiltration and percentage of original fetal structures preserved. All fetal hepatic grafts were completely rejected (grade III) by the tenth posttransplantation day. In contrast, the degree of rejection of the kidneys was age-dependent. Fifteenth-GD kidneys showed a minimal or moderate degree of rejection (grade I or II) at 10, 20, and 30 days; however, 18th- and 19-GD kidneys were rejected (grade III) by the tenth post-transplantation day. To explore the basis for the decreased immunogenicity of 15th-GD kidneys, 20 adult W/F rats were divided into two groups. Each animal in the first group received one FSH 15th-GD kidney implanted under the kidney capsule.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2723999 TI - Leakage of intraluminal low molecular weight polyethylene glycol as a marker of small bowel transplant rejection. AB - To facilitate early detection of small bowel allograft rejection, we correlated transluminal leakage of low molecular weight polyethylene glycol (PEG) with the development of allograft rejection. Vascularized allogeneic and syngeneic jejunal transplants were performed in rats, without immunosuppression. A control group underwent creation of jejunal Thiry-Vella fistulas of similar length. Jejunal segments were perfused with a physiologic solution containing [3H]-PEG-900. At the end of an equilibrium period, an urinary bladder aspirate was collected and [3H]-PEG-900 measured by scintillation counting. Results are expressed as disintegrations per minute per 100 microL urine. Histologic examinations were performed at all experimental time points. Two days following transplantation, urinary PEG levels were elevated in both allogeneic and syngeneic groups (3943 +/ 935 and 4007 +/- 1164, respectively). Four days after the transplant, syngeneic urine PEG levels decreased to 581 +/- 159, and were not significantly different (P greater than .05) from Thiry-Vella controls (635 +/- 145). Syngeneic levels remained at this low level for the rest of the experiment. The allogeneic group continued to show significantly higher levels (P less than .05) compared with syngeneic and Thiry-Vella groups from day 4 until the end of the experiment. These elevated levels most likely represented the development of rejection, preceding the first significant histologic signs of rejection, which were found at six days post-transplant. Detection of transluminal leakage of low molecular weight PEG may be a useful adjunct in monitoring for small bowel transplant rejection. PMID- 2724000 TI - Deficient neurogenic innervation of the myenteric plexus with normal submucous plexus involving the entire small and large bowel. AB - A newborn presented with a picture of intestinal obstruction. Multiple biopsies of the small and large bowel showed an unusual neurogenic innervation. The myenteric plexus of Auerbach was severely depleted of ganglion cells and nerve fibers, while the submucous plexus of Meissner was normally innervated. An ileostomy failed to function and extended trial with experimental smooth muscle stimulant (Cisapride) was equally ineffective. The patient was finally treated by a myectomy from the duodenum to the descending colon with a sigmoid colostomy. This procedure, coupled with a Nissen fundoplication, stopped the vomiting and allowed normal defecation through the colostomy. The patient is presently taking increasing increments of oral fluids with a concomitant decrease in the volume of parenteral nutrition. The myectomy initiated marked hypertrophy of the muscularis mucosa. Could this muscular hypertrophy account for the improvement in bowel function? Possible etiology will be discussed. We caution that rectal submucosal suction biopsy alone may be misleading if normal ganglion cells and nerve fibers are found, yet the patient's clinical symptoms fail to improve. A full thickness bowel wall biopsy is then recommended. PMID- 2724001 TI - Ideal treatment for total colonic Hirschsprung's disease. AB - Five children were treated for total colonic Hirschsprung's disease between 1982 and 1986. Three girls and two boys underwent total colectomy and straight ileoanal endorectal pull-through, with creation of a suprapelvic side-to-side anastomosis of 10 cm of cecum and ascending colon to ileum (Boley procedure). All patients have been followed for periods of greater than 1 year, and they have been free of any postoperative complication. Stool frequency on an unrestricted diet has been between one and five semiformed per day. Their growth and development have been excellent. An advantage of this procedure is excellent water absorption without the risks of mechanical problems encountered with a variety of pelvic pouch creations in the young growing child. PMID- 2724002 TI - Creating pediatric trauma systems. AB - The establishment of a pediatric trauma system is an exercise in regionalization. The first step in program development is the acquisition of data necessary to understand the region. What are its boundaries? How many children are injured each year? How many die? What facilities already exist for the care of these patients? Who controls EMS? Are any referral systems in place? Next, agreement must be reached among the participants regarding which patients will be transferred. Who will make the transfer decision? Will it be made in the field or in the hospital? Will a numerical scoring system be used, or accident descriptors, or both? How and by whom will patients be transported? What method of communication will be used to link the components of the system? The linchpin of effective trauma systems is public involvement, yet in most parts of the United States and Canada the public is unaware of the trauma problem, and the importance of trauma as the number one child health problem remains unrecognized. Since trauma is as much a societal problem as a medical one, the enthusiasm of individuals and public service organizations should be cultivated and a coalition formed to create a regional system. The educational, research, and prevention programs of a pediatric trauma center are not usually self-supporting, making progress in these areas dependent upon outside support. In several cities, grants and endowments have been received from service organizations, foundations, public spirited companies, and individual philanthropy. Some assurance of a continuing source of funds usually is necessary before hospitals will accept part of the financial risk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2724003 TI - Emergency medical services for children and pediatric trauma system components. AB - The concept of an emergency medical service for children (EMS-C) is new. Although adult EMS systems exist in every region of the United States, the needs of the child suffering from acute injury or illness have not been previously addressed. The development and incorporation of an EMS-C system into the existing adult EMS system is the most time- and cost-effective method to achieve efficient care for the acutely injured or ill child. The components of an EMS-C system include system design, education, prevention, standards of care, research and development, quality assurance, and funding. PMID- 2724004 TI - National Pediatric Trauma Registry. AB - The National Pediatric Trauma Registry (NPTR) is a multi-institutional database designed to compile information concerning all aspects of pediatric trauma care. The registry is designed and operated in a manner that maximizes data accuracy and provides this information to all participating investigators. The growth of the database has allowed the NPTR to provide the first accurate epidemiologic description of pediatric trauma as a national disease, as well as to develop national norms for pediatric trauma care. The registry presently contains 10,177 patients, and is undergoing revisions (phase II) to allow a more focused evaluation of various aspects of the clinical care and rehabilitation of the pediatric trauma patient. PMID- 2724005 TI - Quality assessment in the pediatric trauma care system. AB - The goal of the pediatric trauma care system is to prevent death, disability, and suffering of injured children. Quality assessment (QA), the evaluation of clinical performance and quality, is essential not only for formal accreditation processes, but also for day-to-day trauma center operation. QA involves three basic types of performance measures: input, process, and outcome. Input measures are inventories of the resources of a given institution, such as the availability of a surgeon on a 24-hour-a-day in-house basis. They give baseline descriptions of facilities and do not monitor performance directly. Process measures attempt to verify that the system is using its resources appropriately in response to demands, which at Children's Hospital of Pittsburgh (CHP), involves tracking all admitted patients from injury to discharge with the assistance of a system of audit screens to help identify problem cases. The methodology of the Major Trauma Outcome Study (MTOS) provides basic outcome data by identifying unexpected survivors and deaths. However, the few cases identified (four of 316 patients submitted to MTOS; 1.3%) limit conclusions regarding trauma center performance. Performance measures, when applied to admitted trauma patients, allow timely recognition of individual complications and problem trends. QA provides necessary data for important clinical decisions and resource allocations that affect trauma center operation. PMID- 2724006 TI - Malignant hyperthermia: experience in the prospective management of eight children. AB - Malignant hyperthermia (MH) is a seemingly rare genetic myopathy. Hypermetabolic crisis accompanied by a rise in body temperature to as high as 44 degrees C, is its hallmark. Malignant hyperthermia is usually triggered by potent inhalation anesthetics and/or depolarizing muscle relaxants. Because of the extraordinary incidence of death in patients who are at risk, pediatric surgeons may be reluctant to operate on these patients. Eight such patients were referred to the Pediatric Surgery Service and the UCLA Malignant Hyperthermia Center following pediatric surgical procedures aborted for first episodes of malignant hyperthermia (five) or for a strong family history of malignant hyperthermia (three). They were anesthetized with nitrous oxide, barbiturates, opiates, tranquilizers, and nondepolarizing muscle relaxants. The patients were not treated prophylactically with dantrolene. Cardiac monitoring, end-tidal PCO2, and rectal temperatures were monitored. After completion of their pediatric surgical procedures, all eight patients had a vastus lateralis muscle biopsy performed and subsequent caffeine/halothane contracture studies completed. The contracture study result was positive in all patients studied. No anesthetic or surgical complications were encountered. This study shows that patients at risk for developing MH crisis can have pediatric surgical procedures performed safely with appropriately selected general anesthesia. PMID- 2724007 TI - Drug-induced toxic epidermal necrolysis in children. AB - Nine pediatric patients with drug-induced toxic epidermal necrolysis were treated with a regimen of basic burn care and without the use of steroids or topical or systemic antimicrobial agents. Although septic complications continue to occur frequently, infections are better tolerated when potential iatrogenic sources of decreased host resistance, such as steroids, are eliminated. Neutropenia, gram negative sepsis, and mortality were all greatly reduced with this regimen, while healing was neither impaired nor prolonged. Thus, steroids and sulfa-containing topical agents should be avoided in the treatment of this disorder. PMID- 2724008 TI - Caustic esophageal lesions in childhood: prevention of stricture formation. AB - Accidental caustic ingestion, a problem of childhood, can lead to esophageal stricture formation. We studied 132 children less than 19 years of age who were admitted to our hospital for suspected caustic ingestion. Forty-nine had burns in the esophagus, 11 of whom had deep and circular burns and were therefore prone to developing esophageal strictures. Only these 11 children were treated for prevention of stricture formation with a special nasogastric tube, functioning as intraluminal stent; this was their sole treatment. No corticosteroids were used. Only one of the 11 developed mild stenosis. In none of the other untreated children was stricture formation observed. Therefore, we believe that this approach spares many children unnecessary treatment and hospitalization, that our nasogastric tube effectively prevents stricture formation, and that there is no need for the use of corticosteroids in the treatment of caustic esophageal lesions in childhood. PMID- 2724009 TI - Isolated ileal-loop endorectal pull-through: a new approach in the management of complicated Hirschsprung's disease. AB - The isolated ileal-loop endorectal pull-through was performed on two patients with Hirschsprung's disease complicated by disuse atrophy of the distal colon. In both patients there was not only a short length of the proximal ganglionic colon, which could not be safely pulled down to the perineum, but also nonavailability of the distal aganglionic colon, which had to be resected for nonfunctioning disuse atrophy. This technique allowed a safe endorectal pull-through with primary anal anastomosis, and also prevented complications like frequent watery diarrhea, steatorrhea, malabsorption of vitamins A, D, and K, and pernicious anemia frequently observed following popular surgical procedures for long-segment and total colonic aganglionsis. PMID- 2724010 TI - Congenital anal fistula with normal anus. AB - Three patients with a congenital anovestibular/perineal fistula were treated at the Montreal Children's Hospital. Two females (one of East Indian and the other of Japanese origin) had anovestibular fistulae that became symptomatic in the first few months of life. The third patient, a boy of Korean descent, presented at 9 months of age with a chronically draining perineal fistula. During surgery, a small fistula tract was easily dissected out and excised. Microscopic examination showed a well-preserved rectal mucosa throughout the tract. Most male patients described to date had anourethral fistulae, often accompanied by other major anomalies such as esophageal atresia or renal malformations. We believe our patient is the first male to be described with a congenital perineal fistula; this suggests that some fistula-in-ano in male infants may be due to a congenital sinus that secondarily becomes infected and drains to the skin. PMID- 2724011 TI - Epithelioid sarcoma in children and adolescents: a report of four cases. AB - Epithelioid sarcoma is an uncommon soft tissue tumor, most prevalent in the extremities of young adults. Youth has been described as a favorable prognostic factor. We describe four patients (two children aged 10 years and two adolescents aged 18 years) with extremity epithelioid sarcoma. Both 10-year-old children had rapid disease evolution and died 3 and 6 months after the diagnosis was made. Both tumors were strict diploid at DNA flow cytometry, but one had an abnormal karyotype (trisomy 2). Both adolescents are disease-free 18 months and 18 years after combined treatment consisting of local resection, regional lymph node dissection, and isolated regional perfusion with cytostatic agents. PMID- 2724012 TI - Improved survival rates in children over 1 year of age with stage III or IV neuroblastoma following an intensive chemotherapeutic regimen. AB - Combined chemotherapeutic regimens of (1) cyclophosphamide (40 mg/kg x two days), (2) cisplatinum (20 mg/m2 x five days) plus VM-26 (100 mg/m2), and (3) Adriamycin (60 mg/m2) plus DTIC (250 mg/m2 x five days) were prescribed for 42 Japanese children greater than 1 year of age with stage III or IV neuroblastoma. The protocol was separated into three forms (A, B, and C) from the combination pattern of three such high-dose courses. The cumulative survival rates for those with stages III and IV 48 months after initiation of therapy were 76.2% and 20.1%, respectively, and the overall rate was 36.7%. The tumor disappeared during the course of treatment in 25 of 42 children (59.5%). The 48-month survival rate was superior in patients greater than 5 years of age than younger patients (P less than .01). Even in patients with a tumor originating in the suprarenal region, the 48-month survival rate was 30.5%. Among 12 patients in whom the N-myc oncogene was measured, one of five with one to ten copies of amplification died, whereas all seven with greater than ten copies died or had a recurrence. Thus, the present chemotherapeutic regimens, in particular alternate administration of each high-dose course, considerably improved the survival of patients with stage III neuroblastoma. More aggressive protocols are needed for those with stage IV neuroblastoma who are greater than 1 year of age, particularly in those with an amplified N-myc oncogene. PMID- 2724013 TI - Improvement in survival after excision of primary tumor in stage III neuroblastoma. AB - Fifty-eight patients with stage III neuroblastoma (according to the Childrens Cancer Study Group) underwent 86 operative procedures. Initial diagnostic or therapeutic operations were followed by chemotherapy and radiation therapy, and second- or third-look procedures were performed on patients whose tumors showed evidence of clinical response. Complete resection was obtained during the initial procedure in 12 patients, during the second operation in 12 others, and at the time of the third procedure in two additional children. Twenty of these 26 patients have survived with no evidence of disease for a median duration of greater than 3 years since initiation of therapy. Only nine of the 32 patients in whom complete tumor excision could not be accomplished are still alive. The chemotherapy and radiation therapy employed in this protocol may have enhanced resectability in many patients. The site of the primary tumor does not seem to influence ease of resectability or outcome in this group. The "favorable" prognostic factors of patient age and histopathology of the tumor do not necessarily predict that the tumor will be resectable. While patients with complete resection at the time of the second operation had an outcome superior to those with incomplete resections, the influence of the inherent tumor biology or other selection factors on the eventual tumor resectability in these patients is not known. Extensive operative procedures were required to completely resect stage III tumors, and a moderate complication rate may be anticipated. However, this may be justifiable if complete tumor resection can be achieved and ultimate patient survival possibly enhanced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2724014 TI - Flow cytometric analysis of DNA content in children with neuroblastoma. AB - Flow cytometric DNA content analyses were performed in a retrospective study of archival tumor specimens of 15 patients with diagnosed neuroblastoma treated at a single institution. Survival statistics were positively influenced by the presence of aneuploidy. Kaplan-Meier analysis indicated a significant survival advantage for patients with aneuploid tumors (P = .036). Survivors were significantly younger at the time of diagnosis than nonsurvivors, but age at diagnosis did not correlate with DNA content. We conclude that DNA content analysis may be of value in determining the prognosis for children with neuroblastoma. PMID- 2724015 TI - An unusual sincipital meningoencephalocele: a case report. AB - A congenital nasoglabellar mass is usually either a meningocele or an encephalocele. Occasionally, lipoma, sarcoma, dermoid, glioma, or scalp angioma may resemble an encephalocele. This report describes a rather unusual sincipital meningoencephalocele in an 8-month-old boy. PMID- 2724016 TI - Renal artery spasm: a cause of acute renal failure following abdominal surgery for neuroblastoma. AB - Interruption of arterial blood supply to the kidney results in acute renal failure (ARF). We describe a case of ARF caused by renal artery spasm following resection of a large abdominal neuroblastoma, combined with paraaortic lymph node dissection and ipsilateral nephrectomy. The blood flow was reestablished by administration of local anesthetics (lidocaine) into the obliterated renal artery through the angiographic catheter. An urgent angiography was of value for the early diagnosis and treatment of this lesion. PMID- 2724017 TI - Simultaneous symptomatic biliary and renal calculi in a child. AB - We report on the unusual finding of both symptomatic biliary and renal calculi in a child. A review of the literature failed to provide any definite common etiologic factors, although the possible role of systemic infection cannot be ruled out. PMID- 2724018 TI - Non-Hodgkin's lymphoma of the uterus in a child. AB - A unique case of a 14-year-old girl with malignant lymphocytic lymphoma of the uterus clinically misdiagnosed as sarcoma botyroides is presented. Total abdominal hysterectomy was performed followed by limited chemotherapy. The patient is asymptomatic and without clinical evidence of tumor 38 months after the onset of symptoms. PMID- 2724019 TI - Retroperitoneal fibrosis in a patient with Turner's syndrome. AB - Retroperitoneal fibrosis rarely affects children. Its clinical manifestations are protean, but if recognized early and properly treated, the prognosis is generally good. This is the report of a 14-year-old girl with Turner's syndrome and retroperitoneal fibrosis. PMID- 2724020 TI - Health education needs of adolescents with congenital heart disease. AB - Self-concept, health beliefs, health behaviors, health information sources, and perceived health information needs were assessed in 90 patients with congenital heart disease and 54 peers without chronic illness, ages 13 to 22 years. Data revealed that patients with congenital heart disease did not differ from their healthy counterparts in overall self-concept, health beliefs, use of preventive health services, and sources of health information. Patients with congenital heart disease reported greater perceived stress in comparison to peers. Significantly more patients with heart disease needed information regarding pregnancy and contraception, and older cardiac subjects were less likely to be sexually active. For these patients who currently seem to rely largely on peers for some critical health information, sensitive and comprehensive counseling by health professionals is imperative. PMID- 2724021 TI - Chlamydia trachomatis infections: a health problem of infants. AB - As a result of chlamydia epidemic in the adult population, the incidence of Chlamydia trachomatis in infants is increasing. Certain population groups are at risk for development of an infection. This article discusses the epidemiology, microbiology, symptomatology, and management of this problem. PMID- 2724022 TI - Child care. PMID- 2724023 TI - Federal government initiates National Practitioner Data Bank. AB - The formulation of the data bank will require the exchange of data and merging of information from a number of sources. The development and the implementation of this computerized system will be the work of the UNISYS Corporation in concert with the Bureau of Health Professions' Office of Quality Assurance, a part of the Health Resources and Services Administration, HHS. The assurance of the quality of the data on each nurse--correct, up-to-date, etc.--is the responsibility of the parties reporting to the data bank. In addition, each and every pediatric nurse practitioner will need to become knowledgeable regarding the data base and periodically ascertain that the information regarding himself or herself is correct. As additional information is received on the process by which you can monitor the bank's data on you, it will be published. PMID- 2724024 TI - Chronic diarrhea: management in pediatrics. PMID- 2724025 TI - Bulimia. PMID- 2724026 TI - Periodontal ligament cells and gingival fibroblasts respond differently to attachment factors in vitro. AB - One of the initial events required for regeneration of periodontal tissues lost due to disease is the establishment of connective tissue attachment to root surfaces. Thus, considerable research efforts have focused on developing reliable procedures to gain new connective tissue attachment. Our studies focus on evaluating agents for their ability to promote cell attachment and spreading using an in vitro assay. For these studies human gingival fibroblasts (GF) and human periodontal ligament (PDL) cells, after exposure to fibronectin; 44 kilodalton bone phosphoprotein (44K BPP-osteopontin) or guanidine EDTA extracts of bone, cementum, or dentin, were compared as to degree of cell attachment and spreading. Fibronectin equally enhanced attachment and spreading PDL cells and GF. In contrast, 44K BPP, as well as guanidine EDTA extracts of bone and cementum, preferentially promoted attachment of GF when compared with attachment of PDL cells. For both PDL cells and GF the attached cells exhibited spreading. The guanidine EDTA extract of dentin did not promote attachment of either cell type. These results suggest that PDL cells and GF have different attachment properties which need to be considered for investigations directed at developing regenerative periodontal treatments. PMID- 2724027 TI - Evaluating the anti-plaque capabilities of a copper-containing prophylaxis paste. AB - The purpose of this study was to evaluate a dental prophylaxis paste containing mono-copper citrate (MCC) for short term anti-plaque capabilities. In addition to other baseline data, plaque scores were recorded on 36 paid volunteer subjects from the dental school student, staff, and faculty populations. After scaling, two quadrants of each subject's dentition were polished with the MCC containing paste and two quadrants with the placebo paste, using a diagonal split mouth double blind design. Subjects did not brush or floss for two days. Plaque scores were recorded at 24 and 48 hours, after which they resumed normal hygiene. Results showed that after 24 hours placebo areas had 92% higher plaque and after 48 hours 33% higher plaque than the active paste areas. This was statistically significant at the P less than .001 level. The diminishing effect of the copper containing prophy paste over 48 hours might indicate that the copper ion should be applied on a daily basis for best anti-plaque results. PMID- 2724028 TI - Clinical effect of a sanguinaria dentifrice on plaque and gingivitis in adults. AB - A clinical trial was conducted to evaluate the effects of a sanguinaria-zinc chloride dentifrice on the prevention of plaque formation and gingivitis. A total of 59 young adults, 18 to 30 years of age, either performed supervised brushing with a 0.075% sanguinaria-0.05% zinc chloride dentifrice, a 0.24% sodium fluoride dentifrice, or rinsed daily with a 0.05% NaF solution. Clinical evaluations for plaque and gingivitis were performed after 7, 14, and 21 days of the test regimen. After 21 days, all subjects resumed twice daily supervised brushing and flossing and post-test evaluations were conducted after two weeks. The results showed that after 7, 14, and 21 days both groups using dentifrices had significantly less plaque and gingivitis than the group using the rinse, and there were no significant differences between the two groups using either the sanguinaria-ZnCl2 or the NaF dentifrices. PMID- 2724030 TI - The relationship between gingivitis and plaque levels. AB - Some confusion exists in the literature whether correlations exist between gingivitis severity and plaque levels as measured by the corresponding indices. The results of a clinical trial and a re-analysis of literature data indicate that a strong statistical correlation exists between the Loe-Silness Gingival Index values and both the Loe and the Quigley-Hein Plaque Index measurements. Furthermore, regression analyses also indicate that Loe-Silness Gingival Index can be expressed as linear functions of either the Loe Plaque Index or the Quigley-Hein Plaque Index and that for each unit increment in the mean plaque index values a half unit increase in the gingival index value can be expected. PMID- 2724029 TI - Gingival resistance to probing forces. I. Determination of optimal probe diameter. AB - This paper presents the results of a study designed to determine (1) if advancement of a periodontal probe under a given force against healthy gingiva differed from its advancement under a similar force, against inflamed gingiva, and (2) to select the diameter which best distinguishes healthy gingiva from that which is inflamed to varying degrees. The teeth of eight beagle dogs were cleaned three times per week for two months until a Gingival Index (GI) of 0 and gingival fluid flow (GFF) of 9 or less, as measured by the Periotron, were obtained. Probes of diameters 0.4, 0.6, 0.7, and 0.8 mm were advanced perpendicularly against the attached gingiva in the incisor, premolar, and molar regions by an electromechanical device which simultaneously plotted force versus displacement following initial contact of the probe tip with the gingiva. These forces ranged from 0.1 to 0.9N. This process was repeated in the same animals following cessation of plaque control measures when the GI reached a value of 1 and GFF reached levels of 10 to 19. It was repeated again following placement of an irritating ligature when GI reached 2 and GFF greater than 20. An analysis of covariance showed significant differences between all three levels of health and disease for all probe diameters. F values for the 0.6 mm probe were highest at all probing forces indicating that this diameter most consistently discriminated variation of gingival health status. PMID- 2724032 TI - Cell and fiber attachment to demineralized cementum from normal root surfaces. AB - The purpose of this study was to assess connective tissue and epithelial responses to cementum (from normal human root surfaces covered by periodontal ligament) after surface demineralization with citric acid. Each rectangular specimen had a face of cementum and an opposite surface composed of pulpal dentin. One half of the specimens were treated with citric acid (experimental group), while the remainder served as untreated control specimens. Specimens were implanted vertically into incisional wounds on the dorsal surface of rats with one end of the implant protruding through the skin. Four specimens in each group were available for examination 1, 3, 5, and 10 days after implantation. Histologic and histometric analyses of the implants included counts of adhering cells, evaluation of attached connective tissue fiber density and diameter, and assessment of epithelial migration. At day 1, a distinct lighter staining zone was present on the surface of both cementum and dentin in the experimental group which corresponded to a zone of surface demineralization produced by the acid treatment. Histometric comparisons between experimental and control groups at 10 days showed a greater number of cells attached to demineralized cementum surfaces. Also, a connective tissue fiber attachment system had developed on these experimental surfaces, but which differed morphologically from periodontal ligament fiber attachment to normal cementum. It was concluded that citric acid treatment can surface demineralize cementum from normal roots, and that the surface demineralization of this cementum facilitated a cell and fiber attachment to the cementum surface. PMID- 2724031 TI - The prognosis of tunnel preparations in treatment of class III furcations. A follow-up study. AB - The present study evaluated the long-term prognosis of tunnel preparations performed in a large number of teeth with advanced periodontal furcation defects. One hundred seven (107) patients, in which 156 teeth had been treated by tunnel preparations, were recalled for an evaluation, which was based on a questionnaire, a clinical examination, and radiographs; 102 patients attended (149 teeth = 95%). The mean observation time per tooth was 37.5 months (range 10 to 107 months). The results showed that 10 teeth (6.7%) had been extracted and 7 teeth (4.7%) hemisected. The indication for 12 of these extractions or hemisections was root caries. Among the remaining 132 teeth, 23 (15.4%) showed initial or established caries. There was no relationship between caries development and length of the observation time. Thus, approximately 75% of the teeth were still caries-free and in function. The findings demonstrated that tunnel preparations have a considerably better prognosis than previously reported and should be considered a valid treatment alternative. PMID- 2724033 TI - Humoral immune response to selected subgingival plaque microorganisms in insulin dependent diabetic children. AB - Juvenile diabetics have been shown to have an increased susceptibility to gingivitis and periodontitis following puberty. However, little data are available on changes in the microbial flora that occur at the onset of puberty. This study was performed to determine if antibacterial antibody titers to selected periodontal disease-associated microorganisms might be helpful in revealing changes in plaque flora at the onset and conclusion of puberty. Sera was obtained from 35 subjects (ages 7 to 18 years) selected from a population of insulin-dependent diabetics. The subjects were given a thorough medical examination which included an assessment of sexual maturation and a dental examination which included the recording of onset and magnitude of bleeding according to the papillary bleeding score. Antibody titers to A. naeslundii (AN), B. intermedius (BI), B. gingivalis (BG), F. nucleatum (FN), A. actinomycetemcomitans (AA), C. ochracea (CO) and T. denticola (TD) were determined using the microELISA. Stratification of antibody titers by age groups (less than or equal to 12 years, 12 to 15 years, greater than 15 years) revealed that titers to AN increased significantly (P less than 0.025, ANOVA) and progressively (P less than 0.05, regression analysis) with increasing age. In contrast, the titers to FN were maximal in the under 12 year group and decreased with age (ANOVA, P less than 0.05; regression analysis, P less than 0.05). There were no significant variations in titers observed for the other microorganisms. Stratification by sexual maturity revealed a similar progressive decrease of the titer to FN (ANOVA, P less than 0.05; regression analysis, P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 2724034 TI - The effect of various concentrations of collagen barrier on periodontal wound healing. AB - Collagen membrane preparations were manufactured with the aim of enhancing wound healing following periodontal surgery. In order to clarify effects of different concentrations of collagen on wound healing, a basic study was performed. Solutions containing 0.5%, 1.0%, and 1.3% atelocollagen were treated with hexamethylenediisocyanate (HMDIC) for cross-linking, and collagen membranes were prepared with each solution. Periodontal flap surgery was performed on the palatal gingiva beside the maxillary first molar teeth in rats. The root surface of the tooth was exposed and curretted. Then, a piece of atelocollagen membrane was implanted. The healing of the wound was studied histologically and the following findings were made. (1) Apical migration of the junctional epithelium occurred within 2 weeks postoperatively. (2) The implantation of atelocollagen membrane significantly reduced the apical migration. (3) The apical migration of the epithelium did not vary with collagen concentration.